HAM 13 ANNUAL REPORT OF THE Medical Officer of Health OF THE borough of hammersmith For the Year 1911. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE BOROUGH OF HAMMERSMITH For the Year 1911. Public Health Department, Town Hall, Hammersmith. April 26th, 1912. 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 30th December, 1911. 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 figures slightly differ from the figures in the published return of the Registrar-General, who is not restricted to the same prescribed regulations. 2 BIRTHS. During last year 2,807 births, 1,443 males, 1,364 females, were registered in this Borough against 2,910 in the previous year. Making due allowance for the increase of the population, the number of births registered last year was 278 below the average number registered during the previous 10 years. Adding 128 births which occured outside the Borough, transferred by the Registrar-General as belonging to Hammersmith, and deducting 6 births which occurred in this Borough which are transferred to other districts by the RegistrarGeneral, the corrected number of births for last year was 2,929. On the population estimated up to the middle of the year, i e., 121,766 inhabitants, the corrected number of births registered was equal to an annual rate of 24.1 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., 4,521,301 inhabitants, was equal to an annual rate of 24.8 births per 1,000 persons living. These figures are calculated upon the corrected number of births registered. Distribution of the births of children whose parents lately resided elsewhere has been made. The Registrar-General has corrected the births by allotting them to the districts to which the mothers were said to belong. DEATHS. During last year 1,927 deaths were registered in this Borough, 998 males, 929 females, against 1,569 in the previous year. Making due allowance for the increase of the population, the number of deaths registered in the Borough last year was 285 above the average number registered during the previous 10 years. Adding 206 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, also 39 deaths of residents reported to me by the Registrar-General as having occurred in other parts of England, and deducting 259 deaths of non-residents 3 which occurred, 224 at the West London Hospital, 22 at Nazareth House, 12 at the Hammersmith Infirmary, and 1 at St. John's Hospital, Uxbridge Road, the corrected number of deaths of residents registered last year was 1,913. On the before-mentioned estimated population, the corrected number of deaths of residents registered last year was equal to an annual rate of 15.7 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 15.8 deaths per 1,000 persons living. This is the first time that information has been supplied by the Registrar-General to enable me to correct the death rate by adding the deaths of parishioners that have occurred outside London. DEATHS OF INFANTS. The corrected number of deaths of residents under one year of age registered last year was 434, against 304 in the previous year. The number of deaths of infants under one year of age registered last year was equal to 227 per 1,000 of the total deaths of residents registered, and to 148 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 212 per 1,000 of the total deaths registered, and 129 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, 19 per 1,000 greater in this Borough than in London. The great increase in infant mortality last year was due to the prolonged hot and dry weather in the summer. It clearly shows how little the infantile mortality can be controlled by official action and how greatly it is dependent on climatic conditions. Had there been a reduction of infant mortality one might have assumed that it was due to official advice to mothers. The following table on infantile mortality has been prepared by me in accordance with the direction of the Local Government Board. 4 Local Government Board Return.—Table IV. Infant Mortality during the year 1911. Nett Deaths from stated Causes at various Ages 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. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under 1 year. ALL CAUSES. Certified 85 11 15 16 127 80 105 61 61 434 Uncertified - - - — — — - — — - i. Common Infectious Diseases. Small-pox — — — — — — — — — — Chicken-pox — — — — — 1 — — — 1 Measles — — 1 — 1 — 1 4 4 10 Scarlet Fever — — — — — — — — — — Diphtheria and Croup — — — — — — — — 2 2 Whooping Cough — — — — — 3 2 3 6 14 ii. Diarrhœal Diseases Diarrhœa — — — 2 2 18 39 19 16 94 Enteritis — 1 — — 1 15 23 14 10 63 iii. Tuberculous Diseases. Tuberculous Meningitis — — — — — — 3 1 1 5 Abdominal Tuberculosis (b) — — — — — — — — 1 1 Other Tuberculous Diseases — — — — — — 3 I 2 6 iv.Wasting Diseases. Congenital Malformations (c) 5 2 — — 7 1 — — — 8 Premature Birth 58 6 4 3 71 6 — 1 — 78 Atrophy, Debility, and Marasmus 6 1 1 3 11 4 7 — — 22 v. Other Causes. Atelectasis 2 — — — 2 — — — — 2 Injury at Birth 2 — — — 2 — — — — 2 Erysipelas — — — — — 2 — — — 2 Syphilis — — — 2 2 — 3 — 1 6 Rickets — — — — — — — — — — Meningitis (not Tuberculous) — — — — — 3 3 — — 6 Convulsions 3 1 3 — 7 2 1 1 1 12 Gastritis — — — — — 1 — — 1 2 Laryngitis — — — — — — — — — — Bronchitis — — 2 1 3 2 4 4 1 14 Pneumonia (all forms) — — 3 1 4 9 10 10 13 46 Suffocation, overlying 4 — — 2 6 4 2 — 1 13 Other causes 5 — 1 2 8 9 4 3 1 25 85 11 15 16 127 80 105 61 61 434 Nett Births in the Year: Legitimate, 2,775; Illegitimate, 154. Nett Deaths in the Year of: Legitimate Infants, 377; Illegitimate Infants, 57. 5 NOTES TO TABLE IV. (a) The total in the last column of Table IV. should equal the total in column 10 of Table I., and in column 3 of Table III. (b) Under Abdominal Tuberculosis are to be included deaths from Tuberculous Peritonitis and Enteritis and from Tabes Mesenterica. (c) The total deaths from Congenital Malformations, Premature Birth, Atrophy, Debility and Marasmus, should equal the total in Table III. under the heading Congenital Debility and Malformation including Premature Birth. Want of Breast Milk should be included uuder Atrophy and Debility. (d) For references to the meaning of any other headings, see notes attached to Table III. In recording the facts under the various headings of Tables I., II., III. and IV., attention has been given to the notes on the Tables. N. C. COLLIER, Medical Officer of Health. 6 Table showing the Infantile Mortality Rates of the County of London, the City of London, and the Metropolitan Boroughs during the 52 Weeks of 1911, as calculated by the Registrar-General. Deaths under 1 year to 1,000 Births Registered. County of London 129 Hampstead 78 Woolwich 97 Stoke Newington 102 City of Westminster 103 Lewisham 104 St. Marylebone 108 Camberwell 109 Chelsea 109 St. Pancras 112 Holborn 115 Hackney 119 Wandsworth 122 Lambeth 123 City of London 124 Battersea 124 Fulham 125 Islington 127 Paddington 127 Greenwich 128 Kensington 133 Deptford 142 Stepney 144 Southwark 144 *Hammersmith 146 Bethnal Green 151 Finsbury 156 Bermondsey 156 Poplar 157 Shoreditch 170 *The Registrar-General has calculated this figure on the corrected births of Hammersmith, which he gives at 2,927 instead of 2,929, and the corrected deaths of infants as 428, which I make 434. 