EDM 5 Edmonton Urban District Council. REPORT of the MEDICAL OFFICER OF HEALTH by A. W. J. MacFadden. M.B., C.M., D.P.H., and of the INSPECTOR OF NUISANCES by Richard J. Butland. FOR THE YEAR 1903. JOLLY THE PRINTER (T.U,), THE "EDMONTON PRINTERY,' 238, FORE STREET. Public Health Department, Town Hall, Edmonton, March 30th, 1904. To the Chairman and Members of the Urban District Council. Gentlemen, I have the honour to present to you herewith the Annual Report on the health and sanitary condition of this District for the year ending December 31st, 1903. Although I participated in the work of the District for but a short period of the time under review, it has been deemed advisable, both by your late Medical Officer and myself, that this report should take its present form, rather than that we should present separate statements for those portions of the year with which we were respectively concerned. In preparing this report, therefore, I have been at pains to consult Dr. Adamson on such matters as related to the period during which he held office, and I have derived the year's statistics from the register kept by him up to the time of my succeeding him, and continued by me from that date till the end of the year. In dealing with the subjects of Infantile Mortality and Phthisis, I have dwelt at some length on the extent to which the problems involved in these two questions may be affected in the future, by, in the case of the first, the new powers, acquired by the Council under the Education Act, and in the case of the second, by the hoped for acquisition of suitable means in the future for controlling the spread of consumption in the county. I wish to express to the Sanitary Committee and the Council, my appreciation of the support they have given to the public health work of the District, and at the same time to Mr. Butland and the staff of my department for the zeal and efficiency with which they have carried this work out. I am, Gentlemen, Your obedient Servant, A. W. J. MacFadden, Medical Officer of Health. 5 GENERAL. The Urban District of Edmonton, seven miles distant from Liverpool Street terminus on the Enfield branch of the Great Eastern Railway, is situated on the west bank of the River Lee. It is bounded by Enfield Urban District on the north and by the Urban Districts of Southgate and Tottenham on the west and south respectively. Chingford Urban District lies to the east on the opposite bank of the river. The district is for the most part flat, rising slightly from the river marshes on the east to the higher ground to the westward. Geologically, Edmonton is situated in the London chalk basin. The subsoil consists for the most part of valley drift (sand and ballast), beneath which at varying depths lies the London clay. The surface loam is not deep, and, in the northern part of the District especially, there is a rich and extensive deposit of brick earth. The water supply is derived from the New River Company's Works, and only a very small number of wells are now being used. The sewerage is on the separate system, the surface water being carried into the Pymme's and Salmon's Brooks, while the sewage proper is conducted in sewers to the Council's sewage farm, where it is treated by broad irregation. 6 VITAL STATISTICS. The population of the district, exclusive of the two Union Workhouses, was— By Census 1881 13,065 1891 23,437 „ 1901 44,911 The estimated population of the district for the year is arrived at by multiplying the number of inhabited houses at the middle of the year by the number of inhabitants per house as given in the last census report. This figure for Edmonton in 1901 was 5.75. The number of houses in the district at the middle of 1903 was 9,889, of which 850 were uninhabited. The population for the year, excluding the two Union Workhouses, is, therefore, 51,974. In the following table is shown statistics relating to the two Union Workhouses situated in Edmonton. Population at middle of year. Births. Deaths. Edmonton Union Workhouse *685 †59 ‡201 Strand Union Workhouse and Schools 1219 5 47 Total *1904 †64 ‡248 *165 of these were residents of Edmonton. †19 of these were born of Edmonton parents. ‡54 of these were residents of Edmonton. 7 The Density of Population.—For this calculation the total population of the two unions is added to the estimated population, giving the gross population 53,874. The area of the district is 3,890 acres, and from these figures the average number of persons per acre is found to be 13.8. The natural increase of the population by excess of births over deaths during the year was 1,122. In calculating the various rates that follow, I have included in the population the 165 residents of Edmonton Workhouse, who belong to the district. The other inmates of the Unions have been excluded, as they do not properly enter into our statistics. The population for this purpose is therefore 52,139. BIRTHS. During the year there were 1,891 births registered in the district, 64 of which occurred in the workhouses. Of these, 19 are included in our statistics, as the parents belong to Edmonton. The corrected number of births for the district is therefore 1,846, which, with the population of 52,139, gives a birth rate of 35.4 per 1,000. This is an increase of 8 per 1,000 on the rate of last year, and exceeds the average of the last 10 years by almost 2. The rate for England and Wales is 28.4, which is the lowest figure that has yet been recorded. The birth-rates of the District during the past 10 years will be found on table 1 p. 32. 8 DEATHS. The number of deaths registered in the District for the year is 844. The deaths occurring among the inmates of the Strand Union and Schools (47), and those of non-residents of Edmonton dying in Edmonton Workhouse (147), do not properly enter into our statistics, and have therefore been excluded. The deaths among Edmonton residents dying in Edmonton Workhouse (54), are, however, included. To these must be added 74 deaths of Edmonton residents, who died in various institutions outside the district, giving a net total of 724 deaths. The death rate is therefore 137 per 1,000. The death rate for England and Wales is 15-4 per 1,000. The age, distribution, and causes of death are set out on Table IV., pp. 34 & 35. On p. 14 will be found a table showing the death rates of the district for the last 11 years, in which it will be seen that the figure for the present year is the lowest recorded. Edmonton, indeed, has participated fully in that general drop in the country's death-rate, which has been the chief statistical feature of the year. After allowing for the reduction which is annually looked for as the result of the continued efforts of sanitary authorities in the improvement of the people's health, there remains a large margin of the decrease in this year's death-rate, both in Edmonton and elsewhere, that must be accounted for in other ways. It is the generally accepted view that the unprecedented 9 rainfal of 1903 has been the prime factor in effecting this reduction. In addition to the repeated scourings that our streets and the back yards of our houses received from the heavy downpours which occurred so frequently during the summer months, there is the fact that on very few days throughout the year were the conditions such as to allow of the formation of dust. In this fact is to be found the explanation of the position, and if the lesson in sanitation which nature has given us is to be followed up and put into practice, our aim should be directed towards the prevention of dust as far as is mechanically possible. The proper cleansing and watering of streets and roads is, of course, in this respect, of great importance, but what is of even greater moment is the condition in which the back yards of dwellings are kept. It is the dust arising from this source that is the most fruitful in producing disease. An ill-kept back yard is the receptacle for all the refuse and rubbish that a bad housewife finds time to throw out of her house. Probably only a small part of this filth reaches the dust-bin ; the rest remains to rot in the yard and there to breed the germs of disease. In hot weather this germ-laden rubbish is soon converted into dust, which soon finds an easy access to the house through the kitchen door. In the kitchen it mixes freely with the food that is stored there; it becomes deposited on the utensils, etc. The food made for the baby comes in for its share, and as this is commonly prepared in bulk in the morning, to be "warmed 10 up" as required through the day, this excellent medium for the multiplication of organisms before long helps their numbers to