LoN 43 REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON Foe the Year 1913. By WILLIAM J. HOWARTH, M.D., D.P.H. medical officer of health of the city of london. LONDON: Printed by Chari.es Skipper & East, 49, Great Tower Street, E.C. 1914. INDEX. AGE. Actinomycosis in Argentine Ox-Tongues 107 Anndal Rateable Value 10 Anthrax (in Animals) 31 „ (in Man) 31 Area 10 Argentine Meat 105 Argentine Ox-Tongues—Actinomycosis 107 Artizans' Dwellings—Stoney Lane, Houndsditch—Baths at 43 „ „ „ „ —Births and Deaths at 42 Atmospheric Pollution 68 Australian Meat 104 Bacterial Food Poisoning—Report to the Local Government Board by Dr. W. G. Savage 52 Birthplaces of City Residents 15 Births 19 Bodies of Unknown Dead—Preservation of 45 Bye-laws -Fish Curbr 109 ,, —Fried Fish 109 , —Rag And Bone Dealer 109 —Water Closets—Neglect to comply with— 194, Aldersgate Street 60 „ „ „ „ „ „ —26, Holborn Viaduct 60 „ „ „ „ „ „ —Well Street 60 Census, 1911 11 Children Act, 1908—Cleansing of Verminous School Children 39 Cleansing of Verminous School Children 39 Common Lodging-House—116, Middlesex Street 59 Courts— Limewashing of 63 „ —Summer Flushing of 63 Cremations 40 Dairies, Cowsheds and Milkshops Orders 113 Death Rates 20 Deaths from Violence 23 „ in City Institutions 21 Deaths Registration and Burials Bill 48 Density 10 Diseased Meat Prosecutions 104 Disinfectants 45 Disinfection, &c., at the City Mortuary 44 Disinfection of Conveyances after Carrying Cases of Infectious Diseases 45 Dispensary—Tuberculosis 29 Drainage Plans 60 Enumeration Districts—Census, 1911 11 Examination for Pathogenic Bacteria 32 Examination of Milk for Tuberculosis 32 Exhumation and Re-interment of Bodies at the City of London Cemetery 42 Export of Meat Foods to the United States of America and the Philippine Islands 79 Factory and Workshop Act, 190187 „ —bakehouses 78 „ „ „ „ —Export of Meat Foods to the united States of America and the Philippine Islands 79 „ „ „ „ —Factories 68 „ „ 1, n —Legal Proceedings 86 „ „ ,t „ —Office Sanitation 73 „ „ „ „ —Outworkers and "Home" Workers 83 „ „ „ ,, —8anitary Defects in Factories and Workshops Notified by H.M. Inspector of Factories 83 „ „ „ „ —Workplaces—Kitchens of Restaurants, &c. 71 „ „ » ,, —Workshops 70 Families—Size of 15 Fire inquests 44 Fish Curer—bye-laws 109 ,, Offal—removal of 64 „ Returns—monthly 110 „ Supplies 110 Foot and Mouth Disease—Siberian Ox-Tongues 106 Fried Fish Bye-laws 109 General Administrative Work 109 Glanders 32 Hairdressers' Shops—Hygiene of 65 House, Trade and other Refuse—Removal of 62 Human Remains, Removal of 65 Hygiene of Hairdressers' and Barbers' Shops 65 Ice Cream 112 Infantile Mortality 20 22 Infectious Disease and Sanitary Defects 62 „ —Notification of 20 INDEX(continued). PAGE. Inspection op Food at Rivebside Wharves, &c 111 Itinerant Ice Cream Vendors 112 Legal Proceedings 68, 80 Limewashing of Courts . 63 Lodging-House—Common—116, Middlesex Street 59 Meat—Actinomycosis in Argentine Ox-Tongues 107 „ —Argentine Meat 105 —Australian Meat 104 „ —Average Deliveries op, at Central Markets 102 „ —Orange Streaks in Beep Suet 108 „ —Siberian Ox-Tongues appected with Foot and Mouth Disease 106 „ —Sources op Origin op Central Market Supplies 102 „ —Weight op Meat delivered at Central Markets 104 „ Inspection—Diseased Meat Prosecutions 04 n „ —General Administrative Work 109 n „ —Unbound Meat Seized 103 „ „ —Veterinary Surgeon's Report 90 n „ „ „ „ -Aldgate Mabkkt and Slaughterhouses 97 n n „ „ ,, —Aldgate Market and Slaughterhouses—Carcases and Quarters seized and Destroyed 99 n n „ „ „ —Analysis and Comparison op Suppliesm 90 „ „ „ „ ,, —australian meat92 „ „ „ „ „ —Cold Stores (Unsound Food) 96 „ „ „ „ ,. —Examination op Meat for Export (Certificates Granted by Medical Officer of Health) 92 „ „ „ „ „ —Leadenhall Market and City Shops (Unsound Food Destroyed) 95 „ „ ... „ „ „ —Record op South American Tongues Examined at Cold Stores 91 „ „ „ „ „ —South American Meat 91 „ „ „ „ „ —Summary of Unsound Food Destroyed 101 „ „ „ „ „ —Swedish Meat 92 „ „ „ „ „ —Tuberculous Meat—Central Market 94 Medical Examinations 124 Milk and Cream Regulations 114 Milk and Dairies Bill50 „ —Examination op, for Tuberculosis 32 „ —Samples at Railway Stations 37 Monthly Fish Returns 110 Mortality 19 „ —Infantile 20,22 Neglect to comply with Water Closet Bye-laws—194, Aldersgate Street 60 „ „ „ „ „ „ —26. Holborn Viaduct 60 „ „ » „ —4, Well Street 60 Notification of Births Act, 1907 21 „ „ Infectious Disease 26 „ „ Tuberculosis 29 Office Sanitation 73 Orange Streaks in Beef Suet 108 Overcrowding 62 Ox-Tongues—Argentine—Actinomycosis 107 „ —Siberian, affected with Foot and Mouth Disease 106 Plans, Drainage 60 Poisons and Pharmacy Act, 1908—Regulations as to Receptacles for Poisonous Liquids intended to bf, used for Purposes of Disinfection 45 Population 10 „ Housed in Excess of Two Persons per Room 17 „ of Tenements 13, 14 Preservation op Bodies of Unknown Dead 45 Preservation of Stone 63 Prosecutions—Diseased Meat 104 „ —Sale of Food and Drugs Acts 120 Public Health Legislation in 1913 47 „ (Milk and Cream) Regulations, 1912 114 „ (Prevention and Treatment of Disease) Act, 1913 47 „ (Tuberculosis) Regulations, 1912 29 Rag and Bone Dealer—Bye-laws 109 Railway Stations 62 „ —Milk Samples at. 37 Rat Exterminator 46 Receptacles for Poisonous Liquids intended to be used for Purposes op Disinfection 45 Registered Lodging-Houses 57 INDEX (continued). PAGE. Removal of Fish Offal 64 „ „ House, Trade and other Refuse 62 „ „ Human Remains 65 Report of the Veterinary Surgeon 94 Sale of Food and Drugs Acts—Articles Examined 122 „ „ „ „ —Butter 117 „ „ » H —Currants, &c 118 „ „ „ „ —drugs 119 „ „ „ „ —Jam and Marmalade 119 „ „ „ „ —Margarine 118 „ „ „ „ —Milk 116 „ „ „ „ —Other Groceries 119 „ „ „ „ —Prosecutions 120 „ „ „ „ —Spirits 119 „ „ „ „ —"Warranty Defence" 120 Sanitary Defects and Infectious Disease 62 „ Inspections 55 Siberian Ox-Tongues Affected with Foot and Mouth Disease 106 Size of Families 15 Smoke Abatement Bill 49 Smoke Nuisances 66 Stone, Pbeservation of 63 Street Oullies 62 Suet, Beef, Orange Streaks in 108 Summer Flushing of Court's 63 Tenements—Average Numbeb of Pebsons peb Room 14 „ —Of Diffebent Sizes—Numbeb of Pebsons Occupying 14 „ —Number of Persons per 13 „ —Size of 13 Tuberculosis Dispensary 29 ,, — Examination of Milk for 32 „ —Notification of 29 „ Order, 1913 51 „ —Treatment and Prevention of 29 Unbound Meat 103 Vaccination Act, 1907 19 „ Acts (Repeal) Bill 47 „ Statistics 19 Verminous School Children, Cleansing of 39 Veterinary Subgeon, Repobt of 90 Violent Deaths 23 Vital Statistics 23 Water Closet Bye-laws—Neglect to comply with—194, Aldebsgate Street 60 „ „ „ „ „ „ —26, Holbobn Viaduct 60 „ „ „ „ ,, „ —4, Well Street 60 Weight of Meat Delivered at Central Markets 104 Well Water Supply in the City 66 APPENDICES. PAGE Appendix A—Street Lists of Mortality 127 „ B— „ „ „ Infectious Disease 129 „ C—Register of Houses let in lodgings or occupied by membebs of mobe than one family 131 „ D—List of Pebsons registebed undeb the Daibies, Cowsheds and Milk Shops Obdebs 136 SANITAKY STAFF. MEDICAL OFFICER OF HEALTH. Date of Appointment. Howarth, Wm. J., M.D., D.P.H Dec., 1912 VETERINARY SURGEON. Young, T. Dunlop, M.R.C.V.S. Not., 1909 CLERICAL STAFF. Lowe, George Sanitary Clerrc Nov., 1902 Galloway, R. E March, 1904 Gray, Charles M. March, 1911 Stephenson,' F. H. (Meat Inspector's Office) Feb., 1909 Bedwell, Norman (Meat Inspector's Office) Oct., 1910 Mellish, Cyril (Meat Inspector's Office) Feb., 1912 Harper, Joseph (Meat Inspector's Office) Jan., 1913 Beckles, virgine Jan., 1907 WOMEN SANITARY INSPECTORS. Safford, Ada J. Feb., 1902 Wilkinson, Annie M June, 1909 SANITARY INSPECTORS. Hills, Arthur Reginald 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 Robinson, Ernest S. Feb., 1913 SANITARY INSPECTORS AND MEAT INSPECTORS. Sharp, Owen, Senior Inspector May, 1892 Kelland, William C May, 1899 Mettam, Harry Aug., 1903 Davie6, Thos. L. Dec., 1903 Stanley, Ralph S. March, 1907 Bintcliffe, Charles E. March, 1907 Matson, William S. Dec., 1910 Mitchenicr, William E. Dec., 1910 Jones, J. April, 1914 Slatter, C. May, 1908 INSPECTOR OF SLAUGHTERHOUSES AND MEAT. Eglin, William July, 1896 ASSISTANT INSPECTORS OF SLAUGHTERHOUSES AND MEAT. King, George G. April, 1910 Murray, Samuel Sept., 1911 Penman, T. July, 1913 MATRON IN CHARGE OF THE SHELTER, GOLDEN LANE. Mrs. A. R. Hills Dec., 1900 KEEPER OF THE MORTUARY. Oakley, J. E Feb., 1909 DISINFECTOR. Tripp, A March, 1912 LABOURER'S. McDonnell, R. J. (General Duties at Mortuary) April, 1903 Adams, T. (Meat Shed) May, 1905 Ludgate, G. (Meat Shed) Oct., 1906 PORTERS, CENTRAL MEAT MARKET. Potter, R. March, 1J14 Strong, S. March, 1914 REPORT OF MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON. 1913. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1913. To the Right Honourable the Lord Mayor, Aldermen and Commons of the Corporation of London. Public Health Department, Guildhall, E.C., 25th March, 1914. Gentlemen, I beg to submit herewith the Annual Report of the Medical Officer of Health for the year 1913, as required by Article 18 of the Local Government Board Order of December 8th, 1891. It will be remembered that for the first three months of the period under review the Department was under the control of Dr. Collingridge, whom I succeeded on March 25th ; but to avoid unnecessary complications the Report has been prepared without distinguishing these few months. The Report contains an account of the vital statistics of the City of London; information relating to the various conditions which affect the health of persons resident, or working, within the City; and a fairly complete survey of the action which it has been found necessary to take, either to remove conditions inimical to health, or to ensure that adequate safeguards are maintained in respect of matters for which the City Corporation can be held responsible. These various details are set out at some length in the different sections into which this Report is divided. The form of the Report has not been altered except as regards a few Tables which have been recast in the form required by the Local Government Board. The earlier months of my tenure of office were chiefly occupied in making those changes in the organisation which invariably result from a change of Officer. This work was rendered easier by the orderly state of the Department, and I desire to express my appreciation of my predecessor's efforts in this direction. The knowledge of the administrative details possessed by Mr. Lowe, Sanitary Clerk, were of the greatest service, and from him and other members of the Staff, both clerical and inspectorial, I received the utmost assistance. I should also state that I found in Mr. Young and the Staff at the Central Meat Market most valuable Officers, and through Mr. Young's efforts the change of control passed practically without notice. I might here also be allowed to express my thanks to the Sanitary Committee for their indulgent attitude during the time I was obtaining the knowledge of the details of the new work, and to the ex-Chairman (Mr. Leo Taylor) for much valuable time and advice which he so willingly placed at my disposal. 10 AREA. The City of London Registration District comprises an area of 675.2 acres (excluding tidal water and foreshore), or 1.051 square miles, equal to a square of 1.0252 miles to a side. The area of "Registration London" is 74,817 acres (excluding tidal water and foreshore), or 116.9 square miles, equal to a square of 10.81 miles to a side. DENSITY (1913). City of London, Registration District, at night 26.5 persons to an acre. „ „ „ „ during the day *544*6 „ „ Registration London, at night 60.4 „ ANNUAL RATEABLE VALUE. The rateable value of property within the administrative county of London was £39,270,777 on 6th April, 1913—whilst on the same date the corresponding rateable value of property in the City of London was £5,759,323, or nearly one-seventh of the whole County. POPULATION. The undermentioned figures are abstracted from the report of the Registrar-General on the Census of England and Wales, 1911 (County of London). Area. Statute Acres. Inhabited Houses. Population.. 1901. 1911. 1901. 1911. City of London 672.7 3,865 2,784 26,923 19,657 These figures represent the population on the night of the 1st April, 1901, and 3rd April, 1911. For Registration, Parliamentary and Municipal purposes the boundaries of the City are co-terminous. * This figure refers only to persons " actively engaged in the City during the daytime," and is based upon a Census taken in May, 1911. 11 The following table shows the progressive decline which has taken place since 1861 in the number of inhabitants who reside within the City boundaries, and the progressive increase in the number of workers who are daily employed in the City:— year. Imperial Census. Night Population. City Census. Day Population. 1861 112,063 - 1866 - 170,133 1871 75,983 - 1881 51,405 261,061 1891 37,705 301,384 1901 26,923 - 1911 19,657 364,061 For statistical purposes, in the following pages the "Registration" District is referred to when speaking of the " City." This consists of two sub-districts, together containing a population of 17,916 at the middle of 1913, calculated on the last Census Returns:— St. Botolph 7,326 *St. Sepulchre and Allhallows 10,590 17,916 The Night population, therefore, of the City of London Registration District at the middle of 1913, is taken at 17,916, and it is upon this figure that all vital statistics in this Report have been calculated. The Day Census taken in May, 1911, showed that the Day population was 364,061 persons, and also that 1,077,155 persons and 94,095 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. CENSUS 1911. The completed tables of the Census 1911 are now available in respect of the City and Metropolis; much of the information contained therein is of considerable value and no apology need therefore be made for presenting it at the earliest opportunity in the Annual Report of the Medical Officer of Health. To the Sanitary Authority it is of considerable importance that the dispersion of the population in the district for which they are responsible should be accurately known. To those engaged in Social work the information is also of value, and in the past, I have found that these details issued in the Report of the Medical Officer of Health have been much appreciated. Enumeration Districts. The following Table shows the population, males and females, in each of the enumeration districts into which the City was divided for Census purposes—it also sets out the number of tenements or dwellings, grouped as inhabited, uninhabited and in course of erection. * On the 1st April, 1901, the Middle Temple was transferred from the Strand Sub-District to St. Sepulchre and Allhallows Sub-District. 12 Each district in the table is given a number and a corresponding number will be found on the attached map. Anyone acquainted with the City will readily appreciate by reference to the map the limitations of the area indicated, although the small scale has made it impossible to indicate all the streets; anyone who is particularly interested in these areas can obtain the complete boundaries upon application to the Medical Officer of Health. TABLE 1. The Population in the various Enumeration Districts in the City of London at the Census 1911. Enumeration District. Dwellings or Tenements. Buildings not used as Dwellings. Population. Inhabited. Uninhabited. Buildings. Males. Females. Persons. 1 2 3 4 1 86 ... ... 115 132 169 301 2 114 8 5 85 191 246 437 3 88 ... ... 85 118 160 278 4 57 1 ... 134 117 110 227 5 92 8 ... 92 181 209 390 6 58 8 5 100 84 125 209 7 83 3 1 112 126 173 299 8 85 ... ... 121 147 210 357 9 64 6 3 130 145 155 300 10 76 4 1 108 87 149 236 11 42 4 ... 140 87 112 199 12 63 ... ... 75 82 115 197 13 40 4 ... 159 137 71 208 14 15 ... ... 138 52 41 93 15 14 2 ... 159 73 41 114 16 36 ... ... 177 130 93 223 17 31 ... ... 217 83 123 206 18 27 2 ... 196 71 66 137 19 57 7 ... 241 365 185 550 20 40 1 ... 248 326 136 462 21 82 7 ... 180 232 194 426 22 111 8 ... 263 500 324 824 23 185 6 ... 127 364 400 764 24 109 7 ... 522 317 267 584 25 140 5 ... 135 264 308 572 26 94 4 ... 166 387 246 633 27 72 1 ... 115 103 113 216 28 279 2 ... 230 410 503 913 29 128 68 ... 440 167 95 262 30 1 ... ... • • • 350 628 978 31 77 ... ... 357 140 170 310 32 95 3 ... 198 157 203 360 33 72 3 ... 109 118 116 234 34 263 6 ... 194 524 512 1,036 35 32 19 ... 155 60 86 146 36 59 1 ... 102 99 143 242 37 72 1 ... 79 106 158 264 38 137 4 ... 209 210 282 492 39 69 7 ... 333 281 184 465 40 30 4 ... 274 109 78 187 41 16 ... ... 70 27 37 64 42 211 13 ... 73 597 695 1,292 43 246 3 ... 33 410 470 880 44 78 15 ... 173 217 220 437 45 60 9 2 62 122 156 278 46 88 2 1 49 218 188 406 Hotel 1 ... ... ... 33 32 65 Salvation Army Shelter 1 ... ... ... 594 ... 594 Hotel 1 ... ... ... 67 78 145 Shipping 18 ... ... ... 163 2 165 Totals 3,995 256 24 7,480 10,080 9,577 19,657 CITY OF LONDON - CENSLUS 1911. DIACRAM SHEWING ENUMERATION DISTRICTS. 13 Number of Persons per Tenement. The following Table shows the position of the City in respect of the distribution of the resident population living in tenements of less than ten rooms. It will be seen that of the City population, 22.6 per cent. (column "b") are housed in such a manner that they average less than one person to a room; 60.8 per cent. (column "c") are accommodated in the proportion of one to two persons per room; 12.4 per cent. (column "J") live under conditions which only allow of more than two persons per room; and the balance of 4.2 per cent. (column "e") live in houses with more than 10 rooms. Compared with London as a whole it will be observed that there are rather more persons in the City living under conditions in which the average is less than two persons per room, and fewer in which the average exceeds two persons. It should be remarked that the calculations are based on the actual number of persons, which includes both adults and children, but as two children under 10 years of age may be very properly counted as one adult, it follows that if children were so regarded, the percentage of more than two persons to a room would be reduced. TABLE 2. PLace. Percentage of Population. In tenements of less than 10 rooms. In tenements of 10 or more rooms. Less than 1 person per room. From 1 to 2 persons per room inclusive. More than 2 persons per room. (a) (b) (c) (d) (e) The whole of London (County) 20.6 55.4 17.7 6.3 City of London 22.6 60.8 12.4 4.2 Size of Tenements. When considering whether the conditions of domestic life be healthy or require amelioration, other aspects in addition to the foregoing should be examined. Table 3 shows the proportion per 1,000 tenements, of tenements of various size. Thus, in the last line of the table it will be seen that the greatest number of tenements in the City are those of two rooms (column c.), viz., in the proportion of 260 to the 1,000; the next numerous being three-roomed tenements, 231 per 1,000. Of four-roomed tenements the proportion is 163 per 1,000, and that of one-room tenements only 130 per 1,000; the remaining 216 per 1,000 (the sum of columns †. to l.) being tenements of 5 rooms and upwards. 14 TABLE 3. Place. Proportion, per 1,000 Tenements, of Tenements consisting of 1 room. 2 rooms. 3 rooms. 4 rooms. 5 rooms. 6 rooms. 7 rooms. 8 rooms. 9 rooms. 10 rooms (a) (b) (c) (d) (e) (f) (g) (h) (i) (k) (l) The whole of London (County). 135 192 214 161 92 71 45 31 18 41 City of London 130 260 231 163 72 58 27 23 14 22 Number of Persons occupying tenements of different sizes. Table 4 shows the proportion per 1,000 persons enumerated in tenements of various sizes. In the last line of the following table it will be seen that the largest separate grouping of the City population, viz., 219 per 1,000 inhabit tenements of three rooms, the next highest proportion, viz., 217 per 1,000, tenements of two rooms ; 174 per 1,000 inhabit tenements of four rooms, and 63 per 1,000 inhabit tenements of one room, the remainder or 327 per 1,000 inhabit tenements of more than four rooms. The number of persons occupying these different sized tenements does not quite run parallel with the available tenements as shown in the previous table. There are more tenements of two rooms than three rooms, but the excess is not great enough to balance the larger number living in tenements of the latter size. TABLE 4. Place. Proportion, per 1,000 Persons, enumerated in Tenements consisting of 1 room. 2 rooms. 3 rooms. 4 rooms. 5 rooms. 6 rooms. 7 rooms. 8 rooms. 9 rooms. 10 rooms or more. (a) (b) (c) (d) (e) (f) (g) (h) (i) (k) (l) The whole of London (County). 62 158 213 185 114 89 54 38 24 63 City of London 63 217 219 174 94 91 43 33 24 42 Average Number of Occupants per Room. Table 5 shows the average number of occupants per room in tenements of various sizes. It will be noticed that in tenements of one to four rooms the average number of occupants per room in the City is less than in London as a whole. In certain districts in London the number of occupants of one room tenements exceeds two per room, e.g.:—Bermondsey 2.05, Holborn 2.06, Finsbury 2.15, Bethnal Green 2.2, Shoreditch 2.26, and Stepney 2.29. 15 TABLE 5. Place. Average Number of Occupants per Room in Tenements consisting of 1 room. 2 rooms. 3 rooms. 4 rooms. 5 rooms. 6 rooms. 7 rooms. 8 rooms. 9 rooms. 1 to 9 rooms. The whole of London (County). 1.92 1.71 1.37 1.19 1.03 0.87 0.72 0.65 0.59 1.14 City of London 1.72 1.48 1.12 0.95 0.93 0.94 0.81 0.65 0.71 1.07 Size of Families. Table 6 shows the proportion, per 1,000 families, of families of various sizes. As for example, in the last line of the table, it is seen that of 1,000 families in the City of London, 249 consist of two persons to each family, 200 per 1,000 of three persons, 152 per 1,000 of four persons, 135 families per 1,000 consist only of one person, and 108 per 1,000 families are of five persons. The remaining 156 (sum of columns "g" to "n") families per thousand families, consisting of more than five persons to each family. TABLE 6. Place. Proportion, per 1,000 families, of families consisting of:— 1 person 2 persons 3 persons 4 persons 5 persons 6 persons 7 persons 8 persons 9 persons 10 persons l1 persons 12 persons or more. (a) (b) (c) (d) (e) (f) (g) (h) (i) (k) (l) (m) (n) The whole of London (County). 93 181 185 164 129 93 64 41 24 13 7 6 City of London 135 249 200 152 108 61 32 29 11 11 5 7 Birthplaces of City" Residents. Table 7 shows the birthplaces of the resident population. Of the total of 19,657 persons, 17,392 were born in England and Wales, and of this number 10,938 were Londoners. The proportion of foreigners in the City is large, being l,047 persons (see last line of table), or 5.3 per cent. of the population, and this latter figure does not include the children of foreigners born in the City. Of the total population of England and Wales, 0.79 per cent. were foreigners, but in the neighbouring Borough of Stepney, of a population of 279,804 no less than 53,060 were foreigners, or 19.3 per cent. 16 TABLE 7. Birthplaces of males and females of the population of the City of London:— Total Population. Birthplaces. Males. Females. Totals. 10,080. 9.577. 19,657. England and Wales 8,625 8,767 17,392 Scotland 293 139 432 Ireland 166 154 320 Isle of Man and Channel Islands 19 11 30 British Colonies or Dependencies 85 67 152 British Subjects, born abroad 20 34 54 Naturalised British Subjects 57 32 89 Foreigners 759 288 1,047 Born at Sea 4 7 11 Birthplace not stated 52 78 130 The birthplaces of the foreigners were as follows:— Males. Females. Totals. Europe — Austria 38 15 53 Hungary 9 3 5 Belgium 10 3 13 Denmark 7 - 7 France 40 10 50 Germany 214 45 259 Greece 2 - 2 Holland 104 23 127 Italy 68 32 100 Norway 27 1 28 Portugal - 1 1 Russia 69 53 122 Russian Poland 75 68 143 Servia, Roumania, &c. 3 5 8 Spain 3 3 6 Sweden 7 - 7 Switzerland 37 5 42 Turkey 4 6 10 Asia — China - 1 1 Japan - - - Other Countries 2 - 2 Africa 1 - 1 America—Argentine Republic 1 - 1 Brazil 3 - 3 Mexico, &c. - - - United States 38 13 51 Other Countries 2 - 2 Born abroad (country not stated) 2 1 3 759 288 1,047 17 Population Housed in Excess of Two Persons Per Room. The following particulars are closely associated with the exceedingly difficult problem of overcrowding. While safely assuming it is improbable that any overcrowding exists where one or two persons only occupy a room, it is strong presumptive evidence that the contrary may obtain where it is shown that in a tenement more than two adults per room are living. The Registrar-General remarks that in previous Census Reports such a standard as the latter "has been spoken of, as indicating cases of overcrowding, though in the absence of information as to the size of the rooms occupied, the justification of the term may be open to question. It will, however, be convenient to adopt this standard for comparative purposes." In the year 1911 the population in the City of London was 19,657; it is now known that 13,408 of these persons were members of 3,764 families. The following Table "8" shows the size of 2,953 of such families who were found to occupy tenements consisting of from one to four rooms. The term "room" in these notes is used irrespective of its size, and includes a kitchen, but not a scullery, landing, lobby, closet, bathroom, warehouse or shop ; and the word "family" to describe a person living alone, or a family together with possibly boarders, lodgers, visitors, servants, &c. The children enumerated are those under 10 years of age. The method of reading the table is as follows:—If the Table 8 be examined we observe by the sixth line (columns "q" and "r") that 489 families consisting of 843 persons occupied one room tenements, and from the third line we learn that of these one room tenements, there were 14 instances (column "f") of families, each consisting of four persons, and that of the four persons, two were children under 10 years of age (column " b.") In the Table a thick divisional line is shown from top to bottom, and it will be observed that in every total on the right hand side of this line a standard of two to a room is exceeded, even if we count two children as one adult. 18 TABLE 8. r of Rooms per Tenement. Number of Children under 10 years of age. Number of Private Families consisting of Total Number of Private Families. Total Number of Persons. 1. 2, 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Persons. Persons. Persons. Persons. Persons. Persons. Persons. Persons. Persons. Persons. Persons. Persons. Persons. (a) (b) (c) (d) (e) (f) (g) (h) (i) (k) (l) (m) (n) (o) (p) (q) (r) 1 Adults 272 133 21 6 ... ... ... ... ... ... ... ... ... 432 625 „ and 1 child ... 8 12 8 ... ... ... ... ... ... ... ... ... 28 84 „ „ 2 children ... ... 1 14 7 1 ... ... ... ... ... ... ... 23 100 " ,, 3 „ ... ... ... ... 4 1 ... ... ... ... ... ... ... 5 26 " " 3 " ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 8 272 141 34 28 11 2 ... 1 ... ... ... ... ... 489 843 2 Adults 105 354 131 61 21 3 2 ... ... ... ... ... ... 677 1,587 „ and 1 child ... 3 104 31 17 10 3 ... ... ... ... ... ... 168 608 „ „ 2 children ... ... 2 45 16 ... 1 ... ... ... ... ... ... 67 291 „ „ 3 „ ... ... ... ... 31 7 ... 2 1 1 ... ... ... 42 232 „ „ 4 „ ... ... ... ... ... 13 4 1 1 ... ... ... 1 21 141 „ „ 5 „ ... ... ... ... ... ... 1 1 1 ... ... ... ... 3 24 „ „ 6 „ ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 8 105 357 237 137 86 36 11 5 3 1 ... ... 1 979 2,891 3 Adults 71 246 175 75 37 15 4 3 ... 1 ... ... ... 627 1,725 ,, and 1 child ... 3 45 34 19 9 3 ... 1 ... ... ... ... 114 456 „ „ 2 children ... ... ... 36 23 8 ... 3 1 ... ... ... ... 75 368 „ „ 3 „ ... • • • ... ... 14 10 3 4 2 1 ... ... ... 34 211 „ „ 4 „ ... ... ... ... ... 5 3 2 ... ... ... ... ... 10 67 „ „ 5 „ ... ... ... ... ... ... 3 3 1 1 1 ... 1 10 88 „ „ 6 „ ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 11 71 249 220 145 93 47 20 15 5 3 2 ... 1 871 2,926 4 Adults 30 114 134 85 44 20 8 4 ... ... ... ... ... 439 1,428 „ and 1 child ... ... 24 30 23 9 4 2 1 ... ... ... ... 93 414 „ „ 2 children ... ... ... 16 20 12 7 ... 3 1 1 ... ... 60 333 „ „ 3 „ ... ... ... ... 3 1 5 2 2 1 ... ... ... 14 100 „ „ 4 „ ... ... ... ... ... 2 2 1 ... 2 ... ... ... 7 54 „ „ 6 „ ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 10 30 114 158 131 90 44 26 9 6 5 1 ... ... 614 2,339 Total, occupying tenements of from one to four room9 2,953 8,999 19 BIRTHS. During the year 1913, 405 births were registered in the City, 250 of which, however, did not belong thereto. To the remaining 155 must be added 12 children born to Citizens temporarily residing outside the City boundary. The number of births, therefore, on which the rate should be calculated is 167. The annual birth rate was 9.4 per 1,000 persons of all ages, compared with a quinquennial mean rate of 16.9 per 1,000. In the Metropolis the birth rate in 1913 was 24.5 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 402 births notified to the Vaccination Officers during 1913, 135 had been successfully vaccinated by the end of the year, 35 had died before the age for vaccination, and in one case the child was insusceptible. Vaccination was postponed by medical certificate in 8 cases, 141 had removed into other districts, and 24 vaccinations were pending at the end of the year. There were 58 cases of conscientious objection. The Public Vaccinators performed 56 re-vaccinations during the year. Vaccination Statistics in the City of London. Year. Number of Births notified to Vaccination Officer. Successfully Vaccinated. Insusceptible. Had Small-pox. Died before Vaccination. Vaccination Postponed. Cases pending or removed at the end of the year. Conscientious Objections. 1908 281 per crrt. 59.8 per cent. •71 per cent. Nil. per cent. 9.6 per cent, 3.9 per cent. 21.3 per cent. 4.6 1909 248 58.4 •80 „ 9.6 5.4 16.5 8.8 1900 262 57.6 •38 55 9.5 3.8 15.6 12.9 1911 410 37.5 •24 „ 8.2 3.4 38.7 11.9 1912 410 43.9 Nil „ 6.8 0.5 33.6 15.1 Average previous 5 years 322 51.4 •43 „ 8.7 3.4 25.1 10.6 1913 402 33.6 •25 „ 8.8 1:9 41.1 14.5 VACCINATION ACT, 1907. It will be seen that the number of conscientious objectors is increasing. This is doubtless due to the Vaccination Act of 1907, which is a direct encouragement to persons not to take advantage of a means which it is known reduces the susceptibility of their children to an attack of small-pox. MORTALITY. During the year under review, 870 deaths were registered in the District, including 733 persons dying in the City, but not belonging thereto. See Table, p. 24, for details. 20 Deducting these latter, 137 deaths remain, to which must be added those of 122 persons who died in Institutions in outside districts, where they were registered ; the total, therefore, on which the City death-rate is calculated is 259. The death rate for 1913 was 14.5* per 1,000 per annum of the population (the previous year being 9*5), whilst that for the whole of the Metropolis was 14.2. These two death rates as here stated show a marked difference to the disadvantage of the year under review ; this is due to the fact that during the present year considerable care has been taken to obtain knowledge respecting the deaths of persons usually resident within the City but who died outside the City boundaries, there is, of course, equal justification for including in the City mortality returns the deaths of such persons as there is for excluding the deaths of non-residents dying within the City. These latter deductions have always been made, and as a consequence of the additions referred to above, the death rate is on the present occasion higher than has been reported in the few previous years. The increase in the mortality rate is due entirely to this cause and not tc any extraordinary prevalence of disease. The additional figures mentioned are furnished by the Registrar-General, and although in some instances absolute proof that the deaths are those of City residents is not forthcoming, there is no alternative but to accept them. Death Rates, per 1,000 per Annum. Year. City of London. 95 Great Towns of England and Wales. Metropolis. 1908 12.6 15.5 14.0 1909 16.0 15.6 14.0 1910 12.1 13.4 12.7 1911 10.9 15.5 15.0 1912 9.5 13.8 13.6 Average previons five years 12.2 14.8 13.9 1913 14.5 14.7 14.2 The death rate from zymotic disease per 1,000 of the population was 0.34 compared with 1.38 in the Metropolis. The deaths from phthisis correspond to a rate of 1.6 per thousand of the population, as compared with 1.30 in the Metropolis, Infantile Mortality. The deaths of children under one year of age were at the rate of 96 per 1,000 births, as against 105 for the whole of London. The Table of infantile mortality on p. 22 shows the deaths of children under one year arranged according to monthly age periods. From this it will be seen that no less than 43.8 per cent. of these deaths occurred in the first month, 68.8 per cent. within the first three months, and 81.3 per cent. during the first six months of existence. * The death rate as calculated from statistics in my possession differs from that stated by the Registrar-General by reason of the fact that during the first months of the year the system of inward transfer of deaths was not in operation. 21 NOTIFICATION OF BIRTHS ACT, 1907. The work under the notification of Births Act has been continued. During the year 149 births were notified belonging to the City, including two still-births. 255 other notifications, not belonging to the City, were received and were forwarded to the Medical Officers of the respective districts. Of the 149 City Births notified under the Act:— 90 were notified by Medical Practitioners. 25 ,, ,, by Hospital Authorities, &c. 15 „ „ by Midwives. 19 „ „ by Parents. Daring the year, 328 visits were paid to the homes to give instruction in the care and feeding of infants. The visits are looked forward to and much appreciated by the mothers. Of the babies visited :— 84 per cent. were breast-fed. 10 ,, were hand-fed. 6 „ were partly hand-fed and partly breast-fed. To all necessitous nursing mothers the grant of 1½ pints of milk daily has been allowed for periods varying from one month to six months, and in three exceptional cases the grant was continued for nine months. During the year, thirty mothers were allowed the grant of milk, twenty-six of these mothers Were asked to attend the "Shelter" (a building in Golden Lane belonging to the Corporation) each Monday afternoon in order that their babies might be weighed In all cases improvement was noted. The City mothers take an intelligent interest in the health of their children and appreciate and value all that is done. Many poor mothers find it very difficult to provide warm clothing for their infants, and some actually find it impossible, although the amount required to purchase suitable articles is small. Several necessitous families have been recommended for help from the poor box, and grateful thanks are due to Mr. Savill, Clerk to the Sitting Justices, and Mr. Douglas, Clerk to the Lord Mayor, for their kindness in making grants in cases brought to their notice.. Deaths in City Institutions. During 1913, 82 citizens died in City Workhouses, Workhouse Infirmaries or Lunatic Asylums, or no less than 31.7 per cent. of the whole City mortality, the corresponding figure for the Metropolis being 43.1 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 1913, compared with the previous five years:— Year. City of London. Metropolis. Per cent. Per cent. 1908 23-0 25-8 1909 38-0 42-0 1910 34-6 43-3 1911 39-4 41-2 .1912 26-9 43-3 Average of previous five years... 32-4 39-1 1913 31-7 43-1 22 (This Table is prepared in accordance with the requirements of the Local Government Board.) City of London. Infantile Mortality during the Year 1913. Nett Deaths from stated Causes at Various Ages under One Year of Age. CAUSES OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 Weeks. 4 Weeks and under 3 Months. 3 Months and under 6 Months. 6 Months and under 9 Months. 9 Months and under 12 Months. Total Deaths under 1 year. All Causes. 1 Certified 4 2 ... 1 7 4 2 1 2 16 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... 2 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... . Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... ... ... ... ... ... 1 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... Pneumonia (all forms) ... ... ... ... ... ... ... ... ... ••• Diarrhœa ... ... ... ... ... ... ... ... ... 1 Enteritis ... ... ... ... ... ... ... ... ... ... Gastritis ... ... ... ... ... ... ... ... ... 2 Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation (overlying) ... ... ... ... ... ... ... ... ... ... Injury at Birth 1 ... ... ... 1 ... ... ... ... 1 Atelectasis ... ... ... ... 1 ... ... ... ... 1 Congenital Malformations ... ... ... ... ... ... ... ... ... 1 Premature Birth 3 1 ... ... 4 ... ... ... ... 4 Atrophy, Debility and Marasmus ... ... ... 1 1 1 ... ... 1 3 Other Causes ... ... ... ... ... ... ... ... ... ... 4 2 ... 1 7 4 2 1 2 16 (legitimate 162 (legitimate infants 14 Nett Births in the year Nett Deaths in the year of (illegitimate 5 (illegitimate infants 2 23 Deaths from Violence. Of the City deaths, 2'8 per cent. were caused by injuries or violence, as compared with 5.2 in 1911 and 3.4 in 1912. This is 0.3 below the average for the previous five years. PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE. year. City of London. Metropolis. Per cent. Per cent. 1908 4.5 4.4 1909 5.1 3.5 1910 5.7 4.0 1911 5.1 3.8 1912 3.3 5.9 Average previous five years 4.8 4.4 1913 2.8 4.1 VITAL STATISTICS, 1913. City of London compared with the Metropolis for the Year 1913 and the previous five years. City of London. Birth Bate. Death Rate. Deaths of Children under 1 year to 1,000 Births. Violent Deaths, per cent. of Deaths Registered. Deaths from prinoipal Zymotic Disease per 1,000 of the Population. Estimated Night Population (Imperial Census). Estimated Day Population(Cor poration Census). City. Metropolis. City. Metropolis. City Metropolis. City. Metropolis. City. Metropolis. 