AC 434 LON 36 Corporation of London. REPORT MEDICAL OFFICER OF HEALTH for the CITY OF LONDON for the year 1903; 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. LON 36 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON For the Year 1903, BY WM. COLLINGRIDGE, M.A., M.D., D.P.H., LL.M., medical officer of health fob the city of london, late medical officer of health for the port of london. LONDON: Printed by Charles Skipper & East, 49, Great Tower Street, E.C. 1904. CONTENTS. PAGE. Aerated Waters— Manufacture of 104 Annual Rateable Value 10 Area 10 Artizans' Dwellings, Stoney Lane 56 „ „ Vital Statistics 57 Births 12 Census Returns 11 Dairies and Milkshops 104 Deaths in City Institutions 14 „ from Violence 15 Density 10 Diseased Meat Prosecutions 120 Disinfectants 60 Disinfection 59 Dust Removal 63 Enteric Fever and Infected Army Blankets 24 „ „ and Shellfish 29 Factory and Workshop Act, 1901.—Summary of Work for the Year 69 ,. „ „ „ —Workshops. Details of Inspection 70 ., „ „ —Underground Bakehouses 72 „ „ „ —Aboveground Bakehouses 75 ,. „ „ „ —Tailors' Workshops 76 „ „ „ „ —Furriers' Workshops 79 „ ., „ „ —Kitchens of Restaurants 80 „ „ „ „ —Voluntary Sanitary Certificates for Kitchens of Restaurants and Aboveground Bakehouses 83 „ „ „ „ —Defects Reported by H.M. Inspectors 89 „ „ „ „ —Domestic Workshops and Factories 90 „ „ „ „ —Woman Sanitary Inspector 92 ,, ,. ,, „ Blouse and Underskirt Makers 92 „ „ ., .. Outworkers 93 „ „ ,, Sanitary Accommodation in Offices 93 ,, „ „ „ „ Order 94 „ „ „ „ Legal Proceedings 94 Fire Inquests 59 Fish Seizures 122 „ Supplies 121 Glanders 50 Hairdressers' and Barbers' Shops 65 House Refuse Removal 63 Ice Creams 105 International Congress of Hygiene and Demography 18 Introductory Remarks 9 Legislation in 1903 84 Limewhiting of Courts 90 Measles 48 „ —Closure of St. Botolph's Infant School 48 Meat Inspection 117 „ Supplies, Notes on 107 Meteorology and Death Rates 21 Midwives and Puerperal Fever 51 Mortality 13 Mortuary Returns 59 Notification of Infectious Disease 21 Nuisance from Pigeons 64 Plague Notification 50 Population 11 Removal of Human Remains 101 „ „ ,, —Old Bridewell Burial Ground 101 „ „ „ —Abchurch Lane (St. Nicholas Acons) 101 „ „ „ —Corner of Liverpool Street and Blomfield Street 102 Page. Removal of Uncertified Persons in company with Certified Small-pox Cases 50 Report of Royal Commission on Sewage Disposal 42 Riverside Wharves. Inspection of Food 123 „ „ Local Government Board Enquiry 124 Sale of Food and Drugs Acts—Samples Examined—Comparative Tables 125 „ „ „ „ —Use of Margarine in Coffee Houses 127 „ „ „ „ —Milk and Butter Adulteration 129 „ „ „ ,, —Milk Deliveries 130 „ „ „ „ —Notes on Articles Examined 131 „ „ „ „ —Prosecutions 134 „ „ ., „ —Report of Royal Commission on Arsenical Poisoning 135 „ „ „ „ —Permissive Milk Adulteration 137 „ „ —Report of Butter Regulations Committee 138 „ „ „ „ —Sale of Butter Bill 139 Sanitary Inspections 61 „ Staff 6 Sewage-Polluted Oysters 30 „ „ Mussels 34 „ „ Cockles 37 Shelter for Temporary accommodation 23 Slaughterhouses 111 Small-pox 48 Smoke Nuisances 98 Spitting in Public Places 55 Summer Flushing of Courts and Alleys 95 Tenement Houses 66 „ „ —Kyffin r. Simmons 67 Tuberculosis 51 Tuberculosis in Meat 111 Vaccination 13 Vital Statistics 15 APPENDICES. page. Appendix A—Street Lists of Mortality 143 „ B— „ „ „ Infectious Disease 146 „ C—Tenement House Register 149 „ D-List of Persons Registered under the Dairies, Cowsheds and Milk Shops Orders 158 „ E—Regulations as to Milk-Stores and Milk-Shops 163 Spot Map of the City showing Infectious Diseases. SANITARY STAFF, 1903. 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 woman sanitary inspector. Safford, Ada J. Feb., 1902 sanitary inspectors. Hills, Arthur Reginald lst 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 inspectors of slaughterhouses and meat. Terrett, George Patrick, Chief Inspector May, 1881 Leeson, John (Retired October, 1903) Dec., 1890 Sharp, Owen May, 1892 Jenkins, Harry April, 1896 Down, William Edward July, 1896 Eglin, William July, 1896 Kelland, William C May, 1899 Mettam, Harry Aug., 1903 Davies, Thos. L. Dec., 1903 Matron in charge of the shelter, golden lane. Mrs. A. R. Hills Dec., 1900 keeper of the mortuary. Faubel, Daniel April, 1903 disinfector. Lee, Robert Oct., 1894 labourers. McDonnell, Robert (General Duties at Mortuary) April, 1903 Steward, Arthur (Meat Shed) Aug., 1903 REPORT OF MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON, 1903. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1903. To the Right Honourable the Lord Mayor, Aldermen and Commons of the Corporation of London. Public Health Department, Guildhall, E.C., April, 1904. Gentlemen, In presenting my fourth Annual Report as Medical Officer of Health for the City of London, it may be convenient to refer here to the most important undertakings in which your Staff has been engaged during the year under review. 1. One matter which attracted much public attention during the summer was the importation into this country of infected military blankets from South Africa, which for the time involved a heavy correspondence, and threw a great strain upon the resources of the Department. Full details will be found in the following pages. 2. In the latter part of the year the polluted shellfish question was again forced upon the notice of your Medical Officer, and it was probably owing to the definite action taken by the Corporation in the endeavour to prevent the continued sale of unwholesome shellfish that the Royal Commission on Sewage Disposal issued their fourth Report. As the matter stands at present it is clear that legislation on the subject is inevitable. 3. The inspection and registration of all workshops and workplaces throughout the City is being pushed forward as rapidly and completely as circumstances permit, and special attention has been given to tailors' workshops, bakehouses—both under and above ground—also to kitchens of restaurants and other places where food is prepared for sale. 4. Fresh evidence is daily forthcoming of the usefulness of the work in which your Woman Sanitary Inspector is engaged, and it is not too much to say that her services have now become essential to the comfort and well-being of those of her sex who earn their living in the City. 5. The statutory powers now in the hands of Local Authorities for controlling the manufacture and sale of ice cream have been fully utilised, and have already proved to be of much advantage to the public. 10 6. The revised Regulations for Dairies and Milkshops, which came into force in September, 1903, have been found in practice to work with good results, and it is satisfactory to find that purveyors of milk throughout the City are co-operating in their proper observance. 7. The severe criticism of Municipal Bodies by the President of the Local Government Board on 11th June, 1903, when he is reported to have stated in the House of Commons that in the administration of the Adulteration Acts " there had undoubtedly been a want of activity in London, and "his business was to urge the Municipal Authorities in London to do their "work properly," cannot apply to the Corporation of London. Both in 1902 and 1903 one sample was examined for every 21 persons resident in the City. In 1902 the proportion in the Metropolis and England and Wales was 1 in 252 and 1 in 450 respectively. The figures for 1903 are not yet obtainable. From a return presented to the London County Council in December, 1903, we learn that in London in the previous year 18.4 milk samples were taken to each 10,000 of the population, whereas in the City 236.3 samples were examined for every 10,000 of the inhabitants. From the same return we find that in 1902 the percentage of adulterated milk samples was 15.6 in London, against 13.2 in the City, and this latter figure was further reduced to 11.6 in 1903. AREA. The City of London Registration District comprises an area of 672.7 acres (excluding tidal water and foreshore), or 1.051 square miles, equal to a square of 1.0252 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 (1903). City of London, Registration District, at night 37.1 persons to an acre. „ „ „ „ during the day *533.5 „ „ 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 £40,625,245 in 1903—whilst the corresponding rateable value of property in the City of London, including Temples, was £4,962,862 in 1903, or nearly one-eighth of the whole County. *This figure refers only to persons "actively engaged in the City during the daytime." The actual number of persons visiting the City daily is probably nearly 1,500,000. 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). TABLE A. Area. Statute Acres. Inhabited Houses. Population. 1891. 1901. 1891. 1901. City of London 672.7 5,340 3,865 37,702 26,923 For Registration, Parliamentary and Municipal 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 26,923 — 12 For statistical purposes, in the following pages the " Registration " District is referred to when speaking of the "City." Ihis 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 1903, calculated on the last Census Returns, were:— St. Botolph 9,294 Allhallows Barking 8,367 St. Sepulchre 7,297 Total 24,958 The Night population, therefore, of the City of London Registration District at the middle of 1903, is taken at 24,958, and it is upon this figure that all vital statistics in this Report have been calculated. The Day population at the middle of 1903 was estimated at 358,930. 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. In 1903 it was ascertained that in the week ending 19th July no less than 347,463 vehicles passed to and from the four City bridges, viz.:—London, Southwark, Blackfriars and Tower, equivalent to upwards of 18,000,000 vehicles per annum. BIRTHS. During the year 1903, 338 births were registered in the City. The annual birth rate was at the rate of 13.6 per 1,000 persons of all ages, compared with a quinquennial mean rate of 14.4 per 1,000. The birth rates last year in the Sub-Districts were— St. Botolph 18.3 per 1,000 Allhallows 5.9 ,, St. Sepulchre 16.3 „ In the Metropolis the birth rate in 1903 was 28.4 per 1,000, being the lowest hitherto recorded therein, and 0.1 below the rate for the year 1902. This decline in the birth rate has been in operation since 1871 or 1872, and is common to nearly all European countries. *On the 1st November, 1903, the sub-district of St. Sepulchre and Allhallows Barking were united and called St. Sepulchre and Allhallows. †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 of 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. 13 VACCINATION. Of the children born in 1903, 230 had been successfully vaccinated by the end of the year, and 33 had died before the age for vaccination. Vaccination was postponed by medical certificate in 15 cases, 1 infant was reported to be insusceptible to vaccination, 28 had removed into other districts, and 32 vaccinations were pending at the end of the year. There were no cases of conscientious objection. Vaccination Statistics in the City of London. Year. Number of Births. Successfully Vaccinated. Insusceptible. Had Smallpox. 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. 1898 468 45.3 Nil. Nil. 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 1902 338 63.3 .29 ,, 8.3 5.0 22.50 0.6 Average previous 5 years 404 59.9 .45 Nil. 10.2 4.8 21.5 2.9 1903 339 67.9 0.29 Nil. 9.7 4.4 17.7 — 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. MORTALITY. During the year under review, 839 deaths were registered in the District, including *631 persons dying in the City, but not belonging thereto. See Table I. for details. Deducting the latter we have to deal with 208 deaths, to which we must add 91 persons who died at City Institutions in outside districts, where they were registered. The mortality, therefore, upon which our death rate is calculated is 299. The death rate for 1903 was 12.0 per 1,000 per annum of the population (the previous year being 16.4), whilst that for the whole of the Metropolis for 1902 was 15.6. These figures are not corrected for sex and age distribution. Death Rates, per 1,000 per Annum. Year. City of London. Great Towns of England and Wales. Metropolis. 1898 16.3 19.0 18.7 1899 18.5 20.2 33 towns 19.8 1900 19.4 19.5 18.8 1901 16.6 18.6 17.1 1902 16.4 17.4 76 towns 17.7 Average previous five years 17.4 18.7 18.4 1903 12.0 — 15.6 * These deaths occurred in St. Bartholomew's Hospital. 14 In comparing the above with the Registrar-General's Returns, some discrepancies will be observed, due to the fact that I have not been 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 0.56 compared with 1.77 in the Metropolis. The deaths of children under one year of age to 1,000 births come out 115, against 131 for the whole of London. Deaths in City Institutions. During 1903, 91 persons died in City Workhouses, Workhouse Infirmaries, or Lunatic Asylums, or no less than 30.4 per cent. of the whole City mortality, the corresponding figure for the Metropolis (1902) being 19.3 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 1903, compared with the average for the previous five years:- Year. City of London. Metropolis. Per cent. Per cent. 1898 28.8 16.8 1899 29.9 17.8 1900 27.9 18.3 1901 25.2 18.8 1902 31.2 19.3 Average of previous five years 28.6 18.2 1903 30.4 Figures not yet published. It will be seen that in 1903 30.4 per cent., or 1 in every 3.3, deaths in the City occurred in one of the above-named Institutions, compared with 19.3 per cent., or about 1 in 5.2, in the Metropolis (1902) under analogous circumstances. 15 Deaths from Violence. Of the City deaths, 5.02 per cent. were caused by injuries or violence (as compared with 8.03 in 1902), being 2.28 below the average for the previous five years. In the City of London, the ratio of deaths from violence to deaths from all causes, which had regularly risen during the previous four years, showed a marked diminution in 1903, the above quoted figures being the lowest recorded. PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE. Year. City of London. Metropolis. Per cent. Per cent. 1898 7.02 4.19 1899 6.56 4.19 1900 7.44 4.27 1901 7.45 4.28 1902 8.03 4.13 Average previous five years 7.30 4.25 1903 5.02 Not yet published. VITAL STATISTICS, 1903. 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 1,000 of the Population. Estimated Night Population (Imperial Census). Estimated Day Population(Cor poration Census). City. Metropolis. City. Metropolis. City. Metropolis. City. Metropolis. City. Metropolis. 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 27,411 348,760 13.7 29.0 16.6 17.1 160 148 7.4 4.3 0.51 2.24 1902 26,546 353,800 12.7 28.5 16.4 17.7 124 139 8.0 4.1 0.67 2.21 Average previous five years. 27,623 343,850 14.4 29.1 17.4 18.4 143 156 7.3 4.2 0.85 2.39 1903 24,958 358,930 13.6 28.4 12.0 15.6 115 131 5.0 * 0.56 1.77 * Figures not yet published. 16 Table I. (This Table is prepared in accordance with the requisitions of the Local Government Board.) Vital Statistics of Whole District during 1903 and Previous Years. Name of District: CITY OF LONDON. Year. 1 Population estimated to Middle of each Year. 2 Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. 9 Deaths of Nonresidents registered in Public Institutions in the District. 10 Deaths of Residents registered in Public Institutions beyond the District. 11 Nett Deaths at all Ages belonging to the District. Number. 3 Rate* 4 Under 1 Year of Age. At all Ages. Number. 12 Rate.* 13 Number. 6 Rate per 1,000 Births registered. 6 Number. 7 Rate.* 8 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 1896 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 1902 26,546 339 12.7 42 124 910 34.3 643 610 136 436 16.4 Averages for years 1894-1902 29,825 455 15.3 64 141 1,000 33.5 630 619 149 529 17.7 1903 24,958 338 13.6 39 115 839 33.6 647 631 91 299 12.0 * 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. Total population at all ages 26,923† Area of City of London Registration District in acres (exclusive of area covered by water) 672.7 Number of inhabited houses 3,865 Average number of persons per house 6.96 †At the date of the Census the civil parish of Glasshouse Yard was included in the City. This parish was subsequently transferred to another Registration District outside the City (see note on page 12). The population of Glasshouse Yard is therefore not included in this figure. At Census of 1901. 17 (This Table is prepared in accordance with the requisitions of the Local Government Board.) Causes of, and Ages at, Death during Year 1903. Deaths in or belonging to whole District at subjoined ages. Deaths in or belonging to Localiteis at all Ages). Total 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 wards. St. Botolph. Allhallows. St. Sepulchre. * 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1. Small-pox ... ... ... ... ... ... ... ... ... ... 2. Measles 2 ... 1 1 ... ... ... 1 ... 1 ... 4 3. Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... 4. Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... 6. Epidemic Influenza 2 ... ... ... ... 2 ... ... 1 1 ... ... 6. Whooping Cough 3 1 2 ... ... ... ... 2 ... 1 ... 3 7. Diphtheria, Membranous Croup 1 ... 1 ... ... ... ... ... ... 1 ... 7 8. Croup ... ... ... ... ... ... ... ... ... ... ... ... 9. Enteric Fever 2 ... ... ... ... 2 ... 1 1 ... ... 6 10. Asiatic Cholera ... ... ... ... ... ... ... ... ... ... ... ... 11. Diarrhoea, Dysentery 4 1 ... ... ... 3 ... 2 ... ... 2 7 12. Epidemic or Zymotic Enteritis 2 2 ... ... ... ... ... ... ... 2 ... ... 13. Enteritis 1 1 ... ... ... ... ... ... ... 1 ... 6 14. Other Continued Fevers 1 1 ... ... ... ... ... 1 ... ... ... 2 15. Erysipelas ... ... ... ... ... ... ... ... ... ... ... 5 16. Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... 17. Other Septic Diseases ... ... ... ... ... ... ... ... ... ... ... 12 18. Intermittent Fever and Malarial Cachexia. ... ... ... ... ... ... ... ... ... ... ... ... 19. Tuberculosis of Meninges 4 2 1 ... ... 1 ... 2 ... 2 ... 17 20. Tuberculosis of Lungs 28 1 ... ... 4 20 3 11 4 7 6 27 21. Other Forms of Tuberculosis 1 1 ... ... ... ... ... 1 ... ... ... 18 22. Alcoholism 1 ... ... ... ... 1 ... ... ... 1 ... 1 23. Cancer 11 ... ... ... ... 6 5 4 2 3 2 75 24. Premature Birth 6 6 ... ... ... ... ... 3 2 1 ... 4 25 Developmental Diseases 10 10 ... ... ... ... ... 6 1 3 ... 17 26. Old Age 27 ... ... ... ... 1 26 13 5 5 4 ... 27. Meningitis 3 ... 1 ... ... 1 1 1 ... 2 ... 17 28. Inflammation and Softening of Brain ... ... ... ... ... ... ... ... ... ... ... 2 29. Organic Diseases of Heart 9 ... ... ... 1 5 3 6 3 ... ... 13 30. Acute Bronchitis 8 4 1 ... ... 2 1 4 1 3 ... 5 31. Chronic Bronchitis 31 ... ... ... ... 11 20 12 3 11 5 9 32. Lobar (Croupous) Pneumonia 2 ... ... ... ... 2 ... 1 1 ... ... 1 33. Lobular (Broncho-) Pneumonia 3 1 ... ... ... 1 1 3 ... ... ... 25 34. Diseases of Stomach 3 ... ... ... ... 1 2 1 ... 2 ... 9 35. Obstruction of Intestines 3 ... ... ... ... 1 2 ... ... 2 1 20 36. Cirrhosis of Liver 7 ... ... ... ... 6 1 1 2 3 1 8 37. Nephritis and Bright's Disease 9 ... ... ... ... 7 2 6 ... 3 ... 30 38. Tumours and Other Affections of Female Genital Organs. 1 ... ... ... ... 1 ... ... 1 ... ... 2 39. Accidents and Dis. of Parturition 2 1 ... ... ... 1 ... 2 ... ... ... 1 40. Deaths by Accident or Negligence 11 3 ... ... ... 4 4 6 ... 3 1 65 41. Deaths by Suicide 4 ... ... ... ... 3 1 1 ... 2 1 9 42. Deaths from Ill-defined Causes 2 1 ... ... ... 1 ... 2 ... ... ... 4 43. All other Causes 95 3 2 2 ... 55 33 41 12 36 6 217 Total all Causes 299† 39 9 3 5 138 105 134 40 96 29 647 * Residents dying in City Institutions. City address not stated on certificate of death, †Including 16 Citizens, distributed in Columns 1 to 11. ‡ncluding 91 Citizens who died in City Institutions outside, distributed in the several Registration Districts to which they belong. 18 INTERNATIONAL CONGRESS OF HYGIENE AND DEMOGRAPHY. At the Congress held in Brussels in September, 1903, your Medical Officer of Health attended as the official delegate of the Corporation. I here quote only those conclusions and resolutions agreed to by the Congress which are of especial interest to your Worshipful Committee. (1) That human tuberculosis is mainly transmitted from man to man ; nevertheless, in the present state of our knowledge, the Congress is of opinion that it is advisable to prescribe measures against the possibility of infection of man by animals. ( I have already directed attention to the value of this resolution and its important bearing on the action of your officers in the Central Markets.) (2) That meat is unfit for human consumption when it is derived from animals attacked by the following diseases: bacterial anthrax; glanders and farcy; rabies, and suspected rabies (in cases of bite from mad animals the meat can be consumed after sterilization); tetanus; septicemic gangrene; pyaemia; trichinosis; leprosy of the ox and pig (leprous meat can be consumed after use of method ensuring the destruction of the cysticerci); generalised actinomycosis; tuberculosis in the following cases:— (а) When the disease is generalised, whatever the condition of the animal may be ; (b) When the animal suffers from marked wasting, whatever the extent of the lesions. Meat seized for generalised tuberculosis may, when the animal is in good condition, be used for food after sterilization ; the same will apply in doubtful cases, regard being had to the extent of the lesions. It will be necessary to proceed to total seizure of the visceral organs when tuberculosis is demonstrated in one organ; typhoid fever of the horse; acute enteritis with diarrhoea in the calf; gangrenous coryza in cattle; cattle plague (flesh of a beast suffering from cattle plague can be used for food when on post-mortem examination only very limited lesions can be found); dropsy; psorospermosis; when the lesions are purulent or calcareous; albuminuria with infiltration of the muscles; hydremia; general melanosis; jaundice; uræmia; carcinoma; diseases rendering the meat bloody, infiltrated or changed to any marked extent; poisoning when the substance ingested can be harmful to the health of man. The flesh of animals attacked by measles of the pig or contagious pleuro-pneumonia of the ox can be eaten if it presents a normal appearance. 19 Unsound meat should be destroyed by chemical or physical agents; burial ought only to be allowed when these means cannot be used. (3) Nothing should be considered as "milk," and sold as such, except "entire milk," that is to say, milk from a complete milking, and furnished by healthy cows. The sub-products of the milk trade, such as skim-milk, half-skimmed, separated milk, and poor milk, ought not to be used for food by young infants, sick or old persons. These sub-products clearly represent a food value which cannot be neglected, but they should only be sold in special shops, or after having given them a definite distinctive character. Antiseptics, preservatives, &c., of any kind should be forbidden for the preservation of milk. The Congress desires— (a) To see the different Governments organise a system of inspection of cow sheds. (b) To see fixed for the different parts of each country the minimum amounts of casein, salts, sugar and fats which milk used for food should contain. (c) To have brought forward at the next Congress of applied chemistry the unification of methods of milk analysis. (4) The employment of food stuffs of bad quality, or in course of decay, ought to be absolutely forbidden and repressed in the manufacture of preserved foods. Sterilization should be complete. It is not possible to fix in one formula, applicable to all cases, the conditions by which this should be carried out. The conditions vary with the apparatus, the receptacles, the nature of the foods, the method of preservation, &c. The receptacles in which the preserves are contained should be hermetically closed. The resistance of the tins to bulging after an incubation of a. week at 38° (C) is sufficient, as a rule, to verify the sterility of the preserves. There is no necessity to allow the use of antiseptics in the preservation of food. (5) A milk of which neither the source nor the conditions of production are known ought to be considered as dangerous for public consumption, and it is necessary to submit it to the action of heat before consumption. The process of heating, carried out under special conditions, will remove its actual pathogenic power without sensibly injuring its alimentary value. 20 A.—Public Consumption. (a) Simple boiling destroys with certainty the tubercle bacillus, which is the most resistant of the pathogenic microbes of milk, provided that the milk is allowed to cool in the heating vessel, and the skin found on the surface is removed. (b) The industrial or domestic methods of pasteurization will ensure the destruction of tuberculous germs in milk, but they do not sterilize it. It is necessary to consume this milk within twentyfour hours. (c) The sterilization of milk relatively rare in practice gives good hygienic guarantee for the public consumption of milk, when the conditions relative to the sanitary condition and feeding of the producing animals have been observed. B.—Dairies. (a) Pasteurization in the dairies which use milk in common is necessary and indispensable. (b) Many forms of apparatus allow, without any serious drawbacks, of killing the pathogenic germs of entire milk, skim milk, and cream by pasteurization at 85° (C.). Nevertheless, for cream it will be desirable to submit the point to further experiment as to the method of operation and temperature. On the other hand, the manufacture of hard cheese with milk treated in this way has not up to the present given satisfactory results. The Congress wishes to see experiments made with apparatus used in dairies, in order to fix the technical conditions for the destruction of pathogenic germs by heating to temperatures near 65° (C.). (6) That Governments should recommend the administration of districts where fairs or markets where markets are held, to require the sale of animals to take place under the supervision of Veterinary Inspectors. (7) The Congress considering that food is a powerful weapon in the struggle against transmissible diseases, is of opinion that every movement, having for its object the study and popularisation of all the means tending to improve the food supply of man and animals, should be officially supported. (8) That the Commission appointed at the Vienna Congress in 1887 for the study of international measures to be taken against the falsification of food stuffs should prepare for the next Congress a new Report on the legislation in existence, and the supervision exercised in different countries. (9) The Congress, impressed with the importance of the role played by micro-organisms in general hygiene, and more particularly in the hygiene of food, desires to see organised the teaching of the elements of bacteriology in the faculties of science on the same footing as physics, chemistry, botany, &c. 21 meteorology at Greenwich, and death rates recorded in London and the City respectively for each year from 1894 to 1903. Year 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 Registered Sunshine in Hours. 1052 1225 1016 1540 1415 1708 1506 1567 1236 Returns not yet published. Mean Temperature 49.9 49º.3 50º.1 50°.3 51º.3 50º.6 50°.4 49º.2 48°.8 Degree of humidity Saturation=100. 81 78 79 79 78 77 79 78 80 Rainfall in inches 26.9 19.7 22.4 22.1 18.9 22.3 22.3 20.3 19.5 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 11.51 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 15.6 City of London 17.2 18.3 17.8 19.3 16.3 18.5 19.4 16.6 16.4 12.0 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 1903, and information as to the removal of patients to hospitals, &c.:— NATURE OF 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. Not City cases. Small-pox — — — — — — — — Diphtheria 30 — 17 3 4 3 2 1 Membranous Croup — — — — — — — Scarlet Fever 79 2 61 7 — 5 2 2 Typhus „ — — — - — — — — Enteric „ 15 — 11 — 2 1 — 1 Continued „ — — — — — — — — Relapsing „ — — — — — — — - Puerperal „ 1 1 — — — — — — Cholera — — — — — — — — Erysipelas - 7 — — 2 1 — 1 Totals 136 10 89 10 8 10 4 5 Chicken-pox 59 57 - — - 2 — — Phthisis 4 4 — — - — — - It will be seen from the above that during the year, excluding Chicken-pox and Phthisis, 131 Certificates were received, including 10 "duplicates," and 4 in which the diagnosis was subsequently found to be incorrect. The total number of cases of " dangerous infectious disease " was therefore 117. 22 Table C shows that of the 117 cases of notifiable infectious disease occurring, exclusive of Chicken-pox and Phthisis, 91.5 per cent. were removed to hospital for treatment, the remaining 8.5 per cent. being nursed at their own homes. Removed to Hospital. Treated at Home. Per cent. Per cent. Scarlet Fever 97.2 2.8 Diphtheria 100.0 - Enteric Fever 100.0 - Erysipelas 22.3 77.7 Excluding Erysipelas from the above, 99 per cent. went to hospital, against 7 7.5, 73.6, 79.1, 87.1 and 85.9 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 1903, 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. 1898 158 79.1 20.9 1899 235 60.5 39.5 1900 196 79.1 20.9 1901 214 82.2 17.8 1902 245 77.9 22.1 Average for previous five years. 209 75.7 24.2 1903 117 91.5 8.5 The mortality per cent. of those attacked with Diphtheria, Scarlet Fever and Enteric Fever was 9.1, 1.4 and 18.2 respectively. All these were treated at hospital with the exception of two cases of Scarlet Fever, both of whom recovered. Recovered. Died. Total. Case mortality per cent. Diphtheria. 22 2 24 9.1 Scarlet Fever 69 1 70 1.4 Enteric Fever 11 2 18 18.2 Puerperal Fever 1 - 1 - Erysipelas 9 - 9- Chicken-pox 57 - 57- Phthisis 4? - 4 - 173 5 178 23 Cases of Infectious Disease notified during- the Year 1903. 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. St .Sepulchre. Under 1. 1 to 5. 5 to 15. 15 to 25. 26 to 65. 65 and upwards. Small-pox - - - - - - - - - - - - - Diphtheria 24 — 10 8 4 2 — 11 8 5 11 8 5 Membranous Croup — — — — — — — — — — — — — Scarlet Fever 70 — 22 37 8 3 — 43 14 13 41 41 13 Typhus — — — — — — — — — — — — — Enteric „ 13 — 1 4 4 4 - 4 5 4 4 5 4 Continued „ - - - - - - - - - - - - - Relapsing „ - - - - - - - - - - - - - Puerperal ,, 1 — — — — 1 — 1 — — — — — Cholera — — — — — — — — — — — — Erysipelas 9 — — 1 1 7 — 4 3 2 1 — 1 Totals 117 — 33 50 17 17 — 63 30 24 57 27 23 Chicken-pox 57 3 20 29 4 1 — 24 12 21 — — Phthisis 4 — — — 1 2 1 - - 4 — — — This Table is prepared in accordance with the requisitions of the Local Government Board. SHELTER FOR TEMPORARY ACCOMMODATION DURING DISINFECTION. The Shelter in Golden Lane, Barbican, provided in accordance with Sec. 60 (4) of the Public Health (London) Act, 1891, which enacts that "sanitary "authorities shall provide free of charge temporary shelter or house "accommodation with necessary attendants for the members of any family "in which any dangerous infectious disease has appeared, for the purpose of "enabling such dwellings to be disinfected by the sanitary authority," has been visited by 11 families during the year. They numbered 39 persons, of which 16 were adults and 23 were children, and who were housed during the disinfection of the houses after— Scarlet Fever - 8 families Diphtheria 2 ,, Enteric Fever 1 family 11 families One family came from a home consisting of four rooms, 4 of three rooms, 5 of two rooms, and 1 of one room. 24 ENTERIC FEVER AND INFECTED ARMY BLANKETS. On the 19th May, Mr. Hancock, the Acting Medical Officer of Health for the Port of London, reported that an outbreak of Enteric Fever had occurred on the "Cornwall" Training Ship, and that in the course of his investigations he had traced the source of infection to condemned army blankets returned from South Africa. These blankets were found to be in a filthy condition, and were soiled with blood and excrement. They were submitted to Professor Klein, who reported that they were stained with faecal matter and urine and contained innumerable typhoid bacilli. Mr. Hancock had further ascertained that the blankets had been purchased through two City firms. Their premises were at once visited, and all the blankets then remaining seized and removed to the City Mortuary. The quantities of blankets thus dealt with were in the one case 140 and in the other 280. Further enquiry showed that these goods had been supplied from a firm in Whitechapel, who, there is reason to believe, obtained them from Hamburg, as at a meeting of the Cape Town Council, reported in a leading London daily paper on the 29th May, the Mayor is stated to have said that "he had ascertained from their own Medical Officer, as a result of his "enquiries, that 120,000 of the blankets bought in Cape Town were sent to "a representative of the purchaser in Hamburg. It had also been learned "that another firm bought a quantity of army blankets at Cape Town, which "were sold locally, principally at Maitland, where, no doubt, they were "purchased by natives." Examination of those seized in the City showed that they were in a filthy condition, full of dust and dirt, and that in many cases fæcal matter, bloodstains, portions of partly digested food, grease, &c., were apparent. Although nearly all the blankets inspected had been used, it was evident from their condition that none had been washed. This was obvious from the appearance of the "nap" and edges, and this was subsequently confirmed by the experts who handled them. These facts were immediately formally reported to the Director of Army Contracts, the Under-Secretary of State for War, and the Local Government Board. The Director of Army Contracts was further requested to undertake. that no further issue of such goods should be allowed. There still remained the serious question of those blankets which had been sold by the two City firms referred to above. From both I obtained a complete list of purchasers, to whom I at once sent a circular letter informing them that the goods must not be sold or used 25 without the sanction of the Medical Officer of Health of their district. To each Medical Officer of Health concerned I wrote a short résumé of the above facts. In cases where blankets had been sent to the Colonies and other places abroad, notice was given to the representatives of the respective Governments. Three days later I received a letter from the Under-Secretary of State for War, informing me that Mr. Brodrick was causing an immediate enquiry to be instituted into the circumstances attending the disposal of the blankets in question, and in a further letter dated the 25th May the Under-Secretary said :— "I am directed by the Secretary of State for War to explain "that the blankets in question appear to have been disposed of while in "South Africa, contrary to the Standing Regulations of this Department "and contrary to certain specific orders as to the disposal of textile "fabrics and kindred articles, which had been sent to the military "authorities with the object of avoiding the spread of infection. "Mr. Brodrick desires me to say that he very much regrets the "circumstances, which, primâ facie, appear to have been caused by the "disregard of both ordinary precautions and his special instructions, and "at the same time to convey his assurance that the investigation he has "promised will be alike thorough and complete. "Meantime he has directed instructions to be dispatched to South "Africa to cause any similar blankets that may still be in the hands of "local purchasers to be destroyed as infectious." On the 8th June, 1903, the Secretary of State for War made an official explanation in the House of Commons as to how these blankets were offered for sale to the public. Mr. Brodrick said,* in reply to a question by Sir Thomas Dewar:— "The General Officer Commanding South Africa reports that in "October last, owing to the rapid demobilisation of the troops, an "enormous stock of unwashed general service blankets, returned to "store by the troops on demobilisation, was stored at the Cape Town "Ordnance Stores, stacked in the open under tarpaulins. Efforts were "made to have these washed and properly stored, but meanwhile the "stacks took fire by spontaneous combustion and endangered the entire "Ordnance Dep6t. Prompt action became imperative, and the chief "ordnance officer gave instructions for large numbers of those in the "worst condition to be destroyed by fire, and accepted tenders for the "sale of 80,000, provided they were removed within three days. These "blankets were not unserviceable, though they had not been washed. * Hansard. 26 "The amount realised by the sale was £1,495. Medical Officers have, "under the regulations, power to destroy any articles of public property "on sanitary grounds, and are expressly ordered to disinfect all soiled "bedding which has been in contact with the sick. I am not prepared "to issue so wide an order as that suggested—that all textile fabrics "which have been used in the field should be disinfected before being "sold. As previously stated, the ordnance and medical regulations "contain clear instructions as to the disposal of condemned and infected "articles; and I also issued special orders forbidding the sale in South "Africa of any textile article which might cause infection. There "appears to have been an error of judgment on the part of the respon"sible officer, who has otherwise done excellent service. The military "authorities are investigating the matter." Again, on the 19th June, 1903, Mr. Brodrick said, in reply to a further question on the subject by the same Member:— "There are at Woolwich 20,000 blankets which have been handed "over from transports coming home. These were washed before being "handed over by the Admiralty, but, as an additional precaution, they "are being disinfected. It is not known whether any of these blankets "were used in the field, nor can any date of despatch from South Africa "be specified, as they were only taken over by the War Department in "bulk." As a result of the action taken in the City it was found that about 20,000 of these blankets had been sold to 338 customers, distributed over 207 towns in the United Kingdom and 19 Metropolitan Boroughs. This involved a correspondence with 224 Medical Officers of Health, from which 212 replies were received, stating what action they had taken in the matter. In 12 instances only was.no reply received. In the greater number of cases the blankets were traced and disinfected or destroyed by the Medical Officers of Health throughout the country. Sixty-nine firms in London and the Provinces returned 3,192 blankets to the City dealers who had supplied them with the goods. These were cleansed and returned to the owners disinfected, the expense incurred in washing them being subsequently repaid to the Corporation by the War Office. The generally dangerous character of these blankets was shown by the results of bacteriological examinations furnished to me by the undermentioned Medical Officers of Health— Dr. Herbert Williams, Medical Officer of Health, Port of London. 