BET 20 THE Metropolitan Borough of Bethnal Green REPORT ON THE SANITARY CONDITION AND VITAL STATISTICS DURING THE YEAR 1914. 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. 1915. THE Metropolitan Borough of Bethnal Green REPORT ON THE SANITARY CONDITION AND VITAL STATISTICS DURING THE YEAR 1914. 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. 1915. Metropolitan Borough of Bethnal Green. PUBLIC HEALTH COMMITTEE, 1914-15. Meetings held at the TOWN HALL, Cambridge Rd., E., 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 W. T. Garner „ J. Robertson. „ R. Larkins. Councillor T. Brooks. „ J. Sigournay. „ T. A. Dean. „ J. J. Vaughan. F. W. Eaton. „ J. W. Ward. Ex-Officio 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. Law and General Purposes Alderman R. E. Pearson. Baths „ J. Pullen. Electricity Councillor J. J. Cole. Public Libraries Councillor W. Rawles. The Chairman of the Valuation Committee is an elected member 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. Richards „ *W. Billings „ W. Rowsell ,, A. S. Henley „ J. O. G. Weeks ,, *J. H. Hewitt, Sanitary Inspector (Temporary). Miss C. Hammond, Health Visitor. †Mrs. M. A. Hodgkins ,, (Temporary). E. Q. Bilham, Chief Clerk. F. G. Thomas, Assistant Clerk. H. A. Saunders „ „ *H. W. Pendrill W. H. Heron, Office Youth. †Two Temporary Clerks. *G. I. Brighting, General Assistant (Temporary). Sanitary Inspector Billings and Assistant Clerk Pendrill proceeded on active service upon outbreak of European War. General Assistant Hewitt was transferred as temporary Inspector to fill vacancy and Assistant Clerk Brighting made temporary General Assistant. Two temporary appointments made to fill the two vacant clerkships. †Temporary appointments. Disinfectors. One Leading Disinfector. Two Assistant Disinfectors. One Assistant Disinfector 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, Betlmal Green, E. Mortuary. Church Row, Bethnal Green Road, E 4 SYNOPSIS OF Medical Officer's Annual Report, 1913. page General Summary 8 Population 9 Table " A," Population 10 Births 10 Deaths 11 Transferable Deaths 13 & 18 Table “B,” Public Institutions outside Bethnal Green into which residents have been received and where they have died 15 Table “C,” Public Institutions in Bethnal Green 17 Deaths in Sub-districts, Table “D” 19 Death Rate 20 Table “E,” Monthly Mortality Rates—London and Bethnal Green 21 Table “F,” Quarterly Death Rates—London and Bethnal Green 21 Birth Rate 22 Table “G,” Marriages 22 Deaths of Infants 22 Table “H,” Special Causes of Infantile Deaths 23 Infantile Death Rates—Ten Years 24 Deaths of Young Children 25 Senile Mortality 25 Table “I,” Quarterly Mortality—Bethnal Green 26 Table “J,” Quarterly Mortality—London 27 Deaths from Notifiable Infectious Diseases 28 Do. do. Table "K" 29 Deaths from the Seven Principal Zymotic Diseases, Table “L” 29 Table “M,” Percentages of Deaths from Zymotic Diseases 30 Notification of Infectious Diseases 30 Table “N,” Details of Notifications 32 Table “O,” Condition of Premises 33 Scarlet Fever 33 Diphtheria 34 5 SYNOPSIS— continued. page Enteric Fever 35 Whooping Cough 35 Diarrhœa 36 Measles 36 Chicken Pox 37 Erysipelas 39 Appendicitis 39 Diseases of Parturition 39 Ophthalmia Neonatorum 40 Cerebro-Spinal Meningitis 40 Poliomyelitis and Polioencephalitis 41 Tuberculosis 43 Do. Occupations and persons notified 45 Tuberculosis Dispensary 47 Cancer 47 Uncertified Deaths 48 Inquests 48 Customs and Inland Revenue Acts, 1890 to 1903 49 Ancient Foundation of the College of St. Katharine 49 Schools for Mothers and Infant Consultations 50 Children's Country Holidays 51 Health Visitors 52 Brady Street Unhealthy Area 53 Staff and the War 75 Report of Health Visitors 79 APPENDIX. Table I. Vital Statistics of Whole District 83 II. Cases of Infectious Disease Notified 84 II. (a) Public Health Tuberculosis Regulations, 1912—Notifications 85 III. Causes of, and Ages at Death 86 IV., IV. (a), IV. (b) Infantile Mortality 87-89 V. Number of Deaths from the Seven Principal Zymotic Diseases in ten years, 1904 to 1913, and in the year 1914 90 Administration of Factory and Workshop Act, 1901 91, 92 Street List 93-99 Plans—Brady Street Area — Return relating to Tuberculosis Dispensary Schemes throughout London — 6 LONDON and the METROPOLITAN BOROUGHS—Births and Deaths of Persons belonging to London and the Metropolitan Boroughs during the 52 Weeks ended 2nd January, 1915. oroughs. Population estimated to the middle of 1914. Births. Deaths from Deaths under 1 year of Age. All Causes. Enteric Fever. Small-pox. Measles. Scarlet Fever. Whooping cough. Diphtheria. Diarrhœa and Enteritis (under 2 years). Pulmonary Tuberculosis. County of London 4,518,021 109,667 64 994 147 1385 316 918 706 3031 6281 11395 West. Paddington 142,193 2965 1846 3 — 4 8 25 20 79 145 281 Kensington 171,234 3210 2242 1 — 15 17 7 13 63 187 302 Hammersmith 123,853 2935 1717 5 — 41 5 21 16 67 170 275 Fulham 157,303 4154 2101 9 — 31 21 42 22 126 205 468 Chelsea 64,511 1299 870 3 — 3 5 6 8 21 87 87 City of Westminster 154,544 2155 1936 9 — 6 10 21 15 35 205 173 North. St. Marylebone 114,355 2132 1577 6 — 2 9 20 18 59 146 208 Hampstead 86,388 1273 893 4 — 2 2 16 10 11 55 102 St. Pancras 214,133 5223 3334 4 — 56 18 51 30 121 379 481 Islington 325,496 8171 4923 15 — 97 24 84 43 228 470 857 Stoke Newington 50,511 1045 661 - - 1 3 6 4 16 58 81 Hackney 223,393 5460 3099 8 — 106 9 53 39 127 303 502 Central. Holborn 46,832 764 754 6 — 11 2 9 4 13 92 69 Finsbury 84,521 2541 1652 2 — 76 6 45 9 88 167 312 City of London 17,831 181 239 1 — 1 1 3 2 1 20 17 East. Shoreditch 109,569 3511 2075 2 — 112 5 55 20 148 234 496 Bethnal Green 127,807 3786 2034 4 — 68 7 48 28 174 210 518 Stepney 275,081 8058 4539 8 — 182 28 72 70 268 465 997 Poplar 160,839 5073 2743 6 — 66 10 31 34 195 268 590 South. Southwark 188,321 5604 3350 2 — 95 22 59 37 207 330 693 Bermondsey 124,683 3849 2165 3 — 81 8 14 18 140 203 482 Lambeth 297,094 7022 4319 16 58 16 40 50 202 422 728 Battersea 167,451 4303 2220 3 — 50 11 26 17 122 210 402 Wandsworth 331,321 6675 3617 5 — 26 13 56 41 148 298 591 Camberwell 261,828 6580 3589 5 — 65 23 47 39 143 873 653 Deptford 109,269 3115 1572 3 — 51 9 9 25 91 150 308 Greenwich 96,018 2408 1412 5 — 47 7 6 16 53 132 235 Lewisham 169,211 3336 1836 6 — 7 8 19 24 55 126 247 Woolwich 122,431 2839 1679 8 — 25 9 27 34 30 171 240 7 LONDON and the METROPOLITAN BOROUGHS—Birth-rates and Death-rates of Persons belonging to London and the Metropolitan Boroughs daring the 52 Weeks ended 2nd January, 1915. 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. Diarrhoea and En- teritis (under 2 years). Total deaths under 1 year. Crude. Standardized. County of London 24.3 14.4 14.4 0.03 — 0.31 0.07 0.20 0.16 1.39 27.64 104 West. Paddington 20.9 13.0 12.9 0.02 — 0.03 0.06 0.18 0.14 1.02 26.64 95 Kensington 18.8 13.1 13.1 0.01 — 0.09 0.10 0.04 0.08 1.10 19.63 94 Hammersmith 23.8 13.9 13.7 0.04 — 0.33 0.04 0.17 0.13 1.38 22.83 94 Fulham 26.5 13.4 13.8 0.06 — 0.20 0.13 0.27 0.14 1.31 30.33 113 Chelsea 20.2 13.5 12.9 0.05 — 0.05 0.08 0.09 0.12 1.35 16.17 67 City of Westminster 14.0 12.6 13.2 0.06 — 0.04 0.06 0.14 0.10 1.33 16.24 80 North. St. Marylebone 18.7 13.8 14.1 0.05 — 0.02 0.08 0.18 0.16 1.28 27.67 98 Hampstead 14.8 10.4 11.0 0.05 — 0.02 0.02 0.19 0.12 0.64 8.64 80 St. Pancras 24.5 15.6 15.6 0.02 — 0.26 0.08 0.24 0.14 1.77 23.17 92 Islington 25.2 15.2 14.8 0.05 — 0 .30 0.07 0.26 0.13 1.45 27.90 105 Stoke Newington 20.7 13.1 12.5 — — 0.02 0.06 0.12 0.08 1.15 15.31 78 Hackney 24.5 13.9 14.0 0.04 — 0.48 0.04 0.24 0.18 1.36 23.26 92 Central. Holborn 16.4 16.1 16.2 0.13 — 0.24 0.04 0.19 0.09 1.97 17.02 90 Finsbury 30.1 19.6 19.4 0.02 — 0.90 0.07 0 .53 0.11 1.98 34.63 123 City of London 10.2 13.4 14.0 0.06 — 0.06 0.06 0 .17 0.11 1.12 5.52 94 East. Shoreditch 32.1 19.0 19.6 0.02 — 1.02 0.05 0.50 0.18 2.14 42.15 141 Bethnal Green 29.7 16.0 16.6 0.03 — 0 .53 0.05 0 .38 0.22 1.65 45.96 137 Stepney 29.4 16.5 17.3 0.03 — 0.66 0.10 0.26 0.26 1.70 33.26 124 Poplar 31.6 17.1 16.9 0.04 0.41 0.06 0.19 0.21 1.67 38.44 116 South. Southwark 29.8 17.8 17.9 0.01 — 0 .51 0.12 0.31 0.20 1.76 36.94 124 Bermondsey 31.0 17.4 17.4 0.02 — 0.65 0.06 0.11 0.14 1.63 36.37 125 Lambeth 23.7 14.6 14.3 0.05 — 0.20 0.05 0.14 0.17 1.42 28.77 104 Battersea 25.8 13.3 13.4 0.02 — 0 .30 0.07 0.16 0.10 1.26 28.35 93 Wandsworth 20.2 10.9 11.0 0.02 — 0.08 0.04 0.17 0.12 0.90 22.17 89 Camber well 25.2 13.7 13 .6 0.02 — 0 .25 0.09 0.18 0.15 1.43 21.73 99 Deptford 28.6 14.4 14 .3 0.03 — 0 .47 0.08 0.08 0.23 1.38 29.21 99 Greenwich 25.1 14.7 14.5 0.05 — 0.49 0.07 0.06 0.17 1.38 22.01 98 Lewisham 19.8 10.9 10.7 0.04 — 0.04 0.05 0.ll 0.14 0.75 16.49 74 Woolwich 23.3 13.8 14.1 0.02 — 0.20 0.07 0.22 0.28 1.40 10.57 85 8 SUMMARY. 1913. 1914. Estimated Population of Bethnal Green- 127,824 127,662 Young Children, under 5 years- 16,280 16,250 Old People, over 65 years- 4,827 4,820 Area—759 acres. Number of Inhabited Houses 14,756 14,758 Rateable Value £535,336 £535,734 Average number of Persons to each House- 8.7 8.7 Average number of Persons to each Acre 168.4 168.2 Total number of Deaths in the year- 2,011 2,036 Total number of Births in the year 4,008 3,786 Total number of Marriages- 1,046 1,009 Marriage Rate—Bethnal Green- 16.4 16.4 Marriage Rate—London- 18.3 19.1 Death Rate—Bethnal Green 15.7 15.9 Death Rate—London- 14.2 14.4 Birth Rate—Bethnal Green 31.3 29.6 Birth Rate—London 24.5 24.3 Infantile Death Rate (on Births)—Bethnal Green 117.5 137.0 Infantile Death Rate (on Births)— London- 105.0 104.0 Young Children's Death Rate (on estimated number of Young Children) 43.2 48.3 Old People's Death Rate (on estimated number of Old People) 95.3 80.0 Zymotic Death Rate (Bethnal Green)- 1.97 2.58 Zymotic Death Rate (London)- 1.37 2.21 Inquest Cases 247 263 Metropolitan Borough of Bethnal Green. REPORT. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Bethnal Green. Sir and Gentlemen, I have the honour to submit for your consideration my thirty-ninth annual report on the health of the Borough of Bethnal Green. The vital and mortal statistics are calculated for the registration year 1914, which terminated on January 2nd, 1915. I may here remark that I trust this report will be in your handssomewhat earlier than that of 1913, which was not published until March, 1915. It is obvious that the value of a health report is largely discounted by delay in publication. POPULATION. The official estimate of the population of Bethnal Green for the year 1914 is 127,662; the Registrar- 10 General assumes that our numbers have decreased to the extent of 162 persons, and although the excess of the births over deaths during the year amounted to 1,750, yet such a large number of our inhabitants must have left the district for military and other purposes that I very much question if sufficient allowance has been made for these exceptional circumstances. Table “A” shows the figures set out in detail:— TABLE A. 1913. 1914. Estimated population in the middle of the year 127,824 127,662 Total Births 4,008 3,786 Total Deaths 2,011 2,047 Excess of births over deaths, shewing the natural increase of the population 1,907 1,739 BIRTHS. The children born alive in Bethnal Green during the year numbered 3,609, but two of the births which were registered as occurring at the Workhouse were infants born of mothers who were not inhabitants of Bethnal Green. In addition to the local births, I have received information from the Registrar-General that during the year 179 infants were born of Bethnal Green mothers in some one or other of the Metropolitan institutions where maternity cases are admitted. The details of these transferable births are given below, and the adjustment of the total number is as follows:— 11 London Hospital 102 City of London Lying-in Hospital 36 East End Mothers' Home 18 Maternity Home, Underwood Street 12 St. Bartholomew's Hospital 2 Whitechapel Infirmary 1 Various 8 Total 179 Births registered in the Borough 3,609 Add inward transfers 179 Gross total 3,788 Deduct outward transfers 2 Net total of Bethnal Green births 3,786 DEATHS. The deaths actually recorded in the returns of the Local Registrars numbered 2,113, but included in this number are particulars of the deaths of 434 non-residents who were under treatment at one or other of the four Bethnal Green Public Institutions where sick persons are received; ten other non-residents died sudden or violent deaths whilst temporarily residing in or passing through Bethnal Green. The details are as follows:— 1. An infant, aged ten months, died from whooping-cough and pneumonia whilst on the way to the Queen's Hospital; its parents resided in Haggerston. 12 2. A greaser, aged 20 years, of Leytonstone, was crushed between the buffers of some trucks on the railway between Bethnal Green Junction and Brick Lane. 3. A baby, aged three weeks, of London Fields, died on the way to the London Hospital from pneumonia. 4. A chair maker, aged 63 years, of Cassland Road, Hackney, committed suicide at Albert Buildings by hanging himself. 5. A porter, aged 43 years, of St. George-inthe-East, died at 53, Gretton Houses, from chronic alcoholism. 6. A tool maker, aged 61 years, of Shoreditch, died at 302, Hackney Road, from pneumonia. 7. A baby, aged one year, of London Fields, died in Goldsmith Bow from broncho-pneumonia. 8. The wife of a baker, aged 47 years, of Walworth, died at la, Alias Road from cerebral hæmorrhage. 9. A woman, aged 30 years, of Edmonton, died at 424, Corfield Street, from cardiac valvular disease. 10. A baker, aged 72 years, of Globe Road, Mile End, died at the Congregational Church, Approach Road, from aneurism of the aorta. 13 The monthly returns of transferable deaths for warded by the Somerset House authorities contain particulars of 354 deaths; these include, in addition to the deaths in public institutions, the names of 15 inhabitants of Bethnal Green who have died or were found drowned in various parts of London. They were :— 1. A baby, aged eight months, of Globe Road, who was found dead in bed at Lichfield Road, Bow. The cause was found to be a spasm of the glottis. 2. A woman, aged 74 years, of Old Ford Road, died at High Street, Homerton, from pneumonia. 3. A school boy, aged eight years, of Thorold Street, was drowned in the Regent's Canal (Shoreditch) while bathing. 4. An infant, aged two years, of Ravenscroft Street, died at a surgery in Hackney Road, from lacerated lungs, after being run over by a brewer's dray. 5. A druggist's assistant, aged 41 years, of Florida Street, died at Artillery Lane, Spitalfields, from heart failure supervening on interstitial pneumonia. 6. A school girl, aged 13 years, of Burnside Street, died at High Street, Homerton, from tubercular enteritis and peritonitis. 7. An infant, aged two years, of Cambridge Circus, died at Adley Street, Hackney, from shock 14 following an accidental wound of the heart by a broken needle. 8. A platelayer, of Corfield Street, aged 22 years, died at Liverpool Street Station from fracture of skull and ribs and other injuries received while at work. 9. A boot laster, aged 18 years, died at Chatham Place, Hackney, from cardiac rupture due to fatty degeneration. 10. A van boy, aged 17 years, of Tuscan Street, died in Marylebone Road, from haemorrhage consequent on fracture of skull and laceration of brain, caused by his falling from a motor van and being run over by one of the wheels. 11. A baby, whose mother ordinarily resided at Culham Buildings, was born at Underwood Street, Spitalfields. The birth was premature, and the infant only survived a few hours. 12. A draper, aged 36 years, of Canrobert Street, was found drowned in the River Lea, near Sherry's Wharf, Hackney. 13. A woman, aged 73 years, of Florida Street, died at Hobbs' Place, Shoreditch, from syncope, due to fatty heart. 14. A cabinet maker, aged 16 years, of Merceron Houses, was found drowned in the River Lea, near High Hill Ferry. 15. A tailor's machinist, aged 24 years, of Finnis Street, was drowned while swimming in the Bathing Lake, Victoria Park (Poplar portion). 15 TABLE B. Public institutions, situated outside the Borough, into which Bethnal Green residents have been received, and where they have subsequently died :— Bromley Sick Asylum 1 Brompton Hospital 1 Camberwell House 1 Cancer Hospital, Chelsea 1 Cane Hill Asylum 1 Caterham Asylum 3 Charing Cross Hospital 2 Children's Hospital, Great Ormond Street 1 'City of London Lying-in Hospital 1 Claybury Asylum 14 Colney Hatch Asylum 8 Darenth Industrial Colony 2 Dartford Heath Asylum 1 Downs Sanatorium 7 East London Hospital 7 Eastern Hospital 16 Epileptic Colony, Ewell 1 Evelina Hospital 1 Fountain Asylum 1 Friedenheim Hospital 3 Guy's Hospital 3 Hackney Infirmary 2 Hanwell Asylum 3 Horton Asylum 3 Homoeopathic Hospital 1 Joyce Green Hospital 2 King's College Hospital 1 Leavesden Asylum 5 16 London Hospital 164 London Fever Hospital 2 Metropolitan Hospital 3 Middlesex Hospital 2 Mile End Infirmary 2 National Hospital, Queen's Square 2 Northern Hospital 1 North-Eastern Hospital 12 North-Western Hospital 3 Park Hospital 4 Peckham House Asylum 1 Poplar Hospital 1 Queen Mary's Hospital for Children, Carshalton 3 Royal Hospital for Diseases of the Chest, City Road 1 St. Bartholomew's Hospital 18 St. George's Hospital 2 St. Joseph's Hospice 2 St. Luke's House, Kensington 1 Shoreditch Infirmary 4 South-Eastern Hospital 9 South-Western Hospital 1 Tooting Bee Asylum 3 Victoria Hospital 3 Whitechapel Infirmary 1 Whitechapel Workhouse 1 Deaths occurring in various Institutions outside London, particulars of which were forwarded me by the RegistrarGeneral and subsequently verified 14 353 17 TABLE C. Public Institutions in Bethnal Green. Institution. Beds Available. In-patients Treated. Out-patients Treated. Deaths— Bethnal Green Residents. Deaths— Bethnal Green Non-Residents. City of London Hospital for Diseases of the Chest 175 1,024 8,681 9 105 Queen's Hospital for Children, Hackney Road 134 1,750 40,094 91 247 Mildmay Mission Hospital 50 580 12,405 16 21 Bethnal House Asylum 300 293 — 2 19 Bethnal Green Infirmary 669 3,136 — 726 33 18 TRANSFERABLE DEATHS. The following Memorandum was received from Somerset House on February 1st last:— Deaths of reservists, Territorials and other troops enlisting for the war only will be transferred to the home address of the deceased where this information is obtainable. Deaths of other British troops not possessing a private residence, and of foreign troops and refugees, will be regarded as non-transferable, but it is proposed to publish a supplementary table in the Registrar-General's Annual Report showing for each administrative area appreciably affected the number of deaths and the death rate exclusive of all deaths arising through the war. So far no deaths of any of our men fighting abroad or training in camp at home have been included in the mortality returns supplied to me by the RegistrarGeneral, but during the compilation of the statistics for this report I observed differences between the figures I obtained and those issued from Somerset House which I could not reconcile. I accordingly requested my Chief Clerk, Mr. Bilham, to interview Mr. Finch, of the Statistical Department at Somerset House. This gentleman explained that the figures issued by the Registrar-General in his annual summary do not include certain transferable deaths of which information is received by local medical officers of health during the year; it also appears that when the final figures for the year are issued these transferable deaths are included, but are for a slightly different period. It follows therefore that, in present circumstances, close agreement between 19 the figures in this report and those of the RiegistrarGeneral cannot be looked for. SUMMARY. Total deaths registered 2,113 Sudden deaths of residents outside the Borough 15 Deaths of residents in institutions outside the Borough 353 2,481 From these must be subtracted:— Sudden deaths of strangers in Bethnal Green 10 Deaths of strangers in Bethnal Green institutions 424 434 2,047 DEATHS IN SUB-DISTRICTS. In the North-East Sub-district 1,039 deaths occurred amongst the residents, and 987 in the SouthWest. Twenty-one persons who had no fixed homes died in the Workhouse or in the Infirmary. These details are shown in Table D. TABLE D. District. Deaths. Population. North-East 1,039 63,706 South-West 987 63,956 Previous residence unknown 21 — Total 2,047 127,662 20 DEATH BATE. We show a mortality for the year 1914 of 15.9 per thousand living. This rate, which is slightly higher than that of the previous year, is one and a half points above the rate for London, which is 14.4 per thousand. MORTALITY RATES IN SUB-DISTRICTS. The death rate for the North-East Sub-district was 16.3, and that for the South-West 15.4. These rates are exclusive of the twenty-one homeless paupers who died in the Workhouse, although those are of necessity included in the general rate for the whole of the Borough. Table E shows the mortality rates for Bethnal Green and for London, compared by months, the rainfail and the mean temperature for each quarter also being shown. 21 TABLE E. Month. London Death Rate. Bethnal Green Death Rate Mean Temperature Degrees.) Rainfall. Inches). January 18.4 19.1 42.5 6.87 February 14.8 15.3 March 15 .2 17.4 April 13.8 16.9 54.9 4.08 May 12.9 13.2 June 12.6 12.0 July 11.3 11.4 62.2 3.31 August 12.6 15.9 September 15.5 18.4 October 14.1 16.3 November 14.6 15.8 46.5 959 December 16.8 18.2 Average 14.4 15.9 51.5 Total Rainfall, 23.85 Table F compares the death rates for London and for Bethnal Green bv quarters:— TABLE F. Quarter Ending. London. Bethnal Green. April 4th 16.1 17.3 June 30th 13.1 14.0 September 30th 13.1 15.2 January 2nd (1915) 15.2 16.8 Yearly average 14.4 15.9 22 BIRTH RATE. The births actually registered in Bethnal Green during the year numbered 3,609, but to theses must be added the balance of the transferable births (177) notified by the Registrar-General, thus raising the total to 3,786. This gives a birth rate of 29.6 per thousand population, nearly two per thousand below that of last year. The general London rate stands at 24.7 per thousand, TABLE G. MARRIAGES, 1914. First Quarter 174 Second do. 265 Third do. 287 Fourth do. 283 Total 1009 These figures indicate a marriage rate of 16.4 to every thousand persons, as against 19.1 in the County of London. DEATHS OF INFANTS. One-quarter (25.5 per cent.) of the total deaths at all ages were those of infants in the first year of life; these numbered 519, giving an infantile death rate of 137 per thousand births. This is a very considerable increase on the figure for 1913, which was only 118. The metropolitan infantile death rate has fallen to 104, as against 105 for the previous year. An inspection of the accompanying table of special causes of infantile deaths will demonstrate the fact that, 23 though there has been an increase in all causes except two, the great increase of mortality was due to deaths from diarrhœa, a disease which was epidemic in the autumn of 1914. Tubercular meningitis and tabes mesenterica each caused 2 deaths, other forms of tuberculosis caused 6, a total of 10, which gives a mortality of 2.6 per thousand births. TABLE H. Special causes of infantile Deaths. Totals. Rate per thousand births. 1914 1913 1914 1913 Diarrhœal Diseases 140 115 36.0 28.7 Premature birth, injury at birth, and congenital defects, including Atelectasis 102 88 26.9 22.0 Respiratory diseases 89 83 23.5 20.7 Wasting diseases 47 39 12.4 9.7 Convulsive diseases 33 39 8.7 9.7 Common infectious diseases 41 32 10.8 8.0 Suffocation 24 17 6.3 4.2 Tubercular diseases 10 16 2.6 4.0 24 INFANTILE DEATH RATES. The following table compares the total infantile death rates during the last ten years for Bethnal Green with the rates for London as a whole. Year. Bethnal Green. London. 1905 151 129 1906 157 130 1907 138 131 1908 116 113 1909 129 122 1910 108 103 1911 151 129 1912 96 91 1913 117 105 1914 137 104 Averages for ten) years 130 115.7 25 DEATHS OF YOUNG CHILDREN. The deaths of young children aged less than five years, including infants, numbered 785, and formed 38.5 per cent. of the deaths at all ages; this is equivalent to a rate of 48.3 per thousand of the population of young children. SENILE MORTALITY. The deaths of persons aged over 65 numbered 387, a proportion of 19 per cent. of the total deaths at all ages, and a mortality rate of 80.3 as calculated upon the population of elderly people. 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 showing the number of deaths week by week in the Borough, corrected for institution deaths. 26 TABLE I. Quarterly Mortality for the Borough of Bethnal Green. 1914. Estimated Population in the middle of 1914. 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) to 1000 Births registered Total deaths under 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 April 4th 127,662 941 553 1 — 5 2 18 8 15 57 123 17. 