Fin 16 THE METROPOLITAN BOROUGH OF FINSBURY. ANNUAL REPORT on the Public Health of Finsbury for the Year 1926 by A. E. THOMAS, M.A., M.D., D.P.H., Medical Officer of Health. Barrister-at-Law. London: Printed by Waterlow & Sons Ltd., London, Dunstable and Watford. 1927. Public Health Committee, 1926-7. Chairman: Alderman WM. HOWES, J.P. Vice-Chairman: Councillor E. TROTT, J.P. HIS WORSHIP THE MAYOR. (Councillor S. G. NUNN, J.P.) Alderman W. R. PUTTERILL. Councillor Mrs. A. CHAPMAN, J.P. Councillor H. G. DAINTY. Councillor F. T. FOULGER. Councillor G. GLANVILLE. Councillor Mrs. M. F. HAGGITH. Councillor F. HAYES. Councillor T. A. HUTCHINSON. Councillor Mrs. E. J. L. LORD. Councillor A. P. ROBINSON. Maternity and Child Welfare Committee, 1926-7. Chairman : Councillor Mrs. E. J. L. LORD. Vice-Chairman : Councillor Mrs. A. CHAPMAN, J.P. HIS WORSHIP THE MAYOR. (Councillor S. G. NUNN, J.P.) Alderman W. HOWES, J.P. Alderman W. R. PUTTERILL. Councillor H. G. DAINTY. Councillor F. T. FOULGER. Councillor Mrs. M. F. HAGGITH. Councillor E. TROTT, J.P. Co-opted Members : Lady BARTON. Miss E. F. BOLTON. Mrs. S. S. NUNN. 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. A 2 TABLE OF CONTENTS. PAGE Statistics 5 Population 6 Births and Birth Rates 8 Maternity and Child Welfare 10 Health Visitation 18 Weighing Centres 18 Grants to Mothers and Children 19 Hospital Treatment 21 Puerperal Fever 22 Ophthalmia Neonatorum 22 Deaths and Death Rates 22 Inquests 23 Infant Mortality 24 Tuberculosis 28 Phthisis Notifications and Deaths 29 Tuberculosis Dispensary 36 Infectious Disease 37 Housing 45 Finsbury Housing Scheme 46 Housing on L.C.C. Estates 61 Disinfection 61 Food Inspection 64 Slaughter Houses 67 Butchers' Shops 68 Milk Shops 70 Samples for Analysis 74 Offensive Trades 76 Factories and Workshops 76 Homework 83 Rats and Mice (Destruction) Act, 1919 84 Common Lodging Houses 84 Canal Boats 84 Mortuary 85 Staff 85 Work of the Staff 87 Legal Proceedings 90 Statistical Tables 92 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1926. STATISTICS.—A summary of the principal facts of the statistics for 1926 is given below :— Area (acres) 587 Estimated civilian population at the middle of 1926 77,550 Finsbury residents in outlying institutions at the end of June, 1926 917 Number of inhabited houses (structurally separate dwellings), Census, 1921 10,889 Number of families or separate occupiers (Census, 1921) 20,005 Rateable value £1,239,950 Sum represented by a penny rate £4,952 Birth rate, Finsbury 21.4 per 1,000 inhabitants. Birth rate, London 17.1 per 1,000 inhabitants. Birth rate, England and Wales17.8 per 1,000 inhabitants. Death rate, Finsbury 12.9 per 1,000 inhabitants. Death rate, London 11.6 per 1,000 inhabitants. Death rate, England and Wales 11.6 per 1,000 inhabitants. Infant mortality, Finsbury 66.0 per 1,000 births. Infant mortality, London 64.0 per 1,000 births. Infant mortality, England & Wales 70.0 per 1,000 births. Phthisis death rate, Finsbury 1.13 per 1,000 inhabitants. Finsbury death rate from all forms of tuberculosis 1.29 per 1,000 inhabitants. In comparison with the results for 1925, the following matters are of interest:— The number of births and the birth rate are less in 1926. The general death rate is lower in 1926. The death rates for consumption of the lungs and for all forms of tuberculosis are both less in 1926. The infant mortality is higher in 1926. 6 The deaths from cancer, whooping cough, diarrhoea, violence and accidents, are less in 1926. The deaths from measles, premature birth, and heart disease, are more in 1926. Diphtheria and scarlet fever have been less prevalent than in 1925. Measles has been much more prevalent in 1926. 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 1926 was estimated by the Registrar-General to be 77,550, which is the figure used in compiling this report. Estimate of Population 1926. Estimated population 1926. Census population 1921. Census population 1911. Clerkenwell 51,362 50,322 57,121 St. Luke 25,095 24,592 28,976 St. Sepulchre 1,103 1,081 1,826 Totals 77,550 75,995 87,923 The estimate does not include the Finsbury residents detained in the following institutions:—The Holborn Union Institution, la, Shepherdess Walk, (520); the Holborn and Finsbury Hospital, Archway Road, Holloway (217); and the Holborn Schools, Mitcham (180); giving a total of 917. Adding this number to the RegistrarGeneral's estimate 77,550, we get a corrected population of 78,467 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 and in London, and in England and Wales during 1926. 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 17.1 11.6 64 Paddington 15.3 12.6 86 Kensington 15.1 12.8 60 Hammersmith 16.3 11.4 66 Fulham 16.2 10.8 64 Chelsea 13.3 12.5 64 City of Westminster 11.3 11.6 59.7 St. Marylebone 12.7 11.9 81 Hampstead 12.3 10.6 60 St. Pancras 16.7 12.4 76 Islington 19.0 12.0 66 Stoke Newington 16.0 10.7 48 Hackney 17.2 10.8 59 Holborn 12.38 12.1 90 Finsbury 21.4 12.9 66 City of London 7.1 10.4 66 Shoreditch 23.5 12.2 66 Bethnal Green 20.9 11.6 70 Stepney 19.4 11.5 65 Poplar 21.6 11.4 70 Southwark 20.2 12.7 70 Bermondsey 19.6 12.1 60 Lambeth 17.9 11.5 38.4 Battersea 17.3 11.4 61.6 Wandsworth 14.1 10.37 64 Camberwell 16.6 11.0 70 Deptford 18.2 11.3 56 Greenwich 17.7 10.8 61 Lewisham 15.3 10.0 40 Woolwich 17.4 10.2 43 England and Wales 17.8 11.6 70 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 2,833 31.8 1911 87,566 2,676 30.6 1912 86,130 2,579 29.9 1913 84,679 2,494 29.4 1914 83,212 2,558 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 32.4 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 1926 77,550 1,659 21.4 The rates for the various districts were as follows:— Population. Births. Birth rate. Clerkenwell 51,352 1,030 20.05 St. Luke 25,095 614 24.46 St. Sepulchre 1,103 15 13.59 The whole Borough . 77,550 1,659 21.4 9 The corresponding birth rates for the rest of the country are attached :— England and Wales 17.8 London 17.1 Finsbury 21.4 105 great towns 18.2 158 smaller towns 17.7 The number of Finsbury births reported as illegitimate was 61. The number of deaths in illegitimate children under one year was three. NOTIFICATION OF BIRTHS ACTS, 1907 AND 1915. The statistics for the last five years are given in the panying table. Year 1922 1923 1924 1925 1926 Total Births notified 3.510 3,421 3,167 3,362 3,169 Percentage attended by Doctors 2.4 2.4 3.8 3.5 2.5 Percentage attended by Midwives 28.4 27.5 29.0 31.2 25.2 Still Births notified 59 51 42 41 47 Births registered 1,934 1,844 1,662 1,754 1,659 The number of Finsbury births notified in 1926 was 1,643. Notifications were received of 23 sets of twins. The percentage of births notified by parents was 7.1, by medical men 2.5, by midwives 25.2, by hospitals, infirmaries and nursing homes 21.7, and by others, chiefly medical students and midwifery students was 43.5 per cent. The mothers of this last group were all attended gratuitously in their confinements by medical students and student midwives from various hospitals and institutions. In 1926 the number of instances in which parents omitted to notify was 57. To these a printed form was sent drawing attention to the omission. 10 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 1926, were as follows:— Monday Sale of Dried Milk, 9 a.m. to 10 a.m. Mothers' and Babies' clinic, 10 a.m. Dental clinic, 2 p.m., alternate weeks. Babies' clinic (old cases only), 3 p.m. Tuesday Sewing Class or Cookery Class, 2 p.m. Talks to Mothers, 3 p.m. Wednesday Sale of Dried Milk 9 a.m. to 10 a.m. Weighing of Children, 10 a.m. Children's clinic and Weighing Centre, 2 p.m. Clothing Club and Mothers' Holiday Fund, 3 p.m. Thursday Dental gas clinic, 11 a.m., arranged when necessary. Friday Sale of Dried Milk, 9 a.m. to 10 a.m. Weighing of Children, 10 a.m. Children's clinic and Weighing Centre, 2 p.m. Clothing Club, 3 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 69 expectant 35 of children 1—5 years 48 Children 1—5 years 321 Infants under 1 year 379 Total number 852 Children's Clinic.—In 1926 the number of meetings was 105. The patients who attended were :—Children, 1—5 years, 321; infants under 1 year, 379; the attendances were, children, 1—5 years, 1,412; infants, 1,746. Average attendances per clinic:—Children 13, infants 16. 11 Mothers' Clinic.—In 1926 the number of meetings was 45; the patients were :—Nursing mothers 62, expectant mothers 23. The attendances were :—Nursing mothers 158, expectant mothers 54. Average attendances :—Nursing mothers 3—4, expectant mothers 1—2. Dental Clinic.—The number of clinics was 32. The patients were:—Nursing mothers 30, expectant mothers 4, mothers of children under 5 years 34, children 1 to 5 years 24. The attendances were:—Nursing mothers 82, expectant mothers 8, mothers of children under 5 years 89, children 36. Average attendance at a clinic 6—7. Two 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. 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 90, expectant mothers 111. Sale of Dried Milk.—2,130 one-pound packets were sold in 1926 at cost price. The number of packets given free by order of the Maternity Committee 381, at part cost 49. 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. Cookery Class.—Number of classes held 9 ; attendances 78. 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 52, attendances 446. Average attendance 8. During the class, children and babies were looked after in the nursery. Attendances of children 427. 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 6 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 :— Mothers—Post-Natal. Subinvolution 4, anaemia 24, constipation 21, haemoptysis 1, influenza 1, pruritus 1, dental caries 12, abscess 5, debility 37, headache 1, cough 7, general advice 23, mastitis 1, coryza 2, menopause 2, menorrhagia 1, tonsilitis 7, rheumatism 1, valvular disease of the heart 1, stomatitis 1, dyspepsia 2, albuminuria 2, myopia 1, pyrexia 1. The following cases were referred to a Hospital or to a private doctor:— Subinvolution, haemoptysis, abscess, menorrhagia, heart disease, albuminuria, myopia, pyrexia. The cases of dental caries were referred to the dental clinic. M others—A nte-Natal. Anaemia 2, varicose veins 2, haemorrhage 2, general advice 27, constipation 16, dyspepsia 1, phthisis 1, oedema 2, debility 1. 13 The following cases were referred to hospital:— Haemorrhage, Oedema. The case of phthisis was referred to the Tuberculosis Dispensary. Children 1—5 years. General advice 457, general inspection 32, constipation 21, diarrhoea 68, cough 260, marasmus 12, malnutrition 83, phimosis 4, pyrexia 5, debility 28, blepharitis 15, rickets 18, anaemia 43, thrush 2, otorrhoea 13, worms 15, digestive disturbance 13, dental caries 18, rash 3, impetigo 29, stomatitis 8, alopoecia 2, bronchitis 1, melaena 1, dermatitis 7, rhinorrhoea 1, cyst 5, enuresis 1, ringworm 3, pemphigus 5, tonsilitis 11, whooping cough 1, eczema 24, septic wound 3, urticaria 6, bacilluria 2, squint 14, septic finger 1, burn 5, furuncle 2, coryza 11, abscess 2, adenoids 1, conjunctivitis 3, pneumonia 2, cretinism 1, adenitis 10, mumps 5, enlarged tonsils 16, lupus 2, prolapsus ani 1, rash 11, herpes 9. There following cases were referred to hospital:— Phimosis, pyrexia, rickets, otorrhoea, alopoecia, melaena, rhinorrhoea, cyst, whooping cough, bacilluria, squint, burn, abscess, adenoids, conjunctivitis, pneumonia, cretinism, mumps, enlarged tonsils, lupus. The cases of dental caries were referred to the dental clinics. Infants up to one year. General advice 585, general inspection 290, constipation 118, diarrhoea 59, cough 245, malnutrition 41, rash 26, naevus 19, marasmus 57, digestive disturbance 69, impetigo 25, debility 6, blepharitis 3, ringworm 2, otorrhoea 22, hernia 18, worms 2, coryza 17, phimosis 11, conjunctivitis 14, adenitis 9, abscess 3, thrush 24, club foot 3, rickets 2, jaundice 2, bronchitis 1, anaemia 5, spina bifida 2, enlarged tonsils 1, burn 1, stomatitis 2, herpes 6, nasal obstruction 1, rhinorrhoea 2, hare lip 1, urticaria 1, pruritus 3, eczema 7, pemphigus 5. 14 The following cases were referred to hospital:— Naevus, otorrhoea, phimosis, conjunctivitis, adenitis, abscess, club foot, rickets, jaundice, spina bifida, enlarged tonsils, burn, rhinorrhoea, hare lip. South Clerkenwell Centre, Old Sessions House, Clerkenwell Green.— The work and classes held at this Centre during 1926 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. Children's Clinic, 3 p.m., alternate weeks. Tuesday Mothers' and Children's Clinic, 10 a.m. Sewing Class and Talks to Mothers, 2 p.m. Clothing Club, 3 p.m. Thursday Dental Gas Clinic, 11 a.m., when necessary. Children's Clinic and Weighing of children, 2 p.m. Clothing Club and Mothers' Holiday Fund, 3 p.m. Friday Sale of Dried Milk, 9 a.m. to 10 a.m. Saturday Sale of Dried Milk, 9 a.m. to 12 noon. Numbers of individual mothers, children and infants who have attended clinics and classes:— Mothers, nursing 64 expectant 21 of children 1—5 years 21 Children 1—5 years 124 Infants 235 Total number 465 15 Children's Clinic.—In 1926 the number of meetings was 95. The patients who attended were:—Children 1—5 years 124, infants under 1 year 235. The attendances were:—Children 1 to 5 years 1,441, infants under 1 year 2,044. Average attendances per clinic: children 15, infants 22. Mothers' Clinic.—In 1926 the number of clinics held was 52. The number of patients was 84—post-natal 63, expectant mothers 21. Attendances at these clinics numbered 241—post-natal 171, expectant 70. Dental Clinic.—The number of clinics was 31. The patients were:—Nursing mothers 37, expectant mothers 5, mothers of children 1—5 years 29, children from 1 to 5 years 30. The attendances were :—Nursing mothers 71, expectant mothers 9, mothers of children 1 to 5 years 65, children 36. Average attendance at a clinic 6. Eight mothers were fitted with dentures at the clinic; six by their own efforts, and with help granted by their Approved Societies, were provided with dentures. Two were referred to the Charity Organisation Society, who in one case enabled the grant of dentures free and in one case arranged with the mother 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 97, expectant mothers 160. In connection with the dental clinic, 6 visits. Dinners were served to twelve mothers, who made a total of 366 attendances. Sale of Dried Milk.