AC 434 LON 9 Corporation of London. PUBLIC HEALTH DEPARTMENT. ANNUAL REPORT OF MEDICAL OFFICER OF HEALTH FOR 1909. Ordered to be printed 23rd June, 1910. Corporation of London. PUBLIC HEALTH DEPARTMENT. \ ANNUAL REPORT OF MEDICAL OFFICES OF HEALTH FOR 1909. Ordered to be printed 23rd June, 1910. KNILL, Mayor. A Common Council holden in the Chamber of the Guildhall of the City of London, on Thursday, the 23rd day of June, 1910. THE Court proceeded to consider the following Report of the Sanitary Committee delivered in on the 9th instant, and then adjourned and ordered to be printed:— On the Reference of the 5th ultimo with regard to the Annual Report of the Medical Officer of Health for 1909, again directing attention to the following paragraph therein, viz. (see page 10):— "It is to be feared that matters connected with the public "health will be neglected or treated as of minor importance "in the councils of the nation until the creation of a Minister "of Public Health is advocated by all parties;" stating that the Committee are in sympathy with the opinion of the Medical Officer, and recommending that the said Report be printed and circulated amongst the Members of the Court as usual, and that a copy thereof be forwarded to the Local Government Board, the London County Council, the Metropolitan Borough Councils, and others. Motion—To agree with the Committee in their Report ? Amendment—That the Report of the Medical Officer of Health be printed and circulated as usual, but the Court must not be taken as expressing any opinion in regard to the suggestion of the Medical Officer as to the creation of a Minister of Public Health ? Carried in the Affirmative. Question as amended—Resolved in the Affirmative, and Ordered accordingly. BELL. To the Right Honourable the Lord Mayor, Aldermen and Common of the City of London, in Common Council assembled. REPORT—SANITARY COMMITTEE. We have farther considered the Report of the Medical Officer of Health for 1909, which was referred back to us at the last Court in view of the following paragraph therein contained, to which we directed your special attention:— "It is to be feared that matters connected with the public health will "continue to be neglected or be treated as of minor importance in the "councils of the nation until the creation of a Minister of Public Health "is advocated by all parties. This the Medical Officer has slightly varied, and the sentence now reads as follows:— "It is to be feared that matters connected with the public health will "be neglected or treated as of minor importance in the councils of the "nation until the creation of a Minister of Public Health is advocated "by all parties." Having given our special attention to the point raised by the Medical Officer, we beg to report that we are in sympathy with his opinion, and recommend that the said Report be printed and circulated amongst the Members of the Court as usual, and that a copy thereof be forwarded to the Local Government Board, the London County Council, the Metropolitan Borough Councils, and others. All which we submit to the judgment of your Honourable Court. Dated this sixth day of June, 1910. Signed on behalf of the Committee, W. BULL, Chairman. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON For the Year 1909, 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. INDEX PAGE Anthrax 25 Area 12 Artizans' Dwellings—Stoney Lane, Houndsditch 48 i. „ —Birth and Death Rate at 48 ,, —Baths at 49 Bacteriological Examinations for Medical Men 23 „ „ of Milk 32 „ „ „ Oysters 92 Bakehouses 77 Births and Birth Rate 14,15 „ —illegitimate 17 „ —Notification of 87 Boric Acid in Cream 119 Brandy, Definition of 133 Bye-laws for Lodging-houses—Arlidge v. Islington Borough Council 59 „ „ —Griffiths v. Southwark Borough Council 59 „ Vendors of Fried Fish, Fish Curers and Rag and Bone Dealers 93 Canned Foods, Tin in 91 "Carriers" of Enteric Fever 25 Census Returns 13 cerebro-Spinal Fever 28 Children Act, 1908 43 Chinese Pork. Importation of 9,105 Cleansing of Verminous Children 43 Combined Drainage—Amendment Bill 86 Common Lodging-House 80 Condemned Meat Returns 110, 111 Contaminated Milk 32 „ Oysters 92 Cream, Preservatives in 119 Cremation 45 „ —Cost of 45 „ in United Kingdom, 1886-1909 47 „ —Suggested Conference on 48 Dairies, Cowsheds and Milkshops Orders 95 Day Census 11.13 Death Rate from Zymotic Disease 18 „ Registration and Burial Bill 21 Deaths and Death Rate 15 „ —Causes of and Ages at 20 „ from Phthisis 18 „ „ Violence 18 „ in City Institutions 18 Density 13 De Rechter Apparatus for Preservation of Bodies 52 Disinfectants 51 Disinfecting Apparatus, New 51 Disinfection at City Mortuary 50 Drainage Plans 60 Enteric Fever, "Carriers" of 25 Factory and Workshops Act 71 „ „ „ „ —Bakehouses 77 „ „ „ „ —Defects Reported by H.M. Inspector 77 „ „ „ „ —Factories 72 „ „ „ „ —Homework—Returns for Home 79 ,, -Kitchens 75 „ „ „ „ —Outworkers, &c. 78,83 „ ,, „ „ —Women Sanitary Inspectors 82 „ „ „ „ Children Act 88 „ „ ,, „ Domestic Workshops 85 „ „ „ „ Factories, Workshops and Workplaces 82 „ „ „ „ Ladies' Waiting Rooms 86 „ „ „ „ Offices 86 „ „ „ „ Outworkers' Trades 84 „ „ „ „ —Workplaces 75 „ „ „ „ —Workshops 74, 80 Fish, Condemned 113,114 „ Offal, Removal of 61 „ Supplies 113,114 Food Inspection at Riverside Wharves1 15 „ Legislation, &c. 90 „ —Sale of, from Barrows, Stalls, &c 94 INDEX (continued). PAGE. Flushing Courts and Alleys 63 Foreign Meat Regulations 104 Gin, Definition of 134 Gullies, Street 60 Hairdressers' and Barbers' Shops 68 Health Visitors (London) Order, 1909 80 Hop Bills 00 House Drainage 60 „ Refuse Removal 61 Human Remains, Removal of 62 Ice Creams 96 Illegitimate Births 17 Importation of Chinese Pork 9,105 „ „ Immature Calves 106 „ „ Parasitic Colonial Beef 106 „ „ Pigs' Stomachs 104 „ „ Sheep and Ox-Livers 104 Infantile Mortality 17 „ „ and Meteorological Conditions 16 Infants, Care of 87 Infectious Disease and Sanitary Defects 61 „ „ —Notification of 22 Inquests 50 Inspection of Food at Riverside Wharves 115 Introductory Remarks 9 Kitchens of Restaurants 75 Ladies' Waiting Rooms, Inspection of 86 Legal Proceedings 62 Limewhiting Courts 64 London County Council (General Powers) Act, 1909 69 Marking of Tinned Foods 91 Meat Inspector's Office 109 „ Marking Bill 108 „ Prosecutions 112 „ —Sale of Foreign as English 109 „ Seizures 111, 112 „ —Statistics relating to 110 „ Supplies in 1909 97 „ -Tuberculous 107 Medical Examination of Officers 139 Metropolitan Sewers and Drains Bill 66 Milk, Adulteration 118 „ and Dairies Bill 33.36 „ —Bacteriological Examination of 32 „ —contaminated 32 „ Churns 41 „ Purveyors—Registration* of 95 „ —Tuberculous 10 Minister of Public Health 10 Mortality 15 „ —Infantile 16,17 „ Returns 15 Mortuary Returns 50 Naval Officers—Instruction in Meat Inspection 101 Necessitous Mothers (Assistance) Bill, 1909 89 Notification of Births 86 „ Infectious Disease 22,24 Overcrowding 60 Phthisis 26 „ —Death Rate 16 Population 13 Preservation of Bodies of unknown Dead 11, 52 Preservatives in Cream 119 Prosecutions—Ice cream 97 „ —Meat 112 „ —Sale of Food and Drugs Acts 138 Public Health (Foreign Meat) amending Regulations, 1909 102.162 Queensland Beef—Parasitic 106 Railway Milk Churns 42 Railway Stations, Sanitary Accommodation at 61 Rateable Value 13 INDEX (continued). PAGE. Registered Hairdressers' and Barbers' Shops 68 „ Houses Let in Lodgings 56 „ Kitchens op Restaurants 75,82 „ Lodging-Houses 56 „ Purveyors op Milk 156 „ Workshops and Workplaces 71,72 Regulations—Amended, for Imported Foreign Meat 11 „ —Tuberculosis 26 Removal of Fish Offal 61 „ „ Human Remains 62 „ „ Snow with Salt 64 Royal Commission on Tuberculosis 35 „ „ Whisky and Other Potable Spirits 130 Rum, Definition of 134 Sale of Foo» and Drugs Acts—Articles Examined 116,136 „ „ „ „ —Beeswax 129 „ „ „ „ —butter 126 „ —Coffee 128 „ „ „ „ —Cream, Dr. Teed's Notes on 125 „ „ „ „ „ Preservatives in 119 „ „ „ „ „ „ „ —Dr. HamILL'S report on 120 „ ,, „ „ Starch in 124 „ „ „ „ „ Sucrate of Lime in 124 „ „ „ „ —Drugs 129 „ „ „ „ —Golden Syrup 129 „ „ „ „ —Milk 118 „ „ „ „ —Mustard 128 „ „ „ ,, —Prosecutions 138 „ „ „ „ —Report of Royal Commission on Whisky 130 „ „ „ „ —Sale of Margarine Bill 127 „ „ „ „ —Statistics relating to 116,117 „ „ „ „ —Suggested Court of Reference 12 „ „ from Barrows, Stalls, &c. 94 Salt and Snow Removal 64 Salvation Army Shelter 60 Sanitary Accommodation at Railway Stations 61 „ „ for Women at Underground Conveniences 86 „ Defects and Infectious Disease 61 „ Inspections 54 „ Staff 6 Sewers and Drains Bill 66 Shelter for Temporary Accommodation during Disinfection 27 Small-pox 25 Smoke Nuisance 66 Spitting Evil, the 10 28 Street Gullies 60 Terreit, Retirement of Chief Inspector 12 Tin in Canned Foods 91 Tinned Foods, Marking of 91 Tuberculosis—Royal Commission on 35 „ Order, 1909 10,39 Tuberculous Meat Circular 167 Vaccination 14 Veterinary Inspector, Appointment of 12 Vital Statistics 18,19 Whisky, Definition of 132 Working Classes, Definition of 70 Zymotic Disease, Death Rate from 16 APPENDICES. PAGE Appendix A—Street Lists of Mortality 143 „ B— „ „ „ Infectious Disease 146 „ C—Registered Houses Let in Lodgings or Occupied by Members of more than One Family 148 „ D—List of Persons Registered under the Dairies, Cowsheds and Milk Shops Orders 156 „ e—The Public Health (Foreign Meat) Amending Regulations, 1909, dated September 2th, 1909 162 „ F—Tuberculous Meat—Revised Circular 167 ,. Q—The Health Visitors (London) Order. 1909 171 SANITARY STAFF. medical officer of health. Date of Appointment Collingridge, Wm., M.A., M.D April, 1901 veterinary inspector. Young, T. Dunlop, M.R.C.V.S Nov., 1909 clerical staff. Turner, Howard Blake, F.I.C., Sanitary Clerk June, 1877 Lowe, George Nov., 1902 King, Guy H July, 1901 Beckles, Virgine Jan., 1907 Stephe son, F. H. (Meat Inspector's Office) Feb., 1909 women sanitary inspectors. Safford, Ada J Feb., 1902 Pole, Millicent M. Dec., 1904 Wilkinson, Annie M June, 1909 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 Robbinb, Francis Joseph „ „ Sept., 1892 Ralph, William Holden „ „ July, 1898 Dunworth, James „ „ Jan., 1902 Wheaton, Arthur „ „Oct., 1902 Galloway, Reginald E Assistant, May, 1905 sanitary inspectors and meat inspectors. Sharp, Owen, Senior Inspector May, 1892 Kelland, William C May, 1899 Mettam, Harry Aug., 190& Davies, Thos. L. Dec., 1903 Stanley, Ralph S. March, 1907 Bintcliffe, Charles E. March, 1907 inspectors of slaughterhouses and meat. Jenkins, Harry April, 1896 Eglin, William July, 1896 assistant inspectors of slaughterhouses and meat. Way, Edward (on probation) Oct., 1907 Slatter, C. ( ditto ) May, 1908 King, G. (Junior Assistant) April, 1910 matron in charge of the shelter, golden lane. Mrs. A. R. Hills Dec., 1900 keeper of the mortuary. Oakley, J. E. Feb., 1909 disinfector. Lee, Robert Oct., 1894 labourers. McDonnell, R. J. (General Duties at Mortuary) April, 1908 Adams, T. (Meat Shed) May, 1905 Ludgate, G. (Meat Shed) Oct., 1906 REPORT OF MEDICAL OFFICER OF HEALTH FOR THE CITY OF LONDON. 100©. « 9 « ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1909. To the Right Honourable the Lord Mayor. Aldermen and Commons Corporation of London. public Health Department, Guildhall, E.C., 21st March, 1910. Gentlemen, In conformity with the requirements of the Local Government Board, I have the honour to present my tenth Annual Report as Medical Officer of Health for the City of London. The activity of the Local Government Board in securing the co-operation of local authorities in their endeavour to protect the Public from the consequences resulting from the consumption of questionable food products imported from abroad, has thrown considerable strain upon the administrative resources of the department. This was inevitable when the wide-reaching nature of the Board's requirements are taken into consideration. In the result, however, of the year's working of the Regulations for the control of imported meat products, there is no question but that they have been an unqualified success, and that the placing of restrictions upon the entry into this country of imported food has done much to check what was, to say the least, becoming a very doubtful class of business. Foreign Governments, that were formerly somewhat lax with regard to the supervision exercised by them over meat exports, have now to fall into line with the requirements of the Local Government Board in force in this country, as, unless they do so, their own traders find it difficult to get their goods released by the Customs on this side, and are thus liable to lose their market. An illustration of the value of the Regulations was shown in the case of the Chinese pork, the first consignment of which was landed at Red Bull Wharf in July last, particulars of which are given on p. 105. Since then, Dr. Williams, Medical Officer of the Port of London, has reported the arrival of two other cargoes of frozen Chinese pigs, the landing of which was prohibited under the Regulations. Other instances will be found in this Report where the value of Regulations in protecting the public from the distribution of questionable food products is clearly evidenced. 10 It is gratifying to note that the public are beginning to take some practical interest in the direction of the suppression of tuberculosis. They are slowly realising that the disease is a preventable one, and in my view it is desirable that in the near future it should be classified as an infectious disease to which the notification sections of the Public Health Acts apply. No consideration of a political character, if such exist, should be allowed to stand in the way of the adoption of remedial measures in a case of such national importance as the prevention of tuberculosis. Societies for the suppression of this scourge doubtless have their uses, but also their limitations. The patent fact that from 8 to 9 per cent. (see page 34) of the milk sold in this country contains the living organism of the disease imperatively demands more active measures being taken than the introduction of a Bill at the end of a session, and the issue of an order by the Board of Agriculture and Fisheries, which remains inoperative. There is no reason why the Tuberculosis Order of 1909 here referred to should not come into force at once. The enforcement of its provisions will be of immense value, and it can only be regarded as a grave neglect of the public interests if its issue is withheld, especially as it is the deliberate and formed view of those best entitled to express an opinion upon the subject, that "a very considerable amount of disease and loss of life, especially among the young, must be attributed to the use of cow's milk containing tubercle bacilli."* Any further delay, therefore, in dealing with the matter can only be considered inexcusable in a civilised community. Since I have held my present office I have aimed unceasingly at directing your attention to the unsatisfactory condition of milk supplies, and urged the importance of seeking for a remedy at the source of the evil. Commence with the cow and eradicate the disease from every herd in the country. This, in my opinion, is the only solution of the milk theory of the spread of tuberculosis. This is a national question and therefore requires general legislation. Attempts to deal with it locally are to be deprecated. Piecemeal legislation is mischievous, as tending to concentrate the evil in particular districts. It is obviously anomalous that the inhabitants of a town or district should, by special legislation, be granted protection withheld from, and to the detriment of, others. It is to be feared that matters connected with the public health will be neglected or treated as of minor importance in the councils of the nation until the creation of a Minister of Public Health is advocated by all parties. Another source of infection is dealt with on p. 28, where attention is directed to the danger arising from the habit of indiscriminate spitting in public places and especially on the footways. It is generally admitted that the practice of spitting in railway carriages and other public conveyances is * Second Interim Report of he Royal Commission on Tuberculosis, January, 1907. 11 far less prevalent than formerly, owing to the exhibition of cautionary notices, and if similar notices were displayed in the streets, there is every reason to believe it would tend to minimise the evil. From time to time attention has been called to the lack of any apparatus in the Metropolis for the preservation of the unknown dead. The Paris Morgue is too well known to need any description here further than to say that refrigeration is the method employed. During the past year the Corporation decided to make provision at the City Mortuary for the preservation of dead bodies for the purpose of identification, but for reasons stated on p. 52 it will be seen that refrigeration methods were discarded in favour of a simpler and more economical process. The apparatus has been a complete success, and has been the cause of identification of bodies which would otherwise have been buried "unknown" at the expense of the ratepayers. The enquiry with regard to the Artesian Wells in the City, referred to in the last Annual Report, was continued during the year. Adverting to the suggestion made in the last Annual Report that the Corporation should take a Day Census in 1911, I take this opportunity of reminding you that the consideration of the matter should not be deferred, as, should you concur therein, the necessary arrangements for carrying out the undertaking in a reliable and tactful manner should be proceeded with. There is another point upon which I desire to direct attention. There is a strong feeling, and a growing one, that sanitary administrators are greatly hampered in their work by the prevalence of legislation by reference, and that our sanitary laws generally require re-codification. In this connection the Housing and Town Planning Act may be referred to, the first part of which has been fittingly described by a legal critic as containing "a bewildering maze of cross references to the provisions of previous statutes." Year by year the London County Council promote Bills in Parliament, which introduce important amendments to the Public Health Act, with regard to the utility of which great difference of opinion may exist amongst other metropolitan sanitary authorities. The Public Health (Regulations as to Food) Act is another instance of a complicated character. Reference may also be made to the laws relating to the sale of foods and drugs, which have now reached a stage when they require consolidation. In this case there is a pressing need for the appointment of a Statutory Board or Court of Reference, who should be empowered from time to time to fix standards of purity for food and drugs, and to give guidance to local authorities on any difficult or doubtful points that may arise in connection with their administrative action. 12 Owing to the absence of any standards other than milk, local authorities, Public analysts and others are continually faced with new problems that at present can only be solved in the High Court. The "What is whisky" case, referred to on p. 130, may be quoted as a case in point. Manufactured articles such as chocolate are difficult to deal with, and it seems a hardship that cases of this kind can only be satisfactorily settled by appeal to the Law Courts at great cost both to traders and the local authority concerned. If a further illustration of the present unsatisfactory state of affairs is required, mention may be made of the vexed question of preservatives and colouring matter in food, which has been practically in abeyance since the Departmental Committee, appointed by the Board of Agriculture and Fisheries, reported thereon on 16th January, 1901. The requirements of the existing Sale of Food and Drugs Acts are in some respects of such a cumbersome nature as to be a positive bar to taking action against offenders under these statutes. This is shown in the last Annual Report (1908-1909) of the Local Government Board, where a case in West Sussex is referred to, where "an habitual offender, a hawker, having no regular place of business, was "found selling margarine as butter, and was dealt with under the ordinary "law. Had a formal sample been obtained, divided and submitted for "analysis under the Sale of Food and Drugs Acts, the vendor would "have had time to abscond, but on receipt of the certificate of analysis "of an informal sample, a warrant was applied for, and the vendor was "arrested, charged with obtaining money by false pretences, and (as "there were several previous convictions recorded against him) sentenced "to three months' hard labour." I regret to have to record the retirement, after twenty-nine years' loyal and faithful service, of Mr. G. P. Terrett, who had held the office of Chief Inspector of Slaughterhouses and Meat for the last seven years, previous to which he was Senior Inspector for seven years. The vacancy thus created was filled by Mr. T. Dunlop Young, M.R.C.Y.S. 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. 13 DENSITY (1909). City of London, Registration District, at night 20" 7 persons to an acre. „ „ „ „ during the day *581*3 „ „ Registration London, at night 64*6 „ „ „ „ during the day not known. No Imperial Day Census has yet been taken. ANNUAL RATEABLE VALUE. The rateable value of property within the administrative county of London was £44,602,362 on 6th April, 1909—whilst on the same date the corresponding rateable value o£ property in the City of London, including Temples, was £5,451,836, or nearly one-eighth of the whole County. 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). 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 page 14). 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 to be regretted that no Day enumeration was made in the City during the last Imperial Census year. 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 1831 37,705 301,384 1901 26,923 For statistical purposes, in the following pages the "Registration" District is referred to when speaking of the " City." * 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. 14 This consists of two sub-districts, together containing a population of at the middle of 1909, calculated on the last Census Returns:— *St. Botolph 5,544 *St. Sepulchre and Allhallows 12,649 Total 18,193 The Night population, therefore, of the City of London Registration District at the middle of 1909 is taken at 18,193, and it is upon this figure that all vital statistics in this Report have been calculated. The Day population at the middle of 1909 was estimated at 391,220 ‡ 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 count 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 1909, 244 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 14.3 per 1,000. The birth rates last year in the Sub-Districts were— St. Botolph 20.5 per 1,000. St. Sepulchre and Allhallows 10.3 „ In the Metropolis the birth rate in 1909 was 24.2 per 1,000. This decline in the birth rate has been in operation in this country since 1876, and is common to nearly all European countries. VACCINATION. Of the 248 children born in 1909, 145 had been successfully vaccinated by the end of the year, 24 had died before the age for vaccination, and 2 were insusceptible. Vaccination was postponed by medical certificate in 14 cases, 22 had removed into other districts, and 19 vaccinations were pending at the end of the year. There were 22 cases of conscientious objection. The Public vaccinators performed 1,522 re-vaccinations during the year. * At the date of the last Census, this District included the "civil parish" of Glasshouse Yard. The parish was transferred to the Holborn Union by the Local Government Board Order, No. 43156, which came into operation on 29th September, 1901, and to the Registration District of Holborn (Finsbury Sub-District) on 1st January, 1902, making the Registration District of London City co-extensive with the Municipal City of London. All the Registration Districts in London are co-extensive with the Poor-Law Parishes or Unions except the District of Fulham. † On the 1st April, 1901, the Middle Temple was transferred from the Strand Sub-District to St. Sepulchre Sub-District. † This figure is based upon the assumption that the number of persons residing, occupied or employed within the City during the active hourt 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. 15 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 art. per cent. per cent. per cent. per cent. per cent. per cent. 1904 353 64.8 .28 Nil. 7.9 4.0 21.5 1.4 1905 302 63.6 Nil. „ 8.9 3.6 22.5 1.3 1906 344 62.2 2.0 „ 7.3 5.2 22.9 1.7 1907 269 62.4 1.11 „ 11.5 4.8 17.0 2.6 1908 281 59.8 .71 „ 9.6 3.9 21.3 4.6 Average previous 5 years 310 62.5 .82 Nil. 9.0 4.5 21.0 2.3 1909 248 58.4 .80 Nil. 9.6 5.4 16.5 8.8 VACCINATION ACT, 1907. It will be seen that the number of conscientious objectors continue to increase. This is doubtless due to the Vaccination Act of 1907, which is a direct encouragement to persons not to protect their children from the risk attending an attack of small-pox. MORTALITY. During the year under review, 912 deaths were registered in the District, including *725 persons dying in the City, but not belonging thereto. See Table, p. 20, for details. Deducting the latter 187 deaths remain, to which must be added 105 persons who died at City Institutions in outside districts, where they were registered. The mortality, therefore, from which the City death rate is calculated is 292. The death rate for 1909 was 16.0 per 1,000 per annum of the population (the previous year being 12.6), whilst that for the whole of the Metropolis was 14.0. Death Rates, per 1,000 per Annum. Year. City of London. 76 Great Towns of England and Wales. Metropolis. 1904 12.9 17.2 16.6 1905 13.9 1.2 15.1 1906 13.0 16.0 15.1 1907 12.7 15.4 14.6 1908 12.6 15.5 14.0 Average previous five years 13.0 15.8 15.3 1909 16.0 15.6 14.0 In comparing the above with the Registrar-General's Returns, some discrepancies will be observed, due to the fact that 1 have not been furnished with the number of citizens who died in Institutions other than those with which the City is connected. * These deaths occurred in St. Bartholomew's Hospital, and the Union Depot, Thavies Inn. 16 The death rate from zymotic disease per 1,000 of the population was .44 compared with 1.3 in the Metropolis. The deaths from phthisis correspond to a rate of 1.36 per annum of the population. Infantile Mortality. The deaths of children under one year of age to 1,000 births were 106 against 108 for the whole of London. The Table of infantile mortality on p. 17 shows the deaths of children under one year arranged according to monthly age periods. From this it will be seen that no less than 50 per cent. of these deaths occurred in the first month, 73 per cent. within the first three months, and 77 per cent. during the first six months of existence. The following notes from the last annual summary of the Registrar-General (1908) may be quoted in connection with this subject:— "It is a reasonable assumption that the fall in the rate of infantile "mortality in London in recent years is in some measure due to the "increasing attention the subject of the waste of infant life has received "from all classes of the community. It has been clearly shown that there is a direct relation between infantile mortality and meteorological conditions—high rates corresponding to years in which the summers were comparatively hot and dry, and low rates to years in which the earth temperature was low and the rainfall excessive. Deaths in City Institutions. During 1909, 111 persons died in City Workhouses, Workhouse Infirmaries, or Lunatic Asylums, or no less than 38 per cent. of the whole City mortality, the corresponding figure for the Metropolis (1908) being 25.8 per cent. Percentage of Deaths occurring in Workhouses, Workhouse Infirmaries and Lunatic Asylums to total Deaths in the City of London and the Metropolis respectively, for 1907, compared with the previous five years:— Year. City of London. Metropolis. Per cent. Per cent. 1904 27.8 20.8 1905 29.4 22.4 1906 12.9 22.3 1907 37.6 24.8 1908 23.0 25.8 Average of previous five years 26.1 23.2 1909 38.0 Figures not yet published. 17 (This Table is prepared in accordance with the requisitions of the Local Government Board.) City of London. Infantile Mortality during the Year 1909. 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 13 ... ... ... 13 3 3 ... ... 1 ... 1 ... 1 3 1 26 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... i. Common Infectious Diseases. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria Including branous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Whooping Cough ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 2 ... 3 Diarrhoea, all forms ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ii. Diarrhoeal Diseases. Enteritis, Muco-enteritis, Gastro-enteritis ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... 2 Gastritis, Gastrointestinal Catarrh ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 Premature Birth 4 ... ... ... 4 ... ... ... ... ... ... ... ... ... ... 4 iii. Wasting Diseases. Congenital Defects 6 ... ... ... 6 ... ... ... ... ... ... ... ... ... ... ... 6 Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Want of Breast-milk, Starvation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atrophy, Debility, Marasmus 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 iv. Tuberculous Diseases. Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 Tuberculous Peritonitis: Tabes Mesenterica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... v. Other Causes. Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 2 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Suffocation (overlying) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Other Causes 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 13 ... ... ... 13 3 ... ... ... 1 1 ... 1 3 1 26 ...Total Births in the year 244. Population 18,193. (Estimated to middle of 1909.) Births in the year legitimate 237 illegitimate *7 Deaths in the year of Legitimate infants 26 lillegitimate infants 0 Deaths from all Causes at all Ages 292 * In one of these cases the mother did not belong to the City. 18 Deaths from Violence. Of the City deaths, 5.1 per cent. were caused by injuries or violence (as compared with 3.1 in 1907 and 4.5 in 1908), being .08 above the average for the previous five years. PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE. Year. City of London. Metropolis. Per cent. Per cent. 1904 6.20 3.86 1905 4.15 4.27 1906 7.18 3.92 1907 8.10 3.75 1908 4.50 4.43 Average previous five years 5.02 4.04 1909 5.10 • VITAL STATISTICS, 1909. City of London compared with the Metropolis, previous five years. City of London. Birth Bate. Death Bate. 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. 1904 23,565 364,120 15.0 27.9 12.9 16.6 96 146 6.0 3.9 0.21 2.18 1905 22,425 369,380 13.4 27.1 13.9 15.2 139 131 4.1 4.3 0.27 1.71 1906 21,368 374,730 15.9 26.5 130 15.1 88 131 7.2 3.9 0.28 1.93 1907 20,310 380,150 13.1 25.6 12.7 14.6 86 116 3.1 3.7 0.44 1.41 1908 19,252 385,640 14.4 25.2 12.6 13.8 65 113 4.5 4.0 0.15 1.35 Average previous five years. 21,384 374,784 14.3 26.4 13.0 15.0 95 127 5.0 3.9 0.27 1.71 1909 18,193 391,220 13.4 24.2 16.0 14.0 106 107 4.7 * 0.44 1.3 * Figures not yet published. 19 (This Table is prepared in accordance with the requisitions of the Local Government Board.) Vital Statistics of Whole District during 1909 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 Deaths 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 1905 22,425 302 13.4 42 139 896 39.5 701 675 92 313 13.9 1906 21,368 341 15.9 30 88 901 42.1 691 658 36 279 13.0 1907 20,310 268 13.1 23 86 853 41.9 715 692 97 258 12.7 1908 19,252 277 14.4 18 65 899 46.7 736 712 56 243 12.6 Averages for years 1894-1908 26,686 398 14.9 50 125 950 35.5 654 639 120 431 16.1 1909 18,193 244 13.4 26 106 912 50.1 756 725 105 292 16.0 * Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Note.—The deaths included in Column 7 of this Table are the whole of those registered during the year as having actually occurred within the district or division. The deaths included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term " Residents " is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. Area of City of London Registration District in acres (exclusive of area covered by water) 672.7 Total population at all ages 26,923† Number of inhabited houses 3,865 Average number of persons per house 6.96 At Census of 1901. † At the date of the Census the civil parish of Glasshouse Yard was included in the City. This prish was subsequently transferred to another Registration District outside the City (see note on page 14). The population of Glasshouse Yard is therefore not included in this figure. 20 (This Table is prepared in accordance with the requisitions of the Local Government Board.) Causes of, and Ages at, Death during Year 1909. Deaths in or belonging to whole District at subjoined ages. Deaths in or belonging to Localities (at all a.ges). Total Deaths in Public Institutions in tub district. At all ages. Under 1 year. 1 and under 6. 5 and under 16. 15 and under 25. 25 and under 65. 65 and wards. St. Botolph. St. Sepulchre. * 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11 1. Small-pox ... ... ... ... ... ... ... ... ... ... ... 2. Measles ... ... 2 ... ... ... ... ... 2 ... 5 3. Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... 4. Typhus Fever ... ... ... ... ... ... ... ... ... ... ... 5. Epidemic Influenza 2 ... ... ... ... ... 2 2 ... ... ... 6. Whooping Cough 4 3 1 ... ... ... ... 1 3 ... 9 7. Diphtheria, Membranous Croup 1 1 ... ... ... ... ... ... 1 ... 19 8. Croup ... ... ... ... ... ... ... ... ... ... ... 9. Enteric Fever 1 ... ... ... ... 1 ... 1 ... ... 9 10. Asiatic Cholera ... ... ... ... ... ... ... ... ... ... ... 11. Diarrhoea, Dysentery ... ... ... ... ... ... ... ... ... ... 11 12. Epidemic or Zymotic Enteritis ... ... ... ... ... ... ... ... ... - 13. Enteritis 8 2 ... ... ... ... 1 3 ... ... 9 14. Other Continued Fevers ... ... ... ... ... ... ... ... ... ... ... 15. Erysipelas ... ... ... ... ... ... ... ... ... ... 2 16. Puerperal Fever 1 ... ... ... ... 1 ... 1 ... ... 4 17. Other Septic Diseases ... ... ... ... ... ... ... ... ... 22 18. Intermittent Fever and Malarial Cachexia. ... ... ... ... ... ... ... ... ... ... ... 19. Tuberculosis of Meninges 4 2 2 ... ... ... ... 1 3 ... 19 20. Tuberculosis of Lungs 25 ... ... 1 2 20 2 7 18 ... 21 21. Other Forms of Tuberculosis 6 ... ... 1 1 3 ... 2 3 1 29 22. Alcoholism 2 ... ... ... ... 2 1 1 ... 2 23. Cancer 20 ... ... ... ... 11 9 7 13 ... 68 24. Premature Births 4 4 ... ... ... ... ... 3 1 ... 6 25. Developmental Diseases 6 6 ... ... ... ... ... 2 4 ... 14 26. Old Age 29 ... ... ... ... ... 29 11 18 5 2 27. Meningitis ... ... ... ... ... ... ... ... ... ... 9 28. Inflammation and Softening of Brain ... ... ... ... ... ... ... ... ... ... 2 29. Organic Diseases of Heart 5 ... ... ... ... 2 3 1 4 ... 12 30. Acute Bronchitis 9 1 2 ... ... 1 5 6 3 ... 8 31. Chronic Bronchitis 29 ... 1 ... ... 14 14 11 18 ... 12 32. Lobar (Croupous) Pneumonia 5 ... ... ... 2 2 1 3 2 ... 8 38. Lobular (Broncho-) Pneumonia 13 1 5 ... ... 5 2 4 9 1 52 34. Diseases of Stomach 5 1 1 ... ... 1 2 1 4 ... 21 35. Obstruction of Intestines 4 ... ... ... ... 1 3 1 3 ... 20 36. Cirrhosis of Liver 4 ... ... ... 3 1 3 1 ... 6 37. Nephritis and Bright's Disease 8 ... ... ... ... 5 3 4 4 ... 27 38. Tumours and Other Affections of Female Genital Organs. ... ... ... ... ... ... ... ... ... ... 2 39. Accidents and Dis. of Parturition ... ... ... ... ... ... ... ... ... ... 2 40. Deaths by Accident or Negligence 12 3 ... ... ... 8 1 4 8 ... 81 41. Deaths by Suicide 3 ... ... ... ... 3 ... 1 2 ... 9 42. Deaths from Ill-defined Causes ... ... ... ... ... ... ... ... ... ... 4 43. All other Causes 86 1 1 1 1 47 35 34 52 ... 231 Total all Causes ‡292 26 14 3 6 130 113 115 177 7 ‡756 * Persons dying in City Institutions. Address not stated on certificate of death. † Including 31 Citizens, distributed in Columns 1 to 10 (25 died in St. Bartholomew's Hospital and 6 at the Union Depot, Thavies Inn). ‡ Including 105 Citizens who died in City Institutions outside, distributed in Columns 1 to 10. 21 DEATH REGISTRATION AND BURIAL BILL. A Bill for effecting a much needed reform with regard to death registration was read a first time on 1st March, 1909. An explanatory memorandum to the Bill stated that the object of its promotion was to give effect to the principal recommendations put forward by the Select Committee on Death Certification, which met in 1893, in order to guard against crime and premature burial. Briefly, the Bill provided that no death should be registered until a proper certificate of death had been delivered to the Registrar either by— (1) The registered medical practitioner who attended the deceased during his last illness, or (2) The "Public Certifier of Deaths" in cases when the deceased was unattended by a medical man, or (3) In Inquest cases when the Coroner's certificate of death and a verification certificate signed by the "Public Certifier of Deaths" would be required. It will be seen that the Bill created a new public functionary, viz., the "Public Certifier of Deaths." This officer was required to be a registered medical practitioner, who was to be appointed and paid by the Board o Guardians, who were to appoint one in each registration sub district in their Union. Medical men in attendance on a deceased person were required to certify the death within five days. Children delivered still-born after twenty-eight weeks pregnancy were to have been registered as having been born alive. The Local Government Board were to make regulations prescribing the duties of the "Public Certifier of Deaths." If passed, the Bill would have become operative on the 1st January in this year, but it was dropped before reaching a second reading. There can be no question that the law with regard to death certification and registration requires amendment. The last published Report of the Registrar General shows that during the year 1908 there were 7,433 cases, or 1.42 per cent. of all deaths during that period in England and Wales in which the cause of death was not certified either by medical practitioners or by coroners.* The Parliamentary Committee of 1893, referred to in the Memorandum published by the authors of the Bill, referred to above, was appointed at the instance of the Cremation Society of England under the guidance of its founder, the late Sir Henry Thompson, and, notwithstanding the strong case for reform shown by the nature of the evidence given at that enquiry and the * This is the lowest proportion of uncertified deaths hitherto recorded. 22 recommendation of the Select Committee to give effect to various obvious and much needed reforms, the state of the law with regard to earth burial remains unaltered. The Bill now referred to was certainly an improvement on existing legislation for dealing with death certification, but, as drafted, required modification in at least two respects. The limit of time within which deaths were to be certified, viz., five days, was too long, and in inquest cases might result in the burial being unduly delayed. The registration of still-born children as being born alive, as suggested in the Bill, should not be permitted. Such a course would be indefensible on moral grounds; it is also desirable for statistical and other purposes that the number of still-births should be accurately known. NOTIFICATION OF INFECTIOUS DISEASE. In the following Tables will be found particulars of infectious disease notified under Sections 55 and 56 of the Public Health (London) Act, 1891, and information as to the removal of patients to hospitals, infirmaries, &c.:— NATURE OF DISEASE. Number of Certificates received. Treated at Home. Removed to tbe Metropolitan Asylums Board Hospitals. Removed to the London Fever Hospital. Treated at other Hospitals and Infirmaries. Duplicate Certificates received. Diagnosis incorrect. Small-pox 2 — — — — 1 1 Diphtheria, including 1 Membranous Croup 21 2 13 1 1 2 2 Scarlet Fever 47 2 24 8 1 8 4 Enteric „ 4 1 2 — — — 1 Puerperal Fever 1 1 — — — — — Erysipelas 12 6 — — 4 2 — Anthrax 2 — — — 1 1 — Totals 89 12 39 9 7 14 8 Chicken-pox 28 28 — — — — — Phthisis 6 3 — — 3 — — Totals 123 43 39 9 10 14 8 The notification of this disease is voluntary in the City of London. 23 It will be seen from the foregoing that during the year, excluding Chickenpox and Phthisis, 89 Certificates were received, including 14 "duplicates," and 8 in which the diagnosis was subsequently found to be incorrect. The total number of cases of "notifiable infectious disease" was therefore 67, as compared with 90 for the previous year. The total number of cases of Scarlet Fever reported was 35, compared with 46 of last year. The following is a Return of infectious disease notified, exclusive of Chickenpox and Phthisis, occurring in the City of London, with the percentages of such cases removed for treatment to hospitals or nursed at home during 1909, compared with the figures for the previous five years:— Year. Number of cases reported. Per cent. of cases reported. Removed to Hospital. Treated at Home. 1904 100 84.0 16.0 1905 113 77.9 22.1 1906 149 91.9 8.1 1907 140 84.8 15.7 1908 90 91.0 9.0 Average for previous five years. 118 85.8 14.2 1909 67 82.1 17.9 EXAMINATION FOR PATHOGENIC BACTERIA. Should any medical practitioner in the City desire examination of specimens for pathogenic bacteria in cases of suspected infectious disease occurring amongst their patients residing in the City, they are examined free of charge, and the result communicated as speedily as possible. During the year the following 11 specimens were so dealt with. It will be seen that positive results were obtained in 54 per cent. of these cases:— Specimen. • Disease suspected. Result— Positive. Negative. Two of Blood Enteric Fever 1 1 Five of Sputum Phthisis 2 3 Four Throat Swabs Diphtheria 3 1 24 Cases of Infectious Disease notified during the Year 1909. CITY OF LONDON. Disease. Casks notified in Whole District. Total Casks notified in each Locality. No. ok Cases removed to Hospital from each localitt. Total Cases removed to Hospital. At all Ages. At Ages—Tears. St. Botolph. St.Sepulchre. St. Botolph. St .Sepulchre. Under 1. 1 to 5. 6 to 15. 15 to 25. 26 to 65. 65 and upwards. Small-pox - - - - - - - - - - - - Cholera - - - - - - - - - - - - Diphtheria, including 1 Membranous Croup 17 10 6 1 — — 7 10 7 8 15 Erysipelas 10 — — — 1 7 2 7 3 1 3 4 Scarlet Fever 35 1 4 12 11 7 — 13 22 12 21 33 Typhus „ - - - - - - - - - - - - Enteric „ 3 — — 1 2 — 1 2 — 2 2 Relapsing „ - - - - - - - - - - - Continued „ - - - - - - - - - - - - Puerperal ,, 1 — — — — 1 — — 1 — — — Plague - - - - - - - - - - - - Anthrax 1 — — — — 1 — — 1 — 1 1 Totals 67 1 14 18 11 18 2 28 39 20 35 55 Chicken-pox 28 1 8 21 2 1 — 8 20 — — — Phthisis 6 — — — 1 5 — 2 4 1 2 3 Totals 101 2 17 39 17 24 2 38 63 21 37 58 This Table is prepared in accordance with the requisitions of the Local Government Board. * The notification of this disease is voluntary in the City of London. † For cases of this disease notified under the Public Health (Tuberculosis) Regulation, see p. 26. In each case a detailed examination was made of the sanitary condition of the premises where infectious cases occurred, and a summary of defects found by the District Inspectors is given on page 61. 