WES 21 ANNUAL REPORT ON THE STATISTICS AND SANITARY CONDITION RELATING TO THE CITY OF WESTMINSTER FOR THE YEAR 1907. BY FRANCIS J. ALLAN, M.D., C.M., D.P.H. Camb., F.R.S. Ed. MEDICAL OFFICER OF HEALTH. Printed by Order of the Council. LONDON: HARRISON AND SONS, PRINTERS IN ORDINARY TO HIS MAJESTY, ST. MARTIN'S LANE, W.C. III TABLE OF CONTENTS. PAGE Introductory Remarks 1 PART I. A. Statistics. Population 9 Births 11 Deaths 14 Infantile Mortality 16 In Block Dwellings 19 In Common Lodging-Houses 20 Tables 21-34 B. Communicable Diseases. (1) Compulsorily Notifiable— Smallpox 35 Vaccination 35 Statistical Tables 36-40 Scarlet Fever 40 Diphtheria 42 Typhoid Fever 43 Puerperal Fever 43 Cerebro-spinal meningitis 43 (2) Voluntarily Notifiable Diseases— Tuberculosis 45 (3) Non-notifiable Diseases— Measles 50 Whooping Cough 51 Diarrhœal Diseases 52 Schools and Infectious Disease 53 Medical Inspection of School Children 55 Bacteriological Laboratory 56 Disinfection 56 Cleansing of Persons 57 Mortuaries 57 PART II. C. House Inspection, &c. Defects Remedied 59 Legal Proceedings 60 PAGE Removal of Manure 61 Removal of House Refuse 61 Removal of Offensive Refuse 61 Drainage, &c., Plans 62 Drain Testing 62 Petroleum in Drains and Sewers 63 Water Supply 63 Houses Let in Lodgings 64 Revenue Act 65 Smoke Prevention 65 D. Workshops. Number on Register 65 Defects 66 Outworkers 67 Infectious Disease 71 E. Food Supply. Food and Market Inspection 73 Restaurants, &c. 75 Ice-cream Premises 76 Bakehouses 77 Aerated Water Works 77 Slaughter-house 78 Cow-sheds 79 Milkshops 79 Sale of Food and Drugs Acts— Samples Taken, Result of Analysis and Proceedings 81 Milk 82 Separated and Dried Milk 83 Butter and Margarine 83 Cream 83 Appeal re Boric Acid 85 Coffee 86 Potted Meats and Fish 87 Tinned Vegetables 88 Preserved Fruits 88 Drugs 88 Details of Prosecutions 89 A 2 Annual Report on the Health and Sanitary Condition of the City of Westminster. 1907. To the Mayor, Aldermen, and Councillors of the City of Westminster. My Lords and Gentlemen, I have the honour to submit to you my Annual Report on the Health and Sanitary Condition of the City of Westminster during the year 1907. Returns required by the Local Government Board, and particulars relating to Factories and Workshops required by the Home Office, are incorporated therein. Meteorological conditions play an important part with regard to the prevalence of disease and the mortality resulting therefrom. The amount of rain, the frequency and period of its fall, the temperature during the various months, periods of drought, &c., have an influence which may extend over several years. The effect of such conditions on agricultural crops has received some attention, but there is still room for careful study in relation to diseases, especially such as are due to low forms of life. Thus it has been found that the date when corn ripens depends on the total excess of heat above a given figure, and it is not improbable that the occurrence of diarrhoea and the increase in scarlet fever and diphtheria in autumn depends to some extent upon the same circumstance. This year the rainfall in Westminster, as shown in the subjoined Table (compiled from the Meteorological Office Reports), was only 19.52 inches, being 80 per cent. of the average rainfall of the last thirty years, and it fell on 162 days as compared with 149 days in 1906. The temperature was below the average until September, and thus there were comparatively few diarrhoea deaths (in London 4,507 in 1906 and 1,523 in 1907), and these were in the fourth 2 quarter of the year instead of the third. The prevalence of scarlet fever and diphtheria, (see charts), also occurred later and rose to a considerable height, hut the incidence was chiefly in the eastern RAINFALL. TEMPERATURE. 1907. Amount. Inch. Percentage of average. Number of days on which rain fell. Mean. Difference from Average. January 0.70 38 8 39.4 + 0.2 February 0.99 62 11 38.5 -1.9 March 0.78 50 12 44.5 + 1.6 April 2.88 174 17 47.4 -0.5 May 1.67 98 15 53.8 + 0.4 June 1.87 84 15 57.5 -2.4 July 1.25 52 14 59.6 -4.3 August 1.64 64 13 60.8 -1.6 September 0.58 28 8 59.3 +1.4 October 2.26 82 22 52.5 +3.3 November 1.84 79 13 46.1 +2.3 December 3.06 153 14 42.6 +2.9 Year 19.52 80 162 — — group of Metropolitan Boroughs; in Westminster these diseases were below the usual amount. Deaths from whooping cough and measles were also more numerous in London. The death-rate in England and Wales was 15 per 1,000, being 0.4 below the rate in 1906, and constitutes the lowest annual rate ever recorded. Infant mortality was 118 per 1,000 registered births, being 14 below the rate in 1906, and 27 below the average of the previous ten years. The death-rate in London was 14.6 per 1,000 inhabitants, the average of the previous five years having been 15.7. This decrease has been practically continuous for a long period of years, thus in the ten years 1861-70 it was 24.4, in 1891-1900 it had fallen to 19.6, but the infant mortality in London remained at about 160 per 1,000 births for the forty years before 1901. During the six years 1901-1906 it has fallen, and was only 116 in 1907. In Westminster the general death-rate works out at 12.9 per 1,000 inhabitants, the average rate for the six preceding years having been 14.1. The infant mortality was 110 per 1,000 on the registered births, as compared with 123 during the years 1901-6. The corrected rate is 103, the corrected average of the previous five years having been 115. The most interesting event of the year from a public health point of view was the passing in the Education Act of a provision for the medical inspection of children in public elementary schools. The Board of Education state, in a Memorandum they have issued, that for some years past evidence has been accumulating that there exists in 3 certain classes of the English people a degree of physical unfitness which calls for amelioration, and, as far as possible, for prevention, and they regard the medical inspection of children as the first practical step towards remedy. They recognise that if this work is to produce the best results, it should be carried out through the existing staffs of Sanitary Authorities, who are already in intimate connection with the factors affecting the health of the community. Experience already points out that the defects which are found in school children in many cases have their origin at an early period of the child's existence, and are due to either debility at birth, improper feeding, or to unfavourable hygienic conditions. For many years Sanitary Authorities confined themselves solely to the removal of insanitary conditions, but latterly they have directed their attention to questions affecting the rearing and feeding of children, which has resulted in a further decrease in the mortality. Analysis of the Statistical Tables which are annually laid before you reveals the fact that infant deaths may be divided into two groups. The first group includes those children who die from causes of a prenatal character which result in premature births, imperfect development or structural deficiency (congenital defects), or in a low vitality. Many of these children die within a few hours or days after their birth, others die from various complaints before they are a year old, while a few may survive till later life, burdened possibly by some mental or bodily weakness. Scarcely any steps have been taken to deal with the ante-natal influences which tend to these results, and it would appear that the mortality from premature birth and congenital defects (equal to 22.8 per 1,000 children born in England and Wales) is on the increase. An enquiry into the conditions leading to this result may probably also reveal that similar causes operate to some extent in rendering mothers unable to suckle their children. The Home Secretary has had under consideration the report of the Physical Deterioration Committee in regard to the further regulation of the industrial employment of women before and after childbirth, together with the resolutions adopted by the Conference on Infantile Mortality, held in Caxton Hall in 1906, that women should not be employed in a workshop or factory within three months after giving birth to a child, and that women advanced in pregnancy should not be employed. He found that the question of imposing further restrictions presents difficulties both from a social and administrative point of view, but, before forming a decision, he considered it necessary to have fuller information than is at present available, and with that view he held a Conference of Medical Officers of Health, at which it was decided that a systematic and simultaneous inquiry on uniform lines should be made 4 in a number of industrial centres throughout the kingdom, the inquiry in each case to be limited to homogeneous districts and to families of the same class and circumstances. It will relate to children born in the year 1908, and, as it is to cover the whole of the first year of life, it cannot be completed until some time in 1909. The two main objects of the inquiry, so far as the Home Office is concerned, are:— (1) To determine the effect of the employment of women before and after childbirth on the health of mother and child, and particularly by means of a comparison between women who have been at work in a factory or workshop and women who have been otherwise employed or engaged only in domestic duties, whether employment in a factory or workshop has any special prejudicial effect; and, (2) so far as the Medical Officer of Health may be able to collect material bearing on the question, to gauge the social and economic effects which further restrictions on the employment of women in factories and workshops before and after confinement would entail, and in particular whether such restrictions would or would not have indirect effects prejudicial to infant life, either (a) by adding to the economic burden of childbearing and so leading to a further fall in the birth-rate, or (b) by increasing the poverty of the household, and so— through worse feeding, &c.—leading to an increase in the infant death-rate. The second group of infant deaths comprise those who are born physically healthy but who die from improper feeding, neglect, and insanitary conditions (overcrowding, filth, &c.), but of these the chief is undoubtedly the improper feeding. Fortunately, the proportion of children born healthy is much higher than of those born defective; it has been placed at from 80 to 90 per cent. The mother may be ill-fed, anaemic, or suffering from general ill-health, but, as a general rule (if the illness is not due to syphilis or consumption, and there is no hereditary taint in the family), the child will be born healthy. However, if the mother is in ill-health or badly fed, it is useless to expect that the mother will be able to suckle her child for very long, and even if she can do so the milk may be of an inferior quality on which the child is unable to thrive. As it is in the highest degree important that mothers should nurse their children, it is essential that during the whole of their pregnancy their health should be maintained at the best possible standard. So soon as artificial means of feeding have to be adopted, considerable care has to be exercised, and in a great many instances the food which is given is not suited to the requirements 5 of the child, besides which there is the constant risk of contamination of the milk by dirt, disease germs and chemical substances. The effects of unsuitable feeding in infancy are much more reaching than would at first sight appear. Many infants improperly fed die very soon from stomach and bowel troubles induced thereby, while others may grow up, but have had their power of resistance to disease so weakened that they are liable to any complaint. Dr. Eichholz, an Inspector of Schools, in giving evidence before the InterDepartmental Committee, stated that food is at the base of all the evils of child degeneracy. Dr. Hall found, on examining 2,335 board school children in Leeds and the neighbourhood, that half of them were suffering from the effects of rickets, and more than half had decaying or badly-developed teeth. Dr. Ralph Vincent states that physical and mental deficiencies of all possible kinds are caused by infantile malnutrition, the effects of which extend throughout the whole of life. School inspection, while ensuring that the children are being educated under healthy conditions, will reveal the existence of defects produced during infancy ; but education authorities, although they may be able to do something to ameliorate the condition, will be unable to take any steps for the prevention of these defects if they do not work in the closest relationship with the sanitary authorities. If increased attention can be given to ensure that methods of proper feeding, &c., are carried out, school authorities in the future will have less cause to complain that the children are not in such a state of health that they can profit by the education provided. In 1891, in every 1,000 infants born in Westminster, 164 died before attaining one year of age; in 1900, when the City was incorporated, this rate had been reduced to 148; in 1907 a further reduction to 110 had been effected. Part of this is due to the removal from parts of the City of a poor class of persons living under insanitary conditions, but the reduction has not been confined to these districts, so that to other agencies must be attributed a considerable proportion of the improvement. These are the more thorough execution of the Public Health Acts by the Council, as compared with their predecessors, the more frequent removal of refuse from the houses, better scavenging of the streets, and improved and cleaner sewers. In addition, there has been during the last three years the increasing work of the Health Society, through whose agency in 1907 sixty-five lectures were given to mothers and girls, more than 1,200 families in which there were newly-born children were visited (in 400 instances both before and after the confinement), and leaflets giving advice to mothers in various languages have been widely distributed. It is anticipated that the Act for the earlier notification of births will be of value by enabling advice and assistance 6 to be given at an earlier period than is at present possible, but it is of (at least) equal importance that the health and welfare of the prospective mothers should receive more care and attention. The inspection and supervision of workshops and of home-workers is now much more fully undertaken since lady sanitary inspectors were appointed. Numerous difficulties occur in obtaining the addresses of workers. A conference took place at the Home Office on the whole question, when the difficulties experienced in carrying out the homework provisions of the Factory and Workshops Act were discussed with the Chief Inspector. An inspection of licensed premises in 1906, revealed the existence of so many defects that it was deemed advisable to have the kitchens of the many restaurants and hotels in Westminster examined. An Inspector was set aside for this purpose, and the results of his work are given in detail. The defects discovered and the improvements which have been effected, not only structurally, but in the better and cleaner methods of storing and keeping food, amply justify the appointment. The inspection and examination of food has been maintained; the Public Health Committee attach special importance to the necessity for a supply of milk which shall be pure and unadulterated. Particulars of the prosecutions and other proceedings are appended. Some years ago the City Council suggested to other Metropolitan Boroughs the desirability of taking steps to have the qualification "black" omitted from the section of the Public Health Act which deals with smoke nuisances. Apparently they did not then appreciate that as much nuisance might be caused by brown or yellow smoke as by black, and little support was given to Westminster in the matter. The failure of a neighbouring borough to obtain a conviction against a company producing electric power, on the ground that the smoke was not black, accompanied by the payment of three hundred guineas costs to the company, has once more directed attention to the matter. It appears to have been contended that the whole construction of and method of using the generating station were as perfect as human ingenuity could devise. It was also represented to the magistrate that the conversion of the underground railways from steam to electric traction has conferred inestimable benefits on the inhabitants of London. As Westminster suffers to some extent from the smoke given off from the chimneys of this generating station at Lot's Road, it is of interest to observe in the report of the Public Health Board of New York for 1905, that generating stations there are even more perfect in this respect than is the Chelsea one, in that they do not give off smoke at all. The report says: "In the Borough of Manhattan at the present time there are six large power houses consuming an enormous quantity 7 of coal every twenty-four hours, and producing a great amount of electrical power. This power is utilised in lighting hotels, theatres, public buildings, the public streets, and in operating the three great systems of transportation, the subway, the surface railways and the elevated roads. All of these plants have been conducted, through the co-operation of the managing officials, with very little, if any, discharge of smoke, with one exception, and in that case the operating officials have made very strong efforts within the past two or three months to entirely discontinue the discharge of smoke and abate any nuisance which may exist." If this can be done in New York, local authorities should insist on having similar powers here. Westminster had 1,234 hours of sunshine in 1907 (90 more than the average), but in the suburbs there was over 200 hours more sunshine than in Westminster; further out the additional hours of sunshine rose to 400, and at south coast towns there was 500 to 600 extra hours. With stricter powers for suppressing smoke, these differences with their consequent expenses, might be considerably reduced. House inspection for the discovery and abatement of nuisances has been carried on as usual, and lists of the number of visits and details of the work done are duly set out. Parts of St. John's Ward which are in a transitional stage have demanded a large amount of attention. The delay in proceeding with the scheme for reconstruction has a very detrimental effect upon the property which is left, landlords being naturally unwilling to expend money on structural improvements when they may be called upon to give up their holdings at any moment; tenants also are less careful. I have the honour to be, My Lords and Gentlemen, Your obedient servant, FRANCIS J. ALLAN, Medical Officer of Health. February, 1908. 9 PART I. A. Population. The resident population of the City of Westminster has been calculated by the Registrar-General at 172,219 for the year 1907. At the census, 1901, the number was 183,011. This is arrived at by a calculation based on the assumption that the rate of decrease ascertained at the census taken in 1901 as having taken place since the census taken in 1891 is still continuing. In Westminster, where improvement schemes on a large scale are in progress, it is obvious that the risk of error may be considerable. There are, moreover, a large number of persons resident in Poor Law establishments beyond the boundaries of the City whose deaths are allocated to the City, hence these people should be added in as part of the resident population. To counterbalance this there are many persons in hospitals and hotels in the City who are only temporary residents, and in order to be exact these should be excluded. For the purpose of obtaining approximately exact figures for the Wards, I have added paupers to the various Wards in the proportion in which they were found in the Workhouses and Infirmaries at the time of the census, and deducted a proportion of the persons in hospitals and hotels, with the result that the figures given in Table I are arrived at, making a total of 172,900, but without a direct census it is impossible to ascertain the correct figures. The Registrar-General, for the purpose of the Equalisation of Rates Act, estimated the population of the City in another way and makes it to be 172,041, without paupers in outlying workhouses and infirmaries. This he does by calculating the number of persons per inhabited house at the time of the census, and applying such to the number of houses found on the rate books in May of each year. The City Comptroller has been good enough to supply me with a copy of the figures sent to the Local Government 10 Board in 1902, 1903, 1904, 1905, 1906, and 1907, and I append them so that comparisons may be made:— 1 Number of Houses as defined in Local Government Board Schedule. 2 Number of Houses comprising two or more Rateable Properties. 3 Number of Separate Occupations included in Col. 2. 4 Actual Number of Rated Occupiers. 5 Estimated Population Equalisation of Rates Act. 8 Estimated Population RegistrarGeneral's 1st Method. 1902. St. George Hanover Square 9,838 56 2,236 12,018 75,923 76,424 St. Margaret and St. John 5,638 54 3,974 9,558 50,690 52,791 St. James 2,882 7 84 2,959 21,294 21,060 St. Anne 1,135 45 827 1,917 11,168 11,414 St. Martin and Strand 2,708 69 1,805 4,444 19,459 20,200 The City 22,201 231 8,926 30,896 178,489 181,889 1903. St. George Hanover Square 9,848 56 2,253 12,045 76,000 75,715 St. Margaret and St. John 5,474 59 4,347 9,762 49,213 52,284 St. James 2,854 9 202 3,047 21,042 20,094 St. Anne 1,135 45 827 1,917 11,168 11,304 St. Martin and Strand 2,523 69 1,833 4,287 18,282 19,827 The City 21,834 238 9,462 31,058 175,705 179,224 1904. St. George Hanover Square 9,822 59 2,318 12,081 75,799 75,440 St. Margaret and St. John 5,420 60 4,545 9,905 48,727 51,960 St. James 2,822 9 219 3,032 20,806 19,730 St. Anne 1,128 45 829 1,912 11,099 11,250 St. Martin and Strand 2,460 64 1,835 4,131 17,840 19,560 The City 21,652 237 9,746 31,061 174,271 177,940 1905. St. George Hanover Square 9,786 61 2,405 12,130 75,522 74,800 St. Margaret and St. John 5,357 91 5,082 10,348 48,160 51,256 St. James 2,792 11 239 3,020 20,585 19,400 St. Anne 1,121 46 833 1,908 11,031 11,000 St. Martin and Strand 2,447 79 1,991 4,359 17,762 19,150 The City 21,503 288 10,550 31,765 173,060 175,606 11  l Number of Houses as defined in Local Government Board Schedule. 2 Number of Houses comprising two or more Rateable Properties. 3 Number of Separate Occupations included in Col. 2. 4 Actual Number of Rated Occupiers. s Estimated Population Equalisation of Rates Act. 6 Estimated Population RegistrarGeneral's 1st Method. 1906. St. George Hanover Square 9,736 63 2,413 12,086 75,136 74,355 St. Margaret and St. John 5,354 96 5,002 10,260 48,133 50,420 St. James 2,727 13 256 2,970 20,106 19,250 St. Anne 1,104 48 859 1,915 10,863 10,900 St. Martin and Strand 2,456 86 2,041 4,411 17,347 18,980 The City 21,377 306 10,571 31,612 172,085 173,905 1907. St. George Hanover Square 9,749 69 2,495 12,175 75,236 74,050 St. Margaret and St. John 5,343 104 5,210 10,449 48,034 49,320 St. James 2,726 19 436 3,143 20,099 19,150 St. Anne 1,105 48 873 1,930 10,873 10,810 St. Martin and Strand 2,450 87 2,087 4,450 17,799 18,8S9 The City 21,373 327 11,101 32,147 172,041 172,219 The number of dwelling houses has steadily decreased, but the number of houses containing two or more rateable properties has increased, so that the total number of separate occupations has consequently increased also. The total number of rated occupiers has increased by 1,251. According to the proportion existing at the last census, there are 80,230 males and 92,670 females in the estimated population. Births. 2,732 births were registered in the City in the 52 weeks ending December 28th, 1907. On examination, 48 births were found to be referable to other districts. Through the courtesy of the Committees of Management of Endell Street, York Road, and the Queen Charlotte Lying-in Institutions, of the Master of the Strand Workhouse at Edmonton, and the Steward of St. George's Workhouse, Fulham Road, and of other Medical Officers, I have ascertained that 243 children were born in these institutions, the home address of whose mothers was in Westminster. The net number of births was, therefore, 2,927, as compared with 2,931 in 1906; the birth-rate, uncorrected, was 15.8, corrected 16.9 per 1,000 persons. The birth-rate for the County of 12 London for 1907 was 25.6, the rate during the ten preceding years averaged 29 per 1,000. The birth-rate in England and Wales was 26.3, the average of the preceding ten years being 28.4. Consequent upon differences in sex and age distribution, and the proportion of married and unmarried persons in the various Wards of the City, the rates must vary widely. Table I.—Showing the number of Births in the City of Westminster and its Wards (corrected by distributing Institution Births). Wards. Births (corrected). 