7 DEATHS OF AGED PERSONS. The corrected number of deaths of residents at 65 years of age and upwards that were registered during last year was 495, against 409 in the previous year. These deaths last year were equal to 4.1 per 1,000 of total persons living, and 259 per 1,000 of the total deaths of residents registered. The corrected deaths registered of persons at 65 years of age and upwards belonging to London last year was equal to 3.9 per 1,000 of the total persons living, and 257 per 1,000 of the total deaths of London residents registered. This death rate was, therefore, .2 greater in this Borough than in London as compared with the total persons living, and 2 per 1,000 greater in this Borough than in London as compared with the total deaths registered. 8 local government board return.—table I. Vital Statistics of Whole District during 1911 and Previous Years. BOROUGH OF HAMMERSMITH. Year. Population estimated to middle of each year. Births. Total Deaths Regostered in the District Transferable Deaths‡ Nett Deaths belonging to the District. Uncorrected Number. Nett. of Non-residents registered in the District.† of Residents not registered in the District.† Number. Rate. Under 1 Year of Age. At all Ages. Number.† Rate. Number Rate per 1,000 Nett Births. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1906 117037 3020 1591 13.2 173 355 1773 14.7 1907 117997 3006 1777 14.5 233 173 1717 14.0 1908 118957 3102 1754 14.1 210 213 1757 14.2 1909 119917 2887 1778 14.1 220 217 1775 14.1 1910 120877 2910 1569 12.3 240 209 1538 12.1 1911 121766 2807 2929 24.1 1927 15.8 259 245 434 148 1913 15.7 Notes.—This Table is arranged to show the gross births and deaths in the district, and the births and deaths properly belonging to it with the corresponding rates. For years before 1911 some of the corrected rates probably will not be available. The rates should be calculated per 1,000 of the estimated gross population. In a district in which large Public Institutions for the sick or infirm seriously affect the statistics, the rates in columns 5 and 13 may be calculated on a nett population, obtained by deducting from the estimated gross population the average number of inmates not belonging to the district in such institutions. *In column 6 are to be included the whole of the deaths registered during the year as having actually occurred within the district. In column 12 is to be entered the number in column 6, corrected by subtraction of the number in column 8 and by addition of the number in column 9. Deaths in column 10 are to be similarly corrected by subtraction of the deaths under 1, included in the number given in column 8, and by addition of the deaths under 1 included in the number given in column 9. †The Medical Officer of Health will be able from the returns made to him by the local Registrar of Deaths to fill in column 8 in accordance with the rule in the next paragraph below. The Registrar-General, either directly or through the County Medical Officer of Health, will supply the Medical Officer of Health with the particulars of deaths to be entered in column 9; and all such deaths must be included in this column, unless an error is detected, and its correction has been accepted by the Registrar-General. For column 4 the Registrar-General will furnish to the Medical Officer of Health, a Statement of the number of births needing to be added to or subtracted from the total supplied by the local Registrar. ‡ "Transferable Deaths" are deaths of persons who, having a fixed or usual Residence in England or Wales, die in a district other than that in which they resided. The deaths of persons without fixed or usual residence, e.g., casuals, must not be included in columns 8 or 9, except in certain instances under 3 (b) below. The Medical Officer of Health will state in column 8 the number of transferable deaths of "non-residents" which are to be deducted, and will state in column 9 the number of deaths of "residents" registered outside the district which are to be added in calculating the nett death-rate of his district. The following special cases arise as to Transferable Deaths:- (1) Persons dying in institutions for the sick or infirm, such as hospitals, lunatic asylums, workhouses, and nursing homes (but not almshouses) must be regarded as residents of the district in which they had a fixed or usual residence at the time of admission. If the person dying in an institution had no fixed residence at the time of admission, the death is not transferable. If the patient has been directly transferred from one such institution to another, the death is transferable to the district of residence at the time of admission to the first institution. (2) The deaths of infants born and dying within a year of birth in an institution to which the mother was admitted for her confinement should be referred to the district of fixed or usuaJ residence of the parent. (3) Deaths from Violence are to be referred (a) to the district of residence, under the general rule; (b) if this district is unknown, or the deceased had no fixed abode, to the district where the accident occurred, if known; (c) failing this, to the district where death occurred, if known; and (d) failing this, to the district where the body was found. Area of District in acres (exclusive of area covered by water) 2282.555 Total population at all ages 121,603 Number of inhabited houses 18,766 Average number of persons per house 6.5 At Census of 1911. 9 DEATHS OF RESIDENTS. Belonging to the Borough occurring in Public Institutions, &c., in districts outside, during the year 1911. Fever Hospitals. Western Fever Hospital 39 North Western Fever Hospital 6 London Fever Hospital 1 General Hospitals. St. Mary's Hospital 12 Middlesex Hospital 11 St. George's Hospital 8 Children's Hospital, Paddington 6 Victoria Hospital 5 St. Thomas' Hospital 4 German Hospital, Hackney 3 Grove Hospital 3 London Hospital 3 Charing Cross Hospital 2 University College Hospital 2 Cancer Hospital, Chelsea 2 Homœopathic Hospital 2 Children's Hospital, Great Ormond Street 2 Westminster Hospital 2 London Temperance Hospital 1 Evelina Hospital 1 King's College Hospital 1 National Hospital, Queen Square 1 Cheyne Hospital 1 Friedenheim Hospital 1 Great Northern Hospital 1 St. Bartholomew's Hospital 1 Guy's Hospital 1 General Lying-in Hospital Waterloo Road 1 Asylums. Hanwell Asylum 20 Banstead Asylum 6 Tooting Bec Asylum 5 Horton Asylum 4 Darenth Asylum 3 Long Grove Asylum 3 Manor Asylum 2 Leavesden Asylum 2 Colney Hatch Asylum 2 Caierham Asylum 2 Middlesex County Asylum 1 Other Institutions. Fulham Infirmary 4 St. Luke's House, Kensington 3 Queen Mary's Hospital, Carshalton 3 St. Marylebone Workhouse 2 St. Marylebone Infirmary 2 Hostel of God, 29, North Side 1 Kensington Infirmary 1 Paddington Infirmary 1 Chelsea Infirmary 1 Hospice of St. John and St. Elizabeth, St. Marylebone 1 Various. 