25 "CARRIERS" OF ENTERIC FEVER. In the last Annual Report reference was made to the arrangements made by the Local Government Board for protecting the public from the danger arising from the discharge from hospitals of patients who, although in other respects perfectly healthy, were carriers of infection by reason of their still passing the bacillus typhosus in their stools and urine. It has been recognised that there may be persons not displaying this condition in their discharge, that nevertheless prove on further investigation to be "carriers." This difficulty has now been met by the Local Government Board making arrangements by which it is possible to make a periodical examination of the stools and urine of all cases of enteric fever after their discharge from a Metropolitan Asylums Board hospital. As this is a most useful extension of the system in operation last year, I have gladly consented to the request of the Local Government Board's medical advisers to co-operate therein. The procedure for making the examination of stools and urine will be similar to that given on page 37 of your Medical Officer's Annual Report for 1908, and the necessary apparatus for taking samples have been supplied by the Lister Institute with instructions for use. SMALL-POX. No small-pox occurred among the residents of the City during the year, but one case was reported from an adjoining Borough, where the patient, a barman, was employed daily at a tavern in the City. The disease was diagnosed as modified small-pox by a City medical practitioner. The patient was immediately removed to hospital, his fellow employes re-vaccinated and the premises disinfected, and no spread of infection occurred. Another case was notified from St. Bartholomew's Hospital, and the usual precautions were adopted, but in this instance the illness proved to be blood - poisoning. ANTHRAX. One case of anthrax occurred during the year. The patient, a housekeeper, became ill on the 2nd June, 1909, a local lesion having appeared a day or two previously. He was admitted to the London Hospital on the 3rd June, for operation. He had been engaged at a block of offices, one of which was occupied by a firm of leather merchants dealing in box calf and dressed 26 leather. There were some samples of wool in the office, but he was not supposed to touch any of these. A dealer in scheduled horsehair and bristles occupied a small room on another floor, and the housekeeper had swept up loose hair from the floor there from time to time. This room and its contents were disinfected, as being the possible source of infection. The facts were reported to the Home Office, with the suggestion that samples as well as the bulk of consignments from which they are taken should be disinfected, especially as they are more likely to spread the disease. CEREBRO SPINAL FEVER. (Epidemic Cerebro-Spinal Meningitis.) This disease (referred to in the Annual Reports for the years 1906 and 1907), was first made notifiable for a period of six months, by order of the London County Council, as from the 12th March, 1907. The order was duly approved by the Local Government Board, and was renewed from time to time until the 12th March, 1909, An order was then made for a further period of twelve months, as from the 13th March, 1909, and applies to the Administrative County of London, and thus includes the City. The order has been further extended for another year, from the 13th March, 1910. By the advice of the President of the Royal College of Physicians it has been decided, that for notification purposes, the disease at present known as posterior basal meningitis is included in the term "cerebro-spinal fever." This term, however, is not to be interpreted to include cases of meningitis due to tuberculosis, syphilis, middle ear disease or injury. The details of the cases of cerebro-spinal fever reported as occurring in adjacent Metropolitan Boroughs are carefully examined in case any connection with the City should be disclosed. No case has been reported within the City since the disease first became notifiable. PHTHISIS. The Public Health (Tuberculosis) Regulations, 1908, which became operative on the 1st January, 1909, require that medical advisers and certain officials of Boards of Guardians shall notify to the Medical Officer of Health the particulars of cases of "poor persons" suffering from pulmonary tuberculosis that are brought to their notice. 27 During the year 81 notifications have been received in conformity with these Regulations, of which 9 were duplicates, and 16 referred to old cases, some of which had been under treatment in the Infirmary in former years. 42 refer to cases in which the previous movements of the patients are unknown, but in 14 the information furnished proved useful in enabling disinfection to be effected where the patient has been removed to the Infirmary; and more especially in those cases treated at home, in precautions being observed to minimise the danger of the spread of the disease. As in former years several medical practitioners in the City notified cases of phthisis which came under their observation in private practice, and, as recorded on p. 24, six cases (other than "poor persons" ) have been dealt with under this system of voluntary notification. Disinfections have been also effected in any cases that can be found where those in attendance at establishments in the City have been suspected to be suffering from phthisis ; but in a place like the City, so densely populated during business hours, there must always be a danger from the presence of a large number of unrecognised and incipent cases that are constantly associated with their fellow workers. 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 disinfested by the sanitary authority," has been visited by eight families during the year. They numbered 24 persons, of whom 17 were adults and 7 were children, and who were housed during the disinfection of their houses after:— Scarlet Fever 3 families. Diphtheria 2 „ Enteric 2 „ Measles 1 family. 8 families. Four families came from homes consisting of 4 rooms, two of 3 rooms, and two of 2 rooms. 28 Some structural alterations were made at the Shelter, in order to provide additional space required in connection with the extension of the disinfecting plant. The kitchen on the ground floor has been converted into a storage place for the reception of articles that have been through the process of disinfection, and a room on the first floor fitted up as a kitchen in place thereof. This re-arrangement has the advantage of installing the kitchen on the same floor as the apartments used by the visitors to the Shelter, and obviates the necessity for a good deal of going up and down stairs in the preparations for meals. THE SPITTING EVIL. Attention having been again directed to the danger arising from the filthy and disgusting practice of indiscriminate expectoration in the streets and elsewhere, the following epitome of the action taken by your Medical Officer to abate the evil may be of interest. The matter was particularly referred to in the Annual Report for 1901, and it was in the hope of minimising the nuisance that some suggestions on the subject had been previously submitted for the consideration of the Sanitary Committee. In July, 1902, a circular memorandum, addressed to large employers of labour, was issued by the Corporation. In this the co-operation of the firms was invited in the endeavour as far as possible to prevent spitting in streets and places of public resort. It was pointed out that the practice of spitting was known to be the main factor in spreading the disease known as phthisis or consumption. It was further suggested that the exhibition of cautionary notices, warning the public against the dangerous habit of spitting, would be of great value. Cautionary notice cards, in the following form, for exhibition in places of business, were then largely distributed throughout the City, and applications are constantly received at this office for further supplies:— "CORPORATION OF LONDON. " Public Health Department. "NOTICE. "In order to aid in the prevention of consumption you are earnestly "requested to abstain from the dangerous and objectionable habit of "spitting." In my Annual Report for 1902 I referred at considerable length to legislation in force, both abroad and in some large provincial towns in this country, for the abatement of this dangerous nuisance. 29 In 1903 the London County Council took practical measures for preventing spitting in certain public places in the Metropolis by issuing the following bye-law on the 12th May of that year, made under Section 23 of the Municipal Corporations Act, 1882, and Section 16 of the Local Government Act, 1888, viz.:— . "No person shall spit on the floor, side or wall of any public carriage "or any public hall, public waiting room, or place of public entertainment, "whether admission thereto be obtained by payment or not." "Any person who shall offend against this bye-law shall be liable for "such offence to a fine not exceeding forty shillings." In September, 1903, I further advised that the attention of all governing bodies of schools in the City should be directed to the desirability of their taking active steps towards checking the evil amongst scholars under their charge. This suggestion was adopted, and a circular letter to this effect sent to all schools in the City. In replying to this letter on the 10th November, 1903, the Clerk to the School Board for London stated that the Board proposed issuing a notice in their "Gazette," advising teachers who give lessons in hygiene that they would do well to impress upon their scholars the danger of spitting in public places. The issue of the bye-laws referred to was a step in the right direction, but measures are still required for preventing the infection of pu blic thoroughfares with the sputa of tuberculous patients. The pathogenic bacilli are always present in enormous numbers in the sputa of infected persons, and when dried are carried into the air and liable to infect any person who furnishes a suitable soil for development. Unfortunately, the Corporation have no power to prevent persons from spitting on the footpaths or roadways. In these circnmstances the Sanitary Committee, on the 25th June, 1903, recommended that a clause be inserted in the next omnibus bill empowering the Corporation to make and enforce byelaws with a view to effectually remedying the nuisance. The Court agreed with the report except that the proposed clause should not apply to streets. At a meeting of the Sanitary Committee on the 11th July, I suggested that probably the best way of bringing to the notice of the public the danger to health arising from the objectionable habit of spitting on the pavements would be to have a notice, at a convenient height, exhibited on all lamp-posts, as had already been done in several towns, notably in Birmingham. 30 The Committee concurred in this recommendation, and on the 2nd October, 1903, submitted the following report to the Court of Common Council:— "We have further considered the steps taken with a view to prevent as "far as possible the objectionable practice of spitting, and it having "been suggested that notices might with advantage be fixed to the lamp"posts in the City, we placed ourselves in communication with the City "of London Electric Lighting Company, in order to secure their consent "to the proposal, which we have since obtained, and we now suggest "that enamelled iron notices, requesting the public to abstain from "spitting on the footways, be fixed to the electric lamp-posts, under the "direction of the Streets Committee, at a cost of about 7 5l. This recommendation was negatived by the Court, probably owing to the impression that the Notice was intended to refer to the roadways as well as the footways. In 1906 the principal railway companies adopted a bye-law making spitting on platforms, booking offices, &c., or in railway carriages a punitive offence. Name of Railway Company. Date when the bye-law was approved by the Board of Trade. London, Brighton and South Coast 24th March, 1905. London, Tilbury and Southend 5th April, 1905. Great Western 10th April, 1905. Midland 14th April, 1905. Great Eastern 3rd May, 1905. South Eastern and Chatham 27th May, 1905. Great Central 7th July, 1905. London and North Western 16th Sept., 1905. Metropolitan District 6th Nov., 1905. City and Waterloo 14th March, 1905. Central London 6th March, 1907. City and South London 30th April, 1907. The following is a copy of the bye-law referred to:— "No person shall spit upon the floor or upon any part of any carriage "using or being used 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 5l. for any subsequent offence. 31 On several occasions proceedings have been taken against offenders against this bye-law. Id this connection it may be mentioned that Dr. John Robertson, Medical Officer of Health for Birmingham, is the author of a report, "The spread of tuberculosis by indiscriminate spitting," that deals exhaustively with the spitting evil. In this, Dr. Robertson takes as his text the following resolution, passed at the London Congress in 1901:— "Tuberculous sputum is the main agent for the conveyance of the virus of "tuberculosis from man to man ; indiscriminate spitting should therefore be "stopped." Considerations of space prohibit any lengthened reference to the points discussed in Dr. Robertson's Report, which I have already referred to in detail in a report presented to the Sanitary Committee on the 13th December last. It must, however, be mentioned that an examination of Dr. Higgins of one hundred sputa, gathered from the foot pavements in Birmingham, showed that seven per cent. contained tubercle bacilli, and that Dr. Annett found them present in five per cent of spits deposited on the foot walks of Liverpool. Dr. Robertson's report also clearly shows that America is far in advance of this country in dealing with the evil, and gives particulars of the regulations in force for that purpose in the following places in the United States, viz.:— New York Philadelphia Baltimore Chicago San Francisco Boston Pittsburg Washington Buffalo Milwaukee Atlanta Springfield (Mass.) It is also stated that similar information has been obtained from St. Louis, Missouri, New Orleans, Cincinnati, Ohio, and Cleveland. In my Annual Report for 1902 a list is given of 26 other places in the United States of America where regulations against spitting on side walks have been adopted. In view of these facts, which are of the utmost interest and importance from a public health point of view, it appeared that the time had arrived when the Corporation should re-consider the recommendation made by the Sanitary Committee upwards of six years ago, viz., 2nd October, 1903, with regard to placing cautionary notices on street lamps, and I accordingly made a representation to the Committee to this effect in the report presented to them on the 13th December last, referred to above. 32 CONTAMINATED MILK. The enquiry into the character of the milk arriving in London consigned to traders in the City, which was commenced in 1902 and repeated during the years 1904, 1905, 1906, 1907 and 1908, was continued during March and April, 1909. In 1909, 32 samples were bacteriologically examined with the following result:— Character of Milk. No. of Samples. Percentage. Fairly clean and pure 14 43.7 Unclean 14 43.8 Tuberculous 4 12.5 32 100.0 The 12.5 per cent. was the largest proportion of tubercle infected milk found in the City since the commencement of the enquiry. The 32 samples came from the following counties:—Suffolk 11, Essex 8, Cambridge 6, Norfolk 4, and one each from Buckingham, Herts and Bedford. As the result of enquiries as to the health of the cows at the four farms from which the tubercular samples were consigned it was found in three of them that the herds supplying the milk contained cows suffering either from tuberculosis of the udder, generalised tuberculosis or pulmonary tuberculosis. In each case the co-operation of the Medical Officer of Health of the district in which the farm was situated was readily afforded. No difficulties were placed in the way of the enquiry by the farmers concerned, who at once stopped the sale of milk from the affected animals. The results of the examination of the several series for the five years 1904-9 were as under:— Character of Milk. 1904. per cent. 1905. per cent. 1906. per cent. 1907-8. per cent. 1909. per cent. Fairly clean and pure 48.7 68.2 80 54.2 43.7 Unclean 43.6 22.7 12 37.5 43.8 Tuberculous 7-7 9.1 8 8.3 12.5 During November and December, 1909, a further series of milk samples was collected on arrival of milk churns at Liverpool Street Railway Station and submitted to Dr. Klein for bacteriological examination. 33 These represented the milk supply from the following counties:— Essex 14 samples. Suffolk 15 „ Norfolk 7 „ Cambridgeshire 3 „ Hertfordshire 3 „ Total 42 samples. Dr. Klein summarised the results of his examination of these samples as under:— Appreciable amount of dirt in 14 samples 33.33 per cent. Little dirt in 12 samples 28.58 „ „ Mere traces of dirt in 12 samples 28.58 „ „ No dirt in 4 samples 9.52 „ „ Acute pathogenicity in 15 samples 35.7 per cent. Real tubercle in 2 samples 4.7 „ „ No pathogenicity of any kind in 25 samples 59.5 „ „ It may be noted that the proportion of tubercular samples found in this series is the lowest recorded since this investigation commenced. The results of this enquiry were forwarded to the Medical Officer of the London County Council in accordance with agreements and arrangements entered into under the provisions of Section 35 of the London County Council (General Powers) Act, 1907. In the two cases in which the milk was found to be tuberculous the names of the senders, and the situation of the farms from which the milk came, were forwarded to the Medical Officer of the County Council, who informs me that upon enquiry it was found that in each case a cow was discovered on the farm suffering from tuberculosis of the udder. The owners undertook not to send the milk of these cows to London, and the attention of the local authorities in whose districts the farms are situate was directed to the cows in question. Although the proportion of tubercular samples found was comparatively low, the number reported as showing acute pathogenicity indicates an exceedingly unsatisfactory state of affairs. Had the Milk and Dairies Bill introduced into Parliament last Session come into being, the public would be better protected than they are at present from the danger arising from the consumption of milk of this class. Dr. Klein's report also shows that in the great majority of the samples, few, if any, precautions are taken to prevent contamination of the milk by dust and other impurities. No matter what care may be exercised at the farms in 34 preventing contamination of this kind, it can never be entirely obviated in cases where the old-fashioned, badly designed churns are in use. I am glad to say that, acting upon my advice, many of the large milk trading firms are adopting more modern types of churns, specially designed for excluding aerial and other contamination. By direction of the Court of Common Council a copy of this Report was forwarded to both the Board of Agriculture and Fisheries and the Local Government Board, with a representation to the latter Authority urging the importance of obtaining further Parliamentary powers in relation to the milk supply. Of the 184 milk samples taken in the City between November, 1904, and December, 1909, and specially examined for the tubercle bacillus, that organism was present in 15 cases or 8.15 per cent. In a report to the County Council of the Public Health Committee dated 3rd February this year, it is stated that since the Council obtained power under Part IV. of their General Powers Act, 1907, for dealing with milk supply (tuberculous), 1,930 samples had been examined, of which 187 or 9.6 per cent. were found to be tuberculous. It is evident, therefore, that an enormous quantity of tubercular milk is now, and has been for many years past, distributed throughout the country. The mischief does not stop here, tubercular milk is not the only class of milk that requires supervision, but it is known from my own investigations and those of others engaged in similar enquiries that still larger proportions of milk sold to the public are contaminated with other pathogenic organisms. There is ample evidence that, owing to the neglect of elementary precautions at dairy farms, their supplies more often than not contain evidence of faecal contamination from the cows. Again, the mode of distribution as ordinarily practised favour the further pollution of the milk in transitu. As showing the real danger attending the distribution of milk containing tubercle bacilli, attention is directed to the following abstract of the Third Interim Report of the Royal Commission on the relation between human and animal tuberculosis. 35 ROYAL COMMISSION ON THE RELATION BETWEEN HUMAN AND ANIMAL TUBERCULOSIS. Third Interim Report. The Commission appointed on the 18th March, 1907, to inquire and report with respect to the above, issued in January, 1909, a Third Interim Report thereon, as from the result of further experiments they thought it advisable to describe their results. They point out that in the Second Interim Report they expressed the opinion, as a result of their investigation, that a very considerable amount of disease and loss of life, especially among infants and children, must be attributed to the consumption of coin's milk containing tubercle bacilli. They were undecided, however, what is the danger, if any, attaching to the milk of tuberculous cows in which the udder presents no evidence of disease, and they therefore made a number of experiments bearing on this point, using for this purpose the milk of cows which had contracted the disease in a natural way. They found that the milk of cows obviously suffering from tuberculosis contained tubercle bacilli, and this confirms the opinion expressed in the Second Interim Report that the milk of such cows must be considered dangerous to human beings. It was also found, by experiments made with a view of obtaining information regarding the excretion or discharge of tubercle bacilli in the milk and faeces of tuberculous cattle, that the excrement of cows obviously suffering from tuberculosis of the lungs or alimentary canal must be regarded as much more dangerous than the matter discharged from the mouth and nostrils. Further that, even in the case of cows with slight tuberculous lesions, tubercle bacilli in small numbers are discharged in the fasces, while as regards cows clinically tuberculous, the experiments show that the faeces contain large numbers of living and virulent tubercle bacilli. The presence, therefore, of tuberculous cows of this class in company with healthy cows in the cowshed is distinctly dangerous, as some of the tubercle bacilli which escape from their bodies in the excrement are almost certain to find their way into the milk. These experiments show that it is not sufficient for the farmer to ascertain merely whether a cow is suffering from tuberculosis of the udder, but that no cow can be considered as free from danger unless it passes the tuberculin test. The Report illustrates the importance of seeing that cows are housed under sanitary conditions, and properly groomed before milking; also that infected cows should be kept apart from healthy animals. 36 MILK AND DAIRIES BILL. This Bill, which had been looked forward to with great interest on the part of sanitary authorities, dairy farmers and others throughout the country, was introduced in the Commons by the President of the Local Government Board on the 25th May, 1909. It was not to apply to Scotland, and in its application to Ireland it was subject to certain modifications. Your Medical Officer reported at length to the Sanitary Committee on the 17th June, 1909, on the details of the Bill, and owing to considerations of space the main provisions of the same can only be referred to here. The Bill reached a second reading and was referred to a Select Committee, but owing to pressure of business in the House was not proceeded with. The Bill was prefaced by a memorandum, which stated that the main objects of the Bill were to provide for— 1. The more effective registration of dairies and dairymen. 2. The inspection of dairies and the examination of cows therein. 3. The prohibition of the supply of milk from a dairy where such a supply has caused, or would be likely to cause, infectious disease, including tuberculosis. 4. The prevention of sale of tuberculous milk. 5. The regulation of the importation of milk so as to prevent danger to public health arising therefrom. 6. The issue of regulations. 7. The establishment by local authorities in populous places of milk dep6ts for the sale of milk specially prepared for infants. The provisions as to registration supersede the provisions as to the registration of dairies contained in the Contagious Diseases (Animals) Acts and the Orders made thereunder. The provisions as to the inspection of dairies and the prohibition of the supply of milk reproduce, with amendment, Section 4 of the Infectious Diseases Prevention Act, 1890, Section 71 of the Public Health (London) Act, 1891, and the model milk clauses incorporated in many local Acts. The clauses as to the prevention of the sale of tuberculous milk is also taken from the model milk clauses, but the scope of the enactment is somewhat extended. The memorandum further stated that the Board of Agriculture and Fisheries would, in connection with this Bill, issue an Order under the Diseases of Animals Act, 1894, dealing with the notification of 37 tuberculosis in cattle and the inspection, examination, detention, isolation, and slaughter of tuberculous cattle, and the giving of compensation in appropriate cases.* To effect the purpose of the Bill the Local Government Board, after consultation with the Board of Agriculture and Fisheries, were empowered under Section 6 of the Bill to make general or special orders with respect to all or any of the following matters :- (a) The registration with the Sanitary Authority of Dairies and Dairymen, including the inspection and taking copies of and making extracts from the registers, and the fees to be charged in respect of such matters. (b) The inspection and examination of dairies and cows therein. (c) The lighting, ventilation, cleansing, drainage, water supply, floor space, air space, and construction of floors of dairies. (d) The prevention of impurities in milk intended for human consumption and the cleanliness of vessels used for or containing such milk. (e) The measures to be taken for cooling milk and otherwise for protecting milk against infection or contamination. (f) The prohibition or regulation of the use of preservatives in milk. (g) The manner of conveyance of milk intended for sale for human consumption and the identification of churns and vessels used for the conveyance of such milk. (h) The prohibition or regulation of the mixing of milk in one such churn or vessel with the milk in another such churn or vessel. (i) The labelling of the receptacles of milk for sale for human consumption where the milk is sold otherwise than in its natural state. (j) The provision of assistance to be given by Sanitary Authorities to County Councils, and by County Councils to Sanitary Authorities, in carrying out their duties under this Act. (k) The form of orders to be made by Sanitary Authorities and Medical Officers of Health under this Act. (l) The qualifications, duties, salaries, and tenure of office of Veterinary Inspectors. (m) The authorities by whom the orders are to be executed and enforced, and the powers of entry and inspection exercisable by such authorities and their officers for the purpose. * This ordrr is further referred to on p. 39. 38 The whole value of the measure, so far as these important questions are concerned, will depend upon the regulations, and in the absence of these it is impossible to criticise or comment upon their usefulness. One important feature of the Bill was the proposed repeal of the warrantyclauses of the Sale of Food and Drugs Acts when milk was the article concerned, where proceedings were taken for an offence under those Acts. This is a greatly needed reform. Provision was also made for the making of regulations under the Public Health (Regulations as to Food) Act, 1907, by the Local Government Board, with regard to the importation of milk. Section 9 of the Bill authorised the establishment and maintenance of depots for the sale of milk for infants in any district with a population of upwards of 50,000, or less than 50,000, with the consent of the Local Government Board. Although there can be no question of opinion as to the necessity for the control of milk supplied for young children, it is at least doubtful whether this would be the best way of effecting it. Apart altogether from the question of municipal trading in direct competition with dairy companies, the inclusion of this section is an admission of a prospective failure of the rest of the Bill when put into practice. In my opinion, in cases where poor women have lessened vitality as a result of insufficient or unsuitable food and are unable to nourish their offspring, it would be a distinct advantage if the milk were given for the mother's consumption at the public expense. If the Bill is ever placed on the Statute Book, the Corporation will have no need to adopt it. The mother of every child born in the City is visited and instructed in the best methods of feeding her infant. The results have been most encouraging, and a general extension of this system, together with a more active administration of the Dairies and Milkshops Order in the rural districts, would be a better and far more economical method of dealing with the question of infant feeding. We are energetic, and rightly so, in prosecuting those who supply watered milk to the community, but there is many an infant of to-day among the breast-fed who may shortly swell our returns of deaths from marasmus, atrophy, and debility, because from lack of nourishment to the mother, her milk is too poor in quality to nourish the child. There are good reasons for not encouraging the use of pasteurised milk for infants. 39 In order that she may properly nourish her child, a mother must herself have sufficient nourishment. A large number of infants die every year from marasmus and debility, and the cause of these deaths may frequently be traced to the deficient quality of the milk secreted in the mother's breast. When there is poverty in the home it is the mother and baby who suffer. The husband and children must be fed, so the woman herself goes without. She is often underfed before the baby comes into the world, and underfed all the time she is suckling it, consequently her milk becomes poor and unsatisfying, the child fails to thrive, and gradually dies for want of that nourishment which nature's food should provide. In such cases, if only help in the way of good milk and other nourishment could be extended to the mother before and after childbirth, it might often be the means of saving the life of a child, or ensuring for those living greater health and strength. The establishment of milk depots will not tend to encourage breast feeding. With the proviso as to the unknown value of the regulations to be made by the Local Government Board under Section 6, and on the understanding that the powers and privileges of the City are in no way interfered with, your Medical Officer advised the Corporation to support the Bill, with the exception of Section 9, dealing with the establishment of milk depots for infants. On all other points the Corporation had already expressed opinion in favour of the principles of the Bill. TUBERCULOSIS ORDER OF 1909 (made under the Diseases of Animals Acts, 1894 to 1903). As already mentioned, on the introduction of the Milk and Dairies Bill on the 25th May, 1909, it was announced that the Board of Agriculture and Fisheries would, in connection with that Bill, issue an order under the Diseases of Animals Act, 1894, dealing with " the notification of tuberculosis " in cattle and the inspection, examination, detention, isolation and slaughter " of tuberculous cattle, and the giving of compensation in appropriate cases." The Board of Agriculture and Fisheries accordingly made an order on the 26th May, 1909, to be cited as the " Tuberculosis Order of 1909," which was to come into operation on the 1st January, 1910. Although it was not to come into force until that date, it was prepared in order that the proposals of the Government as a whole might be laid before Parliament. 40 Starting with the acceptance of the fact that tuberculosis is transmissible by the agency of milk, it pointed out that any action resulting in the reduction of the number of tuberculous bovine animals must reduce the risk of the spread of tuberculosis among the community. Bearing in mind the importance of securing the continuance of an adequate supply of milk and of avoiding disorganisation of this industry, the Board in the first place proposed to deal only with (1) Cows suffering from tuberculosis of the udder, (2) Bovine animals emaciated from tuberculosis, and (3) Cows proved to be giving tuberculous milk. For the first time the Board proposed that such animals should be slaughtered, and compensation given to the owner. If the animal after slaughter was found to be healthy, compensation was fixed at the value of the animal plus 20s. Where tuberculosis was found to exist the compensation was based on the recommendations of the Royal Commission of 1898, i.e., where the animal was in such a condition as to justify the seizure of the entire carcase and the organs, compensation was to be a sum equal to one-fourth of the value of the animal, or 2/., whichever sum was the greater after deduction of half the cost of valuation. For convenience these conditions were described in the order as " advanced " tuberculosis. In all cases where tuberculosis was found to exist to an extent which did not justify the seizure of the whole animal, the compensation was to be a sum equal to three-fourths of the value of the animal after deduction from this compensation of half the cost of the valuation. The order further described the precautions to-be taken with regard to milk of suspected animals, and made provision for dealing with suspicious animals in markets, fairs and sales. The Board laid great stress on the importance of moving with caution in this matter, and pointed out that while public opinion is favourable to the adoption of concerted measures designed to check the spread of tuberculosis, and that any action would be unsatisfactory which failed to make provision for dealing with the disease in animals, at the same time, heroic measures would only defeat their own object. They further pointed out that at the outset of the operations the expenditure of the local authorities would be heavy, inasmuch as they would have to deal with what might be called arrears ; but after a few years the expenditure would probably be considerably less. In reply to a question addressed to the President of the Board of Agriculture and Fisheries on the 1st September, 1909, asking whether it was still proposed to issue the Tuberculosis Order of 1909, having regard to the fact that the Milk and Dairies Bill had been abandoned, it was stated that the reply was in the negative, but the question of the postponement of its operation was under consideration. 41 MILK CHURNS. Having in view the importance of ensuring that milk should be protected from contamination while in transit from farms to the Metropolis, and the fact that the churns at present in general use are so constructed as to defeat the very purpose for which they should be intended, owing in a great measure to a prevalent erroneous impression that it is essential that milk cans should be ventilated, I suggested it would serve a useful purpose if it were made a condition that the sum subscribed by the Corporation towards the prize fund of the British Dairy Farmers' Association Show, held annually at Islington, should be awarded as a premium to the exhibitor of the railway churn best designed in accordance with the recommendation of the Board of Agriculture and Fisheries. These were contained in a circular letter dated the 27th February, 1907, addressed to makers in Great Britain of churns for carriage of milk by rail. These were as under :- (1) The churn should have the tare weight stamped on the outside. (2) The lid of the churn should be constructed so as to facilitate sealing. (3) The churn should be constructed so as to prevent, as far as possible, the removal of milk from the churn while sealed. (4) The churn should be constructed so as to prevent water being added to the milk in the churn while sealed. (5) The churn should be constructed so as to prevent dust or dirt from being blown or washed into the churn when the lid is affixed. This recommendation having received the approval of both the Sanitary and the Coal and Corn and Finance Committee, and the Corporation having made the Association a grant for the purpose, it was left with the Society to give effect to the Corporation's wishes in the matter. This was willingly agreed to, the Chairman of the City Lands Committee, Mr. George Briggs, being appointed on the Jury as the representative of the Corporation. The thirty-fourth Dairy Show of the British Dairy Farmers' Association was held at the Royal Agricultural Hall, London, on October 5th, 6th, 7th and 8th, 1909. 42 The prizes given by the Corporation for milk churns were scheduled in the catalogue as under :- " Inventions." " Class 94. Railway milk churns, dust proof, suitable for the con" veyance of milk, capable of containing from 12 to 17 Imperial gallons. " First prize 10/. 10s. ; Second prize 5l. 5s. Offered by the " Lord Mayor and Corporation of London." There were eleven exhibitors in this class who entered eighteen milk churns for competition. The following is a copy of the award of the Judges :- RAILWAY MILK CHURNS. None of the churns competing for the prizes offered by the Lord Mayor and Corporation of London showed any special new features of real practical importance, although most of the churns were of excellent workmanship and finish, and therefore the first and second prizes were divided between the best two. It is a somewhat difficult matter to turn out a really first class railway milk churn to suit the general conditions of the milk trade, but the judges are of opinion that the resources of mechanical genius are not yet exhausted in this direction. We are of opinion that the best pattern railway milk churn is one which has a dust proof lid without any openings. The so-called "ventilation" holes in the lids of some churns are useless for the purpose of aeration, while they allow the entrance of dirt of all kinds in transit. If milk is quite clean and properly cooled it will keep longer and better in vessels with closely fitted lids, and certainly none but clean and well cooled milk should be sent out. Signed GEORGE BRIGGS, C.C. P. McCONNELL, B.Sc. M. EWING, The prizes were divided between the undermentioned firms :- " Exhibit No. 1,729. Vipam and Headly, Leicester. Railway milk " churn, 17 gallons. Price 1l. 10s. " Exhibit No. 1733. Abbott, Field and Co., Ltd., No. 106, York " Road, Lambeth, S.E. Railway churn, 17 gallons. Price 1l. 7s, 43 The following extract from the Annual Report for 1908 of the Intelligence Division of the Board of Agriculture and Fisheries is a practical illustration of the need both for the improvement in the methods of transit of milk by railway companies and the designing of milk churns. " Damage to Milk." " It was reported to the Board by a London Dairy Company that " milk conveyed by one of the southern lines was frequently contaminated " by smuts from the engines. On enquiry it was ascertained that the " trucks in which the milk was carried were of the open-boarded type, " and that these trucks were being gradually superseded in favour of " vans ventilated at the bottom. It appeared, however, that the " construction of the milk can in use was also partly responsible for the " condition in which the milk was received, as the lids were not of the " type best calculated to prevent the contamination of the milk by dust " and smuts." CLEANSING OF VERMINOUS SCHOOL CHILDREN. The London County Council (General Powers) Act, 1907, empowers the Council, as the Local Education Authority for the County, to take effective measures for dealing with children in a verminous condition attending their schools. It enables the Council's Medical Officer, or any person provided with written authority from that Officer, to make a formal examination of the children and their clothing, and failing the cleansing of any verminous child by the parents, to require the compulsory cleansing of its person and clothing in suitable premises and with suitable appliances. The Council may make use of any premises or appliances suitable for the purpose the local Sanitary Authority may possess. . Similar powers were also given by the Children Act, 1908, which extended their application to the whole country, whereas the London County Council's Act was confined to the Metropolitan area. The Children Act further contains a penalty clause which renders the parent, guardian, or other person liable to maintain the child that has been allowed to get into such a condition that it is again necessary to proceed under this Act, liable to a fine not exceeding Ten Shillings. The Council having invited the Corporation to co-operate in putting these very useful statutory provisions into effect, it was referred to me to make the necessary arrangements with the Council's Officer for dealing with any cases that might arise among children residing in the City who attended the Council's schools. 44 As a result the following procedure was agreed to :- The Nurse visiting the schools will send printed instructions to the parents of any child found in a verminous condition as to the simplest and quickest mode of cleansing and disinfection. If, at the end of 48 hours, the nurse finds the child in the same unsatisfactory state, the parents will be warned that unless the child is cleansed at home it will be done in a compulsory manner under the provisions of Section 122, sub-section 2, of the Children Act, 1908. An experimental disinfecting station provided with a sterilizer and bath has been installed by the County Council at Finch Street School, situated in Whitechapel, near the City boundary, and the Council have asked the Corporation to co-operate with them by dealing with the homes, bedding, &c., of all children residing in the City who have been cleansed at this Station. The names and addresses of all children cleansed under this arrangement will be forwarded to your Medical Officer of Health, This system will be of great value in the prevention of the spread of school infection, and will, moreover, furnish the Corporation with a new source of information as to houses which require sanitary supervision. The cleansing of the bodies and clothing of children will be of but little lasting value unless the condition of their environment be dealt with at the same time. The care and control of the sanitary condition of the homes of school children is one of the most important duties of a Sanitary Authority, but hitherto there has been a practical difficulty in obtaining information except through the costly and necessarily inefficient system of house to house inspection. If the experimental system of the Education Authority works satisfactorily, it will be welcomed as one more link in the chain of sanitary efficiency. I may add that by arrangement with the Council in February, 1907, verminous school children resident in the City had hitherto been cleansed at the Thavies Inn Dep6t, under an agreement entered into by the Corporation and the City of London Union Authorities under the Cleansing of Persons Act. 45 CREMATION. The number of cremations at the Corporation Cemetery at Ilford during the year was 24, as compared with 19 in 1908, while the total number in the United Kingdom has risen from 795 to 855. Year by year the total number of cremations in the United Kingdom show a steady increase, yet such increase is small considering that there are now 13 crematoria in operation. There is undoubtedly a prejudice against this form of disposal of the dead, except amongst the more intellectual class of the community, and the progress of the practice must depend upon the education of the people. As in former years, I have invited the views of Superintendents of other crematoria on the subject. The Secretary of the Cremation Society of England informs me that no new crematoria were established during 1909, but a Society has been inaugurated at Edinburgh to provide means for a local crematorium. It will be seen by the table on p. 47 that a crematorium was established in Glasgow fifteen years ago. A Cremation Congress promoted by the Society for Cremation in Belgium, will be held at Brussels in September of this year. New Zealand has established the first crematorium at Wellington, and there is a movement to provide a similar building for Auckland. It was mentioned in the last Annual Report that with a view of popularising cremation the Corporation had reduced their inclusive charge to 2l. 15s. 6d. This fee includes all attendance after the body is placed on the catafalque table by the undertakers, a plain urn for the remains, and storage of the latter for three months. Although the number of cremations at Ilford rose from 19 in 1908, to 24 last year, it is still too early to judge the effects of this step. In this connexion I may quote the views of the Honorary Secretary of the Birmingham Crematorium- " We find that cremation is making very slow progress in Birmingham " although we have advertised considerably, and have commenced to " deliver lectures on the subject. We also find that on one or two " occasions persons have left written instructions to be cremated, but the " relatives, on account of their objection to this mode of disposal, have " disregarded the instructions left. " Until cremation can be carried out at a much less figure than that at " present charged, we fear that the progress of the cremation movement " will be greatly retarded." 