BET 24 AC 4366 THE Metropolitan Borough of Bethnal Green REPORT on the HEALTH OF THE BOROUGH OF BETHNAL GREEN DURING THE YEAR 1922 BY GEOFFREY EUGENE OATES M.D., B.S. (London), M.R.C.P. (London), D.P.H. (Cambridge); Barrister-at-law,of the Honourable Society of Gray's Inn; Lieutenant (late R.A.M.C.); Fellow of the Royal Society of Medicine; Fellow of the Royal Institute of Public Health ; Fellow of the Society of Medical Officers of Health; Fellow of the Zoological Society; Member of the Royal Sanitary Institute; and Medical Officer of Health and Administrative. Tuberculosis Officer for the Metropolitan Borough of Bethnal Green. LONDON: Printed by Frowde & Co. (T.U. all Depts), 242-244, Old Kent Road, S.E. 1. Town Hall, Bethnal Green, E. 2. To the Mayor,Aldermen and Councillors of the Metropolitan Borough of Bethnal Green. May, 1923. Ladies AND Gentlemen,) I have the honour to present to you my fourth Annual Report, which deals with the health of the Borough of Bethnal Green during the year 1922. The health of the Borough continued good as judged by previous experience, but the death-rate was 15.3 per thousand as compared with 12.9 in the year 1921. This increase in death-rate was accounted for by a slight outbreak of influenza in the first quarter of the year. The death-rate during the last three quarters of the year was 12.15. The birth-rate for 1922 was 25.2, and appears to have become stationary at this figure, which is considerably below the usual figures before the Great War. The outstanding event in health matters during the year was the opening of the new Maternity and Child Welfare Centre in Cornwall Road. This Centre is well equipped and staffed for the task of improving the health and welfare of our child population and our mothers. The subject of midwifery which is just as important in its results and as affecting life and health, may now well deserve renewed consideration by the Council. As in past Reports, I have to express my thanks to the members of the Council, and more particularly to members of the Public Health Committee, for the support and consideration they have accorded myself and my staff during the past year. I must also tender my thanks to the officers and employees of the Public Health Department for the support I have received from them, and to other officers of the Council's staff for the help and courtesies received. I am, Ladies and Gentlemen, Your obedient servant, GEOFFREY EUGENE OATES, Medical Officer of Health. Metropolitan Borough of Bethnal Green PUBLIC HEALTH COMMITTEE, 1922-1923 as on 31st December, 1922. Meetings held at the TOWN HALL on the first and third Wednesdays, at 7 p.m. Alderman T. J. Boyce, Chairman. Councillor Mrs. R. Elsbury, Vice-Chairman. The Mayor (The Rev. G. E. A. Whitworth, M.A., J. P.) Alderman Mrs. H. Jeffcote. „ J. E. A. King. Councillor J. Alabaster. Councillor S. Elsbury. „ T. Brooks. „ J. J. Fleming, J. P. „ H. Buck. „ G. E. Snelling. „ F. W. Eaton. One Vacancy. Ex-Officio Members of the Public Health Committee: (Chairmen of other Standing Committees of the Council.) COMMITTEE. CHAIRMAN. Finance Councillor J. Valentine. Works and Stores J. W. Martin. Law and General Purposes „ J. J. Vaughan. 1 Baths „ W. H. Bryant. „ D. J. Pickering. Electricity Valuation A. H. Gillison. Public Libraries „ D. G. Alabaster. Housing Alderman C. W. Hovell. The Public Health Committee is also the Statutory Committee to which all matters relating to Maternity and Child Welfare stand referred. PUBLIC HEALTH DEPARTMENT. STAFF as on 31st December, 1922. Geoffrey Eugene Oates, M.D., M.R.C.P., London, D.P.H., Cambridge, Barrister-at-Law, Medical Officer of Health and Administrative Tuberculosis Office r. Alfred W. Stokes, F.C.S., F.1.C., Public Analyst. Sanitary Inspectors. *§Evan Richards, Chief Sanitary Inspector. *F. T. Bare. *E. J. Jenkins. *W. Billings, Junr. *I. R. Jones. *G. I. Brighting. *§W. Rowsell. *§A. S. Henley. *J. O. G. Weeks. *J. H. Hewitt. * Certificated Sanitary Inspector. § Certificated Meat, etc. Inspector. Health Visitors. †‡ Miss G. I. Le Geyt, Superintendent Health Visitor. (Member Central Mlciwivts Board) †Mrs. F. M. Barden. †‡Miss E. M. Patrick. ‡Miss V. D. Cornish. †Mrs. A. W. Rosling. †‡Mrs. E. L. Hann. †‡Miss L. F. Wright. ‡Mrs. M. A. Hodgkins. - †‡Miss C. E. Love. †‡Miss E.S. Crisp (Tuberculosis) ‡ Certified Midwife. † Certificated Nurse. Clerical Staff. *J. Henry Lloyd, Chief Clerk. F. G. Thomas, Assistant Clerk. S. Slater, Junior Clerk. R. W. Slyfield, Assistant Clerk. - F. J. Bryant, Shorthand Typist. H. A. Saunders, General Assistant G. E. Gould, Assistant Clerk. W. H. Heron, General Assistant. L. A. Taylor, Assistant Clerk. * Certificated Sanitary Inspector. Temporary (Part Time) Medical Officers (Maternity and Child Welfare Centres). Mrs. K. Addison, M.B., B.S. Miss E. F. Iredell, M.D. Miss M.C. Ferguson, M.B.,B.Ch. Mrs. O. Langmead, M.B., B.S. Mrs. N. D. Pinkerton, M.B., B.S., M.R.C.S., L.R.C.P., B.Sc. Clinical Tuberculosis Officers. (appointed by the Governors of the City of London Hospital for Diseases of the Chest). Senior, H. Tylford Howell, M.R.C.S., L.R.C.P., London. Junior, F. W. Hamilton, M.B., B.S., London, D.P.H., Oxon. CHANGES DURING 1922. Mrs. E. M. Burden, Health Visitor, resigned her appointment as from the 28th January. Miss C. E. Love was appointed to this vacancy and took up her duties on the 10th April. POPULATION. The final figures for the Census of 1921 are now available, and the enumerated population on 19th June, 1921, was :— 56,766 Males Females 60,472 Total 117,238 On comparing this with the enumerated population of 1911, which was 128,183, there is seen to be a decrease in population of 10,945, or 8.5 per cent. Furthermore, during the ten years between the Censuses, there was an excess of births over deaths in the Borough of 14,871. Adding to this figure the figure 10,945, being the decrease in population, we have a total loss to the Borough by migration of 25,816, during the ten years. This number includes the number of those dead or missing owing to the war. This was 3.1 per cent, of the total male population in England and Wales, which gives a number 1,760 for Bethnal Green. The best local estimate of the number of war casualties is about 1,130, but this is probably much too low. It will be seen that during the ten intercensal years there has been a net overflow from Bethnal Green into other parts to the extent of approximately 24,000 individuals, and this apart from war casualties. These have served to increase the population of other parts of Great Britain and the Empire, and other countries to a minor extent. From these facts the moral may be drawn that the welfare and health of a poor Borough such as Bethnal Green is of real interest to other more favoured parts, and that Bethnal Green contributes her share in populating the vacant places of the Empire. The population, as estimated by the Registrar- General in the middle of 1922, was 118,400. CENSUS STATISTICS, 1921. Certain further statistics arising out of the Census taken in 1921 have now been published, and a few of the more interesting tables are given below. The present distribution of the population among the four wards of the Borough, and in separate families and dwellings, is shown in the following tables :— Table I. TOTAL POPULATION Area in Statute Acres 1921 1911 WARDS Persons Persons per Acre Females Persons Males 760 56,766 60,472 154 128,183 117,238 356 40,742 20,728 114 East 42,622 20,014 North 115 21,344 19,804 9,490 10,314 172 South 158 34,479 31,307 15,027 16,280 198 West 131 29,738 25,385 12,235 13,150 194 Table II. PRIVATE FAMILIES AND DWELLINGS. WARDS Population in Private Families Structurally Separate Dwellings occupied Rooms occupied Rooms per Person Private Families 27,596 114,203 78,045 0.68 18,281 East 5,683 0.74 9,579 38,090 28,166 North 4,809 19,681 3,089 13,431 0.68 7,314 South 31,207 5,319 20,353 0.65 5,894 West 25,225 4,190 16,095 0.64 The reduction of population is most marked in the West Ward. A slight correction should be made in the figures for the East Ward, because while its acreage is correctly given as 356, this includes 100 acres of park land. If the nett acreage be taken as 256, the number of persons per acre will be seen to be 198 instead of 114. The density of the population per acre for the Borough (154) may be compared with the average of 60 for the County of London. Only two Metropolitan boroughs exceed Bethnal Green in density—Shoreditch (158) and Southwark (163). The extent to which the residents in the Borough are living under congested conditions is further brought out by the following table, which classifies the population according to the size of family, number of rooms occupied, and consequent density of occupation : — 4 315 1,491 1,432 797 243 110 17 2 4,407 16.0 17,628 12,848 0.73 1,260 - 5,964 5,728 5 86 960 1,191 791 241 148 18 3 3,438 12.5 17,190 11,037 0.64 430 4,800 5,955 3,955 24 532 896 13 2 2,522 9.1 15,132 0.57 144 9,360 1,512 6 664 252 139 8,678 3,192 7 8 257 598 545 227 129 14 2 1,780 6.5 12,460 6,561 0.53 1,855 4,186 3,815 2,380 8 3 124 384 440 177 95 11 3 1,237 4.5 9,896 4,755 0.48 1,016 3,072 4,936 760 9 1 39 204 280 133 85 12 1 755 2.7 6,795 3,109 0.46 360 4,356 1,827 225 3,980 10 - 10 82 156 86 58 5 1 398 1.4 1,724 0.43 100 2,380 1,4l0 80 11 - 4 32 64 28 28 2 - 158 0.6 1,738 689 0.40 396 1,012 308 22 12 - - 5 22 17 2 - 58 0.2 696 285 0.41 408 216 12 12 60 - - 1 3 - 1 1 14 0.1 182 69 13 143 13 13 13 14 1 - - 8 3 1 1 9 0.0 126 52 0.38 1 4 0.41 14 98 - 14 15 and over - - - 2 5 3 - - 10 0.0 153 52 0.34 31 122 - - Total Private Families 4,320 7,992 7,755 21 27,596 100.0 - - - - - - - 4,786 1,658 942 122 704 129 - - 114,203 - - 5,679 26,013 42,486 14,701 Population in Private Families 8,588 34,649 5,945 26,245 27,925 10,018 Rooms occupied 4,319 15,984 23,265 19,144 8,290 5,803 1,009 231 - - - 78,045 0.68 - - - - I 15.7 17.5 29 0 27.0 28.1 26.0 17.3 16.5 6.0 7.3 0.1 0.2 100.0 100 0 1921 Percentage of families living in various units of occupation 1911 „ „ „ „ „ „ „ 3.4 4.7 0.4 0.8 This table may be condensed into the following summary : — Percentage of population living at following densities of occupation : — Rooms per person. Under .3 4.8% .3 & under .5 22.2% .5 & under .7 36.2% .7 & under 1.0 12.5% or, in other words, 27% of the population live more than 2 per room, and 75% of the population live more than 1 per room. The following table shows how the population is made up according to age and conditions as regards marriage :— 12,419 5,975 29 1 6,347 95 2 10.5 15-19 5,945 - 6,444 - 10.8 10,663 906 2 2 31 2 20—24 4,841 3,931 5,822 4,208 1,581 8.5 9.6 8,794 4,052 1,649 2,375 24 4 4,742 1,681 2,911 144 6 7.1 25—29 7.8 30—34 7,971 3,709 748 2,917 35 9 4,262 753 3,245 261 3 6.5 7.0 35-39 7,642 3,637 521 3,045 66 5 4,005 460 3,224 315 6 6.4 6.6 40—44 7,274 3,559 408 3,059 89 3 3,715 358 3,012 343 2 6.3 6.1 45—49 6,491 3,270 323 2,767 176 4 3,221 282 2,479 459 1 5.8 5.3 50-54 5,199 2,571 271 2,074 3 2,628 220 1,867 538 3 4.5 4.3 223 3.5 55—59 3,962 1,990 170 1,554 261 5 1,972 162 1,231 578 1 3.3 2.9 2.7 60-64 3,274 1,634 167 1,165 298 4 1,640 128 840 672 - 2.2 65—69 2,447 1,138 88 728 322 - 1,309 96 533 680 - 2.0 1.4 70—74 1,502 645 58 365 222 - 857 64 236 556 1 1.1 801 313 149 488 - 0.6 75—79 29 135 - 38 98 352 0.8 80—84 0.2 0.4 345 126 10 46 70 - 219 17 27 175 - 0.0 85—89 90 25 1 6 18 - 65 6 5 54 - 0.1 90—94 21 7 - 3 4 - 14 1 1 12 - 0.0 0.0 0.0 0.0 95—and over 5 4 - - 1 - - 1 - 4 - NOTE.—The following table contains analyses of (1) the buildings, and (2) the structurally separate dwellings of each area. In the upper part of each section the several classes (Groups I.— V.) are analysed both in the left-hand column (a— c), in respect of their characteristics as buildings, and in the right-hand columns (f— p), in respect of the dwellings which they comprise. In the lower part of each table the subjects of analysis on the left and right- respectively are different; on the left, the "buildings" analysis is continued in respect of an expanded classification of one of the five buildings groups; while on the right, the analysis according to dwellings is continued in respect of certain selected classes of private family occupations. Buildings [left hand columns (a— c)]— ln the enumeration of buildings, a building has generally been regarded as a structure wholly detached or separated from another by a vertical party wall. A block of flats would be one building though there might be one or more separate flats on each floor. The allocation of buildings among the several classes shown in Column (e) is based on the descriptions furnished by the local enumerators. The varieties of type encountered in the buildings enumerated have, however, inevitably given rise to some difference of practice on the part of enumerators in describing borderline cases; and the numbers of buildings assigned to the several classes in Column (e) should therefore be regarded as approximate. (a) Structurally divided private houses are separately shown for the first time, with a view to affording an indication of the extent to which houses originally built for the occupation of single families have been structurally divided to provide separate and independent accommodation for two or more families. There is evidence, in the returns, that it has not always been possible for enumerators to distinguish between buildings originally erected to comprise, e.g., maisonettes and those subsequently converted for the purpose. (b) Inns and Public Houses in which the business of the establishment is primarily that »f retailing liquors are classed with Shops (Group IV) instead of with Hotels (Group V), which are thus limited in the table to those of a residential character. STRUCTURALLY SEPARATE DWELLINGS (right-hand columns (f— p) ).