—1,787 one-pound packets were sold in 1926 at cost price. The number of packets given free by order of the Maternity Committee was 464; 6 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. 52 classes were held, and these were attended by 39 mothers; these made in all 635 attendances. The attendances of children in the nursery on these occasions numbered 959. 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. General advice 445, general inspection 174, cough 132, constipation 98, diarrhoea 30, eczema 16, rash 19, impetigo 9, digestive disturbance 18, malnutrition 35, coryza 11, hernia 8, abscess 3, measles 3, marasmus 38, otorrhoea 6, thrush 4, blepharitis 6, debility 4, melaena 1, rickets 8, conjunctivitis 3, furuncle 1, phimosis 3, pemphigus 3, burn 1, anaemia 2, herpes 3. The following recommendations to hospital or private doctor were made:— Hernia, abscess, melaena, rickets, phimosis, burn, measles, otorrhoea, melaena. The cases of measles were notified to the Medical Officer of Health. Children aged 1 to 5 years. General advice 267, cough 130, constipation 23, diarrhoeal3, malnutrition 71, general inspection 21, rhinorrhoea 3, pemphigus 4, anaemia 11, coryza 7, enlarged tonsils 11, herpes 2, rash 16, debility 18, blepharitis 4, digestive disturbance 5, dental caries 12, worms 7, tonsilitis 6, thrush 1, adenitis 2, burn 3, otorrhoea 5, rickets 29, eczema 2, marasmus 2, measles 1, septic finger 1, colitis 1, stomatitis 1, impetigo 5, urticaria 4, cyst 2. 17 The following recommendations to hospital or private doctor were made:— Rhinorrhoea, enlarged tonsils, tonsilitis, adenitis, otorrhoea, rickets, measles, septic finger, colitis, cyst. The case of measles was notified to the Medical Officer of Health, and the cases of dental caries referred to the Dental Clinic. M others—A nte-N atal. Dyspepsia 2, constipation 26, antepartum haemorrhage 1, general advice 30, anaemia 1, agalactia 2, haemorrhoids 1, contracted pelvis 3, dental caries 1, debility 2. The following cases were recommended to attend a hospital or a private doctor :— Antepartum haemorrhage, contracted pelvis. The case of dental caries was referred to the dental clinic. M others—Post-N atal. Constipation 20, cough 16, general advice 48, debility 36, neuralgia 3, anaemia 14, mastitis 2, dyspepsia 9, neuritis 1, furuncle 2, urticaria 3, coryza 1, mammary abscess 1, dental caries 18, incomplete abortion 1, tonsilitis 2, pruritus 1, rheumatism 2, pharyngitis 1, subinvolution 3, erosion 3, heart disease 2. The following cases were recommended to attend a hospital or private doctor :— Neuritis, furuncle, abs ;ess, incomplete abortion, tonsilitis, subinvolution, erosion, heart disease. The cases of dental caries were referred to the Dental Clinic. During the year the Assistant Medical Officer of Health administered gas at the Old Sessions House Centre, for extraction of teeth. Eleven such gas-dental clinics were held, and gas was administered 91 times, making an average attendance of 8 at these clinics. Lectures on Measles, Vaccination, Diet for Toddlers, The nose, Summer Diarrhoea, and Whooping Cough, were given to the mothers attending the Sewing Class. b 18 Health Visitation. The number of visits paid by the Health Visitors in 1926 was as follows:— District. First Births. Total Births. Total Visits. No. 1 180 567 4,394 No. 2 141 541 3,123 No. 3 104 519 4,239 Totals 425 1,627 11,756 The numbers for 1925 were 340 first births, 1,744 total births, and 11,240 visits. In 1926 the total number of Finsbury births notified was 1,643, so that the figures in the preceding table show that during 1926 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 71 births notified. 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 1926 is appended:— Centre. No. of Meetings. Attendances. Average Attendance. No. of Babies and Children up to 5 years. Lever Street 104 4,918 47 700 Old Sessions House 95 3,485 38 359 Total 199 8,403 42 1,059 The number of new babies brought during the year was 467. Of these 351 were solely breast fed, 19 were bottle fed, and 97 breast fed and bottle fed, when they were brought to the Centres. 19 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 383 babies were fat and plump, 73 were thin, while 11 were wasting. Only 21 per cent, were brought while they were still under the age of 1 month. 64 per cent, attended under three months. The number of premature babies kept under supervision was 9, twins 5 sets. 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:— Weights at Birth. District No. 1. District No. 2. District No. 3. Totals. Under 4 lbs. 4 2 2 8 4—5 lbs. 9 12 4 25 5—6 lbs. 23 50 22 95 6—7 lbs. 76 128 80 284 7—8 lbs. 204 178 137 519 8—9 lbs. 160 74 129 363 9—10 lbs. 44 30 78 152 10—11 lbs. 22 0 26 48 11—12 lbs. 3 0 7 10 Over 12 lbs. 2 0 0 2 Totals 547 474 485 1,506 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. b 2 20 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 and sign a printed form of application. 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 1926, 1,533 applications were received, an average of 128 per month; 433 families received grants in respect of these applications ; the largest proportion of applications was made during the June quarter, 1926. Many applications related to both mother and child, and in respect of 1,501 applications 1,607 21 grants were made. Thirty-two 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 30,408 pints, dinners 7,965, and dried milk 855 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 £718 6s. 8d. The Ministry of Health refunds onehalf of the approved net expenditure in this connection. Of the 433 families who received grants 117 were in receipt of unemployment benefit ; 151 were in receipt of poor law relief ; 29 were in receipt of either unemployment benefit or poor law relief whilst receiving grants from the Council. 284 of the applicants were Ex-Service men. 40 of the fathers were stated to be "chronicout-of-works." In 61 cases "large families" were reported, that is, families with six or more children. 80 of the applicants were regularly employed, and 288 irregularly employed. 71 applicants were in the employ (casual) of the Finsbury Borough Council. Grants were made in respect of 10 illegitimate children. In 10 cases the man and wife were living apart. 12 widows applied for, and received, grants. Of the total 433 families dealt with, 204 lived in one-roomed tenements, 206 in two-roomed tenements, and 23 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. Od. to 12s. 6d. 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. Hospital Treatment.—The Borough Council renewed their agreement with the governing body of the Infants' Hospital, Vincent Square, Westminster, S.W.1, from 1st October, 1925, for the retention of three cots for use when required for the reception and 22 treatment of ailing Finsbury children up to the age of 5 years. 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, 1927. The cots have been occupied in 1926 by 18 ailing babies. Puerperal Fever.—In 1926 there were 3 notifications, with 1 death. The statistics for previous years are appended:— Years. 1912-17 1918 1919 1920 1921 1922 1923 1924 1925 1926 Totals Notifications 53 1 6 5 6 7 13 7 11 3 112 Deaths 24 0 3 5 1 4 1 1 1 1 41 The cases of puerperal fever are investigated by the Assistant Medical Officer of Health. The premises are visited, the sanitary defects ascertained, and made the subject of notice for amendment. If the patient is admitted to hospital, the rooms are disinfected immediately after the patient's admission. Ophthalmia Neonatorum.—Twelve cases were notified in 1926. 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 6 attended Moorfields Eye Hospital, and two attended University College Hospital as out-patients. One case was attended by a private doctor in the patient's home, and one case was reported from an institution in the Borough. In no case was impairment of vision reported. DEATHS AND DEATH RATES. The number of Finsbury residents who died in 1926 was 1,001; equivalent to a death rate for the whole Borough of 12.9 per 1,000 inhabitants living. The death rate for the whole of London was 11.6 per 1,000. 23 The death rates for previous years are given in the attached table. Death Rates, 1912-1926. 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 1926 12.9 12.3 13.9 15.4 The Finsbury deaths were apportioned as follows:—Clerkenwell 635, St. Luke's 349, St. Sepulchre 17 deaths. The comparison of Finsbury with the rest of the country may be seen below :— Death Rates for 1 926. England and. Wales 11.6 London 11.6 Finsbury 12.9 105 great towns 11.6 158 smaller towns 10.6 Inquests.—During the past year 105 inquests were held in the Borough of which 7 were on the bodies of non-residents who died suddenly in the district. Eleven 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 2, accidental falls 7, accidental scalds 1, collision of vehicles 1, accidental drowning 2, injury to head 1, knocked down by pedal bicycle 1, poisoning 1, run over by motor vehicle 17, run over by tramcar 1, suicide 12. 24 INFANT MORTALITY. The infant mortality of the Borough for 1926 is 66. Expressed in popular manner, this means that out of every 1,000 children born during the year 66 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 75 1925 1,754 105 59. 8 1926 1,659 109 66 25 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 course 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:— England and Wales 70 Whole of London 64 Finsbury 66 Great towns 73 Smaller towns 67 26 Amongst the 29 Metropolitan cities and boroughs 16 have an infant mortality lower than Finsbury ; those with lower rates of infant mortality were Greenwich, Lewisham, Woolwich, Kensington, Fulham, Chelsea, Westminster, Hampstead, Stoke Newington, Hackney, Stepney, Bermondsey, Lambeth, Battersea, Wandsworth, Deptford. 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. 1911-20 1921 1922 1923 1924 1925 1926 Total. Measles 137 1 1 0 11 4 4 158 Diphtheria 14 2 3 2 1 1 0 23 Scarlet Fever 3 1 0 0 0 0 1 5 Whooping Cough 87 6 7 3 8 4 1 116 Diarrhoea and Enteritis 469 34 5 23 12 20 15 578 Premature Birth 446 44 50 28 30 14 33 645 Congenital Defects 20 13 7 1 1 1 1 44 Marasmus 170 5 10 2 6 4 5 202 Tuberculous Meningitis 40 0 2 0 0 0 0 42 OtherTuberculous Diseases 38 2 1 1 1 1 2 46 Erysipelas 4 0 0 1 0 0 1 6 Syphilis 53 2 4 0 2 1 0 62 Convulsions 71 3 5 1 3 2 5 90 Bronchitis 146 6 8 6 8 7 6 187 Pneumonia 394 35 36 25 28 23 19 560 Overlying 103 4 3 0 2 2 0 114 Other Causes 335 23 16 19 12 21 16 442 Totals 2,530 181 158 112 125 105 109 3,320 27 During the same period the births have numbered 32,220 and the resulting average infant mortality for the last 16 years has been 103 per 1,000 births. The infant deaths in 1926 were chiefly in the following streets: Albert Street (2), Baker's Row (2), Brewer Street North (2), City Road (2), Galway Street (2), Goswell Road (2), Great Bath Street (2), Ironmonger Street (2), Margaret Street (2), Northampton Road (2), Northampton Street (2), Southampton Street (2), Bowling Green Lane (3), Donegal Street (3), Risinghill Street (3), Rosoman Street (3), Warren Street (3), Waterloo Street (3), Bastwick Street (4), Cumming Street (4), Rodney Street (4), Lever Street (5). In 1926 the infant deaths were in Clerkenwell 71, in St. Luke's 38, and in St. Sepulchre, 0 deaths. Infant Mortality by Districts.—The infant mortality rates for the period 1909—1926, arranged according to districts, are given in the subjoined table. Infant Mortality, 1909-26. Year. The Borough. Clerkenwell. St. Luke's. 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 128 119 144 111 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 1926 66 69 62 0 28 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 1926 Number of deaths from Tuberculosis 132 134 121 103 106 126 99 Number of cases notified only at death 39 40 11 a3 b10 c6 d3 Number of cases dying non-notified a18 b20 e17 f14 Number of cases notified within a month of death 12 7 13 11 7 14 13 Number of cases notified within 1 to 3 months of death 12 15 5 11 12 12 15 Number of cases notified within 3 to 6 months of death 8 21 12 6 6 12 11 Of the numbers given above, those deaths which occurred in poor law institutions are as follows :—a, 14; b, 23; c, 5; d, 2; e, 12; f, 9. 29 Tuberculosis of the Lungs.—The notification and deaths of Finsbury cases of Phthisis since 1901, are appended:— Phthisis Notifications and Deaths, 1901-1926. 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 45.9 151 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 27.7 116 1.51 1922 140 18.2 102 1.33 1923 150 19.4 90 1.16 1924 144 18.6 95 1.23 1925 202 26.0 111 1.43 1926 160 20.6 88 1.13 30 The actual number of notifications received in 1926, was 642, but of these many refer to the same patient. There were 306 total primary notifications, but of these 146 were duplicates, leaving 160 true cases ; of these 30 were from poor law sources, 86 from hospitals and dispensaries, 39 from private doctors, and 5 from sundry sources. In reference to the poor law cases there were also received 135 notices of admission and discharge relating to patients previously notified; 201 such notices were also received in respect of tuberculous persons entering and leaving institutions other than poor law. 100 gave a Clerkenwell address, 59 lived in St. Luke's, and one lived in St. Sepulchre. How many of the whole number are Finsbury Cases— 1. Finsbury cases by residence and infection 106 2. Finsbury cases by infection 14 3. Finsbury cases by residence only 5 4. Not Finsbury cases 12 5. Not ascertainable 23 160 The cases which may be definitely associated with the borough are the first two groups, and amount to 120, that is 75 per cent. of the whole number. Distribution by Streets.