AC 434 LON 37 Corporatíon of London. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON FOR THE YEAR 1905; 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. LONDON: Printed by Charles skipper & East, 49. Great Tower Street, E.C. 1906. LON 37 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON For the Year 1905, 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. LONDON: Printed by Charles Skipper & East, 49, Great Tower Street, E.C. 1906. VAUGHAN MORGAN, Mayor. A Common Council holden in the Chamber of the Guildhall of the City of London, on Thursday, the 29th day of March, 1906. THE Sanitary Committee did this day deliver into this Court a Report in writing under their hands, submitting the Annual Report of the Medical Officer of Health for the City of London for the year 1905; and recommending that the same be printed and circulated for the information of the Court as usual, and a copy thereof forwarded to the Local Government Board and the London County Council. Agreed to, and Ordered accordingly. BELL. CONTENTS. PAGE Accommodation in Hospitals for Persons not Suffering from Infectious Disease 40 Aliens and the Sale of Food and Drugs Acts 135 Annual Rateable Value 11 Anthrax 44 Area 10 Arsenic in Beer 135 Artizans' Dwellings—Vital Statistics 56 „ „ —Baths, Attendance at 57 „ „ —Well, Analyses of Water from 58 Births and Birth-Rate 12 Block Dwellings, Number of Tenements in 66 Case Mortality of Infectious Disease 20 Causes of, and Ages at Death during 1905 18 Census Returns 11 Cerebro-Spinal Fever 42 Closure of Schools 51 Common Lodging-Houses 67 Contaminated Milk Supplies 31 Cremation 53 „ —Chart showing Increase of 54 Dairies, Cowsheds and Milkshops Orders, 1905 93 Deaths and Death-Rate 13 Deaths from Violence 16 Deaths in City Institutions 14 Density 10 Disinfectants 59 Disinfection 58 Factory and Workshop Act, 1901—Summary of inspections 70 „ „ „ „ —Factories 70 „ „ „ „ —Workshops 72 „ „ „ „ —Bakehouses (Underground) 74 „ „ „ „ — Bakehouses (Aboveground) 75 „ „ „ „ —Workplaces 75 „ „ „ „ —Defects reported by Home Office 77 „ „ „ „ —Voluntary Certificates for Kitchens and Bakehouses 78 „ „ „ „ —outworkers 78 „ „ „ „ —Women Sanitary Inspectors—Summary of Work Done 79 „ „ „ „ Outworkers' Premises 80 „ „ „ „ Industrial Law Indemnity Fund 81 „ „ „ „ Kitchens 81 „ „ „ „ Domestic Workshops 81 „ „ „ „ Offices 83 „ „ „ „ Ladies' Waiting Rooms at Railway Stations 83 „ „ „ „ Sanitary Accommodation for Women 83 „ „ „ „ —Amendment Bill 88 „ „ „ „ —Laundries, Inspection of, in Charitable Institutions 88 Fish Seizures 123 „ Supplies 122 Flushing of Courts and Alleys 89 Hairdressers' and Barbers' Shops-Registration of 63 House Refuse Removal 65 Ice Creams 93 Infantile Mortality 14,15,22 Infected Milk—Liability for Selling 36 Infectious Disease—Spread of, by Vagrants 46 Inspection of Food at Riverside Wharves 124 Introductory Remarks 9 Limewhiting of Courts 91 London County Council (General Powers) Act, 1905 64 Meat Inspection 118 „ „ —Diseased Meat Prosecutions 121 Meat Supplies-Notes on 96 „ „ —Tubebculous Pork 99 „ „ —Imported Continental Meat 103 „ „ —Table of, 1874 to 1905 l16 Page. Mortality 13 Mortuary Returns 59 Notification op Infectious Disease 19 Parker v. Talbot 68 Population 11 Prevention of Tuberculosis 26 Registration of Births and Deaths—Suggested Transfer of Duties 21 Removal of Human Remains from Christ's Hospital 62 Sale of Food and Drugs Acts—Comparative Tables 125 „ „ „ „ —Milk 126 „ „ „ „ —Warranties 128 „ „ „ „ —Butter 128 „ „ „ „ —Sale of Butter Bill, 1905 130 „ „ „ „ —Butter, Methods of Sophistication 131 „ „ „ „ —Coffee 133 „ „ „ „ — Drugs 134 „ „ „ „ —Arsenic in Beer 135 „ „ „ „ —Aliens and 135 „ „ „ „ —Public Analyst's Quarterly Reports and Summary 138 „ „ „ „ —Prosecutions 140 „ „ „ „ —Division of Samples—Smith v. Savage 137 Sanatoria for Consumptives, Proposed 27 Sanitary Inspections 60 Shelter for Temporary Accommodation 21 Smoke Nuisances 91 „ „ —Conference on Smoke Abatement 92 Spitting Evil, The 38 Telephone Call-Boxes 39 „ Mouthpieces 38 Tenement Houses 66 Tuberculosis—International Congress in Paris 26 Vaccination 13 Vaccination Acts—Suggested Transfer of Duties 21 Vital Statistics 16,17 Watercress, Report on, Issued by London County Council 94 APPENDICES. PAGE Appendix A—Street Lists of Mortality 145 „ B— „ „ „ Infectious Disease 148 „ C—Tenement House Register 151 „ D—List of Persons Registered under the Dairies, Cowsheds and Milk Shops Orders 160 „ E—Kitchens of Restaurants 166 SANITARY STAFF. 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 WOMEN SANITARY INSPECTORS. Safford, Ada J. Feb., 1902 Pole, Millicent M. Dec., 1904 SANITARY INSPECTORS. Hills, Arthur Reginald 1st Class, April, 1888 Gathercole, Wm. Henry Joseph „ „ May, 1891 May, William Hussey „ „ May, 1891 Simmons, Edward John „ „ June, 1892 Robbins, Francis Joseph „ „ Sept., 1892 Ralph, William Holden „ „ July, 1898 Dunworth, James 2nd Class, Jan., 1902 Wheaton, Arthur „ „ Oct., 1902 Galloway, Reginald E. Assistant, May, 1905 INSPECTORS OF SLAUGHTERHOUSES AND MEAT. Terrett, George Patrick, Chief Inspector May, 1881 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 Adams, T. (Meat Shed) ... ... ... ... •• ••• ••• May, 1905 REPORT OF MEDICAL OFFICER OF HEALTH i FOR THE CITY OF LONDON, 1905. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1905, To the Right Honourable the Lord Mayor, Aldermen and Commons of the Corporation of London. Public Health Department, Guildhall, E.C., March, 1906. Gentlemen, In conformity with the requirements of the Local Government Board, I have the honour to present my sixth Annual Report as Medical Officer of Health for the City of London. Some of the more important matters dealt with by my Department in the year under review are briefly referred to in the following introductory observations. Much attention has been given to the character of the milk supply to the City, which, unfortunately, has again been shown to leave much room for improvement in the manner of its control and distribution. On p. 31 will be found the result of a further series of bacteriological analyses of milk samples from 22 different Counties from which milk is sent to the City. These again show unmistakeably the great need for a stricter supervision of dairy farms. With regard to contamination of shellfish by sewage, a case of much importance to the public has quite recently been the subject of litigation. In this suit the lessee of some shellfish layings was successful in obtaining damages from a seaside local authority, together with an injunction restraining them from polluting layings with sewage. This decision will, it is stated, be the subject of appeal to a higher Court, and as the details will, no doubt, be fully discussed in the public Press, the matter is not further referred to in this Report. An active administration of the Sale of Food and Drugs Acts has been continued, and some tables will be found herein showing how the City compares with other Metropolitan districts with regard to the amount of adulteration practised in each locality. Some account is also given of the methods of manufacture of sophisticated butter, which supporters of a Pure Butter Bill would do well to give attention to. The question of warranties has been much in evidence during the year, and unscrupulous traders find them a ready means of evading the consequences of their acts. In no less than nine instances last year in the City the production of a warranty by defendants led to the cases against them being dismissed. Similar defences have been successful elsewhere, and it is clear that unless some amendment or repeal of the existing warranty clauses of the Sale of Food and Drugs Acts are made, adulteration, especially of milk, will flourish exceedingly. In the course of the year the Corporation was asked to subscribe to a recommendation to transfer the administration of the Vaccination Acts and 10 the Registration of Births and Deaths from the Boards of Guardians in London to the Borough Councils. The Sanitary Committee approved the suggestion, which was made by the Finsbury Borough Council, for reasons stated in this Report. The final test of the furnace at the Crematorium erected by the Corporation at the City of London Cemetery, Little Ilford, was carried out on the 3rd March, in the presence of a medical representative of the Home Office. The first human cremation took place on the 18th March, and in the course of the year there were eight others. From careful weighings it has been ascertained that the average percentage of ash was 2.86 of the weight of the body, the average time for the completion of incineration being 63 minutes. On p. 54 will be found a chart showing the development of this method of disposing of the dead since cremation received legal sanction in 1884. The opinions of several persons in charge of Crematoria in different parts of the Kingdom as to the probability of cremation becoming more general are also given, from which it will be seen, as might have been expected, that the more intelligent class of the community are less prejudiced against an ideal method of destroying dead matter without danger to the living than others less favoured. It will be noted that the meat seizures during the year have been exceedingly heavy, and have consequently thrown a severe strain upon the resources of the staff engaged in meat inspection. Much of the Report is taken up with details of the working of the sanitary provisions of the Factory and Workshop Act by your Inspectors. It will be seen on p. 25 that in view of the general increase of organised effort to reduce infantile mortality, one of your Women Inspectors is engaged in visiting all houses in the City where births have occurred, in order to instruct mothers as to the best methods of rearing children, especially during the first twelve months of life. 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 74,817 acres (excluding tidal water and foreshore), or 116.9 square miles, equal to a square of 10.81 miles to a side. DENSITY (1905). City of London, Registration District, at night 33.3 persons to an acre. „ „ „ „ during the day *550 „ „ Registration London, at night 62.6 „ „ „ „ during the day not known. No Imperial Day Census has yet been taken. * This figure refers only to persons "actively engaged in the City during the daytime." The actual number of people visiting the City daily is probably nearly 1,500,000. 11 ANNUAL RATEABLE VALUE. The assessed rateable value of property within the administrative county of London was £41,657,244 on 6th April, 1905—whilst on the same date the corresponding rateable value of property in the City of London, including Temples, was £5,107,182, or nearly one-eighth of the whole County. 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, exclusive of sub-district of Glasshouse Yard (see note on next page). 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." This consists of two sub-districts, together containing a population of at the middle of 1905, calculated on the last Census Returns:— *St. Botolph 7,853 †St. Sepulchre and Allhallows 14,572 Total 22,425 The Night population, therefore, of the City of London Registration District at the middle of 1905 is taken at 22,425, and it is upon this figure that all vital statistics in this Report have been calculated. The Day population at the middle of 1905 was estimated at 369,380 ‡ persons. 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 1905, 302 births were registered in the City. The annual birth rate was at the rate of 13.4 per 1,000 persons of all ages, compared with a quinquennial mean rate of 13.9 per 1,000. The birth rates last year in the Sub-Districts were— St. Botolph 17.8 per 1,000. St. Sepulchre and Allhallows 11.5 „ In the Metropolis the birth rate in 1905 was 27.1 per 1,000, being the lowest hitherto recorded therein. This decline in the birth rate has been in operation since 1871 or 1872, and is common to nearly all European countries. * At the date of the last Census, this District included the "civil parish" of Glasshouse Yard. The parish was transferred to the Holborn Union by the Local Government Board Order, No. 43156, which came into operation on 29th September, 1901, and to the Registration District of Holborn (Finsbury Sub-District) on 1st January, 1902, making the Registration District of London City co-extensive with the Municipal City of London. All the Kegistration 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. ‡ This figure is based upon the assumption that the number of persons residing, occupied or employed within the City during the active hours of the day has increased at the same rate since the last Day Census in 1891 that it did between that and the previous Day Census in 1881. 13 VACCINATION. Of the children born in 1905, 192 had been successfully vaccinated by the end of the year, and 27 had died before the age for vaccination. Vaccination was postponed by medical certificate in 11 cases, 32 had removed into other districts, and 36 vaccinations were pending at the end of the year. There were 4 cases of conscientious objection. Vaccination Statistics in the City of London. Year. Number of Births. Successfully Vaccinated. Insusceptible. Had Small-pox. Died before Vaccination. Vaccination Postponed. Cases pending or removed at the end of the year. Conscientious Objections. per cent. per cent. per cent. per cent. per cent. per cent. per cent. 1900 403 60.5 .99 Nil. 12.6 4.4 19..3 1.9 1901 381 67.7 .52 „ 12.8 4.2 12.0 2.6 1902 338 63.3 .29 „ 8.3 5.0 22.5 0.6 1903 339 67.9 .29 „ 9.7 4.4 17.7 0.0 1904 353 64.8 .28 „ 7.9 4.0 21.5 1.4 Average previous 5 years 363 64.8 .47 Nil. 10.2 4.4 18.6 1.3 1905 302 63.6 Nil. Nil. 8.9 3.6 22.5 1.3 MORTALITY. During the year under review, 896 deaths were registered in the District, including *675 persons dying in the City, but not belonging thereto. See Table, p. 17, for details. Deducting the latter we have to deal with 221 deaths, to which we must add 92 persons who died at City Institutions in outside districts, where they were registered. The mortality, therefore, upon which our death rate is calculated is 313. The death rate for 1905 was 13.9 per 1,000 per annum of the population (the previous year being 12.9), whilst that for the whole of the Metropolis was 15.1. 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. 1900 19.4 19.5 33 towns 19.2 1901 16.6 18.6 17.7 1902 16.4 17.4 76 towns 17.7 1903 12.0 16.2 15.7 1904 12.9 17.2 16.6 Average previous five years 15.4 17.8 17.4 1905 13.9 15.2 15.1 * 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 0.44 compared with 1.70 in the Metropolis. Infantile Mortality. The deaths of children under one year of age to 1,000 births were 139, against 129 for the whole of London. The Table of infantile mortality on p. 15 shows the deaths of children under one year arranged according to monthly age periods. From this it will be seen that no less than 31 per cent. of these deaths occurred in the first month, 38 per cent. within the first three months, and 69 per cent. in the first six months of existence. Deaths in City Institutions. During 1905, 92 persons died in City Workhouses, Workhouse Infirmaries, or Lunatic Asylums, or no less than 29.4 per cent. of the whole City mortality, the corresponding figure for the Metropolis (1904) being 20.8 per cent. This high percentage is caused in the City by the excessive proportion the number of inmates in these places (exclusive of officers and their families) bears to our population, the ratio being about 1 : 20, as compared with 1 : 94 in the Metropolis (Census 1901). In other words, these figures represent that one in every 20 citizens is an inmate of either a Workhouse, Workhouse Infirmary or a Lunatic Asylum, in comparison with one 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 1905, compared with the previous five years:— Year. City of London. Metropolis. Per cent. Per cent. 1900 27.9 18.3 1901 25.2 18.8 1902 31.2 19.3 1903 30.4 21.4 1904 27.8 20.8 Average of previous five years 28.5 19.7 1905 29.4 Figures not yet published. 15 (This Table is prepared in accordance with the requisitions of the Local Government Board.) City of London. Infantile Mortality during the Year 1905. Deaths from stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 Week, 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Causes. Certified 11 1 ... 1 13 2 1 8 2 3 5 1 ... 2 4 1 42 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Common Infectious Small-pox ... .... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... .... ... ... ... Diphtheria : Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... .... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 Diarrhœa, all forms ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Diarrhœal Diseases. Enteritis (not Tuberculous) ... ... ... ... ... 1 ... 2 ... ... 1 ... ... ... ... ... 4 Gastritis, Gastrointestinal Catarrh ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 Premature Birth 9 ... ... ... 9 ... 1 1 ... ... ... ... ... ... ... ... 11 Congenital Defects 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Wasting Diseases. Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Want of Breast-milk ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atrophy, Debility. Marasmus ... 1 ... 1 2 ... ... 3 ... ... ... ... ... ... 1 ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Diseases. Tuberculous Peritonitis: Tabes Mesenterica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 Convulsions ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 ... 3 Bronchitis ... ... ... ... ... ... ... 1 ... ... 1 1 ... ... ... ... 3 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia ... ... ... ... ... ... ... ... ... 1 1 ... ... 2 ... ... 4 Suffocation (not overlaid) 1 ... ... ... 1 1 ... 1 ... ... ... ... ... ... ... ... *3 Other Causes ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11 1 ... 1 13 2 1 8 2 3 5 1 ... 2 4 1 42 * ()ne sleeping alone in a eot; one during an attack of syncope; and one "suffocation," no evidence how caused. Total Births in the year 302. Population 22,425. (Estimated to middle of 1905.) Deaths from all Causes at all Ages 313 16 Deaths from Violence. Of the City deaths, 4.15 per cent. were caused by injuries or violence (as compared with 5.03 in 1903 and 6.20 in 1904), being 2.68 below the average for the previous five years. PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE. Year. City of London. Metropolis. Per cent. Per cent. 1900 7.44 4.27 1901 7.45 4.28 1902 8.03 4.13 1903 5.02 4.31 1904 6.20 3.86 Average previous five years 6.83 4.17 1905 4.15 4.2 VITAL STATISTICS, 1905. 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. Deathsfromprincipal Zymotic Disease per 1,000 of the Population] Estimated Night Population (Imperial Census). Estimated Day Population (Corporation Census). City. Metropolis. City. Metropolis. City. Metropolis. City. Metropolis. City. Metropolis. 1900 26,998 343,790 149 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 1903 24,958 358,930 13.6 28.4 12.0 15.6 115 131 5.0 4.3 0.56 1.77 1904 23,565 364,120 15.0 27.9 12.9 16.6 96 146 6.0 3.9 0.32 2.18 Average previous five years. 25,895 353,880 13.9 28.6 15.4 17.1 135 145 6.7 4.2 0.70 2.12 1905 22,425 369,380 13.4 27.1 13.9 15.1 139 129 4.1 4.2 0.44 1.70 17 (This Table is prepared in accordance with the requisitions of the Local Government Board.) Vital Statistics of Whole District during 1905 and Previous Years. Name of District: CITY OF LONDON. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Death at all Ages belonging to the District. Number. Rate.* Under 1 Year of Age. At all Ages. Number. Rate per 1,000 Births registered. Number. Rate.* Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1894 34,831 520 14.9 82 157 993 28.5 570 562 169 600 17.2 1895 33,823 552 16.3 81 147 1,057 31.2 629 627 189 619 18.3 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 1903 24,958 338 13.6 39 115 839 33.6 647 631 91 299 12.0 1904 23,565 353 15.0 34 96 865 36.8 662 644 85 306 12.9 Averages for years 1894-1904 28,813 435 15.1 59 135 973 33.8 635 623 138 488 16.9 1905 22,425 302 13.4 42 139 896 39.5 701 675 92 313 13.9 * Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Note.—The deaths included in Column 7 of this Table are the whole of those registered during the year as having actually occurred within the district or division. The deaths included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term “Non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term “Residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. Area of City of London Registration District in acres (exclusive of area covered by water) 672.7 Total population at all ages Number of inhabited houses... Average number of persons per house 26,923† 3,865 6.96, At Census of 1901. † 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. 18 (This Table is prepared in accordance with the requisitions of the Local Government Board.) Causes of, and Ages at, Death during Year 1905. Deaths in or belonging to whole District at subjoined ages. Deaths in or belonging to Localities (at all Ages'). Total deaths in public institutions in the district At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards St. Botolph. St. Sepulchre. * 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 1. Small-pox ... ... ... ... ... ... ... ... ... ... 2. Measles 1 1 ... ... ... ... ... 1 ... ... ... 3. Scarlet Fever ... ... ... ... ... ... ... ... ... ... 1 4. Typhus Fever ... ... ... ... ... ... ... ... ... ... ... 5. Epidemic Influenza 4 1 ... ... ... 1 2 2 2 ... 1 6. Whooping Cough 2 1 1 ... ... ... ... 1 1 ... ... 7. Diphtheria, Membranous Croup 1 ... ... 1 ... ... ... ... 1 ... 7 8. Croup ... ... ... ... ... ... ... ... ... ... ... 9. Enteric Fever ... ... ... ... ... ... ... ... ... ... 1 10. Asiatic Cholera ... ... ... ... ... ... ... ... ... ... ... 11. Diarrhœa, Dysentery 2 1 ... ... ... 1 ... ... 2 ... 7 12. Epidemic or Zymotic Enteritis 1 1 ... ... ... ... ... ... 1 ... 10 13. Enteritis 3 3 ... ... ... ... ... 2 1 ... 3 14. Other Continued Fevers ... ... ... ... ... ... ... ... ... ... ... 15. Erysipelas 1 ... ... ... ... ... 1 1 ... ... 1 16. Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... 17. Other Septic Diseases ... ... ... ... ... ... ... ... ... ... 14 18. Intermittent Fever and Malarial Cachexia. ... ... ... ... ... ... ... ... ... ... ... 19. Tuberculosis of Meninges 1 1 ... ... ... ... ... ... 1 ... 25 20. Tuberculosis of Lungs 20 ... ... ... 1 18 1 9 11 ... 25 21. Other Forms of Tuberculosis 4 1 ... ... ... 3 ... 1 3 ... 33 22. Alcoholism 4 ... ... ... ... 3 1 1 3 ... 1 23. Cancer 19 ... ... ... ... 9 10 7 11 1 67 24. Premature Birth 8 8 ... ... ... ... ... 4 4 ... 6 25. Developmental Diseases 9 9 ... ... ... ... ... 4 5 ... 16 26. Old Age 23 ... ... ... ... 1 22 8 15 ... 2 27. Meningitis 3 1 1 ... 1 ... ... ... 3 ... 11 28. Inflammation and Softening of Brain 3 ... ... ... ... 2 1 1 2 ... 2 29. Organic Diseases of Heart 4 ... ... 1 ... 2 1 3 1 ... 4 30. Acute Bronchitis 19 5 1 1 ... 7 5 7 11 1 11 31. Chronic Bronohitis 23 ... ... ... ... 11 12 9 14 ... 19 32. Lobar (Croupous) Pneumonia 2 1 ... ... ... 1 ... 1 1 ... 6 33. Lobular (Broncho-) Pneumonia 13 2 2 ... 1 8 ... 2 11 ... 49 34. Diseases of Stomach 2 ... ... ... ... ... 2 ... 2 ... 13 35. Obstruction of Intestines 2 ... ... ... ... 1 1 ... 2 ... 17 36. Cirrhosis of Liver 7 ... ... ... ... 6 1 4 3 ... 10 37. Nephritis and Bright's Disease 5 ... ... ... ... 3 2 ... 5 ... 20 38. Tumours and Other Affections of Female Genital Organs. ... ... ... ... ... ... ... ... ... ... 3 39. Accidents and Dis. of Parturition 1 ... ... ... ... 1 ... 1 ... ... 1 40. Deaths by Accident or Negligence 13 2 ... 1 1 5 4 5 7 1 81 41. Deaths by Suicide ... ... ... ... ... ... ... ... ... ... 7 42. Deaths from Ill-defined Causes 3 ... ... ... ... 2 1 ... 3 ... 5 43. All other Causes 110 4 3 3 6 52 42 41 62 ... 222 Total all Causes ‡313 42 8 7 10 137 109 115 188 10 701† * Residents dying in City Institutions. City address not stated on certificate of death. † Including 26 Citizens, distributed in Columns 1 to 10 (19 died in St. Bartholomew's Hospital, 4 at the Union Depdt, Thavies Inn, and 3 in the City Police Hospital). ‡ Including 92 Citizens who died in City Institutions outside, distributed in Columns 1 to 10. 19 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 1905, 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. Small-pox — — — — — — — Diphtheria 16 1 6 2 4 1 2 Membranous Croup 1 — 1 — — — — Scarlet Fever 88 4 53 14 3 14 — Typhus „ — — — — — — — Enteric „ 4 1 1 — — — 2 Continued „ — — — — — — — Relapsing „ — — — — — — — Puerperal „ — — — — — — — Cholera — — — — — — — Erysipelas 28 19 — — 4 5 — Totals 137 25 61 16 11 20 4 Chicken-pox 21 20 — — — 1 — Phthisis 29 2 — — 26 1 — Totals 187 47 61 16 87 22 4 It will be seen from the above that during the year, excluding Chicken-pox and Phthisis, 137 Certificates were received, including 20 "duplicates," and 4 in which the diagnosis was subsequently found to be incorrect. The total number of cases of" dangerous infectious disease" was therefore 113. The percentage of cases removed to hospital and treated at home during the year was as under:— Removed to Hospital. Treated at Home. Per cent. Per cent. Scarlet Fever 94.6 5.4 Diphtheria 92.3 7.7 Enteric Fever 50.0 50.0 Erysipelas 17.4 82.6 Membranous Croup 100.0 — Excluding Erysipelas from the above, 93.4 per cent. went to hospital, against 79.1, 87.1, 85.9, 99 and 90.1 in the preceding five years. * See page 40 re accommodation of patients incorrectly diagnosed. 20 TABLE C. Return of infectious disease, exclusive of Chicken-pox and Phthisis, occurring in the City of London, with the percentage of such cases removed to hospital or treated at home during 1905, compared with the previous five years:— Year. Number of cases reported. Per cent. of cases reported. Removed to Hospital. Treated at Home. 1900 196 79.1 20.9 1901 214 82.2 17.8 1902 245 77.9 22.1 1903 117 91.5 8.5 1904 100 84.0 16.0 Average for previous five years. 174 82.9 7.1 1905 118 77.9 22.1 The case mortality of those attacked with notifiable disease was:— Recovered. Died. Total. Case mortality per cent. Diphtheria 12 1 13 7.7 Scarlet Fever 73 1 74 1.3 Enteric Fever 2 — 2 — Puerperal Fever — — — — Erysipelas 23 — 23 — Chicken-pox 20 — 20 — Small-pox — — — — Membranous Croup — 1 1 — Totals 130 3 133 Cases of Infectious Disease notified during the Year 1905. 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. St. Sepulchre. St. Botolph. St. Sepulchre. Under 1. 1 to 6. 6 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox – – – – – – – – – – – Diphtheria 13 — 5 3 2 3 — 11 2 10 2 Membranous Croup 1 — 1 — — — — 1 — 1 — Scarlet Fever 74 — 14 31 23 6 — 31 43 29 41 Typhus „ — — — — — — — — — — — Enteric „ 2 — — 1 1 — — 2 — 1 — Continued „ — — — — — — — — — — — Relapsing „ — — — — — — — — — — — Puerperal „ „ — — — — — — — — — — — Cholera — — — — — — — — — — — Erysipelas 23 — — 2 — 18 3 10 13 2 3 Totals 113 — 20 37 26 27 3 55 58 43 46 Chicken-pox 20 1 9 8 2 — — 11 9 — — Phthisis 28 — — — 3 25 — 4 24 2 24 Totals 161 1 29 45 31 52 3 70 91 45 70 This Table is prepared in accordance with the requisitions of the Local Government Board. 21 In 79 houses (exclusive of St. Bartholomew's Hospital) where Scarlet Fever, Diphtheria, Membranous Croup and Enteric Fever occurred, 47 premises were found in good order. In 32 instances, or about 40 per cent., insanitary conditions of more or less importance were reported and duly remedied. 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," was injured by the fire which occurred at some premises in rear on 29th October, 1904. Although the necessary repairs are not yet complete, three families have been received. They numbered eight persons, of whom six were adults and two were children, and were housed during the disinfection of their homes after— Scarlatina Two families. Phthisis One family. One family came from a home consisting of three rooms, and two families from homes of two rooms. REGISTRATION OF BIRTHS AND DEATHS AND VACCINATION. SUGGESTED TRANSFER OF DUTIES. On 23rd January, 1905, a letter was received from the Finsbury Borough Council, stating that they approved the principle of a suggestion made by the Deptford Borough Council that the duties at present performed by Board of Guardians in London, in connection with the registration of births and deaths, should be transferred to Borough Councils and the registration effected at the Town Hall or municipal offices instead of at the private residence of the Registrars. They also stated that they agreed with the principle of a further suggestion made by the same Borough Council, that the administration of the Vaccination Acts should also be similarly transferred. The Finsbury Borough Council hoped both proposals would meet with the approval of the Corporation. The matter having been referred to me for consideration, I reported to the Sanitary Committee that I was entirely in accord with both propositions. With regard to the first, the whole question of registration is so intimately associated with the satisfactory compilation of vital statistics that it is evident the work should be carried out by those concerned in the administration of the Public Health Acts. Under the existing system, or 22 rather lack of system, considerable delay and expense is incurred by Sanitary Authorities in obtaining information from registrars of subdistricts that is indispensable for the proper discharge of their duties. A further disadvantage is that at present the registrars are only available to the public during very limited hours. There is a lack of dignity attaching to the present mode of conducting the statutory obligations of registration at private houses and retailers' shops, which is incompatible with a modern sense of the fitness of things, and the local Town Hall, Guildhall, or other public building is the proper place for the purpose. As to the manner in which the various Acts relating to vaccination are carried out, I made no criticism of the manner in which they were administered by the Guardians, except to point out that the last returns then issued by the Local Government Board showed that in London the number of cases not finally accounted for as regards vaccination amounted to no less than 25.8 per cent. of the number of births. I advocated this transfer in a Report in which the Sanitary Committee concurred in January, 1902. It is too lengthy for reproduction here, but time has only strengthened the views then set forth. The financial question involved, if the suggested administrative duties are transferred to the Borough Councils, hardly comes within my province, but I do not anticipate there would be any difficulty in so apportioning the rates that the cost incurred in each case would be paid by the Borough Councils and a corresponding reduction made in the Poor Rate levy. INFANTILE MORTALITY. On the 5th June, 1905, a Conference of Imperial, County and Municipal representatives of St. Pancras, Medical Men and Nurses, Ministers of Religion and District Visitors, Philanthropists and Social Workers, was held at the Town Hall, Pancras Road, N.W., at the initiation of the St. Pancras Borough Council, to consider the question of Infantile Mortality. The following Resolutions were considered and agreed to:— A.—Mothers. 1.—That it is desirable that every encouragement should be given to prospective mothers to seek advice as to the management of their health so that they may endow their offspring with good constitutions and prepare themselves to suckle their infants when born. 2.—That it is desirable that all efforts should be exhausted upon improving the health of suckling mothers before devoting attention solely to their infants. 23 B.—Breast-Feeding of Infants. 1.—That it is desirable that births should be registered within five days of their occurrence as is required in the case of deaths by the Births and Deaths Registration Acts, and be not delayed for six weeks and longer as now by law permitted. 2.—That it is desirable that the municipal authority should obtain weekly returns of births from the registrars. 3.—That it is desirable that the municipal authority should send to the addresses of all mothers, furnished in the weekly returns, cards or leaflets of advice, laying greatest stress on the improvement of antinatal conditions, on the preparation for and maintenance of breastfeeding of infants during the first nine months of life, and strongly advising mothers not to wean their infants prematurely except upon medical advice. 4.—That it is desirable that women inspectors should be appointed with a view to the prevention of infantile mortality by selecting from the weekly returns suitable cases amongst the poor for inquiry, affording general information in the hygiene of nursing, and directing the necessitous poor where to apply for such advice and assistance as may be urgently required in order to maintain breast-feeding. 5.—That it is desirable that medical practitioners, midwives, and nurses, the staffs of hospitals and dispensaries, and the religious, charitable and social organisations should co-operate with the municipal authority in endeavouring to encourage breast-feeding, and to diminish the infantile mortality. 6.—That it is desirable that any suggestions or arrangements made by medical practitioners or by the medical charities for the purpose of advising nursing mothers with a view to preventing infantile mortality should be communicated to the municipal authority in order that they may be made known through the women inspectors. 7.—That it is desirable that the information should be spread broadcast that breast-feeding is the most economical, easy, and safe mode of feeding infants under nine months of age, with a view to reducing the number of hand-fed sucklings to the smallest proportion possible. C.—Premature Weaning. 1.—That it is undesirable that a suckling mother should be separated from her infant, or the infant from the mother, except for reasons of ill-health and under medical advice. 2.—That it is desirable that when a woman inspector has reason to believe that a suckling mother is in a necessitous condition and unprovided with sufficient food to enable her to maintain her own strength and suckle her infant as well, she should endeavour to prevent weaning by reporting the case to the charitable organisation most appropriate to deal with the circumstances. 24 3.— That it is desirable that when a woman inspector finds that a suckling mother has insufficient nourishment due to the husband being out of work, she should report the case to the labour bureau. 4.— That it is desirable that mothers should be urged not to wean their infants until the ninth month of age except upon medical advice. 5.— That it is desirable that mothers should be warned that the hand-feeding of infants is expensive, troublesome, and unsatisfactory, risky at all times, and in summer dangerous and often fatal. 6.— That with a view not to encourage premature weaning, it is desirable that milk for the hand-feeding of infants provided privately or publicly by milk depots at or below cost should be distributed upon the orders of medical practitioners. D.— Hand-Feeding of Infants. 1.— That, having reduced the number of sucklings required to be hand-fed to the smallest proportion possible, means should be devised for providing suitable milk for the remainder. 2.— That it is undesirable to encourage the use of pasteurised or sterilised milk for the use of hand-fed infants who unfortunately cannot be fed from the breast. 3.— That it is desirable that cow's milk intended for hand-fed infants should be milked, transported, and distributed under special precautions. 4.— That the special precautions required in the production of cow's milk for infants should include not only care in the selection, testing, and feeding of the cows, but also care in their pasturing, sheltering and tending, not only extreme cleanliness in milking, but also rigid aseptic precautions, accompanied by immediate refrigeration, maintained during transport, and by prompt dispatch so that the number of microorganisms and the lactic acid in the milk may be reduced to a minimum at the time of delivery instead of the hundreds of thousands and millions of organisms and excess of lactic acid now to be found in so-called fresh milk. 5.— That, in order to prevent the pollution of infants' milk in distribution and in the home, it is desirable that it should be protected in stoppered Dottles ready for feeding, and not be transferred to other bottles. 6.— That on account of the facilities that hand-feeding affords for the overfeeding and under-feeding of infants, due to want of knowledge, especially amongst the poor, it is desirable that the quantity and quality of milk required for each feed at the particular age should be distributed in a separate stoppered bottle, and that each basket or crate of bottles for use should be accompanied by written instructions as to the frequency and manner of feeding, and that such instructions should be supplemented by oral instructions given by women inspectors or health visitors at the houses of the milk consumers. 25 7.— That the provision of cow's milk produced under aseptic conditions accompanied by extreme cleanliness, refrigeration and dispatch, so diluted and enriched and put up in stoppered bottles in such quantities to be administered at specified intervals suitable for suckling infants, should be regarded not only as ordinary food, but in the nature of medical assistance. 8.— That for the special protection of hand-fed infants it is desirable that Municipal Authorities should not only ascertain the quality of milk intended for infants by chemical analysis, and receive from the public analyst a statement of the percentage composition of each sample of milk submitted, as to fat, solids not fat, and total solids, and the absence of chemical preservatives, but also by bacteriological examination, and receive from a bacteriologist a statement in regard to each sample of milk submitted as to the number of micro-organisms per cubic centimetre and the proportion of lactic acid per cent., these being the best existing tests of cleanliness and freshness of the milk. With the whole of the above Resolutions, anyone with a knowledge of the importance of the subject must be in complete accord, and the only points for consideration are those of detail in carrying out the scheme. It should, however, be pointed out that underlying the whole question is the danger, from a public health point of view, of introducing in a subtle manner the evil of municipal trading. As I have previously pointed out when reporting on the Milk Depots (London) Bill in March, 1905, that in view of the opinion of the Committee on Physical Deterioration that inasmuch as any difficulty in obtaining pure and sterilised milk can be got over without recourse to direct municipal action, any such trading by public authorities would be both an unnecessary and costly charge upon the rates. Moreover, the proper function of local authorities is to supervise traders rather than to enter into what must necessarily be an unfair business competition with them. Owing to the small number of inhabitants, and therefore children in the City, the matter is not one of imminent importance so far as the City inhabitants are concerned; but in view of the general increase of organised effort now made to save these young lives, which are now doubly valuable to the State owing to the continued decrease in the birth rate, Miss Pole, one of your Women Sanitary Inspectors, who has previous experience of this work, has undertaken the duty of visiting all houses where births have been notified by the Registrars, and also those where deaths of children under one year of age have occurred. The main object of these visits is to impress upon mothers the great advantage of breast-feeding as compared with hand-feeding. It has been shown that in some large towns the mortality during the first year of life among breast-fed infants was only about one-third of that among hand-fed children. It is impossible to overrate the significance of these figures, which clearly indicate a great loss of life from a preventable cause. 26 While improved sanitation has reduced the death rate in London from 21.2 per 1,000 in 1881 to 16.6 in 1904, the deaths of children under one year of age per 1,000 births, which were 148 in the former year, reached almost the same high proportion, viz., 146, in 1904. It is now well recognised that this heavy infantile mortality is due to ignorance on the part of the mothers as to the danger incurred by injudicious feeding, and the efforts now being made in the direction of educating women, especially those of the poorer classes, in the proper manner of rearing their offspring during the first twelve months of their existence will, it is hoped, remove what is now undoubtedly a blot upon our civilization. A Table is given on page 15 showing the deaths of children in the City during 1905 under one year, arranged according to monthly age periods. PREVENTION OF TUBERCULOSIS. INTERNATIONAL CONGRESS IN PARIS. In July last, at the invitation of the National Association for the Prevention of Consumption and other forms of Tuberculosis, your Medical Officer was appointed as delegate to represent the Corporation at the International Congress on Tuberculosis which was held in Paris, October 2nd— 7th, under the patronage of the President of the French Republic. The meetings of the Congress were held within the above-mentioned dates, at the Grand Palais, Avenue d'Antin, Champs Elysées, under the Presidency of Dr. Herard. The work of the Congress was divided into four sections, of which sections 1, 2 and 3 respectively dealt with the Medical Pathology of Tuberculosis, the Surgical Pathology of Tuberculosis, and the Prevention and Treatment of Tuberculosis in Children, while section 4 was separated into two subsections, of which one considered the Prevention and Treatment of Tuberculosis in Adults, and the other was devoted to Social Hygiene. The fourth section was the one possessing most attractions for those interested in public health questions. The following resolutions were passed by this section, after a discussion on the part played by sanatoriums and dispensaries in the struggle against Tuberculosis:— 1. It is permissible to discuss to what degree dispensaries and sanatoriums are useful or necessary according to the customs, the institutions, and resources of each country, but the principle involved must be recognised. 