—Above the "total" line dwellings are classified according to the type of building in which they occur, while below the "total" line the same premises are classified according to the number of families enumerated within them. Dwellings "Vacant on Census night" include those unoccupied through the temporary absence of the usual occupier as well as those without a tenant. BUILDINGS, DWELLINGS, ROOMS AND FAMILIES. Table V. The classification differs from that adopted in 1911 in the following respects :— The total rooms in dwellings occupied by private families as shown in the following table is usually slightly in excess of the total rooms occupied owing to the fact that in certain dwellings inhabited by two or more families, part of the dwelling was unoccupied on Census night. Definitions : —For definitions of "Private Family," "Structurally Separate Dwelling" and "Rooms" see note at the head of Table 3. Buildings Population 1921 e Dw'ngs occupied by non-pvte families (excl'd from cols. g-p). Structurally Separate Dwellings Occupied by Private Families or Vacant. Vacant on Census night. Occupied by Caretaker (included in cols. k-p) Total Dwellings. o Total Rooms. P in course of Erection a completed 1—3 Rooms. k 4—5 Rooms. I 6—8 Rooms. m 9 or more Rooms. n not containing Dwellings b containing Dwellings c Cols. 83,522 I. Undivided Private Houses 3 - - - 10,892 9 54 5 1,515 4,603 4,424 341 10,883 55,683 3 22 II. Structurally divided Private Houses - - - 5 3 - - 8 26 19,111 III. Blocks of Flats, Tenements, etc. - 116 - 4,989 341 17 - 5,347 13,043 6 - 418 - 275 2,059 11,089 IV. Shops 2 41 - 528 1,044 458 27 2,057 9,308 A very elaborate analysis of the buildings, dwellings, number of rooms and families (according to the nature of their dwellings) is given in the preceding table : — The number of people living in institutions in the Borough is shown in the following table :— Table VI. Institutional Population of Bethnal Green. TOTAL POPULATION INMATES ONLY Persons Males Persons Males Females Females 582 539 318 325 257 Bethnal Green Workhouse 221 Bethnal Green Hospital (Poor Law) 485 209 276 383 200 183 69 152 221 130 65 Queen's Hospital for Children 65 222 86 136 City of London Hospital for Diseases of the Chest 161 79 82 15 Mildmay Mission Hospital 46 31 16 64 18 VITAL STATISTICS of Bethnal Green During 1922 and Previous Years. Population Estimated to Middle of Each Year. Births. Transferable Deaths. Nett Deaths of Persons Resident in the Borough. Year. Civilian for calculating death-rate Including combatants serving for calculating birth-rate. Uncorrected Number. Nett. Of Residents not registered in the Borough Of Non residents registered in the Borough Under 1 year of age. At all Ages. Total Deaths Registered in THE Borough. Rate Number Rate per 1,000 births or infantile mortality. Death rate. Number. Number. MARRIAGES. The number of marriages celebrated in Bethnal Green during 1922 was 960. This is equal to a rate of 16.2 persons married per 1,000 total population BIRTHS. The number of births registered in the Borough during 1922 was 2,579, and in addition 402 occurred outside the Borough to Bethnal Green residents in excess of those occurring in Bethnal Green to residents of other localities, making a total of 2,981 births. The birth rate for 1922 was therefore 25.2 births per 1,000 population. This compares with : — 1916 27.3 1917 22.8 1918 19.2 1919 22.4 1920 33.1 1921 25.4 The birth rates in the four quarters of the year were : — First quarter 27.4 Second „ 26.2 Third „ 24.1 Fourth „ 22.9 Of the 2,981 births, 1,480 were those of males and 1,501 those of females. ILLEGITIMACY. Of the 2,981 births credited to this Borough, 66 were illegitimate, being 34 males and 32 females, and being 2.2 per cent. of the total number of births. STILLBIRTHS. 67 stillbirths were brought to notice, being a proportion of 2.2 per cent. of all births, live and dead. DEATHS. The number of deaths that were registered during the year as having taken place in the Borough was 1,776. Of these 349 were of persons whose residence was not in Bethnal Green, 346 dying in Bethnal Green Institutions, and 3 in other places in the Borough. There were also reported to the Registrar-General 379 deaths of Bethnal Green persons who died in institutions in other parts of London, and 12 who died in other parts of England and Wales. This correction gives the net number of deaths for Bethnal Green as 1,818, making an annual death rate of 15.3 per 1,000 of population. Death rates of previous years are : — 1916 15.3 1917 15.8 1918 23.9 (Influenza pandemic) 1919 13.9 1920 14.6 1921 12.9 There was one uncertified death during the year. The death rate for Bethnal Green, 15.3, is not far removed from the death rate for the County of London. Infant mortality is reported on in the section dealing with maternity and child welfare on page 25. The causes of death among the general population are shown in the following table :— Causes of Death. Queen's Hospital for Children. All Ages. Under 1 year. 1 and under 2 years 2 and under 5 years. 5 and under 15 years. 15 and under 25 years 25 and under 45 years 45 and under 65 years. 65 and up-wards. Mildmay Mission Hospital. City of London Hospital for Diseases of the Chest. Bethnal Green Hospital (Poor Law) Bethnal Green Workhouse. (Poor Law) Total Institutional Deaths All causes Certified Uncertified 269 189 132 62 114 1817 74 218 425 448 259 49 619 69 1110 ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1. Enteric Fever 2 ... ... ... ... ... 2 ... ... ... ... ... 1 ... 1 2. Small Pox 1 ... ... ... ... 1 ... ... ... .. ... ... ... ... ... 98 19 44 29 6 ... ... ... ... 1 ... ... 77 ... 78 3 Measles 4. Scarlet Fever 6 ... 3 1 2 ... ... ... ... 1 ... ... ... ... 1 5. Whooping Cough 83 19 10 24 ... ... ... ... 4 1 ... 62 ... 67 6. Diphtheria & Croup ... 34 1 7 22 3 ... 1 ... ... 2 ... ... 3 ... 5 7. Influenza 75 2 3 1 1 2 14 25 27 3 ... 1 10 ... 14 8. Erysipelas 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 9. Phthisis (Pulmonary Tuberculosis) 194 2 2 2 35 75 63 15 8 1 50 83 3 145 10. Tuberculous Meningitis ... 10 1 2 ... 1 ... ... ... 21 2 1 1 ... 25 6 11 Other Tuberculous Diseases 15 ... ... 2 5 1 1 ... 1 4 ... 9 4 2 4 12. Cancer, malignant disease 128 1 32 3 5 14 ... 64 ... 2 20 73 42 ... ... 10 13. Rheumatic Fever 15 ... ... ... 6 3 3 2 1 5 1 ... 4 ... 16 14. Meningitis 10 5 ... 1 3 ... 1 ... ... 15 ... ... 1 ... 15. Organic Heart Disease 215 ... ... ... 7 4 58 1 71 39 128 28 118 1 16 1 1 7 41 91 4 1 9 65 11 90 16. Bronchitis 172 16 9 6 63 8 10 81 2 164 17. Pneumonia(all forms) 231 64 68 27 7 4 9 27 25 18. Other diseases of respiratory organs 6 ... 4 5 15 21 ... ... ... ... 2 12 7 ... ... 19. Diarrhoea and Enteritis 25 3 ... ... 34 4 ... 8 ... 46 32 ... 1 2 1 20. Appendicitis and Typhlitis 9 2 1 ... ... 3 ... 1 5 1 1 ... 1 ... ... 21. Cirrhosis of Liver 4 ... ... ... ... 3 ... 1 ... 1 ... ... ... 1 1 1 21A. Alcoholism 1 .. ... ... ... ... 1 ... ... ... ... ... ... 1 22. Nephritis and Brights Disease 22 ... ... 2 6 ... 10 8 2 3 1 2 8 1 ... 1 23. Puerperal Fever 3 ... ... ... 1 3 ... ... ... ... ... ... ... ... 16 17 MATERNITY AND CHILD WELFARE NOTIFICATION OF BIRTHS ACTS, 1907 & 1915. During the year 2,864 births were notified, 2.797 being live births and 67 stillbirths. This number includes notifications of Bethnal Green births taking place in maternity institutions outside the Borough, the notifications being usually transmitted by the Medical Officer of Health of the Borough in which the birth took place. It will be seen that out of 2,981 births of living children, 2.797 were notified. Of these, 1,816 were notified by midwives, 454 by maternity assistants of the London Hospital, 321 by doctors, and 206 by parents and others. MATERNITY AND CHILD WELFARE CENTRES. During the year 14,446 attendances of infants were recorded at the Centres. Of these, 1,623 were new cases brought to the Centres during the year, and 349 expectant or nursing mothers were seen for the first time. The Medical Officers in charge saw 9,541 of the infants, and held 710 ante-natal and other consultations with expectant and nursing mothers. 8,302 attendances in connection with the supply of milk and food on the ground of necessitous circumstances were dealt with during the year. Three of the Council's Centres (namely, 49, Green Street;26,Preston Street; and St.Andrew's Institute), were closed in May upon the opening of the new Centre in Cornwall Road. The Centre at Thornton Hall was retained until September, when, after a temporary suspension, it was reopened for one session per week only, the mothers attending this Centre being given the option of attending the new Centre on another afternoon. The new Centre, which was formally opened by the Mayor (Councillor J. J. Vaughan) on the 29th May, contains 3 consulting rooms, 2 weighing and dressing rooms, a treatment room, a dispensary, a large waiting and lecture hall, a health visitor's office and a staff room, as well as ample storeroom accommodation in the basement. The premises have been well adapted and equipped and the decoration of the building has been designed with a view to enhancing its attractiveness and educational value as a welfare Centre. The increased accommodation enables a fair range of activities to be carried on there, and the popularity of the Centre already appears likely to tax its capacity. Infant consultations are held on three afternoons a week, three doctors usually being in attendance each afternoon. Maternity consultations are held on two mornings a week. The Centre is also used as an office for the receipt of applications and making of enquiries respecting milk grants in necessitous cases on two mornings per week. MATERNITY CLINIC. New ante-natal cases 253 Subsequent attendances 279 532 New post-natal cases 97 Subsequent attendances 86 183 Total attendances 715 There were 101 sessions, the average attendance being 7. The ante-natal cases, 253 in number, may be analysed as follows:— Number of primigravidse 51 Full-term confinements, including 6 stillbirths 144 Premature births (1 stillborn) 4 Miscarriages 5 Not yet confined (March 12th, 1923) 45 Found not to be pregnant 24 58 cases attended to ascertain if they were pregnant, and of these— 24 were not pregnant. 24 had full-time confinements. 4 were still pregnant (March 4th, 1923). 2 left the Borough. 3 miscarried at the fifth month. 