46 The Registrar and Superintendent of the Bradford Crematorium writes :" I am sorry to say that progress is very slow considering the " number of funerals we have. There would, however, be many more " cremations if relatives would carry out the deceased's wishes." Referring to the 19 cremations that took place at Leicester last year, the Registrar and Manager of the Crematorium notes that three of them " belonged to the working class, with whom cremation seems to be gaining " favour." As to the disregard of the wishes of deceased persons who desired that their remains should be cremated, referred to above, although a written request for cremation is not necessary or legally binding, it leaves no doubt as to the testator's Avishes, and should relieve executors and others of the responsibility of deciding. Any direction in a will as to how or where the testator's body is to be disposed of has no binding force in law, and may be disregarded with impunity. More often than not the will is not examined until after the funeral of the testator, but it is open to a testator to make a gift to his executor depend on his body being cremated or otherwise disposed of. In such a case he should acquaint his executor with what he has done.* On the 10th November last the Town Clerk received the following copy of a Resolution passed by the Directors of the Manchester Crematorium, Ltd., on the 5th November :- " That in the opinion of this Board it is desirable that there should be " a Conference of the Officials and Boards of all the British Crematoria " and any other persons or authorities interested in the question of crema" tion with a view to considering how the matter (cremation) might best " be popularised, and whether any mutual steps could be taken to " generally help the progress of the movement throughout the country. " That the Secretary convey this Resolution to the Burial Board of the " City of London with the request that that Authority should make " arrangements for and convene such a Conference." The matter was duly considered by the Sanitary Committee, and the Directors of the Manchester Crematorium were informed in reply that the Committee did not see their way to recommend the Corporation to convene a Conference as suggested. The last Conference in this country on cremation was held at Leicester in March, 1906, when a Provincial Sessional Meeting of the Royal Sanitary Institute was opened for the consideration of the subject in all its bearings, your Medical Officer being in attendance as the representative of the Corporation. The several towns in the United Kingdom where crematoria are erected are shown in the accompanying Table, and the date of opening them indicated in the first column. * An epitome of the law relating to the disposal of a dead body, from " Cremation in Great Britain," published by The Cremation Society of England, 1909. 47 CREMATIONS IN THE UNITED KINGDOM, 25 Years—1885-1909. YEAR. Woking. Manchester. Glasgow. Liverpool. Hull. Darlington. Leicester. Golder's Green. Birmingham. Leeds. Ilford. 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 2 ... ... ... ... ... ... ... ... 201 1897 173 51 16 10 ... ... ... ... ... ... ... ... 250 1898 240 62 12 27 ... ... ... ... ... ... ... ... ... 341 1899 240 88 16 23 ... ... ... ... ... ... ... ... ... 367 1900 301 83 20 40 ... ... ... ... ... ... ... ... ... 444 1901 273 96 18 40 17 2 ... ... ... ... ... ... ... 446 1902 275 81 20 54 13 1 1 5 ... ... ... ... ... 450 1903 143 92 24 35 18 1 5 158 8 ... ... ... ... 479 1904 138 98 19 40 20 8 8 220 19 ... ... ... ... 570 1905 95 97 35 35 15 3 16 252 20 16 9 7 1 601 1906 140 90 45 46 17 13 12 298 25 15 23 6 13 743 1907 108 96 30 34 29 8 13 290 33 16 18 18 13 706 1908 119 116 28 32 37 6 14 364 18 24 19 12 6 795 1909 105 106 30 46 15 9 19 421 30 19 24 18 13 855 Total 3,220 1346 324 464 181 51 88 2008 148 90 93 61 46 8,120 * "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. 48 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. The buildings contain 501 rooms, arranged in 244 tenements, and are occupied by 878* persons, compared with 919 in 1908. Sixty-nine per cent. are adults, and thirty-one per cent. children (under 14 years). This reduction in the number of inhabitants is owing to the steps taken to prevent overcrowding, which had been brought to my notice in the course of the year. It should be stated that where overcrowding was found to exist, it was not due to the abuse of sub-letting but mainly to the natural increase of families. The death rate for 1909 was 15.9 per 1,000 per annum [of which 29 per cent. was of children under 5 years of age]. The number of deaths per 1,000 births of children under one year was 77, as against 103 for the City generally. Table of Births and Deaths occurring at the Artizans' Dwellings, Stoney Lane, Houndsditch, during the year 1908. Name of Block. Births. Mortality from all Causes at subjoined ages. Male. Female. At all ages. Under 1 year. 1 and under 5 5 and under 16 15 and under 25 25 and under 60 60 and upwards. NORTH BLOCK 2 5 3 1 ... ... ... 1 1 SOUTH „ 1 2 3 ... ... ... ... 1 2 KING'S „ 1 3 2 ... ... ... ... 1 1 QUEEN'S „ 4 1 1 ... ... ... ... 1 ... PRINCE'S „ 5 2 5 1 2 ... ... 1 1 TOTALS 13 13 14 2 2 ... ... 5 5 For details of Mortality, see Appendix A, page 145. The number of births was 26, viz.: 13 males and 13 females. The birth rate was 29*6 per 1,000, and is 0.7 per 1,000 below the average for the previous five years. * i.e., persons sleeping on the premises. 49 The birth rate in these Dwellings reached a maximum of 46.9 per 1,000 in 1896, and has since been falling, as shown by the following figures:— Birth Rate, Artizans' Dwellings. 1896 46.9 1903 31.2 1897 40.3 1904 30.1 1898 43.1 1905 29.1 1899 37.5 1906 26.1 1900 38.4 1907 35.0 1901 33.8 1908 31.5 1902 45.8 1909 29.6 The Baths provided for the use of the tenants of these Buildings, which were opened in May, 1904, continue to be extensively used, the number of persons bathing during 1909 being 11,261, of whom 5,257 were males and 6,004 were females. The accompanying Table is compiled from the monthly records of attendances at the Baths. Record of Attendances at the Baths, Artizans' Dwellings. (The corresponding figures for 1908 are in italics.) Month. Sbx. Total. Males. Females. Children. Adults. Children. Adults. 1908. 1909. 1908. 1909. 1908. 1909. 1908. 1909. 1908. 1909. January 162 179 220 199 148 125 320 281 850 784 February 1S9 124 221 145 191 73 307 210 858 552 March 134 143 200 189 147 64 218 182 699 578 April 138 192 201 239 186 195 284 300 809 926 May 204 163 343 273 292 231 510 402 1,349 1,069 June 143 153 299 207 314 174 514 314 1,270 848 July 208 274 342 392 331 365 530 445 1,411 1,476 August 175 175 250 354 251 279 411 352 1,087 1,160 September 161 182 227 279 127 256 415 356 930 1,073 October 239 166 246 327 246 196 364 349 1,095 1,038 November 179 138 198 308 154 156 288 255 819 857 December 135 150 158 306 94 166 231 278 618 900 Totals 2,017 2,039 2,905 3,218 2,481 2,280 4,392 3,724 11,795 11,261 50 DISINFECTION, &c., AT CITY MORTUARY. 325,831 articles of bedding, clothing, furniture, &c., were received at Golden Lane and disinfected. Of these 322,916 were disinfected at the request of City firms engaged in exporting second-hand clothing to South Africa, where the authorities will not allow such articles to enter the country unless accompanied by a certificate duly signed by a medical officer of health, vouching for the proper disinfection of each consignment, the remaining 2,915 articles were from premises in the City where infectious disease had occurred. 205 bodies were received at the Mortuary, pending interment, 77 post-mortem examinations were made, 187 inquests were held on bodies, and 3 inquests on fires. Number of Articles disinfected, Bodies received at the Mortuary, and Inquests held at the Coroner's Court in the City during 1909, 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. 1904 2,560 184 150 6 1905 2,158 183 164 8 1906 3,796 236 216 3 1907 4,672 193 165 8 1908 10,078 194 173 3 Average for previous five years 4,653 198 173 6 1909 325,831 205 187 3 * Excluding articles disinfected for export. Dr. F. J. Waldo, J. P., Coroner for London and Southwark, has kindly furnished me with the following list of places in the City which were the subject of Fire Inquests held by him during 1909:— 1909. Inquest held on Name of Premises. Date of Fire. 1. April 16th and 23rd No. 89, Fleet Street 12th April, 1909 2. June 25th No. 5, Lauderdale Buildings, Aldersgate Street. 18th June, 1909 3. September 28th and October 1st. No. 14, London Wall 17th September, 1909 51 DISINFECTANTS. It was not found necessary to use disinfectants so freely as usual in keeping the roadways free from nuisance. This was due to the cold and wet summer season experienced in 1909. As heretofore, all the disinfectants used in the Public Health Department were obtained through your Medical Officer of Health. They are used for the following purposes:— A. Deodorizing and " denaturalizing " condemned meat, disinfecting public conveniences (urinals, &c.). B. Disinfecting roadways, street gullies, &c. C. 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. 12 0 4 B. 214 9 9 C. 22 4 7 Total £248 14 8 The above amounts only relate to materials purchased for the use of the Public Health Department. Arrangements have been made with the heads of other departments whereby any disinfectants required by them can be obtained direct from the Contractor supplying the Public Health Department. ADDITION TO DISINFECTING PLANT. Owing to the increased amount of work the disinfecting apparatus at the depot in Golden Lane was called upon to perform, it became necessary to supplement it by a second but smaller machine. This was installed in October last, and has been found most useful in dealing with articles requiring disinfection after notification of infectious disease. 52 PRESERVATION OF BODIES. In January, 1909, I presented a report to the Sanitary Committee, drawing attention to the need of some provision for preserving bodies at the City Mortuary. The City Coroner had also from time to time, at the request of juries, forwarded riders to the Court of Common Council suggesting the desirability of some special means of preserving unidentified bodies with a view of their ultimate identification. Such provision would also be of value in cases where a body is decomposing on reception, especially in cases of drowning; further, as the duty of viewing bodies is always an unpleasant one, and at times even dangerous, every possible precaution should be taken to protect the jury. . It had been originally proposed that a method of refrigeration should be adopted, and it was referred to your Engineer and myself to report upon the practicability and cost of the various systems available. In the course of these enquiries our attention was directed to an apparatus invented by Dr. G. De Rechter, which had been in use for some time in Brussels, and in which the action of formalin is utilised. With regard to refrigeration, although quite practicable, it was found that a complete installation would be costly, and that the working cost would be considerable. The disadvantages of refrigeration are:— (1) The space taken up by the apparatus; (2) The cost of working and skilled supervision inseparable from the use of machinery of this kind; and (2) The fact that the preservation lasts only during the actual freezing, so that decomposition commences directly a body is removed from the apparatus. As preservation by formalin by Dr. De Rechter's process was stated to have given excellent results, the Sanitary Committee referred to their Chairman and Medical Officer the duty of inspecting this apparatus at Brussels, which was carried out from the 9th to 13th of January, a body being provided for the purpose, and every facility afforded by the municipal authorities of the town. The great advantage of the De Rechter apparatus is its simplicity. Briefly, it consists of an air-tight case communicating with a smaller chamber in 53 which formalin vapour is generated. The body is placed in the larger compartment, through which the vapour of formic aldehyde is continuously circulated by means of an electric fan. The body within can be readily viewed through glass windows provided for the purpose. Provision is also made for illuminating the interior of the chamber by electricity. Arrangement is made for neutralising the formalin vapour by ammonia before opening the chamber containing the body, thus avoiding any inconvenience from the fumes given off by the formic aldehyde, which would otherwise be the case. This system possesses the following advantages:— (1) The small initial cost. (2) The nominal cost of working, and the fact that no skilled supervision is required. (3) Whatever the condition of the body therein may be, it can be viewed without discomfort by the jury, or for purposes of identification by relatives and others. As a result of these enquiries the Sanitary Committee endorsed my recommendation and Dr. De Rechter's apparatus was provided. It was used for the first time on 16th March, when the body of an unknown man (drowned), that had been received at the mortuary on the 10th March and been the subject of a post-mortem examination on the 12th March, was placed therein. At the end of seven weeks, the body being then in a good state of preservation, was removed to the mortuary, where it remained in good condition without further treatment until the 16th June. Inasmuch as the time limit, viz., one month, for which it is usually necessary to preserve a body for the purpose of identification, was greatly exceeded, this experiment showed that the apparatus fully answers all requirements. 54 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.) Month. Premises inspected. Orders issued. Notices served. Works completed. January 117 8 17 21 February 206 5 21 23 March 163 18 21 39 April 822 2 158 35 May 279 7 16 53 June 280 29 33 56 July 164 10 32 46 August 360 6 16 40 September 200 3 31 48 October 191 6 13 31 November 229 7 15 26 December 349 8 34 70 Totals 2,840 109 407 488 MIDDLE DISTRICT. (Inspector E. J. Simmons.) Month. Premises inspected. Orders issued. Notices served. Works completed. January 120 8 5 23 February 217 6 16 28 March 114 6 7 28 April 340 25 38 42 May 260 16 34 41 June 218 12 19 22 July 186 20 16 27 August 270 12 26 36 September 307 ... 10 48 October 185 18 21 25 November 266 10 21 52 December 372 11 50 84 Totals 2,855 144 263 456 55 EAST DISTRICT. (Inspector W. H. Ralph.) Month. Premises inspected. Orders issued. Notices served. Works completed. January 118 4 8 25 February 209 10 17 35 March 169 10 16 24 April 334 4 133 53 May 294 9 34 96 June 263 39 49 61 July 156 10 14 34 August 254 6 25 48 September 300 3 14 51 October 195 9 18 36 November 248 4 20 28 December 306 17 37 47 Totals 2,846 125 385 538 The foregoing are summarised as under:— District. Number of inspections made. Orders issued. Notices served. Improvements effected. West 2,840 109 407 488 Middle 2,855 144 263 456 East 2,846 125 385 538 Totals 8,541 378 1,055 1,482 Average of previous five years 8,504 415 1,152 1,455 56 REGISTERED LODGING-HOUSES. Public Health (London) Act, 1891, Sec. 94. The Corporation, as the Sanitary Authority in the City, are required, under the provisions of Sec. 94 of the Public Health (London) Act, 1891, to make and enforce Bye-laws applying to houses let in lodgings or occupied by members of more than one family for the following purposes:— For regulating the number of persons and separation of the sexes. For the registration and inspection of such houses. For enforcing drainage, and promoting cleanliness and ventilation. For the cleansing and lime-washing of the premises at stated times. For the taking of precautions in any case of infectious disease. The Bye-laws now in force in the City for this class of property were made by the Court of Common Council on 24th November, 1904, and confirmed by the Local Government Board on the 20th January, 1905. Unfurnished lodgings, when the rent is not less than 10s. a week, and furnished lodgings when the rent is not less than 12s 6d. a week, are exempt from the operations of the Bye-laws. Particulars relating to the registered Lodging-houses in the City now on the Register are given in the accompanying table:— Registered Lodging-houses. District. No. of Houses on Register. No. of Lodgers. No. of Tenements. Average No. of Persons per Tenement. Cleansing Notices Served. West 129 1,045 428 2.44 174 Middle 37 89 42 2.12 17 East 120 812 841 2.38 142 Total 286 1,946 811 2.39 333 These 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 333 Notices during the year. A list of registered Lodging-houses is given in Appendix C (p. 148). 57 The following were the corresponding figures for 1899, and show the reduction in this class of property in the City since that date:— Registered Lodging-Houses (1899). District. No of Houses on Register. No of Lodgers. No of Tenements. Average No. of Persons per Tenement. Cleaning Notices Served. West 182 1,490 647 2.3 282 Middle 65 427 164 2.6 166 East 158 1,248 511 2.44 266 Total 405 3,165 1,322 2.4 714 In addition to the foregoing there are eleven Blocks of Dwellings let out in tenements, but not placed on the Register for the reason that each holding is "self-contained," it having been decided in a Court of Law that in 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. No. of Inhabitants. One Room. Two Rooms. Three Rooms. Four Rooms. Five Rooms or more Albion Buildings (No. 21), Bartholomew Close ... 10 ... ... ... 34 (Albion Buildings (No. 22), Bartholomew Close ... 10 ... ... ... 28 Bartholomew House, Bartholomew Close 14 3 ... ... ... 88 Dean Street Blocks, Fetter Lane— Block A 3 4 ... 1 ... 34 „ b 2 5 ... ... ... 22 „ C 6 3 ... ... ... 29 „ D 2 5 ... ... ... 18 „ E 2 5 ... ... ... 26 „ F ... 4 ... 1 ... 19 St. Ann's Chambers, Ludgate Hill 3 22 ... ... ... 40 Took's Court, Nos. 1 and 2 ... 6 ... ... ... 21 Bloomfield House, Snow Hill ... 24 ... ... ... 68 Total Six "Blocks'' 32 101 ... 2 ... 377 58 middle district. Name and situation of Artizans' Block Dwellings. No. of Tenements. No. of Inhabitants. One Boom. Two Booms. Three Booms. Four Booms. Five, or more Booms. Bridgewater House, Fann Street ... 12 ... ... ... 28 City Buildings, Moor Lane ... 20 12 ... ... 74 Total Two "Blocks" ... 32 12 ... ... 102 east district. Name and situation of Artizans' Block Dwellings. No. of Tenements. No. of Inhabitants. One Boom. Two Booms. Three Booms. Four Rooms. Five, or more Rooms. Harrow Alley and Stoney Lane— North Block ... 48 8 ... ... 211 South „ 5 22 13 ... ... 175 Prince's „ 5 50 ... ... ... 162 Queen's ,, 5 40 5 ... ... 167 King's „ 8 16 16 ... ... 163 Barker's Buildings, Catherine Wheel Alley, Bishopsgate Street Without 12 10 3 ... ... 52 Total Two "Blocks" 35 186 45 ... ... 930 These ten Blocks, containing 445 tenements, are inhabited by 1,409 persons = 3.16 persons to each tenement. 59 BYE-LAWS AS TO LODGING-HOUSES. Arlidge v. Islington Borough Council. This was a case in which the landlord of a registered lodging-house appealed from a decision of a magistrate that he was liable to a penalty for not causing every part of the premises to be cleansed in accordance with the Bye-laws in force in the Metropolitan Borough of Islington. On behalf of the appellant it was stated that he had let the premises in question on a yearly tenancy, not in writing, and no right of entry was reserved to the landlord; and he had not complied with a notice as to cleansing the premises, as he contended that he had not the right to enter the house and that he would commit a trespass if he did. The case was heard in the King's Bench Division on the 29th March, 1909, before Lord Alverstone, L.C.J., Darling and Jelf, J.J. The Court allowed the appeal, deciding that a Bye-law made under the Public Health (London) Act, 1891, requiring a landlord to cleanse lodginghouses let to a tenant, and which the landlord has no right to enter, is unreasonable and invalid. PROVISION OF A WATER SUPPLY TO THE UPPER STOREYS OF A HOUSE Under Section 78 of the London County Council (General Powers) Act, 1907. Griffith v. Weatheritt (Southwark Borough Council). This was an appeal to Quarter Session by a person, upon whom an order had been made at the Lambeth Police Court, to provide proper and sufficient water supply to the upper floors of a tenement house situated at 16, Olney Street, Southwark, as required by Section 75 of the London County Council (General Powers) Act, 1907. The premises were occupied by two separate families, the family without a supply of water being on the top floor. There were three storeys, the lowest one being a half-basement. The water supply was from two taps, one in the yard, and the other in a wash-house in the yard. The case was heard at the Session on the 1st January this year, when the Bench unanimously dismissed the appeal, and upheld the Magistrate's Order with costs. 60 COMMON LODGING-HOUSE. 116, Middlesex Street. The "Salvation Army Working Men's Hotel and Shelter," No. 116, Middlesex Street, is the only Common Lodging-House in the City. It was opened on the 7th February, 1906, and provides accommodation for 453 persons. The charge for the Hotel portion is 5d. per night, and the Shelter 2d. per night, which includes a "bath and a bake" (disinfection of clothing). Food can be purchased cheaply. The premises are periodically inspected and always found to be well managed and kept in a cleanly condition. The nuisance complained of, formerly caused by numbers of men congregating outside waiting for admission and spitting on the pavement, has been abated, in consequence of applicants being refused admission if they have been waiting about outside the premises before the doors are open at 5 p.m. DRAINAGE PLANS. In the course of the year 327 plans for the proposed reconstruction of water-closets or drains were submitted for approval. Of these, 279 were approved, 36 revised and approved, and 12 not approved. In all cases where, on revision, it was found that the plans were not in accordance with the Corporation Bye-laws, the matter was submitted to the judgment of the Sanitary Committee. STREET GULLIES. The gradual substitution of properly trapped gullies for those formerly existing, has greatly reduced the complaints received of nuisance from those receptacles, especially in warm weather, when the nuisance arose from the faulty construction of many of them. The City Engineer has given special attention to this matter for several years past, and a large number of the appliances have now been reconstructed, greatly to the relief of passers-by and persons living in the vicinity. OVERCROWDING. . Overcrowding is a nuisance dealt with under Section 2 (1) (e) of the Public Health (London) Act, 1901, and nine cases were reported during the year. Notices of abatement being served, the overcrowding was discontinued in each instance. 61 SANITARY DEFECTS AND INFECTIOUS DISEASE. All premises where infectious disease was notified were inspected with reference to drainage, soil and waste pipes, water-closets, water supply, ventilation, &c., and of the 64 cases investigated in 1909, it has been necessary to entirely reconstruct the sanitary system in 3 instances, and to make amendments to soil, waste pipes, and W.C's in 20 others. HOUSE REFUSE REMOVAL. The City Engineer informs me that the refuse removed from the City in 1908 consisted of 28,938 cartloads of street sweepings and slop, and 51,821 loads of house and trade refuse. Total, 80,759 loads. The use of the Destructor was discontinued in September, 1905, since which date all refuse has been removed by barge from Lett's Wharf to the Corporation land on Hornchurch Marshes, where it is dealt with. REMOVAL OF FISH OFFAL. The contract with Messrs. F. S. Hempleman and Co. for the removal of Fish Offal expired on the 21st May, 1909, and on the recommendation of the City Engineer and your Medical Officer of Health was renewed for a further period of twelve months. The conditions of the contract require that the Contractor collect and remove, free of charge, between the hours of 7 p.m. and 9 a.m., all fish offal from the Corporation Markets and Fishmongers' premises in the City, to the entire satisfaction of the Medical Officer of Health, in specially constructed galvanised iron bins, of a pattern approved by that officer, and to thoroughly cleanse and disinfect such bins before returning them to the markets and shops. The Contractor has undertaken to remove the material during the evening hours instead of the morning, so as to obviate the necessity of the offal remaining in the markets all night. RAILWAY STATIONS. Periodical inspections were made of the sanitary accommodation provided at the twenty-five Railway Stations in the City. In 14 of them, the Companies they belong to have been called upon to effect sanitary improvements thereat The defects, for the most part, have been due to lack of proper cleaning, and to defective drains and sanitary fittings. In each case the necessary works have been satisfactorily carried out. 62 LEGAL PROCEEDINGS. In 10 cases only, out of 1,055 Notices issued during the year by the District Inspectors, was it found necessary in consequence of non-compliance to refer the matter to the City Solicitor with a view to taking such steps as he deemed necessary to ensure the required sanitary improvement being carried out. With one exception the Notices were subsequently complied with without the matter being taken into Court. The following are the cases referred to:— Premises. 28-29, Aldersgate Street Insufficient W.C. accommodation. Notice complied with. 153-5, Cannon Street Ditto Ditto. 4, Ludgate Circus Ditto Premises closed. Buildings. 6, Paternoster Row Ditto Notice complied with. 7, Water Lane Ditto Ditto. 84, Fore Street Fumes from gas stove Case adjourned and notice complied with. 7, Giltspur Street Insufficient W.C. accommodation. Notice complied with. 33, Bury Street Ditto Ditto. 3-5, Whitecross Street Ditto Ditto. 1-6, Bridgewater Place Ditto In Solicitor's hands. REMOVAL OF HUMAN REMAINS. Fetter Lane. During some rebuilding operations at Nos. 104-107, Fetter Lane, a quantity of human remains were discovered. Application was therefore made to the Home Secretary for a Licence authorising the removal and re-interment of the same at the City of London Cemetery, Little Ilford. A Licence dated the 1st January, 1909, was issued subject to the following conditions:— (1) That the removal be effected with due care and attention to decency, early in the morning. (2) That freshly made ground lime be freely sprinkled over the coffins, the soil, or any matter that may be offensive. (3) That the coffins be forthwith re-interred in the City of London Cemetery at Little Ilford. The remains, placed in five specially constructed cases, were removed in accordance with the terms of the Licence, to Ilford Cemetery, at 7 o'clock in the morning of the 12th January, 1909, under the supervision of your Medical Officer. 63 St. Mary-le-Bow, Cheapside. In the annual report for last year, reference was made to the application of the Rector and Churchwardens of the above-mentioned Church for the removal of the bodies stored in the Crypt under the Building. There are in all some 700 bodies to be dealt with, and although no nuisance could be detected as arising therefrom, I reported that such removal would on general principles be advisable. The chief difficulty in the way of speedy action in the matter is the question of expense, the extreme care necessary, and the precautions indispensable on such occasions to prevent scandal and nuisance arising, adding greatly to the cost of removal. In accordance with Section 23 of the Burial Act of 1857, the removal of the remains in question can only be effected under an Order in Council, and this Order can only be obtained by the "Churchwardens or such other persons "as may have the care of any vaults or places of burial for preventing them "becoming or continuing dangerous or injurious to the public health," and all expenses incurred are to be paid out of the Poor Rate of the Parish. By virtue of Section 5 (1) the City of London (Union of Parishes) Act, 1907, there is now only one Parish for the whole of the City, but for Ecclesiastical purposes the Parish of St. Mary-le-Bow remains as heretofore. The Corporation were therefore not the proper body to make the application to the Home Office for the removal, nor could the cost thereof be paid out of the general Poor Rate of the City. The Churchwardens were accordingly informed that the matter was purely an ecclesiastical one, and as such, the necessary removal and re-interment must be carried out by them, and the cost borne by the Poor Rate of the Parish of St. Mary-le-Bow. SUMMER FLUSHING OF COURTS. There are 266 courts and narrow passages throughout the City which were regularly flushed during the summer months under the direction of the City Engineer. Of these, 9 were flushed six times a week, 21 five times a week, 2 four times a week, 26 three times a week, 128 twice a week, and 80 once a week. The City Engineer informs me that in this service and the washing of the main streets last year no less than 65,840,502 gallons of water were used. Disinfectants were also freely applied where necessary. The condition of the approaches to Billingsgate Market and the Custom House, as heretofore, required special attention, there having always been a difficulty in keeping the thoroughfares in the neighbourhood of these places free from the nuisance caused by the drippings from the fish carts, especially in hot weather. 64 LIMEWHITING OF COURTS. There are ninety-six courts and narrow passages in various parts of the City, the walls of which, unless cleansed regularly, become dirty and unsightly through the traffic of passengers or vehicles and the action of a smoke-laden atmosphere. These are cleansed or limewashed twice a year under the direction of the City Engineer. Of the places so dealt with during 1909, 24 were situated in the East district, 39 in the middle district, and 33 in the West district. USE OF SALT IN THE REMOVAL OF SNOW. On the 26th January, 1909, the question having been raised as to whether it was desirable to continue the practice of using salt in the removal of snow from the thoroughfares, the Sanitary Committee requested me to consider the matter, and report thereon. In discharging this reference I pointed out that it was apparent to everyone that this practice caused the roadways and footpaths to be covered with a liquid mass of bitterly cold and dirty slush. The more rapidly the snow reaches this condition the more effectively is the salt doing its work, and thus the more readily are the cleansing staff able to clear the surface of the public thoroughfares. Approval of the use of salt, however, must be subject to this reservation, viz.:—That it should only be used when sufficient labour can be obtained for promptly cleansing the roads and footpaths. With regard to the main objections that are generally taken to the use of salt for dissolving the snow, these are— (i.) That it causes damage to boots. (ii.) That horses hoofs are injured thereby. (iii.) That it is dangerous to health in the case of persons badly shod. As to (i.) and (ii.) I believe that the damage to footwear is largely exaggerated, and I have it on good authority that it does not appear to have any injurious effect upon horses' hoofs. With regard to (iii.) the case is different. It must cause great discomfort, and may in some cases cause actual harm to those who are badly shod to have to walk through a mixture that may reach a temperature of five degrees below zero Fahrenheit, and this evil cannot be disregarded in considering the question which has been discussed again and again by public authorities. The late Commissioners of Sewers paid great attention to the question of snow removal, and in 1867 went so far as to offer premiums to those 65 submitting the best plans and models, &c., of apparatus for thawing snow with the aid of heat, but in spite of the ingenuity of the competitors no effective machine was evolved, although the sum of fifty guineas was given in premiums. In 1870 the Commissioners installed Clark's apparatus for snow melting by gas in Fore Street, and later on an additional apparatus of a similar character was fitted up at Finsbury Circus. In these, large gullies in direct communication with the sewer were lined with coils of burning gas jets, through which the snow was cast. Whatever the merits of these contrivances may have been, they were evidently not of much use, as they have been long since removed. Experiments were also made in January, 1871, in melting snow by means of steam, but the cost was found to be excessive. When snow possesses certain physical characteristics the reaction with salt is modified. For instance, when snow is in a particular form of large crystals, and not in the usual feathery flakes, salt has the effect of caking the mixture into solid masses; also when a very low air temperature exists, the action of salt in melting snow is retarded. This was the case after the great snow fall in the City on the 18th January, 1881, and a similar difficulty was referred to by the City Engineer in his report on the snowstorm of the 29th December, 1908. The fact that the use of salt in snow removal is the general practice in the Metropolis, and in most large towns in this country, bears testimony to its utility. It is the business of the Corporation, if possible, to keep the thoroughfares open for traffic at all times, and snow must therefore be removed as speedily as means permit. No one would use salt for this purpose if any better or quicker method could be devised, but snow cannot be got rid of in large quantities without much expense and inconvenience. The balance of evidence tends to show that the arguments against the use of salt for facilitating the melting of snow are founded on insufficient grounds. The question having practically resolved itself into a choice of two evils, I advised the Committee that, provided salt be used in proper proportions, under suitable conditions, and the resultant slush washed away at once, this treatment would be productive of less harm and injury to the public health, than would be caused by allowing the snow to remain, or by attempting toremove it without previous thawing. 66 METROPOLITAN SEWERS AND DRAINS BILL. The object of this Bill was to amend the state of the law relating to combined drainage. It was introduced in the Commons by a private member in the Session of 1908, and again in that of 1909, but in neither year did it reach a second reading. A memorandum attached to the Bill quotes the following observations of the Lord Chief Justice:— "It seems to me, as I have before pointed out to be essential, that "there should be some amendment of the law upon this subject. The "state of the authorities is such that it appears to be impossible either "to reconcile the various decisions or to deduce from them any logical "rule." The Bill met with the general approval of the Metropolitan Borough Councils and the Corporation of London. Several Provincial authorities, notably, West Ham, Croydon, Carlisle, Leighton, Wood Green, Sheffield, &c., have been successful in obtaining the powers which the Metropolitan Local Authorities ask for by this Bill. SMOKE NUISANCES. Fourteen cases of smoke nuisance were reported during 1909. The number of observations recorded amounted to 287, as against 542 noted at twelve premises in 1908. The service of Notices upon offenders resulted in the abatement of the nuisances in all cases, and therefore there has been no occasion to take further action in the matter. In my Annual Report for 1908 reference was made to some amendments suggested by the London County Council with a view of strengthening the powers of both the Council and Local Authorities in the Metropolis for abating smoke nuisances. Part IV. of the London County Council (General Powers) Bill to be laid before Parliament this Session contains several proposed amendments, and extensions of the Public Health (London) Act, 1891, for this purpose. These are contained in Sections 20, 21 and 22 of the Bill. Under Section 20 powers are sought to amend Section 24 of Public Health (London) Act, 1891 (summary proceedings for abatement of nuisance caused 67 by smoke) so as to read and have effect as if the word "black" were omitted from paragraph (&), which now reads as under— (b) "Any chimney (not being the chimney of a private dwelling "house) sending forth black smoke in such quantity as to be a nuisance "shall be a nuisance liable to be dealt with summarily." It is also proposed to extend this section so as to apply to chimneys of— (a) "Any factory or workshop as defined by the Factory and Work"shop Act, 1901, belonging to or used by the Crown, and— (b) "Any building or place in which any operation or process is "carried on under statutory powers." The expression "chimney" is to include any opening through which smoke is emitted. This will be a most useful alteration, as local authorities have been deterred from taking offenders into Court owing to the difficulty of proving that the smoke causing the nuisance was "black." The Council seek powers to enforce certain provisions of the Public Health (London) Act, 1891, as under:— (1) In any case in which a sanitary authority request them so to do, it shall be lawful for the Council, in lieu of such sanitary authority, to enforce the provisions of Section 23 (furnaces and steam vessels to consume their own smoke), and of the said Section 24 of the Act of 1891 as amended and extended by this part of the Bill. (2) Without prejudice to the powers conferred upon the sanitary authorities by Section 14 (power to proceed where cause of nuisance arises without district) of the Act of 1891, it shall be lawful for the Council to enforce the provisions of the said section in the case of any nuisance from smoke which appears to be wholly or partially caused by some act, default, or sufferance committed or taking place without the county, and affecting the inhabitants of the county : provided that in any case in which the Council institute proceedings under this sub-section, it shall not be lawful for any sanitary authority to institute proceedings in respect of the same nuisance. (3) It shall be lawful for the Council to enforce the provisions of the said Sections 23 and 24 of the Act of 1891, as amended and extended by this part of the Bill, in their application to any building or premises belonging to or used by a sanitary authority, and fireplaces or furnaces therein, and chimneys thereof. 68 (4) For the purposes of this section the Council may institute any proceedings and do any action as if, within the meaning of the Act of 1891, the Council were a sanitary authority and the county were their district. Under Section 22 the Council suggest they should be allowed to spend a sum not exceeding 500/. per annum "in investigating and advancing "measures with respect to smoke consumption and the abatement of nuisance "arising from smoke." It is doubtless praiseworthy to encourage any invention conducent to the well being and comfort of the community, but it may be open to question whether this should be done at the expense of the London ratepayers. The question of smoke nuisance is not a local one, and it would therefore be better if experimental work of the kind indicated should be both carried out and paid for by the State. HYGIENE OF HAIRDRESSERS' AND BARBERS' SHOPS. The Hairdressers' establishments throughout the City remain under the constant supervision of your officers, and there are now 32 proprietors of these places who hold certificates that they have undertaken to comply with the Regulations of the Corporation for the conduct of their business. Two new firms have been placed on the Register, one saloon has been closed, one certificate was withdrawn on account of failure to comply with the Regulations, and in two cases there was change of ownership. The following establishments are now on the Register:— Morris Alper, 2, St. Andrew's Hill. Jacob Arbeiter, 9, Duke Street. The Army and Navy Toilet Club, 35, Bucklersbury. Chester and Co., 42, Old Broad Street. Civil Service Supply Association, 136-140, Queen Victoria Street. William Clarke, 5, Birchin Lane. Samuel Cohen, 120, Newgate Street. Fox's Paragon Toilet Club, 60, Fore Street. Frederick Gr. Foerstel, 1, Telegraph Street. Ditto 112a, Queen Victoria Street. Franz Friedel, 35, Moorgate Street. Antoine Heifer, 6, King Street, Cheapside. Carl Hartmann, 5, Queen's Head Passage, Newgate Street. Frederick Heitman, 13, Pilgrim Street. 69 Philipp George Hoerr, 1, Cullum Street. Gustav Krajewski, 137, Fencliurch Street. Anton Kaiser, 4, Liverpool Street. Kingstone and Hubbard, 8-10, Ludgate Arcade. Charles Lehman, 8-9, Aldermanbury Postern. Heinrich A. E. Leopold, 8, Masons' Avenue. Charles Massberg, 12, Cullum Street. Marsh, Decker and Prince, 36, Coleman Street. Albin Antony May, 77, Fetter Lane. Thomas W. Monk, 5, Angel Court. The New Baltic Toilet Co., 37, St. Mary Axe. Pierre Pozzi, 16, Lawrence Lane. Lucien Saulet, 5, Eastcheap. Alexander Schocke, 149, Cannon Street. Stephen J. Schuster, 125, Wood Street. Arthur Jules Schweitzer, Royal Hotel, Victoria Embankment. Henry Theobald, 201, Bishopsgate Street Without. Joseph Witte, 151, Aldersgate Street. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1909. This measure, if passed in the form in which it was introduced, would have empowered the County Council, inter alia, to take samples of milk at any railway station within the county for the purpose of ascertaining if it contained any matter rendering it unwholesome or unfit for the food of man. In order to effect this the clauses relating to unwholesome milk—which were struck out of the Council's General Powers Bill of 1908 by the Select Committee on an instruction carried upon the second reading, on the understanding that the Government would promote legislation dealing with the subject for the whole country—were again brought forward.