CHE 10 Metropolitan Borough of Chelsea. ANNUAL REPORT For 1903, OF THE medical Officer of health, LOUIS C. PARKES, M.D.; D.P.H. Lond. Univ.; M.R.C.S. Eng. consulting sanitary adviser so h.m. office of works ; fellow of the sanitary institute j fellow of the society of medical officers of health j member of council of the epidemiological society ; lecturer on hygiene and public health at st. george's hospital medical school. TOWN HALL, KING'S ROAD, CHELSEA. 1904. TABLE OF CONTENTS. SEC. I.—Statistical :— page. Population of Chelsea 3 Births and Birth-rate 3 Deaths and Death-rate 3 Statistical Tables (Local Government Board Forms, I., II., III., IV.) 8—11 SEC. II. Infectious Diseases— Small-pox 12 Scarlet Fever 13 Diphtheria 13 Enteric Fever 14 The Case Mortality 14 Prevalence of Scarlet Fever, Diphtheria, and Enteric Fever in West London Boroughs 15 Bemoval of Patients to Hospitals 15 Voluntary Notification of Phthisis 16 SEC. III. : - The Housing op the Working Classes— Onslow Dwellings 17 The Beaufort-street Dwellings 17 Demolitions in 1903 18 SEC. IV.:— Reports presented to the Borough Council 19 SEC. V. : — The Sanitary Condition op the Borough— Bestaurant Kitchens 20 Underground Bake-houses 20 Administration of the Factory and Workshop Act 23 Water Supply 25 SEC. VI.: — Summary of Nuisances, and other matters reported upon 27 Magisterial Proceeding during 1903 29 L of Bake-houses, Cow-houses, and Slaughter-houses 30 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH For 1093. Section I.-STATISTICAL. POPULATION OF CHELSEA. The census popululation of the Borough of Chelsea for the year 1901 was 73,842. The estimated population of the Borough for 1903 is 74,169; the population of each sub-district being as follows : — Chelsea North 42,702 Chelsea South 31,467 BIRTHS AND BIRTH-RATE FOR 1903. Table I. Number of Births. Birth-rate per 1,000. Males. Females. Total. Chelsea North 422 424 846 19.9 Chelsea South 314 356 670 21.4 Chelsea 736 780 1,516 20.5 London .. .. 130,906 28.5 In 1902 the birth-rate of Chelsea Borough was 22.4 per 1,000, and in 1901 22.1 per 1,000. The average birth-rate of the Home District of Chelsea Parish for the 5 years 1896-1900 was 24.1 per 1,000. The rate for 1903—20.5, is the lowest yet recorded. DEATHS AND DEATH-RATE FOR 1903. The total number of deaths registered in the Borough was 1579. Of this number 615 were deaths, within the Borough, of nonparishioners—chiefly occurring in hospitals and in the St. George's Infirmary ; and 167 deaths of parishioners of Chelsea occurred outside 4 the Borough in various public institutions. There were, therefore, 1131 deaths of parishioners of Chelsea. These 1131 deaths are equivalent to a death-rate for the year of 15.3 per 1,000, as against a deathrate of 18.0 per 1,000 in 1902. Table II. gives the death-rates of the Home District of Cholsea, of Chelsea Borough, and of London during the past 13 years. Table II. Year. Chelsea.* London. Death-rate. Death-rate. 1891 22.1 21.4 1892 21.9 20.7 1893 21.6 21.4 1894 17.6 17.8 1895 20.8 19.9 1896 19.0 18.6 1897 17.9 18.2 1898 18.1 18.7 1899 20.0 19.8 1900 18.1 18.7 1901 16.6 17.7 1902 18.0 17.7 1903 15.3 15.7 *1891-1900, Chelsea Home District. The death-rate of Chelsea for 1903 is the lowest yet recorded. Zymotic Death-rate.—The death-rate in Chelsea from the seven principal zymotic diseases was l.26 per 1,000 in 1903, the lowest rate yet recorded, the corresponding rate for London being 1.78. In 1902 the zymotic death-rate in Chelsea was 2.22 per 1,000. The decrease in 1903 is due to the diminished prevalence of all the infectious diseases with the exception of whooping-cough. Table III.—For the year 1903. Zymotic death-rate. Diarrhoea death-rate. Phthisis death-rate. Other Tubercular diseases death-rate. Respiratory diseases death-rate. Cancer death-rate. Influenza death-rate. Deaths under 1 year to 1,000 births. Percentage of deaths under 5 to total deaths Deaths in Public Intutions % of total. Chelsea 1.26 0.54 1.61 0.38 2.72 1.27 0.08 144 27.6 45.6 London 1.78 0.84 1.60 0.60 2.21 1.02 0.14 131 35.7 35.4 5 Small-pox.—There were 6 cases of small-pox amongst Chelsea residents in 1903, but no deaths. Measles.—This disease caused 14 deaths in 1903, as compared with 68 in 1902. Five of the deaths were registered in North Chelsea, and 9 in South Chelsea. Three of the deaths were of infants under 1 year of age, and 10 were of children between 1 and 5 years. The disease was again commencing to assume an epidemio form towards the end of the year in accordance with its usual periodicity—an epidemio every other year. Scarlet Fever.—This disease caused only 2 deaths in 1903, as compared with 8 in 1902. Both the deaths were of fever hospital patients, one a resident of North Chelsea, the other of South Chelsea. Scarlet fever was epidemic in April and May in the Duke of York's lloyal Military School, 82 cases being sent to the M.A.B. hospitals; but the disease assumed a mild type there being not a single death amongst these 82 cases. Diphtheria.—This disease caused 4 deaths in 1903, as compared with 13 in 1902. This is the lowest recorded mortality from diphtheria since 1890. Two of the fatal cases were of residents in North Chelsea, and 2 in South Chelsea. Three of the deaths were of fever hospital patients, and one occurred at the patients' own home. Chelsea continues to remain free from epidemic diphtheria, as the following Table shows :— Table IV.— Cases of, and Deaths from Diphtheria and Membranous Croup in Chelsea* 1890-1903. Cases. 1890. 1891. 1892. 1893. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 1902. 1903. 172 162 163 200 207 273 429 242 153 136 150 106 131 99 Deaths. 1890. 1891. 1892. 1893. 1894. 1895. 1896. 1897. 1898. 1899. 1900. 1901. 1902. 1903. 32 20 32 43 41 52 96 45 22 13 14 9 13 4 *1890-1900, Chelsea Home District. Whooping Cough.—This desease caused 29 deaths in 1903, as compared with 13 in 1902. Twenty-one of the deaths were of North Chelsea residents, and 8 of South Chelsea residents. Twelve of the fatal cases were infants under 1 year of age, and 16 were of children between 1 and 5 years of age. 6 Enteric Fever.—This disease caused 4 deaths, two from North Chelsea, and two from South Chelsea. Two of the deaths occurred in hospital, and two at the patients' own homes. Table V.—Zymotic Disease Mortality in Chelsea, in 1903. Actual number of deaths in Chelsea. Chelsea's proportion of total London deaths according to its population. Average number of deaths annually in Chelsea, 1896-1902. Measles 14 33 41 Scarlet Fever 2 6 10 Diphtheria 4 12 30 Whooping Cough 29 26 28 Enteric Fever 4 6 9 Diarrhœa 40 62 81 Diarrhœa.