FINC 5 The Urban Sanitary District OF FINCHLEY. REPORT OF THE Medical Officer of Health FOR THE YEAR 1905, BY GERARD C. TAYLOR, M.A., M.D., B.C. (Cantab.), D.P.H., MEDICAL OFFICER OF HEALTH, TOGETHER WITH THE REPORT OF THE SANITARY INSPECTOR. Finchley: J. H. Warden & Co., "Finchley and Hendon Times" Office, II, Regents Parade, North Finchley. TABLE OF CONTENTS. Vital Statistics— page. Population of the District and each of the Sub- Districts 7 Number of People to the Acre 8 Births and Birth-rate 8—9 Mortality, Death-rates and Causes of Mortality 9 — 25 Infantile Mortality 14 -19 Infectious Diseases and Measures taken to prevent their Spread 26—35 Isolation Hospitals 27 Bacteriological Diagnosis 27 Scarlet Fever 33 Diphtheria 33 Typhoid or Enteric 34 Measles and Whooping Cough 34 Consumption (Phthisis) 34—35 Middlesex Open-Air Sanatorium 36 School Hygiene 37—41 Water Supply 42 Housing 42 Drainage and Sewage Disposal 43—44 Disposal of House Refuse 45 Sanitary Work Performed During the Year 45—48 Analyses 45 The Factory and Workshops Act, 1901 47 Underground Bakehouses 48 The Revenue Act of 1903 49 Adoptive Acts, Byelaws, and Regulations 48 Report of the Sanitary Inspector 51 — 65 Summary of Work done 53—57 House Drainage 57—59 Inspection of Workshops 59—60 Slaughterhouses and Pood Inspection 61—63 Dairies, Cowsheds and Milk shops 63—64 Paving of Yards 64—65 Game Licences 65 Petroleum Licences 65 TO THE CHAIRMAN AND MEMBERS OF THE FINCHLEY DISTRICT COUNCIL, Gentlemen, In presenting this report I wish to acknowledge my indebtedness to the Chairman and Members of both the Public Health and Education Committees, and to the Medical Practitioners in the District, for the assistance and support they have given me in carrying out my duties. The active co-operation of the Education Committee has proved a great help in eliciting early information of the existence of non-notifiable infectious disease, and has enabled me to obtain the aid of the Teaching Staff in dealing with matters affecting the health of the children. The mortality rates for the District during the past year are amongst the lowest, recorded in Finchley, and well below the average of the preceding ten years. The most noticeable feature in the statistics is the comparatively small number of cases of infectious disease notified. 6 The usual systematic inspection of the District has been carried out by your Sanitary Inspectors and myself, and it is with much pleasure I record the able manner in which your Sanitary Inspector, Mr. Franklin, and your late Assistant Inspector, Mr. Topping, discharged their duties. Some of the points dealt with in the following report arc already well known to the Council, and reference to them may seem superfluous, but in order to give a clear statement of existing conditions, a certain amount of repetition is inevitable. I am, Gentlemen, Your obedient servant, GERARD C. TAYLOR. 8th March, 1906. 7 Vital Statistics—Population and Acreage. In the case of a. rapidly-growing district it is no easy matter to arrive at an accurate estimate of population in the years remote from a census. The population of Finchley at the census of 1891 was 16,647, and at the census of 1901, 22,126. Had the same rate of increase persisted to the middle of last year, the population would then have amounted to 24,970. But the rate of increase has undoubtedly been far more rapid of late than during the first eight years that elapsed between the last two census enumerations, and I believe, under the circumstances, an estimate based on the number of houses in occupation at the middle of 1905 gives a nearer approximation to the true figure. In calculating the population by this latter method, I have allowed the same average number of persons to each occupied house as that found at the time of the last census. It is usual to allow in addition one person for each unoccupied house, so as to account for caretakers and their families, but owing to the very considerable number of small flats and houses that have been erected during the past few years, it is probable that the average number of persons per house is now somewhat below that which held in 1901, and I have therefore intentionally omitted any allowance for unoccupied dwelling's. The approximate population and the number of occupied houses in each of the sub-districts at the end of June, 1905, was as follows:— Occupied Houses. Estimated Population. East Finchley 1,973 11,049 North Finchley 1,212 6,787 West Finchley 1,553 8,696 Whetstone 390 2,184 Total 5,128 28,716 8 The Natural Increase of the Population by excess of births over deaths during the year was 743–285=458, compared with 296 in 1904, and 412 in 1903. Number of People to the Acre.— The area of the District is 3,381 acres, and the average number of persons to each acre is 8.5. The estimate for each sub-district is as follows:- East Finchley (1,219 acres), 9.1 people to the acre. North Finchley (788 „ ), 8.6 ,, West Finchley (1,002 „ ), 8.7 „ „ Whetstone (373 „ ), 5.8 „ „ The average density of population per house at the last census was 5.6 for the whole district. Birth-Rate. During the year 1905 there were 743 births registered in the district, i.e., 391 males and 352 females. The birth-rate par 1,000 of population was therefore 25.9, the average for the preceding ten years was 24.6. The rate for England and Wales in 1905 was 27.2, and that for the 76 Great Towns 28.2. The rapidly declining birth-rate of the country is a matter that cannot well be passed over without comment. For the ten years, 1841-50, the birth-rate of England and Wales averaged 32.6; for 1861-70, 35.2; and for 1871-80, 35.5, having reached its maximum (36.3) in 1876; for 1881-90 the rate was 32 3 and for 1891-1900, 29.9. In 1905 it was only 27.2 per 1,000 of the population, which is lower than the rate in any other year on record. 9 The fall in birth-rate has not been limited to this Country; it has occurred to a. greater or less degree in all parts of Europe, and similar accounts have been received with respect to Australia and the United States of America. So far as this Country is concerned, it appears be those town populations in which the great majority of the members possess individually least wealth, and are therefore least able to make adequate provision for their children, that as a general rule have the highest birth-rates. Looked at from another point of view, it is from amongst the weekly wage earners that the population of the Country is being recruited in an ewer increasing proportion, and, if the Nation is to hold its own, no efforts must be spared to educate their children into mentally and physically fit citizens. Death -Rate General Mortality.- The deaths of 285 Finchley residents occurred during the year, which number included 143 females and 142 males. The Recorded General Death- Rate was therefore 9.9 per 1,000 of population; in 1904 the rate was 13.2, the average for the ten years 1895-1904 being 10.8. The rate of England and Wales in 1905 was 15.2, which is lower than the rate in any other year on record, and that of the 76 Great Towns was 15.7. The Corrected Death- Rate.— The proportionate number of different sexes in any given population and the number of persons at the different age-periods have a marked effect on the mortality. In order to obtain more accurate figures for comparing the death-rates of different districts, allowance should be made for these variations in the composition of the populations concerned. 