increase a thousandfold. It is not much wonder under circumstances like these that infants die of diarrhoea, and that ill-health is produced in other members of the family. A wellpaved yard, capable of being frequently washed down and a properly kept dust-bin are the best preventives of these evils. By giving attention to these points, the conditions as to dust, which proved so beneficial in 1903, could with little trouble be produced artificially right through the driest season, and would, there is little doubt, help very materially in the reduction of of the death-rate. INFANTILE MORTALITY. There were 259 deaths during the year of children under one year of age. The number of births during the year (exclusive of those occurring in the Edmonton Union, whose parents do not belong to this District) was 1,846. The infantile mortality therefore is 140.3 per 1,000 births, In order to make this comparable with the figures for preceding years, in which it has been the custom to deduct from the number of infant deaths those due to premature birth, we must allow for 37 such deaths which occurred during the past year. This gives a total of 222 deaths under one year, or an infantile mortality rate of I20'2, the lowest figure recorded for the last 10 years. The infantile mortality figure is a fairly accurate indication of a district's health, and we have here an 11 instance of the general improvement that we have shared in with the rest of the country generally during the year. When we include, as is most generally the custom, the 37 deaths attributed to premature birth (a rather high proportion of the infantile deaths) we find that our true infantile mortality figure, 140.3, is still a high one. It means that roughly one out of every seven children born does not reach the age of one year. The drain on the population that this loss represents is a serious matter, and every effort made by a sanitary authority to reduce the number of these deaths is a direct addition to the nation's assets. The causes tending to an excessive infantile mortality will be alluded to in detail under the various diseases that contribute to it. But here it may be stated broadly that ignorance on the part of the mothers as to (a) the rudiments of hygiene, and (b) the proper feeding of infants, plays the chief part. To a great extent the State, through its system of education is responsible for this ignorance. Large sums of money are spent yearly in a more or less successful effort to drive an increasing amount of theoretical knowledge into the heads of the children of our working classes. A real benefit is conferred by this method on the infinitely few whose mental gifts are high—the infinitely many suffer deeply in the process. They are given something which, in the various callings they come to 12 fill in their manhood and womanhood, is of little use to themselves and of none to the State—their time has been wasted and the State has not benefited. Surely the more logical aim would be to first make good citizens and then make clever ones—the latter would follow as a natural sequence in any case. Why, instead of wasting their precious hours over parsing, cube root, and such like refinements, should these boys and girls not be given practical lessons in the science of living decently; in the dangers lurking in dust and dirt; in the importance of having clean air to breathe and clean homes to live in? As a mental exercise instruction of this kind would be equally useful and its educational value immensely superior. In the case of the girls more particularly, what profit might the State and the municipality not derive from their having gained in school a good practical knowledge of such subjects as housekeeping—how to cook foods properly and how not to waste them—the nature of a substance like milk and the terrible wastage of infant life that results yearly from its improper use and careless handling? If the elder girls were given a course of sound instruction in the care and management of infants, their feeding and clothing; if they were shown why it is necessary to a child's health that it should be kept clean and live in a clean home, we should find before long the present unnecessarily high infantile death-rate rapidly on the decrease. I am aware that elementary science, both general and sanitary, is, in many cases being taught in our 13 schools, but at the best the instruction is only fragmentary and theoretical. To obtain practical results these subjects must be practically taught, otherwise, like the parsing and the cube root, they will be forgotten long before the time arrives for their proper application. The new Education Act has given to the Public Health Authority a greater opportunity for exercising a high and powerful influence for good on the wellbeing of the community. It is a new weapon in its armament, which, if employed in a wise and skilful way, should do more in the next 15 years to reduce the evils I have indicated, and at the same time make the lives of our working classes healthier and happier, than almost any enactment that has been passed since that authority came into existence. ZYMOTIC DEATH RATE. The number of deaths from the principal zymotic diseases, including persons belonging to the district whose death occurred without the district, is given in the following table:— Small-pox 0 Measles 10 Scarlet Fever 2 Whooping Cough 19 Diphtheria 1 Membranous Croup Croup Enteric Fever 6 Diarrhœa 62 100 14 Taking the basis of calculation used in estimating the crude death rate, I find the zymotic death rate to be 1.91 per 1000. That for England and Wales is 1.46 per 1000. The following table shows the Death Rate, Infantile Mortality, and Zymotic Death Rate per 1000 for eleven consecutive years. Death Rate. Infantile Mortality. Zymotic Death Rate. 1893 16.9 132.2 2.4 1894 15.6 132.2 3.06 1895 13.98 122.2 2.37 1896 15.6 153.6 3.8 1897 15.95 157.8 3.8 1898 16.8 195.8 5.08 1899 17.4 161.87 4.6 1 goo 16.o 168.1 2.6 1901 14.3 139.0 2.4 igo2 17.88 143.69 4.7 1903 13.7 *140.3 1.91 *In calculating the infantile mortality for 1903, deaths due to premature birth have been included for the first time. INFECTIOUS DISEASES. The Infectious Diseases Notification and Prevention Acts are in force in this District. The following is a tabulated statement of the number of cases of each disease notified during each of the last three years. Cases notified twice being counted as one case:— Chart shewing the number of cases of Important Infectious Diseases Notified during each month of he year 1903. 15 1901. 1902. 1903. Small Pox 13 701 1 Scarlatina 156 179 119 Enteric Fever 65 86 28 Diphtheria 40 58 18 Puerperal Fever 443 Membraneous Croup 221 Erysipelas 54 66 63 Chicken Pox — 188 141 334 1284 377 The coloured diagramatic chart shows the number of notifications received month by month of the chief infectious diseases. Apart from the almost entire absence of smallpox it will be noted that there is a great decrease in the numbers of the important notifiable infectious diseases as compared with the last two years. This decrease is most marked in the case of diphtheria which, as Dr. Newsholme has pointed out, is a disease that is greatly influenced by the rainfall. It flourishes best where the conditions are in favour of dryness and the formation of dust, and is a disease of comparatively rare occurrence in districts where the rainfall is excessive. Here, again, we have a striking demonstration of the beneficent influence of a wet year. The Case Mortality Rate—that is the percentage of cases dying to those notified—is as follows:— 16 Small-pox 0 per cent. Scarlet Fever 1.67 „ Diphtheria 5.26 ,, Enteric Fever 21.43 „ Erysipelas 3.12 „ Puerperal Fever 33.33 ,, The following table shows the number of cases removed to the Isolation Hospitals during the year, and the percentage of these to the cases notified:— Number isolated in Hospital. Percentage of notified cases isolated in Hospital. Small-pox 1 100 per cent. Scarlet Fever 57 47.9 ,, ,, Enteric Fever 15 53.5 ,, ,, Diphtheria 5 26.3 „ „ Erysipelas 1 1.5 ,, ,, Total 79 34'3 SMALL-POX. One case only of small-pox was notified during the year. It occurred in Bush Hill Park, and from the history obtained it was clear that the patient got her infection outside the district. Prompt measures were taken to isolate the case and disinfect the house and, as the contacts were few in number and had all been recently re-vaccinated, no secondary case occurred. 