1908 19,252 385,640 * 25.2 12.6 13.8 * 113 4.5 4.0 0.15 1.35 1909 18,193 391,220 * 24.2 16.0 14.0 * 107 4.7 3.5 0.44 1.30 1910 17,132 387,755 12.9 23.9 12.1 12.7 64 102 5.7 4.0 0.17 1.10 1911 19,475 364,061 10.6 25.0 10.9 15.0 93 128 5.1 3.8 0.20 0.31 1912 18,695 366,087 9.9 24.5 9.5 13.6 54 91 3.3 5.9 0.16 0.13 Average previous five years. 18,549 378,952 11.2 24.6 12.3 13.9 71 109 4.7 4.3 0.23 0.84 1913 17,916 367,727 9.4 24.5 14.5 14.2 96 105 2.8 4.1 0.34 1.38 * Figures not available. 24 (This Table is prepared in accordance with the requirements of the Local Government Board.) Vital Statistics of Whole District during 1913 and Previous Years. Name of District: CITY OF LONDON. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths.‡ Nett Deaths belonging to the District. Uncorrected number. Nett. of Nonresidents registered in the District. † of Residents not registered in the District. † Under 1 Year of Age. At all Agea. Number. † Rate. Number. * Rate. Number. * Rate per 1,000 nett Births. Number. * Rate. 1 2 a 4 5 6 7 8 9 10 11 12 13 1908 19,252 277 ** ** 899 46.69 712 56 18 ** 243 12.6 1909 18,193 244 ** ** 912 50.12 725 105 26 ** 292 16.0 1910 17,132 262 221 12.89 768 44.82 629 69 14 64 208 12.1 1911 19,475 410 205 10.52 842 43.23 711 82 19 93 213 10.9 1912 18,695 387 185 9.89 806 43.11 674 46 10 54 178 9.5 1913 17,916 405 167 9.32 870 49 733 122 16 96 259 14.5 Notes.—This Table is arranged to show the gross births and deaths in the district, and the births and deaths properly belonging to it with the corresponding rates. For years before 1911 some of the corrected rates probably will not be available. The rates should be calculated per 1,000 of the estimated gross population. In a district in which large Public Institutions for the sick or infirm seriously affect the statistics, the rates in Columns 5 and 13 may be calculated on a nett population, obtained by deducting from the estimated gross population the average number of inmates not belonging to the district in such institutions. * In Column 6 are to be included the whole of the deaths registered during the year as having actually occurred within the district. In Column 12 is to be entered the number in Column 6, corrected by substraction of the number in Column 8 and by addition of the number in Column 9. Deaths in Column 10 are to be similarly corrected by substraction of the deaths under 1, included in the number given in Column 8, and by addition of the deaths under 1 included in the number given in Column 9. † The Medical Officer of Health will he able from the returns made to him by the local Registrar of Deaths, as well as from the quarterly lists furnished by the Registrar.General, to till in Column 8 in accordance with the rule in the next paragraph below. The Registrar.General, either directly or through the County Medical Officcr of Health, will supply the Medical Officer of Health with the particulars of deaths to be entered in Column 9 ; and all such deaths must be included in this Column, unless an error is detected, and its correction has been accepted by the Registrar.General. For Column 4 the Registrar.General will furnish to the Medical Officer of Health a Statement of the number of births needing1 to be added to or subtracted from the total supplied by the local Registrar. ‡"Transferable Deaths" are deaths of persons who, having. a fixed or usual residence in England or Wales, die in a district other than that in which they resided. The deaths of persons without fixed or usual residence, e.g., casuals, must not be included in Columns 8 or 9, except in certain instances under 3 (J) below. The Medical Officer of Health will state in Column 8 the number of transferable deaths of " non.residents " which are to be deducted, and will state in Column 9 the number of deaths of "residents" registered outside the district which are to be added in calculating the nett death.rate of his district. The following special cases arise as to Transferable Deaths (1) Persons dying in Institutions for the sick or infirm, such as hospitals, lunatic asylums, workhouses, and nursing homes (but not almshouses) must be regarded as residents of the district in which they had a fixed or usual residence at the time of admission. If the person dying in an Institution had no fixed residence at the time of admission, the death is not transferable. If the patient has been directly transferred from one such Institution to another, the death is transferable to the district of residence at the time of admission to the first Institution. (2) The deaths of infants born and dying within a year of birth in an Institution to which the mother was admitted for her confinement should be referred to the district of fixed or usual residence of the parent. (3) Deaths from Violence are to be referred (a) to the district of residence, under the general rule ; (J) if this district is unknown, or the deceased had no fixed abode, to the district where the accident occurred, if known ; (c) failing this, to the district where death occurred, if known ; and (d) failing this, to the district where th« body was found. Total population at all ages 19,657 Area of City of London Registration 3 District in acres (land and inland Number of inhabited houses 2,784 Average number of persons per house water) 672.7 10^^^ * Figures not available. 25 (This Table is prepared in accordance with the requirements of the Local Government Board.) Causes of, and Ages at, Death during the Year 1913. Causes of Death. Nett deaths at the subjoined ages of "Residents" whether occurring within or without the district. Total Deaths whether of "residents" or " nonresidents" in institutions in the district. All ages Under 1 year. 1 and Under 2 years. 2 and under 5 years 5 and under 16 years. 15 and under 25 years. 25 and under 45 years. 45 and under 66 years. 65 and upwards. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. All causes Certified 259 16 4 1 1 7 31 74 125 676 Uncertified ... ... ... ... ... ... ... ... ... ... 1. Enteric Fever 1 ... ... ... ... ... 1 ... ... 1 2. Small.pox ... ... ... ... ... ... ... ... ... ... 3. Measles ... ... ... ... ... ... ... ... ... 1 4. Scarlet Fever 1 ... ... ... 1 ... ... ... ... ... 5. Whooping Cough 2 ... ... ... ... ... ... ... ... ... 6. Diphtheria and Croup ... ... ... ... ... ... ... ... ... 6 7. Influenza 3 ... ... ... ... ... 1 2 ... ... 8. Erysipelas ... ... ... ... ... ... ... ... ... 1 9. Phthisis (Pulmonary Tuberculosis) 27 ... ... 1 ... 4 10 9 3 19 10. Tuberculous Meningitis ... ... ... ... ... ... ... ... 20 11. Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... 11 12. Cancer, malignant disease 22 ... ... ... ... ... ... 10 12 62 13. Rheumatic Fever 1 ... ... ... ... ... ... ... 1 3 11. Meningitis ... ... ... ... ... ... ... ... ... 7 15. Organic Heart Disease 26 ... ... ... ... 1 1 5 19 23 16. Pronchitis 25 ... 1 ... ... ... 1 4 19 9 17. Pneumonia (all forms) 16 ... 3 ... ... ... 1 7 7 62 18. Other diseases of respiratory organs 6 ... ... ... ... ... 2 l 3 12 19. Diarrhoea and Enteritis 2 ... ... ... ... ... ... ... ... 37 20. Appendicitis and Typhlitis 1 ... ... ... ... ... 1 ... ... 11 21. Cirrhosis of Liver 2 ... ... ... ... ... ... l 1 8 21a. Alcoholism 3 ... ... ... ... ... 2 l ... 1 22. Nephritis and Bright'e Disease 8 ... ... ... ... ... 1 3 4 18 23. Puerperal Fever ... ... ... ... ... ... ... ... ... 2 24. Other accidents and diseases of Pregnancy and Parturition ... ... ... ... ... ... ... ... ... 6 25. Congenital Debility and Malformation, including Premature Birth 8 8 ... ... ... ... ... ... ... 34 26. Violent Deaths, excluding Suicide 6 ... ... ... ... ... 2 2 2 62 27. Suicide 1 ... ... ... ... ... ... 1 ... 9 28. Other Defined Diseases 88 4 ... ... ... 1 6 26 51 210 29. Diseases ill.defined or unknown 10 ... ... ... ... 1 2 4 3 52 259 16 4 1 1 7 31 74 125 676 Sub. Entries. included in above figures. 14. Cerebrospinal Meniugitis 1 ... ... ... ... 1 ... ... ... ... 28. Poliomyelitis ... ... ... ... ... ... ... ... ... ... 26 NOTIFICATION OF INFECTIOUS DISEASES. 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 the Metropolitan Asylums Board Hospitals. Removed to the London Fever Hospital. Treated at other Hospitals and Infirmaries. Duplicate Certificates received. Diagnosis subsequently found to be incorrect. Diphtheria 32 Nil 16 2 9 3 2 Scarlet Fever 54 Nil 35 8 2 8 1 Enteric „ 9 Nil 1 1 3 3 1 Puerperal „ — — — — — — — Erysipelas 9 4 — — 4 1 — Cerebro.Spinal Meningitis — — — — — — — Acute Polio.myelitis and polioencephalitis 2 Nil — — 2 — — Opthalmia neonatorum 2 1 — — — 1 — Totals 108 5 52 11 20 16 4 *Chicken.pox 5 5 . . . . . Totals 113 10 52 11 20 16 4 * The notification of this disease is voluntary in the City of London. It will be seen from the foregoing that during the year, excluding Chicken.pox, 108 Certificates were received, including 16 "duplicates," and four in which the diagnosis was subsequently found to be incorrect. The total number of cases of "notifiable infectious disease" was, therefore, 88, as compared with 66 for the previous year. The total number of cases of Scarlet Fever reported was 45, compared with 33 last year. These figures call for no special comment. The large number of cases of Scarlet Fever which have been notified in Greater London during the year naturally has had an effect upon City residents who are surrounded by a numerous and dense population. Any abnormal increase of infection is readily conveyed from outlying parts to the centre. The following is a Return of infectious diseases notified, exclusive of Chicken.pox, in the City of London, with the percentages of such cases removed for treatment to hospitals or nursed at home during 1913, compared with the figures for the previous five years:— Per cent. of cases reported. year Number of cases reported. , Removed to Treated at Hospital. Home. 1908 90 91.0 90 1909 67 82 .1 17.9 1910 54 79.6 20.4 1911 67 83.6 16.4 1912 66 84.8 15.2 Average for previous gg 84.2 15.8 five years. 1913 88 94.3 5.7 27 The majority of City residents have but little accommodation and convenience for the treatment at home of cases of infectious disease during the illness of the patient, and what is equally important, during convalescence; it is a satisfaction that so many have availed themselves of the facilities for prompt removal to hospital, and in the year under review not one case of Scarlet Fever or Diphtheria was treated at home. Cases of Infectious Disease notified during the Year 1913. CITY OF LONDON. This Table is prepared in accordance with the requirements of the Local Government Board. Notifiable Disease. Number of Cases Notified. Total Cases removed to Hospital. At all Ages. At Ages—Tears. Under 1. 1 and under 6 years. 6 and under 15 years. 16 and under 25 years. 26 and under 46 years. 45 and under 65 years. 65 and upwards. Small.pox — — — — — — — — . Cholera — — — — — — — — — Plague — — — — — — — — — Diphtheria (including Membranous croup) 27 — 8 6 7 6 — — 27 Erysipelas 8 1 — — 3 3 1 — 4 Scarlet Fever 45 — 6 19 15 5 — — 45 Typhus „ — — — — — — — — — Enteric „ 5 — — — 2 3 — — 5 Relapsing „ — — — — — . — — — Continued „ — — — — — — — — — Puerperal ,, — — — — — — — — — Cerebro.spinal Meningitis — — — — — — — — — Polio.myelitis 2 — 1 — 1 — — — 2 Pulmonary Tuberculosis 72 — — 1 8 35 25 3 26 Other forms of Tuberculosis 8 — 3 3 1 1 — — 3 Ophthalmia Neonatorum 1 1 — — — — — — — Totals 168 2 18 29 37 53 26 3 112 Isolation Hospitals, or Hospitals, Sanatoria, &c.: Metropolitan Asylums Board Hospitals, London Fever Hospital, City of London Infirmary, St. Bartholomew's Hospital, City Police Hospital, &c. 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 62. No case of Small.pox, Cholera, Typhus, Relapsing, Continued or Puerperal Fevers, Plague, Anthrax, Cerebro.Spinal Fever or Epidemic Cerebro.Spinal Meningitis has occurred. 28 One case of Polio.myelitis and one of Polio.encephalitis have been notified; and in compliance with the requirements of the Local Government Board the details of these two cases are appended. Case No. 1. Acute Anterior Polio.Myelitis. 30th July, Male, aged 4 ½years. Extract from the Notes on this Case. Son of a porter, patient not in attendance at School. Illness commenced 25th Julj, is supposed to have had a fall 22nd July. First symptoms, headache. Whole of left lower limb and extensor muscle of right thigh paralysed. Pain on flexion of head and positive Kernig's sign suggestive of meningitis. Pain a marked feature at onset: now passing off. No mental defect. Reflexes:—K.J. absent both legs. P.R. Extensor left foot. Flex of right foot. Superficial reflexes natural. Patient said to have been feverish with headache a month ago, with running of the nose and sweating of head, and was taken once to King's College Hospital and "got better." Has not been away from London. There is no eruption, nor is sweating a prominent feature. Mother and brother of patient occupy one room in a block of dwellings, but the father, two adult sisters and one adult brother live elsewhere. The house was in fair condition, was not verminous, and there were no animals or birds. Other inmates of the house were all well. The patient has not been associated with other suspicious cases of illness. The patient was taken and admitted to St. Bartholomew's Hospital 28th July. Examination of blood shows Red B.C. 5,160,000, W.B.C. 6,800 H.G. 84 per cent. Swabs of the nose and throat examined and inoculation test with c. s. fluid carried out. The child recovered, but is still under treatment as out.patient. Case No. 2. Acute Polio.encephalitis. 26th November, 1913, Male, aged 19. Extract from the Notes on this Case. Clerk. Beginning of present illness, supposed biliousness, headaches for some weeks but able to work until November 19th, then felt weak with sore throat, no vomiting, and no headache except prior to 19th November, no delirium—Coma just before death—No local paralysis, diaphragm and intercostals not affected, but left leg, palate, tongue, cheeks exhibiting paresis, not paralysis. No symptoms suggestive of meningitis. Pain not a marked feature. Reflexes:—Left plantar extensors, left K.J. absent and + + at different times, right absent, abdominal absent, pharyngeal absent, palatal absent. Patient had not recently been ill, has had headaches since childhood which have been less frequent since eye glasses were adopted in 1911; the headaches have been worse for the last four weeks. Patient has not been away from London for a month. There is no eruption, sweating is a prominent feature only during attacks of cyanosis. Patient has been living in a hostel of 50 rooms with 107 males and two female staff. Names and ages of patient's family unknown. The house is in good condition, no vermin, no animals. Other inmates of the house are all well. 29 The patient has not been associated with other suspicious cases of illness. Was removed to St. Bartholomew's Hospital 24th November, 1913. An examination of the blood shows great increase in lymphocytes in cerebro.spinal fluid. The patient died within a few hours of admission to the Hospital. P.M. showed typical infiltration and vascular changes in cord and medulla, marked congestion of lungs, kidneys, liver, &c. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. The Regulations for dealing with Tuberculosis, then obtaining and proposed, were reported upon in the Annual Report for the year 1912. The Local Government Board Public Health (Tuberculosis) Regulations, 1912, are there described. These new Regulations came into force upon the 1st February last, their chief effect being that it is now compulsory that all cases of human Tuberculosis, whether of the lungs or localised in other parts of the body, be notified, upon prescribed forms, to the Medical Officer of Health. The number of cases notified during the year and tabulated according to the ages of the patients will be found with particulars of infectious diseases upon page 27. All cases of Tuberculosis have been investigated and such action taken as was possible, to improve the condition of the sufferers, and to prevent the spread of infection. The following tabulation indicates the course of events. Removed to Hospi tals or Sanatoria. Treated in Infirmaries. At present treated at Home. Died. Removed to other District*. Not traced. Totals. Pulmonary Tuberculosis 5 21 12 12 15 7 72 Other forms of Tuberculosis 3 — 3 2 — . 8 Totals 8 21 15 14 15 7 80 Twenty.three additional or duplicate notifications were also received referring to these cases. TREATMENT AND PREVENTION OF TUBERCULOSIS. Proposals for the establishment of a Tuberculosis Dispensary for the City have received careful consideration during the year. This was advisable in consequence of the passing of the National Insurance Act, 1911, and the necessity which existed for dealing with the problem of the prevention of tuberculosis. Upon communicating with the Governing Body of St. Bartholomew's Hospital, it was ascertained that that Body would view with the greatest favour proposals for the co.operation between the Corporation of London and the Hospital in a scheme for the treatment of tuberculosis. This fundamental principle of utilising the resources of a large general hospital has lately been approved by the Local Government Board. 30 Conferences were arranged, and a suggested scheme prepared, in which a combination of the Boroughs of Holborn and Finsbury with the City of London and St. Bartholomew's Hospital was proposed for carrying out the necessary work. The Borough of Finsbury has since decided to establish a Dispensary to supply that district alone. In addition to a Report of a Departmental Committee appointed to report upon "The considerations of general policy in respect of the problem of tuberculosis in the United Kingdom, &c.," memoranda have been issued by the Local Government Board and the London County Council. A circular letter of the Local Government Board outlined the position that should be assumed respectively by the Corporation of London, the London County Council and the Metropolitan Borough Councils in the provision of dispensary treatment, and the arrangements which such would entail. The Circular deals with Schemes as a whole, Preventive Measures, Duties of Medical Officers of Dispensaries, and Finance. Reference is also made to a resolution of the London County Council of November 4th, 1913, proposing contributions to be made by the London County Council towards the cost of dispensary treatment of uninsured persons. Whether the conditions attached to this latter resolution be accepted or not by the Corporation, it is certainly proposed to supply the London County Council with such information as may be necessary for the efficient execution of their duties, and whatever the final decision may be, every endeavour will be made to ensure that the scheme for the City of London shall be in complete uniformity with the work in connection with the prevention and treatment of tuberculosis in London generally. It was decided that the authorities of St. Bartholomew's Hospital be approached with a view to ascertaining whether they would favour the creation of a special department at the Hospital which would correspond with a Tuberculosis Dispensary, and whether they would accept responsibility for staffing, housing and maintaining (in conformity with suitable financial arrangements with the Corporation), so that all City cases might be treated in such special department, and further that where it would be of advantage, any non.resident person engaged in work in the City of London should be entitled to the benefits of the City Dispensary. The arrangement would leave the Hospital free to arrange with any other Metropolitan Borough. The following matters were receiving the attention of the Sanitary Committee at the close of the year:— (1) Arrangements to be made between the Corporation and the St. Bartholomew's Hospital for the treatment of Pulmonary Tuberculosis occurring among City residents in accordance with a scheme to be approved. (2) Consideration to be given to the Resolution of the London County Council respecting the terms attaching to the contribution of 25 per cent. of the net cost. (3) The opinion of the Local Government Board to be sought with respect to the possibility of the grant in aid of the dispensary being paid direct to the Corporation. 31 (4) A suggestion to the London County Council to arrange, if practicable, that beds for the purpose of observations, &c., should be available at St. Bartholomew's Hospital. (5) Negotiations to be entered into with the London Insurance Committee with a view to an arrangement between that Committee and the City Corporation; and (6) A decision to be arrived at as to whether the Dispensary should be so organised as to be available for non.resident workers in the City as well as the resident population, in which event it would also be necessary to decide:— (a) Whether the cost of treating such patients shall be regarded as a City obligation, and (b) Whether the outside Councils within 20 miles of London shall be notified that the City Corporation is prepared to give facilities for residents in their respective districts who may be working in the City, and who require assistance from such an Institution as that which the Corporation are proposing to provide. (7) Steps to be taken to obtain the approval of the Local Government Board. ANTHRAX (IN MAN). During the year, there has been one instance reported of a City worker dying from Anthrax. Deceased was a casual labourer who, on December 5th, was employed at Three Cranes Wharf, Upper Thames Street, to replace some horsehair in bales which had been opened for inspection by a customer. He was again employed at the same warehouse on the 9th, 11th, 13th, 15th and 16th of December. He was taken ill on the 19th, removed to hospital on the 20th, and died on the 21st December. There was no evidence to show that the deceased contracted the disease at the warehouse in question, Copies of the Anthrax Order were exhibited, and lavatory accommodation provided. Suggestions were made to the owner with regard to periodical cleansing of the place. ANTHRAX (IN ANIMALS). The circumstances attaching to a case of Anthrax notified to me on the 23rd December by the Veterinary Inspector under the Diseases of Animals Act, are sufficiently unusual to merit mention in this Report. The animal—a cow, being taken to the slaughterhouse—dropped on the street near the Islington Cattle Market about midnight on the 21st December and was there bled, and the carcase removed on a float to the Aldgate Slaughterhouses. 32 The Inspector on duty at these Slaughterhouses examined the carcase, and, suspecting Anthrax, communicated with the Veterinary Surgeon, who inspected the carcase the next day, and agreed with the opinion of the Inspector. Confirmatory diagnosis was subsequently received from the Board of Agriculture. Special precautions, necessitated by the bleeding of the animal in a public thoroughfare, were carried out, as were also the customary ones taken in all cases of Anthrax. The carcase was burnt. GLANDERS. In accordance with Article 3 (3) of the Glanders and Farcy Order, 1907, the Veterinary Inspector under the Diseases of Animals Acts, has notified two cases of Glanders, one in a horse presented for shipment at Custom House Quay on the 5th April, 1913, and the other in a horse, the property of a firm in the City. The animals were slaughtered, and the carcases burnt, every precaution being taken to prevent contagion. EXAMINATION FOR PATHOGENIC BACTERIA. Any medical practitioner desiring examinations of specimens for Pathogenic Bacteria in cases of suspected infectious disease occurring amongst their patients residing in the City, should forward them to the Medical Officer of Health at the Guildhall. Arrangements have been made for free examination, and the results obtained are communicated as speedily as possible. During the year, the following specimens were so dealt with. It will be seen that positive results were obtained in 56.2 per cent. of these cases. Result— Specimen. Disease suspected. Positive. Negative. Six specimens of Sputum Tuberculosis 3 3 Nine Throat Swabbings Diphtheria 6 3 One specimen of Blood Enteric Fever . 1 EXAMINATION OF MILK FOR TUBERCULOSIS AND CONDITION AS TO CLEANLINESS. One of the duties of the staff of the Public Health Department is to supervise the food supply of the City, and with this object in view, an investigation has recently been made into the condition of milk arriving at various railway stations in the City. The three main objects in such an enquiry are :— (а) To ascertain whether the milk is received in a cleanly condition. (b) To ascertain whether the milk is free from pathogenic bacteria, the chief of which in this instance is the bacillus of tubercle. (c) To ascertain whether the milk has been diluted, or the cream abstracted. 33 Forty.eight samples have been taken representing supplies from the following counties Essex 17 Suffolk 14 Norfolk 8 Cambridge 1 Hertfordshire 2 Bedfordshire 2 Staffordshire 2 Buckinghamshire 1 Northamptonshire 1 48 Samples were sent to the City Bacteriologist, Dr. Andrewes, for bacteriological examination, and to the City Analyst, Dr. Teed, for chemical analysis. The Bacteriologist reports upon the question of cleanliness and pathogenicity, and the Public Analyst on the chemical constitution. Dr. Andrewes' Report is as follows:— Report on Samples of Milk received from the City during the Month of November, 1913. No. of Sample. Date of Receipt. Cleanliness. Date of inoculation of guinea.pig. Date of the animal's death. Interval after inoculation. Condition of animal at death. Result as regards tubercle. 1 Nov. 3 Clean Nov. 4 Killed Dec. 5 31 days Slight local inflammation at seat of injection. No tubercle. Viscera normal. Negative. 2 ” Clean ” Killed Deo. 2 28 days. Normal Negative. 3 ” Very little dirt ” Killed Dec. 3 29 days Normal Negative. 4 ” Very little dirt ” Killed Dec. 5 31 days Normal Negative. 5 ” Clean ” Dead Nov. 26 22 days Small local abscess. No tubercle bacilli found. Glands unaffected. General peritonitis. Septicaemia (B. Coli). Negative. 6 ” Clean ” Dead Nov. 15 11 days Local abscess, with Staphylococci and Streptococci, but no tubercle bacilli. Glands enlarged, but not caseous. Viscera normal. Blood sterile. Negative. 7 Nov. 5 Clean Nov. 6 Killed Dec. 6 30 days Normal Negative. 8 ” Clean ” Killed Dec. 6 30 days Local abscess. No tubercle bacilli found. Glands unaffected. Viscera normal. Negative. 9 ” Clean ” Dead Nov. 12 6 days Slight inflammation round remains of milk with Staphylococci and Streptococci. Liver fatty. No cause found for death. Presumably negative 10 ” Clean ” Killed Dec. 9 33 days Normal Negative. 11 ” Clean ” Killed Dec. 9 33 days Local abscess, with tubercle bacilli. Gl»nds enlarged and tuberculous. Early tubercles in spleen. Positive. 34 No. of Sample. Date of receipt. Cleanliness. Date of inoculation of guinea.pig. Date of the animal's death. Interval after inoculation. Condition of animal at death. Result at regards tubercle. 12 Nov. 5 Clean Nov. 6 Killed Dec. 9 33 days Normal Negative. 13 ” Clean Nov. 11 Dead Nov. 22 11 days No local lesion found. Glands and viscera normal. Blood sterile. No cause found for death. Negative. 14 ” Clean ” Killed Dec. 10 29 days Normal Negative. 15 ” Clean ” Killed Dec. 10 29 days Normal Negative. 16 ” Clean ” Killed Dec. 11 30 days Normal Negative. 17 ” Very little dirt ” Killed Dec. 11 30 days Normal Negative. 18 ” Clean ” Killed Dec. 11 30 days Normal Negative. 19 Nov. 12 Clean Nov. 13 Killed Dec. 15 32 days Local abscess, with caseous lymphatic glands. Tubercle bacilli abundant. No visceral tubercle. Positive. 20 ” Clean ” Killed Dec. 15 32 days Normal Negative, 21 ” Clean ” Dead Nov. 23 10 days Local staphylococcal abscess. No tubercle bacilli found. Glands normal. Suppurative pericarditis and mediastinitis due to a coliform bacillus. Negative. 22 ” Clean ” Dead Dec. 13 30 days Local abscess with no tubercle bacilli. Two or three small abscesses in liver. (No tubercle bacilli found—but B. coli grown from pus). Negative. 23 ” Trace of dirt. ” Dead Nov. 20 7 days No inflammation round residue of cream. No tubercle bacilli present. Gartner's bacillus cultivated from spleen and heart'e blood. Negative (presumably). 24 ” Clean Nov. 13 Killed Dec. 15 32 days Normal Negative. 25 Nov. 17 Clean Nov. 18 Killed Dec. 18 30 days Normal Negative. 26 ” Clean ” Killed Dec. 18 30 days Normal Negative. 27 ” Clean ” Killed Dec. 18 30 days Normal Negative. 28 ” Clean ” Killed Dec. 19 31 days Normal Negative. 29 ” Clean ” Killed Dec. 19 31 days Normal Negative. 30 ” Very little d ” Killed Dec. 19 31 days Normal Negative. 31 Nov. 19 Clean Nov. 20 Killed Dec. 22 32 days Normal Negative. 32 ” Clean ” Killed Dec. 22 32 days Tuberculous abscess at site of inoculation. Inguinal, femoral and iliac glands caseous. Tubercle bacilli found. No viscera tubercle. Positive. 33 ” Clean ” Killed Dec. 22 32 days Normal Negative. 34 ” A little dirt ” Killed Dec. 22 33 days Normal Negative. 35 ” Clean ” Killed Dec. 23 33 days Normal Negative. 36 ” Very little d ” Dead Dec. 4 14 days No local inflammation. No sign of tubercle anywhere Viscera normal. Blood sterile. No cause for death found. Negative. 35 No. of Sample. Date of receipt. Cleanliness. Date of inoculation of guinea.pig. Date of the animal's death. Interval after inoculation. Condition of animal at death. Result as regards tubercle. 37 Nov. 24 Clean. Nov. 25 Dead Dec. 20 25 days Tuberculous abscess at site of inoculation. Inguinal, femoral and iliac glands caseous. Tubercle bacilli found. Early tubercles in spleen. Positive. 38 ” Clean ” Killed Dec. 29 34 days Small local abscess. Large caseous inguinal gland, with many tubercle bacilli. Solitary tubercles in lung and liver. Positive. 39 ” Trace of dirt ” Killed Dec. 29 34 days Small local abscess, with no tubercle bacilli. Glands barely enlarged, not caseous. Viscera normal. Negative. 40 ” Clean. ” Killed Dec. 29 34 days Normal. Negative. 41 ” Clean ” Killed Dec. 29 34 days Large abscess between skin and abdominal muscles; no tubercle bacilli found. No caseation of glands. Viscera normal. Negative. 12 ” Clean ” Dead Dec. 26 31 days Large local abscess. No tubercle bacilli in pus. Glands unaffected. Viscera normal. Negative. 43 Nov. 26 Clean Nov. 27 Killed Dec. 29 32 days Normal Negative. 44 ” Clean. ” Dead Dec. 13 16 days Remains of cream locally encapsuled. No tubercle bacilli found. Glands unaffected. Viscera normal. Negative. 45 ” Clean. ” Killed Dec. 30 34 days Normal Negative. 46 ” Clean ” Killed Dec. 30 34 days Normal Negative. 47 ” Clean ” Killed Dec. 30 34 days Normal Negative. 48 ” Clean ” Killed Dec. 30 34 days Normal Negative. SUMMARY AND REMARKS. (1) As regards the presence of dirt, this series of Samples comes out very well. In 110 single case could I apply the term "dirty" to a sample, and the great majority showed merely a scanty greyish deposit with only a few blackish specks, if any. Such samples I have recorded as clean. (2) As regards pathogenic effects. In each case a guinea.pig was inoculated subcutaneously in the right thigh with a mixture of the cream and the sediment, after the milk had been allowed to stand overnight in a cold place. Of the 48 animals inoculated, 11 died spontaneously at periods varying from 6 to 31 days after inoculation. Of these 11 animals I could find no cause for death in two. Six died with local abscesses, due to Staphylococci and Streptococci or coliform bacilli, and in two of these there were secondary foci of suppuration. One animal died of peritonitis and septicaemia, and one of Gartner infection. One died of tubercle. 36 In only two cases was there any reason for supposing that premature death may have invalidated the experiment. In these cases I have recorded the experiment as "presumably negative," The remaining animals were killed with chloroform during the fifth week after inoculation. Eleven of the 48 animals (or 22.9 per cent.) developed local suppuration as the result of the inoculation. Five of the 48 developed tubercle, i.e., 10.4 per cent of the milk samples contained living tubercle bacilli. The last series of milks examined by me for the Corporation was in January, 1912, when two samples out of 30 (6.6 per cent.) proved tuberculous. (Signed) F. W. ANDREWES, M.D., F.R.C.P., D.P.H. December 30th, 1913. So far as cleanliness is concerned, these results show a considerable improvement on any recorded in the past. It will be observed that the Bacteriologist states that in no single instance can the term "dirty" be applied to any of the samples under review, and the unclean, which range from "trace of dirt" to "a little dirt," total 8 out of 48 samples, or 16.7 per cent. For purposes of comparison, I give the results obtained in previous investigations:— 1909. 1904. per cent. 1905. per cent. 1906. per cent. 1907.8. per cent. 1st. per cent. 2nd. per cent. 1910. per cent. 1911. per cent. 1912. per cent. 1913. per cent. Fairly clean 48.7 68.2 80 54.2 43.7 66.6 75 28.6 79.9 Clean 83.3 Unclean 43.6 22.7 12 37.5 43.8 33.3 25 71.6 20 Unclean 16.7 Tuberculous 7.7 9.1 8 8.3 12.5 4.7 6.25 Nil. 6.6 Tuberculouis 10.4 As regards the presence of the tubercle bacillus the percentage is higher than in any previous year since 1909. It should, however, be remembered that comparisons based on small numbers often show wide differences in the results, and possibly the conditions are not worse in the present year than they have been in the past. During the first year (July, 1908, to July, 1909) of the administration of the Act under which these samples were taken, the percentage of tuberculous milks averaged 12.9 for the whole of the County of London. The percentage, however, for the period July, 1908, to 30th September, 1913, is appreciably lower, being 9.9 per cent. These samples of milk were taken under Section 35 of the London County Council (General Powers) Act, 1907, in which the City have concurrent powers with the London County Council in respect of milk sold in the City of London. By arrangement with the London County Council, details of instances in which positive results have been obtained have been forwarded to the Medical Officer of Health of that body, whose practice in the past it has been to follow up the milk to 37 its source, and when it has been established that a cow is there suffering from Tuberculosis, to prohibit the sending of milk of such cow to London. Although obviously of some advantage to the Metropolis, this limited administrative action only diverts the milk to other markets, and operates to the prejudice of those districts in which such markets were situate. These powers have now been augmented by the Tuberculosis Order of 1913, to which reference is made on page 51. The five tuberculous samples were consigned from five different farms, and enquiry has shown the existence at two of these, of a tuberculous cow. These two animals were subsequently slaughtered. The report on the samples submitted to the Public Analyst, details of which are given below, must be regarded as satisfactory. It shows that at the time the milk is delivered in the City, it is, in nearly all cases, up to the official standard. The highest percentage of fat was 4.77, the lowest 2.96, while the mean was 3.76. MILK SAMPLES AT RAILWAY STATIONS, NOVEMBER, 1913. Result of Chemical Examination. Sample received. No. of Sample Fat. per cent. Solids not Fat. per cent. Water. per cent. Total Solids. per cent. Nature and amount of Adulteration. Remarks. 1913. Nov. 3 1 4.27 8.87 86.86 13.14 ... Boric acid and formalin absent. ” 3 2 3.87 9.01 87.12 12.88 ... Ditto. ” 3 3 3.50 8.88 87.62 12.38 ... Ditto. ” 3 4 3.45 8.97 87.58 12.42 ... Ditto. ” 3 5 3.83 8.75 87.42 12.58 ... Ditto. ” 3 6 4.77 8.95 86.28 13.72 ... Ditto. ” 5 7 3.22 9.18 87.60 12.40 ... Ditto. „ 5 8 3.75 8.79 87.46 12.54 ... Ditto. ” 5 9 4.02 8.54 87.44 12.56 ... Ditto. „ 5 10 4.27 8.67 87.06 12.94 ... Ditto. ” 5 11 4.03 9.21 86.76 13.24 ... Ditto. ” 5 12 2.96 7.86 89.18 10.82 7 per cent. added water Ditto. ” 10 13 3.40 8.34 88.26 11.74 Contained 1 per cent. added water Ditto. ” 10 14 3.18 9.04 88.78 12.22 ... Ditto. „ 10 15 3.68 8.76 87.56 12.44 ... Ditto. „ 10 16 3.30 8.44 88.26 11.74 ... Ditto. „ 10 17 4.35 8.81 86.84 13.16 ... Ditto. 38 Sample Received. No. of Sample. Fat. per cent. Solids not Fat. per cent. Water. per cent. Total Solids. per cent. Nature and amount of Adulteration. Remarks. 1913. Nov. 10 18 4.30 8.40 87.30 12.70 Boric acid and formalin absent. „ 12 19 4.10 8.32 87.58 12.42 Contained 1 per cent, added water. Ditto. 12 20 3.60 9.00 87.40 12.60 ... Ditto. » 12 21 3.83 8.57 87.60 12.40 ... Ditto. „ 12 22 3.89 9.31 86.80 13.20 ... Ditto. „ 12 23 3.32 8*70 87.98 12.02 ... Ditto. „ 12 24 4.00 9.10 86.90 13.10 ... Ditto. „ 17 25 3.23 9.07 87.70 12.30 ... Ditto. „ 17 26 4.32 8.98 86.70 13.30 • • • Ditto. „ 17 27 3.59 901 87.40 12.60 ... Ditto. „ 17 28 4.20 8.90 86.90 13.10 ... Ditto. „ 17 29 3.27 8.87 87.86 12.14 ... Ditto. „ 17 30 3.95 8.95 87.10 12.90 ... Ditto. „ 19 31 4.37 8.65 86.98 13.02 • • • Ditto. „ 19 32 3.82 8.68 87.50 12.50 ... Ditto. „ 19 33 4.61 8'85 86.54 13.46 ... Ditto. „ 19 34 3.50 9.00 87.50 12.50 ... Ditto. „ 19 35 4.05 8.85 87.10 12.90 ... Ditto. „ 19 36 3.43 8.93 87.64 12.36 ... Ditto. „ 24 37 3.93 8*71 87.36 12.64 ... Ditto. .. 