—The deaths in Chelsea in 1903 from diarrhœal diseases (diarrhoea, dysentery, cholera, enteritis, and gastro-enteritis) were 40 in number, as compared with 52 in 1902. Thirty of the deaths were of infants under 1 year of age, and 4 were between 1 and 5 years of age. Eighteen were deaths of North Chelsea residents, and 22 of South Chelsea residents. The summer diarrhœa prevalence of 1903, like those of 1901 and 1902, was slight owing to the cold and wet weather in July and August. Table VI.—Mortality from Diarrhceal Diseases. Year. Chelsea. London. Death-rate per Million. Death-rate per Million. 1896 1,037 1.112 1897 1,340 1,446 1898 1,258 1,556 1899 1,282 1,663 1900 1,187 1,251 1901 788 1,184 1902 692 737 1903 541 837 Influenza.—The number of deaths attributed to influenza amounted to 6, as against 20 in 1902. Two deaths occurred in North Chelsea, and 4 in South Chelsea. In London generally the disease was but slightly prevalent, only 644 deaths occurring in 1903, as against 1,083 in 1902. Of the fatal cases in London in 1903, 350 ocourred in the first quarter of the year. 7 Respiratory Diseases.—The death-rate from these diseases in Chelsea in 1903 was only 2.72 per 1,000, as against 4.14 per 1,000 in 1902. The small prevalence of influenza and measles and the absence of extremes of temperature account for the low respiratory disease death-rate. Tubercular Diseases.—The death-rate from phthisis and other tubercular disease in Chelsea in 1903 was 1.99 per 1,000, as against 1.87 per 1,000 in 1902, and 2.2 per 1,000 in London in 1903. The average death-rate from these diseases in Chelsea for the 6 years, 1897-1902, is 2.3 per 1,000. Cancer.—Malignant cancerous diseases caused 94 deaths amongst Chelsea residents in 1903, the average of the past 7 years being 73 deaths. Forty-four of the cancer deaths were of North Chelsea residents, and 50 of South Chelsea residents. Alcoholism.—Twenty-one deaths were registered as being due to intemperance or to cirrhosis of the liver, as against 26 in 1902, and 31 in each of the years 1900-1901. Other Causes.—A death of a North Chelsea resident was registered as due to actino-mycosis; and a Westminster parishioner died in the St. George's Infirmary from glanders, contracted from a stable in the City of Westminster. Deaths in Lunatic Asylums.—Forty deaths of Chelsea parishioners occurred in 1903 in lunatic asylums. The average of the 12 years, 1891-1902, is 32 deaths annually in lunatic asylums. Deaths in Public Institutions.—In 1903, 45.6 per cent, of the total deaths of parishioners of Chelsea occurred in public institutions, as compared with 40.2 per cent. in 1902. In London generally, 35.4 per cent. of the total deaths occurred in public institutions. The deaths in the Chelsea Infirmary in 1903 formed 23.2 per cent. of the total deaths of Borough residents, as compared with 21.9 per cent. for 1902. 8 TABLE VII.—(I.) FOR WHOLE DISTRICT. Year. Population estimated to Middle of each Year. Births. Deaths under One Year of Age. Deaths at all Ages. Total. Deaths in Public Institutions in sea. Deaths of non- residentsre. gistered in District. Deaths of Residents registered beyond District Deaths at all Ages. Nett. No. Rate.* No. Itate per 1000 Births reeis'td No. Rate.* No. Rate.* 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 1893 96,430 2854 29.6 456 160 2125 22.0 765 412 245 1958 20.3 1894 96,508 2700 28.0 356 132 1720 17.8 658 332 229 1617 16.8 1895 96,587 2723 28.2 464 170 2002 20.7 682 323 241 1920 19.9 1896 96,666 2651 27.4 443 167 1903 19.7 648 305 251 1849 19.1 1897 96,745 2549 26.3 410 161 1777 18.4 668 298 235 1714 17.7 1898 96,823 2332 24.1 410 176 1827 18.9 678 300 231 1758 18.2 1899 96,902 2381 24.6 391 164 1927 19.9 661 255 225 1900 19.6 1900 96,990 2245 23.1 333 148 1802 18.6 662 277 213 1737 17.9 Averages for years 1893-1900. 96,706 2554 26.4 408 160 1885 19.5 678 313 234 1807 18.7 1901 73,856 1626 22.1 226 139 1601 21.8 855 546 165 1220 16.6 1902 74,018 1685 22.4 244 145 1896 25.2 1086 716 175 1355 18.0 1903 74,169 1516 20.5 218 144 1579 21.4 964 615 167 1131 15.3 •Rates calculated per 1000 of estimated population. Note—The deaths to be included in Column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths to be included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non-residents" is meant persons brought into the district on account of illness, and dying there; and by the term "Residents" is meant persons who have been taken out of the district on account of illness, and have died elsewhere. Area of District in acres (exclusive of area covered by water 660 At Census of 1901. Total population at all ages 73,856 Number of inhabited houses 9,063 Average number of persons per house 8.1 9 TABLE VIII.—(II.) Names of Localities. CHELSEA. HOME DISTRICT. KENSAL TOWN. Year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 Year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 Year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 Year. (a.) (b.) (c.) (d.) (a.) (b.) (c.) (d.) (a.) (b.) (c.) (d.) 1893 96,430 2854 1958 456 74,794 2128 1607 346 21,635 726 351 110 1894 96,508 2700 1617 356 74,940 2028 1315 271 21,568 672 302 85 1895 96,587 2723 1920 464 75,086 2028 1559 341 21,500 695 361 123 1896 96,666 2651 1849 443 75,233 1999 1453 323 21,433 652 396 120 1897 96,745 2549 1709 410 75,380 1902 1344 287 21,367 647 365 123 1898 96,823 2332 1758 410 75,527 1761 1360 283 21,300 571 398 127 1899 96,902 2381 1900 391 75,674 1772 1505 277 21,234 609 395 114 1900 96,990 2245 1737 333 75,822 1674 1373 243 21,168 571 364 90 Averages for years 1893-1900. 96,706 2554 1807 408 75,307 1901 1439 296 21,401 643 366 111 Chelsea North. Chelsea South. 1901 73,856 1626 1220 226 42,515 914 629 107 31,341 712 591 119 1902 74,018 1685 1355 244 42,615 915 736 139 31,403 770 619 105 1903 74,169 1516 1131 218 42,702 846 588 113 31,467 670 543 105 Notes.