HAM 10 Hammersmith 1908 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH of the BOROUGH OF HAMMERSMITH For the Year 1908 Annual Report of the MEDICAL OFFICER OF HEALTH of the BOROUGH OF HAMMERSMITH For the Year 1908. Public Health Department, Town Hall, Hammersmith. June 25th, 1909. Gentlemen —I beg to present to you my Annual Report for last year. The Report will deal with the vital statistics, and with the Sanitary work carried out under the direction of your Council during the 53 weeks ending on 2nd January, 1909. The statistical tables prescribed by the Local Government Board are added, as well as the several other tables that directly or indirectly relate to the Public Health of the Borough. The deaths of non-Residents have been deducted, and the deaths of Residents occurring in other parts of London have been added as heretofore. Deaths of persons occurring in institutions, receiving sick and infirm persons, have alone been regarded for the purpose of correction. This is in accordance with the direction of the Local Government Board, some of the 126 figures consequently materially differ from the figures in the published return of the Registrar-General. BIRTHS. During last year 3,102 births, 1,561 males, 1,541 females, were registered in this Borough against 3,006 in the previous year. Making due allowance for the increase of the population, the number of births registered last year was 198 below the average number registered during the previous 10 years. On the population estimated up to the middle of the year, i.e., 124,012 inhabitants, the number of births registered was equal to an annual rate of 25.0 births per 1,000 persons living. The birth rate in London on the estimated population of London up to the middle of the year, i.e., 4,795,757 inhabitant, was equal to an annual rate of 25.2 births per 1,000 persons living These figures are calculated upon the actual number of births registered in the Borough and in London. No distribution of the births of children whose parents lately resided elsewhere has been made. The RegistrarGeneral has corrected the births by allotting them to the districts to which the mothers were said to belong. He gives the corrected births of Hammersmith as 3,204. I have no data at my disposal for so correcting the births in this Borough. DEATHS. During last year 1,754 deaths were registered in this Borough, 873 males, 881 females, against 1,777 in the previous year. Making due allowance for the increase of the population, the number of deaths registered in the Borough last year was 19 above the average number registered during the previous 10 years. Adding 213 deaths of residents of this Borough, which took place in general hospitals and other public institutions in other Boroughs of London, in London 127 County Lunatic Asylums and Metropolitan Imbecile Asylums, and deducting 210 deaths of non-residents which occurred, 163 at the West London Hospital, 24 at Nazareth House, 23 at the Hammersmith Infirmary, the corrected number of deaths of residents registered last year was 1,757. On the beforementioned estimated population, the corrected number of deaths of residents registered last year was equal to an annual rate of 14.2 deaths per 1,000 persons living. The death rate in London on the estimated population of London up to the middle of the year was equal to an annual rate of 14.5 deaths per 1,000 persons living. DEATHS OF INFANTS. The corrected number of deaths of residents under one year of age registered last year was 383 against 362 in the previous year. The number of deaths of infants under one year of age registered last year was equal to 218 per 1,000 of the total deaths of residents registered, and to 123 per 1,000 of the total registered births. The number of deaths of infants under one year of age, residents in London last year, was equal to 203 per 1,000 of the total deaths registered, and 115 per 1,000 of the total registered births The mortality rate of infants under one year of age was, as compared with the total deaths of residents registered, 15 per 1,000, and, as compared with the total births registered 8 per 1,000 greater in this Borough than in London. The increase in number of cases of diarrhoea which occurred last year, as compared with the previous year, was the cause of the increase of the infantile mortality in this Borough as compared with the previous year. The infantile mortality rate in this Borough has, however, not decreased as compared with the County of London since the year 1905. The following table on infantile mortality has been prepared by me in accordance with the direction of the Local Government Board. 128 LOCAL GOVERNMENT BOARD RETURN—TABLE V. Infantile Mortality during the year 1908. Deaths from stated Causes in Weeks and Months under 1 Year of Age. METROPOLITAN BOROUGH OF HAMMERSMITH. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under 1 Year. all Causes. Certified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Common Infectious Diseases. Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... 3 Scarlet Fever ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Diphtheria: Croup ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 Whooping Cough ... ... ... ... ... 1 1 ... 1 ... 1 3 1 ... ... ... 10 Dianhœa. all forms ... ... ... 1 1 8 9 10 7 9 5 4 1 2 1 3 60 Diarrheal Diseases. Enteiitis.Muco-enteritis.} Gastro-enteritis} ... ... ... ... ... 2 6 3 1 ... 1 4 ... 4 2 ... 23 Gastritis. Castro- } intestinal Catarrh} ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... 2 Wasting Diseases. Premature Birth 41 8 2 ... 51 2 ... ... ... ... ... ... ... ... ... ... 53 Congenital Defects 3 2 ... ... 5 2 1 1 ... 1 ... ... ... ... ... ... 10 Injury at Birth 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Want of Breast-milk-} Starvation } ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atrophy, Debility, } Marasmus} 11 2 9 4 26 5 7 3 4 ... 3 ... ... ... ... ... 48 Tuberculous Diseases. T uberculous Meningnitis ... ... ... ... ... ... ... 1 1 ... 3 ... ... ... 2 1 8 Tuberculous Peritonitis: } ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 1 3 Tabes Mesenterica} Other Tuberculous Diseases ... ... ... ... ... ... ... 2 1 ... 1 ... ... 1 ... ... 6 Other causes Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... 1 ... 1 ... 2 3 1 ... ... ... ... ... ... ... 8 Rickets ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 3 Meningitis (no/ Tuberculous) ... ... ... ... 1 ... ... 1 3 ... ... ... ... 2 ... ... 30 C onvulsions 6 6 1 ... 16 3 1 1 2 2 ... ... 1 1 ... 1 15 Bronchitis 1 ... ... ... 1 3 2 2 ... 2 ... ... ... ... ... 1 2 Laryngitis ... ... ... ... ... ... ... 1 3 ... 7 4 2 4 1 6 58 Pneumonia 1 1 1 ... 5 9 5 5 1 7 ... ... ... ... ... ... 10 Suffocation, overlying 2 ... 2 ... 5 1 2 1 1 ... ... 1 2 ... ... ... 28 Other Causes 11 7 2 3 10 2 1 ... ... 1 ... ... ... ... ... ... ... 77 24 8 14 133 38 38 34 27 24 23 18 9 18 8 13 383 Population (estimated to middle of 1908). 124012 Births in the Year: Legitimate, 3023: Illegitimate, 79 Deaths in the Year of: Legitimate Infants, 339 : Illegitimate Infants, 44. Deaths from all Causes at all Ages, 1,757. 129 Table showing the Infantile Mortality Rates of the County of London, the City of London, and the Metropolitan Boroughs during the 53 Weeks of 1908, as calculated by the RegistrarGeneral. Deaths under 1 year to 1,000 Births Registered. County of London 113 Hampstead 69 Lewisham 86 City of London 92 Stoke Newington 92 Woolwich 94 Wandsworth 97 St. Marylebone 101 City of Westminster 102 Islington 102 Paddington 103 Battersea 104 Camberwell 104 Lambeth 104 Chelsea 107 St. Pancras 107 Holborn 112 Hackney 115 Fulham 116 Kensington 119 Greenwich 120 Hammersmith 120 Deptford 122 Poplar 123 Stepney 130 South wark 131 Belhnal Green 132 Finsbury 133 Shoreditch 139 Bermondsey 144 * The Registrar-General has calculated this figure on the corrected Births of Hammersmith, which he gives at 3,204 instead of 3,102, and the corrected death of infants the same as I do. 130 DEATHS OF AGED PERSONS. The corrected number of deaths of residents at 60 years of age and upwards that were registered during last year was 589, against 552 in the previous year. These deaths last year were equal to 4.7. per 1,000 of total persons living, and 335 per 1,000 of the total deaths of residents registered. The corrected deaths registered of persons at 60 years of age and upwards belonging to London last year was equal to 5 0 per 1,000 of the total persons living, and 322 per 1,000 of the total deaths of London residents registered. This death rate was, therefore 3 less in this Borough than in London as compared with the total persons living, and 13 per 1,000 greater in this Borough than in London as compared with the total deaths registered. Both of these figures are a favourable indication as regards the Public Health of this Borough. 131 LOCAL GOVERNMENT BOARD RETURN.—TABLE I. Vital Statistics of Whole District during 1908 and Previous Years. BOROUGH OF HAMMERSMITH. Year. Population estimated to middle of each year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Non-residents registered in Public Institutions in the District. Deaths of Residents regis) tered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District. Number. Rate* Under 1 Year of Age. At all Ages. Number. Rate per 1,000 Births Registered. Number. Rate* Number. Rate* 1 2 3 4 5 6 7 8 9 10 11 12 13 1898 107370 3026 28-2 505 167 1669 15.5 194 123 383 1884 17.5 1899 108785 3061 28l 527 172 1802 16.6 229 152 369 1985 18.2 1900 110203 2994 27.2 470 157 1617 14.7 204 140 383 1806 16.4 1901 112631 3019 26.8 467 155 1646 14.6 241 168 398 1885 16.7 1902 114210 3192 27.9 410 128 1597 14.0 246 160 435 1872 16.4 1903 115803 2989 25.8 374 125 1323 11.4 207 150 434 1607 13.9 1904 117412 3146 26.8 459 146 1632 13.9 263 178 359 1813 15.4 1905 119037 3110 26.1 391 126 1419 11.9 245 161 385 1643 13.8 1906 120679 3020 25.0 418 138 1591 13.2 394 173 355 1773 14.7 1907 122337 3006 24.6 378 126 1777 I4.5 602 233 173 1717 14.0 Averages for years 1898-1907 114846 3056 267 439 144 1607 14.0 282 163 367 1798 15.7 1908 124012 3102 250 383 123 1754 14.1 640 210 213 1757 14.2 * Rates in columns 4, 8, ana 13 calculated per 1,000 of estimated population. Note—The deaths to be included in Column 7 of this Table are the whole of those registered during the year as having actually occurred within the district or division. The deaths to be included in Column 12 are the number in Column 7, corrected by the substraction of the number in Column 10 and the addition of the number in Column 11. By the term "Non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term "Residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The "Public institutions" to be taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses and lunatic asylums. A list of the Institutions in respect of the deaths in which corrections have been made should be given on the back of this Table. Area of District in acres (exclusive of area covered by water) ... 2282.555 Total population at all ages ... 112,239 Number of inhabited houses ... 15,198 Average number of persons per house ... 7.4, At Census of 1901. I. Institutions within the District receiving sick and infirm persons from outside the District. II. Institutions outside the District receiving sick and infirm persons from the District. III. Other Institutions, the deaths in which have been distributed among the several localities in the district. West London Hospital Nazareth House Hammersmith Infirmary St. John's Hospital for Skin Diseases, Uxbridge Road General Hospitals, and other Public Institutions of a like character. London County Lunatic Asylums and Metropolitan Imbecile Asylum Fever and Small Pox Hospitals of the Metropolitan Asylums Board Islington Fever Hospital Convent of the Good Shepherd St. Mary's Orphanage, St. Joseph's School. Kensington and Chelsea District School H.M. Prison,Wormwood Scrubs Is the Union Workhouse within the District? Yes. 132 DEATHS OF RESIDENTS. Belonging to the Borough occurring in Public Institutious, etc., in districts outside, during the year 1908. Fever Hospitals. Western Fever Hospital 26 North Western Fever Hospital 1 London Fever Hospital, Islington 1 General Hospitals. St. George's Hospital 16 Infants'Hospital, Vincent Sq. 16 Children's Hospital. Gt.Ormond St. 5 University College Hospital 44 Children's Hospital, Paddington Green 9 St. Mary's Hospital 8 Friedenhiem Hospital 2 Middlesex Hospital 8 French Hospital 3 Charing Cross Hospital 4 King's College Hospital 1 Guy's Hospital 1 Westminster Hospital 1 Central Long Sick Asylum 2 St. Thomas' Hospital 1 Samaritan Free Hospital 1 Victoria Hospital 1 Royal Hospital, Waterloo Road 1 Seamen's Hospital 1 Children's Hospital, Kensington 2 Asylums. Banstead Asylum 7 Darenth Asylum 6 Hanwell Asylum 14 Long Grove Asylum 6 Caterham Asylum 1 Dartford Heath Asylum 1 Horton Asylum 6 Manor Asylum, Epsom 1 Claybury Asylum 2 Belmont Asylum 1 Leavesden Asylum 2 Tooting Bee Asylum 2 Colney Hatch Asylum 2 Cane Hill Asylum 1 City of London Asylum 1 Other Institutions. St. Luke's House, Kensington 5 St. Peter's House, Kennington 1 Fulham Workhouse 1 Fulham Infirmary 8 Home of Compassion, paddington 1 St. Josephs Hospice, Hackney 2 Cancer Hospital, Chelsea 2 Brompton Hospital 1 Royal London Opthalmic Hospital 1 Kensington Dispensary 1 Wandsworth Infirmary 1 British Hospital for Incurables 1 Queen Charlotte's Hospital 6 St. Peter's Hospital, Covent Hospital 1 Hostel of God, 29. North Side, Clapham 2 St. George's Infirmary, Chelsea 1 Strand Union Infirmary 1 City of London Lying-in Hospital 1 St. Marylebone Infirmary, Kensington 1 Home for Incurables, Hampstead. 