CAM 12 Camberwall Appendix I. to Annual Report. Report of the medical Officer of health. The population of London as used by the Registrar General for the calculation of the birth and death rates is estimated at 4,758,218 at the middle of 1907. The number of births registered in the county totalled 122,205, being over 3,000 less than in 1906. The birth rate, therefore, shows a reduction of 0.9 on the previous year, and one of 2 on the 1902-6 average. The total deaths registered for the same period were 70,013. In this number are included the deaths of Londoners who died in the various asylums, &c., outside the boundaries of the County, and in respect of whom it was possible to ascertain any information as regards their previous whereabouts, but it does not include those whose deaths occurred in London but who had not previously had a permanent residence therein. The death rate consequently works out at 14.6 per thousand, a reduction of 0.5 on the previous year and of no less than 1.1 on the average for the live years 1902-6. The practice of estimating the population on the number of persons per assessment has been continued in this report. The procedure is to take in the census year the number of persons enumerated and the number of assessments; from this we obtain the average figure for each individual assessment in each of the wards of the Borough. To ascertain the population for any year subsequent to the census it is only necessary to multiply these, as ascertained from the rate book, by the factor which was fixed in the census year. Table A.—Population of Camberwell and Sub-Districts. Borough. Dulwich. South Camberwell. North Camberwell. South Peckham. North Peckham. St. George's. As enumerated at census 1896 253,076 7,519 90,286 88,242 67,029 90,465 65,589 As enumerated at census 1901 259,339 93,038 10,247 As calculated for middle of 1903 92,079 94,286 65,283 262,968 11,214 As calculated for middle of 1904 94,323 14,259 108,028 47,449 265,139 As calculated for middle of 1905 94,856 14,677 110,648 47,420 267,594 As calculated for middle of 1906 45,125 66,598 45,585 49,682 15,130 48,033 270,153 67,195 As calculated for middle of 1907 45,915 49,872 48,660 272,479 15,600 45,831 The calculation depends on the idea that the assessments which are not houses, e.g. bill-posting stations, have only proportionally increased, and that there has only been an ordinary amount of immigration, just as the older method depends for its correctness on the assumption that the population continues to increase in the same ratio as in the intercensal period. With the birth-rate falling as it is, this method must tend to become more and more unreliable, and, as a matter of fact, we have found that the first-named method more nearly approached the actual figures obtained on the taking of the census. Table B. —Births in Camberwell and its Sub-Districts. Borough. Dulwich. South Camberwell. North Camberwell. South Peckham. North Peckham. St. George's. Unattached. Year. 111 130 1906 1907 226 205 1,018 969 1,045 1,029 1,471 1,439 1,473 1,386 7,020 6,733 1,676 1,575 — 287 — 49 — 87 + 19 — 21 — 16 — 32 — 101 Difference The births showed a decrease of 287 in the whole Borough, the greatest reductions being shown in the North Camberwell and St. George's registration sub-districts. There are 6,733 births reported by the Registrar-General as opposed to 6,603 actually registered in Camberwell; these extra 130, being the offspring of Camberwell parents, have been distributed among the sub-districts in a similar manner to the deaths in outside institutions. Table C. — Birth-rates of Camberwell and its Sub-Districts. Year. Borough. Dulwich. South Camberwell. North Camberwell. South Peckham. North Peckham. St. George's. 22.9 22.9 25.9 24.7 14.9 13.1 22.5 21.5 25.1 23.9 30.6 29.3 1906 1907 29.6 29.3 The birth-rate consequently shows a reduction of 1.2 on that of 1906. This will, no doubt, be pounced upon by the alarmists as a national danger; but, as it has been previously pointed out, it surely is sounder policy to consider the quality rather than the quantity of ii births as concerning the future well-being of the race, and, further, that the reduction in the birth-rate has been accompanied by a reduction in the number of deaths of infants under a year, together with a general lessening of those at all ages. The total number of deaths due to the Borough was 176 less than in the previous year. As I have previously said, this figure differs from the number registered in the Borough. For the sake of accuracy it has been necessary to exclude the deaths of the persons dying in St. Saviour's Infirmary, who are really parishioners of Southwark, and who are only removed here when ill. The two lunatic asylums also receive patients from Camberwell and other parts, so that any fatal cases among the latter class should find no place in our death records. The deaths of inhabitants of the Borough who happen to have been taken for their last illness to hospitals, &c., outside the Borough boundary must, on the other hand, be included among our deaths. Re-Distribution of Deaths among the Sub-Districts of Camberwell. District. Deaths returned classified according to sub-districts. Deaths of persons removed from unknown addresses in the Borough re-distributed. Estimates of total deaths due to subdistricts. 6 Dulwich 136 142 South Camberwell 497 16 513 North Camberwell 979 24 1,003 566 16 South Peckham 582 787 805 18 North Peckham St. George's 761 17 778 Total 3,726 97 3,823 As a result of the calculations that have been referred to above, the death-rate works out at 14.0 per 1,000 per annum, a decrease of 0‘8 on the previous year, a reduction which coming on a previously low rate is eminently satisfactory. The Registrar-General's calculation is even a little less than the above, a difference which is probably due to his estimate of the population being calculated by a different method from that adopted above, by which it is taken as 277,059, whereas we reckon it as 272,479. iii Death-rates in Camberwell and its Sub-Districts for the past 10 years. Year. Borough. Dulwich. South Camberwell. North Camberwell. South Peckham. North Peckham. St. George's. 1898 16.70 10.05 15.07 18.74 17.03 10.60 15.30 17.68 19.01 1899 19.05 1900 16.54 14.24 10.14 17.96 18.59 1901 16.49 7.51 13.91 18.41 18.81 16.34 8.07 1902 14.53 17.01 19.13 7.57 14.10 13.80 1903 13.04 15.39 6.66 15.16 1904 12.07 16.11 22.97 13.8 13.40 9.87 1905 14.18 15.60 9.5 15.5 l2.7 16.5 11.7 1906 14.8 15.6 1907 14.0 9.0 14.9 12.6 11.2 16.1 16.1 Beginning with 1903, there has been a very decided fall in the death-rate, slightly interrupted by a rise in 1904. This event is, no doubt, partially due to the healthier conditions of weather, for improved conditions of existence, and especially of prosperity, can hardly have had any great influence. The year made a bad start, for owing to the cold weather there was a decided increase in the number of deaths in the first weeks, especially among the very young and the old; nevertheless, the subsequent lessening of the number of deaths brings the figures for the year to the reduced rate of 14.0. Turning to the rates in the sub-districts, it will be seen that North Camberwell and North Peckham, now that they have been separated from the southern divisions, show a rate which is an increase on that for the old combined districts, and which has not shown a decrease concomitant with those of the other sub-districts for the past year. The actual number of deaths to be credited to the Borough was 176 less than in 1906, and of this deficiency 137 were in the class of children under one year. The question of infantile mortality still holds the field before the public, and attention continues to be given to measures which are considered likely to influence its decrease. Milk depots, health visitors, and the instruction of young girls in the duties of motherhood have each had their respective advocates. Perhaps most attention is now beginning to centre round the mother and the necessity for her welfare during pregnancy. This idea is based on the principle of the necessity of the mother being healthy before she can bear and rear healthy children. But it is impossible to