— (a.) The separate localities adopted for this Table should be areas of which the populations are obtainable from the census returns, such as wards, parishes or groups of parishes or registration sub-districts. Block 1 may, if desired, be used for the whole district; and blocks, 2, 3, &c., for the several localities. In small districts without recognised divisions of known population this Table need not be filled np. (b.) Deaths of residents occurring in public institutions beyond the district are to be included in subcolumns c of this Table, and those of non-residents registered in public institutions in the district excluded. [See note on Table I. as to meaning of terms "resident" and " non-resident."] (c.) Deaths of residents occurring in public institutions, whether within or without the district, are to be allotted to the respective localities according to the addresses of the deceased. (d.) Care should be taken that the gross totals of the several columns in this Table respectively equal the corresponding totals for the whole districts in Tables I. and IV.; thus, the totals of subcolumns a, b, and c, should agree with the figures for the year in the columns 2, 3, and 12, respectively, of Table I.; the gross total of the sub-columns c should agree with the total of column 2 in Table IV., and the gross total of sub-columns d with the total of column 3 in Table IV. 10 TABLE IX.—(III.) Cases of Infectious Disease notified during the Year 1903. Notifiable Disease. Cases notified in Whole District. Total Cabes notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. At Agest—Years. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Chelsea North. Chelsea South. Chelsea North Chelsea South. Whole Boroughs. Small-pox 6 .. .. .. 1 5 .. 1 5 1 5 6 Cholera .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 98 2 30 51 9 6 .. 42 56 38 50 88 Membranous croup 1 .. 1 .. .. .. .. 1 .. 1 .. 1 Erysipelas 58 1 2 3 5 38 9 27 31 2 5 7 Scarlet fever 207 1 39 146 14 7 .. 56 151 47 141 188 Typhus fever .. .. .. .. .. .. .. .. .. .. .. .. Enteric fever 13 .. .. 1 4 8 .. 5 8 3 5 8 Relapsing fever .. .. .. .. .. .. .. .. .. .. .. .. Continued fever .. .. .. .. .. .. .. .. .. .. .. .. Puerperal fever 6 .. .. .. .. 6 .. 3 3 1 2 3 Plague .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox 7 1 3 3 .. .. .. 2 5 .. .. .. Totals 396 5 75 204 33 70 9 137 259 93 208 301 Notes.—The localities adopted for this table should be the same as those in Tables II. and IV. † These age columns for notifications should be filled up in all cases where the Medical Officer of Health, by inquiry or otherwise, has obtained the necessary information. TABLE X.—(iv.) Causes of, and Ages at, Death during Year 1903. Causes or Death. Deaths is or belonging to whole District at subjoined Ages. Deaths in or belonging to Localities (at all Ages). Total Deaths in Public Institutions in the District. All Ages. Under 1 Year. 1 and under 5. 5 and udner 15. 15 and under 25. 25 and under 65. 65 and upwards. Chelsea North. Chelsea South. Small-pox .. .. .. .. .. .. .. .. .. .. Measles 14 3 10 1 .. .. .. 5 9 4 Scarlet Fever 2 1 .. 1 .. .. .. 1 1 .. Whooping-cough 29 12 16 1 .. .. .. 21 8 10 Diphtheria and Membranous Croup 4 .. 3 1 .. .. .. 2 2 1 Croup .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. Enteric 4 .. .. .. 1 3 .. 2 2 .. Other continued .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 6 1 1 .. .. 3 1 2 4 1 Cholera .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. Diarrhœa (See Notes at foot) 30 24 2 .. .. 2 2 13 17 11 Enteritis (See Notes at foot) 10 6 2 1 .. .. 1 5 5 8 Puerperal Fever 7 .. .. .. 1 6 .. 6 1 2 Erysipelas 5 .. 1 .. .. 3 1 2 3 1 Other septic Diseases 3 1 .. .. 1 1 .. 2 1 .. Phthisis 119 .. 3 3 6 98 9 71 48 168 Other Tubercular Diseases 28 10 10 3 1 3 1 18 10 24 Cancer, Malignant Diseases 94 .. 1 .. 2 64 27 44 50 157 Bronchitis 148 37 20 .. .. 32 59 77 71 125 Pneumonia 49 7 8 3 .. 16 13 29 20 37 Pleurisy 3 .. .. .. .. 1 2 2 1 5 Other Diseases of Respiratory Organs 1 .. .. .. .. 1 .. 1 .. 4 Alcoholism- Cirrhosis of Liver 21 .. .. .. 1 16 4 12 9 12 Venereal Diseases 7 6 .. .. .. 1 .. 4 3 2 Premature Birth 27 27 .. .. .. .. .. 15 12 1 Diseases and Accidents of Parturition 2 .. .. .. 1 1 .. 1 1 .. Heart Diseases 126 8 1 3 6 62 51 55 71 96 Accidents 50 12 7 2 3 17 9 23 27 18 Suicides 12 .. .. .. 1 8 3 9 3 3 All other causes 330 68 9 5 3 120 125 166 164 274 All causes 1131 218 94 24 29 458 308 588 543 964 Notes .—(a) In this Table all deaths of "Residents" occurring in public institutions, whether within or without the district, are to be included with the other deaths in the columns for the several age grouprt (columns 2-8). They are, also, in columns 9-15, to be included among the deaths in their respective " Localities according to the previous addresses of the deceased as given by the Registrars. Deaths of " Non-residents " occurring in public institutions in the district are in like manner to be excluded from columns 2-8 and 9-15 of this Table. (b) See notes on Table I. as to meaning of "Residents" and "Non-residents, and as to the "Tublic Institutions" to be taken into account for the purposes of these Tables. The " Idealities" should be the same as those in Tables II. and III. (c) All deaths occurring in public institutions situated within the district, whether of "Residents" or of "Non-residents," are, in addition to being dealt with as in note (a), to be entered in the last column of this Table. The total number in this column should equal the figures for the year in column 9. Table I. (d) The total deaths in the several "Localities" in columns 9-15 of this table should equal those for the year in the same localities in Table II., sub-columns c. The total deaths at all ages in column 2 of this Table should equal the gross total of columns 9-15, and the figures for the year in column 12 of Table I. (e) Under the heading of "Diarrhœa" are to be included deaths certified as from Diarrhœa, alone or in combination with some other cause of ill-defined nature; and also deaths certified as from Epidemic Enteritis; Zymotic Enteritis; Epidemic Diarrhoea. Summer Diarrhoea; Dysentery and Dysenteric Diarrhoea; Choleraic Diarrhoea. Cholera, Cholera nostras (in the absence of Asiatic Cholera). Under the heading of " Enteritis " are to be included those certified as from Gastro-enteritis, Muco-enteritis, and Gastric Catarrh, unless from information obtained by enquiry from the certifying practitioner or otherwise, the Medical Officer of Health should have reason for including such deaths, especially those of infants, under the specific term "Diarrhoea?" Deaths from Diarrhoea secondary to some other well-defined disease should be included under the latter. In recording the facts under the various headings of Tables I., II., III. and IV., attention has been given to the notes on the Tables. 12 Section II. INFECTIOUS DISEASES. Small-pox.