17 It is satisfactory to note this almost complete absence of small-pox from the district during the year. The temporary building erected during the last epidemic, together with all the tents and hospital furniture and equipment are in good condition, and if the occasion should occur, could be made ready for use at short notice. Tents, however, are unsuitable for the treatment of a disease like Small-pox and should only be used as a last resort. In addition to this temporary accommodation, the Council have retained 6 beds at the South Mims Small-pox Hospital for the use of the district, and, should an outbreak occur, these are the beds that would be used in the first instance. Until the state of vaccination in this country reaches the perfection in which it at present exists in Germany,—where small-pox hospitals have ceased to exist,—adequate permanent means for isolating the disease will always be required and must be provided. It is greatly to be desired, therefore, that the Joint Hospital Scheme brought forward by the Middlesex District Council's Association will before long take practical form, for at the best, temporary hospitals are neither satisfactory nor economical. SCARLET FEVER. There were 119 cases of scarlet fever notified during the year, of which 57 were removed to hospital. The cases were of a mild type and there were but two deaths, which is equivalent to a case mortality rate of 18 1.6 per cent. It will be seen on referring to the coloured chart that the disease was most active during the summer months. ENTERIC FEVER. 28 cases of enteric fever were notified during the year, 15 of which were removed to hospital. There were six deaths from the disease. One-fourth of the total cases notified occurred in the month of September. DIPHTHERIA & MEMBRANOUS CROUP. There were 18 cases of diphtheria and one of membranous croup notified during the year. This is a remarkably low figure. One death only occurred from the disease. A supply of antitoxin is kept at the Town Hall for the use of medical practitioners in those cases which cannot be removed immediately to hospital. PUERPERAL FEVER. Three cases occurred and there was one death. ERYSIPELAS. 63 cases were notified and, as in the year 1902, there were two deaths, both in children under one year of age. CHICKEN-POX. This disease was notifiable throughout the year up to the 1st December, when it was withdrawn from the list of notifiable diseases. There were 140 cases reported. 19 CONTINUED FEVER. There were three cases of this indefinite disease notified, all by the same medical practitioner. NON-NOTIFIABLE INFECTIOUS DISEASES. The deaths registered under this head numbered 102 which is equivalent to a death rate of 1.95. If we add the 12 deaths occurring from the notifiable infectious diseases, we find that the total infectious diseases death rate amounts to 2.2 per 1,000 living, or in other words, that these preventable diseases account for over 15 per cent, of the total deaths for the year. MEASLES. There were ten deaths from this disease, most of them occurring in the 2nd age period. This is the time at which children first begin school attendance in the baby and infant classes, and it is to this fact that the wide spread of the disease during its epidemic periods is to be chiefly ascribed. WHOOPING COUGH. 19 deaths were registered as due to Whooping Cough, and 14 of these were among children under one year of age. Complicated as this disease frequently is by pneumonia, it is a peculiarly dangerous one in young infants. DIARRHœA. 62 deaths were returned as due to this disease. 52 of these deaths occurred in children under one year, which is equal to 20 per cent. of the total infant 20 deaths. The accompanying chart shows clearly the influence of the time of year on the behaviour of this disease:- During the hot weather, milk, which, in its various forms, is the chief food of infants and young children, becomes a yet more suitable vehicle than usual for the growth of micro-organisms, and, as I have before pointed out, it is also at this time more liable to be contaminated by certain germs of disease, which, during these months probably reach the height of their virulence, and are carried in the atmosphere by particles of the powdered filth of all sorts in which they originally existed, and so gain access to the milk. This condition of things can and should be guarded against, and it is by the spread of knowledge on this and 21 kindred subjects among women in particular that the evils in question are to be combated. INFECTIOUS DISEASES HOSPITAL. The present arrangement betweeen the District Council and the Enfield Council whereby a certain number of beds are reserved in the Enfield Isolation Hospital for infectious cases from Edmonton, is likely before long to prove quite inadequate. I should be wanting in a sense of duty if I allowed the low figures registered under the notifiable infectious diseases during the past year to lull the Council into what would be a false feeling of security. As I have already pointed out, these figures are largely the result of a quite exceptional circumstance, namely, the unusual meteorological conditions that prevailed during the past 12 months and it would be unwise in the extreme to take them as a starting point for yet better records in future years. Much as this is to be desired, it is not, in the nature of things, to be expected, and although we may benefit for some time to a considerable extent from the years downpour, a return to normal conditions of weather is inevitable, and a hot dry summer may, at any time, rob us of the temporary advantage we have gained over the organisms of disease. Moreover, permanent hospital accommodation cannot be evolved at the point of the magician's wand. It would take at least 18 months from the commencement of the work to complete a properly-built and equipped isolation hospital such as would be adequate for the needs of our rapidly 22 increasing population,—a population be it remembered, that is composed almost entirely of that class in which the incidence of infectious disease is the heaviest, and the necessity for isolation the most urgent. PHTHISIS AND OTHER TUBERCULAR DISEASES. The total deaths from phthisis during the year numbered 58, giving a death-rate from this cause of 1.11 per 1,000 living. Of these deaths 13 occurred among residents of Edmonton in the Edmonton Workhouse. The total deaths from phithisis in the public institutions in the district numbered 40. Other tubercular diseases were answerable for 56 deaths, giving a death-rate of 1.07 per 1,000 living. Of these 56 deaths, 3 occurred among Edmonton residents in the Workhouse, and 6 were returned from various hospitals outside the district. It will be seen, therefore, that tuberculosis accounted for 2.18 deaths per 1,000 living, or nearly 16 per cent. of the total deaths of the district. In the case of phthisis the large bulk of the deaths occurred in persons between the ages of 25 and 45, the age period at which life is most valuable and possesses the greatest number of duties and responsibilities. For this reason, and also on account of the lengthened course it runs, this disease must be regarded as involving a problem of the highest economic importance. The friendly societies of Germany have, indeed, shown their appreciation of this fact, and their belief in the efficacy of early sanatorium treatment as a remedy, by 23 their having established numbers of these institutions for the reception of their members who have become consumptive. Great care is taken to diagnose the disease at the earliest possible moment, and the patient is immediately sent to the sanatorium, with a good prospect of being cured in a few months and enabled to return to work. The societies claim a large saving in their funds by the adoption of this course. It is better, they find, to treat a case as soon as it is recognised, even at the expense of six or eight months in a sanitorium, with the prospect of having at the end of that time their member healthy and ready again for work, than to keep him on their funds for perhaps a year or two while the disease runs its fatal course. In this latter case they would have not only expended the funds in vain and lost their member, but his wife and children, brought to poverty by the bread winner's long illness, would be reduced to a condition in which they might fall an easy prey to infection with the father's disease. These children, too, in their turn, would prove bad material from which to recruit future members. So that by following the plan they have instituted, the German societies accomplish not only an eminently humane ideal but one that is also of high economic value. There is a proposal on foot to establish a Sanatorium for Middlesex, to be run on municipal lines. Such an institution would