(???) ANNUAL REPORT ON THE STATISTICS AND SANITARY CONDITION RELATING TO THE CITY OF WESTMINSTER FOE THE YEAR . 1915 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: HARBISON AND SONS, PRINTERS IN ORDINARY TO HIS MAJESTY, ST. MARTIN'S LANE, W.C. •,:v < S s: ■^ : ANNUAL REPORT ON THE STATISTICS AND SANITARY CONDITION RELATING TO THE CITY OF WESTMINSTER FOR THE YEAR 1915 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. TABLE OF CONTENTS. PAGE Introductory Remarks iii PART I. A. Statistics. Population 1 Births 3 Mother Craft and Child Welfare 4 Deaths 5 Infantile Mortality 6 Statistics of Block Dwellings 7 Common Lodging Houses 7 Tables 8-20 B. Communicable Diseases. Smallpox 21 Vaccination 21 Scarlet Fever 21 Diphtheria 23 Typhoid Fever 23 Ophthalmia Neonatorum 23 Tables 22-4 Tuberculosis 24 Diarrhoeal Diseases 31 Measles 31 Whooping Cough 31 Schools and Infectious Disease 31 Bacteriological Laboratory 33 Disinfection 34 Cleansing of Persons 34 Verminous School Children 34 Verminous Houses 35 Mortuaries 36 PAGE PART II. C. House Inspection, Sfc. Defects Remedied 37 Legal Proceedings 39 Drainage, &c., Plans 38 Removal of Refuse 38 Housing Conditions— Sanitary Survey of Houses 39 Underground Rooms, 40 Houses Let in Lodgings 41 Water Supply 41 Revenue Act 41 Smoke Prevention 41 Offensive Smells 42 D. Workshops. Number on Register 43 Defects 44 Outworkers 45 Infectious Disease 48 E. Food Supply. Restaurants, &c 49 Ice Cream Premises 49 Bakehouses 49 Certification of Food for Export 50 Milkshops 50 Food and Market Inspection 50 Sale of Food and Drugs Acts— Samples Taken, Result of Analysis and Proceedings 52 Milk and Cream Regulations 55 Details of Prosecutions 59 Annual Report on the Health and Sanitary Condition of the City of Westminster. 1915. To the Mayor, Aldermen, and Councillors of the City of Westminster. Mr. Mayor, my Lords, Lady and Gentlemen, I have the honour to submit to you my Annual Report for the year 1915. I have restricted the matter therein as far as possible to the Returns required by the Local Government Board, and particulars relating to Factories and Workshops required by the Home Office. . It is not possible with any degree of accuracy to state what were the birth and death rates during 1915, but from the figures given in the report it will be seen that the total number of births was less than in previous years, but unfortunately there was an increase in illegitimate births. More deaths were recorded, particularly of persons in the later years of life. Influenza and chest affections accounted for many of the deaths, but doubtless the anxieties and strain produced by the war told upon persons at the higher ages. An Act of Parliament was passed during the year extending the notification of Births Act of 1907, to enable local authorities to make arrangements for the care of mothers, including expectant mothers, and young children. At a time like the present, the urgent need for taking all possible steps to secure the health of mothers and children, and to diminish ante-natal and post-natal infant mortality is obvious, and local authorities were urged by the Local Government Board to prepare schemes whereby the services of hospitals and voluntary societies should be utilised and linked up with the work of the Borough Councils, on the lines laid down by the Board in their Memorandum of 30th July, 1914. A 2 iv Work on these lines has for some time been carried out in Westminster, but the Council decided that in order to secure greater efficiency the City should be divided into three parts, to each of which a Health Visitor should be appointed. To one of these the Council's Health Visitor (Mrs. Watkinson) was appointed, and with respect to the other two an arrangement was come to with the Westminster Health Society whereby that body should provide properly qualified health visitors. This scheme received the approval of the Local Government Board, and will be put into operation during 1916. Each of the three general hospitals in the City—Charing Cross, St, George's, and Westminster Hospitals—has a maternity department through which women receive medical and other attention at their homes, and if necessary, in difficult cases, can be admitted as in-patients to the hospital. Expectant mothers are also seen, and advice and treatment given as and when necessary. Inquiry is being made to ascertain how far they are prepared to co-operate with the Council in order that their schemes may be effectually linked up with that of the Council. Although Parliament placed upon the Borough authorities the. duty of carrying out work of this description, the County Council introduced a Bill asking that they should have power to supervise Lying-in-Homes. It was pointed out to the Committee of the House of Lords that if the County Council received such powers it would cause considerable overlapping, and the Committee apparently agreed that this would occur, but as there were in the Bill other sections dealing with urgent matters, not relevent to this portion, the Committee were forced to pass the Bill as it stood, otherwise had they substituted the Borough Councils for the County Council they were threatened that the whole Bill would be endangered. The Committee, however, were able to insert a clause empowering the County Council to delegate their powers. The Borough Councils subsequently expressed their willingness to undertake the duty, pointing out that it could be carried out without any extra expense, but the County Council declined to accede. Consequently these homes are now subjected to a double inspection. The County Council in their evidence relied upon the fact that they had two medical inspectors of midwives who could undertake the necessary supervision, anil that the number might be supplemented, but after the Bill was passed the Council appointed the Public Control Committee (which deals with weights and measures, storage of petrol, &c.) to carry out its provisions ! With the view of saving the lives of young children suffering from measles, the Local Government Board has made an Order making compulsory the notification of measles and German measles at the beginning V of 1916. The Order enables local authorities to provide medical, including nursing, assistance for the poorer inhabitants in their district when suffering from these diseases. It will cause a considerable increase in clerical work, and expense in fees. As special attention is asked to be given to young children suffering from the disease, it is probable that equally good results might have been obtained had notification been restricted to children. Hitherto, intimation of school children suffering from measles has been received from the teachers, and the families in Westminster have been visited, and where necessary nursing attendance has been obtained. In my report for 1914, I detailed the work which had ensued in consequence of 'the war. Co-operation with the Army authorities has been continued, and assistance rendered where possible. During 1915, while the various regimental headquarters were kept under weekly supervision, serious improvements had not to be carried out, but several hundred dwellings were inspected as to their suitability for billets. It is satisfactory to note that objection had to be taken on sanitary grounds to less than a dozen. Considerable work has resulted from the establishment of headquarters for the Canadian and Australian Forces, the utilisation of private houses as hospitals for officers, from the erection or conversion of existing premises into clubs and rest huts, from the fumigation of verminous clothing, and in connection with cases of infectious disease among soldiers, or in houses in which they were staying. In view of the prevalence of scarlet fever, diphtheria, and cerebro-spinal meningitis much care had to be taken to prevent infection being carried by soldiers to their regiments. Contractors for the supply of food for the Army have also been regularly visited, and the quality of the meat, vegetables, &c., used and the methods employed have been kept under supervision. Outworkers' premises, especially where Army work was being carried out, have received special attention. Refugees.—-Westminster continued for a good part of the year a's a centre for dealing with refugees, and at the Refuge in Poland Street a large number of Jewish refugees have been housed. This place entailed much supervision in the early days. An inspector has visited the premises daily. With regard to general sanitary work, the Council accepted the suggestion of the Local Government P>oard that, whilst not unduly relaxing the standard of public health administration in their area, local authorities should, as far as possible, refrain from requiring the execution of work, the cost of which has to be borne by private individuals, unless the work is urgently necessary for the removal of nuisances or for the protection of health. vi Food Inspection.—In view of the increased price of food, the Council decided that it was desirable to maintain the number of samples taken for analysis. The Committee promised by the Local Government Board before the war, to enquire as to the use of boric acid in cream, has not been formed, and the Council's attempts to keep down the use of this drug has been hampered thereby. The contention of the trade that the amounts recommended in Dr. Hamuli's report should be adopted in preference to that decided by the High Court has also led to some confusion. Dr. Hamill's report was founded on an investigation by Mr. Arthur Harden, D.Sc., on the length of time cream would keep sweet with varying quantities of boric acid at various temperatures, and the recommendations' were founded on his conclusions, apparently without any considefation as to effects on health. On the other hand, the High Court, whose decision it is sought to set aside in the interests of the trade, found that 22 grains of boric acid per lb. of cream was injurious to health. So long as the trade is allowed to use preservatives, it is unlikely that steps will be taken to find other and better methods. Since the Government sanctioned a low standard for milk, it has become necessary for infants and children that larger amounts of cream should be added to milk, and the necessity of having it free from boric acid is, therefore, of the greatest importance. It would be much safer to raise the legal standard of fat in milk, and prevent the abstraction which now takes place to a large extent to the detriment of the children of the poor, who cannot afford to buy cream separately to re-enrich the milk. Staff.—Additional members of the staff, including one of the Sanitary Inspectors, have joined the Army during the year, and the work has had to be carried out with temporary assistance, or by the existing members taking on extra work. In view of the altered conditions, and the appointment of two additional Health visitors, the Council, with the consent of the Local Government Board, decided not to fill up the vacancy oaused by the resignation of one of the women sanitary inspectors, whose duties have been distributed among the existing inspectors and the visitors. I have the honour to be, Mr. Mayor, my Lords, Lady and Gentlemen, Your obedient servant, FRANCIS J. ALLAN, Medical Officer of Health. April, 1916. PART I. A. STATISTICS Population. The Registrar-General has issued the following Memorandum:— Estimate of Civil Population, 1915.—The war has made it impossible to adhere to the methods of estimation of local and national populations hitherto in use. Men of military age have been largely drafted to military training centres or sent abroad with the Army, and the remainder of the male adult population, as well as, to a lesser extent, the female population, has migrated on an unprecedented scale into areas other than those in which it was enumerated at the last census. Under these circumstances, estimates of local populations based on the census returns were clearly inadmissible, and it became necessary to search for a substitute. Fortunately this was ready to hand in the shape of the National Register, which referred to a date only six weeks removed from that for which estimates were required, viz., the middle of the year 1915. No doubt this does not form a perfect record, as it is known that a number of persons escaped registration. From investigations, however, which have been made in another connection, it appears that the defects in the register, taken as a whole, are not 011 such a scale as to affect seriously the estimates of population based upon it. By the method described below it was possible to derive from these returns estimates of the civil population only of each administrative area on August 15th. No attempt has been made to increase these by allowance for members of the fighting forces because, apart altogether from the difficulty of ascertaining the average military population of each district during the year, experience has shown that under present circumstances only civilian deaths can be tabulated for local areas. If military deaths were to be included they would have either to be debited to the area in which they occurred, a course which would render the death-rates ol districts containing large military hospitals meaningless, or to the area of residence. An attempt made to pursue the latter course has had to be abandoned owing to military authorities having been unable to furnish to the registrars the necessary information. It has been found necessary therefore to limit the tabulation of deaths by local areas to deaths of civilians, and under these circumstances the civilian population is obviously the proper one to use for the calculation of death-rates. 2 An additional advantage in the use of National Register populations is that these consist of habitual residents in each locality, and not merely of the persons who happened to be present therein on a certain date. The deaths tabulated from the year 1911 onwards are also those of habitual residents only, and, therefore, the use hitherto of populations which in certain cases included very large institutional elements, chiefly composed of non-residents, introduced in these cases serious errors into the rates calculated from them, as pointed out in the Registrar-General's Annual Reports. This source of error now, of course, disappears for the time being, and in such districts an unavoidable break in the continuity of the previously misleading rates will result. In any case, however, the maintenance of continuity is, under present circumstances, obviously impossible, and it is felt that the present estimates will furnish deathrates calculated to indicate as nearly as may be the health conditions of the civil population. The method by which the estimates of civil population have been derived from the National Register returns may now be described. The ratio of the total population, less the males aged 15-65 years to the number of females aged 15 to 65 years at the date of the census was calculated for each administrative area, and this ratio was applied to the number of females on the National Register; the resulting products plus the number of males aged 15 to 65 years on the National Register was taken to be the number of the Civil population of the district. A small adjustment was necessary in order to make the sum of the estimates for the several districts equal to the estimate for the country as a whole made on the same basis. Further, the population in institutions was not registered, and this (taken to be the same in the aggregate for England and Wales as at census date) together with a number of persons of no fixed abode were distributed evenly over the whole country. These two adjustments raised the original estimates by about one per cent. The question of the population to be used for the calculation of birthrates has also required consideration. The births registered are not only those of the children of civilians, and the estimates of civil population therefore, form an unsuitable basis for the calculation of birth-rates. It is impossible to frame any estimate that would give reliable birth-rates, and it is suggested, therefore, that the birth-rates for 1915 be based upon the existing estimates of total population for 1914. These will sometimes be seriously in error owing to extensive migration having occurred. Difficulties, which will probably prove insoluble, remain as to estimation of populations in sex and age groups, and the standardizing factors dependent upon them. 3 The population of Westminster as estimated to the middle of the year 1915, on this method is 135,104. Under normal conditions the population would have been about 150,000. liates calculated on such figures cannot be regarded as reliable. o O Births. [###hs Registered. Births Notified. In Westminster. Belong elsewhere. Born out of Westmin ster. Nett. Total. Alive. Stillborn. Notified by Doctor. Midwife.