HAM 66 ANNUAL REPORT OF THE Medical Officer of Health OF THE borough of hammersmith For the Year 1912. annual report OF THE MEDICAL OFFICER OF HEALTH OF THE BOROUGH OF HAMMERSMITH For the Year 1912. Public Health Department, Town Hall, Hammersmith. April 26th, 1913. Gentlemen—I beg to present to you my Annual Report for last year. The Report will deal with the vital statistics, and with the Sanitary work carried out under the direction of your Council during the 52 weeks ending on 28th December, 1912. The statistical tables prescribed by the Local Government Board are added, as well as the several other tables that directly or indirectly relate to the Public Health of the Borough. The deaths of non-residents have been deducted, and the deaths of residents occurring in other parts of England have been added. Deaths of persons occurring in institutions receiving sick and infirm persons, have been regarded for the purpose of correction. The Registrar-General has furnished me with a list of transferable deaths, being residents of this Borough who have died at various places in England. This is a new method, which is done to assist in obtaining as nearly as possible the correct death rate. BIRTHS. During last year 2,755 births, 1,412 males, 1,343 females, were registered in this Borough against 2,807 in the previous year. Making due allowance for the increase of the population, the number of births registered last year was 394 below the average number registered during the previous 10 years. Adding 130 births which occured 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 2,883. On the population estimated up to the middle of the year, i.e., 122,750 inhabitants, the corrected number of births registered was equal to an annual rate of 23.5 births per 1,000 persons living. The birth rate in London on the estimated population of London up to the middle of the year, i.e., 4,519,754 inhabitants, was equal to an annual rate of 24.5 births per 1,000 persons living. These figures are calculated upon the corrected number of births registered. DEATHS. During last year 1,595 deaths were registered in this Borough, 764 males, 831 females, against 1,927 in the previous year. Making due allowance for the increase of the population, the number of deaths registered in the Borough last year was 113 below the average number registered during the previous 10 years. Adding 214 deaths of residents of this Borough, which took place in general hospitals and other public institutions in other Boroughs of London, in London County Lunatic Asylums and Metropolitan Imbecile Asylums, also 37 deaths of residents reported to me by the Registrar-General as having occurred in other parts of England, and deducting 253 deaths of non-residents which occurred, 188 at the West London Hospital, 29 at Nazareth House, 17 at the Hammersmith Infirmary, 1 at St. John's Hospital, Uxbridge Road, and 3 18 transferable deaths of non-residents which occurred in this Borough, the corrected number of deaths of residents registered last year was 1,593. On the beforementioned estimated population, the corrected number of deaths of residents registered last year was equal to an annual rate of 130 deaths per 1,000 persons living. The death rate in London on the estimated population of London up to the middle of the year was equal to an annual rate of 13.6 deaths per 1,000 persons living. DEATHS OF INFANTS. The corrected number of deaths of residents under one year of age registered last year was 261, against 434 in the previous year. The number of deaths of infants under one year of age registered last year was equal to 164 per 1,000 of the total corrected deaths of residents registered, and to 91 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 165 per 1,000 of the total deaths registered, and 91 per 1,000 of the total registered births. The mortality rate of infants under one year of age was, as compared with the total deaths of residents registered, 1 per 1,000 less in this Borough than in London, and the same as compared with the total births registered in this Borough as in London. The great reduction of infant mortality in this Borough and in London was due to the low temperature during the summer months and the consequent small number of deaths from summer diarrhoea. The following table on infantile mortality has been prepared by me in accordance with the direction of the Local Government Board. 4 LOCAL GOVERNMENT BOARD RETURN.—TABLE IV. Infant Mortality during the year 1912. Nett Deaths from stated Causes at various Ages under 1 Year of Age. METROPOLITAN BOROUGH OF HAMMERSMITH CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 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 69 11 14 13 107 46 49 37 22 261 Uncertified — — — — — — — — — — Small-pox — — — — — — — — — — Chicken-pox — — — — — — — — — — Measles — — — — — 1 1 3 3 8 Scarlet Fever — — — — — — — — — Whooping Cough — — — — — 1 4 6 — 11 Diphtheria and Croup — — — — — — — — — — Erysipelas — — — — — 1 — — — 1 Tuberculous Meningitis — — — — — — 2 1 1 4 Abdominal Tuberculosis (b) — — — — — j — 1 2 4 Other Tuberculous Diseases — — — 1 1 — — 2 — 3 Meningitis (not Tuberculous) — — — — — — 1 — — 1 Convulsions 6 — 1 2 9 2 3 — — 14 Laryngitis — — — — — — — — — — Bronchitis — — 1 1 2 4 2 5 4 17 Pneumonia (all forms) — 2 1 3 6 9 9 10 6 40 Diarrhoea — — — — — 5 2 2 1 10 Enteritis — — 1 1 2 3 11 2 2 20 Gastritis — — — — — 1 — — 1 2 Syphilis — 1 — 1 2 3 3 — — 8 Rickets — — — — — — — — — Suffocation, overlying 6 — — 1 7 2 1 1 — 11 Injury at Birth — — — — — — — — — — Atelectasis 2 — — — 2 — — — — 2 Congenital Malformations (c) 4 1 2 — 7 — — — — 7 Premature Birth 35 4 5 3 47 4 2 — — 53 Atrophy, Debility, and Marasmus 10 2 2 — 14 5 5 1 1 26 Other causes 6 1 1 — 8 4 3 3 1 19 69 11 14 13 107 46 49 37 22 261 Nett Births in the Year : Legitimate, 2,748; Illegitimate. 135. Nett Deaths in the Year of : Legitimate Infants, 240; Illegitimate Infants, 21 5 NOTES TO TABLE IV. (а) The total in the last column of Table IV. should equal the tolal in column 10 of Table I., and in column 3 of Table III. (b) Under Abdominal Tuberculosis are to be included deaths from Tuberculous Peritonitis and Enteritis and from Tabes Mesenterica. (c) The total deaths from Congenital Malformations, Premature Birth, Atrophy, Debility and Marasmus, should equal the total in Table III. under the heading Congenital Debility and Malformation including Premature Birth. Want of Breast Milk should be included under Atrophy and Debility. (d) For references to the meaning of any other headings, see notes attached to Table III. In recording the facts under the various headings of Tables I., II., III. and IV. attention has been given to the notes on the Tables. N C. COLLIER, Medical Officer of Health. 6 Table showing the Infantile Mortality Rates of the County of London, the City of London, and the Metropolitan Boroughs during the 52 Weeks of 1912, as calculated by the Registrar-General. Deaths under 1 year to 1,000 Births Registered. County of London 91 Hampstead 62 Chelsea 68 Lewisham 70 Stoke Newington 72 Woolwich 73 Wandsworth 76 Hackney 80 Holborn 80 City of London 81 Camberwell 83 City of Westminster 84 Battersea 84 Greenwich 84 Lambeth 86 Islington 87 St. Pancras 88 Deptford 89 *Hammersmith 90 Kensington 91 St. Marylebone 93 Fulham 94 Bethnal Green 96 Paddington 98 Stepney 105 Southwark 105 Poplar 107 Bermondsey 111 Finsbury 114 Shoreditch 123 * The Registrar-General has calculated this figure on the corrected births of Hammersmith, which he gives as 2,880 instead of 2,883, and the corrected deaths of infants as 259, which 1 make 261. 7 DEATHS OF AGED PERSONS. The corrected number of deaths of residents at 65 years of age and upwards that were registered during last year was 457, against 495 in the previous year. These deaths last year were equal to 3.7 per 1,000 of total persons living, and 287 per 1,000 of the total deaths of residents registered. The corrected deaths registered of persons at 65 years of age and upwards belonging to London last year was equal to 3.9 per 1,000 of the total persons living, and 289 per 1,000 of the total deaths of London residents registered. This death rate was, therefore, .2 less in this Borough than in London as compared with the total persons living, and 2 per 1,000 less in this Borough than in London as compared with the total deaths registered. 8 LOCAL GOVERNMENT BOARD RETURN.—TABLE I. Vital Statistics of Whole District during 1912 an 1 Previous Years. 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.† Under 1 Year of Age. At all Ages. Number.† Rate. Number* Rate. Number Rate per 1.000 Nett Births. Number.* Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1907 117997 3006 1777 14.5 233 173 1717 14.0 1908 118957 3102 1754 14.1 210 213 1757 14.2 1909 119917 2887 1778 14.1 220 217 1775 14.1 1910 120877 2910 1569 12.3 240 209 1538 I2.I 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 Notes.