Metropolitan Borough of Deptford. REPORT OF THE MEDICAL OFFICER OF HEALTH For the year 1902. Deptford: Printed by F. Gaylard, 446, New Cross Road, S.E Metropolitan Borough of Deptford. REPORT OF THE MEDICAL OFFICER OF HEALTH For the Year 1902. To the Mayor, Aldermen and Councillors. SIŔ AND GENTLEMEN, I have the honour to present to you the Annual Report on the vital statistics and sanitary work for the Registration Year 1902, 52 weeks ending December 27th, 1902. POPULATION. According to the Registrar-General's returns, the population for the Metropolitan Borough of Deptford is estimated at 111,577, at the middle of the year 1902. BIRTHS. The number of Births registered during the year 1902, was 3,315 (1,646 males and 1,669 females), equivalent to an annual rate of 29.7 per 1,000 of the population. The Birth-rate for the County of London was 28.5. MARRIAGES. The number of Marriages registered in the Borough of Deptford during the year 1902 was 713. The Marriages for the past seven years were— 1896 1897 1898 1899 1900 1901 1902 588 687 709 735 666 746 713 DEATHS. The number of Deaths registered during the year was 1,826 (males 948, females 878), of these 502 were registered in Public Institutions beyond the district. There were 537 belonging to the North District, 537 to the South District, and 752 to the Central District. The death-rate was equal to an annual rate of 16.3, whilst the death-rate for the Metropolis as a whole was 17.2, and for England and Wales 16.3. Table No. 1. DEATH RATES PER 1,000 PER ANNUM—1894--1902. 1894 1895 1896 1897 1898 1899 1900 1901 1902 17.1 18.0 18.7 19.3 17.7 18.5 17.5 18.2 16.3 Borough of Deptford 19.8 18.6 18.7 18.8 17.6 17.2 London 17.8 18.2 19.8 MORTALITY AT GROUP OF AGES. The 1,826 deaths recorded during the year included 672 children under five years of age. The deaths of 459 children occurred under one year; 213 deaths were registered between one and five years; 80 between five and fifteen; 73 between the ages of 15 and 25; 565 of persons over 25 and under 65; and 436 of persons aged upwards of 65 years. INFANTILE MORTALITY. Infantile mortality, that is to say, the proportion of deaths of infants under one year to every 1,000 children born was 138, as compared with 150 for the previous year, and 139 for the County of London, and in seventy-six of the largest provincial towns 146. Table No. 2. SHEWING THE NUMBER OF BIRTHS AND DEATHS IN THE BOROUGH DURING THE YEAR 1902. BIRTHS 3315 DEATHS (including Parishioners in the South-Eastern Hospital, and 396 in the Outlying Institutions) 1826 Excess of Births over Deaths 1489 ZYMOTIC DISEASES. The Registrar-General classifies under this heading _Small- Pox, Scarlet Fever, Measles, Diphtheria, Whooping-Cough, "Fever" (Typhus, Enteric and Continued), Diarrhœa, Plague. The number of deaths registered from these Zymotic diseases amounted to 211, as compared with 257 for the previous year. The average deaths from Zymotic diseases was 1.89 per 1,000 persons living, as compared with 2.32 for the previous year, and 2.21 for the County of London, and for seventy-six of the largest towns in England per 1,000 persons living 2.12. NOTIFIABLE INFECTIOUS DISEASES. The number of Notifications received during the year, under the provisions of the Public Health (London) Act, 1891, was *2,456, as compared with 1,116 for the previous year. Table NO.13 gives a detailed account of the Notification of Infectious Diseases during the year and the number of cases notified in each district and those removed to hospital from each district. SMALL-POX. The disease appears to have made its appearance in London during the month of June, 1901, and is said to have been introduced from Paris. No less than 1,700 cases were reported in London at the close of the year 1901, of these the Borough of Deptford contributed but 4 (1 in October, 2 in November, and 1 in December). *This large increase is due to the fact that Chicken-Pox was made a notifiable disease from February 7th. From January of the year 1902 to the end of October, 7,788 cases were notified in London. In this Borough 188 certificates were received, dealing with 139 cases, of these 6 were returned as not Small-Pox (two cases which do not appear in the total were dealt with as Small-Pox, but on being returned home as errors of diagnosis, the certificates were withdrawn). Two cases were sent to the Fever Hospital as Scarlet Fever, but were there found to be suffering from Small-Pox. Two cases died at home, and both were removed to the Mortuary; one case was an infant who was born whilst the mother was suffering from Small-Pox, and died within 15 days, the other an adult; in the latter case the body was buried within 48 hours after death. Twenty-eight secondary cases were notified; they occurred in 15 different houses, and were thus distributed: 4 houses had each 3 cases, 9 houses had 2 cases each, one house had 5 cases (4 in one family), and another had 7 cases (2 families). These secondary cases arose chiefly from the delay or refusal to be vaccinated or re-vaccinated after contact with the first case. Source of infection (excepting the secondary cases) could only be traced in 9 cases, viz.: 3 cases to Newington Causeway, 1 to Essex (Ingatestone), 2 to Sydenham, 3 to Gore Farm Hospital (one, the patient worked at the Hospital), one, the patient, a Railway Guard, came in contact with the workmen returning to and from the Small-Pox Hospital at Gore Farm, one patient was visited by a nurse from the Hospital, 14 days before the rash appeared. To assist medical practitioners in the diagnosis of doubtful cases of Small-Pox the County Council appointed certain medical men to act in consultation. Every case, however, was removed to the South Wharf Shelters at Rotherhithe, and if found to be suffering from Small-Pox sent on to the Hospital Ship at Long Reach. If the case was doubtful it was detained for observation, and if it proved not to be Small-Pox the patient was vaccinated or re-vaccinated and sent home, information at the same time being forwarded to the Medical Officer of Health. The first case to appear in Deptford was on October 29th, 1901, in a common lodging-house, in which there were no less than 213 lodgers. Prompt measures were adopted, and I am glad to say no other case occurred on the premises. On receipt of a Notification of Small-Pox, the premises were visited immediately, at whatever hour of the day or night, and enquiries made as to the source of infection, the names and ages of all the inmates noted, the place of occupation of the patient, the names and addresses of all persons who had been in contact with the case, and the schools attended by the children, the conditions as to vaccination and re-vaccination so far as could be ascertained. The Ambulance Service of the Metropolitan Asylums Board was at once communicated with by telephone or otherwise, and in no case was there any delay in removing the patient. A copy of the Notification was sent to the Metropolitan Asylums Board, to the Medical Officer of Health of the London County Council, and to the head teachers of the London Board Schools and Private Schools attended by any of the children from the infected house. The Medical Officers of Health were communicated with in whose district any person residing or working outside this borough who had in any way been in contact with a case of Small-Pox. Inaccordance with the Local Government Board's instruction, the Vaccination Officer of the Board of Guardians (the Local Authority for vaccination purposes) was immediately informed of each case, and every information given him, as far as possible, as to children and others unprotected by vaccination. All infected premises were visited, and the occupants kept under constant supervision until free from infection. All infected rooms were fumigated with sulphur, and afterwards the walls were stripped of paper; ceilings, floors and walls thoroughly washed with carbolic acid; bed, bedding, clothing, &c., removed to the Council's Wharf and disinfected by steam and returned. During the period of disinfection, temporary lodgings were obtained for 3 families, until such time as the "Shelter" was made habitable and furnished, since which it has been occupied three times by 6 persons. Articles Disinfected.—Beds 173, Pillows 317, Bolsters 131, Palliasses 108, Mattresses 108, Sheets 263, Blankets 298, Odd Articles 2,785. Articles Destroyed at Owners' Request.- Palliasses 37, Beds 5, Pillows 2, Odd Articles 62. Number of Rooms Cleansed, Stripped, and Disinfected, 175. Staff.—The staff consisted of the Medical Officer of Health. Sanitary Inspector. Disinfector. Two Assistant Disinfectors. One Van Driver. Who, with the exception of the Disinfector (who has previously had small-pox), were all re-vaccinated. No case occurred amongst the staff. Cost of the Outbreak. £ s. d. Disinfection—Wages for extra men 124 0 0 Approximate cost of materials 10 0 0 Compensation for destruction of, and damage to articles during disinfection 5 7 6 Printing, re Small-pox and Chicken-pox 9 15 2 Petty Cash (Inspector Simpson) 1 11 11 £150 14 7 I append a table showing the numbers and distribution of Small-pox cases notified, together with the number of those who were vaccinated and un-vaccinated, and the deaths which occurred in the different wards of this borough. Table No. 4 shows the mortality per cent, among the vaccinated and un-vaccinated at all ages. Table No. 5 shows the distribution of Small-pox cases during the outbreak, with proportionate incidence in each Metropolitan Borough. Table No. 6 shows the number and distribution of deaths from Small-pox during the outbreak, with proportionate fatality for each Metropolitan Borough. Table No. 3. NOTIFICATIONS AND DEATHS IN EACH WARD. Wards. Notification. Returned as not Small Pox. Small Pox. Vaccinated. Unvaccinated. Deaths Unvaccinated. Vaccinated. North 25 - 25 20 5 6 1 North-West 5 45 2 38 5 43 2 East 2 38 7 31 9 40 2 South 9 - 9 7 2 3 1 South-East 11 1 12 1 10 3 - 12 2 South-West 1 11 1 9 1 Total 6 115 22 27 143 137 7 Table No. 4. MORTALITY PER CENT. AMONG VACCINATED AND UNVACCINATED AT VARIOUS AGES. Ages. Cases. Deaths. Mortality per cent. Under 1 year Vaccinated 1 1 100.00* 80.00 Unvaccinated 5 4 14.28 Vaccinated From 1 year to 10 years 7 1 11.11 Unvaccinated 9 1 22.12 10 years and upwards Vaccinated 113 25 25.00 Unvaccinated 8 2 121 27 22.31 Vaccinated. All ages 31.81 Unvaccinated 22 7 *This case was a child who died at the age of 15 days, whose mother was suffering from Small Pox at the time of its birth. Death rate, 3.0 per 10,000 population. Table No. 5. SHOWING DISTRIBUTION OF SMALL-POX CASES. DURING THE OUTBREAK, WITH PROPORTIONATE INCIDENCE IN EACH METROPOLITAN BOROUGH. Estimated Population in - the middle of 1902. 