1901. 1902. 1903. 1904. 1905. 1906. 1907. Conduit 47 46 43 27 30 25 27 Grosvenor 153 157 151 148 133 131 145 Knightsbridge St. George 163 162 125 164 160 150 150 Victoria 836 886 884 862 890 864 846 St. Margaret 197 160 162 165 156 141 152 St. John 869 953 877 828 908 860 873 Knightsbridge Hamlet 68 97 79 77 67 72 66 St. Anne 289 278 240 232 242 217 205 Regent 21.3 226 184 143 163 141 129 Pall Mall 32 23 22 17 20 18 18 Great Marlborough 208 180 162 151 149 137 132 Charing Cross 41 26 34 42 38 26 34 Covent Garden 163 163 151 156 147 129 135 Strand 153 104 71 42 17 20 15 City of Westminster 3,432 3,461 3,185 3,054 3,120 2,931 2,927 A comparison of the corrected and uncorrected birth-rates, and of the death-rates of infants under one year of age, is made in the following table:— Parliamentary Divisions. Births. Birth-rate. Deaths, under 1, per 1,000 births. Uncorrected. Corrected. Uncorrected. Corrected. Uncorrected. Corrected. St. George 1,101 1,168 14.8 15.7 86 81 St. Margaret and St. John 998 1,091 19.9 21.8 142 130 Strand 633 668 10.3 9.3 96 98 The City 2,732 2,927 15.8 16.9 110 103 For a number of years I have pointed out that unless the birth-rate is corrected in the same way that the death-rate is, by the distribution of births in lying-in and other hospitals, unfair conclusions may be drawn. The Registrar-General, in his last Report, has now recognised this, and publishes tables for each of the Metropolitan Boroughs 13 showing the rates for a number of past years. I have also shown in my Reports each year the birth-rate calculated on the number of married women in Westminster, distinguishing the legitimate and illegitimate. This, also, he has adopted. The number of married women between the ages of 15 and 45 is estimated to be 18,164, and the unmarried and widows at the same age-period 38,736. The London figures show a heavy fell, which may be correct, or may be due to variation in the population. Westminster. 1902. 1903. 1904. 1905. 1906. 1907. Legitimate Births (net) 3,275 3,051 2,920 2,971 2,744 2,764 Per 1,000 Married 174 156 156 161 150 151 Illegitimate Births (net) 186 150 134 149 187 163 Per 1,000 Unmarried 4.6 3.4 3.4 3.7 4.8 4.2 London.—Legitimate per 1,000 Married 223 223 218 211 208 173 Illegitimate per 1,000 Unmarried 6.9 6.8 7.1 6.8 6.8 5.4 The birth-rate of Westminster, calculated in this way, is the lowest in London, Hampstead being next. There is, however, a slight increase in the number of legitimate births over the 1906 figures. The number of illegitimate births in London is increased by a number of women who come up from the country, and it is not always possible, for various reasons, to refer the births to the district to which they properly belong. The City of Westminster Health Society have continued and extended their visiting of infants, and state in their Annual Report that as a result of the arrangements with the various general and lying-in hospitals in the City and neighbourhood, whereby the Society is supplied from time to time with list of impending maternity cases on their books, they have been able to visit 401 houses before the confinement took place; subsequently they visit once a month, or oftener if required, during the first three months, later on once a quarter. In all about 1,300 infants were visited during the year. It is sometimes alleged that people resent such visits, but the contrary is the case, and only seven mothers did not wish to be visited. From 991 records which were fully kept, it appears that 653 were breast-fed up to the usual time for weaning, 195 were partly breast-fed from an early age, and 94 were bottle-fed entirely from birth; 78 of the mothers were engaged in work away from home, 161 were engaged in industrial work at home. The nationality of 712 mothers was English, and 496 of their babies were wholly and 119 partially breast-fed; 174 were Russian or Polish (with one or two exceptions Jews), 93 of the babies B 14 being wholly and 51 partially breast-fed. Italians numbered 55, 36 being wholly and 11 partially breast-fed. The following notes are of interest:— "The Italian residents in Soho are usually of a respectable class, who come from Piedmont, and hope to return there after making sufficient money in England to enable them to live comfortably in Italy. They live economically in London, and all take in lodgers. The mothers keep their babies, as a rule, well, and are an example to our people as regards preparations for the arrival of the baby. Comforters are not used in Italy, but, unfortunately, our custom of using them is often copied. Cradles are always provided, and breast feeding is general. Poverty is not very apparent. "Most of the Jewish families recently become residents in Soho have come from Poland and other parts of Russia. Their standard as regards cleanliness is a low one. They live in over-crowded rooms (often taking in lodgers), and bring their children up in excessively hot rooms. Their point of view is different from that of the Italians, as they mean to settle in England and rise to a better position. Most of the men are tailors. As regards the children—they are spoiled by their parents, who are devoted to them. They suffer more from too rich and highly-spiced food than from actual want. The infants are nursed by their mothers for a longer period than is usual with English mothers. Infant Consultations.—The Medical Committee of the Western Provident Dispensary, Rochester Row, S.W., have made arrangements by which any gratuitous maternity case attended from the Dispensary is permitted to attend at the Dispensary to receive advice. In Soho arrangements have also been made which are working very satisfactorily. Deaths. 2,396 deaths were registered in the City in the 52 weeks ending the 28th December, 1907. After deducting 992 deaths of non-citizens in public institutions in the City, and adding those of 833 citizens who died in other districts, the corrected total is 2,237, and is equivalent to an annual rate of 12.9 per 1,000 persons. The London death-rate for the same period was 14.6, and for England and Wales 15.0. The rates were in each instance below the average of the preceding ten years to the following extent: The City 2.3 per 1,000, London 2.5 per 1,000, and England and Wales l.7 per 1,000. A Factor for Correction of Death-rates, whereby differences in the age and sex constitution of the population may be removed 15 is arrived at by obtaining the age and sex distribution of the population of a district at the last census; after ascertaining the death-rate for each sex, at each age-period in England and Wales during the last ten years, a calculation is made of the number of deaths which would have occurred in the district had similar rates been obtained; thus a "standard" death-rate is obtained. The difference between this rate and that for England and Wales is, on the above assumption, due to differences in the age and sex constitution on the population of the district, and dividing the latter by the former a factor is obtained for correcting the crude death-rate of the district. Applying such factors (1.0511 for London, 1.12176 for Westminster) to the 1907 rates, the figures are:— District. Standard death-rate. Recorded death-rate. Corrected death-rate. Comparative mortality figure. England and Wales 18.19 15.0 15.0 1,000 County of London 17.31 14.6 15.3 1,020 City of Westminster 16.22 12.9 14.4 960 For the six previous years, 1901-06, the comparative mortality figures were for the County 1,065, 1,100, 1,032, 1,042, 1,039, and 1,025. and for the City 1,100, 1,082, 1,025, 940, 993, and 941. Tables II to XII show the vital statistics of the City and five groups of districts from 1891 to 1907. The death-rates, according to the old districts of the City, are:— District. Average of Previous 10 Years. 1907. St. George 12.7 12.2 Westminster 18.2 15.5 St. James 14.8 10.1 St. Anne 14.2 10.4 Strand and St. Martin 17.6 13.0 The City 15.2 12.9 Ages at Death.—Of the total deaths, 303 were those of children under 1 year of age, and 718 of persons over 65 years of age; these are referable to the various wards, as follows:- B 2 16 1907. Wards. Under 1 Year of Age. Over 65 Years of Age. 1st Quarter. 2nd Quarter. 3rd Quarter 4th Quarte. The Year. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year. Conduit - - 1 - 1 2 1 2 - 5 Grosvenor 4 1 1 1 7 23 15 6 12 56 Hamlet of Knightsbridge 4 1 1 1 7 6 4 7 5 22 Knightsbridge St. George 5 4 2 2 13 16 13 8 12 49 Victoria 21 22 9 22 74 62 42 33 63 200 St. Margaret 8 4 3 3 18 15 7 5 10 37 St. John 45 28 16 28 117 60 37 30 47 174 St. Anne 7 3 5 2 17 9 3 4 7 23 Great Marlborough 3 3 6 5 17 8 6 5 4 23 Pall Mall 1 - - 1 2 4 3 2 2 11 Regent 3 2 2 4 11 11 9 3 3 26 Charing Cross 1 2 2 1 6 4 5 5 1 l5 Covent Garden 2 4 1 4 11 13 7 11 9 40 Strand 2 — — — 2 13 7 12 5 37 The City 1907 106 74 49 74 303 246 159 133 180 718 1906 82 68 106 67 323 193 170 119 182 664 The deaths of young children were less and those of old persons more than in the previous year, the latter resulting from influenza and chest affections. Infantile Mortality.—The uncorrected rate for the City was 110 deaths per 1,000 births registered in the City, as compared with 136, the average of the previous ten years. The corrected rate was 103, the average of the years 1901-6 being 117. On deducting the births and deaths of illegitimate children, it will be seen below that the infant death-rate has fallen regularly from 125 to 97 per 1,000. The London rate for 1907 was 116, the average being 147. The infantile death-rate in England and Wales was 119, being 27 per 1,000 below the average. Table VII, required by the Local Government Board, shows in detail the ages and causes of death of children under 1 year of age. It will be noted in the Table above that the decrease in infant deaths was confined to the 3rd. Quarter of the year, when diarrhoea was almost absent. Measles, whooping cough, and chest affections increased the rates in other quarters, together with some diarrhoea in the early part of the last quarter. Thirty-four deaths in 1907 were those of illegitimate miants. The death-rate of such children is much higher than that of legitimate infants:— 17  Legitimate. Illegitimate. Rate. Births. Deaths. Rate per 1,000. Births. Deaths. Rate per 1,000. 1902 3,275 410 125 186 32 172 127 1903 3,035 345 113 150 25 166 116 1904 2,920 320 109 134 40 298 118 1905 2,971 305 102 149 24 161 105 1906 2,744 285 103 187 38 203 110 1907 2,764 269 97 163 34 208 103 Six years 17,709 1,934 108 969 193 199 113 It is evident that the improvement is confined to the legitimate children, among whom it is continuous, the 1907 rate being 22 per cent. less than that in 1902. The following table shows the number of deaths of infants, and their relation to births in the last three years. It also shows the age periods at which they died:— Deaths per 1,000 born (corrected figures). Age at Death. 1905. 1906. 1907. No. Rate. No. Rate. No. Rate. Under 1 week 66 21.1 64 21.8 85 29.1 ,, 1 month 131 41.9 120 41.0 126 43.1 3 months 195 62.5 195 66.6 182 62.3 Between 3 and 6 months 38 12.1 53 18.1 57 19.4 „ 6 „ 9 ,, 52 16.6 46 15.8 30 10.3 „ 9 „ 12 „ 44 14.1 29 9.9 31 11.5 Total in year 329 105.4 323 110.4 303 103.5 The causes of death in each year are given below, together with the relative proportion each group bears to the whole of the infant deaths:— 18  1905. 1906. 1907. No. Per cent. of total deaths. No. Per cent. of total deaths. No. Per cent. of total deaths. Common infectious diseases 37 11.2 12 3.7 17 5.5 Diarrhœal diseases 46 13.9 76 23.5 30 9.9 Premature birth3 aud injury, &c., at birth 84 25.5 72 22.5 96 31.6 Did not thrive—wasting—want of milk—rickets 49 14.8 50 15.4 43 14.0 Tuberculous diseases 17 5.1 18 5.5 15 4.9 Erysipelas and other septic diseases - - 10 3.0 9 2.9 Syphilis 15 4.5 7 2.1 12 3.9 Meningitis, convulsions 11 3.3 13 4.0 11 3.6 Bronchitis and pneumonia 45 13.6 44 13.6 56 18.4 Suffocation—overlying, &c. 5 1.5 6 1.8 6 1.9 Other causes 20 6.0 15 4.6 4 1.3 329 100 323 100 303 100 Among the 303 deaths of infants under one year of age, a large proportion is included under the headings of Prematurity, Debility at Birth, and Injury at Birth. It is alleged that deaths from these causes are increasing in the country generally (partly, perhaps, on account of greater care in registering). Enquiry shows that it is net infrequently those premature or weakly children who succumb later in life to various diseases. Analysis of the information obtained relative to these deaths brings out the fact that the chief causes of these infants being born in this condition are syphilis, alcoholism, kidney disease, heart disease, accidents, consumption, and emotional disturbances. In some instances the work in which the mother has been engaged has contributed towards the result (under this head instances are recorded where the carrying of heavy weights, such as pails of water from the ground floor to the top of the house, has been injurious). It would appear that when there are twins there is a great liability to death of one or both. Probably at least nine more deaths at, or soon after, birth than those recorded under the heading syphilis may be ascribed to that complaint. After the first month the question of feeding becomes a more prominent factor, although it is evident that in many instances in which the child does not thrive it is due to the debilitated or diseased condition when born. Such children under very careful dieting from the first may grow up strong, but frequently they are unable to digest anything. 19 A large proportion of Westminster babies are breast-fed, but from the condition of the health of the mother or child, or both, it sometimes happens that the child has to be weaned at an early age. If the mother is in bad health or is insufficiently nourished, the milk supplied cannot be sufficient in quality or quantity for the child, and thus hand-feeding has to be resorted to. Fortunately, a small proportion only of babies in Westminster are weaned on account of the mother's work. When it does occur, it leads to the infant being left in charge of neighbours or children. Illegitimacy also leads to the same result, and the child is generally nursed out with a stranger; instances of neglect in both classes of cases are recorded. Unfortunately, the intemperate habits of some mothers render them equally neglectful, and in two instances in which proceedings were taken by the National Society for the Prevention of Cruelty to Children, women were sent to prison for neglecting their children; in one case two children died. Cause of death at all Ages.—These are set forth in Table VI, and also their distribution in the various Wards of the City. There is a large increase (17) over 1906 in deaths from influenza and diseases of the respiratory system (78), but there is also a large decrease (49) in diarrhceal diseases. Deaths from violence (accidents, suicides, &c.), are also considerably (29) less. Statistics of Dwellers in Block Dwellings.—These are set out in Table XII. A comparison of the births and deaths in the Council's Buildings in Eegency Street during the last three years is given below. The buildings were not occupied during the whole of 1904. The population has been ascertained by the Superintendent. Year. Population. Births. Rate. Deaths. Rate. Deaths of Infants under one per 1,000 births. 1905 1,138 57 50.0 23 20.2 140 1906 1,150 63 54.7 16 139 111 1907 1,163 60 51.6 18 15.5 116 Average of three years — - 52.1 — 165 127 Average of last two years - - 53.1 - 14.7 114 Attention is at once drawn to the extremely high birth-rate. The rate for St. John's Ward, in which the Buildings are situated, is 29.6 for the same period. In the adjoining County Council Buildings at Millbank the average rate is 38.0, in the Peabody Buildings 27.25, and in the Improved Industrial Buildings 15.0, the difference being due to the ages of the residents. In the course of time the birthrate will, doubtless, approximate to the rates in these older buildings, 20 The death-rate compares favourably with the district in which they are situated, viz., 20.5. Probably it is fairer not to include the year 1905, as people coming into the Buildings had not had time to benefit by the improved conditions, and in a number of instances ill-health existed before entering the Buildings. Taking the average of the last two years, I find that the death-rate is practically the same as that of the Millbank and several other Buildings, but is not quite so low as the Improved Industrial and Peabody Group of Buildings. Here, again, the age constitution of the population accounts for the difference. Deaths in Common Lodging-houses.—96 deaths occurred in 1907 among inmates of the common lodging-houses and shelters in the City (92 males and 4 females). There were also recorded the deaths of 2 babies. 31 of the deaths were due to phthisis, and 31 to respiratory diseases. There were 57 deaths in St. John's Ward, 1 in St. Anne's, 4 in Regent, 30 in Covent Garden, and 6 in Strand. Bruce House, Kernble Street, which was opened as a common lodging-house, has contributed during the year, according to a statement made to the Strand Guardians, as many claimants on the Poor Law as it has inmates. The authorised accommodation in the City is 1,834, and the average occupation 1,550. The following is a list of the common lodging-houses in Westminster, the number for which they are licensed, and the number of deaths which occurred in 1907 among persons alleged to be inmates:— Men. Deaths. Bruce House, Kemble Street (L.C.C.) 699 14 33, Gt. Peter Street 397 18 6, 6a, 6b, and 6c, Gt. Smith Street 201 7 Ham Yard Hospice, Gt. Windmill Street 20 1 11, 12, and 13, Hanover Court 105 15 26, Litchfield Street 53 1 23 and 25, Millbank Street (S.A. Shelter) 449 7 108, Regency Street 8 — The Schools, Kean Street (S.A. Shelter) 125 2 16, Strutton Ground 211 14 45 and 47, Tufton Street 91 3 Women. 40, Gt. Peter Street 75 6 (including 2 infants) In addition, 10 deaths were recorded among inmates of the following premises, the use of which as common lodging-houses has now been given up:—Harvey's Buildings, 29, Vere Street, 107, Wardour Street, 10, Monck Street, 10, Stanhope Street. 21 Table II.—City of Westminster.—Statistics of Births and Deaths during the ,52 Weeks from 31 st December, 1906, to 28tli December, 1907. 1 2 3 4 5 6 7 8 9 10 11 12 Average Deathrate 1901-6. Wards. Population Estimated to Middle of the Year 1907 Births (Corrected). Deaths Under One Year of Age. Deaths at all Ages. Total. Deaths of Citizens in Public Institutions. Deaths of NonResidents Registered in District. Deaths of Residents Registered beyond District. Deaths at all Ages. Nett. Number. Rate.* Number. Rate per 1,000 Birth (Corrected). Number. Rate.* Conduit 5,400 27 5.0 1 37 24 5 7 6 23 4.2 6.5 Grosvenor 14,700 145 3.8 7 48 103 44 11 52 144 9.7 9.0 Knightsbridge St. George 14,700 150 10.2 13 86 448 37 364 36 120 8.1 8.7 Victoria 39,300 846 21.5 74 87 354 273 13 277 618 15.7 15.3 St. Margaret 13,000 152 11.6 18 118 334 53 244 33 123 94 121 St. John 29,400 873 29.6 117 134 328 313 51 318 595 20.2 20.7 Hamlet of Knightsbridge 7,520 66 8.6 7 106 35 26 2 27 60 7.9 8.8 Pall Mall 2,950 18 6.1 2 111 26 4 5 5 26 88 9.4 Regent 9,240 129 13.9 11 85 44 43 8 43 79 85 133 Great Marlborough 6,900 132 19.1 17 128 62 47 15 42 89 12.8 14.9 Charing Cross 4,150 34 8.1 6 176 34 15 9 16 41 9.8 10.2 Covent Garden 8,400 135 16.0 11 81 304 83 248 73 129 153 16.7 Strand 6,340 15 2.3 2 133 197 61 182 61 76 11.9 18.6 St. Anne 10,900 205 18.8 17 82 103 57 48 59 114 10.4 12.9 The City 172,900 2,927 16.9 303 103 2,399 1,061 992 833 2,237 1293 141 * Rates calculated per 1,000 of estimated population. The uncorrected birth-rate was 15.8, the uncorrected death-rate, 13.8. Note.—The deaths included in Column 7 of this table are the whole of those registered as haying actually occurred within the ward. The deaths included in Column 11 are the number in Column 7 corrected by the subtraction of the number in Column 9 and the addition of the number in Column 10, The death-rate for all London during the same period has averaged 14.5 per 1,000, 17 per 1,000 being the mean rate in the ten years 1891-1900. 22 Table III.— Vital Statistics of Whole Districts during 1901-1907. City of Westminster. 1 2 3 4 5 6 7 8 9 10 11 12 13 Year. Population Estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Non. Residents Registered in Public Institutions in the District. Deaths of Residents Registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District, Number (Uncorrected). Rate.* Under 1 Year of Age. At all Ages. Number (net). Rate per 1,000 Births Registered. Number. Rate.* Number. Rate.* 1901 182,567 3,232 17.8 435 135 2,998 16.3 1,227 1,019 921 2,900 15.8 1902 1184,211 3,284 17.8 442 134 2,899 15.7 1,129 906 959 2,952 16.0 53 weeks 1903 179,052 3,017 16 8 370 122 2,517 14.0 1,086 931 833 2,419 13.5 1904 177,321 2,897 16.3 360 124 2,626 14.8 1,228 1,073 823 2,376 13.4 1905 175,606 2,940 16.7 329 111 2,545 14.5 1,217 1.035 837 2,347 13.3 1906 173,905 2,766 15.9 323 116 2,482 14.3 1,223 1,045 790 2,227 12.8 1907 172,900 2,732 15.8 303 110 2,396 13.8 1,061 992 833 2,237 12.9 *Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Note.—The deaths to be included in Column 7 of this Table are the whole or those registered during the year as having actually occurred within the district or division. The deaths to be included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term "Residents" is meant persons "who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The ''Public Institutions" to be taken into account for the purpose of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses, and lunatic asylums. A list of the institutions in respect of the deths in which corrections have been made is given on tlie next pages. Total population at all ages 183,011 Area of District in acres (exclusive of area covered by water) 2502.7 Number of inhabited houses 18,366 At Census of 1901, Average number of persons per house 23 Table III.—continued. I. II. II—continued. Institutions within the District receiving Sick and Infirm Persons from outside the District. (Total Number of Deaths in brackets.) Institutions outside the District receiving Sick and Infirm Persons from the District. Institutions outside the District receiving Sick and Infirm Persons from the District. St. George's Hospital (361). Middlesex Hospital. Home Hospital, Fitzroy Square. Westminster Hospital (250). St. Thomas's Hospital. Charing Cross Hospital (225). St. Bartholomew's Hospital. St. George's Infirmary, Fulham Road. King's College Hospital (171). St. Mary's Hospital. St. Peter's Hospital (22). Guy's Hospital. Chelsea Infirmary. Grosvenor Hospital (6). Endell Street Lying-in Hospital. Camberwell InfIrmary. Heart Hospital, Soho Square (16). Holborn Infirmry. Italian Hospital. Mile End Infirmary. Women's Hospital, Soho Square (24). German Hospital. Marylebone Infirmary. French Hospital. Fulham Infirmary. Throat Hospital, Golden Square (4). Victoria Hospital. Edmonton Workhouse. General Lying-in Hospital, York Road. St. Giles Workhouse. Gordon Hospital (1). St. George's Workhouse, Fulham Road. Military Hospital, Millbank (4). London Hospital. Evelina Hospital. Central London Sick Asylum, Cleveland Street. Queen Alexandra Military Hospital, Millbank (17). West London Hospital. Great Northern Hospital. Central London Sick Asylum, Hendon. St. George's Workhouse Wallis Yard (4). Queen Charlotte's Hospital. Great Ormond Street Children's Hospital. Banstead Asylum. Poland Street Workhouse (17). Belmont Asylum. Canccr Hospital, Chelsea. Long Grove Asylum. Sheffield Street Workhouse (6). University College Hospital. Camberwell House. Brompton Hospital. Metropolitan Benefit Asylum. 22, George Street, Hanover Square, Nursing Home (4). Hospital of St. John and St. Elizabeth. Cane Hill Asylum. Caterham Asylum. Infants' Hospital (18). North-Eastern Fever Hospital. Claybury Asylum. Women and Children's Hospital, Lupus Street (2). Colney Hatch Asylum. Western Fever Hospital. Darenth Asylum. Lock Hospital (4). Northern Fever Hospital. Hanwell Asylum. Royal Ear Hospital (2). Fountain Fever Hospital. Horton Asylum. Royal Western Ophthalmic Hospital (1). Grove Fever Hospital. Leavesden Asylum. Royal Hospital, Waterloo Road. Tooting Bee Asylum. Manor Asylum. Grove End Road Hospital. Clapham Maternity. Homoeopathic Hospital. S.A. Maternity, Hackney. Antivivisection Hospital. III. Other Institutions, the Deaths in which have been distributed among the several localities in the District. III—continued. Other Institutions, the Deaths in which have been distributed among the several localities in the District. III — continued. Other Institutions, the Deaths in which have been distributed among tue several localities in the District. 55, Welbeck Street. 68, Hereford Road, Paddington. 30, Cavendish Square. Hostel of g od. 29, Wimpole Street. St. Joseph's Home. 47, Fitzjohn's Avenue, Hampstead. The Priory, Putney. 46 and 22, Beaumont Street. H.M. Prison, Hollo way. St. Luke's House, Pembridge Square. 32, Stockwell Green. Whittington College. 