4 0.03 — 0.16 0.06 0.57 0.25 1.79 15.94 131 July 4th 127,662 967 446 — — 16 1 15 4 17 49 106 14.0 — — 0.50 0.03 0.47 0.13 1.54 17.58 110 October 3rd 127,662 912 493 3 — 24 1 8 6 99 50 153 15.5 0.09 — 0.75 0. 03 0. 25 0.19 1.57 108.55 168 January 2nd, 1915 127,662 789 542 — — 23 3 7 10 43 54 136 17.0 — — 0.72 0.09 0.22 0.31 1.70 54.50 172 127,662 3,609 2,034 4 — 68 7 48 28 174 210 518 15.9 0.03 — 0.53 0.05 0.38 0.22 1.65 49.14 145 27 TABLE J. Quarterly Mortality tor the County of London. 1914. Estimated Population in the middle of 1914. Births. All Causes. Enteric Fever. Small Pox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Diarrhoea 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 Deaths under 1 year to 1000 Births registered. County of London. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 April 4th 4,516,612 28,235 18,112 47 — 148 66 281 161 265 1783 2717 16.1 0.04 — 0.13 0.06 0.25 0.14 1.58 9.39 96 July 4th 4,516,612 28.373 14,711 32 — 346 69 310 143 230 1445 2238 13.1 0.03 — 0.31 0.06 0.28 0.13 1.28 8.10 79 October 3rd 4,516 612 27,990 14,992 36 — 412 73 206 138 1944 1381 3557 13.3 0.03 — 0.37 0.06 0.18 0.12 1.23 69.45 127 January 2nd, 1915 4.516 612 26,398 17,179 32 479 108 121 264 59.2 1672 2883 15.3 0.03 - 0.43 0.10 0.11 0.23 1.48 22.43 109 4,516,612 111,001 64,994 147 — 1385 316 918 706 3031 6281 11395 14.4 0.03 — 0.31 0.07 0.21 0.15 1.39 27.34 103 1914. Deaths from all causes. 28 DEATHS FROM INFECTIOUS DISEASES. During the year 1914 no additional disease was included in the list of those already notifiable under Sec. 55 of the Public Health (London) Act, 1891. The following table indicates the locality (hospital or home) of the deaths from this class of disease; in addition, it includes measles and whooping-cough, cases of which are now admitted to the hospitals of the Metropolitan Asylums Board from Poor Law Infirmaries, etc. The admission of cases from private residences, however, has been temporarily suspended owing to the pressure upon the hospital accommodation during last Autumn caused by the large number of Scarlet Fever and Diphtheria cases requiring removal. At present Measles and Whooping-cough are not notifiable, but a circular was recently issued by the Local Government Board offering to sanction medical notification of these diseases to the extent of the first case in each family. In the event of this being accepted and put in operation, it is the view of the Local Government Board that subsequent cases could not fail to be discovered by the staff of the Health Department without formal notification. I should prefer full notification, such as obtains with Scarlet Fever, etc., but as there is no probability of this being granted, I am of opinion that the offer of the Local Government Board should be accepted. At present we receive reports from the School Authorities only, and though we are informed of most of the cases of Measles, the information comes too late to be of much use. 29 INFECTIOUS DISEASES. TABLE K. Disease. Deaths at Home. Deaths in Hospitals. Total. Scarlet Fever — 7 7 Diphtheria 4 24 28 Enteric Fever - 4 4 Erysipelas 7 7 14 Puerperal Fever — 2 2 Measles 48 22 70 Cerebro-Spinal Meningitis — 1 1 Polio-Myelitis - 2 2 Whooping Cough 27 21 43 THE SEVEN PRINCIPAL ZYMOTIC DISEASES. (Decennial average of deaths from Zymotic Disease, 285.) The total number of deaths from the diseases usually included under this heading was 330, an increase of 78. There has been a general increase of fatality in each disease with the exception of Enteric Fever, as will be seen from the following comparative table of mortalities in 1913-14:— TABLE L. Disease. 1913. 1914. Small Pox — Measles 59 70 Scarlet Fever 3 7 Diphtheria 11 28 Whooping Cough 30 48 Entcric Fever 4 4 Diarrhœa 145 173 Totals 252 330 30 The death rate from these Zymotic diseases is 2.58 for 1914, against 1.97 for the previous year, the corresponding rates for the whole of London being 2.21 and 1.37. The deaths from Zymotic diseases form 16.2 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. TABLE M. Small Pox caused 0 deaths 0 per cent. Measles „ 70 „ 21.2 „ or 1 in 4.7 deaths. Scarlatina „ 7 „ 2.1 „ „ 47.1 „ Diphtheria „ 28 „ 8.5 „ „ 11.8 „ Whooping Cough „ 48 „ 14.5 „ „ 6.9 „ Typhus Fever „ 0 „ 0 „ — Enteric Fever „ 4 „ 1.2 „ „ 82.5 „ Diarrhœa „ 173 „ 52.4 „ „ 1.9 „ NOTIFICATION OF INFECTIOUS DISEASE. During the year a proposal was made by the London County Council, and referred to the Borough Councils by the Local Government Board, to the effect that it should be made the duty of Medical Officers of Health to report to the County Medical Officer of Health on the occurrence of any case of epidemic disease, and to furnish any subsequent information elicited in the course of enquiry. I reported to the Public Health Committee that I was quite unaware of any necessity for the proposed 31 requirement, inasmuch as an existing rule of the Local Government Board orders information of the outbreak of infectious disease to be sent to the Board and to the County Council; moreover, it is my invariable custom to communicate with the County Medical Officer of Health immediately on receipt of notification of cases of Cholera or Small-Pox, with full information of the results of inspection. The Council agreed as to the undesirability of the proposal, and as other Borough Councils followed suit the matter was allowed to drop. A gross total of 1,530 notification certificates have been received from medical practitioners, but as 120 of these were duplicates (7.8 per cent.) the actual number of cases of infectious disease dealt with was 1,410, a rate of 11 per thousand on the estimated population of the Borough. Of the sufferers, 988 were removed to Hospitals under the control of the Asylums Board and 149 to other Hospitals. In thirty-two instances (a proportion of about two per cent.) information was received from one or other of the Hospital Medical Superintendents that the diagnosis as stated in the notification certificate was incorrect. Table N sets out full particulars of all the notifications:— 32 TABLE N. Details of Notifications Received. 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 394 24 370 14 341 15 11 Membranous Croup 6 — 6 — 6 — — Scarlet Fever 678 23 655 23 628 4 18 Erysipelas 373 66 307 192 — 115 - Enteric Fever 18 — 18 — 12 6 3 Ophthalmia Neonatorum 40 4 36 36 — — — Cerebro-Spinal Meningitis 2 — 2 1 — 1 — Puerperal Fever 9 — 9 2 1 6 — Polio-Myelitis 10 3 7 5 - 2 — Totals 1,530 120 1,410 273 988 149 32 33 TABLE 0. Condition of Premises where Cases of Infectious Disease occurred during 1914. Scarlet Fever Diphtheria. Enteric Fever. Satisfactory 456 234 8 w.C.'s, or apparatus defective 60 39 1 Internal Drainage defective 8 11 1 External Drainage defective 25 12 2 Minor Insanitary Defects 284 113 8 Single Room Tenements 31 20 2 Overcrowded - 2 — SCARLET FEVER. Deaths 7 (Decennial average, 19). This disease was prevalent during the year; 655 cases were notified, and (with the exception of 23) removed to Hospital. Eighteen of the patients so removed were found upon examination not to be suffering from Scarlet Fever. There were seven deaths in Hospital, none at home. The case mortality was 1.07 per cent., as against 1.5 per cent. amongst all the Scarlet Fever cases treated in the M.A.B. Eascern Hospital. The Inspectors report that the homes of 456 of the patients were in a satisfactory condition; the w.c. or the apparatus connected with it was defective in 60 instances, the drains inside the house were leaky in 8, and the yard drainage was faulty in 25; minor insanitary 1914. Scarlet fever. 1914. Diphtheria. Cases, continuous line Deaths, dotted line 34 defects were noted in 284 instances. Thirty-one persons were removed from single-room tenements. DIPHTHERIA. Deaths 28 (Decennial average, 23). Diphtheria was notified in 394 cases, and Membranous Croup in six. Twenty-four of the certificates were duplicates; fourteen of the cases were treated at home, where four of them died; 341 were removed to Hospital, but eleven of these were found not to be suffering from Diphtheria. Of the 330 genuine hospital cases 24 died, making with the home deaths a total of 28, a case mortality of 7.00 per cent., as against 11.52 amongst the whole of the Eastern Hospital cases. The Inspectors report that 234 of the homes of the patients were in a satisfactory condition, but the w.c. or apparatus connected therewith was faulty in 39 cases, the internal drains were defective in 11 cases, and the yard drains in 12; minor insanitary defects were noted in 113 cases. Twenty patients were removed from single-room tenements, two of which were overcrowded. 144,000 units of anti-toxin were supplied free to medical practitioners during the year, and 248 throat swabs were submitted to the Clinical Research Association for examination. Seventy-four of these gave positive results, and 174 negative. Eighteen of the deaths from diphtheria were amongst young children aged less than five years, a mortality of 1.1 per thousand on the estimated population of young children. 35 ENTERIC FEVER. Deaths 4 (Decennial average, 8.5). Eighteen persons suffering from Enteric Fever were notified and removed, twelve to Hospitals of the Metropolitan Asylums Board and six to general hospitals; there were four deaths, a case mortality of 22.2 per cent., as against 18.6 amongst the Eastern Hospital cases. The Inspectors report eight of the homes as satisfactory. The w.c. was defective in one case, bad drainage was noted in three others, and minor insanitary defects in eight. Two persons were removed from single-room tenements. Fifteen samples of blood in suspicious cases were examined at the request of medical practitioners; in one case only was a positive reaction reported, though partial reactions were obtained in two others. In no case could the cause of the illness be definitely traced, but suspicion was cast in five cases upon fried fish eaten by the patient, shell-fish in three cases, icecream in three cases, and water-cress in one case. No information as to suspicious articles of food could be obtained in eight cases. WHOOPING-COUGH. Deaths 48 (Decennial average, 44). All these deaths, with the exception of one, were amongst young children aged less than five years, a mortality of 2.9 per thousand on the estimated population of young children. Twenty-seven of these deaths occurred at home, and the remaining twenty-one at Hospitals. 1914. Enteric fever. Cases. continuous line Deaths, dotted line 36 DIARRHŒA. Deaths 173 (Decennial average, 90). Diarrhoea was prevalent and very fatal during the autumn; it was the cause of 173 deaths, a mortality of 45.7 per thousand births, against 27.6 for the County of London. The infantile deaths numbered 141, equal to a mortality of 37.2 on the births. MEASLES. Deaths 70 (Decennial average, 80). The mortality from Measles (though below the average) advanced slightly during the year, rising from 59 to 70 deaths. All these, with the exception of three, were amongst young children aged less than five years, a mortality rate of 4.1 per thousand children under this age. Simple Measles is rarely fatal; death, when it occurs, is usually due to Broncho-pneumonia, and the younger the sufferer the more serious is this complication, as the diminutive bronchial tubes of an infant soon become choked by the mucus secreted, thus practically causing suffocation. During the year 703 cases of Measles were reported to us by Head Teachers of Elementary Schools; all were visited and such action taken as was possible, but, as I have previously remarked, this information comes too late to be of practical use. Moreover, it is worthy of note that 86 of these school reports proved to be inaccurate; either the children reported were not suffering from Measles or the address given was incorrect, so that many futile visits were paid. All these troubles would disappear 37 with compulsory notification, but the wholesale removal to hospital of children suffering from Measles is quite unnecessary where medical attendance and adequate domestic nursing are available. Power to remove selected cases where these conditions cannot be obtained is urgently required, and sufficient suitable hospital accommodation should be provided for purposes of treatment. From a preventive point of view, the result of such removal is disappointing; the long incubation period of Measles (ten to twelve days) favours its unexpected dissemination. Moreover, the infection is most intense before the characteristic rash appears, so that in at least half the cases met with the disease has been contracted from others suffering from the premonitory or catarrhal symptoms. The power to infect probablv continues during the height of the disease, but rapidly subsides during convalescence; in this it is quite unlike Scarlet Fever, which continues to be infectious long after all remnants of local morbid action have disappeared ; this condition may persist for months, and the germs of Scarlet Fever may lurk in clothes and furniture for even longer. On the other hand, the infection of Measles is fugitive, and elaborate methods of disinfection are not required, as the plentiful use of soap and water, together with free admission of fresh air, effect all that is necessary. SMALL POX AND CHICKEN POX. Soon after the outbreak of war a communication was received from the Local Government Board urging the necessitv for Local Authorities to have in readiness 38 adequate arrangements for dealing with cases of Smallpox, which might be imported from abroad, and enclosing a copy of a memorandum on the steps requisite to be taken in the event of an outbreak. These precautionary measures are such as have been in force in the Borough on the occasion of past outbreaks. The opening words of the memorandum point out that an outbreak of Small-pox at the present time would be especially serious, and attention is drawn to the fact that in the past valuable time has been lost owing to cases of this disease having been mistaken for Chickenpox. About this time a circular letter was received from Lambeth Borough Council, urging Bethnal Green to join in an appeal to the London County Council to make Chicken-pox a compulsorily notifiable disease. The matter was referred to the Public Health Committee, upon whose recommendation the Council agreed to support the Lambeth appeal. The reply of the County Council was to the effect that it felt unable to make the order, but agreed that the greatest vigilance should be exercised so as to detect immediately any case of Small-pox which might occur; it also pointed out that arrangements are still in force by which any medical practitioner can secure, free of charge, the advice of a Small-pox expert in cases of doubtful diagnosis. Since the writing of this report was commenced the County Council has been better advised, and has now made Chicken-pox a temporarily notifiable disease. We received notice from schools of 320 cases of Chicken-pox during the year; all were visited and dealt with in the usual manner. In 56 instances it was found 39 that the information was incorrect, either as to the address given or as to the disease from which the child was suffering. No case of Small-pox was reported. ERYSIPELAS. The actual number of certificates notifying Erysipelas was 373, but no fewer than 66 were duplicates (17.7 per cent.). This redundancy arises from the fact that Erysipelas cases are not welcome at General Hospitals, and, if removed, have to be taken to the Infirmary. Where this course is adopted the same case is notified by the District Medical Officer and the Medical Superintendent of the Infirmary, as well as by the private medical practitioner first called in. The homes of all the patients were visited, insanitary conditions noted and remedied, and, where necesary, disinfection of the premises was carried out after removal or recovery. There were fourteen deaths from Erysipelas, seven at home and an equal number in hospital. In addition to these deaths from true Erysipelas, thirty-one persons died from diseases of a septic nature, four of these being cases of oral sepsis and five of middle ear disease; the others were from pvoemia, cellulitis, carbuncle, abscess, etc. APPENDICITIS. Nine deaths were registered as from this cause, three of them occurring after operation. DISEASES AND ACCIDENTS OF PARTURITION. Nine cases of Puerperal Fever were reported; one of these was removed to an Asylums Board hospital, 40 six to other hospitals, and two were treated at home. Two of the hospital cases proved fatal. The deaths of four women were due to some one or other of the diseases or accidents connected with the puerperal state. A girl aged eighteen died after an operation for Caesarian Section, two women died after miscarriage, and one each from convulsions and pulmonary embolism. OPHTHALMIA NEONATORUM. The compulsory notification of this disease has been extended to the whole of England by order of the Local Government Board under the Public Health Acts of 1875 and 1896. The form of notification and the fees payable are similar to those scheduled in the Public Health (London) Act of 1891, with the addition that certified midwives are under a similar obligation to notify and are entitled to a fee of one shilling for each certificate. Thirty-six infants were reported to be suffering from this disease; the mothers were attended by doctors in twenty-one cases, midwives in seventeen, and London Hospital maternity assistants in two. At the end of the year four of the infants were still under treatment, two had left the district, and the remainder had been cured without obvious impairment of vision. CEREBRO-SPINAL MENINGITIS. Only two notifications of this disease were received during the year. The first referred to a baby girl of Hackney Road, aged six months, and was dated February 11th. The patient was removed to the Queen's 41 Hospital, where a lumbar puncture was made, the result of which confirmed the diagnosis. The child died on March 12th, and a post-mortem examination revealed thick pus at the base of the brain and much fluid in the ventricles. The second case was that of a boy, aged nine years, of Old Bethnal Green Road; he was notified on August 23rd, admitted to the London Hospital on September 2nd, and died on the 8th. A lumbar puncture was made prior to death with a negative result, and a post-mortem examination demonstrated the fact that the case was really one of tuberculous disease. Death was certified to be due to Tuberculous Meningitis and General Disseminated Tuberculosis. ACUTE POLIO-MYELITIS. Seven cases of this disease were notified during the year, the following being a summary of the notes :— (1) A boy, aged eighteen months, of Quinn's Square, who was under treatment at the Tottenham General Hospital; no history of the case can be given, as the Medical Officer of the Hospital refused to give particulars without payment of a fee. The home of the patient was in fair condition and no animals were kept; the patient was one of four children who appeared to be without proper care, as the mother had deserted the family and the father was engaged on night work. The child ultimately recovered. (2) A girl, aged eighteen months, of Chester Street, under treatment at the London Hospital, was notified on June 8th. The symptoms included paralysis of face, 42 arms, legs, and right half of diaphragm. The child recovered. (3) A boy, aged two years, was notified on August 7th. removed to hospital on the 15th, and discharged on the 21st. The symptoms at the onset of this case were inability to move right arm or leg; he was also unable to sit up, talk, or cough. The child gradually improved, and at the end of the year was reported as having recovered. (4) A male infant, aged nine months, of Poyser Street, was notified on August 28th. The child was an out-patient at the Queen's Hospital. The shoulder muscles were paralysed. He is still under treatment. (5) A girl, aged two years, of Bullard's Place, was notified on August 28th. At first the child was an out-patient at the London Hospital, but towards the end of the year was transferred to the Mildmay Hospital. The symptoms were paralysis of both legs and incontinence of urine. She is still under treatment. (6) A girl, aged three years, of Pedley Street, was notified on October 2nd. The child was an out-patient at the London Hospital, the symptoms at the onset being paralysis of right arm, with tenderness all over the limb. The last report was that the child was much improved and was about to be taken to America to join her father. (7) This case, a boy aged two years, presented peculiar symptoms, and was originally notified as a case of Diphtheria. Paralysis of the right arm developed, and he was taken to the Queen's Hospital. He was 43 subsequently certified to have Polio-myelitis, and is still under treatment TUBERCULOSIS. Diseases due to the ravages of the tubercle bacillus caused 277 deaths during the year, these forming 13.5 per cent. of the total deaths from all causes in the Borough, equal to a death rate of 2.1(3 per thousand estimated population. Forty-two of the deaths were amongst young children, a mortality of 2.6 per thousand children living. Six infants died from tubercular disease of the brain, and fourteen from other tubercular diseases. PULMONARY TUBERCULOSIS. The deaths from tubercular lung disease (Phthisis) numbered 210, equal to a mortality rate of 1.64, as against 1.39 for the whole of London. NOTIFICATION OF TUBERCULOSIS. All forms of tuberculosis have been notifiable under the Public Health (Tuberculosis) Regulations since February 1st, 1913. The total number of certificates received during the year 1914 amounted to 918; of these 564 were on Form "A, which is intended for primary notifications only, but this total includes no fewer than 110 duplicates. On Form "B" 20 certificates were received, including seven duplicates; this form is for the use of School Medical Officers. Form "C" is for the use of Institution Medical Officers (Hospital, 44 Sanatorium, Poor Law, etc.), and is required to be forwarded when a patient with tubercular disease is admitted. The certificates on this Form numbered 221 from Poor Law Medical Officers and 113 from Hospitals and Sanatoria. Of the sufferers from Tuberculosis, 344 were notified on the primary certificate as cases of Phthisis and 110 as other forms of Tuberculosis. The School Medical Officers notified three cases of Phthisis and ten others. On Form " C " Medical Officers reported 297 cases of Phthisis and 37 of other forms of Tuberculosis. Amongst the persons notified as suffering from Tuberculosis, 341 were stated to be insured under the National Insurance Act, 1911, but 317 were uninsured; no information could be obtained as to the remaining 143. 293 specimens of sputum were submitted to the Clinical Research Association for examination; the tubercle bacillus was detected in 75, but the examination proved negative in 218. The homes of all the sufferers from Tubercular disease were visited, insanitary conditions were noted, and as far as possible remedied. By direction of the Public Health Committee the sufferers from Phthisis were supplied on request with paper-lined spitting cups and glass metal-capped pocket spittoons; this arrangement was continued on the same lines as in previous years, as was also the supply of dis infectants. 45 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Occupations of Persons Notified during 1914. Occupation. Males. Females. Total. Artificial Flower Makers — 3 3 Bioscope Operator 1 — 1 Baker 1 — 1 Billiard Marker 1 — 1 Boxmakers 4 19 23 Book binding Trade 2 3 5 Boot and Shoe Trade 14 5 19 Bon-Bon Maker — 1 1 Brass Finishers 3 — 3 Bricklayers 2 — 2 Brush Makers 3 2 5 Builder 1 — 1 Button Work — 1 1 Cabinet Makers and Furniture Trade 33 — 33 Cap Makers 1 2 3 Carmen, Cab, 'Bus and Tram Workers 17 — 17 Caretaker 1 — 1 Carpenter 1 — 1 Cellarman 1 — 1 Charwomen — 10 10 Cigar and Cigarette Makers 8 1 9 Clerks 10 3 13 Clock Maker 1 — 1 Cooper 1 — 1 Cycle Maker 1 — 1 Confectioner — 1 1 Costers 3 — 3 Decorators 3 — 3 Domestic Servants 1 10 11 Dressmakers — 2 3 Electrical Worker 1 — 1 Engineers 4 — 4 Feather and Fur Workers 2 2 4 Fish Curer 1 — 1 French Polishers 12 4 16 Gas Fitters 2 — 2 Gold-workers 1 1 2 Glass-workers 2 — 2 Greengrocer — 1 1 Hawkers 9 1 10 Housebreaker 1 — 1 House-wives — 77 77 Infants 32 14 46 Carried forward 181 163 344 46 Public Health (Tuberculosis)—continued. Occupation. Males. Females. Total. Brought forward 181 163 344 Insurance Agent 1 — 1 Labourers:— Genera] 21 — 21 Dock 6 — 6 Laundresses — 3 3 Lavatory Attendant — 1 1 Leather Workers 2 1 3 Machinists 1 10 Mechanics 2 — 2 Milliner — 1 1 Musician 1 — 1 Nurse — 1 1 Painters 2 — 2 Packers 6 — 6 Paper Bag Mak«r — 1 1 Paper and Rag Sorters 1 1 2 Pill and Tablet Maker 1 — 1 Picture Framer 1 — 1 Plumber 2 — 2 Porters 11 — 11 Printers, Compositors, etc. 7 1 8 Public-house Employees 7 3 10 Sand Blaster 1 — 1 Sawyers 2 — 2 Seamen 3 — 3 Shop Assistants 6 6 11 Shop Keepers 2 — 2 Silk-workers 1 3 4 Soldiers 2 — 2 Stick Makers 8 — 8 Suspender Maker — 1 1 Tailors and Tailoresses 23 13 36 Tea Sifter 1 — 1 Tie-maker — 1 1 Ticket Numberer — 1 1 Trimmings 1 4 5 Upholsterers 1 1 2 Van Boys 2 — 2 Waitresses — 3 3 Warehousemen 2 — 2 Wool Samplers. 