HAM 11 Annual Report OF THE Medical Officer of Health OF THE BOROUGH of HAMMERSMITH For the Year 1909. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE BOROUGH OF HAMMERSMITH For the Year 1909. Public Health Department, Town Hall, Hammersmith. February 22nd, 1910. 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 52 weeks ending on 1st January, 1910. 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 4 direction of the Local Government Board, some of the figures consequently materially differ from the figures in the published return of the Registrar-General, who is not restricted to the same prescribed forms. BIRTHS. During last year 2,887 births, 1,447 males, 1,440 females, were registered in this Borough against 3,102 in the previous year. Making due allowance for the increase of the population, the number of births registered last year was 419 below the average number registered during the previous 10 years. On the population estimated up to the middle of the year, i. e., 125,704 inhabitants, the number of births registered was equal to an annual rate of 23.0 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., 4,833,938 inhabitants, was equal to an annual rate of 24.3 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 2,995. I have no data at my disposal for so correcting the births in this Borough. DEATHS. During last year 1,778 deaths were registered in this Borough, 879 males, 899 females, against 1,754 in the previous year. Making due allowance for the increase of the population, the number of deaths registered in the Borough last year was 34 above the average number registered during the previous 10 years. 5 Adding 217 deaths of residents of this Borough, which took place in general hospitals and other public institutions in other Boroughs of London, in London County Lunatic Asylums and Metropolitan Imbecile Asylums, and deducting 220 deaths of non-residents which occurred, 172 at the West London Hospital, 33 at Nazareth House, 14 at the Hammersmith Infirmary, and 1 at St. John’s Hospital, Uxbridge Road, the corrected number of deaths of residents registered last year was 1,775. On the before-mentioned estimated population, the corrected number of deaths of residents registered last year was equal to an annual rate of 14.1 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 14.7 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 361, against 383 in the previous year. The number of deaths of infants under one year of age registered last year was equal to 203 per 1,000 of the total deaths of residents registered, and to 125 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 186 per 1,000 of the total deaths registered, and 107 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, 17 per 1,000, and, as compared with the total births registered, 18 per 1,000 greater in this Borough than in London. 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. 6 LOCAL GOVERNMENT BOARD RETURN.— TABLE V. Infant Mortality during the year 1909. 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 58 22 19 14 113 33 32 21 25 25 23 23 16 20 13 17 361 Uncertified — — — — — — — — — — — — — — — — — i. Common Infectious Diseases. Small-pox — — — — — — Chicken-pox — — — — — — — — — — — — — — — — — Measles — — — — — — — — — — 3 2 2 4 4 4 19 Scarlet Fever — — — — — 1 — — — — — — — — — — 1 Diphtheria (including Membranous Croup) — — — — — — — — — — — — — — — — 3 Whooping Cough — — — — — 2 1 — 4 2 2 2 2 — 3 2 20 ii. Diarrhœal Diseases. Diarrhœa, all forms 2 — — 2 1 4 6 2 6 3 6 1 3 — 34 Enteritis, Muco-enteritis, Gastroenteritis — — 1 1 2 — 1 1 — 2 — 1 — — — 2 9 Gastritis, Gastro-intestinal Catarrh — — — — — — 1 — 1 — — — — — — — 2 iii. Wasting Diseases. Premature Birth 30 8 6 3 47 4 — — — — — — — — — — 51 Congenital Defects 5 — 2 — 7 1 1 — 1 — 1 1 — — — — 12 Injury at Birth 10 — — — 10 — — — — — — — — — — — 10 Want of Breast-Milk, Starvation — — — — — — — — — — — — — — — — — Atrophy, Debility, Marasmus 5 7 2 4 18 6 7 4 2 3 — 2 — — — — 42 iv. Tuberculous Diseases. Tuberculous Meningitis — — — — — 1 — 2 1 2 1 — 1 — — 1 9 Tuberculous Peritonitis : Tabes Mesenterica — — — — — — 1 1 1 — 1 — 2 — — — 6 Other Tuberculous Diseases — — — — — — — — — 1 — 1 — 3 — — 5 v. Other Causes. Erysipelas — — — — — — — — — — — — — — — — — Syphilis — 1 — — 1 1 1 — — — — — 1 — — — 4 Rickets — — — — — — — — — — — — — — — — — Meningitis (not Tuberculous) — — — — — — — — 3 — 1 — — — 1 5 Convulsions 3 2 4 1 10 5 — 2 2 3 1 — — — — 1 24 Bronchitis — 1 3 2 6 1 6 1 2 — 2 2 — 4 1 — 25 Laryngitis — — — — — — — — — — — — — — — — — Pneumonia 1 — — 1 2 7 5 3 7 2 8 3 6 3 2 5 53 Suffocation, overlying 2 — 1 — 3 1 1 — 1 1 — — — — — — 7 Other causes 2 1 — 2 5 2 3 1 1 — 1 1 2 3 — 1 20 58 22 19 14 113 33 32 21 25 25 23 23 16 20 13 17 361 Population (estimated to middle of 1909), 125,704. Births in the Year: Legitimate, 2,795; Illegitimate, 92. Deaths in the Year of: Legitimate Infants, 330; Illegitimate Infants, 31. Deaths from all Causes at all Ages, 1,775. 7 Table showing the Infantile Mortality Rates of the County of London, the City of London, and the Metropolitan Boroughs during the 52 Weeks of 1909, as calculated by the Registrar-General. Deaths under 1 year to 1,000 Births Registered. County of London 108 Lewisham 74 Hampstead 75 Stoke Newington 80 Woolwich 82 Wandsworth 86 City of Westminster 95 St. Marylebone 99 Paddington 100 Camberwell 100 Greenwich 100 Islington 101 St. Pancras 102 Holborn 102 Hackney 102 Deptford 102 Battersea 107 Chelsea 107 Fulham 108 Lambeth 109 City of London 113 Kensington 113 Stepney 119 Southwark 119 Hammersmith 120 Poplar 129 Bethnal Green 129 Finsbury 131 Bermondsey 138 Shoreditch 140 * The Registrar-General has calculated this figure on the corrected births of Hammersmith, which he gives at 2,995 instead of 2,887, and the corrected deaths of infants as 360, which I make 361. 8 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, males 255, females 334, against 589 in the previous year. These deaths last year were equal to 4.7 per 1,000 of total persons living, and 332 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 4.8 per 1,000 of the total persons living, and 341 per 1,000 of the total deaths of London residents registered. This death rate was, therefore, 1 less in this Borough than in London as compared with the total persons living, and 9 per 1,000 less in this Borough than in London as compared with the total deaths registered. 9 LOCAL GOVERNMENT BOARD RETURN.—TABLE I. Vital Statistics of Whole District during: 1909 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 registered 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. Num ber. Rate per 1,000 Births R.gistered. Number. Rate* Number. Rate* 1 2 3 4 5 6 7 8 9 10 11 12 13 1899 108785 3061 28.1 527 172 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 167 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 14..5 602 233 173 1717 14..0 1908 124012 3102 25.0 391 123 1754 14.1 640 210 213 1757 14.2 Averages for years 1899-1908 116511 3064 26.3 429 140 1616 13..9 327 173 350 1786 15..3 1909 125704 2887 23.0 367 125 1778 14.1 592 220 217 1775 14.1 * Rates in Columns 4, 8, and 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 subtraction 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. 