—Six cases of small-pox were notified during the year, namely—1 in North Chelsea and 5 in South Chelsea. A case was also notified as small-pox in December, and was removed to the M.A.B. Isolation Wharf, but was returned home on the following day as a case of chicken-pox. The six cases occurred in 4 houses, namely—3 in one house (husband and wife notified on the same day, and three weeks later a sister of the wife's, who had declined re-vaccination), and a single case in each of the three other houses. Threa of the cases occurred in March, 2 in April, and 1 in June. The period elapsing between the onset of the disease and notification was in 1 case, 2 days, in I case 3 days, in 1 case 4 days, and in 3 cases 5 days. The patient was removed to hospital on the same day the case was notified in 5 instances, and on the following day in one instance. The period of detention in hospital ranged from 25 to 53 days, and averaged 37 days for the 6 cases. All the patients recovered, the type of the disease appearing to be distinctly milder than during the epidemic period 1901-2. The ages of the patients were 15 years, 25 years, 26 years (2), 31 years, and 53 years, 4 being males and 2 females. Five of the patients had been vaccinated in infancy, but one presented no scars. Only one of the cases, a man of 53, had been revaccinated, and that many years ago. The unvaccinated case was that of a girl of 15, but she had a short attack, being only detained 31 days in hospital. There was no history of infection in 4 cases. In addition to the unvaccinated girl of 15, who contracted the infection from her married sister, there was a history of infection in one other case. This was the case of a man of 26, not revaccinated, who had been at work in the erection of a temporary small hospital in County Durham, such temporary hospital being in close proximity to a hospital occupied by convalesing small-pox patients. This man was attacked with small-pox 4 days after his return home to Chelsea. Revaccination was offered to the other inmates of the invaded houses over the age of 10 years, and was accepted in 10 instances. Three unvaccinated children were vaccinated; and 4 other persons residing in the neighbourhood, who had visited invaded houses, were revaccinated. There was no extension of the disease from the primarily invaded houses to other persons, except in the case of the unvaccinated girl of 15 previously alluded to. Small-pox in London.—In London, during the year 1903,417 cases of small-pox were notified in the various Boroughs as against 7797 cases in 1902. There were 38 cases in the first quarter of the year, 162 in the second quarter, 121 in the third quarter, and 96 in the fourth quarter. Chelsea's proportion of the total London cases according to its population is 7 cases, and 6 were actually notified. The case mortality or percentage of deaths to attacks of the 417 London cases was only 3.1 per cent, in 1903, as compared with a fatality of 16.4 per cent, during the epidemic period of 1901-2. 13 Scarlet Fever.—Apart from an outbreak of this disease in the Duke of York's Royal Military School in April and May, 1903, scarlet fever was less prevalent in the Borough than it has been for many years past. Excluding the Duke of York's School cases, the case-rate per 10,000 of the population was only 16.9, as against 27.6 in 1902. The case-rate for 1903, including the Duke of York's School cases, was 27.9 per 10,000. Eighty-two cases of scarlet fever were removed to the M.A.B. hospitals from the Duke of York's School in April and May, and the School was broken up at the latter end of May and transferred temporarily to the country in consequence of the outbreak. The disease was of a mild type, no deaths resulting, and the average duration of the stay in hospital of the School cases was 54 days. There was no autumnal increase in the prevalence of this disease in Chelsea in 1903. The number of cases notified in the first quarter of the year being 40, in the second quarter 117 (82 Duke of York's School cases), in the third quarter 30, and in the fourth quarter 20. The number of cases notified in North Chelsea was 56, and in South Chelsea, exclusive of the Duke of York's School cases, 69. The percentage of cases of sohool age (3 to 13 years) in the whole Borough was 76 per cent. The average duration of the stay in hospital of 165 cases, of which records are to hand, was 63 days. Six cases admitted to the M.A.B. hospitals were subsequently certified by the Medioal Superintendents of those Institutions not to be suffering from scarlet fever, or any other notifiable disease. The average duration of the stay in hospital of these 6 cases was 23 days. Diphtheria.—The case-rate of this disease in Chelsea for 1903 was 13*4 per 10,000 of the population, which is considerably lower than the case-rate for 1902 (17.7). In the first quarter of the year 39 cases were notified (including 8 from the Duke of York's School at the end of March), in tho second quarter 22, in the third quarter 19, and in the fourth quarter 20. The percentage of cases of school age (3 to 13) for the whole Borough was 68 per cent. With the exception of 9 cases of the disease from the Duke of York's School in March and April, most of which preceded the scarlet fever outbreak in the same Institution, there were no outbreaks in the course of the year specially attributable to sohool infection. In North Chelsea 43 cases were notified, in Sonth Chelsea 56. There was no autumnal increase in prevalence of the disease. During a period of 6 weeks from the early part of April until the latter end of May, only one case of diphtheria was notified in the whole Borough—such an occurrence being probably unprecedented. The average duration of the stay in hospital of 60 cases, of whioh the records are to hand, was 54 days. Fifteen cases admitted to the M.A.B. hospitals were subsequently certified by the Medical Superintendents of these Institutions not to be suffering from diphtheria or any other notifiable disease. This proportion of mistaken diagnoses (15 per cent.) is rather larger than in 1902 (6 per cent.). The average duration of the stay in hospital of these 15 cases was 14 days. 14 Enteric Fever.—The number of cases of enteric fever notified in Chelsea in 1903 was 13, the case-rate being an exceedingly low one, namely—1-75 per 10,000 of the population, as against 4'9 in 1902, and 5-3 in 1901. Six of the 13 cases were notified in the fourth quarter of the year. In North Chelsea 5 cases were notified, in South Chelsea 8. Four out of the 13 cases had a fatal termination. One of the notified cases, which proved fatal, was probably not a case of enteric fever. Of the remaining 12 cases, in 6 the infection was contracted outside the Borough of Chelsea. In one of these cases the consumption of infected cockles at Southend was in all probability the cause of the disease. Case Mortality.