2 — 2 Window Cleaners 1 — 1 Wire Spring Mattress Maker — 1 1 Woodworkers 5 — 5 No occupation 28 31 59 No information obtainable, or persons removed 83 47 130 Sohool-children 48 30 78 Total 475 326 801 47 TUBERCULOSIS DISPENSARY. The outbreak of the European war diverted so much energy to other directions that the arrangements for the provision of a Dispensary necessarily remain in abeyance. Careful enquiry was, however, made as to what has been done in other parts of London. The replies to my circular were carefully collated by Mr. Bilham, the Chief Clerk in my department, and will be, found in the appendix to this report. I cannot speak too highly of the care and ability displayed by this officer in the preparation of this table, which will, I am sure, prove of great value to Metropolitan Medical Officers of Health, amongst whom it has already been circulated. CANCER. Included under this head are deaths from Cancer, Sarcoma, Epithelioma, Glioma and Rodent Ulcer; they numbered 115, and, with the exception of five, occurred amongst persons aged over 25 years. The following list shows the organs and parts of the body chiefly affected by cancerous growths. Stomach, Liver and Pancreas 29 Female Organs of Generation 13 Intestines 11 Female Breast 10 Tongue and Mouth 9 Rectum 9 Larynx and Oesophagus 8 Prostate and Male Bladder 4 Lung and Mediastinum 3 Brain 5 48 UNCERTIFIED DEATHS. Thirteen deaths were registered without the certificate of a qualified medical practitioner. Eight of the deceased persons had been attended during life by the unqualified assistant of a medical practitioner in Bethnal Green, who had incautiously engaged this person on a false statement that he was " Surgeon-Major Harrison," and had been engaged by the War Office to examine recruits. It subsequently transpired that " Dr. Harrison " had assumed the name of a registered practitioner who was abroad; his real name was John Cubbin, and he must have had some medical education, for he gave evidence at inquests, signed death certificates, etc., and, I am told, was much liked by the people he attended. The Coroner's suspicions were aroused, however, and he communicated with the authorities. Subsequently Cubbin was prosecuted on the initiative of the Medical Defence Union, and on conviction was sentenced to three years' penal servitude. The particulars of the remaining cases were submitted to the Coroner, and as he did not consider an inquest necessary the deaths were registered upon such information as could be obtained. INQUESTS. The total number of inquests held during the year was 263. Twelve persons committed suicide and 74 others died violent or sudden deaths. 49 CUSTOMS AND INLAND REVENUE ACTS, 1890 to 1903. Applications made during the year for my certificate to obtain exemption from inhabited house duty were in respect of Nos. 20 to 26 and Nos. 28 to 36, Chambord Street. These premises are new buildings which have been erected on the site of some very old and worn-out houses, which were demolished by the owners under much pressure from this Authority. The new premises complied with my requirements, and were certified accordingly. THE ANCIENT FOUNDATION OF THE COLLEGE OF ST KATHARINE. At the instance of Her Majesty Queen Alexandra, Patron of the College of St. Katharine, the restoration of the benefits of this Ancient Foundation to the poor of East London has recently been undertaken. At Her Majesty's request, the Lord Chancellor framed rules to this end, providing inter alia that in the immediate future there shall be established in the East of London a College of resident Health Visitors. These are to be experienced women possessing nursing, obstetric and public health certificates, who shall devote themselves to maternity and health visiting in defined areas under the direction and control of the Medical Officers of Health of the Borough Councils of East London. The Chapter of the College enquired of the Borough Council whether, having regard to the density, etc., of the population in Bethnal Green, it would be considered advantageous were one or more of such Health Visitors appointed to work in the Borough, and whether the 50 Council would co-operate with the Chapter in giving effect to the provisions of the scheme. The desirability of securing to the Borough the undoubted benefits which would accrue was so obvious that, upon the recommendation of the Public Health Committee, the Council cordially accepted the proposals and expressed its desire to co-operate with the Chapter. So far nothing further has been heard of this matter, but it is understood that it is intended to establish the College in the Borough of Poplar.* SCHOOLS FOE MOTHERS AND INFANT CONSULTATIONS. The administration of the grants made out of moneys provided by Parliament to Schools for Mothers and Infant Consultations was the subject of a Conference (convened by the St. Pancras Borough Council) of representatives of the Metropolitan Boroughs and Cities. At this Conference a resolution was passed, expressing the opinion that, as the work of such institutions must be on similar lines to that of local sanitary authorities, aiming at reduction of infantile mortality under the provisions of the Notification of Births Act, 1907, rhe proposed grants should be made by the Local Government Board through the Local Sanitary Authorities. The Council supported the action of the Conference, and communicated with the local Members of Parliament accordingly. Nothing has yet been heard as to whether the Central Authorities will agree to the proposal. A further proposal to which the Council agreed was that put forward by the Poplar Borough Council, * The Medical Officer of Health for Poplar states that the Principal of the College informed his Council that it had been decided to fake Bromley Hall, Brunswick Road, Poplar, for St. Katharine's College, for a term of three years. 51 to the effect that under these schemes there is pressing necessity for authorising assistance to necessitous mothers both before and after child-birth (outside the Poor Law), and that the cost of such assistance should rank for contribution from the Government grant. Bethnal Green communicated with the Local Government Board, supporting the representations made by the Poplar Borough Council. CHILDREN'S COUNTRY HOLIDAYS. A letter was received from the Local Government Board with reference to complaints which have occasionally been made of the unfortunate results of sending town children (at the instance of philanthropic organisations or agencies) for holidays to country districts, and pointing out the precautionary measures which should be taken in regard to the prevention of infectious disease, the supervision of housing conditions, and the prevention of injurious overcrowding in dwellings. The suggestions contained in the letter related mainly to precautions which should be observed by the agencies concerned, but stress was laid upon a suggestion that medical officers of health would facilitate enquiries as to children coming from infected homes by indicating upon lists of children proposed to be sent away from any homes where infection is suspected. The course suggested has been followed in my department for many years. With the growth of the agencies concerned, the task is no light one; it consumes much time and requires much attention on the part of the staff. The work, however, is carried out thoroughly, and although the burden of these semi-official enquiries 52 is very considerable, the staff have invariably co-operated willingly in this matter. HEALTH VISITORS. During the year it became increasingly apparent that the amount of work devolving upon the Health Visitor was excessive. There are upwards of 16,000 children in the Borough under five years of age, a large proportion of whom come more or less within the scope of this officer's observation. Nearly 4,000 births are notified annually, of which three-fourths require to be not only visited but re-visited. Beyond this there are many matters requiring attention, including the visitation of certain notifiable diseases, special enquiries in seasonal infantile complaints, etc., etc. In addition to » these matters, the distress which arose in consequence of the European war increased Miss Hammond's work, and it became necessary for an additional Health Visitor to be appointed. Mrs. M. A. Hodgkins, who holds the necessary qualifying certificate, was selected and appointed temporarily. I submitted to the Committee rules for the guidance of both officers; I proposed to allot to each one of the registration districts into which the Borough is divided. Miss Hammond selected the South-West and Mrs. Hodgkins the North-East. The rules were agreed to and apparently work satisfactorily. If no further duties are added to those detailed above, the ground may now be regarded as fairly well covered, but any further activities requiring the services of these officers will undoubtedly result in the necessity for further appointments. 53 The joint report of the Health Visitors will be found in the appendix. BEADY STREET AREA. In March, 1914, the Public Health Committee became aware that representations had been made to the London County Council by the Local Government Board on the subject of the Brady Street Area since the date of the Inquiry. The Town Clerk was directed to communicate with the Local Government Board, asking whether, in view of the very lengthy period that the area had been suffered to remain in a condition dangerous and injurious to the health of the inhabitants, and the serious concern of the Borough Council that proper steps should be taken without any further delay to deal with the area in the manner provided by law, the Board could afford the Council information as to the position of the matter, and, in particular, as to the substance, if not the terms, of the report of Major Norton. In reply, the Board stated that it was in communication with the London County Council on the subject, and transmitted a copy of a letter dated February 16th, 1914, from the Board to the London County Council. The letter stated that the Board understood that the County Council was prepared to consider further the question of dealing with the Brady Street area, though unwilling, at that time, to proceed by way of an improvement scheme under Part I. of the Act of 1890, and the Board desired to defer for the present coming to any formal decision under Section 10 of the Housing of the Working Classes Act, 1890, and Section 4 54 of the Act of 1903; and suggested 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—indicating that the under-mentioned areas might be considered in that connection :— (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, &c., 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. (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 houses immediately abutting on the last-named street. The letter added that the Board understood that the County Council had under consideration a proposal for acquiring a site in the neighbourhood of area No. 4 for educational purposes, and that this area might be suitable for such a site, and pointed 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: 55 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 showed that re-housing in the immediate neighbourhood is required. Further, that as regards the houses abutting on Pereira Street and Foster Street, the Board was disposed to consider that a satisfactory arrangement with the Brewery Company, who own the greater part of the property, was 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 Committee expressed surprise to learn that subsequently to the date of Inquiry, the Local Government Board, which is the authority to adjudicate upon the matter at issue between the London County Council and the Borough Council respecting my representation, should have addressed a communication in these terms to the London County Council without the knowledge of the Borough Council, and without the Council being asked to submit its observations thereon. The London County Council is the " local authority " within the meaning of Section 4 of the Housing of the Working Classes Act, 1890, relating to official representations under Part I. of the Act, which Section provides as follows:— "the local authority shall take "such representation into their consideration, and "if satisfied of the truth thereof, and of the suffi" ciency of their resources, shall pass a resolution " to the effect that such area is an unhealthy area, 56 "and that an improvement scheme ought to be " made in respect of such area, and after passing " such resolution they shall forthwith proceed to make a scheme for the improvement of such " area." The accuracy of my official representation had never been impugned. No question as to the sufficiency of the resources of the London County Council had been raised. The position was so unsatisfactory that a letter in the following terms was addressed to the Board :— Metropolitan Borough of Bethnal Green, Town Hall, Bethnal Green, E. May 7th, 1914. 39,131 D. 1914. Sir, I am directed to reply to your communication of April 15th, transmitting for the information of the Borough Council a copy of a letter, dated February 16th, 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, Bpthnal 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 57 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 sub judice. 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 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 " (see Minutes of the London County Council, July 29th, 1913, at page 472), and that would appear to be the position now. The Inquiry was primarily and mainly as to 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 58 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 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 the inhabitants either of the buildings in the area or of the neighbouring buildings. With reference to the houses abutting on Pereira Street and Foster Street, I am to express the regret of the Council that the Board should at this date put 59 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 no 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 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 Inquiry; nor to the further question whether the 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 60 the Council is strongly of opinion that the further postponement of the discharge of a most important public duty affecting the lives of thousands 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, (Sgd.) C. G. E. Fletcher, Town Clerk. The Secretary, Local Government Board. A copy of the recent correspondence with the Local Government Board was forwarded to each of the Borough representatives on the London County Council. On June 3rd the Public Health Committee conferred with the four Borough representatives on the London County Council, who proved to be fully in accord with the Borough Council in its desire that the area should be dealt with by the London County Council under Part I. of the Housing of the Working Classes Act, 1890; moreover, they had repeatedly endeavoured to forward the action taken by the Borough Council. After the Conference a letter was received from the Local Government Board, dated June 5th, transmitting copy of correspondence between the Board and the County Council. The Board did not, however, reply to the enquiries referred to in the penultimate paragraph of the letter dated May 7th, addressed to the Board by the Town Clerk. 61 The position remained so unsatisfactory that after serious consideration the Committee recommended the Council to ask the President of the Local Government Board to receive a deputation, consisting of the members of the Public Health Committee and the local Members of Parliament, to lay before the President the views of the Council on the matter. In the copy of the correspondence above referred to was a letter from the County Council which contained the observations of the Housing of the Working Classes Committee on the proposals of the Board (see page 54). It recited the resolution of the County Council of July 29th, 1913, as to the reasons of the London County Council for not proceeding with a scheme under Part I. of the Housing of the Working Classes Act, 1890, in view of prospective legislation, which would " enable the area to be dealt with in a more satisfactory manner and at less cost to the ratepayers than is the case under the present law," and quoted Ministers of the Crown as the source of their belief in the imminence of such legislation. The principle expressed in the resolution with regard to the cost of a Part I. scheme would, it was stated, "apply, though with less force, to the much more moderate scheme suggested by the Local Government Board." The Housing Committee was, however, prepared to recommend the County Council to carry into effect at its own cost a scheme, under Part II. of the Act of 1890, for the clearance of Section 4 (see page 54), except the houses fronting on Merceron Street, the site probably to be utilised for a new County Council School, provided that the Borough Council would undertake to deal with 62 the block of tenement dwellings in Lisbon Street, either by means of a scheme under Part II. of the Act, or under the provisions of Section 38, and would arrange with the Brewery Company—which owns a large part of the property on the area—for the demolition of the houses in Pereira Street, and the construction of a new street on the site of the houses on the west side of that thoroughfare, with a view to enabling the Company to re-develop its property to the best advantage. The Housing Committee suggested that it would be desirable to defer, until the effect of the proposed legislation had been seen, the question of a scheme for Sections Nos. 1 and 2 (see page 54). With regard to the question of the housing of the people who would be displaced, the County Council, on grounds both of cost and of public health, expressed its unwillingness to undertake the erection of further block dwellings in the central and overcrowded regions of London, except where circumstances made such provision absolutely necessary. In reply, the Board stated that it was advised that Sections Nos. 1 and 2 contained some of the worst property in the area, and that the Board was strongly of opinion that these portions should be dealt with without delay. As regards Section No. 4, and the question of rehousing displaced persons, the Board could not decide upon this matter until all the local circumstances and interests had been investigated in connection with a definite scheme. It was at this stage that the President of the Local Government Board consented to receive the proposed deputation, which waited on the President at the House of Commons on July 7th, 1914. 63 Sir Edwin Cornwall, D.L., M.P., introduced the deputation to the President, and made a statement as to the unhealthy condition of the area, and the efforts which have been made with a view to effect some improvement in it, and expressed the Council's desire of ascertaining the result of the Public Inquiry. The Mayor expressed the deep concern of the Council that steps should be taken without further delay for the preparation and carrying out of an improvement scheme. The Town Clerk explained the case of the Council to the President, and summarised the steps taken since the first representation under the Housing Acts made by the Medical Officer of Health in 1904 to deal with the area. He stated the reasons why the Council considered the present position so extremely unsatisfactory, especially in view of the evidence which demonstrated the need for a Part I. scheme, and urged the importance of steps being taken to remedy the evils existing in the area, and which for so long had been injurious to public health in Bethnal Green. I submitted vital statistics and other information relating to the area, and Mr. Foot gave particulars of the diligent action taken by the Public Health Department to remedy insanitary conditions. We expressed our opinion that such action had resulted only in effecting certain temporary improvements, and that it was impossible. within the powers of the Council, to do anything of a permanent character. We also strongly supported the evidence already given as to the need of a Part I. scheme. The reply of the President to the representations 64 of the deputation was disappointing. It contained a clear indication that the unissued decision of the Local Government Board on the subject of the Public Inquiry was unfavourable to the Borough Council. It was evident that the Board was satisfied that the evidence of the Council abundantly demonstrated the necessity for an entire clearance of the area and a subsequent improvement scheme, but it was also evident that the Board did not intend to make an order on the County Council to prepare a scheme under Part I. of the Housing of the Working Classes Act, 1890. Apparently the Board desired to defer the announcement of their decision, and in the meantime the President made a suggestion that a conference should take place between the representatives of the Board, the County Council and the Borough Council, with a view to effect an improvement of certain parts of the area by means of schemes under Part II. of the Act. The Public Health Committee met specially on July 18th, 1914, to consider the matter further, but prior to our meeting the Town Clerk received a request from the President of the Local Government Board that a small deputation should see him with further reference to the Brady Street area, and the Mayor, the Chairman (Mr. Councillor O'Grady, J.P.), and Mr. Councillor Brooks, together with the Town Clerk, the Chief Sanitary Inspector, and myself, met the President at the House of Commons on July 20th, 1914. The President outlined a proposal which would, if adopted, effect an improvement in part of the area, viz., Section 4, by the London County Council, with a view 65 to the erection by that authority of a public elementary school on the site so cleared; the Borough Council would be required to undertake the clearance of an area comprising the tenement buildings in Lisbon Street, and by means of a scheme under Part II. of the Act to deal with the area comprising houses on the south sides of Scott Street and Dixie Street. The proposals appeared to be for part of this area to be dealt with by the London County Council, part by the Borough Council, and the other part of it to remain as at present. The Town Clerk pointed out to the President that the negotiations for some months appeared to have been in the light of an adverse decision as regards the representation made by the Medical Officer of Health for a Part I. scheme, and that the Council would prefer to learn definitely what the judicial decision of the Board was as the result of the Public Inquiry held at the Town Hall in October last. We learnt from the President that the Local Government Board had made it clear to the London County Council that the Brady Street area could not remain in its present unsatisfactory condition, and that effective steps must be taken to remedy the evil conditions therein. The Council, upon receiving a report from the Committee as to the proceedings detailed above, resolved unanimously :— (i.) That the report be received and approved, and that the Council do thank the members of the deputation for their services in waiting upon the President of the Local Government Board, 66 and the members of the Public Health Committee for their efforts to effect a clearance of the Brady Street area under Part I. of the Housing of the Working Classes Act, 1890, and that the Council do record its extreme disappointment at the lines of action suggested by the President of the Local Government Board for the clearance of the Brady Street area. (ii.) That the Council is still strongly of opinion that nothing whatever has so far been brought to its knowledge that would cause it to vary its original opinion in regard to the Brady Street area, having regard to the extent of the area, its congested nature, the small worn-out and dilapidated condition of the properties contained therein, and the number of cul-desacs on the area; and that it adheres to its opinion that nothing short of an improvement scheme under Part I. of the Housing of the Working Classes Act, 1890, can meet the merits of the case, apart from any other consideration. (iii.) That this Council will be glad to learn on what evidence (if any) the suggestion is based for altering the procedure hitherto invariably followed under Part