18th May, 1903. "Of these blankets fully 75 per cent. showed some kind of patches of dirt and "large and small discoloured stains. 27 "A bacterioscopic analysis was made of some of the dirt, as also of some of the stains, with the following result:— "(a.) Some of the dirt was paint. "(b.) Some of it was dried farinaceous material, probably arrowroot. "(c.) Some of it was distinctly fæcal matter, since in culture it yielded "abundance of bacillus coli and bacillus enteritidis sporogenes. "(d.) Some of the stains looked like old stains of urine. Chemical test for "chlorides and for ammonia fully confirmed the surmise. Bacterioscopic analysis "of such stain, with the view of discovering the presence of the bacillus typhosus "(knowing that the urine of typhoid patients in the later stages contains this "microbe, sometimes in great numbers), yielded highly important results, viz., "the cultures contained great abundance of colonies which in aspect and '' constitution corresponded to the colonies of bacillus typhosus. "Agglutination test was made, subjecting an emulsion of some of the above "suspected colonies to the influence of blood serum of a typhoid immunised rabbit. "One part of this blood serum added to forty parts of the emulsion of the suspected "bacilli caused striking and complete agglutination in ten to twenty minutes. "I have made all necessary sub-cultures in order to definitely decide the nature "of the above colonies, but from the strikingly characteristic aspect of the colonies "and from the decided nature of the agglutination, I think it extremely probable "that we are dealing with the real bacillus typhosus. "May 19 th, 1903. "In continuation of yesterday's report I have to state that all further tests made "with the bacillus, which was considered yesterday as highly probable to be bacillus "typhosus, proved the microbe to be the true bacillus typhosus. I do not remember "whether I mentioned it, but I do so now, viz., that two to three drops of the fluid "emulsion of the stain on the blanket that we examined yielded innumerable "colonies of the bacillus typhosus. "E. Klein." Dr. John T. Wilson, Medical Officer of Health, County of Lanark, found it easy to isolate very active bacilli which respond to the tests for bacillus coli. Dr. G. H. Fosbroke, Medical Officer of Health, County of Worcester, reports that their County Bacteriologist examined them with a negative result. Dr. H. Meredith Richards, Medical Officer of Health, Croydon. (1.) They contained large quantities of the typical fine brick-red dust of South Africa. (2.) Patches of mud, dung (cow and horse), cart and candle grease and dried food. (3.) Some contained particles of straw, hay and South African pricle grass. Bacteriological examination showed the presence of the bacillus subtilis, bacillus of the proteus group and bacilli of the coli group. Bacillus typhosus was not detected. 28 Dr. E. Seaton, Medical Officer of Health, County of Surrey. The following micro-organisms were found:— 1. Several moulds. 2. Numerous spore-bearing bacilli. 3. A few colonies of streptococci, staphylococci, sarcinæ and proteus vulgaris. 4. A few bacilli morphologically resembling the bacillus coli communis. Lord Milner, Governor of the Transvaal, writing on the subject of the consignment of infected army blankets to Pretoria, says:— "Bacteriological examination, to which a number of blankets were subjected, has "failed to disclose the presence in them of any of the recognised faecal bacteria, "though they were stained with starchy patches, probably due to vomited matter. "All the blankets have now been destroyed." Chas. Powell White, M.D. The following extract from a letter received from the Medical Officer of Health of a northern county town illustrated the condition of some of these blankets when received by purchasers in the country:— "Those obtained by the-Blind Schools were handed over to me by them "to be destroyed, for they were all more or less soiled. Fortunately they had not "been brought into use, but had been reserved for possible camp use during the "summer. Two or three were suspicious of excremental soiling ... We "offered to steam disinfect them, but their condition was so repulsive that the " Superintendent preferred to have them destroyed. The other batch of blankets " had been sold to the-Asylum in the Rural District. I passed your "communication on to the Medical Officer of Health of that District. I believe "he found that the blankets had only been recently obtained, and when opened up "had been found so filthy that they were at once destroyed. "I myself saw blankets exhibiting unmistakable signs of hospital use. The "very food—arrowroot-used by patients being identified." In another case the Medical Officer of Health for one of the home counties found marks of faeces and sago stains. It was further ascertained that in many instances dealers in the country who purchased from sample declined to accept delivery when the goods arrived, owing to their disgusting condition. The Medical Officer of Health for a town in Kent wrote: "I have recovered "them all, except one, which had been sold and cannot be traced. The rest " I have had burnt, many of them being in a filthy condition.'' It should be mentioned, on the other hand, that in numerous instances the goods when unpacked were found to be perfectly new, and had evidently never been used, showing that the consignment was a mixed one. 29 At the request of the Principal Medical Officer I furnished the Local Government Board with a list of the Medical Officers of Health (and their districts) with whom I had communicated in regard to blankets that had already been distributed, it being necessary that the Board should ascertain if the notice given by your Medical Officer of Health had been followed up. For similar reasons lists of those Metropolitan Districts to which blankets had been consigned were sent to the Medical Officer of Health for the London County Council. A large quantity of these goods had been bought by the Managers of Institutions, Convents, Industrial Homes, &c., who were, no doubt, attracted by the low prices they were offered at. It was a fortunate circumstance that most of such purchasers had hitherto held them in reserve, and had not issued them for use to those under their charge, otherwise outbreaks of Enteric Fever, such as occurred on the "Cornwall" Training Ship in the Thames would, in all probability, have been repeated all over the country. This enquiry established the important fact that the bacillus typhosus can retain activity in infected articles for so long a period as six months; the most lengthy case of similar persistent infection previously recorded not having exceeded three months. Throughout this investigation it was my desire to avoid, as far as possible, giving publicity to the names of the different towns to which these blankets were distributed, and thus possibly injuriously affect, at that early part of the season, their several claims to attraction as holiday resorts. It was regrettable, therefore, to find that some journalists had apparently no such scruples, and columns of the Press were filled with the fullest details procured by their agents scattered throughout the kingdom. This, however, may not have been without advantage to the public welfare, as attention was so forcibly directed to the matter that, in all likelihood, we shall never again experience a repetition of such a wholesale dissemination of filthy, and, in some cases, infected articles. ENTERIC FEVER AND SHELLFISH. During 1903, nine instances were brought to my notice where Enteric Fever was attributed to the consumption of shellfish sold in the City. Of these, oysters were the vehicle in five cases, and mussels in the other four. It will be observed that with the exception of the case reported in June all the others occurred during the last three months of the year, six of these being in December. 30 These are summarised in the accompanying Table. Cases reported during 1903. Date when reported. By whom notified. Shellfish implicated. Source of origin. 1903. June 18 Medical Officer of Heath, Southend. Oysters French ; taken from Pegfleet and relaid in South Deep. Oct. 5 Medical Officer of Health, Paddington. Mussels Hadleigh Ray, Leigh-on-Sea. „ 6 Medical Officer of Health, Wandsworth. Oysters Whitstable. Dec. 2 Medical Officer of Health, Hastings. Do. "Gann's Princesses," Whitstable. „ 12 Medical Officer of Health, Wandsworth. Do. Ditto. „ 17 Medical Officer of Health, Wandsworth. Do. Selected Natives from Whitstable. „ 28 Medical Officer of Health, Wandsworth. Mussels Hadleigh Ray, Leigh-on-Sea. „ 31 Medical Officer of Health, Wandsworth (2 cases, 1 fatal). Do. Ditto. Samples from the several suspected sources were taken and submitted for bacteriological examination, and in every instance they were found to be sewagecontaminated. Details of these cases will be found under the respective headings, "Oysters" " Mussels " and " Cockles," in the following pages. OYSTERS. Last year I submitted the results of the bacteriological examination of 18 samples of oysters sent to me by the Fishmongers' Company for examination. Of these, 12, or nearly 67 per cent., were found to be polluted. My Department was not again actively engaged on this subject of oyster pollution until the 18th June last, when I received information from the Medical Officer of Health for Southend that a case of Typhoid Fever had been notified to him in which the patient had eaten oysters procured from Max Ullman, Merchant, Fish Street Hill. One of your Officers immediately visited the premises and purchased one dozen natives, which were submitted to Professor Klein for examination, the result being that they were found to be polluted. Your Medical Officer then visited the premises and directed the seizure of two sacks of oysters from the same source, viz., South Deep, that had just been delivered at the shop. 31 The owner of these oysters said that they were French, taken from Pegfleet about one month before and relaid in South Deep in a pit divided into four divisions that was left dry at low water only. On the 23rd June an application was made at the Mansion House for an order for the destruction and condemnation of these oysters on the ground that they were unwholesome, having been taken from a sewage-polluted source. The Magistrate, Mr. Alderman Burnett, directed the adjournment of the application pending bacteriological examination of the oysters before the Court, as the place of origin was disputed by the owner. Duplicate samples were therefore taken from the two sacks on behalf of both the owner and the Corporation and forwarded to Professor Klein. At the adjourned hearing on the 25th, Dr. Klein's reports were put forward. These showed that all four samples were sewage-polluted. There being no question, therefore, as to their contamination, the Alderman condemned them, and made an order for their destruction, which was accordingly carried into effect. On the 6th October the Medical Officer of Health for Wandsworth informed me that a case of Enteric Fever had been notified to him from Fulham, in which the patient had eaten oysters purchased from a local fishmonger, who obtained his supplies from a large dealer in Monument Street. Enquiries showed that the oysters sold by this firm were from layings that examination had shown to be free from pollution in January and February last, it was therefore not considered necessary at the time to make any further investigation or analysis. On the 2nd December, however, an outbreak of illness in a family at Hastings (one of whom was attacked with Enteric Fever) was attributed to oysters obtained from the same dealer as the one referred to above in the case reported from Wandsworth on the 6th October. Five samples, marked la, 2a, 3a, 4a, and 5a, were purchased from him on the 3rd December, with results as stated in the accompanying Table. On the 13th December the Medical Officer of Health for Wandsworth reported another case of Enteric Fever in his District, in which the patient had purchased oysters from a local fishmonger, who procured his supplies from a dealer named Charles Wood, 2, Billingsgate Buildings, E.C. A sample of oysters, marked 6a, stated to be the same kind as those supplied to the above-mentioned local dealer, were purchased from Mr. Charles Wood on the 14th December. These oysters are known as "Gann's Princesses," and come from the " Pollard " bed at Whitstable. 32 This sample was submitted to Dr. Klein for examination, who, on the 17th December, reported:— "I consider these oysters distinctly sewage-polluted, and unsafe for consumption." On the 18th December a further case of Enteric Fever, in which oysters were implicated, was reported by the Medical Officer of Health for Wandsworth, and here again the local fishmonger obtained his supplies from C. Wood, of Billingsgate. Another sample (11a) of "Gann's Princesses" was therefore taken at Mr. Wood's shop on the 18th December and submitted to Dr. Klein, who reported on the 21st December that they were " decidedly polluted." On the 22nd December an Inspector was instructed to purchase 100 "Gann's Princesses" at Charles Wood's, who stated he had none in stock at the time, and referred him to Gann's shop, 11, Lower Thames Street, E.C., where 100 of these oysters were seized on the ground that they were unwholesome. The oysters in question were taken to the Mansion House, and application made to the Lord Mayor for a Condemnation Order under the provisions of Section 47 of the Public Health (London) Act, 1891. The Lord Mayor adjourned the case to the 28th December to enable Dr. Klein to make an examination of a sample (13a) of the 100 oysters then before the Court. At the further hearing on the 28th December, the result of Dr. Klein's analysis to the following effect was put in by your Medical Officer of Health:— " December 24th, 1903. "Re SAMPLE OF OYSTERS 13a, 'GANN'S PRINCESSES.' "The analysis made shows that of twelve oysters eight have bacillus coli communis "in numbers. "This proves that these oysters are decidedly sewage-polluted, to the amount of "over 60 per cent., and therefore I consider them not safe for human consumption. (Signed) "E. KLEIN." Counsel for the Defendants did not attempt to contest the fact of sewage pollution, and gave an undertaking that "Gann's Princesses" would be at once withdrawn and not again offered for sale. The Lord Mayor made the usual Order for condemnation under the Public Health (London) Act of the 100 oysters seized on the 22nd December. An undertaking has since been received from the chairman of the Company that they will discontinue the sale of any oysters (including "natives") from the "Pollard" layings at Whitstable during the remainder of the season, and sell only off the "Ham" ground. This latter is in deep water, some miles from the shore, and apparently free from pollution. 33 Examination of Oysters submitted by the Corporation of London to Dr. Klein, 1903. No. of Sample. Date when procured. Whence procured. Source of origin. Dr. Klein's Report. la 1903. 3rd Dec. Monument Street Large American (Blue Points) not re-laid. Three oysters contained bacillus coli communis in numbers. One oyster contained some bacillus coli. The Drigalski plate made with three drops of the liquor and juice showed four colonies of the appearance of bacillus typhosus. Tested for agglutination with typhoid serum, clumping was distinct and decisive. The colonies consist of bacilli, which, in respect of size and mobility, resembled bacillus typhosus. Gelatine subcultures produced growth, which resembled that of bacillus typhosus. Subsequent experiments showed that in morphological and cultural respects, and in respect of agglutination with typhoid serum, no difference can be detected between the microbes of further cultivations and the bacillus typhosus. 2a Do. Do. South American not re-laid. Of nine oysters two contained bacillus coli of some sort fairly abundant. No colonies in Drisalski medium resembling bacillus typhosus. 3a Do. Do. Small Dutch not re-laid. Of nine oysters three had bacillus coli communis in numbers. Two other oysters had some other kind of bacillus coli. The Drigalski plate made with three drops of juice and liquor showed four colonies of the type and aspect of bacillus typhosus, but on subculture it was found that none of them could be considered as those of bacillus typhosus. 4a Do. Do. Burnham Of nine oysters two bad bacillus coli communis. Drigalski plate negative qua typhoid-like colonies. 5a Do. Do. (Supplied to Peckham Fishmonger—Implicated in Hastings case.) Whitstable Princesses. Of nine oysters four had bacillus coli communis in numbers. One other oyster had some other kind of bacillus coli. Drigalski plate made with three drops had one typhoid-like colony, but on subculture had to be discarded as bacillus typhosus, as it gave no reaction of agglutination with typhoid serum. 6a 14th Dec. Billingsgate Buildings (Supplied to Putney Fishmonger— Implicated in case of Charles Wheeler, Putney. Reported from Wandsworth.) Whitstable, known as "Gann's Princesses." Four of twelve contained bacillus coli communis in numbers. One other oyster contains some other kind of bacillus coli. Of four oysters specially examined two have streptococci. Of four oysters specially examined two have spores of enteritidis sporogenes. I consider these distinctly sewage-polluted, and unsafe for consumption. 7a 17th Dec. Monument Street Burnham Of eight examined none had bacillus coli communis. One of the eight had some kind of bacillus coli in small numbers, i.e., an acid and gas-producing organism. 34 No. of Sample. Date when procured. Whence procured. Source of origin. Dr. Klein's Report. 8a 1903. 17th Dec. Monument Street Whitstable, " Gann's Princesses." Five of eight contained bacillus coli communis in numbers. The three others had some other kind of bacillus coli. 9a Do. Do. Small Dutch from Yerseke. Two of eight contained bacillus coli communis in numbers. Three others contained some other kind of bacillus coli. 10a 18th Dec. Billingsgate Dutch oysters from Bruinisse. Taken on delivery from barrel marked "Z." Of eight oysters two contained bacillus coli communis in numbers. One or two others have some other kind of bacillus coli. Sample is moderately polluted. 11a Do. Billingsgate Buildings Whitstable, "Gann's Princesses." Of eight oysters five have bacillus coli communis in numbers. One other has some other kind of bacillus coli. Sample is decidedly polluted. 12a Do. Do. (Sapplied to Balham Fishmonger—Implicated in case of Clara Levy. Reported from Wandsworth.) Selected natives from Whitstable supplied by Gann. Of eight oysters one has bacillus coli communis in numbers. Two others have some other kind of bacillus coli. Sample is slightly polluted. 13a 22nd Dec. Lower Thames Street (Examined by order of the Lord Mayor, 22nd Dec., 1903.) Whitstable, ''Gann's Princesses," Pollard Bed. Of twelve oysters eight have bacillus coli communis in numbers. This proves that these oysters are decidedly sewage-polluted, to the amount of over 60 per cent., and therefore I consider them not safe for human consumption. MUSSELS. In my Report last year upon Shellfish pollution, cockles and oysters only were dealt with. This year my attention has been called to mussels, as on the 7th October last a case of Enteric Fever was notified from Paddington as having in all probability been caused by mussels sold in Billingsgate Market. Upon enquiry it was found that these mussels came from Hadleigh Ray, and had been purchased from a dealer at Leigh-on-Sea, which laying had been known for some time past to be sewage-polluted to a serious extent. On the 10th October, two samples of mussels were purchased in the City, one of Dutch mussels from Brouwershaven, South Holland, and the other, taken from Hadleigh Ray, from a shellfish dealer in Monument Street. Bacteriological examination of these showed that both were seriously polluted with sewage. These facts were brought to the notice of the Fishmongers' Company. 35 Further samples, marked 3, 4, 5, 6, 7 and 8, were procured on the 9th December, and one other, marked 9, on the 15th December. These were examined by Professor Klein, with results as shown in the Table appended. It will be seen that all seven samples were polluted, and that six of them came from South Holland. As the result of enquiries it was ascertained that the dealers sold these mussels in accordance with instructions received from the Fishmongers' Company, viz., to caution purchasers to boil them for three-and-a-half minutes,* and that a notice was exhibited to this effect. The Company were at once informed that this was obviously a most unsatisfactory mode of dealing with the matter. The mussels are known to be sewage-contaminated, and therefore dangerous to health, and under no circumstances can there be any sufficient guarantee that the recommendation would be properly carried out. It is well known that these shellfish are bought by costermongers and other small dealers who have no appliances for efficient cooking. As these shellfish are largely imported from Holland at this season of the year, these facts were brought to the notice of the Board of Agriculture and Fisheries, the Medical Department of the Local Government Board, the representative of the Netherlands Government in this country and the Fishmongers' Company. On the 28th December one case, and on the 31st December two other cases, of Enteric Fever attributed to mussels purchased in the City, were reported by the Medical Officer of Health for Wandsworth. The mussels in each instance came from layings in Hadleigh Ray, Leigh-on-Sea, Essex. A sample of mussels (No. 11) from this source was purchased on the 2nd January and submitted to Professor Klein. As these were found to be polluted, the dealers were informed that if they continued to send them to our markets proceedings for condemnation would be taken under the Public Health (London) Act, 1891. Your Medical Officer of Health has, however, now received written undertakings from the two proprietors of these layings; in the one case not to expose Hadleigh mussels for sale without giving him due notice of their intention to do so, and in the other not to have any more up until your Medical Officer of Health considers them free from contamination. No further action, therefore, was necessary. In the case of the polluted Dutch mussels, the Fishmongers' Company are co-operating with the Netherlands Government with a view to a thorough investigation being made of the conditions under which they are cultivated and exported to this country. * Some of the merchants advise their customers to boil mussels for four minutes. 36 Examination of Mussels by Dr. Klein on behalf of the Corporation. No. of Sample. Date when procured. Whence procured. Source of origin. Dr. Klein's Report. No. 1 1903. 10th Oct. Billingsgate Brouwershaven, South Holland. All had bacillus coli communis in abundance. Four had streptococci; one had bacillus enteritidis sporogenes. No. 2 Do. Monument Street Hadleigh Ray All had bacillus coli communis in abundance. Three had streptococci; one had bacillus enteritidis sporogenes. No. 3 9th Dec. Billingsgate Market Bruinisse, South Holland. Three of eight had bacillus coli communis in numbers. Two others had some other kind of bacillus coli. No. 4 Do. Do. Do. One of eight had bacillus coli communis in numbers; one other had bacillus coli in small numbers. No. 5 Do. Do. Brouwershaven, South Holland. Two of eight had bacillus coli communis : one in numbers, one less so. No. 6 Do. Monument Street. Hadleigh Bay . One of eight had bacillus coli communis in small numbers. No. 7 Do. Lower Thames Street Bruinisse, South Holland. Three of eight had bacillus coli communis. No. 8 Do. Do. Do. Five of eight had bacillus coli communis in numbers. One other had some other kind of bacillus coli. No. 9 15th Dec. Billingsgate Do. Eight were examined with the following result:—Seven had bacillus coli communis in numbers. Two of four specially examined had the spores of enteritidis sporogenes. I consider these distinctly sewagepolluted. No. 10 21st Dec. Monument Street Do. Of eight mussels examined one had bacillus coli communis in small numbers. One other had some other kind of bacillus coli. None have the spores of bacillus enteritidis. One of four specially examined has streptococci. From this, I think the mussels of fair quality, considering that mussels, as a rule, are dirty feeders. No. 11 1904. 2nd Jan. Do. (Implicated in 3 cases reported from Wandsworth. Hadleigh Ray Of eight mussels examined four contained bacillus coli communis in numbers. All contain spores of bacillus enteritidis sporogenes. These mussels are dirty inside and outside. 37 COCKLES. In December, 1902, in consequence of some cases of Enteric Fever in Wandsworth having occurred that were attributed to the consumption of cockles from Leigh-on-Sea purchased in Billingsgate Market, I reported fully upon, the dangerous nature of this shellfish as sold under the existing conditions. The Fishmongers' Company endeavoured to meet the case by compelling the discontinuance of the practice of laying cockles in the sewage-polluted water of Leigh Creek, and the exercise of greater care in their preparation, so as to assure more perfect cooking. In my last Annual Report I referred to the unsatisfactory nature of these measures, and pointed out the impossibility of ensuring that they would be carried out in practice. In June last, fresh cases of Enteric Fever having been reported as traceable to shellfish, further samples of Leigh cockles were purchased at Billingsgate and submitted to Professor Klein for analysis. These samples, four in number, all showed evidence of sewage-pollution, and that in the process of cooking the temperature had not been high enough to ensure devitalisation of sewage bacilli, thus clearly showing the impossibility of relying upon any arrangement with irresponsible fishermen to carry out precautions necessary to protect the public health. These facts were brought to the notice of the Fishmongers' Company, who informed me on the 11th June last that on the previous Saturday they had seized no less than 70 gallons of cockles in Billingsgate Market, which they had reason to believe had been relaid in Leigh Creek. In the following October, on learning from correspondence and the Report of the Medical Officer of Health for the Port of London that the Leigh cocklers still failed to carry out their undertaking as to the deposit and cooking of cockles, three samples were again taken. On these Professor Klein reported on the 12th October that they were all polluted with sewage, one to a dangerous extent. This showed that the cooking of them must have been very superficial, since they all contained abundance of non-sporing microbes (bacillus coli and streptococci), which are killed by a temperature of 165° F.—i.e., far below the temperature of boiling water. A copy of this Report, together with a letter calling attention to the serious condition of affairs, was immediately sent to the Fishmongers' Company, 38 from whom I received the following copy of a circular letter addressed to the Leigh cocklers:— "Fishmongers' Hall, "London, E.C., "October 14th, 1903. "Sir, "On Saturday last three samples of cockles from Leigh were "taken at Billingsgate Market by one of the officers of the Medical "Officer of Health of the City of London, and submitted for analysis to "Professor Klein, who has reported that the cockles could not have been "cooked properly, as most of them were semi-raw inside, and that they "were so polluted with sewage that they were unsafe for human con"sumption. "The Fishmongers' Company, in the interest of the cockle industry, "have endeavoured throughout to suggest means by which the trade in "cockles might with safety to the public be maintained; and the con"tinued assurances of the Leigh cocklers at Billingsgate Market that "their cockles had not been relaid in Leigh Creek and had been boiled "the time indicated as necessary by the Fishmongers' Company have "been accepted, and the sale of the cockles hitherto allowed. "The Fishmongers' Company very much regret that they are now "compelled to inform you, in common with all Leigh cocklers, that in "view of Professor Klein's report, the sale of cockles from Leigh will be "from this date absolutely prohibited in the London markets. "Yours faithfully, "(Signed) J. WRENCH TOWSE." With a view to ensuring the supply of uncontaminated cockles, a person established a cockling business at Southend, his intention being to procure cockles from the mother beds at West Shoebury, and cook them at Southend without relaying. A sample of these cockles was purchased at Billingsgate Market on the 19th October, and the bacteriological examination of them showed that they were distinctly sewage-polluted, and that obviously the cooking had been inefficient. This result is only what might have been expected, as on the 27th January, 1902, I reported that " the result of Professor Klein's experiments clearly "points to extensive pollution of the whole estuary of the River Thames and "the consequent contamination of such shellfish and fish as are found "therein." These facts were also brought to the notice of the Fishmongers' Company, who at once prohibited the sale in London of cockles from this source. 39 In the course of the year a mass of evidence accumulated which clearly demonstrates the risk incurred by consumers of shellfish under existing conditions, owing to lack of legislation for effectively dealing with the subject. The evidence that Enteric Fever can be, and is, caused by eating sewagecontaminated shellfish is overwhelming. Indeed, in my own recent experience, the specific micro-organism of typhoid has been found both in cockles and mussels, while the bacillus coli communis and bacillus enteritidis sporogenes, indicative of sewage-pollution, have been present in almost every sample of shellfish examined during the year. The full significance of the presence of these bacilli in shellfish is clearly presented to the lay mind in a letter to the " Lancet," of the 9th May last, on this subject, by Dr. R. Tanner Hewlett, Professor of General Pathology and Bacteriology in King's College, London, who states:— "From my observations I have no hesitation, therefore, in concluding "that oysters uncontaminated with sewage do not normally contain the "colon or allied bacilli or the bacillus enteritidis sporogenes." Other investigators have arrived at similar conclusions, and it is not too much to sav that prompt and efficient legislation in the direction indicated in my last Annual Report is, from the sanitarian's point of view, one of the most pressing needs of the day. In my remarks on oysters on page 28 will be found particulars of a case where a magisterial order was made on the 25th June, 1903, for the condemnation and destruction of a quantity of oysters (1,600) seized in the City of London under Section 47 of the Public Health (London) Act, 1891. The oysters were seized on the ground that they were sewagecontaminated, this fact being proved by Dr. Klein's certificate to that effect. So far as I am aware, this is the first case where shellfish has been ordered to be destroyed on the evidence of bacteriological examination in police court proceedings under the Public Health (London) Act, 1891, although in the City unwholesome ice creams had been similarly dealt with. Although successful in this instance in stopping the sale of a dangerous article of food, yet it can be readily understood how impossible it would be to examine all samples of shellfish at every shop in the district. Even if a salesman were found dealing in shellfish from a source known to be polluted, a bacterioscopic analysis would have to be made in every case before Section 47 of the above-mentioned Act could be put into operation. It is true that when such cases are made the subject of police court proceedings, and a condemnation and destruction order made, the person to 40 whom the shellfish belongs is liable to fine or imprisonment, but it would be extremely difficult to prove guilty knowledge in cases of this kind. In December, 1903, Dr. A. Marcus Fraser, Medical Officer of Health for Portsmouth, in reporting an outbreak of Typhoid Fever caused by oysters, stated:— "It is a sorrowful confession, that in the present state of the law the "Sanitary Authority is almost helpless. The only steps we could take "was to warn the public not to eat the oysters." The oysters in this case came from a source (Emsworth) that had been known to be contaminated since 1894. Pending particular legislation for dealing with shellfish, there still remains in the hands of the Fishmongers' Company a powerful agent for the protection of the public, in London at least, on which, for the moment, they must rely, viz., their charter granted by James I., in 1604, under which they have power to seize unwholesome fish. Unfortunately, however, beyond causing the destruction of unsound fish, the Company has no punitive powers. In August last the following notice was issued by the Fishmongers' Company:— "OPENING OF THE OYSTER SEASON, 1903. "The Fishmongers' Company have for some time past had under "their serious consideration the condition of the Oyster industry and the "danger to Public Health arising from beds and layings existing in "waters liable to pollution. "Owing to the reports of the insanitary condition under which, in "some instances, oysters have been cultivated, they have fallen into "disfavour with the public, and the consumption very seriously "decreased. "This has thrown out of employment a large number of men and "vessels, and caused much distress as well as the loss of what should be "a useful and wholesome food supply. "The Fishmongers' Company have therefore inspected, and caused "samples of oysters to be taken from, many fisheries on different parts "of the Coast, whence oysters are sent to the London Market, and sub"mitted them for examination to their official Analyst, one of the leading "bacteriologists of this country. "As a result, certain beds, pits and layings were reported so far "contaminated as likely to be a source of danger to the Public Health. "These have now been closed; and no oysters from these places will "knowingly be allowed to be sold or placed on the Market for sale until 41 "they have been proved to be safe and wholesome, and their insanitary "surroundings satisfactorily remedied. "A Committee of Oyster Merchants, Planters and others interested in "the Trade has held frequent meetings at the Company's Hall, when the "conditions under which oysters have been cultivated and the remedies "to be applied to regain the confidence of the Public have been carefully "discussed. Those present pledged themselves to use every effort in "their power to ensure that none but healthy oysters from known "uncontaminated sources should be placed on the market for sale. "The Fishmongers' Company invite the Medical and Sanitary "Authorities in those districts in which oysters are grown or stored to "co-operate in protecting the Public Health by noting and reporting any "defects of drainage, &c., in the neighbourhood of beds, pits or layings "which may adversely affect their purity. "The Fishmongers' Company are always ready to afford such infor"mation and assistance as may be in their power to Local Bodies or "others whose object is to ensure the safety of the Public and the welfare "of an important branch of the Fishing Industry. "J. Wrench Towse, "Clerk of the Worshipful Company of Fishmongers, London. "Fishmongers' Hall, "London Bridge. "Scotch Office— "24, Charlotte Square, "Edinburgh. "August, 1903." The Company having sent me a copy of the above, I pointed out the desirability of publishing in conjunction with it a list of those oyster merchants who were willing to carry out its provisions in the conduct of their business. It would further be to the public interest if the Fishmongers' Company also published the results of the bacteriological examination of the samples, referred to in the notice, they have caused to be taken from the many fisheries in different parts of the coast. Nothing short of this, with the addition of the names of those merchants dealing in shellfish from sources of undoubted purity, will satisfy the public. At present, without such assurance, we may safely say the consumption of all shellfish must be regarded as attended with grave risk to the purchaser. 42 Subsequent events have, moreover, shown that, in some instances, the above-quoted resolution appeared in no way to affect the action of the signatories in taking steps to prevent the sale of sewage-contaminated shellfish. In January, 1903, the whole matter was referred to a Joint Committee of the Sanitary and Port Sanitary Committees, who, after careful consideration, resolved, inter alia, that:— "(1) A communication be addressed to the Local Government Board "identical with that agreed to by the Court on the 29th January, on "the recommendation of the Sanitary Committee, urging legislation on "the lines suggested in the Report of the Medical Officer of Health for "the protection of the public against danger arising from the consump"tion of unwholesome oysters and other shellfish. "(2) That, for reasons given in the Report, the Joint Committee be "dissolved, and the enquiry in regard to the pollution of the Thames "Estuary by sewage be continued by the Port of London Sanitary "Committee, leaving the Sanitary Committee to take such further action "as they may be advised under the City of London Sewers Act, the "Public Health (London) Act, 1891, &c., &c., to prevent the consump"tion of unwholesome oysters and other shellfish, both Committees "reporting from time to time to the Court as may be necessary." These resolutions were agreed to by the Court of Common Council on the 26th February, 1903. This Joint Committee was reconstituted on the 28th January, 1904, when your Medical Officer of Health's notes on the Fourth Report of the Royal Commission on Sewage Treatment and Disposal were considered. The following are the notes referred to:— POLLUTION OF TIDAL WATERS AND CONTAMINATION OF SHELLFISH. NOTES on the Fourth Report of the Royal Commission on Sewage Treatment and Disposal. The Fourth Report of the Royal Commission on Sewage Treatment and Disposal, dated 28th December, has recently been issued. It is of special interest at the present time, as it deals particularly with the contamination of shellfish in tidal waters by the discharge of sewage therein. 