—This Table is arranged to show the gross births and deaths in the district, and the births and deaths properly belonging to it with the corresponding rates. For years before 1911 some of the corrected rates probably will not be available. The rates should be calculated per 1.000 of the estimated gross population. In a district in which large Public Institutions for the sick or infirm seriously affect the statistics, the rates in columns 5 and 13 may be calculated on a nett population, obtained by deducting from the estimated gross population the average number of inmates not belonging to the district in such institutions. * In column 6 are to be included the whole of the deaths registered during the year as having actually occurred within the district. In column 12 is to be entered the number in column 6. corrected by subtraction of the number in column 8 and by addition of the number in column 9 Deaths in column 10 are to be similarly corrected by subtraction of the deaths under 1, included in the number given in column 8, and by addition of the deaths under 1 included in the number given in column 9. † The Medical Officer of Health will be able from the returns made to him by the local Registrar of Deaths, as well as from the quarterly lists furnished by the Registrar-General, to fill in column 8 in accordance with the rule in the next paragraph below. The Registrar-General, either directly or through the County Medical Officer of Health, will supply the Medical Officer of Health with the particulars of deaths to be entered in column 9; and all such deaths must be included in this column, unless an error is detected, and its correction has been accepted by the Registrar-General. For column 4 the Registrar-General will furnish to the Medical Officer of Health, a Statement of the number of births needing to be added to or subtracted from the total supplied by the local Registrar. ‡ "Transferable Deaths" are deaths of persons who, having a fixed or usual Residence in England or Wales, die in a district other than that in which they resided. The deaths of persons without fixed or usual residence, e.g., casuals, must not be included in columns 8 or 9. except in certain instances under 3 (b) below. The Medical Officer of Health will state in column 8 the number of transferable deaths of " non-residents " which are to be deducted, and will state in column 9 the number of deaths of " residents" registered outside the district which are to be added in calculating the nett death-rate of his district. The following special cases arise as to Transferable Deaths :— (1) Persons dying in institutions for the sick or infirm, such as hospitals, lunatic asylums, workhouses, and nursing homes (but not almshouses) must be regarded as residents of the district in which they had a fixed or usual residence at the time of admission. If the person dying in an institution had no fixed residence at the time of admission, the death is not transferable. If the patient has been directly transferred from one such institution to another, the death is transferable to the district of residence at the time of admission to the first institution. (2) The deaths of infants born and dying within a year of birth in an institution to which the mother was admitted for her confinement should be referred to the district of fixed or usual residence of the parent. (3) Deaths from Violence are to be referred (a) to the district of residence, under the general rule ; (b) if this district is unknown, or the deceased had no fixed abode, to the district where the accident occurred, if known ; (c) failing this, to the district where death occurred, if known: and (d) failing this, to the district where the body was found. Area of District in acres (land and inland water) 2285.3 Total population at all ages 121,521 Number of inhabited houses 18,766 Average number of persons per house 6.5 At Census of 1911 9 DEATHS OF RESIDENTS. Belonging to the Borough occurring in Public Institutions, &c., in districts outside, during the year 1912. Fever Hospitals. Western Fever Hospital 25 General Hospitals. St. George's Hospital 15 St. Mary's Hospital 14 Children's Hospital, Paddington 8 Middlesex Hospital 7 Queen Charlotte's Hospital 6 St. Thomas' Hospital 5 University College Hospital 5 Victoria Hospital 3 Cancer Hospital, Chelsea 3 Brompton Hospital, Chelsea 3 London Hospital 2 Consumption Hospital, Brompton 2 Westminster Hospital 2 St. Bartholomew's Hospital 2 Grove Hospital 1 King's College Hospital 1 National Hospital, Queen Square I Friedenheim Hospital 1 Guy's Hospital 1 City of London Lying-in Hospital 1 Kensington and Fulham General Hospital 1 Hampstead General Hospital 1 Chelsea Hospital for Women 1 Samaritan Free Hospital 1 New Hospital for Women 1 Florence Nightingale Hospital, St. Marylebone 1 Southern Hospital, Gore Farm 1 East London Hospital 1 Infants' Hospital 1 Children's Hospital, Great Ormond Street 1 Asylums. Hanwell Asylum 16 Banstead Asylum 8 Tooting Bee Asylum 6 Horton Asylum 4 Manor Asylum 4 Caterham Asylum 4 Colney Hatch Asylum 2 Long Grove Asylum 1 Leavesden Asylum 1 Middlesex County Asylum 1 Dartford Heath Asylum 1 Cane Hill Asylum 1 Other Institutions. Fulham Workhouse 6 Fulham Infirmary 4 Queen Mary's Hospital, Carshalton 3 Kensington Infirmary 3 Westminster Workhouse 2 St. Luke House, Kensington 2 St. George's Infirmary 1 Camberwell House 1 Chelsea Workhouse 1 Holborn Workhouse 1 St. Joseph's Hospice, Mare Street, Hackney 1 Lambeth Infirmary 1 Bow Institution, Bromley 1 St. Marylebone Infirmary 1 Hospice of St. John and St. Elizabeth, St. Marylebone 1 3, Mandeville Place, St. Marylebone 1 122, Lancaster Road, Kensington 1 96, Woodpecker Road, Deptford 1 Brooke House, Upper Clapton 1 In River Lea, near Lea Place 1 In Holland Park Avenue 1 In Basing Road, Kensington 1 21, Dartmoor Street, Kensington 1 93, Edith Road, Fulham 1 Lower Common, Putney 1 In River Thames, off Vicarage Wharf, Battersea 1 Holloway Prison 1 108, Portland Road, Kensington 1 In River Thames, near Lambeth Bridge 1 3, Cambridge Lodge Villas, Mare Street, Hackney 1 97, Talgarth Road, Fulham 1 43, Medina Road, Highbury 1 In an omnibus on the way to the Children's Hospital, Paddington Green 1 IO Corrected Death-rates of Metropolitan Boroughs after Distribution of Deaths in Public Institutions, &c., as calculated by the Registrar-General for year 1912. Death rate from all causes. Average County of London 13.6 Lewisham 10.2 Wandsworth 10.2 Hampstead 10.4 Stoke Newington 11.5 Woolwich 11.9 Hackney 12.2 Paddington 12.3 Battersea 12.3 Camberwell 12.7 Kensington 12.9 Greenwich 12.9 City of Westminster 13.0 Lambeth 13.0 Deptford 13.0 *Hammersmith 13.0 Fulham 13.2 Chelsea 13.8 Islington 14.0 City of London 14.0 St. Marylebone 14.1 St. Pancras 14.6 Holborn 15.4 Stepney 15.9 Bethnal Green 15.9 Poplar 16.2 Bermondsey 16.8 Southwark 16.8 Finsbury 18.6 Shoreditch 18.7 11 LOCAL GOVERNMENT BOARD RETURN.—TABLE III. Causes of, and Ages at. Death during the Year 1912. Name of District. METROPOLITAN BOROUGH OF HAMMERSMITH. Causes of Death. Nett Deaths at the subjoined ages of " Residents" whether occurring within OR WITHOUT THE DISTRICT (a). Total Deaths whether of "Residents" or "Nonresidents" in Institutions in the District. (b) All ages. Under i year. | 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 All causes Certified (c) 1593 261 67 56 52 52 249 399 457 648 Uncertified 0 0 0 0 0 0 0 0 0 0 Enteric Fever 4 0 0 0 1 1 1 1 0 1 Small-pox 0 0 0 0 0 0 0 0 0 0 Measles 28 8 14 6 0 0 0 0 0 1 Scarlet Fever 3 0 0 2 1 0 0 0 0 0 Whooping Cough 16 11 4 1 0 0 0 0 0 2 Diphtheria and Croup 14 0 1 10 3 0 0 0 0 2 Influenza 13 1 0 0 0 1 2 6 3 1 Erysipelas 5 1 0 0 0 0 0 1 3 5 Phthisis (Pulmonary Tuberculosis) 168 2 1 4 5 25 72 48 11 78 Tuberculous Meningitis 19 4 5 5 3 i 1 0 0 9 Other Tuberculous Diseases 20 5 2 4 2 2 3 1 1 5 Cancer, malignant disease 129 0 0 0 0 2 15 74 38 55 Rheumatic Fever 10 0 0 1 2 0 0 2 5 3 Meningitis (see note (d)) 19 2 3 5 5 1 2 0 1 9 Organic Heart Disease 136 0 0 0 8 4 26 43 55 38 Bronchitis 156 17 7 3 0 0 7 43 79 45 Pneumonia (all forms) 142 39 23 10 5 1 21 25 18 61 Other Diseases of Respiratory Organs 34 1 0 0 0 0 5 5 23 13 Diarrhoea and Enteritis (see note (e)) 38 30 2 0 0 0 2 1 3 18 Appendicitis and Typhlitis 9 0 0 1 2 2 1 2 1 13 Cirrhosis of Liver 12 0 0 0 0 0 0 11 1 4 Alcoholism 7 0 0 0 0 0 5 1 1 2 Nephritis and Bright's Disease 61 0 0 1 1 0 16 15 28 24 Puerperal Fever 2 0 0 0 0 0 2 0 0 0 Other accidents and diseases of Pregnancy and Parturition 9 0 0 0 0 1 8 0 0 2 Congenital Debility and Malformation, including Premature Birth 86 85 0 1 0 0 0 0 0 12 Violent Deaths, excluding Suicide 59 5 1 1 8 2 15 16 11 57 Suicide 9 0 0 0 0 0 3 5 1 5 Other defined Diseases 385 50 4 1 6 9 42 99 74 183 Diseases ill-defined or unknown 0 0 0 0 0 0 0 0 0 0 Total 1593 261 67 56 52 52 249 399 457 648 SubEntries included in above figures. Cerebro-spinal Meningitis 1 0 1 0 0 0 0 0 0 2 Poliomyelitis 0 0 0 0 0 0 0 0 0 1 ¤ ¤ * Sub-Entries should here be made for other deaths which it is desirable to distinguish, on account of their administrative importance or special interest (e.g., any deaths from Anthrax, Typhus or Glanders, which have been included under Other Defined Diseases ; or deaths from pneumonia other than bronchopneumonia which have been included under Pneumonia, all forms.) See notes on next page. I 2 NOTES TO TABLE III. (a) All " Transferable Deaths" of residents, i.e., of persons resident in the District who have died outside it, are to be included with the other deaths in columns 2-10. Transferable deaths of non-residents, i.e., of persons resident elsewhere in England and Wales who have died in the District, are in like manner to be excluded from these columns. For the precise meaning of the term "transferable deaths," see footnote to Table I. The total deaths in column 2 of Table III. should equal the figures for the year in column 12 of Table I. (6) All deaths occurring in institutions for the sick and infirm situated within the district, whether of residents or of non-residents, are to be entered in the last column of Table III. (c) All deaths certified by registered Medical Practitioners and all Inquest cases are to be classed as " Certified " ; all other deaths are to be regarded as " Uncertified." (d) Exclusive of "Tuberculous Meningitis" (10), but inclusive of Cerebro-Spinal Meningitis. (e) Title 19 should be used for deaths from Diarrhcea and Enteritis at all ages. (In the "Short List" deaths from Diarrhcea and Enteritis under 2 years are included under Title 19; those at 2 years and over being placed under Title 28.) 