[/### 1909 2,520 39 270 2,751 1,612 1,571 41 609 492 1910 2,365 49 276 2,592 1,674 1,621 53 632 561 1911 2,110 60 311 2,361 1,562 1,507 55 578 483 1912 2.134 49 264 2,349 1,501 1.469 34 564 451 1913 1,992 35 276 2,233 1,162 1,424 38 474 570 1914 1,860 15 312 2,157 1,386 1,347 39 484 477 1915 1,721 71 329 1,979 1,292 1,250 42 515 527 The following table shows the distribution of births (including infants born in institutions outside the City) according to wards :— 1914. 1915. 1914. 1915. Conduit 28 15 Regent 71 77 Grosvenor 86 117 Pall Mall 6 6 Knightsbridge St. George 135 140 Great Marlborough 52 56 Victoria 685 644 Charing Cross 19 20 St. Margaret 101 104 Covent Garden 92 74 St. John 660 535 Si rand 5 6 Knightsbridge Haiulet 71 61 Homeless — 10 St. Anne 146 114 The birth-rate, uncorrected, was 11.4, corrected 13.2 per 1,000 persons. The birth-rate for the County of London for 1915 was 22.6, and for England and Wales, 219. Ihe subjoined table shows that the births ot legitimate children were considerably less, while there was an increase among the illegitimate. Westminster. 1908. 1909. 1910. 1911. 1912. 1913. 1914. 1915. Legitimate Births (net) 2,739 2,548 2,399 2,195 2,194 2,057 1,995 1,798 Illegitimate Births (net) 174 203 193 166 155 176 162 181 The proportion of males and females born is of interest, in view of the theory that more boys than girls are born under war conditions than 4 in times of peace. In 1913, for each 1,000 girls born there were 1,006 boys, in 1914 there were 1,080 boys, and in 1915, 1,033 boys. The total number of births were unfortunately fewer in 1915 than in preceding years. The death-rate of boys is much greater than that of girls, but with the greater proportion of boys born in the last two years the number of boys alive at the end of the first year was still in excess of the girls:— Number Born. Number of Deaths under 1 year. Number remaining at end of year. Boys. Girls. Boys. G iris. Boys. Girls. 1913 1,120 1,113 111 102 1,009 1,011 1914 1,120 1,037 103 68 1,017 969 1915 1,006 973 103 79 903 894 The death-rates per 1,000 births were:— Boys. Girls.| Boys. Girls. Boys. Girls. 1913 99.1 91.6 1914 91.9 65.5 1915 102.3 81 There were 42 stillborn children, whose births are not subsequently registered; 4 other stillbirths were known but not notified, making 46 in all. Maternity and child welfare work has been carried out by the Council's visitor in conjunction with the visitors of the Health Society. The Ante-Natal Clinic for expectant mothers suggested in the Local Government Board Memorandum has been carried out to a certain extent by the hospitals in and around the city. Besides seeing at the hospitals regularly (once a month at least) mothers who were to be attended from the hospitals, the physicians at the hospitals have also had referred to them a number of cases which appeared to require medical supervision and treatment. The home visiting of 758 expectant mothers has been carried on during the year. The names of 579 were forwarded by the hospitals, the others were found by the visitors or the women called at one or other of the offices for advice. The mother-craft classes (needlework, cookery, health talks, &c. were attended by 142 expectant mothers. In-patient treatment for complicated cases was obtained at the various hospitals. Infants.—Of the 1,979 births, 1,821 first visits were paid, and in addition 46 visits were paid where stillbirths occurred; 740 re-visits 5 were paid by the Council's visitor,0 592 to children between the ages of 1 and 5 years of age, and 590 in connection with measles, whoopingcough, ophthalmia neuratorum, &c. During the year 5,519 families were visited by the Health Society's visitors, and 16,383 visits were paid by them. Infant medical inspections were conducted at three centres as follows:— Health Centre. New Cases (under 1—over 1). Ke-inspections (under 1—over 1). Total Attendances (under 1—over 1). Pimlico 272 (193- 79) 695 (456-239) 967 (649-318) Soho 279 (188- 91) 844 (447-397) 1,123 (635-488) Westminster (9 months) 107 (61- 46) 195 (126- 69) 302 (187-115) 658 (442-216) 1,734 (1,029-705) 2,392 (1,471-921) Deaths. 2,129 deaths were registered in the City in the 52 weeks ending the 2nd January, 1916. After deducting 949 deaths of non-citizens in public institutions in the City, and adding those of 958 citizens who died in other districts, the corrected total is 2,138, and is equivalent to an annual rate of 15*7 per 1,000 persons, calculated on the civil population. The London death-rate for 1915 was 16-1. For England and Wales the rate was 15T, all being higher than in the preceding year. Tables appended to this part of the Report show the vital statistics of the City and five groups of districts from 1892 to 1915. Cause of Death at all Ages.—These are set forth in Table I, and also their distribution in the various Wards of the City. The increase in the number of deaths was chiefly due to influenza and diseases of the chest, but there were also marked increases in deaths from measles, kidney disease, and syphilis. Ages at Death.—The distribution in age-groups for the last four years is shown below:— All ages. Under 1. 1-2. 2—5. 5—15. 15—25. 25—45. 45—65 65 and upwards 1911 2,005 243 66 53 36 63 295 586 658 1912 1,981 195 43 44 49 54 306 594 699 1913 2,030 213 46 36 41 68 328 609 689 1914 1,946 171 31 34 48 71 314 575 702 1915 2,138 182 66 53 51 78 293 611 804 An increase in the number of deaths is apparent at all ages except between the ages of 25 and 45, a group which has been largely drawn upon for the Army. The mortality has been heavy on persons above 45 years of age. 6 Deaths of males and females numbered:— Males. Females. Deducting Deaths'under 1 year. Males. Females. 1913 1,086 944 975 842 1914 1,109 837 1,006 769 1915 1,122 1,016 1,019 937 Infantile Mortality.—The corrected death-rate of infants for Westminster was 92 deaths per 1,000 births, the average of the previous five years having been 88, and of the preceding five years 1905-9, 102. while there has been a slight proportionate increase in the deaths of legitimate infants, viz., from 73 to 78, the higher rate on the total deaths is due to the increase in deaths of illegitimate infants as shown below. Below are given figures for both births and deaths of infants corrected, distinguishing legitimate and illegitimate births, showing the true rate in eash of the last fourteen years:— Year. Legitimate. Illegitimate. Total Rate. Births. Deaths. Death-rate per 1,000 births. Births. Deaths. Death-rate per 1,000 bitths. 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 1908 2,739 266 97 174 27 155 100 1909 2,548 232 91 203 26 128 93 1910 2,399 189 78 193 25 129 82 1911 2,195 210 95 166 33 198 102 1912 2,194 168 76 155 27 174 83 1913 2,057 184 89 176 29 164 95 1914 1,995 147 73 162 24 148 79 1915 1,798 141 78 181 41 225 92 Victoria Ward 577 41 71 67 13 194 83 St. Margaret and St. John 592 63 100 47 9 191 112 Rest of City (including unknown) 629 37 58 67 19 283 80 For all London the rate was 112 in 1915, compared with 104 in 1914, 105 in 1913 and 91 per 1,000 in 1912; for England and Wales the rate was 110, compared with 105 in 1914, 109 in 1913, and 95 for 1912. Table V shows the causes of death of infants in the City as a whole, and separately in Victoria Ward, St. Margaret and St. John Wards, and in the remaining Wards. In the latter are included 10 deaths of infants found in the parks and elsewhere in the City whose births were not 7 registered. Without them the illegitimate death-rate would have been 158 and the total rate 67. Statistics of Dwellers in Block Dwellings.—These are set out in Table VI. A comparison of the births and deaths in the Council's Buildings in Regency Street during the last 10 years is given below. Year. Population. Births. Rate. Deaths at all ages. Rate. Deaths of Infants under one per 1,000 births. 1906 1,150 63 54.7 16 13.9 Ill 1907 1,163 60 51.6 18 15.5 116 1908 1,155 50 43.2 10 8.6 120 1909 1,156 44 38.0 12 10.3 99 1910 1,120 37 33.0 8 7.1 108 1911 1,063 37 34.8 19 17.8 81 1912 1,215 43 35.3 15 12.3 69 1913 1,113 39 34.3 9 7.9 128 1914 1,212 39 32.1 17 14.0 77 1915 1,109 30 27.0 15 13.5 100 Common Lodging.houses. Deaths.—88 deaths (males) occurred in 1915 among inmates of the common lodging.houses and shelters in the City. 26 of the deaths were due to phthisis, 17 to respiratory diseases, 5 to nervous diseases, 13 to diseases of the heart and blood vessels, 10 to cancer, and 5 to kidney disease. There were 50 deaths in St. John's Ward, 4 in Covent Garden, and 33 in Strand. The following is a list of the common lodging-houses in Westminster, the number for which they were licensed, and the number of deaths which occurred during the last five years among persons alleged to have been inmates:— In addition, 2 deaths were recorded of former inmates of common lodging-houses the use of which has been discontinued. Common Lodging Houses. No. of beds. Deaths. 1911. 1912 1913. 1914. 1915. Men. Bruce House, Kembie Street (L.C.C.) 706 34 24 32 35 33 33, Great Peter Street 397 8 14 16 16 22 Ham Yard Hospice, Great Windmill Street 20 — — — — — 11,12, and 13, Hanoyer Court 105 8 8 9 8 4 108, Regency Street 8 — — — 2— 16, Strutton Ground 222 8 7 12 9 13 S.A. Shelter, Great Peter Street 593 6 8 2 10 12 Women. 40, Great Peter Street 62 4 1 5 2 — 8 Table I.—Causes of, and Ages at, Death du/ring the year ended, 1st January, 1916. Causes of Death. Corrected Deaths in the City at subjoined Ages. Deaths in Wards (at all Ages). All ages. | Under 1. i 1 | 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 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. Homeless. Smallpox — — — — — — — — — — — — — — — — — — — — — — — — Measles 39 7 13 14 2 — 3 — — 1 1 1 10 4 15 1 — — 3 1 1 1 Scarlet fever 11 — — 5 5 — 1 — — — 1 — 1 2 — 5 — — — — 2 — — Influenza 52 1 — — — 1 5 17 28 2 2 4 4 19 2 5 3 2 — 3 — 2 — 4 Whooping-cough 10 3 6 1 — — — — — — — 1 1 2 1 3 1 — — — — 1 — — Diphtheria, Memb. croup 12 — 1 4 7 — — — — — — — 1 5 — 4 — — — — — 2 — — Cerebro-spinal meningitis 9 1 — 1 1 2 3 1 — — — — 1 1 2 2 1 — 1 1 — 1 — — Enteric fever 2 — — — — — 1 1 — — — — 1 — 1 — — — — — — — — — Infective Diarrhœa 8 7 — 1 — — — — — — — — — 1 — 2 2 2 — — — 1 — — Enteritis 29 20 3 1 — — 1 2 2 — — — — 10 2 12 — 2 — — — 2 — 1 Erysipelas 4 1 — — — — — 3 — 1 — 1 — 2 — — — — — — — — — — Puerperal fever 3 — — — — — — — — — — — — — — — — — — — — — — Other septic diseases 12 1 — — 2 1 2 5 1 — — 1 2 5 — — — — — — — 2 2 — Syphilis, &c 19 10 1 1 — — 4 2 1 — — — — 5 1 7 1 — — 2 — — 1 2 Diabetes 25 — — — 4 8 7 6 3 4 — 2 6 1 3 1 — — 1 2 2 — — Rheumatic fever 5 — — 1 2 2 — — — — — — — 3 — 1 — — — — — 1 — — Tuberculosis of meninges 14 4 2 7 — — 1 — — — — — — 6 — 3 — 2 — 1 1 — 1 — Tuberculosis of lungs 193 1 2 4 4 24 84 61 13 — 6 2 10 47 7 56 8 10 1 3 — 10 17 16 9 Tuberculosis of peritoneum 11 — 4 — 2 2 3 — — — — — 1 2 — 3 2 1 — 1 — 1 — Other forms of tuberculosis 10 1 — — 1 3 3 1 1 1 — — — 0 1 2 — — — 1 — 1 — — Malignant growths 168 — 1 — 1 — 16 82 68 2 11 6 13 49 10 35 6 3 4 9 — 5 4 9 Premature birth 41 41 — — — — — — — — 1 — — 11 3 14 3 3 — 1 3 1 — 1 Developmental diseases 39 34 5 — — — — — — — — — 2 11 2 14 3 3 — 2 — 1 — — Old age 80 — — — — — — 3 77 — 6 — 6 19 1 27 1 3 3 3 — — — 11 Meningitis and convulsions 6 3 1 — 1 1 — — — — 1 — 1 1 — 3 — — — — — _ — — Loc. ataxia and general paralysis 26 — — — — — 12 13 1 1 2 2 — 5 1 4 1 — 2 2 1 — 1 4 Other diseases of nervous system 49 — 1 1 1 2 6 17 21 5 3 1 10 2 9 1 1 — 2 2 5 2 6 Valvular diseases of heart 107 — — — 3 2 16 41 45 — 6 3 8 24 7 16 7 5 2 6 3 4 3 13 Other circulatory diseases 322 — — — 1 7 17 108 189 7 14 4 21 89 18 58 11 13 6 l0 3 14 11 38 Bronchitis 217 6 2 — 1 1 9 47 151 2 9 3 13 48 6 51 13 7 1 10 2 15 7 30 Broncho-pneumonia 98 17 18 7 — 1 2 22 31 1 2 4 2 28 9 34 2 2 — 1 — 3 — 10 Pneumonia, other forms 97 6 2 2 5 3 19 27 33 — 8 2 3 30 1 20 5 5 1 7 1 5 2 7 Other respiratory diseases 24 — 1 — 1 — 2 11 9 — — — 2 13 3 2 — 1 — — 1 1 — 1 Alcoholism 14 — — — — 6 5 3 — 1 — — 2 — 6 — — — 3 — 1 1 — Cirrhosis of liver 30 — — — — — 3 20 7 1 — 1 1 13 2 6 2 1 1 — — — — 2 Appendicitis and typhlitis 7 — — — — — 3 3 1 — 1 — 1 l — — — — — 1 — 1 1 1 Other digestive diseases 57 4 — — 2 4 9 23 15 1 4 1 4 15 5 12 3 2 — 2 1 1 1 5 Wright's disease, &c. 114 — — — 1 2 15 36 60 2 10 6 5 27 8 15 10 — 2 2 3 8 4 12 Generative system diseases 8 — — — — 1 3 4 — — 1 1 — 3 — 1 1 1 — — — — — — Accidents and diseases of parturition 6 — — — — 3 2 1 — — — 1 — 2 1 — 1 — — — — 1 — — Deaths by accident or negligence 76 10 2 3 6 2 9 17 27 2 2 1 2 20 3 17 3 3 2 2 2 3 1 13 Deaths by suicide and murder 40 1 — — — 6 14 15 4 — 3 1 8 2 7 1 — — 4 — 4 1 9 Other defined diseases 44 3 1 — 2 4 8 16 10 — 5 1 3 11 3 9 3 1 — 2 1 1 — 4 Diseases, ill defined or unknown — — — — — — — — — — — — — — — — — — — — — — — — All causes 2,138 182 66 53 51 78 293 611 804 26 106 49 113 571 109 485 97 73 26 90 28 103 61 201 10 Table II.— Vital Statistics of Whole Districts during 1915 and previous years. 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. Transferable Deaths t Nett Deaths belonging to the District. Of NonResidents Registered in the District. Of Residents not Registered in the District. Under 1 Year of Age. At all Ages. Number (Uncorrected). Nett. Number.* Rate. Number.* 1 Rate per 1,000 Nett Births. Number.* Rate. Number. Rate. 1906 170,652 2,766 2,931 17.1 2,482 14.5 1,045 790 323 110 2,227 13.0 1907 168,396 2,732 2,927 17.3 2,396 14.2 992 833 303 103 2,237 13.3 1008 166,170 2,665 l',913 17.5 2,437 14.6 1,089 829 293 100 2,177 13.1 1909 163,974 2,520 2.751 16.7 2,406 14.6 1,091 881 258 93 2,196 13.3 1910 161,803 2,365 2.592 16.0 2,164 13.3 1,023 750 214 82 1,891 11.6 1911 159,709 2,110 2,361 14.7 2,286 14.3 1,103 822 243 102 2,005 12.5 1912 157,693 2,134 2,349 14.8 2,113 13.4 982 853 195 83 1,984 12.5 1913 155,678 1,992 2,233 14.1 2,208 13.1 1,048 870 213 95 2,030 12.7 1914 152,346 1,860 2,157 14.1 1,971 12.9 958 933 171 79 1,946 12.7 1915 150,000 1,721 1,979 13.2 2,129 15.7 949 958 182 92 2,138 15.8 * In Column 6 are included tlie whole of the deaths registered during the year as having actually occurred within the district. In Column 12 is entered the number in Column 6, corrected by subtraction of the number in Column 8 and by addition of the number in Column 0. Deaths under 1 year of age in Column 10 are similarly corrected. Rates in Columns 5, 7, and 13 are calculated per 1,000 of estimated population corrected from the 1911 Census. †" Transferable Deaths" are deaths of persons who, having a fixed or usual residence in England or Wales, die in a district other than that in which they resided. The following special cases arise as to Transferable Deaths:— (1.) Persons dying in institutions for the sick or infirm, such as hospitals, lunatic asylums, workhouses, and nursing homes (but not almshouses), must be regarded as residents of the district in which they had a fixed or usual residence at the time of admission. If the person dying in an institution had no fixed residence at the time of admission, the death is not transferable. If the patient has been directly transferred from one such institution to another, the death is transferable to the district of residence at the time of admission to the first institution. (2.) The deaths of infants born and dying within a year of birtli in an institution to which the mother was admitted for her confinement should be referred to the district of fixed or usual residence of the parent. (3.) Deaths from violence are to be referred (a) to the district of residence, under the general rule; (b) if this district is unknown, or the decoased had no fixed abode, to the district where the accident occurred, if known; (c) failing this, to the district where death occurred, if known ; and (d) failing this, to the district where the body was found. Area of District in acres (exclusive of area covered by water) 2,502*7 Estimated Civil Population, 1915 135,104 Total population at all ages 160,2611 Number of inhabited houses 17,540 Average number of persons per house 9 .1 At Census of 1911. 