I. of the Housing of the Working Classes Act, 1890, and proceeding under Part II. of the Act by a series of small and indefinite schemes. (iv.) That this Council affirms its considered opinion that the proposals made by the Local 67 Government Board for the division of the Brady Street area into four small areas or schemes are of an indefinite and inconclusive nature, and are not calculated to lead to a practical or effectual treatment of the area; and the Council is of opinion that procedure on the lines suggested would lead to a maximum of expenditure of public funds with a minimum of improvement, and would not meet the merits of the case from a public health point of view. (v.) That copies of the foregoing resolutions be forwarded to the Prime Minister, the President of the Local Government Board, the members of Parliament for the Borough, and the local members of the London County Council. In October a letter was received from the Local "Government Board enclosing copies of an Order made by the Board with regard to the Brady Street area. The Order was as follows :— To the County Council of the Administrative County of London;— And to all others whom it may concern: Whereas by Section 4 of the Housing of the Working Classes Act, 1903 (herein-after referred to as " the Act of 1903 "), it is enacted that if, on the report made to the Confirming Authority on an Inquiry directed by them under Section 10 of the Housing of the Working Classes Act, 1890 (in the Act of 1903 and herein-after referred to as " the Principal Act "), that Authority are satisfied that 68 a scheme ought to have been made for the improvement of the area to which the inquiry relates or some part thereof, they may, if they think fit, order the Local Authority to make such a scheme either under Part I. of the Principal Act, or, if the Confirming Authority so direct, under Part II. of that Act, and to do all things necessary under the Housing Acts for carrying into execution the scheme so made, and that the Local Authority shall accordingly make a scheme or direct a scheme to be prepared as if they had passed the resolution required under Section 4 or Section 39 of the Principal Act, as the case may be, and do all things necessary under the Housing Acts for carrying the scheme into effect; And whereas the County Council for the Administrative County of London (herein-after referred to as the "Local Authority") are the Local Authority for the purposes of Part I. of the Principal Act for the said County; And whereas an official representation was made to the Local Authority by the Medical Officer of Health of the Metropolitan Borough of Bethnal Green with a view to their passing a resolution in favour of an improvement scheme for the rearrangement and reconstruction of the streets and houses within a certain area in the said Metropolitan Borough comprising the following streets and courts:—Brady Street (West side), Nos. 53, 55, 57, 59, 61, 63, 65, 67, 69, 71, 73, 75, 77, 79, and 81; Dixey Street; Scott Street; Southampton Terrace; Tent Street; Somerford Street (South side, 69 excluding Somerford Houses and Mission Hall); Collingwood Street (West side, excluding Delamere Dwellings); Cambridge Buildings (Darling Row); Lisbon Street Buildings; Foster Street; Merceron Street; Brady Street (East side, Nos. 82 to 140); James Yard; Holmes Avenue; Dagnall Place; Reuben Street; Tapp Street (Nos. 10, 12, and 14); Neath Place; Pereira Street; Colling Place; and Colling Street; and the Local Authority passed a resolution to the effect that they would not proceed with such scheme, and a copy of the official representation and the reasons of the Local Authority for not acting upon it have been sent to Us, the Local Government Board, as the Confirming Authority aforesaid for the purposes of Part I. of the Principal Act; And whereas in pursuance of Section 10 of the Principal Act We directed a Local Inquiry to be held by One of Our Inspectors, and a Report to be made to Us with respect to the correctness of the official representation and other matters connected therewith; And whereas, on the report made to Us by the said Inspector, We are satisfied that, subject as herein-after mentioned, a scheme or schemes ought to have been made by the Local Authority for the improvement of the area aforesaid or of some part thereof; Now therefore, in pursuance of the powers given to Us by the Statutes in that behalf, We hereby Order the Local Authority forthwith to make a scheme or schemes under Part II. of the Principal 70 Act for the improvement of the areas specified in the Schedule to this Order, and which respectively form part of the aforesaid area, and to do all things necessary under the Housing Acts for carrying into execution the scheme or schemes so made. Schedule. (a) The area comprising the houses situate on the south side of Scott Street, the houses in Dixie Street, and the houses numbered 53, 55, and 57 in Brady Street; (/)) The area comprising the houses numbered 12(3, 128, 130, 132, 134, 136, 138, and 140 in Brady Street, the houses numbered 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, and 28 in Somerford Street, the houses numbered 10, 12, and 14 in Tapp Street, and the houses numbered 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12-, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22. 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, and 36 in Neath Place, together with the two properties not numbered and situate respectively west of No. 2 and east of No. 36 Neath Place; (c) The area comprising all properties situate in Dagnall Place, Holmes Avenue, and James Yard, the houses numbered 82, 84, 86, 88, 90, 92, 94, 96, 98, 100, 102, 104, and 106, and the piece of land formerly the site of the house numbered 108, in Brady Street, the house numbered 1 in Merceron Street adjoining Number 82 Brady Street, and the houses numbered 2 and 3 in Merceron Street; 71 (d) The area comprising all properties situate in Pereira Street, Colling Place, and Colling Street, the house numbered 1 situated in Merceron Street at the rear of Numbers 41 and 43 Collingwood Street, the houses numbered 39, 67, 69, 71, 73, 75, 77, 79, 81, 83, 85, 87, 89, and 91 in Collingwood Street, and the houses numbered 45, 47, 49, 51, 53, 55, 57, 59, 61, and 63 in Neath Place; (e) The area comprising Foster Street and all pro- perties facing that street on its eastern side. Given under the Seal of Office of the Local Government Board, this Twenty-second day of September, in the year One thousand nine hundred and fourteen. Herbert Samuel, President. John Lithiby, Assistant Secretary. Upon the advice of the Town Clerk, it appeared to the Committee to be unnecessary for the Council to take any action upon the Order for the time being, and no further developments had occurred in the matter at December 31st. In view, however, of the desirability of bringing this matter as closely up to date as possbile, I append notes of happenings up to the time of going to press with this report. On February 23rd, 1915, the London County Council adopted reports on the subject of the area 72 presented by the Housing of the Working Classes Committee and the Finance Committee of that Authority. The report of the Housing of the Working Classes Committee, after briefly recapitulating the events relating to the area down to February 16th, 1913 (see Annual Report, 1913), reproduced the correspondence between that Authority and the Local Government Board as to the methods to be adopted in dealing with the area. Following this, the Local Government Board, on September 24th, 1914, made an Order, requiring the London County Council to forthwith make a scheme or schemes under Part II. of the Housing of the Working Classes Act, 1890, for the improvement of the areas specified in the Schedule to the Order (see ante). The European War had broken out previous to this, and subsequent to the making of the Order the London County Council communicated with the Local Government Board, referring to opinions expressed by the Chancellor of the Exchequer in a speech delivered on October 8th to representatives of the Association of Municipal Corporations, pointing out the desirability of strict limitation of Municipal capital expenditure. The Board stated in reply that " . . . . . . . .the London County Council would not be justified by anything in that speech if they delayed giving effect to the requirements of the Board's Order of September 22nd .... " The Housing of the Working Classes Committee noted the decision with regret, but felt it undesirable, in the existing circumstances, that the London County Council should enter into controversy with the Board. The Committee were of opinion that the operation 73 affecting the area should be effected under two distinct schemes, and that such schemes should in all the circumstances of the time be undertaken not simultaneously, but successively, so as to spread the cost of the operation and the displacement of the inhabitants over a long period. It is proposed to deal in the first scheme with the undermentioned property :— 1— 31 (odd numbers) 2—36 (even numbers) Neath Place. 45—63 (odd numbers) 10, 12, and 14, Tapp Street. 53, 55 and 57 82—106 and site of 108 (even numbers) 126—140 (even numbers) Brady Street 2—28 (even numbers) Somerford Street. 39, 89, 91, and 93 Collingwood Street. 2—24 (consecutive numbers) Dixie Street. 2—38 (even numbers) Scott Street. 1—25 (odd numbers) Dagnall Place. 4—20 (even numbers) la and 1—18 (consecutive numbers) Holmes Avenue. 1 and 2, James Yard. 1, 2, and 3, Merceron Street. The London County Council estimates the net cost of the first scheme, including acquisition of property, cost of roads, &<•., and allowing for estimated value of surplus land and re-housing sites, will be £46,800, and it is proposed that the expenditure shall be extended over a period of five years, the gross expenditure being 74 £53,000. The number of persons to be displaced by the first scheme would be 1,121, and the Housing of the Working Classes Committee propose to provide rehousing accommodation for 560 persons, at a further expenditure estimated at £20,800, for which at present no financial provision is made. As the scheme is to be undertaken under Part I1 of the Housing of the Working Classes Act, 1890, it is possible for the Borough Council either by agreement or compulsion to contribute towards the cost, but in view of the low rateable value of the Borough and the fact that the population largely follows miscellaneous industries, which may be especially hard pressed as a result of the war, the London County Council does not propose to press the Council to make any such contribution. The Report of the Finance Committee of the County Council submitted the estimate for the necessary expenditure of £53,000 (which does not include cost of re-housing), and stated that this expenditure is expected to fall approximately as follows :— 1915-16 £5,000 1916-17 £25,000 1917-18 £20,000 1918-19 £3,000 The Finance Committee stated that, on financial grounds, they were in complete accord with the view expressed by the Housing of the Working Classes Committee to the effect that the present was not an opportune time for embarking upon a new and large clearance 75 scheme, but remarked that the Order of the Local Government Board had deprived the County Council of any choice in the matter. It thus appeared that at last steps were actually about to be taken in regard to this long delayed improvement, but it was not to be, for on May 5th the Town Clerk informed the Public Health Committee that a report on the Agenda of the London County Council for that week showed that the Comptroller of the Council had been in communication with the Treasury on the subject of capital expenditure, and inter alia had mentioned the Brady Street area. In reply, the Treasury stated that in conformity with what was being done in other cases, work in connection with the scheme should not at present be proceeded with, as it entailed expenditure which could not be dealt with otherwise than by loan. There the matter at present rests. The plans in the appendix show (1) The area referred to in my official representation, and (2) The sections of the area referred to in the Order of the Local Government Board, which the London County Council propose to deal with in succession, and which are coloured pink and blue, respectively. THE STAFF AND THE WAR. Medical Officer of Health. Appointed by the Director-General of Medical Services as Sanitary Officer for the Borough of Bethnal Green, exercising supervision over billets and encampments, etc. 76 Chief Sanitary Inspector. Appointed as a member of the Executive Committee of the Bethnal Green Emergency Relief Committee. Chief Clerk. Appointed Honorary Clerk to the West Ward Committee of the Bethnal Green Emergency Relief Committee. Sanitary Inspector Henley. Appointed Almoner to the East Ward Committee of the B.G.E.R.C. Sanitary Inspector Richards. Appointed Almoner to the North Ward Committee of the B.G.E.R.C., and also acting since the beginning of December, 1914, to the end of March, 1915, as Hon. Clerk to the Committee. Sanitary Inspector Bare. Appointed Almoner to the West Ward Committee of the B.G.E.R.C. Sanitary Inspector Weeks. Appointed member of the South Ward Committee of the B.G.E.R.C. Sanitary Inspector Billings. Rejoined 1st London (City of London) Sanitary Company (T.). 77 Fourth Assistant Clerk Pendrill. Enlisted in the 4th Batt. Essex Regt. (T.). Health Visitor, Miss Hammond. Member of the Women's Workroom Sub-Committee since September 24th, 1914. Member of the Teachers' War Distress Committee since January 20th, 1915. From March 29th to present date also acting as Hon. Clerk to the Women's Workroom Sub-Committee. TEMPORARY APPOINTMENTS. General Assistant J. H. Hewitt.—Sanitary Inspector. Mrs. Hodgkins.—Health Visitor. Mr. Bagwell, Mr. Wiseman.—Assistant Clerks. Owing to the outbreak of the European War the work of the Public Health Department has been carried on under considerable disadvantages. One Sanitary Inspector and a Clerk joined the Army, and other members of the staff have been occupied part time on relief committees and other kindred work. Inspector Billings was recalled to the 1st London Sanitary Company, and Mr. Pendrill enlisted in the 4th Batt. of the Essex Regiment; Mr. Hewitt, my personal clerk, who holds the certificate of the Sanitary Inspectors' Board, was temporarily appointed in place of Mr. Billings, and two temporary assistant clerks were selected to fill the vacancies thus created. 78 It is obvious that new officers have much to learn before they can become as efficient as those they replace, but I am satisfied that every officer has done his utmost to make things work smoothly, and it gives me much pleasure to record my appreciation of the efforts of each and every one. My best thanks are due to my colleagues in all departments and to the members of the Public Health Committee for their unvarying kindness and cordial support. I have the honour to subscribe myself, Sir and Gentlemen, Your most obedient servant, GEORGE PADDOCK BATE. 79 SUMMARY OF WORK OF HEALTH VISITORS, 1914 Number of Birth Notifications, 3,491. Notifications were sent in by— Doctors 867 Midwives 1,167 London Hospital 1,134 Infirmary and Workhouse 37 Relatives 216 Outlying Institutions 53 Whom not stated 17 3,491 The mothers were attended at their confinements by:— Doctors in 1,062 cases. Midwives in 1,185 „ London Hospital Students and Nurses in 1,029 „ Whom not stated in 20 ,, Maternity assistants of the London Hospital 105 ,, Midwives in the Infirmary 37 ,, Midwives in other Institutions 53 ,, 3,491 cases. Forty-eight of the notifications were twin births, bringing the total of infants born up to 3,539. 80 Of these, 1,769 were males 1,765 were females 5 sex was not stated 3,539 There were 16 sets of male twins. ,, 13 ,, female twins. ,, 19 ,, male and female twins. Information as to whether the child is living or stillborn is not always given. This year it is given in the case of:— 35 stillborn boys. 35 stillborn girls. 3 sex not stated. 1 set of male and female twins. Of 1 set of male twins, 1 was living and 1 stillborn. Of 1 set of female twins, 1 was living and 1 stillborn, making a total of 77 stillborn infants. There were 143 cases of Summer Diarrhoea, all of which were visited. In the majority of cases the homes were clean and the premises were in fairly good condition. About 75 per cent, of the infants were breast-fed. 81 TOTAL VISITS FOR THE YEAR. Maternity Visits 2,463 Maternity Re-visits 631 Ophthalmia Neonatorum 68 Puerperal Septicæmia 9 Diarrhœa 143 Measles 268 School Complaints 251 Special Visits 338 Futile Visits 78 4,249 82 Metropolitan Borough of Bethnal Green. PUBLIC HEALTH DEPARTMENT. REPORT OF VISITS BY HEALTH VISITORS. Year ended 31st December, 1941. Births. Ophthalmia Neonatorum: Puerperal Fever. Measles. Diarrhœa. School Complaints. Cases reported to Inspectors. Visits of Special Character. Futile Visits, Total Visits for Year. Name. Notified Visits Revisits. Cases. Visits and Revisits. New cases. Visits. Reported. Visits. Reported. Visits. Reported. Visits. 3491 2153 537 29 48 9 9 116 116 128 128 153 153 6 338 - 3842 C. Hammond 310 94 7 20 - - 152 152 15 15 98 98 25 - 78 767 M.A.Hodgkins 3491 2463 631 36 68 9 9 268 268 143 143 251 251 31 338 4249 4249 — 83 TABLE I. Vital Statistics of Whole District during 1914 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 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 15·4 406 375 516 122·6 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 1914 127,662 3,609 3,786 29·6 2,113 16·5 434 368 519 137·0 2,047 16·0 Area of District, 759 acres. At census of 1911 Total Population (all ages) 128,282. Total families or separate occupiers, 27,755. 84 TABLE II. Cases of Infectious Disease notified during the Year 1914. Notifiable Disease. Number of cases Notified. Total Cases Notified in each Locality. (e.g., Parish orWard) of the District. Total Cases Removed to Hospital. At all Ages. Under 1. 1 and under 5 years. At Ages—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. Diphtheria (including Membranous Croup) 380 19 167 161 27 4 2 - 199 181 180 176 Erysipelas 304 9 15 16 57 108 79 20 165 139 — — Scarlet Fever 655 12 234 368 33 8 — — 239 416 229 399 Typhus Fever — — — — — — — — — — — — Enteric Fever 18 — 2 5 4 5 2 — 9 9 9 9 Relapsing Fever (R) Continued Fever (C) - - _ _ - - Puerperal Fever 9 — - — 1 8 - — 2 7 6 Cerebro-spinal Meningitis 2 1 1 - - — 2 2 Poliomyelitis 7 1 5 1 — - - — 4 3 1 2 Ophthalmia Neonatorum 39 39 - - - - - 23 16 3 _ Pulmonary Tuberculosis 347 11 12 23 72 149 75 5 160 187 — - Other forms of Tuberculosis 120 3 20 61 22 11 3 - 51 69 — — Totals 1,881 95 455 636 216 293 161 25 854 1027 424 592 [Total, 1,016 85 TABLE 11a. Public Health (Tuberculosis) Regulations, 1912. Summary of Notifications received during the year 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 previously notified by other doctors). Primary Notifications. Total Notifications (i.e. including notifications by other doctors). Poor Law Institutions. Sanatoria. 0 to 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 to 10 10 to 15 Total Pulmonary— Males 7 8 4 4 20 19 45 43 33 15 3 201 260 - — 1 1 2 148 71 Females 4 4 3 9 15 18 36 25 19 8 2 143 176 — 2 — 2 2 50 28 Non-pulmonary— Males 2 14 18 17 5 2 2 2 2 — — 64 76 1 5 1 7 11 13 6 Females 1 5 8 9 11 4 6 1 1 — — 46 52 — 1 2 3 5 10 8 Totals 14 31 33 39 51 43 89 71 55 23 5 454 564 1 8 4 13 20 221 113 86 TABLE III. Causes of, and Ages at, Death during the Year 1914. Causes of Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the district. Total Deaths whether of Residents or Non residents in Institutions 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. 1 2 3 4 5 6 7 8 9 10 11 Enteric Fever 4 — — — 1 2 1 — — Small Pox — — — — — — — — — - Measles 70 21 26 20 1 2 — — — 38 Scarlet Fever 7 1 1 1 3 1 — — — — Whooping Cough 48 24 11 12 1 — — — — 18 Diphtheria and Croup 28 5 6 7 9 1 — — — 8 Influenza 10 1 — — — 1 2 4 2 - Erysipelas 13 1 — — — 1 4 5 2 14 Phthisis (Pulmonary Tuberculosis) 210 4 4 32 99 66 5 192 Tuberculous Meningitis 26 3 3 9 9 2 — — — 30 Other Tuberculous Diseases 41 11 3 9 3 3 5 6 1 53 Cancer, malignant disease 115 — — 1 — 4 16 49 45 56 Rheumatic Fever 9 — — — 5 — 1 1 2 4 Meningitis 5 3 — 2 — —- —■ — .— 3 Organic Heart Disease 201 — 2 2 9 18 35 57 78 126 Bronchitis 188 35 8 1 1 1 9 55 78 78 Pneumonia (all forms) 220 53 33 27 11 6 24 38 28 125 Other diseases of Respiratory organs 13 2 3 — 1 — 2 3 2 13 Diarrhoea and Enteritis ... 173 141 32 — — — — — — 146- Appendicitis and Typhlitis 9 — —- — 4 3 1 1 — 1 Cirrhosis of Liver 21 3 15 3 11 Alcoholism 5 2 3 — l Nephritis&Bright's Disease 54 — — — 2 1 10 29 12 50 Puerperal Fever ... 2 2 — Other accidents and diseases of Pregnancy and Parturition 4 2 2 1 Congenital Debility and Malformation, including Premature Birth 135 132 3 70 Violent Deaths, excluding Suicide 93 26 2 6 15 5 8 15 16 36 Suicide 12 — — — — 1 4 5 2 — Other Defined Diseases ... 211 42 3 4 5 5 25 57 69 116 Diseases ill-defined or unknown 89 27 5 2 — 1 5 7 42 35 Other Septic Diseases 31 6 — 3 4 1 3 8 6 26 Totals 2047 534 138 113 87 92 264 425 393 1251 Subentries included in above figures- ' Cerebro - spinal Meningitis 5 3 2 3 ( Polio - myelitis... 2 1 1 1 87 TABLE IV. Whole District. Infantile Mortality during the Year 1914. 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 - - - - Cbicken-pox - - - - — - Measles - - - - — 3 2 4 7 16 Scarlet fever - - - - — - 1 - 1 Whooping Cough - - - 2 7 5 5 18 Diphtheria and Croup - 1 - 1 4 6 Erysipelas - - - 1 1 - 1 - 2 Tuberculous Meningitis - - - - - 2 Abdominal Tuberculosis - - - - - - 1 1 — 2 Other Tuberculous Diseases - - - - — — 1 1 4 6 Meningitis (not tuberculous) - - 1 3 3 1 8 Convulsions 5 2 2 1 10 4 3 6 2 25 Laryngitis — — — - - - 1 - - 1 Bronchitis 1 1 — 1 3 12 12 4 4 35 Pneumonia 1 1 1 3 9 13 14 12 51 Di irrhosa — — — - - 9 34 14 13 51 70 Enteritis — 1 1 - 2 8 32 15 10 68 Gastritis — 2 2 1 4 2 - 9 Syphilis 2 1 1 4 2 3 - 9 Rickets — — — - — — — 1 — 1 Suffocation, overlying 3 1 — 3 7 6 10 1 — 24 Injury at birth 3 — — 1 4 4 Atelectasis 14 1 1 1 17 1 — — — 18 Congenital Malformations 9 2 2 — 13 3 3 — — 19 Premature birth 40 6 6 2 54 7 — — — 61 Atrophy, Debility and Marasmus 3 4 4 4 15 12 11 8 1 47 Other Causes 2 3 1 1 7 4 2 3 - 16 Totals 83 23 19 17 142 85 142 87 63 519 Nett Births in the year 3,786. Nett Deaths in the year (Infants) 519. 88 TABLE IV. (a). North-East Betiinai. Green. Infantile Mortality during the Year 1914. 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 — 3 1 1 5 10 Scarlet Fever - - 1 - 1 Whooping Cough — - — 2 4 2 3 11 Diphtheria and Croup — — — 1 - 1 - 2 Erysipelas — - — 1 1 - 1 2 Tuberculous Meningitis — - — — 1 1 Abdominal Tuberculosis - - - - 1 1 - 2 Other Tuberculous Diseases - - - - - - 1 2 3 Meningitis (not Tuberculous) — - — — - 2 2 1 5 Convulsions 2 - — 2 1 - 4 1 8 Laryngitis — — - - 1 - - 1 Bronchitis 1 1 2 7 4 4 2 19 Pneumonia (all forms) 1 - — — 1 4 4 6 6 21 Diarrhoea — 7 14 7 6 34 Enteritis — 1 — - 1 5 13 8 6 33 Gastritis — - - 1 2 1 - 4 Syphilis 2 - 1 1 4 1 - - 5 Rickets — _ - - - Suffocation, overlying 2 - — 1 3 3 9 - 15 Injury at birth 3 - — 1 4 — 4 Atelectasis 2 - — 1 3 - 3 Congenital Malformations 5 1 — 6 1 2 9 Premature birth 19 3 5 27 4 - 31 Atrophy, Debility and Marasmus 3 2 3 1 9 2 8 5 - 25 Other Causes 2 2 1 - 5 1 — 1 7 Totals 42 9 10 7 68 43 65 47 33 256 Nett Births in Sub-District 1,889 (est.). Nett Infantile Deaths in Sub-District 256. 89 TABLE IV. (b) South-West Bethnal. Green. Infantiie Mortality diking the Year 1914. 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 - - - - - - 1 3 2 6 Scarlet fever - - - - - — - - - — Whooping-cough - - - - - - 3 2 2 7 Diphtheria an d Croup - - - - - - - - - 4 Erysipelas - - - — — — — - - — Tuberculous Meningitis - - - - - - - 1 - 1 Abdominal Tuberculosis - - - - - - - - - - Other Tuberculous Diseases - - - - - - 1 — 2 3 Meningitis (not tuberculous) - - - - - 1 1 1 — 3 Convulsions 3 2 2 1 8 3 3 2 1 17 Laryngitis — — - — — — — — — Bronchitis — 1 - — 1 5 8 — 2 16 Pneumonia (all forms) — — 1 1 2 5 9 8 6 30 Diarrhoea — — - — — 2 20 7 7 36 Enteritis — — 1 — 1 3 19 8 4 35 Gastritis — 2 — — 2 — 2 1 — 5 Syphilis - - - - - 1 3 — — 4 Rickets — — — — — — — 1 — 1 Suffocation, overlying 1 1 — 2 4 3 1 1 — 9 Injury at birth — — — — — — — — — — Atelectasis 12 1 1 — 14 1 — — — 15 Congenital Malformations (d] 4 1 2 — 7 2 1 — — 10 Premature birth 21 3 1 2 27 3 — — — 30 Atrophy, Debility and Marasmus - 2 1 3 6 10 3 3 — 22 Other Causes — 1 — 1 2 3 2 2 - 9 Totals 41 14 9 10 74 42 77 40 30 263 Nett Births in Sub-District 1,897 (est.). Nett Infantile Deaths in Sub-District 263. 90 TABLE V. Showing the number of Deaths from the seven principal Zymotic Diseases, inclusive of Hospital Deaths in the 10 years 1904 to 1913 and in the year 1914. Disease. 1904. 1905. 1906. 1907 1908. 1909. 1910. 1911. 1912. 