E FIN 15 THE METROPOLITAN BOROUGH OF FINSBURY. ANNUAL REPORT on the Public Health of Finsbury for the Year 1925 by A. E. THOMAS, M.A., M.D., D.P.H., Medical Officer of Health, Barrister at-Law. London: Printed by Vail & Co., 170, Farringdon Road, E.C, 1926. 6c THE METROPOLITAN BOROUGH OF FINSBURY. ANNUAL REPORT on the Public Health of Finsbury for the Year 1925 by A. E. THOMAS, M.A., M.D., D.P.H., Medical Officer of Health, Barrister at- Law. London: Printed by Vall & Co., 170, Farringdon Road, E.C, 1926. Public Health Committee, 1925-6. Chairman: Alderman W. R. PUTTERILL. Vice-Chairman : Alderman Wm, HOWES, J.P. HIS WORSHIP THE MAYOR. (CounciUor J. T. WALLIS, J.P.) CounciUor F. T. FOULGER. CounciUor C. J. SMITH. Councillor T. A. HUTCHINSON. Councillor Mrs. A. CHAPMAN, J.P. Councillor H. G. DAINTY. Councillor Mrs. M. F. HAGGITH. Councillor G. GLANVILLE. Councillor Mrs. E. J. L. LORD. Councillor S. G. NUNN. Councillor E. TROTT, J.P. Maternity and Child Welfare Committee, 1925-6 Chairman: Councillor F. T. FOULGER. Vice-Chairman: Councillor Mrs. E. J. L. LORD. HIS WORSHIP THE MAYOR. (Councillor J. T. WALLIS, J.P.) Alderman W. HOWES, J.P. Councillor Mrs. A. CHAPMAN, J.P. Councillor H. G. DAINTY. Councillor E. TROTT, J.P. Councillor Mrs. M. F. HAGGITH. Alderman W. R. PUTTERILL. Co-opted Members: Lady BARTON. Miss E. F. BOLTON. Mrs. L. WALLIS. Miss M. WILMSHURST. The Public Health Committee meets on Tuesdays, when necessary, at 2.30 p.m., and the Maternity and Child Welfare Committee meets on Tuesdays after the Public Health Committee. TABLE OF CONTENTS. Statistics 5 Population 6 Births and Birth Rates 8 Maternity and Child Welfare 9 Health Visitation 17 Weighing Centres 18 Grants to Mothers and Children 19 Hospital Treatment 24 Puerperal Fever 24 Ophthalmia Neonatorum 25 Deaths and Death Rates 25 Inquests 26 Infant Mortality 27 Tuberculosis 31 Phthisis Notifications and Deaths 32 Tuberculosis Dispensary 39 Infectious Disease 40 Housing 48 Proposed Housing Scheme 49 Housing on L.C.C. Estates 50 Disinfection 56 Food Inspection 57 Slaughter Houses 59 Milk Shops 59 Samples for Analysis 60 Factories and Workshops 62 Homework 69 Rats and Mice (Destruction) Act, 1919 70 Common Lodging Houses 70 Canal Boats 70 Mortuary 71 Staff 71 Work of the Staff 73 Legal Proceedings 76 Statistical Tables 78-81 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1925. STATISTICS.—A summary of the principal facts of the statistic3 for 1925 is given below:— Area (acres) 587 Estimated civilian population at the middle of 1925 77,560 Finsbury residents in outlying institutions at the end of June, 1925 988 Number of inhabited houses (structurally separate dwellings), Census, 1921 10,889 Number of families or separate occupiers (Census, 1921) 20,005 Rateable value £1,108,656 Sum represented by a penny rate £4,481 Birth rate, Finsbury 22.6 per 1,000 inhabitants. Birth rate, London 18.0 per 1,000 inhabitants. Birth rate, England and Wales 18 3 per 1,000 inhabitants. Death rate, Finsbury 13.6 per 1,000 inhabitants. Death rate, London 11.7 per 1,000 inhabitants. Death rate, England and Wales 12.2 per 1,000 inhabitants. Infant mortality, Finsbury 59.8 per 1,000 births. Infant mortality, London 67.0 per 1,000 births. Infant mortality, England & Wales 75.0 per 1,000 births. Phthisis death rate, Finsbury 14.3 per 1,000 inhabitants. Finsbury death rate from all forms of tuberculosis 1.62 per 1,000 inhabitants. In comparison with the results for 1924, the following matters are of interest— The number of births and the birth rate are less in 1925. The general death rate is lower in 1925. The death rate for consumption of the lungs and from all forms of tuberculosis are both higher in 1925. The infant mortality is much lower in 1925. 6 The deaths from tuberculosis, cancer, heart disease, and diarrhoea, are more in 1925. The deaths from measles, whooping cough, diphtheria, influenza bronchitis and pneumonia, are less in 1925. Diphtheria and scarlet fever have been much more prevalent than in 1924. POPULATION. At the Decennial Census made on the 19th-20th June, 1921, the population of Finsbury was given as 75,995. The RegistrarGeneral, however, in view of information obtained by him as to the movements of population, considered the population to be 76,019, in the middle of 1921. The population of Finsbury at the middle of 1925 was estimated by the Registrar-General to be 77,560, which is the figure used in compiling this report. Estimate of Population 1925. Estimated population 1925. Census population 1921. Census population 1911. Clerkenwell 51,358 50,322 57,121 St. Luke 24,095 24,592 28,976 St. Sepulchre 2,107 1,081 1,826 Totals 77,560 75,995 87,923 The estimate does not include the Finsbury residents detained in the following institutions The Holborn Union Institution, la, Shepherdess Walk (560); the Holborn and Finsbury Hospital, Archway Road, Holloway (224), and the Holborn Schools, Mitcham (204), giving a total of 988. Adding this number to the Registrar-General's estimate 77,560, we get a corrected population of 78,548 for Finsbury in the middle of the current year. 7 The following table shows the general birth and death rates and infant mortality in each of the Metropolitan Boroughs ana in London, and in England and Wales during 1925. Births annual rate per 1,000 persons living. Death Rate per 1,000 living. Deaths of Infants under 1 year, to 1.000 births. LONDON 18.0 11.7 670 Paddington 15.9 12.1 72 Kensington 15.8 13.2 78 Hammersmith 17.5 11.9 65 Fulham 16.9 10.7 76 Chelsea 14.4 13.6 69 City of Westminster 10.7 12.3 69 St. Marylebone 14.1 11.6 63 Hampstead 12.0 10.2 55 St. Pancras 17.9 12.7 72 Islington 19.4 12.26 63 Stoke Newington 15.8 11.2 61 Hackney 17.9 10.9 65 Holborn 12.16 12.51 63 Finsbury 22.6 13.6 59-. City of London 7.5 11.8 60 Shoreditch 24.6 13.3 88 Bethnal Green 21.9 12.0 80.6 Stepney 21.2 11.9 73 Poplar 22.7 11.7 75 Southwark 21.2 13.1 77 Bermondsey 23.4 12.6 78 Lambeth 24.6 12.1 44.8 Battersea 18.5 10.5 58.1 Wandsworth 14.31 10.43 52 Camberwell 17.7 11.1 64.7 Deptford 18.8 12.1 63 Greenwich 18.8 11.23 70 Lewisham 15.6 10.3 55 Woolwich 18.3 10.8 55 England and Wales 18.3 12.2 79 8 BIRTHS AND BIRTH RATES- These are given in the annexed table :— Year. Population in the middle of each year. Corrected Births Corrected Birth Rates. 1910 88,987 3,833 31.8 1911 87,566 2,676 80.6 1912 86,130 2.579 29.9 1913 84,679 2,494 29.4 1914 83,212 2,658 30.7 1915 76,915 2,192 28.5 1916 80,764 1,926 23.8 1917 75,813 1.572 20.7 1918 74,502 1,275 17.1 1919 78,431 1,582 20.2 1920 78,423 2,540 82.4 1921 76,690 1,973 25.7 1922 76,840 1,934 25.2 1923 77,230 1,844 23.9 1924 77,180 1,662 21.5 1925 77,560 1,754 22.6 The rates for the various districts were as follows :— Population. Births. Birth-rate. Clerkenwell 51,358 1,105 21.5 St. Luke 24,095 630 26.1 St. Sepulchre 2,107 19 9.0 The whole Borough 77,560 1,754 22.6 The corresponding birth rates for the rest of the country are attached :— England and Wales 18.3 London 18.0 Finsbury 22.6 105 great towns 18.8 157 smaller towns 18.3 9 The number of Finsbury births reported as illegitimate was 52. The number of deaths in illegitimate children under one year was five. NOTIFICATION OF BIRTHS ACTS 1907 AND 1915. The statistics for the last five years are given in the accompanying table. Year 1920 1921 1922 1923 1924 1925 Total Births notified 4,200 3,694 3,510 3,421 8,167 3.8 3,362 Percentage attended by Doctors 3.5 2.6 2.4 2.4 3.5 Percentage attended by Midwives 31.3 43.4 28.4 27 5 29-0 31.2 Still Births notified 70 55 59 51 42 41 Births registered 2,540 1,973 1,934 1,844 1,662 1,754 The number of Finsbury births notified in 1925 was 1,778. Notifications were received of 17 sets of twins. The percentage of births notified by parents was 6.2, by medical men 3.8, by midwives 29, by hospitals, infirmaries and nursing homes 17, and by others, chiefly medical students and midwifery students was 44 per cent. The mothers of this last group were all attended gratuitously in their confinements by medical students and student mid-wives from various hospitals and institutions. In 1925 the number of instances in which parents omitted to notify was 142. To these a printed form was sent drawing attention to the omission. The East Finsbury Maternity and Infant Welfare Centre, 162, Lever Street.— The work and classes at the Maternity and Child Welfare Centre, 162, Lever Street, in 1925, were as follows:— Monday Mothers' clinic, 10 a.m. to 12 p.m. Dental clinic, 2 p.m. to 3 p.m., alternate weeks. 10 Tuesday Sale of Dried Milk, 9 a.m. to 10 a.m. Sewing Class and Cookery Class, alternate weeks, and Talks to Mothers, 2 p.m. to 4.30 p.m. Wednesday Sale of Dried Milk 9 a.m. to 10 a.m. Weighing of Children, 10 a.m. to 11 a.m. Children's clinic and Weighing Centre, 2 p.m. to 5 p.m. Clothing Club, 3 p.m. to 5 p.m. Thursday Sale of Dried Milk 9 a.m. to 10 a.m. Dental gas clinic, 11.30 a.m. alternate fortnights. Friday Sale of Dried Milk, 9 a.m. to 10 a.m. Weighing of Children, 9 a.m. to 11 a.m. Weighing Centre 2 p.m. to 5 p.m. Clothing Club 3 p.m. to 5 p.m. Saturday Sale of Dried Milk, 9 a.m. to 12 noon. Number of individual mothers, children and infants who have attended clinics and classes— Mothers, nursing 89 expectant 39 of children 1—5 years 48 Children 1—5 years 343 Infants under 1 year 408 Total number 927 Children's Clinic.—In 1925 the number of meetings was 102. The patients who attended were:—Children, 1—5 years, 330; infants under 1 year, 401; the attendances were, children 1—5 years, 2,537; infants, 2,374. Average attendances per clinic:—Children 24, infants 23. 11 Mothers Clinic.—In 1925 the number of meetings was 45; the patients were:- Nursing mothers 70, expectant mothers 31. The attendances were:—Nursing mothers 157, expectant mothers 58. Average attendances:—Nursing mothers 3—4, expectant mothers 1—2. Dental Clinic.—The number of clinics was 25. The patients were:—Nursing mothers 26, expectant mothers 6, mothers of children under 5 years, 16, children 1 to 5 years, 16. The attendances were:—Nursing mothers 44, expectant mothers 19, mothers of children under 5 years 65, children 16. Average attendance at a clinic 5—6. Ten mothers were fitted with dentures from this clinic. These were referred to the Charity Organisation Society, who arranged with the mothers for the reduced cost of the dentures and for weekly instalments to be paid. Grants were in some cases obtained from the Hospital Sunday Fund. Nitrous oxide gas, with or without oxygen, was given by the Assistant Medical Officer of Health to those requiring an anaesthetic for extractions. Fortnightly dental clinics were continued, the clinic being held at the Old Sessions House centre on alternate weeks. Patients were allowed to attend at either Centre. Home visits were paid by the Superintendent General visits 64, expectant mothers 73, dental cases 14. Sale of Dried Milk.—2,847 one-pound packets were sold in 1925 at cost price. The number of packets given free by order of the Maternity Committee 489, at part cost 52. Talks to Mothers.—The Assistant Medical Officer of Health gave short talks to mothers during the Sewing Classes. The subjects included breast and bottle feeding, weaning, diarrhoea, the care of teeth, ante-natal care, preparations for confinement, and the importance of clean milk. 12 Sewing Class.—In this class mothers were taught to knit or to sew garments for themselves or their children out of their own material or materials bought through the Centre at cost price. The number of sewing classes was 47, attendances 330. Average attendance 7. During the class, children and babies were looked after in the nursery. Attendances of children 480. Clothing Club.—This Club was held to sell woollen and other garments at cost price for the children of those mothers who attended the Centre. Mrs. Mason, the voluntary helper in charge of the club, attended the Centre twice a week, and it was through her efforts and the work of other helpers, particularly those of the League of Remembrance, that the club continued to be selfsupporting. In addition, there were 10 other ladies, voluntary helpers, whose assistance extended the work of the Centre. Advice and treatment were given at the clinics held at 162, Lever Street for the following conditions :— Babies under 1 year: General advice 594, general inspection 282, cough 253, constipation 135, diarrhoea 79, malnutrition 29, digestive disturbance 34, marasmus 34, impetigo 15, rash 44, hernia 20, prolapse of rectum 2, herpes 9, chicken pox 2, eczema 13, anaemia 13, ringworm 2, pemphigus 10, conjunctivitis 7, vulvitis 1, coryza 25, debility 6, nasal obstruction 7, whooping cough 2, intertrigo 11, blepharitis 3, diarrhoea and vomiting 2, thrush 18, cough and diarrhoea 7, naevus 3, pyrexia 1, otorrhoea 12, acute mammary abscess 1, impetigo and intertrigo 5, jaundice 1, adenitis 2, furunculosis 2. phimosis 2, broncho-pneumonia 1, stomatitis 4, dermatitis 1, umbilical sepsis 2, measles 1. The following recommendations to hospital were made:— For impetigo 3, marasmus 3, otorrhoea 8, nasal obstruction 1, haemoptisis 1, whooping cough 1, naevus 2, worms 1, abscess 1, adenitis 2, conjunctivitis 1, malnutrition 1, diarrhoea 1, phimosis 2, hernia 1, measles 1, enlarged tonsils 1. 