shut one's eye to the question of the influence of the father; and taking an analogy from the breeders of stock in the animal kingdom, where the male parent is selected with great care, one is brought face to face with the necessity of seeing that not only the mothers, but also the fathers are kept in such a state of nutrition that they are fit to procreate children. I mention this as a difficulty which is likely to render the special efforts made for looking after the mother as not being of the same value as they appear at first sight. A witness before the Departmental Committee stated that food was at the base of all evils of child degeneracy, but I think I would omit the qualification of the opinion inferred by the word child, and would say that all measures whose purpose is to lessen infantile mortality unless they include attention on this point are likely to disappoint their advocates. The question of health visitors has been very strongly insisted on by many. Some speakers have even gone so far as to pillory those Boroughs where these officials have not been appointed as belonging to a class who do not properly recognise their responsibilities, and who are not efficiently carrying out the duties entrusted to them by the State. There are many Boroughs who have already appointed such inspectors, and they claim to have secured a diminution in the rate of infantile mortality by that means. Huddersfield, in particular, has made such a statement, and in connection with this I propose to give the figures for the corresponding period for Camberwell. whereby it will be seen that there have been considerable reductions here without such an appointment and its consequent expense. Infantile Mortality. Annual Rate per 1,000 Births for the years 1903-4-5-6-7. Huddersfield Rate. Camberwell Rate. Year. 120 1903 123 1904 144 136 1905 124 119 135 1906 130 97 1907 115 There can be no doubt that the weather exercises a paramount influence, for it will be seen that in a certain year there was a fall, and in others there may be a rise, which is shown in all localities, but especially among the poorer classes, where extremes of weather cannot be so well guarded against. From the following statement it will be seen that, from the statistical point of view, there seems to be no absolute difference between those Metropolitan Boroughs where health visitors are wholly and partly employed and where they are not, and by no means is there any striking diminution of infantile mortality in the former category. V Infantile Mortality in Metropolitan Boroughs for the Years 1906 and 1907. Deaths of Infants under One Year of Age to 1,000 Births. 1906. 1907. Average, 1902-6. Boroughs where Health Visitors are employed— 128 132 140 Kensington 138 117 140 Wandsworth 121 99 118 Woolwich 109 112 116 Boroughs where Health Visitors are partly employed— 130 159 Finsbury 160 Marylebone 117 101 130 St. Pancras 123 108 132 Boroughs where Health Visitors are not employed— 123 156 Bermondsey 153 Camberwell 130 115 131 Holborn 120 131 132 Lewisham 113 90 109 Paddington 105 109 118 Stepney 134 117 144 The mortality from measles is a little higher than last year, there being 8 more deaths; St. George's showed a considerably increased number, but in the other districts there was an improvement. In the spring, as the disease appeared to be spreading, I asked the Committee for instructions as regards the distribution of bills; not, indeed, that I had any faith in this procedure, but I wished to ascertain whether they intended to continue the practice ordered in 1906. They decided to take no action in this direction. Since last Easter routine disinfection after measles is no longer carried out, and we only act on a special request being made by the householder. A decided saving of expense has thereby occurred without any observable increase in the prevalence of the disease. In view of the fact that the mischief, so far as the spread is concerned, is done before the nature of the illness is recognised, disinfection to my mind could never have had any practical advantage. There were 36 more deaths from hooping cough, and the increase showed itself in all of the districts, but to the greatest extent in the Camberwell division. The increase was indeed general all over the metropolis, the number being 30 over the decennial average. The prolonged duration and the extreme infective power of this disease render it very intractable to direct preventive measures, and it is only by impressing upon the community the importance of care in avoiding complications that decrease in the mortality is likely to result. It is in the mortality from diarrhœa that the most noticeable decline is found. In 1906 there were 224 deaths from diarrhœa, Hammersmith vi while in the last there were only 61. I have already alluded, in dealing with the marked reduction in the general rate, to the healthy effect of the weather on the youthful division of the community, especially in the third quarter. The Registrar-General in his annual report gives a comparative table in which he deals with the infantile mortality, the rainfall, and the earth temperature since 1870, and points out the fact that a cool summer means a low infantile death-rate, which in its turn brings down the general average. It appears, however, that there must be another factor or factors whose influences have recently been more effective. For example, in 1879, in 1888 and 1902, the average earth's temperature was nearly identical with that of the past year, and with also the additional advantage, from the health point of view, of an excessive amount of rain, yet the infantile mortality in the third quarter in each of these particular years was considerably higher than 1907. There were 1,572 notifications of scarlet fever, that is, over 400 more than last year, the increased prevalence being most noticeable in North and South Peckham. As is shown by the number of deaths, the type of illness was very mild, and judging from the number of attacks of a type suspicious of this disease that have come to my knowledge, without having been notified, I am inclined to think that the amount of prevalence much exceeds that which has come to our notice. Thirty-seven fatal results were recorded, being 12 more than in 1906. Very careful inquiries were made as to the evidence of any infecting focus in the schools, and also whether an infected milk supply might not account for the increase, but there was no evidence to indicate that either of these agencies was at work. Compared with scarlet fever there was only a moderate increase in diphtheria, there being only 72 more notifications than in the past year, and the number of deaths was the same, viz., 40. The greater incidence, in the year under review, was in the age groups 1 to 5 and 5 to 15. So far as localities are concerned, North and South Peckham and Dulwich suffered more severely than the rest. The infants' department of a North Camberwell school was closed in October last year on account of the positive result of a bacteriological examination of some throats of those who were attending that department. Several of these children were subsequently notified to us as suffering from diphtheria, in some cases to the surprise and disgust of the parents who, in the absence of clinical signs, refused to admit the diagnosis. Every year it becomes increasingly certain that a systematic examination of swabs taken from school children even when only sore throats have been prevalent, will often result in the discovery of specific infection by the diphtheria bacillus, an infection which, if not promptly and thoroughly dealt with, is likely to spread to all susceptible at the moment, who are actually in attendance. Of enteric fever we received intimation of 82 cases, an increase of 24 on the last year. The incidence on the South Peckham district vii was to the extent of 14 in excess of the former notifications, and to some extent may be traced to infection from person to person in a house where a case was unrecognised and untreated for several days; but the source of the original case, although sought for, was not discovered. There were 16 notifications of the various conditions which