24 38 3.53 9.01 87.46 12.54 ... Ditto. „ 24 39 3.19 8.55 88.26 11.74 ... Ditto. „ 24 40 3.51 9.11 87.38 12.62 ... Ditto. „ 24 41 4.58 9.10 86.32 13.68 ... Ditto. „ 24 42 4.18 8.76 87.06 12.94 ... Ditto. „ 26 43 3.28 9.06 87.66 12.34 ... Ditto. „ 26 44 3.83 9.33 86.84 13.16 ... Ditto. „ 26 45 3.65 8.91 87.44 12.56 ... Ditto. „ 26 46 3.00 8.54 88'46 11.54 ... Ditto. „ 26 47 3.24 7.96 88.80 11.20 6 per cent. added water. Ditto. „ 26 48 3.30 8.96 87.74 12.26 ... Ditto. Mean of 48 Samples 3.76 8.81 87.43 12.57 Average of 30 Samples previous year 3.87 8.66 87.46 12.52 39 CLEANSING OF VERMINOUS SCHOOL CHILDREN. By virtue of an arrangement made with the London County Council in 1907, children attending the schools of that Authority, and who were found to be in a verminous condition, could obtain a bath and disinfection at the City Disinfecting Station. Although doubtless this resulted in some improvement in the condition of the scholars, the London County Council had no statutory powers in the matter. The passing of the Children A.ct, 1908, however, empowered the Education Authority to take effective measures for dealing with children attending school in a verminous condition, and by an agreement entered into on the 26th April, 1911, between the London Count.v Council and the City Corporation, the latter body agreed to grant to the Council the use of the Cleansing Station at the City Mortuary for the purpose of cleansing the clothing and persons of verminous children residing in the City and in attendance at Public Elementary Schools provided and maintained by the Council. Among other matters the agreement provided as follows:— (1) That the Cleansing Station at the City Mortuary, Golden Lane, be reserved for this purpose on Tuesdays and Thursdays, between the hours of two and four o'clock p.m. (2) That the Corporation's own officials shall be responsible for this cleansing and disinfection process. The number of children required to be cleansed to be limited to not more than 10 in any one day or 20 in any one week. (3) That the Corporation, concurrently with the cleansing of any child, take such steps as they may legally be empowered to take to cleanse the homes when such is reasonably necessary for the health and cleanliness of the child. It will be observed that the facilities granted by the Corporation in this respect were limited to children resident in the City. During the year 1913, the London County Council approached the Corporation with a view to extending the practice to children in attendance at City Schools, but resident outside the City boundaries. The nine ordinary Elementary Schools within the City have accommodation for 3,490 scholars. The numbers in attendance, however, are usually somewhat below this figure, but in June last there were 1,354 City children attending such schools. There were also 2,144 children residing outside the City attending the City schools. It will be seen, therefore, that less than one.half of the places in these schools are occupied by City children, and it was only for the smaller proportion of children that the disinfection and bathing facilities were available. Having regard to this fact and to the consequent risk of contamination to City children, it was decided by agreement, dated 28th November, 1913, that the facilities which had in the past been available for cleansing City children should be extended to those resident outside the boundaries, but who attended schools situate within the City limits. The objection to this policy is that it involves a dual responsibility—i.e., one authority being responsible for the child and another for the home, but as no other authority would undertake the cleansing of these children, the question became one of self.preservation, and this consideration, in my opinon, outweighs this single objection. 40 CREMATIONS. The number of Cremations at the Corporation Cemetery at Ilford during the year was 21, as compared with 32 in 1912. It will be seen from the Table on page 41 that a decrease in numbers is reported from four other Crematoria ; these decreases, however, are slight and the aggregate of all Cremations at the Crematoria tabulated shows a total increase of over 10 per cent. A lthough cremations increase in number each year the increase is slower than one would have expected, and it is interesting to compare progress with that made in other countries. In Germany* the number of Cremations carried out in 1912 was 8,858, and since the opening of the first Crematorium at Gotha in 1879 to December 31st, 1912, the total number has been 46,387. In Switzerland the total for 1912 was 1,587, which brings up the aggregate to 9,332 since 1889. In the United States, the latest available figures show that 7,250 Cremations were carried out in 1912, bringing the total up to 65,000 since 1876. The modern revival of Cremation began in Italy, and what progress has been made in this country is greatly due to the efforts of the Cremation Society which was founded by Sir Henry Thompson in 1874. Considerable prejudice existed, and still exists against this method of disposal of the dead, but the example of numerous men and women of distinction who have left directions that they should be cremated after death is doing much to establish the position of Cremation as being the most sanitary and satisfactory means of disposal of the dead. Apart from sentiment, perhaps the most practical objection is the slight increase in trouble which is incurred by the necessary formalities which must be observed before a cremation can take place. These very formalities, which in the main are directed towards ensuring that death from natural causes has taken place, and which are not compulsory in the case of ordinary burials, provide additional safeguards against foul play, and what to some people is a real fear—premature burial, and rather than suggest any material relaxation of these safeguards with a view to helping forward the cremation movement, I would advocate an improvement in the methods of death certification and registration in general. Cremation is not more costly than ordinary burials, it can be conducted with the same regard to religious observances, and it provides a means which would enable burial inside churches to be again reverted to. Other advantages to the community could be enumerated and doubtless cremations will continue to increase, but the increase would be more rapid if those who favour this method of disposal of the dead would leave written instructions that they are to be cremated after death. The Crematorium of the City Corporation is at Ilford, Essex, in the grounds of the City of London Cemetery. The foundation stone was laid on October 14th, 1903, by Mr. R. W. Edwards, the then Chairman of the Sanitary Committee. The cost was £7,536. It may, perhaps, be of interest to record thi fact, that the cost of a Cremation at Ilford is only 21. 15s. 6d. * Transactions of the Cremation Society of England, 1913. 41 CREMATIONS IN THE UNITED KINGDOM, 29 YEARS—1885-1913. YEAR. Woking.* Manchester. Glasgow. Liverpool. Hnll. 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 3 ... ... ... ... 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 38 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 1910 106 114 28 37 21 9 16 415 38 12 22 8 14 840 1911 114 124 39 50 25 12 13 542 44 17 20 10 13 1,023 1912 125 149 44 52 27 15 14 521 40 24 32 12 9 1,064 1913 128 172 49 66 23 12 11 602 59 16 21 15 15 1,189 Total 3,693 1905 484 669 277 99 142 4088 329 159 188 106 97 12,236 * "Viscount Cross in the year 1879 forbade 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. 42 EXHUMATION AND RE.INTERMENT OF BODIES AT THE CITY OF LONDON CEMETERY. During the year the bodies of four persons buried at the City of London Cemetery at Ilford have been exhumed. Of these, three were re.interred in other parts of the same Cemetery, and one removed for burial elsewhere. In accordance with the terms of the Licences issued by the Home Secretary in respect of these cases the work of removal and re.interment was carried out in the early morning under the supervision of the Medical Officer of Health. 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 241 tenements, and are occupied by 842* persons, compared with 839 in 1912. 69.8 per cent. are adults, and 30.2 per cent. children (under 14 years). The number of births was 25, viz.: 12 males and 13 females. The birth rate was 29.7 per 1,000, which is 1.6 per 1,000 above the average tor the previous five years. The death rate for 1913 was 5.93 per 1,000 per annum. The number of deaths of children under one year, per 1,000 births, was 80, as against 96 for the City generally. Table of Births and Deaths occurring at the Artizans' Dwellings, Stoney Lane, Houndsditch, during the year 1913. Name of Block. Births. Mobtality fbom all Caches 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 65 65 and upwards. NORTH BLOCK 3 3 ... ... • • • ... • • • ... ... SOUTH 1 2 1 •• ... ... 1 ... ... KING'S 1 1 2 1 ... ... ... ... 1 QUEEN'S „ 3 1 1 ... ... ... 1 ... ... PRINCE'S „ 4 6 1 1 • • • ... ... ... ... TOTALS 12 13 5 2 • • • ... 2 ... 1 * i.e., persons sleeping on the premises. 43 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 1905 29.1 1897 40.3 1906 26.1 1898 43.1 1907 35.0 1899 37.5 1908 31.5 1900 38.4 1909 29.6 1901 33.8 1910 32.9 1902 45.8 1911 29.5 1903 31.2 1912 33.4 1904 30.1 1913 29.7 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 1913 being 12,483, of whom 5,390 were males and 7,093 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 1912 are in italics.) Month. Sex. Total. Males. Females. Children. Adults. Children. Adalts. 1912. 1913. 1912. 1913. 1912. 1913. 1912. 1913. 1912. 1913. January 122 137 283 311 132 192 240 361 777 1,001 February 104 126 313 281 146 151 292 301 855 859 March 156 107 350 333 207 191 377 364 1,090 995 April 110 101 335 336 199 176 337 323 981 936 May 142 151 409 409 302 315 430 487 1,283 1,362 June 123 118 412 375 282 227 442 450 1,259 1,170 July 132 133 383 343 283 299 530 444 1,328 1,219 August 153 160 318 347 280 286 450 445 1,201 1,238 September 125 103 284 278 211 255 350 328 970 964 October 131 141 311 298 166 258 327 373 935 1,070 November 147 138 331 307 188 154 344 337 1,010 936 December 100 89 294 268 164 92 307 284 865 733 Totals 1,545 1,504 4,023 3,886 2,560 2,596 4,426 4,497 12,554 12,483 44 DISINFECTION, &c., AT CITY MORTUARY. 283,989 articles of bedding, clothing, furniture, &c., were received at Golden Lane and disinfected. Of these 280,170 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. In all, 1,186 such certificates were issued during the year. The remaining 3,819 articles were from premises in the City where infectious disease had occurred. 205 bodies were received at the Mortuary pending interment, and 93 post.mortem examinations were made. 176 inquests were held on bodies, and 6 inquests on fires. Number of Articles disinfected, Bodies received at the Mortuary, and Inquests held at the Coroner's Court in the City during 1913, compared with the previous five years. Beddfnf reed'mi ^quests Year. £Tt thf ^on h*Id footed. Mortuary. bodies. Flie. 1908 10,078 194 173 3 1909 325,831 205 187 3 1910 418,957 180 161 2 1911 406,014 204 182 6 1912 355,151 191 161 6 Average for previous five years 303,206 194 172 4 1913 283,989 205 176 6 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 1913:— 1913. Inquest held on Name of Premises. Date of Fire. 1. 30th December, 1912, and 27th January, 1913 14, Fore Street 16th December, 1912. 2. 6th August, 1913 Electric Theatre, 168, Bishopsgate 26th July, 1913 (5.40 p.m.) 3. Ditto Ditto Ditto (7 p.m.) 4. Ditto 5. 17th and 22nd Sept., Ditto Ditto (8.22 p.m.) and 1st October, 1913 . 29a, Bartholomew Close 9th September, 1913. 6. 13th and 20th Nov., 1913. 35 and 36, Aldermanbury . 7th November, 1913. 45 DISINFECTION OF CONVEYANCES AFTER CARRYING CASES OF INFECTIOUS DISEASE. Three public conveyances, which had been used to convey patients suffering from intectious diseases to hospital, and six police litters used by verminous persons, have been disinfected at the City Disinfecting Station, Golden Lane, E.C. DISINFECTANTS. 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. Deodorising 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 12 months under the several headings were:— £ s. d. A 30 2 5 B 351 2 0 C 21 14 0 Total £402 18 5 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. PRESERVATION OF BODIES OF UNKNOWN DEAD. The De Rechter apparatus for the preservation of the dead, installed at the City Mortuary in March, 1909, was fully described in the Annual Report for that year. Since its establishment 28 bodies have been placed therein, four during 1909, eight during 1910, five during 1911, five during 1912, and six during 1913. With one exception these were all the bodies of unknown persons who had met their death by violence, and the preservation has in several cases rendered identification possible. RECEPTACLES FOR POISONOUS LIQUIDS INTENDED TO BE USED FOR PURPOSES OF DISINFECTION. In April the Local Government Board called attention, by Circular Letter, to the possible danger to life attending the distribution of disinfectants by Local Authorities, and suggested the desirability of adopting precautions similar to those prescribed by the Regulations made under the Poisons and Pharmacy Act, 1908. 46 These Regulations provide that any liquid substance to which Section 5 of the Act applies shall not be delivered or sent out except in bottles or other containers rendered distinguishable by touch from ordinary bottles or containers. Provision is also made for efficient indication on the bottle that the contents are not to be administered internally. With these recommendations I am in complete agreement, and although disinfectants are rarely distributed by the Public Health Department, I have made arrangements that when such is done the disinfectants shall be contained in such a special bottle as suggested. Other Departments of the Corporation, however, are larger distributors within the meaning of the Circular referred to, and these have accordingly been acquainted with the suggestions of the Local Government Board. RAT EXTERMINATOR. Having regard to the dangerous character of some of the vermin destroying viruses that have from time to time been placed upon the market, special attention is always given to any new preparation of this nature. In the early part of the year such a virus was in use in the Central Meat Market and other places in London infested with rats. A specimen of this virus was obtained and submitted to Dr. Andrewes, who reported thereon as follows:— "This virus is stated to contain a modified Loeffler's bacillus, which I take "to mean the bacillus typhi murium of Loeffler. As I stated in my preliminary "Report, there is doubt whether such a bacillus exists as an independent "species. The bacilli described as such appear to belong to the Gartner Group, "and the exposure of such bacteria in and about dwellings would be fraught "with the same danger as exists in the case of the Danysz virus and similar "preparations. "The virus submitted to me appears wholly inert. I have failed on "two occasions to isolate from it any number of the Gartner Group, though "B. coli is present. "Two white rats were fed for two days (November 22nd and 23rd) "exclusively on this virus, consuming between them 20 of the gelatine tubes. "Both animals have remained up to the present (24 days) in perfect health." It was claimed that the preparation was impervious to the action of sun, rain or moist atmosphere, and that a peculiar merit of the bait was that the infected rat did not break out in sores, but "in some mysterious way is rendered more palatable to " his fellows who devour his carcase with avidity." On the representation of my predecessor, Dr. Collingridge, the Firm responsible for placing this virus on the market, have withdrawn it from sale. I am at present engaged in obtaining information respecting the question of rat nuisance in the City, and I hope in a short time to present a report. 47 PUBLIC HEALTH LEGISLATION IN 1913. The following Measures for safeguarding public health interests were introduced into Parliament during 1913:— The Public Health (Prevention and Treatment of Disease) Act, 1913 (see below). Passed. The Vaccination Acts (Repeal) Bill (see below). Dropped. The Deaths Registration and Burials Bill.(see page 48). Dropped. The Smoke Abatement Bill, 1913 (see page 49). Dropped. The Milk and Dairies Bill (see page 50). Dropped. Tuberculosis Order of 1913 (see page 51). Passed. The Underground Workrooms Bill (see page 73). Dropped. The following official publication was also issued during the year. It contained much information which will be of considerable value to those interested in food supply and control. Report to the Local Government Board on Bacterial Food Poisonings and Food Infections, by Dr. W. G. Savage (see page 52). PUBLIC HEALTH (PREVENTION AND TREATMENT OF DISEASES) ACT, 1913. This is a short Act, that among other matters, empowers the Council of any County or of any Sanitary Authority to make any such arrangements for the treatment of Tuberculosis as may be necessary. Provision is made, however, for approval by the Local Government Board. VACCINATION ACTS (REPEAL) BILL. The Vaccination Acts (Repeal) Bill—a short private Bill which had as its object the repeal of the Vaccination Acts—provided that no public money should be available, either to pay for vaccination or for providing a supply of vaccine lymph, and further that vaccination should cease to be a condition of admission to the public service. Mainly owing to the operation of the Vaccination Act, 1907, the number of persons accepting the protection afforded by vaccination has unfortunately decreased, and any attempt to further limit the scope of this method of prevention of the spread of Small.pox is much to be regretted, as there is not the slightest doubt that it is one of the most valuable means we possess of combating outbreaks of this disease. Whenever Small.pox occurs either in sporadic or epidemic form, it is my experience that advantage is taken of the public facilities which are provided. In both instances direct contacts are generally ready to accept the advice to be vaccinated, and in the latter, varying numbers who are not known to have been in contact with the disease protect themselves against attack by voluntarily requesting to be vaccinated. 48 The abolition of free vaccination would enormously increase the difficulties at present met in dealing with Small.pox, as many persons, willing and even anxious to avail themselves of the protection afforded, would be prohibited therefrom, through lack of means, to pay for the necessary medical service. Moreover, the admission of unvaccinated persons into such public services as the Navy, Army, or Public Health is most undesirable, for reasons upon which it is not necessary here to enlarge. The Bill, which received little support, was dropped before the second reading. THE DEATHS REGISTRATION AND BURIALS BILL. The above, which was a private Bill, was ordered to be printed by the House of Commons on the 27th March, 1913, and was described as "a Bill to amend the Law " relating to the registration of Deaths and to Burials." Its main object was to guard against crime and premature burial, and with this end in view gave effect to the principal Recommendations of the Select Committee on Death Certification. This Committee, which gave considerable time to the consideration of the question, was much impressed with the weighty opinions of the witnesses who appeared before it, and having regard to the serious possibilities implied in the present system which permits death and burial to take place without the production of satisfactory medical evidence of death, arrived at the conclusion that means should be devised whereby a medical certificate should be obtained in every case of death not certified by a registered medical practitioner in attendance. The Departmental Committee on Coroners which sat in 1909, also was of opinion that a certificate of death should not be accepted from a medical practitioner unless it stated that he had by personal examination of the body satisfied himself as to the fact of death. As the law at present stands, he may certify merely on the information given him by the relatives, there being no statutory obligation on his part to view the body. In the course of these investigations the Departmental Committee on Coroners accumulated evidence that indicated that many certificates have been carelessly or even recklessly given. The following were the main provisions of the Bill as submitted for the first reading. Owing to pressure of other business, however, it did not reach a further stage. 1. The prohibition of registry of deaths without a proper certificate, which means a certificate in prescribed form signed by a practitioner who attended the deceased during his last illness, or where there was no such practitioner in attendance, a certificate in prescribed form signed by the public certifier of death. In the case of an inquest, there must be in addition to the Coroner's certificate, a verification or certificate signed either by the public certifier of deaths or a registered medical practitioner. 49 The public certifier of deaths was to be a new official—a registered medical practitioner—to be appointed by the Board of Guardians. 2. Deaths to be certified within two days of death instead of five as at present, and at the time of notification, information to be given to the Registrar as to whether the deceased person was or was not attended by a registered medical practitioner. In the former case, the name of the practitioner to be given. Other clauses were inoluded which specified what should be regarded by a doctor as "being in attendance''; provision for certification by the certifier of deaths when no doctor had been in attendance; the presence of the certifier of deaths at inquests; the holding of inquests, and provisions respecting burials. Provision was also made for the registration of still-births, and for the purpose of the section a still-born child would mean any child "who has issued forth from its "mother after the expiration of the 28th week after pregnancy, and which was not "alive at the time of its so issuing forth." The Bill prescribed the form of the necessary certificates and provided for the making of regulations by the Local Government Board and the Registrar-General. SMOKE ABATEMENT BILL, 1913. Amplification of the powers at present possessed by local authorities in respect of the smoke nuisance has long been desirable, and had the Smoke Abatement Bill presented in the early part of 1913 been made law, a material advance would have been made in the desired direction. The existing law forbids the emission of "black smoke in such quantity as to be a nuisance," and it is the necessity to prove that the smoke is black that has been the stumbling block to many a prosecution in cases where a very real nuisance has been committed, but where the colour of the smoke was not sufficiently deep to justify the application of the adjective " black." % Section 1 of the Bill under discussion made it an offence to cause the emission of smoke or grit from any furnace or its chimney. The Local Government Board, however, were furnished with powers to make special exemptions in those cases in which it is impracticable to avoid making smoke in carrying on a business, but such powers to exempt to be limited to 10 years from the passing of the Act, and the exemption to be renewed every two years. Penalty clauses were included in the Bill, and provision was made for the appointment of local smoke abatement authorities in those areas in which the local sanitary authorities failed to carry out their duties with regard to smoke abatement. In London the London County Council were made the Local Smoke Abatement authority, and in this respect the autonomy of the City was not preserved. 50 The powers conferred were in addition to, and not in derogation ot, those contained in existing Acts of Parliament, and the appointment of a local Smoke Abatement authority within the district of a defaulting local sanitary authority would not deprive the latter authority of the right to act under their original powers, and there is considerable possibility that such dual control and inspection would have created difficulties and perhaps friction. The Bill was dropped after the first reading. MILK AND DAIRIES BILL. The principles outlined in this Bill were good, and in the main agreed with the views that have from time to time been placed before your Worshipful Committee. It was a long-expected measure, which aimed at the control of the production and distribution of milk by the application to the whole kingdom of certain powers that have been obtained by some of the large towns in respect of this matter, especially in regard to the relation to Tuberculosis. The main objects of the Bill, as given in a Memorandum attached thereto, were to provide for:— (1) The more effective registration of dairies and dairymen. (2) The inspection of dairies and the examination of cows therein and the examination of the milk. (3) The prohibition of the supply of milk from a dairy where such supply has caused or would be likely to cause infectious diseases, including Tuberculosis, (4) The prevention of the 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 for securing the supply of pure and wholesome milk. (7) The establishment by local authorities in populous places of milk depots for the sale of milk specially prepared for infants. The difficulty that has arisen in regard to the registration of a "purveyor of milk " under the Dairies, Cowsheds and Milkshops Orders may be here referred to. It will be within the recollection of your Worshipful Committee that in the case of Spiers and Pond, Limited, v. Green, it was held that the occupiers of a refreshment buffet and restaurant at a railway station, who sell milk in small quantities to customers for consumption on the premises, and who obtain their milk from a wholesale firm which guarantees its purity, do not carry on the trade of "purveyors of milk," and do not require to be registered as purveyors of milk under the Dairies, Cowsheds and Milkshops Orders, 1885. As bearing on this point, it is of interest to note the definitions of "dairy" and "dairyman." These are as follows: "The expression 'dairy' includes any farm, "farmhouse, cowshed, milk store, milk shop, or other place from which milk is supplied 51 "or in which, for purposes of sale or manufacture into butter or cheese for sale, milk is "kept or used, but does not include a shop from which milk is not supplied otherwise "than in the closed receptacles in which it was delivered to the shop, or a shop "or other place in which milk is sold for consumption on the premises only." "The expression 'dairyman' includes any occupier of a dairy, cowkeeper, or "purveyor of milk." A point which calls for comment is the removal of the powers possessed by those authorities who are at present administering milk control Acts, of entering other districts for the purposes of conducting their investigations. Whether the abolition of these powers be desirable is debatable, but personally I am of opinion that it would be a retrograde step to remove such until the new authorities show that they are in a position competently to undertake their obligations. The success of the Bill would have depended largely upon— (1) Efficient local administration. (2) The efficiency of the Veterinary Inspector appointed; and (3) The competence of the Bacteriologists who are to carry out the bacteriological part of the work. Local administration would, to some extent, have been controlled by the powers vested in the Sanitary Authority of a district to lodge formal complaint, if milk entering their district was not of the standard required, but the efficiency of the Veterinary Inspector or Bacteriologist was not secured in any way, and in my opinion the Bill should contain a clause providing for the appointment of officers approved by the Local Government Board. The Bill was withdrawn at the second reading, and its re-introduction is awaited with interest. TUBERCULOSIS ORDER OF 1913. Some measure of success has now attended the repeated representations of public health officers throughout the country of the necessity of prohibiting the sale of milk from cows certified as being affected with Tuberculosis. The Tuberculosis Order of 1913, which came into operation on the 1st May, 1913, aims at securing the destruction of every cow found to be suffering from Tuberculosis of the udder or to be giving tuberculous milk, as well as all bovine animals suffering from Tuberculosis with emaciation. It will be noted that the provisions of the Order are confined to these specific forms of Tuberculosis, but the Board of Agriculture and Fisheries have not lost sight of the fact that in the near future, as a result of the experience gained, it may be necessary to extend the principle. 52 The Board are satisfied that it mast be accepted as a fact that Tuberculosis is ransmissible from the cow to man by the agency of milk, but have limited the scope of the present Order, as it is known that the particular forms defined disseminate freely the germs of the disease. The authorities charged with the administration of the Order referred to, are required to cause every animal found by them to be suffering from one of the specified forms of Tuberculosis, to be slaughtered, and to compensate the owner, such compensation to be based upon the conditions of the animal at the time of slaughter, and not upon its market value as a sound and healthy beast. Should, however, post-mortem examination not confirm the ante-mortem diagnosis of Tuberculosis, the compensation payable is to be a sum equal to the full value of the animal, and a further sum of twenty shillings. There is a point in this question of compensation, which although not of public health interest, is one, I think, merits attention. For some time to come it is obvious that the expenditure under the Order will be exceedingly heavy, as cows of all ages suffering from tuberculosis of the udder and giving tuberculous milk, and all bovine animals showing signs of tuberculosis with emaciation, will be brought within the province of the Order, and as the local authorities responsible for its working are the authorities from whom compensation will be recoverable, it is obvious that agricultural districts devoting large areas to milk production and cattle raising, will be heavily penalised. The milk and meat produced in such districts will doubtless be consumed in districts not devoted to agriculture, and these will, therefore, reap a benefit to which they have made no financial contribution. It would appear that compensation from the Imperial Exchequer would have been a more equitable provision. Local authorities will have refunded to them one-half the net amount payable by way of compensation for slaughtered animals during a period of five years from the coming into operation of the Order. One of the advantages that should result from the Order is the diminution in the incidence of Tuberculosis in the pig. These animals are frequently fed on milk, and it is now generally accepted that it is from this source that they often contract the disease. BACTERIAL FOOD POISONING. Report to the Local Government Board by Dr. W. G. Savage. A summary of our present knowledge of the subject of Food Poisoning has been presented to the Local Government Board in the form of a valuable report by Dr. W. G. Savage. In the past, especially during the summer months, instances of illness have been brought to the notice of the Local Government Board in which certain characteristics were common to each, and on investigation, these illnesses have been attributed to the consumption of foodstuffs which have undergone some slight putrefactive changes, and as a consequence have contained the products of putrefaction known as ptomaines. Dr. Savage's investigations supply additional proof of what has been recognised for some time past, namely, that illness following ingestion of apparently wholesome foodstuffs, in a large number of cases is caused by the presence of certain pathogenic organisms in the foods consumed. 53 How these organisms contaminate foodstuffs forms an important and instructive part of the enquiry. Dr. Savage's labours in this direction point to the conclusion that in those outbreaks due to the infection of the food with bacilli of the Gaertner group, the food is contaminated in some cases because it is derived from an animal suffering from a general or local disease caused by one or other member of the true Gaertner group, and in others because the Gaertner group bacilli have gained access to the foods subsequent to slaughter from outside sources. With regard to the first conclusion, he writes it is "at present impossible to state "in what proportion these outbreaks are to the whole." In regard to the second conclusion, great difficulty was experienced in accurately tracing the origin of outbreaks due to contamination by organisms of the Gaertner group bacilli from outside sources, and in explanation of these difficulties the following three hypotheses are set out: — "Hypothesis A. That the Gaertner group bacilli which are the cause of "the food poisoning outbreak, are of human origin, the meat being infected "with pathogenic Gaertner bacilli from a human source, i.e., a case of disease "(paratyphoid fever) or a carrier case." "Hypothesis B. That the Gaertner group bacilli, which set up the food"poisoning outbreaks, are derived from ordinary fecal infection." "Hypothesis C. That food-poisoning outbreaks are due to infection of "the food with virulent Gaertner group organisms (or other special bacilli) "derived from animals which are either at the time suffering from disease due " to Gaertner group bacilli or acting as carriers of these bacilli." After quoting numerous instances for and against these hypotheses, the investigator is unable to accept any one of them as a general explanation for all outbreaks. By reason of the rapidity of the onset, course and cessation of bacterial foodpoisoning, many cases are over before their investigation can be completed, and one of the greatest barriers to a complete and efficient elucidation of the mystery is the destruction of the remains of the suspected food, thus rendering the collection of pathological specimens for bacteriological examination impossible. Section 7 of the Report deals at length with the preventive measures available, and the following are suggested as worthy of careful consideration:— (1) Meat inspection at the time of slaughter. (2) Separation of the slaughterhouse from the food-preparing places. (3) Cleanliness in premises where made-up foods are prepared. (4) The limitation of diseases in animals caused by bacilli of the Gaertner group. (5) Steps to obtain official cognisance of food-poisoning outbreaks. With regard to (1)— Although rigid supervision at the time and place of slaughter would doubtless reduce the number of cases of food-poisoning, it could not altogether be regarded as a certain preventive, as outbreaks due to infected animals would in all probability still 54 occur by reason of the fact that diseases from which animals might be suffering had been overlooked at the time of inspection. However, under the present system of isolated slaughterhouses in which slaughtering is conducted at any hour or time under any conditions, and without any attempt at inspection at the time of slaughter, it is an easy matter for carcases of disease-infected animals to be put upon the market for human consumption. In the City of London steps have been taken to secure adequate inspection at the time of slaughter, and one of your Officers is now always present when any slaughtering takes place at any slaughterhouse in the City. With regard to (2)— The practice of preparing foodstuffs', or of otherwise carrying out procedures secondary to the actual slaughtering in slaughterhouses, appears to be much in evidence, and is one which should be unhesitatingly condemned. The Bye-laws of the Corporation of London for regulating the business of a slaughterer of cattle forbid the use of a slaughterhouse for any other purpose than that of slaughtering and dressing the animals. With regard to (3)— The prevalence of conditions that would militate against freedom from contamination in the premises where the food has been made up have been found to be very marked. In hardly any of the instances investigated by Dr. Savage, did any serious attempt appear to be made to ensure cleanliness. Special attention is given in the City to the question of control of places where food is prepared or sold, and the London County Council (General Powers) Act, 1908, empowers the Corporation to demand that certain conditions shall be observed in those premises. With regard to (4):— This question of the limitation of diseases in animals due to the Gaertner group bacilli is a highly scientific one, and as stated by Dr. Savage, this ideal would be difficult to secure, but attention is drawn to the unchecked distribution of this bacillus in the form of the various rat and mice viruses now on the market. These media for the destruction of rodents are advertised as innocuous to domestic animals and human beings, and although there are numerous instances of their use without harm, several instances are known in which cases of illness in man have been attributed to infection by these viruses. It will be within the memory of your Worshipful Committee that my predecessor, Dr. Collingridge, directed attention to one such case in 1908, and then urged the desirability of prohibiting the sale of such material. 