13 DEATHS FROM THE SEVEN PRINCIPAL ZYMOTIC DISEASES. The total number of deaths of residents that were registered from the seven principal zymotic diseases was 103 against 315 in the previous year. The deaths of residents last year from these diseases were equal to 65 per 1,000 of the total deaths of residents registered, and were at the rate of .8 deaths per 1,000 persons living. The deaths from the seven principal zymotic diseases in the whole of London were equal to 80 per 1,000 of the total deaths registered, and were at the rate of 1.1 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, .3 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 1903 to 1912:— year. small-pox. measles. scarlet fever. diphtheria and membranous croup. whooping cough. enteric fever. diarrhoea and cholera. Total. 1903 0 27 8 19 31 10 87 182 1904 o 105 7 23 32 5 126 298 1905 o 30 11 21 54 3 89 210 1906 o 56 16 27 20 8 144 271 1907 0 52 10 23 31 6 39 161 1908 0 14 11 15 18 5 108 171 I909 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 Average in last 10 years. 0 50 8 2.2 30 6 92 208 14 It will be seen from the above table that the total number of deaths from these zymotic diseases last year was, making no allowance for the increase in population, 105 below the average number registered in the last 10 years. CASES OF ILLNESS REPORTED AS DUE TO INFECTIOUS DISEASE. There were, omitting phthisis, 650 cases reported as due to notifiable infectious diseases in this Borough against 581 in the previous year. The number of cases of phthisis notified was 438, against 264 in the previous year. There were also reported 1,058 cases of infectious diseases that were not notifiable, against 1,108 in the previous year; 363 of these were chickenpox, 487 measles, and 208 whooping cough. SMALL-POX. No case of small-pox was notified in the Borough last year, against no case in the previous year. CHICKEN-POX. Three hundred and sixty-three cases of chicken-pox were reported, against 304 cases in the previous year. Three hundred and sixty-two cases reported last year were treated at the homes of the patients and 1 at Hampstead Workhouse. No death was registered. MEASLES. Four hundred and eighty-seven cases were reported as due to measles, against 554 cases in the previous year. Four hundred and twenty-one cases were treated at the homes of the patients, 65 at the Metropolitan Asylums Board's Hospitals, and 1 at Hampstead Workhouse. Twenty-eight deaths were registered. As this is not a notifiable disease it is of no use my giving the 15 mortality rate on the cases reported, as no doubt only a proportion of the cases which occurred were known of by me. Owing to the stringent instructions of the Educational Department of the London County Council most of the cases, as usual, occurring among pupils at the schools of the London County Council 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 26 deaths, whereas from measles alone there were 28 deaths. In every case that was reported the premises were at once inspected as to the sanitary condition. SCARLET FEVER. Three hundred and thirty-five cases were notified as due to scarlet fever, against 236 in the previous year. Two hundred and ninety-five cases reported last year were isolated at Isolation Hospitals, and 43 cases were treated at the homes of the patients. Three deaths were registered. The mortality rate on the cases reported was only .9 per cent. DIPHTHERIA AND DIPHTHERITIC MEMBRANOUS CROUP. One hundred and seventy-seven cases were reported as due to diphtheria or diphtheritic membranous croup, against 195 cases in the previous year. One hundred and sixty-two cases reported last year were treated at the Isolation Hospitals, and 15 at the homes of the patients. Fourteen deaths were registered. The mortality rate on the cases reported was 7.9 per cent. 16 WHOOPING COUGH. Two hundred and eight cases were reported as due to whooping cough, against 250 cases in the previous year. One hundred and ninety-eight cases were treated at the homes of the patients, and 10 cases were treated at the Isolation Hospitals of the Metropolitan Asylums Board. All of the cases reported last year were treated at the homes of the patients. Sixteen deaths were registered. As this is not a notifiable disease it is of no use my giving the mortality rate on the cases reported, as doubtless a very large number of cases occurred which were not known of in the Public Health Department. I have continued to receive as heretofore information as to cases from the Head Teachers of the Schools of the London County Council. ENTERIC FEVER. Eleven cases were reported as due to enteric fever, against 28 in the previous year. Three of the cases reported last year were treated at the Isolation Hospitals of the Metropolitan Asylums Board, one at the Hammersmith Infirmary, and seven at the homes of the patients. Four deaths were registered. The mortality rate on the cases reported was 36.4 per cent. TYPHUS FEVER. No case was reported as due to typhus fever, against one case in the previous year. SIMPLE CONTINUED FEVER. No case was reported as due to simple continued fever, against one case in the previous year. No death was registered. 17 RELAPSING FEVER. No case was reported as due to relapsing fever, against no case in the previous year. PUERPERAL FEVER. Seven cases were reported as due to puerperal fever, against 3 cases in the previous year. Four of the cases reported last year were treated at the home of the patients, 2 of the cases were treated at the •Hammersmith Infirmary and 1 at the Samaritan Free Hospital. Two deaths were registered. The mortality rate on the cases reported was 28.6 per cent. CHOLERA. No case was reported as due to cholera, against no case in the previous year. ERYSIPELAS. Ninety-nine cases were reported last year as due to erysipelas, against 97 cases in the previous year. Seventy-eight cases were treated at the homes of the patients, 19 at the Hammersmith Infirmary, 1 at the West London Hospital, and 1 at St. Mary's Hospital. Five deaths were registered. The mortality rate on the cases reported was 5.1 per cent. PLAGUE. No case was reported as due to plague, against no case in the previous year. CEREBRO-SPINAL FEVER. Three cases were reported as due to cerebro-spinal fever, against one case in the previous year. One case 18 was treated at the home of the patient and 2 at the West London Hospital. Two deaths were registered, one patient, however, was a non-parishioner, the mortality rate being 66.6 per cent. 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. HYDROPHOBIA. No case was reported as due to hydrophobia last year, against no case in the previous year. OPHTHALMIA NEONATORUM. Seventeen cases were reported as due to ophthalmia neonatorum, against 18 cases in the previous year. The cases reported last year were treated: 16 at the homes of the patients and 1 at Queen Charlotte's Hospital, Marylebone Road. ACUTE POLIO-MYELITIS. One case was reported as due to polio-myelitis, against 1 case in the previous year. The case reported was treated at the West London Hospital. 19 TABULAR STATEMENT— ZYMOTIC DISEASES. The following table shows the number of cases that were reported as due to the undermentioned 20 zymotic diseases during the years 1903 to 1912. 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 1903 6 314 160 0 58 1 0 6 0 108 0 104 137 132 0 0 0 0 0 0 1026 1904 0 283 201 0 38 1 0 11 0 120 0 283 742 102 0 0 0 0 0 0 1781 1905 0 360 237 0 41 0 0 13 0 125 0 219 417 286 0 0 0 0 0 0 1698 1906 0 439 270 0 33 1 0 10 0 125 0 68 627 56 0 0 0 0 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 0 6 0 65 0 113 161 156 1 0 0 0 0 0 1113 1909 0 380 188 0 17 0 0 14 0 75 0 140 847 281 1 0 0 0 0 0 1943 1910 0 340 161 0 31 1 0 9 0 63 0 228 484 200 2 1 1 0 0 0 1521 1911 0 236 195 1 28 1 0 3 0 97 0 304 554 250 1 0 0 0 18 1 1689 1912 0 335 177 0 11 0 0 7 0 99 0 363 487 208 3 0 0 0 17 1 1708 Av'rge in last 10 yrs. 1 365 200 0 33 0 0 9 0 95 0 202 499 201 1 0 0 0 3 0 1609 * Not a notifiable disease. COMPULSORY NOTIFICATION OF INFECTIOUS DISEASES. The London County Council made an order on 27th February, 1912, that from and including 13th March, 1912, section 55 of the Public Health (London), Act, 1891, with respect to the notification of Infectious Diseases, should apply to the diseases known as Acute Polio-Myelitis, or Acute Polio-Encephalitis and Cerebrospinal Fever (Epidemic Cerebro-Spinal Meningitis). 20 LOCAL GOVERNMENT BOARD RETURN.—TABLE II. Cases of Infectious Disease notified during the year 1912. METROPOLITAN BOROUGH OF HAMMERSMITH. Notifiable Disease. Number of Cases Notified Total Cases Notified in Each Locality. (e.£. Parish or Ward) of the District. Total Cases Removed to Hospital. At all Ages. At Ages†—Years. Under 1 1 & under 5 Years. 5 & under 15 Years. 15 & under 25 Years. 25 & under 45 Years. 45 & under 65 Years. 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) 177 3 76 74 15 8 1 0 86 61 30 162 Erysipelas 99 3 7 6 8 36 28 11 35 40 24 21 Scarlet Fever 335 1 80 195 38 20 1 0 135 124 76 293 Typhus Fever 0 0 0 0 0 0 O 0 0 0 0 0 Enteric Fever 11 0 1 3 2 4 1 0 10 0 1 4 ‡Relapsing Fever (R) Continued Fever (C) 0 0 0 0 0 0 0 0 0 0 0 0 Puerperal Fever 7 0 0 0 1 6 0 0 5 2 0 3 Cerebro-Spinal Meningitis 3 1 2 0 0 0 0 0 2 0 1 2 Polio-myelitis 1 0 1 0 0 0 0 0 0 O 1 1 Pulmonary Tuberculosis 438 1 9 53 73 197 94 11 204 155 79 109 Ophthalmia Neonatorum 17 17 0 0 0 0 0 0 6 11 0 1 Totals 1088 26 176 331 137 271 125 22 483 393 212 596 NOTES.—State in space below the name and position within or without the district of the isolation hospital or hospitals, sanatoria or other institutions to which the residents in the district, suffering from infectious disease, have usually been sent, and the name of the authority by whom the hospital is provided. † These age columns for notifications should be filled up in all cases where the Medical Officer of Health, by inquiry or otherwise, has obtained the necessary information. ‡ Specify the disease by initial against the figure. 