HAC 7 The Parish of Hackney. REPORT on the SANITARY CONDITION OF THE HACKNEY DISTRICT, FOR THE YEAR 1899, J. KING WARRY, M.D., LOND., M.R.C.P., Diplomate in Public Health; Licentiate of the Society of Apothecaries; Fellow of the Society of Medical Officers of Health; Fellow of the Royal Institute of Public Health; Member of the Sanitary Institute; Member of the Jenner Institute of Preventive Medicine; Foreign Associate Member of the Society of Hygiene of France; Medical Officer of Health for the District. London: A. T. Roberts, Son & Co., Ltd., Printers, 6, Hackney Road, N.B. 1900. INDEX. page Bakehouses 25 Birth Rate 4 Byelaws (Houses let in Lodgings) 28 Canal Boats Act 33 Care of Infants 58 Constitutional Diseases 22 Consumption (prevention of) 49 Cow Sheds, List of 91 Customs and Inland Revenue Act 34 Death Rate 5 Diphtheria 17 Dusting Account 41 Enteric Fever 18 Erysipelas 18 Estimated Population 4 Factory and Workshops' Act 27 Illegitimacy 5 Infant Mortality 6 Infectious Fevers and Drain Effluvia 34 Marriage Rate 4 Measles 21 & 55 Meteorology 48 Mortuary 43 Notifiable Diseases 16 Non-Notifiable Diseases 20 Population and Density 4 Prosecutions under Food and Drugs Act 66 Prosecutions under Public Health Act (London) 71 Public Health Act (London) 1891 23 Puerperal Fever 18 Register of Sanitary Work 45-46 Removal of House Refuse 39 River Lea 35 Senile Mortality 8 Scarlatina 16 Slaughter-Houses, List of 90 Small-pox 16 Smoke Nuisances 25 Specific Causes of Death 9 Tuberculosis in Milk 29 Whooping Cough 21&53 Zymotic Diseases 8 Tables— Analysis of Lea Water 35 Births 5 Bakehouses 92 Deaths 6 Deaths from Diarrhœa 20 Death Statistics, according to Diseases, Ages and Localities 12-13 Dusting Account 42 Infant Mortality 7 Influenza 20 Inquests 44 Population, Area and Density in Sub-Districts of Hackney 4 Population. Births, and New Cases of Infectious Sickness 14 Requests for Removal of Dust 41 Suicides and Accidental Deaths 44 Tubercular Diseases 22 Vaccination 40 The Parish of Hackney. MEDICAL OFFICER'S REPORTS FOR THE YEAR 1899. PUBLIC HEALTH DEPARTMENT, TOWN HALL, HACKNEY, N.E. To the Members of the Hackney Vestry. Gentlemen, I beg to present my Report upon the Health of the Hackney District for the year 1899. On the whole, the District has maintained its reputation of being one of the healthiest districts in London. The death-rate was only slightly higher than that of 1898, in spite of an excess of summer diarrhoea, and towards the end of the year an outbreak of influenza of a very fatal type. The birth-rate was satisfactory, being 29 0 per 1,000 living. Notifiable infectious disease was less prevalent than during 1898 ; but on the other hand there was an excess of measles, whooping cough, and influenza. Although each year brings increasing demands upon the energies of the Public Health Department, I am pleased to record the work executed maintains the high standard of former years. The various officers of the Department, both inspectors and indoor officers, have carried out their different duties with zeal and ability and to my entire satisfaction. 4 Population and Density.—I estimate the population of Hackney at the middle of the year 1899 to be 222,429. This is assuming the rate of increase during the year to be the same as that observed during the quinquennium 1891-1896. The density is correspondingly higher, becoming for the whole of Hackney 67.5 persons per acre, and ranging from 44.3 per acre in the North District to 106.6 per acre in the South West District. Below is given a table showing these figures compared with similar data for all London. Table I. Showing estimated Population, Area and Density of the Registration Sub-Districts in Hackney, at middle of 1899. North. Central South West. South East. Total for Hackney Total for London. Estimated Population 50,182 48,302 64,090 59,855 222,429 4,546,752 Area in square acres 1,132 815 601 770 3,292 77,389 Density = persons per acre 44.3 59.2 106.6 77.7 67.5 60.9 *Marriages.—The number of marriages solemnized in Hackney during 1899 was 1,754. This is equivalent to a marriage rate of 157 per 1,000 living. The rate for all London is 18.4 per 1,000. Births.—During the year 1899 there were 6,458 births registered in the Hackney district. This is an increase of only 8 on the number registered in 1898. The birth-rate is therefore 29.0 per 1,000 persons living. The rate varied considerably in the different parts of the district, from 22.0 in the North Sub-district to 31.1 per 1,000 in the South East Sub-district. * I have here to acknowledge my indebtedness to Mr. Tom Hosgood, Superintendent Registrar, who has kindly abstracted for me the number of marriages, and illegitimate births for the year 1899. 5 * Illegitimacy.—There were 266 illegitimate births registered in the district of Hackney during the year 1899, and of these 1.37 were born in the Rescue Homes of the Salvation Army in this district, of non-Hackney parents. This leaves a total of 129 illegitimate children amongst Hackney persons, which is equivalent to an illegitimate birth-rate of nearly 20 per 1,000 births. Table II. Births. tion District of Hackney. Registration Sub-Districts. All London. North. Central. South West. South East. Total No. of Births 6,453 1,116 1,512 1,961 1,864 133,l20 Rate per 1000 living 29.0 22.0 31.3 30.5 31.1 29.4 No. of Illegitimate Births 12.9 Rate per 1000 Births 20.0 Deaths.—The total number of deaths registered in the district during 1899 was 4,033, but amongst these were 520 of persons from other districts, and in addition there were 294 deaths of Hackney residents in outside institutions. After making the necessary corrections, the deaths properly credited to Hackney number 3,807. With a population of 222,429 persons this gives a death-rate of 17.11 per 1,000 living. A further correction for age and sex distribution by means of the factor, 1 04645 gives a true death-rate of 17.9 per living persons. The rate is slightly higher than that for 1898, this latter being 17.1 per 1,000, but the increase is, no doubt, due to the excess of deaths from summer diarrhoea and influenza. The rates vary in the different sub-districts, the lowest being 11.7 per 1,000 in the North, and the highest 24.2 per 1,000 in the South East sub-district. The following table shews the number of deaths with corrections in each sub-district with their respective rates per 1,000. The mortality-rate for all London for 1899 is 19.8 per 1,000 living persons. 6 Table III. Showing the corrected number of deaths in Hackney during the year 1899 distributed in the Registration Sub-Districts, with the annual rate per 1,000 living persons. North Hackney. South E. Hackney. South W. Hackney. Central Hackney. All Hackney. Total Deaths registered in the sub-districts. 564 1,410 1,089 970 4,033 Deaths occurring in the sub-districts amongst persons not belonging thereto. 3 79 185 253 520 Deaths occurring outside the subdistricts amongst persons belonging thereto 30 117 94 53 294 Corrected No. of Deaths 591 1,448 998 770 3,807 Rates per 1,000 living 11.7 24.2 16.6 15.9 17.1 Infant Mortality.—The deaths under one year in Hackney during 1899 numbered 1,069, an increase of 27 on the number of deaths at that age in 1898. This is equivalent to an annual infantile mortality of 165 per 1,000 births, being an increase of 4 per 1,000 compared with the previous year. The largest number of deaths occurred in the third quarter of the year, no less than 438 being recorded in this period. Amongst these deaths were 36 due to accident or violence, and of these 19 were due to overlaying by parents. These deaths were distributed during the last two years in the four quarters as follows : Deaths From Overlaying. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Year 1898 11 3 1 12 „ 1899 7 2 2 8 In considering the individual causes of this infantile mortality, one cannot help being struck with the fact that the large majority of infant deaths are due to comparatively few causes. Thus, summerz 7 diarrhoea and enteritis claim 300, tubercular diseases 56, lung diseases 150, debility and wasting 134, infectious diseases 84, accidents and violence 36, a total of 760 or three-fourths of the whole for the year. My reason for thus particularising is to draw attention to the fact that many of these diseases are preventible. Amongst the deaths under the head of accident and violence were 19 from overlaying. These clearly were preventible, and many deaths from summer diarrhoea and wasting are due to improper feeding. Many deaths from infectious disease, especially measles and whooping cough, would be prevented if parents realised the gravity of these diseases, and understood the value of isolation in preventing their spread, and the danger of a fatal issue from complications by exposure and want of proper treatment. In addition, many deaths of infants are no doubt due to lung disease, induced by improper clothing and exposure to cold. These facts were brought to the notice of the Public Health Committee, and, as a consequence, I was instructed to draw up a memorandum on the feeding and care of infants for public distribution. This I did, and have arranged (by the consent of the Superintendent Registrar of Births) with the District Registrars, to give a copy of the memorandum with each birth certificate issued. A copy of the memorandum will be found in the appendix. Table IV.—Eleven principal causes of Infant Mortality. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total Measles 7 19 3 0 29 Scarlatina 0 0 1 1 2 Whooping Cough 7 6 3 6 22 Teething 3 7 5 1 16 Diarrhœa 6 6 147 6 165 Convulsions 18 19 16 17 70 Lung Diseases 45 29 15 61 150 Tubercular Diseases 15 8 21 12 56 Atrophy and Debility 24 26 42 42 134 Premature Birth 25 34 35 30 124 Accidents & Violence 9 7 9 11 36 Total 159 161 297 187 804 Other Causes 48 35 141 41 265 Total 207 196 438 228 1,069 8 Much has been done by legislation and local administration to lower the death-rate, but it appears to me that the infant death-rate would be very much less if it were not for the want of knowledge and carelessness on the part of the public generally and individually. I think the time has now arrived when some superior effort should be made to educate the public, especially the poorer part of it in tbe simple principles of home sanitation, personal hygiene, and the feeding and care of infants, if we are to further reduce the infant death-rate. And I regard such an idea with more favour, because I know it represents a field of labour where the greatest prospects of success exist. In Manchester, Birmingham, Liverpool, and Buckinghamshire women have been appointed to visit the houses of the poor, and, by practical demonstration, instruct them in the sanitation of their homes, in personal hygiene, and in the feeding and care of infants. I should be glad to see such an appointment made in Hackney ; for I am strongly of opinion that it must be by the public that the infant death-rate must be further reduced, and that will not be brought about, until they are familiarised by actual demonstration with the elementary principles of preventive medicine. Senile Mortality.—The deaths amongst persons at 65 years and upwards were 872; between 65 and 75 years, 438; between 75 and 85 years, 344; and above 85 years, 90 deaths. The death for the age period of 65 and upwards is 3.8 per 1,000 living. SPECIFIC CAUSES OF DEATH. Class I. Specific Febrile or Zymotic Diseases.—The deaths during the year due to the chief zymotic diseases numbered 747. This is a decline of 55 upon the number recorded during 1898, and is equivalent to a zymotic death-rate of 3.3 per 1,000 living persons. The zymotic deathrate for all London for 1899 is 2.48 per 1,000 living persons. 9 TABLE OF DEATHS Of Inhabitants of the Hackney District between 1st Jan. and 31st Dec., 1899. AGES Under 1 year. 1 to 5. 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards. Totals. Chicken Pox 1 .. .. .. .. .. .. .. .. .. .. 1 Membranous Croup 1 4 .. .. .. .. .. .. .. .. .. 5 Smallpox. Vaccinated .. .. .. .. .. .. .. .. .. .. .. .. Unvaccinat'd .. .. .. .. .. .. .. .. .. .. .. .. Vaccndoubtfi .. .. .. .. .. .. .. .. .. .. .. .. Measles 29 78 8 1 .. .. .. .. .. .. 116 Scarlet Fever 2 15 8 1 1 .. .. .. .. .. .. 27 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough 22 28 2 .. .. .. .. .. .. .. .. 47 Diphtheria 18 161 73 2 3 0 1 .. .. .. .. 258 Simple Fever .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 1 2 15 21 23 6 5 3 .. .. .. 76 Other Miasmatic Diseases .. .. .. .. .. .. .. .. .. .. .. .. English Cholera 3 .. .. .. .. .. .. .. .. .. .. 3 Diarrhoea, Dysentery 165 18 2 0 1 2 3 2 8 10 4 215 Ague,Remittent Fever .. .. .. .. .. .. .. .. .. .. .. .. Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. Syphilis, &c. 11 .. .. 1 .. 1 1 .. .. 1 .. 15 Erysipelas 5 1 1 1 1 1 5 0 3 3 0 21 Pyaemia 3 1 5 1 2 1 2 1 1 .. .. 17 Puerperal Fever .. .. .. 1 2 2 .. .. .. .. .. 5 Thrush Vege Parasites .. .. .. .. .. .. .. .. .. .. .. .. Worms, Hydatids .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast Milk .. .. .. .. .. .. .. .. .. .. .. .. Alcoholism .. .. .. .. 3 11 11 4 0 1 1 31 Influenza 3 4 1 7 12 9 13 10 15 10 3 87 264 307 115 36 48 33 41 20 27 25 8 924 Constitutional Diseases. Rheumatic Fever .. .. .. 1 .. 1 1 .. .. .. .. 3 Rheumatism .. .. 2 3 2 2 .. 2 1 2 .. 14 Gout .. .. .. .. .. 1 1 2 .. .. .. 4 Rickets 1 2 .. .. .. .. .. .. .. .. .. 3 Cancer .. 1 1 1 9 24 40 59 43 19 3 200 Tabes Mesenterica 16 7 2 .. .. .. .. .. .. .. .. 25 Tubercular Meningitis 15 19 6 .. .. 2 .. .. .. .. .. 42 Phthisis 2 3 1 64 69 80 48 34 9 .. .. 313 Scrofula, Tuberculosis 23 15 9 16 12 10 6 4 1 .. .. 96 Purpura Hæsmorrhagica .. .. .. 1 .. .. .. .. .. .. .. 1 Anaemia, Leucocytha 2 2 2 2 1 2 .. 1 1 .. .. 13 Diabetes .. .. .. 1 2 1 3 4 3 3 .. 17 Other Constitutional Diseases 1 .. 1 1 1 1 .. .. .. .. .. 5 60 49 27 90 96 124 99 106 58 24 3 736 Developmental Premature Birth 124 .. .. .. .. .. .. .. .. .. .. 124 Malformations 20 1 .. 1 .. .. .. .. .. .. .. 22 Old Age .. .. .. .. .. .. .. 1 26 114 49 190 336 _ 144 1 .. 1 .. .. .. 1 26 114 49 10 TABLE OF DEATHS—Continued. AGES Under 1 year. 1 to 5. 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards Totals Nervous Diseases. Inflammation of Brain or Membranes 30 15 13 7 2 3 3 2 0 1 .. 76 Apoplexy, Hemiplegia .. .. 2 3 6 12 34 39 59 23 1 179 Insanity, General Paralysis .. .. .. .. 4 13 3 7 8 5 1 41 Epilepsy 1 .. 2 1 3 3 3 .. 3 1 .. 17 Convulsions 70 6 2 .. .. .. .. .. .. .. .. 78 Laryngismus Stridulus .. 3 .. .. .. .. .. .. .. .. .. 3 Diseases of Spinal cord 1 .. .. 1 1 1 .. 3 1 .. .. 8 Paraplegia .. .. .. .. .. .. .. 1 .. 2 .. 3 Other Nervous diseases 1 1 .. .. 4 4 3 5 11 .. .. 29 103 25 19 12 20 36 46 57 82 32 2 34 Diseases of Circulating Organs. Peri & Endo-Carditis .. .. 5 2 5 3 4 4 1 .. .. 24 Valvular Disease of Heart 6 1 9 21 16 24 34 45 39 22 4 221 Other diseases of heart .. .. .. 1 .. 4 6 2 4 .. 1 18 Aneurism .. .. .. .. 1 1 1 6 .. .. .. 9 6 1 14 24 22 32 45 57 44 22 5 272 Respiratory Organs. Laryngitis 1 4 2 1 .. .. .. .. .. 1 .. 9 Croup 2 5 .. .. .. .. .. .. .. .. .. 7 Asthma .. .. .. .. 1 2 5 8 7 .. .. 23 Bronchitis 81 34 2 2 4 11 23 43 94 66 14 374 Pneumonia 65 67 10 14 16 33 41 33 30 12 2 323 Pleurisy .. 1 1 .. 1 3 .. 3 2 2 .. 13 Other Respiratory Dis. 1 1 .. .. 1 1 1 3 2 1 .. 11 150 112 15 17 23 50 70 90 135 82 16 700 Diseases Digestive System. Dentition 16 10 .. .. .. .. .. .. .. .. .. 26 Quinsy, Sore Throat .. .. .. .. .. .. .. .. .. .. .. .. Disease of Stomac. 4 1 .. 1 2 2 2 2 .. 1 .. 15 „ Bowels 1 .. 1 1 3 3 .. 2 .. 2 .. 13 Enteritis 132 15 4 4 2 2 3 2 3 4 1 172 Obstruction of Intestines 3 .. 2 2 1 4 4 4 1 2 .. 23 Peritonitis 5 2 6 6 7 7 2 1 1 .. .. 37 Spleen .. .. .. .. .. .. .. .. .. .. .. .. Jaundice, Liver Dis. 3 1 .. 3 1 9 14 8 6 2 .. 47 164 29 13 17 16 27 25 19 11 11 1 333 11 TABLE OF DEATHS—Continued. AGES Under 1 year. 1 to 5. 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards Totals Diseases of Urinary System. Kidney Diseases 1 .. 1 2 2 9 4 14 6 3 .. 42 Nephritis .. 1 1 5 6 5 3 6 6 3 .. 36 Bright's Disease .. .. .. 2 1 6 3 4 8 1 .. 25 Other Kidney Diseases .. .. .. .. .. .. .. .. .. .. .. .. Bladder and Prostate .. .. .. .. .. 1 2 3 6 5 1 18 1 1 2 9 9 21 12 27 26 12 1 121 Diseases of Uterus&c Disease of Uterus .. .. .. .. 4 4 1 .. .. .. .. 9 Abortion, Flooding .. .. .. 1 4 .. .. .. .. .. .. 5 Puerperal Convulsion .. .. .. .. .. .. .. .. .. .. .. .. Ovarian Dropsy. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. 1 8 4 1 .. 1 .. .. 15 Bones and Joints, &c. Caries, Necrosis .. 1 1 .. 1 1 .. 1 .. .. .. 5 Arthritis, Ostitis .. .. .. .. .. .. .. 2 .. .. .. 2 Carbuncle, Phlegmon .. .. .. .. .. .. 1 1 .. 3 .. 5 Other Skin Diseases 4 .. .. .. .. .. .. .. .. .. .. 4 4 1 1 .. 1 1 1 4 .. 3 .. 16 Violence. Accidents & Violence 35 21 14 3 15 15 14 13 16 11 3 160 Homicide 1 1 1 1 1 .. .. .. .. .. .. 5 Suicide .. .. .. 5 3 •• 8 5 3 2 .. 25 36 22 15 9 19 15 22 18 19 13 3 191 Ill-Defined Causes. Dropsy .. .. 1 .. 1 .. .. 1 1 .. 1 5 Debility and Atrophy 134 2 .. .. .. .. .. 1 .. 2 .. 139 Mortification .. .. .. .. .. 2 .. 1 2 2 1 8 Tumour .. .. 2 1 2 .. 1 .. 1 .. .. 7 Abscess .. .. 1 2 .. 3 2 .. .. .. .. 