2. They constitute a means of action which cannot be considered either as exclusive or predominant; dispensaries open to all have for their essential objective prophylaxy, hygienic education, and the relief of distress. They can also become a valuable source of information. The popular sanatoriums are establishments 27 reserved for in-patients suffering from pulmonary Tuberculosis, who are susceptible of permanent cure or a durable amelioration; they are likewise instruments of prophylaxy and education. But the problem of sanitary dwellings will always dominate the prophylaxy of Tuberculosis. 3. It is important that the functions of these establishments should, as far as possible, and while not infringing their freedom and their anatomy, be made to work in harmony with a general scheme. They can only benefit by being connected one with another and by being placed in relation with allied institutions such as public health and benefit societies. 4. As desiderata to be realised at the same time as the development of dispensaries and sanatoria, the Congress would urge the necessity of certain reforms: (a) That poor relief should assume a more preventive character and take a more active part in promoting good sanitation. (b) That friendly societies should also endeavour to exercise a direct action in bringing about a more rational application of precautionary and sanitary measures. With regard to Tuberculosis in relation to the housing question, the sections subscribed to the following recommendations:— 1. Municipalities should adopt the necessary measures to encourage the use in the dwellings of the poor of an abundant and cheap water supply. 2. To combat the tendency to the production of Tuberculosis by overcrowding it is desirable to augment the number of workmen's gardens and of public gardens, to increase the open spaces, to plant trees in open spaces of the large towns, and to resist all that tends to increase the crowding into towns while encouraging a return to the open fields. The following propositions were adopted with reference to Tuberculosis and disinfection of dwellings:— 1. It is desirable that it should be the general practice to notify all cases of advanced Tuberculosis. 2. The means of disinfection taken in cases of advanced Tuberculosis should be in keeping with the methods and with the aid of the processes that have been found to be most effective. 3. The administrative ordinances, or, if necessary, the legislative enactments which shall sanction and ensure the practice of disinfection, should be promulgated with the least possible delay. PROPOSED SANATORIA FOR CONSUMPTIVES. In May, 1905, the Metropolitan Asylums Board forwarded for the consideration of the Corporation a copy of a memorial which the Managers had received from the Metropolitan Branch of the Incorporated Society of Medical Officers of Health on the subject of the provision by the Metropolitan Asylums Board of hospital accommodation for the treatment and isolation of patients suffering from pulmonary Phthisis, and asked to be furnished with any observations that the Corporation might desire to offer. 28 This communication was referred to your Medical Officer of Health, who reported as follows to the Sanitary Committee on the 25th July, 1905:— "PROPOSED SANATORIA FOR CONSUMPTIVES. "This is a matter of the highest importance from a public health point of view, "and one that has been under consideration for some considerable period. Involv"ing, as it must of necessity do, the expenditure of a very large sum of money, and "that obtainable only from the ratepayer, it is essential that the most careful "consideration be given to the scheme. It is scarcely needful to refer to the "necessity for some such provision. The fact alone that the deaths from Phthisis in "London amount to between 7,000 and 8,000 every year is sufficient to show the "vital importance of the question. Seven thousand deaths per annum would mean "approximately that 50,000 people are actually suffering from the disease in "London at the same time, and for these the only provision are four Consumption "Hospitals. "Hospital provision is required for two classes of cases. Firstly, those in the "early stages of the disease, which should be isolated for the purpose of bringing "them under hygienic conditions and treatment with a view to the cure or arrest of "the disease; and, secondly, those in a more advanced stage, where the risk of "infection is most marked, and which should be isolated so far as possible to "prevent danger to their fellow-creatures. "Both classes require consideration. It is not suggested (and it certainly is not "advisable), that costly and palatial hospitals be provided for these cases, but rather "that inexpensive buildings situated in healthy neighbourhoods at some little "distance from the Metropolis be erected for their accommodation. The use of "such sanatoria as suggested is twofold. In the first place the patient is removed "from conditions in which he may be a serious danger to others; and, secondly, "during the stay in such institution he is accustomed to hospital discipline, and is "instructed as to the best methods of preserving his own health and minimising "the possible danger to others. In other words, the object of the treatment is both "remedial and preventive. "It has been estimated that every bed provided will accommodate two persons "per annum, and that of the 50,000 who are suffering from Tuberculosis at any "given time, there are probably 10,000 to whom remedial treatment is of value, "therefore 5,000 beds would be sufficient to deal with these cases. The maintenance "alone of these would cost— at an estimated expenditure of 25s. per week per head— "£325,000 per annum. There is also the cost of provision of the buildings, which "would probably be covered by £100 for each bed— i.e., a capital expenditure of at "least £500,000. As to the question of the authority by whom this work "should be undertaken, only two such have been suggested, viz., the Metro"politan Asylums Board and the London County Council, and there can, "I think, be no difference of opinion as to the suitability of the Metropolitan "Asylums Board rather than the London County Council being entrusted with this "if it be undertaken. In the first place because the London County Council, "already overburdened with work, have no power under the Isolation Hospitals "Act, 1893, which does not apply to London, and, moreover, is not a sanitary "authority. The Metropolitan Asylums Board have, further, had great experience "in dealing with epidemic diseases, and have carried out this large and responsible "work for a long period to the satisfaction of the ratepayers of the Metropolis 29 "Probably the simplest plan would be to obtain an order from the Local Govern"ment Board under Section 5 of the Metropolitan Poor Act, 1867:— "'Asylums to be supported and managed according to the provisions of this "'Act may be provided under this Act for Reception and Relief of the Sick, "'Insane, or Infirm, or other class or classes of the Poor, chargeable in Unions "'and Parishes in the Metropolis (and in this Act the term "Asylum" means "'an Asylum provided under this Act),' "to enable them to deal with suitable cases of the chargeable poor suffering from "Phthisis, and to obtain an amendment of section 80 of the Public Health Act, 1891, "to enable them to deal with non-chargeable cases. "This section reads as follows:— "'The Metropolitan Asylums Managers, subject to such regulations and "'restrictions as the Local Government Board prescribe, may admit any "'person, who is not a pauper, and is reasonably believed to be suffering from " 'Fever or Small-pox or Diphtheria into the hospitals provided by the "'Managers.' "The addition of the word "or tuberculous Phthisis" after Diphtheria would effect "this. "I may mention that the advisability of the Metropolitan Asylums Board being "made the authority for dealing with Phthisis in the case of persons chargeable to "the poor rates was agreed to by a conference, to which (among others) the Metro"politan Medical Officers of Health and the Medical Superintendents of the Poor "Law Infirmaries were invited, held on the 9th January, 1905, when the following "Resolutions were passed:— "'(1) That it is of urgent importance that further and more complete public "'provision be made for cases of Phthisis. "'(2) That it is desirable that provision be made by the Metropolitan "'Asylums Board for persons suffering from Phthisis who are or may from " 'time to time become chargeable to the poor rates. "'(3) That the Council of the Charity Organisation Society approach the "'following Societies, amongst others, with a view to these or similar resolu"'tions being submitted to the Local Government Board, jointly, viz., the "'Society of Medical Officers of Health, the National Association for the "'Prevention of Consumption, the National Health Society, the Royal Sanitary "'Institute.' "The Society of Medical Officers of Health organised a deputation on these lines. "Resolutions in favour of the Metropolitan Asylums Board being the authority "were also passed by the Society of Medical Officers of Health in October, 1903— "by the delegates of the Metropolitan Borough Councils at a Conference convened "by the London County Council held in July, 1904— and by the National Society "for the Prevention of Consumption, in March, 1905. "At a conference held in October, 1900, at which 20 of the 32 Metropolitan "Boards of Guardians were represented, the following Resolutions were passed:— "'That this conference of Poor Law Authorities, having discussed the "'question of the open-air treatment of Consumption, are of opinion that the 30 "'time has come when provision should be made for the treatment by this "'method of the Sick Poor of the Metropolis suffering from Phthisis, and "'it recommends the matter for the consideration of the Local Government "'Board with a view to the necessary steps being taken by the Board for the "'carrying out of the proposal.' "The matter then resolves itself into a question of public health, on which "the Corporation is now asked to give an opinion. From the public health point of "view it seems absolutely essential that some reasonable precautions should be "taken, and that the Metropolitan Asylums Board should be called upon to make "the same." The Corporation having concurred in these views, the Metropolitan Asylums Board were in due course informed "that the Corporation is of "opinion that the provision of a Sanatorium for Consumptives is absolutely "essential as a reasonable precaution to public health, and that the Metro"politan Asylums Board is the proper authority for dealing with it." At a Meeting held on the 17th February, 1906, the General Purposes Committee of the Metropolitan Asylums Board submitted a report stating that with the object of ascertaining in the first instance the views of the Local Government Board, administrative bodies of Borough Councils, Boards of Guardians, and Hospitals for Consumption upon the subject, the Committee gave directions that the Boards of Guardians should also be asked what steps, if any, they had taken to deal with tuberculous cases in their infirmaries, and also with what result. The Local Government Board replied, under date 27th June, 1905, to the effect that they were then "obtaining information on the whole "subject." They were not "in a position to express an opinion on the "question as to whether the Managers should undertake the new duties "suggested." Of the 65 other authorities consulted, 19 were wholly favourable to the prayer of the memorial, 9 were favourable if the cost were made a national charge, 14 were unfavourable, and the replies of the remaining 23 were indefinite. In the absence of any authoritative expression of opinion by the Local Government Board, and as a result of its consideration of the question in all its bearings, the Committee recommended, and the Board of Managers adopted the following:— "(1) That the Managers do forward to the Local Government Board a copy of "the memorials addressed to the Managers (a) by the Metropolitan Branch of the "Incorporated Society of Medical Officers of Health on the 15th April, 1905; and "(b) by Sir William Broadbent, Bart., K.C.V.O., M.D., F.R.S., on the 4th "November last on the subject of the provision of hospital accommodation for the "treatment and isolation of patients suffering from Pulmonary Phthisis. "(2) That the Local Government Board be further informed that, having regard "to the uncertainty which prevails as to the probable number of patients who would "come under the schemes referred to in the memorials, and to the great prospective "cost to the ratepayers of the metropolis, the Managers will be glad to receive the "judgment of the Local Government Board upon the prayer of the memorials "referred to." 31 CONTAMINATED MILK SUPPLIES. In my Annual Report for last year the results were given of a bacteriological examination of a series of samples of milk representing the supply to the City from the following 22 Counties:— Bedfordshire. Gloucestershire. Nottinghamshire. Berkshire. Hertfordshire. Oxfordshire. Buckinghamshire. Huntingdon. Somersetshire. Cambridgeshire. Leicestershire. Staffordshire. Derbyshire. Lincolnshire. Suffolk. Dorsetshire. Middlesex. Warwickshire. Essex. Norfolk. Wiltshire. Worcestershire. These samples yielded the following results:— Character of Milk. Number of Samples. Percentage. Clean and pure 19 48.7 Bacillus tuberculosis 3 7.9 Staphylococcus pyogenes aureus 7 17.9 Bacillus enteritidis Gaertner 10 25.5 Total 39 samples. 100.0 This examination showed that much of the milk supplied to the City was seriously contaminated. It was therefore considered advisable to make a further investigation of the character of milk consigned to City dealers, and in August last another series of milk samples for the undermentioned 22 Counties was taken, viz.:— Berkshire. Huntingdon. Surrey. Buckinghamshire. Hampshire. Somersetshire. Cambridgeshire. Leicestershire. Staffordshire. Derbyshire. Norfolk. Warwickshire. Dorsetshire. Northamptonshire. Wiltshire. Essex. Oxfordshire. Worcestershire. Gloucestershire. Rutland. Hertfordshire. Suffolk. These samples were submitted to Dr. Klein, who reported as follows:— "The appended Tables give the summary of results obtained by "injecting guinea-pigs with the milk delivered here by your Inspector "May between August 2nd and August 23rd inclusive. As in the "former tests, of each sample 300 cubic centimetres were allowed to "sediment, and this sediment was injected in about equal proportions "into one guinea-pig peritoneally, and into a second guinea-pig " subcutaneously. "As will be noticed in the Tables, several animals died spontaneously, "viz.:— "Guinea-pig 5a.— Subcutaneously injected with sample 5. This "animal showed extensive pneumonia, but no microbes could be "discovered. 32 "Guinea-pig 8a.— Subcutaneously injected with sample 8. This "animal showed typical septicæmia with copious presence of "bacillus coli communis in the blood and in all viscera. "Guinea-pig 17.— Peritoneally injected with sample 17. It showed "typical necrotic-purulent deposits in the omentum, liver and "spleen, with the copious presence of bacilli pseudo-tuberculosis. Guinea-pig 22.— Peritoneally injected with sample 22. Died of "acute peritonitis on August 24th, with copious presence of "bacillus coli communis. "The companion of this animal, viz., guinea-pig 22a, subcutaneously "injected with sample 22, developed big tumour in groin, which "became necrotic, leading to extensive ulceration of the skin of the "groin and abdomen (healed by September 18th), a condition "known to occur after subcutaneous injection of some virulent "forms of bacillus coli communis. "Of the other animals killed between three weeks and four weeks, "only those of sample 16 (sixteen) and 17 (seventeen) showed the "lesions of true tuberculosis, with the copious presence of the bacilli "tuberculosis." County. Sample. Guinea-pigs. Inoculated. Died. Killed. Result. ESSEX Guinea-pig 1 Peritoneal Aug. 29 Negative, all viscera normal. „ la Subcutaneous „ „ „ „ HERTFORD ,, 2 Peritoneal ,, „ ,, ,, „ 2a Subcutaneous „ „ ,, „ SUFFOLK „ 3 Peritoneal „ „ „ „ „ 3a Subcutaneous „ „ „ „ HUNTINGDON „ 4 Peritoneal „ „ „ „ 4a Subcutaneous „ „ ,, „ CAMBRIDGE „ 5 Peritoneal „ „ „ „ „ 5a Subcutaneous „ Aug. 11 Animal died on August 11th from septicemic lobar pneumonia. NORFOLK ,, 6 Peritoneal „ Aug. 29 Negative, all viscera normal. ., 6a Subcutaneous „ „ „ RUTLAND „ 7 Peritoneal Aug. 5 Aug. 31 „ „ „ 7a Subcutaneous ,, „ „ „ BUCKINGHAM „ 8 Peritoneal „ „ „ „ 8a Subcutaneous „ Aug. 8 Animal died August 8th from cæmia due to B. coli communis. LEICESTER „ 9 Peritoneal „ Aug. 31 Negative. All viscera normal. „ 9a Subcutaneous „ „ „ „ DERBY „ 10 Peritoneal „ „ „ „ ,, 10a Subcutaneous „ „ „ „ 33 County. Sample. Guinea-pigs. Inoculated. Died. Killed. Result. WARWICK Guinea-pig 11 Peritoneal Aug. 5 Aug. 31 Negative. All viscera normal. „ 11a Subcutaneous „ „ „ ,, BERKS „ 12 Peritoneal Aug. 9 Sept. 4 „ „ „ 12a Subcutaneous ,, „ „ „ WILTS ,, 13 Peritoneal ,, „ „ „ ,, 13a Subcutaneous ,, „ „ „ GLOUCESTER „ 14 Peritoneal „ „ 14a Subcutaneous „ „ „ OXFORD „ 15 Peritoneal „ „ „ „ ,, 15a Subcutaneous „ „ Abscess in groin (size of pigeon's egg) full of grumous pus, containing a pure culture of streptococci. All viscera normal. SOMERSET „ 16 Peritoneal „ „ Typical tubercle in omentum, liver and spleen, with abundance of bacilli tuberculosis. „ 16a Subcutaneous „ „ Tubercle in inguinal gland, liver and spleen, abundance of bacilli tuberculosis. STAFFORD „ 17 Peritoneal Aug. 11 Aug. 22 Pronounced pseudo-tubercle of omentum, liver and spleen. „ 17a Subcutaneous „ Sept. 4 Distinct tubercle in inguinal glands, spleen and liver, numerous bacilli tuberculosis (also pseudo-tubercle). NORTHAMPTON ,, 18 Peritoneal „ Sept. 6 Negative. All viscera normal. „ 18a Subcutaneous ,, „ „ WORCESTER „ 19 Peritoneal „ „ „ „ „ 19a Subcutaneous „ „ Inguinal abscess (size of filbert), streptococci; all viscera normal. HAMPSHIRE ,, 20 Peritoneal Aug. 22 Sept. 18 Negative, all viscera normal. „ 20a Subcutaneous „ „ „ „ SURREY „ 21 Peritoneal Aug. 23 Sept. 21 „ „ ,, 21a Subcutaneous „ „ „ „ DORSET „ 22 Peritoneal „ Aug. 24 Acute peritonitis. „ 22a Subcutaneous „ Sept. 21 Negative, all viscera normal. The following is a summary of the results obtained:— Character of Milk. Number of Samples. Percentage. Clean and pure milk 15 68 Unclean milk 5 23 Tubercular 2 9 Total 22 100 The percentage composition of the two series referred to above may be classified as under:— 1904. 1905. Clean and pure 49 per cent. 68 per cent. Unclean 43 „ 23 „ Tubercular 8 „ 9 „ 34 Although in the last series there is anincrease in the proportion of "clean" milks, and a corresponding decrease in the percentage of those found "unclean," the recurrence of such a heavy ratio of milk from tuberculous animals must give rise to serious misgivings. The City milk supplies have been examined on three occasions for the bacilli of Tuberculosis. First in 1902, when 24 samples were examined with negative results in each instance; and again in 1904 and 1905 with the results as stated above. The number of samples examined will scarcely justify the assumption that the percentage of tuberculous milk sent from the country to the City has risen from nothing in 1902 to 9 per cent. in 1905, but it may be fairly assumed under existing conditions that at least 8 per cent. of the milk sold in the City is derived from animals affected with Tuberculosis.* However much this fact is to be regretted, it can scarcely create surprise when it is remembered that out of 500 cows examined, after slaughter, by the City Veterinary Inspector some evidence of Tuberculosis was found in no less than 234 = 46.8 per cent.† The great necessity of a purer milk supply has been largely engaging the attention of sanitarians of recent years, but until the Dairies and Cowsheds Regulations are properly enforced throughout the country it is to be feared little improvement can be expected. The report of the Inspectors who have been sent by the Local Government Board to inquire into the sanitary conditions of various districts throughout England and Wales show that in very many instances little or no attempt is made to carry out the Orders in Council, which unfortunately are not mandatory. The conveyance of milk in insanitary railway vans is a source of contamination, with regard to which many complaints have been made to the Board of Agriculture and Fisheries, who state in their last Annual Report that during the year they had enquired into nine specific complaints. In one instance the Inspector of the Board saw milk being loaded in the same van with fish, and in another it was found that milk vans on a certain route frequently contained or smelt of fish. One other point may be noted: Section 71 (1) of the Public Health Act, 1875, makes provision for the protection of the public from the sale of milk "likely to cause infectious disease," but unfortunately action can only be taken when the disease is a "dangerous infectious disease"— in other words, diseases notifiable by statute— and Tuberculosis is not one of these; were it otherwise, this section might be of considerable service. A case of much importance to farmers was decided in the Tower Bridge Police Court on 12th May, 1905. The defendant, a farmer under contract to supply pure new milk to a firm of wholesale milk distributors, was summoned * This has been confirmed by further experiment. † Vide Annual Report, Veterinary Inspector, to the Cattle Markets Committee, for the year 1901. 35 by the St. Pancras Borough Council under Section 47 of the Public Health (London) Act, 1891, for depositing for sale at Euston Station milk that was unwholesome and unfit for food. It having been proved that the milk in question contained fæcal matter, pus cells, and bacilli of Tuberculosis, the defendant was fined 25l, and 5l. 5s. costs. The case is notable as being the first of the kind with regard to milk, and should have a good effect in awakening farmers to a sense of their responsibilities and the importance of cleanliness in handling milk. An appeal to the pocket to the extent of over £30 is likely to protect the public better than a benevolent admonition in cases of this kind. One important point requires consideration, viz., the advisability in the interests of public health of publishing the name of the dairyman, in any case where full information is not given as to the source of any contaminated supply, and where immediate investigation is not made as to the sanitary condition of the farm and the health of the cows, and where steps are not taken to discontinue the supply until any insanitary conditions found are removed. This is necessary, inasmuch as the consumers are unaware of the conditions under which the milk is produced, and are therefore unable to protect themselves against an undoubted danger to health. It is evident that generally the milk trade is conducted under most unsatisfactory conditions, there being no guarantee whatever that milk as usually sold is free from infection, or even that it is reasonably clean, as out of 61 samples examined during the past two years no less than 22, or 36 per cent., were contaminated with filth. The only remedy is to insist upon the Dairies and Cowsheds Regulations being enforced by Local Authorities, by giving powers to County Councils to act in default, and further, to sanction Central interference where this is not sufficient. In the meantime, I recommend that further evidence be obtained by bacterial examination of samples on the same lines, especially of those supplied by the Dairy Companies referred to in previous Reports. There is no difficulty in securing a clean milk supply if cowkeepers carry out the simple recommendations of the Board of Agriculture and Fisheries which the Board desire to be made known to all interested in the subject. These are embodied in a leaflet issued in July last, in which the subject is dealt with in a practical and common-sense manner. Attention is chiefly directed to cleanliness in the dairy, cleanliness in the management and housing of cows, and cleanliness in milking. The sources of bacterial contamination so inimical to milk are also clearly indicated, and photographs of plate cultivations graphically illustrate the very material differences which exist between dirty and cleanly cows, pails, and byres. The importance of "grooming" cows, especially in winter time, when they pass most of their time under cover, is insisted upon, and simple directions are given for keeping the animals under proper sanitary conditions, dealing 36 with air space, ventilation, water and supply. Precautionary measures for preventing contamination during milking are also detailed, and the importance of cleanliness in dairy utensils and the best means of cleansing them pointed out. Some good advice is also given to the milk sellers, both wholesale and retail, and I strongly recommend all those engaged in the production of milk and its distribution to read the pamphlet and carry out the recommendations of the Board. It may serve a useful purpose to mention that copies may be obtained, free of charge and post free, from the Secretary of the Board of Agriculture and Fisheries, No. 4, Whitehall Place. LIABILITY OF PERSONS SELLING INFECTED MILK. Frost v. Aylesbury Dairy Company. This case is of so much importance, both to the public and milk distributors, that the following notes which appeared in Public Health for April, 1905, are here reproduced. "HIGH COURT OF JUSTICE. "COURT OF APPEAL, 24th February, 1905. "Before Henn Collins, M.R., Mathew, and Cozens-Hardy, L.J J. "Infected Milk— Sale of— Breach of Warranty— Damages. "When milk is sold by a dairy company for consumption as food there is an implied "warranty on the part of the vendors that it is reasonably fit for that purpose, "and they will be held liable for damages caused by reason of its being infected, "although such infection was latent and not discoverable by ordinary care "and skill. "This was an appeal by the defendants asking for a new trial or judgment in an "action tried before Grantham, J., and a special jury, and reported in Public Health, "xvii. p. 260, where the facts are set out. The action was brought by the plaintiff "to recover damages owing to the illness and death of his wife from typhoid fever, "caused, as he alleged, by the milk which was supplied to him by the defendants "being contaminated with the germs of typhoid fever. The jury found a verdict "for the plaintiff for £106, the expenses to which the plaintiff had been put in "consequence of the illness and death of his wife; and judgment was entered for "him accordingly. "Macmorran K.C., and W. Mackenzie appeared for the defendants, and "contended that under Section 14 (1) of the Sale of Goods Act, 1893, the "defendants did not impliedly warrant that the milk was free from infection, as no "care and skill on their part could have discovered whether it was infected or not. "They also contended that the verdict was against the weight of the evidence, and "that the Judge at the trial had misdirected the jury and introduced topics of "prejudice against the defendants. "Duke, K.C., and Holman Gregory, for the plaintiff, were not called upon, and "the Court dismissed the appeal. 37 "The Master of the Rolls said that the first point taken was that, admitting that "the milk was the cause of the typhoid fever, upon the facts of the case there was "no actionable wrong on the part of the defendants. The question was whether, in "the particular circumstances, the case had been brought within Section 14. "Sub-section 1, of the Sale of Goods Act, 1893. It was said that the buyer had "not made known to the seller the particular purpose for which the goods were "required so as to show that he relied on the seller's skill or judgment. They had "not evidence in any precise detail of the inception of the relationship between the "plaintiff and the defendants. They began with the fact that the plaintiff was "dealing with the defendants. The result was that milk was purchased by the plaintiff from the defendants. That involved a contract for the supply of an "article of food— namely, milk. The purpose for which the milk was supplied "was obviously for consumption as an article of food. It did not require any "evidence to prove the particular purpose for which the milk was supplied. The "jury must be taken to have found that. Where was the condition so as to show "that the buyer relied on the seller's skill or judgment fulfilled? If any seller "ever did inform the mind of a buyer of his special care as a seller, as an "inducement to the would-be buyer to deal with him, those defendants did. The "book which had been called the pass-book, which was supplied to the plaintiff, "was full of particulars of their skill and knowledge in the matter. It contained "paragraphs headed 'Milk in relation to tuberculosis and other diseases'— stating "the precautions taken to ensure that only pure milk free from all germs of "disease and free from adulteration was supplied. One paragraph related to "'medical inspection,' another to 'milk analysis,' another to 'veterinary "surgeon.' The buyer could not escape being permeated with the sense that he "was secured against the possibility of danger if he bought the defendants' milk. "Milk, therefore, for the supply of the plaintiff and his family was tendered by a seller "with all this knowledge and skill. It was then said that the buyer could not rely "upon the sellers' skill or judgment in a case where no skill or judgment could "have found out the defect. That was a contention that a person could not "become liable for an undiscoverable latent defect. The law upon the point was "the same now as it was at common law before the Sale of Goods Act, 1893. "That point had been dealt with and decided by the Court of Appeal in Randall v. "Newson (2 Q.B.D., 102), where it was held that on the sale of an article for a "specific purpose there was a warranty by the vendor that it was reasonably fit for "the purpose, and that there was no exception as to latent undiscoverable defects. "Then, with regard to the alleged misdirection, it was a well-established rule that "even if there was misdirection, still if that misdirection did not affect the result, "of the trial, the Court would not be justified in sending the case down for a new "trial. Mr. Macmorran complained, and he (the Master of the Rolls) must admit "with some justice, that the learned Judge made some observations about the name "of the defendant company, though that had nothing to do with the case; and he "thought that it was unfortunate that the learned Judge had made those "observations. In his (the Master of the Rolls') opinion there was not the shadow "of a foundation for any aspersion on the defendants in connection with their "bearing the name of the Aylesbury Dairy Company. But those observations of "the learned Judge had no effect upon the case. He did not think that "depreciating the use by the defendants of the name had any effect on the case, "The circumstances of the case showed plainly the purpose for which the milk was "sold. The circumstances spoke for themselves, and it would be a waste of time "to ask a jury a specific question upon that particular point. With great respect "and deference to the learned Judge, he thought that his direction to the jury was 38 "capable of improvement, but it did not affect the result of the trial. The "application must therefore be dismissed. "Lord Justice Mathew delivered judgment to the same effect, in the course "of which he said that there was no reason whatever for any reflection upon "the defendant company. They had imposed stringent conditions upon the "farmers from whom they obtained the milk, but it was obviously impossible, "where their milk was drawn from different parts of the country, to see that each "farmer complied in every respect with their conditions and requirements. He "(the Lord Justice) regretted that the use of the word 'Aylesbury' in the name "of the defendant company was reflected upon by the learned Judge. He desired "to say that he did not concur in those reflections, and in his opinion the defendant "company came well out of the inquiry. "Lord Justice Cozens-Hardy agreed." THE SPITTING EVIL. The principal Railway Companies, with one exception, recast their Byelaws during the year, and, it is satisfactory to note, availed themselves of the opportunity to add Bye-laws making spitting on platforms, booking offices, &c., or in railway carriages, a punitive offence. In each case the wording of the new Bye-law is identical, and has been duly allowed and approved by the Board of Trade. It is to the following effect:— "No. 22.— No person shall spit upon the floor or upon any part of any carriage "using or being on the railway, or upon the platform at any station of the Company, "or upon the floor, side or wall of any hall, office, waiting-room, refreshment-room, "public room, or public passage at any station of the Company. Any person "infringing or not observing this bye-law and regulation shall be liable to the penalty "prescribed by Bye-law No. 1, and in case of non-compliance with the request of any "servant or agent of the Company to desist, may, without prejudice to any such "penalty, be forthwith removed from the Company's premises by or under the "direction of any such servant or agent. The penalty referred to is a fine not exceeding forty shillings for a first offence, and not exceeding £5 for any subsequent offence. Hitherto Railway Companies have been powerless to do more than appeal to a public sense of decency by exhibiting cautionary notices against spitting in carriages, &c., but unhappily there still exists a section of the community to whom such appeal is useless. The Railway Companies are now armed with a ready means of dealing with such persons, who can be made to pay smartly for indulging in indiscriminate expectoration, and it is to be hoped that the public will render the Companies every assistance in the enforcement of this Bye-law. TELEPHONE MOUTHPIECES. Representations having been made from time to time as to the danger of infection from the use of telephone mouthpieces in Public Call Offices, and it especially being suggested that Tuberculosis and 39 Diphtheria might in this way be passed on from one user to another, it was decided to investigate the question bacteriologically. With the sanction of the National Telephone Company, a number of their Call Offices were selected, the mouthpieces removed, placed in sterilized bottles and submitted to Dr. Klein for bacteriological examination. These were "washed out with 2-3 cubic centimetres of sterile distilled water by means of "sterile brushes, and the whole of the washing was injected in about equal "parts into two guinea-pigs: one peritoneally, one subcutaneously. The "washings were very dirty, containing a lot of mineral matter (dust) and "some soot. The object being to discover whether there were present any "tubercle bacilli in the mouthpieces, the animals were allowed to live for four "weeks, by which time any tubercle present could be readily discovered. The "animals of all these injections (24 in all) appeared during these four weeks "in normal condition, and showed no pathological symptom, either locally "or otherwise," and subsequent post-mortem examination showed that the animals were all free from Tubercle and Diphtheria. In all, twelve mouthpieces were so treated, these being selected by your Medical Officer from Callboxes in different parts of the City. The result of these experiments was exceedingly satisfactory, and showed that in none of these mouthpieces were any tubercle bacilli present, and, with the exception of one guinea-pig in one experiment, no other microbe pathogenic to the guinea-pig. The exception was an accidental one, and it is obvious that if a sufficiently large number of samples were taken some other germ would almost certainly be found. This has, however, no practical bearing on the case. The conclusion, therefore, is that there is no real risk in the use of the telephone at Public Call Offices, and that the alarm that has been raised has no foundation in fact. It is satisfactory to be assured that the use of so valuable a means of communication is without any attendant danger, and that the only precaution advisable is the obvious common-sense one of keeping the mouthpieces clean. PUBLIC TELEPHONE CALL-BOXES. The attention of the National Telephone Company was also directed to the lack of ventilation of their "call-boxes" in general use, and to the unsuitable character of the material with which they were lined. The Company at once took steps to effect improvements in this direction, and through their courtesy your Medical Officer was afforded an opportunity of viewing and advising upon a specimen of the improved cabinets they propose to erect in future. In the new pattern ample ventilation is provided by means of an opening two feet by six inches in the roof, and by an ingenious mechanical arrangement this is always open except when the instrument within is in actual use, the opening and closing of the tightly-fitting door ensuring free circulation of air throughout. A hard smooth impervious material painted in enamel has been used for lining the interior. As this can be readily cleansed, it is a great improvement upon the former method. 40 A specimen of one of these cabinets was exhibited at the recent Electrical Exhibition, and the Company are to be congratulated upon the prompt and effective manner in which they have dealt with a matter directly connected with the health of their customers. Through the courtesy of the Postmaster-General, I also had an opportunity of examining at the Post Office Factory, Mount Pleasant, the pattern telephone cabinet adopted for the Post Office telephone service, and was able to make some suggestions that might improve their ventilation, &c. ACCOMMODATION OF PATIENTS NOT SUFFERING FROM INFECTIOUS DISEASE IN METROPOLITAN ASYLUMS BOARD HOSPITALS. In September last a communication was received from the Town Clerk of Holborn, stating that the Council of the Metropolitan Borough of Holborn had had under consideration the reports of the Metropolitan Asylums Board for the past four years, and that their attention had been drawn to the fact that during that time no less than 10,000 patients had been admitted suffering from diseases for which the Board's Hospitals were not provided, and that they had been detained on an average about three weeks at a total cost for the whole period of about £60,000, and that having regard to these figures he was directed to ascertain whether, in the view of other Metropolitan Boroughs interested, a joint conference on the subject, between the Metropolitan Boroughs and the Asylums Board, could with advantage be held to discuss the matter. Amongst the suggestions that had been made was one that the Medical Officer of Health should be required to confirm the diagnosis of the medical practitioner in each case. The Corporation were also asked whether they would be prepared, in the event of a conference being decided upon, to appoint representatives. The matter was considered by the Sanitary Committee on the 24th October, when it was decided that no action should be taken in the matter. In view of the sweeping statements contained in the letter in question, it was hardly likely that the Asylums Board would let such a charge go unchallenged, and on the 16th November they issued the following copy of a report which the Metropolitan Asylums Board had received from their Hospitals Committee upon the subject of the circular letter addressed to them by the Holborn Borough Council referred to above:— "METROPOLITAN ASYLUMS BOARD. "Board Meeting (11th November, 1905). "Copy Report of Hospitals Committee. 12nd November, 1905. "Accommodation of Patients.