ham 16 ANNUAL REPORT OF THE Medical Officer of Health OF THE BOROUGH OF HAMMERSMITH For the Year 1915. CONTENTS. A page Aged Persons, Deaths of 19 Anthrax 35 B Births 6 Bakehouses 52 C Chickenpox 24 Continued Fever 34 Cholera 34 Cerebro Spinal Meningitis 35 Customs and Inland Revenue Acts 56 D Deaths 7 Death Rate (London) 21 Diphtheria 32 Diarrhœa 40 Diagnosis, Wrong 48 Disinfection 48 Dairies, Cowsheds, and Milk- shops Order 71 E Enteric Fever 33 Erysipelas 34 F Food Seizures 58 Factories, Inspection of 66 G Glanders 35 H Health Visitor, Report on work of 11 Hydrophobia 37 Houses Let in Lodgings 62 Housing, Town Planning, etc., Act 64 Home Office Return 67 I Introduction 3 Illegitimate Children, Death Rate 9 Infantile Mortality Rates 8, 17, 18 Influenza 49 Ice Cream Manufacturers 71 M page Maintenance of Live Stock Order of 1915 59 Marriages 6 Maternity and Child Welfare 13 Measles 25 Military Encampment 63 Mortuary 73 Meteorology 74 N Notification of Births 7 Notices 62 O Outlying Institutions, Deaths at 20 Ophthalmia Neonatorum 37 Olympia 64 P Population 6 Puerperal Fever 34 Plague 35 Poliomyelitis 37 Proceedings 73 R Relapsing Fever 34 Rag Flock Act, 1911 72 S Smallpox 24 Scarlet Fever 31 Slaughterhouses 51 Seizure (unsound food) 58 Staff 62 Summonses 72, 73 Smoke Abatement 74 T Tables, Registrar General 10, 19, 22, 45 Typhus Fever 34 Tuberculosis 49 Tuberculosis Dispensary 49 W Whooping Cough 32 White City Camp 63 Z Zymotic Diseases, Deaths from 23 Do. do. Number of Cases 40 ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE BOROUGH OF HAMMERSMITH For the Year 1915. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hammersmith. Gentlemen,—I beg to present to you my Annual Report for 1915. The Report will deal with the vital statistics, and with the work carried out under the direction of your Council during the 52 weeks ending 011 January 1st, 1916. The statistical tables prescribed by the Local Government Board are included, as well as the several other tables that directly or indirectly relate to the Public Health of the Borough. The vital statistics of the Borough for the year under review were, with the exception of a decline in the birth rate from 23.5 to 22.8 per 1,000, of a satisfactory nature. The death rate, 16.2, compares favourably with the death rate of 16.8 for the whole of the Metropolis. The infantile mortality rate (the number of deaths under 1 year of age to every 1,000 births) was 102, being 8 above that of the previous year, while that for the whole of London was 112. I regret to have to report this increase, and it is obvious that our efforts should be continued with increasing vigilance, in order to permanently reduce this loss of infant life. 4 The number of cases of infectious diseases (excluding tuberculosis) were very much lower than in the preceding year, and compare very favourably with that for the Metropolis. With the outbreak of war it was expected that an increased prevalence of disease would follow. Fortunately this has not been the case, and the general health of the population has remained quite good up to the present. The White City, which was taken over by the Territorial Association soon after the outbreak of war and used for the purpose of housing troops, was partly taken over by the Royal Naval Air Service. The large building known as the Machinery Hall has been taken over by Messrs. Waring and Gillows for the purpose of making tents, tarpaulins, &c. This factory has been kept under constant supervision. Olympia, which was taken over by the Military Authorities and used as an internment camp, is now being used for the purposes of a store by the Army Ordnance Corps. During the year your Council has received, through the Public Health Department, many requests both from the Naval and Military Authorities to carry out disinfection of articles of clothing and bedding, &c. In every instance satisfactory arrangements were made, and disinfection carried out. I am, Gentlemen, Your obedient servant, J. B. HOWELL, Medical Officer of Health. 5 SUMMARY OF STATISTICS, Etc. FOR THE YEAR 1915. Population of Registration area at Census 121,521 Civil Population (estimated) 118,559 Natural increase, i.e. excess of births over deaths 787 Area of Borough 2,282.5 acres. Density of population 51.95 persons per acre over total area. Marriages registered 1,503 Births registered. (Corrected) 2,708 Birth rate 21.7 Deaths registered. (Corrected) 1,921 Death rate 16.2 Infantile mortality 277 deaths under one year, or 102 per 1,000 births. 6 POPULATION. According to the Census of 1901, the population of the Borough was then 112,239. By the Census of 1911 the population for the same area was 121,521, showing an increase during the 10 years to the extent of 9,282. In previous years it has been the practice of the Registrar-General to estimate the population of the various boroughs, &c., on the Census Returns. Owing to the War it was impossible to adhere to this method of estimation, and it became necessary to find a substitute. Fortunately this was ready to hand in the shape of the National Register, which referred to a date only six weeks removed from that for which estimates were required, viz.:—the middle of the year 1915. In this Report the death rates are calculated on the estimated civil population for the year 1915, viz., 118,559, and the birth rate on the estimated population for the year 1914, viz., 124,750. The corrected number of births registered was 2,708, whilst the corrected number of deaths of residents was 1,921, thus showing a natural increase of population by excess of births over deaths of 787. The area of the Borough is 2282.5 acres, there being 51.95 persons to the acre, showing a decrease as compared with the Census 1911 with the estimated civil population of 1.20 per acre. MARRIAGES. The number of marriages during the year was 1,503, the marriage rate being 24.1 per 1,000 of the population (124,750). BIRTHS. During last year 2,588 births, 1,324 males, 1,264 females, were registered in this Borough against 2,824 in the previous year. The number of births registered last year was 236 below the number registered 7 during the previous year. Adding 122 births which occurred outside the Borough, transferred by the Registrar-General as belonging to Hammersmith, and deducting 2 births which occurred in this Borough which are transferred to other districts by the RegistrarGeneral, the corrected number of births for last year was 2,708. On the population estimated up to the middle of the year 1914, i e., 124,750 inhabitants, the corrected number of births registered was equal to an annual rate of 21.7 births per 1,000 persons living. The birth rate in London on the estimated population of London up to the middle of the year 1914, i.e., 4,518,021 inhabitants, was equal to an annual rate of 22.5 births per 1,000 persons living. These figures are calculated upon the corrected number of births registered. NOTIFICATION OF BIRTHS ACT, 1907. Births registered 2,588 Corrected number of births 2,708 Notifications received from Midwives. Doctors. Lying-in Hospitals. Poor LawInstitutions. Parents. 1,210 851 97 36 152 Total notifications received 2,346 DEATHS. During last year 1,872 deaths were registered in this Borough, 983 males, 889 females, against 1,676 in the previous year. The number of deaths registered in the Borough last year was 196 above the number registered during the previous year. Adding 261 deaths of residents of this Borough, which took place in general hospitals and other public institutions in other Boroughs of London, London County Lunatic 8 Asylums and Metropolitan Imbecile Asylums, also 30 deaths of residents reported to me by the RegistrarGeneral as having occurred in other parts of England, and deducting 242 deaths of non-residents which occurred, 162 at the West London Hospital, 26 at Nazareth House, 25 at the Hammersmith Infirmary, 23 transferable deaths of non-residents which occurred in this Borough and 6 deaths of soldiers, the corrected number of deaths of residents registered last year was 1,921. On the before-mentioned estimated civil population, the corrected number of deaths of residents registered last year was equal to an annual rate of 16.2 deaths per 1,000 persons living. The death rate in London on the estimated civil population of London up to the middle of the year was equal to an annual rate of 16.8 deaths per 1,000 persons living. The increase in the death rate is more apparent than real, the decrease in the population making the death rate higher, but it is to be remembered that the decrease in the population is due to the absence on military duties of men in the prime of life amongst whom the death rate is extremely low. These remarks apply to all the Metropolitan boroughs, but the death rate in Hammersmith, relative to the other boroughs, is better than in the previous year. DEATHS OF INFANTS. The corrected number of deaths of residents under one year of age registered last year was 277, against 276 in the previous year. The number of deaths of infants under one year of age registered last year was equal to 144 per 1,000 of the total corrected deaths of residents registered, and to 102 per 1,000 of the total corrected registered births. The number of deaths of infants under one year of age, residents in London last year, was equal to 157 per 1,000 of the total deaths registered, and 112 per 1,000 of the total registered births. The mortality rate of infants under one year of 9 age was, as compared with the total deaths of residents registered, 13 per 1,000 less in this Borough than in London, and as compared with the total births registered 10 per 1,000 less in this Borough than in London. DEATHS OF ILLEGITIMATE CHILDREN. The corrected number of deaths of illegitimate children under 1 year of age was 35, or at the rate of 265 per 1,000 illegitimate births. The following table on infantile mortality has been prepared by me in accordance with the direction of the Local Government Board. 10 LOCAL GOVERNMENT BOARD RETURN.—TABLE IV. Infant Mortality during the year 1915. Nett Deaths from stated Causes at various Ages under 1 Year of Age. METROPOLITAN BOROUGH OF HAMMERSMITH. CAUSES OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 Weeks. 4 Weeks and under 3 Months. 3 Months and under 6 Months. 6 Months and under 9 Months. 9 Months and under 12 Months. Total Deaths under 1 year. ALL CAUSES. Certified 61 11 10 9 91 40 57 40 49 277 Uncertified — — — — — — — — — — Small-pox — — — — — — — — — — Chicken-pox — — — — — — — — — — Measles — — — — — — 1 5 8 14 Scarlet Fever — — — — — — — — — — Whooping Cough — — — — — 1 2 5 4 12 Diphtheria and Croup — — — — — — — — 2 2 Erysipelas — — — — — 1 — — — 1 Tuberculous Meningitis — — — — — — 2 1 2 5 Abdominal Tuberculosis — — — — — — — — — — Other Tuberculous Diseases — — — — — — — 1 — 1 Meningitis (not Tuberculous) — — — — — 2 3 1 2 8 Convulsions 1 1 2 — 4 — 1 — 1 6 Laryngitis — — — — — — — — — — Bronchitis — 1 2 — 3 3 2 2 1 11 Pneumonia (all forms) — — 2 — 2 6 9 13 16 46 Diarrhœa — — — — — 3 10 2 4 19 Enteritis — — — — — 2 7 4 6 19 Gastritis — — — — — 1 2 — 3 Syphilis 1 — — 1 2 3 2 — — 7 Rickets — — — — — — — 2 — 2 Suffocation, overlying 1 — — — 1 1 — — — 2 Injury at Birth 1 — — — 1 — — — — — Atelectasis 4 — — — 4 — — — — 4 Congenital Malformations 5 — — — 5 1 4 1 1 12 Premature Birth 35 6 1 2 44 4 — — — 48 Atrophy, Debility, and Marasmus 8 3 3 5 19 11 6 1 1 38 Other causes 5 — — 1 6 1 6 2 1 16 61 11 10 9 91 40 57 40 49 277 Nett Births in the Year : Legitimate, 2,576 ; Illegitimate, 132. Nett Deaths in the Year of Legitimate Infants, 242 ; Illegitimate Infants, 35. 11 REPORT ON THE WORK OF THE HEALTH VISITOR. During the year 2,588 births were registered in the Borough. Adding 122 births which were registered outside the Borough and transferred by the Registrar-General as belonging to Hammersmith, and deducting 2 births which were registered in the Borough and transferred by the RegistrarGeneral to other districts, the corrected number of births for the year was 2,708. Two hundred and seventy-eight deaths of infants under 1 year of age were registered in the Borough, 42 of which occurred in the West London Hospital, and 42 in the Hammersmith Infirmary. Twenty-three deaths of infants and non-residents of this Borough occurred, 21 at the West London Hospital, 1 at the Hammersmith Infirmary, and 1 was transferable to another district. Twenty-two deaths of infants were registered outside the Borough, 18 occurring in Institutions, and 4 being transferred by the Registrar-General. Deducting 23 deaths of infants, being non-residents, and adding 22 deaths of infants of this Borough, the corrected number of deaths of infants was 277. Of the 277 deaths, 47 were prematurely born and 61 died under one week. During the year 2,836 visits were made by the Council's Health Visitor. Of this number 2,029 were first visits, and 521 second and subsequent visits. Two hundred and eightysix visits were made when it was found that the parents had removed or were out. Twenty-one visits were paid to cases of Ophthalmia Neonatorum by the Health Visitor, and 27 visits were made in special cases in accordance with instructions of the Medical Officer of Health. In 40 cases the Health Visitor found conditions requiring the attention of the Sanitary Inspectors. The feeding of the 2,029 infants was found to be as follows :— Breast fed 1,642 Hand and breast 167 Hand only 183 Out or engaged on first visit 37 2,029 12 The following table gives the number of births and deaths and the death rate per 1,000 births, as calculated by the Registrar-General, during the past nine years, commencing 1906, the year of the appointment of the Health Visitor. Births. Deaths. Deaths of infants per 1,000 births. 