43 The Commissioners point out that this branch of their' enquiry was undertaken in consequence of the numerous communications the Local Government Board had received during the past two years from Local Authorities and Reports from Medical Officers of Health relative to outbreaks of Enteric Fever and other illness attributed to sewage-polluted shellfish. That there is a growing demand for legislation for dealing with this question is shown by the statement that, in addition to the Corporation of London, many of the Metropolitan Boroughs (including the City of Westminster), the London County Council, the Corporations of Brighton and Southampton, and the Rural District of Chelmsford advocate this course, and the Commissioners state that the evil is sufficiently grave to demand a remedy. As to the possibility of communication of disease through shellfish the Report states that experience has confirmed the view that at times the specific organisms of typhoid in a living condition might be conveyed by shellfish to the consumer and thus produce in him Enteric Fever. A. note is also made of the fact that the representatives of the shellfish industry do not seriously contend that this view is unsound. The extent of illness attributable to such cause is difficult to determine precisely, but a consideration of the whole of the evidence satisfied the Commission that a considerable number of Enteric Fever cases and other illnesses are due to sewage-polluted shellfish, also that, as before stated, " the evil is sufficiently grave to demand a remedy." The Report emphasises the fact that the Government admitted the need for legislative interference so long ago as 1899 by the introduction of the " Oyster Bill," referred to in my former Reports to the Committee. The remedial measures proposed are divided into three general classes:— 1. Purification of the sewage before its discharge into tidal waters. The Commission do not consider it possible to lay down by enactment any general rule for treatment of sewage effluent, but that careful and skilled examination must be made of the local condition in each case before determining the conditions under which its discharge into tidal waters would be permitted. 2. The seizure or destruction of unwholesome shellfish exposed for sale. They consider that the necessities of the case cannot be met by general enactment as to sewage treatment or as to seizure of unwholesome shellfish, but that "the remedy must be. sought in connection with the waters, "foreshores, pits, ponds and layings themselves." 44 3. The setting up of a competent authority to deal with all tidal waters, with power to control foreshores, to close dangerous beds, pits, ponds and layings, and in certain circumstances to require treatment of sewage. As to the remedy recommended, this is contained in paragraph 39, and is to the following effect:— "REMEDY RECOMMENDED : CONTROL OF WATERS AND PITS "PONDS, LAYINGS AND BEDS. "39. After carefully considering the whole of the evidence, together with "the results of our own investigations and local inquiries, we are strongly of "opinion that the only way in which this evil can be effectively dealt with is "by placing tidal waters under the jurisdiction of some competent authority, "and conferring on that authority power to prevent the taking of shellfish "for human consumption from any position in which they are liable to risk of "dangerous contamination, and to enforce restrictions as regards pollution, "and as regards waters, foreshores, pits, ponds, beds and layings in which "shellfish are fattened or stored, as and when required. "For this purpose the powers of the authority must be elastic. The case of "each river and estuary is a problem by itself, and it would not be practicable "to fix by enactment any standard or standards which would be generally "suitable to the widely different conditions of different cases. Moreover, "as the conditions are shifting in character, it is necessary to provide some "permanent machinery by which restrictions can be varied." The next section of the Report deals with the nature of the proposed controlling machinery. They advise that the necessary power of control for the pollution of tidal waters, and over waters, foreshores, pits, layings, &c., where shellfish is grown, fattened or stored, should be vested in the Rivers Board, subject to an appeal to the Central Authority, and that in the case of the Rivers Board having tidal waters under their jurisdiction, they think it advisable that the Fisheries Committee should be empowered to appoint one or more representatives. The definition of the " Rivers Board " will be found in the third Report of this Commission. They will be joint Committees of the County Councils, and will possess for the combined areas the same powers which the individual Councils might have exercised in their respective districts. The Rivers Board will thus have jurisdiction over practically the whole of the water-sheds—a most important consideration. It is proposed that the Central Authority should be a new department under the Local Government Board, and shall have the following permanent chief officers:— 1. An administrative head. 2. A bacteriologist with a special knowledge of bacteriology of sewage, trade effluent, and water supply. 45 3. A chemist having special knowledge of the chemistry of sewage, trade effluents and water supply. 4. An engineer having special knowledge of geology and water supply. It should also be provided with a laboratory. The Commission indicate the nature of the proposed legislation necessary to carry out their recommendations. They are comprised under the following headings:— 1. Survey of Districts. 2. Prohibition of areas, and registration of pits, ponds, beds, layings, &c. Under this heading it is proposed that all beds, layings, &c., should be registered, and the sale of shellfish from unregistered places declared illegal. The registration will depend upon the report of the inspecting officer of the Rivers Board, with right of appeal on the part of the owner or occupier of them. It also provides for any local authority having reason to consider that any registered bed, &c., whether within or without their district, is not free from liability to dangerous contamination, to be empowered to represent the matter to the Rivers Board. 3. Temporary closing of pits, layings, beds, &c. An important provision is suggested that makes it the duty of the Medical Officer of Health of any district concerned to report to the Rivers Board any circumstance, such as outbreak of infectious disease failure or alteration of sewage works, which he may consider to increase the liability of dangerous contamination of shellfish in the waters under jurisdiction of the Rivers Board. 4. Appeal to Central Authority. In all the foregoing cases provision shall be made for appeal to the Central Authority, whose decision shall be final. 5. Treatment of sewage in certain cases. Details are here given of the procedure that shall be followed in those cases where the sewage should be required to be treated before its discharge into tidal waters. It also provides for dealing with the discharge from private drains. 6. New Outfalls. The construction of a new sewage outfall or drain to be subject to the consent of the Rivers Board, with power of appeal to the Central Authority. 7. Divided Jurisdiction. At present the consent, of the Board of Trade is required for the construction of sewers or other work below high-water mark, and it is the 46 practice of the Board of Trade to ascertain the views of the Fisheries Committee before coming to a decision on applications for consent to construct sewage outfall. The Board of Trade have in several instances refused consent, on the representation of the Fisheries Committee, that such construction would damage shellfish in the neighbourhood, and it is now recommended that the Board of Trade discontinue the practice of consulting the Fisheries Committee in such cases, as both the Rivers Board and the Local Government Board will have skilled advice on these matters. FOREIGN SHELLFISH. In connection with foreign shellfish, an opinion is expressed that it would be sufficient precaution to require a guarantee on the part of each Government concerned that— "All oysters or other shellfish imported into this country for "human consumption have been procured from locations where they "were not liable to be contaminated by sewage or other objectionable "filth." It is also proposed that foreign Governments be requested to grant facilities for a representative of the British Central Authority to inspect layings, pits, &c., abroad from which shellfish are imported. (This latter suggestion is good as far as it goes, but it would be an additional security to the English consumer if authority to collect samples at such visits were also granted.) Failing such guarantee or permission, they advise that imported shellfish should be deposited, for not less than six weeks before being placed on the market, in registered layings or nonprohibited areas in this country. The bacteriological aspect of the question in its relation to sewagepolluted shellfish is discussed at some length, and the Commission conclude with the admission that they accept the very general view that "the results of bacteriological examinations must be interpreted in the "light of topographical observations." The publication of this Report has happily at length brought the whole subject of sewage-polluted shellfish to an issue, and the opinion so often expressed by your Medical Officer of Health that legislation is imperative is fully endorsed by the Commission. It further lays stress upon the importance of beginning with the question of shellfish, and leaving that of sewage to a later date, when more knowledge has been obtained as to the value of the different methods of dealing therewith. It is sufficiently obvious that the solution of the sewage question is one which is still a long way off, if, indeed, it is ever practically attainable. 47 If the remedial measures referred to in these notes are entered on the Statute Book, much, if not all, the evil due to polluted shellfish will cease to exist. They should therefore receive the active support of the Corporation, but with one reservation, however, viz.:— That the Authority for the Thames should be the Corporation of London as Port Sanitary Authority so far as their jurisdiction over the River now extends. There are many reasons why the Corporation should be the Authority within the limits of the Port:— (i.) The Corporation was practically the first Authority to raise the importance of protecting the public health from the danger of polluted shellfish. (ii.) The Corporation has already the staff of Medical Officers, Chemists, Bacteriologist and Inspectors, together with the requisite Launches and other appliances. (iii.) The work of the Port Sanitary Authority has, since 1873, been undertaken by the Corporation at very considerable expense entirely out of the City's Cash, and at 110 charge to the ratepayers. (iv.) So far back as 1897 the Corporation expressed their willingness to undertake at their own expense the duty of supervision of all shellfish, within the limits of the Port of London, if legal powers were granted for the purpose. 48 SMALL-POX. No cases of Small-pox occurred in the City in 1903; but during the year 48 "contacts" (persons who had been in the company of those suffering from Small-pox) employed in the City were reported from other districts. This resulted, upon the advice of your Medical Officer of Health, in the re-vaccination of 118 persons on premises where the other contacts were employed. The names and addresses of 46 employes who refused vaccination were communicated to the Medical Officer of Health of the several districts in which they resided. Eight workshops (in three premises) were disinfected at the request of the occupiers, and 27 articles of clothing from premises, where Small-pox had occurred, outside the City were disinfected. In the course of the year 1,508 persons were re-vaccinated by Public Vaccinators in the City. MEASLES. On the 20th January, 1903, the London County Council issued an order approved by the Local Government Board, which came into force on the 1st April following, declaring Measles to be a dangerous infectious disease within the limits of the Administrative County of London for the purposes of Sections 60, 61, 62, 63, 64, 65, 68, 69, 70, 72, 73 and 74 of the Public Health (London) Act, 1891. These Sections deal with disinfection, shelters, clothing, infected rubbish, letting of houses, wilful exposure, transmission of infected clothing, milk and fruit trade, use of public conveyances, burial of dead, removal of corpses, and use of hearses—but do not require notification or removal to Hospital. Although it was not quite clear that legal power existed for making such order, it was clearly advisable that such restrictions should be imposed in the case of a disease so extremely infectious, and which is directly and indirectly the cause of so many deaths among our infantile population. As a matter of fact, it should be noted that the precautions with regard to disinfection and removal of families to Shelter, &c., have been for many years practised within the City. MEASLES-CLOSURE OF ST. BOTOLPH'S INFANT SCHOOL, BISHOPSGATE STREET WITHIN. In June last I considered it advisable to recommend the closing of the above School, as, since the 4th May, 26 of the children had been attacked with Measles, 2 were then excluded on account of the disease in the same house, and 9 others were " suspected," a total of 45 out of 78 scholars on the roll. 49 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 St. Botolph's Infant School, " Bishopsgate Street Within, E.C. "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. Botolph "Infant School, situated in Bishopsgate Street Within, in the City of "London, for the period of twenty-one days from the date hereof, with a "view to preventing the spread of Measles, and the danger to health "likely to arise therefrom. "Given under our hands this 18th day of June, 1903, at the Offices "of the Public Health Department, Guildhall, E.C. "(Signed) R. W. EDWARDS, C.C., "Chairman, Sanitary Committee. " H. DIXON KIMBER, C.C." EPIDEMIC GRANT TO ELEMENTARY SCHOOLS. The Board of Education announced that after March 31st, 1903, they would discontinue the special epidemic grant which had hitherto been allowed to schools in compensation for loss of income in any particular year owing to the grant being payable on the diminished attendance while the expenditure on staff and maintenance remain unreduced. The Board gave as a reason for this action that the amounts paid on this head to individual schools had as a rule been inconsiderable, and also that administration difficulties had arisen in this connection. Your Medical Officer of Health reported to the Sanitary Committee on May 26th, 1903, that there was an important principle involved in this question, and that the change of policy was a bad one, inasmuch as the Government grant is awarded on a basis of number of attendances, and as the teachers are pecuniarily interested in the award it will now be in their interest to discountenance closure of schools or exclusion of children on account of infectious disease. The Committee endorsed this view, and recommended that representation be made to the Education Board with a view to obtaining their reconsideration of the alteration. This course, unfortunately, met with no success. The present "code," however, is provisional only pending the establishment of the new Education Authority, which it is to be hoped will be sufficiently well organised to deal with such a minor matter of administration. 50 GLANDERS. A warehouseman residing within the Borough of Stepney was admitted to the London Hospital on the 26th April, supposed to be suffering from Pleurisy, and afterwards from Pyæmia. Bacteriological examination proved that the disease was Glanders. As the man had been working up to the date of admission to hospital at a warehouse in the City, the facts were notified to your Medical Officer of Health. The Commissioner of Police and the City Veterinary Inspector were at once informed, and the horses of the carmen and others calling at the premises in question inspected, but no evidence could be obtained connecting the case with the City of London. PLAGUE NOTIFICATIONS. On the 30th July the Medical Officer of Health for the Port of London reported that the effects of a seaman who had died of Bubonic Fever on board the s.s. "Starling "had been landed at Brewer's Quay. These were at once removed, disinfected, and returned, and a certificate to that effect forwarded to the Mercantile Marine Office. On the 14th August the Right Hon. the Lord Mayor forwarded the original and a translation of a telegram received that morning from the Vienna Health Authorities, stating that three persons from a plague-infected district arriving at that city were on their way to this country, via Ostend, and that on arrival they would stay at a certain club in London. As the address given, however, could not be identified with any place in the City, the particulars were forwarded to the Medical Officer of Health of the metropolitan district in which the majority of small clubs used by foreigners are situated. Subsequent inquiries showed that these persons probably went to an hotel in the City of Westminster, and left there on the morning of the 17th August for an unknown destination. REMOVAL OF UNCERTIFIED PERSONS IN COMPANY WITH CERTIFIED SMALL-POX CASES. The Metropolitan Asylums Board wrote to draw attention to the fact that it occasionally happens that the healthy mother of a suckling infant who is certified to be suffering from Small-pox is removed with the infant to South Wharf and vice versd, and pointing out that the admission to the wharf of healthy persons is attended with danger of infection, and moreover causes 51 much inconvenience to the Ambulance Service. As the infants are always weaned at once, it is necessary to isolate the infected person for observation at the wharf for ten days or a fortnight. The Board are desirous that in cases of Small-pox the separation of the mother and suckling infant should take place at the home of the patient, and not at the wharf. Instructions were therefore given which will ensure, as far as possible, that mothers should be made aware of the practice above referred to, and every endeavour will be made to dissuade them from accompanying their children, or taking them with her to the wharf, as the case may be. MIDWIVES AND PUERPERAL FEVER. On the 1st August a case of Puerperal Septicæsmia was notified at a house in the Minories. It having been ascertained that the midwife attending the patient was a maternity nurse residing at Islington, the facts were at once reported to the Medical Officer of Health for that District, with a view to his taking such steps as he might consider necessary to prevent the spread of infection. This was the only case of the kind reported during the year. TUBERCULOSIS (Consumption). This subject, as in the two previous years, has received much attention, especially the education of the public as to the disgusting and dangerous practice of spitting. The cautionary Notices illustrated in my Annual Report for 1902, approved by the Sanitary Committee in November of that year, have been extensively circulated by means of a house-to-house distribution, and requests for additional copies are constantly received. The experiment was made in June last of having some of these Notices printed on metal, and they have been found exceedingly useful for exhibition in places exposed to the weather where cards quickly deteriorate. With a view to checking this nuisance amongst children, it was suggested that the School Board Authorities should instruct their teachers to warn their pupils of the danger of the practice, and thus check the mischief at its inception. The idea was a good one, and the School Management Committee of the Board had already had its attention called to the matter by a private individual. It appeared to me, however, that a more useful purpose would be served if the Corporation directed the attention of all governing bodies of schools in the City to the advisability of their taking active steps in the direction of checking the evil amongst scholars under their charge. It is unquestionable 52 that the habit is commonly acquired in early life, and if young offenders were punished for indulging in such a filthy practice it would be speedily discontinued, and it was not too much to expect that the hearty co-operation of all teachers would be secured in an endeavour to stamp out the evil. This suggestion was adopted and a circular letter to the above effect sent to all schools in the City. In replying to this circular, the Clerk to the School Board stated on the 10th November, 1903, that the Board purposed issuing a Notice in their Gazette advising teachers who give lessons in Hygiene that they would do well to impress upon their scholars the dangers of spitting in public places. As evidence of the growing interest taken by the public in the direction of the prevention of Tuberculosis, it should be mentioned that it is now a common thing to be requested by heads of firms, who have members of their staff suffering from Phthisis, to advise as to the proper precautionary measures that should be taken in the circumstances, and it is pleasing to note that in all cases they gladly act on the advice given. A circular letter issued by the Corporation on the subject of Tuberculosis in animals slaughtered for food will be found on page 112. In the course of the year every endeavour has been made to bring to the notice of the several railway companies whose system enters the City the beneficial results that would ensue if more general and systematic measures were taken in the cleansing and disinfection of railway stations, platforms, and carriages. Although we have not been entirely successful in inducing all the companies to adopt our suggestions, much has been done in this direction, and it is gratifying to note that many of them have gladly accepted our good offices in our efforts on behalf of the public health. Great advance has been made in the exhibition of Notices warning passengers of the danger from spitting in railway carriages, and on platforms, stations, &c. The majority of the companies have adopted this means of stamping out an admitted primary cause of much evil, and there is every reason to hope that they will in the near future be adopted by all railway companies. With regard to the important question as to the best mode of cleaning railway compartments, it may serve a useful purpose to refer to the perfect manner in which the work is performed by the vacuum system of cleansing. This method is adopted by the Great Eastern Railway Company and the City and South London Railway Company, and its more general employment would undoubtedly be a distinct advantage over the old and incomplete method with its attendant dangers to health. 53 The following is a summary of the measures in force by the different railway companies having stations in the City:— EAST DISTRICT. London, Tilbury and Southend Railway. Fenchurch Street Station. Platforms and approaches disinfected and swept four times daily. Spitting cards on platforms and approaches to ticket offices. They are not well placed and unlikely to attract attention. Spitting Notices are in all the London, Tilbury and Southend Railway Company's carriages; those belonging to the Great Eastern Railway Company will be supplied with Notices on return to yard for usual repairs. Carriages cleansed at Stratford, Ilfordand Woolwich. Note.—The Spitting Notices in the carriages of the London, Tilbury and Southend Railway Company are designed with excellent taste, and unlikely to give offence to the most fastidious. MIDDLE DISTRICT. South Eastern and Chatham Railway. Cannon Street Station. Carriages cleansed at Rotherhithe and Maize Hill. Wet sawdust is used when platforms are swept. Disinfectants used when fish is unloaded. Spitting Notices in station; none in railway carriages. Great Eastern Railway. Liverpool Street Station. Carriages cleansed at Stratford by vacuum cleanser. Platform swept and watered, but not disinfected. Spitting Notices exhibited both in stations and carriages. North London Railway. Broad Street Station. Carriages are swept and disinfected each trip, also at night. Platforms swept frequently. Disinfectants used during hot weather. No Spitting Notices. Midland Railway. Moorgate Street Station. Carriages cleansed at Kentish Town. Platform watered and swept when required. No disinfectant used. Spitting Notices on platform; none in carriages. Great Northern Railway. Moorgate Street Station. Carriages cleansed at King's Cross. Platforms swept and watered. No disinfectant used. Spitting Notices on platforms; none in carriages. 54 Central London Railway. Bank Station. Carriages are swept and disinfected each trip. Platforms swept and disinfected constantly. Spitting Notices in carriages, lifts and station. City and South London Railway. Bank Station. Carriages swept and cleansed by vacuum cleanser at Clapham. Platforms disinfected and swept twice daily at least. Spitting Notices in carriages, lifts and stations. City and Waterloo Railway. Bank Station. Carriages cleansed at Waterloo. Platforms watered and swept frequently. No disinfectant used. Spitting Notices in carriages and station. City and Finsbury Railway. Finsbury Pavement Station. Carriages are watered and disinfected, swept and dusted at Drayton Park. It is proposed to adopt the vacuum cleanser. Spitting Notices in all carriages. Platforms watered with disinfectant as often as necessary. WEST DISTRICT. Central London Railway. Post Office Station, Newgate Street. Carriages disinfected and swept each trip at Bank Station. Platforms, stairs, &c., disinfected and swept several times daily. Spitting Notices on platforms, and in lifts, carriages and booking hall. South Eastern and Chatham Railway. St. Paul's Station. Carriages swept at Holborn Viaduct Station. Platforms, stairs and booking hall swept once a day. Disinfectants used once a week. No Spitting Notices in carriages or station. South Eastern and Chatham Railway. Snow Hill, Ludgate Hill and Holborn Viaduct Stations. Carriages swept at Holborn Viaduct. No disinfectant used. Sprinkled with water before sweeping in summer months. Platforms, stairs and booking halls swept twice daily. No disinfectant used. Spitting Notices on platforms and booking hall at Snow Hill, on stairs and booking hall at Ludgate Hill, and in booking hall and waiting-room at Holborn Viaduct; more are required. There are no Spitting Notices in any of the South Eastern and Chatham Railway Company's carriages. 55 In the crowded streets of the City it is almost impossible to exaggerate the importance of all measures tending to minimise the amount of dust in the air. Much can be done by the thorough cleansing of the streets, and watering them in dry and hot weather with a disinfectant solution. This is carried out continuously by your Cleansing Department, and the City streets will bear favourable comparison with those in other districts of the Metropolis. But more than this is required—Public Companies (rail, tram, omnibus, &c.) can effect much by introducing more effective methods of cleansing their vehicles, and by adopting a simple plan of moistening with a cheap form of disinfectant all floors and platforms before sweeping. Further, the private individual and employer of labour should certainly do his share by insisting upon frequent cleansing, with the same precautions. The provision of proper covers to the dust carts during the last year at the suggestion of your Medical Officer of Health has considerably diminished the dangerous nuisance caused by the scattering of light refuse by the wind, and it is to be desired that before long this precaution will be completed by the compulsory provision by householders of efficiently covered dust bins. The Corporation has power under Section 4, City of London (Public Health) Act, 1902, to make Bye-laws to compel householders to "deposit "their refuse before eight o'clock in the morning on the kerbstone of the "pavement, 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," and the provision of such Bye-laws is one of the most urgent requirements of the Sanitary service. SPITTING IN PUBLIC PLACES. It cannot be too generally known that spitting in certain public places in the Metropolis is now a punishable offence. Included in some Bye-laws for the good rule and government of the County of London, which includes the City, made by the London County Council on 12th May, 1903, under Section 23 of the Municipal Corporations Act, 1882, and Section 16 of the Local Government Act, 1888, is one dealing with the spitting evil, which provides that:— "No person shall spit on the floor, side or wall of any public carriage, "or any public hall, public waiting-room, or place of public entertainment "whether admission thereto be obtained upon payment or not." "Any person who shall offend against this Bye-law shall be liable for each offence to a fine not exceeding forty shillings." 56 This is a step in the right direction, but does not go far enough, and powers should certainly be obtained for preventing the practice of spitting on pavements and footpaths. A recommendation of the Sanitary Committee that notices to this effect should be placed upon all lamp posts within the City was negatived by the Court of Common Council. This was probably due to the impression that the notice was intended to refer to the streets as well as the footways. ARTIZANS' DWELLINGS, STONEY LANE, HOUNDSDITCH. These buildings, erected by the late Commissioners of Sewers and opened in January, 1885, stand upon ground formerly the site of several courts and alleys in the Ward of Portsoken. There are five "blocks" of dwellings, severally named King's—Queen's— Prince's—North—and South, designed for occupation by persons of the artizan class; some of the ground floors being let as shops. Exclusive of the shops and cellars, they contain 539 rooms, arranged in 260 tenements, and are occupied by 1,057 persons. Fifty-nine per cent. are adults and forty-one per cent. children (under 16 years). The death rate for 1903 was 15.1 per 1,000 per annum [of which 56.2 per cent. was of children under 5 years of age]. Deaths of children under one year to 1,000 births wefe 242, as against 115 for the City generally. The number of births was 33, viz.: 21 males and 12 females. The birth rate, 31.2 per thousand, is the lowest recorded since 1894, and is 10.9 per 1,000 below the average for the previous five years. In June, 1901, your Medical Officer of Health having directed attention to the lack of bath accommodation at these dwellings, the matter was referred to your Engineer to submit plans for this provision, and that Officer in the following March submitted the same to the Improvements and Finance Committee. These were subsequently approved by the Court, and the work commenced early in 1903. The building was opened for use on 2nd May, 1904. It is a structure of one storey, situated on the North-East entrance to the dwellings from Harrow Alley, having separate entrances from the yards of the dwellings. It comprises accommodation for seven baths for women and children, with female attendant's room and separate entrance, and four baths for males, with male attendant's room, also with a separate entrance. The heating apparatus is placed in the basement. They are admirably adapted for the purpose, and will doubtless contribute materially to the comfort and well-being of the tenants. 57 ARTIZANS' DWELLINGS, STONEY LANE. Vital Statistics 1903, compared with previous five years. YEAR. Death rate per 1,000. Deaths of children under 5 years of age. Deaths of children under one year 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. 1898 8.4 66.6 65 43.1 1* 1 (Measles) 1899 15.0 18.8 75 37.5 — 1 (Whooping Cough) 1900 17.8 52.6 146 38.4 — 1 (Scarlet Fever) 1901 14.2 53.8 226 45.8 — 1 ( Puerperal Septicæmia ) 1902 9.8 44.4 48 45.8 — Nil. Average for previous Ave years. 13.0 472 112 42.1 — 0.8 1903 15.1 56.2 242 31.2 — 1 (Measles) *The mother is reported to have been of weak intellect, and a mere child. NAME OF BLOCK. 1903. North. South. King's. Queen's. Prince's. Total. Number of Births 9 2 2 9 11 33 Number of Deaths 2 1 4 8 1 16 Deaths of Children under five years of age 2 — 2 4 1 9 Deaths of Children under one year of age 2 — 14 1 8 Number of illegitimate Children born — — — — — — Deaths from Infectious Diseases — — — — — 1 The re-arrangement of the sanitary accommodation at these buildings referred to in my Report for last year has now been completed. City of London. Table of BIRTHS OCCURRING AT THE ARTIZANS' DWELLINGS, STONEY LANE, HOUNDSDITCH, DURING THE YEAR 1903, 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 of 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. Diarrhœa and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. V iolent Deaths. Injuries. All other Diseases. Totals. Typhus. Enteric or Typhoid. Continued. Eelapsing. Puerperal. Male. Female. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 10. 17. 18. 19. 20. 21. 22. NORTH BLOCK 7 2 2 2 ... ... ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 2 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 SOUTH „ 2 - 1 ... ... ... ... 1 ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 2 4 KING'S „ 1 1 4 1 1 1 ... ... 1 5 upwds. ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 2 Under 5 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 3 4 8 QUEEN'S 4 5 8 4 ... ... ... 4 ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 4 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 PRINCE'S 7 4 1 1 ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Under 5 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... 1 6 9 16 TOTALS 21 12 16 8 1 1 ... 5 1 5 upwds. ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... 5 7 59 DISINFECTION, &c., AT CITY MORTUARY. 7,064 articles of bedding, clothing, furniture, &c., were received at Golden Lane and disinfected. Of these, 3,192 were infected army blankets from South Africa. 190 bodies were received at the Mortuary, pending interment; the number for the three preceding years being 98, 111, and 164. Number of Articles disinfected, Bodies received at the Mortuary, and Inquests held at the Coroner's Court in the City during 1903, COMPARED WITH THE AVERAGE FOR THE PREVIOUS FIVE YEARS. Year. Articles of Bedding, &c., disinfected. Bodies received at the Mortuary. Inquests held on bodies. Inquests held on Fires. 1898 5,349 108 59 2 1899 9,175 102 49 Nil. 1900 4,100 98 61 Nil. 1901 5,527 111 77 1 1902 5,399 164 140 1 Average for previous five years 5,910 116 77 0.8 1903 7,064 190 160 7 The inquests on fires related to the following places:— Date of Inquest. Situation of Premises where Fire occurred. 17th October, 1903 34-35, Gracechurch Street. „ „ „ 61, Queen Street. 15th December „ 16, New Street Square. „ „ „ 39-40, Hutton Street. 23rd „ „ 19a-21, Fore Street Avenue. „ „ „ 18, Long Lane. 31st „ „ 38, Bow Lane. 60 DISINFECTANTS. The methods adopted in 1901 for disinfecting public thoroughfares, &c., referred to in detail in your Medical Officer's Annual Reports for 1901 and 1902, were continued with marked success during 1903. As heretofore, all chemicals and disinfectants supplied throughout the Public Health Department were 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 premises, &c., after infectious disease, and sundries. This is £64 0s. Id. less than the amount spent for similar purposes last year, and it is doubtful, having due regard to the public health, if any further economy can be effected in this direction, the above low figure being mainly due to the cold and wet season of 1903. The amounts spent during the past twelve months under these several headings were:— £ S. d. A. 16 12 6 B 13 1 5 C 71 12 11 D 29 6 9 Total £130 13 7 61 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. Works completed. January 154 17 13 14 • February 284 8 27 18 March 241 15 18 21 April 254 2 128 20 May 261 10 85 46 June 259 7 16 43 July 202 6 13 69 August 401 15 28 44 September October 273 14 27 46 November 220 8 15 25 December 341 7 15 29 Totals 2,839 109 385 375 MIDDLE DISTRICT. (Inspector - - E. J. Simmons.) Date of Report. Premises inspected. Orders issued. Notices served. Works completed. January 152 6 5 18 February 239 28 31 33 March 217 9 38 18 April 258 25 77 38 May 268 18 55 21 June 209 17 25 31 July 242 10 38 50 August 406 37 27 117 September October 273 21 53 44 November 224 12 32 34 December 362 11 22 36 Totals 2,850 194 403 440 62 EAST DISTRICT. (Inspector - W. H. Ralph.) Date of Report. Premises inspected. Orders issued. Notices served. Works completed. January 137 10 14 19 February 228 9 23 33 March 231 11 20 27 April 264 8 184 31 May 278 9 12 73 June 197 9 21 34 July 231 11 17 29 August 415 14 31 57 September October 266 10 32 33 November 231 15 24 29 December 268 8 57 37 Totals 2,746 114 435 402 The foregoing are summarised as under:— District. Number of inspections made. Orders issued. Notices served. Improvements effected. West 2,839 109 385 375 Middle 2,850 194 403 440 East 2,746 114 435 402 Totals 8,435 417 1,223 1,217 63 Sanitary Inspections During 1903, compared with previous four years. Year. Inspections made. Sanitary Improvements effected. Notices served. 1899 7,323 1,211 1,319 1900 8,463 1,186 1,053 1901 9,128 1,219 1,266 1902 8,000 957 1,131 Average previous four years... 8,228 1,143 1,192 1903 8,435 1,217 1,223 The apparent reduction in the amount of work performed by the Sanitary Inspectors in 1902 was due to the fact that in that year for the first time the work done under the Factory and Workshop Act, 1901, was not included in this Table, and was transferred to the part of the Report dealing with that subject. In several instances, owing to non-compliance with notice to remedy sanitary defects, it was found necessary to refer the particulars to the City Solicitor, and in each case the work was subsequently completed without further legal proceedings. HOUSE REFUSE REMOVAL. The Superintendent of Cleansing reports that the refuse removed from the City in 1903 consisted of 31,863 cartloads of street sweepings and slop, and 50,584 loads of house and trade refuse ; total, 82,447. Of this bulk, 26,421 loads were consumed by the Destructor at Letts' Wharf; this was 1 per cent. less than last year, but 0'3 per cent. above the average for the previous five years. Refuse Dealt with during 1903 and previous Five Years. Year. Street Sweepings and slop. House and Trade Refuse. Total. No. of Loads Cremated in Destructor. Per Cent. Cremated. 1898 Loads. 29,745 Loads. 43,960 Loads. 