6, Beaumont Street, Marylebone 2 Westminster Bridge Road Railway Station, Baker Street and Waterloo Railway 1 49, Church Street, Kensington 1 Craven Arms, Craven Passage, Strand 1 120, Boundary Road, Hampstead 1 7, Knaresborough Place, Ken- sington 1 59, Anselm Road, Fulham 1 The Serpentine, Hyde Park 1 4, Cambridge Buildings, Upper Garden Street, St. George's, Hanover Square 1 Bonnington Hotel, Southampton Row 1 New Schools, Arbour Square, Mile End 1 42, Racton Road, Fulham 1 15, Queensbury Place, Kensington 1 10 Corrected Death-rates of Metropolitan Boroughs after Distribution of Deaths in Public Institutions, &c., as calculated by the registrar-general for year 1911. Death rate from all causes. Average County of London 15.8 Hampstead 10.9 Lewisham 11.8 Wandsworth 12.6 Stoke Newington 13.6 Woolwich 13.7 City of Westminster 14.0 Paddington 14.3 Kensington 14.7 Camberwell 14.8 Greenwich 15.0 Hackney 15.0 Fulham 15.0 Battersea 15.3 Lambeth 15.4 Islington 15.5 Chelsea 16.0 St. Marylebone 16.1 *Hammersmith 16.2 St. Pancras 16.2 Deptford 16.4 City of London 16.6 Holborn 16.9 Stepney 18.1 Bethnal Green 18.3 Bermondsey 18.9 Southwark 19.2 Poplar 19.5 Finsbury 20.5 Shoreditch 21.1 The calculation of the Registrar-General is not made on the same figures as mine. *I give the death rate of Hammersmith as 157, as I deduct the deaths of Non-Parishioners which occurred at Nazareth House. 11 LOCAL GOVERNMENT BOARD RETURN.—TABLE III. Causes of, and Ages at, Death during the Year 1911. Name of District. METROPOLITAN BOROUGH OF HAMMERSMITH. Causes of Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or wfthout the District (a). Total Deaths whether of "Residents" or "Nonresidents" in Institutions in the District. (b) All ages. Under 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 All causes Certified (c) 1913 434 112 78 77 68 251 398 495 776 Uncertified 0 0 0 0 0 0 0 0 0 0 Enteric Fever 7 0 0 0 2 1 4 0 0 2 Small-pox 0 0 0 0 0 0 0 0 0 0 Measles 34 10 13 9 1 1 0 0 0 4 Scarlet Fever 5 0 0 2 3 0 0 0 0 0 Whooping Cough 31 13 9 8 1 0 0 0 0 3 Diphtheria and Croup (see note (d)) 32 2 4 13 12 0 0 1 0 5 Influenza 12 0 0 0 1 0 3 2 6 0 Erysipelas 11 2 0 0 0 0 2 2 5 7 Cerebro-Spinal Fever 0 0 0 0 0 0 0 0 0 1 Acute Polio-myelitis 2 0 1 1 0 0 0 0 0 0 Chicken-pox 1 i 0 0 0 0 0 0 0 0 Phthisis (Pulmonary Tuberculosis) I48 2 1 0 2 28 72 37 6 66 Tuberculous Meningitis (see note (e)) ... l6 5 4 2 3 2 0 0 0 7 Other Tuberculous Diseases 37 5 4 2 9 1 11 4 1 15 Rheumatic Fever 9 0 0 1 4 0 3 1 0 4 Cancer, malignant disease (see note (f) ) 126 0 0 0 0 1 9 71 45 53 Bronchitis 151 14 5 2 2 0 3 37 88 44 Broncho-Pneumonia 104 37 22 11 2 0 8 12 12 40 Pneumonia (all other forms) 106 10 11 6 3 2 20 30 24 39 Other Diseases of Respiratory Organs 9 0 0 2 0 0 2 2 3 2 Diarrhoea and Enteritis (see note (g)) 206 160 25 6 0 1 2 3 9 85 Appendicitis and Typhlitis 13 0 0 1 5 1 1 5 0 27 Alcoholism (see note (h)) 4 0 0 0 0 0 1 3 0 i Cirrhosis of Liver 16 0 0 0 0 0 1 10 5 5 Nephritis and Bright's Disease 50 0 0 1 0 3 11 18 17 22 Puerperal Fever (see note (i)) 2 0 0 0 0 0 2 0 0 2 Other accidents and diseases of Pregnancy and Parturition 9 0 0 0 0 3 6 0 0 3 Congenital Debility and Malformation, including Premature Birth (see note (j)) 108 107 0 1 0 0 0 0 0 16 Violent Deaths, excluding Suicide 74 12 4 4 9 4 15 14 12 72 Suicides 12 0 0 0 0 2 4 6 0 3 Other defined Diseases 578 54 9 6 18 18 71 140 262 248 Diseases ill-defined or unknown 0 0 0 0 0 0 0 0 0 0 Total 1913 434 112 78 77 68 251 398 495 776 * Here should be enumerated any deaths from other diseases than those given above, having public health importance, such as Typhus Fever, Continued Fever, Relapsing Fever, Dysentry, Glanders, Anthrax, and Lead-poisoning. See notes on next page. 12 NOTES TO TABLE III. (а) All "Transferable Deaths" of residents, i.e., of persons resident in the District who have died outside it, are to be included with the other deaths in columns 2-10. Transferable deaths of non-residents, i.e., of persons resident elsewhere in England and Wales who have died in the District, are in like manner to be excluded from these columns. For the precise meaning of the term "transferable deaths," see footnote to Table I. The total deaths in column 2 of Table III. should equal the figures for the year in column 12 of Table I. (b) All deaths occurring in institutions for the sick and infirm situated within the district, whether of residents or of non-residents, are to be entered in the last column of Table III. (c) All deaths certified by registered Medical Practitioners and all Inqutst cases are to be classed as "Certified" ; all other deaths are to be regarded as " Uncertified." (d) This heading includes all deaths from croup except those certified as due to "spasmodic," "stridulous," "catarrhal," or "false" croup. (e) Under " Tuberculous Meningitis " are to be included deaths from Acute Hydrocephalus. ( f) Under "Cancer" should be included deaths under such headings as Carcinoma, Scirrhus, Epithelioma, Rodent ulcer, Sarcoma, Cancer, and Malignant Disease. (g) Under this heading are to be included deaths registered as due to Epidemic Diarrhœa, Epidemic Enteritis, Infective Enteritis, Zymotic Enteritis, Summer Diarrhœa, Choleraic Diarrhœa, Cholera (other than Asiatic), Gastro-Enteritis, Gastro-Intestinal Catarrh, Muco-Enteritis, Colitis, &c. Deaths from Diarrhœa secondary to some other well-defined disease should be included under the latter. For "Dysentry" see note at foot of Table III. (h) Under this heading are to be included deaths from Delirium Tremens, acute and chronic alcoholism, Sc., but not those certified as due to organic disease attributed to alcoholism. The number of the latter may with advantage be stated separately, though this statement cannot be included in Table III. (i) Under "Puerperal Fever" are to be included deaths under such headings as Pyaemia, Septicaemia, Sapruemia, Pelvic Peritonitis, Peri- and Endo-Metritis occurring in the Puerperium. (j) Under this heading are to be included also deaths from Atrophy and Marasmus of Infants, and want of Breast-Milk, but not from Atelectasis. In any case of doubtful classification of deaths, the Manual to be issued shortly by the Registrar-General should be followed. 13 DEATHS FROM THE SEVEN PRINCIPAL ZYMOTIC DISEASES. The total number of deaths of residents that were registered from the seven principal zymotic diseases was 315 against 165 in the previous year. The deaths of residents last year from these diseases were equal to 165 per 1,000 of the total deaths of residents registered, and were at the rate of 2.6 deaths per 1,000 persons living. The deaths from the seven principal zymotic diseases in the whole of London were equal to 145 per 1,000 of the total deaths registered, and were at the rate of 2.2 deaths per 1,000 persons living. These deaths were, therefore, as compared with the total deaths of residents registered, 20 greater per 1,000 deaths belonging to this Borough than in London, and, as compared with the population, •4 per 1,000 greater in this Borough than in London. The following table shows the deaths of residents registered from the seven principal zymotic diseases which occurred in the 10 years 1902 to 1911:— YEAR. Small-pox. Measles. Scarlet Fever. Diphtheria and Membranous Croup. Whooping Cough. Enteric Fever. Diarrhœa and Cholera. Total. 1902 14 75 7 23 25 11 81 236 1903 0 27 8 19 31 10 87 182 1904 0 105 7 23 32 5 126 298 1905 0 30 11 21 54 5 89 210 1906 0 56 16 27 20 8 144 271 1907 0 52 10 23 31 6 39 161 1908 o 14 11 15 18 5 108 171 1909 0 84 9 26 39 5 42 205 1910 0 67 6 25 26 4 37 165 1911 0 34 5 32 31 7 206 315 Average in last 10 years. 