1906 3,112 430 138 1907 3,029 362 117 1908 3,204 383 120 1909 2,995 360 120 1910 2,906 329 99 1911 2,929 434 146 1912 2,880 259 90 1913 2,951 314 103 1914 2,935 276 94 1915 2,708 277 102 During the year 113 hospital letters were given for mothers and infants to attend the West London Hospital for medical treatment. The education of the young mothers is an important factor in the preservation of infant life. A healthy child can be made unhealthy by improper feeding, whether the child is fed by the breast or by hand. It is important to impress on the young mothers the necessity of having regular times for feeding, quite as much by breast-feeding as by hand. Feeding cards provided by the council nave been distributed where necessary, and the mothers take great care of them. On many occasions, the existing card, which has become dirty from hanging up in the living room, has been replaced by a clean one. The Hammersmith School for Mothers has extended its usefulness by opening another branch centre during the year at Blacks Road. The Women's League of Service has provided several mothers with free dinners where they were required. There are a great many young inexperienced mothers who welcome the visits of the Health Visitor. Many of them have no friends in London and are very glad to have advice on the feeding, rearing and clothing of infants. The home talks are very much appreciated by the mothers and in many cases the Health Visitor has been requested to call and see their babies when visiting in the district where they live. 13 REPORT OF MEDICAL OFFICER OF HEALTH ON MATERNITY AND CHILD WELFARE. Gentlemen,—In accordance with your instructions I beg to submit the following report with reference to maternity and child welfare. In October, 1914, a report was prepared on the subject at the Committee's request. This report covered the circular of the Local Government Board of July 1914. In that report was described the suggestions of the Board dealing by means of institutions and otherwise with the care of expectant mothers during pregnancy and at the confinement, and subsequently the care of the nursing mother and the supervision of the child until it reached school age. This report was considered by the Committee when the matter was adjourned (sine die.) In the latest circular of the Local Government Board dated July 1915, they sanction the expenditure of money for, and will pay grants up to one half of the total expended for the following:— 1. The salaries and expenses of inspectors of midwives. 2. The salaries and expenses of health visitors. 3. The provision of a midwife or a doctor for the aid in confinement of necessitous women. 4. The expenses of a maternity centre, i.e., an institution providing any or all of the following activities, viz. :—medical supervision and advice for expectant and nursing mothers, and for infants and little children, and medical treatment for cases needing it. Grants will be paid to voluntary agencies aided by the Board on condition :— 1. That the work of the agency is approved by the Board and co-ordinated as far as practicable with the public health work of the local sanitary authority and the school medical service of the local education authority. 2. That the premises and work of the institution will be subject to inspection by any of the Board's officers or inspectors. 3. That records of the work done by the agency are kept to the satisfaction of the Board. 14 In the development of general schemes the Board desire that the services of hospitals and other efficient voluntary agencies should be fully utilised. They are also anxious that the co-operation of medical practitioners should be secured. The value of a maternity centre will be much increased by obtaining the co-operation of the medical practitioners in the area to be served by it and in organising the arrangements it is desirable that they should be consulted. I would add to this, that the co-operation and assistance of the local midwives is very essential to the efficient working of the scheme, more especially the ante-natal part. It is also suggested that much of the required work can be provided by various hospitals and voluntary agencies at work, and in some cases the chief need is to secure that the work is co-ordinated and properly linked up with that done by the Borough Council. In Hammersmith a large amount of work is done amongst nursing mothers and children, and a lesser amount among expectant mothers, but both require extending and developing. I he principal Societies at work in the Borough are :— 1. Hammersmith School for Mothers, i, Shaftesbury Road East. This Society has been in existence since 1911, and has opened the following branches :— (а) Becklow Road, opened May, 1915. (б) College Park, opened July, 1915. (c) Blacks Road, opened July, 1915. 2. The Mothers' Welcome, Bramley Road. This Welcome is on the Kensington side of Bramley Road but is utilised by the whole of the district round Latimer Road in Hammersmith, East of the London & North Western Railway, and the district is visited by their nurses. 3. The Women's League of Service, Sulgrave Road. This Society opened at Blythe Road, but has now removed to Sulgrave Road where they have more adequate premises. In addition to the above there are three creches or day nurseries in the Borough. These are principally concerned 15 with the care and feeding of children at nominal charges during the absence of the mothers at their various occupations (Laundrywork, &c.), and do not hold infant consultations. 1. The Princess Christian Creche, Blythe Road, which has accommodation for 40 children ; 2. The Blechynden Street Mission which has modation for 40 children ; and 3. The Princess Mary Adelaide Day Nursery, Wood Street, which has accommodation for 15 children. Besides the above-mentioned societies and creches, the West London Hospital also deals with a large number of children under school age, both in the out-patient department and in the wards as in-patients. The services of the experts there are utilised by the above centres, who refer cases requiring indoor or more specialised treatment to this institution. At the centres the babies are weighed, their progress noted and if this is not satisfactory the mother is given appropriate advice, for which purpose doctors of both sexes attend. Advice is given to the mothers individually on their own particular baby and in classes generally. The nursing mother is also advised as to her own health. Expectant mothers are also seen and given any necessary advice by the doctors and trained nurses present. These are at present few in number and difficult to persuade to attend the consultations, but the numbers are gradually increasing. Sewing classes are held on certain evenings, when the mothers are taught to cut out and make garments for children. In addition to these classes held at the various centres, a large amount of visiting is done to the homes of those people who attend the classes and the homes of many who do not attend. The visiting is done by trained nurses and also by voluntary workers. These visits to the homes do a vast amount of good. Insanitary conditions are noted and where necessary reported and useful advice is given to the mothers. These centres are proving extremely useful, and appreciation of the centres is shown by the fact that those who are persuaded to attend do so regularly, and often bring their friends who are in need of advice with them. Formerly infants under one year of age were treated, but now every child up to the age of five years is dealt with. 16 The Local Government Board point out that the importance of conserving the infant life of the population makes it desirable that steps should be taken in the direction indicated, even at the present time when strict economy is required in the expenditure of public bodies. It is not, however, intended that any large outlay should be involved in the provision of the services mentioned. The health visitors and many of the doctors required to work such a scheme will be women, and no labour need be employed which is required for more direct purposes of the war. The Board also observe that the initiation of a complete scheme involves time, and the Board do not desire that work should be delayed until a complete scheme can be formulated. The Board are of opinion that the local authority should in the first instance carefully consider whether the existing arrangements for home visitation are adequate. After the provision of health visitors the next step should be to arrange in populous centres for a maternity centre at which medical advice and treatment may be provided for mothers, including expectant mothers, and for children, whether ailing or not. With regard to the establishment of maternity centres, I am of opinion that for the present we have sufficient in the Borough, but I think the Committee should consider the appointment of more health visitors. At present the Council employs one health visitor, who has been endeavouring to cope with the work of the whole Borough. In 1914 there were 2,935 births, out of which 2,184 were visited, and in addition 512 subsequent visits were paid. To make these visits of permanent value there should be constant supervision, and the babies should be visited and revisited as often as is found necessary in each case. To do this adequately it will be necessary for the Council to appoint additional health visitors. They could, if appointed, pay more frequent visits, and where necessary advise the mothers to take their children to the centres, where they themselves could attend at suitable times. The Local Government Board has set up as an ideal standard that there should be one health visitor to every 500 births. This would mean, if adopted in Hammersmith, a staff of six health visitors. It will probably interest the Committee to compare the infantile mortality in Hammersmith with that of the other Boroughs and London as a whole during the last ten years. 17 INFANTILE MORTALITY RATES of the County of London, the City of London and the Metropolitan Boroughs during the 10 years 1905 to 1914, calculated by the Registrar-General. Borough. 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 Average per 1,000 County of London 129 131 116 113 108 103 129 91 105 104 113 West Districts. Paddington 123 105 109 103 100 96 127 98 100 95 106 Kensington 144 132 128 119 113 106 133 91 112 94 117 Hammersmith 135 138 117 120 120 99 146 90 103 94 116 Fulham 145 134 122 116 108 107 125 94 96 113 116 Chelsea 117 133 122 107 107 101 109 68 90 67 102 City of Westminster 114 110 102 102 95 84 103 84 96 80 97 North Districts. St. Marylebone 88 117 101 101 99 108 108 93 91 98 100 Hampstead 94 77 69 69 75 60 78 62 75 80 74 St. Pancras 135 123 108 107 102 102 112 88 92 92 106 Islington 125 124 116 102 101 94 127 87 107 105 109 Stoke Newington 122 102 100 92 80 64 102 72 82 78 89 Hackney 129 119 112 115 102 98 119 80 99 92 107 Centre Districts. Holborn 92 110 131 112 102 103 115 80 104 90 105 Finsbury 127 120 130 133 131 123 136 114 138 123 134 City of London I49 101 94 92 113 66 124 81 96 94 101 East Districts. Shoreditch 167 163 150 139 140 146 170 123 155 141 149 Bethnal Green 151 155 138 132 129 123 151 96 118 137 133 Stepney I4I 134 117 130 119 112 144 105 112 124 124 Poplar 153 152 124 123 129 Il8 157 107 112 117 129 South Districts. Southwark I48 144 138 111 119 Il6 144 105 115 124 128 Bermondsey 148 153 125 144 138 126 156 111 132 125 136 Lambeth 115 131 120 104 109 94 123 86 102 104 109 Battersea 131 126 114 104 107 97 124 84 111 93 109 Wandsworth 119 121 99 97 86 78 122 76 88 89 98 Camberwell 124 130 115 104 100 94 109 83 106 99 106 Deptford 122 143 108 122 102 122 142 89 112 99 116 Greenwich 119 119 100 120 100 107 128 84 103 98 108 Lewisham 92 113 90 86 74 80 104 70 78 74 86 Woolwich 102 109 112 94 82 85 97 73 79 85 92 In a Return prepared in April of this year by the Medical Officer of Health for Bethnal Green it is shown that 11 Boroughs have Municipal Maternity Schemes in entire or partial operation, in 8 there were voluntary societies at work, whilst in 9 there appeared to be neither voluntary nor municipal centres. In conclusion I would suggest to the Committee that as advised by the Local Government Board they consider the advisability of appointing additional health visitors, and that instructions be given to me to prepare a scheme on the suggestions laid down by the Board. 