10 The so-called "factor for correction" in the case of Finchley is about 1.05, the sex and age-distribution obtaining in England and Wales as a whole being taken as a standard. In other words the sex and age-distribution of the population in Finchley slightly favours a low mortality, and the death-rate corrected for age and sex-distribution would be 9.9 × 1.05 = 10.4. Recorded Death- Rate of each Sub-District: Number of Deaths. Rate per 1000 of population. East Finchley 132 11.9 North Finchley 66 9.7 West Finchley 66 7.6 Whetstone 21 9.6 11 Table A. Causes of and Ages at Death during the Year 1905 Causes of Death. 1 Deaths in Whole District at subjoined ages. Deaths in Localities (at all ages). Deaths in Public Institutions. All ages Under 1. 1 and under 5. 5 and under 15 15 and under 25. 25 and under 65. 65 and Upwards. North Finchley. East Finchley. West Finchley. Whetstone. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... Whooping-cough 8 4 4 ... ... ... ... 1 5 2 ... ... Diphtheria and Membranous Croup 2 ... ... 1 1 ... ... ... 1 1 ... ... Croup ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... Enteric 1 ... ... ... 1 ... ... ... 1 ... ... ... Other continued ... ... ... ... ... ... ... ... ... ... ... ... Epidemic Influenza 4 ... 1 ... ... 3 ... 1 3 ... ... 3 Cholera ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 7 7 ... ... ... ... ... 1 3 2 1 2 Enteritis 2 2 ... ... ... ... ... ... 2 ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases 12 2 1 ... 1 6 2 3 7 2 ... ... Phthisis 20 ... ... 1 2 14 3 6 7 5 3 1 Other Tubercular Diseases 10 3 5 ... 1 ... 1 2 6 1 1 2 Cancer. Malignant Diseases 23 ... ... ... ... 14 9 9 6 7 1 2 Bronchitis 17 4 3 ... ... 1 9 3 7 5 2 2 Pneumonia 23 7 5 1 4 6 ... 6 13 2 2 ... Pleurisy ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Respiratory Organs 3 ... ... ... 1 ... 2 ... 3 ... ... ... Alcoholism Cirrhosis of Liver 5 ... ... ... ... 3 2 1 2 1 1 ... Venereal Diseases 2 1 ... ... ... 1 ... ... 2 ... ... ... Premature Birth 19 19 ... ... ... ... ... 5 11 3 ... ... Diseases and Accidents of Parturition 1 ... ... ... ... 1 ... ... 1 ... ... ... Heart Disease 35 1 ... 1 l 17 15 13 13 8 1 ... Accidents 4 3 ... 1 ... ... ... ... 2 1 ... 2 Suicides 2 ... ... ... 1 1 ... ... 2 ... ... ... Senile Decay 16 ... ... ... ... ... 16 4 7 4 1 2 All other causes 69 11 3 3 ... 22 30 11 28 22 8 3 All causes 285 64 22 8 13 89 89 66 132 66 21 19 18 Table A3. Showing the Causes of Infantile Mortality in the District during each of the Four Quarters of the Year 1905. Cause of Death. 1st Quar. 2nd Quar. 3rd Quar. 4th Quar. Totals All Causes Certified 14 13 22 19 68 Uncertified ... ... ... ... ... Common Infectious Diseases Small-pox ... ... ... ... ... Chicken-pox ... ... ... ... ... Measles ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphtheria : Croup ... ... ... ... ... Whooping-cough ... 2 2 ... 4 Diarrhœal Diseases Diarrhœa, all forms ... ... 8 3 11 Enteritis (not Tuberculous) ... ... ... ... ... Gastritis, Gastro-intestinal Catarrh ... ... 1 ... 1 Wasting Diseases Premature Birth 3 7 4 5 19 Congenital Defects 1 ... ... 1 2 Injury at Birth ... ... ... ... ... Want of Breast-milk ... ... ... ... ... Atrophy, Debility, Marasmus 2 ... 1 1 4 Tuberculous Diseases Tuberculous Meningitis 1 ... ... ... 1 Tuberculous Peritonitis : Tabes Mesenterica ... ... 1 1 2 Other Tuberculous Diseases ... ... ... ... ... Erysipelas ... ... ... ... ... Syphilis ... ... 1 ... 1 Rickets ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... 1 1 Convulsions ... ... ... 1 1 Bronchitis 4 ... ... ... 4 Laryngitis ... ... ... ... ... Pneumonia 2 1 1 3 7 Suffocation, overlaying ... ... 1 1 2 Other Causes 1 3 2 2 8 Total 14 13 22 19 68 19 Table A4.—Infantile Mortality During the Year 1905. Deaths from stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2- 3 Weeks. 3-4 Weeks. Total under 1 Month. 1 -2 Months. 2 3 Months. 3-4 Months. 4- 5 Months. 5-6 Months. 6- 7 Months. 7-8 Months. 8- 9 Months 9-10 Months. 10- 11 Months. 11-12 Months. Total Deaths under One Year. All Causes. Certified 19 2 ... 3 24 8 6 5 7 2 3 4 3 2 1 3 68 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Common Infectious Diseases. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheric : Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping cough ... ... ... 1 1 ... 1 ... ... ... ... 1 1 ... ... ... 4 Diarrhœal, Diseases. Diarrhœa, all forms ... ... ... 1 1 ... 2 ... 3 ... 2 2 ... 1 ... ... 11 Enteritis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (not Tuberculous) Gastritis, Gastrointestinal Catarrh ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Wasting Diseases. Premature Birth 13 1 ... 1 15 1 1 2 ... ... ... ... ... ... ... ... 19 Congenital Defects 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 2 Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Want of Breast milk ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atrophy, Debility Marasmus ... ... ... ... ... ... 2 ... 1 1 ... ... ... ... ... ... 4 Tuberculous Diseases. Tuberculous Meningitis ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 Tuberculous Peritonitis ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 2 Tabes Mesenterica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Meningitis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 (not Tuberculous) Convulsions ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 Bronchitis ... ... ... ... ... 2 ... ... ... ... ... ... ... 1 1 4 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia ... 1 ... ... 1 2 ... 1 ... 1 1 1 ... ... ... ... 7 Suffocation, overlaying ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... 2 Other causes 5 ... ... ... 5 2 ... 1 ... ... ... ... ... ... ... ... 8 19 2 ... 3 24 8 6 5 7 2 3 4 3 2 1 3 68 District of Finchley. Population estimated to middle of 1905 : 28,716. Births in the year Legitimate, 729 743. Deaths from all Causes at all Ages, 285. Illegitimate, 14 20 Senile Mortality. Of the 285 deaths registered, 66 were of persons over 70 years of age. The proportion of deaths occurring among those over 70 years of age to the total deaths was therefore 23.1 per cent. 65 and under 70. 70 and under 80. 80 and under 90. 90 and upwards. Total. First Quarter 6 12 8 – 26 Second Quarter 3 9 2 – 14 Third Quarter 5 5 7 – 17 Fourth Quarter 9 16 7 – 32 23 42 24 – 89 Epidemic or Zymotic Mortality. The diseases grouped together in the Registrar General's Reports under the term Principal Epidemic Diseases are Smallpox, Measles, Scarlet Fewer, Whooping-cough, Diphtheria, "Fever" (including Typhus, Enteric or Typhoid Fever, and Simple Continued Fever), and Diarrhoea. The Epidemic Death- Rate for 1905 was 0.63, as against 1.72 in 1904, and 0.54 in 1903. The average rate for the ten years 1895 to 1904 was 1.28. The low rate of 1905 is accounted for by the absence of any severe epidemic of Measles or summer Diarrhœa. 21 DEATHS IN PUBLIC INSTITUTIONS WITHIN THE DISTRICT. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total Home for Homeless Children 3 1 1 1 6 National Hospital Convalescent Home 1 1 1 1 4 Woodside Home, Whetstone 1 1 1 1 4 Home of the Good Shepherd, East Finchley 1 1 – – 2 St. Joseph's Home, Convent of the Good Shepherd, East Finchley – 1 – 2 3 6 5 3 5 19 The Public Mortuary. Nineteen bodies were deposited during the year in the Public Mortuary in Summers Lane, as against twenty-three in the preceding year; eighteen of these had been parishioners of Finchley, and one of Friern Barnet. INQUESTS, 1905. