LON 35 Corporation of London. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1902; BY Wm. COLLINGRIDGE, M.A., M.D., D.P.H., LL.M., medical officer of health for the city of london, late medical officer of health for the port of london, fellow of the sanitary institute, fellow of the incorporated society of medical officers of health. PER MUS. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON For the Year 1902, BY Wm. COLLINGRIDGE, M.A., M.D., D.P.H., LL.M., medical officer of health for the city of london, late medical officer of health for the port of london, fellow of the sanitary institute, fellow of the incorporated society of medical officers of health. LONDON: Printed by Charles Skipper & East, 49, Great Tower Street, E.C. 1903. CONTENTS. page. Annual Rateable Value 10 Anthrax 30 Area 10 Artizans' Dwellings, Houndsditch 43 „ „ Vital Statistics 44 Births 12 Census Returns 11 Chemical Analysis of City Milk 131 „ „ „ „ —Public Analyst's Report on Samples taken at Railway Stations in City 132 City of London (Various Powers) Act, 1900—Bye-Laws for W.C's, Ash-Pits and Receptacles for Dung 106 „ „ „ —Crematorium 106 „ „ ., —Regulations for Cremation 107 Cleansing of Persons Act, 1897 32 Common Lodging Houses 55 „ „ „ —Regulations for 57 „ „ „ —Return for those within the City 61 Dairies and Milk Shops 109 „ „ —Amended Regulations for Ill „ „ —List of Breaches of Regulations 112 Danger from Powdered Mica 53 Death Registration and Nomenclature of Disease 23 Deaths in City Institutions 19 „ from Violence 20 Density 10 Diseased Meat Prosecutions 166 Disinfection 46 Disinfectants 46 Escape of Steam from Sewers 53 Factory and Workshop Act, 1901 61 „ „ „ —Duties of the Corporation 02 Factory and Workshops—Defects reported by Home Office 87 „ „ —Outworkers Employed in City 89 „ „ —Domestic Workshops in City 90 „ „ —Legal Proceedings 90 „ „ —Summary of the Work for the Year 91 „ „ —Woman Sanitary Inspector 91 „ „ Summary of Work 91 „ „ Ventilation and Heating of Workshops 92 „ „ Sanitary Accommodation in Workplaces 93 „ „ „ ,, Offices 95 „ „ Wobkplaces—Kitchens of Restaurants, &c. 90 Fish Supplies 167 „ Seizubes 168 House Refuse Removal 51 „ „ „ —City of London (Public Health) Act, 1902 51 „ „ „ —Nuisance from Dust Bins, &c. 52 Ice Creams 112 „ „ —Provisions of London County Council (General Powers) Act, 1902 113 „ „ —Poisoning 116 ,. „ —Bacterioscopic Analysis 126 „ „ —Regulations for Manufacture of 127 Inquests 40 Kitchens of Restaurants 85 Limewhiting of Courts 98 Meat Inspection and Condemned Meat 163 „ Supplies, Notes on 158 Meteorology and Death Rates 26 Mortality 18 Pack. Mortuary Returns 46 Notification op Infectious Disease 26 Offensive Trade 53 Population 11 Preliminary Remarks 9 Professor Klein's Reports on Leigh-on-Sea Cockles 148 „ „ „ Oysters156 Prosecutions for Neglect of Sanitary Works 50 Removal of Human Remains 102 „ „ —Allhallows', London Wall 102 „ ,, —St. Ethelburga, Bishopsgate 103 „ ,, —Christ's Hospital 103 „ „ „ —St. George's, Botolph Lane, Eastcheap 103 „ „ —Newgate Gaol 104 ,, „ ,, —Notes on Intramural Burial in Prisons 105 Removal of Infected Articles to the City from an outside District 32 Report of Cremation Committee 107 Report on Re-Vaccination 13 Sale of Food and Drugs Acts—Notes on Articles Examined 169 „ „ „ „ —Circular Letter from Home Secretary to Clerks of Justices 170 „ „ „ „ —Prosecutions 174 „ „ „ „ —Milk—Regulations of the Board of Agriculture 177 „ „ „ „ —Butter—Report of Butter Regulations Committee 179 „ „ „ „ ,, -Regulations of the Board of Agriculture 180 „ „ „ „ —Amendment Bill 183 Sanitary Staff 6 Sanitary Inspections 48 Scarlet Fever—Closure of St. Bride's Infant School 33 Shellfish and Enteric Fever 134 Shelter fob Temporary Accommodation 28 Skips 99 Slaughterhouses—Aldgate 162 Small-pox 29 Smoke Nuisances 99 „ „ —List of Premises Watched 100 „ „ —Prosecutions 101 Summer Flushing of Courts, &c. 96 Tenement Houses 53 Tuberculosis in Meat 167 Tuberculosis in Milk 128 „ „ —Professor Klein's Report 130 Tuberculosis and Spitting 34 Underground Bakehouses 80 Unsound Fruit, Vegetables, Tinned Food, &c. 107 Vaccination 13 Vital Statistics 20 APPENDICES. Appendix a—Street Lists of Mortality. „ B— „ „ Infectious Disease. „ C—Tenement Houses. „ D-List of Persons Registered under the Dairies, Cowsheds and Milk Shops Orders. „ e—New List of Causes of Death as used in the Annual Reports of the Registrar-General of England and Wales. Spot Map of the City showing Infectious Diseases. SANITARY STAFF, 19 0 2. MEDICAL OFFICER OF HEALTH. Date of Appointment. Collingridge, Wm., M.A., M.D. April, 1901 CLERICAL STAFF. Turner, Howard Blake, F.I.C. (Sanitary Clerk) June, 1877 Lowe, George Nov., 1902 King, Guy H. July, 1901 SANITARY INSPECTORS. Hills, Arthur Reginald 1st Class, April, 1888 Gathercole, Wm. Henry Joseph „ „May, 1891 May, William Hussey „ „ May, 1891 Simmons, Edward John ,, „ June, 1892 Robbins, Francis Joseph „ ,, Sept., 1892 Ralph, William Holden „ „ July, 1898 Dunworth, James 2nd Class, Jan., 1902 Wheaton, Arthur „ „ Oct., 1902 Benson, John Assistant, May, 1890 WOMAN SANITARY INSPECTOR. Safford, Ada J. Feb., 1902 INSPECTORS OF SLAUGHTERHOUSES AND MEAT. Terrett, George Patrick (Chief Inspector) May, 1881 Leeson, John Dec., 1890 Sharp, Owen May, 1892 Jenkins, Harry April, 1896 Down, William Edward July, 1896 Eglin, William July, 1896 Kelland, William C May, 1899 MATRON IN CHARGE OF THE SHELTER, GOLDEN LANE. Mrs. A. R. Hills Dec., 1900 KEEPER OF THE MORTUARY AND ENGINEER IN CHARGE. McDonnell, John (died 27th Nov., 1902) Feb., 1896 LABOURERS. Lee, Robert (General Duties) Oct., 1894 Skinner, Henry (Meat Shed) June, 1901 REPORT OF MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON, 1902. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1902. To the Right Honourable the Lord Mayor, Aldermen and Commons of the Corporation of London. Public Health Department, Guildhall, E.C., April, 1903. Gentlemen, In presenting my third Annual Report as Medical Officer oF Health for the City of London, it may be advantageous to briefly summarise the more important changes made during the year under review for perfecting the work of the Sanitary Department. Factory and Workshop Act, 1901. The statutory requirements of the recent Factory and Workshop Act have, as anticipated, thrown great strain upon the Department, and necessitated the appointment of additional officers. Full particulars of the special work done in connection with the sanitary conditions of bakehouses, kitchens, and restaurants, which are workplaces within the meaning of the Act, will be found in the body of this Report. Woman Sanitary Inspector. An important new departure was the appointment of a Woman Sanitary Inspector, whose duties are chiefly confined to the supervision of the sanitary accommodation provided in places where women are employed, both in workplaces, private offices, and other business premises. This step has. proved a success, and has tended to much improve the conditions under which a large number of women are engaged in earning a living in the City. Bacteriologist. The appointment of an official Bacteriologist has more than justified the recommendation of your Medical Officer. In the course of the year Dr. Klein, Bacteriologist, has conducted several important investigations at the instance of the Corporation. These inquiries embraced the subjects of Tuberculosis and Milk Supply, Anthrax, Ice Cream Poisoning, and the Pollution by Sewage of Shellfish. Artizans' Dwellings, Stoney Lane. Measures have been taken for reconstructing the sanitary accommodation provided for the tenants at the Artizans' Dwellings, Stoney Lane, in addition to which properly arranged bath rooms are now in course of erection. 10 Post-mortem Room. The alterations to the Post-mortem Room at Golden Lane were completed early in the year. This place, which had been established for a quarter of a century, had become obsolete and unfitted for present requirements. It is now furnished with every modern convenience, and is one of the best equipped places of the kind in the metropolis. Disinfectants. Some important changes have been made in the arrangements for disinfecting the public roadways. These have effected large economies both in time and money, while the work has been more efficiently performed. Intramural burial in gaols. In the course of the year a considerable number of bodies have been exhumed in various parts of the City and re-interred elsewhere, and in this connection I would particularly direct attention to the question of intramural burial in gaols dealt with on page 104. Ice Creams. Statutory provisions for regulating the manufacture and sale of Ice Creams came into operation on the 1st November last, and are now strictly enforced throughout the City. Dairies and Milk Shops. In June last the administration of the several Dairies, Cowsheds and Milk Shops Orders was transferred from the County Purposes Committee to my Department, since which date the number of persons registered as purveyors of milk in the City has been considerably increased. New Regulations for dealing with these places in the City, in conformity with modern requirements, have been drafted, and are now under consideration. AREA. The City of London Registration District comprises an area of 678.3 acres (excluding tidal water and foreshore), or 1.06 square miles, equal to a square of 1.0295 miles to a side. The area of "Registration London'' is 74,839 acres (excluding tidal water and foreshore), or 116.9 square miles, equal to a square of 10.81 miles to a side. DENSITY (1902). City of London, Registration District, at night 39.1 persons to an acre. „ „ „ „ during the day 530.6 „ „ „ Registration London, at night 60.6 „ „ „ „ during the day not known. No Imperial Day Census has yet been taken. ANNUAL RATEABLE VALUE. The assessed rateable annual value of property within the administrative county of London was £40,209,391 in 1902—whilst the corresponding rateable value of property in the City of London, including Temples, was £4,888,378 in 1902, or nearly one-eighth of the whole County. 11 POPULATION. The undermentioned figures are abstracted from the Registrar-General's Report, dated 30th December, 1901, on the Census of England and Wales, 1901 (County of London). The "City of London" may mean either of the following: Parliamentary Borough. Municipal City. Registration District. TABLE A. Area. Statute Acres. Inhabited Houses. Population. 1891. 1901. 1891. 1901. Parliamentary Borough or Municipal City. 672.7 5,340 3,865 37,702 26,923 Registration District 678.3 5,408 3,934 38,481 27,664 For Parliamentary, Municipal, Police, and School Board purposes the boundaries of the City are co-terminous. These figures represent the population on the night of the 1st April, 1891 and 1901. A Day Census—the number of persons actively engaged in the City during the daytime—has been taken on three occasions, viz., in 1866, 1881, and 1891. It is a matter for regret that no Day enumeration was made in the City dUring the last Imperial Census year. TABLE B. CENSUS RETURNS. year. Imperial Census. Night Population. City Census. Day Population. 1861 112,063 - 1866 - 170,133 1871 75,983 - 1881 51,405 261,061 1891 37,705 301,384 1901 27,664 ______ - 12 For statistical purposes, in the following pages the "Registration" District is referred to when speaking of the "City." This consists of 114 "civil parishes," divided into three sub-districts, as under, viz.:— *St. Botolph including 17 parishes. Allhallows Barking „ 85 „ †St. Sepulchre „ 12 „ The populations of the above at the middle of 1902, calculated on the last Census Returns, were:— St. Botolph 10,461 Allhallows Barking 8,525 St. Sepulchre 7,560 Total. 26,546 The Night population, therefore, of the City of London Registration District at the middle of 1902, is taken at 26,546, and it is upon this figure that all vital statistics in this Report have been calculated. The Day population at the middle of 1902 was estimated at 359,940. A Day Census taken in May, 1891, proved that 1,186,000 persons and 92,000 vehicles entered and left the City on the day the counting was made. BIRTHS. During the year 1902, 339 births were registered in the City. The annual birth rate was at the rate of 12.7 per 1,000 persons of all ages, compared with a quinquennial mean rate of 15.1 per 1,000. The birth rates last year in the Sub-Districts were— St. Botolph 16.6 per 1,000 Allhallows 7.7 „ St. Sepulchre 13.1 „ In the Metropolis the birth rate in ‡1901 was 29.0 per 1,000, being the lowest hitherto recorded therein, the revised rate for 1900 having been 29.2. This decline in the birth rate has been in operation since 1871 or 1872, and is common to nearly all European countries. * At the date of the last Census, this District included the "civil parish" of Glasshouse Yard. The parish was transferred to the Holborn Union by the Local Government Board Order, No 43156, which came into operation on 29th September, 1901, and to the Registration District of Holborn (Finsbury Sub-District) on 1st January, 1902, making the Registration District of London City co-extensive with the Municipal City of London. All the Registration Districts in London are co-extensive with the Poor Law Parishes or Unions except the District of Fulham. † On the 1st April, 1901, the Middle Temple was transferred from the Strand Sub-District to St. Sepulchre Sub-District. ‡ The figures for the Metropolis for 1902 are not yet published. 13 VACCINATION. Of the children born in 1902, 214 had been successfully vaccinated by the end of the year, and 28 had died before the age for vaccination. Vaccination was postponed by medical certificate in 17 cases, 1 infant was reported to be insusceptible to vaccination, 26 had removed into other districts, 50 vaccinations were pending at the end of the year, and there were 2 cases of conscientious objection. Vaccination Statistics in the City of London. Year. Number of Births. Successfully Vaccinated. Insusceptible. Had Small pox. Died before Vaccination. Vaccination Postponed. Removed or unaccounted for at the end of the year. Conscientious Objections. per cent. per cent. per cent. per cent. per cent. per cent. per cent. 1897 491 59.3 .20 Nil. 6.9 5.5 28.10 - 1898 468 45.3 Nil. ji 8.1 5.4 34.20 7.0 1899 430 62.8 .46 9.5 5.3 19.52 2.3 1900 403 60.5 .99 12.6 4.4 19.30 1.9 1901 381 67.7 .52 > 12.8 4.2 12.00 2.6 Average previous 5 years 435 59.1 .43 Nil. 10.0 4.9 22.62 3.4* 1902 338 63.3 .29 Nil. 8.3 5. 7.7 0.6 * Average for four years. The decline in the proportion of conscientious objectors during a year when Small-pox was epidemic, is some indication of the little faith the average anti-vaccinationist attaches to his own teachings when face to face with the disease. VACCINATION AND RE-VACCINATION. The following is a copy of a Report on this subject presented to the Sanitary Committee by your Medical Officer on the 28th January, 1902. At your last Meeting it was referred to me to report upon the following Resolution passed by the Board of Guardians for the Parish of Paddington:— "That it is expedient that all powers and duties belonging to the "Guardians in connection with Vaccination be transferred to the Public "Health Department of the Borough Councils, so that all questions "relating to public health can be dealt with by one Authority." 14 The whole question of vaccination and re-vaccination is one of prevention of disease, and as such should clearly be in the hands of the Public Health Department. The prevention of disease in no way concerns the Poor Law Administration, and its association therewith is not calculated to increase its importance or popularity in the public mind. This was shown in the early days of the Metropolitan Asylums Board, when it was found that the association with Poor Law was a hindrance to many persons, and Parliamentary enactment was found necessary to deal with the question. Inasmuch as the spread of Small-pox is a matter for the Public Health Department, and the prevalence of Small-pox is directly dependent upon the amount of protection by vaccination, it seems only reasonable that such Department should be able to control the system upon which they have to rely. By vaccination being placed in the hands of the Guardians, the Public Health Department is deprived of by far the most important factor—one may almost say the only one—in the case of prevention of Small-pox. 30 & 31 Vic., cap. 84, sec. 28. In the 1867 Act there is a Clause enacting that the Guardians may pay all expenses in working this Act, and in or about'inquiries and reports as to the state of Small-pox and Vaccination in their Union or Parish, and in taking measures to prevent the spread of Small-pox. It is noteworthy that practically no Board of Guardians has given any effect to the latter part of this Clause, and it has remained with the Medical Officer of Health to carry out these inquiries, more especially since the Notification Act came into force. When the Vaccination Act was passed, the laws relating to public health were in their infancy, and the 1875 Public Health Act, not to speak of the more extended 1891 Act, was not thought of. It is, however, a fact worth noting that so long ago as 1868 Sir John Simon, then Medical Officer to the Privy Council (the first Medical Officer of Health to the City of London), in referring to the subject, says: "The "authority for public vaccination is now universally the destitution-authority, "which in all common health-areas is identical with the nuisance-authority, "but in all special health-areas is separate from it. Under the system I am "suggesting, public vaccination in the common health-areas would remain "practically unchanged; it would be one of the health-functions of the "double-functioned local authority; but as regards special health-areas, it "would certainly admit of question whether public vaccination ought not "rather to be a function of the consolidated health authority than a function "of the authority for destitution; and I am myself disposed to think that "in those areas the transfer would generally be desirable." 15 In an excellent pamphlet just issued by the British Medical Association, "Facts about Small-pox and Vaccination and the Lesson of a Hundred Years "of Vaccination in Europe," the following passage occurs:— "England did not begin obligatory vaccination till the law of 1853— "Statistics begin in 1838—and it was better enforced by the law of 1871 "(the epidemic years are 1871-2). Both laws were unfortunately left to "the Guardians of the Poor to administer." A Conference of Representatives of the Sanitary Authorities of the Metropolis, convened by the Council of the Metropolitan Borough of Holborn, was held on the 7th February, at the Offices of the Metropolitan Asylums Board, on the Embankment, for the purpose of considering whether the measures at present adopted in dealing with outbreaks of Small-pox can be in any way improved. Mr. B. M. Hensley, Chairman of the Metropolitan Asylums Board, welcomed the delegates. He reminded them of some of the figures contained in the report presented at a recent meeting of the Metropolitan Asylums Board as proving the value of vaccination and re-vaccination, and said it was a regrettable fact that among the patients in the present epidemic there were a number of officials of sanitary authorities who had failed to adopt the precaution of re-vaccination. Professor Smith was elected to the chair, and various resolutions were afterwards proposed. After considerable discussion, the following, submitted on behalf of the Borough of Holborn, were agreed to:—(a) "That in the opinion of the "Conference the powers and duties at present vested in Guardians of the Poor "with regard to vaccination and re-vaccination should be transferred to and "enforced by Borough Councils." (b) "That in the opinion of the "Conference an amendment of the law is necessary to ensure compulsory "vaccination and re-vaccination of all persons (who have not been vaccinated "within five years) in a dwelling-house wherein Small-pox has broken out." (c) "That in the opinion of the Conference it should be declared an offence "under the Public Health (London) Act, 1891, to refuse or withhold "information, or give false information, with respect to persons living in a "house in which Small-pox has broken out, with regard to (a) their names, "(b) employment or occupation, (c) schools attended by their children, or "(d) as to any persons not living in such house but employed therein." (d) "That in the opinion of the Conference the provisions of the Public Health "(London) Act, 1891, with regard to the prevention of infectious diseases, "require amendment by (a) shortening the period of 24 hours, allowed by "Section 60, for the master of a house to decide whether he will undertake "the disinfection or allow the Sanitary Authority to do so, and (b) extending "the provisions of Section 63 to the taking of any house, or part of a house, "by a person suffering from an infectious disease, or who has been exposed "to infection." (e) "That in the opinion of the Conference all disinfections "should be carried out by the Sanitary Authority." 16 It was further resolved, "That in the opinion of the Conference it is advisable "that application be made to the Metropolitan Asylums Board to send out to "every Medical Officer of Health in London daily lists of Small-pox cases "only, with age and addresses of patients, as is done weekly in the case of all "infectious diseases." Upon the consideration of a letter addressed by the Council of the Metropolitan Borough of St. Pancras to the President of the Local Government Board with regard to the steps to be taken to prevent the spread of Small-pox by contact, a resolution was passed to the effect that the Local Government Board be informed that it was desirable to amend the law by providing that when a person inhabits any part of a house in which there have been cases of Small-pox, and knowingly associates with other persons without having his own person and clothes disinfected and cleansed to the satisfaction of the Local Sanitary Authority, he should be liable to a penalty not exceeding 20/. The Public Health Department alone has information as to the existence of disease, and would be in possession of all information as to the protection of the various parts of their District. The Sanitary Authority has a Medical Officer capable of and charged with the duty of directly advising it in all matters relating to vaccination, while under the present system the Boards of Guardians have not. In all recent epidemics the Sanitary Authority has been invested with the duty of combating the spread of the disease, and if such authority had had the control of the vaccination arrangements, its Officers would have been in a far better position to cope with it. Obviously, in the presence of an outbreak, the case becomes much stronger. If the Sanitary Authority had the Public Vaccinator and Vaccination Officer, then, under their control, they would be enabled to arrange for the immediate protection of all persons in the vicinity of any case, and to ascertain when such protection had been provided. In the City the Board of Guardians are anxious to do all that is possible, and the Vaccination Officer is most zealous in his duties, but even now the dual system is productive of much inconvenience and delay. Not only is much valuable time lost in communicating with the Vaccination Officer, who, in his turn, has to communicate with the Public Vaccinator, but there is very great difficulty in obtaining information as to the results of such action. Lists of "Contacts" are received daily by your Medical Officer, and these, with the assistance of a special temporary Inspector, are at once visited, and the advisability of re-vaccination urged upon all who are in the same building. 17 Many large firms are asking for the protection of their employes, and the work is getting into arrear. Considering the vast importance of the question in the City of London, I am of opinion that any application for vaccination or re-vaccination should be dealt with within twenty-four hours of its being made. Vaccination Order, 1898, Article 10(2). The Board of Guardians has power to appoint any number of Assistant Public Vaccinators, and there is at the present time justification for such appointment. I have asked the Board to increase their staff, suggesting that if they were unable to do so, the Corporation would be advised to appoint Vaccinators of its own. Ill this latter case the whole cost would be borne by the Public Health Department. In consequence of my representations the Board has decided to appoint two additional Public Vaccinators, and to open Stations at different points within the City. This to some extent (though only partially) will meet the difficulty experienced in obtaining vaccination or re-vaccination for the large number seeking it. It does not, however, obviate the delay, and therefore danger, in the immediate re-vaccination of all contacts and persons in the vicinity of a case of Small-pox, on account of the loss of time in communicating with the officers. If the Public Vaccinator were an officer of the Public Health Department he would be furnished twice daily, or as occasion required, with a list of those requiring treatment, and would report daily as to his work. While the system would work well in ordinary times, it would seem to be the only one which can be satisfactorily carried out in the case of an outbreak of Small-pox, when time is of such supreme importance. I have therefore to recommend: (i.) That the Board of Guardians be requested to increase temporarily the staff of Public Vaccinators to enable the arrears to be efficiently dealt with, and to appoint a Vaccination Station, where applicants can attend daily, say from 9 till 12, and if the Guardians are unable to make such additions to their staff, that your Medical Officer should be authorised to engage medical practitioners to act in any case of emergency, and to pay for their services at a contract rate ; and (ii.) That your Worshipful Committee do agree with the Resolution of the Paddington Guardians, and do represent to the Court of Common Council the advisability of formally adopting the following Resolutions:— (1.) That it is expedient that all powers and duties belonging to the Guardians in connection with vaccination be transferred to the 18 Public Health Department of Borough Councils, so that all questions relating to Public Health can be dealt with by one Authority. (2.) That a copy of the foregoing Resolution be sent to the Local Government Board, the Metropolitan Boards of Guardians, and the Metropolitan Borough Councils. These recommendations were agreed to by the Sanitary Committee at the February Meeting, and subsequently approved by the Court of Common Council. MORTALITY. During the year under review, 910 deaths were registered in the District, including *610 persons dying in the City, but not belonging thereto. See Table I. for details. Deducting the latter we have to deal with 300 deaths, to which we must add 136 persons who died at City Institutions in outside districts, where they were registered. The mortality, therefore, upon which our death rate is calculated is 436. The death rate for 1902 was 16.4 per 1,000 per annum of the population (the previous year being 16.6), whilst that for the whole of the Metropolis for 1902 was 17.2. These figures are not corrected for sex and age distribution. Death Rates, per 1,000 per Annum. Year. City oE London. 33 Great Towns of England and Wales. Metropolis. 1897 19.3 19.1 18.2 1898 16.3 19.0 18.7 1899 18.5 20.2 19.8 1900 19.4 19.5 18.8 1901 16.6 18.6 17.1 Average previous five years 18.0 19.3 18.5 1902 16.4 17.2 In comparing the above with the Registrar-General's Returns, some discrepancies will be observed, due to the fact that I have not been * Most of these deaths occurred in St. Bartholomew's Hospital. 19 furnished with the number of citizens who died in Institutions other than those with which the City is connected. The deaths from zymotic disease per 1,000 of the population was 0.67 compared with 2.21 in the Metropolis. The deaths of children under one year of age to 1,000 births come out 124, against 139 for the whole of London. Deaths in City Institutions. During 1902, 136 persons died in City Workhouses, Workhouse Infirmaries, or Lunatic Asylums, or no less than 31.2 per cent. of the whole City mortality, the corresponding figure for the Metropolis (1901) being 18.8 per cent. This high percentage is caused in the City by the excessive proportion the number of inmates in these places (exclusive of officers and their families) bears to our population, the ratio being about 1:20, as compared with 1:94 in the Metropolis (Census 1901). In other words, these figures represent that one in every 20 citizens is an inmate of either a Workhouse, Workhouse Infirmary or a Lunatic Asylum, in comparison with 1 in every 94 inhabitants of the Metropolis. Percentage of Deaths occurring in Workhouses, Workhouse Infirmaries and Lunatic Asylums to total Deaths in the City of London and the Metropolis respectively, for 1902, compared with the average for the previous five years:— Year. City of London. Metropolis. Per cent. Per rent. 1897 25.7 16.4 1898 28.8 16.8 1899 29.9 17.8 1900 27.9 18.3 1901 25.2 18.8 Average of previous five years 27.5 17.6 1902 31.2 Figures not yet published. It will be seen that in 1902 31.2 per cent., or 1 in every 3.2, deaths in the City occurred in one of the above-named Institutions, compared with 18.8 per cent., or about 1 in 5.3, in the Metropolis (1901) under analogous circumstances. The above is the highest figure recorded since 1896, and is 6 per cent. above that for 1901, and 3.7 in excess of the average of the previous five years. 20 Deaths from Violence. Of the City deaths, 8.03 per cent. were caused by injuries or violence (as compared with 7.45 in 1901), being 0.52 above the average for the previous jive years. In the City of London, the ratio of deaths from violence to deaths from all causes, which had regularly diminished during the years 1896-7-8-9, has shown a tendency to rise during the past three years (1900-1-2). The large proportion of deaths from violence within the City as compared with the rest of London, though striking, is easily accounted for by the enormous concentration of vehicular traffic in crowded streets, and the greatly increased danger resulting therefrom. It is probably only due to the excellent management of the traffic by the City Police that this mortality is not much larger. PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE. Year. City of London. Metropolis. Per cent. Per cent. 1897 9.07 4.29 1898 7.02 4.19 1899 6.56 4.19 1900 7.44 4.27 1901 7.45 4.28 Average previous five years 7.51 4.24 1902 8.03 Not yet published. VITAL STATISTICS, 1902. City of London compared with, the Metropolis, previous five years. City of London. Birth Rate. Death Rate. Deaths of Children under 1 year to 1,000 Births. Violent Deaths, per cent. of Deaths Registered. Deaths from principal Zymotic Disease per i,000 of the Population. Estimated Night Population (Imperial Census). Estimated Day Popuation(Cor poration Census). City. Metropolis. City. Metropolis. City. Metropolis. City. Metropolis. City. Metropolis. 1897 30,245 329,290 16.2 30.0 19.3 18.2 109 158 9.1 4.3 1.35 2.56 1898 29,121 334,050 16.1 29.5 16.3 18.7 118 167 7.0 4.2 0.62 2.79 1899 28,039 338,850 14.8 29.4 18.5 19.8 135 167 6.6 4.2 1.03 2.48 1900 26,998 343,790 14.9 29.2 19.4 18.8 179 160 7.4 4.3 1.44 2.22 1901 27,411 349,180 13.7 29.0 16.6 17.1 160 148 7.4 4.3 0.51 2.24 Average previous five years. 28,363 339,032 15.1 29.4 18.0 18.5 140 160 7.5 4.3 0.99 2.46 1902 26,546 359,940 12.7 * 16.4 17.2 124 139 8.0 * 0.67 2.21 * Figures not yet published. 21 Table I. (This Table is prepared in accordance with the requisitions of the Local Government Board.) Vital Statistics of Whole District during 1902 and Previous Years. Name of District: CITY OF LONDON. Year. Population estimated to Middle of each Tear. Births. Total Deaths Registered in the District. Total Deaths in public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District. Number. Rate.* Under 1 Year of Age. At all Ages. N umber. Rate.* Number. Rate per 1,000 Births registered. Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1894 34,831 520 14.9 82 157 993 28.5 570 562 169 600 17.2 1895 33,823 552 16.3 81 147 1,057 31.2 629 627 189 619 18.3 1890 31,412 534 17.0 72 133 1,066 33.9 677 672 164 558 17.8 1897 30,245 491 16.2 58 118 1,046 34.6 615 608 146 584 19.3 1898 29,121 468 16.1 55 118 957 32.9 620 615 132 474 16.3 1899 28,039 416 14.8 56 135 1,011 36.0 649 642 149 518 18.5 1900 26,998 403 14.9 72 179 987 36.6 625 609 146 524 19.4 1901 27,411 377 13.7 60 160 974 35.5 644 633 115 456 16.6 Averages for years 1894-1901 29,307 470 16.0 67 143 1,011 34.5 636 618 154 539 17.9 1902 26,546 339 12.7 42 124 910 34.3 643 610 136 436 16.4 * Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Note.—The deaths 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 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 sickness or infirmity, and dying in public institutions there; and by the term "Residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. Area of City of London Registration District in acres (exclusive of area covered by water) 678.3 Total population at all ages 27,664 Number of inhabited houses 3,934 Average number of persons per house 7.03 At Census of 1901. 22 (This Table is prepared in accordance with the requisitions of the Local Government Board.) Causes of, and Ages at, Death during Year 1902. Deaths in or belonging to whole District at subjoined ages. Deaths in or belonging to Localities at all Ages Deaths in Public Institutions in the District. All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards St. Botolph. Allhallows. St. Sepulchre. * 1 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... 2. Measles 10 2 8 ... ... ... ... 3 2 5 ... 1 3. Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... 1 4. Typhus Fever ... ... ... ... ... ... ... ... ... ... ... 2 5. Epidemic Influenza 6 ... ... ... ... 4 2 1 1 3 1 1 6. Whooping Cough 2 2 ... ... ... ... ... 1 ... 1 ... ... 7. Diphtheria, Membranous Croup 3 ... 1 2 ... ... ... 2 ... 1 ... 9 8. Croup ... ... ... ... ... ... ... ... ... ... ... ... 9. Enteric Fever 1 ... ... ... ... 1 ... ... ... 1 ... 9 10. Asiatic Cholera ... ... ... ... ... ... ... ... ... ... ... ... 11. Diarrhœa, Dysentery 2 1 ... ... ... 1 ... 1 ... 1 ... 10 12. Epidemic or Zymotic Enteritis ... ... ... ... ... ... ... ... ... ... ... ... 13. Enteritis 4 1 ... ... ... 2 1 2 ... 2 ... 4 14. Other Continued Fevers 1 ... ... ... ... ... 1 ... 1 ... ... ... 15. Erysipelas 2 ... ... ... ... 1 1 1 1 ... ... 3 16. Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... 5 17. Other Septic Diseases 3 ... ... ... 2 ... 1 ... 1 2 ... 20 18. Intermittent Fever and Malarial Cachexia. ... ... ... ... ... ... ... ... ... ... ... ... 19. Tuberculosis of Meninges 4 ... 3 1 ... ... ... 2 ... 2 ... 21 20. Tuberculosis of Lungs 38 ... 2 ... 6 30 ... 15 8 13 2 20 21. Other Forms of Tuberculosis 4 2 ... 1 ... 1 ... 3 ... 1 ... 19 22. Alcoholism 2 ... ... ... ... 1 1 2 ... ... ... 1 23. Cancer 32 ... 1 ... 1 14 16 14 2 16 ... 79 24. Premature Birth 8 8 ... ... ... ... ... 3 2 3 ... 2 25. Developmental Diseases 10 8 2 ... ... ... ... 7 1 2 ... 8 26. Old Age * 37 ... ... ... ... ... 37 20 5 10 2 1 27. Meningitis 1 ... 1 ... ... ... ... ... ... 1 ... 9 28. Inflammation and Softening of Brain 3 ... ... ... ... 3 ... 1 1 ... 1 1 29. Organic Diseases of Heart 5 ... ... ... 1 2 2 1 2 1 1 10 30. Acute Bronchitis 11 5 ... ... ... 2 4 6 2 3 ... 3 31. Chronic Bronchitis 46 ... ... ... ... 11 35 22 5 19 ... 5 32. Lobar (Croupous) Pneumonia 1 ... ... ... ... 1 ... ... 1 ... ... 3 33. Lobular (Broncho-) Pneumonia 19 4 7 ... ... 3 5 7 5 7 ... 30 34. Diseases of Stomach 5 ... ... ... 1 2 2 1 2 2 ... 12 35. Obstruction of Intestines 3 ... ... ... ... ... 3 2 ... 1 ... 24 36. Cirrhosis of Liver 5 ... ... ... ... 5 ... 1 2 1 1 9 37. Nephritis and Bright's Disease 13 ... ... ... 1 9 3 7 2 2 2 23 38. Tumours and Other Affections of Female Genital Organs. ... ... ... ... ... ... ... ... ... ... ... 5 39. Accidents and Dis. of Parturition ... ... ... ... ... ... ... ... ... ... ... 1 40. Deaths by Accident or Negligence 23 4 ... 1 2 12 4 6 9 8 ... 79 41. Deaths by Suicide 12 ... ... ... 2 10 ... 2 8 2 ... 11 42. Deaths from Ill-defined Causes ... ... ... ... ... ... ... ... ... ... ... 2 43. All other Causes 120 5 3 2 6 55 49 56 27 32 5 200 Total all Causes 436‡ 42 28 7 22 170 167 189 90 142 15 643† * Residents dying in City Institutions. City address not stated on certificate of death. † Including 33 Citizens, distributed in Columns 1 to 11. ‡ Including 136 Citizens who died in City Institutions outside, distributed in the several Registration Districts to which they belong. 23 DEATH REGISTRATION AND NOMENCLATURE OF DISEASE. In September last Dr. J. F. W. Tatham, Superintendent of Statistics of the General Register Office, Somerset House, was good enough to forward me a copy of the circular now appended to each book of forms of medical certificate of cause of death issued by the Registrar-General. It has been drafted with a view to secure uniformity in classifying causes of death, and if generally adopted will be of much assistance to Medical Officers of Health in tabulating the annual returns required by the Local Government Board. The following is a copy of the circular referred to :— suggestions to medical practitioners respecting certificates of causes of death. It is highly desirable that Medical Practitioners should use, in their Certificates of Death, only those terms which are recognised by the Royal College of Physicians of London. The list of diseases now used in the Registrar-General's Reports [a copy of which is printed in Appendix E, page 221] is condensed from the Nomenclature of the Royal College of Physicians, with the addition of certain unofficial terms which are still in common use, but which are objectionable, either as being the names of symptoms merely, or as being otherwise indefinite. In the copy of the list here given, these objectionable terms are printed in italics: and it is hoped that Medical Practitioners will use them only when accurate information is wanting. 1. The cause of death should be stated precisely and briefly; English names for diseases being used in preference to their equivalents in other Languages. Yague terms such as decline, consumption, tabes, cachexia, &c., should be avoided ; and haemorrhage should not be assigned as the cause of Death without indication of its origin and probable cause. Dropsy should never be returned as the cause of Death without particulars as to its probable origin, e.g., in Disease of the Heart, Liver, Kidneys, &c. 2. Small-pox.— In certifying deaths from Small-pox, the patient's condition with respect to vaccination should be carefully stated—say, in one or other of the following forms:— (1.) No evidence of vaccination. (2.) Vaccinated in infancy only—number of scars. (3.) Vaccinated only after infection by Small-pox. (4.) Stated to have been vaccinated but no scars. [If the patient has been re-vaccinated, the date should be given when possible.] 24 3. Measles.— It is desirable that the use of the term "Rubeola" as a synonym for Measles should be discontinued. "Morbilli" is the only Latin equivalent for this disease recognised by the Royal College of Physicians. 4. Puerperal Fever and other Septic Diseases.— The term "Puerperal fever" should no longer be used. Pyæmia, Septicaemia, or Sapræmia occurring in puerperal women should be described as puerperal pyæmia, p. septicaemia or p. sapræmia respectively (Nomen.: R.C.P., p. 11). In the new list of diseases provision exists for the separate entry of several forms of Septic infection. 5. Diarrhcea.— Attention is especially invited to a recent minute of the Royal College of Physicians advocating the use of authorised names for this malady, which is as follows :— "The Royal College of Physicians is convinced, after careful enquiry : (a) that various "unauthorised and misleading terms, such as 'gastro-enteritis,' 'muco-enteritis,' 'gastric "catarrh,'' &c., are now commonly employed to designate the disease officially known as "' epidemic diarrhoea,' whereby its specific character is in danger of being ignored, and groat "confusion ensues ; (b) that the present confusion of terms renders it impossible to determine "accurately either the prevalence of the disease in special places and at special times, the "extent to which it influences the public health, or the effects produced by sanitary measures; "(c) that there is a widespread objection, on the part of medical practitioners, to the "employment of the term 'diarrhœa,' in certifying the cause of death, probably because that "term is generally held by the public to imply a mild disease insufficient by itself to cause "death." "The College, therefore, has sought to discover as an alternative for the authorised term ''(epidemic diarrhœa) some other name, which, whilst equally accurate, should convey to the "public the idea of a more serious affection. But the College regards it as essential that the "idea of specificity, intended to be conveyed by the term ' epidemic' should be retained. "As the result of much deliberation, the College has agreed to authorise the use of the "term 'epidemic enteritis' (or if preferred by the practitioner, 'zymotic enteritis'), as a "synonym for epidemic diarrhœa. The College has further decided to urge upon "practitioners the entire disuse, in medical certificates of death, of such terms as ' gastro"' enteritis,' ' muco-enteritis,' or ' gastric catarrh,' as synonyms of epidemic diarrhoea." 6. Malignant Diseases.— Among Cancerous affections "Carcinoma" is now distinguished from "Sarcoma." This distinction should be observed wherever possible. A separate line is however still retained for those forms of malignant disease the nature of which cannot be specified precisely. 7. Tuberculous Diseases.— "Phthisis."— When this condition is due to tubercle, the term "tuberculous phthisis' or "pulmonary tuberculosis" should be used instead of the ambiguous term phthisis, which is sometimes used to designate other besides tuberculous diseases of the lungs. "Tabes mesenlerica."— The use of this term to describe tuberculous disease of the peritoneum should be discontinued, as it is frequently used to denote various other wasting diseases which are not tuberculous. "Tuberculous peritonitis" is the better term to employ when the condition is due to tubercle. 25 Hydrocephalus.— In certifying deaths thus caused, it would be advantageous if those due to tuberculous affections were distinguished from those due to meningitis or to other affections of the brain. " Congenital hydrocephalus " should always be returned as such. 8. Convulsions.— It is hoped that this indefinite term will henceforth be restricted to those cases in which the true cause of convulsions cannot be ascertained. At present more than eleven per cent. of the total deaths of infants under one year old are referred to "convulsions" simply. 9. Paralysis.— The classification of deaths would be much facilitated if brain paralysis were always distinguished from paraplegia. In certifying deaths from brain paralysis, the terms "hemiplegia" and "apoplexy," which denote symptoms merely, might usefully be replaced by the names or such definite lesions as " cerebral haemorrhage," &c., &c. 10. Pneumonia.— Three separate forms of Acute pneumonia have now been added to the list, viz.:—Croupous or lobar pneumonia, Broncho or lobular pneumonia, and Epidemic pneumonia ; the old term for undefined cases of pneumonia being still retained. The term " typhoid pneumonia " should never be employed, as it may mean either Enteric fever, with pulmonary complications, on the one hand, or Pneumonia, with so-called typhoid symptoms, on the other. 11. Croup.— It were greatly to be wished that the use of the term "Croup" to designate non-diphtheritic affections of the larynx or trachea should be abandoned. Diphtheritic croup or membranous croup should be returned as such. 12. Childbirth.—Whenever parturition or miscarriage has occurred within one month before the death of the patient, the fact should be certified, even though childbirth may not have contributed to the fatal issue. 13. Violence.—In every case of death by Violence, or by suspected Violence, the Medical Practitioner, in addition to stating the fact in his certificate, should advise the friends of the deceased to inform the Coroner forthwith. 14. When the cause of death has been verified by a post-mortem examination, the letters P.M. should be added. 26 METEOROLOGY at Greenwich, and DEATH RATES recorded in London and the City respectively for each year from 1894 to 1902. METEOROLOGY, 1902. Year 1894 1895 1896 1897 1898 1899 1900 1901 ###] Registered Sunshine in Hours 1052 1225 1016 1540 1415 1708 1506 1567 Returns not yet published. Mean Temperature 49.9 49.3 50.1 50.3 51.3 50.6 50.4 49.2 Degree of humidity Saturation =100. 81 78 79 79 78 77 79 78 Rainfall in inches 26.9 19.7 22.4 22.1 18.9 22.3 22.3 20.3 Mean hourly horizontal movement of the air. 12.4 miles 11.6 miles 11.4 miles 12.2 miles 11.8 miles 11.5 miles 12.1 miles 11.5 miles Annual Rate of Mortality per 1,000. London 17.8 19.8 18.6 18.2 18.7 19.8 18.8 17.1 17.6 City of London 17.2 18.3 17.8 19.3 16.3 18.5 19.4 16.6 16.4 NOTIFICATION OF INFECTIOUS DISEASE. In the following Tables will be found particulars of the cases of infectious disease notified under Sections 55 and 56 of the Public Health (London) Act, 1891, during 1902, and information as to the removal of patients to hospitals, &c.:— NATURE OP DISEASE. Number of Certificates received. Treated at Home. Removed to the Metropolitan Asylums Board Hospitals. Removed to the London Fever Hospital. Treated at other Hospitals and Infirmaries. Duplicate Certificates received. Diagnosis Incorrect. Small-pox 38 — 28 — — 3 7 Diphtheria 102 19 54 8 10 11 — Membranous Croup 3 1 1 — 1 — — Scarlet Fever 97 7 43 21 4 21 1 Typhus „ — — — — — — — Enteric „ 19 3 3 — 9 4 — Continued „ — — — — — — — Relapsing „ — — — — — — — Puerperal „ — — — — — — — Cholera — — — — — — — Erysipelas 34 24 — — 8 2 — Totals 294 54 129 29 33 41 8 Chicken-pox 86 84 — — 1 1 — Phthisis 10 6 — — 4 — — It will be seen from the above that during the year, excluding Chicken-pox and Phthisis, 294 Certificates were received, including 41 "duplicates," and 8 in which the diagnosis was subsequently found to be incorrect. 27 Table C shows that of the 245 cases of notifiable infectious disease occurring, exclusive of Chicken-pox, 77.9 per cent. were removed to hospital for treatment, the remaining 22.1 per cent. being nursed at their own homes. Removed to Hospital. Per cent. Treated at Home. Per cent. Scarlet Fever 90.7 9.3 Diphtheria 79.1 20.9 Enteric Fever 80.0 20.0 Erysipelas 25.0 75.0 Small-pox l00.0 — Excluding Erysipelas from the above, 85.9 per cent. went to hospital, against 83.9, 77.5, 73.6, 79.1 and 87.1 in the five preceding years. TABLE C. Return of infectious disease, exclusive of Chicken-pox, occurring in the City of London, with the percentage of such cases removed to hospital or treated at home during 1902, compared with the average for the previous five years :— Year. Number of cases reported. Per cent. of cases reported. Removed to Hospital. Treated at Home. 1897 208 63.9 36.1 1898 158 79.1 20.9 1899 285 60.5 39.5 1900 196 79.1 20.9 1901 214 82.2 17.8 Average for previous five years. 202 72.9 27.1 1902 245 77.9 22.1 28 Cases of Infectious Disease notified during the Year 1902. Disease. 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. St. Botolph. Allhallows. St. Sepulchre. St. Botolph. Allhallows. epulchre. Under 1. 1 to 5. 6 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox 28 1 — 2 13 11 1 13 3 12 13 3 12 Diphtheria 91 1 34 36 11 9 — 47 12 32 33 10 29 Membranous Croup 3 — 3 — — — — 2 — 1 1 — 1 Scarlet Fever 75 2 24 25 18 6 — 19 18 38 16 18 34 Typhus „ — — — — — — — — — — — — — Enteric „ 15 — — 6 1 8 — 8 2 5 8 — 4 Continued „ 1 — — — 1 — — — — 1 — — 1 Relapsing „ — — — — — — — — — — — — — Puerperal ,, — — — — — — — — — — — — — Cholera — — — — — — — — — — — — Erysipelas 32 — — 2 9 18 3 17 7 8 3 — 5 Totals 245 4 61 71 53 52 4 106 42 97 74 31 86 Chicken-pox 85 7 31 44 2 1 — 58 19 8 1 — — Phthisis 10 — — — 2 8 — 6 1 3 3 — 1 This Table is prepared in accordance with the requisitions of the Local Government Board. SHELTER FOR TEMPORARY ACCOMMODATION DURING DISINFECTION. The establishment at Golden Lane, Barbican, was utilized for the first time on the 11th March, 1901. This Shelter is not intended for the use of the poor only. Any person residing in the City is entitled to accommodation there whilst his home is being disinfected, a provision of great value in preventing the spread of infection. Twenty-three families, comprising 26 adults [and 40 children, total 66 persons, were received and provided with lodging, food, and attendance during the disinfection and cleansing of their houses after Small-pox from 16 families Diphtheria „ 4 „ Erysipelas „ 1 family Phthisis „ 2 families 23 families Two families came from homes consisting of four rooms, 9 of three rooms 9 of two rooms, and 3 of one room. 29 SMALL-POX. The day population, i.e., the number of persons residing, occupied, or employed in the City during the active hours of the day in the middle of the year 1902 was estimated at 359,940. As it would have been obviously impossible with the resources at our disposal to have ensured the re-vaccination of such a large number of persons, a circular letter was sent to all firms in the City carrying on the following businesses:— Banks, Insurance Offices, Railway Companies, Forwarding Agents, Envelope Addressers, Hotels, Laundries, Restaurant and Dining Rooms, Clothiers, Drapers, Haberdashers, Glovers, Lithographers, Dealers and Manufacturers of dresses, fancy goods, leather goods, laces, linen, &c. The issue of this letter resulted in the vaccination or re-vaccination of nearly 45,000 persons, or about 15 per cent. of the day population. The actual number of persons engaged in the City who were re-vaccinated during the epidemic is, of course, an unknown quantity, but it must have reached far higher figures, four times as many would probably be a low estimate. In view of the fact that we have a day population approaching 360,000, in intimate association with a resident (night) population of upwards of 26.000, it is remarkable that the number of cases notified in the City was so small, there having been only 44 in all, of which, in eight instances, or 18.2 per cent., the diagnoses were subsequently found to be incorrect. Another adverse influence with which we had to contend with was the presence in our midst of St. Bartholomew's, one of the largest public hospitals in London. From this institution alone no less than 37 cases of Small-pox were removed, none of which had any connection with the City, all being outpatients who belonged to outside districts. The comparative immunity from the disease observed in the City was doubtless largely due to the re-vaccination crusade, referred to above, instituted in the early stages of the epidemic, and the following figures are an indication of the labour involved and the thoroughness with which this undertaking was prosecuted. 30 VACCINATION AND RE-VACCINATION. 28,429 By public vaccinators, excluding primary infant vaccinations. 16,273 By private practitioners. 107 By medical men engaged by the Corporation. 44,809 CASE MORTALITY. Mortality amongst all cases 21.6 per cent. ,, „ those vaccinated in infancy only 15.0 „ „ „ ,, unvaccinated cases 33.3 „ „ Experience of former outbreaks of Small-pox having shown that a recrudescence of the epidemic might be reasonably expected to occur in the winter, a further appeal advocating re-vaccination was left at the latter end of the year at every place of business in the City. This has resulted in an additional number of persons being protected, but the figures at present are incomplete. ANTHRAX. On the 2nd August, a notification was received from the Medical Inspector of Factories that an inmate of Guy's Hospital, who had been employed at a fruit brokers in Lower Thames Street, was suffering from Anthrax. It was found upon enquiry that this man was a casual labourer employed by the Orange Porters' Society, and had been recently occupied in the carriage of packages of fruit from a warehouse to vans in the above-mentioned street, and was one of about 30 men so employed. In pursuit of his investigations, an Inspector visited the patient in Guy's Hospital on Saturday, the 2nd August, and collected the following information : — REPORT re CASE OF ANTHRAX. Patient Joseph Brown. Age 28 years. Residing at 18, Bell Court, Bermondsey. "I called at Guy's Hospital to-day, about 1.30 p.m., and obtained permission "from House Surgeon A. C. H. Grey to see patient. "The patient states he was sick, with pains in the stomach, on Wednesday, "23rd July, 1902, and Thursday, 24th July, 1902, and did not go to work on "those days. I pointed out to him that the foreman said he was at work on 31 "Thursday, 24th July, 1902, but he seems positive he was not. He was at work "all day Friday, 25th July, until 7 p.m. He felt no irritation on face till "after he left work on Friday, 25th July, 1902, and then noticed a white blister, "which he picked off. The blister was on right cheek. His face commenced to "swell on Monday, 28th July, 1902. He went to Guy's Hospital on Tuesday, "29th July, 1902, and was admitted on Wednesday, 30th July, 1902. On "Friday, 25th July, 1902, he worked on the wharf at Fresh Wharf, carrying "boxes of fruit, Ac. He was not on any ship, and saw no hides or skins. His "movements for some time previous to 23rd July, 1902, are as follows:— He "had to report himself daily to the Orange Porters' Society, and some days "he obtained work, and the other days he was idle. He has been working in "this way for the last four years. He is positive he has handled no skins for a "long time past, and is acquainted with the strips of hide used to bind the ends "of fruit boxes. "His father-in-law and brother-in-law reside in the same house as patient, "and are employed in a skin warehouse at Davis' Wharf, Tooley Street. Nothing "is brought to the house from the warehouse. He has no idea as to probable "source of infection." 2nd August, 1902. The strip of hide referred to above was submitted to a bacteriological examination by Dr. Klein, who reported as under : — 6th August, 1902. "The greater part of the piece of hide sent was rubbed down into "powder, and with this an emulsion was made ; one part of this was heated to "80° C. for ten minutes, the other part left unheated. The heating was used in "order to destroy all non-sporing microbes and to leave the spore of Anthrax, "if any, untouched. "Both from the heated and unheated emulsion an agar plate was made, and "from each portion of the emulsion, thick and very turbid, one guinea-pig and "one mouse were inoculated, large doses being used for the inoculation. "The plates were examined after 24, after 48, and after 72 hours; large "numbers of colonies were examined, but no colonies resembling Anthrax could "be found. After four days the animals are still well and lively. "E. KLEIN." The above particulars were at once forwarded to the Medical Officer of Health for Bermondsey, in whose district the patient resided. A copy was also sent to the Medical Inspector of Factories. No other cases were reported, and the patient made a good recovery. 32 CLEANSING OF PERSONS ACT, 1897. Under the provisions of this Act any person who shall apply to the Local Authority on the ground that he is infested with vermin shall have at the discretion of such Authority the use, free of charge, of the apparatus (if any) which the Authority possess for cleansing the person and his clothing from vermin, &c., and the Local Authority in the City is the Corporation of London. On the 22nd August, a man presented himself at the Guildhall, by direction of the City of London Union Authorities, for the purpose of availing himself of the Act. The applicant was sent to the Shelter at Golden Lane, where he was provided with a bath and his garments were disinfected. It was found that the man's underclothing was in such a deplorable condition that the Keeper of the Mortuary, with the man's permission, burnt them and gave him new. This was the first case of the kind that had occurred in the City since the Act came into operation five years previously. There being many objections to the use of the Shelter at Golden Lane for this purpose, your Medical Officer suggested that an arrangement be made with the City of London Union Authority for them to undertake the practical working of the Act on behalf of the Corporation, this method of carrying out the provisions of the Act having been adopted by other Metropolitan Boroughs. This recommendation was adopted, and the City Guardians undertook to provide the requisite accommodation at a charge of 10s. 6d. for each case. REMOVAL OF INFECTED ARTICLES TO THE CITY FROM AN OUTSIDE DISTRICT. On the 25th August, a request was received for the removal and disinfection from premises in Copthall Avenue of clothing belonging to a servant in the employ of the applicant, who had brought it into the City from his residence at Barnet. The request was immediately complied with, and the applicant, a solicitor, informed that he has rendered himself liable to a fine not exceeding 5l. under the provisions of the Public Health (London) Act, 1891, sec. 68 (c), and that it would be the duty of your Medical Officer to report the fact to the Sanitary Committee. He subsequently called at the Guildhall and expressed his thanks for our good offices in disinfecting the clothing, and explained that he had been unable to get anyone in his own district to do the necessary disinfection. 