18 Table showing the Infantile Mortality Rates of the County of London, the City of London, and the Metropolitan Boroughs during the 52 Weeks of 1915, calculated from the Figures Published by the Registrar-General. Deaths under 1 year to 1,000 Births Registered. County of London 112 Hampstead 78 Lewisham 80 City of Westminster 92 Woolwich 94 Wandsworth 94 Chelsea 96 St. Marylebone 99 Greenwich 101 Holborn 101 Hammersmith 102 Camberwell 103 Stoke Newington 103 St. Pancras 104 Lambeth 105 Islington 108 Hackney 109 Battersea 112 Fulham 115 Paddington 115 Stepney 115 Kensington 118 City of London 120 Bethnal Green 122 Finsbury 128 Deptford 132 Poplar 132 Southwark 132 Shoreditch 145 Bermondsey 149 19 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 577, against 525 in the previous year. These deaths last year were equal to 4.9 per 1,000 of total persons living, and 300 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 5 per 1,000 of the total persons living, and 296 per 1,000 of the total deaths of London residents registered. This death rate was, therefore, .I less in this Borough than in London as compared with the total persons living, and 4 per 1,000 greater in this Borough than in London as compared with the total deaths registered. LOCAL GOVERNMENT BOARD RETURN.—TABLE I. Vital Statistics of Whole District during 1915 and Previous Years. METROPOLITAN BOROUGH OF HAMMERSMITH. year. Population estimated to middle of each year. Births. Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District. Uncorrected Number. Nett. of Non-residents registered in the District. of Residents not registered in the District. Number. Rate. Number. Rate. Under 1 Year of Age. At all Ages. N umber Rate per 1,000 Nett Births. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1910 120877 2910 3045 25·2 1569 12·3 240 209 304 104 1538 12·1 1911 121766 2807 2929 24·1 1927 15·8 259 245 434 148 1913 15·7 1912 122750 2755 2883 23·5 1595 13·0 253 251 261 91 1593 13·0 1913 123745 2951 3042 24·6 1704 13·8 227 275 314 103 1752 14·2 1914 124750 2824 2935 23·5 1676 13·4 233 269 276 94 1712 13·7 1915 118559 2588 2708 21·7 1872 15·8 242 291 277 102 1921 16·2 Area of District in acres (land and inland water) 2282·5 At Census of 1911 (of. Census, Vol. 5). Total population at all ages 121,521 Total families or separate occupiers 28,462 20 DEATHS OF RESIDENTS. Belonging to the Borough occurring in Public Institutions, &c., in districts outside, during the year 1915. Fever Hospitals. Western Hospital 22 North Western Hospital 7 Northern Hospital 2 South Western Hospital 1 Eastern Hospital 1 General Hospitals. St. George's Hospital9 Middlesex Hospital 11 Guy's Hospital 1 Children's Hospital, Paddington 5 St. Mary's Hospital 8 Cancer Hospital, Chelsea 5 Queen Charlotte's Hospital 1 Infants' Hospital 2 Charing Cross Hospital 2 St. Thomas' Hospital 3 Westminster Hospital 1 London Hospital 2 German Hospital, Hackney 2 Victoria Hospital 1 French Hospital 1 Samaritan Free Hospital 1 Consumption Hospital, Kensington 1 Brompton Hospital 4 University College Hospital 3 Italian Hospital 1 Children's Hospital, Great Ormond Street 3 National Hospital for Diseases of Heart, St. Marylebone 1 Chelsea Hospital for Women 1 Hospital of St. John and St. Elizabeth 1 Grove Hospital 2 Homoeopathic Hospital, Great Ormond Street 3 Eveline Hospital 1 City of London Lying-in Hospital 1 St. Peter's Hospital 1 Putney Hospital 1 Royal Waterloo Hospital 1 New Hospital for Women 1 St. Columbus Hospital 1 Alexandra Hospital, Queen Square 1 Chest Hospital, Bethnal Green 1 Asylums. Hanwell Asylum 32 Banstead Asylum 10 Long Grove Asylum 5 Colney Hatch Asylum 9 rooting Bee Asylum 3 Horton Asylum 2 Caterham Asylum 6 Leavesden Asylum 2 Cane Hill Asylum 2 Clayburv Asylum 4 Fountain Temporary Asylum 3 Manor Asylum 3 Dartford Heath Asylum 3 L.C.C. Asylum, Norwood 2 Other Institutions. Fulham Workhouse 4 Bow Institution 5 Kensington Infirmary 5 Marylebone Infirmary 2 Fulham Infirmary 3 British Home and Hospital for Incurables 1 Whitechapel Union Workhouse 2 St. Luke's House, Kensington 5 St Mary's Nursing College, Hampstead 1 Lambeth Infirmary 1 Holborn Workhouse, Mitcham 1 Downs Sanatorium 1 Camberwell Workhouse 1 Kensington Dispensary 1 Warrington Lodge, Paddington 1 Hostel of God 1 Chelsea Workhouse2 Woolwich Infirmary 1 Camberwell House 1 Union Workhouse, Wandsworth 1 Bethnal House 1 Cranford Nursing Home, 11, Waltersville Road, Islington 1 St. Barnabas Home, Clerkenwell1 Hackney Branch Workhouse, Brentwood 1 Various. 122. Ladbroke Grove 1 Central London .Tube Station, Oxford Circus 1 57, Everington Street, Fulham 1 31, Morella Road, Battersea 1 43, Gloucester Terrace, Paddington 1 17, Park Lane, W. 1 On way to and near Westminster Hospital 1 Area of 46, Perham Road. Fulham 1 In Blomfield Street, E.C. 1 139, King's Avenue, Clapham 1 20, Pembridge Crescent, Kensington 1 Holland Park Avenue, Kensington 1 109, Rushey Green, S.E. 1 37, Greville Road, Hampstead 1 21 Corrected Death-rates of Metropolitan Boroughs after Distribution of Deaths in Public Institutions, Etc., for the year 1915, calculated from the Figures Published by the Registrar-General. Death rate from all causes. Average County of London 16·8 Hampstead 12·4 Lewisham 12·9 Wandsworth 13·4 Woolwich 14·1 Hackney 15·0 Camberwell 15·4 Stoke Newington 15·4 Fulham 15·5 City of London 15·8 Hammersmith 16·2 City of Westminster 16·4 Battersea 16·4 Kensington 16·7 St. Marylebone 16·9 Paddington 17·2 Stepney 17·3 Lambeth 17·4 Bethnal Green 17·6 Islington 17·6 St. Pancras 17·6 Deptford 17·7 Greenwich 17·7 Holborn 18·8 Chelsea 19·1 Poplar 19·5 Shoreditch 19·8 Southwark 20·7 Bermondsey 21·4 Finsbury 21·4 22 LOCAL GOVERNMENT BOARD RETURN.—TABLE III Causes of, and Ages at, Death during the Year 1915. METROPOLITAN BOROUGH OF HAMMERSMITH. Causes of Death. Next Deaths at the subjoined ages of "Residents" whether occurring within or without the District. Total Deaths whether of " Residents" or " Nonresidents" in Institutions in the District. 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 1921 277 89 96 74 72 259 477 577 730 Uncertified 0 0 0 0 0 0 0 0 0 0 Enteric Fever 2 0 0 0 0 0 1 1 0 1 Small-pox 0 0 0 0 0 0 0 0 0 0 Measles 47 14 19 13 1 0 0 0 0 4 Scarlet Fever 14 0 1 6 6 0 1 0 0 0 Whooping Cough 27 12 8 6 1 0 0 0 0 2 Diphtheria and Croup 14 2 1 5 4 0 2 0 0 0 Influenza 26 2 0 0 0 0 3 13 8 1 Erysipelas 3 1 0 0 0 0 0 0 2 2 Phthisis (Pulmonary Tuberculosis) 203 1 2 7 8 31 73 70 11 95 Tuberculous Meningitis 21 5 4 7 3 2 0 0 0 12 Other Tuberculous Diseases 10 0 0 2 4 0 1 3 0 8 Cancer, malignant disease 161 0 0 0 0 0 25 71 65 63 Rheumatic Fever 8 0 0 0 4 0 1 1 2 3 Meningitis 24 8 3 4 0 1 1 1 0 11 Organic Heart Disease 189 0 0 0 4 11 23 74 77 53 Bronchitis 152 11 4 6 1 1 7 28 94 53 Pneumonia (all forms) 240 46 27 27 10 4 31 53 42 83 Other Diseases of Respiratory Organs 21 4 0 0 2 1 3 6 5 6 Diarrhœa and Enteritis 55 38 10 3 0 0 2 1 1 32 Appendicitis and Typhlitis 4 0 0 0 2 2 0 0 0 8 Cirrhosis of Liver 15 0 0 0 0 0 5 8 2 6 Alcoholism 6 0 0 0 0 0 2 4 0 0 Nephritis and Blight's Disease 77 0 0 0 0 4 9 31 33 36 Puerperal Fever 0 0 0 0 0 0 0 0 0 0 Other accidents and diseases of Pregnancy and Parturition 5 0 0 0 0 1 4 0 0 0 Congenital Debility and Malformation, including Premature Birth 98 98 0 0 0 0 0 0 0 18 Violent Deaths, excluding Suicide 65 2 2 3 8 3 9 18 20 48 Suicide 4 0 0 0 0 0 2 2 0 4 Other defined Diseases 428 33 7 6 10 11 54 92 215 181 Diseases ill-defined or unknown 2 0 1 1 0 0 0 0 0 0 Total 192I 277 89 96 74 72 259 477 577 730 SubEntries included in above figures. Cerebro-spinal Meningitis 13 5 1 2 3 1 1 0 0 2 23 DEATHS FROM THE SEVEN PRINCIPAL ZYMOTIC DISEASES. The total number of deaths of residents that were registered from the seven principal zymotic diseases was 159 against 158 in the previous year. The deaths of residents last year from these diseases were equal to 83 per 1,000 of the total deaths of residents registered, and were at the rate of 1.3 deaths per 1,000 persons living. The deaths from the seven principal zymotic diseases in the whole of London were equal to 98 per 1,000 of the total deaths registered, and were at the rate of 1.7 deaths per 1,000 persons living. These deaths were, therefore, as compared with the total deaths of residents registered, 15 less per 1,000 deaths belonging to this Borough than in London, and, as compared with the population, •4 per 1,000 less 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 1906 to 1915 :— YEAR. Small-pox. Measles. Scarlet Fever. Diphtheria and Membranous Croup. Whooping Cough. Enteric Fever. Diarrhœa and Cholera. Total. 1906 0 56 16 27 20 8 144 271 1907 0 52 10 23 31 6 39 161 1908 0 14 13 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 1912 0 28 3 14 16 4 38 103 1913 0 49 7 12 41 0 77 186 1914 0 41 5 15 20 3 74 158 1915 0 47 14 14 27 2 55 159 Average in last 10 years. 0 47 9 20 27 4 82 189 24 It will be seen from the preceding table that the total number of deaths from these zymotic diseases last year was 30 below the average number registered in the last 10 years. CASES OF ILLNESS REPORTED AS DUE TO INFECTIOUS DISEASE. There were, omitting tuberculosis, 869 cases (including 138 cases of chicken-pox) reported as due to notifiable infectious diseases in this Borough against 1,267 in the previous year. The number of cases of tuberculosis notified was 433, against 443 in the previous year. There were also reported 1,077 cases of infectious diseases that were not notifiable, against 958 in the previous year; 231 of these were chickenpox, 619 measles, and 227 whooping cough. There were also reported 208 military cases of infectious diseases. 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 sixty-nine cases of chicken-pox were reported, against 235 cases in the previous year. Three hundred and sixty-four cases were treated at the homes of the patients, 1 at Hammersmith Infirmary, 1 at Westminster Infirmary, and 3 at Kensington Infirmary. No death was registered. One military case was reported and removed to Isolation Hospital. On the 9th day of March the London County Council made an order as a case of emergency, having regard to the occurrence of cases of small-pox and to the fact that mild forms of this disease were liable to be mistaken for chicken-pox, with respect to the notification of chicken-pox. The order, which was 25 approved by the Local Government Board, came into operation on the 17th March, and was in force up to and including the 30th Tune. One hundred and thirty-eight cases were notified during this period. MEASLES. Six hundred and nineteen cases were reported as due to measles, against 491 cases in the previous year. The following chart shows the number of Deaths from Measles per 100,000 inhabitants since 1000. 26 Six hundred and thirteen cases were treated at the homes of the patients, I at the Metropolitan Asylums Board's Hospitals, I at Hammersmith Infirmary, I at the West London Hospital, and 3 at Paddington Infirmary Forty-seven. deaths were registered. As this is not a notifiable disease it is of no use giving the mortality rate on the cases reported, as no doubt only a proportion of the cases which occurred were known. One hundred and eighty-six military cases were also reported and removed to various Isolation Hospitals. 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 33 deaths, whereas from measles alone there were 47 deaths. In every case that was reported the premises were at once inspected as to the sanitary condition. In November the Local Government Board, under the powers conferred upon them, issued a General Order whereby the diseases known as Measles and German Measles were made notifiable diseases, and made the following regulations, which came into operation on the 1st day of January, 1916:— ORDER OF LOCAL GOVERNMENT BOARD. NOTIFICATION AND TREATMENT OF MEASLES AND GERMAN MEASLES. To the Mayor, Aldermen, and Commons of the City of London, in Common Council assembled ;— 27 To the Councils of the several Metropolitan Boroughs, Municipal Boroughs, and other Urban Districts in England and Wales ;— To the Councils of the several Rural Districts in England and Wales ;— To all Medical Practitioners ;— And to all others whom it may concern. Whereas We, the Local Government Board, are empowered by Section 130 of the Public Health Act, 1875, as amended by the Public Health Act, 1896, from time to time, to make, alter, and revoke Regulations with a view to the treatment of persons affected with any endemic or infectious disease and for preventing the spread of the disease; and to provide for the enforcement and execution of the Regulations ; And whereas by section 133 of the Public Health Act, 1875, any local authority may, with Our sanction, themselves provide or contract with any person to provide a temporary supply of medicine and medical assistance for the poorer inhabitants of their district; And whereas Measles and German Measles are endemic and infectious diseases : Now therefore, We, by this Our Order and in the exercise of the powers conferred upon Us by the Public Health Act, 1875, the Public Health (London) Act, 1891, and the Public Health Act, 1896, and of every other power enabling Us in that behalf, do hereby make the following Regulations, that is to say :— Definitions. Article I.