—The largest numbers were notified from the following places:—Old Street 11, Lever Street 10, Farringdon Road 7, St. John Street 5, King's Cross Road 4, Affleck Street 4, Roscoe Street 4, Northampton Road 4, Risinghill Street 3, White Lion Street 3, Cumming Street 3, Wynford Road 3, Seward Street 3, Granville Square 2, Winchester Street 2, Donegal Street 2, Chapel Street 2, Pentonville Road 2, Galway Street 2, Central Street 2, Norman Street 2, Dufferin Street 2, Ironmonger Street 2, Bastwick Street 2, Cyrus Street 2, Little Sutton Street 2, Buxton Street 2, Claremont Square 2, Gloucester Street 2, Great Bath Street 2, Sekforde Street 2, Rosoman Street 2, Arlington Street 2. The Homes and Tenements of the Patients.—Out of the whole number, excluding lodging houses, 29 were one-roomed tenements, that is to say, in these tenements the patient and family lived 31 and slept in one room only. 41 were two-roomed tenements, 25 had three to eight rooms, 5 were notified from institutions, and their families had left the addresses given, one requested that he should not be visited, 5 were not traceable and 11 were inmates of common lodging houses. One of the tenements was overcrowded. One tenement had only one cupboard for food and coal. Four 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 familes, the abatement of overcrowding is insisted upon forthwith. Twenty-four tenements were on the list of houses let in lodgings, 31 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, seven were used for the sale or preparation of food products. It is very unfortunate and most undesirable that these con sumptive patients should have to do with the handling or manufacture 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. 32 The only statutory power for preventing consumptives handling food for human consumption is given by the Public Health tion of Tuberculosis) Regulations, 1925: "No person who is aware that he is suffering from tuberculosis of the respiratory tract shall enter upon any employment or occupation in connection with a dairy which would involve the milking of cows, the treatment of milk, or the handling of vessels used for containing milk; further, if a local authority on the report of their Medical Officer of Health are satisfied that any person engaged in the milk trade as above is suffering from tuberculosis of the respiratory tract and is in an infectious state they may by notice require such person to discontinue his employment. Certain provisions of the Public Health Acts relating to compensation for damages sustained by reason of the exercise of these powers apply to any person so affected, where he is not himself in default." 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:—Roof leaky 5, room dirty 9, dustbin dilapidated 5, water closet out of order 2, dirty yard and area 1, choked water closet 1, water closet pan foul 1, leaky drain 1, flooring weak 1, sash cords broken 2, ceiling broken 1, absence of gutter 1, broken area and yard 1, dustbin accommodation insufficient 1. 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. Persons. Families. Persons. Families. 1 42 1 0 2 45 2 12 3 11 3 21 4 0 4 5 5 1 5 0 6 0 6 1 7 0 7 0 33 One bedroom contained eight beds, and eight persons regularly used the beds, but this was a boarding house. Eleven patients gave common lodging house addresses. Only 42 patients out of 139 living in private houses were able to have a bed and bedroom all to themselves. In 57 other households, where only one bed was available, 72 persons slept in the same bed with the consumptives, and were consequently exposed to infection. This number refers to those families which only possessed one bed. In addition to these there were 81 persons who occupied the same bedroom as a phthisical patient, and in some instances the same bed. Seven bedrooms were dark, or had insufficient light. The ventilation was insufficient in 3 other bedrooms, and 2 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 four. 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. Three bedrooms were dirty; 2 were verminous. In 20 instances the patients were said to be of careless habits. The Kitchen.—In 82 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 two were 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. C 34 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 1926 the number of specimens examined was 165, of which 34 gave positive results. Free systematic and periodic disinfection is offered after the notification of patients. In 1926 the rooms, bedding, feeding utensils, towels, handkerchiefs and linen were disinfected in 59 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 472. 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 995. Deaths.—In 1926 the number of Finsbury persons who died of phthisis or pulmonary tuberculosis was 88. In addition to these, 2 died from tuberculous meningitis, and 10 from other forms of tuberculosis. The deaths from all forms of tuberculosis were 100. The deaths for previous years are given in the subjoined table:— 35 Phthisis Deaths and Death Rates, 1901-1926. 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 160 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 1926 88 12 1.13 .771 The Phthisis Death Rate for 1,000 inhabitants in London during 1926 was .88. C 2 36 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 : 56 deaths from phthisis belonged to Clerkenwell, 32 to St. Luke's, and 0 to St. Sepulchre. Of the whole of the 1,001 deaths in Finsbury in 1926, 8.8 per cen. were due to phthisis, as against 10.52 for 1925, 8.7 per cent. for 1924, and 8.9 per cent. for 1923. Sixty-seven 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 35, derived from Clerkenwell 20, St. Luke's 15, and St. Sepulchre 0 cases. The parts chiefly affected were the peritoneum (2), spine (2), glands (10), meninges (2), knee (5), arm (2), hip (2), abdomen (2) cases. Five patients were bedridden at the time of notification. In these, notification was a very late incident in the disease. 14 cases were infants under school age. 6 were examples of "open tuberculosis" associated with external discharges, and therefore presumably infectious to those brought into contact with the sufferers. 9 were school children. Of the whole number, 19 were considered to be Finsbury cases by residence and infection, 15 Finsbury cases by infection, and the remaining one was not a Finsbury case. Three of the tenements was overcrowded. The close contacts in the same families included 98 adults and children over school age, and 78 other children. The kitchen was used for sleeping purposes in 23 instances. In 9 cases the mother was the chief or only wage earner. The deaths included 2 from tuberculous meningitis (Clerkenwell 1, St. Luke's 1, St. Sepulchre 0) and 10 (Clerkenwell 7, St. Luke's 3, St. Sepulchre 0) from forms of tuberculosis other than phthisis. Altogether 53 primary notifications were received, but 18 of these were duplicates. The Finsbury death rate from all forms of tuberculosis in 1926 was 1.29 per 1,000 ; the corresponding rate for England and Wales in 1926 was .961, and for London in 1926, was 1.033. Tuberculosis Dispensary.—A Tuberculosis Dispensary for Finsbury residents was established at the Royal Chest Hospital, 37 City Road, on December 1st, 1916. During 1926 new patients numbering 414 were examined; of these, 192 were under 15 years of age, the rest above that age. Those suffering from tuberculosis were 86 (38 insured and 48 not insured). The suspects were 27 (4 insured and 23 not insured). The total number of patients, new and old, who attended during the year was 921. The total attendances were 4,387. The visits to the homes of the patients were 3,208. These visits were nearly all made by the nurse attached to the dispensary. 137 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 close contacts examined at the Tuberculosis Dispensary was 230, out of a possible 472. The number of "X"ray examinations was 22. The number of sputum specimens examined by the hospital pathologist was 408. The Tuberculosis Officer made 409 visits to the homes of the patients. Under the scheme formulated by the Ministry of Health in Memorandum 30/T the Tuberculosis Officer furnished 303 reports to the Ministry of Pensions in respect of the examination of exservice men during 1926. 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 1926. 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 1926. Cerebro Spinal Fever.—One case was notified in 1926. There was one death. 38 Anthrax, Glanders and Hydrophobia.—No cases were notified during 1926. Encephalitis Lethargica.—Six cases were notified during 1926. Two deaths were reported. Poliomyelitis and Polio Encephalitis.—One case of acute poliomyelitis was notified in 1926. There were no deaths. Measles.—1,142 cases of measles and german measles were notified during 1926. Measles and german measles have 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. 240 cases were removed to hospital. In these cases disinfection was carried out immediately after the patient's removal, excepting where there was another case remaining in the same room. Comparative Table.—In 1926 measles caused 21 deaths (all of these were under 5 years) and whooping cough 5 deaths. These two diseases are extremely fatal to children under 5 years. Deaths in Children under 5 years, 1901-1926. 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 — 1924 44 25 — 2 14 — 1925 12 15 — — 4 — 1926 21 5 — 2 5 — Totals 1,333 757 13 143 346 1 39 From this table is appears that the deaths in 26 years due to scarlet fever, diphtheria, typhoid fever and small-pox, all taken together, numbered 503, to whooping cough 757, and measles 1,333. 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 186, all except 3 of which were admitted to isolation hospital. Of these, 22 were subsequently sent home as not suffering from diphtheria, one case proved to be scarlet fever, one case proved to be laryngitis, 9 cases were diagnosed as tonsilitis, 1 measles, 10 were described as " not diphtheria," and in one case the notification certificate was withdrawn after the patient's admission to hospital, leaving 163 true cases of diphtheria. There were 5 deaths, so that 3 per cent. of all the patients died. The number of cases was 38 less than last year ; the number of deaths is 1 less than in 1925. The 3 cases treated at home were kept under observation ; suitable measures were adopted to secure isolation, and the premises were disinfected upon the recovery of the patients. 40 The particulars of cases in previous years are appended:— Year. No. of Cases. No. of Deaths. Case Mortality. No. of Deaths per 100 cases notified. No. of Cases per 10,000 of Population. No. of Deaths per 10,000 of Population. 1911 159 17 10.7 18.1 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 11 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 1926 163 5 3.1 21.0 .64 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. 3 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. 41 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. 1 such case occurred in 1926. 21 patients upon discharge had enlarged neck glands. One patient had sores on the face. Swabs are examined bacteriologically free of charge for medical men by the Public Health Department. In 1926 483 specimens were submitted, with positive results in 39 instances. A supply of diphtheria 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 258 notifications of scarlet fever in 1926. Of these, 27 were subsequently sent home as not suffering from scarlet fever, leaving 231 true cases.* There were 2 deaths. All the patients were treated in hospital, excepting two. The cases treated at home were kept under observation, suitable measures were adopted to secure isolation and the premises were disinfected upon the recovery of the patient. * The cases marked not suffering from scarlet fever were reported to be suffering from enteritis 2, septic throat 1, measles 1, whooping cough 1, erythema 4, tonsillitis 1, and " not scarlet fever " 17. 42 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 29.6 .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 .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 .00 33.6 .00 1926 231 2 .86 29.7 .26 Seven patients developed scarlet fever while they were detained in hospital for other causes. There were two " return " cases. Thirty-six cases were not discovered until some days after the rash had appeared. 7 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, were disinfected. 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 43 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. Twenty 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 1926, the number of cases notified was 2. There were no deaths. The numbers in previous years are given in the accompanying table:— 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 .58 .11 1913 15 0 .0 1.7 .00 1914 15 2 12.5 1.8 .24 1915 3 1 33.3 .39 .13 1916 4 0 .0 .53 .00 1917 2 1 50.0 .29 .14 1918 2 0 .0 .30 .00 1919 7 0 .0 .93 .00 1920 5 0 .0 .64 .00 1921 5 0 .0 .65 .00 1922 4 1 25.0 .52 .13 1923 2 0 .0 .26 .00 1924 5 0 .0 .64 .00 1925 7 3 42.8 .90 .39 1926 2 0 .0 .26 .00 44 Cases of typhoid fever, on their discharge from hospital, are visited and examined. A leaflet of instruction is left with them, 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 1926, 5 specimens of blood were received for diagnosis ; they were all negative. Trench Fever, Dysentery, Malaria.—One case of dysentery was notified during 1926. 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. 