— On the 14th October last, the Board referred to us for "report a letter from the Council of the Metropolitan Borough of Holborn, dated 18th "September, 1905, in which they call attention to an alleged expenditure amounting, 41 "according to their estimate, to about £60,000, which they say has been occasioned "by the admission during the last five years into the Board's Hospitals of some 10,000 cases not suffering from diseases for which these hospitals are provided, and suggest a "conference between the Board and the several Metropolitan Councils to consider the "subject. "As regards the financial statement the Holborn Borough Council seems to have "been misled. The Accountant of the Board has estimated that the extra cost to "which the Board has been put by the admission of these patients would not exceed "an average sum of £3,200 per annum. "As regards the matter which it is proposed to discuss, it is undeniable that in the "earlier stages of many cases of infectious disorder there can be no absolute certainty of diagnosis, and that to detain at home every patient until such certainty is obtained "must frequently result in the spread of infection, the prevention of which is the "primary object of the Board's hospitals. "It must, therefore, be always to remove a doubtful case than to leave it outside "with the danger of infecting others, which if done would of necessity increase the "number of admissions and thus cause a very considerable expenditure of the rates. "The business of the Managers is to receive cases which are certified by a qualified "practitioner, provide proper accommodation, and then leave them in the experienced "hands of the Medical Superintendents. "In our opinion, the Managers would be going quite beyond the scope of their "functions if they took any step which would have the effect of discouraging medical "practitioners from freely exercising their judgment in seeking for their patients "admission to the Board's hospitals. "The suggestion that the Medical Officer of Health should confirm the diagnosis "is not one for the Board; but in our opinion it is very doubtful whether such a "proceeding would be of any value, and it certainly would be attended with "distinct disadvantages. "We do not see that any useful purpose would be served by such a conference as "the Borough of Holborn suggest, and we cannot recommend the Managers to take "any part therein. "We recommend:— "That the report (2nd November, 1905) of the Hospitals Committee on the "subject of the letter (18th September, 1905) from the Council of the "Metropolitan Borough of Holborn with reference to accommodation of patients "be approved and adopted, and a copy thereof forwarded to the Town Clerk in "reply to such communication. "(Adopted.)" As many of the Borough Councils in the Metropolis evidently agreed with the views of the Asylums Board on the subject, in the result a letter, dated the 31st January of this year, was received from the Holborn Borough Council, stating that in reply to their communication of the 18th September, 1905, seventeen Councils were in favour of the conference being held, and nine were against it, they had therefore come to the conclusion not to convene the conference, and that in these circumstances they had asked the Metropolitan Borough Councils' Association to undertake the consideration of the matter. 42 CEREBRO-SPINAL FEVER. A circular letter of the Local Government Board, dated 24th August, 1905, dealing with this disease, was referred to your Medical Officer of Health by the Sanitary Committee for consideration and report. The letter stated that the Board "have reason to believe that the fact that "Cerebro-spinal Fever has been recently somewhat extensively prevalent in "Central Europe and in America has given rise to a doubt, in some quarters, "whether the disease in question may not have newly extended to or have "been developing in this country. The Board think it desirable, therefore, "to state that, so far as they have been able to ascertain, there is no ground "for such apprehension Nevertheless, they consider that "Sanitary Authorities should be on the alert to detect the presence of the "disease in their districts, or to satisfy themselves as to its absence, and to "this end have issued a Memorandum which has been prepared by their "Medical Officer, dealing generally with the characteristic symptoms of the "disease, and especially with its minor and anomalous manifestations." The Board having suggested that there would be advantage in the local Medical Officer of Health endeavouring to secure, by arrangement with the medical men practising in his district, information as to the existence of cases of the kind in question, copies of the Memorandum referred to were forwarded to all practitioners in the City of London, with the following covering letter:— "Corporation of London, "Guildhall, E.C., "11th November, 1905. "Dear Sir, "Cerebro - Spinal Fever. "I beg to enclose copy of a Memorandum issued by the Local Government "Board, pointing out the characteristic symptoms and the minor and anomalous "manifestations of the above disease. "As an aid to diagnosis, should a suspected case occur in your practice, if you "will communicate with me, I will arrange for an examination of the cerebro"spinal fluid for the diplococcus of Weichselbaum, by the Corporation Bacteriologist, "should you so desire it. "Yours faithfully, "W. COLLINGRIDGE, "Medical Officer of Health for the City of London." MEMORANDUM ON CEREBRO-SPINAL FEVER. Cerebro-spinal fever, known also as epidemic cerebro-spinal meningitis, spotted fever, and by many other less frequently used names, has recently attracted renewed attention in this country by reason of the serious mortality occasioned by disease of this class in New York and in certain localities on the Continent of 43 Europe. Interest in this malady has been farther stimulated by the public notice which has been taken of the recent identification of a case in the neighbourhood of London, and of several cases, four of which terminated fatally, at Irthlingborough in Northamptonshire. Cerebro-spinal fever is not of [rare occurrence in the United Kingdom. In the course of the last forty years this malady is known to have been prevalent in a considerable number of different localities in England and Wales, several of these local outbreaks having taken place in recent years. In some instances they have formed the subject of investigation by a medical Inspector of the Local Government Board, whose report has usually been made public. Occurrences of cerebro-spinal fever have also been observed in Scotland and in Ireland. There is, indeed, as will appear later, reason for belief that this disease is even less uncommon in this country than the foregoing particulars would seem to indicate. The late Mr. Netten Radcliffe defined cerebro-spinal fever as "an acute, epidemic disease, characterised by profound disturbance of the central nervous system, indicated at the onset chiefly by shivering, intense headache or vertigo, or both, and persistent vomiting: subsequently by delirium, often violent, alternating with somnolence or a state of apathy or stupor: an acutely painful condition with spasm— sometimes tetanoid— of certain groups of muscles, especially the posterior muscles of the neck, occasioning retraction of the head; and an increased sensitiveness of the surface of the body. Throughout the disease there is marked depression of the vital powers; not unfrequently collapse: and in its course an eruption of vesicles, petechial or purpuric spots, or mottling of the skin, is apt to occur. If the disease tend to recovery, the symptoms gradually subside without any critical phenomena, and convalescence is protracted: if to a fatal termination, death is almost invariably preceded by coma. After death the enveloping membranes of the brain and spinal cord are found in a morbid state, of which the most notable signs are engorgement of the blood vessels, usually excessive, and an effusion of seropurulent matter into the meshes of the pia mater and beneath the arachnoid." To the clinical manifestations of the disease, indicated in this definition, may be added the presence of Kernig's sign* and of tache cérébrale.† Local prevalence of a malady distinguished by the foregoing features would, no doubt, attract attention and would, it may be presumed, lead to early recognition of its true nature. But, while these features are characteristic of cerebro-spinal fever of typical and severe sort, experience has taught us that this fever may and does appear in milder or in anomalous forms which render identification difficult, and which lead to its being mistaken for other ailments of more common occurrence in this country. Illustration of this is afforded by certain localised outbreaks of cerebrospinal fever in the eastern counties in 1890, where this disease was generally mistaken for sunstroke or for enteric fever, or was looked upon as a new form of illness; by the prevalence of what would seem to have been cerebro-spinal fever in Northamptonshire in 1890-91, where the malady was for the most part diagnosed * To obtain this sign, the patient is placed so that the hip-joint is semi-flexed, and while the hip-joint is retained in this position, the knee-joint is extended passively. A contraction of the hamstrings then sets in, which causes resistance to the extension. † A congested streak produced by drawing the finger-nail gently over the patient's thigh, abdomen, or face. In cases of meningitis this appears earlier (within 30 seconds), lasts longer (8, 10, or 15 minutes), and is broader and of deeper colour than in healthy persons. 44 as pneumonia or as sore throat; and by the occurrence of cerebro-spinal fever in Irthlingborongh in the present year, where many of the persons attacked were regarded as suffering from influenza. In these anomalous forms of cerebro-spinal fever, many or even most of the symptoms associated with the recognised type of the disease may be absent, while, in mild cases, they may be so slight or of such brief duration as to escape notice. It is, however, for such cases that it is necessary to be on the outlook, whether in relation with a definite occurrence of cerebro-spinal fever in a locality, or by reason of the prevalence in a particular neighbourhood of illness not clearly referable to definable cause. In these circumstances, there would be advantage in the local medical officer of health endeavouring to secure, by arrangement with the medical men practising in his district, information as to the existence of cases of the kind in question. Failure to recognise cerebro-spinal fever is also apt to happen when the malady is of the "fulminant" variety, in which death ensues rapidly. In these instances the disease has been mistaken for typhus fever, idiopathic tetanus, or malignant measles. An important aid to diagnosis may be found in examination of the cerebro-spinal fluid, withdrawn from the lower part of the spinal canal by lumbar puncture, for the presence of the "diplococcus meningitidis intracellulars" of Weichselbaum; a micro-organism which is now generally regarded as the specific cause of cerebrospinal fever. Whether cerebro-spinal fever is spread by direct infection from person to person is matter of uncertainty; indeed, there is as yet no definite knowledge as to the way or ways in which its transmission may take place. Since, however, the possibility of direct personal infection cannot, on the evidence available, be excluded, it will be wise to endeavour to secure, as far as practicable, the isolation of the sick from the healthy. It will also be advisable to apply suitable measures of disinfection to premises that have been occupied by the sick, and to articles that may have been in relation with them. In view of the fact that the presence of Weichselbaum's diplococcus has been observed in the mucus of the nose and mouth, not only of the sick, but also of those attending on the sick, there may be advantage in resorting to periodical ablutions of the nasal and buccal passages of the sick and their attendants. W. H. POWER, Local Government Board, Medical Officer. July, 1905. ANTHRAX. Two cases of this disease were reported during the year. On the 13th May the Home Office reported that a man employed at a wholesale skin warehouse in the City had died from Anthrax in the London Hospital two days previously. On investigation it was ascertained that the man, who resided at Walthamstow, was taken ill on the 8th May, and admitted on the following day to the London Hospital, where he died on the 11th. 45 The premises where he had been employed were inspected throughout, and many of the skins— Australian Opossum and American Wolf— that it was stated the deceased might have handled were examined, but in the absence of any means of identifying those that may have conveyed the infection, a special search for the bacillus was not made. In the second case notification was received from the Home Office on the 13th that a market clerk employed by a firm of furriers in the City was under treatment for Anthrax at Guy's Hospital. Upon enquiry it was ascertained that the infection did not originate in the City. The patient had been employed inspecting hides on the wharves on the South side of the Thames, the hides coming from all parts of the world, especially from Morocco and the Black Sea, and were of every description. He had been at business during the early part of the week, and on Tuesday, the 9th January, complained of illness and went home. On Friday, the 12th, he was removed to Guy's Hospital, and at once operated upon. Daily reports were received as to his condition, and the patient made good recovery. On 10th October, 1905, the Board of Agriculture and Fisheries issued a Notice giving a brief summary of the symptoms of Anthrax in animals, and calling attention to the danger incurred in slaughtering any animal that appears to be ill, from an unknown cause, and the precautions that should be taken in dressing such an animal after slaughter. The following is the text of the Notice. It is addressed to butchers, slaughterers, knackers, and other persons engaged in Great Britain in slaughtering animals, or in dressing or otherwise handling carcasses of animals:— "ANTHRAX. "Cases come under the notice of the Board of Agriculture and "Fisheries from time to time of persons having contracted Anthrax "whilst engaged in slaughtering animals, or in dressing or otherwise "handling the carcasses of animals. In connection with inquiries made "under the Diseases of Animals Acts, 1894 to 1903, into outbreaks of "Anthrax, it appears from the Reports of the Board's Inspectors as "regards the outbreaks which occurred in Great Britain during the "period from the beginning of July to the end of December of last year, "that as many as twelve persons are known to have contracted the "disease whilst so employed, and that six of these persons died, whilst "in one case amputation of the arm became necessary. "The Board, therefore, think it is desirable to warn persons against "shedding the blood of an animal which appears to be ill from some "unknown cause, and also against cutting or handling the carcass or 46 "skin of any animal which has died suddenly, until careful inquiries "have been made with a view to see whether or not any symptoms* of "Anthrax had been exhibited during life. Should there appear to be "any reason to suspect the presence of Anthrax, it is very desirable "that the slaughter of the animal or the dressing of the carcass "should not be commenced until steps have been taken to investigate "the cause of illness or death, and that the owner should be warned of "the grave risk to human life which might without such investigation "be incurred. "If the course above indicated be followed in suspicious or doubtful "instances, material assistance would thus be rendered to the respective "Authorities concerned in dealing with this very dangerous disease in " man and in animals. "* The symptoms of Anthrax may be summarised as follows:— The disease "shows itself suddenly. It is very fatal, usually within 48 hours. It does not "often in the United Kingdom spread with rapidity from animal to animal, but it "may affect a number o£ swine at the same time if they have been fed on anthrax "flesh or organs. A beast which a short time before appeared to be well is found "dead or in a dying condition. Frequently blood oozes from the nostrils and the "anus. In cattle there are no typical symptoms, but in horses and pigs the region "of the throat is often found to be swollen. "After death the carcass is swollen. Blood is found around the nostrils and "anus. The muscles are often infiltrated with blood at certain points. The lungs "and glands are congested. The spleen is very much enlarged; it is softer and "darker than normal, and its substance usually resembles tar." Instructions were given for a copy of this Notice to be posted in each slaughterhouse in the City. SPREAD OF INFECTIOUS DISEASE BY VAGRANTS. The consideration of this question was initiated in October, 1904, when your Medical Officer was appointed to represent the Corporation at a Conference held at Spring Gardens under the auspices of the London County Council. The meeting was convened with the view of determining how best to prevent the spread of Small-pox throughout the country by vagrants. The Sanitary Committee have been acquainted from time to time with the details of the deliberations both of the Conference and of the Committee to whom active measures were delegated, and the following is a summary of the whole proceedings, which terminated in June, 1905, with no other result than the sympathetic reception by a Minister, now out of office, of a deputation representing the Conference, and associations of public bodies interested in the subject. 47 The Conference met on 10th November, 1904, and was attended by representatives of the following bodies:— The City of London. The London County Council. Twenty-eight County Councils of England and Wales. Fifty-three County Boroughs of England and Wales. Twenty-six Metropolitan Borough Councils. The Metropolitan Asylums Board. The total number of representatives present was 189. The following Resolutions were adopted by the Conference:— "GENERAL MEASURES FOR THE PREVENTION OF THE SPREAD "OF INFECTIOUS DISEASE BY VAGRANTS. "(1) (a) That this Conference of urban and sanitary authorities of England and "Wales recognises the increasing amount of habitual vagrancy as the cause of "wide-spread and disastrous consequences to the public health, and is of opinion "that much more effective measures than are at present adopted should be taken for "preventing the spread of infectious disease by vagrants, and for effectually dealing "with this great and growing danger. "(b) That the evil can only be met by conferring further powers upon the local "authorities, viz., the sanitary authority, the board of guardians, and the magistracy. "(2) That means should be provided for the detention and isolation of any "vagrant found wandering in a public place, if reasonably suspected of being liable "to convey infectious disease. (3) That this Conference is of opinion that it is desirable that— "(a) Parliamentary powers should be sought for the compulsory vaccination and "re-vaccination of all vagrants unable to produce proof of being sufficiently "protected against small-pox on entering casual wards or common lodging-houses, "who, in the opinion of the sanitary authority, have been exposed to the infection "of small-pox, and also that sanitary authorities should have power to grant such "compensation as they think necessary to persons vaccinated or re-vaccinated at "their request who may be prevented on that account from work; "(b) It should be an offence to withhold information or make false statements to "the sanitary authority in carrying out its powers with respect to the disease. "(4) That in order to deal effectually with the transmission of notifiable infectious "disease by tramps, power should be given to county councils to enforce the "existing laws in all cases where sanitary authorities in the county refuse or neglect "to do so. "(5) That the Local Government Board should obtain powers to secure weekly "returns of all cases of infectious disease from all central authorities throughout the "country, and circulate the same. J ' "(6) That it is desirable that in districts comprising groups of counties and "county boroughs, intelligence bureaux should be established, to which information 48 "should be sent from sanitary authorities and workhouses in the district, of persons "of the wandering class who have been exposed to the infection of small-pox; and "that a printed copy of such information should be distributed from the bureau to "every sanitary authority and board of guardians in the district, and that the "expense of working the bureau should be met by contributions from the county "councils and county boroughs forming the district. "(7) That this Conference is of opinion that the port sanitary authorities should "be authorised to take more stringent precautions to prevent the importation of "disease by persons arriving by vessel at the ports who are suffering from small-pox, "or who have been exposed to infection by that disease. "COMMON LODGING-HOUSES AND CASUAL WARDS. "(8) That the local authority should have increased control over common lodging"houses, their keepers, and occupants. Thus the Local Authority should have "power— "(a) to medically examine the inmates; "(6) to detain and isolate persons exposed to infection and to disinfect them and "their clothes; "(c) to temporarily close a common lodging-house in whole or in part, compen"sation to be given to the keeper of the house. "(9) That the local authority should have power to order the keeper of a common "lodging-house in which there has been infectious disease to refuse fresh admissions "for such time as may be required by the authority. "(10) That the local authority shall be empowered to require medical examination "and disinfection of all persons entering casual wards. "(11) That the local sanitary authority should have power to require the removal "and isolation of any inmate of a casual ward who may reasonably be suspected of "being liable to convey infectious disease. "(12) That the local authority should have full power to require the cleansing of "the person and the disinfection of the clothes of any person in a casual ward, "whether infected or exposed to infection. "LABOUR BUREAUX. "(13) (a) That the time has arrived when the Local Government Board should "promote legislation for the establishment of labour bureaux in the areas of every "county council and every county borough council. "(b) That this Conference is also of opinion that it is desirable that a national "voluntary agency should be formed for assisting bona fide working men while "travelling through the country in search of work, and that such agency should be "worked on the same lines as the Inter-Cantonal Union of Switzerland for the "relief of poor travellers. "(14) That the unemployed travelling bona fide in search of work, not being "habitual vagrants, should not be treated as vagrants, but as far as possible be "assisted to obtain employment. 49 " LABOUR COLONIES. "(15) That the time has arrived when the Local Government Board should " promote legislation for the establishment of labour colonies for the compulsory " detention of habitual vagrants until they have acquired power to work and " self.constraint. "(16) That this Conference approves and affirms the resolutions passed by the " executive council of the Association of Poor Law Unions in England and " AVales at their meeting in September, 1903, as follows :— "(a) That boards of guardians should be grouped in suitable areas to provide " labour colonies for vagrants. "(b) That such colonies should be established and governed by the joint " committees of the boards of guardians of the unions in the said areas. " (c) That habitual vagrants should be sent to such labour colonies by magistrates. "(d) That the expenses of each colony should be spread over the unions in " the areas served by such colonies. "CHILDREN OF VAGRANTS. (17) That the powers of the poor law guardians under the Poor Law Acts " of 1889 and 1899 to assume and exercise, in certain circumstances, parental " rights over the children of pauper parents, should be extended so as to confer " similar rights over the children of habitual vagrant " GENERALLY. "(18) That, in order to give practical effect to the foregoing resolutions, this " Conference is in favour of uniting with the County Councils' Association, the " Association of Municipal Corporations, the Association of Metropolitan Borough " Councils, the Magistracy, and the Association of Poor Law Unions of England "and Wales for the following purposes, viz.:—(a) To enlist the sympathy and " co.operation of members of Parliament ; (b) to appoint representatives to wait " on the Local Government Board ; (c) to give evidence before the Inter. " Departmental Committee of the Government on the Vagrancy Question ; (d) to " take such other measures as may be thought desirable in support of the " resolutions arrived at by the Conference. " That a Committee be appointed to give effect to this resolution. "That the Committee do consist of the following members :— " Four to represent the County Councils, seven to represent the County Borough " Councils. For the Corporation of London and Metropolitan Borough Councils, " your Medical Officer and three other members. The Committee to have power " to add to their number." The fact being established that Small.pox is largely spread by vagrants, it is evident that additional powers are necessary for dealing with an evil which necessarily increases with the extension of habitual vagrancy. 50 The general measures proposed by the Conference seem well adapted for this purpose, and it is to be hoped that in spite of the opposition of fanatical anti.vaccinationists, Parliamentary powers will be obtained for the compulsory vaccination and re.vaccination of all vagrants insufficiently protected against Small.pox. Common lodging.houses and casual wards are admittedly frequently foci of disease, and the increased control over them in the direction indicated in the resolution would further lesson the extension of Small.pox. The establishment of Intelligence Bureaux would also be most valuable as going far towards checking the spread of the disease. With regard to the establishment of Labour Bureaux and Labour Colonies, in reporting thereon to the Sanitary Committee, I preferred not to express any opinion, the subject being really one of Poor Law administration, and therefore hardly within a Medical Officer's province. The assumption by the guardians of parental rights over the children of habitual vagrants was also a matter I preferred not to discuss for similar reasons. When the Committee appointed by the Conference met on the 15th December, 1904, your Medical Officer of Health stated the position of the Sanitary Committee with reference to compensation for vaccination in the case of habitual vagrants, and it was understood that as the delegates had no definite instructions to pledge their respective authorities, it would be advisable to rely upon the weight of the Congress, and make it clearly understood that the various authorities were not bound by all the resolutions. (This would cover the objection as to compensation for compulsory vaccination in the cases referred to.) It was generally felt that in the state of public business at the time, a Private Bill, backed by both sides of the House and approved by the Local Government Board, would stand a better chance of becoming law than a Government Bill, and it was therefore agreed that the alternative, i.e., public or private, should be placed before Mr. Long by a deputation. The Chairman further pointed out that the delay in the issue of the report of the Vagrancy Committee would obviously stand in the way of immediate public legislation. After some discussion it was finally agreed that a deputation should wait upon the President of the Local Government Board— (1) To lay before him the Resolutions of the Conference ; (2) To urge in the first place the public health point of view (i.e., the connection between infectious disease and vagrancy), while pointing out the importance of the Labour Bureaux and Labour Colony question as an essential part of the problem. (3) To point out that while certain remedies could be at once applied by the Local Government Board, either by new regulations or by 51 compelling compliance with those already issued, others would require legislation. (4) To offer expert evidence on the question to the Vagrancy Committee. It was resolved that such deputation should consist of members of the Committee only, and that a letter should be addressed to the County Councils of England and Wales, the Corporation of the City of London, the Councils of County Boroughs and Metropolitan Boroughs, the Metropolitan Asylums Board, and to the Clerks of the Peace of the Quarter Sessions, requesting them to take such individual action as they are able within their own districts. It was not until 22nd June last year that arrangement could be made for a deputation, consisting of the Committee of the Conference and representatives from the Association of Poor Law Unions, to be received by the President of the Local Government Board. The deputation, introduced by Sir Walter Plummer, J.P., was received by Mr. Balfour at the House of Commons. Alderman Dr. Newton of Newcastle.upon.Tyne submitted the resolutions adopted by the Conference, and similar resolutions adopted by the Association of Municipal Corporations and of Metropolitan Borough Councils and the Association of Poor Law Unions of England and Wales. He urged that legislation should be promoted at an early date to give effect to the views of the Conference. The Mayor of Wandsworth spoke on behalf of the Metropolitan Authorities, and Dr. G. Millner Rhodes on behalf of the County Councils. At the conclusion of the latter's remarks Mr. Balfour, who gave the deputation a most sympathetic reception, invited all those present to express their views on the question. CLOSURE OF SCHOOLS. In the course of the year three cases occurred where it was necessary to issue formal orders for closure of schools to prevent extension of infectious disease. ST. BARTHOLOMEW THE GREAT SCHOOLS—INFANTS' DEPARTMENT. On the 30th January, 1905, 16 children attending the Infants' Department at St. Bartholomew the Great Schools in Bartholomew Close were attacked with Measles, eight others were excluded on account of disease in the same house, and two were suspected, a total of 26 out of 50 scholars on the roll. In order to comply with the requirements of the Education Board, two Members of the Sanitary Committee, acting upon my advice, signed a formal order directing the closure of the Infant School for fourteen days from the 30th January, 1905. During the closure the school buildings were disinfected and cleansed, and no further extension of the outbreak occurred. 52 SIR JOHN CASS INFANT SCHOOL—MITRE STREET, ALDGATE. The above.mentioned school was closed by order for fourteen days from the 7th April, 1905, in consequence of an outbreak of Measles, it having been ascertained on the previous day that 18 children had been attacked and that in nine cases children were excluded from the school owing to the disease having occurred in their homes. Thus, 27 out of 60 scholars on the roll were absent. The usual cleansing and disinfection of the school buildings was effected during the closure, and no further cases were reported. GRAVEL LANE BOARD SCHOOL. On the 19th May, 1905, it was reported that 32 of the children attending the Infants' Department of the Gravel Lane Board School had been attacked with Measles, that in 16 cases children had been excluded on account of the disease having occurred in their homes, and that 22 other children were kept away on account of Ophthalmia, Ringworm, &c. Thus, 70 out of 360 on the roll were absent In the circumstances I advised the issue of an order, as in the previous case, requiring the closure of the Infants' Department for fourteen days from the 19th May ; in the interval the usual disinfection and cleansing of the school buildings were carried out. Subsequent to the closing of this department, cases of Measles, Ophthalmia, Ringworm, Favus and Scabies occurred in the other departments of the school, and this, together with the fact that 42 of the children were necessarily absent on account of infectious disease occurring in the other persons of the household, occasioned some alarm among the teachers and others as to the advisability of closing the school altogether. Though there did not seem to me to be any reason for this, it appeared to be wise to have the whole school thoroughly disinfected. I therefore called upon the Medical Officer of the Education Department of the London County Council to have this carried out. The school was closed for the purpose from the 29th May to the 3rd June. During this interval the whole of the buildings were sprayed with a solution of Cyllin (the routine method of dealing with cases of infected rooms in the City), and the books and materials disinfected. I subsequently called the attention of the Medical Officer to certain points which were unsatisfactory with regard to the school generally, viz.:— 1.—The staff provided for cleansing is too small to secure it being thoroughly carried out. This is essential in all schools, especially where Ringworm, Favus and Ophthalmia have appeared, the spread of which is effected by the presence of dust. 2.—In view of the practical impossibility of preventing the use of towels in common with a large number of children, that it is advisable that the lavatories should be locked during such time as there are any cases of these diseases in the school, and any necessary use of such accommodation made only under personal supervision, so as to prevent the spread of infection by towels. 53 3.—In order to minimise the risk of infection by handling books in common, it was suggested that the material should be allotted to individual scholars, and that for this purpose each set of books should be enclosed in a separate bag of such material as can be easily and readily cleansed. The expense of this would be small. 4.—With a view to minimise the amount of dust in the school, the drilling should be carried on out of doors or in a covered shed, and if at any time this was found to be impracticable, instructions should be given to prevent stamping on the floor during such exercises, as observations have shown that this is productive of dust. 5.—Attention was called to the insanitary construction of the latrine closets at present in use. The Medical Officer in reply wrote stating that "the defective sanitation has been reported to the Architect, and will be attended to." With the exception of Nos. 1 and 2 the above recommendations have been carried out. CREMATION. The principal objection to this—the most sanitary method of disposal of the dead—is entirely one of sentiment. Since the passing of the Cremation Act of 1902 the chief cause of opposition, apart from sentimentalism, was based upon the opportunity it might afford for the destruction by fire of evidence of foul play in cases of murder. This has now been entirely eliminated. The Cremation Act directs that cremation can only be carried out under regulations issued by the Home Secretary, and the regulations now in force are so carefully drawn up that—while they do not impose any unreasonable restrictions—the chances of any person who caused death maliciously being able to escape justice are now less than in cases when bodies are interred in the usual manner. This will be made clear by reference to the regulations themselves. It is scarcely necessary to discuss here the serious objections attaching to the system of earth burial now obtaining. They are many, and its abandonment for a method that is without danger to the living will inevitably be forced upon the public. Firstly, intramural burial was prohibited ; next, burial grounds in thickly populated districts have one by one been closed. When it is remembered that some 735,000 bodies have annually to be disposed of in England and Wales every year, it is not surprising to find that these difficulties arise— London alone contributes between seventy and eighty thousand of these bodies, and the time must come when the question of earth burial will become acute. It is not only insanitary, but expensive, and any method that provides the poorer classes with a cheaper mode of dealing with their dead should be 54 welcomed by them. Prejudice for many 'years has to a great extent been responsible for the slow growth of cremation in this country ; there are, however, clear indications of its coming into greater favour. That such is the case is shown by the following tabulated statement giving the number of bodies cremated annually since the Woking installation was established in 1885.. The several towns where Crematoria are erected are shown, and the date of opening them indicated in the first column. Thirteen Crematoria are now in operation in this country, four of which were opened during 1905. CREMATIONS IN THE UNITED KINGDOM, 21 Years—1885.1905. YEAR. Woking. Manchester. Glasgow. Liverpool. Hull. Leicester. Golder's Green. Birmingham. Darlington. Leeds. Word. Sheffield. Bradford. No. of Cremations each Year. 1885 3 ... ... ... ... ... ... ... ... ... ... ... ... 3 1886 10 ... ... ... ... ... ... ... ... ... ... ... ... 10 1887 13 ... ... ... ... ... ... ... ... ... ... ... ... 13 1888 28 ... ... ... ... ... ... ... ... ... ... ... ... 28 1889 46 ... ... ... ... ... ... ... ... ... ... ... ... 46 1890 54 ... ... ... ... ... ... ... ... ... ... ... ... 54 1891 99 ... ... ... ... ... ... ... ... ... ... ... ... 99 1892 104 3 ... ... ... ... ... ... ... ... ... ... ... 107 1893 101 30 ... ... ... ... ... ... ... ... ... ... ... 131 1894 125 47 ... ... ... ... ... ... ... ... ... ... ... 172 1895 150 58 1 ... ... ... ... ... ... ... ... ... ... 209 1896 137 52 10 ... ... ... ... ... ... ... ... ... ... 199 1897 173 51 16 7 ... ... ... ... ... ... ... ... ... 247 1898 240 62 12 23 ... ... ... ... ... ... ... ... ... 337 1899 240 88 16 23 ... ... ... ... ... ... ... ... ... 367 1900 301 83 20 40 ... ... ... ... ... ... ... ... ... 444 1901 273 96 18 37 17 ... ... ... ... ... ... ... ... 441 1902 275 81 20 54 13 1 5 ... ... ... ... ... ... 449 1903 143 92 24 38 18 5 158 3 1 ... ... ... ... 482 1904 138 98 19 42 20 8 220 17 7 ... ... ... ... 569 1905 95 97 35 35 15 16 252 22 4 16 9 7 1 604 Totals 2,748 938 191 299 83 30 635 42 12 16 9 7 1 5,011 . "Viscount Cross in the year 1879 forbid the practice of cremation there (Woking) under the threat of " passing an Act to make it illegal .... But in 1884 appeared the well.known judgment of Mr. Justice " Stephen, which, in the case of a child's body having been burned by its father contrary to the order of the " coroner, determined cremation to be a legal act, provided no nuisance be caused thereby to others."—Extract from speech made by the late Sir Henry Thompson at the opening of Golder's Green Crematorium, 22nd November, 1902. Vide " Transactions of Cremation Society of England, 1903," p. 31. Chart showing the increase of Cremation in the United Kingdom since that mode of disposal of the dead received legal sanction in 1884.. Average time occupied in incineration — 63 minutes. Average weight of Ash — 2 85% of Body. ResuIts, 1905. City of London Crematorium, IIford. 55 The chart, p. 54, shows in a graphic manner the marked increase of recent years in the proportion of cremations to deaths occurring in the United Kingdom. Reference is made in the foregoing remarks to the sentimental aspect of the question, and, unfortunately, while a great number of persons—probably the majority—express their sympathy with this method of burial reform, when death occurs their friends do not follow out the wishes of the deceased, in many cases because they shrink from a procedure of which they have at present but little information. As an illustration showing how familiarity with cremation dispels prejudice against it, the Manager of the Manchester Crematorium states that "out of " ninety.seven cremations in 1905, no fewer than sixty.eight were those of " persons who had resided in the immediate neighbourhood of the Crema. " torium. This important fact demonstrates that it is only necessary for a " true knowledge of cremation to become more widely spread to ensure its " more general adoption." There is one point with regard to cremation which should be placed very clearly before the working classes. Not only is it cheaper than interment, but there is only one method of procedure when cremation takes place, and that, therefore, all classes receive exactly the same treatment. The Honorary Secretary of the Scottish Burial Reform and Cremation Society, in reply to my enquiry as to the trend of public opinion, says : " Since I first came in touch with this movement, about sixteen years ago, " there is no doubt that the abhorrance and repugnance with which the public " originally regarded the subject has almost entirely disappeared. ... I am " quite convinced that, as time goes on, cremation will be more and more " adopted, although its universal adoption is out of the question." It is important that the sympathy of undertakers should be enlisted in the movement, as there is no question as to the great influence they are able to exercise in the question of disposal of the dead. In this connection the Superintendent of the Hull Crematorium remarks: "I am afraid it will be " some time before cremation will make much progress, unless we can get the " undertakers more in favour of it." Several cases I have heard of, " the " undertaker has persuaded the friends against it when they have been a bit " doubtful." The Manager of the Leicester Crematorium thinks "that in the near future " cremation will become much more popular than at present, more particularly " if it is adopted by the upper class as a means of disposing of the dead (and " there seems to be a leaning in that direction), then the middle classes " (upper and lower) are almost sure to ape them in this as in most things." The Manager of the Birmingham Crematorium is exceedingly sanguine, he considers "the prejudice which exists is gradually lessening, and that in a few " years cremation will be a general mode of the disposal of the dead." 56 The Superintendent of the Leeds Crematorium is of opinion "that the "prejudice against cremation is lessening, though dying hard. Personally I " Believe that there is an appreciable tendency towards this form of disposal of "the dead, and one hears repeated expressions of satisfaction that a Crema"torium has been provided in this neighbourhood. The near future may not "see any great change in the sentiment and opinion of the general public "towards cremation, but I incline towards the belief that the next generation "will accept cremation more as a custom and less as an innovation, the feeling " against it having to be banished by education and familiarity." 