1902. Total. Rate per 10000 Population. 1901. BOROUGHS. 2nd quarter 3 rd quarter 4th quarter 1st quarter 2nd quarter 3rd quarter — I - * 134 West— 6 9.2 145107 ... 17 62 45 Paddington 4 10 113 43 6.3 10 177605 4 47 9 ... Kensington 41 4 8 141 ... 61 12.3 27 114210 Hammersmith 54 6 106 ... 7.4 ... 15 31 14310 2 Fulham 44 2 20 1 ... 18 5.9 74018 3 Chelsea 332 9 174 180800 2 18.4 91 56 City of Westminster ... North — 111 232 17.5 36 39 3 132069 2 41 St. Marylebone 3 ... 3 10 26 0 3.1 83743 10 Hampstead 15 227 515 235596 1 153 26.1 118 101 St. Pancras 1 4 8 16 346 337268 13 137 10.5 14 1 Islington 2 38 517 00 7 12 70 1 3.7 11 ... Stoke Newington 3 22 461 20.8 221926 18 196 1 221 Hackney , I Central— ... Holborn 58535 18 198 186 29 3 434 73.1 Finsbury 79 303 ... 31 4 8 100487 14 131 30.3 6 ... 11 47 City of London 25598 19 18.8 2 9 East— I I Shoreditch 117980 2 313 118 7 456 38.9 ... 16 1 28 276 199 546 Bethnal Green 129889 3 39 4 2 .3 1 55 417 929 1 38 1544 Stepney 300551 4 5 1 .3 ... 68 332 282 699 Poplar 169214 15 41.3 2 South— 260 Southwark 206825 7 82 251 7 607 29.4 ... 107 101 330 ... 107 Bermondsey 130218 15 25.3 ... ... 48 189 415 Lambeth 141 13 .6 305102 3 24 53 11 ... 99 66 241 Battersea 23 14.0 171401 ... 54 162 70 ... 23 Wandsworth 241810 8 7 6.7 408 Camberwell 54 147 262775 ... 190 17 15.5 ... 4 62 147 Deptford ... 71 11.2 111577 10 ... 34 ... 11 Greenwich 58 110 98013 7 11.2 ... 100 Lewisham ... 10 50 33 132432 2 5 7.5 1 Woolwich 22 ... 111 257 119556 116 7 21.5 Port of London ... 1 9 4 15 ... 1 ... ... 1416 4475 7 353 20.6 9451 Total 4579107 272 2928 Table No. 6. SHOWING THE NUMBER AND DISTRIBUTION OF DEATHS FROM SMALL-POX DURING THE OUTBREAK WITH PROPORTIONATE FATALITY FOR EACH METROPOLITAN BOROUGH. BOROUGHS. 1901. Total. Rate per 10,000 Population. 1902. Estimated Population in the middle of 1902. 2nd quarter 3rd quarter 4th quarter 1st quarter 2nd quarter 3rd quarter West— I I I Paddington ... 11 20 1.4 145107 9 ... ... ... ... ... 5 12 Kensington 1 6 ... 0.6 177605 12 ... 2 2.4 Hammersmith 13 8 ... 28 5 114210 16 Fulham ... 8 ... 3 4 1 0.1 143102 Chelsea ... 1 1 8 ... 5 1 0.1 74018 33 15 6 55 3.0 City of Westminster ... 1 ... 180800 North— St. Marylebone 17 2.3 132069 1 4 2 7 31 ... ... 1 5 Hampstead 1 2 1 0.6 83743 ... 41 St. Pancras ... 20 21 31 122 5.1 235596 9 2 17 62 6 1.8 Islington ... 30 7 337268 1 2 2.1 5 3 11 Stoke Newington ... ... 51700 Hackney 1 4 44 75 ... 1 221926 25 3.3 Central— Holborn 58535 43 ... 76 1 29 3 13.1 ... Finsbury 43 1 9 4.3 100487 26 ... 7 ... 3 City of London 4 25598 ... 2 3.6 ... ... 9 East— I " 14 6 1 Shoreditch 117980 5 1 81 6.8 ... ... Bethnal Green 33 27 129889 1 66 1 4 5.1 ... Stepney 77 172 300551 22 282 ... ... 11 9.4 Poplar 40 169214 50 10 3 103 6.0 ... ... South— Southwark 206825 36 3 ... 1 13 39 92 4.4 Bermondsey 45 22 130218 14 ... ... 7 2 3.4 Lambeth 23 64 305102 1 3 35 ... 2 2.0 Battersea 13 11 29 171401 2 14 2 1.6 ... ... Wandsworth 28 7 241810 16 ... 3 2 1.1 ... 42 69 Camberwell 262775 7 17 2.6 ... ... 3 Deptford 15 ... 34 111577 1 18 3.0 ... ... Greenwich 1 25 98013 12 3 9 2.5 Lewisham ... ... 3 12 132432 ... 5 4 0.9 ... ... Woolwich 22 39 119556 1 14 2 ... ... 3.2 Port of London ... ... ... ... ... ... ... ... ... Total 1542 35 506 73 4579107 2 192 734 3.3 CHICKEN-POX. Chicken-Pox was made a notifiable disease in London on February 7th, 1902, under Section 50 (5) of the Public Health (London) Act, 1891. A number of cases of Small-Pox in the Metropolis had been primarily regarded and treated as Chicken-Pox, and owing to the lack of precautions taken, a number of persons had contracted Small-Pox from these cases. The number of Notifications received during the year was 1,199. Table No. 7. CASES OF CHICKEN POX NOTIFIED MONTHLY DURING THE YEAR ENDING 27th DECEMBER, 1902. Total cases notified in each locality. CASES NOTIFIED IN WHOLE DISTRICT. Month. At all Ages. At Ages—Years. South Deptford. North Deptford. Central Deptford. Under 1 1 to 5 5 to 15 15 to 25 25 to 65 65 and upwards ... January ... ... ... ... ... ... ... ... ... 25 5 50 7 12 5 1 ... February 24 21 126 12 61 5 42 6 ... March 51 35 40 ... 101 12 43 43 3 ... April 43 17 41 12 2 3 141 72 52 May ... 38 51 52 31 106 ... ... 258 119 2 June 102 81 75 ... 154 21 73 58 2 ... July 8 4 22 4 8 1 10 22 21 1 ... August 55 21 15 19 56 21 ... 9 24 2 ... September 21 10 25 7 36 19 2 2 ... October 66 23 11 32 ... 100 13 45 38 4 ... November 18 33 49 92 ... 8 41 1 ... December 42 26 24 42 15 1199 142 455 43 464 291 543 1 444 Totals Chart shewing week by week the number of cases of Small Pox notified by Medical Practitioners as having occurred in the Borough of Deptford during the epidemic. Chart shewing week by week the number of cases of Scarlet Fever and Chicken Pox notified by Medical Practitioners as having occurred in the Borough of Deptford during the 52 weeks ending the 27th December, 1902. Chart shewing week by week the number of cases of Diphtheria, Enteric Fever and Small Pox notified by Medical Practitioners as having occurred in the Borough of Deptford during the 52 weeks ending the 27th December, 1902. SCARLET FEVER. Of this disease 638 certificates of notification were received, as against 550 for the previous year; the number of deaths registered was 18. DIPHTHERIA AND MEMBRANOUS CROUP. There were 257 cases notified during the year, as compared with 414 for the previous year, and the number of deaths recorded was 18, whilst the number of deaths for the previous year amounted to 34. ENTERIC FEVER OR TYPHOID FEVER. The number of cases notified during the year was 73, and the deaths were 11; for the previous year the number notified was 60, and the deaths 10. ERYSIPELAS. Of this disease 147 certificates were received, whilst last year 78 only were notified; three deaths only were registered. PUERPERAL FEVER. Three cases were notified and two deaths were registered. MEASLES. As this disease is not notifiable under the provisions of the Public Health (London) Act, 1891, it is impossible to form an exact idea of the extent of an outbreak, except by means of the death returns and school certificates; it is commonly considered a trivial ailment amongst the well-to-do, where isolation and nursing is easily obtained, but among the poorer classes this is difficult and sometimes impossible, hence the heavy mortality. In London alone, the deaths from this disease amounted to 2,360 during the year, whilst the deaths referred to Scarlet Fever were 560, and to Diphtheria 1,159. The number of deaths registered in the borough during the year was 58, as compared with 46 for the previous year. I have reason to hope the distribution of the leaflet on "Precautions against the spread of Infection of Measles" last year may have been of some good. The London County Council has made an order applying the provisions of the Public Health (London) Act, 1891, to Measles, as a dangerous infectious disease. This comes into operation on 1st April, 1903; such provisions, however, do not include compulsory notification. The Metropolitan Asylums Board Hospitals have no power to receive cases of Measles, and the London County Council is not empowered to provide Hospitals. In accordance with the regulations of the London School Board, certificates were received from the school teachers to the number of 715. The following schools (Infants' Department) were closed in consequence of the prevalence of Measles: — Dec. 3. Clyde Street—for a period of three weeks. „ 4. Regent „ „ „ „ „ 4. Clifton Road „ „ „ „ 10. Nynehead St. „ „ „ WHOOPING COUGH caused 36 deaths during the year; all children under 5 years of age. For the previous year the deaths numbered 50, and for the year 1900 they were 58. NON-NOTIFIABLE INFECTIOUS DISEASES. Certificates have been forwarded to me by most of the school teachers in the district, relating to children who have been excluded from school on account of non-notifiable infectious disease existing in their homes, such as Measles, Whoopingcough, Mumps, &c. DIARRHŒA. Under this heading are now included deaths certified as from Diarrhœa alone, or in combination with some other cause of illdefined nature. The number of deaths registered during the year was 38. INFLUENZA. Influenza was the cause of 17 deaths as against 21 for the previous year. PHTHISIS, CONSUMPTION OR TUBERCULOSIS. That this disease is contagious, i.e., communicable from person to person is now a recognised fact. It is due to what is known as a germ or microbe, called the bacillus tuberculosis, which is known to flourish in unhealthy and unwholesome conditions of life; therefore our attention should be directed to procure pure air, sanitary dwellings, good food, warm clothing, all milk should be boiled and meat well cooked. As Sir William Broadbent has said, "If we could ensure the destruction of all sputa of the sufferers from Phthisis, and secure a supply of milk and meat absolutely free from tubercle bacilli, all the diseases due to Tuberculosis, which now cause one-seventh or one-eighth of the total number of deaths, would cease from the land." In all cases of removal of a consumptive person from one house to another, or after death of a consumptive patient, application should be made to the Medical Officer of Health to have the rooms, carpets, rugs, bedding, clothing, etc., disinfected, which is done free of cost. The following hints should be observed by consumptive patients—not to spit about the house, workshop, or