* I reported fully to the Sanitary Committee on the 26th January, 1909, with regard to the re-introduction of these clauses, and recommended that they should be opposed upon the same grounds as obtained with regard to similar clauses in the Council's General Powers Bill, 1908. On the 11th March, 1909, on the motion in the House of Commons that the Bill be read a second time, there was some opposition to Part III., on the ground that it contained drastic provisions dealing with milk supply. Upon the promoters of the Bill stating that the Council did not ask for these powers with regard to milk if the Government were going to bring in a general Bill * Similar powers with regard to milk were sought by the County Council in their General Powers Bill introduced this session, 1910, which, on the second reading in the Commons on the 8th April last, were again ordered to be deleted. 70 the President of the Local Government Board informed the House that he was on the eve of introducing such a measure, An undertaking was then given on behalf of the London County Council that Part III. would be withdrawn, and the Bill read a second time. Section 13 of the Act gives sanitary authorities in the Metropolis power to require owners of tenement houses to provide suitable accommodation for storage of food for the use of each family in the storey, or one of the storeys in which are situate the rooms or lodgings in the separate occupation of each family. The requirement is not retrospective, and only applies to tenement houses used or occupied as such after the passing of the Act. The Corporation is defined as the local authority for the administration of this section in the City. As an example of legislation by reference it may be mentioned that a "tenement house" is defined as any house occupied by any person of the working class which is wholly or partially let in lodgings, or which is occupied by members of more than one family. "Working class" has the same meaning as in the schedule to "the Houses of the Working Class Act, 1903," which is as under:— "The expression 'working class' includes mechanics, artisans, "labourers and others working for wages; hawkers, costermongers, "persons not working for wages but working at some trade or handicraft "without employing others except members of their own family, and "persons other than domestic servants whose income in any case does "not exceed an average of thirty shillings a week, and the families of "any of such persons who may be residing with them." This Act received the Royal Assent on the 16th August, 1909. 71 FACTORY AND WORKSHOP ACT, 1901. FACTORIES, WORKSHOPS AND WORKPLACES. The work done under the above Act in the City continues to increase both in volume and importance from year to year. Separate registers have hitherto been kept for factories, workshops and workplaces, but in the future, one register only will be kept, comprising the whole, which will facilitate the work of inspection as well as being more convenient for reference. It is the duty of all Local Authorities to send annually, a copy of the report of their Medical Officer of health on the work done under the Act to His Majesty's Home Office, in the form specified by that department (see pp. 79-81), and much of the information required in such report can only be obtained from the registers before mentioned. It is therefore necessary to make them as complete as possible, and the labour involved may be judged from the fact that upwards of 6,900 separate workrooms, &c., have to be accounted for during the year 1910. The lists of outworkers required to be kept by employers, who are also under obligation to send a copy of the same to the local authority twice a year, involve a considerable amount of work. Last year nearly 17,000 names and addresses had to be dealt with, detailed information being required to be sent to the various local authorities concerned outside the City, in each case. The year's reference book shows 5,622 entries, an increase of nearly 600 over last year. During the year, 3,115 notices were issued for various purposes under the Act. The figures show an increase of 245 premises registered for the year, representing 424 additional workrooms, &c. The number of Factories, Workshops, and Workplaces at present registered is as follows:— Premises. Workrooms, &c. Factories 703 2,687 Workshops 2,036 3,226 Workplaces:— Kitchens of Restaurants, &c. 644 861 Kitchens of Tea Rooms, &c. 217 Stables 28 28 Other places 107 107 Totals 3,735 6,909 72 The following figures abstracted from the several Registers will be of interest. Of the 2,687 Factory Workrooms registered, 949 were occupied by men only, 64 by women only, and 1,674 by men and women. Of the 3,226 Workshops registered, 1,699 were occupied by men only, 419 by women only, 1,073 by men and women, and 35 were Domestic Workshops. The number of workers employed was as follows:— Men. Women. Factories 16,379 11,770 Workshops 8,095 10,958 Workplaces (Kitchens, &c.) 4,056 6,409 Totals 28,530 29,137 The following is a summary of inspections of separate Workrooms, &c., made annually since the passing of the Act:— Factories. 1904—Inspections during the year 78 1905 „ ,, „ 735 1906 „ „ „ 1,708 1907 „ „ „ 2,387 1908 „ „ „ 3,325 1909 „ „ „ 3,938 12,171 Workshops. 1901 745 1902 481 1903 547 1904 1,293 1905 2,025 1906 3,481 1907 4,087 1908 4,668 1909 5,166 22,493 Workplaces. 1902 468 1903 357 1904 93 1905 854 1906 1,159 1907 887 1908 1,077 1909 744 5,639 The foregoing figures include the work of the Women Inspectors. 73 FACTORIES. During the year, Factories owned by 84 firms were registered and inspected for the first time. H.M. Inspector is primarily responsible for Factories; the Local Authority dealing with sanitary defects. * Details of Factory Inspections, 1909. Initial inspections (workrooms) 291 Periodical inspections 3,030 Re-inspections (sanitary work needed) 961 4,282 Notices served— Intimation 234 Statutory 26 - 260 Defects remedied- Drains relaid or amended - 11 Soil pipes repaired or renewed - 12 Urinals repaired or renewed 39 „ cleansed 19 — 58 Sink wastes amended - 78 Rain-water pipes repaired - 2 Cisterns cleansed or covered - 12 Refuse receptacles provided - 12 Water-closets— Separate and suitable provided 11 Additional provided 2 Lobbies constructed 150 Ventilated 21 Floors made impervious 33 Pans cleansed 547 Walls and ceilings cleansed 218 Flush improved 42 Other defects 13 - 1,037 General defects remedied - 256 Total defects remedied - . 1,478 * For details of Women Sanitary Inspectors' work, see page 82. 74 WORKSHOPS. These are inspected principally for the purpose of ascertaining where want of cleansing exists, to see that efficient ventilation is provided, that there is no overcrowding, and that suitable and separate water-closet accommodation exists for both sexes, &c., &c. The Factory Inspector has the same power over Workshops as over Factories, but the Local Authority is required by the Act to see to the abatement of nuisances and to the general condition of Workshops and Workplaces, failing which, the Factory Inspector has power to intervene and take any action which might have been taken by the Local Authority. During 1909 the names of 110 firms were added to the register. * Details of Workshop Inspections, 1909. New workshops notified by H.M. Factory Department 248 No Abstract of Act affixed where women and young persons were employed—cases notified to H.M. Factory Inspector 88 Matters referred by Workshop Inspectors to District Inspectors 146 Domestic workshops on register 35 Statutory Certificates for cleansing issued by Medical Officer of Health 194 Outworkers working in the City notified to the Corporation 674 Outworkers notified by Corporation to outside districts 16,193 Complaints— From H.M. Factory Inspector - 23 General 29 Total number of complaints— 52 Initial inspections (workrooms)-314 Periodical inspections-3,019 Re-inspections (sanitary work in hand)-2,299 Notices served— 5,632 Intimation 625 Statutory 206 - 831 * For details of Women Sanitary Inspectors' work, see p. 82. 75 Defects remedied. Walls, ceilings, and approaches cleansed 576 Ventilation improved - 39 Overcrowding abated - 8 Drains relaid or amended - 30 Soil pipes repaired or renewed - 16 Urinals repaired or renewed 17 „ flush improved 4 „ cleansed 20 - 41 Sink wastes amended - 54 Rain-water pipes repaired - 8 Cisterns cleansed or covered - 38 Refuse receptacles provided 20 Water-closets— Separate and suitable provided 22 Additional provided 3 Lobbies constructed 64 Ventilated 76 Floors made impervious 11 Pans cleansed 474 Walls and ceilings cleansed 253 Flush improved 83 - 986 General defects remedied - 464 Total defects remedied - 2,280 WORKPLACES (Kitchens of Restaurants, &c). It would be a great public advantage if all Kitchens were required to be registered under definite conditions before being occupied, at present there is nothing to prevent businesses being run under all sorts of improper conditions, which can only be dealt with as ordinary nuisances. The principal defect found is want of cleanliness, and although as a whole, Kitchens show an improvement as regards their- general condition as compared with earlier times, whitewashing and limewashing are still insufficiently practiced. This is put off until the Inspector comes round instead of being regularly done, say once in six months. The provision of water-closet accommodation for both sexes is another serious difficulty, especially so when small numbers of workers are employed. 76 At the present time there are 135 Workplaces other than the 861 Kitchens of Restaurants, &c., registered, some of these are places where food is stored or prepared, and there are many others needing inspection, such as grocers, provision merchants, fishmongers, fruiterers, &c., &c. A large number of such places exist in the City, and it is proposed to deal with many of them during the coming year. * Details of Workplace Inspections, &c., 1909. Initial inspections 28 Periodical inspections 576 Re-inspections (sanitary works) 522 Total inspections 1,126 Notices served— Intimation 234 Statutory 67 Total Notices served 301 Defects remedied. Drains relaid or amended 8 Kitchens— Walls and ceilings cleansed 128 Light and ventilation improved 24 — 152 Water-closets— Separate accommodation provided for sexes 25 Arrangements improved 56 — 81 Water supply improved - 6 Refuse receptacles provided - 21 General defects remedied - 227 Total defects remedied during the year 495 * For details of Women Sanitary Inspectors' work, see page 82. 77 BAKEHOUSES. Bakehouses are scheduled as Workshops (Part II., Sixth Schedule), and are required to be registered by the Local Authority (Sec. 132). The following is a list of bakehouses registered in the City:— Aboveground Bakehouses. 90, Bishopsgate Street Without. *18-19, Leadenhall Market. +61, Middlesex Street. *155, Minories. †85, Middlesex Street. *4, Water Lane. *93-94, Upper Thames Street. Underground Bakehouses. 188, Aldersgate Street. 81, Bishopsgate Street Without. 59 to 62, „ „ f4, Broadway. 95, Cannon Street. 8, Copthall Avenue. 15, Cornhill. †67, Farringdon Street. †88, „ „ †93, Fetter Lane. †l2, Gracechurch Street. 8 to 14, King Street, Snow Hill. 48, Knightrider Street. 18, Long Lane. †37, Middlesex Street. †63 to 65, „ †122, 31, Newbury Street. 3, Pancras Lane. 21, Stoney Lane. 68, St. Mary Axe. †75, St. Paul's Churchyard. 194, Upper Thames Street. SUMMARY. Aboveground bakehouses 7 Underground bakehouses 23 Total number of bakehouses in the City 30 The bakehouses were inspected as usual, 136 visits being made. Cleansing was needed in six cases, which was carried out forthwith on service of notice. As a rule these places are kept in good condition and up to the standard required by the Act. SANITARY DEFECTS IN FACTORIES AND WORKSHOPS NOTIFIED IN 1909 BY H.M. INSPECTOR OF FACTORIES. Complaints were received from H.M. Inspector of Sanitary defects at 23 places, and all these were disposed of before the end of the year. H.M. Inspector was notified of defects in factories at 28 premises, including want of cleansing, ventilation, overcrowding, and other nuisances. * Established during 1903. † These have been established at least 24 years. 78 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. 1901 51 1902 54 1903 66 1904 31 1905 32 1906 39 1907 21 1908 19 1909 23 Annual Average 37.3 OUTWORKERS AND "HOME" WORKERS. A sustained effort has been made to carry out the provisions of the Act respecting outworkers, &c. During the past year the Lists due on February 1st and August 1st respectively were all obtained without having recourse to legal proceedings. As something like 750 lists have to be got in on each occasion, that result must be pronounced satisfactory. There are but few "home" workers in the City, but the outworkers numbered 277, and of this number only 49 were "home" workers in any sense of the word. These are visited by your Women Inspectors. The following figures will illustrate what has occurred:— Year. Number of Lists received. Outworkers Employed in City. Outworkers Employed outside City. Total number of Outworkers. 1902 — 17 3,752 3,769 1903 — 118 2,729 2,847 1904 272 123 3,334 3,457 (Note.—1st Notice issued to all employers at end of 1904.) 1905 576 236 7,891 8,127 1906 1,112 229 14,376 14,605 1907 1,426 491 16,570 17,061 1908 1,506 624 16,909 17,533 1909 1,515 674 16,193 16,867 It was necessary in 85 cases, which were not on the register, to require lists to be sent in and for copies of the same to be kept at the places where the work was given out. Legal proceedings were not necessary in any case. In no case during the year did infectious disease invade the premises of any outworker in the City, but 15 "contacts" were reported as follows:— phthisis 1, diphtheria 5, and scarlet fever 9. Each case was specially visited, and all necessary precautions taken to prevent the spread of infection. 79 THIS TABLE WAS ISSUED BY THE LOCAL GOVERNMENT BOARD BY REQUEST OF THE SECRETARY OF STATE FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK. 1 9 0 9. 1.—INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of (1) Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories (including Factory Laundries) 8,938 264 - Workshops (including Workshop Laundries) 5,166 887 - Workplaces (other than Outworkers' premises included in Part 3 of this Report.) 744 359 - Total 9,848 1,510 - 2.—DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts:—* Want of cleanliness 899 734 21‡ — Want of ventilation 119 65 2‡ — Overcrowding 18 17 - — Want of drainage of floors ... 1 1 — — Other nuisances 1,423 1,388 6‡ 2 — insufficient 42 30 - — †Sanitary accommodation unsuitable or defective 2,343 2,077 - — not separate for sexes... 46 41 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) — — — — Breach of special sanitary requirements for bakehouses(SS. 97 to 100) — — — — Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) — — — — Total 4,891 4,353 32 — * Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act as remediable under the Public Health Acts. † For districts not in London state here whether Section 22 of the Public Health Acts Amendment Act, 1890, has been adopted by the District Council ; and if so what standard of sufficiency and suitability of sanitary accommodation for persons employed in factories and workshops has been enforced. ‡ Defects in Factories. 80 81 HOME WORK NATURE OF WORK. * OUTWORKERS' LISTS, SECTION 107. Inspections of Outworkers' premises. OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109,110. Lists received from Employers. Addresses of Outworkers.§ Notices served on occupiers as to keeping or sending Lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110) Twice in the year. Once in the year. Received from other Councils. Forwarded to other Councils. Failing to keep or permit inspection of lists. Failing to send lists. Lists, f Outworkers, † Lists. Outworkers.+ Contractors. Workmen Contractors. Workmen. (1) (2) (3) (4) (6) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) Wearing Apparel— \°) (1) making, &c. 1,278 Feb., 1,288 Aug., 1,305 2,593 Feb., 6,666 ) Aug., 6,096 ) 11,752 92 Feb., 63 88 Aug., 25 Feb., 164 Aug., 270 434 (2) cleaning and washing ... ... ... ... ... . . . ... i4,4yy Lace, Lace Curtains and Nets 6 fFeb., 25) 75 ... ... ... ... Artificial Flowers ... 16 Feb., 81 Aug., 110 89 Feb., 117 Aug., 94 211 2 Feb., 27 ... 75 6 Nets, other than Wire Nets ... 327 18 ... ... 1 Tents Sacks Furniture and Upholstery ... ... ... ... ... ... Fur pulling (Furriers) 52 Feb., 93 Aug,, 110 203 Feb., 157) Aug., 145 302 3 Feb., 11 Aug., 1 ... 483 55 ... ... 25 Feather sorting ... ... ... ... ... ... ... ... Umbrellas, &c. 56 Feb., 30 Aug., 28. 58 Feb., 359 714 2 Aug. 4 ... ... ... ... ... 8 Carding, &c., of Buttons, &c. Aug., 355 ... 740 58 ... ... 23 Paper Bags and Boxes 4 Feb., 5 Aug., 5 10 Feb., 1 Aug., 2 3 ... ... ... Basket making ... 11 4 ... ... 2 Brush making 4 ... Feb., 27 Aug.., 31 58 ... ... • •• ... 58 4 Racquet and Tennis Balls Stuffed Toys ... ... ... ... ... ... File making ... ... ... ... 1 Electro Plate ... ... ... ... ... Cables and Chains ... ... ... ... 2 Anchors and Grapnels Cart Gear Locks, Latches and Keys Pea picking Total 1,416 2,958 13,115 99 99 466 234 16.193 1.515 Nil. Nil. 277 Nil. Nil. Nil. Nil. Nil. Nil. * If an occupier gives out work of more than one of the classes specified in column 1. and subdivides his list in such a wav as to show the number of workers in each class of work, the list should be included among those in column 2 (or 6 as the case may be) against the principal class only, but the outworkers should be assigned in columns 3 and 4 (or 6 and 7) into their respective classes. A footnote should be added to show that this has been done. † The figures required in columns 2, 3 and 4 are the total number of the lists received from those employers who comply strictlv with the statutory duty of sending two lists each year and of the entries of names of outworkers in those lists. The entries in column 2 must necessarily be even numbers, as there will be two lists for each employer—in some previous returns odd numbers have been inserted The figure in columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. § In view of the wide discrepancies found to exist between the totals in the two columns when the returns are added together it is desired that care may be taken to give exact figures. Only those addresses should be counted which have actually been received from or forwarded to other Council during the year covered by the reports. 4.—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year. Number. (1) (2) Important classes of workshops, such as workshop bakehouses, may be enumerated here. General Workshops 3,196 Workshop Bakehouses (including two Factory Bakehouses) 30 Total number of Workshops on Register .3,226 5.—OTHER MATTERS. Class Number. (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (S. 133) 90 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (S. 5) Notified by H.M. Inspector Reports (of action taken) sent to H.M. Inspector 23 23 Other — Underground Bakehouses (S. 101):— Certificates granted during the year None. In use at the end of the year 23 Dated 31st December, 1909. (Signature) W. COLLINGRIDGE, Medical Officer of Health, Note.—The Factory and Workshop Act, 1901 (S. 132), requires the Medical Officer of Health in his Annual Report to the District Council to report specifically on the administration of that Act in workshops and workplaces, and to send a copy of his Annual Keport, or so much of it as deals with this subject, to the Secretary of State (Home Office). If the Annual Report is presented otherwise than in print it is unnecessary to include in the copy sent to the Home Office the portions which do not relate to factories, workshops, workplaces, or homework. The duties of Local Authorities and the Medical Officer of Health under the Act of 1901 are detailed in the Home Office Memorandum of December, 1904. A further Memorandum, on the Home Work Provisions of the Factory Act was issued to all District Councils and Medical Officers of Health in October, 1906. 82 WOMEN SANITARY INSPECTORS. FACTORIES, WORKSHOPS AND WORKPLACES. In factories the Sanitary Authorities deal chiefly with sanitary accommodation, other health questions being within the purview of H.M. Inspectors of Factories. Six hundred and twenty-four visits were paid during the year by your Women Inspectors to factories in which women was employed. In many instances the sanitary accommodation was found to be dirty and defective or badly ventilated, and a large number of cases of unsuitable or insufficient accommodation were reported, and where structural alterations were required, were dealt with by the District Inspectors. Workshops in the City where women are employed are for the most part connected with the Clothing trades, and include Millinery, Tailoring, Furriers, Blouses, Underclothing, Ties, Belts, Shirts, Collars, Caps, Lace, Gloves, Frilling, Feathers and Artificial Flowers. There are also many Umbrella makers, and among other trades represented are:—Upholstery, Carpets, Leather Goods, Frames, Engraving, Machine Ruling, Blinds, Cork Dipping and Christmas Cards. The number of inspections made during the year is as follows:— Initial Inspections 200 Periodical Inspections 1,497 Re-inspections 114 Total 1,811 This number includes visits paid to Domestic Workshops. The defects found were chiefly in relation to dirty walls and ceilings, insufficient ventilation, overcrowding, and dirty and defective sanitary arrangements. In the case of one domestic workshop the walls were reported as being in a verminous condition, and were promptly stripped and cleansed. Speaking generally, the standard of cleanliness in domestic workshops in the City is fairly good. The inspection of Restaurant Kitchens where women are employed is being continued. 83 OUTWORKERS. The lists of outworkers sent in by employers during 1909 contain 674 entries of names of persons in the City to whom work is given out. As one outworker may be employed by several firms (as many as 16 employers of one man being notified in some cases), and each firm may send in his name twice in one year, it is not surprising to find that these 674 entries represent only 277 outworkers; of this number 175 had been notified in previous years, and the remaining 102 were newly notified as outworkers, though the majority of them were already on the Workshop Register, and had been inspected in the usual course of visits. In view of the fact that that part of the Home Office Return which deals with outworkers is headed "Home Work," it is necessary to point out that the actual number of outworkers carrying on work in their own homes is only 49, made up as follows:— Three employ persons other than members of their own families, and appear on the Register of Workshops. Thirty-three employ only members of their family, and are classed as Domestic Workshops. Thirteen are "occasional workers," i.e., those whose "labour is "exercised at irregular intervals and does not furnish the whole "or principal means of living to the family," and who are consequently exempt from the provisions of the Factory and Workshop Acts. 84 The following Table shows the number of premises in the City where work is carried on by "outworkers," and a List ot Domestic Workshops is also appended:— Factories. Workshops. Domestic Workshops. Occasional. Total. Number of Workers. Men. Women. . WEARING APPAREL. (1) Making. Tailors — 91 20 5 115 420 347 767 Furriers — 23 2 — 25 119 294 413 Costumes, &c. 1 22 2 — 25 53 289 342 Mantles — 16 1 — 17 23 135 158 Ties — 11 3 — 14 9 104 113 Embroidery — 10 — — 10 26 74 100 Caps 1 5 — — 6 34 111 145 Shirts and Collars — 4 1 — 5 1 39 40 Blouses 2 1 1 — 4 — 107 107 Boots and Shoes — 1 — 1 2 6 1 7 Children's Clothing — 1 — 2 3 — 10 10 Millinery — 1 1 1 3 — 124 124 Belts — 4 — — 4 7 12 19 Feather dressing — 2 — 1 3 2 36 38 Gloves — 3 — — 3 — 31 31 Dressmakers' Sundries — 1 - 1 2 — 1 1 Frilling 1 1 - — 2 — 27 27 FURNITURE AND UPHOLSTERY 1 1 — 2 — 37 37 UMBRELLAS, &c. 1 21 1 - 23 43 177 220 PAPER BAGS AND BOXES — 1 - 1 2 - 3 3 DOLL DRESSING — — 1 — 1 — 1 1 LEATHER WORK — 1 — 1 2 1 73 74 FRAMES — 1 — — 1 — 2 2 ENGRAVING — 1 — — 1 2 — 2 ELECTRO-PLATING — 2 — — 2 3 2 5 7 225 33 13 277 749 2,037 2,786 85 DOMESTIC WORKSHOPS, 1909. Premises. Trade. Number of Workers. Remarks. M. K. Total. 32, Aldersgate Street Millinery — 1 1 Outworker. 22, Artillery Lane Tailoring — 1 1 Do. 84, Bartholomew Close Ties — 1 1 Do. 85, Do. Tailoring — 1 1 Do. 34a, Beech Street Do 1 — 1 Do. Do. Millinery - 1 1 Do. 43, Bishopsgate Street Without Tailoring ... - 2 Do. 130, Do. Do — 1 1 Do. 14, Brushfield Street Do — 1 1 Do. 2, Cavendish Court Do 1 — 1 Do. 26, City Buildings Doll Dressing — 1 1 Do. 43, Cloth Fair Tailoring — 1 1 Do. Do Stick Mounter 1 — 1 Independent business 7, Dorset Street Umbrellas - 1 1 Outworker. Do. Boot Repairs 1 — 1 Do. 9, Ellison Street Tailoring 1 — 1 Do. 2, Evangelist Court Umbrellas — 1 1 Do. 2, Fenton Buildings Tailoring 1 — 1 Do. 117, Gravel Lane Do — 1 1 Do. 35, Harrow Alley Do 5 — Do. 20, Houndsditch Do 1 — 1 Do. 10, Huggin Lane Artificial Flowers. — 1 1 Do. 17, Hutchison Street Caps 2 — Do. 21, Do. Tailoring — 1 1 Do. 31, Little Britain Do 1 1 2 Do. 20, Middle Street Ties — 1 1 Do. 2, Middlesex Passage Tailoring 1 - 1 Do. 96, Minories Do 2 - 2 Do. 39, New Street Do 1 — 1 Do. 8a, North Block. Dressing-gowns - 2 2 Do. 2, Pope's Cottages Boot Maker 1 - 1 Independent business. 7, Stoney Lane Tailoring 1 — 1 Outworker. 6, Temple Lane French Polishing — 1 1 Do. 9, Vine Street Tailoring — 1 1 Do. 30, West Smithfield Blouses — 1 1 Do. 86 OFFICES. The complaints which have been received during the past year with regard to insanitary conditions in offices in which women clerks are employed may be grouped under the following headings:— Absence of any sanitary accommodation. No separate sanitary accommodation. Unsuitable or defective sanitary accommodation. Offices overcrowded. Offices in dirty condition. These have all been investigated, and the defects found were, in every instance, remedied or are now in hand. UNDERGROUND CONVENIENCES FOR WOMEN. The usual inspections of underground conveniences have been carried out. An additional convenience for women has been opened in Eastcheap, and there are now 14 in the City, situated at:— Aldersgate Street (North). Aldersgate Street (South). Aldgate. Bishopsgate Street Without. Circus Place (Finsbury Circus). Eastcheap. Farringdon Street (North). Farringdon Street (South) (Ludgate Circus). Golden Lane. Guildhall Buildings. Holborn. Minories. Upper Thames Street (near London Bridge). West Smithfield. LADIES' WAITING ROOMS AT RAILWAY STATIONS. The usual inspections of Ladies' Waiting Rooms at Railway Stations have been carried out. The defects found were all of a minor character, and were promptly remedied on being brought to the notice of the Railway Companies concerned. CHILDREN ACT, 1908. This Act, which received the Royal Assent on the 21st December, 1908, came into operation on the 1st April, 1909. An abstract of the Act will be found in your Medical Officer's Annual Report for last year. The Corporation, as the Local Authority under Part I. of the Act dealing with Infant Life Protection, delegated its powers to the Sanitary Committee, and at the meeting of the Court of Common Council on the 4th March, 1909, Miss A. J. Safford and Miss M. M. Pole, two of your Women Sanitary 87 Inspectors, were appointed Inspectors for the purpose of the Act, and your Committee were authorised to take such steps as might be necessary to ensure that the provisions of the Act were brought to the notice of such persons residing in the City as were likely to be affected thereby. With a view therefore of making such persons acquainted with their obligations, a Notice has been left at every registered tenement house in the City, at the ten blocks of dwellings, including those belonging to the Corporation in Harrow Alley and Stoney Lane, and at the various Police Stations throughout the City. The City medical men and midwives have also been supplied with copies. Since these Notices were distributed, four communications have been received from persons taking charge of children, but on investigation it was found that to none of these cases did the Act apply. In three instances the child was in the care of relatives; in the fourth instance, though in the care of a stranger for reward, the child was taken charge of by day only, and slept with her mother at night. A case was discovered where parents resident in the City had put out their infant to nurse in another district, and this was duly reported to the authority concerned. NOTIFICATION OF BIRTHS ACT, 1907. During the year 224 births of children were notified under the above Act, including 7 still-births. Fifty-one other notifications relating to children not belonging to the City were forwarded to the Medical Officers of their respective districts. Of the 224 City births— 122 were notified by Medical Practitioners. 57 „ „ from Hospitals, &c. 20 „ „ by Midwives. 25 „ „ „ the Parents. THE CARE OF INFANTS. During the year 885 visits were paid to the homes to give instruction in the care and feeding of infants. The visits appear to be appreciated, and in many cases looked forward to. This is extremely gratifying, for the success of the work depends wholly on the way in which the visits are received. 88 The most satisfactory cases appear to be those where the father is in regular and fairly remunerative employment, and the mother is able to provide herself with nourishing food, and if artificial feeding has unfortunately to be resorted to, it can be properly carried out. The child is warmly clad, and generally the many little details which affect health are carefully attended to. The contrast between such children and those whose fathers' earnings are small and precarious, is painful and striking. The following particulars of feeding relate to 194 newly-born babies seen during the year. One hundred and fifty-seven were found, on the first visit, to be breast-fed only; 17 were partly breast and partly hand-fed; and 20 were entirely hand-fed. One hundred and fifty-nine infants appeared to be in a healthy condition, and 35 were suffering from various diseases, or were weakly and ill-nourished. Twenty-four of these sickly infants were breast-fed, doubtless owing their debility in many cases to the obviously ill-nourished condition of the mother. The mothers are advised as to what foods it would be best for them to choose in order to improve and keep their milk. It is obvious that if all mothers were well nourished, both before and after the birth of their children, breast feeding would be satisfactorily continued for the natural period, and the children would be of a stronger and finer physique, the benefits accruing therefrom being felt, not only by each child during its lifetime, but by the nation at large. Care is taken to impress upon the mother the need of warm clothing. Many people have a mistaken idea that children who are never clothed in woollen garments will become less susceptible to cold. The lack of adequate clothing retards development and saps the vitality and resisting power of the young. A final visit is paid to all mothers when the child has attained the age of 12 months. An attempt has been made to give the mothers some guidance as to the method of feeding which should be adopted after this age. A great number of mothers have expressed their gratitude for the advice given. It is surprising that the mothers do not appreciate the fact that after weaning, milk must still find a prominent place in the child's diet. Of 218 children born in 1908 it was found that 59 had been removed from the City before completing the first year; 145 attained the age of 12 months, and there were 14 deaths. 89 NECESSITOUS MOTHERS (ASSISTANCE) BILL, 1909. The object of this Bill was to reduce infantile mortality, and to make practical efforts to raise the standard of physical motherhood among workingclass mothers by rendering it possible for pregnant and nursing mothers of that class to stay at home and refrain from hard physical work for a limited period before and after parturition; also to encourage breast-feeding of infants for an adequate period. The Bill was permissive, and gave local authorities power to provide such food, medical aid, nursing and other accessories—to be specified in regulations to be made by the local authority and approved by the Local Government Board—for the purpose of assisting necessitous women during pregnancy and child-birth. The nature of the assistance to be rendered by the local authority, provided the women agreed to comply with the regulations, included (a) food and any other necessaries for the woman, (b) medical assistance and nursing in relation to and during confinement, and (c) food and other necessaries for the woman during a period not exceeding six months after child-birth. The local authority might make it a condition of supplying food or other necessaries to the mother that (if capable) she should feed the infant at the breast. It was made a condition under which such maintenance was to be provided that the woman pledged herself not to work for wages for a specified time before and after child-birth. This Bill was dropped before the second reading. HEALTH VISITORS (LONDON) ORDER, 1909. Section 6 of the London County Council (General Powers) Act, 1908, empowers sanitary authorities in the Metropolis to appoint suitable women, to be known as Health Visitors, for the purpose of giving to persons advice as to the proper nurture, care and management of young children, and under the same section the Local Government Board may issue an order making Regulations with respect to the qualifications, mode of appointment, duties, salary, and tenure of office of such Health Visitors. An Order for the purpose was accordingly issued by the Board on the 4th September, 1909. (See Appendix G, p. 171.) No Health Visitors have been appointed by the Corporation, the work for which their appointment is suggested being carried out as part of the duties of your Women Sanitary Inspectors. In the circumstances no action could be taken under the Order in question. 90 FOOD LEGISLATION, ETC. Several measures for safeguarding the public health and interests with regard to food supplies were introduced in Parliament during the year, of which the following is a summary:— Milk and Dairies Bill (see p. 36). (Not proceeded with.) Hops Bill (see below). (Not proceeded with.) Meat Marking Bill (see p. 108). (Not proceeded with.) Sale of Margarine Bill (see p. 127). (Not proceeded with.) Departmental Orders or Regulations were issued as under:— The Public Health (Foreign Meat) Amending Regulations, 1909 (see p. 102). (Local Government Board.) Tuberculosis Order of 1909, made under the Diseases of Animals Act, 1894 to 1903. (Board of Agriculture and Fisheries.) (Withdrawn, in abeyance.) (See pp. 10 and 39.) Official publications dealing with the following subjects were also published during the year, viz.:— Dr. J. M. Hamill's Report to the Local Government Board on " facing " and other methods of preparing rice for sale. Dr. G. S. Buchanan's Report on the work of Inspectors of Foods for the years 1906-1908. Reports to the Local Government Board by Dr. G. S. Buchanan and Dr. S. B. Schryver on the Application of Formaldehyde to Meat. Reports to the Local Government Board by Dr. G. S. Buchanan and Dr. S. B. Schryver on the presence of tin in certain canned foods. Report to the Local Government Board by Dr. J. M. Hamill on the Use of Preservatives in Cream. The above contain a mass of information, which will be found of much use to all interested in the purity of food supplies. HOP BILLS. Several Bills were introduced in Parliament last year for dealing with the use of hop substitutes in brewing, but although some of them came under discussion in the House of Lords, they were eventually abandoned. 91 TIN IN CANNED FOODS. In my Annual Report for 1908 reference was made to an endeavour to persuade packing firms in New Zealand to agree upon a scheme for marking tinned foods in such a way as to indicate where and when they are packed. The age of a tin of preserved food is a matter of considerable importance by reason of the liability of the contents to metallic contamination. In the early part of 1909 the Local Government Board published Reports by Dr. G. S. Buchanan and Dr. S. B. Schryver, D.Sc., on "The Presence of Tin in certain Canned Foods, together with some investigation on the Toxicology of Tin," and one of the conclusions arrived at by the former was that— "The inquiry illustrates the advantage which would be gained, from "the administrative point of view, if the persons or firms by whom "canned foods are prepared were in a position to determine by marks, "labels, or otherwise the date and place of preparation, and could be "required to furnish such particulars, on reason shown, to public health "authorities concerned with food inspection and wholesomeness of foods." The following other conclusions were arrived at in the Report:— That practically all ordinary canned foods are contaminated with tin as the result of contact of the food with the tin-plate of the can. More tin is found in meat extracts and essences than in other meat foods, owing to the acidity of the meat extractives. Certain canned fruits, vegetables, and food made as soups are also liable to take up tin in consequence of their natural acidity. These include canned peaches, cherries, pears, apricots, pineapples, tomatoes, asparagus, canned fruit puddings, and tomato soup. Canned lobster has been found to contain notable quantities of tin. As time goes on the quantity of tin taken up from the can increases. Meat essences and extracts, six years old, returned from South Africa, usually contained from l½ to 3 grains of tin to the pound. Canned carrots, apricot jam, and fruit puddings of the same age contained 2 to 3 grains of tin per pound. Flesh foods of that age, however, such as brawn, curried rabbit, sausages, tongues, sliced bacon, etc., contained considerably less, ranging between ½ and 1½ grains per pound. The cheaper quality of tin plates are most liable to erosion, causing solution of the tin, than those more thickly coated with tin. If solder (containing both tin and lead) finds its way into a can, a very conspicuous solution of tin may take place. Owing to this cause, the contents of one tin examined was found to contain no less than 20 grains of tin to the pound. 92 At present there is not sufficient evidence to prove actual injury to health from the accumulated effects of small doses of tin taken over a lengthy period, though it is quite clear that such quantities may be sufficient to produce severe illness in consequence of local irritation. Canned fruits, which are specially liable to act on tin, examined between one and two years from the date of canning, were not found in any case to contain more than one grain of tin to the pound of fruit. The Report suggests that the presence in the contents of a sample can, of tin in quantities approaching two grains to the pound may be taken to signify that the food has become potentially deleterious to health, and calls for further examination of other samples with a view to dealing with the consignment in accordance with the results obtained. CONTAMINATED OYSTERS. As in former years, several cases were brought to my notice where cases of enteric fever were attributed to the consumption of contaminated oysters. Experience has shown that in single cases it is generally an exceedingly difficult matter to satisfactorily trace any connection between shellfish and reported cases of illness. On the 12th November a case of this kind was reported from Paddington, where the suspected oysters were stated by the local dealer to have been obtained from a salesman at Billingsgate Market. Upon investigating the matter it was ascertained that the oysters in question were of French origin, and had been relaid at Brightlingsea for more than a year. A sample from the same source was submitted to Dr. Klein, who reported as follows:— "Of eight oysters, seven contained B. coli communis. "Of four specially examined, three contained Stroptococci. "Of two specially examined, both contained Enteritidis sporogenes. "Result.—Oysters distinctly polluted." These facts were brought to the notice of the Fishmongers' Company, who at once obtained an undertaking from the dealer at Brightlingsea to discontinue the sale of these oysters. A case of a similar kind was reported from Eastbourne on the 19th November. In this instance the person attacked with enteric fever had consumed a quantity of oysters within the incubation period, which were stated to have been supplied by two firms in Billingsgate Market, from one of which the oysters referred to in the previous case at Paddington had been obtained. 93 The Fishmongers' Company were communicated with, who at once instituted inquiries. In the meantime the salesmen at Billingsgate undertook to discontinue the suspected source of supply. I was subsequently informed by the Fishmongers' Company that the oysters supplied to the Eastbourne dealer were "certificated oysters from Dutch grounds, which from analysis are shown to be perfectly pure." It will be seen from the foregoing that in spite of the efforts of your officers and those of the Fishmongers' Company, to prevent the distribution and sale of polluted shellfish, it is clear that until the public are better protected than they are at present from the danger incurred in the consumption of such questionable food, the evil will continue. There is little doubt that the traders in shellfish would welcome any remedial legislation that would restore public confidence in the wholesomeness of their wares. The whole question has been thoroughly investigated by the Commissions engaged in the enquiry relating to sewage treatment and disposal, and in their fourth report—issued as far back as December, 1903—they strongly advocated the remedial measures referred to in the Annual Report for 1908. Although this Commission went so far as to express the opinion that "the evil was sufficiently grave to demand a remedy," no steps appear to have been taken by the Government to give effect to their recommendations. BYE-LAWS FOR VENDORS OF FRIED FISH, FISH CURERS, AND RAG AND BONE DEALERS. Under the provisions of the London County Council (General Powers) Act, 1908, it is enacted [Section 9 (1)] that the Council may make and enforce bye-laws within the county (elsewhere than in the City of London and so much of the Port of London as established for the purposes of the laws relating to the Customs of the United Kingdom as is within the county) for regulating the businesses of a vendor of fried fish, a fish curer, and a rag and bone dealer, or any of them, and with respect to the premises in or upon which any such business is carried on, and the apparatus, utensils, and appliances used for the purposes of or in connection with any such business. Similar powers can be exercised by the Corporation within the City [Section 9 (3)]. As it is essential that the bye-laws within and without the City should be in harmony and, if practical, identical, in order to avoid confusion and 94 hardship, I communicated with the Medical Officer ot the County Council, suggesting the advisability of conferring on the subject. I subsequently reported to the Committee that I had met the Medical Officer of the County, and after suggesting certain modifications to the bye-laws as drafted by the Council, agreed that the matter should be left in the hands of the Council pending the confirmation by the Local Government Board, when the Corporation Bye-laws would be framed on similar lines. This agreement was, of course, without prejudice in any way to the right to make any alteration the Committee or the Court of Common Council may desire. Thus the matter remains for the present. I may add there are eleven fried fish vendors, and one rag and bone dealer within the City, who would come within the Bye-laws, but there are no fish curers. SALE OF FOOD FROM BARROWS, STALLS, &c. Section 8 of the London County Council (General Powers) Act, 1908, gave power to local authorities in the Metropolis to enforce certain sanitary regulations as set out in the section which apply to any room, shop, or other part of a building in which any article whether solid or liquid intended or adapted for the food of man is sold or exposed for sale, or deposited for the purpose of sale, or of preparation for sale, or with a view to future sale. In July last I reported that the London County Council proposed to extend these powers so as to apply to barrows, stalls and other vehicles in which food is exposed for sale, and had asked for suggestions as to the best method for regulating the sanitary condition of barrows and stalls. It is undoubtedly desirable that as much control as possible should be exercised over the sale of food, and there can be no objection to the proposed extension. As it would be difficult to frame any regulation which would be applicable beyond those of general cleanliness, the Council were informed, at my suggestion, that the Corporation is in favour of the proposed extension, and that they are willing to carry into execution any further powers that may be imposed upon them by extension of the Act in the direction indicated. 