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 1902 31,251 48,297 79,548 26,245 33.0 Average of previous five years: 29,879 45.423 75,302 23,868 31.7 1903 31,863 50,584 82,447 26,421 32.0 64 THE PIGEON NUISANCE. At the latter end of the year, in consequence of numerous complaints from property owners of the nuisance caused by pigeons depositing dung on buildings, an attempt was made to determine the number of these birds, when it was ascertained that there were probably not less than 4,000 of them within the City limits. In addition to the local nuisance thus created, owners are put to frequent and not inconsiderable expense in keeping premises frequented by pigeons free from accumulated filth, which must inevitably and especially in hot weather—contribute materially to the general pollution of the atmosphere. Of course, on sentimental grounds, no one would venture to suggest the banishment of these birds from the City, but the time has arrived when it is necessary that their numbers should be lessened, the evil having been aggravated in later years in consequence of the demolition of City churches, and there is now hardly a building of any importance where pigeons do not congregate. The matter was fully considered by the Sanitary Committee in November last, but it was found impossible to take any active measures for abating the evil, as the birds have no actual owners. In consequence of the publication of this fact, the number of pigeons has since been considerably reduced, doubtless owing to housekeepers and others having captured them without fear of prosecution. This has effected a desirable thinning out, which, however, might be still further extended to the public advantage. LEGISLATION IN 1903. During the year the undermentioned Bills were introduced into Parliament in which the Public Health Department was more or less interested. As these will be fully explained by Mr. Remembrancer in his Annual Report, there is no occasion to refer to them here in detail: — London County Council—General Powers Bill. British and Irish Meat Protection. Housing of the Working Classes. Public Health. Sale of Adulterated Butter. 65 HYGIENIC REFORM IN HAIRDRESSERS' AND BARBERS' SHOPS. In October last it was referred to your Medical Officer of Health to ascertain what regulations, if any, were in force in other countries for controlling the business of hairdresser or barber. Enquiries in this direction were instituted, and replies received from the British representatives abroad in 48 Foreign States and 14 British Colonies. As a result of these enquiries it was ascertained that sanitary or other regulations or statutes especially controlling the conduct of the business of hairdressers or barbers exist in but few countries, and that there are none in force in any British Colony. It is of interest to note that in many quarters the matter is under consideration, and it is extremely probable that sooner or later regulations of this nature will be universally applied. It being advisable that the City should lead rather than follow in questions of hygienic reform, the Sanitary Committee have under consideration a scheme, pending legislation, that there is every reason to believe will satisfactorily deal with the matter so far as the City is concerned. 66 TENEMENT HOUSES. The houses let in lodgings or occupied by members of more than one family have been re-surveyed. 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 169 1,402 595 2.35 191 Middle 44 306 103 2.97 59 East 153 1,168 477 2.45 169 Total 366 2,876 1,175 2.45 419 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 419 Notices [or, 191, 59, and 169 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 1,057 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, King 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 1,760 Average number of persons to each tenement, 3.66. 67 This was an appeal from a judgment delivered by Mr. Alderman Strong on the 3rd June, 1902, when John Benjamin Kyffin, a Surveyor and Agent, of Tacsowa House, Dulwich Common, was fined £5 and £2 2s. expenses for permitting overcrowding on the first floor of No. 13, Shaftesbury Place, and a further fine of £2 and 5s. per day for permitting the overcrowding to continue at the said premises for sixteen days. The case was heard in the King's Bench Division of the High Court on the 27th March, 1903, before Lord Chief Justice Alverstone and Justices Wills and Channell, when the following important principle was established:— It is a question of fact to be decided by the Magistrate as to whether or not a building let in separate tenements is a house "which is let in lodgings or occupied by members of more than one family "within the meaning of Section 94 of the Public Health (London) Act, 1891. Mr. Alderman Strong had found that the building was a house let in lodgings within the meaning of Section 94 of the Public Health (London) Act, 1891, and convicted. It was contended on behalf of the appellant that the families were tenants and not lodgers, and the case of Weatheritt v. Cantlay (1901), 2 K. B. 285, was relied upon. In the result the Court dismissed the appeal with costs. The Court delivered judgment in the following terms:— "Lord Alverstone: If this house, under the circumstances stated "in the case, does not fall within the Section, I fail to see what house "would fall within the Section. The Magistrate has found as a fact that KYFFIN v. SIMMONS. Closed or Demolished during 1903. west district. No. 6, Sugar Loaf Court. No. 4, Bartholomew Place. No. 87, Long Lane. No. 8, Little New Street. No. 88, Do. No. 2, New Street Square. No. 33, Bartholomew Close. No. 22, Middle Street. No. 35, Do. No. 8, East Passage. No. 35½, Do. No. 19, Cloth Fair. No. 3, Bartholomew Place. No. 17, King's Head Court, Fetter Lane. A full list of Tenement Houses still on the Register is given in Appendix C, page 149. 68 "it is an ordinary six-roomed house with a common staircase, each pair "of rooms being occupied by a separate family, and it is within the "words, ' house occupied by members of more than one family.' The "Magistrate has found that, and whether it is a question of degree or a "question of fact, makes no difference. He has found it as a fact, and if "there was evidence upon which he could so find it, we should not upset "it. It was conceded that in the case of Weatheritt v. Cantlay a "contrary view was taken. It seems from that case that the test which "the Magistrate has applied here is the right test. In that case there "were a number of floors containing separate tenements which might be "defined to be separate houses, and they did not cease to be separate "houses because they were under one common roof. I there used the "expression, which I repeat, that if that were not the true test, all "blocks of buildings occupied as flats would be places occupied by more "than one family, and would come within the purview of the Section. "I think that is an observation which is entitled to weight. I think that "here the Magistrate was perfectly entitled to come to the conclusion "that this is a house within Section 94 of the Act." "Mr. Justice Wills : I am of the same opinion. I think this is a "house, or the Act of Parliament would be of no use." "Mr. Justice Channell: I agree on the ground that it is a question "of fact. I have a little doubt whether the separate tenements were "separate houses, but I think that, upon the facts as found, the "Magistrate was right." 69 FACTORY AND WORKSHOP ACT, 1901. WORKSHOPS AND WORKPLACES. This Act came into operation on the 1st January, 1902, and during the preceding year a systematic inspection of workshops and workplaces was commenced in view of the additional obligations the Act imposed upon the Corporation as a Sanitary Authority. Full details of the progress made in this undertaking will be found in your Medical Officer of Health's Annual Reports for 1901 and 1902. The work of registration and inspection was continued through 1903, and there are at present on the Register 1,781 premises in which workshops are situated. Of these, 905 have been inspected and found to contain 1,773 workshops, which have been registered in accordance with the provisions of the Act. With respect to workplaces there is no statutory obligation to register them, but this course has been adopted in the case of kitchens of restaurants, &c., with the result that at the end of 1903, 825 kitchens had been inspected and entered in the books. The following is a summary of the work done in this direction during the past three years:— Registered Workshops. 1901 745 Inspected during the year. 1902 481 „ „ 1903 547 „ „ 1,773 Total for three years. Kitchens of Restaurants, &c. (Workplaces). 1902 468 Inspected and Registered. 1903 357 „ „ *825 Total for two years. Total Number of Workshops and Workplaces. Inspected during 1903 904 „ during 1901-2-3 2,598 The sanitary defects more generally found at workshops and workplaces may be classified under the following headings, viz.:— Want of cleansing. Insufficient ventilation. Overcrowding. The lack of separate and suitable W.C. accommodation for both sexes. (Some important notes on the last subject will be found on p. 93.) *These figures refer to inspections, &c., made up to the 31st December, 1903. A supplementary Iteport on the completion of the inspection of these places was presented to the Sanitary Committee on the 22nd March, 1904. 70 The Act does not make the provision of appliances in workshops for washing hands, &c., compulsory. As it is to the advantage of the workers that they should have facilities for personal ablution, owners of workshops have had their attention directed to this matter where occasion arose, and in many cases your Medical Officer of Health has succeeded in persuading them to furnish the requisite fittings. The question as to the best methods of ventilation and the maintenance of a uniform and proper temperature continually arises. The latter is a subject that appears to rest with ELM. Factory Inspectors, but at present no definite standard for this purpose has been prescribed by the Secretary of State. Ventilation, however, is dealt with by your Officers, and its provision in an efficient and continuous manner must be insisted upon in all cases if the workers are to carry on their duties under healthy conditions. The mere opening of doors, windows and skylights cannot be considered anything more than a makeshift method of dealing with the matter, and in most cases some inexpensive mechanical appliance is found best for the purpose. The extension of electricity affords a ready means of operating a fan which, when properly fixed, causes a continuous change of air without producing draughts. Section 2 of the Public Health (London) Act, 1891, provides that any factory, workshop or workplace 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 carried on therein, that are a nuisance, or injurious or dangerous to health, is a nuisance liable to be dealt with summarily under that Act. The Secretary of State has also power under the Factory and Workshop Act, 1901, to prescribe a standard of sufficient ventilation to be observed in the case of any class of workshops, but those places where men only are employed are excluded from this requirement. WORKSHOPS. Details of Inspections, &c., 1903. Inspections 264 Re-inspections 1,364 Workers employed— Males 1,116 Females 1,332 Young persons Males 5 Females 4 Total workers employed 2,457 71 Notices served— Intimation 255 Statutory 100 Total number of Notices served 355 Outworkers living in the City notified to the Corporation 118 Outworkers notified by Corporation to outside districts2,729 Complaints— From H.M. Factory Inspector 66 General 24 Total number of complaints 90 New workshops notified by H.M. Factory Department 114 No abstract of Act affixed, women and young persons employed—cases notified to H.M. Factory Inspector 14 Domestic workshops registered 16 Statutory Certificates for cleansing issued by Medical Officer of Health 29 Cases referred to the City Solicitor 5 Summary of Sanitary Defects in Workshops remedied, 1903. Workshop— Walls and ceiling cleansed 90 Ventilated 26 Overcrowding abated 11 127 Drains— Re-laid or amended 6 Ventilated 13 19 Urinals improved or renewed 14 Water supply improved 51 Refuse receptacles provided or improved 80 Water-closets— Separate accommodation provided for sexes 15 Additional provided for men- 1 Additional provided for women 4 Arrangements improved— Males 118 Female 50 168 Total improvements in relation to W.C's effected 188 General defects remedied 377 Total improvements of all kinds effected in workshops during the year 856 72 BAKEHOUSES. (Underground.) Bakehouses have been the subject of special legislation for many years, and since the 1st January, 1896, it has been unlawful to establish any new one underground. The Factory and Workshop Act of 1901 introduced some stringent measures with regard to these places, and it was therein enacted that after the 1st January, 1904, no existing underground* bakehouse should be used unless certified by the Sanitary Authority to be "suitable as regards construction, light, ventilation, and in all other respects" (Sec. 101 (4) ). The evident intention of the Legislature was their abolition, and it therefore became the duty of the Sanitary Authorities to adopt a high standard of sanitary requirements in connection with them before granting certificates. Immediately after the passing of the Act referred to above, due notice was given to the owners of the underground bakehouses then in the City, stating the requirements of the Corporation that would have to be complied with before a certificate would be issued. It would, of course, have been unreasonable to rigidly enforce standard requirements in every case, as the circumstances in no two instances were identical. It was therefore considered advisable to deal with each one upon its merits, and as far as possible the accompanying standard was kept in view. (1) Construction. Floors, walls, and ceilings to have suitable hard, smooth, and jointless surface. The joints of any drain passing beneath the floor of any bakehouse to be gas and water-tight. Any covers necessary to inspection chambers to drains to be of metal, and be double covers with double sealed joints. The floor of the bakehouse to be laid to proper falls from the sides to the centre and be drained by means of a suitable channel to a gully, over which a draw-off tap shall be fixed, the gully being surrounded by a kerb and properly dished. Where possible the said gully shall be fixed outside the bakehouse. No certificate should be granted for any bakehouse which is liable to be flooded with sewage owing to the public sewer becoming surcharged. *An underground bakehouse is one in which the floor surface of any baking room 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. 73 (2) Light. The bakehouse shall, if possible, be lighted naturally, either by windows, floor lights, or in any other manner possible. This could in some cases be effected by areas opening on the footway glazed with reflecting prisms, the walls of the areas being built in white glazed bricks. Electric light only to be used for illuminating purposes. (3) Ventilation. "Through" ventilation to be insisted upon ; but this is not to be obtained from the footway surface or the stall board of the shop front, except at a height of at least 12 inches above the footway surface; and not even then when ventilation can be had in other ways (shafts, &c., at higher level, &c., &c.). (4) Walls. The walls of all bakehouses must be absolutely free from dampness. (5) Furnaces. The furnace in connection with any oven is to be provided with an efficient outlet or flue to carry off sulphurous fumes generated in the process of baking. An outlet for heat and steam is also to be provided immediately in front of and above the oven door. The outer doors of furnaces and the oven door to be perfectly close fitting. Where gas is used in the process of baking efficient means of ventilation is to be provided to carry off any fumes generated. (6) Lavatory Accommodation for workpeople outside bakehouse. (7) Generally. All dough troughs and benches, &c., in bakehouses to be fixed on wheels to facilitate cleansing of floors, walls, &c., as well as the troughs, &c. Section 97 of the Act to be strictly enforced.* Any special case to be considered on its merits by the Authority before deciding as to grant of certificate. The following is a list of the Underground Bakehouses in the City dealt with under the Factory and Workshop Act, 1901, and indicates those which are certified, and those disused or demolished:— *This Section refers to certain specific sanitary requirements in relation to drains, water-closets, water supply, &c. 74 Situation. Certificate granted. Bakehouse closed or disused. Bakehouse demolished. 188, Aldersgate Street 1 ... ... 107, Bishopsgate Street Within ... 1 ... 81, ditto Without 1 ... ... 59 to 62, ditto ditto 1 2 ... 113, ditto ditto ... 1 ... Bridge water House, Fann Street ... 1 ... *4, Broadway 1 ... ... 95, Cannon Street 1 ... ... 8, Copthall Avenue 1 ... ... 15, Cornhill 1 ... ... 15, Duke Street 1 • • • ... 28, Fore Street ... 1 ... 62, ditto ... 1 ... 85, ditto 1 ... ... *67, Farringdon Street 1 ... ... *88, ditto 1 • •• ... *93, Fetter Lane 1 • •• ... *12, Gracechurch Street 1 • •• ... *21, Holborn 1 ... ... 24, Jewin Street ... 1 ... 8 to 14, King Street, Snow Hill 1 • •• ... 48, Knightrider Street 1 ... ... 8, Lambeth Hill 1 ... ... 18 and 19, Leadenhall Market ... 1 ... 18, Long Lane 1 ... ... 16, Ludgate Hill ... 1 ... *37, Middlesex Street 1 ... ... *63 to 65, ditto 1 ... ... *122, ditto 1 ... ... 155, Minories ... 1 ... 28, New Broad Street ... 1 ... 31, Newbury Street 1 ... ... 3, Paucras Lane 1 ... ... 7, Sparrow Corner ... ... 1 21, Stoney Lane 1 ... ... 68, St. Mary Axe 1 ... ... 112, Shoe Lane ... 1 ... *75, St. Paul's Churchyard 1 ... ... 194, Upper Thames Street 1 ... ... 4, Water Lane ... 1 ... 25, Warwick Lane • • • 1 ... 5, Whitefriars Street ••• 1 ... Total 27 16 1 44 It will thus be seen that of the 44 Underground Bakehouses in existence when the Act became operative, one has been demolished, 16 closed or disused, and the remaining 27 have been so improved as regards their sanitary condition as to have been certified as suitable for use. These have been established at least 20 years. 75 On 30th June, 1902, the occupier of an Underground Bakehouse in Cloth Fair was informed that if he wished to use his bakehouse as such after the 1st January, 1904, it would be necessary for him to make certain alterations to the premises in order to obtain the statutory certificate. Being unwilling to bear the whole of the cost the occupier made application on the 12th October, 1903, at the Guildhall Justice Room, for relief under Section 101 (8) of the Factory and Workshop Act, which provides that:— "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 Juris"diction, 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, 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." The Alderman decided that the application was premature, and that he had no power to deal with the matter until the Corporation had formally notified the applicant that a certificate would not be issued until the specified improvements had been carried out. A resolution to this effect was therefore passed at the next meeting of the Court of Common Council, and the occupier informed accordingly. The work required was subsequently done by mutual agreement, the owner paying one-third of the estimated cost. ABOVEGROUND BAKEHOUSES. The following is a list of bakehouses in the City situated aboveground:— *26, Aldgate High Street. 90, Bishopsgate Street Without. *9 and 10, Hart Street. †18-19, Leadenhall Market. *61, Middlesex Street. †l55, Minories. *85, Middlesex Street. 5, Sparrow Corner. †4, Water Lane. *13, Widegate Street. 59 to 62, Bishopsgate Street Within. †93-94, Upper Thames Street. †Established during 1903. *These have been established at least 20 years. 76 Summary. Underground bakehouses certificated 27 Bakehouses aboveground 12 Total number of bakehouses in the City 39 Bakehouses closed or demolished during 1903 in consequence of the operation of the Factory and Workshop Act, 1901 17 During the year 32 re-inspections of bakehouses aboveground were made, and 560 of bakehouses underground. TAILORS' WORKSHOPS. Recognising the importance of bringing tailors' shops within the provisions of Part VI. of the Factory and Workshop Act, 1901, relating to "home work,'' the Home Secretary, in pursuance of the powers conferred upon him,* made an order, that became operative concurrently with the Act, specifying the tailoring trade, amongst others, as coming under the requirements of the following sections, viz.:— "107.—In the case of persons employed in such classes of work as "may from time to time be specified by Special Order of the Secretary "of State— "(1.) The occupier of every factory and workshop, and every "contractor employed by any such occupier in the business of the "factory or workshop, shall— "(a) keep in the prescribed form and manner, and with the "prescribed particulars, lists showing the names and "addresses of all persons directly employed by him, either "as workmen or as contractors, in the business of the "factory or workshop, outside the factory or workshop, "and the places where they are employed; and "(6) send to an inspector such copies of, or extracts from, ''those lists as the inspector may from time to time "require; and 77 "(c) send on or before the first day of February and the first "day of August in each year copies of those lists to the "district councilf of the district in which the factory or "workshop is situate. "(2.) Every district council shall cause the lists received in pur"suance of this section to be examined, and shall furnish the name "and place of employment of every outworker included in any such "list whose place of employment is outside its district to the council "of the district in which his place of employment is. "(4.) This section shall apply to any place from which any work "is given out, and to the occupier of that place, and to every con"tractor employed by any such occupier in connection with the "said work, as if that place were a workshop. "108.—(1.) If the district council within whose district is situate a "place in which work is carried on for the purpose of, or in connection "with, the business of a factory or workshop, give notice in writing to ''the occupier of the factory or workshop, or to any contractor employed "by any such occupier, that that place is injurious or dangerous to the "health of the persons employed therein, then, if the occupier or con"tractor after the expiration of one month from receipt of the notice "gives out work to be done in that place, and the place is found by the "court having cognizance of the case to be so injurious or dangerous, he "shall be liable to a fine not exceeding ten pounds. "110.—(1.) If any inmate of a house is suffering from an infectious "disease to which this section applies, the district council of the district "in which the house is situate may make an order forbidding any work to "which this section applies to be given out to any person living or working "in that house, or such part thereof as may be specified in the order} "and any order so made may be served on the occupier of any factory "or workshop, or any other place from which work is given out, or on "the contractor employed by any such occupier. "(2.) The order may be made notwithstanding that the person "suffering from an infectious disease may have been removed from the house, and the order shall be made either for a specified time or subject "to the condition that the house or part thereof liable to be infected "shall be disinfected to the satisfaction of the medical officer of health, "or that other reasonable precautions shall be adopted. "(3.) In any case of urgency the powers conferred on the district "council by this section may be exercised by any two or more members "of the council acting on the advice of the medical officer of health." †In the City of London the Corporation is the "district council." 78 An inspection and registration of tailors' shops was accordingly undertaken last year, when it was ascertained there were 495 of these places in the City, and that at 126 of such premises 165 workshops existed. The latter were distributed as under:— 1 workshop existed at 97 premises. 2 workshops „ ,, 20 „ 3 ,, ,, ,, 8 ,, 4 ,, ,, ,, 4 ,, It will be seen, therefore, that workshops exist at about one-fourth of the tailors' shops in the City ; the majority having none, as most of the goods sold are made up by outworkers. Forty of these workshops were notified to the Corporation by H.M. Factory Inspectors, twelve of which were "domestic workshops." * The majority of the workers in the tailoring trade are males, and out of the 598 women employed 182 work for one firm alone. According to the returns of the Night Census, 1901, there were 235 females (of which about 68 per cent. were unmarried) and 245 males engaged in the tailoring trade resident in the City. The artificial illuminants employed at the 165 tailors' workshops were as under:— Gasin 137 Electricity „ 24 Oil „ 4 The following is a summary of the result of the inspections of these places during the year:— Tailors' Workshops. Number of workshops inspected 165 Domestic workshops found 12 Original inspections made 584 Re-inspections 510 1,094 Number of workers—Male 757 „ „ —Female 598 1,355 Number of outworkers 1,962 Complaints received from H.M. Factory Inspector 4 * Vide p. 90 for definition of "domestic workshop." 79 The undermentioned were the defects reported and remedied:— Drainage defects 35 Water-closets:— Opening into workshops 22 No fastening to doors (women) 9 Not "suitable 8 Defective light or ventilation 44 Other defects 75 158 Urinals defective and dirty 3 Water supply defects 36 Sanitary defects in workshops 52 Workshops overcrowded 11 General defects on premises 54 Gas stoves not ventilated 24 Total defects remedied 373 The above involved the service of 106 "Intimation" and 22 "Statutory" Notices. Whatever may have been the conditions under which clothing was made in tailors' shops in the City in the past, it may safely be said that these businesses are now carried on under proper sanitary control. As regards the work put out and made up by outworkers in other districts, the names and addresses of all these persons are duly notified to the various local authorities in whose districts they reside, and the responsibility of securing the proper sanitary condition of such premises rests with the several local authorities concerned. FURRIERS' WORKSHOPS. Special attention has been given during the year to the sanitary condition under which furriers conduct their businesses in the City. The presence of dust and clippings of fur, inseparable from the trade, constitute a special danger, which may not only seriously affect the health of the workers, but also become a vehicle of conveying infectious disease. In the course of the year 58 of these premises, containing 57 workshops were inspected, and in order that the persons employed therein should be protected as far as possible from the dangers referred to above, attention was 80 chiefly directed to the provision of adequate ventilation, the constant removal of refuse, and the prevention of dust accumulation by covering the floors with smooth impervious material, &c. It was ascertained that hitherto little attention had been paid to these points, and many of these workshops were found to be dirty and sanitarily defective in other respects. The greater part of these defects were remedied by the end of the year, and the work of inspection is still in progress. KITCHENS OF RESTAURANTS, &c. The inspection of the kitchens and places where food is prepared in restaurants, &c., referred to at length _in your Medical Officer of Health's Annual Report for 1902, has been continued during the year. In the 155 kitchens inspected last year, 76, or 49 per cent., were situated in the basement. Of the 343 visited in 1903, 135, or 39 per cent., of the kitchens were similarly located. This is an improvement on last year, and a proportion that it is hoped to materially decrease in the future, as in new structures the kitchen is almost invariably placed on the top floor. In November last, when discussing the proposed legislation by the London County Council for 1904, your Medical Officer of Health made the following observation:— "All such places (i.e., places where any article intended for human "food is sold or prepared for sale) should be registered, and I see no "reason why the baker and milk dealer should trade under greater "restrictions than the proprietors of other businesses where food is "prepared for sale. Underground kitchens in hotels and restaurants "should certainly be discountenanced, and placed on all fours with "underground bakehouses." As the result of two years' experience gained in the City, it has been clearly demonstrated that this view is correct, and that sufficient warranty exists for legislation on these lines. Should the London County Council General Powers Bill, 1904, as drafted, come into being, local authorities will be better able to deal with places where food is sold or prepared for sale; but, as stated above, it would be to the public advantage to go a step further and abolish underground kitchens at all such places. Without mechanical means, it is almost impossible to properly ventilate a kitchen placed in a basement. In many cases the ventilation has to be partially obtained by means of open gratings on the footway pavement— indeed in some instances nothing else can he had. As a consequence, mud, filth, and dust finds direct access to the kitchens—indeed, it is a common thing to observe marks of expectoration through these gratings, one occupier even 81 being obliged to attach a brass notice requesting the casual passer-by not to spit down one of the openings. Others attach movable trays beneath, but this only partly obviates the evil. Another difficulty met with is in respect to the provision of separate sanitary conveniences for the use of both sexes, as required by the Act. In some premises the basement and ground floors are used as an eating house, where both sexes are employed, the upper part of the house being let as offices, &c., and one water-closet only is provided for the use of all the occupants. The women workers, therefore, frequently decline to avail themselves of such improper accommodation, obviously to the prejudice of their health and comfort. Again, in a large number of cases the W.C. accommodation was in a very defective condition, in 35 cases the W.C. either opened or communicated directly with the kitchen, and in 9 others they were actually within the kitchen itself without either light or ventilation. Hoods have been fixed over gas stoves and led into flues for ventilation. In 79 of the kitchens gas only was used in the process of cooking; and where it is possible to use gas only it is advisable, and effectively assists in dealing with the smoke problem. In a number of cases the ovens, cooking utensils, and larders were found in a dirty condition. In one case it was found necessary to close the kitchen. The following defects existed:—Floor of kitchen rotten, drains and soil-pipe defective, earth under kitchen floor sodden with sewage, walls and ceiling dirty, sink in a very dirty and offensive condition, kitchen badly lighted and ventilated, cistern dirty, sink on third floor connected to soil pipe, no ventilation to W.C's, and flushing cisterns defective, cooking utensils dirty. As this inspection progresses, one is better able to estimate the great advantages accruing therefrom to the health of customers using these places, and still more to the workers, who are compelled to spend their time in underground kitchens that are frequently found to be badly lighted, ill-ventilated, and insanitary. Summary of Sanitary Defects remedied in Kitchens of Restaurants, &c., 1903. Drains relaid or amended 31 Kitchens— Walls and ceilings cleansed 169 Light and ventilation improved 57 226 82 Water-closets— Separate accommodation provided for sexes— Males 11 Females20 31 Arrangements improved— Males48 Females49 97 Water supply improved 128 Refuse receptacles provided 61 General defects remedied 500 Total defects remedied during the year - 1,074 WORKPLACES (KITCHENS OF RESTAURANTS). Details of Inspections, &c., 1903. Inspections 343 Re-inspections1,681 Total inspections 2,024 Workers employed— Ma1es1,716 Females1,763 Total number of workers 3,479 Notices served— Intimation 246 Statutory 32 Total Notices served 278 Kitchen— Situated in basement 135 Situated on top floor 83 Situated on other floors 125 Total number of kitchens 343 *Number of persons licensed to sell beer, wines, &c. 168 Artificial light used— Gas301 Electric42 343 Fuel used in cooking— Coal 53 Gas 79 Coal and Gas 211 343 Premises where W.C. accommodation is provided for customers— Males 44 Females5 49 *As a rule the kitchens in the licensed premises were the better kept. 83 VOLUNTARY SANITARY CERTIFICATES FOR KITCHENS OF RESTAURANTS AND ABOVEGROUND BAKEHOUSES. The following Report was presented by your Medical Officer of Health to the Sanitary Committee on the 27th October, 1903:— "The question of granting Certificates as to the sanitary condition of "premises is by no means new. "The practice has existed for many years in some districts, more especially "in seaside resorts, where the possession of such 'hall mark' is naturally "considered of definite value by the owner. "The matter was brought forward by me in June last in consequence of "repeated representations by owners and occupiers who, having been called "upon to carry out repairs, improvements, &c., felt strongly that as some "recompense for the outlay they had made they should be in a position to "exhibit a Certificate that their premises were then in a satisfactory sanitary "condition. "The general principle was then agreed to by your Worshipful Committee, "and referred back to your Medical Officer of Health to report as to details of "standards, &c. "What I now suggest is that in order to meet an expressed want, all "owners of Kitchens and Aboveground Bakehouses be informed that a "standard of requirements has been drawn up by the Corporation, and that "upon complying with such, a Certificate would be granted to the effect that "the Kitchen or Aboveground Bakehouse had been inspected and found in a "satisfactory condition. "These inspections could be repeated from time to time, and fresh "Certificates issued. "From the Authority's point of view there are many advantages in "adopting such a course. Owners would be more willing to carry out require"ments and suggestions of the Authority, with the result that great benefit "would accrue to the public from the consequent raising of the standard of "sanitation. "Further, a precedent for issuing Certificates that premises are in a sanitary "condition is furnished by the Customs and Inland Revenue Act, 1890, when "the owners of property wholly let in tenements at rents not exceeding a "certain amount are exempted from paying Inhabited House Duty on such 84 "property, provided he can produce a Certificate from the Medical Officer of "Health for the district in which the house is situated, that the house is so "constructed as to afford suitable accommodation for each of the families or "persons inhabiting it, and that due provision is made for their sanitary "requirements, and the Medical Officer of Health is required to examine "such houses, on request of the owner, for the purpose of ascertaining if the "Certificate can be properly granted, and if it can, he must certify the same "accordingly. "I may mention that among the proposals of the London County Council "for legislation during 1904 is one for dealing with the question of inspection "of premises where food is prepared for sale. "Such powers have already been granted in the cases of Milk, Ice-creams, "Bakehouses, &c., and there is no reason why provisions which are necessary "in the case of Bakehouses should not be necessary with regard to any place "where food is prepared for sale. "Legislation pending, it would be obviously an advantage to have a system "of voluntary certification which would enable those who were willing to "obtain authoritative evidence as to the condition of their premises. "The experience gained in dealing with Underground Bakehouses under "the Factory and Workshop Act, 1901, is of considerable value in this connec"tion. Generally speaking, the main points for consideration do not differ "materially in Kitchens or Bakehouses, underground or aboveground. Thus, "to ensure the utmost cleanliness, the walls, floor, and ceiling are required to "be impervious, the walls being as little encumbered as possible by shelves, "woodwork or other obstructions placed against them. This enables the "place to be thoroughly washed down and cleansed effectively and "expeditiously. "In the case of Kitchens, the proper storage of almost every class of "perishable food has to be dealt with. It is therefore desirable that a "separate store-room should be provided for the purpose. It is also a great "advantage to have a separate room as a scullery for washing up, &c. In "many cases it will be difficult to comply with all these obvious require"ments. "The standard should, therefore, not be so rigidly .enforced as to press "unduly on persons willing to comply as far as possible with its spirit. I "submit for your consideration standards of suitability both for Kitchens and "Bakehouses aboveground, and would recommend that, as in the case of "Underground Bakehouses, your Committee will not refuse a Certificate "because the standard cannot be complied with in all respects, but will "consider every case upon its merits." 85 BAKEHOUSES—ABOVEGROUND. Standard for Voluntary Certificates. (I.) CONSTRUCTION. 1. Floors, walls and ceilings to be finished to a hard smooth surface impervious to moisture. 2. When practicable, the floor of the Bakehouse to be laid to proper falls and be drained by suitable channels leading to a gully outside the Bakehouse. 3. The finished walls of the Bakehouse to be absolutely free from dampness. Should damp walls exist, an inner wall of brick-work, at least half-a-brick thick, to be built, with a space between it and the damp wall of two inches, such space to be ventilated and drained, and such half-brick wall to be tied to the existing wall—or some other equally efficient and approved method is to be adopted for ensuring absolute dryness. 4. The joints of any drain passing beneath the floor of the Bakehouse to be gas and water-tight, and all pipes and sanitary fittings to be of the most efficient and approved type. Covers to inspection chambers to drains to be of metal, and to be double covers, both covers having an efficient seal. 5. The Bakehouse to have a minimum height of 8 ft., a minimum cubic capacity of fifteen hundred feet clear of the ovens and of any flour stored in the Bakehouse, and not less than 400 cubic ft. per head for each workman employed therein. (II.) LIGHTING. 6. Where practicable, natural light only should be utilized. In cases where artificial illumination is a necessity, electricity is to be preferred, and when gas is used, the incandescent type of burner, properly protected from flour dust, should be adopted, together with ample means for carrying off the products of combustion from the same. (III.) VENTILATION. 