13 Children aged 1 to 5 years: The following attendances were made:- For general advice 454, general inspection 27, cough 316, constipation 39, diarrhoea 57, anaemia 127, debility 66, malnutrition 106, blepharitis 15, eczema 23, ringworm 8, adenitis 21, digestive disturbance 11, bad teeth 5, pyrexia 3, abscess 4, otorrhoea 9, tuberculous peritonitis 4, broncho-pneumonia 4, herpes and rickets 2, marasmus 2, whooping cough 4, coryza 17, adenitis, impetigo, and otorrhoea 1, pneumonia 2, cough and diarrhoea 2, herpes 5, impetigo 41, enlarged tonsils and adenoids 15, worms 15, rickets 32, hernia 7, stomatitis and diarrhoea 2, phimosis 4, acute tonsilitis 2, rash 12, squint 1, conjunctivitis 10, stomatitis 5, chilblains 2, injury to foot 1, measles 1, club foot 1, stitch abscess 2, chicken pox 1, scarlet fever 1, melaena 1, burns 2, alopoecia 1, urticaria 4, rheumatism 1, injury to eye 1, thrush 3, dermatitis 3, pemphigus 6, diarrhoea and vomiting 5, septic toe 1, rhinorrhoea 3, furunculosis 2. The following recommendations to hospital were made:— Otorrhoea 3, rickets 10, pyrexia 1, adenitis 3, ringworm 1, pneumonia 2, enlarged tonsils 9, malnutrition 1, marasmus 1, whooping cough 3, chicken pox 2, phimosis 2, acute tonsilitis 1, squint 1, conjunctivitis 3, septic toe 1, injury to eye 1, hernia 2, rheumatism 1, diarrhoea and vomiting 2, melaena 1, abscess 1, scarlet fever 1, club foot 1, measles 1. Mothers, expectant: General advice 21, constipation 8, cough 4, dental caries 5, rheumatoid arthritis 3, cracked nipples 1, toxaemial dyspepsia 3, haemoptysis 1, varicose veins 3, pruritis 1, diarrhoea 2, neuralgia 1, anaemia 3, debility 2, albuminuria 1. The following recommendations to hospital were made:Nasal obstruction 1, dyspepsia 1, haemoptysis 1, varicose veins 1, albuminuria 1. Mothers, nursing: Iridocyclitis 2, abscess 2, anaemia 28, debility 29, general advice 27, menorrhagia 10, pleurisy 1, constipation 7, rheumatoid arthritis 2, dental caries 7, sacralgia 3, incomplete abortion 2, neuralgia 4, 14 nervous debility 4, albuminuria 6, dyspepsia 4, mitral regurgitation 2, stomatitis 4, acute mammary abscess 1, cough 2, renal colic 1, abortion 1, conjunctivitis 1, diarrhoea 1, urticaria 1, rheumatism 1, septic finger 1, menopause 1, haemorrhoids 1, mystitis 1. The following recommendations to hospital were made:— Iridocyclitis 1, abscess 2, menorrhagia 4, pleurisy 1, albuminuria 2, mit al regurgitation 1, incomplete abortion 2, dyspepsia 1, renal colic 1, cough 1, rheumatism 1, menopause 1, haemorrhoids 1. South Clerkenwell Centre, Old Sessions House, Clerkenwell Green. The work and classes held at this Centre during 1925 were as follows:— Monday Sale of Dried Milk 9 a.m. to 10 a.m. Dental Clinic, 2 p.m. to 3 p.m., in alternate weeks. Tuesday Mothers' Clinic, 10 a.m. to 12 noon. Sewing and Cookery Class, Talks to Mothers and Clothing Club, 2.30 p.m. to 4.30 p.m. Thursday Dental Clinic, 11 a.m. to 12 noon. Children's Clinic, Weighing Centre, Clothing Club and Mothers' Holiday Fund, 2 p.m. to 5 p.m. Friday Sale of Dried Milk 9 a.m. to 12 noon. Saturday Sale of Dried Milk 10 a.m. to 12 noon. Numbers of individual mothers, children and infants who have attended clinics and classes:— Mothers, nursing 45 expectant 20 of children 1—5 years 15 Children 1—5 years 95 Infants 203 Total number 378 15 Children's Clinic.—In 1925 the number of meetings was 53, The patients who attended were:—Children 1—5 years 95, infants under 1 year 203. The attendances were:—Children 1 to 5 years 1,099, infants under 1 year 1,652. Average attendances per clinic: Children 20, infants 31. Mothers' Clinic.—In 1925 the number of clinics held was 51. The number of patients was 46—post-natal 28, expectant mothers 18. Attendances at these clinics numbered 121—post-natal 77, expectant 44. Dental Clinic.—The number of clinics was 38. The patients were:—Nursing mothers 31, expectant mothers 12, mothers of children 1—5 years 26, children from 1 to 5 years 17. The attendances were:—Nursing mothers 83, expectant mothers 24, mothers of children 1 to 5 years 87, children 23. Average attendance at a clinic 6. Six mothers were fitted with dentures at the clinic. These were referred to the Charity Organisation Society, who in two cases enabled the grant of dentures free and in four cases arranged with the mothers for the payment of part cost of the dentures. Nitrous oxide gas, with or without oxygen, was given by the Assistant Medical Officer of Health to those requiring an anaesthetic for extractions. The dental clinic was held fortnightly. The clinic was held at 162, Lever Street, on alternate weeks. Patients were allowed to attend at either centre. Home visits were paid by the Superintendent:—General visits 66, expectant mothers 115, and in connection with the dental clinic 4 visits. Dinners were served to twelve mothers, who made a total of 642 attendances. Sale of Dried Milk.—1,551 one-pound packets were sold in 1925 at cost price. The number of packets given free by order of the Maternity Committee was 634; 56 were supplied at part cost. 16 Sewing Class.—Mothers were taught at the sewing class to knit and to make garments for themselves, their husbands, or their children, and special instructions were given as to outfits for expectant mothers. Some provided their own material and to others material was supplied at cost price through the Centre. 51 Classes were held, and these were attended by 34 mothers; these made in all 566 attendances. The attendances of children in the nursery on these occasions numbered 664. Clothing Club.—This club was held to sell woollen and other garments at a reduced cost for the babies and children of those mothers who attended the Centre. Advice and treatment were given at the clinics held at the Old Sessions House, Clerkenwell Green, for the following conditions : Babies under 1 year of age: Cough 132, constipation 90, general advice 347, general inspection 151, coryza 30, diarrhoea 33, marasmus 22, anaemia 3, digestive disturbance 34, malnutrition 19, rupture 3, hydrocephalus 1, phimosis 3, conjunctivitis 4, herpes 1, constipation and naevus 5, venereal disease 4, cough and otorrhoea 2, constipation and rupture 2, diarrhoea and vomiting 3, rash 11, impetigo 2, pemphigus 2, otorrhoea 3, intertrigo 1, broncho pneumonia 1. The following recommendations to hospital or private doctor were made:— Marasmus 2, phimosis 2, naevus 2, rupture 1, otorrhoea 4, digestive disturbance 1, venereal disease 1, broncho pneumonia 1. Children aged 1 to 5 years: General advice 235, general inspection 17, cough 94, marasmus 9, diarrhoea 21, injured arm 2, rash 3, constipation 26, enuresis 3, digestive disturbance 11, anaemia 24, debility 17, eczema 12, coryza 17, adenitis 6, malnutrition 24, otorrhoea 15, worms 7, impetigo 5, conjunctivitis 5, enlarged tonsils 5, pemphigus 3, whooping cough 2, dental caries 3, pruritis 1, rickets 2, burn 4, urticaria 1, genu varus 2, abscess 2, chicken pox 1, stomatitis 2, phimosis 2. 17 The following recommendations to hospital were made:— Otorrhoea 7, injured arm 1, enlarged tonsils 3, whooping cough 1, adenitis 1, genu varus 2, abscess 1, chicken pox 1, burn 1, phimosis 1, rickets 1. Mothers, expectant: Constipation 22, anaemia 7, dental caries 4, general advice 23, sacralgia 2, dyspepsia 12, varicose veins 3, cough 1. Recommended for hospital treatment:— Anaema 2. Mothers, nursing: Anaemia 14, constipation 9, tonsilitis 1, general advice 21, cough 3, debility 23, menorrhagia 3, coryza 1, mastitis 6, dyspepsia 3, rash 1, cracked nipples 1, furunculosis 2. Recommended for hospital treatment for menorrhagia 2. HEALTH VISITATION. The number of visits paid by the Health Visitors in 1925 was as follows:— District. First Births. Total Births. Total Visits. No. 1 144 621 4,528 No. 2 102 576 2,776 No. 3 94 547 3,936 Totals 340 1,744 11,240 The numbers for 1924 were 328 first births, 1,585 total births, and 10,589 visits. In 1925 the total number of Finsbury births notified was 1,778, so that the figures in the preceding table show that during 1925 practically every birth that occurred in the Borough came under the supervision of the Public Health Staff. The number of twins born and visited was 23 sets, or one set of twins for every 77 births notified. 18 Weighing Centres: There are two municipal weighing centres in Finsbury, held at the following places:— 162, Lever Street.—Wednesday, at 10 a.m. and at 2 p.m.; Friday, at 9 a.m. and at 2 p.m. Old Sessions House, Clerkenwell Green.—Thursday, at 2 p.m. A summary of the meetings held in 1925 is appended:— Centre. No. of Meetings. Attendances. Average Attendance. No. of Babies and Children up to 6 years. Lever Street 102 4,911 48 731 Old Sessions House 53 2,751 52 298 Total 155 7,662 100 1,029 The number of new babies brought during the year was 439. Of these, 349 were solely breast fed, 34 were bottle fed, and 56 breast fed and bottle fed, when they were brought to the Centres. The average gain in weight per week while under observation was 4 4 ounces. The highest weekly average gain was 6 4 ounces. On their first visits 361 babies were fat and plump, 74 were thin, while 4 were wasting. Only 20 per cent. were brought while they were still under the age of 1 month. 66 per cent. attended under three months. The number of premature babies kept under supervision was 31. The weights of the children at birth are not always known or recorded by the parents. As far as they are known they are given in the following table:— 19 Weights at Birth District No. 1 District No. 2 District No. 3 Totals Under 4 lbs 0 2 4 6 4—5 lbs 3 6 9 18 5—6 lbs 20 30 16 66 6—7 lbs 91 175 58 324 7—8 lbs 221 181 150 552 8—9 lbs 146 67 171 384 9—10 lbs 56 40 74 170 10—11 lbs 17 3 32 52 11—12 lbs 2 0 4 6 Over 12 lbs 0 0 0 0 Totals 556 504 518 1,578 The fathers were mainly of the working class, and chiefly labourers, porters, carmen, printers, packers, fitters, street hawkers, motor drivers, newsvendors, warehousemen and postal employees. MILK AND/OR DINNERS FOR MOTHERS AND MILK FOR CHILDREN. The Council makes grants of milk and/or dinners to nursing and expectant mothers, and grants of milk to babies under 1 year and children from 1 to 5 years of age. The grants are given free or at a reduced cost in conformity with a scale of income agreed to by the Borough Council and approved by the Ministry of Health already reported. The Borough Council reserves the right in particular circumstances to vary this scale in favour of the applicant, subject to every case of alteration being specially sanctioned by the SubCommittee. Each applicant for a grant has to fill up a,nd sign a printed form of application. 20 The family is then visited by the Health Visitor or Maternity Superintendent, who, after full consideration of the home circumstances and condition of the mother and children, recommends a grant of milk and/or dinners. Thereafter the Medical Officer of Health immediately reviews the whole case, increases the grant recommended, if need be, and an order is forthwith sent to the milkman or dinner centre, and information of the grant is sent to the applicant. Urgent cases are dealt with at once before enquiries are completed, and the grants are re-adjusted later when full information has been received. All grants are periodically reviewed by a Sub-Committee of the Borough Council, which sits for about one-and-a-half to two hours every alternate Monday afternoon. In this connection it is pleasing to record that a grant has never been refused to any necessitous mother or child. Generally speaking, grants to children between 1 and 5 years are only made in cases of illness, where a medical certificate is furnished. During the year 1925, 1,344 applications were received, an average of 112 per month. 540 families received grants in respect of these applications; the largest proportion of applications was made during the March quarter, 1925. Many applications related to both mother and child, and in respect of 1,320 applications 1,726 grants were made. Twenty-four applications were refused for various reasons, for example : Income beyond scale approved by the Council, mother not expectant within the prescribed period of three months, child over five years of age. The grants comprised milk 30,294 pints, dinners 7,511 and dried milk 1,215 pounds. The majority of grants were free of cost to the applicant. In some cases the applicants paid half the cost of the grant. The net cost to the Council for the grants of milk, dinners and dried milk was £721 l1s. 11d. The Ministry of Health refunds one half of the approved net expenditure in this connection. 21 Of the 540 families who received grants 304 were in receipt of unemployment benefit; 189 were in receipt of poor law relief; 119 were in receipt of both unemployment benefit and poor law relief whilst receiving grants from the Council. 400 of the applicants were Ex-Service men. 59 of the fathers were stated to be "chronicout-of-works." In 81 cases "large families" were reported, that is families with six or more children. 119 of the applicants were regularly employed, and 313 irregularly employed. 16 applicants were in the employ (casual) of the Finsbury Borough Council. Grants were made in respect of 16 illegitimate children. In 21 cases the man and wife were living apart. 5 widows applied for, and received, grants. Of the total 540 families dealt with, 227 lived in one-roomed tenements, 237 in two roomed tenements, and 76 in three-roomed tenements. The rents for unfurnished rooms were as follows :— For one room from 2/6 to 7s. weekly. For two rooms from 3s. to 10s. 6d. weekly. For three rooms from 7s. 4d. to 12s. 3d. weekly. The rents for furnished rooms were :—For one room from 12s. to 14s. weekly. For two rooms from 14s. to 16s. weekly. For three rooms from 14s. to £1 weekly. The following cases illustrate the difficulties which poor parents in receipt of grants have to contend with, and the fact that though they can barely support their children when they first apply, yet additional children continue to be born and make the circumstances of the families harder and almost intolerable. 1. The first application for a grant was made in January, 1922. The family consisted of the parents and four children—12, 9, 7, 1, years. They rented 3 rooms at 9s. 10d. a week. The father was out of work and drew sick pay. In January, 1923, the father was out of work and made a second application. There was now another child. Five grants were made in 1923. In January, 1924, the father was out of work and made a third application. Four grants were made. In January, 1925, the father who had been employed for a short time as a motor finisher made another application. He was now out of work. His wife was expecting another child. Grants were made continuously through 1925. The father died in 22 July, 1925, leaving a wife and six children dependent on the Guardians. The mother endeavoured to raise a little money by pawning her sewing machine. This was redeemed by the Charity Organisation Society. The total cost of the grants was £13 odd. 2. The first application was made in February, 1921. The mother was then expectant and occupied one room at a weekly rent of 3s. 9d. The father was in a military prison for desertion. The second application was made in August, 1922. The third application was in May, 1923. The family now consisted of the parents and two children. The father was out of work. The fourth application was in October, 1925. The mother was now expectant. The father worked as a shoe repairer at 25s. per week. The total cost of the grants was a little over £9. 3. The first application was made in September, 1920. The family consisted of the parents and three children—6, 3, years, and 5 months respectively. The father was a casual labourer out of work and unable to work through illness. They occupied two rooms at a weekly rent of 8s. The father received unemployment benefit of 15s. per week and 10s. weekly poor law relief. From the first this case appeared to be one to be dealt with adequately only by the poor lawGuardians and the father was so informed. However, he made his second application for a grant in February, 1921, and his third application in October, 1924. By this time the father was again out of work and receiving the "dole" and poor law relief. A fourth child was born in March, 1925. Grants were made almost continuously through 1925. The total cost of the grants was nearly £14. 