95 DAIRIES, COWSHEDS AND MILKSHOPS ORDERS. Section 5 of the London County Council (General Powers) Act, 1908, provides that any Sanitary Authority in the Metropolis may remove from or refuse to enter on the Register the names of dairymen or purveyors of milk whose premises are, in the opinion of such Sanitary Authority, for any reason unsuitable for the sale of milk thereon. Any person feeling aggrieved by any decision of a Sanitary Authority under the provisions of this section has the right of appeal within twenty-one days from the date of such decision to a Court of Summary Jurisdiction. Before this Act came into force purveyors of milk could be placed on the Register without any restrictions, and it is greatly to the advantage of the public health that Sanitary Authorities should be armed with the powers provided by this section as the sale of milk in small chandlers' shops, entirely unfitted for the proper storage of such a susceptible article as milk, is most objectionable from a public health point of view. Five cases occurred in the course of the year in which action was taken under the section referred to above with regard to premises unfitted for the sale or storage of milk. In four of these, registration was deferred until suitable alterations were made to ensure the milk being kept under proper sanitary conditions. In one case a firm in Fetter Lane failed to comply with the regulations, and the matter was referred to the City Solicitor to deal with. Before, however, any legal proceedings could be taken, the firm went into liquidation, and the premises were closed. The following is a summary of action taken under the Dairies, Cowsheds and Milkshops Orders:— A case was referred to the City Solicitor in which an unregistered milk seller was found purveying milk. He subsequently made formal application at the Guildhall, and the premises being found in a suitable condition he was duly placed on the register. At the end of the year there were 602 purveyors of milk on the Register, as compared with 612 in 1907, a decrease of 10. During the year the sale of milk was discontinued at 48 premises, and the owners' names removed from the Register, 38 new premises were added, and 47 changes of ownership necessitating re-registration occurred. One case of the use of dirty vessels was reported. In this instance the milk was delivered at a City Company's Hall in a rusty and unclean can. Proceedings were taken against the offender, who was fined 20s. and expenses. An Italian carrying on business as a confectioner and purveyor of milk in Moor Lane was summoned for selling milk without being registered, and was fined 20s. and 7s. costs. 96 No case of infectious disease occurred at any milk dealer's premises during the year. Each place on the Register is regularly and systematically inspected, and their general condition has greatly improved during recent years. A list of registered purveyors of milk in the City is given in Appendix D, p. 156. ICE CREAMS. Under the provisions of the Ice Cream Sections, Nos. 42, 43 and 44 of the London County Council (General Powers) Act, 1902, which became operative on 1st November, 1903, any person engaged in the manufacture, sale or storage of ice cream, or any such commodity, who does any act or thing likely to expose such commodity to infection or contamination, or omit to take any proper precaution for the due protection of such commodity from infection or contamination, shall be liable for every such offence, on conviction, to a penalty not exceeding forty shillings. He is also liable to a similar penalty if he omits to notify the outbreak of any infectious disease amongst persons employed by him in the sale, manufacture or storage of such commodity. An itinerant vendor of ice cream, &c., must exhibit a notice on his barrow stating the name and address of the person from whom he obtains such articles, failing which, he also incurs a penalty not exceeding forty shillings. In 1909 there were 248 premises in the City where ice creams were sold as compared with 246 in 1908, and 207 in 1907. These places may be classified as under:— Place of Manufacture. Number. In the City. In other districts. Tea shops 119 36 83 Confectioners 20 16 4 Small confectioners and light ment shops 109 51 58 Total 248 103 145 With one exception, the 109 small confectioners and refreshment shops were kept by foreigners. The number of places in the City where ice creams are manufactured decreased from 109 in 1908, to 103 last year, while 145 dealers obtained their supplies from other districts, as compared with 137 in 1908. From enquiries made in other districts, it was ascertained that with one exception the manufacture was carried on under satisfactory sanitary conditions, and in the case reported against, the purchase of ice cream therefrom was prohibited until notification was received that the necessary sanitary improvement had been effected. 97 Itinerant Ice Cream Vendors. In the coarse of the year 26 itinerant ice cream vendors were found in the City, being 15 less than in the previous year. It was ascertained that in all cases the material they were selling was made outside the City. Upon making enquiries of authorities of outside districts it was found that in three cases the addresses displayed on the barrows were incorrect, and that in one instance the ice cream was made under unsatisfactory conditions. As the police have no power of making arrests in cases where no notices of place of manufacture is displayed, there will always be a difficulty in exercising control over these itinerant dealers. One prosecution was instituted during the year, for non-compliance with the law with regard to exhibiting a notice on his barrow stating the name and address of the person from whom the ice cream was obtained, viz.:— Marney Rebeiras, 13, Providence Place, King's Cross-1s. and 3s. expenses. MEAT SUPPLIES IN 1909.* After two years of diminished supplies it is gratifying to find that the swing of the pendulum again places the authorities of the Central Market in a position to report an increase. The weight of meat and other produce sent in for sale has amounted to a total of 420,060 tons, being, with the single exception of 1906, the largest quantity of meat ever received at Smithfield, and it is with great satisfaction we note that of the 10,000 tons by which this exceeds the weight of last year, over 7,000 tons was in the produce of our own country. We have repeatedly advanced the opinion that the English farmer can produce meat at the prices he now gets for it, and if only the price of corn could be maintained at a level which would make it remunerative for him to produce meat at all, we might look forward to making our country more self dependent in the near future than it has been for a long time. 1. English Town-Killed.—Encouraged by the prices they obtained at the close of last year, the beef producers seem to have shaken off their lethargy, with the result that almost every week there has been a good show of fat cattle at Islington for which our town slaughterers have paid remunerative prices, especially at the Christmas market, which was one of the largest and best witnessed there for many years. With diminishing supplies from the United States, and even those held for prices greatly in advance of those which formerly obtained, carcase butchers are forced to turn their attention to English produce, and with a falling-off of some 27,000 tons in the total North American produce to Smithfield for the year, it would seem only a question of time for them to give it their undivided support. • I am indebted to Mr. G. P. Terrett for the remarks on pp. 97 to 101. 98 There is always a good show of sheep at Islington, but we regret to say that the abnormally high prices of 1906 and 1907 had so stimulated production that the amount realised for them this year has been frequently unremunerative. Carcases of the primest mutton were sold during the early months of the year at little if anything over 6d. per lb., a price which —considering the time, labour, and money expended upon them—cannot be regarded as satisfactory. Then, during the early summer months things improved, only to fall away again, and the close of the year has seen a very low level of prices; but, as that is largely attributable to the heavy influx of frozen mutton from New Zealand, Australia, and Argentina during the summer months, which as the year closed had to be cleared at almost any price, it is hoped that we shall soon see an improvement. Of pigs there has been a good supply throughout the year. Commencing at a comparatively low price the trade became firmer up to the summer, when there is little doing in pork. The resumption in September saw a level of prices considerably in advance of those which have been obtained of late years, and this condition of things has continued to the close of the year. It is gratifying to note that a much smaller number of diseased pigs have been sent, though it would be too much to argue from this that there is a diminution of tuberculosis. 2. British Country-Killed.—There has been a steady supply of English beef from Norfolk and other producing centres throughout the year, and the prices realised for it have been satisfactory. The excellent crops of turnips both in England and Scotland have helped to produce some excellent beef and mutton during the closing months of the year. For the Christmas market a large quantity of beef was sent, some of which was really splendid; but the Christmas week was one which many would be only too glad to forget. Opening on Monday, December 20th, there were 3,917 tons of meat sent in, being a close approximation to the largest quantity ever received at the Central Market in one day, the record being held by 21st December, 1896, when 4,159 tons were delivered. The weather was clear and cold, and with a brisk demand most of this was sold at excellent prices. Both salesmen and senders seem to have thought this was to continue, consequently, on Tuesday there was again a large supply which at first sold well ; then the trade dragged and became so heavy that it only needed the change to mild, wet weather, which came on Wednesday, to convert it into a regular slump, from which there was not, and could not be any recovery. To add to the difficulty a large shipment ot Argentine chilled beef came, which has a painful propensity for coming heavy just when it can do most harm. This monopolised the attention of the dealers in low priced meat, who might otherwise have assisted to clear the home produce at some price, and so completed the demoralisation of the market. The Christmas week will long be remembered as one of the most disastrous on record. 99 The supply of mutton has been good throughout the year, but except for two months in the summer the range of prices has been low. Some of the finest mutton in the world is sent to the Central Market, but there also come Dutch, Danish, and Colonial produce. This supplies the wants of so many as to limit the number of buyers who can pay an extra price for a first-class article. The result is that the best class of meat is almost always relatively the lowest in price, and the appreciation of that fact will give an outline of the trade in the best mutton throughout the year. Pork has been a good trade through the fall of the year. It is hoped the prices realised will stimulate production. We have, however, still to complain of the irregularity of the inspection. In some places the heads only of those which are tuberculous are condemned, while other authorities seem too anxious to err on the side of severity. Any little cloudiness of the gland is held to be a tuberculous deposit, and the carcase is seized accordingly. This absence of uniformity is most embarrassing to dealers and bewildering to those who have, like your Inspectors, to occupy a position midway between the slaughterers and the retail trade, and are thus open to the criticism and hostility of both. 3. Foreign-Killed, i.e., Continental, chiefly from Holland, Denmark, and Belgium.—There has been a diminution in the supply of Continental meat to the extent of 1,200 tons, and we are glad to say a much smaller number of diseased pigs. The effect of the Foreign Meat Regulations has been that all Dutch meat sent into this country must bear the label of the Dutch examining officer, although instances occur from time to time showing careless inspection, there is an evident desire on the part of the authorities to conform to our requirements. There has been quite an average supply of pork from Holland, which realised fair prices at the beginning of the year and very good ones at the close. The mutton has been generally good and has probably made quite as much as it was worth. Of Danish meat there has been very little. Denmark has an excellent customer for all its best meat in Germany, where the needs of the population increasing so rapidly in numbers and wealth have absorbed most of what Denmark had to spare. England can only have it when Germany does not want it, or when it is not good enough to go there. There has been the usual autumnal supply of pigs from Belgium, concerning which we are pleased to note that inspection at the port of debarkation and on this side has left little room for criticism, as all the weedy, wasted element seems to have been eliminated. 4. Cattle Imported Alive and Slaughtered at Deptford and elsewhere.—We now come to what has hitherto been a very important branch of the trade, but which seems to be undergoing a change, of which the effects may be serious and far reaching. The ever-increasing population of the United States seems to be rapidly reaching the point at which they will 100 no longer be exporters of meat, but will either have to get some of their supplies from outside or to develop their own resources in some new direction. Hence, the American cattle firms in acquiring and developing the works in Argentina may have some other views than merely capturing the meat trade of England; and if the United States is likely to become an importer in course of a few years, these far-seeing firms may be trusted to be prepared for such an eventuality and quite capable of turning it to their own advantage. In 1905 there were imported into this country from the United States 415,000 bullocks, from Canada 148,000; last year the number from the States was 205,000, from Canada 113,000, and so far as the Central Market is concerned there was a falling off in the supply of English-killed American of 10,054 tons. The carcase butchers have devoted themselves so unreservedly to the "Foreign Cattle Trade" that if they should be unable to persuade the Government to allow the importation of those from Argentina, they will have to turn their attention to our home markets. There is still the same diversity of opinion amongst farmers and stock breeders as to the advisability of admitting Canadian store cattle, so much so, that it is quite curious to hear the different views to which they give expression. It simply amounts to this—those who buy store cattle for feeding want them admitted, as the supply of stores being then larger, they would buy theirs cheaper, and so have wider margin for profit. Those who breed cattle object, as they say that the lower price they would get for their stores would make their business unremunerative. It is evident that someone has to suffer ; the question is, who ? but it is one for themselves, the general public is not interested, as there is nothing in it which would make beef either better or cheaper. The depressed condition of the mutton trade would of itself account for the very small number of sheep sent alive. It is really pitiful to see the fine sheep market at Deptford standing idle and unoccupied month after month. 5. Refrigerated Beef.—The imports of refrigerated beef from the United States have been about one-third of what they were four years ago. At the Central Market the decrease has amounted to nearly 17,000 tons, and unfortunately this does not, by any means, indicate the extent of the fallingoff—which has been more marked in the quality of the meat sent than in the quantity. The firms who import United States beef are all pretty largely interested in the Argentine trade, and seem to be much more concerned in developing it than in bringing meat here from the States. The returns kindly furnished by the Superintendent of the Central Market show that while there has been a falling-off of 10,054 tons in North American (English-killed) and of 16,826 tons in North American chilled—together 26,880 tons, this deficit has been compensated for by an increase of 26,595 tons from Argentina. At the commencement of the year there were several lots of this beef more or less out of condition, and the trade being slow the owners were unable to move it on as rapidly as they would have liked. The 101 consequence was that a considerable percentage had to be condemned. Later on the trade got much firmer, but unfortunately the very hot weather which prevailed in Argentina during June and July made it impossible to reduce the animal heat, with the result that a large quantity of splendid beef was in a putrid condition on its arrival. The fall of the year, though the range of prices has been low, has presented but little difficulty in this way, except when someone forgets that meat is a perishable article and thinks it can be played about with in a refrigerator indefinitely. Some of the importers have felt aggrieved at the seizure of their beef, in consequence of the formations of mould upon it. One feature of especial interest has been the first arrival of chilled beef from Australia. It was brought by the s.s. "Marathon," from Brisbane, and consisted of about 1,200 hind-quarters and 150 fores. The selection was by no means good, some of the quarters being poor little stuff. The contrast in the condition of these and the stouter ones was very marked and formed a fine object lesson of what we have so often insisted upon in these pages, viz., that meat for any system of preservation must be substantial and well-fed to begin with. The journey lasted 62 days, and the method of preservation was that known as the "Linley" system, which consists in sterilizing the air of the chamber. If this experiment is to lead to a successful issue it is an imperative necessity that better beef be shipped. If they send rubbish it will be nothing but rubbish when it gets here, and as such cannot lead to remunerative business. 6. Frozen Meat from New Zealand, Argentina, and Australia.— There has been a very considerable increase in the quantity of both beef and mutton sent by Australia, affording welcome evidence that the effects of the great drought have nearly or quite passed away, and there has also been an enormous quantity of New Zealand lamb, amounting, as we are informed, to over three million carcases. Argentina mutton has been abundant throughout the year, and good in quality. The frozen trade is not well handled ; there are so many intermediaries between the producer and the consumer, all of whom seem to thrive amazingly; some means of reducing these is greatly needed. The regulations of the Local Government Board in respect of Foreign Meat and Unsound Meat have had an excellent effect in curbing that which was fast developing into a source of danger. It is largely owing to these that we show a great reduction in the weight of tuberculous meat seized during the year. Five persons have been summoned for sending diseased meat to the Central Market, and convictions obtained in each case. The following Naval Officers have received instruction in the examination of meat, viz.: 1 Victualling Store Officer, 1 Fleet Paymaster, 8 Staff Paymasters, 5 Paymasters, and 10 Assistant Paymasters, to whom with one exception Certificates of Competency were granted. 102 THE PUBLIC HEALTH (FOREIGN MEAT) AMENDING REGULATIONS, 1909. It having been found, as the result of experience in their working, that the Public Health (Foreign Meat) Regulations, 1908, made by the Local Government Board under the Public Health (Regulations as to Food) Act, 1907, on the 12th September, 1908, required some addition to, or amendment, the Board issued, under date 27th September, 1909, further Regulations, modifying in certain particulars those of 1908. These amending Regulations, which may be cited as the Public Health (Foreign Meat) Amending Regulations, 1909, are to be read into the Regulations of 1908 and into any order made under Article XVI. of those Regulations. (Article XVI. refers, in the case of the City, to the order relating to joint action on the part of the Port Sanitary Authority and the Corporation as the Sanitary Authority for the City.) The following are the additions and amendments comprised in the Amendment Order:— Of the eighteen articles contained in the Regulations of the 12th September, 1908, Article I. only has been varied. This Article contains the definition of foreign meat for the purpose of the Regulation. The substituted Article follows verbatim the terms of Article I. of the Regulations of 1908, except in the cases of paragraphs (h), (i), (j), (k) and (o). (See Appendix, page 162.)* The effect of these amendments is thatcertain "official certificates," declared admissible by notices published in the "London Gazette" for purposes referred to in Article I. of the Regulations of 1908 during the period ending on the 30th September, 1909, will continue to be admissible until by a further notice published in the "London Gazette" it is declared to be so no longer, and the same will apply to any further "official certificates " that may be approved by the Local Government Board: The "official certificates" now recognised relate to meat imported from the following countries—Canada, Denmark, Netherlands, New Zealand, Belgium, Victoria and New South Wales. Scrap meat or trimmings of carcases which contain bone are occasionally imported, which must be considered open to the same objections which attach to the importation of boneless scrap meat. The Amending Regulations apply to meat which consists of scraps, trimmings or other pieces of such shape and such condition as to afford insufficient means of identification, and the restrictions with regard to boneless meat of this class have been extended to such scraps, trimmings, &c., whether or not bone is present. * The full text of the Foreign Meat Regulations of the 12th September, 1908, to which these amendments relate, is given on page 195 of your Medical Officer's Annual Report for that year. 103 The Regulations of 1908 do not require that bacon and ham, or certain salted parts of the carcase of a pig which are prepared in a manner comparable to that in which bacon or ham are prepared, should necessarily be attested by an "official certificate" in evidence of approved inspection in the country of origin as a condition of their importation for human food. In the case of uncertified packages containing pigs' heads and other salted products, however, the meat has on several occasions been found to show evidence of tuberculosis or other disease conditions. In other cases the lymphatic glands, which would naturally be present in the portions of the salted carcase, have been removed before importation in such a way as to suggest that the object of such removal has been to conceal the fact that they were affected by disease, or to prevent any attempt to discover the existence of disease on arrival in this country. In regard to these salted articles the Amending Regulations apply to any severed part of the carcase of the pig which is not contained in a package bearing an "official certificate" in the definition of "Foreign Meat of Class I." if the lymphatic glands about such part are not present in their natural position. The stomachs or "maws" of pigs are sometimes imported, in brine or packed in salt, for human consumption. The Amending Regulations include any salted part of the pig which is not a severed part of the carcase in the definition of "Foreign Meat of Class I." if it is not imported in a package which bears an " official certificate." Foreign bacon, ham, and salted pig products will be detained by Customs Officers on receipt of an intimation from the Medical Officer of Health that he desires to examine salted pig products which arrive from some specified country or port of shipment, or particular consignments of such meat; and your Medical Officer of Health; has accordingly requested Customs Officers in the City to notify him of the importation of any salted pigs stomachs and hog casings arriving from the Continent. The Amending Regulations also include any meat which comprises the ribs, but which on importation is ascertained to be without the pleura in the category of "Foreign Meat of Class I." This will restrict the importation of meat, especially beef, in the form of carcases, or portions of carcases from which the pleura or lining membranes of the thorax have been stripped, such removal of the pleura having been frequently practised in order to conceal evidence of disease conditions. These Amended Regulations will be most useful in preventing danger to the public health arising from the importing of the several kinds of meat foods referred to therein. 104 FOREIGN MEAT REGULATIONS. SHEEP AND OX LIVERS. On the 4th November last the Local Government Board directed attention to the terms of the following Order which was stated to have been circulated to the Meat Inspectors of the different packing houses in the United States:— Certification of Edible Organs for Export. "The Port Medical Officers at London, England, recently inspected "on arrival 280 cases of ox livers and 300 cases of lamb livers, bearing the "authorised American marks of inspection. About 20 per cent. of the "lamb livers and about 30 per cent. of the ox livers were alleged to be "diseased and were condemned because sections of the organs had been "removed. In view of these circumstances Bureau Inspectors are "directed in future not to certify for export edible organs, such as "livers, which have been mutilated, or from which portions have been " removed." It is clear that all organs from which sections have been removed should be rejected, the inference being that they were excised in order to remove evidence of disease. The Board are of opinion that if the Order referred to above is effective in practice and the offal from the United States is satisfactorily packed in the manner indicated by their instructions, the inspection of this material under the Foreign Meat Regulations will apparently be facilitated. PIGS' STOMACHS. On the 5th November the Board further advised your Medical Officer that consignments of pigs' stomachs, packed in salt, had been objected to in Manchester for the double reason that they showed signs of gastritis (possibly associated with epidemic swine erysipelas), and also because they were imported without an official certificate. These "maws" were imported from Hamburg and packed in rough salt. They were in barrels, which in the Bill of Entry were stated to contain "sausage skins.'' The necessity for strict supervision over this class of imported meat was shown on 12th October last when two barrels of pigs' stomachs, packed in rough salt, consigned from abroad to a dealer in Bermondsey who sent them to the Central Market, were seized on account of putridity. It was stated that these stomachs were intended for use as casings for filling with chopped meat and other ingredients, but no information as to what port they came from was obtainable. As it was possible that this term might be used to cover similar importations in the City, the Customs Authorities were requested to detain any uncertified pigs' stomachs or "sausage skins" which do not seem to justify that description. 105 IMPORTATION OF CHINESE PORK. On the 24th July last, the s.s. Palermo, from China, arrived at the Royal Albert Docks with a large number of frozen pigs' carcases on board. In accordance with the Foreign Meat Regulations, notice was served upon the owners by the Customs prohibiting the removal of the pigs, and the Medical Officer of the Port was also notified of their arrival. As trichinosis is common among Chinese pigs, Dr. Williams, Medical Officer at the Port, examined, microscopically, portions of the diaphragm and other muscular tissues from 100 pigs, but without finding any indication of trichinae. Owing to there being insufficient accommodation at the cold air stores at the Port at the time of the ship's arrival, and the delay to the ship that would have been incurred in examining the pigs on ship board, the owners were permitted to remove the whole consignment to cold air stores in the City, when the carcases were thawed out from time to time as the market required and examined by your Officers. The result of this inspection was as under:— Received at the cold air stores in the City 4,641 Passed as fit for food 4,250 Condemned as unfit for food 391 Percentage condemned 8.4 Each carcase had a label attached stating that it had been "medically examined, and certified free from disease," but it was evident that this inspection was very incomplete, as many of the pigs were found to be tuberculous and were consequently seized. Many severe comments with regard to the importation of Chinese pork appeared in the Press and elsewhere. There seems to have been a general impression that it was not unlikely that, as pigs in China generally act as scavengers, the consignment might have consisted of pigs of that class. This view appears to have been erroneous, as the President of the Local Government Board confirmed, by reference to the British Consul at Hankow, the statement made by the importer that the pigs in question were country bred and fed on rice. The animals were of the black and white variety and raised in the district between Tunting Lake and Lokow, where the pig breeding industry is a very large one, and where the best class of pigs are reared. They were brought down to Hankow by boat and there killed, and examined as previously referred to. 106 Owing to the size and fatness of these pigs they were unsuitable for marketing as fresh or salt pork, and nearly the whole consignment was converted into bacon which, I am informed, fetched a fair price. There seems to be no object whatever in shipping a diseased pig, as the suppliers are under contract to take back all pigs rejected by the local examiner. When asked in the House of Commons as to whether or no it was possible to distinguish Chinese Pork when exposed for sale from English or Irish pork, the President of the Local Government Board replied : "I do not think it would be possible to distinguish Chinese Pork from "English or Irish, except in its fresh or uncured condition, when the "Inspector might be able to say that the pork had been frozen, and " therefore was probably not English or Irish." In view of the importance of this question of the wholesale import of more or less doubtful pigs from China, the Court of Common Council referred the whole question of imported Chinese pigs to the Sanitary and the Port Sanitary Committees for consideration and report. IMPORTATION OF IMMATURE CALVES. Adverting to a note in the Report for 1908 in which it was stated that the attention of the Netherlands Government had been directed to the exportation from that country of immature calves, some correspondence on the subject ensued between myself and the Consul-General for the Netherlands in this country. I have since been informed that according to a Ministerial Resolution of the 29th November last, the Government Inspectors are not allowed to pass for export to Great Britain and Ireland, calves which, without heart, skin and intestines, weigh less than 21½ kilos., equivalent to 47.3 lbs. This is satisfactory as being approximate to the minimum weight allowed to be sold in the City, viz., 48 lbs. IMPORTED PARASITIC COLONIAL BEEF. In November last a question of some importance arose in connection with a consignment of Queensland beef, as a large percentage of it was found to contain a parasite embedded in (a capsule lying in the connective tissue between the fatty and muscular layers of the flank and brisket. 107 When the meat is thawed its presence can be easily felt by passing the fingers over the surface, but it cannot be readily detected when the meat is in a frozen condition. As the lesion is confined to certain parts of the carcase, and the thawing of the whole would involve considerable loss, I arranged to meet the convenience of the Trade by directing the removal and thawing out of the flanks and briskets only. When possible, the parasite was removed with a small portion of the surrounding tissue, the rest of the meat being passed for food. In some cases the organisms were so numerous that their removal would have practically left nothing ; in these the whole of the meat was condemned. The parasite in question is not found in this country, and appears to be confined to certain localities in Australia. It has been identified by Mr. A. E. Shipley, F.R.S., of Cambridge, as the worm described by Neumann as the Spiroptera reticulata,* and by Leiper as Onchocera reticulata. TUBERCULOUS MEAT. RE-ISSUE OF ADVISORY CIRCULAR. In March, 1903, in view of the gross ignorance prevailing amongst small farmers and butchers in country districts as to the signs of tuberculosis, both in live animals and in carcases of animals after slaughtering, a circular letter on the subject, together with observations thereon by your Medical Officer and Veterinary Inspector, was largely circulated. Copies of this circular have been in constant request ever since, and last year the supply was exhausted. As their distribution has been attended by excellent results, the Sanitary Committee, upon your Medical Officer's recommendation, sanctioned a reprint of 4,000, containing as additional information an extract from leaflet No. 100, published by the Board of Agriculture and Fisheries (revised May, 1907), describing the character of tuberculosis in pigs, giving warnings against feeding the animals on refuse milk and diseased offal from tuberculous cattle, and recommending improved sanitation and periodic disinfection of the premises where pigs are kept, and the disinfection of all empty pens before the introduction of fresh stock (see Appendix 167). Copies of this circular were sent to the salesmen in the City markets for distribution amongst their customers sending meat from country districts, and to others interested in the matter. * A treatise on the Parasites and Parasitic Diseases of the Domesticated Animals, Neumann— Macqueen. Second Edition. Published by Baillifere, Tindall and Cox, London. 108 MEAT MARKING BILL. On the 29th April, 1909, a Bill was introduced in the House of Lords, providing for the marking of all imported meat and for the registration of dealers in such meat. It was known as the Meat Marking Bill, and provided that it should be the duty of the Commissioners of Customs to see that all meat imported dead is marked in the country of origin with the word "foreign" or "colonial" in printed capital letters. In the case of meat imported in wrappers, each wrapper was also to be marked in a similar manner. Every carcase was also to be so marked that when cut up in the ordinary way each separate joint would bear those words or part of those words. It was made the duty of the Commissioners of Customs to see that all imported dead meat is so marked before it leaves the wharf. In the case of animals imported alive for slaughter, the carcases were to be similarly marked before removal from the abattoirs adjoining the place of debarkation. There was a clause in the Bill making it compulsory for every vendor of foreign and colonial meat to affix the words "Dealer in Foreign and Colonial Meat" on his shop, stall, vehicle or place where such meat is sold, offered, exposed or kept for sale. Local Authorities were to be required to keep a register of all dealers in foreign and colonial meat within their districts. It was made the duty of every Local Authority to see that the provisions of the Bill were enforced, failing which the Board of Agriculture and Fisheries were empowered by order to execute and enforce the same at the expense of the Local Authority. The Commissioners of Sewers were defined as the Local Authority within the City and its liberties, and the London County Council for the rest of the County of London. The reference to the late Commissioners of Sewers is a curious error on the part of the draughtsman. The words "Corporation of London" should have been substituted. The Bill was withdrawn on the 19th May, 1909, without being read a second time, but I understand it will be introduced in the Commons next Session. This measure is presumably advocated in the interest of British agriculturists, but it would have been more to the purpose if the inspection and marking of all British meat were made compulsory. 109 SALE OF FOREIGN MEAT AS ENGLISH. As bearing upon the foregoing, the following note taken from the Annual Report (1908) of the Intelligence Department of the Board of Agriculture and Fisheries is of public interest: "The attention of agriculturists was drawn this year to the sale of "foreign meat as English by a law suit against a meat salesman, in the "course of which it was stated for the defence that it was the custom of "the trade to describe as English the meat of animals imported from "abroad and slaughtered at the point of landing, and several complaints "on this subject were received by the Board. "The Board enquired into these complaints to ascertain if there was "any evidence of an offence against the Merchandise Marks Acts, but "without result. As a general rule, butchers do not 'apply' within "the meaning of the Merchandise Marks Acts any description whatever "to their meat, and if they did it would still be very difficult to obtain "evidence to prove that the meat to which the description 'English' " was applied was, in fact, foreign." With a Meat Marking Act in force, this abuse could not exist. CERTIFICATION OF MEAT PRODUCTS FOR EXPORT. In the Annual Report for last year reference was made to the appointment of your Medical Officer by the Local Government Board as " Certifying Officer" in relation to the export of meat products to Argentina, and the United States of America and the Philippine Islands. During 1909, 64 certificates were issued, 41 of which were in connection with exports to Argentina, and 23 with exports to the United States of America and the Philippine Islands. These certificates are issued in accordance with Regulations prescribed by the Local Government Board, and no case has arisen where it has been necessary to refuse to grant a certificate. MEAT INSPECTORS' OFFICES. During the year, in consequence of the Corporation requiring for market purposes the space occupied by the Meat Inspectors' offices in the Central Avenue at Smithfield Market, other accommodation for the purpose was acquired at No. 62, Long Lane, to which the staff were transferred in January last year. Increased office accommodation has been further necessitated by the appointment of a Veterinary Surgeon, and arrangements have been made for surrendering the lease of the premises at No. 508, in the Western end of the Market, and moving into more extensive premises in the Fish section. 110 *Table showing the average deliveries at the Central Meat Market, and other details for successive quinquennial periods during the past 35 years:— Quinquennium. Annual Average General Supply. Seizures by Inspectors. % of Bad Meat. Tons cwts. qrs. Tons cwts. qrs. 1874-1878 178,373 10 0 192 18 2 •108 1879-1883 218,200 12 3 282 11 2 •129 1884-1888 249,580 19 2 248 1 2 •099 1889-1893 304,986 5 1 461 15 1 •151 1894-1898 372,440 12 2 749 3 3 •201 1899-1903 410,456 18 1 1,082 13 2 •263 1904-1908 414,906 11 1 1,584 19 3 •382 Year 1909 420,059 14 2 1,505 0 2 •358 The sources of origin of the Central Market Supplies during the past five years are here expressed in terms per cent. of total annual deliveries. British. †Foreign Killed. Amebican. Australian and New Zealand. Country Killed. Town Killed. Home Killed. American Killed. Per cent. Per cent. Per cent. Per cent. Per cent. Per cent. 1905 18.2 3.6 12.7 17.8 24.4 23.3 1906 17.2 3.4 11.1 17.3 26.0 25.0 1907 17.4 31 13.1 16.1 24.6 25.7 1908 17.3 4.2 14.3 13.4 26.1 24.7 1909 17.8 4.9 13.6 10.6 27.5 25.3 † Includes "General Foreign Meat and Produce." Some idea of the amount of the work of your Inspectors of Slaughterhouses and Meat may be obtained from the following figures supplied by the Superintendent of the Market:— 1906. 1907. 1908.  Average daily delivery into the Markets Tons. 1,375 Tons. 1,358 Tons. 1,335 Tons. 1,368 Minimum delivery on any one day 186 204 192 229 Maximum delivery on any one day 2,607 2,594 3,235 3,918 The heaviest weight previously recorded on any one day (21st December, 1896) was 4,159 tons. One ton in every 278 tons of meat paying toll in the Central Markets, Smithfield, was condemned last year, as compared with one ton in 319 in 1908. * I am indebted to the Clerk and Superintendent of the Central Markets for the figures relating to the market supplies, sources of origin, &c. 111 UNSOUND MEAT, 1909. The meat, &c., seized by your Inspectors as unfit for food is classified as under:— 1908. Diseased. Unsound. Unwholesome. Poultry. Offal. Fish. Total. tons. cwts qrs. lbs. tons. cwts. qrs. lbs. tons. cwts. qrs. lbs. tons. cwts. qrs lbs. tons owts. qrs. lbs. tons. cwts. qrs lbs. tons. cwts. qrs. lbs. First Quarter 28 19 3 15 326 17 1 7 22 12 0 6 6 2 1 8 22 4 1 2 0 0 3 21 406 16 3 3 Second „ 19 7 1 21 374 18 2 24 27 3 0 20 6 6 3 24 23 0 2 7 1 11 2 6 451 8 1 18 Third „ 13 18 1 17 287 13 1 8 7 0 2 23 15 6 2 0 58 10 0 12 0 0 0 0 382 9 0 4 Fourth „ 50 3 2 6 134 9 0 19 18 6 0 22 17 1 0 11 39 18 0 5 2 11 3 4 262 9 3 11 Total 112 9 1 3 1123 18 2 2 75 2 0 15 43 16 3 15 143 12 3 26 4 4 1 S 1503 4 0 8 The above figures include 33,836 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:— Tear. Diseased. Unsound.