7. The method of ventilation to be such as to ensure a constant and sufficient change of air without producing draughts, and such that the temperature of the Bakehouse shall not exceed 80° Fahr. except during the half-hour after a batch of bread has been drawn. Where a fan or other mechanical appliance is necessary to effect this it must be provided. 8. The furnace in connection with any oven to be provided with an efficient outlet or flue to carry off sulphurous fumes generated in the process of baking—an outlet for heat and steam to be provided immediately in front of and above the oven door—the outer doors of furnaces and oven doors to be perfectly close fitting. 9. Proving ovens, where necessary, are to be efficiently ventilated. Where gas is used in the process of baking, means to be provided for carrying off the fumes generated. (IV.) GENERALLY. 10. Proper provision to be made for the storage of flour, elsewhere than in the Bakehouse, if practicable. 11. Lavatory basins to be provided in a suitable position, outside Bakehouse if possible, for the use of the employes. 86 12. Suitable W.C. accommodation to be provided for hands employed. 13. Storage (water) cisterns to be of the most approved type with dust-tight fixed covers. 14. Provision to be made for hanging wearing apparel (not worn by staff during working hours) in a suitable place outside Bakehouse. 15. Flour not to be deposited immediately on the floor, but to be stacked upon small, trestles or a wooden platform raised 12 inches above the floor. 16. All dough troughs, benches, &c., in Bakehouse to be provided with castors or wheels, where necessary, to render them easily moveable. 17. Any shelves necessary, to be fixed two inches away from walls, and all unnecessary woodwork to be removed from walls. 18. Jet and hose to be provided, with the necessary connection to a proper water supply for washing down the Bakehouse in an efficient manner. 19. A sufficient number of metal bins, with tightly fittiug covers, for reluse to be provided. KITCHENS OF RESTAURANTS, &c. Standard for Voluntary Certificates. (I.) CONSTRUCTION. 1. Floors, walls and ceilings to be finished to a hard smooth surface impervious to moisture. 2. Where practicable, the floor of the Kitchen to be laid to proper falls and be drained by suitable channels leading to a gully outside the Kitchen. 3. The finished walls of the Kitchen to be absolutely free from dampness. Should damp walls exist, an inner wall of brick-work, at least half-a-brick thick, to be built with a space between it and the damp wall of two inches, such space to be ventilated and drained, and such half-brick wall to be tied to the existing wall—or some other equally efficient and approved method is to be adopted for ensuring absolute dryness. 4. The joints of any drain passing beneath the floor of the Kitchen to be gas and water-tight, and all pipes and sanitary fittings to be of the most efficient and approved type. Covers to inspection chambers to drains to be of metal, and to be doable covers, both covers having an efficient seal. 5. The Kitchen to have a minimum height of 8 ft., a minimum cubic capacity of 1,500 ft., except under special circumstances, and not less than 400 cubic ft. per head for each person employed therein. 87 (II.) LIGHTING. 6. Where practicable, natural light only should be utilized. In cases where artificial illumination is a necessity, electricity is to be preferred, and when gas is used, the incandescent type of burner should be adopted, together with ample means for carrying off the products of combustion from the same. (III.) VENTILATION. 7. The method of ventilation to be such as to ensure a constant and sufficient change of air without producing draughts, and such that the temperature of the Kitchen shall not exceed 80° Fahr. Where a fan or other mechanical appliance is necessary to effect this it must be provided. 8. Where the Kitchen is situated underground, inlets for ventilation must be at least 12 inches above the footway or the ground abutting upon the Kitchen. 9. Where gas is used in the process of cooking, means to be provided for carrying off the fumes generated. 10. Hoods to be placed over all stoves and ranges to carry off fumes and heat—such hoods to be in direct communication with the external air by means of shafts or flues. (IV.) GENERALLY. 11. Where practicable, there shall be elsewhere than in the Kitchen— (а) Provision for the storage of food. (b) A Scullery (with all necessary draining racks for plates, shelves for saucepans, &c.). Where this is not possible, portions of the Kitchen must be arranged for the purpose enclosed by fixed partitions, and suitably fitted for their respective purposes. 12. Proper bins or other receptacles for flour and other articles of food to be provided and suitably placed. 13. Storage (water) cisterns to be of the most approved type with dust-tight fixed covers. 14. Proper enamelled stoneware sinks, &c., to be provided in which to wash vegetables, &c., only. 15. A sufficient number of strong metal bins, with tight fitting covers, for the reception of refuse to be provided, which are to be emptied daily. 16. Suitable W.C. accommodation to be provided for the employes. 17. Lavatory basins to be provided in a suitable position, for each sex, outside the Kitchen if possible, for the use of employes. 18. Provision to be made for hanging wearing apparel (not worn by the staff in working hours) in a suitable place outside Kitchen. 88 19. All tables, benches, &c., to be provided with castors or wheels, where necessary, to render them easily moveable. 20. All shelves necessary, to be fixed two inches away from walls, and all unnecessary woodwork to be removed from walls. 21. Jet and hose to be provided, with the necessary connection to a proper water supply, for washing down the Kitchen in an efficient manner. This Report was approved and adopted by the Court of Common Council on the 28th January, 1904, and a number of enquiries and applications for Certificates have since been received. (FORM OF CERTIFICATE.) Corporation of London. PUBLIC HEALTH DEPARTMENT. This is to Certify that the situate at was inspected on the day of 19 , and was then in a satisfactory sanitary condition. Town Clerk. To Guildhall, E.C., 190 . 89 Sanitary Defects in Factories and Workshops notified in 1903 by H.M. Inspectors of Factories. In 1903 sixty-six notifications of Factories and Workshops where sanitary defects existed that were remediable under the Public Health (London) Act, 1891, were received from H.M. Inspectors of Factories under the provisions of Sec. 5 (1) of the Factory and Workshop Act, 1901. Under the latter statute the local sanitary authority is under the obligation of informing the Factory Inspector of the action taken by them in each instance, and further, to commence proceedings to remedy the defects discovered within one month of the date of the notice. With five exceptions the sanitary defects reported at the sixty-six places referred to above were remedied before the end of the year, and the works required at those then outstanding have since been completed. A comparison of the number of such notifications received in past years with the year under review shows as follows:— Year. No. of Complaints received. 1897 34 1898 65 1899 55 1900 49 1901 51 1902 54 1903 66 Average 53 On investigating the reports of H.M. Factory Inspectors, 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. (3) Defective drains. (4) Defective soil pipes. (5) Defective urinals. (9) Defective waste pipes, &c. 90 FACTORIES. Details of Inspections, &c., 1903. Inspections 17 Re-inspections45 Workers employed— Males 124 Females206 330 Notices served— Intimation12 Statutory 9 — 21 Oases referred to City Solicitor 2 Defects in Factories remedied, 1903. W.C. accommodation improved— Males13 Females9 - 22 Urinals improved or renewed 2 Refuse receptacles renewed2 General defects remedied 40 Total defects remedied during the year 66 DOMESTIC WORKSHOPS AND FACTORIES. "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 Domestic Workshops within the City were duly notified to H.M. Chief Inspector of Factories as required. 91 The following is a list of them:— Premises. Trade. Workers. Total Workers. M. F. 6, Aldgate Tailor 1 1 2 *9, Artillery Lane Do. 1 1 2 34a, Beech Street Do. 1 — 1 Do. Millinery — 1 1 Do. Dolls' Dressmaker — 1 1 2, Bride Street Tailor 1 — 1 *2, Bridgewater House Waistcoats — 1 1 1, The Circus, Minories Tailor 1 1 2 29, Cloth Fair Do. 2 — 2 4, Cockerill's Buildings Do. 2 — 2 8, Ellison Street Do. 1 — 1 9, Ellison Street Do. 1 — 1 2, Gunpowder Alley Blouses — 1 1 20, Middle Street Ties - 1 1 96, Minories Tailor 2 — 2 10, North Block, Artizans' Street Dressing-gowns — 3 3 9, Vine Street Tailor 1 1 2 12, Water Lane Do. 1 1 2 Totals 15 13 28 *Registered in 1902. 92 WOMAN SANITARY INSPECTOR. Summary of work done under Factory and Workshop Act, 1901, during the year 1903*:— Factories inspected 36 „ re-inspections 21 Workshops inspected, measured, &c. 283 „ re-inspections 277 Domestic workshops inspected 18 „ „ re-inspections 21 Workplaces (kitchens) inspected 13 „ „ re-inspections 59 Laundries inspected 13 „ re-inspections 7 Offices inspected 32 „ re-inspections 16 Schools inspected 1 Workers employed:—Men, 526; Women, 4,629 5,155 Number of defects found 295 Number of defects remedied—Ventilation of workrooms improved 40 Overcrowding abated 15 Workrooms, &c., cleansed 50 W.C's provided or improved 109 General defects remedied 41 Total number of defects remedied and improvements effected 255 Notices served:—Intimation, 90; Statutory, 25 115 Cases referred to Solicitor 2 In addition to the above, the ladies' waiting rooms at Railway Stations, and the underground conveniences for women, have been inspected from time to time. BLOUSE AND UNDERSKIRT MAKERS. An inspection has been made of all the premises where blouse and underskirt making is carried on, known to exist in the City. These comprise nine factories and ninety-five workshops. Over one hundred defects were found, four-fifths of which were in respect of defective or unsuitable sanitary accommodation. The actual workrooms were on the whole in a fairly satisfactory condition; in many workrooms special means of ventilation have been adopted to remove the injurious products of combustion emanating from gas stoves used for heating irons; gas irons are more difficult to deal with: where these are used they should, if possible, be placed in a specially ventilated room, apart from the general workroom. Electric irons are used in some workshops, and they are far the most desirable from a health point of view. * These figures are included in those given on p. 69. 93 OUTWORKERS. Eighty-two outworkers' premises have been visited; of these, thirteen were no longer occupied by outworkers; forty-one were workshops ; eighteen domestic workshops, and at six premises the work is done only at irregular intervals, and does not furnish the whole or principal means of living to the family, and are therefore exempt from the provisions of the Factory and Workshop Act; these were accordingly omitted from the list of domestic workshops forwarded to the Home Office. Four premises were found to be occupied by contractors employed by occupiers of factories or workshops, by whom no work is carried on, but who give work out to outworkers. It is important to notice that Sections 107,108,109 and 110 of the Factory and Workshop Act, 1901, which relate to the keeping and forwarding to the local authority of lists of outworkers, and to the prohibition of work in unwholesome premises or where there is infectious disease, apply to contractors equally with occupiers of factories or workshops. SANITARY ACCOMMODATION IN OFFICES. Complaints continue to be received of the want of suitable sanitary accommodation for women clerks employed in offices. It is satisfactory to be able to state that in every case dealt with the owners of the premises have shown themselves willing to make such alterations and improvements as were required to secure the necessary accommodation. With regard to this question it is regrettable that the Section 38, Public Health (London) Act, 1891, which relates to the provision of sanitary accommodation in factories, workshops and workplaces, is less explicit than the corresponding section of the Public Health Amendment Act, 1890. Section 22 of the latter Act reads:— "Every building used as a workshop or manufactory, or where "persons are employed or intended to be employed in any trade or "business, whether erected before or after the adoption of this part "of the Act, in any district, shall be provided with sufficient and "suitable accommodation in the way of sanitary conveniences, having "regard to the number of persons employed in or in attendance at "such building, and also where persons of both sexes are employed "or in attendance, with proper separate accommodation for persons "of each sex." The expression "building . . . where persons are employed ... in any trade or business "is replaced in the London Act by the vague term "workplace," of which there is no definition in the Act. But in the case of Bennett v. Harding, 1900, 2 Q.B. 397, which was taken under Section 38, Public Health (London) Act, 1891, it was held that the word "workplace" 94 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." This definition would surely include offices. In this relation it may be of interest to quote the view taken by H.M. Principal Lady Inspector of Factories. In a letter dated 21st December, 1903, in reference to sanitary accommodation in offices, Miss Anderson writes: "I trust that the case of Bennett v. Harding will cover the circum"stances of clerks and typewriters, so as to enable the protection of Section "38 of the Public Health (London) Act, 1891, to be fully extended to "them. The increasing employment of women clerks in city offices in "subordinate posts, and by twos and threes or small numbers in each case, "for long hours, makes the matter one of grave importance to health." SANITARY ACCOMMODATION ORDER. As stated in last year's Report, the provisions of the Sanitary Accommodation Order issued by the Secretary of State have been adopted by the Sanitary Committee as the standard of sufficient and suitable accommodation under Sections 37, 38, Public Health (London) Act, 1891. A statement of these requirements has been printed on the reverse side of the Notices (Intimation and Statutory) served under the sections referred to, and this new form of Notice has proved effective in saving unnecessary correspondence and discussion. It is gratifying to find that this action of the Corporation has been quoted by the Home Office for the example of other local authorities. A letter was received in August last from Miss Deane, one of H.M. Inspectors of Factories, in which she asked that copies of the Sanitary Accommodation Notice issued by the Corporation might be forwarded for the use of the Factory Department, as "it is considered desirable to call the attention of certain "other Public Health Authorities to this excellent form of intimation, and to "the standard which has been adopted by the Corporation following on the "recent order of the Home Secretarv relating to this matter." LEGAL PROCEEDINGS. During 1903 nine cases occurred in which it was necessary to ask the City Solicitor to take such action as he might consider expedient to enforce orders to remedy sanitary defects found in workshops or workplaces. In eight instances the required works were eventually executed without police court proceedings, and one case is still under consideration. 95 SUMMER FLUSHING OF COURTS. The usual flushing of courts and alleys in the more thickly-populated and poorer parts of the City was carried out as usual during the summer months under the directions of your Superintendent of Cleansing. The main streets and thoroughfares were also regularly and frequently washed, and your Engineer informs me in the above services no less than 42,552,601 gallons of water were used. Disinfectants were also freely used, as explained on p. 60. In the subjoined lists the places marked *** were flushed every twentyfour hours, those marked ** twice a week, and those marked * once a week. EAST DISTRICT. ***Montague Court *Little George Street Minories **Rose Alley *New Square *Cock Hill *** Harrow Alley **Sandy's Row **Church Row (Houndsditch **White Rose Court end of) Alduate **Swedeland Court Bishopsgate *Black Horse Yard **Artillery Lane * Little Somerset Street **George and Catherine Wheel *** Aldgate Avenue Alley **Northumberland Alley ***Catherine Wheel Alley *Church Court Fenchurch Street *** 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 **Hutchinson Street Market and H.M's Custom House) * *Hutchinson Avenue ***Pudding Lane **Ellison Street . ***Botolph Lane **Providence Place Middlesex Street *Botolph Alley Eastcheap **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 *St. George's Avenue Aldermanbury **Three Herring Court Redcross Street *George Yard **Hart's Court Fann Street * Mason's Avenue Basmghall Street ***Hare Court *Church Alley ***Shaftesbury Place *Moorgate Street Buildings **Maidenhead Court *Copthall Buildings ***Lauderdale Buildings *Union Court Old Broad Street ***Cotton Street Passage Aldersgate peahen Court ***Cotton Street *Helmet Court Wormwood Street **Australian Avenue **Cripplegate Churchyard *Fann Street ***Gun Yard Bishopsgate *Jacob's Well Passage Barbican **Miles Lane London Bridge *Braime's Buildings Beech Street *Sermon Lane Doctors' Commons **Upper Thames Street, St. Benet's Church to King *Foster Lane William Street *Carey Street *Friar's Alley *Gutter Lane Upper Thames Cheapside **Brook's Yard street *Goldsmith Street **Huggin Court and Lane **Grocers' Hall Court **St. James's Place **Dove Court **Sugar Loaf Court *Sun Court, Swan Alley,Moorgate Street (leading to **Three'Nuns Court Aldermanbury Cross Key Court). 96 WEST DISTRICT. **Bishop's Court *Paul's Alley *Prujean Square *Cannon Alley *Evangelist Court Pilgrim Street *Lovell's Court **Dolphin Court *Panyer Alley **Horse Shoe Court *London House Yard Paternoster Row *Pilgrim Street Ludgate Hill *Stationers' Hall Court ***Cob's Court, Broadway *Paternoster Buildings *Boy Court *Amen Corner *Johnson's Court *Queen's Head Passage Newgate Street *Red Lion Court **Seacoal Lane *Bolt Court **Fleet Lane *Pleydell Court *Harp AlleyFarringdon Street *Hind Court Fleet Street *New Court *Wine Office Court ***Holborn Viaduct Steps *Crown Court **Green Dragon Court *Poppin's Court **Currier's Row *St. Bride's Avenue *Ireland Yard St. Andrew s Hill **Glasshouse Alley Tudor Street *Cloisters Court ) **Bell's Buildings Salisbury Square **Blomfield House Yard . . Snow Hill **George Yard *Took's Court Furnival Street **Ashentree Court Whitefriars Street *Queen's Head Court *Giltspur Street **Britton' s Court *Ball Court **Fleur-de-Lis Court **Dorset Court *Trinity Passage **Sugar Loaf Court Dorset Street **Nevill's Court etter Lane **Hanging Sword Alley *Greystoke Place **Upper Thames Street, between Blackfriars and *Plough Court St. Benet's Church **Gunpowder Alley *Crown Court Chancery Lane **King's Head Court Shoe Lane **Holborn Buildings **Robin Hood Court **Middle Street *Castle Court Poppin's Court **Kinghorn Street ***Back Court **Cloth Street ***Back Passage **Montague Court **Barley Mow Passage **Little Montague Court Little Britain **Sun Court **Cox's Court **New Court Cloth Fair *Bartholomew Close ***East Passage **Middlesex Passage ***Red Lion Passage **Westmorland Buildings **Cloth Fair **Albion Buildings Bartholomew Close ***Half-Moon Passage Aldersgate **Cockerill's Buildings *Three Tuns Passage *Fenton's Buildings *Duke's Head Passage **Bartholomew Place As heretofore, this process was 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 rapidly decompose, and cause great annoyance unless promptly dealt with, 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) French Ordinary Court Fenchurch Street Hutchinson Avenue (Stoney Lane entrance) Harrow Alley Butcher Row Providence Place Black Horse Yard Aldgate Garden Place Middlesex Street Sussex Place Leadenkall Street White Rose Court Widegate Street 97 MIDDLE DISTRICT. St. James's Place Garliek 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 Crown Court Gunpowder Alley Shoe Lane 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 Bed Lion Passage Half-Moon Passage Aldersgate East Passage Middlesex Passage Bartholomew Back Passage Cloth hair Bartholomew Place Close Sun Court Montague Court Back Court Little Britain Little Montague Court 98 SMOKE NUISANCES. The question of smoke abatement has received much attention during the year, and the greater part of the time of one of your officers has been engaged in keeping offending chimneys under observation. It should be remembered that the Act is very precise as to the character of the smoke complained of from time to time. Before any successful proceedings can be taken against offenders in the cases of smoke issuing from a chimney—not being a chimney of a private dwelling-house—the prosecution is under the obligation of proving that the smoke was "black." On this point the City of Westminster invited the co-operation of the City authorities in endeavouring to obtain the deletion of the word " black " from Section 24 (b) of the Public Health (London) Act, 1891. Your Medical Officer of Health having reported that it had been found by experience that many complaints were received of smoke nuisances that could not at present be dealt with by reason of the fact that the smoke emitted, although intolerably objectionable, was not black, but some less pronounced tint, the Westminster authorities were informed that the Corporation agreed with their view. Of late years two important judgments in smoke abatement cases have been given in the High Court, which are here inserted for the purpose of reference In each instance the question at issue was the definition of a "private dwelling-house." Extract from "The Solicitors' Journal," Vol. XLVI., No. 4, for Saturday November 23rd, 1901, p. 70:— "Queen Anne Residential Mansions and Hotel Co. v. Mayor "of Westminster (Div. Court. 9th November). "Metropolis—Public Health—Smoke issuing from Chimney in such quantities as "to be a Nuisance—Block of Residential Flats—Public Health (London) Act "1891, Section 24. "Appeal against a conviction under the Public Health (London) Act, "1891, for unlawfully permitting to be sent forth black smoke from "Queen Anne Mansions in such quantities as to be a nuisance. Three "summonses were issued for separate alleged violations of the Act. The "building consisted of 300 sets of residential chambers, none of which "were provided with a chimney, there being a general kitchen, in which "all the cooking is done for the residents. There was a general dining "room in which the residents might have their meals instead of in their "rooms. In the basement there were five boilers, used for generating "steam, for cooking in the kitchen, for warming the building, for "generating electricity, for lighting, and also for the laundry. The 99 "boilers were connected with a chimney 168 feet high. On behalf of "the appellants it was contended that no offence had been committed "under the 24th Section of the Act, the chimney being the chimney of "a private dwelling-house. Every reasonable precaution had been taken, "they said, to prevent any black smoke being emitted, but this, the "respondents said, formed no defence for their action. The Magistrate "held as a mixed question of law and fact that the chimney was not the "chimney of a private dwelling-house, and he ordered the appellants to "pay a fine of £5 and £5 5s. costs on the first summons, and a fine of "10s. on each of the other two summonses, and the question for the "Court was whether his decision was correct in law. "The Court, without hearing Counsel for the respondents, dismissed "the appeal. "Lord Alverstone, C.J., said he expressed no opinion whether "Section 24 of the Act did not apply to the chimney of a private "house, because he saw no reason for regarding Queen Anne Mansions "in the light of a private dwelling-house at all. In his opinion it was a "large trade establishment, and therefore the decision of the Magistrate "was right. "Darling and Channell, J J., concurred. "Counsel: R. Cunningham Glen, Travers Humphreys. Solicitors : "Lee and Pemberton, Solicitors to the Corporation." Extract from "'The Justice of the Peace"for December 19 th, 1903:— "(Before Lord Alverstone, C.J., Lawrance and Kennedy, JJ., "December 9th, 1903.) "McNair v. Baker. "Club—Chimney emitting Black Smoke—Private Dwelling-house—Public "Health (London) Act, 1891, Section 24 (6). "Case stated by a Magistrate, sitting at the Marlborough Street Police "Court, raising the question whether the St. James' Club was a private "dwelling-house within Section 24 (b) of the Public Health (London) "Act, 1891. The appellant, McNair, a Sanitary Inspector for the City "of Westminster, summoned the respondent, Baker, for not complying "with a notice requiring him to abate a nuisance arising from black "smoke issuing from a chimney on the premises of the St. James' Club. "The respondent was the Secretary of the Club, and represented the "Club in the matter. The Club was managed by a Committee, and had "occupied the premises for thirty or forty years past. Previously they "were used as the French Embassy. The Club consisted of 750 100 "members, and its premises comprised the ordinary accommodation of a "West End Club. There were two dining rooms for the general use of "members, and there were also private dining rooms which might be "engaged by members without extra payment for special occasions. "There were five bedrooms for the use of members, four of which might "be hired by members respectively for a week only at one time, and one "of which might (at the discretion of the Committee) be hired by a "member for three, six, or nine months at one time. The use of the "bedrooms was in these and other respects subject to the rules of the Club and the regulations of the Committee thereunder. There were "eight other bedrooms for the use of the staff. The Club was open "during particular hours according to the rules. The food was bought "by the Committee and sold to members. In the basement there were "several covered-in cooking ranges, a large roasting grate, and a vertical "boiler, with furnace attached. The smoke from these various arrange"ments discharged into the flue, which was the chimney complained of. The principal part of the smoke emitted from the flue originated in the "furnace and boiler, which were used for heating the premises. It was "submitted by the respondent that the chimney was the chimney of a "private dwelling-house, within Section 24 (b), and was therefore not liable "to be dealt with under the Act. The appellant contended that 'private "dwelling-house' meant a family residence or house, and that the use of "the premises excluded them from the exemption of the Section. The "Magistrate found as a fact that the chimney sent forth black smoke in "such quantity as to be a nuisance, but he held, on the construction of "the Section, that the chimney was the chimney of a private dwelling"house, and that the premises as used by the Club were a private "dwelling-house within the meaning of the Section, and he dismissed "the summons. "The Court held, allowing the appeal, that a club was not a private "dwelling-house within the meaning of the Public Health (London) "Act, 1891, Section 24 (b)." Smoke nuisances were reported at 57 premises during 1903. The number of observations recorded in relation to them amounted to 1,306, as against 3,536 noted at 66 places in 1902. In no case was the evidence sufficient to justify the institution of legal proceedings for abatement of smoke nuisance. Fewer complaints are being received, and it is evident that the summonses taken out against offenders in the previous year have acted as a deterrent. The improvement existing is due, in a large measure, to the partial substitution in restaurants of coke for soft bituminous coal. Again, considerable advance has been made in inducing users of furnaces to so arrange the fuel combustion as to reduce the evil to a minimum. 101 REMOVAL OF HUMAN REMAINS. During 1903 there were three cases in which human remains were disinterred in the City, under the supervision of your Medical Officer of Health. It is estimated that the remains of about 518 persons were so dealt with at the undermentioned places:— Old Bridewell Burial Ground, (58 Bodies removed. Under Licence from the Home Dorset Street. Secretary, under 20 and 21 Vic., cap. 81, sec. 25. Abchurch Lane 200 „ „ Ditto. Corner of Liverpool Street and 250 „ „ Ditto. Blomfield Street. Total 518 Bodies removed. In 1902, 4,051 bodies from five places were similarly dealt with in the City. OLD BRIDEWELL BURIAL GROUND, DORSET STREET. In February, 1903, the Home Secretary granted a Licence in the usual terms for the removal and re-interment of human remains discovered during the progress of lowering a piece of ground in Dorset Street, Salisbury Square, and four cases, estimated to contain the remains of 68 bodies, were disinterred and re-buried at the City of London Cemetery, under the superintendence of your Medical Officer of Health. It should be mentioned that in the Summer of 1892, 15 cases of bones and 15 coffins from the same spot had been similarly dealt with by the late Medical Officer of Health. On the 11th May, 1903, a Bill promoted in the House of Lords by Earl De la Warr, to remove the restrictions of the Disused Burial Grounds Act, 1884, as amended by the Open Spaces Act, 1887, in order to permit this piece of ground to be built upon, was rejected in the House of Commons on the second reading. ABCHURCH LANE. A quantity of human remains having been discovered in April, 1903, in the course of some building operations at some premises in Abchurch Lane, adjoining the Churchyard of St. Nicholas Acons, the matter was reported to the Home Secretary, who granted a Licence for their exhumation and removal to the City of London Cemetery at Ilford, and 13 cases of bones, estimated to contain the remains of 200 persons, were duly removed and reinterred at Ilford Cemetery, in accordance with the terms of the Licence. 102 CORNER OF LIVERPOOL STREET AND BLOMFIELD STREET. In July last, ten cases of bones, representing the remains of from probably 200 to 300 bodies, discovered in excavating a site for an underground latrine at the corner of Liverpool Street and Blomfield Street, were exhumed under the supervision of your Medical Officer of Health, and dealt with in accordance with the terms of a Licence issued by the Home Secretary. The question as to whether the above were the remains of persons who had died during the great plague having been raised in the Press, your Medical Officer's Report on the subject to the Sanitary Committee is reproduced here for the purpose of future reference. "The spot where these bones were found originally formed a portion "of the South side of Bethlem* [see footnote] burial ground thrown into "the public way in Liverpool Street when the North London Railway "was built. "The remains themselves show unmistakable evidence of having been "disturbed on a previous occasion, and it is probable that, during the "erection of Broad Street Station, when the roadway was widened, "many of the bones then exhumed were collected and re-buried at the "place where the excavations are now in progress. "There is no direct evidence that this was a plague pit—a critical "examination of the bones indeed shows that they must have been "originally interred at widely different periods—this in itself negatives "the assumption. "That persons who died during the great plague were buried in the "neighbourhood is evidenced by Defoe's notes on the subject, referred to "by Mrs. Basil Holmes in a chapter on Pest-fields and Plague-pits in "her work on the 'London Burial Grounds.' "The accompanying extracts also bear upon the question. " Extract from 'Creighton's History of Epidemics in Britain.'' "'In excavating the foundations of the Broad Street terminus of "'the North London Railway, the workmen came upon a stratum "'4 feet below the surface and descending 8 or 10 feet lower, "'which was full of uncoffined skeletons. Some hundreds of them "'were collected and reinterred. (Notes and Queries 3rd Ser. *Respecting the Bethlem Burial Ground, Stow remarks:— "In the year 1569, Sir Thomas Roe, Merchant Taylor, Mayor, caused to be enclosed with "a wall of brick about 1 acre of ground, being part of the Hospital of Bethlem. This he did for "burial and ease of such parishes in London as wanted ground convenient within their parishes. "The lady, his wife, was there buried (by whose persuasion he enclosed it)." 103 "'IV. 85.) The ground was part of the old enclosure of Bethlem Hospital (St. Mary Spital outside Bishopsgate), and was acquired "'for a cemetery, to the extent of an acre, by Sir Thomas Roe "'in 1569. "'Probably there were plague pits dug in it during more than "'one of the great epidemics from 1593 to 1665.' "The following Extract is made from 'Notes and Queries' dated August Lst, 1863. "'Plague Pit.—Excavations are now being made for the works "'of the North London Railway in Broad Street Buildings, and a "'very large quantity of human bones have been met with. "'The excavations do not extend over the whole space to be "'covered by the works, but are only on the site to be occupied by "'the brickwork. The bones being at about 4 feet from the "'surface, and from thence to about 8 or 10 feet lower the ground "'is full of them. They lie without any arrangement, and there "'are no coffins except in a corner of one of the pits where the "'remains of some, but comparatively few, have been found at a "'lower part of the excavation. Probably some 300 or 400 "'skeletons have at least been taken out. "'My Query is whether this is the site of a Plague pit? "'The place is about 100 yards from the City wall, and perhaps '''three times that distance from Bishopsgate, and somewhat further "'from Moorgate. It would appear from the way in which the "'bones lie, as if at first the bodies had been buried in coffins, but "'afterwards they had been thrown in indiscriminately.' "'Quisquis.' "Note.—This Query appears to have remained unanswered. [M. 0. H.] " ST. BARTHOLOMEW-THE-LESS. Proposed Removal of Human Remains. The Governors of St. Bartholomew's Hospital having given notice in the "London Gazette " of their intention to apply next Session for Parliamentary powers, inter alia, for the removal of human remains from the burial ground and church of St. Bartholomew-the-Less, Mr. Remembrancer was instructed by the Corporation to secure the insertion of a provision that such exhumation and removal be done under the supervision and direction of the Corporation. 104 MANUFACTURE OF AERATED WATERS. Owing to the increasing consumption of mineral waters, and the danger to health incurred when these beverages are manufactured under unwrholesome conditions, enquiries were instituted in November last, when it was ascertained that no bottled aerated waters were then manufactured in the City. An inspection was subsequently made of those places—chemists' shops, cafes, &c.—where soda fountains and similar machines were in use, and on the whole they were found to be conducted in a satisfactory manner. In New York mineral water factories are only permitted when conforming to a sanitary code of the Department of Health, and it would be well if a similar prohibition obtained in this country, not only in the Metropolis, but throughout the Kingdom. DAIRIES AND MILKSHOPS. There are now 553 Purveyors of Milk registered in the City under the Dairies, Cowsheds and Milkshops Orders, as compared with 528 in 1902. In the course of the year the sale of milk was discontinued at 28 premises, while 53 new premises were added. Those now on the Register are classified as under:— Large refreshment room proprietors of the better class 242 Small refreshment rooms of a good class 43 Refreshment rooms of all classes; kept by foreigners 79 Dairies where light refreshments are sold 36 Bakers 16 Confectioners 4 General Shops 50 Vegetarian Restaurants 7 Coffee houses and cheap dining rooms 76 553 A Street List of the above, arranged alphabetically, will be found in Appendix D, page 158. 105 Considering the large number of these establishments in the City, it is satisfactory to note that in only four cases was it found necessary to take steps to remedy sanitary defects, and in no case was there any occasion to take legal proceedings. Three cases of infectious disease were notified as having occurred at registered milkshops. In each instance the proprietors were prohibited from dealing in milk until the premises had been certified by your Medical Officer of Health as free from infection. A case was reported by one of the City clergy in which a woman, suffering from a specific contagious disorder, was found to be personally engaged in the conduct of business at a milkshop. The matter being brought to the attention of her husband, he at once consented to the woman ceasing to take any active part in the business. In Appendix E, p. 163, will be found the revised Regulations for Milkshops, &c., made by the Court of Common Council, which came into force on the 1st day of September, 1903, and which supersede all Regulations heretofore made under, or having effect in pursuance of the Dairies, Cowsheds and Milkshops Order of 1885, so far as were in force in the City of London. A copy of these Regulations was left with every Registered Dairyman or Purveyor of Milk, and attention particularly directed to the regulation provided to ensure the provision of suitable coverings for all milk vessels, for the purpose of protecting the milk at all times from contamination. So far as is known such a provision does not occur in any other Regulations, although the great importance of keeping milk free from contamination by dust and dirt is well recognised. In view of the enormous amount of traffic this Regulation is especially valuable in the City. ICE CREAMS. In the summer of 1902 your Medical Officer of Health reported that out of 23 samples of ice cream procured in the City, no less than 12, or about 52 per cent., were found to be absolutely poisonous, and that cases of illness with definite and similar symptoms had occurred amongst persons who had consumed them. This was before the statutory provisions relating to ice creams were in force, as they did not come into operation until the 1st November following. During 1903 only one case of this kind was notified. In this instance, a lad, aged 15, who had been in the habit of buying icecream from a shop in the 106 Minories, was attacked with Enteric Fever. A sample was submitted to Professor Klein, who reported as under:— "1. No bacillus typhosus was detected in the sample. "2. The sample contained in great abundance a highly virulent bacillus, which "belongs to the coli group, but is distinctly different from bacillus coli "communis. A trace of culture proved virulent on injection of a guinea pig." This ice cream was manufactured in Stepney, and the Medical Officer of Health of that Borough stated, in reply to enquiries, that it was made under insanitary conditions, and that a sample submitted by him to bacterioscopic examination was found to contain the bacillus coli communis. Although the specific organism of typhoid was not found in the sample, there appeared to be sufficient evidence to warrant the conclusion that the patient's illness was probably due to the consumption of ice cream made under insanitary conditions. These facts are an ample illustration of the necessity of rigidly enforcing the requirements of the statute relating to the manufacture and sale of this article of food. During the summer months an inspection was made of the two hundred and thirty-nine shops where ice creams are sold within the City of London, and these premises were kept under constant supervision. It was found that ice creams were manufactured at seventy-two premises in the City of London, and that in one hundred and fifty-four instances the commodity exposed for sale was manufactured at places outside the City. When the manufacture took place in the City, the premises were periodically visited, and the Regulations in regard to the manufacture and sale of ice creams enforced. Insanitary conditions were discovered in eleven instances, and remedial works were duly executed. In cases where the manufacture was carried on outside the City, the Medical Officer of Health of the District in which the ice cream was made was advised of the name and address of the manufacturer, and asked for information as to the sanitary condition of the manufactory, &c. In three cases unfavourable replies were received, and steps were at once taken to prevent ice creams manufactured at these places from being sold until the occupiers had complied with the requirements of the Medical Officer of Health of the District, and an intimation received to that effect. The utensils and material of forty-seven itinerant ice cream vendors were inspected, and the place of manufacture of their wares ascertained. In one case only was the article found to be manufactured within the City; as in the above cases the District Medical Officers of Health were advised in each instance, with satisfactory results. 