be of immense benefit to this district as well as to the county at large, and 24 it is earnestly to be hoped that the near future will see it an accomplished fact. By instituting a system of voluntary notification of consumption, the Council would have most of the existing cases of phthisis brought to their notice, and a selection could be made from amongst them of cases suitable for sanitorium treatment, either on account of the early stage of the disease giving reasonable hopes of a cure, or, in more advanced cases, where the home conditions of the patient were such as to threaten other members of the family with the danger of infection. In these latter cases where a cure cannot be hoped for, a few weeks treatment and instruction in the methods for preventing the infection of others, that every consumptive person should have full knowledge of, are of immense value. It is a matter now of common experience that those who have undergone sanatorium treatment, come back to their ordinary life with an enthusiasm for carrying out the principles they have been taught, which is almost unparalled, and considering that 8 or 10 such cases per bed per year could be so treated, it would not be long before the influence of the institution would make itself felt in the locality from which the patients were drawn. In order to secure suitable cases for cure, the earliest possible diagnosis of the condition is essential. Early recognition of the diseases is often extremely difficult, and in very early cases it is impossible without the aid of bacterial examination of the patients 25 sputum. In a district, therefore, where the sanatorium treatment is about to be established, it is of the greatest importance that facilities for having bacterial examinations of this kind made, should be given to the medical practitioners. The steps that are now being taken to deal with consumption in this District are confined to visiting the houses where deaths from phthisis have taken place, and offering the necessarydisinfection, and where, in the course of the ordinary visits for other purposes, a phthisical case is encounted a card is left on which the following instructions are printed:— EDMONTON URBAN DISTRICT COUNCIL. Precautions for Consumptive Persons. Consumption is, to a limited extent, an infectious disease. It is spread chiefly by inhaling the expectoration (spit) of patients which has been allowed to become dry and float about the room as dust, or by directly inhaling the spray which may be produced when a patient coughs. Do not spit except into receptacles, the contents of which are to be destroyed before they become dry. If this simple precaution is taken, there is practically no danger of infection. The breath of consumptive persons is free from infection, except when coughing. The following detailed rules will be found useful, both to the consumptive and to his friends:— I.—Expectoration indoors should be received into small paper bags and burnt immediately; or into a 26 receptacle which is emptied down the drain daily and then washed with boiling water or disinfectant. 2.—Expectoration out of doors should be received into a suitable bottle, to be afterwards washed out with boiling water. If a paper hankerchief is used, this must at once be placed in a waterproof bag, the contents subsequently burnt and the bag washed daily with disinfectant. 3.—Ordinary handkerchiefs, if ever used for expectoration, should be put into boiling water before they have time to become dry; or into a solution of a disinfectant, as directed by the doctor. 4.—Wet cleansing of rooms, particularly of bedrooms occupied by sick persons, should be substituted for "dusting " and sweeping. 5.—Sunlight and fresh air are the greatest enemies of infection. Every patient should sleep with his bedroom window open top and bottom, a screen being arranged, if necessary, to prevent direct draught; and the patient should occupy a separate bedroom. N.B.—The patient himself is the greatest gainer by the above precautions, as his recovery is retarded and frequently prevented by renewed infection derived from his own expectoration. 6.—Persons in good health have little reason to fear the infection of consumption. Over-fatigue, intemperance, bad air, dusty occupations and dirty rooms favour consumption. Disinfectants can be obtained on application at Town Hall, Edmonton. 27 FACTORY AND WORKSHOP ACT, 1901. Premises coming under this Act have been inspected from time to time, and the Register of Outworkers is kept up to date. The Register requires constant revision as the number of outworkers fluctuates with the movement of the population to and from the district. The total number of factories and workshops on the Register is 120. Each workshop where persons are employed has been furnished with a card on which the following particulars are recorded:— (copy of workshop card) EDMONTON URBAN DISTRICT COUNCIL. The Public Health Act, 1875, and Factory and Workshops' Acts. Situation of Workroom This Workroom has accommodation for persons. When working Overtime for persons only. The above numbers assume that the means of ventilation are kept in good working order. Any alteration made in the accommodation of the above workroom must be immediately reported to the Sanitary Inspector. Occupier Address Business 28 Herewith is appended a list of the works carried out directly or indirectly, in connection with the Act. FACTORIES— Ceilings repaired 1 Dampness remedied 1 W.C. pans cleansed 4 Syphon cisterns repaired 3 WORKSHOPS— Overcrowding abated 3 Premises cleansed 3 Yard paved 1 New apparatus to W.C.s 2 Storage cistern repaired 1 Workshop enlarged 1 Roof repaired 3 Water supplied to W.C. new pan and trap, new seat, floor rendered impervious 1 LAUNDRIES— Overcrowding abated 2 Yard paved 8 New laundries 1 Laundry enlarged 1 BAKEHOUSES— Limewashed 22 Drains repaired and re-trapped 2 W.C. pans cleansed 7 Yards paved 3 Overcrowding abated 1 Ceilings rendered dust proof 4 29 Stables removed 1 Yards cleansed 1 W.C.s. repaired 1 Window added for light and ventilation 1 New River water supply put to bakehouse 1 Bakehouse repaired 1 New bakehouse 1 Bakehouses reconstructed 1 Bakehouse walls rendered 1 Floor re-constructed 1 I am pleased to say there is only one underground bakehouse in the district that comes within the definition of Underground Bakehouse Sec. 101 states, "For the purpose of this section an underground bakehouse shall mean a bakehouse, any baking room of which is so situate that the surface of the floor is more than three feet below the surface of the footway of the adjoining street, or of the ground adjoining or nearest to the room." The Bakehouse in question is four feet below the level of the adjoining footway, and so comes within the definition. However, the owner of the bakehouse is carrying out the necessary work by rendering the walls and ceiling to a smooth surface, making the dough troughs moveable, and the whole of the drains watertight; and when this is completed, he will be entitled to a certificate under the Act. HOUSES OF THE WORKING CLASSES. New houses continue to be built in great numbers in Edmonton, and new streets are rapidly springing up in all directions. The Council's Building Bye-Laws are carried out under the supervision of the Building Inspectors; drains are water-tested by them, and when the houses are completed, they are visited by me for the purpose of ascertaining their fitness for habitation. During the past year, 346 houses and 14 shops were inspected in this way. It is to be regretted that the cottage property at present being built, does not include a class of house much needed in this District. I refer to such a selfcontained dwelling as would be suitable, both in regard to size and rent, for the lower wage earners whose families are still young. There are not nearly enough houses of this kind in the District, and the result is that two or more families of the class referred to, are compelled to share the same dwelling, much to the encouragement of overcrowding and the destruction of that sense of responsibility for, and interest in, the home, which is of such value to the community. If by abolishing, say, the unnecessary and useless front parlour and entrance passage, a smaller house could be devised with one good sized kitchen and living room combined on the ground floor, and three sleeping-rooms upstairs, the case might be met and much good result to the District in consequence. 