HAM 68 ANNUAL REPORT OF THE Medical Officer of Health OF THE borough of hammersmith For the Year 1913. ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH OF THE BOROUGH OF HAMMERSMITH For the Year 1913. Public Health Department, Town Hall, Hammersmith. April 28th, 1914. Gentlemen—I beg to present to you my Annual Report for last year. The Report will deal with the vital statistics, and with the Sanitary work carried out under the direction of your Council during the 53 weeks ending on 3rd January, 1914. 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. 2 BIRTHS. During last year 2,951 births, 1,488 males, 1,463 females, were registered in this Borough against 2,755 in the previous year. Making due allowance for the increase of the population, the number of births registered last year was 155 below the average number registered during the previous 10 years. Adding 96 births which occured outside the Borough, transferred by the Registrar-General as belonging to Hammersmith, and deducting 5 births which occurred in this Borough which are transferred to other districts by the RegistrarGeneral, the corrected number of births for last year was 3,042. On the population estimated up to the middle of the year, i.e., 123,745 inhabitants, the corrected number of births registered was equal to an annual rate of 24.6 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., 4,518,191 inhabitants, was equal to an annual rate of 24'9 births per 1,000 persons living. These figures are calculated upon the corrected number of births registered. DEATHS. During last year 1,704 deaths were registered in this Borough, 906 males, 798 females, against 1,595 in the previous year. Making due allowance for the increase of the population, the number of deaths registered in the Borough last year was 5 below the average number registered during the previous xo years. Adding 239 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 36 deaths of residents reported to me by the Registrar-General as having occurred in other parts of England, and deducting 227 deaths of non-residents which occurred, i74 at the West London Hospital, 2i at Nazareth House, i6 at the Hammersmith Infirmary, and i6 transferable deaths of non-residents 3 which occurred in this Borough, the corrected number of deaths of residents registered last year was 1,752. On the before-mentioned estimated population, the corrected number of deaths of residents registered last year was equal to an annual rate of 1.42 deaths per 1,000 persons living. The death rate in London on the estimated population of London up to the middle of the year was equal to an annual rate of 14.4 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 314, against 261 in the previous year. The number of deaths of infants under one year of age registered last year was equal to.179 per 1,000 of the total corrected deaths of residents registered, and to 103 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 183 per 1,000 of the total deaths registered, and 105 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, 4 per 1,000 less in this Borough than in London, and 2 per 1,000 less as compared with the total births registered in this Borough than in London. The following table on infantile mortality has been prepared by me in accordance with the direction of the Local Government Board. LOCAL GOVERNMENT BOARD RETURN.—TABLE IV. Infant Mortality during the year 1913. Nett Deaths from stated Causes at various Ages under 1 Tear of Age. METROPOLITAN BOROUGH OF HAMMERSMITH. CAUSE OF DEATH. ' Under i 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 i year. ALL Certified CAUSES. Uncertified 68 11 13 9 101 62 52 50 49 314 Small-pox - Chicken-pox — — — — — - — Measles — — — — — - 5 7 12 Scarlet Fever — - Whooping Cough — — — 1 1 1 2 6 8 18 Diphtheria and Croup — — — — — — . 