33 Under these circumstances the Committee considered it unnecessary to take any further action in the matter. This is an illustration of the want of knowledge of the responsibility of individuals for rendering themselves familiar with the duties of sanitary authorities in assisting them in similar cases, and it cannot be too generally known that any person who gives, lends, sells, transmits, removes, or exposes, without previous disinfection, articles which have been exposed to infection, is liable to a penalty for so doing. Also that every sanitary authority is bound to remove, disinfect, and return, free of charge, within their district, any infected articles. SCARLET FEVER-ST. BRIDE'S INFANT SCHOOL. In consequence of the occurrence of a number of cases of Scarlet Fever at this School a special investigation was made of the building and its surroundings, in the course of which several grave sanitary defects were discovered. At the time of your Medical Officer's visit the Managers had already closed the School to obviate further spread of infection. In order to comply with the requirements of the Education Board two Members of your Worshipful Committee, acting upon my advice, signed a formal order directing the closing of the School for twenty-one days, of which the following is a copy:— "To the Managers of the St. Bride's Infant School, Bride Lane, "Fleet Street, in the City of London. "We, the undersigned, being Members of the Sanitary Authority for the "City of London, acting upon the advice of Dr. William Collingridge, Medical "Officer of Health for the said City, do hereby order and require the closure "of the Public Elementary School, known as the St. Bride's Infant School, "situated in Bride Lane, in the City of London, for the period of twenty"one days from the date hereof, with a view of preventing the spread of "Scarlet Fever and the danger to health likely to arise from the general "insanitary condition of the said School. "Given under our hands this tenth day of October, 1902, at the Offices of "the Public Health Department, Guildhall, E.C. "(Signed) HY. A. SUMMERS, " WALTER LOW." The usual Notices were served to remedy the sanitary defects found, which were duly complied with. The drains were thoroughly repaired, four new closets constructed, and the premises cleansed and whitewashed throughout. The Schools were re-opened in January of this year. 34 TUBERCULOSIS. This subject was dealt with at. some length in your Medical Officer's Annual Report for 1901, but those observations were more particularly directed to the Report of the British Conference on Consumption, held in July of that year—the voluntary notification of that disease in the City— and the relation between human and bovine tuberculosis. On page 31 of that Report attention was drawn to the danger attending the practice of expectoration in public places, and it was in the hope of minimising this evil that your Medical Officer reverted to the subject, and submitted some suggestions for the consideration of the Committee. The casual observer cannot have failed to note the exhibition at railway stations, tram cars, and omnibuses, &c., of Placards urging the public to abstain from the filthy habit of spitting. Although it would be difficult to defend such notices upon æsthetic grounds, it would have been dangerous to condemn them, as they serve a useful purpose in reminding offenders of the duty they owe to the public in this respect. In order that the community should be further educated on this point the co-operation of certain large employers of labour was invited, and I had little doubt that the Corporation would have the active support and sympathy of all classes in its endeavour to limit the extension of a disease that is in a great measure preventable. The following Circular Memorandum on the subject was accordingly addressed to firms carrying on the following businesses within the City of London, viz.:—Railway Companies, Omnibus Companies, Post Offices, Telegraph Offices, Telephone Offices, Market Superintendents, Public Offices, Licensed Victuallers, Restaurant Keepers, Police Authorities, Fire Brigade Authorities, School Boards and other Educational Establishments. CITY OF LONDON. Public Health Department, Guildhall, E.C., To July, 1902. Sir, The Corporation is anxious to secure your co-operation in preventing, so far as, possible, the growing habit of spitting in the streets, and other places of public resort. 35 This is not only a filthy and objectionable practice in itself, but, as pointed out by Dr. Collingridge, the Medical Officer of Health for the City of London, is known to be the main factor in spreading the disease known as Phthisis, or Consumption. It is thought that employers of labour could materially assist the Corporation in its attempts to remedy this dangerous nuisance, by directing the attention of their employes to the evils of the habit and to the importance of suppressing it. At the same time, the exhibition of Notices warning the public would be of the greatest possible value. I shall be glad to hear that you are prepared to co-operate in the manner indicated. I am, Your obedient Servant, JAMES BELL, Town Clerk. A large number of replies was received, and it was gratifying to note that the Citizens evidently appreciated the efforts of the Corporation to check the evil. Very many applications having been received for cautionary notice cards for exhibition in places of business throughout the City, the following card was printed and sent to all applicants :— Corporation of London. PUBLIC HEALTH DEPARTMENT. NOTICE. IN ORDER TO AID IN THE PREVENTION OF CONSUMPTION, you are earnestly requested to abstain from the dangerous and objectionable habit of spitting. GUILDHALL, E.C. 1902. 36 So great, indeed, was the demand for these cards that in November last the Committee considered it advisable they should be circulated by a general house-to-house distribution. This is now in progress, and will necessarily take some further time to complete. Such action, however, does not appear to have very marked influence in dealing with offenders against decency and the laws of public health, and I am of opinion that the time is come to deal with the question in a more radical and stringent manner. I have therefore collected some information as to legislation on this subject in our own and foreign countries. New York.—It is forbidden to spit in trams and omnibuses under pain of a fine of 500 dollars, or imprisonment not exceeding one year, or both, and many persons have been already punished for the offence, special plain clothes detectives being employed to deal with this habit. Boston, U.S.A.— The Board of Health on the 23rd March, 1899, issued a Regulation as follows:— "The Board of Health hereby adjudges that the deposit of sputum in "public places is a nuisance, source of filth, and cause of sickness, and " hereby orders that spitting upon the floor, platform or steps of any railroad "or railway station, car, public building, hall, church, theatre, market or "any sidewalk immediately connected with said public places, be, and "hereby is prohibited.'' I am indebted to the Hon. H. K. Evans, Consul-General for the United States of America, for the following information concerning regulations on the subject in the United States, compiled by Surgeon-General Maine, of Washington, from Dr. C. V. Chaplin's work on Municipal Sanitation in that country: " SPITTING. "The first anti-spitting law in the United States was adopted 12 May, 1896, "in New York City, at the suggestion of Drs. Biggs and Prudden.1 "It was adopted for the purpose of diminishing the spread of tuber"culosis. It had been shown tubercle bacilli are thrown off in large "numbers in the sputum of many cases of phthisis, and that this sputum "when it becomes dry on the floor or sidewalk would be readily "pulverized and carried about by air currents, and might on reaching "the air passages of those who breathed this dust-laden air, cause the "disease in them. This danger was believed to be a very real one, and 1New York City, Report of Board of Health (1896), p. 29. 37 "hence the ordinance. While the evidence in support of the view that "this danger is great enough of itself to warrant such legislation is not "entirely satisfactory, the legislation itself has met with very general "approval. Spitting on the floor or sidewalk is a dirty habit, creates a "nuisance, and is annoying to the majority of persons. It is probable "because it prevents nuisance rather than because it prevents disease "that the law meets with popular favor. It is, however, usually "adopted by boards of health under authority to legislate for the "prevention of disease. "At present such regulations are found in the cities named below,2 but "have not yet been incorporated into statute law; but in Indiana they "have been promulgated as rules of the state board of health. "Some of the regulations, especially the earlier ones, forbade spitting "in street cars only, as in Baltimore, Minneapolis, Lowell, Lynn, "Boston, Cambridge, and New Orleans. " 'Resolved, That the deposit of sputum in street cars is a public " 'nuisance, source of filth and cause of sickness, and hereby orders : " 'That spitting upon any floor of any street car be, and hereby is, " 'prohibited.'3 "The word spit has in most of the regulations been deemed sufficient "to describe the act which it is desired to prohibit, but it has been "further explained in some cities. It has, furthermore, been found "insufficient to forbid spitting on the floor, and it has been said that "persons seeing the rule above given exhibited before them, have "deliberately spat upon some other portion of the car. The Minneapolis "rule takes note of both these points : " 'No person shall spit or expectorate, or deposit or place any " 'sputum, saliva, phlegm, or mucus upon the floor or inside " 'furnishings or equipments or in any place upon the outside, or " 'upon any platform of any street car while the same is in use " 'upon any of the streets or highways in the City of Minneapolis, " 'or in any manner defile or pollute the floor, furnishings, equip" 'ments or platform of any street car while in use upon any of the " 'streets or highways of said city.'4 "Most of the more recent rules forbid spitting in any' public con"veyance.' Among the conveyances mentioned are 'street cars,' " 'railroad cars,' 'ferry boat,' 'omnibus,' 'hack,' 'carriage,' 'vehicle,' " ' steam car,' and 'steamboat." * Boston, Baltimore, Buffalo, Brookline, Cambridge, Colorado Springs, Columbus, Cleveland, Cincinnati, Camden, Denver, Dayton, Fitchburg, Fall River, Hartford, Indianapolis, Jersey City, Kansas City, Louisville, Lowell, Lynn, Minneapolis, New York, New Orleans, Omaha, Peoria, 111., Rochester, Springfield, Q., Salem, San Francisco, Scranton, Seattle, Trenton, Waltham, Worcester, and Washington, D. C. 3Lowell, Report of Board of Health (1898), p. 36. 4Minneapolis, Ordinance of 25 June, 1897, Sec. 53. 38 "A good many of the rules go further, and prohibit spitting on the "floor of 'public buildings,' as in New York City. Among public places mentioned are 'public halls,' 'assembly rooms,' 'shops,' 'stores,' " 'halls,' 'churches,' 'school houses,' 'railroad stations,' 'public places.' "The Indiana rules forbid spitting on stairways. Some of the rules go "further still and forbid spitting upon the sidewalk, as in the present "rule in Boston, Cambridge, and Lynn, and in Cincinnati, Providence, "Brookline, Mass., Springfield, Mass., Colorado Springs, and Rochester. " 'rdered, That no person shall spit upon the floor of any " 'public conveyance, shop, store, hall, church, school house, " 'railroad station, or other public building in said town, or upon " 'the steps of any of said conveyances or buildings, or upon the " 'sidewalk (spitting into the gutter or street is not forbidden) of " 'any public way in said town.'5 "These rules have very generally met the approval of the street "railway and other transportation companies, and they have been very "ready to post notices continuing the rule, and to assist in its enforce"ment. Some of the rules, however, provide that the companies shall " do this : " 'Spitting upon the floors of public buildings and of railroad cars " 'and of ferry boats is hereby forbidden, and officers in charge or " 'control of all such buildings, cars and boats shall keep posted " 'permanently in each public building and in each railroad car and " 'in each ferry boat a sufficient number of notices forbidding " 'spitting upon the floors, and janitors of buildings, conductors " 'of cars and employes upon ferry boats shall call the attention of " 'all violators of this ordinance to such notices.'8 "In Providence, the street railway company not only posted such "notices in its cars, but furnished its conductors with slips on which was "printed the rule, and the conductors were directed to hand one of the "slips to every person seen violating the rule. In Minneapolis, cards "containing the rule are printed and very generally distributed by the "board of health. In Brookline, where spitting on the side walk is "forbidden, the police carry copies of the law to show to offenders. "In order to render compliance with this rule easier, it is provided in "Colorado Springs as follows : " 'Every owner, agent, lessee or occupant of any public hall or " 'building shall provide the same with cuspidors in sufficient " 'number to accommodate the necessities thereof. And any such 5Brookline, Mass., Report of Board of Health (1898), p. 10, Orders of the Board of Health, No. 16. 6New York City, Sanitary Code (1899), Sec. 194. 39 " 'owner, agent, lessee or occupant who shall refuse or neglect to " 'comply with any order of the health officer in supplying said " 'cuspidors, shall be fined in a sum not less than one dollar nor " 'more than five dollars for each offence.'7 "In New Orleans, the rule first adopted only forbade spitting tobacco "on street cars, but it has been recently modified to forbid all spitting." Toronto, Ottawa, Halifax and Nova Scotia have all made the habit a penal offence. New South Wales.—By Section 130 of "The New South Wales Municipalities Act, 1897," the Council of any Municipality is empowered to make Bye-laws (inter alia) for "Providing for the health of the Municipality, "and against the spreading of contagious or infectious disease," and although spitting in public is not specifically included therein, a Bye-law has been made by the Council of the Borough of North Sydney under the provisions of this Act, in regard to expectorating on the footway, as follows: "No "person shall expectorate on the footway of any street in the Borough, and "any person so offending shall for each offence, upon conviction, forfeit and "pay a penalty or sum not exceeding one pound (1l.)— 12th November, "1901." And again, in a Bill" to codify and amend the Municipalities Act, 1897, "and to make further and better provision for Municipal government," which Bill was introduced into the Legislative Assembly of New South Wales by the Premier on the 7th August, 1902, "the prevention of persons "expectorating on any footway under the control of the Council" is expressly included in the matters of which the Council of a Municipality may make Bye-laws. So far as can be ascertained the Bill has not yet become law, but the Legislative Assembly in Committee has agreed to the Clause above indicated. Another Borough, Glebe, has a Bye-law under the Act of 1897, providing a penalty " not exceeding Ten pounds " in respect of this offence. In Germany, the law of 1898 strictly prohibits the practice of spitting on the platforms and in the carriages of the railway companies. In Austria.— A Circular issued by the Railway Minister orders Notices to be placed in all railway carriages forbidding spitting. In Belgium, spitting on the ground is prohibited. * 7Colorado Springs, Sanitary Code (1897), Sec. 60. 40 In Denmark, spitting is forbidden in all public conveyances, railway carriages, tramcars, &c. In France, spitting is forbidden in public places, and special regulations are issued for dealing with the habit in public buildings. Hungary A special circular of the Minister of the Interior, dated 1898, deals with the prohibition of spitting in public places. In this country at present but little has been done. The Post Office Authorities have posted the following Notice in all Post Offices :— " Prevention of Consumption. "To aid in the prevention of Consumption, and in the interests of the "health of the staff, it is forbidden to spit on the floors, passages, stair"cases, or in any part of this building. "Disciplinary measures will be enforced against any member of the "staff found to act in disregard to this Notice. "By Order of the Postmaster-General." In Liverpool, the Corporation, owning its own tramcars, has inserted in the Bye-laws a Clause, as follows:— "Offensive Language or Conduct. "No person shall swear or use obscene or offensive language, or "conduct himself offensively whilst in or upon any car, or spit or "commit any nuisance in or upon or against any car or tramway station, "or premises used in connection with the tramway system, or in any "way wilfully interfere with the comfort of any passenger." The Notices on the cars with reference to spitting are as follows:— Inside. " Please do not spit in the car." On the trolley standard on the top of the car:— "Spitting is forbidden. By Order." Since the new Bye-laws came into operation on the 1st March last, there have been a number of prosecutions for spitting on the cars, in which the defendants have been fined. The Bye-laws provide for a penalty of not exceeding 40s. for infringement, and a penalty of 10s. for a continuing offence. 41 Manchester and Glasgow have Bye-laws imposing a penalty on persons found spitting in the Corporation tramcars. In Belfast, although the Corporation has not issued any notice concerning spitting in tramcars, the Manager of the cars evidently considers there are good grounds for cautioning passengers, and has accordingly placed the following notice in each car:— "Spitting in tramcars is a filthy habit ; persons committing this "offence render themselves liable to the disgust and loathing of their "fellow-passengers." It is difficult to conceive anyone so lost to a sense of decency as to disregard such an admonition. In many towns, Notices are posted asking people to refrain from spitting, but these do not go far enough. If the habit is to be checked, it must be by legislation. The Glamorganshire County Council have obtained the following Bye-law, made under the Municipal Corporations Act, 1885, incorporated in the Local Government Act, 1888:— "Glamorgan County Council.— Bye-law for the good rule and "government of the County, made by the Glamorgan County Council, "on the 19th day of June, 1902, and duly published and submitted "to the Secretary of State, and not disallowed within the time fixed "by law. "A person shall not spit on the floor, side or wall of any public "carriage, or of any public hall, public waiting room, or place of public "entertainment, whether admission thereto be obtained upon payment "or not. "Any person offending against this Bye-law shall be liable to a "fine not exceeding 5l. "This Bye-law is in force throughout the County of Glamorgan, "except within the limits or any Municipal Borough." The following paragraph is taken from the Times of 21st June, 1902:— "A Bye-law to prevent spitting.— The Glamorgan County Council, "in March this year, considered means to prevent the spread of "tubercular disease, and approved of a Bye-law to prohibit spitting 42 "in public rooms and vehicles. This was submitted to the Secretary of "State for the Home Department, and at a meeting of the Council on "Thursday a reply was read from Sir Kenelm E. Digby, as follows :— " 'I am directed by the Secretary of State to say, for the information of " 'he County Council, that, as the proposal is a new one, he has " 'considered it very fully, and has taken expert advice, and that he has " 'arrived at the conclusion that (subject to the consideration of any " 'objections that may be received within the statutory period of forty " 'days after a sealed copy has been submitted to him) he will allow the " 'Bye-law to come into force if its operation is confined to public " 'carriages, public waiting rooms, public halls, and places of public " 'entertainment. He thinks that the Bye-law cannot properly be made " 'to apply to churches, chapels, schools, and shops.' In accordance "with the terms of the letter, amendments were made in the draft Bye"law, which was then adopted, and a copy ordered to be forwarded to "the Home Secretary." Although only those affected with Tuberculosis can spread the disease in this way, the early stages of the disease are so insidious that they are not recognised by either the patient or his relatives, and it would be useless to attempt to deal with "infected" sputa only, and the habit must be totally prohibited in the case of both healthy and sick. The matter was in due course referred to Mr. Remembrancer and Mr. Solicitor to advise as to how best the necessary power can be obtained, suggesting only that the co-operation of the whole of the Metropolitan Borough Councils be sought in dealing with so important a subject. Not only would the case become far stronger than individual action, but it would be somewhat unreasonable to attempt to confine the restriction to the City area. However obtained, the prohibition should be made to apply to all pavements and footways, platforms, halls, booking offices, staircases and waiting rooms of railway and omnibus companies, all public conveyances, and all public halls, buildings and places of public entertainment, whether admission be obtained thereto by payment or not. 43 ARTIZANS' DWELLINGS, STONEY LANE, HOUNDSDITCH. These buildings, erected by the late Commissioners of Sewers during 1884-1885, were opened in January of the latter year. They stand upon ground formerly the site of Mount Court, Wood Green Court, Ebenezar Square, Meeting House Yard, Angel Court, Coak's Buildings, George Court, and Petticoat Square, in the Ward of Portsoken. There are five "blocks," severally named King's—Queen's—Prince's— North—and South, of dwellings, designed for occupation by persons of the artizan class. Some of the ground floors are let as shops. Exclusive of the shops and cellars, they contain 539 rooms, arranged in 260 tenements, and are occupied by 916 persons. Fifty-eight per cent. are adults and forty-two per cent. children (under 16 years). The total cost of the buildings and land upon which they stand was £202,242, which are now maintained at an annual expenditure of about £2,500. The income derived last year from letting the tenements was £5,664, being about 1½ per cent. interest on the capital outlay. They are much sought after, and the rooms are rarely empty. The rent varies from 4s. 6d. to 9s. per week. The death rate for 1902 was 9.8 per 1,000 per annum [of which 44.4 per cent. was of children under 5 years of age]. Deaths of children under one year to 1,000 births were 48, as against 124 for the City generally. The number of births was 42, viz.: 25 males and 17 females. The birth rate, 45.8 per 1,000, is the highest recorded since 1896, and is 4.8 per 1,000 above the average for the previous five years. There has only been one illegitimate birth in these buildings since 1894, a fact that speaks well for the morality of the inhabitants, who are mostly Jews. 44 ARTIZANS' DWELLINGS, STONEY LANE. Vital Statistics 1902, compared with previous five years. YEAR. Death rate per 1,000. Deaths of children under 5 years of age. Deaths of children under 5 years of age per 1,000 births. Birth rate per 1,000. Number of illegitimate children born in the Buildings. Deaths from Infectious Diseases. Per cent. 1897 16.9 27.8 93 40.3 Nil. 2 1898 8.4 66.6 65 43.1 1* 1 (Measles) 1899 15.0 18.8 75 37.5 Nil. 1 (Whooping cough) 1900 17.8 52.6 146 38.4 Nil. 1 (Scarlet Fever) 1901 14.2 53.8 226 45.8 Nil. 1 ( Puerperal Septicæmia) Average for previous five years. 14.5 43.9 121 41.0 — 1.2 1902 9.8 44.4 48 45.8 Nil. Nil. * The mother is reported to have been of weak intellect, and a mere child. NAME OF BLOCK. 1902 North. South. King's. Queen's. Prince's. Total. Number of Births 9 6 7 9 11 42 Number of Deaths 2 2 3 1 1 9 Deaths of Children under five years of age 2 1 1 — — 4 Deaths of Children under one year of age 1 1 — 2 1 5 Number of illegitimate Children born — — — — — Nil. Deaths from Infectious Diseases — — — — — Nil. In June, 1901, your Medical Officer of Health advocated a re-arrangement of the sanitary accommodation at these buildings, which, although of the most approved type at the time they were established in 1884, had since become obsolete and unsuitable for modern requirements. Attention was also directed to the lack of any provision for baths. It having been decided to rectify these defects, the matter was referred to your Engineer, who in August last submitted plans and specifications, which were approved by the Court of Common Council in November, 1902. Authority has also been given for the erection of a building containing baths for the use of the residents. Contracts for these improvements have been entered into, and the work is now in hand. ??? of London. Table of BIRTHS OCCURRING AT THE ARTIZANS' DWELLINGS, STONEY LANE, HOUNDSDITCH, DURING THE YEAR 1902, to which are added the DEATHS registered during the same period classified according to Diseases, Ages, and Localities. Name of Block. Births. mortality from all causes at subjoined ages. mortality from subjoined causes, distinguishing deaths op children under five years of age. At all ages. under 1 year. 1 and under 5 6 and under 15 15 and under 25 25 and under 60 60 and upwards. Small-pox. Scarlatina. Diphtheria. Membranous. Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. violent Deaths. Injuries. All other Diseases. s. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Male. Female. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. NORTH BLOCK 6 3 2 ... 2 ... ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 2 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 SOUTH „ 3 3 2 1 ... ... ... ... 1 Under 5 ... ... ... ... ... ... 1 1 2 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 king's „ 4 3 3 1 ... ... ... 2 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 3 5 upwds. ... ... 2 2 QUEEN's „ 7 2 1 ... ... ... ... ... 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 PRINCE'S „ 5 6 1 ... ... ... ... 1 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 TOTALS 25 17 9 2 2 ... ... 3 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... 1 3 9 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 5 6 * A woman aged 100 years. 46 DISINFECTION, &c., AT CITY MORTUARY. 5,399 articles of bedding, clothing, furniture, &c., were received at Golden Lane and disinfected. 164 bodies were received at the Mortuary, pending interment; the number for the three preceding years being 102, 98, 111. Number of Articles disinfected, bodies received at the Mortuary, and Inquests held at the Coroner's Court in the City during 1902, compared with the average for the previous five years. Year. Articles of Bedding, kc., disinfected. Bodies received at the Mortuary. Iuquests held on bodies. sts held on Fires. 1897 5,075 131 68 3 1898 5,349 108 59 2 1899 9,175 102 49 Nil. 1900 4,100 98 61 Nil. 1901 5,527 111 77 1 Average for previous five years 5,845 110 63 1.2 1902 5,399 164 140 1 DISINFECTANTS. In the Annual Report for 1900 reference was made to a projected scheme of supplying the Cleansing Department with disinfectants in a concentrated form. This system— partially in use in 1901— was in full operation during 1902, and the Superintendent of Cleansing (Mr. Keillor) states that it has effected considerable economy in cost of cartage, this item alone having been reduced from £76 in 1900, and £88 in 1901, to £l 2s. 6d. in the year under review. During the summer weather all main streets— and especially those paved with wood— were liberally sprinkled, through the agency of water carts, with a non-poisonous disinfectant solution, which was found admirably suited for 47 the object in view. Not only was the dust laid, the roadway surfaces effectively deodorized, and all animal and refuse matter thereon disinfected, but it was found as anticipated, that even on the hottest days the roadway surfaces retained moisture for a considerably longer period than obtained when water alone was used for laying the dust. The advantage accruing from this measure was most noticeable in those places used as "lay-byes," where the abominable nuisance caused by the fecal matter and stalings from horses was reduced to a minimum, while it is hardly necessary to point out that the spread of tuberculosis, through the agency of dried sputa, must be materially checked when thoroughfares in crowded places are so treated in dry weather. The method formerly in use of manufacturing disinfecting liquids in bulk at Golden Lane has been to a great extent discontinued, only a comparatively small stock being kept for emergencies. All chemicals and disinfectants supplied throughout the Public Health Department are obtained through your Medical Officer. They are used for the following purposes :— A. Deodorizing and "denaturalizing" condemned meat. B. Disinfecting public conveniences (urinals, &c.). C. Disinfecting roadways, street gullies, &c. D. Disinfecting Offices (Public Health Department). E. Disinfecting premises, &c., after infectious disease, and sundries. The amounts spent during the past twelve months under these several headings were :— £ s. d. A 14 12 5 B 12 8 6 C. 102 3 6* D 0 12 1 E. 64 17 2 Total £194 13 8 Including cartage, £1 2s. 6d. This shows a saving of upwards of £400 per annum over the average amount spent for similar purposes during the preceding twelve years. 48 SANITARY INSPECTIONS. The following is a Statement of the work of the Sanitary Inspectors in their several Districts during each month of the year :— WEST DISTRICT. (Inspector F. J. Robbins.) Date of Report. Premises Inspected. Orders Issued. Notices served. completed. January 156 11 9 9 February 216 5 22 18 March 151 14 11 10 April 214 7 109 18 May 335 8 114 43 June 254 1 13 40 July 219 14 14 60 August 341 29 82 50 September October 275 12 38 25 November 206 8 19 27 December 250 11 17 32 Totals 2,617 120 398 332 MIDDLE DISTRICT. (Inspector E. J. Simmons.) Date of Report. Premises inspected. Orders issued. Notices served. Works completed. January 154 15 10 6 February 225 4 32 18 March 221 15 23 26 April 194 16 18 16 May 266 9 98 25 June 203 8 21 31 July 223 13 20 33 August 316 16 46 57 September October 329 9 27 40 November 193 13 17 17 December 291 13 24 41 Totals 2,615 131 336 310 49 EAST DISTRICT. (Inspector - W. H. Ralph.) Date of Report. Premises inspected. Orders issued. Notices served. Works completed. January 148 4 11 10 February 203 11 22 21 March 216 13 32 19 April 203 10 54 16 May 347 10 148 26 June 243 10 22 49 July 213 8 19 29 August 314 21 30 47 September ... ... ' October 319 10 25 31 November 209 10 16 33 December 353 6 17 34 Totals 2,768 113 396 315 The foregoing are summarised as under:— District. Number of Inspections made. Orders issued. Notices served. Improvements effected. West 2,617 120 398 332 Middle 2,615 131 336 310 East 2,768 113 396 315 Special 1,044 — 1 317 Totals 9,044 364 1,181 1,274 50 Sanitary Inspections During 1902, compared with previous five years. Year. Inspections made. Sanitary Improvements effected. Notices served. 1897 8,733 1,109 944 1898 7,444 1,141 1,221 1899 8,087 1,470 1,397 1900 9,221 1,447 1,125 1901 9,836 1,379 1,286 Average previous five years 8,664 1,309 1,195 1902 9,044 1,274 1,131 The apparent reduction in the amount of work performed by the Sanitary Inspectors is due to the fact that the work done under the Factory and Workshop Act, 1901, is not included in the above Table, and will be found in detail on page 61. Full details of this and every other branch of departmental work are laid before each meeting of the Sanitary Committee. In the course of the year there were four cases, when, owing to noncompliance with Notice to remedy sanitary defects, it was found necessary to refer the particulars to the City Solicitor, and in each instance the work was subsequently carried out without further legal proceedings. The following are the places referred to:— 1, Beech Street Dirty staircase. 1 and 2, Beech Street Defective water-closet and soil pipe. 4a, Bury Street Defective drain. 148a, Queen Victoria Street W.C. unventilated. Summonses were issued in the three following cases :— PROSECUTIONS UNDER THE PUBLIC HEALTH (LONDON) ACT, 1891. Date. Name. Business. Address. Where heard. Before whom. Offence. Result, 1902. May 22 Joseph Perry Bookbinder No. 19, Shaftesbury Place, Aldersgate Street. Guildhall Justice Room. Mr. Aid. Strong. Permitting overcrowding on the second floor of No. 19, Shaftesbury Place. *Fined £2 and 2s expenses. J une 3 John Benjamin Kyffin. Surveyor and Agent. Toksowa House, Dulwich Common. Ditto Ditto Permitting overcrowding on the first floor of No. 13, Shaftesbury Place. Fined £5 and £2 2s. expenses. „ 3 Ditto Ditto Ditto Ditto Ditto Permitting overcrowding at No. 13, Shaftesbury Place to continue for 16 days. *Fined £2 and 5*. per day for 16 days. Dec. 2 Nokes and Nokes. Surveyors 20, Ironmonger Lane. Ditto Aid. Sir D. Evans. Non-completion of sanitary work at No. 13, Chapel Street. No order made. *Conviction appealed against. Appeal dismissed with Costs, 27th March, 1903. 51 HOUSE REFUSE REMOVAL. The Superintendent of Cleansing reports that the refuse removed from the City in 1902 consisted of 3],251 cartloads of street sweepings and slop, and 48,297 loads of house and trade refuse ; total, 79,548. Of this bulk, 26,245 loads were consumed by the Destructor at Letts' Wharf, being 1*5 per cent, above the average for the previous five years. Refuse Dealt with during 1902 and previous Five Years. Year. Street Sweepings and slop. House and Trade Refuse. Total. No. of Loads Cremated in Destructor. Per Cent. Cremated. 1897 Loads. 30,065 Loads. 43,725 Loads. 73,790 23,750 32.2 1898 29,745 43,960 73,705 23,836 32.3 1899 29,577 45,044 74,621 22,481 30.1 1900 28,708 44,841 73,549 24,121 32.8 1901 30,115 44,975 75,090 22,657 30.2 Average of previous five years: 29,642 44,509 74,151 23,369 31.5 1902 31,251 48,297 79,548 26,245 33.0 In a Report to the Sanitary Committee, dated 1st February, 1902, on the whole question of Dust Removal, your Medical Officer directed attention to the nuisance caused by dust receptacles in the streets, arising from the fact that many offices and warehouses are not open till 9 or 9.30 a.m., and that at that time the operation of cleansing and collecting the dust often only begins, and that in consequence in many parts receptacles are not placed outside until nearly 10 o'clock. CITY OF LONDON (PUBLIC HEALTH) ACT, 1902. This Act, originally introduced as the City of London (Streets) Bill, 1902, was promoted by the Corporation last year. The Bill was sent in due course to a Select Committee, where the greater part of it was thrown out, leaving only Parts 3 and 4, relating to the removal of dust and refuse and nuisance caused by the demolition of houses. It was, in consequence, proposed to withdraw the Bill and incorporate these clauses in a future one. 52 Your Medical Officer reported at the time that this was an inadvisable step to take, inasmuch as the condition of the streets so far as the removal of dust and refuse was concerned was most unsatisfactory, and dangerous to the public health, and that no efficient solution of this question could be arrived at until the Corporation had power to regulate the pattern of receptacle, and the time of removal. These powers were provided for in the Bill as drafted, and as any postponement of legislation on the subject would undoubtedly have beep detrimental to the interests of the City, he expressed the hope that this matter would be re-considered. As the result of such representation it was decided to proceed with the measure as amended. This course was adopted, and the Bill finally received the Royal Assent on the 22nd July last. The only section coming within the province of your Medical Officer is number 4, which enacts that:— "4. Notwithstanding anything contained in any Act of Parliament "the inmates and- occupiers of any house within the City who do not "deposit their house refuse in the ashpit attached to the building of "which they are the inmates or occupiers shall deposit such house refuse "before eight o'clock in the morning on the curb stone of the foot "pavement in a street and all house refuse deposited in a street in "accordance with the provisions of this Act or of The Metropolitan "Streets Act 1867 shall be contained in a box barrel or receptacle of a "prescribed pattern or patterns. The Corporation may make bye-laws "for giving effect to this section." Byelaws in accordance with the above provisions are now under consideration. They will require the approval of the Local Government Board before they become operative. NUISANCE FROM DUSTBINS, &c. With the object of preventing the nuisance and danger to health involved in the "sorting over" of the dust receptacles in the streets by persons seeking materials which they could profitably dispose of, the Commissioner of Police gave instructions that due warning was to be given to such individuals that the dust was the property of the Corporation, and that the removal was forbidden, and that if the offence continued after such caution their names and addresses would be taken, and the necessary proceedings taken to put an end to a filthy and dangerous practice. 53 ESCAPE OF STEAM FROM SEWERS. Attention having been called to the escape of vapour from the sewer ventilators and gullies in Aldersgate Street, opposite the Post Office, the matter was specially investigated, and Mr. Engineer caused observations of the temperature of the discharge into the sewer to be made. These showed that on consecutive days, while the temperature of the flow in the sewer was 84°, that of the discharge was 94° and 108° respectively. While it was clear that the escape of steam into the street was most objectionable, and likely to frighten horses, there was not sufficient evidence for your Medical Officer to furnish a Certificate that it was "a nuisance injurious or dangerous to health" within the meaning of the Public Health (London) Act, 1891, and therefore no proceedings could be taken under that Statute. OFFENSIVE TRADE. An instance of an offensive trade, viz., that of a fellmonger, was discovered to be carried on within the City in the neighbourhood of Smithfield (without the sanction of the Corporation). Notices were served, with the result that the nuisance arising from the drying of hare and rabbit skins was abated. The owner's representatives also gave an undertaking that in future no skins should be dried upon the premises in question, that all skins purchased should be removed within twelve hours, and that the business should be removed from the City before the end of the year. The owners of this place having failed to obtain from the Corporation permission to establish a new business of this character, had rendered themselves liable to a fine of £50, and a further penalty of £50 for each day during which it was conducted. The above undertaking having been carried out, no further proceedings were necessary. DANGER FROM POWDERED MICA. My attention was invited by the Commissioner of Police to the proposed use of powdered mica as confetti during the Coronation festivities. I pointed out the danger to eyesight incurred by the use of such material, and steps were taken to prevent its use. TENEMENT HOUSES. The houses let in lodgings or occupied by members of more than one family have been re-surveyed. 54 Those now on the Register are:— District. • No. of Houses on Register. No. of Lodgers. No. of Tenements. Average No. of Persons per Tenement. Sanitary Notices Served. West 185 1,514 658 2.30 291 Middle 48 296 99 2.99 77 East 158 1,183 494 2.39 230 Total. 391 2,993 1,251 2.39 598 The houses in question are frequently inspected, and in April of each year their owners called upon to undertake a thorough cleansing of them, in accordance with the provisions of your Bye-laws. This necessitated the service of a total of 598 Notices [or, 291, 77 and 230 during the year, in the West, Middle, and East Districts respectively]. In addition to the foregoing there are eleven Blocks of dwellings let out in tenements, but not placed on the Register for the reason that each holding is "self-contained," it having been decided in a Court of Law that under these circumstances they are not subject to the Bye-laws for houses let in lodgings, or occupied by members of more than one family :— Situation. No. of Tenements. No. of Inhabitants. "Artizans'Dwellings," Stoney Lane, Houndsditch 260 1,066 Nos. 21 and 22, Albion Buildings, Bartholomew Close 20 66 Bartholomew House, Cloth Fair 17 47 Barker's Buildings, Catherine Wheel Alley 24 71 Blomfield House Buildings, KiDg Street, Snow Hill 24 82 Bridgewater House, Fann Street 12 50 City Buildings, Moor Lane 31 111 Dean Street, Fetter Lane 37 113 St. Ann's Chambers, Broadway 41 107 Nos. 1 and 2, Fleur-de-Lis Court, Carter Lane 3 8 Nos. 1 and 2, Took's Court, Furnival Street 12 48 Total 481 2,769 Average number of persons to each tenement, 5.75. 55 TENEMENT HOUSES. Closed or Demolished during 1902. west district. No. 5, Wine Office Court. No. 4, do. do. No. 2, Bartholomew Place. No. 37, Hutton Street. No. 30, Furnival Street. No. 2, Queen's Head Court. No. 11, New Court. middle district. No. 104, Bishopsgate Without. Nos. 5 and 6, Bridgewater Street. No. 14, Fann Street. east district. Nil. A full list of Tenement Houses still on the Register is given in Appendix C, page 198. COMMON LODGING HOUSES. The Common Lodging Houses Acts (14 and 15 Vict., c. 28, and 16 and 17 Vict., c. 41) were repealed by the Public Health Act, 1875, except so far as relates to the Metropolitan Police District, and they are still in force in that District, where they are administered by the London County Council. The Metropolitan Police District, as provided by 10 Geo. 4, c. 44, s.s. 4, 34, and extended by Orders in Council under 2 and 3 Vict., c. 47, s. 2, now includes the County of London exclusive of the City and its Liberties, the County of Middlesex, the County Boroughs of Croydon and West Ham, and certain parishes and places in the Counties of Surrey, Kent, Herts and Essex. In June last, as the Regulations for Common Lodging Houses then in force in the City were made no less than forty years ago, your Medical Officer of Health submitted the desirability of their re-consideration, with the object of bringing them into line with modern requirements, and laid before the Committee a draft of revised Regulations, based upon those in force in the City for tenement houses and the model Bye-laws of the Local Government Board. 56 These Regulations were drafted under Section 10 of the City of London Sewers Act, 1851, which reads as follows:— "And whereas the Owners and Keepers of Lodging Houses of an "inferior description, for the accommodation of mendicants and strangers, "and other persons for the night or other short periods, and of other "houses inhabited by the poorer classes of people, allow the same to be "crowded by receiving more lodgers than such lodging houses are "adapted to contain with a due regard to health, and allow many "persons of both sexes to be crowded together in a single room, and "allow persons afflicted with fever and other diseases of a contagious "or infectious nature to remain in them till infection has been "communicated to other lodgers, and receive other lodgers into the "apartments and beds from which diseased persons have been removed "without any purifying or other disinfecting process : Be it enacted, "That whenever the Medical Officer of Health shall certify that the "owner or keeper of any Common Lodging House has received into "such lodging house more lodgers than the same is adapted to contain "with due regard to health, or has suffered them to be crowded together "in an indecent and improper manner, or has allowed persons afflicted "with contagious or infectious disorders to remain therein, or has "received other lodgers into the apartments and beds from which "diseased persons have been removed, without previously purifying or "disinfecting the same, or that the house is unfit for the reception of "lodgers, either from being ill-ventilated or not sufficiently cleansed, or "from any other reason whatever, or that any undue or excessive "sickness or mortality has occurred in such house, and Notice of the "Medical Officer of Health having so certified shall have been given by "the Commissioners to the owner or keeper of such lodging house after "such notice shall have been so given or left as aforesaid to accom"modate or receive any lodgers therein unless and until such house "shall have been registered in a book to be kept by the Commissioners "for that purpose ; and it shall be lawful for the Commissioners from "time to time to fix and determine the number of lodgers who may be "accommodated in each such lodging house, and to make such other "Regulations as they shall think necessary for the preservation of "decency and health, and the names of the keepers of such lodging "houses shall be recorded by the Commissioners in a Register to be "kept for that purpose ; and the Commissioners may order that a ticket "containing the number of lodgers for which the house is registered "and any Rules or Instructions of the Commissioners regarding health, "cleanliness or ventilation, shall be hung up or placed in a conspicuous ''part of each room into which lodgers are received ; and the keepers of "all such lodging houses shall at all times give access to such room "when required by any person appointed by the Commissioners for the "purpose of making an inspection and inquiry, or for the purpose of 57 "introducing, using or performing any disinfecting process which the "Commissioners may order, and the expenses incurred by the Com"missioners in so introducing, using or performing any disinfecting "process shall be recoverable by them in a summary manner from the "owner or person keeping the lodging house in which the same shall "have been so introduced, used or performed ; and if any keeper of such "lodging house shall offend against any of the provisions in this "Enactment contained, or against any of the Regulations made by the "Commissioners from time to time by virtue of this Act, he shall be "liable for each such offence to a penalty not exceeding Five Pounds, "and the like penalty for any day after the first upon which any such "offence shall be continued ; and the expression " Common Lodging "House" shall, for the purposes of this Act, mean any house not being "a Licensed Victualling House, let, or any part of which is let at a daily "or weekly rent not exceeding the rate of Three Shillings and Sixpence "per week, or in which persons are harboured or lodged for hire for a "single night or for less than a week at one time, or in which any room "let for hire is occupied by more than one family at one time." These revised Regulations were formally approved and adopted by the Court of Common Council on the 30th October last, on which date they came into operation. REGULATIONS for the preservation of decency and health, made on the 30th October, 1902, by the Mayor and Commonalty and Citizens of the City of London, pursuant to Section 10 of the City of London Sewers Act, 1851. INTERPRETATION OF TERMS. In these Regulations the following words and expressions have the meanings hereinafter respectively assigned to them; that is to say:— "Common Lodging House" means any house, not being a licensed victualling house, let, or any part of which is let, at a daily or weekly rent not exceeding the rate of 3s. 6d. per week, or in which persons are harboured or lodged for hire for a single night, or for less than a week at one time, or in which any room let for hire is occupied by more than one family at one time. "Keeper" in relation to a Common Lodging House means the person whose name is recorded in the Register kept by the Corporation as owner or Keeper of a Common Lodging House. "The Corporation" means the Mayor and Commonalty and Citizens of the City of London acting as the Common Council of the said City. 58 1.—No Keeper of a Common Lodging House within the City of London shall permit to sleep in any room at any one time a greater number of persons than will admit of the provision of three hundred and fifty cubic feet of free air space for each person of an age exceeding ten years, and of one hundred and seventy-five cubic feet of free air space for each person of an age not exceeding ten years. 2.—Every Keeper shall at all times give access to each room into which lodgers are received when required by any person appointed by the Corporation, for the purpose of making any inspection and enquiry, or for the purpose of introducing, using or performing any disinfecting process which the Corporation may order, and the expenses incurred by the Corporation in so introducing, using, or performing any disinfecting process, shall be recoverable by them in a summary manner from the Keeper in which the same shall have been so introduced, used or performed. 3.—The Keeper shall cause every drain or means of drainage with which any water-closet belonging to such house may communicate to be maintained at all times in good order and efficient action. He shall also cause all such means of ventilation as may be provided in or in connection therewith to be maintained-at all times in good order. 4.—Every Keeper shall cause all solid or liquid filth or refuse to be removed once at least in every day from every room therein which has been let for hire, and shall once at least in every day cause every vessel, utensil, or other receptacle for such filth or refuse to be thoroughly cleansed. 5.—No Keeper shall allow persons of different sexes to occupy the same sleeping room, except in the case of a married couple, or parents with their children under ten years of age, or except any children under ten years of age. 6.—No Keeper shall allow more than one married couple to occupy the same sleeping room, unless the beds are separated by a partition sufficiently high to secure the privacy of each married couple, such partition to be of wood, or other solid material, which shall be so constructed and fixed or placed so as to allow adequate means of access to the bed which such partition is intended to screen, and so as to extend upwards throughout the whole length and breadth of such bed to a sufficient height, above such bed, and downwards to a distance of not more than six inches above the level of the floor. 7.—Every Keeper shall thoroughly cleanse all the rooms, passages, stairs, floors, windows, doors and walls thereof, as often as shall be necessary, and shall also wash or otherwise cleanse all the bedsteads, beds, mattresses or 59 palliasses, pillows, blankets, rugs, covers, sheets, and chamber utensils used in such house as often as shall be necessary to keep the same at all times in a clean and wholesome condition. 8.—Every Common Lodging House shall be provided with separate water-closet accommodation for persons of each sex in the proportion of one water-closet to every twenty authorised lodgers of either sex, and shall cause such water-closets to be kept at all times in a clean and wholesome condition. 9.—Every Common Lodging House shall be furnished with proper and sufficient movable receptacles for containing dust and ashes, and refuse, and such receptacles shall be cleared out and the contents removed from the house and premises daily. 10.—Every Keeper shall cause each room occupied as a sleeping room to be properly furnished with bedsteads and sufficient bedding, and necessary utensils, for the number of persons authorised to be received in such room, and he shall cause every room occupied by single men to be furnished with bedsteads and bedding of a size adapted for one person only. 11.—No Keeper shall permit any room in the basement, or any room the floor of which is below the level of the ground, to be used as a sleeping room. 12.—No Keeper shall permit any kitchen or cellar to be occupied as a sleeping room. 13.—Every Keeper shall, for the separate use of the lodgers of both sexes received into such house, cause to be provided a sufficient number of basins or other receptacles for water, of adequate capacity and suitably placed, and a sufficient supply of water and a sufficient number of towels for use in connection with such basins and receptacles. He shall cause such basins or receptacles to be kept clean and in good order, and the supply of towels to be renewed, from time to time, as often as may be requisite. 14.—The Keeper shall, in the first week of the month of April in every year, cause every part of the premises to be cleansed. He shall, at the same time, except in such cases as are hereinafter specified, cause every area, the interior surface of every ceiling and wall of every watercloset belonging to the premises, and the interior surface of every ceiling and wall of every room, staircase, and passage in the house to be thoroughly lime-washed. Provided that the foregoing requirement with respect to the lime-washing of the internal surface of the walls of rooms, staircases and passages shall not apply in any case where the internal surface of any such wall is painted, or 60 where the material of or with which such surface is constructed or covered is such as to render the lime-washing thereof unsuitable or inexpedient, and where such surface is thoroughly cleansed, and the paint or other covering is renewed, if the renewal thereof be necessary for the purpose of keeping the premises in a cleanly and wholesome condition. 15.— The Keeper shall provide and maintain in good working order all requisite means for the ventilation of the rooms, passages and staircases thereof. 16.—The Keeper shall cause every room therein and every passage and staircase in such house to be thoroughly ventilated daily 17.—The Keeper shall cause the walls and ceilings of every room, and of the staircases, passages, water-closets, cupboards, and out-houses thereof, to be thoroughly cleansed, and where not papered well and sufficiently limewashed at least once in every year. He shall also cause all the inside and outside wood and ironwork which shall have been painted to be well washed with soap and water once (at least) in every year, namely, in the month of April, and all floors, stairs, yards, and areas to be kept well washed and free from dust and dirt. 18.—The Keeper shall, when a person in such house is suffering from any dangerous infectious disease, give immediate notice thereof to the Medical Officer of Health of the City of London. 19.—In every case where, in pursuance of any statutory provision in that behalf, an order of a Justice has been obtained for the removal from a Common Lodging House to a hospital of a person who is suffering from any dangerous infectious disease, the Keeper of such house shall, on being informed of such order, forthwith take all such steps as may be requisite to secure the safe and prompt removal of such person in compliance with such order, and shall in and about such removal adopt all such precautions as, in accordance with any instructions which he may receive from the Medical Officer of Health of the City of London, may be most suitable for the circumstances of the case. 20.—A Keeper shall not cause or suffer any animal to be kept in any room which has been let for hire to, or is occupied by, any lodger, or elsewhere upon the premises in such a manner as to render such room or premises filthy. 21.—The Keeper shall cause a copy of these Regulations to be hung up or placed in a conspicuous part of each room into which lodgers are received. 61 PENALTIES. Any Keeper of a Common Lodging House offending against any of the Regidations made by the Corporation from time to time by virtue of the City of London Sewers Act, 1851, shall be liable for each offence to a penalty not exceeding Five Pounds, and the like penalty for any day after the first upon which any such offence shall be continued. Guildhall (Public Health Department), London, E.C., / 30th October, 1902. Return of Common Lodging Houses within the City of London. Reg. No. Name and Residence of Keeper. Situation op Common Lodging House. Authorised No. of I<odgers. Sex of Lodgers. Date when registered. Name. No. of House. Street or Place. No. of House. Street or Place. 1 1903. Jan. 14 William Benjamin Buller. 3 Vernon Street, King's Cross Road, W.C. 24 New Street, Bishopsgate. 23 M. 2 ,, 14 Ditto - ,, Ditto 25 Ditto 35 M. 3 ,, 19 Colin Young - — F riend's Farm, Great Wakering, Essex. 4 Vine Street, Minories 11 M. FACTORY AND WORKSHOP ACT, 1901. In the last Annual Report attention was called to the great increase of work which must fall upon the Department. In September, 1901, a systematic inspection of workshops and workplaces in the City was initiated on my suggestion in anticipation of the requirements of the Act, which came into force the 1st January of this year, with the result that 745 workrooms were inspected, measured, &c., involving some 1,190 inspections (including re-inspections). Numerous defects of a structural character were discovered, but as these inspections were made at the end of the year, most of the remedial works necessary were effected during 1902, and are embodied in the general summary of the work for the year. 62 Since the beginning of the year the whole work has been reorganised as a distinct Department, this being necessary to prevent overlapping and confusion. This Department now consists of three Inspectors and a Woman Sanitary Inspector, and Inspector W. H. J. Gathercole is responsible to your Medical Officer for its control. I propose shortly bringing up a scheme showing the details of the work and duties of these officers. The Sanitary Committee instructed me to report generally on the Factory and Workshop Act, 1901, which I did as follows:— "This new Act, which came into force on the 1st January, 1902, which "transfers all the powers and obligations of His Majesty's Factory Department, "so far as workshops and workplaces are concerned, to the Corporation as the "Sanitary Authority for the City, will add very largely to the duties and "responsibilities of your Medical Officer of Health and your Sanitary "Inspectors. I should point out that ' workplace ' has a most extended "meaning for the purposes of this Act. It is not defined in the Act, but in "a case under Section 38 of the Public Health (London) Act, 1891, where "the same phrase as in this Act occurs, viz., ' factory, workshop, and "workplace,' it was held that the word is not to be limited to places where "something is being manufactured or made, but includes ' any place where "'work is done permanently, and where people assemble together to do work "'permanently of some kind or other.' It is therefore a word of wider "signification than the word ' workshop.' In the case in question a stable "and stable yard where men were employed as cab cleaners and horsekeepers "was held to be a workplace. Similarly the Secretary of State has been "advised that the kitchens of restaurants, &c., though they are not work"shops, come within the meaning of the term workplace. " In view of the importance of these great changes, I append hereto copies of— " (i.) Letter of Home Secretary. (A, page 67.) " (ii.) Memorandum issued by Home Office : ' Duties of Local Authorities' " (so far as it relates to the City). (B, page 68.) " (iii.) Home Work Order, dated 11th December, 1901. (C, page 77.) " The duties of the Corporation under the Act are :— "Workshops and Workplaces. 