45 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) 4 (2) Number of dwelling-houses which were inspected and recorded under the Housing (inspection of District) Regulations, 1910, or the Housing Consolidated Regulations, 1925 4 (3) Number of dwelling-houses found to be in a state so dangerous or injurious to health as to be unfit for human habitation 4 (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 0 46 (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 (6) Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 2279 (2) Number of dwelling-houses in which defects were remedied:— (a) By Owners 2279 (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 4 (2) Number of dwelling-houses in respect of which closing orders were made 4 (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 suance of demolition orders 0 (6) Number of dwelling-houses demolished voluntarily upon the making of closing orders 4 Finsbury Housing Scheme.—Mantell Street and Southampton Street.—The Borough Council is engaged in promoting the building of 95 flats in Mantell Street and Southampton Street. There will be 6 flats with five rooms each, 60 flats with 4 rooms each, 25 flats with 3 rooms each, and 4 flats with 2 rooms each. The number of rooms will be 353. This enumeration leaves out of count the sculleries and bathrooms provided for each flat. The cost of the 47 land is £10,500. The estimated cost of the buildings is £69,011 ; in addition there will be Architect's fees £1,600, Quantity Surveyors' fees £1,000, Clerk of the Works salary £450, and Contingencies £939. These are estimated amounts. The total cost of the buildings is estimated at £83,250. On this basis, the cost per room, living or sleeping, and excluding sculleries and bathrooms, works out at £235 odd, which does appear to be rather a large sum. If we include the sculleries and bathrooms as " rooms," then the cost amounts to £153 per room. Housing Enquiry.—A housing enquiry was held by an Inspector of the Ministry of Health on June 8th, 1926, at the Finsbury Town Hall, in connection with the Finsbury (White Horse Alley) Reconstruction Scheme, 1925. The following report was made by the Medical Officer of Health:— The houses, rooms, families, and persons concerned in this reconstruction scheme are given below. Houses. Rooms. Families. Persons. White Horse Alley 6 33 13 58 Pump Court 9 29 20 71 Market Buildings 1 17 14 39 Totals 16 79 47 168 The present housing enquiry is concerned with the small area containing the dwelling houses in White Horse Alley, Market Buildings and Pump Court. White Horse Alley is a narrow alley running obliquely north and south and connecting Benjamin Street with Cowcross Street. Market Buildings are situated at the southern end of White Horse Alley, and are at the rear of Numbers 19 and 20, Cowcross Street. Pump Court is a cul-de-sac, connected with White Horse Alley by a short narrow passage near the northern end of White Horse Alley, and runs almost parallel to White Horse Alley, and east of it. 48 White Horse Alley is roughly 240 ft. long ; Pump Court, 110 ft. The entrance to the north end of White Horse Alley is 7 ft. 1 in. wide, the entrance to the south end is 4 ft. 11 in. wide. Near the junction of the lower and middle thirds of the Alley there is a diversion of the Alley on its west side forming a small open space 44 ft. by 13 ft. The widths of White Horse Alley in its upper or northern half range from 5 ft. 11 in. to 8 ft. ; in its lower they range from 5 ft. 5 in. to 6 ft. 5 in. The occupancies in White Horse Alley, beginning at the south end and on the east side, are as follows:— 1. Side wall of 48, Cowcross Street. 2. Merivale Press, as far as the recess. 3. No. 7, White Horse Alley. 4. No. 8, White Horse Alley. 5. Nos. 9, 10, 11, White Horse Alley. 6. Nos. 12, 13, 14, 15—four empty derelict houses. 7. The side walls of 37, 38, Red Lion Street. Returning along the Alley from the north end, and on the west side, the occupancies are :— 8. The side wall of 9, Benjamin Street. 9. The side wall of a timber yard, having an entrance from Benjamin Street. This wall is nearly 12 ft. high. 10. The back wall of a cold storage establishment, belonging to Simons and Swain, 26, Cowcross Street. This wall is at least 14 ft. high. 11. A builder's workshop—formerly No. 18, White Horse Alley, and now to let. 12. The recess already referred to. In the north-west corner of this recess is an occupied house, No. 19, White Horse Alley. 13. Market Buildings. 14. The side wall of No. 19, Cowcross Street. 49 White Horse Alley, Nos. 7, 8, 9, 10, 11, 19. The occupied houses in White Horse Alley, excluding Market Buildings, for the moment, are Nos. 7, 8, 9, 10, 11, 19. The occupants are 13 families, 58 persons in all, made up as follows:— 18 heads of families, 33 children over 10, and 7 children under 10 years. These houses are all, more or less, of the same type. They are working class houses, of a very poor character, containing three floors and a basement. There are two rooms on each floor. No. 19 has one room on each floor. There is no basement in Nos. 7 and 8. The houses are obstructed in respect of light and ventilation by adjacent walls and buildings in the back and front. There is very little air perflation—this was noticed by observing the lack of movement in flags, pieces of tissue paper, suspended in the Alley. The brickwork of the houses is bulging in places out of the vertical. The brickwork has many cracks, some of which have been filled in. There is much evidence of subsidence to be seen in the dislocation of door frames, window frames, and the sloping or sagging floors. The window sills are sometimes fractured; the copings are in a state of disrepair. The back yards are small, have broken and sunken pavings which allow of the accumulation of stagnant water after washing in the yard or after rainy weather. These yards contain a water tap, a water closet, and a dustbin. There is no other water supply; there is no separate water tap on each landing. The occupants of the top floors have therefore to fetch the water for domestic use by descending and ascending the stairs, 28 steps from the ground floor. The water for the washing of clothes has to be carried from the yard into the washing copper in the basement. In some houses the water closets are dirty, have insufficient flush from the cistern, and have leaky cisterns or foul pans. D 50 The clothes, after washing, have to be dried in these small yards, but owing to the lack of sufficient accommodation for all the families in each house, and to the inconvenience of watching them to prevent theft, the clothes are usually dried on lines in the living room or sleeping room or both. For this purpose nails are driven into the walls of these rooms and lines are stretched across from nail to nail. The ground floor passage is also used for drying clothes in the same way. In one room, these lines were also used for hanging up the usual work-a-day clothes when disrobing at night. The basements contain the washing copper as a rule. These basements are very dark and dirty; they contain rubbish, straw, road dirt, paper, broken china, broken wood, string, tub hoops, old rope, old iron, old sacking and discarded clothes. In one basement, the washing copper was said not to be used and contained a lot of foul water. The water for use in washing has to be carried down into the basement from the yard, and this appears to have some deterring influence in connection with their use for washing. There is a deficiency of locks and keys for security to the doors of the houses and to the doors of the water closets. Privacy is usually maintained in the water closets during use by the aid of a discreet and retentive bit of string held in the hand of the user to prevent the door being pulled outwards unexpectedly. In the houses the stairways are winding and narrow, and dangerous, and would present great difficulties of rapid egress in case of fire. The walls are in parts dilapidated. The treads of the staircases are much worn. Many of the tenants complain that the rooms are verminous. In some, the ceilings are damp or leaky, the floor boards broken, or walls dilapidated. Some window-panes are broken ; the window frames are old and worn out; the brickwork has in some cases moved away from the frames, uncovering the reveals. Very many of the tenants complain of the lack of satisfactory storage accommodation for food. A cupboard is usually provided divided into two compartments. The lower is used for 51 the storage of coal or coke, the upper compartment for crockery, pots and pans, and sometimes food. These cupboards are often not used for food for various reasons—the presence of mice or vermin, or the want of suitable ventilation; the food appears to become musty. Some of the tenants keep their food wrapped up on the table in the living room, others in a chest of drawers, others in a small wooden chest, kept on the landing, which they have made themselves. The rooms on each floor communicate with each other, occasionally by a door, more often by a thin curtain placed across an open doorway. There are no baths in any of the houses, no gas, no electricity. Apart from the recess already mentioned, there is no open space for children's play. Some of the children are said to go to the gardens in Benjamin Street, but these are unsuitable for play as it is generally understood. One of the tenants said she sent her children to play in St. James' Park during the holidays. It is not meant that all the foregoing defects are present in any one house. The property might well be described as being old and worn out, for want of a better term. The tenants were questioned as to their health and sickness records during their present occupancies. Some stated they and their families had had much illness, others averred that they had never had a day's illness, had lived there since they were born, they and many of their forbears. The total number of rooms in these houses is 33. Of these 8 are used as living rooms only, 8 for living and sleeping purposes, and 17 for sleeping only. No. 19, White Horse Alley deserves special mention. On each floor there is only one room and there is no through ventilation. The water closet is placed in the basement near the washing copper. The weekly rents in White Horse Alley range from 3s. to 3s. 6d. per room. The rents stated to be paid for Nos. 7, 8, 9, 10, 11, 19, amount to £5 7s. per week. The rates and taxes are paid by the owners. D 2 52 Pump Court.—Pump Court is a blind alley lying east of White Horse Alley and contains 9 houses numbered consecutively from 1 to 9, commencing at the north end. The fronts of Numbers 1 to 8 face west towards the backs of the buildings in White Horse Alley. No. 9, Pump Court, at the south end of the Court faces north. The occupants of the court are 20 families, comprising 36 heads of families, 15 children over ten, and 20 children under ten years— a total of 71 persons. The total number of rooms is 29, occupied as follows : for living only, 3 rooms; for sleeping only, 9 rooms; for living and sleeping, 17 rooms. The weekly rents paid range from 3s. lid. to 5s. 5d. per room. The total weekly amount paid in rents is £6 9s. 7d. or a weekly average of 4s. 5d. per room. The rates and taxes are said to be paid by the owners. All the houses are obstructed in respect of light and ventilation by the buildings and premises in front of the Court. The houses are all working class houses of a very poor character. Numbers 1 to 8 have 3 floors with one room on each floor. To these rooms there is no ventilation. No. 9 has one room on the ground floor with no through ventilation, and two rooms on the first and second floors. These last four rooms have through ventilation but are obstructed in respect of light and ventilation by the adjacent wall of the premises of the Danish Bacon Company. Some of the rooms of these houses are dark, dirty, with floors shaky, sagging or sloping. Some of the floor boards are broken. The staircases are steep, narrow, dark or dangerous, and would offer serious obstacles to rapid egress in case of fire. The walls of the stairways are in places dilapidated. There is evidence of subsidence in the bulging of some walls, the sloping of some floors and the dislocation of door frames, window frames, window arches and the fractures of window sills. There are cracks in the brickwork. The window frames are old and dilapidated. Most of the tenants complain of the presence of bugs, some of the presence of rats and beetles. There is no satisfactory provision for the storage of food— this is often kept wrapped up on the table or in a chest of drawers. There are two washing coppers in a room adjacent to the ground 53 floor of No. 9, Pump Court, but some of the occupants state that they send their washing out. The two washing coppers appear to be quite insufficient to meet the needs of the 20 families who inhabit the Court. The wash-house walls are dirty, the floor is broken in places ; around one copper the cement is broken. The clothes may be dried in the narrow yard of the Court, or more often in the living rooms on lines attached to nails driven into the walls of the rooms. There are 5 water closets in the yard of the Court and placed against its west wall. In some of these closets the walls are dirty, the pans foul, the flooring broken, the seats dilapidated or fouled, or the cistern leaking. Privacy may be obtained by a retaining string attached to the door. One closet has a leaky wooden roof. The water closet accommodation— 5 closets for 71 persons—is insufficient. It must not be inferred that the whole of the foregoing defects are present in every tenement or in every water closet. There is one dust receptacle for the use of all the tenements— a large galvanised bin roughly 3 ft. by 3 ft. by 2 ft., much dilapidated with no bottom, an open top, and a hole in front patched up with a piece of metal placed inside the bin. The water supply consists of a large stone cistern, near No. 5, Pump Court, with a wooden cover made of wooden planks irregu— larly assembled, dirty and littered with paper, sticks, ashes and bits of rope. Inside this large cistern there is a smaller cistern, receiving water from the main, and having a wooden cover. This cistern has dimensions 3 ft. by 2 ft. by 2 ft. The tap placed at the south end was leaking at the time of inspection. This tap discharges over a gully yard. There are no baths provided by the owners in these tenements, no gas or electric light for lighting. There are no kitchen ranges; the cooking facilities usually consist of open fire grates with ovens. In both these sets of tenements the conditions of housing are not compatible with the standards of clean and healthy living which may now be reasonably requested by the working classes. 