4. The first application was made in February, 1921. The family consisted of the parents and six children whose ages ranged from 3 months to 9 years. The father was a van washer earning 65s. per week. He gave his wife 50s. weekly. They occupied two rooms at a weekly rental of 9s. 5d. Thereafter applications and grants were made every year. A sixth child was born in 1922. The mother became expectant in 1925. The father was out of work in 1922, 1923, 1925. The total cost of the grants was about £9. 5. The first application was made in January, 1923. The family consisted of the parents and one child 15 months old. They 23 occupied one room at a weekly rental of 5s. 9d. The income of the family was given as " The Dole " 21s. and a grocery ticket from the Guardians value 5s. The father was out of work. A second child was born in November, 1923. In 1923 and 1924, twenty-two grants were made of the value of £15 5s. 0d. A second and third application were made in 1925. Another child was born in November, 1925. 6. The first application was made in October, 1922. The family consisted of the parents, one of the mother's children by a former marriage, one illegitimate child, and 5 of the father's children by a former marriage. The ages of the 7 children ranged from 2 years to 16 years. The father was employed at a railway at a weekly wage of 58s. The mother had a "permanent" tracheotomy tube in her throat. Many grants were made in 1922, 1923 and 1925. This family later adopted another little girl aged 2 years, who had apparently been abandoned by its mother, and a grant of milk was subsequently applied for and granted in respect of this last child. 7. The first application was made in June, 1923. The family consisted of the parents only, who received poor law relief. The mother was expectant. The first child was born in November, 1923. A second child was born in March, 1925. Grants were made almost continuously in respect of these children at a cost of nearly £25. The father was out of work nearly the whole of this period. They occupied one room at a weekly rental of 4s. 8d. 8. The first application was made in February, 1922. The family consisted of the parents and 6 children with ages ranging from 5 weeks to 8 years. They occupied two rooms at a weekly rental of 10s. The weekly income was stated to be 50s. Frequent grants were made up to 1924. A seventh child was born in May, 1923, and an additional child in January, 1925. By this time the father was out of work and in casual employment only. He was said to have been dismissed for assaulting a fellow worker. He had been taken back on account of his large family but was again dismissed for bad time keeping due to an alleged fictitious illness. His employers stated that "he does not intend to work as he is better off, we understand, while unemployed, having a disability allowance, drawing unemployment dole and also having an allowance from the Guardians." 24 The above examples are quoted to show the difficulties and difficult cases which are considered by the Maternity and Child Welfare Sub-Committee. It will be seen that some of the difficulties are, in part, due to the improvidence and lack of restraint on the part of the parents. However, the sympathy of the Sub-Committee does not falter. To this committee the health and nourishment of the baby or babies are paramount. The father may be a ne'er-dowell, the mother may even be of reputed loose character, the father may be on strike, the mother may have an illegitimate child, all these things may be brought before the committee in passing and may be considered by them, but the chief concern of the SubCommittee is to see and to be sure that the baby does not suffer for its parents sins or omissions. It is not the baby who is on strike, it is not the the baby who is a waster ; let the baby have its grant of milk. The baby did not choose its parents, and is not responsible for its parents—the baby is not to blame. Give the baby its milk just the same. That, put in a nutshell, is the attitude and decision of the Maternity and Child Welfare Sub-Committee to whom these applications for grants are referred. Hospital Treatment.—The Borough Council renewed their agreement with the governing body of the Infants' Hospital, Vincent Square, Westminster, S.W.I, from 1st October, 1925, for the retention of cots for use when required for the reception and treatment of ailing Finsbury children up to the age of 5 years. The number of cots retained was increased from two to three. The Borough Council pays £75 per annum retaining fee, and £2 per week per cot when occupied, by cases sent in under the agreement. The new agreement terminates on the 1st October, 1926. The cots have been occupied in 1925 by 18 ailing babies. Puerperal Fever.—In 1925 there were 8 notifications, with 1 death. The statistics for previous years are appended:— Years. 1912-17 1918 1919 1920 1921 1922 1923 1924 1925 Totals Notifications 53 1 6 5 6 7 13 7 8 106 Deaths 24 0 3 9 1 4 1 1 1 40 25 The cases of puerperal fever are investigated by the Maternity Superintendents. The premises are visited, the sanitary defects ascertained, and made the subject of notice for amendment. The rooms are disinfected. Ophthalmia Neonatorum.—Sixteen cases were notified in 1925. The children were all visited from the Public Health Department and the mothers were shown how to carry out the treatment advised by the doctors. Two of the patients were sent into hospital and 5 attended Moorfields Eye Hospital as out-patients. In no case was impairment of vision reported. DEATHS AND DEATH RATES. The number of Finsbury residents who died in 1925 was 1,055; equivalent to a death rate tor the whole Borough of 13 6 per 1,000 inhabitants living. The death rate for the whole of London was 11.7 per 1,000. The death rates for previous years are given in the attached table. Death Rates, 1912-1925. Year. The Borough. Clerkenwell. St. Luke's St. Sepulchre. 1912 18.5 18.0 19.1 28.3 1913 18.4 18.0 19.0 38.1 1914 19.6 18.7 21.8 16.3 1915 21.5 20.7 25.5 16.3 1916 19.3 19.2 20.3 8.4 1917 20.4 20.0 21.9 10.6 1918 23.7 24.3 22.9 17.4 1919 15.4 15.8 15.2 9.0 1920 14.7 14.5 15.4 9.2 1921 14.7 14.4 15.4 10.6 1922 16.3 15.9 16.6 23.7 1923 13.0 13.1 12.9 12.7 1924 14.1 14.3 13.6 19.1 1925 13.6 13.3 14.1 16.3 26 The Finsbury deaths were apportioned as follows:—Clerkenwell 682, St Luke's 355, St. Sepulchre 18 deaths. The comparison of Finsbury with the rest of the country may be seen below:— Death Rates for 1925. England and Wales 12.2 London 11.7 Finsbury 13.6 105 great towns 12.2 157 smaller towns 11.2 Inquests.—During the past year 117 inquests were held in the Borough of which 6 were on the bodies of non-residents who died suddenly in the district. Twenty-three were on children under 5 years of age, and 94 on adults and children over 5 years of age. Amongst the causes of death were the following:— Accidental burns 5, accidental falls 12, accidental suffocation by food in the windpipe 1, accidental scalds 2, drowning 3, overlying 2, run over by horse and van 1, run over by motor vehicle 11, suicide 14, accidentally caught in engine shafting 1. 27 INFANT MORTALITY. The infant mortality of the Borough for 1925 is 59'8. Expressed in popular manner, this means that out of every 1,000 children born during the year 60 died before reaching their first birthday. The corresponding figures for previous years are annexed :— Year. Corrected Births. Corrected Deaths. Infant Mortality. 1901 3,254 533 163 1902 3,191 558 174 1903 3,162 503 159 1904 3,095 522 168 1905 2,886 429 148 1906 3,012 474 157 1907 2,884 368 127 1908 2,916 400 137 1909 2,837 366 128 1910 2,813 342 121 1911 2,676 411 154 1912 2,579 290 112 1913 2,494 348 139 1914 2,558 304 118 1915 2,192 281 128 1916 1,926 240 124 1917 1,572 187 118 1918 1,275 141 110 1919 1,582 140 89 1920 2,540 188 74 1921 1,973 181 92 1922 1,934 158 82 1923 1,844 112 60.7 1924 1,662 125 76 1925 1,754 105 59.8 28 From time to time questions are asked in Council which bear upon the evaluation of the Infant Mortality over the short intervals between successive Committee meetings ; these intervals may be of 4, 5, or 6 weeks duration. The calculation of the infant Mortality figure over short periods, say a month, five weeks, or three months gives very fallacious results. It will be noted that in the definition of the infant mortality figure, the births are counted for one year, and the deaths are of children up to one year ; the periods in both are the same—to wit, one year. In estimating the infant mortality say for four weeks, the births cover a period of four weeks, but the infant deaths during that month may be of children 6 weeks, 4 months or even 11 months of age. Here it will be noticed that while the births cover 4 weeks, the deaths may cover a duration of 51 or 52 weeks. Two courses are open, under the circumstances :— (a) To count, in the case under review, only those deaths of children up to 4 weeks of age, and estimate the infant mortality on the births during 4 weeks, and the deaths of children up to 4 weeks of age during the same period. It may and does happen that the deaths of children up to 4 weeks of age may be absent or very few, whereas the deaths of older children may be many. So that on this basis, the current monthly infant mortality might be constantly small and the annual infant mortality quite large. The possibility of this discrepancy shows that this basis is fallacious. (b) To include all the births and all the infant deaths for a year up to the end of the period being considered, and to give the infant mortality figure for the twelve months thus brought in. This is the method now adopted and gives fairly accurate results. The following table compares Finsbury with London and England and Wales generally:— 29 England and Wales 75 Whole of London 67 Finsbury 598 Great towns 79 Smaller towns 74 Amongst the 29 Metropolitan cities and boroughs only 6 have an infant mortality lower than Finsbury; those with lower rates of infant mortality were Hampstead, Lambeth, Battersea, Wandsworth, Lewisham and Woolwich. In respect of its own figures, therefore, Finsbury has established a first-class record for 1925. The deaths of infants allocated to the various diseases are given in the following table, which contains the records for previous years:— Infant Deaths, 1911-26. Disease. 19)1-20 1921 1922 1923 1924 1925 Total Measles 187 1 1 0 11 4 154 Diphtheria 14 2 3 2 1 1 23 Scarlet Fever 3 1 0 0 0 0 4 Whooping Cough 87 6 7 3 8 4 115 Gastritis 7 0 0 0 0 0 7 Diarrhoea and Enteritis 469 34 5 23 12 20 563 Premature Birth 446 44 50 28 30 14 612 Congenital Defects 20 13 7 1 1 1 43 Marasmus 170 5 10 2 6 4 197 Tuberculous Meningitis 40 0 9 0 0 0 42 Other Tuberculous Diseases 38 2 1 1 1 1 44 Erysipelas 4 0 0 1 0 0 5 Syphilis 53 2 4 0 2 1 62 Convulsions 71 3 5 1 3 2 85 Bronchitis 146 6 8 6 8 7 181 Pneumonia 394 35 36 25 28 23 541 Overlying 103 4 3 0 2 2 114 Other Causes 328 23 16 19 12 21 419 Totals 2,530 181 158 112 125 105 3,211 30 During the same period the births have numbered 30,561 and the resulting average infant mortality for the last 15 years has been 105 per 1,000 births. The infant deaths in 1925 were chiefly in the following streets: Southampton Street (2), Wynyatt Street (2), Berkeley Court (2), Sekforde Street (2), Rosoman Street (2), Coldbath Buildings (3), Muriel Street (2), Godson Street (2), White Lion Street (2), Northampton Buildings (4), Risinghill Street (2), Busaco Street (3), Donegal Street (4). Lever Street (10) Seward Street (3), Guest Street (2), Gee Street (3), Bastwick Street (4), Sydney Street (2), Langton Avenue (2), Helmet Row (2), Ironmonger Street (3), Elizabeth Place (2), City Road (4). In 1925 the infant deaths were in Clerkenwell 61, in St. Luke's 42, and in St Sepulchre, 2 deaths. Infant Mortality by Districts.—The infant mortality rates for the period 1909—1925 arranged according to districts are given in the subjoined table. Infant Mortality, 1909-25. Year. The Borough Clerkenwell. St. Lukes. St. Sepulchre 1909 128 135 130 300 1910 121 122 120 71 1911 154 145 169 181 1912 112 110 111 210 1913 139 135 146 200 1914 118 112 131 121 1915 128 118 144 111 1916 124 127 120 62 1917 118 116 138 0 1918 110 119 95 111 1919 89 90 84 166 1920 74 70 82 105 1921 92 93 90 83 1922 82 85 75 154 1923 61 58 66 0 1924 75 72 79 153 1925 59.8 55.2 66.6 105.3 31 TUBERCULOSIS (All Forms). Tuberculosis.—The voluntary notification of pulmonary tuberculosis and of tuberculosis of other parts of the body associated with discharges was adopted by the Finsbury Borough Council in 1900. Now by the Public Health (Tuberculosis) Regulations 1912 all forms of tuberculosis are compulsorily notifiable from and after the 1st February, 1913. The following information is of interest as throwing some light on the approximate duration of cases of tuberculosis after notification:— 1920 1921 1922 1923 1924 1925 Number of deaths from Tuberculosis 132 131 121 103 106 126 Number of cases notified only at death 1 40 11 *3 †10 §6 Number of cases dying non-notified 18 20 ‡17 Number of cases notified within a month of death 12 7 13 11 7 14 Number of cases notified within 1 to 3 months of death 12 15 5 11 12 12 Number of cases notified within 3 to 6 months of death 8 21 12 6 6 12 * Fourteen of these cases died in a poor-law institution or a hospital. † Twenty-three of these cases died in a poor-law institution or a hospital ‡ Twelve of these cases died in a poor-law institution or a hospital. § Five of these cases died in a poor-law institution or a hospital. 32 Tuberculosis of the Lungs.—The notifications and deaths of Finsbury cases of Phthisis since 1901 are appended:— Phthisis Notifications and Deaths, 1901 1925. Total No. of Primary Notifications. No. of Cases notified per 10,000 of inhabitants. Total No of Deaths. Death Rate per 1,000. 1901 70 6.9 216 2.13 1902 121 12.1 240 2.40 1903 219 22.2 223 2.22 1904 210 21.6 251 2.54 1905 178 18.5 215 2.24 1906 217 22.9 232 2.45 1907 217 23.2 243 2.60 1908 220 23.9 221 2.40 1909 359 39.7 228 2.52 1910 319 35.8 166 1.86 1911 419 47.8 159 1.81 1912 438 49.6 160 1.81 1913 421 49.7 151 1.78 1914 382 l45.9 151 1.78 1915 315 40.9 153 1.95 1916 272 33.6 150 2.02 1917 306 44.9 165 2.42 1918 257 38.6 152 2.28 1919 265 33.8 114 1.51 1920 201 25.6 106 1.35 1921 213 27.7 1l6 1.51 1922 140 l8.2 102 1.33 1923 150 19.4 90 1.16 1924 144 18.6 95 1.23 1925 202 26.0 111 1.43 33 The actual number of notifications received in 1925 was 334, but of these many refer to the same patient. There were 202 primary notifications, of which 42 were from poor law sources, 101 from hospitals and dispensaries, 55 from private doctors, and 4 from Army sources. In reference to the poor law cases there were also received 58 re-notifications and notices of admission and discharge. 