107 The following are the Regulations to be observed by persons being manufacturers of, or merchants, or dealers in ice cream, or similar commodity within the City of London, approved by the Corporation on the 26th day of November, 1902. A copy of these Regulations has been handed to the proprietors of each of the two hundred and thirty-nine shops where ice creams are sold within the City of London. "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 room 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." MEAT SUPPLIES. The supply of Meat to the Central Market has this year reached the highest point on record, viz., 415,915 tons, being, however, but very slightly in excess of 1901, when 415,510 tons were sent in, but an advance of 10,895 tons on last year's figures; this year has also provided us with the heaviest supply on any one day, viz., December 21st, when 4,209 tons arrived, as against 4,159 tons on December 21st, 1896, that being the previous highest on record; in regard 108 to condition and soundness it is satisfactory to note that in comparison with 1901, with which the supply corresponds so very closely, there is a diminution in the weight seized as unfit for food by your Inspectors. There is, however, still a great waste, which, to a certain extent, is an inevitable consequence of the long distance by which we are separated from the sources of supply, and although greater care in selection and preparation of meat for shipment, together with improvements in machinery for refrigerating, may do much to minimise the loss, yet it is one we can scarcely hope wholly to eliminate. Referring to the Report of last year and the forecast of future supplies therein contained, it will be found that the opinion expressed has been justified. The close of the war in South Africa has left the firms engaged in the export of meat from the Argentine at liberty to supply the wants of this country, and refrigerated beef from the River Plate district is now on sale daily at the Central Market, and proves a formidable competitor to the similarly preserved article from the United States with which we have been for so long conversant; but it must be admitted there is still much to be desired in point of quality, the Argentine productions of to-day being about on a level with the early consignments from America thirty years ago, and it is easy to understand that careful selection at the breeding farms, together with the importation of some of the best blood in this country, have effected considerable improvement during that period. The effect on the meat coming to this country is still more marked, as it has been always found, both in regard to frozen and refrigerated meat, that if any were prejudicially affected by conditions obtaining during the time of preservation, it was the carcasses of imperfectly fed animals which suffered most, and when it is borne in mind that the passage from Buenos Ayres takes three weeks, while that from New York occupies six days, it will be seen that any deficiency of quality is sure to tell upon the Argentine beef to a greater extent than upon that from North America. Still we have the fact that it comes in regular shipments, that notwithstanding the defects noted above it answers the purpose of some salesmen to pay special attention to it, that the companies in the trade have been able to pay good dividends to their shareholders, and that they are managed by men of business who know what is wanted, and so we are justified in looking for a gradual and steady improvement in the quality of the meat, and the condition in which it may be expected to arrive on this market. The American beef trade in London is mainly in the hands of some halfdozen firms, and the article they supply is now so well known as to render comment unnecessary; it has been on sale in sufficient quantities of satisfactory quality. Some of these same firms are also engaged in bringing live cattle to the waterside markets at Deptford, Birkenhead, &c.; these are 109 now so carefully prepared and brought so free from, bruises or other injury as to be more than ever in competition with the home-grown cattle; but as, against this, they have themselves to face competitors of no mean order in the productions of the great plains of Canada, the presence of which, in such large numbers of excellent quality on our English markets, is one of the best features of the year, and the most reliable information is to the effect that notwithstanding the comparatively low prices realised they will increase in number and improve in quality. Some of the effects of the prolonged drought in Australia are still apparent in the poorly nourished beef which has found its way to the English market from that quarter, and much of the Australian mutton has also fallen far short of what we consider it ought to be, but meat producing is a matter requiring time, and, already, we have the earnest that our Australian Colonies are not going to be left out in the cold, as shown by the presence on this market of the very finest lot of lambs we have yet seen from Melbourne; if they can find them in continuity as good as these, our New Zealand breeders will have all their work cut out to maintain their precedence. The quantity of fresh meat from Denmark has been less than previous years. There has been some pork from Russia which has come in generally good condition and met a fair trade, also some beef, but of the latter it can only be said that if what we have seen is a fair sample of Russian beef it is hardly likely to be greatly appreciated in this country. On the 15th April, 1903, an important measure was put into force by the Nether land Government with the object of preventing the export to this country of any doubtful meat from Holland. In 1902 Dr. Poels was sent from the Netherlands to make enquiries respecting our method of meat inspection, and the system now adopted in Holland is the result of his report. The details of the scheme now in operation in that country are fully described in the Netherland Royal Decree of 21st November, 1902, and in a Ministerial Order dated 31st December of that year, which are too lengthy for reproduction here. Briefly, it amounts to this: pending legislation of a compulsory character, the Netherland Government have introduced a system of voluntary inspection and marking by Government officials, at a very small chai'ge, of all meat intended for export. This has been attended with a considerable measure of success so far as the larger and better class of Dutch dealers are concerned, only the smaller merchants not availing themselves of the opportunity of having their goods inspected. An attempt was made to induce all the steamship companies carrying Dutch produce to this country to refuse to convey any meat not officially marked. Unfortunately one company—the Great Eastern—demurred, and the 110 project fell through. This is much to be regretted, as, if adopted, it would have practically converted the voluntary system of inspection and marking into a compulsory one. It is gratifying to note that on the whole this action of the Netherland Government has been attended with a marked improvement in the quality of the consignments of Dutch pork that find their way to our markets. It is stated on good authority that although the system has been in force for a comparatively short time, quite 70 per cent. of the meat, chiefly pork coming from Holland, is now inspected and marked by expert Government Inspectors, the remaining proportion being sent by other dealers who have no opportunity of having their meat inspected, or who may have good reasons for not submitting their goods for examination. In these circumstances it would be greatly to the public advantage if the Great Eastern Railway Company could see their way to fall into line with the other carriers of meat from Holland, and refuse to ship any not bearing the guarantee of the Netherland Authorities. This voluntary marking was first introduced at the Hook of Holland, and it has since been extended to the towns of Oss, Assen, Rotterdam, and Eindhoven. In the month of October Servian sheep again made their appearance on the market. They are sent in refrigerator vans as far as Ostend, whence to London there is no means of preserving them; the consequence was that the weather being mild and wet, the time after leaving the refrigerator van was just long enough for them to get thoroughly "nasty " before they reached the Central Market, so that although they did not carry the same appearance of disease as those of last year, they soon earned for themselves the nickname of "Bulgarian atrocities;" a large proportion was seized, and for those sold such a poor price was realised that it seems unlikely that any considerable trade will be developed. Correspondence with the Admiralty has resulted in a succession of Officers of the Royal Navy being sent to the City Markets to undergo a course of training in order to enable them to determine whether the meat supplied to the Service by Contractors is of good quality, and in accordance with the terms of the Admiralty contract. Seventeen prosecutions were instituted during the year for sending diseased meat to London. One fishmonger has been summoned for exposing unsound fish for sale, and one game dealer for exposing and selling unsound rabbits. Convictions were obtained in each case, the fines and costs imposed amounting 1ll to 568l. 19s. 6d. Four prosecutions were in respect of beef, three of mutton, seven of pigs or pork, one fish, and one rabbits. There has been no new development at Leadenhall Market; in its own particular line it stands alone, but as it is a toll-free market there is no account taken of the weight of meat, poultry, game, &c., going into it, and so it is impossible to tell the rate of increase in the supply. ALDGATE SLAUGHTERHOUSES. The Slaughterhouses at Aldgate continue an unsatisfactory feature, the trade is on the decline, and it seems probable that in the near future some of them will cease to be used as such, a consummation devoutly to be desired. Most of the meat consumed by the Jewish community in the Metropolis was formerly killed at these places, but it is now chiefly slaughtered at Deptford. Since 1898, two, viz., Nos. 53-54, and 62, Aldgate High Street, have been closed by order of the Lord Mayor for neglect of Bye-laws, and in three, viz., Nos. 57, 58 and 60, the right to slaughter therein has lapsed owing to non-user. Those now remaining are situated at the following places, viz., Nos. 44, 45, 46, 48, 49-51, 52, 55 and 56, Aldgate High Street. TUBERCULOSIS IN MEAT. The circular letter on the subject of Tuberculosis in Meat, referred to in your Medical Officer's last Annual Report, was issued in March, 1903. Upwards of 6,800 were sent out, of which 3,050 were supplied in response to written applications to the Town Clerk for further copies. The accompanying list will show that the distribution was made as far-reaching as possible. TO LOCAL AUTHORITIES IN ENGLAND AND WALES. Copies. Copies. Urban District Councils (including County Boroughs and Boroughs) 1,150 Rural District Councils 550 County „ „ 63 Metropolitan Borough Councils 28 Newspapers, London 454 1,791 „ Provinces 1,443 „ Wales 107 2,004 Total 3,795 The following is a copy of the circular:— 112 Corporation of London. PUBLIC HEALTH DEPARTMENT. TUBERCULOUS MEAT. The Corporation of London has for many years instituted legal proceedings (resulting in many instances in the infliction of heavy fines or terms of imprisonment) against farmers, butchers, and other persons for sending diseased or unwholesome meat into the City Markets, or for exposing the same for sale. It would appear that in some cases such offence may have been due to gross carelessness, or even ignorance of the symptoms of disease in the living animal, or of the appearance of unsound carcasses after slaughter. The following indications of Tuberculosis, both in the carcass and in the living animal, drawn up by Dr. Collingridge, the Medical Officer of Health for the City, and Mr. King, Veterinary Inspector to the Corporation, are therefore published as guidance for the use of persons dealing in meat, and all salesmen and dealers are earnestly desired to bring them to the notice of those specially interested. This appeal is made as, from experience, it has been made manifest that salesmen within the City are anxious and willing to do anything in their power, in the interests alike of the public health and legitimate trading, to prevent unsound meat being offered for sale. Further copies of this Circular will be supplied on application. JAMES BELL, Public Health Department, Town Clerk. Guildhall, London, E.C., March, 1903. 113 SIGNS OF TUBERCULOSIS IN THE CARCASS AND ORGANS. At the time of slaughter, when the carcass and all the organs are available for examination, there should be no difficulty in detecting the presence of tubercle. Beef.—Any unnatural appearance should be looked for, and any case of doubt referred to an Inspector before sending meat to market. The following are indications of disease:— (i.) The kernels on the paunch and in the fat round the entrails are enlarged, and may be hard and gritty, or soft and cheesy, according to the stage of the disease. (ii.) The lungs are studded with small masses containing matter, varying from the size of a pin's head and upwards, the larger being gritty when cut into. If there are many of these masses they may form bunches like grapes, and the disease often spreads to the skirt, and the inner side of the ribs, when the lungs grow to the ribs and skirt, and have to be cut away in dressing. (iii.) As the disease progresses the masses of tubercle are found on the other side of the skirt, and inside the flanks to which the intestines sometimes grow. "Stripping" or removal of skin from the inside of the ribs or flanks only partially removes the signs of disease, while it always arouses suspicion, and must be considered as proof that the person dressing the animal had guilty knowledge of the existence of disease (Tuberculosis). The Local Government Board has ordered that Stripping, in the case of foreign dead meat, shall be sufficient reason for condemnation. (iv.) White or yellowish masses in the liver, which on cutting present the appearances described above in (i.). Pork.—The conditions are more stringent, and the report of the Royal Commission advises that all pigs showing any evidence of Tuberculosis should be condemned. It frequently occurs, however, that well-nourished pigs are tuberculous; therefore special attention should be paid to the kernels on the mudgeon and on the belly and weasand. These should be split with a knife to ascertain if they are hard or gritty. The kernels on the windpipe and between the lungs should be carefully examined. The lungs should be tested by pressure between the finger and thumb— hard, shotty lumps will indicate disease. All the kernels should be of natural size and colour, free from all gritty feeling or cloudy appearance. It is strongly recommended that no pigs, the lungs of which have grown to the side, and no meat of a doubtful character should be sent to market. WILLIAM COLLINGRIDGE, M.D., Medical Officer of Health, City of London. 114 TUBERCULOSIS. SYMPTOMS IN THE LIVING ANIMALS. In the early stages of this disease the majority of animals may appear to be in perfect health, there being no symptoms which would lead a veterinary surgeon, farmer or butcher to say definitely that the animal was suffering from Tuberculosis, although those in constant attendance on the animal would notice that at times they appear to be out of sorts and have a disinclination for their food, and occasionally after feeding, especially if the lungs are the seat of the disorder, the animal has a sharp, irritable cough, but as the disease advances in many cases the symptoms become more pronounced and more obvious to those attending and feeding the animals; there is often enlargement of the glands of the throat, the nose becomes dry and the eyes have a glassy appearance and often appear to sink in the socket; the cough becomes more frequent, the coat dry and staring, and the hide tight; the animals also often suffer from intermittent diarrhœa. On tapping the chest of an animal in this condition with the fingers, there will often be found a dulness, or a sound of solidity in patches over the region of the lungs, and the animal gradually loses flesh. When the udder is affected, small nodular swellings can be felt in one or more of the quarters; these gradually enlarge and run together until the whole quarter or quarters become a diseased mass; this differs from ordinary Mammatis or Garget, inasmuch as there is little or no pain on pressure and the swellings gradually increase. Should the owner of cattle find an animal exhibiting any of the above symptoms, it is his duty, in the interests of the community at large, to seek the advice of his veterinary surgeon, who will be able to satisfy him as to the condition of the animal, either by the symptoms present or by the use of Tuberculin. JAMES KING, M.R.C.V.S., Veterinary Inspector to the Corporation of London. January, 1903. 115 Table showing the annual deliveries and other details during the past 30 years:- MEAT SUPPLIES, 1874 TO 1903. Year. General Supply. Seizures by Inspectors. % of Bad Meat. Tons cwts. qrs. Tons cwts. qrs. 1874 157,628 18 l 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 807,519 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 1903 415,915 12 1 1,142 9 1 .275 *The figures relating to the Central Market supplies are compiled from the Monthly Returns of the Superintendent of the Market. 116 The monthly deliveries during 1903 and the two preceding years are here given. Monthly Deliveries at the Corporation Markets, Smithfield. month. 1901. 1902. 1903. Tons cwts. qrs. Tons cwts. qrs. Tons cwts. . qrs. January 38,097 7 2 39,000 16 2 35,116 4 3 February 32,746 10 3 32,193 13 2 32,134 9 1 March 34,912 7 3 32,915 8 3 35,039 12 2 April 34,032 0 3 35,221 8 2 34,823 16 3 May 35,927 11 0 34,704 15 0 33,870 4 0 June 32,562 3 2 31,864 7 3 34,407 9 0 July 32,655 13 2 33,115 14 2 34,655 5 3 August 32,092 16 0 29,340 2 1 30,758 18 2 September 31,631 2 0 32,134 5 2 33,033 19 2 October 37,407 10 2 36,020 18 2 37,939 16 0 November 36,390 18 3 32,320 4 0 35,452 10 0 December 37,054 15 2 36,187 19 0 38,683 6 1 Total 415,510 15 2 405,019 13 3 415,915 12 1 The sources of origin during the past seven years are here expressed in terms per cent. of total annual deliveries. Country Killed. Town Killed. *Foreign Killed. American. Australian and New Zealand. Home Killed. American Killed. Per cent. Per cent. Per cent. Per cent. Per cent. Per cent. 1896 30.8 20.4 11.2 20.1 17.5 1897 28.2 20.1 12.9 18.8 20.0 1898 27.8 197 12.6 19.0 20.9 1899 27.3 15.5 14.2 23.0 20.0 1900 25.2 14.6 15.1 23.2 21.9 1901 25.7 13.1 14.4 25.5 21.5 1902 27.2 12.7 17.3 21.5 21.3 1903 22.7 6.8 17.0 10.4 24.1 19.0 *Includes " General Foreign Meat and Produce." From 1896 to 1902 American cattle slaughtered at Birkenhead and Deptford were classed "country killed" and "town killed " respectively. In 1903 they were included under the heading " American home killed." 117 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:— 1901. 1902. 1903. Number of loads weighed during the year upon the Market Weighbridges for the purpose of ascertaining the amount of Toll due thereon - Loads. Loads. Loads. 206,807 Tons. Tons. Tons. Average daily delivery into the Markets 1,355 1,290 1,341 Minimum on any one day 244½ 245 237 Maximum delivery 2,948 3,576 4,209 The heaviest weight previously recorded on any one day (21st December, 1896) was 4,159 tons. One ton in every 364 tone of meat paying toll in the Central Markets, Smithfield, was condemned last year, as compared with one ton in 468 in 1902. MEAT INSPECTION. The seizures of diseased and unsound meat amounted to 1,142 tons 9 cwts. 1 qr., including 304 tons 7 cwts. 2 qrs. 4 lbs. of imported frozen and chilled meat. Month. 1901. 1902. 1903. Tons cwts qrs. Tons cwts qrs. Tons cwts .qrs. January 37 7 0 69 2 0 60 3 2 February 30 16 2 56 3 3 55 1 1 March 46 3 3 76 12 1 84 1 2 April 86 10 2 75 3 1 108 3 0 May 122 15 3 67 8 0 59 19 2 June 85 5 2 123 4 1 65 8 0 July 127 8 1 99 12 1 131 8 0 August 283 9 1 58 18 2 76 7 1 September 114 19 3 63 18 2 135 2 2 October 113 17 1 62 0 1 182 15 2 November 112 10 0 60 14 2 89 17 0 December 109 17 3 52 14 2 94 2 1 Totals *1,271 1 1 865 12 0 1,142 9 1 *The heaviest total recorded. 118 UNSOUND MEAT, 1903. The 1,142 tons 9 cwts. 2 qrs. 18 lbs. seized by your Inspectors as unfit for the food of man, were classified as under:— 1903. Diseased. Putrid. Unwholesome. Poultry. Offal. Fish. Total. tons. cwts. qra. 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 48 6 2 5 99 15 2 12 23 15 2 16 14 13 3 0 12 19 2 22 0 1 2 8 199 12 3 7 Second „ 47 0 3 10 126 7 0 5 14 16 0 13 12 12 3 8 29 14 0 15 0 3 0 24 230 14 0 19 Third „ 31 13 2 7 222 13 2 3 5 12 2 22 20 2 0 7 66 1 0 14 0 0 0 20 346 3 0 17 Fourth „ 66 2 2 2 153 7 3 5 32 12 0 23 41 6 2 7 70 19 0 2 1 11 1 20 365 19 2 3 Total 193 3 1 24 602 3 3 25 76 16 2 18 88 15 0 22 179 13 3 25 1 16 1 16 1142 9 2 18 The above figures include 32,729 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. Per Cent. Per Cent. Per Cent. 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 1902 17.4 77.7 4.9 Average for 5 years 11.7 84.3 4.0 1903 16-9 76.4 6.7 *Including poultry, offal and fish. There was a decrease recorded in the proportion of diseased meat seized, but the figure is still far too high, being 5.2 above the average percentage for the preceding five years. There was a notable increase in the quantity of meat seized as "unwholesome," the percentage last year being 2.7 above the average for the previous five years. The proportion of meat condemned on account of putridity was the lowest recorded since 1894, and was no less than 7.9 per cent. below the average of the preceding five years. CENTRAL MARKETS, SMITHFIELD. Table showing Weight of Meat delivered, seized as unsound, and proportion condemned to that delivered during each Month of the Year 1903. 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 35,116 4 3 60 3 2 1 ton in 584 tons, or .171% February 32,134 9 1 55 1 1 584 „ .171 „ March 35,039 12 2 84 1 2 417 „ .239 „ April 34,823 16 3 108 3 0 „ 322 „ .310 „ May 33,870 4 0 59 19 2 „ 566 „ .177 „ June 34,407 9 0 65 8 0 526 „ .190 „ July 34,655 5 3 131 8 0 263 „ .379 „ August 30,758 18 2 76 7 1 403 „ .248 „ September 33,033 19 2 135 2 2 244 „ .409 „ October 37,939 16 0 182 15 2 208 „ .482 „ November 35,452 10 0 89 17 0 395 „ .253 „ December 38,683 6 1 94 2 1 411 „ .243 „ Totals 415,915 12 1 1,142 9 1 1 ton in 364 tons, or .275 % 119 DISEASED MEAT PROSECUTIONS, 1903. Date of Hearing. Where Heard. Before whom. Occupation of Person Summoned. Defendant's Place of Business. Result. 1903. Jan. 2 Guildhall Mr. Ald. Burnett Farmer Coombe Martin, Ilfracombe, Devon Fined £50 and £6 15s. expenses. „ 19 Do. Mr. Ald. Guthrie Farmer Denver Lodge, Epping „ £50 „ £3 3s. „ or two months' imprisonment. (Defendant went to gaol.) Feb. 10 Do. Mr. Ald. Vaughan Morgan Fishmonger 415, Central Fish Market,E.C. „ £26 and 7s. 6d. expenses. „ 10 Do. Do. Fishmonger Do. „ £18 „ 7s. 6d. „ „ 26 Do. Mr. Ald. Alliston Dairyman Lower Westcot, Cullompton, Devon „ £20 „ £4 4s. „ „ 27 Do. Ald. Sir J. C. Bell Cattle Dealer Smeaton, nr. Kibworth, Leicester „ £100 „ £3 3s. March 6 Do. Do. Poulterers, &c. 19, Liverpool Street „ £20 „ £2 2s. April 6 Do. Ald. Sir J. Renals, Bart. Publican and Butcher Sprowston, Norwich „ £20 „ £6 6s. ,, 8 Do. Do. Publican and Cattle Dealer Gazeley, Newmarket „ £10 „ £4 4s. „ 23 Do. Mr. Ald. Smailman Butcher and Cattle Dealer 10, Westgate, Grantham „ £30 „ £6 6s. „ „ 28 Do. Mr. Ald. Alliston Pig Dealer, &c. Downham Market, Norfolk „ £30 „ £5 5s. May 14 Do. Ald. Sir G. F. Faudel-Phillips,Bt. Bill Poster, &c. Ruskinton, Sleaford, Lines. ,, £10 „ £6 6s. „ Nov. 3 Do. Mr. Ald. Simmons Butcher Old Leake, nr. Boston, Lines. „ £5 „ £3 3s. „ „ 17 Do. Ald. Sir W. P. Treloar Butcher Culmstock, Devon „ £20 „ £12 15s. „ Dec. 7 Do. Ald. Sir G. W. Truscott Dealer Stoke Ash, nr. Eye, Suffolk „ £15 „ £5 „ 8 Do. Do. Farmer Black Notley, nr. Braintree, Essex „ £50 „ £3 „ or two months' imprisonment. (Defendant went to gaol.) „ 15 Do. Mr. Ald. Alliston Pig Dealer Wool pit, Suffolk „ £20 and £2 12s. expenses. The average of fines and expenses in the cases convicted amounted to £35 4s. 8d, 120 121 FISH SUPPLIES. 218,475 Tons of fish, of which 160,741 were land-borne and 57,734 water-borne, were received at or near Billingsgate Market during the year. Of the above, 163,897 tons were consigned to Billingsgate Market, the remainder, viz., 54,578, 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. 1902 Tons. *156,357 Tons. 59,826 Tons. 216,183 1903 163,897 54,578 218,475 7,540 increase. 5,248 decrease. 2,292 increase. *Extracted from the Annual Report of the Clerk of the Market. There was a slight falling off in the land deliveries, but the deliveries by water again showed a marked increase, being 13,573 above the average for the five preceding years. 122 MONTHLY FISH RETURNS, 1903. 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 1903. Month. Weight of Fish Delivered.* Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. January Tons. Tons. Tons. Tons. cwt. qrs. 1 in 839 tons, or .120 per cent. 12,942 4,105 17,047 20 6 1 February 11,508 2,542 14,050 31 12 1 1 „ 444 „ .225 „ March 14,313 3,975 18,288 34 1 3 1 „ 358 .279 April 13,845 4,324 18,169 28 12 0 1 „ 635 „ .158 „ May 13,974 5,738 19,712 136 9 2 1 „ 144 „ .692 June 14,074 5,067 19,141 176 1 2 1 „ 109 „ .920 „ July 14,073 5,060 19,133 273 17 2 1 „ 70 „ 1.431 August 15,078 5,615 20,693 128 4 2 1 „ 161 „ .620 „ September 13,893 6,321 20,214 310 10 3 1 „ 67 „ 1.492 October 12,852 5,373 18,225 98 8 3 1 „ 185 „ .54 November 12,147 4,631 16,778 56 17 3 1 295 „ .339 „ December 12,042 4,983 17,025 18 13 1 1 „ 912 „ .11 „ Total 160,741 57,734 218,475 1,304 15 3 1 in 168 tons, or.595 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 1903 and the five years 1898-1902. Y ear. Weight of Fish Delivered. Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. Tons. Tons. Tons. Tons Cwts. qrs. 1898 135,693 46,874 182,567 1,068 5 0 1 ton in 170 tons, or .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 „ 1902 169,951 46,232 216,183 1,148 7 1 1 „ 188 „ .53 „ Average (5 years) 148,360 44,161 192,521 925 0 2 1 ton in 208 tons, or .48% 1903 160,741 57,734 218,475 1,304 15 3 1 ton in 168 tons, or .59% The quantity of fish condemned is the largest since 1894, when these figures were first recorded in my Department. It will be seen they are no less than 379 tons, 15 cwts., 1 qr. above the average for the five preceding years. 123 INSPECTION OF FOOD AT RIVERSIDE WHARVES, &c. Special attention has been directed towards the character o£ the various articles of food landed or stored at the several wharves and warehouses abutting on the River. There are 28 riverside wharves within the City limits at which food is received, viz.: 7 in the East District, 17 in the Middle District, and 4 in the West District. The following are the places referred to: — EAST DISTRICT. London Bridge Wharf Tinned foods; wet and dried fruit. Fresh Wharf Tinned foods; wet and dried fruit. Cox and Hammond's Quay Tinned foods; wet and dried fruit. Isaacs' Wharf (goods landed at Fresh Green fruit. Wharf). Nicholson's Wharf (includes Botolph, Tinned foods; wet, dry and green fruit. Lyons, and Somers Quays). Custom House and Wool Quays Tinned fruit; wines, spirits, beer, green fruit, &c. Brewer's, Chester, and Galley Quays Little tinned food, with exception of condensed milk; also wines, spirits, beer, and general provisions. MIDDLE DISTRICT. Paul's Pier Wharf Frozen meat. Brooks' Wharf Frozen meat and canned goods. Kennett Wharf Frozen meat. Union Wharf (under Cannon Street Frozen meat. Station). Commercial Wharf Frozen meat. Trig Wharf Canned goods. Lyons' Wharf Canned goods and general foods. Smith's Wharf Tea, coffee, and preserved ginger. Three Cranes Wharf Canned food, tea, coffee, and cocoa. Dowgate Dock Wharf Tinned milk, sardines, margarine, and milk Fishmongers' Hall Wharf Canned food. Abbey Wharf Tea, coffee, &c. Bull Wharf Tapioca, cocoa, and chicory. Hambro' Wharf Sugar. Red Lion Wharf Tea, coffee, cocoa. Monument Wharf Tea, wine. Tennant's Wharf Cereals and macaroni. WEST DISTRICT. Purfleet Wharf (Cold Storage) Frozen meat only. Victoria Wharf Tinned food, &c. Wheatsheaf Wharf Corn only. Rutland Wharf Corn only. During the year under review, 284¼ loads of unsound food were removed from the above places by the Cleansing Department, and destroyed as trade refuse at the written request of the owners. 124 The material so disposed of comprised:— Tons. Cwts. Qrs. Tinned fruit and vegetables 65 2 3 Condensed milk 6 4 3 Miscellaneous tinned food 44 12 2 Fruit and vegetables 12 15 0 Tinned meat 7 6 2 Fruit pulp 9 16 2 Eggs 0 17 0 Yeast 1 10 0 Total 148 5 0 The number of loads similarly dealt with in previous years was Loads. 1897 325 1898 250 1899 452 1900 312 1901 253 1902 362 Average 326 Where practicable, the material was burnt in the Destructor at Letts' Wharf, otherwise it was removed 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. In some instances, when food had become unsound in bonded warehouses, it was released from duty and destroyed in the presence of an Inspector of His Majesty's Customs. Difficulties rarely occur with the Wharfingers, who are generally anxious to assist the Department in the inspection of imported food, and most of them employ experts to periodically overhaul the goods in store. Your Officers are not infrequently asked to advise as to the quality of goods, and any case of doubt or difficulty is at once referred to your Medical Officer of Health. In April last it was reported to the Court of Common Council that the Local Government Board had decided to hold an Inquiry at Guildhall, by one of the Inspectors of the Board, as to the proposed extension of the jurisdiction of the Corporation, as the Port of London Sanitary Authority, in the matter of unsound food, by the inclusion of wharves forming part of or abutting on the Port. As this involved the jurisdiction of your Worshipful Committee over the various wharves and landing places within the City limits, your Medical Officer was instructed to give evidence as to the means adopted by the Corporation for the inspection of food thereat. 125 The Inquiry was-held at the Guildhall on the 24th April and 18th May. In the course of his evidence your Medical Officer stated that food and tinned meat (other than fresh meat which was not then under consideration) is received in the City at twenty-eight wharves and warehouses, situated in three districts, which are periodically visited by the Sanitary Inspectors of the City specially charged with the duty. The work was further facilitated by intercommunication between the Medical Officers of Health of the City and Port, and by information as to arrivals from Customs Bills A and B, information collected in the daily routine of seven other Sanitary Inspectors, and the co-operation of merchants, wharfingers, and traders generally in carrying out the provisions of the Public Health Act, 1891, and the City of London Sewers Acts. That in cases of emergency, such as an exceptionally large consignment of unsound food having to be dealt with, the services of the above mentioned officers were available. The Medical Officer of Health was also consulted as to the probability of any benefit accruing to the public health by instituting changes in the regime now obtaining. The Local Government Board subsequently communicated with the Manager of the London and India Docks Company, who were the originators of the movement in favour of such transfer of the Authority, and also to the Port Sanitary Authority, stating that the Board had carefully considered the Inspector's Report and the evidence placed before him at the Inquiry. They had also taken into consideration the proceedings in Parliament during the past Session with reference to the proposals in the Port of London Bill ; and they had decided, having regard to all the circumstances, not to accede to the application at the present time. The Board, however, communicated with the Councils of certain Metropolitan Boroughs with regard to the examination of food-stuffs landed at wharves abutting on the River Thames. SALE OF FOOD AND DRUGS ACTS, 1875-1899. The number of samples submitted to your Public Analyst for examination during the year was 1,179; of these, 1,081 were found to be genuine, the remainder, 98, or 8.31 per cent., being certified as adulterated. The figures for 1903 and the two preceding years were as follows:— Year. 1901. 1902. 1903. Number of samples taken 854 1,248 1,179 Number of samples genuine 742 1,138 1,081 Number of samples adulterated 112 110 98 Percentage of adulteration 13.11 88 8.31 126 For the purpose of comparison the following Table is given showing the percentage of adulteration in England and Wales since 1877:— Per cent. Quinquennium 1877-81 16.2 „ 1882-86 13.9 „ 1887-91 11.7 „ 1892-96 10.6 „ 1897-1901 9.0 1900 8.8 1901 8.8 These figures are abstracted from the Annual Report of the Local Government Board, 1901-2. The accompanying Table has been partly compiled from the Annual Reports of the Local Government Board, to which are added some' figures for the City of London, and London as a whole:— Year. Total Number of Samples Examined in England and Wales. Number Examined in the City of London. Percentage of Total Number Examined in City of London. Number of Persons to each Sample examined. England and Wales. "City of London. London. 1881 17,823 162 .92 1,462 318 760 1882 19,439 197 1.01 1,350 252 732 1883 19,648 201 1.02 1,363 240 725 1884 22,951 285 1.24 1,182 164 716 1885 23,230 206 .88 1,184 221 699 1886 23,596 188 .79 1,181 235 672 1887 24,440 294 1.20 1,171 146 596 1888 26,344 178 .67 1,086 235 551 1889 26,954 249 .90 964 162 542 1890 27,465 165 .62 946 239 557 1891 29,028 169 .42 999 227 580 1892 32,447 123 .38 894 303 573 1893 37,233 104 .28 779 347 530 1894 39,516 161 .40 734 216 492 1895 43,962 266 .60 661 127 414 1896 45,555 212 .47 636 148 399 1897 46,856 220 .47 619 138 381 1898 49,555 230 .46 585 122 353 1899 53,056 171 .32 547 164 325 1900 62,858 145 .23 461 186 312 1901 67,841 854 1.26 479 32 291 1902 72,321 1,248 1.72 450 21 252 1903 Return not yet received. 