30 31 Periodical inspection of the District has been made by myself and your Sanitary Inspector from time to time, and this, together with the questions of overcrowding, removal of house refuse, sewers, &c., are dealt with in his report. TABLE I. EDMONTON URBAN DISTRICT. Vital Statistics of Whole District during 1903 and previous years. Year. Population estimated to Middle of each Year. Births. Deaths under One Year of Age. Deaths at all Ages. Total. Deaths in Public Institutions. Deaths of Non-residents registered in the District. Deaths of Residents registered beyond District. Deaths at aix Ages. Nktt. Number. Rate.* Number. Rate per 1,000 Births registered. Number. Rate.* Number. Rale.* I 2 3 4 5 6 7 8 9 10 11 12 13 1893 26,164 945 30.74 123 133.2 613 23 .4 261 100 16 529 20.2 1894 28,419 906 30.152 121 132.24 584 20.54 235 91 22 515 18.12 1895 30,080 1024 32.237 116 122.65 608 20.2 243 196 17 424 13.95 1896 31.888 1020 30.57 169 153.68 691 21.6 253 208 17 500 15.6 1897 33,804 1139 32.5 163 157.18 704 20.8 291 201 39 542 15.95 1898 35,836 1148 31.03 217 195.84 783 21.8 272 221 44 606 l6.8l 1899 39,523 1146 34.9 242 161.87 831 21.0 207 175 32 688 17.4 1900 47,166 1606 34.0 301 168.1 983 20.8 307 268 42 757 16.0 1901 44.911 1640 365 271 139.0 787 15.2 233 183 70 674 15.0 1902 50,388 1747 34.67 251 143.67 1006 19.9 270 161 56 90I 17.88 Averages for years 1893-1902 36,818 1232 33.46 197.4 160.22 759 20.61 257 180 35.5 6I3.6 16.69 1903 52,139 1846 35. 4 259 140.3 844 5.6 248 194 74 724 13.7 Area of District in acres (exclusive of area covered by water) 3,890. Total population at all ages, excluding Union Workhousea—44,911 Number of inhabited houses—7,807 Average number of persons per house—5.75 1 At Census 1 1901. I.—Institutions within the District receiving sick and infirm persons from outside the District. II.—Institutions outside the District receiving sick and infirm persons from the District. III - Other Institutions, the deaths in which have been distributed among the several localities in the District. Edmonton Union Workhouse. Strand Union Workhouse Strand Union Schools. Enfield Fever Hospital. South Mimms Small Pox Hospital. Tottenham Hospital. Great Northern Hospital Great Ormond Street Children's Hospital. * Rates in columns 4, 8 and 13 calculated per 1,000 of estimated populatation. Note.—The deaths to be included in column 7 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths to be included in column 12 are the number in column 7, corrected by the subtraction of the number in column 10 and the addition of the number in column 11. By the term "Non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there ; and by the term "Residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The "Public institutions" to be taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses and lunatic asylums. (Table III.) CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1903. EDMONTON URBAN DISTRICT. Notifiable Diseases. 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. Angel Road Ward. Bury Street Ward. Church Street Ward. Fore Street Ward. Silver Street Ward. Total. Angel Road Ward. Bury Street Ward. Church Street Ward. Fore Street Ward. Silver Street Ward. Under 1 1 to 5 5 to 15 15 to 25 25 to 65. 65 and upwards. Small-pox 1 - - - - 1 - - - 1 - - 1 - - 1 - - Cholera - - - - - - - - - - - - - - - - - - Diphtheria 18 - 3 12 2 1 - 4 7 6 - 1 5 2 2 1 - - Memb. Croup 1 — 1 — — — - - 1 — - - - - — - - - Erysipelas 63 3 4 6 8 38 4 6 11 17 11 18 1 - — 1 - - Scarlet fever 119 1 35 68 13 2 - 21 19 38 15 26 57 5 7 21 8 16 Typhus fever - - - - - - - - - - - - — — — — — - Enteric fever 28 1 3 10 9 5 - 2 5 10 6 5 15 1 4 4 3 3 Relapsing fever — - - — - - - - - - — - - - - - - - Continued fever 3 - — 2 1 — — — 2 1 — — — — — — — — Puerperal fever 3 - — — 1 2 — 1 1 — 1 — — — — — — — Plague - - — — — — — — — — — — — — — — — — Chicken Pox 141 17 65 57 2 — — 24 37 36 16 28 - - - - - - Totals 377 22 111 145 36 49 4 58 83 109 49 78 79 8 13 28 11 19 Isolation Hospital—Enfield Isolation Hospital, situated in Enfield Urban District. TABLE IV. EDMONTON URBAN DISTRICT. Causes of, and Ages at, Death during Year 1903. Causes of Death. Deaths in whole District at subjoined Ages. Deaths in or belonging to Localities (at all Ages). Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Edmonton Union. Strand Union. Hospitals, etc. Residents of Edmonton. Nonresi dents. Small-pox — — — - - - - - - — — — Measles 10 2 7 1 — — — - 2 — — 2 Scarlet fever 2 — 1 1 - - - - - - - - Whooping-cough 19 14 5 — — — — - - — — — Diphtheria and membranous croup — - - - - - - - - - 1 - Croup — — — — — — — - - — — - Fever Typhus — — — - - - - - - - - - Enteric 2 1 — — 1 - - - — — 4 - Other continued — — — — - — — - - — - — Epidemic influenza 2 — — — — 1 1 - - - - - Cholera — — ... — - - - - - — — - Plague - - - - - - - - - - - - Diarrhœa 6l 52 8 - - - - - - - 1 - Enteritis 8 7 - 1 - - - - - — - — Puerperal Fever — — — — — — — - — — 1 — Erysipelas 2 2 — - - - - - - - - — Other septic diseases 20 7 3 1 1 5 2 - — 2 8 2 Phthisis 45 3 2 1 2 34 2 13 25 2 — 40 Other tubercular diseases 47 23 16 5 2 2 — 3 6 — 6 9 Cancer, malignant disease 25 — — - - 16 9 8 16 — 7 24 Bronchitis 41 23 5 — 1 6 8 1 6 6 2 13 Pneumonia 55 21 19 1 — 9 3 2 5 1 4 8 Pleurisy - - - - - - - - - - - - Other diseases of Respiratory organs 1 1 - - - - - - 1 1 - 2 Alcoholism Cirrhosis of liver 12 — — — - 7 5 — 3 5 — 8 Venereal diseases 1 1 - - - - - - - - 1 - Premature birth 37 37 — — - - - - — — 2 — Diseases and accidents of parturition 7 3 - - 1 3 - - 1 - - 1 Heart diseases 38 1 — 2 4 20 11 3 19 7 7 29 Accidents 13 3 1 2 - 6 1 - - - 4 - Suicides 2 — — — — 1 1 — — — 1 — Murder — — — — - - - - 1 — — 1 All other causes 146 58 15 4 4 31 34 24 62 23 25 109 All causes 596 259 82 19 16 142 1 78 54 147 47 74 248 37 Edmonton Urban District Council. SANITARY DEPARTMENT, TOWN HALL, EDMONTON. REPORT. To the Chairman and, Members of the Edmonton Urban District Council. Mr. Chairman and Gentlemen— I have the honour to present to you my Report upon the work of the Sanitary Department for the year 1903. It is a relief to know the year has been practically free from a return of that dire disease Small Pox. One or two useful enactments have been placed upon the Statute Book, by the past Session of Parliament, which are directly connected with the work of the Sanitary Department, viz., the amendment in several respects of the law relating to the Housing of the Working Classes, and the Employment of Children. 38 We have not yet, however, been given the new Public Health Act, which is much to be desired. The variety of the work, as shown in the accompanying details, has increased considerably. The addition of a Female Assistant to the Staff of the Department will, I trust, meet with the desired result. No doubt there is wide scope for the energies of such an officer. In advising parents in the slight ailments of their infants, and the necessity for strict attention to cleanliness alone the appointment will, I feel, be amply justified. The visiting of premises where females are employed is also to be commended. DISINFECTION. The steam disinfecting apparatus continues to work well. It has been overhauled by the Insurance Company and passed as satisfactory. The saving of time and the thorough disinfection of clothing, &c., has to a great extent repaid the cost. The number of articles passed through the apparatus was 3920. The number of articles destroyed by order of the owners, and the Medical Officer of Health was 12. The number of rooms disinfected was 217. 39 The number of rooms cleansed by stripping the paper from off the walls, and washing the walls, ceiling, paint-work, &c., was 101. DISINFECTANTS. The public still continues to avail themselves of the opportunities afforded them by the Council in procuring disinfectants (fluid and powder) and the increase in the number of applications has been very great, especially when the general good health of the district during the year is considered. The disinfectants are given out from the Sanitary Department Store between 9 and 10 a.m. and from 4 to 5 p.m. each day. On Saturday from 9 to 10 a.m. only, and precautions are taken, as far as possible to see that children under the age of ten years are not supplied. The name and address of each applicant is carefully entered in a book kept for the purpose, and the entries shew that 25,586 applicants were supplied during the year. TEMPORARY BUILDING, CLAVRING'S FARM. The wooden building, constructed to act as the administrative block of the late Temporary Small Pox Hospital, is still used for storing the bedsteads, bedding, and numerous other articles which may be of value in the future. 