are classed together under the heading of puerperal fever, an exactly similar number to last year, but there is a great improvement to mention in the number of deaths, there having been only 3, as compared with 12 in 1906 and in 1905. Erysipelas caused 7 deaths compared with 10 in the previous year. Of these the greater number occurred in public institutions, and the disease was usually the termination of chronic illness. The notifications were 20 less than last year. No cases of small-pox or typhus fever were reported to us. There were three notifications of cerebro-spinal fever. With one exception they were all in children under the of 12 years, and all terminated fatally. There were also two other patients who suffered from symptoms suspicious of this disease, who both succumbed. In one instance a post mortem examination was made, at which I was present; no obvious lesions were discovered and only negative cultures could be got by Dr. Bousfield from structures and fluids which are usually affected by the disease. In all, 32 fewer deaths took place from cancer, there being a great decrease in North Camberwell and an increase in Dulwich. From our knowledge of this disease we are not justified on looking on the change in numbers as anything more than an accidental variation. Alcoholism and cirrho is of the liver jointly were responsible for 68 deaths, being 9 more than the previous year, Although these two morbid conditions are combined together for the purposes of classification, it must not be supposed that every case of cirrhosis is due to alcohol. The deaths actually returned as due to this cause were 26. The deaths from accidental causes of various kinds were 26 less than in 1906, but those from suicide were 6 more than in that year, while those from mental diseases were 8 less. The numbers ascrited to the diseases and accidents of parturition and to premature birth were almost identical for the two years. There was a considerable increase in the fatal cases both of pneumonia and bronchitis. There were 3 more deaths from pulmonary tuberculosis than in 1907. Increase was shown in the sub-district of North Camberwell, decrease in Dulwich and St. George's, while Peckham and South Camberwell remained practically stationary. A decrease also showed itself in the age periods of 15 to 25 and 25 to 65. The last Council had expressed their approval of the system of voluntary notification, but had never taken any active steps to secure its adoption. I therefore brought the matter before the new Committee viii to take their instructions. They asked for a further report on the subject of which the following is a copy:— July 11th, 1907. Gentlemen, — The question of taking measures to prevent the spread of phthisis, directed especially to such means as are in accordance with the view that it is frequently conveyed direct from person to person, has been before the Vestry and Council ever since the end of 1898. During the last year, however, matters came to a crisis on the receipt of a letter from the L.C.C. accompanied by a report from their M.O.H., Sir S. F. Murphy, in which it was urged that voluntary notification should become universal throughout London. According to the L.C.C. letter, voluntary notification is carried out in all the London Boroughs except Paddington, Hackney, Shoreditch, Bethnal Green, Stepney, Poplar, Battersea, Camberwell, Deptford Lewisham, and St. Pancras. Information was asked from the other Metropolitan Borough Councils at that time by this Council, and, as a consequence, Hackney, Deptford, and Lewisham, in their answers, expressed opinions favourable to voluntary notification. Some of the Borough Councils, Kensington, for example, indeed went so far as to strongly support the system of compulsory notification. On April 4th, 1906, my report, which was against taking any action, was before the Council, but in opposition to my opinion, the resolution was passed that the L.C.C. be informed that Camberwell is in favour of voluntary notification, and that certain steps should be taken with regard to obtaining and circulating particulars relating to hospital and dispensary patients. This resolution has, however, never been acted on, and I have brought the matter before the new Council to ask them whether they wish me to take any steps to carry out the resolution as to voluntary notification or not. Before doing so, however, they have ordered me to report on the subject. For a disease to be benefited by notification it should be of a decidedly infectious character from person to person, either directly or through the medium of an infected article, and it should be recognisable at an early stage. Are either of these conditions fulfilled in the case of phthisis ? The first one would lead one to suppose that a large proportion of cases would be those of persons who lived in the houses where there were, or had been, other cases of the same disease, and the closer the relationship the more frequent should such occurrences be. lam well aware of the exaggerated pictures drawn by Koch and many others of the liability of remaining members of a family to contracting a recognisable form of this disease from someone dying of it ; but as a matter of fact it rarely occurs. The advocates of notification urge that this is because removal to an infirmary, where the supposed precautions are taken, has taken place, removing the patient who is said to be the source of danger ; and so they maintain that to the removal from home of a greater number of cases which, according to their theory, are most likely to be centres of infection, is partly attributable the decrease of phthisis of late years. It is obvious, however, that much must depend, if the arguments have any weight, on how long the patients have been ill before removal. From the inspection of the Infirmary bed-cards, which have been kindly placed at my disposal by Dr. Keats, out of 148 cases, 45 were in the Infirmary less than two weeks, 33 less than one month, and 70 more than one month, the disease having always lasted much longer; and, as a rule, when the lodging was of the poorest and most crowded description, it was there that the greatest delay in removal took place, the patient frequently not being more than a week in the infirmary before death, while they had been ill at home for months; and according to the theories of those who believe in the extreme personal infectivity of the disease, there should have been a goodly proportion of cases of tuberculosis, if not of phthisis, in their homes, which was not the case. As I have mentioned before, the prime factor in tuberculosis appears to be the existence of a medium in which it can grow and flourish, and the rational system of dealing with such an ubiquitous gern as the bacillus of this disease is not to try to destroy it, for such events are likely to be futile, but to render impossible its increase in the human body and consequent power of mischief. For this purpose indirect means, while less sensational, and perhaps less likely to appeal to the public, are the more efficacious. I refer to the improvement of food and lodging, using both these terms in the widest sense. It is found especially that those who are addicted to the excess of alcohol in their occupation, and also those who are restricted in the way of food and liable to exposure, are the ones to suffer. The fatal cases of consumption had been diminishing for many years before the policy of treating the disease as infectious had ever been initiated, and when reliance had been confined to hygienic measures. The object really to be aimed at is bringing every individual to much the same condition that many of us are in, i.e., that the tubercle bacillus has attacked us, but has found it impossible to do us any material harm. I therefore see no reason to alter in any shape the views I expressed to the Council in 1906, nor to advise that consumption be made compulsorily notifiable, while to such a half-hearted measure as voluntary notification I should offer opposition, believing that it is neither useful nor consistent. (Signed) FRANCIS STEVENS, Medical Officer of Health. The Committee, and subsequently the Council, decided to take no