1. To see that every workshop and workplace is kept in a cleanly state " and free from nuisance. "2. That it is ventilated in such a manner as to render harmless as far as "practicable from gases, vapours, dust, or other impurities generated "in the course of the work that are a nuisance or injurious to "health. 63 " 3. That there is no overcrowding. The standard is fixed by the Act. " 4. That a reasonable temperature is maintained. " 5. That the water supply is suitable and sufficient. "6. That adequate means are provided for draining floors liable to be wet " in the course of trade. "7. That suitable and sufficient sanitary appliances are provided for the " use of each sex. " 8. That under certain conditions proper means of exit are provided. "9. That children, young persons and women are not improperly employed " therein. "10. That young persons are not improperly employed during the night. "11. That the ' prescribed ' notices are affixed within the workshop. "12. To notify the Borough Councils of the Metropolis and other outside "Districts, of the names and addresses of out-workers residing and "working in their Districts. "13. To notify the District Inspector of Factories when any child, young "person or woman is employed in a workshop in which no abstract "of the Act is posted up. "14. To see that premises occupied by out-workers (where their daily "work is performed) are in fit condition to be occupied, and not "injurious to the health of the workers. "15. To make orders forbidding work to be carried on in any premises "where infectious disease has occurred, until after disinfection or "such time as may be specified. "16. To see that Jews' workshops are not improperly occupied, that is to "say, during every day of the week. "17. To keep a Register of all workshops existing in the City. " Factories. "18. To see that notifications of sanitary defects in factories (received from "His Majesty's Inspector of Factories) are attended to and the "defects remedied. 64 " Bakehouses. "19. To see that no underground bakehouse is used as a bakehouse unless "it was so used at the passing of the Act. "20. To see that bakehouses are not improperly occupied, having regard " to various requirements enumerated in the Act. "21. To see that no sleeping place exists on the same level (or floor) as a "bakehouse, except on certain conditions specified in the Act. "22. To see that the walls and ceilings of bakehouses are lime-washed, "&c., 'at least' twice a year. "23. To very carefully inspect all underground bakehouses, to ascertain their "suitability for that purpose, as regards ' construction, light, venti" 'lation, and in all other respects,' and to certify as to their condition. "24. To see that all unsuitable bakehouses, situated underground, are "discontinued after Januarv 1st, 1904. "For the purposes of their duties with respect to workshops and work"places under the Act, the Corporation and their Officers, without prejudice "to their other powers, have all such powers of entry, inspection, taking "legal proceedings, or otherwise, as His Majesty's Factory Inspector. " In the case of bakehouses, the Medical Officer of Health is invested under " the Act with all the powers possessed by His Majesty's Factory Inspector. "Should the Corporation make default in carrying out the provisions of the "Act with respect to workshops and workplaces, His Majesty's Secretary of "State may authorise His Majesty's Factory Inspector to take any action "which could have been taken by the Corporation, and to recover the costs of "so doing from the Corporation. The Factory Inspector has similar powers "with respect to nuisances in factories, but in this case he is empowered to "act upon his own responsibility. "It will be at once evident that the first step must be the compilation of " the ' Register of Workshops and Workplaces.' "In order to estimate what amount of work this would entail upon your " Staff, the registration was commenced during 1901. "The list of workshops on the books of His Majesty's Inspectors was taken "and copied into special registers, each District being kept distinct. "At present there are 1,452 firms on the list, located as under:— " East District 346 " Middle „ 814 " West „ 292 1,452 65 "This total does not, however, represent the number of rooms to be "inspected and measured, but only the actual number of firms. In the East "District the figures are found to be:— " Number of workshops (firms) - 346 " ,, workrooms found - 494 " being 43 per cent, more than shown on the register. " In the Middle and West Districts the number of workrooms at present inspected is 155 and 96, the excess number of rooms over the number of " firms being 86 and 54 per cent, respectively. "The mean percentage for the three Districts, so far as the work has at " present progressed, being 61. "Applying this figure to the workshops on the register remaining to be " inspected, there will be about 2,292 workrooms at present on the register. "But, as investigation proceeds, it is still further found that there are a "considerable number of workshops in the City which do not appear upon "the Home Office register, while others are constantly being added. "It will not, therefore, be unreasonable to estimate the actual number " of rooms requiring detailed inspection as 2,500. "Again these figures refer to 'workshops' only, and do not include ' work"places.' There are to be added the large number of kitchens attached to "restaurants, &c. "In February, 1897, your Medical Officer of Health reported upon the "restaurants, &c., of the City in considering the question of the Smoke " Nuisance. "He then stated:— " 'There are 614 establishments in which food is cooked for sale,. " 'distributed over the City, and dividing these for convenience of " ' reference over the three Sanitary Districts, we find in the " ' East District 178 " ' Middle „ 290 " ' West „ 146 614 " The prospective number of workshops and workplaces to be inspected " within the City may therefore be estimated to be:— " Workshops (rooms) 2,500 " Workplaces (kitchens, &c.) - 614 " Bakehouses 40 3,154 66 "Although this takes into account only one class of workplace, viz., " kitchens of restaurants, &c., and will have to be largely increased. "At present one inspector only is engaged upon the work, and your "Female Sanitary Inspector, when appointed, will be available for those " workshops where female labour only is employed. "It is important that the preliminary inspection, measurement and "registration should be completed within a reasonable time, say twelve "months, and that thereafter, each workshop should be visited say twice a "year, and each bakehouse say four times a year. "The amount of clerical work in connection with the above will " undoubtedly be large. "It would seem advisable, and even necessary, that in the first instance the "greater part of the clerical work, involving, as it would, expert knowledge, "should be carried out by the Inspectors, though later on it will probably be "found more economical to relieve them so far as practicable of mechanical "details. "In order to give a definite idea of the amount of clerical work, the " following Schedule has been prepared :— " 1. The keeping up of the prescribed ' Register' of workshops. "2. The keeping of the Register of sanitary work done, and nuisances " abated in factories, workshops and workplaces. "3. The preparation and record of notices and certificates under the " Act. "4. The preparation of the Monthly Report of the Medical Officer of " Health to the Sanitary Committee. "5. The examination of lists of "out-workers," and transmitting "names and addresses to Metropolitan Borough Councils and "others outside the City. "6. The keeping up of the Inspector's note books of inspections and " measurements (squaring dimensions, &c.). " 7. Keeping up diaries. "8. Correspondence with the Factory Department respecting nuisances "in factories, &c., and with owners and occupiers of factories "and workshops. 67 "9. Preparing Annual Report of Medical Officer of Health for " Secretary of State on the condition of workshops in the City. "10. Indexing Letter books, Register of workshops, Register of "sanitary work done, Inspector's note books, Diaries, Register "of notices served, &c. "I have therefore to recommend that, in addition to your present Staff, " two Inspectors be appointed, and one Junior Clerk. "This may seem a large addition to the Staff, but it certainly is the "minimum required, if the Act is to be properly and efficiently carried out "within the limits of your jurisdiction." A. " Home Office, Whitehall, " 20th December, 1901. "Sir, "The Act which was passed in the last Session of Parliament to amend and "consolidate the existing Factory and Workshop Acts having made considerable "changes in the duties of Local Authorities with regard to factories, workshops, and "workplaces, the Secretary of State has thought it would be useful if he circulated to "Local Authorities a memorandum showing exactly what their duties will in future be, "and calling attention to the alterations and additions made by the new Act. "Two copies of the memorandum which he has drawn up for the purpose are "accordingly enclosed for the use of the Council and its Officers, and with them copies "of the abstract of the Act which is required to be affixed in workshops, and of the "Order of the Secretary of State on the subject of Home Work, which is referred to in "part (iv.) of the memorandum. " I am, Sir, " Your obedient Servant, " KENELM E. DIGBY. "The Clerk to the Council." 68 HOME OFFICE. B. FACTORY AND WORKSHOP ACT, 1901. DUTIES OF LOCAL AUTHORITIES. ENGLAND AND WALES. The Factory and Workshop Act, 1901, which consolidates with amendments all previous Acts relating to factories and workshops, makes considerable alterations in and additions to the duties of District Councils in regard to factories, workshops and workplaces. The present memorandum describes the duties of District Councils as now extended by that Act. " District Council" includes for the purposes of the Act:— (i.) Councils of municipal boroughs, including county boroughs. (ii.) Councils of urban districts. (iii.) Councils of rural districts. In London, subject to certain exceptions,† " District Council" means the Court of Common Council and the Councils of the Metropolitan Boroughs. District Councils have duties in regard to each class of places named above, factories, workshops and workplaces. It will be useful therefore at the outset to state briefly what is included in these terms by the Act. Definitions. Factories include (1) all places in which mechanical power is used in aid of the manufacturing processes; and (2) all places, whether mechanical power is used or not, in which the industries specified in Part I. of Schedule VI. to the Act are carried on (that is, print works, bleaching and dying works, earthenware works, lucifer match works, percussion cap works, cartridge works, paper staining works, fustian cutting works, blast furnaces, copper mills, iron mills, foundries, metal and india rubber works, paper mills, glass works, tobacco factories, letterpress printing works, bookbinding works, flax scutch mills, electrical stations).* Workshops include:— (1) The places specified in Part II. of Schedule VI. (that is, hat works, ropeworks, bakehouses, lace warehouses, ship-building yards, quarries, pit banks of metalliferous mines, dry cleaning works, carpet beating works, and bottle washing works),* unless mechanical power is used and they are in consequence factories within the meaning of the Act. (2) Any other premises (not being factories in which manual labour is exercised by way of trade or for purposes of gain in or incidental to the making, altering, repairing, ornamenting, finishing or adapting for sale of any article and to or over which the employer of the persons working there has the right of access or control. * The definitions of these places in the schedule should be consulted. † See page 76. 69 (3) Any workplace (termed in the Act "tenement workshop") in which" with the permission of or under agreement with the owner or occupier two or more persons carry on any work which would constitute the workplace a workshop if the persons working therein were in the employment of the owner or occupier." These are included for the first time by the Act of 1901. Previously they were partially or wholly excluded because some or all of the persons working there were not employed but worked on their own account. Instances of tenement workshops are (a) the Sheffield file-cutting shops where file-cutters work on their own account with or without other persons to help them, at stalls hired by them from the owner or occupier of the shop ; (b) journeymen tailors' workshops where journeymen tailors work on their own account, with or without other other person^ to help them, each hiring a separate " sitting " or place to work at from the owner or occupier of the workshop. These will for the future be deemed to be workshops within the meaning of the Factory Act. Laundries* do not come within the definitions o£ "factory" and "workshop" ;but under sec. 103 of the Act they are, so far as sanitation and means of escape from fire are concerned, to be treated as factories if mechanical power is used; if mechanical power is not used, as workshops. Laundries, however, which are worked by inmates of a prison, reformatory school, industrial school or any institution subject to inspection under other Acts or by inmates of a bond fide religious or charitable institution, or by members of the same family dwelling on the premises, are excluded from the Act, if the inmates of the prison, &c., or the members of the family work the laundry by themselves or with the assistance of not more than two persons from outside. Factories and workshops belonging to or in the occupation of the Crown are excluded from the jurisdiction of the District Council, the powers of the Council being exercised in regard to them by the Inspector of Factories (sec. 150). "Workplace" is not defined in the Act, but in a case under sec. 38 of the Public Health (London) Act, 1891, where the same phrase as in this Act occurs, viz., " factory workshop and workplace," it was held that the word is not to be limited to places where something is being manufactured or made, but includes any " place where work is done permanently, and where people assemble together to do work permanently of some kind or other." It is therefore a word of wider signification than the word "workshop." In the case in question a stable and stable yard where men were employed as cab cleaners and horse keepers was held to be a workplace. Similarly the Secretary of State has been advised that the kitchens of restaurants, &c., though they are not workshops, come within the meaning of the term " workplace." Factories. In the case of factories the duties of a District Council are few. The Council is charged with the duty of seeing that every factory in its district is provided with means of escape in case of fire ; and also has special duties in regard to domestic factories and underground bakehouses. These duties, which apply also in the case of workshops, will be further referred to below. Another duty in regard to factories, though not arising under the Factory and Workshop Act, is (in Districts where Part III. of the Public Health Acts Amendment Act, 1890, is in force) the enforcement of the requirement in sec. 22 of that Act as to the provision of suitable and sufficient sanitary conveniences. * Laundries on factory or workshop premises form part of the factory or workshop, and are subject to all the provisions of the Act. Bennett v. Harding, 1900, Q.B. 397. 70 Workshops and Workplaces. In regard to workshops and workplaces, District Councils have important duties, which may bo classified under four heads :(1) the sanitary condition of workshops and workplaces generally; (2) provision of means of escape from fire; (3) special sanitary regulations for bakehouses; (4) homework. Sanitation. (Sees. 2, 3, 7 and 8.) The District Council is made the authority responsible for the sanitary condition of the workshops and workplaces in its district, while the Factory Inspector is responsible for the sanitary condition of factories. "Sanitary conditions" include (a) the cleanliness, (b) air space, (c) ventilation, and (d) drainage of the floors of workshops and workplaces. For these purposes the provisions of sec. 91 of the Public Health Act, 1875, apply and are supplemented by additional provisions in the Factory Act. It should be noted that the other sanitary provisions in Part I. of the Act, viz., with regard to temperature and sanitary conveniences (sees. 6 and 9) are not brought under the law relating to public health, and will therefore be enforced by the Factory Inspectors. The requirements of the Act in the matters above-mentioned which it is the duty of a District Council to enforce are as follows:— (a) Cleanliness (sec. 2).—Every workshop and workplace must be kept in a cleanly state and free from effluvia, and if not so kept may be dealt with by the Council as a nuisance under sec. 91 of the Public Health Act, 1875. If the medical officer of health, or the inspector of nuisances, certifies that it is necessary, for the health of the persons employed that a workshop* or any part of a workshop, should be limewashed, cleansed or purified, the District Council may give notice to the owner or occupier of the workshop to carry out such limewashing, cleansing or purifying as the case may require, within a time specified in the notice. If the person to whom the notice is addressed fails to comply with it in the time specified, he will be liable to a penalty of 10s. for each day during which the default continues, and the Council may themselves undertake the work and recover the expense from him in a summary manner. (a) Air space (sees. 2, 3).—Workshops and workplaces must not be overcrowded while work is carried on so as to be dangerous or injurious to the health of the persons employed, and a workshop or workplace which is overcrowded may be dealt with as a nuisance under sec. 91 of the Public Health Act. A workshop is deemed to be overcrowded unless in each room at least 250f cubic feet of air space (or during overtime 400) are allowed for each person employed in the room, and the Act requires a notice to be affixed in the workshop specifying the number of persons who may be employed in each room of the workshop. (c) Ventilation (sees. 2, 7).—Every workshop and workplace must be ventilated in such a manner as to render harmless as far a practicable any gases, vapours, dust or other impurities generated in the course of the work that are a nuisance or injurious to health. Any workshop or workplace not so ventilated may be dealt with as a nuisance under sec. 91 of the Public Health Act. * In Loudon, this power extends also to domestic factories and to workplaces.—Public Health (London) Act, 1891, sec. 25. †Under sec. 3 (3) of the Act the Secretary of State has power to alter this amount in the case of a workshop, not being a domestic workshop, which is occupied by night as a sleeping apartment. He proposes to make an order increasing the amount in such cases to 400 cubic feet. 71 This general provision is supplemented in the case of workshops by a special requirement introduced for the first time by the Act of 1901, that in every room in a workshop sufficient means of ventilation must be provided and sufficient ventilation maintained, and where a standard of sufficient ventilation has been prescribed by the Secretary of State (as he has now power to do) for any class of workshops, that standard mu?t be observed. Workshops, however, where men only are employed are excluded from the operation of this requirement. Any workshop where this requirement is contravened may be dealt with as a nuisance. In workshops where dust, gas, or other impurities are generated and inhaled by the workers to an injurious extent, the Factory Inspector has power to require the provision of a fan or other mechanical means for preventing such inhalation. If in any case the Council are of opinion that this power could be usefully employed, they should refer it to the Inspector of the district. (d) Drainage of floors (sec. 8).—A provision introduced for the first time by the Act of 1901, requires that in every workshop or part of a workshop in which any process is carried on which renders the floor liable to be wet to such an extent that the wet is capable of being removed by drainage, adequate means shall be provided for draining off the wet. A workshop not so drained may be dealt with as a nuisance under sec. 91 of the Public Health Act. This provision, however, does not apply to workshops in which men only are employed. (e) Sanitary accommodation.—In districts where Part III. of the Public Health Amendment Act, 1890, is in force, every building used as a workshop or manufactory, or where persons are employed or intended to be employed in any trade or business, must be provided with sufficient and suitable accommodation in the way of sanitary conveniences (sec. 22). On a report from their surveyor that this requirement is not observed in the case of any building, the Council may serve a written notice on the owner or occupier requiring him to make such alterations or additions as may be required for the purpose. (iii.) Bakehouses. (Sees. 97-102.) Bakehouses are either factories or workshops within the meaning or the Act according as mechanical power is or is not used in aid of the processes carried on. They are, therefore, subject to the general provisions of the Act; and the same powers will be exercised by District Councils in regard to bakehouses that are exercised by them in regard to factories and workshops. A general power is also given to the Council in the case of any bakehouse which is in such a state as to be, on sanitary grounds, unfit for use or occupation as a bakehouse, to bring the case before a court of summary jurisdiction; and the Court may thereupon impose a fine of 21. (if a first offence) or 51. (if a subsequent offence), and, either in addition to or in lieu of imposing a fine, order means to be adopted for the purpose of removing the ground of complaint. In addition to the general regulations of the Act, special sanitary regulations for bakehouses are contained in the Act. These regulations require that:— (1) A bakehouse must not contain or communicate directly with a water closet, privy or ashpit; a cistern supplying water to a bakehouse must be separate from any cistern supplying water to a water closet; and a sewage pipe or drain must not have any opening in the bakehouse. The penalty for any contravention is a fine not exceeding 21. both on the occupier and on the person letting or suffering the 72 bakehouse to be occupied, and a further fine not exceeding 5s. for each day occupation continues after conviction. (2) All inside walls and ceilings of rooms and all passages and staircases must be limewashed every six months, or coated with three coats of paint or varnish every seven years and washed with hot water and soap every six months; if not, the bakehouse will be deemed not to be kept in conformity with the Act. (3) Places on the same level with a bakehouse, and forming part of the same building, must not be used as sleeping places unless effectually separated from the bakehouse by a partition from floor to ceiling and provided with an external glazed window 9 square feet, of which 4½ feet must be made to open: for a first offence a penalty of 11., and for a second or subsequent offence a penalty of 51. may be imposed both on the person occupying and on the person letting or knowingly suffering the place to be occupied. These regulations will in the case of all retail bakehouses* be enforced by the District Council; a "retail bakehouse" meaning any bakehouse or place in which no mechanical power is used and the bread, biscuits, or confectionery baked in which are sold not wholesale, but by retail, in some shop or place occupied with the bakehouse. The medical officer of health is, for the purpose, given all the powers of entry, inspection, taking legal proceedings, and otherwise of a Factory Inspector. Further, new duties of great importance are placed by sec. 101 of the Act on District Councils in regard to underground bakehouses:— (i) The Act provides generally that no underground bakehouse shall be used as such unless it was so used on the 17th August last; this provision it will be the duty of the Council to enforce in the case of retail bakehouses.* (ii) Moreover, after 1st January, 1904—that is, after a period of two years from the coming into force of the Act—it will not be lawful to use any underground bakehouse (whenever established) unless the Council are satisfied that it is suitable for the purpose in regard to construction, light, ventilation, and in all other respects, and have given it a certificate of suitability. This provision will apply to all bakehouses, whether wholesale or retail. Every bakehouse will be deemed an underground bakehouse if any room used for baking or for any process incidental thereto, is so situate that the surface of the floor is more than 3 feet below the surface of the footway of the adjoining street, or of the ground adjoining or nearest to the room. An underground bakehouse used in contravention of these provisions will be deemed to be a workshop not kept in conformity with the Act. (iv.) Home Work. (Sees. 107-115.) Very important powers of controlling the conditions under which certain classes of work are done in the homes of the workers are for the first time given to District Councils by the Act of 1901. These powers aim at the prevention of home work being done (1) in dwellings which are injurious or dangerous to the health of the workers themselves, e.g., through overcrowding, want of ventilation, or other insanitary conditions ; (2) in premises where there is dangerous infectious disease. * In London these provisions will be enforced by the Borough Councils in every bakehouse (whether retail or not) which is a workshop.—Public Health (London) Act, 1891, sec. 26. 73 The provisions of the Act are as follows:— (1) Unwholesome dwellings.—If any place in which home work is being done in connection with the business of a factory or workshop is injurious or dangerous to the health of the persons working there, the Council may, by notice to the occupier of the factory or workshop, or to any contractor employed by such occupier, prohibit him from giving out work to be done in that place. The power may be exercised also in the case of work given out from places other than factories or workshops, e.g., laundries, warehouses, shops, &c. The power does not apply to all classes of home work, but only to those which may be specified by orders of the Secretary of State. The classes of work in regard to which the power may be exercised by the Council have been fixed as follows:— The making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel, and any work incidental thereto. The making, ornamenting, mending, and finishing of lace, and of lace curtainsand nets ; Cabinet and furniture making, and upholstery work ; The making of electro-plate ; The making of tiles ; and Fur-pulling. (2) Infected dwellings.—If any inmate of a house in which home work is done is suffering from any infectious disease which is required by law to be notified to the local authority, the Council may, whether such inmate has been removed from the house or not, by order served on the occupier of any factory, workshop, or other place from which work is given out, or on any contractor employed by such occupier, prohibit him from giving out such work to any person living or working in the house during such time as the Council may fix. In an emergency, the power may be exercised by any two or more members of the Council acting on the advice of the Medical Officer of Health. This power, like the last, does not apply to all classes of work, but only to such as the Secretarv of State may fix. The classes of work in regard to which the power may be exercised have been fixed as follows :— The making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel, and any work incidental thereto ; The making, ornamenting, mending, and finishing of lace, and of lace curtains and nets ; Upholstery work ; and Fur-pulling. In order that the Council may be kept fully informed as to the places in its district in which home work is being done, occupiers of factories, workshops, or any place from which work is given out, and contractors employed by such occupiers are required, in regard to such classes of work as may be fixed by the Secretary of State, to keep lists showing the names and addresses of all persons employed by them, either as workmen or as contractors outside such factory, workshop or place, and the place where they are employed, and to send to the Council twice a year (viz., on or before the 1st February and the 1st August) copies of such lists. 74 In the event of any occupier failing to keep or to send such lists he will be liable to a fine of 21. for the first offence, and to a fine of 51. for a second or subsequent offence. Proceedings to recover the fine may be taken by the Council. It will be the duty of the Council to have the lists so sent to them examined, and if the place of employment of any outworker included in the list is in another district, to furnish his name and place of employment to the Council of that district. The list required to be kept by the occupier or contractor will be open to inspection by any duly authorised officer of the Council ; and the copies sent to the Council, and any particulars furnished to it by another Council, will be open to inspection by any of the Inspectors of Factories and Workshops. The classes of work to which these provisions apply have been fixed by the Secretary of State so as to include all those which have been fixed by him in regard to (1) and (2) above, as follows :— The making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel and any work incidental theret ; The making, ornamenting, mending, and finishing of lace, and of laco curtains and nets; Cabinet and furniture making, and upholstery work; The making of electro-plate; The making of files; and Fur-pulling. Domestic Factories and Workshops. In some cases it will be found that dwellings in which home work is done will constitute a factory or workshop, in consequence of the employment by the occupier of the dwelling, or some part of it, of persons on work which comes within the definitions in the Act. Such places will be subject to the ordinary provisions of the Act with regard to factories and workshops. An important exception, however, is made for dwellings in which no mechanical power is used and the only persons employed are members of the same family dwelling there. These places (termed in the Act "Domestic Factories" and "Domestic Workshops") are exempted from many of the provisions of the Act.* Domestic Factories are exempted from the provisions in the Act as to the sanitation of factories, and are made subject only, so far as sanitary conditions are concerned, to the provisibns in sec. 2 (1) and sec. 3 ; i.e., if not kept in a cleanly state, or not ventilated in such a manner as to render harmless, as far as practicable, any gases, vapours, dust or other impurities generated in the course of the work that are a nuisance or injurious to health, or so overcrowded while work is carried on as to be dangerous or injurious to the health of the workers, it is liable to be dealt with as a nuisance under sec. 91 of the Public Health Act, 1875. A domestic factory will, for the purpose of this provision, be deemed to be overcrowded unless in each room at least 250 cubic feet of air-space (or during overtime 400) are allowed for each person employed in the room. These provisions will be enforced by the District Council. Domestic workshops are exempted from the special provisions as to means of ventilation and the drainage of floors, but are otherwise, so far as sanitary conditions are concerned, to be treated as ordinary workshops.t *The only classes of factories which can come within the definition of "Domestic Factory" are those specified in Part 1. of the Sixth Schedule to the Act. See page 68. † Domestic workshops in which the work is only done at irregular intervals and does not furnish the whole or principal means of living to the family, or in which certain classes of work of a light character (viz., straw plaiting, pillow-lace making and glove making) are carried on are wholly exempt, except so far as they come within the term " workplace." See sec. 114. 75 Any domestic factory and workshop, however, in which any work is carried on that has been certified by the Secretary of State as dangerous, is subject to all the provisions of the Act as though it were an ordinary factory or workshop. Administration. Powers of District Council.—For the purpose of their duties with respect to workshops and workplaces under the Act, and under the Public Health Acts, the District Council and their officers are given the same powers of entry, inspection, taking legal proceedings, or otherwise as a Factory Inspector possesses. These powers in the case of workplaces are given for the first time by the Act of 1901. The powers of an Inspector are contained in sec. 119 of the Act, and include the power to enter, inspect, and examine, to take a constable in cases in which there is reason to apprehend any serious obstruction, to examine the persons found therein, to require the production of documents, &c. In cases where proceedings are taken under the Factory Act, and not under the Public Health Acts, special attention should be paid to the provisions of sec. 146 of the Act with respect to legal proceedings. Register of Worksliops.—The Act places a new duty on every District Council to keep a register of all workshops situate within its district (sec. 131.) To assist the Council in preparing such a register, instructions have been given to the Factory Inspectors to allow the District Council to make copies of the register of workshops kept by the Inspector, and the Council will also continue to receive (sec. 127) from the Inspector any notices of occupation of a workshop which may be sent to him. The Council should not, however, depend exclusively on these sources of information for compiling their register, but should take steps, through their own officers, to ascertain what workshops are situate in their district, with a view to making the register as complete as possible. Duties of Medical Officer of Health.—Under sec. 132 of the Act, the Council's Medical Officer of Health is required for the future in his annual report to the Council lo report specifically on the administration of the Act in workshops and workplaces so far as the matters under the charge of the Council are concerned, and to send a copy of his report on the subject to the Secretary of State. The matters which the report should specially deal with will be the provisions as to sanitation, bakehouses, and homework. It is also the duty of the Medical Officer, if he finds any woman, young person, or child employed in a workshop in which no abstract of the Act is posted up, to inform the District Inspector of Factories in writing. Matters referred to Council by Factory Inspectors.—The Factory Inspector will, on finding in a factory or workshop any act, neglect, or default in relation to a drain, water-closet, earth-closet, privy, ash-pit, water supply, nuisance, or other matter which is punishable or remediable under the Public Health Acts but not under the Factory Act, give notice to the Council of such Act, &c.; and it will then be the duty of the Council to make enquiry into the matter, take such action as may seem proper, and inform the Inspector of the proceedings taken. If proceedings are not taken by the Council within one month, the Inspector is authorised to take the same proceedings as the Council might have taken, and to recover from the Council the expenses incurred by him which have not been recovered from any other person, and have not been incurred in any unsuccessful proceedings (sec. 5). 76 The Inspector may take similar action for the purpose of enforcing in a factory or workshop the provision of means of escape in case of fire. In the event of a District Council failing generally to carry out the provisions of the Act and the Public Health Acts with regard to factories, workshops, and workplaces, the Secretary of State may authorise a Factory Inspector during such time as he may fix to enforce those provisions. An Inspector so authorised will be entitled to recover from the Council any expenses incurred by him which are not recovered from any other person (sec. 4). General.— It is provided that the powers conferred by the Act on district councils shall be in addition to and not in substitution for any other power which they may possess. Application in London. The duties of District Councils as described above will be discharged in London by the Metropolitan Borough Councils, and, in the City, by the Court of Common Council, with the following exceptions:— (1.) The duties in regard to the provision of means of escape in case of fire will be discharged by the London County Council. (2.) For the references to sec. 91 of the Public Health Act, 1875, should be substituted references to sec. 2 of the Public Health (London) Act, 1891. (3.) For the references on pp. 69 and 71 to sec. 22 of the Public Health Acts Amendment Act, 1900, should be substituted a reference to sec. 38 of the Public Health (London) Act, 1891, which applies throughout the County of London, and requires that every factory, workshop, or workplace shall be provided with sufficient and suitable accommodation in the way of sanitary conveniences. The Metropolitan Borough Councils are charged with the duty of enforcing this provision. (4.) The Metropolitan Borough Councils have special powers under secs. 25 and 26 of the Public Health (London) Act, 1891. See notes on pp. 70, 72 and 74 above. 77 C. STATUTORY RULES AND ORDERS, 1901. No. 983. FACTORY AND WORKSHOP Home Work. The Home Work Order of 11th December, 1901. In pursuance of the powers conferred on me by Sections 107, 108, and 13 0 of the Factory and Workshop Act, 1901, I hereby make the following Order:— I. Section 107 (relating to lists of out-workers) and Section 108 (relating to employment in unwholesome premises) shall apply to the following classes of work:— The making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel, and any work incidental thereto; The making, ornamenting, mending, and finishing of lace, and of lace curtains and nets; Cabinet and furniture making, and upholstery work; The making of electro-plate; The making of files; and Fur-pulling. II. Section 110 (relating to the prohibition of home work in places where there is infectious disease) shall apply to the following classes of work:— The making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel, and any work incidental thereto (as in the said section specified); The making, ornamenting, mending, and finishing of lace, and of lace curtain and nets; Upholstery work; and Fur-pulling. III. The lists of out-workers required to be kept by Section 107 and the copies thereof shall be kept and made in the form and manner and with the particulars shown in the Schedule hereto. The Order of 23rd March, 1898, relating to lists of out-workers is hereby revoked. This Order may be referred to as the Home Work Order of 11th December, 1901, and shall come into force on 1st January, 1902. Chas. T. Ritchie, One of His Majesty's Principal Secretaries of State. Home Office, Whitehall, 11th December, 1901. 78 Schedule. List of Out-Workers. A correct list of out-workers employed in the following classes of work— (a) Making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel, and any work incidental thereto; (b) Making, ornamenting, mending, and finishing of lace, and of lace curtains and nets; (c) Cabinet and furniture making, and upholstery work; (d) Making of electro-plate; (e) Making of files; (f) Fur-pulling; must be kept in the form and with the particulars specified below in the factory or workshop or place from which the work is given out, and must be open to inspection by H.M. Inspectors and the officers of the local authority; and a copy of the list signed and dated and corrected up to that date must be forwarded to the local authority of the district on or before the first day of February and the first day of August in each year. In order that the list may be correct, the name of any person newly taken into employment should be immediately entered, and the name of any person ceasing to be employed should be immediately struck out. Factory, Workshop, or place from which the work is given out. Full Postal Address Business Name of Occupier List of Persons directly employed by (a) W in the business of, but outside the above Factory, Workshop, or Place, in the classes of work specified above. (а) Give name of employer. (b) Say whether the occupier or a contractor employed by the occupier. Name in full. (1.) Whether employed as Workman (W) or Contractor (C). (2) Place of Employment, i.e., place where the work is actually done. (3.) Address. [No entry need be made in this column if the entry in column (3) it a sufficient address], (4.) 79 This Report was approved by the Court of Common Council, and the two additional Inspectors and a Clerk were appointed in November, 1902. Although, owing to the exigencies of the Department generally, their whole time has not been devoted to the work for which they were specially engaged, I am trusting to be able to remedy this defect during the coming year, recognising that the best results can only be obtained by a rigid continuity of action. Much time has been occupied in the preparation of books, forms and tables, to enable a proper record of the work of inspection to be kept, a very necessary measure, and more especially so, as a copy of your Medical Officer's Annual Report on the working of the Act is required to be sent year by year to H.M. Factory Department. WORKSHOPS. Speaking generally, the defects needing remedy in Workshops are as follow:— (a) Want of cleansing. (b) Insufficient ventilation. (c) Overcrowding. (e) The need for separate and suitable water-closet accommodation for each sex. The Act does not require convenience for personal ablution to be provided, but in a number of instances this has been done on my advice. The question of the temperature to be maintained in workshops appears to rest with the Factory Inspector, and it is greatly to be hoped that a definite standard, so far as is possible, be fixed in the near future. The question of efficient and continuous ventilation is an all-important factor, and one which will have to be dealt with if healthy conditions are to be maintained in workshops. So long as the simple expedient of opening doors and windows has to be resorted to when fresh air is needed, little improvement can be expected, and some inexpensive system of ventilation which would obviate the danger of draughts, &c., should be compulsory. Electricity, both for heating and ventilation, may be expected to play an important part in this connection in the near future. BAKEHOUSES. The Bakehouses within the City (which are "Workshops" under the Act) have been duly inspected and found in fair condition generally, as regards cleanliness, &c. 80 Local Authorities have for many years past possessed extensive powers with regard to the sanitary condition of bakehouses, but these powers are still further increased by the Factory and Workshop Act, 1901 (section 101), which enacts that "After the 1st day of January, 1904, an underground bakehouse "shall not be used as a bakehouse unless certified by the Local "Authority to be suitable as regards construction, light, ventilation, "and in all other respects." The evident intention of the Act is to abolish underground bakehouses, and if any are to be allowed to remain, it is obvious that the most hygienic conditions can be insisted upon before such an enabling Certificate is granted. Of the 44 bakehouses existing, 36 are "underground bakehouses," that is to say, the floor is more than 3 ft. below the surface of the ground adjacent (see Diagram, page 84). Inasmuch, however, as the Certificate must be obtained by the 31st December, 1903, and a large amount of capital is invested in some of these premises, it seemed only reasonable that the owners should have due notice of the probable requirements some time in advance to enable them to be in a position to decide upon their course of action. Notices were therefore issued early in the year, upon my advice, and with the sanction of the Sanitary Committee, to all bakehouse owners calling their attention to the law, and requesting such as were desirous of continuing the use of their premises, to make written application to the Corporation upon forms specially prepared for the purpose, accompanied by plans and sections showing the construction and means of lighting and ventilation, &c., of the bakehouse for which a Certificate was desired. The following is a copy of the Notice, &c., issued:— Corporation of London NOTICE Re UNDERGROUND BAKEHOUSES. To of or other the owner or occupier of the Underground Bakehouse situate No. Under Section 101 of the Factory and Workshop Act, 1901 (see next page), an Underground Bakehouse may not be occupied as such in the City of London after January 1st, 1904, unless certified by the Corporation of London to be suitable for the purpose. 81 It is therefore requested that all persons desirous of continuing the use of such Bakehouses, will make application to the Corporation of London, addressed to me, upon the Forms attached, accompanied by Plans and Sections, to a scale of not less than 8 ft. to an inch, showing the construction, means of light and ventilation, and also the means of drainage of the Bakehouse, and of any premises connected therewith. By Order, Town Clerk. Guildhall, E.C. June, 1902. FACTORY AND WORKSHOP ACT, 1901. Section 101, relating to Underground Bakehouses. Prohibition of Underground Bakehouses. "101. (1) An Underground Bakehouse shall not be used as a Bakehouse "unless it was so used at the passing of this Act. "(2) Subject to the foregoing provision, after the First day of January, "One thousand nine hundred and four, an Underground Bakehouse shall "not be used unless certified by the District Council to be suitable for that "purpose. "(3) For the purpose of this Section an Underground Bakehouse "shall mean a Bakehouse, any baking room of which is so situate "that the surface of the floor is more than 3 feet below the surface "of the footway of the adjoining street, or of the ground adjoining or "nearest to the room. The expression 'baking room' means any "room used for baking, or for any process incidental thereto. "(4) An Underground Bakehouse shall not be certified as suitable unless "the District Council is satisfied that it is suitable as regards construction, "light, ventilation, and in all other respects. "(5) This Section shall have effect as if it were included among the "provisions relating to Bakehouses which are referred to in Section 26 of the "Public Health (London) Act, 1891. "(6) If any place is used in contravention of this Section, it shall be "deemed to be a workshop not kept in conformity with this Act. "(7) In the event of the refusal of a Certificate by the District Council, "the occupier of the Bakehouse may, within twenty-one days from the refusal, "by complaint apply to a Court of Summary Jurisdiction, and if it appears "to the satisfaction of the Court that the Bakehouse is suitable for use as "regards construction, light, ventilation, and in all other respects, the Court 54 and 55 Vict., c. 76. 82 "shall thereupon grant a Certificate of suitability of the Bakehouse, which "shall have effect as if granted by the District Council. "(8) Where any place has been let as a Bakehouse, and the Certificate "required by this Section cannot be obtained unless structural alterations are "made, and the occupier alleges that the whole or part of the expenses of "the alterations ought to be borne by the owner, he may by complaint apply "to a Court of Summary Jurisdiction, and that Court may make such order "concerning the expenses or their apportionment as appears to the Court to "be just and equitable, under the circumstances of the case, regard being had "to the terms of any contract between the parties, or in the alternative the "Court may, at the request of the occupier, determine the lease." Application for Certificate. To the Town Clerk, Public Health Department, Guildhall, E.C. Sir, Be Underground Bakehouse.—No I am desirous of obtaining the Certificate of the Corporation of London, under Clause 101 of the Factory and Workshop Act, 1901, and for that purpose beg to forward herewith the particulars required, together with plans and sections of the Bakehouse, &c. My interest in the property is as follows:—* I am, Sir, Your obedient Servant, * Give particulars of ownership generally. Particulars to accompany Application for Certificate in respect of the Underground Bakehouse situate No. 1. Surfaces. How finished? (a) Floors; (6) Walls; (c) Ceilings. 2. Is floor laid to proper falls for drainage? Describe method adopted. 3. Describe openings to drain in Bakehouse, if any. (a) Inspection Chambers, and how covered; (b) Gullies; (c) Other drain openings in Bakehouse, or premises connected therewith. 4. Has Bakehouse been flooded at any time ? If so, state cause, if known. 5. Number of Sinks in Bakehouse, and whether waste pipes are " disconnected," and how. 83 6. Number of Water-closets for—(a) Males; (b) Females, and where situated. 7. Height of Bakehouse—(a) From floor to ceiling; (/») Depth of floor below surface of footway or ground adjoining. 8. How is Bakehouse lighted ? (a) No. of windows, their size and situation ; (b) No. of pavement lights, their size and situation; (c) No. of pavement gratings; (d) Openings in stall board, number and size; (e) Floor lights, number and size; (f) Other lights, number and size; (g) What artificial light is used. 9. How is Bakehouse ventilated? (a) Windows. No. and situation; (b) No. of gratings in footway; (c) Openings in stall board. Describe; (d) No. of chimney flues. Describe; (e) Flues or shafts other than chimney flues. Describe; (f) Is any mechanical means of ventilation employed ? If so, give description. 10. Receptacles for refuse, number and description. 11. Number of dough troughs, material, and if provided with covers, and whether fixed or supported on wheels. 12. Number of benches, and whether fixed or on wheels. 13. Situation of storage cistern and draw-off tap for Bakehouse use. 14. Number of Ovens. (a) Brick; (b) Gas; (c) Other ovens. 15. Ventilation of Ovens, (a) Does proper outlet for sulphur fumes exist ? (b) Does outlet for heat and steam exist at face of oven door ? 16. Is provision made for carrying off fumes of coal gas, when this is employed in the baking process ? 17. Is there a flour room or store for flour in connection with the Bakehouse? If so, give description; if not, where is flour stored ? 18. Number of persons employed; (a) Males; (b) Females. Describe hours of work for both sexes, and whether day and night shifts are employed. Signature of Occupier i\ or "Owner" Date In response to the Notice issued 26 applications have been already received, and in a number of cases owners' surveyors have met your Medical Officer of Health at the premises and discussed the details of the work necessary to be done, which will in due course be submitted to the Sanitary Committee for their consideration. I may here state that the Committee have decided upon a general course of action, but have at the same time determined to deal with each case upon its merits. 84 The following is a list of the Bakehouses in existence, in the City, during 1902:— Ref. No. in Diagram. Situation. No. of Bakehouses. 1 188, Aldersgate Street 1 2 26, Aldgate High Street 1 3 107, Bishopsgate Street Within 1 4 81, ditto Without 1 5 90, ditto ditto 1 6 59 to 61, ditto ditto 4 7 113, ditto ditto 1 8 4, Broadway 1 9 95, Cannon Street 1 10 8, Copthall Avenue 1 11 15, Cornhill 1 12 15, Duke Street 1 13 28, Fore Street 1 14 85, ditto 1 15 67, Farringdon Street 1 16 88, ditto 1 17 93, Fetter Lane 1 18 12, Gracechurch Street 1 19 9 and 10, Hart Street 1 20 21, Holborn 1 21 48, Knightrider Street 1 22 8, Lambeth Hill 1 23 18, Long Lane 1 24 16, Ludgate Hill 1 25 37, Middlesex Street 1 26 61, ditto 1 27 63, ditto 1 28 85, ditto 1 29 28, New Broad Street 1 30 31, Newbury Street 1 31 3, Pancras Lane 1 32 5, Sparrow Corner 1 33 7, ditto 1 34 21 (late 10), Stoney Lane 1 35 68, St. Mary Axe 1 36 112, Shoe Lane 1 37 75, St. Paul's Churchyard 1 38 194, Upper Thames Street 1 39 13, Widegate Street 1 40 31, ditto 1 41 5, Whitefriars Street 1 Total number of Bakehouses existing 44 The Bakehouse at the following premises has ceased to be used as such:— 25, Warwick Lane. City of London. 1902. BAKEHOUSES. Diagrams shewing positions of floor & ceiling with; respect to the footway level. N0TE. Am Underground Bakehouse is defined by Sec. 101 of the Factory & Workshop Act 1901. The dotted line A---A indicates the "3 feet limit "below footway, &c. The/ floor of any Bakehouse below this line is therefore an underground Bakehouse under the Act. † See list of Bakehouses page 4. No. of Underground Batcehouses 36 „ „ Bakehouses above ground 8 Total 44. 85 KITCHENS OF RESTAURANTS. The obligation to inspect kitchens is derived from the Public Health (London) Act, 1891 (in conjunction with the Factory and Workshop Act, 1901), which requires all Local Authorities to satisfy themselves as to the sanitary condition of workplaces within their Districts, and a detailed inspection of these places was commenced early in the year. The principal objects of investigation are as follow:— (a) To ascertain as to the position of the kitchen ; the condition of the floor, walls and ceiling ; ventilation, &c. (b) The number of workers employed (male and female). (c) W.C. accommodation provided. (d) The condition of the sinks, &c. (e) The cooking process employed. (f) The cubic contents of the kitchen, to detect overcrowding. The principal defects detected relate to:— (a) Insufficient ventilation. (b) Defective W.C. accommodation. (c) Insufficient and unsuitable W.C. accommodation. (d) Dirty walls and ceilings, cisterns, &c., &c. Out of a total of 155 kitchens inspected, 76 were found to be situated in the basement. This is a serious defect, and one which I am glad to observe is not being repeated in modern structures, in which the kitchen is almost invariably placed upon the top floor. The difficulties of efficiently ventilating an underground kitchen are obvious, and the day is probably not far distant when they will be placed upon the same footing as underground bakehouses, and have to receive a similar certificate of suitability. In numerous cases the ventilation is partially obtained by means of open gratings at the surface of the footway pavement, indeed in some instances little else can be had. The most serious defect in this system is that mud and filth is allowed to fall into the kitchens, but this has been obviated in many cases by the provision of moveable trays placed immediately beneath the openings. In this connection one must be ready to admit that the conditions prevailing with respect to the carriage and footway pavements in the City, which are so frequently cleansed, reduces the opportunity for mud, &c., falling through the open gratings to a minimum. 86 In a large number of cases the W.C. accommodation was in a very defective condition : in 26 cases the W.C. either opened or ventilated directly into the kitchen. In one case the lobby of the W.C. was found to be used for the storage of meat, and in all cases where the W.C. opened directly into the kitchen a similar condition, of course, obtained, though not in so marked a degree. In a number of instances hoods have been fixed over gas stoves and led into a flue for ventilation. In 18 of the kitchens inspected, gas only was used in the process of cooking; and where it is possible to use gas only it is advisable, and would most effectively assist in dealing with the smoke problem. As a very special interest attaches to the condition of the kitchens of Restaurants, &c., the following table of defects, &c., found on inspection, is added: — WORKPLACES (KITCHENS OF RESTAURANTS). Details. Totals. Number of kitchens inspected 155 Kitchens on top floor 30 Kitchens in basement 76 Gas only used for cooking 18 Licensed to sell Beer, Wines, &c. 64 Workers employed:—Male 497 „ „ Female 693 Kitchens badly ventilated 3 Walls and ceiling dirty 45 Floor defective 20 W.C's opening or ventilating into kitchen 26 W.C's without ventilation, or insufficiently ventilated 12 W.C's without light 13 W.C's used by both sexes 13 W.C's provided for use of Customers:—Male 5 „ „ „ „ Female 5 W.C. pans dirty 24 Interior of W.C's dirty 6 Flushing apparatus to W.C's out of order 7 Doors of W.C's defective 5 Seats of W.C's defective 2 Drains defective 9 Sinks defective 29 Cisterns not covered 18 Cisterns needing cleansing 22 Receptacles for refuse defective 39 87 DEFECTS IN FACTORIES AND WORKSHOPS NOTIFIED BY H.M. INSPECTOR OF FACTORIES. The following are the particulars of defects found in factories and workshops, and reported by H.M. Inspectors; also the steps taken by my Department to effect improvement. Fifty-four cases were thus notified in the course of the year, as compared with fifty-one cases in 1901, forty-nine in 1900, fifty-five in 1899, sixty-five in 1898, and thirty-four in 1897, distributed as under:— Situation of Premises. Result of action taken. 23, Middle Street Walls and ceilings of workshops cleansed and whitewashed. 3-4, Friday Street Walls and ceilings of workshops and the staircase approaches cleansed and whitewashed; leakage from w.c. pan remedied. 17, Playhouse Yard Premises not in the City. (Referred to District Medical Officer of Health.) 9, Botolph Alley, Eastcheap Walls and ceiling of workshop cleansed and whitewashed; plastering, &c., amended. 24, Rood Lane Walls and ceiling of workshop cleansed and whitewashed. 14, Aldgate Avenue Walls and ceiling of workshop cleansed and whitewashed ; plastering repaired. 9, Noble Street Additional w.o. provided for women. 16, Carthusian Street Additional w.c. provided for women. 18 and 19, Whitefriars Street w.c. on second floor allotted for use of women. 12 to 16, Maidenhead Court Refuse removed from workshop ; separate w.o. accommodation provided for men and women. 37, Bartholomew Close Staircase approaches to workshop cleansed. 5, Church Row, Aldgate Walls and ceilings of workshops cleansed and whitewashed. 25 to 28, Beech Street Walls and ceiling of workshop cleansed and whitewashed. 86, Beech Street Walls and ceiling of workshop cleansed and whitewashed. 