1 1 — 2 Erysipelas — — — — — - _ Tuberculous Meningitis — — _ _ - 3 2 5 Abdominal Tuberculosis (b) — ( Other Tuberculous Diseases — — — — — -_ 1 _ 1 Meningitis (not Tuberculous) — — _ _ — - 2 2 Convulsions 4 2 3 — 9 2 1 2 3 17 Laryngitis Bronchitis — I i 2 5 2 4 14 Pneumonia (all forms) i — 2 i 4 12 16 13 9 54 Diarrhoea - - 7 4 s 3 iq Enteritis — — — 2 2 11 11 7 9 40 Gastritis — — — — — _ Syphilis — — — 2 2 3 2 - 7 Rickets — - - 1 1 Suffocation, overlying 2 - - 2 - 2 Injury at Birth j - i 1 Atelectasis 7 — _ _- 7 - - 7 Congenital Malformations (c) 4 2 1 - 7 - 1 - 11 Premature Birth 39 5 2 1 47 8 1 56 Atrophy, Debility, and Marasmus 7 - 5 2 15 11 8 1 3 38 Other causes 3 — — 3 2 — 2 7 68 11 13 9 101 62 52 50 49 314 Nett births in the Year : Legitimate, 2,867 ; Illegitimate, 175. Nett Deaths in the Year of : Legitimate Infants, 279 ; Illegitimate Infants, 35. 4 5 NOTES TO TABLE IV. (a) The total in the last column of Table IV. should equal the total in column 10 of Table I., and in column 3 of Table III. (6) 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 53 Weeks of 1913, as calculated by the Registrar-General. Deaths under i year to 1,000 Births Registered. County of London ... ... ... ... 105 Hampstead ... ... ... ... 73 Lewisham ... ... ... ... 78 Woolwich ... ... ... ... 79 Stoke Newington ... ... ... ... 82 Wandsworth ... ... ... ... 88 Chelsea ... ... ... ... 90 St. Marylebone ... ... ... ... 91 St. Pancras ... ... ... ... 92 City of London ... ... ... ... 96 City of Westminster ... ... ... ... 96 Fulham ... ... ... ... 96 Hackney ... ... ... ... 99 Paddington ... ... ... ... 100 Lambeth ... ... ... ... 102 Greenwich ... ... ... ... 103 Hammersmith ... ... ... ... 103 Holborn ... ... ... ... 104 Camberwell ... ... ... ... 106 Islington ... ... ... ... 107 Battersea ... ... ... ... hi Deptford ... ... ... ... 112 Kensington ... ... ... ... 112 Stepney ... ... ... ... 112 Poplar ... ... ... ... 112 South wark ... ... ... ... 115 Bethnal Green ... ... ... ... 118 Bermondsey ... ... ... ... 132 Finsbury ... ... ... ... 138 Shoreditch ... ... ... ... 155 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 496, against 457 in the previous year. These deaths last year were equal to 4.0 per 1,000 of total persons living, and 291 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 4.2 per 1,000 of the total persons living, and 290 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 1 per 1,000 greater in this Borough than in London as compared with the total deaths registered. 8 LOCAL GOVERNMENT HOARD RETURN.—TABLE I. Vital Statistics of Whole District during 1913 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 00 registered in the District.† of Residents not 0 registered in the Disti ict.† Under 1 Year of Ajje. At all Ages. Number.! 4 Rate. 5 Number* 6 Rate. 7 Number * 10 Rate per 1.000 Nett Births. 11 Number.* 12 Rate. 13 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 24c 209 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 130 1913 123745 2951 3042 24.6 1704 13.8 227 275 3M 103 1752 142 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. t 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) 2286 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 (cf. Census, Vol. 5). 9 DEATHS OF RESIDENTS. Belonging to the Borough occurring in Public Institutions, &c., in districts outside, during the year I9I3. Fever Hospitals. Horton Asylum 2 Western Fever Hospital 35 Cane Hill Asylum ... 2 Grove Hospital 6 Claybury Asylum 1 North Western Fever Hospital... 2 Other Institutions. Southern Hospital ... 1 Fulham Workhouse... 6 General Hosnitals. Bow Institution 5 Middlesex Hospital ... St. Mary's Hospital ... St. George's Hospital 19 12 8 St. Luke's House, Pembridge Square Clapham Maternity ... Kensington Infirmarv 3 2 2 Children s Hospital, Haddington Fulham Infirmary ... 