1 lie •• i-'ubiic institutions to be taken into account for the purpose 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 I. Institutions within the District receiving sick and infirm persons from outside the District. West London Hospital. Nazareth House. Hammersmith Infirmary. St. John's Hospital for Skin Diseases, Uxbridge Road II. Institutions outside the District receiving sick and infirm persons from the District. General Hospitals, and other Public Institutions of a like character. London County Lunatic Asylums and Metropolitan Imbecile Asylums. Fever and Small Pox Hospitals of the Metropolitan Asylums Board. Islington Fever Hospital. III. Other Institutions, the deaths in which have been distributed among the several localities in the District. 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. At Census of 1901. 10 DEATHS OF RESIDENTS. Belonging to the Borough occurring in Public Institutions, &c., in districts outside, during the year 1909. Fever Hospital. Western Fever Hospital 1 General Hospitals. St. Mary's Hospital 9 Brompton Hospital 4 Middlesex Hospital 8 St. George's Hospital 16 Samaritan Free Hospital 2 Children's Hospital, Paddington Green 5 Cancer Hospital, Chelsea 5 Children’s Hospital, Great Ormond Street 5 Victoria Hospital, Chelsea 2 Bethnal Green Hospital 1 Queen Charlotte’s Hospital 3 Friedenheim Hospital 1 Gordon Hospital 1 University College Hospital 4 St. Bartholomew’s Hospital 1 London Temperance Hospital 1 King’s College Hospital 2 Heart Hospital, Soho 1 Evelina Hospital 1 National Hospital, Queen Square 1 Guy’s Hospital 1 Queen’s Hospital 1 Homoeopathic Hospital, Great Ormond Street 1 Bethlem Royal Hospital 1 Asylums. Banstead Asylum 9 Hanwell Asylum 22 Middlesex County Asylum, Wandsworth 2 Horton Asylum, Epsom 4 Cane Hill Asylum 1 Dartford Heath Asylum 1 Long Grove Asylum 4 Caterham Asylum 5 Colney Hatch Asylum 4 Camberwell House Asylum 1 Tooting Bee Asylum 5 Leavesden Asylum 1 Other Institutions. Home of Compassion, Paddington 1 Fulham Infirmary 5 Fulharn Workhouse 4 St. Joseph’s Home, Kensington 1 Salvation Army Maternity Home, Hackney 1 St. Peter’s Harbour, 10, Greville Place, Marylebone 1 Children’s Infirmary, Epsom 1 St. Joseph’s Hospice, Hackney 1 Children’s Infirmary, Carshalton 1 St. Luke’s House, Kensington 5 Chelsea Infirmary 2 Kensington Infirmary 3 Paddington Infirmary 1 Hospice of St. John and St. Elizabeth, Marylebone 1 Home for Invalids, 2, Highbury Terrace 1 Marylebone Workhouse 1 St. George’s Infirmary, Chelsea 1 Various. 43, Streatham Hill 1 In railway train, Broad Street Station 1 25, Uxbridge Street, Kensington 1 11, Drayson Mews, Kensington 1 H.M. Prison, Pentonville 1 In road opposite Marble Arch, Marylebone 1 188, Brixton Hill 1 Holland Park Avenue, Kensington 1 In Kitchen, Salters’ Hall, Cannon Street 1 5, Belgrave Terrace, Lambeth 1 17, The Grove, Greenwich 1 63, Sutherland Street, Belgrave 1 40, Grove End Road, Marylebone 1 7, Bedford Court Mansions, St. Giles 1 11 LOCAL GOVERNMENT BOARD RETURN.—TABLE II. Vital Statistics ol Separate Localities in 1909 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 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 1908 124012 3102 1757 383 53196 1615 769 182 50829 1017 676 133 19987 470 312 68 Averages of Years 1899 to 1908 or years in which figures are available. 116511 3064 1786 445 50032 1490 784 217 47760 1102 686 145 18790 471 289 68 1909 125704 2887 1775 361 53922 1538 815 186 51522 885 643 115 20260 464 317 60 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 1 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. (b) Deaths of residents occurring in public institutions beyond the district are to be included in sub-columns c of this Table, and those of non- residents registered in public institutions in the district excluded. (See note on Table I. as to meaning of terms “resident” and “nonresident.”) (c) 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. (d) 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. 12 Corrected Death-rates of Metropolitan Boroughs after Distribution of Deaths- in Public Institutions, &c., as calculated by the Registrar-General for year 1909. Death rate from all causes. Average County of London 14.7 Hampstead 10.1 Lewisham 10.8 Stoke Newington 11.1 Greenwich 12.4 Wandsworth 12.5 Fulham 12.6 Woolwich 12.8 Hackney 13.1 Paddington 13.8 Camberwell 13.9 Battersea 14.0 Deptford 14.3 Kensington 14.4 Lambeth 14.5 Islington 14.6 City of Westminster 14.7 *Hammersmith 14.9 Chelsea 15.0 St. Pancras 15.5 St. Marylebone 15.6 Stepney 16.0 Poplar 16.8 Holborn 16.8 Bethnal Green 17.0 Southwark 17.5 Bermondsey 19.2 Finsbury 19.9 Shoreditch 20.0 City of London 22.3 The calculation of the Registrar-General is not made on the same figures as mine. * 1 give the death rate of Hammersmith as 14.1, as 1 deduct the deaths of Non-Parishioners which occurred at Nazareth House. 13 LOCAL GOVERNMENT BOARD RETURN.— TABLE IV. Causes of, and Ages at, Death during Year 1909. Name of District. METROPOLITAN BOROUGH OF HAMMERSMITH. Causes 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. Centre. South. 1 2 3 4 5 6 7 8 9 10 11 12[ Small-pox 0 0 0 0 0 0 0 0 0 0 0 Measles 84 19 65 0 0 0 0 39 28 17 2 Scarlet Fever 9 1 3 4 1 0 0 5 2 2 0 Whooping Cough 39 20 18 1 0 0 0 17 12 10 5 Diphtheria (including Membranous Croup) 26 3 15 8 0 0 0 13 5 8 3 Croup 1 0 0 1 0 0 0 1 0 0 0 Fever Typhus 0 0 0 0 0 0 0 0 0 0 0 Enteric 5 0 0 0 2 3 0 1 3 2 Other continued 0 0 0 0 0 0 0 0 0 0 0 Epidemic Influenza 37 0 0 1 4 18 14 16 16 5 0 Cholera 0 0 0 0 0 0 0 0 0 0 0 Plague 0 0 0 0 0 0 0 0 0 0 0 *Diarihœa 42 34 4 0 0 2 2 27 10 5 30 *Enteritis 13 9 2 0 0 1 1 9 2 2 5 *Gastritis 7 2 0 0 0 3 2 3 2 2 2 *Puerperal Fever 8 0 0 0 3 5 4 3 1 4 Erysipelas 3 0 0 0 1 1 1 0 3 0 1 Phthisis (Pulmonary Tuberculosis) 139 2 3 1 25 105 3 60 52 27 41 Other Tuberculous Diseases 50 18 21 3 3 4 1 18 20 12 20 *Cancer, malignant disease 110 0 0 0 1 66 43 47 42 21 54 Bronchitis 167 25 6 1 0 38 97 80 68 19 26 Pneumonia 231 53 34 3 2 84 55 105 82 44 80 Pleurisy 2 0 1 0 0 1 0 2 0 0 0 Other Diseases of Respiratory Organs 4 0 1 0 1 1 3 0 1 0 Alcoholism Cirrhosis of Liver 19 1 0 0 0 17 1 6 9 4 6 Venereal Diseases 6 4 0 1 0 1 0 0 5 1 6 Premature Birth 51 51 0 0 0 0 0 32 10 9 2 Diseases and Accidents of Parturition 6 0 0 0 1 5 0 4 2 0 2 Heart Diseases 144 6 0 9 10 59 60 53 63 28 36 Accidents 58 18 4 4 4 21 7 20 21 17 58 Suicides 11 0 0 0 3 7 1 3 5 3 2 Cerebro Spinal Meningitis 1 0 1 0 0 0 0 1 0 0 0 All other Causes 502 95 27 10 8 149 213 246 178 78 205 All Causes 1775 361 205 47 69 591 502 815 643 317 592 * See notes on next two pages. 