Borough of Hackney. REPORT ON THE SANITARY CONDTION OF THE HACKNEY DISTRICT, FOR THE YEAR 1915. BY J. KING WARRY, M.D. LOND., M.R.G.P., Diplomate in Public Health; Licentiate of the Society of Apothecaries; Fellow of the Society of Medical Officers of Health; Member of the Lister Institute of Preventive Medicine; Foreign Associate Member of the Society of Hygiene of France. Medical Officer of Health for the Borough. London: Chas. Straker & Sons, Ltd., 5-9, Bishopsgate Avenue, E.C. 1916. INDEX. PAG Alcoholism 21 Anthrax 19 Birth Hate 8 By-laws—Houses let in Lodgings 24 Canal Boats Act 25 Cancer 21 Cerebro-Spinal Meningitis 1 Cleansing of Persons Act, 1897 36 Combined Drainage and Sewers 35 Constitutional Diseases 20 Cowhouses, Dairies, and Milkshops 22 Customs and Inland Revenue Act 25 Death Rate 9 Deaths in Public Institutions 11 Diarrhœa 19 Diphtheria. 17 Disinfection 35 Enteric Fever 17 Erysipelas 18 Estimated Population 7 Factories 29 Factory and Workshops Act, 1901 29 Glanders and Farcy Order 25 Glanders, Anthrax and Hydrophobia in Man 19 Home Work and Home-Workers 31 Housing and Town Planning Act, 1909 25 Ice Cream Vendors 25 Illegitimacy 9 Infant Mortality 10 Influenza 19 Marriage Rate 8 Measles 20 Mortuary 37 Notification of Births Act. 8 Notifiable Diseases 16 A 2 index. page Non-Notifiable Diseases 19 Offensive Trades 23 Ophthalmia Neonatorum 19 Plague 13 Polio-myelitis 19 Population and Density 7 Prosecutions under Food and Drugs Acts 40 Prosecutions under Public Health (London) Act 41 Public Health (London) Act, 1891 22 Public Health (Tuberculosis) Regulations, 1912 26 Puerperal Fever 18 Register of Sanitary Work 42-49 Removal of House Refuse 36 River Lee 26 Senile Mortality 11 Scarlet Fever 16 Shelter 35 Slaughter-Houses 23 Small-pox 16 Smoke Nuisances 24 Specific Causes of Death 14 Tuberculous Disease 20 Tuberculosis Dispensaries 28 Typhus 18 Vaccination 21 Verminous Children 36 Whooping Cough 20 Workshops and Laundries 30 Zymotic Diseases 16 Tables— Articles Disinfected during 1914 35 Births 9 Causes of Infant Mortality 10 Death Statistics, according to Causes and Ages 14 Infectious Sickness 13 Inquests 38 Requests for Removal of Dust 37 Samples of Foods and Drugs Purchased 39 Suicidal and Accidental Deaths 38 Metropolitan Borough of Hackney. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1915. PUBLIC HEALTH DEPARTMENT, Town Hall, Hackney, N.E. July, 1916. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hackney. Gentlemen, I beg to present herewith my Twenty-fourth Annual Report on the Public Health of the Borough of Hackney. The general death-rate for the year 1915 was 14.9 per 1,000 of the population, and the infant mortality 107 per 1,000 births. These figures show an increase in the general death-rate and in the infant death-rate compared with the year 1914. These increased mortality rates are not confined to the Borough, but are more or less general throughout London, and are due to a large increase in the deaths from bronchitis and pneumonia. There was a decrease in the prevalence of notifiable infectious diseases, the total number of such notified being 1,559, compared with 1,656 during 1914. The number of deaths from the seven chief zymotic diseases numbered 263, which is equivalent to a zymotic death-rate of 1.2 per 1,000 living. A slight increase in the mortality from tuberculosis took place during the year. This subject is dealt with in detail on page 20 of this Report. On the whole, the general tendency of this disease is to a gradual decline in prevalence. 6 The question of infant mortality is dealt with on page 10 of this report. Detailed reference to the preventive measures taken in connection with the prevention of the spread of tuberculosis is made on page The following table shows the change which is gradually taking place in the Borough, viz., a change from a residential locality to that of an industrial centre :— Years. No. of Factories. No. of Workshops. No. of Outworkers. 1910 444 1,321 3,164 1911 489 1,157 3,071 1912 507 1,221 2,559 1913 553 1,217 2,451 1914 563 1,142 2,542 1915 580 1,086 2,768 The relative position, from a health point of view, occupied by Hackney may be seen from the sub.joined table, compiled from figures supplied by the Registrar.General, showing the death.rates from all causes and the death.rates of infants under one year of age in the Metropolitan Boroughs and the Cities of London and Westminster for the year 1915. Boroughs. Death-rate from all causes per 1,000 living (corrected). Deaths under 1 year to 1,000 births. Hampstead 11.5 106 Wandsworth 12.1 92 Lewisham 12.9 98 Hackney 14.1 111 Fulham 14.4 135 Kensigton 14.5 94 City of Westminster 14.7 129 St. Marylebone 14.9 57 Battersea 151 112 Hammersmith 15.2 109 Camberwell 15.4 129 City of London 15.5 51 7 Boroughs. Death-rate from all causes per 1,000 living (corrected). Deaths under 1 year to 1,000 births. Woolwich 15.7 104 Stoke Newington 15.9 128 Haddington 16.1 158 Greenwich 16.2 102 Bethnal Green 16.2 150 Lambeth 16.6 101 St. Pancras 16.9 134 Islington 17.2 133 Chelsea. 17.4 125 Holborn 17.5 124 Deptford 17.7 137 Stepney 18.1 137 Poplar 19.0 150 Bermondsey 20.1 177 Shoreditch 20.3 228 Finsbury 211 123 Southwark 21.7 172 This table shows the death-rate from all causes in the Borough of Hackney to be the fourth lowest in all London, and the infant mortality the eleventh lowest. I have pleasure in stating that the officers of the Department have, on the whole, carried out the duties entrusted to them to my entire satisfaction. Population and Density.—Owing to the fact that during the present war "men of military age have been largely drafted to military centres or sent abroad with the army, and the remainder of the male adult population, as well as, to a lesser extent, the female population has migrated on an unprecedented scale into areas other than those in which it was enumerated at the last census," estimates of population based upon the methods hitherto in use would be entirely unreliable. The Registrar.General has therefore suggested a method more applicable to the present circumstance which "will furnish death.rates calculated to indicate as near as may be the health conditions of the civil population." 8 The population of Hackney for the year 1915, based upon this method is estimated to be 217,883, and its density 66.2 persons per acre. Marriages and Marriage Rates.—During 1915 there were 2,723 marriages solemnized in the Borough of Hackney, being an increase of 753 marriages on the previous year. The annual rate for persons married during this period is therefore 25.0 per 1,000 of the population. Births and Birth-rate.—The births registered in the Borough during the year 1915 numbered 5,091, of which 2,551 were males and 2,540 females. The total shows a decrease of 617 compared with the number registered during 1914. This total is the actual number of births registered in Hackney; but this figure must be corrected by the proper allocation of transferrable births. The Registrar-General has supplied me with the necessary figures, viz., 368 births to be transferred to other districts and 104 to HackneyAfter making these corrections, the correct total of registered births amongst Hackney residents is 4,827. From this figure I calculate the birth-rate during 1915 to be 21.5 per 1,000 of the population. Notification of Births Act, 1907.—Under the provisions of this Act, I received 5,080 notifications of births occurring in the Borough during 1915. This total includes notifications from medical practitioners, midwives, and other persons. It also includes still births. This total is 11 less than the number registered by the Registrars of Births. Still Births.—Amongst the births notified were 159 still-born. This is equal to 2.9 per cent. of those notified. I give here a table showing the number of notifications received, with other details in connection with the same. 9 (b) NOTIFICATION OF BIRTHS ACT, 1907. Notifications of Births (Live or Still-born) received during the year 1915. Year 1915. Medical Practitioners. Midwives. Parents and Others. Total. Live. Still. Live. Still. Live. Still. Live. Still. M. F. M. F M. F. M. F. M. F. M. F. M. F. M. F. Totals. 815 807 29 24 1.238 1,224 49 45 408 429 8 4 2,461 2,460 86 73 Illegitimate Births and Birth-rate.—The total number of illegitimate births registered in the Borough during the year 1915 was 404; but of these, I am informed by the Registrar-General. 300 should be transferred to districts outside of Hackney, as the mothers were not Hackney residents, and 18 births, taking place in other districts, should be transfer to Hackney. Making these corrections, there remain 122 illegitimate births amongst Hackney residents. This is equivalent to an illegitimate birth-rate of 25.2 per 1,000 births. The illegitimate birth-rate for 1914 was 25.0 per 1,000 births, practically the same as this in 1915. Deaths.—The deaths registered in the Borough during 1915 numbered 3,402, but of these 723 were deaths of non-residents dying in institutions and other places in the Borough. There were, however, 552 residents of Hackney who died, during the year, in institutions in other districts. On making the necessary corrections, I find the correct number of deaths amongst Hackney residents during 1915 was 3,231. This is an increase of 103 upon the number of deaths occurring during 1914. The general deathrate from all causes for the year 1915 is 14.8 per 1,000 of the population. On further correcting this rate for age and sex distribution by means of the factor 1.0066, I obtain the corrected general death-rate of 14.9 per 1.000 of the population for the year 1915. Compared with the corrected general death-rate for 1914, that of 1915 is 1 per 1,000 higher. 