7 and 3, Mandeville Place, Marylebone. 14, Endsleigh Gardens. St. Joseph's Hospice, Hackney. 11, Duchess Street, Marylebone. 49, Duke Street, Marylebone. Home for Blind, Islington. 45, Devonshire Street. 5, Kensington Court. 24 Table IV.— Quarterly and Annual Death-rates per 1,000 Inhabitants in the City of Westminster (in Various Wards), b the United Kingdom, England and Wales, and the County of London. Period. Unitel Kingdom. England and Wales. County of London. The City. Conduit Ward. Grosvcnor Ward. Hamlet of Knightsbridge Ward. Knightsbridge St. George Ward. Victoria Ward. Sr. Margaret Ward. St. John Ward. St. Anne Ward. Great Marlborough Ward. Pall Mall Ward. Regent Ward. Charing Cross Ward. Covent Garden Ward. Strand Ward. 1st Quarter 10.0 18.7 18.5 17.5 6.6 15.6 12.7 8.7 19.3 13.2 28.9 14.3 16.2 13.5 13.4 12.5 18.5 18.9 2nd Quarter 15.3 14.6 14.0 12.0 2.2 7.0 4.7 11.7 15.0 9.5 18.6 8.8 10.4 6.7 10.3 9.6 12.8 8.8 3rd Quarter 12.4 12.1 11.5 9.8 5.1 5.7 6.3 5.1 11.0 7.4 15.5 8.4 11.5 8.1 5.1 9.6 15.2 13.2 4th Quarter 15.0 14.7 14.3 12.3 2.9 10.8 7.9 7.0 17.4 8.6 17.8 9.9 13.3 6.7 5.1 7.7 15.2 6.9 The Yeae 1907 14.7 15.0 14.6 12.9 4.2 9.7 8.8 8.7 15.3 12.1 20.7 12.9 14.9 9.4 13.3 10.2 16.7 18.6 „ 1906 15.5 15.4 15.1 12.8 4.6 7.2 8.2 7.6 15.5 10.6 19.6 13.3 10.7 8.7 9.4 7.1 15.5 11.8 1905 15.5 15.2 15.1 13.3 6.2 8.2 9.6 7.4 15.1 10.8 21.0 11.2 12.3 9.6 12.1 10.8 16.4 12.9 „ 1904 16.5 16.2 16.1 13.4 5.6 9.6 9.6 8.2 14.7 10.8 19.1 11.6 14.5 10.6 10.4 10.9 18.2 16.2 „ 1903 15.6 15.4 15.2 13.5 4.8 7.5 8.4 8.2 14.2 12.6 18.8 13.6 14.4 9.1 15.7 11.8 15.2 20.0 1902 16.5 16.3 17.2 16.0 9.8 11.1 7.8 9.6 16.9 14.1 23.3 14.9 18.1 7.8 16.1 10.5 16.8 24.3 1901 — 16.9 17.1 15.6 8.4 10.3 9.4 11.2 15.4 13.7 22.6 12.7 19.8 10.6 16.0 10.3 18.5 26.3 25 Table V.—City of Westminster.—Monthly and Quarterly Death Rates, 1901-7. Births. Deaths. 1901 1902 1903 1904 1905 1906 1901 1902 1903 1904 1905 1906 Monthly. 1 — 18.3 16.1 16.3 18.5 16.9 16.3 18.7 16.6 16.7 16.6 15.0 2 — 19.7 17.4 18.7 18.5 15.7 20.2 26.8 14.5 15.6 15.8 13.3 3 — 18.8 15.0 16.7 17.5 16.5 17.5 17.7 14.8 16.0 13.5 13.1 4 17.5 17.7 16.1 17.1 16.0 15.4 17.0 14.1 14.6 12.7 12.2 15.1 5 16.5 15.7 19.1 15.1 17.2 16.3 14.3 14.6 13.8 13.3 12.4 12.0 6 19.2 16.9 17.3 16.7 15.9 14.2 13.0 11.9 11.7 9.7 11.8 12.6 7 15.9 20.6 18.1 15.3 14.9 18.0 13.0 14.2 11.9 11.6 11.0 10.0 8 18.7 18.0 15.6 16.9 16.8 16.6 14.3 11.9 11.6 13.0 13.0 11.9 9 19.9 15.7 17.7 13.4 16.5 14.5 12.8 12.5 11.5 11.2 11.6 12.1 10 17.0 15.8 16.1 15.0 13.6 16.4 13.9 13.7 11.4 13.1 13.1 10.3 11 17.0 17.2 16.2 16.7 16.4 14.4 18.6 16.2 14.6 10.7 13.2 12.5 12 13.6 14.8 16.0 15.4 16.6 15.4 17.3 16.8 15.5 16.0 16.0 15.6 Quarterly. 1 — 18.8 16.0 17.2 18.1 16.4 18.0 20.9 15.2 16.1 15.2 13.7 2 17.6 16.8 17.4 16.4 16.4 15.4 14.8 13.5 13.2 11.7 12.1 13.1 8 18.3 18.3 17.1 15.1 16.1 16.1 18.4 12.9 11.6 12.1 11.9 11.4 4 15 .9 16.0 16.0 15.7 15.6 15.3 16.4 15.8 13.9 13.5 14.0 12.8 Yearly. 18.5 18.7 17.7 17.2 17.7 16.8 15.6 16.0 13.5 13.4 13.3 12.9 Months. London. Westminster. Average of 5 Years, 1902-06. 1907. Average of 5 Years, 1902-06. 1907. January 17.6 19.9 16.7 18.8 February 18.2 18.8 17.2 17.7 March 17.1 16.9 15.0 14.9 April 15.7 16.0 13.7 12.7 May 14.2 14.0 13.2 12.1 June 12.0 12.2 11.5 11.1 July 12.6 11.4 11.7 10.2 August 15.5 11.2 12.2 8.6 September 15.1 12.0 11.7 10.6 October 14.8 13.5 12.3 11.1 November 16.9 14.5 13.4 12.6 December 17.8 15.2 16.0 13.5 Quarters. 1st 17.6 18.5 16.2 17.5 2nd 14.4 14.0 12.7 12.0 3rd 14.6 1.5 11.9 9.8 4th 16.3 14.3 14.0 12.3 Year 15.7 14.6 13.8 12.9 26 Table VI.—Causes of, and Ages at, Death during the 52 weeks ending 28th December, 1907. Causes of Death. Corrected Deaths in the City at subjoined Ages. Deaths IN Wards (at all Ages). All ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Conduit. Grosvenor. Hamlet of Knightsbridge. Knightsbridge St. George. Victoria. St. Margaret. St. John. St. Anne. Great Marlborough. Pall Mall. Regent. Charing Cross. Covent Garden. Strand. Smallpox - - - - - - - - - - - - - - - - - - - - - Measles 22 3 18 1 - - - - 3 - 2 4 3 6 2 1 - - - 1 - Scarlet fever 12 - 8 4 - - - - 2 - - 6 - 4 - - - - - - - Epidemic influenza 42 - - - - 18 24 - 7 2 5 8 3 8 - - - 3 2 1 3 Whooping cough 27 12 15 — - - - - 2 1 - 7 - 13 3 1 - - - - - Diphtheria, Memb. croup 16 2 10 3 — 1 - - - - - 4 2 5 - 1 - - - 3 1 Cerebro-spinal meningitis 2 1 1 — — — — — — — — 1 — - 1 - - - - - - Enteric fever 9 — — — 2 7 — 1 — — 1 4 — 2 — 1 1 — — — 1 Diarrhœa 20 13 2 — — 3 2 1 — - - 6 — 9 1 2 1 - 1 Epidemic enteritis 7 5 2 - - - - - - - - - - - - - - - - - - Enteritis 19 9 — — — 6 4 — — — 1 8 3 2 2 - - - - 3 - Erysipelas 6 — — — — 1 5 — 1 — — 1 — 2 — 1 - — - 1 - Puerperal fever 3 — — — 1 2 — — — — 1 2 — — — — - — — - - Other septic diseases 28 8 1 2 2 13 2 - 2 - 4 4 1 8 1 1 - 2 1 4 - Syphilis, &c 17 12 - - - 5 - - - - - 4 2 5 1 - - 1 3 - - Diabetes 21 - - - - 15 6 - 1 - 2 11 - 1 - - 1 1 ] 1 Malarial diseases 1 — — — — 1 - — 1 - - - — - — - - - - - - Rheumatic fever 11 — — 5 2 4 — — 1 — 1 4 1 2 — 1 - 1 — — — to ^-7 Tuberculosis of meninges 26 5 14 2 2 3 — — — — 2 6 1 9 3 3 — 1 — 1 — Tuberculosis of lungs 232 1 4 5 25 174 23 3 8 3 7 65 13 79 10 6 3 5 3 16 11 Tuberculosis of peritoneum 11 2 6 1 1 1 — — — 1 — 4 — 5 1 — - - - - Other forms of tuberculosis 20 7 3 3 3 2 2 — — — — 8 2 5 — — — — — 4 1 Alcoholism 29 — — — 1 24 4 — — 1 2 10 1 10 1 1 1 1 1 — — Malignant growths 160 — — — 1 97 62 3 13 7 16 47 8 31 5 5 5 6 1 9 4 Premature birth 72 72 — — — — — 1 2 1 4 17 3 28 3 7 1 4 2 1 — Developmental diseases 60 63 3 1 1 4 17 4 27 4 1 1 2 1 2 1 Old age 98 — — — — 3 95 1 7 2 6 31 5 18 7 3 — 4 1 5 8 Meningitis and convulsions 17 9 6 1 — 1 — — 1 — 3 2 1 8 — 2 — — — — — Other diseases of nervous system 106 - - - 6 60 40 - 8 2 7 26 6 18 6 9 1 6 1 9 7 Valvular diseases of heart 65 — — 3 3 38 21 — 9 2 2 16 3 18 2 3 — 4 2 3 1 Other circulatory diseases 212 — — 2 4 105 101 4 16 8 11 67 12 45 12 12 4 3 4 11 3 Bronchitis 226 24 5 — — 61 133 1 8 5 7 52 14 56 16 12 3 13 9 17 13 Lobar (croupous) pneumonia 35 1 - - 3 20 11 1 3 4 2 7 2 8 1 1 1 - 3 2 Lobular (broncho-) pneumonia 100 29 16 1 - 13 41 - 5 5 3 30 6 37 3 3 - 2 1 3 2 Other respiratory diseases 110 3 14 6 3 53 31 — 8 — 8 26 6 37 5 6 2 5 1 5 1 Cirrhosis of liver 42 — — — — 31 11 1 9 2 2 8 3 7 2 - 1 2 — 2 3 Other digestive diseases 85 10 2 7 7 42 17 2 11 4 4 22 6 14 4 2 — 5 1 8 2 Bright's disease, &c. 129 — 1 1 6 62 59 2 8 5 8 37 6 42 7 3 — 3 — 3 5 Generative 6ystem diseases 6 - — — — 5 1 1 1 — — 1 — 3 — — — — — — — Accidents and diseases of parturition 3 - - - 1 2 - - - - 1 1 - - 1 - - _ - - - Deaths by accident or negligence 67 11 4 3 7 28 14 1 4 1 3 21 5 12 5 - - 2 4 5 4 Deaths by suicide and murder 25 - - - 2 22 1 - - - - 8 - 4 1 1 2 - 2 4 3 All other causes 32 1 1 1 2 19 8 1 1 1 1 12 1 4 4 — 1 1 1 3 1 All causes 2,237 303 136 51 84 945 718 23 144 60 120 618 123 595 114 89 26 79 41 129 76 to ' oc Table VII.—Infantile Mortality during the year 1907. Deaths from Stated Causes in Weeks and Months under One Year oj Age. CAUSE OF DEATH. Under 1 Week. 1—2 Weeks. 2—3 Weeks. 3—4 Weeks. Total under 1 Month. 1—2 Months. 2—3 Months. 3—4 Months. 4—5 Months. 5—6 Months. 6—7 Months. 7—8 Month?. 8—9 Months. 9—10 Months. 10—11 Months. 11—12 Months. Total Deaths under One, Year. Common infectious diseases— Small-pox - - - - - - - - - - - - - - - - - Chicken-pox - - - - - - - - - - - - - - - - - Measles - - - - - - - - - - - - - 1 — 1 3 Scarlet fever - - - - - - - - - - - - - - - - - Diphtheria (including membraneous croup) - - - - - - - - - - - - 1 1 - - 2 Whooping cough - 1 — — 1 — — 1 2 — 1 1 1 2 2 1 12 Diarrliceal diseases— Diarrhoea, all forms — 1 — — 1 — 1 2 4 3 — — 1 3 — — 15 Enteritis, muco-enteritis, gastro-enteritis — 1 - — 1 2 1 1 3 1 - - - - - - 9 Gastritis, gastro-intestinal catarrli - - 1 - 1 1 1 1 1 1 1 - - - - - 6 Wasting diseases— Premature birth 56 4 6 2 68 3 1 - - - - - - - - - 72 Congenital defects 8 3 2 — 13 1 - - - - - 1 - - - - 15 Injury at birth 8 — — — 8 1 - - - - - - - - - - 9 Want of breast-milk, starvation - - - - - - 1 - — — 1 — — — — — 2 Debility from birth 8 2 1 — 11 4 2 2 — 1 1 — — — — — 21 Marasmus - 1 — 1 2 2 3 3 5 - - - - - - - 16 Neglect 2 - — — 2 — — — — — — — 2 — — — 4 Tuberculous diseases— Tuberculous meningitis - - - - - - - - 1 - - 1 1 1 - 1 5 Tuberculous peritonitis, tabes mesenterica - - - - - - - - - - - - - 2 29 Other tuberculous diseases — — - 1 1 1 - 1 1 - - - - 1 1 2 8 Other causes— Erysipelas — — — - - - - - - - - - - - - - - Other Septic — — 2 1 3 2 1 — 1 — — — — 1 — 1 9 Syphilis 2 2 — — 4 1 3 2 1 — — — — — 1 — 12 Rickets — — — — — — — — — 1 - - - - 1 2 4 Meningitis (not culous) - - - - - - 1 1 1 - 1 1 - - - - 5 Dentition — — — — — — — — — — — — — 1 — — 1 Convulsions — 1 — — 1 — 1 — — - 1 - - — — 2 5 Bronchitis — — 1 — 1 6 3 1 2 3 3 — 2 3 — — 24 Broncho-pneumonia — 2 2 2 6 8 3 1 3 3 3 — 2 — 1 30 Pneumonia.. — — — — — — — — — — — 1 1 — 2 Suffocation, overlying 1 — — — 1 — 1 — — — — — — • — — 2 Accidents — — — — — — — 2 — — — 1 1 — — — 4 Other causes — 1 — — 1 — 1 — 1 — 1 — — — — — 4 85 19 15 7 126 32 24 18 26 13 15 6 9 17 6 11 303 Population, estimated to middle of 1907, 172,900. Births in the year—Legitimate, 2,764; illegitimate, 163. Deaths in the year of legitimate infants, 269 ; illegitimate infants, 34. Deaths from all causes at all ages, 2,237. 30 Table VIII.—Deaths of Citizens during the Year ending 28th December, 1907, showing Locality ai Time of Death. Wards. Locality at Time of Death. Total Deaths (Nett). At Home. Workhouses and Infirmaries. General and Special Hospitals. Fever Hospitals. Lunatic Asylums. Elsewhere. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. males. Females. Total. Conduit 10 7 17 1 - 1 1 3 4 - - - - - - 1 - 1 13 10 23 Grosvenor 46 45 91 11 8 19 8 7 15 1 1 2 4 3 7 8 2 10 78 66 144 Hamlet of Kniglitsbridge 14 19 33 5 7 12 11 2 13 — — — - 1 1 - 1 1 30 30 60 Kniglitsbridge St. George 34 38 72 5 6 11 13 7 20 — — — 2 3 5 5 7 12 59 61 120 Victoria 161 175 336 79 59 138 53 38 91 2 4 6 16 19 35 7 5 12 318 300 618 St. Margaret 34 34 68 9 9 18 22 8 30 — — — 2 2 4 2 1 3 69 54 123 St. John 139 133 272 150 61 211 52 35 87 3 4 7 6 1 7 8 3 11 358 237 595 St. Anne 36 19 55 10 15 25 12 11 23 1 — 1 4 3 7 1 2 3 64 50 114 Great Marlborough 22 20 42 11 10 21 10 4 14 — 1 1 3 8 11 - - - 46 43 89 Pall Mall 13 8 21 1 — 1 1 2 3 — — — — — — 1 — 1 16 10 26 Regent 20 16 36 13 7 20 9 7 16 — — — 3 2 5 2 - 2 47 32 79 Charing Cross 10 12 22 2 3 5 5 3 8 — — — — 2 2 3. l 4 20 21 41 Covent Garden 24 20 44 32 11 43 17 12 29 2 1 3 5 3 8 2 - 2 82 47 129 Strand 7 5 12 30 23 53 1 2 3 1 - 1 2 2 4 3 - 3 44 32 76 City of Westminster 570 551 1,121 359 210 578 215 141 356 10 11 21 47 49 96 43 22 65 1,244 993 2,237 31 Table IX (L.G.B. Table).-Vital Statistics of Separate Localities in 1907 and 16 Previous Years' Numbers. Names of Localities 1. The City of Westminster. 2. St. George's, comprising Conduit, Grosvenor, Victoria, and Knightsbridge St. George Wards. 3. Westminster, comprising St. Margaret, St. John, and the Hamlet of Knightsbridge Wards. 4. St. James, comprising Regent,Marlborough, and Pall Mall Wards. 5. St. Anne Ward. 6. Strand, comprising Covent Garden, Strand, and Charing Cross Wards. Year. Population estimated to middle of each year. Births registered uncorrected. Deal hs at all ages corrected). Deaths under 1 year. Population estimated to middle of each year. Births registered (uncorrected). Deaths at all ages (corrected). Deaths under 1 year. Population estimated to middle of each year. Births registered (uncorrected). Deaths at all ages (corrected). Deaths under 1 year. Population estimated to middle of each year. Births registered (uncorrected). Deaths at all ages (corrected). Deaths under 1 year. Population estimated to middle of each year. Births registered (uncorrected). Deaths at all ages (corrected). Deaths under 1 year. Population estimated to middle of each year. Births registered (uncorrected). Deaths at all ages (corrected). Deaths under 1 year. 1891 202,136 4,507 4,024 740 79,967 1,610 1,312 216 55,651 1,449 1,148 256 24,839 508 493 84 12,422 334 293 65 29,257 606 778 119 1892 199,382 4,377 4,070 710 78,649 1,519 1,334 220 55,217 1,418 1,297 246 24,368 524 446 76 12,378 310 261 67 28,770 606 732 101 1893 198,249 4,255 3,970 699 78,883 1,496 1,217 204 54,783 1,350 1,290 255 23,873 520 470 71 12,334 330 278 58 28,376 559 715 111 1894- 197,283 4,017 3,277 587 79,123 1,499 1,096 177 54,349 1,219 1,006 180 23,571 456 390 80 12,290 288 202 41 27,950 555 583 109 1895 296,254 4,155 3,559 683 79,368 1,470 1,185 204 53,915 1,278 1,154 246 23,149 528 407 74 12,246 324 203 43 27,576 555 610 111 1806 194,866 3,968 3,277 642 80,041 1,407 1,117 211 53,481 1,222 987 209 22,955 484 396 72 12,200 292 231 58 26,189 563 546 92 1897 194,120 3,846 3,177 587 80,376 1,365 1,067 183 53,047 1,238 1,005 200 22,576 446 388 75 12,150 314 185 39 25,971 483 532 90 1898 193,304 3,715 3,324 571 80,703 1,411 1,072 172 52,613 1,088 1,093 198 22,200 434 408 73 12,150 290 205 39 25,638 492 546 89 1899 192,452 3,610 3,442 600 81,033 1,348 1,156 177 52,179 1,114 1,174 229 21,827 435 387 69 12,100 296 210 40 25,313 417 515 85 1900 191,269 3,433 3,234 509 81,364 1,295 1,140 146 51,745 1,056 1,097 208 21,457 410 341 62 12,000 273 189 36 24,703 399 467 75 1901 185,648 3,241 2,900 435 77,475 1.199 1,007 156 52,851 1,124 871 151 21,403 453 350 62 11,590 289 148 21 22,329 387 425 43 1902 (53 weeks) 180,880 3,284 2,952 442 76,424 1,204 1,074 143 52,791 1,153 1,007 163 21,060 383 327 52 11,414 256 173 35 20,200 283 371 49 1903 179,052 3,017 2,419 370 75,675 1,156 833 135 52,284 1,071 824 143 20,094 325 286 39 11,304 218 154 24 20,007 247 322 29 1904 177,321 2,897 2,376 360 75,440 1,183 886 139 51,960 985 813 150 19,730 234 235 27 11,250 205 130 16 19,827 240 312 28 1905 175,606 2,940 2,347 329 74,800 1,162 868 115 51,256 1,057 857 138 19,400 306 229 29 11,000 227 124 21 19,150 188 269 26 1906 173,905 2,766 2,227 323 74,350 1,150 868 124 50,420 973 789 124 19,250 296 189 33 10,900 217 145 25 18,985 179 236 17 Averages of 10 years 1896 to 1905 186,391 3,388 2,944 520 78,334 1,274 1,022 159 52,420 1,111 955 180 21,543 396 342 56 11,715 265 174 33. 23,132 367 422 60 1907 172,900 2,732 2,237 303 74,100 1,101 905 95 49,920 998 778 142 19,090 258 194 30 10,900 179 114 17 18,890 196 246 19 The figures for the several districts previous to the formation of the City in November, 1900, relate to the areas as then existing, except as regards No. 6, in which case the figures relating to the added part were obtainable from the reports of the late Medical Officer of Health for St. Giles. 0 2 32 Table IX, continued.-Vital Statistics of Separate Localities in 1907 and 16 Previous Years-Rates. Names of Localities 1. City of Westminster. 2. St. George's. 3. Westminster. 4. St. James. 5. St. Anne's. 6. Strand. Year. Births Registered (uncorrected). Rate per 1,000. Deaths at all Ages (corrected). Rate per 1,000. Deaths under 1 Year. Rate per 1,000 Births (uncorrected). Births Registered (uncorrected). Rate per 1,000. Deaths at all Ages (corrected). Rate per 1,000. Deaths under 1 Year. Hate per 1,000 Births (uncorrected). Births Registered (uncorrected). Rate per 1,000. Deaths at all Ages (corrected). Rate per 1,000. Deaths under 1 Year. Rate per 1,000 Births (uncorrected). Births Registered (uncorrected). Rate per 1,000. Deaths at all Ages (corrected) Rate per 1,000. Deaths under 1 Year. Rates per 1,000 1 Births (uncorrected). Births Registered (uncorrected). Rate per 1,000. Deaths at all Ages (corrected). Rate per 1,000. Deaths under 1 Year. Rate per 1,000 Births (uncorrected). Births Registered (uncorrected). Rate per 1,000. Deaths at all Ages (corrected). Rate per 1,000. Deaths under 1 Year. Rate per 1,000 Biiths (uncorrected). 1891 22.2 10.9 164 20.1 16.4 134 26.0 20.6 176 20.4 1908 165 26.9 23.6 194 20.7 26.6 196 1892 21.9 20.4 162 19.3 16.9 144 25.6 23.4 173 21.4 18.2 145 25.0 21.2 216 21.1 25.5 166 1893 21.4 20.0 164 18.9 15.4 136 24.6 23.5 188 21.8 19.7 136 26.8 22.6 175 19.7 25.2 198 1894 20.3 16.6 146 18.9 13.8 118 22.4 18.5 147 19.4 16.5 175 23.4 16.4 142 19.8 20.8 181 1895 20.6 18.1 164 18.5 14.9 138 23.7 21.4 192 22.8 17.6 140 26.5 16.6 148 20.1 22.1 200 1896 20.3 16.8 161 17.5 13.9 149 22.8 18.4 171 21.0 17.2 148 24.0 19.0 124 21.4 20.8 163 1897 19.8 16.3 152 16.9 13.2 135 23.3 18.9 161 19.8 17.2 168 25.9 15.3 134 18.5 20.4 186 1898 19.2 17.1 153 17.4 13.2 121 20.6 20.7 182 19.5 17.3 168 24.0 17.0 135 119.2 21.3 180 1899 18.7 17.8 166 16.6 14.2 132 21.3 22.4 206 19.9 17.7 158 24.5 17.4 131 16.4 20.3 203 1900 17.9 16.9 148 15.9 14.0 113 20.4 21.2 196 19.1 15.9 151 22.8 15.8 135 16.1 18.9 187 1901 17.4 15.6 134 15.4 12.9 130 21.2 16.4 134 21.1 16.3 136 24.9 12.7 131 17.3 19.0 111 1902 17.8 16.0 134 15.6 14.0 119 21.8 19.1 141 18.0 15.6 134 22.3 14.9 72 13.2 18.4 173 1903 16.8 13.5 122 15.2 11.0 116 20.5 15.7 133 16.1 14.2 120 19.2 13.6 136 12.7 16.1 117 1904 16.3 13.4 124 15.6 11.7 117 20.6 15.6 152 14.4 11.9 95 18.3 11.7 110 12.1 15.8 116 1905 16.7 13-3 111 15.5 11.6 99 20.6 16.7 131 16.7 11.8 94 20.6 11.2 69 9.8 14.0 138 1906 15.9 12-8 116 15.4 11.6 100 19.3 15.6 127 15.4 10.0 111 19.9 11. 2 13.3 92 9.4 94 13.3 116 Averages of 10 years 1897 to 1906 17.6 15.2 136 15.9 12.7 118 20.9 18.2 156 17.9 14.8 133 22.2 14.2 111 14.4 17.6 152 1907 15.8 12.9 110 14.8 12.2 86 19.9 15.5 142 13.5 10.1 116 16.4 10.4 94 10.3 13.0 96 33 Table IX continued.—Rates in 5 and 10 Yearly Periods from 1891. Names of Localities 1. City of Westminster. 2. St. George's. 3. Westminster. 4. St. James. 5. St. Anne's. 6. Strand. Years. Population. Births Registered (uncorrected). Rate per 1,000. Deaths at all ages. Rate per 1,000 (corrected). Deaths under 1 year. Rate per 1,000 Births (uncorrected). Population. Bin lis Registered (uncorrected). Rate per 1,000. Deaths at all ages (corrected). Rate per 1,000. Deaths under 1 year. Rate per 1,000 Births (uncorrected). Population. Births Registered (uncorrected). Rate per 1,000. Deaths at all ages (corrected). Rate per 1,000. Deaths under 1 year. Rate per 1000 Births (uncorrected). Population. Births Registered (uncoirected). Rate per 1 000. Deaths at. all ages (corrected). Rate per 1,000. Deaths under 1 year. Rate per 1,000 Births (uncorrected). Population. Births Registered (uncorrected). Rate per 1,000. Deaths at all ages (corrected). Rate per 1,000. Deaths under 1 year Rate per 1,000 Births (uncorrected). Population. Births Registered (uncorrected). Rate per 1,000. Deaths at all ages (corrected). Rate per 1,000. s under 1 year. Rate per 1,000 Births (uncorrected). Average of 5 years 1891-1895 198,060 21.2 19.0 160 79,198 19.1 15.4 134 54,783 24.4 21.4 175 23,960 21.1 18.3 152 12,334 25.7 20.0 175 28,385 20.2 24.0 188 Average of 5 years 189G-1900 193,202 19.1 16.9 156 80,713 16.8 13.7 130 52,613 21.6 20.3 183 22,203 19.8 17.2 158 12,120 24.2 16.9 144 21,562 18.3 20.3 183 Average of 10 years 1891-1900 195,931 20.1 17.9 158 79,905 17.9 14.5 132 53,698 23.0 20.8 179 23,081 20.4 17.7 155 12,227 24.9 18.4 159 24,973 19.2 22.1 185 Average of 5 years 1901-1905 179,701 17.0 14.3 125 75,962 15.4 12.2 116 52,228 20.9 16.7 138 20,331 17.0 13.9 115 11,311 21.0 12.8 95 20,302 13.0 16.6 131 Reduction in Birth, Death and Infant Death-rates in the 5 years 1901-5, as compared with the rates in the previous 10 years 1891-1900. Per Cent. Per Cent. Per Cent. Per Cent. Per Cent. Per Cent. 15.4 20.1 20.8 15.8 15.9 12.1 9.1 19.7 22.9 16.6 21.4 25.8 15.6 30.4 40.2 32.2 24.9 29.1 34 Table X.— Vital Statistics relating to Residents in Blocks of Dwellings in the City of Westminster, 1907. Buildings. Population. Births. Total Deaths. Infectious Deaths. Tubercular Deaths. Respiratory. Digestive. Circulatory Diseases. Nervous Diseases. Kidney Diseases. Violence. Cancer. Other Deaths. Deaths Under 1. Deaths Over 65. Westminster City Council— Regency Street 1,163 60 18 4 4 1 2 2 — — 1 1 3 7 1 St. James's Dwellings, Ingestre Place, and Marshall Street 168 4 1 - - - - - — — — 1 - — 1 Peabody 6,761 183 85 10 18 15 7 6 5 4 1 8 10 15 24 Westminster 187 7 6 1 1 1 1 — 1 1 — — — 2 2 London County Council— Millbank 3,043 118 50 6 7 10 1 6 4 3 — 5 8 14 9 Drury Lane 1,009 31 12 1 3 3 1 1 1 — — — 2 2 4 Improved Industrial 6,878 114 63 11 8 10 5 6 4 3 3 5 8 6 17 Metropolitan Association 757 22 12 1 1 2 1 1 - - - 2 4 4 2 St. George's Model Dwellings 419 13 4 1 — — 2 — 1 — — — — 1 1 Clerkenwell and Soho Company (Newport Market) 1,184 32 15 - - 5 - 6 2 3 1 1 - 1 3 GTreencoat 119 - - - - - - - - - - - - - - Spencer 99 — 2 - - - - 2 - - - - - - 1 Chapter Chambers 175 2 1 — 1 - - - - - - - - - - Alexandra and Castle — 3 2 — — — 1 1 — — — — — 1 1 New Buildings — — 2 — — 1 — 1 — — — — — 1 — St. James's Residences - 13 - - - - - - - - - - - - - 35 B. Communicable Diseases. (1) Compulsorily Notifiable Diseases. The details respecting the 725 notifications of infectious disease received by me are set out in the Local Government Board's Return (Table XII), which also shows the number treated in hospital as well as the number of deaths. The number of cases of each disease notified in London since 1890 are shown in Tables XI and XIII, together with cases notified during the same period in the different divisions which, with some modifications, now form the City. These figures are exclusive of duplicate notifications. _ The chart on p. 39 indicates the number of notifications of scarlet fever, diphtheria, enteric fever, and erysipelas in each week. One hundred and sixty-one visits were paid in connection with doubtful cases, contacts, children returning from fever hospitals, &c. Five persons were notified by Port Sanitary Authorities as having been in contact with or come from a port infected with cholera, 5 with respect of plague, and 12 yellow fever. Small-pox.—There were no notifications of this disease in Westminster. Fifty-six persons were notified as having been in contact with cases of small-pox elsewhere than in the City, and these were kept under observation. Two persons suspected to be suffering from smallpox were seen by me at the request of their medical attendants. A gentleman living in the Borough of Hampstead, employed in Westminster, developed small-pox on his return from Madeira, where he was infected. He had been in contact with a number of persons for a few days before the illness fully declared itself. -3rhese were kept under observation, and most of them were re-vaccinated. Disinfection was also carried out as far as practicable, and no other cases developed. Vaccination.—The Vaccination Officers have supplied me with the following particulars relating to vaccination of infants born in 1906:— Vaccination Statistics. 1906. Union. Births. Died Unvaccinated. Successfully Vaccinated. Insusceptible. Vaccination Postponed. Conscientious Objectors. llemoved and Vaccination Officer Informed. Not. Found. liemoved to Address Unknown. St. George 2,237 170 1,865 9 5 16 34 38 Westminster 471 36 383 3 1 5 14 24 Strand 180 12 147 0 3 5 8 5 The City 2,888 218 2,400 12 9 26 56 67 36 The following is a summary of the total primary vaccinations performed in the City during the years 1901-07, and of re-vaccinations, in so far as these were made by the Public Vaccinators:— Vaccination Returns. Primary Vaccinations under 14 years of age, in the Union District of Re-vaccinations performed by Public Vaccinators in the Union District of St. George's. Westminster. Strand. St. George's. Westminster. Strand. 1901 2,467 1,491 725 4,039 3,317 2,201 1902 2,893 715 450 7,453 6,226 3,910 1903 2,178 369 245 159 9 347 1901 2,065 325 *144 72 13 398 1905 2,162 498 142 47 7 418 1906 2,110 372 145 51 5 397 1907 2,013 443 155 45 7 468 *There were also 16 primary vaccinations of persons over 14 years of age. Table XI.—Infectious Diseases Notified, 1890-1907, in London. Year. Smallpox. Scarlet Fever. Diphtheria and Croup. Enteric Fever. Typhus Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Cholera. Relapsing Fever. Totals. 1890 60 15,330 5,870 2,877 35 237 206 4,598 25 7 30,245 1891 114 11,398 6,412 3,372 27 152 221 4,764 23 39 26,552 1892 423 27,095 8,353 2,465 20 147 347 6,934 54 7 45,848 1893 2,813 36,901 13,694 3,666 22 205 397 9,700 86 4 67,485 1894 1,192 18,440 11,190 3,360 21 162 253 6,080 21 2 40,925 1895 979 19,757 11,223 3,506 14 105 236- 5,660 29 3 41,512 1896 225 25,647 13,941 3,190 6 103 279 6,438 13 3 49,845 1897 104 22,848 13,199 3,103 4 65 264 5,800 38 1 45,361 1898 32 16,894 11,855 3,024 16 55 247 5,169 23 1 37,316 1899 29 18,113 13,704 4,463 14 69 330 5,615 15 1 42,353 1900 87 13,800 11,985 4,291 7 73 237 4,762 5 - 35,247 1901 1,700 18,381 12,157 3,194 20 48 253 4,604 3 - 40,360 1902 7,796 18,252 10,731 3,407 4 47 311 5,536 1 2 46,087 1903 416 12,531 7,739 2,339 22 40 233 4,372 - - 27,692 1904 489 13,439 7,219 1,896 3 29 273 4,943 1 1 28,293 1905 74 19,461 6,482 1,552 9 14 292 4,972 - 1 32,857 1906 31 20,343 8,035 1,606 7 9 297 5,026 2 - 35,356 1907 8 25,925 8,771 1,394 5 36 255 4,496 - — 40,890* In the City of Westminster. 