14 NOTES TO TABLES IV. AND V. (a) In Table IV., all deaths of “Residents” occurringin 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 9-11, 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” occurring in public institutions in the district are in like manner to be excluded from columns 2-8 and 9-11 of Table IV. (b) 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 occurring 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. (rf) The total deaths in the several “Localities” in columns 9-11 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 9-11, and the figures for the year in column 12 of Table I. (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 (other than Asiatic or epidemic), and Cholera Nostras. Deaths from diarrhœa secondary to some other well-defined disease should be included under the latter. Deaths from Enteritis, Muco-Enteritis, Gastro-Enteritis, and Gastritis (see under the heading Diarrhœal Diseases in Table V.) in Tables IV. and V. should be placed immediately below, but separately from, those enumerated under the heading Diarrhœa as defined by enumeration above. This is particularly important for deaths under one year of age, as many of the deaths in infancy returned as due to Enteritis are really caused by Epidemic Diarrhœa. In the course of years, by the adoption of this recommendation, it will be practicable to ascertain the probable amount of transfer between these different headings. (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 Pyæmia, Septicæmia, Sapræmia, Pelvic Peritonitis, Peri- and Endo-Metritis occurring in the Puerperium. 15 (g) Under “Congenital Defects” in Table V. are to be included deaths from Atelectasis, Icterus Neonatorum, Navel Hæmorrhage, Malformations and Congenital Hydrocephalus. (h) Under “Tuberculous Meningitis” are to be included deaths from Acute Hydrocephalus. (i) Under “Other Tuberculous Diseases” are to be included deaths from Tuberculosis, Tuberculosis of bones, joints and other organs, Lupus and Scrofula. (j) 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.” 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. COLLIER, Medical Officer of Health. February 22nd, 1910. 16 DEATHS FROM THE NINE PRINCIPAL ZYMOTIC DISEASES. The total number of deaths of Residents that were registered from the nine principal zymotic diseases was 205 against 171 in the previous year. The deaths of Residents last year from these diseases were equal to 115 per 1,000 of the total deaths of Residents registered, and were at the rate of 1.6 deaths per 1,000 persons living. The deaths from the nine principal zymotic diseases in the whole of London were equal to 93 per 1,000 of the total deaths registered, and were at the rate of 1.3 deaths per 1,000 persons living. These deaths were, therefore, as compared with the total deaths of Residents registered, 22 greater per 1,000 deaths belonging to this Borough than in London, and, as compared with the population, 3 per 1,000 greater 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 1900 to 1909:— YEAR. Small-pox. Measles. Scarlet Fever. Diphtheria and Membranous Croup. Whooping Cough. Typhus Fever. Enteric Fever. Simple continued Fever. Diarrhcea and Cholera. Total. 1900 0 87 7 28 7 0 18 0 138 285 1901 14 50 13 36 75 0 16 1 134 339 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 39 161 1908 0 14 11 15 18 0 5 0 108 171 1909 0 84 9 26 39 0 5 0 42 205 Average in last 10 years. 3 58 10 24 33 0 9 0 99 236 17 It will be seen from the above table that the total number of deaths from these zymotic diseases last year was, making no allowance for the increase in population, below the average number registered in the last 10 years. CASES OF ILLNESS REPORTED AS DUE TO INFECTIOUS DISEASE. There were, omitting phthisis, 675 cases reported as due to notifiable infectious diseases in this Borough against 683 in the previous year. The number of cases of phthisis notified was 199. There were also reported 1,268 cases of infectious diseases that were not notifiable, against 439 in. the previous year; 140 of these were chicken-pox, 847 measles, and 281 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 forty cases of chicken-pox were reported, against 113 cases in the previous year. The 140 cases reported last year were treated at the homes of the patients. No death was registered. MEASLES. Eight hundred and forty-seven cases were reported as due to measles, against 161 cases in the previous year. Eighty-four 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 18 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 were reported to me. A strict system of disinfection was carried out in accordance with the provisions of the Public Health (London) Act, 1891, and very little opposition was met with. The disinfection in the case of measles has entailed a large amount of extra work on the Public Health Department, and particularly so on the Disinfectors. From the whole of the notifiable infectious diseases there were only 52 deaths, whereas from measles alone there were 84 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 cases were notified as due to scarlet fever, against 383 in the previous year. Three hundred and nine cases reported last year were isolated at Isolation Hospitals, and 71 cases were treated at the homes of the patients. Nine deaths were registered. The mortality rate on the cases reported was only 2.4 per cent. DIPHTHERIA AND DIPHTHERITIC MEMBRANOUS CROUP. One hundred and eighty-eight cases were reported as due to diphtheria or diphtheritic membranous croup, against 199 cases in the previous year. One hundred and sixty-seven cases reported last year were treated at the Isolation Hospitals, and 21 at the homes of the patients. Twenty-six deaths were registered. The mortality rate on the cases reported was 13.8 per cent. 19 WHOOPING COUGH. Two hundred and eighty-one cases were reported as due to whooping cough, against 156 cases in the previous year. All of the cases reported last year were treated at the homes of the patients. Thirty-nine 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. Seventeen cases were reported as due to enteric fever, against 29 in the previous year. Twelve of the cases reported last year were treated at the Isolation Hospitals of the Metropolitan Asylums Board, and five at the homes of the patients. Five deaths were registered. The mortality rate on the cases reported was 29.4 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 no case in the previous year. RELAPSING FEVER. No case was reported as due to relapsing fever, against no case in the previous year. 20 PUERPERAL FEVER. Fourteen cases were reported as due to puerperal fever, against six cases in the previous year. Seven of the cases reported last year were treated at the homes of the patients, 1 at the West London Hospital, and 6 of the cases were treated at the Hammersmith Infirmary. Eight deaths were registered. The mortality rate on the cases reported was 47.1 per cent. CHOLERA. No case was reported as due to cholera, against no case in the previous year. ERYSIPELAS. Seventy-five cases were reported last year as due to erysipelas, against 65 cases in the previous year. Sixty-three cases were treated at the homes of the patients, 11 at the Hammersmith Infirmary, and one at the West London Hospital. Three deaths were registered. The mortality rate on the cases reported was 4.0 per cent. PLAGUE. No case was reported as due to plague, against no case in the previous year. CEREBRO-SPINAL FEVER. One case was reported as due to cerebro-spinal fever, against one case in the previous year. The case reported last year was treated at the home of the patient. One death was registered, the mortality rate being 100 per cent. 21 TABULAR STATEMENT—ZYMOTIC DISEASES. The following table shows the number of cases that were reported as due to the undermentioned 15 zymotic diseases during the years 1900 to 1909. 