11 Table II—continued. I. 'Institutions within the District receiving Sick and Infirm Persons from outside the District. (Total Number of Deaths in brackets.) II. Inst itutions outside the District receiving Sick and Infirm Persons from the District. II—.continued. Institutions outside the District receiving Sick and Infirm Persons from the District. St. George's Hospital (355). Westminster Hospital (165). Charing Cross Hospital (163). St. Peter's Hospital (29). Grosvenor Hospital (7). Women's Hospital, Soho Square (20). Throat Hospital, Golden Square (10). Gordon Hospital (4). Queen Alexandra Military Hospital (47). Infants' Hospital (135). Royal Ear Hospital (1). King Edward's Hospital (7). Westminster Ophthalmic Hospital (3). All Saints' Hospital (3). Lock Hospital (2). Empire Hospital (12). Military Hospital, Rochester Row (4). 24, Chapel Street (1). 17, Park Lane (9). 96, St. George's Road (4). 22, George Street (7). 42, Belgrave Road (1). 96, Belgrave Road (2). 9, John Street, Mayfair (4). 49, Poland Street (3). City of Westminster Workhouse, Wallis Yard (1). Middlesex Hospital. St. Thomas's Hospital. St. Bartholomew's Hospital. St. Mary's Hospital. German Hospital. French Hospital. Italian Hospital. Guy's Hospital. Freidenheim Hospital. Brompton Hospital. Northern Hospital. Victoria Hospital. Great Ormond Street Hospital. Cancer Hospital. University College Hospital. London Hospital. Evelina Hospital. Homoeopathic Hospital. West London Hospital. Queen Charlotte's Hospital. Home Hospital, Fitzroy Square. Royal Free Hospital. King's College Hospital. St. Nicholas's Hospital, Thanet. Royal Waterloo Hospital. Hostel of God. Belgrave Hospital. Bethlehem Royal Hospital. Battersea General Hospital. St. Peter's Home. City of London Lying-in Hospital. National Heart Hospital. Fountain Temporary Hospital. St. Saviour's Hospital. Central London Throat and Ear Hospital. Samaritan Free Hospital. St. Joseph's Home, Hackney. London Lock Hospital, Pad- dington. Royal County Hospital, Ryde. Cottage Hospital, Builth. Brompton Hospital, Frimley. St. Catherine's Hospital. Jews Hospital, Tottenham. Child's Hospital, Newbury. Connaught Hospital. Helena Hospital. Cottage Hospital, Abingdon. Holloway Sanatorium. Florence Nightingale Home. Western Fever Hospital. South-Western Fever Hospital. North-Western Fever Hospital. Mount Vernon Hospital. Downs Sanatorium. City of Westminster Infirmary, Fulham Road. City of Westminster Infirmary, Hendon. City of Westminster Workhouse, Fulham Road. Marylebone Infirmary, llolborn Infirmary. Chelsea Infirmary. Lambeth Infirmary. Cleveland Street Infirmary. Belmont Infirmary, Sutton. St. James' Infirmary, Battersea. St. Pancras Infirmary. City of London Infirmary, Hackney. Bow Institution. Fulham Infirmary. Paddington Infirmary. Southwark Infirmary. Islington Infirmary. Huntingdon Infirmary. Isle worth Infirmary. Holborn Workhouse. Banstead Asylum. Cater!)am Asylum. Cane Ilili Asylum. C lay bur v Asylum. Colney Hatch Asylum. Camber well House Asylum. Darenth Asylum. Hanwell Asylum. Horton Asylum. Leavesden Asylum. Manor Asylum. Tooting Bee Asylum. Dartford Heath Asylum Long Grove Asylum. Peckham House Asylum. Abergavenny Asylum. B 12 Table II—continued III Other Institutions, the Deaths in which have been distributed among the several wards in the City. III—continued. Other Institutions, the Deaths in which have been distributed among the several wards in the City. III—continued. Other Institutions, the Deaths in which have been distributed among the several wards in the City. 20, 49, 53, Beaumont Street. 51, 73, Welbeck Street. 9, Mandeville Place. 4, Dorset Square. 50, Weymouth Street. 43, South Side, Clapham Common. St. Luke's House, Pem- bridge Square. 14a, Upper Wimpole Street. 19, Manchester Street, Marylebone. Flower House, Sydenham. 165, St. James Road, Bermondsey. 51, Earl's Court Road. 14, Henrietta Street, Marylebone. 3, York Place, Marylebone. 41, Manchester Street, Marylebone. 62, Cambridge Terrace. 16, Grove Park, Camberwell. 7, Lower Seymour Street. 3, Manor Park, Lee. Manresa House, Putney. 12, Hinde Street, Marylebone. 216, Portsdown Road, dington. 47, Kellett Road, Brixton. 13 Table III.— Vital Statistics of Separate Localities, 1905-1915. 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 Ilamlet of Knightsbridge Wards. 4. St. James, comprising llegent, Marlborough, Pall Mall and St. Anne's Wards. 5. Strand, comprising Covent Garden, Strand, and Char ing Cross Wards. Year. Population estimated to middle of each year. Births registered (uncorrected). Deal lis 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 j 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, i Population estimated to middle of each year. Births registered (uncorrected). Deaths at all ages (corrected). Deaths under 1 year. 1905 172,938 2,940 2,347 329 73,967 1,162 868 115 49,804 1,057 857 138 29,589 533 353 50 19,479 188 269 26 1900 170,052 2,766 2,227 323 73,280 1,150 868 124 49,459 973 789 124 28,823 513 334 58 18,996 179 236 17 1907 168,39(1 2,732 2,237 303 72,601 1,101 905 95 49,116 998 778 112 28,077 437 308 47 18,524 196 246 19 1008 166,170 2,665 2,177 293 71,927 1,076 878 111 48,776 993 688 117 27,349 416 323 42 18,065 180 288 23 1909 163,974 2,520 2,196 258 71,260 1,038 843 104 48,437 930 771 94 26,641 384 343 46 17,617 168 239 14 1910 161,803 2,365 1,891 21 1 70,598 958 759 74 48,101 893 640 100 25,951 358 267 30 17,180 156 225 10 1911 159,709 2,110 2,005 243 69,943 924 798 102 47,768 797 672 97 25,279 268 291 25 16,753 121 241 19 1912 157,693 2,134 1,985 195 69,294 898 847 87 47,437 812 670 81 24,624 275 259 19 16,338 149 208 8 1913 155,678 1,992 2,030 213 68,651 901 830 83 47,108 703 671 88 23,986 264 299 25 15,933 124 230 17 1914 152,346 1,860 1,946 171 67,413 826 802 77 46,373 709 703 74 23,160 218 227 13 15,400 107 211 7 Averages of 10 years 1905 1914 102,935 2,408 2,104 264 70,893 994 839 97 43,237 886 723 105 26,347 366 300 35 17,428 156 239 16 1915 — 1,721 *2,138 182 — 795 816 60 — 643 643 75 — 198 286 26 — 85 192 9 * This is the nett number of civilian deaths, and includes 201 deaths of persons whose address was not known. It does not include 44 deaths of soldiers and sailors. B 2 14 Table 111, continued.— Vital Statistic* of Separate Localities, 1905-1915.—Rates. Localities 1. City of Westminster. 2. St. George's. 3. Westminster. 4. St. James. 5. 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. 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 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 Births (uncorrected). 1905 17 .0 13.5 111 15 .7 11.7 99 21.2 17.2 131 18.0 11.9 93 9.6 13.8 92 1906 16.2 13.0 116 15.6 11.8 100 19.6 15.5 127 17.8 11.5 113 9.4 12.4 115 1907 16.2 13.2 110 15.1 12.4 86 20.3 15.8 142 15.5 10.9 107 10 5 13.2 94 1908* 16.0 13.1 109 14.9 12.2 103 20.3 14.1 117 15.2 11.8 100 9.9 15.9 104 1909 15.3 13.3 102 14.5 11.8 100 19.2 15.9 101 14.4 12.8 119 9.5 13.5 149 1910 14.6 11.6 90 13.5 10.7 77 18.5 13.3 111 13.7 10.2 83 9.0 13.0 100 1911 13.2 12.5 115 13.2 11.4 110 16.6 14.0 121 10.6 11.5 93 7.2 14.5 71 1912 13.5 12.5 91 12.9 12.2 96 17.1 14.1 99 11.1 10. 5 69 9.1 12.7 53 1913* 12.5 12.7 106 12.8 11.8 92 14.6 13.9 125 10.8 12.1 94 7.6 14.1 137 1914 12.2 12.7 91 12.2 11.8 93 15.2 15.1 104 9.4 9.8 59 6.9 13.8 65 Average of 1 10 years I 1905.14 J 14.6 12.8 104 14 0 11.7 95 17.2 14.8 117 13.6 11.3 93 8.8 13.6 98 1915.. 11.4 15.8 105 — — 75 — — 116 — — 131 — — 105 * The rates in these years are calculated on a 53.week population. 15 Tabi.e IV.—Deaths of Citizens during the Year ending 1st January, 1916, showing Locality at 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. 31 ales. Females. Total. Conduit 9 10 19 1 2 3 1 1 2 — — — 1 — 1 1 — 1 13 13 26 Grosvenor 36 25 61 6 6 12 10 6 16 — 1 1 3 3 6 5 5 10 60 46 106 Ilamlet of Knightsbridge 13 20 33 1 1 2 6 2 8 — — — — 2 2 2 2 4 22 27 49 Knightsbridge St. George 27 44 71 4 4 8 9 10 19 1 — 1 — 2 2 7 5 12 48 65 113 Victoria 130 170 300 69 77 146 37 37 74 3 5 8 6 11 17 19 7 26 264. 307 571 St. Margaret 19 35 54 7 13 20 10 14 24 — — — 2 — 2 2 7 9 40 69 109 St. John 82 114 196 107 66 173 49 33 82 4 6 10 8 8 16 3 5 8 253 232 485 St. Anne 21 18 39 11 14 28 10 7 17 1 — 1 4 4 8 3 1 4 53 44 97 Great Marlborough 20 13 33 9 17 26 9 2 11 — — — 1 2 3 — — — 39 34 73 Pall Mall 13 3 16 1 — 1 3 — 3 — — — 1 — 1 5 — 5 23 3 26 Regent 23 18 41 12 6 18 13 4 17 1 1 2 2 3 5 6 1 7 57 33 90 Charing Cross 11 6 17 3 — 3 1 1 2 — — — 2 — 2 2 2 4 19 9 28 Covent Garden 26 16 42 19 6 25 10 12 22 3 1 4 — 4 4 4 2 6 62 41 103 6 5 1 1 30 5 35 6 4 10 — — — 1 3 4 1 — 1 44 17 61 Homeless, &c. 2 — 2 86 47 133 13 4 17 — — — 15 17 32 9 8 17 125 76 201 City of Westminster 438 497 935 369 264 633 187 137 324 13 14 27 46 59 105 69 45 114 1,122 1,016 2,138 16 Table V.—Infant Mortality, 1915. Nett deaths from stated causes at various ages under One Year of Age in the City of Westminster. CAUSES OF DEATH. Under 0 Week. 1 —2 Weeks. 2—3 Weeks. 3—i Weeks. Total under 4 Weeks. 4 Weeks and under 3 Months. 3 Months and under 6 Months. <? Months and under 9 Months. 0 Months and under 12 Months. Total Deaths under 1 Year. Measles — — — — — 1 — 4 2 7 Whooping cougli — — — — — — 1 2 — 3 Erysipelas — — — — — 1 — — 1 Septic causes — — — — — 2 —- — — 2 Tuberculous meningitis — — — — — — 2 1 1 4 Other tuberculous diseases — — — — — — — — 2 2 Meningitis — — — — — — — 1 1 2 Bronchitis — — — — — 2 2 1 1 6 Pneumonia (all forms) — — — 1 1 2 9 5 5 22 Diarrhœa — — — — — 2 2 1 2 7 Enteritis — — 1 — 1 1 9 6 3 20 Gastritis — — — — — — 1 2 — 3 Syphilis — 1 — 1 2 4 3 1 — 10 Rickets — — — — — — — — 2 2 Injury at birth 1 1 — 1 3 1 — — — 4 Neglect at birth 9 — — — 9 — — — — 9 Murder 1 — — — 1 — — — — 1 Atelectasis 4 — — — 4 — — — — 4 Congenital malformations 2 1 1 4 3 1 — — 8 Premature birth 26 3 4 1 34 6 1 — — 41 Atrophy, marasmus — — — — — 4 4 — 1 9 Debility from birth 2 1 — — 3 5 2 — — 10 Other causes — 1 — — 1 1 1 1 1 5 Totals 4o 8 G 4 63 31 39 25 21 182 Nett Births in the year— Legitimate 1,798 Illegitimate 181 Nett Deaths in the year of— Legitimate infants 141 Illegitimate infants 41 The causes of death of the Illegitimate were:—Mea3les 2, abscess 1, tuberculous meningitis 1, bronchitis 1, pneumonia 2, enteritis 6, gastro enteritis 2, syphilis 4, injury at birth 1, neglect at birth 9, murder 1, atelectasis 1, congenital malformation 1, prematurity 7, marasmus and debility from birth 2. Of these 10 newly-born infants had no known address, death was ascribed to neglect at birth 7, atelectasis 1, prematurity 1, murder 1, The births were not registered but are included in the figures given above. 17 Table V, continued.—Infant Mortality, 1915. Nett Deaths from stated, causes at various ages under One Year of Age in St. John and St. Margaret Wards. CAUSES OP DEATH. Under 1 Week. 1—2 Weeks. 2—3 Weeks. 3—4 Weeks. Total under 4 Weeks. 4 Weeks and under 3 Months. 3 Months and under 6 Months. 6 Months and under 9 Months. 9 Months and under 12 Months. Total Deaths under 1 Year. Measles — — — — — — — 2 1 3 Whooping cough — — — — — — — 1 — 1 Umbilical sepsis — — — — — 1 — — — 1 Tuberculous meningitis — — — — — — 1 — — 1 Other tuberculous diseases — — — — — — — — 1 1 Meningitis — — — — — — — — 1 1 Bronchitis — — — — — 1 — — — 1 Pneumonia (all forms) — — — 1 1 — 6 — 2 9 Diarrhoea — — — — — 1 — — 1 2 Enteritis — — — — — — 5 3 1 9 Gastritis — — — — — — 1 1 — 2 Syphilis — 1 — — 1 2 1 1 — 5 Rickets — — — — — — — — 2 2 In j ury at birth — — — 1 1 — — — — 1 Congenital malformations — — 1 — 1 1 — — — 2 Premature birth 7 2 1 1 11 6 — — — 17 Atrophy, marasmus — — — — — 3 2 — — 5 Debility from birth 1 — — — 1 2 2 — — 5 Other causes — 1 — — 1 1 — 1 1 4 Totals 8 4 2 3 17 18 18 9 10 72 Nett Births in the year— Legitimate. 592 Illegitimate 47 Nett Deaths in the year of— Legitimate infants 63 Illegitimate infants 9 Causes of death of Illegitimate:—Syphilis 1, pneumonia 1, enteritis 4, prematurity 2, marasmus 1. 18 Table V, continued..—Infant Mortality, 1915. Nett deaths from stated causes at various ages under One Year of Age in Victoria Ward. CAUSES OF DEATH. Under 1 Week. 1—2 Weeks. 2—3 Weeks. 3—4 Weeks. Total under 4 weeks. 1 Weeks and under 3 Months. 3 Months and under 6 Months. 6 Months and under 9 Months. 9 Months and under 12 Months. Total Deaths under One Year. Measles — — — — — 1 — 1 1 3 Abscess — — — — — 1 — — — 1 Tuberculous meningitis — — — — — — 1 1 — 2 Other tuberculous diseases — — — — — — — — 1 1 Meningitis — — — — — — — 1 — 1 Bronchitis — — — — — 1 1 1 — 3 Pneumonia (all forms) — — — — — 2 1 2 3 8 Diarrhoea — — — — — — 1 — — 1 Enteritis — — 1 — 1 1 3 2 — 7 Gastritis — — — — — — — 1 — 1 Syphilis — — — — — 1 2 — — 3 Injury at birth — — — — — 1 — — — 1 Atelectasis 2 — — — 2 — — — — 2 Congenital malformations 2 1 — 3 1 — — — 4 Premature birth 7 1 3 — 11 — — — — 11 4 Atrophy, marasmus and debility from birth — — — — — 3 — — 1 Other causes — — — — — — 1 — — 1 Totals 11 2 4 — 17 12 10 9 6 54 Nett Births in the year.— Legitimate 577 Illegitimate 67 Nett Deaths in the year of.— Legitimate infants 41 Illegitimate infants 13 Causes of death of Illegitimate:—Measles 2, syphilis 2, abscess 1, tuberculous meningitis 1, prematurity 2, bronchitis 1, gastro-enteritis 2, congenital malformation 1, asthenia congenitalis 1. 19 Table V, continued.—Infant Mortality, 1915. Nett Deaths from stated causes at various ages under One Year of Age in the other Wards, including those whose address was unknown. CAUSE OF DEATH. Under 1 Week 1—2 Weeks. 2—3 Weeks. 3—4 Weeks. Total under 4 Weeks. 1 Weeks and under 3 Months. 3 Months and under 5 Months. 6 Months and under 9 Mouths. 9 Months and under 12 Months. Total Deaths under 1 Year. Measles — — — — — — — 1 — 1 Whooping cough — — — — — — — 1 — 2 Erysipelas — — — — — — 1 — — 1 Tuberculous meningitis — — — — — — — — 1 1 Bronchitis — — — — — — 1 — 1 2 Pneumonia (all forms) — — — — — — — 3 — 5 Diarrhoea — — — — 1 1 1 1 4 Enteritis — — — — — — 1 1 2 4 Syphilis 1 — — 1 1 1 — — — 2 Injury at birth 1 1 — — — — — — — 2 Atelectasis 2 — — — 2 — — — — 2 Congenital malformations — — — — — 1 1 — — 2 Premature birth 12 — — — 12 — 1 — — 13 Atrophy, marasmus and debility from birth 1 1 — — 2 1 2 — — 5 Want of attention at birth 9 — — — 9 — — — — 9 Murder 1 — — — 1 — — — — 1 Totals 26 2 — 1 29 4 11 7 5 56 Nett Births in the year— Legitimate 629 Illegitimate 67 Nett Deaths in the year— Legitimate infants 37 Illegitimate infants 19 Causes of death of Illegitimate:— Syphilis 1, pneumonia 1, enteritis 2, prematurity 3, atelectasis 1, injury at birth 1, neglect at birth 9, murder 1, Of these the home address was unknown in 10 instances— Atelectasis 1, prematurity 1, neglect at birth 7, murder 1. The births of these infants were not registered, but have been added to the illegitimate births, and are included in the figures given above. 