—In these Regulations, unless the contrary intention appears :— (а) Words importing the masculine gender include females ; (b) Words in the singular include the plural, and words in the plural include the singular ; (c) Expressions referring to writing include references to printing, and to other modes of representing or reproducing words in a visible form, and references to printing include references to other mechanical modes of so representing or reproducing words ; (d) The expression "Local Authority" means, as the case may be, the Mayor, Aldermen, and Commons 28 of the City of London in Common Council assembled, the Council of a Metropolitan Borough, the Council of a Municipal Borough or other Urban District, or the Council of a Rural District; (e) The expression 'District" means the District subject to the jurisdiction of the Local Authority for the purposes of the Public Health (London) Act, 1891, or of the Public Health Act, 1875, as the case may be ; (f) The expression "Medical Officer of Health" means Medical Officer of Health of a Local Authority; (g) The expression " Medical Practitioner " means any person for the time being registered under the Medical Acts ; Commencement of Regulations. Article II.—These Regulations shall come into operation on the First day of January, One thousand nine hundred and sixteen, and shall then and thereafter apply and have effect throughout England and Wales, and shall *be enforced and executed by every Local Authority. Notice of Provisions of Regulations. Article III.—(1) The Local Authority shall forthwith cause notice to be given to all Medical Practitioners resident or practising within the District of the Local Authority of the duties imposed upon them by these Regulations. (2) Fourteen days at least before the date on which these Regulations come into operation, the Local Authority shall give public notice of the effect of the provisions of the Regulations by advertisement in some one or more newspapers circulating within the District and by causing notice thereof to be affixed to the principal doors of every church and chapel in the place in which notices are usually fixed, and otherwise in such manner as the Local Authority think sufficient for giving notice thereof to all persons interested. Supply of Forms of Notification. Article IV.—For the purposes of these Regulations every Local Authority shall provide and maintain a sufficient supply of printed copies of the Form set out in the Schedule to these 29 Regulations, and shall as soon as practicable after these Regulations come into operation, and afterwards from time to time when application is made to them, furnish printed copies of the said Form to every Medical Practitioner resident or practising within the District of the Local Authority. Notification by Parents or Guardians. Article V.—Every Parent or Guardian, or other person, as soon as he becomes aware of, or has reasonable grounds for supposing that any person in his charge is suffering from Measles or German Measles shall, unless the case has been already notified by a Medical Practitioner, forthwith notify the case to the Medical Officer of Health for the District, stating the name and age of the patient, and his address. Notification by Medical Practitioners. Article VI.—(i) Subject to the provisions of these Regulations, every Medical Practitioner, as soon as he becomes aware that a person upon whom he is in professional attendance is suffering from Measles or German Measles, shall forthwith make and sign a notification of the case in the Form set out in the Schedule to these Regulations, and shall transmit the notification to the Medical Officer of Health for the District: Provided that a Medical Practitioner shall not be required to notify a case of Measles or German Measles under this Article and shall not be paid a fee for so doing— (a) if he has reasonable grounds for supposing that the case has already been notified under these Regulations ; or (b) if the case is notifiable or has been notified by a Medical Practitioner under the Infectious Disease (Notification) Act, 1889, Section 55 of the Public Health (London) Act, 1891, or under the provisions of any Local Act or Order made thereunder: or (c) if a case of the disease which he is attending, whether Measles or German Measles, has to his knowledge occurred in the same household or institution, and been notified within the period 30 of two months immediately preceding the date on which he first becomes aware of the disease in the case he is attending ; or (d) if the case is being treated in a hospital for infectious diseases. (2) Every Medical Practitioner who transmits to a Medical Officer of Health a notification of a case of Measles or German Measles under the Infectious Disease (Notification) Act, 1889, Section 55 of the Public Health (London) Act, 1891, or under the provisions of any Local Act or Order made thereunder, shall transmit such notification in the Form set forth in the Schedule to these Regulations. Transmission of Notifications. article VII.—a notification to be transmitted to a Medical Officer of Health in pursuance of these Regulations shall be enclosed in a sealed envelope addressed to that Officer and may be transmitted by being delivered to him or by being delivered at his office or residence, or may be sent by prepaid letter post addressed to him at his office or at his residence. Fees for Notification. Article VIII.—(1) The Local Authority shall pay to every Medical Practitioner a fee of two shillings and sixpence for each notification duly made, signed and transmitted by him under these Regulations if the case occurs in his private practice, and of one shilling if the case occurs in his practice as medical officer of any public body or institution. (2) The said fees shall in each case be deemed to cover all expenses, including the cost of transmission. Duties of Local Authorities and Medical Officers of Health. Article IX.—(1) A Medical Officer of Health on receipt of a notification under these Regulations in relation to a case occurring in a house or institution which is not in his District shall forthwith notify the Medical Officer of Health of the District in which the house or institution is situated. (2) Upon the receipt of a notification under these Regulations, or on becoming aware in any other way of a case or suspected case of Measles or German Measles in his District, the Medical Officer of Health, or an Officer of the Local 31 Authority acting under the instructions of the Medical Officer of Health, shall make such inquiries, and take such steps as are necessary or desirable for investigating the source of infection, for preventing the spread of infection, and for removing conditions favourable to infection, and if a Medical Practitioner is not in attendance on the patient, the Medical Officer of Health shall also take such steps as are necessary or desirable for ascertaining the nature of the case. The Local Authority may provide or contract tor the provision of medical assistance for the poorer inhabitants of the District when suffering from either of the diseases above mentioned : Provided that nothing in this Article shall be deemed to authorise a Medical Officer of Health or other Officer to take any of the steps herein mentioned at any Institution other than one belonging to the Local Authority, except with the consent of the Managers of that Institution. (3) The duties assigned to the Medical Officer of Health by the Sanitary Officers (London) Order, 1891, or the Sanitary Officers (outside London) Order, 1910, as the case may be, shall be deemed to extend to and to include all action by the Medical Officer of Health in the execution of these Regulations. Notification not required in certain cases. Article X.—Nothing in these Regulations shall be deemed to require a notification to be transmitted to a Medical Officer of Health in respect of an inmate of any building, ship, vessel, boat, tent, van, shed, or similar structure belonging to His Majesty the King. Short Title. Article XI.—These Regulations may be cited as "The Public Health (Measles and German Measles) Regulations, I9I5- SCARLET FEVER. Four hundred and five cases were notified as due to scarlet fever, against 954 in the prev1ious year. Three hundred and seventy-five cases reported last year were isolated at Isolation Hospitals, 1 at Kensington D 32 Infirmary, 1 at a private nursing home, and 28 cases were treated at the homes of the patients. Fourteen deaths were registered. The mortality rate on the cases reported was 3.5 per cent. Nine military cases were also notified and removed to Isolation Hospitals. DIPHTHERIA AND DIPHTHERITIC MEMBRANOUS CROUP. One hundred and sixty-three cases were reported as due to diphtheria or diphtheritic membranous croup, against 157 cases in the previous year. One hundred and fifty-one cases reported last year were treated at the Isolation Hospitals, 1 at St. Mary's Hospital, and 11 at the homes of the patients. Fourteen deaths were registered. The mortality rate on the cases reported was 8.6 per cent. One military case was also notified and removed to Isolation Hospital. During the year 38 orders on the Lister Institute of Preventive Medicine, with swabs, were supplied to medical practitioners attending suspected cases of diphtheria. WHOOPING COUGH. Two hundred and twenty-seven cases were reported as due to whooping cough, against 232 cases in the previous year. Two hundred and twenty-five cases were treated at the homes of the patients, 1 at Hammersmith Infirmary, and 1 at the West London Hospital. Twenty-seven deaths were registered. As this is not a notifiable disease it is of no use giving the mortality rate on the cases reported, as doubtless a very large number of cases occurred which were not known 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. 33 The following chart shows the number of Deaths from Whooping Cough per 100,000 inhabitants since igoo. ENTERIC FEVER. Nineteen cases were reported as due to enteric fever, against 14 in the previous year. Fifteen of the cases reported last year were treated at the Isolation Hospitals of the Metropolitan Asylums Board, 1 at the Hammersmith Infirmary, 1 at the West London Hospital, and 2 at the homes of the patients. Two deaths 34 were registered. The mortality rate on the cases reported was 10.6 per cent. One military case was notified and removed to Isolation Hospital. During the year seven orders on the Lister Institute of Preventive Medicine, with Widal outfit, were supplied to medical practitioners attending suspected cases of enteric fever. 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. PUERPERAL FEVER. Five cases were reported as due to puerperal fever, against 7 cases in the previous year. Two of the cases reported last year were treated at the homes of the patients, and 3 at the Hammersmith Infirmary. No death was registered. CHOLERA. No case was reported as due to cholera, against no case in the previous year. ERYSIPELAS. Ninety cases were reported last year as due to erysipelas, against 102 cases in the previous year. Sixty-six cases were treated at the homes of the 35 patients, 23 at the Hammersmith Infirmary, and 1 at the West London Hospital. Three deaths were registered. The mortality rate on the cases reported was 3.3 per cent. Two military cases were reported. One case being removed to the Third London General Hospital and one to the Central London Throat and Ear Hospital. PLAGUE. No case was reported as due to plague, against no case in the previous year. CEREBROSPINAL FEVER. Eighteen cases were reported as due to cerebrospinal fever, against two cases in the previous year. Eight cases were removed to the hospitals of the Metropolitan Asylums Board, 2 to the Hammersmith Infirmary, 1 to Kensington Infirmary, 1 to St. Mary's Hospital, 1 to the West London Hospital, and 5 were treated at the homes of the patients. Four cases were dead at the time of notification. Thirteen deaths were registered, the mortality rate being 72.2 per cent. Twelve military cases were notified, 8 cases being removed to the Metropolitan Asylums Board's hospitals, 2 to the First London General Hospital, 1 to the London Fever Hospital, and 1 to the Second London General Hospital. GLANDERS. No case was reported as due to glanders, against no case in the previous year. ANTHRAX. No case was reported as due to anthrax, against no case in the previous year. Although no case of anthrax was notified in Hammersmith, one case in a human subject was of 36 interest to, and concerned the public health of the Borough, as the following account will show. The patient was a man aged about 32, living in the Borough of Paddington. On June 29th he noticed a small pimple or boil on the front of his neck. On the following morning, the 30th, he woke and found considerable swelling of his neck. He was seen by his doctor who sent him on the following day, July 1st, to the West London Hospital. A slight operation was performed the same evening, but the patient died the following morning, July 2nd, at 7.30. It was suspected that it was a case of human anthrax, and post-mortem