54 Market Buildings.—Market Buildings is situated at the south end of White Horse Alley, and consists of 16 tenements in 17 rooms. These 17 rooms are occupied by 14 families, comprising 24 heads of families, 8 children over 10 years, 7 children under 10 years, a total of 39 persons. The 17 tenements are numbered consecutively from 1 to 17. One family occupies Nos. 6 and 8. There are 2 rooms in No. 11. No. 9 is at present unoccupied—the tenants recently went away clandestinely, leaving their children behind, and the room dirty and littered with rubbish and broken furniture. Of the 17 rooms, 15 were used for living and sleeping, 1 for sleeping only, and 1 for living only. The weekly rents ranged from 3s. lid. to 5s. per room. The total weekly rent of the whole buildings is £3 17s. 2d., giving an average rent per room of 4s. 2d. per week. In addition the tenants pay the rates and taxes. The buildings are entered from White Horse Alley, and have one side overlooking the narrow part of the Alley. The width of this portion of the Alley ranges from 5 ft. to 6 ft. 5 in. One side of the buildings is opposed to the back walls of 19 and 20, Cowcross Street. One side overlooks the recess in White Horse Alley. The remaining or west side of Market Buildings overlooks various covered-in business premises. The Buildings therefore lie in a crowded business quarter and are obstructed more or less in respect of light and ventilation by adjacent buildings. There is an extensive crack in the brickwork near the southwest corner of the buildings. It runs from the window arch of No. 5 almost vertically upwards to the second floor level. Some of the tenements, notably Nos. 3 and 8, are very dark, so much so that gas has to be kept burning most part of the day. Speaking generally, with the exception mentioned above, the carcase of the buildings, the bricks, mortar, concrete and ironwork 55 are good and strong. There are several defects, mostly of a minor character, slight dilapidations, dirty or verminous rooms, dark rooms, broken floor boards and leaky ceilings. Cupboards are provided for the storage of food, but in one tenement the tenant complained that the cupboard could not be used owing to the presence of blackbeetles, so that the food was put out on the table every night. Many of the tenants complained of bugs. There are no baths provided by the owner. Gas is available for lighting and for cooking. There is no resident caretaker. A water tap and sink are provided on each floor. There are 4 water closets and a washing copper and sink provided on the ground floor. There is a flat roof to the buildings which gives facilities for the drying of clothes. There does not appear to be a sufficient number of washing coppers or of drying facilities. The washed clothes are often to be seen drying in the passages of the building. The disposition of the various tenements is as follows :— Ground floor : Nos. 1, 2, 3, 4, 5 ; First floor : Nos. 6, 7, 8, 9, 10 ; Second floor : Nos. 11, 12, 13, 14 ; Third floor : Nos. 15, 16. The case of No. 5 deserves special mention. It has one window and the only outlook from this window is on to the three water closets which lie about 6 feet from the window. On the ground floor there are 2 small yards; the first, to a person entering the buildings, faces the street entrance, and is roughly 7 ft. 9 in. by 6 ft. 3 in. It contains a yard gulley, a water closet, and a drain manhole cover. This water closet is, by the unwritten code of the tenants, generally understood to be used for men only. 56 This water closet had, at the time of my visit, a seat broken and fouled, and a dirty pan. When its door was shut the inside was rather dark. The second yard has its entrance from the passage way between Nos. 3 and 4. Between the two yards there is a small covered outhouse containing a washing copper, a large washing sink and a wooden tub placed on a large galvanised iron cistern for support. The floor of this outhouse is concrete, worn, broken and sunken in parts. The second yard is divided by a high wall from the back yard of No. 20, Cowcross Street, and has dimensions 9 ft. 6 ins. by 4 ft. 9 ins. There is a small extension of this yard eastwards, having dimensions 4 ft. 6 ins. by 2 ft. 8 ins. This extension contains the dustbins for the household refuse. In this yard there are the 3 water closets which are near and opposite to the only window of No. 5. The condition of these water closets was as follow:—two pans were cracked, all the pans were dirty, the floors and walls were dirty. Some of the one-roomed tenements of Market Buildings deserve special mention owing to the sex-promiscuity which prevailed ; the observed instances of this were as follows :— 1. The parents and a girl aged 14 years. 2. The parents and a boy aged 13 years. 3. The parents and a daughter aged 19 years. 4. The mother, two boys aged 15 years and 3 years, and a girl aged 13 years. The cooking arrangements are usually good, and consist of an open firegrate with an oven, and often a gas cooker. (11 gas cookers.) Photographs.—Photographs were produced showing the various details enumerated below. 1. The narrow entrance from Benjamin Street to White Horse Alley. 57 2. The front elevation of Nos. 11, 12, 13, 14, 15, White Horse Alley, with cracks in the front wall of No. 11. The window arch on the ground floor of No. 11 is bowed down. 3. The front passage, the sloping and worn out passage floor, the back entrance, and the water closet in the yard of No. 11, White Horse Alley. 4. The front passage, the sloping and worn out passage floor, the back entrance, the water closet and water tap in the yard of No. 10, White Horse Alley. In the foreground at the right bottom corner is an iron grid which is placed over the front of the basement. The arch over the street door shows slight bowing. 5. Front entrance of Nos. 9 and 8, White Horse Alley, showing the general worn out character of the premises. 6. Front elevation of Nos. 11, 10, 9, 8, 7, White Horse Alley, looking south, showing the buildings in front which obstruct light and ventilation, iron grids placed over the basements, 2 ties on the fronts of the houses, a pronounced bulge forward in one house, and the general worn out character of the property. 7. Front passage, sloping floor, back entrance and general worn out condition of No. 8, White Horse Alley. 8. The water closet and wash-house in the yard of No. 7, White Horse Alley. 9. The entrance to No. 19, White Horse Alley. 10. The north wall of Market Buildings on the right, and the entrance to the Merivale Press, taken from the " recess." The group of one woman and four children is seen on the left of the picture, standing in the continuation of White Horse Alley. 11. White Horse Alley, looking north, showing the entry to Market Buildings on the left, and the Merivale Press building on the right. 12. The exit at the southern end of White Horse Alley into Cowcross Street. 58 13. The back wall of the south-west corner of Market Buildings, showing extensive cracks in the masonry, and incidentally two pieces of string attached to the rain-water pipes for the purpose of drying clothes. 14. Three water closets and a portion of the wash-house of Market Buildings. These water closets are the only outlook from No. 5, Market Buildings. 15. Interior of the ground floor of Market Buildings. 16. Entry to Pump Court from White Horse Alley. 17. A typical water closet in Pump Court. 18. Forecourt of Pump Court, showing the water supply and dustbin of Pump Court, and the backs of houses in White Horse Alley, which obstruct the light and ventilation of Pump Court. 19. Front elevation of Pump Court, looking north. The houses in Pump Court are on the right of the photograph. 20. Front elevation of No. 8, Pump Court, showing cracks in the brickwork above the door. 21. The two washing coppers provided for the use of Pump Court. Some of the photographs were designed to show subsidences and dislocations, but owing to the angular displacements involved in the perspectives of the various views, these subsidences and disloca— tions were not clearly apparent in every case. STATISTICS.— 1. Area of Borough of Finsbury 587 acres. 2. Population— Borough of Finsbury Census, 1921 75,995 Estimated Population, Borough of Finsbury, middle of 1925 77,560 White Horse Alley, Pump Court, Market Buildings 168 3. Borough of Finsbury Rateable Value— Produce of a penny rate £4,481 59 4. Birth Rates— Finsbury, 1925 22.6 per 1,000 population. The area under review 26 per 1,000 population. 5. General Death Rates— Finsbury, 1925 13.6 per 1,000 population. The area under review 19.04 per 1,000 population. 6. Infant Mortality Rate— Finsbury, 1925 59.8 per 1,000 births. The area under review 136 per 1,000 births. 7. Infectious Disease Notifications— Finsbury, 1925 644 The area under review 2 Rates per 1,000 population—Finsbury 8.3 Area under review 11.9 8. Tuberculosis Notifications— Finsbury, 1925 224 The area under review 1 Rates per 1,000 population—Finsbury 2.8 Area under review 5.9 9. Issue of Sanitary Notices, Intimation Notices calling for the abatement or abolition of various public health nuisances— Rate per 100 occupancies—Finsbury, 1925 8.2 Area under review 38 These notices were chiefly in respect of:— Unsatisfactory water closet accommodation. Choked or dirty water closets. Dirty or verminous rooms. Overcrowding. Leaky roofs. Too much importance must not be attached to the figures in the foregoing statistical tables. The population of the area is too small to yield reliable and consistent figures—it is subject to the " fallacy of small numbers," which is treated of in text books on statistics. As a result of the enquiry, the Reconstruction Scheme was approved by the Ministry of Health, and the clearance is now gradually proceeding. 60 MODEL BUILDINGS AND MASSED TENEMENTS. The following is a list of the addresses and owners of the various model buildings and massed tenement dwellings in Finsbury:— Dwellings. Owners. Barnstaple Mansions, Rosebery Avenue Trustees of the late Mr. J. Hartnell. Bideford Mansions, Kosebery Avenue Trustees of the late Mr. J . Hartnell. Braunton Mansions, Rosebery Avenue Trustees of the late Mr. J. Hartnell. Brewers' Buildings, Rawstorne Street The Brewers' Company. Buxton Houses, Buxton Street Messrs. Knocker, Knocker & Fos- kett, Mr. Granville Bevan, Exors. of Mrs. A. Bevan. Cavendish Dwellings, Allen Street Prudential Mortgage Co., Ltd., Mr. W. S. Hoare. Chadworth Buildings, Lever Street London County Council. Charter Buildings, Berry Street Mr. Arthur Grover, on behalf of Exors. of late Mr. John Grover. Coldbath Buildings, Coldbath Square Artisans', Labourers' and General Dwellings Co., Ltd. Compton Buildings, Compton Street Improved Industrial Dwellings Co., Ltd. Corporation Buildings, Farringdon Corporation of the City of London. Road, Ray Street, and Crawford Passage. Costers' Dwellings, Dufferin Street London County Council. Donegal Street Buildings, Donegal Mr. James Watt; Mr. S. F. Prior, Street. Agent. Dundee Buildings, Berkley Street Mr. Ernest G. Law. Eagle Dwellings, City Road Mr. Henry Goldblum. Farringdon Road Buildings, Farringdon Metropolitan Association for ImRoad. proving the Dwellings of the Industrial Classes. Fryes' Buildings, High Street Mr. Charles Collins De Winton ; Messrs. A. G. Ball & Co. Agents. Glasshouse Chambers, Glasshouse Yard Mr. D. Cohen. Guinness Buildings, Lever Street Guinness Trust Fund. Lever Buildings, Lever Street Elizabeth H. Jesse, Mary Con— stable Martineau. Little Sutton Street Buildings, Little Mr. O. R. Goodman. Sutton Street. Mallory Buildings, St. John Street London County Council. Northampton Buildings, Rosoman Artisans', Labourers' and General Street; Plumbers' Place. Dwellings Co., Ltd. Peabody Buildings, Baird Street; Peabody Donation Fund. Dufferin Street; Errol Street ; Guest Street; Roscoe Street; and Farring — don Road. Pennybank Chambers, St. John Square Greater London Agency and In— vestment Co., Ltd. Penton Residences, Risinghill Street Late Mr. W. S. Pritchard, Exors. of. per Mrs. G. Kloster. Pollard Houses, Northdown Street East End Dwellings Co., Ltd. Rodney Residences, Rodney Street Late Mr. W. S. Pritchard, Exors. per Mrs. G. Kloster. St. Bartholomew's Buildings, Seward Messrs. Brown and Sons. Street. St. Clement's Buildings, Lever Street London Labourers' Dwelling Society, Ltd. St. John's Mansions, St. John Street Mr. Geo. E. Chamberlain. Victoria Dwellings, Little Saffron Hill ; The Soho & Clerkenwell Industrial Clerkenwell Road ; Farringdon Street. Dwellings Co., Ltd. Wenlake Buildings, Roby Street ,. London County Council. Winton Houses, Winchester Street East End Dwellings Co., Ltd. 61 London County Council Houses.—Particulars of the housing estates of the London County Council available for occupation, were given in my Report for 1925. The estates on which accommodation was available in 1926 were the same as in 1925, i.e., Becontree, Essex, and Downham, Kent. It was stated that the Watling Estate, Hendon, would be available early in 1927. The London County Council continued throughout 1926 to accept recommendations from metropolitan Medical Officers of Health for the granting of priority to the applications of those most sorely needing housing accommodation. In 1926, applications were received from 175 families for preferential consideration in the allocation of housing accommodation on L.C.C. Estates, on account of special alleged housing hardships. Of these 16 withdrew their applications before enquiry being deterred from proceeding further on account of the additional expense of travelling to and from their work. 41 families were not recommended for various reasons, e.g., insufficient means or distance from place of employment. 