any other place. Spitting in the street is a dangerous habit; spit only into a covered cup, spittoon, or wide-mouthed bottle kept for the purpose, to which some disinfectant fluid has been added; to use such articles for wiping the mouth as can be burnt or placed in boiling water; not to swallow the spit. The spit when it becomes dry is carried about in the air and is very dangerous. Sleeping rooms should be well ventilated, well lighted and free from damp. Fresh air and sunlight kills the germs of consumption. Cleanliness and temperance are all-important. Milk should be boiled and meat well cooked. BACTERIOLOGICAL EXAMINATIONS. The Council renewed the arrangement made last year with the Clinical Research Association to make Bacteriological Examinations and Reports upon the specimens of blood for Enteric Fever and membrane for Diphtheria, for a further period of 12 months, expiring on the 12th November, 1903. During the year ending December 31st, 1902, 88 Examinations were made of blood and membrane for Enteric Fever and Diphtheria— 21 for Enteric Fever, and 67 for Diphtheria, at a cost of £16 Os. 6d. It is very gratifying that so many medical men have availed themselves of the opportunity thus afforded by the Borough Council. DISINFECTION. A steam disinfecting apparatus (Washington Lyons) is provided at the Council's yard, in which all articles of clothing and bedding are disinfected. The building is divided into two rooms, into each of which the apparatus has an opening. One side is reserved for receiving articles about to undergo disinfection, the other for removing them from the apparatus after the process is completed. There are two vans employed, one for use in collectinginfected articles, the other for returning them, after disinfection is completed. With very few exceptions all disinfection is carried out by the staff of the Council, and no charge is ever made. During the year 1,076 rooms were disinfected, and 11,565 articles were subjected to steam disinfection at the Council's yard. Only a few complaints were received during the year as to damage done to bedding, &c.; every care is taken by the disinfectors. Most of the articles destroyed was by desire of the owners. Disinfecting fluid is supplied gratis were required by the staff. Table No. 8 gives detailed account of the work done during the year. Table No. 8. ANNUAL REPORT OF ROOMS, BEDDING, ETC., DISINFECTED DECEMBER 28th, 1901, TO DECEMBER 27th, 1902, INCLUSIVE. Date. Rooms Disinfected. Beds. Pillows. Bolsters. Palliasses. Mattresses. Sheets. Blankets. Odd Articles. Articles Destroyed. 1901 December 15 8 18 6 ... 4 10 18 19 134 394 1902 January 68 56 28 102 104 153 12 February 60 139 15 29 82 127 516 1 Mattress, 15 Palliasses 78 47 March 123 105 207 61 43 1 34 169 1116 2 Mattresses, 3 Beds, 16 Palliasses, 4 Pillows, 1 Bolster, 1 Sheet, 70 odds. 74 117 792 103 April 106 87 160 62 21 47 2 Beds, 4 Palliasses, 9 odds 8 4 454 May 74 123 4 8 10 35 89 140 3 Beds, 1 Bolster, 7 Palliasses June 81 6 4 90 1 Palliass, 1 Carpet, 2 Mats 132 49 20 22 120 533 July 86 63 108 44 6 18 80 95 1 Palliass 223 August 50 45 103 12 68 228 2 Mattresses 34 5 59 September 94 64 136 42 21 59 101 237 3 Beds, 1 Mattress, 2 Palliasses, 3 Pillows, 3 Sheets, 2 Blankets, 18 odds 4 128 103 147 92 217 29 October 70 42 ... 1 Bed, 3 Mattresses, 1 Palliass 65 45 2 7 133 568 November 85 132 2 70 54 odds December 67 61 86 24 91 215 36 ... 65 339 1076 1644 1044 Total 834 585 156 1432 237 articles 5531 Total Number of Rooms Disinfected 1076 „ „ Beds „ 834 „ „ Pillows „ 1644 „ „ Bolsters „ 585 „ „ Palliasses „ 156 „ „ Mattresses „ 339 „ „ Sheets „ 1044 „ „ Blankets „ 1432 „ „ Odd Articles „ 5531 Total 12,641 Total Number of Beds Destroyed 12 „ „ Mattresses „ 9 „ „ Palliasses „ 47 „ „ Pillows „ 7 „ „ Bolsters „ 2 „ „ Sheets „ 4 „ „ Blankets „ 2 „ „ Odd Articles, 1 Carpet and 2 Mats 154 Total 237 20 SPECIAL ITEMS. February 1st — St. John's Nursing Home. Maternity case. 2 Sheets, 1 Blanket, 62 odds. Disinfected. April 11th — Childers Street. Cancer. 1 Bed, 4 Pillows, 1 Bolster, 1 Mattress. Disinfected. April 29th — Abinger Road. Cancer. 1 Bed, 1 Counterpane. Disinfected. June 14th — Breakspears Road. Consumption. 3 Pillows, 1 Mattress, 1 Bolster, 2 Sheets, 7 Blankets, 18 odds. Disinfected. September 16th — Batavia Road. Murder. 2 Beds, 1 Mattress, 2 Palliasses, 3 Sheets, 2 Blankets, 18 odds. Destroyed. September 29th — Senegal Road. Consumption. 1 Bed, 3 Palliasses, 1 Bolster. Disinfected. October 17th — Shardeloes Road. Consumption. 1 Bed, 2 Palliasses, 1 Bolster, 1 Mattress, 3 Sheets, 3 Blankets, 25 odds. Disinfected. N.B. — All the above articles are included in the total of the Annual Report. During the hot weather all the courts and alleys were kept constantly flushed with disinfectants by the Surveyor's staff. MORTUARY AND CORONER'S COURT. The Public Health Committee have had under consideration the site for a Mortuary and Coroner's Court, which they have reason to believe will be acquired during the year 1903, and plans have been submitted by the Surveyor which will be presented to the Council in due course. The number of bodies taken into the existing mortuary during the year was 82. HOUSE PROPERTY INSPECTIONS, &c. A summary of the Sanitary work done during the year will be found on Table No. 9. The total number of premises inspected was 3,510, whilst re-inspections, calls, service of notices, &c, amounted to 15,022. The number of preliminary notices or "Intimations" served during the year was 1,369, whilst the number of Statutory Notices served was but 192, and in only 7 cases was it necessary to take legal proceedings to enforce these orders. Overcrowding was abated in 19 cases, without having to take any legal proceedings. Smoke Nuisances. Observations were kept on the different factories in the borough, and 159 cases reported to the Public Health Committee, and notices were served to abate the nuisance in several cases. ANNUAL REPORT OF SANITARY INSPECTORS, FOR THE YEAR ENDING DECEMBER 31st, 1902. Number of District. Totals. 1 2 3 4 5 Table No. 1. 63 29 Complaints Received 43 57 26 218 662 3510 727 Total Premises Inspected 716 655 750 Re-Inspections, Calls, Service of Notices, &c., &c. 2844 4029 2478 15022 2836 2835 39 8 15 Inspections under notice from Con- tractors, per Bye-Laws 83 14 159 2 2 ... ... Number of Cases in which Pro- ceedings have been taken 3 7 276 333 1369 291 306 "Intimations" Served 163 23 "Statutory Notices" Served 44 34 31 60 192 Houses Closed by Magistrate's Order ... ... ... ... ... ... „ „Voluntarily ... ... ... ... ... ... Table No. 2. I I Water Closets— 3 1 2 Old Closets abolished 9 6 21 2 5 3 New Closets provided 5 7 22 New Closets provided in Workshops ... ... ... ... ... ... Basin and Trap provided 118 234 137 822 119 214 Water Supply provided 19 ... 3 12 49 83 Water Supply Apparatus provided 62 55 50 62 21 250 16 8 14 Limewashed 5 6 ... Walls Repaired ... ... 234 9 Floors Repaired ... ... 119 ... 435 ... 12 2 Doors provided ... 7 2 Ventilated ... ... 1 22 ANNUAL REPORT OF SANITARY INSPECTORS. FOR THE YEAR ENDING DECEMBER 31st, 1902— continued. Number of District. Table No. 2—continued. 1 2 3 4 5 Totals. Seats provided ... 195 57 ... 252 ... Basins Cleansed 7 8 14 43 14 ... Drains — ... ... ... ... ... ... Drains Re-Constructed 13 184 90 84 74 445 ... 1 6 ... 3 Surface Drains provided 10 Cleansed and Amended 87 56 28 342 137 34 Gulley Traps fixed 151 120 195 113 8 4 663 New Soil Pipes and Vent Pipes fixed 44 6 1 114 62 1 18 Chambers built and Interceptors provided 11 228 116 13 70 Interceptors only fixed ... 1 1 ... 2 ... Ventilated 68 245 28 64 49 36 Provided to Stables 2 1 3 3 2 11 Clearing Eyes ... ... ... 21 ... 21 Sinks, Bath & Lavatory Wastes, and Rain Water Pipes— ... ... ... ... ... ... Disconnected from drains, trap- ped and ventilated 107 67 12 62 73 321 ... ... ... ... ... ... Cesspools— 1 ... 7 2 ... Abolished 10 Dustbins — ... ... ... ... ... ... Provided 64 58 132 33 32 219 Repaired ... ... ... ... ... ... Yards— ... ... ... ... ... ... 19 190 53 Paved 39 83 384 Surface Repaired 15 2 3 6 6 34 8 4 23 ANNUAL REPORT OF SANITARY INSPECTORS, FOR THE YEAR ENDING DECEMBER 31st, 1902—continued. Number of District. Table No. 2 —continued. Totals 3 4 5 1 2 Scullery and Wash=house Floors— ... ... ... ... ... ... Paved 36 3 9 4 ... 20 Forecourts — ... ... ... ... ... ... 5 64 Paved ... 6 53 ... ... ... ... ... ... Surface Repaired ... Gutters and Rain Water Pipes— ... ... ... ... ... ... 60 52 8 30 39 Provided and Repaired 189 ... ... ... ... ... ... Water Supply— Store Cisterns provided ... ... ... ... ... ... 10 10 ... 23 „ „ Covers provided 3 ... „ „ Cleansed ... 2 20 6 3 31 7 9 3 11 2 32 Store Cisterns abolished Supply Re-instated 5 2 7 42 13 15 22 13 ... 22 3 60 Fittings Repaired New Houses Inspected for Certificates before Occupation 53 ... 30 2 178 93 Potable Water provided from Service 8 ... ... ... 8 ... Cleansing and Repairs — ... ... ... ... ... ... 43 165 129 116 Houses Cleansed and Limewashed Houses Repaired and Ventilation Improved 17 4 26 203 703 House Roofs Repaired 32 ... 10 9 27 78 ANNUAL REPORT OF SANITARY INSPECTORS, FOR THE YEAR ENDING DECEMBER 31st. 1902-continued. Number of District. Table No. 2—continued. Dung Receptacles— Totals. 1 2 3 4 5 Abolished ... ... ... ... ... ... Provided 1 ... 5 ... ... 6 Underground Rooms— ... ... ... ... ... ... Use as dwellings abolished ... ... ... ... ... ... ... ... ... ... ... ... Cases Abated 1 1 10 5 2 19 Accumulations— ... ... ... ... ... ... Removed 10 2 6 4 28 6 Animals — ... ... ... ... ... ... Ceased keeping as a Nuisance ... 2 2 ... 1 5 Smoke Nuisances — ... ... ... ... ... ... Cases Abated ... ... ... 6 1 7 12 110 ... 159 Observations 16 21 ... ... ... ... ... ... Rooms occupied in such a manner as to be a nuisance Unsound Food Destroyed * ** *** ... ... ... * 2 Boxes of Haddocks. ** 2½ Barrels of Potatoes. *** 50 pieces of Beef, 8 pieces of Mutton. District No. 1. — Inspector Priest. District No. 2. — Inspector SHELLEY. District No. 3.