75a, Little Britain Floor and wall of w.c. in yard repaired. 65, Finsbury Pavement Screens provided in connection with w.c's for men and women. 5, Jewin Street Workshop discontinued to be used as such after notice served. 3, White Street, Houndsditch Staircase approach to workshop improved. 13, Little Britain Walls and ceiling of workshop cleansed and whitewashed and w.c's shut off from workshop. 53, Fann Street Premises not within the City. (Referred to District Medical Officer of Health.) 22 to 24, Maidenhead Court Separate w.c. accommodation provided for men and women. 8c, Aldgate Avenue Nuisance from overcrowding abated. 21, Middlesex Street Nuisance from overcrowding abated. 37, Mansell Street Walls and ceilings of workshops cleansed and whitewashed. 14, Stoney Lane Lock provided to door of w.c. used by women and the apartment cleansed. 88 Situation of Premises. Result of action taken. 30, Beech Street Premises outside City. (Referred to District Medical Officer of Health.) 14, Aldgate Avenue Water supply to w.c. pans amended. 24, Maidenhead Court Refuse removed from staircase and water supply to w.c. used by females improved. 7a, South Place Notice served in respect of w.c. accommodation for men. 1, Aldgate Avenue Walls and ceiling of workshop cleansed and whitewashed. 26, Camomile Street Walls and ceilings of workshops and staircase approaches thereto cleansed and whitewashed, and w.c. accommodation improved. 29, Middlesex Street Walls and ceiling of workshop cleansed and whitewashed. 3, Exchange Buildings Nuisance from overcrowding abated. 12a, Aldgate Avenue Walls and ceiling of workshop cleansed, repaired and whitewashed. 3, Pilgrim Street Walls and ceilings of workshops and staircase approaches thereto cleansed and whitewashed, drain relaid, and w.c. accommodation improved. 10, Kinghorn Street Walls and ceiling of workshop cleansed and whitewashed ; separate w.c. accommodation provided for women. 38, Bartholomew Close Nuisance from dampness of workshop wall (basement) abated and w.c. pan cleansed. 43, Moorgate Street w.c. accommodation provided for men. 19, Hamsell Street w.c. accommodation for women shut off from workshop— lobby formed. 22, Coleman Street Walls and ceilings of workshops cleansed and whitewashed. 13, Chapel Street w.c's cleansed and shut off from workshop—lobby formed. 14, Lovell's Court Walls and ceiling of workshop cleansed and whitewashed and nuisance from defective waste-pipe abated. 24, Mitre Street Separate w.c. accommodation provided for both sexes ; one w.o. shut off from workroom—lobby formed. 21, Australian Avenue w.c. accommodation found to be sufficient. 25, Paper Street Walls and ceilings of workrooms cleansed and whitewashed. 38, Barbican w.o. pans cleansed and notice served with respect to the unsuitability of w.c. accommodation for the sexes. 23, Ivy Lane Separate w.c. accommodation to be provided for women —notice served. 49, Aldermanbury Walls and ceiling of workshop cleansed and whitewashed. 64, Fore Street Walls and ceilings of workshops, &c., cleansed and whitewashed ; cistern cleansed and w.c. in basement shut off from workroom—lobby formed. 18, Queenhithe Separate W.C. accommodation to be provided for women—notice served. 29, Middlesex Street Cleansing of workroom not insisted on, as workroom will shortly cease to be used as such. 21 and 23, Middlesex Street Nuisance from overcrowding abated. Playhouse Yard Premises not within the City. (Referred to District Medical Officer of Health.) 6 and 7, Redcross Street Separate w.c. accommodation to be provided for women— notice served. On investigating the complaints of the Factory Inspector, defects other than those notified have been remedied when necessary ; the additional defects found included:—(1) w.c's opening directly into workshops, &c. (2) Gas stoves, &c., not ventilated. 89 OUTWORKERS EMPLOYED IN THE CITY. The following is a list of premises where Outworkers are employed, viz.:— Premises. Trade. Workers. Total Workers. M. F. 7, Aldgate Avenue Tailor 3 8 11 9, Aldgate Avenue Tailor 6 8 14 16, Aldgate Avenue (1st floor) Tailor 8 4 12 Ditto (2nd floor) Tailor 12 3 15 Ditto (3rd floor) Embroidery 1 1 2 8, Aldgate High Street Tailor 2 ... 2 20, Australian Avenue Mantles 1 3 4 21, Castle Street, Falcon Square (3rd floor) Mantles ... 7 7 Ditto ditto (4th floor) Furs ... 2 2 8, Ellison Street Tailor 1 ... 1 9, Ellison Street Tailor 1 ... 1 92, Minories Tailor 2 6 8 6, Red Lion Passage, Cloth Fair Furs ... 2 2 3, White Street, Houndsditch Tailor 4 ... 4 4, Bartholomew Close Skirts ... 1 1 30a, Threadneedle Street Children's Clothing ... 1 1 2, Bridgewater House, Fann Street Tailor ... 3 3 Totals 41 49 90 Of the 17 Workshops, as above, 4 were discovered by your Woman Inspector, 2 by the District Inspectors, and 11 were notified in the usual manner. 90 DOMESTIC WORKSHOPS AND FACTORIES. Up to the present only two Domestic Workshops in the City have come under the notice of my Department, as follows:— Premises. Trade. Workers. Total Workers. M. F. 5, Artillery Lane Breeches 1 1 2 2, Bridgewater House Waistcoats ... 1 1 Totals 1 2 3 It may be of interest to mention that "Domestic Workshops" and "Domestic Factories" are places in which no mechanical power is used, and in which the only persons employed are members of the same family dwelling there ; but when work is done only at irregular intervals, and does not furnish the whole or the principal means of living to the family, the place ceases to come under the provisions of the Act. Places where the family are engaged either in straw plaiting, pillow lace making, or glove making are also exempt. The two Domestic Workshops within the City were duly notified to H.M. Chief Inspector of Factories, as required. LEGAL PROCEEDINGS. The City Solicitor was instructed to take proceedings in respect to the following matters, viz.:— Premises. Defects needing to be remedied. 5, Artillery Lane Workshop in dirty condition. Middlesex House, Middlesex Street W.O. opening directly into workroom. 65, Finsbury Pavement W.C. accommodation for men and women not suitable. 7a, South Place W.C's opening directly into workrooms. 143, Fleet Street No separate W.C. accommodation for the workers employed. In the cases of No. 5, Artillery Lane, Middlesex House, Middlesex Street, and No. 65, Finsbury Pavement, the summonses were not proceeded with, the orders of the Sanitary Committee having been complied with. With respect to No. 7a, South Place, and No. 143, Fleet Street, proceedings were still pending at the end of the year. 91 The following will give some indication of the work performed by your Workshop Inspectors during the year:— Summary of Work under the Factory and Workshop Act, 1901, for the year 1902. Totals. Workshops and Workplaces (not including Kitchens) inspected, measured, &c. 341 Ditto ditto re-inspections 1,599 Bakehouses, re-inspections 94 Ditto newly established 1 Ditto (Factories) notified to H.M. Chief Inspector of Factories 2 Domestic Workshops notified to H.M. Chief Inspector of Factories 2 Workplaces (Kitchens) inspected 155 Ditto ditto re-inspections 341 Workers employed:—Males, 1,298; Females, 1,931 ; Outworkers, 3,752 6,981 Outworkers notified or discovered living in the City 17 Ditto notified by Corporation to outside districts 3,752 Complaints received from H.M. Factory Inspector 54 General complaints received 34 Abstract not affixed notified to H.M. Chief Inspector of Factories 1 New Workshops notified by H.M. Factory Inspector 180 Certificates for Cleansing issued by the Medical Officer of Health 49 Defects remedied (W.C's provided or improved 193 Drains re-laid or amended 10 Total number of defects remedied, 595. Ventilation of Workrooms, &c., improved 13 Overcrowding abated 5 Rooms, &c., cleansed 170 General defects remedied 204 Notices served (Intimation 292, Statutory 180) ... ... 472 Legal proceedings ordered by the Sanitary Committee ... ... 5 WOMAN SANITARY INSPECTOR. The appointment of a Woman Sanitary Inspector in February last has been amply justified, and I would especially call attention to Miss Safford's remarks with reference to sanitary accommodation in offices, quoted on page 95. SUMMARY FOR THE NINE MONTHS—APRIL TO DECEMBER, 1902. Factories Inspections 1 Total number of inspections, 697. Re-inspections 1 Workshops Inspections 140 Re-inspections 34 Workplaces Inspections 390 Re-inspections 131 Notices Served Intimation 184 Total number of Notices served, 219. Statutory 35 In addition to the above, the Ladies' Waiting Rooms at all the Railway Stations in the City were inspected in June, and again in December. 92 The premises inspected have included the following:— Factories Tobacco Manufacturers. Workshops Artificial Flower Makers, Blackborderers, Blind Makers, Blouse Makers, Carpet Sewers, Costume Makers, Fancy Goods Makers, Feather Dressers, Frame Makers, Furriers, Glove Sewers, Hat Makers, Mantle Makers, Milliners, Shirt Makers, Tie Makers, Umbrella Makers, Underclothing Makers. The condition of the workshops has been found to be on the whole satisfactory. Five cases of overcrowding were detected. At 13 premises the sanitary accommodation was insufficient or unsuitable, and several cases of defective drainage, or where structural works were needed, were dealt with by the District Inspector. VENTILATION AND HEATING OF WORKSHOPS. The question of the proper ventilation and heating of workshops in accordance with Sections 6 and 7, Factory and Workshop Act, 1901, and Section 2, Public Health (London) Act, 1891, was raised with regard to several of the workshops inspected. In many instances the means of ventilation are adequate for ordinary purposes, but when, in order to obtain a reasonable temperature, ordinary gas burners are lighted early in the day, the fumes generated render special means of ventilation necessary, if purity of air is to maintained. It has been pointed out to the employers that the method of heating rooms by ordinary gas burners is unhealthy, inadequate and expensive, and their attention has been invited to the Report recently published by the Committee appointed by the Home Secretary to enquire into the ventilation of factories and workshops, wherein it is shown that the products of combustion from an ordinary gas jet burning five cubic feet of gas per hour, vitiate the air to the same extent as the breathing of four men or five women. So that, while the use of the ordinary gas jet for lighting purposes is undesirable (unless special means of ventilation be provided), burning gas all day through these burners as a means of heating is positively injurious ; and a workshop so heated must be deemed not to be kept in conformity with the Act. Stress has also been laid on the danger—in view of the quantity of gas consumed—of gas stoves, when unprovided with a flue or other means of carrying ofl* the products of combustion. It appears from the wording of Section 6, Factory and Workshop Act, 1901, that the duty of enforcing this Section (which relates to temperature) devolves upon H.M. Inspectors of Factories. In the case of a contravention of this Section being detected by an officer of the Sanitary Authority, the right course to pursue would presumably be for the said officer to report the 93 matter to the Factory Inspector, who would take the necessary legal proceedings. Two cases of breach of Section 6 of the Factory Act were tried before the Magistrate at Marylebone Police Court. The employers in each case were summoned by Miss Dean, one of H.M. Inspectors of Factories, and the case for the prosecution was that the rooms in which women had to work were mainly heated by ordinary gas jets. The Magistrate held the case proved in each instance, and fined the employers £10 and costs. SANITARY ACCOMMODATION IN WORKPLACES. Section 38 of the Public Health (London) Act, 1891, requires that:— "Every factory, workshop and workplace, whether erected before "or after the passing of this Act, shall be provided with sufficient "and suitable accommodation in the way of sanitary conveniences, "regard being had to the number of persons employed in or in "attendance at such building ; and also where persons of both sexes "are or are intended to be employed or in attendance with proper "separate accommodation for persons of each sex." Failure to comply with these requirements renders the offender liable to a fine not exceeding £20, and a further fine of £2 for every day after conviction during which non-compliance continues. With regard to the standards of sufficiency and suitability, the Home Secretary has issued the following "Sanitary Accommodation Order ":— "The Sanitary Accommodation Order of 4th February, 1903. "In pursuance of Section 9 of the Factory and Workshop Act, "1901, I hereby determine that the accommodation in the way of "sanitary conveniences provided in a factory or workshop shall be "deemed to be sufficient and suitable within the meaning of the said "section if the following conditions are complied with and not "otherwise:— "1. In factories or workshops were females are employed or in "attendance there shall be one sanitary convenience for every 25 "females. 94 "In factories or workshops were males are employed or in attendance "there shall be one sanitary convenience for every 25 males : provided "that "(a) in factories or workshops where the number of males employed or "in attendance exceeds 100, and sufficient urinal accommodation "is also provided, it shall be sufficient if there is one sanitary "convenience for every 25 males up to the first 100, and one for "every 40 after; "(b) in factories or workshops where the number of males employed or "in attendance exceeds 500, and the District Inspector of Factories "certifies in writing that by means of a check system, or otherwise, "proper supervision and control in regard to the use of the con"veniences are exercised by officers specially appointed for that "purpose it shall be sufficient if one sanitary convenience is "provided for every 60 males, . in addition to sufficient urinal "accommodation. Any certificate given by an Inspector shall be "kept attached to the general register, and shall be liable at any "time to be revoked by notice in writing from the Inspector. "In calculating the number of conveniences required by this order, "any odd number of persons less than 25, 40, or 60, as the case may be, "shall be reckoned as 25, 40, or 60. "2. Every sanitary convenience shall be kept in a cleanly state, shall "be sufficiently ventilated and lighted, and shall not communicate with "any work-room except through the open air or through an intervening "ventilated space : provided that in work-rooms in use prior to 1st "January, 1903, and mechanically ventilated in such manner that air "cannot be drawn into the work-room through the sanitary convenience, "an intervening ventilated space shall not be required. "3. Every sanitary convenience shall be under cover and so partitioned "off as to secure privacy, and if for the use of females shall have a proper "door and fastenings. "4. The sanitary conveniences in a factory or workshop shall be "so arranged and maintained as to be conveniently accessible to all "persons employed therein at all times during their employment. "5. Where persons of both sexes are employed, the conveniences for "each sex shall be so placed or so screened that the interior shall not be "visible, even when the door of any convenience is open, from any place "where persons of the other sex have to work or pass ; and, if the "conveniences for one sex adjoin those for the other sex, the approaches "shall be separate. "6. This order shall come into force on the 1st day of July, 1903. 95 "7. This order may be referred to as the Sanitary Accommodation "Order of 4th February, 1903. "A. AKERS DOUGLAS, "One of His Majesty's Principal Secretaries of State. "Home Office, Whitehall, "4th February, 1903." It is important to note that although the "Order" does not apply to the Administrative County of London (in which the City is included), nor to any place where Sec. 22 of the Public Health Amendment Act, 1890, is in force, it will certainly be the standard generally adopted throughout the country. On the recommendation of your Medical Officer of Health it has been accepted by the Sanitary Committee as governing the provision of sufficient and suitable accommodation under Secs. 37 and 38 of the Public Health (London) Act, 1891, in the way of sanitary conveniences for both sexes in all premises where persons are employed or in attendance. "SANITARY ACCOMMODATION IN OFFICES. "The obligation to provide such accommodation is brought to the "notice of occupiers of factories and workshops by the terms of the "prescribed Abstract of the Factory Act, which they are required to "affix at the entrance of every factory or workshop, in such position as "to be easily read by the persons employed. "In workplaces, however, the obligation imposed by Section 38, "Public Health (London) Act, 1891, is generally disregarded, and "there is grave reason to believe that this is especially the case in "such workplaces as offices where women are employed as typewriters, "clerks, &c. The number of girls so employed in the City in constantly "increasing, and it is not too much to say that in the very large "majority of these offices there is no sanitary' accommodation provided "for the women employed. The injury to health caused by the absence "of such necessary provision is incalculable. Complaints from the girls "themselves are almost unknown, they naturally shrink from the idea of "the discussion of such matters with their employers, and are, moreover, "imbued with the erroneous and very widespread idea that sanitary "legislation is only concerned with the welfare of the 'factory worker.' "A. J. S." A systematic visitation of these offices is now in progress with a view to ascertaining what provision (if any) is made to carry out the requirements of Section 38, Public Health (London) Act, 1891. 96 WORKPLACES—KITCHENS OF RESTAURANTS, &c. By far the larger number of restaurant kitchens are in the basement, and from this fact arises nine-tenths of the defects. The "natural" ventilation of a basement (if any) is obtained from fanlights under the stallboard and gratings in the pavements, and the air thus admitted is laden with dust charged with all manner of impurities from the street. Artificial light has in most cases to be used all day, and is usually in the form of ordinary gas jets adding their quota of impurities to the air, and blackening walls and ceiling. Even without the further defects, too often found, of direct communication between the sanitary convenience and the kitchen, it is obvious that this state of things is undesirable both for the health of the workers and of those who consume food cooked in such an atmosphere. In some basement kitchens, electric light is used, and an elaborate system of air drafts and electric fans has been fitted up with excellent results, both as regards cleanliness and ventilation. The expense of this is very great, and electric fans are always liable to get out of order. All these difficulties are obviated by placing the kitchen on the ground or upper floors (the higher up the better). Given sufficient cubic space, ample ventilation can be obtained from ordinary windows, and where gas stoves are used a hood and flue carried into the chimney is easily fixed. SUMMER FLUSHING OF COURTS, &c. The flushing of the more thickly-populated and poorer parts of the City during the hot months was carried on as usual, followed by the use of deodorants in the channels running through the courts and alleys, &c. In this service, but including the streets, your Engineer informs me that 46,971,365 gallons of water were used. Disinfectants were also freely employed, as explained on page 46. Forty-seven places were so treated in the East District; thirty-eight in the Middle District ; and eighty-three in the West District. Total 168. The entrances to forty-one courts were cleansed and lime-washed, viz. : thirteen in the East District; three in the Middle District; and twenty-five in the West District. A list of places dealt with is subjoined. In Lower Thames Street, and especially in the neighbourhood of Billingsgate Market and the Custom House, road flushing was freely employed and deodorants subsequently used at least twice in twenty-four hours, it being always difficult to keep the place free from nuisance caused by the leakages from the fish carts, which rapidly decompose, and cause great annoyance to the public unless promptly dealt with. 97 FLUSHING OF STREETS, COURTS, &c. In the subjoined lists the places marked * * * were flushed every twentyfour hours, those marked * * twice a week, those marked * once a week. EAST DISTRICT. *** Montague Court * Little George Street Minories ** Rose Alley * New Square * Cock Hill *** Harrow Alley Aldgate ** 8andy's Row ** Church Row (Houndsditch ) end of) ** White Rose Court ** Swedeland Court Bishopsgate * Black Horse Yard ** Artillery Lane * Little Somerset Street ** George and Catherine Wheel ** Aldgate Avenue Alley ** Northumberland Alley Fenchurch Street *** Catherine Wheel Alley * Church Court *** Cavendish Court ** Back Alley * Carter Street *** French Ordinary Court * Exchange Buildings > Houndsditch * Rose Court, Beer Lane Lower Thames Street ** Gravel Lane *** St. Mary-at-Hill ** New Street Gravel Lane *** Lower Thames Street (especially in front of Billingsgate Market and H.M's Custom House) ** Hutchison Street ** Hutchison Avenue *•** Pudding Lane ** Ellison Street / Middlpspv Strppf Middlesex Street *** Botolph Lane Eastcheap ** Providence Place * Botolph Alley ** Middlesex Street * Church Passage * * Garden Place *** Love Lane ** Wrestler's Court Camomile Street *** Fish Street Hill * Brown's Buildings St. Mary Axe *** King's Head Court Fish Street Hill ** Heneage Lane Bevis Marks *** Waterman's Steps ** Golden Fleece Court Minories *** London Bridge Steps MIDDLE DISTRICT. ** Honeysuckle Square Milton Street ** Three Nuns Court Aldermanbury ** Three Herring Court Redcross Street * St. George's Avenue ** Hart's Court Fann Street * George Yard *** Hare Court * Mason's Avenue Basinghall Street *** Shaftesbury Place Aldersgate * Church Alley ** Maidenhead Court * Moorgate Street Buildings *** Lauderdale Buildings * Copthall Buildings *** Cotton Street Passage * Union Court Old Broad Street *** Cotton Street * Peahen Court Wormwood Street ** Australian Avenue * Helmet Court * Fann Street ** Cripplegate Churchyard * Jacob's Well Passage Barbican *** Gun Yard Bishopsgate * Braime's Buildings Beech Street ** Miles Lane London Bridge * Upper Thames Street, St. Benet's Church to King William Street * Sermon Lane Doctors' Commons * Foster Lane Cheapside * Friar's Alley Upper Thames Street * Carey Street ** Brook's Yard * Gutter Lane ** Huggin Court and Lane * Goldsmith Street ** St. James's Place Garlick Hill ** Sun Court, Swan Alley, Moorgate Street (leading to Cross Key Court). ** Sugar Loaf Court 98 WEST DISTRICT. ** Bishop's Court Old Bailey * Paul's Alley Paternoster Row * Prujean Square * Cannon Alley * Evangelist Court Pilgrim Street * Lovell's Court ** Dolphin Court * Panyer Alley ** Horse Shoe Court Ludgate Hill * London House Yard * Pilgrim Street * Stationers' Hall Court *** Cob's Court, Broadway * Paternoster Buildings * Boy Court * Amen Corner * Johnson's Court Fleet Street * Queen's Head Passage Newgate Street * Red Lion Court ** Seacoal Lane Farringdon Street * Bolt Court ** Fleet Lane * Pleydell Court * Harp Alley * Hind Court * New Court * Wine Office Court *** Holborn Viaduct Steps * Crown Court ** Green Dragon Court St. Andrew's Hill * Poppin's Court ** Currier's Row * St. Bride's Avenue * Ireland Yard * Glasshouse Alley Tudor Street * Cloisters Court ** Bell's Buildings Salisbury Square ** Blomfield House Yard Snow Hill ** George Yard Whitefriars Street * Took's Court Furnival Street ** Ashentree Court * Queen's Head Court Giltspur Street ** Britton's Court * Ball Court ** Fleur-de-Lis Court Fetter Lane ** Dorset Court Dorset Street * Trinity Passage ** Sugar Loaf Court ** Nevill's Court ** Hanging Sword Alley * Greystoke Place ** Upper Thames Street, between Blackfriars and St. Benet's Church * Plough Court ** Gunpowder Alley Shoe Lane * Crown Court Chancery Lane ** King's Head Court ** Holborn Buildings ** Robin Hood Court ** Middle Street * Castle Court Poppin's Court ** Kinghorn Street *** Back Court Cloth Fair ** Cloth Street *** Back Passage ** Montague Court Little Britain ** Barley Mow Passage ** Little Montague Court ** Sun Court ** Cox's Court ** New Court * Bartholomew Close *** East Passage ** Middlesex Passage Bartholomew Close *** Red Lion Passage ** Westmorland Buildings ** Cloth Fair ** Albion Buildings *** Half-Moon Passage Aldersgate ** Cockerill's Buildings * Three Tuns Passage Ivy Lane * Fenton's Buildings * Duke's Head Passage ** Bartholomew Place As heretofore, this process has been assiduously carried on in the neighbourhood of Billingsgate Market and the Custom House. In this part of Lower Thames Street deodorants are necessary at least twice in twenty-four hours in the Summer, it being difficult to keep the place free from nuisance caused by the leakages from the fish carts, which then rapidly decompose, and stink abominably, LIMEWHITING OF COURTS. The walls of the following courts were cleansed and limewhited, and where the same are approached by a covered way, the ceiling treated in a similar manner. EAST DISTRICT. Montague Court Rose Court Beer Lane Rose Alley New Square (entrance) Minories Catherine Wheel Alley (entrance) Hutchison Avenue (Stoney Lane entrance) French Ordinary Court Fenchurch Street Harrow Alley Butcher Row Providence Place Middlesex Street Black Horse Yard Aldgate Garden Place Sussex Place Leadenhall Street White Rose Court Widegate Street 99 MIDDLE DISTRICT. St. James's Place Garlick Hill Friar's Alley Upper Thames Street Gun Yard Bishopsgate WEST DISTRICT. Cloister Court St. Andrew's Hill Britton's Court Whitefriars King's Head Court Shoe Lane Crown Court Gunpowder Alley Dorset Court Dorset Street Fleur-de-Lis Court Carter Lane Ball Court Giltspur Street Nevill's Court Holborn Buildings Holborn Greystoke Place Fetter Lane Evangelist Court Pilgrim Street Fleur-de-Lis Court Took's Court Furnival Street Boy Court Ludgate Hill Red Lion Passage Cloth Fair Half-Moon Passage Aldersgate East Passage Middlesex Passage Bartholomew Close Back Passage Bartholomew Place Sun Court Montague Court Little Britain Back Court Little Montague Court SKIPS. This skip system for house refuse removal, which commenced in 1892, has been extended as circumstances demanded, and much benefit has accrued to the persons for whose relief the method was adopted. The public dust-bins, which were, from their misuse, a nuisance and constant source of trouble, have been abolished. « Up to the end of the year 898 of these skips had been supplied in the poorer neighbourhoods without charge, and 720 were paid for by ratepayers : total 1,618. SMOKE NUISANCES. Much attention has been devoted to the abatement of smoke, and so seriously did the nuisance require that active measures should be instituted, the services of a temporary Inspector (appointed for this work at the latter end of 1901) were retained until the summer months. The result has been encouraging—in many cases formerly a great source of nuisance, practically no smoke is now emitted—in other instances the volume, intensity and length of time for which smoke has been observed to escape has been greatly reduced. A few chimneys remain, however, that from time to time cause great offence, and it is these that necessitate the vigilance of your staff should in no way relax. 100 The number of observations recorded during the year were 3,536, relating to the 66 places enumerated below. List of Premises watched foR Smoke Nuisances, 1902. The Cannon Street Hotel. Simpson's Restaurant, Bird-in-Hand Court, Cheapside. Premises of "St. James's Gazette," Dorset Street. "The Argus" Printing Works, Temple Avenue. "The Daily News" Printing Works, 19 to 22, Bouverie Street. "The Daily Chronicle" Printing Works, 31 to 34, Whitefriars Street. Spiers and Pond's Electric Light Works, Water Lane, Blackfriars. Spiers and Pond's Restaurant,Tokenhouse Yard. Farringdon Works, Plum Tree Court. The Royal Hotel, Victoria Embankment. "The Bay Tree" Tavern, St. Swithin's Lane. The Gresham Club, Gresham Place. Slaters' Restaurant, 7 and 8, King William Street. The Bank of England. The Holborn Viaduct Hotel. Messrs. Griffiths and Sons, Prujean Square, Old Bailey. Ye Gresham Restaurant, Bucklersbury. The New Gresham Restaurant, Gresham Street. The Bucklersbury Restaurant, Bucklersbury. The "Apple Tree" Restaurant, London Wall. The "Evening News" Printing Works, Whitefriars Street. Harding's Restaurant, Farringdon Street. The King William Tavern, King William Street. The Guildhall Tavern, Gresham Street. Castle's Restaurant, 16, St. Bride Street. The Windmill Restaurant, Cannon Street. Sir W. A. Rose and Co., 66, Upper Thames Street. Purfleet Wharf, Upper Thames Street. Restaurant, 74, Cheapside. "Lloyd's," Royal Exchange. The Langbourn Restaurant, Ball Alley, Lombard Street. Lake's Restaurant, Gracechurch Street. Messrs. Cassell and Co., Ludgate Hill. The White Hart Tavern, Cannon Street. "The Daily Telegraph" Printing Works, Fleet Street. The Mansion House Restaurant,' Grocers' Hall Court, Poultry. The "News of the World" Printing Works, Bouverie Street. Slaters' Restaurant, Ludgate Circus Buildings. Alderman Restaurant, 69, Basinghall Street. Refreshment Rooms, Broad Street Station. 14 and 15, Miles Lane. Crosby Hall Restaurant, 32, Bishopsgate Street. Landale, Baker, 95, Cannon Street. Lombard Restaurant, 2, Lombard Court. Railway Tavern, 15, Liverpool Street. W. D. and H. O. Wills, Limited, Holborn Viaduct. The "Crown and Cushion," 73, London Wall. 101 Hermann's Restaurant, 41, London Wall. Refreshment Rooms, Liverpool Street Station, Great Eastern Railway. The Arcadian Restaurant, Queen Street. Brooks' Wharf, Upper Thames Street. "The Spaten," Restaurant, Newgate Street. Spiers and Pond's Restaurant, Mansion House Railway Station. The Stock Exchange. The Castle Tavern, Gresham Street. The General Post Office. Cold Air Stores, Cousin Lane. Devonshire House Hotel, 12, Bishopsgate Street Without. Wilkinson's Dining Rooms, 44, Fish Street Hill. The Queen Anne Restaurant, Cheapside. Messrs. Slaters' Restaurant, 26, Cheapside. Messrs. Williamson's, Snow Hill. Union and Castle Offices, Fenchurch Street. Messrs. Taddy's, Minories. No. 58, Bishopsgate Street Within. In five of the above, prosecutions were instituted under the Public Health (London) Act, 1891, with the following results:— Date. Name. Business. Address. Where heard Before whom. Offence. Result. 1902. April 2 Frederick H. Callingham. Proprietor "Queen's Arms," Bird-in-Hand Court. Mansion House. Mr. Ald. G. W. Truscott. Permitting smoke nuisance. Pined £1 and 2s. expenses. Abatement and Prohibition Order issued (six weeks). „ 25 Ed. J. Bennett Ditto "Castle Tavern," Gresham Street. Ditto Ditto Ditto Fined £1 and 4s. 6d. expenses. Abatement and Prohibition Order issued (six weeks). „ 25 & May 1 Philip A. Berrisford. Ditto "Windmill Restaurant," Cannon Street. Ditto Ditto Ditto Fined £1 and 7s. 6d. expenses. Abatement and Prohibition Order issued (seven days). July 22 Great Eastern Railway Co. Refreshment Rooms. Liverpool Street Station. Guildhall Ald. Sir G. F. Phillips. Smoke nuisance. Abatement and Prohibition Order (one month). „ 23 Messrs. Slaters, Ltd. Restaurant 8, King William Street. Mansion House. Mr. Ald. Alliston. Ditto Abatement and Prohibition Order (forthwith), with 21s. expenses. 102 REMOVAL OF HUMAN REMAINS. During 1902 there were five cases in which human remains were disinterred in the City under the supervision of your Medical Officer of Health, and re-interred elsewhere. It is not lawful to remove a body from one consecrated place of burial to another without a faculty granted by the Ordinary for that purpose, and it is, further, illegal to remove any body, or the remains of any body, which may have been interred in any place of burial except with a License under the hand of one of His Majesty's Principal Secretaries of State, and with such precautions as such Secretary of State may prescribe as the condition of such license. In cases where churches are demolished and parishes united under the Union of Benefices Acts, 1860 and 1898, bodies are removed and re-interred under an "Order in Council." There is a fourth course occasionally adopted in obtaining authority to exhume bodies, viz., by Act of Parliament. This procedure was followed in the case of Christ's Hospital, referred to below. It is estimated that the remains of no less than 4,051 persons were dealt with during 1902. The following is a summary of these proceedings:— Place. Number of Bodies dealt with. Authority for Removal. Allhallows', London Wall 2,368 Faculty. St. Ethelburga, Bishopsgate 80 Faculty. Christ's Hospital 91 Act of Parliament. St. George's, Eastcheap 1,420 Order in Council. Newgate Gaol 92 License from Home Secretary. Total 4,051 ALLHALLOWS, LONDON WALL. In this case the remains were exhumed from the churchyard at the Eastern end of the church, upon which a "shelter" adjoining the building was erected. The excavations for the foundation involved the examination and removal of 265 loads of earth, in which were found enough bones to fill 102 cases, estimated to represent the remains of 2,368 persons. These were re-interred 103 at the City of London Cemetery, Little ford, under a Faculty granted by the Consistory Court, which provided that such removal and re-interment should be carried out under the direction of your Medical Officer of Health. ST. ETHELBURGA, BISHOPSGATE. This was a comparatively small undertaking, in which four boxes of bones, containing the remains of about 80 persons, were exhumed and re-interred at Ilford. These remains were disturbed in the course of the erection of a Vestry Hall on the site of the churchyard. CHRIST'S HOSPITAL. In order to give effect to the objects and purposes of the scheme involving the sale and disposal of the site of Christ's Hospital, the Council of Almoners was empowered to make arrangements for the removal of any interred bodies therein. Section 7 of the Christ's Hospital (London) Act, 1901, provided that— "It shall be lawful for the Council of Almoners to cause to "be removed, under the superintendence and to the satisfaction of the "Medical Officer of Health of the City of London, any human remains "buried in any part of the site of Christ's Hospital. The remains "removed shall be enclosed for removal in shells well pitched, and shall "be re-interred, at the expense of the Council of Almoners, in some "consecrated burial ground which may lawfully be used for interments." In accordance with this provision 21 complete bodies in shells, and 10 cases, estimated to contain the bones of 91 persons, were dealt with; six of the bodies were taken to private cemeteries, and the remainder were re-interred at the City of London Cemetery, Little Ilford, in the private ground of the Christ's Hospital Authorities. ST. GEORGE'S CHURCH, BOTOLPH LANE, EASTCHEAP. These remains were dealt with under an "Order in Council," following a scheme prepared by the Ecclesiastical Commissioners under the Union of Benefices Acts, 1860 and 1898, for effecting the union of the benefice of St. Mary-at-Hill with St. Andrew Hubbard, and the benefice of St. George, Botolph Lane, with St. Botolph, Billingsgate. The exhumation was commenced on the 15th September, 1902, and completed on the 13th December last. In all, 150 lead coffins, and 71 cases of bones—estimated to contain the remains of 1,420 bodies—were disinterred and re-buried at the Necropolis, Woking. 104 NEWGATE GAOL. The demolition and rebuilding of the Prison necessitated the removal of the remains of convicts who had been executed and buried within its walls. For this purpose a license was granted in October last by the Home Secretary, under the provisions of the Burial Act, 1857, of which the following is a copy:— "License for the Removal of Human Remains, "20 and 21 Vic., cap. 81, s. 25. In virtue of the power vested in me by the 25th section of the "Burial Act, 1857 (20 and 21 Vic., cap. 81), I hereby grant license for "the removal of all human remains which have been interred within the "precincts of Newgate Prison, on the following conditions:— "1. That the removal be effected with due care and attention to "decency, early in the morning. "2. That freshly-made ground lime be freely sprinkled over the "remains, the soil, or any matter that may be offensive. "3. That the remains be placed in well-pitched shells, and be in each "case entirely surrounded by four inches of newly-made "vegetable charcoal in powder. "4. That the removal be carried out under the supervision and to the "satisfaction of the Medical Officer of Health for the City of "London. "This License simply exempts from the penalties which would be "incurred if the removal took place without a license ; it does not in "any way alter civil rights. It does not, therefore, confer the right to "bury the remains in any place where such right does not already exist. "This License shall, if any of the conditions on which it is granted "be not complied with, be deemed to have been void from the beginning, "and if not acted upon within twelve months from this date shall become "void. "(Signed) A. AKERS DOUGLAS, "One of His Majesty's Principal Secretaries of State. "Whitehall, 21st October, 1902." The work of removal, commenced on the 11th November, 1902, was completed on the 7th January last, during which period 73 baskets of bones, 57 skulls, and 35 bodies, representing in all the remains of 92 persons, were exhumed, placed in 46 cases, and re-interred in accordance with the terms of the license. 105 Your Medical Officer of Health was in constant attendance at Newgate during these operations, which afforded an excellent opportunity of ascertaining whether the existing method of intramural burial in cases of capital punishment is attended with danger to the public health. Without going into unnecessary and undesirable details, it suffices to state here that the condition of the remains of the exhumed malefactors in Newgate Gaol forced the conclusion that the present system of burial is fraught with danger to the living, being lacking in every essential conducive to the public health. It would not become your Medical Officer to discuss here whether or not that part of the death sentence relating to the place of burial of a murderer is a remnant of a vindictive and barbaric age, but there can be no impropriety in urging the cessation of a system that the experience gained at Newgate has proved unmistakeably to be both ineffective and dangerous. In this connection it may be interesting to quote from Mr. James Brooke Little's work on the "Law of Burial" (Third Edition, 1902). In discussing the subject of the burial of murderers, the writer states:— "That the bodies of murderers were at one time denied burial "altogether. By 25 Geo. 2, c. 37, it was directed that after execution "the body of a murderer should be delivered to Surgeons' Hall, or if "the execution took place out of Middlesex, to some surgeon to be "named by the judge at the trial, to be dissected and anatomised; or "the judge might order the body to be hung in chains. In no case was "the body to be buried unless previously dissected and anatomised. The 9 Geo. 4, c. 31, which repealed this Act, also provided that the body "of every murderer should, after execution, either be dissected or hung "in chains. Dissection was abolished by the Anatomy Act, 1832, "s. 16, which directed the body either to be hung in chains or buried "within the precincts of the prison, as the court might order; and "finally hanging in chains was abolished by 4 and 5 Will. 4, c. 26, and "the body was directed in all cases to be buried within the precincts "of the prison. The last statute was repealed by the Statute Law "Revision Act, 1874, its place having been taken by the Offences "against the Persons Act, 1861, s. 3, which directs that the body of "every person executed for murder shall be buried within the precincts "of the prison in which he shall have been last confined after conviction. "This Act is, however, modified by the Capital Punishment Amendment "Act, 1866, s. 6, which provides that the body of every offender "executed shall be buried within the walls of the prison within which "judgment of death is executed on him; provided that if there is no "convenient space within the walls for such burial, the Secretary of State "may, by writing, appoint some other place for that purpose."* * The italics are mine (W. C.). 106 It will be noticed that the law as it stands provides an alternative, and there is, therefore, no excuse for the continuance of intramural burial in prisons. Upon representation being made to the Home Secretary, under the Capital Punishments Amendment Act of 1866, that functionary can direct burial of murderers elsewhere, and it is difficult to conceive that any responsible Minister would fail to adopt.this course in the future, bearing in mind the state of affairs disclosed during the rebuilding of Newgate. In these circumstances, I recommend that a copy of this Report be forwarded to the Home Secretary, the Local Government Board, H.M. Prisons Commissioners, and the Medical Officers of the County Gaols throughout the country. CITY OF LONDON (VARIOUS POWERS) ACT, 1900. Section 54 (Part VII.) of the above enacts that— PART VII.—PUBLIC HEALTH. 54. "The Corporation shall make and enforce bye-laws with "respect to water-closets, earth-closets, privies, ashpits, cesspools, and "receptacles for dung, and the proper accessories thereof in connection "with buildings. Provided that nothing in this Part of this Act "contained shall authorise the Corporation to make or enforce any "bye-laws with respect to water-closets or the accessories thereof which "would be inconsistent with or contrary to anything contained in the "Metropolis Water Act, 1852, or the Metropolis Water Act, 1871, or "any regulations or bye-laws made thereunder. Ashpit in this Section "means any ashpit, dust-bin, ash-tub, or other receptacle for the "deposit of ashes or refuse matter." This Section is mandatory. Bye-laws have accordingly been drafted in accordance with its provisions, and are now under consideration. Power to enable the Corporation to provide a Crematorium at the City of London Cemetery at Little Ilford is conferred by Section 19 (Part IV.) of the same Act. PART IV.—CREMATORIUM. 19. "Subject to the provisions of this Act the Corporation may, in a "convenient and proper place in the City of London Cemetery, in the 107 "parish of Little Ilford, in the county of Essex, set apart for and build, "provide, fit up, equip, and maintain a crematorium proper and sufficient "for the cremation of human remains." It will be noted that this Part of the Act is permissive. The Corporation having decided to adopt it, plans have been prepared, which have been approved by the Secretary of State, and tenders for the erection of a Crematorium have been advertised for. The Corporation will have to make Regulations for cremation, which must be submitted for the approval of a Secretary of State. On this question a Departmental Committee was appointed by the Home Secretary on the 12th October last to prepare a draft of the Regulations to be made by the Secretary of State in pursuance of the powers given him by Section 7 of the Cremation Act, 1902, and any Regulations for cremation made by the Corporation will have to be on the lines indicated by this Committee. Considerations of space prohibit the reproduction here of the draft Regulations of the Cremation Committee, but their Report,* together with the evidence laid before them, is a most interesting document, and well worth the perusal of those interested in the subject. * Report of the Cremation Committee. 1903. Published by the King's Printers. UNSOUND FRUIT, VEGETABLES, TINNED FOOD, &c. Three hundred and sixty-two cartloads of unsound food were removed by the Cleansing Department and destroyed as trade refuse at Letts' Wharf at the written request of the owners. The material so disposed of comprised:— Vegetables and fruit 254 loads. Condensed milk 7 „ Miscellaneous 101 „ Total 362 loads. The number of loads similarly dealt with in the years 1899, 1900 and 1901 were 452, 312 and 253 respectively. 108 During the first six months the above included:— 14,734 tins of various kinds of fruit. 12,480 „ condensed milk. 12,300 „ miscellaneous preserved foods. 3.880 jars of preserved ginger. 72 „ sauce. 162 „ sweetmeats. 192 tins of fish. 49 bags of flour. 20 „ onions. 459 cases of raisins. 356 bushels of walnuts. 154 pecks of strawberries. In the second half of the year this material was weighed on delivery at the Wharf before being destroyed and the enumeration of tins, &c., discontinued. When practicable it was burnt in the Destructor, otherwise it was placed in barges and buried at a suitable place down the River under the supervision of the Medical Officer of Health of the Port, who was duly notified in each instance when the barge left the Wharf for its destination down stream. Tons cwt. crs. July 15 Tinned fruit 1 11 0 „ 17 2 1 0 „ 23 „ „ 2 1 0 Aug. 1 Two vanloads tinned fruit 3 16 0 „ 6 One vanload „ 0 18 0 „ 8 „ „ „ 2 2 0 „ 13 Two loads tinned tomatos 2 9 2 „ 14 One load tinned fruit 2 5 2 „ 20 ,, „ condensed milk 0 17 0 „ 20 „ „ tinned food 2 2 0 „ 22 Ten baskets of eggs 0 10 0 „ 26 One load tinned tomatos 1 3 2 „ 27 „ „ „ „ 0 15 0 Sept. 1 „ „ „ fruit 1 19 0 „ 3 Two loads tinned apricots 2 9 2 „ 4 One motor vanload of tinned apricots 2 4 0 „ 5 „ „ „ „ „ 2 15 0 „ 6 Three vanloads of apricots and peas 3 13 0 „ 8 One vanload of peas 1 5 0 „ 9 „ „ fruit 1 13 0 „ 10 Half a load of tinned peaches 0 15 0 „ 10 One motor vanload of tinned peas 2 7 0 Carried forward 41 12 0 109 Tons cwt. qrs. Brought forward 41 12 0 Sept. 11 One vanload of tinned fruit 2 0 0 „ 18 Tinned fruit and sardines 1 5 0 „ 23 „ „ „ 1 18 2 „ 23 Tinned fruit 0 17 2 „ 29 „ „ 1 0 0 Oct. 1 „ fish 1 0 0 „ 6 „ fruit 1 5 2 „ 7 „ „ 1 7 2 „ 8 „ milk 0 10 0 „ 11 „ fruit 1 6 0 „ 13 ,, ,, 1 8 2 „ 14 „ „ 1 0 0 „ 15 „ tomatos 1 4 0 „ 21 „ fruit 1 0 0 „ 24 „ „ 1 5 0 Nov. 4 „ „ 1 5 2 „ 5 Unsound pears 6 18 2 „ 8 Tinned fruit 1 5 2 „ 12 „ sardines 0 16 0 „ 13 Condensed milk 0 7 0 „ 14 Tinned fruit 1 3 2 „ 19 „ apples 0 3 0 „ 20 „ fruit 1 7 0 „ 24 Coffee and chicory 0 13 3 Dec. 2 Raisins 1 3 2 „ 4 Tinned fruit 1 8 0 „ 10 „ fruit and vegetables 7 3 1 Total 83 14 0 DAIRIES, COWSHEDS AND MILKSHOPS. The Dairies, Cowsheds and Milkshops Order of 1885 was issued by the Privy Council in pursuance of the 34th Section of the Contagious Disease (Animals) Act, 1878. In 1886 an Amending Act was passed (The Contagious Disease (Animals) Act, 1886), transferring the powers under this Section from the Privy Council to the Local Government Board, and an Amending Order was issued by that Board (The Dairies, Cowsheds and Milkshops Amending Order, 1886), substituting the Board for the Privy Council in the provisions of the Order of 1885, and remedying certain omissions in regard to penalties. In a further Order, viz., the Dairies, Cowsheds and Milkshops Order of 1899, provision was made for the examination of cows for tuberculosis by a veterinary surgeon. The effect of these Orders was to require every local authority to keep a register of every purveyor of milk, dairyman, or cowkeeper in their district, to supervise the milk trade, and to carry out certain general regulations prescribed in the Orders. 110 These Orders also gave local authorities discretionary powers, from time to time, to make regulations for the following purposes, or any of them, viz.:— (а) For the inspection of cattle in dairies; (b) For prescribing and regulating the lighting, cleansing, drainage, and water supply of dairies and cowsheds, in the occupation of persons following the trade of cowkeeper or dairyman ; (c) For securing the cleanliness of milk stores, milkshops, and of milk vessels used for containing milk for sale by such persons; (d) For prescribing precautions to be taken by purveyors of milk and persons selling milk by retail against infection or contamination. In the City of London the local authority for making regulations as above is the Corporation of London, and elsewhere in the Metropolis the London County Council. Under the London Government Act, 1899, the duty of carrying out the enforcement of the regulations devolved upon the several Metropolitan Borough Councils. From 1885 to 1891 the Central Markets Committee carried out the administration of the Orders in the City, but in the latter year it was transferred to the County Purposes Committee, who deputed the Inspectors of Weights and Measures to carry out the duties. In my last Annual Report I recommended that this work, which deals entirely with sanitary questions affecting the distribution of a most important article of food, and can only be properly dealt with by a sanitary expert, should be undertaken by the Public Health Department. This course was agreed to by the Court of Common Council on the 29th May, 1902, and the transfer to my Department was made on the 18th June following. Section 28 of the Public Health (London) Act, 1891, also conferred powers upon the Local Government Board to make Orders and Regulations for the following purposes:— (а) For the registration with the Corporation in the City, and the London County Council elsewhere in the Metropolis, of all persons carrying on the trade of dairyman; (b) For the inspection of cattle in dairies, and for prescribing and regulating the lighting, ventilation, cleansing, drainage and water supply of dairies; (c) For securing the cleanliness of milk vessels used for containing milk for sale; (d) For prescribing precautions to be taken for protecting milk against infection and contamination. 111 (e) For authorising the Corporation in the City, and the London County Council elsewhere in the Metropolis, to make bye-laws for any of these purposes. Up to the present the Local Government Board have taken no action under this Section, and the Dairies, Cowsheds and Milkshops Orders, 1885, 1886 and 1899, made under the Contagious Disease (Animals) Acts, 1878 and 1886, not having been revoked or replaced by any subsequent Order, remain in force, and the regulations made thereunder by the Corporation in 1885 are still in operation in the City. These having been made nearly 18 years ago, do not as a consequence meet modern requirements. In January last, therefore, Amended Regulations of a more comprehensive character were prepared by your Medical Officer. These are now under the consideration of the Local Government Board, to whom they have been sent in accordance with the suggestion contained in the following letter from the Board, dated 11th March, 1889:— "The Board's confirmation of any regulations which may be made by "the Council will not be required, but if at any time the Board are "satisfied on enquiry with respect to any regulation that the same is of "too restrictive a character, or otherwise objectionable, they may direct "its revocation; and the Board suggest that the draft of any regulations "which the Council may propose to make should be sent to them for "consideration before the regulations are formally adopted. The number of persons registered as carrying on the business of dairymen or purveyors of milk in the City of London is given in the Annual Report of the Chief Inspector of Weights and Measures for the year ending December, 1901,' as being 421. The total number of persons now appearing on the register as either dairymen or purveyors of milk amount to 528, showing an increase of 107. All premises occupied by the persons so registered have been regularly inspected. On the whole the milk retailed in the City is sold under satisfactory conditions. The classification of retailers of milk in the City may be taken as follows:— 225 are shops of large refreshment room proprietors of the better class; 59 are smaller refreshment room keepers; 60 are refreshment places kept by foreigners; 26 are dairies where refreshments 112 are sold; 14 are bakers who sell milk; 5 are confectioners who sell milk; 54 are general shop keepers who sell milk; 7 are vegetarian restaurant keepers where milk is sold; and 78 are other cheap dining places where milk is retailed. In eight cases the vendors attention has been directed to breaches of the regulations, as hereunder appended:— Premises. Offence. Action taken. 28, Jewin Street Measures requiring cleansing. Cleansed in presence of Inspector. 29, Aldersgate Street Vessel required cleansing Ditto. 3, Ivy Place Vessel required cleansing Ditto. 62, Farringdon Street Milk stored in uncovered vessel in dusty basement. Vessel provided with a cover and basement discontinued to be used for the storage of milk. 38, Mansell Street Milk kept in old rusty churn. New covered milk vessel provided. 14, Tudor Street Walls and ceiling of room in which milk was kept, dirty. Premises cleansed and whitewashed. \ 35, Hutton Street Ditto Ditto. 19 and 20, Farringdon Street. Paving of milk stores defective, walls and ceiling dirty, and w.c. insufficiently ventilated and partitioned off. Paving repaired, premises cleansed and whitewashed, and w.c. improved, ventilation and isolation. A case of infectious disease occurred at No. 18, Mansell Street, on 11th December, the owner of the business being registered as a purveyor of milk"; immediate steps were taken to preserve the milk stored on the premises from contamination, and the persons engaged in the business from coming in contact with the infected person. The persons registered either as dairymen or purveyors of milk in the City of London, classified for convenience in streets, alphabetically arranged, will be found in Appendix D. MANUFACTURE OF ICE CREAMS, &c. The London County Council (General Powers) Act, 1902, supported by the Corporation of the City, received the Royal Assent on the 31st July, 1902, and came into force on the 1st November following. 113 The Clauses relating to ice creams are as follows:— Ice Creams. 42. Any person being a manufacturer of or merchant or dealer in ice creams or other similar commodity who within the County— (а) Causes or permits ice creams or any similar commodity to be manufactured sold or stored in any cellar shed or room in which there is any inlet or opening to a drain or which is used as a living room or sleeping room; (b) In the manufacture sale or storage of any such commodity does any act or thing likely to expose such commodity to infection or contamination or omits to take any proper precaution for the due protection of such commodity from infection or contamination; or (c) Omits on the outbreak of any infectious disease amongst the persons employed in his business or living or working in on or about the premises in or on any part of which any such commodity as aforesaid is manufactured sold or stored to give notice thereof forthwith to the Medical Officer of the Sanitary District in which such business is carried on or such premises are situate; shall be liable for every such offence on conviction in a Court of Summary Jurisdiction to a penalty not exceeding forty shillings. 43. Every itinerant vendor of any such commodity as aforesaid shall if not himself the manufacturer thereof exhibit in a legible manner on a conspicuous part of his barrow a notice stating the name and address of the person from whom he obtains such commodity and if such vendor is himself the manufacturer of such commodity he shall in the same manner exhibit his own name and address every such itinerant vendor who shall fail to comply with the provisions of this Section shall be liable for each offence on conviction as aforesaid to a penalty not exceeding forty shillings. 44. Proceedings for the recovery of the penalties imposed by the two last preceding Sections of this Act shall be instituted by the Sanitary Authority for the District in which the offence was committed or of the District to the Medical Officer of which such notification as aforesaid ought to have been made or in which such itinerant vendor as aforesaid shall offer any such commodity as aforesaid for sale as the case may be. Provided always that if any Sanitary Authority omit to institute such proceedings the Council may institute the same as if such omission were a default within the meaning of "The Public Health (London) Act 1891" and the provisions of that Act relating to any such default and the consequences thereof shall apply with respect to such proceedings. [The City is specially exempted from the operation of the latter part of this Section.] 114 45. The provisions of this part of this Act shall not come into operation until the expiration of a period of three months from the date of the passing of this Act and during such period of three months the Council shall cause to be given public not ice of the effect of the provisions of this part of this Act by advertisement in two or more London daily newspapers in two successive weeks and by handbills and otherwise in such manner as they think sufficient. It will be seen that the powers are to be exercised by each Sanitary Authority within its own area, but that by Section 45 general notice of the provisions of the Act are to be given by advertisement and otherwise by the County Council. In view of the importance of the question, a copy of the following Notice was handed in the month of September to the proprietors of each of the 141 shops where ice creams are sold in the City. Similar Notices were exhibited at the several City Police Stations by the courtesy of the Commissioner of Police. It was also duly advertised in the Press:— ICE CREAMS. This is to give Notice that on and after 1st November next, the following statutory provisions will come into operation in the City of London:— (1) Any person being a manufacturer of or merchant or dealer in ice creams or other similar commodity who within the City of London:— (а) Causes or permits ice creams or any similar commodity to be manufactured sold or stored in any cellar shed or room in which there is any inlet or opening to a drain or which is used as a living room or sleeping room; (б) In the manufacture sale or storage of any such commodity does any act or thing likely to expose such commodity to infection or contamination or omits to take any proper precaution for the due protection of such commodity from infection or contamination; or (c) Omits on the outbreak of any infectious disease amongst the persons employed in his business or living or working in on or about the premises in or on any part of which any such commodity as aforesaid is manufactured sold or stored to give notice thereof forthwith to the Medical Officer of the City of London in which such business is carried on or such premises are situate; shall be liable for every such offence on conviction in a Court of Summary Jurisdiction to a penalty not exceeding forty shillings. 