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total Heart disease 3 2 — 1 6 Acute pneumonia 1 — — 1 2 Congestion of lungs 1 — — — 1 Intussusception of bowel – 1 – – 1 Cerebral apoplexy — — 1 — 1 Paraplegia — — — 1 1 Suicide — 2 — — 2 Fractured skull — — 1 — 1 Accidental suffocation in bed (Infants) – – 1 2 3 Want of attention at birth (2 infants found in Street) – 1 – 1 2 Accidental burns — — — 1 1 5 6 3 7 21 24 Table A7. Vital Statistics of Whole District during 1905 and Previous Years. Year. Population estimated to middle of each year Births. Total Deaths Registered in the District. Deaths in Public Institutions in the District. Deaths of Non residents registered in the District. Deaths of Residents registered beyond District. Deaths at all Ages Nett. Under One Year. All Ages. Number. * Rate. Number. * Rate. Number. Rate per 1,000 Births registered. Number. * Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1891 16,419 484 29.5 42 86.8 ... ... ... ... ... 182 11.1 1892 17,002 477 28.0 43 90.1 ... ... ... ... ... 207 12.2 1893 17,500 486 27.7 52 107.0 224 12.4 ... ... ... 231 13.2 1894 18,015 515 28.6 57 110.7 ... ... ... 17 14 221 12.2 1895 18,598 466 25.0 46 98-7 220 11.8 ... 21 11 210 11.3 1896 19,218 496 25.8 46 92.7 197 10.2 ... 9 12 200 10.4 1897 20,064 501 24.4 51 101.8 204 10.1 ... 11 12 205 10.2 1898 20,907 498 23.8 68 136. 5 216 10.4 ... 10 12 218 10.4 1899 21,800 507 23.2 56 110. 4 246 11.3 ... 19 22 249 11.4 1900 22,750 522 23.9 58 111.1 244 10.7 ... 17 17 244 10.7 1901 22,500 540 24.0 53 98.1 211 9.4 ... 12 20 219 9.7 1902 23,400 578 24.7 54 93.4 269 11. 5 ... 27 17 259 11.0 1903 24,125 646 26. 8 59 91. 3 220 9.1 15 29 234 9.7 1904 25,564 634 24. 8 87 137. 2 325 12. 7 14 14 27 338 13.2 Averages for years 1895 1904 21,892 539 24.6 58 107. 6 235 10. 7 ... 155 177 238.6 10.8 1905 28,716 743 25.9 68 91. 5 266 9. 3 19 11 30 285 9.9 Note. -The deaths 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 included in Column 12 are the number in Column 7, corrected by the substruction 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 illness, and dying there; and by the term "residents" is meant persona who have been taken out of the district on account of illness, and have died elsewhere The ''Public Institutions" 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. A list of the Institutions in respect of the deaths in which corrections have been made is appended. *Rates calculated per 1,000 of estimated population. 25 Table A7—Continued. Area of district in acres(exclusive of area covered by water). 3,384 Total population at all ages 22,126 At Census of 1901. Number of Inhabited Houses 3,949 Average number of persons per house 5.6 1 Institutions within the District receiving sick and infirm persons from outside the District. 2. Institutions outside the District receiving sick and infirm persons from the District. Convent of the Good Shepherd. Home of the Good Shepherd. Woodside Home, Whetstone National Hospital, Convalescent Home, Hast Finchley. Home for Homeless Children, Fallow Corner, North Finchley. Small pox Isolation Hospital. Union Infirmary, Barnet. Hornsey Isolation Hospital. Great Northern Hospital, Holloway. Children's Hospital, Great Ormond Street. St Thomas' Hospital. Royal Free Hospital. Homoeopathic Hospital. University College Hospital. Brompton Consumption Hospital. King's College Hospital. Maternity Hospital, Hackney. Middlesex Asylum, Wandsworth. Islington Infirmary, Highgate. Nursing Home, Marylebone. Private House in Holloway. The Union Workhouse is situated in the Barnet Urban District. 26 Infectious Diseases and the Measures Taken to Prevent their Spread. It will be seen from Table B that 140 notification certificates of Infectious Disease were received from medical practitioners, as against 265 in the preceding year, 159 in 1903, and 189 in 1902. The Infectious Sickness Rate of the District was 4.9 to each 1,000 of the population, compared with 10.3 in 1904, 6.6 in 1903, and 8.0 in 1902. The 140 cases represent infection in 84 different houses. The cases removed to the Hornsey Isolation Hospital numbered 75, i.e., 53 per cent of those notified. The actual number of Finchley patients in the Isolation Hospital on various date® during the year is given in the following table:— Scarlet Fever Diphtheria. Enteric. Total January 6th, 1905. 11 1 - 12 January 27th, 20 3 l 24 February 17 th 17 2 — 19 March 10th, 16 1 — 17 March 31st, 16 1 — 17 April 21st, 8 — l 9 May 12th, 9 2 l 12 June 2nd, 10 1 2 13 June 23rd, 8 1 2 11 July 14th, 6 2 3 11 August 26th, 2 1 2 5 September 15th, 4 1 — 5 October 6th, 7 — — 7 October 27th, 5 — — 5 November Nth, 4 — — 4 December 8th, 4 — — 4 December 29th, 4 1 — 5 27 Disinfection of Premises, Etc.— As scon as possible after a patient is removed to Hospital, or, when the patient is nursed at home, directly the medical attendant notifies that the patient is free from infection, the room is fumigated with formic aldehyde vapour, and the bedding, blankets, and wearing apparel which cannot be conveniently washed are passed through an ''Equifex" steam-disinfector. Whenever considered necessary, directions are given to have the wall-paper stripped and the ceiling whitewashed. Notification of School Authorities.— This is done in order to assist the School Authorities in excluding children coming from an infected house. Isolation Hospital.— The agreement with the Hornsey Borough Council with reference to the conjoint use of their Isolation Hospital for Hornsey and Finchley patient® came into operation on April 1st, 1903. By this arrangement. 25 beds are reserved for the use of Finchley residents, and case© of three different infectious diseases (scarlet fever, diphtheria, and enteric) can be isolated. Other Precautionary Measures.— At least one visit is paid to every infected house by either the Medical Officer of Health or Sanitary Inspector, and the opportunity taken to examine the sanitary condition of the premises. Especial care is taken to prevent the spread of infection by those engaged in the milk trade, laundry work, or the manufacture of wearing apparel. Bacteriological Diagnosis. During the year 1905 64 Bacteriological Examinations were made in order to determine the existence of diphtheria, phthisis, and enteric fever in doubtful cases. The results were as follows:— Positive. Negative. Total. Diphtheria 12 31 43 Enteric 5 6 11 Phthisis 3 7 10 28 Some eight years have now elapsed since the Council decided to arrange for the free examination of specimens forwarded by medical practitioners in the District, and it is satisfactory to note the increasing number of specimens sent to the Lister Institute each year for bacteriological examination. In the case of diphtheria, the examination of swabs taken from the throat of a patient during convalescence, and in some instances from the throats of other members of the household, is of considerable value from the preventive point of view, and I believe that much good would result from the more frequent use of these precautionary measures, as it is well recognised that persons in apparently good health may harbour the bacillus of diphtheria, and thus prove a source of infection. In order to avoid needless delay, the result of an examination is now sent by telegraphic message direct from the Lister Institute to the practitioner who forwarded the specimen, at the same time a copy of the report is posted to these offices. For several years a. supply of anti-diphtheritic serum has been kept at the Public Health Offices, and doctors have been supplied with the same at cost price. In December last the Council resolved that the serum should in future be given free of charge, if required for use in cases where the means of the patients do not enable them to pay for it. 29 Table B. -Cases of Infectious Disease Notified During the Year 1905. 