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 501 rooms, arranged in 241 tenements, and are occupied by 995 persons. Sixty.one per cent, are adults and thirty.nine per cent, children (under 14 years). The death rate for 1905 was 17.0 per 1,000 per annum [of which 35.3 per cent, was of children under 5 years of age]. Deaths of children under one year to 1,000 births were 138, as against 139 for the City generally. The number of births was 29, viz. : 17 males and 12 females. The birth rate, 29.1 per 1,000, is the lowest recorded since 1894, and is 6.7 per 1,000 below the average for the previous five years. Only one illegitimate birth has been recorded in these Dwellings since 1894, which is consistent with the high reputation for morality among the Jews, by whom they are mainly occupied. Table of Births and Deaths occurring at tiie Artizans' Dwellings, Stoney Lane, Houndsditch, during the year 1905. Name of Block. Births. Mortality from all Causes at subjoined Ages. Male. Female. At all ages. Under 1 year. l and under 5 5 and under 15 15 and under 25 25 and under 60 60 and upwards. NORTH BLOCK 4 1 4 1 ... 1 ... ... 2 SOUTH „ 3 3 4 2 ... ... ... 1 1 KING'S „ 1 3 1 • • • ... ... ... ... 1 QUEEN'S „ 6 1 4 ... ... ... ... ... 4 PRINCE'S „ 3 4 4 1 1 ... ... 1 1 TOTALS 17 12 17 4 1 1 ... 2 9 For details of Mortality, see Appendix A, page 147. 57 The baths provided for the use of the tenants of these buildings, which were opened on the 2nd May, 1904, were used during the last eight months of that year by 7,827 persons. An increase in the use of the baths is shown by the following figures for the corresponding months of 1905:— Males. Females. Total. May to December, 1904 3,766 4,061 7,827 „ „ 1905 4,155 4,963 9,118 Increase 389 Increase 902 Increase 1,291 The attendances during the whole year 1905 were as under Record of Attendances at the Baths, Artizans' Dwellings, 1905. Month. Sex. Total. Males. Females. Children. Adults. Children. Adults. January 188 175 147 158 668 February 138 132 92 153 515 March 138 186 127 192 643 April 170 168 115 168 621 May 269 300 333 366 1,268 June 231 255 317 358 1,161 July 359 414 599 630 2,002 August 377 315 230 240 1,162 September 190 200 323 281 994 October 261 246 285 227 1,019 November 159 180 231 194 764 December 206 193 183 166 748 Totals 2,686 2,764 2,982 3,133 11,565 The water supply to these buildings and the baths is derived from an artesian well, the sinking of which, commenced in August, 1887, was 58 completed in December, 1891. The bottom of the bore.hole is 512 feet 6 inches from the surface, and penetrates into the chalk to a depth of 284 feet 10 inches. In December, 1891, the surface or normal level of the water was 74 feet 8 inches below Ordnance datum and 62 feet 3 inches below Trinity High Water Mark, and when no pumping was taking place was 123 feet from the surface. In March, 1906, the normal level from the surface was 163 feet. The water has been analysed on several occasions and is of excellent quality, as shown below. For the purpose of comparison, the results of the analysis of an artesian well sunk at the " Baltic " is given. The water from both these wells have been certified to have the characteristics of green sand water of great organic purity. GRAINS PER GALLON. Well at Artizans' Dwellings. Well at " Baltic." 1897. 1899. 1906. 1906. Free Ammonia 0.0385 0.0406 0.0360 0.0345 Albuminoid Ammonia 0.0014 0.0011 0.0035 0.0015 Oxygen absorbed — — 0.018 0.025 Nitrogen as Nitrates None. None. 0.04 None. Chlorine 7.35 6.95 6.60 7.70 Equivalent to Common Salt 12.11 11.45 10.88 12.69 Total Hardness, in degrees 6° 6.3° 7° 6° Total Solids 44.66 46.90 46.20 49.40 DISINFECTION, &c., AT CITY MORTUARY. 2,158 articles of bedding, clothing, furniture, &c., were received at Golden Lane and disinfected, 1,635 of which were dealt with by arrangement by the Finsbury Borough Council during the rebuilding of the City disinfecting apparatus after destruction by fire. 183 bodies were received at the Mortuary, pending interment, and 164 inquests were held on bodies, and 8 inquests on fires. 59 Number of Articles disinfected, Bodies received at the Mortuary, and Inquests held at the Coroner's Court in the City during 1905, compared with the previous five years. Year. Articles of Bedding, &c., disinfected. Bodies received at the Mortuary. Inquests held on bodies. Inquests held on Fires. 1900 4,100 98 61 Nil. 1901 5,527 111 77 1 1902 5,399 164 140 1 1908 7,064 190 160 7 1904 2,560 184 150 6 Average for previous five years 4,930 149 118 3 1905 2,158 183 164 8 Inquests were held on fires that occurred at the following places :— 3rd February, 1905 . City Mills Buildings, 1, Upper Thames Street. 4th April, „ . 11, Queen Victoria Street—Mansion House Chambers. 4th „ „ . 1 and 2, Oxford Court. 19th October, „ . 63, St. Paul's Churchyard. 24th „ ,, . City Mills Buildings, 1, Upper Thames Street. 27th „ „ . A wagon laden with petrol burnt in Cornhill. 7th November, „ . 49, Queen Victoria Street. 30th „ „ 11, Bradford Avenue. Plans for re.constructing and re.arranging the buildings containing the post.mortem room, disinfecting machinery, &c., destroyed in October, 1904, were passed by the Committee on 28th March, 1905, tender for rebuilding accepted on 25th July, 1905, and the work of restoration is now almost completed. DISINFECTANTS. The methods adopted in 1901 for disinfecting public thoroughfares, &c., referred to in detail in your Medical Officer's Annual Reports for that and the succeeding year, were continued during 1905. As heretofore, all chemicals and disinfectants supplied throughout the Public Health Department were obtained through your Medical Officer. 60 They are used for the following purposes :— A. Deodorizing and " denaturalizing " condemned meat. B. Disinfeu :.g public conveniences (urinals, &c.). C. Disinfecting roadways, street gullies, &c. D. Disinfecting premises, &c., after infectious disease, drain testing, and sundries. The amounts spent during the past twelve months under these several headings were:— £ S. d. A. 8 12 0 B. 14 18 10 C. 115 1 0 D. 34 7 7 Total £172 19 5 The average amount expended during the previous three years for similar purposes was £169 2s. 4d. 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 101 4 2 7 February 262 7 13 21 March 189 5 175 19 April 314 4 8 26 May 283 7 30 45 June 279 14 14 93 July 276 12 23 56 August 590 8 26 103 September October November 271 4 11 37 December 282 4 10 32 Totals 2,847 69 312 439 61 MIDDLE DISTRICT. (Inspector E. J. Simmons.) Date of Report. Premises inspected. Orders issued. Notices served. Works completed. January 108 12 5 14 February 284 19 25 42 March 231 16 75 32 April 309 16 28 41 May 207 11 16 30 June 271 22 22 71 July 257 20 38 36 August 599 21 69 128 September October November 261 10 35 64 December 290 9 22 57 Totals 2,817 156 335 515 EAST DISTRICT. (Inspector W. H. Ralph.) Date of Report. Premises inspected. Orders issued. Notices served. Works completed. January 97 8 7 10 February 272 11 22 28 March 195 12 149 24 April 283 15 50 32 May 275 10 49 79 June 263 15 18 41 July 273 10 28 38 August 586 11 36 99 September October November 276 9 23 64 December 293 6 19 74 Totals 2,813 107 401 489 62 The foregoing are summarised as under :— District. Number of inspections made. Orders issued. Notices served. Improvements effected. West 2,847 69 312 439 Middle 2,817 156 385 515 East 2,813 107 401 489 Totals 8,477 332 1,048 1,443 Sanitary Inspections During 1905, compared with previous five years. Year. Inspections made. Sanitary Improvements effected. Notices served. 1900 8,463 1,186 1,053 1901 9,128 1,219 1,266 1902 8,000 957 1,131 1903 8,435 1,217 1,223 1904 8,282 1,209 1.077 Average previous five years 8,461 1,157 1,150 1905 8,477 1,443 1,048 REMOVAL OF HUMAN REMAINS FROM THE SITE OF THE OLD CHRIST'S HOSPITAL. In the course of excavations for additional buildings to St. Bartholomew's Hospital on the site of the old Christ's Hospital a large number of human remains were discovered. There is no record as to how or when these were placed in this position, but from the way in which they were grouped it would appear that they had been shot here after removal from some burial ground. A licence was obtained from the Home Office for the removal of these remains, and they were reinterred at the City of London Cemetery at Ilford under the supervision of your Medical Officer of Health. 63 HYGIENE OF HAIRDRESSERS AND BARBERS' SHOPS. Considerable progress has been made during the year in effecting improvements in the conduct of the business of Hairdressers and Barbers within the City, in accordance with the recommendations of the Sanitary Committee approved by the Corporation. Some difficulty was experienced in inducing City Hairdressers to effect registration with the Incorporated Guild of Hairdressers, Wigmakers and Perfumers, it being found that many of them, while willing to make improvements in the conduct of their business, declined to apply for the Certificate through the Incorporated Guild of Hairdressers. Inasmuch as the public health is directly concerned with the sanitation of Barbers' shops and Hairdressers' saloons, it is undesirable that any obstacle should be placed in the way of those willing to conform to the regulations and recommendations adopted by the Corporation. In these circumstances your Medical Officer advised that members of these trades should be notified that the Corporation would grant voluntary Certificates to any Hairdresser within the City boundary whose premises were in a sanitary condition and who would undertake to carry the regulations into effect. This course was agreed to and a form of Certificate adopted. Applications were received from the undermentioned Hairdressers whose establishments were in a satisfactory sanitary condition, and Certificates were issued to them upon their undertaking to comply with the Regulations of the Corporation :— Saulet, Lucien, 5, Eastcheap. " Electra House" (L. Flittner), Finsbury Pavement. The Gresham Toilet Company (E. H. Prince), 93a, Gresham Street. Danziger, Isaac, 8, Aldgate High Street. Schocke, Alexander, 149, Cannon Street. Woodhams, Percy, 17, Lime Street. .Collier, James Astill, 75, Little Britain. Cohen, Samuel, 1 and 2, Snow Hill. Foerstel, Frederick Gustav, 1, Telegraph Street. Gilbert, Percy, 14, Ivy Lane. Heifer, Antoine, 6, King Street, Cheapside. Kreisman, Louise, 21, Liverpool Street. Lehman, Charles, 8 and 9, Aldermanbury Postern. Meinhardt, Gustav Adolph, 120, Cheapside. New Baltic Toilet and General Requisite Company, Limited, £7, St. Mary Axe. * These premises have been closed since registration. 64 Pozzi, Pierre, 16, Lawrence Lane. Schwefel, Carl, 45, Eastcheap. .Szalay, Joseph Page, 8, Cullum Street. Friedel, Franz, 35, Moorgate Street. Hartmann, Carl, 5, Queen's Head Passage, Newgate Street. Krajewski, Gustav, 137, Fenchurch Street. Rudolph, Henry, 5, Crosby Square. A number of other Hairdressers have applied for registration, and are still under consideration. There is a general movement of the City Trade towards increased attention to sanitary matters, and the registration will undoubtedly give a feeling of confidence to those who make use of these establishments ; there is also indication of a growing desire on the part of Hairdressers in the City, and especially those occupying the better class of saloon, to take advantage of the Corporation's scheme of voluntary registration. Cases have occurred where members of the Trade, who at first opposed the movement, now recognise that it is of advantage to fall into line with those who have been placed on the register, particularly where there is close trade competition, even when so doing involves expenditure in carrying out the sanitary requirements. A case heard in the Marylebone County Court on the 1st January last illustrates the importance—both from the customer's and tradesman's point of view—of taking precautions against transmission of disease through the agency of infected implements. The plaintiff in the case sued a barber and hairdresser for damages in respect of his wages, pain, and suffering sustained through an attack of barber's rash, which it was alleged was contracted on the defendant's premises. The Jury awarded the plaintiff 15/. damages and costs. It is not too much to say that a similar cause for action cannot arise in connection with any of the registered Hairdressers in the City, while it is clearly shown by the above case that in unregistered places of business or in those where no proper antiseptic precautions are taken, not only is the customer liable to contract disease, but the proprietor of the business is rendered liable for heavy damages as a consequence. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1905. The Bill, as introduced, contained certain clauses relating to the prevention of Tuberculosis and infectious disease caused by contaminated milk, which were, with certain modifications, a reproduction of clauses introduced for similar purposes in the London County Council (General Powers Bill) for 1902, with regard to which I reported at length to the Sanitary Committee in January, 1905. * These premises have been closed since registration. 65 Powers were asked for the more efficient dealing not only with milk that had been contaminated and likely to cause infectious disease or Tuberculosis in those consuming it, but also with milk found to be for any reason unsound, unwholesome or unfit for the food of man. There was a general consensus of opinion that these former were needed, but there was much difference of opinion as to the administration of them, and the Corporation and the majority of the Borough Councils in the Metropolis petitioned against the County Council being the authority for that purpose as suggested in the Bill. In the passage of the Bill through the Commons an instruction was given to the Police and Sanitary Committees that the powers asked for by the London County Council, which were admitted to be important, should be entrusted to the City and the Metropolitan Borough Councils, but the County Council subsequently withdrew the whole of these provisions, Part V. of the Bill, which was to give power to the London County Council to make representations to the Local Government Board as to the administration of the Sale of Food and Drugs Acts, having previously been struck out by resolution of the House. HOUSE REFUSE REMOVAL The Engineer informs me that the refuse removed from the City in 1905 consisted of 31,915 cartloads of street sweepings and slop, and 51,527 loads of house and trade refuse ; total, 83,442. Of this bulk, 16,222 loads were consumed by the Destructor at Letts' Wharf; this was only 19'4 per cent., but the use of the Destructor was discontinued in September, 1905, since which date all refuse has been removed by barge. Refuse Dealt with during 1905 and previous Five Years. Year. Street Sweepings and Slop. House and Trade Refuse. Total. No. of Loads Cremated in Destructor. Per Cent. Cremated. 1900 Loads. 28,708 Loads. 44,841 Loads. 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 1903 31,863 50,584 82,447 26,421 32.0 1904 31,979 50,742 82,721 27,554 33.3 Average of previous five years : 36,699 56,896 93,595 25,399 27.1 1905 31,915 51,527 83,442 16,222 19.4 66 TENEMENT HOUSES. District. No. of Houses on Register. No of Lodgers. No. of Tenements. Average No. of Persons per Tenement. Sanitary Notices Served. West 158 1,306 545 2.39 204 Middle 43 283 98 2.88 52 East 142 1,101 430 2.55 209 Total 343 2,690 1,073 2.50 465 The houses in question are periodically 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 465 Notices [or, 204, 52, and 209 during the year, in the West, Middle, and East Districts respectively. In addition to the foregoing there are ten 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:— west district. Name and situation of Artizans' Block Dwellings. No. of Tenements. One Room. Two Booms. Three Rooms. Four Rooms. Five, or more Rooms. Albion Buildings (No. 21), Bartholomew Close ... 10 ... ... ... Albion Buildings (No. 22), Bartholomew Close ... 10 ... ... ... Bartholomew House, Bartholomew Close 16 2 ... ... ... Dean Street Blocks, Fetter Lane— Block A 3 4 ... 1 ... „ B 2 5 ... ... ... „ C 6 3 ... ... ... „ D 2 5 ... ... ... „ E 2 5 ... ... ... „ F ... 4 ... 1 ... St. Ann's Chambers, Ludgate Hill 6 18 ... ... ... Took's Court, Nos. 1 and 2 ... 9 ... ... ... Bloomfield House, Snow Hill ... 20 ... 2 ... Total Seven " Blocks " 37 95 ... 4 ... 67 MIDDLE DISTRICT. Name and situation of Artizans' Block Dwellings. No. of Tenements. One Room. Two Rooms. Three Rooms. Four Rooms. Five, or more Rooms. Bridgewater House, Fann Street ... 12 ... ... ... City Buildings, Moor Lane ... 20 12 ... ... Total Two " Blocks " ... 82 12 ... ... EAST DISTRICT. Name and situation of Artizans' Block Dwellings. No. of Tenements. One Room. Two Rooms. Three Rooms. Four Rooms. Five, or more Rooms. Harrow Alley and Stoney Lane— North Block ... 48 8 ... ... South „ 5 22 13 ... ... Prince's ,, 5 50 ... ... ... Queen's ,, 5 40 5 ... ... King's „ 8 16 16 ... ... Barker's Buildings, Catherine Wheel Alley, Bishopsgate Street Without 12 7 3 ... ... Total Two " Blocks " 35 183 45 ... ... These ten Blocks, containing 443 tenements, are inhabited by 1,556 persons = 3.5 persons to each tenement. COMMON LODGING-HOUSES. Of the three common lodging.houses on the Register at the commencement of 1905 two have been closed, the property having been acquired by the Corporation for rebuilding purposes. One other has been placed on the Register, viz., No. 116, Middlesex Street. This building, which has been acquired by the Salvation Army, is a substantial brick structure of the warehouse class formerly used as a boot factory. It is situated near the boundary of Stepney, but within the City precincts. The premises consist of basement, ground, and five upper floors. All floors have been rendered fireproof. The doors of the dormitories are of two. inch teak and open outwards on to stone staircases. The dormitories are well 68 lighted and have through ventilation. The whole building is warmed by hot.water pipes. The drainage, water.closets, lavatory basins, baths, &c., were newly constructed, and the whole of the appointments and fittings are of excellent design. On 27th February of this year your Medical Officer laid before the Sanitary Committee formal certificate with regard to this building as required by Section 10 of the City of London Sewers Act, 1851, and the premises are now registered as a common lodging.house for accommodating 453 persons. The establishment of a common lodging.house of such dimensions within the City will probably result in an increase in the number of persons chargeable upon the City of London Union ; as destitute inmates will be removed to the Infirmary, and will require careful supervision. An important judgment was delivered last year in the case of Parker v. Talbot, which decided that charitable institutions run on common lodging. house lines and where no charge is made are not common lodging.houses, and can therefore be carried on without licence or registration. "HIGH COURT OF JUSTICE.. " COURT OF APPEAL, October 24th, 25th, November 1st. " Before Vaughan Williams, Stirling, and Cozens Hardy, L.JJ. " parker V. talbot. " Common Lodging.House—Registration—No payment. .' If no charge is made to persons who frequent a charitable instihition which is con. " ducted on lines similar to common lodging.houses, such institution is not a " common lodging.house within the meaning of the Common Lodging.IIouses Act, " 1851.1853, and no registration or licence is required. " This was an appeal from a judgment of Kekewich, J., holding that a charitable " institution known as the Providence (Row) Night Refuge and Home was a com. " mon lodging.house, and ought to have registered as such under the Common " Lodging.Houses Act, 1851, and that a licence to carry it on should have been " obtained under the London County Council (General Powers) Act, 1902. The " action was started with the object of obtaining a decision of the Court of Appeal " on the point, as a divisional court had held in Gilbert v. Jones (1905), 2 K.B. 691, " that the institution was a common lodging.house, and there was no appeal from " that decision. Kekewich, J., held in accordance with that decision. " Vaughan Williams, L.J., said he would have decided the case in the same way " as the divisional court had done, were it not for the Common Lodging.Houses " Act (Ireland), 1860. He thought the definition clause in Section 3 of that Act " was meant to apply to the English Acts of 1851.1853. That Section defined the " term ' common lodging.house ' as meaning ' a house in which persons are harboured " ' or lodged for hire for a single night or for less than a week at a time, or any part " ' of which is let for any term less than a week.' People in this institution were " not lodged for hire, and therefore it was not a common.lodging.house. The " attention of the lower courts had not been drawn to this statute. " It was afterwards pointed out to the Court that the Common Lodging.Houses " (Ireland) Act, 1860, had been repealed. The Court held that this made no " difference, as the Act declared what meaning was intended to be put on the " earlier Acts." . " Public Health," January, 1906. 69 FACTORY AND WORKSHOP ACT, 1901. FACTORIES, WORKSHOPS, AND WORKPLACES. This Act came into operation on the 1st January, 1902, but in view of the obligations of the Corporation thereunder, the work of inspection was commenced in the preceding year. The nucleus of the Register of Workshops was compiled from information supplied by H.M. Factory Department from the existing Registers. This, however, was found upon inspection, to be very imperfect, many of the workshops having ceased to exist, and some factories inadvertently having been included. These discrepancies, with others, as, for instance, places originally occupied as " workshops " developing into " factories," have been adjusted, and the Register is now as reasonably complete as the fluctuating character of the trades registered permit. It has been found necessary, in order to ensure accuracy in the record, as well as for the convenience of the Department, that a new Register should be compiled each year, all lapsed workshops being eliminated. The Act defines various classes of workshops, and the Workshop Register is so arranged as to show the nature of the workshops inspected, whether of a general character, or those specially defined in the Act as "Domestic," " Tenement," or " Men's " workshops, the date notified or discovered and inspected, the number of workers employed (whether male or female), and the initials of the officer inspecting. The Register of Workshops for 1905 shows a total of 1,947 premises where workshops exist or have existed during the preceding year. Workshops at 478 premises have ceased to exist, and 612 new premises have been added. It has not been found possible to inspect all the premises registered, so that the total number of workrooms existing cannot be given. Some of the trades have ten or more workshops on the premises. There is no statutory obligation to keep a Register of factories or workplaces, but for the sake of convenience Registers have been adopted in both cases on similar lines to that for workshops, but the registration of workplaces has been confined to kitchens of restaurants, &c.—total number of kitchens registered during the year was 44. The Register of workplaces dates from 1902, that for factories was commenced towards the end of 1904. The total number of workrooms in factories, workshops, and workplaces inspected during the year amounts to 3,443, but this does not represent the total number registered, owing, as before mentioned, to some 330 premises not 70 having been re.inspected. It should be mentioned that railway station and other public lavatories, stable yards, &c., are not included in the above figures, although they come within the definition of " workplace." These places are regularly inspected, although they do not appear in the Factory Act Registers. Barbers' shops are also workplaces, even if they are not workshops, and there are many other occupations where the Act would apply. The inspections of the Women Sanitary Inspectors are included in the above figures, but the details of the work performed appear under a separate heading on page 79. The following is a summary of inspections made annually since the passing of the Act:— Factories. 1904—Inspections during the year 78 1905 ,, ,, ,, 735 813 Workshops. 1901 745 1902 481 1903 547 1904 1,293 1905 2,025 - 5,091 Workplaces. 1902 468 1903 357 1904 93 1905 854 1,772 Totals. Inspections during 1901-5 7,676 ” ” 1905 3,614 FACTORIES. In my last Annual Report I mentioned that but little opportunity had hitherto existed for the inspection of factories. The inspection of factories falls primarily within the scope of the duties of H.M. Factory Department, but Local Authorities also have duties with respect to the sanitary conditions, independently of the Home Office, it being their duty to deal with nuisances existing on any premises. It is the duty of 71 H.M. Factory Inspector to give notice to the Local Sanitary Authority of any nuisance which is not remediable under the Factory and Workshop Act. A list of complaints thus received is dealt with on page 77. With a view of anticipating the action of H.M. Factory Inspectors, a regular inspection of factories within the City was instituted in 1904, and systematically pursued during 1905, with the result that 230 premises have been inspected, having an aggregate of 750 workrooms, an average of over three workrooms to each. The trades engaged in include :— Bookbinding. Bookfolding. Cigarette making. Cigars and tobacco. Cloth working. Costumes. Die sinking. Electrotyping. Engraving. Envelopes. Hatmaking. Machine ruling. Mantle making. Perfumery. Pickling. Printing. Stationery. Stereotyping. Surgical instruments, &c., &c. Speaking generally, the defects found are similar to those found in most workshops on first inspection, viz., want of suitable water.closet accommodation and defective sanitary fittings, also defective and dirty walls, floors, and ceilings. Most of the work before mentioned has been performed independently of any action on the part of H.M. Factory Inspectors, and in no way interferes with the work of that department, except in removing cause for future complaint. It may be of interest to state that in the 230 premises visited there were 39 workrooms in which women were exclusively employed ; 74 where men were so employed, and in the remaining 637 both sexes were engaged. . Details of Factory Inspections, 1905. Initial inspections (workrooms) 610 Periodical inspections 15 Re.inspections (sanitary work needed) 793 1,418 Workers employed— Men 3,600 Women 2,317 Young persons (male) 15 5,932 Notices served— Intimation 145 Statutory 35 180 *For details of Women Sanitary Inspectors' work, see page 79. 72 Defects remedied. Walls, ceilings and approaches cleansed 117 Ventilation improved 27 Overcrowding abated 8 Drains relaid or amended 13 Soil pipes repaired or renewed 18 Urinals repaired or renewed 5 „ cleansed 2 „ flush improved 1 „ floor made impervious 1 9 Sink wastes amended 27 Rain-water pipes repaired 25 Cisterns cleansed or covered 33 Refuse receptacles provided 12 Water-close ts— Separate and suitable provided 9 Additional provided 7 Lobbies constructed 90 Ventilated 53 Floors made impervious 5 Pans cleansed 128 Walls and ceilings cleansed 90 Flush improved 39 421 General defects remedied 295 Total defects remedied 1,005 Number of water-closets improved— For men 182 For women 78 260 WORKSHOPS. As mentioned in previous Reports, the sanitary defects generally found in workshops may be classified under the following headings:— Want of cleansing. Insufficient ventilation. Overcrowding. The lack of separate and suitable water-closet accommodation for both sexes. An impression is prevalent that whitewashing and cleansing generally are only required at stated periods, say once in six or twelve months or longer, the real test, viz., whether cleansing is wanted at the particular time, being overlooked. However, but little trouble has been experienced in 73 getting necessary work done when the facts were brought to the knowledge of the parties responsible. Much difficulty is experienced in dealing with the subject of ventilation where the employment of gas rings and stoves, &c., is the polluting agent— in many cases the only real solution in such cases is mechanical ventilation. * Details of Workshop Inspections, 1905. New workshops notified by H.M. Factory Department 66 No Abstract of Act affixed where women and young persons were employed — cases notified to H.M. Factory Inspector 51 Domestic workshops registered 8 Statutory Certificates for cleansing issued by Medical Officer of Health 74 Outworkers living in the City notified to the Corporation 236 Outworkers notified by Corporation to outside districts 7,891 Complaints— From H.M. Factory Inspector 32 General 24 Total number of complaints 56 Initial inspections (workrooms) 548 Periodical inspections 758 Re-inspections (sanitary work in hand) 2,974 3,280 Workers employed— Men 3,493 Women 2,870 Young persons (male) 44 ,, „ (female) 55 6,462 Notices served— Intimation 463 Statutory 123 586 Defects remedied. Walls, ceilings, and approaches cleansed 426 Ventilation improved 125 Overcrowding abated 15 Drains relaid or amended 47 Soil pipes repaired or renewed 54 Urinals repaired or renewed 3 „ flush improved 4 7 * For details of Women Sanitary Inspectors' work, see page 79. 74 Sink wastes amended 81 Rain-water pipes repaired 28 Cisterns cleansed or covered 71 Refuse receptacles provided 66 Water-closets— Separate and suitable provided 35 Additional provided 6 Lobbies constructed 85 Ventilated 147 Floors made impervious 7 Pans cleansed 252 Walls and ceilings cleansed 141 Flush improved 89 762 General defects remedied 603 Total defects remedied 2,285 Number of water-closets improved— For men 305 For women 196 501 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)). Early in that year the whole of the underground bakehouses had been dealt with, i.e., were certified as suitable or had permanently ceased to be used as such. The following is a list of the underground bakehouses in the City dealt with under the Factory and Workshop Act, 1901:— 188, Aldersgate Street. 85, Fore Street. 81, Bishopsgate Street Without. †67, Farringdon Street. 59 to 62, „ „ †88, †4, Broadway. †93, Fetter Lane. 95, Cannon Street. † 12, Gracechurch Street. 8, Copthall Avenue. †21, Holborn. 15, Cornhill. 8 to 14, King Street, Snow Hill. 15, Duke Street. 48, Knightrider Street. * 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. † These have been established at least 21 years. 75 8, Lambeth Hill. 3, Pancras Lane. 18, Long Lane. 21, Stoney Lane. †37, Middlesex Street. 68, St. Mary Axe. †63 to 65, „ †75, St. Paul's Churchyard. †l22, ,, 194, Upper Thames Street. 31, Newbury Street. ABOVEGROUND BAKEHOUSES. The following is a list of bakehouses in the City situated aboveground:— 90, Bishopsgate Street Without. *155, Minories. 19 and 20, Fetter Lane. †85, Middlesex Street. †9 and 10, Hart Street. *4, Water Lane. *18-19, Leadenhall Market. †l3, Widegate Street. †61, Middlesex Street. *93-94, Upper Thames Street. SUMMARY. Underground bakehouses 27 Aboveground bakehouses 10 Total number of bakehouses in the City 37 During the year 89 inspections of bakehouses were made, and with three exceptions they were found to be up to the standard required by the Act. The defect in each of the three cases mentioned was want of cleanliness in the walls or ceilings, which was remedied forthwith on service of Notice. One new aboveground bakehouse was registered. WORKPLACES. (Kitchens of Restaurants, &c.). The inspection of these places was proceeded with as usual, and there is little to add to what has been set forth in former Reports, especially that of last year. In that Report the subject was dealt with in a fairly exhaustive manner from the sanitary standpoint, and some of the paragraphs which might be of value to anyone seeking information on the several points are added as an appendix to this Report (see page 166). The question of suitable larder accommodation has received special attention. In one case, meat was found deposited in what was practically the lobby of a water-closet, the occupier protesting that he had no other place for it; but an application to the owner of the premises resulted in a good safe being provided outside a staircase window. * Established during 1903. † These have been established at least 21 years. 76 Most of the persons spoken to on the subject of larder accommodation state that they have no need for a larder, as they clear out from day to day, and so have nothing to store in the way of perishable food. This is no doubt usually the case, but it is obvious that a suitable larder cannot fail to be required occasionally. The meat and other foods purveyed in the City restaurants is inspected in the course of the ordinary visits of the Inspector. *Details of Workplace Inspections, &c., 1905. Initial inspections 32 Periodical inspections 523 Re-inspections (sanitary works) 329 Total inspections 884 Workers employed— Males 2,884 Females 2,686 Total number of workers 5,570 Notices served— Intimation 50 Statutory 28 Total Notices served 78 Defects remedied. Drains relaid or amended 2 Kitchens— Walls and ceilings cleansed 40 Light and ventilation improved 35 75 Water-closets— Separate accommodation provided for sexes— Males1 Females 1 2 Arrangements improved— Males11 Females 16 27 Water supply improved 10 Refuse receptacles provided 15 General defects remedied 112 Total defects remedied during the year 243 * For details of Women Sanitary Inspectors' work, see page 81. 77 Sanitary Defects in Factories and Workshops notified in 1905 by H.M. Inspectors oe Factories. In 1905 thirty-two 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. With few exceptions, the sanitary defects reported at the thirty-two 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 1904 31 1905 32 Annual average 48 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. (6) Defective waste pipes. &c. 78 VOLUNTARY SANITARY CERTIFICATES FOR KITCHENS AND ABOYEGROUND BAKEHOUSES. In January, 1904, the Corporation adopted a standard of sanitary requirements for kitchens and aboveground bakehouses to be complied with by applicants for Certificates. Up to the present only three Certificates have been granted. Two applications were received during the year, but were not proceeded with. OUTWORKERS. The difficulty of getting employers of outworkers to send in lists as required by the Act still continues. With a view of dealing with defaulters in an effectual manner, all employers of outworkers registered were informed by post of the requirements of the Act, but out of a total of 376 notices issued only 162 firms replied, leaving 214 who either neglected or declined to send lists. It has been decided to give notice to all employers of outworkers, in the future, a short time before the lists become due. This was done early in the present year (1906) with good results. INFECTIOUS DISEASE AT OUTWORKERS' PREMISES. Domestic Workshop. Two cases of Scarlet Fever occurred in the children of an outworker. The family consisted of 13 persons in all, the elder children being, with their parents, engaged in the tailoring trade. The work was stopped immediately, and every precaution taken to prevent the spread of the disease. After disinfection the premises were thoroughly cleansed throughout. 79 WOMEN SANITARY INSPECTORS. Summary of work done under the Factory and Workshop Act, 1901, during the year 1905:— Factories inspected 19 „ periodical inspections 12 „ re-inspections 12 Workshops (workrooms inspected, measured, &c.) 262 „ Periodical inspections 457 „ re-inspections 219 Domestic workshops inspected 3 „ Periodical inspections 18 „ re-inspections 7 Workplaces (Kitchens) inspected 12 „ Periodical inspections 287 „ re-inspections 391 Offices inspected 38 „ re-inspections 14 Workers employed:—Men, 785 ; Women, 11,088 11,873 Complaints received from H.M. Inspectors of Factories 8 General complaints received 29 Defects found 833 Defects remedied—W.C's provided or improved 180 Ventilation of workrooms improved 58 Overcrowding abated 10 Workshops, &c., cleansed 144 General defects remedied 67 Total number of defects remedied and improvements effected 459 Defects referred to District Inspectors 153 Notices served:—Intimation, 143; Statutory, 19162 WORKSHOPS. Seven hundred and nineteen workshops where women are employed have been inspected during the year. The figures for the previous three years were :—1902, 140 ; 1903, 283 5 and 1904, 345. The following Aprons Art needlework Artificial flowers Baby clothes Bags Belts Black bordering Blinds Blouses Bonnet shapes trades are represented:— Boxes Christmas cards Braces Collars Brushes Corsets Butchers' clothing Costumes Button-holing Cushions Carding combs, Dressmakers pencils, &c. Carpet-sewing Caps Chiffon tucking Dressing gowns Dressmakers' sundries Drugs Embroidery Fancy goods Feathers Fine art publishers Fans Flags Frames Frilling Fur sewing Gloves 80 Gold blocking Mantles Shirts Ties Gold polishing Millinery Shoes (babies') Trimmings Hair nets Motor veils, &c. Shoe-bows Umbrellas Hat making Muslin caps Silk hemming Umbrella tassels Hat-bands Pattern cards Skirts Underclothing Household linen Perfumery Stay busks Upholstery Lace Pickles String bags Wadding Lampshapes Pleating Tailors (outWaistcoats Laundries Robes workers) Waterproof goods Lining As in previous years, by far the largest number of defects found was in respect of sanitary accommodation; want of cleansing, and insufficient ventilation of workrooms being next in order. Vitiation of the air of the workshop by gas whether used for heating or for lighting continues to be a source of difficulty. Where gas stoves are used a hood and flue are required in order to carry off the injurious products of combustion, and where the gas is used for lighting purposes, the substitution of incandescent for ordinary burners effects a considerable reduction in the vitiation of the air. OUTWORKERS' PREMISES. In the majority of cases the outworkers on the register employ workers other than members of their own families, and their premises are therefore included under the heading "Workshops." There are, besides, twenty-one domestic workshops which have been inspected; with two exceptions, these latter were found to be in a fairly satisfactory condition as regards cleanliness of rooms, &c. Some drainage and structural defects were discovered and were referred to the District Inspector. In the case of one outworker, an alien, who employed three men and two women, the workrooms were found to be in such an extremely dirty condition that the outworkers' employer (a tailor living outside the City) was informed that the place in which the work was being done was in such a condition that no more work should be sent to him until the premises had been cleansed, failing which the matter would be dealt with under Section 108, Factory and Workshop Act, 1901. The employer wrote in reply thanking your Medical Officer for the notification, and stating that no more work would be given to the outworker. In addition to the dirty condition of the workrooms, one was found to be overcrowded, the roof was defective, an accumulation of refuse on an out-house roof gave off very offensive effluvia, which came into the house through the staircase window, the stairs were dirty, the W.C. in the yard was in a filthy condition and was used in common by the persons of both sexes employed. Notices were served on the owner and on the occupier, calling upon them to abate the nuisances and remedy the defects complained of. 81 The owner put the more immediately necessary cleansing in hand, and after some difficulty got rid of the tenant, when the premises were cleansed throughout and the other defects remedied. INDUSTRIAL LAW INDEMNITY FUND. A report of the working of this Fund has been received. It is formed to protect women and young persons of both sexes who are dismissed from their employment for giving truthful evidence to H.M. Inspectors of Factories and Mines, Sanitary Inspectors and Shop Hours Inspectors. Several typical cases are quoted which show that the Fund is administere with discretion and that it does useful work in removing hardships which must often arise in enforcing the provisions of the Factory and Workshop Act, and other laws relating to industrial matters. WORKPLACES (Kitchens). Twelve new kitchens have been inspected and two hundred and eightyseven periodical inspections of those previously visited have been made. The defects found may be grouped under three heads, viz.:— (i.) Want of cleansing. (ii.) Want of ventilation— (a) Gas stoves in kitchens without any effectual means of carrying off the injurious products of combustion. (b) Kitchens otherwise badly ventilated. (iii.) Sanitary conveniences not properly cut off from direct communication with the kitchens or the rooms. In several cases it was found that in order to enlarge the kitchen an adjoining passage had been thrown into it, or some other structural alteration had been made which resulted in establishing a direct communication between the kitchen and the sanitary convenience. The work needed to remedy the defects has necessitated three hundred and ninety-one re-inspections, and is for the most part now completed. 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. 82 Eight Domestic Workshops within the City were duly notified to H.M. Chief Inspector of Factories as required —four were removed from the Register, having ceased to exist. The following is a list of those on the Register at the end of the year:— ]Premises. Trade. Workers. Total Workers. M. F. †9, Artillery Lane Tailor 1 1 2 *11, Bartholomew Close Do - 1 1 †34A, Beech Street Do 1 - 1 Do. Millinery - 1 1 †2, Bride Street Tailor 1 - 1 †2, Bridgewater House Waistcoats - 1 1 *2.5, City Buildings Tailor 1 1 2 6, Cloth Fair Waistcoats - 2 2 †29, Cloth Fair Tailor 2 - 2 *2, Evangelist Court Umbrellas - 1 1 †8, Ellison Street Tailor 1 - 1 †9, Ellison Street Do. 1 - 1 2, Fenton's Buildings Do. 1 - 1 *9, Giltspur Street Shoe-bows - 1 1 2, Gunpowder Alley Blouses - 1 1 35, Harrow Alley Tailor 5 - 5 17, Hutchison Street Caps 2 - 2 31, Little Britain Tailor 1 1 2 †20, Middle Street Ties - 1 1 †96, Minories Tailor 2 - 2 41, Mitre Street Do. 1 - 1 †l0, North Block, Artizans' Street Dressing-gowns - 3 3 2, Queen's Court Tailor 1 - 1 Do. Waistcoats - 1 1 9, Vine Street Tailor 1 1 2 †l2, Water Lane Do. 1 1 2 Totals 23 18 41 † Registered in 1903. * do. 1904. 