8 Hemorrhage 2 .. .. 1 .. 3 3 1 2 1 .. 13 Sudden Deaths (doubtful) 1 .. 1 .. .. .. .. 2 2 1 .. 7 Causes not Specified .. .. .. .. .. .. 1 .. 1 .. .. 2 137 2 5 4 3 8 7 6 9 6 2 189 Totals 1069 550 226 220 265 351 369 405 438 344 90 4327 12 13 Table A. TABLE OF DEATHS during the year 1899 in the Hackney Metropolitan District, classified according to Diseases, Ages, and Localities. Names or Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. Columns for Population and Births are in Table B.) Mortality from all causes, at SUBJOINED AGES. MORTALITY FROM SUBJOINED CAUSES, DISTINGUISHING DEATHS OF CHILDREN UNDER FIVE YEARS OF AGE. At all ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 16 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis. Pneumonia, Heart Disease. Injuries. All Other Diseases. Total. Typhus. Enteric or Typhoid. Continued Relapsing Puerperal (a) (b) (c) (d) (e) (f) (g) (h) (i) North Hackney 564 129 34 16 27 208 150 Under 6 .. .. 2 .. .. 1 .. .. .. .. .. 4 8 19 .. .. 34 1 .. 4 90 163 5 upwds. .. 1 .. .. .. 3 .. .. 3 .. .. 1 .. 3 1 27 80 37 .. 17 228 401 South West Hackney 861 292 81 20 34 254 180 Under 5 .. .. 5 1 .. 1 .. .. .. .. .. 34 5 60 .. 1 57 2 .. 12 195 373 5 upwds. .. .. 1 .. .. 6 .. .. .. .. 1 1 .. 9 2 63 116 41 .. 22 226 488 Metropolitan Hospital 95 21 14 13 6 38 3 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8 .. .. 5 22 35 5 upwds. .. .. 1 .. .. 5 .. .. .. .. .. 1 .. .. .. 10 4 3 .. 10 26 60 German Hospital 133 3 4 8 21 84 13 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. 1 2 .. .. .. .. .. 1 3 7 5 upwds. .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. 24 8 20 .. 15 57 126 South East Hackney 812 317 109 30 26 2???7 123 Under 5 .. .. 10 .. .. .. .. .. .. .. 2 26 20 72 .. 2 71 2 .. 12 207 126 5 upwds. .. 2 2 2 .. 5 .. .. .. .. 1 1 1 5 .. 52 89 38 .. 12 178 386 Infirmary 586 33 27 7 28 263 228 Under 5 .. .. .. .. .. .. .. .. .. .. .. 1 .. 4 .. .. 8 .. .. 5 42 60 5 upwds. .. .. .. .. .. 5 .. .. .. .. 10 .. .. 7 .. 75 82 63 .. 24 260 526 French Hospital 3 .. .. .. .. .. 3 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. 1 3 Workhouse 9 .. .. .. 1 1 7 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 2 1 .. .. 5 9 Central Hackney 655 238 97 28 30 150 112 Under 5 .. 1 2 2 .. .. .. .. .. .. 4 40 11 29 .. 2 61 2 .. 15 166 335 5 upwds. .. .. 2 .. .. 5 .. .. 1 .. 1 4 1 7 .. 34 59 33 .. 17 156 320 Eastern Fever Hospital 310 19 156 90 16 28 1 Under 5 .. 11 153 .. .. 1 .. .. .. .. .. 2 .. .. .. .. 3 .. .. 2 3 175 5 upwds. .. 7 72 .. .. 33 .. .. .. .. .. .. .. .. .. .. 9 4 .. .. 10 135 City of London Workhouse 6 .. .. .. .. 1 4 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 5 Totals 4033 1052 522 212 189 1234 824 Under 6 .. 12 172 5 .. 3 .. .. .. .. 6 107 45 186 .. 5 242 7 .. 56 728 1574 5 upwards .. 10 78 .. .. 65 .. .. 4 .. 13 8 2 31 3 285 451 240 .. 117 1152 2459 The subjoined numbers have also to be taken Into account in judging of the above records of mortality. Deaths occurring outside the district among persous belonging thereto ) 294 17 28 14 31 156 48 Under 5 .. 5 7 .. .. .. .. .. .. .. .. .. .. .. .. .. 6 .. .. 2 25 45 5 upwds. .. 0 1 .. .. 8 .. .. 1 .. 2 1 .. 1 .. 23 11 25 .. 16 160 249 Deaths occurring within the district among persons not belonging thereto 520 54 143 91 37 144 51 Under 5 .. 7 115 .. .. 1 .. .. .. .. .. 4 1 10 .. .. 8 .. .. 7 44 197 5 upwds. .. 5 59 .. .. 36 .. .. 1 .. 2 .. .. 2 .. 30 24 26 .. 32 106 323 14 15 Table B. TABLE Of POPULATION, BIRTHS, and of NEW CASES of INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, during the year 1898, in the Hackney District; classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions being Shown as separate localities. Population at all ages. Registered Births. Aged under 5 or over 5. New Cases of Sickness in each Knowledge of the Locality, coming to the Medical Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Last Census Estimated to middle of 1899. 1 2 3 4 5 6 7 8 9 10 11 12 13 1 2 3 4 5 6 7 8 9 10 11 12 13 Smallpox. Scarlatina Diphtheria Membranous Croup. Fevers. Cholera. Erysipelas Smallpox. Scarlatina Diphtheria Membranous Croup. Fevers. Cholera. Erysipelas Typhus Enteric or Typhoid. Continued Relapsing Puerperal Typhus. Enteric or Typhoid. Continued Relapsing Puerperal. <«) (b) (c) (d) (e) North Under 5 .. 72 14 2 .. l .. .. .. .. 4 .. 53 3 .. .. 1 .. .. .. .. .. 5 upwds. .. 173 48 .. .. 35 2 .. 4 .. 32 .. 97 21 .. .. 17 1 .. .. .. 2 Central (H) Under 5 .. 61 74 4 .. 3 .. .. .. .. 9 .. 35 53 .. .. 1 .. .. .. .. 1 5 upwds. .. 159 115 .. .. 70 .. .. 2 .. 63 .. 115 65 .. .. 45 .. .. .. .. 5 South West Under 5 .. 80 61 4 .. 2 1 .. .. .. 3 .. 57 39 2 .. .. .. .. .. .. .. 5 upwds. .. 176 108 1 .. 60 2 .. 6 .. 68 .. 125 72 .. .. 35 1 .. .. .. 10 South East Under 5 .. 61 92 8 .. 4 .. .. .. .. 10 .. 41 60 5 .. .. .. .. .. .. .. 5 upwds. .. 151 127 1 .. 71 .. .. 7 .. 117 .. 103 66 .. .. 53 .. .. 2 .. 7 Eastern Hospital Under 5 .. 17 3 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 22 19 .. .. 7 1 .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. Hackney Workhouse Under 5 .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 5 upwds. .. 2 1 .. .. 1 .. .. .. .. 2 .. 2 1 .. .. 1 .. .. .. .. 2 Hackney Infirmary Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 1 .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. Metropolitan Hospital Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. City of London Workhouse Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. l .. .. .. .. .. .. .. .. .. .. 1 Convent, Hassett Road Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. French Hospital Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 1 .. .. .. .. .. .. .. .. l .. .. .. .. .. .. .. .. .. .. .. Congress Hall Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. 2 2 .. .. .. .. .. .. .. .. .. 2 2 .. .. .. .. .. .. .. .. Totals Under 5 .. 292 244 18 .. 10 1 .. .. .. 24 .. 187 155 8 .. 2 .. .. .. .. 1 5upwds. 2 688 420 2 .. 244 4 .. 19 .. 278 .. 446 227 .. .. 151 2 .. 2 .. 27 16 A.—NOTIFIABLE DISEASES. Small Pox.—Two cases of this disease were notified in this district towards the end of December. The disease in both cases was contracted in the Eastern Fever Hospital, Homerton, where these persons had been removed suffering from scarlet fever. It appears that a person supposed to be suffering from scarlet fever was admitted to the E.F. Hospital in the month of Dec. It was soon after ascertained that he was really suffering from small-pox. As soon as this was known he was removed to the Small-Pox Hospital. In the meantime several patients in the same ward became infected, amongst whom were the two above mentioned from this district. The following are the particulars of the Hackney cases:— 1. H.R., aged 19 years, entered the Eastern Hospital, Dec. 3rd, suffering from scarlet fever, and was notified by the Medical Superintendent as suffering from Small-pox on Dec. 20th, 1899. State of vaccination not known. 2. A.S., aged nine years, entered the Eastern Hospital, Nov. 17th, suffering from Scarlet Fever, and was notified by the Medical Superintendent as suffering from Small-pox on Dec. 27th, 1899. State of vaccination not known. Scarlatina.—This disease was slightly less prevalent during 1899 than the previous year, 986 cases being notified as against 1,002 in 1898, the difference being 16. But of above total, 19 cases were returned from the Fever Hospital by the Medical Superintendent as not suffering from any infectious disease, thus reducing the cases to 967. This is equal to an attack rate of 4.3 per 1,000 living persons. The deaths numbered only 15, which gives a mortality rate of 1.5 per cent, attacked. Both the attack and mortality rates are lower than during 1898. The disease was below the average during the first six months of the year; then a gradual increase set in which reached its highest point in the second week of October. This was followed by a rapid decline to the end of the year. These changes may be seen in CHART SHEWING THE RISE AND FALL WEEKLY IN CASES OF SCARLET FEVER, DIPHTHERIA, & TYPHOID FEVER, REPORTED DURING 1880. Notes: Scarlet Fever Diptheria Typhoid Fever 17 the chart furnished with this Report. The rise during the second half of the year did not appear to be associated in Hackney with any particular agency such as school, milk supply, etc. It is very probable that outbursts arise from the multiplication of mild and unrecognised cases, for which no precautions of isolation, etc., are taken. In some of these cases the initial symptoms are very slight, and the desquamation almost absent; consequently, medical aid is not sought. I believe it is by means of these cases that the prevalence of Scarlet Fever is maintained in the district, and wide spread outbursts occasionally occur. Diphtheria and Membranous Croup.—The past year has shown a diminution of this disease as compared with 1898. The cases of diphtheria notified numbered 644, and membranous croup 20. The corresponding figures for 1898 were 847 and 19. Amongst the number sent to hospital 20 were returned by the Medical Superintendent as not suffering from any infectious disease. This reduces the total cases to 846, which are equal to an attack-rate of 2.9 per 1,000 living. The deaths for the year numbered 84, and is equal to a deathrate of .3 per 1,000 attacked. The disease was prevalent during the whole year, but rose much above the average during the months of February, March, June, November and December (see accompanying chart). 1 could not trace this rise to any general agency, as school attendance, or milk supplies, etc. In the last report issued by the Asylum's Board the Medical Superintendents, reporting upon the treatment of diphtheria by antitoxin, state that "the figures for 1898 tally very closely with those of the preceding year, and fully bear out the favourable opinion previously expressed as regards the serum treatment." This treatment is certainly finding favour with medical practitioners in this district, to whom during the year 45 bottles were supplied form the Public Health Department. 18 Enteric or Typhoid Fever.—The cases notified numbered 254— an increase of 47 upon the number in 1898. Of this total, 12 were returned from the Metropolitan Fever Hospitals by the Medical Superintendent as not suffering from any infectious fever, thus reducing the total to 242. The attack-rate is, therefore, 1.0 per 1,000 living persons. The deaths numbered 39, which give a mortalityrate from this disease of 16.1 per cent, attacked. The disease was low from the beginning of the year until the month of September, when the usuil autumn rise set in, which did not reach its maximum until the second week in November, after which a rapid fall set in, continuing to the end of the year. Six cases appear to have been introduced into Hackney from outlying districts. Typhus.—No case of this disease was notified during 1899. Continued Fever.—Five cases under this name were notified during the year. Puerperal Fever.—Nineteen cases of this disease were notified during 1899, and 5 of these were fatal. A considerable amount of uncertainty has always existed as to what puerperal condition should be recognised under the term Puerperal Fever. This has now been authoritatively determined by the Royal College of Physicians, which expressed the opinion to the London County Council that "Puerperal Fever should be taken to include septicaemia, pytemia, septic inflammations in the pelvis, occurring as the direct result of child-birth." A copy of this resolution was, on my suggestion, circulated amongst the medical practitioners of the district. Cholera.—This disease was not responsible for any death in Hackney during 1899. Erysipelas.—During the year under review 304 cases of erysipelas were notified, amongst which were 19 deaths. The mortality-rate is 6 9 per cent, attacked. 19 Table showing the percentage of cases of Scarlatina, Diphtheria and Enteric Fever removed to Hospital during the years 1893—1899, compared with the attack-rate for the District. Infectious Diseases. Scarlet Fever. Diphtheria, including Mem. Croup. Enteric or Typhoid Fever. Years 1893 1894 1895 1890 1897 1898 1899 1893 1894 1895 1896 1897 1898 1899 1893 1894 1895 1896 1897 1898 1899 Number notified 2121 1006 1044 1492 1386 1002 986 859 550 481 13 554 18 738 25 865 646 327 186 256 198 203 207 254 Number removed to hospital 669 742 441 669 738 613 633 167 164 140 3 176 5 312 1 476 392 104 66 86 73 83 122 153 Percentage removed 31.5 46.9 42.2 44.8 52.5 61.1 64.6 19.4 29.8 28.8 31.6 41.0 55.0 60.0 31.8 35.4 33.5 36.8 40.8 59.4 60.6 Attack-rate per 1,000 persons living 10.2 4.7 4.8 6.9 6.4 4.5 4.3 4.1 2.5 2.2 2.6 3.5 3.9 2.9 1.5 0.8 1.1 0.9 0.9 0.9 0.9 Estimated population 206469 212547 215620 213766 216651 219540 222429 20 B.—NON-NOTIFIABLE DISEASES. Influenza.—This malady caused 87 deaths during the year, which, as will be seen from the table below, occurred mostly during the months of March and April. This total shows an increase of 32 upon the number for 1898. There seems to be no doubt that many deaths from Influenza are preventible. Many deaths are due to complications of the lungs, which in turn are brought on by indiscreet exposure during the initial stages of the disease. The mortality-rate for the year is nearly .4 per 1,000. Deaths from Influenza during the years 1891 to 1899. Year. Jan. Feb. Mar. Apl. May June July Aug. Sep. Oct. Nov. Dec. 1891 0 0 0 2 86 39 6 3 2 1 1 1 1892 77 29 6 3 1 1 1 0 0 0 0 1 1893 3 4 11 10 4 4 3 1 1 1 7 37 1894 18 5 2 4 1 3 0 0 1 1 1 3 1895 2 6 91 9 3 1 0 0 2 2 3 5 1896 1 4 2 3 2 1 0 1 0 1 3 4 1897 1 1 6 5 9 3 0 0 1 2 2 7 1898 11 16 7 5 4 3 2 2 2 1 1 1 1899 3 9 35 11 6 3 1 1 0 5 3 10 Diarrhœa.—To this malady 218 deaths were attributed during the year; but, in addition, 172 deaths were ascribed to Enteritis, due probably to the same causes as Diarrhœa. Of the total, 300 occurred amongst infants under one year old, and 251 of these during the third quarter of the year. The total death-rate for Diarrhoea and Enteritis combined is therefore 1.1 per 1,000. I have commented elsewhere on the high death-rate of infants under one year (vide p. 6). Deaths at all ages during the year from Deaths under one year. In the third quarter, all ages. In the third quarter, und'rone ye'r Diarrhœ 218 168 185 147 Enteritis and Gastroenteritis 172 132 129 104 21 Measles.—The deaths from this disease reached the high figure of 116 during the year. This is an excess of 61 over the deaths from the same cause in 1898, and is equivalent to a death-rate of .5 per 1000 persons living. No less than 107 of these deaths occurred under the age of five years. The above number of deaths must, therefore, indicate a widespread prevalence of Measles in Hackney during the year 1899. In the "School Board for London Gazette" of March 21st, 1899, Head Teachers are requested amongst other things to bring to the notice of the Medical Officer of Health of their districts the names and addresses of any children excluded from school suffering either from Measles, Whooping Cough, Chicken Pox, or Mumps, or any children excluded because of such disease existing in their homes. I immediately brought this action of the School Board to the notice of the Public Health Committee, and on my suggestion it was resolved to offer disinfection of clothing, home, etc., after the recovery of every case of Measles and Whooping Cough thus reported by the School Board Teachers. At the same time I was instructed to prepare a memorandum for distribution upon the measures which should be adopted by parents and others to prevent the spread of these diseases. A copy of this memorandum is sent to the parent of every infected child reported by the Board Officers. This is the beginning of an attempt to arouse the public to a sense of the seriousness of these diseases, and to the possibility of their partial prevention. A copy of the Memorandum will be found in the appendix. Whooping Cough.—There were 47 deaths from this disease during 1899, being just half the number registered in 1898. This is equal to a death-rate of .2 per 1,000 living persons. The same offer of disinfection, etc. to parents is made in this disease as in Measles, and a similar memorandum was printed for distribution. A copy of this will also be found in the appendix. 22 Class II. Constitutional Diseases.—The deaths in this class numbered 736, the majority being due to Cancer and Tubercular Diseases. The deaths due to the former were 200, and the latter 476, the mortalityrates from these being respectively .8 and 2.1 per 1,000 living persons. Below is given a table showing the number of deaths in Hackney duo to Tubercular Diseases during the years 1894 to 1899 inclusive. Number of deaths in Hackney during the years 1894-1899, inclusive from Tubercular Diseases. 1894 1895 1896 1897 1898 1899 Tabes Mesenterica 35 62 35 34 37 25 Tubercular Meningitis 40 43 35 41 53 42 Phthisis 278 292 294 299 308 313 Scrofula and Tuberculosis 52 62 44 63 85 96 Totals 403 459 408 434 483 476 Class III. Developmental.