REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON For the Year 1914. BY WILLIAM J. HOWARTH, M.D., D.P.H. medical officer of health of the city of london. LONDON: Printed by Chahi.es Skipper & East, 49, Great Tower Street, E C 1915. INDEX. page Annual Rateable Value 12 Apples—Spraying with Insecticide 46 Area 11 Artizans' Dwellings 49 Atmospheric Pollution 67 Births 13 Butter and Margarine Act, 1907 116 Caretakers' Dwellings—Inspection of 41 Cemetery, City of London—Cremations 47 Children's Country Holidays 46 Cloth Fair Improvement Scheme 42 Common Lodging-House—1)6, Middlesex Street 63 Courts—Limewashing of 65 „ —Summer Flushing of 65 Dairies, Cowsheds and Milkshops Orders 105 Deaths Registration and Burial Bill 56 „ In City Institutions 15 „ from Violence 17 Density 11 Diarrhcea—Prevention of 31 Disinfectants 52 Disinfection, &c., at City Mortuary 51 Disinfection of Conveyances after Carrying Cases of Infectious Disease 52 Drainage Plans 64 Enteric Fever and Oysters 33 „ „ „ Periwinkles 32 Examination of Milk for Tuberculosis 34 Examinations for Pathogenic Bacteria 40 Exhumation and Re-interment at City of London Cemetery 49 Factory and Workshop Act, 1901 68 „ „ „ „ — Aboveground Bakehouses 71 „ „ „ „ —Kitchens of Restaurants 71 „ „ „ „ —Outworkers and "Home" Workers 82 „ „ „ ., —Sanitary Defects in Factories and Workshops Notified by H.M. Inspector of Factories 81 „ „ „ „ —Summary of Work in Factories and Workshops 77 „ „ „ „ —Underground Bakehouses 71 Fish Offal—Removal 66 „ Returns—Monthly 103 „ Supplies 102 Foot and Mouth Disease—Symptoms 33 Glanders 33 Hairdressers' Shops 66 House to House Inspection 41 House, Trade and other Refuse—Removal 65 Houses—Inspection of Tenements and Dwellings 41 Houses Let in Lodgings 61 Housing Problem—Conference 40 Human Remains—Removal—3, Frederick's Place, Old Jewry 66 Humane Slaughtering of Animals Bill 54 Ice Cream 104 Infantile Mortality 16 Infants' Milk Bill 53 Infectious Disease and Sanitary Defects 64 „ „ —Disinfection of Public Conveyance 52 „ „ —Notification of 20 Insecticides—Use of 46 Inspection of Food at Riverside Wharves, &c 104 Introductory Remarks 9 Legal Proceedings 65 Limewashing of Courts 65 Local Government Board—Proprietary Foods for Infant Feeding 59 London Housing Problem—Conference 40 Mansion House Council—Conference re London Housing Problem 40 Measles—Notification of 31 INDEX (continued). Page. Meat— Certification op Meat for Export to U.S.A. 96 „ —inspection 86 „ „ —Central Markets, Smithfield 101 „ „ —Diseased Meat Prosecutions 102 „ „ —Unsound Meat 100 „ —Public Health (Regulations as to Food) Act, 1907- Foreign Meat 97 „ —Senior Inspector's Report 87 „ „ „ „ —Aldg ate—Carcases and Quarters seized and Destroyed 93 „ „ „ „ —Aldgate Market and Slaughterhouses 92 „ ., „ „ „ —Organs Seized 94 ,, „ „ „ —Australian Meat 88 ,, „ „ ,, —Cold Stores 91 „ „ „ ., —Examination of Meat for Export 89 „ „ ,. , —Exportation „ 89 „ ., „ „ —Leadenhall Market and City Shops 90 „ „ „ „ —South American Beef 88 , „ „ „ „ „ Tongues 88 „ „ „ „ —Summary op Unsound Food Destroyed 95 „ „ „ „ —Tuberculosis in Central Markets 89 „ „ „ ,, —Visit of Veterinary Surgeon to Argentina 98 Medical Examination 116 Middlesex Street, 116—Common Lodging-house 63 Milk and Dairies Act 54 „ —Examination for Tuberculosis 34 „ Samples at Railway Stations 34 Mortality 13 „ —Infantile 14,16 Mortuary—Disinfection, Bodies Received and Inquests Held 51 Notification of Births Act, 1907 14 „ „ Infectious Diseases. 20 „ „ Measles 31 „ „ Ophthalmia Neonatorum 30 Overcrowding 64 Oysters and Enteric Fever 33 Population 12 Preservation of Bodies of Unknown Dead 52 Prevention of Epidemic Diarrhcea 31 Proprietary Foods for Infant Feeding—Report to Local Government Board 59 Public Health Legislation 52 „ (Ophthalmia Neonatorum) Regulations, 1914 30 „ (Sewers and Drains) Bill 55 „ (Tuberculoms) Regulations, 1912 22 Rag Flock Act, 1911—Suggested amendment 59 Railway Stations 65 „ —Samples of Milk at 34 Refuse Removal 65 Registered Lodging-Houses 61 Sale of Food and Drugs Acts and Public Health (Milk and Cream) Regulations- articles Examined 114 Butter 110 Drugs 111 Honey, Jam and Golden Syrup 111 Margarine 111 Milk 107 Other Groceries 111 Pickles and Sauces 111 Preservation of Milk and Cream 109 Prosecutions 102 Spirits 111 Warranty 112 Salvation Army Common Lodging House—116, Middlesex Street 63 Sanitary Defects and Infectious Disease 64 „ Inspections 59 „ Staff 6 Scarlet Fever 30 Shell Fish (Oysters) and Enteric Fever 33 „ (Periwinkles) and Enteric Fever 32 Small-Pox 29 INDEX (continued). Page. Smoke Abatement Bill 55 „ and Atmospheric Pollution 67 Street Gullies 64 Summer Flushing op Courts 65 Tenement Houses and Dwelling Houses—Inspection of 41 Tuberculosis Dispensary, City of London 24 „ —Notification of 22 „ —Notification to the London Insurance Committee of Deaths of Insured Persons 29 Underground Workrooms Bill 57 Vaccination Act, 1907 13 „ Act (Repeal) Bill 54 Vaccinations 13 Violent Deaths 17 Vital Statistics 17 Water Closet Bye-laws—Request to comply with 64 Water Supply 46 Wharves—Inspection of Food 104 Winkles and Enteric Fever 32 APPENDICES. page. Appendix A—Street Lists of Mortality 119 „ B— „ „ „ Infectious Diseases 121 „ C—Register of Houses let in lodgings or occupied by members of more than one family 123 „ D—List of Persons registered under the Dairies, Cowsheds and Milk Shops Orders 128 „ E—Export of Meat and Meat Food Products to the United States of America—Scheduled Forms of Certificates 134 P—Precautionary Measures which should be observed by Tuberculous Patients 139 SANITARY 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 Nov., 1909 CLERICAL STAFF. Lowe, George Sanitary Clerk Nov., 1902 Galloway, R. E. March, 1904 Gray, Charles M. March, 1911 Stephenson, F. H. (Meat Inspector's Office) Feb., 1909 Mellish, Cyril (Meat Inspector's Office) Feb., 1912 Harper, Joseph (Meat Inspector's Office) Jan., 1913 Bkckles, Virgine Jan., 1907 Pallett, Frank Nov., 1914 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 Robbins, 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 Davies, 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 LABOURERS. McDonnell, R. J. (General Duties at Mortuary) April, 1903 Adams, T. (Meat Shed) May, 1905 Lcdgate, G. (Meat Shed) Oct., 1906 PORTERS, CENTRAL MEAT MARKET. Potter, March, 1914 Strong, S. R March, 1914 REPORT OF MEDICAL OFFICER OF HEALTH OF THE CITY OF LONDON. 1914. ANNUAL REPORT THE MEDlCAL OFFICER OF HEALTH FOR THE YEAR 1914. To the Right Honourable the Lord Mayor, Aldermen and Commons of the Corporation of London. Public Health Department, Guildhall, E.C., 25th March, 1915. Gentlemen, I have the honour to submit herewith my Report as Medical Officer of Health of the City of London for the year 1914. The year has been marked by events which have affected the work of the Department, and the following brief particulars in this connection may possibly not be out of place in introducing the Report. The immediate result of mobilization was to reduce the Staff considerably. Many men had been engaged on Territorial duties for years, and subsequent to the declaration of war a number of others expressed a desire to join His Majesty's Forces. Permission was granted in these cases subject to the regulations laid down by the Corporation being observed. The name of each man who has left to join, together with a statement as to the office which he held under the Corporation and the branch of the service he has joined, are as under:— Name Office held Branch of Imperial Forces to which they are attached. T. Dunlop Young, M.R.C.V.S. Veterinary Surgeon Captain, R.A.V.S. J. Dunworth Sanitary Inspector Staff Sergeant, 1st City of London Sanitary Company R.A.M.C. R. E. Galloway Clerk Sergeant, 14th Battalion (London Scottish). C. E. Bintcliffe Meat Inspector Petty Officer, R.N. Air Service. G. King Assistant Meat Inspector - Seaman, R.N.V.R. R. S. Macdonald Disinfector Private, R.A.M.C. S. Murray Assistant Meat Inspector - Trooper, 3rd Scottish Horse. T. Penman Ditto Driver, Transport Section A.S.C. C. Slatter Meat Inspector Trooper, 2nd Warwickshire Yeomanry. R. S. Stanley Ditto Trooper, Westminster Dragoon Guards. F. Stephenson Clerk Rifleman, 3rd Battalion 9th County of London (Queen Victoria's Rifles). It is quite obvious that with such a depleted Staff some customary work would have to be left undone or assistance obtained to fill vacant places unless those who were left behind made considerable extra effort. This effort has been made and continues to be made most loyally by all who remain at their posts, and although some of what might be termed the refinements of Sanitary work have been put aside for the present, I am satisfied that no necessary work has been neglected, and that the public health has not suffered from the change. It has been found necessary to obtain a certain amount of clerical help, and a few temporary assistant meat inspectors recently have had to be appointed. This latter course could not be avoided, as the Staff is at its 10 irreducible minimum, and without some help no leave would be possible, which is most essential if men are to be maintained in a state of efficiency when working at high pressure over long periods. In the advertisement notifying these vacancies, an age minimum of 38 years was made, i.e., the maximum for military service, or if under that age then a cause of unfitness for military duties required to be submitted. Workshops.—In the early stages of the war there was some dislocation of trade, and it was anticipated that there would be a certain amount of distress. In this latter connection your Lady Inspectors carried out investigation work for the Prince of Wales' Fund, and brought to the notice of such Committees as that of the Sailors' and Soldiers' Families' Association, cases which would appear to require assistance. Considerable alteration was noticed later in certain trades. Many premises were rapidly adapted so as to enable Government Work to be undertaken, and instead of slackness there was extraordinary activity. In offices and in certain trades it was found that women had replaced men, or at any rate there was an increased number of women employed. Additional inspections were required by the changes; in some instances, to avoid overcrowding, and in others to ensure that adequate sanitary provision was made for the alterations in the Staff. The Home Office supplied me with a list of outworkers engaged on Army Contracts. Such places were placed on the list for more frequent inspections than would have been the case in normal times, and visits were made to houses where home work was being carried out. Food Supplies.—At intervals the Local Government Board has forwarded lists of firms who are engaged in supplying meat and food products to the Army. These places have all been subjected to weekly inspection and special supervision. The foods chiefly coming under observation were butter, cheese, bacon, hams, meat, prepared foods and the like. Refugees.—The Manchester Hotel, Aldersgate Street, was examined with a view to ascertaining its suitability for housing Belgian Refugees, and at a later date a Committee was formed which undertook the organisation and administration of the Hotel for this particular purpose. Some 500-600 beds were available. I believe my Department was able to offer many suggestions in the arranging of this building, and since it has been in actual use, various members of the Staff have been of service in giving advice of a special character, e.g., in respect of the control of infectious and contagious diseases, and of the allocation of work rooms and staff rooms. Help has been given in the disinfection of the clothing of inmates when first brought to the Institution, or who developed some infectious disease during the time they were resident there. Practically every patient is now fully protected against Small-pox, as those who did not show vaccination marks have been submitted to the operation of vaccination. Other refugees have been housed at the Salisbury Hotel. These did not come within the scope of regular enquiries; they have, however, at times been the subject of special enquiries. Red Cross Work.—Your Medical Officer of Health at the request of the Red Cross Committee gave assistance in designing, equipping, and staffing the hospital for the treatment of Officers which has been established at the Fishmongers' Hall, and since the opening has acted as Honorary Medical Administrator; his later duties being limited to those of advising in cases of medical administrative difficulties. 11 Several other buildings were inspected by him both within the City area and outside the county, and reports were made thereon to the Red Cross Committee. Billets.—Your Medical Officer of Health acts as Sanitary Supervisor of the City of London for the Military Authorities, and is responsible for supervising the sanitation of troops billeted therein. These billets have been inspected each week and the routine work has been under the direct supervision of the Inspector for the district in which the respective billets were located. A weekly report has been forwarded to the War Office in respect of this work. Wounded Soldiers.—At the request of the Wounded Allies' Relief Committee the Lord Mayor was requested to find provision for a number of wounded Belgian Soldiers in the earlier stages of the war. At His Lordship's instructions your Medical Officer of Health was able to arrange with the Authorities of St. Bartholomew's Hospital—with the concurrence of the War Office—that certain beds in that hospital should be used for those soldiers. The City of London Red Cross Ambulance Corps undertook the transfer of the patients from the station to the Hospital. Infectious Diseases.—Various memoranda have been issued by the Local Government Board outlining precautionary measures which should be adopted in respect of Small-pox, Cerebro-Spinal Fever, Cholera and Enteric Fever. Intimations in respect of contacts of each of these diseases have been received, the circumstances investigated, and action appropriate to the occasion has been taken. A carefully arranged scheme of co-operation between Military and Civil Sanitary services has been prepared, and the requirements therein set out have been duly observed. In addition formal official notes have been received respecting the important subjects of the nutrition of children under school age, and the existence of unemployment and distress among outworkers. Further orders relating to the necessity of ensuring the strict observance of the Factory and Workshop Act as to home work in connection with the manufacture of clothing for the Army have been issued. The above matters although referred to only in brief form have involved my Department in much increased responsibility, but as everyone has cheerfully accepted a share of the work, all has gone smoothly and no considerable difficulties are being experienced. I have hesitated about making any special reference to members of the staff, all of whom have worked well, but I do not think that the efforts of Mr. Sharp, who has acted as Chief Meat Inspector dnring the absence from duty of Mr. Young, should be allowed to pass without my favourable acknowledgment. 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 (1914). City of London, Registration District, at night 25.4 persons to an acre. „ „ „ „ during the day *547.3 „ „ Registration London, at night 60.4 „ * This figure refers only to persons "actively engaged in the City during the daytime," and is based upon a Census taken in May, 1911 12 ANNUAL RATEABLE VALUE. The rateable value of property within the administrative county of London (excluding the City) was £39,543,612 on 6th April, 1914—whilst on the same date the corresponding rateable value of property in the City of London was £5,798,001, or about one-eighth 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 Homes. 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. 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 37,705 301,584 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 17,129 at the middle of 1914, calculated on the last Census Returns:— St. Botolph 7,067 *St. Sepulchre and Allhallows 10,062 17,129 The Night population, therefore, of the City of London Registration District at the middle of 1914, is taken at 17,129, and it is upon this Bgure 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. * On the 1st April, 1901, the Middle Temple was transferred from the Strand Sub-District to St. Sepulchre and Allhallows Sub-District. 13 In 1903 it was ascertained that in the week ending 19th July no less than 347,463 vehicles passed to and from the four City bridges, viz.:— London, Southwark, Blackfriars and Tower, equivalent to upwards of 18,000,000 vehicles per annum. BIRTHS. During the year 1914, 4.50 births were registered in the City, 295 of which, however, did not belong thereto. To the remaining 155 must be added 16 children born to Citizens temporarily residing outside the City boundary. The number of births, therefore, on which the rate should be calculated is 171. The annual birth rate was 10.0 per 1,000 persons of all ages, compared with a quinquennial mean rate of 10.7 per 1,000. In the Metropolis the birth rate in 1914 was 24.3 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 464 births notified to the Vaccination Officers during 1914, 150 had been successfully vaccinated by the end of the year, 38 had died before the age for vaccination, and in no case was a child reported as insusceptible. Vaccination was postponed by medical certificate in 6 cases, 171 had removed into other districts, and 15 vaccinations were pending at the end of the year. There were 84 cases of ■conscientious objection. The Public Vaccinators performed 30 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. per cent. per cent. per cent. per cent. per cent. per cent. per cent. 1909 248 58.4 0.80 Nil. 9.6 5.4 16.5 8.8 1910 262 57.6 0.38 9.5 3.8 15.0 12.9 1911 410 37.5 0.24 8.2 3.4 38.7 11.9 1912 410 43.9 Nil 6.8 0.5 33.6 15.1 1913 402 33.6 0.25 8.8 1.9 41.1 14.5 Average previous 5 years 367 46.2 0.34 8.6 3.0 29.1 12.7 1914 464 32.3 Nil 8.2 1.2 40.1 18.2 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, 856 deaths were registered in the District, including 750 persons dying in the City, but not belonging thereto. See Table, p. 19, for details. 14 Deducting these latter, 106 deaths remain, to which must be added those of 125 persons who died in Institutions in outside districts, where they were registered; the total, therefore, on which the City death-rate is calculated is 231. The death rate for 1914 was 13.5 per 1,000 per annum of the population (the previous year being 14.5), whilst that for the whole of the Metropolis was 14.4. Death Rates, per 1,000 per Annum. Year. City of London. 97 Great Towns of England and Wales. Metropolis. 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 1913 14.5 14.7 14.2 Average previous five years 12.6 14.6 13.9 1914 13.5 15.0 14.4 The death rate from zymotic disease per 1,000 of the population was 0.53 compared with 0.21 in the Metropolis. The deaths from phthisis correspond to a rate of 1.2 per thousand of the population, as compared with 1.4 in the Metropolis, Infantile Mortality. The deaths of children under one year of age were at the rate of 100 per 1,000 births, as against 104 for the whole of London. The Table of infantile mortality on p. 16 shows the deaths of children under one year arranged according to monthly age periods. From this it will be seen that no less than 47.1 per cent. of these deaths occurred in the first month, and 76.5 per cent. within the first three months of existence. No deaths were recorded between the ages of three and six months. NOTIFICATION OF BIRTHS ACT, 1907. The work under the notification of Births Act has been continued. During the year, 163 births, which total includes eight still-births, were notified as belonging to the City. 326 other notifications not belonging to the City were received, and these were forwarded to the Medical Officers of Health of the respective districts. Of the 163 City Births:— 94 were notified by Medical Practitioners. 38 ,, „ by Hospital Authorities, &c. 19 ,, „ by Midwives. 12 „ „ by Parents. During the year, 276 visits were paid to homes to give instruction in the care and feeding of infants, and 412 attendances were made by the mothers at the City Shelter. Of the babies visited:— 81.7 per cent. were breast-fed. 10.3 „ were hand-fed. 8.0 „ were partly breast-fed and partly hand-fed. 15 To all necessitous nursing mothers the grant of one and a half pints of milk daily has been allowed for periods varying from one to six months; in certain exceptional cases arising out of conditions created by the War, the grant was continued for nine months. Forty-eight mothers received the allowance of milk under the scheme and these mothers were, as a rule, asked to attend the "Shelter" (a building in Golden Lane belonging to the Corporation) each Monday afternoon in order to have their babies weighed. In all cases improvement was noted. The scope of the work at the shelter has been increased, lectures on various subjects are to be given and classes for the making of underclothing for babies are to be held. In December the class for knitting was commenced. The mothers were greatly interested and pleased. They appreciate the fact that by making the garments themselves they will be able to provide their babies with warmer clothing at less expense than would be the case if they had to purchase it. The poorer mothers lack knowledge of many of the elementary rules of cooking, sewing and household management, and they are most grateful for any advice which will help them to improve their skill. Several necessitous families have been recommended for help from the poor-box, and thanks are due to Mr. Savill, Clerk to the Sitting Justices, and Mr. Douglas, Clerk to the Lord Mayor, for their kindness in assisting cases brought to their notice. In January a festive gathering was held at which about 70 mothers who had been visited during the previous year were present. A few encouraging words were spoken by former Chairmen of the Committee, viz.:—Rev. Clementi-Smith and Mr. Leo Taylor. The Chairman, Mr. B. T. Swinstead, was unable to be present, but it was announced that he had very kindly offered prizes to the mothers of the babies which had been best cared for during the year, all circumstances being considered. This resulted in great interest being evinced by the mothers during the year at the Monday afternoon meetings, and the progress and care taken of the respective babies were noted and commented upon. Deaths in City Institutions. During 1914, 79 citizens died in City Workhouses, Workhouse Infirmaries or Lunatic Asylums, or no less than 34.2 per cent. of the whole City mortality, the corresponding figure for the Metropolis being 45.7 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 1914, compared with the previous five years:— Year City of London. Metropolis. Per cent. Per cent. 1909 38.0 42.0 1910 34.6 43.3 1911 39.4 41.2 1912 26.9 43.3 1913 31.7 43.1 Average of previous five years 34.2 42.6 1914 34.2 45.7 16 (This Table is prepared in accordance with the requirements of the Local Government Board.) City of London. Infantile Mortality during the Year 1914. 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. Certified 4 1 2 1 8 5 ... 2 2 17 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... 1 1 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... ... ... ... ... 1 Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... 1 1 Abdominal Tuberculosis ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (wot Tuberculous) ... ... ... ... ... ... ... ... ... ... Convulsions ... ... ... ... 1 ... ... ... ... 1 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... ... ... ... ... ... Pneumonia (all forms) ... ... ... ... ... ... ... ... ... 1 Diarrhoea ... 1 ... ... 1 ... ... ... ... 1 Enteritis ... ... ... ... ... ... ... ... ... ... Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... Rickets ... ... ... ... ... ... ... ... ... ... Suffocation (overlying) ... ... ... ... ... ... ... ... ... ... Injury at Birth ... ... ... ... ... ... ... ... ... ... Atelectasis 1 ... ... ... 1 ... ... ... ... 1 Congenital Malformations ... ... ... ... ... ... ... ... ... ... Premature Birth 2 ... ... ... 2 2 ... ... ... 4 Atrophy, Debility and Marasmus 1 ... 2 ... 3 1 ... ... ... 4 Other Causes ... ... ... ... ... 2 ... ... ... 2 4 1 2 1 8 6 ... 2 2 17 legitimate 160 legitimate infants 16 Nett Births in the year Nett Deaths in the year of illegitimate 11 illegitimate infants 1 17 Deaths from Violence. Of the City deaths, 5.7 per cent. were caused by injuries or violence, as compared with 3.4 in 1912 and 2.8 in 1913. This is 1.3 above the average for the previous five years. PERCENTAGE OF REGISTERED DEATHS FROM VIOLENCE. Year. City of London. Metropolis. Per cent. Per cent. 1909 5.1 3.5 1910 5.7 4.0 1911 5.1 3.8 1912 3.3 5.9 1913 2.8 4.1 Average previous five years 4.4 4.3 1914 5.7 4.2 VITAL STATISTICS, 1914. City of London compared with, the Metropolis for the Year 1914 and the previous five years. City of London. Birth Rate. Death Rate. Deaths of Children under 1 year to 1,000 Births. Violent Deaths, per cent. of Deaths Registered. Death fromprincipal Zymotic Disease per 1,000 of the Population. Estimated Night Population (Imperial Census). Estimated Day Popu. lation(Corporation Census). City. Metropolis. City. Metropolis. City Metropolis. City. Metropolis. City. Metropolis. 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 0.18 1913 17,916 367,727 9.4 24.5 14.5 14.2 96 105 2.8 4.1 0.34 1.38 Average previous five years. 18,283 375,370 10.7 24.5 12.6 13.9 77 107 4.4 4.3 0.27 0.85 1914 17,129 369,384 10.0 24.3 13.5 14.4 100 104 5.7 4.2 0.53 0.21 * Figures not available. 18 (This Table is prepared in accordance with the requirements of the Local Government Board.) Vital Statistics of Whole District during 1914 and Previous Years. Name of District: CITY OF LONDON. Year. Population estimated to Middle of each Year. Uncorrected number. Birtbs. Total Deaths Registered in the District. Transferable Deaths.‡ Nett Deaths belonging to the District. Nett. Under 1 Year of Age. At all Ages. of Nonresidents registered in the District, † of Residents noi registered in the District, † Number, † Bate. Number. * Rate. Number. * Rate per 1,000 nett Births. Number. * Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 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 1914 17,129 450 171 10.0 856 49.98 750 125 17 100 231 13.5 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 be 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 directlv or through the County Medical Officer 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 fnrnish to the Medical Officer of Health a Statement of the number of births needing 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 (b) below. The Medical Officer of Health will state in Column 8 the number of transferable deaths of "non-regideuts" 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. (8) Deaths from Violence are to be referred (a) to the district of residence, under the general rule; (b) if this district is unkuown, 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 the body was found. Area of City of London Registration District in acres (land and inland water) 672.7 Total population at all ages Number of inhabited houses Average number of persons per house ** Figures not available. 19,657 2,784 7 At Census of 1911 (of. Census, Vol. V.). 19 (This Table is prepared in accordance with the requirements of the Local Government Board.) Causes of, and Ages at, Death during the Year 1914. Causes of Death. Nett Deaths at the subjoined auks op "Residents" whether occurring within or without the district. Total Deaths whether op "Residents" on " non- "Residents" in Institutions in the District. All ages Under 1 year. 1 and under 2 years 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upwards. All causes 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Certified 231 17 2 4 1 4 43 65 95 722 Uncertified ... ... ... ... ... ... ... ... ... ... 1. Enteric Fever 1 ... ... ... ... ... ... ... ... ... 2. Small-pox ... ... ... ... ... ... ... ... ... ... 3. Measles 1 1 ... ... ... ... ... ... 3 4. Scarlet Fever 1 ... ... ... ... ... 1 ... ... ... B. Whooping Cough 3 1 1 1 ... ... ... ... ... 4 6. Diphtheria and Croup 2 ... ... 1 ... ... 1 ... ... 16 7. Influenza ... ... ... ... ... ... ... ... ... ... 8. Erysipelas 1 ... ... ... ... ... ... ... 1 4 9. Phthisis (Pulmonary Tuberculosis) 19 ... ... ... ... 1 12 4 2 18 10. Tuberculous Meningitis 1 1 ... ... ... ... ... ... ... 18 11. Other Tuberculous Diseases 6 ... ... 1 1 ... 1 3 ... 14 12. Cancer, malignant disease 24 ... ... ... ... 1 1 8 ... 72 13. Rheumatic Fever 2 ... ... ... ... ... ... 2 ... 1 14. Meningitis ... ... ... ... ... ... ... ... 7 15. Organic Heart Disease 27 ... ... ... ... ... 6 6 15 37 16. Bronchitis 14 ... ... ... ... ... ... 4 10 16 17. Pneumonia (all forms) 16 1 1 ... ... ... 3 9 2 82 18. Other diseases of respiratory organs 2 ... ... 1 ... ... ... ... 1 14 19. Diarrhoea and Enteritis 1 1 ... ... ... ... ... ... ... 20 20. Appendicitis and Typhlitis 2 ... ... ... ... 1 ... ... ... 11 21. Cirrhosis of Liver 3 ... ... ... ... ... 1 2 ... 12 21a .Alcoholism 1 ... ... ... ... ... 1 ... ... 1 22. Nephritis and Bright's Disease 5 ... ... ... ... ... 1 3 ... 23 23. Puerperal Fever ... ... ... ... ... ... ... ... ... 7 24. Other accidents and di&eases of Pregnancy and Parturition ... ... ... ... ... ... ... ... ... 5 25. Cougenital Debility and Malformation, including Premature Birth 9 9 ... ... ... ... ... ... ... 28 26. Violent Deaths, excluding Suioide 9 ... ... ... ... 1 ... 5 ... 76 27. Suicide 4 ... ... ... ... ... 2 2 ... 6 28. Other Defined Diseases 73 ... ... ... ... ... 11 16 43 221 29. Diseases ill-defined or unknown 4 ... ... ... ... ... 1 1 2 7 231 17 2 4 1 4 43 65 95 722 SubEntries. 14. Cerebro-spinal Meniugitis ... ... ... ... ... ... ... ... ... ... 2S Poliomyelitis ... ... ... ... ... ... ... ... ... ... included in above figures. * * * 20 NOTIFICATION OF INFECTIOUS DISEASES. In the following Tables will be found particulars of infectious diseases 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. Small-pox 1 — 1 — — — — Diphtheria 36 1 14 6 8 6 I Scarlet Fever 101 — 60 18 2 19 2 Enteric „ 7 — 3 — 2 2 — Puerperal „ — — — — — — — Erysipelas 14 4 i — 6 4 — Cerebro-Spinal Meningitis — — — — — — — Acute Polio-myelitis and Polio-encephalitis — - — — — — — Ophthalmia neonatorum 4 3 — — — 1 — Totals 163 8 79 24 17 32 3 •Chicken-pox 22 21 — - — 1 - Totals 185 29 79 24 17 33 3 * 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, 163 Certificates were received, including 32 "duplicates," and three in which the diagnosis was subsequently found to be incorrect. The total number of cases of "notifiable infectious disease" was, therefore, 128, as compared with 88 for the previous year. The total number of cases of Scarlet Fever reported was 80, as compared with 45 last year. In Greater London the number of cases of Scarlet Fever has recently greatly increased; during one week, viz., seven days ended 17th October, no less than 876 cases were reported and more than †25,000 during the year 1914; as indicated in my report last year this increase has naturally 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 districts 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 to hospitals for treatment or nursed at home during 1914, compared with the figures for the previous five years — Year. Number of cases reported. Per cent, of cases-reported. Removed to Hospital. Treated at Home. 1909 67 82.1 17.9 1910 54 79.6 20.4 1911 67 83.6 16.4 1912 66 84.8 15.2 1913 88 94.3 5.7 Average for previous five years. 68 84.9 15.1 1914 128 93.8 6.2 † This figure is obtained by totalling weekly returns of the Metropolitan Asylums Board. The corrected figures for the year will be published by the Metropolitan Asylums Board in their printed report for 1914, which will probably be issued in August. 21 The majority of City residents have but little accommodation or convenience for the treatment 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 Enteric Fever was treated at home. Cases of Infectious Disease notified during the Year 1914. 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—Years. Under 1. 1 and under 6 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upwards. Small-pox 1 — — — — 1 — — 1 Cholera — — — — — — — — — Plague — — — — — — — — — Diphtheria (including Membranous Croup) 29 2 4 12 5 6 — — 28 Erysipelas 10 1 — — 1 2 2 4 5 Scarlet Fever 80 — 6 39 24 11 — — 80 Typhus „ - — — — — — — — 6 Enteric „ 5 - — 1 3 1 — — 5 Relapsing „ — - — — — — — — — Continued „ — — — — — — — — — Puerperal ,, — — — — — — — — — Cerebro-spinal Meningitis - — — — — — - — — Polio-myelitis - — — — — — — — — Pulmonary Tuberculosis 47 — — 2 14 16 12 3 26 Other forms of Tuberculosis 7 — — 4 1 2 — — 6 Ophthalmia Neonatorum 3 3 — — — — — — — Totals 182 6 10 58 48 39 14 7 157 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 64. No case of Cholera, Plague, Typhus, Relapsing, Continued or Puerperal Fevers, Anthrax, Cerebro-Spinal Fever or Epidemic Cerebro-Spinal Meningitis, Acute Polio-encephalitis or Polio-myelitis has occurred. * Metropolitan Asylums Board Hospitals, London Fever Hospital, City of London Infirmary, St. Bartholomew's Hospital, City Police Hospital, &c. 22 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. The Regulations for dealing with Human Tuberculosis have been referred to in previous reports; they deal with all cases of tuberculosis both of the lungs and when localised in other parts of the body. 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 21. 