* Unwholesome. Per Cent. Per Cent. Per Cent. 1904 13.9 78.8 7.2 1905 7.9 88.4 3.7 1906 8.6 88.1 3.3 1907 15.1 77.4 7.5 1908 14.2 78.2 7.5 Average for 5 years 11.9 82.2 5.8 1909 7.5 87.5 5.0 * Including poultry, offal and fish. The percentage of diseased meat seized was the lowest yet recorded in the City. TUBERCULOUS MEAT. Of the 112 tons of diseased meat seized during the year, 56 tons, or 50 per cent., was found to be tuberculous, the percentage during the preceding three years 1906, 1907 and 1908 being 29, 56, and 54 respectively. The following are the details of these seizures in 1909:— 1,182 pigs weighing lbs. 117,795 Pieces of pork ,, 2,847 58 plucks and livers ,, 422 Pieces of veal ,, 133 * 7 carcases of beef ,, 4,060 4 quarters and pieces of beef ,, 1,136 5 calves ,, 437 126,830 Total weight 56 tons, 12 cwts. 1 qr. 18 lbs. 112 CENTRAL MARKETS, SMITHFIELD. Table showing Weight of Meat delivered, and Meat seized as unsound, during each Month of the Years 1908 and 1909. Month . Meat delivered at the Market, 1908. Meat seized by the Inspectors, 1908. Meat delivered at the Market, 1909. Meat seized by the Inspectors, 1909. Tons cwts. qrs. Tons cwts. qrs. Tons cwts. qrs. Tons cwts. qrs. January 37,287 14 0 101 15 I 35,481 18 0 94 8 0 February 32,810 3 0 90 5 0 32,525 13 1 133 16 0 March 35,538 7 0 75 6 2 36,488 18 1 192 19 1 April 34,508 17 3 113 5 3 34,968 14 3 236 18 1 May 32,690 13 2 82 8 3 32,438 5 2 95 15 2 June 32,025 6 3 62 4 3 36,137 18 2 132 5 0 July 32,917 0 1 141 3 1 35,303 19 0 125 7 3 August 30,258 4 2 100 0 0 31,650 12 0 130 18 2 September 32,788 2 2 102 17 3 34,990 7 0 104 4 0 October 36,338 1 1 199 5 0 34,559 1 1 126 2 0 November 34,733 14 0 82 5 1 36,513 3 0 70 9 3 December 37,835 15 2 132 19 1 39,001 4 0 61 16 2 Totals 409,732 0 0 1,283 16 2 420,059 14 2 1,505 0 2 DISEASED MEAT PROSECUTIONS, 1909. Date of Hearing. Where Heard. Before whom. Occupation of Person Summoned. Defendant's Place of Business. Result. 1909. Mar. 25 Guildhall Mr. Ald. Charles Johnston. Hide and Skin Dealer. Canterbury Fined £10 and £1 Is. expenses. June 15 Do. Ald. Sir Charles C. Wakefield, Knt. Wash Dealer Merton Road, Wandsworth Fined £50 and 15a. expenses. ,, 17 Do. Mr. Ald. Charles Johnston. Dairyman Mill Hill, Hendon Fined £20 and £2 12s. expenses. ,, 17 Do. Ditto Pig Dealer Stonebridge Park, Harlesden. Fined £10 and £2 17s. expenses. Dec. 15 Do. Ald. Sir Charles C. Wakefield, Knt. Do. Bures, Suffolk Fined £40 and £4 expenses. In addition to the above there were five cases which, upon enquiry, Mr. Solicitor did not find sufficient evidence to justify a prosecution. The average of fines and expenses was £28 5s. 0d. 113 FISH SUPPLIES. 248,075 tons of fish, of which 179,157 were land-borne and 68,918 water-borne, were received at or near Billingsgate Market during the year. Of the above, 196,321 tons were consigned to Billingsgate Market, the remainder, viz., 51,754 being delivered at the salesmen's shops in the neighbourhood of the Market. Tear. Fish Delivered at Billingsgate Market. Fish Delivered in the neighbourhood of Billingsgate Market. Total Deliveries. Tons. Tons. Tons. 1908 *93,821 47,366 †241,187 1909 *196,821 51,754 †248,075 2,500 increase 4,888 increase 6,888 increase * Extracted from the Annual Reports of the Clerk of the Market. There was an increase of 1,265 tons in the land deliveries, and 5,623 tons in the deliveries by water. MONTHLY FISH RETURNS, 1909. 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 1909.† month. Weight of Fish Delivered. Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. Tons. Tons. Tons. Tons. cwt. qrs. January 14,832 4,130 18,962 17 10 1 1 in 1,083 tons, or 092 per cent. February 15,303 5,490 20,793 20 1. 2 1 „ 1,036 „ .097 „ March 16,401 6.840 23,241 36 11 3 1 „ 635 „ .157 April 15,156 5,902 21,058 97 0 2 1 ,, 211 ,, .460 „ May 15,822 5,479 21,301 76 13 0 1 „ 278 „ .360 „ June 16,602 6,687 22,289 107 18 1 1 „ 206 „ .484 „ July 17,199 5,673 22,872 123 5 1 1 „ 186 „ .589 „ August 14,985 6,437 21,422 196 4 0 1 „ 109 „ .916 „ September 14,649 7,075 21,724 96 3 1 1 „ 226 „ .443 „ October 11,667 5,424 17,091 73 6 2 1 „ 233 „ .429 „ November 13,482 5,497 18,979 71 5 1 1 „ 266 „ .376 „ Deceuber 13,059 5,284 18,343 30 16 3 1 „ 595 „ .168 „ Total 179,157 68,918 248,075 946 15 1 1 in 262 tons, or .382 per cent. t Compiled from the Monthly Returns furnished to the Corporation by the Fishmongers' Company, 114 Monthly Deliveries of Fish at London Central Markets, Smithfield, 1909. Tons Cwts. Qrs. January 142 5 0 February 156 13 0 March 153 15 0 April 149 10 0 May 145 7 0 June 173 2 0 July 170 12 0 August 106 13 0 September 120 12 0 October 153 11 0 November 140 10 0 December 154 8 0 1,766 18 0 Of the above, 6 tons 10 cwts. 0 qrs. 3 lbs. were seized by your Officers, and those of the Fishmongers' Company as unsound, equal to .367 per cent. or 1 ton in 271 tons. Weight of Fish Delivered, Fish seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market during 1909 and the five tears 1904-1908. Year. Weight of Fish Delivered. Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. 1904 Tons. Tons. Tons. Tons cwts. qrs. 1 ton in 222 tons, or .45096 185,872 57,934 243,806 1,098 0 2 1905 164,016 47,626 211,642 674 3 2 1 „ 314 „ .318,, 1906 157,591 55,483 213,074 1,444 17 3 1 „ 147 „ .678 „ 1907 162,115 71,630 233,745 783 16 0 1 „ 297 „ .335,, 1908 177,892 63,295 241,187 1,236 12 3 1 „ 195 „ .511,, Average (5 years) 169,497 59,194 .228,691 1,047 10 0 1 ton in 218 tons, or .458 % 1909 179,157 68,918 248,075 946 15 1 1 ton in 262 tons, or .383 % 115 INSPECTION OF FOOD AT RIVERSIDE WHARVES, &c. As the result o£ the daily inspection of the City wharves, 127 loads of unsound food were removed from these places during the year by the Cleansing Department. The material so disposed of comprised:— • Tons Cwts. Qrs. Tinned fruit and vegetables 22 7 2 Condensed milk 11 14 2 Miscellaneous tinned food 50 16 3 Fruit pulp 27 0 1 Fruit and vegetables 14 10 2 Miscellaneous food 6 14 3 Total 133 4 1 The greater portion of the above was removed at the written request of the owners. Section 47 (8) of the Public Health (London) Act, 1891, provides that— "Where a person has in his possession any article which is unsound "or unwholesome or unfit for the food of man, he may, by written "notice to the Sanitary Authority, specifying such article, and containing "a sufficient identification of it, request its removal, and the Sanitary "Authority shall cause it to be removed as if it were trade refuse." This provision takes away the ground of a common defence in prosecutions for being in possession of unsound food. It has often been suggested that the food was set aside with the intention of destroying it before it was discovered by the Inspector. This power to notify to Sanitary Authorities under this section affords a test where this line of defence is adopted. Additional powers with regard to dealing with imported food have now been conferred upon your Officers by the Regulations made by the Local Government Board under the provisions of the Public Health (Regulations as to Food) Act, 1907. 116 SALE OF FOOD AND DRUGS ACTS. During the year 1,191 articles of food and drugs were analysed under the Sale of Food and Drugs Acts, 1875 to 1899. Of these, 39, or 3.27 per cent., were certified by the Public Analyst to be adulterated*, or not up to standard, as compared with 6.59 per cent. in 1908. A summary of the Quarterly Reports made during the year by the Public Analyst in accordance with the provisions of Section 19 of the Food and Drugs Act, 1875, is given on pp. 136, 137. Table I. The figures for the last nine years are here given:— Year. No. of Samples taken. Found Genuine. Found Adulterated. Percentage of Adulterated Samples. 1901 854 742 112 13.11 1902 1,248 1,138 110 8.89 1903 1,179 1,081 98 8.31 1904 1,035 978 57 5.50 1905 1,102 1,040 62 5.62 1906 1,030 962 68 6.60 1907 1,092 1,019 73 6.68 1908 1,183 1,105 78 6.59 1909 1,191 1,153 39 327 9,914 9,219 697 7.03 Table II. For the purpose of comparison the following Table is given showing the percentage of adulteration in England and Wales since 1877. These figures are abstracted from the Annual Reports of the Local Government Board:— Per cent. Quinquennium 1877-81 16.2 „ 1882-86 13.9 „ 1887-91 11.7 „ 1892-96 10.6 „ 1897-1901 9.0 „ 1902-1906 8.5 Year1907 8.1 1908 8.5 * Throughout this Report the term "adulterated " includes samples found to be not up to standard. 117 The accompanying Table has been partly compiled from the Annua 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 c a .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 86,182 1,102 1.28 377 20 211 1906 90,504 1,030 1.20 359 20 203 1907 93,716 1,092 1.16 347 19 188 1908 95,664 1,183 1.23 340 16 188 1909 97,985 1,190 1.31 330 15 202 * 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. It will be seen from Table I. on the previous page that there was a marked decline during the year in the percentage of adulterated articles, having fallen from 6.59 per cent. in 1908 to 3.27 in 1909, the lowest recorded since I have held office. 118 Table II. shows that this reduction in the proportion of adulterated Food and Drugs sold has been general throughout the country since 1877, and has been in direct proportion to the activity displayed by local authorities in the administration of the law. In this connection Dr. Teed's remark in commenting on the low percentage of adulteration during the Quarter ended the 30th September last, when it had fallen to 1.3 per cent., may be quoted:— "This is the lowest figure I have as yet been able to report, and I "hope that it will so continue, but my experience does not lead me to "expect it. Adulteration seems occasionally to approach vanishing point, "only to break out later with renewed vigour." MILK. It is satisfactory to note a further decrease in milk adulteration during 1909, as shown by the following Table:— Year. No. of Samples Examined. Found Genuine. Found Adulterated. Percentage of Adulterated Samples. 1901 392 209 83 21.2 1902 599 519 80 13.3 1903 517 457 60 11.6 1904 452 417 35 7.7 1905 481 445 36 7.5 1906 556 513 43 7.7 1907 472 432 40 8.4 1908 469 440 29 6.2 1909 520 495 25 4.8 From this it will be seen that the percentage of adulterated samples was the lowest recorded since 1901, when it was no less than 21.2 per cent. No sophistication of this article other than its impoverishment by watering or skimming, or both, was reported during the year. The added water found varied from 5 to 38 per cent., and the abstraction of fat from 7 to 40 per cent. One sample contained 23 per cent. of added water, and 32 per cent. of fat had been abstracted. Traces of boric acid were found in two cases. The following Table shows the relation between place of purchase and adulteration:— Where Purchased. No. of Samples taken. No. Adulterated. Percentage of Samples Adulterated. 1908. 1909. 1908. 1909. 1908. 1909. At shop 372 488 20 21 5.4 43 In the street 65 18 6 1 9.2 55 During delivery 32 14 3 3 9.4 214 Total 469 520 29 25 6.2 4.8 119 These figures show a decrease in the proportion of adulterated samples taken at shops and in the streets, and a marked increase amongst those taken during delivery. Of the 25 samples reported against by the Public Analyst, the vendors of 19 were proceeded against, and in four of these, or 21 per cent., the cases were dismissed on proof of warranty. The offence in five cases consisting in adding water, in 13 in the removal of cream, and one sample, as before mentioned, was both skimmed and watered. The vendors of six samples were cautioned. The penalties imposed upon offenders on conviction varied from £20 and £3 3s. expenses to s. and 18s. 6d. expenses. One summons was dismissed upon technical grounds. At the instance of the Intelligence Division of the Board of Agriculture and Fisheries, 120 samples of condensed milk (including dried milk) were taken during 1909 under Section 1 of the Sale of Food and Drugs Act, 1899. In three cases it was found that the condensed or dried milk had been prepared from skimmed milk and the packages were not labelled "machineskimmed milk," or "skimmed milk," as required by the Act. In these cases proceedings were instituted by the Customs Authorities and convictions obtained. Thirty-eight samples of fresh milk were also taken by the same authority, and one sample of tinned sterilised milk was reported as being deficient in fat. PRESERVATIVES IN CREAM. Of recent years the sale of cream in small vessels has greatly extended, especially during the summer months. By far the larger proportion of this material contains some boron preservative, the addition of which it is claimed by the traders is rendered necessary by the exigencies of their business in this article. It is unfortunate from a public health point of view that Sec. 6, Sub-sec. 1, of the Sale of Food and Drugs Act, 1875, sanctions the addition of preservatives in cream when prepared as an article of commerce, provided that the preservative is not present in such amount as to render the cream injurious to health. A Departmental Committee of the Board of Agriculture appointed in January, 1901, to enquire into the use of preservatives and colouring matter in food, recommended in the case of cream "that the only preservative which "it shall be lawful to use be boric acid or mixtures of boric acid and borax, "and in amount not exceeding 0.25 per cent. expressed as boric acid." 120 "The amount of such preservative to be notified by a label upon the " vessel." Although the Board of Agriculture have power to adopt this recommendation under Sec. 4 of the Food and Drugs Act, 1899, which enables them to make regulations determining, inter alia, what addition of extraneous matter in cream shall for the purposes of the Sale of Food and Drugs Acts raise a presumption, until the contrary is proved, that the cream is not genuine or injurious to healthy the Board have not thought it desirable to do so. Great uncertainty and much litigation having occurred in relation to what addition of preservative renders such an article of food injurious to health, the Local Government Board, who have power to make regulations with regard to food under the Public Health (Regulations as to Food) Act, 1907, directed Dr. Hamill to specially investigate and report upon the use of preservatives in cream, with a view to the Board making regulations on the subject if necessary. Dr. Hamill's report, dated 11th August, 1909, contained the following recommendations:— (1) In the interest of the public health and of the consumer, and also with a view to removing difficulties which traders in cream are experiencing on account of present uncertainties, it appears desirable that effect should be given (subject to (2) below) to the recommendations made by the Departmental Committee on Preservatives in 1909, that the only preservative to be used in cream should be boric acid, borax, or mixtures of these boron preservatives ; that a maximum limit of boron preservatives calculated as boric acid (H3BO3) should be prescribed; and that the presence of boron preservatives should be in all cases declared. These provisions should also apply to clotted cream. (2) An exception might, however, be made in respect of the use of hydrogen peroxide, the addition of which to cream might be permitted, provided that only traces were allowed to remain in the cream. (3) It appears desirable that the question of issuing regulations in this matter should receive the Board's consideration, and that account should be taken of the following points:— (a) The declaration of the presence of preservative to the purchaser, whether wholesale or retail, should in all cases be adequate, and the preserved cream as an article of commerce should be differentiated from cream which contains no added preservative. 121 (b) In the case of boracised cream, the maximum amount of boron preservative, calculated as boric acid (H3B03), should be 0.4 per cent. from May to October inclusive, and 0.25 per cent. during the remainder of the year. (c) Cream in which boron preservatives are permitted subject to the above limits should in all cases contain at least 40 per cent. of milk fat. (4) Having regard to the use of sweetening agents, such as saccharine, to conceal sourness of cream and to impart an unnatural sweetness, it appears desirable that their presence should be notified to the purchaser. Although the introduction of chemical preservatives into any article of food (other than salt and saltpetre in the case of meat) is to be deprecated as a general principle, I consider the suggested regulations will, in the main, meet the difficulty. The proposal contained in Article (1), "that the presence of preservatives in cream should in all cases be declared," should, however, be modified so as to agree with the recommendations of the Departmental Committee, which, as will be seen above, advised that the amount of preservative should be notified on a label upon the vessel. Many firms at the present time declare the presence of preservative in cream by means of a label on the vessel containing it, but in most of these cases the notice is printed in microscopically-sized characters, and is therefore likely to be overlooked by the purchaser. If the declaration of the addition of a preservative is made obligatory, it is essential that it should be adequate. Dr. Hamill suggests that the labels used should be in a prescribed form to be affixed to every receptacle in which the cream treated with preservative is sold. If this method is adopted the declaration will be a real one, and not as now obtains, an attempt to evade the provisions of the Food and Drugs Acts. It would serve a useful purpose for the Local Government Board to adopt another recommendation contained in the Report of the Departmental Committee, viz.:— "That the artificial thickening of cream by any addition of gelatine "or other substance, shall raise a presumption that the cream is not "genuine." It should be remembered that hitherto the Board of Agriculture and Fisheries were the only statutory authority empowered to make regulations with regard to preservatives or colouring matter in cream. This authority may, if they think fit, adopt Dr. Hamill's recommendations and thereby give them a legal value, but no regulations that may be made by the Local Government Board under the Public Health (Regulations as to Food) Act, 1907, can be read into any of the Sale of Food and Drugs Acts now in force. 122 Further, in any regulations for dealing with this question made under the Public Health (Regulations as to Food) Act, provision should be made, as obtains in the Sale of Food and Drugs Acts, for the due protection of the vendor, viz., for division of the sample, and for the proper qualification of the analyst employed. In order to determine the extent to which preservatives were used in preparing cream for retail in the City, and also to ascertain the quality of the article as usually sold, twelve samples were purchased from various shops and submitted to your Public Analyst for examination. The results found are given on page 123. It. will be seen that, with the exception of the samples obtained from the Express Dairy Company and Welford and Sons (Samples 955 and 963 respectively), all the samples contained boracic acid preservatives, but that in three cases only was the amount found in excess of the limit recommended in the Departmental Committee's Report. The percentage of fat was also determined in each instance, the amount varying from 32.4 to 62.1 per cent., the average being 49.5 per cent. It is upon the amount of fat contained in cream that the richness or strength of the article depends. The amount of fat present in these samples is practically the same as that found in samples reported upon by Dr. Hamill, who gives 50 per cent. as the usual amount; but the greatest amount found in the City, viz., 62.l per cent., is 3.1 per cent. in excess of the largest amount present in Dr. Hamill's samples, viz., 59 per cent. A minimum limit of 40 per cent. of fat has been fixed by the British Farmers' Association for cream exhibited at the Dairy Show. In five of the ten samples containing boric acid, its presence was notified by label on the vessel containing the cream. Four of the samples were sold "loose"; six were contained in earthenware jars or pots; and two were in paper receptacles impregnated with paraffin wax—a method which has been recently introduced. Six of the twelve samples were described on labels as "Preserved Cream," although in each instance "Cream '' only had been asked for. Since the decision of Cullen v. McNair, some dealers have intimated on the label that boracised cream is not suitable for infants and invalids. Five of the samples were so labelled. The results given in the table are confirmatory of those found by Dr. Hamill, and point to the same conclusion, viz., that while some firms can and do supply cream that is free from preservatives, most of that sold is boracised, some to an excessive extent: for instance, one sample, No. 960, contained 0.62 per cent. boric acid, equivalent to no less than 43.4 grains to the pound. The dose of boric acid as given in the British Pharmacopoeia is from five to 123 fifteen grains. It is therefore necessary that the use of boron compounds and other preservatives in cream should be regulated by statutory authority. In each instance the attention of the firms concerned was called to the above facts. No. of Sample. Date of Purchase. By whom the Cream was prepared. Copy of Labels on Sample. Fat Content. Nature and Amount of Preservative, if any. 1909. Per cent. Per cent. 955 Oct. 4 Express Dairy Co., Ltd., 58, London Wall. "Pure Rich Cream. This Cream is Guaranteed Pure and Free from Preservatives. It is therefore intended for Immediate use." 42.3 No preservative present. 956 „ 4 Turner's Cheshire Dairy Co., Granby Street, Hampstead Road, N.W. "Rich Cream containing a small percentage of Boron Preservative to retard sourness." "Rich Preserved Cream. This Cream contains a small proportion of Boron Preservative (not exceeding half of one per cent.) to keep it sweet and wholesome, which has been the recognised method of preservation for over 20 years. Fresh Cream without preservative is recommended for children and invalids, and this Cream, therefore, is not sold for their use." 48.8 0.15 Boric Acid. 957 4 The West Surrey Central Dairy Co., Guildford. "Preserved Pure Rich Cream. This Cream contains a small percentage of Boron Preservative. See label on back." From label on back.—"This Cream contains a small percentage of Boron Preservative (not exceeding one-half of one per cent.) to keep it sweet and wholesome, which has been the recognised method of preservation for over 20 years." Note.—Sterilized Cream, which can be supplied if specially ordered, is recommended for invalids and children instead of preserved Cream. 51.6 0.24 Boric Acid. 958 ,, 4 Free and Co., 38, Leadenhall Market. Unlabelled. Cream served "loose." 32.4 0.10 Boric Acid. 959 ,, 4 Friern Manor Dairy 3, Ship Tavern Passage. "Thick Rich Cream." 621 0.33 Boric Acid. 960 „ 4 Crowson and Sons, 61, Charterhouse Street. "The Surrey Cream of Creams Brand." "Preserved Cream.—This Cream contains a small proportion of Boron Preservative (not exceeding one-half of one per cent.) to keep it sweet and wholesome, which has been the recognised method of preservation for over 20 years. Cream without preservative is recommended for children and invalids, and this Cream, therefore, is not sold for their use." "Rich Preserved Cream.—The Cream of Creams.—This Cream contains a small proportion of Boron Preservative (not exceeding one-half of one per cent.) to keep it sweet and wholesome, which has been the recognised method of preservation for over 20 years. "Cream without preservative is recommended for invalids and children." 47.8 0.62 Boric Acid. 124 No. of Sample. Date of Purchase. By whom the Cream was prepared. Copy of Labels on Sample. Fat Content. Nature and Amount of Preservative, if any 1909. Per cent. Per cent. 961 Oct. 4 Cream Dairy Co., 2½, St. Andrew's Hill. "Preserved Cream.—This Cream contains a certain quantity of Boracic Preservative to retard sourness, in accordance with the practice of the last 12 years, and it is not generally recommended for invalids or infants. C. D. Co., Ltd." 51.0 0.15 Boric Acid. 962 „ 4 E. H. Jones, 98, Shoe Lane. Unlabelled. Cream served "loose." 47.0 0.18 Boric Acid. 963 ,, 4 Welford and Sons, 33, Little Britain. Unlabelled. Cream served "loose.'' 51.9 No preservative present. 964 ,, 5 The Mapleton Dairy Co., Edenbridge, Kent. " Pure Thick Cream. Rich." "Pure Rich Thick Cream. 26 Prize Medals and Awards. "This Cream being separated immediately after the milk is drawn from the cow, will be found to be sweeter and keep better than that produced by the ordinary skimming process, and is superior to the Devonshire Cream." "Rich Preserved Cream.—This Cream contains a small proportion of Boron Preservative (not exceeding one-half of one per cent.), to keep it sweet and wholesome, which has been the recognised method of preservation for over 20 years. "Cream without preservative 1s recommended for invalids and children.'' 52.1 0.19 Boric Acid. 965 ,, 5 Peck's Surrey Cream Co., Sole Depot, Snow Hill, London. "Rich Surrey Cream." "Preserved Cream." "Peck's Surrey Cream Co. Archer Brand. Special Rich Thick Cream. Eight prize medals for excellence of quality." 49.3 0.33 Boric Acid. 966 „ 5 John Davis, 15, Copthall Avenue. Unlabelled. Cream served "loose." 56.9 0.11 Boric Acid. As before stated, the richness or strength of cream is influenced by the amount of fat it contains. Unscrupulous dealers are known to take advantage of this feature and improve the appearance of a poor article by thickening it with gelatine, starch paste and "sucrate of lime." A sample purchased in the City in 1906 was certified to contain 3 per cent. of starch. A prosecution ensued, but warranty being proved, the case was dismissed. With regard to "sucrate of lime." This material having been openly offered for sale by chemical manufacturers to cream dealers, the Board of Agriculture and Fisheries issued a circular letter on the 1st October last, directing the attention of sanitary authorities to the nature of this adulterant as shown by analyses made by the Principal Chemist of the Government 125 Laboratory, who reported on one sample as being "a solution of lime in cane-sugar syrup. This substance, under various "names, has been in use for some years, and is said to have a remarkable "effect in increasing the thickness of the cream. In ordinary analysis "its presence would not be suspected, as, if used in the quantities "mended it would increase the ash of the cream only ".04 per cent. and the total solids .19 per cent. There is, however, no "reason why an analysis, directed specifically to the detection of cane "sugar and to the estimation of the relative proportion of lime in the "ash, should not reveal the presence of this substance. Its use, even in "small quantities, gives a fictitious value to cream." Another article of a similar character was described as follows:— "The sample consists of a solution of lime in cane-sugar syrup and is "coloured with annatto colouring matter." The circular also directed attention to a third article intended to increase the weight and bulk of cream, with regard to which the Principal Chemist at the Government Laboratory reported as under:— The examination of the sample gives the following results: — "Water 83.46 per cent. "Proteins 11.90 „ "Lactine 1.55 „ "Milk fat 1.26 „ "Mineral matter 1.28 „ "Boric acid .30 „ "The substance would appear to consist of some form of albuminoid "matter which has been worked into an emulsion with milk and water. "When received, the substance was thick and pasty, but in the course "of two days it became decomposed, and was then of the consistency of "thin cream. "Cream to which this substance has been added is undoubtedly "adulterated, and although the material does not appear to give any "distinctive reaction, its detection in cream is not difficult if regard is "had to the ratio between the non-fatty solids and fat, and particularly "to the proportion of proteins in the non-fatty solids." The views of your Public Analyst on this circular are contained in the following report, copy of which was ordered to be forwarded to the Board of Agriculture by the Court of Common Council on the 2nd December, 1909:— "I have carefully perused and considered this circular. "The analysis of a substance said to be employed for the purpose of "thickening cream is given, but the analysis is incomplete. Before it 126 "could be really useful, something of the nature of the 'proteins' must "be known. This does not appear to have been investigated, as the "report says: 'The substance would appear to consist of some form " 'of albuminoid matter.' "No information is given as to the probable amount in which such a "substance would be used. "I cannot agree with the statement that' its addition in cream is not " 'difficult if regard is had to the ratio between the non-fatty solids and " 'fat' In ordinary (not clotted) cream the above ratio would vary "according to the richness of the sample in fat. This is merely a question "of arithmetic. In an ordinary (not clotted) cream containing 50 per "cent. of fat, the non-fatty solids should be about 4.5, or a ratio of ll.l. "In a similar cream containing 30 per cent. of fat, the non-fatty solids "would be about 6.3, or a ratio of fat to non-fatty solids of 4.8. "The 'proportion of proteids in the non-fatty solids' would give "important information in the case of ordinary creams, but, on the other "hand, with clotted creams it would vary within undetermined limits. "The ratio of non-fatty solids to the water in the sample, about 1.10 "in genuine creams (not clotted), is a very important point, and any "material addition of this thickening agent would affect this ratio, as "the ratio in the thickening agent is about 1.5. "With regard to the solution of lime in cane sugar, I do not think "the presence of 0.15 per cent. of cane sugar could be detected with "certainty, and even if it could, I doubt whether the Courts would "regard it as an adulteration. "Annatto, which occurs in a third thickening agent, would, I feel "certain, not be regarded by the Courts as an adulteration. ''The Board of Agriculture have power under Section 4 of the Sale of "Food and Drugs Act, 1899, to fix a limit for fat in cream. If it would "exercise this power it would be very useful both to the analyst and the "public." This circular is referred to here particularly, as it is an illustration of the ceaseless war waged between analysts on the one side and those practising scientific methods of adulteration on the other. BUTTER. Four hundred and fifty-seven samples of butter were taken, of which five, or 1.9 per cent., were certified as being adulterated. 127 The figures for 1909 and eight previous years are given hereunder:— Year. No. of samples taken. No. of samples found Genuine. No. of Samples found Adulterated. Percentage of Adulterated Samples. 1901 241 226 15 6.2 1902 299 292 7 2.34 1903 368 367 1 .27 1904 442 429 13 2.94 1905 354 350 4 1.14 1906 328 311 17 5.18 1907 411 398 13 3.16 1908 381 376 5 1.30 1909 457 452 5 1.09 For the last seven years special attention has been paid to the character of the butter sold at coffee-houses, when served upon slices of "bread and butter" and, as will be seen from the following table, the fraud of substituting margarine for butter has been almost stamped out:— Date. Samples taken. Cases of Substitution. Percentage Substituted Samples. 1903 71 19 26.7 1904 101 12 11.8 1905 16 Nil. Nil. 1906 87 12 13.8 1907 184 8 4.3 1908 112 1 0.9 1909 115 1 0.9 Of 106 other samples supplied when a "roll and butter" was purchased, four were found to be margarine. In the five cases of adulteration reported during the year, one vendor was cautioned, one fined 20s. and 17s. 6d. expenses, one 40s. and 12s. 6d. expenses, one £5 and 17s. 6d. expenses, and one case was dismissed on payment of £l 18s. 6d. expenses. SALE OF MARGARINE BILL. This was a private Bill, read a first time on the 10th March, 1909. It was described as a Bill to provide for the further prevention of the fraudulent sale of margarine, and it was stated in the preamble that it is expedient to make provision for this purpose for the protection of the public, and to prevent margarine being made or sold in such a form as to facilitate its substitution for butter. It was proposed to effect this object by making it unlawful to manufacture, sell, or deal in margarine which, or any part of the constituent of which, contains any colouring matter, or to use in the manufacture of margarine any substance which has the effect of imparting any colour to margarine. 128 The following definition of margarine was to be substituted for that provided in the Butter and Margarine Act, 1907:— "Margarine shall mean any substance prepared from beef or mutton "fat, or from any vegetable oil, which in any way resembles butter, or "is capable of being used for the same general purpose for which butter "is used, and which is not butter." Penalties for an offence under the Act varied from £20, £50, and £100 for first, second, and third, or any subsequent offence, respectively. The clause prohibiting colouring matter in margarine was struck out by the Standing Committee of the House of Commons, and some variation was made in the penalty clauses. The Bill was eventually dropped. COFFEE. It is satisfactory to report that none of the 35 samples of coffee examined during the year were reported against. The amount of Coffee adulteration found in the City during the last nine years is here given. Year. Samples taken. Found genuine. Found adulterated. Percentage of Adulterated Samples. 1901 11 10 1 9.0 1902 27 26 1 3.7 1903 21 21 Nil. Nil. 1904 20 18 2 10.0 1905 79 68 11 13.9 1906 28 26 2 7.1 1907 46 46 Nil. Nil. 1908 38 37 1 2.6 1909 35 35 Nil. Nil. MUSTARD. Of the 24 samples examined, one only was reported against. In this case the vendor made a satisfactory explanation of the matter to the Committee. The accompanying Table shows the amount of mustard adulteration discovered during the last nine years. Year. Samples taken. Found genuine. Found adulterated. Percentage of Adulteration. 1901 23 20 3 13.0 1902 28 28 Nil. Nil. 1903 15 15 Nil. Nil. 1904 15 15 1 6.2 1905 50 48 2 4.0 1906 8 8 Nil. Nil. 1907 14 14 Nil. Nil. 1908 39 38 1 2.5 1909 24 23 1 4.2 129 DRUGS. There was a further slight decrease in drug adulteration, the percentage falling from 3.5 in 1908 to 2.3 in 1909. The following Table includes particulars of drug adulteration in the City during the past nine years:— Samples taken. Found genuine. Found adulterated. Percentage of adulteration. 1901 111 103 8 7.2 1902 79 74 5 6.3 1903 65 60 5 7.7 1904 52 48 4 7.7 1905 61 56 5 8.2 1906 47 42 5 10.6 1907 65 59 6 9.2 1908 57 55 2 3.5 1909 86 84 2 2.3 In the two cases where the article was reported against, saffron had been asked for by the purchaser. In the first instance an informal sample was taken, another sample being subsequently bought under the provisions of the Act at the same shop. This second sample was certified to be adulterated with 17 per cent. of barium sulphate. Proceedings were instituted, and the vendor fined £5 and £l 3s. 6d. expenses. The 86 drugs examined during 1909 included the following:—Oil of eucalyptus, 8; liniment of camphor, 6; tartaric acid, 3; citric acid, 3; light magnesia, 6; crushed linseed. 11; liniment of soap, 4; compound liquorice powder, 4; milk of sulphur, 5; iron pill, 4; tincture of iodine, 6; Gregory's powder, 5; ammoniated tincture of quinine, 7; saffron, 6; sal volatile, 4; compound tincture of rhubarb, 1; and sweet spirit of nitre, 3. All these were genuine with the exception of the two samples of saffron referred to above. GOLDEN SYRUP. Two samples were examined, one of which was certified to contain 50 per cent. of glucose syrup. The vendor was summoned and fined £l and 17s. 6d. costs. BEESWAX. With a view of ascertaining the character of this article as sold to the public at oilmen's shops, 8 samples were procured, two of which were certified as being adulterated with paraffin. Both traders were cautioned. 130 OTHER SAMPLES. The remaining samples, which were all genuine, comprised 4 of cocoa, 2 of olive oil, 1 of cheese, 6 of pepper, 1 of wine, 2 of preserving fluid, 1 of meat, 3 of rice, 3 of Demerara sugar, and 1 of an article described as "Cydro." With regard to the latter article it appears that for some time past the Board of Agriculture and Fisheries have been endeavouring to prevent the application of the description "Cider" to any liquid not wholly derived from the apple. It was brought to my notice by the Board that a firm in the City were selling as "Cyder, non-alcoholic," a beverage that had been reported on by the Government Analyst as under:— "The sample received on the 8th November, 1909, is a mixture of "genuine cider and a solution of cane sugar, to which a small quantity "of phosphoric acid has been added." A sample of this so-called "cyder" was therefore procured by one of your officers and submitted to the Public Analyst, who found on analysis it contained 2.6 per cent. of proof spirit and 2.09 grammes per 100 c.c. of cane sugar. The firm were notified that they were selling and describing as "nonalcoholic cyder" a liquid which was not only not "non-alcoholic," but, moreover, was not cider, and their position under the Sale of Food and Drugs Acts therefore pointed out to them. Upon the firm explaining that the error was due to their not having the name altered on their menu, and giving an undertaking to have the article correctly described on each label and on the show-cards exhibited in all their establishments, I recommended that no further action need be taken in the matter. REPORT OF THE ROYAL COMMISSION ON WHISKY AND OTHER POTABLE SPIRITS. WHISKY. This Commission was appointed under the following circumstances:— In November, 1905, two summonses were heard at the North London Police Court, charging contravention of Section 6 of the Sale of Food and Drugs Act, 1875 (selling to the prejudice of the purchaser any article of food or any drug which is not of the nature, substance and quality of the article demanded by the purchaser). In each case the Public Analyst had certified that the sample (whisky) "consisted entirely of patent-still, silent or neutral spirit." 131 The magistrate came to the conclusion— (1) "That the patent-still spirit alone is not whisky.' (2) "That the produce of the patent-still unmixed with pot-still "whisky cannot be Irish or Scotch whisky, although made in Ireland or "Scotland." (3) "That the material to be used to produce Irish or Scotch whisky "is, in Irish whisky, barley-malt as to about 75 per cent., and as "to the rest of the mash, barley, wheat, oats, and rye, or any of them, "and in Scotch whisky it is wholly barley-malt." (4) "That maize, not having been commonly used in the pot-still or "Irish and Scotch method of making whisky, cannot be material from "which Irish or Scotch whisky is derived." (5) That what the defendants "sold as Irish and Scotch whisky "respectively was patent-still spirit, made largely of maize, to which "had been added a dash, not ten per cent., of Irish or Scotch whisky." (6) That the one defendant's sample was "not Irish whisky," and the other defendant's sample was "not Scotch whisky, and Irish "whisky and Scotch whisky having been demanded by the purchaser" from the two defendants respectively, that "each of the defendants did "sell an article of food which was not of the nature, substance and "quality demanded." (7) "That the sales in these cases by the defendants were both to the "prejudice of the purchaser." The result of these proceedings was regarded by whisky traders as so serious that they resolved to unite with the common object of obtaining some final and authoritative settlement of the questions raised. They accordingly appointed a deputation to wait upon the President of the Local Government Board. Upon doing so the deputation strongly urged the appointment of a Royal Commission. This request was agreed to, and a Royal Commission was appointed on the 17th February, 1908, to inquire and report— (1) Whether, in the general interest of the consumer, or in the interest of the public health or otherwise, it is desirable— (a) To place restrictions upon the materials or the processes which may be used in the manufacture or preparation in the United Kingdom of Scotch whisky, Irish whisky, or any spirit to which the term whisky may be applied as a trade description; (b) To require declarations to be made as to the materials, processes of manufacture or preparation, or age of any such spirit; 132 (c) To require a minimum period during which any such spirit should be matured in bond ; and (d) To extend any requirements of the kind mentioned in the two sub-sections immediately preceding to any such spirit imported into the United Kingdom; (2) By what means, if it be found desirable that any such restrictions, declarations, or period should be prescribed, a uniform practice in this respect may be satisfactorily secured; and to make the like enquiry and report as regards other kinds of potable spirits which are manufactured in or imported into the United Kingdom. With regard to whisky it will be seen from the foregoing that the prominent questions moving the nomination of the Commission were:— (1) Whether the application of the term "whisky" should or should not be restricted to spirit manufactured in pot stills. (2) Whether the spirit manufactured in patent stills should, either alone or when mixed with the product of pot stills, be allowed the use and name "whisky." (3) Whether restrictions should be placed upon the materials used in the manufacture of whisky. On the 24th June, 1908, the Commission presented an Interim Report, in which they stated they had arrived at the following conclusions:— (1) That no restrictions should be placed upon the processes of, or apparatus used in, the distillation of any spirit to which the term "whisky" may be applied as a trade description. (2) That the term "whisky" having been recognised in the past as applicable to a potable spirit manufactured from (1) malt or (2) malt and unmalted barley or other cereals, the application of the term "whisky" should not be denied to the product manufactured from such materials. The final Report of the Commission, dated 28th July, 1909, states that in the opinion of the Commission the use of the terms "Scotch" and "Irish" as applied to whisky cannot be denied to any whisky distilled in Scotland and Ireland respectively. This Report also states that the general conclusion of the Commission on this part of their enquiry is that "whisky" is a spirit obtained by distillation from a mash of cereal grains saccharified by the diastase of malt; that "Scotch whisky" is whisky as above defined distilled in Scotland, and that "Irish whisky" is whisky as above defined distilled in Ireland. From the tenor of the Report the Commission appear to have been influenced by a desire not to publish conclusions that might lead to any 133 arbitrary restrictions being imposed upon traders. It is true they have expressed the opinion that whisky should be defined as "a spirit obtained by distillation from a mash of cereal grains saccharified by the diastase of malt," and would therefore prohibit any spirit prepared from potatoes, beet, or molasses from being sold as whisky, but there must be a general feeling of disappointment that the Commission have not seen their way to advocate some measures to prevent the sale of unmatured spirit. A perusal of an abstract given in the Report of the medical evidence placed before the Commission confirms this view. Thus on page 18 it is stated that:— "Most of the medical witnesses recommended that the spirits used in "the treatment of disease should be of good quality and old. Some "considered that pot-still whisky was preferable for this purpose to the "patent-still variety, as they considered that more powerful medicinal "properties were possessed by it owing to the larger percentage of "secondary products. The majority of medical witnesses attached no "importance to the question whether the whisky were pot or patent-still, "and considered that the value of it in the treatment of disease depended "essentially on the ethylic alcohol. This view was held by the majority "of observers who had directed their attention to the subject, and some "adduced definite evidence in support of the statement that no difference "in the results obtained could be attributed to the mode of preparation "of the whisky. We concur in this view." Further, the Report says:— "With regard to the dietetic use of whiskies, all the medical witnesses "were agreed that flavour plays a part of considerable importance, since "a whisky that is unpalatable tends to interfere with digestion, while a "whisky that is agreeable to the patient may increase the activity of the "digestive processes, and also exert a favourable mental effect quite "apart from the direct effect dependent on the alcohol itself. On this "account they held not only that a mature whisky is preferable to a new "whisky, but also that whiskies of different flavours may have a "particular dietetic value in particular instances." With regard to the vexed question of the "Battle of the Stills," the Report states that the Commission received no evidence to show that the form of still has any necessary relation to the wholesomeness of the spirit produced. BRANDY. With regard to this spirit the Commission came to the conclusion that the term "brandy" is applicable to a potable spirit manufactured from fermented grape juice, and from no other materials. 