— Inspector DANSON. District No. 4. — Inspector SNOWDON. District No. 5. — Inspector OWNER. COMMON LODGING-HOUSE ACTS, 1851 AND 1853. The Secretary of State, by a Provisional Order which came into operation on the 1st November, 1894, transferred to the London County Council the powers of the Commissioner of Metropolitan Police in respect of Common Lodging-Houses. The following is a list of the Common Lodging-Houses registered in this district, providing accommodation for 552 persons:— COMMON LODGING HOUSES Reg. No. Name and Residence of Keeper. Situation of the Common Lodging House. Authorized No. of Lodgers. Sex of lodgers. M = Men. W = Women, MC = Married Couples. Date of Approval of premises. Date when registered. Name. Street or Place. No. of House Sanitary District. No. of House Parish. Street or Place. 8th June, 1887 Letitia Catherine Longinotto - Twickenham 1 Church-street Deptford 57 19th March, 1887 "The Hut," Strawberry Hill-road M 3997 29th Oct, 1898 Mary Ann Hazelton 16 4491 Watson-street Deptford 39 Baildon-street Deptford 13 M 15th Jan, 1873 29th Oct, 1898 Mary Ann Hazelton 16 Watson-street Deptford 37 Baildon-street Deptford 2 4 M 15th Jan, 1873 4492 5399 5th March, 1887 Letitia Catherine Longinotto "The Hut," Strawberry Hill-road Twickenham 146 Church-street Deptford 42 M 26th Feb, 1887 - 5482 8th May, 1885 Sarah Ann Mantle 110 Malpas road Brockley 35 Baildon-street Deptford 42 M 22nd April, 1885 6007 Ellen McCarthy 88 Douglas-street Deptford 42 Albury-street Deptford 50 6th Oct, 1894 M 22nd Sept, 1894 18th Dec, 1889 - "The Hut," Strawberry Hill-road Twickenham 27 Watergate street Deptford 36 27th Nov, 1889 6030 Letitia Catherine Longinotto M 6043 18th April, 1890 Bernard Jaffa 112 High-street Deptford 112 High-street Deptford 213 M 29th March, 1890 6187 30th Oct, 1894 Joseph Mitchell 33 New King-street Deptford 33 New King-street Deptford 7 M 19th Oct, 1894 6206 5th Feb, 1897 James Webster 171 Lewisham High road New Cross 124 Tanner's-hill Deptford 68 M 15th Feb, 1897 Seamen's Lodging House, 22, New King-street In addition to the above, the Lodging house now in course of erection by the London County Council, in Mill Lane, which will be completed about May or June, 1903, will provide accommodation for 804 lodgers. The following account of the plan is contained in the report of the Housing of the Working Classes Committee to the London County Council: — "The entrance is central, and gives access to the dining-room on the right, and to the smoking and reading rooms on the left. The office commands the entrance for lodgers and for the staff, and is arranged close to the Superintendent's quarters. The dining-room is planned with a long hot-plate chamber in the centre, with lodgers' sculleries. It is well lighted from side and roof. The hot-plate chamber is ventilated by two fans driven by electricity, and this arrangement helps the ventilation of the dining-room. Immediately adjoining the dining-room is the lodgers' crockery room. The shop for sale of hot and cold viands is placed in a convenient position with a direct servery thereto, and with easy communication to the kitchen in the rear. The smoking-room is arranged on the Mill Lane frontage. It is well lighted, and has good ventilation. The reading room is approached from two of the main corridors; it is of a suitable shape, and is well lighted by side and top lights. This room also will have cross-ventilation. The accommodation in the dining, reading, and smoking rooms is as follows:— No. of Lodgers. Area in superficial feet. Superficial feet per lodger. Total superficial feet per lodger. Dining room. Reading room. Smoking room. Reading room. Smoking room. Dining room. 804 6,067 (inc. 475 round hotplate) 3,057 2,031 7.45 3.80 2.53 13.87 With regard to the sleeping accommodation, two principal staircases leading to the dormitories, and one emergency 27 staircase, are provided. It will therefore be practically impossible for all egress from the house to be blocked in the event of fire. Each cubicle is 4 feet 10½ inches wide and 7 feet 4½ inches long (internal dimensions), and is provided with a window so that ample means of through ventilation are secured. Two cubicles on each floor will be occupied by the resident male staff. The dormitory corridors are 4 feet 6 inches wide, and four water-closets and two sinks for night use are provided on each of the five dormitory floors. The lodgers' promenade is provided over the reading room and part of the dining room, and is approached by means of the south-west staircase. This is the first lodging house on these lines that the London County Council has attempted. The architect's estimate of the cost of the building is £51,500, and a further sum of about £4,000 will be required for furniture. The Council resolved that the charge for accommodation in the house should be 6d. per bed per night." UNDERGROUND BAKEHOUSES. Bakehouses first came under the control of the State in 1863, when the Bakehouse Regulation Act came into force. The three chief points in this Act were 1. Employment of persons under 18 years of age. 2. Cleanliness of buildings. 3. Position of sleeping apartments. In 1878 this Act was repealed by the Factory and Workshop Act. All control of bakehouses was then given to the Inspector of Factories, instead of Local Sanitary Authorities as formerly. The Factory and Workshop Act of 1883, gave back the control of Bakehouses to the Sanitary Authorities, and gave to the Medical Officer of Health the powers of an Inspector of Factories. In 1889 "The Lancet" held a special Sanitary Commission, who decided that it was impossible to build a really wholesome bakehouse underground, and in 1895 the Factory and Work- shop Act, in Section 27, prohibited the occupation of underground bakehouses unless they were in use before January 1st, 1896. The Factory and Workshop Act of 190 1 enacted that no underground bakehouse should be used unless certified by the Sanitary Authority as suitable, as regards 1. Light. 2. Construction 3. Ventilation. In 1894 the Master Bakers' Association of Manchester and Salford stated that they would favourably consider any proposed Act of Parliament that would gradually close all underground bakehouses, provided the reasonable interests of the trade were safeguarded, and others considered at this time that underground bakehouses were doomed. Great improvements, however, have been made since this period, in many of the underground bakehouses, as to sanitary conditions, ventilation and lighting; where formerly daylight could not penetrate, it is now supplied by means of reflectors, pavement lights, electric lights, &c. The Sanitary Authority has now the power to decide which underground bakehouses may still be used. Should, however, this body refuse to give a certificate of suitability, the occupier of the premises may appeal to a summary court of jurisdiction, then the justices would certify, instead of the Sanitary Authority. It is to be hoped that neither body will sanction a continuance of these premises unless a sufficiently high standard of suitability is secured. The Incorporated Society of Medical Officers of Health have considered the question, and have drawn up an excellent document of suggestions. SUGGESTED REQUIREMENTS FOR UNDERGROUND BAKEHOUSES. A.— Construction. 1. No underground bakehouse shall be less than 8 feet in height throughout, measured from the floor vertically to the ceiling; and in case the floor area exceeds 300 square feet, such height shall be at least 8 ft. 6 ins. 2. No underground bakehouse shall have a cubic capacity, clear of the oven, of less than 1,500 feet. 3. The floor shall be constructed of hard, smooth, durable and impervious material. 4. The walls shall be constructed of a material which is hard, smooth, durable, and impermeable to damp. [Note. — Where adjacent ground abuts on a wall, or walls, such walls should be lined with the best glazed bricks, uniformly joined with Portland cement, to form internal walls, separated from the existing walls by a cavity, and bonded to them, the intervening space being ventilated to the outer air.] 5. The ceiling shall be even, impermeable to damp and dust, and durable. 6. Every underground bakehouse shall be approached by a suitable staircase, adequately lighted and ventilated. No outside staircase shall terminate within an underground bakehouse. Any opening into the shop above must be so covered as to prevent the entrance of dust. B.— Light. 7. The underground bakehouse shall be adequately lighted with daylight throughout, to the satisfaction of the Sanitary Authority, and the lighting maintained shall be such that an Official Copy of the Abstract of the Factory Act may ordinarily be read in all parts of such bakehouse, between the hours of 11 a.m. and 3 p.m. C.— Ventilation. 8. Ventilation should be so arranged that the circulation of air is confined to the underground bakehouse. 9. Ventilation shall be adequate, that is to say, fresh clean air shall be supplied constantly during working hours, so as to provide not less than 3,000 cubic feet of air, per hour, for each person employed, with any additional amount required for purposes of combustion, in such a manner as to avoid the occurrence of draught, and so that the air is sufficiently renewed in all parts of the underground bakehouse; and by the aid of mechanical power, where, in the opinion of the Medical Officer of Health, such is necessary. Provision shall be made for the removal of steam from the underground bakehouse. Where mechanical power is used, the fresh air shall be taken from a height above the level of the adjoining ground of not less than 6 feet, and be distributed to different parts of the underground bakehouse in such a manner as to change the air of such bakehouse in all parts. [Note. — This will generally require the provision of a fan. Foul air may also be extracted by means of a fan with any aid available from gas and ventilating shafts.] 10. Arrangements for ventilation shall be such that the temperature of the underground bakehouse from October 1st to May 31st shall not exceed 80° Fahr., except within half-anhour after a batch of bread has been drawn. D. — All other Respects. 