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. 1 East Finchley. 2 West Finchley. 3 North Finchley. 4 Whetstone. 1 East Finchley. 2 West Finchley. 3 North Finchley. 4 Whetstone. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 32 1 3 17 7 4 .. 15 11 5 1 8 6 2 1 Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 15 .. .. .. 1 13 .. 7 5 1 2 .. .. .. .. Scarlet Fever 85 .. 17 50 10 8 .. 45 22 16 2 30 7 14 2 Enteric Fever 8 .. .. .. 4 4 .. 5 2 .. 1 4 .. .. 1 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. ... ... .. .. .. .. Puerperal Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 140 1 20 67 22 29 1 72 40 22 6 42 13 16 4 30 Table B1. Showing the Number of Cases and Deaths from the Principal Infectious Diseases Notified from among Parishioners During the Years 1890—1905 (inclusive). Small-pox. Scarlet Fever. Diphtheria and Croup. Cases. Deaths. Cases. Deaths. Cases. Deaths. 1890 .. .. 53 1 31 4 1891 .. .. 80 .. 32 3 1892 .. .. 125 2 37 6 1893 .. .. 189 3 30 9 1894 .. 1 57 .. 66 4 1895 .. .. 27 .. 22 2 1896 .. .. 33 .. 25 5 1897 .. .. 54 .. 20 1 1898 .. .. 91 .. 12 .. 1899 8 2 58 .. 32 6 1900 1 .. 94 2 12 1 1901 7 1 98 .. 21 2 1902 15 1 115 1 31 3 1903 .. .. 67 .. 72 3 1904 .. .. 161 1 68 3 1905 .. .. 85 .. 32 2 Erysipelas. Puerperal Fever. Typhoid Fever. Cases. Deaths. Cases. Deaths. Cases. Deaths. 1890 16 .. .. .. 7 1 1891 14 .. 1 .. 3 1 1892 17 .. 2 .. 3 1 1893 38 .. 1 .. 14 1 1894 22 .. 4 4 12 1 1895 15 2 1 1 12 3 1896 14 .. 1 .. 12 2 1897 15 .. 2 .. 13 2 1898 6 .. .. .. 9 3 1899 14 2 2 2 12 .. 1900 16 2 1 .. 7 3 1901 10 .. .. .. 15 3 1902 13 1 1 1 13 1 1903 15 .. 1 .. 4 .. 1904 30 2 2 2 4 .. 1905 15 .. .. .. 8 1 31 Table B2. Cases of Infectious Disease Notified during each month of the Year 1905. Diphtheria. Erysipelas. Scarlet Fever. Enteric Fever. Puerperal Fever. Totals. January 6 3 20 1 .. 30 February 4 1 17 .. .. 22 March 3 1 9 .. .. 13 April 3 2 6 1 .. 12 May 3 1 7 2 .. 13 June 1 .. 2 1 .. 4 July 3 3 1 1 .. 8 August 3 2 1 1 .. 7 September .. .. 5 .. .. 5 October 3 1 6 .. .. 10 November .. 1 8 .. .. 9 December 3 .. 3 1 .. 7 Totals 32 15 85 8 .. 140 32 If we take into consideration the number of children under 15 years of age in Finchley (6,642 at the census of 1901 and now estimated at about 8,620), and the frequent opportunities for the introduction of epidemic disease from London and elsewhere, it is not surprising to find that an outbreak of one or other form of infectious disease is of fairly frequent occurrence. But on comparing the epidemic mortality of Finchley for various years with that of other districts round London, or with that of England and Wales generally, the incidence of epidemic disease in the District appears to be below the average. The past year has been one of exceptional freedom from any severe epidemic in Finchley, and much as one might wish such a state of things to continue for a lengthy period, it would be contrary to all experience. One should, however, recognise the fact that, although it may be impossible to entirely banish infectious disease in spite of every reasonable precaution, we can at least minimise the opportunities for infection, and ought especially to do so in the case of young children. For at the earlier ages children are, generally speaking, far more liable to infection, and if disease attacks them, the effects are usually more serious. In view of these facts are we fully justified in permitting infants to attend the public elementary schools? It is true that if the children were not at school many of them would be playing together in the streets, but I do not believe under such circumstances the opportunities for infection are so frequent as under ordinary school conditions. If it is held that the greater weight of advantage is on the side of early school attendance, then we must be prepared for troubles similar to those of the past, though I hope with increasing vigilance on the part of all concerned and the prompt exclusion of cases of suspected illness, school closure will not be so frequently called for. 33 Scarlet Fever or Scarlatina. The epidemic that commenced in June, 1904, and was prevalent throughout the District up to the end of the year, gradually diminished during the early months of 1905, and only four cases were notified between the end of May and beginning of September. From that date onwards the disease was slightly more prevalent, but I have no reason to connect these latter cases with the previous epidemic. Altogether 85 cases of scarlet fever were notified during the year, and these represented infection in 55 houses. In most instances the illness ran a fairly mild course, and no case ended fatally. At the same time it must be remembered that many chronic ailments date from an attack of scarlet fever, probably the most frequent being ear disease, though kidney and heart complications are not rare. For many years past the type of epidemic in Finchley appears to have been mild, but in some localities a casemortality of 20 or 30 per cent. has been noted, and a mortality of 5 to 10 per cent. of those attacked is by no means uncommon in very poor neighbourhoods. Diphtheria. Of the 32 cases notified, two ended fatally. The number of different houses invaded was 29. The cases were distributed fairly evenly throughout the year, and the incidence did not appear to fall on any special portion of the District. In a few instances direct infection from an already notified case seemed probable, but in the majority it was impossible to ascertain any evidence as to the source. Gross sanitary defects on the premises were seldom noted, and even when present it was matter for conjecture whether they were more than predisposing causes. 34 Typhoid or Enteric Fever. Eight cases of enteric fever were notified during the year, one of which ended fatally. So far as could be ascertained, there was no probable connection between any two of the cases. In most instances the period of incubation pointed to infection outside the District, and in no instance could any local source of infection be ascertained. Measles and Whooping-Cough. Measles gave rise to comparatively little trouble during the year, and although whooping-cough was somewhat more prevalent, it was not to so serious an extent as in the previous year. Almost the entire mortality from these diseases is due to lung complications, and it is mainly on this account that marked differences in the case-mortality are noted at different seasons of the year. Smallpox. No case of this disease was notified in Finchley during the year. The hospital in Summers Lane, which has accommodation for 24 patients, has been kept in readiness for immediate use. By an agreement with the Hornsey Borough Council this hospital is available for cases from their district, and one patient was sent in during February for treatment. Consumption (Phthisis) A voluntary system of notification of cases of phthisis has now been in force within the District for rather more than two years. During 1904 eight notification certificates were received from medical practitioners, and during 1905 the same number. 