115 gave a Clerkenwell address, 87 lived in St. Luke's, none lived in St. Sepulchre. How many of the whole number are Finsbury Cases— 1. Finsbury cases by residence and infection 128 2. Finsbury cases by infection 13 3. Finsbury cases by residence only 5 4. Not Finsbury cases 20 5. Not ascertainable 36 202 The cases which may be definitely associated with the borough are the first two groups, and amount to 141, that is 70 per cent. of the whole number. Distribution by Streets.—The largest numbers were notified from the following places:—Old Street 18, Cumming Street 7, Rosoman Street 8, Lever Street 6, Farringdon Road 6, Margaret Street 4, Wynford Road 5, Gee Street 5, Seward Street 3, St. John Street 3, Little Sutton Street 3, Wharton Street 3, Southampton Street 3, Corporation Row 3, Bastwick Street 4, Claremont Square 4, Buxton Street 2, Union Place (Glasshouse Yard) 2, New Charles Street 2, Amwell Street 2, King's Cross Road 2, Myddelton Square 2, Pentonville Road 2, Penton Place 2, Risingbill Street 2, White Lion Street 2, Rosebery Avenue 2. Tysoe Street 2, Gt. Bath Street 2, Central Street 2, Norman Street 2, Radnor Street 2, Galway Street 2, Leage Street 3, Helmet Row 3, Dufferin Street 2, Roscoe Street 2, Macclesfield Street 2. The Homes and Tenements of the Patients.—Out of the whole number, excluding lodging houses, 41 were one-roomed tenements, that is to say, in these tenements the patient and family lived 34 and slept in one room only. Fifty-three were two-roomed tenements, seventy-eight had three to eight rooms, eight were notified from institutions, and their families had left the addresses given, one requested that he should not be visited, three were not traceable and eighteen were inmates of common lodging houses. Thirteen of the tenements were overcrowded. Eight tenements had only one cupboard each for food. One had no cupboard accommodation at all. These are very unsatisfactory conditions for a phthisical household. When the household utensils of the patient are kept in the same cupboard as the other household utensils; when his clothes are hung on the common peg ; when he uses the common towel and washing basin, the common knives, forks, spoons, cups, saucers and glasses, when the utensils of the household are all washed together indiscriminately, the spread of infection from the patient to his family is greatly favoured. When in addition to these, the tenement is overcrowded, the conditions for promoting the disease are as pernicious as they possibly can be. It is difficult to conceive a condition which favours the spread of the infection more than overcrowding. In phthisical families, the abatement of overcrowding is insisted upon forthwith. Thirty tenements were on the list of houses let in lodgings, 30 tenements were in the so-called '* model " buildings, which, with their common landings and their many points of contact between the families who occupy them, are only too well adapted for the spread of phthisis. Homework was not carried on in the home of any case notified. Of the houses occupied by the patients, six were used for the sale or preparation of food products. It is very unfortunate and most undesirable that these consumptive patients should have to do with the handling or 35 ture of articles for human consumption. There is not, however, at present, any practical method of preventing or otherwise satisfactorily dealing with their employment in such occupations. A sanitary survey was made of every tenement, and the nuisances found were made the subject of subsequent notice and amendment. The following defects were ascertained:—Rooms dirty 15, drain choked 2, water closet without water supply 2, roof leaky 4, water closet pan leaky 1, window sashcords broken 5, dustbin broken 3, rain water pipe broken 1, and minor structural defects 4. The patient's bedroom.—The number of beds in the patient's bedroom, the number of persons occupying the patient's bedroom, and the number of families affected are given in the attached table:— Persons and Beds in the Patients' Bedrooms. One Bed. Two Beds Three Beds. Persons. Families. Persons Families. Persons Families. 1 55 1 0 1 0 2 61 2 9 2 0 3 12 3 14 3 2 4 0 4 7 4 2 5 0 5 2 5 1 6 0 6 0 6 1 7 0 7 1 7 0 One bedroom contained four beds, but two persons only regularly used it. Eighteen patients gave common lodging house addresses. Only 55 patients out of 167 living in private houses were able to have a bed and bedroom all to themselves. In the 73 other households, where only one bed was available, 85 persons slept in the same bed with the consumptives, and were 36 consequently exposed to infection. This number refers to those families which only possessed one bed. In addition to these there were 1)1 persons who occupied the same bedroom as a phthisical patient, and in some instances the same bed. Two bedrooms were dark, or had insufficient light. The ventilation was insufficient in 31 other bedrooms, and 11 bedrooms were stuffy. The defective ventilation and absence of ventilation greatly facilitates the spread of the disease. It is difficult sometimes to suggest means by which it may be overcome—occasionally owners have been induced to place gratings in the walls. Unfortunately, even when they have been provided, the occupants have been known to stuff the aperture with rags, and thus render these gratings useless. All the bedrooms occupied by consumptives had fireplaces save one. It is extremely important that every room used for human habitation should have a fireplace or means of communication with the outer air in addition to the window frame. 4 bedrooms had dirty walls and ceilings; 4 were verminous. In 23 instances the patients were said to be of careless habits. The Kitchen.—In 100 instances or 50 per cent. of the whole number of cases, the kitchen was being used as a living room and a sleeping room. This is one index of poverty, and shows the difficulties of accommodation and the facilities for infection which accrue in these poor households. Sometimes the patient himself occupies the kitchen by day and night. 4 of the kitchens were dirty and one was also verminous. The presence of dirt and vermin may be taken to connote carelessness, and carelessness in the family of a consumptive means increased risk of infection for the rest of the family. Other Measures.—Enquiry is made in every infected household for missed or suspected cases of tuberculosis. Cases so found are urged to seek medical advice and treatment, and are informed where and how to obtain them. The free bacteriological examination of sputum is offered to all medical men who practise in the Borough. In 1925 the number of specimens examined was 175, of which 26 gave positive results, 37 Free systematic and periodic disinfection is offered after the notification of patients. In 1925 the rooms, bedding, feeding utensils, towels, handkerchiefs and linen were disinfected in 36 households. A special leaflet of instruction in disinfection is left in every home where a case of phthisis occurs and also after a death from phthisis, and its terms are explained. Sputum flasks are given free to poor patients, and sold at cost price to others. A disinfectant soap for cleansing purposes is given gratis to those who would like to scour out their rooms. Contacts.—The number of close contacts, that is, the number of persons of the same households as the consumptive patients was 555. The number of remote contacts, that is, the number of persons living in the same houses as the consumptive patients, but not being members of the consumptives' families, was 1,070. Deaths.—In 1924 the number of Finsbury persons who died of phthisis or pulmonary tuberculosis was 111. In addition to these, 8 died from tuberculous meningitis, and 7 from other forms of tuberculosis. The deaths from all forms of tuberculosis were 126. The deaths for previous years are given in the subjoined table:— 38 Phthisis Deaths and Death Rates, 1901—1925. Year. Finsbury Deaths from Phthisis. Finsbury Deaths from other forms of Tuberculosis. Phthisis Death Rates per 1,000 inhabitants. Finsbury. England and Wales. 1901 216 30 2.13 1.260 1902 240 23 2.40 1.230 1903 223 39 2.26 1.200 1904 251 67 2.58 1.230 1905 215 52 2.24 1.140 1906 232 48 2.45 1.150 1907 243 42 2.60 1.140 1908 221 39 2.40 1.115 1909 228 31 2.52 1.081 1910 166 31 1.86 1.015 1911 159 45 1.81 1.084 1912 l60 44 1.81 1.017 1913 151 63 1.78 1.004 1914 151 56 1.81 1.016 1915 153 63 1.95 1.185 1916 150 33 2.02 1.259 1917 165 40 2.42 1.406 1918 152 40 2.25 1.543 1919 114 15 1.51 .996 1920 106 26 1.35 .887 1921 116 18 1.51 .854 1922 102 19 1.33 .889 1923 90 13 1.16 .836 1924 95 11 1.23 .841 1925 111 15 1.43 .833 The Phthisis Death Rate for 1,000 inhabitants in London during 1925 was .95. 39 It is very probable, however, that this list does not contain all the deaths from phthisis which occur in Finsbury. Many are doubtless concealed on the death certificates, and wrongly entered, as due to pneumonia, bronchitis, chronic bronchitis, pleurisy, asthma or influenza. Allotted to districts: 72 deaths from phthisis belonged to Clerkenwell, 37 to St. Luke's, and 2 to St. Sepulchre. Of the whole of the 1,055 deaths in Finsbury in 1925, 10 52 per cent were due to phthisis, as against 8 9 per cent for 1923 and 8 7 per cent. for 1924. 75 per cent. of the total deaths due to phthisis took place between 25 and 65 years. Other forms of Tuberculosis.—The number of new cases notified was 22, derived from Clerkenwell 15, St. Luke's 7, and St. Sepulchre 0 cases. The parts chiefly affected were the peritoneum (3), spine (2), glands (2), meninges (3), skin (2) cases. 8 patients were bedridden at the time of notification. In these notification was a very late incident in the disease, 4 cases were infants under school age. 11 were examples of " open tuberculosis " associated with external discharges, and therefore presumably infectious to those brought into contact with the sufferers. 8 were school children. Of the whole number, 15 were considered to be Finsbury cases by residence and infection, 6 Finsbury cases by infection, and the remaining one was not a Finsbury case. One of the patients lived and slept with his family in one room. One of the tenements was overcrowded. The close contacts in the same families included 73 adults and children over school age, and 44 other children. The kitchen was used for sleeping purposes in 15 instances. In 5 cases the mother was the chief or only wage earner. The deaths included 8 from tuberculous meningitis (Clerkenwell 5, St. Luke's 3, St. Sepulchre 0) and 7 (Clerkenwell 5, St. Luke's 2, St. Sepulchre 0) from forms of tuberculosis other than phthisis. The Finsbury death rate from all forms of tuberculosis in 1925 was 162 per 1,000 ; the corresponding rate for England and Wales in 1925 was 104, and for London in 1925, was 1T2. Tuberculosis Dispensary.—A Tuberculosis Dispensary for Finsbury residents was established at the Royal Chest Hospital, 40 City Road, on December 1st, 1916. During 1925 new patients numbering 442 were examined; of these, 156 were under 15 years of age, the rest above that age. Those suffering from tuberculosis were 128 (74 insured and 52 not insured). The suspects were 28 (7 insured and 21 not insured). The total number of patients, new and old, who attended during the year was 841. The total attendances were 4,003. The visits to the homes of the patients were 3,403. These visits were nearly all made by the nurse attached to the dispensary. 177 persons were recommended by the Tuberculosis Officer for sanatorium or hospital treatment. In the great majority of these cases institutional treatment was given. The total number of contacts examined at the Tuberculosis Dispensary was 261, out of a possible 555. The number of " X ray examinations was 22. The number of sputum specimens examined by the hospital pathologist was 474. The Tuberculosis Officer made 266 visits to the homes of the patients. Under the scheme formulated by the Ministry of Health in Memorandum 30/T the Tuberculosis Officer furnished 321 reports to the Ministry of Pensions in respect of the examination of exservice men during 1925. The fees paid for this work are handed over by the Borough Council to the Tuberculosis Officer. INFECTIOUS DISEASE. Small Pox.—No case was notified during 1925. Cases were notified in other London boroughs, and the names and addresses of many persons living in Finsbury, and who had been in contact with persons suffering from small pox were notified to me. Each contact was kept under observation during the incubation period. Free supplies of calf lymph were maintained for use in emergency, and were distributed free to medical practitioners in Finsbury upon request, for use in the cases of persons who had been in close contact with small pox and persons closely associated with close contacts. Typhus Fever.—No case was notified in 1925. Cerebro Spinal Fever.—No case was notified in 1925. 41 Anthrax, Glanders and Hydrophobia.—No cases were notified during 1925. Encephalitis Lethargica.—Five cases were notified during 1925. One death was reported. Poliomyelitis and Polio Encephalitis.—2 cases of acute poliomyelitis were notified in 1925. There were no deaths. Measles.—735 cases of measles were notified during 1925. Measles has been compulsorily notifiable in Finsbury from 8th January, 1923 (except cases occurring within two months of any notified case in the same household) by order made by the Ministry of Health at the suggestion of the Borough Council. Comparative Table.—In 1925 measles caused 12 deaths (all of these were under 5 years) and whooping cough 15 deaths. These two diseases are extremely fatal to children under 5 years. Deaths in Children under 5 years, 1901-1925. Period. Measles. Whooping Cough. Small Pox. Scarlet Fever. Diphtheria. Typhoid Fever. 1901-5 278 211 13 53 80 — 1906-10 347 202 — 39 80 1 1911-15 366 169 — 27 48 — 1916 36 12 — 1 11 — 1917 117 10 — 2 7 — 1918 51 54 — 3 9 — 1919 9 — — — 11 — 1920 10 12 — 4 27 — 1921 3 13 — 6 22 — 1922 29 22 — 2 20 — 1923 10 7 — 2 8 — 1914 44 25 — 2 14 — 1925 12 15 — — 4 — Totals 1,312 752 13 141 341 1 42 From this table it appears that the deaths in 25 years due to scarlet fever, diphtheria, typhoid fever and small-pox, all taken together, numbered 496, to whooping cough 752, and measles 1,312. In children under 5 years therefore, it is seen that measles kills nearly three times the number of children whose deaths are caused by small pox, scarlet fever, diphtheria and typhoid fever all combined. Whooping cough causes nearly twice the number of deaths accredited to the other four named infectious diseases. Diphtheria.