1 54 9 23 31 7 96 221 14 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, 94 above the average number registered in the last 10 years. The increase was due to the excessive mortality from diarrhoea which was caused by the exceptionally prolonged hot and dry summer. CASES OF ILLNESS REPORTED AS DUE TO INFECTIOUS DISEASE. There were, omitting phthisis, 581 cases reported as due to notifiable infectious diseases in this Borough against 609 in the previous year. The number of cases of phthisis notified was 264, against 163 in the previous year. There were also reported 1,108 cases of infectious diseases that were not notifiable, against 912 in the previous year; 304 of these were chickenpox, 554 measles, and 250 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. Three hundred and four cases of chicken-pox were reported, against 228 cases in the previous year. The 304 cases reported last year were treated at the homes of the patients. One death was registered. MEASLES. Five hundred and fifty-four cases were reported as due to measles, against 484 cases in the previous year. Thirty-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 15 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 continued to entail 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 44 deaths, whereas from measles alone there were 34 deaths. In every case that was reported the premises were at once inspected as to the sanitary condition. SCARLET FEVER. Two hundred and thirty-six cases were notified as due to scarlet fever, against 340 in the previous year. Two hundred cases reported last year were isolated at Isolation Hospitals, and 36 cases were treated at the homes of the patients. Five deaths were registered. The mortality rate on the cases reported was only 2.1 per cent. DIPHTHERIA AND DIPHTHERITIC MEMBRANOUS CROUP. One hundred and ninety-five cases were reported as due to diphtheria or diphtheritic membranous croup, against 161 cases in the previous year. One hundred and seventy-four cases reported last year were treated at the Isolation Hospitals, 20 at the homes of the patients, and 1 at the Children's Hospital, Great Ormond Street. Thirty-two deaths were registered. The mortality rate on the cases reported was 16.4 per cent. 16 WHOOPING COUGH. Two hundred and fifty cases were reported as due to whooping cough, against 200 cases in the previous year. All of the cases reported last year were treated at the homes of the patients. Thirty-one 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-eight cases were reported as due to enteric fever, against 31 in the previous year. Twenty of the cases reported last year were treated at the Isolation Hospitals of the Metropolitan Asylums Board, three at the West London Hospital, one at the Hammersmith Infirmary, and four at the homes of the patients. Seven deaths were registered. The mortality rate on the cases reported was 25.0 per cent. TYPHUS FEVER. One case was reported as due to typhus fever, against no case in the previous year. The case reported last year was removed to the Isolation Hospital of the Metropolitan Asylums Board. No information as to the origin of the infection was obtainable. SIMPLE CONTINUED FEVER. One case was reported as due to simple continued fever, against one case in the previous year. The case reported last year was removed to the Western Fever Hospital. No death was registered. 17 RELAPSING FEVER. No case was reported as due to relapsing fever, against no case in the previous year. PUERPERAL FEVER. Three cases were reported as due to puerperal fever, against 9 cases in the previous year. One of the cases reported last year was treated at the home of the patient, and 2 of the cases were treated at the Hammersmith Infirmary. Two deaths were registered. The mortality rate on the cases reported was 66.6 per cent. CHOLERA. No case was reported as due to cholera, against no case in the previous year. ERYSIPELAS. Ninety-seven cases were reported last year as due to erysipelas, against 63 cases in the previous year. Sixty-five cases were treated at the homes of the patients, 31 at the Hammersmith Infirmary, and 1 at the West London Hospital. Eleven deaths were registered. The mortality rate on the cases reported was 11.3 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 two cases in the previous year. The case 18 reported last year was treated at the Isolation Hospital of the Metropolitan Asylums Board. One death was registered, the patient, however, was a non-parishioner, the mortality rate being 100 per cent. GLANDERS. No case was reported as due to glanders, against one case in the previous year. ANTHRAX. No case was reported as due to anthrax, against one case in the previous year. HYDROPHOBIA. No case was reported as due to hydrophobia last year, against no case in the previous year. OPHTHALMIA NEONATORUM. Eighteen cases were reported as due to ophthalmia neonatorum, this disease having been made notifiable from the 13th March, 1911. The cases reported last year were treated: 14 at the homes of the patients, 3 at the Hammersmith Infirmary, and 1 at St. Mary's Hospital, Paddington Green. ACUTE POLIO-MYELITIS. One case was reported as due to polio-myelitis, this disease having been made notifiable from 1st September, 1911. The case reported was removed to the Isolation Hospital of the Metropolitan Asylums Board. 19 TABULAR STATEMENT—ZYMOTIC DISEASES. The following table shows the number of cases that were reported as due to the undermentioned 20 zymotic diseases during the years 1902 to 1911. 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.t Anthrax. Glanders. Hydrophobia. Ophthalmia Neonatorum. Acute Polio-Myelitis. Total. 1902 92 349 172 0 49 0 0 7 0 110 0 659 293 78 0 0 0 0 0 0 1809 1903 6 314 160 0 58 1 0 6 0 108 0 104 137 132 O 0 O 0 0 0 1026 1904 O 283 201 0 38 1 O 11 0 120 0 283 742 102 O 0 0 O 0 0 1781 1905 0 360 237 0 41 O 0 13 O 125 0 219 417 286 O 0 0 0 0 0 1698 1906 0 439 270 0 33 1 0 10 O I25 O 08 627 50 0 0 0 0 0 0 1629 1907 0 577 207 0 40 O O 7 0 76 O 198 538 337 4 O O 0 0 0 1984 1908 0 383 199 0 29 0 0 6 0 65 0 113 161 156 1 0 0 0 0 0 l113 1909 0 380 188 O 17 0 0 14 0 75 0 140 847 281 1 0 0 0 0 0 1943 1910 0 340 161 0 31 1 0 9 0 63 0 228 484 200 2 1 I 0 0 0 1521 1911 0 236 195 1 28 1 0 3 0 97 0 304 554 250 1 0 0 0 18 1 1689 Av'rge in last 10 yrs. 9 366 199 0 36 1 0 9 0 96 0 232 480 188 1 0 0 0 2 0 1619 * Not a notifiable disease, † Disease was made notifiable on 13th September, 1907. COMPULSORY NOTIFICATION OF INFECTIOUS DISEASES. The London County Council continued the order for the notification of Cerebro-Spinal Fever (Epidemic Cerebro-Spinal Meningitis), and also made Acute PolioMyelitis, Polio-Encephalitis and Ophthalmia Neonatorum notifiable infectious diseases. 20 LOCAL GOVERNMENT BOARD RETURN.