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. 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 0 115 0 28 193 207 0 1241 1902 92 349 172 0 49 0 0 7 0 110 0 659 293 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 0 125 0 219 417 286 0 1698 1906 0 439 270 0 13 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 4 1984 1908 0 383 199 0 29 0 0 6 0 65 0 113 161 156 1 1113 1909 0 380 188 0 17 0 0 14 0 75 0 140 847 281 1 1943 A‛v’ge in last 10 yrs. 15 378 211 0 49 1 0 8 0 103 0 183 444 165 1 1558 * Not a notifiable disease. † Disease was made notifiable on 13th September, 1907. COMPULSORY NOTIFICATION OF INFECTIOUS DISEASES. The London County Council issued an order for the notification of Cerebro-Spinal Fever (Epidemic Cerebro-Spinal Meningitis). The disease of Cerebro-Spinal Fever (Epidemic Crebro-Spinal Meningitis) has been made notifiable within the Administrative County of London, and this disease is notifiable throughout the whole of the Administrative County of London for a period up to and including the 13th March, 1910; and an order was also issued for the 22 NOTIFICATION OF GLANDERS, ANTHRAX, AND HYDROPHOBIA IN MAN. I have received from the Clerk to the London County Council a copy of the following order:— “The London County Council doth hereby resolve and order that Section 55 of the Public Health (London) Act, 1891, with respect to the notification of infectious disease, shall apply, in the Administrative County of London, to the diseases known as Glanders, Anthrax, and Hydrophobia in man." This order, came into operation as from and including 26th April, 1909. 23 LOCAL GOVERNMENT BOARD RETURN.—TABLE III. Cases of Infectious Disease notified during: the year 1909. METROPOLITAN BOROUGH OF HAMMERSMITH. Notifiable Disease. 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 Centre South W Centre South Total cases removed to Hospital. Under 1 1 to 5 5 to 15 15 to 25 25 to 65 65 and upwards North North 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) 188 6 62 97 12 11 0 93 51 44 84 44 39 167 Erysipelas 75 1 3 8 8 47 8 27 35 13 3 6 3 12 Scarlet Fever 380 6 100 210 39 25 0 174 146 60 137 121 51 309 Typhus Fever 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Enteric Fever 17 0 0 6 6 5 0 9 7 1 6 5 1 12 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 14 0 0 0 4 10 0 4 5 5 2 3 2 7 Plague 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Cerebro Spinal Meningitis 1 0 1 0 0 0 0 1 0 0 0 0 0 0 Phthisis 199 0 1 4 32 158 4 75 65 59 38 42 28 108 Totals 874 13 167 325 101 256 12 383 309 182 270 221 124 615 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, and the accommodation, available for the district, afforded by it. Mack (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. † These age columns for notifications should be filled up in all cases where the Medical Officer of Health, by inquiry or otherwise, has obtained the necessary information. 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, and when necessary the Small-pox Hospitals of the Metropolitan Asylums Board. 24 The following table of Deaths from Infectious Diseases is compiled from the Registrar's General Report. Boroughs. Population estimated to the middle of 1909. Births. Deaths from Deaths under 1 year of Age. All causes. Principal Epidemic Diseases. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping-cough. Typhus. Enteric Fever. Pyrexia (Origin uncertain). Diarrhæa. Phthisis. COUNTY OF LONDON 4,833,938 116,559 67,632 6,285 2 2,324 283 605 1,246 — 146 2 1,577 6,337 12,582 West. Paddington 151,955 3,120 1,956 136 36 14 10 36 — 4 — 36 164 312 Kensington 183,683 3,362 2,440 183 — 58 9 19 40 — 8 — 49 176 379 Hammersmith 125,704 2,995 1,791 210 — 80 11 23 47 — 5 — 44 137 360 Fulham 176,406 4,307 2,113 276 — 74 10 40 49 — 4 — 99 205 466 Chelsea 75,249 1,391 1,084 75 — 24 6 15 13 — 2 — 15 109 149 City of W'stmnstr 168,883 2,730 2,212 104 1 25 18 18 19 — 7 — 16 225 260 North. St. Marylebone 126,027 2,595 1,836 105 — 33 8 9 25 — 1 — 29 170 258 Hampstead 94,185 1,328 839 50 — 14 4 5 18 — 5 — 4 57 99 St. Pancras 237,422 5,609 3,510 230 — 105 17 27 30 — 6 — 45 382 570 Islington 351,202 8,320 4,913 423 — 199 26 30 86 — 13 — 69 430 843 Stoke Newington 54,423 1,025 612 34 — 10 3 2 14 — 1 — 4 45 82 Hackney 237,601 5,416 2,288 220 — 57 10 19 51 — 6 — 77 289 550 Central. Holborn 53,802 976 836 45 — 14 3 3 15 — 1 — 9 110 100 Finsbury 95,289 2,810 1,829 224 — 85 11 14 51 — 3 — 60 211 367 City of London 18,193 247 368 13 — 6 — — 4 — 1 — 2 39 669 East. Shoreditch 114,802 3,632 2,178 328 — 130 9 22 72 — 6 — 89 200 510 Bethnal Green 131,316 4,132 2,201 260 — 79 25 17 40 — 4 — 95 202 535 Stepney 312,525 9,506 4,759 526 1 236 26 51 69 — 6 — 137 521 1,130 Poplar 171,965 5,192 2,787 405 — 156 23 20 84 — 13 — 109 221 669 South. Southwark 211,125 5,969 3,528 350 — 127 14 33 57 — 6 — 113 377 711 Bermondsey 127,569 4,104 2,388 348 — 200 15 9 55 — 2 — 67 227 567 Lambeth 324,188 7,578 4,544 387 — 104 27 58 85 — 9 1 103 455 823 Battersea 186,036 4,447 2,416 239 — 90 8 22 63 — 7 — 49 227 477 Wandsworth 297,646 7,005 3,524 286 — 111 14 27 69 — 6 1 58 275 601 Camberwell 283,022 6,689 3,776 306 — 105 17 43 52 — 5 — 84 337 666 Deptford 118,583 3,117 1,611 178 — 67 12 15 47 — 6 — 31 148 317 Greenwich 111,014 2,481 1,350 114 — 38 9 7 20 — 4 — 30 110 249 Lewisham 160,749 3,529 1,656 93 — 6 15 21 20 — 2 — 29 128 262 Woolwich 133,374 2,947 1,587 137 — 55 19 26 15 — 3 — 19 160 242 25 The following table of Deaths from Infectious Diseases per 1,000 persons living is compilec from the Registrar's General Report. Boroughs. Per 1,000 Persons Living. Deaths under 1 year to 1,000 Births. Births. Deaths From All Causes. Principal Epidemic Diseases. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping-cough. Typhus. Enteric Fever. Pyrexia (Origin uncertain). Diarrhœa. Phthisis. Crude. Corrected. COUNTY OF LONDON 24.2 14.0 14.7 1.31 0.00 0.48 0.08 0.13 0.26 — 0.03 0.00 0.33 1.31 108 West. Paddington 20.6 12.9 13.8 0.91 0.24 0.09 0.07 0.24 — 0.03 0.24 1.08 100 Kensington 18.4 13.3 14.4 1.00 — 0.32 0.05 0.10 0.22 — 0.04 — 0.27 0.96 113 Hammersmith 23.9 14.3 14.9 1.67 — 0.64 0.09 0.18 0.37 — 0.04 — 0.35 1.09 120 Fulham 24.5 12.0 12.6 1.57 — 0.42 0.06 0.23 0.28 — 0.02 — 0.56 1.17 108 Chelsea 18.5 14.4 15.0 1.00 — 0.32 0.08 0.20 0.17 — 0.03 — 0.20 1.45 107 City of Westminster 16.2 13.1 14.7 0.63 0.01 0.15 0.11 0.11 0.11 — 0.04 — 0.10 1.34 95 North. St. Marylebone 20.6 14.6 15.6 0.83 0.26 0.06 0.07 0.20 _ 0.01 0.23 1.35 99 Hampstead 14.1 8.9 10.1 0.52 — 0.15 0.04 0.05 0.19 — 0.05 — 0.04 0.61 75 St. Pancras 23.7 14.8 15.5 0.97 — 0.44 0.07 0.11 0.13 — 0.03 — 0.19 1.61 102 Islington 23.8 14.0 14.6 1.22 — 0.57 0.07 0.09 0.25 — 0.04 — 0.20 1.23 101 Stoke Newington 18.9 11.3 11.8 0.63 — 0.18 0.06 0.04 0.26 — 0.02 — 0.07 0.83 80 Hackney 22.9 12.6 13.1 0.93 — 0.24 0.04 0.08 0.22 — 0.03 — 0.32 1.22 102 Central. Holborn 18.2 15.6 16.8 0.85 — 0.26 0.06 0.06 0.28 — 0.02 0.17 2.05 102 Finsbury 29.6 19.2 19.9 2.36 — 0.89 0.12 0.15 0.54 — 0.03 — 0.63 2.22 131 City of London 13.6 20.3 22.3 0.72 — 0.33 — — 0.22 — 0.06 — 0.11 2.15 113 East. Shoreditch 31.7 19.0 20.0 2.87 — 1.14 0.08 0.19 0.63 — 0.05 — 0.78 1.75 140 Bethnal Green 31.6 16.8 17.0 1.99 — 0.60 0.19 0.13 0.31 — 0.03 — 0.73 1.54 129 Stepney 30.5 15.3 16.0 1.68 0.00 0.76 0.08 0.16 0.22 — 0.02 — 0.44 1.67 119 Poplar 30.3 16.3 16.8 2.37 — 0.91 0.13 0.12 0.49 — 0.08 — 0.64 1.29 129 South. Southwark 28.3 16.8 17.5 1.67 — 0.60 0.07 0.16 0.27 0.03 0.54 1.79 119 Bermondsey 32.3 18.8 19.2 2.74 — 1.57 0.12 0.07 0.43 — 0.02 — 0.53 1.78 138 Lambeth 23.4 14. 1 14. 5 1.19 — 0.32 0.08 0.18 0.26 — 0.03 0.00 0.32 1.41 109 Battersea 24.0 13.0 14.0 1.29 — 0.49 0.04 0.12 0.34 — 0.04 — 0.26 1.22 107 Wandsworth 23.6 11.9 12.5 0.96 — 0.37 0.05 0.09 0.23 — 0.02 0.00 0.20 0.93 86 Camberwell 23.7 13.4 13. 9 1.08 — 0.37 0.06 0.15 0.18 — 0.02 — 0.30 1.19 100 Deptford 26.4 13.6 14.3 1.51 — 0.57 0.10 0.13 0.40 — 0.05 — 0.26 1.25 102 Greenwich 22.4 12.2 12.4 1.03 — 0.34 0.08 0.06 0.18 — 0.04 — 0.33 0.99 100 Lewisham 22.0 10.3 10.8 0.57 — 0.04 0.09 0.13 0.12 — 0.01 — 0.18 0.80 74 Woolwich 22.2 11.9 12.8 1.02 — 0.41 0.14 0.20 0.11 — 0.02 — 0.14 1.20 82 26 Death-rates during 1909 in London and the several Metropolitan Boroughs, from All Causes, and from Certain Diseases (I) before Distribution,* and (2) after Distribution of Deaths in Public Institutions, &c., as compiled by RegistrarGeneral. Boroughs. Death-rate per 1000 living. All Causes. Scarlet Fever. Diphtheria. Enteric Fever. Phthisis. Before Distribution After Distribution Before Distribution After Distribution Before Distribution After Distribulion Before Distribution Alter Distribution Before Distribution After Distribution County of London 14.2 14.0 0.07 0.08 0.13 0.13 0.03 0.03 1.29 l.3l West. Paddington 14.2 12.9 0.01 0.09 0.03 0.07 0.02 0.03 1.03 1.08 Kensington 15.1 13.3 — 0.05 0.01 0.10 0.03 0.04 1.65 0.96 Hammersmith 14.2 14.3 0.01 0.09 0.05 0.l8 0.02 0.04 0.93 1.09 Fulham 11.0 12.0 0.27 0.06 0.56 0.23 0.09 0.02 1.03 1.17 Chelsea 21.8 14.4 0.01 0.08 0.09 0.20 0.01 0.03 2.69 1.45 City of Westminster 14.3 13.1 — 0.11 0.04 0.11 0.04 0.04 0.75 1.34 North. St. Marylebone 14.0 14.6 0.02 0.06 0.02 0.07 0.02 0.01 0.79 1.35 Hampstead 11.3 8.9 0.37 0.04 0.39 0.05 0.05 0.05 1.47 0.61 St. Pancras 15.2 14.8 — 0.07 0.05 0.11 0.03 0.03 1.54 1.61 Islington 13.7 14.0 0.03 0.07 0.02 0.09 0.03 0.04 1.46 1.23 Stoke Newington 8.6 11.3 0.02 0.06 — 0.04 — 0.02 0.59 0.83 Hackney 13.0 12.6 0.11 0.04 0.23 0.08 0.04 0.03 1.30 1.22 Central. Holborn 19.9 15.6 0.06 0.11 0.06 0.04 0.02 1.47 2.05 Finsbury 9.2 19.2 — 0.12 — 0.15 0.01 0.03 0.74 2.22 City of London 50.7 20.3 — — 0.88 — 0.17 0.06 2.48 2.15 East. Shoreditch 17.7 19.0 0.08 0.02 0.19 0.04 0.05 1.74 1.75 Bethnal Green 17.1 16.8 0.01 0.19 0.05 0.13 0.03 0.03 1.63 1.54 Stepney 16.7 15.3 0.01 0.08 0.11 0.16 0.03 0.02 1.50 1.67 Poplar 16.2 16.3 0.02 0.13 0.04 0.12 0.03 0.08 1.37 1.29 South. Southwark 14.2 16.8 0.01 0.07 0.09 0.16 0.01 0.03 0.93 1.79 Bermondsey 15.4 18.8 0.01 0.12 — 0.07 — 0.02 1.60 1.78 Lambeth 15.1 14.1 0.12 0.08 0.26 0.18 0.05 0.03 1.37 1.41 Battersea 13.2 13.0 — 0.04 0.01 0.12 0.01 0.04 1.30 l.22 Wandsworth 11.1 11.9 0.10 0.05 0.16 0.09 0.01 0.02 0.89 0.93 Camberwell 14.6 13.4 0.06 0.04 0.15 0.01 0.02 1.73 1.19 Deptford 10.3 13.6 0.46 0.10 0.33 0.13 0.08 0.05 0.74 1.25 Greenwich 15.6 12.2 0.41 0.08 0.33 0.06 0.14 0.04 1.45 0.99 Lewisham 10.7 10.3 0.26 0.09 0.32 0.13 0.01 0.01 0.78 0.80 Woolwich 10.6 11.9 0.01 0.14 0.05 0.20 — 0.02 1.08 1.20 * The Deaths “before Distribution” are those actually registered in the several Boroughs without any correction whatever. 27 LONDON AND THE METROPOLITAN BOROUGHS. Death rates per 1,000 persons living and Infantile Mortality (corrected) in the five years, 1904-1908, and in 1909, as issued by Registrar General. Boroughs. All Causes. SmallPox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Pyrexia. Diarrhoea. Phthisis. Deaths under One Year to 1000 Births. 19041908. 1909. 19041908- 1909. 19041908. 1909. 19041908 1909. 19041908. 1909. 19041908. 1909. 1904- 1908. 1909. 19041908. 1909. 19041908. 1909. 19041908. 1909. 19041908. 1909. 1904 1908. 1909. County of London 14·9 14·0 0·00 0·00 0·39 0·48 0·11 0·08 0·15 0·13 0·30 0·26 — — 0·05 0·03 0·00 0·00 0·71 0·33 1·44 1·31 127 108 Paddington 13·1 12·9 0·00 — 0·26 0·24 0·09 0·09 0·10 0·07 0·19 0·24 — — 0·04 0·03 — — 0·58 0·24 1·08 1·08 113 100 Kensington 13·7 13·3 0·00 — 0·30 0·32 0·06 0·05 0·11 0·10 0·21 0·22 — — 0·04 0·04 0·00 — 0·56 0·27 1·17 0·96 132 113 Hammersmith 14·5 4·3 — — 0·44 0·64 0·09 0·09 0·17 0·18 0·27 0·37 — 0·05 0·04 — — 0·71 0·35 1·25 1·09 130 120 Fulham 14·0 12·0 — — 0·42 0·42 0·09 0·06 0·18 0·23 0·35 0·28 — — 0·06 0·02 — — 1·08 0·56 1·22 1·17 134 108 Chelsea 15·3 14·4 — — 0·38 0·32 0·09 0·08 0·12 0·20 0·29 0·17 — — 0·04 0·03 — — 0·52 0·20 1·53 1·45 125 107 City of Westminster 13·1 13·1 — 0·01 0·13 0·15 0·07 0·11 0·07 0·11 0·12 0·11 — — 0·04 0·04 0·00 — o·33 0·10 1·40 1·34 107 95 St. Marylebone 15·2 14·6 — — 0·27 0·26 0·11 0·06 o·o9 0·07 0·17 0·20 — — 0·03 0·01 0·00 — 0·47 0·23 1·47 1·35 116 99 Hampstead 9·3 8·9 — — 0·12 0·15 0·06 0·04 0·06 0·05 0·10 0·19 — — 0·04 0·05 — — 0·17 0·04 0·76 0·61 83 75 Sr. Pancras 15·8 14·8 — — 0·37 0·44 0·11 0·07 0·12 0·11 0·32 0·13 — — 0·04 0·03 0·00 0·51 0·19 1·68 1·61 121 102 Islington 14·5 14·0 0·00 — 0·41 0·57 0·09 0·07 o·11 0·09 0·26 0·25 — — 0·05 0·04 0·00 — 0·49 0·20 1·32 1·23 118 01 Stoke Newington 12·3 11·3 — — 0·18 0·18 0·08 0·06 0·09 0·04 0·24 0·26 — — 0·04 0·02 — — 0·41 0·07 1·22 0·83 104 80 Hackney 13·8 12·6 0·00 — 0·31 0·24 0·12 0·04 0·17 0·08 0·23 0·22 — — 0·08 0·03 — — 0·80 0·32 1·25 1·22 125 102 Holborn I7·5 15·6 0·01 — 0·36 0·26 0·06 0·06 0·10 0·06 0·26 0·28 — — 0·06 0·02 — — 0·49 0·17 2·55 2·05 124 102 Fins bury 19·7 19·2 0·01 — 0·65 0·89 0·17 0·12 0·17 0·15 0·39 0·54 — — 0·09 0·03 — — 0·97 0·63 2·21 2·22 144 131 City of London 17·2 20·3 — — 0·08 0·33 0·09 — 0·12 — 0·20 0·22 — — 0·03 0·06 — — 0·18 ·11 1·69 215 106 113 Shoreditch 19·5 19·0 00·1 — 0·67 1·14 0·20 0·08 0·14 0·19 0·58 0·63 — — 0·06 0·05 — — 1·22 0·78 2·05 1·75 161 140 Bethnal Green 18·3 16·8 0·01 — 0·57 0·60 0·23 0·19 0·22 0·13 0·42 0·31 — — 0·07 0 ·03 0·00 — 0·92 0·73 1·99 1·54 145 129 stepney 17·4 15·3 0·00 0·00 0·60 0·76 0·I7 0·08 0·25 0·16 0·39 0·22 — — 0·07 0·02 o·oo — 1·05 0·44 1·74 1·67 136 119 Poplar I7·3 1·63 0·00 — o·53 0·91 O·l7 0·13 0·28 0·12 0·43 0·49 — — 0·07 0·08 — — 1·18 0·64 1·50 1·29 140 129 Southwark 18·2 16·8 