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 table indicates the several forms of notifications received, and whether they refer to males or females, together with particulars of the ages of the patients. This tabulation is required by the Local Government Board for the year commencing 4th January, 1914, and ending 2nd January, 1915:— 23 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 4th January, 1914, to the 2nd January, 1915, in the City of London. Age-periods Notifications on Form A. Notifications on Form B. † Number of Notifications on Form C. Number of Primary Notifications.* Total Notifications on Form A. Number of Primary Notifications.* Total Notifications on Form B. Poor Law Institutions. Sanatoria. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 15 to 55 55 to 65 65 and upwards Total Primary Notifications. Under 5 5 to 10 10 to 15 Total Primary Notifications. Pulmonary Males - - — 1 4 7 5 6 7 3 1 34 42 - - — Nil. Nil. Nil. 3 „ Females — — 1 — 2 1 1 4 1 1 2 13 16 — — — „ „ „ — Non pulmonary Males — — 2 — 1 - 1 1 — — — 5 5 — — — „ „ „ 1 „ „ Females — — 1 1 — - - - — — — 2 2 — - — „ „ „ — Col. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) Patients notified as suffering from both pulmonary and nun-pulmonary diseases have been included among the "pulmonary" returns only. All notifications on Form D have been disregarded in preparing this return. * Primary notifications relate to patients who have not previously been notified in this or former years, either on Form A or on Form B, in the area to which the return relates. Any additional notification of a case which has been previously notified in the area is regarded as duplicate. (Note.—No primary notifications should be made on Form C.) † A School Medical Inspector, or the Medical Officer of Health of a county, county borough, or other district, if acting as a School Medical Inspector, is required to notify on Form B all cases of tuberculosis discovered in the course of inspection of children attending public elementary schools whether or not these have previously been notified. Cols. 2-13. Only those cases which have been notified for the first time during the year on Form A in the area concerned, and which have never previously been notified in the area, either on Form A or on Form B, have been included in these columns. Col. 14. The object of this column is to show the extent to which duplicate notification of the same case occurs on Form A, and all notifications on Form A, whether duplicate or not, are included in this column. Cols. 15-18. Only those cases which have been notified for the first time during the year on Form B in the area concerned, and which have never previously been notified in the area, either on Form A or on Form B, have been included in these columns. Col. 19. All notifications which have been made during the year on Form B in the area concerned, whether the cases have previously been notified in the area, or not, either on Form A °r on Form B, have been included in this column. Col. 21. Only notifications on Form C made by the Medical Officers of Sanatoria, as defined in the Tuberculosis Regulations, have been entered in this column. 24 CITY OF LONDON TUBERCULOSIS DISPENSARY. The City of London Tuberculosis Dispensary at St. Bartholomew's Hospital, which was opened on the 3rd November last, will, I hope, prove of considerable value in combating the spread of consumption. The rapidity of development of the Dispensary is affected to a large extent by the degree of publicity which attends its establishment, and with the object of ensuring that as large a section of the public as possible were made aware of the facilities that were available the following action was taken. Communications were addressed to:— (1) The Press. (2) The several Exchanges throughout the City. (3) The National Union of Clerks. (4) The London Clerks' Association. (5) The various City Dispensaries. (6) The Ward Beadles. (7) The Ward Clerks. (8) The Vestry Clerks. (9) The Secretary, Cripplegate Institute. (10) The Secretary, Bishopsgate Institute. (11) The City Clergy. (12) The Registrar of Births, Deaths and Marriages. (13) The Occupiers of all Factories, Workshops and Workplaces throughout the City. (14) To Wharfingers and Occupiers of Houses and Dwellings, &c., throughout the City. (15) To Medical Men practising within the City. (16) And to the various City Dispensaries. These communications were accompanied by a pamphlet on the "Precautionary Measures which should be observed by Tuberculous Patients" (see Appendix F) and a printed notice signed by the Town Clerk drawing attention to the Dispensary. In addition to the above, communications were addressed to the County Councils, Metropolitan Borough Councils, and other Local Authorities situated within a radius of twenty miles of London. It is satisfactory to note that some of these Councils have appreciated the attitude adopted by the Corporation in this matter, and are giving publicity to the scheme. Notices drawing attention to the Dispensary have also been exhibited in prominent places throughout the City. 25 The Dispensary was formally opened on November 3rd by the Sanitary Committee of the Corporation. It is situated in the Out-patient Department of St. Bartholomew's Hospital, in rooms set apart by the Governing Body for that purpose, and is carried on separately from the usual work of the Hospital. It is administered by the Public Health Department of the Corporation, so that the work is co-ordinated with the public health work of the City. A medical officer has been appointed for the clinical work and the assistance of the honorary staff, as well as all the resources of the Hospital, are available for diagnosis and treatment. The Dispensary is at the present time open on Tuesdays and Fridays from 12.30 to 2.30 p.m.; but persons unable on account of their work to attend at these times are seen on Thursdays between 6 and 7 p.m. Residents in the City and non-resident workers therein are eligible, whether insured under the National Health Insurance Act or not. In all 36 persons presented themselves (17 were residents in the City and 19 were non-resident workers), and these made a total of 84 attendances. These figures only relate to the period November 4th to December 31st. Negotiations have been opened between the Corporation and the London Insurance Committee with a view to the latter body making a contribution towards the expenses incurred. In the next report fuller details of organisation and administration will be submitted. For the present it will suffice to state that the work is progressing smoothly and rapidly increasing. The following is the scheme as it has finally been adopted and approved by the various public bodies concerned:— TUBERCULOSIS DISPENSARY. ADOPTED SCHEME to Provide Treatment for Cases of Tuberculosis occurring among Persons resident in the City of London and Non-Residents who are Employed in the City of London. 1. The treatment of cases of tuberculosis affecting persons resident in the City of London and non-resident workers to be undertaken at St. Bartholomew's Hospital. 2. The treatment of patients under this Scheme does not include residential treatment. 3. The hospital will, in addition to providing facilities for the treatment of patients suffering from the various forms of tuberculosis, arrange for the examination of suspected cases and contacts. See Meno No. 1 below. 4. For the above purposes the hospital will arrange:— (a) That the full resources of the hospital shall be available for therapeutic and diagnostic purposes. (b) That a suitable room shall be provided in which patients shall be received. (c) That a medical man who would require the approval of the Local Government See Meno No.2 below Board, shall be placed in charge of the work, and that he shall also perform the duties as set out below. (d) That a nurse shall be specially delegated to help at the dispensary and also visit patients at their homes, and in addition perform such duties as are set out below. (e) That the services of the honorary staff shall be available when the Medical Officer in Charge requires additional professional advice and assistance and (f) That the necessary drugs, dressings, or other necessities for treatment, shall be provided by the hospital. (1.) These will only represent contacts and suspects actually engaged in work in the City, and not relatives at home. (2.) Not necessarily a whole-time man, but the Officer appointed shall not be engaged in general practice. 26 The Medical Officer in Charge of the dispensary will render the following services:— (i.) Undertake the treatment of persons resident in the City of London and non-residents working therein who may present themselves for treatment, subject to the rules of admission being observed. (ii.) Undertake the necessary clerical work which may be entailed by the keeping of records of patients, recording conditions observed on visiting the homes of patients resident within the City of London, and conducting the necessary correspondence. (iii.) Undertake the examination of "contacts" and "suspects." These examinations would usually take place at the dispensary, but he would be required to visit the homes of the patients resident within the City of London in cases where this was necessary. (iv.) Perform the duties of "Consulting Officer" within the meaning of the Order of the Local Government Board of 26th July, 1912, in respect of patients resident within the City of London. (v.) Report to any Insurance Committee requiring certificates, and attend the meetings of the London Insurance Committee when required to do so in his capacity as Consulting Officer. (vi.) Furnish such information in his possession as may reasonably be required by any practitioner attending patients who are also receiving treatment at the dispensary, (vii.) Furnish information respecting patients who have been under treatment at the dispensary to the Medical Officers of residential institutions. (viii.) Send information to the Medical Officer ot Health of the district in which the patient resides, whether or not the case needs to be notified by the Medical Officer of the dispensary under the Tuberculosis Regulations, in every case in which a tuberculous patient residing outside the City attends the dispensary. (ix.) Visit patients at their homes when requested to do so by the Medical Officer of Health. (x.) Furnish the Medical Offical of Health with such information as he may require, and prepare and submit to the Medical Officer of Health a monthly and Annual Report. (xi.) Act generally in respect of matters associated with the dispensary under the administrative supervision of the Medical Officer of Health, and call at his office not less than once in each week. See Meno No. 3 below The nurse attached to the dispensary will render the following services:— (i.) Attend at the dispensary at all times during which it is open to receive patients. (ii.) Assist generally the Medical Officer in Charge of the Dispensary. (iii.) Visit at their homes the patients resident within the City of London'who are under treatment at the dispensary for the purpose of ensuring that the instructions of the Medical Officer are being followed, and of ascertaining whether conditions prejudicial to the recovery of the patient exist therein. (iv.) Arrange for the examination of " contacts " and " suspects." (v.) Keep notes of her visits, and submit the same to both the Medical Officer of Health and the Medical Officer of the dispensary. (vi). Obtain for the Medical Officer of Health such information respecting patients as he may require. (vii.) Act generally under the directions of the Medical Officer of the dispensary in respect of work connected with the dispensary. (viii.) Call on the Medical Officer of Health not less than once each week. (3.) The nurse must be continuously engaged in this work. 27 GENERAL. The responsibility in respect of clinical matters will devolve entirely upon the Medical Officer in Charge of the dispensary. The dispensary will be open on two days in each week ; days and hours to be arranged later. See Memo No. 4 below Arrangements will be made for patients who require treatment at night, e.g., injections of tuberculin in the case of patients who may be engaged in the daytime. The Corporation to provide all forms required in connection with the work, and cabinets in which to keep the same. The Medical Officer of Health to have access to the dispensary at his pleasure. PERIOD OF AGREEMENT. This Scheme to be operative for twelve months in the first instance, and to be subject to renewal after a Conference between Representatives of the Corporation and the Governing body of the Hospital. PAYMENT. The Corporation will pay to the Governing Body of St. Bartholomew's Hospital a sum of not less than 500Z. and not more than 7001, per annum to cover all the above services during the first year. Appendix I. SUGGESTED RULES regulating the Admission of Patients to the DISPENSARY. In view of the fact that the Dispensary will only be available for the treatment of patients at certain fixed hours, it seems desirable that rules should be framed which will ensure to some extent that, in case of urgency, any patient who is undergoing treatment at the Dispensary will be able to obtain medical assistance during such hours as the Dispensary is not open. Even if the Medical Officer in charge of the Dispensary resided at the Hospital, it would not come within the scope of his duties to attend to urgent calls outside the hospital. Such duties would fall within the recognised sphere of a General Practitioner's activities. To provide, therefore, that assistance should always be available, I beg to suggest that some similar arrangement to the following might advantageously be made:— 1. All persons resident in the City of London or non-resident but working in the City shall be medically examined and receive treatment on the first occasion on which they present themselves at the Dispensary. 2. At such first visit, enquiry will be made of the patient as to whether he (or she) is— (a) An insured patient; (b) Under treatment as a private patient, or (c) Under treatment as a Poor Law patient. (4.) Must be mid-day. 28 3. In the event of his coming within one of the above three groups he will be given a card to take to his doctor. This card will indicate that it is proposed to continue the treatment at the Dispensary if the doctor approves. In many cases such treatment will be in addition to treatment by his doctor, as, for example, when he is receiving tuberculin injections at the Dispensary but continuing under systematic observation at home. The card will also indicate that the Medical Officer in charge of the Dispensary will supply the patient's private doctor with any information required so far as such may be within his knowledge; and, finally, the doctor will be asked to append his signature to the card to indicate his approval of the patient attending the Dispensary, and that he would respond to an urgency call just as he would have done had the patient not been so attending. 4. In the event of a person not being under the care of a practitioner, the card will be brought to the Medical Officer of Health, who will discuss the situation with the patient, and will endeavour to arrange that he (or she) may be included in one of the groups indicated in paragraph 2. Number of Patients treated at the Dispensary during the Months of November and December, 1914. NEW PATIENTS. Residents— Tuberculous. Not Tuberculous. Doubtful. Insured 7 3 2 2 Not insured 10 0 2 8 Non-Residents— Insured 14 3 1 10 Not insured 5 2 0 3 Total 36 8 5 23 36 ATTENDANCES. Residents— Tuberculous. Not Tuberculous. Doubtful. Insured 24 15 6 3 Not insured 15 0 2 13 Non-Residents— Insured 31 9 5 17 Not insured 14 6 0 8 Total 84 30 13 41 84 Sputa examined:—positive 8, negative 12. Total 20. Consultations:— With Physicians: several. With Surgeons: 1. Operations:—1. Patients recommended for admission to Sanatoria:—1. Persons presenting themselves, but found to be ineligible:—5. 29 NOTIFICATION TO THE LONDON INSURANCE COMMITTEE OF DEATHS OF INSURED PERSONS SUFFERING FROM TUBERCULOSIS. In connection with the establishment of the new measures taken to prevent the spread of Tuberculosis, the Corporation of London have been requested to furnish the London Insurance Committee with a periodical return of the deaths from Tuberculosis of insured persons within the City area. In return for this information the Committee have undertaken to notify me of cases of insured persons notified as suffering from Tuberculosis, but who, on examination by their experts, were found not to be so suffering. This interchange of information is in my opinion one of mutual advantage, and 1 was authorised by the Corporation to make the necessary arrangements for carrying the suggestion into effect. SMALL-POX. Until the year under review no case of Small-pox has occurred in the City of London since 1904, and the subjoined particulars may prove of interest. On the afternoon of Thursday the 19th February, at the request of the Medical man in attendance, I examined a man at one of the City Hotels, diagnosed Small-pox, and arranged for his removal to the Hospital. The room occupied by the patient, his personal property, the bedding and all articles in the room, together with the carpets on the entire ground floor, and the bedding of the two small rooms which opened out of the same lobby as the patient's room, were disinfected. The Hotel smoking room, dining room, &c., were thoroughly cleansed and a considerable amount of redecoration carried out throughout the building. The laundry used by the Hotel, which was situate in the Metropolitan Borough of Lambeth was notified, as was also the Medical Officer of Health for that District, and every precaution taken to prevent spread of infection by that channel. Names and addresses of all persons who might have been in contact with the patient were communicated to the Medical Officer of Health interested and the Local Government Board notified of the case. With one exception the employees at the Hotel were revaccinated, and all were kept under observation during the period of incubation. From the onset of his illness until he was removed to hospital in the Metropolitan Asylums Board ambulance, the patient had not left the Hotel. The patient, an Engineer, was a passenger on board the R.M.S.P "Avon" from Buenos Ayres. He joined the boat at Pernambuco which was the last Port of call on the Brazilian Coast. One of the passengers developed Small-pox and was landed at Vigo on the 5th February. As many of the passengers as consented were revaccinated and on the arrival of the vessel at Southampton all were again examined.. No further case was reported. 30 SCARLET FEVER. During the middle months of the year London as a whole experienced a somewhat serious epidemic of Scarlet Fever. The Authority responsible for the provision of hospital accommodation throughout the Metropolis is the Metropolitan Asylums Board, and that body found that their accommodation was so seriously taxed that a request was made that Medical Officers of Health of Local Authorities within their jurisdiction, should select for removal to hospital during the prevalence of the disease only those patients who most needed hospital treatment. The City in common with the rest of London was affected by the outbreak, but I am glad to say that little difficulty was experienced in the acceptance of City cases for hospital treatment. This is satisfactory as it will be readily appreciated that the nursing of Scarlet Fever patients in the homes of the majority of City residents would be attended with considerable possibility of a spread of the infection. The increase in City cases was in my opinion due to the opportunities which exist for persons resident within the City coming into contact with infection outside. No other reason has been discovered which would account for it. THE PUBLIC HEALTH (OPHTHALMIA NEONATORUM) REGULATIONS, 1914. Compulsory Notification of Ophthalmia Neonatorum. By virtue of powers contained in Section 56 of the Public Health (London) Act, 1891, the London County Council obtained an Order which was approved by the Local Government Board on December 20th, 1910, making Ophthalmia Neonatorum a notifiable disease. This Order became operative on March 13th, 1911. The Local Government Board have now issued an order dated February 5th, 1914, making Ophthalmia Neonatorum a compulsory notifiable disease throughout the Country. This order became operative on April 1st, 1914, and contains certain requirements additional to those contained in the previous London County Council Order. Ophthalmia Neonatorum means a purulent discharge from the eyes of an infant, commencing within 21 days from the date of birth. A large proportion of the blindness contracted in childhood is due to the neglect of proper precautions against this disease. The object of the Order is, therefore, to prevent a certain amount of this blindness by enabling Local Authorities to take early preventive measures in respect of the cases which are notified to them. Notification.—In addition to compulsory notification by the Medical Practitioner, it is now incumbent on a certified midwife to notify on a prescribed form any case of this disease which may arise in her practice, unless the case has already been notified by a Medical Practitioner. 31 A Medical Practitioner must notify such case on the form prescribed under Section 7 of the Infectious Disease (Notification) Act, 1889, unless the case has already been notified under Section 55 of the Public Health (London) Act, 1891, or by a certified midwife. In addition to filling in the usual notification form the Medical Practitioner must supply, either on the form or on a separate sheet attached to the form, the following information:— The date of birth of the child, The name and address of the parent or other person, if any, having charge of the child, and The date of the onset of the disease. In order that City Medical Practitioners and midwives should be acquainted with the duties imposed upon them by the above regulations, a circular letter, together with a copy of such regulations, were duly forwarded to them, and advertisements were inserted in the newspapers circulating within the City. Further, all certified midwives known to be practising within the City were supplied with copies of the prescribed notification form. MEASLES. In the early part of the year a neighbouring borough approached the Corporation, with the view of convening a conference to consider the desirability of taking some steps to lessen the incidence and mortality of Measles. The main value of such a conference in the present state of our knowledge of the disease would be to direct attention to its incidence, and for this alone a conference would hardly appear justified. The most urgent matter in respect of Measles and certain other zymotic diseases is the discovery of the organism on which the disease exists, and a careful and thorough research into the life history of the organism. I believe it is assumed that the organism is one of the ultra-microscopic group, and I think some work is being done at the present time on these lines. The Metropolitan Asylums Board so long ago as November, 1912, decided to increase the scope of their bacteriological work by appointing a special bacteriologist, and I believe that research work in respect of Measles is being carried out. The Corporation were of opinion that the suggested conference should be postponed, and the initiating Local Authority were accordingly so informed. PREVENTION OF EPIDEMIC DIARRHŒA. Despite the advance in practical hygiene that has been made in recent years, during the summer and autumn months the child mortality arising from Epidemic Diarrhœa and other infectious diseases of infants is still very high. If this is to be reduced to a satisfactory figure, it is essential that all practical measures for the prevention of such diseases, and the promotion of hygienic conditions in respect of the feeding of infants should be adopted. In view of the urgency of the reduction of the infantile mortality rate, the Local Government Board issued on the 10th July last a Circular Letter intimating what precautions should be taken by Sanitary Authorities with a view to the prevention of Epidemic Diarrhœa. 32 The following are the main suggestions of the Board:— 1. Notification of Births and home visiting in regard to the feeding and the care of Infants 2. The exercise of certain precautions in regard to the method of storing milk and other food, and the condition of the vessels in which such are kept. 3. The necessity of ensuring that vigorous efforts are made to prevent the accumulation of decomposed animal and vegetable matter or other refuse in the neighbourhood of dwelling-houses. 4.. The destruction of flies. The above suggestions are carried out as routine by my Department. The Corporation have always taken a particular interest in the welfare of the young, and a considerable proportion of the time of one of its Women Sanitary Inspectors is devoted to the work of Infant visiting. It is gratifying to report that during the present year Diarrhoea has only been responsible for the death of one City child. ENTERIC FEVER AND PERIWINKLES. Enquiries into three cases of Enteric Fever occurring in June last in an adjoining borough, elicited the fact that in each case there was a possibility of the disease being associated with the partaking of Periwinkles. The circumstances were such that I deemed further enquiries necessary, and with the assistance of the Officers of the Worshipful Company of Fishmongers, I ascertained the name of the retailer supplying the patients, the date of the purchase of his stock, the name of the wholesale dealer, and the source from which the winkles were obtaiued. Samples were obtained and these were submitted to Dr. Andrewes for bacteriological examination. The bacteriological report with regard to one sample showed that it was improbable that the outbreaks of Enteric Fever were associated with their consumption as at first seemed possible. Neither the Bacillus Coli Communis nor the Bacillus Enteritidis Sporogenes was found, though Dr. Andrewes found Streptococci present in 1/10th but not in 1/100th of a periwinkle. Although it was not possible to state that the winkles were sewage polluted, the presence of Streptococci is objectionable. The report of Dr. Andrewes with regard to another sample was as follows:— "These periwinkles show evidence of sewage contamination. They were examined with the same aseptic precautions as the previous sample. "Bacillus Coli.—6 entire winkles examined separately showed the same presence of lactose fermenters—with gas formation. Two tubes were planted out and yielded typical B. Coli Communis (saccharose negative) and also in smaller numbers a bacillus resembling B. fæcalis alkaligenes. 5 winkles were chopped up and diluted to 50 c.c., 1 c.c.=1/10 winkle. Two tubes each inoculated with 1/10 winkle gave no evidence of B. Coli. 33 "B. Enteritidis Sporogenes.—2 entire winkles were incubated anærobically in litmus milk. One showed the typical Enteritidis change the other not. "Streptococci.—Two tubes inoculated with winkle yielded both streptococci and staphylococci. "These facts point to definite sewage contamination and I should regard these periwinkles as objectionable." Further enquiries elicited the fact that the fish had been gathered practically in the open sea, with little or no possibility of sewage pollution, so that it would appear that the contamination must have occurred not at the gathering grounds but subsequently in transit to the laboratory. ENTERIC FEVER AND OYSTERS. In the early part of December the circumstances attending a case of Enteric Fever in a person residing in a neighbouring borough were inquired into. The iliness occurred on the 20th October, and the patient was said to have partaken of oysters on or about the 10th of the same month. The case was brought to my notice on the 8th December. Although such a long period had elapsed before the case was reported to me and the date of purchase of the oysters last consumed was unknown, enquiries were instituted and the oysters traced through the hands of the several dealers to the original beds, the position of which, so far as could be ascertained, is satisfactory for oyster layings. No evidence was obtained that established any connection between the case of Enteric Fever in question and the consumption of oysters. GLANDERS. In accordance with Article 3 (3) of the Glanders and Farcy Order, 1907, the Veterinary Inspector under the Diseases of Animals Acts notified one case of Glanders in a horse at Custom House Quay on the 31st July last. The animal was slaughtered and the carcase disposed of in the usual manner, every precaution being taken to prevent contagion. FOOT AND MOUTH DISEASE. In continuation of the policy adopted in connection with the outbreak of Foot and Mouth Disease in 1912, the Local Government Board, when that disease again made its appearance in the early part of the present year, issued a circular letter to Local Authorities suggesting that Medical Officers of Health, Inspectors of Nuisances, and Assistant Officers should exercise the strictest vigilance in the supervision of slaughterhouses and abattoirs and other places where meat is deposited, prepared, or exposed for sale. Accompanying this circular letter was a leaflet issued by the Board of Agriculture describing the symptoms of Foot and Mouth Disease, and as the symptoms therein enumerated may be of general assistance they are here reproduced:— "FOOT AND MOUTH DISEASE.—SYMPTOMS. "In the early stages of the disease the animal is lame and frequently smacks its lips, and shows by the movement of its tongue that the mouth is the seat of suffering; and the saliva flows freely from the mouth. An examination of the mouth shows the existence 34 of vesicles on the tongue and on the inner part of the upper lip and on the pad. These vesicles show themselves in the form of a tough white skin which can be easily stripped off, and a red raw surface is found beneath. The animal seldom refuses food, but rolls it about in its mouth, and often drops it instead of swallowing it. In most instances the feet are affected as well as the mouth, and blisters will form between the toes and on the heels between hair and hoof, causing the animal to walk tenderly, and frequently to catch up one foot after the other and shake it as if to dislodge something which was producing pain. In milch cows the teats may be affected with vesicles, especially at the opening of the milk duct. This often leads to sores and crusts being formed, which prevent the ready flow of the milk. The disease frequently exists simultaneously among the cattle, sheep and pigs of the farm." Signed) 'SIDNEY OLIVER, " Secretary. "Board of Agriculture and Fisheries, "4, Whitehall Place, "London, S.W. "March, 1914. "Note.—All persons owning or having in their charge any animal or animals presenting any of the above symptoms are required, by Law, to give notice to the Police with all practicable speed." The outbreak this year was a serious one and there was considerable possibility of it spreading, and for this reason it was especially desirable that strict supervision should be exercised by Local Authorities and their Officers over the meat supply in order that any meat or offal bearing any indication of the disease might be detected and detained. The circular letter under consideration suggested that whenever lesions or signs suspicious of the disease were discovered, the Officer making such discovery should communicate at once with the Inspector appointed under the Disease of Animals Acts, retaining for inspection the suspected parts in order that such further action as might be deemed necessary to trace the source of the disease might be taken. No difficulty is experienced in carrying out the above suggestions in the City, as not only are all the Meat Inspectors fully competent to detect suspicious cases of Foot and Mouth Disease, but the Veterinary Surgeon in charge of the Meat Inspection Staff is also the Inspector under the Diseases of Animals Acts referred to above. EXAMINATION OF MILK FOR TUBERCULOSIS AND CONDITIONS AS TO CLEANLINESS. In 1902 a system of taking samples of Milk on arrival at the several City railway termini was instituted with a view to ascertaining the conditions as regards presence of dirt and pathogenic bacteria in milk arriving from the country. These investigations have since been continued in succeeding years, and in October and November of the year under review 48 samples were procured, representing supplies from the following counties:— Norfolk 18 Suffolk 11 Essex 9 Cambridge 4 Bedfordshire 2 Buckinghamshire 2 Staffordshire 1 Lincolnshire 1 35 Milk is regarded, and rightly regarded, as a possible medium for the spread of Tuberculosis, and all possible steps should be taken to ensure that consumption of this important article of diet is unattended by risk. The main objects of the enquiry were to ascertain:— (1) Whether the milk was clean, (2) Whether it was free from pathogenic bacteria, especially the tubercle bacillus, and (3) Whether water had been added or cream abstracted. The samples were sent to the City Bacteriologist, Dr. F. W. Andrewes, for bacteriological examination, and to the City Analyst, Dr. Teed, for chemical analysis. The Bacteriologist's report upon the question of cleanliness and pathogenicity is as follows:— Report on Samples of Milk (taken at Railway Stations) as regards Dirt and Tubercle Bacilli. October and November, 1914. No. of Sample. Presence of dirt. Date of inoculation of guinea-pig. Date of animal's death. Condition found after death. Result as regards presence of tubercle bacilli. 1 Clean Oct. 16 Killed Nor. 23 Normal Negative. 2 Clean „ Killed Nov. 23 Normal Negative. 3 Clean „ Killed Nov. 23 Local abscess at point of inoculation, swarming with tubercle bacilli. Local glandular infection. Tubercles in liver and spleen. Positive. 