—TABLE II. Cases of Infectious Disease notified during; the year 1911. METROPOLITAN BOROUGH OF HAMMERSMITH. Notifiable Disease. Number of Cases Notified. Total Cases Notified in Each Locality. (e.g. Parish or Ward) of the District. Total Cases Removed to Hospital. At all Ages. At Agesf—Years. Under i 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards. North Centre South Small-pox o o 0 0 0 o 0 o 0 0 0 0 Cholera 0 o 0 0 0 o 0 0 0 0 0 0 Diphtheria (including Membranous Croup) 195 4 66 114 5 6 0 0 96 65 34 175 Erysipelas 97 2 3 6 5 28 36 17 43 34 20 32 Scarlet Fever 236 1 59 139 23 13 1 0 no 101 25 200 Typhus Fever 1 0 0 1 0 0 0 0 i 0 0 1 Enteric Fever 28 0 1 11 6 8 2 0 8 18 2 24 Relapsing Fever 0 0 0 0 0 0 0 0 0 0 0 0 Continued Fever 1 0 0 1 0 0 0 0 1 0 0 1 Puerperal Fever 3 0 0 0 2 1 0 0 3 0 0 2 Plague 0 0 0 0 0 0 0 0 0 0 0 0 Cerebro-Spinal Fever 1 0 0 1 0 0 0 0 1 0 0 1 Phthisis Under Tuberculosis Regulations, 1908 125 0 5 15 9 51 42 3 47 32 46 63 Under Tuberculosis Regulations, 1911 131 0 0 26 35 57 12 1 73 40 18 40 Others 8 0 0 0 5 2 1 0 1 5 2 0 Ophthalmia Neonatorum 18 18 0 0 0 0 0 0 11 5 2 4 Polio-myelitis 1 0 0 1 0 0 0 0 1 0 0 1 Totals 845 25 134 315 90 166 94 21 396 300 149 544 NOTES. State in space below the name and position within or without the district of the isolation hospital, if any, to which residents in the district, suffering from infectious disease, are usually sent, the accommodation available for the district afforded by it, and the name of the authority by whom the hospital is provided. † 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—Name and Situation—Western District Hospital 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. 21 The following table of Deaths from Infectious Diseases is compiled from the Registrar's General Report. Boroughs. Population estimated to the middle of 1911. Births. Deaths from Deaths under 1 year of Age. All causes. Enteric Fever. Small-pox. Measles. Scarlet F ever. Whoopi ng-cough. Diphtheria. Diarrhoea and Enteritis (under 2 years) Phthisis. COUNTY OF LONDON 4,521,301 111,738 67,826 144 9 2,570 172 1,038 612 5,313 6,084 14,440 West. Paddington 142,513 3,038 1,897 5 — 48 3 44 11 134 173 387 Kensington 172,203 3,252 2,349 4 — 94 2 54 18 146 159 432 Hammersmith 121,766 2,927 1,891 7 — 36 5 35 28 178 153 428 Fulham 153.705 4,12! 2,203 8 — 64 7 28 27 213 224 517 Chelsea 66,189 1,269 1,020 — — 30 10 5 55 96 138 City of W'stmnstr 159,662 2,358 1,983 4 — 23 3 26 14 63 193 244 North. St. Marylebone 117,761 2,376 1,772 2 — 66 7 28 5 83 172 257 Hampstead 85,589 1,276 823 2 — 14 — 3 17 22 52 99 St. Pancras 217,941 5,559 3,371 7 — 108 12 55 37 201 342 624 Islington 327,203 8,108 4,853 12 — 130 21 70 5i 365 405 1,032 Stoke Newington 50,644 1,045 658 1 — 28 3 18 3 28 55 107 Hackney 222,623 5.226 3,185 8 — 148 11 58 20 195 311 621 Central. Holborn 49,002 945 768 3 — 15 3 3 3 34 102 109 Finsbury 87,566 2,674 1,728 8 — 79 6 24 17 142 163 418 City of London 19,466 226 293 — — 1 1 1 1 10 31 28 East. Shoreditch 111,199 3,533 2,226 1 128 6 32 24 222 204 601 Bethnal Green 128,144 4,029 2,320 3 — 130 5 49 21 248 208 610 Stepney 279.309 8,743 4.833 6 7 303 7 49 32 468 493 1,261 Poplar 162,274 5,015 3,054 M 2 225 10 44 44 316 213 787 South. Southwark I9I.53I 5,693 3,509 5 - 120 6 64 30 298 326 818 Bermondsey 125.775 3,908 2,3u 5 — 55 6 50 13 212 223 609 Lambeth 297.957 7,292 4,430 12 — 112 8 67 43 336 419 897 Battersea 167.712 4,372 2,391 3 — 112 4 36 20 222 223 540 Wandsworth 313.453 6,747 3,743 9 — 230 10 70 33 293 277 823 Camberwell 261.380 6,399 3,724 5 — 112 7 45 25 276 35o 696 Deptford 109,472 3,000 i,706 2 — 69 7 37 15 171 139 425 Greenwich 95.973 2,376 1,409 3 — 41 3 14 16 152 112 305 Lewisham 161,712 3,420 1,821 5 — 21 5 18 28 128 104 354 Woolwich 121,487 2,811 1,555 28 3 6 11 102 162 273 * For the purpose of this table the Births registered in London have been corrected by distributing those which occurred in the principal institutions treating maternity cases to the boroughs in which the mothers resided. In 1,088 cases the residence was outside the County of London and these cases have been excluded. On the other hand 31 births that occurred outside the County have been included. With regard to the Deaths of London residents, all transferable deaths (i.e., those of persons who, having a fixed or usual residence in England and Wales, die in a district other than that in which they resided) occurring in greater London and in certain Metropolitan Institutions outside Greater London have been distributed to the Metropolitan Borough to which the deceased belonged. Of the deaths registered in London the previous residence was outside the county in 3,299 cases, while on the other hand the deaths of 2,826 London residents occurred in the Outer Ring or in Metropolitan Institutions outside Greater London. 22 The following table of Deaths from Infectious Diseases per 1,000 persons living is compiled 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. Enteric Fever. Small-pox. Measles. Scarlet Fever. Whooping-cough. Diphtheria. Diarrhoea and Enteritis (under 2 years). Phthisis. Crude. 'Corrected. COUNTY OF LONDON 24.8 15.0 15.8 0.03 0.00 0.57 0.04 0.23 0.14 1.18 1.35 129 West. Paddington 21.4 13.3 14.3 0.04 — 0.34 0.02 0.31 0.08 0.94 1.22 127 Kensington 18.9 13.7 14.7 0.02 — 0.55 0.01 0.31 0.10 0.85 0.93 133 Hammersmith 24.1 15.6 16.2 0.06 — 0.30 0.04 0.29 0.23 1.47 1.26 146 Fulham 26.9 14.4 15.0 0.05 — 0.42 0.05 0.18 0.18 1.39 1.46 125 Chelsea 19.2 15.5 16.0 — — o.45 0.02 0.15 0.08 0.83 1.45 109 City of Westminster 14.8 12.5 14.0 o.o3 — 0.14 0.02 0.10 0.09 0.40 1.21 103 North. St. Marylebone 20.2 15.1 16.1 0.02 — 0.56 0.06 0.24 0.04 0.71 1.46 108 Hampsiead i4.9 9.6 10.9 0.02 — 0.16 — 0.04 0.20 0.26 0.6l 78 St. Pancras 25.6 i5.5 16.2 0.03 — 0.50 0.06 0.25 0.17 0.92 1.57 112 Islington 24.8 14.9 15.5 0.o4 — 0.40 0.06 0.21 0.16 1.12 1.24 127 Stoke Newington 20.7 13.0 13.6 0.02 — 0.55 0.06 0.36 0.06 0.55 1.09 102 Hackney 23.5 14.3 15.0 O.O4 — 0.67 0.05 0.26 0.09 0.88 1.40 119 Central. Holborn 19.3 15.7 i6.9 0.06 0.31 0.06 0.06 0.06 0.69 2.08 115 Finsbury 30.6 19.8 20.5 0.09 — 0.90 0.07 0.27 0.19 1.63 1.87 156 City of London 11.6 15.1 16.6 — — 0.05 0.05 0.05 0.05 0.52 1.60 124 East. Shoreditch 31.9 20.1 21.1 o.oi — 1.15 0.05 0.29 0.22 2.00 1.84 170 Bethnal Green 31.5 18.2 18.3 0.02 — 1.02 0.04 0.38 0.16 1.94 1.63 151 Stepney 31.4 17.4 18.1 0.02 0.03 1.09 0.03 0.18 0.11 1.68 1.77 144 Poplar 31.0 i8.9 19.5 0.09 0.01 1.39 0.06 0.27 0.27 1.95 1.32 157 South. Southwark 29.8 i8.4 19.2 0.03 — 0.63 0.03 o.34 0.16 1.56 1.71 144 Bermondsey 31.2 i8.4 18.9 O.O4 — 0.44 0.05 0.40 0.10 1.69 1.78 156 Lambeth 24.5 14.9 15.4 0.04 — 0.38 0.03 0.23 0.14 1.13 1.41 123 Battersea 26.1 14.3 15.3 0.02 — 0.67 0.02 0.22 0.12 1.33 1.33 124 Wandsworth 21.6 i2.0 12.6 0.03 — 0.74 0.03 0.22 0.11 0.94 0.89 122 Camberwell 24.5 14.3 14.8 0.02 — 0.43 0.03 0.17 0.10 1.06 1.34 !°9 Deptford 27.5 I5.6 16.4 0.02 — 0.63 0.06 0.34 0.14 1.57 1.27 142 Greenwich 24.8 14.7 15.0 0.03 — o.43 0.03 0.15 0.17 1.59 1.17 128 Lewisham 21.2 11.3 11.8 o.o3 — 0.13 0.03 0.11 0.17 0.79 0.64 104 Woolwich 23.2 12.8 13.7 — — 0.23 0.02 0.05 0.09 0.84 1.34 97 In this Table 0.00 indicates that the deaths were too few to give a rate of 0005; where no death occurred, — is inserted. * The Corrected death-rates represent the Crude death-rates multiplied by the respective Factors for Correction for differences of sex and age constitution of population as in 1901. (See Table , page .) 23 LONDON AND THE METROPOLITAN BOROUGHS. Death rates per 1,000 persons living, and Infantile Mortality, after Distribution of Births in the chief Institutions treating Maternity cases, and of Deaths in all Public Institutions, &c., in the Five years, 1906-1910, and in 1911. Boroughs. All Causes. Enteric Fever. SmallPox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Diarrhcea and Enteritis (.under 2 Years.) Phthisis. Deaths under One Year to 1000 Births. 