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. 21 The following table of Deaths from Infectious Diseases is compiled from the Registrar General's Report. Boroughs. Population estimated to the middle of 1912. Deaths from Deaths under 1 year of Age. Births. All causes. Enteric Fever. Small-pox. Measles. Scarlet Fever. Whooping-cough. Diphtheria. Diarrhoea and Enteritis (under 2 years) Phthisis. COUNTY OF LONDON 4,519.754 110,353 61,100 117 1 1.799 159 970 452 1,371 6,069 10,056 West. Paddington 142,362 3,021 1,751 1 — 31 3 20 6 43 124 296 Kensington 171,746 3,326 2,226 4 — 27 5 24 6 37 183 303 Hammersmith 122,750 2,880 1,606 4 — 29 4 17 13 29 165 259 Fulham 155,402 4,213 1,985 8 — 65 6 45 15 33 209 306 Chelsea 65,397 1,229 949 1 — 22 2 14 5 8 85 84 City of W'stmnstr 57,248 2,348 1,942 4 — 37 4 16 11 38 183 197 North. St. Marylebone 116,155 2,243 1,602 5 — 40 11 19 8 26 146 209 Hampstead 85,166 1,281 842 1 — 11 1 4 17 1 55 79 St. Pancras 216,145 5,367 3,148 3 — 95 5 44 25 37 341 472 Islington 326,398 8,213 4,662 8 — 151 9 57 39 90 441 712 Stoke Newington 50,581 1,033 611 — — 5 — 3 — 3 44 74 Hackney 222,986 5,266 2,691 3 — 19 8 33 12 60 303 421 Central. Holborn 48,026 902 733 1 _ 25 — 7 7 8 99 72 Finsbury 86,130 25.75 1,612 1 — 129 5 29 13 44 165 294 City of London 18,695 185 251 — — 2 — 1 1 4 37 15 East. Shoreditch 110,430 3,562 1,997 4 — 116 5 47 19 94 231 439 Bethnal Green 127,985 3,902 1,954 3 — 91 2 32 12 48 210 375 Stepney 277,315 8,533 4,211 9 — 170 13 96 26 153 465 897 Poplar 161,597 5,045 2,635 7 — 112 3 64 17 68 243 541 South. Southwark 190,017 5,587 3,164 4 — 139 6 49 27 104 354 587 Bermondsey 125,260 3,872 2,098 5 — 102 8 36 16 67 218 431 Lambeth 297,550 6,952 3,95o 13 — 97 9 55 29 98 406 601 Battersea 167,589 4,258 2,042 2 — 55 6 40 15 50 195 358 Wandsworth 321,881 6,757 3,265 8 — 5o 11 61 19 73 297 513 Camberwell 261,591 6,422 3,362 6 — 81 8 51 21 65 339 535 Deptford 109,377 2,896 1,432 2 — 28 6 25 11 29 147 259 Greenwich 95,994 2,391 1,254 2 — 28 9 30 15 25 135 201 Lewisham 165,249 3,356 1,714 6 — 11 6 24 27 26 115 236 Woolwich 121,932 2,738 1,411 2 1 31 4 27 20 10 128 200 22 The following table of Deaths from Infectious Diseases per 1,000 persons living is compiled from the Registrar General's Report. Boroughs. Per 1,000 Persons Living. Rate. per 1,000 Births. Deaths From Births. All Causes. Enteric Fever. Small-pox. Measles. Scarlet Fever. Whooping-cough. Diphtheria. Phthisis. Diarrhoea and Enteritis (under 2 years). Total Deaths under 1 year. Crude. Corrected. COUNTY OF LONDON 245 13.6 13.6 0.03 0.00 0.40 0.04 0.22 0.10 1.35 12.42 91 West. Paddington 21.3 12.3 12.3 0.01 — 0.22 0.02 0.14 0.04 0.87 14.23 98 Kensington 19.4 13.0 12.9 0.02 — 0.16 0.03 0.14 0.04 1.07 11.12 91 Hammersmith 23.5 13.1 13.0 0.03 — 0.24 0.03 0.14 0.11 1.35 10.07 90 Fulham 27.2 12.8 13.2 0.05 — 0.42 0.04 0.29 0.10 1.35 7.83 94 Chelsea 18.8 14.6 13.8 0.02 — 0.34 0.03 0.21 0.08 1.30 6.51 68 City of Westminster 15.0 12.4 13.0 0.03 — 0.24 0.03 0.10 0.07 1.17 16.18 84 North. St. Marylebone 19.4 13.8 14.1 0.04 — 0.35 0.09 0.16 0.07 1.26 11.59 93 Hampstead 14.9 9.8 10.4 0.01 — 0.13 0.01 0.05 0.20 0.64 0.78 62 St. Paneras 24.9 14.6 14.6 0.01 — 0.44 0.02 0.20 0.12 1.58 6.89 88 Islington 25.2 14.3 14.0 0.02 — 0.46 0.03 0.18 0.12 1.35 10.96 87 Stoke Newington 20.5 12.1 11.5 — — 0.10 — 0.06 — 0.87 2.90 72 Hackney 23.7 12.1 12.2 0.01 0.09 0.04 0.15 0.05 1.36 11.39 80 Central. Holborn 18.8 15.3 15.4 0.02 — 0.52 — 0.15 0.15 2.07 8.87 80 Finsbury 30.0 18.8 18.6 0.01 — 1.50 0.06 0.34 0.15 1.92 17.09 114 City of London 9.9 I3.5 14.0 — — 0.11 — 0.05 0.05 1.98 21.62 81 East. Shoreditch 32.3 18.1 18.7 0.04 — 1.05 0.05 0.43 0.17 2.10 26.39 123 Bethnal Green 30.6 15.3 15.9 0.02 — 0.71 0.02 0.25 0.09 1.69 12.30 96 Stepney 30.9 15.2 15.9 0.03 — 0.61 0.05 0.35 0.09 1.68 I7.93 105 Poplar 31.3 16.4 16.2 0.04 — 0.69 0.02 0.40 0.11 i1.51 13.48 107 South. Southwark 29.5 16.7 16.8 0.02 — 0.73 0.03 0.26 0.14 1.87 18.61 105 Bcrmondsey 31.0 16.8 16.8 0.04 — 0.82 0.06 0.29 0.13 1.75 17.30 111 Lambeth 23.4 13.3 13.0 00.4 — 0.33 0.03 0.19 0.10 1.37 14.10 86 Battersea 25.5 12.2 12.3 0.01 — 0.33 0.04 0.24 0.09 1.17 11.74 84 Wandsworth 21.0 10.2 10.2 0.02 — 0.16 0.03 0.19 0.00 0.93 10.80 76 Camber well 24.6 12.9 12.7 0.02 — 0.31 0.03 0.20 0.08 1.30 10.12 83 Deptford 26.6 13. 1 13.0 0.02 — 0.26 0.06 0.23 0.10 1.35 10.01 89 Greenwich 25.0 13.1 12.9 0.02 — 0.29 0.09 0.31 0.16 1.41 10.46 84 Lewisham 20.4 10.4 10.2 0.04 — 0.07 0.04 0.15 0.16 0.70 7.75 70 Woolwich 22.5 11.6 11.9 0.02 0.01 0.25 0.03 0.22 0.16 1.05 3.65 73 In this Table 0.00 indicates that the deaths were too few to give a rate of 0.005; where no death occurred, — is inserted. to LONDON AND THE METROPOLITAN BOROUGHS. (Compiled from Registrar General's Report.) Death rates per 1,000 persons living, and Infantile Mortality after Distribution of Births in the chief Institutions treating Maternity cases, and of Deaths in all Public Institutions, &c., in the Five years, 1907-1911, and in 1912. Boroughs. All Causes. Enteric Fever. SmallPox. Measles. Scarlet Fever. Whooping Cough. Diphtheria. Phthisis. Per 1000 Births. diarrhcea and Enteritis (under 2 Years.) Total Deaths UNDER One Year. 1907- 1912. 1907- 1912. 1907- 1912. 1907- 1912. 1907- 1912. 1907- 1912. 1907- 1912. 1907- 1912. 1907- 1912. 1907- 1912. 1911. 1911. 1911. 1911. 1911- 1911. 1911. 1911. 1911. 1911. County of London 14*7 13*6 0*04 0'03 o-oo 000 0*45 040 0'09 0'04 0'28 0'22 044 040 1*37 1*35 1242 114 91 Paddington i3*4 123 003 001 — — 032 022 007 002 024 014 009 004 no 087 The average mortality under this heading cannot be stated. 14-23 107 98 Kensington 13 7 130 003 0O2 — — 031 016 003 0 03 025 014 012 004 C98 107 1112 120 91 Hammersmith ...• 14-6 131 004 003 — — 043 024 o'o 003 027 014 017 (ill 1*21 1 35 1007 120 90 Fulham 141 12 8 004 005 — — 046 042 008 004 033 029 0'2c 010 132 1 35 7 83 116 94 Chelsea i5'6 14 6 0*03 002 — — 037 034 005 003 022 021 013 008 1 47 13H (>•51 109 68 City of Westminster 12-8 124 004 003 000 — 013 024 005 003 012 010 0 09 1)07 1-28 117 16-18 97 84 St. Marylebone 14-8 138 C03 004 — — 028 035 009 009 0'26 016 oo9 007 1 35 1*26 11-59 103 93 Hampstead 97 9-8 004 001 — — 014 013 004 001 0*12 005 oo9 020 0 71 0-64 0 78 70 62 s r. Pancras 155 14 6 003 001 — — 044 044 009 002 030 0'20 0°i2 012 i'6i 1 58 689 106 88 Islington 14-6 14 3 0-04 002 — — 043 040 ct07 003 0-28 018 oi3 012 1 29 1 35 10 96 108 87 Stoke Neyvington 124 121 0*04 — — — 026 010 009 — 025 006 006 1 02 087 290 87 72 Hackney 138 121 0-05 001 — — 037 ooy 009 004 0 26 U 15 oi3 005 1-28 136 11*39 109 80 Holborn 16 6 15-3 ot)6 002 — _ 0'26 052 006 027 015 oio 015 2*24 207 8-87 113 80 Finsbury 196 18 8 006 001 — — 072 1-50 o'll 006 0*42 034 019 015 214 192 17t)9 134 114 City of London 153 135 005 — — — oio 011 003 — 014 0'05 007 005 1*66 198 2162 81 Shoreditch 190 181 006 004 — — 091 105 0-13 005 049 043 0-17 d-17 i-86 210 26-39 H9 123 Beihnal Green I7'3 15 3 007 002 — — 069 0 71 019 0 02 035 025 016 009 1 65 169 1230 134 96 Stepney 16*9 15*2 004 003 001 — 075 061 013 0 05 033 035 019 0-09 1'69 168 1793 125 105 Poplar 172 164 008 004 000 — 074 069 0-15 002 045 040 020 Oil 138 151 13 48 130 107 South w ark 182 16 7 004 002 _ — o-68 073 009 003 0'34 026 017 014 i'95 1 87 1861 130 105 Bermondsey 18*4 168 005 004 — — 088 082 015 0*06 035 0-9 o-i 3 013 1-83 175 17 30 137 111 Lambeth 148 133 0 04 004 — — o"37 033 009 003 0-25 019 015 010 148 1 37 14 10 110 86 Battersea 138 122 003 001 — — 047 033 0*07 004 0-31 024 0 14 0 09 1-30 117 11-74 109 84 Wandsworth 11*6 102 003 002 — — °'33 016 006 003 02O 019 olo 0-06 092 093 10-80 97 76 Camber well 141 129 003 002 — — 040 031 007 003 026 020 0 13 0 08 128 1 30 10-12 104 83 Deptford 151 131 005 002 — — 051 026 o-o8 0 06 0"35 023 014 o-10 1-32 1 35 1001 119 89 Greenwich 142 131 005 002 — — 042 029 006 009 031 031 0-14 016 118 141 1046 hi 84 Lewisham 11'o 104 002 004 — — 013 007 007 004 019 015 017 016 078 070 7-75 87 70 Woolwich 127 116 002 002 — 001 031 025 009 003 019 022 013 016 1 29 105 365 94 73 24 INFLUENZA. Thirteen 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. PHTHISIS. Four hundred and thirty-eight cases were notified to me against 264 cases in the previous year. One hundred and forty-one were reported under the Public Health (Tuberculosis) Regulations, 1908, from infirmaries, workhouses, and District Poor Law Medical Officers, 131 were reported under the Public Health (Tuberculosis in Hospitals) Regulations, 1911, and 166 were reported under the Public Health (Tuberculosis) Regulations, 1911, an Order made by the Local Government Board under the powers conferred upon them by the Public Health (London) Act, 1891, &c. This Order came into operation on the First day of January, 1912. In all cases notified, or in which death occurred, the premises were at once inspected, and after death in all cases occurring in private dwelling-houses an offer was made to disinfect the premises at the expense of your Council. In every case a printed instruction as to the course that should be adopted for the prevention of consumption was left at the premises. In many instances advantage was taken of the offer of the Council to disinfect. One hundred and sixty-eight deaths were registered against 148 in the previous year. On December 20th, 1912, the Local Government Board issued a further series of Regulations to be known as the Public Health (Tuberculosis) Regulations, 1912, which they have made consolidating and amending the Public Health (Tuberculosis) Regulations, 1908, 25 the Public Health (Tuberculosis in Hospitals) Regulations, 1911, and the Public Health (Tuberculosis) Regulations, 1911. These Regulations come into operation on February 1st, 1913, a copy of which is printed hereafter. THE PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. DATED DECEMBER 19, 1912. To the Councils of the several Administrative Counties in England and Wales ;— To the Mayor, Aldermen, and Commons of the City of London, in Common Council assembled ;— 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 the Board of Guardians of every Poor Law Union in England and Wales ;— To the Board of Management of each Asylum District formed under the Metropolitan Poor Act, 1867, and of every District School 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 Tuberculosis is an endemic and an infectious disease ; And whereas by the Public Health (Tuberculosis) Regulations, 1908, by- the Public Health (Tuberculosis in Hospitals) Regulations, 1911, and by the Public Health (Tuberculosis) Regulations, 1911, We made certain Regulations for preventing the spread of Pulmonary Tuberculosis ; And whereas it appears to Us to be expedient that the said Regulations should be revoked, and that the Regulations which are herein-after set forth should be made in relation to Tuberculosis. 