83 OFFICES. Thirty-eight offices where lady clerks are employed have been inspected with reference to the sanitary accommodation provided. In thirty cases no separate sanitary convenience was provided, at three premises the accommodation was unsuitable, and at three the conveniences were dirty. One room, in which eleven girls were employed in typewriting, was found to be in a very dirty condition, two rooms were badly ventilated and there were five "general" defects, making a total of forty-four defects in thirty-four offices. In four cases there was no cause for action. Thirty-one defects have already been remedied and the remainder are in hand, with one exception, where the firm were shortly giving up the lease of the premises, and the required re-arrangement of the sanitary accommodation was not pressed. On the whole the owners of premises as well as the employers have shown themselves ready to carry out the suggestions made. LADIES' WAITING ROOMS AT RAILWAY STATIONS. There are twenty-three railway stations in the City at which ladies' waiting rooms are provided. The number of waiting rooms is twenty-nine, containing eighty-eight conveniences. These have been periodically inspected, and a very marked improvement is noticeable in the condition of the lavatories and sanitary conveniences. This is especially the case at Liverpool Street Station, where, on the suggestion of your Medical Officer of Health, new wash-down closets have been substituted for those of the old valve pattern. The latter were a constant source of complaint, but since the new ones have been adopted the conveniences at all the waiting rooms at this station have been reported as being in quite a satisfactory condition. The ventilation of the ladies' waiting rooms at Fenchurch Street (First Class) and at Aldersgate Street has been considerably improved, and at the latter station the conveniences are now lighted naturally, doing away with the gas which was formerly burnt all day. Some minor defects were found at various stations, and these have been remedied. SANITARY ACCOMMODATION FOR WOMEN. In November last your Medical Officer reported to the Streets Committee on the above question as follows:— " There are now eleven underground conveniences for women in the " City, as follows :— " Aldersgate Street (General Post Office). " Aldersgate Street (North end). *" Circus Place. *" Farringdon Street South (Ludgate Circus). 84 " Farringdon Street North. *" Golden Lane. " Holborn. " Minories. " Upper Thames Street. " West Smithfield. " Guildhall Buildings (not yet opened). " Free Accommodation. "At those marked with an asterisk free accommodation is provided " for women only, and at Circus Place for children only. "These conveniences are systematically inspected by your Women "Sanitary Inspectors, and as a rule are found to be kept clean and in "good sanitary condition. "Marked improvement has been effected in some of them by the "fixing of new gas stoves with suitable flues to carry off the products " of combustion, and I understand that shortly all will be thus provided. "Minor defects are reported to Mr. Engineer from time to time and " dealt with by him. "I have now to call your attention to the urgent necessity for "increased free accommodation, and improvement in that already "supplied. "It is not necessary to enter into details as to the serious injury that "may be inflicted upon women by the absence of lavatory accommodation. "Suflice it is to state that serious and life-long trouble is at times the "result of such absence. This has already been recognised and "provision made wherever practicable. "While the ill-results are far more serious in the case of women than "of men for physiological reasons, yet with the exception of the two "places above mentioned, no free accommodation is provided for them, "and unfortunately, as long as payment is required, for many it is beyond "reach. "The largest class of woman for whom free accommodation is needed "in the City is composed of girls who carry materials to and from the "shops and places where the work is given out. "The number of outworkers employed by City firms is considerable "(already more than 7,000 have been registered), and of these only a "very small proportion live in the City. "These outworkers largely employ girls to carry the work to and fro, "and these girls have frequently long distances to traverse, often carrying "heavy weights. The nature of their employment entails upon them "long waiting and need for haste on their return journey. For them no 85 "accommodation is provided at the workshop, and they obviously cannot "afford to pay out of their scanty earnings even the small amount "required for the use of the public convenience, and the present provision "being situated in the Northern and Western Districts only, it is not ''available to many of these women to whom time is money, and who "have but little knowledge of the grave consequences that often result "from neglect of natural functions. "It is necessary that free accommodation be provided for women "at each public convenience, and I recommend that this be at once "arranged for. "Arrangements for Free Accommodation. "At present the closets for free accommodation are provided with "doors without fastenings, or curtains only, to which system there are "many objections. "The attendant has no control as to the number of persons entering "the compartment at once—has no opportunity (where the conveniences "are in constant use) of seeing whether the closet is in proper order — " and in any case of abuse has no means of detecting the offender— "while further, the absence of privacy undoubtedly means unnecessary "discomfort in the case of decent persons who by reason of poverty or "other cause are compelled to seek free accommodation. "I have therefore to recommend that all free conveniences be fitted "with doors (without inside bolts), and that such doors be fastened "with locks under the control of the attendants. "Increased accommodation for women is urgently needed in the "Eastern Districts, Aldgate and Bishopsgate, and I recommend that it "be referred to Mr. Engineer to consider and report as to how this "should be provided." On consideration of the above Report the Committee decided at once to provide free accommodation at each public convenience within the City. It was further resolved to refer to Mr. Engineer to report as to further sanitary accommodation for women in Aldgate and Bishopsgate, and the Court of Common Council subsequently agreed (1st March, 1906) to provide further accommodation for women at the existing underground conveniences in Aldgate High Street and Bishopsgate Street Without at an estimated cost of £1,600. The gas stoves referred to in the foregoing Report have since been removed, and new ones with suitable flues for carrying off the products of combustion substituted. These have effected a marked improvement in the condition of the atmosphere in the attendants' rooms. 86 THIS TABLE WAS ISSUED BY THE LOCAL GOVERNMENT BOARD BY REQUEST OF_THE SECRETARY OF STATE. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1 9 03. 1.—INSPECTION. Inspections made by Sanitary Inspectors. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) † 656 184 - Workshops (including Workshop Laundries) † 2,025 709 - Workplaces † 854 102 - Homeworkers' Premises † 21 5 - Total † 3,556 1,000 - 2.—DEFECTS FOUND. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts:—* Want of cleanliness 852 727 - - Want of ventilation 471 245 1 - Overcrowding 34 33 - - Want of drainage of floors - - - - Other nuisances ‡ 1,258 1,545 - - †Sanitary accommodations insufficient 24 17 - - unsuitable or defective ‡ 1,220 1,374 - - not separate for sexes 66 51 - - Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) - - - - Breach of special sanitary requirements for bakehouses(SS. 97 to 100) 3 3 - - Failure as regard lists of outworkers (S. 107) 376 214 - - Giving out work to be done in Premises which are unwholesome ( S.108) 1 1 - - infected (S.110) 1 1 - - Allowing wearing apparel to be made in premises infected by scarlet fever or small-pox (8. 109) - - - - Other offences - - - - Total 4,306 4,211 1 - * IncludiDg those specified in Sections 2, 3, 7 and 8 of the Factory Act as remediable under the Public Health Acts, † These figures include initial inspections and periodical re-inspections, as indicated in the body of the Report. ‡ N.B.—Defects remedied include those brought forward from last year. 87 3.—OTHER MATTERS. Class. Number. Matters notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (S. 133) 51 Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (S. 5) Notified by H.M. Inspector 32 Reports (of action taken) sent to H.M. Inspectors 32 Other 1 Underground Bakehouses (S. 101):— In use at the end of 1905 27 Homework:— Number of Lists of Outworkers* (S. 107):— Lists. Outworkers. Lists received 576 8,127 Addresses of outworkers forwarded to other Authorities 7,891 received from other Authorities 236 Homework in unwholesome or infected premises:— Wearing Apparel. Other. Notices prohibiting homework in unwholesome premises (S. 108) 1 - Cases of infectious disease notified in homeworkers' premises 1 - Orders prohibiting homework in infected premises (S. 110) — — Workshops on the Register (S. 131) at the end of 1905. Important classeof workshops, such as workshop bakehouses, may be enumerated here. Workshop Bakehouses (including two Factory Bakehouses) 37 Other Workshops †1,947 Total number or Workshops on Register 1,984 * The Lists should be received twice in the year. The year's figures required in the Table are then obtained by adding together the two half-yearly totals. † Number of premises registered (number of workshops not known, the whole of the premises registered not having been re-inspected). 88 FACTORY AND WORKSHOP ACT (1901) AMENDMENT BILL. This Amendment Bill was an attempt by Private Members to give effect, with some slight modification, to the clause affecting laundries of religious or charitable institutions, as provided for in the original draft of the Factory and Workshop Act Amendment Bill of 1901. Under the existing law laundries carried on in religious or charitable institutions by way of trade or for purposes of gain are exempted from the operations of the Factory and Workshop Act. This exemption was made originally in the Factory and Workshop Act, 1895, when laundries were brought within the scope of the Factory Act. The Factory and Workshop Act Amendment Bill, 1901, contained considerable amendments of the provisions relating to laundries, while those of religious and charitable institutions were to be placed under supervision under certain conditions. In Committee, however, so much opposition was made to these proposals that the clause was withdrawn by the Government, and the law of 1895 on the subject was left unaltered. In 1902, in consequence of considerable discussion both in the House of Commons and the House of Lords, the Home Secretary, in a circular letter dated the 24th January of that year, endeavoured to ascertain whether any considerable number of these institutions would be willing to receive visits from Factory Inspectors, and intimated that if such were the case he would instruct these officers to visit them and offer such advice and assistance as might be in their power. He also stated that, if so desired, the visits would be made by Lady Inspectors of the Home Office Staff. The results of this enquiry are summarised in a Parliamentary White Paper issued last year, which conclusively proves that there are a very large number of institutions taking in laundry work from outside and carrying on their trade without the supervision to which all other laundries are subjected. It is common knowledge that owing to the operations of French law the number of these places has largely increased in this country of recent years, and it has been stated that manv thousands of women are now ensured in an unfair competition with those working in laundries to which the existing Factory Act applies. It will be seen from this return that 264 such institutions with laundries are known to exist, and that 204 of these are carried on for the purpose of gain, Of the latter, 117 have expressed their willingness to accept inspection by the Factory Department and 87 declined to accept inspection or gave no definite answer to the Home Office Circular. There were also about 60 others who failed, after a reminder, to reply to it; as to these it is not known, therefore, whether they carried on laundry work for gain or not. 89 As the majority of those known to be trading are willing to be placed under supervision, and as the object of such control aims at nothing more than:— (1) Reasonable hours of work, (2) Healthy conditions of employment, (3) Prevention of accidents from machinery, it seemed only reasonable that the protection of the Act should be made compulsory in all cases, and the Sanitary Committee approved the principle on the recommendation of your Medical Officer of Health. The Bill reached the Second Reading, but was withdrawn on the 6th July. 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 the Superintendent of Cleansing. The main streets and thoroughfares were also regularly and frequently washed, and your Engineer informs me that in the above services no less than 61,953,459 gallons of water were used. Disinfectants were also freely applied where necessary. In the subjoined lists the places marked * * * were flushed every twenty four hours, those marked * * twice a week, and those marked * once a week. EAST DISTRICT. *** Montague Court Bishopsgate * Little George Street Minories * * Rose Alley * New Square * Cock Hill *** Harrow Alley Aldgate ** Sandy's Row ** Church Row (Houndsditch end of) ** White Rose Court ** Swedeland Court . * Black Horse Yard ** Artillery Lane * Little Somerset Street ** George and Catherine Wheel Alley * ** Aldgate Avenue ** Northumberland Alley Fenchurch Street *** Catherine Wheel Alley * Church Court *** Cavendish Court Houndsditch ** Back Alley * Carter Street *** French Ordinary Court * Exchange Buildings ** Rose Court, Beer Lane Lower Thames Street ** Gravel Lane *** St. Mary-at-Hill ** New Street Gravel Lane *** Lower Thames Street (especially in front of Billingsgate Market and H.M's Custom House) ** Hutchison Street Middlesex Street ** Hutchison Avenue *** Pudding Lane ** Ellison Street *** Botolph Lane. Eastcheap ** Providence Place * Botolph Alley ** Middlesex Street * Church Passage ** Garden Place *** Love Lane ** Wrestler's Court Camomile Street *** Fish Street Hill * Brown's Buildings St. Mary Axe *** King's Head Court Fish Street Hill ** Heneage Lane Bevis Marks *** Waterman's Steps ** Golden Fleece Court Minories *** London Bridge Steps 90 MIDDLE DISTRICT. * * Honeysuckle Square Milton Street * George Yard Alderman bury * * Three Herring Court Redcross Street * Mason's Avenue Basinghall Street * * Hart's Court Fann Street * Church Alley Hare Court * Moorgate Street Buildings *** Shaftesbury Place Aldersgate * Copthall Buildings Old Broad Street ** Maidenhead Court * Union Court *** Lauderdale Buildings * Adam's Court *** Cotton Street Passage * Cushion Court * Peahen Court Wormwood street *** Cotton Street * Helmet Court ** Australian Avenue ** Cripplegate Churchyard * Fann Street Barbican *** Gun Yard Bishopsgate * Jacob's Well Passage Beech Street ** Miles Lane London Bridge * Braime's Buildings * Sermon Lane Doctors' Commons ** Upper Thames Street, St. Benet's Church to king William Street * Foster Lane Cheapside * Carey Street * Friar s Alley Upper Thames Street * Gutter Lane ** Brook's Yard * Goldsmith Street ** Huggin Court and Lane ** Grocers' Hall Court ** St. James's Place Garlick Hill ** Dove Court ** Sugar Loaf Court ** Sun Court, Swan Alley, Moorgate Street (leading to Cross Key Court) ** Three Nuns Court Aldermanbury * St. George's Avenue WEST DISTRICT. ** Bishop's Court Old Bailey * Paul's Alley [ Paternoster Row * Prujean Square * Cannon Alley *Evanglist Court Pilgrim Street * Lovell'B Court ** Dolphin Court Ludgate Hill * Panyer Alley ** Horse Shoe Court * London House Yard * Pilgrim Street * Stationers' Hall Court *** Cob's Court, Broadway * Paternoster Buildings * Boy Court * Amen Corner Newgate Street * Johnson's Court Fleet Street * Queen Head Passage Farringdon Street * Red Lion Court ** Seacoal Lane * Bolt Court ** Fleet Lane * Pleydell Court * Harp Alley * Hind Court * New Court * Wine Office Court *** Holborn Viaduct Steps * Crown Court ** Green Dragon Court St. Andrew's Hill ** Currier's Bow * Poppin's Court * Ireland Yard * St. Bride's Avenue ** Glasshouse Alley Tudor Street * Cloisters Court Snow Hill ** Blomfield House Yard ** Bell's Buildings Salisbury Square Furnival Street ** George Yard Whitefriars Street * Took's Court Giltspur Street ** Ashentree Court * Queen's Head Court Dorset Street ** Britton's Court ** Dorset Court ** Fleur-de-Lis Court Fetter Lane ** Sugar Loaf Court * Trinity Passage ** Hanging Sword Alley ** Nevill's Court ** Upper Thames Street, between Blackfriars and St. Benet's Church * Greystoke Place * Plough Court * Crown Court ** Gunpowder Alley Shoe Lane ** Holborn Buildings ** King's Head Court ** Middle Street ** Bobin Hood Court ** Kinghorn Street * Castle Court Poppin's Court ** Cloth Street | Little Britain **** Back Court Cloth Fair ** Montague Court * ** Back Passage •* Little Montague Court ** Barlev Mow Passage ** Cox's Court ** Sun Court * Bartholomew Close Bartholomew Close Middlesex Passage ** New Court *** East Passage ** Westmorland Buildings ** Albion Buildings *** Red Lion Passage ** Cloth Fair ** Cockerill's Buildings *** Half-Moon Passage Aldersgate ' Fenton's Buildings * Three Tuns Passage Ivy Lane ** Bartholomew Place * Duke's Head Passage As heretofore, this process should be assiduously carried on in the neighbourhood of Billingsgate Market and the Custom House. In this part of Lower 91 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 (entrancce) French Ordinary Court Fenchurch Street Hutchinson Avenue (Stoney Lane entrance) Harrow Alley Butcher Row Providence Place Middlesex Street Black Horse Yard Aldgate Garden Place Sussex Place Leadenhall Street White Rose Court Widegate Street MIDDLE DISTRICT. St. James's Place Garlick Hill Friar's Alley Upper Thames Street Gun Yard Bishopsgate WEST DISTRICT. Cloister Court St. Andrew's Hill Britton's Court Whitefriars King's Head Court Shoe Lane Crown Court Gunpowder Alley Dorset Court Dorset Street Fleur-de-Lis Court Carter Lane Holborn Buildings Holborn Nevill's Court Fetter Lane Evangelist Court Pilgrim Street Greystoke Place . Took's Court Furnival Street Fleur-de-Lis Court Red Lion Passage Cloth Fair Boy Court Ludgate Hill East Passage Half-Moon Passage Aldersgate Back Passage Middlesex Passage Bartholomew Close Sun Court Bartholomew Place Back Court Montague Court Little Britain Little Montague Court SMOKE NUISANCES. Smoke nuisances were reported at 21 premises during 1905. The number of observations recorded in relation to them amounted to 554, as against 1,202 noted at 55 places in 1904. In all cases the service of the usual notices resulted in the abatement of the nuisance, and in no instance has the evidence been sufficient to justify the institution of legal proceedings for abatement of smoke nuisance. One case is pending, the nuisance at some times being great, but the offenders are reconstructing their furnaces at a considerable cost, and the nuisance will probably not recur. The improvement of the last few years continues, but is only maintained by constant watchfulness of your officers and by the service of intimation Notices where an old nuisance recurs by carelessness or otherwise. In cases where ventilation is properly provided for, the use of electrical radiators for the warming of offices, and gas stoves for cooking will probably in the near future be a partial solution of the London smoke problem. 92 CONFERENCE ON SMOKE ABATEMENT. In September last, the Royal Sanitary Institute issued invitations to all Municipal Authorities throughout the Kingdom to send delegates to a Conference and Exhibition on Smoke Abatement arranged by that body, and in conjunction with the Coal Smoke Abatement Society. The Conference was held at the Horticultural Hall, Westminster, from December 12th to loth, the Chairman of the Sanitary Committee (Mr. G. T. S. Tranter) and your Medical Officer of Health attending as representatives of the Corporation. The question of the abatement of smoke and its attendant evils, including the reduction in daylight and sunshine, has an important bearing on the public health. In addition to the prevention of smoke from factories, much might be done to reduce the volume of smoke from dwellings, which in the aggregate probably amounts to as much as that from factories, by the increased use of gas and electricity and smokeless fuel and by encouraging improved forms of stove and grate construction, and it was in order to ascertain in which way this important problem might best be approached, that the Conference in question was convened. With a view to the collection of accurate information on the subject, a series of questions were submitted to Local Authorities charged by the Public Health Acts with the duty of abating nuisances arising from black smoke. From the 205 replies to these questions, a considerable amount of interesting information may be extracted, and while it is true that a feeling of indifference or hopelessness is manifested by the minority of Sanitary Authorities, the reports show that on the whole when a Local Authority takes steps with the determination to enforce the provisions of the Public Health Acts, it has not experienced insuperable difficulties in minimising the inconvenience and danger to health consequent upon the emission of black smoke. The following subjects were fully discussed during the conference:— Domestic Smoke Abatement. Factory and Trade Smoke Abatement. Administration, Legislation, and necessary reform. As the result of their deliberations, the Conference passed the following Resolution:— "That in view of the need for husbanding our coal resources, the deplorable "and increasing evils produced by smoky fogs, and the desirability of "providing a cheap smokeless fuel for domestic and industrial use, the Councils "of the Royal Sanitary Institute and the Coal Smoke Abatement Society be "asked to join in a memorial to His Majesty's Government setting forth the "urgency of these questions." The Council of the Royal Sanitary Institute decided to record this Resolution and to state that they would join the proposed memorial, subject to its being submitted and approved by them. 93 DAIRIES, COWSHEDS, AND MILKSHOP " ORDERS," 1905. There are now 567 purveyors of milk registered in the City of London under the Dairies, Cowsheds, and Milkshops "Orders" as compared with 552 in 1904. In the course of the year the sale of milk was discontinued at 30 premises, 33 new premises were added to the register, and 36 changes in ownership occurred. The storage of milk has been satisfactory as regards the vessel, utensils and surroundings—the only cases in which interference has been found necessary being three milk vessels unprovided with coverings, and three covers to milk vessels found to be dirty ; in the former cases the covers were at once provided by the proprietors, and in the latter cases the coverings were cleaned in the presence of the Inspector. Two cases of infectious disease have been reported affecting premises occupied by registered purveyors of milk. In one case infectious disease occurred at the residence of a man engaged in a City dairy ; he was suspended from his employment until removal of case to hospital and disinfection of dwelling by Local Authority. In the other case infectious disease occurred on April 19th at Cloth Fair; immediate steps were taken to prevent the sale of milk at the shop until the premises had been disinfected. ICE CREAM. The 85 places in the City where ice creams are made were kept under observation during the season with a view to ensuring that the regulations with regard to its manufacture were properly carried out. Enquiries were also made respecting the conditions under which ice creams were manufactured at the 164 places in other districts supplying the article to tradesmen in the City, and in all cases the replies were satisfactory. There can be no doubt that the legislation with regard to the sale and manufacture of this commodity has been of considerable advantage to the public without placing undue restriction upon the traders. No case of illness attributed to eating ice cream has been reported in the City during the year. The number of itinerant vendors in the City, which had dropped from 47 in 1903 to 19 in 1904, increased to 37 in 1905. 94 There will always be a difficulty in exercising control over trade in ice creams carried out by these itinerant vendors as long as the police have no power of making arrests in those cases where the place of manufacture is not exhibited on the barrow in accordance with the requirements of the law. From enquiries made in outside districts where these men obtained their supplies, it was ascertained that in 20 cases only was the material made under satisfactory conditions. In ten instances the place of manufacture exhibited on the barrow was incorrectly stated, in three cases the name mentioned was unknown at the address given, and in four cases the conditions of manufacture were stated to be unsatisfactory. The premises where ice creams are sold in the City may be classified as under:— Place op Manufacture. Number. In the City. In other districts. Tea shops 115 31 84 Confectioners 19 9 10 Restaurants 12 66 Small confectioners and light refreshment shops 5 4 1 Do. owned by foreigners 98 35 63 Total 249 85 164 From the above it will be seen that of the 103 small confectioners and light refreshment shops in the City where ice creams are sold no less than 98 of them, or 95 per cent., are owned by foreigners. WATERCRESS. In May last the Sanitary Committee referred to me for consideration and review a Report issued by the London County Council on Watercress and Watercress Beds in the neighbourhood of London. On a former occasion I expressed the opinion with regard to this investigation that the Local Government Board were the proper authority for conducting such an enquiry. The Report contains a large number of facts relating to all the known watercress beds "within some fifty miles of the County supplying the "London market," some 129 beds in all, but in no single instance can any of the beds referred to be identified. It is disquieting to find of the samples of water examined there were 22 in which the nitrogenous organic matter was large in quantity, and that in four of them a slight odour of sewage was detected on heating; some of these are reported as being contaminated with sewage matter. There were also 95 seven other samples, all organically of very bad quality, six being reported as undoubtedly polluted with sewage; with one exception these seven samples gave a distinct odour of sewage on heating. The conclusion arrived at by the author of the Report that " it may be assumed that there is under existing circumstances no " material risk in consuming the watercress supplied from the majority "of the beds sending watercress to London," may be justified, but the Report would have fulfilled a more useful purpose if it indicated the situation of the polluted beds. Had the Local Government Board made this investigation the whole of the facts would have been made known, the locality of the beds would have been indicated, and the public would have known those to be avoided as containing elements of danger. This course was adopted by the Local Government Board when reporting upon the sanitary condition of oyster layings round the coast, and has been of the greatest service to those interested in the protection of the public from the danger attending the consumption of polluted food, and they would doubtless have followed this precedent had they been reporting upon watercress beds. 96 MEAT SUPPLIES. Although the weight of meat delivered at the Central Markets during the year 1905 was 4,777 tons in excess of that received in 1904, it failed to equal the deliveries during 1901 or 1903, to which, however, it approximates very closely. It is satisfactory to find that the volume of trade has been so well maintained, especially as the practice of importers of delivering meat ex ship or cold-air stores direct to the retail trade has been more in evidence than in any previous year, in addition to which dep6ts for sale of imported meat to the trade have been opened at Croydon, Kingston, and elsewhere, to which many buyers have been attracted who formerly chose their supplies at Smithfield. The crowded condition of the salesmen's shops and the congested state of the traffic through the Market Avenues point to the conclusion that the maximum amount of business that can be carried on there has been nearly reached unless further accommodation is provided, which would probably be a matter of some difficulty. So greatly does this crowded condition of the Market interfere with the supervision of your officers, that it has become necessary to consider the question of further increasing the staff of Inspectors to cope with it. The returns furnished by the Superintendent of the Market continue to show an increasing ratio of imported to home-grown supplies. In 1896 the proportions were nearly equal, but last year the amount of foreign produce was about three times as large as that of British. This will probably continue so long as the present low prices can be profitably accepted for meat grazed on the Australian downs, the South American pampas, and the Canadian prairies. These advantages are at present driving the home producer altogether out of the race, while the excellent quality of this imported meat shows that the growers oversea can not only undersell the English farmer in his own market, but can also produce an equally good article. Careful breeding for several generations from the best British blood has resulted in " Scotch " cattle reared in Illinois being equal to those found in the markets of Aberdeen or Huntley—"Herefords" bred in Kansas rival those shown at Hereford or Shrewsbury, and American "Shorthorns" are now as good as any to be seen at the great Midland markets. The Canadians are following the example set by their neighbours, and there seems little doubt but that many cattle which the latter send to England are really bred in Canada, and sent to the warmer pastures further south to be fattened. What bearing this may have on the proposal to import Canadian store cattle for fattening in this country it is difficult to say, but it is clear that the 97 Canadians themselves experience no difficulty in making their stores into Beef, as proved by the fact that the fat cattle imported from Canada during the past year have been better than any previously seen from that source. This was foreshadowed in the last Annual Report, and in all probability the movement will continue to develop. Much of the meat which is thus classed as "Foreign" would be more correctly described as "Colonial," but none the less it is seaborne, and our increasing dependence upon it for our food supply cannot fail to emphasise the danger to this country in the event of war with any great naval Power. No doubt many of our home methods of production are obsolete, and it is certainly worth while considering whether the State cannot in some way, whether by State aid or otherwise, assist our farmers in the unequal competition with the great cattle-raising countries. The mutton trade has been fairly well supported lor carcasses of good quality throughout the year, but large over-fat and inferior carcasses have been difficult to sell, and have realised very irregular prices, while the low figure at which New Zealand, Australian, and River Plate sheep can be obtained has rendered the Market unattractive for American and Canadian sheep, which have come in very small numbers, especially towards the close of the year. The importation of chilled meat from the Argentine was first referred to in 1902, and has since increased, until in 1905 it was the predominating feature of the Market. It is unfortunate that the firms engaged in its importation seem to have been desirous of putting as large a quantity as possible on the Market, at any price, rather than by paying more attention to the quality to obtain a more remunerative price. The large quantities on offer, coupled with the fact that it has frequently been out of condition, has had the effect of depressing the value to a very low level, and also to some extent has affected the Market generally. This is doubly unfortunate, as not only does it make this particular business unremunerative, but renders it difficult for other branches of the trade to obtain a reasonable profit. American refrigerated beef has suffered somewhat from Argentine competition, to which, however, it still maintains a marked superiority, although there has been a tendency on the part of some of the importing firms to regard the subject of quality as of secondary importance if only they can compete successfully in price. This is much to be regretted, the tendency should be to improve in quality, as the health of the consuming public is more likely to benefit by a moderate quantity of carefully selected and well preserved meat than by a larger amount of lower quality. The great favour with which refrigerated beef is received is this country led certain persons in New Zealand to attempt sending their productions here 98 in that form, and accordingly 500 quarters of specially selected beef were shipped on the s. s. "Tokomaru," but the length of the journey proved too great, and on its arrival at the Docks it all had to be condemned. About three weeks seems to be the longest period for beef to keep in good condition (the fastest of the Argentine boats invariably land their cargo best), and anything much in excess of that time is sure to bring your Inspectors on the scene. It is, therefore, probably useless for New Zealand to attempt to supply us with refrigerated beef, unless some new and greatly improved machinery can be devised. That the large quantity of refrigerated beef above referred to should have the effect of limiting the demand for a similar article in a frozen state is but a logical conclusion ; hence, as a result, we find that beef from New Zealand and Australia has not for the past year been so much in demand. In that which has been shown on the Market, the requirements of the English trade have been more carefully studied than was formerly the case (more perhaps, than was possible during the period of severe drought in Australia); there also has been a more accurate timing of supply to demand, and a fuller use of that better judgment which is begotten of experience, with the result that there has probably been less of Australian and New Zealand meat condemned than has been the case for several years past. The criticism of its officers' methods and the subsequent representation to the Danish Government at the commencement of the year has had the effect of greatly improving the character of the pork which is sent from there, and although occasionally some is seized as not being up to the required standard, yet a diseased or indifferent carcass is a very rare exception, instead of, as was formerly the case, to be expected, in nearly every consignment. Little or no Russian pork has come, the disturbed state of that country probably precluding the possibility of its export, and the same applies to Servian sheep, which latter are so carelessly selected that salesmen will not be troubled with them. Only one lot has come during the year, of which about two-thirds were seized by your officers. The voluntary inspection of meat exported from the Netherlands continues to show the good results spoken of in last year's Report, and the difference between that which bears the label of the Dutch Government Officials and that which is not labelled is even more marked as time goes on. There is, undoubtedly, a sincere wish on the part of the principal Dutch exporters to comply with our requirements, but they are manifestly placed in an unfair position by the possibility which exists of persons, who for reasons which can only be surmised, sending their produce here without first subjecting it to official examination. With a view to taking steps to equalise matters, Dr. H. Remmelts, Chief of the Government Inspection Service, paid a visit to this country in December, and on several occasions accompanied your Medical Officer and Chief Inspector to the Markets, where demonstration was given of the necessity for compulsory inspection of all meat exported from that country. It is hoped this result may follow his visit. 99 Taking the year as a whole there has been an abundance of meat of indifferent quality, the latter feature being especially marked in the closing months of the year, when so much Argentine beef has come to compete with the trade in carcasses of animals half fattened on the American ranches. Best meat, especially mutton, has for the most part realised satisfactory prices, but it has been weighted down by a superabundance of second and third class qualities, which have not themselves been a good trade. The wharves and cold-air stores have received careful attention, the arrival of shipments in bad condition, especially in one case, having demonstrated its necessity. The following officers have been sent by the Lords Commissioners of the Admiralty for instruction in meat examination, viz., one Superintendent of Victualling Yard, one Deputy Store Officer, one Assistant Inspector of Victualling Stores, six Fleet Paymasters, two Staff Paymasters, four Paymasters and three Assistant Paymasters; all of whom, with one exception, have been granted certificates of competency. The degree of tuberculous disease which is to justify the condemnation of a carcass is still a burning question between meat traders on the one hand and Sanitary Authorities on the other. Whatever may be the case with cattle, there can be no doubt that the necessity for severity in seizure is exercising an influence tending to annihilation of the pig-breeding industry of this country. Probably the practical remedy is an Act of Parliament, of which the principle has already been approved, providing that where it can be shown that the animals were in life apparently sound, the owner should be compensated for their seizure. It is to be hoped that, should the Bill of last Session again be brought forward, it will be found possible to simplify the method of procedure. TUBERCULOUS PORK. The question as to dealing with tuberculous pork has been brought into prominence in the Metropolis during the year owing to Sanitary Authorities, through their medical advisers, acting on the recommendations contained in the Report of the Royal Commission on Tuberculosis, 1898, as ordered by the Local Government Board in circular letters addressed to the Councils of Metropolitan and other Boroughs and of Urban and Rural Districts on the 11th March, 1899, and the 6th September, 1901. With regard to pork, the Commissioners advised— "In view of the greater tendency of generalisation in the pig, we "consider that the presence of tubercular deposit in any degree should "involve seizure of the whole carcass and of the organs." 100 This recommendation has always been carried out in its integrity by your officers, as also generally throughout the Metropolis, and the importance of so doing is emphasized in Dr. G. S. Buchanan's Report to the Local Government Board dated 7th December, 1905, on "Administration in London with regard to meat of pigs affected with Tuberculosis." In considering the relation between human Tuberculosis and Tuberculosis in certain of the lower animals, Dr. Buchanan remarks (page 9) that— "Any person who takes tuberculous matter of animal origin "(containing living tubercle bacilli) into the body along with food, "thereby incurs some risk of acquiring tuberculous disease"* is an inference which is generally drawn and which rests upon a considerable mass of evidence, experimental and clinical. The extent to which meat from tuberculous animals may be responsible for producing human Tuberculosis is, however, a matter in which it is impossible to express an opinion. Relatively to other causes of Tuberculosis it is no doubt small. The Royal Commission of 1898 pointed out that in this country there has been in some quarters a tendency to exaggerate the risk in question; and in commenting on the recommendations of the Commissions before referred to regarding meat of tuberculous pigs, Dr. Buchanan says (pages 9 and. 10):— In Tuberculosis of the bovine animal it is practicable in a great number of instances to distinguish between those internal organs and those parts of the carcass which contain recognisable tubercle bacilli and remaining organs or other parts of the carcass in which there is ground for assumption that no tuberculous matter exists. The working rulesf framed by * Report, Royal Commission on Tuberculosis, 1895, paragraph 22. † "The following principles should be observed in the inspection of tuberculous carcasses of " cattle:— " (a.) When there is miliary Tuberculosis of both lungs "(b.) When tuberculous lesions are present on the "pleura and peritoneum "(c.) When tuberculous lesions are present in the "muscular system, or in the lymphatic glands "embedded in or between the muscles "(d.) When tuberculous lesions exist in any part of an "emaciated carcass The entire carcass and all the organs may be seized. " (a.) When the lesions are confined to the lungs and "the thoracic lymphatic glands " (b.) When the lesions are confined to the liver " (c.) When the lesions are confined to the pharyngeal "lymphatic glands "(d.) When the lesions are confined to any combination "of the foregoing, but are collectively small "in extent The carcass, if otherwise healthy, shal not be condemned, but every part of it containing tuberculous lesions shall be seized. "In view of the greater tendency to generalisation of Tuberculosis in the pig, we consider that the "presence of tubercular deposit in any degree should involve seizure of the whole carcass and of "the organs. "In respect of foreign dead meat, seizure shall ensue in every case where the pleurae have been "'stripped.'" The Local Government Board drew attention to this matter in the circular letters which they addressed to the Councils of Boroughs and Urban and Rural Districts on the 11th March, 1899, and they again referred to it in a circular dated 6t.h September, 1901, and strongly urged Councils to direct those of their officers who were employed as Meat Inspectors to act in accordance with the principles laid down by the Royal Commission. 