—The following Table shows the case mortality, or percentage of deaths to notifications of scarlet fever, diphtheria (including membranous croup) and enteric fever in Chelsea and London, in each of the 14 years, 1890-1903. TABLE XI.—Case Mortality in Chelsea, and in London, 1890-1903. Scarlet Fever. Diphtheria and Membranous Croup. Enteric Fever. Chelsea. London. Chelsea. London. Chelsea. London. 1890 7.0 5.7 17.6 24.1 17.4 23.0 1891 3.6 5.1 15.4 22.5 17.4 15.6 1892 5.3 4.3 22.9 23.9 13.6 17.2 1893 5.3 4.3 23.4 24.5 22.1 18.4 1894 5.1 5.2 21.7 23.6 14.7 18.1 1895 4.0 4.2 18.7 20.4 18.4 17.0 1896 4.9 3.7 22.9 19.3 14.7 17.7 1897 3.5 3.4 17.9 17.1 26.4 18.8 1898 4.2 3.4 15.1 14.8 25.0 19.3 1899 2.8 2.2 10.6 14.2 28.1 18.0 1900 3.0 2.6 9.9 12.8 24.4 17.5 1901 2.6 3.2 8.5 11.1 12.8 16.8 1902 4.0 3.1 10.0 11.0 16.6 16.3 1903 1.0 2.9 4.0 9.7 31.0 16.6 The case mortality of Chelsea scarlet fever cases—10 per cent.—is exceedingly low, and shows the very mild type of the disease now prevailing. The case mortality of the Chelsea diphtheria cases-—4.0 per cent.—is also remarkably low, and like scarlet fever is the lowest recorded since compulsory notification came into force in 1890. The reduction in fatality of all London diphtheria cases from 23.6 per cent. in 1894 to 9.7 per cent. in 1903 is also highly satisfactory, and is largely the result of the almost universal resort in these cases to Antitoxine as a curative agent. The Chelsea enteric fever case mortality shows a high figure, but as the number of cases (only 13) was very small, the figure has but little value for the purpose of comparative statistics. 15 Prevalence of Scarlet Fever, Diphtheria, and Enteric Ferer, in West London. The following Table is based upon the notified cases of scarlet fever, diphtheria and membranous croup, and enteric fever, recpestively, in each of the six boroughs constituting West London, the rates being calculated upon the estimated population of each district. TABLE XII.—Notifications per 10,000 of Population in 1903. Scarlet Fever. Diphtheria. Enteric Fever. Chelsea 27.9 13.4 1.7 Kensington 18.5 9.0 3.4 Paddington 28.6 10.3 2.9 Hammersmith 27.7 14.3 5.1 Fulham 27.4 20.0 5.4 Westminster 19.7 10.4 4.0 West London 24.1 12.6 3.9 London 27.2 16.7 5.1 The prevalence of all these diseases was notably lower in London in 1903 than in 1902. As usual the prevalence was less in the six boroughs constituting West London than in the Metropolis as a whole. Chelsea had the lowest enteric fever rate of any of the Western Boroughs in 1903, whilst Kensington had the lowest scarlet fever and diphtheria rates. Fulham again had the highest diphtheria rate, but the prevalence in 1903 was 33 per cent, less than in 1902. Removals to Hospitals.—Table XIII. exhibits the removals of patients suffering from scarlet fever, diphtheria, and enteric fever, from their homes to hospitals, in each of the 14 years, 1890-1903, expressed as percentages of the total number of cases notified. TABLE XIII.—Percentage Removals to Hospitals. Scarlet Fever. Diphtheria. Enteric Fever. 1890 38 20 29 1891 40 15 22 1892 48 27 32 1893 50 41 38 1894 71 58 63 1895 55 62 51 1896 61 56 56 1897 76 67 54 1898 74 74 54 1899 77 76 69 1900 81 80 71 1901 78 63 72 1902 90 83 67 1903 91 88 62 16 In 1903 the percentage of removals both of scarlet fever and of diphtheria cases was higher than in any previous year. There was no delay in effecting the removal of any Chelsea cases to the M.A.B. hospitals. Voluntary Notification of Phthsis.-On the 10th June, 1903, the Borough Council resolved to adopt the voluntary notification of phthisis in the Borough, the fees to medical practitioners to be the same as under the Public Health (London) Act. The provision of sanatoria by the Metropolitan Asylums Board for the open-air treatment of London consumptives, which was approved by the Borough Council, on a report presented by me to the Public Health Committee, has again been the subject of consideration. The Metropolitan Asylums Board has now referred the whole question of such treatment of consumptives to the Local Government Board for the opinion of that Board on the principles involved. 17 Section III. HOUSING- OF THE WORKING CLASSES. Onslow Dwellings. The Borough Council having in 1902 purchased from the Freake Trustees the leasehold interest in Onslow Dwellings for the sum of £5000, the Dwellings came into the possession of the Council at the end of the first quarter of 1903. No special expenditure has been incurred in connection with the buildings, with the exception of supplying 72 new "Beetonette" cottage kitchen ranges, manufactured by the Carron Company, to replace ranges that were worn out and beyond repair. These new ranges were supplied and fixed at a total inclusive cost of about £2 each range. During the year the Borough Council has acquired from Mr. Sloane Stanley for the sum of £2,300 his freehold interest in Nos. 21, 23, 25, 27, 29, and 31, Pond-place, which were included in the Freake leasehold of Onslow Dwellings. The area of the land covered by these houses with their curtilages is about 8,500 square feet, the depth 100 feet, and the frontage to Pond-place, 85 feet. The price per foot super, is 5s. 5d., the price paid in 1901 to Mr. Sloane Stanley for his reversionary freehold interest in Onslow Dwellings being £13,350, or 6s. 2½d. per foot super. The lease of the premises in Pond-place held by the Freake Trustees expires at Christmas, 1909, as does also that of Onslow Dwellings. The Pond-place houses are held under various sub-leases, which expire within some months or a year anterior to the expiry of the head lease. The existing profit rental of the premises is about £25 per annum. Beaufort Street Dwellings. During the past year contracts have been entered into as follows for the erection of the dwellings in accordance with the plans submitted by the architects, Messrs. Joseph, Son & Smithen, and accepted by the Council in 1902:- £ s. d. Foundations—Messrs. Foster & Dicksee 3,919 0 0 Superstructure—General Works—Mr. C. Wall 32,650 0 0 Fireproof Floors— „ 3,630 0 0 Plastering— Mr. J. Bickley 3,721 1,632 3 11 4 10 Artificial Stone— „ Granolithic Paving— „ 1,975 13 6 Sanitary Fittings— Messrs. Shanks & Co 1,064 1 9 Iron Railings and Gates—Messrs. Hawkins & Baxter 1,260 0 0 Iron Stoves—Messrs. Ashton & Green 169 15 9 Ranges and Mantels— „ 593 18 5 18  £ s. d. Coppers—Messrs. Yates, Heywood & Co. 393 0 0 Wall Tilings and Pavings—The Art Pavements and Decorations Company 1,125 0 0 Wall Partitions—Mr. J. Bickley 977 8 11 Venetian Blinds—Messrs. F. G. Messent & Co. 298 0 0 