2 Green 7 Charing Cross Hospital 6 St. Joseph's Hospice, Mare Street Downs Sanatorium ... 2 2 Children s Hospital, Great St. Pancras Infirmarv Ormond Street... 5 Chelsea Infirmary ... University College Hospital 4 Bishopsgate Institute ! St. Thomas Hospital 4 Whitechanel Workhouse ( Queen Charlotte's Hospital 2 Darenth Industrial Colony j Bethlem Royal Hospital Mount Vernon Hospital 2 2 Islington Infirmary,Highgate Hill Belmont Workhouse I I Brompton Hospital, Chelsea 2 Holborn Workhouse Brook Hospital 2 Camberwell House ... I St. Bartholomew s Hospital 2 Hospice of St. John and St. Cancer Hospital, Chelsea 2 Rlizaheth I St. Mark's Hospital ... 2 Various. Hoinueopathic Hospital 2 Victoria Hospital 2 On ambulance near Guy s Central London Throat and Ear pital... I Hospital 1 26, Holland Park Gardens, Queen's Hospital 1 sington I West End Hospital ... 1 In warehouse, Somcrs Town Royal Hospital for Incurables ... 1 Station, Midland Railway ... I London Temperance Hospital ... 1 Paddington Station ... I Metropolitan Hospital 1 106 to 110, Tabernacle Street, London Hospital 1 Shoreditch I Kensington General Hospital 1 49, Church Street, Kensington ... I Westminster Hospital 1 Peckham House I Friedenheim Hospital 1 In River Thames, off Jews Row, Maternity Hospital, Hackney ... 1 Wandsworth I Chest Hospital, Victoria Park ... 1 On the way to the London Queen Mary's Hospital, perance Hospital I Carshalton 1 At Notting Hill Railway Station, Throat Hospital, Golden Square 1 Kensington I Asylums. 14, Upper Wimpole Street, St. Marylebone I Hanwell Asylum 18 7, Osnaburgh Terrace, St. Pancras I Banstead Asylum 8 Warrington Lodge, Kensingion... I Tooting Bee Asylum 5 II, Clarendon Street, Pimlico ... I Long Grove Asylum 3 Paddington General Post Office, Calerham Asylum ... 2 London Street ... I Wandsworth Asylum 2 52, Thurloe Square, Kensington I Colney Hatch Asylum 2 338, Albany Road, Camberwell... I 10 corrected death-rates of metropolitan boroughs after distribution of deaths in public institutions, &c., as calculated by the registrar-general for year 1913. Death rate from all causes. Average County of London 14.2 Lewisham 10.6 Wandsworth 10.6 Hampstead 10.7 Fulham 12.5 Woolwich 12.6 City of Westminster 12.7 Hackney 13.4 Paddington 13.4 Stoke Newington 13.6 Camberwell 13.7 Kensington 13.7 Battersea 13.9 Chelsea 13 .9 Hammersmith 13.9 St. Marylebone 14.o Greenwich 14.2 Lambeth 14.3 Holborn 14.6 Stepney 14.9 Islington 15.1 City of London 15.2 St. Pancras 15.2 Deptford 15.3 Bethnal Green 15.4 Poplar 16.3 South wark 174. Bermondsey 17.9 Finsbury 18.3 Shoreditch 186 II LOCAL GOVERNMENT BOARD RETURN.—TABLE III. Causes of, and Ages at, D«ath during the Tear 1913. 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 1 year. 1 and under 2. 2 and under 5. 5 and under 15. 15 and under 25. 25 and under 45. 45 and under 65. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 all causes certified (c) 1752 0 314 0 91 0 77 0 60 0 62 0 243 0 409 0 496 0 660 0 Enteric Fever 0 0 0 0 0 0 0 0 0 0 Small-pox 0 0 0 0 0 0 0 0 0 0 Measles 49 12 21 14 2 0 0 0 0 0 Scarlet Fever 7 0 4 0 3 0 0 0 0 0 Whooping Cough 41 18 10 12 1 0 0 0 0 4 Diphtheria and Croup 12 2 1 5 4 0 0 0 0 0 Influenza 13 0 0 0 0 0 3 2 8 0 Erysipelas 3 0 0 0 0 0 0 2 1 3 Phthisis (Pulmonary Tuberculosis) 153 1 2 1 5 22 71 44 7 58 Tuberculous Meningitis 25 5 4 7 8 1 0 0 0 18 Other Tuberculous Diseases 5 0 0 0 2 1 2 0 0 3 Cancer, malignant disease 152 0 0 0 0 0 16 80 56 53 Rheumatic Fever 5 0 0 0 1 0 3 0 1 1 Meningitis (see note (d) ) 10 2 2 1 1 0 0 3 1 7 Organic Heart Disease 171 0 0 0 7 11 32 63 58 47 Bronchitis 175 14 7 3 1 2 7 35 106 57 Pneumonia (all forms) 200 54 28 15 5 6 35 30 27 96 Other Diseases of Respiratory Organs 44 1 1 2 0 0 3 19 18 14 Diarrhoea and Enteritis (see note (e) ) 77 59 7 5 1 0 0 2 3 52 Appendicitis and Typhlitis 6 0 0 0 3 1 1 0 1 6 Cirrhosis