4 Throughout the year the rooms have been cleansed fortnightly, and the bedding, &c., thoroughly overhauled from time to time by the Caretaker, and kept in readiness in case of emergency. I am pleased that the building has not yet been required to be used for its original or any similar pnrpose, and sincerely hope the agreement entered into with South Mimms Hospital authorities will fully meet the requirements of the District. With an ever increasing population the Council must be prepared for difficulties, and in emergency, even this building might be utilised for one or two patients, and might prove a boon when it is necessary to isolate a case occurring say, in the middle of the night, although it must be remembered that the building was not constructed to serve for the purpose of hospital wards. The Caretaker of the building is also in charge of the Steam Disinfector, and all clothing, &c., from infected houses is taken to him for disinfection. There still remains in store in the Barn at Clavering's Farm the flooring boards, poles, &c., of the tents, together with the heavy goods, such as tables, cupboards, heating stoves, and washing machinery, &c. Several useful articles formerly used at the Hospital are now used on various parts of the Council's property (by permission of the Council). These are 41 much better for being so used, especially so in the case of iron goods, as these deteriorate far sooner when lying idle. PATIENTS REMOVED TO HOSPITAL, WINCHMORE HILL. The number of patients removed to Hospital in the Council's ambulance during the last year was as follows:— Scarlet Fever 57 Enteric Fever 15 Diphtheria 5 77 The number of beds at the Council's disposal is as follows :— Scarlet Fever 12 Enteric Fever 3 Diphtheria 4 For which the Council pay the sum £1153 11s. 4d. per annum. Our thanks are due to the Superintendent and the Matron of the Hospital for their uniform consideration, and ready acquiescence in taking patients beyond our prescribed number, when occasion arose. To hear praise from the parents and children, of the care and 42 attention they received at the hands of the Medical Superintendent, and the Matron, was qnite refreshing. Besides the above, the following cases were removed:— 1 Small Pox—to South Mims. 1 Erysipelas—to London Hospital, 1Pneumonia—to Tottenham Hospital. 1General Complications—from King's College Hospital, to Marsden Road, Edmonton. MORTUARY. On the 15th October, 1903, the new Mortuary was opened. Rules for the observance of persons using it have been adopted. This is a decided improvement, and marks a step in the right direction. Under the best conditions persons visiting such places do not do so with a light heart, but the appearance of the premises generally, and the sanitary measures adopted, viz., viewing the bodies through a glass screen, &c., is greatly appreciated, and reduces the disagreeable and morbid feeling that would otherwise exist, to a minimum. Inquests are now held at the Town Hall, under better conditions than hitherto. Number of Inquests held 14 Do. Post Mortems 14 43 and Verdicts were delivered as follows:— 1. Bronchial Pneumonia. 2. Still-born. 3. Heart Failure caused by accidental fractured ribs. 4. Suffocation while in bed with mother. 5. Rupture of Heart, Embolism. 6. Asphyxia. 7. General Tuberculosis. 8. Glumatious Tumour of the Brain, Acute Coma. 9. Convulsions. 10. Premature Birth, Collapse of Lungs. 11. Aneurism of Aorta. 12. Capillary Bronchitis, Convulsions, Heart Failure 13. Syncope. 14. Still-born. URINALS. The whole of the Public Houses in the District are provided with these conveniences and are regularly inspected. Generally, speaking the owners do their best to keep them in a cleanly condition, but as the majority are accessible to the public, they require constant attention. The Council have four Public Urinals in the district. 44 (1) The Park (of modern construction). This is in much request, especially during the summer time; but unfortunately there are persons who wantonly and maliciously damage it in spite of the Council's notices. I hope the time is not far distant when the offenders will be brought to Justice. (2) Grove Street—this is of a very obsolete type; but even if the Council chose to improve this, I am afraid the owners of the land adjoining would protest, as I believe :hey would be pleased to see it removed altogether. However, to remove this, would, I am afraid, only make matters worse. (3) Angel Road (six stalls). (4) Lower Edmonton Railway Station (six stalls). These urinals are regularly inspected, and cleansed twice a day during the week and once on Sundays. I cannot refrain from repeating my sentiments of last year, viz., that I hope the time is not far distant when public conveniences will be in evidence on the Green and at Angel Road for both sexes, especially does this apply to the Green. The enormous numbers of people who pass to and fro at these points require some such accommodation. 45 SEWERS AND DRAINS. The flushing of sewers and drains is still continued during the summer and a portion of the winter months; disinfectants being freely used. This operation greatly benefits the health of the district by preventing fœcal matter lying in the sewers and drains to undergo decomposition, thereby minimising the danger from sewer gases that would otherwise obtain. Speaking generally, the Council's sewers are well ventilated, and very few complaints of sewer emanation have been received during the past year. One great difficulty yet to be overcome and which still continues to cause much strife is the definition given in the Public Health Acts, of the words "Sewer and Drains." There are many conflicting decisions. I should heartily welcome the time when this much discussed and vital question has disappeared, for it certainly has a deterrent effect in the carrying out of much needed improvements. Legally, the Council may be liable, but morally they cannot be. To make an authority responsible for drains on private lands over which they have practically no control, seems somewhat of an anomaly. During the year construction of the new deep Sewer and Pumping Station at Angel Road has been in progress, but your Engineer has met with considerable trouble owing to the heavy rainfall. 46 I hope shortly to see the system in working order so that the drains of the Factories, Cottages, and other property in the vicinity can be connected. This will do away with a great nuisance which has frequently arisen. The number of drains repaired during the year was 364. The number re-constructed was 59. SLAUGHTERHOUSE. There are seven Slaughterhouses in the District, four of which are licensed from year to year under the Public Health Amendment Act, 1890. The four that are Licensed from year to year are of modern construction and well within the control of the Council. With regard to the three Registered, one is well situated and of fair conslruction. One is a fair Slaughterhouse, but the entrance to it is very bad. One is very old and situated in a bad position, being close to dwelling-houses. I am hoping that within a few hours the lastmentioned will be demolished and a better class property substituted. The Slaughterhouses generally are well kept and the periodical limewashing carried out, as required by the Bye-laws. 47 DAIRIES, COWSHEDS & MILKSHOPS ORDERS. There are six cowsheds in the district. One of these has not been used during the year, the cows being kept in another district. The periodical limewashing and cleansing has been carried out. The cows in this district are not always confined to the sheds, but are turned out to graze during the greater portion of the year. Continual attention aud much persuasion is required to convince some of the cowkeepers of the necessity of well-grooming and keeping the cows quite clean, especially the Teats and Udders. The number of Milk Sellers on the Register is 48. Several have had to discontinue the sale of milk owing to the conditions under which it was stored not being conducive to cleanliness, &c. They were informed that unless the conditions were improved, they would be dealt with under the Bye-Laws, as a result they gave up selling milk. HOUSE REFUSE AND DUSTBINS. The collection of House Refuse is done by contract. The dustmen have complained that in several instances they cannot get admission to premises, and 48 that occupiers refuse admission. On investigation it is found that many of the occupiers are out at the time of call. It has also been found that most of the refusals have been made on wet days. However, on the whole, few complaints have been received. Each case has been investigated, and the matter attended to. The approximate weight of the dust, &c., deposited at the shoots was 7,500 tons. The number of new dustbins supplied during