1890 1 402 150 79 - 9 128 1 - 770 1891 2 379 174 100 - 7 9 144 1 - 817 1892 14 864 349 99 - 8 7 191 2 - 1,534 1893 165 1,366 353 148 - 5 11 230 4 - 2,284 1894 21 535 263 106 - 9 2 134 - - 1,134 1895 195 715 383 114 - 4 4 138 - - 1,297 1896 7 846 323 121 - 5 7 178 - - 1,487 1897 13 658 336 104 - 5 6 175 1 - 1,298 1898 2 409 338 112 - 2 5 131 - - 999 1899 - 534 283 143 - 1 3 176 - - 1,140 1900 2 453 287 118 - 4 5 129 - - 998 1901 102 475 253 104 - 2 6 117 - - 1,059 1902 232 475 285 132 - 1 6 144 - - 1,275 1903 45 352 186 71 - 2 5 111 - - 772 1904 6 313 145 51 1 2 5 125 - - 648 1905 2 370 118 41 - - 12 123 - - 606 1906 — 540 206 47 - 2 9 127 - - 931 1907 - 418 145 51 — 2 3 102 — — 721* * There were also notified 132 cases of Cerebro Spinal Meningitis in London, 4 in Westminster. 37 Table XL—continued. Case-rates per 10,000 Living in London. Year. Smallpox. Scarlet Fever. Diphtheria. Enteric. Typhus. Other Continued Fevers. Puerperal. Erysipelas. 1891 0.3 27.1 15.2 8.0 0.1 0 .5 0.5 11.3 1892 1.0 63 .8 19.6 5.8 - 0.3 0.8 16.3 1893 6.5 86.1 32.0 8.5 0.1 0.5 0..9 22.6 1894 2.7 42 .5 25.9 7.7 0.0 0.4 0.6 14.0 1895 2.2 45.2 25.7 8.0 0.0 0.2 0.5 12.9 1896 0.5 57.0 30.7 7.1 0.0 0.2 0.6 14.3 1897 0.2 51.2 29.6 7.0 0.0 o.1 0.6 13.0 1898 0.1 37.6 26.3 6.7 0.0 0.1 0.5 11.5 1899 0.1 39.9 30.1 9.8 0.0 0.2 0.7 12.3 1900 0.2 30.1 26.1 9.3 0.0 0.2 0.6 10.3 1901 3.7 40.1 26.7 7.0 0.04 o.1 0.5 10.1 Average of 10 years 1892-1901 1 .7 49.4 27.2 7'.7 0.02 0 .2 0.6 13.5 1902 16.7 39.1 23.0 7.3 0.00 0.1 0.6 11.8 1903 0.9 27.1 16.7 5.0 0.04 0.08 0.5 9.4 1904 1.0 28.9 15.5 4.0 0.00 0.06 0.59 10.6 1905 0.15 41.5 13.5 3.3 0.02 0.03 0.6 10.6 1906 0.06 43.0 17.0 3.3 0.01 0.01 0.6 10.6 Average of 5 years 1902-06 3.7 35.9 17.1 4.6 0.01 0.05 0.6 10.6 1907 0.01 54.1 18.4 2.9 0.01 0.05 0.5 9.4 In the City of Westminster. 1891 o.1 19.1 8.8 5.0 o.1 0.4 0.5 7.3 1892 0.7 43.9 17.8 5.0 - 0.4 0.4 9.6 1893 8.4 69.7 18.1 7.5 - 0.3 0.6 11.7 1894 1.1 27.4 13.7 8.5 - 0.5 o.i 6.9 1895 1.0 36.9 J5.6 5.9 - 0.2 0.2 7.1 1896 0.4 43.1 16.4 6.2 - 0.3 0.4 9.1 1897 0.7 34.3 17 .5 5.4 - 0.3 0.3 9.1 1898 o.i 21.5 17.7 5.9 - 0.1 0.3 6.9 1899 — 28.1 14.9 7.5 — 0.1 0.2 9.3 1900 0.1 24.0 15 .2 6.2 - o.1 0.3 6.8 1901 5.5 35.7 13.6 5.6 - 0.1 0.32 6.3 Average of 10 years 1892-1901 1.8 35..5 16.0 6.3 — 0.25 0.31 8.3 1902 12.6 25.8 15.4 7 .1 - 0.05 0.32 7.8 1903 2.5 19.6 10.3 3.9 - 0.11 0.27 6.2 1904 0.3 17.6 8.2 2.9 0.05 0.11 0.28 7.1 1905 00.1 21.0 6.7 2.3 - - 0.68 7.0 1906 — 31.0 11.8 2.7 — 0.11 0.51 7.2 Average of 5 years 1902-06 3.1 23.0 10.5 3.8 0.01 0.07 0.41 7.1 1907 - 24.2 8.4 2.9 -- 0.11 0.17 5.9 38 City of Westminster. Table XII. Local Government Board Table 0.— Cases of Infectious Disease Notified during the 52 weeks from 31st December, 1906, to 28th December, 1907. Notifiable Diseases. Cases Notified in the City of Westminster. Total Cases Notified in each Ward. Number of Cases Removed to Hospital from each Ward. At Ages—Years. Conduit. Grosvenor. Knightsbridge St. George. Victoria. St. Margaret. St. John. Hamlet of Knightsbridge. Pall Mall. Regent. Great Marlborough. Charing Cross. Co vent Garden. Strand. St. Anne. Conduit. Grosvenor. Knightsbridge St. George. Victoria. St. Margaret. St. John. Hamlet of Knightsbridge. Pall Mall. Regent. Great Marlborough. Charing Cross. Covent Garden. Strand. St. Anne. Total. At all Ages. 0 to 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Diphtheria— Cases 145 2 20 53 14 26 — 2 5 17 39 9 38 3 - 11 4 - 9 2 6 2 516 16 37 8 38 3 - 11 4 - 9 2 2 141 Deaths 16 2 10 3 — Erysipelas— Cases 102 5 4 6 9 67 11 3 3 3 24 4 33 1 - 2 4 2 13 3 7 1 - 2 10 1 14 - - - - - - - - - Deaths 6 - - - - - 5 1 - - 1 2 - - - - - - - - - - Fevers. Cases 418 3 101 196 71 47 — 15 39 26 11/ 22 88 7 6 26 22 8 19 5 18 15 35 22 113 16 85 7 6 26 22 6 19 5 18 395 Deaths 12 — 8 4 — - — - - - 6 - 4 - - - - - - - - - - - - - Enteric— Cases 51 — 1 2 12 35 1 1 4 3 9 2 8 4 1 3 2 4 6 3 1 - 3 1 6 - 6 4 - 1 2 4 5 3 1 35 Deaths 9 — — — 2 7 - 1 - 1 4 - 2 - - - - - - - - - - - - - - Cerebro-spinalCases 4 3 1 — — - - - - - 1 - 2 - - - - - 1 - - - - - 1 - 1 - - - - - 1 - - 3 . Cases 2 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Puerperal— Cases 3 — — — - 1 — — 1 1 1 - - - - - - - - - - - 1 1 1 - - - - - - - - - - 3 Deaths 3 - - - 1 2 - - - 1 2 - - - 1 2 - - - - - - Total Cases 725 13 157 257 108 178 12 21 52 50 191 37 170 15 7 42 32 15 48 13 32 18 44 42 167 25 144 14 6 38 29 10 38 11 27 613 23 cases notified as scarletfever, 19 as diphtheria and 1 as enteric fever were eventually alleged not to be suffering from the disease notified. In addition to the above, case of diphtheria and 1 of puerperal fever were not notified. There were also cases among soldiers in barracks. 39 Notifications of Infectious Diseases during the year 1907. London. 40 Table XIII.—London and the Metropolitan Boroughs.—Notified Gases of Infectious Disease in 1907. Cities and Boroughs. Estimated population in the middle of 1907. Small-pox. Scarlet Fever. Diphtheria. Typhus Fever. Enteric Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Cerebro-spinal Meningitis. Total. Annual rate per 1,000 persons living. County of London 1,758,218 8 25,925 8,771 5 1,394 36 255 4,496 132 41,022 8.6 West Districts. Paddington 149,909 - 577 169 - 34 1 6 124 - 911 6.1 Kensington 181,842 — 532 250 — 40 4 2 127 2 957 5.3 Hammersmith 122,337 — 581 215 - 40 — 7 78 4 925 7.6 Fulham 166,749 — 668 605 - 58 1 15 130 3 1,480 8.9 Chelsea 74,857 — 219 153 - 21 — 4 44 4 450 6.0 City of Westminster 172,219 — 418 145 - 51 2 3 102 4 725 4.2 North Districts. St, Marylebone 127,718 1 435 128 - 31 - 7 134 4 740 5.8 Hampstead 91,137 1 320 112 — 21 — 3 56 — 513 56 St. Pancras 236,753 1 818 349 — 55 1 4 183 5 1,446 6.1 Islington 347,017 — 1,216 482 - 95 1 23 254 11 2,082 6.0 Stoke Newington 53,613 — 252 118 — 15 — 2 30 1 418 7.8 Hackney 232,993 — 1,808 543 1 103 2 15 311 4 2,792 12.0 Central Districts. Holborn 55,134 _ 157 64 1 14 — 1 39 2 278 5.1 Finsbury 96,732 — 505 155 — 23 — 3 109 3 798 8.3 City of London 20,310 2 97 28 — 9 ~ — 15 — 151 7 .4 East Districts. Shoreditch 115,662 1 877 223 - 36 - 3 138 6 1,284 11.1 Bethnal Green 130,831 — 1,288 290 1 55 - 5 247 8 1,894 14.5 Stepney 308,923 — 3,123 751 1 120 10 16 473 9 4,508 14.6 Poplar 171,086 1 1,285 360 — 81 — 14 187 11 1,939 11.4 South Districts. Southwark 209,781 — 1,275 422 — 80 19 256 10 2,062 9.9 Bermondsey 128,2553 — 1,021 319 — 45 — 5 143 7 1,540 12.0 Lambeth 318.538 — 1,478 327 1 54 6 23 225 13 2,127 6.7 Battersea 181,736 — 977 359 — 44 1 13 175 10 1,579 8.7 Wandsworth 281,419 — 1,321 636 — 69 1 27 214 3 2,271 8.1 Camberwell 277,059 — 1.571 405 — 82 — 16 264 3 2,341 8.5 Deptford 116,510 — '777 318 — 34 6 4 145 2 1,286 11.1 Greenwich 1U7,222 — 661 257 — 18 — 2 93 1 1,032 9.7 Lewisham 152,532 — 604 302 — 32 — 7 86 1 1,032 6.8 Woolwich 129,336 — 1,027 279 — 27 — 6 113 1 1,453 11.3 Port of London — 1 2 2 — 2 — — 1 — 8 — Scarlct Fever.—This disease caused a large number of cases of illness, especially in the eastern group of boroughs, but in Westminster the number was less than in 1906. The notifications were, as usual, greatest in autumn, as shown in the accompanying chart. The number of cases among school children is given below with the schools affected. The mortality remains low. Scarlet Fever. 1901. 1902. 1903. 1904. 1905. 1906. 1907. Deaths per 100 Cases— The City 1.8 3.3 2.5 2.8 4.0 2.5 2.8 The County 3.2 3.0 2.8 2.7 2.8 2.6 2.49 41 There were 2 cases in one house in 25 instances, 3 cases in 10 instances, and 4 cases in 1 instance. Cases occurred among soldiers in the various barracks in the City. The Metropolitan Asylums Board has recently passed a resolution to the following effect:— "That in view of the continued prevalence of scarlet fever, notwithstanding the extensive isolation accommodation which has been provided, the Local Government Board be asked to cause an inquiry to be instituted into the cause of this disease, and whether any, and, if so, what further means can be adopted for its prevention." The anxiety of the Board has probably arisen from the great increase in the number of persons who take advantage of their hospitals; naturally expense has increased also, but not at a greater rate than that of the number of patients treated. Dividing the list of notifications given on a preceding page into three groups of five years— (a) 1891-95, (b) 1896-1900, (c) 1901-1905—each, it appears that in the first period 50 per cent, only of the notified cases of scarlet fever were treated in the Metropolitan Asylums Board hospitals, in the second period the figure had risen to 70 per cent., and in the third to 84 per cent. There has also been an increase in the number of diphtheria patients admitted. The number of scarlet fever cases notified per 10,000 of the population has decreased from 523 per 10,000 to 432 in the second period, and to 35'5 in the third period. There has been, moreover, a marked improvement in the number of deaths. In 1891-95 4'6 deaths occurred in every 100 cases notified; that has gradually fallen, so that in the last period only 2.8 deaths occur. If all or even part of this saving of life is to be attributed to the skilled treatment under good hygienic conditions which the Board supplies it is not likely that the hospitals will be less used. Whatever may be the circumstances of rural districts, in London the treatment of eases of scarlet fever at home would lead to a serious dislocation of business, the cessation of the work of the parents, and the interruption of education for the children in the house. The flat or block type of building, which has largely taken the place of single dwellings, also renders difficult effective isolation in the house. Although there has been an increase in the number of cases notified in 1907 in some parts of London, as a matter of fact there is not so much scarlet fever now as there was, notwithstanding the increase in population. In the three groups of years already quoted there were 112,781 cases in the first five years (1891-95), 97,278 in the next, and 82,064 in the last (1901-05). 42 Diphtheria.—Cases of this disease were also fewer than in 1906, although in other parts of London there was a marked increase. From the subjoined table it will be seen that the cases of Diphtheria in Westminster were fairly spread over the twelve months, and Table XII shows that the southern part of the city suffered chiefly. Notification of Diphtheria Gases Received in each Month of the Years 1901, 1902, 1903, 1904, 1905, 1906, and 1907. January. February. March. April. May. June. July. August. September. October. November. December. Total. 1901 13 10 16 22 19 19 34 19 27 36 21 17 253 1902 27 19 17 17 25 20 39 25 9 27 32 28 285 1903 17 13 23 8 18 14 21 9 13 17 13 20 186 1904 6 17 10 12 9 18 11 10 10 27 9 6 145 1905 7 7 12 11 9 6 10 8 14 15 12 118 1906 20 23 11 8 13 20 21 14 13 28 22 13 206 1907 20 21 8 11 9 12 18 1 7 18 7 13 145 Advantage was taken by medical men of the means provided by the City Council to have the diagnosis of their cases assisted by bacteriological examination of swabbings from the nose or throat in 89 instances. In 10 instances I have had a bacteriological examination made of the throats of the members of families in which a case has occurred, and no medical man was in attendance; the true bacillus was not found in any of them. The body of a child who had died suddenly was admitted to the mortuary on an order of the Coroner. The medical man, on making an examination, found adherent membranes, apparently of diphtheritic origin, on the tonsils and palate. Six persons in the house in which the child had lived were seen, and Hoffman's pseudo-diphtheria bacillus was discovered in the throat of one of them. Within a week, however, of the child's death four of the family were notified to be suffering from scarlet fever, so that probably the child's death was due to this disease and not to diphtheria. There were 16 deaths, equal to a mortality of 11.0 per cent, of the notified cases; in London the rate was 8.9:— Diphtheria. 1901. 1902. 1903. 1904. 1905. 1906. 1907. Deaths per 100 Cases— The City 10.0 11.0 8.6 3.4 4.2 7.6 11.0 The County 10.9 10.8 9.6 10.2 8.6 8.8 8.9 43 Previous to the introduction of the antitoxin method of treatment, the rate was 22 per cent,, but it cannot be too strongly impressed upon medical men and parents that to be of use it must be used very early in the disease. In three instances three cases occurred in one house, and in four instances two cases. Seven cases occurred in members of the nursing staff of one of the general hospitals. Typhoid Fever.—As usual, many of these cases resulted from infection contracted out of London, often abroad, and these were generally visitors in hotels. To shellfish of various kinds was attributed the source of infection in a number of instances. Enquiry in one instance revealed that the patient, a man, had visited Portsmouth on Easter Monday and eaten 1½ dozen "butterfish" in an uncooked condition from a street barrow. He was seized with illness shortly after, and eventually developed typhoid fever. Dr. A. Mearns Eraser, Medical Officer of Health for Portsmouth, informed me that notices warning the public against eating these fish and cockles picked up off the mud have been displayed in the town for some time, as a number of cases of typhoid fever have been traced at different times to the consumption of butterfish. Dr. Eraser was good enough to forward some of these fish, which are, in external appearance, like large cockles. Examination by Dr. J. Eoster Beale proved them to be polluted by sewage; 1,000 bacilli coli and 10 bacilli enteritidis sporogenes were found in each fish. f rom one house two notifications were received relative to a brother and sister. It was found that their mother had died a short time previously, and there is a strong suspicion that she must have suffered from this disease, although the symptoms were masked by chronic alcoholism. Continued Fever.—Two cases were notified; both were in puerperal women, and should be included in the next group. Puerperal Fever.—Three notifications were received, and three deaths occurred (one of a person not notified). The two cases sent in as " continued fever " and one of the puerperal were due to the death of the child before birth from syphilis. Disinfection was carried out after each case, including the clothing, &c., of those in attendance. Cerebro-Spinal Meningitis or Spotted Fever.—The County Council on the 26th February, 1907, made an order requiring the notification of cerebro-spinal fever in the County of London for a period of six months, which was later extended for a. further period of eighteen months, as from and including the 13th September, 1907. Meningitis, both in adults and children, may be connected with a variety of conditions; therefore the County Council had to consider what the term " cerebro-spinal fever " should include. On the advice 44 of a committee appointed by the President of the Royal College of Physicians, they have decided that, for notification purposes, the disease at present known as posterior basal meningitis is included in the term "cerebro-spinal fever." That term, however, is not to be interpreted to include cases of meningitis due to tuberculosis, syphilis, middle-ear disease, or injury. One hundred and thirty-two cases were registered in London, four being in Westminster. Enquiries were made with regard to all deaths from meningitis where not due to one of the above-mentioned causes. Some of them might be included as cerebro-spinal fever, but in a number the cause could not be determined m the absence of a postmortem and bacteriological examination, probably the pneumococcus which produces pneumonia was responsible for a proportion, and influenza for others. There has been no epidemic of this disease, as has occurred in other towns, as Glasgow, Leith, Belfast, Hamburg and in America. It is believed that these towns have been specially affected through being sea ports, many passengers from Eussia, Germany, &c., passing through them on their way to America. Dock labourers in Leith were found to have organism in their throats, and the same germ was found in the engine room and hold of a ship. Dry and dusty weather appears to favour its spread, and the germ may be either inhaled or consumed in food to which it has gained access in the dust. It has also been suggested that as in the case of tuberculosis so in this disease, children are more liable to be attacked because they play about on floors which may be infected by the promiscuous spitting of an infection-carrying " intermediary " such as the lather. In trying to control this disease, steps must be taken to detect the "intermediaries," to destroy the organism which they may be carrying about, and disinfect the places frequented by these people. 45 (2) Voluntary Notifiable Diseases. Tubercular Disease.—Deaths from tuberculosis have teen decreasing in numbers since 1901. The figures for the last five years are set forth below:— The City of Westminster. Year. Pulmonary. Abdominal. Meningeal. Other. Total. Deaths. Rates. Deaths. Rates. Deaths. Rates. Deaths. Rates. Deaths. Rates. 1901 341 187 16 10 31 16 25 12 413 226 1902 328 178 18 9 32 17 35 17 413 224 1903 309 172 9 5 23 13 19 10 360 200 1904 271 153 12 6 26 14 32 18 341 192 1905 259 147 12 6 31 17 31 17 333 189 1906 237 136 13 7 36 20 25 14 311 178 1907 232 134 11 6 26 15 20 11 289 167 These rates are calculated per 100,000 inhabitants. For purposes of comparison with the whole of London, differences in the number of males and females, and their relative ages, have to be taken into account. This may be effected by multiplying the rates by a factor (0'89205). The figures are then:- Year. Pulmonary Tuberculosis. Total Tubercular Rates. County. City. County. City. 1901 165 167 229 202 1902 161 159 223 199 1903 155 154 213 178 1904 163 136 217 171 1905 140 131 191 168 1906 144 121 196 158 1907 140 119 148 The average death-rate per 100,000 inhabitants for London during the five years 1902-06 was 153, for Westminster 154; the 1906 rates show a decline to 140 and 134 respectively. The phthisis rates would be considerably reduced if there were no common lodging houses in the city; 31 deaths occurred among inmates of such houses, 18 being in St. John's Ward. Subjoined is a list of the occupations of persons who have died from tubercular disease. D 46 Occupations of Adult Males and of Husbands or Parents of Persons who died from, Tubercular Disease in the 7 years 1901-7. Occupation. Adult Males. Wives and Children of. Occupation. Adult Males. Wives and Children of. General or Local Government— Conveyances of Men and Goods—contd. Police 3 14 Market ,, 33 6 Postmen and sorters 11 2 Drapers and tailors' porters 7 — Paviors and sweepers 10 4 Warehousemen and packers 30 19 Sewermen 1 — Metals, Machines. Implements and Conveyances— Watchmen 3 — Defence of Country— Metal workers 25 12 Soldiers 22 8 Coach builders — 5 Professional— Precious Metals, Instruments, Games— Clergymen 2 — Barristers 1 1 Silversmiths and refiners 11 3 Solicitors 3 1 Instrument makers 3 1 Medical men 2 1 Clock and watchmakers 1 1 Veterinary surgeons 3 — Tennis racquet makers — 1 Teachers 3 2 Building, &c.— Translators 1 — Builders and masons 24 6 Journalists 3 1 Carpenters 17 20 Engineers 4 5 Scatfolders 3 1 Draughtsmen 3 — Plasterers — 3 Surveyors 1 1 House painters 31 11 Photographers 4 — Glaziers, paperhangers 4 2 Musicians 8 7 Plumbers and gasfitters 14 3 Artists — 3 Wood, Furniture, Fittings, &c.— Actors 4 — Commercial— Furniture makers 3 3 Merchant 1 2 French polishers 4 2 Accountants 2 1 Upholsterers 5 4 Commercial travellers and agents 10 9 Glass— Glass blower 2 — Clerks 62 9 Skins, Leather, &c.— Collectors — 3 Trunk maker 2 — Domestic Services or Offices— Saddler 1 3 Cooks (male) 23 8 Printers, Stationers, &c.— Other Male servants 20 10 Compositors, printers 34 11 Coachmen 21 20 Machine rulers 1 — Gardeners 2 4 Relief stampers 1 — Waiters, carvers 58 15 Print colorers 2 — Billiard markers 3 1 Bookbinders 3 2 Hall and hotel porters, and messengers 35 17 Circular folders 1 — Ticket writers 1 — Bath, lavatory, and office attendants and cleaners 5 2 Publishers' assistants 1 — Booksellers 1 2 Caretakers 2 — News vendors 19 3 Conveyances of Men and Goods— Paper bag maker — 1 Dress— Railway porters 7 6 Hatters 1 1 Cab,' bus and motor drivers 18 15 Tailors 52 33 Carmen 25 28 Collar cutter 1 — Bus conductors 2 2 Seamstresses — 2 Stablemen, grooms 56 19 Shoemakers and leather workers „ 32 12 Carriage and cab attendants 3 - Hairdressers 4 2 General porters 44 27 Stickmounters — 1 Sailors 2 4 Dyer 1 — Lightermen 5 2 Drapers 1 — Shop porters 21 2 47 Occupation. Adult Males. Wives and Children of. Occupation. Adult Males. Wives and Children of. Food, Tobacco, Drink, and Lodging— General Workers and Dealers— Dairymen 2 3 Shopkeepers 32 21 Butchers 5 4 Hawkers 42 11 Bakers 5 1 Firemen, engine drivers 1 4 Fishmongers 2 1 Stokers 2 2 Provision merchants and grocers 10 2 Chimney sweeps 7 4 Modeller 1 — Ice cream vendors 1 — Window cleaners 5 1 Brewer 1 — Bottle labelled 1 - Lodging house and chambers keepers 16 7 Superintendents — 1 Scene shifters, 13 3 Coffee house keepers — 1 Basket makers — 1 Lodging house deputies 4 — Brush makers 1 1 Licensed victuallers 5 — Gas workers — 3 Barmen, potmen, cellarman 41 18 Labourers 150 76 Mineral water bottler 1 Wood chopper - 1 Shoeblack 1 — Blacklead maker 1 — Occupations of Adult Females where separately stated. Teacher 2 Paper sorter 1 Dancer 1 Tailoresses 21 Nurse 3 Milliners 2 House keeper, manageress 7 Dressmakers, sempstresses 36 Cooks 21 Staymakers 2 Other servants 64 Wigmaker 1 Charwomen 49 Cigarette maker 1 Laundresses 23 Dairy assistant 1 Waitresses 5 Seed sorter 1 Clerk 1 Incandescent mantle makers 2 Upholsteress 2 Flower sellers, market women 5 Furniture dealer 1 Hawker 8 Printer's ruler 1 Packer 1 Book folders, sewers 2 Shop assistants 4 Notification.— One hundred and ten notifications were received in 1907; the numbers in previous years were: 1903, 123; 1904, 148; 1905, 112; 1906, 78. Two hundred and ninety-two visits were paid in connection with consumption cases, and in addition thereto 82 cases were visited from time to time by the Health Society's visitors. At the end of the year the department is in touch with 242 persons known to be suffering from consumption, who are now in sanatoria, in infirmaries, hospitals, or at home. Difficulty is experienced in securing proper treatment for cases in the early stages, when most good can be done. The St. Henry Fund assists those living in St. Anne's Parish, and the Jewish Health Board looks after the Jewish cases; but in the rest of the city, patients unable to get away at their own cost are D 2 48 dependent on Brompton and the General Hospitals. The Asylums Board were invited to utilise one of their hospitals for this purpose, but that body, on applying to the Local Government Board, were informed that it would he inexpedient to do so at present as the proposed arrangement would involve questions that will have to be dealt with by the Royal Commission on the Poor Laws, which is now sitting. One hundred and seventy-five rooms in 122 houses and 1,569 articles were disinfected by the Council's staff, and general cleansing of the premises was carried out after each death, or on removal from one house to another. The County Council have obtained powers to deal with milk suspected to be tuberculous, but, as I have pointed out on previous occasions, personal and domestic infection plays a not inconsiderable part in the dissemination of the tubercle germ; even if all the tuberculous milk is stopped, it must not be expected therefore that consumption in its various forms, particularly as affecting the alimentary, will be completely prevented. Without actual bacteriological examination, it is impossible to determine in how many instances cow's milk was the medium by which infection has been conveyed; but the Boyal Commission found that of 60 cases, in only 14 were the organisms present, of the bovine type, and I find that of 33 infants under 1 year of age who died in Westminster from some form of tuberculosis, 8 had never touched cow's milk, and 7 others were breast-fed at first and afterwards had cow's milk which had been sterilised or condensed; 4 had been breast-fed until the child became ill, when cow's milk was substituted. In older children and adults, it is, of course, impossible to obtain such definite evidence, but the number of instances which result after association with cases of active pulmonary consumption at home or in places of business where ventilation is not good, and proper precautions are not taken, leaves little room for doubt that such conditions play an appreciable part in the spread of tuberculosis. The provision of a non-tuberculous milk is most desirable, but too much must not be expected to result therefrom. The general improvement in hygienic conditions, better housing and feeding, have done much to diminish tuberculous disease by raising the standard of health, so that persons can the better resist the attacks of the tubercle organism. A Conference of Bepresentatives of the City and Metropolitan Borough Councils was held at the Town Hall, Paddington, on June 6th, 1907, to consider the question of the measures to be taken to limit the spread of pulmonary tuberculosis, at which the following resolutions were passed:— 49 (1.) That it is desirable that the notification of pulmonary tuberculosis should be compulsory. (2.) That application be made to the Local Government Board for an Order to be made:— (a.) To include pulmonary tuberculosis among the diseases to be notified under Ssction 55 of the Public Health (London) Act, 1891. (b.) To extend the provisions of the following Sections of the above Act to pulmonary tuberculosis. Section 60—Cleansing and disinfecting of premises, &c. „ 61—Disinfection of bedding, &c. „ 62—Infectious rubbish thrown into ash-pits, &c., to be disinfected. „ 63—Penalty on letting houses in which infected persons have been lodging. „ 64—Penalty on persons letting houses making false statements as to infectious disease. „ 65—Penalty on ceasing to occupy house without disinfection or notice to owner, or making false answer. „ 69—In so far as it relates to the milking of cows and to the sale and distribution of milk. (This was proposed by the Westminster City Council's representatives.) (c.) That, in the opinion of this Conference, it is desirable, in order to limit the spread of tuberculosis, that provision should be made for public inspection and control, at its several sources, of the milk supply of England, and that the Local Government Board be asked to take steps to secure the efficient administration of the Dairies, Cowsheds and Milkshops Order, 1885, and Orders amending the same, by making compulsory regulations. (.d.) That the provision conferred by Section 7 (1) of the Factory and Workshop Act, 1901, namely, that in every room in any factory or workshop sufficient means of ventilation shall be provided and sufficient ventilation maintained, be rigidly enforced, and a similar provision extended to all places where people are assembled together for any lengthened period, with a view to restricting the spread of pulmonary tuberculosis. (e.) That a Sanitorium is needed for the open-air treatment of poor persons, and that the Metropolitan Asylums Board be asked to obtain power to utilise the Southern Hospital at Carshalton for this purpose. 