of Liver 8 0 0 0 0 0 5 2 2 Alcoholism 5 0 0 0 0 0 4 0 1 3 Nephritis and Bright's Disease 64 0 0 0 1 3 Q 26 25 27 Puerperal Fever 2 0 0 0 0 1 1 0 0 1 Other accidents and diseases of Pregnancy and Parturition Congenital Debility and Malformation, 3 0 0 0 0 0 3 0 0 0 including Premature Birth 105 105 0 0 0 0 0 0 0 18 Violent Deaths, excluding Suicide Suicide 43 13 1 0 0 0 6 0 8 0 3 5 7 4 7 4 11 0 49 2 Other defined Diseases 358 40 4 6 6 6 41 87 168 137 Diseases ill-defined or unknown 3 0 0 0 1 0 0 0 2 2 Total 1752 314 91 77 60 62 243 409 496 660 Sub- Ceiebro-spinal Meningitis 2 2 0 0 0 0 0 0 0 Entries Poliomyelitis 0 0 0 0 0 0 0 0 0 0 included in above figures. * * * 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. 12 NOTES TO TABLE III. The classification and numbering of Causes of Death are those of the "Slmrt List" oil page XXV. of the Manual of the International list of Causes of Death, which should be consulted and followed in all cases of doubt. (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. (b) All deaths occurring in institutions for the sick and infirm situated within the district, whether of residents or of non-residents, are to be entered in the last column of Table III. (c) All deaths certified by registered Medical Practitioners and all Inquest cases are to be classed as " Certified " ; all other deaths arc to be regarded as " Uncertified." (d) Exclusive of " Tuberculous Meningitis" (10), but inclusive of Cerebro-Spinal Meningitis. (c) Title 19 should be used for deaths from Diarrhoea and Enteritis at all ages. (In the " Short List " deaths from Diarrhoea 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 186 against 103 in the previous year. The deaths of residents last year from these diseases were equal to 106 per 1,000 of the total deaths of residents registered, and were at the rate of 1.5 deaths per 1,000 persons living. The deaths from the seven principal zymotic diseases in the whole of London were equal to 95 per 1,000 of the total deaths registered, and were at the rate of 1.4 deaths per 1,000 persons living. These deaths were, therefore, as compared with the total deaths of residents registered, 11 greater per 1,000 deaths belonging to this Borough than in London, and, as compared with the population, .1 per 1,000 greater in this Borough than in London. The following table shows the deaths of residents registered from the seven principal zymotic diseases which occurred in the 10 years 1904 to 1913 :— YEAR. Small-pox. Measles. Scarlet Fever. Diphtheria and Membranous Croup. Whooping Cough. Enteric Fever. Diarrhoea and Cholera. Total. i904 0 105 7 23 32 5 126 298 I905 0 30 11 21 54 5 89 210 1906 0 56 16 27 20 8 144 271 1907 0 52 10 23 31 6 39 161 1908 0 14 11 15 18 5 108 171 I909 0 84 9 26 39 5 42 205 i9io 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 IO3 1913 0 49 7 12 41 0 77 186 Average in last 10 years. 0 52 8 22 31 5 91 209 14 It will be seen from the preceding table that the total number of deaths from these zymotic diseases last year was, making no allowance for the increase in population, 23 below the average number registered in the last 10 years. CASES OF ILLNESS REPORTED AS DUE TO INFECTIOUS DISEASE. There were, omitting tuberculosis, 818 cases reported as due to notifiable infectious diseases inthis Borough against 650 in the previous year. The number of cases of tuberculosis notified was 718, against 438 in the previous year. There were also reported 1,242 cases of infectious diseases that were not notifiable, against 1,058 in the previous year ; 171 of these were chickenpox, 700 measles, and 371 whooping cough. SMALL-POX. No case of small-pox was notified in the Borough last year, against no case in the previous year. CHICKEN-POX. One hundred and seventy-one cases of chicken-pox were reported, against 363 cases in the previous