1913. Annual Average of lOyrs. 1904 -1913. 1914 Small Pox 8 — — — — — — — — 0.8 — Measles 89 48 60 71 105 78 58 128 90 59 79 70 Scarlet Fever 18 27 22 43 39 25 9 6 2 3 19 7 Diphtheria 48 31 20 18 29 20 20 5 15 11 22 28 Whooping Cough 44 50 63 53 42 37 34 44 28 30 42 48 Fever 7 9 14 7 13 4 18 3 3 4 8 4 Diarrhoea (and Enteritis after 1910) under 2 years 147 119 152 59 102 90 43 230 48 145 114 173 Totals 361 284 331 251 330 254 182 416 186 252 285 330 91 Administration of the Factory and Workshop Act, 1901, in connection with FACTORIES, WORKSHOPS, WORKPLACES & HOMEWORK. 1.—Inspection of Factories, Workshops and Workplaces. Premises. Inspections. Number of Written Notices. Prosecutions. Factories (Including Factor Laundries) 206 23 - workshops (Including Workshop Laundries) 4,958 1.268 - workplaces (Other than Outworkers' premises (Included in Part 3 of this Report) 868 29 - Total 6,032 1,320 - 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 850 850 — — Want of ventilation 50 50 — — Overcrowding 6 6 — — Want of drainage of floors 6 6 — • — Other nuisances 1,116 1,116 — — Sanitary (insufficient unsuitable or defective accommodation not separate for sexes 19 19 — — 726 726 — 7 7 — — Offences under the Factory and Workshop Acts :— Illegal occupation of underground bakehouse (s. 101) Bieach of special sanitary requirements for bakehouset (ss. 97 to 100) — — - — Other offences (Excluding offences relating to outwork which are included in Part 3 of Report) - - - 2,780 2,780 - — 92 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 1760 9 86 2 - 320 534 - - - - Furniture and upholstery 10 69 1 18 — — 38 50 - — - — Umbrellas, &c 4 14 — — — — 18 31 - — - — Racquet and Tennis Balls — — 1 7 — — 1 1 - — - — Paper, &c., boxes, paper bags 26 432 2 18 — — 147 239 - — - — Brush making 6 537 — — — — 34 60 - — - — Carding, &e., of buttons, &c. 2 17 — — — — 1 2 - — - — Textile weaving 2 37 — — — — 14 23 - — — — TOTAL 184 2866 13 129 2 — 573 940 - — — — 4.—Registered Workshops. Workshops on the Register (s. 131) at the end of the year. Number. Workshops, including Laundries 2,244 Food Premises 210 Bakehouses 89 Total number of Woikshops on Register 2,543 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) 10 Action taken in matters referred by/Notified by H.M..Inspector 241 H.M. Inspector as remediable under the Public Health Acts, but not under Reports (of action taken) the Factory and W orkshop Actls. 5) sent to H.M. Inspector 237 Other 4 Underground Bakehouses (s. 101)— Certificates granted during the year In use at the end of the year 26 93 METROPOLITAN BOROUGH OF BETHNAL GREEN. STREET LIST. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases General Diseases Total. Name of Street. Zymotic Diseases Tubercular Diseases. Respiratory Diseases. General Diseases. -Total. Abbey street 1 2 ... 4 7 Bonner street 1 ... 2 2 5 Abingdon buildings ... 1 1 1 3 Bonwell street 1 ... 2 2 5 Abingdon street ... 1 ... ... 1 Boreham street ... 1 ... 1 2 Ada place 1 ... 1 1 3 Boundary street 1 ... 1 1 3 Ainsley street ... ... ... 2 2 4 Brady's buildings ... 1 1 1 3 Albert buildings ... ... ... ... ... Brady street ... 3 1 3 7 Albion place ... ... ... ... ... Braemar street 1 ... ... 1 2 Alfred place ... ... 1 ... 2 Bratley street ... ... ... ... ... Allas road ... 1 1 2 4 Brick lane 1 ... 7 6 14 Alma road ... 2 1 4 7 Brierley street 1 1 3 5 10 Ames street 2 1 2 4 9 Bucks court ... ... 1 ... 1 Angela gardens ... ... ... 1 1 Buckhurst street 1 ... 1 6 8 Anglesea street 1 ... ... 2 4 Bullards place ... 1 ... ... 1 Anns place ... ... ... ... ... Bunsen street ... ... ... ... ... Approach road ... 1 ... 2 3 Burgoyne road 1 ... ... ... 1 Arbery road ... 3 2 3 7 Burnham square ... ... ... ... ... (Except Nos. 74 and 76) Burnside street ... 2 1 ... 3 Busby square ... ... 1 ... 1 Archer street ... ... ... ... ... Busby street ... 3 2 4 9 Arline street ... ... 1 ... 4 Butler's buildings 1 ... ... ... 1 Artillery street ... ... 1 1 2 Butler street 2 1 ... 3 6 Ash well road ... ... ... 1 1 Buxton street ... ... ... 1 1 Auckland road 1 1 1 5 8 (Odd Nos. 1 to 33 Even Nos. 2 to 10) Austin road ... ... 3 3 6 Bacon street 1 ... 3 3 7 Cadell street 1 2 3 ... 6 Baker's court ... ... ... ... ... Calvert avenue ... ... ... ... ... Baker's rents ... ... ... ... ... Cambridge bldgs ... 2 2 3 7 Baker street ... 1 ... ... 1 Cambridge circus 1 ... ... 1 2 Bandon road 1 2 2 2 7 Cambridge road 3 ... 2 12 14 Barnet grove 2 1 2 2 7 (All Odd Nos. and Even Nos. from 160) Barnsley houses 1 ... 1 2 4 Barnsley street 2 1 3 2 8 Cambridge street ... ... ... ... ... Baroness road 1 2 6 5 14 Camden street 1 ... 1 6 8 Bath grove ... ... 1 2 3 Camlet street ... ... ... ... ... Bath street ... ... ... ... ... Canrobert street 2 3 6 9 20 Baxendale street ... 2 1 4 ... Carlisle street 1 ... ... ... 1 Bellhaven street 1 ... ... 1 2 Carmel house ... ... ... 2 2 Benson buildings ... ... ... ... ... Carter street ... ... ... ... ... Bessy street ... ... ... ... 1 Casket street ... ... ... 1 1 Bethnal Green road 3 1 5 10 19 Caslon place ... ... ... 1 1 Birkbeck street ... ... ... 3 3 Catherine street ... 1 ... ... 1 Bishops road ... ... 4 4 8 Centre street ... ... ... 1 1 Blyth street ... ... ... ... ... Chambord street ... 1 ... 4 5 Bonner road ... ... 4 4 11 Chance street ... ... ... ... ... 94 STREET LIST—continued. Name of Street. Zymotic Diseases, Tubercular Diseases. Respiratory Diseases. General Disea-es. Total. Name of Stret t. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. Genet al Diseases. Total. Chanel street 1 ... 2 3 6 Dagnall place ... ... ... 1 1 Charles terrace ... ... 1 1 2 Daniel street 1 ... ... 2 3 Charlotte street 1 1 1 5 8 Darling row ... 1 ... ... 1 Chertsey buildings ... ... ... ... ... Davis place ... ... 1 ... 1 Cheshire street ... 3 2 4 9 Davis buildings ... ... ... ... ... Chester street 1 ... 1 ... 2 Delamere dwellings ... ... ... ... ... Chilton street 1 ... 2 3 6 Delta street 2 ... ... ... 2 Chisenhale road 2 1 3 5 11 Derbyshire street 1 ... 5 1 9 Church row ... 1 2 1 4 Digby street ... ... ... 2 2 Church street 2 ... 3 1 6 Digby walk 2 ... ... ... 2 (Except EvenNos. from '2 to 26) Dinmont street 1 2 4 ... 7 Diss street 1 ... ... 3 4 Clare street 3 1 2 1 7 Dixie street 2 1 1 3 7 Claremont street Driffield road (Odd numbers) ... 1 2 3 6 Clarence street ... 2 1 1 4 Clarkson street ... 4 ... 4 8 Ducal stree: ... ... 1 1 2 Clifton buildings ... ... ... ... ... Durant street ... ... ... 2 2 Club row " ... ... ... ... ... Coate street, 1 ... 2 4 7 Code street 2 1 ... 3 6 Colling place ... ... ... 1 1 Colling street ... ... ... ... ... Eastman street ... 1 1 3 5 Collingwood street 1 2 2 4 9 Ebor street • Even Nos only) ... ... 1 ... 1 Collyer's court ... ... ... 1 1 Columbia market ... ... ... ... ... Eckersley street 1 ... ... 1 2 Columbia road 1 ... 3 8 12 Edgar place 1 ... ... ... ... Columbia square 3 3 2 5 13 Edward place ... ... ... ... ... Conyer street ... ... ... ... ... Ellesmere road 2 2 1 3 8 Conkham buildings ... 1 2 1 4 Elwin street ... ... 3 5 8 Co operative b'ld'gs ... ... ... ... ... Emma street 3 2 ... 5 10 Cooper's gardens 1 l 1 2 5 Ernest place ... 1 ... 1 2 Cordova road 1 3 2 3 9 Evesham houses ... ... ... ... ... Corfield street 3 6 1 19 29 Ezra street ... ... ... ... 2 Cottage place ... ... ... ... ... Coventry place ... ... ... ... ... Coventry street 7 ... 5 4 19 Cox's buildings ... ... ... ... ... Cranbrook road 1 ... ... 1 2 Falcon buildings ... 1 ... ... 1 Cranbrook street 1 4 2 3 10 Felix street 4 2 2 4 12 Craven buildings ... ... 1 1 2 Fellbrigg street 1 3 1 5 10 Crescent cottages ... ... ... ... ... Finnis street ... 1 ... 6 7 Crescent place 1 1 4 3 9 Fleet street hill ... ... ... 1 1 Cross street ... ... ... ... ... Flint court 1 ... ... ... 1 Crossland square ... l 1 ... 2 Florida street 1 ... 1 4 6 Cud worth street ... 2 1 4 9 Florida terrace ... ... ... ... ... Culham buildings ... ... ... 1 1 Fossett's buildings ... ... ... ... ... Cygnet street ... ... 1 ... 1 Foster street 1 1 ... 1 3 Cymon street ... 1 ... 5 6 Fountain street ... ... ... ... ... Cyprus street ... 3 5 7 15 Fox street ... 1 2 ... 3 95 STREET LIST—continued. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiatory Diseases. General Diseases. Total. Name of Street, Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Fox's buildings ... ... ... ... ... Hare court ... ... ... ... ... Fuller street ... 1 4 5 10 Hare marsh ... ... ... 1 1 Hare street 1 ... 4 1 6 Gales Gardens 7 1 4 6 18 Harold street 1 1 ... 2 4 Hartley street ... 1 1 3 5 Garden place ... ... 1 ... 1 Hassard place ... ... ... ... ... Violet street Garden place ... ... ... ... ... Hassard street ... ... 1 4 5 Havelock place 1 ... ... 2 3. James street Gardeners road ... ... 4 1 5 Hemming street 1 2 1 2 6 Hedsor buildings ... 3 ... 1 4 Garner street 3 ... ... 5 8 Helens place ... ... 1 ... 1 Gascoigne place ... ... ... 1 1 Henley buildings ... ... ... 1 1 Gawber street 1 ... ... ... 1 Henrietta street ... ... 2 4 6 George place ... ... ... ... ... Hereford buildings ... ... ... ... ... Goorgina gardens ... ... ... 1 1 Hereford street ... ... 2 4 6 Gernon road ... ... 1 1 2 Hersee place 1. ... ... 4 5 Gibraltar buildings ... ... ... ... ... Hocker street ... ... ... ... ... Gibraltar gardens 1 ... 1 ... 2 Holly Mansions ... ... ... ... ... Gibraltar walk 2 ... 2 4 8 Hollybush gardens 2: 2 3 4 11 Gilman street ... 1 ... 2 3 Hollybush place ... ... ... ... ... Glass street 1 ... ... 1 2 Holmes avenue 2 2 4 1 9' Globe road 1 1 3 10 15 Horatio street ... ... 2 2 4 ( Even Nos. from 156 Odd f rom 131) Horts place ... ... ... ... ... Hunslett street ... 1 5 ... 6 Gloucester passage ... ... ... ... ... Huntingdon bldgs. ... 1 1 1 3 Goldsmith's row ... ... ... ... ... Hurley buildings ... ... 1 ... 1 (Children's Hospital & Nos. 8 to62 Even) Gossett street ... 1 3 2 6 Granby place ... ... ... ... ... Iffley buildings ... ... ... ... ... Granby street 1 1 3 2 7 Ion square 1 2 ... 3 6 ... Gt. Eastern bldgs. ... Ivimey street ... 1 2 2 5. Green street 3 5 4 13 25 G'etton houses 5 1 4 7 17 Griinsbv street ... 1 ... ... 1 James court ... ... ... ... .... Grove road (Odd Nos. from 59 Even Nos. from 110) 3 4 4 9 20 James place ... ... ... 1 1 Jaines street (Odd Nos. from 3D Even from No. 4) ... ... 1 1 2 Guinness' buildings 3 3 1 8 15 Jersey street ... ... ... 5 5 Hackney road 3 5 6 16 30 (All Even Nos. and Kay street 2 1 2 6 11 Odd Nos. from 323) (Nos. S to 53 odd) Hague buildings ... 1 ... 1 2 Kelsey street ... ... ... ... ... Hague place ... ... ... 1 1 Kenilworth road ... ... 2 3 5 Hague street ... 1 1 2 4 Kerbela street 2 1 3 3 9 Hammond's gardens i... ... ... 1 1 Kirkwall place 2 1 ... 1 4 Hamilton road ... ... 1 5 6 Kite place ... 1 1 2 4 96 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 ... ... 1 2 Minerva street ... ... ... 9 9 Minto place ... ... 1 1 2 Mocatta house ... ... ... ... ... Laleham buildings ... ... ... 1 1 Molesey buildings ... 2 ... ... 2 Lansdell place ... ... ... 1 1 Montclare street ... ... ... ... ... Lark row ... 1 ... ... 1 Montfort house ... ... ... ... ... Lawfranc road ... ... 1 1 2 Moravian street ... ... ... 2 2 Leopold buildings ... ... ... 1 4 Morpeth street 1 1 2 6 10 Leslie house 1 ... ... 1 2 Moss street 1 2 3 5 11 Letchford buildings ... ... ... ... ... Mount street 1 ... 2 2 5 Lessada street 1 ... 1 1 3 Mowlem street 1 1 ... 1 3 Ligonier street ... ... ... ... ... Museum buildings ... ... 1 ... 1 Lily house ... ... ... ... ... Linden buildings ... ... ... 2 4 Lisbon buildings 2 1 ... 1 4 Nant street 1 2 ... 1 4 Lisbon street • •• ... ... 1 1 Navarre street ... ... ... ... ... London street 1 1 1 2 5 Neath place 1 1 1 3 6 Lucas street ... ... ... ... ... Nelson place ... ... ... 2 2 Lyal road (Nos. 57u, and 58 to 88 Consecutive Nos.) 1 ... ... ... 1 Nelson street ... 1 ... 1 2 New Church street ... 1 ... 1 2 Newling street ... ... ... ... ... Lyte street l ... 1 1 3 New Tyssen street 1 ... ... 2 3 Norah street 1 ... 1 4 6 Northampton street ... 2 3 3 8 Mace street 3 ... 1 3 7 Nortron street ... ... 1 2 3 Manchester bldgs ... ... 1 ... 1 Manchester place ... ... ... ... ... Mansford buildings 1 2 2 4 9 Octagon street ... ... 1 ... 1 Mansford street ... 2 2 9 13 Old Bethnal Green road 1 1 3 1 6 Map street 1 1 2 6 10 Margaret place ... ... 2 ... 2 Old Ford road (Odd Nos. to 205, Even Nos. to 363) 2 2 11 23 38 Marian place ... ... ... ... ... Marian square l ... ... ... 1 Marian street l ... 1 ... 2 Old Nicol street ... ... ... ... ... Mariow buildings ... ... ... 1 1 Olga street ::: ... ... 3 3 Martha court ... 1 ... 1 2 Orange street 2 ... 1 8 12 Matilda street 3 ... 3 2 8 Oval 2 1 ... 1 4 Meadows dwellings 1 ... 1 5 7 Medhurst road ... ... 1 2 3 Medway buildings ... ... ... ... ... Palissy street ... ... ... ... ... Medway road {Odd Nos. 3 to 49, Even Nos. 2 to 62) ... 1 3 2 6 Palm street ... 1 3 5 9 Palmer's road ... ... ... ... ... Paradise row ... 1 ... ... 1 Memorial Hall bgs. ... ... ... ... ... Parliament place ... ... ... 2 2 Mendip houses ... ... ... 4 4 Parliament street ... ... ... ... ... Menotti street 1 1 2 5 9 Parmiter houses ... ... ... ... ... Merceron houses ... ... ... 2 2 Parmiter street ... 1 1 1 3 Mercer on street ... ... ... ... ... Patriot square ... 1 ... ... 1 Middleton street ... 2 ... 2 4 Peabody buildings 1 ... 3 4 8 97 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 .... .... .... 1 1 Roan horse yard .... .... .... .... .... Peacock street .... .... .... .... .... Robert street .... .... 1 1 2 Pearl yard .... .... .... .... .... Robinson road .... .... 2 l 3 Peary place i .... .... 1 2 Rochelle street .... .... .... .... .... Pedley street .... 1 4 3 8 Roman road (Odd Nos. to 127 Even Nos. to 142) 2 .... 1 7 10 Peel grove 1 .... .... 1 2 Peel grove mews .... .... .... .... .... Pelter street 2 .... .... 3 5 Pereira street .... 1 1 2 4 Peter street .... .... 2 1 3 Rooks place .... .... .... .... .... Pollard place .... .... .... .... .... Ropley street .... .... .... 1 1 Pollard row 3 .... .... 1 4 Ross building Moss street ... ... ... 3 4 Pollard street 2 1 1 3 7 Portman place .... .... .... 2 2 Royal Victor place .... .... .... .... .... Pott street 2 2 1 2 7 Royston street 2 2 1 10 15 Poyser street 2 1 3 1 7 Russia lane 3 3 3 1 10 Preston street 1 1 3 2 7 Primroso street 1 ... .... .... 1 Princes court 1 .... .... .... 1 Pritchard's road 3 2 3 1 9 Sabbage yard Sale street .... 1 5 8 14 Except Nos. 57 to 117) Sandford buildings .... .... .... .... .... Satchwell rents 2 1 2 .... 5 Prospect terrace 2 1 .... 1 4 Satchwrll street 2 1 2 .... 5 Providence place 1 .... ... 1 2 Sclater street 1 .... 9. 1 5 Providence yard .... .. ... ... Scott street 1 1 4 2 8 Punderson gardens 7 ... 5 2 14 Seabright street 2 3 4 4 13 Selby street (Even Nos.) ... ... ... 4 4 Queen's buildings Princes Place ... ... ... ... ... Sewnrdstone road 1 1 ... 8 10 Shacklewell street ... ... ... ... ... Queen's buildings Gossett street ... ... ... J ... Sheldon place ... ... ... ... ... Shetland street 2 ... ... ... 2 Queen's buildings Chambord street ... ... 1 ... 1 Shepton houses ... ... 2 3 5 Shiplake buildings ... ... 1 2 3 Qu'n Caroline place 1 ... 1 ... 2 Shipton street ... ... 5 4 9 Quilter street 1 3 2 4 10 Skinners court ... ... ... ... ... Quinns square 6 ... 4 14 24 Sidney street ... ... 5 1 6 Smart street ... 1 1 ... 2 Smiths buildings ... ... ... 2 2 Railway arches ... ... ... ... ... Somerford houses ... ... ... 2 3 Ramsey street ... ... 1 3 4 Somerford street ... 3 3 1 7 Rapley place ... ... ... ... ... Sonning buildings ... 1 ... 1 2 Ravenscroft bldgs. 7 4 2 2 15 S'hampton cottages ... ... ... ... ... Ravenscroft street 1 ... 1 5 7 Southampton place ... ... ... ... ... Reid's mansions Gossett street ... ... ... 1 1 Southampton street ... ... ... 2 2 Southampton terr. 1 ... ... ... 1 Reuben street 1 ... ... 1 2 Spencer passage ... ... ... ... ... Riders buildings ... ... ... ... ... Spicer buildings ... ... ... 1 1 98 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. Spital street (Nos. 11 to 27) ... ... ... 1 1 Turin street ... ... 4 4 8 Turville street ... ... 1 1 2 Squirries street 2 ... ... 3 5 Tuscan street ... 1 ... 3 4 St. Andrews street ... ... ... ... ... Type street ... ... ... 2 2 St. James road ... ... ... ... ... Tyrrell street 1 1 ... 2 4 St. Jude street ... ... 1 1 2 St. Mark's bldgs. Tagg street ... 1 ... ... 1 Usk street ... 1 3 5 9 St. Mary's place ... ... ... ... ... St. Matthias place ... ... ... ... ... St. Peter square ... ... 1 ... 1 St. Peter street 2 3 2 5 12 Vallance road 1 1 ... 6 8 Stainsbury street 1 ... 1 1 2 Venice street 2 1 1 ... 4, Stamp place 1 2 ... ... 3 Viaduct place ... ... ... 1 1 Stanfield road (" Stoneleigh" House & Gateway adjoining) ... ... ... ... ... Viaduct street 2 1 1 6 10' Victoria park ... ... ... ... ... Victoria place ... ... ... ... ... Steels buildings ... ... ... ... ... Victoria place ... ... ... 2 2- Strahan road (Odd Nos.) ... ... ... 4 4 James street Victoria Park sq. ... ... 3 2 5- Streatley buildings 1 ... ... 1 2 Violet row 1 ... ... ... 1 Stroud place ... ... ... ... ... Violet street ... ... ... ... ... Sugar Loaf walk ... ... ... 1 1 Virginia road ... ... ... 6 6 Sunbury buildings 1 1 1 ... 3 Vivian road 1 ... 1 1 3 Surat street 3 1 4 2 10 Voss street ... ... 1 1 2 Sutton buildings ... ... 2 3 5 Vyner street 2 1 ... 5 8 Sweet Apple square ... ... 1 1 2 Tagg street 1 1 1 3 6 Wadeson street 3 ... 2 3 8 Taplow buildings ... ... ... ... ... Walter street 1 ... 5 3 9 Tapp street ... ... ... ... ... Walton buildings ... ... ... 2 2 Tavistock street ... ... 1 ... 1 Wargrave bldgs. ... ... ... 3 3 Teale street ... 1 ... ... 1 Warley street 5 ... 6 3 14 Teesdale street 2 1 3 5 11 Warner place ... l 5 4 10 Temple dwellings 1 ... ... 1 2 Waterloo place ... ... ... ... ... Temple street 1 3 4 3 11 Waterloo road 2 l ... ... 8 Tent street 1 1 3 2 7 Waterloo terrace 1 ... ... ... 1 Thorold street 2 1 3 2 8 Wear street ... ... ... ... ... Thoydon road ... ... 1 3 4 Weaver street (Odd Nos ) ... ... 4 1 5 Three Colt corner ... ... ... ... ... Three Colt lane. ... ... 4 2 6 Weldon street ... ... ... ... ... Thurlow place ... ... ... 3 3 Wellington place ... ... ... ... ... Totty street 2 ... 1 5 8 Wellington row 2 3 4 5 14 Toyes buildings ... ... ... ... ... Wennington road 2 ... 2 ... 4 Old B'thnal G'n r'd Wharf road ... ... ... 1 1 Toyes buildings Mansford stree ... ... 2 3 5 Wharncliffe street 2 1 ... ... 3 Wheeler street ... ... ... ... ... Treadway street 8 ... 2 1 11 Whitby street 1 1 1 1 4 99 STREET LIST—continued. Name of Street. Zymotic Diseases. Tubercular Diseases. Reppiratory Diseases. General Diseases. Total. Name of Street. Zymotic Diseases. Tubercular Diseases. Respiratory Diseases. General Diseases. Total. Whites court ... ... ... ... ... Winchester cr'sc'nt 1 ... ... 1 2 Whitechapel road (Odd Nos from 319 ... ... ... 1 1 Winchester place 2 ... ... ... 2 Winchester street ... 1 1 2 4 Whitmore buildings ... ... ... ... ... Wolverley passage ... ... ... ... ... Wilmot house ... ... 2 ... 2 Wolverley street 1 2 ... 3 6 Wilmot street ... ... 1 9 11 Wood close ... ... ... ... ... Wimbolt street ... ... ... 1 1 Wood street ... ... 2 1 3 Wingham street ... ... l ... 1 Winchester bldgs ... ... ... ... ... No Home 1 11 1 16 29 Metropolitan Borough of Bethnal Green. PUBLIC HEALTH DEPARTMENT Summary of Replies to enquiries as to arrangements obtaining in Metropolitan Boroughs and Cities in regard to:- (1) TUBERCULOSIS DISPENSARIES. (2) SCHOOLS FOR MOTHERS. (3) MATERNITY AND CHILD WELFARE CENTRES. APRIL, 1915. Synopsis. No. of Boroughs with Dispensaries in operation 18 Average annual attendance of Patients per 1000 population 8.9 (On this figure Bethnal Green = 1136 attendances per annum). Average annual No. of attendances per patient 12.5 No. of Boroughs with Municipal Maternity Schemes in entire or partial operation 11 London: J. S. Forsaith & Son, Printers, 329, Bethnal Green Road. 1915. MUNICIPAL TUBERCULOSIS DISPENSARIES AND MATERNITY AND INFANT WELFARE ORGANISATIONS. Population ADiMINISTRATION, ESTABLISHMENT, &c. Battersea. 167,338 Bermondsey. 124,213 Camberwell. 264,176 Chelsea. 67,400 Deptford. 109,182 Finsbury. 84,000 Fulham. 156,000 Greenwich. 96,015 Hackney. 223,716 Hammersmith. 124,750 Hampstead. 86,731 Holborn. 49,357 Islington. 324,764 Kensington. 172,317 Lambeth. 296,724 Lewisham. 172,433 London, City of. 17,129 Paddington. 141,946. Poplar. 160,222 St. Marylebone. 118,211 St. Pancras. 218,387 Shoreditch 111,390 Southwark. 186,941 Stepney. 279,804 Store Newington. 50,511 Wandsworth 333,154 Westminster. 152,346 /Woolwich 128,556 1. Is there, in your Borough, a Dispensary established in accordance with the National Insurance Act and the Orders and Memoranda of the Local Government Board ? if so, There is a Volun tary Tuberculosis Dispensary in the Borough temporarily approved by the Local Government Board, but no scheme has yet been arranged with the Local Government Board, and the matter is still under consideration. Yes. Yes. A scheme will shortly be adopted for a Tuberculosis Dispensary for Chelsea in connection with the Brompton Hospital for Consumption. One of the junior visiting staff of Physicians will be appointed by the Hospital as Tuberculosis Officer, and he will be paid £150 per annum by the Borough Council. Cases will be recommended as Dispensary patients by the Medical Officer of Health, and insured persons will be examined and treated at the Dispensary after sanction is given by the Insurance Committee for London. The estimate of the cost of working the Dispensary is about £400 per annum, and grants in aid will be received from the Local Government Board, the London County Council, and the Insurance Committee. Yes. Scheme approved. Notes below relate to intended organisation. Yes. Yes. Yes. No,butscheme submitted to L.G.B. and L.C.C. Yes. Yes, at University Col. Hospital. Scheme formulated and approved by the Council. 2 Dispensaries. No. Scheme approved by L.G.B. and L.C.C. for Dispensary treatment at (1) Kensington Tub.Dispensary (vol.) (2) Brompton Hospital. Yes. Scheme under consideration. Yes. A scheme has been passed by the Borough Council under which it is proposed to enter into agreements with two existing institutions, viz., the Yes. It is proposed to use Middlesex Hospital, St. Marylebone AntiTuberculosis Dispensary, and Margaret Street Dispensary, and arrangementshave been made with Governing Bodies. Yes. Yes. Yes. Yes. Yes, in conjunction with Hackney (see ante). Yes—two. ; S cheme is under consideration of L.G.B. Yes. 2. (a) Was the Dispensary instituted as a new organisation by your Council ? or, No. No. Yes. Yes. No. Yes. Yes. . King Edward VII. Memr'l Building, purchased and adapted by volun. subs. Equipped and maintained by Council. No. Yes. Hospital the Council would make a payment on account of salary of Tuberculosis Officer, whose duties will be prescribed, Yes. Yes. Dispensary and the St. Mary's Hospital. The details of the agreement are still "under consideration. No. Scheme not yet settled. Institutions will provide all staff necessary, except one woman at present a member of Council's staff, to whom a salary of £200 per annum will be paid. No. Yes. Yes—two. No. —r lNO. (b) Was the Dispensary taken over as a going concern by the Council from another body ? No. Negotiations pending. No. No. No. No. No. No. No. will not exercise any other control except that a breach of contract might be No. No. — No. No. 1 roposed Dispen- j saries to be at Char- j ing Cross and St. ( Giles' Hospitals. No. 3. (a) Is the Dispensary carried on in a building erected for the purpose by the Council ? or, No. No. No. No. Building to be erected. No. j King Edward VII. Memr'l Building is termed Health Inst., and is governed by scheme approved by Charity Com. Dispensary on No. No. met by a cessa-' tion of payment. No. No. Council pays Margaret Street Dispensary and St. Marylebone AntiTuberculosis Dispensary each £100 per an. No. No. No. No. JNo. (b) In adapted premises ? or, No. Yes. Yes. Yes. Yes. Yes. No. — — No. No. — Yes. — No. — — — No. — Yes. — Yes. No. Yes. (c) In an existing Institution (Hospital or Dispensary), by arrangement with the Governing Body thereof ? Yes. No. No. No. MetropolitanHospital. Victoria Park Hospital. — No. Yes. Yes. — — — St. Bartholomew's Hospital. — Yes. Yes. Yes. No. Yes, but have not entered into a working agreement with Committee. — Yes. Yes. 4. (a) Is the Staff wholly appointed and controlled by the Council ? or, No. No. Yes. Yes. No. Yes. No. — Yes. No. No. — Yes. — No. — No. — No. No. Yes. No. Yes. No. No. (b) If the Dispensary is carried on at an Institution on behalf of the Council, what measure of control has the Council over the conduct of the work of the Dispensary ? or, Council has 5 representatives on Dispensary Committee. Whole control. Council appoint three members on Committee. By provisions of agreements entered into between Council and Hospital Authorities. Joint Committee representing Hospital, Boroughs of Holborn and St. Pancras, Med. Practitioners of Holborn and St. Pancras. Joint Committee representing Hospital. Borough Council. Borough Panel Committee. M.O.H. to have access to Dispensary at all times. Borough Council is represented on Dispensary Committee, including M.O.H. Council represented on Dispensary Committee. Council represented on Dispensary Committee. No. L ■ :ontrol through IV he M.O.H. & Asst. M.O.H-, J ivho is the Tuberculosis j Officer- .