—The number of cases notified was 252, all except one of which were admitted to isolation hospital. Of these, 51 were subsequently sent home as not suffering from diphtheria, one case proved to be scarlet fever, 3 cases proved to be laryngitis, 15 cases were diagonised as tonsillitis, 1 conjunctivitis and impetigo, 1 headache, 1 Vincent's angina, 1 diphtheritic conjunctivitis, 1 acute pneumonia,and 27 were described as "not diphtheria," leaving 201 true cases of diphtheria. There were 6 deaths, so that 3 per cent. of all the patients died. The number of cases is 58 more than last year ; the number of deaths is 8 less than in 1924. The case treated at home was kept under observation ; suitable measures were adopted to secure isolation, and the premises were disinfected upon the recovery of the patient. 43 The particulars ot cases in previous years are appended: — Year. No. of Cases. No. of Deaths. Case Mortality. No of Deaths per 100 cases notified. No. of Casts per 10,000 of Population No. of Deaths per 10,000 of Population. 1911 159 17 10.7 181 1.9 1912 148 14 9.4 17.1 1.6 1913 91 9 9.8 10.7 1.06 1914 134 9 6.7 16.1. 1.08 1915 116 9 7.7 15.0 1.17 1916 162 14 8.6 21.8 1.88 1917 144 8 5.5 21.1 1.17 1918 110 10 9.1 16.5 1.50 1919 116 II 9.5 15.4 1.46 1920 215 27 12.5 27.4 3.45 1921 324 36 11.1 42.2 4.69 1922 352 31 8.8 45.8 4.03 1923 260 8 3.07 33.6 1.03 1924 163 14 8.6 21.1 1.81 1925 201 6 2.9 25.9 .77 All the cases were investigated, and the source, if possible, was ascertained. The premises were inspected, and notices were served for sanitary defects. The drains were carefully examined, and in nearly every case tested, 8 of the cases were contracted in hospital after the patients had been admitted suffering from diseases other than diphtheria. There was 1 "return" case. Cases Discharged cured from Hospitals.—A few days after their return home from fever hospitals, all patients are examined very carefully, and a record kept of their condition. A leaflet is given to the patients, its terms explained, and precautionary measures are advised. If a child has a discharge from the nose, or if for any other reason the infection is believed to persist, the mother is advised to take the child to her own doctor, or if poor, to bring it to the Public Health Department. 44 The cases discharged from hospital with nasal discharge, ear discharge or sore throat were, after their return home, examined by the Medical Officer of Health, and swabs taken from the throats and noses. 5 such cases occurred in 1925. 26 patients upon discharge had enlarged neck glands. Two patients had sores on the lips and face. Swabs are examined bacteriologically free of charge for medical men by the Public Health Department. In 1925, 647 specimens were submitted, with positive results in 96 instances. A supply of diptheria anti-toxin serum is kept at the Public Health Office, and is available gratis for doctors on request for the treatment of Finsbury patients prior to removal to hospital, or for patients treated at home. A fee of 2s. 6d. is paid for each case where the serum is injected between 9 a.m. and 9 p.m. A fee of 5s. per case is paid where the serum is injected after 9 p.m. and before 9 a.m. Scarlet Fever.—There were 283 notifications of scarlet fever in 1925. Of these 22 were subsequently sent home as not suffering from scarlet fever, leaving 261 true cases. There were no deaths. All the patients were treated in hospital, excepting one. The case treated at home was kept under observation, suitable measures were adopted to secure isolation and the premises were disinfected upon the recovery of the patient 45 The particulars of previous years are subjoined:— Year. No. of cases. No. of Deaths. Case Mortality. No, of Deaths per 100 cases No. of cases per 10,000 of Population. No. of Deaths per 10,000 of Population. 1911 171 6 3.5 19.5 .6 1912 159 5 3.15 18.4 .58 1913 251 5 1.93 2.6 .59 1914 438 6 1.36 52.6 .72 1915 390 10 2.56 50.7 1.30 1916 178 2 1.12 23.9 .26 1917 99 2 2.02 14.9 .29 1918 148 3 2.02 22.2 .45 1919 235 0 0.00 31.2 0.00 1920 418 4 0.96 53.4 .51 1921 586 6 1.02 76.4 .78 1922 335 4 1.19 43.6 .52 1923 165 2 1.21 21.3 .25 1924 189 2 1.05 24.4 .24 1925 261 0 0.00 33.6 0.00 Nine patients developed scarlet fever while they were detained in hospital for other causes. There were two "return cases." Nine cases were not discovered until some days after the rash had appeared. Four were then peeling. All the houses where cases occurred were visited and inspected. Nuisances that called for remedy were made the subject of notice and amendment. The rooms, the bedding and clothing, weredisinfected. Cases discharged for Home.—In Finsbury every case discharged from the fever hospital is visited soon after return home and carefully examined. The possibility of further infection is 46 explained to the mother, suitable measures suggested, and a leaflet of instruction left with her. Special attention is paid to children who develop a discharge from the nose or ears after their return home, to children with adenoids, to children with enlarged neck glands, and to children with sores on their lips, ears or on their faces. Thirty-nine such cases were kept under the observation of the Medical Officer for periods varying from one to four weeks before they were certified as being free from infection and fit to resume school attendance. Enteric Fever.—In 1925 the number of cases notified was 7, with 3 deaths. The numbers in previous years are given in the accompanying table:— Enteric Fever, 1911-1925. Year. No. of cases notified. No. of Deaths. Case Mortality No. of Deaths, per 100 cases. No. of Cases per 10,000 of Population. No. of Deaths per 10,000 of Population. 1911 74 9 12.2 8.4 1.02 1912 5 1 20.0 0.58 0.11 1913 15 0 0.0 1.7 0.0 1914 15 2 12.5 1.8 0.24 1915 3 1 33.3 0.39 0.13 1916 4 0 0.0 0.53 0.0 1917 2 1 50.0 0.29 0.14 1918 2 0 0.0 0.30 0.00 1919 7 0 0.0 0.93 0.00 1920 5 0 0.0 0.64 0.00 1921 5 0 0.0 0.65 0.00 1922 4 1 25.0 0.52 0.13 1923 2 0 0.0 0.26 0.0 1924 5 0 0.0 0.64 0.0 1925 7 3 42.8 0.90 0.39 Cases of typhoid fever, on their discharge from hospital, are visited and examined. A leaflet of instruction is left with them, 47 and special attention is directed to its more important clauses, which are orally explained at some length. The faeces and urine are examined bacteriologically only in those patients discharged for home where there is some evidence or suspicion which points to their acting as typhoid carriers. Diagnosis.—Specimens of blood from suspected cases of typhoid fever are examined free of charge for medical men by the Public Health Department. The examinations are conducted at the Royal Institute of Public Health, 37 Russell Square, London, W.C. Telephone address "Museum 0766" In 1925, 3 specimens of blood were received for diagnosis, one of these gave a positive result. Trench Fever, Dysentery, Malaria.—One case of dysentery was notified during 1925. Infectious Disease—Exclusion from School.—The London County Council has recently altered its rules for the exclusion from school of contacts with cases of scarlet fever, measles and German measles. The following regulations now obtain :— Scarlet Fever.—School children living in houses in which cases of scarlet fever have occurred are to be excluded from school for 7 days from the date of the disinfection of the premises. Measles and German Measles.—School children suffering from measles are to be excluded from school for 3 weeks from the date of the appearance of the rash. 48 HOUSING. Number of new houses erected during the year:— (a) Total 0 (b) With State assistance under the Housing Acts: (i) By the Local Authority 0 (ii) By other bodies or persons 0 1. Unfit dwelling-houses:— Inspection (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 41 (2) Number of dwelling-houses which were inspected and recorded under the Housing (inspection of District) Regulations, 1910, or the Housing Consolidated Regulations, 1925 ... 41 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 33 (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 0 2. Remedy of defects without Service of Formal Notices : Number of defective dwelling-houses rendered fit in consequence of informal action by the Local Authority or their officers 0 3. Action under Statutory Powers : (a) Proceedings under Section 3 of the Housing Act, 1925. (1) Number of dwelling-houses in respect of which notices were served requiring repairs Q 49 (2) Number of dwelling-houses which were rendered fit after service of formal notices:— (a) By Owners 0 (b) By Local Authority in default of Owners 0 (3) Number of dwelling-houses in respect of which closing orders became operative in pursuance of declaration by owners of intention to close 0 (b) Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 2341 (2) Number of dwelling-houses in which defects were remedied:— (a) By Owners 2341 (b) By Local Authority in default of Owners 0 (c) Proceedings under sections 11, 14 and 15 of the Housing Act, 1925:— (1) Number of representations made with a view to the making of closing orders 0 (2) Number of dwelling-houses in respect of which closing orders were made 0 (3) Number of dwelling-houses in respect of which closing orders were determined, the dwellinghouses having been rendered fit 0 (4) Number of dwelling-houses in respect of which demolition orders were made 0 (5) Number of dwelling-houses demolished in pursuance of demolition orders 0 Finsbury Housing Scheme.—The housing scheme of the Borough Council, referred to in the last annual report, was under consideration by the central authorities in 1925. Following 50 representations by the Ministry of Health, the scheme was re-cast and divided into two separate schemes, one, a housing and clearance scheme for the Mantell Street and Southampton Street areas, the other, a clearance scheme for Pump Court, White Horse Alley and Market Buildings. London County Council Houses:—The London County Council is at present erecting houses for London residents on its estates at Becontree and Downham. The Becontree scheme is a very extensive one and its houses touch the districts of Ilford, Chadwell Heath and Dagenham. The nearest railway stations are, for Becontree (Ilford Section) Chadwell Heath Station, London and North Eastern Railway; Becontree (Dagenham Section) Dagenham & Barking Stations, London Midland and Scottish Railway, and Barking Station, District Railway; Downham—Grove Park, Bellingham and Catford Stations, Southern Railwav. The inclusive rents of the various cottages and maisonettes, are as follows:— Ilford Section. Dagenham Section. Becontree Estate: s. d. S. d. 2 room maisonettes 11 3 10 0 3 room maisonettes 13 6 11 6 3 room cottages 16 6 13 0 4 room cottages 17 6 14 6 5 room cottages 20 0 17 6 6 room cottages 23 6 All rents are payable weekly in advance. 51 On its estates, the London County Council sets apart each year a certain small number of houses, to accommodate families in each metropolitan borough, subject to special housing hardships on the recommendation of the local medical officers of health. Such priority recommendations are successfully advanced, for example, where there is grave overcrowding, sex promiscuity, or where large families with many small children, or tuberculous members, live in dark, ill ventilated basements. Other examples include cases where the families are under notice to quit following a magistrate's order, or where the premises are being partly or completely demolished owing to their dangerous condition. Before priority claims are sent to the London County Council, the homes of the prospective tenants are visited by the district sanitary inspector and by the medical officer of health, and those cases selected where the tenants have clean, good homes, are not given to destroying or damaging their premises, are good neighbours, not quarrelsome and are able to afford the rents of the new houses, and the fares, where necessary, to proceed to and from their places of business. On the last head it is felt to be unkind to help persons to get a better home in the country and after removal for them to find that they are unable to pay the increased rents, the comparatively high fares and the other charges. The other enquiries, at the special request of the London County Council, are directed to the prevention of the establishment of slums in the new districts. Every application for priority is carefully and sympathetically considered, and the unsuccessful applications are again reconsidered as the number of applications gets less. Before the prospective tenants are finally accepted, they are visited by a special officer of the County Council. In 1925, applications were received in the Finsbury Public Health Department for preferential treatment on account of special alleged housing hardships from 103 families. Of these, 8 withdrew their applications before enquiry, chiefly because they had obtained accommodation elsewhere, 26 were deterred from proceeding further on account of the additional expense of travelling to and from their work. 32 families were not recommended for various reasons, e.g., because of their serious arrears of rent, dirty homes, quarrelsome or destructive proclivities. 52 The remaining 37 families were specially recommended to the London County Council for preferential treatment. Of this number, 5 families did not accept the accommodation offered to them, 8 families were rejected by the County Council as being unsuitable, 24 families were offered and accepted accommodation. Excerpts from the letters of application and in other instances the circumstances of the families are set out in detail hereunder. They show that the housing problem is as acute as ever and reveal the very distressing conditions under which some of the residents in Finsbury live. In the course of the investigations several interesting facts emerged : these are subjoined:— 1. The affection which many residents had for their squalid homes and the streets and neighbourhood where they lived. This was made manifest in the extreme reluctance with which they left for their new country homes and the oft expressed desire to return when the Borough Council had built the new houses in Mantell Street. One family removed to Becontree into an excellent cottage with 3 bedrooms, a box room, a living room, water-closet, bath room and separate scullery for 14s. 4d. per week, reduced later to 13s 8d. per week. The family consisted of the parents and 5 children. Later, the family returned to a 2-roomed tenement in Finsbury, giving as the reason that "they all felt so lonely in Becontree." 