10 Infantile Mortality.—The deaths under one year of age in the Borough during 1915 numbered 520. This is an increase of 28 upon the number of infants' deaths recorded during 1914. The infant mortality rate for the year is 107 per 1,000 births. The increased rate is due chiefly to an increase in the number of deaths from bronchitis and pneumonia. Other special causes of infant deaths deserving mention are premature birth (72), diarrhoea (95), atrophy, debility and marasmus (78). TABLE IV.—INFANT MORTALITY 1915. Nett Deaths from stated causes at various ages under 1 Year of Age. CAUSE OF DEATH. Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total Deaths under 1 year. Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... 3 4 4 11 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... 1 1 4 4 7 5 21 Diphtheria and Croup ... ... ... ... ... ... ... 1 2 3 Erysipelas ... ... ... 1 1 1 ... ... ... 2 Tuberculous Meningitis ... ... ... ... ... 2 1 1 2 6 Abdominal Tuberculosis ... ... ... ... ... 1 l 2 4 8 Other Tuberculous Diseases ... ... ... ... ... 1 2 7 1 11 Meningitis (not Tuberculous) ... 1 ... ... 1 2 3 5 2 13 Convulsions ... 2 1 2 8 4 4 ... 5 21 Laryngitis ... ... ... ... ... ... 1 ... ... 1 Bronchitis 1 1 1 1 4 8 8 8 8 36 Pneumonia (all forms) ... ... 2 1 3 9 11 18 23 64 Diarrhœa ... ... 1 ... 1 13 12 15 13 54 Enteritis ... 1 1 2 4 11 12 8 6 41 Gastritis ... ... ... ... ... 2 ... ... ... 2 Syphilis ... 2 1 ... 3 6 3 3 1 16 Rickets ... ... ... ... ... ... ... ... ... ... Suffocation, overlying 3 ... ... 1 4 1 4 ... ... 9 Injury at Birth 2 ... ... ... 2 ... ... ... ... 2 Atelectasis 4 ... ... ... 4 ... ... ... ... 4 Congenital Malformations 12 5 2 ... 19 6 ... ... ... 25 Premature Birth 52 10 6 1 69 2 1 ... ... 72 Atrophy, Debility and Marasmus 10 7 5 ... 22 24 23 6 3 78 Other Causes 4 2 2 1 9 4 1 3 3 20 Total 91 31 22 11 155 101 94 88 82 520 11 During the year Mrs. Rhodes, Health Visitor, made 1,558 primary visits to the homes of nursing mothers and their infants, and 951 subsequent visits. There were also 230 fruitless visits, the mothers being either out at the time, or having changed their address. The weekly weighing meetings at the Town Hall have been continued during the year with slight interruption. The actual number of meetings was 46, and the total number of infants weighed 1,466. Senile Mortality.—The deaths which occurred in Hackney at 65 years of age and upwards during 1914 numbered 997, and of these 514 were between the ages of 65 and 75 years, 374 between 75 and 85 years, and 109 at 85 and upwards. The annual mortality rate of persons at 65 years and upwards is 4-6 per 1,000 living. Deaths in Public Institutions.—There were 1,654 deaths in public institutions in the Borough during 1915; of these 723 were residents of other districts, and the remaining 931 were residents of Hackney. TABLE I.—HACKNEY DISTRICT. Vital Statistics of Whole District during 1915 and Previous Years. Year. Population estimated to middle of each year. Births. Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett. of Nonresidents registered in the District. of residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate. Number. Rate. N umber. Rate per 1,000 Nett Births. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1909 222,095 5,702 5,436 24.4 3,123 14.0 442 447 616 113 3,128 14.0 1910 222,384 5,493 5,240 23.5 2,878 12.9 506 450 543 104 2 822 12.6 1911 222,674 5,410 5,243 23.5 3,546 15.9 779 443 633 120 3,210 14.4 1912 223,022 5,425 5,267 23.6 2,952 13.2 663 431 426 79 2,720 12.2 1913 223,369 5,733 5,523 24.7 3,156 14.1 665 563 519 99 3,054 13.6 1914 223,718 5,708 5,460 25.5 3,233 14.4 662 557 492 85 3,128 13.9 1915 217,883 5,091 4,827 22.1 3,402 156 723 552 520 107 3,231 14.8 12 TABLE II.- HACKNEY DISTRICT. Cases of Infectious Disease Notified during the Year 1915. Notifiable Disease. Cases Notified in whole Districts. Total Cases Notified in each Locality. Total cases removed to Hospital. At all Ages. At Ages—Years. 1 2 3 4 Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. North. Central South-East SoutH-We Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup; 355 12 120 177 27 18 1 ... 79 67 104 105 317 Erysipelas 224 3 5 25 36 66 64 25 23 75 67 59 36 Scarlet Fever 732 3 167 444 81 35 2 ... 130 247 180 175 685 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 31 ... ... 9 7 17 1 ... 3 23 4 4 29 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever 2 ... 1 ... ... 1 ... ... ... ... 2 ... 2 Puerperal Fever 9 ... ... ... 3 6 ... ... 3 1 4 1 6 Cerebro-Spinal Meningitis 34 5 9 11 4 1 4 ... 10 9 8 7 26 Polio Myelitis ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum 26 20 ... ... ... ... ... ... 2 4 13 7 ... Pulmonary Tuberculosis 531 ... 8 40 130 246 98 9 109 124 146 152 308 Other forms of Tuberculosis 150 ... 36 65 31 16 ... ... 34 29 46 41 61 Chicken Pox 142 13 50 74 4 1 ... ... 18 38 44 42 2 Anthrax 1 ... ... ... 1 ... ... ... ... ... 1 ... 1 Totals 2,240 02 396 845 324 407 172 31 411 617 619 593 1,473 13 TABLE III.—HACKNEY DISTRICT. Causes of, and Ages at, Death during the Year 1915. CAUSES OF DEATH. Deaths in whole Districts at Subjoined Ages. Deaths in Public Institutions. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Enteric Fever 5 ... ... ... ... 2 3 ... ... 11 Small Pox ... ... ... ... ... ... ... ... ... ... Measles 60 11 22 23 4 ... ... ... ... 47 Scarlet Fever 7 ... 1 3 3 ... ... ... ... 22 Whooping-cough 37 21 6 9 ... 1 ... ... ... 20 Diphtheria and Croup 28 3 6 12 7 ... ... ... ... 79 Influenza 24 ... ... 1 1 2 3 7 10 3 Erysipelas 11 2 1 ... ... 1 2 1 4 6 Phthisis (Pulmonary Tuberculosis) 291 1 1 1 9 57 138 73 11 158 Tuberculous Meningitis 40 6 9 11 10 2 2 ... ... 19 Other Tuberculous Diseases 50 18 7 9 5 2 5 4 ... 33 Cancer, Malignant Disease 276 ... 1 ... 2 4 41 131 97 133 Rheumatic Fever 10 ... ... ... 3 1 5 1 ... 4 Meningitis 22 13 ... 3 2 1 3 ... ... 46 Organic Heart Disease 324 ... ... ... 14 15 41 120 134 158 Bronchitis 320 36 5 4 2 ... 7 81 182 102 Pneumonia (all forms) 325 64 55 28 14 10 43 68 43 115 14 TABLE III.—HACKNEY DISTRICT—continued. Causes of, and Ages at, Death during the Year 1915. CAUSES OF DEATH. Deaths in whole Districts at Subjoined Ages. Deaths in Public Institutions. All Ages. Under 1. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. Other Diseases of Respiratory Organs 51 ... ... 1 1 2 5 22 20 31 Diarrhoea and Enteritis 126 14 4 2 2 2 2 7 93 59 Appendicitis and Typhlitis 15 ... ... ... 2 3 4 2 4 8 Cirrhosis of Liver 27 ... ... ... ... 1 4 14 8 12 Alcoholism 2 ... ... ... ... ... ... 1 1 ... Nephritis and Bright's Disease 110 ... ... ... 1 3 7 49 50 71 Puerperal Fever 4 ... ... ... ... 2 2 ... ... 4 Other Accidents and Diseases of Pregnancy and Parturition 5 ... ... ... ... ... 3 2 ... 3 Congenital Debility and Malformation, including Premature Birth 103 101 ... ... 1 1 ... ... ... 61 Violent Deaths, excluding Suicide 73 3 3 5 3 3 12 18 26 60 Suicides 18 ... ... ... ... 4 5 8 1 4 Other Defined Diseases 634 147 25 16 18 19 68 168 173 319 Diseases ill-defined or unknown 233 80 8 ... ... 1 ... 4 140 66 Totals 3,231 520 154 128 104 139 405 784 997 1,654 Sub-Entries (included in above figures) — Cerebro-Spinal Meningitis 28 6 4 3 6 4 1 4 ... ... Poliomyelitis 1 ... 1 ... ... ... ... ... ... ... 15 16 SPECIFIC INFECTIOUS DISEASE. During 1915 there were 1,645 cases of acute infectious disease notified in the Borough; of these 86 were subsequently found not to be suffering from notifiable infectious disease, thus reducing the number of genuine cases to 1,559. This total shows a decrease of 97 upon those notified during 1914. The attack rate in respect of the acute notifiable infectious diseases for the year 1915 is 7.1 per 1,000 persons living. In addition I received 531 notifications of pulmonary tuberculosis and 150 of other forms of tuberculosis. The deaths from the chief zymotic diseases numbered 263. This is equivalent to a zymotic death-rate of 1.2 per 1,000 living in the Borough. A.—NOTIFIABLE INFECTIOUS DISEASES (ACUTE). Small-pox.—No case of this disease was notified in the Borough during 1915. Scarlet Fever or Scarlatina.—The number of cases of scarlet fever notified during 1915 was 762, but of these 30 were found afterwards not to be suffering from this disease, thus reducing the genuine cases to 732. This is a decrease of 58 upon the number of genuine cases notified during 1914. The disease was most prevalent during the last six months of the year. The attack rate for scarlet fever is 3.3 per 1,000 persons living. The number of cases of scarlet fever removed to hospital was 685. This is equal to 90 per cent. of the total notified. This disease was most prevalent in the Central Registration Sub-District, 247 cases being notified during the year, and least prevalent in the North Sub-District, 130 cases being notified. 17 The deaths from scarlet fever during 1915 numbered 7, which is equal to a mortality of 9.6 per 1,000 attacked and .03 per 1,000 living. Diphtheria and Membranous Croup.