26 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 the 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 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 "Joint Committee" means a Joint Committee constituted for a combination of Poor Law Unions in pursuance of Section 8 of the Poor Law Act, 1879; (g) The expression "Board of Managers" means, as the case may be, the Board of Management of an Asylum District formed under the Metropolitan Poor Act, 1867, or of a School District formed under the Poor Law Amendment Act, 1844; (h) The expression "Tuberculosis Dispensary" means a non-residential institution, approved by the Local Government Board under the National Insurance Act, 1911, for the treatment of tuberculosis ; (i) The expression " Sanatorium " means a residential institution, approved by the Local Government Board under the National Insurance Act, 1911, for the treatment of tuberculosis; 27 (j) The expression "Poor Law Institution'' means a Workhouse, a Workhouse Infirmary, or other building subject to the government of a Board of Guardians of a Poor Law Union, or of a Joint Committee, or an Asylum (not being a lunatic asylum) or School subject to the government of a Board of Managers; (k) The expression "Hospital" means any hospital, dispensary, or similar institution for the treatment of the sick, and includes a lunatic asylum but does not include a Poor Law Institution, a Tuberculosis Dispensary, or a Sanatorium; (l) The expression "Institution" means a Hospital, Poor Law Institution, Tuberculosis Dispensary, or Sanatorium; (m) The expression "Medical Practitioner" means any person for the time being registered under the Medical Acts; (n) The expression "Medical Officer" when used in relation to a Poor Law Institution, Tuberculosis Dispensary, or Sanatorium means the Medical Practitioner who is in medical charge of the patients at the institution or any Medical Practitioner who may be duly authorised or appointed to act as the deputy of or substitute for the first-named Medical Practitioner, and the said expression when used in relation to a Hospital means any Medical Practitioner who is in medical attendance on a patient at a Hospital; (o) The expression "Medical Officer of Health" means Medical Officer of Health of a Local Authority; (p) The expression "School Medical Inspector" means any Medical Practitioner appointed under Section 13 of the Education (Administrative Provisions) Act, 1907, to undertake the medical inspection of children attending a Public Elementary School; (q) The expression "the previous Regulations" means the Public Health (Tuberculosis) Regulations, 1908, the Public Health (Tuberculosis in Hospitals) Regulations, 1911, and the Public Health (Tuberculosis) Regulations, 1911; (r) The expressions "Form A.", "Form B.", "Form C.", and " Form D."mean respectively the Form A., Form B., Form C., and Form D. set out in the Schedule A. to these Regulations; (s) The expression "week" means a week ending at midnight on Saturday. 28 Revocation of previous Regulations. Article II.—On and after the date of the question of these Regulations the previous Regulations and all Orders made by the Local Government Board thereunder shall be revoked. Commencement of Regulations. Article III.—These Regulations shall come into operation on the First day of February, One thousand nine hundred and thirteen, and, subject to the provisions of Article XVII. of these Regulations, shall then and thereafter apply and have effect throughout England and Wales, and shall be enforced and executed by every Local Authority. 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 Forms set out in the Schedule A. to these 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— (a) printed copies of Form A. to every medical practitioner resident or practising within the District of the Local Authority. (b) printed copies of Form B. to the School Medical Inspector or Inspectors of every Public Elementary School situate within the District of the Local Authority; and (c) printed copies of Form C. and Form D. to the Medical Officers of every Poor Law Institution and Sanatorium situate within the District of the Local Authority. Notification by Medical Practitioners. Article V.—Subject to the provisions of these Regulations every Medical Practitioner (unless acting as a School Medical Inspector) attending on or called in to visit any person (whether at an Institution or otherwise), shall, within forty-eight hours after first becoming aware that such person is suffering from Tuberculosis, make and sign a notification of the case in Form A., and shall transmit the notification to the Medical Officer of Health for the District within which the place of residence of the person is situate at the date of notification : 29 Provided that a Medical Practitioner shall not notify a case of Tuberculosis under this Article if he has reasonable grounds for believing that the case has already been notified, either under this Order or under the previous Regulations or otherwise, to the Medical Officer of Health for the District within which the place of residence of the person is situate: Provided further that if a notification is required in pursuance of this Article in respect of an in-patient at an Institution, the notification shall be sent to the Medical Officer of Health for the District in which the usual place of residence of the patient is situate. Weekly Notification by School Medical Inspectors. Article VI.—Every School Medical Inspector shall, as soon as practicable after the end of each week, make and sign a notification in Form B. of all cases of Tuberculosis of which he has first become aware in the course of inspections made by him during the week of children attending Public Elementary Schools, and shall transmit the notification to the Medical Officer of Health for the District within which the places of residence of the children are situate. When the places of residence are situate in more than one District, a separate notification shall be transmitted to the Medical Officer of Health of each District. Weekly Notification by Medical Officers of Poor Law Institutions and Sanatoria. Article VII.—The Medical Officer of a Poor Law Institution or of a Sanatorium shall, as soon as practicable after the end of each week— (а) make and sign a notification in Form C. of all cases of Tuberculosis admitted during the week and not being cases which are required to be notified under Article V. of these Regulations, and transmit the notification to the Medical Officer of Health for the District within which the places of residence of the persons notified are situate; and (b) make and sign a notification in Form D. of all cases of Tuberculosis discharged during the week, other than cases transferred to a Poor Law Institution or a Sanatorium, and transmit the notification to the Medical Officer of Health for the District within which the places of destination of the persons notified are situate. « When the places of residence, or the places of destination, as the case may be, of the persons to be notified are situate in more 30 than one District a separate notification shall be transmitted to the Medical Officer of Health of each District. Diagnosis of Tuberculosis. Article VIII.—For the purposes of these Regulations a Medical Practitioner shall be deemed to have become aware that a person is suffering from Tuberculosis when he has arrived at this conclusion from evidence other than that derived solely from tuberculin tests applied to that person. Transmission of Notifications. Article IX.—A notification to be transmitted to a Medical Officer of Health in pursuance of these Regulations may be transmitted by being delivered to that Officer 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. Every notification shall be enclosed in a sealed envelope addressed to the Medical Officer of Health. Remuneration of Medical Practitioners. Article X.—(i) Every Medical Practitioner described in column i of the Schedule B. to these Regulations shall be entitled to receive for each notification duly made, signed and transmitted by him under Article V. of these Regulations the fee specified in column 2 of the said Schedule opposite to the description of the Medical Practitioner in column 1, and for every notification duly made, signed and transmitted by him under Article VII. of these Regulations, the fee specified in column 3 of the said Schedule opposite to the description of the Medical Practitioner in column 1. (2) As soon as practicable after the end of the quarter during which the notification was sent to the Local Authority for the District within which the place of residence or place of destination of the person notified is situate that Local Authority shall pay the fee for the same, and a Medical Practitioner shall not be required for that purpose to submit an account of fees claimed by him under these Regulations. (3) The said fees shall in each case be deemed to cover all expenses, including the cost of transmission. Duties of Medical Officers of Health. Article XI.