2. The frequency with which families living already under crowded conditions sublet parts of their holdings or took in lodgers even when these matters were expressly forbidden in the contract for letting. A man and his wife occupied a one-roomed tenement in a so-called model building of massed tenements. The wife's sister, within a few weeks of her confinement, and her unemployed husband had been ejected from their home for non-payment of rent and came to live with their relatives in the "models." There were now 2 families living in one room, the one openly, the other clandestinely. The second husband and wife used to come and go out of the "buildings" secretly and furtively after dark in order to avoid the scrutiny of the caretaker. 3. When families sublet a portion of their small crowded holding or take in lodgers, they nearly always desire to take their 53 tenants with them to the new home, despite the fact that sub-letting and lodgers are forbidden on the County Council housing estates. They therefore seek means of evading the restrictions and wrongly name their lodgers as members of the family. 4. The worst rent payers are often those families who have the largest incomes. These are also frequently the most thriftless and most careless. 5. The housing problem has its reflex in the moral degradation and the change for the worse in the habits and social amenities of those affected by the housing shortage. A family consisted of the parents and 5 children whose ages ranged from 8 weeks to 4 years. They occupied one very small back room and were very overcrowded. They were originally taken in by the owner temporarily until they could get better accommodation. This was found to be impossible. The owner wanted the room and cut off the gas and made things generally unpleasant. They had one double bed and a cot. There was no oven, and the fireplace was very small. The weekly income was 65s. The mother explained that since the family had had to live in one room, her husband had completely changed. He used to be a steady industrious sober man, he had been a "good" man, who stayed at home at night with the family. But now "since they had had to pig it in one room" he never came home until very late at night, often drunk, and used the most dreadful language. He had taken to excessive drinking to try and forget the awful conditions under which they were living. Illustrative cases. 1. The parents and seven children occupied one small top room at a weekly rent of 6s. They had lived here for 10 years. The room was much overcrowded. The children's ages ranged from 10 months to 14 years. The two youngest were twins. The father was an ex-service man and had been a war prisoner in Germany. He worked at Shepherds Bush. He found it impossible to accept a house at Becontree owing to the exigencies of his employment. 2. The parents and twelve children occupied 3 rooms at a weekly rental of l1s. 4d. They had lived here for 8 years. The 54 children's ages ranged from 3 months to 21 years. The income of the family was £13 l1s. Od. per week. They were in arrears with their rent and were spoken of as undesirable tenants. 3. The mother and six children occupied 2 rooms at a weekly rental of 10s. 11d. They had lived here for 6 years. The children's ages ranged from 12 to 24 years. The income of the family was said to be £8 per week. During the investigation it was discovered that a married daughter and her two children aged 3 years and 1 year also lived with the family. 4. A letter of application from Tottenham: "I was reading about the flats in Finsbury which are going to be built and I should very much like to return to the neighbourhood again I am asking you to put my name down as we were the Tenants that were forced to come to Tottenham on the L.C.C. estate as we could get no other place to live in My mother and myself occupied—Street for 9 years and that was condemned and that was pulled down over our head 4 years ago and then we managed to get into —Street which has now been demolished a month ago we had previously lived in Grimaldi Street for 28 years and it came a great blow when we found we had to come up here. My mother and father had to come as they could not get a place they are both old Dear Sir my husband works at—and it costs him 5s. a week for riding and I have to ride to do my shopping and it comes very dear with the rent and the rates and 3 children to keep and I think I ought to be one of the first to come back hoping you will oblige and not only that I have a girl with parylisis and have to take her from Tottenham to Great Ormond Street. I am out of the way for everything and it is like being in a strange country after being used to Kings Cross all my life. So I hope you put my name on the list as we had to move out of the place and it is only right we should come back again hoping you will do what you can for me." 5. The parents and a son 18 years occupied for living and sleeping one small back room which was overcrowded. Later, the mother took in her married daughter and the daughter's family of 4 children with ages ranging from 11 to 16 years. This necessitated a re-modelling of the sleeping arrangements. Living and sleeping in this back room were now the original parents, the married 55 daughter and the 2 daughters of the last named, making in all, 1 male adult and 4 female adults. The married daughter was daily expecting to be confined. The room was grossly overcrowded. The son 18 years was employed on day and night work in alternate weeks. When on night work he slept during the day at his father's one room, already overcrowded. When on day work he slept at another address. The daughter's husband slept at a common lodging house 2 miles away. Two other members of the daughter's family lived in Hampstead and at another Finsbury address. The family was recommended for urgent and early priority of accommodation, but were unable to wait for a vacancy on the L.C.C. estate They moved elsewhere and were lost sight of. 6. The parents and 6 children occupied 2 dark rooms at a weekly rental of 7s, 7d. They had lived here 6 years. The family weekly income was £3. The children's ages ranged from 1 year to 12 years. There were 2 beds and a cot. The parents and 2 children slept in one bed, three children in another bed and the baby in the cot. 7. The parents and 5 children, all girls, occupied one room at a weekly rental of 4s. 6d. The room was very much overcrowded. The girls ages ranged from 3 months to 18 years. The case was recommended for priority to the London County Council who accepted the recommendation. The parents were asked to view a vacant cottage at Becontree but did not keep the appointment and sent no letter of explanation to the County Council. The house was therefore given to some one else and the applicant's name removed from the register by the County Council. 8. The parents and 7 children occupied one room at a weekly rental of 6s. 1d. They had lived here 8 years. The ages of the children ranged from 3 weeks to 14 years. The father earned 45s. per week. They were in arrears with their rent. Their home was very dirty. 9. The parents and 5 young children lived in 2 rooms at a weekly rental of 8s. 11d. They all slept in one room. The mother was pregnant and expecting shortly to be confined. The family 56 complained of rats. They were offered rat poison and instructed how to use it but the offer was refused. The family owed nearly a year's rent. 10. The father was a comparatively young man who had married a war widow much older than himself and had adopted her 6 children by a former husband. There were 2 children of the present marriage. The parents and 6 children occupied one room at a weekly rental of 5s. 4d. per week. One son was in Scotland because there was no room for him at home. One daughter stayed with her grandmother in Ireland. The father earned 42s. per week. The total income of the family was said to be 74s. per week. The ages of the 6 children at home ranged from 1 month to 18 years. DISINFECTION. The Finsbury Disinfecting Station is at 49, Northampton Road, Clerkenwell. Here provision is made for the housing and accommodation of families during the disinfection of their premises after infectious disease, and for the reception of small pox contacts, and of suspected cases of smallpox during the incubation period. The " shelter " was used on four occasions only in 1925, by three families from Finsbury, and one family from Holborn. The Holborn Metropolitan Borough is allowed to use this shelter by an agreement made between the two Boroughs, dated 4th October, 1911, and terminable at the pleasure of either Council. The payment by the Holborn Borough Council was increased from £10 per annum to £37 10s. per annum as from 1st August, 1922. The disinfector is a Washington-Lyons high-pressure steam apparatus. In 1925, 946 separate rooms were disinfected, of which 97 were for measles, 36 after notification of phthisis, 12 after deaths from phthisis, 283 after scarlet fever, 252 after diphtheria, 67 after other diseases, 98 on account of vermin, and 101 on request. In addition, bedding and mattresses were steam disinfected for the following institutions: Claremont Hall Creche, St. Barnabas' Home, St. Mark's Hospital, Women's League of Service. Altogether, 13,158 articles were disinfected in connection with cases of infectious disease and phthisis. These were chiefly mattresses, pillows, bolsters, sheets, blankets, quilts and wearing 57 apparel. Besides these, 268,632 articles of partly worn wearing apparel (511 separate charges of the disinfecting apparatus) were disinfected for exporting firms at the price agreed upon, prior to exportation to South Africa and other foreign parts. The conversion in 1922 of the disinfecting apparatus from the direct-fired type to a separately steamed apparatus, with upright boiler, has proved to be very satisfactory. The Ford ton chassis, fitted with two interchangeable bodies for the conveyances of articles before and after disinfection, has continued to be of great advantage in the speedy handling of clothing and bedding. FOOD INSPECTION. Certification of Meat Food Products:—The Medical Officer of Health, with the consent of the Council, was designated the certifying officer by the Local Government Board for certification of meat food products for export to Canada, to the Untied States of America, to Australia, to the West Indies, and to the Philippine Islands. 421 certificates were issued in 1925. Meat and Food Inspection:—In March, 1924, the Borough Council appointed Mr. T. Penman as a special meat inspector to inspect systematically butchers' shops, food stuffs, shops for food preparation and cold stores throughout the whole district. In addition, he pays special attention to the meat deliveries in the wholesale market in Charterhouse Street, St. John Street and Cowcross Street, all adjacent to Smithfield Market. All the unsound, diseased and decomposed meat is removed under agreement by Messrs. C. & B. Webb, fat melters, 155, Bow Road, London, E. 58 Diseased and Unsound Meat:—The total amount confiscated in 1925 was over 135 tons, as follows:— tons. cwts. qrs. lbs. Diseased meat 20 14 1 9 Diseased offals 22 — — 1 42 14 1 10 Decomposed meat 22 12 3 9 Decomposed offals and other goods 69 15 1 13 92 8 — 22 Total for 1925 135 tons 2 cwts. 2 qrs. 4 lbs. Prosecutions.—There were heard at Clerkenwell Police Court during 1925, several prosecutions at the instance of Mr. Penman, under the provisions of the Public Health (London) Act, 1891, the Sale of Food Order, 1921, and the Public Health (Meat) Regulations 1924. Particulars of these prosecutions will be found on pp. 76 of this report. Sale of Food Order, 1921.—This order provides that imported meat and imported eggs shall not be exposed for sale by retail unless the article bears a label with the word "imported" or a word or words disclosing the country of origin. During the year it has been necessary to warn many of the traders in the district of this requirement. It became necessary to prosecute certain traders who were neglectful after repeated warnings by the meat inspector ; in each case a conviction was recorded, and a noticeable improvement in the labelling of imported produce has since then been noticed. Public Health (Meat) Regulations, 1924.—These Regulations came into force during the year and have resulted in some improvement in the handling and exposure for sale of meat and meat products. There is ample room for further improvement, but so long 59 as the present system of marketing prevails adequate reform will be hindered. A few successful prosecutions were undertaken at the instance of the meat inspector in the cases of certain traders who neglected repeated warnings. Foreign Beef Tongues.—During the year 13,862 parcels containing 112,408 frozen Argentine beef tongues were delivered to the cold-air stores in Finsbury. A special examination was made of 4,408 of these tongues, with the result that 82 or 186 per cent. were found to be diseased—actinomycosis 81, tuberculosis 1. Unsound Bacon for Soap.—During 1925, 24 tons, 2 cwts., 2 qrs., 21 lbs., of unsound bacon was sold by bacon firms in Finsbury to reputable firms of soap boilers, under the supervision of the meat inspector. Slaughter Houses.—In Finsbury there is now only one slaughter house, viz.:—that of Mr. J. A. Mobbs, 14, Penton Street. This slaughter house was inspected in 1925 on 70 occasions. No defects were ascertained and consequently no notices were served. Only a few small animals were slaughtered in the slaughter house during the year. There are no knackers' yards in the Borough. MILK SHOPS. At the end of 1925 there were on the register 149 milk shops. These were inspected on 175 occasions. 37 notices were served for the abatement of various nuisances. There were no prosecutions. 60 SALE OP FOOD AND DRUGS ACTS. The number of samples taken in 1925 was 600. The results are given in the table below:— Articles. Total No. of Samples. Samples Adulterated. Articles. Total No of Samples. Samples Adulterated. Almonds (Ground) 1 0 Lemonade Powder 3 0 Blackberry Jelly 2 0 Margarine 32 0 Bread and Butter 1 0 Meat Paste 1 0 Butter 105 0 Milk 255 7 Cheese 3 0 Mincemeat 4 0 Chocolate 1 0 Mustard 6 0 Cinnamon 7 0 Mustard (Comp ) 1 0 Cocoa 22 0 Oatmeal 5 0 Coffee 14 0 Oli ve Oil 2 0 Cornflour 1 0 Pepper 6 0 Custard Powder l6 0 Rice 27 0 Flour 2 0 Salmon (Canned) 1 0 Flour (Self-Raising) 17 0 Sausages 12 4 Frying Oil 1 0 Sponge Cake 1 0 Ginger (Ground) 5 0 Tea 5 0 Jelly Crystals 2 0 Lard 39 0 Total 600 11 61 The statistics for previous years are sub-joined:— Year. Total examined. Genuine. Adulterated. Percentage of adulterated samples. 