115 (2) Every itinerant vendor of any such commodity as aforesaid shall if not himself the manufacturer thereof exhibit in a legible manner on a conspicuous part of his barrow a notice stating the name and address of the person from whom he obtains such commodity and if such vendor is himself the manufacturer of such commodity he shall in the same manner exhibit his own name and address. Every such itinerant vendor who shall fail to comply with the above provisions shall be liable for each offence on conviction as aforesaid to a penalty not exceeding forty shillings. JAMES BELL, Public Health Department, Town Clerk. Guildhall, E.C. 1st September, 1902. In addition to the foregoing, the accompanying Notice in Italian was distributed amongst itinerant vendors. The Italian Vice-Consulate was good enough to prepare the translation, which may therefore be accepted as a correct rendering of the statutory requirements:— Consiglio Municipale delle Titta di Londra. GELATI DI CREMA ed altri generi consimili. Col Presente si Notifica che a partire dal giorno 1° Novembre prossimo, le seguenti prescrizioni andranno in vigore nella citta di Londra a tenore di Legge: Ogni venditore ambulante di una tal merce summentovata se non ne sara egli stesso il fabbricante, dovra mostrare in modo leggibile, in una parte conspicua della sua carretta, un affisso che indichi il nome e l'indirizzo della persona dalla quale esso ottiene siffata merce, e se il cennato venditore e egli stesso fabbricante di quella merce, egli dovra mostrare nello stesso modo il proprio nome ed indirizzo. Qualsiasi siffatto venditore ambulante che manchera di conforinarsi alle disposizioni di questa legge sara passibile per ciascuna contravvenzione se condannato, come sopra si e detto, di una multa non eccedente Quaranta Scellini. JAMES BELL, Amministrazione Della Sanita Publica, Segretario Municipale. Guildhall, E.C. 1° Settembre 1902. 116 ICE CREAM POISONING. The value of the powers under the Act before mentioned will be fully exemplified by the experience gained in the City during last Summer. On the 24th July, a report was received from the Medical Officer of the General Post Office, that two telegraph boys had presented themselves for examination "complaining of severe pains in epigastrium, nausea, headache "and depression (weakness), believed to be due to poisoning from ice cream "bought at an Italian shop in Aldersgate Street;" and further, that there had been several other similar cases. Samples were therefore purchased at the shops in the neighbourhood indicated, and submitted to Professor Klein for bacteriological examination. Professor Klein's report was received on the 28th, as follows:— St. Bartholomew's Hospital and College, July 28th, 1902. I write herewith a preliminary report of the results of the examination re Ice creams. Ice cream No. 1 and ice cream No. 2 contained a comparatively small number of microbes—comparatively I mean as compared with most ice creams which are quite wholesome. But though comparatively few microbes were present, those present were of a poisonous nature, as proved by the extremely virulent effect on the guinea-pig—less on mice. The effect was intensive inflammation and gangrene after injection. This effect —fatal with both samples—was more pronounced and more rapid with sample No. 1 than with No. 2; moreover, the local exudation of the first series of the guineapigs proved extremely virulent and lethal, even in small doses, to a second series of animals. I cannot at present tell you exactly the nature of the virulent microbe, because I have not got it yet in pure culture, but hope to be able to secure it after a few days' further study. E. KLEIN. REPORT ON TWO SAMPLES OF ICE CREAMS. These two samples, labelled No. 1 and No. 2 respectively, were collected in sterile bottles on July 24th. The bacterioscopic analysis showed that the creams contained comparatively few microbes. I have examined a good many samples of ice creams which were bought in first-class shops, and which creams were in all respects satisfactory except that thev contained a very large number of microbes—as far as could be made out, all of the harmless kind. In the present instance, however, the number of microbes, as just stated, was comparatively small, but the nature of the microbes present was by no means of the harmless kind. From ice creams No. 1 and 2 I have isolated : (a) Bacillus mesentericus, very abundant in No. 1, less abundant in No. 2. This microbe is quite harmless, and is widely distributed in nature. 117 (b) Bacillus coli communis, and one other coli-like species; both harmless. (c) An anaerobic species of bacilli which proved highly pathogenic. This microbe was predominating both in ice cream No. 1 and in No. 2, in the former more copious than in the latter. The injection of a small quantity (1 c.c.) of ice cream under the skin of guineapigs produced disease after several hours, and death within 20 hours. The animal injected with ice cream No. 1 died several hours sooner than the animal with No. 2. The disease consisted in the development of severe and extensive inflammation leading to gangrene; the wall of the abdomen, chest, neck and thighs being greatly inflamed; the subcutaneous, cutaneous and muscular tissues showing haemorrhagic infiltration; the whole of the intestine and stomach was inflamed and filled with sanguineous mucus. The microbe causing this condition corresponds in some respects to the bacillus of malignant oedema, in others to the bacillus emphysematosus, both of these being anaerobic bacilli, which have been found in connection with and causing of serious illness also in the human subject. I have as yet not been able to ascertain quite definitely whether the microbe in question is the bacillus of malignant oedema or the bacillus emphysematosus, or perhaps—which seems not improbable— an as yet undescribed species, but this much is quite certain, that even small doses of it are readily absorbed into the blood, and cause, besides the local extensive inflammation, severe inflammation of the alimentary canal and liver with fatal result. E. KLEIN. St. Bartholomew's Hospital, E.G., July 31.st, 1902. Addendum.—During the further more detailed study of this microbe, another highly virulent bacillus paracoli was found associated with it. E. K. On the 29th July the Medical Officer of the General Post Office reported that he had a record of 13 suspicious cases, which presented the following symptoms in common:— Bellyache diffuse colicky pains in abdomen in all. Headache in nearly all. Vomiting in half. Diarrhæa in less than half. Nervous depression in nearly all cases to less or greater degree. These symptoms were attributed to ice creams bought in the City. On the 31st July another case was reported, with "symptoms of collapse, "extreme pallor, anxious and contracted features, headache, slight pain in "epigastrium; no vomiting or diarrhoea; pulse 95, feeble. He was taken "ill with headache and nausea two hours after eating ice cream and "Tottenham cakes." Samples, No. 3 and No. 4, of the ice cream were at once obtained and forwarded to Professor Klein, who found them to be innocent. St. Bartholomew's Hospital and College, August 6th, 1902. Re ICE CREAM, No. 3 and No. 4. I beg herewith to report on the bacterioscopic analysis of the two samples of Ices, No. 3 and No. 4, received July 31st. They were: No. 3, Water Ice. No. 4, Cream Ice. 118 Both were examined on exactly the same lines as the previous samples, No. 1 and No. 2, on which I have already reported. The microscopic and cultural examination showed that in both ices were extremely few bacteria present, and these of the harmless kinds. One cubic centimetre of each was injected into one guinea-pig (for each) ; the animals remained perfectly well, and did not show any local effect. E. KLEIN. It was thus obvious that ice creams of a poisonous nature were being sold in the City, and arrangements were made for taking samples generally. A full list of these is appended. The next two (No. 5 and No. 6) were found to be poisonous, Professor Klein's report being as follows:— St. Bartholomew's Hospital and College, August 8th, 1902. I beg to report on the result of the bacterioscopic analysis of ice creams received August 5th, Samples No. 5 and No. 6. Sample No. 5 caused on subcutaneous injection formation of big abscess, due to staphylococcus and streptococcus pyogenes. Sample No. 6 caused purulent enlargement of the lymphatic glands near the seat of injection, due to a virulent variety of bacterium lactis aerogenes. E. KLEIN. Addendum.—I ought to have stated that all the microbes in Samples Nos. 5 and 6 were non-sporing, and therefore killed by temperatures above 70° C. From this fact I should say that the microbes in question had found entrance into the ices after they (ices)had been prepared, provided I am correctly informed that the materials of the ice cream are boiled before subjected to the freezing. E. K. Two further cases of suspicious sickness after the ingestion of ice creams were reported, the symptoms being bellyache and vomiting, but no diarrhoea, patient pale and collapsed; tongue clean, no rash, no cough or pneumonia symptoms. Further samples were then taken as under:— No. 7, obtained on the 11th August at No. 50, Bishopsgate Street Without, but made at the same premises as No. 5. No. 8, obtained on the 11th August at No. 106, Bishopsgate Street Without, but made at the same premises as No. 5. No. 9, obtained on the 12th August at No. 20, Artillery Lane (the premises where Nos. 5, 7 and 8 were manufactured). This sample was made on the 12th and taken on the same day after boiling, and before freezing. This sample was found to be wholesome. No. 10, obtained on the 12th August from No. 5, Water Lane. No. 11, obtained on 13th August from Pilgrim Street. No. 12, obtained on the 13th August from a barrow in Dean's Yard. 119 The report of Professor Klein on these samples is as follows:— St. Bartholomew's Hospital and College, August 16th, 1902. Re ICE CREAMS. (Samples Nos. 7 and 8, received August 11th.) No. 7 contained very large numbers of bacteria, amongst them some virulent proteus and virulent bacillus coli. Guinea-pig injected with the ice cream was dead within 20 hours, extensive inflammation with sanguineous exudation in groin, abdomen and chest. Sample No. 8 contained very few microbes. Guinea-pig injected with the ice cream remained well and lively. (Samples Nos. 9 and 10, received August 12th.) Sample No. 9 contained very few cocci. Guinea-pig injected with the ice cream remained quite well and lively. Sample No. 10 contained very few cocci and some spores of bacillus mesentericus (harmless). Guinea-pig injected with the ice cream remained quite well and lively. (Samples Nos. 11 and 12, received August 13th.) Sample No. 11 contained comparatively few microbes, chiefly cocci. Guineapig injected with the ice cream remained quite well and lively. Sample No. 12 contained comparatively few microbes, sporing bacillus mesentericus, and bacillus coli. The guinea-pig injected with the ice cream remained quite well and lively. E. KLEIN. Sample No. 13 was taken on the 21st August at No. 20, Artillery Lane, from a bucket. The material had been boiled on the 20th. Sample No. 14 was taken at the same time from an uncovered churn of milk on the same premises. Sample No. 15, taken at No. 20, Artillery Lane, on the 22nd August, from the same bulk as No. 13, but after freezing. It had been frozen on the 22nd August, in the early morning. In the forenoon of the same day I received notice from Professor Klein that No. 13 was poisonous. The bulk from which the sample had been taken was therefore seized as unfit for food, under the provisions of the Public Health Act. The ice cream found in the original bucket was taken before the sitting magistrate on the morning of the 23rd, who, after hearing evidence as to the dangerous nature of the material, and the progress of the investigation called for by the cases of sickness which had been attributed to this cause, at once condemned it, and issued the usual formal order for its destruction. The following is a copy of Professor Klein's certificate relating to this sample:— St. Bartholomew's Hospital and College, August 22nd, 1902. I certify that the sample of ice cream No. 13 is, on microscopic and experimental evidence, poisonous and unfit for the food of man. E. KLEIN, M.D., F.R.S. 120 Sample No. 16 was taken on the 22nd August from No. 50, Bishopsgate Street, but made at No. 20, Artillery Lane. This also was found to be poisonous, but had been sold before any action could be taken. Sample No. 17 was taken on the same day at No. 6, Lambeth Hill, but made at No. 20, Artillery Lane. This was also found to be poisonous, but was sold before action could be taken. Professor Klein's report on these samples, Nos. 13 to 17, was as follows:— St. Bartholomew's Hospital and College, August 25th, 1902. Be ICE CREAMS. No. 13 (21/8) contained enormous numbers of microbes. Guinea-pig injected was dying within 24 hours, extensive inflammation all over abdomen and chest, intestines much inflamed. No. 14 (21/8) (Sample of milk) was found curdled very soon after receipt. Guinea-pig injected with the sediment died on 27th August. Post-mortem examination showed extensive gangrene in the subcutaneous tissue of the abdomen. No. 15 (22/8) contained an enormous number of microbes. Guinea-pig injected was dead in 24 hours with extensive hæmorrhagic infiltration and gangrene. No. 16 (22/8) contained a very large number of microbes, was fermented on receipt, full of gas. Guinea-pig injected was dead in 24 hours, extensive hæmorrhagic infiltration and gangrene. No. 17 (22/8) was crowded with microbes, was fermented and full of gas. Guineapig injected was dying in 48 hours, extensive gangrene in groin and abdomen, chest and neck much hæmorrhagic oedema. E. KLEIN. On the 23rd August, the Medical Officer of Health for Finsbury reported that a child living at Smithfield Buildings was suffering from "ice cream poisoning," and that the vendor of the ice cream was an itinerant vendor standing in Charterhouse Street. A sample (No. 19) was thereupon taken and examined by Professor Klein, who issued the following certificate:— St. Bartholomew's Hospital and College, August 27th, 1902. I certify that the sample of ice cream No. 19 is, on microscopic and experimental evidence, poisonous and unfit for the food of man. E. KLEIN, M.D., F.R.S. The Inspector of the District on receipt of this certificate visited the spot and seized remainder of the stock. On the following morning an application was made to .the sitting magistrate, who, after hearing evidence as to the case of sickness, the insanitary condition of the premises where the material was made, and the results of examination, made the usual order for its destruction. No. 18 was obtained on the 25th August at 11.15 a.m., from No. 50, Bishopsgate Street. It had been made on the 24th at No. 20, Artillery Lane, and frozen on the 25th. 121 The report of Professor Klein on these two samples, No. 18 and No. 19, is as follows:— St. Bartholomew's Hospital and College, August 27th, 1902. Re ICE CREAMS, No. 18 and No. 19. These were received here on August 25th. No. 18 contained few microbes. Guinea-pig inoculated with it developed slight oedema extending over abdomen and chest; the animal was generally ill. No. 19 contained numerous microbes. Guinea-pig No. 19 inoculated with it was found distinctly ill in 24 hours, dead within 40 hours ; on post-mortem examination extensive gangrene over abdomen, chest and neck; fibrinous pleuritis with copious sauguineous effusion ; liver much hyperaemia, bowels inflamed. The disease was caused by a highly virulent aerobic microbe belonging to the group of bacillus coli, the morbid products and the blood swarming with the microbe. E. KLEIN. Sample No. 20 was taken on the 27th August at Cutler Street, and found wholesome. Sample No. 21, from Eldon Street, satisfactory. Sample No. 22, on the 28th August, from No. 20, Artillery Lane. This sample was boiled on the 27th August, at 5 p.m., and frozen on the 28th. Professor Klein reports as follows:— St. Bartholomew's Hospital and College, August 29th, 1902. Re ICE CREAMS. No. 20 and No. 21, received August 27th. No. 20.—Few microbes. Guinea-pig injected, quite well, no swelling. No. 21.—Very few microbes. Guiuea-pig injected, quite well, no swelling. Ice Cream No. 22, received August 28th. Fair number of microbes. Guinea-pig injected, is very ill, will be dead in the course of the day ; it has extensive oedema over the abdomen and chest. E. KLEIN. St. Bartholomew's Hospital and College, August 29th, 1902. I certify that the sample of ice cream No. 22 proved on examination—microscopic and by experiment—to be poisonous and unfit for food of man. E. KLEIN. The premises were at once visited, but the whole stock had been sold. A further sample, No. 23, was taken at the same place on the 29th, and found to be satisfactory. St. Bartholomew's Hospital and College, September 1st, 1902. Re Ice Cream No. 23, received August 30th. Cultures show very few microbes; guinea-pig injected is quite well. E. KLEIN. 122 No. 24 was taken from the same shop on the 11th ultimo; also proved satisfactory. St. Bartholomew's Hospital and College, September 13th, 1902. Ice Cream No. 24, received 11/9/02, contained very few microbes, and proved non-poisonous to guinea-pig. E. KLEIN. From the Table appended it will be seen that of 23 samples of ice cream examined, 12, or about 52 per cent., were found to be absolutely poisonous, and that a certain number of cases of illness with definite and similar symptoms were reported among persons who had eaten such contaminated material. One practical difficulty has been already incidentally referred to. It is not sufficient to find cases of illness traced to a particular source to enable the stock of a trader to be seized under the Public Health Act, one must be able to go further, and state that such stock is "unsound or unwholesome or unfit for the food of man." Such statement cannot be made until the result of the bacteriological examination is known, and this means that two or three days must as a general rule elapse before any effective action can be taken under this section, during which time the ices will in nearly all cases have been sold and eaten. In two instances only was it possible to connect the sample with the goods still held by the dealer. As will be shown, however, later on, this will not probably involve any special danger to the public health when the provisions of the 1902 Act are in force. The result of the survey of all places within this City where ice creams are retailed is as follows:— There are 173 establishments (exclusive of clubs and licensed premises where ice creams are served to diners, &c.) where such goods are sold, and in 32 only are these goods actually made within the City. The figures are:— District. Total. Percentage. East. Middle. West. Number of shops in the City where Ice Creams manufactured outside the City are sold 37 67 37 141 81.5 Number of shops in the City where the vendor's stock is made in the City 18 7 7 32 18.5 Total 55 74 44 173 100.0 123 In addition to these are a certain varying number of itinerant vendors whose ices are in nearly all cases made without the City. It is a difficult matter at present to ascertain where the premises are situated, but this will be overcome as soon as the Act comes into force. The Manufacture. At the outset it may be stated that, generally speaking, the materials are good in the sense that they are not unfit for food, and certainly their condition is not such as to give rise to the symptoms met with. There are practically four methods of manufacture:— (i.) The real ice cream, which cannot be sold at a low price, and which is made simply by mixing cream (with a small proportion of milk), fruit or fruit pulp and sugar. This mixture is then at once frozen. This form of ice cream was not implicated. (ii.) Milk is flavoured with fruit, or fruit essence and sugar, and has then added to it a small quantity of dissolved gelatine, and at once frozen. In these two processes there is no boiling, and both are frozen immediately after mixture. (iii.) This is the ordinary "icecream" as vended in shops and in the streets. Milk is boiled, either with or without the addition of some form of starch (generally corn flour) with a certain number of eggs, sugar and flavouring. Practically the number of eggs used varies inversely with the amount of starch, the effect of both being to thicken the mixture, and in some cases the practice has been to at once freeze the mixture ; in others, in order to economise the consumption of ice, the heated liquid has been allowed to cool naturally, under conditions to which reference will again be made. (iv.) This method of manufacture was only met with in one case. A freezing mixture is bought which contains all the materials in a dry powder, and all that is necessary is to boil a certain quantity of this in milk, and subsequently freeze it. This "ice cream" was found to be wholesome. The important stage of the operation would appear to be that between the boiling and freezing. Professor Klein, in his report, called special attention to the fact that the majority of the specific pathogenic bacilli discovered in several of the samples were of a non-sporing variety, and that, therefore, if originally present in the material, would have been destroyed by boiling, and, if found subsequently, must have gained access to the material while cooling. The subsequent freezing, while it might inhibit such bacillus, would certainly not destroy it, and on ingestion and melting its growth and development would again commence. 124 Now the effect of boiling such a mixture would be to sterilize it to a considerable extent, and destroy all the benign or protective organisms usually present. If, therefore, the material were stored while cooling in dirty and insanitary places, where infective organisms could gain access thereto, such organisms, free from all interference of saprophytic bacilli, would be under the most favourable conditions for their rapid multiplication. In other words, the mere fact of the previous sterilization would greatly increase the possibility of danger, provided that the pathogenic organism found an entrance. If this be true, then such ice creams as were stored under improper conditions, and especially those which were exposed thereto for any length of time, would be found especially dangerous. As a matter of fact this was usually found to be the case. Samples Nos. 2, 6 and 19, outside the City, and Nos. 5, 7, 8, 9, 13, 14, 15, 16, 17, 18 and 22 were manufactured in insanitary premises, and in the case of many of these the length of exposure to such conditions was extremely long, in the case of No. 13 not less than 72 hours. The details of samples taken from No. 20, Artillery Lane, are instructive. The time between boiling and freezing was in all cases long, and the condition of the premises most insanitary. The whole of the samples taken from 5th August to 22nd August (10 in number) were found to be poisonous with two exceptions (Nos. 8 and 9), and of these two, one was taken immediately after it had been boiled. The premises were disinfected and cleansed throughout, structural alterations were carried out which allowed of the material being kept in a clean and wellventilated place, and the ice cream made under these improved conditions was found to be wholesome. The sample, No. 13, which had been kept 72 hours before freezing was placed in an open bucket in a filthy area exposed to contamination from the room, area, and a badly kept yard. The sample of milk, No. 14, which was found to contain the same organisms, had been exposed to the same sources of contamination. The great practical points, therefore, to be considered are (i.) the condition of the premises, and (ii.) the manufacture, so far as the length of time between boiling and freezing is concerned, and these have been dealt with as under:— (i.) The ice creams sold in 141 shops in the City were manufactured in districts outside at 48 different places. The shops were inspected, and Notices served to rectify any insanitary conditions where necessary. These have all been complied with. Notice was sent in each instance to the Medical Officer of Health concerned, stating the facts of the case, and asking for information as to the sanitary condition of the premises where the ices were manufactured. Replies were 125 received showing that nine were in an unsatisfactory condition. For obvious reasons, the result of such investigations are not here referred to in detail, and in the Table of Analyses the addresses outside the City limits are omitted. The 32 places within the City where ice creams are made and sold were carefully inspected, and in 15 of them sanitary defects discovered, which were subsequently remedied. As regards (ii.) Sub-section (b) of Section 42, which enacts that "any "person being a manufacturer of ice creams, who in the manufacture, "sale or storage of any such commodity does any act or thing likely to "expose such commodity to infection or contamination, or omits to "take any proper precaution for the due protection of such commodity "from infection or contamination," will give ample power to insist upon the freezing being carried out immediately after the mixture is boiled, and, as a matter of fact, this has already been carried out. The majority of the manufacturers are aliens, and although the premises may be kept in a fairly sanitary condition, their personal habits unfortunately leave much to be desired where the preparation of food is concerned. As a result of this enquiry the following facts were established:— (1) That in a number of cases of illness occurring among young persons of a susceptible age the symptoms were strictly identical, and were characteristic of poisoning by ingestion of toxic material. (2) That the cases reported followed the ingestion of ice creams. (3) That ice creams subsequently obtained at shops frequented by the patients contained bacilli of a virulent character. (4) That the symptoms observed were those generally following the ingestion of material containing such bacilli. (5) That where pathogenic bacilli were found, the ices had been manufactured under insanitary conditions. Beyond this your Medical Officer was unable at the time to draw further conclusions, but recommended that:— (i.) Professor Klein be asked to pursue his enquiries into the origin, and life history, &c., of these pathogenic bacilli. (ii.) That measures of a preventive character, as above indicated, be taken within the City; and (iii.) That a copy of this Report be sent to the Local Government Board, the London County Council, and the Metropolitan Boroughs. These recommendations were agreed to. It may be permitted to point out that the above-mentioned facts amply justified the action taken by the Corporation on the advice of your Medical Officer in promoting with the London County Council the Act giving to each Borough Council power to deal efficiently with this special trade. 126 ICE CREAMS—BACTERIOSCOPIC ANALYSIS. No. of Sample. Date of Collection. Name and Address of Vendor. Place of Manufacture. Result of Analysis. 1 1902. 24 July Fraulo 90, Aldersgate Street. Holborn Poisonous. 2 24 „ Allocca 42, Aldersgate Street. Finsbury Poisonous. 3 31 „ Allocca Corner of Burgon Street and Carter Lane. Ditto Satisfactory. 4 31 „ Castagnetti 21, Pilgrim Street. Shoreditch Satisfactory. 5 5 August Mauro 6, Lambeth Hill. Mauro 20, Artillery Lane, City. Poisonous. 6 5 „ Bottone 36, Upper Thames Street. Holborn Poisonous. 7 11 „ Mauro 50, Bishopsgate Street Without. Mauro 20, Artillery Lane, City. Poisonous. 8 11 „ Mauro 106, Bishopsgate Street Without. Ditto ditto Satisfactory. 9 12 „ Mauro 20, Artillery Lane. Ditto ditto Satisfactory. 10 12 „ Halcomb' 5, Water Lane, Ludgate Hill. Halcomb 5, Water Lane, Ludgate Hill, City. Satisfactory. 11 13 „ Oresto and Co. Pilgrim Street. Holborn Satisfactory. 12 13 „ Darame From a barrow outside "The Deanery," Dean's Yard, Carter Lane. Ditto Satisfactory. 13 21 „ Mauro 20, Artillery Lane. Mauro 20, Artillery Lane, City. Poisonous.* 14 21 „ Sample of Milk 20, Artillery Lane. Supplied by Dairy in Finsbury Poisonous. 15 22 „ Mauro 20, Artillery Lane. Mauro 20, Artillery Lane, City. Poisonous.* 16 22 „ Mauro 50, Bishopsgate Street Without. Ditto ditto Poisonous. 17 22 „ Mauro 6, Lambeth Hill. Ditto ditto Poisonous. 18 25 „ Mauro 50, Bishopsgate Street Without. Ditto ditto Poisonous. 19 25 „ Apollinaire From a barrow at the corner of Cowcross Street, Charterhouse Street. Holborn Poisonous. ** 20 27 „ Ferrari 1, Cutler Street, Houndsditch. Stepney Satisfactory. 21 27 „ Cattlini 18, Eldon Street. Hackney Satisfactory. 22 28 „ Mauro 20, Artillery Lane. Mauro 20, Artillery Lane, City. Poisonous. 23 29 „ Ditto ditto Ditto ditto Satisfactory. 24 11 Sept. Ditto ditto Ditto ditto Satisfactory. * Samples Nos. 13 and 15 were taken from the same bulk—13 before and 15 after freezing—seized, taken before a Magistrate and condemned, 23rd August, 1902. ** Seized, taken before a Magistrate and condemned, 28th August, 1902. 127 REGULATIONS TO BE OBSERVED IN THE MANUFACTURE OF ICE CREAMS, &c. The foregoing investigation clearly showed that the methods adopted in the process of manufacture were of marked importance. It therefore became necessary to instruct those engaged in the trade as to the best means of conducting their business so as to prevent ice creams from becoming a vehicle for the dissemination of disease. With this view a code of Regulations, drafted by your Medical Officer of Health, was approved by the Corporation, and steps will be taken to ensure that the same are strictly enforced in the future in all places where ice creams or other similar commodities are prepared in the City. The following is a copy of these Regulations: — Corporation of London. Regulations to be observed by persons being Manufacturers of, or Merchants, or Dealers in Ice Creams, or other similar commodity in the City of London, approved by the Corporation on the 26th day of November, 1902. 1. No such commodity must be manufactured, sold or stored in insanitary premises, nor in any cellar, shed, or room in which there is any inlet or opening to a drain, or which is used as a living or sleeping room. 2. Such premises must at all times be kept in a thoroughly clean and sanitary condition. 3. All materials must be of a sound and wholesome description. 4. All utensils used in the preparation of ice cream, &c., should be thoroughly cleansed and scalded with boiling water before use. 5. Such utensils should not be used for. any other purpose than for making ice creams, &c. 6. When in the process of manufacture materials are boiled, freezing must take place immediately afterwards. 7. Such materials, after manufacture, should be kept in clean vessels, covered, and placed in cool, well-ventilated rooms. 8. No ice cream or other similar commodity should be kept for a longer period than 48 hours after manufacture, if remaining then unsold it must be destroyed. 9. If any case of infectious disease occur amongst the persons employed in the business, or living, or working in, on, or about the premises, in or on any part of which any such commodity is manufactured, sold or stored, notice shall be forthwith given to the Medical Officer of Health, Public Health Department, Guildhall, E.C. Any infringement of the above Regulations will be dealt with as the Law directs. Guildhall, E.C., 26th November, 1902. 128 TUBERCULOSIS AND MILK. The infective nature of Phthisis is now so generally realised that there are few persons not aware of the necessity for insisting upon all reasonable steps being taken to prevent its spread. Although probably not the most important, there can be but little doubt as to the causal effect of tuberculous meat and milk, the latter being undoubtedly the more powerful. The opinion of Professor Koch as to the great influence of infected sputa is shared by most practical observers, although his dictum that the extent of "infection by the milk, and flesh of tubercular cattle, and the butter made of "their milk, is hardly greater than that of hereditary transmission, and I "therefore do not deem it advisable to take any measures against it," is certainly not at present accepted. Until the Report of the Royal Commission is issued it would certainly be most unwise to omit any precautions in dealing with these infected products. It is clearly proved that the use of "Sterilized" or "Pasteurized" milk is free from danger, if reasonable care be taken to keep it free from subsequent possibility of contamination. But this implies a considerable expenditure of time and trouble, added to a certain increased cost, which will certainly prevent its general adoption, especially among the poorer classes. It is a remarkable fact that while tubercular disease at all ages has greatly diminished in this country during the last half century, that among children during the first years of life has practically remained stationary. The diminution in tubercular diseases at all ages is due to the great improvement in the hygienic condition of the people generally, while the high rate among young children is probably owing to the ingestion of infected cows' milk. Observations show that a very large percentage of milk cows are affected to some extent with Tuberculosis. Mr. James King states that of 500 carcasses of cows examined by him only 266, or 53.2 per cent., were found to be entirely free from disease, and that all the remainder showed tubercular lesions in some part or other. It has been asserted that the tubercle bacillus is found only in the milk of animals in which the mammary glands are diseased. The proportion of cows so affected in this country is found to be about 2 per cent. of the total number examined, and if this were correct it would appear that the risk is but small. Unfortunately, however, this cannot be absolutely accepted, while at the same time there are other undoubted indirect ways in which the milk can become contaminated. The dust of the cowshed or byre in which tuberculous animals 129 are kept must certainly become infected, and this can readily obtain access to the vessels during the' operation of milking. It thus becomes a most important matter to determine how far the milk supply of a town is infected in order to consider as to what means should be adopted to combat this source of danger. At the suggestion of your Medical Officer, Professor Klein was asked to make a preliminary examination of typical samples of milk coming from various parts of the country into the City. These were all taken on arrival, and before any chance of contamination within the district could occur. They represented the milk supply from Essex, Suffolk, Cambridgeshire, Hertfordshire, Staffordshire, Derbyshire, Buckinghamshire, Somersetshire, Cheshire Huntingdonshire and Middlesex. Professor Klein's report was as follows :— St. Bartholomew's Hospital, E.G., 19th September, 1902. I beg herewith to report on the experimental analysis of twenty-four samples of Milk delivered here by your Inspectors, in batches of six samples, on the following dates :— Nos. 1, 2, 3, 4, 5, 6 on July 15th, 1902. Nos. 7, 8, 9, 10, 11, 12 on July 22nd, 1902. Nos. 13, 14, 15, 16, 17, 18 on August 20th, 1902. Nos. 19, 20, 21, 22, 23, 24 on August 27th, 1902. The samples were all contained in sterile bottles supplied by me. With the exception of sample No. 17, which was devoid of cream, all others look normal milk. The examination was in all instances carried out in order to detect the bacillus tuberculosis. For this purpose, of each sample 250 cubic centimetres were placed for 24 hours in the ico chest. After this time the whole of the sediment was collected and used for the injection of two guinea-pigs : one [uneven number] intraperitoneally, the other [even number] subcutaneously ; therefore 48 guineapigs in all were experimented with, all the even numbers indicating the subcutaneous, all the uneven numbers peritoneal injections. The animals were kept for from between three to four weeks, and then a careful post-mortem was made of each, in order to detect any abnormal condition, either locally or generally. The use of two animals for each sample has proved of great use, not only in enabling one to test a large amount of the milk sediment, but also on account of making provision against accident in this manner. It not unfrequently has happened—and the same occurred also in the present examination—that a guinea-pig, after receiving such a considerable amount of milk sediment as is used in these experiments, succumbs from an acute septicemic infection. My experience of analysis of milk for tubercle is very considerable, having within the last three or four years examined more than 300 samples, and in all this time I have not known a single instance when both the subcutaneously and the intraperitoneally-injected guinea-pig [for one particular sample] succumbed from acute infection ; when acute infection occurred it always affected one only of the two animals used for the particular sample, so that one animal at all events remained for the tubercle test. The following Table gives a comprehensive account of the result of the experiments:— 130 Milk Sample. Date of Experiment. Guinea-pigs injected. Date of P.M. Result. 1902 No. 1 July 16th No. 1 intraperitoneal Killed, August 12th Negative. „ „ „ 2 subcutaneous „ „ Purulent abscess in groin, [no tubercle. Nc. 2 „ „ 3 intraperitoneal „ „ Negative. •» „ ,, 4 subcutaneous „ „ „ No. 3 „ „ 5 intraperitoneal Died, August 5th Big abscess on margin of liver, „ „ ,, 6 subcutaneous Killed, August 15th Negative. [no tubercle. No. 4 „ „ 7 intraperitoneal Died, July 17th Septicæmia. „ „ „ 8 subcutaneous Killed, August 15th Negative. No. 5 „ „ 9 intraperitoneal „ „ „ „ „ „ 10 subcutaneous Died, July 25th Abscess in groin, gangrene of abdominal wall, no tubercle. No. 6 „ „ 11 intraperitoneal Died, August 5th Abscess in abdominal wall, „ „ „ 12 subcutaneous Killed, August 15th Negative. [no tubercle. No. 7 July 23rd „ 13 intraperitoneal Killed, August 16th „ „ „ „ 14 subcutaneous „ „ „ No. 8 „ ,, 15 intraperitoneal „ „ „ „ „ „ 16 subcutaneous „ „ No. 9 „ „ 17 intraperitoneal „ „ „ „ „ „ 18 subcutaneous „ „ „ No.10 „ „ 19 intraperitoneal „ „ „ „ „ „ 20 subcutaneous „ „ „ No.11 „ „ 21 intraperitoneal „ „ „ „ „ ,, 22 subcutaneous „ „ „ No. 12 ,, „ 23 intraperitoneal „ „ „ „ „ „ 24 subcutaneous „ „ „ No.13 August 21st ,, 25 intraperitoneal Killed, September 13th „ „ „ „ 26 subcutaneous Died, August 22nd Septicæmia. No. 14 „ ., 27 intraperitoneal Killed, September 13th Negative. „ „ ,, 28 subcutaneous „ „ „ No.15 „ „ 29 intraperitoneal „ „ „ „ „ „ 30 subcutaneous „ „ „ No.l6 „ ,, 31 intraperitoneal „ „ „ „ „ „ 32 subcutaneous „ „ „ No.17 „ ,, 33 intraperitoneal „ „ „ „ „ „ 34 subcutaneous „ „ „ No.18 „ ,, 35 intraperitoneal Died, September 8th Purulent peritonitis; no tulercle. „ „ „ 36 subcutaneous Killed, September 13th Negative. No.19 August 28th ,, 37 intraperitoneal Killed, September 19th „ „ „ ,, 38 subcutaneous „ „ „ No.20 „ ,, 39 intraperitoneal „ „ „ „ „ „ 40 subcutaneous „ „ „ No.21 „ ,, 41 intraperitoneal „ „ „ „ „ „ 42 subcutaneous „ „ „ No 22 „ ,, 43 intraperitoneal „ „ „ „ „ „ 44 subcutaneous „ „ „ No.23 „ „ 45 intraperitoneal „ „ „ „ „ ,, 46 subcutaneous „ „ „ No.24 „ „ 47 intraperitoneal „ „ „ „ „ ,, 48 subcutaneous „ „ „ [The term "Negative " means no pathological condition of any kind was found locally or generally, all viscera being perfectly normal.] E. KLEIN. 131 These results were satisfactory, as showing that so far as the samples taken could indicate, the milk supply of the City was free from the tubercle bacillus. It must, however, be borne in mind that the number taken was small, and will require to be supplemented later before any decided deduction can be drawn therefrom, though, on the other hand, the samples represented a considerable proportion of the milk supply. A similar enquiry, carried out by the Medical Officer of the County Council and Professor Klein in 1900, showed that of 97 samples of milk sent into London seven contained the tubercle bacillus. In case of one supply only was any reliable information forthcoming as to the condition of the udders, and in this the animals were all certified to be free from tubercular disease. From an examination of milk cows by the London County Council's Veterinary Inspector (1900 and 1901), it was found that in 13,467 inspections only 40 cases of actual or suspected tubercular disease of the udder were found. On the other hand Professor Klein, who examined milk from some of the others, found the bacillus present in one sample. CHEMICAL ANALYSIS OF CITY MILK. It will probably be convenient here to refer to the results of chemical analysis of samples of milk, inasmuch as the adulteration of milk had been found to exist to a large extent in the City, and the almost invariable defence in cases of prosecution had been that the milk was sold in the same condition as received, and that if impoverished in any way, this must have taken place before delivery in London. During the previous year, 1901, of 392 samples of milk purchased for analysis, no fewer than 83, or 21.2 per cent., were found to be sophisticated. In order to check the value of the above-mentioned defence, arrangements were made to take samples under precisely the same conditions from the churns on arrival from the country at the various City railway stations. These were submitted to the City Analyst, whose results are appended:— 132 MILK ANALYSES-SAMPLES TAKEN AT CITY RAILWAY STATIONS. Mark on Sample. Result of Analysis. Fat. Solids (not fat). Total Solids. 1902. Mar. 6th 320 3.45 8.85 12.30 Taken at Liverpool Street Station. „ 321 3.49 8.95 12.44 „ 322 5.95 8.79 14.74 „ 323 4.57 8.57 13.14 „ 324 4.85 8.33 13.18 „ 325 5.40 8.30 13.70 „ 326 4.68 8.24 12.92 „ 327 4.08 8.82 12.90 „ 328 4.37 8.51 12.88 „ 329 5.73 8.75 14.48 Mar. 7th 330 3.90 8.90 12.80 „ 331 3.59 8.85 12.44 „ 332 3.75 8.63 12.38 „ 333 3.10 8.86 11.96 „ 334 3.73 8.87 12.60 „ 335 3.50 9.08 12.58 „ 336 3.85 8.79 12.64 „ 337 3.38 8.70 12.08 „ 338 3.50 8.66 12.16 „ 339 3.43 8.73 12.16 Mar. 12th 354 3.50 9.14 12.64 Taken at Fenchurch Street Station. „ 357 3.41 8.91 12.32 „ 358 3.79 9.17 12.96 „ 359 4.01 9.19 13.20 „ 360 4.25 9.11 13.36 Mar. 24th 418 3.61 8.73 12.34 Taken at Broad Street Station. „ 419 4.12 8.82 12.94 „ 420 3.39 8.71 12.10 „ 421 4.25 8.99 13.24 „ 423 3.23 8.95 12.18 Averages ( 30 samples) 4.00 8.79 12.79 133 These samples being taken during the month of March, did certainly not represent a period of the year when the quality is usually high, but in the majority of seasons would be somewhat below the average for the whole year. The figures were most satisfactory from one point of view, as showing that the milk supply of the City as it reaches the railway station was of a high standard of quality. While the average percentage of fat was 4, in no one instance did it approach the low limit adopted by the Board of Agriculture, viz., 3 per cent., while in one case it was practically double, viz., 5.95. In other words, if this particular sample (322) had been mixed with an almost equal quantity of water, the amount of fat present would have been within the legal limit! The same remark applies to solids not fat. While the average of all the samples was 8.79, in three only was it slightly below this, while the highest contained 9.19 per cent. The average total solids amounted to 12.79, the highest being 14.74, and the lowest 11.96. It will therefore be seen that the City dealer has a milk of high standard to start with, and that but little, if any, attention should be paid to the "sold as bought" defence. All the evidence tends to show that water is added or cream abstracted deliberately, with a view to increase the profit. When the small amount of fines inflicted is considered, and the enormously increased profit, it will be readily understood how well such fraudulent action pays, while the risk of detection is admittedly small. 134 SHELLFISH AND ENTERIC FEVER. During the month of December last the danger to the public from eating shellfish from sources contaminated with sewage was exemplified by two distinct outbreaks, one caused by cockles, and the other by oysters. The following Report on the circumstances was laid before your Sanitary Committee by your Medical Officer of Health on the 27th January last:— COCKLES. On the 5th December Dr. P. Caldwell Smith, Medical Officer of Health for the Metropolitan Borough of Wandsworth, informed your Medical Officer that four cases of Enteric Fever had occurred among persons resident in Clapham, and that in each instance there was strong evidence that the disease was caused by eating cockles bought in the City. The disease was of a markedly virulent type; three cases occurred in one family, two probably from direct and one from indirect infection. In three of the cases the disease appeared almost exactly fourteen days after the ingestion of cockles from a known source; in the fourth the interval was twenty-five days. Of the first three cases reported, unfortunately two proved fatal. Upon enquiry it was found that the cockles in question had come from Leigh-on-Sea, Essex, and that they were sold by a Leigh dealer, P., who, every Saturday, with others, sold cockles at the entrance to Nicholson's Wharf, in the neighbourhood of Billingsgate Market. On the following morning (Saturday, 6th December) a sample of cockles marked No. 1 was purchased from P., and submitted to Professor Klein for bacteriological examination. Pending Professor Klein's report, and as the result of some enquiries made at Leigh as to the mode in which the trade in cockles is conducted, samples marked No. 2, No. 3 and No. 4 were purchased on the following Saturday (13th December) from different dealers at Nicholson's Wharf and submitted for examination. The co-operation of Dr. Douglas Watson, Medical Officer of Health, was invited, and on the 15th December he kindly forwarded samples of cockles taken before and after cooking at Leigh. These were marked No. 5 and No. 6 respectively. On Saturday, 20th December, a further sample (No. 7) of cockles was purchased from P. at Nicholson's Wharf and submitted to Professor Klein. The following reports were received from Professor Klein on the 19th December:— 135 St. Bartholomew's Hospital, E.C., December 19th, 1902. I should have reported before this on the samples of Cockles if the work had 'been finished, that is to say, if the analysis of the last two samples, Fresh Cockles No. 5, and Cooked Cockles No. 6, from Leigh-on-Sea (received on 16th December), had been completed. Unfortunately, it is not completed yet, and I propose giving you here a summary of the results so far obtained. Samples Nos. 1, 2, 3 and 4 were "cooked" cockles. Of each of these twelve cockles were selected, cleaned on the outside, and a fraction of a droplet of the interior of the animal was used for each cultivation in the various media required to discover bacillus coli communis, bacillus typhosus and spores of the anaerobic virulent bacillus enteritidis sporogenes. For each sample (1, 2, 3, 4), therefore, something like three dozen cultures in tubes and plates were used. Of those first tubes, which on incubation showed the changes indicating or suggesting the presence of the above microbes, sub-cultures had to be made for isolating them in pure culture, and these were finally used for applying all the tests and reactions— chemical and physiological—necessary for their identification. The result so far has been this:— From Sample No. 1, received December 6th, were obtained (a) bacillus coli communis; (b) spores of the virulent bacillus enteritidis sporogenes; (c) a microbe which resembles The typhoid bacillus in the following respects: The aspect and growth of the colonies are more like those of the typhoid bacillus than of the bacillus coli; so also those in streak and stab culture. The bacillus in question forms acid in litmus milk, but does not curdle the milk, that is to say, it resembles the bacillus typhosus in those respects, as also in the fact that it does not form Indol. It is cylindrical and highly mobile, just like the bacillus typhosus; but unlike bacillus typhosus, and like bacillus coli, it ferments (that is, bubbles) gelatine. I have tested the emulsion of this bacillus in respect of its relation to typhoid blood; blood of a typhoid protected guinea-pig, which in dilution of 1 in 100 agglutinates the emulsion of the laboratory typhoid bacillus. One in 100 failed to agglutinate the emulsion of the above bacillus in this dilution, but gave a fairly good positive re-action as 1 in 20, though less distinct as 1 in 50. I have obtained, through Dr. Caldwell Smith, from Dr. Beggs, of the Fever Hospital at Tooting, blood of the two patients that have been sent to the Hospital by Dr. Caldwell Smith, and that had been infected by eating cockles. I tested this blood on our laboratory typhoid, and found it gave strikingly positive re-action as 1 in 20, agglutination being complete within 5 to 10 minutes. Tested on an emulsion of our bacillus of the cockles the above blood failed to give any positive reaction as 1 in 20 in one hour. While, then, it appears that the interior of the cockles of this Sample I contained microbes of sewage, there is no evidence that the microbe isolated, and which resembled the typhoid bacillus in several respects, was the real bacillus typhosus. From Sample 2* were isolated the bacillus coli communis, and the same species of coli-like or, rather, typhoid-like bacillus, as was described above. No spores of the bacillus enteritidis sporogenes were obtained from this lot. 136 Of Sample 3, bacillus coli communis and the spores of bacillus enteritidis sporogenes were isolated. Of Sample 4, no bacillus coli communis, the same coli-like or typhoid-like bacillus as of Samples 1 and 2; spores of bacillus enteritidis sporogenes were found abundant. Of Sample 6 (cooked, from Leigh-on-Sea) were obtained no bacillus coli communis ; a coli-like microbe, numerous spores of bacillus enteritidis sporogenes. Of Sample 5, raw cockles from Leigh-on-Sea, were isolated a colon-like bacillus, which is cylindrical, but not very mobile, which in plate and in streak culture is more like typhoid than coli, but which tested with typhoid blood gives no agglutinating reaction, even as 1 in 20 in one hour. Its other further characters are at present under observation†. From this sample we obtained also numerous spores of bacillus enteritidis sporogenes. It ought to be added that of the raw cockles only the interior of the stomach was examined, so as to place it on the same footing as the other samples of cooked cockles. From this analysis I conclude that all these cockles had evidence of sewage pollution in their interior, some, like Samples 1, 2 and 6, more so than others. Sample No. 7, "cooked" cockles were received on December 20th, yielded bacillus coli communis in abundance, a variety of bacillus coli which is characterised by being extremely motile and cylindrical. In streak and plate culture it resembles the typhoid bacillus, but its emulsion gives no sign of agglutination with typhoid blood as 1 in 20 in one hour. This typhoid blood is capable of agglutinating the laboratory typhoid bacillus as 1 in 100 within ten minutes. In addition to these microbes numerous spores of bacillus enteritidis sporogenes were demonstrated by culture in the interior of these cockles. If it be remembered that bacillus coli communis, as also all varieties of bacillus coli and bacillus typhosus, are killed without fail by exposure to heat of 160 deg. Fahrenheit (70 to 71 deg. C.), then it follows that the cooking process of these cockles must have been performed in a very perfunctory manner, that is to say, the temperature of the water to which they were exposed must have been considerably below that of boiling water, 212 deg. F.; indeed below 155 deg. F. (Signed) E. KLEIN. * This Sample 2, as also 3 and 4, were received on December 13th. †Addendum—This microbe "bubbles" (ferments) gelatine, it produces acid and clots milk. From these facts the microbe can with certainty be declared as non-typhoid. Thus in all the samples examined by Professor Klein there is clear evidence that sewage contamination existed in a marked degree. The fact that* he failed to demonstrate the presence of the bacillus typhosus is extremely interesting from a scientific point of view, but is of minor importance in considering cockles from a dietetic point of view. There cannot be any question as to the absolute necessity for prohibiting the use of food which is known to be contaminated with sewage matter, and there is, further, the obvious fact that with such sewage may be associated at any moment the bacilli of any of the infectious diseases which are conveyed therein. * In a later sample (No. 10) the presence of the typhoid bacillus was definitely demonstrated. 137 Probably the mere existence of sewage matter without the incidental chance of specific infection will be sufficient to justify prohibition in the minds of most persons. The responsibility of the Corporation in this question is great. Firstly, the cockles are sold in the City, and secondly, they are obtained and relaid within the jurisdiction of the Corporation, the Sanitary Authority for the Port of London. Full details, so far as obtainable, were therefore forwarded to Dr. Williams, the Port Medical Officer, with whom, on the 3rd January, I visited Leighon-Sea, and inspected the Creek where the cockles are laid (see below). Dr. Williams obtained and submitted to Professor Klein samples of mud and water from the Creek, and (No. 10) also of cockles lying in situ on the bank. Both mud and water were obviously filthy, and without any further examination it was evident that the Creek is not a proper place to deposit cockles in. To Dr. Williams I am indebted for the following Report of Dr. Klein on the three above-mentioned samples. January 7th, 1903. The following is the, as yet, incomplete Report of the bacterioscopic analysis of the three samples received here on January 5th, per Dr. Williams :— 1.—One sample of Water, labelled "Water taken from Leigh Creek, low tide, 11.30 a.m., 3rd December, 1902." 2.—One sample of Mud and Cockles from Leigh Creek, low tide, "taken by Medical Officer of Health, 3rd January, 1903." These samples will be nominated — No. 11. Water from Leigh Creek; „ 12. Mud from Leigh Creek; and „ 10. Cockles, respectively. No. 11. This water contained at least ¼ million microbes per 1 c.c. The water contained abundance of bacillus coli communis and spores of bacillus enteritidis sporogenes; of the latter at least 10 spores per 1 c.c., of the former at least 100 per 1 c.c. From this it follows that the water is practically dilute sewage. No. 12. Mud.—1 gramme of mud was distributed in 10 c.c. of sterile water. After allowing the mineral matter to settle, of the slightly turbid fluid 1/10 c.c., ¼ c.c. and 1 c.c. were used for demonstrating the presence of the bacillus coli communis, and the spores of bacillus enteritidis sporogenes, and the result was practically the same as stated of the water, viz., abundance of bacillus coli communis and of spores of bacillus enteritidis in 1/10 c.c. 138 No. 10. Cockles. — Twelve of the cockles were used, only the exterior being employed. The result is this. All cockles contained the bacillus coli communis and the spores of bacillus enteritidis. In one (possibly two) cockle we isolated, besides, a microbe, which, so far as was possible in the two days, answers to the tests of the typhoid bacillus, but, of course, this time is not sufficient to make a definite statement on the subject.* I may say, however, that typhoid blood agglutinates the emulsion of the bacillus in question as 1 in 100, better, of course, as 1 in 50. Yours truly, E. KLEIN. * All further tests made show that this microbe is the bacillus typhosus. Its characters in all culture media are exactly those of the typhoid bacillus.— 13th January, 1903, E. K. This report simply confirms what was visible on inspection. The small amount of water in the Creek (taken at the end of the ebb tide) was practically sewage. The only effect of depositing cockles in this Creek would be to allow them to exchange the sand of the place where they were originally collected for the sewage mud of Leigh. Numerous other outbreaks of disease have been traced to cockles. Dr. F. J. Allan, Medical Officer for the City of Westminster, in a Report dated 17th October, 1902, makes the following reference to a group of cases occurring in that district:— Enteric Fever.