Heating—Messrs. Z. D. Berry & Co. 347 0 0 £53,756 13 6 The cost per room of the buildings on the above oontracts is £92— the original estimate of the Housing Committee being £90 per room. Mr. Charles Wall, the general contractor for the building, undertook to complete the work in 14 months from the date of sealing of the contract. On the contract for the foundations a saving of £473 2s. 8d. has been effected, the whole amount paid to Messrs. Foster & Dicksee, the contractors, being £3,445 17s. 9d., instead of £3,919. This saving was rendered possible by the fine gravel covering a portion of the site, it being possible to reduce the thickness of the concrete foundations where the gravel was of good quality and depth. No loan has as yet been negotiated to pay for the erection of the Dwellings, but this matter is now receiving the attention of the Council. A question of ancient lights has been raised by the freeholder of the land at the rear of Danvers-street, adjoining the eastern boundary of the site in respect of Stanley Cottage, at the rear of No. 35, Danversstreet, and also by the occupying tenant and leaseholders of the above house, it being alleged that the erection of the middle block of the Council's dwellings will interfere with the air and light of a staircase window in the western wall of Stanley Cottage. This matter is also now receiving the attention of the Council. Considerable progress was made in 1903 with the ereotion of the new blocks of dwellings on the site. HOUSES DEMOLISHED OR VACATED FOR DEMOLITION DURING THE YEAR 1903. Houses. Royal Hospital-road 24 Sloane-street 4 Brompton-road 5 Sydney-street 14 King's-road 8 Basil-street 1 56 Taking the average number of persons per house as 8, 448 persons have been displaced during the year 1903 owing to the demolitions. 19 Section IV. REPORTS PRESENTED TO THE BOROUGH COUNCIL BY THE PUBLIC HEALTH COMMITTEE. 11th February. Nos. 14 and 15, Wellington-square. 25th March. Bye-laws for houses let in lodgings, and extracts from minutes of the Vestry of Chelsea, and of its Public Health Committee. The drainage of the Town Hall, and the ventilation of the Council Chamber. 6th May. Onslow Dwellings. The ventilation and heating of the Council Chamber. Payments to the Publio Vaccinator for re-vaccinations. 20th May. Removal of offensive trade and other refuse. 10th June. The voluntary notification of phthisis. Infected army blankets. Duke of York's Royal Military Sohool. 24th June. Underground bakehouses. 16th December. Underground bakehouses. 20 Section V. THE SANITARY CONDITION OF THE BOROUGH. The tabular statements prepared by the Sanitary Inspectors show that 1,126 separate premises were reported on by them during 1903, 476 of this number being with reference to cases of infeotious disease (notifiable). In addition, 560 separate houses have been inspected in the course of house-to-house inspections made in certain of the poorer streets in the Borough. It has been necessary to take legal proceedings for breaches of the Public Health (London) Act in only 3 cases in 1903. Drainage.—During the year 127 new drains for single houses have been reconstructed in accordance with the Council's drainage regulations. Combined Drainage.—Five systems of combined drainage, for which the owners of the houses were responsible, were sanctioned by the Council in the course of 1903. In addition, one system of combined drainage, which was a sewer for which the Borough Council was responsible, was executed at the cost of the latter body, as follows:— 1903. £ s. d. November .. Nos. 89 and 91, Arthur-street.. 15 0 0 The total amount previously expended on similar works (1896-1902) was £440 5s. 2d. Inspection of Restaurant Kitchens, 1903. Number of restaurant and hotel kitchens 49 „ inspections made 80 „ premises found satisfactory 34 „ premises with sanitary defects 15 „ notices served 20 UNDERGROUND BAKEHOUSES. During the past year the works required in 32 underground bakehouses, in order that certificates of suitability in accordance with Section 101, Sub-section 4, of the Factory and Workshop Act, 1901, might be obtained, were completed. In one case the works required had not been completed at the end of the year; and in six cases the underground bakehouses were disused at the end of the year. In one case the occupier continued the use of her underground bakehouse 21 sequent to the 1st January, 1904, but she has been warned hy the Public Health Committee that the use of the bakehouse must be discontinued, as it is not possible to grant a certificate of suitability. The form of the certificate is as follows:— Metropolitan Bobough of Chelsea. Factory and Workshop Act, 1901. This is to certify that the Mayor, Alddermen and Councillors of the Metropolitan Borough of Chelsea acting as the Council of the said Metropolitan Borough under and pursuant to the provisions of the Factory and Workshop Act, 1901, Sections 101 and 153 (4) are satisfied that the Underground Bakehouse on the premises of No. in the Metropolitan Borough of Chelsea is, at the present time, suitable as regards construction, light, ventilation, and in all other respects, for use as an Underground Bakehouse. Note.—The Borough Council reserves to itself the right to withdraw this Certificate on satisfactory proof that the conditions of the aforesaid Underground Bakehouse, as regards construction, light, ventilation, and in all other respects have been subject to alteration, not approved by the said Council, since the date of granting of this certificate, or are not being maintained as at the aforesaid date. By order, Town Clerk. Date. Town Hall, King's-road, Chelsea. PROCEEDINGS DURING 1903. PREMISES. NUMBER OF PLACES. Number of inspections, 1903. Number of Notices, 1903. Number of prosecutions, 1903. On register at end of 1902. Added in 1903. Removed in 1908. On register at end of 1903 Milk premises 113 10 — 123 246 Cowsheds 4 — — 4 16 Slaughter-houses Other offensive trade 8 — — 8 30 premises — — — — — Ice cream premises — 60 — 60 120 Registered houses let in lodgings 602 — — 602 257 (a)* (a)* (b)* (b)* • (a) For overcrowding. • (b) For other conditions. Overcrowding, 1903— Number of dwelling rooms overcrowded 19 Number remedied 19 Number of notices issued 19 Number of prosecutions — Underground rooms— Number closed during year 7 22 Insanitary houses— Number closed under the Public Health (London) Act, 1891 — Shelters provided under sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 29 Customs and Inland Revenue Acts— Number of houses for which applications were received during year 5 Number of dwellings