this suspicion was confirmed. The question remained as to how the infection took place. The disease is not uncommon among workers in imported hides and hair, but the occupation of this patient, that of a solicitor's clerk, was one of the last to suggest anthrax. The position of the point of infection, over a prominent part of the neck in the shaving area, suggested to the pathologist the origin of the infection. On inquiry it was discovered that the patient had recently been given a new shaving brush. At the inquest this was suggested by the pathologist as being a possible source of infection, and the verdict was brought in that death was due to anthracæmia, possibly contracted from an infected shaving brush. The idea was considered extravagant by some who were opposed to the suggestion, probably because there was no previously recorded case. It appears to have caused annoyance to others who were interested in the manufacture of these cheap shaving brushes. It is perhaps a pity that it was not possible to examine the brush before the inquest. Subsequently the brush was obtained and examined, when it was found to be of a cheap quality (wholesale price 6d.), dyed to resemble badger, and composed of pig bristles, horse hair, and possibly cow tail with some vegetable fibres. Upon a bacteriological examination being made it was conclusively demonstrated that this brush was 37 infected with spores of the anthrax bacillus and the theory put forward at the inquest proved, Unused brushes from the same supply were found to be similarly infected, Some were traced to Hammersmith and were seized on my instructions, Several of these were found to be infected, and were destroyed, Much credit is due to Dr, Elworthy, the pathologist of the West London Hospital, for his investigations and their results, Personally I cannot speak too highly of the great care he took in carrying out these experiments, the details of which I was able to follow day by day, The results obtained are of great value to public health, as showing a new source of danger from anthrax, Since the result of these investigations have been made known, other cases have been discovered, and many consignments of infected shaving brushes and hair intended for their manufacture have been seized and destroyed, HYDROPHOBIA, No case was reported as due to hydrophobia last year, against no case in the previous year, OPHTHALMIA NEONATORUM, Twenty.three cases were reported as due to ophthalmia neonatorum, against 30 cases in the previous year, The cases reported last year were treated : 16 at the homes of the patients, 1 at the Western Ophthalmic Hospital, 1 at the Hammersmith Infirmary, and 5 at the West London Hospital, ACUTE POLIO.MYELITIS, Eight cases were reported as due to polio-myelitis, against 1 case in the previous year, Six cases were treated at the West London Hospital, 1 at the Women's Hospital for Children, Harrow Road, and 1 by private medical practitioner at home, 38 In December, upon the suggestion of the Local Government Board, I submitted to you the following report in reference to the six cases of polio.myelitis treated at the West London Hospital:— Gentlemen,—In accordance with the suggestion of the Local Government Board, I beg to submit a report on the six cases of acute polio.myelitis, notified during the week end of the 16th October, to which the Board has called attention, The notifications in reference to these cases were received four on the 14th October and two on the 16th October, The whole of the six cases were receiving treatment at the West London Hospital at the time of notification, It will be clearly seen from the appended table that in all the cases a considerable time elapsed between the date of onset and the date of notification, in one case as long as 10 weeks, Acute polio.myelitis, or infantile paralysis, is an acute disease of sudden onset, and is not always diagnosed in its early stages, It is only when the resultant paralysis occurs that the true nature of the disease becomes known, It is usually on account of the latter condition, and some time after the onset, that the child is taken to a doctor, and the condition diagnosed, With regard to these particular six cases, although notified in one week, their onset was spread over a period of two months, August 1st, 1915, to October 1st, 1915, and in two cases a considerable time elapsed before medical advice was sought, (August 1st, 1915, to September 4th, 1915; August 30th, 1915, to 25th September, 1915,) The following table shows at a glance the dates of onset and the subsequent dates of the notification, &c, :— Date of onset. First visit to Hospital. Notification received. Enquiry made. 1915 1915 1915 1915 1 L,H, (2½) 48, G,R, Sept, 24th Oct, 9th Oct, 14th Oct, 15th 2 F,H, (3) 37, N,S, Aug, 1st Sept, 4th Oct, 14th Oct, 15th 3 F,D, (1½*) 58, C,R, Aug, 5th Aug, 7th Oct, 14th Oct, 15th 4 G,P, (6) 203, U,R, Aug, 30th Sept, 25th Oct, 14th Oct, 15th 5 R,C, (8) 13, C,S, Aug, 4th Sept, 24th Oct, 15th Oct, 15th 6 L,P, (7) 7, S,S, Oct, 1st Sept, 8th Oct, 16th Oct, 25th * This case was notified as being resident at 3, S,S,, the correct address being obtained on October 24th, 1915, 39 In case No, i the patient was seen by a private practitioner before being taken to the West London Hospital where she had, two months previously, been an in.patient with dysentery, In case No, 2 the child was said to have had a fall about August 1st, 1915, after which he lost the use of both legs and was taken to the West London Hospital on September 4th, I9I5. In case No, 3 the patient had previously been under the care of a private practitioner, when she was said to be suffering from bronchitis, On August 3rd, 1915, the patient lost the use of an arm suddenly and was taken to the West London Hospital, In case No, 4 the patient was taken ill at Brighton on August 30th, 1915, when his parents came to Hammersmith for a short period and the patient was taken to the West London Hospital, In case No, 5 the patient was first taken ill on August 4th, 1915, when a private practitioner was consulted, and was afterwards an in.patient in the West London Hospital from August 7th, 1915, to September nth, 1915, On September 24th, 1915, he again attended the West London Hospital as an out.patient, In case No, 6 the patient was first taken to a private practitioner and afterwards to the West London Hospital on October 1st, 1915, In every case enquiries were immediately made, when the necessary particulars were obtained which were forwarded to the London County Council, It will be clearly seen that owing to the length of time intervening between the onset of the disease and its notification, the steps necessary to be taken for the prevention of the possible spread of the infection are of but little value, In view of the fact I addressed a letter to the Resident Medical Officer at the West London Hospital, who notified the cases, pointing out that a considerable time was allowed to elapse between the attendance of the patients at the hospital and the receipt of the notification certificates, I was informed that the delay in notification had been caused by the lack of permanent help in the out.patients' department at the hospital through depletion of staff owing to the war, The Resident Medical Officer also pointed out, and I agree with his observations, that it is extremely rare for the 40 hospital to see a case at its onset and that none of these cases were seen until the paralysis was well established, The delay in notification, therefore, did not cause any corresponding delay in any preventive action being taken by us, By the time most of these cases are diagnosed the power of infection is probably long past, and any precautions by disinfection quite useless, Enquiry at the homes of the patients showed that not one case had any connection whatsoever with any other, that is to say, no one case was infected from the other, but arose from some other source not ascertainable, Previous to these cases, two cases only had been notified during 1915 in the Borough and none have occurred since, SUMMER DIARRHCEA, The number of deaths from diarrhoea was 55, being 19 less than in the previous year, Thirty.eight were under 1 year of age, During the year leaflets dealing with precautions which should be taken for the prevention of summer diarrhoea were delivered by the Lady Health Visitor where births had occurred during the year of this Report, DANGER FROM FLIES, During the year, illustrated leaflets were distributed, pointing out the danger from flies, and showing how disease was spread by their carrying filth and germs from ashpits, privies, manure heaps, decaying animal and vegetable refuse, to food, etc, Supplies of leaflets were sent to the Registrars of Births and Deaths, who kindly offered to hand them to parents registering the births of their children, 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 1906 to 1915, 41 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. Anthrax. Glanders. Hydrophobia. Ophthalmia Neonatorum Acute Polio-myelitis. Total. 1906 0 439 270 0 33 1 0 10 O 125 0 68 627 56 0 0 O O 0 0 1629 1907 0 577 207 0 40 0 0 7 0 76 0 198 538 337 4 0 0 0 0 0 1984 1908 0 383 199 0 29 0 O 6 0 65 0 113 161 156 1 O 0 0 0 0 1113 1909 0 380 188 0 17 0 0 14 O 75 0 140 847 281 1 O O 0 0 0 1943 1910 0 340 161 0 31 1 0 9 O 63 O 228 484 200 2 1 1 0 0 0 1521 1911 0 236 195 1 28 1 0 3 0 97 O 304 554 250 1 O 0 0 18 1 1689 1912 0 335 177 0 11 0 0 7 0 99 0 363 487 208 3 O O 0 17 1 1708 1913 0 533 141 0 14 0 0 8 0 98 0 171 700 371 1 0 0 O 22 1 2060 1914 0 954 157 0 14 0 0 7 0 102 0 235 491 232 2 0 0 0 30 1 2225 1915 0 405 163 0 19 0 0 5 0 90 0 369 619 227 18 0 0 0 23 8 1946 Av'rge in last 10 yrs. 0 458 186 0 24 0 0 8 0 89 0 219 551 232 3 0 0 0 11 1 1782 • Not a notifiable disease, The Following chart shows the number of Deaths From Diarrhoea per ioo,ooo inhabitants since 19oo, 43 Chart showing the total number of cases of Notifiable Infectious Diseases (excluding Tuberculosis) notified week by week in the Borough during 1915. Chart showing the number of cases notified week by week in the Borough, of Scarlet Fever, Diphtheria and Typhoid Fever during 1915, 44 45 I-OCAL GOVERNMENT BOARD RETURN—TABLE II. Cases of Infectious Disease notified during the year 1915. 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 Ages—Years. At all Ages. Under 1 1 & under 5 Years. 5 & under 15 Years. 15 & under 25 Years. 25 & under 45 Years. 45 & under 65 Yeat s. 65 and upwards. North Centre South Small-pox 0 0 0 0 0 0 0 0 0 0 0 0 Cholera (C) Plague (P) 0 0 0 0 0 0 0 0 0 0 0 0 Diphtheria (including Membranous Croup) 163 4 52 84 13 9 1 0 65 62 36 152 Erysipelas 90 4 4 2 7 27 33 13 48 31 11 24 Scarlet Fever 405 3 96 244 43 18 1 0 174 175 56 375 Typhus Fever 0 0 0 0 0 0 0 0 0 0 0 0 Enteric Fever 19 0 0 3 5 7 4 0 9 9 1 17 Relapsing Fever (R) Continued Fever (C) 0 0 0 0 0 0 0 0 0 0 0 0 Puerperal Fever 5 0 0 0 2 3 0 0 2 3 0 3 Cerebro-spinal Meningitis 18 6 4 4 3 1 0 0 10 4 4 13 Polio-myelitis 8 1 5 2 0 0 0 0 7 1 0 0 Ophthalmia Neonatorum 23 23 0 0 0 0 0 0 13 10 0 1 Pulmonary Tuberculosis 366 1 13 38 58 154 88 14 162 126 78 97 Other forms of Tuberculosis 67 1 17 25 11 5 6 2 33 27 7 31 *Chicken-pox 138 8 56 69 3 2 0 0 59 56 23 4 Totals 1302 51 247 471 145 226 133 29 582 504 216 717 Isolation Hospital or Hospitals. Sanatoria, &c.—Western Fever 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. •Notifiable from 17th March to 30th June, 1915. 