—Under this head the deaths numbered 336, and are equivalent to a death-rate of 1.5 per 1,000 living. The deaths due to premature birth appear very high, and I have a conviction that if the whole circumstances of these premature births were known a large number would be found to be preventible. Class IV. Local Diseases.—These diseases were responsible for 1,951 deaths daring the year, which give, a death-rate of 8.7 per 1,000. 23 Class V. Violence.—To this cause 191 deaths were due, 5 of which were homicides, and 26 suicides. The mortality-rate for the class is .8 per 1,000 living persons. Class VI. Ill-Defined Causes.—No less than 189 deaths with a mortalityrate of .8 per 1,000 were attributed to indefinite causes. PUBLIC HEALTH (LONDON) ACT, 1891. Nuisances.—The nuisances abated during the year amounted to 4,142. Intimation and statutory notices secured the abatement of 3,892, and legal proceedings had to be resorted to in 250 instances. Infectious Diseases.—Under the provisions of this Act 4,246 cases of infectious disease were notified by medical practitioners during 1899. The houses where these cases occurred were inspected, the drains tested, and any defect or insanitary condition found remedied. The rooms fumigated numbered 1,963. In addition, the walls of 740 rooms were stripped of their paper and cleansed; 13,333 articles were steamed at the disinfecting station by the Vestry's steam apparatus, and 129 infected articles were destroyed by request of the owners. Also 905 bottles of carbolic acid and 8,758 one pound bags of carbolic and sanitas powder were given to applicants. A detailed list of the articles disinfected, and destroyed on request, will be found in the appendix. Accommodation for persons during the disinfection of their homes was paid for in six cases only. The cost was £1 5s. Articles Seized Unfit for Food.—The following were seized and ordered to be destroyed by Magistrates as unfit for food during the year, viz.: 1 ton, 14 lbs. of fish, 12 cwts. of fruit and vegetables, 13 cwt., 2 qrs., 46 lbs. of meat. 24 Amongst these articles were four pieces of meat weighing about 1 cwt. 1 qr. seized on the premises of a sausage maker in Hackney. The circumstances which led to their seizure were these. I received information from the Chief Sanitary Inspector of Bethnal Green, that suspicious consignments of meat were being conveyed into the Hackney District from the premises of a wholesale dealer in cats' meat, situated in Mile End. I immediately had the place watched, with the result, that a consignment of meat was traced from the cats'-meat dealer, to the sausage maker above-mentioned. On examining the consignment of meat, I found four pieces which, in my opinion, were so unsound as to be unfit for human food. These I had conveyed to the North London Police Court, where Mr. Bros, the presiding Magistrate, examined them and ordered them to be condemned as unfit for human food. Legal proceedings were subsequently instituted by the Vestry against the sausage maker for having in his possession unsound meat intended for the preparation of food, and against the Mile End wholesalfe dealer in cat' meat for selling the same to the sausage maker, with the result that each defendant was fined £50, or two months' imprisonment in default. Cow-Houses and Slaughter-Houses.—The Public Health Committee inspected these (26 Cow-Houses and 36 Slaughter-Houses) in the month of September, and found them, on the whole, in a very satisfactory condition. The following nuisances were found— Dirty Walls 8 Defective Paving 2 Dirty Pound 1 Defective Dung-Pit 1 Pigs kept 1 13 25 Bakehouses.—These were inspected in the month of November by the Public Health Committee, with the following results:— Number of Bakehouses inspected 120 Number in a satisfactory condition 65 Number requiring limewashing 42 Number requiring small repairs 13 Smoke Nuisances.—During the year 670 observations, averaging about 30 minutes each, were made by one of the officers of the Public Health Department. Notices were served for the abatement of this nuisance. In many instances smoke-consuming apparatus have been erected, and the substitution of anthracite for the ordinary coal, upon the notice only of the Inspector, but legal proceedings were instituted in two instances, with the following result:— St. John's Sanitary Laundry Co.; penalty £10 and 2/- costs; ,, „ „ „ £10 and 2/- costs. In January of last year the London County Council asked the Hackney Vestry amongst other local authorities for information as to any points in which as a result of experience in the administration of the Public Health (London) Act, 1891, they thought any amendment of the Act was necessary or desirable. The Public Health Committee after consideration adopted on my suggestion the following amendments as desirable in the furtherance of Public Health. These were subsequently adopted by the Vestry and a copy forwarded to the London County Council. SUGGESTED AMENDMENTS AND ADDITIONS TO THE PUBLIC HEALTH (LONDON) ACT, 1891. Nuisance. Sec. 2.—To add to Nuisance: Any premises the walls, or floors, or stairs, or passages of which are dirty, or dilapidated, or infested with vermin, shall be a nuisance. Any premises the walls or floors or stairs, or passages of which are dilapidated shall be a nuisance. Power to deal with verminous persons as a nuisance. Power to deal with carpet beating as a nuisance. 26 Offensive TRades. Sec. 19.—Add fried fish shop and marine store as offensive trades, and frame bye laws for their regulation. Removal of Refuse. Sec. 35.—Reduce time for compliance with notice from 48 to 24 hours, and give local authority power to remove the refuse, if offensive, at the cost of owner or occupier. Sec. 36. —Give local authority power to charge for the removal of manure or dung from stables, etc. Repair of Drain and Sanitary Conveniences. Sec. 42.—Make it an offence to repair a drain or sanitary convenience without giving notice to the local authority. No new house to be occupied without certificate of its sanitary condition from the local authority. Food. Sec. 47.—Add section that premises where food is manufactured, or prepared, or stored, should be under regulation by bye-laws of local authority. Special section relating to ice-cream vendors. INFECTIOUS DISEASE. (a) notification. Sec. 55.—That medical partners should only be required to send one certificate, and be entitled to one fee only for each case notified. Puerperal Fever to be defined to include Septicaemia, Pyaemia, Septic Peritonitis, Septic Metrtis, and other acute septic inflammations in the pelvis, occurring as the direct result of child-birth. 27 That all head teachers of schools be required to notify all cases of infectious disease coming to their knowledge amongst their scholars, and also all absentees or children excluded by reason of infectious disease in their homes. (b) prevention. Sec. 66.—Amendment (1). A person suffering from any dangerous infectious disease who is so lodged that proper precautions cannot be taken for preventing the spread of the disease to the other inmates of the house, or who is without proper lodging, etc., etc. Sec. 71.—Milksellers to be compelled to disclose source of milk supply. additions. All farms supplying milk for public consumption shall be registered, and subject to periodical inspection under the Public Health (London) Act, 1891. Government Buildings not to be exempt from inspection. FACTORY AND WORKSHOPS ACTS, 1878-1895. The following is a list of the inspections, with their results, made by the male Sanitary Inspectors of Workshops where males alone are employed. In addition, they attended to 137 workshops where females were employed, on which nuisances had been found, the abatement of which involved structural alterations or repairs. These alterations or repairs were executed under notices served by the inspectors. Miss Teebay, the Sanitary Inspector for Laundries and Workshops where females are employed, paid 730 first visits, and 1,119 visits of re-inspection, and secured the abatement of 201 nuisances during the year. Miss Teebay's full report is given in the appendix. 28 No. of Workshops registered during the year 1899 74 ,, „ inspected on notice by Factory Inspector 23 „ ., „ by instruction of Medical Officer of Health 5 Result of Inspections—(a) Workshops overcrowded 2 (6) Improper W.C. accommodation 2 (c) No W.C. accommodation 1 (d) No separate W.C. tion for the sexes 6 (e) Other nuisances 87 BYE-LAWS AS TO HOUSES LET IN LODGINGS. The following is a list of the Houses registered under the above Bye-Laws during the year, and of the work executed under notice from the Sanitary Inspectors on the same premises. Table of work executed under the Bye-laws as to Houses let in Lodgings under the supervision of Sanitary Inspectors G. White (District 2) and R. J. Sheppard (District 7) during the year 1899. Work done. District 2. District 7. Total. Total number of houses registered .. 27 81 108 No. of houses cleansed 17 80 97 Damp walls properly damp coursed.. Foul pans reiroved or cleansed 5 15 24 15 29 Roofs repaired 7 39 46 Space below ground floor excavated and ventilated 58 58 Sanitary dust-bins provided 4 36 40 Yard paving repaired and re-laid 6 45 51 Defective sink wastes repaired 3 35 38 Choked drains released.. 1 18 19 Defective drains repaired or re-laid .. 1 56 57 Defective washhou.se paving repaired Proper water supply to W.C.'s. 10 21 31 5 12 17 Defective cisterns renewed .. 2 19 21 „ rain water pipes repaired .. 2 17 19 Overcrowding abated by notice 15 15 „ ,, ,, arrangement 7 9 16 Gutters fixed to washhouse 7 7 New pans and traps fixed 44 44 Foul storage cisterns cleansed and provided with covers 24 24 Water supply put on main 22 22 29 TUBERCULOSIS IN MILK. Early in February, 1899, the Hackney Vestry received a letter from the Vestry of Westminster stating that they were advised that the danger of the spread of tuberculosis through the medium of milk and cream is a very real one, especially in the case of young children, and asking the Hackney Vestry to support their application to the Local Government Board to promote legislation during the ensuing Session of Parliament for preventing the sale of milk and cream, both foreign and English, so contaminated, and for the regulation of dairies and the inspection of cows. The Public Health Committee to whom this letter was referred, after consideration reported to the Vestry that before deciding to support the action of the Westminster Vestry it would be advisable to ascertain whether the milk supply to Hackney was affected and to what extent by the bacillus of tubercle, and recommended that 100 samples of milk be obtained and submitted to the Jenner Institute for this purpose. This report was adopted by the Vestry. The samples were in due course obtained and examined by Dr. A. Macfadyen, of the Jenner Institute, who reported on them as follows:— Jenner Institute of Preventive Medicine, Chelsea Gardens, Grosvenor Road, London, S.W. August 3rd, 1899. Retort upon 100 Samplet of Milk from Hackney District, examined for the presence of tubercle bacilli. To Dr. J. Kino Warry, Medical Officer of Health, Hackney Vestry. Sir,—I beg to submit the following Report upon the Samples of Milk forwarded by you to the Jenner Institute for examination as to the presence of tubercle bacilli. The Samples of Milk (100 in number) were received at intervals from 9th March to 30th May, 1899. The fresh samples were examined immediately on their arrival. The milk was centrifugalised for 30 minutes, the cream was then stirred from the top, and the whole centrifugalised for a further period of 30 minutes. In this way the bacteria present in the milk were sedimented. 30 The sedimented portions of the milk were used for examination. A series of microscopical specimens were made from each sample, but such a direct examination does not yield satisfactory results. The only reliable test is by means of inoculation experiments, and these were carried out with each sample of the milk. The accompanying table gives the results obtained, both positive and negative. A period of four to six weeks must elapse before the diagnosis can experimentally be established and the investigation has consequently extended over some months. The results may be briefly summarised:- 1 Seventeen samples of milk were found to contain tubercle bacilli of virulent character. 2 Twenty-three animals succumbed prematurely. It was consequently impossible to establish a diagnosis in three instances. 3 Seventy-seven samples were therefore fully and fairly tested. Taking the 77 absolute tests that were carried out, and the 17 positive results that wore obtained, the proportion of milks from the Ifackney District containing tuborcle bacilli was found to be 22 per cent. I am, yours faithfully, ALLAN MACFADYEN, M.D., Director. On consideration of this report the Public Health Committee, in view of the serious consequences which are likely to follow the use of milk so affected, resolved to present the report of Dr. Macfadyen to the Vestry and make the following recommendations: (a) That the President of the Board of Agriculture be memoralized to introduce a Bill into Parliament to give effect to the recommendations of the Boyal Commission on Tuberculosis. (b) That a copy of the report be sent to the London County Council and the local authorities of the metropolis, and that these bodies be asked to support the action of this Vestry by making similar representations. (c) That copies of the report be sent to the Prime Minister, the Leader of the House of Commons, the President of the Local Government Board, and to the Members of Parliament and London County Council for the district. (d) That a circular be prepared and circulated throughout the district advising the inhabitants to boil all milk before use 31 The Vestry adopted these recommendations of the Committee, and subsequently the memorial was prepared and forwarded to the Board of Agriculture, and communications made to the individuals and authorities mentioned in the report. It may be here stated the 15 London Districts supported the memorial of the Hackney Vestry to the Board of Agriculture on the subject, and on the other hand, the London County Council, amongst others, stated that they could not see their way to take any action at that time. The following circular was also prepared and distributed to every house in the district. CONSUMPTION AND INFECTED COWS' MILK. 'I he Hackney Vestry having had one hundred samples of the milk sold in their district examined by an experienced bacteriologist, have ascertained that 22 per cent, of the samples so examined were infected with tubercle bacilli—the active cause of Consump tion. The Vestry have every reason to believe that these samples are fairly representative of the whole of the cows' milk sold to the public in Hackney. Under these circumstances, the Vestry feel bound to make known the risks the public run in using raw milk, and to warn them that milk infected with tubercle bacilli is capable of causing Consumption in those who consume it without previous sterilizing, and to strongly advise the public to boil or otherwise sterilize all milk before use, in order to avoid the danger of causing Consumption by this means. By order of the Public Health Committee, J. KING WABRY, M.D., Public Health Department, Medical Officer of Health. Town Hall, Hackney, N.E. 12th July, 1899. It is to be hoped that the action taken bv the Vestry in this matter will help to create a public opinion in favour of legislation to prevent the spread of tuberculosis by means of cows' milk, which will ultimately induce the Government to promote a Bill to this end. 32 CLEANSING OF PERSONS ACT, 1890. The Public Health Committee have now decided to adopt the provisions of this Act, and provide means for the cleansing of verminous persons. In view of the excellent results obtained in Marylebone, where such means have been provided, this is an important step in promoting public cleanliness. Costermongers' Refuse.—Early in the year the attention of the Public Health Committee was drawn to the filthy condition of certain streets resorted to by costermongers and others, due 10 the deposit in the roadway of all kinds of rubbish, including vegetable refuse. The Committee decided to give the offenders notice, by means of a hand-bill, to deposit their refuse in a proper receptacle, until a collecting van, ordered by the Committee, had called to collect it; and warned thein that further depositing on the roadway would be followed by prosecution. The action of the Committee has been followed by very great improvement in these streets. It was found necessary during the year to prosecute 19 persons under bye-law 5 made under the P.H. (London) Act, 1891. This bye-law provides for the prevention of nuisances arising from any dust, ice, salt, ashes, or rubbish offal, carrion, fish or filth, or other matter or thing in any street. Each person prosecuted was fined 2s. 6d. on the first offence and 5s. on the second. Below is a copy of the notice issued: — HACKNEY VESTRY. This is to Give Notice That the Hackney Vestry will cause all the Trade Refuse produced by all Stallkeepers, Costermongers, and Itinerant Vendors in the main thoroughfares of Hackney to be collected from 7.30 to 11.30 p.m. on Saturdays ; and all such persons are hereby requested to deposit their refuse in properly covered boxes until the collecting van has removed it; and they are further informed that legal 33 ceedings will immediately be instituted against any person found depositing Refuse of any sort on the Public Footpaths or Carriage ways. By order of the Public Health Committee. J. KING WARRY, M.D., Medical Officer of Health. Public Health Department, Town Hall, Hackney, N.E. 12th July, 1899. No Gratuities Allowed. TEMPORARY SHELTER.