35 As cases can only be notified with the consent of the patient or those in charge of the patient, the certificates received represent only a small proportion of those affected, and give no indication of the actual prevalence of the disease. Judging from the recorded mortality and the average duration of pulmonary tuberculosis, the actual number of cases in the District is probably between sixty and eighty. When we consider how frequently it happens that the wage earner of the family is attacked by the disease and yet struggles on at work knowing his only chance of permanent recovery lies in prolonged rest and treatment, one can somewhat realise the amount of suffering entailed. At the present time it is extremely difficult to find accommodation in any of the existing special hospitals, and even if fortunate enough to obtain an admission order, it is usually only after a long wait. There is an undoubted need of sanatorium provision for the County, and it should be on an adequate scale so as to allow of patients being admitted at an early stage and given prolonged treatment. What is more, it should be possible to admit patients in a comparatively advanced stage, with a view to teaching them the simple and necessary precautions they should observe so as to avoid being a source of infection. In regard to the infective nature of the disease, it does not appear to be sufficiently appreciated by the public generally that thorough disinfection of a consumptive patient's bedroom and belongings is advisable after his death or removal. Every facility has been given by the Council in the hope of inducing the relations to apply for the disinfection to be carried out., and although a few applications were received last year, in the majority of cases the relatives appeared to consider the precaution unnecessary. 36 Middlesex Open Air Sanatorium. The provision of an Open-air Sanatorium for the County of Middlesex has unfortunately not yet become an accomplished fact, owing to the want of sufficient funds. Colonel Gerard Clark, the Honorary Secretary to the Sanatorium, has kindly supplied me with particulars of the scheme, and a corrected list of Authorities who have agreed to establish beds. The estimated cost of buying the land, building, furnishing, lighting, etc., is £30,000, a rate of £300 per bed, and the cost of maintenance 25s. per patient each week. The details of the scheme have been very carefully worked out, and it has wisely been decided not to aim at the erection of palatial buildings, but to provide accommodation on the hut or bungalow system. By this means the treatment will be more readily and efficiently carried out, whilst a considerable sum will be saved on the initial outlay. The following Public Authorities have agreed to establish and maintain beds. In some cases it was stipulated that certain defined conditions should be complied with:— Brentford Council 1 Bed. Edmonton „ 3 Beds. Finchley „ 2 „ Harrow „ 1 Bed. Hornsey „ 5 Beds. Tottenham 3 „ Wood Green „ 3 „ Edmonton Union 6 ,, 37 School Hygiene. The recently published report of the Inter-Departmental Committee on Medical Inspection and feeding of children attending Public Elementary Schools is one that well repays careful reading. Part I. of the report deals with Medical Inspection. It appears that comparatively few Education Authorities have established any definite system of medical inspection, although in the majority of urban districts in England special attention is paid to the detection and prevention of the spread of infectious disease. The nature and extent of the work already undertaken varies considerably, but the Committee reported favourably on the general results, and were of opinion that medical inspection had done much towards bringing to view defects, the treatment of which would secure the child from unnecessary suffering, and might save him from serious trouble in after life. Treatment of any defect is usually considered outside the duties of the school doctor, even if it were legally possible for a local authority to provide treatment under the existing law. The opinion expressed by the Committee on Physical Deterioration is referred to in this connection:—That "in no instance should the inspector do more than state the facts that require the attention of the parent, cases of poverty or neglect being left to the proper authorities to deal with." Apart from dealing with cases of infectious disease, the three principal objects of medical inspection are to ascertain 1. What children are unfitted for the ordinary routine of school life. 2. Whether existing physical or mental defects are likely to be benefitted by treatment. 3. In what directions school conditions might be modified to meet special cases. 38 In order to fully meet these requirements it would be necessary to medically examine all the children in a school from time to time, and keep a record of the conditions found at each examination. But before attempting to carry out such a scheme in Finchley, I think the wisest course would be to first deal with the children standing most in need of attention. These might readily be selected, provided the school staff could spare time from routine work to make a preliminary examination of each child on some uniform plan. It has hitherto been the practice of the Head Teacher of the various schools to draw the attention of the parents to cases of obvious defect or illness and endeavour to' get them treated, and latterly a considerable number of children have been first referred to me for examination. Yet, for want of a systematic scheme of examination including all the children, there must be many cases of commencing trouble that are overlooked. At no very distant date I hope a record will be kept of the infectious disease history and physical condition of each child attending the public Elementary Schools in Finchley. Already a commencement has been made in this direction, and as the scope of the work widens its value will become more apparent. Exclusion from School.—The following regulations regarding the exclusion of children from school on account of infectious disease were adopted by the Education Committee during the summer of last year:— 39 REGULATIONS REGARDING EXCLUSION FROM SCHOOL ON ACCOUNT OF INFECTIOUS DISEASE. 1. No child may attend school while suffering from Smallpox. Scarlet Fever (sometimes called Scarlatina), Diphtheria, Enteric (Typhoid) Fever, Measles, Whooping-cough, Chicken-pox, German Measles, Mumps, Ringworm, Itch, or other communicable disease. 2. No child may attend school from a house where there is a case of Smallpox, Scarlet Fever, Diphtheria, Enteric Fever, Measles, Whooping-cough, Chickenpox, German Measles or Mumps. 3. No child may attend school from a house from which a case of Smallpox, Scarlet Fever, Diphtheria., or Enteric Fever has been removed, until the period of quarantine is completed. 4. If any Assistant Teacher suspects that a child is suffering from some infectious disease, the case should be reported to the Head Teacher, who shall determine whether the child is to be excluded pending further inquiries. 5. In the case of a child believed to be suffering from pulmonary consumption, the Medical Officer should be consulted before any further action is taken. 40 Table of Quarantine Periods. Disease. Date at which Attendance at School may be resumed. After Illness. After exposure to infection at home. Scarlet Fever 8 weeks from appearance of rash, provided peeling has ceased, and there is no sore throat, discharge from ears or nose, suppurating gland or sore patch. 14 days Diphtheria 6 weeks from onset of sore throat, provided there is no sore throat, discharge from nose, ears or eyes. 14 days Measles Never less than 4 weeks from appearance of rash, even if all cough and peeling have ceased. 21 days Whooping-Cough 6 weeks, provided the characteristic cough and whooping have ceased for at least 2 weeks. 21 da Chicken-Pox When every scab has fallen off, particular attention being paid to the scalp 18 days German Measles Not less than 2 weeks from the appearance of rash. 21 days Mumps 4 weeks from commencement of swelling. 