—There were 390 cases of diphtheria and 12 cases of membranous croup notified during the year; but of these, 46 cases of diphtheria and 1 of membranous croup were found subsequently not to be suffering from diphtheritic disease, thus reducing the genuine cases to 355. This is a decrease of 119 upon the number of cases occurring during 1914. The disease was prevalent during the whole year, especially during the months of January, November and December. Diphtheria was most prevalent in the South-East (104 cases) and South-West (105 cases) Sub-Districts. There were 317 cases of diphtheria removed to hospital during 1915. This is equal to 78 per cent. of the cases notified. The attack rate for diphtheria is 1.6 per 1,000 living. The deaths from diphtheritic disease numbered 28. This is equal to a mortality rate of 7.8 per cent. attacked and .09 per 1,000 living. During the year 448 swabbings from throats of persons suspected to be suffering from diphtheria were bacteriologically examined, 106 of which gave positive results, 326 negative results and 16 were reported doubtful. Diphtheria Anti-toxin.—In accordance with the Anti-toxin Order, 1910, a supply of diphtheria anti-toxin was provided and issued as required to medical practitioners applying for it, for cases of diphtheria amongst the poorer inhabitants of the Borough. During the year 14 bottles of anti-toxin of 2,000 units each were supplied to medical practitioners, 8 of which were for curative treatment and 6 for prophylaxis. Typhoid or Enteric Fever.—During the period under consideration 40 cases of enteric fever were notified, but of these 6 cases B 18 were afterwards found not to be suffering from this disease, thus reducing the genuine cases to 34. This is an increase of 11 on the number of cases notified during 1914. The attack rate is .16 per 1,000 living. Of the 40 cases notified, 29 were removed to hospital. This is equal to 72 per cent. The cases of enteric fever were evenly distributed throughout the year, most of them (23) occurred in the Central Sub-district. The deaths from enteric fever during the same period numbered 5. This is equal to a mortaility rate of 14 per cent. attacked and .02 per 1,000 living. During 1915 specimens of blood from 46 persons suspected to be suffering from enteric fever were submitted to Widal's test, of which 10 gave a positive and 36 a negative reaction. Continued Fever.—Two cases of fever were notified as continued fever during the year. Typhus Fever.—No case of this disease was notified during 1915. Puerperal Fever.—There were 9 cases of puerperal fever notified during 1915, of which 6 were removed to hospital. The deaths from puerperal fever and puerperal septicaemia numbered 3. The attack-rate for the year is 1.8 per 1,000 births, and the deathrate .6 per 1,000 births. Plague.—No case of plague occurred in the Borough last year. Erysipelas.—There were 224 cases of erysipelas notified during 1915. This is equal to an attack-rate of 1.0 per 1,000 living. Of the 224 cases notified, 33 were removed to hospital. The deaths from erysipelas numbered 11. This gives a mortality rate of 5 per cent. attacked and .05 per 1,000 living. 19 Cerebrop-spinal Meningitis.—During 1915 there were 36 cases of this disease notified in the Borough, of which 2 were subsequently found not to be suffering from this disease. The deaths from cerebro-spinal meningitis numbered 28, being equal to a mortality rate of .13 per 1,000 living. Polio.myelitis or Polio-encephalitis.—No case of this disease was notified in the Borough during 1915. Ophthalmia Neonatorum.—There were 26 cases of this disease notified during the year. None of these were removed to hospital. All the cases recovered without any permanent impairment of sight. Glanders, Anthrax and Hydrophobia in man.—One case of anthrax in an adult was notified during the year. Chicken-pox.—This disease was made notifiable by the London County Council from March 17th to June 30th, 1915. During this period I receive 142 notifications of the disease, of which 2 were removed to hospital. No death was registered from this disease. I received also 489 notifications of chicken.pox, from the headmasters and mistresses of elementary schools in the Borough, occurring amongst their scholars. B.—NON-NOTIFIABLE INFECTIOUS DISEASES. Influenza.—During 1915 there were 24 deaths in the Borough due to influenza. This is an increase of 7 on the deaths registered from this cause during 1914. The annual mortality rate from influenza is .11 per 1,000 living. Diarrhœa.—There was a slight decrease in the number of deaths due to diarrhoeal disease in the Borough during 1915. The total number of deaths from this cause was 126, of which 68 were registered as diarrhoea and 58 as enteritis or gastro.enteritis, and of these 93 were under 1 year of age. The annual mortality for diarrhoeal disease during 1915 is .58 per 1,000 living. B 2 20 Measles.—The deaths from this disease in the Borough during 1915 numbered 60. This is a decline of 45 on the deaths during 1914. No less than 56 of the deaths occurred in children under 5 years of age. The annual mortality from measles during 1915 is •27 per 1,000 living. I received information of 1,345 cases of measles during the year from headmasters and mistresses occurring amongst the scholars of Elementary schools in the Borough. There were 32 cases of measles removed to the hospitals of the Metropolitan Asylums Board during the same period. On the 27th November, 1915, a General Order was issued by the Local Government Board making measles and German measles notifiable diseases, with regulations thereon. Whooping Cough.—There were 37 deaths from this cause in the Borough during 1915. This is a decline of 13 upon the number registered during 1914. No less than 36 of the deaths occurred in children under 5 years of age. The annual mortality is .17 per 1,000 living. The number of cases removed to the hospitals of the Metropolitan Asylums Board during the year was 5. I received information from the headmasters and mistresses of Elementary schools in the Borough of 504 cases of whooping cough occurring amongst their scholars during the year. CONSTITUTIONAL DISEASES. Tuberculosis.—During 1915, I received 681 notifications of tuberculosis, details of which are given on page — of this report. Bacteriological examination of sputa from 449 cases was made during the same period. In 109 of these examinations the specific organism of the disease was found; in 340 the results were negative. 21 The number of deaths from tuberculous disease in Hackney during 1915 was 381, an increase of 14 upon the deaths during 1914. These deaths are classified as follows:— Tuberculous phthisis 253 Phthisis 38 General Tuberculosis 25 Tuberculous meningitis 40 „ peritonitis 10 Tabes mesenterica 7 Tubercle of other organs 8 381 This number of deaths gives an annual mortality of 1.7 per 1,000 living. Cancer.—There were 276 deaths during 1915 due to the different varieties of malignant disease. This is an increase of 20 on the number registered during 1914. The annual mortalityrate from malignant disease for last year is 1.26 per 1,000 living. Alcoholism.—During the year under consideration there were 2 deaths registered as due to acute alcoholic poisoning. There were also 27 deaths due to cirrhosis of the liver, a condition regarded as being caused by excessive indulgence in alcohol, extending over lengthy periods. VACCINATION. During the year 1915, there were 5,204 birth lists and 1,946 certificates of vaccination received by the Vaccination Officers, i.e., 37 per cent. of the infants born during that period were vaccinated and 63 per cent. escaped vaccination. There were 1,912 certificates and declarations of conscientious objection received during the same period. 22 PUBLIC HEALTH (LONDON) ACT, 1891. (a) Complaints of Nuisance.—During the year 1915 there were 2,248 complaints of nuisance made to the Public Health Department and investigated by Sanitary Inspectors of the Borough. Defects or nuisances were discovered in 1,794 of the complaints. Notices for the remedy or abatement of these were served upon the owner or person responsible under the above Act. (b) Infectious Disease.—The occupied dwellings inspected during the year after infectious disease numbered 2,070. This is a decrease of 116 upon the number inspected during 1914. Any nuisances or defects found were dealt with under the provisions of the above Act. (c) House-to-House Inspections.—The number of house-to-house inspections made by the Inspectors during the year was 978. These inspections are in addition to those made under (a) and (b), and exclusive of inspections made under the Housing, Town Planning Act, 1909. The nuisances or sanitary defects found were dealt with in the same manner as those under (a) and (b). Nuisances or defects found on inspection were remedied in most cases on service of an intimation notice only. The total number of such notices served during 1915 was 4,519. The number of Statutory Notices served was 266. Legal proceedings were initiated in 22 cases. ARTICLES OF FOOD SEIZED OR SURRENDERED AS UNFIT FOR FOOD. During the year the following articles of food were seized by the Inspectors or surrendered as being unfit for food, viz.: 6 tons meat; 10 cwts. fish; 10 cwts. 3 qrs. fruit and vegetables; 1 qr. tinned foods. COW-HOUSES, DAIRIES, AND MILKSHOPS. (a) Cow-Houses.