—PUBLIC HEALTH (LONDON) ACT, 1891 (Sec. 60 (4). This has not yet been provided, bat the subject has again been before the Public Health Committee and the Hackney Vestry during the past year, with the result that plans of the proposed building have been drawn, and are now under consideration. In all probability the shelter will be erected early next year. CANAL BOATS ACTS, 1877-1894. A further improvement in the inspections and re-inspections of canal boats took place during 1899, as compared with 1898; the latter year 67 boats were inspected, but during the former year 98. The following infringements of the Act were found:— Without requisite double bulk-head 1 No proper water vesse 1 Dilapidation 4 Want of proper ventilation 1 Required marking 4 No certificate 2 No legal proceedings were required during the year. The inspector's full report will be found in the appendix. Table Showing condition of Drains of Houses in which primary cases of Infectious Disease occurred during the year 1899. DISEASE. Houses in which drains were defective. Houses in which drains were not defective. Total No. of Houses in which primary cases occurred. Per centage of Houses with defective drains. 1. Enteric Fever 34 161 195 21.1 2. Diphtheria 108 490 598 22.0 3. Scarlatina 112 648 760 17. 2 4. Erysipelas 24 252 276 9.5 34 CUSTOMS AND INLAND REVENUE ACT, 1890. During the year applications were made by two owners for certificates under this Act for 14 dwellings, containing 40 tenements. The certificates were given after a few small repairs had been executed. Infectious Fevers and Drain Effluvia.—The following is a table showing the condition of the house drains in houses where primary cases of the specific fevers had occurred during the year. It is only of interest in so far as it indicates to a slight extent the relative relation of the fevers to effluvia from house drains. I have observed this relationship during the last three years. In each I have found the houses where diphtheria and enteric fever occurred to have a larger proportion of defective drains than the houses in which scarlatina and erysipelas occurred. 35 THE RIVER LEA. The River Lea continues to maintain its reputation as a highly polluted stream, and a source of nuisance to the district of Hackney. During the hot months of the year its evil odour is perceptible at long distances. The following copy of a report on a sample of the river water indicates the character of its pollutions:— Public Analyst's Laboratory, 31, Moorgate Street, London, July 14th, 1899. Report on sample of River Lea Water received from the Hackney Vestry, marked " from Lead Mill Stream (Lead Mill Point), 5/7/99." Received 6/7/99. Total solid residue 55.6 grains per gallon. Saline ammonia 3.36 „ „ Organic ammonia 0.42 „ „ Chlorine 8.0 ,, „ Oxygen required to oxidise the organic matter 2.149 „ „ Nitrates and Nitrites Strong traces. Sulphuretted Hydrogen Absent. The sample possessed a distinct sewage odour, and was brownish-yellow in colour. It is practically diluted sewage. LEO. TAYLOR, P.I.C.. etc., Public Analyst. In my last year's report I stated that Major L. Flower, Engineer to the Lea Conservancy Board, C.E., had been instructed to prepare plans, estimates, etc., of the construction of a main drainage scheme for the Lea Valley. This has been done, and early in April, 1899, these plans were considered by the Public Health and General Purposes Committee of the Vestry, and subsequently the following report embodying their views was presented to and adopted by the Vestry:— 36 REPORT OF PUBLIC HEALTH COMMITTEE ON REFERENCE re LEA AND RODING VALLEYS MAIN OUTFALL SEWER. To the Hackney Vestry. "Gentlemen, "Your Committee have to report that your reference to them and "the General Purposes Committee dated 1st February, 1899, on the "Report of Mr. G. Chatterton, M.I.C.E., and Major L. Flower, "R.E., Sanitary Engineer to the Lea Conservancy Board containing "schemes for a Main Outfall Sewer for the Lea and Roding "Valleys, has been fully considered by both Committees, and in "submitting their report thereon your Committee desire to refer to "the past efforts of the Vestry in the purification of the River Lee. "The Vestry are aware that the foul condition of certain parts "of the River Lea as it passes through the Hackney District for "many years gave rise to complaints of nuisance, originating "chiefly from the Tottenham sewage, and your Public Health "Committee having bought the serious state of things to the notice "of the Board of Works, representation on the subject was made "to the then Sir Charles Russell, M.P. for South Hackney, who "gave it his untiring attention. A Select Committee of Enquiry "was afterwards appointed. Subsequently, in 1886, the Lea "Purification Act was passed. "This Act empowered and required the Hackney District Board "of Works and the late Metropolitan Board of Works respectively, "to admit the effluent water from Tottenham sewage into their "sewers during four months in each year for three years; the "object of limiting the time being in contemplation of a compre"hensive scheme for dealing with the sewage of the Districts "situate in the Valley of the Lea. "No steps having been taken to carry out such scheme, application was made by the Hackney District Board of Works to the " Metropolitan Board of Works to extend the time for two years, " which was refused, but a subsequent application in October, 1888, " was successful in obtaining an extension for one year only. 37 "Arrangements have since been made to receive the Tottenham "effluent into these sewers throughout each year, but, notwithstand"ing this, it appears that the evils complained of in 1886 still exist, "being intensified to some extent by the growth of population in the "Lea Valley ; but the main sources of pollution affecting the Hackney "District are now the effluents from the sewage farm of Waltham"stow and the sewage works of Ley ton. These two districts have "an estimated population of 120,000 inhabitants, the whole of their "sewage, after treatment, passing into the River Lea. "An additional source of pollution below Hackney is the effluent "from the West Ham sewage works. "This condition of the river influenced your Public Health Com"mittee to convene a conference of Members of Parliament, Members "of the London and Essex County Councils, and of public bodies of "districts along the banks of the River Lea to consider the steps to "be taken to remedy the pollution of the said river, which was held "at the Hackney Town Hall on 13th October, 1897, when it was "resolved— 'That this Conference is of opinion that a full inquiry into the 'condition of the whole of the River Lea as to its source of 'impurities should be undertaken by the Government in con'tinuation of the Report of the Select Committee of 1886 ' "Subsequently your Committee approached Mr. W. R. Bousfield, "Q.C., M.P. for North Hackney, who arranged with Mr. Chaplin "President of the Local Government Board, to receive a deputation "on the subject, on Saturday, 10th June, 1898, with a view to asking "the Government to favourably consider the question of introducing "legislation for providing a main drainage scheme for the Lea Valley, "as the only effective remedy for the existing nuisance—a statement "of the deputation's views having previously been forwarded to Mr. "Chaplin—he was, however, unable to receive the deputation, "owingto Government business in the House of Commons. "About this time the Lea Conservancy Board, doubtless having "become aware of the activity displayed by Hackney in this matter, "convened a conference of delegates from districts abutting on the 38 "River Lea, and others interested, to consider what steps should be "taken towards dealing with the sewage from such districts, when "it was decided to adopt a Main Drainage Scheme for the Lea and "Roding Valleys as the best way of dealing with the matter, and "Major L. Flower, R.E., and Mr. G. Chatterton, M.I.C.E., were "deputed to prepare schemes for the same, the cost of which was "subscribed to by the districts concerned (including Hackney). "These schemes are contained in their report as above-mentioned, "and the report of your Surveyor explaining the schemes is attached "hereto for the information of the Vestry. "Your Committee are of opinion that Scheme A, as reported "upon by the Surveyor, is the best submitted, and they recommend "that the Vestry do petition the Local Government Board in "favour thereof; also that a copy of the Surveyor's Report as "annexed do accompany such petition. Further, that immediate "action be taken to bring the facts to the notice of the London "County Council, the districts interested, and other public bodies "by whom influence can be brought to bear, asking them to support "the petition in favour of the proposed scheme, and your Committee "hope that their efforts to prevent the pollution of the River Lea "may ultimately be successful by the adoption and carrying out "of the scheme proposed. "All of which is respectfully submitted." No further progress has been made since the adoption of this report. In fact, it appears that several of the riparian Authorities who were in favour of the adoption of a drainage scheme have fallen away from their first views and may now be regarded as opponents of any scheme of drainage. It now remains for some central authority to overcome the inertia of the local authorities contributing to the pollution of the river and that of the Lea Conservancy Board. Town Hall, Hackney, 6th April, 1899. 39 VACCINATION. The following table is a summary of the returns made by the Vaccination Officers respecting the Vaccination of children whose births were registered in the districts from 1st Jan. to 30th June 1899. For comparison I have added at the foot of the table figures for the corresponding period in 1898. These figures are interesting in that they indicate the effect of the recent legislation, as embodied in the Vaccination Act of 1899, upon public vaccination. On the whole, the effect has been to bring about a great improvement in the number of children vaccinated. Whereas in the 1st half of the year of 1898 only 13.4 per cent. of the births of that period were successfully vaccinated, in the first half of the year 1899 the percentage had increased to 41.1 per cent. of the births. Also, whereas the births unaccounted for by Vaccination Officers amounted to 63.4 per cent. of the total births in the former period, in the latter this percentage had declined to 29 4 per cent. The figures under column IV. are also interesting. This gives the number of certificates of conscientious objections received by the Officers for the two half-years respectively. During the former six months the number was 20, during the latter 26, the percentage to the total births being respectively .65 and .77 If these figures represent the true proportion of conscientious objectors in Hackney, the effect of conscientious objection on the progress of vaccination will be practically nil. Whatever the objections to vaccination may be, they are not sufficiently strong to induce parents in any large numbers to attend before a Magistrate for the purpose of obtaining a certificate of exemption from vaccination. The above figures make the future look more hopeful in keeping small-pox out of the district. REMOVAL OF HOUSE REFUSE. During the year 1899 the amount of House Refuse removed by the contractors rose from 53,283 loads in the year 1898 to 57,990, and the sum paid to the contractors from £13,642 13s. 8d. to £14,849 10s. In addition to the latter sum, £2,051 19s. 4d. was 40 Return made on the 8th February, 1900, by the Vaccination Officers of the Hackney Union, respecting the Vaccination of Children whose Births were registered in their Districts from 1st January to 30th June, 1899, inclusive. REGISTRATION SUBDISTRICTS COMPRISED IN THE VACCINATION OFFICER'S DISTRICT. 1 Number of Births returned in the " Birth List Sheets" as registered from 1st Jan. to 30th June, 1899. 2 Number of these births duly entered by 31st January, 1900, in cols. I., II.,IV. and V. of the" Vaccination Register" (Birth List Sheets) viz:— No. of these births which on 31st January, 1900, remained unentered in the " Vaccination Register " on account (as shown by Report Book) of # No. of these births remaining on 31st January, 1900, neither duly entered in the Vaccination Register (cols. 3, 4, 5,6 and 7 of this Return), nor temporarily accounted for in the " Report Book " (cols. 8, 9 and 10 of this Return. Col. I. " Successfully Vac'in'ted." 3 Column II. Col. IV. Number in respect of whom Certificates of conscientious objection have been received. 6 Col. V.1 "Dead. Unvaccinatecd" 7 Postponement by Medical Certificate. 8 Removal to Districts, the Vaccination Officer of which has been duly apprized. Removal to places unknown or which cannot be reached and cases not having been found. 10 " Insusceptible of Vac'in'ion." 4 "Had Small-pox." North Hackney 604 218 9 — 4 54 24 2 45 248 Central Hackney 777 361 6 — 12 87 7 12 82 210 South-East H'ckney 969 321 1 6 — 3 126 13 20 143 342 South West H'ckney 1,030 492 — 7 26 124 10 80 116 195 Total 3,380 1,392 22 — 391 54 114 386 995 Total for the period of 1898 (1st Jan. to 30th June). 3,046 468 7 — 20 405 5 14 194 1.933 11 expended as wages to the Vestry's dustmen. The inclusive cost for the removal of house refuse to the parish thus works out at 5/7 ¼ per load. Reference has been made in former Reports to the unsatisfactory method of paying for the removal of hoase refuse by load measurement. The refuse should be weighed and payment made by weight. During the past year, I have ascertained by weighing a certain number of loads each month their average weight. The weight has varied between the limits of 8-cwt. 2-qrs. and 25-cwts.—the average weight per load for the year being 14-cwt. 3-qrs. 22-lbs. The following shows the number of requests for the removal of dust received during the year 1899, compared with the number received during previous years. I also append a weekly record of the " refusals " and " no answers " met with by the dustmen during the removal of the house refuse. The average number of refusals is much the same as that met with during previous years. A dust destructor, the provision of which has been urged upon the Vestry by the Public Health Committee for many years, is now about to be built. It is estimated that the Vestry will be able to undertake in connection with their Electric Installation the destruction of house refuse some time during the year 1901. Table XI. A List of the requests for the removal of Dust received during the five years, ending December 31st 1899. 1894 1895 1896 1897 1898 1899 January 136 89 37 21 22 26 February L48 41 17 20 6 7 March 85 53 30 15 6 13 April 97 66 46 8 19 37 May 55 73 22 11 3 21 June 72 46 39 12 11 22 July 63 31 18 17 11 43 August 56 23 12 9 6 14 September 58 38 24 6 8 2 October 73 27 21 8 3 10 November 94 39 14 9 4 6 December 46 26 17 7 15 18 Totals 893 552 297 143 114 220 42 DUSTING ACCOUNT, 1899. MONTH. Northern Division Southern Division Totals. Loads. Cost. Loads. Cost. Loads. Cost. 1899 £ s. d. £ s. d. £ s. d. January 2217 572 14 6 2636 669 19 8 4853 1242 14 2 February 2235 577 7 6 2726 692 17 2 4961 1270 4 0 March 2120 547 13 4 2520 640 10 0 4640 1188 3 4 April 2227 575 6 2 2542 646 1 10 4769 1221 8 0 May 2284 590 0 8 a650 673 10 10 4931 1263 11 6 June 2276 587 19 4 2753 669 14 5 5029 1287 13 9 July 2216 580 4 4 2648 673 0 8 4894 1253 5 0 August 2194 566 15 8 2640 671 0 0 4834 1237 15 8 September 2043 527 15 6 2522 641 0 2 4565 1168 15 8 October 2177 562 7 10 2570 653 4 2 4747 1215 12 0 November 2323 600 2 2 2775 705 6 3 5098 1305 8 5 December 2148 534 18 0 2518 639 19 10 4666 1191 17 10 Totals 26490 £6843 5 0 31500 £8006 5 0 57990 £14819 10 0 Dustmen's Wages £2,051 19 4 Sanitary Labour £746 19 5 Prices per load N. 5s. 2d. 8. 