year. Three hundred and sixty cases reported last year were treated at the homes of the patients and 3 at Hampstead Workhouse. No death was registered. MEASLES. Seven hundred cases were reported as due to measles, against 487 cases in the previous year. Five hundred and ninety-seven cases were treated at the homes of the patients, and 103 at the Metropolitan Asylums Board's Hospitals. Forty-nine deaths were registered. As this is not a notifiable disease it is of no use my giving the mortality rate on the cases reported, 15 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 22 deaths, whereas from measles alone there were 49 deaths. In every case that was reported the premises were at once inspected as to the sanitary condition. SCARLET FEVER. Five hundred and thirty-three cases were notified as due to scarlet fever, against 335 in the previous year. Four hundred and seventy-three cases reported last year were isolated at Isolation Hospitals, and 60 cases were treated at the homes of the patients. Seven deaths were registered. The mortality rate on the cases reported was only 1.3 per cent. DIPHTHERIA AND DIPHTHERITIC MEMBRANOUS CROUP. One hundred and forty-one cases were reported as due to diphtheria or diphtheritic membranous croup, against 177 cases in the previous year. One hundred and twenty-eight cases reported last year were treated at the Isolation Hospitals, and 13 at the homes of the patients. Twelve deaths were registered. The mortality rate on the cases reported was 8.5 per cent. 16 WHOOPING COUGH. Three hundred and seventy-one cases were reported as due to whooping cough, against 208 cases in the previous year. Three hundred and twenty-six cases were treated at the homes of the patients, and 45 cases were treated at the Isolation Hospitals of the Metropolitan Asylums Board. Forty-one deaths were registered. As this is not a notifiable disease it is of no use my giving the mortality rate on the cases reported, as doubtless a very large number of cases occurred which were not known of in the Public Health Department. I have continued to receive as heretofore information as to cases from the Head Teachers of the Schools of the London County Council. ENTERIC FEVER. Fourteen cases were reported as due to enteric fever, against 11 in the previous year. Seven of the cases reported last year were treated at the Isolation Hospitals of the Metropolitan Asylums Board, one at the Hammersmith Infirmarv, one at St. Marv's Hospital, and five at the homes of the patients. No deaths were registered. The mortality rate on the cases reported was o per cent. TYPHUS FEVER. No case was reported as due to typhus fever, against no case in the previous year. SIMPLE CONTINUED FEVER. No case was reported as due to simple continued fever, against no case in the previous year. 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. Eight cases were reported as due to puerperal fever, against 7 cases in the previous year. Three of the cases reported last year were treated at the homes of the patients, 4 of the cases were treated at the Hammersmith Infirmary and 1 at the West London Hospital. Two deaths were registered. The mortality rate on the cases reported was 25.0 per cent. CHOLERA. No case was reported as due to cholera, against no case in the previous year. ERYSIPELAS. Ninety-eight cases were reported last year as due to erysipelas, against 99 cases in the previous year. Fifty-nine cases were treated at the homes of the patients, 36 at the Hammersmith Infirmary, 1 at the West London Hospital, 1 at Middlesex Hospital, and 1 at the Chiswick Hospital. Three deaths were registered. The mortality rate on the cases reported was 3.1 per cent. PLAGUE. No case was reported as due to plague, against no case in the previous year. CEREBRO-SPINAL FEVER. One case was reported as due to cerebro-spinal fever, against