25 days Small-Pox When every scab has fallen off and the skin lesions have all healed. 18 days Enteric Fever Not less than 2 months. 28 days 41 A few points in the above table of quarantine periods require some explanation. The usual period of quarantine enforced after exposure to the infection of scarlet fever varies from 8 to 10 days, but in suggesting a longer period I was influenced by the frequency with which cases are overlooked until peeling commences. Again, in regard to measles, the early symptons may readily be mistaken for those of an ordinary cold. And in regard to enteric fever, the commencement of an attack is often very indefinite. On the whole it seemed better to lose a few more days schooling than run needless risk. The exclusion of all children from school who come from houses where there is infectious disease considerably interferes with regular school attendance, but I trust in time it may be possible to modify the regulations so as to permit children who have previously suffered from certain of the infectious diseases to attend school, provided the invalid is properly isolated. At present there are difficulties in the way of efficient supervision, and we lack any trustworthy record of the children's infectious disease histories. School Closure.—Owing to the presence of epidemic disease and the increasing number of absentees it was found necessary to close the following schools during the course' of the year:— School. Disease. Inclusive dates of closure. Christ Church Infants' Mumps 25th Feb. to 10th March. „ „ Mixed „ „ St. Mary's Infants' Measles 18th June to 15th July. St. John's Infants' Measles and 1st Aug. to 4th Aug. Whooping Cough (end of term). „ „ Mixed „ „ „ „ „ Holy Trinity Infants' Chicken-pox 10th Dec. to 21st Dec. (end of term). 42 WATER SUPPLY. The District is supplied from the mains of the Barnet Water Company. From evidence given before the Parliamentary Bills Committee it appears that the Company pump from five deep wells in the chalk—three at Barnet, one at Potters Bar, and one at East Barnet—and, in addition, can obtain a certain quantity of water from the New River Company. The service is at present intermittent to the greater portion of Finchley, but the Company are under an obligation to give a constant supply to the whole of the District within two years. The quantity of water supplied has been estimated at about 20 gallons per head per day. No water-softening process is in use. HOUSING. Building operations have been actively continued during the past year in all parts of the District, and several new estates are in course of development. The number of new houses passed between December 31st 1904, and December 31st, 1905, as fit for occupation was 355. The new buildings for the most part comprise rows of villa residences, small houses, flats and shops. There is no lack of house accommodation for artisans, but the same complaint is heard here as in other suburban districts, namely, that house rents are as a rule in excess of what the working man can afford. I believe it is mainly in consequence of this difficulty in meeting the rent of an entire house that a considerable amount of sub-letting exists, 43 DRAINAGE AND SEWAGE-DISPOSAL. A dual system of drainage is in force, in the District, the surface water sewers discharging into the streams. Sewage reaches the farm in Summers Lane by either the low or high level sewer. The sewage from the low level sewer passes through a screen, and is then pumped to join the high level sewage. The mixed sewage is screened, and, after the addition of lime and sulphate of iron, passed into one of three precipitation tanks (each having a capacity of 226,260 gallons). The tank effluent is next treated in a double set of bacterial contact beds, in each of which it remains standing about five hours. The effluent is finally run over several acres of meadow before entering the brook at the bottom of the valley. The sludge is drawn off after a precipitation tank has been used one week, and is pumped on to the land at the highest level of the farm. It is there left to drain and evaporate, and is then ploughed in, the land being used for crops of cabbages, etc. The dry weather flow of sewage is estimated at about 700,000 gallons per diem. In wet weather a portion of the sewage is treated in the ordinary way, and the remainder by broad irrigation. The subsoil of the farm is clay, and there is only a shallow surface soil over most of the area, so that considerably more land has to be utilised than would be required with more, suitable soil. The total area of the farm comprises close, upon 80 acres belonging to the Council, and 33 acres rented from the Burial Board. The filter beds number 16, and cover a total area of about 27,000 square yards. Many of the beds are in a far from satisfactory condition, and require thorough reconstruction before efficient work can be expected from them. In their present 44 state they are incapable of sufficiently purifying the sewage, consequently the effluent from them has to be treated by surface irrigation over a large area of land, with a view of further purification, before being discharged into the brook. It is evident that a policy of inaction in respect to> the sewage disposal works is impracticable. The main point at issue is how best to act with a view to the present and future requirements of the District. Three courses appear to be open:— Firstly: To reconstruct the majority of the present filter beds, provide additional pumping plant, and, in all probability, further tank accommodation as well. Secondly: To carry the whole of the sewage by gravitation to the area lying below the low level sewer outfall, make use of detritus and septic tanks in place of chemical precipitation and construct new primary and secondary bacterial beds. Thirdly: To treat the high level sewage on the present system, and the low level sewage by a partial septic process as outlined above. While the adoption of either the second or third course would obviate the necessity for pumping and thus effect an economy, the second has the additional advantages of requiring a comparatively small area of land for the works, and less outlay on upkeep. A scheme based on these lines, i.e., partial septic treatment of the whole volume of sewage, followed by passage of the effluent through a double series of bacterial filter beds, has been prepared by the Council's Surveyor, Mr C. J. Jenkin, and after careful consideration by the Public Health Committee, the Council resolved, on November 12th, 1905, to proceed with the construction of a portion of the works, which will be in themselves a complete installation sufficient for demonstrating the applicability of the system of local requirements, and at the same time form a concrete part of the whole scheme should it be finally adopted. 