11. Proper provision shall be made for the storage of flour elsewhere than in the underground bakehouse itself. 12. There shall be no opening into the underground bakehouse for any purpose which will tend unduly to the admission of dust from the adjoining street. 13. Conveniences for personal ablution shall be provided in a suitable position, and shall include a water tap and a sink or lavatory basin of an approved character. [Note. —These conveniences should be outside the underground bakehouses.] Free access should be provided to suitable sanitary conveniences suitably situated. 14. All troughs, tables, or other furniture standing on the floor of the underground bakehouse shall be provided with strong ball-bearing castors. 15. Proper provision shall be made for the depositing of wearing apparel outside the underground bakehouse. 16. An underground bakehouse shall not be in communication with a wash-house, nor with any room, cellar or area containing; objectionable materials. 17. An underground room, not entirely separated from the underground bakehouse, shall be well lighted throughout, shall be sufficiently protected against the entrance of ground air, shall be properly ventilated, and shall be at all times clean. 18. All statutory obligations shall be fulfilled. 19. Before making any alterations with a view to meeting these requirements, the owners or occupiers of underground bakehouses shall submit to the Sanitary Authority a specification (and plans) of the alterations which they propose making. J. SPOTTISWOODE CAMERON. President. [Adopted by the Incorporated Society of Medical Officers of Health on November 21st, 1902.] APPENDIX. GENERAL STATUTORY REOUIREMENTS A_ALL BAKEHOUSES (1) Every room or place used as a bakehouse shall be in such a state as to be, on sanitary grounds, fit for use or occupation as a bakehouse. (2) No water-closet, earth-closet, privy or ash-pit shall be within, or communicate directly with, the bakehouse. (3) Every cistern for supplying water to the bakehouse shall be separate and distinct from any cistern for supplying water to a water-closet. (4) No drain or pipe for carrying off fœcal or sewage matter shall have an opening within the bakehouse. (5) All the inside walls of the rooms of a bakehouse, and all the ceilings or tops of those rooms (whether those walls, ceilings or tops are plastered or not) and all the passages and staircases of a bakehouse, shall be either painted with oil or varnished, or be limewashed, or be partly painted or varnished and partly limewashed; and (a) Where the bakehouse is painted with oil or varnished, there must be three coats of paint or varnish, and the paint or varnish must be renewed once at least in every seven years, and must be washed with hot water and soap once at least in six months; and ( b) Where the bakehouse is limewashed, the limewashing must be renewed once at least in every six months. (6) No place on the same level with a bakehouse, and forming part of the same building, shall be used as a sleeping place, unless it is constructed as follows, that is to say— (a) is effectually separated from the bakehouse by a partition extending from the floor to the ceiling; and ( b) has an external glazed window of at least nine superficial feet in area, of which, at the least, fourand-a-half superficial feet are made to open for ventilation: and unless such sleeping room (if separately occupied) comply with the requirements as to cellar dwellings or underground rooms (so occupied), laid down in the Public Health Acts. B.— UNDERGROUND BAKEHOUSES (1) An underground bakehouse shall not be used as a bakehouse unless it was so used at the passing of the Factory and Workshop Act, 1901 (i.e., August 17th, 1901.) (2) After January 1st, 1904, an underground bakehouse shall not be used, unless certified by the District Council to be suitable for that purpose; and an underground bakehouse shall not be certified as suitable unless the District Council is satisfied that it is suitable as regards construction, light, ventilation, and in all other respects. DAIRIES, COW SHEDS AND MILK SHOPS, SLAUGHTER-HOUSES AND OFFENSIVE BUSINESSES. Under the London Government Act, 1899, it became the duty of the Metropolitan Borough Councils to enforce the byelaws and regulations with respect to Dairies and Milk Shops, and with respect to Slaughter Houses, Knacker's Yards and Offensive Businesses. All these premises were regularly visited during the year, and notices served for all nuisances or breaches of regulations that were found to exist.— (Vide Inspector Turner's Report). The following is a list of the Registered Cow-Houses in the borough granted in October by the London County Council:— Sexton, Thomas, 7, Blackhorse Place, Lower Road 7 cows Martin, James & Sons, 90, Endwell Rd., Brockley 70 „ Weston, John, 178-182, Grove Street (rear of) 14 „ Abbott Brothers, 3, Nynehead St., New Cross 34 „ Weston, J., & Sons, 32, Octavious Street... .... 25 „ Crutcher, George, 117, Pomeroy Street... ... 12 „ Weston, J., & Sons, 211, Railway Arch, Edward St. 17 „ Charman, Thomas, 14, Vulcan Road... ... 1 cow Glover, George, 49, Watson Street... ... 14 cows SLAUGHTER-HOUSES. The following list shows the number of licenses granted by the London County Council in October, 1902: — Wellbeloved, Alfred, 180, Brockley Road. Williams, William, Friendly Street Mews, Friendly Street. Wellbeloved, William Henry, 13A, High Street. Wells, Jas (trading as Kibble, C, & Co., Ltd.), 41, High St. Mills. Walter. & Son, 160, New Cross Road. Gregory, Louis James, 199, Queen's Road (rear of). SALE OF FOOD AND DRUGS ACTS. The total number of samples purchased during the year 1902 and submitted to the Public Analyist for the borough, was 300. The following is a list of the samples taken, with the number found to be adulterated:— SAMPLES TAKEN DURING 1902. Article. Total No of Samples No. of Samples Genuine. No of Samples Adulterated Butter 100 93 7 Lard 8 8 0 Milk 157 144 13 Pepper 4 4 0 Sweets 5 5 0 Margarine 12 12 0 Coffee 3 3 0 Cream of Tartar 4 4 0 Mustard 4 4 0 Liquorice Powder 2 2 0 Olive Oil 1 1 0 300 280 20 = 6.6% In addition to the 20 adulterated samples there were 7 offences under the Margarine Acts (for not marking, &c.) and 1 offence for refusing to serve the Inspector (for which a fine of £10 and 12s. costs was inflicted). The cost of purchasing the samples, £ s. d. including agent's fees, &c. 33 13 1 The amount of fines inflicted... ... 126 11 0 The amount of costs recovered... ... 13 15 6 ICE CREAM. According to the regulations of the London County Council (General Powers) Act. which came into force on November 1st, 1902, certain very definite requirements are demanded on the part of the makers and vendors of ice cream. The following are the clauses relating to ice creams:— 42. Any person being a manufacturer of or merchant or dealer in ice creams or other similar commodity who within the County— (a) Causes or permits ice creams or any similar commodity to be manufactured sold or stored in any cellar shed or room in which there is any inlet or opening to a drain or which is used as a living room or sleeping room; (b) In the manufacture sale or storage of any such commodity does any act or thing likely to expose such commodity to infection or contamination or omits to take any proper precaution for the due protection of such commodity from infection or contamination; or (c) Omits on the outbreak of any infectious disease amongst the persons employed in his business or living or working in on or about the premises in or on any part of which any such commodity as aforesaid is manufactured sold or stored to give notice thereof forthwith to the Medical Officer of the Sanitary District in which such business is carried on or such premises are situate; shall be liable for every such offence on conviction in a Court of Summary Jurisdiction to a penalty not exceeding forty shillings. 43. Every itinerant vendor of any such commodity as aforesaid shall if not himself the manufacturer thereof exhibit in a legible manner on a conspicuous part of his barrow a notice stating the name and address of the person from whom he obtains such commodity and if such vendor is himself the manufacturer of such commodity he shall in the same manner exhibit his own name and address every such itinerant vendor who shall fail to comply with the provisions of this Section shall be liable for each offence on conviction as aforesaid to a penalty not exceeding forty shillings. 44. Proceedings for the recovery of the penalties imposed by the two last preceding Sections of this Act shall be instituted by the Sanitary Authority for the District in which the offence was committed or of the District to the Medical Officer of which such notification as aforesaid ought to have been made or in which such itinerant vendor as aforesaid shall offer any such commodity as aforesaid for sale as the case may be. Provided always that if any Sanitary Authority omit to institute such proceedings the Council may institute the same as if such omission were a default within the meaning of "The Public Health (London) Act, 1891" and the provisions of that Act relating to any such default and the consequences thereof shall apply with respect to such proceedings. Copies of these regulations have been posted in different parts of the borough and bills distributed in both English and Italian. THE SANITARY STAFF. During the year the Local Government Board approved of the Medical Officer of Health relinquishing private practice and devoting his time to the Public Health work of the borough. The Local Government Board also sanctioned the appointment of Mr. John V. Snowdon and Mr. Joshua Owner as Sanitary Inspectors for the Borough, to fill the vacancies caused by Mr. Thomas Turner being transferred to carry out the duties required to be performed under the Dairies and Milkshops Orders, the Factory and Workshops Acts, the Canal Boats Acts, and the Regulations relating to Slaughter Houses, Knackers' Yards, and Offensive Businesses, and Mr. Robert D. J. Simpson