1 St. Ann's House, Stoke Newington 1 St. Joseph's House, Kensington 1 St. Pancras Infirmary 1 Various. The Priory. Putney 1 19. Manchester Street. Marylehone 1 On footway of Covent Garden Market 1 39, Greyhound Road, Fulham 1 12, Mortimer Market, St. Pancras 1 Holland Park Avenue 1 St. Mary's Priory. Fulham Road 1 55. Heaumont Street. 1 4, Upper Park Place, St. Marylehone 1 39, Royal Avenue, Chelsea 1 Portland Road Station, Metropolitan Railway 1 50, Weymouth Street 1 114, St. Dunstans' Road, Fulham 1 In the roadway, Kensington Gore 1 Addison Gardens, Kensington 1 133 LOCAL GOVERNMENT BOARD RETURN—TABLE II. Vital Statistics of Separate Localities in 1908 and previous years. BOROUGH OF HAMMERSMITH. Names of Localities. 1. Whole Borough. 2. North District. Wards 4, 5, 6 & 7. 3. Centre District. Wards 2 & 3. 4. South District. Ward 1. Year. Population estimated to middle of each year. Births Registered. Deaths at all Ages. Deaths under 1 Year. Population estimated to middle of each year, Births Registered. Deaths at all Ages. Deaths under 1 Year. Population estimated to middle of each year. Births Registered. Deaths at all Ages. Deaths under 1 Year. Population estimated to middle of each year. Births Registered. Deaths at all Ages. Deaths under 1 Year. a b C d a b C d a b C d a b C d 1898 107370 3026 1884 545 46015 1401 ... ... 43977 1160 ... ... 17378 465 ... ... 1899 108785 3061 1985 547 46604 1455 ... ... 44584 1114 ... ... 17597 492 ... ... 1900 110203 2994 1806 476 47227 1424 ... ... 45183 1153 ... ... 17793 417 ... ... 1901 112631 3019 1885 503 48278 1383 836 250 46188 1180 749 183 18165 456 300 70 1902 114210 3192 1872 441 48949 1535 820 224 46838 1155 770 155 18423 502 282 62 1903 115803 2989 1607 418 49676 1423 682 212 47463 1102 661 148 18664 464 264 58 1904 117412 3146 1813 474 50366 1514 797 234 48123 1140 696 158 18923 492 320 82 1905 119037 3110 1643 414 51063 1501 718 208 48789 1120 644 135 19185 489 281 71 1906 120679 3020 1773 433 51767 1531 837 228 49462 1048 667 131 19450 441 269 74 1907 122337 3006 1717 362 52478 1524 815 194 50142 992 622 113 19717 490 280 55 Averages of Years } 1898 to 1907 or} years in which fig- } ures are available } 114846 3056 1798 461 49242 1469 786 221 47074 1116 687 146 18529 470 285 67 1908 124012 3102 1757 383 53916 1615 769 182 50829 1 1017 1 676 133 19987 470 312 68 Notes.—(a) The separate localities adopted for this Table should be areas of which the populations are obtainable from the census returns, such as wards parishes or groups of parishes, or registration sub-districts. Block I may. if desired, be used for the whole district: and blocks 2, 3, &c.. for the several localities. In small districts without recognised divisions of known population this Table need not be filled up. (6) Deaths of residents occurring in public institutions beyond the district are to be included in sub-columns c of this Table, and those of nonresidents registered in public institutions in the district excluded. (See note on Table I. as to meaning of terms "resident" and " nonresident.") Deaths of residents occurring in public institutions whether within or without the district, are to be allotted to the respective localities according to the addresses of the deceased. Care should be taken that the gross totals of the several columns in this Table respectively equal the corresponding totals for the whole districts in Tables I. and IV.: thus, the totals of sub-columns a. b, and c should agree with the figures for the year in the columns 2, 3, and 12, respectively, of Table I.: the gross total of the sub-columns c should agree with the total of column 2 in Table IV., and the gross total of sub-columns d with the total of column 3 in Table IV. 134 Corrected Death-Rates of Metropolitan Boroughs after Distribution of Deaths in Public Institutions &c., and after corrections for variations in sex and age, constitution of the several populations as calculated by the Registrar-General. Death Rate from all causes. Average County of London 14.5 Hampstead 9.6 Lewisham 11.4 Woolwich 12.1 Wandsworth 12.2 Fulham 12.9 Greenwich 12.9 Stoke Newington 12.9 Battersea 13 .1 Camberwell 13.1 Paddington 13.2 Hackney 13.7 Islington 13.7 Lambeth 13.7 Kensington 13.9 City of Westminster 14.2 Deptford 14.5 Hammersmith 14.5 * Chelsea 15.0 St. Maryebone 15.1 St. Pancras 15.4 Poplar 16.3 Southwark 17.0 Stepney 17.1 Bethnal Green 17.3 Holborn 17.6 Shoreditch 18.3 Bermondsey 19.2 Finsbury 19.3 City of London 19.4 The calculation of the Registrar-General is not made on the same figures as mine. * I give the death rate of Hammersmith as 14.2 as i deduct the deaths of Non-Parishoners which occurred at Nazareth House. 135 LOCAL GOVERNMENT BOARD RETURN.—TABLE IV. Causes of, and Ages at, Death during Year 1908. Name of District. METROPOLITAN BOROUGH OF HAMMERSMITH. Cause of Death. deaths at the subjoined ages of " residents " whether occurring in or beyond the district. deaths at all ages of " residents" belonging to localities, whether occurring in or beyond the district. Total Deaths whether of Residents or NonResidents in Public Institutions in the District. All Ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. North District. Cecntre District. South District. 1 2 3 4 5 6 7 8 9 10 11 12 Small-pox o 0 0 0 0 0 0 0 0 0 0 Measles 14 3 10 0 0 1 0 6 2 6 1 Scarlet Fever 11 1 5 4 0 1 0 4 5 2 0 Whooping Cough 18 10 8 0 0 0 0 11 7 0 5 Diphtheria (including Membranous Croup) 15 1 5 7 0 2 0 10 3 2 1 Croup 4 0 3 1 0 0 0 3 1 0 0 Fever {Typhus 0 0 0 0 0 0 0 0 0 0 0 {Erteric 5 0 1 0 1 2 I 2 1 2 4 {Other continued 0 0 0 0 0 0 0 0 0 0 0 Epidemic Influenza 25 0 2 1 1 111 0 13 9 3 0 Cholera 0 0 0 0 0 0 0 0 0 0 0 Plague o 0 0 0 0 0 0 0 0 0 0 *Diarrhoea 108 84 21 1 0 1 i 58 32 18 56 *Enteritis 8 0 6 0 0 1 i 1 3 4 5 *Puerperal Fever 3 0 0 0 1 2 0 1 2 0 2 Erysipelas 3 0 0 0 0 2 i 2 1 0 2 Other Septic Diseases 45 6 4 3 7 24 1 21 17 7 42 Phthisis (Pulmonary Tuberculosis) 159 1 3 7 24 113 11 67 70 22 57 Other Tubercular Diseases 50 16 21 9 4 8 1 21 23 15 22 *Cancer, Malignant Disease 115 0 1 1 0 74 39 43 54 18 47 Bronchitis 158 15 9 0 0 36 98 60 68 30 36 Pneumonia 201 57 23 5 7 73 36 104 66 31 60 Pleurisy 1 0 0 0 0 1 0 1 0 0 0 Other Diseases of Respiratory Organs 5 3 1 0 0 0 1 4 0 1 0 Alcoholism Cirrhosis of liver 19 0 0 0 0 15 4 7 9 3 5 Venereal Diseases 13 9 0 0 0 3 1 6 5 2 14 Premature Birth 53 53 0 0 0 0 0 24 19 10 1 Diseases & Accidents of Parturition 5 0 0 0 0 5 0 2 3 0 0 Heart Diseases 143 5 0 6 7 74 51 63 57 23 41 Accidents 65 15 5 4 2 28 11 29 18 18 55 Suicides 12 0 o 0 1 11 0 5 3 4 7 Murder 1 0 0 0 0 1 0 1 0 0 1 Cerebo Spinal Meningitis 1 0 1 0 0 0 0 1 0 0 1 All other Causes 488 104 10 10 8 150 206 199 198 91 175 All Causes 1757 383 139 59 63 639 474 769 676 312 640 *See notes on next two pages. 136 NOTES TO TABLES IV. AND V. Notes—(a) In Table IV., all deaths of "Residents" occurring in public institutions, whether within or without the district, are to be included with the other deaths in the columns for the several age groups (columns 2-8). They are also, in columns 9-15, to be included among the deaths in their respective "Localities" according to the previous addresses of the deceased as given by the Registrars. Deaths of "Non-residents" occuring in public institutions in the district are in like manner to be excluded from columns 2-8 and 9-15 of Table IV. (A) See notes on Table I. as to the meaning of "Residents" and "NonResidents," and as to the "Public Institutions" to be taken into account for the purposes of these Tables. The "Localities" in Table IV. should be the same as those in Tables II. and III. (c) All deaths occuring in public institutions situated within the district, whether of "Residents" or of "Non-residents," are, in addition to being dealt with as in note (a), to be entered in the last column of Table IV. The total number in this column should equal the figures for the year in column 9, Table I. (d) The total deaths in the several " Localities " in columns 9-15 of Table IV. should equal those for the year in the same localities in Table II., sub-columns c. The total deaths at all ages in column 2 of Table IV. should equal the gross total of columns 9-15, and tho figures for the year in column 12 of Table 1. *(e) Under the heading of " Diarrhœa " are to be included deaths registered as due to Epidemic diarrhœa ; Epidemic enteritis ; Infective enteritis ; Zymotic enteritis ; Summer diarrhœa ; Dysentery and Dysenteric diarrhœa ; Choleraic diarrhœa, Cholera and Cholera Nostras. In addition, and as regards deaths of children under one year of age, under the heading " Diarrhœa " in column 3 (Table IV.) are to bo include d all deaths classified as " Diarrhœal diseases " in Table V. Under the heading of "Enteritis" in Table IV, are to be included only deaths over one year of age registered as due to Enteritis, Muco-enteritis, Gastro-enteritis, Gastric catarrh, Gastritis, and Gastro intestinal catarrh, unless from information obtained by enquiry from the certifying practitioner or otherwise, the Medical Officer of Health should have reason for including such deaths, under the specific term "Diarrhcea." Deaths from diarrhoea secondary to some other Welldifined disease should be included under the latter. 137 (f) Under the headings of ''Cancer" and "Puerperal fever" should be included all registered deaths from causes comprised within these general terms. Thus: Under "Cancer" should be included deaths from Cancer, Carcinoma, Malignant disease, Scirrhus, Epithelioma, Sarcoma, Villous tumour and Papilloma of Bladder, Rodent ulcer. Under "Puerperal Fever" are to be included deaths from Pymia, Septicæmia, Sapæmia, Pelvic peritonitis, Peri- and Endo-Metritis occuring in the Puerperium. (g) Under "Congenital Defects" in Table V. are to be included deaths from Atelectasis, Icterus neonatorum, Navel hæmorrage, Malformations and Congenital hydrocephalus. (h) Under "Tuberculous Meningitis" are to be included deaths from Acute hydrocephalus. (i) Under "Other Tuberculous Diseases" are to bo included deaths from Tuberculosis, Tuberculosis of bones, joints and other organs, Lupus and Scrofula. (f) All deaths certified by registered Medical Practitioners and all inquest cases are to be classed as ''Certified"; all other deaths are to be regarded as Uncertified." * As regards infantile diarrhœa and Table V., it will suffice if Medical Officers of Health, who have already tabulated deaths of 1907 in accordance with the Schedule of the Incorporated Society of Medica1 Officers of Health, enter all deaths under one year that they regard as due to diarrhœa Under the single heading " Diarrhœa, all Forms." This having been done, it will be necessary that the entry against "Diarrhoea" in column 3 of Table IV should tally with the sum of deaths under "Dianhcea, all forms" entered in the final column of Table V. In recording the facts under the various headings of Tables I., II., III., IV. and V , attention has been given to the notes on the Tables. N. C. COLLI ER, Medical Officer of Health. June 25th, 1909. 138 DEATHS FROM THE NINE PRINCIPAL ZYMOTIC DISEASES. The total number of deaths of Residents that were registered from the nine principal zymotic diseases was 171, against 161 in the previous year. The deaths of Residents last year from these diseases were equal to 97 per 1,000 of the total deaths of Residents registered, and were at the rate of 14 deaths per 1,000 persons living. The deaths from the nine principal zymotic diseases in the whole of London were equal to 96 per 1,000 of the total deaths registered, and were at the rate of 1.5 deaths per 1000 persons living. These deaths were, therefore, as compared with the total deaths of Residents registered, 1 greater per 1,000 deaths belonging to this Borough than in London and as compared with the population 1 per 1,000 less in this Borough than in London. The following table shows the deaths of Residents registered from the nine principal zymotic diseases which occurred in the 10 years 1899 to 1908. YEAR. Small-Pox. Measles. Scarlet Fever. Diphtheria and Membraneous C roup. Whooping Cough. Typhus Fever. Entoiic Fever. Simple continued Fever. Diarrhoea and Cholera. Total. 