three cases in the previous year. The patient was a male infant of seven months who was 18 taken to the West London Hospital, where death took place. No information was obtained as to the probable source of infection. Two deaths were registered, one patient, however, was a non-parishioner, the mortality rate being 100 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. Twenty-two cases were reported as due to ophthalmia neonatorum, against 17 cases in the previous year. The cases reported last year were treated : 15 at the homes of the patients and 7 at the Hammersmith Infirmary. 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. I have no information as to the probable source of infection or the recovery of the patient. 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 1904 to 1913. Year. Small-pox. Scarlet Fever. Diphtheria or Diphtheritic Croup. Typhus Fever. Enteric Fever. 1 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 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 I 0 9 0 63 0 228 484 200 2 1 1 0 0 0 1521 1911 0 236 195 1 28 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 1913 0 533 141 0 14 0 0 8 0 98 0 171 700 371 1 0 0 0 22 1 2060 Av'rge in last 10 yrs. 0 387 198 0 28 0 0 9 0 94 0 209 556 225 1 0 0 0 6 0 1713 * Not a notifiable disease. LOCAL GOVERNMENT BOARD RETURN.—TABLE II. Cases of Infectious Disease notified during the year 1913.* 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 Yeais. 65 and upwards. North Centre South Small-pox 0 0 0 0 0 o 0 0 0 0 0 0 ‡ Cholera (C) Plague (P) 0 0 0 0 0 o 0 0 0 0 0 0 Diphtheria (including Membranous Croup) 141 4 38 72 13 12 2 0 56 59 26 128 Erysipelas 98 4 7 9 3 37 28 10 45 40 13 39 Scarlet Fever 533 5 1 '5 346 45 20 2 0 299 160 74 473 Typhus Fever 0 0 0 0 0 0 o 0 0 0 0 0 Enteric Fever ‡Relapsing Fever (R) 14 0 0 2 4 5 3 0 5 7 2 9 Continued Fever (C) 0 0 0 0 0 0 0 0 0 0 0 0 Puerperal Fever 8 0 0 0 2 6 0 0 2 6 0 5 Cerebro-Spinal Meningitis I 1 0 0 0 0 0 0 I 0 0 1 Polio-myelitis I 0 1 0 0 0 0 0 0 0 1 1 Pulmonary Tuberculosis 594 1 15 91 101 242 127 17 263 204 127 159 Other forms of Tuberculosis 124 5 21 46 25 16 10 1 63 47 14 38 §Ophthalmia Neonatorum 22 20 2 0 0 0 0 0 12 8 2 7 Totals 1536 40 199 566 193 338 172 28 746 531 259 860 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. This space may be used for record of other diseases the notification (compulsory or voluntary) of which is in force in the district. † 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. * The figures should take account of any corrections made as a result of error in notification or revision of diagnosis as a result of the further course of the disease (cf para (3) on p 3 of the Weekly Summary of Cases of Infectious Diseases). 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. 20 21 The following table of Deaths from Infectious Diseases is compiled from the Registrar General's Report. Boroughs. Populatii n estimated to the middle of 1913 † Births. All causes. Enteric Fever. Small-pox. Deaths from Deaths under 1 year of Age. Measles. Scarlet Fever. Whooping-cough. Diphtheria. Diarrhoea and Enteritis (under 2 years) Pulmonary Tuberculosis COUNTY OF LONDON 4,518.191 112,637 65.030 114 - i.57o 188 800 43i 3.098 5,98i 11,869 West. Paddintjton 142,210 3.055 1.941 6 _ 55 7 37 12 71 157 305 Kensington 171,284 3.357 2.377 4 — 84 3 29 6 80 188 375 Hammersmith 123,7-15 3,043 1.754 — — 47 7 47 12 64 151 314 Fulham 157.117 4,302 1,992 8 — 50 3 27 14 98 209 414 Chelsea 64,598 1,257 911 1 — 18 3 5 1 24 81 113 City of W'stmnstr 154,810 2.227 1,992 3 — 22 7 7 8 52 206 213 North. St. Marylebone 114.532 2,221 1,633 5 _ 33 10 10 6 37 158 202 Hampstead 86,346 1,326 93« 1 — 21 4 11 3 18 50 97 St. Pancras 214 .330 5.512 3,32i 6 — 41 6 31 16 114 327 508 Islington 325.585 8.357 5.009 5 — 107 17 61 34 221 441 894 Stoke Newington 5o.5i8 1.144 