—__i— I.O.ri. an" wo Boro Councillors neinbers o Dispensary Zornm' fee. (c) Is the Staff, or any portion thereof, voluntary ? Yes. Yes. No. — Secretary. No. — — No. No. — — No. Secretary only. — Consulting Phv. onlv. No. No. Yes. No. No. JNO* 5. What Staff is employed (whole time, part time, &c.), and what are the salaries paid? 1. 2. 3. 4. 5. 6. 1 Chief M.O. £500p.a. whole time. Asst. M.O. £250 p.a. whole time. Nurse £110 p.a. whole time. Nurse £100 p.a. whole time Secretary £100 p.a. whole time Clk.-Disp. £100 p.a. whole time Porter and help 30/- per week Tuber. Officer £500 per ann. Dispenser £70 £90 per. ann. Nurse (Ranyard Assoc.), £30 p. a. Caretaker & Wife £78 and apartments, &c. 3 Health Visitors visiting in conn e c 110 n with other routine work, £ioo-£i30 per annum. Tuberculosis Officer £500 est. 1 Nurse £120 Caretaker £60 Medical Officer £5CO Asst. M.O. £250 Nurse £go Nurse £90 Dispenser £90 Clerk £90 Porter and Wife £75 Tuberculosis Officer £400 Dispenser & Caretaker £80, with rooms, gas and coal. Nurse (Ranyard Assoc.), Nurse do. i r £16 6s. Medical services included in ^payment by Council of 2/- for each attendance. Nurse £8o-£ioo. Nurse £8o-£ioo. ! Medical Officer j (part time) £250. (Physician on Visiting Staff and Mt. Vernon Hospital). Nurse £85. (1) Tuberculosis Officer and Hospital Staff. (2) Visiting Nurse £100 per annum. _A_ i Northern Dispensary. Southern Dispensary. 2 Physicians at £105 2 Physicians at £100 each. each. 1 Tuber. Officer £300 1 Tuber. Officer £400 2 Nurses £100 each. 2 Nurses £110 each. Dispensing and Cleri- Secretarial work £150 cal work £300. Porter, £50. Med. Officer £350 Nurse £80-£90 Caretaker £52 Office Boy 10/-to 20/- Corporation to pay not less than £500 nor more than £700 per an. for all services, treatment, staff, etc. Tuberculosis Officer, £500 Asct. do. £300 Dispenser, £120 Nurse Assistant (part time), £150 Clerk, £96 Caretaker and Wife, £70 (Rooms, coal, &c.) Resident Med. Officer, £300 Dispenser (part time), £50 Nurse, £80 Caretaker (part time), £30 Clerical Assistance, £20 Tuberculosis Officer, £42 Dispensary Sister, £10 Secretary, £50 2 Consulting Phy sicians, £100 ea Dispenser, £36 Porter, £30 | Tuberculosis Officer, £500 Secretary and Dispenser, £100 ; 2 Nurses, ! £80 each Caretaker, £50 and quarters, etc. Tuberculosis Officer, £500 ^urse, £120 ^'spenser. Clerk. Caretaker. ruberculosis Officer, £500 health Visitor, £110 ^urse, £80 Dispenser & Clerk, £78 (Rooms, fire and light). Tuberculosis Officer, £5°° Visitors (2). £125 each.| Bacteriologist- j £50 ie, Executi« 6. (a) Is the Medical Officer of Health the Administrative Tuberculosis Officer ? or, if not Yes. Yes. Yes. Yes. Yes. Yes. In suggested scheme— Yes. Yes. Yes. Yes. A Tuberculosis Officer will beappointed by each Dispensary from the members Yes. — Yes. — No. Yes. Yes, in proposed scheme. Not so designated but perform practically al functions of one Yes. J — Yes. Yes. | a 0 id organ*"* flicer. (b) What is the position of the Medical Officer of Health in relation to the Dispensary ? of its staff. M.O.H. will be quite independent of both Dispensaries, but it — — — — M. O. H. on Executive Committee. __ — - 7. What is the average number of persons who attend the Dispensary, exclusive of contacts ? (a) Insured persons. (b) Others. — (a) 203 (b) 925 (a) 223 (b) 2072 (a) 190 (b) 807 — (a) 286. (b) 1268. (a) 78 (b) 217 (a) 537, estd. (b) 713, estd. — 11 months. (a) 115. (W 340. I (165 were treated, 58 (a) and 107 (&)). Dispensary only recently opened. No statistics yet. him to secure due fulfilment of agreements between Council and Dispensaries. M.O.H. is on Exc. of Vol. Dispy. in N. Kensington. (a) 413 (b) 2815 No statistics yet. Statistics incomplete. Scheme not yet fully working. (a) 1332 (b) 2520 ' Statistics incomplete ; dispensary has not been in , existence a year. (a) 183) 9 (b) 753 j mths. Scheme not yet operate- (a) II3 jf)_535— 35 8. What is the average number of attendances per patient per annum, exclusive of contacts ? 10 11 5 8 Insured 17. Non-In. 15. 16 estd. 165 patients had average of 17. ■ Do. — 4 to 6 — — — 6 9 — 12 j FINANCE. 9. Has the Council incurred any capital charge in the establishment of their Dispensary, and if so, the amount ? — No. No. £125 (furnishing) £300 est. No. Not yet. No. — £165 No. No. No. £328 — — No. No. No. —-—- No. £700 J -1 —- £181 15s. No. 10. Has any of the capital charge been refunded by Central Authorities or other Bodies, if so, which Authorities or Bodies, and to what extent in each case? 1. 2. 3. 4. No. L.G.B. £111 L.G.B.£160 No. L.G.B. has made capital grant of £278 through the Borough Council to the St. Pancras Dispensary. No. No. L.G.B. £130 „cil Wffp0 11. What is the annual expenditure ? (a) Loan charges, (ib) Other. (b) £200 grant to Dispensary. (a) None. (b) £607 (a) — (b) £985 est. maximum. (a) - (b) £750-1914 (a) Nil. (b) £989 (a) — (&)£2300 est. Approx. £750 (a) - (b) £300 Northern. Southern. (a) - (b) £1,135 £2,000 (a) — (&) £1327 — (a) (b) £500—£700 (a) — (b) £1200 (a) — (b) £400 (a) - (b) £564 est. (a) — (b) £700— £800 (a) Nil. (ib) £1100 ( a) — b) £1,107 j c [b) £1,305 est. iai year- r 12. What proportion of annual expenditure isrecovered from other Authorities or Bodies, if so, which Authorities or Bodies, and to what extent in each case ? 1. 2. 3. 4. 1. L.G.B. 50% 2. L.C.C. 25% 1. Ins. Com. £140 2. L.G.B. £264 (Variablel 1. L.G.B. £375 2. L.C.C. £187 10s. 1. Ins. v. ^n. £200 estd. 2. L.G.B. £395 estd. 3. L.C.C. £197 10s. est. 1. Ins. Com. £460 estd. 2. L.G.B. £920 estd. 3. L.C.C. £460 estd. L.G.B.:— '12-13, £51 '13-14, £305 '14-15, £235 on a/c. L.C.C.—nil. 1. Ins. Com. £45 estd. 2. L.G.B. £127 10s. est. 3. L.C.C. £63 15s. est. 1. L.G.B. 50% estd. 2. L.C.C. 25% estd. 1. Ins. Com. 2. L.G.B. 2. L.C.C. £1128 1. Ins. Com. £80 2. L.G.B. £560 3. L.C.C. £280 1. L.G.B. £200 2. L.C.C. £100 1. L.G.B. £282 est. 2. L.C.C. £141 est. 1. L.G.B. 50% 1. Ins. Com. £250 2. L.G.B. £425 3. L.C.C.' £212 10s. 1. L.G.B. 50% ! net exp. 2. L.C.C. 25% net exp. 3. Ins. Com. £100 1. L.G.B. £550 est. 2. L.C.C. £275 est. I. L.G.B. £200 13. Is the cost of treating Insured persons included above, and if not, No. — — Yes. — Yes. Yes. Yes. — Yes. Yes. | Not yet Yes. Yes. Yes. — No. No. Yes. — Yes. — — 14. (a) What is the amount which the Insurance Committee agrees to pay per annum in respect of the treatment of insured persons ? No definite amount. Lump sum paid by Insur. Committee to Central Fund Committee, who divide this amongst their Dispensaries on basis of work done at each Dispensary. £140 as above (12-1) Not settled. Insurance Committee have paid £163 in respect of 1913. Insurance Committee pay lump sum as contribution to cost based upon comparison of attendances of insured persons as against those of others. Estimated at about one fifth of total. ; A sum based upon comparison of attendances of insured persons as against those of others, together with an agreed 1 sum in respect of | certain services rendered to Ins. Com. So far £50 has been received from the In. Com. for the half-year to nth Jan., 1914. See answer toQ. 12-1. J determined. In accordance with their memorial or memorandum of agreement (see answer from rfampstead). Not yet settled. (See answer from Hampstead.) Not decided. (See below). Ins. Com. so fa have agreec nothing. Sun of £50 receivec from Com. fo 1914, and simila amount to be re ceived in 1915. Amount not definitely settled. No agreed figure. Not settled. (b) Is the figure based upon number of insured persons treated or upon the number of attendances made, or upon the number of insured persons living in the area served by the Dispensary, and if so, how many in either case :— (1) Persons treated. (2) Attendances made. [in area. (3) Number of insured persons living In future the grant will be on the basis of number of attendances made Not yet settled. On attend1 ances made. On Nos. of attendances. Under consideration. On proportion of attendances of insured to attendances of noninsured persons. No. On proportion of attendances of insured to attendances of non-insurec persons. Not known. SCHOOL FOR MOTHERS. 1. Have you initiated a School for Mothers ? 2. What arrangements have been made as to: (a) Staff and salaries thereof. (b) Premises. (c) Generally. No. Battersea Volun. Health Society carries out cer tain amount of work under this head. Council also has established an Infants' Milk Depot. Matter under consideration. No. No. A Voluntary Association carries out this work and receives grant from Board of Education, but none from the Borough Council. Yes. 2 (a) 3 Municipal Health Visitors work 3 Centres, j (6) 1. Town Hall, M.O.H. attends; 2. Cornbury Rd. Miss., Dr. Swanson voluntary; 3. Albany Institute, Dr. Crabbe £50 i per annum. One class a week at each Centre. Yes. 3 Municipal j weighing Centres (2 (a) 2 Health Visitors £100- £120 (b) Rented at 10/6, 5/- & 5/- weekly. Yes. Vol. Contributions and grant of £195 from Brd. of Education for year 1914-15. 2. (a) 3 Medical Officers £50 each one half-day per week ; 1 Superintendent £110; 1 Asst. Superintendent £80. (b) N. Branch £70. S. Branch £50. No. A school has recently been established by voluntary subscriptions. No. i 3 Weighing Cen: tres exist. Lady Sanitary Inspector attends and is helped by members of the Hampstead j Health Society. ! Inspector's sal1 ary, £105. A school for ! Mothers is also held at the Health ' Institute apart l from above. Yes. 2 (a) Med. Officer | io/6 for each at tendance. 1 (b) Superintendent £S7 ios. per an. for i£ days per 1 week. Passmore Edwards' Settle1 ment premises. No. Matter under consideration. No. There are 4 | schools provided ! by philanthropic j effort. j Three Municipal j Health Visitors attend 3 of the schools twice a i week. No. Voluntary schemes only working. No. Voluntary schemes only working. Not as a separate i organisation. A mothers' class is held in connec: tion with the Maternity and Infant Welfare Centre. No. Voluntary organisation only. No. Schemes still under disdiscussion providing for organisations which will make use of and link up with following existing institutions in Borough : — 2 Schools for Mothers; 2 Infant Consultation Centres; 1 2 Maternity Hospitals through M.O.H., and staff of 3 women inspectors and health visitors. No wholly Municipal Centres, - but numerous Voluntary Centres. — No. i Matter postponec pending the com j pletion of working arrangements be I tween L.G.B. anc I Board of Education In contemplation — No. Yes. 2 (a) Health Visitor, £135 per annum. (b) Rent, £40 per annum. Municipal Infan Consultation held weekly. 2 (a) The M.O.H and woman Health Visitor. (6) Town Hall. MATERNITY AND CHILD WELFARE CENTRE. 1. Have you initiated a Maternity and Child Welfare Centre ? 2. What arrangements have been made as to : (a) Staff and salaries thereof. (b) Premises. (c) Generally. 3. Is the Centre carried on in combination with the School for Mothers ? If so, are the requirements of the Board of Education and/or the Local Government Board such as to render it necessary to clearly differentiate the activities of the two organisations ? No, but a scheme is being considered. Do. No. No. Yes, but antenatal work riot yet developed. Same staff as above. Do. Yes. It is not necessary to differentiate, and we have applied to L.G.B. for a grant. No. Now being started in combination with above. Application will be made in respect of treatment to L.G.B. Infant consultation centre. Health Visitor and Female Sanitary Inspector. Salary as Public Health servants. Doctor's honorarium £25. Room at Women's Intant Health Association. Medicine, third paid by mothers, remainder of medicine and also honorarium made up from voluntary sources No. No. Arrangements also exist whereby children of 1 persons joining J either of two local i Provident Dispensaries are medically ex amined yearly up 5 years of age on lines of school medical inspec1 tion. j Two-thirds cost is paid by the Council of Social Welfare, and onethird by parents. The C.O.S.W. also pay for operations that | may be necessary. In co-operation with Mat. Depts. j of 3 Hospitals. 2 (a) Provided by Hospitals. (b) Hospitals In co-operation (not combination with the school for mothers. No. Matter under consideration. No. Four schools for Mothers and a Baby Clinic ; provide by vol| untary effort in ! N. Kensington I for Maternity and | Child Welfare. No. Voluntary schemes only working. (There is a Municipal Milk Depot No. Voluntary schemes only working. Yes. 2 (a) Woman Sanitary Insp. (b) The City Shelter No. Voluntary organisation only. ■ Arrangements made for special i visitation, etc ! scheme with Pop- j lar Infant Care j Association, St ! Katharine's Col lege, and Schoo ; Care Committees j working in co1 operation with Public Health Department. Decided to esta lish a scheme far as possible 0 lines suggeste by L. G. B. house is to 1 taken for the pu pose, and a rangements w be made for tl establishment a feeding cent for expectant ar nursing mother with help of t] Women's Leag of Service. 3. Not yet settle > No. S | n 1 d A e j r- I •- ■ 11 e j of 1 re ; d : s> le ! le d. Yes. 2 (a) Health Visitor and Sanitary Inspector, £145 per annum. ; I 3 voluntary workers. ' (b) Medical man attends Infant Clinic every | Thursday. No. Yes. 2 (a) Two Physicians £52 ios. p. an. each ; 2 Superintendents and Health Visitors, £150 and £100 ; 2 Assistant do., £90 and £60. The School and Centre are run in conjunction with the Westminster Health Society. Yes. There is no occasion to attempt to discriminate between the respective spheres of influence. This can be leit to the Central bodies to do. Under con sideration Public Health Department, Town Hall, Bethnal Green, E. April, 1915. In Bethnal Green the questions of the establishment of a Tuberculosis Dispensary and Maternity and Child Welfare Organisations, are under consideration. INDEX TO Report of Chief Sanitary Inspector for 1914. PAGE Adulteration... 41 do. Decennial Period 39 Brady Stre et Area 6 Bakehouses 50 Cases in Hand 19 Clerical Work 60 Combined Drainage 66 Complaints 18 Cowhouses 59 Cream 47 Defective W.C's. 20 do. Water Supply 20 Dirty Premises 20 Disinfectants 55 Disinfecting Work 54 Drains—Defective, relaid, amended, &c. 20,21 Food and Drugs 19, 27-46 Food Inspection 49 Food Premises Inspections 50 General Summary of Inspections I8, 19 House to House Inspections 5 Houses Let in Lodgings ... 52 Housing .. 65 Housing, Town Planning, etc., Act, 1909 . 63 House to House Visitation 52 Ice Cream Premises 50 Improvements Effected 21 Inspections—Bakehouses 50 Complaints 18 Cowhouses 59 Dairies and Milkshops 18, 59 Factories and Workshops 18 Food Premises 50 House to House 18, 52 Ice Cream Premises 18,50 Infectious Disease 5, 18 Milkshops 1 8 New Buildings 18 Out-workers 18. 51 Re-Inspections 18 INDEX—continued. page Inspections (contd.)—Slaughter-Houses 59 Tenement Houses (Houses let in Lodgings) 18,52 Total 19 Trade Premises 18 Unclassified 19 Verminous Homes 53 Milkshops 18.59 Milk and Cream Regulations, 1912 47 Milk and Dairies Act, 1914 16 Miscellaneous Improvements 21 Mortuary Returns 56 New Buildings Inspections 18 Notices served 5 Nuisances Abated 19 do. Discovered 20 Offensive Trades 59 Out-workers 5, 51 do. Trades 51 Overcrowding 6, 12 Pol ice Court Proceedings 22-26 Premises Repaired and Cleansed 21 Public Health Committee 2 Rag Flock Act 61 Sale of Food and Drugs Acts 19, 27-46 Samples—Informal 40 Official 27 Taken on Delivery 39 do. do. at schools 41 Sanitary Conveniences Repaired 15 Sanitary Defects 20 Sanitary Improvements effected 21 Slaughter-Houses 59 Smoke Nuisances 19, 20, 55 Staff 3 Summary of Inspections 18, 19 do. Disinfection 54 Tenement Houses (Houses let in Lodgings) 52 Total Inspections 18,19 Trade Premises 18 Unsound Food 19, 49 Verminous School Children 12, 53 Water Supply 20, 21 Water Closets 20,21 Workshops 5, 21 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 respectfully beg leave to present my Annual Report on the work of the Staff of the Public Health Department for the year ending December 31st, 1914. All the various routine duties have been attended to, and the details set forth in the usual returns annexed hereto. The markets have been regularly inspected, and the condition of the food supply kept under daily observation. Under the provisions of the Sale of Food and Drugs Acts, a total of 766 samples of food and drugs were taken and submitted for analysis by the Public Analyst; whilst 83 samples were analysed in our own Laboratory at the Town Hall, by Mr. Bilham, who, as 5 members know, possesses a considerable amount of practical chemical knowledge and experience, which has proved of the greatest assistance to us in our work in connection with the adulteration of food, House-to-house inspection has proceeded as usual, and Outworkers' Homes and Workshops kept under regular periodic inspection. 1,971 inspections were made in connection with cases of Infectious Disease; 8,197 sanitary notices of various kinds were served; and numerous improvements and repairs effected. The various duties are more particularly detailed in the Appendices A to U following, to all of which I beg to request your attention, and none of which appear to require any special or further description. The two extracts from the Monthly Reports marked respectively 'Overcrowding," "Verminous Children and Overcrowding " and " Milk and Dairies Act, 1914," are included by request. Respectfully soliciting your best consideration, I have the honour to be, Mr. Chairman and Gentlemen, Your most obedient servant, JOHN FOOT. 6 Extraot from Monthly Report. I. June, 1914. OVERCROWDING. During the month the Chief Sanitary Inspector was in receipt of various complaints made by the London County Council District Organiser of Children's Care Work relating to alleged cases of overcrowding. The addresses given were in each instance in parts of the Borough inhabited by the poorest class, and upon a careful investigation of each it was not surprising that the complaints in some of the cases should be substantiated, but these cases were in the main very trifling. Squalid surroundings and intense poverty there were in abundance, the former, it is impossible to deny, so largely dependent upon the latter, especially where the earnings of the man are so small and infrequent as to call for the employment of the wife, thus making for neglect of children and home and destructive of all proper amenities of life. In some of the cases sanitary repairs were necessary and for these notices were served upon the landlords; notices were also served on overcrowded occupants requiring the abatement of such overcrowding within one month. The Public Health Committee carefully considered the complaints and the conditions found, and, being of opinion that the Council should be informed of the circumstances upon which such complaints are sometimes founded, ordered the printing of letters sent to the District Organiser in regard to the complaints as follows :— 7 (Copy.) Public Health Department, The Town Hall, Patriot Square, Bethnal Green, E., 30th June, 1914. Dear Miss Lewis, Adverting to the call of your Miss Bunbury on me the other day respecting certain cases of overcrowding, I beg leave to report that the premises have all been visited and the inspectors' reports are as follows:— S., Q B . The inspector reports there are no insanitary conditions existing at these premises. Mrs. S. and her family occupy two rooms, the mother and two girls sleeping in the near room, and the four boys sleeping in the far room. The cubic capacity of the one room is 994 cubic feet, and of the other room 866 cubic feet, consequently there is no legal overcrowding and although, from a hygienic point of view, it is most undesirable that card-box making, or any process entailing the use of strong and offensive smelling glue, should be carried on in any dwelling, this is not—in the present state of the law—illegal, neither can this Authority interfere with it. The woman appears to be very poor, the children do not seem to have any change of clothes, and I understand they stop in the room naked while such clothes as they have are being washed. 8 As to the condition of the rooms, the inspector reports that they are now much cleaner than when he visited them in March, and at visits subsequent to that date. T., R-S. This family appears to consist of father, mother and four children under six years of age. The father, I understand, earns about 18s. per week, out of which he pays 4s. per week rent. He is under notice to leave his present situation. The mother has been recently confined, and I am informed the baby is in a wasting condition as one can well understand it would be having regard to the poor standard of living obtaining here. As regards overcrowding, the cubic capacity of the room occupied by this family is about 1,387 cubic feet, consequently the overcrowding, if any, would only amount to such a trifle as would not justify interference. Some cleansing and internal repairs are required to some of the rooms, and in respect to this I am serving a notice on the owner. I am also requesting the attention of our lady inspector to the mother and child. R., G G. This family appears to consist of father, mother, and three children, the eldest of whom is 6½ years. The father, I understand, sells papers in the street 9 and is said to give his wife about Is. 6d. a day. The rent of the room seems to be 2s. per week, and the cubic capacity is 708 cubic feet. The sanitary condition of the premises is satisfactory, and although the room is question is overcrowded to some slight extent, the difficulty is what to do with people living in such poor and wretched conditions. P., M - S This family occupy the entire first floor, consisting of four rooms. These rooms are occupied by the man, his wife, and six children, the eldest of whom remaining at home is 12. years. A son 18 years of age is said to live at H G , whilst a girl of 17, is said to live at P . The last two I am given to understand being children of a previous marriage. The father here would appear to be in better circumstances, consequently the features of poverty present in the other cases do not exist in this. As regards overcrowding, the capacity of the rooms occupied by this family are as follows :— First floor front 1,420 cubic feet. First floor back 770 ,, First floor back addition.. 546 ,, First floor off 473 ,, In the aggregate these people have a cubic capacity of 3,209 cubic feet, and on that no legal overcrowding occurs, although some re-arrangement of 10 the sleeping arrangements, particularly as regards the off-room, is desirable, and has been suggested to them. As regards the sanitary condition of the premises, they are already under notice from this Authority in respect of certain repairs required, which repairs were postponed on account of the recent death of the owner. I am, Dear Miss Lewis, Yours very faithfully, John Foot. (Copy.) Public Health Department, The Town Hall, Patriot Square, Bethnal Green, E., 6th July, 1914. Dear Miss Lewis, Re G-S-S Adverting to your favour of the 2nd inst., and in further reply thereto, I beg to report for your information that on these premises being visited it was found that the G-family occupy two rooms on the ground floor. The family seems to consist of the father, mother, boys aged 16 and 11, and girls aged 13, 9, 4, 3, and 19 months. The father is a casual labourer only, and his earnings appear to be very uncertain and precarious. One of the boys earns 11 7s. a week, and the rent of the two rooms is 4s. 6d. The rooms are overcrowded. As regards the premises they are old and dilapidated, and they form part of an Improvement Scheme which we have been unsuccessfully endeavouring to induce the London County Council to deal with under Part I. of the Housing Act, ever since 1907. I will report the matter to my Authority on Wednesday with a view to serving the necessary notices in order that some improvement at least may be effected here. I am, Dear Miss Lewis, Yours very faithfully, John Foot. 12 Extract from Monthly Report. II. November, 1914. VERMINOUS CHILDREN AND OVERCROWDED ROOMS. Herewith I beg to submit particulars of cases recently received from the Care Committee, the Education and other Authorities respecting the vexed question of verminous children and overcrowded rooms. These cases are taken from a large number of others, and are mainly interesting from the fact that, after a very long period of multiplication of Committees, Authorities, and Agencies of all sorts and kinds, there seems to be no one Authority having any real power to intervene and to do something effectual for children coming from such wretched " homes." Male and Female Inspectors, District Nurses, School Board Officers, and a host of Authorities and their Officers are engaged in following one another to the houses, and later on reporting to one another about the conditions. Quite a number of reports and statistics, as well as an interesting supply of tabular and statistical matter, is provided, but nothing effectual seems to follow. It would seem necessary to consider as to whether the time is not ripe for some representation being made to the Government Authorities with a view to this matter being re-opened and considered on an entirely new basis. The practical utility of continuing this repetition of reports and ineffective interference by overlapping Authorities, does not seem altogether apparent. 