899 0 22 13 26 45 0 21 0 204 331 1900 0 87 7 28 7 0 18 0 138 285 1901 14 50 13 36 75 0 16 1 134 319 1902 14 75 7 23 25 0 11 0 81 236 1903 0 27 8 19 31 0 10 0 87 182 1904 0 105 7 23 32 0 5 0 126 298 1905 0 30 11 21 54 0 5 0 89 210 1906 0 56 16 27 20 0 8 0 144 271 1907 0 52 10 23 31 0 6 0 39 l6l 1908 0 14 11 15 18 0 5 0 108 171 Average in last 10 years 3 52 10 24 34 0 11 0 115 248 139 It will be seen from the above table that the actual number of deaths from these zymotic diseases last year was, with the exception of scarlet fever, below the average number registered in 10 years, CASES OF ILLNESS REPORTED AS DUE TO INFECTIOUS DISEASE. There were, omitting phthisis, 683 cases reported as due to notifiable infectious diseases in this Borough against 911 in the previous year. The number of cases of phthisis voluntarily notified was 118. There were also reported 430 cases of infectious diseases that were not notifiable, against 1073 in the previous year, 113 of these were chicken-pox 161 measles, and 156 whooping cough. SMALL-POX. No case of small-pox was notified in the Borough last year, against no case in the previous year. CHICKEN-POX. One hundred and thirteen cases of chicken-pox were reported, against 198 cases in the previous year. The 113 cases reported last year were treated at the homes of the patients. No death was registered. MEASLES. One hundred and sixty-one cases were reported as due to measles, against 538 cases in the previous year. Fourteen deaths were registered. As this is not a notifiable disease it is of no use my giving the mortality rate on the cases reported, as no doubt only a proportion of the cases which occurred were known of by me. Owing to the stringent instructions of the Educational Department of the London County Council most of the cases as usual occurring among pupils at the schools of the London County Council 140 were reported to me. A strict system of disinfection was carried out in accordance with the provisions of the Public Health (London) Act, 1901, and very little opposition was met with. From the whole of the notifiable infectious diseases there were only 38 deaths, whereas from measles alone there were 14 deaths. In each of the cases that was reported the premises were at once inspected as to the sanitary condition. I am still of opinion that it would be a step in the right direction if the disease was made "notifiable." SCARLET FEVER. Three hundred and eighty-three cases were reported as due to scarlet fever, against 577 in the previous year. Three hundred and sixty-seven cases reported last year were isolated at Isolation Hospitals, and 36 cases were treated at the homes of the patients. Eleven deaths were registered. The mortality rate on the cases reported wns only 29 per cent. DIPHTHERIA AND DIPHTHERITIC MEMBRANOUS CROUP. One hundred and ninety-nine cases were reported as due to diphtheria or diphtheritic membranous croup, against 207 cases in the previous year. One hundred and sixty-eight cases reported last year were treated at the Isolation Hospitals, and 31 at the homes of the patients. Fifteen deaths were registered. The mortality rate on the cases reported was 7.5 per cent. WHOOPING COUGH. One hundred and fifty-six cases were reported as due to whooping cough, against 337 cases in the previous year. All of the cases reported last year were treated at the homes of the patients. Eighteen 141 deaths were registered. As this is not a notifiable disease it is of no use my giving the mortality rate on the cases reported, as doubtless a very large number of cases occurred which were not known of in the Public Health Department. I have continued to receive as heretofore information as to cases from the Head Teachers of the Schools of the London County Council. ENTERIC FEVER. Twenty-nine cases were reported as due to enteric fever, against 40 in the previous year. Twenty-three of the cases reported last year were treated at the Isolation Hospitals of the Metropolitan Asylums Board. Five deaths were registered. The mortality rate on the cases reported was 17.2 per cent. TYPHUS FEVER No case was reported as due to typhus fever, against no case in the previous year. SIMPLE CONTINUED FEVER. No case was reported as due to simple continued fever, against one case in the previous year. RELAPSING FEVER. No case was reported as due to relapsing fever, against no case in the previous year. PUERPERAL FEVER. Six cases were reported as due to puerperal fever, against seven cases in the previous year. Four of the cases reported last year were treated at the homes of the patients, and 2 of the cases were treated at the Hammersmith Infirmary. Three deaths were registered. The mortality rate on the cases reported was 50.0 per cent. 142 CHOLERA. No case was reported as due to cholera, against no case in the previous year. ERYSIPELAS. Sixty-five cases were reported last year as due to erysipelas, against 76 cases in the previous year. Three deaths were registered. The mortality rate on the cases reported was 4.6 per cent. PLAGUE. No case was reported as due to plague, against no case in the previous year. CEREBROSPINAL FEVER. One case was reported as due to cerebro-spinal fever, against four cases in the previous year. The case reported last year was removed to the Isolation Hospital. One death was registered, the mortality rate being 100 per cent. The following table shows the number of cases that were reported as due to the undermentioned 15 zymotic diseases during the years 1899 to 1908. Year.. Small-pox. Scarlet Fever. Diphtheria or Diphtheritic Croup Typhus Fever Enteric Fever. Simple continued Fever. Relapsing Fever. Puerperal Fever. English Cholera.. Erysipelas. Plague. Chicken-pox* Measles* Whooping Cough.* Cerebro-Spinal Fever † Total. 1899 0 442 186 0 113 0 0 12 0 109 0 8 42 54 0 976 1900 2 355 252 0 103 4 0 6 0 111 0 21 487 13 0 1354 1901 46 343 227 0 77 2 0 3 0 116 0 28 193 207 0 1241 1902 99 349 172 0 44 0 0 7 0 110 0 fi59 293 78 0 1809 1903 6 314 160 0 58 1 0 6 0 108 0 104 137 132 0 1026 1904 0 283 201 0 38 1 0 11 0 120 0 283 742 102 0 1781 1905 0 360 237 0 41 0 0 13 0 115 0 919 417 286 0 1698 1906 0 439 270 0 33 1 0 10 0 125 0 68 627 56 0 1629 1907 0 577 207 0 40 0 0 7 0 76 0 198 538 337 0 1984 1908 0 383 199 0 29 0 0 6 0 65 0 118 161 156 0 1113 A'vgt in last 10 yrs. 15 386 211 0 58 1 0 8 0 106 0 171 364 142 .58 1461 * Not a notifiable disease. † Disease was made notifiable on 13th September, 1907. 143 LOCAL GOVERNMENT BOARD RETURN.—TABLE III. Cases of Infectious Disease notified during the year 1908. METROPOLITAN BOROUGH OF HAMMERSMITH. Notifiable Diseases. Cases Notified in whole District. Total Cases Notified in Each Locality No. of Cases Removed to Hospital from Each Locality. At all Ages At Ages†—Years. W W Total cases removed to Hospital Under 1 1 to 5 5 to IS 15 to 25 25 to 65 65 and upwards North Centre Souh North Centre South Small-pox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Cholera 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Diphtheria including) Membranous croup) 199 7 53 105 17 17 0 83 72 44 73 61 34 168 Erysipelas 65 0 3 5 4 43 11 31 20 14 40 9 3 22 Scarlet fever 383 2 107 222 33 19 0 1 9 106 88 170 91 86 347 Typhus fever 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Enteric fever 29 0 1 6 11 11 0 14 10 5 10 8 5 23 Relapsing fever 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Continued fever 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Puerperal fever 6 0 0 0 0 6 0 4 2 0 2 0 0 2 Plague 0 0 0 0 0 0 0 0 0 0 0 0 0 0 *CereboSpinal Meningitis 1 0 1 0 0 0 0 1 0 0 1 0 0 1 ‡Phthisis 118 0 1 4 25 84 4 49 35 34 41 32 34 107 Total 801 9 166 342 90 179 15 371 245 185 307 201 162 670 NOTES.- The localities adopted for this table should be the same as those in Tables II. and IV. State in space below the name of the isolation hospital, if any, to which residents in the district, suffering from infectious disease, are usually sent Mark (H) the locality in which it is situated, or if not Within the district, state where it is situated, and in what district. The name of the authority by whom the hospital is provided should also be given. Mark (W) the locality in which a Workhouse is situated. *Cerebo Spinal Fever was made notifiable on September 13th, 1907. †These age columns for notifications should be filled up in all cases where the Medical Officer of Health, by enquiry or otherwise, has obtained the necessary information. ‡Voluntarily notifiable since April 7th, 1902. Isolation Hospital—Western District Hospital at Fulham, and occasionally other Fever Hospitals under the Metropolitan Asylums Board, and exceptionally the London Fever Hospital at Islington, also when necessary the Small-pox Hospitals of the Metropolitan Asylums Board. 144 The following table of Deaths from Infectious Diseases is compiled from the Registrar's General Report, Boroughs. Estimated Population in the middle of 1908 Deaths from Deaths under 1 year of age. Small-pox. Measles. Scarlet Fever, Diphtheria. Whooping-cough. Typhus. Enteric Fever. Pyrexia (Origin uncertain). Diarrhoea. Phthisis, LONDON 4,795.757 - 1524 548 724 984 - 225 2 2592 6419 13943 West Districts— Paddington 150,923 - 35 15 l6 11 - 4 - 52 155 348 Kensington 182,752 - 32 9 27 7 _ 5 . 89 182 424 Hammersmith 124,012 - 15 11 13 19 - 5 - 74 159 383 Fulham 171,562 - 71 17 32 34 _ 10 _ 113 199 545 Chelsea 75,049 - 12 8 12 17 - 5 - 36 97 167 City of Wstmnstr. 170,545 - 23 7 l6 8 - J 6 - 42 213 296 North Districts— St. Marylebone 126,867 - 25 13 14 13 _ 6 - 39 149 268 Hampstead 92,654 - 5 7 5 5 - 5 - 12 73 97 St. Pancras 237,075 - 46 20 22 69 - 10 - 88 363 635 Islington 349,091 - 80 31 57 55 . 18 _ 112 440 897 Stoke Newington 54,015 - 10 5 1 6 _ 4 - 19 59 100 Hackney 235,253 - 75 31 45 44 - 7 - 7 163 292 641 Central Districts— Holborn 54,466 _ 11 7 5 8 - 5 - 23 117 123 Finsbury 96,007 _ 44 13 16 25 - 12 - 95 210 405 City of London 19,252 - 3 - 2 1 - - - 2 35 27 East Districts— Shoreditch 115,227 - 51 29 13 24 - 11 - 117 234 521 Bethnal Green 131,066 - 104 40 28 42 - 13 - 102 215 572 Stepney 310,706 - 264 55 75 129 - 14 1 262 494 1 320 Poplar 171,516 - 82 37 33 73 _ 14 - 155 234 673 South Districts— Southwark 210,442 _ 77 24 32 50 - 7 _ 188 403 820 Bermondsey 127,910 _ 107 25 23 22 - 12 1 109 246 600 Lambeth 321,344 _ 101 42 45 50 8 - 141 472 832 Battersea 183,873 - 48 24 22 39 5 - 83 223 496 Wandsworth 289,506 - 44 21 37 62 _ 7 _ 104 282 717 Camberwell 280,022 - 54 24 41 54 - 7 - 126 318 716 Deptford 117.539 - 33 7 10 24 - 8 - 75 138 384 Greenwich 109,110 _ 16 6 18 31 _ 9 _ 60 122 311 Lewisham 156,627 _ 46 11 43 30 _ 4 - 63 135 316 Woolwich 131,346 - 10 9 21 32 - 3 - 48 160 300 145 The following table of Deaths from Infectious Diseases per 1000 persons living is compiled from the Registrar's General Report. Per 1000 Persons Living. Deaths From Deaths under 1 year to 1000 Births. Births. All Causes. Principal Epidemic Diseases Small-pox. Measles. Scarlet Fever Diphtheria. Whoopingcough Typhus. Enteric Fever Pyrexia(Origin uncertain). Diarrhœa Phthisis Crude Corrected* 25.2 13.8 14.5 1.35 - 0.31 0.11 0.15 0.20 - 0.05 0.00 0.53 1.32 113 22.1 12.4 13.2 0.87 _ 0.23 0.10 0.10 0.07 - 0.03 _ 0.34 1.01 103 19.2 12.9 13.9 0.92 - 0.17 0.05 0.15 O.O4 - 0.03 - 0.48 0.98 119 25.4 14.0 14.5 l.09 - 0.12 0.09 0.10 0.15 - 0.04 - 0.59 1. 26 120 27.0 12.4 12.9 1.59 - O.41 0.10 0.18 0.19 - 0.06 - 0.65 1. 14 116 20.4 14.5 15.0 1.18 - O.l6 0.10 0.16 0.22 - 0.07 - 0.47 1. 27 107 16.7 12.6 14.2 0.58 - 0.13 0.04 0.09 0.05 - 0.03 - 0.24 1. 23 102 20.6 14.2 15.1 0.85 - 0.19 0.10 0 .11 0.10 _ 0.05 - 0.30 1.16 101 14.9 8.5 9.6 0.40 - 0.05 0.07 0.05 O.O5 - 0.05 - 0.13 o.78 69 24.6 14.7 15.4 1.06 - 0.19 0.08 0.09 0.29 - 0.04 - 0.37 1.51 107 24.7 13.2 13.7 1.01 - 0.23 0.09 0.16 0.16 - 0.05 - 0.32 1.24 102 19.7 12.3 129 0.82 - 0.18 0.09 0.02 0.11 - 0.07 - 0.35 1.07 92 23.3 13.2 13.7 1.52 - 0.31 0.13 0.19 0.18 - 0.03 - 0.68 1.22 115 19.6 16.4 17.6 1 .07 . 0.20 0.13 0.09 0.14 _ 0.09 _ 0.42 2.11 113 31.l 18.6 19.3 2.09 - o.45 0.13 0.16 0.26 - 0.12 . 0.97 2.15 133 14.9 17.7 19.4 0.40 - 0.15 - 0.10 0.05 - - - 0.10 1.79 92 32.0 17.4 18.3 2.09 - 0.44 0.25 0.11 0.20 - 0. 09 _ 1.00 2.00 139 32.6 17.1 17.3 2.45 - 0.78 0.30 0.21 o.32 . 0.10 . 0.77 1.61 132 32.1 16.4 17.1 2.53 - 0.84 0.17 0.24 0.41 - 0.04 O.00 0.83 1.56 130 31.5 15.9 16.3 2.26 • 0.47 0.21 0.19 0.42 * 0.08 - 0.89 1.34 123 29.2 16.3 17.0 1.76 - 0.36 O.11 0.15 0.23 - 0.03 - 0.88 1.88 131 32.5 18.8 19.2 2.30 - 0.82 0.19 0.18 0.17 - 0.09 0.01 0.84 1.89 144 24.6 13.3 13.7 1.18 . 