45 The need for storm-water filters has been recognised for some considerable time, a loan for the purpose being sanctioned by the Local Government Board on 27th February, 1903; the necessary extension of the tunnel sewer is now in progress. DISPOSAL OF HOUSE REFUSE. The Council contract for a weekly removal of all house refuse. The refuse is burnt in the open on the sewage farm. It would be a distinct gain from the public health point of view if all the carts used for collecting refuse were furnished with covers, so arranged that only a small section of the van need be uncovered at any one time. The Council undertake to remove trade refuse; a small charge is made, based on the estimated cost of removal. ANALYSES PERFORMED DURING THE YEAR. Through the courtesy of the Education Committee 1 have been enabled to fit up a. small room at the Long Lane School for analytical work. The samples examined during the year include:— A sample of the public water supply taken each month. The samples were drawn from standpipes in various parts of the district, and on chemical analysis were found to conform in each instance to a high standard of purity. Analyses were also made of six samples of sewage, twentyeight of effluent from the sewage farm, several pond, spring and well waters. The samples of effluent were found satisfactory in each caae. The water in a well supplying three cottages was found to show evidence of pollution. After some correspondence with the owner, the public water supply was. laid on to each of the cottages. 46 NOTES UPON SANITARY WORK PERFORMED DURING THE YEAR. Inspection of the District was systematically carried out. includinj visits to the dairies, cowsheds, slaughterhouses, bakehouses, workshops, houses in which epidemic disease had broken out, insanitary property, and routine house to house inspection. In all, some 5,688 inspections were made, and nuisances to the number of 1,665 were discovered. 164 complaints with regard to alleged nuisances were received during the year, and prompt attention was given to each. 156 rooms were fumigated after infectious disease; and 2,734 articles, chiefly bedding and wearing apparel, were disinfected in the Council's steam apparatus. A large number of house drains were reconstructed, the work being supervised in a, thorough and satisfactory manner by the Sanitary Inspector. A plan of each drain re-laid is made by the Inspector, and this, together with all necessary particulars, is filed for future reference. The meat, fruit, fish and poultry shops, and premises where food is prepared for sale, have been kept under observation, and a considerable quantity of unwholesome food condemned in consequence. The sanitary condition of the premises has also received attention. A full statement of the work done under the Nuisance Sections of the Public Health Act, together with notes regarding the dairies, slaughterhouses, etc., will be found in the appended report of the Sanitary Inspector. 47 Factories and Workshops. All the Workshops and Work-places in the District have been inspected during the year, and various sanitary defects remedied as a consequence. Very little home work appears to be given out from Workshops in the District, and the list of out-workers consequently contains but few names. At some of the small Workshops the work done is for firms in London, and their occupants are technically out-workers, but their names are not included in the list of out-workers, as the rooms come under inspection in the ordinary routine. The following is a list of the Workshops and Work-places on the Register at the end of 1905:— Tailors 7 Dressmakers and Milliners 25 Bootmakers 17 Cycle Makers 10 Bakers 17 Laundries 18 Restaurant Kitchens 15 Picture Framers 2 Farriers 9 Ironmongers 4 Die Stampers 1 Saddlers 4 Blind Makers — Cabinet Maker 1 Wheelwright 1 Pinafore Makers 2 Carpenter 1 Upholsterer 1 Coachbuilder 1 Total 136 48 BAKEHOUSES. All the Bakehouses (17 in number) were inspected frequently during the year. There are at present in the District three underground bakehouses. After certain structural alterations had been made these were certified by the Sanitary Authority at the commencement of 1904 as suitable in regard to construction, light, ventilation, and all other respects. The minimum requirements for the Council's certificate included provisions against the entry of ground-air and moisture, and provision for ventilation, light and cleanliness of the premises. Adoptive Acts, Byelaws, and Regulations. The following Adoptive Acts are in farce in the District:— The Infectious Diseases (Prevention) Act, 1890. The Public Health Amendment Act, 1890. The Housing of the Working Classes Act, 1890, Part III. The following Bye-laws are in force:— The cleansing of footways and pavements; the removal of house-refuse; and the cleansing of earth closets, privies, ash pits and cesspools. The prevention of nuisances arising from snow, filth, dust, ashes, and rubbish, and the keeping of animals on any premises as to be injurious to health. Common Lodging Houses. New Streets and Buildings. Slaughterhouses. Houses let in Lodgings. Offensive Trades, 49 Paving of Yards and Open Spaces. Management of Mortuary. Drainage of Buildings. Regulations are in force with respect to:— Dairies, Cowsheds and Milkshops. The Revenue Act of 1903. In 1890 the Customs and Inland Revenue Act granted exemption from inhabited House Duty to all houses used solely for providing separate dwellings at rents not exceeding 7s. 6d. per week for each dwelling, if the Medical Officer of Health certified that the premises afforded suitable accommodation for each of the persons inhabiting them, and that due provision was made for their sanitary requirements. This exemption was in order to encourage the erection of Artizans' Dwellings on good lines, and it has proved a useful piece of legislation. The Revenue Act of 1903 extends the provisions of the former Act, and now where a dwelling house is used for the sole purpose of providing separate dwellings: (a) Any dwelling which is of an annual value of below £20 shall be exempt from Inhabited House Duty; (b) The rate of Inhabited House Duty in dwellings of an annual value of £20, but not exceeding £40, is reduced to 3d.; and (c) The rate in respect of dwellings beyond an annual value of £40, and not exceeding £60, is reduced to 6d. REPORT OF THE SANITARY INSPECTOR For the Year 1905 To the Chairman and Members of the Finchley Urban District Council. Gentlemen, I beg to submit, for your consideration, my fourth Annual Report, in which is recorded the work dome during the year 1905 in connecton with the various branches of sanitation coming under my supervision. During the past twelve months the inspection of the District has been systematically carried out, careful attention being given to all sanitary conditions bearing on the health and comfort of the inhabitants. House inspection, supervision and testing of drainage work, inspection of workshops, bakehouses, restaurants slaughter-houses, butchers', fruiterers', and fishmongers' shops, dairies, cowsheds, and milkshops, have each and all occupied the time of your inspectors, and whereever insanitary conditions were found to exist, or where food was found to be unsound, or stored in such a manner as to endanger its wholesomeness, such action as was necessary was promptly taken. 