13 The most interesting cases are as follows :— (a) C-Family, T-Street. Father, mother, and six children (ages from 2-16 years) in two rooms. Home exceedingly poor. Only one bed, such as it is, for the whole family, and that without clothes, except an apology for a quilt. Circumstances deplorable. Father (a stickdresser) out of work. (b) D-Family, O-Street. Two adults and four children in two rooms. Children's ages range from 10 months to 13 years. Father out of work, and family suffering in consequence. (c) A-Family, C-Street. Children verminous and rooms overcrowded. Father and six children. In considerable arrears with rent, and under notice to quit by the following Monday. Receiving help from the Emergency Relief Committee. Condition of children probably arising from the fact that the mother died some time since. (d) G-Family, C-Street. Father, mother, and four children occupying one room. Father done no work for four weeks, previous to which he was on short time and earned very little money. Previously had two rooms, but unable to pay rent. At present living on the charity of friends. One child ill, and should be in the hospital. (e) A-Family, H-Street. Two adults and three children in two rooms. Mother in the Infirmary ill, children looked after by 14 grandmother. Father and son both out of work. In very poor circumstances, and in arrears with rent. (f) L-Family, B-Street. Two rooms occupied by father and five children, the wife being in a sanatorium. Jewish Board of Guardians now sending someone to look after childlren complained of. (g) P-Family, C-Gardens. Two adults and five children in two rooms. One set of clothing and bedding only, which was being washed at the time of visit. Mother in bad health, shortly to undergo an operation. Circumstances unsatisfactory. (h) P-Family, M-Street. Family equal to four adults and five children. In two rooms. Man and wife only earning part wages, and for some time only 12s. to 13s. per week coming into home, of which 5s. is for rent. Home conditions clean and very poor. (0 E-Family, Q-Buildings. Two adults and seven children, from 14 years downwards, in three rooms. Mother goes office cleaning from daylight to dark with a view to keeping the home together. Mother's absence probably explains the condition of the children. (j) F-Family, S-Street. Parents out at work all day. Children supposed to be looked after by a friend residing in the 15 bourhood. Absence of parents probable explanation of children's condition. (k) N-Family, S-Street. Two adults and three children—ages from 6 to 14—occupying two upper rooms. Mother died about one month ago; father since gone to the front. Children supposed to be looked after by a sister. Home conditions fair, but very poor. Family told to apply for assistance at the Emergency Eelief Committee, Old Nichol Street. (/) 48. P. G. Father, four children—no mother. Father (cab driver) had very little work since outbreak of war in August. Children looked after by sister. Home almost gone. (m) 1. G. B. Mother (widow) and three children. Does a little work when she can get it. Very little home. (n) 29. C. B. Man, wife and four children. Husband out of work for past 16 weeks (French polisher). One daughter and son earn a little, but since war have done very little. Have had notice to quit for arrears of rent. John Foot. 23rd November, 1914. 16 Milk and Dairies Act, 1914. Establishment of Milk Depots. Memorandum by Chief Inspector. Section 9 of the Milk and Dairies Act, 1914, enacts as follows:— (1) " The sanitary authority of any district may, with the approval of the Local Government Board, establish and thereafter maintain depots for the sale at not less than cost price of milk specially prepared for consumption by infants under two years of age, and purchase and prepare milk and provide such laboratories, plant, and other things, and exercise and perform such other powers and duties, as may be necessary for the purposes of this section. (2) " The Local Government Board may attach such conditions to their approval as they may deem necessary." From the above section it appears that local authorities have the power, with the consent of the Local Government Board, to establish and maintain milk depots for the purposes therein stated. It should however be noted :— (1) That the approval of the Local Government Board must be first obtained. (2) That such depots are restricted :— (a) To the sale of milk specially prepared for infants under two years of age, and (b) Such milk must not be sold at less than cost price. 17 There appears to be no guidance as to what the term " cost price " means, consequently one is left in doubt as to whether this means the cost of the milk and its preparation only, or whether the pro rata cost of the establishment, buildings, staff, &c., would have to be included.* The sale of ordinary milk does not appear to be contemplated at all, milk specially prepared for consumption by infants under two years being the only milk mentioned. (3) In view of the provision of sub-section 2, enabling " the Local Government Board to attach such conditions to their approval as they may deem necessary," it would appear desirable that before committing itself to any policy involving the establishment of milk depots, this authority should endeavour to ascertain what the Board's conditions and requirements are likely to be. and (4) Moreover, it should be noted that under the pro- visions of section 18, this Act does not come into operation until the first of January, 1915, or such later date, not being later than the first day of October, 1915, as the Local Government Board may appoint, † John Foot. 29th September, 1914. '[NOTE.—The Local Government Board later stated: " They understand that the words were inserted to prevent milk being sold at less than the price paid for it, and that it was not intended to requite that the price should be fixed sufficiently high to cover all other expenses." tThe Board were not prepared to indicate in advance what conditions they would be likely to impose, and would prefer that particulars of any proposed scheme should be submitted in outline. tThe Board later made an Order appointing the 1st October, 1915, for the commencement of operation of the Act. 18 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 364 216 111 — 2893 97 400 738 98 — 38 B 217 188 735 — 1950 98 284 786 92 l 66 C 292 378 23 — 2655 122 240 339 191 — 32 D 226 68 8 35 3168 218 907 175 304 — 62 * B 213 66 — — 994 95 228 136 140 12 324 220 10 22 2774 80 319 173 175 l 41 F 332 280 11 — 2955 97 642 348 126 — 26 3 33 596 — 3076 — — — — 217 — — 9 265 818 — — — — — — — Totals 1971 1458 1759 875 20465 807 3020 2695 1126 219 277 * Two Inspectors were attached to District E during the year, viz. :— (1) Mr. W. Billings who was on active service from 26th September, 1914. (2) Mr. J. H. Hewitt who was appointed Temporary Sanitary Inspector on the 1st October, 1914, vice Inspector Billings. 19 for the Year ended 31st December, 1914. Smoke Nuisances— 1 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. Inspector. — 193 370 1 97 15 796 65 5518 E. Ainley. — 199 156 — 58 3 307 67 4772 A. S. Henley. — 344 112 — 94 24 649 51 4728 J. G. Weeks. 1 270 20 — 113 12 712 45 5462 F. Bake. — 142 99 _ 17 3 278 60 2125 J. H. Hewett. 280 53 — 81 1 Flock 23 1102 81 4472 W. Billings, Jr. — 312 319 — 96 — 1041 50 5448 I. R. Jones. — 142 42 — — 2 409 66 4109 E. Richards. 373 — 3 164 36 — — 1465 W. Rowsell. 374 1882 1171 4 720 1 Flock 118 5294 485 38099 20 APPENDIX B. Total number of Defects discovered during 1914. Month. Dirty Premises. Defective Drains. Defective and Dirty W.C.'s. Defective Water Supply. Smoke Nuisances. Other Matters. Total. Jan 414 19 249 47 l 674 1,404 Feb 403 43 246 43 — 843 1,578 Mar 492 42 234 36 3 918 1,725 April 370 23 190 22 3 609 1,217 May 329 22 200 15 1 592 1,159 June 489 41 393 71 6 866 1,866 July 361 31 216 32 2 809 1,451 Aug 177 26 173 21 2 391 790 Sept 345 54 143 120 3 960 1,625 Oct 213 42 52 75 1 479 862 Nov 199 36 95 94 1 503 928 Dee 198 32 85 95 — 696 1,106 Totals 3,990 411 2,276 671 23 8 340 15,711 21 APPENDIX C. List of Sanitary Improvements effected during the year. Cleansing— Premises, etc., cleaned, repaired or whitewashed 5,275 Workshops ditto ditto ditto 723 House Drains— Drains relaid 124 Drains amended 163 Drains cleared 393 Drains trapped and ventilated 33 Rain water pipes and waste pipes disconnected 3 Sink and bath waste pipes trapped 90 Water Closets— W.C.'s repaired, cleansed, etc., 1,862 W.C.'s fitted with new pans and traps 157 W.C.'s supplied with water, and water supply apparatus 946 W.C.'s ventilated and lighted 9 W.C.'s rebuilt 3 New W.C.'s provided 32 Partitions provided round W.C.'s to separate same from workshops 3 Water Supply— Houses provided with water supply 169 House supply disconnected from W.C. cistern 6 Cisterns, supplied, repaired or cleansed 107 Miscellaneous— Paving of yards 632 Paving of Wash-houses 121 Forecourts and Areas paved and drained 16 Stables paved and drained 9 Removal of accumulation of Dung or other refuse 145 Removal of animals improperly kept 49 New Dung-pits provided and covers for same 10 Premises closed previous to executing the necessary repairs 81 Premises demolished following the service of notices 2 Gutters, Rainwater Pipes, and Waste Pipes repaired 1,058 Illegal occupation of basements discontinued 5 Overcrowding abated 156 Urinal accommodation provided 2 Urinals supplied with water 23 Urinals cleansed and repaired 66 Grids provided to Gullies 53 Dust Shoots repaired and Receptacles provided 874 Vacant lands cleansed 2 Areas cleansed 5 Yards cleansed 289 Indecent occupation discontinued 3 Verminous rooms remedied 365 Dampness remedied 618 Lighting and Ventilation improved 482 Total 15,164 22 APPENDIX D. (1.) Police Court Proceedings—Public Health (London) Act, 1891. Di,te of hearing. Defendant. Offenc . Inspecor. Magistrate. Result. 1914. Jan. 29 J. R Non-compliance with notice F. Bare Mr. ChesterJ ones Withdrawn. Works competed. Costs 3s. Mar. 5 J. D Non-compliance with notice W. Billings Withdrawn. Work done. Costs 3s. „ 12 P.J.D.&S. (3 summonses) „ Withdrawn. Work done. Costs 9s. „ 12 H.J.B.&S. (2 summonses) „ Withdrawn. Work done. Costs 6s. „ 12 A. „ „ „ Withdrawn. Work done. Costs 3s. „ 19 J. D. „ J.G. Weeks „ Withdrawn. Work done. Costs 3s. April '23 J. F. Exposing for sale unsound Brazil nuts W. Bowsell „ Fine 10s , costs 12s. fid. 23 Police Court Proceedings—Public Health (London) Act, 1891—continued. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1914 May 14 W. M Non-compliance with notice F. Bare Mr. Leycester Withdrawn. Works completed. Costs 3s. May 28 H. Overcrowding W. Billings Mr. Chester Jones Withdrawn. Overcrowding ab&ted June 18 A. B Non-compliance with notice „ „ Withdrawn. Works completed. Costs 3s. July 16 F. & P Non-compliance with notice E. Ainley „ „ 16 S. C. „ W. Billings- „ „ 16 J. H. „ „ 16 J. G. G. (2 summonses) J. G. Weeks „ „ Sep. 24 B. C. Exposing for sale unsound biscuits E. Ainley Mr. Clarke Hall Fine £5, costs £2 24 Police Court Proceedings—Public Health (London) Act, 1891—continued. Date of hearing. Defendant Offence. Inspector. Magistrate. Result. 1914 Sept. 24 s. Exposure of child with infectious disease in public streets W. Billings Mr. Clarke Hall Fine £2, costs £2 24 E. H. Exposing for sale unsound pears W. Rowsell „ Fine 21s., costs 21s. 24 „ Depositfng for sale the above „ „ Summons withdrawn, conviction on other summons Oct. 1 M. L. Failing to keep list of outworkers W. Billings „ Fined 10s., costs 38s. 1 A. R. Non-compliance with notice „ „ Withdrawn. Works completed. Costs 3s. 1 S. C. „ „ „ „ 8 C. &C „ „ Mr Hopkins „ 25 Police Court Proceedings—Public Health (London) Act, 1891—continued. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1914. Oct. 8 W. E. Selling milk from infected premises J. G. Weeks Mr. Hopkins 8 W. E. Failing to give notice of i nfectious disease at premises where milk was sold „ „ LFine £5, costs £1 3s. Nov. 12 E. W. Exposing for sale unsound meat E. Ainley Mr. Clarke Hall Fined £2, costs £2 2s. 12 H. B. Non-compliance with notice (2 summonses) F. Bare „ Withdrawn. Works completed. Costs 8s. 12 R. E. Non-compliance with notice „ „ Withdrawn. Works completed. Costs 3s. Dec, 10 B. A. A. Non-compliance with notice J. H. Hewitt „ Withdrawn. Defendant undertook to comply with notice. Costs £1 4s. 31 W. A „ J. G. Weeks Mr. Chester Jones Withdrawn. Works completed. Costs 3s. 26 APPENDIX D (2). Police Court Proceedings, 1914. Public Health (Milk and Cream) Regulations, 1912. Date of bearing. Defendant. Offence. Inspector. Magistrate. Result 1914. July 23 L. E. Selling preserved cream in unlabelled jar W. Rowsell Mr. Chester Jones Fined £1 1s., costs £1 3s. 23 „ Deporting for sale preserved cream in unlabelled receptacle „ „ Withdrawn upon conviction on other summons 27 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 ation. Arrowroot l l Barley, Pearl 6 6 — — Butter 113 104 9 8 Camphorated Oil 6 5 1 — Cheese 2 2 — — Cocoa 10 10 — — Coffee 11 11 — — Cream of Tartar 2 2 — — Flour, Cake 1 1 — Glycerine 1 1 — — Jam, Raspberry 3 3 — — Lime Water 2 2 — — Macaroni 1 1 — — Margarine 5 5 — — Milk 444 412 32 1 Mustard 10 10 — — Olive Oil 5 5 — — Peas, preseived 1 1 — — Pepper 16 16 — — Rice 50 46 4 — Saffron 3 3 — — Salts of Tartar 1 1 — — Tartaric Acid 1 1 — — Vinegar 44 35 9 — Totals 739 684 55 9 28 Thirty samples of milk, although genuine, were certified to be of poor quality; eight further samples were deficient in fat to so slight an extent as not to warrant legal proceedings, and the vendors were therefore cautioned. In the case of two samples sold as butter, but found upon analysis to be margarine, the article was supplied in a properly stamped wrapper, and no proceedings were therefore taken; in two other cases the vendors were cautioned by the Committee. One genuine sample of vinegar was reported to be of poor quality; another sample was so slightly below the standard that no proceedings were taken against the vendor, but a caution was administered. The samples of rice were purchased as the result of an investigation requested by the Board of Agriculture, it being stated that rice was largely subjected to a process termed " facing" with talc (powdered french chalk) in order to improve its appearance, and to enable the sale of poor grades of rice as an article of better quality. In four cases the presence of talc was proved; it was in such slight quantities in three cases that the vendors were cautioned, and in the remaining case, in view of the ignorance of the retail shopkeeper and a suitable undertaking being given, a caution also was considered to be sufficient. 29 APPENDIX E. (2). Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1914. „ „ „ Jan. 1 A. M. Selling coffee containing 60 per cent, of chicory W. Billings Mr. Chester Jones Fined £1, costs £1 3s. 1 C. C. Selling milk containing 10 per cent, of added water F. Bare „ Fined £1, costs £1 3s. „ 8 A. W. Selling Vinegar 14 per cent, deficient in acetic acid Weeks „ Ordered to pay 12s.6d. costs 8 R. S. Selling Vinegar, 34 per cent, deficient in acetic acid „ „ Ordered to pay 2s. costs. 8 G. D. Selling Vinegar, 15 per cent, deficient in acetic acid „ „ Ordered to pay 12s. 6d. costs 30 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1914, Jan. 8 D. Bros. Selling Vinegar, 13 per cent, deficient in acetic acid (on delivery). Weeks Mr. Chester Jones Ordered to pay £3 3s. costs 8 J. s. Selling Vinegar, 28 per cent, deficient in acetic acid (on delivery). „ „ Ordered to pay £3 3s. costs 8 J. W. Selling vinegar 23 per cent, deficient in acetic acid „ „ Ordered to pay 12s. 6d. costs Feb. 5 E. H. Selling vinegar 10 per cent, deficient in acetic acid E. Ainley „ Ordered to pay 2e. costs • 5 A. L. Selling vinegar 35' per cent, deficient in acetic acid „ „ Fined 10s. Costs 12s. 6d. 5 J. L. Selling vinegar 24 per cent, deficient in acetic acid „ „ Fined 10s. Costs 12s. 6d. 31 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate* Result. 1914. Feb. 5 A. C. Delivering under contract milk containing 27 per cent, added water W. Rowsell. Mr. Chester Jones Withdrawn. Existence of contract not proven. 5 „ Delivering under contract milk containing 20 per cent, added water „ „ „ * 5 E. & A. Motts, 38, Three Colt Lane Delivering under contract milk containing 10 per cent, added water „ „ Fined £20. Costs £5 5s. 26 A. B. Selling vinegar 28 per cent, deficient in acetic acid A. S. Henley „ Ordered to pay 12s. 6d. cos „ 26 W. F. Selling vinegar 40 per cent, deficient in acetic acid „ „ „ "Second or subsequent offences reported by order of the Public Health Committee 32 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence Inspector. Magistrate. Result 1914. Mar. 5 B. S. Selling vinegar 31 per cent, deficient in acetic acid Bare Mr. Chester Jones Ordered to pay 12s. 6d. costs 5 J. S. „ Ainley „ „ 6 A. S. „ „ „ „ 5 D. M. E. Selling milk 9 per cent, deficient in butter-fat Bowsell „ „ 12 J.Sheinbaum, 32, Pedley St. Selling milk 5 per cent, deficient in butter-fat „ „ Fined £2. Costs 23s. 26 s. s. Selling margarine in plain wrapper Henley „ Fined 10s. Costs 12s. 6d. 26 „ Selling margarine from unlabelled bulk „ „ Withdrawn. Conviction on other summons * Second or subsequent offence reported by order of Public Health Committee. 33 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1914. Mar. 26 s. s. Selling an article purporting to be butter containing 83½ per cent, of foreign fat Henley Mr. Chester Jones Withdrawn. Conviction on other summons April 30 J. c. Selling butter containing 5 per cent, excess of water W. Billings Mr. L. Drummond Costs 23s. May 14 M. C. Selling milk 4 per cent, added water „ Mr. Lester Fine £2, costs 23s. 14 „ Selling milk 9 per cent, deficient in fat „ „ Withdrawn, conviction on other summons *June 4 M.Tabakoff, 142, Old Montague Street, E. Selling milk 5 per cent, deficient in fat W. Eowsell Mr. Chester Jones Fined £5, costs £1 3s. * 4 „ „ „ „ Fined £5, costs £1 3s, * 4 „ Selling milk 8 per cent, deficient in fat „ „ Fined £5, costs £1 3s. * Second or subsequent offence reported by order of Public Health Committee. (This defendant was ulable to pay the fines and cotts imposed, and was sent to prison for one month). 34 Police Court Proceedings—Sale of Food and Drugs Acts, 1875- 1907. Date of hearing. Defendant. Offence. Inspector. Magistrate Result 1914. July 2 W. E. Selling milk 18 per cent, deficient in fat J. G. Weeks Mr. Chester Jones Costs £1 3s. 9 J. S. Selling milk 8 per cent, deficient in fat W. Billings „ Dismissed—warranty defence 9 M. C. Selling milk 6 per cent, deficient in fat „ „ Costs £1 lis. 6d. 9 . S. M. Selling margarine in plain wrapper E. Ainley „ Fined £2, costs £1 3s. 9 M. L Selling milk 39 per cent, deficient in fat „ Fined 10s., costs 12s. 6d. 9 W. V Selling milk 11 per cent, deficient in fat Henley „ „ 9 C. McC „ „ „ „ 35 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant. Offence. Inspector. Magistrate. Result. 1914. July 16 I. D. G Refusing to serve inspector J. G. Weeks Mr. Chester Jones Costs £1 3s. 16 W. P Selling milk 8 per cent, deficient in fat „ „ Costs £2 2s. *Aug. 6 S. Marcus, 222, Globe Road Selling milk 5 per cent, deficient in fat E. Ainley Mr.Leycester Fined £2, costs £1 13s. 6d. * 6 D. Jones, 55,Kerbela Street Selling milk 15 per cent, deficient in fat W. Billings „ Dismissed— Magistrate satisfied milk sold as cow gave it 6 J. T. Selling Camphorated Oil 39 per cent, deficient in camphor W. Rowsell „ Fined 10s., costs 12s. 6d. 6 S. M. Selling milk 5 per cent. decient in fat B. Ainley „ Fined £2, costs £1 13s. 6d. "Second or subsequent oSeuces reported by order of the Public Health Committee. 36 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. Date of hearing. Defendant, Offence. Inspector. Magistrate. Result. 1914. Aug. 6 I. N. Selling milk 7 per cent, of added water W. Rowsell Mr.Leycester Fined £1, costs £1 3s. 20 „ Selling milk containing 7 per cent, of added water „ „ „ Sept. 17 M. C. Selling milk 5 per cent, deficient in fat „ Mr. Clarke Hall Dismissed—warranty defence Oct. 8 J. S. Selling milk containing 7 per cent, of added water F. Bare Mr. Hopkins Fined £2. costs 14s. 6d. 22 D. J. Selling milk 11 per cent, deficient in fat W. Rowsell Mr. Chester Jones Costs £2 2s. Dec. 3 R. W. Delivering under contract milk 7 per cent, deficient in fat „ Mr. Wilberforce Dismissed. Magistrate satisfied milk sold as obtained from cow 3. M. D. Selling butter containing 61 per cent, foreign fat „ „ Fined £1, costs 12s. 6d. 37 Police Court Proceedings—Sale of Food and Drugs Acts, 1875-1907. . Date of hearing- Defendant- Offence. Inspector. Magistrate. Result 1914. Dec. 3 „ Selling margarine in plain wrapper W. Rowsell Mr. Wilberforce Withdrawn, conviction on other summons re. same sample 17 M. M. Selling milk containing 18 per cent, added water J. G. Weeks „ Fined £5, costs £1 3s. 31 H. S. Selling milk containing 11 per cent, added water F. Bare Mr. Chester Jones Costs £1 13s. 6d. 38 The following is a summary of legal proceedings, etc., taken in connection with samples taken for analysis:— No. of Adulterated Samples. Other Offences. No. of Summonses Issued and Cases Pending at 31st Dec., 1913. No of Convictions or Costs Obtained. No. of Cases Dismissed. No. of Summonses Withdrawn. No. of Cases Pending at 31st Dec., 1914. 55 9 53 43 4 6 - Two cases were dismissed upon successful "warranty" defences. In two further cases, the magistrate considered the evidence to be in favour of the cow, who, we are asked to believe, in one instance yielded milk 7 per cent. and in a further instance 15 per cent. deficient in fat. In four of the cases withdrawn, convictions were obtained on other summonses in respect of the same samples; and in two cases of milk taken upon delivery there was insufficient evidence of the existence of a contract, and by consent proceedings were stayed. 39 APPENDIX E. (3). Foods and Drugs. Table showing percentage adulteration for Decennial period 1904-1913, compared with 1914. Year. No. of Samples taken. No. of Samples Adulterated. Percentage of Adulterated Samples. 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 1913 710 83 11.7 Decennial average percentage adulteration 10.66 1914 739 55 7.4 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 48 45 4 Vinegar 2 — 2 40 APPENDIX E (4). Summary of samples taken informally and submitted to the Public Analyst during 1914:— Article. No. of Samples. Genuine. Adulterated or deficient in vital constituent. Other offences. Butter 12 6 6 5 Milk 8 7 1 — Mineral Waters 7 7 — — Totals 27 20 7 5 The samples of mineral waters were purchased in consequence of a complaint to the effect that a bottle of lemonade purchased at a certain shop caused the illness of the purchaser. The Public Analyst reported thus upon the portion remaining unconsumed " This had been put into a dirty bottle, the cork of which smelt of carbolic acid; some Epsom Salts had been previously in the bottle; a trace of this was left. The liquid was not in any way injurious to health." Of the other samples of mineral waters above mentioned, four were normal and two were reported to contain harmless minute traces of metallic contamination, probably derived from the apparatus used in making. In these cases the makers were warned. Thirty samples of margarine were purchased to ascertain whether the formalities prescribed by the Margarine Act were complied with. In three cases this was not so; the vendors were later dealt with on the taking of official samples. 