0.31 0.13 0.14 0.15 - 0.02 _ 0.43 1.45 104 24.9 12.2 13.1 1.19 . 0.26 0.13 0.12 0.21 - 0.03 _ 0.44 1.19 106 25.2 11. 6 12.2 0.93 - 0.15 0.07 0.13 0.21 - 0.02 - 0.35 0.96 97 24.2 12.7 13.1 1.06 . 0.19 0.08 0.14 0.19 - 0.02 _ 0.44 1.12 104 26.4 13.8 14.5 1.32 - 0.28 0.06 0.08 0.20 - 0.07 - 0.63 1.16 122 23.5 12.6 12.9 1.25 - 0.14 0.05 0.16 0.28 * 0.08 - 0.54 1.10 120 23.0 11.O 12.4 1.25 - 0.29 0.07 0.27 0.19 - 0.03 - o.40 0.85 86 23.8 11.4 12.1 0.92 - 0.07 0.07 0.16 0.24 - 0.02 - 0.36 1.20 94 146 Death-rates during- 1908 in London and the several Metropolitan Boroughs, from All Causes, and from Certain Diseases (1) before Distrioution,* and (2) after Distribution of Deaths in Public Institutions. 4c.. as compiled by Registrar General. Death-Rates per 1000 living. All Causes Scarlet Fever Diphtheria En ternFever Phthisis Boroughs. Before Distribution After Distribution' Before Distribution After Distribution Before Distribution After Distribution Before Distribution After Distribution Before Distribution After Distribution County of London 14.0 13.8 0.10 0.11 0.15 0.15 0.05 0.05 1.30 1.32 West. Paddinqton 13.6 12.4 — 0.10 0.07 0.10 0.03 0.03 0.98 1.01 Kensington 14.8 12.9 — 0.05 0.01 0.15 0.02 0.03 1.62 0.98 Hammersmith 13.9 14.0 — 0.09 0.03 0.10 0.05 0.04 1.16 1.36 Folham 11.5 12.4 0.32 0.10 0.54 0.18 0.11 0.06 1.06 1.14 Chelsea 21.7 14.5 — 0.10 0.05 0.16 0.05 0.07 2.49 1.27 City of Westminster 14.1 12.6 0.01 0.04 0.03 0.09 0.05 0.03 0.67 1.33 North. St. Marylebone 13.2 14.2 0.01 0.10 0.03 0.11 0.02 0.05 0.67 1.16 Hampstead 10.6 8.5 0.53 0.07 0.48 0.05 0.07 0.05 1.57 0.78 St. Pancras 15.2 14.7 0.00 0.08 0.05 0.09 0.05 0.04 1.56 1.51 Islington 12.8 13.2 0.05 0.09 0.06 0.16 0.03 0.05 1.45 1.24 Stoke Xewington 9.0 12.3 — 0.09 — 0. 02 — 0.07 0.56 1.07 Hackney 13.6 13.2 0.21 0.13 0.31 0.19 0.07 0.03 1.31 1.22 Central. Holborn 19.2 16.4 — 0.13 0.05 0.09 0.09 0.09 1.37 2.11 Finbbury 9.7 18.6 — 0.13 0.03 0.16 0.03 0.12 0.89 2.15 City of London 49.8 17.7 0.05 — 0.36 0.10 0.41 — 2.66 1.79 East. Shoreditch 16.4 I7.4 0.02 0.25 0.03 0.11 0.02 0.09 2.11 2.00 Bethnal Green 16 .9 17.1 — 0.30 0. 07 0.21 0.04 0.10 1.83 1.61 Stepney 17.6 16.4 00.1 0.17 0.14 0.24 0.05 0.04 1.37 1.56 Poplar 16.2 15.9 0.05 0.2 I 0.06 0.19 0.07 0.08 1.55 1.34 South. Southwark 13.9 16.3 0.00 0.11 0.09 O.15 0. 02 0.03 0.95 1.88 Bermondsey 15.1 18.8 0.02 0.19 0.02 0.18 0.05 0.09 1.69 1.89 Lambeth 14.4 13.3 0.11 0.13 0.17 O.14 0.05 0.02 1. 41 1.45 Battersea 12.1 12.2 0.02 0.13 0.02 0.12 0.01 0.03 1.10 1.19 Wandsworth 11.0 11.6 0.22 2.07 0.20 0.13 0.01 0.02 0.98 0.96 Camberwell 13.8 12.7 0.00 0.08 0.02 O.14 0.02 0.02 1 .64 1.12 Deptford 10.5 13.8 0.48 0.06 0.49 0.08 0.13 0.07 0.70 1.16 Greenwich 16.5 12.6 0.41 0.05 0.55 0.16 0.14 0.08 1.67 1.10 Lewisham 11.7 11.0 0.47 0.07 0.52 0.27 0.03 o.03 0.83 0.85 Woolwich 10.5 11.4 0.01 0.07 0.04 0.16 0.01 0.02 1.10 1.20 * The Deaths "before Distribution" are those actually registered in the several Boroughs without any correction whatever. 147 LONDON AND THE METROPOLITAN BOROUGHS. Death rates per 1,000 persons living and Infantile Mortality (corrected) in the five years, 1903-1907, and in 1908, as issued by Registrar General. Boroughs. Deaths under one year to 1000 Births. all Causes. smallpox. Measles. Scarlet Fever Diphtheria whooping Cough typhus. Enteric Fever. pyrexia. Diarrhœa. Phthisis 19031907. 1908. 19031907. 1908. 19031907 1908. 19031907. 1908. 19031907. 1908. 19031907. 1908. 19031907. 1908. 19031907. 1908. 19031907. 1908. 19031907. 1908. 19031907. 1908. 19031907. 1908. County of London 15.2 13.8 0.00 - 0.42 0.31 O.1l 0.11 0.15 0.15 0.33 0.20 0.00 - 0.08 0.05 0.00 0.00 0.73 0.53 1.49 1.32 130 113 Paddington 13.3 12.4 0.00 _ 0.26 0.23 0.08 0.10 0.10 0.l0 5.25 0.07 - 0.05 0.03 - - 0.60 0.34 1.09 1.01 115 103 Kensington 13.9 12.9 0.00 — 0.30 0.17 0.07 0.05 0.10 0.15 0.30 0.04 — — 0.04 0.03 0.00 — 0.58 0.48 1.23 0.98 137 119 hammersmith 14.6 14.0 — — 0.46 0.12 0.08 0.09 0.18 0.10 0.30 0.15 — — 0.05 0.04 0.00 — 0.75 0.59 1.29 1.26 133 120 fulham 14.3 12.4 0.43 0.41 0.08 0.10 0.18 0.18 0.37 0.19 0.07 0.06 1.18 0.65 1.27 1.14 136 116 Chelsea 15.5 14.5 — — 0.39 0.16 0.08 0.10 0.10 0.16 0.32 0.22 — 0.03 007 — — 0.51 0.47 1.59 1.27 131 107 City of Westminster 13.3 12.6 0.00 - 0.17 0 .13 0.07 0.04 0.07 0.09 0.15 0.05 - — 0.05 0.03 0.00 - 0.34 0.24 1.50 1.23 110 102 St. Marylebone 15.6 14.2 _ - 0.29 0.19 0.12 0.10 0.11 0.11 0.23 0.10 - - 0.04 0.05 0.01 - 0.50 0.30 1.60 1.10 122 101 Hampstead 9.6 8.5 — — 0.12 0.05 0.05 0.07 0.07 0.05 0.12 0.05 — — 0.03 0.05 — — 0.17 0.13 0.75 0.78 87 69 St. Pancras 16.1 14.7 - - 0.50 0.19 0.11 0.08 0.13 0.09 0.34 0.29 0.05 0.04 0.00 0.52 0.37 1.74 1.51 125 107 Islington 14.7 13 2 0.00 — 0. 44 0.23 0.09 0.09 0.10 0.16 0.32 0.16 — — 0.05 0.05 0.00 - 0.50 0.32 1.35 1.24 122 102 Stoke newington 12.4 12.3 — — 0.23 0.18 0.07 0.09 0.12 0.02 0.29 0.11 — — 0.04 0.07 — — 0.42 0.35 1.25 1.07 109 92 Hackney 13. 9 13.2 0.00 - 0.35 0.31 0.11 0.13 0.17 0.19 0.26 0.18 — — 0.11 0.03 — - 0.77 0.68 1.26 1.22 126 115 holborn 18.0 16.4 0.01 _ 0.38 0.20 0.05 0.13 0.11 0.09 0.29 0.14 - - 0.06 0.09 - - 0.51 0.42 2.76 2.11 125 113 finsbury 20.0 18.6 0.01 — 0.70 0.45 0.16 0.13 0.16 0.16 0.45 0.26 — — 0.09 0 12 — — 0.93 0.97 2.14 2.15 147 133 city of London 16.6 17.7 - - 0.07 0.15 0.10 0.12 0.11 0.22 0.05 - - 0.05 - - 0.23 0.10 1.65 1.79 115 92 Shoreditch 19.9 17.4 0.01 _ 0.76 0.44 0.16 0.25 0.16 0.ll 0.62 0.20 - - 0.06 0.09 - - 1.28 1.00 2.11 2.00 167 139 Bethnal Green 18.5 17. 1 0.01 — 0 .54 0.78 0.19 0.30 0.22 0.21 0.42 0.32 — — 0.07 0.10 0.00 — 0.94 0.77 2.09 1.61 147 132 Stepney 17.7 16.4 0.00 — 0.55 0.84 0.15 0.17 0.24 0.24 0.38 0.41 — — 0.08 0.04 0.00 0.00 1.10 0.83 1.84 1.56 138 130 Poplar 17.8 15.9 0.01 - 0.63 0.47 0.15 0.21 0.31 0.19 0.44 0.42 - - 0.07 0.08 - - 1.20 0.89 1.58 1.34 146 123 southwark 18.6 16.3 0.00 - 0.61 0.36 0.13 0.11 0.15 0.15 0.41 0.23 - - 0.07 0.03 0.00 - 0.95 0.88 2.20 1.88 148 131 bermondsey 19.0 18.8 — — o.6l 0.82 0.19 0.19 0.16 0.18 0.39 0.17 0.00 - 0.07 0.09 0.00 0.01 1.04 0.84 1.91 1.89 150 144 Lambeth 15.1 13.3 0.00 — 0.37 0.31 0.09 9.13 0.13 0.14 0.32 0.15 — — o.o5 0.02 - - 0.70 0.43 1.43 1.45 131 104 Battersea 14.0 12.2 0. 46 0.26 0.09 0.13 0.13 0.12 0.38 0.21 - 0.05 0.03 0.72 0.44 1.32 1.19 128 106 Wandsworth 12.7 11.6 — — 0.33 0.15 0.08 0.07 0.15 0.13 0.29 0.21 — — 0.05 0.02 - - 0.61 0.35 1.01 0.96 114 97 Camberwell 14.2 12.7 — — 0.37 0.19 0.09 0.08 0.11 0.14 0.32 0.19 - - 0.05 0.02 - - 0.63 o.44 1.27 1.12 126 104 Deptford 15.1 13.8 — — 0.48 0.28 0.12 0.06 0.20 0.08 0.37 0.20 — — 0.04 0.07 o.oo - 0.78 0.63 1.32 1.16 128 122 Greenwich 13.5 12.6 — — 0.33 0.14 0.08 0.05 0.20 0.16 0.34 0.28 — — 0.05 0.08 - 0.71 0.54 1.20 1.10 123 120 Lewisham 11.7 11.0 0.01 — 0. 19 0.29 0.07 0.07 0.11 0.27 0.20 0.19 — - 0.03 0.03 0.00 - 0.52 0.42 0.87 0.85 102 86 woolwich 13.2 11.4 — — 0.27 0.07 0.08 0 07 0.16 0.16 0.25 0.24 — — 0.05 0.02 0.00 - 0.68 0.36 1.44 1.20 113 94 148 INFLUENZA. Twenty-five deaths were registered as due to influenza, against 17 deaths in the previous year.. No official action was taken in referenee to this complaint, as no application was made for the disinfection of any of the houses in which death occurred. PHTHISIS. The voluntary notification of phthisis, which your Council decided upon on 7th April, 1902, was continued during last year. Altogether, 118 cases were notified to me against 109 cases in the previous year. These, no doubt, represent only a small proportion of the cases that actually occurred, as 159 deaths were registered, against 148 deaths in the previous year. In all cases notified or in which death occurred, the premises were at once inspected, and after death in all cases occurring in private dwelling houses an offer was made to disinfect the premises at the expense of your Council. In every case a printed instruction as to the course that should be adopted for the prevention of consumption was left at the premises. In very few instances was advantage taken of the offer of your Council to disinfect. Of the 118 cases notified last year, 96 were reported by the Medical Superintendents of the Infirmaries of Fulham and Hammersmith. Only 11 were reported by private Medical Practitioners, 10 by the Medical Superintendent of Brompton Hospital and one by the Medical Superintendent of St. Margaret's Hospital. Very little or any practical good is done by the voluntary notification of this disease, except that it is a means by which public opinion may be directed as to the necessity of taking precautionary measures against the spread of the disease. In reference to this disease the Local Government Board issued a Code of Regulations (Order 52, 712), an abstract from which is given in the following circular:— 149 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1908. Local Government Board, Whitehall, S.W., 18th December, 1908. Sir, I am directed by the Local Government Board to state that they have had under consideration the desirability of affording facilities for the extension of administrative action for the prevention of tuberculosis, and that with this view they have issued an Order in pursuance of Section 130 of the Public Health Act, 1875, as amended and extended by the Public Health (London) Act, 1891, and the Public Health Act, 1896, to provide for the notification to the Medical Officers of Health of Sanitary Authorities of cases of pulmonary tuberculosis occurring amongst the inmates of Poor Law Institutions, or amongst persons under the care of District Medical Officers, and for the taking of certain measures in such cases. Notification by Medical Officers of Poor Law Institutions. Article IV. of the Order directs that the Medical Officer of a Poor Law Institution, as defined by Article I., shall, within 48 hours after his first recognition of the symptoms of pulmonary tuberculosis in the case of a poor person who is an inmate of the institution, post to the Medical Officer of Health for the Sanitary district in which the person resided immediately before he became an inmate of the institution a notification of the case. The notification must be made on a printed form as set out in the Schedule to the Order. Notification by District Medical Officfrs. Article V. directs that a similar notification shall be posted to the Medical Officer of Health by the District Medical Officer in the case of any poor person suffering from pulmonary tuberculosis on whom he is in medical attendance according to his agreement with a Board of Guardians. The notification must be posted within 48 hours after the District Medical Officer has first recognised the symptoms of pulmonary tuberculosis, and must be addressed to the Medical Officer of Health acting for the sanitary district in which the residence of the poor person is situate. 150 Notification by Superintending Ofeicers of Poor Law Institutions. Under Article VI. it will be the duty of the Superintending Officer of a Poor Law Institution to post to the Medical Officer of Health on a printed form as set out in the Schedule to the Order a notification of the actual or intended place of destination and address at that place of any person leaving the institution in respect of whom a notification has been made by the Medical Officer of the institution under Article IV. The notification must be posted within 48 hours after the departure of the person to whom it relates, and must be sent to the Medical Officer of Health of the sanitary district in which the intended destination of the person is situate. Notification of Changes of Address by Relieving Officers. Article VII. provides that a Relieving Officer shall notify any change of address (other than by admission to a Poor Law Institution,) of a person in respect of whom a notification has been made under Article V. by a District Medical Officer. The notification must be made on a printed form as set out in the Schedule to the Order, and must be sent to the Medical Officer of Health for the sanitary district in which the address to which the person moves is situate. The notification must be posted within 48 hours after the Relieving Officer has obtained accurate information respecting the change of residence. Remuneration to be Allowed. Provision is made by Article VIII. for the remuneration of the Officers who have to make notifications under the Order. In the case of the Medical Officer of a Poor Law Institution or a District Medical Officer, the remuneration will be at the rate of one shilling for every notification, but where in relation to any one case two or more notifications have been posted by the Medical Officer to the same Medical Officer of Health, his remuneration will be at the rate of sixpence for every such notification after the first. In the case of a Superintending Officer of a Poor Law Institution or a Relieving Officer, the remuneration will be at the rate of threepence for every notification. 