698 2 — 11 1 6 6 16 48 94 Hackney 223,353 5,522 3,037 4 — 68 11 23 11 Mi 261 549 Central. Holborr 46,949 798 698 _ _ 10 — 6 4 15 89 83 Finsbury 84,679 2,547 1,576 — — 30 4 3» 9 97 173 352 City of London 17.916 167 276 2 — 1 2 1 2 27 16 East. Shoreditch 109,654 3,513 2,068 1 — 52 3 29 14 207 200 546 Bethnai Green 127.824 3.998 2,006 4 — 62 3 34 10 151 201 470 Stepney 275.300 8.187 4172 ii — <j5 8 26 22 287 471 916 Poplar 160,913 5,230 2,668 5 — 69 12 38 34 159 239 586 South. Southwark 188,487 5.936 3.343 6 _ 105 11 38 19 182 354 682 Bermondsey 124.739 3.896 2,266 3 — 90 4 47 17 '65 204 513 Lambeth 297.139 7,233 4.3m 8 — 99 M 47 37 202 389 736 Battersea 167.464 4.239 2,361 6 — 93 7 28 20 125 192 469 Wandsworth 330.395 6.840 3.550 5 — 116 11 23 16 148 288 603 Camberwell 261.805 6,671 3 653 5 — 68 13 54 18 179 306 708 Deptford 109,280 3.'03 1.704 2 — 50 3 46 17 93 '44 347 Greenwich 96,015 2,54i 1.385 2 — 40 2 24 12 52 114 262 Lewisham 168,822 3,522 1,814 8 — 25 5 23 35 50 127 273 Woolwich 122,382 2,893 1,573 1 9 8 10 17 48 186 229 † Based on the results of the Censuses of 1901 and 1911. 22 The following table of Deaths from Infectious Diseases per 1,000 persons living is compiled from the Registrar General's Report. Per 1,000 Persons Living. Rate per 1,000 Births. Deaths From borqughs. Births. All Causes. Enteric Fever. | Small-pox. Measles. Scarlet Fever. Whooping-cough. Diphtheria. Pulmonary Tuberculosis. Diarrhoea and Enteritis (under 2 years). Total Deaths under 1 year. Crude. Standar dized.* COUNTY OF LONDON 24.5 14.2 14.2 0'.02 - 0'34 0.04 0.17 0.09 1.30 2750 105 West. Paddington 21.1 I3.4 13.4 O.O4 — 0.38 0.05 0.26 0.08 1. 09 23.24 100 Kensington I9'3 13.7 136 0.02 — 0.48 0.02 0.17 0.03 108 23.83 112 Hammersmith 24.2 13.9 13.8 — — 0.37 0.06 0.37 0.10 1.'20 21. 03 103 Fulham 26..9 I2.5 12.9 0.05 — 0.31 0.02 0.17 0.09 1.3I 22. 78 96 Chelsea 19 .1 13.9 13.2 0.02 — 0.27 0.05 0.08 0.02 1.23 19.09 90 City of Westminster 14.2 12.7 13.3 0.02 0.14 0.04 0.04 o.o5 1.3I 23.35 96 North. St. Marylebone 19.1 14.0 14.3 0'04 — 0.28 0.09 0.09 0.05 1.36 16.60 91 Hampstead 15.1 10.7 11.3 0.0i — 0.24 0.05 0.13 0.03 0.57 13.57 73 St. Pancras 25.3 I5'2 15.2 0.03 — 0.19 0.03 0.14 0.07 1.5O 20.68 92 Islington 253 15.1 14.8 0'.02 — 0.32 0.05 0.18 0.10 1. 33 26.44 107 Stoke Newington 22.3 13.6 12.9 O.O4 — 0. 21 0.02 0.12 0.12 0.93 13.99 82 Hackney 24.3 13.4 13.5 0.02 — 0.30 0.05 0.10 0.05 1.15 25.53 99 Central. Holborn I6.7 14.-6 14.7 0.21 0. 13 0.08 1.87 18.80 104 Finsbury 29.6 18.3 18.1 — — 0.35 0.05 0.36 0.10 2.01 38.08 138 City of London 9.2 15.2 15.8 O.1l — - 0.05 O.1l 0.05 1.48 11.98 96 East. Shoreditch 31.5 18.6 19. 2 0.01 — 0.47 0.03 0.26 0.13 1. 79 58.92 155 Bethnal Green 30.8 I5.4 16.1 0.03 — 0.48 0.02 0.26 0.08 1.55 37.77 118 Stepney 29.3 14.9 15.6 0.04 — 0.34 0.03 0.09 0.08 1.68 35.06 112 Poplar 32.0 16.3 16.1 0.03 — 0.42 0.07 0.23 0.21 1 .46 30.40 112 South. Southwark 31.0 17'4 17.6 0.03 — o.55 0.06 0.20 O.IO 1.85 30.66 115 Bermondsey 30.7 17.9 17.8 0.02 — 0.71 0.03 0.37 0.13 1.61 42.35 132 Lambeth 23.9 14.3 14.0 0.03 — 0.33 0.05 o.16 0.12 1. 29 27.93 102 Battersea 24.9 I3.9 14.0 O.O4 — o.55 0.04 0.16 0.12 1. 13 29.49 111 Wandsworth 20.4 10.6 10.6 0.01 — 0.35 0.03 0.07 0.05 0.86 21.64 88 Camberwell 25.1 13.7 13.6 0.02 — 0.26 0.05 0.20 0.07 1.15 26.83 106 Deptford 27.9 15.3 15.2 0.02 — o.45 0.03 O.4I 0.15 1.30 29.97 112 Greenwich 26. 0 14.2 14.0 0.02 — 0.41 0.02 0.25 0.12 1.17 20.46 103 Lewisham 20.5 io.6 10.4 0.05 — 0.15 0.03 0.13 0.20 0.74 14.20 78 Woolwich 23.3 12.6 13.0 0..01 0.07 0.06 0.08 O.I4 1.50 16.59 79 • The Standardized death-rates represent the Crude death-rates multiplied by the respective Standardizing Factors in order to make Correction for differences of sex and age constitution of the several populations in 1911 as compared with that of England and Wales in 1901. 