the year was 276. SMOKE NUISANCES. The nuisances that arises from Smoke in this District are few. Five cases have occurred, of which four were remedied on the attention of the offenders being called to the matter. Only in one instance was it necessary to serve notice to abate the nuisance. These nuisances arise generally from irregular stoking. In several instances I have pointed out the cause, and the nuisance has been greatly diminished. There have been a number of appliances invented from time to time for the prevention of Smoke, but the desired result has not yet been attained. We must have Air, to cause combustion of the gases generated and to produce heat. 49 Most of the Smoke made can be prevented, and if the owners would pay attention to the following details I feel certain there would be little cause for complaint; taking, of course, in consideration the particular circumstances of each case. (1) See that the chimneys are carried to a sufficient height; (2) The top of the chimney must be seen from the firing-hole; (3) Firing lightly; (4) Firing oftener; (5) Admitting the necessary air to the furnaces ; (6) Shutting it off when necessary. HOUSE TO HOUSE—GENERAL AND RE-INSPECTIONS. The number of houses inspected House to House, was 1440 The number inspected generally 3390 The number of Re-Inspections 9397 Total number of Inspections and Re-Inspections 12787 Experience teaches us which streets require most attention. In some streets the House to House work proceeds rapidly, as little is required to be done; while in others it is almost one continual inspection and reinspection. 50 HOUSING OF THE WORKING CLASSES ACT. During the year, Nos. 12, 13 and 14, Eaton Place, were demolished owing to the action taken by the Council. The demolition of these houses has greatly improved the airspace at the rear of several houses in Gilpin Grove, and in this particular instance the yards or open spaces were very restricted. ' Other houses in Eaton Place are getting into a dilapidated condition, and unless the Owners take steps to put them into decent repair, I feel certain that very shortly similar steps will have to be taken to deal with them under this Act. Notices were served on the Owner of Nos. 188 and 190, Hertford Road, which has resulted in the closing of the property. I understand that when the lease runs out, these cottages will be pulled down to make room for better property. Notices were also served to remedy defects at Nos. 1, 2 and 3, Whiteheads Yard, and 61 and 63, Hertford Road. The owner informed me that the requirements were so formidable that he had resolved to put the property up for sale, making it a condition that the notices should be complied with, or the property pulled down. The present owner of the property has expressed his intention to demolish the houses shortly. 51 OVERCROWDING. During the year eighteen cases of overcrowding were found to exist. The problem to solve is can a house of sufficient capacity be provided for a man, his wife, and say a family of five or six children, at a cost not to exceed 5s. per week ? Because a labouring man cannot do justice to himself, wife and family out of his wages, if the rent exceeds this amount. Still I find many who cause overcrowding are old offenders, and who are continually on the move. The deserving poor who maintain cleanliness, should, I think be afforded consideration, but the persons who continually overcrowd, and are of filthy habits should be dealt with. Overcrowding would not be so serious a matter if the persons overcrowding were to observe strict cleanliness, and pay a little attention to ventilation by opening windows, to enable fresh air to thoroughly flush the rooms. This in many instances seems to be entirely forgotten. The power of entry into private houses is more restricted than in the case of Common Lodging Houses, houses let in lodgings, workshops, &c. PAYING OF YARD, &c. During the winter months the work of laying concrete paving is practically at a standstill, owing to 52 the deteriorating effect of the weather on such work. However, during the summer months this work was in good progress. Number of Forecourts paved - 203 Number of Yards paved - - 498 FISH OFFAL COLLECTION. I am pleased to say the method adopted by the Council for the collection of Fish Offal still continues to meet with approval, and from a Hygienic point of view, and my own experience of the collection in many other districts, the Council's system is to be recommended. All fishmongers or dealers in fish are, on application, supplied with strong galvanised pails, with airtight covers, so that the offal can be kept upon the premises free from smell, even in the hottest weather. The collection is made by the Council's men, in a specially designed van, three or four times a week, according to circumstances. The pails, when full, are removed between the hours of 6 and 9 a.m., and clean pails left in their place. The offal is taken to the Council's farm and deposited in holes dug for the purpose, and covered down with earth and disinfectant, the pails being thoroughly cleansed and disinfected and made ready for re-distribution. The charge made for the collection of each pail was 3d., but the Council increased this to 4d. some few months ago. 53 Although the cost is not wholly covered by the amount charged (viz., 4d. per pail), I feel that the results obtained warrant the expenditure. Under the best conditions, nuisance from this trade is bound to exist at times, but the Council's system reduces this to a minimum. During the year there have been collected 3098 pails of Fish Offal, for which the Council has received £39 3s. 6d. The amount collected, however, was £42 6s. 7d., which sum includes the arrears incurred during the Small Pox epidemic 1902. WATER SUPPLY. Samples of Pump Water were taken from time to time, and submitted for analysis. There are very few pumps remaining in the district. Where these exist, the water supply to the w.c.'s is intercepted by flushing cisterns. At a number of cottages, the drinking water is supplied directly from the main. This does away with the liability to contamination by dirty cisterns. Many of the cisterns are fixed in such a position as not to be easily accessible. In houses where hot and cold water is used, cisterns are of course a necessity. I should much like to see a standard cistern (with syphonic action), adopted for flushing all w.c.'s. At 54 present many of the cisterns used are anything but satisfactory, and continually out of order. Number of drinking water cisterns repaired and supplied with covers 254 Number of defective cisterns removed, and water laid on directly from the main 9 UNSOUND FOOD. During the year the following unsound foods were seized and condemned:— 2 Boxes of Fish. 1 Trunk of Codlings. 1 Box of Apples. 1 Box of Bloaters. Several small lots of Bananas. SALE OF FOOD AND DRUGS ACT. This work is carried out by the Middlesex County Council, and from my own knowledge this district is well looked after. However, your Council have authorised me to take samples where deemed expedient. DITCHES AND WATERCOURSES. Systematic inspections are made of these as they are still made the dumping ground for all kinds of filth, garbage, dead animals, &c. 55 The number of animals, deposits, &c., removed and buried during the year was 436. GIPSIES. During the year 477 were seen and 420 removed. Summones were taken out against 20 of them; but owing to their getting knowledge that summonses were to be served, many cleared out. Eight convictions were obtained during the year. Ten summonses taken out at one time were dismissed on technical grounds. The particulars are as follows:— I was instructed to take proceedings against ten gipsies. I received my instructions from the Sanitary Committee on Wednesday evening; on the following morning, Thursday, the summonses were applied for at the Court and granted, and the cases were down for hearing on the following Thursday. The Council met on the Tuesday previous to the hearing of the summonses and confirmed the Committee's action. The Bench dismissed the cases on the ground that the summonses were taken out previous to the Council confirming the Committee's action. According to this jurisdiction, I shall, in future, have to wait until the Council has confirmed the Committee's action, before applying for summonses. 