151 The remuneration will be payable by the Council of the sanitary district for which the Medical Officer of Health acts, it will be deemed to cover the cost of postage, and it will be payable in the manner and subject to the conditions prescribed by the Article. Supply of Forms. It will be the duty of the Poor Law Authorities referred to in Article III. to supply to the officers concerned printed copies of the appropriate forms set forth in the Schedule to the Order. Exception and Application of Enactments. Some of the provisions of the Public Health Act, 1875, and the Public Health (London) Act 1891, relative to infectious disease are not usually appropriate in cases of pulmonary tuberculosis. The Board have, therefore, provided by Article IX. (1) that nothing in the regulations shall have effect so as to apply or to anthorise any one to put in force with respect to a person in relation to whom a notification has been made any enactment which renders him or any other person liable to a penalty or subjects him to any restriction, prohibition, or disability affecting him or his employment, occupation, means of livelihood, or residence on the ground of his suffering from pulmonary tuberculosis. Special Powers of Councils. Subject to what is stated in the preceding paragraph, it is desirable that Sanitary Authorities acting on the advice of their Medical Officers of Health should utilise their powers for the purpose of preventing the spread of infection from pulmonary tuberculosis. The Order confers some special powers which the Board are advised are suitable for this purpose, and which are set out in Article IX. (2) of the Order. The Board propose to issue for the use of Sanitary Authorities and Medical Officers of Health a memorandum by their Medical Officer setting out the appropriate action that can be taken under these powers. Copies of the memorandum will be sent to the Council in due course. Determination of Questions or Difference. Article XI. will enable the Board to determine any question or difference in relation to anything done under the Order on the application of any of the parties affected. 152 Pulmonary Tuberculosis Notifiable under Local Acts. Article XII. deals with those cases in which powers have been obtained with respect to pulmonary tuberculosis by a Local Act. Nothing in the Regulations will have effect in derogation of any power or obligation under any such Act, but subject to this the Regulations will apply to any district in which a Local Act containing provisions with respect to pulmonary tuberculosis is in force. The Board may, however, on the application of the Council of the district direct that so much of the Regulations as relates to a notification by a Medical Officer of a Poor Law Institution or a District Medical Officer shall not have effect in relation to that district. Date on which the Order comes into effect. The Order will take effect on and after January 1st next, and it is desirable that the arrangements which are necessary to facilitate carrying it out should be made without any delay. In fixing January 1st as the day when the Order shall come into operation the Board have had regard to the convenience, from a statistical point of view, of the Order taking effect at the commencement of a calendar year. If, however, any delay occurs in the printing of the forms, it may he understood that it will not be necessary to carry out the Regulations until these can be obtained. Copies of the Order and Circular are enclosed, and I am to request that a copy of each may be given to the Medical Officer of Health. The Order and Circular will be placed on sale so that copies may shortly be obtained, either directly or through any bookseller, from Messrs. Wyman & Sons, Limited, Fetter Lane, London, E. C. I am, Sir, Your obedient Servant, S. B. PROVIS, Secretary. The Town Clerk or The Clerk to the Urban or Rural District Council. 153 LICENSED SLAUGHTER HOUSES. The whole of the licensed slaughter houses in the Borough were under inspection by the Inspector for offensive trades. At the annual inspection of slaughter houses in October, 1908, I had received notices that 10 licences were to be applied for. All of them were found to be, as far as your Council's requirements were concerned, in a satisfactory condition. Your Council decided to inform the London County County that you offered no opposition to the renewal of any of the licences, and at the Special Sessions at the London County Council, held in October, the 10 licences were granted. The following is a list of the licensed slaughter houses in the Borough:— NORTH DISTRICT. Wards Nos. 4, 5, 6, and 7. address. name of licensee. 61, Silchester Road Unoccupied 185, Uxbridge Road Wiliam Matthew East 40, Goldhawk Road Benjamin Holton 138 ,, William Moore CENTRE DISTRICT. Wards Nos. 2 and 3. address. name of licensee. 347, Goldhawk Road Edgar P. Jarrett 55, Dalling Road Oliver Albert Wright 154 SOUTH DISTRICT. Ward No. 1. address. name of licensee. 35, Queen Street Messrs. Garrett and Silcock 49, King Street Benjamin Holton 65, „ Thomas Holton 321 ,, Stanley Brooks Midwinter BAKEHOUSES. The 61 bakehouses now in use as bakeries in the Borough were under a regular half-yearly inspection by the Factory Inspector. Eighty-five defects were discovered upon the premises during the year. Notices were at once served upon the bakers calling upon them to comply with the regulations of your Council. In every case the notice was complied with. It was not decided to apply for any summonses against bakers whose bakehouses were found not to be in conformity with the Act, as they readily complied with the requirements of your Council when called upon by notice to do so. 155 The following is a list of the bakehouses at present in occupation in the Borough:— NORTH DISTRICT. Wards Nos. 4, 5, 6 and 7. address. name, 410 Uxbridge Road J. Plant † 125 Uxbridge Road P. Puhl 121 Askew Road Not in use *242 Goldhawk Road G. Lousden *32 Norland Road H. Lenharth *74 Goldhawk Road R. Steele *128 Askew Road F. Faubel *75 Uxbjidge Road J, J. Sauer *216 Uxbridge Road F. C. Stiles 74 Askew Road J. Wakerbarth *1 Kenmont Terrace, Harrow Road H. T. Rogers * 2, Hunt Street Wm. Burt *4 St. Helen's Terrace W. Allinson *55 Melina Road W. Weinel *167 Askew Road H. Reinders *126 Uxbridge Road H. Seeler 41 Gayford Road W. Radford *39 St. Ann's Road E. Tomlin *106 Goldhawk Road A. J. Wills 104 Latimer Road Spearink & Son 166 Goldhawk Road J. Pendry 7 Market Place, Askew Road J. Miller 156 CENTRE DISTRICT. Wards Nos. 2 and 3. address. name. *54 Richmond Road J. Alderton *13 Shepherd's Bush Green Not in use *87 Masboro' Road Not in use 348 King Street R. Bedser *75 Blythe Road W. Abbot *31 Goldhawk Road J. Anderson *11 Lamington Street Ernest Witt 258 King Street P. Erbach *94 Shepherd's Bush Road Not in use *85 The Grove W. Bates *102 Dalling Road W. Schlarb †*84 Shepherd's Bush Road F. T. Ries 70 Glenthorne Road M. Durand 24 Bradmore Park Road G. Klein *77 Brackenbury Road W. Jennings *134 Shepherd's Bush Road C.Jacobs *1 Masboro Road W. Dodwell *98 Blythe Road Not in use *17 Kilmarsh Road J. Krutgen *7 Shepherd's Bush Road A. Royston *192 Dalling Road W. Bambridge *1 Aldensley Road W. Nan *67, Masboro' Road J. Teague *47 Milson Road W. Warwick *33 Glenthorne Road E. Winstone † * Cadby Hall, Hammersmith Road J. Lyons & Co. † 1 The Grove Palmer's Stores, Ltd. 316 King Street W. Lines. *6 Beaconsfield Terrace Road W. Phipps 157 SOUTH DISTRICT. Ward No. 1. address. name. 65 Bridge Road W. Bass 88 Queen Street F. Taylor †1 Eyot Gardens J. R. Chibnail, Limited 2 and 4 Queen's Road Mrs. Gottig 93 Black Lion Lane A. Gurney *82 Great Church Lane G. Acres 16 Black Lion Lane A. Mulford 213 Hammersmith Road A. Thornhill † Great Church Lane Fullers, Limited 7 St. Peter's Road W. Hooks * Underground Bakehouses. † Factory Bakehouses. 158 Table Showing Number of Inhabited Houses and Number of Persons to each House, at Census, 1901. Name of District. Number of Inhabited Houses, Census, 1901. Number of Persons to each House, Census, 1901. Lewisham 22,750 5.6o Wandsworth 37.764 6.14 Woolwich 18,086 6.47 Stoke Newington 7.717 6.64 Greenwich 14,240 6.72 Deptford 15,823 6.97 Camberwell 36,671 7.07 Hackney 30,634 7.15 Battersea 23,462 7.19 Hampstead 11,294 7.25 Lambeth 41,511 7.27 Hammersmith 15,198 7.38 Fulham 18,534 7.40 Poplar 22,613 7.46 Kensington 22,131 7.98 Paddington 17,684 8.14 Bermondsey 15,817 8.26 Chelsea 8,641 8.54 Islington 38,645 8.66 Bethnal Green 14,005 9.25 Shoreditch 12,743 9.28 Stepney 31.462 9.49 St. Marylebone 13,536 9.84 Southwark 20,878 9.87 St. Pancras 23,715 9.92 City of Westminster 18,366 9.96 Finsbury 9,280 10.93 Holborn 4,703 12.63 159 Table Shewing extent in Acres, and Number of Persons to the Acre, at Census, 1901. Name of District. Extent in Acres. Census, 1901. Number of Persons to the Acre. Census, 1901. Woolwich 8,276.6 14.15 Lewisham 7,014.4 18.17 Greenwich 3,851.7 24.86 Wandsworth 9,129.7 25.41 Hampstead 2,265.0 36.17 Hammersmith 2,282.6 49.09 Camberwell 4,480.0 57.88 Stoke Newington 863.5 59.38 Hackney 3,288.9 66.68 Deptford 1,562.7 70.67 Poplar 2,327.7 72.54 City of Westminster 2,502.7 73.14 Lambeth 4,080.4 73.82 Kensington 2,291.1 77.09 Battersea 2,160.3 77.73 Fulham 1,703.5 80.61 Bermondsey 1,499.6 87.23 St. Pancras 2,694.4 87.34 St. Marylebone 1,472.8 90.55 Paddington 1,356.1 106.17 Islington 3,091.5 108.37 Chelsea 659.6 112.05 Holborn 405.1 146.67 Stepney 1,765.6 169.11 Bethnal Green 759.3 170.85 Finsbury 589.1 172.26 Shoreditch 657.6 180.57 Southwark 1,131.5 182.29 CUSTOMS AND INLAND REVENUE ACTS. During the year 33 applications were received for certificates under these Acts. There was a very considerable amount of work which had to be carried out in reference to these applications. In no case was the certificate granted until the whole of the sanitary requirements were 16o carried out so as to place the premises in a proper sanitary condition. I decided to refuse certificates in all cases in which gas stoves were used which were not provided with a hood and ventilated so as to carry off the products of combustion. The following is a list of premises which were inspected, under the Inland Revenue Acts, last year:— Name and Situation of Property. No. of Houses and blocks for which applications were received. No. of Tenements therein. No. of Tenements for which Certificate was granted. No. of Tenements for which Certificate was refused. No. of Tenements for which Certificate was deferred. 25 to 86, Askew Mansions 2 Blocks 12 12 - - Gros ven or Residences, HavelockRd. 1 Block 16 — 16 — 77, The Grove- 1 House 3 1 2 — 22, Cathnor Road 1 House 3 — 3 — 1, 2 and 3, Goodwin House 1 Block 3 1 - 2 (not completed) 149, The Grove 1 House 4 - - 4 (not completed) 32 to 40, Willow Vale 5 Houses 10 10 — — 11, Nasmyth Street 1 House 2 2 — — 33 to 36, Mark Mansions 1 Block 4 - - 4 (not completed) 1 to 4, Cornwall Mansions 1 Block 4 - - 4 (not completed) 84, Sinclair Road 1 House 2 2 — — 97, Devonport Road 1 House 4 4 — — 72 to 76, Blomfield Road 3 Blocks 9 9 — — 72 to 82, Sinclair Road 6 Houses 12 12 — — 86 to 90, Sinclair Road 3 Houses 6 6 — — 94, Sinclair Road 1 House 2 2 — — 1 to 23, Pennard Mansions 3 Blocks 23 19 4 (not completed) Carried forward 33 119 78 21 18 161 Name and situation of Property. No. of Houses and blocks for which applications were received. No. of Tenements therein. No. of Tenements for which Certificate was granted. No. of Tenements for which Certificate was refused. No.of Tenements for which Certificate was deferred. Brought forward 33 119 78 21 18 61 to 63, Davisville Road 2 Houses 6 6 - — 18 to 36, Godolphin Road 10 Houses 20 20 - — 40 and 44, Godolphin Road 2 Houses 4 4 - — 48 and 50, Godolphin Road 2 Houses 4 4 - — 15 and 17, St. Stephen's Avenue 2 Houses 4 4 - — 184, The Grove 1 House 2 2 - — 45 and 46, Richmond Gardens 2 Houses 4 2 - 2 (not completed) 42 to 46, Stronsa Road 3 Houses 9 9 - — Olympia Mansions 1 Block 4 - 4 — 1 to 6, Westwood House 1 Block 6 - 6 — 30 to 36, Ellingham Road 4 Houses 12 12 — 1 to 8, Lytton House 1 Block 8 - - 8 (not completed) l to 5, Blomfield Gardens, Mansions 1 Block 6 - - 6 (not completed) 2. Cathnor Road 1 House 2 - - 2 (not completed) 12, Richmond Gardens 1 House 4 - - 4 (not completed) 58, Percy Road 1 House 2 - - 2 (not completed) 20, Askew Crescent 1 House 3 - - 3 (not completed) 17, Caithness Road 1 House 4 - - Withdrawn Totals 70 223 131 43 45 One hundred and twenty-two Intimation Notices were served in reference to defects found to exist in certain of the above premises, and one hundred and ten Notices were complied with. 162 The following is a list of the premises certified by me during the year:— 25-36, Askew Mansions. 