—The marked decline which took place in Enteric Fever cases in London in August was not maintained, the cases rising from 287 to 473, a figure in excess of that recorded last year. In Westminster there have been no less than 26 cases, and the manner in which a number of these contracted the disease suggests a possible explanation of the increase in London generally. It will be observed that 14 of the cases were notified in the Wards of Covent Garden and Strand. Two other cases were notified at the end of the month subsequent to the date of this Report, and I am informed that a case has also occurred in the Borough of Holborn, and is connected with this group; a fourth case of bowel complaint in a brother of one of the above patients came to my knowledge, but the medical men in attendance did not feel justified in notifying it as a case of typhoid fever. All those attacked were young persons, and on enquiry it was elicited that all of them had been to Southend-on-Sea or Southwick (a small seaside village between Brighton and Worthing) for a fortnight; of these 18 cases 7 had been to the former place only, 1 to Southwick only, and 10 to both places. All those who went to Southend bought and ate cockles from itinerant vendors, and with one exception (a boy who went to Southend also), those who went to Southwick picked up mussels and ate them—in some cases taking them to their lodgings to be cooked, but in a good many instances the mussels were eaten raw. In the one exception, although the boy did not eat mussels at Southwick, he had eaten cockles at Southend, and the interval between so doing and falling ill was not too long to preclude the cockles as the source of the disease, but he had been constantly in the water bathing or 139 paddling at Southwick, and had assisted other boys in collecting mussels. From enquiries I have made, there is no doubt that infection through the medium of infected shellfish might be contracted at both the places mentioned. The cockles sold in Southend came from Leigh, and I described in my Annual Report for 1901 the conditions under which this industry is conducted, and the Jenner Institute was able to demonstrate in cockles brought from Leigh, the presence of the bacillus which causes Typhoid Fever. Dr. Nash, the Medical Officer of Health of Southend, attributes cases in that Borough to the same cause, and in a paper read at the recent Congress at Manchester stated that he had ascertained that several cases of typhoid fever had occurred in the district supplying the sewage which falls into the creek on the banks of which the cockles are laid. The Medical Officer of Health for Southend-on-Sea, Dr. J. T. C. Nash, referred to the subject in a paper read before the Sanitary Institute Congress at Manchester, 1902. He there states:— In 1901, I found that in no less than twenty-one out of thirty-seven cases of typhoid fever which occurred between August 15th and December 31st, there was a history of the eating of shellfish (generally oysters and cockles) within a month of the onset of illness. The history of typhoid fever in the Borough of Southend-on-Sea indicates that the more closely enquiries were made into the causative influence of shellfish from doubtful layings, the larger became the proportion of cases in this connection. From the internal evidence of the annual reports, it appears that the enquiries as to shellfish for 1895-1897 were almost limited to the eating of oysters, and that only within a limited period of from two to three weeks previous to onset. From 1898 onwards the figures generally show (with the exception of 1899) a larger proportion each year of cases stated to have eaten shellfish. A legitimate inference is that closer enquiries with respect to other shellfish, as well as oysters, in the earlier years 1895-1897, would have revealed a larger proportion of cases of typhoid fever attributable to infected shellfish than the figures given in the reports. Moreover, the incubation period of typhoid fever is very variable, extending from only one or two days to four or five weeks, and therefore enquiries as to shellfish should cover at least a whole month prior to onset, instead of from two to three weeks only. Further, I have pointed out elsewhere* that enquiries should not be limited to the eating of shellfish, but should extend to the handling of shellfish from suspicious sources. It is easy to understand that germs can be carried to the mouth by the unwashed hands after touching infective shellfish, as well as from clothing infected with typhoid dejecta. This latter method of infection is the usual source of secondary cases. * Public Health, August, 1902. Preparation.—Cockles are found in large quantities, mostly on sandy shores around the coast, and are collected by hand at low water. Dr. Bulstrode, in his report to the Local Government Board, 1896, "on "Oyster Culture in relation to disease," states: "There are certain considera"tions which serve to show that contractions of water-borne diseases by the "ingestion of cockles is a somewhat remote contingency. 140 "In the first place these molluscs are, as a rule, only eaten after being "cooked, and in the second place it is seldom that extensive cockle industries "are carried on in other localities than those where large stretches of sand are "exposed at low tide, and such stretches are found chiefly on the actual "seashore or quite at the mouth of estuaries far away from sources of sewage contamination." The cockles prepared at Leigh are collected at various points on the Maplin Sands, and on the Blythe, near Grain Spit. They are taken over to and laid down in Leigh Creek for a day or two; this being done with the object of allowing them to clear themselves of the sand which they naturally contain. I am informed by Dr. Watson, Medical Officer of Health for Leigh-on-Sea that the present sewage system was installed by Mr. Baily Denton, the crude material being treated in coke and ballast filtering tanks, and the effluent discharged on the ebb tide only at a point about half-a-mile above the cockle laying. There is, further, the obvious possibility of pollution from the discharge of sewage from Southend-on-Sea, and from the large amount of sewage sludge and sewage contributed by the Metropolis. From these various sources the cockle layings are contaminated to an extent that renders them absolutely unfitted as a place of deposit. It has been suggested that such deposition might be made in Leigh Ray, but this would be a doubtful advantage, inasmuch as oysters and mussels from the Ray have been found to be sewage contaminated, either from sewage coming down the river, or from Southend-on-Sea. The cockles are raked into hand-nets from the banks of the Creek, and taken to the cockle sheds. Here they are plunged into coppers of boiling water in the nets, after which they are riddled through wide-meshed sieves, which allow the soft parts to pass through, retaining the shells, which are deposited in heaps for sale to oyster cultivators. The cockles themselves are then washed in about five changes of water, to the last of which a certain quantity of salt is added. Formerly they were washed and "boiled" in the Creek water, but latterly the urban district public water supply has alone been used for this purpose. It is clear, therefore, that the sewage contamination must take place before the "boiling" and washing. The so-called boiling is somewhat misleading. Though the water is actually at the boiling point, the cockles are plunged in in a mass, and for a short time, and it by no means follows that every part is exposed to a temperature of 212° F. 141 As Professor Klein points out, the bacilli in question are killed by a temperature of 160° F., and as they are found to be alive, it follows that this temperature has not been exceeded. It is farther stated that if the "fish" were actually boiled they would be tough and useless. The question then arose as to dealing with an obviously dangerously infected source of food supply. Under the Public Health (London) Act, 1891, it is possible to obtain a Justices' Order to destroy "any article, whether, solid or liquid, intended for "the food of man, and sold, or exposed for sale, or deposited in any place for the "purpose of sale, or of preparation for sale, if it appear to such Justice that the "same is diseased or unsound, or unwholesome, or unfit for the food of man." There is no question that the cockles would come under the above section, and could be so dealt with if the fact were at once evident. But the necessary examination involves the lapse of a considerable time, in most cases five or six days, and before the results of such examination could be known in the case of any one sample, the whole quantity from which such sample was taken would have been consumed. Further, even if practicable, such action would only be applicable to such cockles as were brought within the jurisdiction of the Corporation, and the owners, if they were so disposed, would be at liberty to send them to any other part of the country. Under these circumstances the whole of the facts were reported to the Worshipful Company of Fishmongers, which has extensive powers over the fishing industry throughout the country. The Company at once put their powers into force, and issued instructions that they, having previously sent down one of the Company's Inspectors to inspect the site, and receiving from him a report to the effect that the relayings of cockles were in close proximity to the outfall of sewage, gave the cocklers to understand that they would not on any account whatever allow any more cockles than were then actually ready for the market to be relaid in the Leigh Estuary and subsequently boiled, but that if they were to undertake faithfully that they would only take cockles from the parent beds on the Maplins and elsewhere, and boil them directly they were landed without in any way allowing them to be contaminated by any sewage, they would allow their consignments to be sold in London. This action was taken on the assumption that the original source of collection, viz., the Maplin and Blythe Sands, were uncontaminated with sewage, as it was clearly unjustifiable to condemn any cockles until they had been actually proved to be polluted. • • 142 It was, however, obviously necessary to establish this fact beyond doubt, and samples were obtained by the officers of the Fishmongers' Company from the gathering grounds. Sample No. 8 was taken from the lower part of the Blythe, opposite the Chapman Lighthouse, sent to Professor Klein on the 1st January, 1903, who reported thereon on the 3rd January as follows:— Cockles No. 8 received in the shell on January 1st, 1903. Eighteen cockles examined, plentiful bacillus coli communis and spores of bacillus enteritidis sporogenes. Therefore extensive sewage pollution. E. KLEIN. The Clerk of the Fishmongers' Company was at once informed that the sale of these cockles should be stopped absolutely, even if cooked at once without relaying. Sample No. 9, collected on the Maplin Sands abreast of the Mouse Lightship, submitted to Professor Klein on the 3rd January, 1903, who reported on the 8th January as under:— January 8th, 1902. Re COCKLES No. 9. These were received on January 3rd from Maplin Sands. The cockles were all of a very fine size. After thoroughly washing them and brushing them under the tap, twelve of them were opened with sterile instruments and the interior used for the special cultivations in order to discover the presence of microbes of the coli-typhoid group and the spores of bacillus enteritidis sporogenes. The result was this:— Eight cockles contained the bacillus coli communis, three contained coli-like microbes, but these were neither the bacillus coli communis nor the bacillus typhosus. Four cockles contained abundance of spores of the bacillus enteritidis sporogenes; the other eight were free of them. E. KLEIN. This report at once changed the whole position of affairs. The arrangement made to bring cockles from the Maplins and Blythe and cook them at Leigh without relaying in the Creek could not longer be allowed. I therefore at once wrote to the Clerk of the Fishmongers' Company as follows:— "From the report of Professor Klein, 8th January, 1903, it is clear "that the cockles collected from the Maplins are sewage polluted. "As the whole of the Leigh supply is derived from the Maplins and "Blythe, and as both these sources are now shown to be contaminated, it "is clear that there is nothing left but to prohibit the sale of cockles "from Leigh. "This is an unfortunate thing, as it will mean stopping the trade, but I do not see that any other action can be taken in view of the facts." 143 On the 17th January the Clerk to the Fishmongers' Company informed me that he had that day sent two samples of cockles, numbered 22 and 23 respectively, to Dr. Klein for analysis. Sample No. 22 was taken direct from the Maplin Sands and boiled for minutes. Sample No. 23 was taken direct from the Maplin Sands and boiled for one minute. The following is Dr. Klein's report on these samples:— January 19 th, 1903. I beg herewith to report on the two samples of "cooked" cockles, Nos. 22 and 23, received here on January 17th. Labels attached to the samples:— No. 22. Time of boiling sample enclosed 3½ minutes. No. 23. Sample enclosed in continuous boiling water for one minute before leaving the shells. The cultures made of the interior of 12 cockles of batch shows:— No. 22. No bacillus coli communis in any of the cockles. No spores of bacillus enteritidis sporogenes. No. 23. Of only one cockle something like bacillus coli communis (?)* all others free of it. Half of the cockles examined no spores of bacillus enteritidis alone. From this it follows that the 3½ minutes' boiling has effectively sterilized the interior of the cockles; one minute's boiling did this, not sufficiently effectively. E. KLEIN. * This is being further examined by subcultures. These samples had been boiled on the evening of the 16th, and handed to Mr. Towse on the following morning. I was also informed they were submitted to Dr. Klein with the object of ascertaining if cockles so boiled were fit for food. Upon receipt of these facts I wrote to the Clerk to the Fishmongers' Company that I did not consider that the analysis of these samples (Nos. 22 and 23), collected on the Maplins and subsequently cooked for varying periods, would serve any useful purpose. The fact had already been established beyond question that cockles gathered on the Maplins are subjected to, and contaminated with, sewage pollution, and whatever the result of Dr. Klein's investigation of these particular samples, it would have been obviously improper to sanction the sale of Maplin cockles, whatever provisions the Company might endeavour to enforce with regard to the mode of cooking them. The samples in question were practically prepared under laboratory conditions, which it would be impossible to guarantee would always obtain in the cockle sheds. 144 Moreover, being bound to take a judicial view in the interests of the public health, I should hesitate to accept as satisfactory any results derived from an examination of samples submitted by a trader personally interested in the matter as indicated by Mr. Towse's letter. This is not only a serious matter for the Leigh cocklers, but it raises a question of far greater importance. If at points so far apart as the Mouse Light, the Blythe Sands and Leigh Creek the existence of sewage pollution can be proved, it will become necessary to make fuller and more complete examination of all oysters, mussels, cockles or other shellfish within these limits. The results of Professor Klein's experiments clearly point to extensive pollution of the whole estuary of the River Thames, and the consequent contamination of such shellfish and fish as are found therein. The extent to which such pollution affects the food supply is one that can only be determined by a complete investigation. It is most 'desirable that such an investigation should be put in hand at the earliest possible moment, as undoubtedly the whole of the Thames fishery is under grave suspicion. All shellfish should certainly be examined, and in addition all sprats, whitebait and smelts, these latter being eaten "uncleaned," and the cooking being of such a nature as not to ensure a high temperature throughout the whole fish. Such an investigation would naturally come within the purview of the Port Sanitary Committee rather than of your Worshipful Committee. Legislation is urgently required to prevent these periodical outbreaks of disease, and the trouble and expense they entail. Hitherto this trouble has fallen mainly upon the oyster trade, and, as I show later, not without serious justification, but the above facts show that the same protection to the public is required in the case of cockles. As a matter of fact, from one point of view the danger from cockles is greater than that from oysters, inasmuch as Professor Klein has inferred from his investigations that the bacilli of typhoid fever will actually undergo multiplication within the body of the cockle, while in the case of oysters it only survived and failed to multiply. It is interesting here to note that the bacillus of typhoid fever was actually demonstrated in the sample of cockles (No. 10) taken from Leigh Creek on the 3rd January. Again, the fact that cockles are the luxury mainly of the poor should be an argument in favour of greater need for protection. 145 In 1899, consequent upon the report of Dr. Bulstrode and the urgent representation of the Corporation as Port Sanitary Authority, a Bill was introduced into the House of Lords entitled "An Act for the Protection of Public Health against Danger arising from the Consumption of Unwholesome Oysters." This Bill dealt with the question by giving powers— (i.) To enter upon any oyster laying and take samples. (ii.) To prohibit the sale of any oysters from any laying found to be fouled by sewage, giving the owner ten days' notice and allowing him a hearing, with the right of appeal to the Local Government within a period of 21 days. The penalty for so selling oysters after prohibition is a fine of £5. (iii.) The Local Government Board was empowered to act in default of the Authority ; and (iv.) A Clause giving His Majesty in Council power to prohibit the importation of any oysters from foreign layers known to be contaminated. The Authority in the Bill as originally drafted was the County Council, but this was changed by the Select Committee to the Sea Fisheries Committee. Your Medical Officer (acting for the Port Sanitary Authority) gave evidence before the Select Committee as to the advisability of entrusting the powers to Port Sanitary Authorities on the following grounds:— (i.) So far as London is concerned, the Corporation's jurisdiction as Port Sanitary Authority includes some important layers within its limits, and that the effect of the Bill as drafted would be to give concurrent jurisdiction within these limits to another Authority. (ii.) That it would be an unwise step to give this power (as was suggested in the amendment) to bodies like Sea Fisheries Committees, who had no Sanitary Officers, no Sanitary Authority, and who were in no wise responsible to or even in relation with the Central Health Authority. (iii.) That the Corporation, while maintaining the sanitary control of their district entirely at their own expense, had all the machinery required for the purposes of inspection, viz., Medical Officers, Sanitary Inspectors, Launches, &c., and were quite prepared to accept this further duty if entrusted to them. (iv.) That so far back as June, 1897, the Port Sanitary Authority, impressed with the danger to the public health, had communicated with the Local Government calling attention to the position, pointing out that they had no legal power to deal with the question, and asking them to consider the advisability of constituting the Corporation as the Authority for the inspection of oyster beds and layings within the Estuary of the Thames, and obtaining for them such powers as might be necessary. 146 Unfortunately, however, the Select Committee did not appear to realise that the whole object of the Bill was for the protection of the public health, and that as such its powers to be of any value must be exercised by Sanitary Authorities, acting under the supreme control of the Local Government Board. The Bill was amended in Committee so as to give the powers to the "Sea Fisheries Committees," without any attempt to de6ne such bodies, or to ensure their being provided with Sanitary Officers to carry out the duties thus imposed them. As a result the Bill was seen to be quite unworkable, and the Government were unable to support it. A useful and much-needed measure was therefore dropped, and up to the present time has not been re-introduced. Such a measure is urgently needed, and I would recommend that representations be made to the Local Government Board to bring forward a Public Bill on these lines, but applicable to all shellfish. In the meantime provision must be made to prevent the recurrence of such alarms as are raised from time to time, which seriously interfere with legitimate commerce, and which abate as soon as the facts begin to fade without having effected any real improvement. Moreover, the plan of dealing with the question after the mischief has been done is not one which should commend itself to the general public, who naturally desired to be protected. In conclusion, I desire to call attention to the importance and value of inter-communication between Medical Officers of Health with regard to tracing causes of outbreaks of infectious disease and dealing promptly therewith. The above is an interesting example of the facility with which such can be carried out by the Local Sanitary Authorities. Since the foregoing was written further experiments have been made by the Fishmongers' Company in the direction of ascertaining to what extent cockles known to be contaminated with sewage can be rendered inert by cooking, and on the 21st January the following seven samples (Nos. 24 to 30) were submitted to Professor Klein by Mr. Towse:— *No. 24. Cockles from Leigh Creek, where they had been relaid for about four weeks. Taken on the 20th January. Boiled continuously for one minute. *No. 25. Cockles from Leigh Creek, where they had been relaid for about four weeks. Taken on the 20th January. Put in boiling water and boiled for 3½ minutes. * In these cases the water was actually boiling for the period mentioned. 147 No. 26. Cockles from the Maplins. Taken on 18th January (?). Putin boiling water, taken out as the water boiled over. Time in water 3½ minutes. No. 27. Cockles from Leigh Creek, where they had been relaid about four weeks. Taken on the 20th January. Put in boiling water and taken out when the water boiled over. Time in water 3¾ minutes. No. 28. Cockles from Leigh Creek, where they had been relaid for about four weeks. Taken on the 20th January. No. 29. Cockles from the lower part of the Blythe. Taken on the 20th January. Put in boiling water, taken out when the water boiled over. Time in water 3¼ minutes. No. 30. Cockles from Jenkin, opposite Isle of Grain (continuation of Blythe Sands). Taken on the 20th January. Put in boiling water, taken out when water boiled over. Time in water 3¼ minutes. Of these seven samples, Professor Klein reported as follows:— 23rd January, 1903. I beg to report herewith on the result of the bacterioscopic examination of the seven samples of Cockles received here on January 21st. Cooked, No. 24. Strongly polluted; abundant bacillus coli communis. Cooked, No. 25. Negative. „ No. 26. „ „ No. 27. In shell, No. 28. Strongly polluted ; abundant bacillus coli communis. Cooked, No. 29. Slightly polluted with bacillus coli communis. „ No. 30. Negative (?). E. KLEIN. These results in no wise affect the position. It is clearly impossible to rely for protection upon experimental results derived from boiling cockles for any definite time, or to assume that in all cases the temperature throughout is raised to the degree necessary to secure theoretical safety. It would be, therefore, dangerous to allow cockles to be sold for human consumption which are known to have been contaminated with sewage, or to trust to an imperfect and unsupervised method of cooking to ensure sterilization. While strongly sympathising with the unfortunate fishermen, one must protest against the running of a known risk to the public health, which can so easily be avoided by prohibiting, under any circumstances, the use for food of shellfish which is contaminated with sewage, either cooked or uncooked. 148 LEIGH-ON-SEA COCKLES. f sample. Date of collection or receipt of samples. Where obtained. Original source. If relaid in Leigh Creek. Cooked or Uncooked. Result of Dr. Klein's examination. 1902. 1 6th Dec. Nicholson's Gateway, Billingsgate Maplin Sands Yes Cooked Showed evidence of sewage pollution. 2 13th „ Ditto Ditto Yes Cooked Ditto. 3 „ „ Ditto Brain's Pit Yes Cooked Ditto. 4 „ „ Ditto Shoeburyness Sands. Yes Cooked Ditto. 5 14th „ Leigh Creek Cockle Laying Off the Maplins, 9 miles East of Shoeburyness. Yes Uncooked Ditto. 6 „ „ Cooked cockles, same as No. 5 after preparation for market. Ditto Yes Cooked Ditto. 7 20th „ Nicholson's Gateway Maplin Sands Yes Cooked Ditto. 1903. 8 1st Jan. Sent by Fishmongers' Company, 1st Jan., 1903. Lower part of the Blythe, opposite the Chapman Lighthouse; collected on 31st Dec., '02 No Uncooked Ditto. 9 3rd „ Sent by Fishmongers' Company, 3rd Jan., 1903. Maplin Sands, abreast of the Mouse Lightship; collected on 1st Jan., 1903. No Uncooked Ditto. 10 „ „ Leigh Creek, collected by Dr. H. Williams, Medical Officer of Health, Port of London. (?) had been lying in Creek Yes Uncooked Ditto. The bacillus of typhoid fever found to be present. 11 „ „ Leigh Creek Sample of water in which No. 10 cockles were lying. Practically dilute sewage. 12 „ „ Ditto Sample of mud on which No. 10 cockles were lying. Sewage polluted. 22 16th „ Sent by Fishmongers' Company, 17th Jan., 1903. Taken direct from Maplin Sands and boiled for 3½ minutes. No bacillus coli communis. No spores of bacillus enteritidis sporogenes. 23 „ „ Ditto Taken direct from Maplin Sands and boiled for one minute. One cockle only contained something like bacillus coli communis(?)* Half the cockles contained no spores of bacillus enteritidis sporogenes. * This is being further examined by subcultures. 149 LEIGH-ON-SEA COCKLES—continued. f sample. Date of collection or receipt of samples. Where obtained. Original source. If relaid in Leigh Creek. Cooked or Uncooked. Result of Dr. Klein's examination. 1903. *24 20th Jan. Leigh Creek. Sent by Fishmongers' Company. (?) Yes, for 4 weeks. Boiled continuously for one minute. Strongly contaminated; abundant bacillus coli communis. *25 „ „ Ditto (?) Ditto Put in boiling water and boiled lor minutes. Negative. 26 18th „ Sent by Fishmongers' Company. Maplins No Put in boiling water and taken out as water boiled over; time in water 3½ minutes. Ditto. 27 20th „ Leigh Creek. Sent by Fishmongers' Company. (?) Yes, for 4 weeks. Put in boiling water and taken out when the water boiled over; time in water 3¾ minutes. Ditto. 28 „ „ Ditto (?) Ditto Uncooked Strongly polluted; abundant bacillus coli communis. 29 „ „ Sent by Fishmongers' Company. Lower part of the Blythe. No Put in boiling water and taken out when the water boiled over; time in water 3¼ minutes. Slightly polluted with bacillus coli communis. 30 „ „ Ditto From Jenkin, opposite the Isle of Grain (continuation of Blythe Sands). No Ditto Negative (?) * In these cases the water was actually boiling for the period mentioned. 150 OYSTERS. A second outbreak of disease attributed to shellfish was that which occurred at Winchester on 10th November. Although this case does not affect the City to the same extent as the foregoing cockles case, still the fact remains that the oysters implicated are exposed for sale within the City's jurisdiction. The facts have been fully reported in the public press, and I need here state only that after the Mayoral Banquet many of the guests were attacked the same evening with violent purging and diarrhœa, which at the time were attributed to the soup. They were afterwards declared to be typhoid fever, and it was subsequently ascertained that all the patients (10 in number) had partaken of oysters, though many who had eaten these suffered no ill-effects. Unfortunately, three of the cases proved fatal. The Medical Officer of Health for Winchester, Dr. Langdon, was of opinion that the typhoid bacilli could not have been conveyed by any cooked food, and he therefore came to the conclusion that the illness must have been due to the oysters. I was informed by the Clerk to the Worshipful Company of Fishmongers that the Inspector visited the Emsworth beds from which the oysters had been obtained on the same day as eaten, and that he was able to obtain a supply from the same pit that the suspected ones had been taken from (Sample No. 1.) These, at the request of the Clerk, were submitted to Professor Klein on the 18th, together with a sample of water taken one foot below the surface of the pit, which was then full. (No. 2.) The Inspector further states that the sewage from the town enters the river only fifty yards from the oyster pits. In a letter dated 30th December, the Clerk (Mr. J. Wrench Towse) informed me— "The Company's Inspectors who have visited the pits at Emsworth have "reported that the sewage outfall is in close proximity, and that practically "the sewage is flowing over the pits. In consequence of this and of the "serious outbreak at Winchester of typhoid fever from which several persons "had suffered after eating oysters at the Mayoral Banquet of 10th November "taken from the Emsworth pits, the Fishmongers' Company informed the "proprietors of these pits and of the oyster layings at Emsworth that they "would not allow the sale in London of any oysters coming from these "respective places." 151 The complete justification of this action on the part of the Company is best shown by Professor Klein's report received on the 30th December, as follows:— REPORT ON THE BACTERIOSCOPIC ANALYSIS OF— (1.) Oysters. (2.) Emsworth Water. Both materials were received on 19th December, 1902. The oysters appeared all in a good and healthy state, and were contained in a sack, several dozens of them; the water was in what appeared to be an old wine bottle, closed with a cork. Before detailing the results of the analysis of these materials, viz., oysters and water, it is necessary to explain in detail the mode of procedure so as to make the results appear in their true light. (1.) Oysters.—In my report to the Medical Officer of the Local Government Board, 1894-5, I have described the mode of procedure which then had yielded satisfactory results. The same method I have also now followed with certain additions since adopted in bacterioscopic work of this kind. The oyster is thoroughly brushed under the tap with a clean brush, then dried with a clean cloth, opened with a sterile instrument, and the body of the animal cut into with sterile scissors. From the liquid and general milky fluid a fair amount, about 1/6-1/5 c.c., is introduced into each of the following sterile culture media:— (а) Two tubes of phenolated broth. (b) Two tubes of MacConkey, viz., litmus, glucose, taurocholate of soda and peptone in water. (c) Two tubes of recently boiled milk. (d) One plate dish of phenolated gelatine ; this having previously been allowed to set. (e) One plate dish of phenolated Agar ; this also having viously been allowed to set. The object of the cultivations (a, b, d and e) was to discover bacillus coli or bacillus typhosus or any microbe belonging to the same group; (c) was, after the inoculation, heated to 80° C. from 10-15 minutes in order to kill everything except spores. In this case the spores of bacillus enteritidis sporogenes were looked for, as the oysters had been under suspicion of sewage contamination. In my report to the Local Government Board above referred to, I have shown that oysters not polluted by sewage do not contain the bacillus coli communis; since then I have shown that sewage always contains the spores of the anaerobic virulent bacillus enteritidis sporogenes, and therefore the presence of the bacillus coli communis and bacillus enteritidis in oysters or other shellfish may be taken to denote sewage pollution. The medium (a), phenol broth, was used for subsequent secondary plate cultivations. The medium (b) is, in my experience, an excellent medium—first introduced by Dr. MacConkey—in order to quickly demonstrate the probable presence of bacillus coli communis or, under certain conditions, of coli-like microbes and bacillus typhosus; for if, after 24-48 hours' incubation at 37° c., the fluid has changed into red and the 152 fermentation tube contains gas, it is most probable that bacillus coli communis is present; if, on the other hand, the fluid has changed into red, but the fermentation tube contains no gas, then it is quite clear that at this stage, i.e., after 24-48 hours' incubation, the bacillus coli communis is absent, but a microbe may be present belonging to the coli-typhoid group, since MacConkey fluid (taurocholate) hinders, or at least retards most microbes other than those of the coli-typhoid group. Those MacConkey tubes which, after 24 hours' incubation at 37° C., were red and had no gas were used for establishing (f) further surface phenol agar plates and the primary phenol broth tube (a) above-mentioned, belonging to the same set as these MacConkey tubes, were likewise used for establishing (g) further phenol gelatine plates. The primary phenol agar plate and phenol gelatine plate (d and e), after incubation (d at 20-21° C., (e) at 37° C.), were carefully examined, and those colonies which resembled those of the coli-typhoid group were examined microscopically, and of them sub-cultures were made in the different media used for identifying bacillus coli communis, bacillus of Gaertner, or bacillus typhosus. In the same manner, from the secondary plates (f and g) sub-cultures were made of doubtful or suspicious colonies. These sub-cultures were: gelatine streak and gelatine shake cultures, ordinary broth, litmus milk, flagella staining, if necessary, and finally tests with blood of a typhoid immunised guinea-pig kept for the purpose; this blood having been ascertained to agglutinate emulsion of the true typhoid bacillus at 1 in 100, or even 200, within 20-25 minutes. It will, from the foregoing, be understood that the amount of work and the number of cultures used were very extensive, and this must be in the nature of the thing, since nowadays the identification as bacillus typhosus of a microbe belonging to the coli-typhoid group is justly considered unsatisfactory unless the above tests all come out satisfactorily. To examine on this scale, then, a dozen oysters is a work of considerable complexity, and above all, work which requires a great deal of time. In addition to the above cultures of one dozen oysters, I have examined a further half-dozen by litmus lactose phenol Agar or by litmus glycose Agar plates : on incubation the colonies of bacillus coli become noticeable by being surrounded by red medium, due to rapid acid production, whereas those of bacillus typhosus are in blue medium, this microbe not being able to produce acid so rapidly, or fermenting lactose. The result of the above cultures and sub-cultures was this:— (1.) Every one of the eighteen oysters examined contained bacillus coli communis. (2.) Three out of the eighteen oysters contained, in addition, a variety of bacillus coli which differs from the bacillus coli communis by the cylindrical form and the great mobility of the bacilli; by its not forming indol in broth and not curdling milk; by its not fermenting lactose; the bacilli are covered with many thin, long spiral flagella. From these characters it is clear that this variety belongs to the Gaertner-typhoid 153 group; but that it is not the typhoid bacillus is proved by the fact that it ferments glucose, bubbles gelatine in shake culture, and does not agglutinate with typhoid blood. (3.) Three out of fifteen oysters examined in this direction contained the spores of the bacillus enteritidis sporogenes. It follows, then, from these results that the interior of the oysters in question contained distinctly the microbes found in sewage, and, comparing the present results with those obtained by me in 1894-5, it seems that of the Emsworth oysters many more contained sewage microbes than was the case with other oysters derived from other sewage polluted localities. (2.) Emsworth Water.—This water was examined on the lines used for analysing water, and was carried out thus:—(a) Suspecting that the water is of an impure character, ordinary gelatine plates were made with 1/100 and cc respectively; (b) MacConkey tubes were inoculated with 0.1 cc, 1 cc and 2 cc of the water; (c) 1,000 cc were passed through a Pasteur filter, and the outside of the candle was then brushed off into 10 cc of sterile water. Of this filter brushing the following cultures were made:—0.1 cc (corresponding to the particulate matter of 10 cc of the original water) was added to each one phenol broth and one MacConkey tube; 0.1, 0.5 and 1 cc of the filter brushing (equal to the particulate matter of 10, 50 and 100 cc of the original water) were added to the recently boiled sterilised milk; 0.1 cc of the filter brushing was added to each, one phenol Agar and one phenol gelatine plate; from the ensuing growths sub-cultures were made as in the case of the oysters. The result was:— (a) The water contained above 10,000 microbes per 1 cc; (b) the water contained several bacillus coli communis per 0.1 cc, i.e., it contained between 50 and 100 of these per 1 cc; (c) the water contained at least 1 spore of bacillus enteritidis sporogenes per 10 cc; (d) the water contained a variety of bacillus coli which, in most respects, compares with bacillus Gaertner, it clearly belongs to the Gaertner-typhoid group, but its emulsion does not become agglutinated with typhoid blood, not even 1 in 20. It is, however, in morphological (including multiflagellated) and cultural respects identical with the variety mentioned previously as found in the oysters. From this it would appear, therefore, that this water is distinctly, and to a large extent, polluted with sewage; moreover, the identity of the Gaertner-typhoid variety of bacillus coli in the water and in the oyster seems to point to the presence of the same kind of sewage in both. December 30th, 1902. E. KLEIN. The bacterioscopic examination thus, as in the case of the cockles, absolutely demonstrates what one would naturally expect from the result of inspection of the pits and sewage outfall, viz., that both the water and oysters were contaminated with excrementitious matter. Though the bacillus typhosus was not absolutely identified, if sewage be present there is at any moment the possibility of this and other infectious organisms being met with. 154 On the 27th December a sample of oysters from the Mumbles (No. 3), and on the 29th a sample from Bosham (No. 4), were forwarded by the Fishmongers' Company. On these Professor Klein reports as follows:— St. Bartholomew's Hospital. Oyster Sample No. 3. Preliminary Note. Mumbles Oysters* received December 29th, 1902.—Half of the oysters examined contained bacillus coli communis fairly numerous, one out of six contained spores of bacillus enteritidis; therefore there is sewage pollution, but limited. Oyster Sample No. 4. Bosham Oysters* received December 30th, 1902.—Eight out of ten oysters contained bacillus coli communis (plentiful). All those oysters that were examined for spores of bacillus enteritidis sporogenes contained positive evidence of this microbe; therefore sewage pollution extensive. * In these oysters the question that presented itself for answer was chiefly whether or not they are sewage polluted. The examination was carried out thus: Of the interior, i.e., of the shell liquor, of each of six oysters 1/5—1/6 cc was added to one MacConkey tube and to one lactose peptone tube; three drops of the liquor of each of two further oysters was used for two litmus glycose Agar plates; and finally ½ cc of the liquor of each of four further oysters was added to milk incubated anaerobically. A second sample of oysters (No. 5) of Bosham relays, from Bosham Dredgerman's Co-operative Company's layings, was found polluted to the extent of 40 per cent. The supply of oysters from these two sources to London was thereupon prohibited by the Fishmongers' Company, and further samples taken from the Mumbles, Nos. 6, 7, 8 and 9. These, with the exception of No. 6, taken from beds far out in the bay in deep water, were polluted. The prohibition was therefore continued, except so far as the deep-water beds are concerned. Some amount of dissatisfaction has been expressed by the owners of these beds, but on the face of Professor Klein's report it is clear that no other course but prohibition could have been justified. On the 9th January, two samples of oysters (Nos. 13 and 14) taken from the pits and beds respectively at Southwick were found to be polluted. On the 9th, three samples were taken from the Whitstable grounds, Nos. 10, 11 and 12, and these were all reported to be uncontaminated. Of two samples of water taken from the pits and layings respectively of the Whitstable Oyster Company, the former (Sample No. 15) was found to be polluted with sewage, and the latter (No. 16) unpolluted. Although, therefore, the Whitstable oysters are clearly proved to be uncontaminated, there is still the possibility of danger in the polluted water of the pits. 155 Two further samples of Whitstable natives taken from the Ham and Pollard layings, and one of Princess oysters from the Pollard layings on the 10th January (Nos. 17, 18 and 19) were found to be unpolluted. On the other hand, samples of water (Nos. 20 and 21) taken from the Ham layings and pits respectively of the Seasalter and Ham Oyster Fishery Company, Whitstable, were both found to be polluted. Here again, as the water is sewage contaminated, the possibility of the oysters becoming foul must always be borne in mind. On the 22nd January, the following samples of water and oysters from Whitstable (Nos. 31 to 34), collected on the 21st, were sent to Professor Klein by the Clerk to the Fishmongers' Company:— No. 31. Water from Whitstable Oyster Company's Pit. „ 32. Oysters do. do. The water was admitted into the pits on the morning of the 20th January, and the oysters had been in the pits about 48 hours. No. 33. Water from Ham and Seasalter Pit. „ 34. Oysters (called "Princesses") from Ham and Seasalter Layings (Pollard). The Ham and Seasalter Pit water was only admitted to the pit on the evening of the 20th January. Of the above, Professor Klein reports as under:— January 24th, 1903. Water. No. 31. Polluted; abundant bacillus coli communis. „ No. 33. do. do. do. Oysters. No. 32. One out of ten has coli-like bacilli, but no bacillus coli communis. „ No. 34. One of ten has bacillus coli communis and bacillus enteritidis sporogenes. E. KLEIN. Thus far, out of 18 samples of oysters, representing five places, viz. :— Emsworth, Bosham, Mumbles, Southwick and Whitstable, 11 have been found to be polluted, as under:— Of 1 Emsworth sample 1 was contaminated. „ 2 Bosham samples 2 were „ „ 5 Mumble „ 4 „ „ „ 2 Southwiek „ 2 ,, „ ,, 8 Whitstable ,, 2 „ ,, This is at any rate ample justification for the strongly expressed desire of the Trade for legislation, and for the prompt and energetic action of the Fishmongers' Company. 156 Results of Bacterioscopic Examination of Oysters submitted by the Worshipful Company of Fishmongers. No. of sample. Date of collection. Where collected. By whom submitted. Result of Dr. Klein's examination. 1 1902. 17th Dec. Oyster beds at Emsworth. 100 oysters were purchased of the same kind as those supplied at Winchester on 10th November, 1902. The Clerk to the Worshipful Company of Fishmongers. Showed sewage contamination. 2 ,, ,, Sample of water from the pit in which the above were deposited. Sample collected one foot below the surface. Ditto Ditto. 3 27th „ Mumble Natives obtained during low water from Oystermouth Bay (36 oysters). Ditto Ditto. 4 29th „ Bosham oysters taken from a pit (50 oysters). Ditto Ditto. 5 1903. 8th Jan. Bosham relays from Bosham Dredgerman's Co-operative Co.'s layings. Ditto 40% polluted. 6 ,, ,, Mumbles. From beds in Bay (far) Ditto None „ 7 ,, ,, Mumbles. From beds in Bay (nearer shore). Ditto 25% ,, 8 99 99 Mumbles. Plantations Ditto 25 % ,, 9 ,, ,, Mumbles. Perches Ditto 10 to 15% ,, 10 9th „ Whitstable Imperials from grounds of Whitstable Oyster Co. Ditto None „ 11 ,, ,, Whitstable Natives. Slank Ditto None „ 12 99 99 Whitstable large Natives. Inside Slank. Ditto None „ 13 ,, ,, Caen Bays oysters from Southwiek pit. Brazier Bros. Ditto 40% „ 14 99 99 Caen Bays oysters. Southwick beds. Beds. Ditto 25 % „ 15 99 99 Sample of water from pits of the Whitstable Oyster Co. Ditto Polluted. 16 99 99 Sample of water from layings of the Whitstable Oyster Co. Ditto Not polluted (?). 17 10th „ Whitstable Natives from the Ham layings at Whitstable. Ditto None polluted. 18 ,, ,, Whitstable Natives from Pollard layings. Ditto 99 99 19 99 99 Princess oysters from Pollard layings (Whitstable). Ditto ,, ,, 20 ,, ,, Sample of water from Ham layings belonging to Seasalter and Ham Oyster Fishery Co., Whitstable. Ditto Polluted. 21 ,, ,, Sample of water from the pits of the above Company. Ditto 99 157 OYSTERS (continued). No. of sample. Date of collection. Where collected. By whom submitted. Result of Dr. Klein's examination. 31 1903 21st Jan. Sample of water from Whitstable Oyster Co.'s Pit (water admitted into Pits on the morning of the 20th January). Fishmongers' Co. Polluted. 32 ,, ,, Sample of oysters from Whitstable Oyster Co.'s Pit (water admitted into Pit on the morning of the 20th January, and the oysters had been in the Pit for about 48 hours.) Ditto One oyster out of ten contained coli-like bacilli. 33 ,, ,, Sample of water from Ham and Seasalter Pit (water admitted into the Pit on the evening of the 20th January.) Ditto Polluted. 34 ,, ,, Sample of oysters from Ham and Seasalter Layings (Pollard) called "Princesses" (water admitted into the Pit on the evening of the 20th January.) Ditto One oyster out of ten contained bacillus coli communis, and bacillus enteritidis sporogenes. This Report was agreed to, and the Sanitary Committee advised that representations be made by the Court of Common Council to the Local Government Board with a view to the introduction of a Bill applicable to all shellfish, on the lines suggested by your Medical Officer. The Court gave due effect to the Sanitary Committee's recommendation, and we are now waiting for the reply of the Local Government Board. In the meantime, the whole question was referred to a Joint Committee of the Sanitary and Port Sanitary Committees. The Fishmongers' Company are also moving actively in the matter, and are now engaged in an examination of all oyster beds and layings round the coast, in addition to which the Royal Commission on Sewage Disposal are considering the question, which is one intimately associated with the special subject of their enquiry. 158 MEAT SUPPLIES. The total quantity of meat delivered at the Corporation Markets, Smithfield, during 1902 amounted to 405,019 tons 13 cwts. 3 qrs., against 415,510 tons 15 cwts. 3 qrs. in the previous year, being a decrease of 2.53 per cent. In the two preceding years (1900 and 1901) the deliveries showed increased percentages of 1.20 and 1.25 respectively.* Table showing the annual deliveries and other details during the past 29 years:— MEAT SUPPLIES, 1874 to 1902. Year. General Supply, Seizures by Inspectors. %of Bad Mea to Good. Tons OWt8. qrs. Tons cwts. qrs. 1874 157,628 18 1 193 18 2 .123 1875 164,450 8 0 153 1 1 .093 1876 176,162 17 0 238 2 2 .135 1877 197,631 16 2 198 19 0 .100 1878 195,993 10 2 180 18 0 .092 1879 212,987 14 0 258 4 3 .121 1880 218,790 6 3 262 19 3 .120 1881 224,677 19 3 503 12 3 .224 1882 211,461 15 0 175 16 0 .083 1883 223,085 8 0 212 4 1 .095 1884 230.873 1 1 260 7 3 .113 1885 243,296 14 3 214 0 2 .088 1886 250,831 12 1 276 8 2 .110 1887 259,383 12 3 261 8 1 .101 1888 263,519 16 1 228 0 1 .086 1889 276,429 4 2 234 18 1 .085 1890 299,733 15 0 419 2 3 .139 1891 307,519 19 3 476 12 1 .155 1892 323,085 6 0 569 13 3 .176 1893 318,163 1 1 608 9 .3 .193 1894 340,956 16 2 430 0 2 .126 1895 347,283 3 0 598 19 0 .173 1896 380,543 11 1 914 14 3 .243 1897 393,307 2 0 918 3 3 .233 1898 400,112 9 3 884 1 0 .221 1899 405,456 9 2 1,172 5 2 .289 1900 410,380 1 0 961 19 1 .234 1901 415,510 15 2 1,271 1 1 .306 1902. 405,019 13 3 865 12 0 .214 * The figures relating to the Central Market supplies are compiled from the Annual Report of the superintendent of the Market. City of London. CHART shewing the relation between Meat seized by Inspectors & Meat delivered at the Central Meat Markets. 26 years 1877-1902. delivered at Central Markets. Tons of Meat seized. Percentage of Meat seized 159 The monthly deliveries during 1902 and the two preceding years are here given. Monthly Deliveries at the Corporation Markets, Smithfield. month. 1900. 1901. 1902. Tons CWtS. qrs. Tons cwts. qrs. Tons cwts. qrs. January 38,319 3 3 38,097 7 2 39,000 16 2 February 32,814 7 2 32,746 10 3 32,193 13 2 March 38,125 6 1 34,912 7 3 32,915 8 3 April 32,786 15 1 34,032 0 3 35,221 8 2 May 35,108 12 0 35,927 11 0 34,704 15 0 June 32,646 5 1 32,562 3 2 31,864 7 3 July 29,554 1 3 32,655 13 2 33,115 14 2 August 32,293 10 3 32,092 16 0 29,340 2 1 September 30,475 10 3 31,631 2 0 32,134 5 2 October 36,180 0 0 37,407 10 2 36,020 18 2 November 36,216 16 2 . 36,390 18 3 32,320 4 0 December 35,859 11 1 37,054 15 2 36,187 19 0 Total 410,380 1 0 415,510 15 2 405,019 13 3 The sources of origin during the past seven years are here expressed in terms per cent. of total annual deliveries. 1896. 1897. 1898. 1899. 1900. 1901. 1902. Per cent. Per cent. Per cent. Per cent. Per cent. Per cent. Per cent. *Country killed 30.8 28.2 27.8 27.3 25.2 25.7 27.2 †Town „ 20.4 20.1 19.7 15.5 14.6 13.1 12.7 ‡Foreign „ 11.2 12.9 12.6 14.2 151 14.4 17.3 American „ 20.1 18.8 19.0 23.0 23.2 25.5 21.5 Australian and New Zealand. 17.5 20.0 20.9 20.0 21.9 21.5 21.3 * Including American meat killed at Birkenhead. † This includes American and Continental cattle slaughtered at Deptford. ‡ Includes " General Foreign Meat and Produce." 160 It will be seen from the foregoing Table that there has been a decrease in the supplies at the Central Markets for the first time since 1893. A similar falling off has occurred about every ten years since the market was opened, the former occasions being in the years 1873, 1882, 1893.* Another cycle being completed, a drop in the figures for 1902, or the current year, might not have been unreasonably expected. Whatever may have been the causes previously, those for last year are clearly defined. Early in the year, the Australian firms who had been sending mutton and beef to this country undertook to supply both in large quantities to South Africa, but it was found that owing to the drought Australian produce was of too inferior quality to comply with official requirements, and the contractors consequently became large purchasers of Argentine produce, thus greatly restricting our receipts from that source, in addition to reducing those of Australian meat to vanishing point. Again, it has been shown in a recent paper, that the surplus beef available for export to this country from the United States is almost entirely dependent on the harvest of maize, which is an essential necessity in producing it. The maize crop of 1901 was at least half a failure, consequently the supply of beef was small in quantity and poor in quality. These disturbing causes are being gradually eliminated. The maize crop in America this year being fairly good, beef is coming along in sufficient quantities, and this source of supply is not likely to be greatly affected by the outbreak of foot and mouth disease in the New England States, with the consequent stoppage of shipments of live cattle from Boston, as the States affected are more largely concerned in dairying than in beef-producing. Recent advices show that the disorder is well in hand, and that speedy stamping out will probably be effected. The attempt to bring chilled beef from Argentina has met with encouraging success, and cannot fail, with further developments, to have a beneficial effect in the near future ; while the cessation of hostilities in South Africa, and the opening up of Madagascar and other local beef-producing sources, have brought supply and demand there nearer to meeting point. The drought in Australia is said to be breaking up, and though, no doubt, time is necessary to reconstitute their depleted flocks and herds, the Colonial breeders are not willing to lose the market they have created here, and will be expeditious in again sending their produce to England. It is also encouraging to note that the home producer has been receiving better prices for his meat, and it is hoped that he will thereby be stimulated to increase his production, especially as it appears unlikely that the absurdly low levels of recent years will be again reached. *A decrease was actually recorded in 1878, but too small a one to affect the question. 161 Denmark continues to send us beef, mutton, and pork in considerable quantities, and has of late given better attention to its soundness than formerly. From Russia there have been frequent shipments of pork of satisfactory quality. Holland continues to be a large sender of veal, pork, mutton and, to a smaller extent, beef, in connection with which a satisfactory feature was the visit of a Commissioner from the Dutch Government to the Central Markets, where the condition of the meat sent was shown and explained to him by your Chief Inspector, which has already been attended with good effect.* On the 16th of October, for the first time, Servian sheep made their appearance at the Central Market. These had been slaughtered in their own country and sent by rail to Ostend, whence the rabbit boat to Tilbury and train after had brought them to London. They were to a great extent badly selected, weak and poor, to which defects emphasis had been given by most indifferent dressing, in course of which a small piece of liver had, in most cases, been left on the carcass between the diaphragm and kidney. Many of these livers were full of flukes, which in some cases were found singly or in bunches on the surface of the chest wall, clearly showing the reason for their condition. As a consequence a large proportion of the carcasses were seized. In spite of this, they continued to come in varying numbers and at irregular intervals for several weeks. A rumour then reached us that, owing to the large number seized in the City, it was intended to avoid the London market, and send them to provincial towns for sale. The Port Sanitary Authority were at once communicated with, with a view to their inspection at the point of debarkation, and some considerable number were seized by their Officers. Notwithstanding these preventive measures, diseased sheep from this source continued to arrive on the London market up to January 16th. It is understood that larger consignments will be sent next year. Should this be attempted, it is advisable that greater judgment be exercised in selection of the meat, both as to quality and freedom from disease, in which case there seems to be no reason why a remunerative business should not be established. It would be well perhaps to bring these facts to the notice of the Servian Government. In this connection, Dr. Williams, the Medical Officer of Health for the Port of London, made the following observations in a Report presented to the Court of Common Council on the 12th February last:— "One of the routes by which meat comes into this country from the "Continent is by way of Ostend. It is conveyed in powerful fast "steamers to Tilbury, the passage being only of about 7 or 8 hours. "These boats arrive about 10 p.m. each night, except Saturday, and * See Report of Medical Officer of Health to the Sanitary Committee, 28th April, 1903. 162 "the cargoes are inspected from time to time, the meat having been "found almost invariably of good quality. An intimation was received "that some of the meat coming by this route was not of the same good "quality as hitherto. I therefore instructed one of your Food Inspectors "to visit Tilbury, and wait and inspect all the meat and foodstuffs "arriving. This was done for several nights, without anything unusual "being observed, but on the 26th November, 1902, amongst the cargo "were 464 carcasses of sheep. From enquiries made, it was stated that "these sheep came from Servia, where they had been bought up by some "enterprising merchant, slaughtered on the spot, evidently by unskilled "hands, placed in vans containing ice beneath the floor and also in the "roof. These vans were sent from Servia direct to Ostend, where on "arrival the carcasses were placed on the vessel. On inspection of these "carcasses they were found extremely emaciated, and had suffered from "some disease. Portions of the liver had been inadvertently left behind, "and on examination of these portions they were found filled with "flukes, and it was observed that nearly every one of these sheep must "have been suffering in the same way. "On examining the inside of the carcasses quantities of flukes were "seen adhering to the inner walls of the chest and abdomen. These "carcasses were seized and destroyed. A careful watch was kept on "these vessels, and the cargo inspected every night, with the result that "in all 436 carcasses were seized, and it ultimately ceased to be profitable "for the Foreign merchant to send them over, knowing that they would "be rigorously inspected, and if found unsound would be destroyed." In the course of the year 23 senders of diseased meat have been prosecuted, and in all except one, where someone else and not the person charged was shown to be the owner, convictions were obtained, and fines ranging from £1 to £100 were inflicted; 5 prosecutions were for beef, 3 for mutton, and 15 for pigs or pork. Respecting the large proportion of pork prosecutions, there can be no doubt that the higher prices ruling in comparison with recent years has tempted some senders to be indiscreet, the report of the Royal Commission on Tuberculosis rendering imperative the seizure of all pigs showing Tuberculosis in any degree. The business of Leadenhall Market continues on the same lines of steady prosperity as the first poultry market in the world, while there is an excellent daily supply of first-class meat. SLAUGHTERHOUSES. Since the daily record of the slaughterhouses at Aldgate was commenced in October, 1899, two have been closed by order of the Lord Mayor, and in three other instances the right to slaughter has lapsed owing to non-user. There now remain nine, which are generally well kept, but cannot be regarded as desirable features so near the centre of a great City. 163 Some idea of the magnitude of the work of your Inspectors of Slaughterhouses and Meat may be obtained from the following figures copied from the Annual Report of the Market Superintendent:— 1900. 1901. 1902. Loads. Loads. Loads. Number of loads weighed during the year upon the Market Weighbridges for the purpose of ascertaining the amount of Toll due thereon 201,848 206,807 - Tons. Tons. Tons. Average daily delivery into the Markets 1,336½ 1,355 1,290 Minimum on any one day 341¼ 244£ 245 Maximum delivery 2,712¼ 2,948 3,576 The heaviest weight brought in on any one day was on the 21st December, 1896 4,159 tons. One ton in every 468 tons of meat paying toll in the Central Markets, Smithfield, was condemned last year, as compared with one ton in 327 in 1901, which affords satisfactory testimony to the improved quality of the consignments as a whole. MEAT INSPECTION. The seizures of diseased and unsound meat amounted to 865 tons 12 cwts., including 257 tons 7 cwts. 2 qrs. 25 lbs. of imported frozen and chilled meat. Month. 1900. 1901. 1902. Tons cwts. qrs. Tons cwts. qrs. Torts cwts qrs. January 31 16 1 37 7 0 69 2 0 February 53 0 2 30 16 2 56 3 3 March 84 10 3 46 3 3 76 12 1 April 59 4 2 86 10 2 75 3 1 May 79 9 1 122 15 3 67 8 0 June 81 5 3 85 5 2 123 4 1 July 197 5 1 127 8 1 99 12 1 August 114 4 2 283 9 1 58 18 2 September 87 2 2 114 19 3 63 18 2 October 66 11 2 113 17 1 62 0 1 November 60 4 2 11 10 0 60 14 2 December 47 4 0 109 17 3 52 14 2 Totals 961 19 1 *1,271 1 1 865 12 0 * The heaviest total recorded. 