steps in the way of the voluntary notification of pulmonary tuberculosis. Early in June a conference was convened by the Paddington Borough Council to consider the question of legislative action as regards phthisis. Owing to absence from London, I was unable to attend to speak and to vote against a resolution which was adopted by a large majority, that compulsory notification of phthisis was desirable; for I believe that satisfactory evidence has not been given to the effect that person-to-person infection is a factor of any considerable amount in the spread of phthisis. At this conference a resolution was also passed to apply to the Local Government Board to ask them to confer powers on the Metropolitan Asylums Board to provide sanatoria which would be available for London inhabitants. In my last report I called attention to a successful appeal against a decision obtained by this Council in a summons taken out against the proprietors of a motor 'bus for emitting smoke. The result seems to have had the effect of stimulating the drivers of these vehicles to greater efforts in this regard, but their supremacy is seriously challenged by those who drive private cars. The result is that other travellers who have to use the road have to suffer from the effects of a vapour which inflames the eyes, irritates the throat, in addition to running the risk of getting into a dust cloud, the bacteriological composition of which would probably surprise many of those who hailed the motor vehicle as the one hygienic way of progression. Unless it should be the incomprehensible apathy of the public, it would appear that the passion for quick transit has obtained such a hold that people are prepared to suffer any inconvenience provided they can attain their desires in this respect. At the end of 1906 and the beginning of 1907 complaint was made in reference to the shooting of dust from vehicles belonging to the dust contractor to the Lambeth Borough Council into barges near the Canal Head, Peckham, and of the nuisance caused thereby to the inhabitants of Salisbury Cottages and the neighbourhood. The matter was kept under daily observation by two Sanitary Inspectors, and frequent visits were paid by myself. As a result of our inspections the following report was made to the Public Health Committee: — x January 8th, 1907. Gentlemen, —In reference to the complaint caused by the shooting of dust on the canal bank, nuisance, either with or without danger to health, might arise, either from the smell given off by the decomposing animal and vegetable matter, or by dust containing disease-producing organisms being carried into Salisbury Cottages over the wall which separates them from the canal bank itself. It is also alleged that owing to the defective or ill-adapted shape of the shoots, and partly to the carelessness of the men, accumulations occur round the shoots themselves, which are insufficiently swept up, and are allowed to remain to pollute the ground afterwards, in addition to other possible ill effects. There are, therefore, two points for the consideration of the Committee: — First, with regard to the process itself. I have been there on several occasions, both when dust shooting was in progress, and also when no shooting has been taking place, but the barges have been alongside half full of dust, and the hatches have been off. On every occasion the smell has been of the slightest, and were such a smell existing outside my own door I could not swear that it was a source of nuisance to me. In the second place I am unable to agree with the statement that injury or danger to health now exists. With the present conditions of the weather I do not think that either of these are likely to exist, but when the warm weather comes conditions may be altered, and one might possibly be able to swear as to the existence of some detriment to the neighbourhood. But at present I do not think there is sufficient evidence for us to proceed. With regard to the accumulations, the utmost amount that I have seen has never been much more than a large barrow load, taking all the shoots combined, and I doubt a magistrate considering this to be a nuisance, or injurious, or dangerous to health. As the Committee are well aware, there are special by-laws which govern the removal of offensive matter under which is classed household refuse; and, speaking as a layman, and not as a lawyer, it appears to me that so long as these by-laws are carried out, the evidence as to nuisance must be very strong indeed to secure a conviction. If local evidence of sufficient amount could be obtained to support that which your inspectors may be able to give, no doubt a conviction could be obtained, but I am not able to give any corroboration in this respect, and before any further legal proceedings are taken I should advise a survey by the Committee who will then see all the existing conditions. (Signed) FRANCIS STEVENS, Medical Officer of Health. Of the articles seized during the year condensed milk forms a very large proportion. In April, Inspector Kerslake seized 1,328 tins in Belmont Buildings, the owner of which subsequently absconded and has not yet been arrested, a warrant still being out for his apprehension. As there was reasonable ground for supposing that there was a large quantity of this milk still in Camberwell and other districts, sharp look-out was kept by other Inspectors, with the result that other seizures were made in the neighbourhood; but Camberwell and North Peckham seemed to be the favourite localities for the foisting of this milk on the public. We gave information to other authorities, with the result that seizures were made in Hackney and Southwark of this same brand of milk. The tins that were seized came under the description of what is technically termed "blown." In such an enormous number of tins at was manifestly impossible to open each one, so that one is obliged to rely on a selection of a small number, which in this case was made at random. Of those that were opened the taste and smell of their contents left no doubt in my mind that they were unfit for food and should be condemned; those tins which resembled these, so far as bulging was concerned, being seized on similar grounds. The question of seizing unsound tinned food is one which xi always presents some difficulty, as one cannot always say with certainty, while still unopened, what will be the state of the contents. If we condemn tins without opening we may do a trader a serious injustice, and, moreover, weaken our testimony should police-court proceedings be taken. On the other hand, those which have been opened are spoiled for trade, so that in such cases it would be very easy to run up a pretty little bill for the Council to defray. For these reasons tinned food is more likely to escape seizure than other descriptions of food, unless the appearances are in some way characteristic. Further, hardship usually falls on the retailer, for, as the result of our proceedings shows, it is exceedingly difficult to fix the blame on the wholesale dealer. One might have a very strong impression that the goods were unsound at the time of delivery at the shop, but this is quite a different thing from swearing on oath that such was one's opinion. There were 131 applications for certificates of exemption from Inhabited House Duty under the Customs and Inland Revenue Acts, which necessitated inspection being made of all the tenements concerned. Certificates either with or without the carrying out of extra work were granted in respect of 109 of these. From the returns it will be seen that there is no diminution of the work carried out at the Disinfecting Station, and I am glad to be able to say that we have passed through the year without a single claim for damage, whether avoidable or unavoidable, having been received. The Council will, I am sure, agree with me that this reflects great credit on those who are employed in the carrying out of this duty. The Disinfecting Depôt has also been used for the cleansing of persons who, being verminous, apply for treatment; but this part of the work has now been largely increased by the advent of a number of school children. The County Council, as