50 (3) Non.notifiable Diseases. Measles.— Twenty.two deaths were attributed to this cause in 1907 in the City. During the year 566 cases came to my knowledge, 554 having been notified by school teachers (particulars as to schools affected are given later) The deaths per 1,000 calculated on the total population were:— 1901. 1902. 1903. 1904. 1905. 1906. 1907. Westminster— Cases notified 523 294 316 181 412 362 554 So. of deaths 59 43 47 23 44 20 22 Rate per 1,000 population 0.32 0'23 0.26 013 0.25 0.11 0.12 London 0.43 0.51 0.44 0.49 0.37 0.41 0.38 The five-yearly average death-rate being 0'44 for London, 0.19 for Westminster. As 21 of the deaths in Westminster, and the bulk of those in London, occurred in children under five years of age, it affords a better comparison to calculate the deaths on the number of children estimated to be living under five years of age:— Westminster 4.6 3.3 3.7 1.8 3.5 1'4 1.7 London .. .. 3 7 4'6 4.0 4'4 3.3 3.4 3.4 The death-rates per 1,000 persons in each of the four quarters were:— 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Westminster 0.02 0.13 0.18 0.16 London 0.38 0.55 0.33 0.23 Disinfection of 116 rooms in 59 houses, and of 1,266 articles, was carried out by the Council's staff; 27 rooms in 8 schools were alto disinfected. Visits were paid by the lady inspectors in all cases notified from schools. 51 Whooping Cough.— This complaint was responsible for 27 deaths, all of them of children under five years of age. Two hundred and fifty-one cases were notified to me, all from schools (for particulars as to schools affected see list below). Disinfection was carried out in one instance only. The complaint is most fatal in the first six months of the year, when the weather is cold, and there is thus more risk of bronchial and lung troubles supervening. Very little care appears to be taken with the majority of children suffering from this disease, with the result that the mortality from it is higher than scarlet fever and diphtheria. The death-rates per 1,000 persons in each of the four quarters were:— 1st Q,uarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Westminster 0.11 0.39 0.09 0.02 London 0.45 0.56 0.30 0.18 Particulars relative to this disease for the years 1901-7 are:— 1901. 1902. 1903. 1904. 1905. 1906. 1907. Westminster Cases notified 8 145 83 56 210 92 251 Deaths 48 34 33 17 35 23 27 Deaths per 1,000 population 0.26 0.18 0.18 0.09 0.19 0.13 0 15 London 0.35 0.40 0.35 0 33 0.32 0.26 0.38 The five-yearly average death-rate being 033 for London, 0.15 for Westminster. Calculated on the number of children under five years of age, the death-rates per 1,000 were:— Westminster 3.67 2.65 2.63 1.37 2.8 1.6 2.2 London 3.23 3.65 3.22 2.9 2 .9 2.3 3.4 Leaflets giving instructions with reference to the care necessary to be taken in cases of measles and whooping cough are freely distributed to parents. Attention is also called to the danger of exposing children to infection. 52 Diarrheal Diseases.— The third quarter of the year is usually distinguished as that in which epidemic diarrhoea is most prevalent, hut in 1907 the annual mortality for that quarter for England and Wales was only 0'43 per 1,000, being T88 per 1,000 lower than the decennial average rate. The London average is 2'7, the 1907 rate was 0'46, and is thus the lowest rate which has occurred in this quarter in the last 48 years, the next lowest being in 1894 and 1860, when it was T14. In 1894 the average temperature of the quarter was a little higher, but there was 7-^ inches of rain, which fell on 52 days. The temperature in 1860 was lower than 59.2 (that of the 1907 third quarter), and there was 9'6 inches of rain, also spread over 52 days. In Westminster 27 deaths from this particular form of diarrhoea occurred in the whole year as compared with 69, the average of the years 1901-6, the highest number being 97, the lowest 47. There was not so much reduction in other forms of enteritis, which is due probably to cold, to improper feeding, and defective powers of digestion. The following table exhibits the particulars :— Westminster. 1901. 1902. 1903. 1904. 1905. 1906. 1907. Epidemic diarrhoea 79 37 59 42 27 28 20 Epidemic enteritis 18 24 38 20 47 7 Other forms of enteritis 33 27 14 16 17 20 19 Total deaths 110 88 73 96 64 95 46 Number under 1 year of age 78 63 52 72 42 71 27 Number of births 3,432 3,461 3,185 3,054 3,120 2,931 2,927 Deaths of infants per 1,000 births 22.7 18.2 16.3 23.5 13.4 24.2 9.2 Eighteen deaths of the epidemic form were in children under 1, four in children between 1 and 5 years, and five in older persons; of the non-epidemic form there were nine under 1 and the remaining ten were adults. Thirteen of the epidemic deaths were in St. John's Ward, nine in Victoria. The rates per 1,000 persons for each quarter for all forms of diarrhoea were as follows:— 1907. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. The Year.] Westminster 0.06 0.4 0.28 0.0 0.20 London 0.16 0.16 0.46 0.49 0.32 The average for the five years 1902-06 was for London 0.7, for Westminster 0-32, for all forms of diarrhoea, per 1,000 population. 53 Schools and Infectious Disease. School Teachers are required to notify me when they exclude children on account of infectious disease. The following list shows how far this was carried out and the nature of the cases notified:— School. Actual Cases. Infection in House. Other Causes. Chicken- pox. Measles. Mumps. Whoopingcough. Chickenpox. Measles. Mumps. Whoopingcough. Charing Cross Road 1 8 9 13 4 3 3 3 6 German measles. Horseferry Road 2 2 1 29 3 — — 7 1 German measles. Buckingham Gate 1 4 4 34 - 4 3 3 2 eczema. 9 ringworm. Pulteney 8 4 4 18 1 3 — 7 4 ringworm. St. George's Bow 22 89 28 7 12 42 10 1 25 ringworm. Millbank 56 7 13 12 16 5 2 - 28 ringworm. 10 German measles. Tower Street — — — — — 2 — — Wild Street 4 2 - 3 1 2 1 4 3 German measles. 3 ringworm. Brompton Higher Grade — 16 — 6 — 3 — 4 Christ Church 5 5 - 19 6 2 — 1 1 ringworm. 2 blight. Holy Trinity 12 5 2 13 7 9 — 10 1 eczema. Pimlico Booms - - - - - - - - St. Anne's 13 — - 7 7 — — 1 12 ringworm. St. Anselm's — 51 1 6 — 38 — 2 4 ringworm. St. Barnabas 2 47 7 — — 23 3 — 2 ringworm. St. Clement Danes 1 2 — 10 2 — — — 1 ringworm. St. Edward's, Dufour's Place — — - — — — — — St. Gabriel's 17 66 - 29 17 39 — 16 7 ringworm. St. George's, South Street — 42 — — — 1 — — 1 German measles. St. James the Less 3 8 11 7 3 13 4 - 4 ringworm. l German measles. St. Margaret's - 20 - — 1 4 — — St. Martin's, Castle Street — — - — 1 2 — 1 1 ringworm. St. Mary's, 43, Great Peter Street — — 10 — — — — — St. Mary's, Hide Place 2 35 - 6 2 21 — 1 13 ringworm. 2 German measles. St. Matthew's 13 13 6 16 21 10 2 3 8 ringworm. 2 German measles. St. Michael's — 25 - — — 9 — — 1 ringworm. St. Paul's 11 23 - 11 1 3 — 3 1 ringworm. St. Peter's, Lower Belgrave Place 1 38 - — — 17 — — St. Peter's and St. James' - - - - - - - - - St. Stephen's 2 24 — 5 2 9 — — 1 ringworm. Wesleyan Training — 17 1 — 8 — — 1 German measles. Westminster Jews' Free — 1 - - - - - 5 176 554 97 251 107 271 28 72 There were 28 cases of German measles. A copy of each notification of fever, diphtheria. &c., received from medical men is sent to the head teacher of the school attended by the patient (if a child), or by any child who is an inmate of the same house as the patient. 54 In this way 462 notifications were sent out during 1907 to school teachers as follows:— School. Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. Charing Cross Road - 3 - - Horseferry Road — 2 1 — Buckingham Gate — 5 2 — Pulteney — 12 1 — St. George's Row — 10 4 — Millbank — 8 4 — Great Wild Street — 1 1 — Brompton Higher Grade — 1 1 — Christ Church — 2 1 1 Curzon — 3 - — French Protestant - 2 - — Holy Trinity — 6 1 — St. Anne's — 2 2 — St. Anselms - 10 - — St. Barnabas - 5 6 — St. Clement Danes - 2 2 — St. Edward's, Dufour's Place - 10 1 — St. Gabriel's - 17 3 — St. George's, South Street - 9 2 — St. James the Less.. - 19 1 — St. Margaret's - 3 1 — St. Martin's, Castle Street - 5 — — St. Mary's, 48, Great Peter Street - 4 — St. Mary's, Hide Place - 4 — — St. Matthew's - 4 3 — St. Michael's - 5 2 — St. Paul's, Caroline Street - - - — St. Paul's, Wilton Place - 7 2 — St. Peter's, Lower Belgrave Street - 4 2 - St. Peter's and St. James's - 6 1 — St. Stephen's - 2 2 - Wesleyan Training College - 7 — - Westminster Jews'Free - — — — Disinfection of School Library Books.— The Public Health Committee of Bermondsey Borough Council had under consideration a report from their Medical Officer of Health with respect to school library books which have been exposed to infection in cases of dangerous infectious diseases. It appears that the practice was for the head teacher, in accordance with the London County Council regulations, to give instructions that such books should be burned, but it was found that the practice was to have the books brought back to the school. The City Council having been communicated with by the Bermondsey Council agreed to support their action, and wrote the County Council expressing the opinion that if the County Council desired that infected books should be destroyed it would be better if the Borough Councils did the work, for to take back to school books which had been exposed to infection was, in the interests of the public health, unsafe, besides being illegal. The London County Council in reply, dated the 17th August, 1907, stated that they had again considered their regulations for dealing with such books belonging to school lending libraries, and that they had decided to request the Borough Councils to 55 destroy where necessary, school books which have been exposed to infection at private houses; that they consider however, that, in the interest of the public health, they should have some guarantee of the destruction of such books, and have accordingly made it a condition that in the event of the Council requesting the destruction of any book, the work shall be carried out under the immediate supervision of the Medical Officer of Health for the district. They also requested that, in cases where the City Council do not consider it necessary for the books to be destroyed, they may be disinfected and returned to the school to which they belong. The sanitary arrangements of 8 schools were improved or re-constructed during the year. Medical Inspection of School Children.— The Education Act, 1907, makes provision for the inspection of children about the time of their admission to a public elementary school and at such other times as the Board of Education may direct, and also to make such arrangements as may be sanctioned for attending to their health and physical condition. The Board of Education has issued a memorandum on the subject (Circular No. 576), in which they point out the necessity for this work being done in close relationship with the Sanitary Authority. In London the Medical Officer of the county is primarily responsible, but the opinion has been expressed that the work should be carried on through the Medical Officers of the various Metropolitan Boroughs. At present no steps have been taken, but hitherto the County Council has had a staff of medical men attending to school and working independently of the Local Authorities, both being in ignorance of what the other was doing. In the Soho part of Westminster the Health Society has been able to co-operate with the School Managers and Teachers, and in this way 175 children over 4 years of age and 96 under that age were looked after; steps were taken to ensure that they received necessary medical attention, convalescent treatment, the services of a nurse, surgical appliances, &c., either by making arrangements for people able to pay for themselves, or through various relief agencies. If the bad health of the children seems due to insanitary conditions these are notified to nxe, while bad home conditions, such as dirty bedding and floors, carelessness as regards keeping of food, cleanliness of children, &c, are dealt with by the visitors at frequent visits. A number of children with vermin in their heads were visited at the request of the Education Committee. It is found that the parents will at once take the necessary steps to cleanse the children's heads when requested by the officials of the Sanitary Authority, though they have previously ignored the requests and advice of the teachers. 56 Bacteriological Laboratory. During the year 155 examinations have been made at the Lister Institute at a cost of £20 6s. 2d., as follows:— Disease. Persons. Examinations. Results. Positive Negative. Diphtheria— Suspected cases 89 91 21 70 Contacts 10 10 — 10 Returned from hospital with nasal or aural discharges 1 2 — 2 100 103 21 82 Typhoid Fever 21 23 12 11 Tuberculosis 21 29 9 20 Hoffman's pseudo-diphtheria bacillus was found in three instances of suspected diphtheria, and the bacillus fusiformis with numerous spirochaete in another; the Hoffman was also found in the throat of a person who had been in contact with a child who died suddenly from what was believed to be diphtheria. One case of suspected typhoid, in which the Widal reaction was obtained, was returned from hospital as not suffering from that disease. In addition to those mentioned above, many medical men and hospitals obtain reports on their cases from private or hospital laboratories. Disinfection. Below is shown the number of rooms and articles disinfected by the Staff of the Department. The premises included 27 rooms in 8 schools and 24 sets of offices, 3 ambulances, 4 private carriages, and 1 undertakers' carriage were also disinfected. In 16 cases of infectious disease treated at home the laundry linen was collected weekly and disinfected. Disinfection was carried out after all cases of the notifiable diseases, except as regards erysipelas (in which disinfection was performed in 22 instances, when the circumstances of the case required it), and also after 59 cases of measles, 5 chicken-pox, 17 cancer, 1 influenza, 3 mumps, 1 whooping cough, and 122 phthisis. In 15 cases the premises, &c., were disinfected privately, certificates being produced to that effect. Shelters.— Five persons were admitted to the temporary shelters at Horseferry Road and Dufour's Place while disinfection was being carried out. 57 The following table gives a comparative statement of the above work during the past six years:— 1901. 1902. 1903. 1904. 1905. 1906. 1907. Premises 834 1,097 709 581 667 961 840 Rooms 1,287 1,836 ] ,039 935 1,177 1,627 1,455 Articles disinfected 32,218 39,965 27,766 29,107 34,703 47,865 36,115 Articles destroyed 58 37 126 52 151 195 1,660 Books disinfected 95 24 16 10 52 363 136 Number admitted to shelters 13 20 19 39 6 1 5 Cleansing of Persons.— The Guardians have dealt with the frequenters of their casual wards, who are the persons most troubled with vermin, at their own establishments, thus at Bear Yard about ten cases are dealt with daily. Two persons were specially treated at Horseferry Road; 16 children in 13 houses were visited on account of vermiuous heads, these were all cleansed by the parents; 32 visits in connection therewith were paid to the houses and 6 to schools. Verminous Houses.— Seven houses were fumigated with burning sulphur by the staff, and 1,869 articles were passed through the disinfecting apparatus, for this reason, or for being in such a condition as likely to cause disease. Mortuaries. The number of bodies removed to the Council's mortuaries under order of the Coroner, or to await burial, was 358; in four instances death was the result of infectious disease. Inquests were held in 281 instances at Horseferry Eoad, where the Coroner's Court is situated; seven adjourned inquests were held. Postmortem examinations were made in 178 instances at Horseferry Eoad and in four instances at Dufour's Place. It appears that the number of dead bodies taken to the mortuaries for purposes of inquest is steadily declining, but greater advantage is being taken of them as resting places for bodies awaiting burial. The figures for the last seven years are:— Total For Inquest. To await Burial. Total. For Inquest. To await Burial. 1901 438 370 66 1905 370 307 61 1902 389 345 44 1906 345 283 61 1903 393 341 55 1907 358 281 77 1904 388 322 59 58 During 1906 steps were taken to make more generally known the existence of various places in the City where dead bodies might be taken to await burial. Of the 77 bodies admitted for this reason, 60 were taken to Horseferry Road, 12 to Dufour's Place, 5 to Drury Lane, and none to either Ebury Bridge or Mount Street resting places. The last named has now been closed, as it does not appear to be required. The number of bodies taken in at Horseferry Road since 1897 has been:— Year. Bodies. Year. Bodies. Year. Bodies. 1897 131 1901 391 1905 344 1898 165 1902 371 1906 332 1899 273 1903 371 1907 341 1900 309 1904 365 The total number of bodies received at Horseferry Road to await burial has increased from 22 in 1901 to 60 in 1907. 59 PART II. C. House Inspection, &c. Below is a list of details of the work done in connection with insanitary conditions. In many cases some of the work specified was in premises part of which was occupied as workshops:— 1907. 1907. Complaints received and dealt with 904 Sanitary Work completed :— Water-closets:— Premises inspected on complaint, &c. 1,777 Constructed 866 Repaired 1,164 House to house inspection 3,649 Ventilated 420 Premises inspected on complaint, &c., re-inspected 18,562 Separated from rooms 254 Cleansed or limewashed 862 Premises (registered), visits to 2,237 Urinals:— Overcrowding found 17 Other infringements . 293 Constructed 126 Sanitary Work completed :— Houses:— Repaired or improved 48 Cleansed 49 Waste Pipes:— Closed under H.W. Classes Act - To sinks, baths, lavatory basins, &c., fixed 631 Closed under P.H. (London) Act 7 Repaired or unstopped 431 Cleansed throughout 241 Water Supply :— ,, partially 697 Overcrowding abated 71 Provided 90 Light or ventilation improved 121 ,, additional 948 Reinstated 103 Roofs repaired 269 Cisterns fixed 188 Floors and staircases repaired 191 „ cleansed 211 Underground rooms vacated 47 „ covered 233 Yards, areas, paved or repaired 413 „ defective, abolished 85 Taps off main provided 220 Damp walls remedied 87 Pipes repaired 165 Offensive refuse removed 211 Dust Bins :— Keeping of animals discontinued 18 Provided 310 Yerminous premises cleansed 119 Repaired 40 Yerminous and filthy bedding, &c. 1,939 Fixed, abolished 131 Drains :— Stables:— Drained 33 Constructed 345 Paved 27 Amended and repaired 766 Cleansed 23 Tested 1,365 Dung receptacles provided 11 .Rainwater Pipes :— Dung accumulations removed 47 Fixed or repaired 554 3,326 preliminary notices and 189 statutory notices were issued. 60 Police court proceedings for failure to comply with Statutory notices were taken with the following results :— Premises. Offence. Result. 78, Hanover Street Dirty and verminous condition of walls; defective floors; dirty and uncovered drinking water cistern; insufficient and improper water supply Order to carry out work. £1 3s. 6d. costs. 5 and 6, Berwick Street, Soho Accumulation of refuse and filth Prohibition Order. 6s. costs in each case. Do. Failure to comply with Prohibition Order Undertook to employ a man to prevent recurrence. 12 s. costs. 165a, Strand Absence of rain-water pipes, causing dampness to adjoining premises This was the subject of a Magistrate's Order in 1906, but the then owner who was fined for non-compliance died; the present summons was dismissed as the will had not been proved owing to the complicated nature of the estate 34, Greek Street Failure to provide additional sanitary accommodation Fined £1 and £1 3s. costs. 2, Cumberland Street Dirty condition of rooms; defective flooring of washhouse Order to abate within 14 days. 22, Charlwood Street, 24, Charlwood Street and 80, Tachbrook Street Premises dirty and dilapidated; insufficient ventilation of w.c.'s; insufficient water supply; absence of proper dust-bin ; defective roofs, &e. Order to carry out works within 6 weeks. 18s. costs. Summonses subsequently withdrawn, the premises having been closed. Payment of £1 l1s. 6d. costs. 14, Berwick Street, Solio Nuisance arising from position and defective ventilation of w.c.; defective roof: dirty and defective walls; offensive accumulations from sink discharging and collecting in roof gutter Order to do the work within 21 days. 6s. costs. Do. Additional and separate sanitary accommodation required Adjourned for 3 weeks on undertaking to do work. 72, Eaton Terrace Drain between house and sewer broken Summons withdrawn on payment of 2s. costs, work having been done after issue of summons. 65, Westmoreland Street Foul and defective ash-pit; dirty walls and ceiling of staircase Fined 10s, and 2s. costs. 41, Tufton Street Defective and improper construction of w.c. apartment; dirty walls, &c. Summons withdrawn on payment of 10s. 6d. costs, work having been done after issue of summons. 43, Tufton Street Dirty and verminous condition of walls, &c.; defective flooring of w.c. 43, Whitcomb Street.. Want of proper and sufficient supply of water to upper part of premises Order to provide. 6s. costs. 2, Gillingham Mews.. Allowing offensive matter to accumulate in a disused dung-pit Prohibition Order. 2s. costs. St. Leonard's Place Flooding of fore-courts; insufficient and defective drainage Order to abate within 14 days. 6s. costs. 25, Brewer Street, W. Failure to cleanse walls, &c. (outworkers premises) Order made. 6s. costs. 74, Berwick Street, Soho Failure to properly pave and drain floor of laundry Do. Do. King's Arms Yard Non-removal of manure Fined £4 and £1 costs. 61 Legal proceedings were taken for offences under the By-laws with regard to water-closets, as follows:- Premises. Offence. Result. 46, Chadwick Street Failure to keep w.c. supplied with water Fined 10s. and 12s. 6d. costs. 1, Chadwick Street Do. do. Do. do. 21, Chadwick Street Do. do. 9, Lewisham Street Failure to keep w.c. and drain in proper working order 10.s. 6d. costs. Removal of Manure,— The Council passed a resolution to publicly announce that they require the periodical removal, not less frequently than every 48 hours, of all manure or other refuse matter from all stables, cowhouses or other premises in the City. Notice of such requirement was also served on the occupier of every stable, cowhouse or other similar premises in the City. Proceeding's were taken for failure to comply in one case (see above). Removal of House Refuse.— The Council continues to improve its methods, and Poland Street has now been included among the streets from which a daily collection is made. Dust is also being removed earlier in the day. In a number of instances fixed bins have been found in bad positions, improperly constructed or defective. The owners have been recommended in each case to do away with them, but except where the position was such that a nuisance existed, the law does not give power to the Council to compel such removal unless a movable dust-bin has already been provided or a daily collection instituted. The majority, however, complied with the suggestion, and 131 were abolished; 40 were repaired and made more accessible for the dustmen. "W here there is not a daily collection of dust, householders ought to be advised to burn waste matters liable to decomposition. Removal of Offensive Refuse.