77, The Grove (one flat). 1, Goodwin House (one flat). 32-40, Willow Vale. 72-76, Blomfield Road. 72-82, Sinclair Road. 86-90, Sinclair Road. 94, Sinclair Road. 1-19, Pennard Mansions. 61-63, Davisville Road. 18-36, Godolphin Road. 40-44, Godolphin Road. 48-50, Godolphin Road. 15-17, St. Stephen's Avenue. 29, St. Stephen's Avenue. 184, The Grove. 45, Richmond Gardens. SEIZURE OF UNWHOLESOME FOOD. During last year no seizure was made of food which was unsound, unwholesome and unfit for the food of man. HOUSES LET IN LODGINGS. During the last year the Public Health Committee gave directions for the registration of 570 "houses let in lodgings or occupied by the members of more than one family," making a total with those previously ordered to be registered of 3,814 premises. Upon the registration a copy of the Bye-laws of your Council, under which such houses are registered, was forwarded to the landlord (within the meaning of the Bye-laws) for his guidance. From various causes 462 houses have been removed from the list, leaving a total number now on the Register of 3.352. During the year 161 notices were served and 155 were complied with. The registered premises were visited as often as time would allow by the special Inspector appointed for that purpose. 163 SANITARY NOTICES AND ADMINISTRATION. During last year 2,729 notices were reported as having been served by your four District Sanitary Inspectors and by your house to house Inspector, having for their object the removal or prevention of nuisances or insanitary conditions, against 2,412 in the previous year, and during last year 2,638 notices were reported as having been complied with, against 2,171 in the previous year. The House-to-House inspection has been continued during the year. This Inspector reports that during the year he has inspected 3,447 houses and other premises in the borough, against 3,250 houses in the previous year. As a result of his inspection, defects were discovered in 1,166 houses, and 1,166 Intimation Notices were served by the House-to-House Inspector. These cases were subsequently dealt with by the four District Inspectors. Five hundred and fifty-seven houses coming under the provisions of the Bye-laws as to "Houses let in lodgings or occupied by the members of more than one family," were discovered by this Inspector, and were subsequently dealt with by the Inspector in charge of the work under the Bye-laws. SANITATION OF THE FRANCO-BRITISH EXHIBITION. Towards the termination of the year 1907 complaints were received of nuisances in several parts of the grounds of the Exhibition, in consequence of the absence of lavatory accommodation for the workmen 164 employed in erecting the buildings. Notices were served by instruction of your Public Health Committee, requiring the removal of the offensive accumulations that had taken place and the provision of temporary accommodation for the workmen. These Notices were promptly complied with, but from time to time it was found to be necessary to serve further Notices for nuisances occurring in other parts of the grounds. Under instruction of your Committee, special reports were presented by two of your Sanitary Inspectors giving detailed particulars as to the sanitary accommodation provided or proposed to be provided for each of the buildings in the Exhibition, and also information as to the proposed number of employees who would use the accommodation. Your Public Health Committee appointed a Sub-Committee to visit the Exhibition and take into consideration the efficiency and sufficiency of the accommodation for employees. The Sub-Committee spent a very considerable amount of time in carefully considering as to the accommodation provided both as to efficiency and sufficiency. Altogether 132 Notices were served upon the Exhibition Authorities, and upon the Concessionaires, with the object of improving the sanitary condition of the Exhibition, and in every case your requirements were immediately complied with. The work of supervising so large an Exhibition involved an immense amount of extra labour, which had to be carried out by your Public Health Staff without any additional assistance. The question was subsequently considered as to your Council's power to require sufficient sanitary accommodation for the public use. In the first place your Committee recognised the futility of estimating beforehand what amount would be necessary as it was evident that it would depend on the number of persons who would visit the Exhibition, and they were also of opinion that they were not legally 165 entitled to specify the amount of accommodation for the public that should be provided, but only to require that the accommodation provided was efficient and in accordance with the existing by-laws. You subsequently took the opinion of Mr. McMorran, K.C., and he practically endorsed the views of your Committee as to your legal power in the matter. Having regard to the statements that were made to the effect that you had not given the question of the sanitary accommodation the consideration that you should have done, it was highly satisfactory at the close of the Exhibition to note that the Chairman of the Public Health Committee of the London County Council expressed his opinion at a meeting of the London County Council that the sanitary accommodation of the Fianco-British Exhibition was practically satisfactory and that there had been great exageration with regard to the statements that had been made in the press on the subject. I cannot myself see how any Public. Board could have given a more thorough and efficient consideration of the whole question than that which was given by your Public Health Committee. Having regard to the magnitude of the work that had to be undertaken and carried out in a very limited period the result was highly satisfactory, and in my opinion reflected great credit upon those whose duty it was to supervise the sanitary arrangements of the Exhibition. Your factory inspector has during the year served 253 notices under the Factory and Workshop Act, and during the same period 245 notices have been complied with. During the previous year there were 242 notices served and 240 complied with. 166 The following is a list of the Factories and Workshops upon the Register:— Restaurants, Hotels, & c. 135 Bakehouses (5 not used at present as Bakeries) 66 Bootmakers 69 Motor and Cycle Makers and Engineers 48 Dressmakers and Milliners 248 Laundries 305 Letterpress Printers and Bookbinders 29 Electrical and Mechanical Engineers 49 Smiths, Wheelwrights and Coachbuilders 35 Tailors 50 Bottle Washing Works 14 Dry Cleaning, Dying, and Carpet Beating Works 18 Firewood Cutters 15 Builders and Joiners (Machine) 31 Outworkers 533 Miscellaneous 108 Total 1,754 The whole of these premises have been under a systematic inspection by your special Inspector appointed for that purpose, and numerous improvements in the sanitary condition of these premises have been carried out under his supervision TABLE I. Prepared in accordance with the form required by the Home Office on the administration of the Factory and Workshop Act, 1901, in connection with 167 Factories, Workshops, Workplaces and Homework. 1.—INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspector. Premises. Number of tions. Written Notices. tions.  Factories (including Factory Laundries) 408 38 — Workshops (Including Workshop Laundries) 1395 149 — Workplaces *678 66 — Total 2481 253 — *The large increase in number is mainly due to the premises erected and used at the Franco-British Exhibition. 168 2.—DEFECTS FOUND AT FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. Number of Defects. Number of cutions.  Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts:—* Want of Cleanliness 83 83 ... ... Want of Ventilation 2 1 ... ... Overcrowding Nil.. Nil. ... ... Want of Drainage of Floors 4 1 ... ... Other Nuisances 125 125 ... ... Sanitary dation. insufficient 5 3 ... ... unsuitable or defective 38 30 ... ... not separate for sexes 2 2 ... ... Offences under the Factory and Workshop Act:—† Illegal occupation of underground bakehouse (S. 101) ... ... ... ... Breach of special Sanitary requirements, for bakehouses (SS. 97 to 100) 85 85 ... ... Other Offences (Excluding offences relating to outwork, which are included in Part 3 of this Report.) ... ... ... ... Total 344 333 ... ... *Including those specified in Sections 2, 3, 7 and 8 of the Factory Act as remediable under the Public Health Acts. †For districts not in London state here whether Section 22 of the Public Health Acts Amendment Act, 1890. has been adopted by the District Council; and if so, what standard of sufficiency and suitability of sanitary accommodation for persons employed in factories and workshops has been enforced, 169 3.—HOME WORK. Nature of Work. Outworkers' Lists, Section 107. Inspection of Outworkers' premises. Outwork in Unwholesome Premises, Sec. 108. Outwork in Infected Premises, Secs. 109, 110. Lists received from Employers. Addresses of Outworkers. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (S 109, 110). Twice in the year. Once in the year. Received fiom other Councils. Forwarded to other Councils. Notices served on Occupiers as to Lists. Failing to keep or permit spection of lists. Failing to send lists. Lists.† Outworkers.† Lists. Outworkers.† Contractors. Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (l3) (14) (15) (16) (17) (18) (19)  Wearing apparel— (1) making, &c. 38 74 20 15 17 27 271 82 — — — 116 9 9 — — — — (2) cleaning and washing 4 4 — 1 1 — 62 4 — — — — — — —• — — — Lace, lace curtains and nets — — — — — — — — — — — — — — — — — — Artificial flowers — — — — — — — — — — — — — — — — — — Nets, other than wire nets — — — — — — — — — — — — — — — — — — Tents — — — — — — — — — — — — — — — — — — Sacks — — — — — — — — — — — — — — — — — — Furniture and upholstery — — — — — — — — — — — — — — — — — — Fur pulling — — — — — — — — — — — — — — — — — — Feather sorting — — — — — — — — — — — — — — — — — — Umbrellas, &c. — — — — — — — — — — — — — — — — — — Carding, &c. of buttons, &c. — — — — — — — — — — — — — — — — — — Paper bags and boxes — — — — — — — — — — — — — — — — — — Basket making — — — — — — — — — — — — _ — — — — — Brush making — — — — — — — — — — — — — — — — — — Racquet and tennis balls — — — — — — — — — — — — — — — — — — Stuffed toys — — — — — — — — — — — — — — — — — — File making — — — — — — — — — — — — — — — — — — Electro plate — — — — — — — — — — — — — — — — — — Cables and chains — — — — — — — — — — — — — — — — — — Anchors and grapnels — — — — — — — — — — — — — — — — — — Cart gear — — — — — — — — — — — — — — — — — — Locks, latches and keys — — — — — — — — — — — — — — — — — — Pea picking — — — — — — — — — — — — — — — — — — Total 42 78 20 16 18 27 333 86 — — — 116 9 9 — — — — *If an occupier gives out work of more than one of the classes specified in column 1, and subdivides his list in such a way as to snow the number of workers in each class of work, the list should be included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers should be assigned in columns 3 and 4 (or 6 and 7) into their respective classes. A footnote should be added to show that this has been done. †The figures required in columns 2, 3 and 4 are the total number of lists (received from employers who sent them both in February and August as required by the Act) and of the entries of names of outworkers in those lists. They will, therefore, usually be double of the number of such employers and (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. 170 4.—REGISTERED WORKSHOPS. Workshops on the Register (S.131) at the end of the year. Number.  Important cases of workshops such as workshop houses may be enumerated here bakehouses 61 dressmakers 248 restaurants, etc. 135 others 592 Total number of workshops on Register 1036 5.—OTHER MATTERS. Class. Number. Matter notified to H. M. Inspector of Factories— Failures to affix Abstract of the Factory and Workshop Act, (S. 133) — Action taken in matters ferred by H. M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (S.5) Notified by H. M. Inspector 11 Reports (of action taken) sent to H. M. Inspector 11 Other 6 Underground bakehouses (S. 101)— Certificate granted during the year — In use at the end of the year 33 Note—The Factory and Workshop Act, 1901 (s. 132), requires the Medical Officer of Health in his Annual Report to the Borough Council to report specifically on the administration of that Act in workshops and workplaces, and to send a copy of his Annual Report, or so much of it as deals with this subject, to the Secretary of State (Home Office). If the Annual Report is presented other than in print, it is unnecessary to include in the copy sent to the Home Office the portions which do not relate to factories, workshops, laundries, workplaces or homework The duties of Local Authorities and the Medical Officer of Health under the Act of 1901 are detailed in the Home Office Memorandum of December, 1904. A further Memorandum, on the Home Work Provisions of the Factory Act, was issued to all Borough Councils and Medical Officers of Health in October, 1906. 