the Education Authority, employs a certain number of nurses who go round to the various schools to inspect the heads of children, and it has been the practice to send those found to be verminous to the Peckham Park Road Depot for the purpose of being properly cleansed. The question of supervision during this process has, however, arisen in the cases where children of tender years go there without anyone in charge of them, and to secure the property of the Borough Council from damage even when they are properly accompanied. Application has been made to the County Council for recognition of the services rendered in this regard by the wife of the Disinfector, but so far without result. Considering that this cleansing of the children's heads is a duty which clearly belongs to the County Council, it is difficult to understand their action in failing to come to some agreement with this authority as regards payment. Complaints were made at intervals of the smell arising from a factory used for the drying of grains near the Old Kent Road. The matter culminated in a representation being made to the Council under Section 21 of the Public Health Act, and the case was heard at the Lambeth Police Court. The defendant appeared and answered. xii that the works were to be shut down for some weeks in order to carry out certain work. The magistrate adjourned the summons sine die to allow of this being carried out. There were nearly 200 fewer complaints received during 1907 than during 1906, with a corresponding diminution in the inspections arising from this cause. The house-to-house inspections also have diminished, but there has been an increase in the number of visits paid to houses let in lodgings. For the first time we record the periodical visits which are made to eating-houses. Many of these places are in need of constant inspection; not so much, perhaps, as regards the quality of food which they supply, but the general conditions under which it is prepared, and the effect of these conditions on those who carry out the work. The remaining items which are set out in the return of work call for no special notice beyond the indication of the large amount of detailed work which forms the bulk of the duties of your Inspectors. xiii TABLE I. VITAL STATISTICS OF WHOLE DISTRICT DURING 1907 AND PREVIOUS YEARS. Births. Deaths under One Year of Age. Deaths at all Ages. Total. Deaths at all Ages. Nett. Year. Population estimated to Middle of each Year. Number. Rate. * Number. Rate per 1,000 Births registered. Number. Rate. * Deaths in Public Institutions. Deaths of Nonresidents registered in District. Deaths of Residents registered beyond District. Number. Rate.* 2 3 4 5 6 7 8 9 10 11 12 13 1 257,772 7,478 29.0 1,187 4,525 17.5 1,842 620 472 4,377 1897 158.7 16.9 373 1898 261,551 7,427 28.3 1,191 160.3 4,639 17.7 1,856 643 4,369 16.7 18.6 1899 265,385 7,443 28.0 1,181 158.6 4,941 2,200 732 484 4,693 17.6 1900 269,276 7,211 1,107 153.5 4,748 17.6 2,188 767 474 16.5 26.7 4,455 259,660 7,260 1,033 142.2 4,576 17.6 2,224 509 1901 27.9 802 4,283 16.4 17.5 2,304 4,272 16.3 1902 261,309 7,333 28.06 1,035 141.1 5,474 818 516 1903 27.7 262,968 7,286 893 122.5 4,004 15.2 1,768 741 366 3,629 13.8 1904 265,139 7,242 27.3 1,084 148.3 4,352 16.4 1,475 776 445 4,021 15.1 267,601 25.9 865 15.2 1,468 495 1905 6,939 124.7 4,067 849 3,713 13.8 942 4,312 1906 270,153 7,020 25.9 134.1 15.9 1,524 808 495 3,999 14.8 4,563 16.9 1,884 755 462 4,181 15.7 Averages for years 1897 to 1906. 264,081 7,263 27.4 144.4 1,051 1907. 272,479 6,733 24.7 805 119.5 4,217 15.4 1,508 873 479 3,823 14.0 *Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. TABLE II. VITAL STATISTICS OF SEPARATE LOCALITIES IN 1907 AND PREVIOUS YEARS. Names of Localities. 1. Borough. 2. Dulwich. 3. South Camberwell. 4. North Camberwell. Population estimated to middle of each Year. Deaths under 1 year. Population estimated to middle of each Year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Deaths at all Ages. Year. Births Registered. Deaths at all Ages. Births registered. Deaths under 1 year. Camberwell. c d c a b c d b b d a a 367 1897 257,772 7,478 1,187 7,707 94 67 5 92,582 2,385 1,325 4,377 261,551 7,427 384 1898 4,369 1,191 7.861 91 79 8 94,461 2,427 1,424 4,693 9 96,379 1,475 37l 1899 265,385 7,443 1,181 8,018 101 85 2,443 8,178 109 8 1900 269,276 7,211 4,455 1,107 83 98,335 2,356 1,401 315 1901 259,660 4,283 1,033 125 77 15 284 7,260 10,247 90,465 2,295 1,259 261,309 11,275 117 91 32 2,401 290 1902 7,333 4,272 1,035 90,510 1,316 7,286 85 279 262,968 3,629 901 11,214 140 9 92,079 2,341 1,209 1903 92 13 1904 265,139 7,242 4,021 1,084 14,259 181 109,028 2,735 1,275 306 267,601 6,939 3,713 865 14,677 208 22 2,731 1,483 322 1905 145 110,648 1906 270,153 232 17 3,999 942 144 4 5,125 1,036 531 138 66,598 1,703 1,034 194 7,020 15,130 264,081 7,263 10,856 94 13 Averages of Years 1897 to 1906 4,181 1,052 139 98,621 1,373 325 2,485 15,600 212 141 12 45,915 991 516 82 67,195 1,607 1,002 272,479 6,733 3,823 805 209 1907 TABLE II.—Continued. Names of Localities. 5. South Peckham. 6. North Peckham. 7. St. George's. Year. Population estimated to middle of each Year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 year. Peckham d a b c a b c d 1897 2,789 1,286 373 89,472 1,699 442 67,976 2,210 90,469 2,737 1898 1,695 447 68,744 2,172 1,171 352 372 1899 91,476 2,669 1,735 429 69,520 2,230 1,394 1900 70,305 2,041 1,307 354 92,495 2,705 1,664 430 2,742 1,713 398 1,234 336 1901 93,038 65,589 2,098 1902 2,753 1,256 333 94,548 1,609 380 65,640 2,062 284 2,764 1903 329 65,283 2,041 1,005 94,286 1,330 1,474 326 1904 94,323 2,613 47,449 1,713 1,056 439 740 1905 1,345 47,420 1,386 198 94,849 2,611 323 1906 45,585 1,064 158 49,682 1,492 824 224 48,033 751 715 1,493 211 Averages of Years 1897 to 1906 61,595 1,944 1,120 313 93,022 2,693 1,580 399 1907 45,831 1,051 582 118 49,872 1,463 804 217 48,066 1,409 778 167 It has not been possible to correctly allot the deaths of persons removed to Public Institutions and of whose previous address we were unaware. See also report respecting the alteration in boundaries of the sub-districts. A pro rata distribution has been made in respect to the "unattached" births. TABLE III.-CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1907. Cases Notified in Whole District. Total Cases Notified in each Locality. No. of Cases Removed to Hospital from each Locality. At all Ages. At Ages—Years. Dulwich. South Camberwell. North Camberwell. South Peckham. North Peckham. St. George's. Dulwich. South Camberwell. North Camberwell. South Peckham. North Peckham. St. George's. Notifiable Disease. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria(including) Membranous Croup 54 192 101 89 88 35 21 ... 24 36 61 98 90 20 87 410 9 153 29 Erysipelas 268 11 24 164 7 23 71 54 1 2 11 14 14 12 8 28 33 76 37 1,572 951 89 247 380 196 462 185 316 176 418 Scarlet Fever 12 423 128 58 198 55 168 ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 Enteric Fever 82 4 16 24 38 9 12 21 13 7 18 17 11 9 18 7 ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .. ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 16 ... 10 3 6 2 2 3 3 1 6 ... ... ... 5 ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Cerebro- Spinal Meningitis 1 1 2 ... 1 1 ... ... ... ... ... 2 3 1 ... ... ... ... ... 2,351 33 221 223 299 530 Totals 589 1,184 291 33 129 315 573 322 391 621 83 429 257 xviii TABLE IV.-CAUSES OF, AND AGES AT, DEATH DURING YEAR 1907. Deaths in or belonging to whole District at subjoined Ages. Deaths in or belonging to Localities (at all Ages). Causes of Death. 2 All Ages. 5 and under 15. 15 and under 25. 65 and upwards. 3 Under 1. 1 and under 5. 25 and under 65. 9 Dulwich. 12 South Peckham. 13 North Peckham. 16 Deaths in Public Institutions. 10 South Camberwell. 14. St. George's. 11 North Camberwell. 15 Locality unknown. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Mcasles 109 29 75 5 1 9 ... 25 18 22 1 13 Scarlet Fever ... ... 33 37 2 4 19 15 1 ... 6 8 2 6 11 107 ... .. Hooping-cough 5 28 ... 44 61 2 11 17 20 25 ... ... ... 1 6 Diphtheria and Membranous Croup 40 2 7 6 29 1 1 4 7 11 ... 1 11 ... 2 Croup ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 9 ... 