4 Clean „ Killed Nov. 25 Normal Negative. 5 Clean „ Killed Nov. 25 Normal Negative. 6 Clean „ Killed Nov. 25 Normal Negative. 7 Clean Oct. 21 Killed Nov. 26 Small local residual abscess, with no tubercle bacilli. Regional lymph glands normal. No visceral tubercle. Negative. 8 Clean „ Killed Nov. 26 Normal at site of inoculation. A small whitish nodule at lower pole of spleen, not like tubercle. No tubercle bacilli found. Negative. 9 Clean „ Killed Nov. 26 Normal Negative. 10 Clean „ Killed Nov. 27 Normal Negative. 11 Clean „ Killed Nov. 27 Normal Negative. 12 Clean „ Killed Nov. 27 Normal Negative. 13 Clean Oct. 23 Killed Nov. 30 Normal Negative. 14 Clean „ Killed Nov. 30 Normal Negative. 15 Clean „ Killed Nov. 30 Normal Negative. 16 Clean „ Killed Dec. 1 Normal Negative. 17 Clean „ Killed Dec. 1 Normal Negative. 18 Clean „ Killed Dec. 1 Normal Negative. 19 Clean Oct. 28 Killed Dec. 3 Normal Negative. 20 Clean „ Killed Dec. 3 Normal Negative. 36 No. of Sample. Presence of dirt. Date of inoculation of guinea-pig. Date of animal's death. Condition found after death. Result as regards presence of tubercle bacilli. 21 Clean Oct. 28 Killed Dec. 3 Abscess at seat of inoculation, with tubercle bacilli in pus. Local and general glandular infection. Early tubercle in liver and spleen. Positive. 22 Clean „ Killed Dec. 4 Normal Negative. 23 Clean „ Killed Dec. 4 Local residual abscess, with a few cocci in pus, but no tubercle bacilli. Local lymph glands unaffected. Viscera normal. Negative. 24 Clean „ Died Nov. 5 Dead in 8 days of spreading gangrene, starting from point of inoculation. In the cheesy remains of the injected material, a few acidfast bacilli were found, resembling tubercle bacilli. A further sample of this milk was taken (No. 49), but proved negative. Doubtfully positive. 25 Clean Oct. 30 Killed Dec. 7 Normal Negative. 26 Clean „ Killed Dec. 7 Normal at seat of inoculation. Some tiny white specks in lung, liver and spleen. No tubercle bacilli found in them. Negative. 27 Clean „ Killed Dec. 7 Normal Negative. 28 Clean „ Killed Dec. 8 Normal Negative. 29 Moderate amount of dirt. „ Killed Dec. 8 Small residual local abscess at seat of inoculation. No tubercle bacilli found in pus. Lymph glands and viscera normal. Negative. 30 Clean „ Killed Dec. 8 Local abscess at point of inoculation, with tubercle bacilli in pus. Local lymph glands large and caseous. Liver and spleen full of tubercles. Positive. 31 Clean Nov. 4 Died Nov. 24 Died in 20 days, wasted, local abscess at point of inoculation, but no tubercle bacilli in pus. Lymph glands and viscera normal. Negative. 32 Clean „ Killed Dec. 9 Normal Negative. 33 Clean „ Killed Dec. 9 Normal Negative. 34 Clean „ Killed Dec. 10 Small tuberculous abscess at seat of inoculation. Tubercle bacilli found. Lymph glands caseous. Early tubercles in liver and spleen. Positive. 35 Clean „ Killed Dec. 10 Normal Negative. 36 Clean „ Killed Dec. 10 Normal Negative. 37 Clean Nov. 5 Killed Dec. 14 Local tuberculous abscess at seat of inoculation. Tubercle bacilli found. Lymph glands caseous. Early tubercles in liver and spleen. Positive. 38 Clean „ Killed Dec. 14 Normal Negative. 39 Clean „ Killed Dec. 14 Normal Negative. 40 Clean „ Killed Dec. 15 Normal Negative. 41 Clean „ Killed Dec. 15 Normal Negative. 42 Clean „ Killed Dec. 15 Normal Negative. 43 Clean Nov. 11 Killed Dec. 16 Normal Negative. 44 Clean „ Killed Dec. 16 Normal Negative. 45 Clean „ Killed Dec. 16 Normal Negative. 46 Clean „ Killed Dec. 17 Normal Negative. 47 Clean „ Killed Dec. 17 Normal Negative. 48 Clean „ Killed Dec. 17 Residual abscess at seat of inoculation. No tubercle bacilli found in pus. Glands and viscera normal. Animal well nourished. (Duplicate of No. 21.) Negative. 49 Clean Nov. 18 Killed Dec. 22 Normal Negative. 37 Summary of Report on Milk Samples. Forty-nine samples were examined. The Dirt was estimated by the eye, from the sediment formed in a conical glass after standing 24 hoars. The samples, as a whole, were in this respect good. I class 97.9 per cent. as Clean. 2.1 „ „ Unclean. No specimen deserved to be called a really dirty milk. Tubercle.—Each sample was allowed to stand 24 hours, and a guinea-pig was then inoculated subcutaneously with about lcc. of the mixed sediment and cream. The great majority of the animals developed local abscesses, but these mostly healed and disappeared in 4 or 5 weeks. In two instances the animals died prematurely. One died of gangrene 8 days after inoculation. I found acid-fast bacilli in the cheesy remains of the cream, but I cannot class this as a positive result. A second sample from the same source yielded a negative result. One died of wasting 20 days after inoculation. No tubercle was present, and this deserved to rank as a negative result. Five out of the 49 Figs (10.2 per cent.) became tuberculous, i.e., roughly one milk sample in 10 contained living tubercle bacilli. (Signed) F. W. ANDREWES, M.D. So far as cleanliness is concerned these results show a marked improvement on the record of previous years, and the fact that only 2.1 per cent. of the samples Avere found to be unclean is eminently satisfactory. It is of course desirable that no sample should be so classed, but having regard to the difficulties associated with the production and delivery of milk, and to the fact that no specimen could be regarded as a really dirty milk, the result of the examination of this particular series in this respect is gratifying. The results as regards the presence of the tubercle bacillus cannot, however, be regarded with the same satisfaction. The fact that 10.2 per cent. of the samples are shown to harbour living tubercle bacilli would appear to indicate that past efforts to eradicate this source of tuberculosis have not met with the desired success. Certainly it is difficult to base a firm opinion on the result of the examination of an isolated and small group of samples, but one must not forget that the last examination in the City conducted in 1913 on similar lines yielded a percentage of 10.4 tuberculous samples. At the present day one expects that a series of milk samples 38 will show a proportion varying between 7 and 12 per cent., a state of affairs which should not exist. When these cases are discovered, such action as is possible is always taken to ensure that the contaminated supply is not sold to the public. Energetic measures must be pursued if this dangerous condition is to be entirely removed. For purposes of comparison, I give the results obtained in previous investigations:— 1904. 1905. 1906. 1907.8. 1909. 1910. 1st. 2nd. per cent. per cent. per cent. per cent. per cent. per cent. per cent. Fairly clean 48.7 68.2 80 54.2 43.7 66.6 75 Unclean 43.6 22.7 12 37.5 43.8 33.3 25 Tuberculous 7.7 9.1 8 8.3 12.5 4.7 6.25 1911. 1912. 1913. 1914. per cent. per cent. per cent. per cent. Fairly clean 28.6 79.9 Clean 83.3 97.9 Unclean 71.6 20 Unclean 16.7 21 Tuberculous Nill 6.6 Tuberculous 10.4 10.2 The samples were taken under section 35 of the London County Council (General Powers) Act, 1907, under which Act the City have concurrent powers with the London County Council in respect of milk sold in the City of London. During the first year (July, 1908.1909) of the administration of the Act under which these samples were taken the percentage of tuberculous milk averaged 12.9 for the whole of the County of London. The percentage, however, for the period July, 1908, to September, 1913, was 9.9, whilst that for the year 1914 is 8.9. By arrangement with the London County Council details of instances in which positive results have been obtained were forwarded to the Medical Officer of Health of that body, whose practice it is to follow up the milk to its source, and when it has been established that a cow is there suffering from tuberculosis of the udder, to take such steps as the law permits. The following table indicates the results of the visits of the Council's Veterinary Inspector:— Sample No. No. of Cows Examined. Result Remarks. 3 * * * 21 52 2 cows tuberculous Cows now killed. 30 26 1 cow tuberculous Slaughtered previous to visit. 34 27 1 cow tuberculous The farmer stated that milk from the cow in question would not be sent to London again. 37 80 1 cow tuberculous The farmer stated that the cow would be slaughtered. * Results not yet communicated. 39 The Public Analyst's report upon the chemical constitution of the samples submitted to him is as follows:— MILK SAMPLES AT RAILWAY STATIONS. Result of Chemical Examination. Sample No. Fat. per cent. Solids not Fat. per cent. Water. per cent. Sample No. Fat. per cent. Solids not Fat. per cent. Water. per cent. 704 3.85 8.75 87.40 745 3.57 8.85 87.58 705 3.95 8.75 83.30 746 3.63 9.03 87.34 706 3.91 8.83 87.26 747 3.98 8.60 87.42 707 3.40 8.60 88.00 748 3.21 8.69 88.10 708 3.42 8.90 87.68 749 4.13 9.01 86.86 709 3.52 8.90 87.58 755 3.40 9.10 87.50 724 4.33 8.93 86.74 756 3.40 8.72 87.88 725 3.25 8.69 88.06 757 3.38 8.86 87.76 726 3.83 9.13 87.04 758 3.47 9.11 87.42 727 3.71 9.03 87.26 758a 4.00 9.20 86.80 728 3.70 9.06 87.24 759 4.20 8.72 87.08 729 3.45 8.63 87.92 760 3.82 8.56 87.62 730 3.40 8.88 87.72 761 3.65 9.09 87.26 731 3.72 8.68 87.60 762 3.37 8.77 87.86 732 4.22 9.02 86.76 763 3.92 8.82 87.26 733 3.11 9.05 87.84 764 3.28 9.06 87.66 734 3.42 9.12 87.46 765 3.00 8.62 88.38 735 5.22 9.24 85.54 766 3.58 8.74 87.68 738 3.78 8.92 87.30 772 2.95 8.85 88.20 739 3.59 8.51 87.90 773 3.83 8.81 87.36 740 4.15 8.93 86.92 774 4.77 8.73 86.50 741 4.07 8.91 87.02 775 3.18 9.20 87.62 742 4.23 8.77 87.00 776 3.53 8.47 88.00 743 3.90 8.58 87.52 777 4.18 8.86 86.96 744 3.72 8.54 87.74 From the above it will be seen that in nearly every case milk as delivered in the City is up to the official standard as regards chemical composition. The highest percentage of fat was 5.22 per cent., and the lowest 2.95 per cent., whilst the average was 3.72 per cent. 40 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 17.7 per cent. of these cases. Specimen, Disease suspected. Result— Positive. Negative. 21 Swabbings from Throats Diphtheria 3 18 13 Sputum Tuberculosis 3 10 LONDON HOUSING PROBLEM. The Mansion House Council on Health and Housing, at a Conference held in October on the London Housing Problem, discussed the situation at considerable length, and the report of the Housing Committee contains the following recommendations:— 1. That the Local Government Board should take steps to see that the existing law as regards housing in London is effectively administered. 2. That steps be taken with the object of securing more effective administration of the existing law in respect of the improvement of small insanitary areas, and that the relative powers of the County Council and the Borough Councils be considered and if necessary amended with a view thereto. 3. That the five Housing Acts be consolidated, including the provisions ot the London County Council Local Acts, and that any necessary amendments be incorporated. 4. That steps be taken to form a Representative Committee to deal with these two allied matters generally. The above resolutions which resulted from lengthy discussions on the subject embody principles which will be generally approved. They are, however, not of vital importance in respect of City work. In connection with the examination of dwelling-houses, special attention has been given to this matter, and during the year your officers have been engaged on the inspection of every occupied house in the City. The regulations recently issued by the Local Government Board under the Housing of the Working Classes Acts have formed the basis of their examination. The tabulation as required by the regulations is set out below, and the form of actual inspection is conducted in accordance with the details contained on the card, a copy of which is submitted. 41 It will be observed that a fair number of the houses are tenement houses, the remainder are made up principally of caretakers' dwellings which are usually situate on the upper floors of business premises. Inspection of Tenement Houses and Dwelling Houses in the City of London. District. No. of houses inspected. No. of tenements in the houses inspected. No. inspected so injurious to health as to be unfit for human habitation. No. of representations submitted. No. of closing orders made. No. of houses presenting defects . West 92 258 Nil. Nil. Nil. 126 Middle 4 15 „ „ „ 4 East 112 317 „ „ „ 127 Total 208 590 Nil. Nil. Nil. 257 Caretakers' Dwellings and Single Houses. West 183 183 Nil. Nil. Nil. 121 Middle 127 127 „ „ „ 120 East 205 205 „ „ „ 173 Total 515 515 Nil. Nil. Nil. 414 Grand Total 723 1,105 Nil. Nil. Nil. 671 OBVERSE. HOUSE TO HOUSE INSPECTION. Agent Owner Address Landlord Rooms Living Sleeping Position Occupants M. F. Children Rent Furnished Unfurnished Water Supply Closet accommodation Drainage Light & Air Dampness Cleanliness Outbuildings & Yard Refuse disposal arrangements Defects dangerous to health If unfit for human habitation. Reference to report & action GUILDHALL. 42 Reverse. Date of Inspection Action necessary & action taken Inspected by The principal defects noted were defects in connection with drains, water closets, dust-bins, the paving of yards, rain water gutters, rain water pipes, windows and frames, and flushing cisterns, dirty and uncovered storage cisterns, interior of premises dirty, rooms overcrowded, water supplies from unsuitable cisterns, and offensive matter requiring removal. CLOTH FAIR IMPROVEMENT SCHEME. During the year 1913 consideration was given to a report presented by your Medical Officer of Health, which indicated that a small area in Cloth Fair was, for various reasons, in an insanitary condition, and that the defects could only be remedied by means of an improvement scheme. The Sanitary Committee reported to the Court of Common Council to the effect that "Having carefully considered the whole of the circumstances, we feel it is our duty to report that the area comprising sites Nos. 12 to 16, 17, 18, 19, 20, 21, 22, 24, 25 and 26 (sites of), 27, 28, 29, 30, 31, 32, 33, 35 to 37, Cloth Fair, and No. 1, Red Lion Passage, is insanitary, owing to its closeness, narrowness, and bad arrangement, and that some of the buildings therein are in a defective condition and require to be demolished or reconstructed and rearranged in order to remedy the evils. In view of the fact, however, that to deal with such of these houses as are unfit for human habitation under the City of London Sewers Acts, would not result in any great or permanent improvement in the sanitary condition of the neighbourhood, and as it appears that the area is too small to be dealt with under Part I. of the Housing of the Working Classes Act, 1890, we are of opinion that action should be taken under Part II. of that Act, and therefore beg to recommend that a formal resolution be passed by your Honourable Court to this effect, as required by Section 39 of the said Act, and directing the preparation of a scheme for the improvement of the area." "We also recommend that we be authorised to take the necessary steps to carry such a scheme into effect." The above recommendation was approved by the Court, and the necessary authority to proceed with the scheme was granted. At the same time, the Court authorised action to be taken in respect of the property referred to in the following certificate of your Medical Officer of Health. "In accordance with the City of London Sewers Acts, 1848, 1851 and 1897, I hereby Certify that, in my opinion, the premises known as Nos. 6, 7 and 8, Cloth Fair, are permanently unwholesome and unfit for human habitation." Notices were served in accordance with the legal requirements in respect of all the the above property, and later the premises, numbered 23, Cloth Fair, were included for the purpose of making the scheme more complete. 43 The owners of Nos. 6, 7 and 8, Cloth Fair, were duly served with notices under the Sewers Act, but were not anxious to spend further money on what was only unsatisfactory property, and invited the Corporation to purchase the site on which these houses stood in the event of their being demolished instead of being repaired. The Corporation agreed to purchase the site after it had been cleared. This has now been done, and the site at present stands vacant. The land on which these houses stood comprises some 3,000 square feet. It is not a very suitable place on which to build property, and it would appear to be worthy of consideration whether it should not be left as an open space after the part necessary for street widening has been taken. The open grave-yard on which the land abuts, together with this land, would make a valuable open area, and in addition, the architectural features of the Church of St. Bartholomew's are so splendidly opened up that that fact adds additional weight to the suggestion. As regard the area a Public Enquiry was ordered by the Local Government Board, to be held at Guildhall, on October 27th, 1914. This was presided over by one of the Board's Inspectors, Mr. W. H. Collin. Evidence wras submitted by the Chairman of the Sanitary Committee, and your Medical Officer of Health and the Acting Engineer. In the last few days of December, 1914, a communication was received from the Board stating that the proposal had been approved, and that the scheme would be forwarded at a later date. In January, 1915, the following scheme which completes all the necessary preliminaries was received. 44 63,239 (25th January, 1915.) Housing Acts, 1890 to 1909. Order sanctioning Scheme of Reconstruction under Part II. of the Housing of the Working Classes Act, 1890. CITY OF LONDON. To the Mayor, Aldermen and Commons of the City of London in Common Council assembled;— And to all others whom it may concern. WHEREAS the Mayor and Commonalty and Citizens of the City of London, acting through the Common Council, are the local authority for the said City for the purposes of the Housing of the Working Classes Acts, 1890 to 1909, and are herein-after referred to as "the Local Authority And whereas the Local Authority, in pursuance of Part II. of the Housing of the Working Classes Act, 1890, directed a Scheme (herein-after referred to as "the Scheme ") to be prepared for the improvement of the area described in the Scheme and the Scheme is in the following terms:— "SCHEME. "Housing of the Working Classes Acts, 1890—1909. "CLOTH FAIR RECONSTRUCTION AND IMPROVEMENT SCHEME, 1914. "SCHEME made by the Mayor and Commonalty and Citizens of the City of London as "Successors-in-Law to the Commissioners of Sewers of the City of London, acting through "the Common Council as the 'Local Authority' for the said City, and who are hereinafter "referred to as 'the Corporation.' "Whereas the Corporation did on the 11th day of December, 1913, pass a Resolution under "the provisions of Section 39 of the Housing of the Working Classes Act, 1890, that the closeness, "narrowness, and bad arrangement or bad condition of some of the buildings known as Nos. 12 to "16, 17, 18, 19, 20, 21, 22, 24, 25 and 26 (sites of), 27, 28, 29, 30, 31, 32, 33, 35 to 37, Cloth Fair, "and No. 1, Red Lion Passage, and the want of light, air, ventilation and proper conveniences and "other sanitary defects in certain of the said buildings is dangerous or prejudicial to the health of "the inhabitants of such buildings and some of the neighbouring buildings, and that the demolition "and re-arrangement of the said buildings, or some of them, is necessary to remedy the said evils above "referred to, and that the area comprising those buildings and the yards, outhouses, and appur"tenances thereof, and the site thereof is too small to be dealt with as an unhealthy area under "Part I. of the Housing of the Working Classes Act, 1890, and at the same time did direct a "scheme to be prepared for the improvement of the said area. "The area included in this Scheme comprises 1,546 square yards or thereabouts, and includes "the lands and buildings above-mentioned, and also the premises known as No. 23, Cloth Fair, "which is included as neighbouring lands for the purpose of making the Scheme efficient, and all "such lands and buildings are shown on the plan annexed hereto and are thereon enclosed within "the inner edge of the red boundary line. "All the lands and buildings included in the improvement area are intended to be purchased "compulsorily in default of agreement. 45 The whole of the said buildings on the said land shall be demolished, as and when acquired, "provided that Nos. 12 to 16, 17, 32, 33 and 35, 36 and 37, Cloth Fair, may be left standing, and "in occupation, until such time as they shall be required for the purposes of this Scheme. "The whole of the lands included in this Scheme are to be appropriated or used for the purpose "of altering, widening, turning or extending any of the streets or other public places within the "area, or are to be used for open spaces or for some other appropriate public purpose as may be "approved by the Corporation, and any street, court, alley or place within the area may be closed "or diverted as may seem expedient with a view to the improvement of the area and for the general "efficiency of this Scheme. "The Corporation may sell and dispose of in such manner as they may think fit or demise or "lease such lands as shall be ultimately deemed unnecessary for the purposes of this Scheme. "The number of persons of the Working Classes in occupation of the buildings included in this "Scheme, including lodgers, as ascertained on the 2nd February, 1914, is 24 adults and 4 children "—total 28 persons. This total is exclusive of 7 adults and 3 children who were living rent free as "caretakers. The number of tenements exclusive of those used entirely for business purposes in "the several dwelling-houses, as ascertained on the same date was 21, of which number 8 were "empty. "No provision is made in this Scheme for rehousing the persons of the Working Classes who "may be displaced by this Scheme, because the persons displaced will be so few in number, and "because the Corporation has already provided within the City, dwelling accommodation for the "Working Classes by erecting blocks of dwellings in Stoney Lane, Viaduct Buildings, and "Farringdon Street. "The estimated rental value attaching to the premises, which for the present it is proposed to "leave standing and in occupation, is £500 per annum. "This Scheme may be cited as ' The Cloth Fair Improvement Scheme, 1914.' " And whereas the Local Authority, having served notice of the Scheme in manner provided by the Housing of the Working Classes Acts, 1890 to 1909, have petitioned Us, the Local Government Board, for an Order sanctioning the Scheme ; And whereas We are satisfied on the report of one of our Inspectors made after a local inquiry that the carrying into effect of the Scheme would be beneficial to the health of the inhabitants of the buildings comprised in the area described in the Scheme or of the neighbouring dwelling-houses: NOW THEREFORE, We, the Local Government Board, in the exercise of our powers under the Housing of the Working Classes Acts, 1890 to 1909, do, by this Our Order, Sanction and Order as follows, that is to say:— Article I.—We hereby Sanction the Scheme and Order that the provisions of the Lands Clauses Acts shall be incorporated with this Order so as to enable the Local Authority to acquire compulsorily any lands within the area comprised in the Scheme. Article II.—This Order may be cited as the City of London (Housing of the WorkingClasses) Order, 1915. Given under the Seal of Office of the Local Government Board, this Twenty-fifth day of January, in the year One thousand nine hundred and fifteen. HERBERT SAMUEL. President. Walter T. Jerred, Assistant Secretary. 46 WATER SUPPLY. In a certain number of instances business firms have sunk wells for the purpose of providing a supply of water for the premises in addition to, or in substitution for, that supplied by the Metropolitan Water Board. In these cases an analysis is made of the water obtained from the well. Three such examinations were made during 1914, and the results are as follows:— Samples of Deep Well Water examined by the Public Analyst, 1914. No. of Sample. Date of Sampling. analyst'S report. Free n.h.3 Alb. n.h 3 Oxygen absorbed. Nitrogen as Nitrates. Chlorine Total Solids. Hardness. Lead, Copper and Zinc. Remarks. All these results are expressed in grains per gallon. 1914. 1 12th Jan. 0.0795 0.0035 0.028 Absent 7.50 48.00 7¾° Absent Characteristic London Deep well water. 2 „ 0.0535 0.0015 0.024 Absent 7.55 48.00 5¼° Absent „ 10 17th July 0.0599 0.0023 0.0288 Absent 8.55 50.00 3¼° Absent „ THE USE OF INSECTICIDES. In the early part of the year my attention was directed to certain foreign apples, the surfaces of which showed some green deposit. I submitted the apples to the Public Analyst with a request that a chemical examination be made of the material, and was in due course informed that "the deposit on both the whole and the detached portion of "an apple contained copper, but arsenic was absent in both cases." It is probable that the deposit resulted from the use of Copper Sulphate, by means of a spray, but whether such spray was used as an insecticide during late growth or for the purpose of preventing the development of fungus after collection I am not in a position to state. The use of such substances at a time when the fruit is ready for gathering, and more so if used after gathering, is one which I cannot regard without apprehension, and although wiping the deposit from each apple may be a sufficient precaution as far as relates to this particular wash, the use of more dangerous substances might not be unattended by risk. To wipe an apple before consumption is not, I fear, a practice resorted to as largely as could be desired. The circumstances in connection with the case were reported to the Local Government Board. CHILDREN'S COUNTRY HOLIDAYS. As a consequence of the increase of the practice of philanthropic organisations sending the children of the poorer classes away to the country for a short holiday during the summer months, the Local Government Board issued a circular letter dated 25th June, 1914, directing attention to the necessity for in some way controlling the conditions under which this work is conducted. 47 From time to time it has been alleged that infectious disease has been introduced into country areas to which these children have been sent, and the Local Government Board, therefore, although not wishing to impose restrictions upon the movement, the excellent purposes of which are generally recognised, have felt compelled to express the opinion that some precautionary measures should be adopted by the responsible organisations. The circular letter under review briefly discusses the question, and suggests what might be done with a view to minimising as far as possible whatever danger attends the practice. The following are the suggestions which, for the purpose of brevity, I have condensed:— 1. Communications should be made to the Medical Officer of Health of the Country District advising him of the intended dispatch of children, in order that all necessary and desirable administrative action may be taken by him. 2. Enquiry should be made, either by the aid of voluntary workers or through the Medical Officer of Health of the Local Sanitary Authority, with a view to ensuring that no child shall be sent to the country in an infectious condition, or in the incubation stage of any infectious disease, or from any infected house. 3. Efforts should be made to ensure that the children are in a cleanly condition before departure. 4. Should a child fall ill whilst on a holiday, the necessity of immediately calling in medical advice is urged, as is also the notification to the Medical Officer of Health of the district of the incidence of infectious disease. For some years past one of the largest of the philanthropic organisations engaged in the work have always placed themselves in communication with my Department, and the above suggestions have formed the basis upon which have been founded efforts to ensure that the children leaving the City of London for the country are not the medium through which infectious disease is spread to other districts. During the year under review, the arrangements made by the organisation in question in regard to a number of City children were cancelled on account of the War. CREMATIONS. The total number of Cremations carried out at the Corporation Crematorium at llford last year was 42 as compared with 21 in 1913, and reference to the Table on page 48 shows that an increase is recorded at several other Crematoria, the total number in the United Kingdom during 1914 being 1,279, as compared with 1,188 in 1913. The prejudice against this form of disposal of the dead appears to be only slowly losing its hold upon the community. Cremation, with what some regard as its Pagan associations, offend the susceptibilities of many, but apart from sentiment there can be no question that the most hygienic and best method of disposing of the bodies of our dead, is the speedy reduction of them to harmless ashes in specially constructed furnaces. 48 CREMATIONS IN THE UNITED KINGDOM, 30 Years—1885-1914. YEAR. Woking.* Manchester. Glasgow. Liverpool. Hull. Darlington. Leicester. Golder's Green. Birmingham. Leeds. City of London. 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 1 ... ... ... ... ... ... ... 445 1902 275 81 20 54 13 2 1 5 ... ... ... ... ... 451 1903 143 92 24 35 18 1 5 158 1 ... ... ... ... 477 1904 138 98 19 40 20 7 8 220 19 ... ... ... ... 569 1905 95 97 35 35 15 4 16 252 22 16 9 7 1 604 1906 140 90 44 46 17 13 12 298 25 15 23 6 14 743 1907 108 98 30 34 29 8 12 290 33 16 18 18 13 707 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 14 591 40 24 32 12 9 1,134 1913 128 172 49 66 23 11 11 602 59 16 21 15 15 1,188 1914 124 184 57 48 16 11 7† 671 53 28 42 20 18 1,279 Total 3,817 2091 540 717 293 109 148 4829 382 187 230 126 116 13,585 * "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 HeDry Thompson at the opening of Golder's Green Crematorium, 22nd November. 1902. Vide " Transactions of Cremation Society of England, 1903." p. 31. † Closed for reconstruction from August, 1913, to July, 1914. 49 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 immediately re-interred in other parts of the same Cemetery, and one was removed to the Crematorium for cremation, the ashes being subsequently buried in a part of the Cemetery specially dedicated for this purpose. In accordance with the terms of the Licences issued by the Home Secretary in respect of these cases the work of removal, re-interment and cremation 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 827* persons, compared with 842 in 1913. 68.9 per cent. are adults, and 31.1 per cent. children (under 14 years). The number of births was 30, viz.: 13 males and 17 females. The birth rate was 36.3 per 1,000, which is 5.3 per 1,000 above the average tor the previous five years. The death rate for 1914 was 9.68 per 1,000 per annum. The number of deaths of children under one year, per 1,000 births, was 67, as against 100 for the City generally. Table of Births and Deaths occurring at the Artizans' Dwellings, Stoney Lane, Houndsditch, during the year 1914. Name of Block. Births. Mortality from all Causes at subjoined Ages. At all Rges. Under 1 year. l and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards. Male. Female. NORTH BLOCK 5 8 ... ... ... ... ... ... ... SOUTH „ 1 1 3 ... ... ... ... ... 3 KING'S „ 2 2 3 1 ... ... ... 1 1 QUEEN'S „ 1 4 2 1 ... ... ... 1 ... PRINCE'S „ 4 2 ... ... ... ... ... ... ... TOTALS 13 17 8 2 ... ... ... 2 4 * i.e., persons sleeping on the premises. 50 The birthrate 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 1906 26.1 1897 40.3 1907 35.0 1898 43.1 1908 31.5 1899 37.5 1909 29.6 1900 38.4 1910 32.9 1901 33.8 1911 29.5 1902 45.8 1912 33.4 1903 31.2 1913 29.7 1904 30.1 1914 36.3 1905 29.1 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 1914 being 11,804, of whom 4,916 were males and 6,888 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 1913 are in italics.) Month. Sex. Total. Males. Females. Children. Adults. Children. Adults. 1913. 1914. 1913. 1914. 1913. 1914. 1913. 1914. 1913. 1914. January 137 137 311 335 192 189 361 351 1,001 1,012 February 126 120 281 292 151 147 301 305 859 864 March 107 112 333 297 191 149 364 356 995 914 April 101 100 336 281 176 176 323 372 936 929 May 151 134 409 380 315 272 487 444 1,362 1,230 June 118 109 375 326 227 245 450 469 1,170 1,149 July 133 142 343 307 299 299 444 394 1,219 1,142 August 160 95 347 322 286 260 445 382 1,238 1,059 September 103 90 278 301 255 251 328 355 964 997 October 141 106 298 298 258 274 373 345 1,070 1,023 November 138 74 307 270 154 158 337 330 936 832 December 89 63 268 225 92 160 284 205 733 653 Totals 1,504 1,282 3,886 3,634 2,596 2,580 4,497 4,308 12,483 11,804 51 DISINFECTION, &c., AT CITY MORTUARY. 169,452 articles of bedding, clothing, furniture, &c., were received at Golden Lane and disinfected. Of these 147,282 were disinfected at the request of City firms engaged in exporting secondhand 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, 698 such certificates were issued during the year. 6,170 articles were from premises in the City where infectious disease had occurred, and the remainder, 16,000, were articles of clothing disinfected at the request of the Management of the Belgian War Refugees Home, Manchester Hotel. 194 bodies were received at the Mortuary pending interment, and 76 postmortem examinations were made. 172 inquests were held on bodies, and 5 inquests on fires. Number of Articles disinfected, Bodies received at the Mortuary, and Inquests held at the Coroner's Court in the City during 1914, compared with the previous five years. Year. Articles of Bedding, &c., disinfected. Bodies received at the Mortuary. Inquests held on bodies. Inquests held on Fires. 