1 could not be traced. Wassermann reaction for syphilis :— Number of blood tested 34 Number positive 2 Number negative 32 Dr. Norah Pinkerton, the Medical Officer in charge, reports : — " A great deal of the work done was educational. Practically all the expectant mothers required some form of dental treatment, and very many acted on the advice given. " Patients suffering from varicose veins were supplied with crepe bandages at cost price and instructed not to wear elastic or even string garters. Advice was given as to suitable clothing to be worn during pregnancy, more especially in the case of primigravidæ. " A very necessary supervision was exercised over the choice of aperients, since it was found that many patients were relying on the regular use of such drastic ones as castor oil. " The number of patients sent up by midwives showed an increase on last year's number, and a pleas ing feature was the number recommended by other mothers, showing that the necessity for ante-natal care is being realised by the mothers themselves. " One case of contracted pelvis was sent to hospital and was admitted, and several cases of cardiac incompetence were kept under observation. One patient who had previously borne a stillborn child produced a live healthy child after receiving appropriate treatment. " Most of the post-natal patients merely required a tonic, and sometimes advice was necessary on the management of breast-feeding. " Many of these mothers were suffering from varying degrees of prolapse of the womb, and in some cases it. was necessary to order a belt for general abdominal support. " One case of parametritis was sent to hospital and was admitted. Another mother was found to have a rapidly growing ovarian cyst." INFANT CONSULTATIONS. Valuable work continues to be done at the Infant Consultations, and in this connection I cannot do better than quote from a recent communication from Dr. E. F. Iredell, one of the Medical Officers :— " All the best and most essential part of our work at the Infant Welfare Centre is preventive and therefore makes little show on paper. A large number of mothers have at tended owing to the milk grants, but many who first came under economic pressure have really appreciated and profited by their attendances. " Many mothers who had intended to wean their babies and came for instruction as to how to do it and what substitutes to give their babies, have been persuaded to continue suckling. Very frequently, simple treatment for intercurrent ailments in mother or baby has enabled the flow of milk to be completely re- established, and the baby has been satisfactorily reared on breast milk. " The general level of health among the babies has been good, taking into consideration the difficulties arising from the financial straits of the majority of our mothers and the housing problem." SUPPLY OF FOOD. Considerable use was made of the Council's Centres for the distribution of food to mothers and infants. The following food was sold at cost price:— Dried Milk 17,510 lbs. Condensed Milk 163 tins The following amount was distributed free to necessitous cases:— Fresh Milk 2,264½ gals. Dried Milk 8,369 lbs. Condensed Milk together with drugs, etc. 641 tins The approximate cost of the milk given to necessitous cases was £912 Is. 2d. The grants made numbered 2,814. Each necessitous case was carefully investigated before assistance was given, and the usual amount given was 1 lb. of dried milk or 7 pints of fresh milk per week to each case. In the latter part of the year, the Ministry of Health suggested the revision of the scale of income limits for the granting of milk to mothers and children, but after careful consideration the Committee decided that having regard to the economic circumstances of the Borough, the existing scale was a fair one and did not require revision. SUMMARY OF VISITS PAID BY HEALTH VISITORS. Births (first visits) 3,027 Births (re-visits) 11,836 Visits to mothers 1,775 Ophthalmia Neonatorum 234 Puerperal Fever 25 Measles 1,326 School Complaints 421 Special Matters 236 Futile Visits 2,196 Tuberculosis 3,358 Milk Investigations 928 Total visits paid 25,362 NURSING ASSISTANCE. Up to the limits permissible by law, a very complete scheme of home nursing is now in operation. Such nursing is carried out by the mediation of a voluntary organisation, the Shoreditch and Bethnal Green Nursing Association. For each visit a charge of tenpence is made to the Council by the Association. As regards children under the age of five years, the Ministry of Health have sanctioned expenditure on the nursing of all sick cases, but grant is only paid by the Ministry in respect of certain specified conditions, e.g., Measles, Whooping Cough, Diarrhoea, Ophthalmia Neonatorum and Poliomyelitis, which come within the Council's Maternity and Child Welfare Scheme. During the year 220 children under the age of 5 were nursed, a total of 2,650 visits being made at a cost of £110 8s. 4d. Of this expenditure £61 16s. 8d. was expenditure under the Maternity and Child Welfare Scheme. Fifty-one mothers received 538 visits for nursing in connection with conditions incidental to childbearing, the cost being £22 8s. 4d. Eighty-seven adults and children over 5 received 555 visits for nursing at a cost of £23 2s. 6d. Nursing Assistance 1922. Disease. Under Maternity and Child Welfare Scheme. Under Public Health Acts. Under 1 year. 1-5 years. Mothers Children under 5. Others. Ophthalmia Neonatorum ... ... 694 ... ... ... ... .. ... 33 Measles 7 113 42 537 ... ... ... ... 6 58 Pneumonia 1 ... ... ... ... ... 47 418 27 233 Whooping Cough 1 16 7 124 ... ... ... ... 3 26 Puerperal Fever ... ... ... ... 2 30 ... ... ... ... Other pre- and post-natal conditions ... ... ... 508 ... ... ... ... ... 49 Diarrhœa ... ... ... ... ... ... ... ... ... ... Other diseases :— Threadworms ... ... ... ... ... 11 84 ... ... ... Mastoid 3 30 ... ... ... ... ... ... ... ... Septic Throat ... ... 1 10 ... ... ... ... ... ... Septic Glands ... 1 10 ... ... ... ... ... ... ... Septic Leg .. ... ... ... ... ... 1 10 ... ... Constipation ... ... ... ... ... ... 3 15 ... ... Abscess ... ... ... ... ... ... 5 43 ... ... Influneza ... ... ... ... ... ... ... ... 32 238 Bronchitis ... ... ... ... ... ... 4 36 ... ... Tubercular Peritonitis ... ... ... ... ... ... 1 10 ... ... Tuberculosis ... ... ... ... ... ... 1 10 ... ... Otorrhœa 9 ... ... ... ... ... ... 90 ... ... Circumcision ... ... ... ... ... ... 1 4 ... ... Blepharitis 54 ... ... ... ... ... ... ... ... 4 Pyrexia ... ... ... ... ... ... 3 22 ... ... Impetigo ... ... ... ... ... ... 2 20 ... ... Marasmus ... ... ... ... ... ... 1 4 ... ... Corneal Ulcer ... ... ... ... ... ... 1 10 ... ... Croup ... ... ... ... ... 2 16 ... ... ... Injuries to head ... ... ... ... ... ... 2 9 ... ... 12 126 ... ... Discharging Eyes ... ... ... ... ... ... 10 ... ... Ophthalmia ... ... ... .. ... ... 1 Inflamed Eyes ... ... ... ... ... ... 2 20 ... ... Conjunctivitis ... ... ... ... ... ... 8 70 ... ... Eczema ... ... ... ... ... ... 1 10 ... ... Nasal Catarrh ... ... ... ... ... ... 1 10 ... ... Phimosis 5 ... ... ... ... ... ... ... ... 1 ... ... ... 1 10 Vaginitis ... ... ... ... ... 41 49 130 51 Totals 823 661 538 1166 67 555 20 cases were in hand at the beginning of the year. 8 cases were in hand at the end of the year. A total of 3743 visits were paid to 204 cases at a cost of £155 19s. 2d. CONVALESCENT TREATMENT. The Council's arrangements for the provision of convalescent treatment for mothers recovering from their confinements were continued during the year. Twenty mothers, mostly with their babies, were sent to the Catherine Gladstone Convalescent Home, Mitcham, for two weeks each. In accordance with the conditions laid down by the Ministry of Health, in 7 cases the family was required to contribute to the cost of the treatment, the family circumstances of the other 13 cases being such as to preclude any such contribution. Many of the mothers have expressed satisfaction at the treatment at the Home. A similar arrangement has been made for convalescent treatment for young children with the Hertfordshire County Council at their Home at St. Leonard's-on-Sea. This arrangement only came into operation in May, 1922. Up to the end of the year 12 children were sent away, mostly for a period of one month each, but owing to an outbreak of measles at the Home, this period was extended in certain cases. In 5 cases a charge was made for the treatment. INFANTILE MORTALITY. Two hundred and sixty-nine deaths of Bethnal Green infants under one year of age took place during the year. This is equal to a rate of infantile mortality of 90.2 per 1,000 births. Comparison with previous years is as follows: — 1916 106.0 1917 112.0 1918 129.0 1919 85.0 1920 95.0 1921 98.2 So far as can be ascertained. ,258 of the deaths were those of legitimate infants and 11 those of illegitimate infants. Accordingly, we have the following figures for infantile mortality : — Infantile mortality (legitimate) 88.5 do. do. (illegitimate) 166.6 do. do. (all infants) ... 90.2 Of the 269 deaths, 54 were due to prematurity. This is an increase on the figure 47 for 1921, although the number of births of live children was slightly less. The causation of premature birth is a subject about which a great deal is still unknown, and one can only surmise that there was an undue amount of worry amongst expectant mothers during the year owing to the prevalent distress and unemployment. The valuable work done in the municipal maternity clinic should in time make itself felt in a reduction of the number of deaths of infants from prematurity. Twenty-five deaths were due to diarrhœal diseases, the summer having been a healthy one in this respect. The figure is really a wonderful one, even as compared with the figure 99 for 1921. One must look back twenty or thirty years, when 150 or more deaths per annum from diarrhoeal diseases was not unusual, to realise how much things have changed for the better. Eighty-three deaths from bronchitis and pneumonia were registered. Such inflammatory affections of the lungs are, of course, especially prone to affect infants, and appear to be closely connected with the existence of overcrowding. The educational work carried out under the Infant Welfare Scheme has had and can have only a slight effect in reducing mortality from chest ailments. No doubt fewer infants are now allowed to become ricketty and therefore susceptible to bronchitis and pneumonia. Infants are more suitably clothed than they were, and greater care is taken by parents to prevent the onset of chest ailments after measles or whooping cough. But no great reduction in the infantile mortality from this cause can be expected until there is a considerable improvement in the housing conditions of the inhabitants of the Borough. Nineteen deaths were due to measles and 19 to whooping cough, these diseases having been prevalent during the year. Many of the deaths attributed to diseases of the lungs were probably secondary to the debilitating affects of these diseases. Infantile Mortality in Bethnal Green, in 1922. 3 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. 1-2 weeks. Under 1 week. Total under 4 weeks. Cause of Death. 2 3 weeks. 58 J 15 i i 13 i J 12 i i 98 l 38 i i 57 40 i 36 i 269 All causes— Certified Uncertified ... ... Small-Pox ... ... Chicken-Pox ... Measles 3 5 11 19 Scarlet Fever ... Whooping Cough ... 1 6 5 7 19 Diphtheria and Croup ... 1 1 Erysipelas ... Tuberculous Meningitis (30) ... ... 1 1 ... Abdominal Tuberculosis (31) ... ... ... Other Tuberculous Diseases ... Meningitis (not Tuberculous) (61) ... ... 1 1 2 4 Convulsions (71) 2 2 1 3 Laryngitis (87B) ... 1 Bronchitis 1 2 5 5 1 3 16 Pneumonia (all forms) (91 & 92) 1 4 1 4 10 13 18 19 7 67 Diarrhœa (104 B, E & F) 1 1 ... 1 4 2 Enteritis (104 A, C, D & G) 2 2 4 6 5 2 21 4 Gastritis (103 A) 1 ... 1 1 Syphilis 1 1 2 Rickets (36A) ... 1 Suffocation, overlying 1 ... 1 2 Injury at birth (152 C) 3 ... 3 ... 3 Atelectasis (152B) 4 4 ... 4 Congenital Malformations(150) 1 1 4 1 6 Premature birth (151 A) 4 1 52 2 54 44 3 ... ... 3 Atrophy, Debility and Marasmus (151B) 4 5 1 10 14 27 1 Other Causes ... 4 1 1 7 2 2 2 2 15 12 58 15 13 98 39 56 40 36 269 Totals Nett Births in the year legitimate 2915 illegitimate 66 Nett Deaths in the year legitimate infants 258 illegitimate infants 11 Note. The numbers given in brackets after certain causes of death indicate the numbers of the corresponding headings in the detailed International List of Causes of Death, 1909. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... PUERPERAL FEVER. Eleven cases of this complication of childbirth were reported during the year. Three of the patients were removed to the London Hospital, 5 to Bethnal Green Hospital, and one each to the Eastern Hospital. Mildmay Mission Hospital, and Mothers' Hospital, Lower Clapton Road. Two of these patients died from the disease. A third death took place at the London Hospital of a case which was not notified. Puerperal fever was fully discussed in my Annual Report for 1920. OPHTHALMIA NEONATORUM. Thirty-five cases of purulent eye discharge in the newborn were notified to me, all by doctors. In two cases the infant died from another cause, but in the remaining cases the condition was cured without any apparent impairment of vision. Several of the worst cases were removed to a hospital, and 33 cases received nursing attention at home from the Shoreditch and Bethnal Green District Nursing Association, the Borough Council paying part of the cost. Six hundred and ninety-four visits were paid by nurses of the Association, many of the cases requiring visiting for many weeks, and often more than once in a day. NOTIFIABLE DISEASES, Etc. Diphtheria. There were 539 cases of diphtheria notified during the year. Of these, there were 19 cases under the age of 1 year. 216 between the ages of 1 and 5 years. 