— Complaints were made of offensive smells in a number of instances occurring during the removal of kitchen refuse from hotels, &c. Seven persons were cautioned, and the following were prosecuted for removing refuse during prohibited hours :— Date. Name and Address of Defendant. Result of Proceedings. 31st May S. Cornwell, Mitcliam Fined £1 and 2s. costs. 8th Aug H. H. Hunt, Ilarlington Fined £1 and 2s. 6d. costs. E 62 Drainage, &c., Plans— Six hundred and twenty-one sets of plans were examined during 1907. 507 of these resulted from notices served by the Public Health Department, and 114 were plans of new buildings or re-constructions, the drainage of which is under the supervision of the City Engineer, with the exception of such matters as come under the Public Health Act and by-laws made thereunder in respect of water closets, water supply, ventilation, &c. In 151 instances the plans had to be amended, and sanction was refused altogether with regard to three of them. Failure to send in plans as required by law occurred in forty instances. Infringement of the by-laws in connection with the erection of buildings occurred in twenty-five instances. Proceedings against the persons offending were taken in tlie following instances (rt) E. E. Battistoni, of 25, Hanover Square, for failure to give notice of intention to construct water-closet and for fitting a defective soil-pipe. Fined 10s. and 4.s. costs. (5) H. and E. Lea, 3 and 4, Warwick Street, Pegent Street, for failure to deposit plans. Fined 10s. and 2s. costs. In the other instances the persons responsible were cautioned by the Public Health Committee that further proceedings would be taken on subsequent neglect. Testing Drains.— One thousand four hundred and twenty-six tests were applied to 1,365 drains, soil-pipes, &c., during the year, of which 336 with smoke or water were carried out under the supervision of the Sanitary Inspectors by the men of the disinfecting staff. The routine is to test a drain first by means of chemicals, and, if necessary, subsequently with smoke, air, or water. After reconstruction, drains below ground are tested with water, pipes above ground with smoke or air. The numbers of each test employed were:—- Chemical 509 Water 576 Smoke 239 Air 102 Flooding from Insufficient Sewers.— Complaints have been made for many years that at certain seasons of the year, especially when there is a conjunction of heavy rainfall with high tides, houses in parts of the City become flooded through the inadequacy of the main sewers. The attention of the County Council was called to this by the City Council, and the former body in reply state that a new low level sewer is now 63 in course of construction from Hammersmith to Bow, that it will pass through the City of Westminster, and it is hoped that it will very considerably relieve the other main sewers in the district. The City Engineer reports to the Council from time to time the progress of his special survey of the sewers of the City. Petroleum in Drains and Sewers.— I have referred in previous reports to the danger which is caused by the discharge of petroleum into drains. This is not solely due to negligence at premises licensed for the storage of petroleum, but it is due also to its use by private persons for cleaning purposes. There is good reason to believe that much waste spirit is discharged into the drains from private premises, and some of this finds its way into the sewers. The Public Control Committee of the County Council insert conditions in licences granted for the keeping of petroleum, and orders and notices by that body have been served on licensees and others prohibiting such discharges info sewers ; but at large garages and other premises some special precaution is desirable, either by the provision of catch-pits unconnected with the drain, or by the introduction of special intercepting chambers on the surface drainage of the premises. The provision of such interceptors has been secured at several large garages and other premises, whereby it seems impossible with ordinary attention for any spirit to pass beyond the interceptor. The County Council suggest this precaution in addition to, and not in substitution for, the ordinary requirements as to drainage. The apparatus consists of a tank about 3 feet square, having the overflow taken by a pipe from the lower part of the tank; the petroleum being lighter is thus retained in the upper pait of the tank. In small garages one tank may be sufficient, in larger garages two or more, according to the size of the garage and the amount of petroleum which may find access to the surface drains. A chauffeur of Mount How, Berkeley Square, was summoned by the London County Council, under Section 5 of the Locomotives on Highways Act, 1890, for permitting petrol to run into a drain, and was fined. Proceedings were also taken against Queen Anne's Mansions Company for permitting the discharge into the sewers of liquid refuse above the temperature allowed by Section 9 of the London County Council (General Powers) Act, 1904, and they were fined £10 and costs. Watek Supply. Applications were received for certificates that the water supply of seven new buildings was sufficient, and were granted in each instance. 165 notices of withdrawal of water supply were received from the Metropolitan Water Board, and in 103 instances it was reinstated. Additional sources of water supply were provided to houses in 948 E 2 64 instances; this includes the provision of water on the upper floors of tenement houses. The County Council had inserted in the General Powers Act of 1907 a section dealing with the provision of water to the upper floors of such houses. No difficulty had been experienced in Westminster in the matter uucler Section 48 of the Public Health (London) Act, 1891. Almost every house-owner admits the reasonableness of the requirement when it is explained. (See remarks under heading "Infant Mortality."). The Health Visitors report that they have observed great improvement in cleanliness following the introduction of better water supply. Unfortunately no direct power was given to require the provision of sinks. Houses Let in Lodgings. The demolition of property which continues, especially in St. John's Ward, continues to reduce the number of houses on the register. At the end of 1906 the number was 1,602, none were added in 1907, and 30 removed by closure, leaving 1,572 at the end of the year. 2,237 visits were paid. Overcrowding was found in 17 instances, and 293 other defects were remedied. Proceedings were taken in respect of several registered houses for failure to maintain w.c.'s in proper working order and supplied with water (see list of "Legal Proceedings," ante p. 61). Eevenue Act. Certificates under this Act relieve the recipient from the payment of Inhabited House Duty. Applications were received by me in 17 instances comprising 130 tenements. Certificates were granted after inspection of the premises in 117 instances, refused in nine, and outstanding at the end of the year pending structural alterations in four instances. The premises for which certificates wei'e granted are :— 5, Bury Street. 121, Long Acre. 2, Chapter Street. 1, 2, 3 and 4, Regency Street. 18, Chapter Street. 40, Regency Street- Catheclral Mansions, Yauxhall Bridge 29, St. James Street. Road. Stafford Mansions, Stafford Place. ], Frederick Street. 83, 87 and 91, Victoria Street. 37, Hyde Place. In addition, 62 certificates for premises for which application had been made in 1906, but in which the alterations asked for to bring them ' O up to the standard had not been carried out at the end of that year, were granted. They were:— Carey Mansions. Marshall Street Dwellings. 2, 15, 16, 30 and 31, Garden Street. Mercer Chambers. 65 Smoke Prevention. The City is divided into two parts for purposes of smoke inspection, under Inspectors Mc Nair and Williams. The following is a summary of the work done in connection therewith:— North District. South District. Total. Complaints received 35 13 48 Observations taken 1,309 1,108 2,417 Notices issued— Preliminary 54 52 106 Statutory 8 7 15 Summonses 2 - 2 The result of the police-court proceedings under the Public Health (London) Act was:— Date. Name and Address of Defendant. Result of Proceedings. 1907. 15th August Secretary, Oriental Club, Hanover Square Dismissed. Magistrate (Mr. Mead) held that the stoker should have been summoned. 12th December Junior United Service Club, Charles Street Fined £2 and £1 3s. costs. A comparison with previous years is given below:— 1902 1903 1904, 1905 1906 1907 Complaints 81 52 55 52 37 4.8 Observations 2,728 2,731 3,191 2,715 2,722 2,417 Notices Issued :— Preliminary 58 68 142 121 93 106 Statutory 18 18 26 26 25 15 Summonses 6 3 5 11 8 2 D. Workshops. Section 132 of the Factory and Workshops Act directs that " The Medical Officer of Health of every District Council shall in his annual report to them report specifically on the administration of this Act in workshops and workplaces, and he shall send a copy of his annual report, or so much of it as deals with this subject, to the Secretary of State," and forms have been supplied giving a summary of what is required. It is, however, a matter of difficulty in Westminster to apportion work done, as workshops and dwellings are so intermingled. 66 The following shows the state of the register of workshops at the end of 1907:— Workshop. Total Number. Number in which Women are Employed. Tailors, outfitters, shirt makers, hat, cap, and helmet makers 1,607 863 Dressmakers, milliners, embroiderers, lace makers, blouse makers, costumiers, lingerie makers, childrens' outfit makers, feather dying, corset makers, furriers, &c. 690 690 Leather workers, boot and shoe makers, harness makers, &c. 72 27 Carpentry, upholstery, carvers, gilders, &c. 27 4 Surgical and dental instrument makers 4 1 Tobacco manufacturers 15 11 Wig makers and hair workers 32 32 Printing, bookbinding, lithographers, envelope making, stationers, publishers, &c. 66 34 Jewellers, silversmiths and burnishers, diamond cutters and polishers, engravers, &c. 77 19 Metal workers 47 2 Miscellaneous—Basket making, fancy work, shoe ornaments, hat pins, stamp sorters, postcard tinters, fan makers, artificial flower makers, &c. 29 17 Florists 19 19 Laundries 47 47 Bakehouses 92 — Workplaces where food is prepared 839 830 New workshops are always being discovered, at the same time the occupation of premises on the register is constantly changing. Thus the use of 122 registered workshops was discontinued, and 252 additions were made to the register during the year. The number of inspections of workshops and workplaces is shown in the accompanying tables. The inspections have increased from 4,175 in 1906 to 5,918. One hundred and sixteen complaints were received from the Home Office and were duly investigated. Inspection. Premises. Number of Inspections, Intimation Notices. Statutory Notices. Prosecutions. Factories (Including factory laundries) 81 10 1 — Workshops (Including Workshop laundries) 3,204 613 60 5 Workplaces 843 390 22 — Total 5,918 1,013 92 5 07 Westminster.— Defects found.— 1907. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. *Nuisances under the Public Health Acts :— Want of cleanliness 613 610 1 Want of ventilation 150 148 — Want of ventilation of gas stoves 268 264 — Overcrowding 37 37 — Want of drainage of floors 35 35 1 Other nuisances 499 490 — Sanitary accommodation — Insufficient 24 23 2 Unsuitable 129 129 — Defective 341 341 1 Not separate for sexes 170 168 — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouses (Sec. 101) 4 3 1 Breach of special sanitary requirements for bakehouses (Secs. 97 to 100). - — - Other offences — — — Total 2,268 2,246 6 * Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act as remediable under the Public Health Acts. Other Matters. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (Sec. 133) 213 Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts but not under the Factory and Workshop Act (Sec. 5)— Notified by H.M. Inspector 116 Reports (of action taken) sent to H.M. Inspectors 116 Other 4 Workrooms measured *1,146 Underground bakehouses (Sec. 101) :— Certificates granted during the year - In use at the end of the year 77 * This includes 659 kitchens of restaurants, &c. Outworkers.— Firms giving out work in certain trades are required to send in a list twice a year of those they employ. Outworkers are constantly changing their addresses and their employers, so that 68 it is difficult to maintain a correct register. Visits of enquiry to ascertain if outworkers were employed were made by the lady sanitary inspectors. On the 23rd May the Home Secretary further extended the number of classes of work to which the Act applies. They are now :— (а) The making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel. (б) The making, ornamenting, mending, and finishing of lace and of lace curtains and nets. (c) Cabinet and furniture making and upholstery work. (.d) The making of eleclro-plate. (e) The making of files. (/) Fur-pulling. (g) The making of iron and steel cables and chains. (h) The making of iron and steel anchors and grapnels. (i) The making of cart gear, including swivels, rings, loops, gear- buckles, mullin bits, hooks, and attachments of all kinds. (j) The making of locks, latches, and keys. (k) The making or repairing of umbrellas, sunshades, parasols, or parts thereof. (l) The making of artificial flowers. (m) The making of nets other than wire nets. (n) The making of tents. (o) The making or repairing of sacks. (p) The covering of racquet or tennis balls. (q) The making of paper bags. (r) The making of boxes or other receptacles, or parts thereof, made wholly or partially of paper, cardboard, chip, or similar material. (s) The making of brushes. (t) Pea-picking. (u) Feather-sorting. (v) The carding, boxing, or packeting of buttons, hooks and eyes, pins and hair-pins. (w) The making of stuffed toys. (x) The making of baskets and any processes incidental to the above. Section 110 (relating to the prohibition of home work in places where there is infectious disease) applies to the above except (d), (e), (g),(h) (i) and (j). Employers are expected to keep a list of outworkers in a form specified by the Order, but it is seldom so kept. Considerable trouble is 69 still experienced in getting in the lists, and in many instances they are obtained only after advertising, circularising, visiting, and, finally, threatening with proceedings., A conference took place at the Home Office between the Chief Inspector of Factories and a number of Medical Officers of Health on November 6th on the question of the enforcement of the Home Work provisions of the Factory Act, when the difficulties which surround this branch of public health work were fully discussed and suggestions made. The accompanying table giving the details of the returns made in Westminster in 1907, shows a considerable increase in numbers over previous years, thus 654 lists were sent in by employers, as compared with 318 in 1906, in which year the number of addresses on the lists was 4,011, and in 1907 7,907 ; in 3,199 instances the persons employed lived in other boroughs, and the addresses in each instance were forwarded to the authority to which they belonged; 432 addresses of persons living in Westminster and doing work at home for firms in other boroughs were received. It will be noted that the execution of this part of the Act involves a considerable amount of clerical work, in addition to the visits, of inspection to the houses. Workers are frequently in the employ of several firms, so that the number of names returned does not necessarily coincide with the actual number of workers. All those living in Westminster were visited, and the sanitary condition, not only of the rooms occupied, but of the whole house, was inquired into. The actual number of houses in which outwork is done is 1,099. 468 notices were served in respect of defects discovered in these houses. They may be summarised thus :— Sanitary accommodation— "Walls and ceilings dirty 142 Insufficient 14 Rooms verminous 32 Not kept separate 56 Rooms overcrowded 17 Apparatus defective 42 Rooms badly ventilated 10 Requiring oleansing 42 Gras stoves and heaters unventi- Ventilation defective 11 lated 111 Drains defective 39 Other defects 84 In 19 instances statutory notices had to be served before the work required was done. In one instance a Magistrate's Order was obtained against the owner of the property requiring him to clean walls and ceilings of rooms. In several instances where the rooms were dirty or verminous the outworker was seriously warned. Experience shows that it would be useful for sanitary authorities to have the power to require the names of persons by whom outworkers are employed. It has been strongly urged that the workplaces 70 City of Westminster Outworkers, 1907. FEBRUARY LISTS. AUGUST LISTS. Trade. Number of Lists. Number of Outworkers. Received from other Authorities. Sent to other Authorities. Addresses in City. Number of Lists. Number of Outworkers. Received from other Authorities. Sent to other Authorities. Addresses in City. A. Tailoring 254 3,171 177 1,209 2,139 253 3,391 160 1,186 2,365 A. Dressmaking 17 165 21 122 64 19 220 40 172 88 A. Theatrical costumiers 1 19 — 8 11 1 6 — 4 2 A. Waterproofing 3 54 — 18 36 2 39 — 13 26 A. Shirt making 26 101 3 50 54 26 131 4 38 97 A. Boot making 16 208 6 144 70 17 300 13 161 152 A. Veil Spotting — — — — — 1 2 — 2 - A. Corset making — — — — — 2 3 — 1 2 A. Hat making 1 1 — 1 — 1 2 — 2 — A. Gold lace making 1 6 — 6 — 1 7 - 2 5 A. Embroidery 4 27 1 22 6 4 48 2 32 18 B. Lace making — — — — — — — 1 — 1 D. Electro plating — — 1 — 1 — — — — — F. Fur pulling 1 1 1 1 1 1 1 — 1 — L. Paper bag and box making 1 1 1 1 1 1 2 2 - M. Brush making 1 1 1 1 1 - - - - - 325 3,755 212 1,583 2,384 329 4,152 220 1,616 2,756 321 firms sent in lists on both occasions giving a total of 7,783 addresses, 12 sent in once in the year, the number on their lists being 124. 71 of outworkers should be inspected and certified by factory inspectors, but such inspection could be but of a limited character, whereas the inspection by the officers of the local authority embraces not only the workroom but the whole house. Thus improvements can be effected in the hygienic surroundings of the house as well as of the workroom which is only an incidental part of the house. Sixty visits were paid to Domestic Workrooms, i.e., where no work was being taken in from another business firm, and no one outside the family was ever employed. Infectious Disease.— A list of the cases of notifiable infectious disease which occurred in families engaged in the making, &c., of wearing apparel at home, are given below. It was unnecessary to stop their work except temporarily during the time disinfection was being carried out:— Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Total. Clothing trades:- (a) Business in family affected 29 6 3 6 44 (b) Business in other parts of house 36 10 2 2 50 (c) Persons from infected houses employed in clothing business elsewhere 38 10 - 1 49 103 26 5 9 143 Other home workers trades:— (a) Business in family 1 — — — 1 (b) Business in other part of house 1 - - - 1 (c) Elsewhere 3 2 — — 5 In addition, in connection with Laundries there were cases in two of the above three classes :— (a) (b) (c) In Receiving Shops Mangling only — Scarlet Fever (1) — Washing, Ironing, &c. .. Scarlet Fever (1) — — A Magistrate's Order was obtained in respect of a laundry in which the drainage of the floor and other matters were defective. The Factory and Workshops Act, 1907.— The law with regard to public laundries is modified by this Act. In future "laundries carried on by way of trade or for the purpose of gain, or carried on as ancillary to another business or incidentally to the purposes of any public 72 institutions," are to be treated as non-textile factories and workshops within the meaning of the Factory Act, 1901. The new Act prescribes certain rules for the hours of employment of women and young persons in laundries, and makes regulations for ventilation, the use of gas irons emitting noxious fumes, and the drainage of floors. It also applies certain provisions of the Factory Act to institutions where any manual labour is exercised in or incidentally to the making, &c., of articles not to be used for the institution. Another section of the new Act provides for the inspection by factory inspectors of certain government departments which at present do not come within the definition of the term factory on the ground that no process is carried on therein for the purposes of gain. Hotels and other institutions which carry on laundry work are now made amenable to the Factory Acts. 73 E.—Food Supply. The food exposed for sale in shops and on stalls in the street markets has been regularly inspected every day (including Sundays). The following list shows the quantity of food condemned and destroyed during the year. The bulk of it was submitted by the owners or purchasers for the opinion of your officers:— Articles of Food Submitted. Tons. Cwts. Lbs. Tons. Cwts. Lbs. Apples 7 10 28 Limes 1 3 0 Asparagus 0 0 60 Melons 0 6 38 Bananas 30 4 0 Mushrooms 0 0 12 Beans 0 4 14 Peaches 0 2 0 Cauliflowers 0 7 56 Pears 0 12 0 Cherries 8 0 74 Plums 1 41 80 Currants, White 0 2 0 Pineapples 4 10 80 Damsons 0 26 28 Potatoes 9 4 0 Figs, Green 0 0 17 Raspberries 0 6 52 Grapes 0 0 36 Strawberries 0 7 84 Lemons 0 1 28 Tomatoes 10 7 30 Lettuces 4 10 64 Lobsters, 74; Fish (various), 5 cwts. 81 lbs.; Fish (tinned), 24 tins; one sheep's Articles of Food Seized. Milk, separated About 1½ gallons Pigs, carcases, unsound Two Milk unfit for Food.—On the 24th September Inspector McNair saw Edward Hughes, of 6, Shard Square, S.E., hawking milk in a hand-can in Earl Street. He found that he had also a churn on a barrow with about an imperial gallon of milk in it. The milk had a quantity of sooty particles floating on the surface, and a considerable quantity of filthy-looking matter in the bottom layers. The Inspector having informed me, I examined and condemned the milk as unfit for human consumption, and directed him to take it before the Magistrate, who ordered its destruction. A sample was taken, and after standing a few hours the milk gave off an offensive smell. The sediment, on microscopical examination, was found to consist of vegetable and other debris. fine grit, hairs, fibres of clothing, &c. The process by which the cream is separated results in a considerable proportion of the impurities being removed, presumably, therefore, the contamination found in this milk must have occurred subsequently. The nature of the sediment suggested the street or a stable yard as its source, and possibly it may have been introduced by the dipping in the churn of the hand-can from which the milk was 74 sold. This would be placed on the ground while the man was serving from it. and on again being dipped into the milk, any matter adhering to it would be washed off and remain in the churn. The Medical Officer of Health of Southwark informs me that the man from whom Hughes bought the milk, and from whom he hired the barrow, at that time sold milk in the street. Hughes, having failed to appear at Westminster Police Court in answer to a summons, was arrested on a warrant. The hearing was adjourned to October 16th to enable Hughes to produce, as a witness the man from whom he bought the milk, but at the adjourned hearing no evidence was offered in defence, and the Magistrate (Mr. Horace Smith) convicted Hughes under Section 47 of the Public Health Act, 1891, and inflicted the maximum penalty of six months' imprisonment with hard labour. Pigs' Carcases Seized.—One of these pigs had tuberculous glands on both sides of the neck which were not, however, very apparent until the head was taken off. It was alleged that the pig had been examined and certified as sound in Holland, but the owner was unable to produce the 'certificate. There was, however, some evidence that a label had been fixed with wire in the usual place. The other pig, which came from Ostend, through the Central Meat Market, had a large ischio-rectal abscess full of very offensive matter ; the pig was somewhat emaciated, and had probably suffered from septic absorption. It appears to have escaped official inspection in the market, but its condition was at once detected by the retail dealer and the inspector as it was being unloaded outside the shop. Both pigs were destroyed under a Magistrate's Order, but no further action was possible as it could not be proved that the firms in the Central Meat Market who sold them, were aware, at the time of sale, that the pigs were in a condition liable to be seized. In the first case, also, there was the probability that the pig had been examined and passed in Holland. Boracic Acid in Imported Meat.