4 3 2 ... ... 1 4 1 3 3 ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 39 11 ... ... 1 1 3 20 1 7 6 10 7 3 3 8 ... Cholera ... ... ... ... ... ... ... ... .. ... .. ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 61 42 13 1 2 6 18 8 18 11 1 ... 3 ... ... Enteritis 25 37 4 6 2 ... 6 10 6 9 4 7 ... ... 2 Puerperal Fever 3 1 2 ... ... ... 1 1 ... ... ... 1 1 ... ... Erysipelas 7 2 2 2 ... ... ... 3 ... 1 ... 2 1 1 4 Other Septic Diseases 5 10 17 43 4 2 5 1 6 13 5 7 14 11 Phthisis 333 3 5 47 12 ... 11 255 6 38 123 101 54 55 70 9 Other Tubercular Diseases 23 135 40 10 20 ... 7 11 35 42 20 30 31 1 12 Cancer, Malignant Disease 141 46 226 21 36 43 1 2 78 2 2 38 41 1 63 61 Bronchitis 90 39 3 5 6 110 6 409 92 180 44 102 80 75 Pneumonia 381 8 114 117 107 14 90 45 9 36 46 89 81 47 6 Pleurisy 17 1 5 3 ... ... 10 3 1 1 4 2 4 ... Other Diseases of Respiratory Organs ... 4 29 7 ... 3 2 7 2 1 5 10 10 7 ... 3 Alcoholism ... ... ... 68 ... 60 8 7 10 18 10 Cirrhosis of Liver 12 10 1 17 Venereal Discuses 5 1 4 ... ... ... ... ... 2 1 ... ... 2 1 118 ... Premature Birth 17 118 ... ... 1 10 40 30 19 1 6 ... .. ... Diseases and Accidents of Parturition 18 7 ... ... 10 1 ... 2 7 2 3 ... ... 5 4 Heart Diseases 302 1 27 17 151 104 55 2 13 52 69 50 52 11 52 Accidents 105 12 2 25 22 7 41 21 4 10 16 25 23 2 28 Suicides ... 3 22 1 18 2 7 3 1 ... ... ... 8 2 Convulsions 11 ... 78 63 11 ... 1 2 2 12 7 1 23 23 ... ... Defective Vitality 114 111 2 4 20 11 1 ... ... 19 33 27 ... 10 93 1 3 Granular Kidney ... 1 57 34 10 27 12 16 23 37 ... 2 Mental Diseases 30 23 2 7 ... ... ... 1 6 5 9 3 4 2 5 Old Age 272 277 ... 11 49 56 ... ... ... 5 49 46 40 26 76 Cerebro-spinal Meningitis 2 1 49 1 ... ... ... ... ... 2 ... ... ... ... All other causes 26 75 99 569 65 32 18 16 245 193 150 90 118 108 21 97 All causes 805 152 126 1279 735* 3823 467 994 136 497 979 566 787 764 *This number refers to the deaths of parishioners, and excludes the deaths of non-residents who were inmates of Southwark Infirmary. TABLE V.—INFANTILE MORTALITY DURING THE YEAR 1907, Deaths from stated Causes in Weeks and Months under One Year of Age. Cause of Death. Under 1 week. 1 to 2 weeks 2 to 3 weeks. 3 to 4 weeks. Total under 1 month. 1 to 2 months. 2 to 3 months. 3 to 4 months. 4 to 5 months. 5 to 6 months. 6 to 7 months. 7 to 8 months. 8 to 9 months. 9 to 10 months. 10 to 11 months. 11 to 12 months. Total Deaths under 1 year. All Causes Certified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Common Infectious Diseases:— Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... 3 2 1 4 3 ... ... ... ... 4 12 29 Scarlet Fever 1 ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... 2 1 Diphtheria (including Membranous Croup) ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 2 ... ... Hooping Cough 6 3 ... ... ... ... ... 4 2 4 4 5 3 2 5 6 44 Diarrhœal Diseases :— Diarrhœa all forms ... 1 1 4 5 3 5 6 5 1 5 1 42 ... ... 5 1 5 1 1 2 2 4 1 5 1 1 Enteritis, Muco-enteritis, Gastro-enteritis ... ... ... 1 1 1 25 Gastritis, Gastro-intestinal Catarrh ... 1 1 ... ... 1 1 ... ... ... 3 ... ... ... ... ... Wasting Diseases :- xix Premature Birth 65 18 10 9 102 8 3 3 118 1 ... ... ... 1 ... ... ... Congenital Defects 11 2 3 20 4 ... 1 ... 2 2 7 4 ... ... ... ... ... ... 5 1 ... 7 ... Injury at Birth 1 ... ... ... ... ... 7 ... ... ... ... ... Want of Breast-milk, Starvation ... ... ... ... ... 1 1 ... 2 2 ... ... ... ... ... ... ... Atrophy, Debility, Marasmus 26 7 7 54 21 11 4 2 113 14 10 6 1 1 2 1 Tuberculous Diseases:— ... 2 Tuberculous Meningitis 1 ... 1 2 ... 1 ... 2 ... 2 2 2 2 4 20 ... ... Do. Peritonitis : Tabes Mesenterica ... ... 1 ... 1 1 1 4 ... ... ... ... ... ... ... Other Tuberculous Diseases 1 ... 1 1 2 3 21 ... ... 4 2 1 3 ... 2 2 ... 1 ... ... ... ... Erysipelas ... 1 ... 1 ... ... 2 ... ... ... ... ... Syphilis ... 2 3 ... ... ... 1 4 1 ... ... ... ... ... ... ... ... Rickets ... ... ... 2 ... ... ... ... ... ... ... .. 1 ... ... 1 ... Meningitis (not Tuberculous) ... 1 1 1 10 ... ... ... ... 1 ... 2 1 ... 1 ... 2 Convulsions 4 3 1 9 2 18 6 6 3 4 8 1 3 5 63 8 Bronchitis 1 5 11 ... 3 4 13 15 6 3 6 4 8 10 90 7 3 4 ... ... Laryngitis ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 10 Pneumonia ... 5 9 8 10 8 117 3 ... 12 9 7 6 10 10 10 18 5 4 2 Suffocation, overlying 1 7 2 1 3 1 1 1 16 ... ... ... ... ... Other Causes 6 2 4 2 14 5 6 2 1 1 2 3 1 5 2 ... 42 135 43 34 254 84 64 64 39 44 35 39 31 40 69 42 805 42 Institutions within the District receiving sick and infirm persons from outside the District. Southwark Infirmary. Camberwell House Asylum. Peckham House Asylum. Institutions outside the District receiving sick and infirm persons from the District. Manor Asylum, Horton, Epsom. South-Eastern Fever Hospital. Tooting Bec, Asylum. St. Thomas's Hospital. South-Western Fever Hospital. Belgrave Hospital for Children. Lambeth Infirmary. Cancer Hospital, Chelsea. Dartford Heath Asylum. Claybury Asylum. London Hospital. Guy's Hospital. Bethlehem Hospital. Royal Hospital, Waterloo Road. Charing Cross Hospital. Park Hospital, Lewisham. King's College Hospital. St. Peter's Hospital, Covent Garden. Royal Free Hospital. Lambeth Workhouse. Horton Asylum. Leavesden Asylum. London Fever Hospital. University College Hospital. Cane Hill Asylum. Caterham Asylum. Banstead Asylum. Westminster Hospital. St. Bartholomew's Hospital. Darenth Asylum. Children's Hospital, Great Ormonde Street. General Lying-in Hospital, Lambeth. Belmont Asylum. Brompton Hospital, Chelsea. Sick Asylum, Cleveland Street. Strand Union Infirmary. Evelina Hospital. Greenwich Infirmary. Hanwell Asylum. Hospital of St. John & St. Elizabeth, Marylebone. Friedenheim Hospital. Wandsworth Asylum. Great Northern Hospital. Poplar Hospital. Middlesex Hospital. Alexandra Hospital. St. George's Hospital. Other institutions the deaths in which have been distributed among the several localities in the District. Camberwell Infirmary. Constance Road Workhouse. Gordon Road Workhouse. XX Institutions within the District receiving sick and infirm persons from outside the District. Institutions outside the District receiving sick and infirm persons from the District. Epileptic Colony, Epsom. Colney Hatch Asylum. St. Luke's House, Kensington. Marylebone Infirmary. Mount Vernon Hospital, Hampstead. City of London Almshouses. Hostel of God, North Side, Clapham. St. Peter's House, Lambeth. St. George's Workhouse, Southwark. Joyce Green Hospital. German Hospital. Seamen's Hospital, Greenwich. Fountain Hospital. Bethnal House Asylum. National Hospital for Diseases of the Heart. West London Hospital. Long Grove Asylum, Epsom. West End Hospital. Grove Hospital, Tooting. Other institutions the deaths in which have been distributed among the several localities in the District. xxi MORTALITY RETURNS OF ZYMOTIC DISEASES QUARTERLY FOR THE LAST SIX YEARS. Year. Hooping Cough. Measles. Scarlet Fever. Diphtheria. Fever. Small-pox. Diarrhœa. Influenza. 1902. 1st Quarter 15 16 25 0 23 4 5 30 1902. 1st Quarter 2nd „ 36 9 5 10 20 42 6 7 3rd „ 25 23 5 28 11 3 97 5 4th „ 75 10 9 1 7 10 17 23 1903. Ist Quarter 26 40 3 19 14 8 0 12 2nd „ 24 8 0 9 0 6 7 2 3rd „ 6 11 11 5 4 0 62 2 7 4th „ 16 2 3 4 0 7 30 35 1904. Ist Quarter 34 1 6 4 0 8 9 2nd „ 36 53 3 4 3 0 6 0 13 3rd „ 12 5 5 5 0 200 1 0 11 7 8 4 15 16 4th „ 0 1905. Ist Quarter 36 10 3 5 1 0 9 12 2nd „ 28 6 19 10 5 2 0 15 4 4 3 3rd „ 7 4 0 140 1 37 9 11 5 2 0 11 6 4th „ 1906. Ist Quarter 22 72 4 15 3 0 5 10 2nd „ 22 26 7 5 0 9 0 15 1 6 3rd „ 10 4 5 0 194 2 17 10 4th „ 2 14 3 0 16 11 1907 1st Quarter 40 10 9 3 0 7 50 21 2nd „ 51 8 0 33 5 0 6 10 3rd „ 8 24 15 2 0 21 9 1 4 2 10 ANNUAL MORTALITY RETURN OF ZYMOTIC DISEASES, FROM 1856 (inclusive). Year. Hooping Cough. Measles. Scarlet Fever- Diphtheria. Fever. Smallpox. Diarrhœa. 1856 30 !9 32 48 5 29 30 7 1857 44 24 4 50 1858 26 28 129 14 20 7 51 1859 66 ? 31 12 82 1860 5 ? 36 40 34 11 26 1861 72 8 13 25 25 2 ? 1862 53 32 101 40 0 64 ? 1863 57 32 124 29 41 14 ? 1864 61 29 83 16 51 ? 