—At the end of 1915 there were 13 licensed cowkeepers in the Borough with 15 sheds. Inspector Bobbitt 23 reports that he made 341 inspections of these during the year, and found it necessary to serve one notice for repairs, which was immediately complied with. On the 9th of October, the Public Health Committee made their annual inspection of the cowhouses in the Borough. These were found on the whole to be in a satisfactory condition. (b) Dairies and Milkshops.—During the year 31 premises were removed from the Register and nine new premises added, thus making the total on the Register at the end of the year 296. The proprietors of milk premises were changed in 31 instances. Inspector Bobbitt reports that he made 1,460 visits of inspection to these premises during the year. He served five notices for repairs and cleansing, which were immediately attended to. Offensive Trades.—Fifteen visits of inspection were made by Inspector Bobbitt to the only offensive trade premises in the Borough, viz. : a tripe boiler. Slaughter-houses.—The number of slaughter-houses in the Borough at the end of 1915 was 20. Inspector Bobbitt reports that he made 296 visits of inspection to these during that period, during which he examined the carcases and organs of 164 oxen, 1,812 sheep or lambs, 30 pigs and 3 calves and found the following parts and organs diseased, viz.:— Eight ox and 12 sheep livers affected with distomatosis. Four ox livers affected with abscess. Seven sheep plucks affected with parasitic cysts. One ox lungs and heart affected with tuberculosis. Carcase of a sheep in a dying condition when bled. On the 9th of October, the Public Health Committee made their annual visit to the slaughter-houses of the Borough. These were all found in a satisfactory condition except two, the sheep pound of one being delapidated and the paving of another slaughterhouse defective. The defects were remedied on service of a notice. 24 The following statement refers to the milk-places, cow-sheds, slaughter-houses and offensive trades in the Borough:— Premises. Number of Places. Number of Inspections, 1915. Number of Notices, 1915. Number of Prosecutions. On Register at end of 1914. Added in 1915. ' Removed in 1915. On Register at end of 1915. Milk premises 318 9 31 296 1,460 — — Cowsheds 16 — — 15 Ml 1 — Slaughter-houses 20 — — 20 296 — — Other offensive trade premises 1 — 1 15 — — Preserved Provision Factories.—There were two wholesale preserved provision and two black pudding manufacturers in the Borough at the end of 1915. Inspector Bobbitt reports that he made 40 visits to these, and examined the various pieces of meat being used, and found them sound and free from disease. Smoke Nuisances.—The Smoke Inspector made 1,458 observations of chimneys of factories, workshops, and other places in the Borough during the year. These observations lasted from halfan-hour upwards. Notices in connection with this nuisance were served to the number of 28 Intimation and 4 Statutory Notices. Water Supply.—Under section 48 (2) of the Public Health (London) Act, 1891, there were 3 certificates of proper and sufficient water supply issued to owners of new or rebuilt dwellinghouses in the Borough. These certificates refer to 3 premises Bye-laws for Houses Let in Lodgings.—The total number of these houses on the Register at the end of 1915 was 459. Of these, 207 were inspected during the year. Any defects found were remedied on the service of a notice. 25 CUSTOMS AND INLAND REVENUE ACT, 1890. No application to make inspection of premises was made to me during 1915. CANAL BOATS ACTS, 1877-1894. The Canal Boats Inspector reports that he made 49 visits to the waterways in the Borough during 1915 and inspected 15 boats during that period. No infringements of the Canal Boats Acts or Regulations were observed on these visits. ICE-CREAM VENDORS. At the end of 1915 there were 204 ice-cream vendors in the Borough. These were all inspected during the past year. Any sanitary defects found were remedied by the service of intimation notices. GLANDER AND FARCY ORDER, 1907. One notification of glanders in animals in the Borough was received from the Veterinary Inspector of the London County Council during the year. DISEASES OF ANIMALS ACTS.—ANTHRAX ORDER OF 1910. No notification of Anthrax in animals in the Borough was received during 1915. HOUSING OF THE WORKING CLASSES ACTS, 1890-1903. No representation was made nor action taken under the abovenamed Acts during 1915. HOUSING, TOWN PLANNING, &c., ACT, 1909. On the 20th March, 1915, I represented to the Public Health Committee of the Borough Council, 17 cottages to be in a state so 26 injurious or dangerous to health as to be unfit for habitation, viz.:— Nos. 3, 5, 7, 9, 11, 13, 15, 19, 21, 23, 25, 27, 29, 31, 37, 39, Middlesex Wharf. On the 25th March, the Borough Council made Closing Orders for these cottages which were served upon the owners, who forthwith closed the cottages, since which time they have remained empty. On the 1st May, I represented 12 other cottages in the same locality to be in a state so dangerous to health as to be unfit for habitation, viz.Nos. 97, 99, 101, 103, 105, 107, 109, 111, 113, 115, 117 and 119, Middlesex Wharf. On the 3rd May, the Borough Council ordered Closing Order to be served upon the owners. These immediately complied with the Council's orders and closed the cottages, since then they have remained empty. THE RIVER LEE. No serious complaints of nuisance from this River were received during 1915. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Notifications. Under these Regulations, I received 1,152 notifications of cases of pulmonary tuberculosis, during the year 1915, of which 621 were duplicates; also 194 non-pulmonary notifications, of which 44 were duplicates. The following Tables A and B give the age and sex distribution of the notified cases:— 27 A—Pulmonary Tuberculosis. Notifications received during the Year 1915. Under 5. 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 and upwards. Duplicates. Total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Form A 3 2 7 8 55 59 70 47 51 34 66 27 74 43 326 220 Form B — — 5 3 — — — — — — — — 1 — 5 3 Form C 2 1 7 9 8 6 7 16 8 5 9 3 196 77 237 117 Form D — — — 1 — 2 4 1 2 1 1 1 158 73 165 79 Totals 5 3 19 21 63 67 81 64 61 40 76 31 428 193 733 419 B—Non-Pulmonary Tuberculosis. Notifications received during the Year 1915. Under 5. 5 to 15. 15 to 25. 25 to 35. 35 to 45. 45 and upwards. Duplicates. Total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Form A 18 12 18 15 15 11 3 6 3 1 2 — 7 3 66 48 Form B 1 1 9 4 — — — — — — — — 2 3 12 8 Form C 3 1 8 5 3 — 1 — 1 — — — 4 7 20 13 Form D — — 3 3 — 2 1 — — — — — 14 4 18 9 Totals 22 14 38 27 18 13 5 6 4 1 2 — 27 17 116 78 28 The following is a statement in tabular form of the relative number and percentage of insured and non-insured of primary cases of tuberculosis notified during 1915:— National Insurance Act, 1911. Tuberculosis, 1915. Sex. Insured Cases. Non-Insured Cases. Percentage Insured. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. Pulmonary. NonPulmonary. Male 190 24 112 63 62% 27% Female 87 13 142 50 38% 20% Total 277 37 254 113 52% 25% ACTION TAKEN DURING THE YEAR 1915. The action taken include disinfection of rooms and the articles infected by tuberculous patients, inspection of dwellings occupied by tuberculous persons, and the removal of any condition prejudicial to health, instruction of patients in measures to prevent the spread of the disease, and the gratuitous supply of sputum flasks, the number of these supplied during the year being 94. TREATMENT—TUBERCULOSIS DISPENSARIES. The Council's tuberculosis dispensary in connection with the Metropolitan Hospital was opened for the examination and treatment of persons suffering from tuberculosis, on July 28th, 1915. From that time to the end of the year it has been regularly opened on the following days of the week, viz., Tuesday, Wednesday, Thursday, and Friday mornings, from 10.30 a.m. to 12.30 p.m., and on Tuesday and Friday evenings, from 6 to 7.30 p.m. 29 During the period in question 173 patients were examined, and of these 73 were found to be suffering from pulmonary tuberculosis and 11 from non-pulmonary tuberculosis, 42 cases were doubtful and 47 free from tuberculosis. Contact Cases.—Of the 173 cases examined 46 were contact cases, that is persons who have been closely associated with some case of tuberculosis. Of the 46 cases none were found to be tuberculous but 14 were doubtful and were kept under observation. The Council's tuberculosis dispensary in connection with the Victoria Park Hospital was opened for the diagnosis and treatment of persons suffering or suspected to be suffering from tuberculosis, on September 20th. From that time to the end of the year the dispensary was regularly opened on the following days of the week, viz., Wednesday and Saturday mornings from 10 to 12, and on Monday and Thursday evenings from 7.30 to 9 o'clock. During the period in question 136 patients were examined, of which 88 were insured and 48 non-insured persons. Of the 136 cases, 86 were found to be suffering from pulmonary tuberculosis, 18 were doubtful and 30 not suffering from this disease. There were in addition 2 cases suffering from non-pulmonary tuberculosis. Of the 86 positive cases 20 were in the first stage of the disease, 39 in the second stage and 27 in the third stage. Contact Cases.