1,179 - - 21 - *The figures in this column are based on the Imperial night census, and are obviously misleading. Unfortunately there are no accurate means of arriving at the number of persons in the City during the day time. 127 The returns for the City show slight decrease during 1903 in the proportion of adulterated articles, but if the samples of "Bread and Butter," which were taken for the first time in 1903, are eliminated, the percentage of adulteration is 7.1. In connection with these samples, it should be stated that as there was every reason to believe that a particularly mean fraud was being largely practised by the proprietors of small eating and coffee houses, a number of samples of slices of "Bread and Butter" were purchased at these places and sent to the Public Analyst. In all, 71 such samples were dealt with, and, as was anticipated, in a heavy proportion it was found that margarine had been substituted for butter. This was the case in no less than 19, or 26.76 percent., of them. Summonses were issued in five cases, and in each instance a conviction was obtained. In five other cases, however, the summons was dismissed, either on the technical ground that the sample was improperly divided, or, as to the form of the Public Analyst's Certificate. In the remaining cases, therefore, the summonses were withdrawn and the vendors cautioned. As a result of these proceedings, the "London Coffee Restaurant and Dining Room Keepers' Trade Protection Society" issued the following circular letter to its Members:— "IMPORTANT NOTICE TO THE TRADE. "FOOD AND DRUGS AND MARGARINE ACTS. "Dear Sir, "At a Special Sitting of the Executive Committee of the above "Society held on Thursday, 21st May, 1903, "It was unanimously resolved : "'That in consequence of the numerous prosecutions which have recently "'been instituted and convictions obtained by the Corporation of the City of "'London and the Borough Councils' Inspectors, for offences under the Food "'and Drugs and Margarine Acts, more particularly in respect to selling "'Margarine on Slices of Bread when Butter is demanded, the Committee "'desire to point out the absolute necessity for Butter being supplied when "'asked for by the purchaser.' "They also wish to draw your special attention to Clause 20 in the "Rules of the Society, wherein it distinctly states :— "'That the Funds of the Society shall not be used in defending any "'Member who shall knowingly act in contravention of the Law;' "and further, that this Rule will be strictly adhered to. "For the information of Members, the Committee submit herewith "a copy of a 'Form' of warranty to be part of the invoice, together "with signature of the vendor placed thereon as a guarantee that 128 "each separate parcel or package supplied 'Is Butter only 'and they "strongly recommend that every Member shall demand same at the "time of delivery, no matter how small the quantity of purchase. "It has been held by the Courts that this is the only way in which "a Coffee house Keeper can protect himself. "Copt of Warranty on Invoice. "The above package or parcel is guaranteed to be Butter only. "(Signed) "To those Members who prefer to use Margarine, they recommend "that a copy of the following Notice (size, 13 in. by 8 in.) be exhibited "in a conspicuous position in their shops:— "NOTICE. "No Butter is sold at this Establishment. "THE FINEST MARGARINE "only is used for Slices and Haddocks. It is not for Sale by "itself either upon or off the premises. "With regard to the purchase and sale of Milk, the Committee "advise the Members to demand from their wholesale milk dealers a "written guarantee that the milk which is being supplied from time to "time is of a sufficiently good standard to comply with the Act, and "that in all cases where milk is asked for, proper precautions should be "taken (especially in hot weather) to rouse and stir up same to ensure "that the cream becomes thoroughly distributed with the other "component parts. "We are, Dear Sir, "Yours obediently, "Alfred Holton, Chairman. " William Alstrom, General Secretary." It must be borne in mind that each case of this kind must be judged on its merits, and that it is impossible to say definitely that the exhibition of any particular form of notice fulfils all statutory requirements in all places and at all times, the primary intention of the Legislature being to protect the public from fraudulent dealers, and not to protect individual trade interests. On this subject Dr. Teed, your Public Analyst, made the following observations in his Report for the last Quarter of 1903:— "It is a matter of common knowledge that many vendors endeavour "to contract themselves out of the provisions of the Sale of Food and "Drugs Acts by exhibiting notices which, while implying that the goods "sold are of high quality, are designed to act as a bar to any proceedings 129 "under the Acts, should the analytical results prove them to be of "inferior quality or actually adulterated." It is obvious that the whole question turns upon what is a sufficient disclosure within the meaning of the Act. "Whether it is advisable, as suggested by your Analyst, to take a case to the High Court to decide the matter, and also to make the renewal of all licences for the sale of spirits conditional on no dilution notice being exhibited, are matters for your legal advisers to determine. MILK AND BUTTER ADULTERATION. 1901. 1902. 1903. Number of Milk samples examined 392 599 517 Found genuine 209 519 457 Found adulterated 83 80 60 Percentage of adulteration 21.0 13.3 11.6 Number of Butter samples examined 238 299 368 Found genuine 224 292 367 Found adulterated 14 7 1 Percentage of adulteration 5'8 2.34 .27 The figures in the above Table illustrate better than any words the remarkable decrease in the sophistication of milk and butter that has taken place in the City since 1901. Butter adulteration has practically ceased to exist, and it is hoped that the same desirable end will shortly be attained in the case of milk. Your Public Analyst has also some comments in the Report referred to on the subject of milk warranty. He remarks that:— "Many vendors, especially of milk, escape the provisions of the Acts "by pleading a warranty. In all such cases it is very desirable that the "warranty should be carefully scrutinised to see if it is such a warranty "as the Acts require; and in the event of its being so held by the Court, "the giver of the warranty should be proceeded against for giving a false "warranty. If insurmountable difficulties under the present law should "be found to exist, there will be a good case for further legislation, but "these difficulties, if they exist, can only be discovered by bringing " prosecutions and endeavouring to carry them through. "The two questions, 'Notices' and 'Warranties,' are those that give "most trouble in the administration of the Sale of Food and Drugs Acts, "and which frequently enable vendors to escape their provisions. "It is highly desirable that both questions should be settled, even "should it prove that fresh legislation is necessary in order to secure "proper protection to the purchasing public." 130 MILK DELIVERIES. In the course of the year your Medical Officer of Health had occasion to make enquiries as to the amount of milk delivered at the several railway stations in the City, when it was ascertained that milk is delivered at four of them only, where the following are the average daily deliveries:— Liverpool Street 6,400 Imperial gallons. Broad Street 448 „ „ Moorgate Street (Midland Railway) 32 „ „ Fenchurch Street 1,280 „ „ 8,160 Imperial gallons. This does not represent the whole of the milk coming into and passing through the City, as the large dairy supply companies deliver direct from their depots to numbers of retailers and restaurant keepers, &c. In the Annual Report of the Local Government Board, 1901-1902, a statement is made on the authority of the Dairy Trade and Can Protection Society that the quantity of milk received in the London area from outside is approximately 144,000 Imperial gallons a day. Seven samples of milk were taken in the early morning in course of delivery by the wholesale dealer, and in two instances it was found that retailers were being supplied with milk of an inferior quality. A sample of milk purchased at a restaurant in Middlesex Street was certi6ed to be adulterated with 9 per cent. of added water. A statement having been made by the proprietor that the milk was sold as received by him, a sample was taken on delivery. This sample, which was supplied by a wholesale milk dealer in Stepne, was found to contain 12 per cent, of added water. The two cases were heard at the Guildhall Justice Room, when both parties were convicted, and the wholesale dealer fined the maximum penalty of £20 and 16s. 6d. expenses. The restaurant keeper, who had purchased without a warranty, was fined 5s. and 17s. 6d. expenses only. 131 Thirty-six samples of spirits, viz., 12 of rum, 9 of brandy, and 15 of whisky were analysed, and 2, or 5.55 per cent., were found below the statutory limit of alcoholic strength. No adulteration has been detected in any samples submitted of either coffee, pepper, mustard, golden syrup, olive oil, cheese, lard, chocolate, vinegar, or honey. Of cocoa, only 1, or 8.33 per cent. of a total of 12 samples taken, was reported against. Of the sixty-five drugs analysed, 5 were reported against, as against 5 out of 79 in the previous year. This is an increase of 1.39 in the percentage and too high a figure, considering the importance to the medical profession and the public of their being supplied with pure drugs. 132 133 SALE OF FOOD AND DRUGS ACTS, 1875-1899. Articles examined during each Quarter of the year 1903. Articles submitted for Analysis. Quarter ending 31st March. Quarter ending 30th June. Quarter ending 30th September. Quarter ending 31st December. Total for 1903. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of adulteration. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of adulteration. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of adulteration. No. of Samples taken. No. Genuine, No. Adulterated. Percentage of adulteration. No. of Samples taken. No. Genuine. No. Adulterated. Percentage of adulteration. Milk 160 141 19 11.9 104 92 12 11.53 110 97 13 11.81 143 127 16 11.18 517 457 60 11.6 Butter 99 99 ... ... 92 91 1 1.08 80 80 ... ... 97 97 ... ... 368 367 1 .27 Coffee 12 12 ... ... ... ... ... ... 6 6 ... ... 3 3 ... ... 21 21 ... ... Pepper 7 7 ... ... ... ... ... ... 7 7 ... ... 4 4 ... ... 18 18 ... ... Mustard 6 6 ... ... ... ... ... ... 5 5 ... ... 4 4 ... ... 15 15 ... ... Golden Syrup 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... Olive Oil 6 6 ... ... 1 1 ... ... ... ... ... 4 4 ... ... 11 11 ... ... Cheese 4 4 ... ... ... ... ... ... 2 2 ... ... ... ... ... ... 6 6 ... ... Drugs 20 19 1 5.0 9 8 1 11.1 14 13 1 7.1 22 20 2 9.09 65 60 5 7.69 Cocoa 5 4 1 20.0 ... ... ... ... 5 5 ... ... 2 2 ... ... 12 11 ... 8.33 Rum 2 2 ... ... ... ... ... ... ... ... ... ... 10 10 ... ... 12 12 ... ... Brandy 2 2 ... ... ... ... ... ... ... ... ... ... 7 6 1 14.3 9 8 1 11.1 Whiskey 2 2 ... ... ... ... ... ... ... ... ... ... 13 12 1 7.7 15 14 1 6.66 Lard 4 4 ... ... 3 3 ... ... 8 8 ... ... 2 2 ... ... 17 17 ... ... Chocolate 4 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 4 ... ... Bread and Butter 70 51 19 27.14 ... ... ... ... ... ... ... ... 1 1 ... ... 71 52 19 26.76 Bread and Margarine 1 ... 1 100.0 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 100.0 (Non-compliance with Margarine Act.) Vinegar ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... 2 2 ... ... Orange Wine 3 2 *1 33.3 ... ... ... ... ... ... ... ... ... ... ... ... 3 2 1 33.3 Ginger Wine 2 ... *2 100.0 ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 100.0 Honey 2 2 ... .•• ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... Preserved Peas 5 ... †5 100.0 ... ... ... ... ... ... ... ... ... ... ... ... 5 ... 5 100.0 Tinned French Beans 1 ... †l 100.0 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 100.0 Totals 419 369 50 11.9 209 195 14 6.7 237 223 14 6.03 314 294 20 6.36 1,179 1,081 98 8.31 * Contained Salicylic Acid, probably added as a preservative. † Contained minute quantities of Copper. 134 SALE OF FOOD AND DRUGS ACTS, 1875-1899. 19 0 3. RESULTS OF PROSECUTIONS. First Quarter. Sample. Nature and, Extent of Adulteration. Result. 37 Milk 20 per cent. of added water £10 and 12s. 6d. expenses. 43„ 17 per cent. of fat abstracted 10s. and 12s. Gd. expenses. 125 „ 6 per cent. of added water Summons dismissed on proof warranty. 140 „ 5 per cent. of added water Dismissed on technical grounds :as to service of the summons. 170 „ 16 per cent. of added water £1 and 12s. 6d. expenses. 199 „ 6 per cent. of added water Dismissed on technical grounds: as to service of the summons. 200 „ 7 per cent. of added water Dismissed on technical grounds: as to service of the summons. 212 „ 8 per cent. of added water £3 and 17s. 6d. expenses. 233 „ 9 per cent. of added water £3 and 12s. 6d. expenses. 251 „ 40 per cent. of fat abstracted £6 and 12s. 6d. expenses. 274 „ 19 per cent. of fat abstracted £5 and 12s. 6d. expenses. 313 Iron Pills 37½ per cent. deficient in ferrous carbonate. 12s. 6d. expenses. 354 Bread and Butter 100 per cent. bread and margarine Dismissed on technical grounds: as to form of Public Analyst's Certificate. 357 „ „ 100 per cent. bread and margarine £1 and 45s. expenses. 360 „ „ 100 per cent. bread and margarine Dismissed; no evidence offered. 363 „ „ 100 per cent. bread and margarine... £1 and 17s. Gd. expenses. 364 „ „ 100 per cent. bread and margarine... Dismissed on technical grounds : each slice not having been separately divided. 372 „ „ 100 per cent. bread and margarine £2 and 17s. 6d. expenses. 377 „ „ 100 per cent. bread and margarine 10s. and 17s. 6d. expenses. 383 „ „ 100 per cent. bread and margarine Dismissed on technical grounds : as No. 364. 397 ,, ,, 100 per cent. bread and margarine £1 and 17s. 6d. expenses. 416 ,, ,, 100 per cent. bread and margarine Dismissed; no evidence offered. Second Quarter. 619 Milk 10 per cent. of added water and 6 per cent. of fat abstracted. £3 and 12s. 6d. expenses. 622 „ 19 per cent. of fat abstracted £5 and 12s. 6d. expenses. 626 „ 5 per cent. of added water and 7 per cent. of fat abstracted. £5 and 16s. 6d. expenses. 135 Third Quarter. Sample. Nature and Extent of Adulteration. Result. 667 Milk 24 per cent. of fat abstracted £3 and 17s. 6d. expenses. 669 „ 17 per cent. of fat abstracted £10 and 23s. expenses. 845 „ 7 per cent. of added water Dismissed; warranty proved. 855 „ 11 per cent. of added water £1 and 13s. 6d. expenses. Fourth Quarter. 1080 Milk 4 per cent. of added water and 7 per cent. of fat abstracted. £5 and 12s. 6d. expenses. 1107 „ 19 per cent. of added water £5 and 12s. 6d. expenses. 1120 „ 9 per cent. of added water 5s. and 17s. 6d. expenses. 1121 „ 6 per cent. of added water and 29 per cent. of fat abstracted. 40s. and 17s. 6d. expenses. 1180 „ 12 per cent, of added water £20 and 16s. 6d. expenses. SUMMARY. £ s. d. £ 8. d. First Quarter : Fines 34 0 0 Expenses 11 0 0 Second Quarter „ 13 0 0 „ 2 16 Third Quarter „ 14 0 0 „ 2 14 0 Fourth Quarter „ 32 5 0 „ 3 16 6 £93 5 0 £19 12 0 Twenty-three fines were inflicted during the year, and the average fine and expenses imposed was £4 18s. 1d.,the corresponding amounts for 1901 and 1902 being £3 15s. 7d. and £4 2s. 2d. respectively. REPORT OF THE ROYAL COMMISSION ON ARSENICAL POISONING. This Commission was appointed on the 4th February, 1901, in consequence of a serious epidemic in the latter part of 1900, due to arsenical contamination of beer at numerous breweries, owing to the use of glucose or "invert" sugar manufactured by a single firm at Gars ton, near Liverpool. The report is an exhaustive one, and although of much importance and interest, far too lengthy to discuss in detail. Those interested in the subject should read the report as a whole. 136 There are one or two points, however, which are of general importance to all, notably the expression of opinion by various official witnesses that the Sale of Food and Drugs Acts, as at present interpreted and administered, are unsatisfactory for the purpose of protecting the consumer against arsenic or other deleterious substances in food. The Commissioners themselves endorse this view, and consider that the control which can be at present exercised is unsatisfactory. They are of opinion that official standards must be prescribed if the Sale of Food and Drugs Acts are to be satisfactorily applied to control the purity of food, and, for reasons given, they prefer to term these "Standards for the purpose of the Sale of Food and Drugs Acts,"rather than "Standards of purity." With respect to arsenic the Commissioners make the following pronouncement:— "In our view it would be entirely proper that penalties should "be imposed under the Sale of Food and Drugs Act, upon any vendor of "beer or any other liquid food, or of any liquid entering into the "composition of food, if that liquid is shown by an adequate test to contain "Tooth of a grain or more of arsenic to the gallon ; and with regard to "solid food—no matter whether it is habitually consumed in large or "small quantities, or whether it is taken by itself (like golden syrup) or "mixed with water or other substances (like chicory or "carnos")—if "the substance is shown by an adequate test to contain Tooth of a grain "of arsenic or more to the pound." Included in the Commissioners' recommendation as to improvements in official control over the purity of food is one to the following effect:— "We think that the powers which Medical Officers of Health at "present possess under the Public Health Acts to obtain the con"demnation of unsound or unwholesome articles of food should be "extended. Where the Medical Officer of Health has good reason for "believing that particular articles of food or ingredients of food have "caused, or are liable to cause, injury to health, but is of opinion that "analysis of samples is necessary before the facts can be fully established, "powers should be given to lay an embargo on the sale of the suspected "articles or on the use of the suspected ingredients, pending their official "examination. The grant of these powers should be accompanied by "the requirement that a Justice's order should be obtained, or by other "provisions which are adequate to prevent their being used unnecessarily "or improperly." Should this suggestion be adopted, it is clear that one of the difficulties of dealing with sewage-contaminated shellfish referred to in the Fourth Report of the Royal Commission on Sewage would be removed—and in this connection it may not be out of place to point out that the Commission on Sewage 137 expressly mention that the Local Government Board had suggested to the Brighton Corporation that the existing law might suffice in dealing with polluted shellfish. PERMISSIVE MILK ADULTERATION. In April last year the Sanitary Committee referred for my consideration a labulated return received from the Borough of Shoreditch, showing the practice obtaining in London and the Provinces regarding milk prosecutions, together with a letter from their Public Analyst on the same subject. The point reviewed therein was the question of taking proceedings in cases of adulterated milk where the results of analysis, according to the minimum limits fixed by the Board of Agriculture regulations, show a presumptive addition of an excess of water less than five per cent. The Public Analyst for Shoreditch himself does not consider it safe to prosecute when a milk shows only 3 per cent. of added water. From the return it appears that of the 48 Authorities whose opinion are given, 31 have adopted in practice various minima limits of water adulteration, thus:— 1 Authority fixed the limit at 2.4 per cent, added water. 3 Authorities ,, „ 3 ,, „ 3 „ „ „ 4 16 „ „ „ 5 „ „ 1 Authority „ „ 5½ „ „ 4 Authorities „ ,, 6 „ „ 3 „ „ „ 7 „ „ Of the other 17 Authorities some prosecuted if "below the standai'd," others considered each case on its merits," some were guided by the opinion of the analyst, two fixed no limits, and one frankly stated they "did not allow added water at all." The names of the Authorities referred to above are purposely omitted here, as it would be doing the inhabitants of the three districts where milk containing 7 per cent1. of added water is " passed " a very ill service. To fix a minimum for added water is to be a party to adulteration, and directly contrary to the intentions of the Legislature when the Board of Agriculture were given statutory powers to make regulations for determining what deficiency in any normal constituents indicates adulteration. The limit of 8.5 per cent. for "solids not fat" was established for the guidance of the Public Analyst, and anything below that figure is presumptive evidence that the milk is watered. It appears, therefore, that any Authority authorising the sale of milk below the statutory limit incurs a responsibility that not only places them in opposition to the spirit of the Acts they are empowered to administrate, but contrary to the best interests of the public health. 138 BUTTER REGULATIONS COMMITTEE. The Departmental Committee appointed on 3rd July, 1901, to enquire and report as to what regulations, if any, may with advantage be made under Sec. 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, issued an Interim Report on 24th January, 1902, unanimously recommending a limit of 16 per cent, for the proportion of water in butter to be fixed by the Board of Agriculture under the above-named section. This recommendation was accordingly adopted by the said Board on the 22nd April, 1902, and came into operation on the 15th May of that year. ( Vide Medical Officer of Health's Annual Report for 1902.) On the 1st December, 1903, the Departmental Committee issued a final Report dealing with the results of their enquiries as to what regulations, if any, might with advantage be made under the said section for determining what deficiency, if any, of the normal constituents of butter, and what addition of extraneous matter, other than water, should raise a presumption, until the contrary is proved, that the butter is not genuine. In the course of the enquiry the Committee examined 26 witnesses (in addition to those mentioned in the Interim Report whose evidence was not restricted to the question of water in butter), including representatives from the following countries exporting butter to the United Kingdom, viz., Holland, Norway, Denmark, United States of America, Germany, Sweden, Russia and France, and also 12 Analysts, 2 Magistrates and an Inspector of the Board of Agriculture. The Committee finally made the following recommendations :— " (1)That the figure 24 arrived at by the Keichert-Wollny method* "should be the limit below which a presumption should be raised "that butter is not genuine. " (2) That the use of 10 per cent, of sesame oil in the manufacture of "margarine be made compulsory. "(3) That steps should be taken to obtain international co-operation.'' The Report is signed by all the members of the Committee with one exception (who presents a dissentient minority Report), but three of them sign subject to notes of reservation that are appended to it. * Full details of this process are given in a Schedule to the Report. 139 SALE OF BUTTER BILL. The Government have again introduced a short Bill to deal with a particular form of butter sophistication not provided for in existing statutes. In April, 1902, the Board of Agriculture, under the provision of Section 4 of the Sale of Food and Drugs Act, 1899, made an Order limiting the amount of water in butter to 16 per cent. This restriction is made a statutory one in the Sale of Butter Bill, which also prohibits the addition of any substance whereby the amount of water in butter is increased. The object of the Bill is to stop the manufacture and sale of "milk-blended" butter, many cases having arisen where persons were deceived as to the true quality of the article sold under this name. The Bill allows Irish salt firkin butter a limit of 20 per cent1. of water until such date as may be fixed by an Order in Council. It is to be construed as one with the Margarine Act, 1887, and if passed will come into force on the 1st January, 1905. Two or three other Bills on similar lines have been introduced by the Government in recent years, but none of them reached the final stage. I have the honour to be, Gentlemen, Your obedient Servant, m. mvligilg Medical Officer of Health for the City of London. public Health department, Guildhall, E.C., April, 1904. APPENDICES. page. Appendix A—Street Lists of Mortality 143 „ B— „ „ Infectious Disease 146 „ C—Tenement House Register 149 „ D—List of Persons registered under the Dairies, Cowsheds and Milk Shops Orders 158 „ E—Regulations as to Milk-Stores and Milk-Shops 163 Spot Map of the City showing Infectious Diseases. 143 Appendix A. CITY OF LONDON MORTLTY. 1903. 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. Aldersgate Street 90 F 66 18 Feb., 1903 Bronchitis „ „ (Manchester Hotel) F 59 29 April „ Acute Bronchitis „ „ „ „ - M 63 10 June „ Fatty Disease of Heart Inquest „ „ Railway Station — M 55 30 Oct. „ Suicide by throwing himself in front of a train Inquest Aldgate 23 M 55 30 April „ Hœmatemesis Aldgate High Street 3 F 73 20 Jan. ,, Meningitis „ „ „ 28 F 62 15 Mar. „ Chronic Interstitial Nephritis „ „ „ 35 M 52 5 May „ Fatty Degeneration of the Heart „ Railway Station — F new born 18 Oct. „ Laceration of Brain Inquest. America Square 2 F 3 hours 24 July „ Asphyxia Australian Avenue 17 M 56 30 Oct. „ Syncope Inquest Ball Court, Giltspur Street 2 F 60 28 Sept. „ Shock from Perforation of Stomach by swallowing Spirits of Salts Inquest. Suicide Barbican 43a F 82 25 M ar. „ Bronchitis Barker's Buildings, Bishopsgate 23 M 2 days 12 May „ Inanition from Birth Bartholomew Close 43 F 15 m'ths 5 June ,, Acute Bronchitis „ „ 85 F 60 10 Aug. „ Chronic Bronchitis Bartlett's Buildings 15 M 76 2 Jan. „ Cardiac Failure „ „ 22 M 55 13 July „ Heart Disease Beech Street, Barbican 43 M 66 14 Mar. „ Crushed by Van Inquest. Accidental Bell's Buildings, Salisbury Square 7 F 6 m'ths 24 Aug. „ Tubercular Meningitis Bishopsgate Street Without 99 F 11 m'ths 14 June „ Broncho-Pneumonia „ „ „ 35 F 75 9 July „ Cerebral Hœmorrhage M 25 25 Sept. „ Enteric Fever Died in St. Bart.'s Bond Court, W'albrook 6 F 64 2 Mar. „ Pleurisy. Bronchitis Broad Street Avenue (Messrs. Salomon and Co.) —- F 62 15 Sept. „ Dislocation of Spine by being crushed in lift Inquest. Accidental Brushfield Street 14 F 98 24 Dec. „ Senile Decay Cannon Street 64 F 1 29 Jan. „ Pneumonia Carmelite Street Fire Station F 3 16 Aug. „ Tubercular Meningitis Carter Lane (Church Entry) — M 51 4 Jan. „ Pneumonia Carter Lane 59 M 18 18 „ „ Bronchitis and Heart Disease „ „ 79 M 18 10 Nov. „ Acute Pulmonary Tuberculosis Chapel Place, Fetter Lane 1 M 54 21 May „ Cirrhosis of Liver „ „ „ „ 1 F 53 28 Aug. „ Bright's Disease Cheapside 80 M 52 9 Dec. „ Bronchitis Circus, Minories 6 M 65 31 Oct. „ Chronic Interstitial Nephritis ,, „ „ „ 1 M 13 days 30 „ „ Cyanosis City Buildings, Moor Lane 25 M 18' 18 June „ Pulmonary Tuberculosis „ „ „ „ 19 F 70 4 Nov. „ Hemiplegia Clarke's Place. Bishopsgate 8 M 44 24 Dee. „ Morbus Cordis Died in St. Bart.'s „ „ „ 9 M 3 months 11 Oct. „ Diarrhoea. Exhaustion „ „ „ 8 M 84 23 Feb. „ Senile Decay Clement's Lane—" The Shades" - M about 2 hours 15 May „ Premature Birth Cloth Fair 8 M 64 13 Feb. „ Strangulated Hernia „ „ 9 F 75 7 Mar. „ Chronic Bright's Disease „ „ 21 F 65 14 April ., Strangulated Hernia „ „ 45 F 77 28 „ „ Pneumonia „ „ 21 F 77 6 Sept. „ Morbus Cordis Cock Hill, Bishopsgate 2 F new born 8 Jan. „ Found Dead Inquest. Cause of death Cockerill's Buildings, Cloth Fair 2 F 80 11 Jan. „ Old age and Bronchitis [unattainable „ „ „ 4 F 74 18 Feb. „ Bronchitis Coleman Street 35 F 49 2 Sept. „ Carcinoma of Breast Crown Court, Jewry Street 3 F 59 7 Dec. „ Bronchitis „ „ (The Crown Public House) - F 45 22 Aug. Apoplexy Crutched Friars 27 M 64 8 Nov. „ Bronchitis Cutler Street 27 F 47 28 Aug. „ Heart Disease Inquest „ „ 29 M 77 14 Oct. „ Acute Hepatitis „ „ 30 M 54 16 Nov. „ Chronic Bronchitis Dean's Court, Old Bailey 31 F 60 2 Aug. „ Carcinoma of Liver Devonshire Square (Wheeler's Hotel) - F 45 20 Sept. „ Pernicious Anaemia Died in St. Bart.'s Dr. Johnson's Buildings, Inner Temple 3 M 61 19 Jan. „ Bright's Disease Eastcheap 43 M 59 16 April „ Pleuro- Pneumonia „ 71 M 6 weeks 14 May „ Marasmus East Passage, Cloth Fair 5 M 46 20 Sept. „ Exhaustion from Scirrhus of Liver Found dead „ „ Long Lane 79 F 2 weeks 22 Aug. „ Asphyxia Inquest. Accidental Ellison Stree 11 M 43 6 Jan. „ Croupous Pneumonia Fann Street 1 2 F 1 79 26 ,, „ Heart Disease 144 CITY OF LONDON MORTALITY—continued.. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. Farringdon Street 72 M 61 29 April, 1903 Bronchitis Fenchurch Buildings 5 F 68 14 Jan. „ Cerebral Atrophy Fenchurch Street 147 M 43 6 Feb. ,, Pleurisy » » 30 M 42 24 „ Pachycardia Fetter Lane 40 F 50 6 Jan. ,, Influenza „ 41 F 78 24 Feb. „ Bronchitis „ 35 M 75 10 Aug. „ Senile Decay ,, 37 M 40 20 Not. „ Pulmonary Phthisis Fish Street Hill 46 M 3 months 1 Dec. „ Epidemic Enteritis Fore Street 41 M 43 6 Jan. „ Fatal Syncope „ „ 45 F 70 19 May „ Senile Decay George Street 7 F 81 19 July „ Cerebral Thrombosis Golden Lane (Cripplegate Institute) - M 55 31 May „ Chronic Nephritis Goring Street 10 F 45 22 Dec. „ Chronic Bronchitis Gracechurch Street 77 & 78 F 52 16 July ,, Valvular Disease of Heart „ „ 3 F 41 3 Nov. „ Malignant Growth Great Tower Street 31 M 39 7 Dec. „ Pulmonary Apoplexy Great Winchester Street 16 M 38 15 Jan. ,, Coma Urœmic Convulsions „ „ 14 F 3 29 Mar. „ Whooping Cough. Convulsions Greystoke Place, Fetter Lane 9 F 20 m'ths 25 Feb. „ Diphtheria Died in St.1 Bart, 's „ „ „ „ 7 M 39 28 Aug. „ Heart Disease Inquest „ „ „ „ 9 M 54 1 Nov. „ Phthisis Harp Alley 13 F 2 months 18 July „ Perineal Abscess Harp Lane 12 F 42 20 Aug. „ Phthisis Holoorn Buildings 6 M 7 weeks 30 „ „ Bronchitis „ Viaduct 6 F 36 9 April ,, Double Pneumonia „ „ Hotel - F 6 7 July „ Meningitis Coma Houndsditch 140 M 57 3 „ „ Bright's Disease Hutchinson Avenue 25 M 53 8 Mar. „ Phthisis Pulmonalis „ „ 10 F 62 23 April „ Pneumonia „ „ 22 F 16 days 24 „ „ Prematurity „ „ 15 F 4 days 27 May „ Prematurity „ „ 9 F 70 25 Sept. „ Senile Pneumonia „ „ 18 M 2 months 12 Dec. „ Acute Enteritis Ironmonger Lane 9 M 83 5 Feb. „ Senile Decay John Street, Minories 17 F 53 29 Mar. ,, Cirrhosis of Liver King William Street 66 M 37 7 Aug. ,, Dropsy King's Arms Yard 14 F 39 17 Jan. „ Hœmorrhage Little Britain 54 F 62 22 „ „ Diabetic Coma. Dropsy Died in St. Bart.'s Liverpool Street Railway Station - M 68 25 Not. „ Syncope Inquest „ „ „ „ — M 54 18 Dec. „ Syncope Long Lane 76 M 9 months 24 May „ ConTulsions Inquest „ „ 86 M 30 5 Not. ,, Phthisis Ludgate Circus 4 M 9 31 Jan.„ Endocarditis Mansell Street 8 M 50 5 „ „ Syncope Inquest „ „ 8 F 47 13»„ „ Syncope „ „ 13 M 70 14 „ „ Chronic Renal Nephritis „ „ 38 M 64 16 June „ Cerebral Hsemorrhage „ „ 11 F 62 22 Aug. „ Morbus Cordis Mark Lane 47 F 52 12 Oct. „ Morbus Cordis „ ,, 50 M 24 hours 21 Dec. „ Premature Birth Middle Street, Cloth Fair 5 F 73 21 July „ Hypertrophy of LiTcr ,, ,, ,, ,, 4 F 58 13 Dec. „ Bronchitis Middlesex Street 97 M 85 4 Feb. „ Bronchitis ,, ,, 45 F 71 24 Not. „ Acute Gastritis ,, ,, 37 M 64 30 Dec. „ Cardiac Failure Milk Street 5 M 58 25 Oct. „ Sudden Congestion of Brain Inquest Montague Court, Bishopsgate 12 F 79 6 Jan. Bronchitis „ „ Little Britain 4 F about 74 30 „ ,, Cerebral Hsemorrhage ,, ,, ,, ,, 3 M 46 29 July „ Chronic Rheumatic Arthritis Montague Street 2 M 32 19 Oct. Peritonitis Monument House, Monument Square - F 54 9 Feb. „ Paralysis and Bronchitis Nevill's Court, Fetter Lane 13a M 74 15 „ ,, Chronic Bronchitis New Court, Farringdon Street 9 M 5 weeks 24 Dec. „ Marasmus Died in St. Bart.'s New Square, Aldgate 27 F 52 20 Jan. „ Pleurisy New Street, Houndsditch 28 F 49 9 ,, ,, Angina Pectoris 2nd and 3rd attack „ „ Bishopsgate 12 F 82 6 Feb. „ Senile Decay ,, ,, ,,t 23 M 7 months 28 Mar. „ Bronchitis. Convulsions ,, ,, ,, 9 F 66 27 May „ Chronic Bronchitis ,, ,, ,, 24 M 48 8 Oct. „ Pneumonia New London Street 5 M 72 23 Not. „ Apoplexy accelerated by Drink Inquest Newbury Street, Cloth Fair 1 F 62 15 Mar. „ Chronic Bright's Disease ,, ,, ,, ,, 2 M 10 m'ths 18 April „ Bronchitis ,, ,, ,, ,, 1 M 38 22 Oct. „ Phthisis ,, ,, ,, ,, 14 F 71 13 Nov. „ Bronchitis Nicholas Lane Noble Street 8 42a F M 51 58 22 April „ 5 Jan. „ Influenza Phthisis Norwich Street, Fetter Lane 2 F 60 19 ,, ,, Bronchitis Old Bailey (King of Denmark) — F 4 m'ths 23 Dec., „ Acute Gastro-Enteritis Old Bailey, In waiting cell at — M 48 20 „ ,, Suicide—Shooting Inq. Verdict, Felo-de-se Old Bailey 59 M 19 days 7 Sept. „ Inanition Old Jewry 32 M 37 9 June „ Accident. Falling out of Window Inquest 145 CITY OF LONDON MORTALITY—continued. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. Old Serjeant's Inn (The Lodge) - F 65 10 Mar., 1903 Cardiac Failure Paternoster Row 29 F 45 20 Jan. „ Cancer of the Uterus Peahen Court 6 F 58 4 Feb. „ Bronchitis and Heart Disease Phil's Buildings, Houndsditch 7 F 1 m'th 13 „ ,, Asthenia Providence Place 3 F 97 5 July „ Senile Decay Queen Victoria Street (College of Arms) — M 79 11 Dec. „ Senile Decay Queen's Court, Minories 4 F 69 20 Mar. „ Chronic Bronchitis Queen's Street (The Rectory) 67 M 76 27 Sept. „ Senile Decay Red Lion Court 8 F 68 22 „ „ Gastritis Redcross Street Fire Station — F 1 m'th 8 May „ Convulsions ,, ,, ,, ,, — M 42 16 Nor. „ Syncope St. Andrew's Hill 39 F 66 19Mar. „ Carcinoma St. Andrew's Chambers, Ludgate Hill 29 F 70 28 Feb. „ Cerebral Haemorrhage St. Ann's Chambers, Ludgate Hill 25 F 73 20 Aug. „ Bronchitis St. Bartholomew's Hospital - F 25 7 Sept. „ Tuberculosis of Lung Hospital Nurse ,, ,, — F 30 14 Nov. ,, Pericarditis Hospital Wardmaid ,, ,, — F 28 23 „ „ Syncope Hospital Nurse St. Bride Street 10 M 31 29 June „ Influenza St. James' Place, Garlick Hill 4 F 69 19 Feb. „ Bronchitis and Dropsy Shaftesbury Hotel, Farringdon Street — M 26 H „ Syncope, due to Rupture Inquest. Found dead Shaftesbury Place 2 M 72 23 „ Chronic Bronchitis ,, ,, 10 M 4 27 April „ Pneumonia ,, ,, 27 F 8 m'ths 27 Aug. „ Epidemic Enteritis ,, ,, 6 M 2 14 Sept. „ Acute Bronchitis ,, ,, 14 F 8 21 „ ,, Morbus Cordis ,, ,, 14 M 5 weeks 13 Oct. „ Asphyxia. Whilst sleeping in bed with Parents Inquest. Misadventure ^ ,, ,, 24 F 59 18 Dec. „ Chronic Bronchitis Shoe Lane 25 M 33 10 Feb. „ Lift Accident Inquest Silk Street (Whitbread's Brewery) — M 58 1 June „ Heart Disease Inquest Spital Yard, Bishopsgate 7 M 69 24 Dec. „ Chronic Bronchitis Staining Lane 3 M 30 mins. 30 Oct. „ Inanition Swan Lane 15 M 2 weeks 26 „ Premature Birth Temple Lane 6 M 68 8 Aug. „ Heart Disease ,, ,, 6 F 72 2 Dec. „ Bronchitis " Three Nuns" Hotel, Aldgate — M 50 17 Mar. „ Phthisis Tokenhouse Yard 9 M 61 9 July „ Chronic Bronchitis ,, ,, 9 M 21 9 Dec. „ Acute Pulmonary Tuberculosis Vine Street 11 M 72 15 April „ Epilepsy Wardrobe Place 4 F 49 2 Oct. „ Carcinoma of Gall Bladder Warwick Square 12 M 25 20 Jan. „ Appendicitis Died in St. Bart's West Smithfield 18 M 63 22 June „ Morbus Cordis White Rose Court, Bishopsgate 1 M 40 20 ,, ,, Phthisis Widegate Street 25 M 62 8 Dec. „ Bronchitis „ ,, 23 F 63 19 „ Morbus Cordis Wood Street 18 M 70 3 Feb. „ Influenza ,, ,, 30 M 58 28 Mar. „ Fatty Degeneration of Heart Inquest W ormwood Street 7 F 47 29 Nov. „ Shock from Burns at a Fire Inquest and Postmortem. Accident. ARTIZANS' DWELLINGS—ST0NEY LANE, HOUNDSDITCH. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. King's Block 40 M 7 m'ths 24 Mar., 1903 Pulmonary Tuberculosis and Endocarditis ,, ,, 5 F 7 26 April „ Broncho- Pneumonia ,, ,, 19 M 1 30 ,i tt Acute Pneumonia ,, ,, 16 F 75 1 May „ Chronic Bronchitis Queen's Block 24 22 M M 4 m'ths 49 24 Mar. „ 18 April „ Convulsions Arterio-sclerosis and Bronchitis Inquest ,, ,, 40 M 6 m'ths 11 „ Meningitis ,, ,, 16 M 56 8 May „ Cerebral Apoplexy ,, ,, 27 M 17 hours 17 Nov. „ Atelectasis pulmonum ,, ,, 27 M 1 day 18 „ j, Atelectasis pulmonum Prince's Block 16 M 2 days 13 Sept. „ Prematurity North Block 53 M 4 m'ths 19 Aug. ,, Asphycia Inquest ,, ,, 45 M 4 m'ths 30 Oct. ,, Marasmus from Birth South Block 21 F 52 18 Mar. „ Heart Disease 146 Appendix B. LIST OF INFECTIOUS CASES, 1903* STREET LISTS. Compiled from Notifications received. Street or Place. No. of House. Sex. Age. Disease. Adelaide Place 3 F 19 Enteric Fever. Aldersgate Street 133 M 15 Scarlet Fever. Ditto 133 M 41 Ditto. Ditto 164 M 6 Ditto. Aldgate High Street 4-5 F 7 Diphtheria. Ditto 41 M 19 Scarlet Fever. America Square 2 F 35 Puerperal Septicaemia. Arthur Street West 1 F Scarlet Fever. Bartholomew Close 69 M 5 Chicken-pox. Ditto 82 F 10 Ditto. Ditto 82 M 13 Scarlet Fever. Bishopsgate Street Without 20 F Ditto. Ditto 53 M 25 Enteric Fever. Brackley Street 5 M 19 Diphtheria. Britton's Court 5 M 7 Chicken-] )ox. Bucklersbury 35 M 20 Scarlet Fever. Bush Lane 27 M 3 Ditto. Cannon Street 8 M 20 Chicken-pox. Carmelite Street Fire Station 15 M 3 Diphtheria. Ditto 18 M 2 Chicken-pox. Carter Lane (" Ye Olde Bell Tavern ") ... F 26 Erysipelas. Ditto 22 M 21 Varicella. Ditto 22 M 19 Ditto. Ditto 22 M 30 Ditto. Carter Street 19 M 2½ Chicken-pox. Circus, Minories 11 M 15 Enteric Fever. City Buildings, Moor Lane 7 M 4 Scarlet Fever. Ditto 7 M 10 Ditto. Cloak Lane Police Station ... M 28 Enteric Fever. Cloth Fair 9 F 23 Phthisis. Ditto 19 F 10/12 Chicken-pox. Crosby Square 7 M 5 Enteric Fever. Crutched Friars 38 M 16 Scarlatina. Cutler Street 32 M 4 1/1 ½ Varicella. Dean Street, E Block 7 F 11 Chicken-pox. Duke Street 18 M 7 Scarlet Anginosa. Ditto 21 M 5 Chicken-pox. Ditto 29 F 3¼ Ditto. Ditto 29 M 2 Ditto. Ditto 29 M 5/12 Ditto. Eastcheap 55 M 8 Scarlet Fever. East Passage 83 M 8 Ditto. Ditto 83 M 2½ Ditto. Eldon Street 30 M 5 Chicken-pox. Fenchurch Street 18 M 13 Enteric Fever. Ditto 150 M 10 Scarlet Fever. Fetter Lane 35 F 7 Chicken-pox. Ditto 35 M 5 Ditto. Ditto 35 F 11 Ditto. Finsbury Pavement 81 M 12 Scarlet Fever. Fish Street Hill 46 F 8 Ditto. 147 Street ob Place. No. of House. Sex. Age. Disease. Fleet Street 33 M 6 Chicken-pox. Ditto 19.1 M 5 Ditto. George Street 6 F 7 Diphtheria. Giltspur Street 13 M 43 Typhoid Fever. Golden Lane 1 F 26 Erysipelas. Gracechurch Street 34 F 4½ Diphtheria. Greenwich Street (Mosaic Works) • • • M 4 Scarlatina. Greystoke Place 9 F 1 10/12 Diphtheria. Ditto 9 F 5 Ditto. Holborn 30 F 7½ Scarlet Fever. Ditto 30 M 4½ Ditto. Holborn Buildings 7 M 68 Phthisis. Holborn Circus 7 M 48 Erysipelas. Hosier Lane 23 M 4½ Chicken-pox. Hutchison Avenue 14 F 2 Diphtheria. Ditto 23 M 5 Scarlatina. Hutchison Street 2 F 3½ Ditto. Ditto 2 M 1 8/12 Scarlet Fever. Ditto 17 M 6 Ditto. King Arms Yard 13 M 8 Ditto. Leadenhall Street 65 F 6½ Varicella. Ditto 65 M 35 Diphtheria. Lime Street Square 6 F 4 Varicella. Little Britain 29 M 8 Scarlet Fever. Long Lane 61 M 30 Phthisis. Ditto 86 M 30 Ditto. Lower Thames Street 83 F 10 Diphtheria. Ludgate Hill 60 F 61 Erysipelas. Maiden Lane 11 F 19 Scarlatina. Middle Street 2 F 8 Chicken-pox. Middlesex Street 37 M 40 Erysipelas. Milton Street 43 F 30 Ditto. Mincing Lane 4 F 7½ Chicken-pox. Ditto 4 M Ditto. Montague Court 2 M 6 Ditto. Moorgate Street 2a M 7 Scarlet Fever. Ditto 2a M Ditto. Ditto 12 M 8 Ditto. Moor Lane 16 M 19 Ditto. Ditto 16 M 18 Ditto. Neville's Court 13a M 5 Chicken-pox. New Court, Throgmorton Street Exchange • • • F 8 Scarlet Fever. Newbury Street 2 M 8/12 Chicken-pox. New Street 37 F 5½ Scarlet Fever. Ditto 12 F 1 4/12 Diphtheria. New Street Square 12 M 5 Scarlet Fever. Ditto 12 F 11 Ditto. Nicholas Lane 33 F 9 Chicken-pox. Northumberland Alley 4 M 6 Diphtheria. Old Change 2 M 7 Typhoid Fever. Pemberton Row 3 F 5 Scarlet Fever. Ditto 3 M 3½ Ditto. Providence Place 14 M 4 Diphtheria. Queen Street Place 6 F 16 Enteric Fever. Redcross Street Fire Station 6 M 5 Erysipelas. Ditto 6-7 M 8 Scarlatina. Ditto 62 M 6 Scarlet Fever. Robin Hood Court Workhouse • • • M 57 Erysipelas. Rose Alley 7 M 2 Diphtheria. St. Andrew's Hill 2½ F 29 Ditto. Ditto 41 M 15 Scarlet Fever. 