10 1865 52 39 55 14 31 12 118 1866 72 38 59 11 53 35 76 1867 64 20 75 8 41 9 67 1868 58 67 71 17 13 146 45 1869 134 43 164 9 46 9 133 1870 49 24 192 10 57 23 160 1871 50 29 9 153 60 40 143 1872 132 86 1 46 38 41 124 1873 60 49 7 7 38 2 137 1874 76 54 93 24 9 57 2 125 1875 14 64 177 40 1 107 93 78 1876 33 16 31 32 1 26 1877 72 61 38 12 27 124 94 1878 206 88 59 29 41 81 176 1879 122 123 76 31 35 80 75 1880 206 59 126 32 36 33 22 3 1881 95 74 120 29 190 44 127 1882 180 168 76 60 44 66 100 1883 91 112 48 49 35 19 122 1884 173 171 82 78 40 34 240 1885 136 91 20 68 27 154 135 1886 97 48 156 18 30 2 215 203 133 99 71 1887 41 0 239 130 1888 101 105 65 31 1 115 1889 149 193 37 76 27 0 145 1890 191 163 51 144 60 0 26 1891 67 123 29 56 21 1 142 1892 128 189 63 85 1 169 21 1893 104 78 80 118 30 11 213 1894 126 164 45 193 21 2 115 1895 61 100 181 47 30 7 254 1896 180 192 52 0 262 34 238 1897 101 125 32 167 28 5 339 1898 121 113 18 86 25 350 0 1899 76 127 19 162 32 0 371 1900 110 38 11 131 33 0 282 1901 77 149 47 110 22 7 186 1902 96 105 40 88 29 62 131 1903 68 75 11 36 18 0 110 1904 94 100 16 23 0 16 229 1905 70 79 29 18 9 0 166 1906 71 101 25 40 11 0 224 107 1907 109 37 40 9 0 61 Under the head of fever I have only included the deaths from enteric fever. SUMMARY OF SANITARY WORK FOR THE YEAR ENDING DECEMBER, 1907 Description of Work. Pointon. Eagle. Scudamore. Collins. Heath. Kerslake. Morley. Homer. Farmer. Totals. Dewey. Ma lins. Cleanse and limewash 155 149 117 28 251 140 56 75 141 475 1,670 83 Repair glittering, &c. 106 73 43 26 94 99 32 41 55 108 93 770 12 9 16 108 19 36 15 Mentilate under floors, &c. 30 63 44 46 398 16 4 2 3 7 9 21 15 Abate overcrowding 11 8 1 97 3 8 Abate smoke nuisance 2 13 8 1 19 6 16 6 82 - Light and ventilate staircase 1 18 34 - 15 9 8 13 - 3 1 107 60 67 62 117 55 31 67 Provide, repair, or remove dustbin 46 95 67 120 787 69 28 15 21 9 17 7 21 40 21 7 255 Remove refuse or manure 94 91 41 45 57 125 40 64 49 78 144 828 Pave, level, or drain yard, &c. 1 3 3 2 1 2 3 5 - Provide manure pit 3 3 26 xxiv Provide sufficient water supply 2 - 22 28 4 4 6 6 1 3 1 77 4 2 Provide or reconstruct receptacle (render accessible) 9 - 18 4 6 4 1 2 2 52 Repair, cover, or cleanse receptacles 18 15 1 29 10 60 15 4 6 19 7 184 77 40 107 148 62 63 Provide, repair, or remove closets, pans, &c. 64 40 89 110 80 880 15 147 95 69 33 Proper water supply to closet and apparatus 71 105 55 20 56 58 724 Ventilate and remove to outside soil pipes, cleanse, repair, and trap drains or sinks 117 125 87 109 80 156 90 57 53 149 51 1,074 60 16 8 30 Disconnect rain-water pipes, sinks, and other wastes 13 78 23 9 39 10 286 - Empty and cleanse cesspools, or drain into sewer - - - 2 - - - 1 - - 1 4 Totally reconstruct drains 12 50 39 24 32 37 - 39 42 36 2 313 49 22 10 70 13 32 11 21 Partially reconstruct drains 58 18 14 318 4 - Animals to be kept clean or removed 6 2 2 8 2 2 3 4 3 36 Public conveniences—cleanse, supply with water, &c. - - - - - - - - - - - - Private conveniences—cleanse, supply with water, &c. 4 1 - 8 1 3 2 14 2 3 13 51 - - Abate nuisance from offensive trades - - - - - - - - - - Abate nuisance from road gullies - - - 1 2 - 14 - 30 - - 17 71 Miscellaneous 50 - 35 69 4 18 16 - - 30 293 1,196 RETURN OF WORK PERFORMED IN THE SANITARY DEPARTMENT DURING THE 52 WEEKS ENDING DECEMBER, 1907. Description of Work. Inspectors. Pointon. Eagle. Collins. Heath. Kerslake. Morley. Dewey. Malins. Totals. Homer. Farmer. Miss Bevan. Scudamore. 87 102 74 115 Complaints 72 52 83 86 76 68 39 5 859 89 107 175 91 Inspections arising from complaints 208 145 235 334 110 244 84 5 1,827 770 291 578 - House to house inspections 369 155 348 381 429 400 4,832 550 561 2 - - 414 60 42 - 29 49 706 Tenement houses inspected - 110 - - - - - 1,025 Houses let in lodgings inspected - - - - - 23 998 4 2 7 New buildings inspected 78 44 6 132 19 195 2 17 9 - 511 17 - 68 123 107 764 2 539 26 6 Visits to new buildings 194 2,044 3,890 - 29 39 5 17 - 8 1 5 - 133 No. of inspections of slaughterhouses 20 9 57 57 38 100 31 - 633 Do. do. bakehouses 45 83 32 48 109 33 10 4 - Do. do. cowhouses and dairies 25 60 4 77 12 10 27 34 - 263 107 Do. do. milk shops 157 76 198 47 152 149 102 264 113 - 1,437 72 63 21 37 26 54 50 30 23 19 467 Do. do. ice cream shops 53 91 - XXV 12 41 5 3 1 31 2 32 - - - 1 128 Do. do. railway stations Do. do. workshops 117 74 253 35 155 173 62 99 126 616 1,879 106 63 44 90 32 - 4 77 80 1 Do. do. urinals, public - 51 25 51 455 486 170 105 207 350 382 524 194 3,095 Do. do. do. private 368 207 102 - 35 Do. do. schools, L.C.C. 73 30 31 17 23 72 79 33 9 - 462 60 44 3 43 9 7 18 40 43 39 295 Do. do. do. private 17 27 5 49 11 2 4 - 2 14 20 6 79 Do. do. laundries 1 - 188 3 12 1 88 1 9 7 6 28 17 18 1 191 Do. do. re overcrowding Do. do. eating houses 33 25 - 21 17 31 - 8 22 96 287 18 16 2 74 22 - 6 1 - 46 - 21 172 Do. do. factories - - 1 1,138 1 - 1,151 Do. do. re outworkers 11 - - - - - - - 224 60 320 413 Miscellaneous 121 133 26 74 315 814 151 1,055 3,706 2,707 3,908 Re-inspections 3,281 3,658 3,056 3,268 2,689 3,430 120 34,900 2,783 3,251 2,749 170 130 150 362 212 368 135 167 119 71 2,282 No. of infected houses 209 189 142 97 119 72 146 77 76 88 Do. do. re-visited 40 109 81 3 1,050 173 60 108 112 1,425 145 222 86 212 67 74 - Measles 166 265 411 367 430 552 279 216 346 435 543 33 4,133 Intimations served under P.H. Act 256 93 65 61 122 70 10 818 Statutory notices under P.H. Act 82 134 53 42 3 83 - - - - 122 Notiecs re houses let in lodgings - - - - - 11 111 - 2 1 7 1 2 5 Summonses under the P.H. Act 2 5 2 10 - 39 2 6,952 6,167 6,465 5,143 7,291 6,575 6,421 5,390 6,537 7,046 3,347 Totals 6,027 73,361 Factory and workshop act, 1901. MISS G. D. BEVAN. REPORT OF WORK DONE DURING 1907. No. of Visits. Want of Cleanliness. Overcrowding and Want of Ventilation. Defective Roofs and Dampness. Defective Yard and Flooring. Sanitary Accommodation. Miscellaneous Defects. Intimation Notices. Statutory Notices. Summons. Dirty or Defective. Insufficient. Not Separate. Dirty or Uncovered Cisterns. Defective Dust-bins. Other Defects. Factories and Workshops Report:— - - - - Complaints and Visits re ditto 5 - - - - - - - - - 89 Workshops (new) 1 2 7 2 2 - 1 4 - 4 5 - 16 Do. (old) 544 - 4 2 2 - Laundries (new) 3 4 - - - - 1 117 6 3 Do. (old) - - - - - - - - - - Factories (new) 3 - - - Do. (old) - - - - - 69 - - 1 - - - - - 516 Outworkers (new) 31 - - 1 1 - - - - - - 442 - - Do (old) - - - - - Visits re Infectious Disease on Outworkers' Premises - - - 71 - - - - - - - - Re-inspections re Work in Hand 122 - - - - - - - - - - Eating Houses 113 4 3 2 3 - - - - 13 4 - 5 - Public Lavatories for Women 4 - - - - - - - - - - - - - 1,078 - - - Miscellaneous - - - - - - - - - - 46 2 12 7 10 1 3 - 7 - - 11 3,176 Totals 35 RETURN OF WORK CARRIED OUT AT THE DISINFECTING STATION DURING THE YEAR 1907. Articles Disinfected. January. February. March April. May. June. July. August. September. October. November. December. Total. Beds 113 95 103 127 100 108 109 103 156 203 283 155 1,655 311 217 188 156 168 131 269 2,482 206 166 206 200 264 Blankets 188 91 102 1,199 Bolsters 78 66 79 90 82 86 100 90 147 44 30 Books—Public Library 19 21 13 19 18 24 10 23 59 45 325 - 21 - - - 5 15 1 - Books—Sunday School Library - - - - 9 10 12 12 - 10 71 63 48 256 Books—Day School Library 7 14 - 50 38 57 43 34 5 5 667 Cushions 59 37 36 68 71 119 1 4 8 68 Curtains (pairs) 7 8 3 3 12 1 8 7 6 xxvii Carpets 6 8 7 18 19 23 32 23 216 18 10 25 27 792 32 62 57 82 77 73 Mattresses 59 53 63 52 51 131 2 2 75 Palliasses 4 16 - 19 2 2 10 2 8 8 539 3,345 211 231 247 211 235 237 255 226 262 382 309 Pillows 113 124 106 107 148 119 78 149 195 372 158 1,781 Quilts 112 104 112 101 174 1,899 123 166 118 149 126 177 232 317 Sheets - 323 Wearing Apparel (Suits, Dresses, &c.) - - - 240 245 268 219 692 1,179 594 3,760 344 216 424 499 355 237 199 77 218 215 91 16 2,891 Miscellaneous 1,278 1,233 1,727 1,205 1,813 2,619 2,030 21,432 1,437 3,673 Total 1,449 1,452 1,516 51 76 89 129 72 Mattresses Retabbed 59 62 57 82 62 49 820 32 16 5 49 Palliasses do. 4 5 2 2 - 12 3 - - - 38 73 55 593 50 57 59 40 37 36 30 48 70 Cushions do. Total 86 113 119 121 122 90 100 79 129 159 214 1,462 RETURN OF WoRK CARRIED OUT AT THE DISINFECTING STATION DURING THE YEAR 1906 (continued). Articles Disinfected. January. February. March. April. May. June. July. August. September. October. N ovember. December. Total Verminous Cases— 5 4 215 Persons Cleansed 3 4 2 1 8 2 7 95 51 33 Rooms Disinfected 4 3 - - - - - - - - - - 7 - - Bedding do. - - - - 3 - - - - - 3 Total 2 1 12 2 33 3 4 5 7 7 98 51 225 Articles Destroyed— 171 100 102 60 205 193 45 136 225 79 95 77 1,488 Palliasses and Mattresses - 25 31 Miscellaneous - 19 28 77 6 13 8 4 211 - Total 60 233 126 1,699 79 100 121 233 270 51 196 81 149 Houses Visited 334 440 702 572 322 333 405 259 427 512 801 447 5,554 139 192 293 237 185 193 217 242 Rooms Disinfected 163 168 226 194 2,449 Total 809 452 644 473 632 995 485 518 573 754 1,027 8,003 641 Unsound food, &c., destroyed at depot. Fish. Fruit. Meat. RABBITS. Tinned Foods. Tins of Milk. cwt. qrs. lbs. cwt. lbs. cwt. qrs. lbs. Number. qrs. cwt. qrs. lbs. cwt. qrs. lbs. 5 0 5 xxix ADMINISTRATION OF THE FACTORY AND WORKSHOP ACT, 1901, IN CONNECTION WITH FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. In accordance with the requirements of this Act I have to submit a report of the work carried out during the year 1907. Under the head of inspections of factories, workshops, and workplaces there were 3,683 inspections, compared with 3,309 in 1906, The inspections of factories show a decrease, but this diminution in number is more than made up by the extra number of visits paid to workshops (including laundries) and workplaces. The number of notices served was 176, being 25 more than the previous year. 1.—Inspection. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Written Notices. Prosecutions. Inspections. 35 Factories (including Factory Laundries) 172 - Workshops (including Workshop Laundries) 2,700 72 - Workplaces (other than Outworkers' Premises included in Part 3 of this Report) 1 69 811 3,683 176 1 Total 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Referred to H.M. Inspector. Remedied. Found. Nuisances under the Public Health Acts:— * 104 - Want of Cleanliness 104 - Want of Ventilation - - - - 2 Overcrowding 2 - - Want of Drainage of Floors 15 15 - - Other Nuisances 46 46 - - Sanitary Accommodation— Insufficient 5 5 - - Unsuitable or Defective 42 42 - 1 Not separate for Sexes 4 4 - - Offences under the Factory and Workshop Act:- Illegal Occupation of Underground Bakehouse (s. 101) - - - - Breach of Special Sanitary Requirements for Bakehouses (ss. 97 to 100) - - - - Other Offences (excluding Offences relating to Outwork which are included in Part 3 of this Report) - - - - 218 - Total 218 1 * Including those specified in Sections 2, 3, 7, and 8 of the Factory and Workshop Act as remediable under the Public Health Acts. 3.—Home Work. Nature of Work. Outworkers' Lists, Section 107. Number of Inspections of Outworkers' premises. Outwork in Unwholesome Premises, Section 108. Outwork in Infected Premises, Sections 109,110. Lists received from Employers. Numbers of Addresses of Outworkers received from other Councils. Numbers of Addresses of outworkers forwarded to other Councils. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (Sec. 110.) Prosecutions (Secs. 109,110.) Twice in the year. Once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Lists. Outworkers. Contractors Workmen. Contractors Workmen. Wearing Apparel - - 39 - 76 1,756 3 3 7 1,331 509 - - 903 28 - (1) making, &c. 152 - - - - - - - 16 - - - - - - - - (2) cleaning and washing - - - - - - - - - - - - - - Lace, lace curtains and nets - - - - - - - - - - - - - - - - Furniture and Upholstery - - - - - - - - - - - - - - - - - - - - Fur pulling - - - - - - Umbrellas - - - - - - - - - - - - - - - 4 56 1 1 3 21 16 - - 36 4 - - Paper Bags and Boxes 2 - - - 1 1 22 12 15 - - 19 1 - - - Brush making - - - - - - - - Stuffed Toys - - - - - - - - - - - - - - - - - - - File making - - - - - - - - - - - - - - - - - - - - - - - - - - Electro plate - - - Cables and Chains - - - - - - - - - - - - - - - - - - - - - - - - - Anchors and Grapnels - - - - — - - - - - Cart Gear - - - - - - - - - - - - - - - Locks, Latches and Keys - - - - - - - - - - - - - - - - - 540 33 - - Total 156 78 1,812 5 32 1,380 958 - 39 5 - 4.—Registered Workshops. Workshops and Workplaces on the Register (s. 131) at the end of the year. Number. Important classes of workshops, such as workshop bakehouses, may be enumerated here, Laundries 77 Clothing (wholesale and private) 396 Preparation of food 202 Building trades 57 Bakehouses 183 Miscellaneous 571 Total number of workshops on Register 1,486 5.—Other Matters. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 25 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) Notified by H.M. Inspector 9 Reports (of action taken) sent to H.M. Inspector 9 Other — Underground Bakehouses (s. 101):— Certificates granted during the year - 66 In use at the end of the year The defects numbered 218, an excess of 22 on the previous year, and all the conditions which required alteration have received attention; it being only necessary in one instance to take legal proceedings to enforce compliance with our demands, although we had to hold out threats of such a course to several firms who were careless in the sending in the required lists of outworkers. There has thus been an increase in the defects discovered compared with those discovered the previous year, but, on the other hand, it must also be noted that there has been an increase in the number of inspections whereby such complaints are discovered. A large number of outworkers have been received from other Councils, with an accompanying diminution in those that we have had to forward to other authorities. Table 5, as in last year, shows a diminution in the number of offences that were notified to the Inspector of Factories. PROCEEDINGS DURING 1907 (as asked for by the London County Council). Number of Places. Number of Inspections, 1907. Number of Notices, 1907. Number of Prosecutions, 1907. On Register at end of 1906. Added in 1907. Removed in 1907. On Register at end of 1907. Premises. 598 599 1,310 32 31 Milk Premises ... - - Cowsheds 1 18 17 285 - - Slaughterhouses 16 15 6 - - 1 149 - - - Other Offensive Trade Premises - 6 - 1 Ice Cream Premises 233 27 22 16 238 467 - 217 - (a)* 9 (a)* 1 217 1,025 Registered Houses Let in Lodgings - (b)* 305 (b)* 2 *(a) For overcrowding. (b) For other conditions. Total Number of Intimation Notices served for all purposes 4,408 Overcrowding, 1907 :— Number of dwelling rooms overcrowded 97 Number remedied 97 Number of prosecutions Nil Underground Rooms; — Illegal occupation dealt with during year Nil Number of rooms closed Nil Insanitary Houses :- Number closed under the Public Health (London) Act, 1891 Nil Number closed under the Housing of the Working Classes Act Nil Number of Verminous Premises cleansed under Section 20 of the L.C.C. (General Powers) Act, 1904 10 Shelters provided under Section 60 (4) of the Public Health (London) Act, 1891:- Number of persons accommodated during the year Nil Revenue Acts:- Number of houses for which applications were received during year 47 Number of tenements comprised therein 131 Number of tenements for which certificates were— (a) Granted 109 (b) Refused 22 (e) Deferred — xxxii Number of Prosecutions under By-laws under Public Health Act, (a) For prevention of nuisance arising from snow, ice, salt, filth, &c. Nil (b) For prevention of nuisance arising from offensive matter running out of any manufactory, &c. Nil (c) For the prevention of keeping of animals in such a manner as to be injurious to health Nil (d) As to paving of yards, &c., of dwelling houses 2 (c) In connection with the removal of offensive matter, &c. Nil (f) As to cesspools and privies, removal and disposal of refuse, &c. 1 (g) For securing the cleanliness of tanks, cisterns, &c. Nil (h) With respect to water closets, earth closets, etc. 1 (i) With respect to sufficiency of water supply to water closets 4 (j) With respect to drainage, &c. (Metropolis Management Act, Section 202) 8 (k) With respect to deposit of plans as to drainage, &c. (Metropolis Management Acts Amendment (By-laws) Act, 1899) 1 Mortuaries:— Total number of bodies removed 314 Total number of infectious bodies removed 6 In conclusion, I have to thank the Members of the Council for the consideration they have never failed to show, and the Clerks and Inspectors for the help which is always so willingly given. I am, Gentlemen, Your obedient Servant, FBANCIS STEVENS. xxxiii