164 UNSOUND MEAT, 1902. The 865 tons 10 cwts. 3 qrs. 23 lbs. seized by your Inspectors as unfit for the food of man, were classified as under:— 1902. Diseased. Putrid. Unwholesome on account of injury during life. Poultry. Offal. Fish. Total. tons. cwts qrs lbs. tons. cwts qrs lbs. tons. cwts qrs. lbs. tons. cwts. qrs. lbs. tons. cwts qrs. lbs. tons. cwts qrs lbs. tons. cwts. qrs lbs. First Quarter 54 14 2 1 87 18 3 0 11 17 1 24 29 15 1 1 16 16 3 24 0 0 2 14 201 3 2 8 Second „ 36 4 0 11 181 7 2 25 9 6 3 26 16 14 0 12 20 6 3 17 0 3 3 10 264 3 2 17 Third „ 18 19 1 21 145 1 3 12 4 1 2 15 10 i 3 15 41 11 1 16 0 0 2 24 219 19 3 19 Fourth „ 40 9 0 19 81 9 2 21 17 3 3 10 18 13 3 25 22 7 0 6 0 0 0 10 180 3 3 7 Total 150 7 0 24 495 18 0 2 42 9 3 19 75 8 0 25 101 2 1 7 0 5 1 2 865 10 3 23 The above figures include 25,905 separate seizures. The percentages of Meat seized under a summary of the various headings of the above table and for the preceding five years, were as follows:— Year. Diseased. Putrid.* Unwholesome on account of injury during life. Per Cent. Per Cent. Per Cent. 1897 11.0 84.0 5.0 1898 15.0 80.7 4.3 1899 8.1 88.2 3.7 1900 10.1 85.9 4.0 1901 8.1 89.0 2.9 Average for 5 years 10.5 85.5 4.0 1902 17.4 77.7 4.9 * Including poultry, offal and fish. Although the quantity of meat condemned was 32 per cent. below that of last year, being, with one exception, in fact, the lowest since 1896, the proportion seized on account of disease is the highest, viz., 17'4 per cent., recorded in any of your Medical Officer's Annual Reports since 1894. This indicates an increased activity in the supervision of the market supplies, and has as a consequence resulted in a marked growth in the number of prosecutions, no less than 22 convictions being recorded during the year under review. This is the highest figure yet reached in any one year. 165 CENTRAL MARKETS, SMITHFIELD. Table showing Weight of Meat delivered, seized as unsound, and proportion condemned to that delivered during each Month of the Year 1902. Month . Meat delivered at the Market. Meat seized by the Inspectors. Ratio of Meat condemned to that delivered, Tons cwts. qrs. Tons cwts. qrs. January 39,000 16 2 69 2 0 1 ton in 565 tons, or .177% February 32,193 13 3 56 3 3 573 „ ..174 „ March 32,915 8 3 76 12 1 429 „ .233 „ April 35,221 8 2 75 3 1 468 „ .213 „ May 34,704 15 0 67 8 0 515 „ .194 „ June 31,864 7 3 123 4 1 259 „ .387 „ July 33,115 14 2 99 12 1 „ 332 „ .307 „ August 29,340 2 1 58 18 2 498 „ .207 „ September 32,134 5 2 63 18 2 503 „ .198 „ October 36,020 18 2 62 0 1 581 „ .172 „ November 32,320 4 0 60 14 2 „ 532 „ .188 „ December 36,187 19 0 52 14 2 687 „ .145 „ Totals 405,019 13 3 865 12 0 1 ton in 468 tons, or .214% 166 DISEASED MEAT PROSECUTIONS, 1902. Date of Hearing. Where Heard. Before whom. Occupation of Person Summoned. Defendant's Place of Business. Result. 1902. Jan. 9 Guildhall Aid. Crosby, M.D. Farmer and Pig Hall Farm, Bidelston, Suffolk Fined £10 and £3 3s. expenses. „ 16 Do. Mr. Aid. Morris Farmer [Dealer Drewspond Mill, Devizes „ £5 „ £4 ,, 22 Do. Do. Pork Butcher 6,Newland Street W.,Lincoln „ £3 „ £3 „ „ 22 Do. Mr. Aid. Smallman Farmer Mitchingham Farm. Norwich „ £2 „ £4 4s. Feb. 10 Do. Aid. Sir J. Savory, Bart. Farmer Denver, Downham, Norfolk „ £20 „ £3 10s. ,, 17 Do. Mr. Aid. J. Pound Farmer Framlingham, Suffolk „ £10 „ £2 2s. „ 17 Do. Do. Farmer Applington Hall, Eye, Suffolk „ £1 „ £4 As. March 4 Do. Aid. Sir W. P. Treloar Farmer The Mills, East Harling, Norfolk „ £25 „ £4 „ 6 Do. Dealer Bishops Stortford, Hertford Defendant absconded on service of summons. „ 10 Do. Aid. Sir H. Davies, K.C.M.G., Meat Salesman 58, High Street, Aldgate, E. Fined £5 and £1 1s. expenses. „ 11 Do. Do. [M.P. Farmer Thorney, nr. Peterboro' ,, £80 „ £4 4s. „ or 2 months. „ 20 Do. Aid. Sir J. V. Moore Farmer Little Waldingfield, Sudbury, Suffolk „ £20 „ £5 5s. expenses. April 15 Do. Aid. Sir J. Renals, Bart. Farmer Great Baddon, Chelmsford „ £25 „ £2 2s. „ 15 Do. Do. Farmer Mitcham Road, Croydon „ £5 „ £1 1s. June 9 Do. Mr. Aid. T. V. Strong Butcher Lydd, Kent „ £10 „ £4 4s. „ 9 Do. Do. Pig Dealer Bartlett Street, S. Croydon „ £2 „ £1 1s. „ 10 Do. Do. Farmer Piccardo Farm, Guildford „ £10 „ £3 3s. ,, „ 10 Do. Do. Farmer Hardington, Yeovil „ £50 „ £5 5s. July 16 Do. Aid. Sir W. Wilkin, K.C.M.G. Butcher Marden, Kent ., £1 „ £3 3s. „ Oct. 2 Do. Mr. Aid. Alliston Butcher Boxford, nr. Colchester „ £100 or 3 months. „ 2 Do. Do. Cattle Dealer White Roothing, Dunmow, Essex „ £40 and £4 4s. expenses. or 2 months. „ 17 Do. Mr. Aid. T. V. Strong Publican, &c. Lane End Inn, Creek St. Michael, Taunton „ £5 „ £3 10s. expenses, or 14 days. Nov. 12 Do. Aid. Sir J. W. Ellis, Bart. Butcher Martins Yale, nr. Salisbury Summons dismissed. Ownership not proved. Dec. 12 Do. Mr. Aid. Alliston Butcher and Dealer Coate, Devizes Fined £100 and £4 4s. expenses. or 2 months. The average of fines and expenses in the cases fined amounted to £27 5s. 167 TUBERCULOSIS IN MEAT. The presiding Alderman at the Guildhall Justice Room on the 17th October, after adjudicating on a condemned meat case, called attention to the gross ignorance prevailing among small farmers and butchers in country districts as to the signs of Tuberculosis exhibited both in live animals and in carcasses of animals after slaughtering, and suggested that it would serve a useful purpose if steps were taken by your Medical Officer to enlighten them on such points by means of Circulars, &c. The Sanitary Committee endorsed this recommendation, and your Medical Officer of Health was requested to prepare a memorandum on the whole subject, together with some remarks by the Veterinary Inspector to the Corporation on the symptoms of Tuberculosis presented in living animals. A circular on these lines was accordingly issued in March last. FISH SUPPLIES. 216,183 Tons of fish, of which 169,951 were land-borne and 46,232 water-borne, were received at or near Billingsgate Market during the year. Of the above, 156,357 tons were consigned to Billingsgate Market, the remainder, viz., 59,826, being delivered at the salesmen's shops in the neighbourhood of the Market. Year. Fish Delivered at Billingsgate Market. Fish Delivered in the neighbourhood of Billingsgate Market. Total Deliveries. Tons. Tons. Tons. 1901 *148,356 47,834 196,190 1902 156,357 59,826 216,183 8,001 increase. 11,992 increase. 19,993 increase. The 19,993 increase is mainly due to land deliveries, which are 29,386 above the average for the previous five years. The deliveries by water, which had shown a heavy falling off in 1900 and 1901, showed a marked increase in 1902, being 2,462 tons above the average for the five preceding years. * Extracted from the Annual Report of the Clerk of the Market. 168 MONTHLY FISH RETURNS, 1902. Table showing Weight of Fish Delivered, Fish seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market, and on board boats lying off that place, during each month of the year 1902. Month. Weight of Fish Delivered.* Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. January Tons. 12,747 Tons. 2,908 Tons. 15,655 Tons. 25 cwt. 11 qrs. 3 1 in 612 tons, or .163 per cent. February 14,472 3,483 17,955 31 6 0 1 „ 573 „ 174 „ March 16,179 3,569 19,748 53 11 1 1 „ 369 „ "271 „ April 14,172 3,975 18,147 64 0 2 1 „ 283 „ -353 May 15,171 5,170 20,341 70 8 2 1 „ 289 „ -346 „ June 12,729 4,254 16,983 162 3 3 1 „ 105 „ '955 „ July 14,451 4,031 18,482 173 8 0 1 „ 106 „ -938 „ August 16,164 4,133 20,297 152 8 0 1 „ 133 „ -751 „ September 14,871 4,167 19,038 224 7 1 1 „ 85 „ 1-179 „ October 14,572 4,196 18,768 123 6 0 1 „ 152 „ '657 „ November 12,900 3,319 16,219 46 17 1 1 „ 346 „ -289 „ December 11,523 3,027 14,550 20 19 0 1 „ 694 „ -144 „ Total 169,951 46,232 216,183 1,148 7 1 1 in 188 tons, or 533 per cent. * Compiled from the Monthly Returns furnished to the Corporation by the Fishmongers' Company. Weight of Fish Delivered, Fish seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market during 1902 and the five tears 1897-1901. Year. Weight of Fish Delivered. Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. 1897 Tons. 130,975 Tons. 44,276 Tons. 175,251 Tons 958 cwts. 12 qrs. 0 1 ton in 183 tons, or .55% 1898 135,693 46,874 182,567 1,068 5 0 1 „ 170 „ -59 „ 1899 129,469 50,514 179,983 750 0 2 1 „ 240 „ -42 „ 1900 149,615 38,069 187,684 769 13 3 1 „ 244 „ -41 „ 1901 157,072 39,118 196,190 888 16 1 1 „ 220 „ -45 „ Average (5 years) 140,565 43,770 184,335 887 1 2 1 ton in 211 tons, or *48% 1902 169,951 46,232 216,183 1,148 7 1 1 ton in 188 tons, or .5396 The quantity of fish condemned is the largest since 1896, and 261 tons, 5 cwts., 3 qrs. above the average for the previous five years. 169 SALE OF FOOD AND DRUGS ACTS, 1875-1899. The total number of samples examined during the year was 1,248, of which 1,138 were genuine, and 110, or 8'8 per cent. were adulterated. This shows a marked improvement in the character of the articles supplied over last year, when the proportion of adulteration was 13.11 per cent. As in former years, attention has chiefly been directed towards Milk and Butter, and a comparison of the following figures will show that the efforts taken in the City to check adulteration of these important articles of food are being attended with success:— 1901. 1902.[/##] No. of Milk samples examined 392 599 Found genuine 209 519 „ adulterated 83 80 Percentage of adulteration 21. 13. No. of Butter samples examined 238 299 Found genuine 224 292 „ adulterated 14 7 Percentage of adulteration 5.8 2.34 The quality of Milk and Butter supplied to customers at eating-houses and restaurants was made a special subject of investigation. Of the former, 223 samples were examined, of which 46, or 20.62 per cent., were adulterated. In 183 of these cases the Inspector asked for and was served with "a glass of milk," and on 40 of these occasions, or 21.31 per cent., the milk was adulterated. In the remaining 40 cases " pennyworths " were asked for, and of these 6, or 15 per cent., were adulterated. In 10 of the above purchases a cup of tea was ordered at the same time in order to avert suspicion, and in 2 cases the milk was sophisticated. Ninety-one samples of Butter were collected at these places, and 7, or 7.7 per cent., were found adulterated. In 44 of the above, "pats" of butter were purchased, all being genuine, and in the remaining 47 cases two or three pennyworths were asked for, and of these 7, or 15 per cent., were adulterated. Ninety-seven samples of Spirits, viz., 29 of Rum, 29 Brandy, 30 Whisky, and 9 of Gin were analysed, and 11, or 11.4 per cent., were found below the statutory limit of alcoholic strength. 170 None of the Gins were reported against, but the proportion of adulteration found amongst the Rums, Brandies, and Whiskies was 7.0, 10.34, and 20.0 per cent. respectively. Coffee adulteration has dropped from 9.0 per cent. in 1901 to 3.7 per cent. last year. Mustard has shown a remarkable improvement. In 1901, of 23 samples 13 per cent. were adulterated. Last year 28 were examined and all were found genuine. The six samples of "Sweets" examined were certified as being "genuine." These were mixed sweets and taken with the object of ascertaining if paraffin wax was present. In no instance was this found, but your Public Analyst reports that most of them contained "Chocolate" from which the cacao butter natural to the cocoa bean had been removed and replaced by cocoanut stearin—the fat from the cocoanut deprived of its more readily fusible portion, the cocoanut ole'in. Had "Chocolate" been asked for by the Inspector, the vendors might have been liable to a prosecution under Section 9 of the Sale of Food and Drugs Act, 1875, which enacts that:— "No person shall, with the intent that the same may be sold in its "altered state without notice, abstract from an article of food any part "of it so as to affect injuriously its quality, substance, or nature, and "no person shall sell any article so altered without making disclosure "of the alteration, under a penalty in each case not exceeding twenty "pounds." It would not be a good defence to plead that the material substituted was non-injurious as an article of food—the character of the confection being lowered in quality and nature by the substitution of a cheap and foreign ingredient for a higher-priced natural one. In July last, the following Circular Letter was addressed by the Home Secretary to all Clerks to Justices of the Peace throughout the Country:— A. 63,127-3. 24th July, 1902. Sir, I am directed by the Secretary of State to inform you that a Local Authority charged with the enforcement of the provisions of the Sale of Food and Drugs Acts has recently called his attention to the inadequate penalties imposed for breaches of these Statutes, and has represented that the efforts made to suppress the abuses against which the Acts are aimed are thereby 171 greatly impeded. This representation is by no means the first of the kind which has been made to the Home Office, and the Secretary of State is informed by the Local Government Board that they have from time to time received many similar complaints from the Local Authorities entrusted with the administration of the Acts. The matter was considered by the Select Committee of the House of Commons which inquired into the subject of the Adulteration of Food Products in 1896, and their report contains the following passage:— "There has been a general agreement among the witnesses who have "given evidence in reference to this subject that the penalties imposed "in respect of offences under the Acts are for the most part trifling and "quite insufficient to serve as deterrents. Your Committee have been "told that fines such as 10s., with 12s. costs, are frequently inflicted." Notwithstanding the attention, however, which was then drawn to the matter, the Local Government Board inform the Secretary of State that in the year 1900, out of 2,673 fines imposed by Magistrates under the Sale of Food and Drugs Acts, no less than 764, or over 28½ per cent., were of 10s. or less while 193 penalties were under 5s., and 118 were 1s. or even less than that sum. It is unnecessary to point out the injurious consequences of the adulteration of articles of food, or the large and sometimes enormous profits that accrue from the practice ; and it is obvious that when the penalty on detection is trifling it not only fails to be deterrent, but may even spread the mischievous impression that the offence is venial. The Secretary of State does not wish to be understood as suggesting that these considerations are lost sight of by your Bench, but the figures appear to be sufficient to show that the state of things to which the Parliamentary Committee called attention has not yet been set right ; and he will be glad if you will bring the matter to the notice of the Justices, in order that, as occasion arises, they may give special consideration to the question whether the penalties imposed in the cases that come before them are such as are likely to deter the offenders from repeating, and other persons from committing, the offence. I am, Sir, Your obedient Servant, KENELM E. DIGBY. The Clerk to the Justices of the Petty Sessional Division of 172 173 SALE OF FOOD AND DRUGS ACTS, 1875-1899. Articles examined during the year 1902. Articles submitted for Analysis. Quarter ending 31st March. Quarter ending 30th June. Quarter ending 30th September. Quarter ending 31st December. Total for 1902. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of Articles adulterated. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of Articles adulterated. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of Articles adulterated. No. of Samples taken. No. j Genuine. No. Adulterated. Percentage of Articles adulterated. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of Articles adulterated. Milk 253 211 42 16.6 171 153 18 10.5 77 64 13 16.88 98 91 7 7.0 599 519 80 13.3 Butter 101 96 5 5.0 84 84 ... ... 47 46 1 2.0 67 66 1 1.5 299 292 7 2.34 Coffee 6 6 ... ... 7 6 1 14.3 6 6 ... ... 8 8 ... ... 27 26 1 3.7 Pepper 14 14 ... ... 5 5 ... ... 7 7 ... ... 5 5 ... ... 31 31 ... ... Mustard 10 10 ... ... 6 6 ... ... 9 9 ... ... 3 3 ... ... 28 28 ... ... Golden Syrup ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 1 ... ... Olive Oil ... ... ... ... 9 9 ... ... 1 ... 1 100.0 2 2 ... ... 12 11 1 8.3 Arrowroot 1 1 ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 2 2 ... ... Cheese 6 6 ... ... 2 2 ... ... 1 1 ... ... ... ... ... ... 9 9 ... ... Demerara Sugar 4 3 1 25.0 ... ... ... ... ... ... ... ... 1 1 ... ... 5 4 1 20.0 Margarine 4 ... 4 100.0 ... ... ... ... ... ... ... ... ... ... ... ... 4 ... 4 100.0 Non-compliance with Margarine Act. Non-compliance with Margarine Act. Drugs 14 14 ... ... 34 34 ... ... 24 21 3 12.5 7 5 2 28.5 79 74 5 6.3 Cocoa 2 2 ... ... 3 3 ... ... 2 2 ... ... 4 4 ... ... 11 11 ... ... Sweets ... ... ... ... ... ... ... ... ... ... ... ... 3 3 ... ... 3 3 ... ... Cream 5 5 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 6 6 ... ... Rum 2 2 ... ... 27 25 2 7.4 ... ... ... ... ... ... ... ... 29 27 2 7.0 Brandy 2 2 ... ... 27 24 3 11.1 ... ... ... ... ... ... ... 29 26 3 10.34 Whiskey 2 1 l 50.0 28 23 5 18.0 ... ... ... ... ... ... ... ... 30 24 6 20.0 Gin ... ... ... ... 9 9 ... ... ... ... ... ... ... ... ... ... 9 9 • • . ... Flour ... ... ... ... 6 6 ... ... ... ... ... ... ... ... ... ... 6 6 ... ... Lard ... ... ... ... 6 6 ... ... 3 3 ... ... 2 2 ... ... 11 11 ... ... Prescriptions ... ... ... ... 8 8 ... ... ... ... ... ... ... ... ... ... 8 8 ... ... Baking Powder ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 1 1 ... .. Chocolate ... ... ... ... ... ... ... ... ... ... ... ... 9 9 ... ... 9 9 ... ... Totals 426 373 53 12.4 432 403 29 6.7 179 161 18 100 211 .201 10 4.7 1,248 1,138 110 8.8 174 Table II. RESULTS OF PROSECUTIONS. First Quarter. Sample. Nature and Extent of Adulteration. Result. 33 Milk 7 per cent. added water, 11 per cent. fat abstracted. £5 and 17s. 6d. expenses. 40 Butter 100 per cent. margarine £1 and 17s. 6d. expenses. 82 Demerara Sugar Dyed sugar other than Demerara £1 and 19s. 6d. expenses. 91 Milk 11 per cent. added water 1s. and 12s. 6d. expenses. (Milk obtained from vendor of Sample No. 108.) 108 ,, 17 per cent. added water £10 and 13s. 6d. expenses. 132 ,, 25 per cent. fat abstracted Summons dismissed. ranty produced. 147 ,, 12 per cent. added water £10 and 13s. 6d. expenses. 171 ,, 32 per cent. fat abstracted £1and 17s. 6d. expenses. 173 „ 23 per cent. fat abstracted Dismissed. Vendor bankrupt. 178 ,, 19 per cent. added water £15 and 17s. 6d. expenses, or two months' imprisonment. (Second offence.) 189 Margarine Selling margarine unlabelled 5s. and 9s. expenses, or 14 days. 199 Milk 20 per cent. added water, 13 per cent. fat abstracted. 3s. and 27s. expenses. 202 ,, 27 per cent. added water £5 and 17s. 6d. expenses 203 Butter 100 per cent. margarine £2 and 21s. 6d. expenses. 208 Milk 6 per cent. added water £1 and 17s. 6d. expenses. Selling margarine unlabelled Summons withdrawn. Vendors undertaking to exhibit notices "Margarine only." 214 Margarine 216 ,, Selling margarine unlabelled 217 Milk 10 per cent. added water Summons dismissed. Warranty produced. 219 „ 24 per cent. fat abstracted 5s. and 14s. 6d. expenses. 223 ,, 28 per cent. added water 1s. and 5s. expenses. 229 ,, 23 per cent. added water £1 and 17s. 6d. expenses. 235 „ 14 per cent. added water £2 and 17s. 6d. expenses. 248 ,, 26 per cent. fat abstracted £2 and 14s. 6d. expenses. 264 ,, 9 per cent. added water £1 and 17s. 6d. expenses. 286 ,, 14 per cent. fat abstracted £2 and 19s. 6d. expenses. 291 ,, 35 per cent. fat abstracted 10s. and 19s. 6d. expenses. 292 ,, 17 per cent. fat abstracted 1s. 300 ,, 25 per cent. fat abstracted 1s. and 17s. 6d. expenses. 310 ,, 33 per cent. fat abstracted £5 and 19s. 6d. expenses. 312 ,, 4 per cent. added water, 19 per cent. fat abstracted. £2 and 19s. 6d. expenses. 317 „ 42 per cent. fat abstracted £3 and 17s. 6d. expenses. 340 ,, 13 per cent. added water, 6 per cent. fat abstracted. £1 and 17s. 6d. expenses. 349 ,, 6 per cent. added water, 4 per cent. fat abstracted. £5 and 17s.. 6d. expenses. 175 Sample. Nature and Extent of Adulteration. Result. 351 Milk 12 per cent. added water, 22 per cent. fat abstracted. Summons dismissed on proof of warranty. 368 „ 18 per cent. added water £1 and 17s. 6d. expenses. 369 Butter 100 per cent. margarine Summons dismissed, proceedings taken under Sale of Food and Drugs Act. 372 Margarine Selling margarine unlabelled Undertaking given by vendor to exhibit notice "Margarineonlysold here." 376 Butter 100 per cent. margarine £5 and 19s. 6d. expenses. 381 Milk 19 per cent. fat abstracted £2 and 17s. 6d. expenses. 383 „ (1) 8 per cent. added water (1) £2 and 11s. 6d. expenses. (2) 24 per cent. fat abstracted (2) £2 and 11s. expenses. 392 „ 14 per cent. added water £5 and 12s. 6d. expenses. 416 22 per cent. fat abstracted £1 and 18s. 6d. expenses. Second Quarter. 426 Milk 21 per cent. fat abstracted Summons dismissed. Delivery complete at Euston Station. 431 Coffee 48 per cent. chicory £3 and 17s. 6d. expenses. 477 Milk 23 per cent. fat abstracted Summons dismissed. Warranty proved. 601 Brandy 27 degrees under proof 10s. and 12s. &d. expenses. 609 Milk 12 per cent. fat abstracted £3 and 17s. 6d. expenses. 665 „ 12 per cent. fat abstracted £5 and 17s. &d. expenses. 669 „ 15 per cent. fat abstracted Summons dismissed. 698 23 per cent. fat abstracted Summons dismissed. ranty proved. 772 „ 40 per cent. fat abstracted £1 and 17s. 6d. expenses. 774 „ 7 per cent. added water, 29 per cent. fat abstracted. £1 and 17s. 6d. expenses. 781 „ 12 per cent. fat abstracted 10s. and 17s. 6d. expenses. 787 „ 32 per cent. fat abstracted Summons dismissed. Warranty proved. 794 18 per cent. fat abstracted ... £1 and 17s. 6d. expenses. 805 7 per cent. added water, 3 per cent. fat abstracted. 10s. and 17s. 6d. expenses. 807 „ 10 per cent. fat abstracted £20 and 21s. expenses (Third offence.) Third Quarter. 876 Milk 13 per cent. added water, 33 per cent. fat abstracted. £2 and 14s. 6d. expenses. 879 „ 7 per cent. added water £2 and 17s. 6d. expenses. 885 13 per cent. added water Summons dismissed on payment of costs, 14s. 6d. Warranty admitted. 909 18 per cent. fat abstracted £5 and 17s. 6d. expenses. 918 „ 28 per cent. fat abstracted £4 and 12s. 6d. expenses. 924 „ 24 per cent. fat abstracted £2 and 17s. 6d. expenses. 176 Sample. Nature and Extent of Adulteration. Result. 928 Milk 23 per cent. fat abstracted £5 and 19s. 6d. expenses. (Appealed to Quarter Sessions, 7th Jan., 1903. Appeal dismissed with £12 12s. costs.) 940 Olive Oil 70 per cent. earthnut oil Case dismissed on technical grounds for adulteration offence. Fined £2 and 7s. expenses for obstruction. 942 Butter 100 per cent. of margarine £5 and 17s. 6d. expenses. 983 Milk 17 per cent. fat abstracted £1 and 17s. 6d. expenses. 988 Light Magnesia 100 per cent. hydrated carbonate of magnesia. Dismissed on technical grounds. 992 100 per cent. hydrated carbonate of magnesia. Dismissed on technical grounds. Fourth Quarter. 1095 Butter... 36 per cent. butter, 64 per cent. margarine. £15 and 12s. 6d. expenses. (Second offence.) 1216 Milk 10 per cent. added water 5s. and 12s. &d. expenses. 1223 „ 11 per cent. added water, 6 per cent. fat abstracted. £2 and 12s. 6d. expenses. SUMMARY. £ s. d. £ s. d. First Quarter: Fines 94 7 0 Expenses 28 4 0 Second Quarter ,, 35 10 0 ,, 8 13 6 Third Quarter ,, 28 0 0 ,, 20 7 6 Fourth Quarter ,, 17 5 0 ,, 1 17 6 £175 2 0 £59 2 6 Fifty-seven fines were inflicted during the year, the average fine being £3 1s. 5d. The average of fifty-six fines in 1901 was £2 13s. l0d. 177 MILK REGULATIONS. The following Circular was issued by the Board of Agriculture with reference to obtaining samples of food and drugs, and calling attention to standards of purity for Milk, Separated Milk, and Cream, and also to the practice of adding gelatin and other thickening materials to Cream with a view to hiding adulteration by dilution. By direction of your Medical Officer of Health a number of samples of Cream were collected within the City to discover any such sophistication, but these all proved to be genuine. 28th December, 1901. "SALE OF FOOD AND DRUGS ACT, 1899. "(62 & 63 Vict, c. 51.) "Sir, "I am directed by the Board of Agriculture to bring under the notice of "your Local Authority the following observations with reference to the "Regulations relating to the Sale of Milk in Great Britain, which, in "pursuance of the powers conferred upon the Board by Section 4 of the Sale "of Food and Drugs Act, 1899, were made by the Board on the 5th August, "and came into operation on the 1st September, 1901. "The Regulations were as follows:— " MILK. "1. Where a sample of milk (not being milk sold as skimmed, or separated, "or condensed, milk) contains less than 3 per cent, of milk-fat, it shall be "presumed for the purposes of the Sale of Food and Drugs Acts, 1875 to 1899, "until the contrary is proved, that the milk is not genuine, by reason of the "abstraction therefrom of milk-fat, or the addition thereto of water. "2. Where a sample of milk (not being milk sold as skimmed, or separated "or condensed, milk) contains less than 8.5 per cent of milk-solids other than "milk-fat, it shall be presumed for the purposes of the Sale of Food and Drugs "Acts, 1875 to 1899, until the contrary is proved, that the milk is not genuine, "by reason of the abstraction therefrom of milk-solids other than milk-fat, or the "addition thereto of water. "SKIMMED OR SEPARATED MILK. "3. Where a sample of skimmed or separated milk (not being condensed "milk) contains less than 9 per cent. of milk-solids, it shall be presumed for the " purposes of the Sale of Food and Drugs Acts, 1875 to 1899, until the contrary "is proved, that the milk is not genuine, by reason of the abstraction therefrom "of milk-solids other than milk-fat, or the addition thereto of water. "In the Regulations the limits below which a presumption is raised that "the milk is not genuine were necessarily fixed at figures lower than those 178 "which are usually afforded by genuine milk, in which the proportion of "milk-fat and non-fatty solids very frequently exceeds the percentages "specified above. It is therefore important that Local Authorities should "keep steadily in view the possibility of the artificial reduction of the quality "of natural milk to the official limits by the abstraction of cream, or the "addition of separated milk, or of water, and arrangements should be made "for the taking of samples and the submission of the same for analysis "whenever the existence of malpractices of the kind is suspected. In this "connection, it may be observed that the evidence given before the Milk "Regulations Committee [Cd. 491] tended to show that the practice of "fraudulently mixing separated milk with new milk has become increasingly "prevalent, particularly in some of the larger towns. "Although the quality of genuine milk offered for sale will usually be well "above the official limits of milk-fat and non-fatty solids, there may "occasionally, and especially in certain seasons of the year, be cases in which "a sample of genuine milk may fall below those limits. To meet cases of this "kind it is suggested that in the absence of any special circumstances "indicating that the case is a fraudulent one, the Local Authority might, in "the first instance, call the vendor's attention to the analyst's report, and ask "him whether he desires to offer any explanation, and if the explanation is "one they are able to accept, they might, in the exercise of their discretion, "refrain from the institution of proceedings or withdraw any summons which, "in order to prevent the failure of proceedings, by reason of the time-limit "imposed by the Act, it may have been necessary to take out. But it may "be desirable that further samples of milk should be taken in such cases, in "order that a satisfactory conclusion as to the character of the milk supplied "may be arrived at. "CREAM. "The Milk Regulations Committee reported that the evidence submitted "to them went to show that it was a common practice to add gelatin to cream "for the purpose of giving it a fictitious appearance of richness or thickness. "Local Authorities are urged to take steps to ascertain whether this form of "adulteration is practised within their districts, and if a public analyst "reports the presence of gelatin or other similar substance in a sample of ''cream, the Local Authority concerned should consider whether the case is "one in which proceedings might not with advantage be instituted under "Section 6 of the Sale of Food and Drugs Act, 1875. "COLLECTION AND RETENTION OF SAMPLES. "It is desirable that, so far as may be found practicable, there should be "uniformity of procedure in collecting and retaining samples of milk "procured under the provisions of the Sale of Food and Drugs Acts, and the 179 "following recommendations have been drawn up for the guidance of the "local officials employed in this work:— "1. The quantity to be purchased should not be less than one pint, except "that it may be expedient to purchase only half-a-pint in cases where there is "reason to believe that the object of the purchase would be defeated if a greater "quantity were demanded. "2. The division of the sample under Section 14 of the Act of 1875, as "amended by Section 13 of the Act of 1899, should be made as equally as "possible, so that the portion reserved by the purchaser may be not less than "one-third of the whole. "3. The bottle used for each divided part should have a narrow neck, and be "of such capacity that the milk may nearly or quite fill it. The shape of bottle "known as 'Winchester' is strongly recommended, but in any case the bottles "should have rounded sides in order to give security to the sample during transit "by post or otherwise. "4. Corks only should be used, and these should always be new and sound, "and fitting so tightly as to secure the contents without any aid from the wax "which is subsequently used for sealing the sample. It is most desirable that "the sealing should be carried out in such a way as to prevent any attempt to "remove the cork. It is, therefore, recommended that the cork should be slit "down to one-fourth of its length and the string drawn through and securely "fastened round the neck, the ends being afterwards carried to the top of the "cork and sealed thereon. "5. Special attention should be given that the reserved portion of milk be "kept in as equable and cool a temperature as possible, pending its production in "Court in instances where proceedings are taken ; and if directed by the "Justices to be referred to the Government Laboratory, it should be carefully "packed so as to secure its safe transmission. "The Board would be obliged if you would take steps to bring this "Circular under the notice of your Local Authority, and they will be glad to "forward you additional copies for distribution amongst the members of your "Local Authority and the officers concerned, upon being informed of the "number you require." BUTTER. Under Section 4 of the Sale of Food and Drugs Acts, 1875-1899, the Board of Agriculture was empowered to appoint a Committee to determine what deficiency in any of the normal constituents of butter shall, for the purpose of the Sale of Food and Drugs Acts, raise a presumption, until the contrary be proved, that the butter is not genuine. A Departmental Committee to enquire and report as to what regulations, if any, should be adopted, was appointed upon the 3rd July, 1901, and reported as follows:— 180 BUTTER REGULATIONS COMMITTEE. 24th January, 1902. INTERIM REPORT. To the President of the Board of Agriculture, and to the Vice-President of the Department of Agriculture and Technical Instruction for Ireland. Sirs, 1. The Departmental Committee on Butter Regulations was appointed by Minute of the 3rd July, 1901, to enquire and report as to what Regulations, if any, may with advantage be made under Section 4 of the Sale of Food and Drugs Act, 1899, for determining what deficiency in any of the normal constituents of butter, or what addition of extraneous matter, or proportion of water, in any sample of butter shall, for the purpose of the Sale of Food and Drugs Acts, raise a presumption, until the contrary is proved, that the butter is not genuine. 2. At its first meeting held on the 5th July, 1901, the Committee unanimously decided to give precedence to that part of the Inquiry which relates to the proportion of water in butter. The reason for this course was that a considerable period would be necessary for the collecting of the evidence relating to the genuineness of butter so far as this depended upon its other constituents, while the facts bearing upon the proportion of water could be much more easily obtained. Moreover, having regard to the large number of prosecutions which had recently arisen in respect of an alleged excess of water in butter, and since the miscarriage of some of these proceedings was attributed to the absence of Regulations—which must await the result of this Inquiry—the Committee considered it convenient to issue an Interim Report as soon as a conclusion had been reached regarding this particular part of the Reference, and without waiting for the completion of the Inquiry, or for the publication of evidence. 3. The Committee has now held sittings on sixteen days, and evidence has been given in London on seven days, in Dublin on three days, in Limerick on two days, and in Cork on two days. Fifty-five witnesses have been examined, their evidence being restricted to the water question, except in Ireland and in the cases of a few witnesses in London whom it was thought unnecessary to recall on a future occasion. 4. The first question which the Committee had to decide was whether any limit whatever to the proportion of water was required, or whether the public taste—the actual operation of the law of supply and demand—would regulate the matter without the interference of legislative or administrative action. No doubt was left on the minds of the Committtee upon this point. The weight of evidence was overwhelmingly in favour of some official Regulation, and the recent legal proceedings, already referred to, seemed to accentuate the necessity for such action. 5. The real difficulty which the Committee felt in arriving at a decision arose from the existence in the market of a particular article which, many witnesses declared, would be injuriously affected by any limit applicable to all other butters. Evidence was 181 produced to show that while the trade in this article—Irish salt firkin butter—has of late years considerably decreased, the manufacture being almost entirely confined to certain districts of the South West of Ireland, and the sale to certain industrial centres in Lancashire, Yorkshire, and South Wales, there is still a definite demand for this butter on account of its low price, distinctive flavour, and long-keeping qualities. It is also a peculiarity of this butter, owing to the method of its manufacture, which has prevailed for many generations, that it frequently contains—and those interested in its production and distribution say it necessarily contains—a higher percentage of moisture than is found in any other butter coming into the market. 6. Some witnesses proposed that this difficulty should be met by the fixing of two limits—a higher one, which would probably have to be fixed at 20 per cent, for one class of butter—for which various definitions were suggested, but Irish salt firkin butter being exclusively in view—and, for all other butters, a lower limit, which was placed at from 15 to 18 per cent., the weight of evidence settling at 16 per cent. Three bases for the division of butters under the dual limit system were suggested, i.e. (a) the percentage of salt in butter ; (6) the trade description of the particular article in question ; and (c) the price. None of these classifications, however, appeared free from objection, and the Committee was convinced of the undesirability, if it could possibly be avoided, of complicating the Regulations by fixing a dual limit. The Committee also felt that, given time and training, the remaining makers of Irish salt firkin butter would probably be enabled to fall into line with the vast majority of Irish butter producers, who can now with modern methods easily conform with any reasonable limit to the proportion of water in their butter ; and this result would be accelerated in proportion to any further decrease in the demand for this special class of butter. 7. The Committee, moreover, understand that vendors of this type of butter containing water in excess of the proposed official limit, would be legally protected, provided that a sufficient disclosure is made to the purchaser. This consideration finally decided the Committee to recommend a single limit, and to leave it to the vendors of Irish salt firkin butter to protect themselves in the simple manner indicated. 8. There then remained the question of the actual percentage of water which might be fairly adopted as the limit. The Committee sought to learn from practical and scientific dairy farmers, agricultural experts, and analysts how far the amount of water was within the control of the maker. In the case of creameries and factories there was a general agreement that this question presented little difficulty. In carefully-made butters the proportion of water is found to range from 10 per cent, to 15 per cent. The difficulties mainly arose when it became necessary to take into account the position of small producers, with little knowledge, with unsuitable buildings, with rude appliances, and without access to sufficiently cold water in hot weather. After hearing a large amount of evidence on this point, the Committee nevertheless came to the conclusion that a limit of 16 per cent, could safely be prescribed. 9. Were the limit to be placed higher than this, the Committee felt that the reputation of, and the demand for, home-produced in competition with imported butter must inevitably suffer. So far as could be learned no official limit to the proportion of water exists in butter-exporting countries ; but it must be remembered that the industry in some of these States is controlled by inspection and branding, or the producers of butter are encouraged to secure a low percentage of water and a uniform standard of 182 excellence by the general dissemination of information, and by educational and experimental means. 10. In the course of their Inquiry the Committee were informed that the incorporation or blending of water with butter intended for exportation to this country, in order to increase its weight, was at one time extensively practised in Hamburg and in certain parts of Holland. A modified form of this practice is now in operation in this country, and considerable quantities of a material known as " milk-blended butter " are now made by working milk into butter, whereby the amount of water in the original butter is increased from a relatively small proportion up to 20 or 25 per cent. This mixture of milk and butter has been the subject of numerous prosecutions under the Sale of Food and Drugs Acts, but the latest magisterial decisions concerning it would seem to show that the seller would be legally protected, provided that a sufficient disclosure of its real character were made to the purchaser at the time of sale. RECOMMENDATION. We therefore recommend the adoption of a limit of 16 per cent, for the proportion of water in butter to be fixed by a Regulation under Section 4 of the Sale of Food and Drugs Act, 1899, and we make this recommendation on the assumption that butter containing a larger percentage of water that 16 per cent, will escape the operation of this limit provided that a sufficient disclosure is made to the purchaser. The following are the Regulations made by the Board of Agriculture, and which came into operation on the 15th May, 1902 :— BOARD OF AGRICULTURE RULES (Dated 22nd April, 1902). SALE OF BUTTER REGULATIONS, 1902. The Board of Agriculture, in exercise of the powers conferred on them by Section 4 of the Food and Drugs Act, 1899, do hereby make the following Regulations :— 1. Where the proportion of water in a sample of butter exceeds 16 per cent, it shall be presumed for the purposes of the Sale of Food and Drugs Acts, 1875 to 1899, until the contrary is proved, that the butter is not genuine by reason of the excessive amount of water therein. 2. These Regulations extend to Great Britain. 3. These Regulations shall come into operation on the fifteenth day of May, One thousand nine hundred and two. 4. These Regulations may be cited as the Sale of Butter Regulations, 1902. In witness whereof the Board of Agriculture have hereunto set their Official Seal this Twenty-second day of April, One thousand nine hundred and two. T. H. ELLIOTT, Secretary. 183 FOOD AND DRUGS ACTS AMENDMENT BILL. This was a short Bill of only three clauses, introduced by the Government last year in order to deal with a particular kind of sophistication not provided for in existing statutes. Under the provision of Section 4 of the Sale of Food and Drugs Acts, 1899, the Board of Agriculture by an Order dated 22nd April, 1902, limited the amount of water in butter to 16 per cent. The seller of this article containing a greater quantity of water being not liable under the existing Act, provided that sufficient disclosure of the fact in made to the purchaser. Many cases having arisen where persons were deceived as to the true quality of butter that had been mixed with a quantity of milk, Section 1 (2) of the Bill classed such a mixture under the term " Butterine," which was defined as butter to which any substance had been added whereby the amount of water was increased. It also provided that it should be sold under much the same conditions as now obtain in relation to Margarine, in addition to which a statement was to be printed on the wrapper indicating that the butter had been adulterated or impoverished, and stating the approximate increase of water therein caused by such admixture. The Act was to have come into operation on the 1st January, 1903. Special provision, however, was made for dealing with butters mixed with brine to which the Act was not to apply until the 1st January, 1904, after which date the amount of moisture in butter so treated was to be limited to 18 per cent. Owing to the pressure of other public business it was found impossible to proceed with the Bill, which was eventually withdrawn by the Government in November last. In the interest of the public it is to be hoped that the Government will reintroduce this Bill, and that it will become law at an early date.* I have the honour to be, Gentlemen, Your obedient Servant, Medical Officer of Health for the City of London. public Health Department, Guildhall, E.C., April, 1903. * This Bill, with certain modifications, was reintroduced in the Commons on the 4th February, 1903, under the title of " The Adulterated Butter Act, 1903." APPENDICES. PAGE. A Street Lists of Mortality 187 B „ „ Infectious Disease 192 C Tenement House Register 198 D List of Persons registered under the Dairies, Cowsheds and Milk Shops Orders 209 E New List of Causes of Death as used in the Annual Reports of the Registrar-General of England and Wales 221 Spot Map of the City showing Infectious Diseases. 187 Appendix A. CITY OF LONDON MORTALITY. 1902. STREET LISTS, Compiled from Weekly Returns of Registrars of Sub-Districts. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. Albion Buildings 21 F 64 26 Feb. 1902 Bronchitis „ „ 22 F 62 29 Dec. „ Bronchitis Aldermanbury Buildings 3 M 67 10 Nov. „ Morbus Cordis • Ald,ersgate Street 101 M 63 11 Feb. „ Acute Gastro-Enteritis „ „ 133 F 84 24 June „ Bronchitis „ „ 187 F 40 23 Dec. ,. Pulmonary Tuberculosis Aldgate—"Three Nuns Hotel" M 42 16 Oct. „ Cirrhosis of Liver Aldgate High Street 26 M 7 days 25 July „ Trismus Nascentium Angel Court, Throgmorton Street 15 M 69 31 Mar. „ Bronchitis Artillery Lane 5 F 38 5 Jan. ,, Phthisis „ „ 7 F 85 2 Aug. „ Chronic Bright's Disease „ „ 12 F 49 27 Feb. „ Chronic Bronchitis „ „ 12 F 61 5 Mar. „ Erysipelas „ „ 14 F 68 12 Dec. „ Chronic Bronchitis „ „ 16 F 8 m'ths 28 Feb. „ Bronchitis „ „ 16 F 66 20 Nov. „ Chronic Nephritis „ „ 21 M 1 month 25 May „ Inanition from Birth Ball Court 3 M 4 25 Aug. „ Tubercular Meningitis „ „ 6 F 39 25 Jan. „ Morbus Cordis Died in St Bart.'s Barker's Buildings 8 F 16 20 July „ Shock from Burns. Accident Inq. Died in St. Bart's. „ „ 11 F 65 3 Nov. „ Chronic Bronchitis „ „ 15 F 72 10 Aug. „ Senile Decay „ „ 16 F 45 17 Oct. „ Blood Poisoning after Inquest „ „ 22 F 66 18 Feb. „ grene of Right Arm Chronic Bronchitis Bartholomew Close 38 M 50 16 Oct. „ Bronchitis „ „ 44 F newly born 4 Aug. „ Asphyxia „ „ 47 F 57 6 Oct. „ Bronchitis „ „ 48 F 69 18 July „ Acute Gastro-Knteritis „ „ 61 M 67 13 Aug. „ Gastric Ulcer „ „ 77 M 63 14 April „ Acute Diarrhoea „ „ 78 F 14 m'ths 15 Dec. „ Broncho-Pneumonia Died in St. Bart.'s „ „ 80 F 7 m'ths 4 April „ Broncho-Pneumonia Died in St. Bart.'s „ House 10 M 11 m'ths 9 Dec. „ Acute Bronchitis Bartlett's Buildings 20 F 59 1 Sept. „ Typhoid Fever Bell's Buildings 8 M 50 21 „ „ Heart Disease „ „ 10 F 76 10 „ „ Senile Decay Inquest Bishopsgate Street Within 11 106 M F 59 11 days 17 Feb. „ 12 Jan. „ Heart Disease Convulsions „ „ Without 2 F 35 6 Oct. „ Pneumonia „ „ 98 M 4 m'ths 28 Dec. „ Inanition „ „ 102a M 3 m'ths 7 Oct. „ Capillary Bronchitis „ „ 116 M 63 13 Nov. „ Cancer of Liver „ „ 130 M 42 11 Jan. „ Phthisis „ „ 133 F 86 5 Nov. „ Senile Decay Bishopsgate Fire Station F 2 5 Oct. „ Congenital Heart Disease Bloomfield House 4 M 5 m'ths 8 July „ Overlaid in Bed Inq. Died in St. Bart.'s „ „ 8 M 7 m'ths 10 June „ Measles „ „ 23 M 70 21 Aug. „ Bronchitis Bridgewater House 8 11 12 m'ths 8 Oct. „ Tubercular Meningitis Broadway 2 F 63 2„ „ t Chronic Gastric Catarrh Bromley Buildings, Huggin Lane 3 M 64 5 Dec. „ Gangrene of Foot Brushfield Street 14 F 81 25 Mar. „ Senile Decay „ „ 14 F 73 7 Sept. „ Morbus Cordis Camomile Street M 82 26 June „ Syncope Inq. Died in St. Bart 's Cannon Street 20 M 24 30 April „ Lift Accident Inquest „ „ 110 M 33 2 May Cirrhosis of Liver 188 CITY OF LONDON MORTALITY—continued. STREET OK PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. Cannon Street Hotel M 33 29 Sept., 1902 Phthisis Pulmonalis Carmelite Street Fire Station — F 12 m'ths. 20 Mar. „ Measles Carter Lane, Ludgate Hill 48 F 1 7 May „ Morhilli „ Street 19 F 34 12 Feb. „ Cerebral Tumour Catherine Court, Tower Hill 5 F 70 31 Mar „ Strangulated Hernia Charterhouse Street 18 M 22 27 June „ Acute Double Pneumonia Circus, Minories 1 M 18 26 Mar. „ Pulmonary Tuberculosis „ „ 1 M 16 m'ths 6 Dec. , Morbilli, Bronchitis „ „ 7 F 34 20 „ Bronchitis City Police Hospital — M 24 1 Jan. „ Pneumonia „ „ — M 24 11 „ „ Phthisis „ „ — M 27 1 Aug. Pneumonia City Buildings, Moor Lane 7 M 15 m'ths 11 Oct. „ Broncho-Pneumonia „ „ 23 M 12 days 17 July „ Inanition Clark's Place 9 M 1 day 30 Mar. „ Premature Birth Clement's Lane 11/2 M 40 6 Dec. „ Shock from Bullet Wound in Brain. Suicide. Inquest Clifford's Inn 8 M 35 4 Oct. „ Cerebral Haemorrhage Inq. Died in St. Bart.'s Cloth Fair 6 F 49 24 „ „ Carcinoma (Uterus) „ „ 9 F 85 28 Feb. „ Senile Decay „ „ 26 M 6 months 8 Mar. „ " Overlaid " „ „ 26 M 3 21 „ „ Diphtheria Cockerill's Buildings 4 F 64 3 Oct. Cardiac Valvular Disease „ „ 6 M 3 6 April „ Measles „ „ 8 F 75 19 Feb. „ Wound on Head. Accident. Inquest Coleman Street 6 F 77 24 July „ Carcinoma of Stomach „ „ 19 M 41 4 Oct. „ Pneumonia and Pleurisy „ „ 47 F 9 16 May ,, Typhlitis „ „ 59 M 62 8 April „ Suicide by Hanging Inquest Cooper's Row 12 M 48 11 June ., Broncho-Pneumonia Crown Court 2 M 1 5 July „ Measles Crown Place 3 F 81 24 April „ Pulmonary Congestion „ „ 3 F 71 3 Dec. „ Compound Valvular Cardiac Disease „ „ 6 M 1 month 19 Feb. „ Asthenia ,, ,, 6 M 33 31 Mar. „ Apoplexy inquest Crutched Friars 6 M 69 1 Dec. „ Diabetes-albuminuria Currier's Row 5 F 76 19 Mar. „ Senile Decay „ „ 13 F 19 14 May „ Gastric Ulcer Cutler Street 13 M 63 30 Oct. „ Diabetes Mellitus and „ „ M Cerebral Haemorrhage „ „ 29 13 m'ths 28 June „ Measles „ „ 32 M 12 m'ths 20 Jan. „ Norma around Rectum and Perineum Dean's Court, Old Bailey 31 F 39 21 April „ Acute Phthisis Dean Street, C Block * F 73 13 „ Heart Disease „ „ 7 M 69 28 July „ Cancer of the Bowel Duke Street 13 F 4 16 June „ Pulmonary and Laryngeal Tuberculosis „ „ 13 M 9 months 14 Nov. „ Tubercular Enteritis Eastcheap 10 F 37 18 Sept. „ Phthisis East Passage 8 F 20 m'ths 28 „ „ Cirrhosis of Liver Died in St. Bart.'s „ „ 79 M 8 months 16 Oct. Pertussis Ellison Street 3 F 82 17 Jan. „ Senile Decay „ „ 3 M 2 23 Aug. „ Broncho-Pneumonia Elmion Row, Minories 2 M 80 2 Mar, „ Senile Decay Evangelist Court 3 M 64 8 Feb. „ Heart Disease and Bronchitis Farringdon Street 34 M 52 1 Jan. „ Acute Gastritis „ „ Shaftesbury Hotel — M 86 12 May „ Bronchitis Died in St. Bart.'s Fenchurch Street 38 F 71 22 Jan. „ Morbus Cordis „ „ 66 M 29 3 Mar. „ Suicide by Shooting Inquest „ „ 108 F 75 17 Feb. „ Heart Disease Inquest „ „ 124 M 77 6 Jan. „ Morbus Cordis Fetter Lane 36 M 53 4 Oct. „ Dislocation of Neck. Accident Inquest Finsbury Circus 16 F 67 24 Dec., 1901 Cardiac Failure Fishmongers' Alley 2 M 49 2 April, 1902 Pleuro- Pneumonia Fish Street Hill 15 F 71 8 Feb. „ Broncho-Pneumonia „ „ 35 F 4 months 9 Mar „ Marasmus Fleet Street 67 F 8 months 12 Jan. „ Dentition, Convulsions „ „ 71 F 51 19 Nov. „ Rupture of Liver and Fractured Ribs by being run over. Accident Inquest „ „ 141 F 64 28 Dec. „ Cerebral Haemorrhage „ „ 169 F 83 2 Feb. „ Acute Bronchitis Furnival Street 30 F 45 28 Dec. „ Phthisis Garden Place 5 F 73 21 Feb. „ Acute Bronchitis Golden Lane (City Mortuary) — M 41 27 Nov. „ Acute Hemorrhagic Died in St. Bart.'s Pancreatitis Goodman's Yard 18 M 16 m'ths 7 April „ Broncho-Pneumonia Gracechurch Street 22 F 69 7 Mar. „ Chronic Bronchitis Gravel Lane 119 M 89 25 Nov. „ Hemiplegia 189 CITY OF LONDON MORTALITY—continued. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. Great Montague Court 1 M 15 14 Dec., 1902 Gangrenous Appendicitis Died in St. Bart.'s Great Tower Street 55 F 67 17 May „ Erysipelas Gresham Street 46 M 69 18 April „ Chronic Ulcer of Leg Greystoke Place 6 M 5 11 June „ Tubercular Meningitis „ „ 7 9 M 6 months 7 Dec. „ Heart Failure Inquest „ „ 7 9 M 2 20 Feb. „ Measles Guildhall Police Court (in cell) — M 19 19 Sept. „ Bullet Wound in Chest Inquest Gun Square 15 M 52 2 Jan. „ Effusion of Blood on Brain Inquest „ „ 7 16 F 65 17 Feb. „ Acute Bronchitis „ „ 7 17 M 83 26 June „ Syncope Inquest Gunpowder Alley 8 F 6 weeks 1 Jan. „ " Overlaid " by Mother Inquest Half Moon Passage 4 F 87 1 ,, Morbus Cordis Harp Lane 16 F 68 12 Aug. „ Paraplegia Harrow Alley 41 M 73 30 April „ Senile Decay Hatton Court 1 M 30 22 Feb. „ Pulmonary Tuberculosis Holborn Viaduct 55 M 5 weeks 30 July „ Prematurity Houndsditch 140 M 83 27 Nov. „ Failure of Heart „ „ 148 F 66 1 Mar. „ Senile Decay Hutchinson Avenue 21 F 79 1 Jan. „ Senile Decay „ „ 22 F 63 16 Sept. „ Carcinoma of Ventriculi „ „ 26 F 86 24 Nov. ,, Erysipelas after Head Wound Inquest Industrial Dwellings (Barker's Buildings) 8 F 83 12 Mar. „ by fall out of bed. Accident. Bronchitis Inquest „ „ 18 M 13 m'ths 8 Feb. „ Convulsions Ivy Lane 12 M 30 9 Dec. „ Pulmonary Congestion Joiners' Hall Buildings 3 M 57 3 May „ Haemorrhage into Brain Inquest King Street, Smithfield 15 F 46 8 Feb. „ Cardiac Failure Died in St. Bart.'s King's Head Court 10 F 46 23 „ Phthisis „ „ 16 F 6 4 April „ General Tuberculosis Died in St. Bart.'s „ „ 17 M 63 20 Jan. „ Pulmonary Tuberculosis Inquest King William Street 49 F 43 21 Nov. ,, Phthisis Knightrider Street 19 F 23 1 May „ Apoplexy Inquest „ „ 61 F 30 mins. 18 Oct. Immaturity Leadenhall Street 36 F 9 months 1 Jan. „ Pneumonia Lime Street 23 M 49 24 Oct. „ Pleurisy Lime Street Square 3/4 F 8 months 27 Sept. „ Shock and Broncho-Pneumonia. Inquest Accident Little Britain 37 M 72 2 Mar. „ Cystitis Died in St. Bart.'s Little College Street 2 F 51 9 Dec. „ Asthma and Bronchitis- Little Montague Court 1 M 81 18 Mar. „ Pneumonia Little New Street 8 M 2 3 Feb. „ Broncho- Pneumonia Died in St. Bart.'s „ „ 8 M 58 19 „ „ Contracting Kidneys Died in St. Bart.'s Little Trinity Street 4 F 85 3 July „ Gastritis Liverpool Street (Great Eastern Hotel) — M 49 1 Jan. „ Lift Accident Inquest London Wall 43 M 46 3 Nov. „ Nephritis „ „ 59 M 12 m'ths 22 Jan. „ Meningitis ,, ,, (" Crown & Anchor ") — M 28 26 Feb. „ Suicide by Cutting Throat Inquest Lower Thames Street 77 M 6 months 30 Jan. „ Acute Bronchitis Mansell Street 9 F 63 23 June „ Cerebral Haemorrhage Mark Lane 33 F 22 22 Mar. „ Acute Pericarditis Martin's Lane 29 F 62 28 April „ Acute Bronchitis Middle Street 1 F 41 4 June „ Gastric Ulcer „ „ 2 F 82 31 July „ Strangulated Hernia „ „ 2 M 74 15 Nov. „ Influenza „ „ 5 M 74 5 June „ Morbus Cordis Middlesex Street 37 F 5 2 „ Diphtheria Middlesex Passage 2 F 67 29 May „ Bronchitis „ „ 4 M 39 15 „ „ Heart Disease Inquest Mincing Lane 28 F 77 22 Sept. „ Pleurisy Minories — M 38 19 April „ Morbus Cordis 47 M 8 m'ths. 27 June ,, Convulsions „ „ 80 F 33 20 Oct. „ Influenza „ „ 96 M 77 3 Jan. „ Epilepsy „ „ 118 M 4 m'ths. 3 July „ Tubercular Broncho- Pneumonia Mitre Court 1 F 12 hours 23 Mar. „ Premature Birth Monkwell Street 33 F 62 16 Feb. „ Broncho-Pneumonia Montague Court 2 M 61 22 Jan. „ Cancer of (Esophagus Moorgate Street 32 M 57 7 „ „ Suicide by Poison Inq. Died in St. Bart.'s 61 M 67 2 June „ Cancer of Liver Nevill's Court 8 M 16 14 Jan. „ Heart Disease 11 F 70 30 M ar. „ Carcinoma of Liver „ „ 12 F 81 7 Feb. ., Bronchitis ,,New Street, Aldgate 7 F 72 19 „ „ Chronic Bronchitis 22 M 11 18 July „ Morbus Cordis „ „ 28 M 5 months 18 June „ Pertussis „ „ 37 F 37 17 May „ Phthisis Bishopsgate 7 F 52 17 April „ Rodent Ulcer of Face „ „ 8 F 58 21 Feb. „ Cerebral Haemorrhage „ „ 22 F 82 11 Mar. „ Chronic Bronchitis „ „ 26 F 72 12 Dec. „ Chronic Bronchitis 190 CITY OF LONDON MORTALITY—continued. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. New Court, Farringdon Street 2 F 49 25 Dec. 1902 Double Pneumonia Newbury Street 2 M 39 7 Nov. „ Phthisis „ „ 11 F 42 16 Oct. ,, Phthisis „ „ 12 F 57 24 Dec. „ Syncope „ „ 14 F 73 18 May „ Cerebral Hemorrhage New Broad Street 64 M 2 26 June „ Congenital Heart Newgate Gaol — M 21 6 May „ Hanged for Murder Inquest „ Street 80 F 83 19 Feb. „ Senectus „ „ 102 M 67 27 April „ Suicide by drinking Carbolic Acid Inquest Nicholas Lane 31 F 68 11 Apr. „ Fall on Pavement Inquest Noble Street (Post Office Tavern) — M 63 19 Sept. ., Laceration of Brain and Fracture of Skull. Suicide Inquest Northumberland Alley 6 M 33 13 Nov. „ Cardiac Failure Old Jewry 31 M 47 7 Aug. „ Acute Laryngitis Paper Buildings, Temple Phil's Buildings 4 M 22 16 Feb. „ Suicide by Laudanum Poisoning Inquest 7 F 13 m'ths 25 July „ Broncho-I'neumonia Queen Street Place 6 F 42 19 Mar. „ Chronic Nephritis „ „ 6 M 64 27 Nov. „ Rupture of Left Ventricle of Heart Inquest Queen Victoria Street 67 F 18 9 June „ Burns and Suffocation Inquest „ „ „ 67 F 14 9„ „ Suffocation and Burns Inquest „ „ „ near 67 F 17 9 „ „ Syncope and Shock Inquest „ „ „ 67 F 18 9 „ „ Shock and Burn9 Inquest „ „ „ 67 F 14 9 „ „ Suffocation and Burns Inquest „ „ „ 67 F 16 9 „ „ Suffocation and Burns Inquest „ „ „ 67 F 16 9 „ „ Suffocation and Burns Inquest „ „ „ 67 F 15 9 „ „ Suffocation and Burns Inquest „ „ „ 67 F 15 9 „ „ Shock, Burns and Suffocation Inquest River Thames, off Netherland Wharf 79 F 64 18 April „ Hemiplegia — M 65 8 May „ Drowned Inq'st. " No evidence." „ ,, St. Andrew by the — M 56 23 Sept. „ Suicide by Drowning Inquest robe—City „ „ Fresh Wharf — M 45 6 Nov. ,, Asphyxia by Drowning Inq'st. " No evidence." Inq'st. " No evidence." „ „ near Temple Pier — M 30 14 Dec. „ Asphyxia by Drowning Rose Alley 14 M 4 hours 8 Jan. „ Prematurity ,, ,, 16 F 63 1 Dec. ,, Chronic Bronchitis „ Street 11 M 61 11 Aug. „ Exhaustion and Pleurisy. Accident Inq'st. Died in St. Bart's St. Ann's Chambers, Ludgate Hil 19 M 1 10 Jan. „ Nephritis „ „ „ „ 30 F 66 27 Feb. „ Pneumonia St. Bartholomew's Hospital — F 58 26 „ „ Cancer of Breast Hospital Nurse „ „ — F 34 28 „ „ Influenza Hospital Nurse St. Helen's Place 8 F 42 2 Jan., 1903 Pneumonia St. James's Place 1 M 21 2 „ „ Phthisis „ „ 2 M 52 29 „ 1902 Pulmonary Tuberculosis St. Mary Axe 2 M 69 17 Feb. „ Morbus Cordis St. Mary-at-Hill 39 M 23 25 Deo. „ Chronic Nephritis „ „ (Coal Exchange) — M 76 17 Feb. „ Bronchitis St. Peter's Alley 3 F 62 2 „ „ Carcinoma of Breast Salisbury Court 137 F 79 28 Dec. ,. Senile Decay „ Square 17 F 85 29 „ Senile Decay Savage Gardens 10 M 69 13 Oct. „ Diarrhoea Shaftesbury Place 5 F 59 28 Feb. „ Pneumonia „ „ 14 F 61 14 Sept. „ Phthisis Sparrow Corner 7 F 15 m'ths 12 Oct. „ Tubercular Meningitis „ „ 7 F 71 14 Dec. „ Chronic Bronchitis Stoney Lane — M 63 6 Jan. „ Nephritis Temple House, Temple Avenue — F 38 5 Sept. „ Heart Failure Inquest Thavies Inn 17 M 14 m'ths 19 May „ Measles Threadneedle Street 50 M 63 10 Feb. „ Fractured Skull Inquest Tokenhouse Yard 7 F 64 13 Dec. „ Cerebral Haemorrhage Inquest Took's Court 5a M 72 1 Nov. „ Pneumonia „ „ 16 F 78 24 May „ Senile Decay Tower Hill 87 F 64 16 April „ Uraemia Trinity House — M 58 10 Oct. „ Shock and Syncope. Suicide Inquest Tudor Street 26 M 49 11 April „ Heart Disease Upper Thames Street 89 F 71 14 Feb. „ Broncho-Pneumonia „ „ 104 M 89 10 Nov. „ Senile Decay „ „ 178 F 41 18 April „ Addison's Disease Vine Street 9 F 2 7 Feb. „ Pneumonia „ „ 9 F 83 9 Oct. „ Senile Decay „ „ 10 M 71 26 Feb. „ Chronic Bronchitis Walbrook 13 F 68 23 Sept. „ Cirrhosis of Liver „ „ 30 F 76 7 Mar. „ Broncho-Pneumonia ,, „ 35 M 63 12 Dec. „ Syncope due to Bronchitis Inquest Warwick Lane 2 M 65 7 Jan. „ Pneumonia Water Lane, Ludgate Hill Watling Street 3 M 32 17 July „ Hepatitis 64 M 66 3 F eb. ,, Cerebral Haemorrhage „ „ Fire Station — F 30 9 May „ Phthisis „ „ — F 15 hours 9 „ „ Premature Birth 191 CITY OF LONDON MORTALITY—continued. STREET OR PLACE. No. of Uouse. Sex. Age. Date of Death. Certified Cause of Death. Remarks. West Smithfield 21 M 74 28 Jnly, 1902 Chronic Bronchitis White Street 3 M 50 17 Feb. „ Diabetes Whitefriars Street 35 M 4 8 Mar. „ Meningitis „ „ 35 M 3 mins. 1 June „ Prematurity Widegate Street 18 M 7 days 24 Nov. „ Prematurity „ „ 21 F 76 7 Mar. „ Acute Bronchitis „ „ 21 F 73 29 June „ Senile Decay „ „ 17 M 8 m'ths. 19 Mar. „ Measles Wine Office Court 2 F 61 21 Feb. „ Influenza ARTIZANS DWELLINGS—STONEY LANE, HOUNDSDITCH. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. King's Block 5 M 46 27 Aug., 1902 Cirrhosis of Liver „ „ 8 F 39 22 July „ Delirium Tremens „ „ 43 F 10 m'ths. 20 ,, ,, Vomiting and Diarrhoea Queen's Block 20 F 100 6 April, „ Hemiplegia—Senile Decay Prince's Block 9 F 53 27 July „ Cerebral Haemorrhage North Block 26 M 13 m'ths 13 Oct. „ Broncho-Pneumonia „ „ 55 F 3 19 April „ Broncho- Pneumonia South Block 30 F 64 26 Dec. ,, Malignant Disease of Stomach „ „ 45 M 15 days 8 Oct. „ Enteritis 192 Appendix B. LIST OF INFECTIOUS CASES, STREET LISTS. Compiled from Notifications received. Street or Place. No. of House. Sex. Age. Disease. Ahchurch Lane 25 M 5 Chicken-pox. Albion Buildings 21 F 19 Erysipelas. Aldersgate Street ("Champion " Hotel) • •• F 26 Diphtheria. Ditto (The " Star") • •• M 7 Varicella. Ditto 36a F 9 Chicken-pox. Ditto 36a F 6 Ditto. Ditto 36a M 3 Ditto. Ditto 102 F 31 Diphtheria. Angel Court 8½ M 6 Varicella. Ditto 8½ F 3 Chicken-pox. Ditto 8½ M 9£mths Ditto. Ditto 14 M 7 Ditto. Ditto 14 F 210/12 Ditto. Artillery Lane 9 M 23 Variola. Ditto 24 M 32 Ditto. Austin Friars 22 F 11 Erysipelas. Bank of England • • • F 18 Ditto. Ditto ... F 22 Scarlet Fever. Barker's Buildings 8 F 16 Erysipelas. Bartholomew Close 78 M 5 Varicella. Bartlett's Buildings 20 F 60 Typhoid Fever. Billiter Street 18 F 60 Erysipelas. Bishopsgate Street Fire Station • • • F 11 Scarlet Fever. Bishopsgate Police Hospital • •• M • •• Phthisis. Ditto ditto • •• M 30 Varicella. Ditto ditto • •• M 31 Phthisis. Ditto ditto ... M 32 Enteric Fever. Ditto ditto ... M 30 Phthisis. Bishopsgate Street Without 70 F 7 Chicken-pox. Ditto ditto 108 F 7 Diphtheria. Blomfield House, Snow Hill 24 M 20 Erysipelas. Brackley Street 5 M 15 Diphtheria. Bride Lane (St. Bride's Institute) • • • M 7 Ditto. Bridewell Place Police Station ... M 24 Phthisis. Bridgewater House, Fann Street 12 M 23 Scarlet Fever. Broadway, Ludgate Hill 10 M 10 Diphtheria. Budge Row 19 F 8 Scarlatina. Cannon Street Hotel ... F 40 Typhoid Fever. Cannon Street (" Boar's Head") ... F 21 Small-pox. Cannon Street 6 F 29 Ditto. Carmelite Street Fire Station ... M 38 Ditto. Ditto ditto 6 M 3 Diphtheria. Ditto ditto 6 M 5 Ditto. Ditto ditto 6 M 7 Ditto. Ditto ditto 6 M 10 Ditto. Ditto ditto 6 M 3 Ditto. Ditto ditto 7 M 4 Scarlet Fever. Ditto ditto 8 M 4 Ditto. Ditto ditto 8 F 15/12 Ditto. Ditto ditto 13 M 5 Ditto. Ditto ditto 16 M 3 Ditto. Ditto ditto 16 F 2 Ditto. 193 Street or Place. No. of House. Sex. Age. Disease. Carmelite Street Fire Station 16 M 5 Scarlet Fever. Ditto ditto 18 M 2 Ditto. Ditto ditto 24 F 57/12 15 Ditto. Carter Lane 22 M Ditto. Ditto 27 M 33 Variola. Ditto 59 M 16 Diphtheria. Ditto 61 M 11 Scarlet Fever. Carter Street 13 F 3½ Ditto. Ditto 19 M 35 Variola. Charterhouse Street 18 M 19 Scarlet Fever. Ditto 18 M 16 Diphtheria. Cheapside 27 M 7 Varicella. Ditto 64 M 20 Diphtheria. Ditto 105 M 4 Scarlatina. Circus, Minories 5 F 17 Small-pox. City Buildings, Moor Lane 7 M 39 Variola. Ditto ditto 15 M 41 Erysipelas. City Green Yard ... F 17 Scarlet Fever. Clark's Place 1 F 8 Varicella. Ditto 2 M 8 Chicken-pox. Ditto 2 M 2 Ditto. Clark's Yard 14 M 24 Enteric Fever. Ditto 14 M 10 Ditto. Cloth Fair 26 M 3 Diphtheria. Cockerill's Buildings 1 F 53 Erysipelas. College Hill 25 F 10 Varicella. College Street 27 F 58 Erysipelas. Ditto 27 F 18 Ditto. Cornhill 52 F 3 Scarlatina. Crown Place 3 F 68 Erysipelas. Crutched Friars 23 M 4½ Varicella. Cutler Street (" Cutlers' Arms ") • •• F 2½ Diphtheria. Cutler Street 5 F 5 Scarlet Fever. Ditto 3-4 F 7 Varicella. Ditto 13-14 F 2 Ditto. Dean Street 3b F 9 Ditto. Ditto 4d M 17/12 Diphtheria. Ditto 5d M 7 Ditto. Devonshire Square 16-17 M 4 Ditto. Duke Street 7 M 49 Small-pox. Eastcheap 13a M 10 Diphtheria. Ditto 27-29 M 311/12 Ditto. East Passage, Cloth Fair 28 M 3 Varicella. Ellison Street 8 F 2½ Diphtheria. Ditto 8 F 5 Ditto. Exchange Buildings 11 M 2½ Ditto. Farringdon Street 18 M 5 Ditto. Ditto 18 M 9 Scarlet Fever. Ditto 27a M 48 Variola. Ditto 87 F 3 Scarlet F ever. Fenchurch Avenue 2 M 17/12 Chicken-pox. Ditto 4 F 12/12 Diphtheria. Fenton's Buildings, Bartholomew Close 3 F 10 Scarlet Fever. Fetter Lane 10-11 F 33 Typhoid Fever. Ditto 35 F 2 Scarlet Fever. Ditto 35 M 5 Ditto. Ditto 35 F 7 Ditto. Ditto 93 F 7 Chicken-pox. Diphtheria. Finsbury Pavement (Electra House) ... M 7 Finsbury Pavement 36 F 12 Chicken-pox. Fleet Street (Salisbury Hotel) ... M 29 Scarlet Fever. 194 Street or Place. No. of House. Sex. Age. Disease. Fleet Street (Salisbury Hotel) M 14 Typhoid Fever. Fleet Street 22 F 36 Erysipelas. Ditto 69 M 18 Small-pox. Diphtheria. Fore Street 9 M 34 Ditto 45 F 8 Varicella. Ditto 45 F 5 Ditto. Ditto 45 F 7 Ditto. Ditto 45 F 03/12 Ditto. Friday Street 7 M 17 Chicken-pox. Ditto 7 M 15 Diphtheria. Ditto 54 M 12 Scarlet Fever. Garden Place 9 F 3 Membranous Croup. Ditto 9 F 3 Diphtheria. Golden Lane (City Mortuary) ... F 10 Erysipelas. Goodman's Yard 18 M 17/12 Varicella. Great St. Helen's 16 M 10 Enteric Fever. Great Tower Street 40 M 22/12 Diphtheria. Ditto 40 F 9 Varicella. Ditto 55 F 60 Erysipelas. Great Winchester Street 14 F 5 Chicken-pox. Ditto 14 F 2 Ditto. Gresham Street 23 M 16 Diphtheria. Greystoke Place 9 F 4 Scarlet Fever. Gunpowder Alley 2 F 4 Diphtheria. Ditto 2 M 7 Ditto. Ditto 2 M 6 Ditto. Ditto 2 M 2 Ditto. Gutter Lane 36 M 17 Scarlet Fever. Ditto 36 M 16 Ditto. Harrow Alley 35 M 2½ Diphtheria. Holborn Circus 7 F 20 Scarlet Fever. Ditto 7 M 21 Diphtheria. Ditto 7 M 27 Scarlet Fever. Ditto 7 M 21 Diphtheria. Ditto 7 M 26 Ditto. Ditto 7 M 21 Scarlet Fever. Ditto 7 M 17 Ditto. Ditto 7 M 23 Ditto. Hosier Lane 5 M 10 Small-pox. Ditto 23 F 24 Variola. Ditto 23 M 02/12 Ditto. Houndsditch (" Ben Johnson") F 8 Varicella. Ditto (" King Arms ") • • • F 5½ Diphtheria. Ditto 21 F 4 Chicken-pox. Ditto 92 M 40 Diphtheria. Ditto 104 M 010/12 Scarlet Fever. Hugoin Court, Huggin Lane, 2nd floor a • • M 6 Scarlatina. Hutchinson Avenue 6 M 6 Ditto. Ditto 11 M 4½ Varicella. Ditto 11 F 2 Varicella. Ditto 24 F 09/12 Diphtheria. Ditto 20 M 18/12 Ditto. Ditto 24 F Membranous Croup. Ditto 26 F 85 Erysipelas. Hutchinson Street 1 F 6 Diphtheria. Ditto 14 M 3½ Ditto. Ditto 17 M 4 Chicken-pox. Ditto 21 M 1½ Diphtheria. Jewry Street 12 F 12 Varicella. Ditto 13 M 12 Ditto. 195 Street of Place. No. of House. Sex. Age. Disease. John Street, Minories (London & Tilbury M Varicella. Railway Offices). King's Block, Artizans' Dwellings 5 F 6 Diphtheria. Ditto, ditto 5 F 4 Scarlet Fever. Ditto, ditto 36 M 25 Erysipelas. Ditto, ditto 39 M 3 Diphtheria. King Street, Snow Hill 14 F 23 Erysipelas. King Edward Street (The Lodge, Christ's Hospital). ... F 7 Diphtheria. King William Street 12 F 13 Chicken-pox. Ditto 49 F 49 Erysipelas. Ditto 68 F 6 Diphtheria. Knightrider Street 39 M 18 Scarlet Fever. Leadenhall Street 12 F 8 Scarlatina. Ditto 101 F 30 Small-pox. Little Moorfields ("Ye Olde Fyve Bells") ... F 24 Variola. Little Somerset Street 4 F 66 Erysipelas. Liverpool Street (Great Eastern Hotel) • •• M 5 Varicella. Ditto ditto ■ • • F 10 Ditto. London Bridge ("Pearl" Offices) ... F 7 Chicken-pox. Maiden Lane 11 M 23 Scarlet Fever. Mansell Street 8 M 5 Chicken-pox. Ditto 8 M 5 w'ks. Ditto. Ditto 16 F 83 Small-pox. Ditto 16 F 50 Variola. Ditto 16 F 23 Ditto. Ditto 18 M 4 Scarlatina. Ditto 26 F 26 Erysipelas. Ditto 37 M 8 mth's Varicella. Ditto 37 F 2½ Chicken-pox. Ditto 38 F 011/12 Ditto. Mark Lane 79 M 43 Phthisis. Middlesex Passage 1 F 22 Variola. Middlesex Street 11 M 18 Pulm. Tuberculosis Ditto 19 F 10 Scarlet Fever. Ditto 37 F 5½ Diphtheria. Ditto 39 M 4 Varicella. Ditto 99 F 5 Diphtheria. Ditto 99 F 2 Ditto. Minories 80 M 6 Enteric Fever. Ditto 80 F 7 Ditto. Montague Court 5 F 10 Scarlet Fever. Monument Street 2 F 11 Diphtheria. Moor Lane 16-30 M 17 Erysipelas. Moorgate Street (" Globe Tavern") . . • F 6 Varicella. Nevill's Court 13 M 4 8/12 Diphtheria. New Buildings, Took's Court 4 M 49 Small-pox. New Court 5 F 24 Erysipelas. Ditto 11 M 2 Scarlet Fever. Ditto 1 M 4 Ditto. Ditto 11 F 2 Ditto. New Street, Aldgate 5 F 3½ Diphtheria. Ditto 10 F 4 Ditto. Ditto 10 F 4 Varicella. Ditto 13 F 8 Diphtheria. Ditto 14 F 3 Ditto. Ditto 19 M 1½ Ditto. Ditto 22 M 7 Ditto. Ditto 38 F 3 Ditto. New Street, Bishopsgate 26 M 48 Phthisis. 196 Street or Place. No. of House. Sex. Age. se. New Bridge Street 18 M 3 Scarlet Fever. New Broad Street 41-42 M 5 Varicella. Ditto 54 F 34 Erysipelas. Newbury Street 2 M 42 Phthisis. Ditto 11 F 48 Ditto. Nicholas Lane 36 F 3 Chicken-pox. Ditto 37 F 6 Ditto. North Block, Artizans' Dwellings 3 F 23 Variola. Ditto, ditto 7 F 52 Erysipelas. Ditto, ditto 12 F 13 Diphtheria. Ditto, ditto Ditto, ditto 15 F 2½ Scarlet Fever. 19 F 4 Diphtheria. Ditto, ditto 19 M 14/12 Ditto. Ditto, ditto 23 F 19/12 Ditto. Ditto, ditto 30 F 3 Varicella. Ditto, ditto 60 F 10 Diphtheria. Ditto, ditto 61 F 18/12 Varicella. Norton Folgate 105a F 4 Ditto. Old Broad Street (City of London Club) • • • F 32 Enteric Fever. Pemberton Row 3 F 09/12 Varicella. Poultry (Grocers' Hall) ... F 8 Chicken-pox. Ditto • •• M 9 Ditto. Priest Court 3 M 2 Varicella. Prince's Block, Artizans' Dwellings 8 F 8 Diphtheria. Ditto, ditto 34 M 4 Ditto. Ditto, ditto 52 F 3 Ditto. Providence Place 10 F 64 Erysipelas. Ditto 11 F 14 Diphtheria. Ditto 12 F 6 Ditto. Ditto 15 F 5½ Chicken-pox. Queen's Block, Artizans' Dwellings 14 M 3 Membranous Croup. Ditto, ditto 22 F 3 Chicken-pox. Ditto, ditto 44 M 2 Ditto. Ditto, ditto 50 M 2½ Ditto. Railway Place (Railway Tavern) • •• M 6 Varicella. Redcross Street Fire Station 12 M 6 Scarlet Fever. Red Lion Court 11 F 6 Diphtheria. Red Lion Passage 1 M 11 Scarlet Fever. Robin Hood Court Casual Wards ... F 63 Erysipelas. Robin Hood Court Infirmary ... F 30 Continued Fever. Rose Alley 6 F 3 Scarlatina. St. Bartholomew's Hospital ... M 19 Scarlet Fever. Ditto ... F 27 Ditto. Ditto ... F 22 Diphtheria. Ditto ... F 25 Scarlet Fever. Ditto ... F 23 Ditto. Ditto ... F 25 Diphtheria. Ditto ... F 26 Scarlet Fever. Ditto ... F 23 Diphtheria. Ditto ... F 23 Ditto. Ditto ... F 26 Ditto. Ditto ... F 31 Ditto. Ditto ... F 31 Erysipelas. Ditto ... F 23 Scarlet Fever. Ditto ... F 25 Ditto. Ditto • •• F 26 Enteric Fever. St. Dunstan's Alley 4a F 28 Typhoid Fever. St. Helen's Place lA F 65 Erysipelas. St. Martin's House, Gresham Street 1 M 3 Scarlet Fever. St. Mary-at-Hill 26 F 20 Ditto. St. Mary Axe 11 M 28 Small-pox. 197 Street or Place. No. of House. Sex. Age. Disease. Salisbury Court 134 F 4 Diphtheria. Ditto 134 F 4 Varicella. Ditto 135 M 18 Small-pox. Seething Lane 35 M 23 Variola. Shaftesbury Place 9 F 9 Varicella. Ditto 12 M 24 Erysipelas. Ditto 14 F 51 Phthisis. Ditto 19 M 3 Diphtheria. Ditto 21 F 50 Erysipelas. Snow Hill Police Station ... M 24 Small-pox. South Block, Artizans' Dwellings 12 M 6 Scarlet Fever. Ditto, ditto 17 M 3 Diphtheria. Ditto, ditto 18 F 5 Ditto. Ditto, ditto 18 F 10 Ditto. Ditto, ditto 28 F 64 Erysipelas. Ditto, ditto 42 M 5 Scarlatina. Ditto, ditto 46 M 3 Diphtheria. Swan Lane 15 F 7½ Varicella. Ditto 15 M 2 Ditto. Ditto 15 M 6 Ditto. Temple Lane 8 M 4½ Diphtheria. Thavies Inn 22 F 54/12 Ditto. Ditto 23 F 5 Ditto. Threadneedle Street 50 M 5 Chicken-pox. Throgmorton Street 23 F 45 Enteric Fever. Took's Court 4a F 20 Varicella. Ditto 4a M 11 Small-pox. Ditto 4a M 11 Enteric Fever. Trinity House (Ballast Office) ... F 32 Diphtheria. Trinity Square 10 M 12 Ditto. Tudor Street 12 M 6 Scarlet Fever. Upper Thames Street 13 M 12 Ditto. Ditto 40 M 54 Erysipelas. Ditto 97 M 8 Varicella. Vine Street 4 F 811/12 Scarlatina. Walbrook 15 F 9 Ditto. Warwick Lane 10 M 18 Scarlet Fever. Warwick Square 12 M 19 Ditto. Ditto 12 M 21 Ditto. Water Lane ("King's Arms") ... F 5 Varicella. Watling Street 47 M 810/12 Ditto. White Street 3 M Ditto. Ditto 5 F 4 Chicken-pox. Widegate Street 17 F 4 Scarlet Fever. Ditto 17 F 7 Ditto. Ditto 17 M 010/12 Ditto. 198 Appendix C. TENEMENT HOUSES. WEST DISTRICT. Situation of Premises. Name and Address of Owner. Tenements. rs. 1, Burgon Street Lewis Tripp, 1, St. Andrew's Hill 2 5 9, Bell's Buildings James W. Peart, 9, Bell's Buildings 2 4 4, do. Millar, Son & Co., 14, Grafton Street, W. 7 12 8, do. Do. do. 6 12 5, do. Do. do. 2 8 10, do. Do. do. 4 6 7, do. John Lewis, 7, Bell's Buildings 8 18 5, Briton's Court James Hurrel, 5, Briton's Court 2 2 5, Currier's Row Henry Bailey, 5, Currier's Row 3 5 6, do. Arthur Bedford, 5, do. 3 5 7, do. William Bampton, 7, do. 2 14 12, do. Mrs. A. Robinson, 12, do. 4 11 13, do. G. Edmonsey, 13, do. 1 4 1, Chapel Place, Fetter J. F. Pemsel, 32, Fetter Lane 3 4 Lane. 2, do. do. Preston Kingsworth, 2, Chapel Place 1 1 1, Church Entry, Carter Charles Eagle, 1, Church Entry 1 6 Lane. 5, Dorset Street H. Felton, 5, Dorset Street 5 6 7, do. Mary Davis, 7, do. 3 10 2, Evangelist Court Seaton Brown, 5, Broadway, Ludgate 3 9 10, East Harding Street Caroline White 2 5 11, do. F. S. Appt, 11, East Harding Street 2 10 12, do. Jane Smith, 12, do. 1 1 35, Fetter Lane Weatherall & Green, 22, Chancery Lane 5 15 36, do. Edward Daw, 36, Fetter Lane 5 11 37, do. Harriet Jardine, 37, do. 5 6 38, do. W. A. Hooper, 38, do. 5 6 41, do. Eliza Dorly, 41, do. 1 6 42, do. J. Richards, 42, do. 3 7 57, do Paul Quartermass, 57, Fetter Lane 3 3 93, do J. Hook, 106, St. James' Road, Holloway 4 11 39, Furnival Street E. J. Daw, 36, Fetter Lane 2 5 29, Fleet Lane Willats & Co., 66, Holborn Viaduct 1 4 30, do. Do. do. 1 2 31, do. Do. do. 1 2 1, Great New Street James Barnsley, 1, Great New Street 4 13 20, do. G. Stanbury, 25, do. 8 24 2, do. Sidney Gardner, 2, do. 7 15 3, do. Do. do. 4 6 16, do. G. Smee, 16, do. 4 7 Carried forward 130 301 199 WEST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. rs. Brought forward 130 301 5, Green Dragon Court Mr. Johnson, 5, Green Dragon Court 2 2 6, do. W. F. Hurburt, 6, do. 2 4 7, do. G. Edmondsey, 13, Currier's Row 3 4 2, Gunpowder Alley Thomas Young,'2, Gunpowder Alley 2 2 8, do. H. Donaldson & Son, 242, Queen's Road, Dalston 2 2 7½, do Do. do. do. 4 16 2, Greystoke Place G. Reveirs, 4, Greystoke Place 3 6 3, do. Michael Flynn, 3, do. 4 4 6, do. William G. Cuss 1 8 7, do. H. Von Joel, 16, Willis Road, Kentish Town 4 15 8, do. W. Hollingsdale, 8, Greystoke Place 2 12 9, Greystoke Place, Fetter Harriet Evans, 9, do. 4 10 Lane. 36, Hutton Street Elliot & Co., 40, Chancery Lane 2 4 3, Hosier Lane John B. Fuller 3 5 4, do. John Dugan l 6 5, do. W. J. Gardner, 6, Hosier Lane 2 7 23, do. James King, 21, West Smithfield 2 7 6, Holborn Buildings Mr. Fitch, 43, Bedford Row 8 18 7, do. Do. do. 9 18 13, King's Head Court, Shoe Lane. H. Deighton, 54, Great Percy Street, W.C. 4 10 14, do. Do. do. 4 12 16, do. Do. do. 8 16 17, do. Do. do. 5 5 17, King's Head Court, Thomas Lambert, 17, King's Head Court 3 10 Fetter Lane. 8, Little New Street Clara Hayhurst, 8, Little New Street 5 9 1, New Court Francis Butler, 17, Farringdon Street 5 5 2 do. Thomas Anstey, 19, do. 3 9 3, do. Martha Stokes, 3, New Court 3 8 5, do. W. Sullivan, Farringdon Street 4 13 8, do. D. Dixon, 15, Charterhouse Street 5 6 9, do. M. A. Allwry, 95, Commercial Road, Peckham 2 8 10, do Leonard Voullaine, 10, New Court 3 3 13, Newcastle Street, Far- Arthur Wilks, 13, Newcastle Street 7 8 ringdon Street. 5, New Street Hill, and C. Rowsell, 5, New Street 3 6 11, Gunpowder Alley 10, New Street Square Herbert Mogridge, 10, New Street Square 2 6 7, Nevill's Court Charles Ed, 7, Nevill's Court 3 11 8, do. Walter Gulson, 8, do. 3 4 9, do. Kate Hebditch, 9, do. 2 6 10, do. J. F. Pemsel, 34, Fetter Lane 6 10 11, do. Goldsmith Company, Goldsmith Hall 8 15 12, do. Do. do. 8 15 13a, do. Do. do. 6 20 Carried forward 292 666 200 WEST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. rs Brought forward 292 666 14, Nevill's Court Goldsmith Company, Goldsmith Hall 6 10 3, Pemberton Row J. Young, 1, Pemberton Row 3 11 13, Plumtree Court Edward Smith, 13, Plumtree Court 3 3 19, Primrose Hill Crawley & Smee, 19, Primrose Hill 3 10 20, do. E. Coulson, 20, Primrose Hill 4 10 22, do. Thomas Palmer, 22, do. 3 12 4, Red Lion Court Nevitt Bros., 44 and 45, Kirby Street, Hatton Garden. 5 11 8, do. W. Simpson, 95, Rosebery Square 5 7 11, do. F. Southwell, 11, Red Lion Court 3 8 1, Red Lion Passage, J. Vail, 1, Red Lion Passage 2 8 Cloth Fair. 6 & 7, do. H. J. Ward, 6 and 7, Kingborn Street 6 25 6, Sugar Loaf Court, Ward, Lock & Co., Warwick House, Dorset 3 4 Dorset Street. Street. 16, Tudor Street John Evans, 16, Tudor Street 2 10 1 & 2, Took's Court Thurgood & Martin, 27, Chancery Lane 12 42 4a, do. W. J. Ballamy, 9, Furnival Street 6 13 5a, do. E. J. Hopkins 6 2 6, Temple Lane A. Barsht, 106, Cheapside 4 10 7, do. Do. do. 7 20 8, do. Do. do. 7 16 15, Water Street, Tudor George York, 15, Water Street 2 7 Street. 5, Water Lane, Ludgate E. and S. Halcombe, 5, Water Lane 7 7 Hill. 1, Wine Office Court Ann Gates, 2, Wine Office Court 3 7 2, do. Do. do. 2 4 3, do. A. Parsons, 3, do. 2 4 35, Bartholomew Close E. Haley, 2, Cross Key Court, London Wall 7 11 43, do. Do. do. 8 10 44, do. Mr. J. Faulkner, 44, Bartholomew Close 2 4 85, do. Elizabeth Parry, 85, Bartholomew Close 3 7 1, Bartholomew Place J. Smith, 1, Bartholomew Place (Closed) 2 — 2 do. E. Haley, 2, Cross Key Court, London Wall (Closed). 3 — 4, do. William Critolph, 4, Bartholomew Place 4 6 6, do. Henry Hoggett, 6, Bartholomew Place 1 3 3, Cloth Fair George Madewell, 3, Cloth Fair 2 5 4, do. J. Edwin Ponder, 103, Aldersgate Street . 4 8 6 & 7, do. Charles Randall, 9, White Lion Street, Pentonville 7 15 8, do. Do. do. do. 4 8 9, do. Do. do. do. 6 10 19, do. Thomas Belcher, 19, Cloth Fair 5 7 21, do. Alfred Bannister, 21, do. 4 10 22, do. J. Jackson, 22, do. 3 10 Carried forward 458 1,041 201 Situation of Premises. Name and Address of Owner. Tenements. rs. Brought forward 458 1,041 25, Cloth Fair Miss Laura Bassey, 25, Cloth Fair 3 7 28, do. Thomas M. James Janes, 191, Aldersgate Street 3 12 29, do. Charles Randall, 9, White Lion Street, Pentonville. 1 3 30, do. R. J. Jackson, 30, Cloth Fair 1 2 81, do. A. H. Price, 31, do. 8 8 43, do. Charles Randall, 9, White Lion Street, Pentonville. 2 6 44, do. Do. do. do. 4 7 45, do. Florence Struthers, 58, West Smithfield 1 7 1, Cockerell's Buildings Margaret Walker, 1, Cockerell's Buildings 2 5 2, do. E. Haley, 2, Cross Key Court 3 12 8, do. Thomas Bate, 3, Cockerell's Buildings 3 5 4, do. James Sard, 4, do. 2 5 5, do. Charles Fox, 5, do. 4 11 6, do. Stanley J. Torkington, 6, do. 4 10 7, do. G. Demaria, 7, do. 2 4 8, do. E. Haley, 2, Cross Key Court 3 3 5, East Passage, Cloth James T. Deeks, 5, Offerton Square, Clapham 4 8 Fair. 8, do. Joseph Young, 52, Long Lane 3 6 27, do. James T. Deeks, 5, Offerton Square, Clapham 3 6 1, Fenton's Buildings Thomas Matthews, 110, Milton Road, Stoke Newington. 1 2 2, do. Do. do. do. 3 7 3, do. Do. do. do. 3 10 4, Half-Moon Passage Mr. Collins, 4, Half-Moon Passage 2 3 5, do. Mr. Beckett, 6, do. 2 6 6, do. Do. do. 2 8 12, Kinghorn Street Catherine Lewis, 12, Kinghorn Street 3 4 13, do. W. Phelan, 20, Cloth Fair 2 4 25, do. Do. do. 3 6 25a, do. Do. do. 4 13 1, Little Montague Court J. Abbott, 103, Aldersgate Street 2 10 2, do. Do. do. 5 17 41, Little Britain Joseph Freeman, 41, Little Britain 3 8 45, do. William F. Retzleff, 45, do. 1 1 54, do. Thomas N. Janes, 101, Aldersgate Street 3 8 60 and 61, Long Lane George W. Rogers, 60 and 61, Long Lane 4 8 79, do. Robert Dyas, 87, Fore Street 3 6 80, do. Mrs. I. Comfort, 80, Long Lane 3 5 86, do. C Daymon, 86, do. 1 4 2, Montague Court, Little Britain. H. T. L. Tucker, 2, Montague Court 2 6 3, do. James Long, 4, do. 3 8 4, do. Do. do. 3 5 5, do. Florence Driscoll, 5, do. 2 4 6, do. Thomas J. Spernick, 6, do. 3 11 Carried forward 572 1,332 202 WEST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. rs. Brought forward 572 1,332 2, Middle Street Robert N. Galland, 2, Middle Street 3 4 4 and 5, do. J. Hull & Sons, Bartholomew Close 12 18 6, do. E. Haley, 2, Cross Key Court 4 5 20, do. James T. Deeks, 5, Offerton Road, Clapham 2 3 22, do. Joseph Young, 52, Long Lane 3 3 1, Middlesex Passage James Strugnell, 45, Bartholomew Close 4 11 2 and 3, do. Do. do. 11 12 4, do. Robert Warburton, 4, Middlesex Passage 3 5 5, do. Elizabeth Jones, 5, do. 3 4 6, do. J. Sturgeon, 6, do. 3 10 1, Newbury Street J. Hull & Sons, Bartholomew Close 4 12 2, do. A. H. Price, 31, Cloth Fair 3 16 3, do. Mrs. Pike, 3, Newbury Street 3 10 9, do. Mrs. Chissman, 9, do. 1 5 10, do. Heeps, Son & Neve, 4, Old Jewry 2 4 11, do. Do. do. 2 5 12, do. Do. do. 3 8 14, do. J. W. Neighbour, 93, Old Street 4 14 58, West Smith field Rebecca Flower, 58, West Smithfield 6 7 11, Bartholomew Close Ann Clevely, 11, Bartholomew Close 4 7 35½, do. Edward Haley, 2, Cross Key Court, London Wall 6 19 Total 658 1,514 MIDDLE DISTRICT. Situation of Premises. Name and Address of Owner. Tenements. rs. 100, Aldersgate Street J. B. Robertson, 100, Aldersgate Street 1 1 104, do. William Harris, 158, Kingsland Road 2 2 34, Beech Street Lucy Worland 3 5 48, do. Unoccupied — — 50, do. John Richards, 50, Beech Street 3 6 51a, do. M. Manns, 51a, do. 3 10 1 and 2, Huggin Court, Charles Pile, 1 and 2, Huggin Court 5 13 Little Trinity Lane. 9, Huggin Lane Mr. Belcher, 8, Martin's Lane 3 4 10, do. H. Willis, 10, Huggin Lane 5 6 2, Little College Street George Shadbolt, 2, Little College Street 2 5 3, do. Fred. Threadgill, 3, do. 2 4 15, Swan Lane Percy Clarke, 15, Swan Lane 5 6 1, St. James' Place, Gar- Charles J. Shears, 2, St. James' Place 4 13 lick Hill. 2, do. do. Do. do. 2 10 3, do. do. Messrs. Jones, Lang & Co., King Street 4 8 4, do. do. H. H. Martin, 4, St. James' Place 3 8 1, Shaftesbury Place Mrs. Sarah Turner, 1, Shaftesbury Place — — 2, do. J. B. Kyffin, 44, Lauriston Road, Hackney 2 4 3, do. Not now a tenement house 1 1 4, do. Joseph Taylor, 4, Shaftesbury Place 2 5 5, do. Sarah Young, 5, do. 1 6 6, do. Samuel Hipperson, 6, do. 3 14 7, do. J. B. Kyffin, 44, Lauriston Road, Hackney 2 8 8, do. Do. do. 3 7 9, do. Do. do. 3 7 10, do. Do. do. 1 3 11, do. Do. do. 3 18 12, do. Do. do. 2 13 13, do. Do. do. 2 15 14, do. Do. do. 2 10 15, do. George Prosser, 15, Shaftesbury Place 1 4 16, do. John Gilman, 16, do. 1 5 17, do. Alfred Shears, 17, do. 1 1 18, do. James Hemming, 18, do. 1 3 19, do. Joseph Perry, 19, do. — — 20, Shaftesbury Place J. B. Kyffin, 44, Lauriston Road, Hackney 3 14 Carried forward 81 239 203 204 MIDDLE DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. rs. Brought forward 81 239 21, Shaftesbury Place J. B. Kyffin, 44, Lauriston Road, Hackney 3 9 22, do. Do. do. 1 4 23, do. Do. do. 3 4 24, do. Do. do. 3 6 25, do. Do. do. — 26, do. Mrs. Emma Henson, 26, Shaftesbury Place 2 9 27, do. J. B. Kyffin, 44, Lauriston Road, Hackney 2 11 28, do. Maria Rowe, 28, Shaftesbury Place 2 6 29, do. J. B. Kyffin, 44, Lauriston Road, Hackney 30, do. The Ramoneur Co., 30, Shaftesbury Place 2 8 Total 99 296 Average number of lodgers to each tenement: 2.99. 205 EAST DISTRICT. Situation of Premises. Name and Address of Owner. Tenements. rs. 27, Aldgate A. L. Poysner, 27, Aldgate 1 2 6, do. S. Berry, 6, Aldgate 3 10 9, Artillery Lane John Tharp, 9, Norton Folgate 6 14 12, do. E. Quinlin, 25, do. 7 11 14, do. Do. do. 5 8 16, do. Do. do. 6 18 18, do. Quinlan, 18, do. 2 5 20, do. B. Clements, 20, do. 1 5 21, do. P. Donovan, 25, do. 4 7 22, do. Amos Piggott, 22, do. 3 7 9, Brushfield Street W. H. Recknell, 66, Green Lanes, N. 3 6 10, do. James Smith, 10, Brushfield Street 3 6 12, do. H. Walter, 12, do. 5 5 14, do. F. J. Fitch, Bishopsgate Institute (on behalf of the Governors of the Bishopsgate Foundation) 6 9 19, Carter Street, Houndsditch. M. Benjamin, 31, White Lion Street, E. 2 8 2, Cavendish Court A. J. Hawkins, 116, Albion Road, Dalston 3 7 1, Circus, Minories (including upper part of 90, Minories). S. Moses, 65, Mansell Street, Aldgate 5 26 2, Circus, Minories Mr. Grapes, 4, Circus, Minories 2 8 3, do. Eliz. Jones, on behalf of Mrs. Johnson, 66, Watling Street. 1 3 4, do. H. Grapes, 4, Circus, Minories 2 3 5, do. C. Shipman, 5, do. 4 7 7, do. J. Roberts, 7, do. 4 7 12, do. W. Maaser, 12, do. 2 3 11, Clark's Place, Laura Wells, 11, Clark's Place 1 1 Bishopsgate. 14, Clark's Yard Wm. Grouts, 7, High Street, Deptford 4 7 14a, do. Do. do. 2 5 2, Montague Court, Bishopsgate. Do. do. 3 3 9, do. H. Stock, 15, Great Chart Street 3 4 10, do. Mary Applin, 10, Montague Court 2 2 11, do. C. H. Blatherwick, 131, Bishopsgate Without 5 5 12, do. Do. do. 6 6 16, do. J. Hushbwayte, 16, Montague Court 2 2 3, Crown Place, Aldgate Ann Evans, 3, Crown Place 4 6 6, do. A. Hayland, 6, do. 3 6 do. W. Harper, 7, do. 2 2 13, Cutler Street Sarah Collins, 13, Cutler Street 3 12 5, Duke Street, Aldgate Samuel Joseph, 5, Duke Street 2 2 10, do. J. A. Britton, 16 and 18, Houndsditch 3 8 Carried forward 125 256 206 EAST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. rs. Brought forward 125 256 11, Duke Street, Aldgate A. A. Romain, 453, Mile End Road 5 5 13, do. A. Stinner, 18, Duke Street 2 2 19, do. P. Dyson, 19, do. 1 1 6, George Street, Minories Henry C. Geisler, 6, George Street 1 1 7, do. F. W. Loomes, 7, do. 3 11 117, Gravel Lane John Hunt, 117, Gravel Lane 3 6 118, do. Henry Goulston, 118, do. 4 4 1, Hutchison Avenue Mr. Hollington, Middlesex Street 1 3 2, do. Do. do. 5 5 8, do. Jacob Kalonaski, 3, Hutchison Avenue 3 8 4, do. Morris Cohen, 4, do. 2 8 6, do. Aaron Jacobs, 6, do. 1 2 7, do. Jacob Abrahams 1 1 9, do. Mr. Woolf, High Street, Whitechapel 4 11 10, do. Do. do. 3 8 12, do. N. Foley, 26, London Street, Fitzroy Square 3 8 13, do. Theresa Ellis, 13, Hutchison Avenue 3 6 14, do. Morris Finklestan, Boot Factory, Aldgate 3 4 15, do. Sevan Goldbung, 15, Hutchison Avenue 2 2 17, do. James Woolf, 18, Grenville Place, Maida Yale 3 8 18, do. Henry Davis, 18, Hutchison Avenue 3 9 21, do. Sarah Aarons, 21, do. 3 8 22, do. Isaac Schwartz, 22, do. 5 11 23, do. Frances Woolf, 18, Grenville Place, Maida Vale 3 18 24, do. Reynolds & Eason, 43, Bishopsgate Street Without. 2 10 26, do. N. Foley, 28, London Street, Fitzroy Square 3 12 5, Hutchison Street Charles Koski, 35, Houndsditch 2 7 6, do. — Soloman, 6, do. 3 5 10, do. S. Marks, 10, Hutchison Street 1 8 12, do. Eleazar Isaacs, 12, do. 1 1 16, do. — Abrahams 3 14 17, do. — Soloman, 17, Hutchison Street 2 5 18, do. — Jacobs, 18, do. 1 4 19, do. Sarah Finklestein, 17, Houndsditch 1 2 20, do. David Jacobs, 20, Hutchison Street 1 6 Janes Buildings, Hutchison Street. Emmanuel Woolf, 28, High Street, Whitechapel 3 7 5, Mansell Street, Aidgate. John C. Christie, 3 and 5, Mansell Street 4 16 7, do. Robert Card, 7, do. 2 9 8, do. Henry Tuck, 31, Finsbury Square 4 11 9, do. John C. Christie, 3 and 5, Mansell Street 3 9 11, do. Do. do. 2 7 13, do. Henry Tuck, 31, Finsbury Square 5 5 15 do Do do. 6 10 Carried forward 241 554 207 EAST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 241 554 16, Mansell Street, Aldgate Chas. W. Harris 3 4 17, do. Albert F. Smith, 3, Medland Street, Ratcliff Cross. 6 10 19, do. K. Phillips, 19, Mansell Street 2 8 28, do. A. Woolf, 28, do. 3 7 30, do. — Elburn, 30, do. 2 6 35, do. Racliael Ries, 35, do. 1 3 36, do. Sarah Knight, 36, do. 4 5 38, do. George Outten, 38, do. 2 4 23, Middlesex Street Charles Harford, 23, Middlesex Street 1 9 71, do. Aaron Grun, 71, do. 2 4 126, Minories, and 8, New Square. A. Smith, Blomfield Street 6 31 16 & 17, New Square ... Do. do. 1 5 18, do. Thomas Crouch, 18, New Square 4 7 28, do. A. Smith, Blomfield Street 1 4 6,New Street,GravelLane Solomon Levy, 6, New Street 2 7 8, do. do. Mrs. Bella Levy, 8, do. 3 3 9, do. do. Jacob Rodsenski 2 16 10, do. do. Moss Hillier 1 1 11, do. do. Morris Jacobs 3 3 12, do. do. Barnet Bengerman 3 12 12a, do. Bishopsgate George Robert Jackson, 12, New Street 3 6 13, do. Gravel Lane William Murray 3 8 14, do. do. Jacob Miller 2 7 15, do. do. Harris Norden 2 3 16, do. do. Simons Levy 3 8 17, do. do. Marks Joseph 2 2 18, do. do. Solomon Kiel, 18, New Street 3 13 19, do. do. Mrs. Goodman, 19, do. 2 6 22, do. Bishopsgate VVm. Grouts, 7, High Street, Deptford 4 11 23, do. do. Ed. Bullen, 24, New Street 6 12 24, do. do. Charlotte Smith, 24, do. 17 17 26&27,do. do. Reynolds & Eason, 43, Bishopsgate Street Without. 11 27 22, do. Gravel Lane Do. do. 1 4 23, do. do. Sarah Pizer, 23, New Street 2 7 24, do. do. Rebecca Raphael, 24, do. 3 6 26, do. do. Reynolds & Eason, 43, Bishopsgate Without 3 8 27, do. do. Do. do. 3 12 28, do. do. Do. do. 2 7 30, do. do. Do. do. 3 5 32, do. do. Isaac Van Cleep, 32, New Street 3 14 34, do. do. Abraham Marks, 34, do. 1 1 36, do. do. R. Carpal, 36, do. 4 11 Carried forward... 376 898 208 EAST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 376 898 37,New Street,Gravel Lane M. Islinberg 2 2 40, do. do. Mary Roach, 40, New Street 1 2 1, Queen's Court, Vine Street. John Roberts, 7, The Circus 4 7 2, do. do. Do. do. 3 10 3, do. do. Do. do. 2 7 4, do. do. Do. do. 2 10 15, Rose Alley, Bishopsgate Street. John Fitzgerald, 15, Rose Alley 3 7 2, Three Crown Court, Jewry Street. Messrs. Smith, Son & Gowland, 11, Jewry Street 4 8 3, do. do. Do. do. 5 8 1, Union Row, Minories A. H. Ridgway, 95, Minories 3 8 2, do. do. L. Dickinson, 2, Union Row 4 10 2, Vine Street, do. B. B. Baker, Smithfield Institute 2 8 3, do. do. Mr. Mellon, 3, Vine Street 7 9 8, do. do. John Roberts, 7, Circus, Minories 6 19 9, do. do. Do. do. 9 24 10, do. do. W. Kirk, "The Woolpack" Tavern, 94, Minories 5 16 11, do. do. J. Whitaker, 101, Marlborough Road, Chelsea 7 19 11, Widegate Street A. Field, 182, Hanbury Street 2 2 20, do. H. Dixon, 20, Widegate Street 2 10 21, do. A. Field, 182, Hanbury Street 5 8 23, do. Do. do. 6 9 24, do. W. T. Crane, 25, Widegate Street 4 11 25, do. Do. do. 3 9 5, White Street, Cutler Street. Isaac Levy, 1, White Street 2 6 2, Wrestler's Court Arthur Volkman, 2, Wrestler's Court 1 1 3, do. W. Adams, 3, do. 1 1 4, do. F. Tyler, 4, do. 1 1 9, do. Henry Thomas Apps 1 1 54, Lower Thames Street Farebrother, Ellis & Co., 29, Fleet Street 5 13 4, Sparrow Corner, Minories. Eliza Shipman, 5, Circus, Minories 4 9 2, Goodman's Yard, Minories. Messrs. Moss & Jameson, 77, Chancery Lane 4 7 7, Artillery Lane Mr. Hart, 1, Wheeler Street, Spitalfields 8 23 Total 494 1,183 Average number of persons to each tenement: 2.39. 209 Appendix D. List of Persons registered under the Dairies, Cowsheds and Milkshops Order. 1st January, 1903. Date of Registration Premises. Person Registered. 2 May, 1900 24, Aldersgate Street Robert Douglas. 8 Oct., 1902 28/9, do. British Tea Table Co., Ltd. 30 Nov., 1894 35, do. Lockharts, Ltd. 7 April, 1902 42, do. Nunzio Allocco. 20 June, 1901 67, do. Lyons and Co., Ltd. 24 Oct., 1901 72, do. Slaters. Ltd. 24 Sept., 1902 83, do. Charlotte Smith. 21 Dec., 1900 92, do. Joseph James Metcalf. 22 May, 1889 170, do. Aerated Bread Co., Ltd. 5 Feb., 1901 188, do. James Dwarber. 1 Jan., 1902 193, do. Lyons and Co., Ltd. 27 Sept., 1897 68, Aldermanbury British Tea Table Co., Ltd. 9 Nov., 1898 12 and 13, Aldgate Lockharts, Ltd. 19 Sept., 1902 23, Aldgate John Peter Moriggia. 19 Sept., 1902 26, do. John Peter Moriggia. 22 June, 1902 7, Aldgate High Street John Wattam. 23 Sept., 1902 26, do. William Flint. 19 Oct., 1896 73, do. Express Dairy Co., Ltd. 6 July, 1901 7, Artillery Lane Daniel Hart. 7 Nov., 1902 22, do. Thomas Piggott. 5 Nov., 1902 5, Austin Friars Golden Grain Co., Ltd. 20 Sept., 1902 5, Barbican James William Taylor. 11 Feb., 1901 17, do. Peter Fumasoli. 30 Nov., 1894 20, do. Lockharts, Ltd. 27 Sept., 1902 35, do. W. B. Price. 13 Feb., 1901 43a, do. William Henry Callis. 23 April, 1896 67, do. British Tea Table Co., Ltd. 25 Sept., 1902 9, Bartholomew Close Sophia Goodman. 22 June, 1894 21, do. Charles Baker. 3 Feb., 1891 1, Basinghall Street 15, do. Aerated Bread Co., Ltd. Antonio Cattini. 17 Nov., 1894 29/30, do. J. Lyons and Co., Ltd. 23 Dec., 1902 1, Gresham Buildings, Basinghall Street London Cafe Co., Ltd. 24 June, 1897 50, Beech Street John Richards. 23 Feb., 1892 51a, do. Matthew Manns. 30 Nov., 1894 4 Beehive Passage Lockharts, Ltd. 25 Sept., 1902 7, Bell Yard James Henry Mills. 210 Date of Registration. Premises. Person Registered. 25 Sept., 1902 9, Bell Yard Cooper and Holyoake. 23 Aug., 1901 5, Billiter Street British Tea Table Co., Ltd. 17 May, 1895 22, do. J. and B. Stevenson. 28 Feb., 1902 Pagoda Café, Billiter Street Lydia Birch and Ada Smith. 30 Mar., 1901 9, Billiter Square Callard, Stewart and Watt, Ltd. 21 Oct., 1902 49, Bishopsgate Street Within Slaters, Ltd. 16 July, 1902 60, do. William Neave Hill. 16 Oct., 1900 79, do. Lyons and Co., Ltd. 29 April, 1901 101, do. Foster and Hazell. 30 April, 1902 107, do. William Hughes. 12 Feb., 1900 2a, Bishopsgate Street Without Baxter and Craig. 7 Jan., 1892 15/6, do. Aerated Bread Co., Ltd. 20 June, 1901 19, do. J. Lyons and Co., Ltd. 11 Mar., 1896 31, do. Giovanni Beltramini. 5 June, 1901 42, do. British Tea Table Co., Ltd. 29 April, 1902 50, do. Lucidoro Mauro. 5 July, 1901 69, do. Edgar Alexander Macfarlane. 22 Mar., 1901 77, do. Gaston Debry. 1 Nov., 1898 90, do. Donald Henderson. 13 Oct., 1902 102a, do. Octavius Thomas Jeans. 5 Sept., 1899 111, do. Arthur James Tipping. 21 Oct., 1898 147, do. British Tea Table Co., Ltd. 4 April, 1902 23, Birchin Lane M. A. Iviston and Co. 5 June, 1901 8/10, Blomfield Street British Tea Table Co., Ltd. 30 Dec., 1902 8, Botolph Alley Esau Wm. Lambourn. 6 June, 1901 9, Bow Lane Lucidoro Mauro. 4 May, 1900 10, do. Guiseppe Berudi. 20 Nov., 1901 46, do. P. Palumbo. 12 Nov., 1901 20, Bride Lane George Price. 31 Oct., 1901 3, Brushfield Street Henry Pugh Lloyd. 6 Dec., 1893 3, Bridgewater Street Charles Cromwell Crocker. — Aug., 1892 Broad Street Station Aerated Bread Co., Ltd. 28 April, 1879 4, Broadway Caroline L. Vohman. 17 Nov., 1898 7, do. J. Lyons and Co., Ltd. 14 July, 1902 8, do. Free and Co. 14 May, 1902 35, Bucklersbury J. Lyons and Co., Ltd. 14 March, 1895 20, Budge Row J. Lyons and Co., Ltd. 17 Feb., 1892 24, do. Thomas Barge. 8 Oct., 1902 30. do. British Tea Table Co., Ltd. 7 April, 1902 1, Burgon Street Nunzio Allocco. 23 Sept., 1901 1, Bury Street Express Dairy Co., Ltd. 21 Nov., 1899 la, do. Albert Alexander Price. 8 Oct., 1902 40/2, Cannon Street Aerated Bread Co., Ltd. 24 Oct., 1901 50, do. Slaters, Ltd. 18 Oct., 1897 51, do. Aerated Bread Co., Ltd. 8 Oct., 1902 86, do. Aerated Bread Co., Ltd. 1 Jan., 1901 95, do. James Hogg Brown. 23 Dec., 1902 139, do. London Cafe Co., Ltd. 211 Date of Registration. Premises Person Registered. 2 June, 1902 145, Cannon Street Ye Mecca, Ltd. 22 May, 1889 147, do. Aerated Bread Co., Ltd. 3 Jan., 1896 Cannon St. Station Approach Aerated Bread Co., Ltd. 29 Dec., 1894 3, Camomile Street William Neave Hill. 27 June, 1902 36, do. Francesco Alfuso. 8 Mar., 1897 54, Carter Lane William Henry Knapp. 6 Mar., 1894 57a, do. Robert Elijah Bareham. 6 May, 1895 75, do. William Henry Clemence. 1 Oct., 1902 79, do. (Mrs.) Harriett Loader. 14 July, 1902 81, do. R. J. Fitzgibbon. 24 Feb., 1902 5, Castle Street (Mrs.) Mary Jones. 30 Nov., 1894 319, Central Markets Lockharts, Ltd. 7 Oct., 1896 332, do. Cream Dairy Co. 8 Oct., 1902 18, Charterhouse Street British Tea Table Co., Ltd. 2 Aug., 1895 23, Cheapside J. Lyons and Co., Ltd. 11 Feb., 1901 26, do. Slaters, Ltd. 19 Dec., 1902 41, do. Lockharts, Ltd. 8 Oct., 1902 51, do. Aerated Bread Co., Ltd. 8 Oct., 1900 74/5, do. Slaters, Ltd. 9 July, 1888 77, do. Aerated Bread Co., Ltd. 2 June, 1902 140, do. Ye Mecca, Ltd. 21 Oct., 1889 150, do. Aerated Bread Co., Ltd. 20 Dec., 1894 6, Clark's Place Edwin Prosser. 9 Sept., 1879 20, Cloth Fair William Mortimer Phelan. 22 July, 1902 22, do. John Jackson. 10 Oct., 1888 30, do. Reuben Smith Jackson. 22 Sept., 1902 19, Cock Lane David Davies. 2 June, 1902 23, Coleman Street Ye Mecca, Ltd. 19 July, 1902 38, do. The Cabins, Ltd. 11 Oct., 1902 8, Copthall Avenue Alexander Hampton. 17 Oct., 1900 10, do. James William Davis. 29 June, 1901 28, do. Siro Pietro Alberti. 8 Oct., 1902 9, Cornhill Aerated Bread Co., Ltd. 28 Feb., 1896 Corn Exchange Chambers William James Johnston. 30 May, 1901 11, Cree Church Lane Mary Ann Stanton. 18 Oct., 1897 7, Cripplegate Buildings Aerated Bread Co., Ltd. 23 Sept., 1901 7, Crooked Lane M. Morgan Jones. 15 May, 1901 Crown Court (Old Broad St.) J. Lyons.and Co., Ltd. 4 Oct., 1901 13, Crutched Friars Express Dairy Co., Ltd. 1 Feb., 1902 27, do. Elizabeth Miles. 8 Oct., 1902 7, Cullum Street British Tea Table Co., Ltd. 19 July, 1902 21, do. Edward David Morgan. 1 Oct., 1902 14, Cursitor Street Martha Kersey. 25 Oct., 1898 1, E Block, Dean Street William George Cuss. 6 July, 1901 3/5, Devonshire Street Henry Pearce. 23 Oct., 1902 8, do. Mitchell's Dining Rooms, Ltd. 25 April, 1900 7, Dorset Street Guiseppe Indaco. 212 Date of Registration Premises. Person Registered. 1 Nov., 1901 19, Duke Street Frank Dyson. 16 April, 1889 27, do. Henry Richards. 10 Mar., 1902 50, do. Harold Shannon. 8 Oct., 1902 5, Eastcheap Aerated Bread Co., Ltd. 2 June, 1902 15, do. Ye Mecca, Ltd. 8 Oct., 1902 28, do. Aerated Bread Co., Ltd. 25 Nov., 1902 35, do. J. Lyons and Co., Ltd. 14 June, 1901 59, do. Jno. Teaffey. 5 June, 1901 "Ceylon House," Eastcheap British Tea Table Co., Ltd. 13 Feb., 1901 18, Eldon Street Bartolomeo Cattini. 23 April, 1896 25, do. British Tea Table Co., Ltd. 2 May, 1901 2, Falcon Street Saletta Gambardello. 23 Sept., 1902 60, Fann Street Annie Gittus. 25 Sept., 1902 19/20, Farringdon Street Friern Manor Dairy Farm, Ltd. 16 Oct., 1902 22, do. Francis Rodway. 25 Sept., 1902 32, do. Arthur Atkins. 9 Oct., 1902 62, do. David Jones. 9 Oct., 1902 67, do. Lewis Bertram Heyward. 28 July, 1902 70/1., do. Geo. Jas. and Arthur J. Silverlock. 9 Oct., 1902 72, do. William Murray. 26 Mar., 1895 84/5, do. Pearce's Dining and Refreshment Rooms, Ltd. 23 Aug., 1892 88, do. Frederick Philipp Weinel. 4 Nov., 1898 2, Fen Court Aerated Bread Co., Ltd. 22 May, 1889 15, Fenchurch Street Aerated Bread Co., Ltd. 10 Mar., 1896 31, do. J. Lyons and Co., Ltd. 19 July, 1902 47, do. The Cabins, Ltd. 24 April, 1894 62, do. Aerated Bread Co., Ltd. 9 Oct., 1901 99, do, Aerated Bread Co., Ltd. 22 Sept., 1902 103, do. Joseph Hubert Bück. 27 Nov., 1897 107, do. British Tea Table Co., Ltd 30 Mar., 1901 118, do. Callard, Stewart and Watt, Ltd. 5 July, 1901 157, do. Diviani Bros. 29 June, 1900 16i, do. Maynards, Ltd. 20 Aug., 1902 Fenchurch Street Station Henry Christian Thomas Amendt. 2 Dec., 1902 31, Fetter Lane Thomas Richards. 6 April, 1880 33, do. Edward Fitch. 1 Mar., 1892 38, do. William Alfred Hooper. 26 Feb., 1900 44/5, do. Stewart and Wight, Ltd. 1 April, 1902 57, do. Paul Quartermass. 22 Sept., 1892 83, do. Mary Harris. 18 Dec., 1902 140, do. Frederick Brock. 12 Feb., 1900 1, Finsbury Pavement Luigi Ostacchini. 2 Oct., 1894 73, do. Aerated Bread Co., Ltd. 21 Oct., 1898 85, do. British Tea Table Co., Ltd. 3 Sept., 1891 139, do. Express Dairy Co., Ltd. 14 May, 1902 Finsbury Pavement House... J. Lyons and Co., Ltd. 13 Nov., 1895 31, Fish Street Hill George Porteous Johnston. 213 Date of Registration Premises. Person Registered. 5 Feb., 1900 37, Fish Street Hill Pasqualino Calumbo. 19 Sept., 1902 2, Fishmongers' Alley Mary Jones. 17 July, 1902 16, Fleet Street George Rice Bolton. 16 Oct., 1900 61, do. J. Lyons and Co., Ltd. 30 Nov., 1894 109, do. Lockharts, Ltd. 25 Nov., 1902 116, do. Aerated Bread Co., Ltd. 18 Dec., 1902 118, do. Alfred Scarlett. 4 Nov., 1887 131, do. Express Dairy Co., Ltd. 30 Nov., 1894 170, do. Lockharts, Ltd. 14 May, 1902 173, do. J. Lyons and Co., Ltd. 15 Oct., 1902 175, do. Romualoto Mausi. 8 Oct., 1902 182/3, do. British Tea Table Co., Ltd. 25 June, 1891 190, do. Aerated Bread Co., Ltd. 28 Sept., 1896 31, Fleet Lane Annie Heald. 1, Fore Street Aerated Bread Co., Ltd. 24 Dec., 1902 17, do. J. Lyons and Co., Ltd. 11 Oct.. 1902 28, do. William R. Child. 20 June, 1901 54, do. J. Lyons and Co., Ltd. 56/7, do. Aerated Bread Co., Ltd. 20 Sept., 1902 62, do. Percy Goodman. 1 Dec., 1897 70, do. Antonio Biagi. 10 June, 1896 84, do. Lockharts, Ltd. 8 Dec., 1897 85, do. John Mardorf. 2 Jan., 1902 112, do. Ulrich Maino. 15 July, 1902 2, Foster Lane Giovanni Devianni. 14 Oct., 1902 5, do. William Walter Burrows and John Roberts. 26 Sept., 1902 9, do. Giorgi Beschizza and Co. 18 April, 1902 41, do. Free and Co. 17 May, 1901 2, Friday Street Felice Tortora. 28 Sept., 1887 65, do. Aerated Bread Co., Ltd. 17 June, 1896 1, Furnival Street Henry Charles Leaver. 10 Oct., 1902 20, Garlick Hill Walter Robert William Marchant. 28 Dec., 1894 7, George Street Annie Loomes. 30 Mar., 1901 12, George Yard Callard, Stewart and Watt, Ltd. 9 Oct., 1902 1, Great New Street Sarah Amelia Barnsley. 17 Oct., 1902 12, do. Jane Smith. 6 Sept., 1899 21, Godliman Street Express Dairy Co., Ltd. 4 Oct., 1887 8, Gough Square James Rushmer. 22 Oct., 1900 12, Gracechurch Street Charles John Haag. 9 Oct., 1886 33, do. Aerated Bread Co., Ltd. 11 May, 1900 41, do. Maynards, Ltd. 6 May, 1897 51, do. Lockharts, Ltd. 30 Mar., 1901 69, do. Callard, Stewart and Watt, Ltd. 10 Mar., 1896 72/3, do. J. Lyons and Co., Ltd. 3 Mar., 1902 8/9, Great St. Helen's Callard, Stewart and Watt, Ltd. 30 Dec., 1902 18/19, do. Margaret Hodgson. 2 June, 1902 "Crosby House," Gt. St. Helen's Ye Mecca, Ltd. 214 Date of Registration. Premises. Person Registered. 9 Oct., 1902 14, Great Tower Street Walter George Rooke and Charles George Cook. 21 June, 1901 17/8, do. Aerated Bread Co., Ltd. 24 Nov., 1902 28, do. Thomas Stevenson. 15 Jan., 1901 54, do. Walter W. Walker. 21 Sept., 1899 58, do. Joseph James Metcalf. 4 Nov., 1898 62/3, do. Aerated Bread Company, Ltd. 3 Mar., 1902 78, do. Callard, Stewart and Watt, Ltd. 7 Feb., 1901 96, do. London Clerks' Café Co., Ltd. 14 Jan., 1901 100, do. Luigi Arpino. 30 Oct., 1895 6, Greystoke Place William George Cuss. 14 Dec., 1900 1, Gresham Street Aerated Bread Co., Ltd. 2 June, 1902 3, do. Ye Mecca, Ltd. 1 Nov.. 1901 5, do. Antonio Ostacchini. 16 Oct., 1900 46, do. J. Lyons and Co., Ltd. 2 June, 1902 54, do. Ye Mecca, Ltd. 22 Dec., 1885 69, do. Aerated Bread Co., Ltd. 13 July, 1901 87, do. Golden Grain Bread Co., Ltd. 2 May, 1902 12, Grocers' Hall Court James Arthur Bruce. 8 Oct., 1902 4, Hart Street British Tea Table Co., Ltd. 6 Feb., 1902 5, do. Margaret Jones and Edwards. 31 Oct., 1898 9/10, do. James Page Geary. 3 Feb., 1891 31, Holborn Aerated Bread Co., Ltd. Oct., 1895 144, do. Luigi Rattazzi. 145, do. Slaters, Ltd. 11 Nov., 1901 1/2, Holborn Viaduct Aerated Bread Co., Ltd. 22 May, 1901 65, do. Alice R. Pearce. 17 Oct., 1900 1, Honey Lane Market P. Verioni. 14 May, 1902 4, do. Lyons and Co., Ltd. 20 June, 1889 9, do. John Gow. 2 April, 1892 1, Hosier Lane Stephen and David Jones. 22 Sept., 1902 27a, do. Richard William Mason. 25 June, 1890 118, Houndsditch David Jones. 19 April, 1902 1/2, Huggin Court Edmund Moore. 6 Mar., 1901 4a, Huggin Lane Edmund Moore. 18 Oct.. 1895 10, do. Mary Ann Williams. 1 Nov., 1901 13, Hutchison Street Joseph Magnus. 28 Nov., 1901 15, do. Jacob and Leah Miller. 12 Mar., 1896 35, Hutton Street Amy Reeve. 29 Mar., 1902 38, do. Timothy Evans. 2 Oct., 1901 13, Idol Lane Stanley E. Twallin. 8 April, 1897 3, Imperial Arcade Friern Manor Dairy Farm, Ltd. 5 June, 1901 Ingrain Court British Tea Table Co., Ltd. 8 Oct., 1902 28/9, Ironmonger Lane British Tea Table Co., Ltd. 23 Sept., 1902 8/9, Ivy Lane Ada Mary Wallis. 18 Mar., 1902 18, do. Elisco Baisi. 21 July, 1902 22, do. West London Dairy Co., Ltd. 20 Sept., 1902 39, Jewin Crescent Antonio Precha. 22 Sept., 1902 6, Jewin Street E. Seton Karr. 215 Date of Registration. Premises. Person Registered. 23 Feb., 1901 24, Jewin Street George McFarlane. 23 April, 1896 28/9, do. British Tea Table Co., Ltd. 25 Oct., 1894 8, Jewry Street John Jones. 1 April, 1901 12, John Street William Alston. 25 Mar., 1901 16, do. Alice Maud Turner. 22 Sept., 1897 29, King Street. Antonio Precha. 25 Jan., 1887 32, do. Aerated Bread Co., Ltd. 15 Nov., 1901 8, King William Street Slaters, Ltd. 30 Nov., 1894 32, do. Lockharts, Ltd. 24 Dec., 1902 34, do. J. Lyons and Co., Ltd. 14 July, 1892 44, do. Aerated Bread Co., Ltd. 16 Oct., 1900 50, do. J. Lyons and Co., Ltd. 1 Nov., 1898 51, do. Edward John Argent. 20 Nov., 1901 64, do. Aerated Bread Co., Ltd. 2 May, 1901 8, Kinghorn Street Saletta Gambardello. 24 Sept., 1896 12, do. Catherine Lewis. 20 Sept., 1902 25a, do. William Phelan. 2 June, 1902 King's Arms Yard Ye Mecca, Ltd. 2 Nov., 1901 8, King's Head Court William Collins. 2 Oct., 1902 48, Knightrider Street William Adamson. 8 Oct., 1902 8, Lambeth Hill British Tea Table Co., Ltd. 23 Oct., .1902 3, Lawrence Lane Seafoods, Ltd. 31 Oct., 1902 19, Leadenhall Market Dowling and Sons. 15 Oct., 1902 38, do. Free and Co. 14 Oct., 1902 40, do. Mary Ellen Bird. 2 July, 1902 50, do. Henry George Saunders. 22 Mar., 1902 56, do. Elizabeth Clary. 8 Oct., 1902 4, Leadenhall Street Aerated Bread Co., Ltd. 30 Mar., 1901 27, do. Callard, Stewart and Watt, Ltd. 15 Oct., 1902 60, do. Romualoto Mansi. 12 July, 1902 64, do. John Edwards. 2 June, 1902 101, do. Ye Mecca, Ltd. 21 June, 1901 106, do. Aerated Bread Co., Ltd. 8 Oct., 1902 140, do. Aerated Bread Co., Ltd. 8 May, 1899 8/9, Lime Street John and Boyd Stevenson. 8 Feb., 1898 15a, do. Express Dairy Co., Ltd. 17 Nov., 1898 23, do. J. Lyons and Co., Ltd. 2 June, 1902 24, do. Ye Mecca, Ltd. 30 Dec., 1902 26, do. Aerated Bread Co., Ltd. 2 Nov., 1898 34, do. Agnes Powell. 19 Sept, 1902 53, do. Frederick Schmitz. 1 Aug., 1900 6/8, Lime Street Square Fruitarian Cafe Co., Ltd. 9 Oct., 1902 4, Little Britain Frederick Pearce. 5 Dec., 1899 19, do. Express Dairy Co., Ltd. 30 Sept., 1896 25, do. John Davies. 24 Mar., 1892 33, do. Welford and Sons, Ltd. 23 Sept., 1902 42/3, do. Catherine A. Cross. 11 Feb., 1901 56, do. Arthur Leonard Message. 216 Date of Registration. Premises. Person Registered. 21 Dec., 1894 6, Little Trinity Lane Helen Louisa Mack. 10 Oct., 1902 20. Liverpool Street George Worth. 11 Oct.. 1902 37, do. David Lowrie. 12 Aug., 1902 Liverpool Street Station H. C. T. Amendt. 2 June, 1902 4, Lombard Court Ye Mecca, Ltd. 21 June, 1901 82, Lombard Street Aerated Bread Co., Ltd. 13 Nov., 1895 3/4, London House Yard George Porteous Johnston. 25 Feb., 1902 la, London Street Marie Seabright. 27 Feb., 1902 4. do. Crosi Carlo. 8 Nov., 1898 8, do. Lockharts, Ltd. 3 Mar., 1902 14, do. Albert Leroy. 8 Oct., 1902 19, do. Aerated Bread Co.. Ltd. 21 Dec., 1894 34, London Wall Andrew Glendinning. 30 Nov., 1894 47, do. Lockharts, Ltd. 2 June, 1902 49, do. Ye Mecca, Ltd. 8 Oct., 1902 55or56, do. British Tea Table Co., Ltd. 4 July, 1901 58a, do. G. Titus Barham. 13 June, 1899 17, Long Lane James Williams. 10 Mar., 1897 23, do. John Vincent. 18 Oct., 1902 54, do. Alfred Home. 23 Oct., 1902 55, do. William H. Collins. 15 Oct.. 1902 77, do. Stewart and Wight, Ltd. 6 May, 1901 80, do. Luigi Migliorina. 1 Nov., 1890 85, do. Evan Rees. 18 Nov., 1898 129½, Lower Thames Street Natali Jurietti. 14 Mar., 1895 5, Ludgate Circus J. Lyons and Co., Ltd. 21 Oct., 1902 1, Ludgate Circus Buildings Slaters, Ltd. 7 Feb., 1901 16, Ludgate Hill Callard, Stewart and Watt, Ltd. 17 Nov., 1898 21, do. J. Lyons and Co., Ltd. 20 Nov., 1901 29, do. Aerated Bread Co., Ltd. 8 Oct., 1902 38, do. Aerated Bread Co., Ltd. 31 Oct., 1900 54, do. Express Dairy Co., Ltd. 2 June, 1902 56, do. Ye Mecca, Ltd. 13 May, 1901 6, Maidenhead Court Mangi Malteo. 5 May, 1902 14, do. Joseph Francis Head. 23 Sept., 1899 20, do. George Endersby. 5 July, 1901 18, Mansell Street Henry Rodney Foakes. 19 Sept., 1902 28, do. Leah Woolf. 23 Sept., 1892 38, do. George Outten. 2 June, 1902 69/70, Mark Lane Ye Mecca, Ltd. 25 May, 1891 78, do. Express Dairy Co., Ltd. 18 Oct., 1902 25, Middlesex Street (Middlesex House). Mitchell's Dining Rooms, Ltd. 11 Feb., 1902 95, Middlesex Street Emanuel Barnet. 10 July, 1901 71, Milton Street Charles Gentry. 8 Oct., 1902 76, do. Andrew Annanson. 12 Oct., 1897 2, Minories British Tea Table Co., Ltd. 12 Oct., 1897 6, do. British Tea Table Co., Ltd. 217 Date of Registration. Premises. Person Registered. 2 Oct., 1885 125, Minories Albert Markwell. 13 Oct., 1902 130, do. Elizabeth King. 16 July, 1902 152/3, do. Robert Phillips. 12 Mar., 1902 155, do. William McGavin Reid. 13 June, 1901 41/2, Monkwell Street Samuel Henry Gregg. 7 June, 1902 "Monument Dairy," Monument Street. Frederick Lewindon. 30 April, 1900 43, Moor Lane Antonio Sammarco. 6 Dec., 1901 2, Moorfields Lucidoro Mauro. 2 April, 1902 9, do. Robert Bell. 28 Feb., 1898 28, do. Express Dairy Co., Ltd. 30 Dec., 1898 38, do. Antonio Precha. 11 Feb., 1901 44, do. G. Offredi. 11 Oct., 1902 19, Moorgate Street Alexander Hampton. 18 Oct., 1897 28, do. Aerated Bread Co., Ltd. 7 Feb., 1902 Moorgate Station Chambers Express Dairy Co., Ltd. 8 July, 1901 2, Moorgate Station Buildings Fullers, Ltd. 21 Oct., 1890 35, New Street Samuel Harris. 8 Oct., 1902 1, New Basinghall Street British Tea Table Co., Ltd. 21 June, 1901 40, New Bridge Street Aerated Bread Co., Ltd. 29 April, 1896 44, do. David Stewart. 17 Nov., 1898 3, New Broad Street J. Lyons and Co., Ltd. 30 Mar., 1901 4b, do. Callard, Stewart and Watt, Ltd. 15 July, 1902 13, do. R. Charles and Co. 8 Oct., 1902 16, do. Aerated Bread Co., Ltd. 18 July, 1902 28, do. William Neave Hill. 22 Dec., 1885 64, do. Aerated Bread Co., Ltd. 17 Oct., 1902 3, Newbury Street Elizabeth Pike. 26 Feb., 1900 13, Newgate Street Stewart and Wight, Ltd. 19 Dec., 1902 87, do. J. Lyons and Co., Ltd. 8 Oct., 1902 94, do. British Tea Table Co., Ltd. 19 Mar., 1902 122/3, do. Peter Diviani. 25 Sept., 1902 4/5, Noble Street Tom Trowsdale. 8 Oct., 1902 24, do. Samuel Henry Gregg. 17 July, 1901 44, do. Alfred Walter Bennett. 30 Nov., 1894 19/20, Old Bailey Lockharts, Ltd. 14 Nov., 1882 22, do. Charles Thompson Hill. 8 Oct., 1902 55/6, do. British Tea Table Co., Ltd. 20 Nov., 1901 33, Old Broad Street Aerated Bread Co., Ltd. 8 Oct., 1902 40, do. Aerated Bread Co., Ltd. 27 June, 1901 2, Old Change Charles D. Bizzanelli. 21 Oct., 1898 13a, do. British Tea Table Co., Ltd. 17 July, 1902 6, Old Jewry The Cabins, Ltd. 21 April, 1902 3, Pancras Lane Frederick Walter Hicks. 7 April, 1902 1, Paternoster Avenue Nunzio Allocco. 8 Oct., 1902 5/6, do. British Tea Table Co., Ltd. 27 Nov., 1897 12, do. Pelegrino Verioni. 14 Oct., 1902 29, do. Seafoods, Ltd. 218 Date of Registration. Premises. Person Registered. 30 Oct., 1901 60, Paternoster Row J. Lyons and Co., Ltd. 18 Dec., 1894 5, Paul's Alley Carlo Demaria. 17 Feb., 1892 8, Philpot Lane Sarah and Bridget Edwards. 26 Feb., 1900 14, do. Stewart and Wight, Ltd. 21 Sept., 1900 22, do. Alfred Walter Bennett. 16 July, 1902 21, Pilgrim Street Matteo Castagnetti. 8 April, 1902 32, do. Priori Oreste. 21 June, 1901 34, do. Aerated Bread Co., Ltd. 30 Oct., 1901 31, Poultry J. Lyons and Co., Ltd. 19 Sept., 1902 6, Queen Street Jane Anderson Carnegie. 29 April, 1901 8, do. Forster and Hazell. 24 Dec., 1902 10, do. J. Lyons and Co., Ltd. 30 Nov., 1894 71, do. Lockharts, Ltd. 30 Jan., 1894 7, Queen Victoria Street Express Dairy Co., Ltd. 14 Mar., 1895 17, do. J. Lyons and Co., Ltd. 5 June, 1901 26, do. British Tea Table Co., Ltd. 5 Nov., 1892 75, do. Golden Grain Bread Co., Ltd. 8 Oct., 1902 105, do. British Tea Table Co., Ltd. 30 Nov., 1894 115, do. Lockharts, Ltd. Dec., 1901 143, do. J. Lyons and Co., Ltd. 12 Nov., 1901 148 a, do. Mary Hayman. 13 Feb., 1892 177, do. Guiseppe Gionta. 23 Sept., 1892 2, Robin Hood Court Emma A. Smith. 27 June, 1895 2/4, Ropemaker Street John Pearce. 7 Oct., 1896 2£, St. Andrew's Hill Cream Dairy Co. 20 May, 1895 5, St. Bride Street George Yexley. 22 Feb., 1901 16, do. William Castle. 26 Feb., 1900 35, do. Stewart and Wight, Ltd. 13 Nov., 1895 3/4, St. Martin's Court George Porteous Johnston. 8 Oct., 1902 31, St. Mary-at-Hill British Tea Table Co., Ltd. 19 Sept., 1902 7, St. Mary Axe Elizabeth Flook. 30 April, 1901 21, do. Fruitarian Café Co., Ltd. 23 May, 1898 34, do. Express Dairy Co., Ltd. 14 May, 1902 49, do. J. Lyons and Co., Ltd. 21 Oct., 1898 65, do. British Tea Table Co., Ltd. 23 April, 1901 18, St. Paul's Churchyard Alfred William Pearce. 30 Oct., 1901 61, do. J. Lyons and Co., Ltd. 19 Dec., 1902 68a, do. Fullers, Ltd. 7 Feb., 1901 75, do. Callard, Stewart and Watt, Ltd. 1 Oct., 1901 82, do. Giorgio Beschizza. 25 Jan., 1890 30/1, St. Swithin's Lane Aerated Bread Co., Ltd. 18 Dec., 1902 135a, Salisbury Court Matteo Mansi. 26 Mar., 1902 136, do. Frederick William Jaggs. 19 June, 1901 19, Sherborne Lane Edward William Davies. 8 Oct., 1902 35/6, Shoe Lane British Tea Table Co., Ltd. 20 April, 1899 98, do. David Jones. 29 Mar., 1897 109, do. Charles Baker. 7 July, 1890 114, do. Simeon Northam. 219 Date of Registration. Premises. Person Registered. 2 May, 1902 18, Silver Street Saletta Gambardello. 11 Oct., 1900 24, do. Pantaleone Pisani. 24 Jan., 1882 27, do. David Haydon. 18 July, 1902 28, Stonecutter Street Aminta Cernaglia. 12 June, 1901 23, Stoney Lane Henry Jones. 16 July, 1902 62, do. Solomon Green. 26 Sept., 1892 16, Swan Lane Frederick William Ward. 4 Feb., 1898 1, Telegraph Street Aldows and Aldows, Ltd. 17 Nov., 1898 17/8, do. J. Lyons and Co., Ltd. 2 June, 1902 do. Ye Mecca, Ltd. 2 May, 1901 8, Temple Lane Jessie Holman. 16 Oct., 1900 27, Throgmorton Street J. Lyons and Co., Ltd. 21 June, 1901 29, do. Aerated Bread Co., Ltd. 14 Dec., 1901 6, Tudor Street John Pantalone. 25 July, 1902 14, do. Walter Thomas Beames. 6 Aug., 1902 32, do. Fanny Payne. 27 Oct., 1897 3, Union Court, Old Broad St. Express Dairy Co., Ltd. 2 June, 1902 do. Ye Mecca, Ltd. 19 April, 1902 57, Upper Thames Street George Chitty. 9 Oct., 1902 58, . do. Albert Ashlee. 15 Oct., 1902 145, do. Stewart and Wight, Ltd. 21 April, 1902 152, do. Eliza Keeler. 11 Dec. 1896 172, do. George Chitty. 6 June, 1901 182, do. Lucidoro Mauro. 11 Oct., 1902 186, do. Robert Waterson. 21 Sept., 1899 190, do. Joseph James Medcalf. 31 Oct., 1901 194, do. Robert Cooper. 10 April, 1899 223, do. Express Dairy Co., Ltd. 31 Oct., 1901 224, do. Robert Cooper. 28 Oct., 1901 4, Walbrook J. Lyons and Co., Ltd. 2 June, 1902 14, do. Ye Mecca, Ltd. 14 Mar., 1895 19/20, do. J. Lyons and Co., Ltd. 8 Oct., 1902 34, do. Aerated Bread Co., Ltd. 9 Oct., 1886 Warnford Court Aerated Bread Co., Ltd. 3 Dec., 1897 14, Warwick Lane Frederick Charles Pearce. 21 Nov., 1894 25, do. John Robert Adamson. 23 Oct., 1902 la, Water Lane (Great Tower Street). Samuel Arthur Turner. 8 Mar., 1902 2, Water Lane (Blackfriars) Albert Alexander Price. 21 Nov., 1894 4, do. Robert Reid. 14 July, 1902 5, do. Ernest A. L. Halcomb. 27 Sept., 1897 7, do. British Tea Table Co., Ltd. 26 Mar., 1895 73, Watling Street Pearce's Dining and Refreshment Rooms, Ltd. 2 June, 1902 "Aldermary House," Watling Street. Ye Mecca, Ltd. 20 May, 1895 12, Well Street George Yexley. 30 Nov., 1894 57a, West Smithfield Lockharts, Ltd. 220 Date of Registration. Premises. Person Registered. 2 May, 1900 31, Whitecross Street Robert Douglas. 20 Jane, 1901 5, Whitefriars Street Frederick Philipp Weinel. 24 Sept., 1902 7, do. Vincenzo Mansi. 25 Sept., 1902 24b, do. Alfred Locke. 10 Aug., 1891 27, do. George Robert Smith. 2 June, 1902 1, Whittington Avenue Ye Mecca, Ltd. 30 Mar., 1901 7, do. Callard, Stewart and Watt, Ltd. 26 April, 1897 13, Widegate Street John Isaacs. 11 Jan., 1897 17, do. Allec Cohen. 22 Feb., 1902 7, Wood Street Lucidoro Mauro. 18 Dec., 1901 25, do. J. Lyons and Co., Ltd. 22 Feb., 1902 37, do. Lucidoro Mauro. 8 Oct., 1902 42/3, do. British Tea Table Co., Ltd. 10 Dec., 1896 78, do. Luigi Terroni. 2 June, 1902 80, do. Ye Mecca, Ltd. 25 Jan., 1890 130, do. Express Dairy Co., Ltd. 3 Mar., 1902 Wool Exchange Callard, Stewart and Watt, Ltd. 20 Jan., 1887 22, Wormwood Street Aerated Bread Co., Ltd. 12 Feb., 1900 36, do. Luigi Ostacchini. 5 June, 1901 38, do. British Tea Table Co., Ltd. 9 Dec., 1902 6, Wrestlers' Court Edwin Prosser. 221 Appendix E. New List of Causes of Death as used in the Annual Reports of the Registrar-General for England and Wales. N.B.—The terms printed in italics, being the names of symptoms merely, or being otherwise objectionable, should be used, in Medical Certificates, only when precise information is wanting. GENERAL DISEASES. Small-pox Vaccinated. Tuberculous Phthisis (Pulmonary Tuberculosis). "Phthisis." Not Vaccinated. Doubtful. Cow-pox. Effects of Vaccination. Tuberculous Meningitis. Chicken-pox. Tuberculous Peritonitis. Measles (Morbilli). Tabes Mesenterica. Epidemic Rose Rash, German Measles. Lupus. Scarlet Fever. Tubercle of other Organs. Typhus. General Tuberculosis. Plague. Scrofula. Relapsing Fever. Influenza. Parasitic Diseases. Whooping Cough. Starvation. Mumps. Scurvy. Diphtheria, Membranous Croup. Alcoholism, Delirium Tremens. Cerebro Spinal Fever. Opium, Morphia Habit. Simple Continued Fever. Ptomaine Poisoning. Enteric Fever. Industrial Poisoning by Lead. Asiatic Cholera. by Phosphorus. Epidemic Diarrhoea, Epidemic (or Zymotic) Enteritis. by Arsenic and other Metals. Rheumatic Fever, Acute Rheumatism. Diarrhœa, Choleraic Diarrhoea. Rheumatism of Heart. Dysentery. Chronic Rheumatism. Rheumatic Arthritis, Rheumatic Gout. Malarial Fever. Gout. Hydrophobia. Glanders, Farcy. Carcinoma. Anthrax, Splenic Fever. Tetanus. Sarcoma. Syphilis. Malignant Disease, Cancer. Gonorrhoea, Stricture of Urethra. Rickets. Puerperal Septicaemia, Sapræmia. Purpura. Puerperal Pyaemia. Hæmophilia, Hæmorrhagic Diathesis. Puerperal Phlegmasia Dolens. Anaemia, Leucocythæmia. Puerperal Fever. Diabetes Mellitus. Infective Endocarditis. Epidemic Pneumonia, Pneumonic Fever. Premature Birth. Erysipelas. Septicæmia (not Puerperal). Congenital Defects. Pyæmia (not Puerperal). Injury at Birth. Phlegmon, Carbuncle (not Anthrax). Atelectasis. Phagedæna. Want of Breast Milk. Other Septic Diseases. Teething. 222 LOCAL DISEASES. Diseases of Nervous System:— Diseases of Digestive System: — Meningitis, Inflammation of Brain. Tonsillitis, Quinsy. Softening of Brain. Mouth, Pharynx, Disease (not specific). General Paralysis of Insane. Gastric Ulcer. Insanitary (not Puerperal). Gastric Catarrh. Chorea. Stomach, other Diseases (not Malignant). Epilepsy. Enteritis (not Epidemic). Convulsions. Gastro-Enteritis. Laryngismus Stridulus. Appendicitis, Perityphlitis. Locomotor Ataxy. Hernia. Paraplegia and Disease of Cord. Intestinal Obstruction. Neuritis, Periph, Poly-Neuritis. Other Diseases of Intestines. Brain Tumour (not specific). Peritonitis (not Puerperal). Nervous System, other Diseases. Cirrhosis of Liver. Diseases of Organs of Sp. Sense:— Liver and Gall Bladder, other Diseases. Digestive System, other Diseases. Otitis, Mastoid Disease. Lymphatic Diseases:— Epistaxis, Nose Disease. Spleen Disease. Ophthalmia, Eye Disease. Lymphatic System, other Diseases. Diseases of Heart:— Thyroid Body Disease. Valve Disease,Endocarditis(not Infective). Supra Renal Capsules Disease. Pericarditis. Diseases of Urinary System:— Hypertrophy of Heart. Nephritis, Acute. Angina Pectoris. Chronic Bright's Disease, Albuminuria. Dilatation of Heart. Calculus (not Biliary). Fatty Degeneration of Heart. Bladder and Prostate Disease. Syncope, Heart Disease (not specified). Urinary System, other Diseases. Diseases of Blood Vessels:— Diseases of Generative System:— Cerebral Haemorrhage, Embolism, Ovarian Tumour (not Malignant). Thrombosis. Other Diseases of Ovary. Apoplexy, Hemiplegia. Uterine Tumour (not Malignant). Aneurysm. Other Diseases of Uterus and Vagina. Senile Gangrene. Disorders of Menstruation. Embolism, Thrombosis (not Cerebral). Generative and Mammary Organs, other Diseases. Phlebitis. Varicose Veins. Accidents, Childbirth:— Blood Vessels, other Diseases. Abortion, Miscarriage. Diseases of Respiratory Organs:— Puerperal Mania. Laryngitis. Puerperal Convulsions. Membranous Laryngitis (not Diphtheritic). Placenta Prævia, Flooding. Other Accidents of Pregnancy and Childbirth. Croup (not Spasmodic or Membranous). Larynx, other Diseases (not specified). Joint Diseases:— Bronchitis. Caries, Necrosis. Lobar, Croupous-Pneumonia. Arthritis, Periostitis. Broncho, Catarrhal, Lobular, Pneumonia. Other Diseases of Locomotor System. Pneumonia. Skin Diseases:— Emphysema, Asthma. Ulcer, Bedsore. Pleurisy. Eczema. Fibroid Disease of Lung. Pemphigus. Respiratory Diseases, other. Skin Diseases, other. LONDON: Charles Skipper and East, Printers, 49, Great Tower Street, E.C. Corporation of London, public' health department. 1902. INFECTIOUS DISEASE CHART. ■