5s. 1d. 43 Table XII. A list of refusals in the collection of Dust during the year 1899. Week ending Refusals. No Auswerg. Week ending Refusals. No Answers January 7th 6,319 893 July 15th 9,385 1,895 „ 14th 8,422 1,413 22nd 8,471 1,749 „ 21st 7,814 1,247 29th 7,893 1,813 28th February 4th 7,700 1,194 August 5th 9,147 1,943 6,871 1,173 „ 12th 8,761 1,519 „ 11th 7,143 1,214 )) 19th 7,792 1,784 „ 18th 6,915 1,321 Sept. 26th 8,985 1,917 „ 25th 7,694 1,403 2nd 9,873 1,895 March 4th 8.413 1.374 9th 9,481 1,817 11th 9,318 1,245 16th 10,249 1,522 „ 18th 8,649 1,315 11 23rd 9,767 1,419 ,, 25th 7,695 1,471 ii October 30th 8,915 1,735 April 1st 8,473 1,319 7 th 9,767 1,620 1,537 „ 8th 9,624 2,001 14th 9,603 „ 15th 8,970 1,348 ii 21st 9,187 1,445 „ 22nd 7,869 1,413 ii Nov. 28th 10,413 1,863 29th May 6th 9,814 1,761 4th 9,215 1,713 9,873 1,815 ii 11th 8,726 1,524 1,478 „ 13th 9,716 2,064 ii 18th 8,518 20th 9,441 1,935 • Dec. 25th 9,379 1,690 1,731 „ 27th June 3rd 8,973 2,160 2nd 9,716 8,611 1,814 9th 9,583 1,775 10th 9,442 1,736 16th 9,174 9,258 1,668 1,735 17th 8,769 1,907 ii 23rd 24th 9,205 1,738 ii 30th 7,315 1,619 July 1st 8,816 1,815 „ 8th 9,648 1,743 Total 4,587,704 84,218 THE MORTUARY. The following tables give the number of bodies deposited in the mortuary during the year, also the number of inquests held there, with the causes of deaths, etc. Number of bodies deposited in mortuary 464 (a). To await inquests 444 (b) Upon request of relatives, to await burial 20 Number of Post-mortems performed 203 44 INQUESTS. Verdicts. Sex. Male. Female. Natural causes 158 122 Accidental Death 65 48 Suicide 19 7 Open Verdict 10 4 Manslaughter 2 Murder 1 2 Stillborn 5 1 Totals 258 186 Table showing nature of above Suicidal and Accidental Deaths in the Hackney District during the Year ended 1899. SUICIDES. ACCIDENTAL DEATHS. nature of suicide. No. nature of accidental death. No. Poisoning 4 Fracture of Arm 1 Cut Throat 5 Poisoning 3 26 5 Drowning 8 Fall Hanging 4 Suffocated Shooting 2 Shock from Burns 13 1 7 Strangulation 1 Blow on Abdomen Jumping from train 1 Drowning Bun over by Train 1 Hun over 3 Shock from Scalds 3 Crushed by Train 3 „ Cart 1 Fracture of Skull 13 Irritant Food 1 Fracture of Hip 6 Suffocated in Bed 24 Hcemorrhage from cut 1 Exposure at night 1 Not stated 1 Total 26 Total 113 45 REGISTER OF SANITARY WORK, 1899. Public Health Department. Letters, etc., sent out 3240 Circulars, Notices, etc. 14400 Committee Notices sent out 1200 Copies of Summonses and Orders made out 2168 Houses from which Bedding, etc., was removed to be disinfected by the Vestry's apparatus I5°5 Articles disinfected by the Vestry's apparatus— Beds 1344 Mattresses 617 Palliasses — Bolsters 939 Pillows 2710 Blankets 2193 Sheet 165 Carpets, Rugs, etc. 822 Quilts 5*5 Other Articles 2428 Rooms fumigated J9&3 Houses cleansed after Infectious Diseases 74° Disinfectants supplied to the poor (bottles) 905 Do. do. (bags) 8758 Infectious Patients removed to Hospital 1208 Cautionary Notices to Schools re Infectious Sickness 1897 Certificates of Disinfection issued to Schools, etc. 1772 Accumulations of Dust specially removed 27 Articles destroyed by request— Beds 34 Mattresses 25 Bolsters 3 Pillows 9 Palliasses Cushions 13 Articles of Clothing 18 Miscellaneous 14 Blankets — 42 REGISTER OF SANITARY WORK, 1899. SANITARY DISTRICTS. Mr. Wood Stamford Hill Mr. Harvey, West Hackney Mr. Lepfi, Hackney Mr. Morley, Clapton Mr. Body, Kingsland. Marc Street and South Hackney. Mr. Bobbitt, Homerton, e. Mr. Minsell, Homerton, N. Mr. Ellis, Homerton, S. Mr. White, Clapton, N.E. Mr. Sheppard, Special. Miss Teebay, Special. Totals. Mr. High, Mr. Kemp Mr. Punter, No. 1 No. 2 N0.3 No. 4 No. 5 N0.6 No7. N0.8 No. 9 No. 10 No. 11 No. 12 Inspections— Made 011 Complaint 285 250 247 226 308 262 224 192 184 268 84 81 8 2619 Workshops 2 7 5 1 2 7 18 2 25 2 538 609 House to House 11 71 50 9 315 68 56 191 94 82 947 Houses after Infectious) 140 174 128 241 188 230 173 108 268 223 117 50 58 2098 Diseases Premises re-inspected 2804 2963 2976 2886 2044 2677 2848 2588 2849 2292 2551 1869 3963 1199 36509 Fishmongers' and Poulterers' Yards 1 3 2 5 4 2 4 2 Slaughterhouses 12 1 1 23 Cow houses (Premises) 14 ,, (Sheds) 9 1 10 Miscellaneous Inspections 30 93 109 84 9 202 26 31 1 585 Greengrocers' Yards 3 5 1 5 3 3 20 Schools 4 2 2 2 3 13 Bakehouses 21 14 13 17 16 12 23 3 8 12 8 1 148 Urinals 7 12 15 9 11 41 74 15 13 60 3 260 Canal Boats 102 102 Animals improperly kept 7 8 10 6 4 4 39 Statutory Notices served 23 75 21 32 80 23 e 10 59 13 16 40 88 9 455 Intimation Notices served 206 323 241 317 347 304 297 318 309 259 317 189 184 180 3781 Peremptory or Final 50 31 35 21 50 30 50 74 52 20 40 16 18 43 530 Notices served Laundries 192 192 47 Outworkers 12 12 Proceedings taken before Magistrate or justices under the Sanitary Acts 10 as 11 15 45 7 1 1 21 29 65 5 2 250 Nuisances abated 2-51 353 441 324 339 346 256 438 366 264 289 108 166 201 4142 Seized and Condemned as Unfit for Human Food— Fish 3 cwt. 1 stone ii cwt. 1 cwt. 3 cwt. 21 cwt. 8jcwt. 14 lbs- Fruit and Vegetables 2 cwt. 14 cwt. 38 lbs. 1 cwt. 1 cwt. i cwt. i cwt. 10 lbs. 2 cwt. 6f cwt. i cwt. 10 lbs. 12 cwt. Meat U cwt. 1 4 cwt. 12 lbs. 14 lbs. 1 cwt. 1 cwt 14 lbs. 6 lbs. 10 cwt. 13cwt. 2qrs. 46 lbs. Other Articles 10 lbs. 10 lbs. Open Spaces cleared 0 1 14 2 1 1 21 Special Reports to) Medical Officer of Health)' 23 29 7 9 5 2 3 50 128 Food Adulteration Samples collected for Analysis 83 54 5t 58 47 45 50 49 47 47 48 48 600 Proceedings taken before Magistrates 6 9 10 15 3 13 3 11 5 6 9 9 99 48 METEOROLOGY. The following table, for which I am indebted to the Secretary of the Royal Meteorological Society, is an abstract of the Climatological Observations made at St. Luke's, Old Street, E.C., for the year 1899. ABSTRACT OF CLIMATOLOGICAL OBSERVATIONS. 1899. Temperature. o **■ si If o p 5 as Rain. Means. Extremes. a p a c * a o o ■ f. 9 a.m. Min. Max. Range Mean 1 Min. Max JANUARY.. o 43-4 o 39-5 o 48-6 0 9-1 0 441 O 30'8 o 55-9 % 85 7-5 in. 2-49 21 FEBRUARY 41-7 37-9 49-3 11-4 43-6 27-8 65'0 83 60 1-87 12 MARCH 41-2 351 49-7 14-6 42-4 24-6 61-5 79 61 •55 9 APRIL 48-4 43-1 54-2 11-1 48-6 35 3 63-6 75 8-3 2-72 22 may 53-5 45-8 60-5 14-7 53'2 361 71 '4 69 7-4 5-0 1-41 1 -30 1-78 •45 12 g JUNE 62-8 54-6 71-4 16-8 630 45-5 82-1 65 JULY G6-7 601 74-5 14-4 67-3 52-5 84-4 69 8-1 10 5 AUGUST.... 671 59-3 75-3 16-0 67-3 52-6 860 69 4-3 SEPTEMB'R 58-6 53-6 65-9 12-3 59-7 43-3 84-6 72 6-6 2-69 14 OCTOBER .. 49-6 450 56-6 11-6 50-8 38-3 62-7 86 5-9 2-03 9 NOVEMBER 491 45-3 53-5 8-2 49'4 371 621 83 8-2 406 10 DECEMBER 38-1 34-6 42-3 7-7 38-5 , 24-3 55-7 83 8-9 109 16 YEAR.. 51-7 46-2 58-5 12-3 52-3 24-3 86 0 77 69 22-44 14« I remain, Gentlemen, Yours faithfully, J. KING WARRY, M.D , D.P.H., &c., Medical Officer of Health. Report of the Medical Officer of Health received, and ordered to be printed aud circulated in the usual manner. HENRY HULLAND, May 2nd, 1900, Chairman of the Vestry. 49 APPENDIX. PREVENTION OF CONSUMPTION. Consumption, or phthisis, or tuberculosis, is a disease of an infectious nature, attacking persons at all ages and of both sexes, and spreading either from person to person or by means of tuberculous food. It causes in Great Britain alone over 70,000 deaths each year, and in Hackney over 400 deaths. The disease is now known to be due to a microbe called "the bacillus of tubercle," which gains access to the body by the nose or moath, from which it is carried to the lungs or bowels, where, under certain favourable conditions, it gives rise to tuberculous disease of these organs. In consumption of the lungs, the patient coughs up a large quantity of phlegm. The phlegm or spit thus coughed up contains a vast quantity of the microbes of tubercle; and it is by means of this spit or phlegm that the disease of consumption is mainly spread from person to person. A patient suffering from consumption does not give off the disease by the skin or the breath, but only in the spit, or occasionally by the bowels. The spit itself is not dangerous while it is kept moist, but only when it is allowed to dry about rooms or on handkerchiefs, afterwards becoming pulverised and dispersed in the atmosphere of rooms or public vehicles as dust. Such dust, inhaled, is capable of producing the disease in other persons. This is more likely to occur in persons in bad or weak health, whether due to disease, over indulgence in alcohol, poverty, overcrowding, or insanitary occupations or surroundings. Now, the microbes in the spit are not destroyed by drying, but remain alive a considerable time as dust, especially in dark, illventilated, or overheated, or dirty, or damp rooms. Fresh air, daylight, and particularly sun-light, kill the microbes speedily; and a healthy body with sanitary surroundings is the best defence against them. Consumption is not only common amongst human beings, but is particularly common amongst certain domestic animals, especially milch-cows and pigs. The flesh of these is capable of giving rise to 50 the disease if eaten; and where the udder of a milch-cow is affected with the disease, the milk of such cows, unless sterilized or boiled, may cause consumption in those drinking it. It may be here stated, for the encouragement of persons suffering from consumption, that this disease is curable in certain of its stages ; and very great improvement by proper treatment has been observed at nearly all stages of the malady. From the above short description of consumption of the lungs and its mode of spread, it will be readily guessed what precautions are necessary on the part of those suffering from the disease, as well as the public at large, to prevent the spread of consumption. These precautions may be given under the following heads:— (a) Precautions to be Adopted by Patients suffering from Consumption, or those in charge of such Patients. 1. A consumptive patient should occupy a bedroom alone, or, if this is impossible, a separate bed. 2. The bedroom should be well lighted and ventilated all day, and a window left partly open at night. (There are simple contrivances available for this to be done without creating draughts.) 3. The patient should not spit about the rooms, but only in a spit-cup or basin containing a small quanitv of disinfectant fluid, or in paper bags, or paper hankerchiefs, which must be immediately afterwards destroyed by burning. (Linen or cotton handkerchiefs should not be used, as the expectoration dries on them, and is, as pointed out before, scattered into the atmosphere as dust.) 4. When out of doors a tuberculous patient should spit in a portable spit-cup, which may be obtained of any chemist, containing a small quantity of disinfectant fluid, and should especially avoid spitting on the floors of any public conveyance or on the public pavements. 51 5. The collected expectorations or spit should be mixed with sawdust or peat-mould and then burnt, or mixed with strong disinfectants and washed down the w.c. or drains; the containing vessel being afterwards washed in boiling water. 6. The expectoration should not be swallowed by the patient, as it is likely to set up tuberculous disease of the bowels. 7. It is dangerous for a consumptive person to kiss others, or be kissed on the mouth. 8. Articles used by consumptive persons, such as cups, saucers, knives, forks, and spoons, etc., should be scalded immediately after use, and, if possible, should be kept separate for the use of the patient. 9. Dusting of rooms and furniture should be done by means of damp cloths, which should be washed in boiling water afterwards. It is important not to raise dust in houses occupied by consumptive patients; so carpets should be scattared with tea leaves before brushing, and a machine brush should be used. (b) Precautions for the Public generally. 1. As consumption may be caused by tuberculous flesh of the ox or pig, these kinds of meat should always be well cooked; milk should also be sterilized or boiled before use. This is especially necessary where milk is the chief article of diet, as with infants, children and invalids. 2. As consumption is encouraged by certain insanitary conditions, such as overcrowding, insuflicent ventilation, dampness, dirt, etc., it is important that these should be quickly removed. 3. The rooms occupied by consumptive persons should be kept scrupulously clean, and on being vacated, either by the removal of the person to hospital or by death, should be thoroughly cleansed and disinfected. 4. This will be done free of cost on application to the Public Health Department, at the New Town Hall, Hackney. The same will be done at any time during the course of the disease on application by the medical attendant. 52 5. As a good state of health is a safeguard against consumption, it will be obvious that those things which promote a healthy body should be encouraged, and those which have a contrary effect discouraged. Finally, it cannot be too clearly understood that consumption, although an infectious disease, is also a preventible disease; and that a consumptive person is not a danger to others if the simple precautions suggested above are observed. By Order of the Public Health Committee, J. KING WAKEY, M.D., D.P.H., Medical Officer of Health. Public Health Department, Town Hall, Hackney, N.E., March, 1899. PREVENTION OF WHOOPING COUGH. Whooping Cough is a highly infectious disease occurring chiefly amongst children under five years of age, and affecting females more than males. It is almost as fatal as measles, causing over 2,000 deaths in London, and nearly 100 deaths in Hackney every year. If not fatal the disease may most seriously damage the constitution for life; and in many cases it certainly leads the way to consumption. The later in life the disease is caught the less serious it is likely to be; but to children under one year old it is probably the most fatal of all diseases. This latter fact alone should induce those who have the charge of children to become acquainted with the early signs of the disease in order, if possible, to prevent its spread to other children. The infection spreads from person to person, being given of by the breath of the patient, and in the secretions coughed up; it is also spread by clothes, bedding, and other things used by a child suffering from the disease. 53 Symptons.—Whooping Cough begins something like measles with what is thought to be a cold. The child looks pale and out of sorts, restless, with a cough, and sometimes has some running at the nose with sneezing. Sometimes the cough, even at the beginning, is very frequent, especially at night, and often ends in retching or vomiting. With this there is usually some fever. Where a cough as above described exists, it would be well to suspect whooping cough, especially if this disease is prevalent in the neighbourhood, and to cause the sick child to be isolated. This stage of the disease lasts about 10 or 12 days, after which the peculiar and characteristic "whoop" of the disease develop. In this the child makes a number of rapid coughs until he is out of breath, then draws in his breath with a peculiar crowing noise, the face at the same time becoming red, and the eyes watery. The fever now disappears. This stage lasts about a month, after which the "whoop" disappears, leaving a cough more or less troublesome, which in turn disappears under proper medical treatment. The infection lasts from the beginning of the disease until five weeks after the commencement of the "whoop," which proves the nature of the disease, and only then if the coughing and "whooping" have ceased for at least two weeks. From the above account it will be seen that to prevent its spreading similiar precautions should be adopted to those recommended in a case of measles. Measures to be adopted to prevent the spread of Whooping Cough. 1. Any child who is suffering from the above described symptons of whooping cough, or who is suffering from a very frequent cough which is worse at night, and which has a tendency to end in retching or vomiting, should be isolated by removal to a room apart from the remainder of the household, and from which all unnecessary clothing, hanging, carpets, etc., have been removed. 2. As the discharges from the mouth, nose, and throat are capable of conveying the disease, these should be received on soft pieces of rag and immediately burned. 54 3. The washable clothing and bedding, and the towels used by the patient should, before removal from the bedroom, be placed in a tub of water, to which some disinfectant has been added. Cups, saucers, spoons, etc., should be scalded before being used by others. 4. Persons attending upon a child ill from whooping cough should wash their hands before leaving the sick room and associating with others. 5. After recovery or death, the room, bedding, clothes, etc., used by the patient should be well disinfected before being used again, and this will be done free of charge on application to the Public Health Department either by the medical attendant or person in charge of a case of whooping cough. 6. No child suffering from whooping cough should be allowed to go to school or to any other public institution; nor should any child recovering from the disease until at least two weeks after the complete cessation of coughing and whooping, and the disinfection of the clothing worn by such child. 7. No child should be allowed to go to school or any other public institution from a house in which there is a case of whooping cough, until the complete recovery of the patient and the disinfection of the house, etc. 8. No child should be allowed to attend school or any other public institution who has been exposed to the infection of whooping cough, until 21 days after exposure, and not even then if there are signs of the disease having been contracted. By order of the Public Health Committee, J. KING WARRY, M.D., D.P.H., Medical Officer of Health. Public Health Department, Town Hall, Hackney, N.E. June, 1899. 