—Of the 136 new cases 40 were contact cases, 7 of which were found to be suffering from tuberculosis, 9 were doubtful and 24 were free from this disease. Of the 7 positive contact cases 5 were in the first stage and 2 in the second stage of the disease. THE FACTORY AND WORKSHOP ACT, 1901. Factories.—During the year 118 factories were inspected by the officers of the Public Health Department, 11 being factory 30 laundries and 107 factories in which articles of clothing, &c., were made and altered. In 18 factories the sanitary accommodation was defective, unsuitable or insufficient:— Nuisance. Found. Abated by Workshop Inspector. Abated by District Inspector. Outstanding. Total. Unsuitableor Defective w.c.'s 18 15 2 1 18 Insufficient „ 5 5 — — 5 Not separate for the sexes. 3 3 — — 3 Workshops.—The number of workshops registered in Hackney at the end of 1915 was 1,086, an increase of 12 on the number registered at the end of 1914. Of this total, 801 were workshops in which females were employed. Of these latter, 568 were workshops in which articles of wearing apparel were manufactured, altered or prepared for sale, &c., 205 in which other articles were manufactured, &c., and 28 were domestic workshops. Amongst the workshops manufacturing wearing apparel, there were 410 employing females alone, and 158 employing both males and females. In workshops of other occupations, there were 127 employing females alone, and 78 employing both males and females. Of the domestic workshops, females alone were employed in 16 and both males and females in 12. During the year notices and complaints were received from H.M. Inspectors of Factories, as follows:— Complaints Factories 11 „ Workshops 14 Notices „ 187 31 Analysis of Occupations Carried On in the Registered Workshops of Hackney. (a) Wearing Apparel. Occupations. No. of Workshops. Occupations. No. of Workshops. Artifical Flower Makers 8 Hats 9 Baby Linen 2 Infants' Millinery 7 Beading 1 Mantles 60 Belts 3 Millinery 46 Blouses 37 Needlework 5 Boot and Shoe Manufacturers 64 Pinafores 2 Shirts 5 Boot Machinists 112 Stays 7 Children's Costumes 14 Tailoring 74 Clerical Robes 1 Ties 41 Clothing 7 Trimmings 11 Collars 1 Underclothing 18 Dressmakers 78 Vests 9 Dressing and Tea Gowns 7 Waterproofs 5 Fancy Bows on Shoes 6 697 Fall Net Chenilling 1 Furriers 56 (b) Other Occupations. Bakers and Confectioners 30 Rubber Goods 6 Baskets 4 Toy Makers 8 Box Makers 21 Trunk and Bag Makers 6 Brush Makers 12 Umbrella Makers 4 Cabinet Makers 58 Upholsterers 14 Doll Manufacturers and Dressers 3 Upholsterers' Trimmings 3 Miscellaneous 106 Fancy Leather Goods 21 389 Laundries 75 Pianoforte Makers 18 During 1915 Miss Teebay, the Workshops Inspector, made 2,348 inspections and re-inspections of factories and workshops where females are employed. In connection with these inspections 382 intimation and statutory notices were served for the abatement of the nuisances found. Outworkers.—The number of outworkers on the register at the end of 1915 was 2,768, against 2,542 at the end of 1914. There were thus 226 outworkers added to the register during the past year. 32 The following analysis shows the trades followed by these outworkers:— Trade. No. of Outworkes. Trade. No. of Outworkers. Artificial Florist 67 Lace Trimmed Goods 22 Baby Linen 26 Millinery 215 Belts 49 Pinafores 1 Blouses 202 Shirts 47 Boots and Shoes 519 Shoe Bows 9 Boxes 192 Skirts and Mantles 263 Braces 15 Tailoring 176 Brushes 173 Ties 175 Canvas Goods 14 Trimming 63 Children's Costumes 22 Umbrellas 21 Clothiers and Outfitters 129 Underclothing 140 Collars and Bibs 15 Upholsterers' Trimmings 11 Confectionery Packing 12 Vests 3 Corsets 3 Military equipment (haversacks, &c.) 36 Dolls 6 Dressing and Tea Gowns 18 Miscellaneous 30 Fancy Goods 19 2,768 Fur Trade 61 Hats 14 The local authorities from which I have received names an addresses of outworkers during the year 1915 are the following:— Battersea 3 Paddington 7 Bethnal Green 204 Poplar 99 Bromley (Kent) 1 St. Marylebone 33 Chelsea 6 St. Pancras 1 City of London 728 Salford 4 Colchester 1 Shoreditch 217 Deptford 1 Southgate 3 Edmonton 1 Southwark 9 Finsbury 302 Stepney 118 Greenwich 1 Stoke Newington 48 Hampstead 4 Tottenham 14 Holborn 11 Walthamstow 25 Hornsey 3 West Ham 7 Ilford 1 Westminster 34 Islington 273 Woolwich 1 Kensington 13 2,225 Lambeth 2 Leyton 50 33 On examination of the lists of outworkers sent in by employers in this Borough during 1915,1 found 2,855 whose addresses were in other districts. The names and addresses of these were forwarded to their respective local authorities, as given in the following list:— Alperton (Middlesex) 2 Amersham 3 Axminster 7 Barking 2 Battersea 4 Beer (Devon) 3 Bermondsey 2 Bethnal Green 606 Bexhill 2 Braintree 1 Brentford 1 Brentwood 2 Bridlington 2 Bristol 1 Camberwell 25 City of London 4 Chard 12 Charmouth 1 Chelsea 1 Chingford 10 Chiswick 4 Chulmleigh (Devon) 2 Croydon 3 Dartford 1 Deptford 4 East Ham 17 Edmonton 10 Enfield 2 Finchley 2 Finsbury 25 Fulham 6 Hammersmith 3 Hampstead 3 Hastings 1 High Wycombe 4 Holborn 1 Hornchurch 2 Hornsey 6 Honiton 1 Ilford 16 Ilminster 1 Islington 302 Kensington 4 Lambeth 9 Leeds 3 Lewisham 10 Leyton 162 Newport (Essex) 2 Paddington 4 Poplar 233 St. Marylebone 3 St. Pancras 8 Shoreditch 518 Southend 2 Southgate 4 Southwark 8 Stepney 196 Stokenchurch 2 Stoke Newington 180 Surbiton 1 Tadcaster 1 Taunton 1 Tottenham 155 Twickenham 1 Walthamstow 189 Wandsworth 5 Wellington (Somerset) 2 West Ham 25 Westminster 3 Willesden 2 Woodford 4 Wood Green 11 2,855 C 34 During the year 1915, Miss Portlock (the inspector appointed for the inspection of outworkers premises) made 1,402 inspections and 998 re-inspections. She also made 464 visits without inspections, the outworkers having left the premises (188), or having given up homework (41), or being out at the time of visit (146), or owing to a wrong address being given (70), or the premises being workshops (10), or male workers alone being employed. Miss Portlock also discovered 10 new workshops and handed their addresses in for registration. During her visits of inspection Miss Portlock discovered 649 premises with sanitary defects. For the abatement of these she served 459 intimation notices. Of the 1,402 premises inspected, in only 88 was a room set apart entirely for work. In the remainder, work was carried on in rooms used for other purposes, as set out below:— Workroom, bedroom, kitchen and living rooms 78 „ „ and living room 63 „ „ „ kitchen 41 „ and kitchen 896 „ „ bedroom 151 „ „ parlour 68 „ scullery 12 „ „ bath rooms 3 „ „ landing 2 Workroom provided separate 88 Total 1,402 35 COMBINED DRAINAGE WORKS REFERRED TO THE BOROUGH ENGINEER AND SURVEYOR DURING 1915. During this year 28 notices of defective systems of combined drainage works were referred for consideration to the Surveyor. DISINFECTION. (a) Rooms.—During 1915 there were 2,247 rooms fumigated and 734 rooms cleansed in the Borough by the staff of the Public Health Department. These totals include disinfections after measles, whooping cough and tuberculosis, in addition to those in connection with notifiable infectious diseases. (b) Articles of Clothing, Furniture, &c.—The number of articles under this head disinfected during last year was as follows:— House, linen and furniture 20,648 Men's clothing 929 Women's clothing 1,149 Children's clothing 292 Other articles 2,880 Total 25,898 There were also 144 articles destroyed on request from the owners. (c) Public Library Books.—During the past year 410 books from homes in which infectious diseases had occurred were disinfected. Of this number 388 had been borrowed from the Hackney Borough Public Library and 22 from other libraries. THE SHELTER. During 1915 there were 22 persons admitted to the shelter whilst their houses were being disinfected. This total consisted of 2 men, 9 women and 11 children. This is a decrease of 2 persons on the number admitted during 1914. The cost of maintenance of the 22 persons thus admitted was £9 13s. 3d. C 2 36 CLEANSING OF PERSONS ACT, 1897. The baths provided by the Borough Council under the above Act for the cleansing of verminous persons were in constant use during last year, 1,188 baths being given during that period. This total shows a decrease of 353 upon the number given during 1914. Of the 1,188 baths given, 190 were sulphur baths for scabies and 998 for pediculi. The great majority of those persons presenting themselves for baths were children from the elementary schools in the Borough. These children received 1,035 baths, a decrease of 471 upon the number given during 1914. Of those persons receiving hot baths, 109 were men and 889 children; of those receiving sulphur baths, 3 were men, 41 women and 190 children. The expenditure incurred during the year in connection with the Disinfecting Station and Shelter was as follows:— £ s. d. Disinfecting Station 666 7 8 Shelter 104 4 7 Cleansing of verminous persons 50 7 8 Total £820 19 11 LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1904. During the year my attention was drawn by the Medical Officer (Education) of the London County Council to 571 houses in