0·00 — 0·60 0·60 0·14 0·07 0·16 0·16 0·39 0· 27 — — 0·06 0·03 o·oo — 0·94 0·54 2·09 1·79 146 119 Bermondsey 19·1 1·88 — — 0·70 1·57 o·19 0·12 0·17 6·07 0·36 0·43 — — 0·07 0·02 o·oo — 1·03 0·53 1·94 1·78 147 138 Lambeth 14·7 14·1 — — 0·35 ·32 o·1o 0·08 O·14 0·18 0·27 0·26 — — 0·04 0·03 o·oo 0·00 0·66 0·32 1·44 1·41 125 109 Battersea 13·6 13·0 — — 0·38 0·49 o·11 0·04 0·12 0·12 0·33 0·34 — — 0·04 0·04 — — 0·69 0·26 1·30 1·22 123 107 Wandsworth 12·5 11· 9 — — 0·27 0·37 0·08 0·05 0·14 0·09 0·20 0·23 — — 0·04 0·02 — 0·00 0·58 0·20 1·01 0· 93 1·12 86 Camberwell 14·0 13·4 — — 0·35 0·37 0·09 0·06 0·12 0·15 0·30 0·18 — — 0·04 0·02 — — 0·61 0·30 1·25 1·19 123 100 Deptford 14·9 13 ·6 — — 0·43 0·57 o·1o 0·10 0·14 0·13 0·33 0·40 — — 0·05 0·05 o·oo 0·78 0·26 1·28 1·25 126 102 Greenwich I3·3 12·2 — — 0·31 0·34 0·08 0·08 0·18 006 0·32 0·18 — — 0·06 0·04 — — 0·68 0·33 1·19 0·99 121 100 Lewisham 11·6 10 ·3 0·01 — 0·20 0·04 0·06 0·09 0·14 0·13 0·23 0·12 — — 0·02 0·01 o·oo — 0·52 0·18 0·87 0·80 101 74 Woolwich 12·8 11·9 — — 0·24 0·41 0·09 0·14 0·17 0·20 0·26 0·11 — — 0·05 0·02 o·oo — 0·65 0·14 1·39 1·20 110 82 28 INFLUENZA. Thirty-seven deaths were registered as due to influenza, against 25 deaths in the previous year. No official action was taken in reference 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, 199 cases were notified to me against 118 cases in the previous year. These, no doubt, represent only a small proportion of the cases that actually occurred, as 139 deaths were registered, against 159 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 199 cases notified last year, 174 were reported under the Public Health (Tuberculosis) Regulations, 1908, from Infirmaries, Workhouses, and District Poor Law Medical Officers. Only 9 were reported by private Medical Practitioners, 14 by the Medical Superintendent of Brompton Hospital, 1 by the Medical Superintendent of St. Margaret's Hospital, and 1 from the Royal Victoria Hospital, Netley. 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, 1909, I had received 29 notices that 9 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 Council 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 9 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. 185 Uxbridge Road John Mullet Allwright 40 Gold hawk Road Benjamin Holton 138 ,, Joseph Moore CENTRE DISTRICT. Wards Nos. 2 and 3. ADDRESS. NAME OF LICENSEE. 247 Goldhawk Road 55 Dalling Road Edgar P. Jarrett Oliver Albert Wright SOUTH DISTRICT. Ward No. I. ADDRESS. NAME OF LICENSEE. 35 Queen Street George A. Silcock 49 King Street Benjamin Holton 65 ,, Thomas Holton 321 ,, Stanley Brooks Midwinter 30 BAKEHOUSES. The 61 bakehouses now in use as bakeries in the Borough were under a regular half-yearly inspection by the Factory Inspector. Ninety-eight 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. 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 Uxbridge 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 31 CENTRE DISTRICT. Wards Nos. 2 and 5. address. name. *54 Richmond Road J. Alderton *13 Shepherd's Bush Green Not in use *87 Masboro' Road W. Chance 348 King Street Not in use *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. Fowers *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. Miller *1 Aldensley Road W. Nau *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 32 SOUTH DISTRICT. Ward No. I. address. name. 65 Bridge Road W. Bass 88 Queen Street F. Taylor †1 Eyot Gardens J. R. Chibnall, 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 Miss H. E. Tolhurst † Great Church Lane Fullers, Limited 7 St. Peter's Road W. Hooks *Underground Bakehouses. † Factory Bakehouses. 33 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 5·60 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 34 Table Showing 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 35 CUSTOMS AND INLAND REVENUE ACTS. During the year 25 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 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. 1, 2 and 3, Goodwin House 1 Block 3 1 — 2 (not completed) 149, The Grove 1 House 4 — — 4 (not completed) 33 to 36, Mark Mansions 1 Block 4 — — 4 (not completed) 1 to 4, Cornwall Mansions 1 Block 4 — — 4 (not completed) 1 to 23, Pennard Mansions 3 Blocks 23 19 — 4 not com pleted) 45 and 46, Richmond Gardens 2 Houses 4 2 — 2 (not completed) 1 to 8, Lytton House 1 Block 8 — — 8 (not completed) Carried forward 10 50 22 — 28 36 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 10 50 22 — 28 1 to 5, Blomfield Garden 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 — 4 — 11, Nasmyth Street 1 House 2 2 - — 84-84A, Sinclair Road 1 House 2 2 — — 1 to 12, Evesham House 1 Block 12 12 — — 1 to 7, Brook Green Studios 1 Block 7 7 — — 1 to 19, Marguerite Mansions 3 Blocks 19 19 — — 182, The Grove 1 House 2 — — 2 (not completed) 1 to 5, The Lodge Mansions 1 Block 5 — — 5 (not completed) 193, Dalling Road 1 House 2 — — 2 (not completed) 370, Uxbridge Road 1 House 3 — — 3 (not completed) 1 to 4, Essex House 1 Block 4 — — 4 (not completed) 1 to 4, Gloucester House 1 Block 4 — — 4 (not completed) 29 to 31, Bassein Park Road 2 Houses 4 — — 4 (not completed) 3 and 41 to 53, Mall Road 8 Houses 17 — — 17 (not completed) Totals 39 154 64 4 86 37 One hundred and twenty-nine Intimation Notices were served in reference to defects found to exist in certain of the above premises, and ninety-three Notices were complied with. The following is a list of the premises certified by me during the year:— 1, Goodwin House, Goodwin Road. 45, Richmond Gardens. 46, Richmond Gardens. 11, Nasmyth Street. 84-84a, Sinclair Road. 1-12, Evesham House, Stanlake Road. 1-7, Brook Green Studios, Brook Green. 1-19, Marguerite Mansions, Queen Street. SEIZURE OF UNWHOLESOME FOOD. During last year one seizure was made of food which was unsound, unwholesome and unfit for the food of man, particulars of which are given under the head of summonses heard. HOUSES LET IN LODGINGS. During the last year the Public Health Committee gave directions for the registration of 465 "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 4,279 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 747 houses have been removed from the list, leaving a total number now on the Register of 3,532. During the year 166 notices were served and 126 were complied with. The registered premises were visited as often as time would allow by the special Inspector appointed for that purpose. 