234 between the ages of 5 and 15 years, 52 between the ages of 15 and 25 years, 14 between the ages of 25 and 45 years, and 4 between the ages of 45 and (55 years. Of the 539 cases, 534 were removed to an isolation hospital. In the remaining 5 instances the diagnosis was found to be incorrect. Thirty-four deaths from this disease occurred during the year, all of which took place at hospitals. Comparison with previous years is as follows : — 1917 19 deaths 1918 26 „ 1919 58 „ 1920 36 „ 1921 34 „ Of the 34 deaths, 29 were those of children over 1 year of age and under 5. The second, third, fourth, and fifth years of life comprise the epoch when the young child is most susceptible to diphtheria, and a heavy toll of life is taken. Of the 216 cases occurring during this period of life, it will be seen that 13.4 per cent. died. At the epoch 5-15 years the mortality was only 1.3 per cent, of those attacked. Scarlet Fever. There were 356 cases of scarlet fever notified during the year. Of these, there were 21 cases under the age of 1 year. 136 cases between the ages of 1 and 5 years. 168 cases between the ages of 5 and 15 years, 23 cases between the ages of 15 and 25 years, and 8 cases between the ages of 25 and 45 years. Of the 356 cases. 352 were removed to an isolation hospital. In 2 instances the diagnosis was found to be incorrect. Six deaths occurred from scarlet fever during the year, all of which took place at hospitals. Comparison with previous years is as follows :— 1917 3 deaths 1918 9 „ 1919 4 „ 1920 12 „ 1921 10 „ Small-pox. One case of this disease was notified, in the person of a youth aged 17, a feather-cleaner by trade. He was seen by a Poor-law Medical Officer and found to be suffering from severe confluent small-pox. He died in hospital. It was impossible to trace the sou ice of infection, but he probably contracted the infection from a mild undiscovered case. About this time (the autumn) there was a slight outbreak of small-pox in the East End of London. It was not possible to ascertain whether the patient had been vaccinated, but he had probably not been vaccinated in infancy. Vaccination in infancy, even after the lapse of 17 years, will usually avert a fatal attack of small-pox although it may not suffice completely to protect against infection. Re-vaccination at the age of 12 years would have probably completely protected this patient, or at any rate modified the severity of the disease. Typhoid Fever. There were 3 cases notified, but one of them was apparently not typhoid fever. In no case was the source of infection ascertained. There were 2 deaths. Erysipelas. There were 58 cases notified and 1 death. Malaria. During the year 1 case was notified. The patient was found to be an ex-Service man who had contracted the infection overseas. Acute Polio-Myelitis and Acute Polio- Encephalitis. Only 1 case of acute polio-mvelitis was notified. Dysentery. There were no cases reported. Acute Encephalitis Lethakgica. There were 3 cases reported. They appear to have been of the usual type, and in no case could any source of infection be traced. In two instances the patient died. Cerebro-Spinal Fever. Five cases of this disease were notified, with a fatal issue in each case. Anthrax. One case of this disease was reported, in the person of a lad aged 15½ years, a horse-hair dresser bv trade. He recovered. Acute Primary Pneumonia and Acute Influenzal Pneumonia. Ninety-six cases of acute primary pneumonia and 30 cases of acute influenzal pneumonia were notified during the year. Statistics tint] notes with, regard to Puerperal Fever, Ophthalmia Neonatorum and Home Nursing will be found in the section relating to Maternity and Child Welfare. Influenza. There was an outbreak of influenza in January which resulted in 54 deaths certified as directly due to influenza, and an excess of 86 deaths from bronchitis and pneumonia over the number for the same month in the previous year, which may be presumed to have been the sequelae of influenza. Posters dealing with the prevention and control of the disease were exhibited in the Borough, and notices urging the need for adequate ventilation were also sent to persons in charge of cinemas and other places of public assembly. The outbreak terminated at the beginning of February. Puerperal Fever 11 ... ... ... 1 10 ... 1 ... Cerebro-pinal Fever 5 2 2 ... ... ... ... Acute Poliomyelitis 1 ... ... 1 ... ... ... ... Acute Encephalitis Lethargica 3 1 1 ... ... 1 ... ... Ophthalmia Neonatorum 35 35 ... ... ... ... ... ... Acute Polio-encephalitis ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... Malaria 1 ... ... ... 1 ... ... ... 96 4 22 15 Acute Primary Pneumonia 25 12 16 2 Acute Influenzal Pneumonia 36 12 ... 2 2 8 9 3 Pulmonary Tuberculosis 252 ... 6 21 37 95 76 17 Other forms of Tuberculosis 48 ... 5 25 10 5 3 ... Cholera, Plague, Relapsing Fever ... ... ... ... ... ... ... ... Continued Fever, Trench Fever ... ... ... ... ... ... ... ... Anthrax 1 ... ... 1 ... ... ... ... Hydrophobia, Glanders ... ... ... ... ... ... ... ... Total 1446 480 158 172 83 395 130 28 Verminous Conditions. Three hundred and fifty-three children reported from the Elementary Schools as being infested with body-lice were visited. In every case advice as to the treatment of the clothing and bedding was and disinfestation by steam was offered. However, in Dnly three cases was advantage taken of such offer. 14 articles being so disinfested. This small proportion of children properly dealt with is a matter for regret, and is due to the reluctance of parents to allow the bedding and clothing to be removed. But it must be added that there are no facilities available in the Borough for the proper cleansing of a family. What is wanted are premises in which baths and warmed rooms are available as well as a disinfesting apparatus. Only in such a way can proper and adequate cleansing be carried out. It is not only unreasonable but quite impossible to expect a whole family to strip naked and take hot baths in a tenement whilst clothing and bedding are in process of being disinfested at the station. Yet anything less than this cannot be expected to eradicate body-louse infestation of a family. On July 20th, 1922, the L.C.C. (General Powers) Act, 1922, came into force. This Act codifies and somewhat strengthens the law relating to verminous conditions. During the year 30 men infested with body-lice were cleansed at the Disinfecting Station and their clothing disinfested. Scabies or Itch. Eighty-one children suffering from this disease were visited after being excluded from the Elementary Schools. In only 16 instances was disinfestation of the clothing and bedding permitted. Three men suffering from scabies had a medicinal bath at the Disinfecting Station and their clothing disinfested. TUBERCULOSIS. Tuberculosis of all kinds is notifiable, and particulars of the number of notification certificates received during the year is set out in the table appended hereto. Owing to the fact that a case of tuberculosis may be notified in several boroughs or districts, the number of notification certificates received is only a very imperfect guide to the amount of tuberculosis in the Borough. There is also the consideration that notification is more strictly enforced in some districts than in others. The only exact means known at present of judging the prevalence of tuberculosis is by the deaths recorded from the disease. There were 194 deaths from pulmonary tuberculosis, 10 deaths from tuberculous meningitis, and 15 deaths from other tuberculous diseases. The notifications received during the year will be seen from the following tables: — Public Health (Tuberculosis) Regulations, 1912. Summary of Notifications on Forms A & B received during the Year 1922. Tuberculosis of the Lungs Other Tuberculosis. Age of patient. Male. Female. Total. Male. Female. Total. Primary Notifications. 0-1 year .. .. .. .. .. .. 1-5 years 6 .. 6 3 2 5 5-10 „ 4 1 5 6 3 9 10—15 „ 4 11 15 11 2 13 15—20 „ 8 8 16 5 3 8 20-25 „ 11 10 21 .. 2 2 25—35 „ 22 18 40 2 2 4 35—45 „ 36 19 55 .. 1 1 45—55 „ 31 12 43 2 1 3 55-65 „ 24 9 33 .. .. .. 65 years and over. 12 5 17 .. .. .. 158 251 45 Total 93 29 16 Cases re-notified 33 25 58 5 8 13 Total Notifications on Form A 191 118 309 34 24 58 Primary Notifications by School Medical Officers. 0-5 years .. .. .. .. .. .. 5-10 „ .. .. .. .. 2 2 10-15 „ .. 1 1 1 .. 1 Cases re-notified 1 2 3 1 .. 1 Total Notifications on Form B 3 1 4 2 2 4 No. of Notifications on Forms C. & D. Poor Law Institutions. Sanatoria. C D C D Pulmonary Tuberculosis— ■ Male 54 69 123 81 Female 24 35 43 28 Non-Pulmonary Tuberculosis— Male 6 2 10 5 Female 4 - 4 8 C = upon admission. D = upon discharge. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1921. During the year the names of 268 patients were removed from the Tuberculosis Register as follows:— Deaths 203 Removals 65 Of the 65 patients who removed from the Borough, it was possible in 25 instances to obtain the new address of the patient, and these cases were duly transferred to the Medical Officer of Health of the district to which the patient had removed. Three cases were added to the register of patients who were reported by other Councils to have removed into this Borough. SOLDTERS AND SAILORS SUFFERING FROM TUBERCULOSIS. Two hundred and twenty-three ex-Service men were under observation during the year. There were 32 deaths amongst these, and 10 removed from the Borough. Five hundred and sixty-eight visits were paid to these men by the Tuberculosis Health Visitor. WORK OF TUBERCULOSIS HEALTH VISITOR. This officer paid 3,358 visits to cases. During the year 57 sputum flasks were distributed to patients. Thirty-eight sputum tins, with 1,634 cardboard refills, were distributed to patients for use indoors. GRANTS OF EXTRA NOURISHMENT. The arrangements with regard to grants of extra nourishment to tuberculous patients were fully reported in my last Annual Report, and were continued, without material change, during 1922. During the year 245 grants were made at an estimated cost of £196. Ninety-five patients were dealt with, 20 of whom were still receiving nourishment at the end of the year. TUBERCULOSIS DISPENSARY. A full report on the work of the Dispensary, by Dr. H. T. Howell, the Clinical Tuberculosis Officer, appears in the appendix to this report on page 66. BACTERIOLOGICAL EXAMINATIONS. The following examinations were carried out by the Royal Institute of Public Health: — Throat Swabs—submitted for examination 440 Diphtheria bacilli present in 116 Sputum—specimens submitted for examination 137 Tubercle bacilli present in 29 Blood-serum-specimens examined 1 DIPHTHERIA ANTITOXIN. INFLUENZA VACCINE. Twenty-five vials of diphtheria antitoxin and 1 of influenza vaccine were issued to local medical practitioners during the year. SALE OF FOOD AND DRUGS ACTS. 715 samples were taken. 663 of these proved to be "genuine," and 52 or 7.3 per cent, adulterated. The details are given in the following table:— SUMMARY OF ANALYST'S REPORTS. Samples taken formally. Samples taken informally. Total Number of Samples taken. Adulterated. No. taken. Adulterated. No. taken. Genuine. Article. Genuine. Milk 333 314 19 18 12 6 351 Butter 135 133 2 13 11 2 148 Jam 58 56 2 ... ... ... 58 Vinegar 30 30 ... 1 1 ... 31 Margarine 24 22 2 ... ... ... 24 Coffee 24 24 ... ... ... ... 24 Cocoa 12 12 ... 5 5 ... 17 Cream 7 ... 7 1 1 ... 8 Preserved Cream 2 2 ... ... ... ... 2 7 Pepper 7 ... ... ... ... 7 Tinned Peas 4 ... 4 2 1 1 6 Flour 4 4 ... 1 1 ... 5 Mustard 5 5 ... ... ... ... 5 Dripping 4 4 ... ... ... ... 4 Cheese 4 4 ... ... ... ... 4 Breakfast Sausage 3 3 ... ... ... ... 3 Nut Oil 3 3 ... ... ... ... 3 Lime Juice Cordial 3 ... 3 ... ... ... 3 Chocolate 2 2 ... ... ... ... 2 Condensed Milk ... ... ... 2 2 ... 2 Sponge Cake ... ... ... 1 ... 1 1 Camphorated Oil ... ... ... 1 1 ... 1 Lard 1 1 ... ... ... ... 1 Olive Oil 1 1 ... ... ... ... 1 Meat Pie 1 1 ... ... ... ... 1 Preservative Powder ... ... ... 1 1 ... 1 Ginger Wine ... ... ... 1 ... 1 1 Ground Ginger 1 1 ... ... ... ... 1 668 11 Totals 627 41 47 36 715 Prosecutions were instituted in respect of 32 of the 41 formal samples which were reported to be adulterated, but in one case the summons was withdrawn in view of proceedings against the wholesaler. Full details are set forth in the following table:— ADMINISTRATIVE ACTION TAKEN WITH RESPECT TO ADULTERATED SAMPLES. Name of Article and Identification No. of Sample. Milk 517 do. 57 do. 115 do. 124 do. 329 do. 334 do. 348 Result of Analysis. Contained 49 per cent, less than the proper amount of fat. Contained 46 per cent. less than the proper amount of fat. Contained 27 per cent. less than the proper amount of fat. Contained 13 per cent. less than the proper amount of fat. Contained 18 per cent. less than the proper amount of fat. Contained 12 per cent. less than the proper amount of fat. Contained 13 per cent. less than the proper amount of fat. Vendor fined £45. Costs £5 5s. or two months' imprisonment in default. Vendor fined £50. Costs .