—(1) A Medical Officer of Health, on receipt of a notification which has been erroneously addressed to him by a Medical Practitioner, shall forthwith transmit the notification to 31 the Medical Officer of Health to whom the notification ought, in pursuance of these Regulations, to have been addressed, and shall at the same time inform the Medical Practitioner that he has done so, and shall give to him the name and address of the Medical Officer of Health to whom the notification has been sent. (2) Every Medical Officer of Health shall cause to be entered in a Register to be kept by him for that purpose the full particulars contained in every notification received by him under these Regulations and relating to a person whose place of residence or place of destination is situate within the District for which he is Medical Officer of Health. The said Register shall be kept in the custody of the Medical Officer of Health and shall not be open to inspection by any person other than a person specially authorised by resolution of the Local Authority, the Medical Officer of Health for the Administrative County within which the District is situate, a School Medical Inspector for any area within which the District is situate, or an Officer of any Government Department authorised in that respect by that Department. Every notification and every document relating to a person notified under these Regulations shall be regarded by the Medical Officer of Health, and by every person who has access thereto, as confidential. (3) The Medical Officer of Health shall, as soon as practicable after the end of each week, send to the Medical Officer of Health for the Administrative County within which the District is situate a statement of every notification received by him during the week in pursuance of these Regulations and relating to a person whose place of residence is situate within the District for which he is Medical Officer of Health. The statement shall show on which Form the notification was made and shall contain the information in regard to each person which was given in the notification. (4) Any expenses incurred by a Medical Officer of Health in carrying out the duties imposed upon him by this Article shall be defrayed by the Local Authority of the District for which he is Medical Officer of Health. Article XII.—Upon the receipt of a notification under these Regulations the Medical Officer of Health, or an Officer of the Local 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 : 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. 32 Special Powers and Duties of Local Authorities. Article XIII.—For the purposes of these Regulations— (1) A Local Authority on the advice of their Medical Officer of Health may supply all such medical or other assistance, and all such facilities and articles as may reasonably be required for the detection of Tuberculosis, for preventing the spread of infection and for removing conditions favourable to infection, and for that purpose may appoint such officers, do such acts and make such arrangements as may be necessary: Provided that nothing in this subdivision of this Article shall be deemed to authorise a Local Authority to take any of the measures herein mentioned at any Institution other than one belonging to the Local Authority. (2) A Local Authority on the advice of their Medical Officer of Health, may provide and publish or distribute suitable summaries of information and instruction respecting Tuberculosis, and the precautions to be taken against the spread of infection from that disease. Notification not required in certain cases. Article XIV.—Nothing in these Regulations shall apply to or inpose any duty or obligation upon any Medical Practitioner acting in his capacity as— (а) Medical Officer of one of His Majesty's Prisons or of a Borstal Institution, a Certified Reformatory School, a Certified Industrial School, a State or Certified Inebriate Reformatory, or a Criminal Lunatic Asylum; (b) Medical Examiner of candidates for some office or appointment; (c) Medical Examiner on behalf of an Insurance Company of a person proposing to insure his life at the risk of that Company; (d) Medical Examiner of the passengers and crew of an emigrant ship; or (e) Certifying or appointed Surgeon under the Factory and Workshop Acts. Article XV.—Nothing in these Regulations shall have effect so as to require a notification to be transmitted to a Medical 33 Officer of Health in respect of any inmate of any building, ship, vessel, boat, tent, van, shed or similar structure belonging to His Majesty the King. Exception and application of Enactments. Article XVI.—Nothing in these Regulations shall have effect so as to apply, or so as to authorise or require a Medical Officer of Health or a Local Authority, or any other person or authority, directly or indirectly, to put in force with respect to any person in relation to whom a notification in pursuance of these Regulations has been transmitted to a Medical Officer of Health any enactment which renders the person, or any one in charge of the person, or any other person, liable to a penalty, or subjects the person to any restriction, prohibition, or disability affecting himself, or his employment, occupation or means of livelihood, on the ground of his suffering from Tuberculosis. Modifications consequent upon Local Acts. Article XVII.—Nothing in these Regulations shall have effect in derogation of any power conferred, or of any duty or obligation imposed with respect to Tuberculosis by a Local Act, and these Regulations shall not apply to a District in which any such Local Act as aforesaid is in force except so far as they impose duties and obligations or confer powers which are not imposed or conferred by the Local Act and which are not inconsistent with any duties, obligations, or powers which are imposed or conferred by the Local Act. Such modification as may be necessary to give effect to the intention of this Article shall be deemed to have been made in these Regulations in relation to any such District as aforesaid. Short Title. Article XVIII.—These Regulations may be cited as "the Public Health (Tuberculosis) Regulations, 1912." TUBERCULOSIS DISPENSARY. Your Public Health Committee has appointed a Sub-Committee to confer with the Sub-Committee of the West London Hospital with the object of providing a Tuberculosis Dispensary for this Borough. LICENSED SLAUGHTER HOUSES. The whole of the licensed slaughter houses in the Borough were under inspection by the Inspector 34 for offensive trades. At the annual inspection of slaughter houses in October, 1912, I had received notices that 9 licences were to be applied for. Eight of them 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 8 licences were granted. The slaughter house at No. 35 Queen Street has not been used for the purpose of the licence since October, 1911, having been used as a warehouse for the storage of furniture. Your Council decided to oppose the renewal of this licence and in consequence of their action the London County Council refused to grant a renewal. 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 138 Joseph Moore CENTRE DISTRICT. Wards Nos. 2 and 3. address. name of licensee. 247 Goldhawk Road Edgar P. Jarrett 55 Dalling Road Charles Meeks. SOUTH DISTRICT. Ward No. 1. address. name of licensee. 49 King Street Benjamin Holton 65 Thomas Holton 321 Stanley Brooks Midwinter 35 BAKEHOUSES. The 62 bakehouses in the Borough were under a regular half-yearly inspection by the Factory Inspector. Ninety-six 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. 410 Uxbridge Road †125 Uxbridge Road 121 Askew Road *242 Goldhawk Road *32 Norland Road *74 Goldhawk Road *128 Askew Road *75 Uxbridge Road *216 Uxbridge Road †74 Askew Road *1 Kenmont Terrace, Harrow Road *2 Hunt Street *4 St. Helen's Terrace *55 Melina Road *167 Askew Road *126 Uxbridge Road 41 Gayford Road †*39 St. Ann's Road *106 Goldhawk Road 104 Latimer Road 166 Goldhawk Road 7 Market Place, Askew Road 165 Askew Road name. J. Haneman Not in use Not in use G. Lousden L. Nau R. Steele H. Hernig J. J. Sauer F. C. Stiles C. Steinmetz H. T. Rogers Wm. Burt W. Allinson W. Weinel H. Reinders H. Seeler G. Phillips E. Tomlin A. ]. Wills Not in use J. Pendry J. Miller J. Cummings 36 CENTRE DISTRICT. Wards Nos. 2 and J. ADDRESS. NAME. *54 Richmond Road *13 Shepherd's Bush Green *87 Masboro' Road 348 King Street *75 Blythe Road *31 Goldhawk Road *11 Lamington Street 258 King Street *94 Shepherd's Bush Road *85 The Grove *102 Dalling Road †*84 Shepherd's Bush Road 70 Glenthorne Road 24 Bradmore Park Road *77 Brackenbury Road *134 Shepherd's Bush Road *1 Masboro' Road *98 Blythe Road *17 Kilmarsh Road *7 Shepherd's Bush Road *192 Dalling Road *1 Aldensley Road *67 Masboro' Road *47 Milson Road *33 Glenthorne Road †* Cadby Hall, Hammersmith Road † The Grove 316 King Street *6 Beaconsfield Terrace Road J. Alderton Not in use W. Gregory Not in use H. Guthiel john Burnett Ernest Witt P. Erbach Not in use W. Gerres W. Schlarb F. T. Ries E. Fursdon J. Heide & Son W. Jennings C.Jacobs W. Dodwell P. Puhl L. Lorenz A. Royston F. Miller H. Stumm J. Teague W. Warwick E. Winstone J. Lyons & Co. Palmer's Stores, Ltd. W. Lines W. Phipps 37 SOUTH DISTRICT. Ward No. I. address. name. 65 Bridge Road †88 Queen Street † 1 Eyot Gardens 2 and 4 Crispe Road 93 Black Lion Lane *82 Great Church Lane 16 Black Lion Lane 213 Hammersmith Road † Great Church Lane 7 St. Peter's Road W. Bass Not in use J. R. Chibnall, Limited Mrs. Gottig A. Gurney G. Acres A. Mulford G. Bamford Fullers, Limited F. Booker * Underground Bakehouses, † Factory Bakehouses 38 Table Showing Number of Families or Separate Occupiers and Number of Persons at Census, 1911. Name of District. Population, Census, 1911. Families or separate occupiers, Census, 1911. Lewisham 160,834 37,013 Wandsworth 311,360 70,155 Woolwich 121,376 26,504 Stoke Newington 50,659 12,163 Greenwich 95,968 20,692 Deptford 109,496 25,040 Camberwell 261,328 58,679 Hackney 222,533 50,622 Battersea 167,743 39,598 Hampstead 85 495 18,625 Lambeth 298,058 70,827 Hammersmith 121,521 28,462 Fulliam 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 South walk 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 1 1,030 39 Table Showing extent in Acres, and Number of Persons to the Acre, at Census, 1911. 