38 SANITARY NOTICES AND ADMINISTRATION. During last year 2,314 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 2,729 in the previous year, and during last year 2,215 notices were reported as having been complied with, against 2,638 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 3,054 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 993 houses, and 993 Intimation Notices were served by the House-to-House Inspector. These cases were subsequently dealt with by the four District Inspectors. Four hundred and sixty-one 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. The Health Visitor reports to me that she has made 2,428 visits with regard to the care of infants, and has advised parents as to the methods of feeding, clothing, etc. She also reports to me that she discovered 70 premises on which insanitary conditions existed. SANITATION OF THE IMPERIAL INTERNATIONAL EXHIBITION. The Sanitation of the Imperial International Exhibition had, as in the previous year, the most 39 careful consideration of your Public Health Committee both as to the efficiency and sufficiency of the sanitary accommodation provided. Owing to the sparseness of attendance at the Exhibition the amount of sanitary accommodation was greatly in excess of the requirement. INSPECTION OF FACTORIES, Etc. Your factory inspector has during the year served 257 notices under the Factory and Workshop Act, and during the same period 244 notices have been complied with. During the previous year there were 253 notices served and 245 complied with. The following is a list of the Factories and Work shops upon the Register:— Restaurants, Hotels, &c. 136 Bakehouses (5 not used at present as Bakeries) 66 Bootmakers 69 Motor and Cycle Makers and Engineers 48 Dressmakers and Milliners 249 Laundries 305 Letterpress Printers and Bookbinders 29 Electrical and Mechanical Engineers 49 Smiths, Wheelwrights and Coachbuilders 35 Tailors 54 Bottle Washing Works 14 Dry Cleaning, Dyeing, and Carpet Beating Works 18 Firewood Cutters 15 Builders and Joiners (Machine) 31 Outworkers 551 Miscellaneous 111 1,780 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. In addition to this work Mr. Neighbour performed for a considerable part of the year the duties of Smoke Inspector. 40 Prepared in accordance with the form required by the Home Office on the administration of the Factory and Workshop Act, 1901, in connection with Factories, Workshops, Workplaces and Homework. 1.—INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspector. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 626 56 — Workshops (including Workshop Laundries) 1,399 137 — Workplaces (other than out-workers premises included in Part III of this report) 542 56 — Total 2,567 249 — 41 2.—DEFECTS FOUND AT FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts:— * Want of Cleanliness 97 95 ... ... Want of Ventilation 2 2 ... ... Overcrowding 1 1 ... ... Want of Drainage of Floors 16 16 ... ... Other Nuisances 127 125 ... ... Sanitary Accommo- dation. insufficient 3 3 ... ... unsuitable or defective 23 22 ... ... not separate for sexes 1 1 ... ... Offences under the Factory and Workshop Act:—† Illegal occupation of underground bakehouse (S. 10l) ... ... ... ••• Breach of special Sanitary requirements, for bakehouses (SS. 97 to 100) 84 84 ... ... Other Offences (Excluding offences relating to outwork, which are included in Part 3 of this report.) ... ... ... ... Total 354 349 ... ... * 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. 42 3.—HOME WORK. Nature of Work.* Outworkers' List, 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. Twice in the year. Once in the year. Received from other Councils. Forwarded to other Councils. Notices served on Occupiers as to List. Failing to keep or permit inspection of Lists. Failing to send Lists. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (S. 109, 110). Lists. † Outworkers. † Lists. Outworkers. † Contractors Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) Wearing apparel— (1) making, &c 48 62 85 14 12 8 214 110 ... ... ... 147 7 7 ... ... ... ... (2) cleaning and washing ... ... ... 1 ... 3 69 ... ... ... ... ... ... ... ... ... ... ... 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 48 62 85 15 12 11 283 110 ... ... ... 147 7 7 ... ... ... ... * 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 show 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. 43 4.—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year. Number. Important classes of workshops such as workshop bakehouses may be enumerated here bakehouses 61 dressmakers 249 restaurants, etc. 136 others 596 Total number of workshops on Register 1042 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 referred 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 10 Reports (of action taken) sent to H. M. Inspector 10 Other 2 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. 44 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, manufacturer, 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 was carried out up to June by Sanitary Inspector S. Huggons Brown, by Sanitary Inspectors Scott Addison, Wm. Brown, J. S. Cromack, and C. V. Nutley from June to October, and by Sanitary Inspector Gee for the remainder of the year. At the present time there are 224 premises upon the register and 15 notices have been served, all of which have been complied with. Sanitary Inspector S. Huggons Brown, besides having charge of work appertaining to ice cream dealers, supervised, up to June, 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 1909. PREMISES. NUMBER OF PLACES. Number of inspections, 1909. Number of notices, 1909. Number of prosecutions, 1909. On register at end of 1908. Added in 1909. Removed in 1909. On register at end of 1909. Milk premises 300 36 2 334 678 34 nil. Cowsheds nil. nil. nil. nil. nil. nil. nil. Slaughter-houses 9 nil. nil. 9 234 11 nil. Offensive trade premises 4 nil. nil. nil. 73 4 nil. Ice Cream premises 227 nil. 3 224 234 15 nil. 45 These registered premises were under regular inspection. During the year three 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 Officers carrying out the duties. There were 31 applications made during the year for registration of premises for sale of milk, and after inspection certificates were granted. In no case was a milkshop taken off the Register on the grounds that the premises were unsuitable. SUMMONSES ORDERED. During last year your Council and the Public Health Committee gave authority for 13 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 all 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 one summons was taken out through the Public Health Department. SUMMONS HEARD. SITUATION OF PREMISES. NATURE OF OFFENCE. RESULT OF PROCEEDINGS. 193, Uxbridge Road. Selling Condensed Milk unfit for the food of man. Fined £10 and 25s. costs. 46 PUBLIC MORTUARY. During last year 234 bodies were removed to the mortuary at Fulham Palace Road. There were 192 bodies brought to the mortuary by order of the Coroner or the Police; 58 bodies were taken from the West London Hospital, and 42 bodies were received for accommodation. PUBLIC NUISANCES. During last year I had occasion to bring before your Public Health Committee complaints in reference to the following alleged Public Nuisances 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. Complaint was also made of a nuisance from the keeping of pigs in Old Oak Lane. I visited the several premises and reported thereon to the Public Health Committee, who gave the matter full and careful consideration. The pig-keepers have since removed from the premises, as they were not willing to comply with your requirements to put the premises in a sanitary condition to your satisfaction. SMOKE ABATEMENT. During last year observations were made in reference to the amount of black smoke emitted from the under-mentioned premises, and during the same period 3 statutory notices were issued. Twenty-one preliminary notices were also served. 