41 APPENDIX E. (5). Summary of samples analysed in the Laboratory at the Town Hall, Bethnal Green, during 1914 Article No. of Samples Genuine. Adulterated or deficient in vital stituent or preservatised. Of low quality. Milk 56 38 18 13 Butter 14 9 5 — Margarine 3 3 — — Camphorated Oil 2 1 1 — Cottonseed Oil 3 3 — — Vinegar 5 2 3 1 Totals 83 56 27 14 APPENDIX E. (6). Extract from Monthly Report. November, 1914. SAMPLES OF MILK TAKEN OX DELIVERY AT SCHOOLS. During the past month a number of samples have been taken at schools of milk delivered to the order of Children's Care Committees, to he consumed by school children. The following is a list of the schools at which samples have been taken, and the result of analyses made :— 42 Name of School. Result. Globe Road 7 per cent, deficient in butter-fat or cream. St. Martin's Mission Genuine Portman Place do. Pritchards Road do. Mowlem Street do. Olga Street do. St. John's do. Mansford Street do. Wilmot Street do. Hague Street do. Abbey Street do. At a few other schools milk is delivered, at which no samples have been taken, as the quantity supplied is so small—usually a pint or so—as to be not worth while. The milk is still supplied under conditions similar to what existed in January last; in some cases under contracts, in others not. In some instances the milk is delivered warm, in others it is warmed by the school authorities before being used. In one case—that of Globe Road—the milk was found to be below the standard to the extent of 7 per cent. deficient in butter-fat or cream. The Public Health Committee ordered legal proceedings to be taken in respect of this sample, and at the hearing of the case at the Police Court on the 3rd inst., the defence set up was that the milk was sold exactly as it came from the cows. It was proved in evidence that a professional analyst had been called in to take samples of milk from certain 43 of the cows in question, and that the result of the analyses showed that, individually and collectively, the milk given by the cows was very much below the standard. As a successful line of defence, this procedure was. of course, entirely satisfactory, but the Public Health Committee consider it to be a question as to whether any contractor keeping cows giving milk of such a low standard should be permitted to supply milk to school centres to be served out to children as food. A letter has been addressed, by order of the Public Health Committee, to the Chairman and the Secretary of the local Association of Children's Care Committees, informing them of the action taken by this Authority, and the results thereof. APPENDIX E. (7) Extract from Monthly Report. January, 1914. SCHOOL CARE COMMITTEES.—MILK SUPPLY. Report re taking samples of milk on delivery at various London County Council Schools in the Borough. Acting under the instructions of Mr. Foot, I have been recently engaged in taking samples of milk on delivery at certain of the London County Council Schools in the district. According to Mr. Stedman (the London County Council Correspondent for this district) there are twentyone schools where milk is supplied to the children. The quantity varies from about twenty-two quarts down to one quart. 44 At the majority of the schools the milk is delivered on the premises; at others, it is customary for one of the schoolboys—by arrangement with the head master—to call at the shop and bring the milk with him as he comes to school. In these cases I have had to make arrangements with the head master to see the boy and follow him to the shop, and take the sample as delivered to him by the milkman. Whilst at most of the schools the milk is delivered cold, and warmed before giving it to the children, there are others, viz., Pritchard's Road, St. John's, and Turin Street where it is supplied warm. At St. Martin's Mission it was supplied warm and sweetened with sugar. The varying manner in which the arrangements are made for the supply of milk makes it very difficult to secure the samples as satisfactorily as could be desired, and the information given was often misleading, and added to the difficulties of the work. There are three schools where, on the advice of Mr. Foot, I did not take any samples, viz. :— (1) St. Bartholomew's, where only a pint in a sealed bottle is supplied by the Aylesbury Dairy Company. (2) Rochelle Street, where also only a pint is sent for as required, and (3) Virginia Road, where only two or three children have milk; in this instance the children go to a coffee shop in Virginia Road for about half-a-pint each. One of these children, I was told, paid 45 for his milk with money supplied by his parents, because it was the only way in which he could be induced to drink any milk. The following are the schools at which I have taken samples, together with the results of the analyses:— Name of School. Result. Globe Road 10 per cent, of added water. Mowlem Street Genuine. Pritchard's Road Do. Hague Street Do. St. John's, Peel Grove Do. Abbey Street Do. Turin Street 3½ per cent. of added water. Cranbrook Road Genuine. Portman Place Do. Olga Street Do. St. Peter's Do. Mansford Street Do. Daniel Street Do. Columbia Road Do. Wilmot Street Do. Teesdale Street Do. Mowlem Street (2nd sample) Do. Bonner Street Do. Somerford Street Do. *St. Martin's Mission (two samples) 20 per cent, and 27 per cent, of added water. *The unsatisfactory features arising out of the absence of any regularised method of contracting for the sale and delivery of milk of a uniform standard at the different schools or centres were strikingly emphasised in this case—St. Martin's Mission. 46 Here I took, as it was being delivered, samples of milk from two different vessels. Both samples proved to be heavily adulterated with 20 per cent, and 27 per cent, of added water respectively. 1 naturally assumed that some contract, verbal or otherwise, for the supply of this milk would be in existence, and issued summonses against the contractor in the ordinary manner. But later, on learning that the Care Committee had not only no effective contract in force, but had knowledge that the milk supplied was diluted to some extent with water, a legal difficulty at once became apparent, and consequently notice had to be given to the contractor that the summonses issued against him would not be proceeded with at the Police Court. The unsatisfactory state of affairs is obvious, and it seems desirable that the Care Committee should consider the question of having a proper understanding with the different tradesmen supplying this milk, in order to secure that all milk shall be delivered pure and up to standard, and that any addition of water that may be required to meet the case of individual children or schools shall be dealt with at the school premises. In any case where it may be necessary that the milk shall be sweetened it is not at all necessary to add water for such a purpose. (Signed) W. Rowsell. 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. Article. Number of samples examined for the presence of a preservative. Number in which a preservative was reported to be present. Milk 444 Nil Cream 9 7 In each case the preservative added was reported to be Boric Acid. In accordance with the provisions of the Regulations the vendors were invited to lay before the Committee any explanation they desired to make of the sale of Cream in contravention of the Regulations, They did so, and explanations were received from three of the vendors relating to six samples that they were not aware that the Cream contained Boric Acid. This appeared to the Committee to be genuine, and the explanations were accepted upon the payment of the costs which had been incurred by the Authority in each case. In the remaining case the vendor had appeared before the Committee on a previous occasion, and had been thoroughly warned of the provisions of 48 the Regulations, but as he appeared to have acted in defiance thereof, proceedings were instituted against him, and he was fined £1 1s., with costs £1 3s. 2. Cream sold as Preserved Cream. No contravention of the provisions of the Regulations relating to the sale of Preserved Cream were detected. 3. Thickening Substances In no case was any evidence discovered by the Public Analyst of the addition of any thickening substances to cream, or to preserved cream. 49 APPENDIX G. Particulars relating to Unsound Food for 1914. Seized. Cwts. Qrs. St. Lb. Meat - 1 — 6 Fruit 4 1 — 3 Broken Biscuits - - — 7 Total Seized 4 2 1 2 Surrendered. Cwts. Qrs. St. ##] Fish 2 1 1 3 Meat 2 1 — 10 Fruit 3 — — 8 Tomatoes 1 1 8 Potatoes 5 — — — Rabbits 2 — — 4 Total Surrendered 15 1 — 5 Also 15 Turkeys. Cwts. Qrs. St. Lb Grand Total Weight 19 3 1 7 50 APPENDIX H (1). Premises where Food is Prepared for Sale. No. of premises on Register at end of 1914 Technical Status. 10 Factories. 210 Workplaces. Do. removed from Register — Factory. 2 Workplaces. Do. added to Register — Factories. 1 Workplace. No. of Inspections 84 Factories. 868 Workplaces. No. of Notices Served — Factory. 29 Workplaces. No. of Prosecutions — Factories. — Workplaces. APPENDIX H (2). Particulars relating to Ice Cream Shops. No. on Register 119 No. removed from Register 12 No. added to Register 8 No. of Inspections made 277 No. of Notices Served 60 APPENDIX I. Particulars relating to Bakehouses. No. of Bakehouses on Register at end of 1913 86 Do. do. do. 1914 89 Do. above ground 63 Do. underground 26 No. of Inspections 239 No. of Notices Served 14 No. of Prosecutions — 51 APPENDIX J. (1). Outworkers. Year. No. of Lists received from Employers. No. of Outworkers comprised therein. Reported from other Boroughs. Reported to other Boroughs. 1913 192 2,947 2,832 1,452 1914 197 2,995 2,763 1,510 Number of Outworkers dealt with in 1913 5,779 „ „ „ 1914 5,758 APPENDIX J (2) Outworkers List of Trades. Artificial Flower Making 16 Lace and Net Making 3 Bathing Costume Making 1 Mantle Making 25 Belt Making 27 Milliners 26 Blouse Making 46 Military Lunch Bags 2 Bone Needle Making 1 Paper Bag Making 9 Boot and Shoe Making 412 Polishing 7 Box and Match Box Making 443 Pyjama Making 1 Brace Making 5 Shirt Making 16 Brush Making 146 Silk Weaving 31 Button Making 1 Skirt Making 17 Cabinet Making 3 Tailoring 435 Canvas Goods 2 Tie Making 33 Chair and Furniture Making 3 Trimming (fancy) 49 Clothing 128 Upholsterer's Trimmings 14 Collar Making 8 Underclothing Making 17 Corset Making 3 Umbrella Making 52 Dress Making 23 Walking Stick Making 1 Dyers 1 Waterproof Making 5 Embroiderers 6 Incorrect addresses and those discontinuing work 326 Feather Workers 19 Furriers 15 2,393 Hat and Cap Making 15 52 APPENDIX K. Houses Let in Lodgings. Number of Houses Let in Lodgings on Register at, end of 1914 273 Number of Houses Let in Lodgings cancelled during 1914 10 Number of Houses Let in Lodgings registered during 1914 30 Number of Inspections made* 1,126 Number of rooms overcrowded 11 Cellars illegally occupied 1 Water provided to upper floors — Cases of indecent occupation — Notices served 360 Registration Forms written and served 38 APPENDIX L. House-to-House Inspections. Number of inspections 1,759 Number of notices served 782 Cases of overcrowding remedied during 1914 156 Number of defects discovered 3,548 53 APPENDIX M. Verminous School Children. 1910. 1911. 1912. 1913  Number of complaints received 252 329 974 928 804 do. inspections and reinspections made 289 358 991 1,742 1,090 do. premises found to be verminous 46 16 82 54 62 do. defects discovered 334 317 1,116 1,401 621 do. notices served 206 • 152 211 466 324 do. prosecutions — — — 1 — 54 APPENDIX N (1). Rooms and Bedding disinfected during the Year ending 31st Dec., 1914. Month. Scarlet Fever. D phtheria. Enteric and Ty phoid. Pulmonary Tuberculosis. Verminous, Cancer. Erysipelas. Scabies. Measles. Chicken Pox. Puerperal Fever. By Request. Schools. Total. No. of Articles Disinfected at Station. January 31 14 - 7 2 1 - 11 - - - - - 66 1382 February 15 37 — 16 6 - l 12 - — - - — 87 1074 March 21 28 2 16 8 - 2 12 - - - 5 — 94 1142 April 30 37 - 10 22 1 — 4 2 - - 2 — 108 2144 May 36 38 1 6 32 - — 15 1 — - - — 129 2263 June 49 24 1 13 11 - — 7 1 1 - — — 107 1582 July 39 21 1 11 21 — — 12 3 - — 6 — 114 2300 August 65 29 3 15 19 - - 8 — - - — — 139 1717 September 97 35 3 13 6 - — 6 3 — 1 2 8 174 2170 October 98 33 2 8 11 - 1 4 1 - - — — 158 13179 November 86 30 — 4 11 — - 5 1 — - — — 137 12544 December 76 28 1 17 5 - 1 5 - - - - — 133 6359 Totals 624 354 14 125 154 2 5 101 12 1 1 15 8 1446 47856 Articles disinfected in Formalin Chamber, Articles of Clothing from Variolas Schools, T.W.D.C., 15226 . Other articles such as Boots and Fancy Materials, 6,586. 20 men had a bath and clothing disinfected at Station. 55 APPENDIX N (2). Disinfectants. Fifty-eight casks of Sanitas Powder, making up into 4,060 packets, have been distributed from the Public Health Department. One thousand two hundred and eighty pint bottles of Sanitas Fluid, and 480 pint tins of Izal Fluid have also been distributed. These numbers continue the increase shown last year above previous years, due doubtless to persons notified under the Public Health (Tuberculosis) Regulations, 1912, taking full advantage of the facilities provided for them. Three-quarters of a ton of sulphur candles were used in the disinfection of rooms throughout the year. Three gallons of Formalin Solution (40%) have been used in spraying the walls of rooms, and seven pounds of Formalin Tablets have been used for fumigating articles in the Formalin Chamber. Seventeen gallons of Creocide were also used for disinfecting purposes. APPENDIX O. Smoke Nuisance Observation. No. of Shafts under Observation 100 No. of Observations Made 374 No. of hours occupied in observation 180 No. of Intimation Notices Served 24 No. of Statutory notices served 5 No. of Prosecutions nil. 56 APPENDIX P. Mortuary Returns, 1914. Bodies removed to Mortuary— On Coroner's Order 250 By Police 8 From London Hospital 9 On Sanitary Inspector's Order 1 By Request of Relatives 64 Total 332 Number of Inquests held 263 Number of Post Mortem Examinations made 95 Particulars of Bodies on which Inquests were held— Bodies removed by Police from Canal 4 Do do. Street 2 Do. do. Great Eastern Railway. 1 Do. do. found in Parcels 1 Bodies received from Bethnal Green Infirmary 59 Do. do. Bethnal House Asylum 2 Do. do. Queen's Hospital 21 Do. do. Mildmay Mission Hospital 8 Do. do. Victoria Park Hospital 2 Do. do. Private Houses, etc. 163 Total 263 Inquest cases according to age periods— Number under one year 77 Number over one year and under live years 18 Do. five do. ten do. 14 Do. ten do. twenty years 9 Do. twenty do. thirty do. 9 Do. thirty do. forty do. 13 Do. forty do. fifty do. 24 Do. fifty do. sixty do. 30 Do. sixty do. seventy do. 28 Do. seventy do. eighty do. 30 Do. eighty years 11 263 57 Causes of Death in Inquest cases— Acute Bronchitis 5 „ Cholecystitis 1 „ Diarrhœa 1 „ Meningitis 1 „ Pericarditis 1 „ Pneumonia 16 Angina Pectoris 1 Apoplexy 15 Atelectasis 5 Atheroma of Aorta 2 Broncho-pneumonia 11 Cardiac Valvular Disease 12 Cancer 2 Cerebral Softening 1 Chronic Nephritis 3 Congestion of Lungs 2 Convulsions 9 Dilatation of Stomach 1 Fatty Degeneration of Heart 8 Gastric Catarrh 1 General Dropsy 2 Inanition 3 Infective Enteritis 4 Jaundice 1 Malformation of Heart 2 Malnutrition 1 Measles 2 Meningitis (Tubercular) 1 Pertussis 2 Pharyngeal Abscess 1 Peritonitis 2 Phthisis 2 Pleurisy 1 Premature Birth 2 Pulmonary Tuberculosis 8 Rupture of Aneurism of Aorta 2 Senile Decay 4 58 Status Lymphaticus 1 Still Born 9 Tumour of Brain 1 Ulcerated Stomach 3 Varicella 2 Chronic Alcoholism 4 Found Drowned 1 Poverty and Destitution 4 Self Neglect 1 Accidental Deaths— Burns 9 Falls 30 Scalds 4 Septicaemia 1 Suffocation whilst in Bed 23 „ „ a Fit 1 „ „ Drunk 2 „ at Birth 2 Misadventure, death whilst under Anæsthetic 3 „ Appendicitis 1 Ptomaine Poisoning 1 Run over in street, etc., by Motor Car 1 8 „ „ Bus 2 „ „ Horse Van 4 „ by Great Eastern Train 1 Knocked down by Tram Car 1 Suicide— Cut Throat 1 12 Drowning 2 Hanging 4 Poisoning 4 Self Strangulation 1 Total 263 Bodies received under Public Health (London) Act— Diphtheria 5 Erysipelas 1 6 59 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 1913. Added in 1914. Removed in 1914. On Register at end of 1914. Milkshops 244 12 10 246 807 116 2 Cow-houses 14 — — 14 60 — — Slaughter-houses 4 — — 4 25 — — Other Offensive Trade Premises 1 — — 1 2 — — 60 APPENDIX R. Clerical Work. Intimation Notices written and served, Public Health Act 4,740 Statutory Notices written and served, Public Health Act 3,457 Notices under Housing, Town Planning, &c., Act, 1909, Section 15 - Entries in Nuisance Register 7,668 „ Tenement House Register 1,785 „ Food and Drugs Register 795 „ Workshops Register 6,115 Notices respecting Combined Drainage 54 Final Notices prepared and served 1,032 Letters written 3,138 Instructions to Solicitor prepared 65 Summonses prepared (4 copies each) 81 School Notifications prepared and despatched 2,255 Notices to District Surveyor 172 61 APPENDIX S. RAG FLOCK ACT, 1911. One sample only of "rag flock" was taken during the year. Owing to the extremely narrow construction placed upon the Act in the Courts, as was pointed out in my Report for 1913, it had become almost a dead letter, but the sanguine hopes which were then expressed in many quarters that the shortcomings of this very unsatisfactory Act would speedily be remedied were unfortunately not realised. The practical object of such an Act should be to prohibit the making up into any form for use, any flock or similar material which does not conform to the standard of cleanliness prescribed by the Regulations made under the Act, but this is far from the result which has been attained. In "Gamble v. Jordan" a mattress maker had undertaken in his spare time and at his own house, to "remake" a mattress, the property of a relative, for the sum of one shilling. He remade the mattress with the same flock and in the same cover; the flock did not conform to the standard of cleanliness laid down, but it was held that what the man had done was not the "making" of an article of bedding within the meaning of the Act. On the other hand, in "Guildford Corporation v. Brown" a person who performed exactly the same operation with flock of the same description as the mattress 62 maker in the above cited case, with the exception that the flock was put back into a new cover, was held in the same Court to have contravened the statute. The case of "Cooper v. Swift" has afforded some little relief to the vexed question of what "rag flock" should consist; in many cases heard in the Police Courts it had been decided that flock made from rags to which the Act applies should contain nothing whatever except flocks actually and entirely made from rags, but in this case it was held that flock consisting partly of refuse composed of waste fluff from machines, and partly of cuttings from woven jute fabric cut away as waste in the course of manufacture, is flock within the meaning of the Act. The position is very unsatisfactory, and nothing short of thorough revision, the provision of a proper and suitable standard of cleanliness, and the insertion of clear and unequivocal definitions, will render the Act workable. 63 APPENDIX T. Housing, Town Planning, etc, Act, 1909. Summary of Results of House-to-House Inspections for the year 1914. Number of houses inspected 607 Number of houses where admission was not obtained — Number of empty houses 30 Number of houses where defects were found and where notices were required 360 Number of houses where no defects were found 122 Number of houses where overcrowding was found 2 Number of houses so unfit for human habitation as to be suitable for Closing Order under Section 17, Housing and Town Planning, etc., Act 13 Number of houses so defective as to be suitable for dealing with under Section 15, Housing and Town Planning, etc., Act 18 Number of houses where ordinary notices under the Public Health (London) Act, 1891, met the case 338 Number of houses to which it was necessary to draw the attention of the District Surveyor 36 EVAN RICHARDS, Special Officer under the Housing, Town Planning, etc.. Act, 1909. During the year, houses in the following streets were inspected :— Arline Street. Hackney Road. Austin Street. Harold Street. Baker Street. Kay Street. Brick Lane. Kirkwall Place. Cadell Street. Lisbon Street. Claremont Street. Newling Street. 64 Coopers Gardens. Peary Place. Cottage Place. Princ s Court. Cymon Street. Satchwell Rents. Derbyshire Street. Southampton Cottages. Digby Street. Teale Street. Emma Street. Temple Street. Garner Street. Virginia Road. Gibraltar Gardens. Voss Street. Gibraltar Walk. CLOSING ORDERS. Nos. 26, 27, 28, 29, 30 and 31, New Tysson Street. Upon representations made by the Medical Officer of Health the Council made Closing Orders in respect of these premises, and the owners agreed voluntarily to demolish Nos. 26 to 30. Demolition was reported in progress on the 31st December, 1914. With regard to No. 31, negotiations were at that date in progress with the owner for submission of a complete plan and specification of repairs and alterations which would be required at these premises in order to render them suitable for human habitation. A Closing Order was also made by the Council upon the representation of the Medical Officer of Health with reference to No. 11, Kay Street. The owner undertook to carry out the necessary repairs at these premises to render the same fit for human habitation, and upon the completion of the repairs the Closing Order was determined by the Council on the 3rd December, 1914. The Medical Officer of Health also submitted representations under the Housing Acts as to the unfitness for human habitation of No. 5, Austin Street, Nos. 21, 23, 25 and 27, Gibraltar Walk, Nos. 5, 6, 8, 9, 10, 11, 12, 13, 65 14, 15, 16, 17, 18, 19 and 20, Princes Court, and Nos. 23 and 25, Harold Street. These representations were under consideration by the Public Health Committee at the end of the year. The land being the site of Nos. 1, 2., 3, 4, 5, 6, 7, 9, 10 and 11, Smith's Buildings, which premises were demolished upon the making of Closing Orders by the Council in 1913, remains vacant and upon offer for sale by the freeholder. Nos. 15, 19 and 30, Smith's Buildings, in respect of which Closing Orders were also made by the Council, remain properly closed and hoarded to the satisfaction of the Committee, the premises being allowed to stand at the special request of the owner—to which there was no objection made—on account of the support afforded to the adjoining premises. HOUSING. Particulars as to houses demolished, and new accommodation provided, during the three years, 1912, 1913 and 1914 Premises demolished from all causes 91 New housing accommodation provided 24 Net loss or decrease in housing accommodation 67 66 APPENDIX U. COMBINED DRAINAGE. No remedy has yet been provided by Parliament for relieving ratepayers from the grossly unjust burden thrown upon them by the defective state of the Public Health laws in relation to combined drainage, and as a consequence, eight additional systems were during the year added to our previous list and relaid as " Sewers " by men in the employ of the Public Health Department. The properties comprised were :— Nos. 35, 37, Weaver Street, and No. 13, Bratley Street. Stables and Workshop in rear of Nos. 2, 4, 6, 8 and 10, Wharf Road and premises in rear of Nos. 106, 108, 108a and 110, Pritchards Road. Nos. 1, 2, 3, 4, 5, 6 and 7, Minto Place, and No. 39, Wolverley Street. Nos. 134, 136, 138, 140 and 142 Vallance Road. Nos. 38, 40 and 42, Sewardstone Road. Nos. 2, 4 and 6, Gawber Street. Nos. 39. 41. 43. 45, 47, Hassard Street, and Nos. 1 and 2. Hassard Place. Nos. 2, 3, 4, 5 and 6, Poyser Street, and 118, Bethnal Green Road. The total number of combined drainage systems vested in the Council at the close of the year amounted to 522 Number of properties involved 2883 67 Number of clearing eyes, manholes, etc., provided to give the requisite facilities for flushing and cleansing such combined systems 1077 Number of flushing operations carried out during the year 597 Number of defective clearing eye covers repaired or reinstated 29 The total approximate cost thrown upon the ratepayers of this Borough owing to the complications and difficulties arising out of the law with respect to combined drains amounted during the thirteen years ending March, 1914, to the substantial sum of £15,902, or an average annual expenditure of £1,223. In addition to their ordinary duties, the men in the employ of the Public Health Department have been engaged during the year on the following works :— Disinfecting Station, minor repairs and renovations. Council's Shelter, do. do. Mortuary, do. do. The services of the Council's men have also been applied for in respect of the undermentioned private works, and for which accounts were duly prepared and submitted :— Bethnal Green Infirmary, flushing, sweeping and amending drains and sanitary fittings, and remedying various defects. 68 L.C.C. School, Rochelle Street, preparing class rooms and disinfecting same. Nos. 5 and 6, St. Andrew's Street, clearing drains. No. 43, Medway Road do. do. No. 9, Gibraltar Gardens do. do. No. 28, Thorold Street do. do. No. 103, Sclater Street do. do. Roman Catholic Church, Victoria Park Square do. do. The amounts charged in respect of these private works have since been received and paid into the Council's Account.