the Borough from which children were attending school in a verminous condition, and I was asked to deal with them under the above Act. I had all these inspected and found that of the 571 homes, 51 had verminous rooms and 16 had both verminous rooms and bedding or clothing. The remainder were clean and free from vermin. REMOVAL AND DISPOSAL OF HOUSE REFUSE. The total quantity of refuse removed from occupied houses in the Borough to the Destructor by the Council's contractors during 37 the year 1915 amounted to 38,765 tons 11 cwts. During the same period the prices paid by the Borough Council for its removal were for the North Division 4s. 2d., and for the South Division 4s. 3d., per ton. The total cost for removal for the whole year amounting to £8,180 10s. Owing to the difficulty of removing the clinker and labour troubles it became necessary toward the end of the year to deposit some of the house refuse on shoots in the neighbourhood of the Borough. The quantity so deposited during the year was 2,336 cubic yards. The cost of this is included in the total given above. DUST REFUSALS AND NO ANSWERS FOR THE YEAR 1915. During the year the dustmen met during their weekly calls with an average of 2,756 "refusals" per month and with an average of 3,787 "no answers" per month. REQUESTS FOR REMOVAL OF HOUSE REFUSE. Requests for the removal of house refuse were received to the number of 680 during the year. This increased number was due to the contractors not being able to carry out a thorough weekly collection owing to their difficulty in getting sufficient dustmen. THE MORTUARY. The following tables gives the number of bodies deposited in the Mortuary during the year, also the number of inquests held there, with the causes of death, &c. Number of bodies deposited in the Mortuary 440 1. To await inquests—(a) Infectious 2 (b) Non-infectious 415 2. To await burial 23 Number of post-mortems made 150 38 INQUESTS. Verdicts. Sex. Male. Female. Natural causes 142 120 Accidental death 66 56 Suicide 13 8 Open Verdict 1 4 Manslaughter 1 ... Murder 1 2 Misadventure 1 2 Totals 225 192 Table showing nature of above Suicidal and Accidental Deaths in the Borough of Hackney during the year ended 1915. Suicides. Accidental Deaths. Nature of Suicide. No. Nature of Accidental Death. No. Poisoning 9 Shock from fall 43 Cut throat 1 Suffocation 1 Drowning 4 Shock from burns 15 Shooting 2 Drowning 6 Run over 1 Run over 26 Hanging 1 Shock from scalds 4 Others 3 Fracture of skull 8 Suffocated in bed 8 Others 11 Total 21 Total 122 39 SALE OF FOOD AND DRUGS ACTS. Samples purchased during 1915. Article Purchased. Number Purchased. Number Adulterated. Number where proceedings taken. Milk 564 41 23 Milk (separated) 1 — — Butter 242 9 6 Margarine 15 2 1 Cocoa 5 — — Coffee 6 — — Arrowroot 3 — — Lard 9 — — Olive Oil 3 — — Demerara Sugar 10 — — Pearl Barley 6 — — Rice 6 — — Pepper 3 — — Vinegar 3 — — Whisky 3 — — Gin 3 — — Sausages 6 — — Cheese 12 — — 900 52 30 40 Prosecutions under the Sale of Food and Drugs Acts during the year 1915. No. of Sample. Article. Adulteration or Offence. Result of Legal Proceedings. Fine. Costs. 12v Margarine Served in plain wrapper Fined £ s. d. £ s. d. 0 7 6 0 12 6 25v Milk 11.88% added water... ,, 5 0 0 2 12 6 37v Margarine 2.26% excess of water Dismissed. (Warranty proved) — — 27w c Served in plain wrapper Fined 0 2 6 0 1 6 71w ,, 25% excess of butter fat ,, 2 0 0 1 3 0 1x Milk 5.34% fat abstracted Withdrawn. (Warranty proved) — — 62x Butter 90% foreign fat Fined 3 0 0 1 1 0 39x Milk 7.8added water ,, 2 0 0 1 1 1) 46x ,, 4.24% ,, ,, 0 9 0 1 1 0 67x ,, 52.82% ,, ,, 3 0 0 I 1 0 69x ,, 25.76 % „ ,, 10 0 0 1 1 0 22y Butter 5.7% excess of water ,, 1 0 0 1 1 0 62y ,, 5.3% ,, 1 1 0 27z Milk 16.34% fat abstracted ,, 2 0 0 0 10 6 50z Margarine Exposed for sale unlabeled ,, 0 3 0 1 1 0 74a Milk 11% Boric acid ,, 2 0 0 — 8b ,, 5.1% added water ,, 2 0 0 — 55b ,, 6.66% fat abstracted ,, 0 10 0 1 11 0 77b ,, 5.06% added water Dismissed. (Warranty proved) — — 38d ,, 8.7% ,, Withdrawn - — 73d ,, Traces of Formalin ,, - - 74d ,, ,, Withdrawn on payment to the Council of 2 2 0 75d ,, ,, Fined - 1 11 6 76d ,, ,, Dismissed. (Warranty proved) — — 77d ,, ,, ,, — — 78d ,, Fined 2 2 0 2 2 0 65d ,, Traces of Mystin ,, 3 0 0 2 12 6 59d ,, ,, Dismissed — — 19f ,, 8.58% added water ,, 42f Margarine... Exposed for sale unlabeled Fined 1 10 0 — 66f Milk 26.67% fat abstracted Dismissed. (Warranty proved) — — 20G ,, 8.58% added water Fined 2 0 0 1 0 0 16G Butter 20% foreign fat ,, 2 0 0 1 1 0 35G ,, 40% Dismissed — — Total 44 4 0 25 19 0 41 Prosecutions under the Public Health (London) Act, 1891, during the year 1915. Address. Complaint. Magistrate's Decision. Penalty. Costs. 237,Rushmore Road Defective drains Order to abate nuisance in three weeks £ s. d. £ s. d. — 2 2 0 239, „ „ „ — 2 2 0 50, Lauriston Road „ Order to abate nuisance in 14 days — 1 12 0 52, „ „ „ — 1 5 0 54, „ „ „ — 1 5 0 11a, Annis Road Defective roof and gutters Order to abate nuisance in two months 5 0 0 — Tyssen StreetWorks Smoke nuisance Fined 0 3 0 2 2 0 l,Overbury Street Defective roof and gutters Order to abate nuisance in 28 days — 1 5 0 27, Hockley Street Defective drains „ — 1 5 0 5, Ribstone Street „ „ — 1 5 0 53. Chatsworth Road Beef deposited for sale unfit for food Fined 10 10 0 1 1 0 260, Rushmore Road „ „ 15 15 0 1 1 0 53, Chatsworth Road Did sell to C. H. Curtis beef unfit for food Fined 31 10 0 1 1 0 260, Rushmore Road Did sell to R. Read beef unfit for food 12, Shacklewell Lane Yard unpaved Withdrawn. (Work done) — 1 3 0 28, Spurstowe Road Defective drains Order to abate nuisance in 21 days — 1 5 0 54, Kyverdale Road Soil-pipe unventilated, &c. Dismissed — 13, Gore Road Defective drain Withdrawn (Work done) — 1 5 0 Stall in Chatsworth Road Bacon deposited for sale unfit for food Fined 2 0 0 1 3 0 382, Wick Road „ „ 30 0 0 — Total 94 18 0 22 2 0 42 43 REGISTER OF SANITARY WORK, 1915. Mr. Ellis, Stamford Hill. Mr. Harvey, West Hackney. Mr. Legg, Hackney. Mr. Bew, Clapton. Mr. Hall. Kingsland. Mare Street and South Hackney Mr. Haben. Homerton, E. Mr. Peverett, Homerton, N. Mr. Sadler, Homerton. S. Mr. Crook, Clapton, N.E. Mr. Goldsworthy Special. Mr. Vobe, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. Totals. Mr. High. Mr. Sheppard. Mr. Punter. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. No. 10. No. 11. No. 12. INSPECTIONS— (a) On complaint 145 193 119 127 249 191 298 188 161 194 66 128 n 166 ... 12 ... 2,248 No. of premises on which defects were discovered 112 165 102 95 223 161 215 149 128 151 44 96 3 150 ... ... ... 1,794 (6) House to House— No. of houses inspected ... 37 3 12 11 72 69 111 28 21 272 62 221 59 ... ... ... 978 No. of houses in which defects were discovered ... 23 3 11 8 43 49 55 27 16 199 43 142 30 ... ... ... 649 No. of Notices served ... 23 3 11 8 43 49 55 27 16 199 43 142 30 ... ... ... 649 (c) Houses after Infectious Dis. No. of houses inspected 105 156 ... 242 218 201 230 126 258 144 110 139 15 126 ... ... ... 2,070 No. of houses in which defects were discovered 9 93 ... 85 109 70 59 26 73 39 29 36 4 27 ... ... ... 659 (d) Miscellaneous— Fishmongers'and Poulterers' yards 4 1 ... 1 ... ... ... 2 9 3 2 ... ... ... ... ... ... 22 Slaughterhouses ... ... ... ... ... ... 3 ... ... ... ... ... ... ... 296 ... ... 299 Cowhouses (premises), Dairies and Milkshops ... ... ... ... ... ... 10 ... ... ... ... ... ... ... 1,801 ... ... 1,811 Greengrocers' yards 4 1 ... 15 ... ... ... 3 ... 5 ... ... ... ... ... ... ... 28 Schools ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Housing, Town Planning, &c. Act, 1909— No. of houses inspected ...... ... ... ... ... ... ... ... ... ... ... 48 ...... ... ... ... ... 48 No. of houses in which defects were found ... ... ... ... ... ... ... ... ... ... ... 48 ... ... ... ... ... 48 No. of houses in which defects were remedied ... ... ... ... ... ... ... ... ... ... ... 48 ... ... ... ... ... 48 Factories and Workshops— No. of inspections 4 32 ... ... 13 7 30 12 10 15 7 ... ... 3 ... 931 ... 1,061 No. of premises on which defects were discovered 2 23 ... ... 11 4 8 4 6 6 2 ... ... 2 ... 427 ... 495 44 45 REGISTER OF SANITARY WORK, 1915 —continued. Mr. Ellis, Stamford Hill. Mr. Harvey. West Hackney. Mr. Legg, Hackney. Mr. Bew, Clapton. Mr. Hall. Kingsland. Mare Street and South Hackney ??? Mr. Peverett, Homerton, N. Mr. Sadler, Homerton. S. Mr. Crook, Clapton, N.E. Mr. Goldsworthy Special. Mr. Vobe, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. Totals. Mr. High. Mr. Sheppard. Mr. Punter. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8 i9. No. 10. No. 11. No. 12. Inspections—continued. Outworkers' Premises— No. of inspections ... ... ... ... ... ... ... ... ... 6 ... ... ... ... ... ... 1,402 1,408 No. of premises on which defects were discovered ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... 649 652 Bakehouses— No. on Register at end 1914 8 12 10 9 12 9 9 5 5 10 8 ... ... ... ... ... ... 97 „ „ „ 1915 7 12 8 8 13 7 8 7 7 9 8 2 ... ... ... ... ... 90 „ above ground 6 6 3 3 6 1 3 3 5 7 8 ... ... ... ... ... ... 51 „ underground 1 6 5 5 7 6 5 4 2 2 ... 2 ... ... ... ... ... 45 „ of Inspections, 1915 8 23 9 33 25 8 20 14 14 30 10 9 ... 1 ... ... ... 204 „ of Notices, 1915 2 5 4 ... 3 ... 1 3 ... 4 9 ... ... ... ... ... ... 