1910 600 541 59 9.83 1911 600 549 51 8.50 1912 601 567 34 5.65 1913 601 570 31 5.1 1914 596 563 33 5.5 1915 600 566 34 5.6 1916 600 565 35 5.8 1917 601 544 67 9.5 1918 600 553 47 7.8 1919 591 569 22 3.7 1920 603 587 16 2.6 1921 602 588 14 2.3 1922 602 590 12 2.0 1923 602 593 9 1.5 1924 600 590 10 1.7 1925 600 589 11 1.8 In respect of the milk supplied in 1925 there were six prosecutions. The vendor of sausages containing boric acid was also prosecuted. To the vendors of the remaining adulterated samples, cautionary letters were sent. The Milk (Special Designations) Order, 1923.—Three applications under the order were received during 1925 for a dealer's licence to use the designation "Certified." The applications were granted. Public Health (Milk and Cream) Regulations, 1912.—Action taken in Finsbury during 1925 under the above-mentioned regulations is shown by the following table;— 62 Nature of Sample No. of samples examined No. of samples containing above prescribed limit of preservative Cream 0 0 Milk 255 0 FACTORIES AND WORKSHOPS. The number of workshops and workplaces on the register at the end of 1925 was 2,423, compared with 2,301 at the end of 1024. During the year under review, 103 entries were removed from the register owing to the closing of premises, the conversion of workshops into factories by the introduction of some form of mechanical power, or to the removal of the occupiers to other places of business. The number of workshops and workplaces newly registered was 315. The factories on the register at the end of 1025 numbered 1,813, compared with 1,714 at the end of 1924. The list included 14 tenement factories in which there were separate occupiers carrying on different trades or processes and supplied with mechanical power by the owners of the premises. The following lists indicate the workshops, workplaces and factories on the registers and show the large variety of manufacturing processes which are carried on in Finsbury :— Factories.—Cardboard box making 44, instrument, jewellery, etc., box making 17, packing case making 26, brushes and combs 9, house repairs and decorating 6, patent flooring 1, tarred felt making 1, clock and watch case making 11, watch making and repairing 15, cloth shrinking 4, pleating 1, disinfectants and soaps manufacturing 4, drug grinding 1, druggists sundries 10, making and repairing addressing machines 1, making and repairing motors and cycles 23, making and repairing domestic machinery 5, making and repairing springs 1, making and repairing typewriting machinery 2, model and pattern making 7, smithing and wheelwrights' work 11, making and repairing sewing machines 7, making and repairing electrical 63 goods and machinery 27, general engineering 119, wireless 7, artificial flower making 13, embroidery 10, making and importing fancy goods 14, ivory and tortoise-shell working 6, leather goods 48, pipe making and mounting 24, toy making 4, walking sticks and umbrellas 40, whip making 1, trouser presses 2, sports goods 13, cleaning feathers 4, dyeing and curling feathers 10, horsehair cleaning 2, cabinet making 21, carpet planning 1, picture-frame making 10, shop fitting 16, upholstery 2, cold storage 6, confectionery 9, drysalting 1, food preparing 27, mineral waters 3, cordial and spirit colouring 1, glass stoppers making 3, glass working 24, sand blasting 2, jewellery making and repairing 35, gold and silver refining 4, rouge manufacturing 1, silversmiths 30, repairs 4, steam laundries 4, diamond cutting and polishing 4, glaziers diamonds making 3, brass workers 17, coppersmiths 10, engraving and die sinking 24, foundry 8, gilding, plating and polishing 82, general metal-working 31, type-founding 6, wire-working 12, sheet-metal working 13, aerography 2, paint, enamel and varnish making 4, panel and screen painting 2, musical instrument making and repairing 17, scientific instrument making 33, electrical instrument making 8, optical instrument making 19, photographic instrument making 1, surgical instrument making 11, weighing and scales instruments making 9, art publishing 25, envelope and paper bag making 6, gold blocking 4, ink and gum making 8, machine ruling 11, pattern cards 10, printing 145, showcards 3, manufacturing stationers 31, stencil cutting 1, waste paper sorting 1, bookbinding 31, fountain pens 2, rubber works 4, rubber stamp making 3, waterproofing 1, stone and marble working 2, statuary 1. Making wearing apparel as follows:—aprons 4, blouses 44, boots and shoes 11, boot socks and laces 1, children's clothing 21, fur garments 17, glove making 3, haberdashery 4, hat making 35, linen collars 7, neckties 11, shirt and pyjama making 24, mantle making 74, tailoring 46, skirt making 15, underclothing 25, button making 9. Beer bottling 1, distilling 6, dealing in wines, spirits and tobacco 3, tobacco, cigarettes and cigar making 14, general woodwork 17, hardwood turning 19, saw milling 5, wood cutting 2, electricity generating station 1, hydraulic power station 1, forage cutting 5, packing and forwarding goods 4, vulcanite and fibre manufacturers 9, cork cutting 2, cutlery grinding 6, van building 3. Total 1,813. 64 Workshops.—Cardboard box making 20, instrument, jewellery, etc., box making 32, packing case making 15, making brushes and combs 11, glazed tiles 1, house repairs and decoration 49, making clock and watch cases 20, dial painting 16, making and repairing clocks and watches 115, shrinking cloth 3, cutting and sorting cloth 9, accordion pleating 4, chemical research work 2, drug and chemical making 7, druggists sundries 31, agricultural engineering 5, cycle and motor repairing 25, electrical workers 27, fitter's work 3, locksmiths 7, machinists 8, pattern making 1, sewing machines 6, smiths and wheelwrights 6, general engineering 35, wireless 8, artificial flowers making 15, artists' materials 2, art needlework and embroidery 11, basket making 15, leather goods 77, fancy goods making, and importing 20, shoe trimmings 4, sports goods 6, ivory working 7, pipe making 6, taxidermy 1, toy making and importing 34, walking sticks and umbrellas 20, wig and costume making 1, soap and perfumery 3, general fancy goods 40, curling and dyeing feathers 14, blind making 3, cabinet making 62, French polishing 21, making and repairing furniture 20, shop fitting 27, upholstery 20, undertakers 7, picture framing 18, confectionery 20, storage and preparation of food stuffs 65, glass working 30, bottle washing 4, china and glass merchants 3, instrument making —musical 27, optical 9, photographic 9, scientific 29, surgical 11; weighing machines 3, gold beating 5, gold and silver refining 12, gold and silver smiths 37, enamelling 4, repairing and making jewellery 87, wholesale and retail jewellers 24, laundries 10, laundry receiving and sorting 18, diamond cutting and polishing 10, general lapidary 3, metal burnishing 6, coppersmiths 8, engraving and die sinking 61, gilding and plating 12, farriers' and smiths' work 18, sheet metal working 22, wire working 15, general metal work 56,. oil and colour manufacturing 6, sign writing 13, ink, gum and varnish making 6, blacking and polish making 5, japanning 5. Bookselling and publishing 23, card and book edge gilding 15, envelope and paper bag making 6, machine ruling 4, paper storage 14, wholesale stationers 34, waste paper sorting 13, card mount cutting 3, relief stamping 11, lithographers 4, rubber goods making 12, ebonite workers 2, stone and marble working 7, statuary 6, blouse making 17, boot and shoe repairing 35, boot and shoe warehouse 11, button making 2, children's clothing 5, corset making 3, furriering 122, glove making 1, hat making 54, mantle making 37, millinery 47, necktie making 5, shirt and collar making 2, tailoring 65 98, underclothing 12, woollen goods 7, haberdashery 7, cigar making 1, wine spirit and tobacco storage cellars 7. Firewood chopping 22, timber yards 9, wood turning 7, van building 9, wood carving 6, wood working 17, hat block making 2, harness making and repairing 7, mat making 1, celluloid workers 1, forwarding agents 42, hardware manufacturers 27, miscellaneous merchants 63, stabling and garage 55, stores 51, towel supplying 4, cork cutting and working 5, window cleaning 3, rope and twine making 4, ammunition storage 1, dyeing and cleaning 4, photography 1. Total 2, 423. The persons employed in the factories in Finsbury are, approximately: Males 38,613, females 32,377. In the workshops and workplaces: Males 12,348, females 9,041; these numbers exclude the office "hands" and clerical staffs. During the year 2,025 first visits and 1,087 revisits were made by the Council's inspectors to factories, and 2,583 first visits and 1,207 revisits to workshops and workplaces. A summary of the defects or insanitary conditions found is appended:— 66 Summary of Defects and Defaults in Factories, Workshops, and Workplaces, for which Notices were served in 1925. Factories Workshops Workplaces Total Animals improperly kept 1 1 .. 2 Absence of water supply 6 8 1 15 Black smoke nuisance .. .. .. .. Cisterns dirty or covers broken .. .. .. .. Dampness in walls 1 4 .. 5 Drains choked 6 2 2 10 Drains leaky 5 2 5 12 Dustbins broken or absent 89 35 10 84 Floors insufficiently drained .. 3 .. 3 Fresh air inlets to drains broken 2 .. 2 Guttering or rainwater piping broken. .. .. .. .. leaking or inadequate 7 10 2 19 Manhole covers broken 1 .. .. 1 Open drain inlets 2 1 .. 3 Overcrowding of workrooms .. 2 .. 2 Refuse accumulations 14 13 2 29 Roofs leaky 2 10 1 13 Floors broken .. 6 .. 6 Ceilings broken 1 17 1 19 Sanitary conveniences not separate for the sexes 13 16 1 30 Sanitary conveniences defective 138 42 16 196 Sanitary conveniences dirty 145 85 11 241 Sanitary conveniences insufficient 20 9 4 33 Sanitary conveniences unsuitable 42 18 3 63 Soil-pipes leaky 4 2 .. 6 Staircases and landings dirty .. 13 .. 13 Urinals foul .. 1 .. 9 Ventilation of workrooms inadequate or insufficient means of .. 5 1 6 Waste material improperly stored 1 3 .. 4 Waste pipes choked or leaky 7 3 2 12 Water closets choked 8 6 8 22 Water fittings leaky 10 4 1 15 Workshops or workplaces dirty .. 76 6 82 Yard paving broken 1 1 .. 2 Yard walls dirty 9 4 13 Total 482 409 81 972 In connection with these matters 350 intimation notices and 12 statutory notices were served. 67 The Home Office.—79 notices of occupation were received from the Home Office during the year, and 38 notices of complaint relating to the following matters:— Premises dirty 3 Sanitary conveniences insanitary 23 Absence of separate accommodation for the sexes 5 Water closet accommodation insufficient 3 Roofs leaky 2 Water closet not provided 1 Floor of workshop not properly drained 1 The notices sent to the Home Office were as follows:— Abstract of the Factory and Workshop Act not affixed, or wrongly affixed 25 Premises dirty 3 New occupation 21 The following matters are presented in the form required by the Home Office. Inspection of Factories, Workshops and Workplaces. Premises. Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 3.112 174 0 Workshops (Including Workshop Laundries) 3.054 152 0 Workplaces (other than Out workers premises) 726 35 0 Total 6,892 361 0 68 Defects found in Factories, Workshops and Workplaces. Particulars. Found Remedied Referred to H.M. Inspector. No. of Prosecutions Nuisances under the Public Health Acts— Want of Cleanliness 82 81 3 — Want of Ventilation 6 6 — — Over-crowding 2 2 — — Want of drainage of floors 3 3 — — Other nuisances 557 554 — — Sanitary accommodation Insufficient 33 32 — — Unsuitable 63 61 Defective 196 193 — — Not separate for the sexes. 30 30 — — Offences under the Factory and Workshop Acts— Illegal occupation of underground bakehouse (S. 101 ) — — Breach of special sanitary requirements for Bakehouses (S S. 97 to 100). — Other offences (excluding offences relating to outwork which are included in Part 3 of this report. — — — — Total 972 962 3 — There were 10 outstanding matters at the close of the year. OTHER MATTERS. Matters notified to H.M. Inspector of Factories:— Failure to affix abstract of the Factory and Workshop Act (S. 133, 1901) 25 Action taken in matters referred to H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act, 1901 (S. 5) Notified by H.M. Inspector 38 Reports (of action taken) sent to H.M. Inspector 38 Underground bakehouses (S. 101) in use at the end of the year 26 69 Home Work, 1925. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107 Lists received from Employers Notices served on Occupiers as to keeping or sending Lists Sending twice in the year Sending once in the year Lists. Outworkers Lists Outworkers Contractors Workmen Contractors Workmen Wearing apparel 75 334 1082 37 50 293 56 Boxes, paper 9 0 141 5 2 45 5 Artificial flowers 7 0 152 3 0 78 I Christmas crackers 3 0 279 1 0 19 1 Sports requisites 1 0 129 0 0 0 0 Brushes 0 0 0 1 C 4 0 Fancy goods 4 2 41 1 0 7 2 Bedding 1 0 3 0 0 0 0 Feather sorting 2 0 4 0 0 0 0 Chocolate making 0 0 0 1 0 2 0 Bookbinding 0 0 0 1 0 2 0 Total 102 336 1831 50 52 35o 65 70 RATS AND MICE (DESTRUCTION) ACT, 1919. The methods indicated in my Report in 1921 have been maintained in 1925. COMMON LODGING HOUSES. In 1925 two common lodging houses were licensed in Finsbury as follows:— 57, White Lion Street, James Shuttleworth—98 men. 88, Old Street, Salvation Army—372 men. CANAL BOATS ACTS, 1877 TO 1884. During the year 1925, the total number of Canal Boats inspected was 93. None carried offensive cargo. The Acts and Regulations were contravened in 2 instances, and for these complaint notes were sent to the owners requiring abatement within a specified time. The infringements were in respect of the following matters 1. Leaky after cabin. 2. Overcrowding. These were remedied and it was not found necessary to take legal proceedings. The following table gives statistics relating to the inspection of Canal Boats for the past 5 years:— Year. Boats Inspected Persons found on boats. Totals. Registered for Men. Women. Children. 