54 DRAINAGE. Number of old Drains examined, tested, exposed, etc. 111 Number of Houses and Premises re-drained 105 Defective Drains repaired 8 Drains unstopped and cleansed 33 Length in yards of Stoneware Drains laid 2048 Length in yards of Heavy Cast-iron Drains laid 459 Manholes provided 84 Manholes altered and repaired 37 New Manhole Covers 3 Intercepting traps fixed 58 New Fresh Air inlets provided to drains 11 Fresh Air inlets to Drains repaired 9 Stoneware Gully Traps fixed 228 New Soil Pipes and Ventilating Shafts fixed 105 Soil Pipes and Ventilating Shafts repaired 19 Bell Traps removed 8 Drain-opening in Bakehouse abolished 1 Old Disused Drain disconnected from sewer 1 New Impervious Sinks provided 21 New Waste Pipes fixed 69 Waste Pipes repaired 23 Waste Pipes trapped 21 Waste Pipe disconnected from Drain 1 Gully Curbs repaired 55 Water Tests applied 375 Smoke Tests applied 150 Number of Plans of Drainage drawn 77 55 WATER CLOSETS AND SANITARY CONVENIENCES. New W.C. Basins of the "Washdown" type fixed 174 W.C.'s cleansed or repaired 12 Flush Pipe connections repaired 11 New Flushing Boxes fitted to W.C.'s 74 Existing Flushing Boxes to W.C.'s repaired 72 Water Supply laid on to W.C. 1 New Urinals 2 New W.C. Apartment provided 1 Insanitary W.C. Apartment abolished 1 Nuisance from absence of Privy abated 1 Nuisance from Temporary Privy abated 1 MISCELLANEOUS. Roofs repaired 55 Eaves Guttering renewed 69 Rainwater Pipes disconnected from Drains 14 Damp Walls remedied 6 Ventilation under Floors provided 1 Yards Paved 126 Paving of Yards repaired 18 Stable Floors re-paved 4 Mews paved 2 Paving of Mews repaired 2 Floors of Rooms repaired 41 New Floor to Bakehouse 1 Bakehouses cleansed and limewashed every six months Bakehouse Floor repaired 1 Bakehouse enlarged 1 58 At the end of the year the drains of 14 houses which had been found to be in a defective condition were being dealt with. New drains are, in all cases, required to be constructed with salt-glazed stoneware, or heavy cast-iron coated pipes, laid on a solid bed of Portland cement concrete. The drains are disconnected from the public sewer by means of approved intercepting traps, and proper means provided for their efficient ventilation, cleansing and testing. As usual, the water test was applied to the drains, both before and after the ground was filled in, and plans were subsequently made by the Inspectors of each drain re-laid, which, together with other necessary particulars, are filed for future reference. I am glad to say that considerable improvement has taken place in the class of work executed in connection with new soil pipes and w.c.'s. Until a few years ago it was not an uncommon practice in the district to use light iron rain water pipe for soil pipes, and zinc pipe for ventilating shafts. Work of this character is. in my opinion, very unsatisfactory, for the putty joints of the iron pipe, and the solder seams of the zinc pipe, soon become defective. The danger arising from such defects is considerably increased by the fact that at least one joint of each soil pipe is inside the house, and many of the other joints outside are usually in close proximity to windows. Happily, work in this connection is now required to be of a more permanent character. Both the soil pipes and ventilating shafts are constructed of solid drawn lead or strong castiron coated pipes, the joints being respectively "wiped solder,'' or "caulked lead" joints. The connections between the soil pipes and w.c. basins are made with Portland cement. Of the 105 houses re-drained during the year, 71 were provided for by means of twenty combined systems of drainage. Five of the main drains, involving 22 houses, constituted sewers within the meaning of the Public Health Acts, and 59 were re-laid at the expense of your Council. The drains cf 7 other houses were also relaid by the Council, but at the cost of the owners, t hey having made default in complying with the notices served upon them. Early in the year I suggested to your Public Health Committee the advisability of having private drainage work executed by local tradesmen under contract, in lieu of direct labour. Your Committee having approved of this suggestion, the work is now carried out in this way, in accordance with plans and specifications which I prepare, and, so far, it has been found to be both satisfactory and economical. INSPECTION OF WORKSHOPS AND WORKPLACES. The Workshops and Workplaces on the register now number 136, as compared with 110 at the end of 1904. Periodical inspections were made during the year to see that the various premises were kept, in conformity with the provisions of the Factory and Workshop Act, and on the occasions of these visits the following sanitary defects were discovered, viz.:— Defective W.C. Pan 1 Defective W.C. Flushboxes 5 Foul W.C. Pans 2 Blocked W.C.'s 3 Defective Flushpipe Connection to W.C. 1 Foul Urinal 1 Untrapped Waste Pipes 3 Defective Waste Pipes 1 Dirty Walls and Ceilings of Workrooms 17 Defective Ceilings of Workrooms 2 62 were not such, however, as demanded drastic action being taken, but the opportunity was used to warn the tradesmen of their legal responsibilities, and I am pleased to be able to report that, so far, it has had the desired effect. At the request. of local tradesmen, on two occasions I inspected meat which had been consigned to them, they being of opinion that, it was of questionable soundness, and in each case the meat was found to be unfit for human food. Altogether, 2351bs. of beef and mutton was condemned and destroyed. There are 34 premises in the District where sausage or pie making, curing of bacon or fish with smoke, fish and potato frying, and ice cream making are carried on. These premises were thoroughly inspected during the year, and a number of sanitary defects which were found to exist have been remedied. In one case it was necessary to request the occupier to cease making sausages in a damp, dark, and unventilated cellar under a butcher's shop. There have been no complaints during the year with regard to smells front fish frying at the various places where this business is carried on. Provision is in each case made for the removal of fumes into a flue by means of a hood over the cooker, and in two of the premises gas cookers are used, which certainly conduce to greater cleanliness. The fruit and fish shops have also received attention. One seizure of fruit, consisting of 13½lbs. of apricots, and 41bs. of raspberries, was made. Your Council, however, decided not to prosecute, but sent a letter of warning to the offending tradesman through the Clerk to the Council. I also examined, at the request of a shopkeeper, one basket of cherries, which I declared to be unsound and unfit for human food. Examinations of 741bs. of haddocks and 70lbs. of fish roes were similarly made, and these also were in such a condition as to call for condemnation. 63 In concluding my remarks on this subject, I wish to acknowledge the ready assistance and the facilities which the various food purveyors in the district have given when their premises have been visited. In no case was there any impediment to the free inspection of the food on their premises. DAIRIES, COWSHEDS, AND MILKSHOPS. Seven new Dairymen, Cowkeepers, or Purveyors of Milk were registered during the past year, and three of those already registered gave up business, thus making a total number of 31 at present on the register. The whole of the premises have been periodically inspected to see that they were kept in accordance with the provisions of the Dairies, Cowsheds, and Milkshcps Order, 1885, and the Regulations made thereunder by your Council. On the occasion of the inspections, a number of sanitary defects, chiefly of a minor character, were discovered. Upon the occupiers' attention being called to these defects they immediately had the works necessary to remedy the same carried out. In shops where milk is sold, and in which other goods besides dairy produce is kept, the vessels containing the milk for sale are required to be kept properly covered. Steam plant is provided in several of the dairies for cleansing the utensils, and this is unquestionably a great improvement on the method of cleansing milk utensils with boiling water only. The cowsheds have been generally well kept, but in several instances it was necessary to request the occupiers to carry out the periodical limewashing required by your Council's regulations. The total number of cows kept in the District is 227, thus showing that a large proportion of the milk consumed by