20 Table VI.— Vital Statistics relating to Residents in Blocks of dwellings in the City of Westminster, 1915. Buildings. Topulation. Births. Total Deaths. Infectious Deaths. Tubercular Deaths. Respiratory. Digestive. Circulatory Diseases. Nervous Diseases. Kidney Diseases. Violence. Cancer. Developmental Diseases. Other Deaths. Deaths Under 1. Deaths Over 65. Westminster City Council— Regency Street 1,109 30 15 4 3 2 — 3 1 — — — 1 1 3 2 St. James's Dwellings, Ingestre Place, and Marshall Street . 101 — 1 — — — — 1 — — — — Peabody 7,031 141 129 16 13 39 6 15 8 4 3 8 11 11 17 32 Westminster 187 1 2 — — — — 2 — — — — — — — 2 London County Council— Millbank 2,914 61 31 2 5 5 2 2 1 — 3 4 3 4 5 8 Drury Lane 708 11 9 1 1 3 1 2 — — 1 — — — — 2 Improved Industrial 4,383 87 43 2 4 7 — 9 3 5 2 4 1 6 3 16 Metropolitan Association 546 15 13 — — 4 1 5 — 1 — 1 — 1 1 8 St. George's Model Dwellings 419 8 2 — — — — 1 — — — — — 1 1 — Clerkenwell and Soho Company (Newport Market) 1,184 22 15 1 4 4 1 3 — 1 — — — 1 — — Greencoat 119 4 — — — — — — — — — — — — — — Spencer 99 1 2 1 — — — — — — — — — 1 — — Chapter Chambers 175 1 — — — — — — — — — — — — — — Alexandra and Castle — 4 5 — — — 1 — — 2 — 1 1 — 1 1 St. James's Residences — 11 4 — — 2 — 1 — — — — 1 — 2 — 21 B. Communicable Diseases. The details respecting the notifications of infectious disease received by me are set out in the Local Government Board's Return (Table VII), 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 1902 are shown in Table VIII, 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 and of military cases for 1915. The rates per 1,000 population were:— Scarlet Fever. Diphtheria. Enteric Fever. Puerperal Fever. Erysipelas. London 3.94 2.11 0.14 0.06 0.89 Westminster 4.48 2.17 0.10 0.07 0.51 Vaccination.—The Vaccination Officers have supplied me with the following particulars relating to vaccination of infants born in 1914:— Vaccination Statistics. 1914. City of Westminster Union. Births Died Unvaccinated. Successfully Vaccinated. Insusceptible. Vaccination Postponed. Conscientious Objectors. Removed and Vaccination Officer Informed. Not Found. Removed to Address Unknown. St. George's District 1,551 85 1,131 2 27 219 32 55 St. James, St. Anne and Strand 323 11 253 1 4 34 — 20 The City 1,874 96 1,384 3 31 253 32 75 The Public Vaccinator for the Strand District informs me that he performed, in 1915, 36 primary vaccinations in persons between 1 and 14 years of age and 77 in persons over 14 years, and 252 revaccinations. 22 City of Westminster. Table VII.—Local Government Board Table C.— Cases of Infectious Disease Notified'during the 52 weeks from 4th January, 1915, to 1st January, 1916. Notifiable Diseases. Cases Notified in the City of Westminster. Total Cases Notified in each Ward. Cases removed to Hospital. At Ages—Years. Conduit. Grosvenor. Kniglrtsbridge St. George. Victoria. St. Margaret. St. John. Hamlet of Knightsbridge. Pall Mall. Regent. Great Marlborough. Charing Cross. Covent Garden. Strand. St. Anne. At all Ages 0 to 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Small-pox— Cases — — — — — — — — — — — — — — — — — — — — — — — Chicken pox- — — — — — — — — — — — — Cases 86 4 26 55 — — — — — 1 2 28 — — — — — — — — — — — Ophthalmia— — 3 39 — — 3 1 — 6 3 1 — Cases 17 17 — — — — — — — — 2 7 2 4 — — — — — — — — — Diphtheria— — — — — — — — — — — — — — — — — — — — 1 — 1 4 Cases 290 4 62 174 25 19 6 — — 5 13 83 29 86 4 1 J 4 5 3 37 1 9 275 Military 6 — — 13 38 10 — — — — — 30 24 — 7 — — — — — — Erysipelas— 61 Cases 69 6 3 1 8 19 22 10 — 4 12 4 32 2 — 3 4 — 3 1 4 35 Military 6 — — — — 6 — — — 4 — — 1 1 — — — — — — — Fevers— — — — — — — — — — — — — — — — — — — — — — 6 Scarlet— Cases €03 6 150 340 55 49 3 — 6 16 32 114 56 160 7 5 29 49 _ Military 12 1 — 7 — — — — — — 8 4 — — — — — 7 — 2 — 591 Polio-myelitis— — — — — — — — — — — — — — — — — — — — — — — 12 Cases — — — — — — — — — Enteric— Cases 13 — — 1 — 9 2 1 — 1 2 2 2 — — 1 — — — 2 — — — Military 1 — — — — — — — — — — — — — — — — — — — — — 11 Cerebro-spinal meningitis- 1 Cases 20 1 2 4 5 7 1 — 1 1 — 3 1 3 — 2 — — — — — — — Military 10 — — 1 5 4 — — — — — 9 1 — — — — — 1 1 — 2 17 Continued— 10 Cases — — — — — — — — — — — — — — — — — — — — — — — Puerperal— Cases 9 — — — 4 5 — — — — 1 1 — 5 — — 1 — 1 — — — 6 Totals Civil 1,107 33 243 575 97 109 34 11 7 28 51 250 97 329 15 10 55 59 12 108 7 79 939 Military 90 — 1 16 51 22 — — — 4 — 47 30 1 8 — — — — — — — 90 Not as notified; 8 cases us scarlet fever, 21 as diphtheria, 1 as enteric fever, 2 as cerebrospinal meningitis, and 1 as puerperal. Not as notified : 7 Army cases as diphtheria, 23 Diphtheria was more prevalent in Westminster than had been the case for many years previously. There were 290 notifications and in addition there were 61 cases in Crown buildings (military and other). The importance of examining other children in schools was well exemplified in several instances. Children were found who were "carriers" of the infection in their throats and these apparently were sources of infection for a succession of cases. So soon as they were detected and isolated the outbreaks ceased. Puerperal Fever.—Nine cases were notified. Three deaths were ascribed to this cause, and there were 6 deaths which occurred from other causes after confinement. Investigation showed that in a number of these cases death was due to serious illness pre-existing, such as phthisis or pneumonia, and properly the death should be ascribed thereto rather than to childbirth. Typhoid Fever.—Notwithstanding the return of persons from infected areas abroad, only 14 cases of this disease were notified in Westminster. With two exceptions the disease was contracted elsewhere. One patient was infected while nursing another; one man, a butcher, is reported to have suffered from typhoid fever in 1904. Ophthalmia Neonatorum.—Seventeen infants were notified as suffering from this complaint and 8 other cases were discovered by the visitors. Ten children were treated at hospitals, 7 as in-patients. Twenty-two were reported to have recovered without permanent impairment of vision. Tn two cases the sight of one eye was lost. One infant died before the eyes were better. In each instance the Health Visitor has visited at the house daily, or less frequently as the circumstances demanded, and has taken steps to see that proper medical and nursing attention was secured for the child. The Inspectors of the County Council under the Midwives' Act have co-operated by calling attention to cases which come under their observation. Plague, Cholera, &c.—Notifications were received from Port Sanitary Authorities of 275 persons coming to Westminster from districts affected with plague, cholera, smallpox, typhus and typhoid fevers and dysentery. The majority of these people came from Servia, Roumania, Bulgaria and Turkey. They were kept under observation. There were, besides, GO Belgian refugees who came to Westminster after having had, possibly, exposure to smallpox infection. A few who had not been revaccinated recently were revaccinated at once, and no cases of smallpox occurred. 24 Table VIII.—Infectious Diseases Notified, 1902-1915, in London. Year. Smallpox. Scarlet Fever. Diphtheria and Croup. EntericFever. Typhus Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Cholera. Relapsing Fever. 1902 7,796 18,252 10,731 3,407 4 47 311 5,536 1 2 1903 416 12,531 7,739 2,339 22 40 233 4,372 — — 1904 489 13,439 7,219 1,896 3 29 273 4,943 1 1 1905 74 19,461 6,482 1,552 9 14 292 4,972 — 1 1906 31 20,343 8,035 1,606 7 9 297 5,026 2 — 1907 8 25,925 8,771 1,394 5 36 2 55 4,496 — — 1908 1 22.059 9,998 1,350 4 13 230 4,209 — — 1909 21 17,251 6,685 1,042 7 20 287 4,194 — — 1910 7 10.512 5,495 1,284 3 15 292 3,981 1 1 1911 72 10,485 7,388 1,023 1 23 303 4,849 10 — 1912 6 11,319 7.104 705 3 8 381 4,099 — — 1913 4 17,550 7,649 762 4 14 349 4,152 — 1 1914 3 25,046 9,154 790 1 17 394 4,984 — 1 1915 11 16,975 9,094 599 4 12 278 3,841 — — In the City of Westminster. 1902 232 475 285 132 — 1 6 144 — — 1903 45 352 186 71 — 2 5 111 — — 1904 6 313 145 51 1 2 5 125 — — 1905 2 370 118 41 — — 12 123 — — 1906 — 540 206 47 — 2 9 127 — — 1907 — 418 145 51 — 2 3 102 — — 1908 1 627 187 41 — — 6 81 — 1909 1 590 225 25 — — 5 102 — — 1910 1 248 149 48 — — 6 61 — — 1911 1 252 145 31 — — 6 82 — — 1912 — 238 160 17 — — 19 91 — — 1913 — 379 192 29 — — 6 75 — — 1914 1 848 188 50 — 1 10 112 — — 1915 — 603 290 13 — — 9 69 — — There were also notified cases of— London. Westminster. London. Westminster. Cerebro-Spinal Meningitis— Poliomyelitis— 1907 132 4 1912 134 6 1908 85 3 1913 145 4 1909 111 3 1914 93 1 1910 115 2 1915 98 — 1911 101 3 Ophthalmia Neonatorum— 1912 105 3 1912 699 18 1913 93 — 1913 641 24 1914 73 1 1914 888 28 1915 624 20 1915 761 l7 Tuberculosis. The total number of certificates received was 780, including 181 notices of admission and 178 notices of discharge from infirmary or sanatorium. The number of new cases of pulmonary tuberculosis was 277 (67 less than in 1914), and included 51 homeless persons or inmates of common lodging houses. The number of new cases of other forms of the disease was 48, of whom 2 were casuals. 25 The following table shows the number of new cases in each of the last 7 years:— Pulmonary. Other Forms. General. Casuals. Total. 1909 270 136 406 5 1910 165 110 275 17 1911 256 100 356 38 1912 368 125 473 27 1913 356 87 443 152 1914 254 90 344 59 1915 226 51 277 48 The notifications of new cases calculated as rates per 1,000 of population were:— Pulmonary. Non-Pulmonary. 1912. 1913. 1914. 1915. 1913. 1914. 1915. Westminster 3.10 2.80 2.12 2.05 0.96 0.39 0.35 London 7.39 5.01 3.64 3.41 1.55 0.85 0.92 England (excluding London) 2.44 2.32 1.99 1.90 1.11 0.85 0.62 The figures for London and England are taken from the Local Government Board's report. A number of deaths occurred from tuberculosis of persons whose illness had not been notified in Westminster during life. These were cases where the disease had not been diagnosed and was found on post mortem examination, a proportion being inquest cases in which there had been no medical attendance. There are also deaths of persons who have been notified in other districts and have subsequently moved into Westminster. In 1915, these were:—Pulmonary: Casuals, 16; General, 24. Other Forms: Casual, 1; General, 23. Combining these with notified cases, the following are the totals for 1911-15:— Pulmonary. Total. Other Forms. Total. Notified. Unnotified. Notified. Unnotified. 1911 356 67 423 38 39 77 1912 473 39 512 27 32 59 1913 443 32 475 152 25 177 1914 344 46 390 59 13 72 1915 277 40 317 48 24 72 26 Public Health (Tuberculosis) Regulations.—Notifications. 1915. Number of notifications on Form A. Primary notifications. Total notifications, on Form A, including cases previously notified. Age periods. 0 to 1. 1 to 5. 5 to 10. 10 to 15. 13 to 20. 20 to 25. 25 to 35. 35 to 45. 45 to 55. 56 to 85. 65 and up. Total new cases. Pulmonary— Casuals — Males — — — — — 2 8 13 9 8 8 48 59 Females — — — — — 2 1 3 3 Males 1 1 1 4 7 13 30 39 28 12 8 139 180 Females — 1 6 5 5 8 29 17 6 4 4 85 120 Other forms— Males 1 4 5 2 1 4 5 — — — 22 29 Females 1 5 4 1 1 5 3 — — — — 20 22 Total 3 11 16 12 14 32 77 69 43 25 15 317 413 Number of notifications on Form B. (School medical inspection.) Number on Form C. Admissions to. Primary notifications. Total notifications, including cases previously notified. Poor Law institutions. Sanatoria. Under 5. 5 to 10. 10 to 15. Total. Pulmonary— Males — — 1 1 1 93 49 Females — — 1 1 1 8. 28 Non-pulmonary— Males — 4 1 5 5 — 3 Females — — 1 1 1 — — Total — 4 4 8 8 101 80 27 Tuberculosis. Table showing distribution in Wards of notified and unnotified cases, and numbers of persons who have been treated in Institutions. All Ages. 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. Homeless. Received Institutional Treatment. Pulmonary— Common Lodging-houses, &c. Males 50 — — — 1 — 12 — — — 1 — — 20 — 24 58 Females 8 — — — — — 1 — — — — — — 1 —- 6 8 General— Males 155 4 6 9 48 8 37 2 1 6 9 — 10 2 10 3 87 Females 95 1 4 5 30 7 26 2 1 2 5 — 3 1 7 1 67 Other forms— Males 46 — — 2 13 6 11 1 1 2 1 — 8 2 3 1 31 Females 20 1 — 2 7 4 5 — — — 4 — — — 2 1 14 Three in Great Marlborough Ward were Polish refugees. C 28 Deaths from Tuberculosis in the City of Westminster. Year Pulmonary. Abdominal. Meningeal. Other. Total. Deaths. Rates. Deaths. Rates. Deaths. Rates. Deaths. Rates. Deaths. Rates. 1911 191 120 6 3 28 17 13 8 238 149 1912 183 116 8 5 17 10 14 8 222 140 1913 198 124 8 5 19 12 15 9 240 151 1914 211 138 6 4 8 5 9 6 234 153 1915 193 142 11 8 14 10 10 7 228 168 Averages:— 5 years, 1901-5 301 169 13 7.2 28 15.4 28 15.2 372 208.8 5 „ 1906-10 217 131.4 10 5.8 25 15.2 22 13.3 276 165.8 5 „ 1911-15 195 128 8 5.6 17 11.0 12 8.0 232 152.6 The rates are calculated per 100,000 inhabitants: for 1915 on the modified population of 135,104. Sixty-two of the deaths from pulmonary disease occurred at home, 36 in hospitals and sanatoriums, 84 in infirmaries, and 10 in asylums. Deaths from other forms occurred at home 10, in hospitals 15, and in infirmaries 9. The number of consumptive patients visited during the year was 707, and patients suffering from other forms, 240. At the end of the year there were 421 consumptives and 173 "other" patients remaining on the visiting list. There were 5,085 visits paid by the visitors during the year (3,901 in the South, 1,184 in the North). Analysis of cases visited in 1915:— Pulmonary. Other Forms. North. South. Total. North. South. Total. Brought forward from 1914 174 285 459 41 129 170 New cases visited 76 172 248 20 50 70 Total cases 250 457 707 61 179 240 Deaths and removals 98 188 286 33 54 87 Remaining at end of 1915 152 269 421 28 125 153 Irrespective of casuals and soldiers, the illness of 73 consumptive (45 males, 28 females) persons notified in 1915 began previous to taking up residence in Westminster, 9 others had been resident for long periods in asylums or workhouses and developed the disease there. Changes of address.—Exclusive of transference to hospital, infirmary, sanatorium or temporary change of address due to visits to the country 29 or seaside, and exclusive of the movements of casuals, 221 changes of address have been noted among pulmonary patients; 80 have moved out of Westminster, 86 have changed houses in the City, and the addresses of 55 are not at present known. Of patients suffering from other forms, 17 left Westminster, 19 changed houses in the City, and 9 have been lost sight of—45 in all. Disinfection was carried out in 322 houses by the Council's staff, after death, or on removal of patients from one house to another or to hospital. In 23 cases, disinfection (or thorough cleaning and re-decoration of rooms) was carried out privately. Diagnosis and Detection of new cases.—Four hundred and sixty-nine persons (suspects and contacts) were specially examined, and 33 were found to be suffering from pulmonary tuberculosis and 7 from other forms. These persons were examined :— N. S. Total. At hospitals, dispensaries, or by private doctors 100 180 280 At school medical inspections ... 19 48 67 At the Pimlico Infant Medical Inspection Centre ... 101 101 At the Soho Infant Medical Inspection Centre 21 — 21 140 329 469 In addition, 203 bacteriological examinations of sputum were made at the Council's expense for medical men who had suspicious cases under observation, and in 55 instances the bacillus was found. In some instances medical men had this examination made by other than the Council's Bacteriologist, and the hospitals have this done by their own staff. Other Forms of Tuberculosis.—In addition to the 48 patients notified there were 24 deaths of patients who had not been notified during life. Fourteen were suffering previous to taking up residence in Westminster. The parts of the body affected were:— Spine 4 Kidney 1 Bones and joints 20 Pleura 1 Glands 15 Skin 3 Abdomen 12 Other parts of body 2 Meninges of brain 13 Insured Persons.