55 PREVENTION OF MEASLES. Measles is a highly infectious fever, occurring chiefly amongst children, especially those under five years of age, and is equally common in both sexes. Although regarded of trifling importance by parents, it causes more deaths than scarlet fever or diphtheria. In London alone it causes nearly 3,000 deaths every year, and in Hackney more than 100 deaths. In addition it leaves many children much weakened in health or even injured for life. The disease is dangerous to very young children, and especially to those in the second year of life; so that, if by any means the attack only is delayed until the age of four or five years is reached, there would be a large saving of life. One difficulty in preventing the spread of measles is the fact that a child may be ill two or three days with the early symptoms before the rash appears which proves the nature of the disease; and during this time the sick child is extremely infectious, and may infect other children; but this difficulty may be greatly overcome by parents and guardians acquainting themselves with the early signs of measles, thus enabling them to isolate any sick child at an early period of the disease. Another difficulty is that the public generally believe that Measles is a mild and harmless disease which children must take, and the earlier they take it the better; whereas, on the contrary, measles is a dangerous disease, and the later in life it is taken the less serious it is likely to be. The danger attaching to measles is mostly due to serious complications which frequently arise during the course of the disease, owing to want of proper medical treatment and to careless exposure to cold. 56 If parents and guardians would bear these facts in mind, and in all cases of measles take such precautions as are here suggested to prevent its spread, we might reasonably expect a large decrease in its prevalence, and a corresponding saving in subsequent ill-health and in deaths. It is with a view to this end that this leaflet has been prepared. Symptoms.—In severe cases the disease may begin with a convulsion, or shivering, or an attack of diarrhœa; but in ordinary cases an observant parent will notice the child looks poorly, does not eat its food as usual, or complains of feeling tired, or is fretful. Then the child developes what appears to be a cold, he sneezes, the eyes get red, and a watery discharge sets in from both eyes and nose, and a slight cough arises; at the same time the child becomes feverish. This condition lasts about three days, then the rash of measles appears. This consists of small dark red spots occurring in irregular patches, first on the face, and then spreading to the trunk and limbs. The rash lasts about four days, and then disappears in the same order in which it appears, after which the skin is partly shed in very fine scales. The child is infectious from the commencement of the disease until the disappearance of rash and cough, and until the skin has ceased to peel. This period of infection is usually about 21 days. It should be specially noted that the child is extremely infectious before the rash appears as well as after. The breath, the secretion from the running eyes and nose, and probably the odour given off from the skin, will all spread the disease. It follows that the clothes, with the bedding and room used by the child will be inlectious. From the above short account it may be easily gathered what should be done to check the spread of measles. Measures to be Adopted to Prevent the Spread of Measles. 1. As soon as there is any suspicion of a child sickening for measles, it should be removed to a warm, well-ventilated room, free 57 from draughts, apart from the remainder of the household, from which all unnecessary clothings, hangings, carpets, etc., have been removed. 2. The discharges from nose, eyes and mouth should be received on soft pieces of rag, and immediately burned. 3. The washable clothings and bedding, and the towels used by the patient, should, before removal from the bedroom, be placed in a tub of water to which some disinfectant has been added. Cups, saucers, spoons, etc., should be scalded before being used by others. 4. Persons attending upon a child ill from measles should wash their hands before leaving the sick room and associating with others. 5. After recovery, or death, the room, bedding, clothes, etc., used by the patient should be well disinfected before being used again, and this will be done free of charge on application to the Public Health Department, either by the medical attendant or person in charge of a case of measles. 6. No child should be allowed to go to school from a house in which there is a case of measles until the complete recovery of the patient, and the disinfection of the house, etc. 7. No child should be allowed to attend school who has been exposed to tne infection of measles until 16 days after exposure, and not even then if there are signs of the disease having been contracted. By Order of the Public Health Committee, J. KING WARRY, M.D., D.PH, Public Health Department, Town Hall, Hackney, N.E., May, 1899. 58 ON THE CARE OP INFANTS. Advice to Mothers and Others in Charge of Infants. During the last ten years the deaths of Infants under one year old in Hackney have averaged over 900 per year. A large number of these deaths has been due to preventible causes, such as improper feeding and clothing, and carelessness on the part of those having the charge of infants. This, it is believed, has arisen mostly from want of knowledge ; therefore it has been thought desirable, in the interests of the public health, to attempt to supply this want by compiling the following few rules for the guidance of young mothers and others inexperienced in the proper feeding and care of Infants. (1) Infant Feeding. (a) Natural Feeding.—If possible, all infants from birth until the time of weaning should be suckled by the mother, if she is healthy. This is the best and natural form of infant feeding. During the first month of life the infant should be given the breast every two hours from 5 a.m. until 11 p.m. It may be necessary to feed the child once during the night. Afterwards the intervals of feeding should be lengthened as set out in the appended table. If the mother can only give the breast once a day this should be done in preference to wholly feeding on cows' milk. No child should be suckled under the best conditions longer than the first year or rickets may follow. It may be explained here that human milk differs greatly in quality from cows' milk, the latter containing a much larger quantity of curd, and less sugar than the former. It is owing to the excess of curd in cows' milk that it has to be largely diluted, otherwise it would be impossible for infants to digest it. Another disadvantage in the use of cows' milk is that most of it contains preservatives, such as boracic acid and formaline, sometimes in such quantities as to cause indigestion in infants feeding on it. 59 (b) Artificial Feeding.— (From birth to the end of Six months). If the mother cannot, or can only partially, suckle her child, it should be fed on fresh cows' milk, diluted in the proportion of one part of milk to two parts of either water or barley water, and slightly sweetened with sugar. Two tablespoonfuls of this mixture should be given to the infant during the first month every two hours between the hours of 5 a.m. and 11 p.m., and once during the night. As this mixture is r; ther deficient in fat, it is better to add a teaspoonful of cream to one of the meals each day, or to give half a teaspoonful of cod liver oil twice a day. After the first week, the quantity and composition of the milk given, and the periods of feeding, must be modified in accordance with the following table up to the end of the sixth month. Food table for average infant up to the end of 6th month. Period. Intervals of feeding. Quantities for each meal. No. 01 feeds in 24 hours. Composition of Food. Ist week 2 hours 2 tablespoonfuls 10 One part milk, two parts water or barley water. Ist month 2 ,, 4 tablespoonfuls 10 2nd „ 2½ ,, 6 to 8 tablespoonfuls 8 Equal parts of|milk and water, &c. 3rd A 4th month 3 ,, 8 to 10 tablespoonfuls 7 Equal parts of milk and water, &c. 5th & 6th month 3 ,, 12 to 14 tablespoonfuls 7 Two parts of milk to one of water, &c. N.B.—All milk or water used should be previously boiled. This table is only intended to be an average. It will, no doubt, be necessary to depart in certain cases from the quantities and proportions as experience teaches, perhaps more being given at one time and less at another; but it would be advisable to keep as close as possible to it, especially as regards the intervals. Condensed skim milk or condensed separated milk must not be used on any account. 60 If cows' milk diluted and prepared as above does not suit the child, humanised milk—i.e., cows' milk so prepared as to have the average composition of human milk—should be tried. Sterilized humanised milk may be obtained in London from several well known firms who will be pleased to supply any customer daily. It cannot be too clearly understood, that infants from the beginning of life should be taught to have their food at stated intervals; and to feed an infant whenever it cries is a most pernicious habit, which leads in many cases to chronic indigestion, vomiting and wasting. 2. (Seventh month). Infants, if thriving, may be kept on the above diet until the seventh month of life, but at this time the digestive organs of the child are able to deal with a small quantity of starchy food, so a teaspoonful of wheaten flour, which must be thoroughly cooked, should be added to the milk once a day. 3. (Ninth month). At nine months old one of the infants' foods may be added to the diet, either Liebig's, Mellin's, Savory and Moore's or Nestle's, with an occasional cup of beef tea or broth, or yelk of an egg, but the main bulk of the food must still be cows' milk. The Feeding Bottle.—Of course artificial feeding requires the use of a bottle. This should be one having a smooth internal surface, free from angles and crevices, and provided with a glass stopper, and a teat capable of being easily cleaned. The bottle should not have any tubes, because it is impossible to keep these clean. It is very convenient if the bottle is also marked in tablespoon measurements. The advantage of a bottle of this kind is that it can easily be kept scrupulously clean, and it must be held by the mother or nurse whilst feeding, who can thus prevent the child from bolting its food, or taking too much, both very common faults, and causing much misery to children. The bottle after use should be immediately rinsed out, the india-rubber teat turned inside out, and the whole then placed in a 61 basin of clean water, to which a little boracic acid has been added, until the next meal is required. It is better to have two bottles and use them alternately. Twice a day, at least, the bottle and its several parts must be thoroughly washed in hot water. Any milk remaining over from one feed must not be used for the next. During the intervals of feeding the infant should not be allowed to suck rubber rings or teats, etc., as thsy cause flatulence, and are the means of conveying dirt to the mouth. Weaning.—The child should be weaned at the end of the 9th month, and the process, if possible, should be gradual. Do not wean— 1. When the child is cutting a tooth; 2. Nor, if possible, during the hot season of the year, or the child may get summer diarrhœa; 3. Nor, if it has just recovered from an illness. Food at One Year and After. At one year old a little bread and butter may be taken at breakfast, and at mid-day a little potato mash d with gravy. When the child is about 18 months old the double teeth are beginning to appear. This is the time to give a little meat, such as mutton or beef, which must be pounded. Veal, pork, pastry, fruit, cheese, tea, coffee, etc., should not be given to infants. (2) Clothing. As infants are extremely sensitive to cold, it is clear that they should be warmly clothed, and in such a manner as to prevent catching cold. The infant should be provided with a binder of soft flannel—soft enough not to irritate the skin, and not so tight as to render the child 62 uncomfortable after having a meal. The remainder of the clothing should be warm and made to cover the neck and limbs. When the child is "shortened," the clothes should be made so as to prevent exposure of the limbs. The neck should be high, and the sleeves come down to the wrist. In addition, the clothing should be fairly loose. Attention to these points is necessary to avoid chilling. A large part of infant mortality is due to respiratory diseases, chiefly bronchitis and pneumonia, which are mostly due to chills. During 1898 there were 61 deaths from the former and 67 from the latter disease amongst children under one year in Hackney. (3) Cleanliness. Infants should have at least one warm bath every day. Great care should be taken to have the water at the proper temperature. Any attempt to harden the infant by having cold water will inevitably lead to its illness and probable death. The proper temperature is 95 deg. Fahr. Soap should not be used with children under nine months old, as it irritates the tender skin of very young children. A good substitute is a handful of oatmeal stirred up with the bath water. (4) Sanitary Condition of the Home. Careful feeding and attention to infants may be rendered absolutely useless by inattention to the sanitary conditions of the home and its surroundings. Infants are the first to be affected by insanitary surroundings. So well is this known that the death rate of infants under one year is taken by sanitarians as a measure of the sanitary condition of the place. In order to make the feeding and attention of infants successful, it will be absolutely necessary to look to the following in connection with the house. 63 (1) Cleanliness.—The rooms should be periodically cleaned especially the floors, stairs, passages and yard. (2) Foul Smells.—These must be removed. Very often they arise from neglected sinks, gullies, foul w.c. pans or accumulations in the dust bins. The sinks and gullies should be cleaned occasionally with hot soda water and flushed with water regularly, the pans must be cleaned with a little acid, and the foul dust bins will be emptied on application to the Town Hall, Hackney. Foul water and slops often accumulate in defective paving. The paving should be repaired. (3) Ventilation.—Want of ventilation gives rise to a stuffiness of the home, which has a bad effect upon the health of the inmates, especially infants. It is therefore necessary to keep the windows of the rooms open some portion of the day. Cupboards where food is stored should always be well ventilated and free from bad smells. (4) Overcrowding—This leads to the same results as want of ventilation, and to accidents such as overlaying when children are compelled to sleep in the same bed with their parents. This should never be allowed; a cot, or substitute for one, should be provided at the side of the mother's bed for the infant, and handy for her to attend to the child during the night. (5) Other Insanitary Conditions, which the tenant cannot deal with, should be reported to the Public Health Department, Town Hall. By order of the Public Health Committee, J. KING WARRY, M.D., D.P.H., Medical Officer of Health. Town Hall, Hacknly. November, 1899, 64 REPORT OF INSPECTOR OF WORKSHOPS, LAUNDRIES, &c, FOR THE YEAR 1899. To the Public Health Committee, Hackney Vestry. Gentlemen, During the year 1899 I have paid 730 first visits and 1,119 visits of reinspection in workshops and laundries. Among these were 42 workshops and 3 laundries, subject to the regulations of the Factory and Workshops Acts, as well as to those of the Public Health (London) Act, which had not previously been visited by any inspector. I found nuisances existing on 395 premises. In 137 cases, where the abatement of the nuisance involved structural alterations or repairs, I handed on complaints to the Sanitary Inspectors of the different districts. Of the remaining 258 nuisances, dealt with by me, I can report the abatement of 201. I have served 180 intimations, 43 final notices, 9 statutory notices, and applied for two summonses. We have now on the registers 737 workshops and 173 laundries, containing a total of 1,343 workrooms. The number of registered workshops and laundries is being continually added to by new ones brought under notice by H.M. Inspectors, by letter, by advertisements in the local newspapers, &c. Workroom cards, showing the number of persons permitted in each room, have been distributed to 336 workrooms. This year I have again to report that I have been unable to visit out workers owing to the large number of workshops and laundries that claim my attention. There are on the register I have kept 974 outworkers living in this district. Of these I have visited 12. The names of outworkers nonresident in this district, but who work for employers carrying on business in the Parish of Hackney have been sent to the Medical Officer of the district in which they live. I am, Gentlemen, Your obedient Servant, ALICE TEEBAY, Sanitary Inspector and Inspector of Workshops, Laundries, &c. Town Hall, Hackney, N.E., 8th February, 1900. 