comprised therein 103 Number of certificates granted 1 Number of prosecutions under By-laws under Public Health, Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. — (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc. — (c) For the prevention of keeping of animals in such a manner as to be injurious to health — (d) As to paving of yards, etc., of dwelling houses — (e) In connection with the removal of offensive matter, etc. 1 (/) As to cesspools and privies, removal and disposal of refuse, etc. — (g) For securing the cleanliness of tanks, cisterns, etc. — (h) With respect to water closets, earth closets, etc. — (i) With respect to sufficienoy of water supply to water closets — (?) With respect to drainage, etc. (Metropolis Management Act, Section 202 (k) With respect to deposit of plans as to drainage, etc. Metropolis Management Act, Section 202) — Mortuaries— Total number of bodies removed 107 Total number of infectious bodies removed — 23 Form for Tabulation of Report required by s. 131 of the Factory and Workshop Act, 1901. INSPECTION OF FACTORIES, WORKSHOPS, AND WORKPLACES. CLASS OF WORKS NUMBER OF PLACES.‡ Numb'r of Inspections, 1903. Numb'r of Notices, 1903. Numb'r of Prosecutions, 1903. On Regist'r at end of 1902. Added in 1903. Removed in 1903. On Register at end of 1903. Premi's Rooms. Factories Factory Laundries — — — — — — — — Factory Bakehouses — 1 — 1 2 2 — — Other Factories 6 — — 6 11 13 5 — Workshops* Workshop Laundri's 19 3 — 22 42 34 — — Workshop Bakeh'ses 47 — 3 44 88 115 6 — Other Workshops 343 130 16 457 540 827 26 — Workplaces Outworkers' Premi's — — — 32 32 64 — — Places where Food is prepared for Salet — 50 — 50 50 100 — — Workplaces other than the above . — 17 — 17 25 50 — — Total 415 201 19 629 790 1205 37 — * In a separate Table the more important classes of workshop industry should be distinguished, each in a separate line. ‡ A Register is required bv s. 131 in the case of "Workshops only. + Under this head should be included the Kitchens of Hotels, Restaurants, Eating Houses of all sorts, Tripe, Fried Fish and Eel Shops, and other places where food is prepared. N.B.—It is not necessary, for the purposes of this return, to distinguish between Domestic Factories, Domestic or Tenement Workshops and other Workshops with which, therefore they should be included. 24 MATTERS DEALT WITH. PARTICULARS. NUMBER OF DEFECTS. Notices Issued. Prosecutions. Fotind. Notified by Home Office. Remedied. Notified to Home Office. Matters under the Public Health (London) Act, 1891. Want of Cleanliness 20 — 20 — 20 — Want of Ventilation 1 — 1 — 1 — Want of Air Space: Overcrowding 4 — 4 — 4 — Sanitary Accommodation (s. 38). Insufficient 1 1 — 1 — Unsuitable — — — — — — Not Separate for Sexes — — — — — — Want of Drainage of Floors 3 — 3 — 3 — Other Nuisances 8 — 8 — 8 — Contravention of Factory and Workshop Act, 1901. Occupying Underground Bakehouse without Certificate — — — — — — Breach of Special Sanitary Requirements for Bakehouses (ss. 97 to 100) — — — — — Failure as regards Lists of Outworkers (s. 107) — — — — — Giving out work Unwholes'me to be done in 1 (s. 108) premises which Infected 1 — 1 — 1 — are (s. 110) — — — — — — Allowing Wearing Apparel to be made in Premises infected by Scarlet Fever or Small Pox (s. 109) — — — — — Other Contraventions — — — — — — Total 38 — 38 — 38 — Cases Reported to H.M. Inspector. Abstract not affixed 22 As to action taken in cases notified by H.M. Inspector 4 Other cases — Number of Underground Bakehouses in use at the end of 1903 34 Certificates granted (S. 101) 32 Number of Workshop rooms measured 56 25 LIST OF OUTWORKERS (S. 107). CLASS OF HOMEWORK. 1903. NUMBER OF LISTS RECEIVED. NUMBER OF ADDRESSES OF OUTWORKERS. Up to Feb. 1st. Up to Aug. 1st. Forwarded to Other Authorities. Received from Other Authorities. No. of Lists. No.of Outworkers. No. of Lists. No.of Outworkers. Wearing Apparel* Dressmaking 9 76 7 95 148 26 Tailoring 10 56 4 31 306 — Bootmaking 2 60 1 59 — — Lace — — — — — — Cabinet making — — — — — — Fur pulling — — — — — — Other — — — — — — Total 21 192 12 185 454 26 * The more important branches of homework wearing apparel should be distinguished, each in a separate line; e.g. dressmaking, tailoring. Number of Notices prohibiting homework in unwholesome premises (S. 108) — Number of Orders prohibiting homework in infected premises (S. 110) 1 Early in the past year Mr. J. W. King, one of the Council's Sanitary Inspectors, tendered his resignation, he having been appointed Sanitary Inspector for the Reigate Rural District. The vacancy was filled by the appointment of Miss M. W. Richardson as a Woman Sanitary Inspector, with the approval of the Local Government Board. Miss Richardson's duties include the inspection of Workshops where female labour is employed, which constitute the majority of the Workshops in the Borough, the house-to-house inspection of the poorer districts, and the making of special investigations in cases of phthisis voluntarily notified by medical practitioners, in cases of infantile mortality, and in measles cases reported from the Schools. Water Supply.—During the year a daily examination of the water drawn from the Chelsea Waterworks' Main has been made at the Town Hall, as regards its temperature and appearance in a 2-ft. tube. The highest temperature attained during the year was 68° F. on the 4th and 11th July. This is one degree lower than the highest temperature in 1902. The lowest temperature reached was 39° on 4 days towards the end of January. The water was slightly cloudy on several occasions in May and onoe in July. In July the water was clear, but had a grass 26 green tint, due to the floods in the Thames Valley when cut grass was lying in the fields. This coloration was noticeable for more than a fortnight. The same coloration, only not so marked, was apparent at the end of July for a week. Towards the end of October and for the first fortnight in Novomber the water had a browny yellow coloration due to the floods following the heavy rainfall in October. Disinfection.—During the year 310 premises have been disinfected after cases of infectious disease, 46 of these being rooms which had been in occupation by persons suffering from phthisis, the disease ending fatally. As many as 7,354 articles were disinfected at the Disinfecting Station, as compared with 3,247 in 1902, the excess being largely due to articles received from the Duke of York's School during and after the scarlet fever outbreak there. WORK OF THE PUBLIC HEALTH DEPARTMENT. Appended are tabular statements which give information as to the work of the department during the year 1903. I am, Mr. Mayor and Gentlemen, Yonr obedient Servant, LOUIS C. PARKES, Medical Officer of Health. 