—Pulmonary males notified or dying unnotified, 79. Pulmonary females, 33. c 2 30 Of these, 61 of the male and 24 of the female pulmonary cases received institutional treatment—in sanatoria 39, in hospitals 30, in infirmaries 16. There were also 8 soldiers, all of whom had hospital treatment. There were 15 non-pulmonary cases among the insured (11 males, 4 females), 1 had treatment in a sanatorium, 2 in the infirmary and 1 soldier in hospital. The Insurance Committee provided treatment for 54 patients (39 males and 15 females) notified in 1915 and previous years, of these 13 were in hospital, 41 in sanatoria; the length of stay varied from 1 week to 3 months in the majority, 10 had from 4 to 6 months. Uninsured.—Exclusive of casuals there were 54 males and 41 females above 16 years of age and 38 below that age suffering from pulmonary disease; of these 39 men and 28 women had some form of institutional treatment—in sanatoria 11, in hospital 16, in infirmaries 29, in asylums 9, in nursing homes 2. Those under 16 years (33) received institutional treatment—11 in hospitals, 1 in sanatorium, and 10 in poor law institutions. The County Council provided institutional treatment for 17 patients of whom 6 were under 16 years of age. Eleven were males and 6 females; 8 were treated in sanatoria, the rest in hospitals. Of the other forms of tuberculosis there were 12 adults and 43 under 16 years of age and of these 25 had treatment in an institution. Dispensary Scheme.—The City Council after protracted negotiations eventually settled a scheme which has now. received the sanction of the Local Government Board and will come into force in 1916. By it patients will receive treatment at Charing Cross and St. George's Hospitals.* The after-care of patients who are discharged from institutions is undertaken by the tuberculosis Visitors, assisted by the Health .Society, and forms one of the most important parts of their work. They are advised and encouraged to continue the treatment and habits in which they were instructed in the sanatorium. Patients, especially the younger ones, are assisted to change their trade from an indoor to an outdoor occupation. Some are assisted to move to more open parts of London, or to the country. Help is obtained in the way of additional food, or grants in aid, of beds and bedding and of clothing. * At the last moment the Hospitals declined to proceed with the scheme to which they had agreed, and the Council were forced to institute a Municipal Dispensary, April, 1916. 31 Diarrhea.—In Westminster, the total deaths were 37, 30 being under 2 years of age. Comparison with former years is made below:— Westminster. 1911. 1912. 1913. 1914. 1915. Epidemic diarrhoea 47 9 20 11 8 Other forms of enteritis 47 28 29 24 29 Total deaths 74 37 49 35 37 Number under 1 year of age 49 27 33 24 27 Number of births 2,361 2,349 2,233 2,157 1,979 Deaths of infants per 1,000 births 20.7 11.4 14.7 11.1 13.6 Number of deaths under 2 years of age — 30 40 29 30 Cold and dampness, improper feeding, want of proper care, defective power of digestion, syphilis and tuberculosis account for many of the cases in which diarrhoea was merely one of the accompaniments of the illness. Measles.—The number of cases notified was 568, mostly by school teachers. There were 39 deaths; with 3 exceptions these occurred in children under 5 years of age. The schools affected are shown below. Owing to the great increase in the number of scarlet fever patients the Asylums Board had to give up the hospital treatment of measles and whooping-cough for a time. Three hundred and seventy-five visits were paid by the health visitors to families in which cases were notified: advice is given verbally and printed instructions are left at the house. Wherever necessary, the visitors visit throughout the illness, see that medical and nursing attendance is obtained, and that proper attention is given to the cleanliness of the rooms, bedding, &c. Whooping-Cough.— Information was received of 84 cases (for particulars as to schools see list below). There were 10 deaths in the City (all of children under five years of age). Children suffering from whooping-cough are also visited by the health visitors: 41 visits were paid to families affected. Schools and Infectious Disease. School teachers are required to notify the Medical Officer of Health when they exclude children on account of infectious disease. The 32 following list shows how far this was carried out and the nature of the cases notified:— School. Actual Cases. Infection in House. Other Causes. Chickenpox. Measles. Mumps. Whoopingcough. Chickenpox. Measles. Mumps. Whoopingcough. Buckingham Gate 1 4 — 1 — 2 — — 1 ringworm. Horseferry Road — 9 — 10 — Millbank 5 48 1 _ 5 8 1 — 2 ringworm. Pulteney 4 40 1 7 3 17 — 2 2 ringworm. Ranelagh Road 1 2 — — — — — — 3 ringworm. St. George's Row 11 33 1 8 4 26 — — 3 ringworm. Wild Street 2 17 — 1 9 — — 1 ringworm. Brompton Higher Grade 2 8 — 2 1 1 — — Burdett Coutts 5 37 1 12 4 13 — 3 11 ringworm. Cathedral, Great Peter Street — 1 2 — — 2 ringworm. Christ Church 2 12 — — 16 — — Holy Trinity 12 16 1 19 26 — 2 ringworm. St. Anne's 4 8 4 1 8 — 4 ringworm. St. Anselm's 1 — 8 — 1 — 1 1 ringworm. St. Barnabas 1 31 4 — — 27 — — 2 ringworm. 2 itch St. Clement Danes 2 4 6 2 6 St. Edward's, Dufour's Place 5 19 — — 2 — — — St. Gabriel's 23 22 3 10 23 14 — 6 6 ringworm. St. George's, South Street 1 24 — — — 10 — — 3 ringworm. St. James the Less 13 51 2 — 5 17 — — 2 ringworm. 1 ophthalmia. St. James' and St. Peter's 5 2 2 St. Margaret's 2 32 — — 1 3 — — St. Martin's, Adelaide Place — _ — 6 — — — 1 ringworm. St. Martin's, Cattle Street — — — — — — St. Mary's, Hide Place 5 13 — — 5 7 — — 1 ringworm. St. Matthew's 9 8 3 — 10 6 — — 7 ringworm. 2 itch. St. Michael's 2 26 — — 1 6 — — 4 itch. St. Paul's 1 — 40 19 — — 16 4 1 ringworm. St. Peter's, Lower Belgrave Place — 32 — — — 2 — — Wesleyan Training 8 36 — — — 18 — — 1 ringworm 125 534 58 84 91 254 — 16 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. In this way 754 notifications were sent out during 1915 to school teachers as follows:— School. Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. Buckingham Gate — 3 2 — Horseferry Road — 8 4 Millbank 28 21 — Pulteney __ 24 6 Ranelagh Road 1 — St. George's Row 13 20 — Wild Street 21 8 — Brompton Higher Grade — — — Burdett Coutts — 16 8 — Cathedral, 48, Great Peter Street — 7 1 — Cathedral Choir School 14 — Christ Church — 7 Curzon — 1 — — 33 School. Small Pox. Scarlet Fever. Diphtheria. Enteric Fever. French Protestant — 1 2 — Grey Coat — 1 1 — Holy Trinity — 5 — — Notre Dame — 14 1 — St. Anne's — 20 3 — St. Anselm's — — — — St. Barnabas — 5 2 — St. Clement Danes — 6 17 — St. Edward's, Dufour's Place — 4 — — St. Gabriel's — 10 4 — St. George's, South Street — 4 1 — St. James's and St. Peter's — 14 7 — St. James the Less — 7 10 — St. Margaret's — 3 — — St. Martin's, Adelaide Place — 3 — — St. Martin's, Castle Street — 3 — — St. Mary's, Hide Place — 12 3 — St. Matthew's — 5 8 — St. Michael's — 9 17 — St. Patrick's — 2 1 — St. Paul's, Wilton Place — 1 — — St. Peter's, Lower Belgrave Street — 9 9 — St. Vincent's — 39 4 — Wesleyan Training College — 19 3 — Guards' School — 3 12 — Exclusive of children under 5 years of age, 1,815 children of school age have been visited by the Health Visitors in co-operation with Care Committees, Hospital Almoners, and the Invalid Children's Aid Association. Bacteriological Laboratory. During the year 595 examinations have been made by Dr. J. M. Burnford, at the Westminster Hospital Medical School, at a cost of £79 1s. 5d., with the subjoined results. The number of examinations in the previous 5 years were: 1910, 270; 1911, 240; 1912, 306: 1913; 406; 1914, 499. Disease. Persons. Examinations. Results. Positive. Negative. Doubtful. Diphtheria 376 380 93 286 1 Typhoid Fever 12 11 2 8 2 Para-Typhoid 1 1 — 1 — Tuberculosis 199 203 55 147 1 In addition to those mentioned above, many medical men and hospitals obtain reports on their cases from private or hospital laboratories. 34 Disinfection. Below is shown the number of rooms and articles disinfected by the Staff of the Department. The premises included 15 schoolrooms, 22 shops and 16 offices; 9 vehicles were also disinfected, and 15 sacks of letters from abroad. In 15 cases of infectious disease treated at home the laundry linen was collected weekly and disinfected. The following table gives a comparative statement of the above work during the past seven years:— 1909. 1910. 1911. 1912. 1913. 1914. 1915. Premises 1,287 841 979 1,020 1,410 1,650 2,017 Rooms 1,865 1,284 1,449 1,346 1,796 2,461 2,637 Articles disinfected 49,843 26,850 26,264 34,478 53,567 57,591 41,561 Articles washed — 514 782 4,999 8,210 4,807 2,590 Articles destroyed 186 1,651 496 699 1,567 2,047 2,220 Books disinfected 281 595 266 815 1,810 414 77 Number of persons admitted to shelters 6 I — — — — — Arising out of the War, disinfection was carried out in 841 instances. Room Articles. Vehicles. Disinfected. Destroyed. Military Deôpts, Offices and Hospitals 112 6,710 1,512 8 Belgian and Polish Refugees 609 1,446 — — 721 8,156 1,512 8 440 tins of dressings from hospitals were collected and destroyed. Cleansing of Persons.—Adults.—The Guardians deal with the frequenters of their casual wards, and at certain of the common lodging houses and Huts for Soldiers facilities are provided for the inmates; 39 adults had baths at the station, and 545 articles of clothing were cleansed of vermin. Children.—1,136 baths were given to 407 school children suffering from vermin, sent by arrangement by the County Council. It is essential that at the same time as the children are treated at the station, their bedding should also be stoved, so as to destroy any vermin in it, and for this purpose the homes of those resident in Westminster were visited. It happens in a proportion of the cases that other members of a family than those at school age are affected, and 35 parents are persuaded to allow them to be treated, otherwise re-infection is almost certain to occur. Six parents were treated in 1915, and 6 children under school age. Borough. Body Lice. Head Lice. Scabies. Westminster 94 89 11 Chelsea 43 32 2 Lambeth 9 3 — Battersea 81 35 7 Kensington 7 — — 234 159 20 6,481 articles of clothing and 479 articles of bedding were fumigated. Scabies.—62 adults and children have been dealt with. Where possible, instead of having persons brought to Station, instructions are given so that baths may be given at home, and where no convenience for this exists, portable baths have been lent. This method has proved extremely satisfactory. The majority of the cases have been in families of soldiers or of refugees. In the supervision of this work 82 visits were paid to the houses. Verminous Houses.—In addition to the school cases, 243 notices were served by the Sanitary Inspectors with reference to vermin in houses: 608 rooms were fumigated with sulphur by the Council's staff. From 284 houses 7,079 articles were stoved, and 1,420 destroyed on account of their verminous condition. The total number of articles of clothing, bedding, &c., dealt with at the station on account of vermin was 10,730, 2,590 articles were washed and 1,423 destroyed. In dealing with verminous conditions, 293 visits were paid by the Disinfecting Superintendent. Eight notices were served at the instance of the Sanitary Inspectors, with reference to bedding, &c., in a filthy condition. (General Powers Act, 1904, Section 19 (1).) Motor Disinfecting Van.—During 1915 the van was used on 286 days, during which it ran 4,740 miles. It consumed 460 gallons of petrol (10.3 miles per gallon), and carried 156 tons 173/4 cwt. of material. The maximum amount carried on any one day was 30 cwt.; the average daily load was 101/2 cwt. During 22 days when the motor was being overhauled, 7 tons 13 cwt. were dealt with by horse-van. 36- Mortuaries. The number of bodies removed to the Council's mortuaries under order of the Coroner, or to await burial, was 376; in five' instances death was the result of infectious disease. One body was received at Drury Lane, the rest at Horseferry Road. Inquests were held at Horseferry Road, where the Coroner's Court is situated, in 349 cases, and there were 6 adjourned inquests. Postmortem examinations were made in 162 instances at Horseferry Eoad. Traffic accidents were the cause of 60 inquests, double the number in 1914. The number of dead bodies taken to the mortuaries for purposes of inquest and to await burial during the last seven years are:— Total. For Inquest. To await Burial. Total. For Inquest. To await Burial. 1909 291 258 33 1913 328 286 42 1910 333 281 52 1914 323 295 28 1911 373 334 49 1915 376 349 27 1912 324. 281 40 From the time when the City was formed, and most of the bodies were taken to Horseferry Road, the accommodation was found to be very inadequate. The premises have now been reconstructed, and ample room is provided for the reception of bodies for post-mortem examinations, and for the viewing of bodies by juries. An additional waiting room has also been provided in the Coroner's Court. 37 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 i n premises, parts of which were occupied as workshops:— 1915. 1915. Complaints received and dealt with 830 Sanitary Work completed:— Drains:— Premises inspected on complaint, &c. 942 Defective traps abolished Manholes built 238 533 House to house inspection 5,724 ,, repaired and cleansed Subsequent visits 22,516 287 Premises (registered), visits to 8,982 „ covers fixed or repaired Overcrowding found 20 621 Other infringements 989 Tested by smoke 205 Sanitary Work completed :— „ chemical 186 Houses:— „ water 494 Cleansed throughout 272 „ air 49 „ partially 1,059 Fresh air inlets fixed or repaired 285 Overcrowding abated—rooms 29 Light or ventilation improved 229 Soil Pipes:— Roofs repaired 82 Fixed 304 Ventilated 206 Floors and staircases repaired 420 Repaired 241 Underground rooms:- Tested by smoke 200 Illegal use 12 Tested by chemical 193 Closed 8 „ water 152 Illegal occupation discontinued 3 „ air ioo Water-closets Yards, areas, paved or repaired Constructed 858 504 Repaired 844 Damp walls remedied 194 Ventilated and light improved 340 Offensive refuse removed 322 Keeping of animals discontinued 16 Cleansed or limewashed 975 Ventilated lobbies provided 311 Verminous premises cleansed 243 Filthy or unwholesome bedding, &c. Unstopped 128 8 Traps ventilated 860 Drains:— Flushing cisterns fixed 1,110 Constructed 253 „ „ repaired 403 Amended and repaired 273 Waste Pipes:— Ventilated 241 Constructed 1,113 Unstopped and cleansed 168 Repaired 172 Interceptor traps fixed 165 Unstopped 66 Cleansed and sealed off from sewer Trapped 1,673 47 Ventilated 1,224 Gully traps fixed 1,041 Disconnected 257 38  1915. 1915. Sanitary Work completed:— Sanitary Work completed:— Rainwater Pipes:— Water Supply:— Fixed or repaired 593 Cisterns defective, abolished 22 Disconnected from drains 135 Taps off main provided 318 Urinals:— Pipes repaired 98 Constructed 74 Dust Bins:— Repaired or improved 61 Movable, provided 69 Cleansed 305 „ repaired 37 Water Supply:— Fixed, abolished 6 Provided 312 Stables: — ,, additional in tenement houses Drained 8 12 Paved 8 Certificates granted 2 Cleansed 6 Cut off 52 Dung receptacles provided — Reinstated 40 Dung accumulations removed 58 Cisterns fixed 101 ,, cleansed 75 Garages constructed 8 „ covered 129 Petrol interceptors provided 1 Plans.—341 sets of plans were examined during 1915. Of these 59 were plans of new buildings. Failure to send in plans or to give notice occurred in 28 instances. Infringement of the By-laws in connection with the erection of buildings occurred in 3 instances. The builders were cautioned and required to do the work properly. Drain-testing.