134 British brandy is entitled still to be so named and sold as "British brandy." They also considered that the determination of the application of the term "brandy" in this country cannot be controlled by the nature of the apparatus or process used in the distillation of the spirit. RUM. The Commission consider that the definition of rum as "a spirit distilled direct from sugar-cane products in sugar-cane growing countries," fairly represents the nature of the spirit a purchaser would expect to obtain when he asks for "Rum." The Customs already recognise the distinction between "rum," "rum from Jamaica," and "imitation rum," and the Commission consider that this differentiation should be continued. GIN. The Commission had several definitions of this spirit submitted to them, and quote two of them, but say nothing conclusive on this point. It appears they were unable to obtain from the Excise information such as furnished with regard to whisky, because gin is not produced under close Excise supervision, but is manufactured out of bond from duty-paid spirit. As a general rule the manufacturer of gin is a rectifier only, and buys the spirit which he uses for rectification from a distiller, This spirit, in the United Kingdom, is produced at patent-still distilleries entirely, and the London gin makers use London spirit for this purpose very largely. The Report also contains interesting notes on Liqueurs, &c., "Unenumerated Spirits" (plain spirit produced in Germany from potatoes, vodka, arrack, kirschwasser, rye whisky, and Canadian club whisky), compulsory bonding, labelling in bond, and the application of the Merchandise Marks Acts and the Sale of Food and Drugs Acts to offences connected with potable spirits. Reference must be made to the two notable suggestions made by the Commission as the result of their deliberations. These are as under:— "In order to assist in a more certain conducting of prosecutions "under the Sale of Food and Drugs Acts, it may be well to consider "whether statutory provisions may not be made for affording to the "presiding magistrate assistance in determining the cases submitted to 135 "him by authorising him to obtain, if he thinks fit, the assistance of two "assessors, being persons of practical and scientific knowledge of the "matters involved, to sit with and advise him thereon. And for such "purpose it may also be desirable to form, under authority, a panel "from which such assessors may be selected. "It is also desirable to consider whether a committee of skilled "persons may be formed under Government authority, who might assist "in mitigating some of the difficulties mentioned above by advising on "technical questions which affect the administration of the Acts by local "authorities and the practice of public analysts." This latter suggestion is very similar to that made by the Departmental Committee appointed in July, 1899, by the Board of Agriculture and Fisheries, to inquire into the use of preservatives and colouring matters in food, who advocated the establishment of a separate Court of Reference for guidance in such matters. 136 137 SALE OF FOOD AND DRUGS ACTS, 1875-1907. Articles examined during each Quarter of the year 1909. Articles submitted for Analysis. Quarter ending 31st March. Quarter ending 30th June. Quarter ending 30th September. Quarter ending 31st December. Total lor 1909. 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 163 153 10 6.13 175 167 8 4.57 79 78 1 1.26 103 97 6 5.82 520 495 25 4.80 Butter 132 131 1 .76 141 138 3 2.12 85 85 ... ... 99 98 1 1.01 457 452 5 1.09 Coffee 4 4 ... ... 13 13 ... ... 12 12 ... ... 6 6 ... ... 35 35 ... ... Mustard 3 3 ... ... 8 7 1 12.5 10 10 ... ... 3 3 ... ... 24 23 1 4.1 Cocoa ... ... ... ... 9 9 ... ... 6 6 ... ... 8 8 ... ... 23 23 ... ... Lard ... ... ... ... 4 4 ... ... ... ... ... ... ... ... ... ... 4 4 ... ... Olive Oil ... ... ... ... 2 2 ... ... ... ... ... ... ... ... ... ... 2 2 ... ... Drugs 21 21 ... ... 27 27 ... ... 32 30 2 6.25 6 6 ... ... 86 84 2 2.32 Cream ... ... ... ... ... ... ... ... ... ... ... ... 12 9 3 25.0 12 9 3 25.0 Cheese 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... Pepper ... ... ... ... ... ... ... ... 5 5 ... ... 1 1 ... ... 6 6 ... ... Beeswax 3 3 ... ... 5 3 2 40.0 ... ... ... ... ... ... ... ... 8 6 2 25.0 Wine 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... Golden Syrup ... ... ... ... 2 1 1 50.0 ... ... ... ... ... ... ... ... 2 1 1 50.0 Preserving Fluid ... ... ... ... 1 1 ... ... 1 1 ... ... ... ... ... ... 2 2 ... ... Meat ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... 1 1 ... ... Rice ... ... ... ... ... ... ... ... 3 3 ... ... ... ... ... ... 3 3 ... ... Demerara Sugar ... ... ... ... ... ... ... ... 3 3 ... ... ... ... ... ... 3 3 ... ... Cydro ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 1 ... ... Totals 328 317 11 3.3 388 373 15 3.8 236 233 3 1.2 238 228 10 4.1 1,191 1,152 39 3.2 138 SALE OF FOOD AND DRUGS ACTS, 1875-1907. 1909. RESULTS OF PROSECUTIONS. First Quarter. Sample. Nature and Extent of Adulteration. Result. 6 Milk 13 per cent. fat abstracted 40s. and 18s. 6d. expenses. 18 „ 5 per cent. added water • Dismissed, warranty, on payment of expenses 17s. 6d. 65 „ 14 per cent. added water 1s. and 18s. 6d. expenses. 93 „ 5 per cent. added water 20s. and 17s. 6d. expenses. 98 ,, 8 per cent. added water 40s. and 17s. 6d. expenses. 159 „ 9 per cent. added water £10 and 17s. 6d. expenses Second Quarter. 291 Milk 6 per cent. added water Dismissed, warranty. 390 Golden Syrup 50 per cent. glucose syrup 20s. and 17s. 6d. expenses. 400 Butter 100 per cent. margarine 20s. and 17s. 6d. expenses. 412 Milk 7 per cent. fat abstracted Withdrawn, warranty pleaded. 437 ,, 15 per cent. fat abstracted Dismissed, warranty. 459 „ 12 per cent. fat abstracted 40s. and £1 18s. 6d. expenses. 460 Butter 100 per cent. margarine Dismissed on payment of costs £1 18s. 6d. 470 ,, 100 per cent. margarine £5 and 17s. 6d. expenses. 523 Milk 14 per cent. fat abstracted £5 and £2 2s. costs. Third Quarter. 562 Milk 40 per cent. fat abstracted 20s. and 17s. 6d. expenses. 654 „ 15 per cent. fat abstracted 10s. and 12s. 6d. expenses. 921 „ 23 per cent. added water and 32 per cent. fat abstracted. Dismissed, no copy of Analyst's certificate served with Summons. 927 Saffron 17 per cent. barium sulphate £5 and 23s. 6d. expenses. Fourth Quarter. 1019 Milk 29 per cent. fat abstracted £10 and 18s. 6d. expenses. 1027 „ 24 per cent. fat abstracted 40s. and 17s. 6d. expenses. 1040 „ 11 per cent. added water 40s. and 17s. 6d. expenses. 1041 Butter 55 per cent. margarine 40s. and 12s. 6d. expenses. 1176 Milk 38 per cent. added water £20 and £3 3s. costs. 1177 „ 36 per cent. added water £4. 139 SUMMARY. £ s. d. £ s. d. First Quarter: Fines 15 1 0 Expenses 34 8 0 Second Quarter „ 14 0 0 8 11 6 Third Quarter „ 6 10 0 2 13 6 Fourth Quarter „ 40 0 0 95 6 9 0 £75 11 0 £22 2 6 Eighteen fines were imposed during the year, as against 33, 35 and 23 in the preceding three years, the average fine and expenses paid being £5 8s. 9d., the corresponding amounts for 1906, 1907 and 1908 being £3 1s. 10d., £6 15s. 0d. and £4 12s. 4d. respectively. By direction of the Sanitary Committee nine persons were cautioned as to the questionable or unsatisfactory character of articles sold by them. MEDICAL EXAMINATIONS. In accordance with the Standing Order of the Court that no person shall enter the employ of the Corporation or any of its Committees without previously passing a medical examination to the satisfaction of the Committee having cognizance of the appointment, 85 persons were so examined during 1909, and of these 2, or 2.35 per cent., were reported by me as physically unfit for office. Six other cases that were examined are now outstanding. 12 officers were also medically examined with a view to their retirement, and of these 10, or 83.33 per cent., were reported to be unfit for duty. In addition to the foregoing, six medical examinations were made of persons accepted by the Central (Unemployed) Body, on the recommendation of the City of London Distress Committee, for employment on the Labour Colony at Hollesley Bay, established by the Central Body under the Unemployed Workmen Act, 1905. I have the honour to be, Gentlemen, Your obedient Servant, Medical Officer of Health for the City of London. Public Department. Guildhall, E.C. APPENDICES. PAGE Appendix A—Street Lists of Mortality 143 „ B—„ „ Infectious Disease 146 „ C—Register of Houses let in lodgings or occupied by members of more than one family 148 „ D—List of Persons registered under the Dairies, Cowsheds and Milk Shops Orders 156 „ E—The Public Health (Foreign Meat) Amending Regulations, 1909, dated September 27th, 1909 162 „ F—Tuberculous Meat. Revised Circular 167 „ G—The Health Visitors (London) Order, 1909 171 143 Appendix A. CITY OF LONDON MORTALITY. 1909. STREET LISTS, Compiled from Weekly Returns of Registrars of Sub-Districts. STREET OR PLACE. No. of House. Sex. Age. Date of Denth. Certified Cause of Death. Remarks. Abchurch Lane 12 F 2 16 Nov., 1909 Pertussis Albion Buildings 22 M 28 30 Mar. „ Pneumonia Aldermanbury Buildings 2 F 64 2 Dec. „ Gastric Ulcer Aldersgate Street 32 F 73 . 14 Mar. „ Chronic Bronchitis Aldgate High Street 3 F 65 21 April „ Malignant growth „ „ 41 F 4 hours 30 „ Premature birth „ „ 59 F 33 2 June „ Incomplete abortion Amen Court 7 M 67 16 April „ Acute Bulbar Paralysis Artillery Lane 12 F 28 12 Jan. „ Tuberculosis „ „ 16 F 4 8 Feb. „ Tuberculosis Died in St. Bart.'s „ „ 7 F 65 5 Mar. „ Acute Bronchitis „ 21 F 85 30 Dec. „ Morbus Cordis Austin Friars 1 M 15 m'ths 26 June „ Bronchitis Barker's Buildings 18 M 7 m'ths 6 Feb. „ Acute Bronohitis „ „ 6 F 69 19 Mar. „ Influenza Bartholomew Close 61 F 84 22 Aug. „ Chronic Bronchitis Died in St. Bart.'s „ „ 11 F 72 31 May „ Morbus Cordis Bartholomew House — F 62 5 Oct. „ Chronic Bronchitis Bartholomew Place 6 M 67 12 Nov. „ Chronic Bronchitis Bartlett's Buildings 8 75 19 May „ Senile degeneration „ „ 21 M 47 26 Nov. „ Apoplexy Bishopsgate Street Without 35 M 82 21 Jan. „ Cerebral Hæmorrhage „ „ 31 F 45 18 Feb. Suicide—poison Inquest and P.M. „ „ 133 M 59 17 April „ Cerebral Hæmorrhage „ „ 135 M 42 17 „ „ Lobar Pneumonia Died in St. Bart.'s „ „ 130 F 86 1 July „ Senile Decay „ „ 8 M 54 14 Nov. „ Arterio-sclerosis Blomfield House, Snow Hill 17 F 74 4 July „ Bronchitis Brushfield Street 12 F 64 3 Dec. „ Acute Bronchitis Bury Street Chambers — F 56 9 Mar. „ Cirrhosis of Liver Inquest and P.M. Bush Lane 301 M 49 14 April „ Heart Failure Inquest Butchers' Hall — M 36 27 May „ Pneumonia Cannon Street 84 F 68 1 Jan. „ Bronchitis „ „ 81 F 49 25 Feb. „ Bronchitis Carmelite Street 7 F 10 22 Jan. „ Heart Disease Carter Lane 22 M 20 24 May „ Lobar Pneumonia Died in St. Bart.'s „ „ 22 M 20 24 „ Lobar Pneumonia Died in St. Bart.'s Charterhouse Street 11 F 53 4 Mar. „ Carcinoma Cheapside 145 M 68 23 Feb. „ Cerebral Thrombosis Died in St. Bart.'s „ „ 69 F 53 12 April „ Apoplexy „ „ 26 M 78 11 Sept. „ Carcinoma Circus, Minories 1 M 67 10 Jan. „ Lobar Pneumonia Cloth Fair 6 F 10 m'ths 29 Mar. „ Tubercular Meningitis „ „ 8 F 76 7 June „ Morbus Cordis „ „ 44 F 17 hours 16 Aug. „ Inanition „ „ 8 M 45 10 Oct. „ Strangulated Hernia Died in St. Bart.'s Cockerell's Buildings 2 F 82 23 Sept. „ Gastric Ulcer „ „ 8 M 9 m'ths 4 Dec. „ Acute Bronchitis Crooked Lane 7 F 39 19 June „ Cardiac failure Crown Office Row 7 M 37 5 April „ Suicide—Cut-throat Inquest. Suicide whilst Custom House Quay — M 50 9 „ Syncope Inquest [insane Dalmeny House, Monument Street — M 30 27 Feb. „ Pulmonary Tuberculosis Dean Street 8b F 37 28 Mar. „ Infective Labyrinthitis Died in St. Bart.'s „ „ 6e M 70 9 July „ Bronchitis „ „ 2a M 76 1 Nov. ,, Carcinoma Died in St. Bart.'s Dean's Court, Old Bailey 31 F 71 8 Mar. „ Acute Bronchitis Devonshire Chambers, Bishopsgate — M 83 24 „ Pneumonia Dorset Street 3 F 10 m'ths 26 Dec. „ Pertussis Ellison Street 5 F 70 14 April „ Senile Decay „ „ 4 F 61 26 June „ Cerebral Hæmorrhage Evangelist Court 3 F 82 24 June „ Chronic Bronchitis Fenchurch Buildings 12 and 13 M 73 31 Oct. „ Strangulated Hernia Fenchurch Street 108 F 58 28 Mar. „ Morbus Cordis „ „ 86 F 2 m'ths 2 June „ Gastro-Enteritis „ „ 167 F 78 3 „ Pericarditis „ „ 157 M 78 7 Dec. „ Senile Decay „ „ 158 F 78 5 Nov. „ Senile Decay Fenton's Buildings, Bartholomew Close 1 M 54 10 Feb. „ Pulmonary Tuberculosis Finsbury Circus 18 M 55 8 April „ Ch. Interstitial Nephritis Fishmongers' Alley 2 M 30 14 Sept. „ Asphyxia whilst intoxicated Inquest and P.M. Acci[dental Fleet Street 184a M 22 19 Nov. „ Phthisis Garden Place 3 M 75 18 June „ Cerebral Hæmorrhage „ „ 9 M 13 26 „ „ Tuberculosis 144 CITY OF LONDON MORTALITY—continued. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. George Yard 12 F 17 m'ths 26 Mar., 1909 Broncho-Pneumonia Gracechurch Street 30 F 4 11 Jan. „ Acute Gastritis Great New Street 22 F 53 22 Mar. „ Chronic Bronchitis „ „ 16 F 82 10 April „ Chronic Bright's Disease „ „ 13 M 46 2 Oct. „ Epithelioma „ „ 20 F 81 10 Nov. „ Mitral Valvular Disease „ „ 16 F 78 29 Dec. „ Senile Decay Great Tower Street — M 39 13 Sept. „ Fell through glass roof Inquest and P.M. Accidental. Died in St. Bart.'s Great Winchester Street 23 F 70 25 May „ Chronic Nephritis Gresham Street 1 F 36 27 April „ Fell down lift well Inquest and P.M. Accidental Gutter Lane 37 M 1 31 Oct. „ Pneumonia Holborn Buildings 7 F 77 24 Mar. „ Cerebral Hæmorrhage Hutchison Avenue 15 M 33 5 Feb. „ Pneumonia „ „ 9 M 15 m'ths 16 Mar. „ Broncho-Pneumonia „ „ 3 F 66 18 July „ Malignant Disease of Liver „ „ 24 M 51 29 Dec. „ Chronic Bright's Disease Hutchison Street 20 F 17 m'ths 22 Oct. „ Broncho-Pneumonia „ „ 5 F 61 21 Dec. „ Morbus Cordis King William Street 9 M 65 5 Mar. „ Morbus Cordis King William Street Steps — F new born 14 Nov. „ Suffocation at birth Inquest. No evidence [how caused King's Head Court 17 F 46 28 Jan. „ Pneumonia Lime Street 23 F 59 28 „ „ Cerebral Hæmorrhage Liverpool Street Station — F new born 3 „ „ Want of attention at birth Inquest and P.M. Long Lane 7 M 18 m'ths 27 Feb. „ Measles „ „ 86 F 75 11 April „ Burns—fell into fire Inq. Died in St. Bart.'s „ „ 76 M 62 21 May „ Uraemia „ „ 55 M 48 30 July „ Valvular Disease of Heart Inq. and P.M. Died in [St. Bart.'s Lower Thames Street 55 M 60 5 Dec. „ Pneumonia Mansell Street 32 F 6 hours 6 June „ Premature birth Middlesex Street 116 M 65 15 May „ Senile Decay Inquest and P.M. „ „ 71 F 67 27 June „ Morbus Cordis „ „ 41 F 80 28 Oct. „ Chronic Bronchitis „ „ 49 M 43 19 April „ Double Pneumonia Died in St. Bart.'s Milton Street 71 F 74 9 June „ Senile Decay Minories 118 M 59 10 Dec. „ Bronchitis Mitre Court, Fleet Street 1 F 59 27 May „ Suicide by poison Inquest and P.M. Montague Court, Bishopsgate 16 F 55 25 Jan. „ Hepatitis „ „ Little Britain 2 M 3 hours 6 „ „ Inanition „ „ „ „ 6 F 43 20 „ „ Chronic Bronchitis „ „ „ „ 2 M 21 8 May „ Morbus Cordis Moor Lane Chambers 24 M 52 7 Dec. „ Enteric Fever Moorgate Street 71 F 78 9 Mar. „ Senile Decay Nevill's Court 13a F 76 30 Oct. „ Chronic Bronchitis New Street 9 F 75 15 Mar. „ Morbus Cordis „ „ 16 F 60 12 April „ Morbus Cordis „ „ 11 F 65 15 June „ Heart failure Inquest and P.M. „ „ 21 F 78 25 Aug. „ Heart Disease New Street Square 10 F 61 13 Sept. „ Rheumatic Arthritis New Broad Street 35 F 63 14 Mar. „ Fractured Femur by fall Inq. and P.M. Died in [St. Bart.'s Norwich Street 2 M 73 30 Aug. „ Acute Intestinal obstruction Died in St. Bart, s Old Bailey 48 M 33 9 „ „ Epileptic Fit Police Building, Bishopsgate 6 F 1 day 6 July „ Debility „ „ „ 36 F 1 month 4 Nov. „ Whooping Cough Providence Place 10 F 69 21 Feb. „ Carcinoma „ „ 19 F 63 2 Sept. „ Myxœdema Queen Street 83 F 53 26 April „ Addison's Disease Queen Victoria Street 84 M 39 27 Dec. „ Pneumonia Redcross Street Fire Station — F 2 months 10 May „ Acute Enteritis „ „ „ — M 2 days 11 June „ Congenital Heart Disease River Thames—Blackfriars — M 66 10 Mar. „ Drowning Inquest. No evidence as to how deceased came into water „ „ „ — F 37 1 July „ Drowning Inquest. No evidence as to how deceased came into water „ „ Brewers' Quay — F new born 17 „ „ Want of attention at birth Inquest and P.M. „ „ Temple Pier — M 60 30 June „ Drowning Inquest. No evidence as to how deceased came into water Robin Hood Court—Union — M 64 4 Jan. „ Broncho-Pneumonia „ „ „ „ — M 64 4 „ „ Heart Failure „ „ „ „ — M 69 22 April „ Pneumonia „ „ „ „ — F 58 4 May „ Capillary Bronchitis „ „ „ „ — M 27 17 „ „ Heart Failure „ „ „ „ — M 45 5 Aug. „ Double Phthisis „ „ „ „ — F 62 6 „ „ Bronchial Catarrh „ „ „ „ — M 54 9 Oct. „ Syncope Inquest and P.M. „ „ „ „ — M 47 21 „ „ Alcoholism Inquest and P.M. „ „ „ „ — M 63 21 Broncho-Pneumonia St. Andrew's Hil 7 F 43 2 April „ Overdose Morphia Inq. and P.M. Accidental St. Helen's Place 8 F 44 1 Nov. Cirrhosis 145 CITY OF LONDON MORTALITY—continued. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. St. Mary-at-Hill 14 F 81 6 Mar., 1909 Senile Decay Seething Lane 15 M 39 3 Julv „ Pulmonary Tuberculosis „ „ 41 F 36 24 Dec. „ Pulmonary Phthisis Serjeants' Inn 11 F 72 16 Feb. „ Capillary Bronchitis Shaftesbury Place 7 M 11 m'ths 18 Sept. „ Diphtheria Died in St. Bart.'s „ „ 1 F 65 29 Nov. „ Gastric Ulcer Suffolk Lane 2 F 48 27 „ „ Cancer Temple Gardens 2 F 18 hours 11 June „ Premature birth Threadneedle Street 30 F 66 22 Jan. ,, Diabetes Three Crown Court 3 F 87 25 Feb. „ Acute Bronchitis Took's Court 5a F 14 „ „ Broncho-Pneumonia Tudor Street 26 M 68 31 Jan. „ Cardiac failure Upper Thames Street 178 M 82 9 Chronic Nephritis Warwick Square 12 F 86 8 April „ Old age Water Lane 3 M 4 hours 20 Nov. „ Inanition Westmoreland Buildings 8 F 51 12 Dec. „ Carcinoma Widegate Street 21 F 81 4 Jan. „ Cerebral Hæmorrhage „ „ 21 M 73 16 Feb. „ Carcinoma „ „ 19 M 3 3 May „ Broncho-Pneumonia „ „ 18 M 58 2 July „ Syncope ARTIZANS' DWELLINGS—STONEY LANE, HOUNDSDITCH. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. King's Block 28 F 79 11 Feb., 1909 Senile Decay „ „ 3 F 52 30 Oct. „ Carcinoma North Block 25 M new born 10 Sept. ,, Premature birth „ „ 25 F 42 24 Oct. „ Bright's Disease „ „ 11 M 85 9 Dec. „ Senile Decay Princes Block 12 M 28 5 Jan. „ Phthisis „ „ 40 M 2 13 Nov. „ Morbilli „ „ 12 M 9 weeks 1 Dec. „ Overlaid Inq. and P.M. Misad[venture „ „ 45 M 13 m'ths 14 „ Acute Bronchitis „ „ 8 M 81 28 „ „ Chronic Bronchitis Queen's Block 26 F 43 2 Feb. „ Valvular Heart Disease South Block 39 F 69 26 May „ Carcinoma „ „ 27 F 82 6 July „ Gastro-Enteritis „ „ 8 M 53 12 Sept. „ Clot of Blood on Brain Inquest and P.M. 146 Appendix B. LIST OF INFECTIOUS CASES, 1909. STREET LISTS. Compiled from Notifications received. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. 1909. Abchurch Lane 31 F 6 Chicken-pox. 25th March. Amen Court 7 F 26 Puerperal Fever. 17th April. Angel Court 12 & 13 F 5 Chicken-pox. 8th March. Ditto 12 & 13 F 8 Ditto. 18th March. Arthur Street West 5 F 9/12 Ditto. 6th April. Ditto 5 F 6 Ditto. 23rd March. Ditto 5 F 10 Ditto. 6th April. Ditto 5 F 13 Ditto. 6th April. Barbican 33 F 26 Erysipelas. 31st December. Bartholomew Close 41 M 1 Diphtheria. 10th May. Ditto 50 M 1 Chicken-pox, 22nd March. Beer Lane 17 M 29 Ditto. 15th January. Bishopsgate Street Within 88 M 8 Diphtheria. 26th April. Bishopsgate Street Without 44 F 22 Scarlet Fever. 19th November. Ditto 136 F 18 Ditto. 7th June. Blomfield Street 13 M 6½ Ditto. 4th January. Ditto 13 F 36 Ditto. 1st January. Brackley Street 5 M 15 Ditto. 20th January. Cannon Street 64 M 3 Diphtheria. 17th June. Ditto 64 M 5 Ditto. 17th June. Carter Lane (Choir House) ... M 22 Chicken-pox. 12th January. Carter Lane 22 M 28 Scarlet Fever. 15th June. Charterhouse Street 18 M 21 Ditto. 19th May. Eastcheap 39 M 5 Chicken-pox. 10th March. Fetter Lane 36 F 5 Scarlet Fever. 1st January. Fish Street Hill 27 M 11 Chicken-pox. 8th April. Fleet Street 162 to 165 F 27 Enteric Fever. 27th January. George Yard, Lombard Street 8 M 6½ Chicken-pox. 22nd March. Ditto 8 F 7½ Ditto. 22nd March. Ditto 8 F 9 Ditto. 8th March. Ditto 12 F 11 Scarlet Fever. 18th March. Ditto 12 F 12 Ditto. 18th March. Gracechurch Street 38 F 3 Chicken-pox. 4th March. Ditto 38 F 5 Ditto. 4th March. Ditto 79 F 16 Ditto. 18th April. Half Moon Passage 5 M 3 Diphtheria. 10th December. High Street, Aldgate 53 F 19 Erysipelas. 10th August. Holborn Buildings 7 M 4 Scarlet Fever. 30th June. Holborn Circus 7 F 28 Phthisis. 11th March. Ditto 7 F 20 Diphtheria. 23rd March. Hosier Lane 30 M 13 Ditto. 27th September. Houndsditch 12 M 11 Scarlet Fever. 12th July. Hutchison Avenue 1A F 44 Erysipelas. 15th September. Ditto 26 M 49 Ditto. 6th December. Hutchison House ... F 5½ Chicken-pox. 18th January. 147 Street or Place. No. of House. Sex. Age. Disease. Date of Notification. 1909. Ireland Yard ... M 15 Scarlet Fever. 20th March. King Street, Snow Hill (Blomfield House) ... F 12 Ditto. 2nd October. Lime Street 1 M 5 Chicken-pox. 10th March. Little Trinity Lane 5 M 54 Erysipelas. 4th December. London Wall Buildings 2 M 7 Chicken-pox. 30th March. Ditto 4 F 7 Scarlet Fever. 4th August. Long Lane 78 M 4 Diphtheria. 25th June. Lower Thames Street 3 F 4 Chicken-pox. 19th April. Mark Lane 20 F 4 Diphtheria. 21st July. Ditto 20 F 6 Ditto. 26th May. Metal Exchange Buildings 2 M 8 Chicken-pox. 9th July. Middle Street 24 M 19 Enteric Fever. 10th February. Middlesex Passage 5 F 8 Scarlet Fever. 23rd June. Middlesex Street 25 M 26 Erysipelas. 2nd February. Milton Street 31 M 17 Scarlatina. 2nd April. Ditto 31 M 18 Ditto. Moorgate Street 52 M 14 Diphtheria. 11th March. Ditto 71 M 19 Phthisis. 16th November. Moor Lane Chambers 24 M 51 Enteric Fever. 1st December. New Street, Gravel Lane 27 F 1 Scarlet Fever. 1st December. North Block, Stoney Lane 3 F 2 Diphtheria. 10th July. Ditto 11 M 87 Erysipelas. 31st May. Pemberton Row 5 M 10/12 Scarlet Fever. 15th November. Plum Tree Court (City Temple) ... M 38 Phthisis. 9th December. Prince's Block, Stoney Lane 55 F 71 Erysipelas. 6th November. Providence Place 7 F 1 Diphtheria. 13th October. Ditto 9 M 2 Ditto. 21st September. Ditto 9 M 3 Ditto. 20th September. Queen Street 96 F 10 Scarlet Fever. 5th June. Robin Hood Court Infirmary, Casual Ward, and Guardians' Depot, 18, Thavies Inn M 31 Erysipelas. 15th November. ... M 38 Ditto. 1st December. M 49 Phthisis. 1st January. Rose Alley 8 M 6 Scarlet Fever. 18th March. Ditto 38 M 5 Chicken-pox. 8th March. Ditto 53 F 8 Ditto. 8th March. St. Bartholomew's Hospital (including Nurses' Home) ... ... ... Scarlet Fever, 5 cases. St. Mary Axe 23 M 39 Phthisis. 12th March. Ditto 23 M 5 Chicken-pox. 12th March. Ditto 23 M 6 Ditto. 12th March. St. Paul's Churchyard (The Chapter House) ... F 18 Scarlet Fever. 12th May. F 52 Ditto. Savage Gardens 3 M 5 Ditto. 5th January. Ditto 11 M 12 Chicken-pox. 22nd June. Seething Lane 41 F 35 Phthisis. 31st December. Serjeants' Inn 13 M 2 Diphtheria. 16th December. South Block, Stoney Lane 40 F 4 Scarlet Fever. 10th February. Ditto 40 M 1 Ditto. 10th February. Three Nuns Court 1 F 45 Ditto. 6th October. Upper Thames Street 107 M 13 Ditto. 5th April. Water Lane 3 & 4 M 53 Anthrax. 4th June. Watling Street 28 M 14 Diphtheria. 27th October. William Street 2 M 20 Scarlet Fever. 11th September. 148 Appendix C. REGISTER OF HOUSES Let in lodgings or occupied by members of more than one family. WEST DISTRICT Situation of Premises. Name and Address of Owner. Tenements. Lodgers. 11, Bartholomew Close A. Clevely, 11, Bartholomew Close 4 7 43, do. E. Haley, 2, Cross Key Court, London Wall 3 10 44, do. T. Veil, 44, Bartholomew Close 2 4 85, do. T. Gibson, The Charterhouse, Charterhouse Square 3 7 6, Bartholomew Place Henry Hoggett, 6, Bartholomew Place 1 3 20, Bride Lane A. Price, 20, Bride Lane 3 6 5, Britton's Court James Hurrel, 5, Britton's Court 2 2 1, Burgon Street Mrs. Lewis Tripp, 1, St. Andrew's Hill 2 5 1, Chapel Place, Fetter Lane. J. F. Pemsel, 15, Oakfield Road, Stroud Green 3 4 2, do. do. Do. do. do. 2 4 6 & 7, Cloth Fair 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 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 1 8 43, do. Charles Randall, 6, Cumming Street, Pentonville. 2 6 44, do. Do. do. do. 4 7 45, do. W. and J. Biggerstaff, 59, West Smithfield 2 7 1, Cockerill's Buildings Margaret Walker, 1, Cockerill's Buildings 2 5 2, do. E. Haley, 38, Bartholomew Close 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, 38, Bartholomew Close 3 3 5, Currier's Row G. Tabor, 5, Currier's Row 3 5 6, do. Arthur Bedford, 6, do. 3 5 7, do. William Bampton, 7, do. 2 14 12, do. Mrs. Edwards, 12, do. 4 11 13, do. H. Scowen, 13, do. 1 4 5, Dorset Street H. Fenlon, 5, Dorset Street 5 6 Carried forward 107 260 149 WEST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers Brought forward 107 260 7, Dorset Street E. King, 23, Whitefriars Street 3 10 10, East Harding Street Mrs. Greenwood, 10, East Harding Street 2 5 11, do. F. Rayner, 11, do. 2 10 12, do. M. Kersey, 12, do. 1 1 5, East Passage, Cloth Fair. James T. Deeks, 5, Offerton Square, Clapham 4 8 27, do. Do. do. do. 3 6 2, Evangelist Court T. Brown, 2, Evangelist Court 3 9 1, Fenton's Buildings Thomas Matthews, 46, Beech Street, E.C. 1 2 2, do. Do. do. do. 3 7 3, do. Do. do. do. 3 10 42, Fetter Lane Mrs. Richards, 42, Fetter Lane 1 4 93, do. J. Hook, 106, St. James' Road, Holloway 4 11 29, Fleet Lane Willats & Co., 66, Holborn Viaduct 3 8 30, do. Do. do. 2 4 31, do. Do. do. 2 5 1, Great New Street James Barnsley, 1, Great New Street 4 13 20, do. G. Stanbury, 25, do. 6 20 2, do. Sidney Gardner, 2, do. 7 15 3, do. Do. do. 4 6 5, Green Dragon Court H. Johnson, 5, Green Dragon Court 2 2 6, do. W. F. Hurburt, 6, do. 2 4 7, do. Mrs. Sawyer, 7, do. 3 4 2, Greystoke Place G. Reveirs, 4, Greystoke Place 3 6 3, do. Michael Flynn, 8, do. 4 4 6, do. WTilliam G. Cuss, 6, d . 1 8 7, do. Harriet Evans, 9, Greystoke Place 4 15 8, do. Do. do. 2 12 9,Greystoke Place, Fetter Lane. Do. do. 4 10 2 Gunpowder Alley Thomas Young, 2, Gunpowder Alley 1 1 8, do. M. Nazzani, 3, Shoe Lane 2 2 7½, do. Do. do. 4 16 4, Half-Moon Passage D. Cohen, 17, Tokenhouse Yard 2 3 5, do. Do. do. 2 6 6, do. Do. do. 2 8 6, Holborn Buildings Prudential Assurance Co. 6 14 7, do. Do. do. 7 16 3, Hosier Lane John Sullivan, S, Hosier Lane 1 2 4, do. Phillips & Tribe, Cock Lane 1 6 5, do. W. J. Lardner, 6, Hosier Lane 2 7 36, Hutton Street Elliot & Co., 40, Chancery Lane 2 4 13, King's Head Court, Shoe Lane. H. Deighton, 54, Great Percy Street, W.C. 4 10 14, do. Do. do. 4 12 16, do. Do. do. 8 16 17, do. Do. do. 5 5 Carried forward 243 607 150 WEST DISTRICT— continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 243 607 25, Kinghorn Street W. Phelan, 20, Cloth Fair 3 6 25a, do. Do. do. 4 13 1, Little Montague Court J. Abbott, 103, Aldersgate Street 2 10 2, do. Do. do. 5 17 54, Little Britain Thomas N. Janes, 101, Aldersgate Street 1 2 79, Long Lane Robert Dyas, 87, Fore Street 3 6 80, do. L. M. Migliorini, 80, Long Lane 3 5 82, do. F. Garnett, 73, Long Lane 2 4 86, do. H. Lee, 86, do. 1 4 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. 1 2 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, 38, Bartholomew Close 4 5 20, do. T. Green, 20, Middle Street 2 3 2, Montague Court, Little Britain. H. Sawyer, 2, Montague Court 2 6 3, do. James Long, 4, do. 3 8 4, do. Do. do. 3 5 5, do. T. Eburne, 5, do. 2 4 6, do. Thomas J. Spernick, 6, do. 3 11 7, Nevill's Court J. F. Pemsel, 15, Oakfield Road, Stroud Green 3 11 8, do. Do. do. do. 3 4 9, do. Do. do. do. 2 6 10, do. Do. do. do. 6 10 11, do. Goldsmiths' Company, Goldsmiths' Hall 8 15 12, do. Do. do. 8 15 13a, do. Do. do. 6 20 14, do. Do. do. 6 10 10, Newbury Street 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 13, Newcastle Street, Farringdon Street. Arthur Wilks, 13, Newcastle Street 1 2 10, New Street Square Herbert Mogridge, 10, New Street Square 1 4 1, Pope's Cottages Edward Haley, 38, Bartholomew Close 6 6 2, do. Do. do. 3 12 19, Primrose Hill Crawley & Smee, 19, Primrose Hill 3 10 20 do. E. Coulson, 20, do. 4 10 22 do. Thomas Palmer, 22, do. 3 12 Carried forward 397 950 151 WEST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers Brought forward 397 950 6 & 7, Red Lion Passage, Cloth Fair. H. J. Ward, 6 and 7, Kinghorn Street 6 25 6, Temple Lane John Allen, 34, New Bridge Street 4 10 7, do. Do. do. 7 20 8, do. Do. do. 7 16 5a, Took's Court E. J. Hopkins, 5a, Took's Court 8 2 57, West Smithfield T. A. Allen, 57, West Smithfield 6 14 9, The Broadway T. Frost, 9, The Broadway 4 8 Total 437 1,045 Average number of lodgers to each tenement: 2.44. WEST DISTRICT. Houses demolished or closed in 1909:—26, Cloth Fair. 35, Fetter Lane. 36, do. 37, do. 38, do. 15, Water Street. 41, Little Britain. Tenement houses 129 Cleansing notices served 174 152 MIDDLE DISTRICT. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. 104, Aldersgate Street William Harris, 158, Kingsland Road 2 2 *34, Beech Street Mr. Perry, 21, Whitecross Street — — 1 and 2, Huggin Court Little Trinity Lane. Heeps, Son and Reeve, 4, Old Jury 4 12 9, Huggin Lane H. Belcher, 8, Martin's Lane 3 3 10, do. H. Willis, 10, Huggin Lane 5 6 2, Little College Street George Shadbolt, 2, Little College Street 2 5 3, do. W. Wild, 3, do. 2 4 15, Swan Lane H. Postlewaithe, 15, Swan Lane 5 6 *2, St. James' Place, Garlick Hill. Charles J. Shears, 2, St. James' Place — — 1, Shaftesbury Place Mrs. Sarah Turner, 1, Shaftesbury Place 2 4 2, do. Messrs. Boyce and Co., 92, Hoxton Street 1 4 3, do. The Ramoneur Co., 30, Shaftesbury Place 1 1 4, do. Messrs. Boyce and Co., 92, Hoxton Street 2 5 5, do. Do. do. 1 6 *6, do. Do. do. — — *7, do. Do. do. — — 8, do. Do. do. 3 7 9, do. T. Wood, 9, Shaftesbury Place 3 7 10, do. J. Regan, 10, do. 2 6 *11, do. Messrs. Boyce and Co., 92, Hoxton Street — — *12, do. Do. do. — — *13, do. Do. do. — — *14, do. Do. do. — — *15, do. Do. do. — — *16, do. Do. do. — — *17, do. Do. do. — — 18, do. J. Page, 18, Shaftesbury Place 2 6 19, do. Joseph Perry, 19, do. 2 5 *20, do. Messrs. Boyce and Co., 92, Hoxton Street — — *21, do. Do. do. — — *22, do. Do. do. — — *23, do. Do. do. — — *24, do. Do. do. — — *25, do. Do. do. — — *26, do. Do. do. — — *27, do. Do. do. — — *28, do. Do. do. — — Total 42 89 *These houses, although at present empty, are retained on the register. Average number of lodgers to each occupied tenement: 2.12. 17 Cleansing Notices served served. 37 Tenement houses on register. 153 EAST DISTRICT. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. 27, Aldgate A. L. Poysner, 27, Aldgate 1 2 6, do. S. Yeomanson, 6, do. 3 10 7, Artillery Lane J. Hart, 1, Wheeler Street, Spitalfields 8 19 9, do. John Tharp, 9, Norton Folgate 6 14 12, do. Mrs. McCarthy, Bridport Arms, Harrison Street, Gray's Inn Road. 7 11 14, do. Do. do. do. 5 8 16, do. Do. do. do. 6 18 18, do. Do. do. do. 2 5 20, do. B. Clements, 20, Artillery Lane 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. Luke Cohen, 12, Brushfield Street 3 6 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 T. Bohn, 6, 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 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 16, do. W. Cunningham, 16, Montague Court 2 2 3, Crown Place, Aldgate W. Braker, 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 S. Wallis, 78, Argyle Road, W. Ealing 2 2 10, do. J. A. Britton, 16 and 18, Houndsditch 3 8 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 Carried forward 115 254 154 EAST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 115 254 1, Hutchison Avenue A. J. Hollington, Middlesex Street 1 3 2, do. I. Solomons, 2, Hutchison Avenue 5 5 3, do. F. Simons, 3, do 3 8 4, do. Morris Cohen, 4, do. 2 8 6, do. M. Ferguson, 6, do. 1 2 7, do. J. Ferguson, 7, do. 1 1 9, do. Barnet Barnet do. 4 7 10, do. C. Zeffie do. 3 8 12, do. N. Foley, 26, London Street, Fitzroy Square 3 8 18, do. Theresa Ellis, 13, Hutchison Avenue 3 6 14, do. H. Messier, 14, do. 3 4 15, do. D. Joel, 15, do. 2 4 17, do. James Woolf, 18, Grenville Place, Maida Yale 3 8 18, do. Jacob Mercado, 18, Hutchison Avenue 3 7 21, do. Sarah Aarons, 21, do. 3 8 22, do. Isaac Schwartz, 22, do. 5 8 23, do. Frances Woolf, 18, Grenville Place, Maida Vale 3 9 24, do. J. Levy, 24, Hutchison Avenue 2 6 25, do. L. Marks, 25, do. 2 6 26, do. Lewis Josephs, 26, do. 3 7 5, Hutchison Street B. Jacobs, 5, Hutchison Street 2 7 6, do. I. Soloman, 6, do. 3 5 10, do. S. Marks, 10, do. 1 8 12, do. Morris Alder, 12, do. 1 1 16, do. J. Noah, 16, do. 3 9 17, do. J. Soloman, 17, do. 2 5 18, do. B. Lazarus, 18, do. 1 4 19, do. S. Ellis, 19, do. 1 2 20, do. David Jacobs, 20, do. 1 6 Janes Buildings, Hutchison Street. Blum, Whipps Cross, Walthamstow 3 7 28, Mansell Street, Aldgate. A. Woolf, 28, Mansell Street 3 7 30, do. Maimes Elbaum, 30, do. 2 6 23, Middlesex Street Charles Harford, 28, Middlesex Street 1 9 71, do. S. Valentine, 71, do. 2 4 6,New Street, Gravel Lane N. Woolff, 6, New Street 2 7 8, do. do. I. Bendon, 8, do. 3 3 9, do. do. Isaac Solomon, 9, do. 2 8 10, do. do. Moss Hillier, 10, do. 1 1 11, do. do. Morris Jacobs, 11, do. 3 3 12, do. do. S. Costa, 12, do, 3 12 12a, do. Bishopsgate Thos. Wicks, 12, do. 3 6 13, do. Gravel Lane W. Murray, 13, do. 3 8 14, do. do. Joseph Panyer, 14, do. 2 7 15, do. do. Harris Norden, 15, do. 2 3 Carried forward 220 515 155 EAST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 220 515 16, New Street, Gravel Lane Simons Levy, 16, New Street 3 8 17, do. do. Marks Joseph, 17, do. 2 2 18, do. do. Harris Zuzzie, 18, do. 3 10 19, do. do. Mrs. Goodman, 19, do. 2 6 22, do. do. A. Hufdel, 22, do. 1 4 23, do. do. B. Nordheim, 23, do. 2 7 24, do. do. Joseph Levy, 24, do. 3 6 26, do. do. Reynolds & Eason, 43, Bishopsgate Street Without 3 8 27, do. do. Do. do. 3 9 28, do. do. Do. do. 2 7 30, do. do. Do. do. 3 5 32, do. do. Henry Jacobs, 32, New Street 3 10 34, do. do. T. Bonislove, 34, do. 1 1 36, do. do. R. Singer, 36, do. 4 11 37, do. do. I. Ichlovitch, 37, do. 2 2 40, do. do. Mary Roach, 40, do. 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 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. Lockharts, 2, Union Row 4 10 8, Vine Street, do. John Roberts, 7, Circus, Minories 6 19 9, do. do. Do. do. 9 24 12, Widegate Street A. Witherington, 12, Widegate Street 2 2 17, do. A. Cohen, 17, Widegate Street 2 6 18, do. S. Franks, 18, do. 2 5 20, do. H. Dixon, 20, do. 2 10 21, do. A. Field, 182, Hanbury Street 5 8 23, do. Do. do. 6 2 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 Allen, 9, do. 1 1 2, Goodman's Yard, Minories. Messrs. Moss & Jameson, 77, Chancery Lane 4 7 5, Artillery Lane J. Hart, 1, Wheeler Street, Spitalfields 8 23 Total 342 811 Average number of persons to each tenement: 2.38. EAST DISTRICT. Houses demolished or closed during 1909:—36, Mansell Street. 38, do. Tenement houses 120 Cleansing notices served 142 156 Appendix D. List of Persons registered under the Dairies, Cowsheds and Milkshops Order. 1st January, 1910. Premises. Person Registered. Premises. Person Registered. 24, Aldersgate Street Robert Douglas. 22, Billiter Street John Stevenson, Andrew Ritchie, and Donald McDonald, trading as J. and B. Stevenson. 28/9, do. "J.P." Restaurants, Ltd. 30, do. John Thomas Gooden. 42, do. Nunzio Allocca. 54, do. Bartolerino Fabrizi. 23, do. William Cole and Grant Yentnor Robert Riach. 67, do. J. Lyons and Co., Ltd. 72, do. Slaters, Ltd. 9, Billiter Square Callard, Stewart & Watt, Ltd. 73, do. Nunzio Allocca. 5, Bishopsgate Church Passage. Gerardo Lamberti. 90, do. Bonaventura D'auria. 92, do. Joseph James Metcalf. 41, Bishopsgate St. W'n. Romulatto Mansi. 170, do. Aerated Bread Co., Ltd. 57, do. Slaters, Ltd. 179, do. Carlo Silvani. 60, do. W. Hill and Son, Ltd. 188, do. James Dwarber. 79, do. J. Lyons and Co., Ltd. 193, do. J. Lyons and Co., Ltd. 107, do. Aerated Bread Co., Ltd. 40, Aldermanbury Luigi Cattini. 15/6, Bishopsgate St.W't. Aerated Bread Co., Ltd. 55, do. Aërated Bread Co., Ltd. 19, do. J. Lyons and Co., Ltd. 62, do. Luigi Cattini. 31, do. Atanasio Diviani. 12 and 13, Aldgate Lockharts, Ltd. 42, do. British Tea Table Co., Ltd. 24, do. J. Lyons and Co., Ltd. 51, do. Antonetta Arpino. 28, do. Dominico George 77, do. Gaston Debry. 7, Aldgate High Street John Wattam. 90, do. William Sandrock. 73, do. Express Dairy Co., Ltd. 111, do. Arthur James Tipping. 7, Artillery Lane Louise Mellor. 23, Birchin Lane Mary Ann Ivison and Jane Laver, trading as M. A. Ivison and Co. 22, do. Thomas Piggott. 1, Austin Friars Olive Marie Muriel Simonds. 5, do. Express Dairy Co., Ltd. Blackfriars Bridge Station J. Lyons and Co. Ltd. 6/7, Barbican Aerated Bread Co., Ltd. 17, do. Peter Fumasoli. 8/10, Blomfield Street "J.P." Restaurants, Ltd. 20, do. Lockharts, Ltd. 4, Botolph Alley Charles Peach. 43a, do. John Davies. 2, Bow Lane "J.P." Restaurants, Ltd. 9, Bartholomew Close Price's Restaurants, Ltd. 9, do. Pasquale Mansi. 21, do. Charles Baker. 11, do. Antoinette Fontanne. 38, do. Catherine Lewis. 38a, do. Frien Manor Dairy Farm, Ltd. 53, do. George Smith. 46, do. P. Palumbo. 89, do. William Henry Letley. 54, do. Andrea Beschizza. 1, Basingball Street Aerated Bread Co., Ltd. 43, Bread Street Dominico Cavalli. 15, do. Luigi Necchi. 33, Breams Buildings Thomas Henry Davis. 16, do. Pasquale Palumbo. 18, Bride Lane Herbert John Heath. 29/30, do. J. Lyons and Co., Ltd. 20, do. David Davies. 54, do. Alfred Golding. 3, Brushfield Street Henry Pugh Lloyd. 65, do. Celia Faulkner. 3, Bridgewater Street Charles Cromwell Crocker. 69, do. Express Dairy Co., Ltd. 5, Broad Street Place Aerated Bread Co., Ltd. 1, Gresham Buildings, Basinghall Street London Cafe Co., Ltd. 14, do. Richard Mills & Co., Ltd. Broad Street Station Aerated Bread Co., Ltd. 50, Beech Street John Richards. 4, Broadway Percy Robson. 4, Beehive Passage Lockharts, Ltd. 7, do. J. Lyons and Co., Ltd. 7, Bell Yard Jane Mary Ann Birch. 35, Bucklersbury J. Lyons and Co., Ltd. 157 Premises. Person Registered. Premises. Person Registered. 2, Budge Row Jane Anderson Carnegie. 8, Copthall Avenue Alexander Hampton. 20, do. J. Lyons and Co., Ltd. 10 & 12, do. J. Lyons and Co. Ltd. 24, do. Edward Jennings. 15, do. James William Davis. 30, do. "J.P." Restaurants, Ltd. 28, Copthall Avenue Ulrich Maino. 3, Bull's Head Passage James Albert Hurry. 29, do. Exchange Cafe Co., Ltd. 9, do. Pasquale Cocchi. 9, Cornhill Aerated Bread Co., Ltd. 1, Burgon Street Nunzio Allocca. 7, Cripplegate Buildgs. Aerated Bread Co., Ltd. 1, Bury Street Express Dairy Co., Ltd. 7, Crooked Lane John Morgan Jones. la, do. Albert Alexander Price. 16. do. Judah Harris. 1, Byward Street Francesco Arpino. Crown Court (Old Broad Street) J. Lyons and Co., Ltd. 9, do. Aerated Bread Co. Ltd. 40/2, Cannon Street ... Aerated Bread Co., Ltd. 2, do. Henry Charles Bainbridge. 50, do. Slaters, Ltd. 13, Crutched Friars Express Dairy Co., Ltd. 51, do. Aerated Bread Co., Ltd. 27, do. Amy Mary White. 86, do. Aerated Bread Co., Ltd. 7, Cullum Street Antonio and Michele Precha. 91, do. W. Hill and Son, Ltd. 16, do. Luigi Cattini. 95, do. Madeline H. Oswald and Geo. Brown, trading as J. H. Brown. 21, Cullum Street Allard Bros. 26, do. Frederick Spiers. 14, Cursitor Street Martha Kersey. 99, do. J. Lyons and Co., Ltd. 3/5, Devonshire Street Henry Pearce. 139, do. London Cafe Co., Ltd. 8, do. Mitchells Dining Rooms, Ltd. 145, do. Ye Mecca, Ltd. 147, do. Aerated Bread Co., Ltd. 1 & 2, Dorset Street City Catering Co., Ltd, 153 and 155, Cannon St. "J.P." Restaurants, Ltd. 7, do. Guiseppe Indaco. Cannon St. Station Approach Aerated Bread Co., Ltd. 5, Dove Court (Old Jewry) Mary Ann Donnelly. 3 & 4, Camomile Street "J.P." Restaurants, Ltd. 2, Duke Street Lucidoro Mauro. 36, do. Pietro Necchi. 12, do. Frank Dyson. 36a & 37, do. Henry Douglas Fletcher. 41, do. Francesco Berti. 46, Carter Lane Albert Edward Knapp. 50, do. Carmelo Canini. 54, do. Reuben Josephus Phillips. 5, Eastcheap Aerated Bread Co., Ltd. 57a, do. Daniel Smith. 15, do. Ye Mecca, Ltd. 75, do. John Humphreys. 28, do. Aerated Bread Co., Ltd. 79, do. T. B. Loader. 35, do. J. Lyons and Co., Ltd. 81, do. City Catering Co., Ltd. 49 & 51, Eastcheap, (Ceylon House) "J.P." Restaurants, Ltd. 12, Carthusian Street Helen F. Higgins. 60, Charles Street George William Copeland. 16, Eldon Street J. Lyons and Co., Ltd. 18, Charterhouse Street "J.P." Restaurants, Ltd. 18, do. Bartolomeo Cattini. 38, do. John Vincent. 25, do. "J.P." Restaurants, Ltd. 23, Cheapside J. Lyons and Co., Ltd. 5, Falcon Square Price's Restaurants, Ltd. 26, do. Slaters, Ltd. 2, Falcon Street Nunzio Allocea 51, do. Aerated Bread Co. 59, Fann Street Serafino Fazzani. 66, do. Tiffin, Ltd. 32, Farringdon Street Arthur Atkins. 74/5, do. Slaters, Ltd. 33, do. Friern Manor Dairy Farm Ltd. 77, do. Aerated Bread Co., Ltd. 128, do. J. Lyons and Co., Ltd. 39, do. "J.P." Restaurants, Ltd. 140, do. Ye Mecca, Ltd. 40, do. " J.P." Restaurants, Ltd. 150, do. Aerated Bread Co., Ltd. 62, do. David and Robert Jones. 7, Clark's Place Jessie A. Harris 65, do. Amerighi Guilio. 2, Cloak Lane Romulatto Mansi. 67, do. Lewis Bertram Heyward. 20, Cloth Fair William Mortimer Phelan. 70/1, do. Geo. Jas. and Arthur J. Silverlock. 22, do. Flora Jackson. 19, Cock Lane Jane Jones. 72, do. City Catering Co., Ltd. 23, Coleman Street Ye Mecca, Ltd. 79, do. Edwin John Ridout. 38, do. Antonio and Valentine Ostacchini, trading as Ostacchini and Son. 87, do. Peter Zanchi. 88, do. Frederick Philipp Weinel. 2, Fen Court... Aerated Bread Co., Ltd. 70, do. Hyman Simons. 15, Fenchurch Street... Aerated Bread Co., Ltd. 74, do. Bartolomeo Zaccarini. 30, do. Rose Malyon. Copthall Ave.(Throgmorton House) Florence Le Breton. 31, do. J. Lyons and Co., Ltd. 47, do. The Cabins, Ltd. 158 Premises. Person Registered. Premises. Person Registered. 62, Fenchurch Street Aerated Bread Co., Ltd. 2, Friday Street, Giero Lovino. 69, do. Croci Carlo. 31, do. Claire Palmyra Jenman. 99, do. Aerated Bread Co., Ltd. 65, do. Aerated Bread Co., Ltd. 107, do. "J.P." Restaurants, Ltd. 1, Furnival Street Henry Charles Leaver. 157, do. Calamiro Diviani. 4, do. Food Reform Co., Ltd. 161, do. Maynards, Ltd. 11, Garlick Hill Walter Robert William Marchant. 164, do. Slaters, Ltd. 1, Fenchurch Buildings "J.P." Restaurants, Ltd. 12, George Yard Callard, Stewart and Watt, Ltd. 1, Railway Approach J. Lyons and Co., Ltd. Fenchurch St. Station Henry Christian Thomas Amendt. 3, Godliman Street Arthur H. Hill, Margaret Hale, and Alice George, trading as Free and Co. 19/20, Fetter Lane "J.P." Restaurants, Ltd. 31, do. Morgan Jones. 21, do. Express Dairy Co., Ltd. 33, do. Joseph Pratt. 8, Gougn Square William Lloyd. 42, do. Elizabeth Richards. 12, Gracechurch Street Charles John Haag. 44/5, do. Stewart and Wight, Ltd. 33, do. Aerated Bread Co., Ltd. 57, do. Paul Quartermass. 41, do. Maynards, Ltd. 83, do. Mary Harris. 51, do. J. Lyons and Co., Ltd. 1, Finsbury Pavement Luigi Ostacchini. 69, do. Callard, Stewart and Watt, Ltd. 73, do. Aerated Bread Co., Ltd. Electra House, Finsbury Pavement Henry Phillips. 72/3, do. J. Lyons and Co., Ltd. 77/78, do. London Cafe Co., Ltd. Finsbury Pavement. House. J. Lyons and Co., Ltd. 119, Gravel Lane, Houndsditch. William Cambridge. 22, Fish Street Hill George Porteous Johnston. 1, Great New Street Sarah Amelia Barnsley 37, do. Pasqualino Palumbo. 12, do. Maria J. L. Kersey. 2, Fishmongers' Alley Mary Jones. 31, Great St. Helen's Rose Malyon. 