171 ICE CREAM DEALERS. The London County Council (General Powers) Act, 1902, which came into operation on the 1st November, 1902, by Part VIII., made provision for the regulation, manufacture, and sale of ice cream or other similar commodities. The duty of obtaining the necessary information for the registration of premises upon which ice creams are made has been carried out as heretofore by Sanitary Inspector S. Huggons Brown. At the present time there are 227 premises upon the register and 37 notices have been served, all of which have been complied with. Sanitary Inspector S. Huggons Brown, besides having charge of the work appertaining to ice cream dealers, supervises the duties which were transferred from the London County Council in reference to the registration of premises where milk is stored or sold; also slaughter-houses and offensive trades. The following is a table in reference to the above-named premises. DAIRIES, COWSHEDS and MILKSHOPS ORDER, &c. PROCEEDINGS DURING 1908. PREMISES. NUMBER OF PLACES. Number of inspections, 1908. Number of notice, 1908. Number of cutions, 1908.  On ter at end of 1907. Added in 1908. Removed in 1908. On ter at end of 1908. Milk Premises 300 21 7 314 894 96 nil. Cowsheds nil. nil. nil. nil. nil. nil. nil. Slaughter-houses 10 nil. 1 9 117 17 nil. Offensive trade premises 4 nil. nil. 4 52 7 nil. Ice Cream premises 200 30 3 227 476 37 nil. 172 As far as time permitted, having regard to the extra work thrown upon the Inspector in consequence of the large amount of extra work at the FrancoBritish Exhibition, the registered premises were under inspection. During the year four cases of infectious disease occurred upon premises where milk was sold. The regulations under the above Order appertaining to the stoppage of sale of milk, disinfection, and the granting of certificates thereafter were strictly enforced under my directions by the Officer carrying out the transferred duties. There were 92 applications made during the year for Registration of Premises for sale of Milk, and after inspection certificates were granted SUMMONSES ORDERED. During last year your Council and the Public Health Committee gave authority for 31 summonses to be taken out against persons for having failed to comply with the requirements of notices which had been served. In all cases before summonses were issued a letter was written to the person in default, informing him that the Public Health Committee had recommended the summons, and asking him if he was willing to give an undertaking in writing that he would forthwith comply with the notice which had been served. In 30 cases the undertaking was at once given, and it was not found to be necessary to apply for the summons. It has been the object of the department, as heretofore, to take out as few summonses as possible, but at the same time in no instance to allow anyone to defy the authority of your Council. During last year two summonses were taken out through the Public Health Department. HAM 1O 173 LIST OF SUMMONSES HEARD. SITUATION OF PREMISES. NATURE OF OFFENCE. RESULT OF PROCEEDINGS.  4, Roxwell Road Defective drains. Defendant paid £2 2s. costs and carried out the 'work required by the Council. Uxbridge Road. For not exhibiting in a legible manner on a conspicuous part of a barrow a notice stating the name and address of the manufacturer of Ice Cream sold by him. Fined 6s. and 2s. costs. PUBLIC MORTUARY. During last year 244 bodies were removed to the mortuary at Fulham Palace Road. There were 195 bodies brought to the mortuary by order of the Coroner or the Police; 60 bodies were taken from the West London Hospital and 49 bodies were received for accommodation. PUBLIC NUISANCES. During last year I had occasion to bring before your Public Health Committee a complaint in reference to the following alleged Public Nuisance in the Borough. Complaint having been made as to a nuisance alleged to be caused by deposit of refuse on certain land on the east side of Wood Lane, in the occupation of the Great Western Railway Company and Mr. Latter, a contractor, I visited the premises and reported thereon to the Public Health Committee, who gave the matter full and careful consideration. 174 SMOKE ABATEMENT. During last year observations were made in reference to the amount of black smoke emitted from the undermentioned premises, and during the same period 19 statutory notices were issued. Eight preliminary notices were also served. The chimneys of the following premises were the subject of the above-mentioned observations :— The Central London Railway, Wood Lane, Shepherd's Bush. Swan Laundry, Blythe Road. West Kensington Park. Kensington Palace Laundry, Spring Vale Terrace, West Kensington Park. Hammersmith Borough Council's Electricity Works. Eton Laundry, Orchard Road, Shepherd's Bush. Glen Laundry, Landor Road, Shepherd's Bush. Waring's Factory, Cambridge Road, Hammersmith. 74, Askew Road (Bakehouse). Phœnix Brewery, Latimer Road. Carpet Beating Works, Wharf Road, Latimer Road. Compressed Air Carpet Beating Company, Brook Green. Incandescent Electric Lamp Works, Brook Green. Kensington and Notting Hill Electric Lighting Company, Wood Lane. Fuller's Limited, Great Church Lane, Hammersmith. Great Western Railway Company's Gas Retorts and Sheds, Scrubs Lane, Willesden Junction. Royal Chiswick Laundry, British Grove. Gwynne's Iron Works, Hammersmith, Lyons & Company, Limited, Cadby Hall, Hammersmith. Knight's Carpet Beating Works, Scrubs Lane, Willesden. Victoria Laundry, Great Church Lane, Hammersmith. Kensington Model Laundry, Goldhawk Road. A number of complaints were received from the London County Council and the Coal Smoke Abatement Society, and in each instance observations were kept upon the premises until no evidence of the emission of black smoke could be obtained. 175 LEGISLATION (PUBLIC HEALTH), 1908. During the year 1908 several Acts of Parliament bearing upon the important question of the Public Health of the County of London received the Royal Assent, i.e.:— The London County Council (General Powers) Act, 1908, Part II., Section 5, gives power to Sanitary Authorities to remove from or refuse to enter on Register names of Cowkeepers, Dairymen or Purveyors of Milk in certain circumstances, subject to a provision that any person who thinks himself aggrieved by any decisions of a Sanitary Authority under the provisions of this Section, may, at any time, within twenty-one days from the date of such decision, appeal against the same to a Court of Summary Jurisdiction. The London County Council issued the following circular in reference to the matter of milk supply to London:— COUNTY OF LONDON. Milk Supply (Tuberculosis). The London County Council, pursuant to Section 31 of the London County Council (General Powers) Act, 1907, hereby gives notice of the provisions of Part IV. of the said Act relating to the supply of milk in the County of London. The effect of these provisions is as follows:— Power to take samples of milk and inspect cows. The Council's Medical Officer of Health or other duly authorised person may take, within and outside the County, samples of milk produced or sold or intended for sale within the County; and if the Council so resolve, the officers of a sanitary authority may as regards their district also take samples of milk for examination by the Council subject to such conditions as the Council may prescribe. The Medical Officer or other duly authorised person may in company with a veterinary surgeon enter any dairy within or outside the County from which milk is being sold or suffered to be sold or used within the County and inspect the cows kept therein, and if the Medical Officer or such person has reason to suspect that any cow is suffering from tuberculosis of the udder he may take samples of the milk of such cow. 176 Power to prohibit supply of milk. If it appears on the reports of the Medical Officer and the veterinary surgeon that tuberculosis is caused or is likely to be caused to persons residing in the County from the consumption of milk from any dairy within or outside the County or from any cow kept therein, the Council may make an order prohibiting the supply of such milk in the County until the order has been withdrawn, and any person contravening the order shall be liable to a penalty of £5, and for a continuing offence to a daily penalty of 40s. Appeal may be made against the Council's order. Obstructing Officers. Any dairyman or person in his employment refusing any reasonable assistance or obstructing the Medical Officer or duly authorised person or veterinary surgeon in his duties shall be liable to a penalty of £5. Selling milk from diseased cow. Every person who knowingly sells or suffers to be sold or used for human consumption within the County the milk of any cow suffering from tuberculosis of the udder shall be liable to a penalty of £10, and any person failing to isolate such cow in his dairy shall be liable to a penalty of £5. Notice in case of disease. Every dairyman who supplies milk within the County shall give notice to the Medical Officer of any cow in his dairy affected with or suspected of or exhibiting signs of tuberculosis of the udder, and any dairyman failing to give notice shall be liable to a penalty of 40s. For further information reference should be made to the London County Council (General Powers) Act, 1907, copies of which can be obtained from Messrs. Eyre and Spottiswoode, East Harding Street, E.C., or Messrs. Wyman and Sons, Limited, Fetter Lane, E.C., price 3s. 3d. each. The Council in further pursuance of Section 31 of the before mentioned Act, also gives notice that a meeting held on the 26th May, 1908, it fixed the 1st July, 1908, as the day on which the provisions of Part IV. of the said Act shall come into operation G. L. Gomme, Clerk of the London County Council. County Hall, Spring Gardens, S.W., 29th May, 1908. 177 Section 6 of the same Act gives power to Sanitary Authorities to appoint Health Visitors under certain regulations to be prescribed by the Local Government Board. Section 7 makes certain provisions as to the accommodation for working in tenement houses provided that the sections shall not apply to any tenement house used or occupied as such before the passing of the Act. Section 8 provides sanitary regulations for premises used for sale, etc., of food for human consumption, as follows:— From and after the passing of this Act the following provisions shall apply to any room, shop, or other part of building within the County in which any article, whether solid or liquid, intended or adapted for the food of man is sold, or exposed for sale or deposited for the purpose of sale, or of preparation for sale, or with a view of future sale. (a) No urinal, water closet, earth closet, privy or ashpit or other like sanitary convenience shall be within such room, shop, or other part of a building, or shall communicate therewith except through the open air or through an intervening ventilated space. (b) No cistern for supplying water to such room, shop, or other part of a building shall be in direct communication with and directly discharge into any such sanitary convenience. (c) No drain or pipe for carrying off fœcar or sewage matter shall have any inlet or opening within such room, shop, or other part of a building. (d) No room, shop, or other part of a building shall be used as a sleeping place, and so far as may be reasonably necessary to prevent risk of the infection or contamination of any such article as aforesaid no sleeping place shall adjoin such room, shop, or other part of a building and communicate therewith except through the open air or through an intervening ventilated space. (e) Refuse or filth whether solid or liquid shall not be deposited or allowed to accumulate in any such room, shop, or part of a building except so far as may be reasonably necessary for the proper carrying on of trade or business. (f) Due cleanliness shall be observed with regard to such room, shop, or other part of a building, and all articles, 178 apparatus and utensils therein, and shall be observed by persons engaged in such room, shop, or part of a building. If any person occupies or lets, or knowingly suffers to be occupied any such room, shop, or other part of a building, wherein any of the conditions prohibited by this section exist, or does or knowingly permits any act or thing therein in contravention of this section he shall be liable on summary conviction to a fine not exceeding for a first offence twenty shillings, and for every subsequent offence five pounds, and in either case to a daily penalty not exceeding twenty shillings. Section 9 empowers the London County Council to make By-laws with respect to the businesses of a vendor of fried fish, a fish curer and a rag and bone dealer. The London County Council has also issued an inportant notification as to the administration of the provisions of the Children Act, 1908, so far as relates to the keeping of nurse infants, as follows:— LONDON COUNTY COUNCIL. Public Control Department. Children Act, 1908. Notice as to the keeping of Nurse Infants. Infants received for hire. Any person who undertakes for reward the nursing and maintenance of one or more infants under the age of seven years apart from their parents for a longer period than forty-eight hours, shall within that time give notice in writing of the fact to the Council. Removal or death of infant. Notice of the removal or death of a nurse infant must within forty-eight hours be sent to the Council, Notice of the death of a nurse infant must within twenty-four hours be sent to the Coroner. If a death certificate has been issued such certificate should be sent with the notice to the Coroner. Forms of notice for the above purposes can be obtained from the Council and any person who has received an infant as aforesaid and fails to give notice as aforesaid or wilfully makes or causes any other person to make any false or misleading statement in any such notice shall be guilty of an offence. 