46 The following table of Deaths from Infectious Diseases is compiled from the Registrar.General's Report, Boroughs, Population estimated to the middle of 1914, (Old Estimate) Births, Deaths from Deaths under 1 year of Age, All causes, Enteric Fever. Small.pox, Measles. Scarlet Fever. Whooping.cough. Diphtheria. Diarrhcea and Enteritis (under 2 years) Pulmonary Tuberculosis COUNTY OF LONDON 4,516,612 101,649 72,399 120 3 2,272 332 1,146 699 2,542 6,782 11,369 West, Paddington 142,055 2,746 2,266 6 — 93 11 31 20 91 1 09 316 Kensington 170,817 3,118 2,607 2 — 111 11 21 16 69 193 367 Hammersmith 124,750 2,707 1,932 2 — 47 13 27 14 45 197 275 Fulham 158,849 3,870 2,349 5 — t / 122 20 50 27 75 197 445 Chelsea 63,791 1,099 1,116 — — 40 5 8 6 / 3 110 106 City of W'stmnstr 152,346 1,969 2,229 4 — 4 38 11 04 12 17 39 205 182 North, St, Marylebone 112,892 1,823 1,700 2 — 53 9 l6 8 46 114 181 Hampstead 86,731 1,317 1,014 1 — 6 10 17 55 103 St, Pancras 212,497 4,755 3,527 8 — 64 22 51 24 102 415 406 Islington 324,764 7.544 5,55 5 — 152 40 105 58 164 525 812 Stoke Newington 50, 454 916 778 2 — 24 7 7 9 7 55 94 Hackney 223,724 4,844 3,259 6 — 67 7 43 29 122 309 526 Central, — Holborn 45,861 672 759 1 - 19 1 12 11 13 80 68 Finsbury 83,212 2,198 1,643 1 54 10 10 45 9 83 169 281 City of London 17,129 150 308 — - 4 — 1 V 3 3 1 20 18 East, Shoreditch 108,869 3,114 2,052 3 — 68 11 36 22 260 260 450 Bethnal Green 127,662 3,514 2,110 4 — 101 11 41 39 135 199 430 Stepney 273,265 7,512 4,603 3 — 111 29 53 72 236 520 867 Poplar I60,222 4,42 3,046 5 — 118 9 72 34 173 252 628 South, Southwark 186,941 5,239 3,727 3 — 131 12 46 37 148 389n 693 Bermondsey 124,213 3,547 2,504 3 - 110 9 79 21 134 239 527 Lambeth 296,724 6,571 4 944 13 — 102 19 49 45 139 460 693 Battersea 167,338 3,824 2,648 6 — 164 9 77 29 79 240 428 Wandsworth 338,998 6,278 4, 195 9 — 165 9 77 29 79 240 589 Camber well 262,020 6,149 3,9l8 6 — 95 8 40 30 146 366 635 Deptford 109,182 2,956 1,948 4 — 55 9 65 10 96 173 390 Greenwich 96,037 2,335 1,710 8 — 46 3 43 14 46 165 237 Lewisham 172,433 3,317 2,124 3 — 51 5 29 16 39 155 267 Woolwich 122,836 2,823 1,828 5 — 45 7 16 20 31 196 265 47 LONDON AND THE METROPOLITAN BOROUGHS, (Compiled from Registrar.General's Report,) Number of Cases of Infectious Disease Notified in the several Boroughs of the Administrative County of London during the 52 Weeks ended 1st January, 1916, (Excluding cases in barracks and military hospitals,) Boroughs, Estimated Population in the middle of 1014 (Old Estimates; Total Cases, Enteric Fever, Typhus, Continued Fever, Small.pox, Scarlet Fever, Diphtheria (including Membranous Croup), Cholera, Erysipelas, Ctrebro.spinal Fever Puerperal Fever, Anthrax, Glanders, Ophthalmia Neonatorum, Polio.myelitis, Varicella, West, Paddington 142055 1,000 18 — 2 1® 435 282 — 138 14 7 1 — 26 1 84 Kensington 170,817 835 19 — 1 1 426 174 — 87 39 11 — — 21 1 55 Hammersmith 124,750 909 22 — — — 416 '85 — 92 19 5 — — 22 8 140 Fulham 158,s49 1,218 13 — — 6 618 268 — 99 17 24 — — 33 2 147 Chelsea 63,79* 356 17 — — — 142 105 — 33 9 5 — — 12 3 30 City of Westminster 152,346 1,112 13 — — — 606 296 — 69 18 9 — — 15 — 86 North, St, Marylebone 112,892 712 11 — — — 303 136 — 83 10 3 1 — 13 1 151 Hampstead 86,731 459 12 — — — 191 137 — 52 10 3 — — 13 2 39 St, Pancras 212,497 2,006 28 — — — 1,006 438 — 201 36 13 —, — 29 8 247 Islington 324,764 2,773 27 — — — 1,332 626 — 203 39 23 — — 34 15 474 Stoke Newington 50,454 378 4 — — — 199 107 — 39 3 2 — — 6 2 16 Hackney 223,724 1,647 39 — 2 — 762 406 — 223 36 9 1 — 25 — 144 Central, Holborn 45,861 300 6 — — — 153 68 _ 28 10 2 6 27 Finsbury 83,212 902 6 — — — 441 133 — 56 10 6 1 — 25 — 224 City of London 17,129 127 2 — — — 57 48 — 4 1 — — — - 1 14 East, Shoreditch 108,869 1,268 22 — 2 — 556 271 — 183 39 9 — — 21 1 164 Bethnal Green 127,662 1,901 18 — — 1 786 532 — 196 23 9 1 — 27 7 301 Stepney 273,265 3,508 37 4 1 1 1,534 1,108 — 298 21 13 — 57 5. 4 29 Poplar 160,222 1,370 18 — — — 475 308 — 188 22 13 — — 62 5 279 South, Southwark 186,941 1,575 23 1 465 387 254 25 26 1 - 56 1 336 Bermondsey 124. 213 920 201 — 1 1* 365 225 — '25 18 7 1 — 13 2 142 Lambeth 296,724 2,15s 26 — — •96 430 — 1/4 4* 27 — — 75 5 481 Battersea 167,338 1,502 20 — — — 672 394 140 20 5 1 41 11 I8 Wandsworth 338,998 2,568 50 — — — 1,300 727 — 190 48 11 — — 39 10 193 Camber well 262,020 1,778 26 — 1 850 404 — 210 27 16 — — 34 1 209 Deptford 109,182 1,045 37 — — — 43s 200 — 150 15 4 1 — 13 2 185 Greenwich 96,037 8n8 18 — — 2 508 170 — 103 ii 4 — — 9 — 63 Lewisham 172,433 1,120 16 — — — 476 250 — 103 13 4 — — 14 1 243 Woolwich 122,836 1,119 26 — — 5602 27S — 125 23 6 - - ,9 2 78 Port of London ? 18 7 — — . 4 i . 5 i — — — — — — ADMINISTRATIVE COURT OF LONDAN 4,516,612 37,481 607 4 11 13 16,974 9,094 . 3,842 627 276 8 1 760 97 5,167 Ages 0.1 1,762 2 - - - 201 187 - 119 111 - - - 760 8 374 " 1-.5 9900 25 — — 1 4,482 .',987 — 158 154 — — — — 60 2,033 ,, 5. 13,112 67 1 7,1*1 3,432 126 112 19 2,238 ,, 10 4,961 77 — — — 3,022 1,292 — 164 6s — — — — 8 330 ,, 15 1,739 61 1 1 — 911 386 — 226 52 11 2 — — 1 87 „ 20. 1,223 87 — 3 1 486 287 — 213 40 <>5 1 — — — 40 ,, 25 1591 129 — 4 4 529 3» — 389 45 '37 2 — — 1 40 „ 35. 1,181 84 3 1 177 130 693 17 60 1 j 14 ,, 45. 927 51 — — 3 36 60 — 747 18 3 2 — — — 7 ,, 55. 580 20 3 — 2 8 14 — 523 7 — — — — — 3 65 and upwards 504 4 — — — 5 7 — 484 3 — — — — — I Age not stated 1 — — — — — — — — — — — — — * Subsequently found not to be small.pox, E 48 WRONG DIAGNOSIS, Twenty.five cases of Infectious Disease were removed to the Hospitals of the Metropolitan Asylums Board and subsequently returned home in consequence of the patients being found not to be suffering from the diseases stated on the certificates, or any other notifiable diseases, This number referred to 7 cases of scarlet fever, 15 cases of diphtheria, 2 cases of enteric fever, and 1 of Cerebro.spinal meningitis, Twenty cases of infectious disease being military cases were removed to hospital and subsequently found not to be suffering from the diseases stated on the certificates or any other notifiable disease, This number referred to 14 cases of measles, 4 cases of cerebrospinal meningitis, 1 case of scarlet fever, and 1 case of enteric fever, DISINFECTION, The following table shows the amount of disinfection carried out by your Council during the year, All bedding and articles of clothing, &c,, being removed to the Council's Disinfecting Station for the purpose of disinfection, Beds 844 Mattresses 1,354 Pillows 2,831 Bolsters 581 Blankets 3,477 Sheets 1,236 Rugs, &c, 1,004 Articles of Clothing 4,565 Rooms 946 Sundries !,977 18,815 Of the above number, 1,560 articles of clothing were disinfected at the request of the Naval and Military Authorities, 49 INFLUENZA, Twenty.six deaths were registered as due to influenza, against 12 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, TUBERCULOSIS, Four hundred and thirty.three cases were notified to me against 443 cases in the previous year, 366 of which were cases of pulmonary tuberculosis and 67 cases of other forms of tuberculosis, 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 of pulmonary tuberculosis a printed instruction as to the course that should be adopted for the prevention of consumption was left at the premises, In many instances advantage was taken of the offer of the Council to disinfect, Two hundred and thirty.four deaths were registered against 212 in the previous year, During the year 33 orders on the Lister Institute of Preventive Medicine, with sputum outfits, were supplied to medical practitioners attending suspected cases of tuberculosis, TUBERCULOSIS DISPENSARY, The Local Government Board and the London County Council have approved of the scheme set out in my Annual Report for 1914, but your Council decided to defer the establishment of the dispensary for the time being owing to the difficulty of obtaining the necessary staff, etc,, under the existing war conditions, The following table shows the number of Notifications of males and females at various age periods from pulmonary and non.pulmonary tuberculosis, during the year 1915, PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912, 50 Summary of Notifications during the period from 3rd January, 1915, to the end of the week ending on the 1st January, 1916, Age Periods, Number of Notifications on Form "A," Total Notifications (i,e,, includingcases previously notified by other doctors,) Number of Notifications on Form " B," Number of Notifications on Form " C,' Primary Notifications, Primary Notifications, Total Notifications (i e, includingcases previously notified by other doctors,; Poor Law Institutions, Sanatoria, 0 to 1, 1 to 5. 5. to 10, 10 to 15, '5 to 20 20 to 25 25 to 35. 35 to 45 45 to 55. 55 to 65 65 & upwards Total. Under 5, 5 to 10 10 to 15 Total Pulmonary, Males — 7 12 5 (1 m) 7 14 (2 m) 37 40 32 20 7 (3 m) l8l 23 5 _ 2 1 3 4 54 59 Pulmonary, Females 1 6 5 10 12 13 32 19 15 9 4 126 183 _ 1 — 1 3 18 31 Non.pulmonary, Males 2 9 6 2 4 1 (1 m) 2 - 1 1 - (1 m) 28 490 36 _ _ 1 1 9 2 7 Non.pulmonary, Females — 4 7 6 4 2 2 1 2 1 1 30 36 _ _ _ _ _ 5 1 51 LICENSED SLAUGHTER HOUSES, I he whole of the licensed slaughter houses in the Borough have been regularly inspected during the year, At the annual inspection of slaughter houses in October, 1915, I had received notices that 7 licences were to be applied for, In all cases they were found to be, as far as your Council's requirements were concerned, in a satisfactory condition and your Council decided to inform the London County Council that you offered no opposition to the renewal of those licences, At the Special Sessions at the London County Council, held in October, the 7 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 Goldhawk Road John Trayling George Langstone Moore CENTRE DISTRICT, Wards Nos, 2 and J, ADDRESS, NAME OF LICENSEE, 247 Goldhawk Road 55 Dalling Road Arthur William Godfrey Charles Meeks SOUTH DISTRICT, Ward No, 1, ADDRESS, NAME OF LICENSEE, 65 King Street 321 „ Thomas Holton Stanley Brooks Midwinter 52 BAKEHOUSES, The 62 bakehouses in the Borough have been regularly inspected, Forty.two 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 the Borough :— NORTH DISTRICT, Wards Nos, 4, 5, 6, and 7, ADDRESS, NAME, 410 Uxbridge Road Mackintosh & Co, ┼125 Uxbridge Road H, Hemmings 121 Askew Road Not in use *242 Goldhawk Road G, Lousley ┼*32 Norland Road J, R, Cobbing ┼*74 Goldhawk Road R, Steele *128 Askew Road — T ravis *75 Uxbridge Road G, Marsh *216 Uxbridge Road F, C, Stiles ┼74 Askew Road Hallett Bros, ┼*i Kenmont Terrace, Harrow Road H, T, Rogers *2 Hunt Street A, Burt ┼*i6 North Pole Road T, Allinson *55 Melina Road W, Tompkins ┼*167 Askew Road Van Brouequet *126 Uxbridge Road H, Seaborne 41 Gayford Road Not in use ┼*39 St, Ann's Road E, Tomlin *106 Goldhawk Road A, J, Wills 104 Latimer Road Not in use 166 Goldhawk Road J, Pendry ┼104 Askew Road J, Miller 53 CENTRE DISTRICT, Wards Nos, 2 and 3. address, name, *54 Richmond Road J, Alderton *13 Shepherd's Bush Green Not in use *87 Masboro' Road Not in use 348 King Street W, Landgrebe *75 Blythe Road F, Guthiel *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 Not in use 24 Bradmore Park Road D, Miller & Son *77 Brackenbury Road G, Gardiner *134 Shepherd's Bush Road F, Hill *1 Masboro' Road W, Macklin *98 Blythe Road Not in use *17 Kilmarsh Road C, Pankhurst *7 Shepherd's Bush Road A, Royston *192 Dalling Road Not in use ┼*i Aldensley Road W, Roberts *67 Masboro' Road J, Teague *47 Milson Road W, Warwick *33 Glenthorne Road E, Winstone ┼* Cadby Hall, Hammersmith Road J, Lyons & Co, |┼i The Grove Palmer's Stores, Ltd, 316 King Street W, Lines *6 Beaconsfield Terrace Not in use Road 54 SOUTH DISTRICT, Ward No, I, address,  65 Bridge Road W, Bass ┼88 Queen Street Not in use ┼ i Eyot Gardens J, R, Chibnall, Limited 2 and 4 Crispe 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 ┼45 Great Church Lane Fullers, Limited 7 St, Peter's Road Not in use Upper Mall Hampshire House Trust * Underground Bakehouses, ┼Factory Bakehouses, 55 Table Showing Number of Families ok Separate Occupier! and Number of Persons at Census, 1911. Name of District. Population, Census, 1911. Families or separate occupiers, Census, 1911. Levvisham 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 85495 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 56 Table Showing extent in Acres, and Number of Persons to the Acre, at Census, 191 i. Name of District. Extent in Acres, Census, 1911. Number of Persons to the Acre. Census 1911. Woolwich 8,276.6 14.66 Lewisham 7,014.4 22.92 Greenwich 3.8517 24.96 Wandsworth 9,107.4 34.19 Hampstead 2,2650 37.74 Hammersmith 2,282.5 53.15 Camberwell 4,480.0 58.33 Stoke Newington 863.5 58.66 City of Westminster 2,5027 64.03 Hackney 3,2878 67.07 Poplar 2,3277 69.78 Deptford 1,562.7 70.06 Lambeth 4,080.4 73.04 Kensington 2,291.1 75.21 Battersea 2,1603 77.64 St. Marylebone 1,4728 8o.22 St. Pancras 2,694.4 80.98 Bermondsey 1,4996 8395 Fulham 1,703 5 89.98 Chelsea 6596 100.64 Paddington 356.1 105.11 Islington 3.091.5 105.9o Holborn 405.1 121.83 Finsbury 586.6 149.87 Stepney 1,765.6 158.47 Bethnal Green 759.3 168.81 Shoreditch 6576 169.38 Southwark 1,1315 169.59 CUSTOMS AND INLAND REVENUE ACTS. During the year 19 applications were received for certificates under these Acts. In every case the premises were inspected as to the sanitary conditions, and 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. 57 The following is a list of applications received during the year under the Inland Revenue Acts :— 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.  5 to 7, Maclise Mansions 10, 28, 32, 40, 41, and 43, Westcroft 3 Houses 3 3 — — Square 6 Houses 12 — 12 — 37 to 39, Granville Gardens 3 Houses 10 — 10 — 15 and 17, Shaftesbury Road Housekeeper's Quarters and 2, 2 Houses 4 4 — Addison Court Gardens 2 Flats 2 1 1 — 52, Rayleigh Road 1 House 2 2 — — 51 and 61. Sinclair Road 2 Houses 5 — 5 — 220, Goldhawk Road 1 House 2 2 — — 110, 112, and 114, Sinclair Road. 3 Houses 6 — 6 — 27, Boscombe Road 54, 56, 58, 58A, 58B, and 58c, 1 House 3 3 — — Vespan Road 6 Houses 12 12 — — 61, 63, and 65, Vespan Road 3 Houses 6 — 6 — 46, 48, and 50, Westville Road 144, 144A, 144B and 144C, Sinclair 3 Houses 6 — 6 — Road 2 Houses 4 — — 4 195, Uxbridge Road 1 House 2 — — 2 16, Maclise Road 1 House 2 — — 2 34, 38, and 40, Rayleigh Road 3 Houses 6 — — 6 7 and 9, The Broadway 2 Flats 2 — 2 — 41 and 43, Rayleigh Road 2 Houses 4 — 4 — Totals 47 93 23 56 14 Forty-three Notices were served in reference to defects found to exist in certain of the above premises, and thirty-seven Notices were complied with. The following is a list of the premises certified by me during the vear :— 6, 8, 9, n, 14, 15, 16, 17 and 19, Lanark Mansions, Goldhawk Road. 5 to 7, Maclise Mansions, Maclise Road. Housekeeper's Quarters, Addison Court Gardens. 