1909 325,831 205 187 3 1910 418,957 180 161 2 1911 406,014 204 182 6 1912 355,151 191 161 6 1913 283,989 205 176 6 Average for previous five years 357,989 197 174 5 1914 169,452 194 172 5 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 1914:— 1914. Inquest held on Name of Premises. Date of Fire. 1. 19th February 36 and 37, Cock Lane 11th February, 1914. 2. 24th July Messrs. Spiers and Pond's 15th July, 1914. Stores, Water Lane. 3. 6th August 23, Nicholl Square 24th July, 1914. 4. 5th November 4, Little College Street, Upper 22nd October, 1914. Thames Street. 5. 18th December 39 and 40, Hutton Street 11th December. 52 DISINFECTION OF CONVEYANCES AFTER CARRYING CASES OF INFECTIOUS DISEASE. On three occasions daring the year the Corporation's Electric Ambulance was used to convey to hospital persons suffering from an infectious disease. Two taxi cabs were used for a like purpose, and all these conveyances were subsequently, and before being put to further use, 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 conveyances (urinals, &c.). B. Disinfecting roadways, street gullies, &c. C. Disinfecting premises, &c., after infectious disease, drain testing and sundries. The amounts paid during the past 12 months under the several headings were:— £ s, d. A. 19 9 4 B. 391 8 4 C. 22 4 4 Total £433 2 0 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 33 bodies have been placed therein, four during 1909, eight during 1910, five during 1911, five during 1912, six during 1913, and five during 1914. 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. PUBLIC HEALTH LEGISLATION IN 1914. The following Measures for safeguarding public health interests were introduced into Parliament during 1914:— The Smoke Abatement Bill (see page 55). Dropped. The Deaths Registration and Burial Bill (see page 56). Dropped. The Public Health (Sewers and Drains) Bill (see page 55). Dropped. The Humane Slaughtering of Animals Bill (see page 54). Dropped. The Underground Workrooms Bill (see page 57). Dropped. The Vaccination Acts (Repeal) Bill (see page 54). Dropped. The Infants' Milk Bill (see page 53). Dropped. The Milk and Dairies Act, 1914 (see page 54), Passed. 53 The following official publications were also issued during the year. They contained much information which will be of considerable value to those interested in food supply and control. Reports to the Local Government Board— i. On the use of Proprietary Foods for Infant Feeding, by Dr. F. J. H. Coutts. ii. On the Analysis and Composition of some Proprietary Foods for Infants, by Mr. Julian L. Baker, F.I.C. Report to the Local Government Board on Localised Tuberculosis in Swine, by Dr. A. Eastwood and Dr. F. Griffith. INFANTS' MILK BILL, 1914. The Infants' Milk Bill was a private Bill, presented in the early part of the year, and contemplated the compulsory sale by Local Authorities of pure milk to mothers, in quantities not exceeding one quart daily, for three months after confinement. The qualifying provisions required the mother to have been resident in the district for one month prior to confinement, and also that, she should be entitled to Maternity Benefit under Section 8 of the National Insurance Act, 1911. The prices to be charged were to be fixed by the Local Government Board after consultation with the local Sanitary Authority, and no person was to suffer any disqualification or disfranchisement by reason only of the acceptance of the milk under this Bill. I was unable, however, to advise the Sanitary Committee to take any active measures to support the Bill. In my opinion it is inadvisable for a Sanitary Authority to undertake the sale of milk. The duty of the Sanitary Authority in this connection is clear. They are entrusted with the responsibility of ensuring that milk sold in their district is pure and clean, and it would obviously be anomalous for them to enter into competition with other sellers of this article of diet. It was not proposed to give, but to sell the milk, so the Bill was apparently not inspired by economic considerations. In the City, the Corporation, as is referred to elsewhere, annually allocates a sum of £40 to be expended in purchasing milk for resident mothers who breast-feed their infants. By reason of pressure of public business, the Bill was not proceeded with. 54 THE HUMANE SLAUGHTERING OF ANIMALS BILL. The Humane Slaughtering of Animals Bill, which was a private measure, was promoted with the object of ensuring the humane slaughtering of animals for the purpose of food. Provision was also made for the closing of private slaughtering houses and for the payment of compensation. The Mayor, Aldermen and Commons of the City of London in Common Council assembled were defined as the Local Authority in respect of the City of London. Except to state that humane slaughtering, the licensing of slaughtermen, and the abolition of private slaughterhouses, are principles with which I am in agreement, the Bill, which was not proceeded with, calls for no special observation. VACCINATION ACTS (REPEAL) BILL. The Vaccination Acts (Repeal) Bill—a short private measure which bad as its object the repeal of the Vaccination Acts—was similar to a Bill presented with the same object in 1913 and not proceeded with, which fate was shared by the present Bill. It provided that no public money should be available either to pay for vaccination or for providing a supply of vaccine lymph, and that vaccination should cease to be a condition of admission to the public service. Briefly expressed, the following are the reasons that the Corporation, as the Sanitary Authority for the City of London, were unable to support the Bill. Although vaccination is unfortunately not practised to the extent it formerly was, there is not the slightest doubt that it is one of the most valuable means we possess of combating outbreaks of small-pox. and any attempt to further limit the scope of this method of preventing the spread of the disease is much to be regretted. 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 instance varying numbers protect themselves against attack by voluntary requesting to be vaccinated. If public vaccination were dispensed with, the difficulty of combating outbreaks would enormously increase, as many persons would be unable to pay for the operation to be privately performed. As regards the public services I consider it would be nothing short of a national calamity if unvaccinated persons were allowed to enter certain of the public services, e.g., the Army, Navy or Public Health, and it is quite conceivable that other public work would be considerably hampered during the period of epidemic prevalence if in such services there were engaged a large proportion of persons who were not protected against an attack. MILK AND DAIRIES ACT, 1914. The details of this Act have already been printed and submitted in the Monthly Report of your Medical Officer of Health, of date 17th October, No. 182. 55 PUBLIC HEALTH (SEWERS AND DRAINS) BILL. The main object of the above-mentioned Bill was to amend the definitions of "sewer" and "drain" in the Public Health Act. Under these definitions any drain used for the drainage of more than one house is technically a sewer, and, therefore, repairable by the Local Authority. This it will be seen may frequently involve interference by the Local Authority with private property, and, moreover, throws upon the whole body of ratepayers the cost of repairing drams which are in all respects private, and are of no use to the public in general. The Public Health Acts Amendment Act, 1890, sought to overcome the difficulty by enacting that where two or more houses belonging to different owners are connected with a public sewer by a single private drain, the Local Authority may call upon the owner of the houses to put the drain in repair. This Section did not meet with the success anticipated, as among other things it only applied to houses belonging to different owners, and to drains conveying sewage to the public sewer. Drains conveying sewage to cesspools, for instance, did not come within its scope. Briefly, the main effects of the provisions of the Bill under review are that a drain shall be one constructed on private land by the landowner or builder, and that a sewer shall be one that has either been constructed by the Local Authority or has been laid along a public highway. An important exception is that when a drain has been constructed by a builder or landowner along a private street, i.e., a street not repairable by the Local Authority, the drain is to be a sewer provided that it has been constructed to the satisfaction of the Local Authority. Whether the Bill would have attained its object is a matter for legal consideration, but some clear legislative enactment on the lines indicated is urgently needed. Owing to the pressure of Government business, this Bill, which was introduced by a private member, did not get beyond the first reading. I might perhaps point out that the difficulty has not been so acute in the City of London, since cases in respect of which any doubt exists are always dealt with under Section 61 of the City of London Sewers Act, 1848, the effect of which is that in all cases wherever any house or building situate within the City shall at any time be found not to be drained by a sufficient drain to the satisfaction of the Corporation, it shall be lawful for the Corporation to require the owner to construct and make a covered drain to the nearest common sewer. SMOKE ABATEMENT BILL, 1914. The existing law on the smoke question, which forbids the emission of "black smoke in such quantity as to be a nuisance," throws upon the Local Authority the onus of proving that the smoke is "black." It is this provision that has been a formidable impediment to many a prosecution in cases where a very real nuisance has been committed, but where the colour of the smoke has not been sufficiently deep to justify the application of the adjective "black." 56 The object of the Smoke Abatement Bill, 1914, was to simplify and strengthen the law on this question by extending to the whole country provisions based on enactments in force in the metropolis, and in some few local areas, the practical utility of which has been proved by experience. The emission of smoke in quantities from furnaces is mainly due to improper and uneconomical construction of the furnace, and to careless use and working. Obviously if the smoke nuisance is due in any degree to extravagant consumption of coal, the introduction of legislative machinery controlling the construction of furnaces would be welcomed alike by the public and manufacturers, and experience has shown that the substitution of modern and economical furnaces for the old-fashioned ones, having regard to the resulting economy, has not been altogether a hardship. Briefly, the main provision of the Bill was the prohibition of the use of a furnace not so constructed as to consume its own smoke and from which smoke of any colour, or ash, grit, particles, or fumes are emitted, and special powers are granted to the Local Government Board to make exceptions in special cases in which it is impracticable to avoid making smoke in the conduct of a business. Penalty clauses were included in the Bill, and provision was made for the appointment of Joint Committees. By Clause 3 (2) "A County Council shall have the same powers as, and shall be "deemed a Local Authority for the purposes of the execution of the provisions of "this Act." From this it will be seen that the complete autonomy of the City was not preserved. Amplification of the powers at present possessed by Local Authorities in respect of the smoke nuisance has long been desirable, and a material advance would have been made had the main principles of the Bill under review been made law. It was dropped after passing the second reading. A committee has, however, been appointed by the House of Commons to enquire into the question, and the result of its investigations will be awaited with interest. DEATH REGISTRATION AND BURIAL BILL. This Bill was described as "a Bill to amend the law relating to the Registration of Deaths and to Burials." It was a private Bill, and its main object was to guard against crime and premature burial, and with this end in view effect was given to the principal recommendations of the Select Committee on Death Certification. This Committee, after carefully considering the question, arrived at the conclusion that having regard to the fact that the present system permits death and burial to take place without the production of satisfactory medical evidence of death, it was desirable that some means should be devised, whereby a medical certificate should be obtained in every case not certified by a registered medical practitioner in attendance. 57 The Departmental Committee on Coroners, which sat in 1909, were also of opinion that a certificate of death should only be accepted from a medical practitioner, who had by personal examination satisfied himself as to the fact of death. There is under the existing law no Statutory obligation upon a medical practitioner to view the body. In the course of their investigation, the Departmental Committee on Coroners, accumulated evidence that indicated that many certificates had been carelessly or even recklessly given. The following were the main provisions of the Bill:— 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 deaths. 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. The public certifier of deaths suggested, was a new official to be appointed by the Board of Guardians, who would be a registered medical practitioner. 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 included:— 1. Specification as to the circumstances in which a doctor may be regarded as being in attendance. 2. Provision for certification by the certifier of deaths when no doctor has been in attendance. 5. The presence of the certifier of deaths at inquests. 4. The holding of inquests. 5. Provision respecting burial. 6. Registration of "still-births." 7. Powers of the Local Government Board and Registrar-General to make Regulations. I am strongly of opinion that the system at present in operation with regard to the certification of ordinary deaths should be improved, and that certification of stillbirths should be made compulsory. UNDERGROUND WORKROOMS BILL, 1914. The Underground Workrooms Bill, 1914, which was introduced into the House of Commons in the early part of the year, was a private measure which had as its object the prohibition of the use of underground workrooms unless certified. It proposed after the 1st January, 1915, or such date not later than 1st January, 1916, to prohibit the use of underground workrooms unless such were certified by the District Council as being suitable for the process or occupation named in the certificate, and unless the conditions contained in the certificate were complied with. 58 Clause 8 of the Bill contemplated certain regulations which could be made by order of the Secretary of State, in reference to the structure of underground rooms to which the Act would apply, and the provision and use as regards such rooms of means of securing the maintenance of:— 1. Reasonable temperature; 2. Proper lighting and ventilation; 3. Freedom from damp, dust, effluvia and exhalations; 4. The carrying off of dust and fumes, and 5. For otherwise securing the health of persons employed in such rooms. It was intended that different regulations should be made as regards the different processes and occupations of the rooms in use when the order came into effect, and rooms not so used. When the regulations in question became operative, the underground workroom would not be certified by the District Council unless such Council were satisfied that the regulations which apply to such rooms were complied with, and the certificate given would be made conditional on the provision of and use of the means prescribed for securing the maintenance of the five provisions referred to above. Although the occupation of a workshop is notified to the Factory Inspector, and by him to the Local Authority, there is no requirement of registration for underground workplaces. A workplace used in contravention of the provisions of the Bill, could only be dealt with summarily as one of non-compliance with the law relating to nuisances. It would, therefore, appear to have been possible for an underground workplace to be occupied without being certificated until it was discovered by your Officers, and as I understand nuisance procedure, no punishable offence would have been committed until the occupier had tailed to comply with the terms of the notice which would be served upon him. This, in my opinion, was a serious defect, and it would have been an improvement if it had been made illegal for an underground workplace, which came within the provision of the Bill, to be occupied without the granting of the certificate by the Local Authorities. Clause 10 defines an underground workroom as "any room any part of which is "so situate that half or more than half the whole height thereof, measured from the "floor to the ceiling, is below the surface of the footway of the adjoining street, or of "the ground adjoining or nearest to the room.'' This definition in my opinion leaves something to be desired, and an underground workroom should be defined in more definite terms, such for example as obtained in the case of an underground bakehouse in the Factory and Workshop Act, which is described as one in which the surface of the floor is more than 3 feet below the surface of the footway. A similar definition is used in the case of an underground room in the Public Health (London) Act, 1891, and I would have preferred to see an underground workroom defined in the Bill under discussion as one the floor of which is a certain number of feet below the surface of the adjoining ground even if the minimum were extended beyond that prescribed by the two definitions referred to above, and made 4 feet or 4 feet 6 inches. On the whole the Bill would have marked an advance in Public Health Legislation, and it is to be regretted that pressure of other work prevented its being fully considered. 59 SUGGESTED AMENDMENT OF THE RAG FLOCK ACT, 1911. The Rag Flock Act, 1911, aims at securing a standard of cleanliness in regard to any rag flock used in the manufacture of any article of upholstery, cushions or bedding, &c. So far as the City of London is concerned the Act is of little importance, as rag flock is rarely if ever used by City firms of upholsterers. Such firms as deal in bedding and bedding materials do so mainly by description or samples, and any remaking undertaken by City houses is usually sent elsewhere for execution. Considerable difficulty appears to be experienced in some districts, however, by the fact that the Act as it at present stands does not apply to "remakes." This is a serious omission and one of considerable importance to some neighbouring authorities which number among their traders a large percentage of upholstering firms. The Metropolitan Borough of Paddington, too, experienced difficulty in this direction, and during the year approached the Corporation with a view to urging upon His Majesty's Government the need of amending the Act to bring "remakes" within its scope. PROPRIETARY FOODS FOR INFANT FEEDING.* The details of this most interesting report formed the subject of an extended reference in the printed monthly report of your Medical Officer of Health of date 29th September, No. 181. 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 78 10 10 17 February 178 6 11 21 March 231 8 8 32 April 304 11 123 23 May 265 49 20 20 June 245 7 58 72 July 252 2 15 50 August 207 6 3 47 September 297 10 20 40 October 255 9 20 26 November 233 3 9 23 December 357 6 12 56 Totals ... 2,902 127 309 427 *Reports to the Local Government Board:— 1. On the use of Proprietary Foods for Infant Feeding, by Dr. F. J. H. Coutts. 2. On the Analysis and Composition of some Proprietary Foods for Infants, by Mr. Julian L. Baker, F.I.C. 60 MIDDLE DISTRICT. (Inspector E. J. Simmons.) Month. Premises inspected. Orders issued. Notices served. Improvements effected. January 127 2 3 16 February 280 12 23 31 March 229 7 19 42 April 254 9 17 47 May 239 5 15 31 June 234 5 13 25 July 244 8 14 30 August 226 4 10 21 September 225 4 16 20 October 267 16 28 48 November 230 5 17 33 December 364 4 14 42 Totals 2,869 81 189 386 EAST DISTRICT. (Inspector W. H. Ralph.) Month. Premises inspected. Orders issued. Notices served. Improvements effected. January 136 12 19 22 February 223 7 11 20 March 145 2 3 8 April 293 4 127 27 May 283 8 21 141 June 227 20 29 30 July 232 3 17 23 August 298 5 13 28 September 247 4 15 33 October 204 5 15 28 November 248 8 25 31 December 382 3 29 50 Totals 2,918 81 324 441 61 The foregoing are summarised as under:— District Number of inspections made. Orders issued. Notices served. Improvements effected. West 2,902 127 309 427 Middle 2,869 81 189 386 East 2,918 81 324 441 Totals 8,689 289 822 1,254 Average of previous five years 8,550 319 810 1,391 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. 1914. 1900. 1914. 1900. 1914. 1900. 1914. 1900. 1914. 1900. West 92 183 622 1,502 258 656 2.5 2.3 126 239 Middle 4 55 27 363 15 130 1.8 2.8 4 66 East 112 158 761 1,186 317 488 2.5 2.5 127 176 Total 208 396 1,410 3,051 590 1,274 2.3 2.6 257 481 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 257 Notices during 1914. 62 In addition to the foregoing, there are eleven Blocks of Dwellings let out in tenements, but not placed on the Register for the reason that each holding is "self-contained," it having been decided in a Court of Law that in these circumstances they are not subject to the Bye-laws for houses let in lodgings, or occupied by members of more than one family:— WEST DISTRICT. Name and situation of Artizans' Block Dwellings. No. of Tenements. No. of Inhabitants. One Room. Two Rooms. Three Rooms. Four Rooms. Fire Rooms or more. Albion Buildings, No. 21, Bartholomew Close ... 10 ... ... ... 28 Albion Buildings, No. 22, Bartholomew Close ... 10 ... ... ... 24 Bartholomew House, Bartholomew Close 18 1 ... ... ... 36 Dean Street Blocks, Fetter Lane— Block A 3 4 ... 1 ... 26 ,, B 2 5 ... ... ... 28 „ C 6 3 ... ... ... 24 „ D 2 5 ... ... ... 26 ,, E 2 5 ... ... ... 30 „ F ... 4 ... 1 ... 20 St. Ann's Chambers, Ludgate Hill 12 25 ... 1 ... 41 Bloomfield House, Snow Hill ... 22 ... 1 1 40 Total 45 94 ... 4 1 323 MIDDLE DISTRICT. Name and situation of Artizans' Block Dwellings. No. of Tenements. No. of Inhabitants. One Room. Two Rooms. Three Rooms. Four Rooms. Five, or more Rooms. Bridgewater House, Fann Street ... 12 ... ... ... 15 City Buildings, Moor Lane ... 20 12 ... ... 108 Total ... 32 12 ... ... 123 63 EAST DISTRICT. Name and situation of Artizans' Block Dwellings. No. of Tenements. No. of Inhabitants One Room. Two Rooms. Three Rooms. Four Rooms. Five, or more Rooms. Harrow Alley and Stoney Lane— North Block ... 48 8 ... ... 217 South ,, 5 22 13 ... ... 178 Prince's „ 5 50 ... ... ... 167 Queen's ,, 5 40 5 ... ... 160 King's „ 8 16 16 ... ... 158 Barker's Buildings, Catherine Wheel Alley, Bishopsgate 12 10 3 ... ... 64 Total 35 186 45 ... ... 944 These Blocks of Dwellings, containing 454 tenements, are inhabited by 1,394 persons, an average of 3.1 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, numbered 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. 64 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 5l. 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. Instances of neglect in this respect have in the past been of frequent occurrence, but during the year under review only one case has arisen. DRAINAGE PLANS. In the course of the year, 277 plans were submitted with regard to proposed reconstruction of water-closets or drains in the City. Of these, 244 were approved, 17 revised and approved, and 16 not approved. 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 8 cases were reported by your officers. On the service of the statutory notice of abatement the overcrowding was discontinued in each instance. 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 179 cases so investigated in 1914, it was found necessary to reconstruct the sanitary system in 4 instances, and to make amendments to soil and waste pipes, water-closets, &c., in 69 others. 65 HOUSE, TRADE AND OTHER REFUSE REMOVAL. The City Engineer informs me that the refuse removed from the City in 1914 consisted of 22,952 cartloads of street sweepings and slops, and 53,008 loads of house and trade refuse, a total of 75,960 loads. The total for the year 1913 was 77,242. 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 11 instances, 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. LEGAL PROCEEDINGS. During the year 822 notices have been served by the District Inspectors at the order of the Sanitary Committee, and in no case 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. 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 47,911,122 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 of 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 1914, 24 were situated in the East District, 33 in the Middle District, and 32 in the West District. 66 REMOVAL OF FISH OFFAL. The Contract with Messrs. F. S. Hempleman for the removal of fish offal entered into in May, 1906, for a period of twelve months, has since been renewed from time to time. The conditions of the Contract require that the Contractor 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. Complaint has sometimes been made of offensive smells due to the fish offal standing in confined places during the night, but the undertaking of the Contractors to collect the material during the evening hours has been attended with the success anticipated, and these complaints have now ceased. In the past, fish offal was removed by the Corporation's own officials in the ordinary way as trade refuse, but the method at present in force has proved not only a public health advance, but has also effected a financial saving. REMOVAL OF HUMAN REMAINS. 3, Frederick's Place, Old Jewry. During the year only one instance has been reported of the disturbance of human remains within the City confines. The workmen engaged in building operations at the above-mentioned premises unearthed a small quantity of human remains. The bones, the position of which indicated that they had been disturbed before, were quite dry and caused no nuisance, and arrangements were made for their reinterment under my supervision. HYGIENE OF HAIRDRESSERS' AND BARBERS' SHOPS. The Registered Hairdressers' establishments throughout the City remain under the supervision of your officers. One additional Certificate has been granted and change of proprietorship has occurred in one instance. The usual list of registered premises is not included here as in some instances the yearly renewal of the licences granted by the Corporation, has not been completed in view of the circumstances of the War and the question of the employment of alien enemy assistants. 67 SMOKE AND ATMOSPHERIC POLLUTION. Sixteen instances of smoke nuisance or annoyance from chimneys were dealt with during the year. Some of these were of a temporary character and did not recur, others were abated upon the service of the usual form of notice upon the offenders and there has been no occasion to take further action. As mentioned in previous reports the annoyance and the evil from coal smoke cannot satisfactorily be dealt with by law until the enactments at present in force are strengthened or amended. The accompanying dirt and discomfort continues, although doubtless in a lesser degree than in former years, and for which the enormous number of the chimneys in surrounding Greater London are partly largely responsible. During the year, with the concurrence of your Sanitary Committee—in conjunction with the Committee for the Investigation of Atmospheric Pollution, appointed by the International Exhibition and Conference in London, 1912—a critical examination of the air in the City has been commenced. An apparatus consisting of a large rain gauge, has been placed in a convenient position upon the roof of the shelter in Golden Lane, and the rainwater from a known area of surface is collected monthly. This rainwater containing the soot, grit and dust washed from the air has been submitted for examination to the Public Analyst and the results tabulated. For comparison the results obtained from similar observations made upon the Thames Embankment by the London County Council are added. Summary of Observations and Reports for the Months of April to December, 1914. Month of the Year 1914. Place. 3 4 5 6 7 8 9 10 11 12 Rainfall in millimetres. Metrio tons of deposit per square kilometre during month. Insoluble matter. Soluble matter. Total solids. Included in soluble matter. Tar. Carbonaceous other than tar. Ash. Loss on ignition. Ash. Sulphate as (SO4). Chlorine (CI). Ammonia (NH3). April City of London 19.27 0.03 1.41 2.24 115 2.24 7.06 1.38 0.42 0.07 County of London 15.61 0.27 5.38 6.31 0.72 3.03 15.71 1.40 0.39 0.04 Way City of London 46.74 0.08 3.37 5.72 1.68 3.74 14.59 2.40 0.65 0.18 County of London 21.47 0.61 7.18 6.51 0.86 2.62 17.78 1.09 0.30 0.01 June City of London 29.92 0.03 1.70 3.26 1.08 1.67 7.74 1.21 0.04 1.13 County of London 34.0 0.24 4.52 7.31 0.90 3.31 16.28 1.38 0.32 0.07 July City of London 36.0 0.04 2.63 3.86 1.02 2.61 10.17 1.51 0.44 0.13 County of London 33.0 0.17 4.08 5.49 1.50 3.65 14.86 1.05 0.42 0.02 August City of London 31.0 0.03 1.36 2.37 0.99 2.35 7.09 1.44 0.36 0.10 County of London Not recorded. September City of London 22.0 0.02 2.50 3.64 1.27 2.44 9.87 1.69 0.37 0.09 County of London 26.0 0.61 6.41 9.60 0.78 10.88 28.27 1.74 1.09 0.02 October City of London 26.0 0.06 3.30 5.24 1.53 3.58 13.71 2.39 0.45 0.13 County of London 26.0 0.14 3.14 4.86 3.80 10.62 22.56 3.13 1.70 0.02 November City of London 74.0 0.07 3.78 4.67 2.06 5.59 15.67 3.67 0.89 0.16 County of London 64.0 0.21 2.84 5.84 2.55 3.95 15.40 2.73 0.79 0.10 December City of London 143.9 0.12 3.16 4.76 4.60 8.63 21.29 6.05 1.43 0.17 County of London 126.2 0.19 4.41 7.90 0.25 9.10 21.85 4.75 1.61 0.10 68 This table gives the rainfall for the months of April to December of the year 1914, and the amounts found of insoluble matter, tar, soot and dust, also the soluble matter, together with the sulphates, ammonia and chlorine in the volume collected. The results as given by the Public Analyst have been re-calculated into metric tons per square kilometre during each month. One metric ton per square kilometre is equivalent to approximately 9 lbs. per acre or 2.56 tons per square mile. Although the presence of much impurity in the atmosphere has been long known, the above is the first definite record obtained by your Officers of the fact. In examining the foregoing table it will be appreciated that in the month of December only, the amount of deposit registered as falling in the City amounted to 21.29 metric tons per square kilometre, which is equal (estimating the City as having an area of one square mile) to no less than 54½ tons avoirdupois. Of this mass of dirt nearly 34 tons were soluble and included the chemicals mentioned, and 20½ tons were insoluble and consisted of tar, carbon and grit. In addition to the foregoing a daily observation has been made at mid-day at the Guildhall of the purity of the air by a new dry method by which the suspended matter can be readily demonstrated. Since the 14th November until the 31st December, the amount of the impurity at noon has varied from half a milligram to three milligrams per cubic metre of air. This includes times when there has been a slight fog, but no dense fog has yet been tested at the Guildhall. The exigencies of space will not permit here an account of similar observations at other places, as for example, Malvern and Sheffield, where results are widely divergent. The value of the work commenced is evident and is an indication of the necessity of its continuation during the ensuing year. FACTORY AND WORKSHOP ACT, 1901. FACTORIES, WORKSHOPS AND WORKPLACES. The premises at present upon the Register number 3,923, which includes 8,089 workrooms, &c. There is a slight decrease in the number of premises registered. 69 The card index register which was mentioned in my last report has been brought fully into operation, and is found to work satisfactorily. There were 3,024 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 885 3,431 Workshops 1,981 3,158 Workplaces:— Kitchens of Restaurants, Tea-rooms, &c. 879 1,090 Stables 21 24 Other places 154 386 Totals 3,923 8,089 The following is a summary of inspections of separate Workrooms, &c., since the passing of the Act:— Factories. Workshop Inspectors. Women 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 1914 „ „ „ 3,025 237 3,262 Workshops. 1901 Inspections during the year 745 — 745 1902 „ „ „ 341 140 481 1903 „ „ „ 264 283 547 1904 „ „ „ 948 345 1,293 1905 „ „ „ 1,306 719 2,025 1906 „ „ „ 2,367 1,114 3,481 1907 „ „ „ 2,701 1,386 4,087 1908 „ „ „ 3,034 1,634 4,668 1909 „ „ „ 3,333 1,833 5,166 1910 „ „ „ 3,826 1,976 5,802 1911 „ „ „ 3,775 1,772 5,547 1912 „ „ „ 3,037 1,195 4,232 1913 „ „ „ 2,437 1,226 3,663 1914 „ „ „ 2,053 658 2,711 70  Workplaces. Workshop Inspectors. Women Inspectors. Totals. 1902 Inspections during the year 78 390 468 1903 „ „ „ 344 13 357 1904 „ „ „ 82 11 93 1905 „ „ „ 555 299 854 1906 „ „ „ 860 299 1,159 1907 „ „ „ 660 227 887 1908 „ „ „ 705 372 1,077 1909 „ „ „ 604 140 744 1910 „ „ „ 846 180 1,026 1911 „ „ „ 977 145 1,122 1912 „ „ „ 991 188 1,179 1913 „ „ „ 560 178 738 1914 „ „ „ 672 138 810 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 94 defects were so referred. 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 furnish 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. BAKEHOUSES. Bakehouses are scheduled as Workshops (Part II., Sixth Schedule), and are required to be registered by the Local Authority (Sec. 132). 