25 applications were deferred for further consideration. 93 families were considered suitable for recommendation to the London County Council for preferential consideration but 12 of these abandoned their applications. 57 families were offered accommodation by the London County Council, fifty of these being recommended by the Medical Officer of Health. 8 families failed to take advantage of the offer. During the year 1926, notifications were received that 6 families who had been recommended for preferential treatment had been rejected by the London County Council. 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 small pox during the incubation period. The " shelter " was used on three occasions only in 1926, by three 62 families from Holbom. 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 cither Council. The Holborn Borough Council pays £37 10s. per annum for this accommodation. The disinfector is a Washington-Lyons high-pressure steam apparatus. In 1926, 1,099 premises, comprising 1,396 separate rooms were disinfected, of which 385 were for measles, 59 after notification of phthisis, 3 after deaths from phthisis, 214 after scarlet fever, 189 after diphtheria, 103 on account of vermin, and 146 premises were disinfected for miscellaneous reasons. In addition, bedding and mattresses were steam disinfected for the following institutions: Claremont Hall Crèche, St. Barnabas' Home, St. Mark's Hospital, Women's League of Service. Altogether, 10,042 articles were disinfected in connection with cases of infectious disease and phthisis. These were chiefly mattresses, pillows, bolsters, sheets, blankets, quilts and wearing apparel. Besides these, 223,026 articles of partly worn wearing apparel and 42½ cwt. of miscellaneous clothing (548 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. Cleansing of Persons.—In 1926, 30 adults and 3 children were cleansed at the St. Pancras Cleansing Station by arrangement with that Borough. The cleansing in every case was for body vermin. 63 New Disinfecting Station.—The time is shortly arriving when the Borough Council will have to take into serious consideration the provision of a new building to serve as a disinfecting station, a cleansing station, a reception house, a mortuary, a general stores for the Public Health Department, and possibly a Coroner's Court. The cleansing station is required for the cleansing of the persons, clothes, and belongings, of those affected with the itch or other body vermin. At present Finsbury residents requiring such cleansing have to procced to the St. Pancras station. There is an arrangement between the two Councils by which Finsbury pays Is. for each person cleansed. The reception house is necessary for the reception of those families living in one, or, at most, two rooms, whose tenements are being disinfected after infectious disease, or who are being kept under close supervision during the incubation period of a serious infectious disease. In connection with these proposals, the following brief notes are submitted.— Disinfecting Station.—The disinfecting station should, if possible have :— 1. A sufficiently wide and easy approach from the road. 2. Separate entrance and exit gateways. 3. A raised floor and covered place for the sorting out of clothes and other materials sent for disinfection, for inspecting them, too, and loosening them. 4. A disinfecting machine, having on its "dirty" side sufficient storage for material awaiting disinfection, coal stores, boiler stores, and a small platform trolley, and on its " clean " side a small platform trolley, and a shelter for disinfected goods. The "clean" side should be clearly and decisively cut off from the " dirty " side. 5. Separate covered-in stalls for the van and chassis on the " clean " and " dirty " sides. 6. A small repairing shop. 64 7. Separate store cupboards for overalls and disinfectors' clothing on each side. 8. A bath room for the employees. 9. A small incinerator for small quantities of unsound foods seized by the Public Health Staff. And in connection with other details, there should be— 10. A cleansing station. 11. A general stores for the Public Health Department—this is a most urgent need. 12. A mortuary, a post-mortem room, a lavatory, and water closet. 13. Storage accommodation for " shells " and coffins. 14. An inspection room for the reception of bodies, dead from an infectious disease. 15. A small room for a Jewish " watcher." 16. A reception house or shelter with living accommodation, for the resident caretaker and his family. 17. A Coroner's Court, with a waiting-room for witnesses and separate lavatories and water closet accommodation for each sex. INCREASE OF RENT & MORTGAGE INTEREST (RESTRICTION) ACT, 1920. Three applications for certificates were received under Section 2 of this Act. The premises were inspected by the Medical Officer of Health. One certificate was given. 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 United States of America, to Australia, to the West Indies, and to the Philippine Islands. 328 certificates were issued in 1926. 65 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. Diseased and Unsound Meat.—The total amount confiscated in 1926, was over 167 tons, as follows:— tons. cwts. qrs. lbs. Diseased meat 23 1 3 22 Diseased offals 48 11 3 1 71 13 2 23 Decomposed meat 31 7 1 21 Decomposed offals and other goods 64 12 0 7 95 19 2 0 Total for 1926 167 tons. 13 cwts. 0 qrs . 23 lbs. Foot and Mouth Disease.—A statement was made by a firm of exporters that foot and mouth disease was probably being spread by carelessness in dealing with straw and other packing material arriving here in crates from abroad. Some colour was given to this impression by the fact that one firm, exporting goods to the United States, was prevented using straw for packing their wares. Enquiry was, therefore, made of the Board of Agriculture as to the view held of the possibility of the dissemination of the disease by packing material. The Board was informed that the Finsbury Borough Council was desirous of co-operating with the Board at all times in E 66 taking the necessary measures to prevent the spread of the disease, and the Finsbury meat inspector was instructed to this end. It was ascertained that the Hoard of Agriculture had made orders:— (1) Prohibiting hay or straw from any source, which has been used for packing purposes, from being brought into contact witlh any animal in Great Britain or from being moved from any premises except for use as packing or for the purpose of destruction or of being returned in a crate or box to the sender thereof for further use as packing. Hay or straw which has been used for packing if not so used again, is required to be destroyed. (2) Prohibiting the exposure for sale of any tree, shrub, plant, bulb or other horticultural product packed in hay or straw, whether imported or not, or the storing of such goods, on any premises which are being used for the sale, or exposure for sale, of animals. (3) Prohibiting any meat cloths, sackings, or other wrappings used for meat or meat products, whether imported or not, from being brought into contact with any animals in Great Britain, unless they have been boiled or otherwise sterilised after being so used, and (4) Prohibiting any box, crate, basket or other receptacle used for the carriage of meat or meat products (except cooked or preserved meats or meat essences) from being brought into contact with any animal in Great Britain. These Orders applied to all material of the character specified, whether of foreign or home origin, as it was found impossible in actual practice to distinguish between the two classes of goods in enforcing the Orders. Prosecutions.—There were heard at Clerkenwell Police Court during 1926, several prosecutions at the instance of Mr. Penman, under the provisions of the Public Health (London) Act, 1891, the Sale of Pood Order, 1921, and the Public Health (Meat) Regulations 1924. Particulars of these prosecutions will be found on pp. 90 of this report. 67 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 nccessary 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 observed. Public Health (Meat) Regulations, 1924.—These Regulations came into force in April, 1925, 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 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. Unsound Bacon for Soap.—During 1920,20 tons, 15 cwts., 3 qrs., 26 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 1926 on 82 occasions. No defects were ascertained and consequently no notices were served. Only a few small animals were slaughtered each week in the slaughter house during the year. There are no knackers' yards in the Borough. E 2 68 Butchers' Shops.—There are in Finsbury 70 butchers' shops, retail and wholesale. They are all very frequently visited by the Finsbury meat inspector, who examines the meat exposed for sale. The list is as follows:— 20, Amwell Street A. Spink. 21, Baron Street Chas. Cohen. 28, Bath Street A. Edfe. 93, Central Street J. Ching. 96, „ „ Payne & Co. 105, „ „ A. J. Cook. 3 & 10, Chapel Street Fredk. Munday. 14, „ „ A. W. Davies. 16, „ „ Robinson (Pork Butchers), Ltd. 21, „ „ C. E. Stokes. 26, „ „ R. Lustig. 28„ „ R. Gunner. 30„ „ John Day. 41, „ „ Bennett & Co. 47, „ „ C. Shelbourne (Mrs.). 60, „ „ E. Allright. 50, „ „ T. Conway. 59, „ „ G. Crowley. 69, „ ,, W. Norwood. 85, Charterhouse Street Johnson & Co., Ltd. 85, „ „ Jones & Cooper. 93, „ „ Henrys, Limited. 95, „ „ E. Martin, Ltd. 97, „ „ J. L. Henson. 99, „ „ T. Kendon & Sons. (G. Burchill. 101 & 103, „ „ (H. B. Dixon. 107„ „ John Palmer, Ltd. 109, 117, „ „ R. Wilson & Co., Ltd. 119, „ „ Perfect & Co. 16, Collier Street H. Holt. 61, Compton Street C. Aldred. 3, Cowcross Street J. F. Edwards & Son. 90, „ „ J. Legrand. 91, „ „ W. Simpson & Co., Ltd. 93, „ „ C. & T. Corne. 13, Exmouth Street J. E. Buckingham. 29,„ „ C. R. Wilson. 40, „ „ A. Medcalf. 55 „ „ C. Smith. 57, „ „ 63, „ „ Geo. Field. 69 3, Goswell Road J. N. Parminter. 191, „ „ T. Webb. 213, „ „ F. Russell. 30, Great Bath Stree D. Santelli. 96, King's Cross Road H. S. Collingwood. 109, Lever Street G. Bacon. 135, „ „ H. Bridger. 14, Penton Street G. F. Mobbs. 30, Sidney Street W. Evans & Co. 1, St. John's Lane F. Curzon & Crebbin. 2, „ „ J. D. Webb. 6,„ „ Woodhouse, Hume & Co. 37, „ „ W. H. Ferguson. 1, St. John Street F. & W. Warman. 3, „ „ Wm. Harris & Sons. 7, „ „ Pepper & Co. 20, „ Walford & Hill. 20, „ „ West (Butchers), Ltd. 35, „ „ T. S. J. Woodhouse. 138, „ „ Lemming & Son, Ltd. 399, „ „ Chalk & Cox. 58/60, Whitecross Street G. Carter. 136, „ „ W.Clifford. 137, „ „ J. L. Henson. 140,„ „ J. Blofield & Son. 141, „ „ T. R. Firmin. 152, „ „ G. C. Stanley. 171, „ „ W.Miller. 179, „ „ E. Boat & Son. Cold Air Stores.—The following is the list of cold-air stores situated in the Borough. They are frequently and systematically inspected by the meat inspector:— Cowcross Street Cold Air Storage and Transport Co., Ltd. 26, Cowcross Street. Eagle Cold Air Stores Eagle Court, St. John's Lane. Palmer's Cold Air Stores 111, Charterhouse Street. Port of London Authority 19/33, St. John Street. Swain's Cold Air Stores 14/17, St. John's Square. Union Cold Air Stores 91, Charterhouse Street. 70 MILK SHOPS. At the end of 1926, there were on the register 155 milk shops. These were inspected on 177 occasions. 33 notices were served for the abatement of various nuisances. There were no prosecutions. Registered Milk-Sellers.—The milk shops are all critically inspected prior to registration and systematically thereafter. Samples of milk and butter are taken from these shops for reference to the Public Analyst, so that in course of time all the shops are sampled not merely at their fixed addresses but also in the streets. The list of registered milk-sellers is given below:— 40a, Affleck Street Fredk. C. Robinson. 39, Amwell Street Annie & Clara Haggis. 54,„ „ Lloyd Lloyd. 6, Aylesbury Street William Jenkins. 39, Baldwin Street Robert Hughes. 53, Banner Street Frederick Thos. Beare. 61, „ „ Domenica Capone. 66, „ „ Harry George Walters. 10, Baron Street Louisa Goring. 66, Bastwick Street Ernest Edwards. 45, Bath Street Richard Lloyd Lewis. 76, „ „ William Ward. 22, Bayer Street Alfonso Bonito. 25, Bowling Green Lane Louisa Ann Horton. 6, Brewer Street North William Mills. 32, Busaco Street Albert Henry Kelly. 3 & 5, Carthusian Street Benjamin John Rees. 6, Castle Street David Jones. 79, Central Street Albert Edward Hodges. 129, „ „ Henry Jenkins. 160, ,, „ Mrs. Cresswell. 161, „ ,, Morris Sprintz. 8, Charterhouse Buildings J. Lyons & Co., Limited. 55, Chiswell Street Lilian E. Owttrim. 80, „ „ Bartolomeo Callegari. 8, City Road The J.P. Restaurants, Ltd. 75, „ „ Bartolomeo Callegari. 214, „ „ Mary and Rachel Evans. 26, „ „ Jessie Connock. 6, Clerkenwell Green Ada E. Caldecourt. 71 114, ClerkenwelL Road Daniel Wm. Green. 13, Collier Street George Hall. 18, „ „ Jane Daly. 24, „ „ Margaret Davies. 49, „ „ Sarah Ann Guppy. (Colthorpe & Gostling. 7, Compton Street (Thos. Hy. Lucy. 20, „ „ Sarah Griffiths. 66, „ „ Sophia Gibbs. 8, Corporation Row Mrs. Maria Rawding. 49, „ „ Phoebe E. Jacques. 15, Crawford Passage Samuel William Yardley. 8, Donegal Street Ernest William Breach. 23, „ „ ,, F. W. Amschwand. 35, „ „ Joshua Gardner. 38, Easton Street Geo. E. Finnes. 19, Fann Street William Jones. 74, Farringdon Road Margaret Williams. 121, „ „ Mrs. O. Timothy. 17, Featherstone Street Evan D. Jones. 28, „ „ Evan Davies. 51, Galway Street Edward T. Shrosbree. 2, Garnault Place John Evans. 14, Gastigny Place Jas. H. Hewitt. (See 52a, Radnor Street.) 29, Gee Street David C. James. 49, Golden Lane Express Dairy Co., Ltd. 125/127, „ Harry Miller. 5, Goswell Road Walter H. Edwards. 40, „ „ Angelo Cioffi. 104, „ „ W. E. Davies. 131, „ „ Albert Tongue. 249, „ „ Ernest Southern & Geo. Chas. Southern. 284, „ „ Ernest Grinsdale. In rear of 332a (ground floor and basement) Knebworth White Cross Milk, Ltd. 3, Great Bath Street Jane E. Barker. 15, „ „ „ John Jones. 69, Great Percy Street David Williams. 1, Great Sutton Street Owen Jones. 