55 With regard to (5): — One of the difficulties experienced in tracing the course of many of the outbreaks of illness due to food poisoning has been the fact that knowledge of such only comes to the Medical Officer of Health in a haphazard manner, as there is no compulsion upon anyone to notify such, but the circular letter of the Local Government Board, dated September, 1911, inviting voluntary notification, has done much to stimulate interest, and to ensure investigation. Although it was believed, that it was generally understood by medical men practising in the City, that the Corporation were willing and anxious to undertake investigation into the character, &c., of any illnesses that might be ascribed to food poisoning, a circular letter was directed to all medical men practising in the City of London calling attention to the readiness of the Corporation to conduct such investigations without charge to the medical men in attendance, or to the patient, or to the family. 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. Improvements effected. January 118 16 8 16 February 240 16 25 32 March 174 2 6 19 April 227 6 116 29 May 301 26 35 47 June 219 12 16 60 July 312 2 14 50 August 220 4 7 42 September 229 5 9 30 October 181 5 11 30 November 205 6 9 19 December 313 5 6 62 Totals 2,739 105 262 436 56 MIDDLE DISTRICT. (Inspector E. J. Simmons.) Month. Premises inspected. Orders issued. Notices served. Improvements effected. January 124 8 6 18 February 282 4 20 38 March 161 5 5 35 April 252 10 14 39 May 281 4 23 30 June 192 5 9 22 July 330 7 12 42 August 231 5 18 36 September 231 5 19 36 October 249 6 17 38 November 226 7 9 31 December 338 6 18 35 Totals 2,847 72 170 400 EAST DISTRICT. (Inspector W. H. Ralph.) Month. Premises inspected. Orders issued. Notices served. Improvements effected. January 132 8 12 28 February 236 12 5 29 March 165 2 6 14 April 235 1 121 18 May 316 27 4 109 June 183 3 8 45 July 75 10 13 48 August 270 5 13 39 September 175 5 11 20 October 236 10 5 32 November 218 12 18 22 December 347 2 17 28 Totals 2,588 97 233 432 57 The foregoing are summarised as under:— District N umber of inspections made. Orders issued. Notices served. Improvements effected West 2,739 105 262 436 Middle 2,847 72 170 400 East 2,588 97 233 432 Totals 8,174 274 665 1,268 Average of previous five years 8,675 366 916 1,460 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 limewashing 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, together with the corresponding figures for 1900:— REGISTERED LODGING-HOUSES. District. No. of Houses on Register. No. of Lodgers. No. of Tenements. Average No. of Persons per Tenement. Cleansing Notices Served. 1913. 1900. 1913. 1900. 1913. 1900. 1913. 1900. 1913. 1900. West 104 183 692 1,502 297 656 2.4 2.3 125 239 Middle 4 55 35 363 15 130 2.4 2.8 4 66 East 114 158 778 1.186 327 488 2.4 2.5 143 176 Total 222 396 1,505 3,051 639 1,274 2.4 2.6 272 481 These houses are periodically inspected, and in April of each year the owners are called upon to carry out a thorough cleansing of them, in accordance with the provisions of the Bye-laws. This necessitated the service of 272 Notices during 1913. 58 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 Artisans' Block Dwellings. No. of Tenements. No. of Inhabitants. One Room. Two Booms. Three Rooms. Four Rooms. Five Rooms or more. Albion Buildings (No. 21), Bartholomew Close ... 10 ... ... .... 26 Albion Buildings (No. 22), Bartholomew Close ... 10 ... ... ... 20 Bartholomew House, Bartholomew Close 18 1 ... ... ... 47 'Dean Street Blocks, Fetter Lane— Block A 3 4 ... 1 ... 24 „ B 2 5 ... ... ... 26 „ C 6 3 ... ... ... 29 „ D 2 5 ... ... ... 28 ,, E 2 5 ... ... ... 26 ,, F ... 4 ... 1 ... 19 St. Ann's Chambers, Ludgate Hill 9 27 ... ... ... 32 Bloomfield House, Snow Hill ... 22 ... 1 1 45 Total Six " Blocks'' 42 96 ... 3 1 322 MIDDLE 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 Booms. Bridgewater House, Fann Street ... 12 ... ... ... 18 City Buildings, Moor Lane ... 20 12 ... ... 90 Total Two " Blocks " ... 32 12 ... ... 108 59 EAST 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. Harrow Alley and Stoney Lane— North Block ... 48 8 ... 217 South 5 22 13 ... 178 < Prince's 5 50 ... ... 167 Queen's 5 40 ... ... ... 160 King's 8 16 16 ... ... 158 Barker's Buildings, Catherine Wheel Alley, Bishopsgate 12 10 3 ... ... 64 Total Two " Blocks " 35 186 45 ... ... 944 These ten Blocks, containing 452 tenements, and are inhabited by 1,374 persons, an average of 3.04 persons to each tenement. COMMON LODGING-HOUSE, 116, Middlesex Street. The Salvation Army "Working Men's Hotel and Shelter," opened on the 7th February, 1906, at 116, Middlesex Street, is the only Common Lodging-House in the City. Accommodation is provided for 455 persons (including a staff of 26), and the charge for the hotel portion is 5d. per night, and for the Shelter 2d. per night, These prices include a bath and disinfection of clothing. Food can be purchased at the Hotel cheaply. The premises are periodically inspected and always found to be well managed and kept in a cleanly condition. During the year, there has been no repetition of the nuisance formerly complained of, caused by a number of men congregating outside waiting for admission and spitting on the pavement. As men so waiting, number on occasions over 100, this nuisance was very real, and the cessation is doubtless due to the action of the Authorities, who refuse admission to applicants if they have been waiting about in the immediate vicinity of the premises before the doors open at 5 p.m. 60 NEGLECT TO COMPLY WITH WATER-CLOSET BYE-LAWS. In accordance with the Bye-laws with respect to water-closets, &c., made under Section 54 of the City of London (Various Powers) Act, 1900, every person who shall intend to construct a water-closet, or to connect or disconnect any water-closet from any soil pipe or drain, shall, at least seven days before the work is to be commenced, deliver or send to the Corporation at the Guildhall, a plan showing the situation of such water-closet, drawn to scale, together with a section showing the proposed means of ventilation. Under Section 17 every person who shall offend against these Bye-laws renders himself liable to a penalty of 51. for every such offence, and in the case of a continuing offence, to a further penalty of 40s. for each day after written notice of this offence from the Corporation. Any infringement of such Bye-law is a serious matter and may lead to considerable trouble and expense to the owner of the property, inasmuch as it may necessitate the condemnation of a system installed in contravention of the Corporation requirements. Three instances of neglect in this respect have occurred during the year, and the following is a resume, of the facts in regard to each. 194, ALDERSGATE STREET. The fact that certain sanitary works were being carried out at the above-mentioned premises was brought to the notice of this Department in April, and on inspection it was found that new water-closets were in course of construction. No notice of this had been given or plans submitted. An explanation was received from the builders and plans were eventually submitted and approved. 26, HOLBORN VIADUCT. In December, information was received of the construction of water-closets at the above-mentioned premises. Investigation showed that a large range of water-closets had been installed, which, although in accordance with the Bye-laws in other respects, infringed the clause relating to the depositing of plans and the giving of notice. An explanation was received, and plans were ultimately submitted. 4, WELL STREET. In this case the owner of the premises employed a workman to instal a new water-closet and carry out certain alterations to the existing sanitary arrangements in the basement. Notice was only given to this Department by the responsible person about a week after the commencement of the work, and I am of opinion that the infringement of the Bye-laws was due entirely to ignorance of the requirements. DRAINAGE PLANS. In the course of the year, 297 plans were submitted with regard to proposed reconstruction of water-closets or drains in the City. Of these, 264 were approved, 24 revised and approved, and 9 not approved. 61 As will be gathered from the foregoing summaries, a considerable amount of the District Inspectors' time is taken up by new drainage work in connection with existing buildings. This work is of a most important character, and much thought has frequently to be given in order that satisfactory drainage may be arranged. From the congested nature of the sites of business premises it will be recognised that in a large majority of instances drains have to be constructed inside the buildings; and in addition much ingenuity has to be displayed so that available space, which is frequently small in amount, may be utilized in a satisfactory manner for the construction of sanitary conveniences. The City Bye-laws are excellent in character, and if complied with, ensure first class sanitation. The difficulties which are chiefly met with are in respect of the following . requirements in connection with sanitary conveniences:—In basements the floor of the water-closet shall be within five feet of the street level; one of the walls shall be an outside wall; and a ventilated lobby must be provided where water-closets open directly into workrooms. In respect of nuisances I must state that in the majority of instances great assistance is received from the owners. The proof of the existence of a defect is as a rule followed, without demur, by immediate action. This co-operation renders the service of even "Intimations" unnecessary in a large proportion of instances, verbal notice being all that is required. This compliance and co-operation are not confined to small works only, but are witnessed in respect of improvements of considerable magnitude. Your inspectors may safely be regarded as experts in respect of drainage work in iron and likewise in respect of plumbing work, and speaking generally this work is carried out in a manner which leaves little to be complained of. With regard to plumbing work I respectfully direct the attention of the Corporation to the suggestion of the Master of the Worshipful Company of Plumbers in December, 1913. Referring to the system of marking plumber's work, the Master, W. D. Caroe, Esq., M.A., F.R.I.B.A., stated that the Company had always recognised that associated with the plumber and his interests were the public, and they had representatives of Corporations, Water Boards, and Health Authorities working with them, and suggested that such bodies might assist the objects of the Plumbers' Company to the extent of requiring the men's registered numbers and the marks of the employers being put on any work which is carried out. He said that it entirely dissociated the registered man from the ordinary man who had no association with the scheme of marking, and he quoted the instance of the Goldsmiths' Company which recently had been doing some plumbing work and had adopted the marking system. He suggested that the City of London would be doing a great deal to further the objects of the Plumbers' Company if they could pass to their officials the order to mark plumbing work done for the City. I do not know whether such requirements could be made compulsory, but at any rate the suggestion is worth careful consideration, and I believe, that if carried out would be productive of material advantage. The Clerk of the Company in a letter to the Editor of Public Health draws attention to the fact that "Under regulations of the Board of Trade and the Company, distinguishing marks may be affixed to the work of Registered Plumbers to indicate standards of quality and the identity of the plumbers responsible for its execution. The regulations provide for the investigation of complaints against Registered Plumbers and the suspension or cancellation of their registration for acts injurious to the public." 62 STREET GULLIES. The gradual substitution of properly trapped gullies for those formerly existing has greatly reduced the number of complaints received of offensive smells arising from those appliances, especially in warm weather. In some cases this nuisance was doubtless due to want of flushing, but in the majority faulty construction was the cause of the trouble. The City Engineer has given special attention to this matter for several years past, and his. action in replacing the old pattern gullies with those of a more up-to-date design will, I hope, eventually lead to a complete abatement of the evil. OVERCROWDING. Overcrowding is a nuisance to be dealt with summarily under Section 2, Sub-section 1 (e), of the Public Health (London) Act, 1891, and during the year 3 cases were reported by your officers. On the service of the statutory notice of abatement the overcrowding was discontinued in each instance. The details respecting overcrowding are set out in the Census Tables on page 18. SANITARY DEFECTS AND INFECTIOUS DISEASE. In every case of notification of infectious disease, the premises involved were inspected with regard to the drainage system, water supply, ventilation, &c. ; and of the 72 cases so investigated in 1913, it was found necessary to reconstruct the sanitary system in 1 instance, and to make amendments to soil and waste pipes, water-closets, &c., in 30 others. HOUSE, TRADE AND OTHER REFUSE REMOVAL. The City Engineer informs me that the refuse removed from the City in 1913 consisted of 26,128 cartloads of street sweepings and slops, and 51,114 loads of house and trade refuse, a total of 77,242 loads. The total for the year 1912 was 77,649. 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. The horse manure collected from the street orderly bins is not included in the above, but is dealt with by a contractor, who sells it to market gardeners and others. RAILWAY STATIONS. Periodical inspections were made of the sanitary accommodation provided at the twenty-six Railway Stations in the City. In 14 of them, the Companies owning them have been called upon to effect sanitary improvements. The defects, for the most part, have been due to the lack of proper cleaning and to defective drains and sanitary fittings. In all cases the necessary works have been satisfactorily carried out. 63 LEGAL PROCEEDINGS. During the year 665 notices have been served by the District Inspectors at the order of the Sanitary Committee, and in two cases only was it found necessary, in consequence of non-compliance therewith, to refer the matters to the City Solicitor with a view to such steps being taken as he deemed necessary to ensure the required sanitary improvements being effected. In one of these two cases, however, the notice was subsequently complied with, without the matter being taken into Court. The following are the cases referred to: — 61 and 62, Barbican Insufficient W.C. accommodation. Orders complied with. 38, Barbican Defective drain. Court Order made and 15s. costs. Drains reconstructed. SUMMER FLUSHING OF COURTS. There are 279 courts and narrow passages throughout the City which were regularly flushed during the summer months under the direction of the City Engineer, who informs me that in this service and the flushing of the main streets, no less than 69,378,336 gallons of water were used. Of these courts and alleys, 20 were flushed six times a week, 10 five times a week, 2 four times a week, 27 three times a week, 126 twice a week, and 94 once a week. Disinfectants are also freely applied where desirable. The condition of the approaches to Billingsgate Market and the Customs House, as heretofore, required special attention. There has always been a difficulty in keeping the thoroughfares in the immediate vicinity of these places free from the nuisance caused by the drippings from the fish carts, especially during hot weather. LIMEWASHING OF COURTS. There are 89 courts and narrow passages situated in various parts of the City, the walls of which, unless cleansed frequently, become dirty and unsightly through the constant traffic ot passengers or vehicles, together with the action of the 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 1913, 24 were situated in the East District, 33 in the Middle District, and 32 in the West District. PRESERVATION OF STONE. During the year consideration was given to a new process of stone preservation. The method consists of the application of arsenic acid to sodium silicate. The combination results in the formation of free silica which fills the pores of the stone, and arsenic acid which combines with the sodium to form sodium arsenate. 64 If the stone is a lime stone, the arsenic acid having a greater affinity for lime than sodium, combines with the lime to form arsenate of lime and caustic soda, this latter at once is carbonated and is washed off as carbonate of soda. The arsenate of lime becomes locked up with the silica both in the pores of the stone and on the surface where it forms a firm and almost insoluble coating. In the case of sandstone there is a possibility in the process as described above of some arsenic being washed off in the form of arsenate of soda, but the patentees are taking steps to remove this risk by an improved process. The public health interest attaching to the question is mainly confined to the possibility of well-water contamination due to the percolation of the arsenic water through the soil to the water-bearing strata beneath. At present the process is not much used, and even if it were, it would be attended with no danger in the City, inasmuch as the washings of all buildings run direct into the sewers. Some slight risk might, however, appear to obtain in the country, but it must not be forgotten that the number of buildings there requiring treatment would be very few, churches probably being the only ones which would be submitted to the process under review. I am of opinion, therefore, that even in rural areas the question is not one which calls for serious consideration. REMOVAL OF FISH OFFAL. The contract with Messrs. F. S. Hempleman and Co., for the removal of fish offal, expired on the 21st May, 1913, and on the recommendation of the City Engineer and your Medical Officer of Health, was renewed for a further period of 12 months. The conditions of the contract, which was originally entered into in May, 1906, and has since that date been in continual operation, require that the Contractors shall 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 undertaking of the Contractors to remove the material during the evening hours instead of the morning in order to obviate the necessity of the offal remaining in the City all night, has been attended with the success anticipated, no complaint having been received this year of smells arising from all-night storing of such offensive matter. Before arrangements were made for the removal of fish offal by a Contractor, it was dealt with by the Corporation's own Officers in the ordinary way as trade refuse, but the present method is both a financial and hygienic advance. 65 REMOVAL OF HUMAN REMAINS. During the year only two instances have arisen of the disturbance of human remains in the City, and the following are the facts with regard to each:— Bishopsgate Churchyard. During the reconstruction of the sewer under this churchyard a quantity of human remains were unearthed. The bones, which had evidently been previously disturbed, were small in number, and they were therefore re-interred in the churchyard on the completion of the works. St. Alphage, London Wall. In the course of excavations in connection with the erection of a new front to this Church a small number of bones was discovered. These had also been previously disturbed and were re-interred on the site. In neither of these instances were the remains in an offensive condition. HYGIENE OF HAIRDRESSERS' AND BARBERS' SHOPS. The Registered Hairdressers' establishments throughout the City remain under the supervision of your officers, and there are now 24 proprietors of these places who hold certificates and have undertaken to comply with the Regulations of the Corporation for the conduct of their business. During the year one name has been removed from the list and two new certificates have been granted. The following establishments are now on the Register:— 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. Kaspar Gleinser, 137, Fenchurch Street. Carl Hartmann, 5, Queen's Head Passage, Newgate Street. Phillip George Hoerr, 1, Cullum Street. Kingstone and Hubbard, 8-10, Ludgate Arcade. Charles Lehman, 8-9, Aldermanbury Postern. Heinrich A, E. Leopold, 8, Masons' Avenue. Martin Longman, 75, Mark Lane. Charles Massberg, 12, Cullum Street. William Henry Newman, 4a, London House Yard. Marsh 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. Ernst Robert and Erich Beyer, 13, Pilgrim Street. Stephen J. Schuster, 125, Wood Street. Arthur Jules Schweitzer, Royal Hotel, Victoria Embankment. Joseph Witte, 151, Aldersgate Street. 66 WELL WATER SUPPLY IN THE CITY. The investigation into the character of the water as obtained from wells sunk in the City has been continued during the year. Three separate City buildings have been added to the already large number that derive their supply of this necessary element from this source, and samples of the water from the wells sunk within their precincts have been taken and submitted to the Public Analyst with satisfactory results. SMOKE NUISANCES. Thirteen instances of smoke nuisances were reported during 1913; the service of the usual form of notices upon the offenders resulted in the abatement of the nuisance in all cases, and there has been no occasion to take further action. As in recent years the nuisance from "black'' smoke (the existence of which has to be proved before a prosecution can be initiated) is much less than in former years, but annoyances from the improper burning of refuse and from low terminals of chimnies in relation to more lofty buildings occasionally arise, and require the attention of your staff. During the year, an improvement in the method of recording observations of smoke nuisances has been effected, and instead of your officers attempting to note nine different varieties of smoke emitted during an indefinite time, a simple diagramatic form of note-book has been devised, by which a graphic record is made, showing details of the density of the smoke every 15 seconds during one hour's observation. ATMOSPHERIC POLLUTION. One of the first subjects in connection with the Health of the City which forcibly arrest attention is the question whether the air we breathe be reasonably pure. Although the continuous emission of black smoke in the City is practically a thing of the past, there undoubtedly appears to be at times much unnecessary dirt, with resulting loss of light, from the suspension in the upper atmosphere of smoke and the products of combustion, the result probably of the thousands of chimneys of the private houses of greater London. The loss of our full quota of life-giving light and sunshine is a very serious matter, but is only indicative of a portion of the loss to health and pocket. Incalculable damage must accrue to the respiratory organs of our City workers from this source, to say nothing of the annoyance and loss from the palpable dust and "blacks" deposited. With the concurrence of your Sanitary Committee, a critical examination of the air in the City—in conjunction with the Committee for the Investigation of Atmospheric Pollution appointed at the International Exhibition and Conference, London, 1912—is proposed to be effected during the coming year, and is expected will be productive of much useful data. 67 FACTORY AND WORKSHOP ACT, 1901. FACTORIES, WORKSHOPS AND WORKPLACES. The premises at present upon the Register number 3,971, which includes 7,405 workrooms, &c. A new register has been made every year, containing only such information as was necessary for the current year's work. This special register has also served a necessary purpose in connection with the report required by the Act to be sent to H.M. Home Office each year, the figures required being abstracted from it. For the coming year a new system of Registration has been devised in the form of a card index. One of the advantages to be derived from this system is that each Inspector will have under his immediate control a list of the premises which he is called upon to inspect, and will not have to search the common register from time to time for information as heretofore. In addition, each card will form a continuous record of the sanitary history of the premises to which the card relates. Specimens of the cards to be used will be found in this Report under their respective headings, viz.—Factories, Workshops or Workplaces, &c. There were 3,224 notices served during the year for various purposes under the Act. The condition of the places inspected shows general improvement as time proceeds. The number of Factories, Workshops, and Workplaces at present registered is as follows:— Premises. Workrooms, &c. Factories 799 2,794 Workshops 2,113 3,552 Workplaces:— Kitchens of Restaurants, Tea-rooms, &c. 899 899 Stables 24 24 Other places 136 136 Totals 3,971 7,405 Of the 2,794 Factory Workrooms registered, 1,655 were occupied by men only, 509 by women only, and 630 by men and women. Of the 3,552 Workshops registered, 1,778 were occupied by men only, 1,065 by women only, 675 by men and women, 31 were "Domestic Workshops," and 3 tenement Workshops. The number of workers employed was as follows:— Men. Women.[/##] Factories 17,280 12,965 Workshops 7,911 12,042 Workplaces (Kitchens, &c.) 5,681 7,121 Totals 30,872 32,128 68 The following is a summary of inspections of separate Workrooms, &c., since the passing of the Act:— Factories. Workshop Inspectors. w omen Inspectors. Totals. 1904—Inspections during the year 39 39 78 1905 ,, ,, ,, 625 110 735 1906 ,, ,, ,, 1,496 212 1,708 1907 ,, ., ,, 1,731 656 2,387 1908 „ „ „ 2,745 580 3,325 1909 „ „ „ 3,331 607 3,938 1910 „ „ „ 3,787 993 4,780 1911 „ ,, ,, 3,649 680 4,329 1912 „ „ „ 3,259 379 3,638 1913 „ ,, ,, 2,502 569 3,071 Worksuops. 1902—Inspections during the year 341 140 481 1905 ,, ,, „ 1,306 719 2,025 1908 „ „ „ 3,034 1,634. 4,668 1911 „ ,, „ 3,775 1,772 5,547 1912 „ „ „ 3,037 1,195 4,232 1913 „ „ „ 2,437 1,226 3,663 Workplaces. 1902—Inspections during the year 78 390 468 1905 „ „ „ 555 299 854 1908 „ „ „ 705 372 1,077 1911 „ „ „ 977 145 1,122 1912 „ „ „ 991 188 1,179 1913 ,, ,, ,, 560 178 738 FACTORIES. The local authority has but limited responsibilities with respect to factories. The necessary cleansing comes under the supervision of H.M. Inspectors, as well as ventilation, &c., &c. The principal defects remediable by the Local Authority are the want of suitable and sufficient water-closet accommodation for both sexes and the abatement of general nuisances. Defects remediable under the Factory Acts other than as above-mentioned, when noticed in the course of inspection, are referred to H.M. Inspector. During the year 22 defects were so referred. The following are some of the trades registered and inspected as factories:— Account Book making. Bookbinding. Bakehouses. Brass-plate making. Christmas Card making. Cigar and Cigarette making. Clothiers, &c. Coffee roasting. Cork cutting and sorting. Cotton winding. Card edge gilding. Cutlery (grinding, &c.) Cloth shrinking. Die sinking and relief stamping. Electrical Engineering. Electric typing. Embroidering. Foundries (iron, brass and zinc). Glass blowing. Gold and Silver lace making. Laundries. Mantles, &c. (making of). Packing case making. Printing. Snuff making. Tea mixing. Tobacco (cutting and blending.) Wine and spirit bottling. 69 The details of the card used in the inspection of Factories, are as below:— Obverse. FACTORY. (M W G ) Address Trade Occupier Date Registered Owner Owner's Address Total workers Males Females Conveniences Males Females Washing Accommodation—Males Females Urinals Outworkers List kept? Regularly Forwarded ? Abstract affixed ? F.I. Notified General condition— Remarks— P H. Dept., Guildhall, E.C. Date of inspection Inspector. REVERSE. Date Inspection Reference F.I. Nuisances Noted Book Factories Workers Inspector From To M W G M F - 70 WORKSHOPS. In the year 1902, it became the duty of Local Authorities to see to the condition of all Workshops and the abatement of nuisances therein. The want of cleanliness and ventilation, the provision of suitable and sufficient water-closet accommodation, the abatement of overcrowding, the affixing of abstracts of the Act within workshops, the keeping of Lists of Outworkers upon the premises, £c., are some of the matters requiring attention. Constant changes in business arrangements are the principal reason for interference on the part of the Local Authority. It is frequently found in such cases that entirely new arrangements have to be made with regard to water-closet accommodation, &c. The following is a fairly representative List of the more important Trades registered and inspected as workshops:— Artificial flower making. Artificial teeth making. Art printing on Leather. Art Needlework. Bakehouses. Basket making (wicker, &c.) Boot making and repairing. Blouse making. Blind making. Chiffon tucking. Costume making. Collar making. Clock making. Christmas card making. Cycles (fitting of parts, &c.) Carpet planning. Carpentering. Druggists' sundries. Dressmaking. Engraving. Embroidering. Fancy box making. Furriers (making up of furs.) Feather dressing, &c. Goldblocking. Hatmaking. Jewellery manufacturing. Leather goods (makings of bags, belts, &c.) Lampshade making. Machine Ruling. Mantle making. Millinery. Packing case making. Pattern card making. Picture frame making. Portmanteau making. Tobacco pipe making. Paper making. Paper cutting. Rubber stamp making. Sticks, and stick mounting. Skirt making. Stationery (envelope making, &c.). Shirt making. Straw hat making. Show card making. Surgical appliances (manufacture of) Tailoring. Tea mixing and blending. Tie making. Tobacco pouch making. Umbrella and umbrella frame making. Underclothing (making of). Upholstery. Wine bottling. Waterproof goods (manufacture of ). Many of the trades above-mentioned are also registered as factories. 71 The details of the card used in the inspection of Workshops are as under:— OBVERSE. WORKSHOP. (M W G ) Address Trade Occupier Date registered Owner Owner's Address No. Position of Workroom. Cuble Capacity Workers Allowed Ventilation. Lighting. Heating. Total workers Males Females Conveniences Males Females Water Supply Cistern Situation and Condition Washing Accommodation—Males Females Urinals Outworkers' List kept ? Regularly forwarded? Abstract affixed ? F.I. Notified General Condition & Remarks— P.H. Dept., Guildhall, E.G. Date of Inspection Inspector Reverse as for card used in Inspection of Factories, see page 69. WORKPLACES. (Kitchens of Restaurants, &c). The kitchens of restaurants, &c., were inspected as heretofore, and speaking generally, an improvement was noticeable in their condition. It should be remembered that the business of a City restaurant is crowded into a very few hours in the day, and this results, in some cases, in extremely untidy conditions in the kitchen, necessitating constant cleansing—the want of which is the principal defect now found in kitchens. As a rule, however, your orders are carried out willingly and without delay. As mentioned in previous reports Workplaces (unlike Factories and Workshops) may be established without notice to anyone. This is a serious defect in the Act, and more especially so in cases where food is stored or prepared. Any basement cellar may be used for the purpose and remain uninspected for years until it happens to be discovered, or complaint of a nuisance is received. Other premises besides kitchens were inspected, including those occupied by provision merchants, grocers, fried fish vendors, fruiterers and greengrocers, &c. 72 The details of the cards used in the inspection of Restaurant Kitchens and General Workplaces, are shown below:— OBVERSE. P.H. Dept. KITCHENS OF RESTAURANTS, &c. Guildhall, E.C. Premises— Nature of Business— Name of Occupier— Licensed to sell— Name of Owner— Owner's address— Situation of Kitchen— Any larder ? Staff Rooms— M. F. Other Kitchen Rooms & how used — KITCHEN. Floor—Material— Condition— Last cleaned Ceiling— do do. do. Ventilation—Means of— Lighting—Artificial— Natural— Cooking Power—Coal Stove— Gas Stove— Steamers— Sinks—Washing dishes— Final rinsing— Drying — Veg. washing Sinks all trapped or discted— Kitchen Utensils, &c.—Condition of— Storage of Coal— Refuse—How & where stored— Can dust from same reach food— REVERSE. Workers—&c.—Kitchen M. F. Dining Rooms—M. F. Bar—M. F. Other persons—M. F. Total No. of persons M. F. Water-Closets—For M. F. For Customers—M. F. W.C's—used by— W.C's—How lighted— How ventilated — Urinal Stalls for Staff— For Customers— Condition— Lavatory Accommodation—M. F. Sitn, as regards W.C's— Water Supply— Reference to—Plans— Dist. Ins.— Notices— Letter Books— Defects not mentioned above— General observations— Date inspected— Inspector. 73 Obverse WORKPLACES. Address Business Occupier Date Reg'd. Owner Owner's Address Floor. How used. Lighting. Ventilation. General Condition. Workers—Males Females Office Staff—Males Females Urinals Conveniences—Males Females Washing Accommodation—Males Females Accommodation for refuse Remarks Date inspected P.H. Dept., Guildhall, E.C. Inspector. Reverse as for Factory Inspection Card. See page 69. OFFICE SANITATION. The question of Office Sanitation is one of exceptional interest to the City Corporation as a Sanitary Authority. During the past few years attention has been directed by the National Union of Clerks and the Railway Clerks' Association to the subject, and in addition, the last two Parliamentary sessions have witnessed the introduction of Bills dealing with this problem. The former of the two Societies mentioned was responsible for one Bill, which was introduced by Mr. Wardle; and Lord Salisbury had charge of the other which dealt mainly with underground workrooms. During consideration by Parliament the latter Bill was subjected to various alterations which resulted in its receiving Government approval. These facts, combined with the knowledge that there is considerable probability of these Bills again coming forward, and that one at least may become law, would appear to justify some attention being given to the matter in this report. Going back to Dr. Farr we find him reporting that "Commercial clerks experience an exceptionally high rate of mortality. The rooms in which they work are generally close and ill-ventilated. They often stoop at their desks. They require Sir John Lubbock's holidays." This was undoubtedly a true statement of affairs at that time, but considerable improvement has been made since then. New buildings have in many instances replaced the cramped and unsatisfactory places which preceded them, and a growing tendency exists to recognise that the best work is done in suitable surroundings. 74 Information respecting the present healthfulness or otherwise of the clerk's occupation can only be deduced—apart from limited statistics obtained as a result of special enquiries—from the reports of the Registrar-General, the last of which dealing with this subject is the decennial supplement of 1901-2-3. In general terms the position is as follows:— "Up to the age of 55 years the mortality of commercial clerks does not differ greatly from that of occupied and retired males generally, whilst at subsequent ages their mortality is considerably less than that standard. Below the age of 25 years, commercial clerks are subject to a lower rate of mortality than are railway clerks and officials. From 25—65 years their mortality is higher than in that occupation, whilst at ages above 65 the advantage reverts to commercial clerks. Their comparative mortality figure is much higher than that of the similar class on the railway, the figures being 911 and 776 respectively as against 1,004, the standard figure for occupied and retired males in the aggregate." This decline has apparently been progressive since the 1860 period, and has taken place at a more rapid rate than has the decline among occupied males in general. The decline is equally well seen if the mortality is divided into the two age periods 25—45 and 45—65. The comparison is set out in the following table:— Death Rate of all Occupied Males and Males Engaged as Commercial Clerks and in Insurance Service at the Age-Groups 25—45 and 45—65 in the Periods 1880-2, 1890-2, 1900-2. Occupation. Age 25-45. Age 45-65. 1900-2. 1890-2. 1880-2. 1900-2. 1890-2. 1880-2. All occupied males 7.84 9.52 9.71 22.73 26.69 24.63 Commercial Clerks 7.04 9.49 10.48 19.72 23.19 24.49 The decline in mortality among commercial clerks in the decennial periods 1890-2 and 1900-2 in respect of all causes and certain selected diseases is seen in the following table, and for comparative purposes the figures are given relating to "all occupied males," "occupied males in London," "railway officers and clerks," and "occupied males in agricultural districts." Comparative Mortality of Males Aged 25—65, Among Certain Groups from Several Causes in the Two Periods 1890-2 and 1900-2. Causes of Death. Commercial Cletks, Occupied Males England and Wales. Occupied Males London. Occupied Males Agricultural Districts. Railway Officials and Clerks. 1890-2. 1900-2. 1890-2. 1900-2. 1890-2. 