148 Street or Place. No. of House. Sex. Age. Disease. St. Bartholomew's Hospital ... F 25 Scarlet Fever. Ditto ... F 27 Enteric Fever. Ditto • • • F 27 Scarlet Fever. Ditto • • • F 24 Diphtheria. Ditto ... F 29 Scarlet Fever. St. Helen's Place 3 M 8 Chicken-pox. Ditto 16 F 5 5½ Varicella. Ditto 16 F 3½ Chicken-pox. Ditto 20 F 10 Scarlet Fever. St. Mary-at-Hill 26 F 6 Chicken-pox. Ditto 26 F 10 Ditto. Ditto 26 M 7 Ditto. St. Mary Axe 27 F 8 Nasal Diphtheria. Savage Gardens 3 F 5½ Scarlet Fever. Shaftesbury Place 8 F 7 Ditto. Ditto 8 M 4 5½ Ditto. Ditto 9 F 9 3/4 Ditto. Ditto 14 M 4 Varicella. Ditto 16 M 5 Scarlet Fever. Ditto 16 M 7½ Ditto. Ditto 16 F 6 Ditto. Ditto 16 F 1 1/4 Varicella. Ditto 16 M 3 Ditto. Ditto 22 M 6 Ditto. Ditto 22 F 11 Ditto. Ditto 27 F 6 Ditto. Ditto 28 F 10 Diphtheria. Shoe Lane 112 F 4 Scarlet Fever. South Place 13 M 9 Ditto. Stoney Lane (King's Block) 40 F 6½ Diphtheria. Ditto, ditto 44 F 22 Scarlet Fever. Ditto (North Block) 5 M 4 Ditto. Ditto, ditto 19 F 6 Ditto. Ditto, ditto 19 M 4 Ditto. Ditto, ditto 41 F 3½ Ditto. Ditto, ditto 41 M 8 Ditto. Ditto, ditto 44 M 2 Scarlatina. Ditto (Princes Block) 24 F 12 Scarlet Fever. Ditto, ditto 52 M 9 Ditto. Ditto, ditto 55 M 2 1/4 Ditto. The Crescent 11 M 3 Ditto. Throgmorton Avenue 10 M 4 Varicella. Ditto 10 M 4 Ditto. Tokenhouse Yard 16 M 13 Chicken-pox. Took's Court 4a F 13 Diphtheria. Tower Dock 3 F 6 Chicken-pox. Trinity Square 10 F 4½ Scarlet Fever. Upper Thames Street 82 M 3 Diphtheria. Ditto 82 M 1 2½ Ditto. Victoria Embankment (Royal Hotel) • • • M 25 Enteric Fever. Vine Street 9 M 34 Ditto. Warwick Square 12 M 20 Diphtheria. Ditto 12 M 20 Erysipelas. Watling Street 12a F 7 Scarlet Fever. Ditto 12a M 7 Ditto. Ditto 28 M 16 Diphtheria. West Smithfield 20 F 6 Varicella. Ditto 20 M 8½ Ditto. Ditto 20 F 7 Ditto. Ditto 20 M 2 10/12 Ditto. Ditto provision Market F 11 Ditto. Whitefriars Street 25 F 13 Typhoid Fever. Widegate Street 26 M 6 Varicella. Ditto 26 F 9 Ditto. Ditto 26 M 4 Ditto. Wood Street 76 M 25 Ditto. 149 Appendix c. TENEMENT HOUSES. WEST DISTRICT. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. 1, Burgon Street Mrs. 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 Lane. J. F. Pemsel, 32, Fetter Lane 3 4 2, do. do. Preston Kingsworth, 2, Chapel Place 1 1 1, Church Entry, Carter Lane. Charles Eagle, 1, Church Entry 1 6 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, 10, East Harding Street 2 5 11, do. F. S. Appt, 11, do 2 10 12, do. Jane Smith, 12, do. 1 1 35, Fetter Lane William Davis, 35, Fetter Lane 5 15 36, do. Do. do. 5 11 37, do. Harriet Jardine, 37, do. 5 6 38, do. W. A. Hooper, 38, do. 5 6 42, do. J. Richards, 42, do. 3 7 ■57, do. Paul Quartermass,.57, do. 3 3 93, do. J. Hook, 106, St. James' Road, Holloway 4 11 39, Furnival Street Messrs. Hutchinson & Co., 40& 41, Furnival Street 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 Carried forward 125 288 150 WEST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 125 288 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. W. Townsend, 2, Middle Street, Cloth Fair 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 Lane. Harriet Evans, 9, do. 4 10 36, Hutton Street Elliot & Co., 40, Chancery Lane 2 4 3, Hosier Lane John B. Fuller 3 5 4, do. John Dugan 1 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 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, Farringdon Street. Arthur Wilks, 13, Newcastle Street 7 8 5, New Street Hill, and 11, Gunpowder Alley ) C. Rowsell, 5, New Street 3 6 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 14, do. Do. do. 6 10 3, Pemberton Row J. Young, 1, Pemberton Row 3 11 13, Plumtree Court Edward Smith, 13, Plumtree Court 3 3 Carried forward 291 658 151 WEST DISTRICT—continued. Situation of Premises. Name and Address o£ Owner. Tenements. Lodgers. Brought forward 291 658 19, Primrose Hill Crawley & Smee, 19, Primrose Hill 3 10 20, do. E. Coulson, 20, do. 4 10 22, do. Thomas Palmer, 22, do. 3 12 4, Red Lion Court J. A. N. Mackay, 31b, Cowcross Street 5 11 8, do. W. Simpson, 95, Rosebery Square 5 7 11, do. F. Southwell, 11, Red Lion Court 3 8 6 & 7, Red Lion Passage Cloth Fair. H. J. Ward, 6 and 7, Kinghorn Street 6 25 16, Tudor Street John Evans, 16, Tudor Street 2 10 1 & 2, Took's Court Thurgood & Martin, 27, Chancery Lane 12 42 5a, do. E. J. Hopkins, 5a, Took's Court 6 2 6, Temple Lane John Allen, 34, New Bridge Street 4 10 7, do. Do. do. 7 20 8, do. Do. do. 7 16 15, Water Street, Tudor Street. George York, 15, Water Street 2 7 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 43, Bartholomew Close E. Haley, 2, Cross Key Court, London Wall 3 10 44, do. J. Sturgeon, 6, Middlesex Passage 2 4 85, do. Elizabeth Parry, 85, Bartholomew Close 3 7 6, Bartholomew Place Henry Hoggett, 6, Bartholomew Place 1 3 3, Cloth Fair G. Shurling, 64, Long Lane, E.C. 2 5 4, do. J. Edwin Ponder, 103, Aldersgate] Street 4 8 6 & 7, do. Charles Randall, 6, Cumming Street, Pentonville 7 15 8, d0 Do. do. do. 4 8 9, do. Do. do. do. 6 10 18, do. C. Brissmire, 18, Cloth Fair 4 12 21, do W. Phelan, 20, do. 8 10 22, do J. Jackson, 22, do. 4 10 25, do. Miss Laura Bassey, 25, Cloth Fair 3 4 28, do. Thomas M. James Janes, 191, Aldersgate Street 3 12 29, do Charles Randall, 6, Cumming Street, Pentonville. 1 3 31, do A. H. Price, 31, Cloth Fair 3 8 43, do Charles Randall, 6, Cumming Street, Pentonville. 2 6 44, do. Do. do. do. 4 7 45, do Florence Struthers, 58, West Smithfield 1 7 1, Cockerill's Buildings Margaret Walker, 1, Cockerill's Buildings 2 5 2, do. E. Haley, 2, Cross Key Court 3 12 3, do. Thomas Bate, 3, Cockerill'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 Carried forward 450 1,169 152 WEST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 450 1,169 5, East Passage, Cloth Fair. James T. Deeks, 5, Offerton Square, Clapham 4 8 27, do. Do. do. do. 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 25, do. W. Phelan, 20, Cloth Fair 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 2, Middle Street W. Townsend, 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 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 11, Bartholomew Close Ann Clevely, 11, Bartholomew Close ... 4 7 1, Pope's Cottages Edward Haley, 2, Cross Key Court, London Wall 6 6 Total. 595 1,402 Average number of lodgers to each tenement : 2.35. MIDDLE DISTRICT. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. 100, Aldersgate Street J. B. Robertson, 100, Aldersgate Street 1 1 104, do. William Harris, 158, Kingsland Road 2 2 34, Beech Street Lucy Shirley 3 9 51a , do. M. Manns, 51a, Beech Street — — 1 and 2, Huggin Court, Little Trinity Lane. Mrs. Mackenzie, 1 and 2, Huggin Court 5 13 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 Shad bolt, 2, Little College Street 2 5 3, do. Mr. Wild, 3, do. 2 4 15, Swan Lane Mr. Postlewaithe, 15, Swan Lane 5 6 1, St. James' Place, Garlick Hill. Charles J. Shears, 2, St. James' Place 4 13 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 4 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. 2 5 20, do. J. B. Kyffn, 44, Lauriston Road, Hackney 3 14 21, do. Do. do. 3 9 22, do. Do. do. 1 4 23, do. Do. do. 3 4 24, do. Do. do. 3 6 25, do. Do. do. 3 7 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 3 6 30, do. The Ramoneur Co., 30, Shaftesbury Place 2 8 Total 103 306 Average number of lodgers to each tenement: 2.99. 153 154 EAST DISTRICT. Situation of Premises. Name and. Address of Owner. Tenements. Lodgers. 27, Aldgate A. L. Poysner, 27, Aldgate 1 2 6, do. J. Vale, 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, Bishopsgate. Laura Wells, 11, Clark's Place... 1 1 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... 125 256 155 EAST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers Brought forward 125 256 11, Duke Street, Aldgate A. A. Romain, 453, Mile End Road 5 5 13, do. A. Stenner, 18, Duke Street 2 2 19, do. F. Dyson, 19, do. 1 1 6, Greorge Street, Minories Henry C. Geisler, 6, George Street 1 1 7, do. P. 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, Hutchinson Avenue Mr. Hollington, Middlesex Street 1 3 2, do. Do. do. 5 5 3, do. Jacob Kalonaski, 3, Hutchinson 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 18, do. Theresa Ellis, 13, Hutchinson Avenue .. 3 6 14, do. H. Messier, 14, do. 3 4 15, do. A. Joseph, 15, do. 2 4 17, do. James Woolf, 18, Grenville Place, Maida Vale 3 8 18, do. Henry Davis, 18, Hutchinson 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, Hutchinson Street . B. Jacobs, 5. Hutchinson Street 2 7 6, do. — Soloman, 6, Houndsditch. 3 5 10, do. S. Marks, 10, Hutchinson Street 1 8 12, do. Eleazar Isaacs, 12, do. 1 1 16, do. — Abrahams 3 14 17, do. — Soloman, 17, Hutchinson Street 2 5 18, do. — Jacobs, 18, do, 1 4 19, do. Sarah Finklestein, 17, Houndsditcli 1 2 20, do. David Jacobs, 20, Hutchinson Street 1 6 Janes Buildings, Hutchinson 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. 241 556 156 EAST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 241 556 16, Mansell Street, Aldgate Chas. W. Harris Albert F. Smith, 3, Medland Street, Ratcliff Cross. 3 4 17, do. 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. Rachael 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 A. Smith, Blomfield Street 6 31 Square. 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,GravelLarie 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 Wm. Grouts, 7, High Street, Deptford 4 11 23, do. do. Ed. Bullen, 24, New Street 6 12 26&2 7,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. 359 883 157 EAST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenemeats. Lodgers. Brought forward 359 883 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 477 1,168 Average number of persons to each tenement: 2.39. 158 List of Persons registered under the Dairies, Cowsheds and Milkshops Order. 1st January, 1904. Premises. Person Registered. Premises. Person Registered. 24, Aldersgate Street Robert Douglas. 9, Billiter Square Callard, Stewart & Watt, Ltd. 28/9, do. British Tea Table Co., Ltd. 49, Bishopsgate St. W'n. Slaters,. Ltd. 35, do. Lockharts, Ltd. 60, do. William Neave Hill. 42, do. Nunzio Allocca. 79, do. Lyons and Co., Ltd. 67, do. Lyons and Co., Ltd. 101, do. Forster and Hazell. 72, do. Slaters, Ltd. 107, do. William Hughes. 83, do. Charlotte Smith. 15/6, Bisliopsgate St.W't. Aerated Bread Co., Ltd. 90, do. Luigi Torre. 19, do. J. Lyons and Co., Ltd. 92, do. Joseph James Metcalf. 31, do. Giovanni Beltramini. 170, do. Aerated Bread Co., Ltd. 42, do. British Tea Table Co., Ltd. 188, do. James Dwarber. 50, do. Lucidoro Mauro. 193, do. Lyons and Co., Ltd. 69, do. Edgar Alexander Macfarlane. 40, Aldermanbury Lorenzo Cattini. 77, do. Gaston Debry. 55, do. Aerated Bread Co., Ltd. 90, do. Donald Henderson. 68, do. British Tea Table Co., Ltd. 102a, do. Octavius Thomas Jeans. 12 and 13, Aldgate Lockharts, Ltd. 111, do. Arthur James Tipping. 23, Aldgate Yitali Babero. 147, do. British Tea Table Co., Ltd. 26, do John Peter Moriggia. 23, Birchin Lane M. A. Iviston and Co. 28, do Dominico George. 8/10, Blomfield Street British Tea Table Co., Ltd. 7, Aldgate High Street John Wattam. 8, Botolph Alley Esau Wm. Lambourn. 26, do. William Flint. 2, Bow Lane British Tea Table Co., Ltd. 73, do. Express Dairy Co., Ltd. 9, do. Lucidoro Mauro. 7, Artillery Lane Agnes Bragg. 10, do. Guiseppe Berudi. 22, do. Thomas Piggott. 46, do. P. Palumbo. 5, Austin Friars Golden Grain Co., Ltd. 20, Bride Lane George Price. 5, Barbican Luigi Cattini. 3, Brushfield Street Henry Pugh Lloyd. 6/7, do Aerated Bread Co., Ltd. 3, Bridgewater Street Charles Cromwell Crocker. 17, do. Peter Fumasoli. Broad Street Station Aerated Bread Co., Ltd. 19, do. Guiseppe Mansi. 4, Broadway Caroline L. Vohman. 20, do. Lockharts, Ltd. 7, do J. Lyons and Co., Ltd. 35, do. W. B. Price. 8, do. Free and Co. 43a, do. William Henry Callis. 35, Bucklersbury J. Lyons and Co., Ltd. 67, do. British Tea Table Co., Ltd. 20, Budge Row J. Lyons and Co., Ltd. 21, Bartholomew Close Charles Baker. 24, do Thomas Barge. 1, Basinghall Street Aerated Bread Co., Ltd. 30, do. British Tea Table Co., Ltd. 15, do. Antonio Cattini. 1, Burgon Street Nunzio Allocca. 29/30, do. J. Lyons and Co., Ltd. 1, Bury Street Express Dairy Co., Ltd. 1, Gresham Buildings, Basinghall Street London Cafe Co., Ltd. la, do. Albert Alexander Price. 40/2, Cannon Street Aerated Bread Co., Ltd. 50, Beech Street John Richards. 50, do. Slaters, Ltd. 51a, do. George Cordery. 51, do. Aerated Bread Co., Ltd. 4, Beehive Passage Lockharts, Ltd. 86, do. Aerated Bread Co., Ltd. 7, Bell Yard James Henry Mills. 91, do. William Neave Hill. 5, Billiter Street British Tea Table Co., Ltd. 95, do. James Hogg Brown. 22, do. J. and B. Stevenson. 139, do. London Cafe Co., Ltd. Pagoda Caf6. Billiter St. The Pagoda Refreshment Co., Ltd. 145, do. Ye Mecca, Ltd. Appendix D. 159 Premises. Person Registered. Premises. Person Registered. 147, Cannon Street Aerated Bread Co., Ltd. 18, Eldon Street Bartolomeo Cattini. Cannon St. Station Aerated Bread Co., Ltd. 25, do. British Tea Table Co., Ltd. Approach 2, Falcon Street Saletta Bifulco. 36, Camomile Street Saletta Bifulco. 60, Fann Street Annie Gittus. 54, Carter Lane William Henry Knapp. 19/20, Farringdon Street Friern Manor Dairy Farm, Ltd. 57a, do. Robert Elijah Bareham. 75, do. William Henry Clemence. 22, do. Francis Rodway. 79, do. (Mrs.) Harriett Loader. 32, do. Arthur Atkins. 81, do. R. J. Fitzgibbon. 62, do. David Jones. 5, Castle Street (Mrs.) Mary Jones. 67, do. Lewis Bertram Heyward. 319, Central Markets Lockharts, Ltd. 70/1, do. Geo. Jas. and Arthur J. Silverlock. 332, do. Cream Dairy Co. 18, Charterhouse Street British Tea Table Co., Ltd. 72, do. William Murray. 23, Cheapside J. Lyons and Co., Ltd. 79, do. Edward Druce. 26, do. Slaters, Ltd. 84/5, do. British Tea Table Co., Ltd. 41, do. British Tea Table Co., Ltd. 88, do. Frederick Philipp Weinel. 51, do. Aerated Bread Co., Ltd. 2, Fen Court... Aerated Bread Co., Ltd. 66, do. Ralph Capper. 15, Fenchurch Street... Aerated Bread Co., Ltd. 74/5, do Slaters, Ltd. 31, do. J. Lyons and Co., Ltd. 77, do Aerated Bread Co,, Ltd. 46, do. Luigi Arpino. The Cabins, Ltd. 140, do. Ye Mecca, Ltd. 47, do. 150, do. Aerated Bread Co., Ltd. 62, do. Aerated Bread Co., Ltd. 6, Clark's Place Edwin Prosser. 69, do. Croci Carlo. 20, Cloth Fair William Mortimer Phelan. 99, do. Aerated Bread Co., Ltd. 22, do John Jackson. 103, do. Joseph Hubert Buck. 30, do Reuben Smith Jackson. 107, do. British Tea Table Co., Ltd. 19, Cock Lane Jane Jones. 153, do. Nora Marcon. 23, Coleman Street Ye Mecca, Ltd. 157, do. Diviani Bros. 38, do. The Cabins, Ltd. 161, do. Maynards, Ltd. Copthall Ave.(Throgmorton House) Mabel Humphrey. 164, do. Slaters, Ltd. 1, Railway Approach J. Lvons and Co., Ltd. 8, Copthall Avenue Alexander Hampton. Fenchurch St. Station Henry Christian Ihomas Amendt. 10, do. James William Davis. 28, do. Siro Pietro Alberti. 31, Fetter Lane Thomas Richards. 9, Cornhill Aerated Bread Co., Ltd. 33, do. Edward Fitch. 11, Cree Church Lane Marv Ann Stanton. 38, do. William Alfred Hooper. 7, Cripplegate Buildgs. Aerated Bread Co., Ltd. 44/5, do. Stewart and Wight, Ltd. 7, Crooked Lane M. Morgan Jones. 49, do. William B. Price. 1, Cross Key Court Catherine Ellis. 57, do. Paul Quartermass. Crown Court (Old Broad Street) J. Lyons and Co., Ltd. 83, do. Mary Harris. 140, do. ... Frederick Brock. 13, Crutched Friars Express Dairy Co., Ltd. 1, Finsbury Pavement Luigi Ostacchini. 27, do. Elizabeth Miles. 73, do. Aerated Bread Co., Ltd. 7, Cullum Street British Tea Table Co., Ltd. 85, do. British Tea Table Co., Ltd. 21, do. Allard Bros. 139, do. Express Dairy Co., Ltd. 14, Cursitor Street Martha Kersey. Finsbury Pavement House. J. Lyons and Co., Ltd. 1, E Block, Dean St. William George Cuss. 3/5, Devonshire Street Henry Pearce. 22, Fish Street Hill ... George Porteous Johnston. 8, do. Mitchell's Dining Rooms,Ltd. 37, do. Pasqualino Palumbo. 7, Dorset Street Guiseppe Indaco. 2, Fishmongers' Alley Mary Jones. 19, Duke Street Frank Dyson. 16, Fleet Street George Rice Bolton. 27, do Henry Richards. 23, do. J. Lyons and Co., Ltd. 41, do Lorenzo Cattini. 61, do. J. Lyons and Co., Ltd. 50, do Harold Shannon. 109, do. Lockharts, Ltd. 5, Eastcheap Aerated Bread Co., Ltd. 116, do. Aerated Bread Co., Ltd. 15, do. Ye Mecca, Ltd. 118, do. Alfred Scarlett. 28, do. Aerated Bread Co., Ltd. 131, do. Express Dairy Co., Ltd. 35, do J. Lyons and Co., Ltd. 167, do. Cabins, Ltd. 59, do Jno. Teaffey. 170, do. Lockharts, Ltd. " Ceylon House," Eastcheap. British Tea Table Co.. Ltd. 173, do. J. Lyons and Co., Ltd. 160 Premises. Person Registered. Premises. Person Registered. 175, Fleet Street Romualoto Mansi. 9/10, Hart Street James Page Geary. 182/3, do. British Tea Table Co., Ltd. 31, Holborn Aerated Bread Co., Ltd. 190, do. Aerated Bread Co.. Ltd. 114/5, do Aerated Bread Co., Ltd. 31, Fleet Lane Annie Heald. 144, do. Luigi Rattazzi. 17, Fore Street J. Lyons and Co., Ltd. 145, do. Slaters, Ltd. 28, do. William R. Child. 1/2, Holborn Viaduct Aerated Bread Co., Ltd. 54, do. J. Lyons and Co., Ltd. 14, do. J. Lyons and Co., Ltd. 56/7, do. Aerated Bread Co., Ltd. 65, do. Alice R. Pearce. 62, do. Percy Goodman. 1, Honey Lane Market P. Verioni. 70, do, Antonio Biagi. 4, do. Lyons and Co., Ltd. 84, do. Lockharts, Ltd. 9, do. John Gow. 85, do. John Mardorf. 1, Hosier Lane John Davies. 112, do. Ulrich Maino. 27a, do. Richard William Mason. 2, Foster Lane Giovanni Diviani. 118, Houndsditch David Jones. 5, do. William Walter Burrows and John Roberts. 1/2, Huggin Court Edmund Moore. 4a, Huggin Lane Edmund Moore. 9, do. Giorgi Beschizza and Co. 10, do. Ada Collins. 41, do. Free and Co. 13, Hutchison Street Morris Drachman. 2, Friday Street Felice Tortora. 15, do. Jacob and Leah Miller. 65, do. Aerated Bread Co., Ltd. 35, Hutton Street Amy Reeve. 1, Furnival Street Henry Charles Leaver. 38, do. Timothy Evans. 20, Garlick Hill Walter Robert William Marchant. 13, Idol Lane ... Stanley E. Twallin. 3, Imperial Arcade Friern Manor Dairy Farm, Ltd. 12, George Yard Callard, Stewart and Watt, Ltd. Ingram Court British Tea Table Co., Ltd. 1, Great New Street Sarah Amelia Barnslev. 20, Ironmonger Lane Joseph Henry Bond. 12, do. Jane Smith. 28/9, do. British Tea Table Co., Ltd. 21, Godliman Street Express Dairy Co., Ltd. 8/9, Ivy Lane A. L. Maitre. 8, Gough Square James Rushmer. 18, do. Carlo Sciarillo. 12, Gracechurch Street Charles John Haag. 22, do. West London Dairy Co., Ltd. 33, do. Aerated Bread Co., Ltd. 39, Jewin Crescent Antonio Precha. 41, do. Maynards, Ltd. 6, Jewin Street E. Seton Karr. 51, do. Lockharts, Ltd. 9, do. J. Lyons and Co., Ltd. 69, do. Callard, Stewart and Watt, Ltd. 24, do. George McFarlane. 28/9, do. British Tea Table Co., Ltd. 72/3, do. J. Lyons and Co., Ltd. 8, Jewry Street John Jones. 8/9, Great St. Helen's Callard, Stewart and Watt, 32, do. Albert Intrepidi. Ltd. 12, John Street William Alston. 18/19, do. Lilian Agnes Clarke. 16, do. Alice Maud Turner. " Crosby House," Gt. St. Helen's. Ye Mecca, Ltd. 29, King Street Antonio Precha. 32, do. Aerated Bread Co., Ltd. 17/8, Great Tower Street Aerated Bread Co., Ltd. 8, King William St Slaters, Ltd. 28, do. Thomas Stevenson. 31a, do. Beniamino Savino. 58, do. Joseph James Metcalf. 32, do. Lockharts, Ltd. 62/3, do. Aerated Bread Co., Ltd. 34, do. J. Lyons and Co., Ltd. 70, do. Luigi Arpino. 44, do. Aerated Bread Co., Ltd. 78, do. Callard, Stewart and Watt, Ltd. 50, do. J. Lyons and Co., Ltd. 51, do. Edward John Argent. 96, do. London Clerks' Cafe Co.,Ltd. 61, do. J. Lyons and Co., Ltd. 100, do. Luigi Arpino. 64, do. Aerated Bread Co., Ltd. 6, Greystoke Place ... William George Cuss. 8, Kinghorn Street ... Saletta Bifulco. 1, Gresham Street ... Aerated Bread Co., Ltd. 12, do. Catherine Lewis. 3, do. Ye Mecca, Ltd. 25a, do. William Phelan. 5, do. Antonio Ostacchini. King's Arms Yard Ye Mecca, Ltd. 46, do. J. Lyons and Co., Ltd. 8, King's Head Court William Collins. 54, do. Ye Mecca, Ltd. 48, Knightrider Street William Adamson. 69, do. Aerated Bread Co., Ltd. 8, Lambeth Hill British Tea Table Co., Ltd. 87, do. Golden Grain Bread Co.,Ltd. 19, Leadenhall Market J. T. Gardner. 12, Grocers' Hall Court James Arthur Bruce. 38, do. Free and Co. 4, Hart Street British Tea Table Co., Ltd. 40, do. Mary Ellen Bird. 5, do. Margaret Jones and Edwards 50, do. Henry George Saunders. 161 Premises. Person Registered. Premises. Person Registered. 56, Leadenhall Market Elizabeth Clary. 8, Mansell Street Elias Manns. 4, Leadenhall Street Aerated Bread Co., Ltd. 18, do. Henry Rodney Foakes. 60, do. Alfonso Delpizzo. 28, do. Leah Woolf. 64, do. John Edwards. 38, do. George Outten. 96/98, do. Aerated Bread Co., Ltd. 69/70, Mark Lane Ye Mecca, Ltd. 101, do. Ye Mecca, Ltd. 78, do. Express Dairy Co., Ltd. 106, do. Aerated Bread Co., Ltd. 25, Middlesex Street (Middlesex House) Mitchell's Dining Rooms, Ltd. 140, do. Aerated Bread Co., Ltd. 8/9, Lime Street John and Boyd Stevenson. 25, do. Izaak Stainfest. 15a, do. Express Dairy Co., Ltd. 71, Milton Street Charles Gentry. 23, do. J. Lyons and Co., Ltd. 76, do. Andrew Annanson. 24, do. Ye Mecca, Ltd. 2, Minories ... British Tea Table Co., Ltd. 26, do. Aerated Bread Co., Ltd. 6, do. British Tea Table Co., Ltd. 34, do. Agnes Powell. 125, Minories ... Albert Markwell. 6/8, Lime Street Square Fruitarian Cafe Co., Ltd. 130, do. Elizabeth King. 4, Little Britain Frederick Pearce. 152/3, do Robert Phillips. 19, do. Express Dairy Co., Ltd. 155, do. William McGavin Reid. 25, do. John Davies. 41/2, Monkwell Street Samuel Henry Gregg. 33, do. Welford and Sons, Ltd. " Monument Dairy," Frederick Lewindon. 56, do. Arthur Leonard Message. Monument Street. 6, Little Trinity Lane Jessie Rosa Young. 43, Moor Lane Bonaventura Mandara. 20, Liverpool Street George Worth. 2, Moorfields... Donato Palumbo. 37, do. David Lowrie. 9, do. Robert Bell. Liverpool Street H. C. T. Amendt. 28, do Express Dairy Co., Ltd. Station 38, do. Antonio Precha. 4, Lombard Court Ye Mecca, Ltd. 44, do. G. Off'redi. 82, Lombard Street Aerated Bread Co., Ltd. 19, Moorgate Street ... Alexander Hampton. 3/4,London HouseYard George Porteous Johnston. 28, do. Aerated Bread Co., Ltd. la, London Street Marie Seabright. Moorgate Station Chambers Express Dairy Co., Ltd. 4, do. Croci Carlo. 8, do. Lockharts, Ltd. 2, Moorgate Station Buildings Fullers, Ltd. 19, do. Aerated Bread Co.. Ltd. 34, London Wall Andrew Glendinning. 7, do. Aerated Bread Co., Ltd. 47, do. Lockharts, Ltd. 35, New Street Samuel Harris. 49, do. Ye Mecca, Ltd. 1, New Basinghall St. British Tea Table Co., Ltd. 55, do. British Tea Table Co., Ltd. 13, New Bridge Street J. Lyons and Co., Ltd. 58a, do. Express Dairy Co., Ltd. 40, do.' Aerated Bread Co., Ltd. 151, do. Aerated Bread Co., Ltd. 44, do. David Stewart. bury House) 3, New Broad Street... J. Lyons and Co., Ltd. 52/53, Long Lane Joseph Young. 4b, do. Pagoda Refreshment, Co., Ltd. 54, do. Alfred Home. 55, do. William H. Collins. 13, do. R. Charles and Co. 77, do. Stewart and Wight, Ltd. 13a, do. Lockharts, Ltd. 80, do. Luigi Migliorina. 16, do. Aerated Bread Co., Ltd. 83, do. Pietro Offredi. 28, do. William Neave Hill. 85, do. Evan Bees. 64, do. Aerated Bread Co., Ltd. 129½, Lower Thames St. Natali Jurietti. 3, Newbury Street Elizabeth Pike. 5, Ludgate Circus J. Lyons and Co., Ltd. 13, Newgate Street Stewart and Wight, Ltd. 1, Ludgate Circus Slaters, Ltd. 18, do. Slaters, Ltd. Buildings 87, do. J. Lyons and Co., Ltd. 4, do. British Tea Table Co., Ltd. 94, do. British Tea Table Co., Ltd. 16, Ludgate Hill Cat lard. Stewart and Watt, 122/3, do. Peter Diviani. Ltd.' 24, Noble Street Samuel Henry Gregg. 21, do. J. Lyons and Co., Ltd. 44, do. Alfred Walter Bennett. 29, do. Aerated Bread Co., Ltd. 19/20, Old Bailey Lockharts, Ltd. 38, do. Aerated Bread Co., Ltd. 22, do. Charles Thompson Hill. 54, do. Express Dairy Co., Ltd. 55/6, do. British Tea Table Co., Ltd. 56, do. Ye Mecca, Ltd. 33, Old Broad Street Aerated Bread Co., Ltd. 6, Maidenhead Court... Matteo Mansi. 40, do. Aerated Bread Co., Ltd. 14, do. Joseph Francis Head. 2, Old Change Charles D. Bizzanelli. 20, do. George Endersby. 13a, do. British Tea Table Co., Ltd. 162 Premises. Person Registered. Premises. n Registered. 6, Old Jewry The Cabins, Ltd. Telegraph Street Ye Mecca, Ltd. 3, Pancras Lane Frederick Walter Hicks. 8, Temple Lane Jessie Holman. 1, Paternoster Avenue Nunzio Allocca. 27, Throgmorton Street J. Lyons and Co., Ltd. 5/6, Paternoster Row British Tea Table Co., Ltd. 29, do. Aerated Bread Co., Ltd. 12, do. Pelegrino Verioni. 6, Tudor Street John Pantalone. 60, do. J. Lyons and Co., Ltd. 10, do. Bertram Geo. Willson. 5, Paul's Alley Carlo Demaria. 14, do. Walter Thomas Beanies. 8, Philpot Lane Sarah and Bridget Edwards. 32, do. Fanny Payne. 14, do. Stewart and Wight, Ltd. 3, Union Court, Old Broad Street. Express Dairy Co., Ltd. 22, do. Alfred Walter Bennett. 21, Pilgrim Street Matteo Castagnetti. do. Ye Mecca, Ltd. 32, do. Priori Oreste. 8, Union Row, Lockharts, Ltd. 34, do. Aerated Bread Co., Ltd. Minories. 31, Poultry J. Lyons and Co., Ltd. 57, Upper Thames Street John Rignold Bush. 1, Queenhithe Albert Ashlee. 134, do. Eliza Keeler. 6, Queen Street Jane Anderson Carnegie. 145, do. Stewart and Wight, Ltd. 8, do. Charles Hy. Belsey. 172, do. George Chitty. 10, do. J. Lyons and Co., Ltd. 182, do. Guiseppe Mansi. 40, do. Egidio Fabrizi. 186, do. Robert Waterson. 71, do. Lockharts, Ltd. 190, do. Joseph James Medcalf. 7, Queen Victoria Street Express Dairv Co., Ltd. 194, do. Robert Cooper. 17, do. J. Lyons and Co., Ltd. 223, do. Albert Alex. Price. 26, do. British Tea Table Co., Ltd. 224, do. Robert Cooper. 75, do. Golden Grain Bread Co., Ltd. 4, Walbrook J. Lyons and Co., Ltd. 105, do. British Tea Table Co., Ltd. 14, do. Ye Mecca, Ltd. 115, do. Lockharts, Ltd. 19/20, do J. Lyons and Co., Ltd. 143, do. J. Lyons and Co., Ltd. 34, do. Aerated Bread Co., Ltd. 148a, do. Reuben Thos. Matthews. Warnford Court Aerated Bread Co., Ltd. 177, do. Guiseppe Gionta. 14, Warwick Lane Frederick Charles Pearce. 2, Robin Hood Court Emma A. Smith. la, Water Lane (Great Tower Street). Samuel Arthur Turner. 2/4, Ropemaker Street John Pearce. 12, Rose Street Alfred Gambardello. 2, Water Lane (Blackfriars). Albert Alexander Price. 2^, St. Andrew's Hill Cream Dairy Co. 16, St. Bride Street William Castle. 4, Water Lane (Blackfriars). Robert Reid. 35, do. Stewart and Wight, Ltd. 3/4, St. Martin's Court George Porteous Johnston. 5, Water Lane (Blackfriars). Ernest A. L. Halcomb. 31, St. Mary-at-Hill British Tea Table Co., Ltd. 21, St. Mary Axe Fruitarian Cafe Co., Ltd. 7, Water Lane (Blackfriars). British Tea Table Co., Ltd. 33/5, do. Slaters, Ltd. 34, do. Express Dairy Co., Ltd. 73, Watling Street " Aldermary House," Watling Street. British Tea Table Co., Ltd. Ye Mecca, Ltd. 45, do. Aerated Bread Co., Ltd. 49, do. J. Lyons and Co., Ltd. 65, do. British Tea Table Co., Ltd. 57a, West Smithfield ... Lockharts, Ltd. 18, St.Paul's Churchyard Alfred William Pearce. 31, Whitecross Street... Robert Douglas. 61, do. J. Lyons and Co., Ltd. 5, Whitefriars Street Frederick Philipp Weinel. 68a, do. Fullers, Ltd. 7, do. Vincenzo Mansi. 75, do. Callard, Stewart and Watt, Ltd. 24b, do. Alfred Locke. 27, do. George Robert Smith. 82, do. Giorgio Beschizza. 1, Whittington Avenue Ye Mecca, Ltd. 30/1, St. Swithin's Lane Aerated Bread Co., Ltd. 7, do. Callard, Stewart and Watt, Ltd. 135a, Salisbury Court . Matteo Mansi. 136, do. Frederick William Jaggs. 13, Widegate Street ... John Isaacs. 19, Sherborne Lane Edward William Davies. 17, do. Allec Cohen. 2, Ship's Tavern Passage Gaetano Mariani. 7, Wood Street Carlo Sciarillo. 35/6, Shoe Lane British Tea Table Co., Ltd. 25, do. J. Lyons and Co., Ltd. 98, do. David Jones. 37, do Lucidoro Mauro. 109, do. Charles Baker. 42/3, do British Tea Table Co., Ltd. 114, do. Simeon Northam. 78, do Nunzio Allocca. 18, Silver Street Saletta Bifulco. 80, do. Ye Mecca, Ltd. 24, do. Pasquale Palumbo. 130, do. Express Dairy Co., Ltd. 27, do. David Haydon. Wool Exchange Callard, Stewart and Watt, Ltd. 1, Stationers' Hall Court Charles D. Bizzanelli. 28, Stonecutter Street Aminta Cernaglia. 22, Wormwood Street Aerated Bread Co., Ltd. 23, Stoney Lane Henry Jones. 36, do. Luigi Ostacchini. 62, do. Solomon Green. 38, do. British Tea Table Co., Ltd. 16, Swan Lane Frederick William Ward. 6, Wrestlers' Court Edwin Prosser. 17/8, Telegraph Street J. Lyons and Co., Ltd. 163 Appendix E. orprafion of Jtiftag * - PUBLIC HEALTH DEPARTMENT. REGULATIONS AS TO MILK-STORES AND MILK-SHOPS, &c., And as to precautions against the infection and contamination of Milk within the City of London. The Contagious Diseases (Animals) Act, 1878, and the Dairies, Cowsheds and Milk-shops Order of 1885. 4- Registration. sec. 6 0 in c. 1—Every Purveyor of milk, Dairyman or Cowkeeper, carrying on his trade in the City of London and the Liberties thereof, must be registered as such by the Corporation of London, but such registration shall not be deemed to authorise such person to occupy as a Dairy or Cowshed any particular building, or in any way preclude any proceedings being taken against any such person for non-compliance with, or infringement of, any of the provisions of these Regulations. Application for registration must be upon the form provided for the purpose to be obtained at the Town Clerk's Office, Public Health Department, Guildhall. Ne Dairies and Cowohede q. Sec. 7. 0 in o. 2.—It shall not be lawful for any person following the trade of Cowkeeper or Dairyman to begin to occupy as a Dairy or Cowshed any building, unless and until he first make provision to the reasonable satisfaction of the Corporation of the City of London for the lighting and the ventilation, including air space, and the cleansing, drainage and water supply of the same while occupied as a Dairy or Cowshed. It shall not be lawful for such person to begin so to occupy any such building without first giving one month's notice in writing to the Town Clerk, Public Health Department, Guildhall, of his intention so to do. Sanitary State of all Dairies and Cowsheds. Sec. 8. 0 in c. 3.—It shall not be lawful for any person following the trade of Cowkeeper or Dairyman to occupy as a Dairy or Cowshed any building, whether so occupied at the date of these Regulations or not, if, and so long as, the lighting and the ventilation, including air space, and the cleansing and drainage and water supply thereof are not such as are necessary and proper for the health and good condition of the cattle therein ; and (a) for the cleanliness of milk vessels used therein/or (b) containing milk for sale ; and (c) for the protection of the milk therein against infection or contamination. Contamination of Milk. Sec. 9.0 inc. 4.—It shall not be lawful for any person following the trade of Cowkeeper, or Dairyman, or Purveyor of milk, or being the occupier of a Milk-store or Milkshop—(a) to allow any person suffering from a dangerous infectious disorder, or 164 having recently been in contact with a person so suffering, to milk cows, or to handle vessels used for containing milk for sale, or in any way to take part or assist in the conduct of the trade or business of the Cowkeeper, or Dairyman, Purveyor of milk, or occupier of a Milk-store, or Milk-shop, so far as regards the production, distribution or storage of milk; or—(b) if himself so suffering or having recently been in contact as aforesaid, to milk cows, or handle vessels used for containing milk for sale, or in any way to take part in the conduct of his trade or business, so far as regards the production, distribution, or storage of milk—until in each case all danger therefrom of the communication of infection to the milk or of its contamination has ceased. 5.—It shall not be lawful for any person following the trade of Cowkeeper or Dairyman or Purveyor of milk, or being the occupier of a Milk-store or Milkshop, after the receipt of notice of not less than one month from the Local Authority, calling attention to the provisions of this Article, to permit any water-closet, earth-closet, privy, cesspool, or urinal to be within, communicate directly with, or ventilate into, any Dairy, or any room used as a Milk-store or Milk-shop. Sec. 11. o. m c. 6.—It shall not be lawful for any person following the trade of Cowkeeper or Dairyman, or Purveyor of milk, or being the occupier of a Milk-store or Milk-shop, to use a Milk-store or Milk-shop in his occupation, or permit the same to be used as a sleeping apartment, or for any purpose incompatible with the proper preservation of the cleanliness of the Milk-store or Milk-shop, and of the milk-vessels and milk therein, or in any manner likely to cause contamination of the milk therein. Milk of Diseased Cows. Sec. is. o. in c. 7.—If at any time disease exists among cattle, the milk of a diseased cow— (a) shall not be mixed with other milk ; and (b) shall not be sold or used for human food ; and (c) shall not be sold or used for food of swine, or other animals unless and until it has been boiled. Regulations for Dairies. Lighting and 8.—Every Dairy shall be sufficiently lighted, and shall be thoroughly ventilated by louvred ventilators, ventilating shafts, or openings in the walls or roof. Floor and wails. 9.—Every Dairy shall be well paved with flagstones, concrete or other suitable material, properly set in cement, and the inner walls thereof shall be covered with hard, smooth and impervious material to a height of at least six feet from the floor of such Dairy, and such hard, smooth and impervious material shall not be covered with cement-wash, lime-wash or other substance. Drainage. 10—The floor of every Dairy shall fall or slope towards an opening in the walls thereof, leading to a properly trapped gully-hole outside such Dairy ; and no inlet to a drain shall be within any Dairy. Water supply. 11.—Every Dairy shall be provided with an adequate supply of water, and, where there is not a constant supply, with a slate, metal or metallic-lined tank, properly covered, and provided with an overflow or warning pipe, and with piping for conveying the water to the Dairy. The tank shall have no communication with any water-closet or drain by means of a waste pipe, and shall be supplied with good and wholesome water, which, if practicable, shall be procured by the occupier from a public water company, and such tank shall be cleansed as often as may be necessary for keeping the same in a clean condition. 165 Cleansing. 12.—The floor of every Dairy, and the portions of the walls and other parts of the Dairy within six feet of the floor thereof, as well as all fixtures and tables therein, shall be cleansed with water as frequently as may be necessary for keeping such Dairy, fixtures and tables in a thoroughly clean and wholesome condition, and the ceilings and the upper parts of the inner service of the walls shall be thoroughly cleansed and limewashed as frequently as may be necessary for keeping the same in a clean condition. Otensils. 13.—All utensils and vessels used by a Dairyman for the reception, storage, or delivery of milk shall be thoroughly cleansed with steam or scalding water as frequently as may be necessary for keeping such utensils and vessels perfectly General. clean and sweet, and only clean water shall be used for the purpose. 14.—Every Dairyman shall, at ali times, employ such means and adopt such precautions, as may be necessary for keeping any Dairy in his occupation, and the utensils and vessels used by him for containing milk, in a clean and wholesome condition, so as to preserve the purity of such milk. Regulations for securing the cleanliness of Milk-stores, Milk-shops, and Milk-vessels used for containing Milk for Sale by persons following the trade of Cowkeepers or Dairymen. Cleansing. 15.—Every Milk-store and Milk-shop, as well as all fixtures and tables therein, used in connection with the keeping or sale of milk, shall at all times be kept in a cleanly condition. utensiis. 16.—All utensils and vessels used for the reception, storage, or delivery of milk shall be thoroughly cleansed with steam or scalding water as frequently as may be necessary for keeping such utensils and vessels perfectly clean and sweet, and only clean water shall be used for the purpose. 17.—All utensils and vessels used for the reception, storage or delivery of milk shall at all times be kept covered; such covering should be constructed of fine meshed brass, copper, or plated metal gauze fitted into suitable frame, and should at all times be kept in a clean condition, General. 18.—Every person following the trade of Cowkeeper or Dairyman shall at all times employ such means and adopt such precautions, as may be necessary for keeping the utensils and vessels used by him for containing milk in a clean and wholesome condition, so as to preserve the purity of such milk. Regulations prescribing precautions to be taken by Purveyors of milk, and persons selling milk by retail against infection or contamination. Notice of outbreak of Disease. 19.—Every Purveyor of milk, or person selling milk by retail, shall immediately on any outbreak of infectious or contagious disease within the building or upon the premises in which he keeps milk, or amongst the persons employed in his business, give notice of such outbreak to the Town Clerk of the City of London, Public Health Department, at his Office in Guildhall. Milk in infected building. 20.—Every Purveyor of milk, or person selling milk by retail, shall, immediately on such outbreak coming to his knowledge, remove all milk for sale, and all utensils for containing milk for sale from such building ; and shall cease to keep milk for sale or to sell milk in such building until the same has been disinfected and declared by the Medical Officer of Health for the City of London to be free from infection. 166 Offensive Effiuvia. 21.—Every Purveyor of milk, or person selling milk by retail, shall not keep milk for sale in any place where it would be liable to become infected or contaminated by gases or effluvia arising from any sewers, drains, gullies, cesspools, or closets, or by any offensive effluvia from putrid or offensive substances, or by impure air, or by any offensive or deleterious gases or substances. Receptacles. 22.—Every Purveyor of milk, or person selling milk by retail, shall only keep milk for sale in clean receptacles ; and all utensils used in connection with the keeping or sale of such milk shall be at all times kept clean, and shall be kept efficiently covered so as to prevent contamination ; such covering should be constructed of fine meshed brass, copper, or plated metal gauze fitted into suitable frame, and should at all times be kept in a clean condition. General. 23.—Every Purveyor of milk, or person selling milk by retail, shall at all times employ such means, and adopt such precautions, as may be necessary for preserving the purity of milk, and for protecting it against infection or contamination. Penalties. 24.—Every person who shall offend against any of the foregoing Regulations shall be liable for every such offence to a penalty of Five Pounds, and in the case of a continuing offence, to a further penalty of Forty Shillings for each day after written notice of the offence from the Corporation of London. Commencement of Regulaations. 25.—These Regulations shall come into force on and after the First day of September, One thousand nine hundred and three. Revocation of Regulations. 26.—From and after the date on which these Regulations shall come into force, all Regulations heretofore made under or having effect in pursuance of the Dairies, Cowsheds and Milk-shops Order of 1885 shall, so far as the same are now in force in the City of London, be revoked. Public Health Department, Guildhall, London, E.C. 1903. At a Meeting of the Corporation of London, at the Guildhall of the City of London, on Thursday, the 23rd day of July, 1903, It was Resolved— That the said Regulations be approved and adopted. Examined, HOMEWOOD CRAWFORD, City Solicitor. BELL. u'orp oration of X 0 n (111 n, PUBLIC HEALTH DEPARTMENT. 1903. INFECTIOUS DISEASE CHART. ■ , : -• . ..,v„ » . , . g/ „ y - : I