30a, „ „ „ Richard Joel. 42, „ „ „ William H. Hawkes. '' The Angel," High Street, N.l J. Lyons & Co., Ltd. 9, High Street, N.l Express Dairy Co., Ltd. 48, Ironmonger Row David Thomas. 72 20, Ironmonger Street Robert Thos. Castle. 2a, King's Cross Road Wm. R. Jones. 124, „ „ „ John Morgan Evans. 1, Leage Street Lydia Clark. 23, „ ,, Amelia Stacey. 5, Lever Street Leberato Savino. 36, „ „ Albert E. Acaster. 42, „ „ J. L. Martin. 99, „ „ Maglona Jenkins. 131, „ „ Jas. V. Warner. 158, „ „ John Morgan. 169, „ „ Richard L. Lewis. 1, Leverington Street Jno. M. Peale. 22, Lizard Street James Sard. 25, Lloyds Row Jno. C. Hammick. 2, Meredith Street Alfred H. Packman. 11, Mitchell Street Myer Cohen. 40, „ „ Charles Wm. Render. 69, Moreland Street Mary Ann Thomas. 47, Myddelton Street Colthorpe & Gostling. 3, New Charles Street Mary Jane Groves. 4, Norman Street Thomas Anderson. 23, Northampton Road Alfred E. Kirby. 48, „ „ James Humphries. 17/21, Old Street The J.P. Restaurants, Ltd. 52, „ „ Jane Davies. 101, „ „ Ethel Mary Sturgeon. 202, „ „ Thomas Edward Archer. 60, Peerless Street Rose Harley (Mrs.). 12, Penton Place Alice Pritchard. 3, Penton Street Rebecca Partrick. 35, ,, ,, Albert Sidney Andrews. 37, „ „ Saml. G. Kerslake. 167, Pentonville Road A. E. Francis. 13, Percival Street Daniel Williams. 57, „ „ Fred. J. Pettit. 7, Pine Street Alice Bradley. 17, „ „ Saml. John Lewis. 32, President Street Jane and Annie Williams. 44, Radnor Street Chas. H. Wilson. 52a, „ „ Jas. H. Hewitt. (See 14, Gastigny Place.) 36, Rahere Street W. C. Chambers. 54, Rawstorne Street Anthony Bellotti. 43, Red Lion Street Jas. Rowland James. 12, Richmond Street Geo. Caffell. 22, Risinghill Street Catherine Bond. 24, Rodney Street Geo. H. Gardner. 28, „ „ Alice M. M. Gibbons. 73 Milk Rounds operated from 28, Rodney Street, by Geo. Moon, 30, Argyle Square, W.C. 1 ; A. Hitch, 12, Mazenod Avenue, N.W. ; T. Morris, 5, Etherley Road, Tottenham ; Ben Trott, 405, Liverpool Road, N.l ; Alice Cooley, 28, Rodney Street; Jas. Gray, 20, Edward Square ; John Kelly, 146, Philip Lane, Tottenham ; P. Wilkinson, 11, Richmond Road, Barnsbury; G. H. Howard, 30, Cloudlesley Street, N. ; H. C. Cover, 39, Lothair Road, N.4 ; Wm. Morton, 189, Putney Bridge Road ; H. R. Mellish, 32, College Street, N. ; II. H. Jones, 103, Barnsbury Road, N. ; John Tanner, 14, Southam Street, W.10 ; C. S. Wotledge, 54, Pigott Street, Lime- house, E. ; F. P. Gray, 96, Hampden Road, N. 28, Rosoman Street Alfred J. Clark. 35, „ „ John Evans. 43, „ „ Alfred Chas. Chambers. 3, St. John's Lane John Thos. Howells. 21, „ „ Carl F. Church. 130, St. John Street William Evans. 318, „ „ John and Mary Phillips. 367,„ „ Mrs. Kate Evans. 414, „ „ Thos. A. Jones. 15, Sekforde Street Fred. Jas. Hosking. 24, „ „ Thomas Jones Evans. 55, Seward Street Charles Chappell. 15, Sidney Street George Hull. 34, Southampton Street Charles Thackray. 79,„ „ Mr. Jesse Newbery. 110,„ „ Catherine Whitehead. 36, Tabernacle Street Bartolomeo Ferrari. 18, Upper Ashby Street Richard Jones. 1, Whiskin Street Evan Timothy. 67, Whitecross Street Antonio Bradi. 70, „ „ Thos. J. Lloyd. 109, „ „ Anna Jones. 124, „ „ Annie, Rhys, and Peter Jones. 145, „ „ Adolfo Santucci. 163, „ „ Fred. R. Rowe. 189, „ „ Martha Annie Jones. 10, White Lion Street Sarah Porcher. 11, „ „ „ Mary Ann Brown. 56, „ „ „ Albert E. Shaw. 27, Wilson Street Herbert D. Thomas. 13, White Conduit Street Owen M. Richards. 5, Winchester Street Ellen J. Clark. 18, Wynford Road Ethel Bowen. 20, „ „ Mary Ellen Bush. 13, Yardley Street John J. Phillips. 74 SALE OF FOOD AND DRUGS ACTS. The number of samples taken in 1926,was 600. The resultd are given in the table below:- Articles. Total No. of Samples. Samples Adulterated. Articles. Total No. of Samples. Samples Adulterated. Apples 9 1 Lard 44 0 Butter 123 0 Lemonade Powder 2 0 Cheese 8 0 Margarine 24 0 Cinnamon (Ground) 4 0 Milk 261 10 Cocoa 21 0 Mustard 7 0 Coffee 9 0 Oatmeal 8 0 Coffee & Chicory 4 0 Pepper 8 0 Custard Powder 11 0 Rice 24 0 Dripping 1 0 Tea 4 0 Flour 2 0 Tea Dust 12 0 Flour (Self-Raising) 12 0 Total 600 11 Ginger (Ground) 2 0 75 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 1926 600 589 11 1.8 In respect of the milk supplied in 1926, there were six prosecutions. To the vendors of the remaining adulterated samples, cautionary letters were sent. The Milk (Special Designations) Order, 1923.—Five applications under the order were received during 1926, four for a dealer's licence to use the designation "Certified," and one to use the designation "Grade A" (Tuberculin Tested). The applications were granted. 76 OFFENSIVE TRADES. In 1926, one application for an Order sanctioning the establishment anew of the business of a dresser of fur skins at the premises 31 and 32, Sidney Grove, was made to the London County Council. Similar trades established in other London Boroughs were visited and it was ascertained that subject to the usual legitimate safeguards the trade could be conducted without causing a nuisance. The Borough Council therefore offered no objection to the proposal; at present there are the following offensive trades established in Finsbury:— Tripe Dresser Messrs. Henson, 137, Whitecross Street. Fur Skin Dresser H. P. Millicent & Co., 8, Mallow Street. Public Health (Milk and Cream) Regulations, 1912.—Action taken in Finsbury during 1926 under the above-mentioned regulations is shown by the following table:— Nature of Sample. No. of samples examined. No. of samples containing above prescribed limit of preservative. Cream 0 0 Milk 261 0 FACTORIES AND WORKSHOPS. The number of workshops and workplaces on the register at the end of 1926, was 2,493, compared with 2,423 at the end of 1925. During the year under review, 161 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 231. The factories on the register at the end of 1926, numbered 1,860, compared with 1,813 at the end of 1925. 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. 77 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 27, brushes and combs 9, house repairs and decorating 6, patent flooring 1, tarred felt making 1, clock and watch case making 12, watch making and repairing 18, cloth shrinking 3, pleating 4, disinfectants and soaps manufacturing 4, drug grinding 1, druggists sundries 17, making and repairing addressing machines 1, making and repairing motors and cycles 16, making and repairing domestic machinery 5, making and repairing springs 1, making and repairing typewriting machinery 2, model and pattern making 8, smithing and wheelwrights' work 8, making and repairing sewing machines 7, making and repairing electrical goods and machinery 19, general engineering 118, wireless components 5, artificial flower making 14, embroidery 12, making and importing fancy goods 15, ivory and tortoise-shell working 6, leather goods 47, pipe making and mounting 25, toy making 5, walking sticks and umbrellas 41, trouser presses 2, sports goods 13, cleaning feathers 4, dyeing and curling feathers 7, horsehair cleaning 2, cabinet making 25, carpet planning 1, picture-frame making 11, shop fitting 18, upholstery 5, cold storage 6, confectionery 9, drysalting 1, food preparing 20, mineral waters 3, cordial and spirit colouring 1, glass stoppers making 3, glass working 22, sand blasting 2, jewellery making and repairing 35, gold and silver refining 4, rouge manufacturing 1, silversmiths 31, repairs 5, steam laundries 4, diamond cutting and polishing 4, glaziers diamonds making 3, brass workers 18, coppersmiths 10, engraving and die sinking 26, foundry 8, gilding, plating and polishing 86, general metal-working 31, type-founding 6, wire-working 12, sheet-metal working 13, aerography 2, paint, enamel and varnish making 5, panel and screen painting 2, musical instrument making and repairing 19, scientific instrument making 33, electrical instrument making 8, optical instrument making 26, photographic instrument making 1, surgical instrument making 12, weighing and scales instruments making 10, art publishing 24, envelope and paper bag making 6, gold blocking 4, ink and gum making 8, 78 machine ruling 15, pattern cards 10, printing 146, showcards 3, manufacturing stationers 28, stencil cutting 1, waste paper sorting 1, bookbinding 33, 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 5, blouses 42, boots and shoes 11, boot socks and laces 1, children's clothing 22, fur garments 18, glove making 3, haberdashery 5, hat making 39, linen collars 4, neckties 10, shirt and pyjama making 26, mantle making 84, tailoring 47, skirt making 15, underclothing 28, button making 8. Beer bottling 1, distilling 6, dealing in wines, spirits and tobacco 3, tobacco, cigarettes and cigar making 12, general woodwork 18, hardwood turning 20, 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 8, cork cutting 2, cutlery grinding 6, van building 4, dyeing 1. Total 1,860. Workshops.—Cardboard box making 21, instrument, jewellery, etc., box making 31, packing case making 15, making brushes and combs 11, glazed tiles 1, house repairs and decoration 46, making clock and watch cases 20, dial painting 15, making and repairing clocks and watches 123, shrinking cloth 3, cutting and sorting cloth 8, accordion pleating 4, chemical research work 1, drug and chemical making 7, druggists sundries 30, agricultural engineering 5, cycle and motor repairing 26, electrical workers 32, fitter's work 4, locksmiths 7, machinists 10 pattern making 1, sewing machines 6, smiths and wheelwrights 8, general engineering 41, wireless components 12, artificial flowers making 15, artists' materials 2, art needlework and embroidery 12, basket making 15, leather goods 75, fancy goods making and importing 21, shoe trimmings 4, sports goods 7, ivory working 7, pipe making 5, taxidermy 1, toy making and importing 34, walking sticks and umbrellas 24, wig and costume making 1, soap and perfumery 3, general fancy goods 36, photo— graphy 2, curling and dyeing feathers 14, blind making 4, cabinet making 64, French polishing 22, making and repairing furniture 21, shop fitting 27, upholstery 21, undertakers 7, picture framing 19, confectionery 18, storage and preparation of food stuffs 67, glass 79 working 32, bottle washing 4, china and glass merchants 3, instrument making—musical 29, optical 9, photographic 9, scientific 30, surgical 13; weighing machines 3, gold beating 5, gold and silver refining 12, gold and silver smiths 41, enamelling 4, repairing and making jewellery 91, wholesale and retail jewellers 28, laundries 9, laundry receiving and sorting 18, diamond cutting and polishing 10, general lapidary 3, metal burnishing 6, coppersmiths 7, engraving and die sinking 59, gilding and plating 12, farriers' and smiths' work 18, sheet metal working 22, wire working 15, general metal work 41, oil and colour manufacturing 6, sign writing 13, ink, gum and varnish making 6, blacking and polish making 3, japanning 5, Bookselling and publishing 23, card and book edge gilding 15, envelope and paper bag making 6, machine ruling 4, paper storage 16, wholesale stationers 28, waste paper sorting 13, card mount cutting 4, relief stamping 11, lithographers 5, rubber goods making 11, ebonite workers 3, stone and marble working 6, statuary 9, blouse making 17, boot and shoe repairing 26, boot and shoe warehouse 9, button making 2, children's clothing 5, corset making 3, furriering 113, glove making 1, hat making 42, mantle making 35, millinery 49, necktie making 5, shirt and collar making 2. tailoring 78, underclothing 11, woollen goods 7, haberdashery 6, cigar making 1, wine, spirit and tobacco storage cellars 7. Firewood chopping 17, timber yards 9, wood turning 6, van building 7, wood carving 7, wood working 16, hat block making 3, harness making and repairing 7, mat making 1, celluloid workers 1, forwarding agents 31, hardware manufacturers 26, miscellaneous merchants 50, stabling and garage 34, stores 41, towel supplying 4, cork cutting and working 5, window cleaning 3, rope and twine making 4, ammunition storage 1, dyeing and cleaning 4. Total 2,493. The persons employed in the factories in Finsbury are, approximately : Males 38,239, females 32,176. In the workshops and workplaces : Males 11,896, females 8,487 ; these numbers exclude the office " hands " and clerical staffs. During the year 1,829 first visits and 1,165 revisits were made by the Council's inspectors to factories, and 2,093 first visits and 1,239 revisits to workshops and workplaces. 80 A summary of the defects or insanitary conditions found is appended:— Summary of Defects and Defaults in Factories, Workshops, and Workplaces, for which Notices were served in 1926. Factories. Workshops. Workplaces. Total. Animals improperly kept — 1 — 1 Absence of water supply — 2 1 3 Cisterns dirty or covers broken 1 — — 1 Dampness in walls 2 4 2 8 Drains choked 6 5 4 15 Drains leaky 1 3 — 4 Dustbins broken or absent 18 37 13 68 Floors insufficiently drained — 2 — 2 Guttering or rainwater piping broken, leaking or inadequate 7 3 2 12 Manhole covers broken — 3 — 3 Open drain inlets 3 1 — 4 Overcrowding of workrooms — 2 — 2 Refuse accumulations 11 16 1 28 Roofs leaky 4 2 — 6 Floors broken — 1 — 1 Ceilings broken — 11 — 11 Sanitary conveniences not separate for the sexes 12 14 4 30 Sanitary conveniences defective 70 48 10 128 Sanitary conveniences dirty 125 83 8 216 Sanitary conveniences insufficient 11 16 — 17 Sanitary conveniences unsuitable 30 16 — 46 Soil-pipes leaky 5 1 — 6 Staircases and landings dirty — 7 1 8 Urinals foul 10 2 2 14 Ventilation of workrooms inadequate or insufficient means of — 3 — 3 Waste pipes choked or leaky 1 7 1 9 Water closets choked 8 4 — 12 Water fittings leaky 3 7 2 12 Workshops or workplaces dirty — 57 9 66 Yard paving broken 2 — 1 3 Yard walls dirty 5 1 6 Total 330 353 62 745 In connection with these matters 422 intimation notices and 19 statutory notices were served. 81 The Home Office.