1921 82 137 57 75 269 317 1922 68 117 45 44 206 251 1923 77 171 28 43 242 279 1924 94 163 56 64 283 336 1925 93 151 54 80 285 321 71 Of the 93 Canal boats inspected 41 were occupied by men only; 17 by men and women only and 35 by men, women and children. The number of children on the boats was 80 of which 41 were of school age and 39 under school age. The children accompanying their parents on the boats appeared to be well cared for. No cases of Infectious disease were notified or discovered on the canal boats, therefore isloation of patients and detention of boats have not been necessary. The inspection of Canal Boats is part of the duty of the Sanitary Inspector whose district includes that part of the Borough in which the canal is situated. This year the duties were carried out by Inspector Newdick. THE MORTUARY. In 1925 the number of post-mortem examinations was 56, the number of bodies brought to the mortuary for the convenience of relatives of the deceased was 142. The number of inquests held in the Borough was 60. The number of bodies received into the mortuary on account of death after infectious disease numbered 4. STAFF OF THE PUBLIC HEALTH DEPARTMENT. The names and appointments of the various members of the staff are here inserted in accordance with the instructions of the Ministry of Health. Inspectorial. Meat Inspector—T. Penman. Sanitary Inspectors—G. E. J. Davis, C. M. Longden, E. A. Norman, H. Newdick. Workshops Inspectors—R. A. Puckle, H. Clinton. Woman Inspector—Miss F. Hall. 72 Clerical. Chief Clerk—E. Q. Bilham. First Assistant Clerk—N. C. Turrell. Second, Assistant Clerk—L. T. H. Mussett. Junior Clerk—J. Hurren. Office Youth—J. Barry. Mortuary and Disinfecting. Mortuary Keeper and, Disinfector—J. Campbell. Disinfector—F. Readstone. Motor Driver Disinfectors—J. J. Sweet and F. W. Battle. Maternity and Child Welfare. Superintendent, 162, Lever Street—Miss M. I. Batty. Superintendent, Old Sessions House—Miss F. Woodruff. Clerk—G. A. Webber. Dispenser (part-time)—Miss A. Preece. Health Visitors—Misses G. M. Bolton, E. J. Smith, D. E. Leggatt. Centre Cleaners—Mrs. Cunningham, Mrs. Purcell. Dentist (part-time, for Maternity and Child Welfare)— Mrs. Marie Verheyden, L.D.S. Assistant Medical Officer of Health—D. H. Geffen, M.D., D.P.H. 73 WORK OF THE STAFF. The work of the staff is presented below in tabular form:— Work of the Sanitary Inspectors. 1925. Inspector Davis. Inspector Longden. Inspector Norman. Inspector Newdick. Totals Houses damp, dirty or dilapidated, remedied 141 156 229 130 656 Doors, windows, floors, walls, ceilings, sashcords repaired 182 185 211 121 699 Overcrowding case9 abated in other than Registered Houses 2 2 1 1 6 Illegal occupation of underground rooms 1 1 2 Water closet defects remedied 188 I40 289 115 732 Water closets erected Il6 5 87 65 273 Urinal defects remedied 7 2 9 Urinals erected 12 2 13 15 42 Soil pipe and ventilating shaft defects remedied 2 7 31 3 43 Soil pipe and ventilating shafts erected 29 8 47 14 98 Yard defects remedied 49 48 171 90 358 Waste pipe defects remedied 4 31 42 11 88 Waste pipes erected 26 2 42 22 92 Water cistern defects remedied 3 22 9 8 42 Accumulations of rubbish or manure removed 14 11 18 6 49 Dung or dust receptacles repaired or renewed 102 75 79 95 351 Drains relaid or amended 24 39 45 42 150 Drains cleared 22 52 34 20 128 Rain water pipes cleared, repaired or renewed 17 11 55 12 95 Water supply to houses reinstated 2 1 1 4 Roofs and gutters repaired 114 81 141 53 389 Area defects remedied 5 15 56 11 87 74 Work of the Sanitary Inspectors, 1924—continued. Inspector Davis. Inspector Longden. Inspector Norman. Inspector Newdick. Totals. Wash ho use defects remedied 62 77 128 51 318 Animal nuisances abated . . 2 5 2 9 Floor space unventilated 2 . . 5 . . 7 Stables cleansed or repaired . . . . 2 . . 2 Smoke observations 5 . . 1 24 30 Water supply laid on to . . . . . . . . . . upper storeys of house . . . . 1 . . 1 Miscellaneous nuisances abated 40 65 56 49 210 Drains tested 41 l6l 200 46 448 Bakehouses, inspections 16 30 26 30 102 Bakehouses cleansed or . . . . . . . . . . paired 3 10 12 7 32 Restaurants, No. of . . . . . . . . . . tions 51 22 83 86 242 Restaurants cleansed or . . . . . . . . . . paired 7 3 47 23 80 Milkshops, No. of inspections 38 47 37 51 173 Milkshops cleansed or repaired 3 8 16 20 47 Public-houses cleansed or . . . . . . . . paired 3 .. 2 . . 5 Ice Cream Premises—No. of . . . . . . . . inspections 50 12 26 30 118 Ice Cream Manufactories . . . . . . . . cleansed or repaired 4 4 10 7 25 Butchers' shops cleansed or . . . . . . . . repaired 1 . . . . 3 4 Registered Houses—visits of . . . . . . . . inspection 1037 1173 1731 757 4698 Registered Houses — . . . . . . . . crowding cases abated 5 1 2 . . 8 Registered Houses—cleansed 220 176 151 88 635 Registered . . . . . . . . tion (Cleansing) Notices . . . . . . . . served 220 202 151 90 663 Registered Houses—Statutory . . . . . . (Cleansing) Notices served 55 55 59 169 First visits (complaints, . . . . . . casual visits) 1732 1610 1590 1938 6870 Re-visits 2369 2135 3254 1459 9217 Intimation Notices served 419 370 594 362 1745 Statutory Notices served 69 42 91 19 221 Infectious disease . . . . . . tions 183 250 216 172 821 House inspections 327 324 438 393 1482 House to house inspections 70 40 110 28 248 Canal Boats inspected . . . . . . 93 93 Slaughterhouses—No. of . . . . . . spections . . 93 . . . . 93 75 Work of the Lady Sanitary Inspector, 1925. Miss Hall made 2,733 visits as follows:- To outworkers' premises 1,537 Factories 480 Workshops 460 Verminous premises 126 Nuisances and complaints 130 158 Intimation notices and 3 statutory notices were served by her in respect of :— Verminous, dirty, or dilapidated internal walls and ceilings 105 Leaky roofs, broken and leaky gutters and choked rain water pipes 31 Damp walls 14 Insufficient, unsuitable, dilapidated or otherwise defective drains and sanitary accommodation 183 Sundry matters 51 76 LEGAL PROCEEDINGS, 1925. Date, 1925. Name and Address of Defendant. Offence. Result. PUBLIC HEALTH (LONDON) ACT, 1891:- 5th Feb. John Loveless, Whitcombe Vale Farm, Winfrith, Dorset Depositing for the purpose of sale, 4 quarters of tuberculous cow beef at 101, & 103, Charterhouse Street. Fined £20 and ordered to pay £10 10s. costs 30th Apr. John Richmond, Thame Aiding and abetting the deposit of tuberculous beef for the purpose of sale for human food. Fined £20 and ordered to pay £21 costs (The owner had died in the period between seizure and prosecution). 18th June H. Woolf, 129, Amhurst Road, E.8. Failing to comply with notice requiring the abatement of a nuisance at 73, Southampton Street. Ordered to pay £2 2s. costs. 3rd Dec. James Egerton, late of 16a, St. John Street, E.C.I. Having unsound bacon in his possession, deposited for the purpose of sale or preparation for sale for human food Fined £40 or 81 days'imprisonment in default 3rd Dec. James Egerton, late of 16a, St. John Street, E.C.I. Obstructing Inspector Penman in the execution of his duty Fined £2 or 11 days' imprisonment in default 3rd Dec. Danish Bacon & Cooperative Trading Company Limited, 9-12, Cowcross St., E.C.I. Selling to James Egerton unsound bacon intended for sale for human food Fined £40 and ordered to pay £15 15s. costs 16th Dec. Henry Newton, 18, Cowcross Street, E.C.I. Having in his possession a quantity of unsound bacon intended for the food of man Fined £10 or 51 days' imprisonment in fault SALE OF FOOD AND DRUGS ACTS, 1875 to 1909:- 16th Apl. J. Sainsbury, Ltd., Blackfriars, S.E.I. Selling sausages at 76, Chapel Street, containing 22.9 grains per pound of boric acid Ordered to pay £5 5s. costs 30th June Paul Sardo, 18, Wynford Road, N.1. Selling milk 18.3% deficient in fat Fined £1 10s. and ordered to pay 12s. 6d. costs 13th July Frank Sutton, 45, Bath Street, E.C.I Selling milk 13.3% deficient in fat Fined 10s. 2nd Sept. James Fred Stacey, 23, Leage Street, E.C.I Selling milk 12.6%deficient in fat Fined £3 and ordered to pay £2 2s. costs 77 LEGAL PROCEEDINGS—contd. Date 1925. Name and Address of Defendant. Offence. Result. LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1908 24th Mar. Louisa Aggett, 44, Radnor St., E.C.I Selling milk whilst not registered Fined 5s. and ordered to pay £2 2s. costs SALE OF FOOD ORDER, 1921: — 9th July John Harvey, 21, Green Terrace, E.C.I Failing to so label imported meat Fined £1 and ordered to pay £1 1s. costs 9th July Charles, Stokes, 21, Chapel Street, N.I. Failing to so label imported meat Fined £1 and ordered to yay £1 1s. costs. 9th July Arthur Higgins, 28, Exmouth Street, W.C.I Failing to so label imported eggs Fined 10s. and ordered to pay 10s. 6d. costs PUBLIC HEALTH (MEAT) REGULATIONS, 1924. 9th July John Davies, The Union Tavern, King's Cross Rd., W.C.I Failing to cover stall Fined £1 and ordered to pay £\ 1s. costs 9th July Hy. Day, 14, Brunswick Close, E.C.I Failing to cover stall Fined 10s. 9th July Hy. Day, 14, Brunswick Close, E.C.I Having no name and address on stall Fined 10s. MILK AND DAIRIES (AMENDMENT) ACT, 1922:— 1st Dec. William Evans, 130, St. John Street, E.C.I Colouring matter in milk Fined £3 and ordered to pay £2 2s. costs 1st Dec. William Hy. Hawkes, 42, Gt. Sutton St., E.C.I. Colouring matter in milk Ordered to pay £2 2s. costs 78 Cases of Infectious Disease Notified during the Year 1925. Notifiable Disease. Number of cases notified. Total cases notified in each locality. Total cases removed to Hospital At all Ages At Ages—Years. Clerkenwell St. Luke St. Sepulchre Under 1 year 1 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and upwards Diphtheria (including Membranous Croup) 252 5 109 106 21 8 3 — 170 80 2 251 Scarlet Fever 283 1 106 159 8 8 1 — 183 100 — 282 Enteric Fever 2 — — — 1 — 1 — 1 1 — 2 Puerperal Fever 8 — — — 4 4 — — 4 4 — 3 Ophthalmia Neonatorum 16 16 — — — — — — 12 4 — 2 Pulmonary tuberculosis 202 1 4 10 48 70 63 6 115 87 — — Other tuberculosis 22 1 3 8 5 3 2 — 14 8 — — Acute Primary Pneumonia 62 2 7 7 8 19 11 8 44 18 — 33 Acute Influenzal Pneumonia 19 1 2 1 4 2 7 2 15 4 — 7 Erysipelas 75 1 1 6 24 13 26 4 59 15 1 8 Encephalitis lethargica 5 — — — 1 1 3 — 5 — — 3 Measles and German Measles 723 40 395 282 5 1 — — 391 332 — 138 Puerperal sepsis 2 — — — 2 — — — — 2 — 1 Acute poliomylitis 2 — 2 — — — — — 1 1 — 1 Puerperal saprœmia 1 — — — — 1 — — 1 — — 1 Cerebro-spinal meningitis 2 2 — — — — — — — 2 — 1 Zymotic enteritis 4 1 2 — 1 — — — 3 1 — — Typhoid Fever 5 — 2 1 1 1 — — 5 — — 4 Dysentery 1 — — — — 1 — — 1 — — — Totals 1,686 71 633 580 133 132 117 20 1024 659 3 737 79 Infant Mortality, 1924. cause of death Under 1 week 1-2 weeks 2-3 weeks 3-4 weeks Total under 4 weeks 4 weeks and under 3 months 3 months and under 6 months 6 months and under 9 months 9 months and under 12 mos Total deaths under 1 year Small-pox .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. 1 1 1 1 4 Scarlet fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. 1 .. 2 1 4 Diphtheria and Croup .. .. .. .. .. .. .. .. 1 1 Erysipelas .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis .. .. .. .. .. .. .. .. .. .. Abdominal Tuberculosis .. .. .. .. .. .. .. .. .. .. Other Tuberculous Diseases .. .. .. .. .. .. .. 1 .. 1 Meningitis (not Tuberculous) .. .. .. .. .. .. 2 .. 2 4 Convulsions 1 .. .. .. 1 .. .. 1 .. 2 Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis 1 1 1 .. 3 1 2 1 .. 7 Pneumonia .. .. 2 2 4 8 3 4 4 23 Diarrhœa .. .. .. .. .. .. 1 .. .. 1 Enteritis 2 2 .. 1 5 7 5 1 1 19 Gastritis .. .. .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. 1 .. .. 1 Rickets .. .. .. .. .. .. .. .. .. .. Suffocation, overlying .. .. .. .. .. 1 .. .. 1 2 Injury at birth .. .. .. .. .. .. .. .. .. .. Atelectasis .. .. .. .. .. .. .. .. .. .. Congenital Malformations .. .. .. .. .. .. 1 .. .. 1 Heart Disease .. .. 2 .. 2 .. 1 .. 1 4 Premature Birth 9 1 1 .. 11 1 1 1 .. 14 Atrophy, Debility and Marasmus .. .. .. .. .. 1 2 1 .. 4 Other causes 5 .. 1 .. 6 .. 3 3 1 13 Totals 18 4 7 3 32 21 23 16 13 105 80 CAUSES OF, AND AGES AT, DEATHS IN FINSBURY DURING THE FIVE YEARS 1921, 1922, 1923, 1924 AND 1925. Cause of Death. Net Deaths at the subjoined ages of " Residents" whether occurring within or without the District. Total Deaths whether of " Residents" or " Non-Residents" in the Institutions in the District. All ages Under 1 year 1 and under 2 years 2 ana under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and under 65 years 65 and upwards Enteric Fever 4 — — — — 1 1 2 — — Small Pox — — — — — — — — — — Measles 101 17 55 26 3 — — — — — Scarlet Fever 14 1 5 5 2 1 — — — — Whooping Cough 84 28 39 14 3 — — — — — Diphtheria and Croup 95 9 15 44 24 2 — — 1 — Influenza 141 5 9 8 4 9 19 50 37 1 Erysipelas 5 1 — — — — — 2 2 — Phthisis 514 2 — 1 17 119 189 166 20 2 Tuberculous Meningitis 34 2 10 10 7 3 1 1 — — Other tuberculous diseases 42 4 5 5 9 7 8 3 1 1 Cancer, malignant disease 552 2 2 1 4 3 55 284 201 24 Rheumatic Fever 30 — — 2 11 8 6 1 2 — Meningitis 18 8 2 1 2 1 4 — — 5 Organic heart disease 614 24 1 2 16 29 85 210 247 16 Bronchitis 623 35 5 5 1 1 28 187 361 2 Pneumonia (all forms) 547 148 109 57 13 13 45 81 81 39 Other respiratory diseases 41 1 2 4 1 2 7 14 10 — Diarrhœa and Enteritis 128 94 17 2 1 1 3 3 7 14 Appendicitis 34 — — 2 10 5 7 7 3 — Cirrhosis of liver 31 — — — — — 2 20 9 — Alcoholism 7 — — — — — — 6 1 — Bright's Disease and Cerebral Hæmorrage 424 — — 2 6 9 27 177 203 6 Puerperal Fever 8 — — — — 2 6 — — 7 Other diseases and accidents of Pregnancy and Parturition 14 — — — — 1 13 — — 21 Congenital Debility and Malformation, including Premature Birth 203 201 1 1 — — — — — 78 Violent Deaths, excluding Suicide 211 30 4 13 37 10 24 41 52 32 Suicide 45 — — — — 2 16 18 9 — Other Defined Diseases 762 33 22 14 21 22 72 167 411 27 Diseases ill-defined or unknown 206 36 4 5 2 4 12 21 122 14 Totals 5532 681 307 224 194 255 630 1461 1780 289 * Broncho-Pneumonia 345 137 95 47 7 2 8 24 25 33 *Other Pneumonias 202 11 14 10 6 11 37 57 56 7 •These figures are included in the above table. 81 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR, 1925. Cause of Death. Net deaths at the subjoined ages of "Residents" whether occurring within or without the district. Total Deaths whether of "Residents" or "Non-Residents' in the Inststutions in the District. All ages Under 1 year 1 and under 2 years 2 and under 5 years 5 and under 15 years 15 and under 25 years 25 and under 45 years 45 and ender 65 yeas 65 and upwards Enteric Fever 3 — — — — 1 1 1 — — Small Pox — — — — — — — — — — Measles 12 4 7 1 — — — — — — Scarlet Fever — — — — — — — — — — Whooping Cough 15 4 6 5 — — — — — — Diphtheria and Croup 6 1 1 2 2 — — — — — Influenza 16 1 — — — 2 2 8 3 — Erysipelas — — — — — — — — — — Phthisis 111 1 — — 4 22 40 40 4 1 Tuberculous Meningitis 8 — 2 1 2 2 1 — — — Other tuberculous diseases 7 — — — 2 1 3 1 — 1 Cancer, malignant disease 117 — 1 — 2 — 9 64 41 6 Rheumatic Fever 4 — — 1 1 1 1 — — — Meningitis 6 4 — 1 1 — — — — 2 Organic heart disease 119 4 — 2 — 5 11 45 52 3 Bronchitis 119 7 — — — — 1 37 74 — Pneumonia, all forms 96 24 15 11 1 1 8 20 16 2 Other respiratory diseases 6 — — — — — 1 5 — — Diarrhoea and Enteritis 26 20 4 — — — — 1 1 9 Appendicitis 5 — — 1 1 1 1 1 — — Cirrhosis of Liver 4 — — — — — — 2 2 — Alcoholism 1 — — — — — — 1 — — Bright's diseose and Cerebral Haemorrage 82 — — — — 1 6 33 42 1 Puerperal Fever 1 — — — — — 1 — — 4 Other diseases and accidents of Pregnancy and Parturition 4 — — — — — 4 — — 2 Congenital Debility and Malformation, including Premature Birth 19 19 — — — — — — — 9 Violence, excluding suicide 41 2 1 3 7 3 6 10 9 7 Suicide 12 — — — — — 5 6 1 — Other defined diseases 175 5 1 4 4 5 13 45 98 7 Diseases ill-defined or unknown 40 9 — — — 3 2 5 21 4 Totals 1055 105 38 32 27 48 116 325 364 58 *Broncho pneumonia 58 22 13 8 1 — 2 7 5 — *Other pneumonias 38 2 2 3 — 1 6 13 11 — * These figures are included in the above table.