who was transferred to execute the duties required to be performed under the Clauses of the Public Health (London) Act, 1891, relating to the notification and prevention of infectious diseases. In consequence of the outbreak of small pox it was found necessary to engage the services (temporary) of an additional disinfector. I desire to express my high appreciation of the manner in which my Inspectors have performed their onerous duties; they have at all times displayed energy, zeal, and above all, tact, which has, in many instances, obviated the necessity of taking legal proceedings to enforce compliance with the bye-laws. During the late epidemic of small-pox, Inspector Simpson and the disinfector (Mr. Dowset) were most indefatigable at all hours of the night and day, Sundays included. I have the honour to remain, Gentlemen, Your obedient servant, Henry William Roberts Medical Officer of Health. ANNUAL REPORT of Inspector Turner, carrying out duties in connection with Factories and Workshops, Dairies, Cowsheds, and Milkshops; Bakehouses, Slaughterhouses, Offensive and Ice Cream Businesses, and Canal Boats; Samples under Food and Drugs Acts, and Margarine Act, and results of Prosecutions. FACTORIES AND WORKSHOPS. The Factory and Workshop Act, 1901, was a consolidating Act, repealing the former Acts of 1878, 1883, 1891, except sections 8, 9, 10, 12, and the first schedule 1895, except section 12, sub-section 3 of section 24; and section 28. The unrepealed sections of the Act of 1895 and 1891 do not affect the duties devolving on the Local Authority but refer to the duties in connection with the department of His Majesty's Inspector of Factories. Under the provisions of the new Act of 1901 the duties of the local authorities are more defined and imperative. Under section 131 the District Council are required to keep a register of all workshops situate in their district. His Majesty's Inspector is also required to furnish a list of the premises on his register to the Local Authority at the commencement of the Act. This list was duly obtained from His Majesty's Inspector and a register compiled, and added to from time to time as required. By section 107, the occupier of every factory, workshop, or place, from which any work is given out as home work, is required to furnish a list of such workers to the District Council, giving names and addresses, on or before the first day of February and the first day of August in each year, and also to keep a copy of such list in the factory, workshop, or place, from which such work is given out. A register of Outworkers has been compiled and the necessary forms and notices served upon the premises employing Outworkers, calling upon them to furnish the information as required hy the statute. The Workshops and the residences of the Outworkers are periodically inspected and any matter requiring attention dealt with. Workshops. * Number on Register 246 Inspected, Measured, &c. 186 Cleansed 34 Overcrowding abated 10 Water Closet accommodation provided 2 „ in connection with workroom abolished 3 „ cleansed 11 „ doors and seats repaired 3 „ water supply provided 2 „ ventilated 1 Drains amended and gully trap fixed 1 Dustbin provided 1 Dung accumulation removed 1 Laundry floor concreted 1 Complaints received 4 The whole of the works required in amendment of defects have been carried out without the service of notices. Outworkers. Number on Register 165 „ of Inspections 208 „ of rooms cleansed 21 „ of floors cleansed 1 „ references from other boroughs 253 Factorles. Water closets and Urinal cleansed 2 „ door and seats repaired 2 „ water supply provided 2 „ abolished 3 * Including Bakehouses and Laundries, Bakehouses. Bakehouses are either factories or workshops within the meaning of the Factory and Workshops Act, 1901, according as mechanical power is, or is not used in aid of the processes carried on, and the same powers are exercised by the District Council in regard to them as in regard to factories and work- shops generally. Sections 97, 98, and 99 of the Act provide for the proper conditions, periodical cleansing, &c., of Bakehouses. Section 101 deals with the question of Underground Bake- houses, and provides "That an underground bakehouse shall not be used as a bakehouse unless it was so used at the passing of the Act." Also "That after the 1st January, 1904, an underground bake- house shall not be used as a bakehouse unless certified by the District Council to be suitable for that purpose." The whole of the bakehouses in the borough have been periodically visited and the necessary works and cleansing carried out from time to time. There are 79 bakehouses in the borough, 43 of these are underground and semi-underground ones. On account of the constant supervision and inspection, the bakehouses of the borough are very well kept by the occupiers. Number in borough 79 „ on level 45 „ underground 34 „ of inspections and visits 361 „ limewashed 39 Cleansing (floors, tables, utensils, &c.) 22 Ceilings repaired 1 Floors repaired 3 Yard surface repaired 1 Sink waste pipe repaired 1 Water Closet cleansed 1 „ water supply provided 2 „ in improper position amended 1 Opening to drain abolished 1 Dustbin abolished 1 Dustbins provided 3 Doors provided to coal places 3 Ventilation improved 2 DAIRIES, COWSHEDS, MILKSHOPS, &c., &c. Under the provisions of the London Government Act, 1899, the powers vested in the London County Council relating to Dairies, Cowsdeds and Milkshops, under the Dairies, Cowsheds and Milkshops Orders, and also the powers relating to the control, supervision and inspection of Offensive Trades, viz., Knackers' Yards, Bone, Blood, or Soap Boilers, Fat and Tallow Melters, Slaughter Houses, and any premises on which offen- sive businesses are carried on, were transferred to the Metropolitan Borough Councils. Lists of the premises in the borough registered under the London County Council, with copies of Bye-laws and regulations and information relating thereto, was duly forwarded to the Borough Council. Since the receipt of such information, the whole of the premises have been inspected. A register of the milk purveyors in the borough has been compiled, and the new registrations from time to time recorded. Constant inspection is necessary to keep the premises in a cleanly state, both in relation to utensils, floors, counters, &c. Licences are still granted by the London County Council for Cowsheds and Slaughter Houses, &c., &c. Cowsheds. Number in the borough 9 „ of inspections 74 Limewashed 7 Yard surface repaired 1 Dung accumulation removed 2 Number of animals licensed 184 Milkshops. Number on register as transferred from London County Council 134 Number registered during the year 66 „ cancelled „ „ 17 „ on register at present 183 „ of inspections 503 „ of infectious cases in connection with Milkshops— Small Pox 1 Scarlet Fever 8 13 Diphtheria 1 Measles 1 Chicken Pox 2 Premises to cleanse 16 Floors concreted 4 New measures provided 6 Drains untrapped (galley traps fixed) 1 „ choked (cleared) 1 „ abolished 1 Dung accumulation removed 1 Slaughter Houses. Number in borough 6 „ of inspections 65 Limewashed 15 Walls repaired 1 Offensive Businesses. Number in borough 5 „ of inspections 52 Limewashed 8 Bones accumulation removed 1 Contraventions of By-laws 1 Legal proceedings 1 ICE CREAMS. The London County Council (General Powers) Act, 1892, which came into force on November 1st, 1892, provides as follows: — Any person being a manufacturer of or merchant or dealer in ice creams or other similar commodity who within the county — (a) Causes or permits ice creams or any similar commodity to be manufactured sold or stored in any cellar shed or room in which there is any inlet or opening to a drain or which is used as a living room or sleeping room; (b) In the manufacture, sale, or storage of any such commodity does any act or thing likely to expose such commodity to infection or contamination, or omits to take any proper precaution for the due protection of such commodity from infection or contamination; or (c) Omits on the outbreak of any infectious disease amongst the persons employed in his business or living or working in, on or about the premises, in or on any part of which any such commodity as aforesaid is manufactured, sold, or stored, to give notice thereof forthwith to the Medical Officer of the Sanitary District in which such business is carried on or such premises are situate; shall be liable for every such offence on conviction in a Court of Summary Jurisdiction to a penalty not exceeding forty shillings. Every itinerant vendor of any such commodity as afore- said shall if not himself the manufacturer thereof exhibit in a legible manner on a conspicuous part of his barrow a notice stating the name and address of the person from whom he obtains such commodity and if such vendor is himself the manufacturer of such commodity he shall in the same manner exhibit his own name and address. Every such itinerant vendor who shall fail to comply with the provisions of this Section shall be liable for each offence on conviction as aforesaid to a penalty not exceed- ing forty shillings. Proceedings for the recovery of the penalties shall be instituted by the Sanitary Authority for the District in which the offence was committed or of the District to the Medical Officer of which such notification as aforesaid ought to have been made or in which such itinerant vendor as aforesaid shall offer any such commodity as aforesaid for sale as the case may be. A register has been prepared, in which to record the necessary information as required by the Act, and, in due course as the season in which the business is carried on arrives, the various premises will be inspected as to their condition, and the requirements enforced. After being placed on the register the premises will be kept under regular inspection. The trade in ice creams is not confined merely to the itinerant vendor, but is carried on very largely by various shops, &c., as in confectionery shops, refreshment rooms, and restaurants. Re-inspections, Calls, &c. 746 Thomas Turner, Inspcctor. CANAL BOATS. I beg to report that during the year 1902, from my appointment as Canal Boat Inspector in April, I have from time to time made inspections on the Canal bank of the Grand Surrey Canal, and the portion of the Creek within the borough, with a view to the inspection of boats; but only on one occasion, May 20th, have I found a boat, "Alice," "Registered No. 231, Port of London," subject to such inspection, on which occasion I found no one on board, and the cabins padlocked. I find the boats plying on the portion of the Canal within the borough are all barges entering and leaving the Surrey Commercial Docks, and coasting vessels certified under the Merchant Shipping Acts, and outside the jurisdiction of the Canal Boats Acts. The dates on which other visits have been made for purposes of inspection are: July 8th and 23rd, August 28th, September 24th, October 20th, November 10th, and December 23rd. The borough not being a registration authority under the Acts, I have no report as to the registration of boats. Thomas Turner, Inspector. 