—In the list given above is shown the number of drains and soil pipes which have been tested under the superintendence of the sanitary inspectors. The chemical test is applied by them, but the other forms of test require assistance, this is frequently given by the builders employed in the work, but in 515 instances the services of the two drain-testers attached to the Department were requisitioned. House Refuse.—As there might be some difficulty in securing the daily removal of house refuse owing to many of the dustmen and drivers being called up for army service, a notice was circulated throughout the City advising householders to burn as much of their house refuse as possible in order to reduce the quantity to be removed and prevent accumulation of offensive matter likely to become dangerous to health. 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. Three persons were cautioned for removing refuse during prohibited hours and two firms were prosecuted and fined 40s. and 10s. respectively. Flies.—Arising out of the difficulty in removing refuse and dangers which were apprehended in connection with the importation of disease 39 from the Continent, the Council had prepared and circulated notices dealing with flies. 2,428 intimations of nuisances, &c., and 105 statutory notices (including 6 for smoke nuisances) were issued; 1,863 letters were written. Police court proceedings for failure to comply with statutory notices were taken with the following results:— Premises. Offence. Result. 11, Motcomb Street (workshop and flats) defective condition of roof Order to abate within 14 days; 11s. costs. 6, Hindon Place (cottage). Wet condilion of walls of rooms and passage. Order to abate within 14 days; 6.9. costs. 23, Cumberland Street (tenements). sink waste pipe stopped Order to abate within 7 days; 6s. costs. 1, Russell Street, Covent Garden (fruit warehouse and offices). Without a supply of water Order to abate within 7 days; 6s. costs. 15, Monck Street (tenements). Premises dilapidated and dirty; defective roof, rain-water pipes, gutters, &c. Fined £3 and 21s. costs. 7, 8 and 9, Willow Street (tenements). Orders made by Magistrate on 25th Nov., 1914, to do certain works in Nos. 7 and 9 and to close N o. 8—not complied with. Fined 40 s. and 2s. costs in each case. 26, Bessborougli Gardens (dwelling house). Defective chamber in drain, untrapped sink waste pipe, improperly connected waste pipe of geyser to bath waste. Order to abate nuisance in 14 days; 6s. costs. 14, Bessborougli Street (tenement). Dirty condition of walls and ceilings of rooms on 2nd floor, accumulation of refuse. Order to abate within 14 days; 6s. costs (Tenant). Order against the Landlord to abate within 4 weeks and to pay 6s. costs. 57, Carnaby Street (dwelling house). Defective drain in yard causing basement of 25, Beak Street to be damp. Work done; summons withdrawn on payment of 10s. 6d costs. 6, New Burlington Place (workshops). Defective roof to workshop at rear, and damp wall to women's workroom. Work done; summons withdrawn on payment of costs, 10s. 6d. 14 and 16, Chadwick Street (dwelling houses). Foul and obstructed condition of drain; generally dirty and dilapidated condition of house. Closing order made. 26, Carnaby Street (workshops and tenements). Dirty condition of premises; front basement damp, accumulation of refuse, &c. Order to abate within 21 days; 10s. 6d. costs. 23, Great Peter Street (tenements) Failing to maintain flushing tank of w.c. in proper state of repair. Fined £1. Housing Conditions. Sanitary Survey of Houses.—This has been continued throughout the year. Special examination has been made of 19 houses in Newport Court and Little Newport Street, 39 in Newport Buildings, 3 in 40 Marsham Street, 3 in Willow Place, 4 in Artillery Row, 3 in Chadwick Street, 4 in Vandon Street, 6 in Tufton Street, 1 in Ann's Place. With regard to the first named consideration was given as to dealing with certain of the houses as obstructive buildings. Representation was made that one house was unfit for occupation but eventually the Council agreed not to make a Closing Order, conditionally on the owners giving a written undertaking to discontinue the use of a room on the ground floor as a living room and to carry out certain works O necessary to render the premises more sanitary. In view of the general circumstances consideration of the general question was not proceeded with, but the use of a basement as a workshop was discontinued and sanitary improvements were carried out in several of the other houses. Improvements in the condition of the basement tenements in Newport Buildings were effected and the owners undertook not to let these rooms to families in which there were children. In the 3 houses in Marsham Street, two of which were empty, certain outbuildings were demolished and part boarded up. Two of the houses in Willow Place were closed by Magistrates' Order and the third voluntarily. Those in Artillery Eow were demolished, having been empty for some years and become ruinous. A Closing Order was made in respect of one house in Chadwick Street and the house has since been demolished, a second one was closed by Magistrate's Order. The houses in Yandon Street and one in Horse Shoe Alley have been closed in view of a scheme for reconstruction. The houses in Tufton Street are being dealt with under the Public Health (London) Act—2 have been closed voluntarily and 1 in Tufton Place. The house in Ann's Place has had improvements effected in regard to ventilation of the rooms. Number of houses specially inspected 82 Number of representations made 2 Number of closing orders made:— Under Housing and Town. Planning Act 1 Under Public Health Act 3 Closed voluntarily 9 Houses demolished 8 Underground Booms.—12 rooms were found to be illegally occupied 3 of these not complying with the requirements of the Housing and Town Planning Act. 41 Begulations were made by the Council under this Act, Sec. 17(7)(b), for securing the proper ventilation and lighting of such rooms and the protection thereof against dampness, effluvia or exhalation. Houses Let in Lodgings.—The number of houses in 1915 was further reduced through closure, and as none were added in that year, the number on the register at the end of the year was 1,244; to this class of house 8,982 visits are recorded as having been paid. In addition to the Inspectors' visits, a large number of these houses are visited by the Health "Visitors, who call attention to any insanitary conditions requiring amendment. The disinfectors also visit a number in the course of the year, where children have been found to be suffering from vermin. Overcrowding was found in 20 instances, and 989 other defects were found and remedied. Particulars are included in the general list given at the beginning of this part of the Report. Twenty-three statutory notices had to be issued before defects were remedied, and in six instances proceedings had to be taken in the Police Court (see above). There were three infringements of the By-law that persons of different sex, above the age of 12 years, not being persons living together as husband and wife, shall not occupy the same sleeping apartment. Water Supply. Fifty-two notices of withdrawal of water supply were received from the Metropolitan Water Board, and in 40 instances it was reinstated, on notice. The reasons given for cutting off the supply were: houses empty, 12; non-payment of rates, 37; by request, 2; irregular fittings, 1. Legal proceedings in connection with water supply was taken in one instance. Two certificates were granted under Sec. 48 (1) Public Health {London) Act. Bevenue Act. Certificates under this Act relieve the recipient from the payment of Inhabited House Duty. One application was received in respect of 3 tenements in 119a, Mount Street, W., and certificates were granted. Smoke Prevention. The following is a summary of the work done in connection with smoke prevention:— 42 1915 Total. 1914 Total Complaints received 67 42 Observations taken 2,022 2,288 Notices issued— Preliminary 128 104 Statutory 6 3 Summonses In six cases complaint was made of smoke entering rooms from adjoining chimneys, due to the chimney being too low or defective. Notices were served with reference to smoke being emitted from 1 traction engine and 1 fixed engine. Two notices were also served with respect to chimneys outside Westminster from which black smoke was blowing into the City. Many of the nuisances arose from the inability to obtain steam coal or coke, a.nd some through the regular stokers having joined either the Navy or the Army, and the temporary men engaged not being used to the work of stoking; but every effort has been made to prevent nuisances. Offensive Smells.—Complaints were received in a number of instances of offensive smells, and 8 notices were issued in respect thereof. These arose from burning fat and refuse, petrol fumes, defective flues, &c. Complaints were also dealt with arising from barges laden with house refuse. 43 D. WORKSHOPS, &c. 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 The following shows the state of the register of work premises at the end of 1915:— Work Premises. Total Number. Number in which Women are Employed. Tailors, outfitters, shirt makers, hat, cap, and helmet makers 1,041 937 Dressmakers, milliners, embroiderers, lace makers, blouse makers, costumiers, lingerie makers, children's outfit makers, feather dyeing, corset makers, furriers, &c. 808 808 Leather workers, boot and shoe makers, harness makers, &c. 37 32 Carpentry, upholstery, carvers, gilders, &c. 46 32 Surgical and dental instrument makers 13 12 Tobacco manufacturers 25 25 Wig makers and hair workers 49 49 Printing, bookbinding, lithographers, envelope making, stationers, publishers, &c. 46 31 Jewellers, silversmiths and burnishers, diamond cutters and polishers, engravers, &c. 160 31 Metal workers 140 — Miscellaneous—Basket making, fancy work, shoe ornaments, hat pins, stamp sorters, postcard tinters, fan makers, artificial flower makers, &c. 80 73 Florists 33 32 Laundries 40 40 Bakehouses 84 — Photosraphers 21 21 Jewel case makers 8 8 There are also 7 distress workrooms employing women. New workshops are always being discovered, at the same time the occupation of premises on the register is constantly changing. The use of 360 registered workshops was discontinued, and 136 additions were made to the register during the year; 78 visits of enquiry were made at places where women were likely to be employed. Statutory notices were issued in respect of 32 workshops and workplaces; 4 prosecutions took place in connection with premises in which work was carried on, as shown above, under the heading of "House Inspection." D 44 Inspection. Premises. Number of Inspections. Keinipections. Defects Found. Intimation Notices. Statutory Notices. Prosecutions. Factories 102 132 97 28 2 - Workshops 2,101 2,798 1,426 656 23 3 W orkplaces (Including restaurant kitchens, &c.) 1,949 1,369 715 308 9 1 Total 4,152 4,299 2,238 992 34 4 Defects found,.—1915. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Nuisances under the Public Health Acts:— Want of cleanliness 704, 704 1 Want of ventilation 77 77 — Want of ventilation of gas stoves 76 76 — Overcrowding 26 26 — Want of drainage of floors 21 21 — Sanitary accommodation— Insufficient 58 58 — Unsuitable 112 112 — Defective 300 300 — Not separate for sexes 73 73 — Other defects 751 751 3 Total 2,198 2,198 4 Offences under the Factory and Workshop Act:— Illegal occupation of underground, bakehouses — — — Breach of special sanitary requirements for bakehouses (included above) 8 8 — Other offences — — — 45 Other Matters. Class. Number. Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act 127 Action taken in matters referred by II.M. Inspectors as remediable under the Public Health Acts but not under the Factory and Workshop Act— Notified by H.M. Inspector 68 Reports (of action taken) sent to H.M. Inspectors 68 Other 17 Workrooms measured 303 Underground bakehouses— Certificates granted during the year — ,, refused ,, — In use at the end of the year 67 Outworkers.—Firms giving out work in certain trades are required to send in a list twice a year of those they employ. Notices were sent to 43 employers for failing to send in lists, no second notice was sent. Those who failed to reply were visited by the Inspector and all the lists were eventually received. In addition 20 visits of enquiry were made to ascertain if outworkers were employed. The accompanying table gives the details of the returns made in Westminster in 1915. 717 lists, containing 7,831 names and addresses, were sent in by employers; 4,278 addresses were sent to other local authorities in whose jurisdiction lived persons to whom work, chiefly tailoring, is sent from Westminster to be done in other boroughs; 400 addresses were received of persons in Westminster taking in work from other boroughs. They were distributed thus:— Council. Sent from Westminster. Received by Westminster. Council. ' Sent from Westminster. Received by Westminster. Feb. Aug. Feb. Aug. Feb. Aug. Feb. Aug. Acton 5 8 — — Brighton — 1 — — Barnes 2 — — — Broadstairs .. 2 2 — — Barnet 1 — — — Bromley 1 1 — — Battersea 80 69 1 — Camberwell 29 23 — — Bedfont 1 — — — Carshalton — 1 — — Bedford 2 1 — — Charlton Kings 1 — — Berkhampstead — 1 — 4 Chelsea 9 7 39 37 Bermondsey 2 3 1 1 Cheltenham — 1 — — Bethnal Green 9 6 1 — Chichester 1 1 — — Billingshurst — — — — Chiswick.. 11 9 — — Bishop's Stortford 1 — — — City of London 7 11 53 55 D 2 46 Council. Sent from Westminster. Received by Westminster. Council. Sent from Westminster. Received by Westminster. Feb. Auk. Feb. Aug. Feb. Aug. Feb. Aug. Colchester 1 — 1 — Northampton 8 8 — — Croydon 10 11 — — Nottingham 1 1 — — Deptford.. 6 3 — — Oxford 1 1 — — Dulverton 1 1 — — Paddington.. 90 74 8 9 Ealing 7 7 — — Penge 3 3 — — East Ham 3 4 — — Poplar 3 6 — — Ea«t Molesey 4 2 — — Redhill 2 2 — — Edmonton 3 2 — — Richmond .. 1 2 — — Enfield 2 — — — Rickmansworth 1 — — — Epsom 2 1 — — Romford 1 — — — Eritli 1 — — — St. Marylebone 668 549 14 58 Finchley.. 3 2 — — St. Pancras 390 359 2 2 Finsbury 20 15 — 6 Shoreditch 15 11 1 1 Friern Barnet .. •1 — — — Southampton — — — 1 Fulham 40 27 — 1 Southend 2 — — — Greenwich 2 2 — — Southgate — 1 — — Hackney 16 15 2 1 Southwark 50 41 — — Hammersmith .. 54 46 — — Stepney 159 103 6 2 Hampstead 13 8 1 1 Stockbridge . — — — — Hanwell .. 2 2 — — Stoke Newington .. 8 4 — — Harpenden 1 1 — — Surbiton — 1 — — Harrow ... 1 1 — — Teddington.. 1 1 — — Hendon .. 6 7 — — Teignmouth 1 — — — Holborn 112 94 24 23 Tottenham 10 9 — — Hornsey .. 8 8 — 1 Twickenham 1 1 — — Horsham.. 1 — — — Walthamstow 3 4 — — Hounslow — 2 — — Wandsworth 67 51 — — Islington.. 69 52 1 1 Wanstead .. 1 1 — — Kenley 1 1 — Watford — 1 — — Kensington 63 48 21 22 Wealdstone 3 3 — — Lambeth 109 80 — — Wembley .. 5 3 — — LaTgley 1 2 — — West Ham 9 6 — — Leeds 1 — — — Willesden .. 82 69 — — Lewisham 11 4 1 1 Wimbledon 5 3 — — Leyton 5 7 — — Woodford .. — — —— — Luton .. 2 2 — — Wood Green 4 1 — — Merton 2 2 - — Woolwich 2 1 1 — Newbury 1 1 — — 2,348 1,930 178 222 New Maiden 2 — — — Workers are frequently in the employ of several firms, so that the number of names returned as resident in the City does not necessarily coincide with the actual number of workers, which, at the maximum, was found to be 1,380. The numbers returned in February are only slightly below those at the corresponding period of the previous year, but there was a considerable fall in the August list. The figures include a number of women to whom work was given out by various war agencies. 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 was being done was 842. 47 City of Westminster. Outworkers. 1915. FEBRUARY LISTS. AUGUST LIST. 