£5 5s. or three months' imprisonment in default. Vendor ordered to pay Costs £1 1s. Vendor fined £3. Costs £1 1s. Vendor ordered to pay Costs £2 2s. Summons withdrawn in view of proceedings against wholesaler (see samples 348, 349 and 350). Case dismissed. Defendant proved milk was sold in same state as given by cow. (b) Two convictions in respect of offences committed in other Boroughs (c) Distress warrant issued but fine and costs eventually paid. (c) At the same hearing Vendor fined 40s. and Coast 2s. for failing to have name and address inscribed on vehicle and receptacle from which milk was Sold. Defendant committed to prison in default of payment. - - - - - Result of Legal Proceedings. (a) Action taken other than legal proceedings. (b) Previous convictions (if any). (c) Other remarks. ADMINISTRATIVE ACTION TAKEN WITH RESPECT TO ADULTERATED SAMPLES. Name of Article and Identification No. of Sample. (a) Action taken other than legal proceedings. (b) Previous Convictions (if any). (c) Other remarks. Result of Analysis. Result of Legal Proceedings. Milk 349 Contained 13 per cent. less than the proper amount of fat. Case dismissed. Defendant proved milk was sold in same state as given by cow. - do. 350 Contained 13 per cent. less than the proper amount of fat. - (a) Proceedings only taken in respect of samples 348 and 349, which were from the same vendor. Vendor fined £2. - Contained 13 per cent. less than the proper amount of fat. do. 399 do. 410 Contained 26 per cent, less than the proper amount of fat. do. (c) At the same hearing Vendor was ordered to pay 10s. costs in respect of a margarine offence. Vendor fined £1. Costs £1 3s. - do 413 Contained 10 per cent. less than the proper amount of fat. do. 415 Contained 10 per cent, less than the proper amount of fat. Vendor ordered to pay costs £1 3s. - Contained 19 per cent. loss than the proper amount of fat. Vendor fined £1 10s. Costs £1 3s. - do. 425 Contained 17 per cent. less than the proper amount of fat. do. 436 Vendor fined £1. Costs £1 3s. - ADMINISTRATIVE ACTION TAKEN WITH RESPECT TO ADULTERATED SAMPLES. Name of Article and Identification No of Sample. (a) Action taken other than legal proceedings. (b) Previous Convictions (if any). (c) Other remarks. Result of Analysis. Result of Legal Proceedings. Milk 527 Contained 6 percent of added water. Roundsman fined £20, or 6 weeks' imprisonment. (c) Roundsman was also summoned under the Milk and Dairies (Amendment) Act, 1922. (1) for adding water to milk. (Fined £5. Costs £3 3s.), (2) for selling milk to which water had been added. (Ordered to pay costs £2 25.). do. 558 Dismissed. Defendant proved milk was sold as given by cow. - Contained 11 per cent, less than thel proper amount of fat. Vendor ordered to pay costs £2 2s. - do. 569 Contained 6 per cent, less than the proper amount of fat. Vendor fined £2. - do. 609 Contained 8 per Cent less than the, proper amount of fat. Vendor fined 15s. Butter 530 Contained 75 per cent, margarine. Butter in this case was purchased on bread. Dismissed in view of conviction on another summons in respect of same sample. (See page 47). - do. 533 Contained 77 per cent, of foreign fat. Vendor ordered to pay 42s. costs. Contained 8 per cent, apple pulp. Jam 222 (c) Third portion submitted to Somerset House Analyst who reported 3 per cent apple pulp only. Contained 10 per cent, apple pulp. Vendor ordered to pay 42s. costs. - do. 443 ADMINISTRATIVE ACTION TAKEN WITH RESPECT TO ADULTERATED SAMPLES Name of Article and Identification No. of Sample. Result of Analysis. (a) Action taken other than legal proceedings (b) Previous Convictions (if any), (c) Other remarks. Result of Legal Proceedings. Contained 1¾ per cent, of added water. - (a) Vendor cautioned. Margarine 414 (b) 28/7/22—Fined £2 for selling milk 26 per cent, deficient in fat. 28/7/22—Ordered to pay 10s. costs for selling margarine in plain wrapper. Contained 2½ per cent, of added water. do. 637 Vendor ordered to pay 2s. costs. (c) At the same hearing defendant was fined in respect of two other offences arising out of this sample. (See page 46). Contained 0.25 per cent, of boric acid (undisclosed). Cream 392 Proceedings taken under the Public Health (Milk and Cream) Regulations, 1912 and 1917. (See page 47). - do. - do. 393 Contained 0.26 per cent, of boric acid (undisclosed). do. 541 Contained 0.285 per cent, of boric acid (undisclosed). - (a) Vendor cautioned. do. 542 Contained 0.4 per cent, of boric acid (undisclosed). Proceedings taken under the Public Health (Milk and Cream) Regulations, 1912 and 1917. (See page 47). - do. 544 Contained 0.4 per cent, of boric acid (undisclosed). Contained 0.35 per cent, of boric acid (undisclosed). - do. - do. 545 (a) Summons taken out in respect of sample 544 taken from the same vendor. ADMINISTRATIVE ACTION TAKEN WITH RESPECT TO ADULTERATED SAMPLES Name of Article and Identification No. of Sample. Result of Legal Proceedings. Cream 452 Tinned Peas 535 do. 538 do. 539 do. 540 Lime Juice Cordial 382 do. 383 do. 384 Contained 0.3 per cent, of boric acid (undisclosed). Contained 3 grs. per lb. of copper sulphate. Contained 3 ½ grs. per lb. of copper sulphate. Contained 1½ grs. per lb. of copper sulphate. Contained 3¼ grs. per lb. of copper sulphate. Contained 8 grs. per pint of salicylic acid. Contained 4½ grs. per pint of salicylic acid. - Contained 3½ grs. per pint of salicylic acid. Proceedings taken under the Public Health (Milk and Cream) Regulations, 1912 and 1917. (See page 47). Vendor fined £1. Vendor ordered to pay costs £3 3s. - Vendor ordered to pay costs £3 3s. Summons dismissed with £5 5s. costs against the Council. - (a) Action taken other than legal proceedings. (b) Previous Convictions (if any). (c) Other remarks. - - (b) 8/5/13—Fined 10s., costs 12s. 6d., for selling glycerine containing 35 per cent, sugar. 7/8/13—Fined 55., costs 12s. 6d., for selling vinegar 55 per cent, deficient in acetic acid. 9/12/20—Fined £1, costs £2 2s., for selling vinegar containing 10 per cent, added water. (a) No action taken in view of notice on tin indicating presence of copper. (b) 31/7/13—Fined 55., costs 12s. 6d.,for selling vinegar 27½ per cent, deficient in acetic acid. - (a) Vendor cautioned. do. Result of Anal ysis. SAMPLES TAKEN INFORMALLY. Eighteen samples of milk were taken informally, 6of which were found to be adulterated. These contained added water in amounts varying from 6 to 33 per cent. Thirteen informal samples of butter were taken, two of which were adulterated as follows:— Sample 527. Found to be 85% margarine. „ 532. Found to contain 80% of foreign fat. Of the two informal samples of tinned peas, one proved to be genuine and the other was found to contain 4 grains per pound of copper sulphate. A sample of non-alcoholic ginger wine submitted for analysis contained 7 ½ grains per pint of salicylic acid. An informal sample of sponge cake contained boric acid to the extent of 14 grains per pound. In addition to the above, the following samples taken informally proved to be genuine:— Cocoa 5 Condensed Milk 2 Vinegar 1 Camphorated Oil 1 Cream 1 Preservative Powder 1 Flour 1 PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912 & 1917. The following is a report of the work done under the Regulations during the year ended the 31st De cember, 1922: — Three hundred and thirty-three formal samples and 18 informal samples of milk were taken, and in no case was the presence of a preservative reported. Nine formal samples of cream were taken, in all of which boric acid was found to be present, the percentages being 0.24, 0.25, 0.26, 0.285, 0.3, 0.31, 0.35, 0.4 and 0.4. One informal sample of cream was found to be genuine. With regard to the formal samples, in 7 cases the cream was delivered to the purchaser in a receptacle which did not bear a proper declaratory label. In the remaining two cases a proper declaratory label was present. Five of the vendors were prosecuted for the absence of a declaratory label (see page 47), and in two cases the vendors were also prosecuted for depositing for sale cream which was not labelled in accordance with the Regulations. In no case was the percentage of boric acid found to be in excess of the permissible amount. "APPEAL TO COW" SAMPLES. No samples of milk were taken direct from the cow in 1922, as the occasion did not arise for taking such samples. PROSECUTIONS FOR OFFENCES OTHER THAN ADULTERATION No. of Sample. Offence. Result of Prosecution. Article. Sale of Food and Drugs Acts. Selling milk from a vehicle and receptacle on neither of which was inscribed the name and address of the vendor as required by the Act. 57 Fined £2. Costs £1 1s. do. 210 Ordered to pay costs £1 1s. (1) Wilfully obstructing and impeding the Inspector in the course of his duties. do. - Fined £20. Costs £5 5s. (2) Refusing to allow Inspector to take a sample of milk on delivery. Withdrawn in view of conviction on first summons. (3) Aiding and abetting the roundsman in the above case of obstruction. do. (4) Aiding and abetting the roundsman in the above case of refusal to allow Inspector to take a sample. do. (1) Exposing for sale an unlabelled parcel of margarine. 365 Fined £1. (2) Selling margarine by retail in a plain wrapper. Withdrawn. do. 508 Fined 10s. in respect of each offence. do. Ordered to pay 10s. costs in respect of first offence. Second summons withdrawn. 564 Fined 5s. Costs 25s. in respect of each offence. 637 do. Exposing for sale an unlabelled parcel of margarine. Fined £1. Costs £1. do. 78 do. Fined 10s. Costs 1Os. 62 do. Fined £1. 256 do. do. do. do. do. PROSECUTIONS FOR OFFENCES OTHER THAN ADULTERATION— continued Article. No. of Sample. Offence. Result of Prosecution. Margarine 499 Exposing for sale an unlabelled parcel of margarine. Fined £1. 497 do. do. do. 554 do. do. Ordered to pay costs 10s. Selling margarine by retail in a plain wrapper. do. 140 Fined 10s. do. 533 do. Fined £4. Costs £1 1s. do. 409 do. Ordered to pay costs 10s. 565 do. do. Public Health (Milk and Cream) Regulations Cream 542 (1) Depositing for sale preserved cream in an unlabelled receptacle. Fined 20s. Costs 635. (one previous conviction). Withdrawn. Conviction on first summons. (2) Delivering to purchaser preserved cream in an unlabelled receptacle. 393 do. Fined 20s. Costs 63s. on first summons. Second summons withdrawn. do. 392 Delivering to purchaser preserved cream in an unlabelled receptacle. Fined £1. Costs £1 1s. do. do. Fined £2. Costs £2 2s. 544 do. 452 do. Dismissed. Prosecution failed to prove defendant wilfully committed the offence. Nine other offences were reported to the Public Health Committee in connection with the sale of margarine, and two in connection with the sale of preserved cream, the offence in each case being in respect of the labelling of such articles. These, being either first offences or of a trifling character, were dealt with by cautionary letter. SANITARY SUPERVISION OF THE BOROUGH. A Summary of Inspections and Visits, with Matters Outstanding for the Year ended 30th December 1922 Smoke Nuisances. Premises under Observations. Other Inspections or work of Special Character. Infectious Cases. House to House Inspections. Tenement House Inspections. Number of Calls. Samples of Food and Drugs taken. Nuisances Abated. Re-Inspections. New Buildings Inspections. Combined Drainage Inspections. Unsound Food Seizures. Complaints. Factory and Workshop Inspections. Outworkers' Home Inspections Total Visits for the Year. Milkshop Inspections. Other Food Premises. Police Court Attendances. Matters Outstanding. District. Inspector. 20 378 152 .. .. A 218 842 146 83 29 3052 .. 577 22 4 .. 5 1004 57 5523 G. I. Brighting .. 246 B 191 539 32 50 63 3226 .. 489 15 73 .. 317 .. .. 17 910 49 5241 J H. Hewitt C 149 545 64 70 102 3635 .. 183 108 23 26 11 189 361 1 .. 29 1114 79 5466 W. Billings D 98 111 33 172 109 4688 .. 93 169 .. .. .. 308 112 .. .. 7 1130 68 5893 F. Bare E 207 720 120 119 298 39 20 .. 7 324 288 .. .. 85 2624 .. 10 1068 60 4851 E. J. Jenkins 3 358 F 212 749 .. 88 63 3183 11 243 15 3 5 310 .. .. 5 1185 59 5243 I. R. Jones .. 6 7 .. .. 2053 2667 .. .. 16 .. .. 11 8 .. 5* 15 776 .. 4768 A. S Henley .. 53 .. .. 1520 110 39 .. .. .. .. .. .. 286 4 59 18 31 .. 2008 W. Rowsell .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 651 79 .. .. .. J. G. Weeks 41 1814 38993 Totals 1075 3565 367 583 2005 22571 2717 1883 368 139 31 1834 5 715 185 7218 372 * 5 Samples of Rag Flock. TOTAL NUMBER OF SANITARY DEFECTS DISCOVERED DURING 1922. Defective Water Supply. Defective Drains. Defective and Dirty W.C.'s. Smoke Nuisances Month. Dirty Premises. Other Matters. Total. Jan. 301 57 126 83 3 1146 1716 Feb. 329 65 121 117 - 1289 1921 Mar. 346 90 128 121 2 1251 1938 April 313 57 118 89 - 1204 1781 May 330 69 123 104 - 1358 1984 June 308 59 137 83 - 1246 1833 July 307 66 1264 133 91 - 1861 Aug. 296 47 138 115 - 834 1430 Sept. 323 58 129 108 - 1289 1907 Oct. 247 68 134 59 - 832 1340 Nov. 313 66 130 113 - 1001 1623 Dec. 204 52 108 66 1 766 1197 Totals 3617 754 1525 1149 6 13480 20531 During the year 5,302 Preliminary Notices were served requiring the remedying of a Nuisance. 