179 Number of infants which may be kept. The number of nurse infants to be kept in a notified dwelling will be fixed by the Council, and no infant must in excess of the number so fixed. Inspection. A visitor duly appointed and authorised in writing by the Council will from time to time inspect the infants referred to in any notice and the dwelling in which they are kept in order to be satisfied as to the nursing and maintenance of the infants and to give any necessary advice or directions. It will be an offence to refuse to allow such officers to visit or examine the infants or the dwelling. Improperly keeping infants An infant shall not be received (a) into premises that are overcrowded, ous or insanitary, (b) by any person who by reason of negligence, ignorance or other cause is unfit to have the care of it, (c) by any person from whose care an infant has been removed by order of a local authority, (d) by any person who has been convicted of cruelty to an infant. Life insurance. A person who receives an infant in respect of which notice is required to be given cannot benefit under any insurance on the life of the infant, and any such person who directly or indirectly insures or attempts to insure the life of such infant will be guilty of an offence. Separate cots. Each infant should sleep in a separate cot. Section 13 of the Act provides for a penalty under the conditions set out in the section where an infant dies of suffocation when sleeping in the same bed as an adult. Fire guards Every fire should be protected with a fire guard. Section 15 of the Act provides for a penalty where through the absence of fire guards an infant is killed or suffers serious injury. Intoxicating liquor. Any person who gives intoxicating liquor to an infant under the age of five years is liable to a penalty of three pounds, except it is given on the order of a doctor or in case of sickness or other urgent cause Any further information and the forms of notice above referred to can be obtained on application to the Chief Officer of the Public Control Department, 31, Spring Gardens, S.W. 180 METEOROLOGY. The average mean temperature registered in London during last year was 50.1° Fahrenheit. The highest temperature registered was 84° in July. The lowest temperature was 12° in December. Rain fell on 150 days. The total amount of rainfall was 23.78 inches. I am, Gentlemen, Your obedient servant, N. C. COLLIER, l.r.c.p., l.s.a., Medical Officer of Health ANNUAL REPORT OF THE PUBLIC ANALYST, Year ended 31st March, 1909. 182 REPORT OF THE PUBLIC ANALYST Upon the Articles analysed during the Year ended 31ST March, 1909. To the Mayor, Aldermen, and Councillors of the Metropolitan Borough of Hammersmith. Gentlemen, I have pleasure in presenting my Annual Report for the year ending 31st March, 1909. During the twelve months ending on that date 605 samples were submitted to me for examination. Of these, 602 were purchased by Inspector Oatley under the provisions of the Sale of Food and Drugs Acts, and of the remaining samples 2 were submitted by the Borough Surveyor, and 1 by the Borough Engineer. In Table I. are given the number of samples received under the Sale of Food and Drugs Acts during the several quarters of the year, together with the number classified as "Genuine," "Inferior," and "Adulterated." Of the total number examined, 448 were reported as genuine, 75 as adulterated, whilst 79 were of inferior quality. TABLE I. Samples Received. Genuine. Genuine but of Inferior Quality. Adulterated. Total. 1908. Quarter ending June 30 104 25 21 150 „ „ „ Sept. 30 110 6 23 139 „ „ „ Dec. 31 113 24 26 163 1909. „ „ Mar. 31 121 24 5 150 183 Including the unofficial samples taken for information the percentage of adulteration was 12.4 as compared with 16.5 last year. The percentage for the whole Metropolis as given in the last Local Government Board report, namely that for 1907, is 10.0 The percentage of articles of inferior quality, where actual adulteration could not be certified, was 13.1 this year and 11.6 last year. In Table II. will be found a statement of the number and nature of the various articles examined during the year, together with particulars of the prosecutions which were instituted. TABLE II. Article No. of Samples Examined. Result of Examination. Summonses heard. Penalties Inflicted. Genuine. Inferior. Adulterated. £ s. d.  Arrowroot 2 2 — — — — Bloater Paste 1 1 — — — — Bread 1 1 — — — — Butter 210 148 12 50 15 35 16 6 Cheese 68 67 1 — — — Chocolate 2 1 — 1 — — „ Assorted 1 - 1 — — — „ Nut 1 - — 1 — — „ Powder 2 2 — — — — Cocoa 10 7 — 3 2 4 11 0 „ Mixture 2 2 — — — — Coffee 6 5 — 1 1 2 5 0 „ and Chicory 6 3 3 — — - Cornflower 1 1 — — — — Egg Flour 1 1 — — — — Flour, Self-raising 1 1 — — — Gin 2 1 1 — — — Honey 1 1 — — — — Ice Cream 7 7 — — — — Indian Corn, Ground 1 1 — — — — 184 TABLE II.—continued. Article. No of Samples Examined. Result of Examination. Summons heard. Penalties Inflicted. Genuine Inferior. Adulterated. £ S. d. Jam, Raspberry 6 6 — — — Jam, Raspberry, with Fruit Juice 1 - 1 - - — — Kidneys, Pigs 1 1 — — — — „ Sheeps 1 1 — — — — Lard 7 7 — — — — Margarine 10 10 — — — — Milk 205 130 57 18 12 21 14 0 Milk, condensed 2 2 — — — — Milk, condensed machine skimmed 2 2 — — — Milk, skimmed 3 3 — — — — Milk, machine skimmeo. 2 1 — 1 — — Mustard 8 8 — — — Pepper, Black 5 5 — — — — „ Cayenne 5 5 — — — — „ White 2 2 — — — — Rum 2 2 — — — — Sugar, Moist 2 2 — — — — Tea 5 5 — — — — Vinegar, Malt 3 2 1 — — — „ Wood 3 3 — — — — Whisky, Scotch 2 — 2 — — — Totals 602 448 79 75 — 64 6 6 185 MILK. During the year 205 samples of Milk were examined, and of these 130 were reported as genuine, 57 as inferior, and 18 as adulterated, particulars of which are as follows: During the year 205 samples of Milk were examined, and of these 130 were reported as genuine, 57 as inferior, and 18 as adulterated, particulars of which are as follows: TABLE III. Milk Samples. Adulteration certified.  1 Fat Abstracted 15% and Added Water 4% 2 „ 51 per cent. 3 „ 31 „ 4 „ 15 „ 5 „ 11 „ 6 „ 10 „ 7 „ 7 „ 8 Added Water 17 „ 9 „ 14 „ 10 „ 11 „ 11 „ 8 „ 12 „ 7 „ 13 „ 6 „ 14 „ 5 „ 15 „ 3 „ 16 „ 3 „ 17 „ 2 „ 18 „ 2 „ The following table gives the average composition of the Milk calculated on the total number of genuine, inferior, and adulterated samples taken in the Borough during the four quarters of the year: TABLE IV. Samples received. Total Solids. Fat. Non-fatty Solids.  1908. Quarter ending June 30 11.99% 3.41% 8.58% „ „ „ Sep. 30 12.33% 3.70% 8.63 % „ „ „ Dec. 31 12.49% 3.56% 8.93% 1909. „ „ Mar. 31 12.45% 3.55% 8.90% Average for year 12.32 % 3.55% 8.76% 186 The percentage of adulteration for the year in the case of Milk is 8.8 as compared with 9.7 for the preceding year. The percentage of adulteration calculated from the Local Government Board Returns for the whole Metropolis for the year 1907, was 11.1. Butter.—During the year 210 samples were examined, and of these 148 were found to be genuine, 12 genuine but of inferior quality, and 50 adulterated. The percentage of adulterated samples was therefore 23.8, and of inferior samples 5.7 per cent. All of the adulterated Butters consisted of Margarine. The extent of adulteration is given below:— 80 to 90 per cent. Foreign Fat 10 samples. 70 to 80 „ „ 31 „ 60 to 70 „ „ 1 „ 50 to 60 „ „ 1 „ 40 to 50 „ „ 6 „ 30 to 40 „ „ 1 „ One of the above samples also contained 1% excess of water. After deducting the repeat samples taken for information the percentage of adulteration for Butter is 8.0 as compared with 5.7 for last year. Coffee and Coffee and Chicory Mixtures.—Of the six Coffees analysed five were of genuine quality, and one was adulterated with Chicory to the extent of 40%. Of the six samples of Coffee and Chicory, three were genuine, and three which contained a high percentage of Chicory were returned as inferior. Cocoa.—Three of the Cocoa samples examined were adulterated. The adulteration in all three cases consisted of the addition of sugar and foreign starch to the extent of between thirty and forty per cent. of each adulterant, and in one of the samples the Cocoa matter present contained not less than nine-tenths of its weight of Cocoa shell. Spirits.—Two samples of Scotch Whisky, two of Rum, and two of Gin were submitted for analysis during the year, and of these, three samples—both the Whiskies and one of the Gins—were diluted practically to the limit, and were returned as inferior. Condiments.—Twelve samples of Pepper, including five black, two white, and five Cayenne, were all found to be genuine, as also were eight samples of Mustard. 187 Chocolate.—Four samples of Cake Chocolate were purchased and examined, and of these two were reported as adulterated. Genuine Cake Chocolate consists of a mixture of Cocoa Nib (containing its full proportion of fat), cane sugar, and usually a trace of flavouring material such as vanilla, &c. If sold as milk chocolate a distinct proportion of milk solids should be present. One of the adulterated samples was sold as "milk chocolate" and the other as "nut chocolate." Upon analysis it was found that the first of these consisted of sugar, arrowroot starch and cocoa shell containing only a minute proportion, if any, of nib, whilst the fat present was derived almost entirely from a source other than the cocoa bean. No evidence of the presence of any milk solids could be obtained. In the case of the other sample the material in which the nuts were embedded had a similar composition. Taking into consideration the large amount of ordinary cake chocolate and milk chocolate now consumed, this form of "chocolate" must be a source of considerable profit to manufacturers since the price of cocoa shell is only a fraction of the cost of cocoa nib. Prosecutions were instituted last year by the City of Westminster in similar cases and the vendors convicted and fined. It would appear that the substitution of cocoa shell for cocoa nib is now spreading from chocolate to ordinary cocoa powder. In February a sample purchased by Inspector Oatley as cocoa was found to consist of 38 per cent. of sugar, 30 per cent. of sago starch, and 32 per cent. of cocoa shell. It may be mentioned that the latter substance is the outer coating of the cocoa beans, and when removed the latter break down into angular pieces known as nibs. The shell or husk contains only half the nitrogen found in the nonfatty portion of the nib whilst the fat present is only about 2.5 per cent. as compared with at least 50 per cent. in the nib. In the case of this particular sample a prosecution was instituted and the vendoer convicted and fined. In addition to the articles taken under the Sale of Food and Drugs Acts, I have examined one sample of Carbolic Powder and one of Carbolic Soap submitted by the Borough Surveyor, and one sample of Turbine Deposit from the Borough Engineer. I am, Gentlemen, Your obedient Servant, P. A. ELLIS RICHARDS. April, 1909. Public Analyst.