56 Most of the old offenders have cleared off and fresh contingents now arrive. There are now eleven warrants out, some remaining from the previous year, and nine committals waiting for them upon their return. Offenders were caught in two cases and had to pay the following penalties:— Encamping on Granville Avenue, £5 and costs. Do. Cumberland Road, £3 and costs. One party of offenders on being arrested, and who had changed their name, declared they had not been in the district before; but upon my taking off the name plate from the van, the proper name was found on the back of it. These people still cause an enormous amount of work and worry, and seem to be monarchs of all they survey. The conditions under which they live are demoralising. Their offspring being brought up without education, renders them as a class a source of contamination to all with whom they mingle throughout the District. Filthiness and bad overcrowding are two of their distinguishing characteristics. In a few isolated cases they are clean, but their healthiness must be attributed to Nature's disinfectant, fresh air; without which the danger to the Public Health from them would be intolerable. Why these people are allowed to roam the country and be a constant source of annoyance to respectable citizens, wholly passes my comprehension. 57 CANAL BOATS. During the year 78 Canal Boats were inspected and 12 contraventions of the Canal Boats Acts and regulations were found as follows:— No certificate aboard 3 Number on boat not in accordance with Certificate 2 Bilge water not removed 1 Cabins dirty 3 Cabin tops defective 2 No double bulkhead 1 Of the above contraventions, 9 have been remedied, the others are receiving my attention. CLERICAL WORK. This work is continually on the increase. Number of Letters written 1739 Do. filed for reference 831 Number of Notices sent to Schools 539 Do. Public Library 52 Do. Technical School 41 Preliminary Notices served 3185 Final Notices 406 FACTORY AND WORKSHOP ACT. It is the duty of Medical Officer of Health, in his Annual Report, to report on the work done under this Act, and to send a copy to the Secretary of State. 58 I have therefore given the details of the work done during the year to your Medical of Health. NEW OFFICES, STORES, &c. During the year, the Council have given me increased office accommodation, and good Sanitary Stores, also a Store for Condemned Food. The Offices have also been furnished. I need hardly say this extra accommodation is much appreciated. The General Office, however, is somewhat small, being barely large enough for the present requirements. Should it be necessary to increase the staff, which in all probability it will be, increased office accommodation will be necessary. The Female Assistant Inspector is using a Temporary Office, when the question of her Permanent Office accommodation is taken into consideration, special attention will have to be paid to Lavatory accommodation. In bringing this Report to a conclusion, I desire to express my sincere thanks for the support I have received on all occasions from my Committee and the Council. I am pleased to say my Assistants continue to perform their duties with tact and efficiency. 59 My thanks are also due to your Medical Officer of Health, your Engineer, your Clerk, and the Officers generally who have so kindly rendered me assistance when necessary. I have the honour to be, Gentlemen, Your obedient Servant, RICHARD JOHN BUTLAND, Mem. San. Inst. (C I.) DISTRICT OF EDMONTON.—COUNTY OF MIDDLESEX.—SANITARY WORK, 1903. Sanitary District. Inspections. Notices. Dwelling Houses Houses let in separate Dwellings or Lodgings. Common Lodging Houses. Canal Boats used as Dwellings. Movable Dwellings, Caravans, Tents, &c. Complaints Received. Cases of Infectious Disease Notified. Number of Premises periodically Inspected. Houses Inspected from House-to-House. Total Number of Houses. Premises, &c., Inspected. Total Number of Re-inspections after Order or Notice. Total Number of Inspections and Re-inspections. Letters written. Cautionary Notices Given. Statutory Orders Issued. Summonses Served. Convictions Obtained. Houses, Premises,&c., Cleansed, Repaired,&c Closed as Unfit tor Habitation. Ke-opened after Repairs, Alterations, &c. Demolished. Illegal Underground Dwellings Vacated. Number Registered under Bye-laws. Periodical Frequency or Number of Inspections. Number of Contraventions. Number Registered under Bye-laws. Periodical Frequency or Number of Inspections. Number of Contraventions. Number Registered under the Acts. Periodical Frequency or Number of Inspections. Number of Contraventions of Regulations. Number Observed during the Year. Number of Nuisances therefrom Abated. Number Removed from District. EDMONTON. 85 376 203 1440 3390 9397 12787 1739 3185 406 18 8 1728 - - 3 - - - - 1 164 - Not a Registration Authority. 78 12 477 [Nuisances exist whenever these people congregate in numbers. 420 (C II.) DISTRICT OF EDMONTON.—COUNTY OF MIDDLESEX.—SANITARY WORK, 1903. Sanitary District. Schools. Workshops and Workplaces. Laundries. Bakehouses. Slaughter houses. Cowsheds. Dairies and Milkshops. Unsound Food. Adulterated Food. Offensive trades. Mortuaries. Number in District. Periodical Frequency or Number of Inspections. Number found defective. Number in District. Periodical Frequency or Number of Inspections. Contraventions of Factory Acts. Number in District. Periodical Frequency or Number of Inspections. Contraventions of Factory Acts. Number in District. Periodical Frequency or Number of Inspections. Contraventions of Factory Acts. Number on Register. Periodical Frequency or Number of Inspections. Contravention of Bye-laws. Number on Register. Periodical Frequency or Number of Inspections. Contravention of Bye-laws. Number on Register. Periodical Frequency or Number of Inspections. Contravention of Bye-laws. Animals seized. Articles or parcels seized. Samples taken, Found adulterated. Number of premises in District. Periodical Frequency or Number of Inspections. Contraventions of Bye-laws. Accommodation. Number of bodies received. EDMONTON 17 45 Attention called to cleanliness in Lavatories, &c. 68 189 3 21 61 2 31 119 5 7 150 1 6 71 1 48 233 nil. - 2 boxes fish, 1 trunk codlings, 1 box apples, 1 box bloaters, quantity of bananas. - - - - - 1 newly-erected and recently opened. 14 (C III.) DISTRICT OF EDMONTON.—COUNTY OF MIDDLESEX.—SANITARY WORK, 1903. Sanitary District. Water Supply and Water Service. Privy and Ash Pits, Ash and Earth Closets. Drainage and Sewerage. Wells. Houses, Water Laid on to. Percentage of Houses Supplied from Mains. Cisterns. Flush Cisterns Provided to W.C.'s. Draw-Taps Removed from Cisterns to Mains. Percentage of Houses Supplied on Constant System. Water Closets. Percentage of Houses Provided with Water Closets. Drains. Cesspools. Percentage of Houses Draining into Sewer. Sewers. New Sunk. Cleansed, Repaired, Etc. Closed as Polluted. | New, Provided. Cleansed, Repaired, Covered, Etc. Overflow Pipes Disconnected from Drains. Above Ground Receptacles substituted for Pits. Movable Receptacles substituted for fixed. Water Closets substituted for Dry Receptacles. New Constructed. New Apparatus Provided. Repaired, Cleansed, Etc. Supplied with Water, or Supply Rendered Efficient. Ventilated. Examined, Tested, Exposed, Etc. Unstopped, Repaired, Trapped, Etc. Waste Pipes, Rain Water Pipes, Etc., Disconnected. Soil Pipes and Drains Ventilated. Disconnecting Traps or Chambers Inserted. Reconstructed. New Laid. Rendered Impervious, Emptied, Cleansed, Etc. Abolished, and Drains Connected to Sewers. Yards of New Sewers Laid. Yards of Sewers Reconstructed. EDMONTON. - - 4 4 99 per cent. - 254 - 43 9 98.7 - - - 3 86 91 90 - 99.9 527 364 - 49 115 59 15,058 yards run. 4 cesspools emptied weekly. - 99.5 6,150 yards run. 226 yards run. C (IV.) DISTRICT OF EDMONTON.—COUNTY OF MIDDLESEX.—SANITARY WORK, 1903. Sanitary District. Disinfection. Dust. Dampness. Sundry Nuisances Abated. Contagious Diseases of Animals. Infant Life Protection Act. Rooms fumigated. Rooms stripped and cleansed. Articles disinfected or destroyed. Dust-bins repaired. New bins provided. Movable receptacles substituted for fixed. Periodical frequency of dust removal. Number of complaints of non-removal received. Roofs, repaired, &c. Guttering and rain pipes repaired, &c. Gardens, Areas, &c., levelled and drained. Yards paved and drained. Surface adjoining houses paved. Dry areas provided. Ventilation below floor provided. Basements rendered impervious. Overcrowding. Smoke. Accumulations of refuse. Foul ditches, ponds, &c., and stagnant water. Foul pigs and other animals. Other nuisances. Outbreaks. Animals infected. Animals destroyed. Number of licensed premises. Number of children. Number of deaths. EDMONTON. 217 101 3932 - 276 - Weekly 122 199 207 - 701 - - - 18 5 18 2 22 436 animal carcases & fish offal deposits, removed from waste lands, ditches, &c. - - - - - -