4,532 Statutory Notices were served. DISINFECTION SEEVICE. During the year, 1,529 rooms and 24,188 articles were disinfected for various reasons, liquid Formalin in the form of a spray being used for the purpose of disinfecting rooms. The table appended gives full details of the rooms, bedding and clothing disinfected. June 26 25 6 83 1 3 144 1306 .. .. .. July 37 28 17 28 1 3 114 1575 August 1 2147 30 51 19 21 1 2 125 September 26 51 24 8 11 1 2 2 125 2338 October 28 47 17 14 3 3 2 114 1598 November 24 49 25 4 6 118 1664 10 December 20 55 20 8 1 2 106 2213 Totals 12 339 535 241 8 320 7 12 55 1529 24188 No. of articles destroyed by request 138 Books for Public Libraries disinfected 424 Articles disinfected in Formalin Chamber, such as boots, boxes, books, etc. 1010 Rooms in Schools disinfected 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. DISTRIBUTION OF DISINFECTANTS. Ten thousand three hundred and seventy-seven pint bottles of disinfectant fluid were distributed. Bearing in view the fact that the disinfectant fluid given out is largely used as a deodorant, for rinsing down sink-wastes and gullies or for washing floors, it is now given out in a diluted form. The giving out of a disinfectant fluid in undiluted form tends to waste, as so many persons do not understand the need for diluting it. SHELTER FOR CONTACTS. (3, St. James' Road.) Fortunately little use had to be made of this house during the year. Three persons were accommodated for a few hours whilst their home was being disinfected after removal of a case of small-pox. RATS AND MICE (DESTRUCTION) ACT, 1919. During the year advice was given to persons needing it and a few informal notices were served on persons whose premises were found to harbour rats. It was not found necessary to serve any formal Statutory Notices. PUBLIC MORTUARY. (Church Row, Bethnal Green, E.2.) During the year 141 bodies were received at the Mortuary, i.e. — On Coroner's order 91 From the Police 10 From London Hospital 6 At the request of relatives 34 Exact particulars are only available as to the 99 bodies on which coroner's inquests were held. On 59 of these bodies post-mortem examinations were made. The Public Mortuary comprises two mortuary rooms and a post-mortem room with lavatories. The postmortem room is now adequately warmed and provided with good natural and artificial light. The Mortuary keeper resides in the Coroner's Court close to the Public Mortuary, and the Police, having a key to the Mortuary, can obtain access to it at any time of the night for the purpose of depositing corpses. During the year the Public Mortuary was repainted and put into repair. STATISTICS. Places from which bodies were brought to the Mortuary. Removed by the Police from the canal 4 „ „ „ „ „ „ streets, etc. 6 Removed from Bethnal Green Hospital 24 „ „ Queen's Hospital 5 „ „ Mildmay Mission Hosp. 1 „ „ Victoria Park Hospital 1 „ „ Private houses, etc. 58 Total 99 Inquest cases classified according to age:— Number under 1 year 24 „ over 1 year and under 5 years 10 „ „ 5 years „ „ 10 „ 3 „ „ 10 „ „ „ 20 „ 2 „ „ 20 „ „ „ 30 „ 2 „ „ 30 „ „ „ 40 „ 5 „ „ 40 „ „ „ 50 „ 9 „ „ 50 „ „ „ 60 „ 11 „ „ 60 „ „ „ 70 „ 17 „ „ 70 „ „ „ 80 „ 13 „ „ 80 „ 3 Total 99 Causes of death in inquest cases: — Natural causes 70 Misadventure : death under an anæsthetic 1 Accidental 10 Open Verdict 8 Wilful murder 1 Suicide 10 Total 99 FOOD PEEMISES. Milkshops and Dairies. Fifty-six applications for registration under the Dairies, Cowsheds and Milkshops Orders were considered during 1922, and were acceded to.* The figures in regard to registration of Milkshops are set out below: — Number of purveyors of milk at retail milkshops on register at end of 1921 196 Deduct number of purveyors removed from register during 1922 7 Add number of new purveyors added to register by resolution of the Public Health Committee during 1922 27 Number of purveyors of milk at retail milkshops on register at end of 1922 216 Number of applications for registration refused 8 During the year 807 inspections of milkshops were made by the Inspectors, and 122 notices were served under the Public Health (London) Act, 1891. No legal proceedings were found to be necessary. On the Ist September, 1922, the Milk and Dairies (Amendment) Act, 1922, came into operation, making certain alterations in the procedure with regard to the registration of purveyors of milk and in *This includes changes of occupiers in premises previously registered. the powers of local authorities in respect of this matter. Cowhouses. There were at the end of 1922 twelve licensed cowhouses in the Borough, as in previous years; 61 inspections were made during the year. List of Licensed Cowhouses. 63, Bishop's Road.— (No. of cows— Shed No. 1—8 cows, Shed No. 2 —6 cows.) 42, Cheshire Street.—(6 cows.) 23, Ezra Street.—(6 cows). 38, Fellbrigg Street. — (No. of cows —Shed No. 1 — 8 cows, Shed No. 2 —8 cows.) 104, Gibraltar Walk.—(18 cows.) 34b, Green Street. —(45 cows.) 1, Hamilton Road. —(13 cows.) 55, Kerbela Street.— (No. of cows —Shed No. 1 — 18 cows, Shed No. 2—2 cows.) 2, Lisbon Street. —(19 cows.) 64, Squirries Street. —(14 cows.) 38, Three Colts Lane.—(23 cows.) 6, Warley Street. —(10 cows.) Ice Cream Premises. Three hundred and forty-three visits were paid to these premises by the district inspectors during 1922. No legal proceedings were found to be necessary. Fried Fish and Fish-Curing Premises. At the end of 1922 there were 51 fried fish vendors' premises in the Borough, at two of which curing was also carried on. There were 23 fish curers' premises, including these two. Six hundred and six visits were made by the Food Inspector to the'se premises. Workshop Bakehouses. In the County of London, the Metropolitan Borough Councils are responsible for enforcing proper sanitary conditions in all bakehouses, whether wholesale or retail, which are workshops, that is, without mechanical power. There are, in Bethnal Green, 69 workshop bakehouses, 21 of which are underground. An occupier was prosecuted for keeping a bakehouse in an insanitary condition, and was fined £5 with 3 guineas cost. Factory Bakehouses. There are in Bethnal Green 12 factory bakehouses, 2of which are underground. In every case the mechanism used, which causes the bakehouse to be a factory, is a dough-mixer. In 11 cases the power used is an electric motor and in one case a gas engine. Generally speaking, the factory bakehouses are kept clean and in a sanitary condition. Sixty-one inspections were made during the year, and arising out of these visits, a notice was served on an occupier calling attention to lack of cleanliness. OTHER PREMISES USED FOR THE PREPARATION OR SALE OF FOOD. There were 217 such premises on the register, the majority being restaurant-kitchens. 1,067 inspections were made during the year, and arising out of such inspections 123 notices to remedy faults or insanitary conditions were issued. UNSOUND FOOD. The Food Inspector has kept under regular inspection food exposed or deposited for sale in slaughter houses, shops (especially butchers', cooked meat and fishmongers' shops), stalls, and market places. Five seizures of unsound food have been made during 1922 as follows: — Seizures. Date. Description of Article. Weight. Prosecution and Result. 25/5/22 Fined £5. Costs £2 2s. Fruit 6 lbs. Meat £10. Costs £3 3s. 28/5/22 50 lbs. 2/8/22 Fish 11 lbs. No Prosecution. Vendor was of unsound mind Bacon 108 lbs. Costs £3 3s. 5/8/22 Fruit 66 lbs. Fined £1. Costs £1 2s. 6u. 30/8/22 On 46 occasions during the year the following articles of unsound food have been surrendered by the owners to the Food Inspector, and destroyed as trade refuse:— Articles Surrendered. Description of Article. Weight. Tons. Cwts. lbs. Fish 11 34 - Meat 11 74 - Fruit 1 6 88 Other Articles 1 6 19 Tinned Meat 42 tins Condensed Milk 64 tins Tinned Fish Eggs 222 tins 2,800 Tinned Pineapple 2 tins Rabbits 5 SLAUGHTERHOUSES. There were 3 licensed slaughterhouses in the Borough at the end of 1922, situated at:— 294. Bethnal Green Road. 354, Bethnal Green Road. 278, Hackney Road. Twenty-five visits were made to slaughterhouses by the Food Inspector during the year. WHOLESALE DEALERS IN MARGARINE. The following premises are registered as being occupied by wholesale dealers in margarine:— 136, Bethnal Green Road. 352, Bethnal Green Road. 374, Bethnal Green Road. 420, Bethnal Green Road. 153, Brick Lane. 200, Brick Lane. 231, Cambridge Road. 477, Cambridge Road. 19, Green Street. 182, Green Street. 199. Green Street. 209, Green Street. 282, Hackney Road. 324a, Hackney Road. 489, Hackney Road. 43a, Old Ford Road. FACTORIES, WORKSHOPS, OUTWORKERS, Etc. Inspection of Factories, Workshops and Workplaces. Number of Premises. Prosecutions. Inspections. Written Notices. Factories (Including Factory Laundries) 328 41 - Workshops (Including Workshop Laundries) 3777 824 9 Workplaces (Other than Outworkers' Premises) 22 1 - Total 4127 866 9 Defects found in Factories, Workshops and Workplaces. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspctr. Particulars. Nuisances under the Public Health Acts:— 354 - Want of cleanliness 361 5 104 - - Want of ventilation 107 5 - - Overcrowding 5 Want of drainage of floors - - - - 1041 - Other nuisances 1072 3 insufficient 29 24 - - Sanitary accommodation unsuitable or defective 111 102 - 1 6 6 - - not separate for sexes Offences under the Factory and Workshop Acts:— Illegal occupation of underground bakehouses (s. 101) - - - - Breach of special sanitary requirements for bakehouses (ss. 97 to 100) 87 - 87 1 74 - - Other offences (Excluding offences relating to outwork) 76 1854 1797 - Total 10 Registered Workshops. Workshops on the Register (s. 131) at the end of the year. Number. Workshops 1766 Workshop Bakehouses 69 Total Number of Workshops on Register 1835 Other Matters. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Acts (s. 133, 1901) 11 Action taken in matters referred by H.M.Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Acts (s. 5, 1901) Notified by H.M. Inspector 98 Reports (of action taken) sent to H.M. Inspector. 98 Underground Bakehouses (s. 101) in use at the end of the year (including factories) 22 HOME WORKERS. Of the 4,168 workmen and contractors whose names appeared on the lists sent in by employers, 2,870 resided within the Borough. In 1921 the number was smaller, being 2,546. This figure, 2,870, is approximately double the number of individual workers, as in the majority of cases the same people are notified in February and in August. The number of visits paid to Home Workers' dwellings was 2,855. The number of premises found to be in an insanitary condition was 495, or 26 per cent, of the 1,883 premises inspected. Notices were served in 410 cases, the other 85 premises being already under notice arising from other visits. Lists received from Employers. Addresses of Outworkers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made, (s. 110). Prosecutions (s. 109,110). Sending twice in the year. Sending once in the year Failing to keep or permit inspection of lists. Failing to send lists. Nature of Work. Lists. Outworkers. Lists. Outworkers. Received from other Council Forwarded to other Councils. Contractors Workmen Contractors Workmen Wearing Apparel— I _ I L_l . II I I I S nn a I I I Making, etc. 124 27 1178 4 33 1705 764 109 264 224 Curtains, Furniture hangings and Trimmings 10 164 2 33 6 111 6 1 1 22 13 Fur-pulling and feathers 2 8 8 4 2 15 11 4 9 2 4 15 8 Umbrellas, etc. Artificial Flowers 2 14 15 2 10 6 41 ... Paper, etc., Boxes, Paper Bags 32 405 118 151 30 123 108 Brush-making 6 381 1 196 6 41 37 Draught Board making 2 2 Cosques, Christmas Crackers, Christmas Stockings, etc. 4 Textile Weaving 2 2 5 3 17 2 Toys 14 1 Total 186 27 2219 6 66 1856 1243 163 1 1 495 410 ... ... ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .. ... ... ... ... ... ... ... ... ... ... CUSTOMS AND INLAND REVENUE ACTS. No applications for certificates for exemption from Inhabited House Duty were received during the year. INCREASE OF RENT AND MORTGAGE INTEREST (RESTRICTION) ACT, 1920. Section 2 (2). During the year three applications for certificates were received and one certificate was granted. SUPPLY OF WATER TO NEW HOUSES. During the year 79 new houses were certified as having a proper and sufficient water supply. SMOKE PREVENTION. During the year, 41 observations of smoke shafts were made, and in 6 cases black smoke was observed in such quantity as to be a nuisance. Five Intimamation Notices and 1 Statutory Notice were served. The law as it stands at present does not prohibit the emission of black smoke from private dwelling houses, manufacturing premises therefore mainly come under control. OFFENSIVE TRADES. During the year under review there was no offensive trade carried on in the Borough. DRESSING OF FUR SKINS. By-Laws regulating this class of business came into force on 22nd March, 1922, but no premises were found on which such business was carried on. RAG FLOCK ACT, 1911. Five samples of rag flock were taken during the year. In no case was the amount of chlorine present found to be in excess of the limit fixed by the Regulations. HOUSING. Housing Statistics for 1922. Number of new houses erected during the year: — (a) Total. 79 (tenements). (b) As part of a municipal housing scheme. 64 „ 1. Unfit dwelling-houses. Inspection— (1) Total number of dwelling-houses inspected for housing defects (under Public Health Acts) 5,007 (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations, 1910 Nil. (3) Number of dwelling-houses found and reported to be in a state so dangerous or injurious to health as to be unfit for human habitation 3 (4) Number of dwelling houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation Nil. 2. Remedy of Defects without Service of formal Notices. Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their Officers. Nil. 3. Action under Statutory Powers. (a) Proceedings under Section 28 of the Housing, Town Planning, etc. Act, 1919:— (1) Number of dwelling-houses in respect of which notices were served requiring repairs. Nil. (2) Number of dwelling-houses which were rendered fit. Nil. (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declarations by owners of intention to close. Nil. (B) Proceedings under Public Health Acts: — (1) Notices served requiring defects to be remedied. Intimations. 5,302 Statutory Notices. 4,532 (2) Number of dwelling-houses in which defects were remedied:— (a) By owners 4,707 (b) By Local Authority in default of owners. Nil. (c) Proceedings under sections 17 and 18 of the Housing, Town Planning, etc. Act, 1909: — (1) Number of representations made with a view to the making of Closing Orders. 3 (2) Number of dwelling-houses in respect of which Closing Orders were made. 2 (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit. Nil. (4) Number of dwelling-houses in respect of which Demolition Orders were made. Nil. (5) Number of dwelling-houses demolished in pursuance of Demolition Orders. Nil. DISS STREET AEEA. The Improvement Scheme under Part II of the Housing Act, 1890, with regard to a portion of the Diss Street Area, was eventually sanctioned by the Ministry of Health, after prolonged negotiations during 1922. Steps were immediately taken to put the scheme into operation, and building operations commenced in October. TENEMENT HOUSES. The number of houses registered as being let in lodgings or occupied by members of more than one family was 209; 908 visits of inspection were made to these houses, and arising out of such visits, 319 Notices were served. The present by-laws do not apply when the landlord himself resides on the premises, or where the rent of the tenement is above a certain figure. This explains the limited number of tenement houses which are now on the register and subject to the by-laws. Revised by-laws are now in process of drafting by the London County Council, and will be applicable to a large number of tenements which are at present excluded from the operation of the by-laws. APPENDIX Bethnal Green Tuberculosis Dispensary REPORT FOR THE YEAR 1922 By H. Tylford Howell, M.R.C.S., Eng., L.R.C.P., Lond., Clinical Tuberculosis Officer. There has been no change in the personnel of the Dispensary during the last two years, the department being very fortunate in having retained the services of Dr. Hamilton, the Junior Tuberculosis Officer, and also of the Nurse and Clerk. There are seven sessions each week, five morning sessions (on Monday, Wednesday, Thursday, Friday and Saturday, from 10 to 12 o'clock), and two evening (on Wednesday from 5.30 to 7 o'clock and on Thursday from 7.30 to 9 o'clock). Saturday mornings are reserved for school children, and such adults as find it difficult to attend at other times, while Wednesday and Thursday evenings are reserved for patients who are at work during the day. Patients may present themselves during any part of the morning session, and on Wednesday and Thursday evenings from 5.30 to 6.30, and from 7.30 to 8.30 respectively. With this method the patient's period of waiting is considerably reduced, the majority being seen by the Tuberculosis Officer within a quarter of an hour of their appearance at the hospital, while it seldom happens that one has to wait for more than half an hour. Although the morning sessions are advertised as of two hours' duration, and the evening one and a half hours', it is generally found necessary to extend these times. Previous to 1922, both evening sessions were held from 7.30 to 9 o'clock, but it was found that a number of patients came direct from their work to the hospital, with the result that they had to wait for an hour or more before being seen. The earlier evening session on Wednesday meets this difficulty, while those who work later may still attend on Thursday. The accommodation of the department is adequate in every respect, and although I have visited several dispensaries during the year, I have not seen Ode nearly so well equipped. This is due to the fact that we have at our disposal (in addition to offices for the Medical Officers and Clerk, and a separate laboratory) the facilities and accommodation of the out-patient department of the hospital, including waiting rooms and two consulting-rooms, with two dressing rooms and dark rooms attached to each. This is one of the advantages of the Dispensary being attached to a hospital, but what is even of more value is the facility with which we can get opinions on difficult cases from the various special departments of the hospital. We have continued to take every advantage of this arrangement, 83* cases having been referred to the X-ray department, while the Surgeon to the hospital, and the Surgeon in charge of the ear, nose, and throat department, have only been too willing to help us with their advice, and, where necessary, have undertaken the treatment, of cases. Previous to September of this year we had no arrangement with the dental department of the hospital for the treatment of dental cases, although in urgent or special cases the Dentist invariably came to our aid. This defect has now been remedied, and the sanction of the Borough Councils has been obtained to a fortnightly session for the treatment of Dispensary cases requiring extractions, fillings, or dentures. The scheme is working very well, but we are experiencing some difficulty in persuading patients to have their teeth attended to. In addition to the special departments, the Tuberculosis Officers consult the Physicians in charge of out-patients in difficult or interesting cases. The help of the charitable societies, such as the Invalid Children's Aid Association, Charity Organisation Society, Soldiers' and Sailors' Families' Association, and the Jewish Board of Guardians, has been of great value. The Invalid Children's Aid Association has arranged for the convalescence of a large number of our so-called pre-tubercular children, either in the country or at the seaside, and, in addition, has supervised their after-care, frequently providing them with clothing, etc., and, where necessary, with suitable occupations. The after-care of tuberculous patients is one of the duties of the Tuberculosis Care Committee, of which the Tuberculosis Officer is a member. The Tuberculosis Officers continue to act as Medical Beferees to the Local Pensions Committees, both for tuberculous ex-service men, and those suspected of having tuberculosis. This has entailed a great deal of work, but it has ensured the regular attendance of these patients at the Dispensary, and has aided their supervision. Two hundred and twenty patients were admitted to hospital or sanatorium during the year. The period between the recommendation for institutional treatment and the patient's admission to Hospital is still much longer than it should be, while there is the same difficulty in obtaining institutional treatment for patients with advanced disease, with the exception of those who *Including Bethnal Green and Hackney cases. are ex-service men. When the advanced case is recommended to the London County Council, which is responsible for the institutional treatment of tuberculosis, the Tuberculosis Officer is usually advised that the Council cannot accept the case for treatment under its tuberculosis scheme. We can then only recommend the Infirmary, but this the patient usually refuses until he is nearly moribund, or compelled by overwhelming economic conditions. The advanced case thus spends months, or even years at home with his family, perhaps sharing the same bedroom with several of his children, and possibly ultimately infecting them. The position would not be so bad if all these cases bad at some time or other received treatment in an institution at which they were taught the methods for the prevention of the spread of infection. I maintain that all cases of tuberculosis, irrespective of the stage of the disease when it is first diagnosed, or of the possibility of any personal benefit being derived by the patient, should receive institutional treatment for a certain period, so that he may be taught the principles of the prevention (if infection. It may be argued that this can be done at the Dispensary, or the patient's home, but my personal experience is that this is impossible, except when the patient is under constant supervision. I have even seen in a sanatorium, sputum scattered over the path in front of the bedroom windows. This state of things, I believe, is rare, and, in a properly managed institution, impossible; but, if such a thing can happen when the patients are supposed to be under constant observation, it is not difficult to imagine what may occur in a patient's home. Whatever may be said against sanatorium treatment, it is rare indeed to find an ex-patient of such an institution, who, although he may not use a sputum flask when in public, would dream of expectorating about the floors of his own house. This fact alone, in my opinion, justifies the expense of a short period (if residence in an institution, even for advanced cases But I would go further than this, and state that every advanced case of pulmonary tuberculosis with tubercle bacilli in the sputum, who is unfit for work, should be kept in an institution as long as he will remain. The present practice of sending these cases to institutions far removed from their homes is not calculated to encourage patients to enter. The patient who has not long to live wants to be within easy reach of his friends, and it would appear that a home for each borough, or for two adjacent boroughs, where the discipline is not so severe as to insist on a hopeless case remaining in bed for a slight rise of temperature, or to prohibit patients smoking except in the grounds, etc., is the only solution of the problem. Facilities for granting pecuniary assistance to patients are limited, but during 1921 the Ministry of Health sanctioned the expenditure of a sum of money not exceeding £2 per 1,000 of the population for the provision of extra nourishment. The Ministry suggested that, owing to the necessarily limited expenditure to be incurred for this purpose, grants should be restricted to cases coming under the following headings : — (a) patients who have received an adequate period of treatment in a residential institution, and have been discharged with working capacity restored; (b) patients who, for some valid reason, have had to leave a sanatorium before completing the full course of treatment desirable; and (c) patients awaiting admission to sanatorium beds. This scheme was agreed to by both boroughs, and has now been in operation since June of 1921. The additional diet given usually takes the form of milk and eggs, and as far as possible the class of case selected has been limited to those included in the headings suggested by the Ministry of Health, although it is very hard to have to refuse the advanced case, who may be in very straitened circumstances. It is difficult to estimate the success of this scheme, but there is no doubt that the extra diet has been of great value in certain cases. The statistical tables shown below give particulars of the work of the department for the