46 47 Table No. 10. ANALYSIS OF THE VITAL STATISTICS OF THE METROPOLITAN BOROUGHS AND OF THE CITY OF LONDON AFTER DISTRIBUTION OF DEATHS OCCURRING IN PUBLIC INSTITUTIONS DURING 1902. Boroughs. Estimated Population middle of 1902. Whooping Cough. Typhus. Enteric Fever. Simple and Ill-defined Fever. Diarrhœa. Deaths of Children under 1 year of age to 1.000 Births. Annual Rate per 1000 Living. Measles. Deaths from Principal Infectious Diseases. Scarlet Fever. Small Pox. Diphtheria. Deaths. Principal Infectious Diseases. Phthisis. Births. Births. Deaths. 4,579, 110 132,810 County of London 80,105 28.5 17.2 2.21 10,280 2,360 560 1,876 537 2,470 7,424 139 1.314 1,159 - 4 145,107 3,304 2,156 22.4 14.6 1.74 256 20 83 Paddington 9 33 23 13 75 155 133 - - Kensington 177,605 3,488 2,768 19.3 1 5.3 1.49 265 93 20 21 81 232 149 11 19 - 19 - Hammersmith 1,895 2 7.5 16.3 1.90 7 23 6 4 166 114,210 3,192 222 13 77 27 - 11 - 143 Fulham 143, 102 4,789 2,488 3 2 .9 17 .1 3.13 454 13 168 19 51 65 9 129 200 148 - - Chelsea 1,685 1,354 22.4 18.0 2.06 155 7 67 8 13 14 - 6 - 40 109 145 74.018 City of Westminster 180,180 3,286 17.9 16.1 1.28 236 39 42 20 1 328 136 2,953 15 29 34 - 54 St. Marylebone 3,976 29.6 18.3 1.98 267 24 27 67 258 132,145 2,455 97 14 23 - 15 - 107 0.81 Hampstead 83.743 1,549 920 18.2 10.8 68 3 15 7 10 10 11 12 72 87 - - St. Pancras 235.521 6,452 4,450 27.0 18.6 2 .46 590 81 113 49 107 113 44 83 450 147 - - Islington 5,634 26.9 16.4 1.80 614 54 116 40 104 156 4 6 98 513 133 337,270 9,217 - - Stoke Newington 702 22,0 13.4 1.17 61 8 5 6 18 66 5 1,700 1,154 5 14 - 4 1 115 Hackney 221,926 6,382 3,378 28.3 15.0 1.98 443 70 78 15 6 1 92 - 31 - 96 323 119 Holborn 58,535 1,647 1,266 27.7 21.3 2 .44 146 4 6 30 8 10 27 6 19 179 129 - - Finsbury 100,487 3,697 2,334 3 6.2 22.9 3.18 325 36 83 15 38 75 - 9 - 69 233 154 City of London 25,598 340 530 13.1 20.4 1.38 3 6 7 10 1 10 4 - 2 - 2 44 126 Shoreditch 118,004 4,069 2,488 33.9 20.7 3.53 425 76 88 8 25 76 - 22 130 217 174 - Bethnal Green 129,865 4,589 2,747 34.8 20.8 2 .5 6 339 64 59 19 33 89 14 - 61 260 155 - Stepney 6,285 38,0 20,6 3,31 1,009 260 164 30 8 5 199 34 2 37 147 300,551 11,590 - - 579 Poplar 169,214 5,890 3,326 34.2 19.3 2 .77 476 93 69 21 57 99 - 2 7 - 110 293 154 Southwark 206,825 6,897 4,495 32.8 21.4 3.10 653 78 164 42 63 114 2 3 169 550 166 - - Bermondsey 130,218 4,346 2,753 32.8 20.8 3.06 405 31 155 18 30 69 13 89 249 155 - - Lambeth 305,102 9,067 5,384 29.2 17.4 1.86 581 60 83 4 8 53 118 38 1 180 526 - 127 Battersea 171,4 01 2,618 28.4 15.0 1.98 4,944 346 27 101 24 18 63 - 16 - 97 229 127 Wandsworth 241,810 6,380 3,306 25.9 13.5 1.62 402 25 97 23 67 64 29 97 221 127 - - Camberwell 262,775 7,487 4,345 28.0 16.3 2.23 596 63 121 41 8 4 110 31 146 402 138 - - Deptford 111,577 3.315 1,826 29.9 16.3 1.89 211 30 58 18 18 36 11 38 142 138 - - Greenwich 98,013 2,802 28.1 15.4 15.9 4 1 6 46 138 1,532 159 22 15 20 - 9 - 119 Lewisham 132,43 2 3,466 1,88 3 25.7 13.6 1.79 241 12 27 19 45 65 9 6 4 143 125 - - Woolwich 119,556 3,734 1,837 30.7 15.1 1.93 235 38 40 9 23 5 1 13 61 181 125 - - Table No. 11. METROPOLITAN BOROUGH OF DEPTFORD. (This Table is prepared in accordance with the requisitions of the Local Government Board). (Table No. I.) VITAL STATISTICS OF WHOLE DISTRICT DURING 1902 AND PREVIOUS YEARS. Population estimated to Middle of each year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Non-residents registered in Public Institutions In the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District. Number. Rate.* Under 1 year of Age. At all Ages. Number. Number. Rate.* Year. Number. Rate per 1,000 Births registered Rate.* 33·2 297 359 1892 3413 1,628 15·8 169 102,800 577 15·8 268 1,537 1893 103,600 3,383 33·6 564 166 1,651 15·9 312 272 377 1,75 6 16·5 138 1894 104,500 3,363 32·1 465 1,248 11·8 270 215 1,417 13·5 374 32·7 1895 105,300 3,440 520 151 1,299 11 ·3 263 162 422 1,559 14·8 33·6 1896 105,900 3,560 613 172 1,444 13·7 288 265 401 1,580 14·9 3,418 1897 107,100 31·9 542 158 1,215 13·3 26 5 241 422 1,396 13·0 1898 3,463 165 13·8 107,900 32·1 569 1,270 11·7 226 208 437 1,499 1899 108,800 31·6 584 12 ·7 3,442 169 1,391 260 251 460 1,600 14·7 3,396 30·7 160 1,669 15·2 230 471 1,949 17·7 1900 109,700 544 221 110,398 3,395 30·6 510 158 1,566 14·1 188 396 1,790 16·1 1901 172 31·2 Averages for years 1892- 1901. 106,598 160 1,429 1,617 3,427 548 13·5 259 411 227 14·8 29·9 162 1,826 1902 138 115 16·3 111.577 3,315 459 1,324 11·8 502 *Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population. Area of District in acres (exclusive of area covered by water). Total population at all ages 110,398 Number of inhabited houses 15,823 Average number of persons per house 7·0. 1,574. At Census of 1901. Table No. 12. METROPOLITAN BOROUGH OF DEPTFORD. (This Table is prepared in accordance with the requisitions of the Local Government Board). (Table No. II.) VITAL STATISTICS OF SEPARATE LOCALITIES IN 1902 AND PREVIOUS YEARS. Whole Borough. Deptford, North. Deptford, South. Deptford, Central. Deaths under 1 year. Births registered. Deaths at all ages. Deaths under 1 year. Deaths under 1 year. Births registered. Population estimated to middle of each year. Deaths at all ages. Deaths under 1 year. Births registered. Deaths at all ages. Deaths at all ages. Births registered. Population estimated to middle of year. Population estimated to middle of each year. Population estimated to middle of each year. Year. 1893 103,600 3,382 1,756 564 28,980 1,120 554 200 32,020 715 412 88 42,570 1548 790 276 465 1,383 190 112 1894 104,500 3,363 1,417 29,040 390 32,340 998 305 42,960 1,962 722 183 32,680 367 98 1895 105,300 3,440 1,559 520 29,340 1,080 476 180 676 43,320 1,694 716 24 2 1896 1,100 513 181 43,690 105,900 3,560 1,580 613 29,500 33,010 764 360 111 1,696 707 203 1897 3,418 1,396 542 29,670 446 175 7 18 333 104 44,070 1,607 263 107,100 1,093 33,260 617 1898 569 29,840 1,151 430 182 33,670 44,430 1,615 667 107,900 3,463 1,499 699 402 102 285 1899 108,800 1,600 584 30,000 1,095 469 195 34,010 763 428 44,810 1,584 703 279 3,44 2 110 1,949 1900 109,700 3,396 544 30,160 1,130 654 172 34,370 711 503 106 45,240 1,555 792 266 1901 110,398 3,395 510 30,330 1,146 566 174 34,700 730 448 86 45,570 1,519 776 248 1,790 1,616 586 29,617 1,144 477 183 395 101 44,172 1,642 721 249 Averages of Years 1893 to 1901 108,022 33,227 752 3,488 1902 3,315 1,826 459 30,480 537 151 34,997 698 537 83 1,540 111,577 1,077 45,903 752 225 Table No. 13. METROPOLITAN BOROUGH OF DEPTFORD. (This Table is prepared in accordance with the requisitions of the Local Government Board). (Table III.) CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR ENDING DECEMBER 27TH, 1902. Notifiable Disease Cases notified in whole district Total cases notified in each locality No. of cases removed to hospital from each locality At all Ages At Ages—Years North Deptford South Deptford North Deptford South Deptford Central Deptford Central Deptford 1 to 5 5 to 15 15 to 25 25 to 65 65 and upwards Under 1 Small-pox 2 28 47 6 63 63 62 139 5 29 34 29 47 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 253 87 121 18 23 70 80 103 32 40 71 4 ... 1 Membraneous croup 3 1 2 1 4 ... ... ... ... ... ... ... 56 46 ... Erysipelas 147 7 5 14 18 93 10 45 1 ... 189 368 236 135 Scarlet fever 638 6 50 25 204 198 157 180 ... Typhus fever ... ... ... ... ... ... ... ... ... ... ... ... ... 32 15 26 8 Enteric fever 73 3 15 20 35 19 15 ... ... Relapsing fever ... ... ... ... ... ... ... ... ... ... ... ... ... Continued fever ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal fever 1 2 ... ... 3 3 ... ... ... ... ... ... 1 Plague ... ... ... ... ... ... ... ... ... ... ... ... ... 1199 1 4 2 543 472 26 15 1 464 291 444 ... Chicken-pox ... ... 2456 165 835 1020 167 256 13 89 1 659 270 212 Totals 906 314 Table No. 14. METROPOLITAN BOROUGH OF DEPTFORD. (This Table is prepared in accordance with the requisitions of the Local Government Board). (Table No. IV.) CAUSES OF, AND AGES AT DEATH DURING THE YEAR ENDING 27th DECEMBER, 1902. Deaths in or belonging to whole Distric at subjoined ages. Deaths in or belonging to Localities (at all ages). Total Deaths in Public Institutions in the Dis- trict (Metropolitan Asylum Board's South Eastern Hospital). Deaths of Residents Registered in Public Institutions beyond the District. All ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 65 and upwards. North District. South District. Central District. Causes of Death. 25 and under 65. 3 .. 30 13 Small-pox 8 2 5 6 14 9 1 29 Measles 58 .. 15 39 4 33 11 14 2 .. .. .. Scarlet Fever 18 1 23 1 .. 6 10 2 34 14 14 2 1 .. .. 11 Whooping-cough 36 13 .. .. 11 14 1 .. .. Diphtheria and membranous croup 18 8 8 1 .. 1 2 15 72 9 .. Croup 2 .. 1 1 .. 2 .. .. .. .. .. .. Fever, Typhus .. .. .. .. .. .. .. .. .. .. .. .. „ Enteric 11 8 4 28 7 .. .. 3 .. 4 3 .. „ Other continued .. .. .. .. 17 .. .. .. .. .. .. .. 5 Epidemic influenza 1 8 5 7 1 17 1 7 .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. 7 .. .. .. .. .. .. Diarrhœa 38 21 27 .. 