31 „ of Prosecutions, 1915 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Urinals 6 9 14 9 ... 8 7 20 17 9 9 ... ... 2 ... ... ... 110 Canal boats ... ... ... ... ... ... ... ... ... ... ... 15 ... ... ... ... ... 15 Visits to waterways ... ... ... ... ... ... ... ... ... ... ... 49 ... ... ... ... ... 49 Animals improperly kept ... 5 ... 1 7 ... 2 1 2 6 1 1 1 ... ... ... 6 33 Laundries ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 78 ... 78 Offensive trades ... ... ... ... ... ... ... ... ... ... ... ... ... ... 15 ... ... 15 New buildings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Special Inspections 10 118 27 318 99 36 93 21 125 96 68 ... 78 271 ... ... 1,360 Re-inspections 1,854 2,360 1,714 2,160 2,180 2,188 2,352 2,295 301 2,391 1,430 1,875 1,960 2,061 ... 1,339 998 31,518 Houses Let in Lodgings— No. on Register at end 1914 ... ... ... ... ... ... ... ... ... ... ... ... 226 ... ... ... ... 226 „ „ „ 1915 ... ... ... ... ... ... ... ... ... ... ... ... 226 ... ... ... ... 226 of Inspections, 1915 ... ... ... ... ... ... ... ... ... ... ... 3 223 ... ... ... ... 226 of Notices, 1915 ... ... ... ... ... ... ... ......... ... ... ... ... 138 ... ... ... ... 138 „ of Prosecutions, 1915 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 46 47 REGISTER OF SANITARY WORK, 1911—continued. Mr. Ellis, Stamford Hill. Mr. Harvey, West Hackney. Mr. Legg, Hackney. Mr. Bew, Clapton. Mr. Hall, Kingsland. Mare Street and South Hackney Mr. Haben, Hom rton, F.. Mr. Peverett, Homerton, N. Mr. Sadler, Homerton. S. Mr. Crook, Clapton, N.E. Mr. Goldsworthy Special. Mr. Vobe, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. Totals. Mr. High. Mr. Sheppard. Mr. ??? No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8 No. 9. No. 10. No. 11. No. 12. Inspections—continued. Common Lodging Houses— No. on Register at end of 1914 ... ... ... ... ... 2 4 ... 1 ... ... ... ... ... ... ... ... 7 „ „ „ 1915 ... ... ... ... ... 2 4 ... 1 ... ... ... ... ... ... ... ... 7 Mews and Stables 25 66 ... 26 43 34 ... 15 52 69 18 35 ... 2 ... ... ... 385 Floodings 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Tenement Houses— No. provided with additional water supply during 1915 ... 9 ... ... 5 ... ... ... ... ... ... ... ... ... ... ... 8 22 Overcrowding— No. of dwelling rooms overcrowded ... 11 ... 5 6 1 7 4 9 11 7 4 6 ... ... ... 4 75 No. remedied ... 11 ... 5 6 1 7 4 9 11 7 4 6 ... ... ... 4 75 „ of Prosecutions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Insanitary Houses— No. closed under Public Health (London) Act, 1891 ... ... ... ... ... ... ... ... ... ... ... ... ... ......... ... ... ... ... No. closed under Housing of Working Classes Act, 1890 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No. of verminous premises cleansed ... 13 ... 21 48 ... 19 42 13 30 15 15 42 6 ... ... 81 345 Underground Rooms— Illegal occupation dealt with ... 2 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 3 No. of rooms closed ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 Places where Food prepared for Sale— No. on Register at end 1915 8 9 12 18 10 22 10 1 8 11 6 6 ... ... ... ... ... 127 ,, of Inspections, 1915 2 3 ... ... ... 9 ... 14 7 11 ... 1 ... ... 40 ... ... 87 „ of Notices ... 1 ... ... ... 1 ... 3 3 3 ... ... ... ... ... ... 11 Other workplaces ... ... ... ... ... ... ... ... ... 5 ... ... ... ... ... ... 5 Miscellaneous Inspections 12 15 ... 38 ... ... ... ... 49 30 ... 15 ... ... 260 ... ... 419 48 49 REGISTER OF SANITARY WORK, 1915—continued. Mr. Ellis. Stamford Hill. Mr. Harvey, West Hackney. Mr. Legs, Hackney. Mr. Rew, Clapton. Mr. Hall. Kingsland. Mare Street and South Hackney Mr. Haben, Honierton, F. Mr. Peverett, Homerton, N. Mr. Sadler, Honierton, S. Mr. Crook, Clapton, N.E. Mr. Goldsworthy Special. Mr. Vobe, Special. Mr. Bobbitt, Special. Miss Teebay, Special. Miss Portlock, Special. Totals. Mr. High. Mr. Sheppard. Mr. Punter. No. 1. No. 2. No. 3. No. 4. No. 5. No. 6. No. 7. No. 8. No. 9. No. 10. No. 11. No. 12. Inspections—continued. Ice Cream Premises— No. on Register at end 1914 17 16 29 19 8 8 17 12 19 23 6 11 ... ... ... ... ... 185 „ „ „ 5 17 13 32 19 8 19 17 13 14 28 13 11 ... ... ... ... ... 204 „ of Inspections 21 13 45 23 8 16 17 13 14 28 13 11 ... ... ... ... ... 222 No. of Notices ... ... 3 4 5 ... ... 1 1 5 4 3 ... ... ... ... ... 26 „ „ Prosecutions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total number of Intimation Notices served 153 288 114 199 416 303 339 262 286 307 318 208 287 219 8 353 459 4,519 Peremptory or Final Notices served 20 ... ... 20 68 3 17 51 27 22 ... 20 ... 16 ... 70 63 397 Statutory Notices served 6 22 ... 33 39 24 13 3 8 29 6 13 14 26 1 29 ... 266 Proceedings before Magistrate under the Public Health Act 1 1 ... 1 2 1 1 3 ... 3 ... ... ... 1 8 ... ... 22 Nuisances abated 140 248 102 220 350 280 283 225 235 240 315 190 269 189 ... 437 508 4,231 Seized and Condemned as Unfit for Human Food— Fish ... ... ... qr. 3 ... ... cwt. 2 ... ... ... ... ... ... qr. 1 cwt. 7 ... ... cwt. 10 Fruit and Vegetables ... ... ... ... ... ... cwt. 3 ... ... ... ... ... ... ... cwt. qr. 7 3 ... ... cwt. qr. 10 3 Meat ... ... ... ... ... ... ... ... tons. 3 ... ... ... ... ... ton 3 ... ... ton 6 Tinned Foods ... ... ... ... ... ... ... ... ... ... ... ... ... ... qr. 1 ... ... qr. 1 Other Articles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Open spaces cleared ... 4 ... 2 ... ... ... ... 2 ... ... 3 ... ... ... ... ... 11 Special Reports to Medical Officer of Health 2 8 15 8 5 3 13 ... 5 ... 5 10 ... 6 12 ... 10 102 Food Adulteration— Samples collected for analysis 66 66 ... 65 66 64 58 66 66 65 54 66 66 66 66 ... ... 900 Proceedings taken before Magistrates 2 8 ... ... 3 2 1 1 1 2 3 4 2 2 4 ... ... 35 50 APPENDIX. REPORT AS TO THE EFFECT ON THE ADMINISTRATION OF THE SALE OF FOOD AND DRUGS ACTS IN THE BOROUGH BY THE USE OF WARRANTIES AS A MEANS OF DEFENCE IN PROSECUTIONS FOR OFFENCES UNDER THESE ACTS. Public Health Department, Town Hall, Hackney, N.E. 25th May, 1915. To the Chairman and Members of the Public Health Committee. Gentlemen, In reporting on the above reference, I wish, in the first place to bring to the notice of the Committee, certain parts of the Sale of Food and Drugs Acts which legalise the use of Warranties for offences under these Acts. Sale of Food and Drugs Acts. Section 25 Sale of Food and Drugs Act, 1875, provides that the defendant shall be discharged if he prove that he bought the article in the same state as sold and with a Warranty. Section 25. "If the defendant in any prosecution under this Act proves to the satisfaction of the Justices or Court that he had purchased the article in question as the same in nature, substance and quality as that demanded of him by the prosecutor, and with a written warranty to that effect, that he had no reason to believe at the time when he sold it that the article was otherwise, and that he sold it in the same state as when he purchased it, he shall be discharged from the prosecution, but shall be liable to pay the costs incurred by the prosecutor, unless he shall have given due notice to him that he will rely on the above defence." 51 Section 20 (6) Sale of Food and Drugs Act, 1899, provides for proceedings against Warrantors for giving false Warranties. Section 20 (6). "Every person, who, in respect of an article of food or drug sold by him as principle or agent, gives to the purchaser a false warranty in writing, shall be liable on summary conviction for the first offence, to a fine not exceeding £20 . . . unless he proves to the satisfaction of the Court that when he gave the Warranty he had reason to believe that the statements or descriptions contained therein were true." Warranties are further referred to in Section 7 of the Margarine Act, 1887. The Sale of Food and Drugs Acts, 1875 to 1907, are amended by the Milk and Dairies Act, 1914, which comes into operation in October, 1915, and the special amendment in reference to Warranties in connection with the sale of milk is contained in the third Schedule to the Act as follows:— "Within 60 hours after the sample of milk was procured from the purveyor he may serve on the local authority a notice stating the name and address of the sellers from whom he received the milk and the time and place of delivery to the purveyor by the seller or consignor of milk from a corresponding milking and requesting them to take immediate steps to procure as soon as practicable, a sample of milk in the course of transit or delivery from the seller or consignor to the purveyor, unless a sample has been so taken since the sample was procured from the purveyor, or within 24 hours prior to the sample being procured from the purveyor, and where a purveyor has not served such notice as aforesaid, he shall not be entitled to plead a Warranty as a defence in any such proceedings. 