19061910. 1911. 19061910. 1911. 19061910. 1911. 19061910. 1911. 19061910 1911. 19001910. 1911. 19061910. 1911. 19061910. 1911. 19061910. 1911. 19061910. 1911. County of London 14.9 15.0 0.04 0.03 0.00 0.00 0.42 0.57 0.l0 0.04 0.29 0.23 0.14 0.14 The average mortality under this heading cannot be stated. 1.18 1.40 1.35 114 129 Paddington 13.3 13.3 0.04 0.04 — 0.27 0.34 0.09 0.02 0.20 0.31 0.10 0.08 0.94 1.09 1.22 103 127 Kensington 13.8 13.7 0.03 0.02 — — 0.30 0.55 0.04 0.01 0.2I 0.31 0.12 0.10 0.85 1.09 0.93 120 133 Hammersmith 14.5 15.6 0.05 0.06 — 0.46 0.30 0.09 0.04 0.24 0.29 0.17 0.23 1.47 1.05 1.26 118 146 Fulham 14.3 14.4 0.05 0.05 — — 0.45 0.42 0.09 0.05 0.33 0.18 0.21 0.18 1.39 I.28 1.46 118 125 Chelsea 15.8 15.5 0.03 — — — 0.45 0.45 0.07 0.02 0.24 0.15 0.l5 0.08 0.83 1.52 1.45 114 109 City of Westminster 12.9 12.5 0.04 0.03 0.00 — 0.13 0.14 0.06 0.02 0.l1 0.16 0.09 0.09 0.40 1.32 1.21 99 103 St. Marylebone 14.8 15.1 0.03 0.02 — — 0.25 0.56 0.l0 0.06 0.23 0.24 0.10 0.04 0.71 1.38 1.46 I05 108 Hampstead 9.8 9.6 0.04 0.02 — — 0.13 0.16 0.05 — 0.11 0.04 0.07 0.20 0.26 0.73 0.61 70 78 St. Pancras 15.8 15.5 0.04 0.03 — — 0.43 0.50 0.10 0.06 0.31 0.25 0.11 0.17 0.92 1.67 1.57 108 112 Islington 14.7 14.9 0.05 0.04 — — 0.47 0.40 0.08 0.06 0.28 0.21 0.1l 0.16 1.12 1.30 1.24 107 127 Stoke Newington 12.2 13.0 0.04 0.02 — — 0.19 0.55 0.08 0.06 0.25 0.86 O.O6 0.06 0.55 1.02 1.09 87 102 Hackney 13.7 14.3 0.05 0.04 — — 0.29 0.67 0.l0 0.05 0.24 0.26 0.13 0.09 0.88 1.27 1.40 109 119 Holborn 17.2 15.7 0.05 0.06 — 0.29 0.31 0.06 0.06 0.29 0.06 O.11 0.06 0.69 2.31 2.08 114 115 Finsbury 19.9 19.8 0.08 0.09 — — 0.80 0.90 0.13 0.07 0.48 0.27 0.20 0.19 1.63 2.21 1.87 134 156 City of London 15.5 15.1 0.06 — — — 0.12 0.05 0.08 0.05 0.16 0.05 0.08 0.05 0.52 1.66 1.60 93 124 Shoreditch i8.9 20.1 0.06 0.01 — 0.81 1.15 0.16 0.05 0.54 0.29 0.l5 0.22 2.00 1.90 1.84 149 170 Bethnal Green I7.5 18.2 0.09 0.02 — 0.58 1.02 0.22 0.04 0.37 0.38 0.l6 0.16 1.94 1.78 1.63 135 151 Stepney 17.2 17.4 0.06 0.02 0.00 0.03 0.65 1.09 0.15 0.03 0.36 0.18 0.2i 0.11 1.68 1.70 1.77 123 144 Poplar 17.1 18.9 0.08 0.09 0.01 0.59 1.39 0.16 0.06 0.46 0.27 0.l8 0.27 1.95 1.43 1.32 129 157 South war k 18.3 18.4 0.05 0.03 0.65 0.63 0.13 0.03 0.33 0.34 0.I7 0.16 1.56 2.04 1.71 130 144 Bermondsey 18.7 18.4 0.04 0.04 0.94 0.44 0.19 0.05 0.35 0.40 0.I7 0.10 1.39 I.88 1.78 137 156 Lambeth 14.9 14.9 0.04 0.04 — — 0.34 0.38 0.l0 0.03 0.25 0.23 O.I5 0.14 1.13 1.49 1.41 112 123 Battersea 13.8 14.3 0.04 0.02 0.38 0.67 0.l0 0.02 0.36 0.22 0.13 0.12 1.33 1.31 1.33 109 124 Wandsworth 11.8 12.0 0.03 0.03 0.23 0.74 0.06 0.03 0.26 0.22 0.13 0.11 0.94 0.94 1.00 109 122 Camberwell 14.3 14.3 0.03 0.02 0.40 0.43 0.09 0.03 0.28 0.17 0.14 0.l0 1.06 1.28 1.34 97 109 Deptford 15.3 15.6 0.05 0.02 — — 0.51 0.63 0.09 0.06 0.40 0.34 0.15 0.14 1.57 1.33 1.27 109 142 Greenwich 14.2 14.7 0.05 0.03 — — 0.40 0.43 0.09 0.03 0.37 0.15 0.17 0.17 1.59 1.21 1.17 119 128 Lewisham 11.2 11.3 0.02 0.03 — — 0.14 0.13 0.09 0.03 0.21 0.11 0.16 0.17 0.79 0.82 0.64 89 104 Woolwich 13.0 12.8 0.03 — — — 0.31 0.23 0.l0 0.02 0.22 0.05 0.15 0.09 0.84 1.31 1.34 96 97 24 INFLUENZA. Twelve deaths were registered as due to influenza, against 14 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, 264 cases were notified to me against 163 cases in the previous year. These, no doubt, represent only a small proportion of the cases that actually occurred, as 148 deaths were registered, against 135 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 264 cases notified last year, 125 were reported under the Public Health (Tuberculosis) Regulations, 1908, from Infirmaries, Workhouses, and District Poor Law Medical Officers. One hundred and thirty-one were reported under the Tuberculosis Regulations, 1911. Only 8 were reported by private Medical Practitioners. On March 26th, 1911, the Local Government Board issued regulations as to tuberculosis in hospitals, and November 16th further regulations were issued by the Board making pulmonary tuberculosis a notifiable infectious disease. The latter order to come into force on January 1st, 1912. 25 PHTHISIS: SANATORIUM AND HOSPITAL ACCOMMODATION. METROPOLITAN BOROUGH OF HAMMERSMITH. Classes for which accommodation is provided. By whom provided. Where situated. Total number of Beds. How are patients selected ? Are patients under the care of a resident Medical Officer ? What charge, if any, is made for the use of Beds ? Do the Sanitary Authority use— (1)their Isolation Hospital, or (2) their Smallpox Hospital, for cases of Phthisis ? Do the Sanitary Authority reserve Beds in any Phthisis Sanitorium : If so, how many, and in what Sanitorium ? Do the Sanitary Authoritj provide portable open-air Shelters or Tents? (a) Early cases — — — — — — — No. No. (6) Intermediate cases — — — — — — — No. No. (c) Advanced cases — — — — — — — No. No. Have the Council, or any Private Body, provided a Dispensary. Is so, give particulars, NO. N. C. COLLIER, April 26th, 1912. Medical Officer of Health. 26 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, 1911, I had received 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 slaughter house at No. 35 Queen Street has, since October, ceased to be used for the purpose of the license. 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 Goldhawk Road Benjamin Holton !38 Joseph Moore CENTRE DISTRICT. Wards Nos. 2 and 3. address. name of licensee. 247 Goldhawk Road Edgar P. Jarrett 55 Dalling Road Charles Meeks. SOUTH DISTRICT. Wards No. 1. address. name of licensee. 35 Queen Street George A. Silcock (not in use since October) 49 King Street Benjamin Holton 65 „ Thomas Holton 321 „ Stanley Brooks Midwinter 27 BAKEHOUSES. The 61 bakehouses now in use as bakeries in the Borough were under a regular half-yearly inspection by the Factory Inspector. Ninety-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. The following is a list of the bakehouses at present in occupation in the Borough :— NORTH DISTRICT. Wards Nos. 4, 5i 6, and 7. ADDRESS. NAME. 410 Uxbridge Road J. Haneman †25 Uxbridge Road Not in use 121 Askew Road Not in use *242 Goldhawk Road G. Lousden *32 Norland Road L. Nau *74 Goldhawk Road R. Steele *128 Askew Road H. Hernig *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 G. Phillips †*39 St. Ann's Road E. Tomlin *106 Goldhawk Road A. J. Wills 104 Latimer Road Not.in use 166 Goldhawk Road J. Pendry 7 Market Place, Askew Road J. Miller 28 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 W. Gregory 348 King Street Not in use *75 Blythe Road W. Abbot *31 Goldhawk Road John Burnett *11 Lamington Street Ernest Witt 258 King Street P. Erbach *94 Shepherd's Bush Road Not in use *85 The Grove W. Gerres *102 Dalling Road W. Schlarb †*84 Shepherd's Bush Road F. T. Ries 70 Glenthorne Road E. Fursdon 24 Bradmore Park Road J. Heide & Son *77 Brackenbury Road W. Jennings *134 Shepherd's Bush Road C.Jacobs *1 Masboro' Road W. Dodwell *98 Blythe Road P. Puhl *17 Kil marsh Road L. Lorenz *7 Shepherd's Bush Road A. Royston *192 Dalling Road F. Miller *1 Aldensley Road H. Sturum *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 29 SOUTH DISTRICT. Ward No. 1. address. name. 65 Bridge Road W. Bass 88 Queen Street G. Bambridge †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 G. Bamford † Great Church Lane Fullers, Limited 7 St. Peter's Road F. Booker * Underground Bakehouses, † Factory Bakehouses. 