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. Tailoring 292 3,410 151 1,603 1,958 263 2,801 190 1,335 1,656 Dressmaking 14 73 4 65 12 9 45 6 35 16 Theatrical costumiers 1 10 — 7 3 1 9 1 6 4 Waterproofing 1 ' 3 — 2 1 1 3 — 2 1 Shirt making ancl hosiers 32 337 10 230 117 29 240 8 180 68 Boot making 21 382 5 335 52 24 334 5 302 37 Corset making — — — — — — — — — — Embroidery 7 71 3 67 7 5 50 3 48 5 Glove making 1 3 — 3 — 1 3 — 3 — Furriers 3 13 1 13 1 5 16 3 16 3 Hat making 1 1 — 1 — — — — — — Millinery — — 1 — 1 1 3 2 2 3 Belt making — — — — 1 1 — 1 — Jewellery — — 2 — 2 — — 2 2 Artificial flower making — 1 — 1 — — — — Bandolier making 1 23 — 22 1 —— — — ' — — Hair working — — — — — —— — 1 —- 1 Brush making — — — — — — — 1 — 1 377 4,326 178 2,348 2,156 340 3,505 222 1,930 1,797 336 firms sent in lists on both occasions, giving a total of 7,120 addresses; 45 firms sent in once in the year, the number on their lists being 711. 48 Notices were served in respect of 717 defects discovered in 294 houses They may be summarised thus:— 1915. 1915. Sanitary accommodation s— Rooms verminous 33 Insufficient 2 Rooms overcrowded 5 Not kept separate 31 Rooms badly ventilated 13 Apparatus defective 68 Other defects (dampness, defective roofs, floors, water supply, dust bins, &c.) 306 Requiring cleansing 46 Walls and ceilings dirty 213 In 13 instances statutory notices had to be served before the work required was done. In several instances where the rooms were dirty or verminous the outworker was seriously warned. Two underground rooms used as workrooms were unfit to be so used, and their use was discontinued. Infectious Disease.—A list of the cases of notifiable infectious diseases which occurred in families engaged in the making, &c., of wearing apparel, are given below. It was unnecessary to stop their work except temporarily during the time disinfection was being carried out:— Smallpox. Scarlet Fever. Diphtheria. Typhoid Fever. Clothing trades:— — (a) Business in family affected — 22 (15) 13 (7) — (5) Business in other parts of house — 38 (29) 9 (8) — (c) Persons from infected houses employed in clothing business elsewhere — 59 15 — The figures in brackets represent outworkers' premises. E. FOOD SUPPLY. During 1915 visits have been paid to the various classes of business as follows:— Visits. Notices served. Visits. Notices served. Dairies and Milkshops 992 21 Food-preserving works 61 2 Hotels, Restaurants and Eating houses 3,545 198 Greengrocers and Fruiterers 263 1 Fishmongers 674 15 Confectioners 96 20 Meat shops (various) 483 22 Aerated water makers 2 — Provision shops 391 2 Breweries and Licensed Premises not included under "Hotels, &c." 219 36 Ice merchants 6 — Bakehouses 298 8 Ice cream makers 241 10 Intimations were served in respect of 417 premises, and 5 statutory notices. 49 Defects have been found in places where food is sold or prepared for sale as follows:— 1915. Restaurants Hotels, EatingHouses and Confectioners. Ice Cream Sbops. Dairies, Bakehouses. Fish Shops. Butchers, Poultry and Provisions. Fruit and Vegetables. Dirty walls and ceilings 108 6 8 2 — 3 13 Dirty floors 11 9 — — — 1 — Defective roofs 7 — 1 — — — — „ floors 5 — 3 1 — — — Absence of or defective dustbins 15 1 1 1 — 1 — Accumulations of refuse 19 5 3 1 1 5 i Food stored or prepared in improper places 12 — — — —— — 1 Yards dirty 5 3 2 1 — — — „ paving defective 5 1 1 — — — — Water cisterns dirty — 2 — — — — „ ,, defective 4 1 — — — — Water—insufficient or none 3 2 1 — — — — W.Cs. defective 34 4 3 — 2 1 8 „ dirty or obstructed 17 7 2 2 — — 3 ,, insufficient —— — — — — — 1 ,, unventilated 1 1 — — — — — „ without ventilated lobby 2 — — — — — — Urinals defective 15 — — — — — — Sink wastes, &c., defective 27 6 3 2 1 — 3 Drainage defective 18 2 3 2 1 — 1 Burning refuse in stoves 5 — — — — — — Defective ventilation 6 — — — — 1 — „ „ of gas stoves 1 — — — — — — Dampness of walls, &c. 10 — 1 — 1 — — Room adjoining used as a bedroom 4 — — — — — 1 Kitchens overheated 2 — — — — — — Cloak-room accommodation absent or unsuitable — — — — — — — Jnvested with flies 1 — — — — — — Restaurants.—The kitchens of hotels and restaurants are inspected at least once a quarter. Ice-cream Premises.—There were during the year 155 places where this commodity was made or sold, and these were kept under supervision. Defects, as shown in the accompanying table, were found and rectified. The making of ice-cream was prohibited in one shop until the place was made suitable, and the vendor severely cautioned. Bakehouses.—At the end of 1914 there were 16 above-ground and 68 underground in use. During 1915 one underground bakehouse was closed and one above-ground was opened and one closed. All the bakehouses were inspected, and cleansing carried out twice a year. Notices were served in respect of various defects. 50 Horseflesh for Human Consumption.—Owing to the number of Belgians now resident in the Soho district, a shop has been opened for the sale of horseflesh. Improper Storage of Food.—In one instance in Soho it was discovered that a man who hawks bread and cakes round tailors' workrooms was found storing the unsold cakes under the bed in a room that was very dirtily kept. Chestnuts and macaroni were found being stored in a bedroom in another house in Pimlico ; under the threat of proceedings these conditions were promptly stopped. Supply of Food for the Army.—Factories holding contracts, as well as caterers supplying meals to soldiers quartered in Westminster, were kept under continuous supervision. Certification of Food for Export.—As Certifying Officer for the City of Westminster for all meat foods prepared or packed for export to several foreign States, I have granted during 1915, 9 certificates for the United States and 6 for the Philippine Islands. Milkshops.—At the end of 1914, 469 names of persons selling milk were upon the register. In 1915, 7 names were removed and 15 added, leaving 477 on the register at the end of the year; 8 of these were registered in respect of new premises; 1 application was refused owing to the premises being unsatisfactory for the sale of milk. Seven persons selling milk were given notice to register, and all complied. Nine hundred and ninety-two visits were paid during the year, besides those by the two Inspectors taking samples under the Food and Drugs Acts, to premises in which milk is sold. Notices requiring improvement of existing conditions were served in a number of instances (see Table). Objection was taken to the milkpans not being covered in 4 instances. Two cases of infectious disease occurred on premises in which milkshops were situated, and 4 persons whose relatives were suffering from an infectious disease were found to be working in milkshops. Satisfactory arrangements were made in each instance and no infection of the milk resulted. Cowshed. — There is now only one cow-shed, namely, at 13, Marsham Street (licensed for 19 cows). These premises were visited 23 times during the year. Inspection of Food. The food exposed for sale in shops and on stalls in the street markets has been regularly inspected every day (including Sundays). The 51 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 2 15 84 Lettuce 0 18 20 Bananas 10 2 28 Mushrooms 0 0 42 Blackberries 0 4 32 Onions 1 2 0 Brussels Sprouts 0 12 28 Oranges 4 5 28 Cabbage 1 0 28 Pears 9 4 84 Cherries 2 2 8 Pineapples 5 17 0 Currants (Bed) 0 1 0 Plums 2 10 0 Currants (Black) 0 1 0 Potatoes 1 2 0 Endive 1 0 92 Spinach 0 2 28 Gooseberries 0 5 84 Tomatoes 4 3 56 Greengages 0 2 0 Turnip Tops 0 3 56 Fisli (various), 7 cwts. 42 lbs.; Ducks, 51; Poultry, 28 lbs. The following articles were seized and condemned; appended is a note of the action taken:— Name and Address of Defendant. Article. Result. R. Cooke, 5, Cambridge Road, Mile End, E. Depositing for the purpose of preparation for sale at 158, Horse ferry Road, five bullocks' hearts, which were unsound The Magistrate did not think that it was intended to prepare these hearts for sale and dismissed the summons. At the same time he thought that the prosecution had been very rightly instituted and that the defendant ought to exercise a great deal more care in getting rid of unsound meat on the premises. Civil Service Co-operative Society, Ltd., 28, Haymarket, S.W. Depositing at 28, Haymarket, for sale unsound turtle soup Fined £20. Lockharts, Ltd., Paul Street, Finsbury, E.C. LTnsound fruit pie exposed for sale Dismissed under Probation Act. The Magistrate considered demnation of the article were proceedings ought not to have the charge proved and that justified, but that the matter been taken. the proceedings for the conwas so slight that further. George Matthews, 11, Carlow Street, Arlington Road, Camden Town Exposing in Berwick Street for sale unsound pears Fined £3 and 10s. 6cl. costs W. J. Bennett, 3, Peter Street, Solio Exposing for sale, unsound herrings Fined £5. Do. Depositing for the purpose of preparation for sale, unsound herrings Withdrawn. 52 Sale ok Food and Dkugs Acts. Samples Purchased under the Sale of Food and Drugs Acts, showing result of Analysis and subsequent Proceedings for year 1915. Number. Article of Food. Number of Samples Purchased. Genuine. (Inferior in brackets.) Adulterated. Prosecutions. Convictions. Withdrawn or Dismissed. Fines. Costs. £ t. d. £ s. d. i Milk 937 756 (99) 82 51 26 25 39 6 0 13 14 0 2 do. separated 3 2 1 1 1 — 5 0 0 0 12 6 3 do. skimmed 1 i 4 Cream, fresh 80 62 18 8 7 1 10 14 0 2 12 6 5 do. preserved 83 5 78 19 4 15 16 0 0 1 17 6 6 Butter 256 236 (7) 13 7 7 — 16 0 0 3 7 0 7 do. milk blended 1 1 — 1 1 — 0 10 0 0 12 6 8 Margarine 6 6 9 Bread and butter 3 3 1(1 Flour 26 26 11 do. self-raising 1 1 12 Kice 42 34 8 13 Barley, pearl 5 5 14 Tea 15 15 15 Coffee 12 12 16 Coffee and chicory 3 3 17 Cocoa 10 10 18 Meats, potted (various) 56 47 9* 19 Meat pies (various) 47 43 4 20 Brawn 5 4 1 21 Beef, corned 1 1 22 Sausages, pork and beef 61 52 9 1 1 — — 0 12 6 23 Sausage rolls 2 2 24 do. luncheon 1 1 25 do. German 3 2 1 1 1 — — 0 12 6 26 Fish, potted (various) 12 10 2 27 Vegetables, mixed 3 3 28 Spinach (tinned) 1 1 29 Beans (tinned) 3 1 2 30 Peas (tinned and bottled) 30 10 20 6 5 1 10 10 0 2 4 0 31 A sparagus (tinned) 1 1 32 Olives, stuffed 1 1 33 Soup (tinned and bottled) 12 10 2 34 Jelly, calvs foot 10 10 35 Jam 16 16 36 Fruit (bottled) 13 13 37 Fruit Tart 1 1 38 Oil, olive 8 8 39 Linseed, crushed 11 9 2 40 Oil, camphorated 18 17 1 Refusal to sell to Inspector — — — — — — 1 10 0 0 16 6 Totals 1,800 1,441 (106) 253 95 53 42 99 10 0 27 1 6 Note re Cream.—15 cases last year and 16 cases this year stand adjourned sine die pending an enquiry into the question of preservatives in cream by the Special Committee to be appointed by the Local Government Board. 53 Summary proceedings were ordered to be taken in 96 instances, 25 cautions were issued, the attention of the vendors was called to the report of the Analyst in 24 instances, and no action was taken with regard to 107 samples which deviated slightly from the standard or were test purchases not taken officially. There were 100 non-official samples purchased during the year. * Milk. —937 samples of ordinary milk were taken during the year. 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). Adulterated are those below the official standard of 3 per cent, for fat and 8'5 for solids not fat. District. Total. Good Quality. No. Percent. Fair Quality. No. Per cent. Poor Quality. No. Per cent. Adulterated. No. Percent. South 412 142 34.4 177 42.9 63 15.2 30 72.0 North 525 161 30.6 150 28.4 162 30.8 52 9.90 1915 937 303 32.3 327 34.8 225 24.0 82 8.70 1914 894 250 27.9 364 40.7 217 24.2 63 7.04 1913 910 255 28.0 343 37.6 233 25. 6 79 8.60 1912 873 251 28.7 297 34.0 252 28.8 73 8.30 1911 911 305 33.3 311 34.1 218 23.9 77 8.40 1910 947 332 35.0 328 34.6 179 18.9 108 11.40 1909 951 285 29.9 357 37.5 223 23.4 86 9.04 1908 860 335 38.9 267 31.0 176 20.4 82 9.50 1907 792 255 32.2 290 36.6 172 21.7 75 9.40 1906 806 267 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 Although superior quality milk shows a decided improvement to that of 1914, there is a deterioration in that of medium quality, and the proportion of adulterated samples was greater. The quality of the milk sold in the North area of the City appears to be inferior to that sold in the South. Fifty-one prosecutions were taken with regard to adulteration— 37 for fat abstracted, 11 for added water, 2 for both fat abstracted and added water, and 1 for having 20.42 grains of boiic acid per gallon. (See 784 S.) 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. Warranties were set up as a defence in 22 instances, 54 and were successful in 21; 1 case was withdrawn, owing to the defendant's business being in liquidation, and 2 were dismissed, 1 owing to the exaggerated difference between the result of analyses of the Council's analyst and that of the Government analyst, and the other to the proved statement of the defendant that the milk was as it came from the cows. (See Samples 351 S. and 725 S.) Sunday Samples.—98 of the samples of milk were taken on Sundays during the year; 10 (10'2 per cent.) were found to be adulterated. {See lists of Prosecutions Nos. 256 S., 325 S., -429 S., 535 S., and 324 S. (Separated Milk).) Samples taken in course of Delivery—- (a) At Railway Stations.—25 samples of milk were taken on arrival at Victoria and Charing Cross Railway Stations. Fourteen were reported of good quality, 5 fair, 5 poor and 1 adulterated:—Fat abstracted, 15 per cent. The defendant had obtained an analysis of the sample left with him which was certified to be pure, the Council's analyst certified a deficiency of 15 per cent, of fat and the Government analyst certified a deficiency of 24 per cent, of fat. The Magistrate dismissed the summons partly on the ground of the variation between the three analyses and partly on the statement of the defendant's solicitor that the milk was as given by the cows, in proof of which he tendered his witnesses. (J) On Delivery at Shops, c&c.—41 samples of milk were taken as it was being delivered by wholesale firms to retail customers, including shops, hotels and hospitals. Of these samples, 19 were good, 15 fair, 5 poor, and 2 adulterated (38 per cent, added water and 13 per cent, fat abstracted). These samples were taken in consequence of previous samples being found below the limit (including cases where a warranty defence was set up). Proceedings were taken against the vendors of the adulterated samples.—See Nos. 156 K and 328 S. in list of prosecutions. Refusal to sell Milk.—Three cases of "refusal to sell" milk to the Inspector occurred during the year. Proceedings were taken in two instances with the result that one was fined 10s. and 14s. Gd. costs, the other 20s. and 2s. costs. In the third case a sample was eventually obtained and found to be genuine, and on the recommendation of the City Solicitors no further action was taken. Infringement of Section 9, Sale of Food and Drugs Act, 1899.— Seven persons were found to be using milk cans and barrows without 55 any name or address and one with wrong name and address. All complied with the Act after being cautioned. Skim and Separated Milk.—One sample of the former and 3 of the latter were examined. One sample only was adulterated, that of separated milk, which was taken on a Sunday and found to contain 10*5 per cent, added water. A fine of £5 and 12s. 6d. costs was inflicted. Milk and Cream Regulations, 1912—In all cases the Public Analysts examine milk and cream for preservatives. A list is appended in the form asked for by the Board:— 1. Milk and Cream not sold as Preserved Cream. Article. (a) Number of samples examined for the presence of a preservative. .(b) Number in which a preservative was reported to be present. Mill 941 1 Cream 80 18 Boric acid preservative was found in one of the samples of milk examined to the extent of 20-42 grains per gallon. A summons was ordered to be taken out against the vendor; but was withdrawn owing to the business being found to be in liquidation. 