16, Fleet Street George Rice Bolton. " Crosby House," Great St. Helen's. Ye Mecca, Ltd. 23, do. J. Lyons and Co., Ltd. 46, do. James Love Lightfoot, Jnr. 12, Great Swan Alley G. Payne, J. J. Rawlings, trading as Sarah Rawlings and Co. 61, do. J. Lyons and Co., Ltd. 62, do. Matteo Mansi. 109, do. Lockharts, Ltd. 14, Great Tower Street Stewart and Wight, Ltd. 116, do. Aerated Bread Co., Ltd. 17/8, do. Aerated Bread Co., Ltd. 131, do. Express Dairy Co., Ltd. 24/25, do. Andrew Glenning. 167, do. Cabins, Ltd. 28, do. Thomas Stevenson. 173, do. J. Lyons and Co., Ltd. 58, do. Joseph James Medcalf. 175, do. Luigi Lieto. 74, do. J. Lyons and Co., Ltd. 182/3, do. " J.P." Restaurants, Ltd. 78, do. Callard, Stewart and Watt, Ltd. 190, do. Aerated Bread Co., Ltd. 30, Fleet Lane Michale Indaco. 96, do. London Clerks' Café Co.,Ltd. 31, do. Albert Edwin Derry. 100, do. Ercole Farnese. 17, Fore Street J. Lyons and Co., Ltd. 1, Gresham Street Aerated Bread Co., Ltd. 28, do. William R. Child. 1, do. ' Friern Manor Dairv Farm, Ltd. 46, do. Antonio Lusardi. 54, do. J. Lyons and Co., Ltd. 3, do. Ye Mecca, Ltd. 56/7, do. Aerated Bread Co., Ltd. 5, do. Antonio Ostacchini. 70, do. Priori Oresti 11, do. Pietro Barbieri 84, do. Lockharts, Ltd. 46, do. J. Lyons and Co., Ltd. 85, do. Walter Arthur Merritt. 54, do. Ye Mecca, Ltd. 90, do. Rafaele Ferrara. 69, do. Aerated Bread Co., Ltd. 108, do. Elizabeth Charlotte Collett. 87, do. Express Dairy Co., Ltd. 112, do. William Brieesser. 93a, do. Raffaele Ferrara. 2, Foster Lane Giovanni Diviani. 12, Grocers' Hall Court Timothy Jones. 5, do. John Roberts. 7½ Gunpowder Alley William James Argent. 41, do. Arthur H. Hill, Margaret Hale, and Alice George, trading as Free and Co. 12, Harp Lane Frederick C. H. Coles. 5, Hart Street Alice Sarah Sycamore. 31, Holborn Aerated Bread Co., Ltd. Freeman's Court, Cheapside. Arthur H. Hill, Margaret Hale, and Alice George, trading as Free and Co. 114/5, do. Aerated Bread Co., Ltd. 144, do. Luigi Rattazzi. 145, do. Slaters, Ltd. 159 Premises. Person Registered. Premises. Person Registered. 1/2, Holborn Viaduct Aerated Bread Co. Ltd. 50, Leadenhall Market Henry George Saunders. 14, do. J. Lyons and Co., Ltd. 54/5/6, do. Lewis Dowling. 65, do. Express Dairy Co., Ltd. 101, Leadenhall Street Ye Mecca, Ltd. 1, Honey Lane Market Dominico Cavalli. 106, do. Aerated Bread Co., Ltd. 4, do. J. Lyons and Co., Ltd. 140, do. Aerated Bread Co., Ltd. 9, do. John Gow. 8/9, Lime Street John Stevenson, Andrew Ritchie, and Donald McDonald, trading as J. and B. Stevenson. 10, do. John Thomas Gow. 1, Hosier Lane David Morgan. 1, Houndsditch Giovanni Devincenzi. 105, do. Bartolomeo Cattini. 15a, do. Express Dairy Co., Ltd. 118, do. David Jones. 23, do. J. Lyons and Co., Ltd. 1, Huggin Court 10, Huggin Lane Emma Watts. 24, do. Ye Mecca, Ltd. Jane Benjamin 26, do. ... Aerated Bread Co., Ltd. 19, Hutchison Avenue Joseph Falk. 29, Lime Street Lozzaro Cattini. 13, Hutchison Street Isidore Spivakoff. 34, do. Agnes Powell. 15, do. Jacob and Leah Miller. 53, do. Ulrich Maino. 35, Hutton Street Amy Reeve. Price's Restaurants, Ltd. 4, Little Britain Frederick Pearce. 13, Idol Lane 17, do. Sarah Page. 3, Imperial Arcade Friern Manor Dairy Farm, Ltd. 19, do. Express Dairy Co., Ltd. 25, do. John Davies. 20, Ironmonger Lane Bertha Annie Gander. 33, do. Welford and Sons, Ltd. 27, do. The Cafe Syndicate, Ltd. 54, do. Guiseppe Fazzani. 28/9, do. "J.P." Restaurants, Ltd. 6, Little Trinity Lane Agnes Howat. 8/9, Ivy Lane Sidney Geo. Doggett. 27, Liverpool Street ... Romulatto Mansi. 14, do. Eisa Riva. 37, do. David Lowrie. 18, do. Andrea Proto Liverpool Street Station. H. C. T. Amendt. 22, do. West London Dairy Co., Ltd. 4, Lombard Court ... Ye Mecca, Ltd. 39, Jewin Crescent Giovanni Caccioli. 5, Lombard Street ... Aerated Bread Co., Ltd. 6, Jewin Street E. Seton Karr. 74, do. Aerated Bread Co., Ltd. 9, do. J. Lyons and Co., Ltd. 319, London Central Markets. Lockharts, Ltd. 24, do. George McFarlane. 26, do. Rosina Andrews. 332, do. Cream Dairy Co., Ltd. 31, do. "J.P." Restaurants, Ltd. 45, do. William Newman. 3/4, London House Yard. George Porteous Johnston. 8, Jewry Street John Jones. 32, do. Angelo Beschizza. la, London Street Friern Manor Dairy Farm, Ltd. 12, John Street William Alston. 4, do. Croci Carlo. 27, King Street Biagio Manzi. 8, do. Lockharts, Ltd. 32, do. Aerated Bread Co., Ltd. 19, do. Aerated Bread Co., Ltd. 22, King Street, West Smithfield Price's Restaurants, Ltd. 34, London Wall Andrew Glendinning. 46/7, do. J. Lyons and Co., Ltd. 8, King's Head Court Frederick Lewindon. 49, do. Ye Mecca, Ltd. 8, King William Street Slaters, Ltd. 55, do. "J.P." Restaurants, Ltd. 32, do. Lockharts, Ltd. 58a, do. Express Dairy Co., Ltd. 34, do. J. Lyons and Co., Ltd. 138a, do. Biagio Manzi. 44, do. Aerated Bread Co., Ltd. 151, do. (Salisbury House). Aerated Bread Co., Ltd. 50, do. J. Lyons and Co., Ltd. 51, do. Mitchell's, Ltd. 52/53, Long Lane Joseph Young. 61, do. J. Lyons and Co., Ltd. 55, do. Edward Woodman. 64, do. Aerated Bread Co., Ltd. 77, do. Francis Arthur Lester. 25a, Kinghorn Street William Phelan. 80, do. Luigi Migliorina. King's Arms Yard Ye Mecca, Ltd. 85, do. Evan Rees. 48, Knightrider Street William Adamson. 75, Lower Thames St. Thomas Deacon. 1, Laurence Lane Angelo Beschizza. 129½, do. Catello Rabicano. 14, do. Anselmo Beschizza. 5, Ludgate Circus J. Lyons and Co., Ltd. 19, Leadenhall Market J. T. Gardner. 1, Ludgate Circus Buildings. Slaters, Ltd. 38, do. Arthur H. Hill, Margaret Hale, and Alice George, trading as Free and Co. 10/12, Ludgate Hill J. Lyons and Co., Ltd. 16, do. Callard, Stewart and Watt, Ltd. 40, do. Lewis Thomas Owen and Percy John Randall. 160 Premises. Person Registered. Premises. Person Registered. 21, Ludgate Hill J. Lyons and Co., Ltd. 18, Newgate Street Slaters, Ltd. 29, do. Aerated Bread Co., Ltd. 24, do. Aerated Bread Co., Ltd. 38, do. Aerated Bread Co., Ltd. 33, do. "J.P." Restaurants, Ltd. 54, do. Express Dairy Co., Ltd. 87, do. J. Lyons and Co., Ltd. 56, do. Ye Mecca, Ltd. 122/3, do. Peter Diviani. 74, do. J. Lyons and Co., Ltd. 33, Noble Street Eginto Landi. Ludgate Hill Station J. Lyons and Co., Ltd. 44, do. Antonio Ostacchini. 6, Maidenhead Court... Matteo Mansi. 19/20, Old Bailey Lockharts, Ltd. 14, do. William John Palmer. 33, Old Broad Street Aerated Bread Co., Ltd. 20, do. David Haydon. 40, do. Aerated Bread Co., Ltd. 48, Mark Lane Liverpool China and Indian Tea Co., Ltd. 2, Old Change Andrea Marroni. 13a, do. "J.P." Restaurants, Ltd. 69/70, do. Ye Mecca, Ltd. 6, Old Jewry The Cabins, Ltd. 78, do. Express Dairy Co., Ltd. 33, do. Katherine Mellisle. 80/81, do. J. Lyons and Co., Ltd. 3, Pancras Lane Frederick Walter Hicks. 3, Mason's Avenue Antonio Ostacchini. 5/6, Paternoster Row "J.P." Restaurants, Ltd. 25, Middlesex Street (Middlesex House) Mitchell's Dining Rooms, Ltd. 12, do. Giovanni Strinate. 60, do. J. Lyons and Co., Ltd. 36a, Milton Street Catherine Ellis. 5, Paul's Alley Carlo Demaria. 71, do. Charles Gentry. 8, Philpot Lane Alberti Intrepidi. 76, do. Andrew Annanson. 22, do. Alfred Walter Bennett. 16, Mincing Lane Luigi Cattini and Giorgio Beschizza. 21, Pilgrim Street Galvani Andrea. 32, do. Priori Oreste. 17, do. London Cafe Co., Ltd. 34, do. Aerated Bread Co., Ltd. 30, do. Slaters, Ltd. 30, Poppin's Court Guiseppe Indaco. 99, Minories Walter Bugden. 31, Poultry J. Lyons and Co., Ltd. 136, do. Elizabeth King. 1, Queenhithe Albert Ashlee. 155, do. William McGavin Reid. 10, Queen Street J. Lyons and Co., Ltd. 9, Mitre Street Henry William Richards. 40, do. Egidio Fabrizi. 10, Monk well Street George Cattini. 70, do. Fredk. Chas. Weidig, trading as Weedon Bros. "Monument Dairy," Monument Street. Frederick Lewindon. 71, do. Lockharts, Ltd. 43, Moor Lane George Vincent. 81, do. Luigi Necchi. 28, Moorfields Express Dairy Co., Ltd. 85, do. Ellen Claire Aveline. 38, do. Conti Celestino. 7, Queen Victoria Street Express Dairy Co., Ltd. 19, Moorgate Street Alexander Hampton. 17, do. J. Lyons and Co., Ltd. 28, do. Aerated Bread Co., Ltd. 35a, do. Raffaele Ferraro. 40, do. Cabins (1901), Ltd. 100c, do. Biagio Manzi. Moorgate Station Chambers. Express Dairy Co., Ltd. 105, do. "J.P." Restaurants, Ltd. 115. do. Lockharts, Ltd. 2, Moorgate Station Buildings. Fullers, Ltd. 130, do. Aerated Bread Co., Ltd. 143, do. J. Lyons and Co., Ltd. 7, do. Aerated Bread Co., Ltd. 148a, do. Antonio Infanto. 35, New Street Sarah Keil. 177, do. Aerated Bread Co., Ltd. 1, New Basinghall St. "J.P." Restaurants, Ltd. 9/10, Redcross Street J. Lyons and Co., Ltd. 4, New Bridge Street "J.P." Restaurants, Ltd. 23, Rood Lane Rose Malyon. 13, do. J. Lyons and Co., Ltd. 2/4, Ropemaker Street John Pearce. 40, do. Aerated Bread Co., Ltd. 12, Rose Street Bidgio Nappi. 44, do. David Stewart. 2½, St. Andrew's Hill Cream Dairy Co., Ltd. 3, New Broad Street J. Lyons and Co., Ltd. 19, St. Bride Street Express Dairy Co., Ltd. 4b, do. The Capital & Counties Cafe Co., Ltd. 35, do. Stewart and Wight, 3/4, St. Martin's Court "J.P." Restaurants, Ltd. 13, do. Richard Charles, trading as R. Charles and Co. 21, St. Mary Axe Ye Mecca, Ltd. 33/5, do. Slaters, Ltd. 13a, do. Lockharts, Ltd. 34, do. Express Dairy Co., Ltd. 16, do. Aerated Bread Co., Ltd. 45, do. Aerated Bread Co.. Ltd. 28, do. W. Hill and Son, Ltd. 49, do. J. Lyons and Co., Ltd. 64, do. Aerated Bread Co., Ltd. 18, St.Paul's Churchyard "J.P." Restaurants, Ltd. 1, New London Street James Barrett 53, do. Nicholson's, Ltd. 2, Newgate Street J. Lyons and Co., Ltd. 61, do. J. Lyons and Co., Ltd. 13, do. Stewart and Wight, Ltd. 68a, do. Fullers, Ltd. 161 Premises. Person Registered. Premises. Person Registered. 75, St. Paul's Churchyard Callard, Stewart and Watt Ltd. 194, Upper Thames Street Robert Cooper. 223, do. Price's Restaurants, Ltd. 80, do. J. Lyons and Co., Ltd. 224, do. Robert Cooper. 82, do. Giorgio Beschizza. 4, Walbrook J. Lyons and Co., Ltd. St. Paul's Station J. Lyons and Co., Ltd. 10/11, do. Antonio and Michele Precha. 30/1, St. Swithin's Lane Aerated Bread Co., Ltd. 14, do. Ye Mecca, Ltd. 135a, Salisbury Court Matteo Mansi. 19/20, do. J. Lyons and Co., Ltd. 19, Sherborne Lane Edward William Davies. 34, do. Aerated Bread Co., Ltd. 3, Ship's Tavern Passage Friern Manor Dairy Farm, Ltd. Warnford Court Aerated Bread Co., Ltd. 1a, Water Lane (Great Tower Street). M. A. S. Pulleyn. 3b, Shoe Lane Gerado Indaco. 35/6, do. "J.P." Restaurants, Ltd. 2, Water Lane) Blackfriars). Price's Restaurants, Ltd. 96, do. Edwin John Ridout. 98, do. Mrs. Laura Jones. 4, Water Lane (Blackfriars). Robert Reid. 109, do. Charles Baker. 112, do. Henry Wallwork. 5, Water Lane (Blackfriars). Priori Oresti. 113, do. Simeon Northam. 18, Silver Street Nuncio Allocca 7, Water Lane (Blackfriars). "J.P." Restaurants, Ltd. 27, do. David Haydon. 6, Stoney Lane Pasquale Manno. "Aldermary House," Watling Street. Ye Mecca, Ltd. 23, do. Henry Jones. 29, do. Mrs. Annie Geviss. 73, Watling Street Lockharts, Ltd. 62, do. Alfred Garcia. 57a, West Smithfield J. Lyons and Co., Ltd. 16, Swan Lane Frederick William Ward. 25, White Street Mary Ann Keeble. 1, Telegraph Street Giovanni Rolle. 31, Whitecross Street Robert Douglas. 17/8, do. J. Lyons and Co., Ltd. 5, Whitefriars Street Frederick Philipp Weinel. — do. Ye Mecca, Ltd. 7, do. Vincenzo Mansi. 27, Throgmorton Street J. Lyons and Co., Ltd. 26, do. Frank Hopwood Middleton. 29, do. Aerated Bread Co., Ltd. 27, do. George Robert Smith. Trump Street (St. Laurence House) The Liesta Cafe, Ltd. 36/38, do. Lockharts, Ltd. 1, Whittington Avenue Ye Mecca, Ltd. 6, Tudor Street John Pantalone. 7, do. Callard, Stewart and Watt, Ltd. 10, do. Frank Gowlett. 14, do. Walter Thomas Beames. 10, do. Antonio Cattini. 32, do. Fanny Payne. 12, Widegate Street Edward Albert Withrington. 3, Union Court, Old Broad Street. Express Dairy Co., Ltd. 17, do. Allec Cohen. 21, do. Alice Issacs. do. Ye Mecca, Ltd. 25, Wood Street J. Lyons and Co., Ltd. 8, Union Row, Minories. Lockharts, Ltd. 78, do. Nunzio Allocca. 80, do. Ye Mecca, Ltd. 5, Upper Thames Street Melchiorre Arpino. 130, do. Express Dairy Co., Ltd. 47, do. Ettore Ferrari. Wool Exchange Callard, Stewart and Watt Ltd. 57, do. George Chitty. 99, do. The City Catering Co., Ltd. 8, Wormwood Street William Henry Neal. 138, do. Stewart and Wight, Ltd. 19, do. Guilio Barbieri. 172, do. George Chitty. 22, do. Aerated Bread Co., Ltd. 186, do. Robert Waterson. 36, do. Luigi Ostacchini. 190, do. Joseph James Medcalf. 38, do. "J.P." Restaurants, Ltd. 162 Appendix E. STATUTORY RULES AND ORDERS, 1909. No. 1064. PUBLIC HEALTH, ENGLAND. Unsound Food. The Public Health (Foreign Meat) Amending Regulations, 1909. Dated September 27, 1909. (54,199) To all Port Sanitary Authorities;— To all other Sanitary Authorities and Local Authorities as herein defined;— To all Officers of Customs and Excise;— To all Medical Officers of Health of the Sanitary Authorities and Local Authorities aforesaid;— To all Masters of Ships;— And to all others whom it may concern. Whereas, in relation to articles of Food, the Public Health (Foreign Meat) Regulations, 1908, provide for the use of an Official Certificate, for the Classification of Foreign Meat, and for the combined action of Authorities for the purposes of those Regulations; And whereas it is expedient that, with respect to the aforesaid matters and to other purposes, the Public Health (Foreign Meat) Regulations, 1908, be altered, and that, accordingly, such Regulations as are hereinafter set forth be made; And whereas the Commissioners of Customs and Excise have signified their consent to the said Regulations, so far as they apply to the Officers of Customs and Excise: Now, therefore, We, the Local Government Board, by this Our Order, and in the exercise of the powers conferred upon Us by the Public Health Act, 1875, the Public Health (London) Act, 1891, the Public Health Act, 1896, 163 and the Public Health (Regulations as to Food) Act, 1907, and of every other power enabling Us in that behalf, do make the following Regulations, that is to say: "Article I.—Article I. of the Public Health (Foreign Meat) Regulations, 1908, shall be revoked : and those Regulations shall be altered so that they shall have effect, with the substitution for the Article so revoked of the following Article, namely:— Revocation of Article I. of former Regulations and substitution of altered Regulation. "Article I.—In these Regulations, unless the contrary intention appears— "Interpretation." "(a.) Words importing the masculine gender include females; "(b.) Words in the singular include the plural, and words in the plural include the singular; "(c.) Expressions referring to writing include references to printing and other modes of representing or reproducing words in a visible form; "(d.) The expression 'cattle' includes a bull, cow, ox, heifer, calf, ram, ewe, wether, goat, and kid; "(e.) The expression 'pig' includes a boar, cow, and hog; "(f.) The expression 'meat' means pork, the flesh of cattle, any other edible part of a pig or of cattle, or a substance, compound, material, or article of which pork, or the flesh of cattle, or any other edible part of a pig or of cattle is an ingredient; "(g.) The expression 'foreign' used in relation to meat means brought from a place situate elsewhere than in the United Kingdom, the Channel Islands, or the Isle of Man; "(h.) The expression 'Official Certificate' used in relation to foreign meat or in relation to a box, case, receptacle, or package containing foreign meat, means a certificate, label, mark, stamp, or other voucher which, by a notice published in the London Gazette at any time during the period of twelve months beginning on the First day of October, One thousand nine hundred and eight, or which, by a notice published in the London Gazette after the expiration of that period, is declared to be admissible in the manner, to the extent, and subject to the rules and conditions, prescribed in that notice, as evidence that the cattle or pig from which the meat is derived has been certified by a competent authority in the place of origin to be free from disease at the time of slaughter, and that the meat has been certified by the like authority to have been dressed or prepared, and packed with the needful observance of all requirements for the prevention of danger arising to public health from the meat as an article of food; and, for the purposes of this 164 definition and of any Regulations under the Public Health (Regulations as to Food) Act, 1907, every Official Certificate which, by a notice published in the London Gazette at any time during the period of twelve months beginning on the First day of October, One thousand nine hundred and eight, is declared to be admissible as aforesaid, shall, notwithstanding anything prescribed in the notice, continue to be so admissible until, by a further notice to be published in the London Gazette, the said Official Certificate is declared to be no longer so admissible; "(i.) The expression 'Foreign Meat of Class 1.' means foreign meat in the form "(a.) Of scrap meat, namely, meat which, whether it is fresh, or has, before importation, been subjected to a process of freezing or other refrigeration, or to chemical or other treatment, with or without the addition of any preservative or colouring substance— "(i.) consists of scraps, trimmings, or other pieces (whether with or without bone in its natural state of attachment) of such shape or in such condition as to afford insufficient means of identification with definite parts of a carcase; and "(ii.) has not, before importation, been made ready for human consumption in the form of a sausage, or of another prepared or manufactured article of food; or "(b.) Of tripe, namely, any edible part of the stomach, or Of a tongue or kidney, to which formalin, or a solution, or other preparation of, or comprising formic aldehyde; or a compound containing fluorine or boron; or salicylic acid, formic acid, sulphurous acid, benzoic acid, or any compound of any such acid has been applied; or "(c.) Of several parts of the carcase of a pig, or of other edible parts of a pig, which have not, before importation, been salted, cured, pickled, dried, or smoked, or otherwise prepared in the manner in which bacon or ham is ordinarily prepared, and which are not contained in a box, case, receptacle, or package with an Official Certificate impressed thereon, or affixed or attached thereto; or "(d.) Of several parts of the carcase of a pig, or of other edible parts of a pig, which have, before importation, been salted, cured, pickled, dried, or smoked, or otherwise prepared in the manner in which bacon or ham is ordinarily prepared, and which are not contained in a box, case, receptacle, or package with an Official Certificate impressed thereon, or affixed or attached thereto, and which, in the case of the 165 severed parts of the carcase, are without the lymphatic glands about those parts in their natural position; or "(e.) Of meat which, whether derived from cattle or a pig, is in the form of a carcase, or of a part of a carcase, and, in either case, comprises the ribs, and is without any such membrane as, in its natural position, forms the lining of the cavity enclosed by the ribs; "(j.) The expression 'Foreign Meat of Class II.' means foreign meat which, being in the form of the entire carcase of a pig, is without the head in its natural state of attachment to the carcase, or is without the lymphatic glands about the throat, or about any other part of the carcase, in their natural position; "(k.) The expression 'Foreign Meat in Class III.' means foreign meat which is in the form of severed parts of the carcase of a pig, or of other edible parts of a pig, which is not and does not comprise any foreign meat of Class I., or any foreign meat of Class II., and which is contained in a box, case, receptacle, or package with an Official Certificate impressed thereon, or affixed or attached thereto; "(l.) The expression 'Foreign Meat Unclassed' means foreign meat other than foreign meat of Class I., foreign meat of Class II., or foreign meat of Class III.; "(m.) The expression 'importer' means any person in the United Kingdom who, either as owner or consignee, agent or broker, is entitled to the possession, custody, or control of any foreign meat; "(n.) The expression 'ship' includes a vessel or boat; "(o.) The expression 'Officer of Customs and Excise' includes any person acting under the authority of the Commissioners of Customs and Excise; "(p.) The expression 'Master' used in relation to a ship includes the officer, or other person for the time being in charge or command of the ship; "(q.) The expression 'Sanitary Authority' means every Port Sanitary Authority, and every Council of a Municipal Borough or other Urban District, and every Rural District Council whose borough or district includes or abuts on any part of a Customs port which part is not within the jurisdiction of a Port Sanitary Authority; "(r.) The expression 'the District' means the District of a Sanitary Authority; "(s.) The expression 'Medical Officer of Heath' includes any duly qualified Medical Practitioner appointed or employed by a Sanitary Authority to act in the execution of these Regulations; and any other person appointed or employed by the Sanitary Authority under these 166 Regulations to exercise any powers, or to discharge any duties assigned to the Medical Officer of Health; "(t.) The expression 'Local Authority' means every Council of a Municipal Borough or other Urban District and every Rural District Council, not being a Sanitary Authority within the meaning of these Regulations, and includes the Common Council of the City of London and every Council of a Metropolitan Borough; "(u.) The expression 'area' used in relation to a Local Authority means the area subject to the jurisdiction of the Local Authority for the purposes of the Public Health Act, 1875, or of the Public Health (London) Act, 1891, as the case may be." Commencement and extent of operation of amending Regulations. Article II.—These Regulations shall come into operation on the Thirtieth day of September, One thousand nine hundred and nine, and then and thereafter the Public Health (Foreign Meat) Regulations, 1908, and any Order theretofore made in pursuance of Article XVI. of those Regulations shall apply and have effect and shall be enforced and executed in such form and in such manner as will give full effect to the alterations made by these Regulations, and as if, throughout the Public Health (Foreign Meat) Regulations, 1908, references to an Officer of Customs and Excise were substituted for references to an Officer of Customs, and as if, throughout any such Order, references to the Public Health (Foreign Meat) Regulations, 1908, as altered by these Regulations, were substituted for references to the Public Health (Foreign Meat) Regulations, 1908, and references to an Officer of Customs and Excise were substituted for references to an Officer of Customs. Short Title Article III.—These Regulations may be cited as "The Public Health (Foreign Meat) Amending Regulations, 1909." Given under the Seal of Office of the Local Government Board, this Twenty-seventh day of September, in the year One thousand nine hundred and nine. L.S. JOHN BURNS, President. S. B. Provis, Secretary. Notice.—The Public Health Act, 1896, provides by. Sub-section 3 of Section 1 that if any person wilfully neglects or refuses to obey or carry out, or obstructs the execution of any regulation made under any of the enactments mentioned in that Act he shall be liable to a penalty not exceeding One Hundred Pounds, and in the case of a continuing offence to a further penalty not exceeding Fifty Pounds for every day during which the offence continues. The power of making regulations under the Public Health Act, 1896, and the enactments mentioned in that Act is enlarged by the Public Health (Regulations as to Food) Act, 1907. Date of Publication in the "London Gazette," 28th September, 1909. 167 Appendix F. Corporation of London. PUBLIC HEALTH DEPARTMENT. NOTICE. TUBERCULOUS MEAT. The Corporation of London has for many years instituted legal proceedings (resulting in many instances in the infliction of heavy fines or terms of imprisonment) against farmers, butchers, and other persons for sending diseased or unwholesome meat into the City Markets, or for exposing the same for sale. It would appear that in some cases such offence may have been due to gross carelessness, or even ignorance of the symptoms of disease in the living animal, or of the appearance of unsound carcasses after slaughter. The following indications of Tuberculosis, both in the carcass and in the living animal, drawn up by Dr. Collingridge, the Medical Officer of Health for the City, and Mr. King, Veterinary Inspector to the Corporation, are therefore published as guidance for the use of persons dealing in meat, and all salesmen and dealers are earnestly desired to bring them to the notice of those specially interested. This appeal is made as, from experience, it has been made manifest that salesmen within the City are anxious and willing to do anything in their power, in the interests alike of the public health and legitimate trading, to prevent unsound meat being offered for sale. Further copies of this Circular will be supplied on application. Public Health Department, Guildhall, London, E.C. March, 1903. JAMES BELL, Town Clerk. 168 SIGNS OF TUBERCULOSIS IN THE CARCASS AND ORGANS. At the time of slaughter, when the carcass and all the organs are available tor examination, there should be no difficulty in detecting the presence of tubercle. Beef.—Any unnatural appearance should be looked for, and any case of doubt referred to an Inspector before sending meat to market. The following are indications of disease (i.) The kernels on the paunch and in the fat round the entrails are enlarged, and may be hard and gritty, or soft and cheesy, according to the stage of the disease. (ii.) The lungs are studded with small masses containing matter, varying from the size of a pin's head and upwards, the larger being gritty when cut into. If there are many of these masses they may form bunches like grapes, and the disease often spreads to the skirt, and the inner side of the ribs, when the lungs grow to the ribs and skirt, and have to be cut away in dressing. (iii.) As the disease progresses the masses of tubercle are found on the other side of the skirt, and inside the flanks to which the intestines sometimes grow. "Stripping" or removal of skin from the inside of the ribs or flanks only partially removes the signs of disease, while it always arouses suspicion, and must be considered as proof that the person dressing the animal had guilty knowledge of the existence of disease (Tuberculosis). The Local Government Board has ordered that Stripping, in the case of foreign dead meat, shall be sufficient reason for condemnation. (iv.) White or yellowish masses in the liver, which on cutting present the appearances described above in (i.). Pork.—The conditions are more stringent, and the report of the Royal Commission advises that all pigs showing any evidence of Tuberculosis should be condemned. It frequently occurs, however, that well-nourished pigs are tuberculous; therefore special attention should be paid to the kernels on the mudgeon and on the belly and weasand. These should be split with a knife to ascertain if they are hard or gritty. The kernels on the windpipe and between the lungs should be carefully examined. The lungs should be tested by pressure between the finger and thumb— hard, shotty lumps will indicate disease. All the kernels should be of natural size and colour, free from all gritty feeling or cloudy appearance. It is strongly recommended that no pigs, the lungs of which have grown to the side, and no meat of a doubtful character should be sent to market. WILLIAM COLLINGRIDGE, M.D., Medical Officer of Health, City of London. 169 TUBERCULOSIS. SYMPTOMS IN THE LIVING ANIMALS. In the early stages of this disease the majority of animals may appear to be in perfect health, there being no symptoms which would lead a veterinary surgeon, farmer or butcher to say definitely that the animal was suffering from Tuberculosis, although those in constant attendance on the animal would notice that at times they appear to be out of sorts and have a disinclination for their food, and occasionally after feeding, especially if the lungs are the seat of the disorder, the animal has a sharp, irritable cough, but as the disease advances in many cases the symptoms become more pronounced and more obvious to those attending and feeding the animals; there is often enlargement of the glands of the throat, the nose becomes dry and the eyes have a glassy appearance and often appear to sink in the socket; the cough becomes more frequent, the coat dry and staring, and the hide tight; the animals also often suffer from intermittent diarrhoea. On tapping the chest of an animal in this condition with the fingers, there will often be found a dulness, or a sound of solidity in patches over the region of the lungs, and the animal gradually loses flesh. When the udder is affected, small nodular swellings can be felt in one or more of the quarters; these gradually enlarge and run together until the whole quarter or quarters become a diseased mass ; this differs from ordinary Mammitis or Garget, inasmuch as there is little or no pain on pressure and the swellings gradually increase. Should the owner of cattle find an animal exhibiting any of the above symptoms, it is his duty, in the interests of the community at large, to seek the advice of his veterinary surgeon, who will be able to satisfy him as to the condition of the animal, either by the symptoms present or by the use of Tuberculin. JAMES KING, M.R.C.V.S., Veterinary Inspector to the Corporation of London. January, 1903. [P.T.O. 170 Attention is also called to the following Extract from Leaflet No. 100, issued by the Board of Agriculture and Fisheries, revised May, 1907:— "Tuberculosis in Pigs. "Too much stress cannot be laid on the fact that a very considerable number "of carcasses of tuberculous pigs have of late been sent to the London markets for "sale as human food, and many persons have been prosecuted on this charge, and "in some cases heavily fined. Pig breeders and feeders are cautioned therefore "against the risk of prosecution which they incur by disposing of such tuberculous "carcasses. Tuberculosis is by no means uncommon in pigs, and is probably "caused chiefly by feeding them on refuse milk from dairies in which cows with "tuberculous udders exist, and on diseased offal from cattle. Especial care should "therefore be taken to prevent swine from coming into contact with any part of "the internal organs of diseased cattle, and refuse milk, if given at all, should be "previously raised to boiling point. When a cow has one or more hard quarters, "her milk should not be fed to the pigs unless it be first boiled. "The indications of tuberculosis in the pig's carcass consist mainly of hard swellings "in the glands around the throat, and the presence of white cheesy-looking deposits "of tubercular material in the mucous membrane of the intestines, and in the "mesenteric glands or in the lungs. In the event of any of these conditions being "found after death, the owner should not send the carcass to market without "ascertaining from the Sanitary Inspector of his district or from his Veterinary "Surgeon that the carcass is free from tubercular disease. "Improved sanitation and periodic disinfection of premises should be the order "of the day wherever pigs are kept, and all empty pens should be carefully "disinfected before the introduction of fresh stock." All communications relating to consignments of Meat should be addressed— "Medical Officer of Health, "Meat Inspectors' Office, "Central Markets, "Smithfield, London, E.C." 171 Appendix G. (54,044) (4th September, 1909.) General Order. Begulations as to Health Visitors. To the London county Council;— To the mayor and Commnalty and Citizens of the City of London, acting by the Mayor, Aldermen, and Commons of the City of London in Common Council assembled; — To the Council of each Metropolitan Borough To the Overseers of the places known as the Inner Temple and the Middle Temple respectively; — And to all others whom it may concern. WHEREAS by Section 6 of the London County Council (General Powers) Act, 1908, hereinafter referred to as "the Act"), it is enacted as follows:— "(1.) Any sanitary authority may on or at any time after the "first day of January one thousand nine hundred and nine appoint "suitable women (to be known as health visitors) for the purpose of "giving to persons advice as to the proper nurture care and manage"ment of young children and the promotion of cleanliness and "discharging such other duties (if any) as may be assigned to them in "accordance with the provisions of this section. 172 "(2) The Local Government Board may make regulations "prescribing the qualification mode of appointment duties salary and "tenure of office of health visitors appointed under this section and no "appointment of a health visitor shall be made otherwise than in "accordance with such regulations. " * * * * * " And whereas by virtue of Section 3 of the Act the expression "Sanitary Authority is defined as meaning— (a) As respects the City of London and so much of the port of London as established for the purposes of the laws relating to the customs of the United Kingdom as is within the administrative County of London the Mayor, and Commonalty and Citizens of the City of London, acting by the Mayor, Aldermen and Commons of the City of London in Common Council assembled; (b) As respect the places known as the Inner Temple and the Middle Temple respectively the Overseers of those places respectively; and (c) As respects any Metropolitan Borough (except as to any portion thereof which may be within the said portion of the port of London) the Council of the Borough; NOW THEREFORE, with respect to the qualification, mode of appointment, duties, salary and tenure of office of every Health Visitor who may be appointed by a Sanitary Authority in pursuance of the Act, We, the Local Government Board, hereby make the following Regulations, that is to say:— Qualification. Article 1.— (1) A woman shall be qualified to be appointed a Health Visitor if she— (a) is a duly qualified medical practitioner within the meaning of the Medical Acts; or (b) is qualified for the appointment of nurse by having undergone, for three years at least, a course of instruction in the medical and surgical wards of any hospital or infirmary, being a training school for nurses, and having a resident physician or house surgeon; or (c) is certified under the Midwives Act, 1902, or (d) has, for a period of not less than six months, undergone in a hospital or infirmary, receiving children as well as adults, and having a resident physician or house surgeon, a course of instruction 173 including subjects relating to personal hygiene, and holds the certificate of the Royal Sanitary Institute for Health Visitors and School Nurses, or the certificate or diploma of the National Health Society, or of any other body which may from time to time be approved by us; or (e) has, in the service of a Sanitary Authority, or of the Council of a Borough or of another Urban District or of any other Public Body or Authority in England or Wales, discharged duties which, in Our opinion, are similar to those described in the Act or prescribed by these Regulations in relation to the office of Health Visitor, and produces such evidence as, in Our opinion, suffices to prove her competency. (2) Where, in Our opinion, the circumstances so require, the Sanitary Authority may, with Our consent, and subject to such conditions as We impose, appoint to the office of Health Visitor a woman who, though not possessing any such qualification as is prescribed by sub-division (1) of this Article, has a competent knowledge and experience of the theory and practice of nurture, of the care and management of young children, of attendance on women in and immediately after child-birth, and of nursing attendance in cases of sickness or other mental and bodily infirmity. Appointment. Article II.—(1) The Sanitary Authority who propose to make an appointment to the office of Health Visitor shall, after their selection of the woman whom they propose to appoint, furnish Us in writing with a statement comprising the name of the woman selected, the particulars of her qualification, a description of the district for which it is proposed that she shall be appointed, the amount of salary proposed to be assigned to the office, and such other details as, in relation to the proposed appointment, are from time to time required by Us, and, except where We, by reason of special circumstances in any particular case, confirm an appointment made without Our previous approval of the selection of the woman to be appointed, no appointment shall be valid until the selection of the woman to be appointed has been approved by Us. (2) The Sanitary Authority who propose to make an appointment to the office of Health Visitor, and who have ascertained that no woman seeking, or proposed for, the appointment, possesses any such qualification as is prescribed by sub-division (1) of Article I. of these Regulations shall, before their selection of the woman whom they propose to appoint, cause to be inserted once at least in one or more of the newspapers circulating in the metropolitan borough or other area for which the Sanitary Authority act, and so that a period of not less than seven days shall elapse after the date of the insertion, or of the first insertion, as the case may be, and before the day fixed for the 174 selection, an advertisement specifying the metropolitan borough or other area and the district within that metropolitan borough or area for which the selection is to be made, together with the amount of salary proposed to be assigned, and the day on or before which the application in writing of any woman seeking the appointment must be sent to the Clerk to the Sanitary Authority. Article III.—When We have approved the selection of the woman to be appointed, the Sanitary Authority shall proceed to the appointment of the woman so selected to the office of Health Visitor. Article IV.—Every selection and appointment of a woman to the office of Health Visitor shall be made by a majority of the Members present and voting on the question at a meeting of the Sanitary Authority. Article V.—Every appointment shall, within seven days after it is made, be reported to us by the Clerk to the Sanitary Authority. Tenure of Office. Article VI.—The appointment of a Health Visitor may at any time be determined by the Sanitary Authority by giving her three months' notice in writing of their intention to do so, and no woman shall be appointed to the office of Health Visitor who does not agree to give three months' notice previous to resigning the office, or to forfeit such sum as may be agreed upon as liquidated damages : Provided as follows:— (1) The appointment of a Health Visitor may be determined by the Sanitary Authority, with Our consent, for any reason which We deem sufficient, at any time before the expiration of any notice given by the Sanitary Authority as aforesaid; (2) The appointment of a Health Visitor may also be determined by Us if at any time it appears to Us to be desirable that she should cease to discharge the duties of her office. Article VII.—The Sanitary Authority may, at their discretion, suspend any Health Visitor from the discharge of her duties. The suspension may be removed by the Sanitary Authority, and in that case the Health Visitor shall forthwith resume the performance of her duties. Duties. Article VIII.—In addition to the duties specified in the Act as the purpose for which a Health Visitor may be appointed, the duties of every Health Visitor shall be as follows ; that is to say— 175 (1) The Health Visitor shall, in relation to each person visited, enter on a suitable card or in a book to be called "the Health Visitor's Report. Book" all such particulars as the Sanitary Authority or the Medical Officer of Health require to be ascertained and recorded, and shall submit the cards or Health Visitor's Report Book to the Sanitary Authority or the Medical Officer of Health so often and at such times as may be required, and, subject to the directions of the Medical Officer of Health, shall keep the cards arranged so that any card may be readily available for reference at any time when the card is not in use for the purpose of a visit. (2) The Health Visitor shall, under the direction of the Medical Officer of Health, discharge such duties, not being duties of a Sanitary Inspector, as may be assigned to her by the Sanitary Authority in connection with and for the purposes of the administration by the Sanitary Authority of any public and general Act or local and personal Act under which powers are conferred or duties are imposed upon the Sanitary Authority with respect to matters relating to public health, the housing of the working classes, and the notification of births, or of any bye-laws or regulations made under any such Act. (3) The Health Visitor shall discharge such duties in substitution for, or in addition to, any duties assigned to her under the paragraph numbered (2) in this Article in connection with any of the Acts, bye-laws or regulations mentioned in that paragraph, or in connection with other Acts, bye-laws or regulations as may be prescribed by Us, whether generally, by further regulations made by Us in pursuance of the Act, or, in the case of any particular Health Visitor, by an Instrument issued by Us in that behalf under Our Hand and Seal. (4) The Health Visitor shall observe and execute, in regard to matters not specifically provided for in this Order, any such instruction issued by Us and any such order or direction of the Sanitary Authority or the Medical Officer of Health as may be applicable to her office. Salary. Article IX.—The Sanitary Authority shall pay to every Health Visitor such salary as may be approved by Us: Provided always that the Sanitary Authority may, with Our approval, make an allowance to any Health Visitor in respect of clothing where uniform or other distinctive dress is required by the Sanitary Authority, or pay her a reasonable compensation on account of extraordinary services, or other unforeseen or special circumstances connected with her duties or the necessities of the district for which she is appointed. 176 Article X.—The salary of every Health Visitor shall be payable up to the day on which she ceases to hold office and no longer: Provided that a Health Visitor who may be suspended, and who may, without the previous removal of the suspension, resign, or be removed under Article VII. of these Regulations, shall not be entitled to any salary from the date of the suspension. Article XI.—The salary assigned to every Health Visitor shall be payable quarterly, according to the usual Feast Days in the year, namely, Lady Day, Midsummer Day, Michaelmas Day, and Christmas Day; but the Sanitary Authority may pay to her at the expiration of every calendar month such proportion as they may think fit on account of the salary to which she would become entitled at the termination of the quarter. Article XII.—All salaries shall be considered as accruing from day to day, and be apportionable in respect of time accordingly, in pursuance of the provisions of the Apportionment Act, 1870. Time to be devoted to duties. Article XIII.—Every Health Visitor shall devote her whole time to the duties of her office: Provided that, if the Sanitary Authority think fit, they may, with Our consent, appoint her to hold concurrently some other office in their appointment and under their control. Title of Order. Article XIV.—This Order may be cited as "The Health Visitors (London) Order, 1909." Given under the Seal of Office of the Local Government Board, this Fourth day of September, in the year One thousand nine hundred and nine. l.s. JOHN BURNS, President. S. B. Provis, Secretary. Charles Skipper & East, Printers, 49, Great Tower Street, B.C.