47 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. Phoenix 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. 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. 48 NOTIFICATION OF BIRTHS ACT, 1907. In reference to the enforcement of the provisions for the early notification of births, the following letter was addressed to the Council:— "Local Government Board, "Whitehall, S.W., "19th September, 1909. "Sir,— "I am directed by the Local Government Board to advert to their letters to the Borough Council of 23rd June, 1908, and 10th May last, in which they expressed the view that it is desirable that the Notification of Births Act, 1907, should be in operation throughout the Metropolis, and to state that they have now issued an Order declaring that from and after the 30th November the Act shall be in force in the Metropolitan Boroughs in which it has not been adopted. Amongst these is the Borough of Hammersmith. "Copies of the Order are enclosed. "By the terms of Section 2 (3) of the Act it will be the duty of the Borough Council forthwith to bring the provisions of the Act to the attention of all medical practitioners and midwives practising in their area, and the Board think it desirable that prior to the 30th November the Council should give public notice by advertisement in one or more newspapers circulating in their area of the fact that the Act will be in force in the Borough on and after that date. "I am further directed to call attention to the provisions of Section 1 of the Act, by which it will be the duty of the Borough Council to supply, without charge, stamped and addressed postcards containing the form of notice of the birth of a child to any medical practitioner or midwife residing or practising in their area who applies for the same. "The ultimate object of the Act is to reduce infant mortality, and with this view it is important that arrangements should be made by the Borough Council under which advice and instruction will be given in suitable cases to mothers and those who have the charge of infants. In this connection the Board may remind the Borough Council of the power to appoint one or more Health Visitors conferred on them by Section 6 of the London County Council (General Powers) Act, 1908, subject to the provisions contained in the Health Visitors (London) Order, 1909, copies of which, with an accompanying circular, were sent to the Borough Council on the 5th September last. "I am, Sir, "Your obedient servant, "(Sd.) H. C. NORRIS, "The Town Clerk, "Assistant Secretary. "Hammersmith." 49 An Order by the Local Government Board was issued in terms as follows :— Declaring the Notification of Births Act, 1907, to be in force. BETHNAL GREEN, CAMBERWELL, CHELSEA, HACKNEY, HAMMERSMITH, LEWISHAM, AND WANDSWORTH. METROPOLITAN BOROUGHS. To the London County Council;— To the Councils of the Metropolitan Boroughs of Bethnal Green, Camberwell, Chelsea, Hackney, Hammersmith, Lewisham, and Wandsworth, being Local Authorities within the meaning of the Notification of Births Act, 1907;— And to all others whom it may concern. WHEREAS by Section 2 of the Notification of Births Act, 1907 (herein-after referred to as "the Act"), provision is made with respect to the adoption, and to the incidents and consequences of the adoption, of the Act by a local authority, including the resolution of adoption, and the consent of the Local Government Board to that resolution;— And whereas by Section 3 of the Act it is enacted that the Local Government Board may by Order declare that the Act shall be in force in the area of any local authority who have power to adopt the Act, although the Act has not been so adopted, if They think it expedient, having regard to the circumstances of the area, and that in that case the Order of the Local Government Board shall have the same effect for the purpose as a resolution of adoption duly passed by the local authority of the area and assented to by the Local Government Board; 50 And whereas the Councils of the Metropolitan Boroughs of Bethnal Green, Camberwell, Chelsea, Hackney, Hammersmith, Lewisham, and Wandsworth, being Local Authorities who have power to adopt the Act, have not adopted the Act in their respective areas, and We, the Local Government Board, think it expedient, having regard to the circumstances of those areas, to declare that the Act shall be in force in the said areas: NOW THEREFORE, in the exercise of Our powers in that behalf, We do hereby Declare that from and after the Thirtieth day of November, 1909, the Act shall be in force in the area of each of the Councils of the Metropolitan Boroughs of Bethnal Green, Camberwell, Chelsea, Hackney, Hammersmith, Lewisham, and Wandsworth. Given under the Seal of Office of the Local Government Board, this Eighteenth day of October, in the year One thousand nine hundred and nine. L.S. JOHN BURNS, President. S. B. PROVIS, Secretary. 51 In accordance with the terms of the said Order of the Local Government Board, circular letters were forwarded to medical practitioners and midwives practising in the Borough, together with postcards for their use as required:— "Town Hall, "Hammersmith, W., "2nd December, 1909. "Dear Sir,— "Notification of Births Act, 1907. "I am directed by the Hammersmith Borough Council to inform you that the Notification of Births Act, 1907, is, in pursuance of an Order of the Local Government Board dated the 18th October, 1909, now in force in the area of the Hammersmith Borough Council, and to call your attention to the principal provisions of the Act. "The Act provides that the birth of a child within the area of the Borough Council shall be notified within 36 hours from the time of such birth to the Medical Officer of Health of the Borough by the father of the child or any person in attendance at the time of or within six hours after birth. This applies to any child which has issued forth from its mother after the expiration of the twenty-eighth week of pregnancy, whether alive or dead. A person failing to give the requisite notice of a birth will be liable on summary conviction to a penalty of Twenty Shillings. "I enclose ten stamped addressed postcards for the purpose of notification, and shall be pleased to furnish you with a further supply on hearing from you. "Yours faithfully, "H. THOMPSON, "Town Clerk" METEOROLOGY. The average mean temperature registered in London during last year was 48·9° Fahrenheit. The highest temperature registered was 86·2° in August. The lowest temperature was 13·6° in March. Rain fell on 186 days. The total amount of rainfall was 25·72 inches. I am, Gentlemen, Your obedient servant, N. C. COLLIER, L.R.C.P., L.S.A., Medical Officer of Health.