27 Section VI. PUBLIC HEALTH DEPARTMENT. Summary of Nuisances and other matters reported on and Work done during the year 1903. Borough. Houses and Premises :— Reported on respecting nuisances complained of 650 Reported on with reference to infectious eases 476 Cleansed, whitewashed, and repaired 205 Defective roofs repaired 110 Disinfected after zymotic diseases 310 Cases of overcrowding abated 19 Dust-bins, new, provided 115 ,, repaired 6 Underground rooms occupied contrary to Act 7 Inspections of restaurant kitchens 80 Drainage :— Drains opened, cleansed, and made sound 473 ,, trapped with stoneware gullies Water-closets cleansed and repaired 51 ,, new pans and traps provided 261 Spout drains cleansed, repaired, or renewed 105 Sink, bath, and lavatory waste pipes provided and repaired 186 Drains and soil pipes ventilated or repaired 27 Soil pipes, new, provided 110 New drains laid, in accordance with Council s regulations (including 5 systems of combined drainage) 132 Additional w.c. accommodation provided 14 Watek Supply :— For domestic purposes,'provided where cut off by Water Company 10 For water-closets, or check cisterns provided and repaired 112 Main cisterns cleansed or repaired 24 „ new, provided 1 Nuisances abated arising from :— Keeping of animals 12 Accumulations of manure and other filth 124 Yards, areas, and wash-houses paved or drained 242 Smoke 2 Dung-pits repaired, drained, &c., or cages, &c., provided 2 *This does not include re-visits to premises to ascertain works in progress, or premises visited where no nuisances are found to exist, which, if added, would at least be treble the number of visits made. 28 Borough. Miscellaneous:— Dead bodies removed to public mortuary for sanitary reasons 7 Goods disinfected after infectious cases at station 7354 Goods destroyed after infectious cases 137 Number of samples taken for analysis (Food and Drugs Act) 181 Unsound Food. Number of boxes of fruit, fish, birds, &c., condemned and destroyed 143† Library books destroyed at Librarian's request 37 Proceedings Taken :— Statutory notices issued 222 Intimations issued for sanitary works, &c., including infectious disease cases 767 Legal proceedings in respect of defective sanitary arrangements, nuisances, &c. 3 Legal proceedings in respect of food adulteration 2 Correspondence:— Number of letters written in connection with sanitary matters 863* Daily returns of infectious cases sent to Metropolitan Asylums Board 126 Notification of infectious cases sent to School Authorities 243 Entries in Inspectors' Report Books 650 „ Inhabitants' Complaint Book 67 Certificates of Disinfection given 218 Certificates of infectious diseases for removal cases 148 Notices sent to Public Library of premises wherein infectious disease has occurred 251 The cow-houses and slaughter houses were inspected by the Medical Officer of Health prior to licenses being renewed in October last, and a list of the retail bakehouses under inspection in Chelsea forms a separate Appendix. There are 123 Dairies and Milkshops, and 60 Ice Cream vendors in the Borough. These have been registered and periodically inspected by the Sanitary Inspectors. All places where fish and potatoes are cooked have been -periodically inspected. Sanitary Inspectors. ALEXANDER GRANT (Chief). G. R. METZLER. W. THORPE. M. RICHARDSON. †This does not include unsound food condemned in the streets and destroyed, for which no condemn note was given. *The department is now connected with the telephone, and consequently the work in connection with Infectious Diseases is done more expeditiously, and considerable time is also saved by its use in other matters. MAGISTERIAL PROCEEDINGS DURING 1903, UNDER THE SALE OF FOOD AND DRUGS ACT. Streets where Purchased. Article Purchased. Extent of Adulteration or Abstraction. Date of Hearing. Result. Keppel-street Milk 6% of added water May 12th Withdrawn, warranty proved. Marlborough-road Butter 86.4% of foreign fat June 6th Fine £1, and 10s. 6d. costs. Total, £1 fine, and 10s. 6d. costs. MAGISTERIAL PROCEEDINGS UNDER THE PUBLIC HEALTH (LONDON) ACT, 1901. Situation of Premises. Nature of Nuisance or Complaint. Date of Hearing. Result. 9, Sloane-street Non-removal of offal and offensive matter Jan. 13th Fine £1, and £1 1s. costs. 9, ,, Unsound food (80 birds) Jan. 19th Fine £10, and £2 2s. costs. Lots-road An emission of black smoke Mar. 24th Withdrawn, on an undertaking to use smokeless steam coal. Total, £11 fines, and £3 3s. costs. 29 30 BAKESHOUSES IN USE ON JANUARY 1st, 1904. Street. Occupier. Above Ground. Below Ground. 74, Arthur-street Solomon Keppler ...... Below. 93, Beaufort-street A. Coventry ...... 11 26, Blantyre-street Hetzler ...... 11 55, Buraaby-street Loe ,, 1, Cadogan-street Spells ...... ,, 2, Cale-street H. Judkins Above. 77, Cheyne-walk D. Mayo ...... Below. 20, Church-street E. Bauer ...... 11 60, College-street Samuel Mills Vines ...... 11 17, Coulson-street Gerres ...... 11 3, Dartrey-terrace H. Kimpel ...... 11 67, Flood-street J. Venner ...... 11 95, ,, C. Gass ...... 11 153, Fulham-road C. M. Nash 11 187, ,, E. Pinnock ...... 11 323, ,, N. Martin ...... 11 53, Godfrey-street H. Becker ...... f) 102, Keppel-street S. Stevens ...... 11 47, King's-road Pennycuick ...... 11 145, ,, J. Humphry & Son Above. ...... 88, ,, G. Nash ...... Below. 134, ,, Buckea ...... ,, 31 Street. Occupier. Above Ground. Below Ground. 351, King's-road H. J. Mardon ...... Below. 399, „ H. Kohler ...... ,, 414, ,, J. Brewer ...... ,, 502, „ W. Schafer ...... ,, 517, ,, S. McKay ...... ,, 1, Leader-street H. Southey Above. ...... 48, Lots-road M. & C. West ...... Below. 83, Lower Sloane-street Miles Above. ...... 43, Manor-street L. Lorenz ...... Below. 62, Marlborough-road Kremers ...... ,, 100, ,, Eeitze ...... ,, 110, ,, Wordley Above. ...... 7, Pavilion-road Mason Above. ...... 3, Pont-street Hue & Co ...... Below. 14, Riley-street W. E. Knee ...... ,, 150, Sloane-street Peunycuick ...... ,, 6, Symon8-street Spiking & Co ...... ,, 43, Stayton-street H. Grassman Above. ...... 25, Walton-street Burrows ...... Below. 32 SLAUGHTER-HOUSES. Occupier. Occupier. Crooked Usage Cridlan, P. and J. W. 169, Fulham-road Philp, J. 341, „ Vaughan, T. 52, King's-road Cobb, G. A. 54, „ ,, 413, „ Chacksfield, E. C. 82, Marlborough-road Iggulden, F. 90, „ ,, COW-HOUSES. 54, Arthur-street Jennings, J. Church-street Emerton, J. 406, King's-road Jorden, G. 3a, Leverett-street Robinson, F.