30 Table Showing Number of Families or Separate Occupiers and Number of Persons at Census, 1911. Name of District. Population, Census, 1911. Families or separate occupiers, Census, 1911. Lewisham 160,834 37,013 Wandsworth 311,360 70,155 Woolwich 121,376 26,504 Stoke Newington 50,659 12,163 Greenwich 95,968 20,692 Deptford 109,496 25,040 Camberwell 261,328 58,679 Hackney 222,533 50,622 Battersea 167,743 39,598 Hampstead 85.495 18,625 Lambeth 298,058 70,827 Hammersmith 121,521 28,462 Fulham 153,284 36,432 Poplar 162,442 35,158 Kensington 172,317 38,387 Paddington 142,551 33,925 Bermondsey 125,903 28,032 Chelsea 66,385 15,936 Islington 327,403 79,902 Bethnal Green 128,183 27,755 Shoreditch 111,390 24,801 Stepney 279,804 56,949 St. Marylebone 118,160 28,509 Southwark 191,907 44,453 St. Pancras 218,387 52,994 City of Westminster 160,261 35,984 Finsbury 87,923 21,239 Holborn 49,357 11,030 31 Table Showing extent in Acres, and Number of Persons to the Acre, at Census, 1911. Name of District. Extent in Acres, Census, 1911. Numbei of Persons to the Acre. Census 1911. Woolwich 8,276.6 14.66 Lewisham 7,014.4 22.92 Greenwich 3,851.7 24.96 Wandsworth 9,107.4 34.19 Hampstead 2,265.0 37.74 Hammersmith 2,286.3 53.15 Camberwell 4,480.0 58.33 Stoke Newington 863.5 58.66 City of Westminster 2,502.7 64.03 Hackney 3,287.8 67.07 Poplar 2,327.7 69.78 Deptford 1,562.7 70.06 Lambeth 4,080.4 73.04 Kensington 2,291.1 75.21 Battersea 2,160.3 77.64 St. Marylebone 1,472.8 80.22 St. Pancras 2,694.4 80.98 Bermondsey 1,499.6 83.95 Fulham 1,703.5 89.98 Chelsea 659.6 100.64 Paddington 1,3561 105.11 Islington 3,091.5 105.90 Holborn 405.1 121.83 Finsbury 586.6 149.87 Stepney 1,765.6 158.47 Bethnal Green 759.3 168.81 Shoreditch 657.6 169.38 Southwark 1,131.5 169.59 32 CUSTOMS AND INLAND REVENUE ACTS. During the year II applications were received for certificates under these Acts. There was a 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. The following is a list ot 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 106, Sinclair Road 1 House 2 — — 2 (not completed) 48 to 62. Tunis Road 5 Houses 10 - — 10 (not completed) 1 to 4, Cornwall Mansions 1 Block 4 4 — — 1 and 31, Brewster Gardens 2 Houses 4 — — 4 (not completed) 380 to 388, Uxbridge Road 5 Houses 15 15 — — 34, Sinclair Road 1 House 2 2 — — 13, Dalgarno Gardens 7, 11, 19, 27, 29, 47, 61, 52, 42, 25, 1 House 2 — — 2 (not completed) 10, Bracewell Road 11 Houses 22 - - 22 (not completed) 113 to 117, Stanlake Road 3 Houses 6 - - 6 (not completed) 1 to 19, Lanark Mansions 2 Blocks 19 - - 19 (not completed) Carried forward 32 86 21 — 65 33 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 deterred. Brought forward 32 86 21 — 65 52 and 52A, Rayleigh Road 2 Houses 4 — — 4 (not completed) 1 to 6, Rosedale Terrace 6 Houses 12 - - 12 (not completed) 11 and 12, Caithness Road 2 Houses 4 - - 4 (not completed) 27, Boscombe Road 2, 12, 13, 15, 16, 17, Granville 1 House 3 - - 3 (not completed) Mansions 1 Block 6 - - 6 (not completed) 2, 4, 5, and 7, Lanark Mansions 1 Block 4 4 - - Totals 45 119 25 — 94 Seventy-five Intimation Notices were served in reference to defects found to exist in certain of the above premises, and twenty-five Notices were complied with. The following is a list of the premises certified by me during the year :— 2, 4, 5, and 7, Lanark Mansions, Pennard Road. 132, King-street. 380, 382, 384, 386, 388, Uxbridge Road. I, 2, 3, and 4, Cornwall Mansions. Applications received under Section 35 of the Towns Planning Act, 1909—one as below :— 132, King Street, Hammersmith ... Accommodation for 49 Lodgers (Common Lodging House) Certificate granted. SEIZURE OF UNWHOLESOME FOOD. During last year no seizure was made of food which was unsound, unwholesome and unfit for the food of man. 34 HOUSES LET IN LODGINGS. During the last year the Public Health Committee gave directions for the registration of 186 "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 4,809 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 1,314 houses have been removed from the list, leaving a total number now on the Register of 3,495. During the year 678 notices were served and 620 were complied with. The registered premises were visited as often as time would allow by the special Inspectors appointed for that purpose. SANITARY NOTICES AND ADMINISTRATION. During last year 1,540 notices were reported as having been served by your four District Sanitary Inspectors having for their object the removal or prevention of nuisances or insanitary conditions, against 2,336 in the previous year, and during last year 1,438 notices were reported as having been complied with, against 2,143 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 724 houses and other premises in the borough, against 2,999 houses in the previous year. As a result of his inspection, defects were discovered in 170 houses, and 170 Intimation Notices were served by the House-to-House Inspector. These cases were subsequently dealt with by the four District Inspectors. One hundred and fifty-seven houses coming under the provisions of the Bye-laws as to "Houses let in lodgings or occupied by members of more than 35 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 2,766 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 113 premises on which insanitary conditions existed. HOUSING AND TOWN PLANNING ACT, 1909. Regulations of Local Government Board. The Local Government Board made an order dated 2nd September, 1910, under Section 17 of the Housing and Town Planning Act, 1909. Sanitary Inspector Cosson reports that he has made 766 inspections during the year, having inspected the houses in the list of streets adopted by your Council on mv report. As a result 01 his inspection 371 Intimation Notices were served and 362 complied with, a list of which follows :— Notices served. Complied with. Notices served. Complied with. Bridge Street 12 12 Melina Road 37 37 Aspen Place 13 13 Hunt Street 46 46 Trafalgar Street 20 20 Latimer Mews 10 10 Felgate Mews 6 6 Southbrook Street 39 33 Orris Mews 5 5 Coleman's Buildings 11 11 Grove Mews 20 20 Lycett Place 7 7 Brook Green Place 6 6 Priory Mews 5 5 Rayleigh Road 97 94 - - Barb Mews 8 8 Leffern Road 29 29 371 362 SANITATION OF THE EXHIBITION PREMISES. The Sanitation of the Exhibition premises, Wood Lane, had, as in the previous year, the most careful consideration of your Public Health Committee both as to the efficiency and sufficiency of the sanitary 36 accommodation provided. The amount of sanitary accommodation was greatly in excess of the requirements. INSPECTION OF FACTORIES, Etc. Your Factory Inspector has during the year served 291 notices under the Factory and Workshop Act, and during the same period 279 notices have been complied with. During the previous year there were 295 notices served and 283 complied with. The following is a list of the Factories and Workshops upon the Register :— Restaurants, Hotels, &c. 162 Bakehouses (5 not used at present as Bakeries) 66 Bootmakers 73 Motor and Cycle Makers and Engineers 51 Dressmakers and Milliners 252 Laundries 305 Letterpress Printers and Bookbinders 29 Electrical and Mechanical Engineers 53 Smiths, Wheelwrights and Coachbuilders 36 Tailors 54 Bottle Washing Works 14 Dry Cleaning, Dyeing, and Carpet Beating Works 18 Firewood Cutters 15 Builders and Joiners (Machine) 31 Outworkers 588 Miscellaneous 116 1,861 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 some part of the year the duties of Smoke Inspector. 