71 The following is a list of bakehouses registered in the City:— Aboveground Bakehouses. §280, Bishopsgate. ‡61, Middlesex Street. §45, Fish Street Hill. §‡85, Middlesex Street. §Great Eastern Hotel, Liverpool Street. Underground Bakehouses. 188, Aldersgate Street. ‡37, Middlesex Street. 262, Bishopsgate. §‡63 to 65, „ ‡4 Broadway. §‡122, „ 8, Copthall Avenue. 31, Newbury Street. 15, Cornhill. 3, Pancras Lane. ‡67, Farringdon Street. 21, Stoney Lane. §‡88, „ ,, 68, St. Mary Axe. ‡93, Fetter Lane. ‡75, St. Paul's Churchyard. §8 to 14, King Street, Snow Hill. 194, Upper Thames Street. 48, Knightrider Street. SUMMARY. Aboveground bakehouses 5 Underground bakehouses 19 Total number of bakehouses in the City 24 The Bakehouses were inspected as usual, 98 visits being made for that purpose. Cleansing, or small repairs, &c., were needed in some 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. 18, Long Lane, has been discontinued, and as neither bread, biscuits or confectionery are made at No. 155, Minories, or No. 4, Water Lane, these several premises cease to be registered as bakehouses. KITCHENS OF RESTAURANTS. The inspection of Kitchens of Restaurants, &c., was commenced in the year 1902, and the value of the work is increasing. The sanitary condition of those places in the City at which food is prepared for the large mass of workers who daily enter the City boundaries is of importance. There are numerous reasons why this work presents problems of difficulty, and ‡ These have been established at least 28 years. § Factory Bakehouses (power is used). 72 perhaps the extremely limited space at disposal which makes it difficult to provide proper accommodation for the storage of the food is one of the most serious. The subject is one worthy of extended reference, and the following details which indicate the work which is carried out by Mr. Gathercole and the Lady Inspectors, may be of interest. It should be remembered that the business of a City restaurant is usually crowded into a very few hours in the day, and 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, suggestions are adopted willingly and without delay. The power to inspect kitchens is derived from the Public Health (London) Act, 1891 (in conjunction with the Factory and Workshop Act, 1901), which requires all Local Authorities to satisfy themselves as to the sanitary conditions of Workplaces within their districts. Until recent years it was a prevalent idea amongst Restaurant keepers and others that the requirements of the Factory and Workshop Act with respect to separate sanitary accommodation for the sexes did not apply to their establishments, but the Memorandum of the Secretary of State on the Act would appear to be clear on the point, and very little opposition is now experienced. In some few instances the Act has operated harshly upon individuals who have been discharged by their employers to enable them to comply with requirements respecting sanitary accommodation. This was inevitable, and it is hardly necessary to state that every effort has been made to avoid anything in the nature of oppression. It would be a great public advantage if all kitchens were required to be registered under definite conditions before being occupied. Defects which are only discovered after the place has come into occupation can generally only be dealt with as ordinary nuisances. If registration were necessary many of these conditions would be dealt with before the premises came into use. The occupiers of several Restaurants have submitted plans for approval, and it cannot be too widely known that this is the proper course to adopt in the best interests of the parties concerned, who are thereby enabled to comply with the necessary requirements at a minimum of expense. Workplaces, in which category are placed Restaurant Kitchens, may be established without notice being given to any Authority, in which respect they differ from Factories and Workshops. They are not required to be registered under the Act, and any person can therefore establish a workplace in any situation and under any conditions without giving notice. It follows that workplaces, except in the few instances where intention to occupy same is voluntarily given, are only discovered during the round of routine inspection work. 73 The principal objects of inspection are to ascertain:— (a) The situation of the kitchen, the condition of the floor, walls and ceiling, the adequacy or otherwise of ventilation, &c. (b) The accommodation for the storage of food. (c) The number of workers employed, both male and female. (d) The water-closet accommodation provided. (e) The provision made for personal ablution. (f) The number and sanitary condition of the sinks, &c. (g) The situation and condition of water storage cisterns. (h) The provision for the storage of refuse. (i) The cooking processes employed. (j) The condition of the cooking utensils, &c. (k) The condition of the food used and stored upon the premises. The principal defects found relate to:— (a) Dirty floors, walls and ceilings, cisterns, &c. (b) Insufficient ventilation. (c) Defective water-closet accommodation. (d) The undue emission of steam from faulty fittings. In the early days of the inspection many defects of a structural nature were met with in connection with drainage, ventilation, water-closet accommodation, &c., but now the commonest defect is want of cleanliness, and although, as a whole, kitchens show a distinct improvement as regard their general condition, whitewashing and limewashing are still insufficiently practised. This necessary work is put off until the Inspector comes round, instead of being regularly done, say every six months. The use of gas for lighting purposes renders more constant cleansing necessary. The provision of water-closet accommodation for both sexes is often a serious difficulty, and especially so when only small numbers of workers are employed. When businesses change ownership, or structural alterations are carried out, this question is often lost sight of. The male members of the staff are said to be "paid to go out" to find accommodation at public conveniences, &c. Such arrangements are not satisfactory, and do not comply with the requirements of the Act. In the case of water-closets used by men, the floors are sometimes found to be wet and foul smelling owing to carelessness, the remedy for which is to cover with, or make the floors of, some impervious material, and to insist on constant cleansing. In some cases the water-closets are found in a dirty and untidy condition, strewn with sodden paper, &c. The provision of boxes for paper sometimes proves a remedy. In all restaurant kitchens it should be made a requirement that a lavatory for hand-washing should be placed in the lobby of the convenience, and that such lavatory should be used by the workers before they return into the kitchen. 74 It is hardly necessary to insist upon the unsuitability of underground premises for use as kitchens. It is beyond dispute that kitchens should be as light and airy as possible, and that the conditions under which food should be stored and prepared for use are difficult, if not impossible, to obtain except in places above ground. The best situation is undoubtedly at the top of the building. Where this cannot be arranged the cost of land in the City will compel proprietors of restaurants to continue to use basements for the purpose. The difficulties of efficiently ventilating an underground kitchen are obvious, and the day is probably not far distant when they will be placed upon the same footing as underground bakehouses and have to receive a similar certificate of suitability. In numerous cases partial ventilation is obtained by means of open gratings at the surface of the footway pavement; indeed, in some cases, little else is possible. The most serious difficulty in this connection is that mud and filth are liable to fall into the kitchens, and to obviate this, movable trays placed immediately beneath the openings have been provided in many instances. Mechanical ventilation is used in some kitchens and with success, but generally speaking it is a poor substitute for natural ventilation. Fans are frequently out of order or are deliberately kept out of use to avoid the cost of the necessary electric current. Where kitchens are provided with good window accommodation above the ground level little else is required. In many cases hoods have been fixed over gas stoves, these are connected with flues, and in this manner help in the ventilation of the kitchen. The question of suitable larder accommodation has received special attention, and several instances were brought to my notice of unsuitable places being used as larders. Many of the persons spoken to on the subject of larder accommodation state that they have no need for a larder, as they clear out from day to day, and so have nothing to store in the way of perishable food. This is no doubt usually the case, but a suitable larder cannot fail to be required occasionally. Storage cisterns cannot be dispensed with when boilers are used for generating steam. These should be properly protected from dust, dirt, &c., and be effectually covered to prevent the access of vermin. In some cases the occupants of premises visited were ignorant of the existence of these cisterns, and their condition when examined need not be described. In many cases the cistern was inaccessible and the cover missing. Where the contents of storage cisterns are used for drinking purposes, the tank should be constructed wholly of suitable metal, with a close-fitting door for access to the ball valve and placed in an accessible situation. As a rule the cooking utensils are kept in good condition. Occasionally table tops whereon food is prepared are found to be saturated with stale grease and the like and have to be either renewed or replaced. Refuse receptacles should of course be placed outside the kitchen where possible, but there is, however, less nuisance from kitchen refuse than might be expected. It is removed daily, and so long as the metal receptacles are kept thoroughly clean, no harm should result. 75 The meat and other foods deposited for sale in restaurants are examined in the course of the ordinary visits of the Inspector, but only on rare occasions has it been found necessary to seize food to be dealt with by a Magistrate. Restaurant Keepers have practically no use for unsound food, and readily surrender or destroy in the presence of the Inspector any of questionable character. A number of complaints have been received during the summer months of nuisance from the smell of cooking, or of burning fat, &c., entering the windows ot offices, and where possible a remedy was suggested to occupiers of kitchens. In one case a pipe shaft was taken from the basement to the roof level with satisfactory results. There seems to be no reason why occupiers of offices should have to tolerate the smell from cooking in restaurants, when by a system of mechanical ventilation or otherwise, the effluvia could be discharged above the roof level without annoyance to anyone. The nature of the fuel used in cooking is of considerable importance, affecting as it does the smoke problem, and the adoption of gas ovens where possible is always an advantage, especially if constructed so that the fumes do not come into contact with the food during the process of cooking. The rat problem, always of great importance, is especially so in connection with premises where food is stored or prepared. Rats frequently gain access to kitchens and more espicially so in the case of very old premises. Many restaurant keepers employ a professional rat catcher, in other cases dogs and cats are employed, as also are various forms of traps. These premises should be made rat proof, and all refuse should be so stored that the animals cannot gain access to it. Neglect of simple precautionary measures makes the rat nuisance become quite a serious problem in some places. Clothing worn by employees in kitchens does not always receive the attention it demands. Some workers- change their clothes and work in old and evil smelling garments, and in some cases a dirty condition of the workers themselves has been noticed. Provision should be made if possible for the storage of clothing belonging to workers. In many cases cupboards have been provided where space was limited and there were no staff rooms. Proper lavatory accommodation for the personal ablution of employees is essential ; without it, cleanliness is difficult, if not impossible. Unless such provision exists a sink in the kitchen may be used, an action which is to be deprecated. Washing facilities should be provided as already stated, in connection with every sanitary convenience in a kitchen. It is found that the businesses are constantly changing hands and that the kitchen arrangements are an ever-varying quantity. Gas stoves are frequently added without any provision being made for carrying off the fumes, the water closet accommodation for the sexes has to be re-adjusted and walls and ceilings of the kitchens soon get dirty. These and many other points need constant and vigilant attention to ensure a decent standard being maintained. The experience gathered from the inspection of these places suggests the following:— The floor, walls and ceiling should be finished in a durable material and be free from obstructions so as to be easily cleansed—all tables and benches should be easily moved. 76 Where gas is used for cooking purposes, means should be provided for carrying off the fumes of the gas. Electric light should be used where practicable, so as to reduce heat as far as possible in the kitchen—as also in the interests of cleanliness. Proper larders and pantries should be provided for the storage of cooked and uncooked food. Special attention should be paid to the condition of storage cisterns, and effectual means taken to exclude dust and dirt, &c. In places where much work is done at least one white enamelled stoneware sink should be provided in which to wash vegetables—indeed it would be better if all sinks were of similar material, the advantage being that dirty conditions are at once apparent and call for immediate attention. The objection raised is that stoneware sinks cause crockery to be broken. Kitchens should be adequately ventilated and the temperature should not exceed 80 degrees Fahr. Many persons appear to imagine that cooking can only be carried on in an extremely hot kitchen. The lack of provision for keeping food hot whilst being served up often results in the temperature being kept unduly high, windows being closed to prevent the rapid cooling of the dishes. Cupboards or other provision outside the kitchen should be available where wearing apparel not in use may be hung. Means should be taken to exclude as much dust and dirt from entering underground kitchens as possible. Proper receptacles for refuse should be provided. Separate sanitary conveniences and lavatory basin accommodation should be provided outside the kitchen for both sexes and where practicable for the use of employees only. Where lifts are used in connection with kitchens they should be cleansed from time to time. Staff rooms should be provided where possible and especiallv where large numbers are employed. In a really well-arranged kitchen many other things suggest themselves, such as separate scullery and cold (ice) larder, separate rooms for cooked and uncooked food, fish larder, vegetable store, dry goods store, plate room, saucepan room, &c., &c. The Women Inspectors attend to kitchens where women only are employed, and arrangements have been made whereby overlapping is avoided on the part of the Workshop and Women Inspectors in respect of the kitchens where male and female labour is employed. The details of the work of inspection will be found on page 78, and the following inspection card indicates how the different matters referred to above are kept under observation:— 77 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. SUMMARY OF WORK IN FACTORIES AND WORKSHOPS. 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. 78 1914. Summary of Work 1done 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. INSPECTIONS. Factories, Initial Inspections (Tenancies) .. 39 55 11 4 109 Do. Initial Inspections (Workrooms) ... 75 141 21 4 241 Do. Periodical Inspections (Tenancies) 15 340 400 67 17 839 Do. Periodical Inspections (Workrooms) ... 1,241 1,568 175 37 3,021 Do. Re-inspections (Sanitary Works, &c., in hand) ... 333 636 27 2 998 Workshops, Initial Inspections (Tenancies) ... 133 71 41 20 265 Do. Initial Inspections (Workrooms) ... 176 98 86 21 381 Do. Periodical Inspections (Tenancies) 63 692 527 193 166 1,641 Do. Periodical Inspections (Workrooms) ... 927 852 300 251 2,330 Do. Re-inspections (Sanitary Works, &c., in hand) 107 624 468 75 38 1,312 Workplaces, Initial Inspections (Tenancies) 39 ... ... 6 22 67 Do. Initial Inspections (Workrooms) 50 ... ... 6 22 78 Do. Periodical Inspections (Tenancies) 426 ... ... 25 82 533 Do. Periodical Inspections (Workrooms) 622 • •• ... 27 83 732 Do. Re-inspections(Sanitary Works, &c., in hand) 605 ... ... 37 20 662 Bakehouses, Inspections 78 ... ... ... ... 78 Do. Re-inspections (Sanitary Works, &c., in hand) 20 ... ... ... ... 20 DEFECTS FOUND. Factories, Workshops and Workplaces, &c.— Want of Cleanliness 120 226 246 21 72 685 Want of Ventilation 22 19 18 7 17 83 Overcrowding ... 8 7 4 4 23 Want of Drainage of Floors ... ... ... ... ... ... Other Nuisances, &c. 108 393 241 23 51 816 Kitchens— Storage Cistern defective 3 ... ... ... 1 4 Accommodation for Refuse 13 ... ... ... 2 15 Accumulation of Refuse 8 ... ... ... ... 8 Sanitary Accommodation— Insufficient (Tenancies) 6 7 7 ... 8 28 Unsuitable ( Do. ) 4 6 5 1 8 24 Defective ( Do. ) 74 308 348 70 93 893 Do. (No. of Conveniences) * 96 703 655 82 109 *1,645 Not separate for Sexes (Tenancies) 3 7 11 5 ... 26 Total Defects found 361 974 883 131 256 2,605 * Figures not included in total defects found or remedied. † Inspector Dunworth, Military Duties (Mobilised 5th August, 1914). 79  Men Inspectors. Women Inspectors. Totals. Special. Inspector Gathercole. Fast District. Inspector †Dunworth. West District. Inspector Robinson. West District. Miss Safford. East District Miss Wilkinson. DEFECTS REMEDIED. Factories, Workshops and Workplaces, &c.— Want of Cleanliness 179 197 191 21 26 614 Want of Ventilation 30 13 8 5 1 57 Overcrowding ... 6 4 4 ... 14 Want of Drainage of Floors ... ... ... ... ... ... ... Other Nuisances, &c. 133 366 234 19 5 757 Kitchens— Storage Cistern defective 5 ... ... ... ... 5 Accommodation for Refuse 24 ... ... ... ... 24 Accumulation of Refuse 13 ... ... ... ... 13 Sanitary Accommodation— Insufficient (Tenancies) 7 7 5 ... ... 19 Unsuitable ( Do. ) 6 5 5 ... ... 16 Defective ( Do. ) 136 274 334 65 10 819 Do. (No. of Conveniences)* 195 653 638 72 10 *1,568 Not separate for Sexes (Tenancies) 3 4 11 ... ... 18 Total defects remedied 536 872 792 114 42 2,356 SPECIAL INSPECTION WORK. Domestic Workshops—Inspections (Tenancies) ... ... ... 4 ... 4 Do. Initial Inspections (Workrooms) • •• ... ... 4 ... 4 Do. Periodical Inspections (Tenancies) ... ... ... 34 9 43 Do. Periodical Inspections (Workrooms) ... ... ... 34 9 43 Do. Re-inspections (Sanitary works, &c., in hand) ... ... ... 1 ... 1 Do. Defects found ... ... ... 2 ... 2 Do.. Defects remedied ••• ... ... 2 ... 2 Outworkers' Premises, Inspections (Tenancies) ... ... ... 96 1 97 Do. Initial Inspections (Workrooms) ... ... ... ... ... ... Do. Periodical Inspections (Tenancies) ... ... ... ... 1 1 Do. Periodical Inspections (Workrooms) ... ... ... ... ... ... Do. Re-inspections (Sanitary Works, &c., in hand) ... ... ... ... ... ... Do. Defects found ... ... ... ... ... ... Do. Defects remedied ... ... ... ... ... ... Offices, Inspections (Tenancies) ... ... ... 49 12 61 Do. Initial Inspections (Rooms) ... ... ... 63 22 85 Do. Re-inspections (Sanitary Works, &c., in hand) ... ... ... 23 1 24 Do. Defects found ... ... ... 16 3 19 Do. Defects remedied ... ... ... 16 2 18 * Figures not included in total defects found or remedied. † Inspector Dunworth, Military Duties (Mobilised 5th August, 1914). 80  Men Inspectors. Women Inspectors. Totals. Special. Inspector Gathercole. East District. Inspector *Dunworth. West District Inspector Robinson. West District. Miss Safford. East District. Miss Wilkinson. SPECIAL INSPECTION WORK- (continued). London County Council (General Powers) Act, 1904,Inspections of Premises after Cleansing of Children ... ... ... 17 18 35 Do. Do. Re-inspections (Sanitary Works, &c., in hand) ... ... ... 2 ... 2 Do. Do. Defects found ... ... ... 6 ... 6 Do. Do. Defects remedied ... ... ... 2 ... 2 Children Act, 1908 (Nurse Children), Inspections of Premises ... ... ... ... 1 1 Do. Do. Re-inspections ( Sanitary Works, &c., in hand) ... ... ... ... ... ... Do. Do. Defects found ... ... ... ... ... ... Do. Do. Defects remedied ... ... ... ... ... ... Underground Conveniences for Women, Inspections ... ... ... 7 34 41 Do. Do. Re-inspections (Sanitary Works, &c., in hand) ... ... ... ... 6 6 Do. Do. Defects found ... ... ... ... 19 19 Do. Do. Defects remedied ... ... ... ... 6 6 Railway Stations (Ladies' Rooms), Inspections ••• ... ... 5 62 67 Do. ( Do. ), Re-inspections (Sanitary Wort s, &c., in hand) ... ... ... ... 1 1 Do. (Ladies' Rooms), Defects found ... ... ... ... 26 26 Do. ( Do. ), Defects remedied ... ... ... ... 14 14 Notification of Births Act, 1907, Visits ... ... ... 19 257 276 Number of Mothers attending City Shelter for Advice ... ... ... 28 384 412 Special Investigation—Visits ... ... ... 32 176 208 OUTWORKERS. Lists received from City Firms 1,581 ... ... ... ... 1,581 Names and Addresses, &c., received from other Authorities 289 ... ... ... ... 289 Names and Addresses transmitted to other Authorities 15,941 ... ... ... ... 15,941 Notices served on Employers 2,026 ... ... ... ... 2,026 Written Communications 1,731 ... ... ... ... 1,731 Firms visited 125 ... ... ... ... 125 Contacts with Infectious Disease visited 10 ... ... ... ... 10 Workshops notified by H.M. Inspector ... 10 3 18 62 93 General complaints received 20 12 10 4 11 57 * Inspector Dunworth, Military Duties (Mobilised 5th August, 1914). 81  Men Inspectors. Women Inspectors. Totals. Special. Inspector Gathercole. East District. Inspector * Dunworth. West District. Inspector Robinson. West District. Miss SafEord. East District. Miss Wilkinson. ACTION TAKEN. Matters referred to H.M. Inspector— Want of Cleanliness 1 11 42 .... ... 54 Want of Ventilation ... 7 12 ... 1 20 Overcrowding ... 1 3 ... ... 4 Want of Drainage of Floors ... ... ... ... ... ... Failure to affix Abstract ... 96 32 ... ... 128 Other Nuisances ... 2 3 9 2 16 Action taken in matters referred by H.M. Inspector— Notified by H.M. Inspector 1 7 4 6 2 20 Reports sent to H.M. Inspector 1 7 4 6 2 20 Other matters ... 2 ... ... ... 2 Notices served— Factories—Intimations ... 101 101 2 1 205 Statutory ... 18 39 ... ... 57 Workshops—Intimation ... 202 81 12 20 315 Statutory 18 113 72 2 ... 205 Workplaces, &c.—Intimation 111 ... ... 4 35 150 Statutory 66 ... ... ... ... 66 Orders required from Sanitary Committee 108 132 1ll ... ... 351 Certificates for Cleansing issued by Medical Officer of Health 61 38 24 ... ... 123 Matters referred to District Inspectors 24 6 9 9 4 52 Matters referred to Women Inspectors 1 ... ... ... ... 1 Matters referred to Workshop Inspectors ... ... ... 8 18 26 Cases reported for Legal Proceedings ... 1 ... ... ... 1 Legal Proceedings taken ... ... ... ... ... ... * Inspector Dunworth, Military Duties (Mobilised 5th August, 1914). SANITARY DEFECTS IN FACTORIES AND WORKSHOPS NOTIFIED IN 1914 BY H.M, INSPECTOR OF FACTORIES. Complaints were received from H.M. Inspector in respect of 20 matters which were all disposed of before the end of the year or early in the year 1915. 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. 82 OUTWORKERS AND "HOME" WORKERS. The provisions of the Act relating to Outworkers were carried out as heretofore, and the lists of the namefe 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 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 to 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 different Local Authorities. In a number of cases employers neglect 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:— Chicken-pox, 1; Diphtheria, 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 1903 — 118 2,729 2,847 1904 272 123 3,334 3,457 1905 576 236 7,891 8,127 1906 1,112 229 14,376 14,605 1907 1,426 491 16,570 17,061 1908 1,506 624 16,909 17,533 1909 1,515 674 16,193 16,867 1910 1,540 664 17,083 17,747 1911 1,515 656 16,405 17,061 1912 1,481 709 15,777 16,486 1913 1,523 718 16,025 16,743 1914 1,581 739 15,941 16,680 83 THIS TABLE WAS ISSUED BY THE LOCAL GOVERNMENT BOARD BY REQUEST OF THE SECRETARY OF STATE. FACTORIES, WORKSHOPS, WORKPLACES AND HOMEWORK. 1914. 1.—INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inbpectoes or Inspectors of Nuisances. Premises. (1) Number. Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories (including Factory Laundries) 3,262 262 — Workshops (including Workshop Laundries) 2,711 520 — Workplaces (other than Outworkers' premises included in Part 3 of this Report.) 810 216 — Total *6,783 998 — 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. Inspect or. (4) Nuisances under the Public Health Acts:—† Want of cleanliness 685 614 54 — Want of ventilation 83 57 20 — Overcrowding 23 14 4 — Want of drainage of floors — — — — Other nuisances 843 809 16 — ‡Sanitary accommodation insufficient 28 19 — — unsuitable or defective 917 835 — — not separate for sexes 26 18 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) — — — — Breach of special sanitary requirements for bakehouse9(SS. 97 to 100) — — — — Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) — — — — Total 2,605 2,366 94 — * These figures indicate separate work-rooms inspected. †Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. ‡Separate tenancies. 84 85 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) Lists. Sending twice in the year. Lists. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Outworkers Outworkers. Contractors. Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (11) (15) (16) Wearing Apparel— making, &c. 1,360 3,933 10,763 75 122 359 2,026 cleaning and washing 4 4 6 Household linen Lace, Lace Curtains and Nets Curtains and furniture hangings Furniture and Upholstery Electro Plate File making Brass and brass articles Fur pulling (Furriers) 58 113 264 3 27 Cables and Chains Anchors and Grapnels Cart Gear Locks, Latches and Keys Umbrellas, &c. 56 17 411 2 ... 6 Artificial Flowers 16 ... 313 2 ... 17 Nets, other than Wire Nets Tents Sacks Racquet and Tennis Balls Paper, &c., Boxes, Paper Bags 4 15 ... 1 ... 21 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 Wearing Total 1,498 4,082 11,757 83 149 403 2,026 Nil. Nil. Nil. Nil. Nil. Nil. Nil. Nil. * If an occupier gi ves 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 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 class only, but the outworkers should be assigned in columns 3 and 4 (or 6 and 7) into their respective classes. A footnote Bhould be added to show that this has been done. t 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 itatntory duty of sending two lists each year and of the entries of names of outworkers in those lists. The entries in column 2 must necessarily be even numbers, as there will be two lists for each employer—in some previous returns odd numbers have been inserted, The figures in columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. 4.—REGISTERED WORKSHOPS. 5.—OTHER MATTERS. Workshops cn the Register (S. 131) at the end of the year. (1) Number. (2) Class (1) Number. (2) Important classes of workshops, such as workshop bakehouses, may be enumerated here. Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshop Act (S. 133, 1901) 128 General Workshops 3,134 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 20 Bakehouses (including Factory Bakehouses) 24 Reports (of action taken) sent to H.M. Inspector 20 Other 2 Underground Bakehouses (S. 101) :— Certificates granted during the year Nil. Total number of Workshops on Register 3,158 In use at the end of the year 19 Date, 31sf December, 1914. (Signature) W. J. HOWARTH, Medical Officer of Health, Note.—The Factory and Workshop Act, 1901 (S. 132), requires the Medical Officer of Health in his Annual Report to the District Council to report specifically on the administration of that Act in workshops and workplaces, and to send a copy of his Annual Report, or ho much of it as deals with this subject, to the Secretary of State (Home Office). If the Annual Report is presented otherwise than in print, it is unnecessary to include in the copy sent to the Home Office the portions which do not relate to factories, workshops, workplaces, or homework. The duties of Local Authorities and the Medical Officer of Health under the Act of 1901 are detailed in the Home Office Memorandum of March, 1912. 86 MEAT INSPECTION. Details referring to the work which has been carried out at the Central Market and at the slaughterhouses at Aldgate have been prepared by Mr. 0. Sharp, Senior Inspector of Meat, who has been acting as Chief Inspector during the time Mr. Young has been absent on Military Duties. I have already expressed my appreciation of Mr. Sharp's services and the efforts of the whole staff, notwithstanding the absence ot many of their colleagues, to maintain that high standard of efficiency which is aimed at in normal times. Additional duties have devolved upon this branch of my work owing to the increased supervision which has been arranged of premises at which food for army use is received. Practically no complaints have to be noted in this work, and perhaps the chief was the condemnation of a quantity of meat, amounting to 1,125 lbs., which showed decomposition changes. The circumstances were accidental and resulted from a supply of food being sent to an encampment in the country ; this could not be delivered and was returned to Smithfield. The changes were noted on return. In another instance a considerable number of very poor quality carcases of imported meat were surrendered as they were regarded as being below the minimum standard which should be observed in the case of meat intended for human consumption. The Army Service Corps had rejected it, and it was sent to Smithfield, due notice having been given, apparently for an authoritative opinion being expressed. The infection of Argentine tongues with actinomycosis, which was referred to in my last report, has been dealt with by increased supervision being exercised in the country of export. Although these tongues are not yet free from infection, the numbers showing lesions are considerably less. No special difficulties have to be reported in respect of Australian meat. The Dutch pig trade in consequence of the war has gradually declined, and at one time the carcases of such as were received lacked several of the usual satisfactory features from the point of view of condition and quality. Condition was affected by delay, and the quality was more mixed than usual owing to internal conditions in Holland resulting in pigs being consigned to London which are not usually forwarded. Among other matters the question of inspection and packing of offal consigned from Ireland formed the subject of correspondence. As an illustration of the loss incurred by defective packing, 1 need only refer to a consignment examined by Mr. Young on April 14th, which resulted in 134 livers, 140 spleens, 60 sweetbreads, and 20 stone of ox-kidneys being surrendered on account ot decomposition. I made enquiries as to the frequency and nature of defects observed among Dutch pigs, and although I am not able to submit information relating to the whole year's work, 1 found that out of 43,330 carcases consigned to one dealer during the nine weeks of September and October, 39 were seized. None of these were on account of tuberculosis, 28 carcases showed a hydrasmic condition, nine were decomposing, one showed hemorrhagic spots, and one was killed in extremis. Five carcases out of the same consignment had been seized by the Port Sanitary officials for reasons which it was not possible to ascertain at the time of my enquiries. The facts are satisfactory. I have continued the practice now of some years' standing of notifying the official representative of the Government of the exporting country in cases where carcases received from abroad have shown defects. As far as practicable negligence in inspection lias been specifically mentioned in the few cases in which it seemed to exist; in other instances where the defect could not have been recognised at the time of inspection, the fact was stated. 87 REPORT OF THE SENIOR INSPECTOR* I beg to submit herewith the Annual Report of the work of this department for the year 1914. During the year 1914, 425,104 tons of meat, &c., were deposited for sale in the Central Markets, Smithfield, being a decrease of 7,007 tons as compared with the total for 1913. Thanks are due to the Superintendent of the Central Markets for the following table:— Comparison—Supplies 1914 and 1913. Source of Supply or Classification. 1914. 1913. Difference. Ratio per cent. Tons. Tons. Tons. United Kingdom 116,275 99,148 17,127 increase + 17.3 Australasian "Frozen" 97,738 103,463 5,725 decrease — 5.5 *North American " English Killed " — 4,541 4,541 ” -100.0 *North American "Frozen" 1,118 2,111 993 ” -47.0 South American " English Killed " — — — — South American " Chilled " and " Frozen " 143,910 172,863 28,953 decrease - 16-7 Continental Countries 66,063 49,985 16,078 increase + 32-2 Total Meat, Poultry and Provisions 425,104 432,111 7,007 decrease - 1-6 Analysis of Supplies, 1914. 