65 REPORT OF CANAL BOATS INSPECTOR. To The Public Health Committee Gentlemen,—I beg to submit my Report upon the Canal Boats, inspected under the Canal Boats Acts and Regulations, 1877 and 1884, from 1st January to 31st December, 1899, viz.:— Number of Boats inspected 98 „ „ re-inspected 4 102 „ „ conforming to regulations 85 „ „ infringing acts and regulations 13 Certificates examined 87 Boats examined, certificate not seen (captain absent) 5 „ „ to ascertain if used as dwelling 4 Adults. Children. Number of persons registered for 240 4 „ „ living on boats so registered 143 2 Adults 143 Children under 12 2 Males 139 Females 4 14 Number of Notices issued 12 „ „ attended to 7 „ ,, outstanding 5 Legal proceedings taken 0 Details showing numbers infringing the Acts and Regulations— Certificate not identifying owner 0 Without requisite double bulkhead 1 Refusal of admittance 0 No proper water vessel 1 Non-removal of bilge water . 0 Dilapidation 4 Ventilation 1 Cleanliness 0 Marking 4 Registration 0 Absence of certificate 2 Overcrowding 0 Separation of sexes 0 Infectious disease 0 I beg to remain, Gentlemen, Your obedient Servant, GEORGE WHITE, Sanitary Inspector and Inspector under the Canal Boats Acts. Town Hall, Hackney, N.E., 11th January, 1900. 66 TABLE. Prosecutions under the Food and Drugs Acts and Margarine Acts during the year 1899. No. of Sample. Article. Adulteration or Offence. Result of Legal Proceedings. Fined. Costs. Remarks. £ s. d. £ s. d. 3 Milk 25% added water Fined 2 0 0 0 12 6 5 Milk 33% fat abstracted Fined 1 0 0 0 12 6 21 Milk 8% added water Fined 0 2 6 0 12 6 22 Milk 7% added water Fined 0 10 0 0 12 6 24 Milk 24% added water Fined 1 10 0 0 12 6 30 Milk 11% fat abstracted Fined 0 5 0 0 12 6 34 Milk 37% fat abstracted Fined 1 0 0 0 12 6 36 Milk 10% added water Fined 0 10 0 0 12 6 44 Milk 22% added water Fined 0 10 0 0 12 6 45 Milk 10% added water Fined 5 0 0 0 12 6 58 Coffee 90% chicory Fined 0 10 0 0 2 0 80 Milk 8% added water Fined 5 0 0 0 12 6 82 Milk 22% added water Fined 3 0 0 0 12 6 82 Milk 10% fat abstracted Fined 0 10 0 0 12 6 74 S. Spirits of Nitre 65% deficient of ethyl nitrite Fined 10 0 0 2 2 0 85 Milk 20% added water Fined 5 0 0 86 Milk 42% added water Fined 2 0 0 0 12 6 88 Milk 10% added water Fined 2 10 0 i 92 Butter 94% foreign fat Fined 2 0 0 0 12 6 93 Butter 91% foreign fat Fined 5 0 0 0 12 6 96 Margarine Exposed for sale unlabeled Dismissed Sample not analysed 114 Butter 75% foreign fat Fined 2 0 0 0 12 6 120 Milk 20% fat abstracted Fined 1 0 0 0 12 6 127 Milk 38% fat abstracted Fined 5 0 0 0 12 6 67 No. of Sample. Article. Adulteration or Offence. Result of Legal Proceedings. Fined. Costs. Remarks. £ s. d. £ s. d. 131 Milk 16% added water Fined 1 0 0 0 12 6 157 Milk 15% added water Dismissed Warranty Proved 158 Milk 8% added water Fined 1 0 0 0 12 6 173 Milk 20% added water Fined 2 0 0 0 12 6 174 Milk 17% added water Fined 1 0 0 0 12 6 175 Milk 9% added water Fined 0 10 0 0 12 6 177 Milk 36% added water Fined 3 0 0 0 12 6 178 Milk 8% added water Fined 0 10 0 0 12 6 183 Milk 49% fat abstracted Fined 2 0 0 0 12 6 189 Milk 28% added water Fined 1 0 0 0 12 6 191 Milk 7% added water Fined 0 5 0 0 12 6 194 Milk 42% added water Fined 5 0 0 3 3 0 200 Milk 7% added water Fined 0 5 0 0 12 6 203 Margarine Exposed for sale unlabeled Fined 5 0 0 0 12 6 205 Margarine Exposed for sale unlabeled Fined 0 5 0 0 12 6 206 Butter 60% foreign fat Fined 0 15 0 0 12 6 210 Milk 8% added water Fined 0 10 0 0 12 6 222 Milk 14% added water Fined 4 0 0 0 12 6 226 Milk 13% added water Fined 1 0 0 0 12 6 231 Milk 18% added water Fined 1 0 0 0 12 6 235 Milk 8% added water Fined 0 5 0 0 12 6 237 Milk 27% tat abstracted Fined 5 0 0 0 12 6 251 Milk 10% added water Fined 0 10 0 0 14 6 249 Milk 6% added water Fined 2 10 0 0 12 6 257 Milk 6% added water Fined 2 10 0 0 12 6 268 Milk 67% fat abstracted Fined 0 2 6 0 12 6 68 No. of Sample. Article. Adulteration or Offence. Result of Legal Proceedings. Fined. Costs. Remarks. £ s. d. £ s. d. 271 Milk 9% added water Fined 1 0 0 274 Milk 7% added water Fined 0 10 0 0 14 6 277 Milk 34% fat abstracted Dismissed 0 12 6 Warranty Proved 280 Milk 10% fat abstracted Withdrawn Wrong form of Summons 300 Milk 12% fat abstracted Fined 0 1 0 0 12 6 304 Milk 7% added water Dismissed £2 2s. costs against Vestry (Broken bottle) 308 Milk 5% added water Fined 0 12 6 317 Milk 21% added water Fined 0 15 0 0 12 6 326 Milk 8% added water Dismissed Magistrate not satisfied with evidence of Contract 318 Milk 5% added water Dismissed Certificate imperfect. 348 Milk 10% added water Fined 1 0 0 0 12 6 349 Milk 9% added water Fined 1 0 0 0 12 6 363 Milk 9% added water Fined 1 0 0 0 12 6 356 Butter 21% foreign fat Fined 0 10 0 0 12 6 381 Milk 8% added water Withdrawn Reserve Sample could not be produced 382 Milk 6% added water Fined 1 1 0 0 12 6 389 Butter 95% foreign fat Dismissed Wrong person summoned. 400 Milk 9% added water Fined 0 5 0 0 12 6 401 Milk 7% added water Fined 0 12 6 410 Milk 7% added water Dismissed Per centage too small. 414 Milk 11% added water Fined 10 0 0 0 12 6 417 Butter 93% foreign fat Fined 2 0 0 0 12 6 69 No. of Sample. Article. Adulteration or Offence. Result of Legal Proceedings. Fined. Costs. Remarks. £ s. d. £ s. d. 423 Milk 12% added water Withdrawn on payment of costs 0 12 6 ! By order of Public Health Committee. 426 Milk 13% added water Fined 0 10 0 0 12 6 446 Butter 83% foreign fat Fined 0 10 0 0 12 6 448 Butter 32% foreign fat Fined 10 0 0 0 12 6 449 Butter 91% foreign fat Fined 10 0 0 0 12 6 451 Butter 84% foreign fat Fined 10 0 0 0 12 6 453 Coffee 67% chicory Fined 0 2 6 0 12 6 457 Coffee 31% chicory Withdrawn By order of Public Health Committee. 459 Milk 11% added water Fined 0 10 0 0 12 6 480 Milk 13% added water Fined I 0 0 0 12 6 496 Butter 78% foreign fat Fined 2 0 0 0 12 6 501 Butter 92% foreign fat Fined 5 0 0 0 12 6 504 Butter 91% foreign fat Fined 5 0 0 0 12 6 506 Butter 92% foreign fat Fined 2 0 0 0 12 6 536 Coffee 44% chicory Warrant issued for arrest. 543 Butter 90% foreign fat Fined 2 0 0 0 12 6 546 Butter 91% foreign fat Fined 2 0 0 0 12 6 547 Butter 90% foreign fat Fined 3 0 0 0 12 6 548 Butter 92% foreign fat Withdrawn On recommendation of Magistrate. 562 Milk 10% added water Fined 2 0 0 0 12 6 580 Butter 90% foreign fat Fined 20 0 0 0 12 6 582 Butter 84% foreign fat Fined 5 0 0 0 12 6 583 Butter 84% foreign fat Fined 4 0 0 0 12 6 70 No of Sample. Article. Adulteration or Offence. Result of Legal Proceedings. Fined. Costs. Remarks. 570 Sweet Spirit of Nitre 25% deficient of ethyl nitrite Fined 1 0 0 0 12 6 571 Sweet Spirit of Nitre 33% deficient of ethyl nitrite Fined 1 0 0 0 12 6 572 Paregoric Not of the nature substance and quality demanded by the purchaser Dismissed Sample changed by Vendor after purchase. 595 Milk 15% added water Fined 2 0 0 0 12 6 596 Milk 27% added water Fined 3 0 0 0 12 6 600 Milk 17% fat abstracted Fined 0 10 0 0 12 6 £ 207 19 6 56 16 0 71 Table. Record of Prosecutions under the Public Health (London) Act, 1891, during the year 1899. Address. Complaint. Magistrate's Decision. Penalties. Costs. £ S. d. s. d. 63, Clapton common Defective drains Order to do work in 28 days 1 0 17, Braydon road Defective soil pipe Order to do work in 14 days 1 0 101, Sandringham road House dirty, &c. Order to do work in 28 days 1 0 6, Sigdon road Yard unpaved Order to do work in 28 days 1 0 31, Sigdon road Yard unpaved and undrained Order to do work in 28 days 1 0 43, Sigdon road Yard unpaved Order to do work in 28 days 1 0 22, Sigdon road Yard unpaved Order to do work in 28 days 1 0 35, Powerscroft road Defective drains Order to do work in 28 days 1 0 Crown and Castle, Kingsland road Defective drains Withdrawn, work done 14, Windsor road Damp walls, &c. Order to do work in 28 days 1 0 59, Holmbrook street Penalty summons Penalty 10 0 1 0 61, Holmbrook street Penalty summons Penalty 10 0 1 0 10, Shacklewell lane Penalty summons Penalty 10 0 1 0 68, Jenner road Defective drains Order to do work in 14 days 1 0 34, Powell road Insanitary condition Withdrawn, work done Vacant land, Marsh hill Land unpaved and undrained Order to do work in 14 days 1 0 72 Address. Complaint. Magistrate's Decision. Penalties. Costs £ s. d. s. d. 3, High street, Homerton No dustbin Order to provide dustbin in 24 hours 1 0 5, Burton terrace Yard paving defective, house dirty Dismissed, £1 1s. costs against Vestry 25, Church road, Kingsland No water supply Order to close house 1 0 1, Windsor road Walls of house damp Withdrawn, work done 2, Windsor road Walls of house damp Withdrawn, work done 3, Windsor road Walls of house damp Withdrawn, work done 4, Windsor Road Walls of house damp Withdrawn, work done 5, Windsor Road Walls of house damp Withdrawn, work done 6, Windsor Road Walls of house damp Withdrawn, work done 7, Windsor road Walls of house damp Withdrawn, work done 8, Windsor road Walls of house damp Withdrawn, work done 9, Windsor road Walls of house damp Withdrawn, work done 10, Windsor road Walls of house damp Withdrawn, work done 11, Windsor road Walls of house damp Withdrawn, work done 12, Windsor road Walls of house damp Withdrawn, work done 13, Windsor road Walls of house damp Withdrawn, work done 15, Windsor road Walls of house damp Withdrawn, work done 78 Address. Complaint. Magistrate's Decision. Penalties Costs. £ s. d. s d. 16, Windsor road Walls of house damp Withdrawn, work done 258, Dalston lane Soil pipe unventilated Withdrawn, work done 15, Clarence road No dustbin, and kitchen ceiling broken Withdrawn, work done 2, Bohemia Place Penalty summons Penalty 1 0 0 2 0 19, Felstead street Penalty summons Penalty 10 0 0 1 1, Windsor road Walls of house damp Order to do work in 28 days 1 0 2, Windsor road Walls of house damp Order to do work in 28 days 1 0 3, Windsor road Walls of house damp Order to do work in 28 days 1 0 4, Windsor road Walls of house damp Order to do work in 28 days 1 0 5, Windsor road Walls of house damp Order to do work in 28 days 1 0 6, Windsor road Walls of house damp Order to do work in 28 days 1 0 7, Windsor road Walls of house damp Order to do work in 28 days 1 0 8, Windsor road Walls of house damp Order to do work in 28 days 1 0 9, Windsor road Walls of house damp Order to do work in 28 days 1 0 10, Windsor road Walls of house damp Order to do work in 28 days 1 0 11, Windsor road Walls of house damp Order to do work in 28 days 1 0 12, Windsor road Walls of house damp Order to do work in 28 days 1 0 13. Windsor road Walls of house damp Order to do work in 28 days 1 0 74 Address. Complaint. Magistrate's Decision. Penalties. Costs. £ s. d. s. d. 15, Windsor road Walls of house damp Order to do work in 28 days 1 0 16, Windsor road Walls of house damp Order to do work in 28 days 1 0 8, Bay street, Dalston Fixing w.c. without giving notice to Sanitary Authority Fined 0 5 0 2 0 8, Bay street, Dalston Improperly repairing w.c.'s Fined 1 0 0 2 0 63, Clapton common Penalty summons Penalty 2 2 0 2 0 90, Farleigh road Accumulation and deposit of offensive refuse at rear Withdrawn, Nuisance abated 92, Farleigh road Accumulation and deposits of offensive refuse at rear Withdrawn 94, Farleigh road Accumulation and deposits of offensive refuse at rear Withdrawn, work done 96, Farleigh road Accumulation and deposits of offensive refuse at rear Withdrawn, work done 98, Farleigh road Accumulation and deposits of offensive refuse at rear Withdrawn, work done 100, Farleigh road Accumulation and deposits of offensive refuse at rear Withdrawn, work done 235, Amhurst road Accumulation and deposits of offensive refuse at rear Withdrawn, work done 75 Address. Complaint. Magistrate's Decision. Penalties. Costs. 85, Wellington road Accumulation and deposits of offensive refuse at rear Withdrawn, work done £ S. d. s. d. 09, Wellington road Accumulation and deposits of offensive refuse at rear Withdrawn, work done 9, Rendlesham road Foul pan in w.c., &c. Withdrawn, work done 11, Rendlesham road Foul pan in w.c. and soil pipe defective Withdrawn, work done 13, Areola street Defective drains, &c. Withdrawn, work done 6B, Rectory road House dirty, &c. Order to do work in 28 days 1 0 24, Prince Edward road Damp walls of house Order to do work in 28 days 1 0 26, Prince Edward road Damp walls of house Order to do work in 28 days 1 0 28, Prince Edward road Damp walls of house Order to do work in 28 days 1 0 30, Prince Edward road Damp walls of house Order to do work in 28 days 1 0 32, Prince Edward road Damp walls of house Order to do work in 28 days 0 34, Prince Edward road Damp walls of house Order to do work in 28 days 0 36, Prince Edward road Damp walls of house Order to do work in 28 days 1 0 38, Prince Edward road Damp walls of house Order to do work in 28 days 1 0 40, Prince Edward road Damp walls of house Order to do work in 28 days 1 0 42, Prince Edward road Damp walls of house Order to do work in 28 days 1 0 76 Address. Complaint. Magistrate's Decision. Penalties. Costs. £ s. d. s. d. 44, Prince Edward road Damp walls of house Order to do work in 28 days 1 0 46, Prince Edward road Damp walls of house Order to do work in 28 days 1 0 48, Prince Edward road Damp walls of house Order to do work in 28 days 1 0 50, Prince Edward road Damp walls of house Order to do work in 28 days 1 0 52, Prince Edward Road Damp walls of house Order to do work in 28 days 1 0 2, Chelmer Road Upper w.c. pan defective, sink waste pipe unmapped, &c. Order to do work in 7 days 2 0 117, High Street, Homerton Defective drains, no dustbin Order to do work in 14 days 2 0 31, St. John's Church Road Penalty summons Fined 10 0 2 0 86, Oswald Steeet Defective drains Order to do work in 14 days 2 0 38, Albert Road Defective drains Order to do work in 14 days 7 0 14, Windsor Road Penalty summons Penalty 5 0 0 2 0 52, Rectory Road Defective eaves, gutters and roof Order to do work in 14 days 4 0 9, Sanford lane Sink waste untrapped & drains unventilaied .. Order to do work in 14 days 2 0 27, Sanford terrace Ventilating shaft of insufficient height Withdrawn,work done 104, Millfields road Defective drains Withdrawn,work done 99, Lenthall road 24, Prince Edward road Defective drains Penalty summons Order to do work in 14 days Withdrawn,work done 2 0 77 Address. Complaint. Magistrate's Decision. Penalties. Costs. £ s. d. s d. 26, Prince Edward road Penalty summons Withdrawn,work done 28, Prince Edward road Penalty summons Withdrawn,work done 30, Prince Edward road Penalty summons Withdrawn.work done 32, Prince Edward road Penalty summons Withdrawn,work done 34, Prince Edward road Penalty summons Withdrawn,work done 36, Prince Edward road Penalty summons Withdrawn,work done 38, Prince Edward road Penalty summons Withdrawn,work done 40, Prince Edward road Penalty summons Withdrawn.work done 42, Prince Edward road Penalty summons Withdrawn,work done 44, Prince Edward road Penalty summons Withdrawn.work done 46, Prince Edward road Penalty summons Withdrawn.work done 48, Prince Edward road Penalty summons Withdrawn.work done 50, Prince Edward road Penalty summons Withdrawn.work done 52, Prince Edward road Penalty summons Withdrawn.work done 1, Windsor road Penalty summons Withdrawn.work done 2, Windsor road Penalty summons Withdrawn.work done 3, Windsor road Penalty summons Withdrawn, work done 4, Windsor road Penalty summons Withdrawn, work done 5, Windsor road Penalty summons Withdrawn, work done 78 Address. Complaint. Magistrate's Decision. Penalties Costs. 