52 "If a purveyor has served on the local authority such a notice as aforesaid, and the local authority have not procured a sample of milk from the seller or consignor in accordance with the foregoing provisions, no proceedings under the Sale of Food and Drugs Acts, 1875 to 1907, shall be taken against the purveyor in respect of the sample of milk procured from him." The Warranty Defence. As to the effect of the use of Warranties on the administration of the Sale of Food and Drugs Acts, the Committee are of course mostly interested in the effect as observed in the Borough of Hackney; but a more complete estimate would be obtained if, in addition to the data available in reference to Hackney, similar information could be obtained from other Metropolitan Boroughs. In order to obtain such information I addressed a circular letter to all the Medical Officers of Health of the London Cities and Boroughs asking replies to the four following questions relating to the five years 1910 to 1914:— 1. The number of summonses taken out under the Sale of Food and Drugs Acts ; 2. The number of convictions obtained ; 3. The number of instances in which the production of a Warranty by the defendant was successfully used as a defence; 4. The number of cases where the Warrantor (i.e., the person giving the Warranty) had been prosecuted, and the results of such prosecutions. The replies to these questions I have incorporated in a table which I annex to this report. 53 It will be seen from this table, in the first place how general this Warranty defence has become in London. During the last five years it has assumed very large proportions in some Boroughs, and in all it has become a serious impediment to safeguarding the public from fraud. Out of a total of 5,763 summonses, no less than 680 were lost, owing to Warranties being produced. These were all proved to the satisfaction of the Magistrate. This number formed nearly 12 per cent. of the total summonses issued. The proportions vary amongst the different Boroughs and Cities of London from 1.5 per cent. to 43 per cent. The reasons for this variation of the summonses in the different Boroughs is difficult to explain. It seems to depend upon and vary with the quantity of milk imported into the district. There are other factors no doubt, contributing to the results referred to. Under Section 20 (6) Sale of Food and Drugs Act, quoted above, the local authority have power, if they have failed to get a conviction against a purveyor using a Warranty in defence, to prosecute the person giving the Warranty for false Warranty. The replies to question 4 in the table give the experience of the London Cities and Boroughs in prosecuting such Warrantors. During the last five years, 10 Boroughs initiated proceedings against certain vendors, with the result set out in the table. Six of these Boroughs had to withdraw their summonses or they were dismissed. Two other Boroughs had a single conviction each against a Warrantor. The results obtained by the remaining Boroughs, Bermondsey and Battersea are exceptional. The former authority prosecuted nine persons in 1913 for false Warranty all of whom were convicted and fined. In all these cases the article warranted was vinegar, and the defendants local dealers. In 1914, the Borough Council prosecuted six persons for false Warranties, the articles adulterated in five of these cases being 54 vinegar, and one milk. Of the six summonses, three of the defendants were convicted and three dismissed. The defendants in these cases were with one exception, local dealers. Battersea prosecuted 34 persons for false Warranties during the 5 years, of which 16 were dismissed; 1 was withdrawn by the Council and 1 adjourned sine die; 7 were withdrawn by the Council on the defendants paying costs only, and 9 were convicted. Thus, during the 5 years in question, only 10 Local Authorities out of 29 in London, ventured to prosecute for false Warranty ; and the results obtained by these only serve to show how difficult it is to get convictions in this class of offence, especially if the Warrantor is not a local firm, as is generally the case where the article warranted is milk. Effect on the Administration of the Sale of Food and Drugs Acts. From a consideration of the foregoing facts, it will be readily seen that:— 1. The Warranty defence is seriously and adversely affecting the administration of the Sale of Food and Drugs Acts. It has been shown that nearly 12 per cent. of the summonses applied for under the above Acts have been dismissed, owing to the production of a Warranty by the defendant. It is true the Local Authority have power to prosecute Warrantors for giving false Warranties ; but the difficulty in most of these cases in bringing home the guilt to the Warrantor is very great. How difficult may be seen by considering the results set out in the table. A few Local Authorities have ventured to prosecute Warrantors, but the amount of success has not been encouraging. In several cases the Warrantor has produced a second Warranty and so thrown the responsibility back a step further. 55 2. The Warranty defence is encouraging the operations of an unscrupulous class of trader. Fraudulent traders will never be wanting where the profits to gained are sufficient to compensate for the risks run. And in no class of offence is the defaulter so gently dealt with, considering the effect of his fraud, as in offences under the Sale of Food and Drugs Acts. The profits to be obtained by the adulteration of foods are so great, and the adulteration, in most cases, is so easily made, that even periodical fines still leave a considerable margin of profit. Knowing that in nearly all instances the production of a Warranty, and in some cases an invoice only, enables the defendant to escape justice, it is not surprising that this form of defence is on the increase. It may be objected that although the defendant produces a Warranty in his defence, he is obliged in addition to prove to the satisfaction of the Magistrate hearing the case, that he sold the article in the same state as when he purchased it, and he believed the article to be as represented. But experience has shown that the defendant has no difficulty in producing some individual who is adequate to the task of furnishing such proof. 3. There is increased cost and great waste of time and energy on the part of public officers without any adequate return, and there is a corresponding loss of protection to the public against fraud. It may be urged by some that the Milk and Dairies Act, 1914, which is to come into operation in October of this year deals with this question of Warranties and that probably some of its worst objections have been met. The Third Schedule to this Act contains certain amendments to earlier enactments; but a consideration of these will, I am sure, 56 fail to convince anyone that the amendments remove the objections to the Warranty defence. On the contrary, I am of opinion they will increase the difficulties and cost of administration. It appears that the only effectual remedy for the above evils is the entire abolition of the Warranty defence. The public must be protected from fraud, and the purveyor made wholly responsible that the article sold by him shall be of the nature, substance and quality demanded by the purchaser. The Local Authority should not be required, in their duty of protecting the public, to go beyond the actual local purveyor. It is the duty of the local dealers to see that they are supplied from wholesale dealers with genuine articles ; and if they are not so supplied, they have the usual remedy at law. I am therefore of opinion that the Warranty defence should be abolished, and I recommend the Borough Council to press this view upon the Local Government Board and the Board of Agriculture. I remain, Yours obediently, J. KING WARRY, M.D., D.P.H., Medical Officer of Health. 57 WARRANTIES-SALE OF FOOD AND DRUGS ACTS. Borough. No. of summonses taken out under the Sale of Food and Drugs Acts during the years 1910—1914. No. of convictions obtained. No. of instances in which the production of a Warranty by the defendant was successfully used as a defence. No. of cases where the Warrantor had been prosecuted, with results. Battersea 482 244 37 34—16 dismissed 9 withdrawn 9 convicted Bermondsey 327 210 101 15—12 fined 3 dismissed Bethnal Green 312 . 216 24 — Camberwell 382 239 6 — Chelsea 6 5 Prosecutions a re not undertaken where the vendors have Warranties Deptford 127 71 43 — Finsbury 127 99 22 1 convicted Greenwich 74 52 5 — Hackney 108 73 16 — Hammersmith 235 189 12 1 convicted Hampstead 76 51 20 — Holborn 74 49 18 — Islington 326 270 20 — Kensington 117 84 12 5—3 withdrawn 2 dismissed Lambeth 258 203 6 — Lewisham 63 42 8 — Paddington 236 128 16 1 dismissed Poplar 63 47 10 — Shoreditch 260 215 25 1—result negative South wark 451 230 56 2 dismissed St. Marylebone 121 95 20 — St. Pancras 215 151 11 — Stepney 371 324 33 — Stoke Newington 23 18 4 — Wandsworth 529 462 36 1 dismissed Westminster, City of 215 117 93 1 dismissed Woolwich 80 60 15 — City of London 105 80 11 — 5,763 4.024 680 62 E 58 ANNUAL REPORT OF THE CANAL BOATS INSPECTOR, 1915. To the Council of the Metropolitan Borough of Hackney. Gentlemen, I beg to submit my annual report upon the canal boats inspected under the Canal Boats Act and Regulations, 1877-1884. for the year ended 31st December, 1915. The details are as follows:— Number of visits to waterways 49 „ boats inspected 15 „ conforming to Acts 15 „ infringing Acts 0 Certificates examined 15 persons for which boats were registered— Adults 47 persons living on boats so registered— Adults 26 The boats inspected were found in good condition. I have the honour to be, Gentlemen, Your obedient Servant, E. S. CROOK, (Temporary) Sanitary Inspector and Inspector under the Canal Boats Acts.