1900-2. 1890-2. 1900-2. 1890-2. 1900-2. All causes 1,056 837 1,102 925 1,325 1,099 795 670 904 707 Alcoholism 14 11 15 16 20 24 8 10 6 6 Phthisis 252 191 214 175 321 262 157 125 226 158 Diseases of Nervous System 112 78 95 78 102 77 73 59 86 75 Bright's Disease 37 34 31 32 43 45 24 25 27 30 Suicide 24 24 17 19 20 22 14 17 11 12 This table shows that commercial clerks have a lower mortality figure from "all causes" than occupied males in England and Wales and London, but a higher one than those in agricultural districts or than railway clerks. The mortality figure for 75 phthisis is, however, higher for commercial clerks than in any of the groups quoted except in the case of "occupied males in London," but the rate of decline noticed in the decennial interval is on the whole comparatively satisfactory, though it was not quite so marked as the decline of phthisis among railway clerks. 'It would appear, therefore, that we might rightly deduce the conclusion that commercial clerks are participating in the improvement in health conditions which have been a feature of the last twenty years in industrial and other occupations. The most unsatisfactory figure is the Phthisis rate which, considering the average social status of clerks, is higher than it ought to be. The sanitation of offices is simply domestic sanitation to which is superadded certain special features dependent upon the peculiarities of the occupation. The most important of these are:— 1. The employment of both sexes with a marked tendency to increase in the number of women employed. 2. The question of common occupation of rooms with the possibility of overcrowding and increased facilities for the spread of infection. 3. The sedentary nature of the occupation, and the cramped position which the body assumes during work, and perhaps the special strain which is thrown upon special organs, e.g., the eyes. 4. The tendency which one finds to loss of tone in clerks owing to the nature of the occupation. This very fact requires that not only shall a high standard of sanitary efficiency be maintained to ensure good health, but that the individual also should adopt such elementary precautions as are necessary to improve his physical condition, and that the fullest advantage be taken of his leisure to attain such end. As regards the details which most frequently come under review in matters affecting office sanitation, the following are the principal ones:— Sanitary Conveniences.—In this connection it is interesting to note that the City Corporation was possibly the first public body to take cognisance of this important matter as affecting Manufactories, Warehouses, &c. Section 101 of the City of London Sewers Act, 1848, reads as follows:— Water closets be provided in Manufactories. Section 101. And be it enacted, That it shall be lawful for the Commissioners, if they shall think fit so to do, by Notice in writing to the owner or occupier of any house or building in which persons of both sexes above twenty in number are employed or intended to be employed at one time in any manufacture, trade, or business, to require such owner or occupier ta provide, within a time to be limited in such Notice, a sufficient Penalty for neglect. number of Water-closets or Privies for the separate use of each sex ; and if any such owner or occupier shall neglect or refuse to comply with such Notice he shall forfeit a sum not exceeding Twenty Pounds, and a further sum of Forty Shillings for every day during which such neglect or refusal shall continue. Since the passing of that Act much progress has been made, and I think it would be generally granted that all premises should be provided with water-closets sufficient and suitable for the number of employees and separate for each sex where both are employed. The fact that women clerks include an increasing proportion of the day inhabitants of the City has resulted in such provision becoming a more pressing necessity than it formerly was. 76 As regards number, the standard set by the Sanitary Accommodation Order of February 4th, 1903, could well be argued as being the minimum necessary in offices. They should be quite separated from those provided for the men, and the approaches should be so arranged that the possibility of men and women meeting should be reduced to a minimum. If this is not the case extreme sensitiveness will prevent some women from using the place until absolutely compelled. Questions of urgency demand that they should be readily accessible. Attention should be paid particularly to the distance in height which has to be climbed. This presents a difficult problem in some of the older places and much ingenuity has to be displayed satisfactorily to solve the problem. In new offices this point requires always to be kept in mind. A lavatory with a supply of soap and a towel should be provided in connection with all conveniences. This need not be an elaborate arrangement, but it is essential in the interests of cleanliness and health. Women's conveniences should as far as practicable be on the premises. The suggestion that outside public conveniences should be used should never be agreed to except in the rarest of circumstances. In addition to the question of accessibility it should be remembered that the use of public conveniences may involve a woman in expense unless a free lavatory is available, which is not generally the case ; and even when it is, I believe, most women would prefer to pay than use the free public provision. A contribution of say 6d. or 1s. a week to the employe does not meet the case. In winter or wet weather some personal preparation is necessary if a person goes outside, and this interferes with routine and perhaps discipline, the latter ultimately resulting in onerous restrictions. Cleanliness.—The standard of cleanliness in a well-kept house should be the standard aimed at, and more attention requires to be paid to the periodical removal of the dust which collects on furniture, or papers not filed, on samples not kept in a store room and on haphazard accumulations of different materials. If dust is not kept under control, the atmosphere is interfered with to the prejudice of the workers. Dust can be reduced somewhat by proper methods of daily cleansing. When damp cleansing has superseded dry dusting in all cleaning work, a marked sanitary advance will have been made. Ventilation, Heating and Overcrowding.—This group of requirements provides one of the most difficult problems for solution. They are closely associated and can hardly be satisfactorily considered alone. The point when an overcrowded condition is reached may depend less upon the number of occupants than upon the ventilation provided, and the efficiency of ventilation may depend upon the method of heating. Standards which arbitrarily fix the number of people who may be allowed to occupy a room are therefore not entirely satisfactory, but it is difficult to suggest an alternative. It would probably be sound practice to require that a workplace should be provided with at least as much cubic capacity per head as is a workshop, and in this instance 250 cubic feet in ordinary time, and 400 cubic feet during overtime represent the minimum. It is impossible to reconcile the standard of 250 cubic feet with accepted physiological requirements. The amount of air necessary to be drawn into a room of that limited cubic capacity in order to reduce the proportion of CO2 to anything like a 77 reasonable amount after occupation of the room for some time, would be so considerable that persons, unless engaged in active occupation, would find a difficulty in tolerating it in cold weather. On the other hand a considerably higher standard, particularly one which approximates the physiological standard would be objected to as impracticable, and 1 must confess that I should have some sympathy with the objection. I think that satisfactory conditions can be fairly well maintained if some trouble is taken and common sense exercised. Rooms are not sufficiently frequently flushed with air, and it is by no means an unusual experience to find that rooms are reoccupied without the air in the room being of the standard of the outside air. Systematic flushing of offices with air, where ventilation is inadequate and cannot be improved would prove useful. Lighting.—Satisfactory lighting is necessary in offices for many reasons. Difficulties are experienced as a result of (a) the relation of window space to floor space being inadequate; (b) windows being wrongly placed; (c) the presence of adjoining buildings; (d) the kind of glass used in the windows; (e) the cleanliness of the windows, and ( f) the room being underground. In new buildings attention can be given to a, b, c and d, and as regards existing buildings one finds that much can be done by increasing the size, and altering the position of windows, bringing the windows to occupy a middle position and increasing the height and so bring them nearer the ceiling ; in underground rooms with an area, an alteration in the angle of the forecourt sometimes helps, when the area is covered, the material forming the cover, requires to be carefully considered, and the supports carrying the glass should be thin but placed at right angles to the wall rather than parallel. Obstructing buildings should, where possible, have a good light-reflecting surface. This is difficult to arrange except in the case of walls which surround a central space. In badly lighted places highly refractive glass is of service, and finally the condition of the windows as regards cleanliness should be noted. Soot and tarry deposits hinder the passage of light, a condition which can readily be remedied. As already stated additional legislation is contemplated, but Acts of Parliament ar not easily obtained, a good case must be made out that existing powers when effectively applied are inadequate, and even in such cases, the new proposals must be free from what may appear to-be excess of zeal. As an instance of this latter I consider that one of the defects of the Railway Offices Bill was the cubic space proposed. The Bill required that there should be 800 cubic ft. during ordinary time and 1,000 cubic ft. during overtime, and 2,000 and 2,500 cubic ft. respectively in underground rooms, with intermediate figures of 1,600 and 2,000 cubic ft. for above-ground offices, where the office is occupied by day and night, or with intervals not exceeding nine hours in any twenty-four hours. These are practically impossible figures. Less cubic capacity would suffice provided adequate ventilation exists. I do not favour the transference of the supervision of offices to the Factory Inspector. To classify offices with workshops would be resented certainly by employers and possibly by employees. Such a step would necessitate additional Inspectors entering offices, and to-day, criticism, with which I have some sympathy, is directed against over-inspection as well as over-legislation. Increased powers are necessary in respect of underground places, and in this connection, as already stated, there is much hope of such being fairly early forthcoming. 78 In Lord Salisbury's Bill the definition of underground workrooms is one which may perhaps not be altogether regarded with favour. Personally I would prefer to see a definite statement as to the distance of the floor below the ground level, rather than the variable standard based on half the height. In this Bill the duty of Supervision of Workplaces remains with the Sanitary Authority, and to facilitate the work of the Authority I consider that it would be an advantage if some provision were made to compel occupiers of a scheduled underground workplace to notify the Authority before occupation, or, in the cases of those in use at the time the Act comes into force to notify within a certain period. Unless this is the case, it appears to me possible that certain underground workplaces may exist for some considerable time before they are discovered. It seems a possibility, also, that an underground workplace may come into occupation after the commencement of the Act, and no punishable offence be committed until the occupier has failed to comply with the Notice of the Sanitary Authority directing his attention to the fact that the room is a nuisance. Since a workplace not kept in conformity with the requirements of the Act can only be made to conform by adopting the "nuisance" procedure. This objection does not hold in the case of workshops, since it is necessary to notify the Factory Inspector of the occupation of a workshop, and these intimations are subsequently forwarded to the Sanitary Authority the workshop being afterwards regularly visited. The above brief summary is sufficient to indicate the importance of the subject, and as most workers in the City live outside the City boundaries the responsibility of ensuring that such persons pass their working lives under satisfactory conditions is not one which can be disregarded or passed over lightly. 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. §280, Bishopsgate. †l55, Minories. §Great Eastern Hotel, Liverpool Street. §‡85, Middlesex Street. ‡61, Middlesex Street. †4, Water Lane. Underground Bakehouses. 188, Aldersgate Street. 18, Long Lane. 262, Bishopsgate. †37, Middlesex Street. ‡4, Broadway. §‡63 to 65, „ 8, Copthall Avenue. §‡122, „ 15, Cornhill. 31, Newbury Street. ‡67, Farringdon Street. 3, Pancras Lane. §‡88, „ „ 21, Stoney Lane. ‡93, Fetter Lane. 68, St. Mary Axe. §8 to 14, King Street, Snow Hill. ‡75, St. Paul's Churchyard. 48, Knightrider Street. 194, Upper Thames Street. † Established during 1003. ‡These have been established at least 27 years. § Factory Bakehouses (power is used) 79 SUMMARY. Aboveground bakehouses 6 Underground bakehouses 20 Total number of bakehouses in the City 26 The Bakehouses were inspected as usual, 86 visits being made. Cleansing, or small repairs, &c., were needed in 16 cases which were carried out forthwith or on service of notice. Generally speaking these places are kept in good condition and up to the standard required by the Act. The use of the underground bakehouse at No. 95, Cannon Street, has been discontinued. The details of the card used in the inspections of Bakehouses are as follows:— Obverse. BAKEHOUSES. Address F. or W. Occupier Established Owner Owner's Address Situation Cubic Capacity Workers. Lighting. Ventilation. Drain opening Sleeping room Flour Store Conveniences—Male Female Washing Accommodation—Male Female Urinals Accommodation for refuse Remarks Date inspected P.H. Dept., Guildhall, E.C. Inspector. Reverse practically the same as for Factory Inspection Card. See page 69. EXPORT OF MEAT FOODS TO THE UNITED STATES AND PHILIPPINE ISLANDS. Persons exporting food to the United States, &c., who give an undertaking to the Local Government Board in writing agreeing to permit and to allow the officers of the Board and others to make any necessary inspections, either with regard to the structure of premises where the food is stored or prepared, or the manufacture of, or the preparation or packing of the food are entitled to receive a Certificate from the Certifying Officer appointed in respect of the particular requirement. In the City of London the Officer appointed is the Medical Officer of Health. A Memorandum upon the subject has been issued by the Local Government Board, and has been referred to in previous annual reports. 80 The following is a List of the Premises and Firms registered in accordance with the terms of the said memorandum:— Messrs. Spiers and Pond, Ltd., Water Lane and City Mills, Upper Thames Street, E.C. Messrs. Hudson Bros., Ltd., Nos. 50-52, Ludgate Hill, E.C. Messrs. Copland and Co., No. 4, Mitre Street, E.C. Messrs. R. F. Potter and Co., No. 7, Central Markets, E.C. Messrs. Campbell Key and Longley, Nos. 260-262, Central Markets, E.C. Messrs. T. G. Hastings and Nephew, No. 6, Rood Lane, E.C. Messrs. G. G. Baxter, Nos. 52-54, Minories, E.C. The details of the cards used for the inspection of premises registered for the preparation of food for export are, as under:— Obverse. EXPORT OF MEAT FOODS. Trade Premises Regd. as Firm Places of exportation Nature of food usually exported Are Firm manufacturers, packers or both ? Structure and Character of premises as regard suitability Cleanliness—Methods of preparation, storage and packing Precautions against use of diseased or unwholesome food Arrangements for disposal of unsound food Average Quantity and frequency of export Workers—Males Females Office Staff—Males Females Urinals Conveniences—Male Female Washing Accommodation—Male Female Accommodation for refuse Remarks Date inspected Inspector. P.H. Dept., Guildhall, E.C. Reverse, practically the same as Factory Inspection Card (page 69). The following Table gives some idea of the Sanitary Work of the Workshop (Men and Women) Inspectors. The details include, Initial Inspections, Periodical Inspections, Re-inspections (Sanitary works, &c., in hand)—the number of the defects found and remedied ; the number of notices served ; Outworkers' names and addresses, &c., dealt with—&c., &c. 81 Summary of Work done under the Factory and Workshop Act, 1901, and the Public Health (London) Act, 1891, &c. Men Inspectors. Women Inspectors. Totals. Special. Inspector Gathercole. East District. Inspector Dunworth. West District. Inspector Robinson. West District. Miss Safford. East District. Miss Wilkinson. Factories, Initial Inspections (Workrooms) ... 21 59 22 8 110 Do. Periodical Inspections (Workrooms) 24 1,385 1,013 349 190 2,961 Do. Re-inspections (Sanitary Works, &c., in hand) 6 348 194 29 1 578 Workshops, Initial Inspections (Workroom*) 7 70 56 180 26 339 Do. Periodical Inspections (Workrooms) 148 1,503 653 623 367 3,294 Do. Re-inspections (Sanitary Works, &c., in hand) 78 683 254 180 23 1,218 Bakehouses, Inspections 73 ... ... ... ... 73 Do. Re-inspections (Sanitary Works, &c., in hand) 13 ... ... ... • •• 13 Domestic Workshops, Initial Inspections (Workrooms) • • • ... ... 4 • •• 4 Domestic Workshops, Periodical Inspections (Workrooms) • •• ... ... 18 8 26 Domestic Workshops, Re-inspections (Sanitary Works, &c., in hand) ... ... ... ... 2 2 Outworkers' Premises, Inspections ... ... 31 6 37 Workplaces, Initial Inspections (Workrooms) 13 ... 15 3 ... 31 Do. Periodical Inspections (Workrooms) 484 ... 48 35 140 707 Do. Re-inspections (Sanitary Works, &c., in hand) 504 ... 20 44 42 610 Offices, Inspections ... ... ... 118 9 127 Do. Re-inspections (Sanitary Works, &c., in hand) ... ... ... 23 • •• 23 London County Council (General Powers) Act, 1904, Inspections of Premises after Cleansing of Children ... ... ... 72 7 79 Do. Do. Re-inspections (Sanitary Works, &c., in hand) ... ... ... 3 • • • 3 Underground Conveniences for Women, Inspections ... ... ... 6 22 28 Railway Stations (Ladies' Rooms), Inspections ... ... ... 21 42 63 Do. ( Do. ), Re-inspections (Sanitary Works, &c., in hand) ... ... ... 3 • •• 3 Notification of Births Act, 1907, Visits ... ... ... 13 328 341 Number of Mothers attending City Shelter for advice ... ... ... 9 205 214 82  Men Inspectors. Women Inspectors. Totals. Special. Inspector Gathercole. East District. Inspector Dunworth. West District. Inspector Robinson. West District. Miss Safford. East District. Miss Wilkinson. Certificates for Cleansing issued by Medical Officer of Health . 48 44 12 3 ... 107 H.M. Inspector notified re " Breaches of Factory Act" 4 59 37 1 5 106 Complaints received from H.M. Inspector of Factories dealt with 1 14 4 9 ... 28 General complaints received dealt with 19 26 15 20 10 90 Workshops notified by H.M. Inspector dealt with 5 23 10 80 42 160 Matters referred to District Inspectors (premises) 23 16 7 • •• ... 46 Matter* referred by Women Inspectors to District and Workshop Inspectors (premises) ... ... • •• 84 189 223 Matters referred to Women Inspectors (premises) 1 ... 2 ... ... 8 Number of defects found (Factories, Workshops and Workplaces, &c.) 642 2,418 920 365 341 4,681 Defects remedied—Water Closets 169 2,200 513 116 37 3,035 Urinals 8 67 15 ... ... 90 Drains relaid or amended 6 13 3 ... ... 22 Overcrowding abated ... 1 ... 7 ... 8 Workrooms, Ac., cleansed 176 354 82 40 24 676 Workrooms, &c., Ventilation improved 27 44 10 18 7 106 General defects remedied 254 271 59 31 22 637 Total number of defects remedied and improvements effected 640 2,950 682 212 90 4,574 Cases reported for Summons • • • 3 ... • •• ••• 3 Legal proceedings taken on Summons • •• 3 ... • • • • •• 3 Intimation Notices served 157 469 157 55 51 889 Statutory Orders served 71 141 84 10 14 320 Orders issued by Sanitary Committee (including Orders to cleanse Workshops on Certificate of Medical Officer of Health) 95 147 87 16 6 351 Outworkers' Lists received from City Firms 1,523 ... ... • •• ... 1,523 Outworkers' Names and Addresses received from other Authorities 275 ... ... ... ... 275 Outworkers' Names and Addresses transmitted to other Authorities 16,025 ... ... ... ... 16,025 Outworkers, Notices served on Employers 2,015 ... ... ... ... 2,015 83 SANITARY DEFECTS IN FACTORIES AND WORKSHOPS NOTIFIED IN 1912 BY H.M. INSPECTOR OF FACTORIES. Complaints were received from H.M. Inspector in respect of 28 matters which were all disposed of before the end of the year or early in the year 1914. As previously mentioned, when dirty conditions or want of ventilation, &c., in Factories are observed, H.M. Inspector is at once notified of the fact—any necessary work being carried out under his immediate supervision. OUTWORKERS AND "HOME" WORKERS. The provisions of the Act relating to Outworkers were carried out as heretofore, and the lists of the names and addresses of 'Outworkers receiving work from the City firms were duly received without the necessity of legal proceedings. Employers of Outworkers in the City of London were for the first time in July last provided with a copy of the "prescribed" form which is required to be used in connection with the transmission of the names and addresses, &c. This was accompanied by a covering letter directing the attention of such employers to their obligations in respect of Outworkers. Considerable difficulty has been experienced in the past in getting firms to transmit these lists with regularity. In the majority of cases it was due to oversight and perhaps also the trouble which was involved in obtaining copies of the prescribed form. The letter acts as a reminder and the supply of the form saves trouble, so that now very little excuse is available for failure to notify the Sanitary Authority with promptitude. As a matter of fact the assistance of the Corporation in this respect has been appreciated and has resulted in greater uniformity being observed as regards the particulars supplied, and in considerably less delay in transmitting the particulars, a matter of no small importance when it is remembered that during the year over 16,000 names and certain other details have been transmitted to a large number of Authorities not only in the districts surrounding London but as far off as the North of England. The following is a copy of the covering letter, &c., before mentioned:— Corporation of London. Public Health Department, Guildhall, E.C., 28th July, 1913. RE—OUTWORKERS. FACTORY AND WORKSHOP ACT. 1901. Sir, I beg to direct your attention to the requirements of Section 107 of the Factory and Workshop Act, 1901. In accordance with this Section, it is necessary for Firms employing Outworkers in certain specified Trades, to forward to the City Corporation on February 1st and August 1st in each year, a List of such Outworkers. Lists should be prepared in the form and manner prescribed by the Act. 84 Enclosed herewith is copy of the prescribed form, and appended to this letter is an extract from the Section referred to above. The Lists as forwarded should include, not only the names of persons employed on the date when the List is transmitted, but also of those who have been engaged on Outwork since the date of forwarding the previous List. Employers are requested to do all in their power to ensure that only correct addresses of Outworkers are sent, as neglect in this direction has caused much unnecessary trouble in the past. I should be obliged if you would arrange for the return to be made as soon as possible after August 1st, 1913. I am, Sir, Your obedient Servant, JAMES BELL, Town Clerk. P.S.— If you have no Outworkers and have not employed any since 1st August, 1913, kindly return the enclosed form Signed, and mark it " NONE." please turn over. EXTRACTS FROM THE FACTORY AND WORKSHOP ACT, 1901. Section 107 (1).—The occupier of every factory and workshop and every contractor employel by any such occupier in the business of the factory or workshop shall:— (a) Keep in the prescribed form and manner and with the prescribed particulars, lists showing the names and addresses of all persons directly employed by him, either as workmen or as contractors, in the business of the factory or workshop, outside the factory or workshop, and the places where they are employed ; and (b) Send on or before the 1st day of February and the 1st day of August in each year, copies of those lists to the District Council of the District in which the factory or workshop is situate. Section 107 (3).—The lists kept by the occupier or contractor shall be open to inspection by any Inspector under this Act, and by any officer duly authorised by the District Council (i.e., the Corporation of London). Section 107 (4).—This section shall apply to any place from which any work is given out, and to the occupier of that place, and to every contractor employed by any such occupier, in connection with the said work, as if the place were a workshop. Section 107 (5).—In the event of a contravention of this section by the occupier of a factory, workshop, or place, or by a contractor, the occupier or contractor shall be liable to a fine not exceeding Forty shillings, and in the case of a second or subsequent offence, not exceeding Five pounds. 85 A card index was established early in the year, and was in working order before the August lists were due. The particulars shown upon these cards are as follows:— OUTWORKER'S LISTS. Guildhall, E.C. Name of Firm Business Address February. August. Observations. No. of Sheets Date. No. No. Date. Only a very few " home " workers are engaged in the City, and these are dealt with by your Women Inspectors, together with outworkers employed in the City, excepting in cases where men only are employed. A card index record has also been inaugurated in connection with this work of inspection, and will be in use during the coming year. The details shown upon the card are as follows:— Obverse. OUTWORKER'S PREMISES, &c. Name of Outworker Address Nature of Work Domestic or Ordinary Workshop Business carried on regularly or intermittently Rooms in house (floor) No. of rooms used Work Domestic For Vhat other purpose is Workroom used? No. of persons in house Under ten Over ten M. F. No. using Workroom Overcrowding Ventilation Sanitary accommodation Lighting Condition of Workroom and House Employers' Names and Addresses Infectious disease H.M.I. notified ? Prohibition orders made Reverse as for card used in Inspection of Factories. See page 69. 86 In a number of cases employers neglected to keep lists at their premises and to send copies of the same to the Corporation as required by the Act. Notice in each case was served upon the offender and in all cases complied with. No case of infectious disease was reported in connection with premises occupied by Outworkers in the City. In 10 cases "contacts" were notified as follows:— Measles, 1; Phthisis, 1; Scarlet Fever, 8. The necessary enquiries were made in each case and all precautions taken. The following figures show the steady increase in the number of Outworkers notified :— Year. Number of Lists received. Outworkers Employed in City. Outworkers Employed outside City. Total number of Outworkers. 1902 — 17 3,752 3,769 (Note.—1st Notice issued to all employers at end of 1904 ) 1905 576 236 7,891 8,127 1908 1,506 624 16,909 17,533 1911 1,515 656 16,405 17,061 1912 1,481 709 15,777 16,486 1913 *1,523 718 16,025 16,743 * This includes five (5) firms who sent three times each. LEGAL PROCEEDINGS. In two cases matters were referred to the City Solicitor to take such action as he deemed necessary. The details were as follows:— No. 6, Aldermanbury Postern.—The pans and floors of three water-closets in a dirty condition, the seats of two water-closets broken, and the water-closet accommodation not suitable for the sexes. In this case the notices served were complied with without the necessity for Court proceedings. No. 6, Falcon Square.—The pan and walls of the water-closet and the walls and ceilings of the staircase in a dirty condition, and the handrail of the staircase defective and dangerous. In this case the matter was before the Court on two occasions and penalties and costs were inflicted amounting to £6 10s. 6d., the notices served being subsequently complied with. A drainage matter in connection with No. 38, Barbican was also the subject of Court proceedings. (See page 63.) 87 THIS TABLE WAS ISSUED BY THE LOCAL GOVERNMENT BOARD BY REQUEST OF THE SECRETARY OF STATE. FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK. 1913. 1 .—INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. (I) Number Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories (including Factory Laundries) 3,071 273 — Workshops (including Workshop Laundries) 3,663 672 3 Workplaces (other than Outworkers' premises included in Part 3 of this Report.) 738 264 — Total 7,472 1,209 3 2.—DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. (1) Number of Defects. Number of Prosecutions . (5) Found. (2) Remedied. (3) Referred to H.M. Inspector. (4) Nuisances under the Public Health Acts:—† Want of cleanliness 702 689 13 1 Want of ventilation 111 104 8 — Overcrowding 10 8 1 — Want of drainage of floors — — — — Other nuisances 861 738 — 2 Sanitary accommodation insufficient 16 8 — — unsuitable or defective ‡2,911 2,985 — — not separate for sexes 70 42 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) — — — — Breach of special sanitary requirementsforbakehouses(SS. 97 to 100) — — — — Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) — — — — Total 4,681 4,574 22 3 * These figures indicate separate work-rooms inspected. †In«luding those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. ‡These figures include separate defects in water-closets. 88 89 3.—HOME WORK. NATURE OF WORK. * OUTWORKERS' LISTS, SECTION 107. OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109,110. Lists received from Employers. Notices served on occupiers as to keeping or sending Lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110) Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists.† Outworkers.† Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Apparel— making, &c. 1,322 3,864 10,693 50 76 267 cleaning and washing 6 2 12 Household linen 2 • • • 6 Lace, Lace Curtains and Nets 4 ... 73 Curtains and furniture hangings. 2 ... 14 Furniture and Upholstery Electro Plate File making Brass and brass articles Fur pulling (Furriers) 50 134 311 4 3 7 Cables and Chains Anchors and Grapnels 2,015 Cart Gear Locks, Latches and Keys Umbrellas, &c. 50 14 510 4 ... 11 Artificial Flowers 18 ... 441 2 ... 14 Nets, other than Wire Nets Tents Sacks Racquet and Tennis Balls. Paper, &c., Boxes, Paper Bags 4 16 Brush making Pea picking Feather sorting Carding, &c., of Buttons, &c. Stuffed Toys Basket making Chocolates and sweetmeats Cosaques, Christmas Crackers, Christmas Stockings, &c.. Textile Weaving Total 1,458 4,030 12,060 60 79 299 2,015 Nil. Nil. Nil. | Nil. Nil. Nil. Nil. Nil. * If an occupier gives out work of more than one of the classes specified in column 1, and su bdivides his list in such a way as to show the 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 †The figures required in columns 2, 3 and 4 are the total number of the lists received from those employers who comply strictly with the be even numbers, as there will be two lists for each employer—in some previous returns odd numbers have been inserted. The figures in and August lists of the same employer the same outworker's name will often be repeated. 4.—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year. (1) Number. (2) Important classes of workshops, such as workshop bakehouses, may be enumerated here. General Workshops 3,526 _ Bakehouses (including Factory Bakehouses) 26 Total number of Workshops on Register *3,552 * These figures indicate separate work-rooms inspected. Note.—The Factory and Workshop Act, 1901 (S. 132), requires the Medical Officer of Health in his Annual Report to the District 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 or homework. The duties of Local Authorities and the Medical Officer of Health under the Act of 1901 are detailed in the Home Office number of workers in each class of work, the list should be included among those in column 2 (or 5 as the case may be) against the principal to show that this has been done. 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 columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose names are given, Since in the February 5.—OTHER MATTERS. Class (1) Number. (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (S. 133, 1901) 106 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, 1901). Notified by H.M. Inspector 28 Reports (of action taken) sent to H.M. Inspector 28 Other 22 Underground Bakehouses (S. 101):— Certificates granted during the year Nil. In use at the end of the year 20 Date, 31st December, 1913. (Signature) Medical Officer of Health, Council to report specifically on the administration of that Act in workshops and workplaces, and to send a copy of his Annual Report, or so unnecessary to include in the copy sent to the Home Office the portions which do not relate to factories, workshops, workplaces, Memorandum of March, 1912. 90 REPORT OF THE VETERINARY SURGEON. During the year 1913, 432,111 tons of meat, &c., were deposited for sale in the Central Markets, Smithfield, being an increase of 1,828 tons over the total for 1912. †Comparison—Supplies 1913 and 1912. Source of Supply or Classification. 1913. 1912. Difference. Rate per cent. United Kingdom Tons. 99,148 Tons. 116,865 Tons. 17,717 decrease 15.2 Australasian "Frozen" 103,463 91,688 11,775 increase 12.8 *North American "English Killed" 4,541 8,393 3,852 decrease 45.9 *North American "Frozen" 2,111 2,913 802 „ 27.5 South American "English Killed " ... ... ... ... South American "Chilled" and "Frozen" 172,863 165,811 7,052 increase 4.2 Continental Countries 49,985 44,613 5,372 „ 12.0 Total Meat, Poultry and Provisions 432,111 430,283 1,828 „ .4 †Analysis of Supplies, 1913. Source of Supply. Beef and Veal. Ratio per cent. Mutton and Lamb. Ratio per cent. Pork and Bacon. Ratio per cent. Poultry, Game, Rabbits, &c. Ratio per cent. Totals. Ratio per cent. Tons. Tons. Tons. Tons. Tons. United Kingdom 48,348 20.9 29,695 21.4 9,399 26.4 11,706 44.9 99,148 22.9 Australasia 15,948 6.9 83,516 60.3 5 .02 3,994 15.4 103,463 23.9 *North America 5,744 2.5 25 .02 187 .5 696 2.7 6,652 1.6 South America 154,503 66.6 18,306 13.2 25 .08 29 .1 172,863 40.0 Continent, &c. 7,268 3.1 7,072 5.1 26,018 73.0 9,627 36.9 49,985 11.6 Totals 231,811 .. 100.0 138,614 100.0 35,634 100.0 26,052 100.0 432,111 100.0 Foot and mouth disease is still prevalent in the Argentine Republic and the dead meat trade has developed into such an important industry that it will in all probability continue to be the method of exporting meat from other countries into Great Britain. The United States of America has become a serious competitor with this country for Argentine meat. As showing how serious an aspect the North American competition has assumed it may be noted that in one week alone 28,000 quarters of beef and 12,000 carcases of mutton and lamb, equal to 7,000 cattle and 12,000 sheep, or a total of 19,000 animals were shipped direct from Buenos Aires to the United States ports in addition to shipments of meat via London and Liverpool. * Includes the Dominion of Canada and the United States of America, † Abstracted from the Superintendent of Market's Report. 91 It is doubtful if even the great resources of Argentina will continue to cope with such demands for meat. There appears a prospect of short supplies of meat in the near future ; this is due to a reduction in the number of animals produced in some of the countries from which Great Britain formerly received supplies, for example, in the United States of America, according to the latest returns, the number of cattle in 1913 as compared with the year 1912, shows a decrease of 1,432,000 and 880,000 sheep. The reduction appears to be a gradual one, as a statement is made showing that a decrease of 16,000,000 head of cattle has taken place during the last six years, while the population is said to have increased 21 per cent. Canadian statistics show a reduction of 152,700 cattle, compared with the figures for 1912, and the population of that country is rapidly increasing. Thus the only sources of meat supply for the Central Markets at present worth considering, are South America, Australia, New Zealand and the Continent, in addition to Home supplies. South American Meat. The supplies from South America to the Central Markets for the year 1913 aggregated 172,863 tons. The quality of the meat arriving from that source is as nearly perfect as possible. The condition of large quantities of the chilled meat exposed for sale in the Central Markets is generally very creditable to those concerned, and an object lesson to those handling meat from a less distant source. Although occasionally diseased quarters of beef are observed, considering the large quantities of meat arriving, the percentage of disease found is very small. The following figures show the amount of meat seized as unfit for human food, due to disease in Argentine meat supplies:— Articles. Disease. 