—97 notices of occupation were received from the Home Office during the year, and 39 notices of complaint relating to the following matters:— Premises dirty 4 Sanitary conveniences insanitary 26 Absence of separate accommodation for the sexes 2 Water closet accommodation insufficient 5 Roofs leaky 4 Water closet accommodation not provided 1 Workroom insufficiently ventilated 1 The notices sent to the Home Office were as follows :— Abstract of the Factory and Workshop Act not affixed, or wrongly affixed 18 New occupation 24 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) 2,994 209 0 Workshops (including Workshop Laundries) 2,448 190 0 Workplaces (other than Outworkers premises) 884 33 0 6,326 432 0 F 82 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 102 98 - - Want of Ventilation 3 3 — — Over-crowding 2 2 — — Want of drainage of floors 2 2 — — Other nuisances 187 187 — — Sanitary accommodation Insufficient 17 15 — — Unsuitable 228 225 — — Defective 174 171 — — 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) - — — — Total 745 733 — — There were 12 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 42 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 43 Reports (of action taken) sent to H.M. Inspector 43 Underground bakehouses (S. 101) in use at the end of the year — 83 Home Work, 1926. 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 83 237 1385 48 91 244 109 Boxes, paper 9 0 111 1 0 15 9 Artificial flowers 5 0 102 1 0 21 3 Christmas crackers 2 0 210 2 0 36 1 Sports requisites 1 0 76 0 0 0 0 Fancy goods 5 3 41 3 1 23 8 Bedding 1 0 6 0 0 0 0 Chocolate making 1 0 6 0 0 0 0 Bookbinding 1 0 4 0 0 2 1 Total 108 240 1941 55 92 341 131 No legal proceedings were necessary during 1926 in regard to outworkers. F 2 84 RATS AND MICE (DESTRUCTION) ACT, 1919. The methods indicated in my Report in 1921 have been maintained in 1926. COMMON LODGING HOUSES. In 1926, 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 1926, the total number of Canal Boats inspected was 97. None carried offensive cargo. The Acts and Regulations were complied with in all instances. 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. 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 1926 97 165 57 53 275 336 Of the 97 Canal boats inspected, 44 were occupied by men only; 25 by men and women only; 27 by men, women and children, one boat was occupied by women only. The number of children on the boats was 53 of which 31 were of school age and 22 under school age. The children accompanying their parents on the boats appeared to be well cared for. 85 No cases of Infectious disease were notified or discovered on the canal boats, therefore isolation 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 1926, the number of post-mortem examinations was 42, the number of bodies brought to the mortuary for the convenience of relatives of the deceased was 193. The number of inquests held in the Borough was 41. The number of bodies received into the mortuary on account of death after infectious disease numbered 3. 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. 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. 86 Mortuary and Disinfecting. Mortuary Keeper and Disinfector—J. Campbell. Disinfector—F. Readstone. Motor Driver Disinfectors—F. W. Battle and J. Luke. 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. 87 WORK OF THE STAFF. The work of the staff is presented below in tabular form:— Work of the Sanitary Inspectors, 1926. Inspector Davis. Inspector Longden. Inspector Norman. Inspector Newdick. Totals Houses damp, dirty or dilapidated, remedied 133 161 183 128 605 Doors, windows, floors, walls, ceilings, sashcords repaired. 202 183 143 114 642 Overcrowding cases abated in other than Registered Houses 5 0 6 0 11 Illegal occupation of underground rooms. 3 0 2 0 5 Water closet defects remedied 164 145 245 112 666 Water closets erected 73 6 81 149 309 Urinal defects remedied 4 3 16 3 26 Urinals erected 2 0 9 13 24 Soil pipe and ventilating shaft defects remedied 2 14 27 2 45 Soil pipe and ventilating shafts erected 19 6 42 36 103 Yard defects remedied 41 52 113 67 273 Waste pipe defects remedied 2 33 27 8 70 Waste pipes erected 16 6 41 35 98 Water cistern defects remedied 7 7 8 I 23 Accumulations of rubbish or manure removed 13 3 14 6 36 Dung or dust receptacles repaired or renewed 58 66 71 68 263 Drains relaid or amended 35 25 62 84 206 Drains cleared 22 44 38 26 130 Rain water pipes cleared, repaired or renewed 13 17 42 22 94 Water supply to houses reinstated 8 1 0 0 9 Roofs and gutters repaired 104 113 114 42 373 Area defects remedied 4 26 22 12 64 88 Work of the Sanitary Inspectors, 1926—continued. Inspector Davis. Inspector Longden. Inspector Norman. Inspector Newdick. Totals. Washhouse defects remedied 45 67 78 52 242 Animal nuisances abated 1 7 2 0 10 Floor space unventilated 1 3 1 0 5 Stables cleansed or repaired 0 0 0 1 1 Smoke observations 13 1 10 4 28 Water supply laid on to upper storeys of house 1 1 3 0 5 Miscellaneous nuisances abated 116 100 46 55 317 Drains tested 50 160 185 95 490 Bakehouses, inspections 16 28 24 27 95 Bakehouses cleansed or repaired 2 17 20 6 45 Restaurants, No. of inspections 66 19 70 71 226 Restaurants cleansed or repaired 11 3 36 14 64 Milkshops, No. of inspections 39 34 42 62 177 Milkshops cleansed or repaired 3 3 8 19 33 Public-houses cleansed or repaired 3 0 10 0 13 Ice Cream Premises—No. of inspections 58 12 28 28 126 Ice Cream Manufactories cleansed or repaired 3 1 11 7 22 Butchers' shops cleansed or repaired 0 0 1 1 2 Fish Purveyors' Shops cleansed or repaired 2 0 1 0 3 Registered Houses—visits of inspection 1078 1098 1136 642 3934 Registered Houses—Overcrowding cases abated 6 0 1 0 7 Registered Houses—cleansed 240 182 178 100 700 Registered Houses—Intimation (Cleansing) Notices served 240 195 178 92 705 Registered Houses—Statutory (Cleansing) Notices served 83 41 46 14 184 First visits (complaints, casual visits) 1925 1557 1596 1733 6811 Re-visits 2329 2332 3166 1642 9469 Intimation Notices served 403 431 456 304 1594 Statutory Notices served 113 59 67 21 260 Infectious disease investigations 161 205 182 198 746 House inspections 324 295 394 338 1351 House to house inspections 28 49 65 63 206 Canal Boats inspected 0 0 0 96 96 Slaughterhouses — No. of inspections 0 65 0 0 65 89 REPORT ON THE WORK OF THE LADY SANITARY INSPECTOR FOR 1926. The following is a summary of the work of the Lady Sanitary Inspector during 1926 :— Visits and re-visits :— Factories (other than outworkers' premises) 335 Workshops (other than outworkers' premises) 376 Outworkers' premises 768 Complaints of verminous conditions 1,363 Other complaints 14 Visits made in connection with notices served 70 2,926 Intimation Notices served in connection with factories and workshops 90 Intimation Notices served in connection with other premises 171 261 Statutory Notices served 3 Summary of matters for which Notices were served:— Dirty and dilapidated premises 276 Leaky roofs 15 Sanitary conveniences dilapidated, dirty, insufficient 116 Drains choked, leaky 12 Rain-water pipes and gutters choked, leaky 4 Damp walls 3 Dustbins absent, broken 11 Other nuisances 16 90 LEGAL PROCEEDINGS, 1926. Date 1926. Name and address of Defendant. Offence. Result. PUBLIC HEALTH (LONDON ACT, 1891) 9th Mar. J. Palmer, Ltd., 107, Charterhouse St., E.C.I. Having possession of 8 quarters of beef, diseased, unsound, and unfit for the food of man. Fined £200 and £25 costs. 9th Mar. J. Nias, Gt. Coxwell, Faringdon, Berks. Depositing at 107, Charterhouse St., 8 quarters of beef diseased,unsound, and unfit for the food of man. Fined £80. 9th Mar. T. W. Jessop, Faversham Ave., Bush Hill Park. Aiding and abetting J. Palmer, Ltd., in the above mentioned offence. Fined £2. 9th Mar. Chas. Goodman, Trehurst Street, Clapton. Aiding and abetting J. Palmer, Ltd., in the above mentioned offence. Fined £1. 9th Mar. H. B. Ingram, Pen tonville Road. Aiding and abetting J. Palmer, Ltd., in the above mentioned offence. Fined £1. 25th Mar. Edward Goddard, Mumford Farm, Gerrards Cross, Bucks. Depositing at 85, Charterhouse St., E.C.I, 4 quarters of beef and 1 beef head, tongue, and tail, tuberculous and unfit for the food of man. Fined £25 and £25 costs. 6th July Harris Woolf, 129, Amhurst Road, Hackney, N.E. Failing to cleanse a House let in lodgings during the period prescribed by the bye-laws. Fined £2 2s. and £2 2s. costs. SALE OF FOOD AND DRUGS A CTS, 1875 to 1909- 26th May Geo. Caffell, 12 Richmond St., E.C.I. Selling milk deficient in fat. Ordered to pay £2 2s. costs. 6th July Robert Hughes, 39, Baldwin St., E.C.I. Selling milk 12 % deficient in fat. Fined £2 2s. 6th July John Lewis, 3, Remington Street, E.C. Selling milk 5.3 % deficient in fat. Fined £2 2s. 6th July John Tudor Richards, 140, Liverpool Road, N.l. Selling milk 5.3 % deficient in fat. Dismissed. 12th Aug. Evan Timothy, 1, Whiskin Street, E.C.I. Selling milk containing 9.4 % of added water. Fined £5 and £2 2s. costs. 21st Dec. Robert T. Castle, 20, Ironmonger Street, E.C.I. Selling milk 17.3 % deficient in fat. Fined £3 and £2 2s. costs. 91 LEGAL PROCEEDINGS, 1926— continued. Date 1926. Name and address of Defendant. Offence. Result. SALE OF FOOD ORDER, 1921:— 27th Jan. Jack Smith, 54, Heaton Street, Peckham, S.E. Exposing for sale imported eggs labelled "New Laid" without the word "Imported." Fined £2 and £1 3s. costs. 25th Mar. Hy. C.ilbertson, Stall Holder, Exmouth Street, E.C.I. Failure to so label Imported Meat. Fined £2 2s. and 2s. costs. 23rd June Mrs. Dinnis, 11, Chapel St.. N.l. Exposing for sale imported eggs, labelled "New Laid" without the the word "Imported." Fined 10s. PUBLIC HEALTH (MEAT) REGULATIONS, 1924:— 23rd June Robert Kidd, 2, Chapel Place. Failing to exhibit name and address on stall. Fined 5s. 23rd June Robert Kidd, 2, Chapel Place. Failing to screen back of stall. Fined 5s. 23rd June Tom McCarthy, 2, Chapel Place. Aiding and abetting Robert Kidd in failing to screen back of stall. Fined 10s. 15th Dec. John Davies, The Union Tavern, King's Cress Road, W.C.I. Failing to cover Meat Stall. Fined £2 and £1 1s. costs. 15th Dec. Chas. Brewer, 10, Whiskin Street. Failing to cover Meat Stall. Fined £2 and £1 1s. costs. MILK AND DAIRIES (AMENDMENT) ACT, 1922. 26th Jan. Wm. Enoch Davies, 104, Goswell Rd., E.C.I. Selling milk containing colouring matter. Ordered to pay £2 2s. costs. 92 CASES OF INFECTIOUS DISEASE NOTIFIED DURING THE YEAR 1926. Notifiable Disease Number of cases notified Total cases notified in each locality Total cases removed to Hospital At all Ages At Ages—Years Clerkcnwell St. Lukes 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 Mem. Croup) 186 5 74 85 15 7 116 68 2 183 Scarlet Fever 258 5 91 139 18 5 — — 149 109 - 256 Enteric Fever 2 — — 1 — 1 - — 1 1 - 2 Puerperal Fever 3 — — — — 3 - — 2 1 - 2 Puerperal Pyrexia 2 — — — 1 1 - — — 2 - 1 Ophthalmia Neonatorum 12 12 — — — — - — 10 2 - 2 Pulmonary Tuberculosis 160 1 1 9 45 46 50 8 64 96 - — Other forms of Tuberculosis 35 — 14 10 6 4 1 — 20 15 - — Acute Primary Pneumonia 69 2 6 12 7 19 18 5 49 20 - 25 Acute Influenzal Pneumonia 17 1 1 2 3 4 5 1 8 9 - 9 Erysipelas 41 3 1 4 5 14 9 5 21 20 - 7 Encephalitis Lethargica 6 — 1 1 2 — 1 1 4 2 - 4 Acute Poliomyelitis 1 1 - - - - - - 1 - - - Cerebro Spinal Meningitis 1 — — — — 1 — — 1 — - 1 Measles and German Measles 1,142 85 720 326 7 3 1 — 758 384 - 240 Zymotic Enteritis — — — — — - — — — — - — Dysentery 1 — — — — — - 1 1 — - — Totals 1,936 115 909 589 109 108 85 21 1,205 729 2 732 93 INFANT MORTALITY, 1926. 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 mths. Total deaths under 1 year Small-pox - - - - - - - - - - Chicken-pox - - - - - - - - - - Measles — — — - - — — — 4 4 Scarlet Fever - - - - - - - - 1 1 Whooping Cough - - - - - - 1 - - 1 Diphtheria and Croup - - - - - - - - - - Erysipelas - - - - - 1 - - - 1 Tuberculous Meningitis - - - - - - - - - - Abdominal Tuberculosis - - - - - - - - - - Other Tuberculous Diseases - - - - - - 1 - - 1 Meningitis (not Tuberculous) - - - - - - 1 - - 1 Convulsions 2 — — - 2 2 1 — — 5 Laryngitis — - - - - - - - - - Bronchitis — — — - — 4 2 — — 6 Pneumonia — 1 1 - 2 5 1 7 4 19 Diarrhœa - - - - - - - - - 2 Enteritis — — 1 - 1 2 5 4 1 13 Gastritis - - - - - - - - - - Syphilis 1 — — - 1 — — — — 1 Rickets - - - - - - - - - - Suffocation (overlying) - - - - - - - - - - Injury at Birth - - - - - - - - - - Atelectasis - - - - - - - - - - Congenital Malformations — 1 — - 1 — — — — 1 Heart Disease 3 1 — - 4 — — — — 4 Premature Birth 21 3 2 1 27 4 2 — — 33 Atrophy, Debility and Marasmus 2 - - - 2 1 1 1 - 5 Other causes 3 — 2 - 5 1 1 2 2 11 Totals 32 6 6 1 45 20 18 14 12 109 94 CAUSES OF, AND AGES AT, DEATHS DURING THE YEAR 1926. 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 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 Enteric Fever - - - - - - - - - - Small-pox - - - - - -- - - - - Measles 21 4 13 4 - - - - - - Scarlet Fever 2 1 — 1 - - - - - - Whooping Cough 5 1 1 3 - - - - - - Diphtheria and Croup 5 — 1 2 2 - - - - - Influenza 19 1 — — — — 5 9 4 — Erysipelas 3 1 — — — — — 1 1 — Phthisis 88 1 — — 2 26 22 30 7 — Tuberculous Meningitis 2 — — 1 — 1 — - — — Other Tuberculous Diseases 10 1 — 1 3 1 3 1 — — Rheumatic Fever 4 — — 1 2 1 — — — — Meningitis 5 1 1 — 2 — 1 — — — Organic Heart Disease 126 4 — 1 3 4 15 45 54 — Cancer, Malignant disease 99 — — — — — 7 50 42 9 Bronchitis 118 6 2 — 1 — 7 36 66 — Pneumonia, all forms 90 19 13 7 4 4 10 15 18 3 Other Respiratory Diseases 7 — 1 1 — — — 3 2 — Diarrhoea and Enteritis 19 15 — — 1 — — 1 2 2 Appendicitis 3 — — — 1 1 — 1 — 1 Alcoholism 1 — — — — — — 1 — — Cirrhosis of Liver 8 - - - - - 1 5 2 — Bright's Disease and Cerebral Hæmorrhage. 85 - - - 2 7 37 39 1 Puerperal Fever 1 - - - - - - - - - Other Diseases and Accidents of Pregnancy and Parturition 4 - - - - - 4 - - 4 Congenital Debility and Malformation, including Premature Birth 39 39 - - - - - - - 6 Violence 35 3 2 2 4 6 2 6 10 3 Suicide 10 — — — — 1 1 5 3 — Other defined diseases 148 7 — 4 5 — 12 37 83 6 Ill-defined diseases 44 5 1 1 1 1 3 2 30 6 Totals 1001 109 35 29 1 48 101 285 363 41 *Broncho Pneumonia 54 18 12 6 1 2 1 5 9 2 *Other Pneumonias 36 1 1 1 3 2 9 10 9 1 *Encephalitis Lethargica 2 - - - - - - - - - *Cerebrospinal Fever 1 - - - - - - - - - * These figures are included in the above table.