1 3 7 10 2 .. .. Enteritis 59 39 12 1 1 4 2 16 10 33 1 .. Puerperal fever .. 2 2 .. .. 2 .. 2 .. .. .. .. .. .. 1 2 .. Erysipelas 3 1 2 .. .. .. .. Other septic diseases 10 1 2 .. 3 5 2 3 7 .. 3 4 Phthisis 142 35 105 202 112 6 9 11 3 17 96 6 51 38 53 .. .. 1 Other tubercular diseases 11 16 7 .. 6 7 22 1 11 .. Cancer, malignant disease .. 66 39 1 .. 1 37 22 44 1 3 2 Bronchitis 55 1 46 77 35 29 3 71 74 54 1 Pneumonia 20 5 3 43 18 33 56 16 23 23 3 Pleurisy .. 1 3 1 1 5 2 .. 4 .. 1 2 Other diseases of Respiratory organs 11 3 2 11 3 2 3 6 2 .. .. Alcoholism, Cirrhosis of liver 12 28 .. .. 24 4 7 9 1 16 .. .. Venereal diseases .. .. .. .. .. .. .. .. .. .. .. .. Premature Birth 96 .. 48 6 96 .. 31 17 .. .. .. .. Diseases and accidents of parturition .. .. 3 3 8 2 5 1 2 2 .. .. Heart diseases 6 15 64 33 28 4 8 55 13 1 1 12 1 24 Accidents 12 5 19 21 8 24 20 53 7 4 6 .. Suicides 8 .. 7 .. .. 4 4 5 1 7 .. .. Murders 5 2 2 1 .. 5 .. .. .. .. .. .. All other causes 16 579 135 2 5 17 9 244 157 203 219 15 189 752 1826 459 213 80 73 565 436 537 537 162 502 All causes 52 53 Table no. 15. 53 Table No. 15. ANALYSIS OF THE VITAL STATISTICS OF SEVENTY-SIX OF THE LARGEST ENGLISH TOWNS DURING 1902 Estimated Population middle of 1902. Deaths. Deaths from Principal Infectious Diseases. Scarlet Fever. Births. Annual Rate per 1,000 Living. Fever Deaths of Children under one year of age to 1,000 Births Rate per cent. of Uncertified Deaths Towns. Measles. Whooping-Cough. Diarrhœa. Small-pox. Diphtheria. Births. Deaths. Principal Infectious Diseases. 76 Towns 452,909 263,091 30.0 17.4 1,764 7,44 1 2,870 3,9 2 4 145 14,862,962 2.12 5,578 2,336 8,108 32, 021 1.2 75 Provincial Towns 10,283,852 3 20 ,099 180,551 31.1 17.6 2.10 21,628 450 5,080 2,307 2,743 3,698 1,746 5,604 146 1.6 4,579,110 132,810 82,540 28.5 17.7 2.23 10,393 1 ,3 1 4 1,181 0.3 London 2,361 563 1,880 590 2,504 141 Croydon 137,917 3,655 1,957 26.1 140 1.31 185 11 30 6 29 31 9 69 132 ... Willesden 121,611 3,922 1,615 31.7 13.1 2.14 264 13 67 11 52 26 10 85 135 1.8 Hornsey 75,565 1,596 659 20.8 8.6 0.63 49 4 7 1 7 9 5 16 84 ... Tottenham 106,535 3,418 1,573 31.6 14.5 2.29 2 4 8 75 2 5 14 37 41 19 37 123 0.7 West Ham 275,408 9,549 4,782 34.1 17.1 3.20 898 150 14 2 4 6 128 115 79 2 3 8 149 0.6 East Ham 104,023 3,853 1,261 36.4 11.9 2.14 225 25 25 10 33 51 24 57 119 0.8 Ley ton 103,479 3,213 1,255 30.5 11.9 1.82 192 11 14 7 37 60 16 47 119 0.8 1,188 Walthamstow 101,318 3,491 33.9 11.5 1.20 122 13 14 7 17 24 14 33 115 0.4 Hastings 65,893 1,222 968 18.2 14.5 0.82 54 1 14 4 10 8 1 6 112 1.1 Brighton 124,539 3,071 2,001 24.3 158 1.26 160 ... 30 3 36 28 14 49 125 0.2 Portsmouth 191,909 5,284 3,269 27.1 16.8 2. 3 2 452 ... 66 15 67 93 55 156 152 1.1 Bournemouth 61,628 1,074 774 1 7 .1 12.4 0.78 4 8 ... 18 15 10 8 11 1 115 0.4 Southampton 107,756 3,154 1,667 28 8 15.2 1.54 169 1 5 2 5 23 44 19 25 123 ... Heading 73,802 1,938 1,024 25.8 13 7 1.35 102 3 25 8 25 1 1 39 122 2.1 Northampton 88,592 2,279 1,37 1 25.3 15.2 1.58 1 4 2 4 2 2 13 27 16 42 138 1.5 ... Ipswich 67,840 1,908 989 27.7 14.3 1.06 73 ... ... 2 7 13 33 18 118 1.2 ... 51,610 1,439 886 27.4 15.9 1.71 90 ... 17 7 18 15 7 26 143 Great Yarmouth Norwich 113,178 3,204 1,919 27.9 16. 7 1.83 211 ... 35 23 10 66 5 72 167 0.6 3,015 1,902 2 7.0 1.7 8 199 1 14 5 96 11 Plymouth 17.0 47 110,057 25 155 0.4 Devonport 7 2 ,307 2,137 1,118 29.1 15.2 1.31 96 ... 21 6 15 11 10 33 121 ... Bristol 334,63 2 9,357 5,905 27.5 17.4 2.82 958 1 415 6 3 185 108 58 128 131 0.3 Hanley 62,486 2,239 1,271 35.3 20.0 3.84 243 2 63 8 81 29 12 4 8 174 1.8 Burton-on-Trent 50,973 1,392 7 11 26.9 13.7 1.12 58 ... 19 14 6 9 1 9 114 1.3 Wolverhampton 95,712 3,071 1,592 31.6 16.4 1.73 168 ... 21 16 19 23 13 76 134 0.4 Walsall 88,338 3,115 1,425 34.7 15.9 2.07 186 1 38 26 16 16 23 66 1 4 1 0.9 Handsworth 55,491 1,444 614 25.6 10.9 0.85 4 8 ... 10 12 7 13 5 1 109 0.4 West Bromwich 65,938 2,336 1,285 34.9 19.2 2.81 188 ... 55 66 10 10 6 41 162 1.2 Birmingham 528,181 17,079 9,997 31.8 18.6 2.53 1,358 4 182 290 131 267 103 381 157 2 .9 Kings Norton 60,779 1,859 718 30.1 11.6 1.13 70 ... 4 17 12 16 8 13 111 1.5 Smethwick 56,893 1,974 834 34. 1 14.4 1.36 78 ... 16 20 7 11 16 8 129 3.5 Aston Manor 78,481 2,339 1,078 29.3 13.5 2.00 159 ... 26 22 7 4 8 16 40 132 2.8 Coventry 71,475 2,073 1,017 28.5 14.0 1.25 91 ... ... 11 32 10 6 32 105 1.9 13 130 153 1.5 Leicester 216,389 6,410 3,275 29.1 14.9 1.54 339 4 75 12 34 7 1 Grimsby 64,596 1,974 966 30.1 14.7 2.03 133 ... 2 3 10 13 29 28 30 145 0.7 Nottingham 243,191 6,867 4,121 27.8 16.7 1.32 324 ... 0.4 24 29 37 52 178 159 0.6 Derby 116,982 3,326 1,6 5 6 28.0 13.9 1.28 152 ... 39 8 12 2 9 14 50 125 ... 55 54 Table No. 15. —continued. ANALYSIS OF THE VITAL STATISTICS OF SEVENTY-SIX OF THE LARGEST ENGLISH TOWNS DURING 1902 Towns. Estimated Population middle of 1902. Births. Deaths. Annual Rate per 1,000 Living Deaths from Principal Infectious Diseases. Small-pox. Measles. Scarlet Fever. Dipththeria. Whooping-Cough. Fever. Diarrhœa. Deaths of Children under one year of age to 1,000 Births Rate per cent. of Uncertified Deaths. Births. Deaths. Principal Infectious Diseases 1,823 9 24 8 13 55 2,636 19.0 27.5 0.3 Stockport 1.84 177 94,42 2 39 29 179 Birkenhead 112,396 3,731 2,024 32.7 17.7 2.27 257 1 36 20 27 60 45 68 148 0.3 56,173 1,602 791 28.1 1.23 70 ... 12 5 5 18 13 107 1.4 Wallasey 13.9 17 Liverpool 692,495 24,087 15,815 34.2 22.5 3 .08 2,175 22 341 320 404 219 659 163 3.7 210 Bootle 59,776 1,991 1,198 32.8 19.7 3.14 1 9 1 5 46 15 11 25 18 7 160 3.2 St. Helens 85,986 3,279 1,751 37.5 2 3 8 ... 59 4 8 21 18 27 65 167 20.0 2.72 5.5 Wigan 61,587 2,368 1,291 37.9 20.6 3.02 189 ... 21 34 23 39 15 57 157 1.6 65,4 1 9 1,091 35.7 16.4 7 37 Warrington 2,37 6 1.31 86 1 12 9 6 14 146 5.8 2,943 27.2 16.9 2.04 355 7 30 117 43 56 34 68 134 0.2 Bolton 171,082 4,736 Bury 58,182 1,232 969 20.8 16.4 1.44 86 6 18 5 34 8 4 11 130 1.9 Manchester 549,170 18,301 11,143 32.8 20.0 1.99 1,113 ... 246 147 118 242 65 295 152 0.8 Salford 224,007 3,659 4,393 33. 8 19.3 2.67 605 ... 157 50 74 118 61 157 0.4 145 Oldham 138,091 3,659 2,677 26.1 19.1 2.00 282 7 104 36 47 30 14 44 148 0.3 Rochdale 84,057 2,048 1,561 24.0 18.3 1.27 109 ... 70 1 8 13 3 14 130 2.7 98,383 2,914 1,946 29.1 19.5 3.61 361 4 149 45 15 19 59 177 1.4 Burnley 70 Blackburn 130,318 3,387 2,243 25.6 16.9 1.79 237 2 80 31 23 26 22 53 159 3.8 Preston 113,766 3,34 1 2,205 28.9 19.1 2.79 323 ... 57 21 28 29 22 166 189 4.0 Barrow-in-Furness 58,372 1,963 926 33.1 15.6 2.67 159 ... 72 2 12 51 9 13 136 3.7 95,084 2,354 1,716 1.57 15 2 57 11 13 6 18 138 2 4.4 17.8 Huddersfield 1 4 6 1.5 Halifax 105,932 2,286 1,691 21.3 15.7 1.07 406 ... 39 15 9 15 15 23 144 2.6 Bradford 281,771 6,575 4,530 23.0 15.8 1 .43 406 ... 159 4 6 85 33 32 51 139 0.7 Leeds 437,037 13,246 7,797 29.8 17.6 1.99 88 5 6 187 55 94 200 78 265 159 0. 4 7,257 71 4 8 150 2.6 Sheffield 418,177 14,182 33.4 1 7. 1 1.67 720 ... 193 56 114 238 Rotherham 55,934 2,007 889 35.3 15.6 1.74 99 1 42 4 13 9 9 21 139 3.6 York 79,114 2,320 1,250 28.9 15.5 1.35 108 1 40 7 7 16 13 2 4 116 0.4 Hull 245,449 8,000 4,286 32.1 1 7. 2 2.27 569 ... 208 18 88 109 43 103 137 1.8 Middlesbrough 93,355 1,915 36.0 20.2 2.66 254 10 46 61 31 24 82 179 3.1 3,413 ... Stockton-on-Tees 51,745 1,74 1 895 33.1 17.0 2. 3 8 125 ... 43 14 8 30 9 21 14 1 2.9 West Hartlepool 65,161 2,393 1,003 3 6. 1 1 5. 1 1.61 106 ... 32 7 2 7 19 9 12 120 0.6 Sunderland 148,007 5,393 2,928 35.9 19.5 1.8 7 281 1 83 25 15 4 8 35 74 152 4.0 South Shields 3,830 2,045 36.5 19.5 2.67 280 3 100 43 6 7 17 147 5.3 103,330 104 Gateshead 4,220 2,033 36.7 17.7 2.01 231 4 81 35 12 51 6 42 136 4.4 113,013 1.76 Newcastle-on-Tyne 219,150 7,259 4,428 32.6 19.9 391 2 140 59 23 100 10 58 139 0.8 98 Tynemouth 52,009 1,784 1,029 33.7 19.5 1.87 2 17 8 5 41 5 20 149 1.7 Newport (Mon.) 68,901 32.8 15.7 1.56 109 2 63 7 8 6 9 126 0.3 2,295 1.103 14 462 Cardiff 168,909 5,408 2,88 5 31.5 16.8 2.69 ... 184 37 89 96 9 47 146 0.1 Rhondda 117,011 4,937 2,223 41.5 18.7 3. 02 357 1 110 27 81 39 21 78 178 0.6 Merthyr Tydfil 70,568 2,824 1,659 39.4 23.1 2.77 135 10 55 8 29 13 25 59 18 5 0.4 Swansea 95,059 3,005 1,556 31.1 16.1 1.40 135 33 7 17 24 1 6 47 135 1.4 Table No. 16. METEOROLOGICAL TABLE FOR LONDON, 1902. (Deduced from Observations at Greenwich, under the Superintendence of the Astronomer Royal). Winter Jan., Feb., March. Spring April, May, June. Summer July, Aug., Sept. Autumn Oct., Nov., Dec. Temperature of Elastic Force of Vapour. Weight of Vapour in a Cubic Foot of Air. Degree of Humidity. Reading of Barometer. Weight of a Cubic Foot of Air. Rain. Reading of Thermometer on Grass. Air. Evaporation. Dew Point. Air- Daily Range. Number of Nights it was Lowest Reading at Night. Highest Reading at Night. Mean. Mean. Mean. Diff. from Average of 60 Years. Mean. Mean. Mean. Diff. from Average of 60 years. Mean (Satn.=100). Diff. from Average of 60 years. Mean. Mean. Amount. Diff. from Average of 86 years. At or below 30°. Between 30° and 40°. Diff. from Average of 130 Years. Diff. from Average of 60 Years. Diff. from Average of 60 Year s. Diff. from Average of 60 Years. Diff. from Average of 60 year s. Diff. from Average of 60 years. Diff. from Average of 60 years. Above 40°. ˚ ˚ ˚ ˚ ˚ in. grs. gr. ins. in. Sums. ins. ins. ˚ ˚ Sums. 1902. ˚ ˚ ˚ ˚ in. grs. grs. 140 111 55.6 3.2 80 29.797 +.020 YEAR. +1 49.2 +0.5 —0.2 45.9 —0.6 42.5 —1.0 14.0 —1.8 .280 -.013 —0.2 -2 543 19.34 —5.46 114 6.9 29.786 0 7 Winter Qr. 40.5 +0.4 2.5 84 +.012 10.9 33 +0.1 38.4 44.0 +1.6 +0.7 +0.6 35.6 —0.9 .210 +.003 0 552 2.79 —2.15 50 6.9 Spring do. 51.0 —0.2 74 28 29 17.8 16.7 3.2 29.771 -.014 + 2 34 —2.1 49.3 55.6 45.5 —1.4 47.2 54.9 43.1 -.123 —3 540 6.85 —1.9 —1.9 43.1 -3.2 .283 +1.24 Summerdo Autumn do. —0.2 50.8 40.6 —2.2 4.2 29.832 56 29.3 59.6 76 +.036 34 45 18.7 —0.4 2 —0.8 -1.6 —1.0 .372 —.030 -1 532 +2 5.67 —1.50 9.8 —4 29.800 +.047 28 19 +1.5 0.0 0 17.3 45.2 2.9 85 +0.8 +0.5 -1.9 .255 —.002 -0.2 547 4.03 —3.05 In this Table + and — respectively signify that the number in the preceding column is above or below the average to the amount of the quantities to which these signs are affixed.