6, Windsor road Penalty summons Withdrawn, work done £ s. d. s. d. 7, Windsor road Penalty summons Withdrawn, work done 8, Windsor road Penalty summons Withdrawn, work done 9, Windsor road Penalty summons Withdrawn, work done 10, Windsor road Penalty summons Withdrawn, work done ii, Windsor road Penalty summons Withdrawn, work done 12, Windsor road Penalty su.nmons Withdrawn, work done 13, Windsor road Penalty summons Withdrawn, work done 15, Windsor road Penalty summons Withdrawn, work done 16, Windsor road Penalty summons Withdrawn, work done 111, Albion road Dirty walls and ceilings to workroom Order to do work in 7 days 7 0 111, Olinda road Soilpipe defective, &c. Order to do work in 14 days 2 0 115, Olinda road Soilpipe defective, &c. Order to do work in 14 days 2 0 30 to 40, Shacklewell lane Accumulation of refuse & manure Order to abate nuisance in 14 days 2 0 21, Temple street Defective drains . Withdrawn, work done 22, Temple street Defective drains . Withdrawn, work done 23, Temple street Defective drains . Withdrawn, work done 123, Holly street General insanitary condition.. Order to do work in 14 days 2 0 175, Glyn street Choked and defective drains Order to do work in 14 days 2 0 40, Chelmer road Bad meat Fined 50 0 0 40, Chelmer road Bad meat Fined 50 0 0 79 Address. Complaint. Magistrate's Decision. Penalties. Costs 191, Richmond road Fixing w.c. without giving notice to Sanitary Authority Fined 0 5 0 2 0 191, Richmond road Refitting soilpipe inside house Fined 0 1 0 2 0 2, Chelmer road Penalty summons Withdrawn, work done 2, Big hill, High hill ferry W.c. pan foul and no water supply to same Order to do work in 14 days 2 0 14, Rendlesham road House dirty Order to do work in 14 days 2 0 Stable rear of 220, Glyn road Paving of stable, stable yard, and passage-way defective, &c. Order to do work in 14 days 2 0 332, Kingsland road Defective drains, &c Withdrawn, work done 34, Somerford grove Defective drains, &c Order to do work in 25 days 2 0 67, Downs road Withdrawn, work done 1, Orchard cottages House dirty and no ventilation under ground floor Withdrawn, work done 2, Orchard cottages House dirty and no ventilation under ground floor Withdrawn, work done 3, Orchard cottages House dirty and no ventilation under ground floor Withdrawn, work done St. John's Sanitnry Laundry, 84, High street, Homerton Smoke Nuisance Penalty 10 0 0 2 0 70, Btooksbys walk Defective dust bin Order to supply dustbin in 7 days 2 0 80 Address. Complaint. Magistrate's Decision. Penalties Cost. 13, Tranby place No water supply to w.c., yard paving defective, &C. Withdrawn, work done £ s. d. s d Prospect Works and cottage, Clarence road No water supply Order to close house and works forthwith 2 0 Barge " Algernon" Carrying Offensive refuse during prohibited hour 0 10 0 2 0 117, High street, Hornerton Penalty Summons Withdrawn, work done 119, Mortimer road No water supply Order to close house in 7 days 2 0 6, Saratoga road No water supply Order to close house in 7 days 2 0 5, Amhurst road Basement dirty and paving of washhouse defective Order to do work in 7 days 7 0 482, Kingsland road Defective drains Withdrawn, work done 429, Kingsland road. Defective drains, paving in scullery, flush to w.c. and gutters Order to do work in 28 days 2 0 427, Kingsland road Defective drains Withdrawn, work done Stable rear of 34, Forest road Stable defectively paved and drained Withdrawn, wrong man summoned 219, Queen's road Defective drains Order to do work in 21 days 2 0 303, Kingsland road.. Broken pan in w.c. and paving defective Withdrawn, work done Block B, Elizabeth buildings, Boleyn road Roof defective and leaky Order to do the work in 28 days 2 0 81 Address. Complaint. / Magistrate's Decision. Penalties Costs. £ s. d. s. d. 256, Amhurst road Defective ventilating shaft Order to do work in 7 days 2 0 Barge " Friendship " Carrying offensive refuse during prohibited hours Fined 1 0 2 0 Barge " Friendship " Carrying offensive refuse uncovered Fined 2 0 0 2 0 Barge " Friendship " Carrying offensive refuse during prohibited hours Barge "Friendship" Carrying offensive refuse uncovered Costs 4 0 Barge " Friendship " Carrying offensive reluse during prohibited hours Barge "Friendship" Carrying offensive refuse uncovered 89, Mandevilie street House dirty, paving of yard defective Withdrawn.work done 114, Glenarm road House dirty, &c. Summons not served, owner moved away 7, Rock road Paving of yard defective Order to do work in 28 days 2 0 123, Holly street Penalty summons Penalty 5 0 0 2 0 219, Queen s road Penalty summons Withdrawn,work done 38, Albert Road Penalty summons Withdrawn, work done 149,Victoria park road Defective drains Withdrawn, work done St. John's sanitary laundry, 84, High street, Homerton Smoke nuisance Fined 10 0 0 2 0 82 Address. Complaint. Magistrate's Decision. Penalties Costs. Rope ground, Crozier terrace Stable unpaved and undrained.. Order to do work in 14 days £ s. d. s. d. 2 0 114, Glenarm road House dirty, &c. Order to do work in 28 days 2 0 91, Mandeville Street House dirty Withdrawn, work done 125, Cazenove road Defective drains, &c. Withdrawn, work done 18, Dalston lane Fixing w.c. without giving notice to the Clerk of the Sanitary Authority Fined 0 10 0 2 0 18, Dalston lane Improperly fixing w.c. Fined 0 5 0 2 0 Mare street, Hackney Accumulation of refuse on roadway Fined 0 2 6 High street, Kingsland Accumulation of refuse on roadway Fined 0 2 6 High street, Kingsland Accumulation of refuse on roadway Fined 0 2 6 High street, Kingsland Accumulation of refuse on roadway Fined 0 2 6 High street, Kingsland Accumulation of refuse on roadway Fined 0 2 6 39, Bayston road Fitting w.c. without giving notice to the Clerk of the Sanitary Authority Fined 0 10 0 2 0 103,Sandring ham road Upper w.c. defective and soil-pipe defective, &c. Withdrawn, work done 83 Address. Complaint. Magistrate's Decision. Penalties Costs. 6, Shack lewell lane House dirty, roof leaky, gutters defective, steps defective Order to do work in 14 days £ s. d s. d. 2 0 241, Amhurst road Soil-pipe unventilated Withdrawn, work done 26, Lynmouth road Defective soil-pipe and improperly ventilated Withdrawn, work done Upper Clapton dairy farm Defective yard paving Withdrawn, work done 6, Daubeney road No cover to cistern, sink waste-pipe untrapped Withdrawn, work done 3, Daubeney road Insufficient water supply to w.c. Withdrawn, work done 10, Link Street w.c. pan foul, eaves, gutters and rain-water pipes defective Withdrawn, work done 154, Mare street 4a, Bushterry road.. House dirty, fishfrying apparatus improperly constructed, foul pan in w.c., &c. Order to do work in 28 days 2 0 36, Forest road Unpaved and undrained yard at rear Order to do work In 28 days 2 0 38, Forest road Unpaved and undrained yard at rear Order to do work in 28 days 2 0 40, Forest road Unpaved and undrained yard at rear 42, Forest road Unpaved and undrained yard at rear Order to do work in 28 days 2 0 84 Address. Complaint. Magistrate's Decision. Penalties Costs 44, Forest road Unpaved and undrained yard at rear Order to do work in 28 days £ s. d. s. d. 2 0 46, Forest road Unpaved and und0rained yard at rear 48, Forest road Unpaved and undrained yard at rear 50, Forest road Unpaved and undrained yard at rear 52, Forest road Unpaved and undrained yard at rear 54, Forest road Unpaved and undrained yard at rear Order to do work in 28 days 2 0 56, Forest road Unpaved and undrained yard at rear Order to do work in 28 days 2 0 37, Richmond road Unpaved and undrained yard at rear 35, Richmond road Unpaved and undrained yard at rear Order to do work in 28 days 2 0 33, Richmond road Unpaved and undrained yard at rear 31, Richmond road Unpaved and undrained yard at rear Order to do work in 28 days 2 0 29, Richmond road Unpaved and undrained yard at rear Order to do work in 28 days 2 0 27, Richmond road Unpaved and undrained yard at rear 85 Address. Complaint. Magistrate's Decision. Penalties Ccsts 219, Queens road Unpaved and undrained yard at rear £ s d. s. d 217, Queens road Unpaved and undrained yard at rear Order to do work in 28 days 2 0 215, Queens road Unpaved and undrained yard at rear 213, Queens road Unpaved and undrained yard at rear 211, Queens road Unpaved and undrained yard at rear 209, Queens road Unpaved and undrained yard at rear Order to do work in 28 days 2 0 207, Queens road Unpaved and undrained yard at rear Order to do work in 28 days 2 0 61, Powerscroft road Defective drains, soil-pipe and yard paving Order to do work in 14 days 2 0 16a, Hamburg street Braithwaite's factory Foul long hopper pan & trap, no receptacle for manure, roof very defective & leaky, &c. Order to do work in 28 days 2 0 Hope cottage, Duncan street House dirty, yard paving and drainage defective Order to do work in 28 days 2 0 Bremer street yard Yard paving defective, rain water pipe connected, &c. Order to do work in 28 days 2 0 Broadway, London fields Accumulation of refuse in road way Fined 2 6 86 Address. Complaint. Magistrate's Decision. Penalties Costs. Broadway, London fields Accumulation of refuse on roadway Fined £ s. d. s. d. 2 6 High street, Kingsland Accumulation of refuse on roadway Fined 2 6 High street, Kingsland Accumulation of refuse on roadway Fined 2 6 High street, Stoke Newington Accumulation of refuse on roadway Fined 2 6 High street, Stoks Newington Accumulation of refuse on roadway Fined 2 6 26, Lynmouth road Obstruction summons Withdrawn,work done 76, Kyverdalo road Yard in a wet condition Order to do work in 14 days 2 0 West London Dairy Co. Drains defective, w.c. foul and untrapped, and yard paving defective 38, Clapton square Defective roof stairs and floor Order to do work in 14 days 2 0 178, Lansdowne road Yard and area improperly paved and no vent under ground floor Withdrawn,work done 13, Urswick road defective w.c., trap syphons Withdrawn,work done 113, Rendlesham road Yard without sufficient paving and drainage Order to do work in 14 days 2 0 Fortescue yard, Mare street No receptacle for manure Order to do work in 14 days 2 0 High street, Kingsland Accumulation of refuse in roadway Fined 5 0 87 Address. Complaint. Magistrate's Decision. Penalties Costs. Chatsworth road Accumulation of refuse in roadway Fined £ s. d. s. d. 2 6 Chatsworth road Accumulation of refuse in road way Fined 2 6 Mews, rear of 52, High street, Stoke Newington Defective and choked drains Mews, rear of 54, High street, Stoke Newington Defective and choked drains Mews, rear of 56, High street, Stoke Newington Defective and choked drains Mews, rear of 58, High street, Stoke Newington Defective and choked drains Mews, rear of 60, High street, Stoke Newington Defective and choked drains Mews, rear of 62, High street, Stoke Newington Defective and choked drains Mews, rear of 64, High street, Stoke Newington Defective and choked drains Highstreet, Kingsland Accumulation of refuse on roadway Fined 2 6 Broadway London fields Accumulation of refuse on roadway Fined 2 6 High street, Kingsland Accumulation of refuse on roadway Fined 2 6 88 Address. Complaint. Magistrate's Decision. Penalties Costs. 58, Forest road Improperly paved and drained passage at rear Order to do work in 28 days £ s. d. s. d. 2 0 131, Clarence road Offensive smells from the drains Order to do work in 14 days 2 0 19, Northwold road Swine improperly kept within 40 yards of any street or road Order to abate nusiance in 7 days 5 0 2 0 12, Hornsey buildings W.c. improper, and no proper light and ventilation; sink connected to drain. Order to do work in 28 days 2 0 1 to 8, St. John's mansions Letting house without obtaining water certificate Fined 5 0 2 0 524a, Kingsland road Defective drains. Order to do work in 28 days 2 0 30, Foulden road Roof of house leaky and walls of house wet; windows defective Order to do work in 14 days 2 0 92, Stoke Newington W.c. foul and without proper light and ventilation; basement dirty Order to do work in 28 days 2 0 1 J, Downs park road Workshops without proper urinal and w.c. accommodation Order to do work in 28 days 2 0 93, Shacklewell lane . Defective and foul w.c., &c. High street, Kingsland Accumulation of reluse on roadway Fined 5 0 89 Address. Complaint. Magistrate's Decision. Penalties Costs High street, Kingsland Accumulation of refuse on roadway Fined £ s. d. s d. 2 6 High street, Kingsland Accumulation of refuse on roadway 2 6 High street, Kingsland Accumulation of refuse on roadway 2 6 90 LIST OP LICENSED SLAUGHTER-HOUSES. in the Hackney District, October, 1898. Name. Address. Friday, E. 285, Amhurst Road Raymond, E. 186, Cassland Road Hussey, A. J. 37, Church Road, Homerton Sharman, J. 90, Frampton Park Road Longthorne, J. W. 5, High Street, Homerton Wragg, W. J 57, Holly Street Roberts, F. 49, High Street, Kingsland Gooch, H. 71, High Street, Kingsland Johnstone, E. 323, Kingsland Road Scott, G. 418, Kingsland Road Woollven, W. H. High Road, Upper Ulapton Barclay, E. J. 78, Stamford Hill Friday, Richard 170, Dalston Lane Joyce, J. 531, Kingsland Road Fish, T. Lea Bridge Corner, Clapton Witherden, C. A. 133, Lower Clapton Road Tyler, A 80, Mare Street Maples, R. W. 142, Mare Street Beaver, W. R 177, Mare Street Palmer, A. J. 266, Mare Street Harris, Samuel 296, Mare Street Capon, J., junr. 32, Morning Lane Lockie, J. J. 200, Queen's Road, Dalston Miall E. D. 211, Queen's Road, Dalston Hammer, William ... ... 103, Rendlesham Road Stallworthy, G. E. 53, Southgate Road Ebbells, E. 94, Southgate Road Row, R. 130, High Street, Stoke Newington 91 Young, J. C. 220, Stoke Newington Road Stoneman, P. 3, Terrace Road Clark, C. Aberdeen House, Upper Clapton Tyler, W 92, Well Street Hill, G. F.169, Well Street Wagstaff, H. J 216, Well Street Friday, R 51, Wilton Road Baker, W, J. 258, Wick Road Browning, J. West Side, London Fields LIST OF LICENSED COW-SHEDS in the Hackney District, October, 1898. Name. Address. No. of Sheds. Jones, L. J. 3, Ardleigh Road, De Beauvoir Town 1 Jones, Mary 46, Brooksby's Walk, Homerton 1 Jenkins, J. 2, Buckingham Road, Kingsland 2 Evans, D. M. 72, Church Road. Homerton 1 Lloyd, E. 84, Clifden Road, Clapton Park 2 Jenkins, Mary 67, Downham Road, Kingsland 1 Davies, D. M. 11, Downham Road, Kingsland 1 T. Walters & J. Jones 6, Florefield Road, Hackney 1 Larter, George William, trading as J. T. Larter 2, Glosler Road, South Hackney 2 Snewin, W. H. 47, Old Hill Street, Upper Clapton. 1 Rumball, T. E. Upper Clapton Road 4 Bates, T. & W. 46a, Leswin Road, Stoke Newington 1 Cashford, W. G. Jerusalem Square, Mare Street, Hackney 4 Reynolds, Edwin Landfield Street, Clapton 1 Warner, J. C.23, Mare Street 1 Bush, J. Marsh Gate, Homerton 1 Lewis, J. 6, Palace Road, Hackney 1 Outram and Faulkner 257, Queen's Road, Dalston 1 Williams, T. R. 79, Shacklewell Lane, Hackney 1 Tasker, J Sigdon Road, Hackney 1 92 Welford, R. W.Spring Hill, Clapton 2 Stapleton, A. Stoke Newington Common 5 Briggs, J. 180, Victoria Park Road 1 Thomas, David 3, Warburton Road, Hackney 1 Brace, E. A. 133, Well Street, South Hackney 1 Jones, John 271, Wick Road, Homerton 2 Roper, R 37, Wilton Road, Dalston 1 Total Cow Sheds 44 LIST OF BAKE-HOUSES, 1898. Name. Address. No. 1 District; Lidstone, J. 77, Upper Clapton Road Budden, J. 126, Northwold Boad Vincent, A. Clapton Common Hurstleigh, W. S. 11, St. Andrew's Pavement Williamson Chapel Road Reis, W. E. 8, Cazenove Road Gibson, R. 9, Northwold Road Austin, W. H. 74, Fountayne Road No. 2 District. Guthrie, J. 176, High Street, Stoke Newington Tanner, Miss E. 24, Sanford Lane Pile, W. 114, High Street, Stoke Newington Curran, H. J. 33, Rectory Road Allardyce, S. W. 62, Evering Road Burch, Mrs. H. 9, Maury Road Willsmer, C 8, Stellman Street Guscott, J. 128, Stoke Newington Road Hickling, Mrs. S. 40, Shacklewell Lane Karsch, J. 239, Amhurst Road No. 3 District Clarke, Mrs. L. L. 134, Sandringham Road Hull, W. E 50, London Road Brion, A. 26, Downs Road 93 Reis, W. C..215, Lower Clapton Road Parish, W. 117, Lower Clapton Road Prestage, T. H. 71, Lower Clapton Road Tanner, J.. 5, Lower Clapton Road Cowley. J. 9, Clarence Road Newell & Co 393, Mare Street Triniman 370, Mare Street Thrift, A. 38, Amhurst Road Steward, R. 240, Dalston Lane No. 4 District. Carpenter, A 13, Median Road Rest, O. 2, Beecholme Terrace Mason, F. 11, Lea Bridge Corner Newcombe, E 3a, Glyn Road Lunken, J. 53, Mandeville Street Saur, H. 198, Rushmore Road Mankertz, L. 182, Chatsworth Road Mack, L 138, „ Remnant, J. E. 136, ,, Ruhl, J. G. 94, „ Lunken, H. 71, ,, Maloney, J. 36, ., Woods, E. 19, ,, Heinlen, L. 219, Glyn Road No. 5 & 6 District. Waters, R. J. 121, Richmond Road Berry, Mrs. A47 „ Ibell, W. . 81, Wilton Road Goodwin, J. 178, Dalston Lane Kitchiner, J. W. 83, ,, Hannerman, L. 72, ,, Shedden, W. 64, Richmond Road Mules, J. 20 & 22, Forest Road Shedden, Mrs. S. F. 11, Holly Street 94 Ellson, W. W. 207, Queen's Eoad Spencer, H. 68; Lansdowne Eoad Birkett, T.25, Westsile, London Fields Granger, J. 550, Kingsiand Road Norman, A. 513, ,, Best, P. 376, ,, Claridge, G. 329, ,, Banbury, G. 51, Southgate Road Kurty, W. C. 174, Allardyce, S. W. 98, ,, Enerby, A. 40, Downham Road Pope, Mrs. E 54b, „ Stein, H. 24, Tottenham Road Pay, E. T. 106, Hertford Road Roessle, W. 88, High Street, Kingsland Mann, W. 28, John Campbell Road Ring, P. 103a, Dalston Lane No. 7 District. Payne, A. 54, Broadway, London Fields May, H70, ,, ,, „ Bushell, F. 10, „ „ ,, Stumm, K 26, West Street Byron, S. T.139, Mare Street Grantham, R. W. 6, Well Street Reitz, C. 183, Mare Street Harvey, A. 231, ,, Hudson, T. 297, ,, Lunken, H. 27, Morning Lane Lauf, M. 77, Frampton Park Road Eley, J. 101, Mare Street No. 8 District. Krauss, J. A 13, Loddiges Road Skaer, P. 76, Well Street Weissgerber, P 105, „ Bland, A. T. 127, ,, 95 Tilbury, W142, Well Street Mustard, Mrs. E. C.79, Lauriston Eoad Holzapfel, C. 142, Victoria Park Road No. 9 District. Grimwood, T 39, High Street Homerton Grimwood, T.59, ,, „ Gibbon, G. 131, ,, Bradford, G. 162, ,, ,, Jessup, H. 167, „ ,, Wells, J. 18, Brooksby's Walk Herz, J. 14, The Grove, Homerton Dillaway, N 3, Churchill Eoad No. 10 District. Hiam, J. S. 220, Wick Eoad Harris, J.184, Cassland Eoad Maul, E. 16, Gloucester Eoad Beck, Mrs. S. 92, Wick Eoad Gunner, G. 31, Church Eoad, Homerton Bruton, J. 12, Berger Eoad Weber, G.50, Kenton Eoad Pates, F. W 154, Well Street Stark, W 126, „ Fey, 233, „ Morse, G. 27, Elsdale Street Carton, H.. 144. Morning Lane No. 11 District. Selzer, H. 89, Sidney Eoad Kehrein, J. 276, Wick Eoad Dance, Mrs. A. 315, ,, Broke,G. 2, Victoria Eoad James, G. 3, Montague Buildings Baden. E. 41, Osborne Eoad Johnson, E. H. 13, Gainsboro Eoad Davis, S, 71, Felstead Street