220, Goldhawk Road. 27, Boscombe Road. 54. 56, 58, 58A, 58B and 58C, Vespan Road. 52 and 52A, Rayleigh Road. 58 No application was received under Section 35 of the Towns Planning Act, 1909. SEIZURE OF UNWHOLESOME FOOD. On the 20th March, Sanitary Inspector Cromack seized 10 tins salmon from the coffee stalls standing at the Uxbridge Road and Goldhawk Road ends of the Railway Approach, Shepherd's Bush, owned by Mr. C. Chance of Worple Way, Acton, which were unsound and unfit for the food of man. The same was submitted to W. P. Hunter, Esq., J.P., who found them to be unfit for the food of man, and gave orders for the destruction of the same. The matter was reported to your Public Health Committee, who gave instructions for proceedings to be taken against Mr. C. Chance. (Result of proceedings reported in " Summonses Heard.") On the 14th May, Sanitary Inspector Cromack was requested by the Street Inspector to visit Norland Market and examine some tomatoes exhibited for sale on a stall. He immediately proceeded to the Market and found the tomatoes to be unsound and unfit for the food of man. The tomatoes were subsequently examined by W. P. Hunter, Esq., J.P., who gave an order for the destruction of the same. The tomatoes seized weighed 140 pounds. The matter was reported to the Public Health Committee, who gave instructions for proceedings to be taken. (Result of proceedings reported in " Summonses Heard.") On the 18th September, Sanitary Inspector Cromack visited the stall in the occupation of Mr. A. Jones in Norland Market and found fish exposed for sale which was unsound and unfit for the food of man. He seized the fish and submitted same to the Magistrate at the West London Police Court (Mr. Fordham) who gave instructions for the same to be destroyed, and took formal evidence as regards seizure. The fish seized weighed 2 cwts. 59 The metter was reported to the Public Health Committee who gave instructions for proceedings to be taken. (Result of proceedings reported in " Summonses Heard.") SANITARY NOTICES AND ADMINISTRATION. ORDER OF THE BOARD OF AGRICULTURE AND FISHERIES. (Dated i8th August, 1915.) MAINTENANCE OF LIVE STOCK ORDER OF 1915. The Board of Agriculture and Fisheries, by virtue and in exercise of the powers vested in them under the Maintenance of Live Stock Act, 1915, and for the purpose of maintaining a sufficient stock of cattle and swine, do hereby order as follows :— Restriction of Slaughter of Animals In-calf or In-pig. 1. An animal which is visibly or obviously in-calf or in-pig shall not be slaughtered, or be caused or permitted by its owner to be slaughtered. Restriction of Slaughter of Calves. 2.—(1) After the thirtieth day of September, nineteen hundred and fifteen, until the Board shall by Order otherwise provide, and subject to the provisions of this Article, a calf as defined by clause (5) of this Article, shall not be slaughtered, or be caused or permitted by the owner thereof to be slaughtered. From the commencement of this Order until the said date this provision shall apply only to calves under the age of eight weeks. (2) This Article shall not apply to the slaughter of a calf of a cow of any of the following dairy breeds, that is to say :— Channel Island, Ayrshire, Kerry and Dexter breeds. (3) This Article shall also not apply to the slaughter of a calf which has been offered for sale by public auction at any market or saleyard in England, Wales or Scotland, without reserve or subject to a reserve price of thirty shillings or less, and for which no bid exceeding thirty shillings has been made on such occasion ; but this provision shall have effect only— (a) if the calf so offered for sale is before movement from the market or saleyard marked by, or under the 60 direction of, the auctioneer in the manner prescribed by this Article ; and (b) if such mark is on the calf at the time of slaughter. (4) The prescribed mark for the purposes of this Article shall be a broad arrow branded, in hot pitch or a mixture of hot pitch and tar, on the back of the calf midway between the hips, the shaft and two barbs of the arrow to be a quarter of an inch in width, and the length of the shaft and of the barbs (outside measurement) to be two and a half inches. (5) For the purposes of this Article the expression "calf " means, except where otherwise expressly stated, a bovine animal in which the first permanent molar or grinder tooth is not cut and visible. Exceptions from Restrictions. 3. The restrictions of slaughter imposed by the preceding Articles of this Order shall not apply to— (a) slaughter of an animal under the powers conferred by the Diseases of Animals Acts, 1894 to 1914, or any Order made thereunder ; or (b) slaughter of an animal necessary or desirable on account of accidental injury to the animal or its illness ; or (c) slaughter of an animal if in the opinion of the Board of Agriculture and Fisheries the slaughter is desirable for any exceptional reason or purpose, and the slaughter is authorised by a licence granted by that Board or an officer of that Board. Local Authorities authorised to execute and enforce Order. 4.—(1) The local authority for the purposes of the Diseases of Animals Acts, 1894 to 1914, and the executive committee (if any) for those purposes of such local authority, may execute and enforce the provisions of this Order within the district of the local authority, and any expenses so incurred by a local authority may be defrayed as if they were expenses incurred under the said Acts. (2) The council of a borough (including a metropolitan borough) or urban or rural district may execute and enforce the provisions of this Order within the borough or district, and any expenses so incurred may be defrayed as part of the 61 expenses incurred by the council in the execution of the Public Health Acts, or the Public Health (London) Act, 1891, as the case may be. (3) A council of a borough which is a local authority for the purposes of the Diseases of Animals Acts, 1894 to 1914, may defray the expenses under either of the powers conferred by this Article or partly under each power, as the council shall determine. Powers of Entry. 5. For the purpose of executing and enforcing this Order any officer of the Board of Agriculture and Fisheries may, subject to any directions given by that Board, and upon production, if so required, of his appointment, enter any slaughter-house or other premises on which animals are slaughtered for human food, and examine any animals or carcases therein ; and any officer of a local authority to which the preceding Article applies shall, subject to any directions given by the local authority, have the like power of entry of premises in the district of the local authority in addition to any power of entry which he is otherwise entitled to exercise. Application of Order. 6. This Order applies to England and Wales. Commencement. Revocation of Existing Order. 7. This Order shall come into operation on the twentythird day of August, nineteen hundred and fifteen, and on that date the Slaughter of Animals Order of 1915 shall cease to operate, except in relation to proceedings for any offence committed before such date, and any licence issued under that Order shall have effect as a licence granted under this Order. Short Title. 8. This Order may be cited as the Maintenance of Live Stock Order of 1915. In witness whereof the Board of Agriculture and Fisheries have hereunto set their Official Seal this eighteenth l.s. day of August, nineteen hundred and fifteen. Sydney Olivier, Secretary. 62 SANITARY STAFF. I regret to have to record the death of the late Mr. J. Cosson, Sanitary Inspector, on 1st June, 1915. The late Mr. Cosson was a most excellent officer. He was in the service of your Council for many years and practically died in harness. He was a trustworthy and very conscientious officer. I have to record the enlistment of Sanitary Inspectors W. Brown and A. Hayes in the Anti-Aircraft Corps of the Royal Naval Air Service. HOUSES LET IN LODGINGS. During the last year the Public Health Committee gave directions for the registration of 114 "houses let in lodgings or occupied by the members of more than one family." Upon the registration a copy of the Bylaws of your Council, under which such houses are registered, was forwarded to the landlord (within the meaning of the By-laws) for his guidance. From various causes 47 houses have been removed from the list, leaving a total number now on the Register of 2,739. During the year 370 notices were served and 220 were complied with. NOTICES. The following is a list of Preliminary Notices served and complied with during the year :— No. of Inspections No. of Notices served. No. of Notices complied with.  Bakehouses 223 42 41 Customs and Inland Revenue 68 43 37 Houses let in Lodgings 1,292 370 220 House to House 1,195 463 328 Housing and Town Planning Act 84 29 28 Factories and Workshops, etc. 2,483 259 237 Smoke 118 22 21 Ice Cream Vendors 162 5 5 Milk Vendors 617 10 10 Miscellaneous 18,028 1,549 1,532 24,270 2,792 2,459 63 STATUTORY NOTICES. Four hundred and eighty Statutory Notices were served and four hundred and eighty-three complied with. SHEPHERDS BUSH EXHIBITION. White City. At the close of the Exhibition, early in 1914, the grounds and buildings were taken over by the London Territorial Association for the purpose of housing troops. The premises were kept under inspection, and many improvements were carried out for the comfort of the troops. The number of troops stationed at this encampment varied from 4,000 to 10,000 officers and men. Every assistance was rendered by this department to the military authorities in the camp. The Sanitary Inspector visited the premises almost daily, and assisted in the inspection of food and gave advice as regards the sanitary arrangements. Many cases of infectious disease including measles, scarlet fever, diphtheria and chickenpox, were notified and immediately removed to appropriate hospitals. Ten cases ot scarlet fever, 1 case 01 diphtheria, 2 cases of typhoid fever, 11 cases of cerebro-spinal meningitis, 2 cases of erysipelas, 198 cases of measles and 1 case of chicken-pox were notified and removed to various Isolation Hospitals. One case of scarlet fever, 4 cases of cerebro-spinal meningitis, 1 case of enteric fever and 14 cases of measles were, however, returned from the hospitals as not suffering. In April the troops were removed and part of the grounds taken over by the Royal Naval Air Service and part by Messrs. Waring & Gillows for the purpose of making tents, etc., for the Military Authorities. Eight thousand men and women were employed by the latter in this work, 5,000 working by day and 3,000 at night. F 64 OLYMPIA. During the year this building has been used by the Military Authorities for the purpose of a store. HOUSING AND TOWN PLANNING ACT, 1909. During the year the owners of the properties 20-30, Boxmoor Street, upon whom Closing Orders were served, informed your Council that a scheme had been drawn up before the putbreak of war, whereby it would be necessary to demolish five or six of the houses in question, in order to carry out certain railway improvements. This work had been postponed, and it was pointed out by the owners that they were unable to raise capital without consent of the Government. The owners suggested that the Council should suspend the Closing Orders, and promised to carry out certain works which were agreed upon. The work has been put in hand, and the houses will soon be in a fit condition for habitation. Following upon my report on the insanitary conditions existing at Trafalgar Street, Aspen Place, etc., your Council decided to serve Closing Orders on the properties Nos. 1-12 and 12A-22, Trafalgar Street, and 3-8, Aspen Place. These closing orders were served in January, 1915. In October your Council decided to determine the Closing Orders which had been served on the premises Nos. 3, 4 and 5, Aspen Place, as the houses had been rendered fit for human habitation. Nos. 6, 7 and 8, Aspen Place having been demolished. Your Council also decided to make Demolition Orders in respect to the properties Nos. 1-12 and 12A-22, Trafalgar Street. At the end of the year the houses in Trafalgar Street were unoccupied, and the work of demolition about to begin. In February it was decided to serve Closing Orders in reference to the properties Nos. 1 and 2, Hermitage Cottages. 