101 the Royal Commission of 1898 for the guidance of Meat Inspectors were framed with the main object of assisting this distinction, and so obviating needless destruction of meat which may reasonably be regarded as wholesome. Since the inquiries of this Commission and its predecessor of 1895 a considerable number of experiments on lower animals (by feeding and inoculation) have been conducted at Continental slaughterhouses and elsewhere (particularly in Germany) with the object of ascertaining the infective ability under varying conditions of meat from tuberculous animals. I have not had the opportunity of studying the accounts of these experiments at first hand, but so far as I have been able to gather from abstracts which I have seen (e.g., those given in Professor Ostertag's work on "Meat Inspection") their effects as regards bovines is to add to the evidence in favour of making a distinction, on practical and wellrecognised lines, between parts of the carcass which are, and those which are not, to be regarded as likely to contain tubercle bacilli. When, however, the principle of separation of relatively safe from relatively unsafe portions of the carcass comes to be applied to pigs, the difficulty is greater, for the reasons (rapidity of local spread, frequency of generalisation, uncertainty as to the existence of recent generalisation, &c.) already indicated. It was for these substantial reasons that the recommendations of the 1898 Commission to the Meat Inspector in the case of the pig was that "the "presence of tubercular deposit in any degree should involve seizure of "the whole carcass and of the organs." * In Dr. Buchanan's general observations on the inquiry he remarks (page 35) "It would, of course, be another matter if it could be successfully "maintained that there is practically no need for Public Health Authorities "to give themselves any concern as to Tuberculosis in pigs. 1 do not "think, however, that the evidence available (so far as I have been able "to examine it) can be said in any way to warrant the assumption that the "risk to man which arises from eating the meat of pigs which have been "affected by Tuberculosis is negligible, no matter how severely or how "recently these animals have been affected by the disease." With regard to the position of the consumer, Dr. Buchanan says (page 12):— "Before leaving the question of departing from the recommendation "of the 1898 Commission, it is desirable, perhaps, to refer to what * The italics are mine.—M. O. H. 102 "would probably be the attitude towards this proposal of many of the "ordinary consumers of pork—namely, that even if the risk of eating "pork from a tuberculous animal is negligible, they prefer to have their "meat from the animal which is sound, especially when they pay "full price." It would probably be difficult to find anyone who would dissent from this view of the question. As a consequence of the increased numbers of carcasses of tuberculous pigs condemned, there has been great disturbance of the trade. The question is obviously one of considerable importance from the public health point of view, as evidenced by the fact that during the year 1905 your officers condemned in the City no less than 4,631 carcasses of pigs, which accounted for 124 tons of the 168 tons of meat returned as diseased during that year. Much difference of opinion exists on the Continent with regard to the advisability of condemning carcasses of pigs only slightly affected with the disease, but as will be seen in another part of this Report, both the Netherland and Danish Governments have adopted the recommendations of the English Commission with regard to pork exported to this country. Owing to representations made by trade associations, the whole matter has for some time past been under the consideration of the Sanitary Committee, to whom your Medical Officer has presented several Reports on the subject, but Dr. Buchanan's Report to the Local Government Board will probably strengthen their determination to carry out the recommendations of the Royal Commission on Tuberculosis in their entirety. The present, and the only possible position for the Corporation to take, is that laid down by the Report of the Royal Commission on Tuberculosis, and subsequently enjoined by the Local Government Board. As has been constantly pointed out, the inspection at the Market cannot be absolutely complete in detail, inasmuch as in some cases evidence of disease cannot be obtained until the carcass is cut up. It is, therefore, only reasonable that at times pigs with small trace of the disease may escape detection, though the above figures are sufficient proof of the value of the inspection. This consideration, however, will not, it appears, satisfy those who desire perfect protection, which could only be obtained at the cost of dislocation of the whole trade of the Market. 103 IMPORTED CONTINENTAL MEAT. From time to time your Medical Officer of Health has reported on the arrangements made to prevent the distribution in the country of unsound meat, especially pork imported from Holland and Denmark, and in October last the necessity arose for advocating the adoption of similar precautionary measures on the part of the Belgian Authorities. The season for Belgian pigs was just commencing, and already your officers had made two seizures of pigs imported from that country that were markedly affected with Tuberculosis. In each instance the carcasses bore impressions in aniline ink from a rubber stamp, the meaning of which it was impossible to interpret as the characters were blurred and indistinct, but it was subsequently ascertained through the British Vice-Consulate at Ghent that this stamp represented "Maldeghem," a village near Ghent, and was probably impressed at the slaughterhouse on all carcasses leaving the district. Hitherto these pigs came in small numbers, of which few found their way to the City markets, and these only on Saturday. The firms dealing in this trade are chiefly located at Smithfield, but their practice is to meet the boats which bring their pigs and Ostend rabbits at some wharf down the River, and receive their consignments into vans which are taken round to the various provision dealers, who buy what they want from them, so that only unsold articles of both kinds come to Smithfield, unless by special arrangement. Both these pigs and rabbits are sent in closed packages, almost precluding inspection by the officers of the Port Sanitary Authority. It was evident, therefore, that the existing arrangements for preventing the import of unsound meat from Belgium were unsatisfactory, and your Medical Officer of Health advised that the Corporation should ascertain from the Belgian Government if any inspection and marking of meat intended for export is exercised by them, and, if not, whether they would favourably consider the question of adopting a system of control similar to that obtaining both in the Netherlands and in Denmark. This recommendation was adopted, and the matter is now under the consideration of the Belgian Authorities. With regard to the seizure in the City markets of unsound meat that had been inspected and passed as sound for export to this country by the Netherlands and Danish Authorities, the following Tables, prepared from Returns kindly furnished by the respective representatives in this country, show what a small proportion of carcasses from these countries are now found unfit for food. 104 IMPORTED FROM HOLLAND. (From figures supplied by the Consul-General for the Netherlands.) Statement of the number of Carcasses Inspected for Export to London, and to which the Government Label was attached, during the Year 1905. Cattle. Calves. Pigs. Sheep. TOTALS.; Inspected and labelled. Seized as diseased; or unfit for food. Inspected and labelled. Seized as diseased; or unfit for food. Inspected and labelled. Seized as diseased; or unfit for food. Inspected and labelled. Seized as diseased; or unfit for food. Inspected and labelled. Seized as diseased; or unfit for food. January 61 ... 3,023 1 28,325 15 4,486 2 35,895 18 February 58 ... 3,973 ... 21,095 9 3,364 ... 28,490 9 March 74 ... 6,005 ... 16,188 3 8,564 ... 30,831 3 April 35 ... 8,542 1 12,991 1 15,327 6 36,895 8 May 61 ... 9,522 2¼ 9,128 3 20,871 2 39,582 7¼ June 50 ... 7,671 2 6,118 2 7,277 ... 21,116 4 July 41 ... 6,465 2 7,185 1 4,063 ... 17,754 3 August 56 ... 5,059 1 14,690 4 7,901 ... 27,706 5 September 51 2 3,469 ... 24,252 4 11,575 1 39,347 7 October 46 ... 2,901 2 22,281 9 12,883 2 38,111 13 November 44 ... 1,998 ... 16,814 6 11,734 ... 30,590 6 December 30 ... 1,843 ... 17,971 9 11,968 1 31,812 10 Total 607 2 60,471 11¼ 197,038 66 120,013 14 378,129 93¼ 105 Whenever marked meat is condemned by your officers the labels are removed and forwarded to the Consul-General, with the object of enabling him to investigate the circumstances under which such meat was passed for export. In order to perfect the system as far as possible, the Netherland Authorities were requested to furnish the results of their enquiries in each case. The importance of such action is emphasized by the fact that Holland furnishes more than 70 per cent. of the total import of pork. IMPORTED FROM DENMARK. (From figures supplied by the Commissioner for the Danish Government.) From Esbjerg to Parkeston, 1905. meat. pork. Of Cattle. Carcasses seized as diseased, or unfit for food. Of Sheep. Carcasses seized as diseased, or unfit for food. Fresh. Carcasses seized as diseased, or unfit for food. January Cwts. 3,907 ... Cwts. 489 Cwts. 5,561 99 February 3,121 ... 81 ... 3,242 34 March 2,181 1 11 1 1,566 5 April 1,811 ... 25 ... 669 ... May 1,580 ... 99 ... 376 ... June 190 ... 68 ... 334 1 July 33 ... 50 ... 43 ... August ... 117 ... 13 ... September 163 ... 1,688 ... 267 ... October 298 ... 2,874 ... 1,095 ... November 419 ... 3,086 ... 1,676 ... December 267 ... 59 ... 1,863 3 Total for 1905 13,970 1 7,647 1 16,705 142 Total from Denmark to United Kingdom 15,240 ... 8,783 ... 17,032 ... In addition to the above, 1,232,152 cwts. of salted bacon were exported from Esbjerg to Parkeston, and 1,517,372 cwts. from Denmark to the United Kingdom during 1905. 106 In the Report of your Medical Officer for 1904, reference was made to some apparent laxity of supervision on the part of the Danish Authorities over the quality of pork intended for export to this country and labelled as having been passed by their officials as of sound quality. The attention of the ConsulGeneral for Denmark having been directed to the number of pigs, officially marked as sound, coming into the City market that were found to be affected with Tuberculosis, the following explanation was offered through the Danish Commissioner in a letter addressed to the Town Clerk dated 20th February, 1905:— "When you, in 1903, adopted the recommendations of the Royal "Commission on Tuberculosis, referred to in the Report, these measures, "as previously explained in my letter of 17th November last, were not "generally adopted in Denmark. The unsatisfactory result of this differ"ence in Standards in the two countries has made itself felt, and has been "manifested to the Danish Inspection by the very system of returning "labels. In 1903 I received seven labels, and in 1904 23 labels, from "condemned carcasses of pigs, and of these 23 no less than 16 during "the months of November and December. The Danish Minister of "Agriculture, wishing to remove, as far as possible, every cause for "complaint, has issued, on the 19th of January this year, the following "Order:— "'Supplement to Instruction by the Minister of Agriculture of "'15th August, 1903, to the Veterinary Inspectors appointed to "'control the export of meat. "'As it has been brought to the notice of the Minister that "'carcasses of pigs which have suffered from Tuberculosis, even in a "'very minute degree, are condemned by English Officers of Health "'as unfit for human food, it shall, under reference to Section 4 of "'the Instructions issued on August the loth, 1903, from now "'henceforth be the duty of the Veterinary Inspectors authorised to "'inspect meat for export to retain from export to Great Britain the "'carcass of any pig examined according to the Order of August "'the 15th, 1903, in which, or in the organs of which, is found the "'smallest deposit of a tuberculous nature. "'As the removal of any part of the serous membranes in several "'markets in England causes a suspicion that the animal in question "'has suffered from Tuberculosis, the Veterinary Inspector shall not "'pass for export to Great Britain any carcass of an ox or pig, "'examined according to the said Order, from which any part of "'pleura or peritoneum has been removed. "'January 19th, 1905, "'(Sign) OLE HANSEN, "'Minister of Agriculture. "'H. GRAM.'" 107 "8. Secondly, the Danish Inspection, as explained in a previous com"munication, has hitherto been exclusively sanitary and veterinary. "Carcasses of pigs showing no sign of disease when slaughtered will, "nevertheless, when sent off closely packed before properly cooled, arrive "in a distant market in a state unfit for food. This has been felt more "of late because of a rickety state among many small pigs, making it "unprofitable to feed them off for bacon, has caused them to be killed "young for pork, and in many cases for export. Such carcasses, even "when perfectly sound and fit for food at the place of slaughtering, have "been found unfit for export. Being otherwise sound they have not "been detained by the Inspector. "9. The many seizures of these carcasses, as revealed by the return of "the labels, together with the explanation of your Medical Officer of "Health of the objection to the use of the label on these carcasses, have "caused an extension of the scope of the Danish Inspection by the follow"ing addition to the Instructions issued to the Danish Inspectors of Meat, "which was signed by the Minister of Agriculture on the 18th of this "month:— "'Carcasses of pigs must not be passed for export before they are "'quite cold, and in that state have been found perfectly firm and "'dry. Carcasses of rickety pigs must not be passed for export.'" "The Minister has, at the same time, by an Order of the same date, "taken steps to limit the number of places where pigs can be slaughtered "for export, so as to ensure a better control. "10. Finally, I would point out that an evident reason for the more "frequent condemnation of carcasses from Denmark in 1904 than in 1903, "and particularly during the last three or four months, is the great "increase in the import of Danish pork. The larger number of seizures, "however undesirable, does not necessarily mean a heavier percentage. "Export of fresh Pork from Denmark to London during the last four months and the "the same period of the previous year. 1903-4. 1904-5. "October 25 tons 95 tons. "November 20 „ 147 „ "December 11 „ 195 „ "January 14 „ 278 „ "11. I have very little doubt but that the Order of January 19th this "year, and the new Order and Instructions just issued, will have the "desired effect. The criticism passed on it by the return through me of "labels of condemned carcasses has undoubtedly been an assistance to the "Danish Inspection of Meat for export to this country. 108 "12. In accordance with the views of the Danish Minister of "Agriculture, I would therefore ask that, in consideration of the "adoption by the Danish Inspection of the same Standard which is "enforced in your markets, the labels might be returned to me through "your Medical Officer of Health. I am to add that the assistance "thereby to be rendered to the Danish Meat Inspection will be highly "appreciated, and will undoubtedly enable the label of the Danish Govern"ment to be accepted by your Officers as a prima facie guarantee of the "soundness and quality of the meat. "I am, Sir, "Your obedient Servant, "HAROLD FABER." Speaking generally, this communication was most satisfactory, inasmuch as it showed clearly throughout the intention of the Danish Government to deal thoroughly with the question, and, if practicable, to place such a value on their certificate as to practically constitute a guarantee as to the condition of the pork. The Order issued by the Danish Minister of Agriculture on the 19th January, 1905, referred to in the Commission letter, which runs as follows, should be specially noted:— "Supplement to Instructions by the Minister of Agriculture of the "15th August, 1903, to the Veterinary Inspectors appointed to control "the export of Meat. "As it has been brought to the notice of the Minister that carcasses "of pigs which have suffered from Tuberculosis, even in a very minute "degree, are condemned by English Officers of Health as unfit for human "food, it shall, under reference to Section 4 of the Instructions issued "on August the 15th, 1903, from now henceforth be the duty of the "Veterinary Inspectors authorised to inspect meat for export to retain "from export to Great Britain the carcass of any pig examined according "to the Order of August the 15th, 1903, in which, or in the organs "of which, is found the smallest deposit of a tuberculous nature. "As the removal of any part of the serous membranes in several "markets in England causes a suspicion that the animal in question has "suffered from Tuberculosis, the Veterinary Inspector shall not pass for "export to Great Britain any carcass of an ox or a pig examined according "to the said Order from which any part of pleura or peritoneum has "been removed. "January 19th, 1905. "(Sign) OLE HANSEN, "Minister of Agriculture, "H. GRAM." 109 In commenting on this reply, your Medical Officer pointed out that if such instructions were efficiently and properly carried out, any animal passed thereunder and certified would be up to the standard qua disease laid down by the Royal Commission on Tuberculosis; provided that the following special instruction, signed by the Minister of Agriculture on the 18th February, 1905, were also strictly carried into effect:— "Carcasses of pigs must not be passed for export before they are quite "cold, and in that state have, been found perfectly firm and dry. "Carcasses of rickety pigs must not be passed for export." This having been added on account of the many seizures of carcasses, as revealed by the return of the labels, together with the explanation of your Medical Officer of Health. It was further evident that the more frequent condemnations of carcasses from Denmark in 1904 than in 1903 was due to the large increase in the import of Danish pork. Striking evidence is given in the Table on page 105 of the thoroughness with which the Danish Authorities carried out their undertaking to secure a more careful inspection in conformity with the instruction of the Danish Minister for Agriculture. It will be seen from this Table, that, commencing with February, there was a marked decrease in the number of seizures of meat imported from Denmark, when there were only 34 compared with 99 in the previous month, the number dropped to seven in March, one in July, and three only in the last six months of the year. CONTROL OF BACON, &c., INTENDED FOR EXPORT FROM DENMARK. In a Report to the Sanitary Committee of the 28th February, 1905, the question of importation of pork from Denmark and the system of marking adopted in that country was dealt with at some length. On the discussion of the same, the question having arisen as to how far the public is protected from the risk of eating bacon that may have been made in this country from tuberculous "green" bacon imported from Denmark, I made full enquiries herein, when the following facts were ascertained. Since the date of the Report referred to above the Commissioner for the Danish Government has been good enough to send me a translation of the full text of a despatch, referred to in the Report, from the Danish Minister of Agriculture to Veterinary Surgeons authorised to inspect meat for export, which I here reproduce:— Despatch to the Veterinary Surgeons authorised to inspect Meat for Export. The Minister of Agriculture has this day given the order that fresh carcasses of pigs, parts of such and offal of pigs shall not be passed for export to Great Britain if they are of rickety pigs. 110 Fresh carcasses of pigs shall not, in any case, be passed for export before they are quite cooled, and after cooling have been found perfectly firm and dry. In accordance with supplement of the 19th of January this year to Instruction of the 15th of August, 1903, fresh carcasses of pigs, parts of such and offal shall not be passed for export to Great Britain, when they are produced from pigs in which or in the organs of which is found the smallest deposit of a tuberculous nature. Neither shall be passed for export to Great Britain carcasses of pigs and oxen from which any part of the membranes of the chest or abdomen has been removed. The Veterinary Surgeons authorised to inspect meat for export will carefully note these instructions and act accordingly. The 18th of February, 1905. OLE HANSEN, Minister of Agriculture. The following is a translation of the Danish law of the 24th April, 1903, on the control of the export of fresh and lightly salted meat, &c.:— Section 1.—The Government shall have power to take the necessary steps to prevent the exportation from the country of fresh and lightly salted meat as well as offal of horses, cattle, sheep, goats, and swine, when it has become putrid or is derived from animals suffering from disease, making it unfit for human food, or from animals emaciated so as to make their flesh unfit for food. Section 2.—Meat and offal which shall be found totally unfit for human food by the Inspectors appointed under this Law to control the export shall under necessary precautions be rendered useless for such purpose: according to regulations to be issued by the Minister of Agriculture. Section 3.—It shall not be lawful for any person in this country to offer for sale or to sell as human food meat and offal of dead horses, cattle, sheep, goats, and swine, fresh or in any way prepared. Such meat and offal shall not be exported from this country in any form whatsoever which would allow it to be used as human food. Section 4.—It shall not be lawful for any person in this country to offer for sale or to sell as human food meat and offal of horses, cattle, sheep, goats, and swine which before slaughtering are found to be diseased, or which after slaughtering show signs of marked diseased conditions, nor shall such meat and offal be exported from this country in any form whatever which would allow it to be used as human food, unless a registered Veterinary Surgeon shall certify that the meat and offal is fit for human food, according to regulations to be issued by the Minister of Agriculture. 111 Section 5.—Every person guilty of an offence against this Law or against any regulation issued under this Law shall, unless the offence shall make him liable to more severe punishment, be liable to a fine of no less than 20 Kr. (£l) and not exceeding 1,000 Kr. (£55), to be paid to the Treasury of the State, while the goods in relation to which the offence has been committed shall be forfeited. The forfeited goods shall be rendered useless for human food by action of the Police. The offender shall, in case of a second or subsequent conviction, be liable to a double fine, and under aggravating circumstances to imprisonment, in which case the conviction shall be published by action of the Police. Prosecutions under this Law shall be brought before the public Police Courts. Section 6.—This Law shall replace the Law of 22nd March, 1897, on the control of the export of fresh meat, and shall come into operation on the 1st September, 1903. Christian R. OLE HANSEN. Under the provisions of this Law a Ministerial Decree was issued on the 15th August, 1903, which was revised on the 18th February, 1905. The following is a translation of the latter:— Translation of Order concerning the Export of Meat and Offal of Horses, Cattle, Sheep, Goats, and Swine, 18th February, 1905. The Minister of Agriculture, by virtue of the power given him by Law of 24th April, 1903, on the control of the export of meat, &c., does hereby, concerning the export of fresh and slightly salted meat (and offal) of horses, cattle, sheep, goats and swine for future observance, order as follows:— Section 1.—Fresh and lightly salted meat and offal (including viscera) of horses, cattle, sheep, goats and swine shall not be exported from this country unless accompanied by a certificate from a Veterinary Surgeon appointed for that purpose, stating that the meat, &c., is not putrid and not derived from animals suffering from any disease, making the meat, &c., unfit for human food, or from animals so emaciated as to make their flesh unfit for human food, according to the following regulations. Section 2.—To each piece of fresh meat weighing 8 pounds or more shall be attached, by means of a wire or string, a label (see Section 5) describing the label, mode of fixing it, and the certificate to be issued by 112 the veterinary inspector and the sender, in the words of previous Order of 15th August, 1903). Section 3.—Fresh meat in pieces weighing less than 8 pounds, lightly salted meat, including bacon, fresh and lightly salted offal (including viscera) of horses, cattle, sheep, goats and swine, shall not be exported unless the packing (barrel, case, wrapper, &c.) shall bear a label to be issued by the Minister (see Section 5), and shall be tied round with a rope or wire sealed by the Veterinary Inspector in such a way that it shall be impossible to remove the contents without breaking the seal. To bacon shall be used the same labels which, by Section 2, have been ordered to be used for fresh meat. They shall be fixed by means of wire or rope on the outside of the bale so as to be visible to the Inspectors controlling the export, and sealed with a lead seal so as to make it impossible to remove the contents without breaking the seal. With each consignment shall be sent a certificate signed manu propria by the Inspector and the consignor as follows:— "This is to certify that I have examined the meat (or offal) "packed in (number of) barrels (or cases, baskets or bales) "destined for export, and that I have found it fit for export according "to Law of 24th April, 1903, on control of export of meat, &c.; "further, that I have this day attached to the packing the prescribed "export labels No " (Address) (Date) (Name) "Veterinary Surgeon authorised under Law "of 24th April, 1903." "This certificate shall be valid for the controlling authorities on the "place of exportation for five days only. "As consignor of (number of) barrels (cases, baskets or bales) "containing meat (or offal), and marked... , I hereby solemnly "declare that these barrels (&c.) contain only the meat (offal) "examined by the Veterinary Inspector, as mentioned in the "certificate above. (Address) (Date) (Name) Section 4. —It shall not be lawful for the Veterinary Inspector to sign the certificates mentioned in Sections 2 and 3 unless he has inspected the animals during or after slaughtering, and, if after 113 slaughtering, then before the carcass has been cut through and while all the viscera are still present so as to be identified. The Veterinary Inspector shall not sign the certificate mentioned in Section 3 unless he has either been present while the meat (offal) was packed in the barrel (case, bale, &c.), or has taken precautions against possible infringements by seeing that all meat or offal present in the slaughtery and unfit for human food has been destroyed (by boiling, cutting to pieces, by petroleum or otherwise). With regard to bacon, he shall not sign the certificate unless he has been present at the wrapping of the bales or in other reliable way has obtained security that the bales contain only such bacon which has been passed as fit for export. The Veterinary Inspector shall not sign the certificates mentioned in Sections 2 and 3 unless the meat has been found absolutely fit for human food according to the instructions issued by the Minister of Agriculture to the Inspectors. Section 5.—The Minister of Agriculture will make arrangements for the supply of the labels, lead seals, squeezers and printed schedules mentioned in Sections 2 and 3. Section 6.—Every person intending to export meat abroad shall send to the Chief Constable of Police a notice in writing applying for permission to do so. Such notice shall, when dealing with an alreadyexisting business, state how many (1) horses, (2) cattle, (3) sheep, (4) goats, and (5) swine have been slaughtered during the last year, and shall, by the Chief Constable, be forwarded to the Minister of Agriculture, who will inform the Chief Constable how far the application can be granted. The Chief Constable shall at the same time communicate to the Minister which Veterinary Surgeon he proposes the Minister to authorise to carry on the control, and how it is proposed to fix the remuneration for the control. The question of remuneration, which shall be defrayed by the sender, shall be finally decided by the Minister of Agriculture. The Minister can at any time withdraw the authorisation as regards both the slaughtery and the Veterinary Inspector. If necessary for the control, several Veterinary Inspectors can be appointed within the same Police District, in which case the Chief Constable shall decide which slaughteries each Inspector shall control, and inform the Minister thereon. The Veterinary Inspector shall have access to the slaughtery at any time. The same power shall be vested in such Inspectors which the Minister of Agriculture might send. 114 The Veterinary Inspector shall follow the instructions given him by the Minister of Agriculture. He shall enter in an authorised journal, sent him by the Minister, all details concerning the control of the export. He shall produce this journal for the Inspector which the Minister might send. If the Veterinary Inspector should have reason to suspect that the Law of 24th April, 1903, or any regulation under this Law, are being infringed, he shall at once inform the Chief Constable. Section 7.—In case of exportation by ship it shall be the duty of the Customs, and in case of exportation by railway it shall be the duty of the stationmaster, to ascertain whether the regulations in Sections 1, 2 and 3 are carried out, and that the goods are not exported to another country than the one stated on the certificates. Section 8.—Consignments of meat destined for abroad, which by their smell prove to be putrid, shall, even if accompanied by the prescribed certificates and otherwise fulfilling the regulations, be detained at the place of export. Notice of such detention shall at once be given to the Police for further action. Section 9.—The preceding regulations do not apply in the case of meat and offal supplied for ship's stores, nor in the case of meat in small pieces exported over the frontier for household use. Section 10.—Meat and offal submitted to the Inspector for export and found to be unfit for human food according to the instructions issued by the Minister of Agriculture shall, under the direction of the Inspector and at the cost of the owner, be made useless for food by heating, boiling, destroying in special ovens, by petroleum or by burying with lime. This Order shall replace the Order by the Minister of Agriculture, Number 142, of loth of August, 1903, and shall come into operation on the 15th of March, 1905. OLE HANSEN. 18th February, 1905. H. Gram. Since the 15th March, 1905, therefore, Danish "green "Bacon has been subject to the same Regulations that are in force in that country with regard to fresh meat, and labels similar to those used for the latter are affixed to every bale exported to this country from Denmark. Hitherto Danish Bacon factories have been regulated partly by the various local Public Health Authorities. 115 The following is a statement of the quantity of Bacon imported from Denmark during the seven years 1899-1905, and has considerable interest as bearing on the subject:— Year. Value. To United Kingdom. To London. £ Tons. Tom. 1899 2,945,757 60,530 52,193 1900 3,058,782 54,731 48,707 1901 3,234,456 53,045 45,552 1902 3,749,108 62,781 52,721 1903 4,294,017 74,805 60,051 1904 4,532,420 86,194 70,315 1905 3,978,317 73,584 61,423 From November, 1899, to October, 1900, the bacon was shipped to Thameshaven. From November, 1900, to August, 1901, it was landed at Cotton's Wharf, Tooley Street. Since the latter date it has come to London viâ Harwich and the Great Eastern Railway. The Danish Commissioner kindly furnished these figures, which show that during the seven years referred to, nearly 84 per cent. of the bacon imported into the United Kingdom from Denmark was consigned to London. The Danish Authorities, both in this country and Denmark, have shown every desire that their meat exports should have a good reputation in the world's markets, and have recently accepted the principles of the Royal Commission with regard to tuberculous meat. These precautions should be amply sufficient to protect the public, and provided they are carried out in their entirety, there is no reason to fear that bacon made from pork imported from Denmark would be more likely to be tubercular than that prepared from animals killed in the United Kingdom. Two cases of seizure of tuberculous pigs' heads consigned to City markets by a firm of bacon curers in the country occurred during the year, but having regard to all the facts no prosecution was instituted. In view of the fact that tubercle bacillus is not destroyed in the process of manufacture, and further, that in the town where the factory is situated there is no inspector, according to the statement of the company, it was thought advisable to bring the matter before the notice of the Local Government Board and the Board of Agriculture and Fisheries. 116 Table showing the annual deliveries and other details during the past 32 years:— MEAT SUPPLIES, 1874 TO 1905. 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 307,519 19 3 476 12 1 .155 1892 323,085 6 0 569 13 3 .176 1893 318,163 1 1 608 9 3 .193 1894 340,956 16 2 430 0 2 .126 1895 347,283 3 0 598 19 0 .173 1896 380,543 11 1 914 14 3 .243 1897 393,307 2 0 918 3 3 .233 1898 400,112 9 3 884 1 0 .221 1899 405,456 9 2 1,172 5 2 .289 1900 410,380 1 0 961 19 1 .234 1901 415,510 15 2 1,271 1 1 .306 1902 405,019 13 3 865 12 0 .214 1903 415,915 12 1 1,142 9 1 .275 1904 410,519 5 3 1,556 2 1 .379 1905 415,296 16 2 2,128 9 2 .512 * The figures relating to the Central Market supplies are compiled from the Returns of the Superintendent of the Market. 117 The monthly deliveries during 1905 and the two preceding years are here given. Monthly Deliveries at the Corporation Markets, Smithfield. month. 1903. 1904. 1905. Tons cwts qrs. Tons cwts. qrs. Tons cwts. qrs. January 35,116 4 3 35,575 2 2 36,326 5 3 February 32,134 9 1 35,154 4 2 34,293 15 0 March 35,039 12 2 37,542 2 1 35,753 9 2 April 34,823 16 3 32,746 17 2 31,528 17 2 May 33,870 4 0 33,641 8 3 36,304 7 0 June 34,407 9 0 33,966 9 0 34,482 4 2 July 34,655 5 3 30,815 18 2 30,507 8 1 August 30,758 18 2 30,339 5 1 33,060 18 3 September 33,033 19 2 34,807 13 2 33,557 13 1 October 37,939 16 0 34,122 1 0 35,981 14 3 November 35,452 10 0 36,121 8 2 36,336 0 3 December 38,683 6 1 35,686 14 2 37,164 1 2 Total 415,915 12 1 410,519 5 3 415,296 16 2 The sources of origin during the past ten 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 19.7 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 25.7 131 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 1904 23.2 3.6 15.6 14.0 23.0 20.6 1905 18.2 3.6 12.7 17.8 24.4 23.3 * 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." 118 Some idea of the magnitude of the work of your Inspectors of Slaughterhouses and Meat may be obtained from the following figures supplied by the Superintendent of the Market:— 1903. 1904. 1905. Tons. Tons. Tons. Average daily delivery into the Markets 1,341 1,355 1,352 Minimum on any one day 237 217 223 Maximum delivery 4,209 3,334 3,769 The heaviest weight previously recorded on any one day (21st December, 1896) was 4,159 tons. One ton in every 195 tons of meat paying toll in the Central Markets, Smithfield, was condemned last year, as compared with one ton in 264 in 1904. MEAT INSPECTION. The seizures of diseased and unsound meat amounted to 2,128 tons 9 cwts. 2 qrs., including 371 tons 17 cwts. 1 qr. 23 lbs. of imported frozen and chilled meat. Month. 1903. 1904. 1905. Tons cwts. qrs. Tons cwts. qrs. Tons cwts qrs. January 60 3 2 84 4 1 114 18 1 February 55 1 1 111 7 2 92 7 1 March 84 1 2 75 3 3 144 19 0 April 108 3 0 177 0 2 89 12 3 May 59 19 2 189 4 3 144 0 2 June 65 8 0 146 6 1 233 0 1 July 131 8 0 115 17 0 283 15 1 August 76 7 1 92 5 1 261 11 3 September 135 2 2 128 8 0 281 10 0 October 182 15 2 238 16 2 183 17 0 November 89 17 0 79 14 0 175 12 3 December 94 2 1 117 14 2 123 4 3 Totals 1,142 9 1 1,556 2 1 *2,128 9 2 * The heaviest total recorded. 119 UNSOUND MEAT, 1905. The meat seized by your Inspectors as unfit for the food of man is classified as under:— 1905. Diseased. Putrid. Unwholesome. Poultry. Offal. Fish. Total. tons. cwts. qrs. lbs. tons. cwts qrs. lbs. tons. cwta. qrs. lbs. tons. cwts. qrs. lbs. tons. cwts. qrs. lbs. tons. cwts. qrs lbs. tons. cwts. qrs. lts. First Quarter 65 0 0 10 209 0 0 22 29 8 3 13 26 13 0 4 20 4 1 12 0 0 0 20 350 6 2 25 Second „ 38 14 2 18 311 1 0 7 19 0 1 23 14 8 3 25 38 3 1 14 0 1 3 11 421 10 1 14 Third „ 19 10 2 0 772 17 3 3 19 17 3 10 19 7 0 26 51 7 2 22 0 4 3 18 873 5 3 23 Fourth „ 44 9 2 0 365 10 1 13 19 12 1 17 29 9 2 25 23 2 3 25 0 3 0 24 482 8 0 20 Total 167 14 3 0 1658 9 1 17 77 19 2 7 89 18 3 24 132 18 1 17 0 10 0 17 2123 11 0 26 The above figures include 37,928 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. 1900 10.1 85.9 4.0 1901 8.1 89.0 2.9 1902 17.4 77.7 4.9 1903 16.9 76.4 6.7 1904 13.9 78.8 7.2 Average for 5 years 13.3 81.5 5.1 1905 7.9 88.4 3.7 * Including poultry, offal and fish. It is satisfactory to note the decrease in the percentage of diseased meat seized, which is the lowest proportion yet recorded. 120 CENTRAL MARKETS, SMITHFIELD. Table showing Weight of Meat delivered, seized as unsound, and proportion condemned to that delivered during each Month of the Year 1905. Month. Meat delivered at the Market. Meat' seized the the Inspectors. Ratio of Meat condemned to that delivered, Tons cwts. qrs. Tons cwts. qrs. January 36,326 5 3 114 18 1 1 ton in 317 tons, or .316 % February 34,293 15 0 92 7 1 371 „ .268 „ March 35,753 9 2 144 19 0 247 „ .408 „ April 31,528 17 2 89 12 3 352 „ .284 „ May 36,304 7 0 144 0 2 252 „ .396 „ June 34,482 4 2 233 0 1 148 „ .675 „ July 30,507 8 1 283 15 1 107 „ .930 „ August 33,060 18 3 261 11 3 126 „ .790 „ September 33,557 13 1 281 10 0 119 „ .861 „ October 35,981 14 3 183 17 0 198 „ .510 „ November 36,336 0 3 175 12 3 206 „ .483 „ December 37,164 1 2 123 4 3 301 „ .331 „ Totals 415,296 16 2 2,128 9 2 1 ton in 195 tons, or .512 % 121 DISEASED MEAT PROSECUTIONS, 1905. Date of Hearing. Where Heard. Before whom. Occupation of Person Summoned. Defendant's Place of Business. Result. 1905. Jan. 3 Guildhall Sir Horatio D. Davies,K.C.M.G. Publican Shefford, Bedfordshire Fined £20 and £3 15s. expenses. (Expenses of two witnesses disallowed.) „ 26 Do. Mr. Ald. Vaughan Morgan Butcher East Dereham, Norfolk Three months' imprisonment and £3 10s. expenses. (Second conviction.) Feb. 23 Do. Ald. Sir John Knill, Bart. Pig Dealer Woolpit, Suffolk Fined £60 and £4 10s. expenses. (Expenses of two witnesses disallowed.) „ 24 Do. Do. Butcher Elswick, Cambridgeshire Fined £50 and £6 expenses. Mar. 14 Do. Mr. Ald. Burnett Butcher Ash ford, Kent Fined £60 and £3 3s. expenses. „ 20 Do. Mr. Ald. Simmons Miller and Merchant. Beccles, Suffolk Fined £5 and £5 3s. expenses. (Expenses of one witness disallowed.) „ 30 Do. Mr. Ald. Guthrie, M.P. Brewer Warboys, Hunts Fined £21 and £5 expenses. April 11 Do. Ald. Sir J. C. Bell Farmer Stambourne, Essex Fined £10 and £3 15s.6d. expenses. „ 11 Do. Do. Cattle Dealer Steeple Bumstead, Essex Fined £10 and £2 2s. expenses. May 19 Do. Do. Butcher Stotford, Bedford Fined £25 and £3 15s. expenses. Dec. 14 Do. Mr. Ald. Burnett Butcher Thaxted, Essex Fined £20 and £4 4s. expenses. „ 19 Do. Mr. Aid. Guthrie, M.P. Farmer Castle Cary, Somerset Fined £2 and £8 8s. expenses. The average of fines and expenses was £30 5s. 0d. 122 FISH SUPPLIES. 211,642 Tons of fish, of which 164,016 were land-borne and 47,626 water-borne, were received at or near Billingsgate Market during the year. Of the above, 157,335 tons were consigned to Billingsgate Market, the remainder, viz., 54,307, being delivered at the salesmen's shops in the neighbourhood of the Market. Year. Fish Delivered at Billingsgate Market. Fish Delivered in the neighbourhood of Billingsgate Market. Total Deliveries. Tons. Tons. Tons. 1904 *175,487 68,319 243,806 1905 157,335 54,307 211,642 18,152 decrease. 14,012 decrease. 32,164 decrease. * Extracted from the Annual Report of the Clerk of the Market. There was a decrease of 21,856 tons in the land deliveries, and 10,308 tons in the deliveries by water. MONTHLY FISH RETURNS, 1905. 