—The attention of the Local Government Board has been drawn to the fact that in two samples of tripe and kidneys sold in Westminster, boric acid to the amount of 49½ and 69 grains per lb., respectively, had been found. It appears that these articles are imported from America, packed in barrels in a solution of the acid. Under the Public Health (Regulations as to Food) Act, 1907, the Local Government Board have power to deal with such food stuffs at the port of entry.* *The Board have since issued a report by one of their Inspectors (Dr. Buchanan), who recommends that the importation of such food stuffs so preserved should be prevented. There is also a further report by Dr. McFadden with regard to tripe. 75 Restaurants, &c.—The Council, from the experience derived from the inspection of bakehouses and licensed premises, considered it desirable that a systematic examination be made as to the sanitary condition of other restaurants and places where food is cooked for sale, and they, therefore, allocated this work to one Inspector (Mr. Dee), who began this special work on the 13th March, in businesses of the followingdescription:— (a) Restaurants of all kinds, including ham and beef shops and pork butchers' premises where food is cooked for sale, fried fish shops, &c. (b) Places where potted meats are prepared. (c) Places where ices and mineral-waters (aerated and non-aerated) are prepared. In a city like Westminster, where restaurants exist in large numbers and are largely patronised by visitors from all parts, it is extremely important to ascertain that due regard is paid to cleanliness, that food is prepared and kept in premises not liable to contamination, and that generally the premises are in thorough sanitary condition. Inspector Dee has visited 787 premises, and the results justify the decision to have this special inspection In 128 premises the sale was confined to food cooked elsewhere. These were chiefly licensed premises which had already been inspected and put into a sanitary condition; of the remainder 567 were restaurants, 21 fried-fish shops, 10 pork butchers (selling food cooked on the premises), 6 ham and beef shops. 34 confectioners, 11 dairies and G bakers, each of the last three classes serving teas and light refreshments. He also inspected four premises where preserving or preparing food on a wholesale scale was carried out; 592 defects were found in 375 of these premises, and may be summarised under the following headings:— General dirty condition of premises 9 Walls and ceilings requiring cleansing 167 Defective ventilation of kitchens 31 Gas stoves used for cooking purposes requiring special ventilated hoods to carry off fumes 57 Food stored so as to be liable to contamination 34 Water-closets connected directly with:— (a) Kitchens 61 (b) Larders 11 (c) Dining rooms 54 Water-closets:— (a) Not ventilated to external air 7 (b) Defective, without water, or dirty 38 76 Drainage defective 97 Refuse bins without proper covers or in improper positions 10 Other defects 16 At first sight it may seem surprising that so many structural defects were found. The explanation is two-fold—any place may be opened as a restaurant without any certification as to its fitness, thus basements which have been used for storage purposes may be cleared out and fitted up as kitchens, without even any notice having to be sent to the Sanitary Authority, or, what very often occurs, alterations are made in existing restaurants to obtain more room or for other purposes, partitions which may have separated water-closets from rooms are taken down or open spaces are covered over. The possibility of these oscurrenees, as well as the want of care as to cleanliness, demands that every place of this description should be visited at least once annually, while a proportion of them require much more frequent visits. The need for this supervision is as much required in some of the more pretentious and fashionable establishments as in some of a cheaper grade. Many in all classes are conducted with the greatest care in every particular. It has only been necessary to ask for statutory notices in seven instances, and no further proceedings were found necessary to obtain the required improvements. The Inspector has pointed out to those who are not as cleanly as they ought to be that when the structural improvements asked for have been carried out increased attention will be given to cleanliness in the preparation and storage of food. As a rule, the kitchens are more dirty, and the mode of food preparation much less cleanly than in bakehouses. 869 visits of re-inspection were paid by Inspector Dee in connection with work which was being carried out or to places which were not being conducted in a cleanly manner. 356 visits were also paid by the other Sanitary Inspectors to those and to other restaurant premises, chiefly during the first quarter of the year, making a total of 2,012 visits to this class of business. Ice Cream Premises.—Inspector Dee found that at 87 of the restaurants, &c., he visited ice cream was prepared. In addition to the above 68 visits were paid by the Inspectors to other places where this commodity is prepared. In twelve instances the places so used were not in accordance with legal requirements. The conditions were rectified. 47 samples of ice cream were taken for analysis and reported as genuine. Three street sellers were cautioned for not having their name and address on their barrows, 77 Aerated Water Works.—These received visits during the year. In one instance, where this business was started on a small scale in a basement unsuitable for the purpose, the owner was persuaded to give up. Steps are being taken by the mineral water trade to raise the standard of their factories and the methods employed therein. Regulations have been framed for this purpose, and certificates as to sanitary conditions are to be asked for. In one case such a certificate was asked for and was granted after thorough examination of the premises. Bakehouses.—At the end of 1906 there were sixteen above-ground bakehouses in use; two have now to be added to the list and three have to be deducted (two not being in use at the end of the year); there are thus fifteen still in use. These are:— Bakehouses Above Ground (15). Berkeley Square, 7 Montpelier How, 23 Strand (Savoy Hotel) Buckingham Gate, 60 Old Compton Street, 10 Strut ton Ground, 6 Church Street, Soho, 9 Peter Street., 27 Victoria Street (Hotel Great Peter Street, 44 Romney Street, 48 Windsor) Horse and Dolphin Yard, 1 Shepherd's Market, 10 York Street, 42 Little Dean Street There were 81 underground bakehouses in use at the end of 1906. Four recently-constructed underground bakehouses were discovered, and as the Factory and Workshops Act, 1901, prohibits the construction of such, notices were served on the owners. In two instances aboveground bakehouses were constructed in their place, one other was given up, and the case of the fourth is being submitted to a Magistrate for his opinion, as the owners (a large hotel company) contend that it is not a retail bakehouse and is merely a department of the kitchen. At the end of 1907 there were 77 in use. They were Certified Underground Bakehouses (77). Bessborough Place, 12 Glasshouse Street, 50 and Marsham Street, 38 Brewer Street, 36 52 Macclesfield Street, 4 Broad Street, 39 Greek Street, 28 Motcomb Street, 11 Broad Street, 1 Greek Street, 47 New Bond Street, 173 Brompton Road, 124 Horseferry Road, 106 New Street (Covent Brook Street (Claridge's Hindon Street, 38 Garden), 13 Hotel) Jermyn Street, 78 New Street (Covent Carnaby Street, 22 Knightsbridge, 66 (Hyde Garden), 26 Chapel Street, 38 Park Hotel) Nassau Street, 12 Charlwood Street, 2 Lexington Street, 41 North Audley Street, 41 Charles Street, 15 Lupus Street, 5 Orange Street, 23 Curzon Street, 46 Lupus Street, 65 Oxford Street, 167 Churton Street, 2 Lupus Street, 109 Oxford Street, 197 and 199 Chandos Street, 7 Little Pulteney Street, 31 Oxford Street, 415 Eaton Terrace, 40 Little Pulteney Street, 4 Oxford Street, 159 Ebury Street, 160 Lower Belgrave Street, 16 Old Compton Street, 32 Elizabeth Street, 48 Moreton Street, 44 Piccadilly, 77 (Berkeley Foubert's Place, 4 Moreton Street, 18 Hotel) Erith Street, 11 Mount Street, 121 Pimlico Road, 69 Floral Street, 44 Marsham Street, 63 Portland Street, 29 F 78 Ponsonby Terrace, 35 St. Martin's Lane, 79 Victoria Street, 4 (West- Park Street, 51 Semley Place, 2a minster Palace Hotel) Raphael Street, 36 Sutherland Terrace, 7 "Warwick Street, 48 Regency Street, 9 Sussex Street, 15 Warwick Street, 19 Regent Street, 227 Strand (Hotel Cecil) Westmoreland Street, 3 Regent Street, 106 Tachbrook Street. 2 West Strand (Charing Rochester Row, 84 Vauxhall Bridge Road, 40 Cross Hotel) St. James's Street, 10 Victoria Street, 162 Whitaker Street, 4 "Liquid Eggs."—In consequence of a communication from the Medical Officer of the Borough of Stepney, that he had seized a quantity of "liquid eggs" in a condition unfit for food, and that the stuff was being supplied to bakers and confectioners, special enquiry was made, but only one baker and confectioner was discovered in Westminster who made use of eggs in this form, and the preparation was not obtained from the firm in question. Other bakers had tried "liquid eggs" but had not found the stuff satisfactory. Infectious Disease in Places where Food is Prepared or Sold (Hotels, Restaurants, Clubs, &c.), not including Milkshops. Scarlet Fever. Diphtheria. Typhoid Fever. Erysipelas. Total. (a) Illness in persons connected with the business 19 2 9 3 33 (b) Business in other parts of house 2 2 (c) Persons from infected houses employed elsewhere 17 7 2 1 27 38 9 11 4 62 Information reached me from a port sanitary authority that an alien (who had previously resided in London), had been admitted suffering from Trachoma, an infectious disease of the eyes, and was to be employed in the kitchen of a well-known restaurant. The man was discovered with some difficulty before beginning work, and the proprietor of the restaurant, on being informed, declined to engage him until he was cured. He was kept under observation for two months, when he was believed to be cured. Slaughter House.—There is only one (14, Regency Street), which is used occasionally. It was visited weekly. A Poultry Slaughter House was opened in the basement of a tenement house, the ground floor being used as a shop for the sale of Kosher meat and poultry. No special regulations exist for such 79 places, but the matter was dealt with under the ordinary nuisance sections of the Public Health Act, and the use of this place for the purpose was given up. Cowsheds.—There are only two cow-keepers, at 13, Marsham Street (licensed for 19 cows), and at 7, Arthur Street (licensed for 12 cows, but only two or three have been kept during the year). These premises were visited 48 times, and one notice was served. Milk Shops.—At the end of 1906, 332 names of persons selling milk were upon the register; 65 new names were added during 1907, and 12 removed, leaving 386 at the end of the year. 662 visits were paid. Whenever an application is made to be placed on the register,- an examination is made of the premises, and the sale of milk was stopped in three instances until sanitary defects were rectified. In a number of instances the premises could not be regarded as satisfactory from the other articles which were sold, and several applicants were persuaded not to add the sale of milk to their other business. In one case the sale of milk was discontinued only on the threat of proceedings. Notices were served with respect to defects in premises in which milk was sold. In one instance, cream cheese was being made in an unsuitable basement, and on notice being served the practice was discontinued. One case of enteric fever and one of scarlet fever occurred on premises in which were milk shops; no persons from houses in which fever occurred were employed in milk shops. In the enteric fever case the patient was a milk deliverer, and had been taking round milk up to five days of the nature of the disease being recognised. A list of the streets in which he sold milk was obtained, and the Medical Officers of the respective boroughs duly warned. No further cases appear to have arisen therefrom. The man, who had been employed in a similar capacity outside London up to a few weeks of being notified, is said to be suffering from consumption also. Two other enquiries have been made in connection with milk supplies:— (a) The first arose from a complaint received that some people had been made ill by the milk supplied them by a dairyman in the City. The complainant had an examination made of the milk, and it was reported to contain blood and pus. He thereupon communicated with me and the dairyman, who I found had at once stopped the supply from the farm, and sent his own Veterinary Surgeon to examine the whole of the cows, 108 in number. Two were found to be suffering from F 2 80 "chilled udders in one quarter," and milk from them was ordered not to be used for human food. On first becoming aware of the occurrence, I found that the dairyman had some of the milk in his possession, which had been despatched from the farmer before his message had been received, and took samples of it. These were submitted to microscopical and bacteriological examination, and pus with streptococci, staphylococci, and diplococci were found present in small quantity, but no blood; b. enteritidis sporogenes were absent. After exclusion of the affected cows, another sample of milk was taken and similarly examined, and found satisfactory. It is not clear from the conditions found that the milk from these two cows had caused the illness, and it appears further that the herd had been examined by the Veterinary Surgeon a few weeks previously, and he states nothing was wrong then. (b) The second enquiry resulted from a communication from the Medical Officer for the County of Middlesex, that a case of scarlet fever was being treated at a farm from which milk was said to be sent to Westminster. The farmer had undertaken to stop the supply until the patient was well. It was found eventually that one firm had at one time received milk from this farm, but had given up the supply some years ago, and that none of the milk was being sent to Westminster. 81 Sale of Food and Drugs Acts. Samples Purchased under the Sale of Food and Drugs A cts, showing result of Analysis and subsequent Proceedings. Number. Articles of Food. Number of Samples Purchased. Genuine. (Inferior in brackets.) Adulterated. Prosecutions. Convictions. Warranty or Disclosure. (Withdrawn and Dismissed. Fines. Costs. £ s. d. £ s. d. 1 Milk 792 625 (92) 75 43 23 20 36 10 6 22 15 6 2 do. Separated 4 2 2 2 2 — 3 0 0 2 8 0 3 do. Skimmed 4 4 4 do. Dried 3 2 1 5 do. Condensed 12 12 6 do. Machine Skimmed condensed 8 8 7 Cream 65 10 55 5 4 1 5 0 0 4 10 6 8 do. Ice 47 47 9 Butter 217 198 (8) 11 4 4 — 2 0 0 1 17 6 10 do. Milk Blended 1 1 11 Margarine 57 56 1 1 1 — 0 10 0 0 12 6 12 Cheese 11 10 1 13 Lard 3 3 14 Coffee 51 49 2 1 — 1 15 do. Extract or Essence 12 10 (2) 16 do. and Chicory 1 1 17 do. and Chicory Extract 4 4 18 Cocoa 40 39 1 1 1 — 5 0 3 19 do. Mixture 2 2 20 Oil, Olive 21 21 21 do. Salad 1 1 22 Honey 29 29 23 Jams, various 10 10 24 Fruits, preserved 20 20 25 Meats, potted 93 75 (1) 17 26 Fish, tinned 73 64 (1) 8 1 1 — 2 0 0 3 3 0 27 Kidney and Tripe 2 2 28 Sausage 3 2 1 29 Pepper 14 14 30 Vinegar 16 16 31 Mustard 20 19 1 32 Peas, preserved 24 9 15 1 1 — 2 0 0 1 3 0 33 Beans, preserved 12 2 10 1 1 — 1 0 0 2 2 0 34 Asparagus, preserved 2 2 35 Spinach, preserved 9 - 9 7 6 1 37 0 0 6 1 0 36 Vegetables, preserved 8 6 2 37 Mineral waters 11 11 38 Cod liver oil 18 18 39 Sulphur, flowers of 1 1 40 do. milk of 31 29 2 2 2 — 4 10 0 1 5 0 41 Tartar, cream of 34 26 (6) 2 42 Zinc, oxide of 10 10 43 Zinc ointment, oxide of 4 4 44 Saffron 1 1 Totals 1,800 1,472 (110) 218 69 46 23 98 10 6 45 17 6 82 Milk.—792 samples of ordinary milk were taken during the year Of these 75 (9.40 per cent.) were reported by the Analysts to be below the standard of the Board of Agriculture, and 47 samples were just on the border line, making a total of 15.4 per cent. of the samples. The percentage of adulterated is below the average (13.5 per cent.), of the preceding 4 years. The Analysts have graded the samples submitted to them into four groups:—Good quality, in which the fat was over 3.8 per cent.; fair quality, in which the fat was between 3.3 and 3.8 per cent.; and poor or inferior quality, in which the fat was between 3 per cent. (the official standard) and 3.3 per cent., or in which the non-fatty solids were between 8.5 and 8.6 (if the fat was also below 3.8). terated are below the standard. The official standard is 3 per cent. for fat and 8.5 for solids not fat. District. Total. Good Quality. Fair Quality. Poor Quality. Adulterated. No. Percent. No. Per cent. No. Per cent. No. Percent. South 345 130 37.6 125 36.2 65 18.8 25 7.20 North 447 125 28.2 165 36.9 107 23.9 50 11.2 1907 792 255 32.2 290 36.6 172 21.7 75 9.40 1906 80S 267 33.1 252 31.2 168 20.8 119 14.07 1905 831 305 36.7 281 33.8 153 18.4 92 11.07 Forty-three prosecutions were taken with regard to adulteration— 18 for fat abstracted, 5 for added water, 2 for both offences in the same sample. Warranties or disclosures were proved in 18 instances Eleven cautions were given to sellers whose milk contained less than 5 per cent. of added water, or had less than 5 per cent. of fat abstracted; in none of these was it found necessary, on subsequent samples being taken, to take further proceedings; 68.8 per cent. of the samples were of good or fair quality, well above the official standard as compared with 64.3 in 1906. Details of the proceedings taken are appended. Sunday Samples.—One hundred and forty-nine of the samples of milk were taken on eleven Sundays during the year; 11 (7.30 per cent.) were found to be adulterated and 1 (0.50 per cent.) was inferior, an improvement on 1906, when the figures were 10.5 and 3 per cent. respectively. Sunday used to show a larger percentage of adulteration than week days. Samples taken in course of Delivery— (a) At Railway Stations.—Fifty-three samples of milk were taken on arrival at Victoria and Charing Cross Railway Stations. Thirty-six were reported of good quality, 15 fair, 2 poor, and 1 adulterated. 83 (b) On Delivery at Shops.—Twenty samples of milk were taken as it was being delivered to retail customers. Of these samples, 5 were good, 6 fair, 7 poor, and 2 adulterated (1 had 26 per cent. of fat abstracted and 1 had 11 per cent. added water). These samples were taken in consequence of the milk sold by the retailer having been previously sampled and found below the limit. The number of samples of milk taken in each of the last seven years are as follows:— 1901. 1902. 1903. 1904. 1905. 1906. 1907. New 492 491 608 741 831 806 792 Separated, condensed, sterilised or dried — 55 55 31 36 11 31 Total 402 546 663 772 867 817 823 In the cases given below attention is called to various points of interest, thus on No. 150 S. a question is raised as to whether a warranty is a protection if a defendant has by neglect skimmed the fat from the milk; on No. 280 the question of the change which milk undergoes when heated was raised, the defendant's analyst stated that when milk was heated above 160 degree Fahrenheit the curd which was formed absorbed the fat, and no amount of stirring would separate it, but if the milk was kept below that temperature it underwent no change of this kind; apparently the defendants kept the milk hot for mixing with coffee, and when a glass of warm milk was asked for, cold milk was added to cool it; in the same case the question of warranty was raised. The vessel from which the Inspector was served contained milk which had been received from two different farmers, each of whom had given a warranty. Separated Milk.—A considerable quantity is sold in the City, almost entirely by street vendors, and much of it is pasteurised. Eight samples were taken, and two prosecutions resulted. A Dried Milk was reported as containing 5 per cent. of dextrinised starch, a milk-blended butter 27 per cent. of water, a margarine 45 per cent. of butter-fat, and a cheese 15 grains of boric acid per lb. Cream.—Sixty-five samples of cream were obtained, of these 19 were fresh cream, two Devonshire cream, and 37 samples were sold in pots and generally marked with a label stating that the cream contained a small percentage of boron preservative and two were in bottles and five in tins. Of the 19 fresh creams bought loose one only was found free from preservatives; boric acid was found in the others in amounts varying 84 from 3.5 to 18 grains per lb. There does not appear to be any rule or method in adding this preservative, as the amounts varied within these limits as much in the cold months as in the hot. Possibly, some dairymen add the acid to cream left over on Saturdays, as the average of the samples taken on Saturday nights, Sunday mornings and Monday mornings is higher than that on other days. The samples of Devonshire clotted cream were both free from preservatives. Of the remainder those sold in bottles were free from preservatives, one was bottled in England and one in Holland; five put up in tins were also free from preservatives, and came from Austria, Switzerland and Norway. They had evidently been pasteurised or sterilized by heat. The jar creams were all prepared in England, and all contained boracic acid in very varying proportions—7.7 to 38.4 grains per lb. Samples were taken in the months of February, April, May, June, July and October. In February one had 6.5 grains, others 15 to 17.5 grains; in April one had 38.4 grains, others 14 to 18.3 grains; in May 17 grains; in June one had 7.7 grains; three varied from 12.8 to 15.2; one had 19.3 and the others 28.5 to 32.5 grains; in July the lowest were 16, 16.8 and 19; six ranged from 21 to 23 grains; three went up to 32 and one to over 42 grains; in October the amount varied between 22 and 26.5 grains. Apparently some dairies add more of the acid in the hot months, but others seem to find 16 or 17 grains sufficient all the year round. The Public Health Committee are of opinion that boracic acid is a drug which should not be used in human food, and they have been struck by the indiscriminate and loose manner of its use which analyses of cream and other articles of food has revealed to them. While holding the opinion that other and better methods can and ought to be employed, they have been guided in legal actions which they have taken by the recommendation of the Departmental Committee, which reported in 1901 "that the only preservative which it shall be lawful to use in cream be boric acid or mixtures of boric acid and borax, and in amount not exceeding 0.25 per cent. expressed as boric acid" (that is 17½ grains per lb.), "the amount of such preservative to be notified by a label on the vessel." A number of summonses have been taken out in cases where this amount has been materially exceeded, and the Police Magistrates, who have heard the cases, have expressed the opinion that the Council had taken a line of action to which traders ought not to object. It transpired, however, that the cream trade is of opinion that not less than 35 grains was absolutely necessary, and with the hope of obtaining a decision which would justify them in adding this amount they resolved to appeal in one of the cases, selecting for that purpose the case of Cullen, in which 21.91 85 grains of boric acid had been found, all the other cases being adjourned pending the decision. The appeal was heard by Mr. Robert Wallace, K.C., the Chairman, and a Bench of Magistrates, at the Quarter Sessions, at Clerkenwell, on October 31st, November 8th and 18th, and a large number of witnesses were called on both sides; for the Council, Mr. Reginald Harrison, Prof. Halliburton, Dr. Ralph Vincent, Prof. Kenwood, Mr. Henry Droop Richmond, F.I.C., Chemist to the Aylesbury Dairy Company; Mr. Cassal, the Public Analyst; myself, and Mr. McNair, the Inspector, who purchased the sample, gave evidence. Mr. McCall, K.C., Mr. Courthope Munro, and Mr. W. F. Clark represented the Council. The appellant was represented by Mr. W. R. Bousfield, K.C., Mr. E. Page, K.C., and Mr. G. Elliott, who called as witnesses Drs. Thresh, Hutchison, Thompson, Yaisey and Luff; Messrs. Bannister and Lloyd, chemists; and four representatives of Dairy Companies. The Court dismissed the appeal with costs, the Chairman, in giving judgment, said:— "In this case the appellant was convicted before the learned police magistrate under Section 3 of the Food and Drugs Act, as selling an article of food mixed, to put it shortly, so as to be injurious to health, and from that decision he has appealed to this court. Now, first, some discussion has arisen in regard to the meaning of the Act itself, Section 3, and we have considered who the class of persons are whose health might or may be injured by the article of food so sold. In our opinion the persons included are, first, what we may call normal persons, and not an invalid in the ordinary sense—that though this article thus mixed would be unprejudicial to the health of the general community even when it might be prejudicial to persons afflicted with particular diseases, we don't think that it would come within the terms of the Section; on the other hand we do think, and for this reason—because of certain findings of fact which I am about to go into—we do think that it includes cases of children and infants, and we think so because we think that now cream has become part of the food used by infants more than formerly. As a question of fact we find that this Section only of course applies to foods and the classes who use those foods, and if cream was not ordinarily used by infants then this Section would have no application, but as we think that now infants do use cream mixed with their milk we think that this Section applies to infants as well, and I may say in regard to that that if there is any desire expressed as to the ground on which we include infants in the classes we will state a case to anyone who is dissatisfied with our finding in respect to this matter. The finding of fact remains of course. We find as a fact that cream is now an article of diet used by the class to whom we referred—the class 86 of children—as an article of food. We are of opinion in regard to this matter that cream if mixed with boracic acid equivalent to that found in this case is as regards grown men and women uninjurious, but we are of opinion that it is injurious to the health of children and invalids. I need not refer to the class of invalids as for the reason given we don't think that they are referred to in the Section, and holding that view that it is injurious to children—to infants and children—and that infants and children are a class to whom this Section can be taken as those by whom this food is used and to whom this Section applies, we hold under these circumstances that the conviction must be affirmed and the appeal dismissed with costs." A further appeal has now been taken to the High Court on a point of law, viz., as to the construction to be placed upon Section 3 of the Food and Drugs Act. From the evidence given, apparently what the trade really want is permission to use 35 grains of one or other of the preparations supplied them and not 35 grains of pure boric acid. It was estimated that 35 grains of one preservative which was mentioned contained 21 grains of boracic acid. Mr. Droop Richmond stated that if cold storage was not employed, even 35 grains of boric acid would not enable people to keep cream in pots for several days in hot weather. Without the addition of any preservative, cream will keep good for two and three-quarter days if kept at a temperature of 50 degrees, and for five days if kept at 40 degrees. At an air temperature of 60 degrees Fahrenheit cream would keep the same length of time with the addition of 17½ grains of boric acid.