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 3,851.7 24.96 Wandsworth 9,107.4 34.09 Hampstead 2,265.0 37.74 Hammersmith 2,286.3 53.15 Camberwell 4,480.0 58.33 Stoke Newington 863.5 58.66 City of Westminster 2,502.7 64.03 Hackney 3,287.8 67.07 Poplar 2,327.-7 69.78 Deptford 1,562.7 70.06 Lambeth 4,080.4 73.04 Kensington 2,291.1 75.21 Battersea 2,160.3 77.64 St. Marylebone 5,472.8 80.22 St. Pancras 2,694.4 80.98 Bermondsey 1,499.6 83.95 Fulham 1.703.5 89.98 Chelsea 659.6 100.64 Paddington 1,356.1 105.11 Islington 3,091.5 105.90 Holborn 405.1 121.83 Finsbury 586.6 149.87 Stepney 1,765.6 158.47 Bethnal Green 759.3 168.81 Shoreditch 657.6 169.38 Southwark 1,131.5 169.59 40 CUSTOMS AND INLAND REVENUE ACTS. During the year 12 applications were received for certificates under these Acts. There was a considerable amount of work which had to be carried out in reference to these applications. In no case was the certificate granted until the whole of the sanitary requirements were carried out so as to place the premises in a proper sanitary condition. The following is a list of premises which were inspected, under the Inland Revenue Acts, last year:— Name and Situation of Property. No. of Houses and blocks for which applications were received. No of Tenements therein. No. of Tenements for which Certificate was granted. No. of Tenements for which Certificate was refused. No. of Tenements for which Certificate was deferred. 106, Sinclair Road 1 House 2 2 – – 43, Shepherd's Bush Green 1 House 2 2 – – 102, Sinclair Road 1 House 2 2 – – 48 to 62, Tunis Road 5 Houses 10 – – 10 (not completed) 142, Sinclair Road 1 House 2 2 – – 1 to 8, Askew Mansions 1 Block 8 8 – – 140, Sinclair Road 1 House 2 2 – – 1 and 31, Brewster Gardens 2 Houses 4 – – 4 (not completed) 45, Maclise Road 1 House 2 2 – – 96, Sinclair Road 1 House 2 – – (2 not completed) 3, Mall Road 1 House 3 – 3 – 13, Dalgarno Gardens 1 House 2 – – 2 (not completed) Carried forward 17 41 20 3 18 41 Name and Situation of Property. No. of Houses and blocks for which applications were received. No. of Tenements therein. No of Tenements j for which Certificate was granted. ! No. of Tenements for which Certificate was refused. No. of Tenements for which Certificate was deferred. Brought forward 17 41 20 3 18 7, 11, 19, 27, 29, 47, 61, 52, 42, 25, 10, Bracewell Road 11 Houses 22 – – 22 (not completed) 27 to 31, Bassein Park Road 3 Houses 6 – – 6 (not completed) 113 to 117, Stanlake Road 3 Houses 6 – – 6 (not completed) 41,43,45.47,49,51,53 and 14 Mall Road 8 Houses 16 – – 16 (not completed) 1 to 19, Lanark Mansions 2 Blocks 19 – – 19 (not completed) 90 to 98, Oaklands Grove 5 Houses 10 – – 10 (not completed) 39, Maclise Road 1 House 2 – – 2 (not completed) 52 and 52A, Rayleigh Road 2 Houses 4 – – 4 (not completed) 1 to 6, Rosedale Terrace 6 Houses 12 – – 12 (not completed) II and 12, Caithness Road 2 Houses 4 – – 4 (not completed) 27, Boscombe Road 2, 12, 13, 15, 16, 17, Granville 1 House 3 – – 3 (not completed) Mansions 1 Block 6 6 – – Totals 62 151 26 3 122 One hundred and eleven Intimation Notices were served in reference to defects found to exist in certain of the above premises, and thirty-eight Notices were complied with. 42 The following is a list of the premises certified by me during the year:— 102, Sinclair Road. 43i 43ai Shepherd's Bush Green. 142, 142a, Sinclair Road. 106, 106a. Sinclair Road. 1 to 8, Askew Mansions. 140, 140a. Sinclair Road. 2, 12, 13, 15, 16, 17, Granville Mansions. 45, 45a, Maclise Road. No application was received under Section 35 of the Towns Planning Act, 1909. SEIZURE OF UNWHOLESOME FOOD. During last year no seizure was made of food which was unsound, unwholesome and unfit for the food of man. HOUSES LET IN LODGINGS. During the last year the Public Health Committee gave directions for the registration of 205 "houses let in lodgings or occupied by the members of more than one family," making a total with those previously registered of 2,617 premises. Upon the registration a copy of the Bye-laws of your Council, under which such houses are registered, was forwarded to the landlord (within the meaning of the Bye-laws) for his guidance. From various causes 166 houses have been removed from the list, leaving a total number now on the Register of 2,451. During the year 759 notices were served and 729 were complied with. The registered premises were visited as often as time would allow by the special Inspectors appointed for that purpose. SANITARY NOTICES AND ADMINISTRATION. During last year 1,657 notices were reported as having been served by your four District Sanitary Inspectors having for their object the removal or prevention of nuisances or insanitary conditions, against 1,540 in the previous year, and during last 43 year 1,546 notices were reported as having been complied with, against 1,438 in the previous year. The House-to-House inspection has been continued during the year. This Inspector reports that during the year he has inspected 1,642 houses and other premises in the borough, against 724 houses in the previous year. As a result of his inspection, defects were discovered in 727 houses, and 727 Intimation Notices were served by the House-to-House Inspector. These cases were subsequently dealt with by the four District Inspectors. Two hundred and five houses coming under the provisions of the Bye-laws as to "Houses let in lodgings or occupied by members of more than one family," were discovered by this Inspector, and were subsequently dealt with by the Inspectors in charge of the work under the Bye-laws. The Health Visitor reports to me that she has made 2,102 visits with regard to the care of infants, and has advised parents as to the methods of feeding, clothing, etc. She also reports to me that she discovered 50 premises on which insanitary conditions existed, and paid 14 visits to cases of ophthalmia neonatorum. HOUSING AND TOWN PLANNING ACT, 1909. Regulations of Local Government Board. The Local Government Board made an order dated 2nd September, 1910, under Section 17 of the Housing and Town Planning Act, 1909. Sanitary Inspector Cosson reports that he has made 749 inspections during the year, having inspected the houses in the list of streets adopted by your Council on my report. As a result of his inspection 278 Intimation Notices were served and 274 complied with, a list of which follows:— 44 Notices served. Complied with. Notices served. Complied with. Bridge Street 11 11 Aspen Place 13 13 Trafalgar Street 20 20 Felgate Mews 5 5 Orris Mews 7 7 Grove Mews 16 15 Brook Green Place 11 It Rayleigh Road 52 52 Barb Mews 6 6 Leffern Road 19 19 Melina Road 18 17 Hunt Street 37 37 Latimer Mews 7 7 Southbrook Street 33 32 Coleman's Buildings 11 11 Lycett Place 8 8 Priory Mews 4 3 278 274 SANITATION OF THE EXHIBITION PREMISES. The Sanitation of the Exhibition premises, Wood Lane, had, as in the previous year, the most careful consideration of your Public Health Committee both as to the efficiency and sufficiency of the sanitary accommodation provided. The amount of sanitary accommodation was greatly in excess of the requirements. INSPECTION OF FACTORIES, Ere. Your Factory Inspector has during the year served 273 notices under the Factory and Workshop Act, and during the same period 269 notices have been complied with. During the previous year there were 2Qi notices served and 270 complied with. The following is a list of the Factories and Workshops upon the Register:— Restaurants, Hotels, &c. 180 Bakehouses (5 not used at present as Bakeries) 62 Bootmakers 70 Motor and Cycle Makers and Engineers 51 Dressmakers and Milliners 255 Laundries 305 Letterpress Printers and Bookbinders 30 Electrical and Mechanical Engineers 53 Smiths, Wheelwrights and Coachbuilders 36 Tailors 54 Bottle Washing Works 14 Dry Cleaning, Dyeing, and Carpet Beating Works 18 Firewood Cutters 15 Builders and Joiners (Machine) 31 Outworkers 588 Miscellaneous 116 1,878 45 The whole of these premises have been under a systematic inspection by your special Inspector appointed for that purpose, and numerous improvements in the sanitary condition of these premises have been carried out under his supervision. In addition to this work, Mr. Neighbour performed for some part of the year the duties of Smoke Inspector. 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. 1.—INSPECTION OF FACTORIES, WORKSHOPS AND WORKPLACES. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 751 53 – Workshops (including Workshop Laundries) 1,532 115 1 Workplaces (other than out-workers premises included in Part III of this report) 908 88 – Total 3.191 256 1 46 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 73 71 ... ... Want of Ventilation ... ... ... ... Overcrowding ... ... ... ... Want of Drainage of Floors 9 9 ... ... Other Nuisances 165 160 ... ... Sanitary Accommodation. insufficient 3 3 ... ... unsuitable or defective 42 40 ... 1 not separate for sexes 1 1 ... ... 