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 1905. 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 1,204 tons, or .083 per cent. 13,686 2,999 16,685 13 17 0 February 13,285 4,509 17,794 7 13 1 1 „ 2,322 „ .043 „ March 15,411 4,117 19,528 40 11 1 1 „ 481 ., .208 „ April 14,445 2,926 17,371 33 16 1 1 „ 514 „ .195 ,, May 14,928 4,398 19,326 67 11 2 1 „ 286 „ .350 „ June 13,914 4,422 18,336 129 16 2 1 „ 141 „ .708 „ July 13,088 3,932 17,020 127 2 1 1 „ 134 „ .747 „ August 14,892 4,085 18,977 39 7 0 1 „ 482 „ .208 „ September 13,236 5,365 18,601 122 13 2 1 „ 151 „ .659 ,, October 13,326 3,592 16,918 48 5 0 1 „ 350 „ .285 „ November 13,128 3,365 16,493 24 4 3 1 „ 680 „ .147 „ December 10,677 3,916 14,593 19 5 1 1 „ 757 „ .132 „ Total 164,016 47,626 211,642 674 3 2 1 in 314 tons, or .318 per cent. * Compiled from the Monthly Returns furnished to the Corporation by the Fishmongers' Company. 123 Monthly Deliveries of Fish at London Central Markets, Smithfield, 1905. Tons. Cwts. Qrs. January 137 10 0 February 174 16 0 March 195 15 0 April 203 14 0 May 173 0 0 June 153 0 0 July 181 19 0 August 119 2 0 September 178 4 0 October 151 4 0 November 157 1 0 December 189 4 0 2,014 9 0 Of the above, 3 tons 16 cwts. 2 qrs. were seized by your Officers and those of the Fishmongers' Company as unsound, equal to .19 per cent., or 1 ton in 530 tons. Weight of Fish Delivered, Fish seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market during 1905 and the five years 1900-1904. Year. Weight of Fish Delivered. Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. 1900 Tons. Tons. Tons. Tons cwts. qrs. 1 ton in 244 tons, or .41 % 149,615 38,069 187,684 769 13 3 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 „ 1903 160,741 57,734 218,475 1,304 15 3 1 „ 168 „ .59 „ 1904 185,872 57,934 243,806 1,098 0 2 1 ,, 222 „ .45,, Average (5 years) 164,650 47,817 212,467 1,041 14 3 1 ton in 204 tons, or .49% 1905 164,016 47,626 211,642 674 3 2 1 ton in 314 tons, or .32% 124 INSPECTION OF FOOD AT RIVERSIDE WHARVES, &c. Daily inspections have been made of the quality of the food landed or stored at the 28 wharves in the City, and in the course of the year 356 loads of unsound food have been removed from these places by the Cleansing Department and destroyed at Letts' Wharf. The material so disposed of comprised:— Tons. Cwts. Qrs. Tinned fruit and vegetables J 26 18 1 Condensed milk 44 12 2 Miscellaneous tinned food 44 10 2 Fruit pulp 36 12 2 Fruit and vegetables 15 11 3 Miscellaneous food 5 5 2 Total 173 11 0 Most of the above was removed as "trade refuse" at the request of the owners. The number of loads and weight of such material dealt with in 1905 and the three previous years were as under:— Weight. Year. No. of Loads. Tons. Cwts. Qrs. 1902 362 83 14 0* 1903 284 148 5 0 1904 316 200 15 1 1905 356 173 11 0 * The loads were weighed during the last six months only of this year. 125 SALE OF FOOD AND DRUGS ACTS. Of the 1,102 samples analysed under the Sale of Food and Drugs Acts in 1905, 5.6 per cent. were found to be adulterated, as compared with 5.5 per cent. in 1904. The figures for 1905 and the three preceding years were as follows:— Year 1902. 1903. 1904. 1905. Number of samples taken 1,248 1,179 1,035 1,102 Number of samples genuine 1,138 1,081 978 1,040 Number of samples adulterated 110 98 57 62 Percentage of adulteration 8.8 8.31 5.5 5.6 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 ,, 1900-1904 8.5 These figures are abstracted from the Annual Reports of the Local Government Board. 126 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 78,077 1,179 1.51 417 21 233 1904 84,678 1,035 1.22 384 23 213 1905 Return not yet received. 1,102 — — 20 — * 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 daytime. MILK. It is satisfactory to note that the decrease in the number of cases of milk adulteration is maintained, as shown by the following figures:— Year 1901. 1902. 1903. 1904. 1905. Number of Milk samples examined 392 599 517 452 481 Found genuine 209 519 457 417 445 Found adulterated 83 80 60 35 36 Percentage of adulteration 21.0 13.3 11.6 7.5 7.5 127 Milk being an article that can be so readily sophisticated, fraudulent milk dealers will always exist, and only a rigorous enforcement of the Sale of Food and Drugs Acts can keep the evil within bounds. The above Table shows very clearly what can be done in this direction, and if only the offenders were more heavily punished for their misdeeds, it cannot be doubted that the quality of the milk sold in the City would be still further improved. Of three samples purchased at shops in the early morning on Sunday, one was impoverished by the abstraction of 4 per cent. of fat, and two out of five samples taken on Sunday evening were adulterated by the addition of water to the extent of 4 per cent. and 8 per cent. respectively. Thirty-three samples were taken from perambulating milk sellers both during the day and in the early morning. Of these, three were adulterated, and prosecutions ensued in each case. Two of the defendants were fined, and in one case the summons was dismissed on proof of warranty. Fifteen samples were taken at the door in course of delivery, and of these four were adulterated. Three of the sellers were prosecuted, and in each instance a warranty defence was successful. The fourth case was not proceeded with, as the Magistrate had taken it into consideration in imposing a fine of £10 and costs in another one previously heard. As before noted, milk adulteration in the City has been reduced from 21 per cent. to 7.5 per cent. after four years' active administration of the Acts; and in this respect the City compares favourably with the rest of the Metropolis, as shown by the following Table compiled from the last Report of the Local Government Board:— Percentage of samples of Milk adulterated. in the City of London and the several Metropolitan Boroughs during 1904, arranged in "order of merit." Whole Metropolis 12.5 per cent. No. of samples examined. Per cent. of samples adulterated. No. of samples examined. Per cent. of samples adulterated. Hampstead 173 2.3 Lewisham 258 10.9 St. Marylebone 260 2.7 Lambeth 515 11.1 Holborn 256 5.1 Stoke Newington 61 11.5 Deptford 215 6.0 Poplar 130 11.6 Kensington 213 6.6 Southwark 1,183 12.8 Hammersmith 130 6.9 Finsbury 346 13.8 Bermondsey 469 7.0 Bethnal Green 378 14.5 Camberwell 318 7.5 Wandsworth 400 15.5 City of London 469 7.5 Fulham 245 16.8 Greenwich 118 7.6 Battersea 452 17.0 Islington 601 7.8 Stepney 641 19.7 Woolwich 370 9.2 Shoreditch 365 23.6 Chelsea 178 9.5 St. Pancras 380 25.3 Paddington 289 10.0 Hackney 425 25.9 Westminster 772 10.4 128 A reference to p. 140 will show that 23 prosecutions were instituted against milk sellers during the year, in which convictions were obtained in 13 instances, and in no less than ten cases warranty defences were successful. With regard to this form of defence, there can be no question that the opportunities afforded by the warranty clauses of the Sale of Food and Drugs Acts are exceedingly prejudicial to the effective administration of the law. This question was the subject of a Special Report presented by your Medical Officer to the Sanitary Committee last January, wherein an amendment of the existing law was advocated. The Board of Agriculture and Fisheries have also had their attention directed to this matter, and in their Annual Report for last year referred to two suggestions for dealing with the difficulty. "The one is that whenever a warranty is pleaded, the Local Authority can "have the summons adjourned in order to apply for a summons, or in the "case of successive warranties, for summonses against the warrantor or "warrantees, and the magistrate shall then hear the two or more summonses "as one case, so as to decide which is the guilty party. The other is that the "warranty sections should be repealed, and the seller of the milk be left to his "remedy at common law against the person from whom he purchased it." The latter appears to be the best remedy by reason of its simplicity, and the Board of Agriculture and Fisheries are also of opinion that it is the one that would commend itself to the agricultural community. BUTTER. Three hundred and fifty-four samples of butter were examined, of which four, or 1.14 per cent., were adulterated. The accompanying figures are those for 1905 and the four preceding years:— Years 1901. 1902. 1903. 1904. 1905. Number of Butter samples examined 238 299 368 442 354 Found genuine 224 292 367 429 350 Found adulterated 14 7 1 13 4 Percentage of adulteration 5.8 2.34 .27 2.94 1.14 The increase last year was due to the substitution of margarine for butter in 12 instances out of 101, where slices of bread and butter were purchased. These figures showed a marked improvement over those of 1903, when out of 71 such purchases 19, or 26.7 per cent., this fraud was detected, as against 11.8 per cent. in 1904. Sixteen samples of bread and butter were examined in 1905, and the butter used was reported as genuine in each case. A decline of adulteration of a particular character from 26.7 per cent. to nil in three years is another illustration showing how a mean fraud can be practically stamped out by repeated sampling. 129 It will be seen from the above Table that butter adulteration in the City has dropped from 5.8 per cent. in 1901 to 1.14 in 1905, and compares favourably with the whole Metropolis, as shown by the accompanying figures extracted from the Local Government Report for 1904:— Percentage of samples of Butter adulterated in the City of London and the several Metropolitan Boroughs during the year 1904, arranged "in order of merit." Whole Metropolis, 8.3 per cent. No. of samples examined. Per cent. of samples adulterated. No of samples examined. Per cent. of samples adulterated. Stoke Newington 21 None St. Pancras 183 7.6 Westminster 211 0.9 Wandsworth 180 7.8 Kensington 1ll 1.8 Paddington 67 8.9 Hampstead 110 1.9 Islington 252 9.1 St. Marylebone 75 2.6 Hackney 196 9.2 City of London 441 2.9 Bethnal Green 104 9.6 Southwark 355 4.8 Bermondsey 179 10.6 Chelsea 60 5.0 Finsbury 120 10.9 Woolwich 78 5.1 Shoreditch 181 11.0 Greenwich 91 5.5 Camberwell 301 13.6 Lambeth 250 5.6 Battersea 114 14.4 Deptford 97 6.2 Fulham 369 15.4 Holborn 73 6.8 Stepney 237 15.6 Lewisham 166 7.2 Hammersmith 76 17.1 Poplar 121 7.4 A case of some interest in relation to the character of some of the butter imported from Holland occurred during the year. A provision merchant at Smithfield received a consignment of butter from Rotterdam, and having reason to doubt its genuineness, requested that a sample might be taken. This was done, with the result that it was certified by the Public Analyst to contain 20 per cent. of margarine (fat and other than butter fat). This discovery placed the salesman in the following position:— 1. He was liable to a penalty of £20 for importing margarine containing more than ten per cent. of butter fat. 2. It obviously could not be sold as butter. 3. It would be unlawful to sell it as margarine. 4. The consignors in Holland threatened to denounce him to their fellow-dealers because he declined to pay for the mixture, 5. As the consignors had guaranteed its purity, the salesman would, if so requested, have sold it with a warranty, in which case he would have been liable to a conviction. This would have placed his tenancy in jeopardy, as in due course his conviction would have been reported to the Markets Committee. This matter was subsequently put into the hands of the Butter Association, and resulted in the Netherland Authorities undertaking to take legal 130 proceedings in Holland against the consignors, provided the English importers undertook to defray the cost of prosecution, it being a penal offence in Holland not to label as margarine any such article intended for export. SALE OF BUTTER BILL, 1905. This Bill was introduced by the Government in the public interest on the 28th March, 1905. Since the 22nd April, 1902, a Regulation has been in operation with regard to water in Butter, made by the Board of Agriculture under the powers conferred upon them by section 4 of the Sale of Food and Drugs Act, 1899. The Regulation is to the following effect:— "When the proportion of water in a sample of Butter exceeds 16 per "cent. it shall be presumed for the purposes of the Sale of Food and "Drugs Acts, 1875 to 1899, until the contrary is proved, that the Butter "is not genuine, by reason of the excessive amount of water therein." Section 1 of the Bill definitely limits the permissible amount of water in Butter to sixteen per cent. without any reservation. Moreover, any person who manufactures, sells or exposes for sale any Butter to which any substance has been added whereby the amount of water has been increased will be rendered liable to penalties of £20, £50 and £100 for the first, second and third offence respectively. This measure was introduced by the Government with the object of protecting the public from a form of sophistication which the law at present is powerless to prevent. Certain traders are now, and had for some time past, been selling an article containing as much as 25 per cent. of water, which has been ingeniously incorporated with genuine Butter and subsequently sold under the guise of "Milk-blended Butter." It is true that the makers of this article protect themselves from prosecution under the Sale of Food and Drugs Acts by disclosing the fact to the purchaser that the article is a mixture, but the ordinary buyer can scarcely be expected to know that the milk so added itself contains from 86 to 88 per cent. of water as one of its natural constituents. The buyer is deceived, because, although "milk-blended" Butter is sold at a lower price than genuine Butter, being loaded with water, it is in fact dearer, and he is consequently ignorant of the real composition of the material he is buying. The main object of this Bill was to stamp out this unfair trading, although such measure is also desirable upon other grounds. From the health point of view, milk-blended Butter is objectionable, as such admixture seriously impairs its nutritive properties, the excess of water being obviously without nourishing properties, and consequently lessens its food value. Its use, therefore, might seriously impair the health of persons placed by force of circumstances or medical advice upon a low diet. In addition to 131 these objections, its keeping properties are also lessened by the addition of water, especially daring warm weather, unless heavily charged with preservatives. It is further stated that the sale of this stuff has opened the door to another questionable sophistication. It was formerly made from Australian Butter; now, however, imported Siberian Butter is used, which can be obtained at a cheaper rate; this is amalgamated with a mixture of skimmed milk and cocoanut oil, and is placed upon the market as a "Milk-blended" Butter. The Bill will prevent this fraud, but if Irish firkin butter containing 20 per cent. of water is legalised for a time as proposed in the Bill, it may lead to the practice of a form of deception that would greatly prejudice the Irish farmers the Bill is intended to protect. In this connection a firm of produce merchants in the North of England have recently made a very interesting exposure of the methods adopted by unscrupulous butter manufacturers, and it may not be without interest to the public to learn how the Siberian product can be converted into mock Irish Firkin Butter. The following details are given:—* MOCK IRISH FIRKIN BUTTER. If the manipulator buys his Siberian Butter at the right time, that is to say in the summer months, he can produce Mock Irish Firkin Butter in the winter at summer prices. The cost of Siberian Butter is estimated on this basis—plus the expenses of cold storage. MODE OF OPERATION. The treated milk is taken cold and placed in a chamber where peat is burning, such as is used by provision merchants to smoke their bacon. It is only allowed to remain here sufficiently long to impart a slightly peaty and smoky flavour, such as one often finds in Irish butter. Note.— The milk must be much colder than the chamber or it will not absorb. The amalgamation is then carried out as follows: Equal weights of the solidified milk and butter are kneaded well together in a kneading machine, after this the remaining quantity of butter is added, and then, whilst the machine is going, the treated milk, previously and quickly heated to a temperature of about 37° cent. or 100° Fahr., is slowly added. The higher the temperature of the butter when going into the machine, the more glossy or vaseline-like will be the product. Should more salt be required, this may be added; but the salt from the preparation of the solidified milk is usually sufficient Several days are required before the butter again assumes its texture. Then it should be packed into firkins. The cost of these are from 2s. 6d. to 3s. per cwt. Farmer's Lump Butter is at the present time being treated in a somewhat similar manner, viz.:—loaded with extra water and solids. * From "Butter Manipulation." Showing "How the British Public are cheated, and many of His Majesty's "Colonial subjects robbed of their just due."By George Wall and Co., Liverpool. Printed 1905. 132 PROCESSES AND PROFITS. Table showing Contents when Siberian Butter is converted into Mock Irish Firkin Butter. 81½ lbs. Butter at 88s. per cwt. = £3 4s. 0d. Allowing for deduction of curds and moisture present, reduces the butter fat weight to 74 lbs., the cost of which remains the same. £ s. d. 74 lbs. Butter Fat 3 4 0 19 lbs. Treated Milk 0 0 2¼ 7 lbs. Solidified Milk 007 100 lbs. £3 4 9¼ Or equal to £3 12s. 6d. per cwt. The following shows the rate of gain obtained by the process, and the relative prices per cwt. and per lb.:— 112 lbs. Original Butter costs 88s. = £4 8s. 0d.; or about 9½d. per lb. 112 lbs. after Manipulation costs 72s. 6d. = 3 12s. 6d.; or about 7¾d. per lb. Gain £0 15s. 6d.; or nearly 1¾d. per lb. This mixture contains nothing which is foreign (analytically) to Irish butter as now sold and passed by the Public Analyst, who would certify it about as follows:— Butter Fats 74.0 Curd, Salt, &c. 8.0 Moisture 18.0 (No Foreign Fat) 100.0 The "Treated Milk" and "Solidified Milk" referred to in the foregoing is thus prepared:— SOLIDIFIED MILK.— How to Prepare. Take some 1,000 lbs. sweet separated milk, which can be obtained at a cost of 1d. per gallon of 10¼ lbs. Heat up to 32° Cent., gently stir, and pour in 200 grammes hydrochloric acid which has been previously diluted with ten times its own weight of water. The action of this acid will separate the casein from the whey in the course of a few minutes. When completed pour off the liquid, drain and press the casein until its weight is reduced to one-tenth the original weight of the milk. This should then be placed in a kneading machine, with enough carbonate of soda to neutralise all acid present. (N.B.— This product must be quite neutral to blue and red litmus test.) The action of the soda converts the casein into a jelly-like substance. This preparation, when found by the analyst in butter, is indicated as curd and salt, both of which are usually present in certain small proportions in best pure butter ; the action of the hydrochloric acid and the carbonate of soda resulting in the formation of common salt, tho chemical equation of which is about as follows:— Na2C03 + 2HCl=2NaCl + C02 + H20 The cost of milk thus solidified is about one penny per lb. 133 TREATED MILK.— How to Make. Separated skim milk, as in the previous instance, is taken, and after being pasteurised is again heated to a temperature of about 80° Fah. It is then infected with a pure culture of lactic ferment, the same that imparts to butter most of its flavour. The following is the chemical equation of the change supposed to take place:— C12H22 O11+OH2=4O3 H6 O3 The acid is allowed to develop to a known quantity, as ascertained by a further delicate test, which it is not necessary to here describe. This point having been reached the milk is now rapidly cooled, and will then be found to have a slightly acid taste, not unlike buttermilk just after churning. Milk so treated and added to butter produces a very delicate flavour and butter aroma. The cost is about one penny per gallon, or one-tenth of a penny per lb.* The Bill shared the fate of somewhat similar Butter Bills introduced on previous occasions, and of this one there is recorded: "Order for Second Reading read and discharged. Bill withdrawn, 20th July, 1905." COFFEE. It is to the discredit of dealers that there is far too much coffee adulteration in the City. Of 79 samples taken during the year, 11, or 15.9 per cent., were adulterated with chicory. In six cases in which proceedings were taken, the following shows the amount of adulterant added was excessive, viz., 23, 40, 41, 66, 64 and 80 per cent. respectively. Last year the number of coffee samples found adulterated was 10 per cent., which compared unfavourably with the whole of the Metropolis, as shown by the following Table, compiled from the Annual Report of the Local Government Board for 1904:— Percentage of samples of Coffee adulterated in the City of London and the several Metropolitan Boroughs during the year 1904, arranged "in order of merit." Whole Metropolis, 8.3 per cent. No. of samples examined. Per cent. of samples adulterated. No. of samples examined. Per cent. of samples adulterated. Deptford 6 None Bermondsey 13 7.7 Hammersmith 9 ,, Greenwich 26 7.2 Holborn 10 ,, Lambeth 85 8.2 Kensington 10 ,, St. Pancras 32 9.4 Paddington 27 ,, Chelsea 10 10.0 Poplar 40 ,, City of London 20 10.0 St. Marylebone 14 ,, Shoreditch 8 12.5 Stepney 55 ,, Camberwell 76 14.5 Stoke Newington 14 ,, Wandsworth 25 16.0 Woolwich 2 ,, Finsbury 15 20.0 Westminster City 79 1.3 Lewisham 57 21.0 Southwark 67 1.5 Islington 28 21.4 Hampstead 37 2.7 Bethnal Green 21 28.6 Hackney 31 3.2 Fulham 11 54.6 Battersea 16 6.3 * Both preparations must be heavily salted after making. 134 DRUGS. Sixty-one samples of drugs were taken, of which 5, or 8.2 per cent., were adulterated. Two of the offenders were convicted and fined, and the three others were cautioned. Last year the percentage of adulterated drugs was 7.7, and it is regrettable to find no improvement this year. It is true that last year with regard to this form of adulteration the City compared fairly well with the whole of the Metropolis, as shown by the figures given below, but it is by no means creditable that the City is not included in the fourteen London districts in which no drug adulteration was discovered. Percentage of samples of Drugs adulterated in the City of London and the several Metropolitan Boroughs during the year 1904, arranged "in order of merit." Whole Metropolis, 9.1 per cent. No of samples examined. Per cent. of samples adulterated. No. of samples examined. Per cent. of samples adulterated. Bethnal Green 8 None Westminster City 106 1.9 Deptford 14 ,, Camberwell 46 4.2 Finsbury 5 ,, Islington 62 6.4 Fulham 3 ,, City of London 52 7.7 Greenwich 11 ,, Kensington 35 8.6 Hammersmith 5 ,, Southwark 98 9.2 Lambeth 27 ,, Bermondsey 32 9.4 Lewisham 7 ,, Hampstead 7 14.3 Poplar 2 ,, Holborn 47 14.9 St. Marylebone 12 ,, Chelsea 47 17.2 Shoreditch 9 ,, Stepney 16 18.8 Stoke Newington 9 ,, Hackney 30 20.0 Wandsworth 19 ,, Battersea 23 30.4 Woolwich 13 ,, Paddington 27 33.3 St. Pancras 9 33.3 The 127 other articles examined comprised 50 samples of mustard, of which 2 were adulterated, 22 of cocoa with 2 adulterated, 1 each of gin and scotch whisky, both reported against, the remainder, all of which were genuine, consisted of 5 each of lard, olive oil, cheese, and baking powder, 27 of pepper, 3 of Demerara sugar, 1 of chocolate, and 2 of yeast. In addition to the foregoing, seven samples were informally taken and are, therefore, not included amongst samples collected under the Act; they consisted of 1 butter and 6 of "four ale." The former was a sample of sophisticated Dutch butter, referred to in my notes on Butter on p. 129, but is not included in the Table on p. 128; the "four ales" were taken under the following circumstances:— 135 ARSENIC IN BEER. In November last, notification was received from a medical man that an illness had come under his treatment, the symptoms of which suggested arsenical poison. The patient had been drinking "more than usual," and had favoured a particular kind of beer known as "Four Ale," obtained from certain public-houses in his district. The diagnosis of arsenical poisoning was strengthened by the fact that traces of this material were found in his hair. Samples of the ale in question were purchased at the public-houses implicated and submitted to the Public Analyst, who reported that they contained a trace of Arsenic less than 1/100 grain per gallon. The Royal Commission in their Report* definitely stated that it was not desirable to fix any standard of Arsenic permissible in beers, as "allowance has to be made for the possibility of other small quantities "of Arsenic being received at the same time from more than one source "of food and drink, and suspectible people have to be considered." It is, however, generally understood that while it may be possible to produce beers absolutely "Arsenic-free," that the majority, when brewed mainly from malt and hops, will contain minute traces, which will, however, be below the amount likely to produce any harmful effects. In two cases the brewers of the samples were identified; in the third case they could only be assumed, as the public-house was "free," and obtained its supplies from various sources. The several makers were at once communicated with, and were found to be fully alive to the importance of taking the utmost precautions. All the details of their processes of manufacture, and the systems of safeguarding the public by the constant examination of all materials as well as the finished article, were explained by the chemical experts advising the brewer in each case. From careful consideration it would seem that no steps are omitted to render the beer practically "Arsenic-free," and that, unless possible in the case of very susceptible persons, no real danger can arise. Further samples will be taken from time to time in order to check the value of the above system. ALIENS AND THE SALE OF FOOD AND DRUGS ACTS. Attention should be called to the fact that, under certain circumstances, aliens who are convicted of offences for which imprisonment can be inflicted without the option of a fine, are liable to be deported under the Aliens Act. The following are the provisions of the above Acts showing what offences under these statutes render those committing them liable to imprisonment without the option of a fine:— Sale of Food and Drugs Act, 1875, Sections 3 and 4. "3.— No person shall mix, colour, stain or powder, or order, "or permit any other person to mix, colour, stain or powder, any article * Final Report of the Royal Commission appointed to enquire into arsenical poisoning from the consumption of beer and other articles of food or drink, dated 6th November, 1903. 136 "of food with any ingredient or material so as to render the article "injurious to health, with intent that the same may be sold in that state, uand no person shall sell any such article so mixed, coloured, stained or "powdered, under a penalty in each case not exceeding fifty pounds for the "first offence; every offence, after a conviction for a first offence, shall "be a misdemeanour, for which the person, on conviction, shall be "imprisoned for a period not exceeding six months with hard labour. "4.— No person shall, except for the purpose of compounding "as hereinafter described, mix, colour, stain or powder, or order, or "permit any other person to mix, colour, stain or powder, any drug "with any ingredient or material so as to affect injuriously the quality "or potency of such drug, with intent that the same may be sold in that "state, and no person shall sell any such drug so mixed, coloured, stained "or powdered, under the same penalty in each case respectively, as in "the preceding section for a first and subsequent offence." Sale of Food and Drugs Act, 1891. "17.— (1) Where under any provision of the Sale of Food "and Drugs Act, 1875, a person guilty of an offence is liable to a fine "which may extend to twenty pounds as a maximum, he shall be liable "for a second offence under the same provision to a fine not exceeding "fifty pounds, and for any subsequent offence to a fine not exceeding one "hundred pounds." This covers all the offences under the Act of 1875, except those created by section 3, as to mixing, &c., any article of food with any ingredients, so as to render the same injurious to health, and selling same; by section 4, as to mixing, &c., drugs with ingredients so as to affect injuriously the quality, dec., of the drug; by section 17, for refusing to sell to any officer; and by section 27, for forging a certificate of warranty. "(2) Where, under any provision of the Sale of Food and Drugs "Acts, a person guilty of an offence is liable to a fine exceeding fifty "pounds, and the offence in the opinion of the Court was committed by "the personal act, default, or culpable negligence of the person accused, "that person shall be liable (if the Court is of opinion that a fine will "not meet the circumstances of the case), to imprisonment, with or with"out hard labour, for a period not exceeding three months." This includes the offences covered by sub-section 1, those created by the Margarine Act, and those created by this Act under sections 1, 7, 8, 16, but only the third offence under any of these provisions. It is important to notice that the Court has no power to imprison under this sub-section, unless in the opinion of the Court the offence, that is, the third offence under the above-mentioned provisions, was committed by the personal act, default or culpable negligence of the person accused. There is a direct connection between the Sale of Food and Drug's Act and the Aliens Act that came into operation at the beginning of this year, and in 137 the administration of the former, section 3 (1) (a) of the latter should be . borne in mind in dealing with those cases where the defendant is an alien who has committed an offence under either of the above-quoted sections of the Sale of Food and Drugs Acts, 1875-1891, that render him liable to imprisonment without the option of a fine. The following is the text of the Aliens Act referred to: — Aliens Act. "Section 3 (1).— The Secretary of State may, if he thinks fit, make an "order (in this Act referred to as an expulsion order) requiring an "alien to leave the United Kingdom within a time fixed by the order, "and thereafter to remain out of the United Kingdom. "(a) If it is certified to him by any court (including a court "of summary jurisdiction), that the alien has been convicted by "the court of any felony or misdemeanour or other offence for "which the court has power to impose imprisonment without the " option of a fine and that the court recommend that the expulsion should be made in his case either in addition to or in "lieu of his sentence." DIVISION OF SAMPLES CONTAINED IN PACKETS. Smith v. Savage. In this case, heard before the Lord Chief Justice, in the King's Bench Division, on the 12th April, 1905, an inspector had bought four packets of cream of tartar from one box. He emptied the four into one place and mixed them up and divided the mixture into three parts. The Justices dismissed the summons and the case was taken to a higher Court, which allowed the appeal upon the following grounds. The case was different from that of Mason v. Cowdary upon which the respondent relied when the case was before the Magistrates. Some question might arise if different articles not of a similar name or articles coming from different people were mixed together in the same shop; that, however, was not the case in this instance. Here the appellant has asked for cream of tartar, which, for the purpose of measurement, was put up in penny packets. He said he would take four packets, and they had to determine whether, because four packets of the same article, labelled in the same way and sold at the same time as cream of tartar, were mixed together and then divided into three parts, it was a good objection to the analysis that followed. The Court was of opinion that it was not a good objection, and sent the case back to the Justices for trial. 138 139 SALE 0F F00D AND DRUGS ACTS, 1875-1899. Articles examined during each Quarter of the year 1905. Articles submitted for Analysis. Quarter ending 31st March. Quarter ending 30th June. Quarter ending 30th September. Quarter ending 31st December. Total for 1905. 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 184 171 13 7.07 66 63 3 4.5 113 101 12 10.5 118 110 8 6.7 481 445 36 7.5 Butter 131 129 2 1.5 57 57 ... ... 88 87 1 1.1 78 77 1 2.5 354 350 4 1.1 Mustard 13 12 1 7.7 13 12 1 7.0 ... ... ... ... 24 24 ... ... 50 48 2 4.0 Cocoa 11 9 2 18.1 3 3 ... ... ... ... ... ... 8 8 ... ... 22 20 2 9.0 Coffee 26 21 5 19.2 18 14 4 22.2 ... ... ... ... 35 33 2 5.7 79 68 11 13.9 Lard 1 1 ... ... 1 1 ... ... 3 3 ... ... ... ... ... ... 5 5 ... ... Olive Oil 2 2 ... ... ... ... ... ... ... ... ... ... 3 3 ... ... 5 5 ... ... Drugs ... ... ... ... 15 13 2 13.3 ... ... ... ... 46 43 3 6.5 61 56 5 8.2 Pepper 15 15 ... ... 6 6 ... ... ... ... ... ... 6 6 ... ... 27 27 ... ... Demerara Sugar 2 2 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 3 3 ... ... Cheese 4 4 ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 5 5 ... ... Baking Powder 4 4 ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 5 5 ... ... Chocolate ... ... ... ... 1 1 ... ... • • • • • • ... ... ... ... ... ... 1 1 ... ... Gin ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 100.0 Scotch Whisky ... ... ... ... 1 ... 1 ... ... ... ... ••. ... ... ... ... 1 ... 1 100.0 Yeast ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... 2 2 ... ... Totals 393 370 23 5.9 182 170 12 6.6 205 192 13 6.3 328 311 14 5.5 1,102 1,040 62 5.6 140 SALE OF FOOD AND DRUGS ACTS, 1875-1899. 1905. RESULTS OF PROSECUTIONS. First Quarter. Sample. Nature and Extent of Adulteration. Result. 208 Butter 15 per cent. margarine 1s. and 12s. 6d. expenses. 220 Milk 6 per cent. fat abstracted Summons dismissed on proof of warranty. 245 „ 7 per cent. added water £4 and 12s. 6d. expenses. 259 „ 6 per cent. fat abstracted Summons dismissed on proof of warranty. 261 Butter 15 per cent. margarine £10 and 17s. 6d. expenses. 262 Milk 7 per cent. added water Summons dismissed on proof of warranty. 270 „ 6 per cent. added water Summons dismissed on proof of warranty. 283 ,, 10 per cent. fat abstracted £10 and 12s. 6d. expenses. 299 „ 9 per cent. added water £5 and 23s. 6d. expenses. 305 „ 18 per cent. fat abstracted Summons dismissed on proof of warranty. 314 „ 6 per cent. added water Summons dismissed on proof of warranty. 315 ,, 7 per cent. added water £10 and 17s. 6d. expenses. 349 Coffee 40 per cent. chicory £2 and 17s. 6d. expenses. 350 Mustard 42per cent. flour, 1 per cent. turmeric 17s. 6d. expenses. 378 Coffee 80 per cent. chicory Dismissed, insufficient evidence. 379 Cocoa 53 per cent. sugar 17s. 6d. expenses. 381 Coffee 64 per cent. chicory ... £3 and 17s. 6d. expenses. 382 Cocoa 39 per cent. sugar and 15 per cent. starch 17s. 6d. expenses. Second Quarter. 424 Coffee 23 per cent. chicory Dismissed. 429 Sweet Spirit of Nitre 33 per cent. deficient in ethyl nitrite 10s. and 17s. 6d. expenses. 440 „ „ ,, 71 per cent. deficient in ethyl nitrite £2 and 17s. 6d. expenses. 442 Gin 39.3 degrees under proof £2 and 17s. 6d. expenses. 443 Scotch Whisky 35.3 degrees under proof 5s. and 17s. 6d. expenses. 477 Mustard 15 per cent. flour, .3 per cent. turmeric £l and 17s. 6d. expenses. 577 Milk 10 per cent. fat abstracted Summons dismissed on proof of warranty. 141 Third Quarter. Sample. Nature and Extent of Adulteration. Result. 644 Milk 7 per cent. added water 2s. 6d. and 13s. 6d. expenses. 646 „ 9 per cent. added water Summons withdrawn, warranty produced. 650 „ 7 per cent. added water £1 and 17s. 6d. expenses. 668 „ 8 per cent. added water 1s. and 12s. 6d. expenses. 698 ,, 7 per cent. added water £10 and 17s. 6d. expenses. 707 „ 30 per cent. fat abstracted £6 and 17s. 6d. expenses. 711 „ 7 per cent. added water Summons dismissed on proof of warranty. 714 Butter 100 per cent. margarine £5 and 17s. 6d. expenses. 738 Milk 29 per cent. fat abstracted £6 and 18s. 6d. expenses. Fourth Quarter. 804 Milk 10 per cent. added water, and 12 per cent. fat abstracted Summons dismissed on question of ownership. 889 Coffee 64 per cent. chicory 40s. and 17s. 6d. expenses. 931 Butter 100 per cent. margarine 10s. and 17s. 6d. expenses. 932 Coffee 41 per cent. chicory 10s. and 12s. 6d. expenses. 1076 Milk 13 per cent. added water (second conviction) £10 and 17s. 6d. expenses. 1098 „ 4 per cent. added water (fourth conviction) £50 and 20s. expenses. 1099 „ 8 per cent. added water (second conviction) £10 and 20s. expenses. SUMMARY. £ s. d. £ s. d. First Quarter: Fines 44 1 0 Expenses 9 3 6 Second Quarter „ 5 15 0 ,, 4 7 6 Third Quarter „ 28 3 6 ,, 5 14 6 Fourth Quarter „ 73 0 0 ,, 5 5 0 £150 19 6 £24 10 6 Twenty-six fines were inflicted during the year, as against 57, 23 and 27 in the preceding three years. The average fines and expenses imposed was £6 15s., the corresponding amounts for 1902, 1903 and 1904 being £4 2s. 2d., £4 18s. 1d., and £2 19s. 2½d. respectively. By direction of the Sanitary Committee eighteen persons were cautioned during the year as to the questionable or unsatisfactory character of articles they sold. I have the honour to be, Gentlemen, Your obedient Servant, W.Muyredfe Public Health Department, Medical Officer of Health for the Guildhall, E.C., City of London. March, 1906. APPENDICES. PAGE Appendix A—Street Lists of Mortality 145 „ B— „ „ Infectious Disease 148 C— Tenement House Register 151 „ D— List of Persons registered under the Dairies, Cowsheds and Milk Shops Orders 160 „ E— Kitchen of Restaurants 166 145 Appendix A. CITY OF LONDON MORTALITY. 1905. STREET LISTS, Compiled from Weekly Returns of Registrars of Sub-Districts. STREET OR PLAOE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. Adam's Court, Old Broad Street 3 F 29 13 April, 1905 Pulmonary Tuberculosis Aldermanbury 32 M 67 26 Sept. „ Suicide by poison Inquest Aldersgate Street 32 F 52 7 May „ Heart Disease ,, ,, 130 M 7 months 20 „ „ Bronchitis Aldgate — M 6 5 Jan. „ Morbus Cordis Aldgate Station - F new born 21 June „ Atelectasis Inquest. Found under seat of railway carriage. Unknown Amen Corner — M 73 7 Dec. „ Apoplexy Arthur Street West 10a F 13 m'ths 3 Mar. „ Pneumonia Artillery Lane 20 M 2 days 27 May „ Prematurity ,, ,, 21 F 63 4 Sept. „ Bronchitis Austin Friars 26 F 6 months 9 Mar. „ Influenza Barker's Buildings, Bishopsgate 29 M 36 5 Feb. „ Pneumonia Bartholomew Close 44 F 57 1 Jan. „ Acute Bronchitis Bartholomew House, Cloth Fair 10 M 6 months 24 Feb. „ Broncho-Pneumonia Basinghall Street 70 M 67 2 Jan. „ Cardiac Failure Beech Street 13 M 33 24 June „ Alcoholism Inquest Beer Lane, The "Yorkshire Green" Public House - M 6 months 25 Aug. „ Diarrhœa Bell's Buildings, Salisbury Square 8 M 71 1 Mar. „ Killed by a fall Inquest ,, ,, 7 M 47 6 July. „ Morbus Cordis ,, ,, 5 F 43 17 Nov. „ Carcinoma Billingsgate Mission Hospital M 23 19 July „ Lobar Pneumonia Birchin Lane. Bank Chambers - M 35 24 Jan. „ Syncope Bishopsgate Street Without 91 M 65 24 May „ Carcinoma ,, ,, 88 F 89 5 Aug. „ Cardiac Degeneration ,, ,, 104 F 57 2 Nov. „ Softening of the Brain ,, ,, 118 F 64 16 „ „ Cerebral Hæmorrhage Blackfriars Station - F 36 21 Sept. „ Run over by train Inquest. Misadventure Bloomfield House, Snow Hill 20 M 21 m'ths 4 Mar. „ Broncho-Pneumonia ,, ,, 1 F 5 months 21 Aug. „ Pneumonia Bolt Court, Fleet Street 6 F 46 1 Sept. „ Apoplexy Bread Street 12 F 58 17 Jan. „ Metral Disease Bridewell Place Police Station - F 2 months 8 „ „ Bronchitis Bridgewater House, Fann Street 1 M 5 months 12 Feb. „ Convulsions Died in St. Bart.'s ,, ,, 12 M 70 26 July „ Acute Pleurisy ,, ,, 4 F 81 26 „ ,, Apoplexy Brushfield Street 12 F 62 20 Sept. „ Pneumonia ,, ,, 14 F 71 9 Dec. „ Fell down stairs and fractured right arm Inquest and P.M. Accidental ,, ,, 12 F 70 23 „ „ Acute Bronchitis Bucklersbury 20 M 57 29 June „ Influenza Cannon Street 119 M 50 17 Aug. „ Syncope Inquest „ „ Station M 78 31 „ Syncope Inquest ,, ,, — M 15 29 July „ Injuries to skull Run over on railway. Inquest. Accidental „ „ Hotel M 75 1 April „ Carcinoma of Prostate Carmelite Street Fire Station - F 10 13 Jan. „ Morbus Cordis ,, ,, - F 15 5 May „ Pneumonia Carter Lane 81 F 30 11 Feb. „ Blight's Disease ,, ,, 50 M 6 months 2 July „ Enteritis Catherine Court 3 F 51 2 Dec. „ Asthenia Circus, Minories 3 M 33 1 Mar. „ Phthisis City Police Hospital, Bishopsgate - M 43 1 June „ Fall in roadway Inquest ,, ,, - M 27 28 May „ Lobar Pneumonia ,, ,, — M 25 11 Mar. „ Cerebral Tumour Clement's Lane 6 F 76 10 Aug. „ Pneumonia Cloth Fair 43 F 73 19 „ „ Gastritis ,, ,, 24 F 35 8 Sept. ,, Cirrhosis of Liver P.M. Died in St. Bart.'s ,, ,, 45 M 27 days 27 Feb. ,, Immaturity Died in St. Bart.'s ,, ,, 45 M 20 days 20 „ „ Immaturity Died in St. Bart.'s Cock Lane 33 F 57 9 „ „ Carcinoma of Uterus Cockerill's Buildings 6 F 49 17 Oct. ,, Cerebral Hæmorrhage Inquest and P.M. Copthall Court 2 M 53 26 Mar. „ Cirrhosis of Liver Currier's Row 7 M 7 6 April „ Acute Bronchitis Dean Street 5a M 5 months 21 July „ Zymotic Enteritis Dean's Court, Old Bailey 31 F 61 18 Feb. „ Phthisis Devonshire Square 5 F 50 29 April „ Cerebral Hæmorrhage Died in St. Bart.'s Dr. Johnson's Buildings 2 F 63 22 May ,, Syncope Inquest East Passage 5 M lOm'ths. 9 June „ Marasmus ,, ,, 27 M 75 5 Aug. „ Chronic Bronchitis East cheap 24 M 65 3 Nov. „ Bronchitis Exchange Buildings, Houndsditch 9 F 51 24 „ ,, Carcinoma of large Intestine 146 CITY OF LONDON MORTALITY— continued. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. Fenchurch Street 69 F 76 1 Jan., 1905 Coma ,, ,, 71 F 64 7 Feb. ,, Cirrhosis of breast ,, ,, 21 F 3 21 Nov. „ Pneumonia ,, ,, 6 M 47 13 Dec. „ Hæmorrhage from ruptured vein in leg Inquest Fecnhurch Avenue 2 F 3months 4 Oct. „ Suffocation Inquest Fetter Lane 38 F 80 3 Jan. ,, Senile Decay ,, ,, 36 F 75 8 „ ,, Morbus Cordis ,, ,, 26 M 48 4 Aug. „ Suicide by hanging Inquest. Suicide ,, ,, 41 M 3months 6 Dec. „ Marasmus Finsbury Circus 6 F 77 11 May „ Chronic Bronchitis „ „ House — M 49 11 Jan. „ Bronchitis Fish Street Hill 36 F 48 15 Mar. „ Broncho- Pneumonia Fleet Street 188 F 56 10 Jan. „ Intestinal Obstruction ,, ,, 166 M 54 29 Sept. „ Suicide by poison Inquest. Suicide Furnival Street 39 F 3 months 3 Dec. „ Marasmus ,, ,, 39 F 62 6 Jan. „ Acute Bronchitis Garden Place, Hutchison Street 9 M 44 2 June „ Phthisis Pulmonalis George Street 13 M 80 25 Jan. „ Cerebral Hæmorrhage Goodman's Yard 3 F 4 months 8 Aug. „ Intestinal Catarrh Great New Street 21 F 69 29 July „ Cancer Great Tower Street 55 M 26 13 May „ Epilepsy ,, ,, 98 F 4 days 4 Dec. „ Congenital Obstruction of the Bile Ducts ,, ,, 5 F 73 12 „ ,, Asthma Great Winchester Street 17 M 72 23 Nov. „ Cystitis Green Dragon Court 7 F 54 14 Jan. „ Chronic Bronchitis ,, ,, 5 F 88 27 „ ,, Pneumonia Gresham Street 75 M 72 26 April „ Gastritis ,, ,, 99 F 71 21 May „ Heart Failure Grocers' Hall Court 5 F 60 2 Mar. ,, Syncope Gutter Lane (Goldsmiths' Hall) — F — 14 July „ Enlarged Lymphatic Glands Halt Moon Passage 5 M 38 10 May „ Syncope Inquest Holborn 23 M 79 2 Nov. „ Uræmia Hutchison Avenue 2 M 1 month 28 July „ Gastro-Enteritis Idol Lane 11 M 48 4 Dec. „ Suicide by shooting Inq. Temporary insane Ivy Lane 12 M 54 21 May „ Shock due to perforation of Anodenal Ulcer Inquest. P.M. King's Street, Cheapside 15 M 86 1 Oct. „ Senile Decay „ „ Snow Hill 18 M 7 25 July „ Failure of Respiration while under Chloroform Inquest. Misadventure ,, ,, 23 F 65 2 Dec. „ Heart Disease King William Street 77 F 56 11 Mar. „ Carcinoma ,, ,, ,, 6&7 F 73 4 July „ Cerebral Hæmorrhage King's Head Court, Shoe Lane 16 M 14 m'ths 16 April „ Lobar-Pneumonia Died in St. Bart.'s ,, ,, ,, ,, 14 F 40 26 Dec. „ Chronic Alcoholism Lime Street 39 F 70 22 Jan. „ Bronchitis ,, ,, 48 M 74 3 April „ Morbus Cordis Little Britain 54 F 25 26 Aug. „ Pott's Disease of Spine Lloyd's Avenue 5 M 10 m'ths 23 Feb. „ Pertussis London Street 10 M 18 15 April „ Chronic Nephritis Long Lane 84 F 42 23 Jan. „ Phthisis Lothbury 5 F 61 15 May „ Chronic Bronchitis Mansell Street 18 F 75 1 Feb. „ Morbus Cordis ,, ,, 18 M 10 m'ths 16 ,, „ Morbilli ,, ,, 14 M 9 months 30 Mar. „ Bronchitis ,, ,, 9 F 3 months 5 Dec. „ Bronchitis Mansion House Station - M new born 20 July „ Suffocation Body found in train. Inquest. No evidence how caused Middle Street 5 M 35 4 Dec., „ Phthisis Middlesex Street 15 F 87 10 April „ Senile Decay ,, ,, 33 F 70 13 May „ Bronchitis ,, ,, 91 F 77 28 Dec. „ Morbus Cordis Middlesex Passage 5 F 59 11 ,, ,, Bronchitis Minories 47 F 22 4 April „ Pulmonary Congestion ,, - M 22 4 May „ Syncope Died in St. Bart.'s ,, 96 F 65 22 Dec. „ Rupture of Coronary Artery Inquest and P.M. Mitre Street 6 M 70 10 July „ Cerebral Thrombosis ,, ,, 5 M 62 5 Sept. ,, Broncho-Pneumonia Montague Court 16 F 54 18 Oct. ., Broncho-Pneumonia Moorgate Railway Station — M 32 9 Sept. „ Run over by train Inquest. Accidental Nevill's Court 12 F 60 6 May „ Senile Decay New Square, Minories 18 M 59 8 Sept. „ Syncope Inquest and P.M. New Street, Houndsditch 8 F 74 22 Mar. „ Cerebral Thrombosis ,, ,, ,, 22 M 74 30 May „ Pernicious Anæmia ,, ,, „ 33 F 48 4 Sept. „ Diabetes ,, ,, ,, 24 M 62 21 Nov. „ Cerebral Hæmorrhage Inquest and P.M. ,, ,, ,, 23 F 16 10 Dec. „ Morbus Cordis ,, ,, ,, 8 M 3 months 24 „ ,, Marasmus New Bridge Street— Angus Hotel — F 79 4 Feb. „ Influenza New Broad Street 45 M 76 9 „ ,, Heart Disease ,, ,, ,, 15 M 77 2 Mar. „ Prostatic Disease ,, ,, ,, 64 F 58 16 ,, ,, Cirrhosis of Liver 147 CITY OF LONDON MORTALITY— continued. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. New Broad Street 64 M 54 18 Dec., 1905 Pneumonia Newbury Street 1 M 18 m'ths 22 Jan. „ Broncho- Pneumonia Died in St. Bart.'s ,, ,, 14 11 64 10 Feb. „ Killed by fall Inquest ,, ,, 12 M 60 14 Mar. „ Bronchitis ,, ,, 2 M 51 12 July „ Heart Failure ,, ,, 11 F 79 1 Sept. „ Hemiplegia Old Bailey— "King of Denmark" — M 6 months 4 Jan. „ Acute Bronchitis ,, 22 M 76 21 April „ Bronchitis ,, 22 F 66 23 Nov. „ Strangulated Hernia Died in St. Bart.'s Pemberton Row 5 M 6 hours 30 June „ Prematurity Philpot Lane 22 F 15 m'ths 10 Feb. „ Heart Failure Inquest Pinner's Court 1 F 82 6 .Jan. „ Bronchitis Poppin's Court 31 M l0½ m'ths 15 May ,, Convulsions Queen Street 70 F 49 16 Mar. ,, Pulmonary Tuberculosis Queen Victoria Street 181 M 35 20 Dec. ,, Apoplexy Red Lion Court 11 F 44 19 Aug. „ Bronchitis ,, ,, ,, 8 M 92 28 Nov. „ Senile Decay River Thames, London Bridge - M 35 18 July „ Drowning Inquest. No evidence as to how deceased came into water „ „ Blackfriars - M 36 22 Oct. „ Drowning Inquest. Accidental. Deceased fell from barge „ „ Fresh Wharf — M 33 29 Dec. „ Drowning Inquest. Accidental Robin Hood Court, Union - M 17 7 Feb. „ Phthisis ,, ,, ,, ,, - M 54 22 „ ,, Broncho-Pneumonia ,, ,, ,, ,, — M 65 20 Aug. „ Cerebral Softening ,, ,, ,, ,, — F 30 16 Nov. „ Broncho-Pneumonia ,, ,, ,, ,, — M 53 23 „ ,, Broncho- Pneumonia St. Bartholomew's Hospital — M 5 19 Sept. „ Diphtheria St. Dunstan's Hill 10 M 50 10 Aug. „ Chronic Alcoholism Inquest St. Helen's Place 9 F 46 4 Dec. „ Acute Bronchitis ,, ,, 17 M 50 14 Jan. „ Bronchitis Died in St. Bart.'s ,, ,, 8 F 79 13 Mar. „ Coma St. Mary Axe 68 M 54 2 Oct. „ Aneurysm Inquest and P.M. Shaftesbury Place 17 F 40 6 Jan. „ Septic Pneumonia ,, ,, 8 M 5 m'ths 16 Aug. „ Meningitis Died in St. Bart.'s ,, ,, 28 F 4 days 10 Sept. „ Atelectasis ,, ,, 2 M 3 4 Oct. „ Tubercular Meningitis Inquest and P.M. ,, ,, 16 11 3 m'ths 28 Nov. „ Gastro-Enteritis Spital Yard 7 F 43 14 July „ Cirrhosis of Breast Temple Lane 7 M 47 3 ,, ,, Morbus Cordis Died in St. Bart's Thavies' Inn 17 F 12 m'ths 2 Sept. „ Meningitis Throgmorton Street 37 F 12 m'ths 8 Dec. „ Pertussis ,, ,, 31 F 64 15 ,, ,, Cirrhosis of Liver Tower of London - F 7 24 April „ Peritonitis Tower Street 26 M 49 16 Feb. „ Carcinoma of Liver Tudor Street 2 & 4 F 50 3 April „ Phthisis Union Court 15 M 34 11 Nov. „ Bronchitis Inquest Upper Thames Street 186 M 3 months 8 Feb. „ Inanition ,, ,, ,, 82 11 54 21 May „ Cirrhosis of Liver Victoria Embankment—Sion College — 11 64 24 April „ Capillary Bronchitis „ „ Royal Hotel — M 40 4 Sept. „ Suicide by poison Inquest and P.M. ,, ,, — M 64 28 Oct. „ Heart Disease Vine Street 8 F 40 18 Feb. „ Pneumonia Walbrook 22 F 42 9 ,, ,, Chronic Nephritis Water Lane 11 M 64 8 ,, ,, Broncho-Pneumonia ,, ,, 5 F 62 15 April Capillary Bronchitis ,, ,, 17 F 62 26 Nov. „ Cerebral Hæmorrhage West Smithfield 57 F 36 3 July „ Syncope Whitecross Street 6 F 62 8 Sept. „ Cerebral Hæmorrhage Died in St. Bart.'s Whitefriars Street— "The Scotch Stores" — M 7 hours 19 Nov. „ Prematurity Widegate Street 13 M 95 4 Feb. „ Senile Decay ,, ,, 18 M 68 5 Aug. „ Senile Decay Wine Office Court 2 F 80 7 Feb. „ Apoplexy Wood Street Temperance Hotel - M 33 22 June „ Suffocation due to Opium poisoning Inquest. Accidental ARTIZANS' DWELLINGS—STONEY LANE, HOUNDSDITCH. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. King's Block 16 F 89 31 May, 1905 Senile Decay Queen's Block 12 F 82 22 Jan. „ Morbus Cordis ,, ,, 45 M 73 4 Sept. „ Epithelioma of Cheek ,, ,, 2 11 68 8 Dec. „ Cerebral Hæmorrhage ,, ,, 38 F 90 23 Oct. „ Bronchitis Prince's Block 53 F 8 weeks 22 Feb. „ Suffocation in bed Inquest ,, ,, 40 M 21 m'ths 9 May „ Heart Failure ,, ,, 36 F 77 14 Sept, „ Gangrene ,, ,, 12 M 48 29 Nov. „ Acute Bronchitis North Block 21 F 10 26 Jan. „ Endocarditis ,, ,, 55 F 63 27 Feb. „ Pulmonary Tuberculosis ,, ,, 26 F 80 21 Mar. „ Cancer ,, ,, 49 M 1 day 18 April „ Prematurity Inquest South Block 22 M 1 hour 12 May „ Prematurity ,, ,, 22 F 15 hour 13 ,, ,, Prematurity ,, ,, 20 M 36 16 ,, ,, Pulmonary Congestion ,, ,, 6 F 84 25 Sept. „ Gangrene 148 Appendix B. LIST OF INFECTIOUS CASES, 1905. STREET LISTS. Compiled from Notifications received. Street or Place. No. of House. Sex. Age. Disease. Adam's Court 3 F 29 Phthisis. Aldersgate Street 64 F 9 Scarlet Fever. Artillery Lane 16 M 12 Ditto. Ditto 22 F 5 Scarlatina. Austin Friars 23 M 35 Erysipelas. Bartholomew Close 85 F 47 Ditto. Ditto 89 M 22 Scarlet Fever. Bartlett's Buildings 18 F 5 Diphtheria. Basinghall Avenue 3 M 85 Erysipelas. Basinghall Street (City of London Court) ... F 13 Scarlet Fever. Billiter Street 22 M 5 Chicken-pox. Birchin Lane 26 M 2½ Scarlet Fever. Ditto 26 M 6¾ Scarlatina. Bishopsgate Street (Police Station) • • • F 11 Chicken-pox. Ditto Without 106 F 3 Scarlet F ever. Bloomfield Street 12 F 20 Scarlatina. Bouverie Street 16 F 23 Diphtheria. Cannon Street ("Coopers' Arms") ... F 23 Enteric Fever. Ditto 4 & 6 M 15 Scarlet Fever. Ditto 106 F 65 Erysipelas. Carter Lane 22 M 22 Scarlatina. Charterhouse Street 18 M 17 Scarlet Fever. Ditto 18 M 19 Ditto. Ditto 18 M 16 Ditto. Circus, Minories 1 F 11 Erysipelas. City Buildings (Moor Lane) 11 F 31 Ditto. Cloth Fair 22 M 8 Scarlet Fever. Coleman Street 74 M 30 Phthisis. College Street 27 F 11 Scarlatina. Cornhill 11 M 9 Chicken-pox. Ditto 33 F 13 Ditto. Ditto 70 M 11 Scarlet Fever. Ditto 74 F 50 Erysipelas. Cross Lane 3 F 1½ Chicken-pox. Ditto 3 M 5 Ditto. Duke Street 21 M 8 Scarlatina. East Passage 28 F 2½ Scarlet Fever. Fenchurch Avenue 13 F 6 Scarlatina. Fenchurch Buildings 6 M 5 Scarlet Fever. Fenchurch Street 112 M 3 Chicken-pox. Ditto 149 M 6 Ditto. Ditto 167 M 12 Ditto. Ditto 167 F 7 Ditto. Finsbury Pavement (Salisbury House) ... F 42 Erysipelas. Fleet Street (Anderton's Hotel) • • • F 25 Ditto. Ditto (Peele's Hotel) • • • F 25 Diphtheria. Friday Street 7 M 15 Chicken-pox. Garden Place 9 M 43 Phthisis. Gracechurch Street 19 M 58 Erysipelas. Ditto 70 M 5 Scarlet Fever. Great New Street 3 M 63 Erysipelas. Great Winchester Street 16 F 18 Scarlatina. 149 Street or Place. No. of House. Sex. Age. Disease. Harp Lane (Bakers' Hall) ... M 9 Scarlet Fever. Harrow Alley 35 M 4 Ditto. Ditto 35 M 5 Ditto. Holborn (Holborn Viaduct Hotel) ... M 56 Erysipelas. Hosier Lane 5 M 6 Scarlet Fever. Houndsditch 118 F 8 Scarlatina. Hutchison Avenue 6 M 2 Diphtheria. Ditto 6 M 2 Scarlet Fever. Ditto 19 F 4 Ditto. Ditto 22 F 40 Phthisis. Hutchison Street 2 F 59 Erysipelas. Ditto 18 M 2 Scarlet Fever. Ireland Yard (Hitchcock, Williams & Co.) ... M 18 Ditto. John Street 13 F 47 Erysipelas. King's Block 19 M 57 Ditto. Ditto 23 F 4 Chicken-pox. Ditto 23 F 1 Ditto. Ditto 34 M 7 Scarlet Fever. Ditto 34 M 11 Ditto. Leadenhall Market ("The Half Moon") ... M 16 Scarlatina. Leadenhall Street 69 M 16 Scarlet Fever. Lime Street 37 F 8 Ditto. Ditto 37 F 3 Ditto. Lime Street Square 2 F 10 Ditto. Ludgate Hill 60 F 4 Diphtheria. Ditto 60 F 4 Ditto. Middle Street 5 M 35 Phthisis. Middlesex Street 57 F 23 Scarlet Fever. Ditto 83 M 4 Ditto. Minories 104 F 14 Ditto. New Court ... M 1 Chicken-pox. Ditto ... M 4 10/12 Ditto. New Street 5 F 45 Erysipelas. Newgate Street ("Viaduct Tavern") ... M 3½ Scarlet Fever. Ditto 23 F 14 Typhoid Fever. North Block 18 M 5 Scarlet Fever. Ditto 18 M 2½ Membranous Croup. Ditto 18 F 5 bcarlet Fever. Ditto 22 F 6 Ditto. Ditto 27 M 5 Ditto. Old Broad Street 33 F 35 Erysipelas. Ditto 70 F 24 Scarlatina. Paternoster Row 46 F 19 Ditto. Prince's Block 37 M 2 Diphtheria. Ditto 49 M 1 9/12 Chicken-pox. Ditto 50 M 1 2/12 Ditto. Queen's Block 21 M 65 Erysipelas. Redcross Street 62 M 7 Scarlet Fever. Ditto 62 M 5 Ditto. Rood Lane 10 F 11 Diphtheria. St. Bartholomew's Hospital (Nurses' Home) ... F 25 Scarlet Fever. Ditto ditto ... F 27 Ditto. Ditto ditto ... F 25 Ditto. Ditto ditto ... F 29 Ditto. Ditto ditto ... F 24 Ditto. Ditto ditto ... F 27 Ditto, Ditto ditto • • • F 23 Ditto. Ditto ditto ... F 21 Ditto. Ditto ditto ... F 24 Diphtheria. Ditto ditto ... F 32 Ditto. Ditto (Porter's Lodge) ... M 5½ Ditto. 150 Street or Place. No. of House. Sex. Age. Disease. St. Bartholomew's Hospital (Wardmaids' Home) F 23 Scarlet Fever. St. Swithin's Lane 24/27 M 22 Ditto. Shaftesbury Place 12 F 6 Ditto. Ditto 13 F 5 Ditto. Ditto 15 M 18 Chicken-pox. Ditto 28 M 3½ Scarlet Fever. South Block 16 F 12 Erysipelas. Ditto 30 M 1 9/12 Chicken-pox. Ditto 30 M 6½ Ditto. Swan Lane 10 M 3 9/12 Diphtheria. Temple Chambers 259 M 51 Erysipelas. Thavies Inn (Infirmary) ... M 36 Phthisis. Ditto ... M 23 Ditto. Ditto ... M 19 Ditto. Ditto ... M 19 Ditto. Ditto ... F 34 Ditto. Ditto ... M 26 Ditto. Ditto ... M 50 Ditto. Ditto ... M 54 Ditto. Ditto ... M 36 Ditto. Ditto ... M 42 Ditto. Ditto ... M 45 Ditto. Ditto ... M 40 Ditto. Ditto ... M 32 Ditto. Ditto ... M 42 Ditto. Ditto ... M 48 Ditto. Ditto ... M 49 Ditto. Ditto ... M 46 Ditto. Ditto ... M 59 Ditto. Ditto ... F 39 Ditto. Ditto ... M 58 Ditto. Ditto ... M 26 Ditto. Ditto • • • M 55 Ditto. Ditto ... F 58 Pulmonary Tuberculosis. Ditto ... F 3¾ Scarlet Fever. Ditto 17 M 10 Ditto. Ditto ... F 6 Ditto. Ditto ... F 7 Ditto. Trinity Square 11 F 3 Ditto. Trump Street 10 M 52 Erysipelas. Tudor Street 28/30 M 18 Scarlet Fever. Wardrobe Place ("Old Bell Hotel") ... M 53 Erysipelas. Warwick Square 12 M 56 Ditto. Ditto 12 M 25 Scarlet Fever. Ditto 12 M 23 Diphtheria. Watling Street Fire Station ... M 6 Scarlet Fever. Ditto ... M 3 Ditto. 151 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 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, 15, Oakfield Road, Stroud Green 3 4 2, do. do. Do. do. do. 1 1 5, Dorset Street H. Fenton, 5. Dorset Street 5 6 7, do. Mary Davis, 7, do. 3 10 2, Evangelist Court Mr. T. Brown, 2, Evangelist Court 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. Mrs. E. Daw, do. 5 11 37, do. Harriet Jardine, 37, do. 5 6 38, do. W. A. Hooper, 38, do. 5 6 42, do. Mr. T. Gibson, 42, do. 3 7 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 117 273 152 WEST DI STRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 117 273 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 8, 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 Prudential Assurance Co. 8 18 7, do. Do. do. 9 18 18, 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 13, Newcastle Street, Farringdon Street. Arthur Wilks, 13, Newcastle Street 7 8 5, New Street Hill, and 11, Gunpowder Alley J. H. Hemmings, 5, New Street 3 6 10, New Street Square Herbert Mogridge, 10, New Street Square 2 6 7, Nevill's Court F. Figg, 7, Nevill's Court 3 11 8, do. J. F. Pemsel, 15, Oakfield Road, Stroud Green 3 4 9, do. Do. do. do. 2 6 10, do. Do. do. do. 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 19, Primrose Hill Crawley & Smee, 19, Primrose Hill 3 10 20, do. E. Coulson, 20, do. 4 10 22, do. Thomas Palmer, 22, do. 8 12 8, Red Lion Court 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 D. Cope, 16, Tudor Street 2 10 Carried forward 281 675 153 WEST DISTRICT— continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 281 675 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 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 4, Cloth Fair J. Edwin Ponder, 103, Aldersgate Street 4 8 6 & 7, do. Charles Randall, 6, Cumming Street, Pentonville 7 15 8 do. 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. 3 10 22, do. J. Jackson, 22, do. 4 10 25, do. Miss Laura Bassey, 25, Cloth Fair 3 7 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 Sniithfield 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 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 Carried forward 431 1,042 154 WEST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 431 1,042 25a, Kinghorn Street W. Phelan, 20, Cloth Fair 4 13 1, Little Montague Court j. Abbott, 103, Aldersgate Street 2 10 2, do. Do. do. 5 17 45, Little Britain William F. Retzleff, 45, Little Britain 1 1 54, do. Thomas N. Janes, 101, Aldersgate Street 3 8 79, Long Lane 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. T. Green, 20, Middle Street 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 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, 38, do. 6 6 2, do. Do. do. 3 12 Total 545 1,306 Average number of lodgers to each tenement: 2.39. WEST DISTRICT. Houses demolished or closed in 1905:—41, Little Britain; 15, Water Street; and 3, Cloth Fair. 155 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 Empty - - 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 Shadbolt, 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. Messrs. Boyce Evens and Co., 92, Hoxton Street 2 4 3, do. The Ramoneur Co., 30, Shaftesbury Place 1 1 4, do. Mr. Birchall, 4, do. 2 5 5, do. Messrs. Boyce .and Co., 5, do. 1 6 6, do. J. Petty, 6, do. 3 14 7, do. C. Roberts, 7, do. 2 8 8, do. Messrs. Boyce and Co., 8, do. 3 7 9, do. T. Wood, 9, do. 3 7 10, do. J. Nevillion, 10, do. 1 3 11, do. Empty - - 12, do. J. Regan, 12, do. 2 13 13, do. Messrs. Boyce and Co., 13, do. 2 15 14, do. T. Pearce, 14, do. 2 10 15, do. Messrs. Boyce and Co., 15, do. 1 4 16, do. S. Cooper, 16, do. 1 5 17, do. Messrs. Boyce and Co. 3 8 18, do. Mr. Page, 18, do. 1 3 19, do. Joseph Perry, 19, do. 2 5 20, do. Messrs. Boyce and Co., 20, do. 3 14 21, do. Do. 21, do. 2 6 22, do. Do. 22, do. 1 4 23, do. Do. 23, do. 3 4 24, do. Do. 24, do. 3 6 25, do. Do. 25, do. 3 7 26, do. Mr. Reason, 26, do. 2 9 27, do. Messrs. Boyce and Co., 27, do. 2 11 28, do. Do. 28, do. 2 6 29, do. Mr. Newbolt, 29, do. 3 6 30, do. Mr. Murkell, 30, do. 2 8 Total 98 283 156 EAST DISTRICT. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. 27, Aldgate A. L. Poysner, 27, Aldgate 1 2 6, do. Jane Silveridge, 6, do. 3 10 9, Artillery Lane John Tharp, 9, Norton Folgate 6 14 12, do. E. Quinlin, 25, Artillery Lane 7 11 14, do. Do. do. 5 8 16, do. Do. do. 6 18 18, do. Do. 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. S. Dubowski, 29, Wentworth 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 Mr. Johnson, 97-99, Southwark Bridge Road. 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 2, Montague Court, Bishopsgate. Wm. Grouts, 7, High Street, Deptford 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 7, do. W. Harper, 7, do. 2 2 5, Duke Street, Aldgate Samuel Joseph, 5, Duke Street 2 2 10, do. J. A. Britton, 16 and 18, Houndsditch 3 8 11, do. A. A. Romaiu, 453, Mile End Road 5 5 13, do. A. Stenner, 18, Duke Street 2 2 19, do. F. Dyson, 19, do. 1 1 Carried forward 124 240 157 EAST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 124 240 6, George Street, Minories Henry C. Geisler, 6, George Street 1 1 7, do. F. W. Loomes, 7, do. 3 11 117, Gravel Lane John Hunt, 117, Gravel Lane 3 6 118, do. Henry Goulston, 118, do. 4 4 1, Hutchinson Avenue Mr. Hollington, Middlesex Street 1 3 2, do. — Cantlovitch, 2, Hutchinson Avenue 5 5 3, do. C. Zagra, 3, do. 3 8 4, do. Morris Cohen, 4, do. 2 8 6, do. Aaron Jacobs, 6, do. 1 2 7, do. Jacob Abrahams 1 1 9, do. Mr. Woolf, High Street, Whitechapel 4 11 10, do. Do. do. 3 8 12, do. N. Foley, 26, London Street, Fitzroy Square 3 8 13, do. Theresa Ellis, 13, 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, 26, 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, Houndsditch 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. City Corporation 4 11 9, d.o. 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 16, do. Chas. W. Harris 3 4 17, do. Albert F. Smith, 3, Medland Street, Ratcliff Cross. 6 10 Carried forward 241 546 158 EAST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 241 546 19, Mansell Street,Aldgate K. Phillips, 19, Mansell Street 2 8 28, do. A. Woolf, 28, do. 3 7 30, do. — Elburn, 30, do. 2 6 35, do. Racliael Ries, 35, do. 1 3 36, do. Sarah Knight, 36, do. 4 5 38, do. George Outten, 38, do. 2 4 23, Middlesex Street Charles Harford, 23, Middlesex Street 1 9 71, do. Aaron Grun, 71, do. 2 4 16 & 17, New Square A. Smith, Blomfield Street 1 5 6,New Street,Gravel Lane 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 Thos. Wicks, 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 A. Smith, Blomfield House 4 11 23, do. do. Ed. Bullen, 24, New Street 6 12 26&27,do. do. A. Smith, Blomfield House, Blomfield Street 11 27 22, do. Gravel Lane Reynolds & Eason, 43, Bishopsgate Street Without. 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 37, do. do. 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 Carried forward 353 855 159 EAST DISTRICT—continued.  Situation of Premises. Name and Address of Owner. Tenements. Lodgers Brought forward 353 855 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 8, Vine Street, do. John Roberts, 7, Circus, Minories 6 19 9, do. do. Do. do. 9 24 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 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 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 430 1,101 Average number of persons to each tenement: 2.55. EAST DISTRICT. Houses demolished or closed during 1905, viz.:—14 and 14a, Clark's Yard; 13, Cutler Street; 2, 3, 10 and 11, Vine Street; 5, White Street, Cutler Street; 126, Minories, and 8, New Square; and 18 and 28, New Square, Minories. 160 Appendix D. List of Persons registered under the Dairies, Cowsheds and Milkshops Order. 1st January, 1906. 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. 5, Bishopsgate Church Passage. Gerardo Lamberti. 35, do. Lockharts, Ltd. 42, do. Nunzio Allocca. 57, Bishopsgate St. W'n. Slaters, Ltd. 54, do. Bartolerino Fabrizi. 60, do. William Neave Hill. 67, do. J. Lyons and Co., Ltd. 79, do. J. Lyons and Co., Ltd. 72, do. Slaters, Ltd. 101, do. Forster and Hazell. 83, do. Robert Stephen Ricketts. 107, do. Aerated Bread Co., Ltd. 90, do. Luigi Torre. 15/6, Bishopsgate St.W't. Aerated Bread Co., Ltd. 92, do. Joseph James Metcalf. 19, do. J. Lyons and Co., Ltd. 170, do. Aerated Bread Co., Ltd. 31, do. Giovanni Beltramini. 188, do. James Dwarber. 42, do. British Tea Table Co., Ltd. 193, do. J. Lyons and Co., Ltd. 50, do. Lucidoro Mauro. 40, Aldermanbury Lorenzo Cattini. 77, do. Gaston Debry. 55, do. Aerated Bread Co., Ltd. 90, do. David Pennycuick. 68, do. British Tea Table Co., Ltd. 106, do. Guiseppe Manzi. 3, Aldgate Anastasio Dimitriou. 1ll, do. Arthur James Tipping. 12 and 13, do. Lockharts, Ltd. 147, do. British Tea Table Co., Ltd. 24, do. J. Lyons and Co., Ltd. 23, Birchin Lane M. A. Iviston and Co. 26, do. John Peter Moriggia. 8/10, Blomfield Street British Tea Table Co., Ltd. 28, do. Dominico George. 8, Botolph Alley Esau Wm. Lambourn. 7, Aldgate High Street John Wattam. 2, Bow Lane British Tea Table Co., Ltd. 73, do. Express Dairy Co., Ltd. 9, do. Pasquale Mansi. 7, Artillery Lane Louise Mellor. 46, do. P. Palumbo. 20, do. David Richards. 43, Bread Street Lazzaro Schia. 22, do. Thomas Piggott. 20, Bride Lane George Price. 5, Austin Friars Golden Grain Bread Co., Ltd. 3, Brushfield Street Henry Pugh Lloyd. 5, Barbican Luigi Cattini. 3, Bridgewater Street Charles Cromwell Crocker. 6/7, do. Aerated Bread Co., Ltd. Broad Street Station Aerated Bread Co., Ltd. 17, do. Peter Fumasoli. 4, Broadway Ann Elizabeth Vohman. 19, do. Guiseppe Mansi. 5a, do. Guiseppe Moretti. 20, do. Lockharts, Ltd. 7, do. J. Lyons and Co., Ltd. 35, do. W. B. Price. 35, Bucklersbury J. Lyons and Co., Ltd. 43a, do. George Frederick Callis. 36 and 37, Bucklersbury Antonio Precha. 67, do. British Tea Table Co., Ltd. 2, Budge Row Jane Anderson Carnegie. 21, Bartholomew Close, Charles Baker. 20, do. J. Lyons and Co., Ltd. 53, do. George Smith. 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. 16, do. Pasquale Palumbo. 1, Bury Street Express Dairy Co., Ltd. 29/30, do. J. Lyons and Co., Ltd. 1a, do. Albert Alexander Price. 1, Gresham Buildings, Basinghall Street London Cafe Co., Ltd. 40/2, Cannon Street Aerated Bread Co., Ltd. 50, do. Slaters, Ltd. 50, Beech Street John Richards. 51, do. Aerated Bread Co., Ltd. 4, Beehive Passage Lockharts, Ltd. 86, do. Aerated Bread Co., Ltd. 7, Bell Yard Jane Mary Ann Birch. 91, do. William Neave Hill. 5, Billiter Street British Tea Table Co., Ltd. 95, do. Madeline H. Oswald and Geo. Brown. 22, do. J. and B. Stevenson. Pagoda Cafe.Billiter St. The Pagoda Refreshment Co., Ltd. 139, do. London Cafe Co., Ltd. 161 Premises. Person Registered. Premises. Person Registered. 145, Cannon Street Ye Mecca, Ltd. 18, Eldon Street Bartolomeo Cattini. .147, do. Aerated Bread Co., Ltd. 25, do. British Tea Table Co., Ltd. 153 and 155, Cannon St. British Tea Table Co., Ltd. 2, Falcon Street Saletta Bifulco. Cannon 8t. Station Approach Aerated Bread Co., Ltd. 60, Fann Street Annie Gittus. 32, Farringdon Street Arthur Atkins. 36, Camomile Street Saletta Bifulco. 33, do. Friern Manor Dairy, Ltd. 54, Carter Lane William Henry Knapp. 62, do. David Jones. 57a, do. Robert Elijah Bareham. 65, do. Amerighi Guilio. 75, do. William Henry Clemence, 67, do. Lewis Bertram Heyward. 79, do. (Mrs.) Harriett Loader. 70/1, do. Geo. Jas. and Arthur J. Silverlock. 81, do. City Catering Co., Ltd. 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. Tiffin, Ltd. 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. 140, do. Ye Mecca, Ltd. 47, do. The Cabins, Ltd. 150, do. Aerated Bread Co., Ltd. 62, do. Aerated Bread Co., Ltd. 6, Clark's Place Edwin Prosser. 69, do. Croci Carlo. 3 and 4, Cloak Lane Guiseppe Pagano. 99, do. Aerated Bread Co., Ltd. 20, Cloth Fair William Mortimer Phelan. 103, do. Joseph Hubert Buck. 22, do. John Jackson. 107, do. British Tea Table Co., Ltd. 30, do. Reuben Smith Jackson. 157, do. Diviani Bros. 19, Cock Lane Jane Jones. 161, do. Maynards, Ltd. 23, Coleman Street Ye Mecca, Ltd. 164, do. Slaters, Ltd. 38, do. The Cabins, Ltd. 1, Railway Approach J. Lvons and Co., Ltd. Copthall Ave.(Throgmorton House) Florence Le Breton. Fenchurch St. Station Henry Christian Thomas Amendt. 8, Copthall Avenue Alexander Hampton. 31, Fetter Lane Thomas Richards. 10, do. James William Davis. 33, do. Edward Fitch. 28, do. Siro Pietro Alberti. 38, do. William Alfred Hooper. 9, Cornhill Aerated Bread Co., Ltd. 44/5, do. Stewart and Wight, Ltd. 11, Cree Church Lane Mary Ann Stanton. 49, do. William B. Price. 7, Cripplegate Buildgs. Aerated Bread Co., Ltd. 57, do. Paul Quartermass. 7, Crooked Lane John Morgan Jones. 83, do. Mary Harris. Crown Court (Old Broad Street) J. Lyons and Co., Ltd. 1, Finsbury Pavement Luigi Ostacchini. 73, do. Aerated Bread Co., Ltd. 13, Crutched Friars Express Dairy Co., Ltd. 85, do. British Tea Table Co., Ltd. 27, do. Henry Smith. Electra House, Finsbury Pavement Henry Phillips. 7, Cullum Street British Tea Table Co., Ltd. 21, do. Allard Bros. Finsbury Pavement House. J. Lyons and Co., Ltd. 14, Cursitor Street Martha Kersey. 3/5, Devonshire Street Henry Pearce. 22, Fish Street Hill George Porteous Johnston. 8, do. Mitchell's Dining Rooms, Ltd. 37, do. Pasqualino Palumbo. 40, do. Frederick Lewindon. 7, Dorset Street Guiseppe Indaco. 2, Fishmongers' Alley Mary Jones. 2, Duke Street Lucidoro Mauro. 16, Fleet Street George Rice Bolton. 19, do. Frank Dyson. 23, do. J. Lyons and Co., Ltd. 27, do. Henry Richards. 61, do. J. Lyons and Co., Ltd. 41, do. Lorenzo Cattini. 109, do. Lockharts, Ltd. 50, do. Harold Shannon. 116, do. Aerated Bread Co., Ltd. 5, Eastcheap Aerated Bread Co., Ltd. 131, do. Express Dairy Co., Ltd. 15, do. Ye Mecca, Ltd. 167, do. Cabins, Ltd. 28, do. Aerated Bread Co., Ltd. 170, do. Lockharts, Ltd. 35, do. J. Lyons and Co., Ltd. 173, do. J. Lyons and Co., Ltd. "Ceylon House," Eastcheap. British Tea Table Co., Ltd. 175, do. Romualoto Mansi. 182/3, do. British Tea Table Co., Ltd. 16, Eldon Street J. Lyons and Co., Ltd. 190, do. Aerated Bread Co., Ltd. 162 Premises. Person Registered. Premises. Person Registered. 31, Fleet Lane Albert Edwin Derry. 5, Hart Street Margaret Jones. 17, Fore Street J. Lyons and Co., Ltd. 9/10, do. James Page Geary. 28, do. William R. Child. 31, Holborn Aerated Bread Co., Ltd. 46, do. Antonio Lusardi and L. Cattini. 114/5, do. Aerated Bread Co., Ltd. 144, do. Luigi Rattazzi. 54, do. J. Lyons and Co., Ltd. 145, do. Slaters, Ltd. 56/7, do. Aerated Bread Co., Ltd. 1/2, Holborn Viaduct ... Aerated Bread Co., Ltd. 70, do. Luigi Cavana. 14, do. J. Lyons and Co., Ltd. 84, do. Lockharts, Ltd. 65, do. Express Dairy Co., Ltd. 85, do. John Mardorf. 1, Honey Lane Market Pelegrino Verioni. 112, do. Giovanni Kolle. 4, do. J. Lyons and Co., Ltd. 2, Foster Lane Giovanni Diviani. 9, do. John Gow. 5, do. William Walter Burrows and John Roberts. 1, Hosier Lane David Morgan. 27a, do. Richard William Mason. 9, do. Giorgi Beschizza and Co. 1, Houndsditch Luigi Delnevo. 41, do. Free and Co. 105, do. Bartolomeo Cattini. 2, Friday Street Felice Tortora. 118, do. David Jones. 65, do. Aerated Bread Co., Ltd. 1/2, Huggin Court Edmund Moore. 1, Furnival Street Henry Charles Leaver. 4a, Huggin Lane Edmund Moore. 4, do. Food Reform Co., Ltd. 10, do. Ada Blunt. 20, Garlick Hill Walter Robert William M archant. 13, Hutchison Street Morris Drachman. 15, do. Jacob and Leah Miller. 12, George Yard Callard, Stewart and Watt, Ltd. 35, Hutton Street Amy Reeve. 38, do. City Catering Co., Ltd. 3, Godliman Street Free and Co. 3, Imperial Arcade Friern Manor Dairy Farm, Ltd. 21, do. Express Dairy Co., Ltd. 8, Gough Square James Rushmer. Ingram Court British Tea Table Co., Ltd. 12, Gracechurch Street Charles John Haag. 20, Ironmonger Lane Alfred Ernest Bradbury. 33, do. Aerated Bread Co., Ltd. 28/9, do. British Tea Table Co., Ltd. 41, do. Maynards, Ltd. 8/9, Ivy Lane Sidney Geo. Doggett. 51, do. Lockharts, Ltd. 18, do. Carlo Sciarillo. 69, do. Callard, Stewart and Watt, Ltd. 22, do. West London Dairy Co., Ltd. 39, Jewin Crescent Giovanni Caccioli. 72/3, do. J. Lyons and Co., Ltd. 6, Jewin Street E. Seton Karr. 1, Great New Street Sarah Amelia Barnsley. 9, do. J. Lyons and Co., Ltd. 12, do. Maria J. L. Kersey. 24, do. George McFarlane. 8/9, Great St. Helen's Callard, Stewart and Watt, Ltd. 28/9, do. British Tea Table Co., Ltd. 8, Jewry Street John Jones. 18/19, do. Lilian Agnes Clarke. 32, do. Angelo Beschizza. "Crosby House," Great St. Helen's. Ye Mecca, Ltd. 12, John Street William Alston. 27, King Street Biagio Manzi. 14, Great Tower Street Stewart and Wight, Ltd. 32, do. Aerated Bread Co., Ltd. 17/8, do. Aërated Bread Co., Ltd. 8, King William St. Slaters, Ltd. 28, do. Thomas Stevenson. 29, do. Luigi Arpino. 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. 74, do. J. Lyons and Co., Ltd. 50, do. J. Lyons and Co., Ltd. 78, do. Callard, Stewart and Watt, Ltd. 51, do. Edward John Argent. 61, do. J. Lyons and Co., Ltd. 96, do. London Clerks' Cafe Co., Ltd. 64, do. Aerated Bread Co., Ltd. 100, do. Luigi Arpino. 12, Kinghorn Street Catherine Lewis. 1, Gresham Street Aerated Bread Co., Ltd. 25a, do. William Phelan. 3, do. Ye Mecca, Ltd. King's Arms Yard Ye Mecca, Ltd. 5, do. Antonio Ostacchini. 48, Knightrider Street William Adamson. 46, do. J. Lyons and Co., Ltd. 6, Lambeth Hill Lucidoro Mauro. 54, do. Ye Mecca, Ltd. 8, do. British Tea Table Co., Ltd. 69, do. Aerated Bread Co., Ltd. 1, Laurence Lane Angelo Beschizza. 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. Lewis Thomas Owen and Percy John Randall. 163 Premises. Person Registered. Premises. Person Registered. 50, Leadenhall Market Henry George Saunders. 38, Ludgate Hill Aërated Bread Co., Ltd. 56, do. Elizabeth Clary. 54, do. Express Dairy Co., Ltd. 4, Leadenhall Street Aërated Bread (Jo., Ltd. 56, do. Ye Mecca, Ltd, 60, do. Alfonso Delpizzo. Ludgate Hill Station J. Lyons and Co., Ltd. 64, do. John Edwards. 6, Maidenhead Court Matteo Mansi. 67, do. William Henry Neal. 14, do. Joseph Francis Head. 96/98, do. Aërated Bread Co., Ltd. 20, do. David Haydon. 101, do. Ye Mecca, Ltd. 8, Mansell Street Elias Manus. 106, do. Aërated Bread Co., Ltd. 18, do. Henry Rodney Koakes. 140, do. Aërated Bread Co., Ltd. 38, do. George Outten. 8/9, Lime Street John and Boyd Stevenson. 69/70, Mark Lane Ye Mecca, Ltd. 15a, do. Express Dairy Co., Ltd. 78, do. Express Dairy Co., Ltd. 23, do. J. Lyons and Co., Ltd. 3, Mason's Avenue Ulderico Maino. 24, do. Ye Mecca, Ltd. 25, Middlesex Street (Middlesex House) Mitchell's Dining Rooms, Ltd. 26, do. Aerated Bread Co., Ltd. 29, do. Lozaro Cattini. 25, do. Lewis Cohen. 34, do. Agnes Powell. 36a, Milton Street Catherine Ellis. 6/8, Lime Street Square Elizabeth Emily Smith. 71, do. Charles Gentry. 4, Little Britain Frederick Pearce. 76, do. Andrew Annanson. 19, do. Express Dairy Co., Ltd. 17, Mincing Lane London Caf6 Co., Ltd. 25, do. John Davies. 2, Minories British Tea Table Co., Ltd. 33, do. Welford and Sons, Ltd. 6, do. British Tea Table Co., Ltd. 74, do. Sarah Page. 130, do. Elizabeth King. 6, Little Trinity Lane James Holt. 152/3, do. Robert Phillips. 20, Liverpool Street George Worth. 155, do. William McGavin Reid. 37, do. David Lowrie. 41/2, Monkwell Street Thomas Snoxell. Liverpool Street Station H. C. T. Amendt. "Monument Dairy," Monument Street Frederick Lewindon. 4, Lombard Court Ye Mecca, Ltd. 43, Moor Lane Carlo Sciarillo. 74, Lombard Street ... Aërated Bread Co., Ltd. 2, Moorfields David Price. 319, London Central Markets Lockharts, Ltd. 28, do. Express Dairy Co., Ltd. 38, do. Antonio Precha. 332, London Central Markets Cream Dairy Co. 44, do. G. Offredi. 19, Moorgate Street Alexander Hampton. 3/4, London House Yard George Porteous Johnston. 28, do. Aërated Bread Co., Ltd. 40, do. Cabins (1901), Ltd. la, London Street Croci Carlo. Moorgate Station Chambers Express Dairy Co., Ltd. 4, do. Croci Carlo. 8, do. Lockharts, Ltd. 2, Moorgate Station Buildings Fullers, Ltd. 19, do. Aërated Bread Co.. Ltd. 34, London Wall Andrew Glendinning. 7, do. Aërated Bread Co., Ltd. 47, do. Lockharts, Ltd. 1, New Basinghall St. British Tea Table Co., Ltd. 49, do. Ye Mecca, Ltd. 13, New Bridge Street J. Lyons and Co., Ltd. 55, do. British Tea Table Co., Ltd. 40, do. Aërated Bread Co., Ltd. 58a, do. Express Dairy Co., Ltd. 44, do. David Stewart. 151, do. (Salisbury House) Aërated Bread Co., Ltd. 3, New Broad Street J. Lyons and Co., Ltd. 4b, do. Pagoda Refreshment Co., Ltd. 52/53, Long Lane Joseph Young. 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. 85, do. Evan Bees. 28, do. William Neave Hill. 129½, Lower Thames St. Natali Jurietti. 64, do. Aerated Bread Co., Ltd. 5, Ludgate Circus J. Lyons and Co., Ltd. 3, Newbury Street ... Edith Emily Whitney. 1, Ludgate Circus Buildings Slaters, Ltd. 1, New London Street ArthuroMusolli and Nicodemo Musolli. 4, do. British Tea Table Co., Ltd. 13, Newgate Street ... Stewart and Wight, Ltd. 16, Ludgate Hill Callard, Stewart and Watt, Ltd. 18, do. Slaters, Ltd. 21, do. J. Lyons and Co., Ltd. 87, do. J. Lyons and Co., Ltd. 29, do. Aërated Bread Co., Ltd. 94, do. British Tea Table Co., Ltd. 164 Premises. Person Registered. Premises. Person Registered. 122/3, Newgate Street Peter Diviani. 82, St.Paul's Churchyard Giorgio Beschizza. 24, Noble Street James George Walker. St. Paul's Station J. Lyons and Co., Ltd 44, do. Alfred Walter Bennett. 30/1, St. Swithin's Lane Aerated Bread Co., Ltd. 19/20, Old Bailey Lockharts, Ltd. 135a, Salisbury Court Matteo Mansi. 22, do. Elizabeth Jane Hill. 136, do. Frederick William Jaggs. 55/6, do. British Tea Table Co., Ltd. 19, Sherborne Lane Edward William Davies. 33, Old Broad Street Aërated Bread Co., Ltd. 2, Ship's Tavern Passage Alfonso Del Pizzo. 40, do. Aërated Bread Co., Ltd. 3b, Shoe Lane Gerado Indaco. 2, Old Change Carlo Sciarillo. 35/6, do. British Tea Table Co., Ltd. 13a, do. British Tea Table Co., Ltd. 98, do. David Jones. 6, Old Jewry The Cabins, Ltd. 1C9, do. Charles Baker. 3, Pancras Lane Frederick Walter Hicks. 114, do. Simeon Northam. 5, Paper Street George Richard Denton. 18, Silver Street Saletta Bifulco. 1, Paternoster Avenue Nunzio Allocca. 24, do. Pasquale Palumbo. 5/6, Paternoster Row British Tea Table Co., Ltd. 27, do. David Haydon. 12, do. Priori Oresti. 1, Stationers' Hall Court Charles D. Bizzanelli. 60, do. J. Lyons and Co., Ltd. 6, Stoney Lane Pasquale Mano. 5, Paul's Alley Carlo Demaria. 23, do. Henry Jones. 8, Philpot Lane Arthur George Smith. 29, do. Annie Risidore. 14, do. Stewart and Wight, Ltd. 62, do. Solomon Green. 22, do. Alfred Walter Bennett. 16, Swan Lane Frederick William Ward. 21, Pilgrim Street Galvani Andrea. 17/8, Telegraph Street... J. Lyons and Co., Ltd. 32, do. Priori Oreste. do. Ye Mecca, Ltd. 34, do. Aërated Bread Co., Ltd. 8, Temple Lane Amelia Price. 30, Poppin's Court Guiseppe Indaco. 27, Throgmorton Street J. Lyons and Co., Ltd. 31, Poultry J. Lyons and Co., Ltd. 29, do. Aerated Bread Co., Ltd. 1, Queenhithe Albert Ashlee. 6, Tudor Street John Pantalone. 6, Queen Street Jane Anderson Carnegie. 10, do. Ernest Arthur Swann. 10, do. J. Lyons and Co., Ltd. 14, do. Walter Thomas Beames. 40, do. Egidio Fabrizi. 32, do. Fanny Payne. 71, do. Lockharts, Ltd. 3, Union Court, Old Broad Street. Express Dairy Co., Ltd. 81, do. Antonio Cattini. 85, do. Ellen Claire Aveline. do. Ye Mecca, Ltd. 7, QueenVictoria Street Express Dairy Co., Ltd. 8, Union Row, Minories. Lockharts, Ltd. 17, do. J. Lyons and Co., Ltd. 26, do. British Tea Table Co., Ltd. 57, Upper Thames Street Henry J. Anscomb. 75, do. Golden Grain Bread Co., Ltd. 104, do. Guiseppe Pagano. 105, do. British Tea Table Co., Ltd. 145, do. Stewart and Wight, Ltd. 115. do. Lockharts, Ltd. 172, do. 182, do. George Chitty. 130, do. Aerated Bread Co., Ltd. Luigi Arpino. 143, do. J. Lyons and Co., Ltd. 186, do. Robert Waterson. 148a, do. Reuben Thos. Matthews. 190, do. Joseph James Medcalf. 177, do. Aerated Bread Co., Ltd. 194, do. Robert Cooper. 2/4, Ropemaker Street John Pearce. 223, do. Albert Alex. Price. 12, Rose Street Saletta Bifulco. 224, do. Robert Cooper. 2½, St. Andrew's Hill Cream Dairy Co. 4, Walbrook J. Lyons and Co., Ltd. 16, St. Bride Street William Castle. 14, do. Ye Mecca, Ltd. 35, do. Stewart and Wight, Ltd. 19/20, do. J. Lyons and Co., Ltd. 3/4, St. Martin's Court George Porteous Johnston. 34, do. Aërated Bread Co., Ltd. 31, St. Mary-at-Hill British Tea Table Co., Ltd. Warnford Court Aërated Bread Co., Ltd. 21, St. Mary Axe Ye Mecca, Ltd. la, Water Lane (Great Tower Street). Benjamin Morley. 33/5, do. Slaters, Ltd. 34, do. Express Dairy Co., Ltd. 2, Water Lane (Blackfriars). Albert Alexander Price. 45, do. Aërated Bread Co.. Ltd. 49, do. J. Lyons and Co., Ltd. 4, Water Lane (Blackfriars). Robert Reid. 65, do. British Tea Table Co., Ltd. 18, St.Paul's Churchyard Alfred William Pearce. 5, Water Lane (Blackfriars). Priori Oresti. 53, do. Nicholson's, Ltd. 61, do. J. Lyons and Co., Ltd. 7, Water Lane (Blackfriars). British Tea Table Co., Ltd. 68a, do. Fullers, Ltd. 75, do. Callard, Stewart and Watt, Ltd. 73, Watling Street British Tea Table Co., Ltd. 165 Premises. Person Registered. Premises. Person Registered. "Aldermary House," Watling Street. Ye Mecca, Ltd. 37, Wood Street Biagio Mansi. 42/3, do. British Tea Table Co., Ltd. 57a, West Smithfield Lockharts, Ltd. 31, Whitecross Street Robert Douglas. 78, do. Nunzio Allocca. 5, Whitefriars Street Frederick Philipp Weinel. 80, do. Ye Mecca, Ltd. 7, do. Vincenzo Mansi. 130, do. Express Dairy Co., Ltd. 26, do. Hannah Yelland. Wool Exchange Callard, Stewart and Watt, Ltd. 27, do. George Robert Smith. 1, Whittington Avenue Ye Mecca, Ltd. 8, Wormwood Street William Henry Neal. 7, do. Callard, Stewart and Watt, Ltd. 22, do. Aërated Bread Co., Ltd. 36, do. Luigi Ostacchini. 10, do. Antonio Cattini. 38, do. British Tea Table Co., Ltd. 17, Widegate Street Allec Cohen. 6, Wrestlers' Court Edwin Prosser. 25, Wood Street J. Lyons and Co., Ltd. 166 Appendix E. KITCHENS OF RESTAURANTS. Extract from Annual Report of Medical Officer of Health for 1904. The experience gathered from the constant inspection of these places suggests the following:— The floor, walls and ceiling should be finished in a durable material and be free from obstructions, so as to be easily cleansed, all tables, benches, &c., being readily movable. Where gas is used for cooking purposes, means should be provided for carrying off the fumes of gas Electric light should be used, so as to reduce heat as far as possible in the kitchen. Proper larders and pantries should be provided for the storage of cooked and uncooked food. Special attention should be paid to the condition of water cisterns, and effectual means taken to exclude dust and dirt, &c. At least one white enamelled stoneware sink should be provided for washing vegetables; indeed, it would be better if all sinks were made of similar material, the advantage being that dirty conditions are at once apparent and call for immediate attention. Cupboards or other provision outside the kitchen should be made for hanging wearing apparel when not in use. Means should he taken to exclude dust and dirt from entering underground kitchens as far as possible. Where inspection chambers to drains exist in kitchens they should be provided with double covers (one cover below another), or be so arranged that the covers cannot become unsealed by being walked on, &c. Separate lavatory basin accommodation should be provided outside the kitchen for both sexes, where practicable, for use of employés. Where lift shafts are used in connection with kitchens they should be cleansed from time to time. 167 In a properly arranged kitchen many other things suggest themselves, such as separate scullery and cold (ice) larder, separate rooms for cooked and uncooked foods, fish larder, vegetable store, dry goods store, plate room, saucepan room, &c., &c. It is almost unnecessary to add that kitchens should be adequately ventilated and that the temperature should not exceed 80° Fahr. Many persons appear to imagine the cooking can only be carried on in an extremely hot kitchen, but this is a wrong impression. The lack of proper provision for keeping food hot whilst being served up often results in the temperature being kept unduly high, the windows being closed to prevent the rapid cooling of the dishes. It is found that the businesses are constantly changing hands, and that the kitchen arrangements are an ever-varying quantity. Gas stoves are frequently added, without any provision being made for carrying off the fumes, the water-closet accommodation for the sexes has to be re-adjusted and the walls and ceilings of the kitchens soon get dirty. These and many other points need constant and vigilant attention to ensure a decent standard being maintained. Special attention is now being paid to the storage of food, and suggestions from my Department are often appreciated and acted upon.