27 hind-quarters of beef Tuberculosis. 10 fore-quarters of beef ,, At present an endeavour is being made to ensure that a label is attached to every carcase of mutton and quarter of beef, the label to show the name of the Frigorifico, and a statement, practically a certificate, to the effect that the meat has been examined and passed, also the name of the responsible inspector, so that when a diseased quarter of beef is found there will be no difficulty in tracing its origin and the person responsible. Towards the end of the year disease was discovered in Argentine ox-tongues, which necessitated the partial thawing out of large quantities of these organs in order to ascertain which were fit or unfit for human consumption. The following figures show the amount of work done:— Record of South American Tongues examined at the Cold Stores during the Year 1913. No of Boxes. No of Tongues. No. of Tongues Passed. No. of Tongues Rejected. 641 7,525 7,279 246 1,292 15,491 14,921 570 1,497 14,038 13,145 893 752 8,907 7,168 1,739 630 6,300 5,971 329 Totals 4,812 52,261 48,484 3,777 92 As a result of better attention being given to the inspection of offal in Argentina, a reduction in the number of diseased tongues was observed at the close of the year, and a further improvement is anticipated in 1914. Australian Meat. Although the last live stock returns show a decrease of 9,772,206 sheep and 157,247 cattle, it is anticipated that with favourable seasons there will be an increase of the number of animals during next year, especially as new territories are being opened up for the breeding and feeding of cattle and sheep. In the report for 1912, gratification was expressed at the improvement that had taken place in the inspection of Australian meat; unfortunately, that improvement has not been maintained, very many quarters of beef arrived improperly cut and on examination parasitic nodules were found in the cut portions. This necessitated all fore-quarters being carefully examined, and if found improperly cut, they were recut. The examination of hind-quarters showed that the work of the inspectors at the place of slaughter, had been more carefully done than in the fore-quarters, but nodules were found in several consignments. In the examination of the hind-quarters some consignments were found with nodules to the extent of 4.8 per cent., and in the fore-quarters some of the consignments showed nodules to the extent of 20 per cent. The following figures show the number of quarters and buttocks examined:— Nos. Notified. 99,254 hind-quarters. 2,436 buttocks. 12,591 crops. Nos. Examined. 88,499 hind-quarters. 2,265 buttocks. 11,878 crops. Two hind-quarters were found affected with tuberculosis. A number of calves' carcases were found unmarketable due to poorness of quality. It is to be hoped that more care will be taken by the inspectors in Australia in order that the inspection label on each quarter of beef or carcase of mutton may be a real guarantee, as it should be, that the meat is above suspicion. Swedish Meat. By arrangement, all Swedish meat (pig-carcases excepted) passing through the Port of London, was allowed to be discharged direct into the Central Markets without examination at the Port, on condition that the meat was examined prior to sale. 93 The following table shows the result of the examination:— Record of Swedish Meat Notified to Arrive on the Market Unexamined at the Port of London. Beef (sides) 46 Livers (Ox) 120 Breads (Calves) 963 Plucks (Calves) 1,403 Calves 1,629 ,, (OX) 29 Feet (Calves) 503 ,, (Pig) 84 Fry 1 „ (Sheep) 944 Heads (Calves) 2,899 Tongues (Calves) 2 (Ox) 29 ,, (Ox) 34 „ (Sheep) 1,130 Tops (Calves) 371 Kidneys (Ox) 20,029 ,, (Ox) 146 Livers (Calves) 2 „ (Sheep) 639 Result of Examination. 1 Calf Tuberculosis 1 Ox Kidney Decomposition. 2 Ox Livers Exportation of Meat. This trade does not increase very rapidly, there being many difficulties with regard to [regulations and heavy customs charges, for example, Australian meat imported into France has to pay duty over 2 5/32d. per pound. The trade would appear to be regulated to a great extent by the prices of meat in the Central Markets, Smithfield; when prices become low in Smithfield, more exportation business is done, but as soon as the prices increase in the Central Markets, exportation would appear to almost cease. The following table shows the amount of meat exported from the Central Markets accompanied bv Certificates from the Medical Officer of Health or Veterinary Surgeon:— Examination of Meat for Export, &c. Certificates granted by the Medical Officer of Health and Veterinary Surgeon. Destination, f ore-quarters of Beef. Hind-quarters of Beef. Crops of Beef. Top pieces of Beef. Flanks of Beef. Briskets of Beef. Pieces of Beef (various). Carcases of Mutton. Pieces of Mutton. Carcases of Lamb. Bags of Suet. Ox Tongues. Barrels of Hogsbungs. Belgium ... ... ... • •• ... ... 7 ... ... ... ... ... France ... ... ... ... ... ... ... ... ... 100 ... ... ... Germany 92 47 ... ... 50 100 ... ... ... ... ... ... ... Holland 319 929 507 815 20 27 10 ... ... ... 66 70 1 Switzerland 147 75 ... ... ... ... ... 30 ... 129 ... ... ... Brand (Lambeth) 4 ... ... ... ... ... ... ... 12 ... ... ... ... United States ... ... ... ... ... ... ... ... ... ... 3 ... ... 562 1,051 507 815 70 127 10 37 12 229 69 70 1 94 TUBERCULOUS MEAT AND OFFAL DISCOVERED IN THE CENTRAL MARKETS. Tuberculosis remains still the disease of greatest concern to the Inspectors in the examination of meat in the Markets. The disease discovered in the meat was generally confined to the lymphatic glands, and could not be observed until these had been incised by the Inspectors. Therefore the consignors would in all probability have no knowledge that the meat was diseased, hence no prosecution followed. For some years a method has been adopted of reserving such meat, and sending for the owners, and on their arrival showing them the disease and where to look for it, so that in future they might not be ignorant as to the disease and where it could be observed. They were at the same time warned that after this lesson any diseased meat forwarded by them would render them liable to prosecution. A statement made in the Report for 1911 is worth reiterating, namely, that County Councils might do some good by arranging lectures and demonstrations at various centres, to which farmers, breeders and feeders should be invited. Education is required in helping to reduce a disease so prevalent. The following table shows the result of the examination during the year :— Tuberculous Meat Seized in the Central Markets doring the Year 1913. Carcases and Pieces. Beef. Pork. Calves. Carcases. Quarters. Pieces. Carcases. Quarters. Pieces. Carcases. 1913 11 60 57 494 9 71 3 1912 13 70 56 862 17 60 — Offal. Beep. Pork. Calves. Heads. Tongues. Langs. Hearts. Livers. Spleens. Mesentery. Heads. Lungs. Hearts. Livers. Mesentery. Kidneys. Lungs. Hearts. Livers. 1913 20 20 5 1 3 1 1 2,690 211 204 224 90 6 1 1 1 1912 16 — 6 4 8 1 4 4,533 370 369 421 51 — — — — Tons. cwts. qrs. lbs. 1913 53 2 1 27 1912 79 10 3 16 95 Leadenhall Market and City Shops. The Leadenhall Markets and City Shops have been carefully inspected during the year, and the following table shows the variety of knowledge required by the City Inspectors in dealing with unsound food:— Unsound Food Destroyed. Poultry and Game. Snipe 314 Capercailzies 10 Sparrows 82 Chickens 528 Starlings 59 Comorant 1 Teal 72 Curlew 2 Turkeys 144 Deterels 7 Widgeon 49 Divers 4 Woodcock 16 Ducks 1,376 Eggs. Fowls 2,291 Game, Black 71 Plovers 2,711 Game (Unclassified) 435 Seagulls 50 Geese 77 Meat and Offal. Gillinots 3 Godwins 21 Beef (Tinned Salt) 90 Grouse 860 „ (Casks) 2 Guinea Fowls 43 „ (Buttocks) 2 Hares 402 „ (Pieces) 174 Hazel Hens 526 Deer 10 Herons 3 Feet (Calves') 29 Jay 1 Heads (Pigs') 5 Landgrouse 2 Kidney Knobs 2 Landrails 15 Kidneys (Ox) 1 Moorhens 2 „ (Pig) 2 Oyster Catchers 23 „ (Sheep) 163 Partridges 1,377 Livers (Ox) 9 Pigeons 1,245 „ (Rabbits) 41 Pintails 26 Mutton (Pieces) 15 Pheasants 304 Pigs 4 Plovers 271 Plucks (Sheep) 1 Ptarmigan 187 Pork (Piece) 1 Quail 2,561 Tops (Sheep) 7 Rabbits 3,886 Tongues (Ox) 5 Redshank 5 „ (Sheep) 3 Sawbill 1 Venison (Quarters) 14 Seagull 1 „ (Pieces) 97 Tons cwts. qrs. lbs. Total for 1912 14 19 l 2 Ditto 1913 17 12 0 14 COLD STORES. Another large Cold Storage is in course of erection at the Central Markets for the Port of London Authority, the capacity of which store will be about 80,000 carcases of mutton. As stated in previous Reports, it is difficult to keep constant watch on all goods leaving the stores at all hours of the day and night. Generally, proprietors give the meat inspectors every information and assistance required, but occasionally, information is received, not from the source it should come from, that goods of a doubtful condition 96 are in store. This is not as it should be, especially as the Corporation now returns to the owners the residual value, less expenses, &c., on all meat, other than diseased meat, ex cold stores, and owners should bear in mind the fact that the Public Health Act gives power to prosecute in any case where meat is deposited for the purpose of sale for human food and not reported to the Sanitary Authority. The following table shows a considerable reduction of the quantity of unsound food destroyed in the cold stores, but does not show the amount of disagreeable work performed by the Inspectors in the examination of some classes of food, an example being the frozen tongues examined during cold weather in the stores. Unsound Food ex Cold Stores. Article. Quantity. How packed. Origin. Cause for destruction. Tons cwts. qrs. lbs. Beef Quarters 1 — Australia Decomposition. 0 1 1 0 Ditto 1 — South America Brine stained 0 1 0 0 Beef Pieces Unenumerated — Australia Parasitic Disease 9 3 1 11 Ditto Ditto — Ditto Bone taint 3 14 1 24 Ditto Ditto — Ditto Decomposition 0 17 3 0 Ditto Ditto — Argentina Ditto 3 2 1 13 Beef (tins) Ditto In tins United States of America. Ditto 0 1 0 8 Beef Pieces Ditto — Argentina Brine stained 0 0 2 2 Beef Skirts Ditto In boxes Ditto Decomposition 0 2 0 0 Beef Head Meat Ditto In bags and cases Ditto Ditto 0 7 3 3 Birds Ditto In hampers Unascertained Ditto 0 2 2 6 Cheese Ditto In boxes Ditto Ditto 1 2 0 22 Ducks Ditto In cases China Ditto 0 2 3 2 Fish Ditto In boxes Unascertained Ditto 3 5 3 14 Fowls Ditto In hampers Ditto Ditto 0 2 2 25 Game Ditto Ditto Ditto Ditto 0 5 0 14 Hares 21 In boxes Ditto Ditto 0 0 3 2 Hearts (ox) Unenumerated Ditto Argentina Ditto 0 1 1 20 Kidneys (sheep) 563 dozen Ditto Ditto Ditto 0 3 2 20 Livers (ox) 32 Ditto Ditto Ditto 0 2 3 8 Mutton Carcases 533 — Australian. Brine stained 9 16 2 22 Ditto 89 — Ditto Decomposition 1 15 2 0 Ditto 110 — Argentina Ditto 1 10 3 1 Ditto 23 — Ditto Emaciated 0 7 2 5 Ditto 7 — Ditto Damaged 0 3 2 21 Ditto 1 — Australia Ulcerated 0 0 1 19 • Carried forward 36 16 0 13 97 Article. Quantity. How packed. Origin. Cause for destruction. Tons cwts. qrs. lbs. Brought forward 86 16 0 13 Mutton Pieces Unenumerated — Australia Brine stained 1 15 3 8 Ditto Ditto — Argentina Decomposition 0 10 3 7 Offal (various) ( Ditto — Unascertained Ditto 4 8 2 21 Poultry Ditto In hampers Ditto Ditto 1 3 3 12 Pork (bacon) 1 piece — Russia Ditto 0 2 0 0 Pork (bams) 7 — Unascertained Ditto 0 0 1 25 Rabbits 12 In boxes Ditto Ditto 0 0 0 24 Sausages — — Argentina Ditto 0 1 0 13 Suet — In boxes Ditto Ditto 0 4 2 11 Sweetbreads (ox) — Ditto Ditto Ditto 0 8 0 0 Tails (ox) — Ditto Ditto Ditto 0 1 3 1 Tongues (ox) 23 Ditto Ditto Ditto 0 0 3 9 Ditto 3,780 In boxes and bags Ditto Diseased 9 16 0 6 Tripe — In boxes Ditto Decomposition ... 0 18 0 12 Turkeys 65 Ditto Unascertained Ditto 0 5 2 22 Venison Carcases 6 — Ditto Ditto 0 2 0 16 Venison Pieces 1 — Ditto Ditto 0 0 1 14 Total for 1913 56 16 2 18 Total for 1912 182 2 1 17 ALDGATE MARKET AND SLAUGHTERHOUSES. The record of work performed by the Inspectors at the Aldgate Slaughterhouses shows the justification of their appointment. No doubt the increase in the number of animals slaughtered at Aldgate accounts for an increase in the quantity of unsound food destroyed, but it is difficult to believe that the difference in the figures for the year 1910 and the year 1913 is accounted for by that factor alone ; for example, during 1910, 6 carcases of beef were destroyed as unfit for human food, 45 during the year 1911, 131 during the year 1912, and during the year under discussion 164. Bye-law No. 19 provides that "Every occupier of a slaughterhouse who shall intend to slaughter any animal in such slaughterhouse, or to cause or to permit any animal to be slaughtered therein, at any time other than between the hours of seven o'clock in the forenoon and three o'clock in the afternoon on a Sunday, or between the hours of six o'clock in the forenoon and nine o'clock in the afternoon on any other day, shall give to the Corporation at least three hours' notice in writing of such intention, which shall be delivered or sent to their Veterinary Inspector at his office. 98 The following table shows the result of this Bye-law during the year 1913:— Extra hours of duty performed by the Inspectors. Weekdays. Sundays.[/.###] No. of Notices received. Before 6 a.m. Hours. After 9 p.m. Hours. Before 7 a.m. Hours. After 3 p.m. Hours. 159 11½ 332 20½ 65½ • The following table shows the number of animals slaughtered compared with the figures for 1912 :— 1913. 1912. Bulls 1,532 726 Calves 8,601 12,037 Cows 2,192 1,890 Heifers 349 151 Oxen 12,389 12,184 Sheep 18,996 19,881 Various 28 9 44,087 46,878 The occasional outbreaks of foot and mouth disease disorganised the regular trade in home-fed animals; it will be observed that there is a great decrease in the number of calves killed at Aldgate. This is due in part to the high prices of these animals, also of beef, and breeders are rapidly observing that it will pay them better to feed their calves than to sell them, and judging from the present prices of meat and the prospects for the future, they are justified in their opinion. As formerly, tuberculosis is the principal disease rendering carcases or portions of them unfit for human food. It will be observed that the number of bovine animals slaughtered at Aldgate was 25,063, of these, 1,684 were found affected with tuberculosis in a varying degree. On analysis of the figures it is found that the percentages under the various headings were as follows:— Bulls 255, or 10.11 per cent. affected. Calves 23, „ 0.2 „ „ Cows 875, „ 39.9 ,, „ Heifers 22, „ 6.3 „ „ Oxen 509, „ 4.1 „ „ Analysis of the percentage of beef carcases and quarters destroyed as unfit for human food due to tuberculosis show:— Carcases. Quarters. Bulls 5.26 per cent. 9.72 per cent. Cows 83.55 „ 75.0 „ Heifers 4.0 „ — Oxen 7.24 „ 15.26 „ 99 Carcases and Quarters Seized and Destroyed. Causes for Destruction. Beep. Mutton. Veal. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Abscess ... ... 1 ... ... ... Anthrax 1 ... ... ... ... ... Asphyxia ... ... 14 ... 11 ... Decomposed ... 7 ... ... ... ... Emaciated ... ... 7 ... ... ... Functional Derangement ... ... 1 ... ... ... Hydremia 3 ... 23 ... 3 ... Injury ... ... 2 ... ... ... Immaturity ... ... 1 ... 13 ... Osteomalacia 1 ... ... ... ... ... Peritonitis 3 ... ... ... ... ... Pleuriay ... 1 ... 1 ... ... Pneumonia 1 ... ... ... ... ... Polyarthritis ... ... ... ... 1 ... Pseudo Leukaemia ... ... ... ... 1 ... Pyaemia 2 ... ... ... ... ... Tuberculosis 152 72 ... ... 6 4 Unmarketable 1 ... ... ... ... ... Totals for year 1913 164 80 50 1 35 4 Totals for year 1912 131 61 98 7 45 2 100 Record of Organs seized at Aldgate. Reason for Destruction. Oxen. Sheep. Calves. Heads. Tongues. Lungs. Hearts. Livers. Stomachs. Spleens. Mesenteries. Intestines. Kidneys. Heads. Tongues. Lungs. Hearts. Livers. Stomachs. Spleens. Mesenteries. Intestines. Kidneys. Heads. Tongues. Lungs. Hearts. Livers. Stomachs. Spleens. Mesenteries. Intestines. Ridneyas. Abscesses 77 35 104 2 479 14 5 ... ... 1 ... ... 2 ... 2 ... ... ... ... ... ... ... 1 ... 11 ... ... ... ... ... Actinomycosis 247 271 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anthrax 1 1 1 1 1 1 1 1 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Asphyxia ... ... ... ... ... ... ... ... ... ... ... 14 14 14 14 14 14 14 14 28 11 11 11 11 11 11 11 11 11 22 Bacteria Necrosis. ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Blood Aspiration. ... ... 248 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cavernous ... ... ... ... 79 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Angioma. Cirrhosis ... ... ... ... 87 ... ... ... ... 1 ... ... ... ... 2 ... ... ... ... ... ... ... ... ... 5 ... ... ... ... ... Decomposition 5 ... 18 ... 7 ... 8 ... 7 4 3 3 3 ... 4 ... 3 ... ... 1 ... ... ... ... ... ... ... ... ... ... Emaciated ... ... ... ... ... ... ... ... ... ... 7 7 7 7 7 7 7 7 7 14 ... ... ... ... ... ... ... ... ... ... Emphysema ... ... 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fatty Infiltration. ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Functional Derangement. ... ... ... ... ... ... ... ... ... ... 1 1 1 1 1 1 1 1 1 2 ... ... ... ... ... ... ... ... ... ... Hepatitis ... ... ... ... 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Hydremia 3 3 3 3 3 3 3 3 3 6 23 23 23 23 23 23 23 23 23 46 3 3 3 3 3 3 3 3 3 6 Injury ... ... ... ... ... ... ... ... ... ... 3 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Immaturity ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 1 1 1 1 1 2 13 13 13 13 13 13 13 13 13 26 Melanosis ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Neoplasms ... ... ... ... ... 1 1 .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... ... 99 ... ... ... ... ... ... ... ... ... 7 ... ... ... ... ... ... ... ... ... 6 Parasitic Disease. ... ... 366 ... 1583 ... ... ... ... ... ... ... 563 676 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Pericarditis ... ... ... 26 ... ... ... ... ... ... ... ... ... 5 ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... Pleurisy ... ... 410 ... ... ... ... ... ... ... ... ... 21 ... ... ... ... ... ... ... ... ... 4 ... ... ... ... ... ... ... Pneumonia Parasitic. ... ... 367 ... ... ... ... ... ... ... ... ... 56 ... ... ... ... ... ... ... ... ... 12 ... ... ... ... ... ... ... Polyarthritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 1 1 1 1 1 1 2 Pseudo- Leukæmia. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 1 1 1 1 1 1 2 Pyæmia ... ... 2 2 ... 2 ... ... 2 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rumenitis ... ... ... ... ... 47 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 20 ... ... ... ... ... ... ... Tuberculosis 988 256 1236 229 480 266 219 470 470 333 ... ... ... ... ... ... ... ... ... ... 4 3 4 19 4 4 4 4 8 Unmarketable 16 9 5 7 3 2 27 9 ... 2 2 1 5 23 28 4 23 3 ... ... ... ... ... 11 ... ... 18 1 1 ... Totals for 1913 1339 577 2765 271 2735 336 266 485 483 452 54 52 696 74 758 51 72 49 46 100 33 32 67 46 64 33 51 34 31 72 Totals for 1912 1156 530 1215 202 2595 300 248 Mesenteries and Intestines. 349 334 94 35 470 49 676 97 102 Mesenteries and Intestines. 961 76 26 93 77 112 78 38 37 Mesenteries and Intestines. 39 74 101 Summary of Unsound Food Destroyed. Tons. cwt. qrs. lbs. Central Markets, Smithfield 879 2 3 20 Cold Stores 56 16 2 18 Leadenhall Market and City Shops 17 12 0 14 Aldgate Market and Slaughterhouses 103 13 2 4 Total for 1913 1,057 5 1 0 Total for 1912 1,134 2 2 0 Decrease 76 17 1 0 During the year 26 Naval Officers and 15 Army Officers attended courses of instruction in Meat Inspection at the Markets. In concluding this report I have pleasure in stating that the members of the meat inspection staff carried out their duties in a loyal and satisfactory manner. T. DUNLOP YOUNG, Veterinary Surgeon. 102 *Table showing the average deliveries at the Central Meat Market, and other details for successive quinquennial periods during the past 40 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 1909-1913 427,146 0 0 1,520 2 3 .356 *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. American. Australian and New Zealand. Country Killed. Town Killed. Home Killed. American Killed.‡ Per cent. Per cent. Per cent. Per cent. Per cent. Per cent. 1909 17.8 4.9 13.6 10.6 27.5 25.3 1910 16.8 5.7 12.6 7.1 32.6 25.2 1911 17.4 5.4 11.2 6.7 37.0 22.3 1912 20.5 6.6 10.4 2.0 39.2 21.3 1913 16.7 6.2 11.6 1.1 40.5 23.9 † Includes " General Foreign Meat and Produce." ‡ Includes 8outh American imports. *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:— 1909. 1910. 1911. 1912. 1913. Average daily delivery into the Markets Tons. 1,368 Tons. 1,371 Tons. 1,390 Tons. 1,379 Tons. 1,408 ‡Minimum delivery on any one day 229 219 171 214 199 Maximum delivery on any one day 3,918 3,200 3,066 2,943 4,398 The heaviest weight previously recorded on any one day (21st December, 1903) was 4,209 tons. The minimum deliveries relate to Saturdays when practically no wholesale business at the Market is carried out. One ton in every 408 tons of meat paying toll in the Central Markets, Smithfield, was condemned last year, as compared with one ton in 263 in 1912. * I am indebted to the Clerk and Superintendent of the Central Markets for the figures relating to the market supplies, sources of origin, &c. 103 UNSOUND MEAT, 1913. The meat, &c., seized by your Inspectors as unfit for food is classified as under:— 1913. Diseased. Unsound. Unwholesome. Poultry. Offal. Fish. Total. tons. cwts. qrs. lbs. tons. cwts. qrs. lbs. tons. cwts. qrs. lbs. tons. cwts. qrs. lbs. tons. cwts. qrs. lbs. tons. Cwts qrs. lbs. tons. cwts. qrs. lbs. First Quarter 38 3 3 4 168 7 0 9 17 12 0 26 9 12 2 12 25 4 2 15 0 0 6 27 259 2 0 9 Second „ 31 15 0 13 183 6 0 6 21 13 0 21 10 8 1 9 34 4 3 13 1 16 1 26 283 4 0 4 Third „ 23 19 1 4 118 15 1 15 39 7 2 16 14 0 1 10 37 19 1 17 2 16 2 6 236 18 2 12 Fourth „ 46 14 1 13 115 14 3 27 23 5 1 5 29 15 0 0 57 17 0 3 0 5 1 1 273 11 3 21 Total 140 12 2 6 586 3 2 1 101 18 1 12 63 16 1 3 155 5 3 20 5 0 0 4 1,052 16 2 18 The above figures include 49,578 separate seizures. The percentages of meat seized under the various headings of the above Table during 1913 and for the preceding five years, classed as diseased, unsound and unwholesome, were as follows:— Year. Diseased. Unsound.* Unwholesome. Per Cent. Per Cent. Per Cent. 1908 14.2 78.2 7.5 1909 7.5 87.5 5.0 1910 7.1 84.2 8.7 1911 3.8 93.1 3.1 1912 12.5 79.2 8.3 Average for 5 years 9.0 84.4 6.5 1913 13.4 77.0 9.6 * Includes poultry, offal and fish. 104 CENTRAL MARKETS, SMITHFIELD. Table showing Weight of Meat delivered, and Meat delivered to Contractors as unsound, during each Month of the Years 1912 and 1913. Month. Meat delivered at the Market. 1912. Unsound Meat delivered to Contractors, 1912. Meat delivered at the Market, 1913. Unsound Meat delivered to Contractors, 1913. Tons cwts. qrs. Tons cwts. qrs. Tons cwts. qrs. Tons cwts. qrs. January 40,152 0 0 127 2 0 39,048 0 0 105 14 3 February 34,714 0 0 107 14 3 33,567 0 0 88 7 2 March 35,768 0 0 147 5 2 35,448 0 0 68 18 2 April 35,984 0 0 151 9 2 34,602 0 0 107 7 0 May 37,585 0 0 98 11 2 37,155 0 0 86 5 1 June 30,947 0 0 71 10 2 35,320 0 0 86 16 3 July 35,258 0 0 103 3 2 36,619 0 0 83 12 0 August 34,653 0 0 49 13 2 32,304 0 0 77 0 3 September 34,160 0 0 50 13 2 35,374 0 0 77 12 3 October 37,742 0 0 66 7 2 39,070 0 0 119 13 0 November 36,073 0 0 64 6 3 33,141 0 0 70 1 0 December 37,247 0 0 86 4 0 40,464 0 0 85 16 0 Totals 430,283 0 0 1,134 2 2 432,112 0 0 1,057 5 1 DISEASED MEAT PROSECUTIONS, 1913. Date of Hearing. Where Heard. Before whom. Occupation of Person Summoned. Defendant's Place of Business. Result. 1913. Dec. 9 Guildhall Mr. Alderman E. C. Moore. Butcher Sawston, Cambridgeshire. One month's hard labour. AUSTRALIAN MEAT. It will be remembered that Australian Meat is liable to be affected with worm nests, or what is termed in more scientific language, Onchocerciasis. It is now several rears since this affection was first brought into prominence so far as affecting carcases used for human consumption. In consequence of representations made to the Commonwealth of Australia in 1907 by the City Corporation, a certain course of action was agreed upon with the object of diminishing, as far as possible, the liability of meat so affected being exposed for sale. In brief, it may be stated that the decision arrived at, was to arrange for an incision to be made over the stifle joint, and for worm nests there found to be removed, and for that portion of the brisket, which is most commonly affected with the lesion, to be excised. This action was to be taken before exportation. 105 It is in these situations that the characteristic lesions are most frequently found, and the exact measures to be followed by the Commonwealth Inspectors were set out in a series of instructions illustrated by prints of photographs which were issued to the State Inspectors engaged on this work. The final instructions were dated January 5th, 1912. Previous instructions had been issued in 1911. On the whole, the object aimed at was attained, but in November, 1913, it was reported to me that certain consignments of Australian meat were showing an excess of infestation in the hind-quarters, and that the fore-quarters had not been cut in accordance with instructions. The consignments in respect of which complaints were made, were from the Burdekin works at Queensland, and the certificates properly contained the name of the Inspecting Official. The difficulty was met by arranging a detailed inspection of each hind-quarter, and recutting the fore-quarters in accordance with the regulations. This additional work was considerable, and the attention of the Commonwealth Authorities was dnected to the defect of inspection. Immediate action was taken, but the state of affairs was not finally remedied until about February, 1911. The delay was due to the fact that certain consignments were already on their way to this country. No cause for complaint exists at the present time. In a few instances, defects were observed in carcases which were exposed for sale in the market, but in the majority of instances they were discovered at the ordinary inspections which take place at the City Cold Stores. ARGENTINE MEAT. The only point which has arisen in respect of Argentine meat beyond that of Actinomycosis, is in an administrative matter having reference to the labelling of carcases. The label is not attached to each quarter, and consequently it has been found impossible in certain instances to associate the Argentine Inspector with the quarter of meat which in some respect has been found to be defective. It should be here mentioned that in the case of all imported meat, when defects are discovered, full particulars are forwarded to the Official Representative of the Country from which the meat was exported, so that inquiries may be instituted in respect of the carcase complained of. I have recently communicated with the Consul-General of the Argentine respecting the importance of more complete identification, and the matter is receiving the consideration of the Government. A question was asked in the House of Commons respecting the prevalence of tuberculosis in Argentine carcases, and both question and reply are of sufficient interest to justify mention in this report. They are as follows:— Question.—Mr. Astor: To ask the President of the Local Government Board, if he will state in how many cases in 1912 and in 1913 was meat imported from the Argentine found to be tuberculous. (10th March, 1914.) 106 Answer.—Mr. Herbert Samuel: I have no complete information on this question, but I may state that early in 1912 the Medical Officer of Health of the City of London began to report the occurrence of tuberculosis in Argentine beef examined in the Central Markets, and, according to information supplied by him, it appears that during 1912, out of a total of 140,179 tons of Argentine beef received in Smithfield Market, 43 hind-quarters, 8 fore-quarters, and 25 other portions were found tuberculous. In 1913, out of a total of 154,503 tons, 27 hind-quarters and 10 fore-quarters were found to be affected with tubercle. In May, 1912, the Medical Officers of Health of the principal meat-importing ports were asked to report any cases in which they discovered tubercle in any of the Argentine beef received at their ports. No such discovery has yet been reported. As a consequence of the reports received from the Medical Officer of Health of the City, representations were made iu the middle of 1912 by the Board, through the Foreign Office, to the Argentine Government, with a result that the staff of inspectors in the Argentine was increased and made more efficient. (10th March, 1914.) SIBERIAN OX-TONGUES AFFECTED WITH FOOT AND MOUTH DISEASE. During the early months of 1913, it was found that certain ox-tongues imported from Siberia were affected with lesions which were indistinguishable from Foot and Mouth disease. Foodstuff so affected could not be permitted to be sold for human consumption, and in addition there might possibly be some risk of outbreaks arising in this country from this source unless care were taken to destroy the infective material. These tongues come into this country in a frozen condition packed in small cases, and it was necessary for each tongue to be partially thawed and so softened before adequate inspection could take place. The following figures indicate the additional labour in which this work involved your inspectors. The number of tongues examined was 98,345, number passed 93,081, number rejected 5,264, or 5.6 per cent. Of the rejected tongues 1,025 showed acute lesions, 3,577 showed healed lesions and old cicatrices, whilst in 662 instances the lesions might possibly have been traumatic stomatitis. The attention of the Local Government Board was directed to the circumstances, and a representative of the importing firm in this country was interviewed. At once the firm sent over a representative to Russia to supervise the packing of these tongues, and to undertake the sorting of them before they were packed. A considerably decreased number of affected tongues reaching this country resulted from this action, and I understand that the firm will adopt every safeguard for the next season. The Board of Agriculture was notified of the occurrence, and subsequently an order of the Board, dated 15th April, 1913, was issued which requires that any box, case or other receptacle and any packing material in which are packed raw bovine tongues, should be brought into Great Britain from any country other than the United States of 107 America, Commonwealth of Australia, Dominion of Canada, Union of South Africa, the Channel Islands, and the Isle of Man, shall, after the tongues have been removed therefrom, forthwith be destroyed by fire by the owner of the tongues at the time of removal, and shall not be permitted to come into contact with any animal. It is hoped that now the facts of the case have been brought to their notice, that the firms exporting tongues from Russia will exercise every vigilance in ensuring that such tongues shall not be exported to this country. If this action is not taken, it may be necessary to refuse to admit them, as it is obviously unreasonable for your Inspectors to be called upon to sort such consignments for the purpose of removing such as are obviously diseased from those which are fit for human consumption. ACTINOMYCOSIS IN ARGENTINE OX-TONGUES. The joint report by the Medical Officers of Health for the City and the Port of London, dealing with the subject of Actinomycosis in ox-tongues exported from the Argentine, was submitted to you for consideration in November. It was found that practically 6 per cent. of the tongues arriving from that country were affected with Actinomycosis. The details are set out in the report above referred to, and on the present occasion it need only be said that a considerable improvement has now been effected, and each tongue and the glands attached to the root of the tongue are now carefully examined in Argentina before exportation. The conclusions arrived at were as follows:— (1) The number of lesions discovered indicated that the condition coming under observation was one which is widely prevalent among Argentine cattle. (2) The frequency of the lesion in the glands indicated the necessity for importers ensuring that the glands are left attached to the tongue, and not removed, as was the case in a percentage of tongues examined in certain consignments. (3) Until action is taken in the Argentine, which will ensure that these tongues are carefully examined, and all those presenting lesions are withdrawn, it will be necessary for your staff to continue the present arrangement of examining every tongue received at the Port and City. The recommendations which your Officers submitted were as follows:— That the facts as set out in the Report be forwarded to the Local Government Board, and that the Board's attention be directed to— (1) The number of instances in which evidence of disease was observed among tongues received at the Port and the City of London. (2) The conclusion therefrom, viz., that the condition chiefly observed is obviously wide-spread in that country, and that the supervision exercised to prevent the exportation of such affected organs is inadequate in respect of this particular matter. (3) The necessity which exists, in the interests of meat inspection coming within your jurisdiction, that these matters should receive attention with as little delay as possible So long as the present condition exists the time of your staff will be unduly taken up by this work to the possible detriment of inspection work in other directions. Although we 108 have always been prepared to assist to the utmost of our powers in elucidating any new problems which come under observation, we are of opinion that when once the position has been clearly defined, the work of sorting and of preventing unsound food reaching this country should be the primary duty of the exporting firms. The responsibilities of your own staff should be restored as soon as possible to normal conditions, which are to insure that all foodstuffs on arrival are sound, free from disease, and fit for human consumption. (4) The observation that a large percentage of the tongues are affected with actinomycosis in the glands alone, and unless these glands remain attached to the roots of the tongues, it will be impossible in such cases to state whether the tongues have come from animals infected with actinomycosis. We, therefore, feel strongly that Regulations should be framed rendering the importation of tongues without the roots and glands attached liable to re-exportation. (5) The question of Actinomycosis as affecting cattle, and even the prevalence of the disease in general, does not appear to us, after a review of the literature on the subject, to have been adequately investigated, and we beg respectfully to suggest that it is a matter on which further research work might be undertaken with advantage. The total numbers examined are set out in the Veterinary Surgeon's report on page 91. The question of Actinomycosis, as affecting both human beings and bovines is one of considerable interest, and to my knowledge much research work is being carried out in various laboratories, and, doubtless, at no distant date, the scientific literature dealing with this problem will receive various contributions of value. ORANGE STREAKS IN BEEF SUET. It has long been observed by your Meat Inspectors, and your Veterinary Surgeon had already taken action in respect of the matter, that the kidney and mesenteric fat of certain of the best fed animals was streaked with lines of orange colour. This has been observed both in home-killed and imported meat. Although as will be seen shortly, the condition is not one which renders the consumption of fat so affected unfit for human food, it occasionally happens that the streaking is so prouounced as to render it unsaleable by reason of its appearance alone. The condition has been described as being due to fatty dissociation, but it was thought desirable that a limited inquiry should be made in respect of the fat, and in consequence several specimens were forwarded to the City Bacteriologist, Dr. Andrewes, for report. In respect of the last specimen forwarded, he states:— It showed very distinct orange veining. The yellow areas examined microscopically in weak caustic potash, after the removal of the fat with ether, showed no yeasts, bacteria, or any other organisms. Cultures taken with aseptic precautions from the yellow areas remained sterile after four days incubation at 20° Centigrade. From these facts it is clear that the condition was not due to growths of yeasts in Cold Storage, and the change must be due to some physiological cause. I have established the following facts. The change appears to occur along the small blood vessels, which accounts for its veined appearance. The fat in the affected areas ig largely split up, with formation of abundant needle-shaped crystals of fatty acids. These do not stain with iodine and are hence a saturated fatty acid, probably stearic acid. Such a change must be brought about by a fat-splitting ferment, which from the distribution of 109 the change is probably conveyed by the blood. It has been proved by Abderhalden that when animals receive a diet containing fat in excess such a fat-splitting ferment becomes actually demonstrable in their blood. It is, therefore, possible that in fattened animals a sufficient amount of the ferment is present in the blood at death to give rise to local fat-splitting around the blood vessels. The pigment of the yellow areas has been examined for me by Mr. Mackenzie Wallis. It is readily extracted with petroleum ether, to some extent with ether, but not with alcohol. Its solution gives the spectrum of a lipochrome. There are no bands suggesting any derivation from hæmoglobin, nor can I find any microscopic evidence of hæmatoiden or any blood derivation. It cannot be determined whether the pigmentation is due to a concentration of the natural lipochrome of the fat, or to the lipochrome brought by the blood stream. The condition as is already stated is not one which will give rise to ill effects, but the average person would refuse to purchase meat from a carcase with the fat so affected. The condition is only found in the best fed animals and probably there is some close relationship between the excess of fat and the nutrition of this element. GENERAL ADMINISTRATIVE WORK. No important changes have been introduced in regard to inspection work at Smithfield during the past year. The system has developed as a consequence of experience, and any variation requires very careful consideration before being adopted. Some few years prior to my coming on duty, the department had been strengthened by the appointment of Mr. Young, your present Veterinary Surgeon, and the organisation has benefited from his experience. There are many matters associated with meat inspection which will ultimately be brought to your notice as the time seems opportune in the form of reports to the Committee. BYE-LAWS WITH REGARD TO THE CONDUCT OF THE BUSINESSES OF A VENDOR OF FRIED FISH, A FISH CURER, AND A RAG AND BONE DEALER. In accordance with the powers conferred under Sub-section III., Section 9, of the London County Council (General Powers) Act, 1908, which enacts that the Corporation may make Bye-laws for regulating the conduct within the City of London of the businesses of a Vendor of Fried Fish, a Fish Curer, and a Rag and Bone Dealer, the Corporation have made such Bye-laws with regard to these three trades. These have been submitted to the Local Government Board and Home Office, who have approved those relating to the Vendors of Fried Fish and Fish Curers. The Bye-laws with regard to Rag and Bone Dealers are still under their consideration. For many years the offensive odours arising from the conduct of these businesses have been a familiar source of annoyance, and but little power has been possessed by Local Authorities to demand that they shall be carried on in such a manner that they shall cause as little nuisance as possible. It is here unnecessary to refer in detail to the new powers with which the sanitary authority is armed. They are, however, comprehensive, and may be regarded as a valuable addition to legislative efforts. 