65 In March your Council decided to serve Closing Orders in reference to the properties No. 20, Warbeck Road, and No. 75, St. Stephen's Avenue, Shepherds Bush. These premises are houses which have never been completed or occupied, but were in such a condition that your Council decided to take action under the above Act. Some difficulty was experienced in tracing the owner of these properties, and Closing Orders were not served until July. At the end of the year the question of serving Demolition Orders was being considered by the Council. In March I submitted to your Public Health Committee the following report dealing with the Insanitary conditions that existed in the houses situated in Gillards Place :— 3rd March, 1915. To the Public Health Committee of the Hammersmith Borough Council. Gentlemen, Gillards Place. This consists of 7 houses built on a site 44 feet by 65 feet, included in which area is a forecourt 26 feet deep. The houses are built 4 on the south side and 3 on the north side facing each other. Each house has a small part of the forecourt, about 11 feet deep, allotted to it and fenced. Between these allotments is a path 4 feet wide, imperfectly paved, and finishing in a dead end. At the west side is an ashpit in a dirty condition and difficult to keep clean. At the same end is a tap, off the main, which supplies all the houses except Nos. 2, 4 and 5. Gillards Place is bounded on the east side by a building about 16 feet high, and on the west side by a wall varying from 9 to 20 feet in height. These structures close in the 7 houses as in a well, preventing movements of air and excluding much of the light. The yards are, at the rear, in the main so small that the water closets are practically up against the back doors. The houses themselves are small, being two-roomed structures and are in a very bad condition F 2 66 of repair. There is no through ventilation, and this fact, together with the shut-in position of the houses, makes stagnation of air in the houses inevitable. The court is approached by means of a path 7 to 8 feet wide, between Nos. 177-179, King Street. About 35 feet of this is paved, the remainder (about 100 feet) is unpaved, has no proper fall, and water lies about in puddles. The general detects in the houses and in No. 8, which is at the rear of No. 179, King Street, are as follows :— Roof dilapidated and defective, unsound ceilings, sash cords broken, walls damp, paving defective, absence of damp courses. Rain water pipes and gutterings insufficient and defective. Insufficient ventilation from windows and absence of rain water pipes. The ground floors are from 2 to 7 inches below the ground level. Besides the above mentioned defects, the following are present :— No. 4. Defective and decayed brickwork. No. 5. Rat infested, rain percolates under front door, and no door to water closet. No. 6. Rain percolates under front door and no door to the water closet. No. 7. No door to water closet. No. 8. No door to water closet. It was decided to serve notices on the owners requiring them to execute certain works, necessary to make the houses fit for human habitation. INSPECTION OF FACTORIES, Etc. During the year 259 notices were served in reference to insanitary conditions and defects found to exist during the inspection of the factories, workshops, and workplaces in the Borough, and during the same period 237 notices have been complied with. During the previous year there were 293 notices served and 310 complied with. The following is a list of the Factories and Workshops upon the Register :— Restaurants, Hotels, etc. 159 Bakehouses (11 not used at present as Bakeries) 62 Bootmakers 75 Motor and Cycle Makers and Engineers 60 Dressmakers and Milliners 178 67 Laundries 253 Letterpress Printers and Bookbinders 28 Electrical and Mechanical Engineers 15 Smiths, Wheelwrights and Coachbuilders 20 Tailors 61 Bottle Washing Works 4 Dry Cleaning, Dyeing and Carpet Beating Works 8 Firewood Cutters 12 Builders and Joiners (Machine) 21 Outworkers 728 Miscellaneous 188 1,872 The whole of these premises have been under a systematic inspection by your Inspectors, and numerous improvements in the sanitary condition of these premises have been carried out under their supervision. TABLE I. Prepared in accordance with the form required by the Home Office on the administration of the Factory and Workshop Act, 1901, in connection with Factories, Workshops, Workplaces and Homework. I.—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) 399 75 — Workshops (including Workshop Laundries) 594 84 — Workplaces (other than out-workers premises included in Part 3 of this report) 1.474 100 — Total 2,467 259 — 68 2.—DEFECTS FOUND IN 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 79 78 ... ... Want of Ventilation 1 1 ... ... Overcrowding 4 4 ... ... Want of Drainage of Floors 4 4 ... ... Other Nuisances. 84 74 ... ... Sanitary Accommodation. insufficient 5 5 ... ... unsuitable or defective 34 34 ... ... not separate for sexes 3 2 ... ... Offences under the Factory and Workshop Act.— Illegal occupation of underground bakehouse (S. 101) ... ... ... ... Breach of special Sanitary requirements, for bakehouses (SS. 97 to 100) 31 31 ... ... Other Offences (excluding offences relating to outwork, which are included in Part 3 of this report.) 16 l6 ... ... Total 261 249 ... ... 69 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. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Twice in the year. Once in the year. Instances. Notices served. Prosecutions. Instances. Orders made (S. no). Prosecutions (S. 109, no). Failing to keep or permit inspection of Lists. Failing to send Lists. Lists. Outworkers. Outworkers. Contractors Workmen. Lists. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing apparel— (1) making, etc. 46 37 68 25 25 20 ... ... ... 27 27 ... ... ... ... (2) cleaning and washing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Household linen ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lace, lace curtains, and nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Curtains and furniture hangings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Furniture and upholstery ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Electro-plate ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... File making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brass and brass articles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fur pulling ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cables and chains ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anchors and grapnels ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cart gear ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Locks, latches, and keys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Umbrellas, etc. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Artificial flowers ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nets, other than wire nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tents ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sacks ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Racquet and tennis balls ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Paper, etc., boxes, paper bags ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brush making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pea picking ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Feather sorting ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carding, etc., of buttons, etc. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Stuffed toys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Basket making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chocolates and sweetmeats ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cosaques, Christmas crackers Christmas stockings, etc. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Textile weaving ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total 46 37 68 25 25 20 ... ... ... 27 27 ... ... ... ... 70 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 44 dressmakers 174 laundries 192 others 322 Total number of workshops on Register 732 5.—OTHER MATTERS. Class. Number.  Matters notified to H. M. Inspector of Factories— Failure to affix Abstract of the Factory and Workshop Act 1901 (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 1901 (S. 5) Notified by H.M. Inspector 14 Reports (of action taken) sent to H. M. Inspector 14 Other 31 Underground bakehouses (S. 101)- Certificates granted during the year - In use at the end of the year 33 71 ICE CREAM MANUFACTURERS. 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. At the present time there are 228 premises upon the register. Five notices were served, all of which have been complied with. The following is a table in reference to the above-named premises, etc. PROCEEDINGS DURING 1915. PREMISES. NUMBER OF PLACES. Number of inspections, 1915. Number of notices. 1915. Number of prosecutions. 1915.  On register at end of 1914. Added in 1915 Removed in 1915- On register at end of 19 15. Slaughter-houses 7 nil. nil. 7 nil. nil. nil. Offensive trade premises nil. nil. nil. nil. nil. nil. nil. Ice Cream premises 230 24 26 228 162 5 nil. DAIRIES, COWSHEDS, AND MILKSHOPS ORDER, ETC. The following is a table in reference to the milk premises and cowsheds. PROCEEDINGS DURING I915. PREMISES NUMBER OF PLACES. Number of inspections, 1915 Number of notices. 1915. Number of prosecutions, 1915. On register at end of 1914. Added in 1915. Removed in 19I5. On register at end of 1915. Milk premises 302 26 22 306 617 10 nil. Cowsheds nil. nil. nil. nil. nil. nil. nil. 72 These registered premises were under regular inspection. During the year no case of infectious disease occurred upon premises where milk was sold. It was therefore not necessary to put into force the regulations under the above Order appertaining to the stoppage of sale of milk, disinfection, and the granting of certificates, &c. There were 26 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. RAG FLOCK ACT, 1911. The Rag Flock Regulations, 1912. No samples of Flock were taken by your inspector during the year. SUMMONSES ORDERED. During last year your Council and the Public Health Committee gave authority for 83 summonses to be taken out against persons for having failed to comply with the requirements of notices which had been served. It was not found necessary to proceed in the great majority of cases, as the work was carried out before the issue of the summonses. In 21 cases summonses were taken out, a list of which, together with the result of the proceedings follows. 73 SUMMONSES HEARD. SITUATION OF PREMISES,&C. NATURE OF OFFENCE. RESULT OF PROCEEDINGS.  J. Lyons & Co., Cadby Hall. Kensington Depositing meat for the purpose of preparation for sale at the White City Encampment which was unfit for the food of man. Fined £50 and £70 costs. 28, Letchford Gardens Failing to comply with statutory notice. Order made. Fined £2 and £5 and 10s. 6d. costs. C. Chance, Worple Way, Acton Exposing for sale 10 tins of salmon unfit for the food of man. Fined 10s. and costs. A. Scott, Stebbing Street, Notting Hill Exposing for sale tomatoes unfit for the food of man. Fined £2 and costs. 71, Cardross Street Failing to comply with statutory notice. Fined 7s. 6d. and 10s. 6d. costs. 73, Cardross Street Do. Fined £1 and 10s. 6d. costs. 5, 7 & 9 Tunis Road Do. Order made. Fined £8. A. Jones, Latimer Road Exposing for sale fish unfit for the food of man. Fined £3. 20, Adelaide Road Failing to comply with statutory notice. Order made. 20, Adelaide Road Do. Fined £4. 83, Cardross Street Do. Withdrawn (work carried out). 45, Raynham Road Do. Do. do. 227, Uxbridge Road Do. Do. do. 43, Raynham Road Do. Do. do. 68, Westville Road Do. Do. do. 3, Alexandra Mews Do. Do. do. 7, Havelock Road Do. Order made. Approach Road Do. Withdrawn (agreement with Council). 29, Masbro Road Do. Order made. 90, Masbro Road Do. Withdrawn (work carried out). 68, Masbro Road Do. Do. do. PUBLIC MORTUARY. During last year 239 bodies were removed to the mortuary at Fulham Palace Road. There were 145 bodies brought to the mortuary by order of the Coroner or the Police ; 60 bodies were taken from the West London Hospital, 31 bodies were received for accommodation, and 3 bodies were received for isolation. 74 SMOKE ABATEMENT. During last year observations were kept in reference to the amount of black smoke emitted from the various factories, laundries, bakehouses, &c., situate in and adjoining the Borough. Twenty-two preliminary notices and 2 statutory notices were served. No summons was taken out. Reports were submitted to the Public Health Committee in reference to the observations made on the chimneys belonging to :— Kensington Palace Laundry, Spring Vale Terrace, West Kensington Park. Eton Laundry, Orchard Road, Shepherd's Bush. Glen Laundry, Landor Road, Shepherd's Bush. Fuller's Limited. Great Church Lane. Hammersmith. Lyons & Company, Limited, Cadby Hall, Hammersmith. Hammersmith Infirmary, Wormwood Scrubs. Addison Feather Mills, Woodstock Road. Great Western Railway Sheds, Scrubs Lane. Imperial Tobacco Co., Fulham Palace Road. 65, Latimer Road (Fried Fish Shop). Hammersmith Public Baths, Lime Grove. Waverley Laundry, Stebbing Street. Waring & Gillows, Cambridge Road. A number of complaints were received from the London County Council and the Coal Smoke Abatement Society. In each instance observations were kept upon the premises, and reports submitted to the Public Health Committee, who gave instructions accordingly. METEOROLOGY. The average mean temperature registered in London during last year was 49.9° Fahrenheit. The highest air temperature registered was 87° in June and July. The lowest air temperature was 220 in January. Rain fell on 159 days. The total amount of rainfall was 776 m.m. Printed by Jas. Truscott & Son, Ltd., Suffolk Lane, e.C.