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) 96 96 Other Offences ... (excluding offences relating to outwork, which are included in Part 3 of this report.) ... ... ... ... Total 389 380 ... 1 * Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act as remediable under the Public Health Acts. 47 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. Prosecutions. Twice in the year. Once in the year. Notices served on Occupiers as to keeping or sending lists. Failing to keep or permit inspection of Lists. Failing to send Lists. Instances. Notices served. Prosecutions. Instances. Orders made (S. no). Prosecutions (S. 109, 110). Lists.† Outworkers. † Lists. Outworkers. † Contractors Workmen. Contractors. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing apparel— (1) making. &c, 50 66 90 14 8 24 ... ... ... 17 17 ... ... ... ... (2) cleaning and washing 10 10 ... ... ... ... ... ... ... ... ... ... ... ... ... 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. &c ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Artificial flowers ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Nets, other than wire nets ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tents ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sacks ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Racquet and tennis balls ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Paper, &c., boxes, paper bags ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Brush making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pea picking ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Feather sorting ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Carding, &c., of buttons, &c ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Stuffed toys ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Basket making ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chocolates and sweetmeats ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total 60 76 90 14 8 24 ... ... ... 17 17 ... ... ... ... If an occupier gives out work of more than one of the classes specified in column i, and subdivides his list in such a way as to show the number of workers in each class of work, the list should be included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers should be assigned in columns 3 and 4 (or 6 and 7) into their respective classes. A footnote should be added to show that this has been done. † The figures required in columns 2, 3, and 4 are the total number of the lists received from those employers who comply strictly with the statutory duty of sending two lists each year and of the entries of names of outworkers in those lists. The entries in column 2 must necessarily be even numbers, as there will be two lists for each employer —in some previous returns odd numbers have been inserted. The figures in columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. 48 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 62 dressmakers 255 restaurants 180 others 597 Total number of workshops on Register 1,094 5.—OTHER MATTERS. Class. Number. Matters notified to H. M. Inspector of Factories— Failure to affix Abstract of the Factory and Workshop Act (S. 133) – Action taken in matters referred by H. M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (S. 5) Notified by H. M. Inspector 15 Reports (of action taken) sent to H. M. Inspector 15 Other 36 Underground bakehouses (S. 101)— Certificates granted during the year – In use at the end of the year 30 Note.—The Factory and Workshop Act, 1901 (s 132), requires the Medical Officer of Health in his Annual Report to the District Council to report specifically on the administration of that Act in workshops and workplaces, and to send a copy of his Annual Report, or so much of it as deals with this subject, to the Secretary of State (Home Office). If the Annual Report is presented otherwise than in print, it is unnecessary to include in the copy sent to the Home Office the portions which do not relate to factories, workshops, workplaces, or homework. The duties of Local Authorities and the Medical Officer of Health under the Act of 1901 are detailed in the Home Office Memorandum of December, 1904. A further Memorandum on the Home Work Provisions of the Factory Act was issued to all District Councils and Medical Officers of Health in October, 1906. 49 ICE CREAM DEALERS. The London County Council (General Powers) Act, 1902, which came into operation on the 1st November, 1902, by Part VIII., made provision for the regulation, manufacture, and sale of ice cream or other similar commodities. The duty of obtaining the necessary information for the registration of premises upon which ice creams are made was carried out by Sanitary Inspector S. Huggons Brown. At the present time there are 176 premises upon the register and 6 notices have been served, all of which have been complied with. The following is a table in reference to the above-named premises. DAIRIES, COWSHEDS, AND MILKSHOPS ORDER, ETC. PROCEEDINGS DURING 1912. PREMISES. NUMBER OF PLACES. Number of inspections, 1912. Number of notices, 1912. Number of prosecutions, 1912. On register at end ot 1911. Added in 1912. Removed in 1912. On register at end of 1912. Milk premises 347 44 58 333 655 25 2 Cowsheds nil. nil. nil. nil. nil. nil. nil. Slaughter-houses 8 nil. nil. 8 107 18 nil. Offensive trade premises nil. nil. nil. nil. nil. nil. nil. Ice Cream premises 170 7 1 176 86 6 nil. 50 These registered premises were under regular inspection. During the year one case of infectious disease occurred upon premises where milk was sold. The regulations under the above Order appertaining to the stoppage of sale of milk, disinfection, and the granting of certificates were strictly enforced under my directions. There were 44 applications made during the year for registration of premises for sale of milk, and after inspection certificates were granted. In no case was a milkshop taken off the Register on the grounds that the premises were unsuitable. SUMMONSES ORDERED. During last year your Council and the Public Health Committee gave authority for 32 summonses to be taken out against persons for having failed to comply with the requirements of notices which had been served. In most cases before summonses were issued a letter was written to the person in default, informing him that the Public Health Committee had recommended the summons, and asking him if he was willing to give an undertaking in writing that he would forthwith comply with the notice which had been served. In most cases the undertaking was at once given, and it was not found to be necessary to apply for the summons. It has been the object of the department, as heretofore, to take out as few summonses as possible, but at the same time in no instance to allow anyone to defy the authority of your Council. During last year four summonses were taken out through the Public Health Department. 51 SUMMONSES HEARD. SITUATION OF PREMISES. NATURE OF OFFENCE. RESULT OF PROCEEDINGS. Roval Chiswick Laundry, British Grove Nuisance caused by the emission of black smoke from chimney of same. Prohibition order made with costs, £4. Royal Chiswick Laundry, British Grove Nuisance caused by the emission of grit from chimney of same. Fined £5 and 2s. costs 44, Brook Green Trading as a Milk Purveyor unregistered. Fined £1 and 2s. costs. 3, Camden Gardens Failing to comply with sanitary notice. Order made for necessary work to be carried out within 21 days. PUBLIC MORTUARY. During last year 211 bodies were removed to the mortuary at Fulham Palace Road. There were 109 bodies brought to the mortuary by order of the Coroner or the Police ; 60 bodies were taken from the West London Hospital, and 42 bodies were received for accommodation. PUBLIC NUISANCES. During last year I had no occasion to bring before your Public Health Committee any complaint in reference to a public nuisance in the Borough. This is the first year that no public nuisance has been reported on by me during the last 37 years. SMOKE ABATEMENT. During last year observations were made in reference to the amount of black smoke emitted from the under-mentioned premises. Eight preliminary notices were served, sixteen statutory notices were issued, and two summonses were issued. 52 The chimneys of the following premises were the subject of the before-mentioned observations :— Swan Laundry, Blythe Road, West Kensington Park. Kensington Palace Laundry, Spring Vale Terrace, West Kensington Park. Hammersmith Borough Council's Electricity Works. Eton Laundry, Orchard Road, Shepherd's Bush. Glen Laundry, Landor Road, Shepherd's Bush. Carpet Beating Works, Wharf Road. Latimer Road. Compressed Air Carpet Beating Company, Glenthorne Road. Kensington and Notting Hill Electric Lighting Company, Wood Lane. Fuller's Limited, Great Church Lane, Hammersmith. Royal Chiswick Laundry, British Grove. Gwynne's Iron Works, Hammersmith. Lyons & Company, Limited, Cadby Hall, Hammersmith. Knight's Carpet Beating Works, Scrubs Lane, Willesden. The Premier Laundry, Goldhawk Road. 74, Goldhawk Road. Bakehouse. 98, Goldhawk Road. Fried Fish Shop. Hammersmith Infirmary, Wormwood Scrubs. Addison Feather Mills. Woodstock Road. West London French Laundry, British Grove. Victoria Laundry, Great Church Lane. A number of complaints were received from the London County Council and the Coal Smoke Abatement Society, and in each instance observations were kept upon the premises until no evidence of the emission of black smoke could be obtained. METEOROLOGY. The average mean temperature registered in London during last year was 51° Fahrenheit. The highest temperature registered was 90° in July. The lowest temperature was 19.1° in February. Rain fell on 183 days. The total amount of rainfall was 24*87 inches. I am, Gentlemen, rYour obedient servant, N. C. COLLIER, L.R.C.P., L.S.A., Medical Officer of Health.