110 FISH SUPPLIES. 221,731 tons of fish, of which 160,053 were land-borne and 61,678 water-borne, were received at or near Billingsgate Market during the year. This was an increase of 4,767 tons in the land deliveries, and a decrease of 6,962 tons in the deliveries by water. MONTHLY FISH RETURNS, 1913. 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 1913. f 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. Per cent. January 13,350 4,106 17,456 271 12 0 1 ton in 64.271 tons, or 1.556 February 12,645 5,897 18,542 17 18 1 1 1,035.126 „ „ .097 March 13,245 6,101 19,346 44 1 2 1 „ 438.933 „ „ .227 April 13,860 5,737 19,597 69 6 0 1 „ 282.784 „ „ .353 May 13,422 4,889 18,311 109 16 3 1 „ 166.709 „ „ .599 June 13,719 4,382 18,101 63 10 1 1 „ 284.999 „ „ .350 July 15,780 4,765 20,545 96 10 3 1 „ 212.818 „ „ .469 August 14,319 5,827 20,146 179 0 2 1 „ 112.549 „ „ .889 September 12,423 6,110 18,533 165 12 3 1 „ 111.881 „ „ .893 October 13,218 5,632 18,850 119 2 1 1 „ 158.253 „ „ .632 November 12,057 4,071 16,128 74 9 3 1 „ 216.619 „ „ .461 December 12,015 4,161 16,176 39 5 0 1 „ 412.127 „ „ .242 Total 160,053 61,678 221,731 1,249 5 3 1 „ 177.492 „ „ .563 †Compiled from the. Monthly Returns furnished to the Corporation by the Fishmongers' Company. Monthly Deliveries of Fish at London Central Markets, Smithfield, 1913. Tons Cwts. Qrs. January 119 6 0 February 124 10 0 March 140 7 0 April 149 14 0 May 126 3 0 June 115 14 0 July 117 8 0 August 102 9 0 September 109 11 0 October 125 10 0 November 112 19 0 December 116 18 0 Total 1,460 9 0 Of the above, 5 tons 0 cwts. 8 qrs. 4 lbs. were seized as unsound by your Officers, and those of the Fishmongers' Company. This equals .34& per cent. of the whole, or 1 ton in 286 tons. 111 Weight of Fish Delivered, Fish seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market during 1913 and the five years 1908-1912. Year. Weight of Fish Delivered. Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. 1908 Tons. 177,892 Tons. 63,295 Tons. 241,187 Tons 1,236 cwts 12 qrs. 3 1 ton in 195 tons, or .511 % 1909 179,157 68,918 248,075 946 15 1 1 „ 262 „ -383 „ 1910 169,968 69,307 239,275 1,288 15 0 1 „ 184 „ .538,, 1911 163,377 71,091 234,468 1,835 12 0 1 „ 127 „ .782 „ 1912 155,286 68,640 223,926 1,336 8 0 1 „ 168 „ .596 „ Average (5 years) 169,136 68,250 237,386 1,328 16 2 1 ton in 179 tons, or .569% 1913 160,053 61,678 221,731 1,249 5 3 1 ton in 178 tons, or 563% INSPECTION OF FOOD AT RIVERSIDE WHARVES, &c. As a result of the daily inspection of the City Wharves, 142 loads of Unsound Food were removed from these places during the year 1913 by the Cleansing Department. The material so disposed of comprised :— (a) Unsound Condensed Milk— Tons. Cwts. Qrs. 1. Milk seized and condemned by Magistrate (Sect. 47, Public Health (London) Act, 1891) 0 0 0 2. Amount of Condensed Milk, regarded as unfit for human consumption submitted by owners to Medical Officer of Health (a) Amount used for other purposes than human consumption under guarantee from owners 2 15 0 (b) Amount destroyed by Corporation at request of owners 19 18 0 3. Amount of imported Condensed Milk, unfit for human food, destroyed under supervision of Customs Authorities 000 (b) Other Tinned Food— Tinned fruit and vegetables 9 7 2 Miscellaneous tinned food 55 7 3 Fruit pulp 38 3 1 Fruit and vegetables 49 6 2 Miscellaneous food 1 16 0 Total - 176 14 0 The greater portion of the above was removed at the written request of the owners. 112 ICE CREAM. In 1913 there were 269 premises in the City where ice cream was sold, as compared with 215 in 1912. In 160 instances the ice cream sold at these establishments was manufactured under supervision within the City, and in 109 cases the commodity was prepared in other districts and brought into the City for sale. In the latter cases, letters of enquiry relating to the conditions of manufacture were sent to the Medical Officers of Health of the Boroughs in which the ice creams were made. It is satisfactory to note that favourable replies were received in each case as to the manner and condition ot preparation. ITINERANT ICE CREAM VENDORS. In last year's report it was stated that a decrease had taken place in the number of itinerant ice cream vendors perambulating the streets of the City. This year, unfortunately, the number has increased to 36, all of whom are aliens, and bear a street trader's badge issued since the City of London Street Traders Act (Traffic), 1909, which came into force on 1st October, 1912. The utensils used by these 36 hawkers were inspected and kept under regular observation. The commodity sold was, without exception, manufactured at places outside the City boundary, and as a result of the letters which were addressed to the Medical Officers of Health of these outside districts, it was found that the address displayed on the barrow was correct in 29 cases, in 4 instances alteration in the place of abode of the vendor had occurred, and in one case it was found that a wrong address of "place of manufacture" had been displayed. As regards the sanitary state of the premises on which manufacture of the ice cream was conducted, it was found that two premises required limewashing and cleansing. As already stated these men are, with rare exceptions, aliens, who leave much to be desired as regards their personal cleanliness, and it is to be regretted that the already overcrowded City thoroughfares are still further congested by the presence of this class of unnecessary street traders. As a rule the utensils are found to be kept in a clean condition. The method of serving the ice cream has of late improved; it is now, for the most part, placed on wafer biscuits made specially for the purpose, instead of being put in a glass, from which it was transferred direct to the mouth by the consumer and the glass afterwards " cleansed " by being dipped into dirty water and dried by still dirtier cloths. By Section 43 of the London County Council (General Powers) Act, 1902— "Every itinerant vendor of any such commodity (Ice Cream) as aforesaid "shall if not himself the manufacturer thereof exhibit in a legible manner on "a conspicuous part of his barrow a notice stating the name and address of "the person from whom he obtains such commodity and if such vendor is "himself the manufacturer of such commodity he shall in the same manner "exhibit his own name and address. Every such itinerant vendor who shall "fail to comply with the provisions of this Section shall be liable to a "penalty not exceeding forty shillings." 113 It is obvious that the intention of this Act was to compel a disclosure of the place of manufacture in order that the manufacture may be supervised to some extent and the purity of the article ensured. Bearing on this subject, the case mentioned above as being one of the display of a wrong address of place of manufacture, the name and address exhibited in this instance was No. 38, Warner Street—the reply received from the Medical Officer of Health of the Borough of Holborn in answer to the enquiry sent him as aforesaid, was "Not made on the premises." Thereupon the itinerant vendor, by name B. Di Gennaro, was interviewed, and he stated that he lived at No. 38, Warner Street, but that he manufactured his ice creams at No. 2, Little Bath Street. It will be seen by this case that the object of the Act may easily be defeated as, from the Section quoted, it does not appear that a person who manufactures ice cream is under any obligation to disclose the place of manufacture if he exhibits his own name and address on his barrow. In consideration of the difficulties with which those who have the administration of the Act are confronted, it would appear desirable that some additional words should be added after the words "name and address" in the Section quoted, which would require that the place at which the commodity was prepared should be given or displayed if such is not the same as the address of the vendor. The same difficulty arises if the itinerant vendor purchases his stock from a person who does not himself make it, inasmuch as there does not appear to be any obligation on the part of this middleman to disclose the place of manufacture. Four itinerant vendors, who were found selling ice cream from barrows which did not display any name or address, were summoned and fined. DAIRIES, COWSHEDS AND MILKSHOPS ORDERS. At the end of the year there were 640 Purveyors of Milk and Dairymen registered in the City of London, as compared with 638 in 1912, an increase of two. • The sale of milk was discontinued at 25 premises, and the owners' names removed from the Register; 65 new registrations have been reported, of which 27 were instances of new businesses being established, and 38 were consequent on there being a change of ownership. The milk sellers of the City may be divided into two groups, viz., retailers, who sell milk in a shop to be taken away, or for consumption on the premises, and are termed "Purveyors of Milk," and those who, in addition to thus selling milk, have a milk round in connection with their business, and who are designated "Dairymen." Of the former there are 616, and of the latter 24. 114 Improvements were necessary in six cases at the premises of persons registered as Purveyors of Milk. In two instances the premises required cleansing and whitewashing, and uncovered milk vessels were found to be in use at four shops. These matters were put right on the attention of the several owners being directed thereto. Improvements in ventilation, &c., have been carried out at the premises of persons registered as Dairymen, whilst at several others, improved facilities for washing and storing of the cans used in the business have and are being effected. In no instance has a case of infectious disease been reported as having occurred at a registered milkshop or dairy during the year. A list of Registered Dairymen and Purveyors of Milk in the City is given in Appendix D. THE PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912. In compliance with the above Regulations samples of Cream have been obtained and submitted to the Public Analyst. 1. Cream sold as "Preserved Cream" (such Cream must contain not less than 35 per cent. by weight of milk fat). Eleven samples were purchased in the vessels supplied by the wholesale dealers— all correctly labelled in accordance with the provisions of the Regulations, and found to contain the proper proportion of milk fat. This is satisfactory as denoting the observance of the requirements by the wholesale dealers. 2. Cream sold as "Cream," i.e., the presence of preservatives not being declared. A total of 34 samples was obtained from small retailers. In these cases the purchaser provided the vessel to contain the Cream purchased. 18 of the samples were purchased without the formality of the Act being observed, and of these, 15 were found, upon analysis by the Public Analyst, not to comply with the Regulations, inasmuch as they contained preservatives and were not labelled "Preserved Cream." In the remaining 3 samples no preservative was found to be present. In 14 of the 15 cases where want of observance of the Regulations had been noted, duplicate samples were obtained formally. In nine of these cases the Regulations were still not being observed; in four, the vessels in which samples were served were found to be correctly labelled, and in one, analysis proved that the sample was free from preservative. In the remaining instance a duplicate could not be obtained. In addition to these samples, two other official samples were obtained at shops not previously sampled. Both of these samples were sold without the Regulations being observed, making, with the former nine, a total of eleven defaults. 115 In the 11 instances in which the Regulations had not been observed, letters were addressed to the vendors to afford them an opportunity of explaining the circumstances, which explanation could be submitted to the Sanitary Committee at the same time as the Analyst's report. Replies were received in each instance, and briefly they were as follows:—Ignorance of legal requirements 5, carelessness 4, "no labels" 1, and "customers tired of having labels attached to the jar" 1. I advised that a caution be administered to the vendors of the above samples, and that a printed copy of the Regulations required to be observed by all persons selling Cream within the City of London be sent by post to all such persons. On October 28th, 1913, the Local Government Board issued a circular, Milk and Cream (No. 2), directing the attention of Local Authorities to these Regulations, and also suggesting a form of report suitable for transmission to the Board. These facts for the year ending December 31st, 1913, are as follows:— 1. Milk ; and Cream not sold as Preserved Cream. Number of samples examined for the presence of a preservative. Number in which a preservative was reported to be present. Milk 398 1 Cream 32 26 (Boric Acid in each case). Of the 26 instances in which Boric Acid was found in the cream, 15 were taken informally. In the remaining 11 instances the vendors were cautioned. 2. Cream sold as preserved cream. (a) Instances in which samples have been submitted for analysis to ascertain if the statements on the labels as to preservatives were correct. i. Correct statement 11 ii. Incorrect statement 0 Total 11 (b) Determinations made of milk fat in cream sold as preserved cream: — i. Above 35 per cent. 11 ii. Below 0 Total 11 (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream have not been observed None, (d) Particulars of each case in which the Regulations have not been complied with and action taken No defaults. SALE OF FOOD AND DRUGS ACTS. During the year, 1,165 articles of Food were examined by the Public Analyst under the Sale of Food and Drugs Acts, 1875 to 1899, and the Public Health (Milk and Cream) Regulations, 1912. This number included 261 samples purchased and dealt with without the formalities of the Act being observed, and 904 taken with the procedure prescribed by the Act. Of the informal samples 34 were found to be deficient, and as a consequence, subsequent samples were obtained from the same vendors. 116 Of the samples purchased formally, 42 were found to be sophisticated, which represents a percentage of 4.6. A summary of the Quarterly Report of all Samples examined by the Public Analyst including those taken in accordance with the Act and otherwise, and the percentage of adulteration of each separate article, is given on pages 122 and 123. A comparison of the percentage of adulteration of samples taken ten years ago and in the present year is of interest as showing the decrease which has taken place in that period. The percentage in 1903 was 8.3, as against 4.6 in the present year. Even this low figure does not constitute a record for the City, but if the samples taken under the Milk and Cream Regulations are excluded, all of which have been regarded as adulterated samples, the percentage of the sophisticated samples is reduced to 3.3. This particular subject is dealt with in another part of this Report. The percentage of adulteration of samples taken in England and Wales in 1877 was 16*2 ; this percentage has been continuously reduced, and in 1912 (that is to say the latest figures obtainable) the percentage was 8.4. The accompanying Table has been partly compiled from the Annual Reports of the Local Government Board, to which are added some figures for the City of London, and London as a whole:— Year. Total Number of Samples Examined in England and Wales. Number Examined in the City of London. Percentage of Total Number Examined in City of London. Number of Persons to each Sample examined. England and Wales. City of London. London. 1881 17,823 162 .92 1,462 318 760 1891 29,028 169 .42 999 227 580 1901 67,841 854 1.26 479 32 291 1909 97,985 1,190 1.31 330 15 202 1910 100,301 1,202 1.19 359 14 187 1911 103,221 1,209 1.18 349 16 181 1912 108,174 1,165 1.17 333 17 179 * The figures in this column are based on the Imperial night census. MILK. The decrease in milk adulteration during 1913 (as compared with 1912) is shown by the following Table:— Year. No. of Samples Examined. Found Genuine. Found Adulterated. Percentage of Adulterated Samples. 1901 392 209 83 81.2 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 1910 474 454 20 4.2 1911 453 438 15 3.3 1912 481 462 19 3.9 1913 398 385 13 3.2 117 The extremes of sophistication in the case of milk were, in respect of added water, 2 to 21 per cent. and of fat abstraction, 11 to 33 per cent. The tine imposed in the case which showed the highest percentage of added water was one of £3 and 17s. 6d. costs, the vendor of the highest percentage of fat abstracted escaped by proving a warranty. The highest fine for adulterated milk was one of £10 and £5 5s, costs, inflicted on a farmer for sending milk to London containing 11 per cent. of added water. Six samples of milk were taken in coarse of delivery. Four of this number were obtained at the Railway Station on arrival from the country, and two, as they were being left at retailers' shops by wholesale dealers. Of these, three were returned as "Genuine" by the Public Analyst, and three (all Railway Station samples) were found wanting. The extent of adulteration in these three cases was 2 per cent., 11 per cent. and 8 per cent. added water respectively—in the first instance the vendor of the sample was cautioned, in the second the vendor was fined £10 and £5 5s. costs, and in the remaining case the defendant's son and an employe stated on oath that the milk was despatched from the local Railway Station in the same condition as given by the cow, and the case was dismissed by the presiding Alderman. In only one instance has the presence of any preservative been detected in the samples of milk submitted to the Public Analyst, and in this case Boric Acid was present to the extent of 0.04 per cent. A further sample of milk was obtained at the shop at which this sample had been purchased, and on analysis, was found to be free from preservative. In no case has formalin as a preservative ever been found in the City milk supply, and only two previous cases of boric acid having been used for this purpose have been recorded—these occurred in 1911 ; it will, therefore, be apparent that this form of tampering with milk is practically non-existent as far as the City of London is concerned. The extent of adulteration of six milks which were purchased at shops and refreshment rooms, was as follows:— 6 per cent. added water, vendor fined £l and 17s. 6d. costs; 21 per cent, added water, vendor fined £3 and 17s. 6d. costs; 11 per cent. fat abstracted, the vendor fined 2s. 6d. and 17s. 6d. costs; 11 per cent. fat abstracted, the vendor was cautioned; 0.04 Boric Acid present, no action taken; and 33 per cent. fat abstracted, the vendor successfully pleaded warranty. BUTTER. 404 Samples of Butter were taken, of which, 5 or 1.2 per cent. were certified as as being adulterated. The figures for 1913 and ten previous years are given hereunder:— Year. No. of samples taken. No. of samples found Genuine. No. of Samples found Adulterated. Percentage of Adulterated Samples. 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 1910 484 477 7 1.4 1911 502 493 9 1.7 1912 563 551 12 2.1 1913 404 399 5 1.2 118 In no case in which butter had been purchased at a shop has it been found to be adulterated, all the five cases of substitution having occurred when bread and butter has been asked for. In four cases, slices of bread and butter were demanded, and in one case a roll and butter were purchased. Four of the Vendors were Coffee Housekeepers, and one, a Restaurant proprietor. One sample was found to contain 90 per cent. of margarine. The vendor of this sample having been punished before for a similar offence, was fined £8 and 21s. 6d. costs. In another case where 66 per cent. admixture of margarine was supplied, the vendor was fined 10s. and 17s. 6d. costs. In another case in which the sample consisted wholly of margarine, the offender was fined 7s. 6d. and 17s. 6d. costs. 90 per cent. margarine mixture supplied with a roll, resulted in the defendant being fined 40s. and 21s. 6d. costs, and in another case where 100 per cent. margarine substitution had taken place, the vendor was fined 40s. and 17s. 6d. costs. Three of the above offenders were new comers, and in each instance the sample was the first that had been taken at each establishment. The substitution of margarine for butter where bread and butter has been asked for, is a particularly mean form of fraud, and one, it is satisfactory to note, is gradually being stamped out in the City. It is obvious that the Coffee House keeper who commits this offence is in unfair competition with his fellow traders who supply their customers with the more costly article which is expected. Should any person carrying on this, or a similar business, desire to supply margarine, he is not prevented from doing so providing the fact is satisfactorily made known to his customers. The following Table shows the figures of adulteration of butter samples when bread and butter has been demanded: — Date. Samples taken. Cases of Substitution. Percentage Substituted Samples. 1903 71 19 267 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 1910 110 5 4.5 1911 144 6 4.1 1912 250 9 3.6 1913 256 5 1.9 MARGARINE. Four samples of margarine were submitted to the Public Analyst. Of these, two were sold contrary to the provisions of the Act, being delivered to the purchaser in unmarked wrappers and taken from bulk which did not bear the word " Margarine." In the other two cases the requirements were observed. 119 In addition to the above, 11 other samples of margarine were obtained but were not submitted to the Public Analyst, the Vendors having sold the article in the manner prescribed by Statute, the only exception being in the case of a shop keeper who wrote the word "Margarine" on the wrapper in which the substance was supplied. The same shop was visited again a week later and another sample purchased ; on this occasion the law was properly complied with. JAM AND MARMALADE. Three samples each of jam and marmalade were submitted to analysis and were found to be genuine. CURRANTS, &c. Three samples of currants, 2 of sultanas, and 1 sample each of muscatels and raisins were obtained on their arrival in this country, and found to be entirely free from any traces of either copper or arsenic. OTHER GROCERIES. Other articles submitted for analysis included 17 samples of coffee, 20 of mustard, 14 of cocoa, 15 of vinegar, 7 of pepper, 10 of olive oil, and 2 of Demerara sugar ; all these were returned as genuine. DRUGS. 46 samples of drugs were purchased for analysis, and all returned genuine. The following Table includes particulars of drug adulteration in the City during the past ten years:— Samples taken. Found genuine. Found adulterated. Percentage of adulteration. 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 1910 40 40 Nil. Nil. 1911 48 47 1 2.0 1912 46 46 Nil. Nil. 1913 46 46 ... Nil. . Nil. SPIRITS. 177 samples of spirits were purchased at the establishments of persons carrying on the business of Licensed Victuallers; 61 of these samples were whisky, 60 gin, and 56 rum. Of the whisky samples, 54 were taken informally; 7 of these, or 12.9 per cent., were found to be below the standard. Official samples were subsequently obtained at the houses where these 7 samples were purchased, and all were found to be diluted in excess of the legal limit. 120 Of the gin samples, 55 were informally procured, and 5 of these, or 9 per cent., were deficient in strength. Duplicate samples of these 5 were subsequently officially taken, and all were found to be diluted in excess of the legal limit. Of the rum samples 53 were informally purchased, and 3 of these, or 5.6 per cent., were deficient in strength. Duplicate official samples of these 3 were purchased and found to be below the legal strength. Prosecutions were instituted in six instances, and the defendants were penalized as follows: — One was ordered to pay costs, 17s. 6d; another to pay costs amounting to 21s.; another was fined 20s. and 31s. 6c?. costs for selling gin 37'4 degrees under proof, and a like amount for selling whisky 30.1 degrees under proof; and another defendant was ordered to pay costs amounting to 42s. for selling gin 43.3 degrees under proof, and whisky 25.9 degrees under proof. In 9 instances cautions were administered to the persons from whom the samples had been purchased. WARRANTY. During the year the " Warranty defence " was successfully pleaded in one case. PROSECUTIONS. 17 prosecutions were instituted, which may be summarised as follows:— 11 defendants were convicted and fined; 1 defendant proved warranty; 1 summons was dismissed; and in 4 instances the summonses were withdrawn on payment of the costs. 121 SALE OF FOOD AND DRUGS ACTS, 1875-1907. 1913. RESULTS OF PROSECUTIONS. 4 First Quarter. Sample Nature and Extent of Adulteration.Result. *36 Butter 90 per cent, margarine £8 and 21s. 6d. expenses. 73 „ 66 per cent, margarine 10s. and 17s. 6d. expenses. Second Quarter. 306 Milk 6 per cent. added water £1 and 17s. 6d. expenses. 312 ,, 21 per cent. added water £3 and 17s. 6d. expenses. 331 „ 11 per cent. added water£10 and £55*. expenses. 396 Butter 100 per cent. margarine 7s. 6d. and 17s. fid. expenses. 421 Milk 11 per cent. fat abstracted. 2s. 6d. and 17s. 6d. expenses. *485 Butter . 90 per cent. margarine . £4 and 21s. 6d. expenses. Third Quarter. 658 Milk 33 per cent. fat abstracted Dismissed. Warranty. 616 Gin37-4 degrees under proof20s. and 31s. 6d. expenses. †617 Whisky30.1 degrees under proof 20s. and 31s. 6d. expenses. 784 Butter 100 per cent. margarine 40s. and 17s. 6d. expenses. Fourth Quarter. 875 Whisky28.8 degrees under proof Expenses 17s. 6d. 890 „ 27.9 degrees under proof Expenses 21s, †943 Gin 43.2 degrees under proof Expenses £2 2s. 944 Whisky 25.9 degrees under proof 1124 Milk 8 per cent. added water Dismissed. SUMMARY. £ s. d. £ s. d. First Quarter: Fines 8 10 0 Expenses 1 19 0 Second Quarter „ 18 10 0 „ 9 16 6 Third Quarter „ 4 0 0 „ 4 0 6 Fourth Quarter „ — „ 4 0 6 £31 0 0 £19 16 6 * Second Offence. † Both samples supplied by the same defendant. 122 123 SALE OF FOOD AND DRUGS ACTS, 1875-1907, and the PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912. Articles examined during each Quarter of the year 1913. Articles submitted for Analysis. Quarter ending 31st March- Quarter ending 30th June. Quarter ending 30th September. Quarter ending 31st December- Total for 1913. 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 159 156 3 1.8 117 113 4 3.4 54 54 ... ... 20 18 2 10.0 350 341 9 2.5 Butter 188 185 3 1.6 151 149 2 1.3 31 31 ... ... 34 34 ... ... 404 399 5 1.2 Mustard 8 8 ... ... 9 9 . . . ... 3 3 ... ... ... ... ... ... 20 20 ... ... Cocoa 7 7 ... ... 5 5 ... ... 2 2 ... ... ... ... ... ... 14 14 ... . .. Coffee 6 6 ... ... 8 8 ... ... 3 3 ... ... ... ... ... ... 17 17 ... ... . Drugs 23 23 ... ... 9 9 ... 2 2 ... ... ... ... ... ... 34 34 ... ... Pepper 2 2 ... ... 5 5 ... ... ... ... ... ... ... ... ... ... 7 7 ... ... Olive Oil 1 1 ... ... 3 3 ... ... ... ... ... ... ... ... ... ... 4 4 ... ... Cream ... .... ... ... ... ... ... ... ... ... ... ... 12 1 11 91.6 12 1 11 91.6 Vinegar 7 7 ... ... 7 7 ... ... 1 1 ... ... ... ... ... ... 15 15 ... ... Margarine 3 2 1 33.3 ... ... ... ... ... ... ... ... 1 ... 1 100.0 4 2 2 50.0 Demerara Sugar 2 2 ... ... ... ... ... . . . ... ... ... ... ... ... ... ... 2 2 ... ... Whisky ... ... ... ... 3 ... 3 100.0 4 ... 4 100.0 ... ... ... ... 7 ... 7 100.0 Gin ... ... ... ... 3 ... 3 100.0 2 ... 2 100.0 ... ... ... ... 5 ... 5 100.0 Rum ... ... ... ... 3 ... 3 100.0 ... ... ... ... ... ... ... ... 3 ... 3 100.0 Marmalade ... ... ... ... ... ... ... ... 3 3 ... ... ... ... .... ... 3 3 ... ... Jam ... ... ... ... ... ... ... ... 3 3 ... ... ... ... ... ... 3 3 ... ... 406 399 7 1.7 323 308 15 4.6 108 102 6 5.5 67 53 14 20.8 904 862 42 4.6 Informal Samples— Milk ... ••• ... ... ... ... ... ... ... ... ... ... 48 44 ... 8.3 48 44 4 8.3 Cream ... ... ... ... ... ... ... ... ... ... ... 18 3 15 83.3 18 3 15 83.3 Preserved Cream ... ... ... ... .... ... ... ... ... ... ... ... 11 11 ... ... 11 11 ... ... Drugs ... ... ... ... ... ... ... ... ... ... ... 12 12 ... ... 12 12 ... ... Olive Oil. 3 3 ... ... ... ... ... ... ... ... ... ... ... ... ... 3 3 ... ... Whisky ... ... ... ... 24 21 3 12.5 26 22 4 15.3 4 4 ... ... 54 47 7 12.9 Gin ... ... ... ... 23 20 3 13.0 28 26 2 7.1 4 4 ... ... 55 50 5 9.0 Rum ... ... ... ... 23 20 3 13.0 26 26 ... ... 4 4 ... ... 53 50 3 5.6 Currants ... ... ... ... ... ... ... ... ... ... ... ... 3 3 ... ... 3 3 ... ... Raisins ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 1 ... ... Muscatells ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 1 1 ... ... Sultanas ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... 2 2 ... ... Total of Informal Samples 3 3 ... ... 70 61 9 12.8 80 74 6 7.5 108 89 19 17.5 261 227 34 13.0 Total Samples for year 409 402 7 1.7 393 369 24 6.1 188 176 12 6.3 175 142 33 18.8 1,165 1,089 76 6.5 124 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, 84 persons were examined by the Medical Officer of Health during 1913, and with one exception, all were reported as physically fit for office. Ten officers were also medically examined with a view to their retirement, and of these 8, or 80 per cent., were reported to be unfit for duty. In addition to the foregoing, 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 Health Department. Guildhall, E.C. APPENDICES. PAGE Appendix A—Street Lists of Mortality 127 „ B— ,, „ Infectious Diseases129 „ C—Register of Houses let in lodgings or occupied by members of more than one family131 „ D—List of Persons registered under the Dairies, Cowsheds and Milk Shops Orders 136 127 Appendix A. CITY OF LONDON MORTALITY. 1913. STREET LISTS. Compiled from Weekly Returns of Registrars of Sub-Districts street or place. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. Aldersgate Street 154 M 5 m'ths 28 Oct. 1913 Gastro-Enteritis Heart Failure Cirrhosis Hepatis Morbus Cordis Acute Bronchitis Gastric Ulcer Phthisis Hæmorrhage into the Pericardium Locomotor Ataxy Hæemoglobinuria Cellulitis of Leg Acute Pulmonary Tuberculosis Morbus Cordis Syncope Progressive Muscular Atrophy Acute Polio-Encephalitis Cerebellar Hæmorrhage Died in St. Bart.'s Inquest and P.M. Natural causes ,, ,, 181 F 80 15 Jan. „ Aldgate 15 M 46 11 Oct. „ Aldgate Avenue 16 M 47 14 April „ Artillery Lane 5 M 61 18 May ,, Bartholomew Close 80 M 80 12 Dec. „ Bartholomew House 11 F 60 21 Aug. „ ,, ,, M 80 21 Sept. „ Basinghall Street 66 M 50 24 Feb. „ Died in St. Bart.'s Bishopsgate 32 M 38 25 Oct. „ ,, 128 M 52 11 Jan. „ 174 F 18 7 July „ Bloomfield House, King Street. Snow Hill 23 F 76 6 Mar. ., Bouverie Street 16 F 65 20 June „ ,, ,, 16 M 72 23 Dec. „ Brackley Street 5 M 19 25 Nov. „ P.M. Died in St. Bart.'s Inquest and P.M. Natural causes Bride Lane 24 F 79 11 May „ Broad Street Avenue - F 67 23 Dec. „ Carcinoma of Œsophagus Laceration of Spine Carter Lane 22 M 28 14 Nov. „ Inquest and P.M. Accidental Charles Street 70 M 72 7 Jan. „ Cancer of Stomach Morbus Cordis Cystitis Gastric Catarrh Heart Failure Circus, Minories 5 F 71 2 Oct. „ College Hill 21 M 51 27 Jan. „ Coopers Row 12 m 1 m'th 17 April „ Copthall Court 11 M 51 9 June „ Inquest and P.M. Natural causes Cornhill 53 M 13 m'ths 14 April „ Broncho-Pneumonia Heart Failure Crescent, Minories 11 M 78 21 Oct. „ Inquest and P.M. Natural causes Died in St. Bart.'s Inquest Died in Robin Hood Court Infirmary. Inquest and P.M. Crutched Friars 42 M 50 11 Dec. „ Morbus Cordis Cancer Syncope Syncope Cursitor Street 14 M 56 8 June „ Dean Street, Fetter Lane, D Block 3a M 74 28 April „ ,, ,, ,, ,, D ,, 3a F about 76 2 May „ ,, ,, ,, ,, F ,, 6 M 79 18 June „ Senile Decay Congenital Cardiac Disease Phthisis Pulmonalis Atheroma Heart Failure Valvular Disease of Heart Syncope Eastcheap 27 M 1 m'th 31 Dec. „ Died in St. Bart.'s P.M. East Harding Street 11 M 43 22 Jan. „ Fenchurch Avenue 1 F 79 5 Dec. „ Fenton's Buildings 2 F 77 3 April „ Fetter Lane 103 F 69 23 Dec. „ Inquest and P.M. Natural causes Fish Street Hill 19 M 70 8 „ Fleur de Lis Court 6 M 59 2 Oct. „ Malignant Disease of Liver Acute Bronchitis Epileptiform Convulsions Apoplexy Senility Asthma Bronchitis Syncope Cerebral Apoplexy Fredericks Place 7 F 82 7 „ Died in St. Bart.'s Golden Lane (Cripplegate Institute) — F 36 15 May „ Great New Street 3 F 63 10 Sept, „ ,, ,, ,, 14 M 77 14 July ,, Great Winchester Street 19 M 52 21 Aug. „ Greystoke Place 2 F 85 10 Feb. „ Gunpowder Alley 2 M 64 17 June „ ,, ,, 7½ F 64 27 July „ Died in St. Bart.'s Inquest and P.M. Natural causes Died in St. Bart.'s Inquest and P.M. Natural causes Holborn Viaduct 50 F 74 27 Dec. „ Cerebral Apoplexy Houndsditch 37 F 71 31 Jan. „ Carcinoma of Liver Prematurity Broncho-Pneumonia Syncope Acute Lobar Pneumonia Chronic Bronchitis Atelactasis Syncope Gall Stones Chronic Nephritis Morbus Cordis Intestinal Obstruction Cerebral Haemorrhage Epileptic Fit Huggin Lane 4a F 9 days 9 June ,, Inquest and P.M. Hutchison Avenue 7 F 13 m'ths 24 Nov. „ ,, ,, 21 F 73 14 Dec. „ ,, ,, 19 F 67 12 May „ Hutchison Street 13 F 76 21 April ,, ,, ,, 16 M 7 days 13 May „ Johnsons Court 4 M 80 7 „ Lawrence Pountney Hill 6 F 56 1 Oct. „ Lawrence Pountney Lane 5 F 73 8 Dec. „ Lime Street 23 F 61 1 Oct. „ Little Montague Court 2 M 65 15 Dec. „ Lloyds Avenue 1 M 67 28 Sept. „ Long Lane 18 F 54 20 July „ 128 CITY OF LONDON MORTALITY—continued. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remark. Long Lane 75 F 70 9 Oct. 1913 Cardiac Valvulitis Chronic Bronchitis Cardiac Disease Arterial Sclerosis Chronic Bronchitis Multiple Neuritis Cerebral Hæmorrhage ,, ,, 79 F 66 20 „ Lower Thames Street 73 M 72 16 Feb. „ Mark Lane 7 2 F 70 5 Jan. ,, Middlesex Passage 2 F 70 18 Dec. „ Middlesex Street 39 F 51 12 Nov. „ ,, ,, 116 M 72 16 July „ Inquest and P.M, Accidental Middle Temple Lane 3 F 78 16 June „ Senile Decay Pulmonary Tuberculosis Acute Lobar-Pneumonia Malnutrition from birth Influenza Tuberculosis Osteal-Pulmonary Heart Disease (Valvular Mitral) Influenza Senile Decay Heart Failure Mincing Lan 3 F 42 2 Feb. „ Died in C.L.U. Infirmar 38 M 55 8 April „ Minories 96 M 25 days 9 Aug. „ Monument Street (Dalmeny House) — 34 26 May „ Died in St. Bart.'s Moorgate Street 4 F 3 5 Nov. „ ,, ,, 31 M 47 20 Feb. „ Moor Lane Chambers 12 M 66 4 Jan. „ New Bridge Street 29 F 91 19 March „ New Court. Temple 1 F 67 26 Oct. „ Inquest and P.M. Natural causes Newgate Street (Central Hotel) — M 40 22 April „ Delirium Tremens Bronchitis Phthisis Syncope New Street 17 F 13 m'ths 18 Sept. „ Nicholl Square 12 F 19 26 Jan. „ Norwich Street 1 M 76 30 Nov. „ Inquest and P.M. Natural causes Old Bailey 60 F 58 12 Sept. „ General Paralysis Capillary Bronchitis Bronchitis Morbus Cordis Acute Pleuro-Pneumonia Acute Bronchitis Syncope Prematurity Suffocation by Drowning Broncho-Pneumonia Heart Failure Phthisis Chronic Bronchitis Whooping Cough Premature Birth Paul's Bakehouse Court 2 M 61 13 Feb. „ Philpot Lane 10 F 71 12 Oct. „ ,, ,, 22 F 69 28 „ Plowden's Buildings. Temple 3 M 56 30 Nov. „ Queen's Court 3 M 74 24 Feb. „ Queen Victoria Street 100 M 84 13 June „ Red Cross Street (Fire Station) — F 4 hours 1 Jan. „ Died in St. Bart.'s Inquest River Thames—Paul's Pier Wharf — F about 48 8 June Robin Hood Court (Union) — F 59 6 Feb. „ ,, ,, ,, — M 57 8 ,, Inquest and P.M. ,, ,, ,, — M 59 24 June „ ,, ,, ,, — M 68 5 Oct. „ Rood Lane 13 M 9 m'ths 14 June „ Rose Alley St. Bartholomew's Hospital 57 M 24 hours 4 July „ (The Warden's House) — M 36 19 April „ General Peritonitis Delirium Tremens St. Bartholomew's Hospital — M 54 18 July „ No fixed abode. In quest and P.M. St. Helen's Place 7 M 75 15 Sept. „ Bronchitis Shock. Fractured skull and laceration of brain by being struck down by motor omnibus Acute Pneumonia Chronic Bronchial Asthma Pulmonary Tuberculosis Tuberculosis of the Lungs St. Paul's Churchyard 58 M 40 20 Jan. „ Inquest and P.M. Accidental St. Swithin's Lane 18 M 57 3 June „ Serjeants' Inn 12 F 71 17 Sept. „ Sherborne Lane 13 M 50 25 Feb. ,, Silver Street 5-6 M 46 2 Sept. „ Died in St. Bart.'s Inquest and P.M. Natural causes Inquest and P.M. Natural causes Temple Lane 8 M 57 2 „ Nephritis Thavies Inn 8 M 24 9 April „ Acute Pulmonary Tuberculosis Cancer Influenza Carcinoma of Stomach Schirrus of left Breast Bronchitis Gangrene of Lung Acute Bronchitis Cancer Perforated Gastric Ulcer Chronic Bronchitis Haemorrhagic Jaundice Diabetes Mellitus Rectal Carcinoma Cancer Chronic Rheumatoid Arthritis Took's Court 3 F 67 14 June „ Tudor Street 36 M 46 29 July „ Died in St. Bart.'s Died in St. Bart.'s Victoria Embankment (Sion College) — F 49 28 Aug. „ Vine Street 26 F 53 27 July „ Walbrook 2 F 75 23 Dec. „ Watling Street 13 F 34 8 Oct. „ Westmoreland Buildings 2 M 26 14 Feb. „ West Smithfield 57 M 65 23 April „ ,, ,, 11 M 34 25 July „ ,, ,, 9-10 F 5 29 Oct. „ ,, ,, 22 F 1 m'th 30 Nov. „ Widegate Street 13 M 64 13 Mar. „ ,, ,, 13 F 59 13 Aug. „ Wine Office Court 3 M 62 26 April „ Wrestler's Court 4 M 72 5 Nov. „ ARTIZANS' DWELLINGS, STONEY LANE, HOUNDSDITCH King's Block 4 F 69 4 Jan. 1913 Dilatation of Heart Epidemic Diarrhoea Pulmonary Tuberculosis Valvular Disease of Heart Chronic Rheumatism Bronchitis Pertussis ,, ,, 26 F 7 m'ths 15 Nov. „ Queen's ,, 43 F 25 5 Jan. „ South „ 27 F 21 26 June „ Princes „ 37 M 33 28 April „ ,, ,, 42 F 83 19 June „ ,, ,, 43 F 4 m'ths 8 Oct. „ 129 Appendix B. LIST OF INFECTIOUS CASES, 1913. STREET LISTS. Compiled from Notifications received. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. 1913. Albion Buildings 22 F 2 weeks Erysipelas 31st March. Bishopsgate Police Hospital ... M 32 Ditto 9th December. Bartlett's Buildings 21 M 7 Scarlet Fever 15th September. Billiter Street 21 F 8 Ditto 6th January. Bow Church Yard 5 F 21 Erysipelas 30th June. Carmelite Street, Fire Station F 3½ Scarlet Fever 1st June. Ditto F 5 Diphtheria 21st January. Ditto M 5 Ditto 1st November. Church Passage 3 M 21 Erysipelas 19th June. Cooper's Row 11 F 15 Scarlet Fever 5th November. Ditto 11 M 10 Ditto 18th November. Charterhouse Street 18 M 22 Diphtheria 23rd February. Ditto 18 M 19 Ditto 24th February. Dean Street "A" Block 1 M 5 Ditto 21st July. Ditto ditto 1 F 3 Ditto 23rd July. Ditto ditto 4 F 5 Scarlet Fever 20th August. Ditto "B" Block 8 F 5 Ditto 13th July. Ditto "C" Block 3 F 9 Ditto 1st September. Ditto "D" Block 8 M 4 Poliomyelitis 29th July. Ditto "F" Block 5 M 17 Scarlet Fever 24th January. Eastcheap 39 F 5 Diphtheria 26th January. East Harding Street 8 M 15 Ditto 5th December. Farringdon Street 46 M 20 Enteric Fever 19th January. Ditto 45 M 21 Scarlet Fever 25th September. Fenchurch Street 134 M 2 Chicken-pox 30th November. Fen Court 5 F 3 Scarlet Fever 14th November. Fetter Lane 39 F 7 Ditto 16th September. Ditto 39 M 5 Ditto 18th September. Finsbury Circus, London Institution ... F 34 Enteric Fever 1st December. Finsbury Pavement 36 F 22 Diphtheria 20th December. Fleet Street 78 F 4 Ditto 7th January. Ditto 78 M 3 Ditto 8th January. Ditto 78 M 1 Ditto 7th April. Ditto 78 M 3 Ditto 13th April. Gracechurch Street 58 M 18 Scarlet Fever 23rd March. Ditto 58 F 22 Ditto 7th August. Godliman Street 16 M 3 Diphtheria 7 th May. Great New Street 13 M 45 Erysipelas 16th December. Great Swan Alley 16 M 13 Scarlet Fever 20th June. Ditto 16 M 4 Ditto 4th July. Gresham Street 23 M 20 Ditto 20th May. Hutchison Avenue 5 F 10/12 Chicken-pox 13th September. Ditto 13 F 3 Scarlet Fever 2nd February. Ditto 20 M 7 Ditto 18th January. India Street, "The Grapes" ... F 12 Chicken-pox 31st May. Ireland Yard 10 M 18 Scarlet Fever 7th July. Jewry Street 37 F 7 Chicken-pox 20th November. King's Block 14 F 1 Diphtheria 27th November. Lombard Street 80 F 7 Scarlet Fever 3rd January. London Wall Buildings 3 F 8 Ditto 16th September. Ditto 3 M 9 Ditto 20th September. Milton Street 31 M 19 Ditto 17th June. Ditto 31 M 20 Ditto 22nd June. Ditto 31 M 17 Ditto 26th June. Minories 96 M 10 Ophthalmia 26th July. days Neonatorum 130 Street or Place. No. of House. Sex. Age. Disease. Date of Notification. 1913. Minories 139 F 28 Scarlet Fever 21st October. Montague Court, Bishopsgate 2 M 4 Diphtheria 19th October. Moorgate Street 15 M 13 Scarlet Fever 17th January. New Street, Gravel Lane 32 F 39 Erysipelas 28th October. North Block 19 F 6 Scarlet Fever 20th March. Old Broad Street 56 F 4 Ditto 10th November. Old Jewry 6 F 5 Ditto 22nd April. Prince's Block 41 F 4 Ditto 19th August. Queen's Block 44 F 3 Chicken-pox 21st July. St. Bartholomew's Hospital ... ... ... Diphtheria 9 cases, Scarlet Fever 6 cases, Erysipelas 2 cases, Enteric Fever 1 case. Salisbury Square, Salisbury Hotel F 27 Scarlet Fever 2nd December. Throgniorton Street 26 M 9 Ditto 6th November. Tudor Street 26 F 9 Diphtheria 16th December. William Street 4 M 33 Enteric Fever 19th January. Ditto 4 M 17 Scarlet Fever 9th September. Ditto 4 M 14 Ditto 27th September, Ditto 4 M 16 Ditto 27th September. Ditto 4 F 24 Ditto 29th October. Wine Office Court 9 M 16 Diphtheria 15th September. Ditio 9 M 16 Scarlet Fever 18th September. Wood Street 18 M 23 Enteric Fever 1st August. 131 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 6, Bartholomew Place Henry Hoggett, 6, Bartholomew Place 1 3 20, Bride Lane T. Graham, 20, Bride Lane 3 6 5, Britton's Court James Hurrel. 5, Britton's Court 2 2 1, Chapel Place, Fetter Lane C. H. Miller, 32, Fetter Lane 3 4 2, do. do. Do. do. 2 4 6 and 7, Cloth Fair Messrs. Heywood and Holland, 31, King Street, Cheapside. 3 7 8, do. Do. do. do. 2 3 9, do. Do. do. do. 2 4 18, do. C. Brissmire, 18, Cloth Fair 4 10 19, do. H. Field, 9, Gracechurch Street 3 6 21, do. W. Phelan, 20, Cloth Fair 3 8 22, do. J. Jackson, 22, do. 4 8 29, do. Messrs. Heywood and Holland, 31, King Street, Cheapside. 1 2 31, do. A. H. Price, 31, Cloth Fair 1 2 43, do. Messrs. Heywood and Holland, 31, King Street, Cheapside. 2 6 44, do. Do. do. do. 4 7 45, do. W. and J. Biggerstaff, 59, West Smithfield 2 7 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 4 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 7, do. E. King, 23, Whitefriars Street 3 10 10, East Harding Street 11, do. 12, do. Messrs. Eyre and Spottiswoode, Little New Street 2 2 1 5 10 1 2, Evangelist Court Morris & Co., 99, Shepherdess Walk 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 Read, 42, Fetter Lane 1 4 93, do. J. Hook. 106, St. James' Road, Holloway 4 11 29, Fleet Lane Messrs. Watney, Coombe and Reid, Pimlico 3 8 30, do. Do. do. do. 2 4 31, do. Do. do. do. 2 5 1, Great New Street James Barnslev, 1, Great New Street 4 13 20, do. G. Stanbury, 25, do. 6 20 2, do. Sidney Gardner, 2, do. 4 10 3, do. Do. do. 4 6 5, Green Dragon Court H. Johnson, 5, Green Dragon Court 1 2 6, do. C. Fleming, 6, do. 2 4 7, do. F. Standeven, 7, do. 2 4 2, Greystoke Place G. Reveirs, 4, Greystoke Place 3 6 3, do. Michael Flynn, 3, do. 4 4 6, do. William G. Cass, 6, do. 1 8 7, do. Harriet Evans, 9, do. 4 15 8, do. Do. do. 2 12 9, Greystoke Place, Fetter Lane. Do. do. 4 10 2, Gunpowder Alley T. Richardson, 2, Gunpowder Alley 1 4 8, do. T. Townsend, 259, Essex Road 2 2 7½, do. Do. do. 3 10 Carried forward 141 347 132 WEST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 141 347 4, Hosier Lane Phillips & Tribe, Cock Lane 1 4 5, do. W. J. Lardner. 6, Hosier Lane 2 7 36, Hutton Street A. E. Reeves, 35, Hutton Street 2 4 25, Kinghorn Street W. Phelan, 20, Cloth Fair 3 6 25a, do. Do. do. 4 10 1, Little Montague Court J. Madley, 21, Little Britain 2 10 2, do. Do. do. 4 10 54, Little Britain G. Fizzani, 54, Little Britain 1 2 79, Long Lane Robert Dyas, 87, Fore Street 3 6 80, do. L. M. Migliorini, 80, Long Lane 1 4 82, do. Mrs. Fairliead, 82, do. 2 4 86, do. E. Rees, 85, do. 1 4 1, Middlesex Passage James Strugnell, 45, Bartholomew Close 4 11 2 and 3, do. Do. do. 11 12 4, do. J. Sturgeon, 6, Middlesex Passage em pty 5, do. Do. do. em pty 6, do Do. do. 1 2 2, Middle Street L. Meluish, 2, Middle Street 3 4 3, do. Do. do. 4 6 4 and 5, do. J. Hull & Sons, Bartholomew Close 5 8 6, do. E. Haley, 38, do. 2 5 20, do T. Green, 20, Middle Street 2 3 1, Montague Court, Little Britain. Mrs. E. Moloney, 1, Montague Court 3 4 2, do. G. Hanlan, 2, do. 2 6 3, do. James Long, 4, do. 3 8 4, do. Do. do. 3 5 5, do. R. Hutchins, 5, do. 2 4 6, do. J. Hogan, 6, do. 3 11 7, Nevill's Court E. H. Miller, 32, Fetter Lane 3 11 8, do. Do. do. 3 4 9, do. Do. do. 2 6 10, do. Do. do. 6 10 11, do. Goldsmiths' Company, Goldsmiths' Hall 8 15 12, do. Do. do. 6 15 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 10 10, New Street Square Herbert Mogridge, 10, New Street Square 1 4 6, Temple Lane John Allen, 34, New Bridge Street 4 10 7, do. Do. do. 4 10 8, do. Do. do. 7 14 57, West Smithfield T. A. Allen, 57, West Smithfield 6 14 9, The Broadway T. Frost, 6, The Broadway 4 8 13, Wine Office Court W. Deighton, 54, Great Percy Street, W.C. 4 10 14, do. Do. do. 4 10 16, do. Do. do. 4 9 17, do. Do. do. 5 8 Total 297 692 Average number of lodgers to each tenement: 2.4. WEST DISTRICT. Houses demolished pr closed in 1913:— 5a, Took's Court. Tenement houses on register 104 Cleansing Notices served 125 133 MIDDLE DISTRICT. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. 1 and 2, Huggin Court, Little Trinity Lane. City Parochial Charities Trustees, 3, Temple Gardens. 6 17 9, Huggin Lane H. Belcher, 8, Martin's Lane 2 4 10, do. H. Willis, 10, Huggin Lane 4 5 15, Swan Lane H. Postlewaithe, 15, Swan Lane 3 9 Total 15 35 Average number of lodgers to each occupied tenement: 2.4. Tenement houses on register 4 Cleansing Notices served 4 EAST DISTRICT. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. 27, Aldgate A. L. Poysner, 27, Aldgate 1 2 7, Artillery Lane Bishopsgate Institute 8 19 9, do. John Tharp, 9, Norton Folgate 6 14 12, do. Wm. Barker, 11, Artillery Lane 7 11 14, do. Mrs. McCarthy, 57, George Street, Blackfriars 5 8 16, do. Do. do. do. 6 18 18, do. Do. do. do. 2 5 20, do. J. Barberis, 20, Artillery Lane 1 5 21, do. Bishopsgate Institute 4 7 9, Brushfield Street W. H. Recknell, 66, Green Lanes, N. 3 6 10, do. J. Shepherd, 8, Brushfield Street 3 6 12, do. Luke Cohen, 12, do. 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 S. Moses, 65, Mansell Street, Aldgate 5 26 90, Minories). 2, Circus, Minories T. Bobn, 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. Claude M. Levy, 20, Steward Street, Spitalfields 4 7 11, Clark's Place, Laura Wells, 11, Clark's Place I 1 Bishopsgate. 2, Montague Court, Bishopsgate. Wm. Grouts, 26, Wilson Street, New Cross 3 6 3, Crown Place, Aldgate W. Harper, 3, Crown Place 4 6 6, do. A. Hayland, 6, do. 3 6 7, do. A. Humphreys, 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 B. Marks, 6, George Street 1 I Carried forward 97 217 134 EAST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements Lodgers, Brought forward 97 217 117, Gravel Lane Empty 118, do. Henry Goulston, 118, Gravel Lane 4 4 1, Hutchison Avenue A. J. Hollington, Middlesex Street 1 3 2, do. I. Solomons, 2, Hutchison Avenue 5 5 3. do. B. Erreira, 3, do. 3 8 4, do. Morris Cohen, 4, do. 2 8 6, do. M. Ferguson, 26, Finsbury Square 1 2 7, do. J. Ferguson, do. 1 1 9, do. Barnet Barnet, 7, Hutchison Avenue 4 7 10, do. C. Zeffie, do. 3 8 11, do. A Cohen, 11, do. 3 9 12, do. N. Foley, 26, London Street, Fitzroy Square 3 8 13, do. B. Levy, 13, Hutchison Avenue P. Seigarman, 14, do. 3 6 14, do. 3 4 15, do. D. Joel, 15, do. 2 4 17, do. B. Moses, 17, do. 3 8 18, do. A. Michaelson, 18, do. 4 11 21, do. Sarah Aarons, 21, do. 3 8 22, do. Isaac Schwartz, 22, do. 5 8 23, do. A. Josephs, 23, do. 3 9 24, do. J. Levy, 24, do. 2 6 25, do. L. Marks, 25, do. 2 6 26, do. Lewis Josephs, 26, do. 3 7 5, Hutchison Street I. Silver, 5, Hutchison Street 2 7 6, do. I. Soloman, 6, do. 3 5 10, do. I. Levy, 10, do. 1 8 12, do. N. Vabler, 12, do. 2 3 16, do. A. Garcia, 16, do. 3 9 17, do. J. Noah, 17, do. 2 5 18, do. A. Solomon, 18, do. 1 4 19, do. B. Tinkel, 19, do. 1 2 20, do. I. Edwards, 20, do. 1 6 Janes Buildings, Hutchison Street. Blum, 3, Homerton Row, N.E. . 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, 23, Middlesex Street 1 9 71, do. S. Valentine, 71, do. 2 4 5, New Street, Gravel Lane J. Frankel, 5, New Street 1 3 6, do. do. N. Woolf, 6, do. 2 7 8, do. do. B. Starker, 8, do. 3 3 9, do. do. A. Schneider, 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. B. Symons, 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 16, do. do. Simons Levy, 16, do. 3 8 17, do. do. Marks Joseph, 17, do. 2 2 18, do. do. A. Bernstein, 18, do. 3 10 19, do. do. H. Marks, 19, do. 2 6 22, do. do. B. Lew, 22, do. 1 4 23, do. do. S. Cohen, 23, do. 2 7 24, do. do. Joseph Levy, 24, do. 3 6 26, do. do. Solomon, 26, do. 3 8 27, do. do. E. Marks, 27, do. 3 9 28, do. do. H. Solomon, 28, do. 2 7 30, do. do. E. Ersen, 30, do. 3 5 32, do. do. E. Barnet, 32, do. 3 10 34, do. do. R. Cohen, 34, do. 1 1 36, do. do. R. Singer, 36, do. 4 11 37, do. do. B. King, 37, do. 2 2 40, do. do. Mary Roach, 40, do. 1 2 Carried forward 250 598 135 EAST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 250 598 1, Queen's Court, Vine St. Claude M. Levy, 20, Steward Street, Spitalfields 4 7 2, do. do. Do. do. do. do. 3 10 3, do. do. Do. do. do. do. 2 7 4:, do. do. Do. do. do. do. 2 10 2, Three Crown Court, Jewry Street. Messrs. Smith, Son & Gowland, 3, Church Street 4 8 3, do. do. Do. do. do. 5 8 8, Vine Street, do. Claude M. Levy, 20, Steward Street, Spitalfields 6 19 9, do. do. 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 Mrs. Fitch, Bishopsgate Institute 8 23 Total 327 778 Average number of persons to each tenement: 2.4, EAST DISTRICT. Houses demolished or closed during 1913:— 1, Union Row. 2, Union Row. 6, Aldgate. 16, Montague Court, Bishopsgate. Tenement houses on Register 114. Cleansing notices served 143. 136 Appendix D. List of Persons registered under the Dairies, Cowsheds and Milkshops Orders. 1st January, 1914. Premises. Person Registered. Premises. Person Registered. 15, Aldersgate Street Express Dairy Co., Ltd. 4, Beehive Passage Lockharts, Ltd. 20, do. John Salter Williams. 7, Bell Yard John Toulson Gardner. 24, do. Robert Douglas. 23, Bevis Marks Express Dairy Co., Ltd. 28/9, do. "J.P." Restaurants, Ltd. 22, Billiter Street Nella Webster. 30, do. John Thomas Gooden. 23, do. William Cole and Grant 42, do. Nunzio Allocca. Yentnor Robert Riach. 67, do. J. Lyons and Co., Ltd. 5, Bishopsgate Church Gerardo Lamberti. 72, do. Slaters, Ltd. Passage. 73, do. Nunzio Allocca. 21, Bishopsgate Aerated Bread Co., Ltd. 84, do. Charles Lanning 35/7, do. Williamsons, Ltd. 90, do. Dominico Bonito. 42, do. Frances Georgian Bailey 92, do. Joseph James Metcalf. 52, do. Romualdo Mansi. 170, do. Aerated Bread Co., Ltd. 66, do. W. Hill and Son, Ltd. 179, do. Nunzio Allocca. 75, do. J. Lyons and Co., Ltd. 188, do. William Robins Thatcher. 84, do. Slaters, Ltd. 193, do. J. Lyons and Co., Ltd. 142, do. Aerated Bread Co., Ltd. 40, Aldermanbury Nunzio Allocca. 152, do. J. Lyons and Co., Ltd. 55, do. Aerated Bread Co., Ltd. 161/3, do. J. Lyons and Co., Ltd. 62, do. Luigi Cattini. 174, do. Atanasio Diviani. 12 and 13, Aldgate Lockharts, Ltd. 188, do. Empire Restaurants, Ltd. 15, do. Francis William Yeomanson. 208, do. Antonetta Arpino. 24, do. J. Lyons and Co., Ltd. 240, do. Express Dairy Co., Ltd. 28, do. Egisto Landi. 254, do. Gaston Debry. 7, Aldgate High Street John Wattam. 266, do. Cattello Rabicano. 73, do. Express Dairy Co., Ltd. 280, do. William Sandrock. 7, Artillery Lane Clara Mason Shepherd. 306, do. John Salter Williams. 1, Austin Friars Olive Marie Muriel Simonds. 23, Birchin Lane Mary Ann Ivison and Jane 5, Barbican Pantolone Pappalardo. Laver, trading as M. A. 6/7, do Aerated Bread Co., Ltd. Ivison and Co. 20, do. Lockharts, Ltd. Blackfriars Bridge J. Lyons and Co., Ltd. 43a, do. Lewis Thos. Owen and Percy John Randall. Station 8/10, Blomfield Street "J.P." Restaurants, Ltd. 59, do. William John Roff. 16, do. Ulrich Maino. 21, Bartholomew Close Mabel Marion Baker. 4, Botolph Alley Charles Peach. 38, do. Catherine Lewis. 1, Bow Churchyard Pasquale Mansi. 89, do. William Henry Letley. 2, Bow Lane " J.P." Restaurants, Ltd. 1, Basinghall Street Aerated Bread Co., Ltd. 9, do. Pasquale Mansi, trading as 15, do. Luigi Necchi. M. Pasquale and Co. 16, do. Pasquale Palumbo and Co. 11, do. Henry Harrod Haines. 29/30, do. J. Lyons and Co., Ltd. 38a, do. Frien Manor Dairy Farm, Ltd. 54, do. Sidney Havard Willmott. 46, do. P. Palumbo. 65/66, do. Walter Peers Jackson. 54, do. Andrea Beschizza. 68, do. Winifred Stenning. 43, Bread Street Archibaldo Egio Sichi. 69, do. Express Dairy Co., Ltd. 33, Breams Buildings Thomas Henry Davis. 1, Gresham Buildings, London Café Co., Ltd. 18, Bride Lane Sarah Angle. Basinghall Street 20, do. Wm. James Graham and 50, Beech Street John Richards. Walter Robert Hider. 137 Premises. Person Registered. Premises. Person Registered. 3, Brushfield Street Henry Pugh Lloyd. 23, Coleman Street Ye Mecca, Ltd. 3, Bridgewater Street Charles Cromwell Crocker. 38, do. Antonio and Valentine 5, Broad Street Place Aërated Bread Co., Ltd. Ostacchini, trading as 14, do. Richards Mills & Co., Ltd. Ostacchini and Son. Broad Street Station Aerated Bread Co., Ltd. 74, do. Bartolomeo Zaccarini. 4, Broadway Percy Robson. 74, Copthall Ave.(Throg-morton House) Florence Le Breton. 7, do. J. Lyons and Co., Ltd. 35, Bucklersbury J. Lyons and Co., Ltd. 8, Copthall Avenue Alexander Hampton 2, Budge Row Jane Anderson Carnegie. 10 & 12, do. J. Lyons and Co. Ltd. 20, do. J. Lyons and Co., Ltd. 15, do. James William Davis. 24, do. John Toulson Gardner 28, Copthall Avenue Pietro Bezchizza. 30, do. "J.P." Restaurants, Ltd. 29, do. The Capital & Counties 9, Bull's Head Passage Pasquale Cocchi. Cafés, Ltd. 12, do. Charles Giles and William 9, Cornhill Aerated Bread Co., Ltd. Gowell. 7, Cripplegate Buildgs. Aerated Bread Co., Ltd. I, Burgon Street Vincent Infanti. 7, Crooked Lane John Morgan Jones. 1, Bury Street Express Dairy Co., Ltd. Crown Court (Old J. Lyons and Co., Ltd. 9, Byward Street Aerated Bread Co. Ltd. Broad Street) 40/2, Cannon Street Aerated Bread Co., Ltd. 2, do. Henry Charles Bainbridge. 44, do. J. Lyons and Co., Ltd. 13, Crutched Friars Express Dairy Co., Ltd. 49, do. J. Lyons and Co., Ltd. 7, Cullum Street Antonio and Michele Precha. 50, do. Slaters, Ltd. 16, do. Luigi Cattini. 51, do. Aerated Bread Co., Ltd. 6 , do. Egisto Landi. 86, do. Aerated Bread Co., Ltd. 14, Cursitor Street Martha Kersey. 91, do. W. Hill and Son, Ltd. 3/5, Devonshire Street Louise Mary Pearce. 95, do. Aerated Bread Co., Ltd. 8, do. Mitchell's Dining Rooms, 99, do. J. Lyons and Co., Ltd. . Ltd. 139, do. London Café Co., Ltd. 7, Dorset Street Guiseppe Indaco. 145, do. Ye Mecca, Ltd. 5, Dove Court (Old Mary Ann Donnelly. 147, do. Aerated Bread Co., Ltd. Jewry) 153 & 155, do. " J.P." Restaurants, Ltd. 3, Dowgate Hill Gaetano Parascandolo. Cannon St. Station Aerated Bread Co., Ltd. 2, Duke Street .. Pasquale Ruocco. Approach 12, do. Frank Dyson. 3 & 4, Camomile Street "J.P." Restaurants, Ltd. 41, do. Francesco Bardinni. 36, do. Luigi Cattini. 50, do. Joseph Alexander Williams. 36a & 37, do. Henry Douglas Fletcher. 5, Eastcheap Aërated Bread Co., Ltd. 46, Carter Lane Albert George Bodenham. 15, do. Ye Mecca, Ltd. 54, do. Reuben Josephus Phillips, 28, do. Aërated Bread Co., Ltd. trading as W. H. Knapp 35, do. J. Lyons and Co., Ltd. and Co. 39, do. Eastcheap Café, Ltd. 57a, do. James Burgess. 49 & 51, Eastcheap, "J.P." Restaurants, Ltd. 81, do. William Henry Overhill. (Ceylon House) 12, Carthusian Street Helen F. Higgins. 16, Eldon Street J. Lyons and Co., Ltd. 60, Charles Street George William Copeland. 18, do. Bartolomeo Cattini. 25, Castle Street Bernardi Pellegrenetti. 22, do. Pasquale Palumbo 18, Charterhouse Street "J.P." Restaurants, Ltd. 25, do. "J.P." Restaurants, Ltd. 23, Cheapside J. Lyons and Co., Ltd. 5, Falcon Square Price's Restaurants, Ltd. 26, do. Slaters, Ltd. 56, Fann Street Celeste Ostacchini. 41, do. Ideal Restaurants, Ltd. 59/60. do. Celeste Ostacchini. 49, do. J. Lyons and Co., Ltd. 32, Farringdon Street Arthur Atkins. 51, do. Aerated Bread Co., Ltd. 33, do. Friern Manor Dairy Farm, 66, do. Tiffin, Ltd. Ltd. 74/5, do. Slaters, Ltd. 39, do. " J.P." Restaurants, Ltd. 77, do. Aërated Bread Co., Ltd. 40, do. " J.P." Restaurants, Ltd. 114, do. London Kaaba Tea and 62, do. David and Robert Jones. Coffee Co., Ltd. 65, do. Amerighi Guilio. 128, do. J. Lyons and Co., Ltd. 67, do. Lewis Bertram Heyward. 136, do. Williamsons, Ltd. 70/1, do. Geo. Jas. and Arthur J. 140, do. Ye Mecca, Ltd. Silverlock. 150, do Aërated Bread Co., Ltd. 73, do. Gertrude Rickenbach. 7, Clark's Place Jessie Annette Knowles. 79, do. Edwin John Ridout. 2, Cloak Lane Romulatto Mansi. 87, do. Peter Zanchi. 20, Cloth Fair William Mortimer Phelan. 88, do. Frederick Philipp Weinel. 22, do. Arthur Burtwell. 1, Fen Court Rose Greenaway. 19, Cock Lane Jane Jones. 2, do. Aërated Bread Co., Ltd. 138 Premises. Person Registered. Premises. Person Registered. 1, Fenchurch Buildings " J.P." Restaurants, Ltd. Freeman's Court, Cheap- Arthur H. Hill, Margaret 15, Fenchurch Street Aërated Bread Co., Ltd. side. Hale, and Alice George 30, do. Aerated Bread Co., Ltd. trading as Free and Co. 31, do. J. Lyons and Co., Ltd. 31, Friday Street Amy Roth and Bessie Lathom, 47, do. , The Cabins, Ltd. • 65, do. Aërated Bread Co., Ltd. 51, do. j Fuller's, Ltd. 4, Furnival Street Food Reform Co., Ltd. 62, do. Aërated Bread Co., Ltd. 11, Garlick Hill Walter Robert William 81, do. Joseph Oapella. Marchant. 99, do. Aërated Bread Co., Ltd. 12, George Yard Callard, Stewart and Watt, 107, do. " J.P." Restaurants, Ltd. Ltd. 161, do. Maynards, Ltd. 3, Godliman Street Antonio Donatantonio. 164, do. Slaters, Ltd. 12, do. Bartolomior Fabrizi, trading 1, Railway Approach J. Lyons and Co., Ltd. as Bartolomio Fabrizi Fenchurch St. Station Henry Christian Thomas and Co. Amendt. 21, do. Express Dairy Co., Ltd. 19/20, Fetter Lane "J.P." Restaurants, Ltd. 8, Gough Square William Lloyd. 31, do. Morgan Jones. 31, Gracechurch Street Fullers', Ltd. 33, do. Joseph Pratt. 33, do. Aërated Bread Co., Ltd. 42, do. Genoroso Sarastano. 41, do. Maynards, Ltd. 44/5, do. Stewart and Wight, Ltd. 51, do. J. Lyons and Co., Ltd. 57, do. Thomas Sydney Quatermass 72/3, do. J. Lyons and Co., Ltd. 83, do. Mary Harris. 77/78, do. London Café Co., Ltd. 145, do. Rafaelo Cattini. 79, do. Charles John Haag. 1, Finsbury Pavement Bartolomeo Zaccarini. 119, Gravel Lane, William Cambridge. 73, do. Aërated Bread Co., Ltd. Houndsditch. Electra House, Finsbury Henry Phillips. 1, Great New Street Sarah Amelia Barnsley. Pavement. 12, do. Maria J. L. Kersey. Finsbury Pavement J. Lyons and Co., Ltd. 15, Great St. Helen's Luigi Necchi, trading as House. Necchi and Co. 13, Fish Street Hill Guileo Barbieri. 31, do. Rose Malyon. 34, do. Frederick Lewindon. " Crosby House," Great Ye Mecca, Ltd. 37, do. Pasqualino Palumbo. St. Helen's. 2, Fishmongers' Alley Mary Jones. 12, Great Swan Alley G. Payne, J. J. Rawlings, 16, Fleet Street John Toulson Gardner. trading as Sarah Rawlings 23, do. J. Lyons and Co., Ltd. and Co. 61, do. J. Lyons and Co., Ltd. 14, Great Tower Street Stewart and Wight, Ltd. 62, do. Matteo Mansi. 17/8, do. Aerated Bread Co., Ltd. 109, do. Lockharts, Ltd. 24/25, do. Express Dairy Co., Ltd. 116, do. Aerated Bread Co., Ltd. 28, do. Antonio and Michale Precha, 131, do. Express Dairy Co., Ltd. 47, do Joseph Mariani. 145, do. Fuller's, Ltd. 58, do. Joseph James Medcalf. 147, do. Agusto Missaghi. 74, do. J. Lyons and Co., Ltd. 167, do. Cabins, Ltd. 78, do. Callard, Stewart and Watt, 173, do. J. Lyons and Co., Ltd. Ltd. 175, do. Luigi Di Lieto. 96, do. London Clerks'Café Co., Ltd. 182/3, do. "J.P." Restaurants, Ltd. 100, do. Francisco Arpino. 190, do. Aërated Bread Co., Ltd. 1, Gresham Street Aërated Bread Co., Ltd. 30, Fleet Lane Salvatore Ferrigno. 1, do. Friern Manor Dairy Farm, 31, do. Albert Edwin Derry. Ltd. 17, Fore Street J. Lyons and Co., Ltd. 3, do. Ye Mecca, Ltd. 28, do. Ellen Hannah Child. 5, do. Celeste Alzapiedi. 50/51, do. Ye Mecca, Ltd. 11, do. John Salter Williams. 54, do. J. Lyons and Co., Ltd. 46, do. J. Lyons and Co., Ltd. 56/7, do. Aerated Bread Co., Ltd. 54, do. Ye Mecca, Ltd. 66, do. Arthur Reginald Staines. 69, do. Aërated Bread Co., Ltd. 70, do. Alfonso Pinto. 87, do. Express Dairy Co., Ltd. 84, do. Lockharts, Ltd. 93a, do. Raffaele Ferrara. 90, do. Rafaele Ferrara. 12, Grocers' Hall Court Timothy Jones. 98, do. Romulatto Mansi. 8, Gunpowder Alley John William Page. 108, do. Elizabeth Charlotte Collett. 9, Harp Lane . Alfonso Samarco 112, do. Elizabeth and Rosa Osborn. 12, do. Frederick C. H. Coles. Williamsons, Ltd. 2, Foster Lane Celestino Conti. 21, do. Aërated Bread Co., Ltd. 9/10, do. John Salter Williams. 114/5, do. Aërated Bread Co., Ltd. 41, do. Arthur H. Hill, Margaret 144, do. Luigi Rattazzi. Hale, and Alice George, 145, do. Slaters, Ltd. trading as Free and Co. 1/2, Holborn Viaduct Aërated Bread Co. Ltd. 139 Premises. Person Registered. Premises. Person Registered. 14, Holborn Viaduct J. Lyons and Co., Ltd. 6, Leadenhall Street J. Lyons and Co., Ltd. 43, do. Fullers, Ltd. 24, do. J. Lyons and Co., Ltd. 65, do. Express Dairy Co., Ltd. 27, do. Slaters, Ltd. 1, Honey Lane Market Dominico Cavalli. 64, do. J. Lyons and Co., Ltd. 4, do. J. Lyons and Co., Ltd. 67, do. William Henry Neal. 9, do. John Thomas Gow. 92, do. Celistino Bertolini. 10, do. John Thomas Gow. 96/98, do. Aërated Bread Co., Ltd. 1, Hosier Lane David Morgan. 101, do. Ye Mecca, Ltd. 1, Houndsditch Giovanni Devincenzi. 106, do. Aerated Bread Co., Ltd. 52, do. Ulisse Pellicci. 140, do. Aerated Bread Co., Ltd. 90, Houndsditch Luigi Cattini and Bartolomeo 9, Lime Street " J.P." Restaurants, Ltd. Beschizza. 15a, do. Express Dairy Co., Ltd. 105, do. Luigi Cattini. 23, do. J. Lyons and Co., Ltd. 118, do. Thomas Benjamin. 24, do. Ye Mecca, Ltd. 1, Huggin Court Emma Watts. 26, do. Aërated Bread Co., Ltd. 10, Huggin Lane Daniel Jones. 29, do. Lozzaro Cattini. 19, Hutchison Avenue Joseph Falk. 34, do. Agnes Powell. 13, Hutchison Street Isidore Spivakoff. 49, do. Elien Gwendoline Vaughan. 15, do. Jacob and Leah Miller. 53, do. Ernesto Rosati. 36, Hutton Street Alfred Ernest Reeve. 17, Little Britain Sarah Page. 3, Imperial Arcade Friern Manor Dairy Farm, 19, do. Express Dairy Co., Ltd. Ltd. 25, do. Mary Ann Davies. 10, Ironmonger Lane Henry Francis Hardy. 33, do. Welford and Sons, Ltd. 20, do. Dora Dee. 54, do. Guiseppe Fazzani. 27, do. London Kaaba Tea and 2, Little College Street Alice Maud Turner. Coffee Co., Ltd. 6, Little Trinity Lane Agnes Howat. 14, Ivy Lane Francesco Ferrigno. 18, do. Ettora Ferrari. 18, do. Andrea Proto 37, Liverpool Street David Lowrie. 22, do. Thos. Daniel Bishop. Liverpool Street H. C. T. Amendt. 39, Jewin Crescent Pietro Damiani. Station. 6, Jewin Street E. Seton Karr. Liverpool Street Station Express Dairy Co., Ltd. 9, do. J. Lyons and Co., Ltd. (Metropolitan Rail- 24, do. Margaret A. S. McFarlane, way). trading as Geo. McFarlane 4, Lombard Court Ye Mecca, Ltd. and Co. 5, Lombard Street Aerated Bread Co., Ltd. 28, do. Express Dairy Co., Ltd. 57, do. Aerated Bread Co., Ltd. 31, do. " J.P." Restaurants, Ltd. 319, London Central Lockharts, Ltd. 8, Jewry Street John Jones. Markets. 32, do. Angelo Beschizza. 332, do. Cream Dairy Co., Ltd. 12, John Street William Alston. 3, London House Yard. Giorgio Beschizza and Luigi 32, King Street Aërated Bread Co., Ltd. Schia. 8, King William Street Slaters, Ltd. la, London Street Friern Manor Dairy Farm, Ltd. 34, do. J. Lyons and Co., Ltd. 4, do. Carlo Croci. 37, do. Francisco Arpino and Alfonso 8, do. Ideal Restaurants, Ltd. Mariani. 19, do. Aërated Bread Co., Ltd. 44, do. Aërated Bread Co., Ltd. 34, London Wall Andrew Glendinning. 51, do. J. Lyons and Co., Ltd. 46/7, do. J. Lyons and Co., Ltd. 61, do. J. Lyons and Co., Ltd. 49, do. Ye Mecca, Ltd. 64, do. Aërated Bread Co., Ltd. 55, do. " J.P." Restaurants, Ltd. 25a, Kinghorn Street William Phelan. 58a, do. Express Dairy Co., Ltd. King's Arms Yard Ye Mecca, Ltd. 151, do. (Salis- Aërated Bread Co., Ltd. 29/33, Knightrider Street John Liddiard Evans and bury House). Arthur George Evans, 55, Long Lane Charles Sach. trading as John Evans 77, do. Francis Arthur Lester. and Co. 80, do. Luigi Migliorina. 44, do. Antonio Donatantonio. 85 do. Benjamin Rees. 48, do. William Adamson. 56, Lower Thames St. Herbert Child. la, Laurence Pountney Walter James Skevington. 75, do. Thomas Deacon. Hill. 129½, do. Franks Bottilieri. 1, Laurence Lane Angelo Beschizza. 1, Ludgate Arcade Vincent Ferrara. 38, Leadenhall Market Arthur H. Hill, Margaret 5, Ludgate Circus J. Lyons and Co., Ltd. Hale, and Alice George, 1, Ludgate Circus Slaters, Ltd. trading as Free and Co. Buildings. 40, do. Lewis Thomas Owen and 10/12, Ludgate Hill J. Lyons and Co., Ltd, Percy John Randall. 21, do. J. Lyons and Co., Ltd. 50, do. Henry George Saunders. 29, do. Aërated Bread Co., Ltd. 54/5/6, do. Lewis Dowling. 38, do. Aërated Bread Co., Ltd. 4, Leadenhall Street Aerated Bread Co., Ltd. 54, do. Express Dairy Co., Ltd. 140 Premises. Person Registered. Premises. Person Registered. 56, Ludgate Hill Ye Mecca, Ltd. 97, Newgate Street Carlyle Café Co., Ltd. 74, do. J. Lyons and Co., Ltd. 122/3, do. Peter Diviani. Ludgate Hill Station J. Lyons and Co., Ltd. 5, New Street Square Spottiswoode and Co., Ltd. 6, Maidenhead Court Michele Ruocco. 44, Noble Street Antonio Ostacchini. 14, Maidenhead Court William John Palmer. 19/20, Old Bailey Lockhart's, Ltd. 20, do. John Edwin Gardner. 59, do. Guilio Pagano and Luigi 9/10, Mark Lane Leonard Ronaldson Church. Di Lieto. 48, do. Liverpool China and Indian 33, Old Broad Street Aerated Bread Co., Ltd. Tea Co., Ltd. 40, do. Aerated Bread Co., Ltd. 69/70, do. Ye Mecca, Ltd. 2, Old Change Andrea Marroni. 73, do. Carlo Croci. 13a, do. "J.P." Restaurants, Ltd. 78, do. Express Dairy Co., Ltd. 6, Old Jewry The Cabins, Ltd. 80/81, do. J. Lyons and Co., Ltd. 33, do. Katherine Mellisle. Mark Lane Station J. Lyons and Co., Ltd. 2, Pancras Lane Frederick Walter Hicks. 3, Mason's Avenue Italo Ferrari. 3, do. Frederick Walter Hicks. 36a, Milton Street Hugh David Pugh. 3, Paper Street Albert Intrepidi. 46, do. Bartolomeo Callagari 5/6, Paternoster Row " J.P." Restaurants, Ltd. 71, do. Gertrude Miriam Gentry. 12, do. Giovanni Strinati. 76, do. Charles and Frank Perrin. 60, do. J. Lyons and Co., Ltd. 83, do. James Charles Blackgrove. 8, Philpot Lane Alberti Intrepidi. 16, Mincing Lane Luigi Cattini and Giorgio 14, do. Luigi Cattini and Georgio Beschizza. Beschizza. 17, do. London Café Co., Ltd. 22, do. Alfred Walter Bennett. 30, do. Slaters, Ltd. 5, Pilgrim Street Joseph Mariani. 2, Minories "J.P." Restaurants, Ltd. 21, do. Galvani Andrea. 99, do. Walter Bugden. 32, do. Priori Oreste. 136, do. Elizabeth King. 34, do. Aërated Bread Co., Ltd. 155, do. William McGavin Reid. 31, Poultry. J. Lyons and Co., Ltd. 9, Mitre Street Henry William Richards. 35, do. Andrew Glendinning. 10, Monkwell Street Olimpio Pietroni. 1, Queenhithe Albert Ashlee. 40½, do. Margaret Blott. 10, Queen Street J. Lyons and Co., Ltd. " Monument Dairy," Frederick Lewindon. 40, do. Egidio Fabrizi. Monument Street. 70, do. Fredk. Chas. Weidig, trading Monument Station The Ideal Restaurants, Ltd. as Weedon Bros. 43, Moor Lane Bartolomeo Carreta. 71, do. Lockharts, Ltd. 9, Moorfields Romuloto Mansi. 81, do. Constantine Necchi and 11, do. Dominico Santoro. Raffale Cattini. 28, do. Express Dairy Co., Ltd. 85, do. Ellen Claire Aveline. 19, Moorgate Street Alexander Hampton. 7, QueenVictoria Street Express Dairy Co., Ltd. 28, do. Aerated Bread Co., Ltd. 17, do. J. Lyons and Co., Ltd. 37, do. J. Lyons and Co., Ltd. 24, do. Joseph Beebe. 40, do. Cabins (1901), Ltd. 35a, do. Raffaele Ferraro. Moorgate Station Cham- Express Dairy Co., Ltd. 105, do. "J.P. Restaurants, Ltd. bers. 115, do. Lockharts, Ltd. 2, Moorgate Station Fullers, Ltd. 130, do. Aerated Bread Co., Ltd. Buildings. 143, do. J. Lyons and Co., Ltd. 7, do. Aerated Bread Co., Ltd. 148b, do. Antonio Infanto. 1, New Basinghall St. "J.P." Restaurants, Ltd. 175, do. Seton and Co., Ltd. 4, New Bridge Street "J.P." Restaurants, Ltd. 177, do. Aerated Bread Co., Ltd. 13, do. J. Lyons and Co., Ltd. 9/10, Redcross Street J. Lyons and Co., Ltd. 40, do. Aërated Bread Co., Ltd. 23, Rood Lane Rose Malyon. 44, do. David Stewart. 2/4, Ropemaker Street John Pearce. 3, New Broad Street J. Lyons and Co., Ltd. 12, Rose Street Silvio Peretti. 4b, do. The Capital & Counties Café 19, St. Bride Street Express Dairy Co., Ltd. Co., Ltd. 35, do. Stewart and Wight. 13, do. Richard Charles, trading as 3/4, St. Martin's Court "J.P." Restaurants, Ltd. R. Charles and Co. 15, St. Mary Axe Harry Byford. 13a, do. Lockharts, Ltd. 21, do. Ye Mecca, Ltd. 16, do. Aerated Bread Co., Ltd. 33/5, do. Slaters, Ltd. 28, do. W. Hill and Son, Ltd. 34, do. Express Dairy Co., Ltd. 64, do. Aerated Bread Co., Ltd. 45, do. Aerated Bread Co., Ltd. 9, Newbury Street George Smith. 49, do. J. Lyons and Co., Ltd. 2, Newgate Street J. Lyons and Co., Ltd. 65/66, do. Overhills, Ltd. 16, do. Ernest Salusbury Price. 18, St.Paul's Churchyard " J.P." Restaurants, Ltd. 18, do. Slaters, Ltd. 53, do. Nicholson's, Ltd. 24, do. Aerated Bread Co., Ltd. 61, do. J. Lyons and Co., Ltd. 33, do. "J.P." Restaurants, Ltd. 68a, do. Fullers, Ltd. 87, do. J. Lyons and Co.,. Ltd. 75, do. Callard, Stewart and Watt, Ltd. 141 Premises. Person Registered. Premises. Person Registered. 80, St. Paul's Churchyard J. Lyons and Co., Ltd. 194, Upper Thames Street Robert Cooper. 82, do. Giorgio Beschizza. 206, do. Angelo Cioffi. St. Paul's Station J. Lyons and Co., Ltd. 217, do. Cosimo Palladino. 30/1, St. Swithin's Lane Aerated Bread Co., Ltd. 223, do. Price's Restaurants, Ltd. 135a, Salisbury Court Matteo Mansi. 224, do. Robert Cooper. 19, Sherborne Lane Edward William Davies. 1, Walbrook Fullers Limited. 3, Ship's Tavern Passage Friern Manor Dairy Farm, 4, do. J. Lyons and Co., Ltd. Ltd. 10/11, do. Antonio and Michele Precha. 3b, Shoe Lane Gerado Indaco. 14, do. Ye Mecca, Ltd. 35/6, do. " J.P." Restaurants, Ltd. 19/20, do. J. Lyons and Co., Ltd. 96, do. Edwin John Ridout. 34, do. Aerated Bread Co., Ltd. 98, do. Mrs. Laura Williams. Warnford Court Aerated Bread Co., Ltd. 109, do. Edwin Stanley Baker. 22, Water Lane (Gt. Egisto Landi. 110, do. Priori Oreste. Tower St.) 112, do. Henry Wallwork. 2, Water Lane) Black- Price's Restaurants, Ltd. 113, do. Simeon Northam. friars). 25, Silver Street Virgilio Zaccarini. 4, Water Lane (Black- Samuel Thomas Withers and 27, do. Percy Toulson Gardner. friars). William Henry Meadway. 1, Star Alley, Fen- William Walter Knight. 5, Water Lane (Black- Priori Oreste. church Street. friars). 18, South Place Romualatto Mansi. 7, Water Lane (Black- " J.P." Restaurants, Ltd. 6, Stoney Lane Pasquale Manno. friars). 23, do. Henry Jones. " Aldermary House," Ye Mecca, Ltd. 29, do. Alfred Garcia. Watling Street. 46, do. Abraham Isaacs. 73, Watling Street Lockharts, Ltd. 3, Talbot Court Giovanni Ferrari. 57a, West Smithfield J. Lyons and Co., Ltd. 1, Telegraph Street Giovanni Rolle. 25, White Street Mary Ann Keeble. 17/8, do. J. Lyons and Co., Ltd. 31, Whitecross Street Robert Douglas. — do. Ye Mecca, Ltd. 5, Whitefriars Street Vincenzo Mansi. 1, Three Tuns Passage, Annie McKay. 24, do. Guiseppe Indacco. Ivy Lane. 27, do. William Thomas Lewis. 27, Throgniorton Street J. Lyons and Co., Ltd. 36/38, do. Lockharts, Ltd. 29, do. Aërated Bread Co., Ltd. 1, Whittington Avenue Ye Mecca, Ltd. 6, Tudor Street John Pantalone. 7, do. Callard, Stewart and Watt, 10, do. Frank Gowlett. Ltd. 14, do. Walter Thomas Beames. 10, do. Antonio Cattini. 32, do. Fanny Payne. 12, Widegate Street Edward Albert Withrington. 3, Union Court, Old Express Dairy Co., Ltd. 25, Wood Street J. Lyons and Co., Ltd. Broad Street. 42/43, do. Cabins (1901), Ltd. do. Ye Mecca, Ltd. 78, do Nunzio Allocca. 8, Union Row, Lockharts, Ltd. 80, do. Ye Mecca, Ltd. Minories. 130, do Express Dairy Co., Ltd. 57, Upper Thames Street George Chitty. Wool Exchange Callard, Stewart and Watt, 99, do. The City Catering Co., Ltd. Ltd. 104, do. John Morgan Jones and 19, Wormwood Street Guilio Barbieri. William Jones, trading as 22, do. Aerated Bread Co., Ltd. Jones Brothers. 36, do. Turino Castignetti. 105, do. Ercole Farnese. 38, do. " J.P." Restaurants, Ltd. 138, do. Stewart and Wight, Ltd. 2, Wrestler's Court David Thomas. 172, do. George Chitty. With Dr. HOWARTH'S Compliments. PUBLIC HEALTH DEPARTMENT, GUILDHALL, LONDON, E.C.