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, of Totals. United Kingdom Tons. 69,366 32.8 Tons. 26,673 19.3 Tons. 7,637 15.9 Tons. 12,599 46.5 Tons. 116,275 27.3 Australasia 10,096 4.8 82,033 59.2 14 03 5,595 20.7 97,738 23.0 North America 183 .1 19 .01 204 .4 712 2.6 1,118 .3 South America 123,228 58.3 20,640 14.9 32 .07 10 .03 143,910 33.9 Continent 8,447 4.0 9,149 6.6 40,277 83.6 8,190 30.2 66,063 15.5 Totals 211,320 100.0 138,514 100.0 48,164 100.0 27,106 100.0 425.104 100.0 * Includes the Dominion of Canada and the United States of America. As stated in last year's Report, the United States of America is still a serious competitor with this country for Argentine meat. This will be readily understood when it is stated that the United States received from South America 48,741 tons of meat in excess of that received in 1913. Presumably this is due to the decline in the Cattle-raising industry. Efforts are being made to cope with same, but as the effect of this cannot be felt for some years, and having regard to the rajiidly increasing population, it appears probable that the Cnited States will continue to be more dependent on imported supplies than hitherto. * This Report has been prepared by Mr. Sharp, Senior Inspector. It is usually undertaken by Mr. Young, Veterinary Surgeon, who was mobilised on August 3rd, and has not since been able to return to his civilian duties. 88 Canadian statistics show a decrease of 12 per cent, in the number of cattle. Canada sent practically no meat to the Uuited Kingdom last year, and further export is unlikely while there is such a near market as the United States of America. South American Beef. Supplies from South America to the Central Markets for the year 1914, aggregated 143,910 tons, which show a decrease of 23,953 tons as compared with 1913. The quality and condition of the meat arriving from this source to the Central Markets, generally speaking, is good, although occasionally diseased quarters of beef are observed, but considering the large quantities of meat arriving, the percentage of disease found is small as shown by the following figures:— Article. Disease. 34 hind-quarters of beef Tuberculosis. 11 fore-quarters of beef „ South American Tongues. A five per cent, examination of all consignments of Argentine ox-tongues is still being carried out. The following figures show the amount of work done:— Record of South American Tongues Examined at the Cold Stores during the Year 1914. Owners. No. of Boxes. No. of Tongues. No. of Tongues Passed. No. of Tongues Rejected. A. 8,214 82,140 81,625 515 B. 10,405 104,050 103,687 363 C. 3,271 32,710 32,332 378 D. 2,436 24,360 24,159 201 E. 524 5,240 5,233 7 Total 24,850 248,500 247,036 1,464 Australian Meat. The importation of Australian Meat shows a decrease as compared with the year 1913, owing to the fact that at the close of the year there were an unusually large number of meat-carrying vessels afloat, some of these having been unduly delayed for transport purposes. The following shows the number of quarters and buttocks examined :— Nos. certified. Nos. examined. 33,418 hind-quarters. 32,962 hind-quarters. 16,924 crops of beef. 16,924 crops of beef. 192 buttocks. 192 buttocks. 89 Exportation of Meat. In May, 1914, the Sanitary Committee agreed to the following scale of charges respect of the examination and certification of meat for export. 1st 100 quarters of beef or carcases of mutton at 6d. each. 2nd ,, ,, ,, ,, at 5d. ,, 3rd „ „ „ „ „ at 4d. „ 4th ,, ,, ,, ,, at 3d. ,, 5th and „ ,, ,, ,, ,, at 2d. ,, over. Notwithstanding the above reduction in charges, the trade shows a large decrease as compared with 1913, and practically ceased towards the latter end of the year, this being due in a great measure to the sudden increase in prices owing to war conditions. The following table shows the amount of meat exported from the Central Markets accompanied by Certificates granted by the Medical Officer of Health. Examination of Meat for Export, &c. Certificates granted by the Medical Officer of Health. Destination. Fore-quarters of Beef. Hind-quarters of Beef. Crops of Beef. Top pieces of Beef. Pieces of Beef (various). Carcases of Mutton. Pieces of Mutton. Carcases of Lamb. Bags of Suet. Ox Tongues. France ... ... ... ... 20 200 ... ... ... ... Holland ... 84 117 78 ... ... ... ... 10 ... Switzerland 1,487 2,312 ... ... 8 930 ... 91 ... 50 United States 150 150 ... ... 3,240 ... 218 ... ... ... Brand (Lambeth) ... ... ... ... 14 & 10 Barrels ... ... ... ... ... Norway ... ... ... ... 3 Barrels. ... ... ... ... ... South America ... ... ... ... ... ... 478 Stone ... ... ... Totals 1,637 2,546 117 78 3282 & 13 Barrels. 1,130 218 & 478 Stone. 91 10 50 TUBERCULOSIS. Tuberculosis still remains the most prevalent disease noted in meat exposed for sale in the Central Markets. It will be observed that there is a slight decrease in the amount of meat seized as compared with the figures for the year 1913, as shown by the following Table. Tuberculous Meat Seized at Central Markets during the Year 1914. Carcases, Quarters and Pieces. Beep. pobk. Veal. Carcases. Quarters. Pieces. Carcases. Q uarters. Pieces. Carcases. Pieces. 1914 12 79 91 431 19 61 3 2 1913 11 60 57 494 9 71 3 — 90 Offal. Beef. Pork. Calves. Heads. Tongues. Lungs. Hearts. Livers. Stomachs. Spleens. Mesentery. Intestines. Kidneys. Heads. Lungs. Hearts. Livers. Mesentery. Kidneys. Lung. Hearts. Livers. 1914 37 53 17 2 12 1 3 1 1 2 1,785 153 153 160 37 9 1 1 1 1913 20 20 5 1 3 — 1 1 — — 2,690 211 204 224 90 6 1 1 1 Tons. cwts. qrs. lbs. Total weight of Tuberculous Meat seized in the Central Markets, 1914 50 2 2 7 „ „ „ „ „ 1913 53 2 1 27 Leadenhall Market and City Shops. The Leadenhall Market and City Shops have been carefully inspected during the year, and tbe following table shows the variety of unsound food dealt with:— Unsound Food Destroyed. Poultry and Game. Rail 2 Capercailzies 164 Snipe 1,425 Curlew 3 Starlings 2 Chickens and Pouissins 1,005 Storks 3 Crow 1 Turkeys 198 Ducks 1,207 Teal 273 Divers 1 W oodcocks 76 Fowls 4,353 Widgeons 64 Game (Unclassified) 1,429 Eggs. Gulls 13 Geese 181 Plovers 1,190 Grouse 737 Hens 3,442 Gosling 1 Ducks 50 Game, Black 440 Meat and Offal. Guinea Fowls 80 Hazel Hens 1,891 Beef (Aitch Bone) 1 Hares 755 Deer 10 Herons 2 Feet (Calves') 104 Leverets 3 Fish (Various) box 1 Ortlands 23 Heads (Pigs') 1 Oyster Catcher 1 „ (Calves) 2 Pintail 1 Lambs 1 Partridges 404 Mutton (Pieces) 1 Ptarmigans 432 Offal (Set Calves) 1 Plovers 509 Pigs 4 Pigeons 845 Plucks (Sows') 1 Pheasants 709 Pork (Piece) 1 Pea Hens 2 Stomachs (Beef) 7 Quails 1,694 Tongues (Sows') 1 Rabbits 3,304 Red Herrings barrel 1 Redshank 1 Venison (Quarters) 5 Rooks 41 „ (Pieces) 12 Tons cwts. qrs. lbs. Total for the year 1914 16 13 2 15 „ „ 1913 17 12 0 14 Decrease 0 18 1 27 91 COLD STORES. The following table shows a slight increase in the amount of unsound food destroyed from the Cold Stores. Much work has been entailed by the examination of Colonial Meat, &c., upon which embargos have been placed. Unsound Food ex Cold Stores. Article. Number. How packed. Country of Origin. Cause for destruction. Tons cwts. qrs. lbs. Beef Quarters 2 — Australia Decomposed 0 2 1 0 Ditto 2 — Ditto Mouldy 0 1 1 16 Ditto 1 — Argentina Decomposed 0 1 2 13 Beef Pieces Unenumerated — Ditto Ditto 1 6 3 17 Ditto Ditto — Australia Ditto 1 11 0 0 Ditto Ditto — Ditto Parasitic affection 22 15 1 3 Ditto Ditto — Argentina Brine stain 0 1 3 8 Ditto Ditto — Ditto Bone taint 1 7 3 12 Beef (tins) 549 In tins United States of America. Decomposed 0 14 3 10 Beef Head Meat Unenumerated In bags and cases Argentina Ditto 3 6 1 23 Birds Ditto In hampers Not ascertained Ditto 0 17 3 22 Ducks Ditto In cases Ditto Ditto 2 3 3 9 Fish Ditto In boxes Ditto Ditto 0 15 0 12 Fowls Ditto In hampers Ditto Ditto 0 4 0 26 Game Ditto Ditto Ditto Ditto 0 15 3 16 Hares 5 c/s In cases Australia Ditto 0 3 0 14 Hearts (ox) Unenumerated In boxes Argentina Ditto 0 0 3 24 Kidneys (sheep) 233 dozen Ditto Ditto Ditto 0 2 2 22 Livers (ox) Unenumerated Ditto Ditto Ditto 4 14 3 6 Ditto Ditto Ditto Ditto Parasitic affection 0 10 0 9 Mutton Carcases 73 — Australia Decomposed 1 11 2 19 Ditto 80 — Ditto Damaged 1 12 2 13 Ditto 73 — Argentina Mouldy 1 12 0 20 Ditto 21 — Ditto Decomposed 0 5 1 14 Ditto 3 — Ditto Brine stain 0 1 1 19 Mutton Pieces Unenumerated — Australia Decomposed 1 6 2 26 Carried forward 48 8 0 9 92 Article. Number. How packed. Country of Origin. Cause for destruction. Tons cwts. qrs. lbs. Brought forward 48 8 0 9 Mutton Pieces Unenumerated — Australia Brine stain 0 0 2 24 Ditto Ditto — Ditto Mouldy 0 0 0 10 Ditto Ditto — Ditto Damaged 0 0 0 18 Ditto Ditto — Argentina Decomposed 0 3 0 9 Ditto Ditto — Ditto Mouldy 0 1 0 10 Ditto Ditto — Ditto Brine stain 0 1 0 25 Offal (various) Ditto In boxes Not ascertained Decomposed 4 1 1 6 Poultry Ditto Ditto Ditto Ditto 0 6 3 8 Pork (hams) 80 Ditto United States of America, Ditto 0 10 2 13 Rabbits 8 Cases In cases Not ascertained Ditto 0 5 1 2 Suet — Ditto Argentina Ditto 0 0 0 4 Sweetbreads (ox) — Ditto Ditto Ditto 0 2 2 8 Tails (ox) — Ditto Ditto Ditto 0 10 1 6 Tongues (ox) 306 Ditto Ditto Diseased 0 14 1 7 Ditto 5 Ditto Ditto Injury 0 0 0 23 Tripe — In boxes Ditto Decomposed 0 1 0 1 Venison Carcases 7 — Not ascertained Ditto 0 1 3 14 Venison Pieces — — Ditto Ditto 0 6 0 6 Eggs 218 In tins Ditto Ditto 1 3 1 12 Turtle 1 — Ditto Ditto 0 3 0 0 Total for 1914 57 1 0 19 Total for 1913 56 16 2 18 Increase 0 4 2 1 ALDGATE MARKET AND SLAUGHTERHOUSES. The reduction in the number of animals slaughtered at Aldgate is accounted for by the high prices and the scarcity of first class quality cattle, together with the fact that very few aged cows are now slaughtered in the City. 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 of any other day, shall give to the Corporation at least three hours' notice in writing of such intention." The following table shows the number of hours of additional duty which resulted from the operation of this Bye-law during the year 1914:— Weekdays. Sundays. No. of Notices received. Before 6 a.m. After 9 p.m. Before 7 a.m. After 3 p.m. Hours. Hours. Hours. Hours. 129 6¾ 280½ 1 18 93 The following table shows the number of animals slaughtered as compared with 1913:— 1914. 1913. Bulls 166 1,532 Calves 8,340 8,601 Cows 109 2,192 Heifers 145 349 Oxen 10,865 12,389 Sheep 15,968 18,996 Various 64 28 35,657 44,087 It will be observed that the number of bovine animals slaughtered at Aldgate was 19,625; of these, 453 were found affected with tuberculosis to a varying degree. On malysis of the figures it is found that the percentages under the various headings were is follows:— Bulls 31, or 18.67 per cent. affected. Calves 31, „ .37 „ „ Cows 27, „ 24.77 „ „ Heifers 4, „ 2.75 „ „ Oxen 360, „ 3.31 „ ,, As formerly stated, tuberculosis is the principal disease rendering carcases or portions of them unfit for human food. Carcases and Quarters Seized and Destroyed at Aldgate. Causes for Destruction. Beef. Mutton. Veal. Goat. Pig. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Carcases. Quarters. Carcases. Asphyxia ... ... 2 ... 7 ... ... ... Decomposed ... ... 1 15 ... 5 ... ... ... Emaciated ... ... ... ... ... ... 1 .... ... Functional Derangement ... ... 3 ... 1 ... ... ... ... Hydræmia ... ... 32 ... 3 ... ... ... 1 Lymphadenitis ... ... 1 ... ... ... ... ... ... Peritonitis ... ... 2 ... ... ... ... ... ... Pleurisy ... ... ... 1 ... ... ... ... ... Tuberculosis 21 13 ... ... 7 4 ... ... ... Not marketable ... ... 10 ... 5 ... ... ... ... Totals for year 1914 21 13 51 36 23 9 1 — 1 Totals for year 1913 164 80 50 1 35 4 — — — 94 Record of Organs seized at Aldgate. Reason for Destruction. Oxen. Sheep. Calves. Goat's. Pigs 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. Kidneys. Heads. Tongues. Lungs. Hearts. Livers. Stomachs. Spleens. Mesentries. Intestines. Kidneys. Heads. Abscesses 30 16 35 ... 382 3 5 ... ... 3 7 7 24 11 22 1 14 ... ... 2 1 ... 5 2 18 1 8 2 2 .... ... ... ... ... ... ... ... ... ... ... ... Actinomycosis 212 414 22 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Asphyxia ... ... 1 ... ... ... ... ... ... ... 2 2 2 2 2 2 2 2 2 4 5 5 5 5 5 5 5 5 5 10 ... ... ... ... ... ... ... ... ... ... ... Bacteria Necrosis ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... l ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Blood Aspiration ... ... 179 ... ... ... ... ... ... ... ... ... 8 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cavernous Angioma ... ... ... ... 15 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis ... ... ... ... 76 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Decomposition ... 15 ... ... ... 52 1 5 ... 8 1 1 12 ... 8 439 ... ... 4 ... ... ... 68 48 20 ... 15 1 1 ... 1 1 ... ... ... ... ... ... ... ... ... Emaciated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 1 1 1 1 2 1 Functional Derangement ... ... ... ... ... ... ... ... ... ... 3 3 3 3 3 3 3 3 3 6 1 1 1 1 1 1 1 1 1 2 ... ... ... ... ... ... ... ... ... ... ... Hydræmia ... ... ... ... ... ... 13 ... ... ... 12 13 8 25 14 8 13 10 10 28 3 3 3 3 3 3 3 3 3 6 ... ... ... ... ... ... ... ... ... ... ... Injury ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lymphadenitis ... ... ... ... ... ... ... ... ... ... 1 1 1 1 1 1 1 1 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Melanosis ... ... 6 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... ... ... ... ... ... ... 7 ... ... ... ... ... ... ... ... ... 9 ... ... ... ... ... ... ... ... ... 8 ... ... ... ... ... ... ... ... ... ... ... Parasitic Disease ... ... 323 ... 1826 ... ... ... ... ... 2 ... 550 ... 524 ... 16 ... ... ... ... ... 3 ... 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Peritonitis ... ... ... ... ... 8 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pericarditis ... ... ... 23 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pleurisy ... ... 618 ... ... ... ... ... ... ... ... ... 21 ... ... ... ... ... ... ... ... ... 13 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Parasitic Pneumonia ... ... 366 ... ... ... ... ... ... ... ... ... 135 ... ... ... ... ... ... ... ... ... 41 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Pyæemia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rumenitis ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ringworm ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis 300 59 225 54 129 48 49 121 122 57 ... ... ... ... ... ... ... ... ... ... 7 7 34 7 31 11 32 12 12 14 ... ... ... ... ... ... ... ... ... ... 1 Not marketable ... ... 4 ... ... 1 4 ... ... ... 1 2 1 10 1 1 3 ... ... ... 3 3 4 6 6 3 4 7 7 6 ... ... ... ... ... ... ... ... ... ... ... Totals for the year 1914 542 504 1779 77 2433 115 72 126 122 75 29 29 767 52 576 455 52 16 20 51 22 21 177 78 93 24 68 31 31 41 1 1 2 1 1 1 1 1 1 2 1 Totals for the year 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 34 72 - - - - - - - - - - - 95 Summary of Unsound Food Destroyed. Tons. cwt. qrs. lbs. Central Markets, Smithfield 1,156 13 1 4 Cold Stores 57 1 0 19 Leadenhall Market and City Shops 16 13 2 15 Aldgate Market and Slaughterhouses 43 9 2 18 Total for the year 1914 1,273 17 3 0 Total for the year 1913 1,057 5 1 0 Increase 216 12 2 0 During the year 9 Naval Officers and 13 Army Officers attended courses of instruction in Meat Inspection at the Markets. O. SHARP, Senior Inspector. 96 CERTIFICATION OF MEAT FOR EXPORT TO THE UNITED STATES OF AMERICA. The importation of meat and meat food products into the United States of America has for some years been the subject of certain restrictions in the form of certification. These restrictions have now been increased by the issue of new regulations* relating to the certificates in question. Persons exporting meat and meat food products to the United States 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 the premises where the food is stored or prepared, &c., are entitled to receive a certificate from the Certifying Officer appointed in respect of the particular premises. Imported meat and meat food products are divided into three groups, and a different certificate is provided for each. Form A is to be given in respect of meat and meat food products derived from animals slaughtered in this country and transported to the United States without unloading in any foreign country, except for the purposes of transfer from one carrier to another. Provision is made in this form of certificate to the effect that the meat (1) is derived from animals which have received ante-mortem and post-mortem veterinary inspection at the time of slaughter, (2) does not contain any preservative or colouring matter, &c., (3) has been handled in a sanitary manner, and (4) is otherwise fit for human food. Form B is the certificate to be used in respect of meat and meat food products, the transportation of which to the United States from the country of the slaughter of the animals has been interrupted by unloading in another foreign country for the purpose other than the transfer from one carrier to another. This form of certificate provides for a declaration to the same effect as in Form A, with the addition of a statement that the meat and meat food products have not been treated in this country with any preservative, colouring matter, &c., and have been handled in a sanitary manner and are otherwise fit for human food. Form C is to be used in respect of articles of a kind customarily prepared to be eaten without cooking and which contains muscle tissue of pork. Provision is made in this certificate for a declaration to the effect that the article when fresh or freshly cured in salt was subjected to a temperature not higher than 12 degrees F. for not less than 20 days, and that the said article contains no muscle tissue of pork which has not been so treated. There are obviously many difficulties which may arise in the signing of the above documents, and in those cases where the meat has not been continuously under the supervision of your own Inspectors, some form of supplementary proof may be required by the Certifying Officer. Your Medical Officer of Health is designated Certifying Officer for the above purposes. Copies of Forms A, B, and C are reproduced in Appendix C. * Bureau of Animal Industry Order 211, Regulation 27. 97 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 premises registered were inspected from time to time to ensure their being kept up to the standard of sanitary requirements set forth in the memorandum before mentioned. THE PUBLIC HEALTH (REGULATIONS AS TO FOOD) ACT, 1907- FOREIGN MEAT. In accordance with the above Regulations the Local Government Board have from time to time caused to be published in the London Gazette, Notices in respect of labels which have been declared admissible as Official Certificates in respect of Pork and other edible portions of the pig which have been subjected to inspection in the particular country to which such Notice refers. The expression " Official Certificate" in the Public Health (Foreign Meat) Regulations, 1908, includes a prescribed label or mark which is accepted as evidence that the pig from which the meat is derived has been certified by a competent authority in the place of origin to be free from disease at the time of slaughter, and that the meat has been certified by the like authority to have been dressed or prepared, and jiacked with the needful observance of all requirements for the prevention of danger arising to public health from the meat as an article of food. The Official Certificate affords a valuable indication as to the extent of examination it is necessary to make of such imported carcases under the Foreign Meat Regulations. It does not, however, exempt meat from liability to inspection in this country. During the year under review eight certificates have been recognised, and the following is a list of the countries in respect of which Official Certificates have now been issued:— Denmark. The Netherlands. The Dominion of Canada. The Dominion of New Zealand. Belgium. The Commonwealth of Australia. 98 Russia (the seven following premises)— 1. No. 1 Slaughterhouse at Libau. 2. Exportation Slaughterhouse (Barselman Society) at Station Rtistchewo of Riasan-Oural Railway. 3. " Union " Slaughterhouse at Kurgan. 4. Kurgan Export Bacon Factory at Kurgan. 5. " Union" Slaughterhouse (Cold Storage Company) at Koslow, Tambov Government. 6. Slaughterhouse (Barselman Brothers) at Esipovo, South Eastern Railway. 7. No. 3 Slaughterhouse (Anglo-Russian Company) at Station Nikiforovka of Riasan-Oural Railway. Sweden. VISIT OF VETERINARY SURGEON TO ARGENTINA. In April last the report of the Veterinary Surgeon respecting his visit to the Argentine Republic was issuer!, and although it is unnecessary to refer again in extenso to that interesting document, a brief review as to the object and result of the visit may be of interest. In July, 1913, the Argentine Government invited the Corporation to allow their Veterinary Surgeon to go out to Argentina to visit the freezing works and to see the system of meat inspection in operation in that country. It may be that this invitation was the result of complaints which had been made by the City Corporation with regard to the condition of Argentine meat on its arrival in this country. The Corporation accepted the invitation of the Argentine Government, subject to the following conditions: — 1. That no public expression of policy or advice be expected or given. 2. That the Veterinary Surgeon should prepare a report, which should be of a private character, the decision as to publication of all or any part to . rest with the Corporation. The first requirement seemed advisable since Mr. Young could not act in any sense as an advisory official to the Argentine Government or to the trade in general ; and further, as Argentine trade extends to other districts than London, it would be inadvisable for the official of one Corporation to make suggestions which might or might not be acceptable to others. The position of advisor could only be assumed by a Government official. Mr. Young's report deals with the following matters:— (a) Importance of the Argentine Meat Trade. (b) Particulars of the different Frigorificos. (c) Buildings and surroundings with criticisms as to the approaches to some of the slaughterhouses, the structure of certain accessories, and the question of cleanliness, &c. (d) Freezing and chilling rooms. Landing of meat into steamers and provision of cool rooms on board transports. 99 (e) Method of slaughter and cleaning carcases. (f) Method of disposal of offal. (g) Method of inspection as conducted in the Frigorificos. (h) The chief diseases and the method of dealing with carcases and organs affected with disease. (i) The inspection of meat used in the Canning industry. With regard to the methods of dealing with carcases and organs, it is interesting to note the ingenious method used in Argentina. Different coloured skewers, in either vertical or horizontal position, are used to indicate the different lesions. This system, if properly carried out, gives valuable information when it is found impracticable for the organs to accompany the carcase throughout the entire inspection. The Inspectors in Argentina are all Veterinary Surgeons. When they can be obtained the Assistant Inspectors are selected from practical butchers, but they do not hold any certificate as to proof of knowledge of the duties entrusted to them. Appendices are added to the report, and these include a statement by Dr. Suarez as to the qualifications of the Meat Inspectors, &c., translations of the different regulations affecting the meat trade, the future prospects of meat supplies, and a concluding suggestion by Mr. Young respecting the advisability of a representative of the English Government being located in a suitable centre in this meat producing area* With this latter suggestion I am in complete accord. It should be remembered that when the meat arrives in this country only the carcases are available for examination, and a considerable amount of confidence must be placed in the methods adopted in the country of slaughter. Although the suggestion throws no reflection upon the character of the inspection in that country, it would, I am of opinion, be an advantage to both the importing and exporting countries if the services of an officer as suggested were available. *Table showing the average deliveries at the Central Meat Market, and other details for successive quinquennial periods during the past 41 years:— Quinquennium. Annual Average General Supply. Seizures by Inspectors. o/0 of Unsound 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 1914 425,104 0 0 1,273 17 3 •300 * I am indebted to the Clerk and Superintendent of the Central Markets for the figures relating to the market supplies, sources of origin, &c. 100 *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. 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 1914 19.9 7.4 15.5 — 34.2 23.0 †Includes " General Foreign Meat and Produce." ‡Includes South 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:— 1910. 1911. 1912. 1913. 1914. Tons. Tons. Tons. Tons. Tons. Average daily delivery into the Markets 1,371 1,390 1,379 1,408 1,385 § Minimum delivery on any one day 219 171 214 199 197 Maximum delivery on any one day 3,200 3,066 2,943 4,398 3,785 The heaviest weight previously recorded on any one day (22nd December, 1913) was 4,398 tons. § The minimum deliveries relate to Saturdays when practically no wholesale business at the Market is carried out. One ton in every 334 tons of meat paying toll in the Central Markets, Smithfield, was condemned last year, as compared with one ton in 408 in 1913. UNSOUND MEAT, 1914. *1 am indebted to the Clerk and Superintendent of the Central Markets for the figures relating to the market supplies, sources of origin, &c. The meat, &c., seized by your Inspectors as unfit for food is classified as under:— 1914. 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 40 10 3 24 117 6 3 11 35 17 3 27 16 17 2 27 25 18 3 19 0 14 2 18 237 7 0 14 Second ,, 36 5 0 6 204 3 3 25 50 2 2 23 13 19 1 16 43 17 2 22 0 10 0 14 348 18 3 22 Third„ 17 4 2 19 306 11 2 24 18 1 1 6 19 10 1 21 91 10 1 0 0 6 0 22 453 4 2 8 Fourth „ 33 8 1 21 73 14 3 16 23 13 1 5 45 8 2 7 55 2 3 23 0 0 0 15 231 8 1 3 Total 127 9 0 14 701 17 1 20 127 15 1 5 95 16 0 15 216 9 3 8 1 11 0 13 1,270 18 3 19 101 The percentages of meat seized under the various headings of the above Table during 1914 and for the preceding five years, classed as diseased, unsound and unwholesome, were as follows:— Year. Diseased. Unsound.* Unwholesome. 1909 Per Cent. 7.5 Per Cent. 87.5 Per Cent. 5.0 1910 7.1 84.2 8.7 1911 3.8 93.1 3.1 1912 12.5 79.2 8.3 1913 13.4 77.0 9.6 Average for 5 years 8.9 84.2 7.0 1914 10.0 80.0 10.0 * Includes poultry, offal and fish. CENTRAL MARKETS, SMITHFIELD. Table showing Weight of Meat delivered, and Meat delivered to Contractors as unsound, during each Month of the Years 1913 and 1914. Month. Meat delivered at the Market. 1913. Unsound Meat delivered to Contractors, 1913. Meat delivered at the Market, 1914. Unsound Meat delivered to Contractors, 1914. Tons cwts. qrs. Tons cwts. qrs. Tons cwts. qrs. Tons cwts. qrs. January 39,048 0 0 105 14 3 37,923 0 0 65 10 1 February 33,567 0 0 88 7 2 34,009 0 0 83 13 2 March 35,448 0 0 68 18 2 38,485 0 0 115 15 2 April 34,602 0 0 107 7 0 36,648 0 0 138 2 1 May 37,155 0 0 86 5 1 37,422 0 0 77 16 1 June 35,320 0 0 86 16 3 34,698 0 0 110 13 1 July 36,619 0 0 83 12 0 36,720 0 0 148 18 0 August 32,304 0 0 77 0 3 30,955 0 0 163 0 1 September 35,374 0 0 77 12 3 31,418 0 0 142 15 2 October 39,070 0 0 119 13 0 34,144 0 0 63 12 3 November 33,141 0 0 70 1 0 36,229 0 0 57 13 1 December 40,464 0 0 85 16 0 36,453 0 0 106 7 0 Totals 432,112 0 0 1,057 5 1 425,104 0 0 1,273 17 3 102 DISEASED MEAT PROSECUTIONS, 1914. Serial Number. Date of Hearing. Where Heard. Before whom. Occupation of Person Summoned. Defendant's Place of Business. Result. 1914. 1 Feb. 20 Guildhall . Alderman Sir John Knill, Bart. Butcher and Cattle Dealer. Evercreech Junction, Chard, Somerset. Fined 251, and 5l. 5s. costs. 2 June 10 Mansion House The Rt. Hon. the Lord Mayor. Butcher Aldgate Adjourned and subsequently withdrawn. 3 Aug. 5 Guildhall . Alderman Sir John Baddeley. Horse Slaughterer East Winch, Kings Lynn. Defendant failed to appear. Warrant issued for arrest. In the course of investigation into case No. 1 (Frederick Clacee), it was ascertained that the defendant carried on the business of a dealer in— a. Meat for human food, b. „ ,, cats' food, c. „ „ pigs' food, d. „ „ poultry food, and that all these businesses were conducted on common premises. In my opinion it is most undesirable that premises on which food is prepared for human consumption should be associated with the production of foods for the use of animals, and I accordingly communicated all the facts to the Medical Officer of Health for the County of Somerset. In future legislation it might be well for the Local Government Board to consider the desirability of preventing such a combination of businesses on common premises. FISH SUPPLIES. 209,023 tons of fish, of which 165,379 were land.borne and 43,644 water.borne, were received at or near Billingsgate Market during the year. This was an increase of 5,326 tons in the land deliveries, and a decrease of 18,034 tons in the deliveries by water. 103 MONTHLY FISH RETURNS, 1914. 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 1914.* 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 14,528 4,966 19,494 45 18 3 1 ton in 424.359 tons, or "235 February 13,959 3,979 17,938 39 18 1 1 „ 449.433 „ „ "222 March 16,441 6,471 21,912 35 5 3 1 „ 620.956 „ „ .161 April 14,265 6,164 20,429 69 2 3 1 „ 295.483 „ „ .338 May 13,286 5,109 18,395 80 15 3 1 „ 227.696 „ „ .438 June 14,901 5,133 20,034 218 15 3 1 „ 91.568 „ „ 1.092 July 13,596 5,026 18,622 235 8 3 1 „ 79.095 „ „ 1.264 August 13,905 1,171 15,076 265 5 1 1 „ 56.834 „ „ 1.759 September 15,345 468 15,813 147 12 0 1 „ 107.134 „ „ 933 October 15,335 2,572 17,907 125 7 1 1 „ 142.841 „ „ .7 November 12,091 1,439 13,530 40 11 1 1 „ 333.659 „ „ .299 December 8,727 1,146 9,873 45 15 3 1 „ 215.626 „ „ .463 Total 165,379 43,644 209,023 1,349 17 1 1 „ 154.831 „ „ .646 * Compiled from the Monthly Returns furnished to the Corporation by the Fishmongers' Company. Monthly Deliveries of Fish at London Central Markets, Smithfield, 1914. Tons Cwts. Qrs. January 127 11 0 February 128 4 0 March 155 16 0 April 140 3 0 May 124 4 0 June 132 4 0 July 112 14 0 August 92 0 0 September 94 0 0 October 116 10 0 November 110 8 0 December 95 5 0 Total 1,428 19 0 Of the above, 1 ton 15 cwts. 3 qrs. 13 lbs. were seized as unsound by your Officers, and those of the Fishmongers' Company. This equals .126 per cent. of the whole, or 1 ton in 793 tons. 104 Weight of Fish Delivered, Fish seized as Unsound, and percentage of Fish Condemned to that Delivered, at or near Billingsgate Market during 1914 and the five years 1909.1913. Year. Weight of Fish Delivered. Total. Weight of Fish Condemned. Ratio of Fish Condemned to that Delivered. By Land. By Water. Tons. Tons. Tons. Tons cwts qrs. 1909 179,157 68,918 248,075 946 15 1 1 ton in 262 tons, or .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 „ 1913 160,053 61,678 221,731 1,249 5 3 1 „ 178 „ .563,, Average (5 years) 165,569 67,927 233,496 1,331 7 1 1 ton in 184 tons, or .573 % 1914 165,379 43,644 209,023 1,349 17 1 1 ton in 155 tons, or .646% INSPECTION OF FOOD AT RIVERSIDE WHARVES, &c. As a result of the daily inspection of the City Wharves, 84 loads of Unsound Food were removed from these places during the year 1914 by the Cleansing Department. The material so disposed of comprised:— Tons. Cwts. Qrs. Tinned fruit and vegetables 9 7 0 Miscellaneous tinned food 18 4 2 Fruit pulp 23 14 0 Fruit and vegetables 41 5 0 Miscellaneous food 540 Total 97 14 2 The greater portion of the above was removed at the request of the owners. There has been a marked decrease in the quantity of food destroyed under the above heading. In 1913 the weight of food so destroyed was 176 tons 14 cwts. This wide difference is doubtless accounted for by the fact that a large firm of tinned goods importers, who weekly surrendered about 1 ton 5 cwts. for destruction, have removed from the City of London to more commodious premises in an adjoining district. ICE CREAM. In 1914 there were 191 premises in the City where ice cream was sold, as compared with 269 in 1913. In 89 instances the ice cream sold at these establishments was manufactured under supervision within the City, and in 102 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 of preparation. 105 ITINERANT ICE CREAM VENDORS. In last year's report it was stated that an increase had taken place in the number of itinerant ice cream vendors perambulating the streets of the City. This year, fortunately, the number has decreased to 26, all of whom are aliens, and bear a street trader's badge issued since the City of London Street Traders Act (Traffic), 1909, came into operation on 1st October, 1912. The utensils used by these 26 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 addresses displayed on the barrows were correct and that the article sold was produced under proper conditions. 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) A.ct, 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 li 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." The above Order has been better observed during this year than heretofore, and it was not necessary to institute a prosecution against any itinerant vendor for failing to exhibit the required name and address. Last year there were four instances of such proceedings having been taken, DAIRIES, COWSHEDS AND MILKSHOPS ORDERS. At the end of the year there were 639 Purveyors of Milk and Dairyman registered in the City of London, as compared with 640 in 1913. The sale of milk was discontinued at 31 premises, and the owners' names removed from the Register; 54 new registrations have been reported, of which 30 were instances of new businesses being established, and 24 were consequent on there being a change of ownership. 