* An important point to note is that although the addition of boric acid may prevent souring of the cream, it does not necessarily prevent putrefaction taking place, and even masks its existence for some time. Further, if the germs of infectious diseases are present, such as those of typhoid fever, scarlet fever, or tuberculosis, they are not destroyed. Coffee.—What purports to be coffee of the best quality is being largely sold in penny packets, but in an out-of-the-way corner there is a statement to the effect that it is a mixture. Analysis showed that the amount of chicory present was no less than 85 per cent. The Public Health Committee prosecuted in one case with a view to calling attention to the method adopted. The Magistrate held that the notice as to the contents being a mixture was a good defence. It would be well if persons who sell such mixtures were required to state the per- *A report of the case "Cullen y. McNair" is given at some length in the Lancet, January 11th, 1908. 87 centage of coffee present, or be prohibited from making use of labels which convey a wrong impression. Fifteen samples of coffee and chicory essences were taken, as it bad been stated that there was an absence of coffee in some. Analysis showed the presence of caffein; in all but two it was in rather small amount. Potted Meats and Fish.—In 1906 a large number of samples were taken. The articles taken and number of each were:— No. containing Preservative. Amount of Boric Acid Found. 1 anchovies - - 6 beef — — 4 brawn 3 9.8 grs.; 10.3 grs.; 7.2 grs. per lb. 1 boar's head — 6 herrings 1 3 grs. 4 herrings in tomato sauce — - 1 herring roes — - 8 lobsters — - 4 prawns — - 1 prawns in jelly — - 23 salmon — - 14 sardines — - 1 sardines and anchovies — - 1 shrimps (peeled) 1 43 grs. 9 tongues 1 16.1 grs. 2 tunny fish — — 1 wild duck — — Pastes. 1 anchovy — — 7 bloater — — 17 chicken and ham 5 27.5 grs.; 26.46 grs.; 3.0 grs.; 3.9 grs.; trace. 2 chicken, ham and tongue 2 9 grs.; 11.9 grs. 1 chicken and tongue — — 1 ham and tongue 1 14 grs. 2 lobster — — 28 salmon and shrimp 5 20.44 grs.; 24.7 grs., 18.5 grs.; 19.4 grs.; 20.5 grs. 3 shrimp 2 2 grs.; 27.2 grs. 1 turkey and ham 1 33.46 grs. 5 turkey and tongue 2 24.78 grs.; trace. 1 veal and ham 1 7.4 grs. Apparently the ingredients were found to be as specified on labels. In 1906, when the Council took a number of samples, very large amounts of preservatives were found, and the manufacturers were then communicated with. It is gratifying to note that the warning was acted upon, and that now the presence of boric acid is practically confined to articles containing pork or shrimps. It is also evident that most makers of this class of goods do not now use ingredients which have been preserved with boric acid, and if they can do so there does not seem to 88 be any reason why other manufacturers should not take equal care. Proceedings were taken with regard to the peeled shrimps which came from Heligoland, and a penalty was inflicted. The importer further voluntarily undertook to give up their sale. Tinned Vegetables.—The action of the Westminster Council with regard to vegetables coloured with sulphate of copper has led to the introduction of several brands free from such colouring matter, and of excellent appearance. Among those makers who still use it the amount has been very considerably reduced. Thus in 23 samples of bottled peas there was no copper in 8, less than 1 grain in 3, less than 1 ½ grains in 5, under 2 grains in 1; those in excess were 2.04, 2.17, 2.21, 2.45, 2.7, and 3.59 grains. A sample of dried peas examined was found to be genuine, but a powder given along with them in a packet was found to be a mixture of borax and carbonate of soda. French or haricot beans were sampled 12 times; 2 had no copper, 1 a trace, 3 less than 1 grain, 5 less than 2 grains, 1 only exceeded, viz., 2.34 grains. Of 6 samples of mixed vegetables, 1 had less than 1 grain, the others none. Preserved asparagus had no preservative added. Spinach continues to give higher amounts than other vegetables, the 9 samples yielding 17 grains, 2.3, 2.5, 2.6, 3.5, 4.75, 4.86, 5.32, and 6.63 grains respectively. Probably in a number of instances where the higher figures were obtained, the Inspector was served from old stock. Preserved Fruits.—Sixteen samples, made up of pine apple, peaches, apricots, pears, greengages, and cherries, were analysed and found free from preservatives. Drugs.—In six of the cream of tartar samples the amount of lead present did not exceed 0.0005 per cent., and in four not more than 0.002 per Cent., the quantity suggested by the Local Government Board as the limit. Two summonses were taken in respect of milk of sulphur. Seventy-five per cent. of the total samples were purchased by the Inspectors by means of agents. 314 samples, chiefly milk, were taken on Sundays, or at times other than the usual office hours, mostly early in the morning. Particulars of each case are appended:- 89 Legal Proceedings' Under the Food and Drug Acts during 1907. No. of Sample. Date of Hearing. Court and Magistrate. Name and Address of Defendant. Offence. Result. 1 2 3 4 5 6 1907. MILK (Including Refusal to Sell and want of Name on Can). 78 N. 21st February Marlborough Street (Mr. Horace Smith) David Pearce, 22, Lexington Street 9 per cent. of fat abstracted Warranty proved. Summons dismissed. 113 S. 22nd March Westminster (Mr. Curtis Bennett) John Button, 8, Rochester Row, S.W. 8 per cent. of fat abstracted Having regard to the defendant's previous good character, the Magistrate inflicted no fine, but ordered him to pay £1 13s. 6d. costs. 167 N. 11th April Marlborough Street (Mr. Kennedy) Dominie Orsi, 1, Whitehorse Street, W. 50 per cent. of fat abstracted,. Fined £1 and 12s. 6d. costs. 142 S. 12th April Westminster (Mr. Curtis Bennett) Mrs. Loveday, 7, Aylesford Street 6 per cent. of added water The defendant stated to be dying. Summons withdrawn. 150 S. 12th April Westminster (Mr. Curtis Bennett) Spiers and Pond, Ltd., 35-38, New Bridge Street, Blackfriars Selling milk at Victoria Station Refreshment Room with 10 per cent. of original fat abstracted Summons dismissed on account of warranty. The defendants raised two defences, firstly, that the usual notices were displayed in a position perfectly visible to the Inspector, and that he was also served in a glass containing the usual notice that the milk was not guaranteed; and secondly that there was a warranty on which they relied. The defendants' witnesses admitted that the milk had not been stirred, and stated that they never did stir it. The City Solicitors contended that, the warranty was valueless as the defendants, on their own admission, had not sold the milk in the same state as they purchased it, having, by their neglect, skimmed it in favour of the earlier customers; but the Magistrate, however, held the warranty a protection, and said the defendants were not bound to stir the milk. 204 N. 2nd May Marlborough Street (Mr. Denman) Charles Golden, 43, Lexington Street 8 per cent. of fat abstracted Fined £1 and 12s. 6d. costs. 211 N 2nd May Marlborough Street (Mr. Denman) Atanasio D'alessandri, 393, Oxford Street Warm milk, 27 per cent. of fat abstracted Fined £3 and 12s. 6d. costs. 243 N. 6th May Bow Street (Mr. Marsham) Dairy Supply Co., Ltd., 29, Museum Street Sample of milk taken in course of delivery at the Charing Cross Hospital on the 25th March, 1907; contained 11 per cent. of added water Warranty proved. Summons dismissed. 90 No. of Sample. Date of Hearing. Court and Magistrate. Name and Address of Defendant. Offence. Result. 1 2 3 4 5 6 1907. 222 S. 17th May Westminster (Mr. Curtis Bennett) Annie Sly, 22, Catherine Street, Westminster 10 per cent. of fat abstracted Fined £1 and £1 3s. costs, or 14 days' hard labour. 228 S. 17th May Westminster (Mr. Curtis Bennett) Alfred Fumagalli, 12, Wilton Road, S.W. 6 per cent. of fat abstracted Defendant pleaded warranty, but documentary evidence held insufficient to connect milk sold with the warranty. Ordered to pay £1 3s. costs. 290 N. 29th May Bow Street (Mr. Marsham) J. Lyons and Co., Ltd., Cadby Hall, Kensington Selling at 34, Bow Street, milk with 15 per cent. of fat abstracted Warranty proved. Summons dismissed. 269 N. 29th May Bow Street (Mr. Marsham) Renoaldo Mansi, 37, Chancery Lane 10 per cent. of fat abstracted. The defendant having left the premises, the summons was adjourned sine die. 315 N. 30th May Marlborough Street (Mr. Plowden) Timothy Jones, 5, Bateman Street 7 per cent. of fat abstracted Warranty proved. Summons dismissed. 306 N 30th May Marlborough Street (Mr. Plowden) Amelia R. Black, 12, Little Grosvenor Street 10 per cent. of fat abstracted Fined 5s. and 12s. 6d. costs. 304 N. 30th May Marlborough Street (Mr. Plowden) Amelia R. Black, 2, Grosvenor Mews 6 per cent. of fat abstracted, and 4 per cent. of water added Fined 5s. and 12s. 6d. costs. 208 S. 31st May Westminsrer (Mr. Curtis Bennett) Daniel E. Davies, 10, Broadway, Westminster 14 per cent. of fat abstracted Warranty proved.) Summons dismissed. 285 N. 5th June Bow Street (Mr. Marsham) Hermann Appenrodt, 442, Strand 14 per cent. of fat abstracted Warranty proved. Summons dismissed. 264 N. 5th June Bow Street (Mr. Marsham) R. Griffiths, 9, Endell Street 12 per cent. of fat abstracted Defendant relied on a warranty, and the Inspector's bottle containing 3rd sample had burst. Summons withdrawn. 381 N. 25th June Marlborough Street (Mr. Denman) Ernest Law, 8, Crown Court.. 8 per cent. of fat abstracted Fined £2 and 12s. 6d. costs. 91 331 S. 28th June Westminster (Mr. Curtis Bennett) Peter Fergusson Anderson, 7, Sutherland Street, Pimlico, S.W. 8 per cent. of fat extracted Fined £2 and 12s. 6d. costs. 311 S. 28th June Westminster (Mr. Curtis Bennett) Alice Jones, 15, Brewer Street, S.W. Selling milk in Carlisle Place, 9 per cent. of fat abstracted Warranty proved. Summons dismissed. 280 N. 5th and 26th June and 3rd July Bow Street (Mr. Marsham) Aerated Bread Co., Ltd., 24, Eastcheap, E.C. Selling at 453, Strand, warm milk with 12 per cent. of fat abstracted *Fined £3 and £5 5s. costs. *The defendants relied on a warranty, but, having mired the milk supplied to them by two farmers together, the Magistrate was against them on the question of the warranty; the defendants' solicitors then raised the point that milk in the course of heating necessarily lost some of its fat and that, there being no standard for warm milk, the Sale of Milk Regulations did not apply, but their witnesses admitted that no change would occur if the milk was not heated above 160° F.; the Magistrate was against them on this point also, finding that warm milk as supplied was not above 160°. 401 N. 12th July Marlborough Street (Mr. Mead) Mrs. Harriet Thorp, 7, St. Annes Court 12 per cent. of fat abstracted Fined £1 9s. 6d. and 12s. 6d. costs. 409 N. 12th July Marlborough Street (Mr. Mead) Cream Dairy Co., Ltd., 27-31, Caledonian Road, N. 26 per cent. of fat abstracted at 45, Deau Street Warranty proved Summons dismissed. 412 N. 12th July Marlborough Street (Mr. Mead) J. W. Carpenter, 7, Carburton Street 5 per cent. of fat abstracted Warranty proved. Summons ^ dismissed h- 410 N. 12th July Marlborough Street (Mr. Mead) M. Waranovsky, 21, Little James Street 5 per cent. of fat abstracted Warranty proved. Summons dismissed. 422 N. 12th July Marlborough Street (Mr. Mead) William Davies, 26, Frith Street 9 per cent. of fat abstracted Warranty proved. Summons dismissed. 490 N. 25th July Marlborough Street (Mr. Mead) Serafino Bazzinotti, 64, Poland Street 9 per cent. of fat abstracted Fined £2 and 12s. 6d. costs. 474 N. 25th July Marlborough Street (Mr Mead) Fuller's, Ltd., Great Church Lane, Hammersmith 16 per cent. of fat abstracted at 207, Regent Street Warranty proved. Summons dismissed. 372 S. 26th July Westminster (Mr. Curtis Bennett) George Douglas Barnes, 25, North Audley Street 25 per cent. of fat abstracted Warranty proved. Summons dismissed. 394 S. 2nd August Westminster (Mr. Curtis Bennett) Williamson's, Ltd., 4, Lloyd's Avenue, E.C. Selling at 17, Wilton Road, milk containing 10 per cent. added water Fined £3 and 12s. 6d costs. 567 N. 8th August Marlborough Street (Mr. Mead) James Fleming's Restaurants, Ltd., 307, Oxford Street, W. 53 per cent. of fat abstracted Fine £4 and 12s. 6d. costs. 456 S. 2nd and 9th August Westminster (Mr. Curtis Bennett) Mary Evans, 9a, Lancelot Place, Knightsbridge 9 per cent. of fat abstracted Warranty proved. Summons dismissed. 595 N. 22nd August Marlborough Street (Mr. Mead) John Jones, 25, James Street, St. Marylebone Selling in Gilbert Street milk 19 per cent. of fat abstracted Fined 1s. and 12s. 6d. costs. 92 No. of Sample. Date of Hearing. Court and Magistrate. Name and Address of Defendant. Offence. Result. 1 2 3 4 5 6 1907. 634 N. 27th August Bow Street (Mr. Marsham) Frederick W. Roberts, 14, Mercer Street 15 per cent. of fat abstracted Fined £1 and 12s. 6d. costs. 810 N. 14th November Marlborough Street (Mr. Mead) Thomas Jones, 26, Broad Street Selling in Dean Street milk with 6 per cent. added water Fined £2 and 12s. 6d. costs. 746 N. 14th November Marlborough Street (Mr. Mead) Herman Frenthal, 27, St. Anne's Court 13 per cent. of fat abstracted Fined £2 and 12s. 6d. costs. 767 N. 14th November Marlborough Street (Mr. Mead) J. Morgan (trading as Morgan and Son), 17, Air Street Selling in Vigo Street milk 13 per cent. of fat abstracted Warranty proved. Summons dismissed. 821 N. 5th December Marlborough Street (Mr. Mead) J. E. Mason, 15, Charles Street, Haymarket, S.W. 8 per cent. of fat abstracted Warranty proved. Summons dismissed. 617 S. 13th December Westminster (Mr. Curtis Bennett) Fanny Fraisnais, 2, Lewisham Street, S.W. 16 per cent. of added water Fined 10s. and 12s. 6d. costs. 1908. 776 S. 3rd January Westminster (Mr. Curtis Bennett) Charles Nurse, 26, Eccleston Place, S.W. 17.5 per cent. of added water Fined £2 and £1 5s. costs. 783 S. 17th January Westminster (Mr. Curtis Bennett) Geo. Henry West, 8, Ponsonby Place, Westminster 6 per cent. added water and 21.27 per cent. of fat abstracted. Fined £2 and £1 3s. costs. 992 N. 23rd January Marlborough Street (Mr. Mead) Silvestre Orefici and Silvestre Pinelli, 26, Sherwood Street 6 per cent. of fat abstracted Conviction against Silvestre Pinelli. Fined £3 and £1 3s. costs. 1907. SEPARATED MILK. 468 S. 25th October Westminster (Mr. Curtis Bennett) Albert Hawkins, 85a, Lillington Street, S.W. 4.79 grains of boracic acid per pint Fined £2 and £1 3s. costs. 597 S. 8th November Westminster (Mr. Curtis Bennett) Charles Wall, 89, Wandsworth Road, S.W. Selling separated milk in Kinnerton Street containing less than 9 per cent. of milk solids and at least 10.82 per cent. of extraneous water Fined £1 and £1 5s. costs. 93 CREAM. 246 S. 31st May Westminster (Mr. Curtis Bennett) Thomas Powell, 21, Motcomb Street, S.W. 0.549 per cent. of boracic acid Fined £2 and £2 4s. costs. 367 S. 26th July Westminster (Mr. Curtis Bennett) Albert Henry Heddon, 35, Churton Street 28 grains of boracic acid per lb. Withdrawn on payment of £1 1s. costs owing to death of defendant's father, who owned the business at time of the sale. 368 S. 26th July Westminster (Mr. Curtis Bennett) Jane Banfill, 50, Cambridge Street 32 grains of boracic acid per lb. Fined £1 and 12s. 6d. costs. 439 S. 2nd August Westminster (Mr. Curtis Bennett) Wm. Henry Cullen, 4, Lupus Street 21.91 grains of boracic acid per lb. Fined £2 and 12s. 6cl. costs. Notice of appeal given. 458 S. 2nd August Westminster (Mr. Curtis Bennett) Pearks, Ltd., 6, Bayer Street Selling at 8, Lower Belgrave Street, cream with 23.87 grains of boracic acid per lb. Adjourned sine die. 457 S. 2nd August Westminster (Mr. Curtis Bennett) Hudson Bros., Ltd., 50 and 52, Ludgate Hill Selling at 2, Wilton Road, cream with 32.48 grains of boric acid per lb. Adjourned sine die. 431 S. 2nd August Westminster (Mr. Curtis Bennett) Henry William Coppen, 42, Marsham Street 32.2 grains of boracic acid per lb. Adjourned sine die. 441 S. 2nd August Westminster (Mr. Curtis Bennett) S. Frost and Co., Ltd , 202, Kennington Park Road Selling at 105, Lupus Street, cream with 42.35 grains of boracic acid per lb. Adjourned sine die. 440 S. 2nd August Westminster (Mr. Curtis Bennett) Edwin Smith, 50, Moreton Street 31.85 grains of boracic acid per lb. Adjourned sine die. 460 S. 2nd August Westminster (Mr. Curtis Bennett) Oakshott's, Ltd., 2, Ellis Street, Sloane Street Selling at 65, Eton Terrace cream with 22.19 grains of boracic acid per lb. Dismissed on a technical ground. 639 S. 2nd August Westminster (Mr. Curtis Bennett) Eliza Johnson, 58, Marsham Street Cream with 26.6 grains of boracic acid per lb. Adjourned sine die. 649 S. 2nd August Westminster (Mr. Curtis Bennett) Express Dairy Company, Victoria Street Cream with 22.05 grains of boracic acid per lb. Adjourned sine die. 650 S. 2nd August Westminster (Mr. Curtis Bennett) Mrs. Day, 3, Artillery Row Cream with 26.25 grains of boracic acid per lb. Adjourned sine die. 655 S. 2nd August Westminster (Mr. Curtis Bennett) Cope Bros., 67, Buckingham Grate Cream with 24.78 grains of boracic acid per lb. Adjourned sine die. 455 N. - Marlborough Street (Mr. Mead) Civil Service Supply Association, Bedford Street, W.C. Cream with 0.42 per cent. of boracic acid Adjourned sine die. G 94 No. of Sample. Date of Hearing. Court and Magistrate. Name and Address of Defendant. Offence. Result. 1 2 3 4 5 6 1907. 570 N. - Marlborough Street (Mr. Mead) West End Grocery, Wine and Provision Stores, 397, Oxford Street Cream with 0.33 per cent. of boracic acid Adjourned sine die. 573 N. - Marlborough Street (Mr. Mead) Whsatley and Co., 65, South Audley Street Cream with 0.32 per cent. of boracic acid Adjourned sine die. 609 N. - Marlborough Street (Mr. Mead) S. Westmoreland and Co., 3, New Street, W.C. Cream with 23.1 grain9 of boracic acid per lb. Adjourned sine die. BUTTER. 92 S. 18th March Westminster (Mr. Horace Smith) Sarah Evans, 24, Chapter Street, Westminster Contained 75 per cent. of margarine Fined 10s. and 12s. 6d. costs. 98 S. 18th March Westminster (Mr. Horace Smith) Fredk. W. Nelson, 19, Morton Street, S.W. Contained 85 per cent. of margarine Fined 10s. and 12s. 6d. costs. 601 S. 8th November Westminster (Mr. Curtis Bennett) T. W. Gannaway, 22, Regency Street, Westminster Contained 86 per cent. of foreign fat Fined £1 and 12s. 6d. costs. MARGARINE. 93 S. 18th March Westminster (Mr. Horace Smith) Sarah Evans, 24, Chapter Street, Westminster Selling without a paper wrapper marked "margarine'1 Fined 10s. and 12. 6d. costs. COFFEE. 305 N. 30th May | Marlborough Street (Mr. Plowden) Amelia R. Black, 2, Grosvenor Mews Selling as coffee a mixture containing 85 per cent. of chicory Summons dismissed. There was a notice at one end of the packet describing the contents as a mixture of chicory and coffee. The Magistrate held this to be a good defence under Section 8, notwithstanding the position of the notice and the large percentage of chicory. COCOA. 483 N. 1st August Marlborough Street (Mr. Mead) Elian Asseraf, 3, Soho Street 60 per cent. added sugar Fined £5. 95 1908. TINNED SHRIMPS. 915 N. 8th January Bow Street (Mr. Marsham) Joseph Launay, 55, Charing Cross Road Peeled shrimps containing 43 grains per pound of boric acid Fined £2 and £3 3s. costs. 1907. SPINACH. 432 N. 12th July Marlborough Street (Mr. Mead) Hudson Bros., London, Ltd., 50 and 52, Ludgate Hill, E.C. Copper sulphate, 532 grains per lb. (160, New Bond Street). Fined £2 and 12s. 6d. costs. 412 N. 26th September. Adjourned from July 25th. Marlborough Street (Mr. Mead) John Bourbon, 81, Wardour Street Copper sulphate, 4.75 grains per lb. Fined £6 and 12s. 6d. costs. 445 N. 4th October Marlborough Street (Mr. Mead) G. Parmigiani, 58, Wardour Street Copper sulphate 4.86 grains per lb. Fined £20 and £1 1s. costs (Analyst's fee). 1908. 925 N. 9th January Marlborough Street (Mr. Mead) Henrietta Mary Masson and Henry Horace Spencer (Barto Valle Pepler and Co.), 60, Haymarket Copper sulphate, 6.63 grains per lb. Fined £6 and £1 3s. costs. 921 N. 9th January Marlborough Street (Mr. Mead) Edouard Robinson, 21, Old Compton Street Copper sulphate, 2.34 grains per lb. Fined £2 and £1 3s. costs. 920 N. 9 th January Marlborough Street (Mr. Mead) Jeanne Marguerite Barron, 13, Old Compton Street Copper sulphate, 3.59 grains per lb. Fined 10s. and 2s. costs. 972 N. 15th January Bow Street (Mr. Marsham) Receiver in Bankruptcy, 6, Coventry Street Copper sulphate, 2.56 grains per lb. Withdrawn. Costs 14s. 6d. paid. 960 N. 22nd January Bow Street (Mr. Marsham) Magdeleine Robert (Legros and Co.), 21, Lisle Street Copper sulphate, 2.64 grains per lb. Fined 10s. and 12s. 6d. costs. PEAS. 918 N. 9th January Marlborough Street (Mr. Mead) Jeanne Marguerite Barron, 13, Old Compton Street Copper sulphate 3.59 grains per lb. Fined £2 and £1 3s. costs. FRENCH BEANS. 734 S. 3rd January Westminster (Mr. Curtis Bennett) Oakshott's, Ltd., 2, Ellis Street, Sloane Street, and 3, Pimlico Road. Copper sulphate 2.346 grains per lb. Fined £1 and £2 2s. costs. Defendants stated that this bottle was an odd one left over from a special order two years ago of preserved fruits and vegetables for a school of cookery, and that the beans were usually used for garnishing and for soups. The sale of this brand had been given up by defendants. 96 No. of Sample. Date of Hearing. Court and Magistrate. Name and Address of Defendant. Offence. Result. 1 2 3 4 5 6 1907. MILK OF SULPHUR. 672 N. 24th September Bow Street (Mr. Marsham) J. A. Thompson, 9a, New Street, W.C. Contained 47.9 per cent. of sulphate of lime Fined £3 and 12s. 6d. costs. The defendant said that at one time it was quite legitimate to sell milk of sulphur containing sulphate of lime in the proportions found in the sample in question, but matters were altered ten or twelve years ago, and now only pure precipitated sulphur ought to be used. He had investigated the matter, and found that some of the old style milk of sulphur was kept at his Hackney establishment (to be used by dyers), and some of it had been sent by mistake to his New Street shop. GS8 N. 4th October Marlborough Street (Mr. Mead) Henry Lieblich, 166, Wardour Street Selling as milk of sulphur, flowers of sulphur Fined £1 10s. and 12s. 6d. costs.