year. There has been a decided fall in the number of new cases for both boroughs, more marked in Hackney than in Bethnal Green. The fall in Hackney is largely due'to the decrease in the number of contacts, but other contributory causes for both boroughs are the smaller number of new pension cases, the mildness of the present winter, and the somewhat improved economic conditions. It should also be remembered that the longer the dispensary system has been established in a borough, the greater is the tendency to a falling off in the numbers of new cases, as once a patient has been registered, he would, on any further attendance, be regarded as an old case. For instance, if a patient attended the department as a contact in 1915, when the dispensary was first opened, and was then discharged as having no signs of tuberculosis, and did not attend again till 1922, the patient would not be registered as a new case, but as an attendance of an old case. The total number of attendance during the year was 10,127,* showing a decrease of 110 as compared with the preceding year. The number of attendances of uninsured cases has increased by 111, so that the drop in the total number is accounted for by the decrease in the attendances of insured cases. Normally the number of attendances would have increased but for a request by the Ministry of Health that the cases treated at the Dispensary should be limited. It was pointed out by the Ministry that "the provision of routine treatment as distinct from consultative work has at some dispensaries been developed to an undesirable extent," and that "treatment at dispensaries should as a rule be limited to patients whose continued treatment requires special knowledge or technical skill, or to those who are unable to obtain other adequate medical attention. Patients who require treatment which can, consistently with the best interests of the patient, be properly *Including Bethnal Green and Hackney cases. undertaken by a general practitioner of ordinary professional skill and competence, and who are either insured persons or can afford to pay for medical attendance, should not be encouraged to attend the Dispensary for routine treatment." It will be seen by the reduction in the number of attendances of insured persons that an attempt has been made to carry out these instructions by referring insured patients to their panel doctors for treatment. It is difficult, however, to reduce the number of uninsured cases, as the patients are usually unable to pay for a private doctor. To reduce the number of children attending the dispensaries of London, the London County Council has introduced a scheme by which children of school age can be transferred to the School Medical Service for supervision. A special card provided for the purpose, on which the Tuberculosis Officer gives such particulars as name of child, date of birth, address, school attended, together with a short history of the case and the result of his examination, is sent to the Divisional School Medical Officer. A circular issued by the Medical Officer of Health of the London County Council gives the following instructions as to the class of case to be transferred :— A. All "unsatisfactory children,"whether contacts or not, who, after a period of observation at the Dispensary are considered to be probably non-tuberculous, but who require supervision; B. All contacts who on his first examination are apparently healthy: and also as far as possible, all other contacts that he has been unable to examine. Each case should be classified by the Tuberculosis Officer under one of the following headings : — Class 1. —An "unsatisfactory child" whether contact or not; Class 2.—An apparently healthy contact; or Class 3.—A contact that has not been examined. The circular further gives the following details as to the procedure to be adopted at the school : — Class 1 shall be— (a) examined by the School Medical Officer quarterly, and referred back to the Dispensary if at any time in his opinion the child should be regarded as probably tuberculous; (b) weighed approximately monthly, and the weight recorded on the chart. Class 2 shall be— (a) examined once a year; (b) weighed quarterly. Class 3 shall be examined as soon after reference as possible, classified by the School Medical Officer, and dealt with as Class 1 or Class 2 as the case may be. In spite of the reduction in the number of new cases and the total number of attendances, the general work of the Dispensary has increased in amount. The total number of systematic examinations has increased from 4,123* to 4,700,* the home visits from 200* to 248,* and the number of letters and reports from 3,567* to 3,610.* It would be to the advantage of the patients if the number of reports could be reduced, as at present the Tuberculosis Officer spends only just over one-third of his time on clinical work, the remaining two-thirds being taken up with reports, visiting, attending various committees, etc. Our relationship with the local general practitioners continues to be quite cordial, and the percentage of new cases referred by them to the department for an opinion remains high. The figures given below are not a true indication of the number of patients sent by doctors during the year for consultation, as those cases who had at any time previously attended the department, either as contacts or sent from some other source, would not be shown. In conclusion, I should like to thank the Dispensary Committees, the Medical Officers of Health, the Hospital Physicians and Surgeons, and the Hospital Secretary, for their help and advice, and also the Dispensers, the Clerk, the Nurse, and the Porter, all of whom have done their work very efficiently. (Signed) H. TYLFORD HOWELL. 1st March, 1923. *Including Bethnal Green and Hackney cases. STATISTICAL TABLES 1. The Totals of New Cases. Males 332 Females 353 685 Total 2. The Sources of the New Cases. Total. Tuberculous. Medical Officer of Health 135 55 Local Practitioners—Primary 94 Contact 7 34 101 3 Contact cases (per M.O.H.) 384 10 21 War Pensions Committee 4 London County Council 16 7 Victoria Park Hospital 17 17 Other sources 11 7 3. The Diagnosis of the New Cases. Insured Uninsured. Diagnosis. Males Females Total Children under 15 Males Females Pulmonary Tuberculosis 47 16 3 14 23 103 Non-pulmonary Tuberculosis 4 6 23 0 1 34 Non-tuberculous 91 61 255 26 94 527 Doubtful 3 0 21 8 4 6 Total 150 87 284 124 685 40 4. The Diagnosis of Contact Cases. Pulmonary Tuberculosis 8 Non-pulmonary Tuberculosis 5 Non-tuberculous 370 Doubtful 8 391 Total 5. Sputum Examinations, of Insured and Uninsured Patients. Insured. Uninsured Total. Tubercle Bacilli present 98 21 119 Tubercle Bacilli absent 392 130 522 6. Other Figures. Uninsured Insured. Total number of attendances 2,167 2,208 Systematic examinations at the above 1,092 1,017 Number of letters written 1,716 Number of visits to patients at their homes 122 Number of patients sent to hospital or sanatorium 90 28 34 Number of patients referred to : — X-ray Department 13 Other Departments 40 59 SUMMARY OF LEGAL PROCEEDINGS, 1922 (Other than under the Sale of Food and Drugs Acts, for which see pp. 39/43 and pp. 46/47.) Date of Hearing. Inspector. Offence. Result and Remarks. 6th Jany. Fined 10s. Costs 20s. Rowsell Exposing Imported Meat for sale without label attached stating same to be "Imported Meat." 19th Jany. Non-compliance with Statutory Notice requiring abatement of a Nuisance. Henley Magistrate ordered work to be done in seven days. Costs 21s. do. 19th Jany. do. Jenkins 26th Jany. do. Henley Magistrate ordered work to be done in six weeks. Costs 3s. 26th Jany. do. do do. do. 26th Jany. do. do 26th Jany. do. do. do. 26th Jany. do. Billings Magistrate ordered work to be done in 14 days. Costs 21s. 14th Feby. 14th Feby. 14th Feby Adding water to Milk intended for sale. Weeks Adjourned sine die (illness of Defendant). Knowingly exposing for sale Milk to which water had been added. do. do. Exposing Imported Meat for sale without label attached stating same to be "Imported Meat." Rowsell Fined £2. Costs £2 2s. 16th Feby. Making default with Nuisance Order issued by the Magistrate on 19th January. Henley Fined £1. Costs £2 2s. 16th Feby. Making default with Nuisance Order issued by the Magistrate on 19th January. Fined £1. Costs £2 2s. Jenkins 3rd April Fined £5. Costs £3 3s. Keeping a Bakehouse not in conformity with the Act. Dr. Oates 6th April Non-compliance with Statutory Notice requiring abatement of a Nuisance. Costs 21s. awarded. Henley Magistrate ordered work to be done in 28 days. Costs 21s. 6th April do. Billings do. 20th April Hewitt Costs 10s. 6d. awarded. 20th April Improperly repairing a drain. Fined £1 1s. Costs £2 2s. Billings 20th April Making default with Nuisance Order issued by the Magistrate on 26th January. Henley Fined £1. Costs 10s. 6d. 20th April do. do. Fined £1. Costs 10s. 6d. 20th April do. do. Fined £1. Costs 10s. 6d. 20th April do. do. Fined £1. Costs 10s. 6d. Making default with Nuisance Order issued by the Magistrate on 22nd December, 1921. 27th April Bare Fined £1. Costs £1 1s. 6th May Non-compliance with Statutory Notice requiring abatement of a Nuisance. Costs £1 1s. Henley Costs £1 1s. 6th May do. do. 1st June Fined 5s. Costs £2 2s. do. Jones SUMMARY OF LEGAL PROCEEDINGS, 1922—continued. Date of Hearing. Offence. Inspector. Result and Remarks. Non-compliance with Statutory Notice requiring abatement of a Nuisance. 1st June Henley Magistrate ordered work to be done in 14 days. Costs £2 2s. 23rd June do. Hewitt Magistrate ordered work to be done in 21 days. Costs nil. 30th June Exposing for sale about 50 lbs. unsound Meat, unfit for human food. Rowsell Fined £10. Costs £3 3s. 4th July Exposing for sale about 6 lbs. Pears, unfit for human food. Billings Fined £5. Costs £2 2s. 4th July Depositing for sale, ditto. do. Summons withdrawn (conviction on other summons). 13th July Non-compliance with Statutory Notice requiring abatement of a Nuisance. Hewitt Magistrate ordered work to be done in seven days. Costs £2 2s. 17th August do. Bare Magistrate ordered work to be done in seven days. Costs 21s. Magistrate ordered work to be done in seven days. Costs 42s. 17th August do. Henley 14th Sept. do. Jones Magistrate ordered work to be done in seven days. Costs £2 2s. 21st Sept. do. Hewitt Costs awarded 21s. 22nd Sept. Making default with Nuisance Order issued by Magistrate on 17th Aug. Bare Fined 17s. Costs £3 3s. Exposing for sale about 108 lbs. unsound Bacon, unfit for human food. Rowsell Costs £3 3s. 3rd Oct. Exposing for sale about 56 lbs. unsound Plums and about 10 lbs. unsound Pears, unfit for human food. do. Fined £1. Costs £1 2s. 6d. 3rd Oct. 5th Oct Non-compliance with Statutory Notice requiring abatement of a Nuisance. Henley Magistrate ordered work to be done in seven days. Costs 21s. Conveying through London, during prohibited hours, offensive matter. Jenkins Fined £1. Costs £1 1s. 5th Oct 5th Oct do. Billings Fined £5. Costs £2 2s. 5th Oct Conveying through London, during prohibited hours, offensive matter in defective and leaky receptacles, and permitting such matter to escape therefrom. do. Fined £5. Costs £2 2s. 12th Oct. Making default with Nuisance Order issued by Magistrate on 17th Aug. Henley Fined 10s. Costs 21s. Failing to supply to Borough Council a List of Outworkers, showing names and addresses of all such persons. Jenkins Fined £1. Costs £2 2s. 12th Oct. Summons withdrawn (conviction on above summons). 12th Oct. Failing to keep in prescribed manner and form at the premises a complete List of their Outworkers, etc. do. 12th Oct. Making default with Nuisance Order issued by Magistrate on 14th Sept. Jones Fined £5. Costs £2 2s. 16th Nov. do. Jenkins Magistrate ordered work to be done in fourteen days. Costs £1 1s. 16th Nov. Making further default with Nuisance Order issued by the Magistrate on 17th Aug. Bare Fined £5. Costs £2 2s. 14th Dec. do. do. Fined £1. Costs £3 3s. 14th Dec. Non-compliance with Statutory Notice requiring abatement of a Nuisance. Jones Magistrate ordered work to be done to three weeks. Costs £2 2s. 28th Dec. do. Hewitt. Magistrate ordered work to be done in 21 days. Costs 6s. 28th Dec. Making default with Nuisance Order issued by the Magistrate on 16th November. Fined £3. Costs £2 2s. Jenkins In addition to the foregoing, proceedings were taken in 65 other cases, for non-compliance with Statutory Notices served for the abatement of nuisances. In all these cases the summonses were withdrawn upon the required works being done and costs being paid as follows : — Cases. Costs in each Case. 1 4/0 55 10/6 5 21/0 2 Nil Two summonses against the Owners of premises were withdrawn in favour of summonses against Agents acting on behalf of the Owners.