106 The milk sellers of the City may be divided into two groups, viz., retailers, who, at a shop, sell milk which may be taken away, or may be consumed 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 are designated "Dairymen." Of the former there are 614, and of the latter 25. Improvements were necessary in six instances at the premises of persons registered as Purveyors of Milk. In three instances the premises required cleansing and whitewashing, and uncovered milk vessels were found to be in use at three 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 the washing and storing of the cans used in the business have been 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. SALE OF FOOD AND DRUGS ACTS AND PUBLIC HEALTH (MILK AND CREAM) REGULATIONS. During the year, 909 articles of food were examined by the Public Analyst, under the Sale of Food and Drugs Acts, 1875 to 1907, and the Public Health (Milk and Cream) Regulations, 1912. This number includes 131 samples obtained and dealt with without the formalities of the Act being observed, and 778 taken with the procedure prescribed by the Act. Of the informal samples 33 were found to be deficient, 17 being instances of non.observance of the requirements of the Milk and Cream Regulations, and 16 of Milk, Butter and Vinegar sophistication. As a consequence, subsequent formal samples were obtained of the same vendors and proceedings taken in the usual way. Of the samples purchased formally, 28 were found to be sophisticated, which represents a percentage of 3.6. It is satisfactory to note that the percentage of adulteration is slightly less than last year, being 3.6 as against 4.6, which is more particularly gratifying when taking into consideration the altered conditions of the last few months. 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 that has taken place in that period. The percentage in 1904 was 5.5, as against 3.6 in the present year. A much lower percentage than this cannot be hoped for, as a generous allowance must always be made for "accidental adulteration," i.e., fat abstracted from Milk by careless employees, and the failure of the cow to maintain under abnormal conditions the percentage of fat required to be present in this product. 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 114 and 115. 107 The percentage of adulteration of samples taken in England and Wales in 1877 was 16.2; this percentage has been continuously reduced, and in 1913 (the latest figures obtainable) the percentage was 8.2. The accompanying Table has been partly compiled from the Annual Reports of the Local Government Board, to which are added some figures for the City of London, and London as a whole:— Year. Total Number of Samples Examined in England and Wales. Number Examined in the City of London. Percentage of Total Number Examined in City of London. Number of Persons to each Sample examined. England and Wales. *City of London. London. 1881 17,823 162 •92 1,462 318 760 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 adulteration of milk during 1914 (as compared with 1913) is shown in the following Table:— Year. No. of Samples Examined. Found Adulterated. Percentage of Adulterated Samples. 1901 392 83 21.2 1902 599 80 13.3 1903 517 60 11.6 1904 452 35 7.7 1905 481 36 7.5 1906 556 43 7.7 1907 472 40 8.4 1908 469 29 6.2 1909 520 25 4.8 1910 474 20 4.2 1911 453 15 3.3 1912 481 19 3.9 1913 398 13 3.2 1914 346 30 8.6 At first sight this high percentage of milk adulteration (as compared with former years) would appear to be serious. This is not so, however, as 9 of the adulterated samples were informal samples, 5 of which were obtained from the same vendor with the object of proving him to be guilty of systematically tampering with the milk sold by him. In this particular case a formal sample was subsequently taken, prosecution followed, and a fine of 30l. and 21. 2s. costs was imposed. The extremes of sophistication in the case of milk were, in respect of added water, 3 to 35 per cent., and of fat abstraction 6 to 31 per cent. The fine imposed in the case of the highest percentage of added water was one of 51. and 1l. 1s. costs; in the case of the vendor of the highest percentage of fat abstracted (two showing 31 per cent. fat abstracted), one was fined 21. and 1l. 1s. costs, the other was able to prove warranty. 108 Sixty samples of milk were taken in course of delivery. Fifty-eight of this number were obtained at the Railway Station on arrival from the Country, the other two were taken at eating.houses as they were being delivered by the wholesale dealers. Of the milks taken at the Railway Station 4 were found to be deficient. One case was that of a farmer who sent two churns consigned to a London dairyman, the milk in one of these churns containing 17 per cent. added water, and the other 7 per cent. added water, he was prosecuted and fined 10l. and 1l. 1s. for the first offence and 3l. and 1l. 1s. for the second; in the case of the other two samples, the churns were both consigned 'by a Dairy Company from their own farm to their London Depot, one churn contained milk adulterated with 5 per cent. added water and the other 3 per cent. added water. The Manager of the Company gave a reasonable explanation of the matter and no action was taken other than to take further samples from the same source, which, on analysis, were found to be satisfactory. In regard to the two samples taken in course of delivery to eating.houses, one of these was found to be adulterated with 6 per cent. of added water, the vendor was summoned, and as it was proved that he had already been fined for a similar offence outside the City of London, a substantial fine of 20l. and 1l. 1s. costs was imposed. In one instance only was the presence of preservative detected in milk; in this case a sample submitted to the Public Analyst was found to contain boric acid to the extent of 0.0046 per cent. which equals 0.4 grains to the pint. The vendor of this sample was cautioned by the City Solicitor. Formalin has not been detected in any milk supplied to the City, of London, and boric acid I am glad to say is a most infrequent addition. The extent of adulteration of the milks which were purchased at Shops, Restaurants and Refreshment Rooms was as follows:— Thirteen per cent. added water, vendor successfully pleaded warranty*; 7 per cent. fat abstracted, vendor cautioned; 15 per cent. fat abstracted, case dismissed; 14 per cent. fat abstracted, vendor fined 1l. and 1l. 1s. costs; 24 per cent. fat abstracted, vendor fined 10s. and 17s. 6d. costs; 7 per cent. fat abstracted, vendor successfully pleaded warranty; 35 per cent. added water, vendor fined 51. and 1l. 1s. costs; 31 per cent. fat abstracted, vendor successfully pleaded warranty; 6 per cent. fat abstracted, vendor cautioned; 31 per cent. fat abstracted, vendor fined 21. and 1l. 1s. costs; 6 per cent. added water, vendor ordered to pay costs, 1l. 1s.; 24 per cent. added water, vendor fined 30l. and 21. 2s. costs*; 0.0046 per cent. boric acid, vendor cautioned; 3 per cent. added water, vendor cautioned; 7 per cent. added water, vendor cautioned. Twelve samples of milk have been purchased from persons selling in the streets, one of this number was found to be deficient in fat to the extent of 18 per cent. The vendor of this sample was prosecuted but escaped by successfully proving a warranty; another sample has since been obtained from this vendor and returned by the Public Analyst as genuine. * Same Vendor, 109 THE PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912. Attention has been given to the Public Health (Milk and Cream) Regulations, 1912, and during the year 1914, samples of Milk, Cream and Preserved Cream have been purchased with a view to ascertaining to what extent the provisions of the Regulations were complied with. The following is a brief summary of the results:— 1. Milk and Cream* not sold as Preserved Cream. Number of samples examined Number in which a preservative for the presence of a preservative. was reported to be present. Milk 375 1 Cream 19 16 (Boric Acid in each case). 2. *Cream sold as Preserved Cream. (a) Instances in which samples have been submitted for analysis to ascertain if the statement on the label as to preservative were correct. i. Correct statement 12 ii. Incorrect statement 1 Total 13 (b) Determination made of milk fat in cream sold as preserved cream:— i. Above 35 per cent. 13 ii. Below 35 „ 0 Total 13 (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. One instance in which the amount of preservative exceeded the amount stated on the label. Another sample was later taken formally and found to be correctly labelled. As regards the 16 samples of "Cream" which, on examination, were found to contain preservative, the vendors of 11 of the samples were written to and asked for an explanation. These vendors were all Restaurant Keepers. From each of the five others another sample was taken with the due observance of the formalities of the Regulations. * All these samples were taken informally. 110 In two of these instances the requirements were complied with, and in three they were still unobserved. At the end of the year these latter cases were under consideration. As regards the single case of preservative being found in milk, the vendor was cautioned by the City Solicitor. BUTTER. 324 samples of Butter were taken, 11 of which were reported against. Five of this latter number, or 1.5 per cent., were cases in which there had been infringements of the Act; the remaining six were informally taken samples obtained at places where notices were exhibited stating that "the substance spread on the Slices of Bread sold at the Establishment was composed of a mixture of the Finest Margarine and Best Butter,"the object of such sampling being to ascertain to what extent this contract was carried out, and also to discover the amount of the component parts in the article supplied. This subject is still receiving attention. The figures for 1914 and ten previous years are given hereunder:— Year. No. of samples taken. No. of Samples found Adulterated. Percentage of Adulterated Samples. 1904 442 13 2.94 1905 354 4 1.14 1906 328 17 5.18 1907 411 13 3.16 1908 381 5 1.30 1909 457 5 1.09 1910 484 7 1.4 1911 502 9 1.7 1912 563 12 2.1 1913 404 5 1.2 1914 324 5 1.5 In regard to the 5 cases of margarine substitution, all took place at coffee houses or cafes, none occurring at shops. A roll and butter was asked for in one instance and margarine was supplied in lieu of butter; a fine of 40s. and 21s. was imposed. In another case bread and butter was demanded and margarine served—dismissed— "notice held to have been exhibited."In a similar case (a second offence) the vendor was fined 20s. and 17s. 6d. costs. In another the summons was withdrawn on the defendants paying the costs, 2l. 2s., and in the other case two slices of bread and margarine was substituted for the bread and butter demanded. This vendor was cautioned, and later another sample was purchased from her and found to be identical with the article asked for. 111 MARGARINE. 12 samples of margarine were obtained at various shops, but as the vendors had complied with every requirement of the Act these samples were not submitted for analysis. HONEY, JAM AND GOLDEN SYRUP. Two samples each of honey, jam and golden syrup were analysed and found to be genuine. PICKLES AND SAUCES. Five samples of sauces of various brands and one of pickles was submitted to the Public Analyst and returned as genuine. OTHER GROCERIES, &c. Other articles submitted for analysis included 11 of cocoa, 18 of coffee, 7 of olive oil, 5 of rice, 6 of arrowroot, 4 of condensed milk, 5 of dripping, 2 of ground ginger, 3 of lard, 2 of baking powder, 5 of cheese, and 16 of vinegar. All these were returned as genuine with the exception of one vinegar sample, which was found to be deficient in acid 22 per cent.; the vendor was cautioned. SPIRITS. Ten samples of spirits were purchased at the establishments of persons carrying on the business of Licensed Victuallers; five of these samples were whisky and five gin. The whisky samples and four of the gin samples were found to be up to standard; in the case of one gin sample, it was found to have been reduced to 61 degrees under proof. The vendor was summoned and ordered to pay the costs, 21s. No conviction was recorded against him as it was proved that the house was under management and the sophistication unintentional so far as he was concerned. DRUGS. 56 samples of drugs were purchased for analysis, and all returned as genuine. They include samples of glycerine, saffron, milk of sulphur, citric acid, tartaric acid, crushed linseed, camphorated oil, castor oil, salicylic acid ointment, boric acid ointment, linseed oil, tincture of iodine, grey powder, potassium Tartrate, paregoric elixir, calomel ointment, purified cream of tartar, compound liquorice powder, cod liver oil, eucalyptus oil, iron pills, glycerine and phenol, almond oil, and lime water. 112 The following Table includes particulars of drug adulteration in the City during the past ten years:— Samples taken. Found adulterated. Percentage of adulteration. 1904 52 4 7.7 1905 61 5 8.2 1906 47 5 10.6 1907 65 6 9.2 1908 57 2 3.5 1909 86 2 2.3 1910 40 Nil. Nil. 1911 48 1 2.0 1912 46 Nil. Nil. 1913 46 Nil. Nil. 1914 56 Nil. Nil. WARRANTY. During the year the Warranty defence was successfully pleaded in three cases. PROSECUTIONS. 19 Prosecutions were instituted, which may be summarised as follows:— Ten defendants were convicted and fined, three defendants proved Warranty, one summons was dismissed, in two cases the "notices "exhibited were held to be sufficient, and three were withdrawn on payment of costs. 113 SALE OF FOOD AND DRUGS ACTS, 1875-1907. 1914. RESULTS OF PROSECUTIONS. First Quarter. Sample. Nature and Extent of Adulteration. Result. †1 Milk 17 per cent. added water £10 and £1 1s. costs. †2 „ 7 per cent. added water £3 and £1 1s. costs. *‡6 „ 13 per cent. added water Dismissed. Warranty. Second Quarter. 140 Milk 18 per cent. fat abstracted Dismissed. Warranty. 145 Gin 61 degrees under proof Withdrawn. £1 1s. costs. 219 Milk 15 per cent. fat abstracted Dismissed. *287 „ 14 per cent. fat abstracted £1 and £1 1s. 6d. costs. 331 ,, 24 per cent fat abstracted 10s. and 17s. 6d. costs. 320 Butter 90 per cent. margarine Dismissed. Notice exhibited. 339 Milk 7 per cent. fat abstracted Dismissed. Notice exhibited. 385 „ 35 per cent. added water £5 and £1 1s. costs. 414 Butter 100 per cent. margarine £2 and £1 1s. costs. Third Quarter. 433 Milk 31 per cent. fat abstracted Dismissed. Warranty. 511 „ 31 per cent. fat abstracted £2 and £1 1s. costs. 471 Butter 100 per cent. margarine Withdrawn. £2 2s. costs. 519 Milk 6 per cent. added water £l 1s. costs. *541 „ 6 per cent. added water £20 and £l 1s. costs. Fourth Quarter. ‡603 Milk 24 per cent. added water £30 and £2 2s. costs. *786 Butter 100 per cent. margarine £1 and 17s. 6d. costs. SUMMARY. £ s. d. £ s. d. First Quarter: Fines 13 0 0 Costs 2 2 0 Second Quarter „ 8 10 0 „ 5 2 0 Third Quarter „ 22 0 0 „ 5 5 0 Fourth Quarter „ 31 0 0 „ 2 19 6 £66 10 0 £15 8 6 * Have been previous complaints. † Same defendant. ‡ Same defendant. 114 115 SALE OF FOOD AND DRUGS ACTS, 1875-1907, AND THE PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912. Articles examined during each Quarter Year 1914. Articles submitted for Analysis. Quarter ending 31st March Quarter ending 30th June. Quarter ending 30th September. Quarter ending 31st December. Total for 1914. 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 98 90 8 8.1 91 85 6 6.5 50 45 5 10.0 59 57 2 3.2 298 277 21 7.0 Butter 88 88 ... ... 114 111 3 2.6 58 58 ... ... 57 55 2 3.5 317 312 5 1.5 Mustard 2 2 ... ... 3 3 ... ... 3 3 ... ... 1 1 ... ... 9 9 ... ... Cocoa 3 3 ... ... 1 1 ... ... 4 4 ... ... 3 3 ... ... 11 11 ... ... Coffee 4 4 ... ... 2 2 ... ... 8 8 ... ... 4 4 ... ... 18 18 ... ... Olive Oil ... ... ... ... ... ... ... ... ... ... ... ... 6 6 ... ... 6 6 ... ... Vinegar 5 4 1 20.0 5 5 ... ... 6 6 ... ... ... ... ... ... 15 16 1 6.2 Sauces 5 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 5 ... ... Rice 5 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 5 ... ... Irish Whisky 5 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 5 ... ... Gin 5 4 1 20.0 ... ... ... ... ... ... ... ... ... ... ... ... 5 4 1 20.0 Arrowroot 3 3 ... ... ... ... ... ... ... ... ... ... 3 3 ... ... 6 6 ... ... Condensed Milk 4 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 4 ... ... Dripping 2 2 ... ... ... ... ... ... ... ... ... ... 3 3 ... ... 5 5 ... ... Ground Ginger 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... Lard 2 2 ... ... ... ... ... ... 1 1 ... ... ... ... ... ... 3 3 ... ... Baking Powder 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... Pickles 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... Drugs 8 8 ... ... 14 14 ... ... ... ... ... ... 34 34 ... ... 56 56 ... ... Cheese ... ... ... ... 5 5 ... ... 130 ... ... ... ... ... ... ... 5 5 ... ... 244 234 10 4.0 235 226 9 3.8 125 5 3.8 170 166 4 2.3 779 751 28 3.6 Informal Samples— Cream ... ... ... ... ... ... ... ... ... ... ... ... 19 3 16 84.2 19 3 16 84.2 Preserved Cream ... ... ... ... ... ... ... ... ... ... ... ... 13 12 1 7.7 13 12 1 7.7 Milk ... ... ... ... ... ... ... ... 29 20 9 31.0 48 48 ... ... 77 68 9 11.5 Vinegar 1 ... 1 100.0 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 100.0 Olive Oil 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... Honey 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... Golden Syrup 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... Jam 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... Butter ... ... ... ... 2 ... 2 100.0 9 7 2 22.2 2 ... 2 100.0 13 7 6 46.1 Total of Informal Samples 8 7 1 12.5 2 ... 2 100.0 38 27 11 28.9 82 63 19 22.9 130 97 33 25.2 Total Samples fob Year 252 241 11 4.3 237 226 11 4.6 168 152 16 95 252 229 23 9.1 909 848 61 6.7 116 BUTTER AND MARGARINE ACT, 1907. One application for registration as a Butter Factory was received in regard to premises at No. 55, Charterhouse Street, which premises were already registered in respect of margarine. Section 1 (3) of the Butter and Margarine Act, 1907, enacts that premises shall not be used as a butter factory if they form part of or communicate, otherwise than by a public street or road, with the premises of manufacturers of or wholesale dealers in margarine, and if premises are so used it shall be regarded as an offence against the Act, and the Local Authorities shall remove such premises from the Register. In order to comply with the terms of this section of the Act, proposed to remove the margarine business to a chamber specially constructed in the basement, to which access was obtained from the public street only. The business of butter blending was then to be conducted in a room specially set apart for the purpose at the top of the building. Before these arrangements were completed, however, war was declared, and as the trade of the firm in question was considerably affected by war contracts, the matter was postponed sine die. 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, 44 persons were examined by the Medical Officer of Health during 1914, and without exception, all were reported as physically fit for office. Twenty officers were also medically examined with a view to their retirement, and of these 19, or 95 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, William J.Howorth. Medical Officer of Health for the Public Health Department. City of London. . Guildhall, E.G. APPENDICES. page Appendix A—Street Lists of Mortality 119 „ B— „ „ Infectious Diseases 121 „ C—Register of Houses let in lodgings or occupied by members of more than one family 123 „ D—List of Persons registered under the Dairies, Cowsheds and Milk Shops Orders 128 „ E—Export of Meat and Meat Food Products to the United States of America.— Scheduled Forms of Certificates 134 „ F—Precautionary Measures which should be observed by Tuberculous Patients 139 119 Appendix A. CITY OF LONDON MORTALITY. 1914.. STREET LISTS. Compiled from Weekly Returns of Registrars of Sub-Districts. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. Albion Buildings, Bartholomew Close 21 F 38 3 Mar. 1914 Pneumonia Albion Buildings 21 M 65 2 July ,, Carcinoma P.M. Aldersgate Street 7-12 M 45 28 July ,, Aortic Disease Inquest and P.M. Natural causes Aldgate "Three Nuns Hotel " — M 41 5 Dec. ,, Heart Failure Inquest and P.M. Natural causes Angel Court 4 F 42 5 April ,, Valvular Disease of Heart Artillery Lane 23 M 9 m'ths 29 Oct. ,, Measles Botolph Alley 8 M 79 7 Feb. ,, Bronchitis Bow Lane (Williamson's Hotel) - F 34 25 Nov. ,, Cardiac Failure Inquest. Misadventune due to Morphine Injection Brushfield Street 8 M 64 17 Aug. ,, Cirrhosis of Liver ,, ,, 12 F 67 3 Oct. ,, Disease of Heart and Arteries Inquest and P.M. Natural causes Cannon Street 143 M 28 27 Jan. ,, Pulmonary Tuberculosis ,, ,, 112 F 41 16 April ,, Charles Street 62 M 41 21 Dec. ,, Phthisis Cloth Fair 9 F 82 19 Mar. ,, Senility Cornhill 14 M 58 27 Aug. ,, Pachy Meningitis ,, 30 M 2 6 June ,, Whooping Cough Crossley Square 3 M 51 26 May ,, Croupous Pneumonia Dean Street, Fetter Lane 3a F 76 5 Sept. ,, Cancer ,, ,, ,, ,, 6c M 71 11 April ,, Coma P.M. ,, ,, ,, ,, 7D M 3 10 Aug. ,, Gen. Tuberculosis Devonshire Square 6a F 40 30 Sept. ,, Strangulated Hernia Duke Street 46 M 77 27 Oct. ,, Arterio Sclerosis East Harding Street 8 M 2 hours 17 June ,, Premature Birth ,, ,, ,, 8 F 2 hours ,, ,, ,, ,, ,, Ellison Street 7 F 79 23 Jan. ,, Senile Decay Farringdon Street (Farringdon Hotel) — F 21 days 5 „ ,, Convulsions Fenchurch Buildings 10 M 53 18 April ,, Syncope Fenchurch Street 118 F 3 26 Aug. ,, Congestion of Lungs Inquest ,, ,, 153 F 53 1 May ,, Chronic Bronchitis Fetter Lane 103 F 66 1 July ,, ,, ,, Fish Street Hill 21 M 14 days 29 Sept. ,, Marasmus Fleet Street 13/4 F 37 19 „ ,, Valvular Disease of Heart Frederick's Place 8 F 49 26 Oct. ,, Suffocation by Hanging Inquest and P.M. Suicide Gracechurch Street 79 F 37 6 May ,, Syncope Great New Street 2 F 69 7 „ ,, Myocarditis ,, ,, ,, 15 M 38 14 Feb. ,, Pulmonary Tuberculosis Harrow Alley (Still and Star P,H.) — M 64 21 Mar. ,, Morbus Cordis Holborn Viaduct Hotel - M 47 23 Sept. ,, Suicide by Shooting Inquest. Felo de se Houndsditch 12 F 84 4 April ,, Congestion of Lungs ,, 92 M 79 25 Oct. ,, Cancer ,, 106 M 32 2 June ,, Poison Inquest. Suicide. Hutchison Avenue 2 M 1 m'th 26 Nov. ,, Marasmus Hutchison Street 4 F 74 11 Jan. ,, Senile Decay Jewry Street 8 M 33 1 Sept. ,, Acute Bronchitis John Street 13 F 74 16 Nov. ,, Cerebral Hæmorrhage King Street, Snow Hill (Blomfield House) — F 53 19 Jan. ,, Arterio Sclerosis Died in St. Bart.'s King William Street 2 F 47 14 Feb. ,, Acute Bronchitis Lawrence Pountney Hill 7a F 79 10 Sept. ,, Gall Stones Lime Street 23 M 61 13 June ,, Cirrhosis of Liver Died in St. Bart.'s London Wall 60 F 85 24 Mar. ,, Cardiac Dilation Long Lane 51 M 65 18 „ ,, Respiratory Failure ,, ,, 79 F 28 days 9 June ,, Prematurity Died in St. Bart.'s Middlesex Passage 2 M 76 9 Oct. ,, Cancer Middlesex Street 71 M 45 20 Dec. ,, Morbus Cordis ,, ,, 116 M 56 21 Oct. ,, Double Basal Fneumonia Died in St. Bart.'s. Inquest and P.M. Natural causes Minories 124 M 16 days 1 Feb. ,, Marasmus ,, 135 F 62" 12 „ ,, Gangrene of Foot ,, 61 F 60 14 April ,, Pneumonia Mitre Court, Fleet Street 2 F 60 20 Jan. ,, Acute Rheumatism Mitre Court Chambers 4 M 73 24 Feb. ,, Valvular Disease of Heart Montague Court 4 M 65 23 July ,, Cancer Moor Lane Chambers 22 F 1 m'th 5 Mar. ,, Broncho-Pneumonia ,, 26 F 4 hours 14 April ,, Debility from Prematurity Moorgate Street 71 F 26 28 Feb. ,, Pulmonary Tuberculosis ,, 30 M 57 3 Nov. ,, Cancer ,, 17 M 53 31 Dec. ,, Pulmonary Tuberculosis Neville's Court 10 F 69 19 Feb. ,, Cardiac Disease 120 CITY OF LONDON MORTALITY—continued. STREET OR PLACE. No. of House. Sex. Age. Date of Death. Certified Cause of Death. Remarks. New Street, Gravel Lane 23 F 73 18 June 1914 Malignant Disease of Gall Bladder ,, ,, ,, ,, 34 F 1 m'th 26 „ ,, Prematurity New Bridge Street 15 F 50 3 May „ Rheumatism New Broad Street 10 M 20 22 Jan. „ Cancer Newgate Street (City Central Hotel) - F 80 21 Aug. „ Syncope Norwich Street 1 F 79 26 Dec. „ Appendicitis Old Jewry 32 M 34 12 Jan. „ Pulmonary Tuberculosis Pump Court, Temple — M 56 26 Aug. „ Diabetes Queen's Court 4 F 8 m'ths 25 Mar. „ Pertussis Queenhithe (The Rectory) - M 60 3 July „ Pleuro Pneumonia Queen Victoria Street 113 F 15 m'ths 1 Mar. „ Pneumonia River Thames (Couain Lane) - M about 50 9 Oct. „ Suffocation by Drowning Inquest. No evidence as to how deceased came in the water Robin Hood Court (Union) — M 63 17 April „ Cancer ,, ,, ,, — M 57 18 Nov. „ St. Mary-at-Hill 16 M 66 7 Oct. „ Arterial Sclerosis St. Paul's Churchyard 72 M 25 23 Feb. „ Diphtheria Shoe Lane 100 M 66 22 May „ Carcinoma Spital Yard 7 M 70 9 Aug. „ Chronic Bronchitis Tangfield Court 4 M 32 2 Feb. „ Delirium Tremens Temple Lane 6 F 52 27 April „ Broncho.Pneumonia ,, ,, 8 M 60 14 Jan. „ Bronchitis Thavies Inn 5 M 37 4 Feb. „ Abscess Psoas Throgmorton Avenue 17 M 72 21 Oct. „ Morbus Cordis Union Court 6 M 54 13 Dec. „ Aortic Aneurism Walbrook 22 F 15 m'ths 3 June „ Pertussis Widegate Street 21 M 52 22 Dec. „ Acute Broncho.Pneumonia ,, ,, 22 F 76 2 Mar. „ Bronchitis Wine Office Court 13 M 61 28 Dec. „ Suffocation by food in (Esophagus Inquest and P,M, Accidental ARTIZANS' DWELLINGS, STONEY LANE, HOUNDSDITCH. King's Block 30 M 11 m'ths 3 Dec. 1914 Tuberculous Meningitis ,, ,, 31 F 77 14 April „ Cerebral Hæmorrhage ,, ,, 39 F 38 19 Mar. „ Cerebral Apoplexy Queen's 41 M 10 m'ths 22 July „ Congenital Cardiac Disease ,, ,, 43 M 38 25 Dec. „ Pulmonary Tuberculosis South „ 1 F 65 2 April „ Chronic Nephritis ,, ,, 4 M 71 24 Jan. „ Bronchitis ,, ,, 28 F 79 14 May „ Cerebral Hæmorrhage 121 Appendix B. LIST OF INFECTIOUS CASES, 1914. STREET LISTS. Compiled from Notifications received. Street or Place. No. of House. Sex. Age. Disease. Date of Notification. 1914. Aldersgate Street 180 M 26 Scarlet Fever 25th March. Ditto (Manchester Hotel) • • • M 9 Enteric Fever 4th December. Ditto ... F 5 Scarlet Fever 26th November. Ditto ... F 11 Ditto 8th December. Ditto ... M 5 Ditto 31st December. Ditto ... F 8/12 Erysipelas 17th December. Ditto ... F 29 Ditto 26th December. Artillery Lane 20 F 65 Ditto 10th October. Austin Friars 1 F 1 Chicken-pox 21st November. Ditto 1 M 10 Ditto 3rd December. Ditto 27 F 7 Diphtheria 20th March. Barker's Buildings 27 M 6 Scarlet Fever 27th January. Bartlett's Buildings 18 F 7 Diphtheria 10th December. Bartholomew Close 13 M 2/52 Ophthalmia Neonatorum 1st February. Ditto 12 F 53 Erysipelas 13th May. Basinghall Street 73 F 58 Ditto 24th November. Birchin Lane 26 F 4 Chicken-pox 19th November. Ditto 26 F 6 Ditto 19th November. Bishopsgate 32 M 9 Scarlet Fever 15th December. Bloorafield House 14 M 2 Ditto 12th August. Brackley Street 5 M 17 Ditto 3rd April. Bridewell Police Station ... F 5 Ditto 1st February. Cannon Street 86 F 8 Ditto 17th July. Ditto 86 M 9 Ditto 13th July. Carter Lane 22 M 21 Enteric Fever 28th June. Ditto 22 M 17 Diphtheria 16th October. Charterhouse Street 18 M 19 Scarlet Fever 25th April. Ditto 18 M 18 Ditto 27th April. Ditto 18 M 15 Ditto 12th May. Ditto 18 M 17 Ditto 29th September. Ditto 18 M 16 Ditto 17th October. Christ Church Passage, Vestry House ... F 10 Scarlet Fever 6th February. Church Passage, Guildhall 3 M 19 Ditto 25th January. The Circus, Minories 4 M 5 Chicken-pox 3rd November. City of London Infirmary, Homerton ... M 63 Erysipelas 15th January. Cooper's Row 11 M 9½ Diphtheria 15th January. Copthall Avenue 15 M 8 Scarlet Fever 4th August. Cornhill 29 F 12 Ditto 1st December. Crooked Lane 9 F 9/365 Conjunctivitis 13th March. Crosby Square 6 M 14 Scarlet Fever 30th October. Crown Court, Fleet Street ... M 6 Chicken-pox 30th January. Crown Court, Warwick Lane ... M 25 Diphtheria 25th February. Uean Street, "A"Block 1 F 4 Scarlet Fever 17th August. Dorset Street 8 F 22 Enteric Fever 13th February. Duke Street 18 M 8 Chicken-pox 18th November. Eastcheap 33 F 6 Ditto 3rd November. Ditto 33 F 6/12 Ditto 19th November. Ditto 33 F 4 Ditto 19th November. Ditto 39 F 6 Diphtheria 14th May. East Passage 27 F 6/12 Ditto 20th October. Ditto 27 F 6 Ditto 22nd October. Ellison Street 2 M 5 Scarlet Fever 27th July. Farringdon Street 21 M 11 Diphtheria 14th December. Fenchurch Street 9 M 13 Chicken-pox 5th February. Fenton's Buildings 1 M 8 Scarlet Fever 15th August. Ditto 1 F 6 Ditto 18th August. Fetter Lane . 41 F 14 Ditto 13th October. Fish Street Hill 21 M 7 Ditto 5th September. 122 Street or Place. No. of House. Sex. Age. Disease. of Notification. 1914. Garden Place 2 M 6 Scarlet Fever 25th September. Ditto 9 F 7 Ditto 2nd December. Great New Street 4 F 6 Ditto 4th August. Ditto 4 F 10 Ditto 4th August. Ditto 4 F 9 Ditto 25th August. Ditto 4 F 7 Ditto 8th September. Gutter Lane 44 F 8 24th January. Harrow Alley 9 M 2 Diphtheria 8th November. Ditto 9 F 8/12 Ditto 11th November. Holborn 20 F 1/52 Ophthalmia Neonatorum 25th September, Holborn Circus 7 F 25 Diphtheria 15th January. Ditto 7 F 43 Ditto 16th January. Ditto 7 M 16 Ditto 4th November. Hutchison Street 4 F 9 Scarlet Fever 1st October. Ditto 13 M 12 Ditto 27th July. Jewry Street 8 M 14 Ditto 21st July. Leadenhall Street 34 F 5 Chicken-pox 3rd November. Ditto 138 M 8 Ditto 3rd November. Mark Lane 16 M 6 Ditto 26th October. Ditto 20 F 13 Scarlet Fever 21st December. Milton Street 31 M 20 Ditto 5th October. Moorgate Court ... F 7 Ditto 10th September. Moor Lane 16 M 16 Ditto 7th January. Ditto 16 M 19 Ditto 23rd July. Moor Lane Chambers 15 F 76 Erysipelas 11th September. Ditto 31 F 70 Ditto 29th September. Newgate Street 50 M 36 Small-pox 19th February. Newman's Court 5 M 8 Scarlet Fever 28th July. New Street, Gravel LaDe 30 F 68 Erysipelas 5th November. Old Broad Street 65 M 4 Chicken-pox 5th November. Old Change 37 F 11 Scarlet Fever 13th January. Paternoster Square 19 F 11 Diphtheria 19th December. Prince's Block 36 F 5 Scarlet Fever 19th September. Ditto 36 F 7 Ditto 19th September. Providence Place 10 F 3 Diphtheria 6th November. Queen's Block 19 M 6 Diphtheria 2nd December. Ditto 19 F 4 Scarlet Fever 21st August. Red Cross Street Fire Station 9 F 3 Ditto 17th March. Hose Alley 8 F 3 Chicken-pox 21st November. Ditto 21 F 6 Scarlet Fever 11th November. Ditto 22 M 5 Diphtheria 23rd October. Ditto 39 M 8 Scarlet Fever 16th December. St. Bartholomew's Hospital ... ... ... Scarlet Fever 19 cases, Diphtheria 5 cases, Erysipelas 1 case. Enteric Fever 2 cases. St. Helen's Place 3 M 5 Chicken-pox 30th December. Sandys Row 9 M 11/365 Ophthalmia Neonatorum 1st August. South Block 37 M 4 Scarlet Fever 11th August. Ditto 37 F 5 Diphtheria 3rd August. Ditto 37 M 9 Ditto 29th July. Ditto 38 M 1 Ditto 10th June. Ditto 39 F 11 Ditto 24th August. Swan Lane 9 M 9 Scarlet Fever 15th September. Temple Chambers ... M 12 Ditto 6th November. Throgmorton Street 8 M 5 Chicken-pox 8th March. Ditto 8 M 11 Scarlet Fever 15th December. Ditto 28 M 4 Diphtheria 11th November. Tower Hill 1 M 4 Chicken-pox 6th November. Vine Street 5 F 5 Scarlet Fever 14th July. Walbrook 40 M 24 Ditto 3rd May. Wardrobe Place 10 M 22 Ditto 12th May. Widegate Street 23 M 4 Ditto 8th September. Ditto 19 M 5 Ditto 18th September. William Street 4 M 25 Ditto 25th March. Ditto 4 M 21 Ditto 19th September. Wood Street 47 M 22 Ditto 1st October. The cases reported as occurring at the Manchester Hotel refer to Belgian Refugees, and the two cases of Enteric Fever at St. Bartholomew's Hospital were two soldiers from France. 123 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 1 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 1 4 1, Chapel Place, Fetter Lane C. H. Miller, 32, Fetter Lane 3 4 2, do. do. Do. do. 2 4 18, Cloth Fair C. Brissmire, 18, Cloth Fair 4 10 19, do. H. Field, 9, Gracechurch Street 3 6 21, do. W. Phelan, 20, Cloth Fair 1 3 22, do. J. Jackson, 22, do. 4 8 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. Biggerstatt', 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. 1 4 12, do. Mrs. Edwards, 12, do. 4 11 13, do. H. Scowen, 13, do. 2 4 5, Dorset Street H. Fenlon, 5, Dorset Street 5 6 7, do E. King, 23, Whitefriars Street 3 10 10, East Harding Street 2 5 11, do. Messrs. Eyre and Spottiswoode, Little New Street 2 10 12, do. J Jr ' 1 1 2, Evangelist Court Morris & Co., 99, Shepherdess Walk 3 9 1, Fenton's Buildings Thomas Matthews, 46, Beech Street, B.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 Barnsley, 1, Great New Street 4 13 2, do. Do. do. 4 10 3, do. Sidney Gardner, 2, 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 6, Greystoke Place William G. Cass, 6, Greystoke Place 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 7⅓, do. Do. do. 3 10 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 Carried forward 136 358 124 WEST DISTRICT—continued. Situation of Premises. Name and Address of Owner. Tenements. Lodgers. Brought forward 136 358 80, Long Lane L. M. Migliorini, 80, Long Lane 1 4 82, do. Mrs. Fairhead, 82, do. 2 4 86, do. E. Rees, 85, do. 0 0 1, Middlesex Passage James Strugnell, 45, Bartholomew Close 4 11 2 and 3, do. Do. do. 11 12 6, do. J. Sturgeon, 6, Middlesex Passage 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. 1 6 14. do. Do. do. 2 4 16, do. Do. do. 2 5 17, do. Do. do. 2 6 Total 258 622 Average number of lodgers to each tenement: 2.3. WEST DISTRICT. Houses demolished or closed in 1914 :— 29 & 6, 7, 8 & 9, Cloth Fair. 6, 7 & 8, Temple Lane. 2 & 3, Greystoke Place. Tenement houses on register 92 Cleansing Notices served 126 125 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 7 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 11 Total 15 27 Average number of lodgers to each occupied tenement: 1.8. 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 90, Minories). S. Moses, 65, Mansell Street, Aldgate 5 26 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, Bishopsgate. Laura Wells, 11, Clark's Place 1 1 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 Imbert Terry, 93, Gresham Street 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 97 217 126 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. J. 