37 TAVLE 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 Factories, Workshops, Workplaces and Homework. 1.-INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 904 81 — Workshops (including Workshop Laundries) 1,614 144 — Workplaces (other than out-workers premises included in Part III of this report) 704 61 - Total 3,222 286 — 38 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 75 70 ... ... Want of Ventilation 1 1 ... ... Overcrowding ... ... ... ... Want of Drainage of Floors 24 24 ... ... Other Nuisances 173 170 ... ... Sanitary Accommodation. insufficient 2 2 ... ... unsuitable or defective 48 48 ... ... not separate for sexes ... ... ... ... 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) 95 95 ... ... Other Offences (excluding offences relating to outwork, which are included in Part 3 of this report.) ... ... ... ... Total 418 410 ... ... 39 3.—HOME WORK. Nature of Work.* Outworkers' List, Section 107. Outwork in Unwholesome Premises, Sec. 108. Outwork in Infected Premises, Sees. 109, 110. Lists received from Employers. Addresses of Outworkers. Prosecutions. Inspection of Outworkers' premises. Twice in the year. Once in the year. 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, † Received from other Councils. Forwarded to other Councils. 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 88 12 6 22 214 118 ... ... ... 128 5 5 ... ... ... ... (2) cleaning and washing 8 8 ... ... ... ... 70 ... ... ... ... ... ... ... ... ... ... ... 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 56 70 88 12 6 22 284 118 ... ... ... 128 5 5 ... ... ... ... * If an occupier gives out work of more than one of the classes specified in column i, 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 the lists received from those employers who comply strictly with the statutory duty of sending two lists each year and of the entries of names of outworkers in those lists. The entries in column 2 must necessarily be even numbers, as there will be two lists for each employer—in some previous returns odd numbers have been inserted. The figures in columns 3 and 4 will usually be (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. 40 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 6l dressmakers 252 restaurants, etc. 162 others 595 Total number of workshops on Register 1,070 5.—OTHER MATTERS. Class. Number. Matters notified to H. M. Inspector of Factories— Failure 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 14 Reports (of action taken) sent to H. M. Inspector 14 Other 33 Underground bakehouses (S. 101)— Certificates granted during the year — In use at the end of the year 32 Note.—The Factory and Workshop Act, 1901 (s. 132), requires the Medical Officer of Health in his Annual Report to the District 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 otherwise 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, 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 District Councils and Medical Officers of Health in October, 1906, 41 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 was carried out by Sanitary Inspector S. Huggons Brown. At the present time there are 170 premises upon the register and 14 notices have been served, all of which have been complied with. The following is a table in reference to the above-named premises. DAIRIES, COWSHEDS, AND MILKSHOPS ORDER, Etc. PROCEEDINGS DURING 1911. PREMISES. NUMBER OF PLACES. Number of tions, 1911. Number of notices, 1911. Number of prosecutions, 1911. On ter at end of 1910. Added in 1911. Removed in 1911. On ter at end of 1911. Milk premises 355 67 75 347 703 38 1 Cowsheds nil. nil. nil. nil. nil. nil. nil. Slaughter-houses 9 nil. 1 8 112 15 nil. Offensive trade premises nil. nil. nil. nil. nil. nil. nil. Ice Cream premises 212 8 50 170 182 14 nil. 42 These registered premises were under regular inspection. During the year two 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 were strictly enforced under my directions. There were 67 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 12 summonses to be taken out against persons for having failed to comply with the requirements of notices which had been served. In most 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 most 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 three summonses were taken out through the Public Health Department. 43 SUMMONSES HEARD. situation of premises. nature of offence. result of proceedings. 35, Nasmyth Street Non-compliance with sanitary notice. Order made for the completion of the work. 383, Goldhawk Road Trading as a Milk Vendor while not registered. Fined 5s., 2s. costs. Excel Meat Co., 2a, Hammersmith Road Odour of Cooked Meat Fined £ 10, 2s. costs. Magistrate refused to make any suggestions as to what should be done to prevent the alleged nuisance, and intimated that the business should be removed to some place not within 50 yards of dwellings of the character of the houses adjacent to the Company's premises. PUBLIC MORTUARY. During last year 262 bodies were removed to the mortuary at Fulham Palace Road. There were 124 bodies brought to the mortuary by order of the Coroner or the Police ; 76 bodies were taken from the West London Hospital, and 62 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 :— Minimax Co., Wormholt Farm, Shepherd's Bush. Hammersmith Borough Council Electricity Works, Fulham Palace Road, Hammersmith. Excel Meat Co., Hammersmith Road, Hammersmith. The whole of these complaints had the careful consideration of your Public Health Committee. 44 SMOKE ABATEMENT. During last year observations were made in reference to the amount of black smoke emitted from the under-mentioned premises, four statutory notices were issued, and nine preliminary notices were 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. Carpet Beating Works, Wharf Road, Latimer Road. Compressed Air Carpet Beating Company, Glenthorne Road. 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. The Premier Laundry, Goldhawk Road. 74, Goldhawk Road. Bakehouse. 98, Goldhawk Road. Fried Fish Shop. Messrs. Rosser & Russell, Queen Street. Lagoon Grill, Coronation Exhibition. Grand Restaurant, Coronation Exhibition. Continental Tyre Works, Hythe Road. Victoria Hair Works, Hythe Road. Cowper Coles Engineering Company, Hythe Road. 2, Wendell Road. Laundry. Hammersmith Infirmary, Wormwood Scrubs. Addison Feather Mills, Woodstock 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. METEOROLOGY. The average mean temperature registered in London during last year was 5i'8° Fahrenheit. The highest temperature registered was ioo° on August 9. The lowest temperature was 220 on February 1. Rain fell on 158 days. The total amount of rainfall was 23*7 inches. I am, Gentlemen, Your obedient servant, N. C. COLLIER, L.R.C.P., L.S.A., Medical Officer of Health.