2. Cream. 1915. Number of samples examined for preservative. Number containing preservative. March quarter 21 4 June quarter 21 6 September quarter 23 6 December quarter 15 2 Total 80 18 Action Taken. 8 Prosecutions ordered. Contained respectively 33, 24.7, 21.7, 18.9, 18.2, 18.2, 17.5 and 16'8 grains boric acid per lb. Seven convictions were obtained and one case was adjourned sine die. Two of the prosecutions were under the Regulations. 3 Cautions Contained respectively 17 3,14 7 and 7.8 grains of boric acid per lb. 56 2 Vendor's attention called Contained respectively 2 and 4 grains of boric acid per lb. 2 Explanation asked for and cautioned Contained respectively 10'5 and 9'8 grains of boric acid per lb. 3Noaction Contained respectively 109, 7*7 and 48 grains boric acid per lb. 3. Preserved Cream. 1915. Number examined. Without preservative. Preservative under amount stated on label. Preservative over amount stated on label. March quarter 15 1 14 — June quarter 23 3 20 — September quarter 21 — 21 — December quarter 24 1 22 1 Total 83 5 77 1 Adian Taken. 19 Prosecutions ordered Contained respectively 36.4, 35, 35, 34 5, 3.38, 31, 30, 30, 29'7, 29 4, 29.4, 27 6, 28, 252, 25 9, 25, 238, 23.4 and 22'5 grains boric acid per lb; 15 cases were adjourned sine die. In one case an appeal lias been taken to the High Court on the point that preserved cream is a recognised article of food, consequently if boric acid is one of its component parts there can be no adulteration with that drug. (See No. 523 Npost). 4 Cautions Contained respectively 25.5, 25.2, 226 and 22.4 grains boric acid per lb. 2 Vendor's attention called Contained respectively 25.2 and 21.8 grains boric acid per lb. 53 No action Contained respectively 26.6, 26, 25.2, 23.8, 21.7, 21, 20.9, 20.5, 20.3, 20.3, 20.3, 19.8, 19.7, 18.3, 18.2, 18, 17.7, 17.5, 17.5, 17, 17, 16.8, 16.6. 16.4, 16.4, 163, 16.1, 16.1, 16, 16.1, 15.9, 15.9,14.5, 14.3, 14, 14, 13.7, 13.3, 11.4, 11.2, 9.4, 9.1, 9, 8.4, 8.4, 8.4, 7.4, 7, 7, 7, 3, .7, and a trace of grains boric acid per lb. 50 samples contained amounts less than 22 grains, the amount fixed by the High Court as injurious. 2 he amount of Fat in Preserved Cream 'was estimated in six samples in the quarter ended, June '60th last, as follows:— Fat , per cent . Boric Acid, per cent. 59 .36 38 .25 39 .23 51 .18 41 .12 48 •26 57 4. Infringements under Article 5 (1), Nil. Infringements under Article 5 (2), Nil. 5. Thickening Substances. — The Analysts have not reported the presence of any foreign substances other than preservatives in any of the milks or creams examined by them. Butter.—Of the 256 samples purchased and submitted for analysis, 13 were found to be adulterated. (See list infra.) Six prosecutions and six convictions were obtained. The remaining adulterated samples, seven in number, were unofficial or "test" samples. Milk Blended Butter.—A vendor was found to be selling milk blended butter under a name not registered. Summary proceedings were taken, and a fine of 10s. and 12s. 6d. costs was inflicted. Three samples of bread and butter were taken and found to be genuine. Rice.—In 42 samples of rice, 8 were found to contain powdered talc:—14, 11*9, 9'8, 9*8, 7, 6'3, 6-3 and 2-8 grains per lb. The vendors' attention was called to the result of the analyses, and cautioned. Sausages, Meat Pies, &c.—Samples were taken during 1915 of sausages, meat pies, &c., as shown in the list printed above. Of 47 Meat Pies (Various) 4 contained boric acid:—9, 7, 4 2 and 3.5 grains per lb. Of 5 Brawn 1 contained boric acid:—1*7 grains per lb. Of 61 Sausages (Beef and Pork) 9 contained boric acid:—26.7, 20. 15.6, 13.1, 11.9, 11.9, 8.6, 8.3 and 4.9 grains per 11). Of 3 German Sausages 1 contained boric acid:—210 grains per lb. (Sample No. 228 list of prosecutions.) Potted Meat.—111 56 samples of potted meats 9 were found to contain preservative to the amount of 23, 21.4, 18.9, 7, 6.5, 6.l, 6, 4.3 and 3.5 grains per lb. respectively. Fish.—Twelve samples of fish (potted and tinned) were examined. One sample of bloater paste contained 2.8 grains boric acid per lb., and one sample of smoked cod's roe contained 1.7 grains of boric acid per lb. Beans.—In 3 samples of beans (tinned), 2 were found to contain copper sulphate to the extent of 1.1 and .4 grains respectively. 58 Peas.—In 30 samples of peas (tinned and bottled), 20 were found to contain copper sulphate:—3, 3, 2.8, 2.4, 2.4, 2.3, 2, 2, 2, 19, 1.7, 1.7, 1.6,1.3, .9, .8, .4, .4, .3 and .2 grains per lb. Soup (various).—In 12 samples of soup (tinned and bottled), 2 were found to contain tin:—.4 and .2 grain per lb. Linseed, crushed.—In 11 samples of crushed linseed meal 2 were found to be deficient in oil to the extent of 16 and 10 per cent. respectively. Camphorated Oil.—In 18 samples of camphorated oil, 1 was found to be deficient in camphor to the extent of 5 per cent. 59 Legal Proceedings Under tiie Food and Drugs Acts during 1915. No. of Sample. Date of Hearing. Offence. Result. 1 2 3 4 1915. MILK. 35 N.* 24th Feb. 12 per cent. of fat abstracted Fined 40s. and 12s. 6d. costs.† 14 S.* 24th Feb. 32'6 per cent. of fat abstracted Fined 40s. and 12s. 6d. costs.† †A warranty was pleaded in these two cases, bnt the Magistrate declined to accept the proof that was tendered to the Court as sufficient. 96 N.* 26th Mar. 16 per cent. of fat abstracted Fined 40s. and 12s. 6d. costs. 156 N.* 26th Mar. Procured in course of delivery at 39, Windmill Street, 13 per cent, of fat abstracted Warranty proved. Summons dismissed. 225 N.* 28th April 15 cent. of fat. abstracted ... Fined £2 and 12s. 6d. costs. 223 N. 28th April 26 per cent. of fat abstracted Fined £2 and 12s. 6d. costs. 189 S.* 5th May 12 per cent. of fat abstracted Warranty proved. Summons dismissed. 292 N. 14th May 17 per cent. of added water and 10 per cent. of fat abstracted Fined £2 and 12s. 6c7. costs. 222 N.* 19th May 45 per cent. of fat abstracted Fined 42s. and 12s. 6d. costs. 290 N. 26th May 18 per cent. of added water Fined 20s. and 12s. 6d. costs. 211 S.* 26tli May 9 per cent. of fat abstracted Warranty proved. Summons dismissed. 256 S.* 9th June 21 per cent. of fat abstracted Fined 40s. and 12s. 6d. costs. 267 S. 9th June 15 per cent. of fat abstracted Warranty proved. Summons dismissed. 325 S. 30th June 6 per cent. of fat abstracted Fined £1 and 12s. 6d. costs. 333 3.* 30th June 6 per cent. of added water Fined £1 and 12s. 6d. costs. 411 N.* 6th July 8 per cent. of fat abstracted Warranty proved. Summons dismissed. 373 N.* 22nd June and 6th July 15 per cent. of added water Warranty proved. Summons dismissed. ‡ 422 N.* 6th July 3 per cent. of added water and 11 per cent. of fat abstracted Warranty proved. Summons dismissed.‡ 404 N.* 22nd June and 6th July 13 per cent. of fat abstracted Warranty proved. Summons dismissed.‡ ‡With regard to these cases it was stated by the Defendant's Solicitor that the milk had been adulterated by the farmer, against whom summonses had been issued by the St. Pancras Borough Council. 420 N.* 9th July 5 per cent. of fat abstracted Warranty proved. Summons dismissed. 442 N.* 9th J uly 20 per cent. of fat abstracted Warranty proved. Summons dismissed. 445 N.* 9th J uly 14 per cent. of fat abstracted Ordered to pay 12*. 6d. costs. Having regard to the Defendants' good record and explanation offered by their Solicitor, the Magistrate thought the payment of costs would suffice. 413 N.* 9th July 17 per cent. of fat abstracted Warranties proved. Summonses dismissed. 302 N.* 18th June and 9th J uly 11 per cent. of fat abstracted 341 S.* 14th July 30 per cent. of fat abstracted Fined 40s. and 13s. 6d. costs. 334 S.* 30th June and 14th J uly 7*5 per cent. of added water Ordered to pay 13s. 6d. costs. The Defendant's Solicitors stated that the milk had been watered by the Company's servant without their knowledge, and that he had since been discharged. *In these cases there have been prosecutions previously. E 60 No. of Sample. Date of Hearing. Offence. Result. 1 2 3 4 1915. 328 S.* 14th July 38 per cent. of added water Fined 40s. and 13 s. 6d. costs. 415 N* 9th and 16th July 21 per cent. of fat abstracted Warranty proved. Summons dismissed. 351 S * 14th and 28tli July Deficient in fat to the extent of 15 per cent. Dismissed. The Defendant had obtained an analysis of the sample left with him which was certified to be pure, the Council's Analyst certified a deficiency of 15 per cent, of fat and the Government's Analyst certified a deficiency of 24 per cent, of fat. Notwithstanding the analyses being two to one against the Defendant, the Magistrate dismissed the summons, partly on the ground of the variation between the three analyses and partly on the statement of the Defendant's Solicitor that the milk was as given by the cows, in proof of which he tendered his witnesses. 404 S. 28th July 8 per cent. of fat had been abstracted. Fined 10s. and 12s. 6d. costs. 380 S.* 28th July 16 per cent, of fat abstracted Warranty proved. Summons dismissed. 405 S * 28th July 5 per cent, of fat abstracted 42s. costs. As the deficiency in this case was small and the Defendant's record was a good one, the Magistrate thought that the payment of two guineas costs would be sufficient. 549 N * 13th Aug. 7 per cent. of added water Warranty proved. Summons dismissed. 479 S * 25th Aug. 10 per cent. of fat abstracted Warranty proved. Summons dismissed. 429 S * 25th Aug. 20 per cent. of fat abstracted Warranty proved. Summons dismissed. 603 N.* 17th Sept. 8 per cent. of fat abstracted Fined £2 including costs. Warranty submitted. The Magistrate, however, inflicted a fine, being satisfied that the Defendant was aware that he was selling defective milk. (See 96 N.) G14 N. 17th Sept. 24 per cent. of fat abstracted Fined £3 including costs. 619 N. 21st Sept. ] 0 per cent. of fat abstracted Fined 12s. and 10s. 6d. costs. 645 N. 8th Oct. 5 per cent. of fat abstracted Warranty proved. Summons dismissed. 648 N. 8th Oct. 22 per cent. of fat abstracted Fined 40s. and 12s. 6d. costs. 639 N.* 8th Oct. 11 per cent. of fat abstracted Warranty proved. Summons dismissed. 561 S* 20th Oct. 33 per cent. of fat abstracted Warranty proved. Summons dismissed. 535 S* 20th Oct. 6 per cent. of fat abstracted Fined 40s. and 10s. 6d. costs. 679 N.* 26th Oct. 14 per cent. of added water Fine 1 42s. 684 N.* 26th Oct. 14 per cent. of fat abstracted Fined 20s. and 12s. Gd. costs. 713 N.* 5th Nov. 11 per cent. of added water Fined 40s. 620 S. 18th Nov. 5 per cent. of added water Fined 10s. and 10s. 6d. costs. 725 S. 22nd Dec. Sample of milk taken in course of delivery from which 9 per cent, of fat had been abstracted. Summons dismissed. Two samples were taken from two different churns consigned by the Defendant. The sample from one churn was found to be satisfactory but the other sample was the subject of the summons. The Defendant gave evidence that the milk was as it came from the cows, and the Magistrate thought that he had established this fact, and having regard to the small deficiency and to the fact that the other sample was genuine lie dismissed the summons. 1916. 791 S.* 26th Jan. 13.6 per cent. of added water Warranty proved. Summons dismissed. 786 S.* 26th Jan. 12 per cent. of added water Fined 10s. and 12s. 6d. costs. 784 S. Contained 20.42 grains of boric acid per gallon. Summons withdrawn. Vendor Company in liquidation. *In these cases there have been prosecutions previously. 61 No. of Sample. Date ofHearing. Offence. Result. 1 2 3 4 1915. SEPARATED MILK. 324 S.* 30th June 10.5 per cent. of added water Fined £5 and 12s. 6d. costs. BUTTER. 91 S. 17th Mar. Selling margarine as butter Fined 40.9. and 12s. 6d. costs. 144 N.* 26th Mar. Containing 5 5 per cent. excess of water. Fined £5 and 12s. 6d. costs. 593 S. 3rd Nov. Selling margarine as butter Fined £3 and 10s. 6d. costs. 669 S.* 24th Nov. Selling margarine as butter Fined 20s. and 10s. 6tf. costs. 829 N. 26th Nov. Selling margarine without a paper wrapper marked "Margarine." Fined £2. 667 S.* 24th Nov. and 1st Dec. Selling margarine as butter £1 1s. costs. This man was fined £3 on the 3rd ult. for a similar offence, but as the offence for which he was to-day summoned was committed before the conviction on the 3rd ult., and as the offence for which lie was this day summoned was mentioned on the 3rd ult., the Magistrate thought it would be sufficient if lie were ordered to pay £1 Is. costs. 878 N. 10th Dec. Selling margarine as butter Fined £3. MILK-BLENDED BUTTER. 314 S. 30th June Selling milk-blended butter under a name not approved by the Board of Agriculture. Fined 10s. and 12s. 6d. costs. CREAM. 281 N* 14th May Contained 18 grains of boric acid per lb. £2 2s. costs. 482 N. 6th Aug. Contained 18'9 grains of boric acid per lb. Fined 42s. 678 N. 5th Oct. Contained 217 grains of boric acid per lb. Fined 22s. and 10s. 6d. costs. 768 N* 19th Nov. Contained 33 grains of boric acid per lb. Fined £3. 738 N* 5th and 19th Nov. Contained 18*2 grains of boric acid per lb. Fined £2. Public Health (Milk and Cream) Regulations, 1912. 130 S. 21st April Selling preserved cream, the receptacle containing which was not labelled. Fined £2. 153 S* 21st April Selling preserved cream, the receptacle containing which was not labelled. Fined 10s. PRESERVED CREAM. 183 N.* 16th and 23rd April and 18th June Contained 29 grains of boric acid per lb. Fined 40s. and 12s. 6d. costs. 242 N. 14th May and 28th June Contained 25 grains of boric acid per lb. Fined 40s. and 12s. 66?. costs. 151 N* 26th Mar., 23rd April and 13th June Contained 28 grains of boric acid per lb. Fined 40s. and 12s. 6d. costs. *In these cases there have been prosecutions previously. 62 No. of Sample. Date of Hearing. Offence. Result. 1 2 3 4 1915. 523 N.* 13th Aug. Contained 23.8 grains of boric acid per lb. Summons dismissed on the grounds that it was sold as "Preserved cream." Appeal to High Court. The Defendants called evidence to show that the portion of the sample left with them contained only 9'8 grains of boric acid per lb., the 3rd sample was sent to the Governmenl Analyst who certified to 29 grains per lb. 522 N.* 17th Aug. Contained 34.3 grains of boric acid per lb. Fined £10. GERMAN SAUSAGE. 228 S.* 26th May Contained 21.693 grains of boric acid per lb. 12s. Qd. costs. The Magistrate thought that as there was no allegation that the boric acid in this case had rendered the article injurious to health (the sausage being a "G-erman" sausage] the matter might be dealt with under the Probation of Offenders Act, and he merely ordered the Defendant to pay 12s. 6rf. costs. SAUSAGE. 628 S. 18th Nov. Contained 26.775 grains of boric acid per lb. 12s. 6d. costs. PEAS. 632 N.* 18th Oct. Contained 2.4 grains of copper sulphate per lb. Fined £3 and 12s. 6d. costs. 542 S. 20th Oct. Contained 2.484 grains of copper sulphate per lb. Fined 40s. and 10s. 6d. costs. 788 N. 17th Nov. Contained 2.8 grains of copper i sulphate per lb. Summons dismissed. The summons in this case was taken out under Section 6 of the Act of 1875, the amount of copper being 2 8 grains per lb., and there having been no notice on the tin tlia the peas contained copper. The Inspector's assistant stated in the witness box that he asked for green peas, and the Magistrate thought that in the absence of evidence that the article was injurious to health that the purchaser was not prejudiced. 646 S.* 18th Nov. Contained 3.036 grains of copper sulphate per lb. Fined 40s. and 10s. 6d. costs. 789 N.* 19th Nov. Contained 3 grains of copper sulphate per lb. Fined 30s. 655 S. 24th Nov. Contained 2.346 grains of copper sulphate per lb. Fined 40s. and 10$. 6d. costs. REFUSAL TO SELL. —\ — 24th Feb. 3rd Mar. Refusal to sell milk to Inspector. Refusal to sell milk to the Inspector. Fined 20s. and 2s. costs. Fined 10s. and 14s. Qd. costs. *In these cases there have been prosecutions previously. harrison and sons, printers in ordinary to his majesty, st. martin's lane, w.c.