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 3 6 14, do. P. Seigarman, 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. Levy, 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 250 598 127 BAST 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, 238, Bishoppgate 4 7 2, do. do. Do. do. do. 3 10 3, do. do. Do. do. do. 2 7 4, do. do. Do. do. do. 2 10 8, Vine Street, do. Do. do. do. 6 19 9, 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. 2 24, do. W. T. Crane, 25, Widegate Street 4 11 25, do. Do. do. 3 9 3, Wrestler's Court W. Adams, 3, Wrestler's Court 1 1 4, do. F. Tyler, 4, do. 1 1 9, do. Henry Allen, 9, do. I 1 2, Goodman's Yard, Minories. Messrs. Charrington, Mile End Road 4 7 5, Artillery Lane Mr. Fitch, Bishopsgate Institute 8 23 Total 317 761 Average number of persons to each tenement: 2.4. EAST DISTRICT. Houses demolished or closed during 1914 :— 2, Three Crown Court, 3 „ „ „ Tenement houses on Register 112. Cleansing notices served 127. 128 Appendix D. List of Persons registered under the Dairies, Cowsheds and Milkshops Orders. 1st January, 1915. Premises. Person Registered. Premises. Person Registered. 15, Aldersgate Street Express Dairy Co., Ltd. 23, Bevis Marks Express Dairy Co., Ltd. 24, do. Robert Douglas. 22, Billiter Street Nella Webster. 28/9, do. "J.P." Restaurants, Ltd. 23, do. William Cole and Grant 30, do. John Thomas Gooden. Yentnor Robert Riach. 42, do. Nunzio Allocca. 5, Bishopsgate Church Gerardo Lamberti. 54/5, do. G. Capone. Passage. 67, do. J. Lyons and Co., Ltd. 21, Bishopsgate Aerated Bread Co., Ltd. 72, do. Slaters, Ltd. 35/7, do. Williamsons, Ltd. 73, do. Nunzio Allocca. 42, do. Frances Georgian Bailey 84, do. Charles Lanning. 52, do. Romualdo Mansi. 90, do. Ernesto Borzoni. 66, do. W. Hill and Son, Ltd. 92, do. Joseph James Metcalf. 75, do. J. Lyons and Co., Ltd. 170, do. Aerated Bread Co., Ltd. 84, do. Slaters, Ltd. 179, do. Nunzio Allocca. 142, do. Aerated Bread Co., Ltd. 188, do. William Robins Thatcher. 152, do. J. Lyons and Co., Ltd. 193, do. J. Lyons and Co., Ltd. 161/3, do. J. Lyons and Co., Ltd. 40, Aldermanbury Nunzio Allocca. 174, do. Atanasio Drriani. 55, do. Aerated Bread Co., Ltd. 188, do. Empire Restaurants, Ltd. 62, do. Luigi Cattini. 208, do.' Antonetta Arpino. 12 and 13, Aldgate Lockharts, Ltd. 240, do. Express Dairy Co., Ltd. 15, do. Francis William Yeomanson. 254, do. Gaston Debry. 24, do. J. Lyons and Co., Ltd. 266, do. Guilio Barbieri. 7, Aldgate High Street John Wattam. 280, do. William Sandrock. 73, do. Express Dairy Co., Ltd. Blackfriars Bridge J. Lyons and Co., Ltd. 7, Artillery Lane Clara Mason Shepherd. Station 1, Austin Friars Olive Marie Muriel Simonds. 8/10, Blomfield Street "J.P." Restaurants, Ltd. 5, Barbican Pantolone Pappalardo. 16, do. Ulrich Maino. 6/7, do Aerated Bread Co., Ltd. 4, Botolph Alley Charles Peach. 20, do. Lockharts, Ltd. 1, Bow Churchyard Pasquale Mansi. 43a, do. Lewis Thos. Owen and Percy 2, Bow Lane " J.P." Restaurants, Ltd. John Randall. 9, do. Pasquale Mansi, trading as 59, do. William John Rolf. M. Pasquale and Co. 21, Bartholomew Close Mabel Marion Baker. 11, do Henry Harrod Haines. 38, do. Catherine Lewis. 38a, do. Friern Manor DairyFarm, Ltd. 1, Basinghall Street Aerated Bread Co., Ltd. 46, do. P. Palumbo. 15, do. Luigi Necchi. 54, do. Andrea Beschizza. 16, do. Merino Belli. 43, Bread Street Archibaldo Egio Sichi. 29/30, do. J. Lyons and Co., Ltd. 20, Bride Lane Sandall Joseph Green. 54, do. Sidney Havard Willmott. 3, Brushfield Street Henry Pugh Lloyd. 65/66, do. Walter Peers Jackson. 3, Bridge water Street Charles Cromwell Crocker. 68, do. Winifred Stenning. 5, Broad Street Place Aerated Bread Co., Ltd. 69, do. Express Dairy Co., Ltd. 14, do. Richards Mills & Co., Ltd, 1, Gresham Buildings, London Cafe Co., Ltd. Broad Street Station Aerated Bread Co., Ltd. Basinghall Street 4, Broadway, Ludgate Percy Robson. 50, Beech Street John Richards. 7, do. do. J. Lyons and Co., Ltd. 4, Beehive Passage Lockharts, Ltd. 35, Bucklersbury J. Lyons and Co., Ltd. 7, Bell Yard 1 John Toulson Gardner. 2, Budge Row Jane Anderson Carnegie. 129 Premises. Person Registered. Premises. Person Registered 20, Budge Row J. Lyons and Co., Ltd. 74, Copthall Ave.(Throg- Florence Le Breton. 24, do. John Toulson Gardner. morton House) 30, do. " J.P." Restaurants, Ltd. 8, Copthall Avenue Alexander Hampton. 9, Bull's Head Passage Pasquale Cocchi. 10 & 12, do. J. Lyons and Co. Ltd. 12, do. Charles Giles and William 15, do. James William Davis. Powell. 28, Copthall Avenue Pietro Bezchizza. 1, Burgon Street Vincent Infanti. 9, Cornhill Aerated Bread Co., Ltd. 1, Bury Street Express Dairy Co., Ltd. 7, Cripplegate Buildgs. Aerated Bread Co., Ltd 9, By ward Street Aerated Bread Co. Ltd. 7, Crooked Lane John Morgan Jones. 40/2, Cannon Street Aerated Bread Co., Ltd. Crown Court (Old J. Lyons and Co., Ltd. 44, do. J. Lyons and Co., Ltd. Broad Street) 49, do. J. Lyons and Co., Ltd. 2, do. Henry Charles Bainbridge. 50, do. Slaters, Ltd. 13, Crutched Friars Express Dairy Co., Ltd. 50, do. Blatch's Restaurant, Ltd. 7, Cullum Street Antonio and Michele Precha. 51, do. Aerated Bread Co., Ltd. 16, do. Luigi Cattini. 86, do. Aerated Bread Co., Ltd. 6, do. Egisto Landi. 91, do. W. Hill and Son, Ltd. 14, Cursitor Street Martha Kersey. 95, do. Aerated Bread Co., Ltd. 1, Cutler Street. Ulisse Pellici. 99, do. J. Lyons and Co., Ltd. 3/5, Devonshire Street Louise Mary Pearce. 113, do. Bartolomeo Zaccarini. 8, do. Mitchell's Dining Rooms, 139, do. London Cafe Co., Ltd. Ltd. 145, do. Ye Mecca, Ltd. 1/2, Dorset Street Alfred Reeve. 147, do. Aerated Bread Co., Ltd. 7, do. Guiseppe Indaco. 153 & 155, do. " J.P." Restaurants, Ltd. 5, Dove Court (Old Mary Ann Donnelly. Cannon St. Station Aerated Bread Co., Ltd. Jewry) Approach 3, Dowgate Hill Gaetano Parascandolo. 3 & 4, Camomile Street " J.P." Restaurants, Ltd. 2, Duke Street Pasquale Ruocco. 36, do. Luigi Cattini. 12, do Frank Dyson. 36a & 37, do. Henry Douglas Fletcher. 41, do. Francesco Bardinni. 46, Carter Lane Albert George Bodenham. 50, do. Joseph Alexander Williams. 54, do. Reuben Josephus Phillips, 5, Eastcheap Aerated Bread Co., Ltd. trading as W. H. Knapp 15, do Ye Mecca, Ltd. and Co. 28, do. Aerated Bread Co., Ltd. 57a, do. James Burgess. 34, do Fredk. Lewindon. 81, do. William Henry Overhill. 35, do. J. Lyons and Co., Ltd. 12, Carthusian Street Helen F. Higgins. 39, do. Eastcheap Cafe, Ltd. 1, Castle Court, Cornhill Edward William Davies. 49 & 51, Eastcheap, " J.P." Restaurants. Ltd. 60, Charles Street George William Copeland. (Ceylon House) 25, Castle Street Bernardi Pellegrenetti. 16, Eldon Street J. Lyons and Co., Ltd. 18, Charterhouse Street "J.P." Restaurants, Ltd. 18, do. Bartolomeo Cattini. 23, Cheap side J. Lyons and Co., Ltd. 22, do. Pasquale Palumbo. 26, do. Slaters, Ltd. 25, do. "J.P." Restaurants, Ltd. 41, do. Ideal Restaurants, Ltd. 5, Falcon Square Price's Restaurants, Ltd. 49, do. J. Lyons and Co., Ltd. 56, Fann Street Celeste Ostacchini. 51, do. Aerated Bread Co., Ltd. 59/60. do. Celeste Ostacchini. 66, do. Tiffin, Ltd. 32, Farringdon Street Arthur Atkins. 74/5, do Slaters, Ltd. 33, do. Friern Manor Dairy Farm, 77, do Aerated Bread Co., Ltd. Ltd. 114, do London Kaaba Tea and 39, do. " J.P." Restaurants, Ltd. Coffee Co., Ltd. 40, do. "J.P." Restaurants, Ltd. 128, do J. Lyons and Co., Ltd. 62, do. David and Robert Jones. 136, do. Williamsons, Ltd. 65, do. Amerighi Guilio. 140, do. Ye Mecca, Ltd. 67, do. Lewis Bertram Heyward. 150, do. Aerated Bread Co., Ltd. 70/1, do. Geo. Jas. and Arthur J. 7, Clark's Place Jessie Annette Knowles. Silverlock. 2, Cloak Lane Romulatto Mansi. 73, do. Gertrude Rickenbach. 20, Cloth Fair... William Mortimer Phelan. 79, do. Edwin John Ridout. 19, Cock Lane... Jane Jones. 87, do. Peter Zanchi. 35, do. Guiseppe Pagano. 88, do. Donald Goodall. 23, Coleman Street Ye Mecca, Ltd. 1, Fen Court Rose Greenaway. 38, do. Antonio and Valentine 2, do. Aerated Bread Co., Ltd. Ostacchini, trading a? 1, Fenchurch Buildings " J.P. " Restaurants, Ltd. Ostacchini and Son. 15, Fenchurch Street Aerated Bread Co., Ltd. 71, do. Bartolomeo Zaccarini. 30, do. Aerated Bread Co., Ltd. 74, do. Bartolomeo Zaccarini. 31, do. J. Lyons and Co., Ltd. 130 Premises. Person Registered. Premises. Person Registered. 47, Fenchurch Street The Cabins, Ltd. 11, Garlick Hill Walter Robert William 51, do. Fuller's, Ltd. Marchant. 62, do. Aerated Bread Co., Ltd. 3, Godliman Street Antonio Donatantonio. 81, do. Joseph Capella. 12, do. Bartolomio:'Fabrizi, trading 99, do. Aerated Bread Co., Ltd. as Bartolomio Fabrizi 107, do. " J.P." Restaurants, Ltd. and Co. 161, do. Maynards, Ltd. 21, do. Express Dairy Co., Ltd. 164, do. Slaters, Ltd. 8, Gough Square William Lloyd. 1, Railway Approach J. Lyons and Co., Ltd. 31, Gracechurch Street Fullers', Ltd. Fenchurch St. Station Henry Christian Thomas 33, do. Aerated Bread Co., Ltd. Amendt. 40, do. Edwin D. Morgan. 19/20, Fetter Lane "J.P." Restaurants, Ltd. 41, do. Maynards, Ltd. 27, do. Guerino Farina. 51, do. J. Lyons and Co., Ltd. 31, do. Morgan Jones. 57b, do. Alfonso Sammarco. 33, do. Joseph Pratt. (entrance in Lead enhall Market.) 42, do. Genoroso Savastano. 72/3, do. J. Lyons and Co., Ltd. 44/5, do. Stewart and Wight, Ltd. 77/78, do. London Cafe Co., Ltd. 57, do. Thomas Sydney Quatermass 79, do. Charles John Haag. 83, do. Luigi Negrini. 119, Gravel Lane, William Cambridge. 145, do. Rafaelo Cattini. Houndsditch. 1, Finsbury Pavement Bartolomeo Zaccarini. 1, Great New Street Sarah Amelia Barnsley. 73, do. Aerated Bread Co., Ltd. 12, do. Maria J. L. Kersey. Electra House, Finsbury Henry Phillips. 15, Great St. Helen's Luigi Necchi, trading as Pavement. Necchi and Co. Finsbury Pavement J, Lyons and Co., Ltd. 31, do. Rose Malyon. House. " Crosby House," Great Ye Mecca, Ltd. 13, Fish Street Hill Americo Ferrari. St. Helen's. 33, do. Michele Ruoceo. 12, Great Swan Alley G. Payne, J. J. Rawlings, 34, do. Frederick Lewindon. trading as Sarah Rawlings 37, do. Pasqualino Palumbo. and Co. 45, do. John T. Gardner. 14, Great Tower Street Stewart and Wight, Ltd. 2, Fishmongers' Alley Mary Jones. 17/8, do. Aerated Bread Co., Ltd. 16, Fleet Street John Toulson Gardner. 24/25, do. Express Dairy Co., Ltd. 23, do. J. Lyons and Co., Ltd. 28, do. Antonio and Michale Precha, 60, do. Albert Formaggia. 47, do Joseph Mariani. 61, do. J. Lyons and Co., Ltd. 58, do. Joseph James Medcalf. 62, do. Matteo Mansi. 74, do. J. Lyons and Co., Ltd. 109, do. Lockharts, Ltd. 96, do. Fredk. Wm. Ulrich. 116, do. Aerated Bread Co., Ltd. 100, do. Francisco Arpino. 131, do. Express Dairy Co., Ltd. 1, Gresham Street Aerated Bread Co., Ltd. 145, do. Fuller's, Ltd. 1, do. Friern Manor Dairv Farm, 147, do. Agusto Missaghi. Ltd. 158, do. Giovanni Rolle. 3, do. Ye Mecca, Ltd. 167, do. Cabins, Ltd. 5, do. Antonio Blacchini. 173, do. J. Lyons and Co., Ltd. 11, do. Pietro Barbeiri. 175, do. Luigi Di Lieto. 46, do. J. Lyons and Co., Ltd. 182/3, do. "J.P." Restaurants, Ltd. 54, do. Ye Mecca, Ltd. 190, do. Aerated Bread Co., Ltd. 69, do. Aerated Bread Co., Ltd. 30, Fleet Lane Salvatore Ferrigno. 87, do. Express Dairy Co., Ltd. 31, do. Albert Edwin Derry. 93a, do. Raffaele Ferrara. 17, Fore Street J. Lyons and Co., Ltd. 12, Grocers' Hall Court Timothy Jones. 50/51, do. Ye Mecca, Ltd. 8, Gunpowder Alley John William Page. 54, do. J. Lyons and Co., Ltd. 9, Harp Lane Alfonso Samarco. 56/7, do. Aerated Bread Co., Ltd. 12, do. Frederick C. H. Coles. 70, do. Alfonso Pinto. 20/22, Holborn Williamsons, Ltd. 84, do. Lockharts, Ltd. 31, do Aerated Bread Co., Ltd. 90, do. Rafaele Ferrara. 114/5, do Aerated Bread Co., Ltd. 98, do. Romulatto Mansi. 144, do. Luigi Rattazzi. 2, Foster Lane Celestino Conti. 145, do. Slaters, Ltd. 9/10, do. Victor Howlett. 1/2, Holborn Viaduct Aerated Bread Co. Ltd. 41, do. Arthur H. Hill, Margaret 14, do. J. Lyons and Co., Ltd. Hale, and Alice George, 43, do. Fullers, Ltd. trading as Free and Co. 65, do. Express Dairv Co., Ltd. 31, Friday Street Amy Roth and Bessie Lathom. 2, Honey Lane Market John Lockhart Gow Norman Gow. 65, do. Aerated Bread Co., Ltd. 4, do. J. Lyons and Co., Ltd. 4, Furnival Street Food Reform Co., Ltd. 9, do. John Thomas Gow. 131 Premises. Person Registered. Premises. Person Registered. 10, Honey Lane Market John Thomas Gow. 96/98, Leadenhall Street Aerated 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. Aerated Bread Co., Ltd. 10, Huggin Lane Daniel Jones. 29, do. Lozzaro Cattini. 19, Hutchison Avenue Joseph Falk. 34, do. Arthur and Percy Fraulo 13, Hutchison Street Isidore Spivakoff. trading as Frauio Bros. 15, do. Jacob and Leah Miller. 49, do. Ellen Gwendoline Vaughan. 36. Hutton Street Alfred Ernest Reeve. 53, do. Ernesto Rosati. 3, Imperial Arcade Friern Manor Dairy Farm. 17, Little Britain Sarah Page. Ltd. 19, do. Express Dairy Co., Ltd. 10, Ironmonger Lane Henry Francis Hardy. 25, do. Mary Ann Davies. 27, do. London Kaaba Tea and 33, do. Welford and Sons, Ltd. Coffee Co., Ltd. 54, do. Guiseppe Fazzani. 14, Ivy Lane Francesco Ferrigno. 2, Little College Street Alice Maud Turner. 18, do Andrea Proto 6, Little Trinity Lane Agnes Howat. 22, do Thos. Daniel Bishop. 18, do. Ettora Ferrari. 39, Jewin Crescent Pietro Damiaui. 37, Liverpool Street David Lowrie. 6, Jewin Street E. Seton Karr. Liverpool Street H. C. T. Amendt. 9. do. J. Lyons and Co., Ltd. Station. 24, do. Margaret A. S. McFarlane, Liverpool Street Station Express Dairy Co., Ltd. trading as Geo. McFarlane and Co. (Metropolitan Railway). 28, do. Express Dairy Co., Ltd. 4, Lombard Court Ye Mecca, Ltd. 31, do. "J.P." Restaurants, Ltd. 5, Lombard Street Aerated Bread Co., Ltd. 8, Jewry Street John Jones. 57, do. Aerated Bread Co., Ltd. 32, do. Angelo Beschizza. 319, London Central Lockharts, Ltd. 12, John Street William Alston. Markets. 32, King Street Aerated Bread Co., Ltd. 332, do. Cream Dairy Co., Ltd. 8, King William Street Slaters, Ltd. 3, London House Yard. Giorgio Beschizza and Luigi 14, do. Lockharts, Ltd. Schia. 34, do. J. Lyons and Co., Ltd. la, London Street Friern Manor Dairy Farm, Ltd. 37, do. Alfonso Appicella. 4, do. Carlo Croci. 44, do. Aerated Bread Co., Ltd. 8, do. Ideal Restaurants, Ltd. 51, do. J. Lyons and Co., Ltd. 19, do. Aerated Bread Co., Ltd. 61, do. J. Lyons and Co., Ltd. 34, London Wall Andrew Glendinning. 64, do. Aerated Bread Co., Ltd. 46/7, do. J. Lyons and Co., Ltd. 25a, Kinghorn Street William Phelan. 49, do. Ye Mecca, Ltd. King's Arms Yard Ye Mecca, Ltd. 55, do. " J.P." Restaurants, Ltd. 29/33, Knightrider Street John Liddiard Evans and 58a, do. Express Dairy Co., Ltd. Arthur George Evans, 151, do. Aerated Bread Co., Ltd. trading as John Evans bury House). and Co. 55, Long Lane Charles Sach. 44, do. Antonio Donatantonio. 77, do. F rancis Arthur Lester. 48, do. William Adamson. 80, do. Luigi Migliorina. la, Laurence Pountney Walter James Skevington. 85 do. Benjamin Rees. Hill. 56, Lower Thames St. Herbert Child. 1, Laurence Lane Angelo Beschizza. 75, do. Thomas Deacon. 38, Leadenhall Market Arthur H. Hill, Margaret 129½, do. Franks Bottilieri. Hale, and Alice George, 1, Ludgate Arcade Vincent Ferrara. trading as Free and Co. 5, Ludgate Circus J. Lyons and Co., Ltd. 40, do. Lewis Thomas Owen and 1, Ludgate Circus Slaters, Ltd. Percy John Randall. Buildings. 50, do. Henry George Saunders. 10/12, Ludgate Hill J. Lyons and Co., Ltd. 54/5/6, do. Lewis Dowling. 21, do. J. Lyons and Co., Ltd. 4, Leadenhall Street Aerated Bread Co., Ltd. 29, do. Aerated Bread Co., Ltd. 6, do. J. Lyons and Co., Ltd. 38, do. Aerated Bread Co., Ltd. 24, do. J. Lyons and Co., Ltd. 54, do. Express Dairy Co., Ltd. 27, do. Slaters, Ltd. 56, do. Ye Mecca, Ltd, 64, do. J. Lyons and Co., Ltd. 74, do. J. Lyons and Co., Ltd. 78a, do. Antonio Del Pizzo. Ludgate Hill Station J. Lyons and Co., Ltd. 92, do. Celistino Bertolini. 6, Maidenhead Court Michele Ruocco. 132 Premises. Person. Registered. Premises. Person Registered. 10, Maidenhead Court John Edwin Gardner. 19/20, Old Bailey Lockhart's, Ltd. 14, do. Alfred Albert Barnes. 59, do. Guilio Pagano and Luiiri 20, do. John Edwin Gardner. Di Lieto. 9/10, Mark Lane Leonard Ronaldson Church. 33, Old Broad Street Aerated Bread Co., Ltd. 48, do. Liverpool China and Indian 40, do. Aerated Bread Co., Ltd. Tea Co., Ltd. 2, Old Change Andrea Marroni. 69/70, do. Ye Mecca, Ltd. 13a, do. "J.P." Restaurants, Ltd. 73, do. Carlo Croci. 6, Old Jewry The Cabins, Ltd. 78, do. Express Dairy Co.. Ltd. 33, do. Katherine Mellisle. 80/81, do. J. Lyons and Co., Ltd. 2, Pancras Lane Frederick Walter Hicks. Mark Lane Station J. Lyons and Co., Ltd. 3, do. Frederick Walter Hicks. 3, Mason's Avenue Italo Ferrari. 3, Paper Street Albert Intrepidi. 34, Milk Street Guiseppe Belli. 5/6, Paternoster Row "J.P." Restaurants, Ltd. 36a, Milton Street Hugh David Pugh. 12, do. Giovanni Strinati. 46, do. Bartolomeo Callagari 60, do. J. Lyons and Co., Ltd. 71, do. Gertrude Miriam Gentry. 8, Philpot Lane Maud Alice Cecchini. 76, do. Charles and Frank Perrin. 14, do. Luigi Cattini and Georgio 83, do. James Charles Blackgrove. Beschizza. 16, Mincing Lane Luigi Cattini and Giorgio 22, do. Alfred Walter Bennett. Beschizza. 5, Pilgrim Street Joseph Mariani. 17, do. London Cafe Co., Ltd. 21, do. Galvani Andrea. 30, do. Slaters, Ltd. 32, do. Priori Oreste. 2, Minories "J.P." Restaurants, Ltd. 34, do. Aerated Bread Co., Ltd. 99, do. Walter Bugden. 30, Poppins Court Ulisse Pelliei. 136, do. Elizabeth King. 31, Poultry J. Lyons and Co., Ltd. 155, do William McGavin Reid. 35, do. Andrew Glendinning. 9, Mitre Street Henry William Richards. 1, Queenhithe Albert Ashlee. 39, do. Balista Baraglia. 10. Queen Street J. Lyons and Co., Ltd. 40½, Monk well Street Margaret Blott. 40, do. Egidio Fabrizi. " Monument Dairy," Frederick Lewindon. 71, do. Lockharts, Ltd. Monument Street. 81, do. Constantine Necchi and Monument Station The Ideal Restaurants, Ltd. Raffale Cattini. 43, Moor Lane Bartolomeo Carreta. 85, do. Ellen Claire Aveline. 9, Moorfields Romuloto Mansi. 7, QueenVictoria Street Express Dairy Co., Ltd. 11, do. Secondo Pelliei. 17, do. J. Lyons and Co., Ltd. 28, do. Express Dairy Co., Ltd. 24, do. Joseph Beebe. 19, Moorgate Street Alexander Hampton. 35a, do. Raftaele Patrono. 28, do. Aerated Bread Co., Ltd. 105, do. "J.P." Restaurants, Ltd. 37, do. J. Lyons and Co., Ltd. 115. do. Lockharts, Ltd. 40, do. Cabins (1901), Ltd. 130, do. Aerated Bread Co., Ltd. Moorgate Station Express Dairy Co., Ltd. 143, do. J. Lyons and Co., Ltd. bers. 175, do. Seton and Co., Ltd. 2, Moorgate Station Fullers, Ltd. 177, do. Aerated Bread Co., Ltd. Buildings. 8, Redcross Street Aerated Bread Co., Ltd. 7, do. Aerated Bread Co., Ltd. 9/10, do. J. Lyons and Co., Ltd. 1, New Basinghall St. "J.P." Restaurants, Ltd. 23, Rood Lane Rose Malyon. 4, New Bridge Street " J.P." Restaurants, Ltd. 2/4, Ropemaker Street Elizabeth Traish. 13, do. J. Lyons and Co., Ltd. 8, Rose Street Andrea Galvani. 40, do. Aerated Bread Co., Ltd. 12 do. Silvio Peretti. 44, do. David Stewart. 2/3, St. Andrew's Hill Lockharts Ltd. 3, New Broad Street J. Lyons and Co., Ltd. 19, St. Bride Street Express Dairy Co., Ltd. 4b, do. The Capital & Counties Cafe 35, do. Stewart and Wight. Co., Ltd. 3/4, St. Martin's Court "J.P." Restaurants, Ltd. 13, do. Richard Charles, trading as 15, St. Mary Axe Harry Bvford. R. Charles and Co. 21, do. Ye Mecca, Ltd. 13a, do. Lockharts, Ltd. 33/5, do. Slaters, Ltd. 16, do. Aerated Bread Co., Ltd. 34, do. Express Dairy Co., Ltd. 28, do. W. Hill and Son, Ltd. 45, do. Aerated Bread Co., Ltd. 64, do. Aerated Bread Co., Ltd. 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, 122/3, do. Peter Diviani. Ltd. 5, New Street Square Spottiswoode and Co., Ltd. 80, do. J. Lyons and Co., Ltd. 44, Noble Street Antonio Ostacchini. 82, do. Giorgio Beschizza. 133 Premises. Person Registered. Premises. Person Registered. St. Paul's Station J. Lyons and Co., Ltd. 223, Upper Thames Street Price's Restaurants, Ltd. 30/1, St. Swithin's Lane Aerated Bread Co., Ltd. 224, do. Albert Pocknell. 135a, Salisbury Court Matteo Mansi. 1, Walbrook Fullers Limited. 136, do. Matteo Mansi. 4, do. J. Lyons and Co., Ltd. 3, Ship's Tavern Passage Friern Manor Dairy Farm, 10/11, do Antonio and Michele Precha. Ltd. 14, do. Ye Mecca, Ltd. 35/6, Shoe Lane "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.) 113, do. Simeon Northam. 2, Water Lane (Black- Price's Restaurants, Ltd. 25, Silver Street Virgilio Zaccarini. friars). 27, do. Percy Toulson Gardner. 4, Water Lane (Black- Samuel Thomas Withers and 18, South Place Romualatto Mansi. friars). William Henry Meadway. 6, Stoney Lane Pasquale Manno. 5, Water Lane (Black- Priori Oreste. 23, do. Henry Jones. friars). 29, do. Alfred Garcia. 7, Water Lane (Black- " J.P." Restaurants, Ltd. 46, do. Abraham Isaacs. friars). 3, Talbot Court Demaste Falcini. " Aldermary House," Ye Mecca, Ltd. 1, Telegraph Street Giovanni Rolle. Watling Street. 17/8, do. J. Lyons and Co., Ltd. 73, Watling Street Lockhart.s, Ltd. — do. Ye Mecca, Ltd. 57a, West Smithfield J. Lyons and Co., Ltd. 1, Three Tuns Passage, Annie McKay. 25, White Street Mary Ann Keeble. Ivy Lane. 31, Whitecross Street Robert Douglas. 27, Throgmorton Street J. Lyons and Co., Ltd. 5, Whitefriars Street Vincenzo Mansi. 29, do. Aerated Bread Co., Ltd. 24, do. Guiseppe Indacco. 6, Tudor Street Pantalone Copolla. 27, do. William Thomas Lewis. 10, do. Frank Gowlett. 36/38, do. Lockharts, Ltd. 14, do. Walter Thomas Beames. 1, Whittington Avenue Ye Mecca, Ltd. 32, do. Fanny Payne. 7, do. Callard, Stewart and Watt, 3, Union Court, Old Express Dairy Co., Ltd. Ltd. Broad Street. 10, do. Pietro Cerigno. do. Ye Mecca, Ltd. 12, Widegate Street Edward Albert Withrington. 57, Upper Thames Street George Chitty. 25, Wood Street J. Lyons and Co., Ltd. 99, do. The City Catering Co., Ltd. 42/43, do Cabins (1901), Ltd. 104, do. John Morgan Jones and 78, do Nunzio Allocca. William Jones, trading as 80, do. Ye Mecca, Ltd. Jones Brothers. 130, do. Express Dairy Co., Ltd. 105, do. Francesco Orpino. Wool Exchange Callard, Stewart and Watt, 138, do. Stewart and Wight, Ltd. Ltd. 167, do. Matteo Mansi. 19, Wormwood Street Guilio Barbieri. 172, do. George Chitty. 22, do. Aerated Bread Co., Ltd. 194, do. Albert Pocknell. 36, do. Dominico Cavalli. 206, do. Angelo Cioffi. 38, do. "J.P." Restaurants, Ltd. 217, do. Cosimo Palladino. 2, Wrestler's Court David Thomas. 134 Form A. Appendix E. OFFICIAL MEAT INSPECTION CERTIFICATE OF COUNTRY OF SLAUGHTER. (For continuous shipment of meat and meat food products to United States.) Place Date (City.) (Country.) I hereby certify that the meat and meat food products herein described were derived from cattle, sheep, swine, or goats which received ante-mortem and post-mortem veterinary inspection at the time of slaughter, and that such meat and meat food products are sound, healthful, wholesome, and otherwise fit for human food, and have not been treated with, and do not contain, any preservative, colouring matter, or other substance not permitted by the regulations of the United States Secretary of Agriculture governing meat inspection, filed with me, and that said meat and meat food products have been handled only in a sanitary manner in this country. Kind of product. Number of pieces or packages. Weight. Identification marks on meats and packages Consignor Address Consignee Destination Shipping marks (Signature) (Name of official of national foreign government authorized to issue inspection certificates for meat and meat food products exported to the United States.) (Official title) Note.—A certificate in the above form is required to accompany each consignment transported to the United Slates from the country of the slaughter of the animals from which the meat and meat food products are derived, without unloading in any other country except to transfer the same from one carrier to another in the course of continuous transportation, and to be delivered by the consignee, or his agent, to the inspector of the Department of Agriculture at the point of inspection in the United States. 135 The following information is required to be supplied on the certificate by each carrier loading the consignment:— Loaded at (Date.) (Place.) on (Name of vessel or car numbers and initials.) ; and, if unloaded at any (Signature of officer or agent of carrier making indorsement.) place prior to arrival in the United States, unloaded __ (Date.) at. , by the (Place.) (Name of carrier.) and reloaded (Signature of officer or agent of carrier making indorsement.) at (Date.) (Place.) on by the (Name of vessel or car numbers and initials.) (Name of carrier). (Signature of officer or agent of carrier making indorsement.) 136 Form B. OFFICIAL MEAT INSPECTION CERTIFICATE OF COUNTRY OTHER THAN COUNTRY OF SLAUGHTER. (For shipment of meat and meat food products to United States not continuous from country of slaughter.) Place Date 191 (City.) (Country.) I hereby certify that the meat and meat food products herein described were originally shipped from (Country or countries of slaughter.) and were accompanied by certificate (or certificates), signed by the official (or officials) of the national government (or governments) of (Name of country or countries of origin.) showing that the meat and meat food products herein described were derived from cattle, sheep, swine, or goats which received ante-mortem and post-mortem veterinary inspection at the time of slaughter, and that such meat and meat food products were sound, healthful, wholesome, and otherwise fit for human food, and had not been treated with, and did not contain, any preservative, colouring matter, or other substance not permitted by the regulations of the United States Secretary of Agriculture governing meat inspection filed with said offical (or officials), and that said meat and meat food products had been handled only in a sanitary manner in the country (or countries) in which the animals from which they were derived were slaughtered. I also hereby certify that the meat and meat food products herein described have not been treated in this country (in which this certificate is issued) with any preservative, colouring matter, or other substance not permitted by the regulations of the United States Secretary of Agriculture governing meat inspection, filed with me, and that the said meat ar.d meat food products have been inspected in this country (in which this certificate is issued) and not found to be unsound, unhealthful, unwholesome, or otherwise unfit for human food, and that said meat and meat food products have been handled only in a sanitary manner in this country. Kind of product. Number of pieces or packages. Weight. [P.T.O. 137 Identification marks on meats and packages Consignor Address Consignee Destination Shipping marks __ (Signature) (Name of official of national foreign government authorized to issue inspection certificates for meat and meat food products exported to the United States.) (Official title) Note.—A certificate in the above form is required to accompany each consignment the transportation of which to the United States from the country of the slaughter of the animals from which the meat and meat food products were derived has been interrupted by unloading in another country for some purpose other than transfer from one carrier to another in the course of continuous transportation, and to be delivered by the consignee, or his agent, to the Inspector of the Department of Agriculture at the point of inspection in the United States. The following information is required to be supplied on the certificate by each carrier loading the consignment :— Loaded (in the country in which this certificate is issued) (Date.) at on (Place.) (Name of vessel or car numbers and initials.) ; and if unloaded at any place (Signature of officer or agent of carrier making indorsement.) prior to arrival in the United States, unloaded (Date.) at by the (Place.) (Name of carrier.) ; and reloaded (Signature of officer or agent of carrier making indorsement.) at (Date.) (Place.) on by the (Name of vessel or car numbers and initials.) (Name of carrier.) (Signature of officer or agent of carrier making indorsement. 138 Form C. OFFICIAL MEAT INSPECTION CERTIFICATE FOR PORK AND PORK PRODUCTS. (For shipment to the United States of articles of a kind prepared customarily to be eaten without cooking, which contains muscle tissue of pork.) Place Date (City.) (Country.) I hereby certify that the article or articles herein described are of a kind prepared customarily to be eaten without cooking and contain muscle tissue of pork, which, when fresh or freshly cured in salt, was subjected to a temperature not higher than 12° F. for not less than 20 days, and that said article or articles contain no muscle tissue of pork which has not been treated as herein specified. Kind of product. No. of pieces or packages. Weight. * Identification marks on meats and packages Consignor ___ Address Consignee . Destination Shipping Marks ( Signature) (Name of official of national foreign government authorized to issue inspection certificates for meat and meat food products exported to the United States.) (Official title) Note.—A certificate in the above form is required to acccompany each consignment of any meat or product of a kind prepared customarily to be eaten without cooking (such as summer sausage, "Italian" and "Westphalia" hams, and the like), which contains any muscle tissue of pork. This certificate is to be delivered by the consignee, or his agent, to the inspector of the Department of Agriculture at the point of inspection in the United States. 139 Appendix F. Corporation of London PUBLIC HEALTH DEPARTMENT. TUBERCULOSIS DISPENSARY (St. Bartholomew's Hospital). PRECAUTIONARY MEASURES WHICH SHOULD BE OBSERVED BY TUBERCULOUS PATIENTS. GENERAL FACTS. Consumption is an infectious disease, and may pass from person to person. It is caused by a living germ, which may attack any part of the body, particularly the lungs and throat. The chief source of infection is the expectorated matter (phlegm) of the consumptive patient which may contain thousands of these living germs. When the phlegm dries these germs are scattered in the dust, and then blown about by draughts and wind. The germs which remain living may be breathed in or swallowed by other persons, and in this way may cause the disease. Germs are also scattered about by severe coughing, even though there be no phlegm. Infection of others can be prevented if the following directions are carefully carried out, and the patient will also benefit, as he himself is less likely to get fresh infection in his own body. Rules for the Prevention of Consumption. 1.—The patient must use a proper spitting cup. The one for indoor use should be wide-mouthed and fitted with a lid. Out of doors he must always carry a pocket spitting flask. Both these vessels must contain a disinfectant, which should be used as directed, in order to prevent the phlegm becoming dry. 2.—Handkerchiefs should not be used for receiving expectoration. It is preferable to use pieces of cheap muslin or rag, which can be burnt. They should be kept in a separate washable pocket lining, which can be removed, and which should be boiled at regular and frequent intervals. 3.—The mouth must be covered by such a handkerchief (not by the hand) during coughing. 140 4.—Spitting in public places (streets, railway carriages, etc.) must be avoided. If the spitting flask cannot be used, the handkerchief may be used and burnt as soon as possible afterwards. 5.—The contents of the spitting cups should be either poured down the w.c., burnt in the fire, or buried in the garden. The vessels should both be boiled frequently in a saucepan kept for that purpose only. 6.—The patient must use separate table utensils—cup, fork, spoon, etc.—which must be put into boiling water after use. 7.—The patient should be clean shaven and should avoid kissing. He must never kiss or be pressed on the mouth. 8.—A consumptive patient should always occupy a separate bed, and, if possible, a separate room. The rooms should have as few hangings as possible, no ornaments, and the furniture be such as can be scrubbed easily. 9.—The floor should be covered with linoleum, which can be scrubbed. The use of carpets as floor covering should be avoided as much as possible. 10.—The rooms should be disinfected before use by anyone else. It will be seen from the above that the most important matter is the proper disposal of the phlegm. General Rules to assist in the Arrest of Consumption. 1.—All windows in the house should, as far as practicable, be kept wide open, day and night, winter and summer. The chimney opening must not be closed. 2.—Take meals at regular times. Eat wholesome food and plenty of it. The following foods are the best:—all fatty foods, such as Meat, Bacon, Dripping, Butter, Margarine, and Suet Pudding, and nourishing foods, such as Herrings, Porridge, Eggs and Thick Soups. Milk of good quality is one of the best foods which can be taken by a consumptive person. 3.—Take no beer or spirits unless ordered to do so by the doctor. It is wiser not to smoke. 4.— Go to bed early. Avoid all crowded indoor places, and particularly excitement and close air at night. 5.—All decayed teeth must be removed or stopped, as they are liable to interfere seriously with recovery. Teeth must be cleaned carefully in the morning, and at night before going to bed. 6.—The phlegm must on no account be swallowed, as the disease may spread in this way to the internal organs. 7.— Breathe through the nose, and teach the rest of your family to do so. 8.— Floors should be swept, after covering with damp sawdust or tea leaves j the sweepings should afterwards be burnt. All dusting should be done with a damp duster, and dusters should be boiled in the process of washing. 9.—Be in the open air as much as possible, but take care not to do too much. The doctor will tell you how much exercise you may take. Charles Skipper & East, Printers, 49, Great Tower Street, B.C.