23 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 53 Weeks ended 3rd January, 1914.* Boroughs. Estimated Population in the middle of I9I3 t Total Cases. Enteric Fever. Typhus. Continued Fever. Small-pox. Scarlet Fever. Diphtheria (including Membranous Croup). Cholera. Erysipelas Cerebro-spinal Fever Puerperal Fever. Anthrax. Glanders. Ophthalmia Neonatorum. Polio-myelitis. West. Paddington 142,210 960 25 _ — — 487 304 — 112 8 — — 22 2 Kensington 171,284 880 28 — — — 558 145 — 112 3 13 — — 17 4 Hammersmith 123,745 821 13 — — — 537 138 — 101 - 8 — — 23 1 Fulham I57.117 1,238 34 — — — 767 270 — 121 5 19 — — 20 2 Chelsea 64.598 323 7 — — — 206 61 — 35 8 — — 3 3 City of Westminster 154.810810 701 29 — — — 379 192 — 75 — 6 — — 16 4 North. St. Marylebone 114.532 662 19 _ — 1 417 130 — 78 3 4 — — 9 1 Hampstead 86.346 400 15 — — — 208 128 — 33 — 1 — — ii 4 St. Pancras 214.330 1,309 41 — 1 — 565 438 — 215 5 11 — — 24 9 Islington 325.585 2,239 50 — — — I.3I5 551 — 228 8 28 — — 40 19 Stoke Newington 50.518 246 9 — — — 109 84 — 35 i 2 — — 1 5 Hackney 223,353 1,449 39 — 1 — 821 331 — 184 8 19 — 31 15 Central. Holborn 46,949 234 7 — — — 132 60 — 29 — 1 — — 3 2 Finsbury 84,679 549 15 — — — 274 107 — 125 5 14 — — 6 3 City of London 17,916 94 6 — — — 47 30 — 8 — — — — 1 2 East. Shoreditch 109,654 757 15 1 — 354 185 _ 159 4 9 — — 22 8 Bethnal Green 127,824 958 23 — — — 411 223 — 265 1 13 — — 19 3 Stepney 275.300 1,810 68 2 1 — 820 471 — 364 10 34 2 — 24 14 Poplar 160,913 1,397 40 — 1 2 754 345 — 173 5 26 1 — 47 3 South. Southwark 188,487 1,586 39 1 2 1 880 327 — 260 6 15 — 55 — Bermondsey 124.739 1.177 27 1 1 — 731 243 — 130 3 M — — 24 3 Lambeth 297,«39 2,170 39 — 2 — 1,397 408 — 219 7 25 — — 65 8 Battersea 167,464 i.43i 20 — 2 — 949 288 — 123 3 10 — — 3i 5 Wandsworth 330,395 1.806 52 — 2 — 1,007 447 — 206 9 32 — — 37 14 Camberwell 261,805 1.893 23 — 1 1.155 403 — 257 6 12 1 — 30 5 Deptford 109,280 1,140 17 — — — 625 245 — 232 — 1 — 1 19 — Greenwich 96.015 739 8 — — — 330 267 — 112 — 5 — — 17 — Lewisham 168,822 1,238 34 — — — 670 431 — 84 — 3 — — 11 5 Woolwich 122.382 1,155 14 — — — 645 402 — 72 — 8 — 13 1 Port of London 1 5 2 Administrative County of London 4,818,191 31,367 788 4 19 4 17,852 7,684 - 4,148 92 349 4 1 641 145 Ages 0-1 1,164 3 - 153 213 127 25 - - _ 634 9 '' 1-5 6,950 26 — - 4,211 2.397 180 27 — — — 5 104 '' 1-5 jo,753 92 1 3 1 7.646 2,816 159 16 1 — 1 17 „ 10- 4,660 96 2 3.375 1,016 153 11 — — — 1 6 '' 15 1.799 99 i 3 1 970 429 — 273 5 14 — 1 — 3 „ 20- 1,200 98 1 i 494 276 237 4 85 — — — 4 " 25- 1,680 154 4 2 519 3i7 — 502 3 178 — — — 1 '' 35- i,160 112 1 2 — 130 119 — 727 68 1 — — — '' 45- 939 50 — — — 37 43 — 802 1 4 1 — — 1 ''55- 576 24 — — — 11 23 — 5i8 — — — — — „ 65 and upwards 485 4 5 5 4/0 — 1 — — — Age not stated - — — 1 — * This table is supplied by the Medical Officer of Health of the Administrative County of London, and is compiled from returns which the London County Council receives from the Metropolitan Asylums Board under section 55 (4) of the Public Health (London) Act, 1891. t Based on the results of the Censuses of 1901 and 1911 24 INFLUENZA. Thirteen deaths were registered as due to influenza, against 13 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. Seven hundred and eighteen cases were notified to me against 438 cases in the previous year, 594 of which were cases of pulmonary tuberculosis and 124 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. I11 many instances advantage was taken of the offer of the Council to disinfect. One hundred and eighty-three deaths were registered against 168 in the previous year. On December 20th, 1912, the Local Government Board issued a series ot Regulations to be known as the Public Health (Tuberculosis) Regulations, 1912, which they had made consolidating and amending the Public Health (Tuberculosis) Regulations, 1908, the Public Health (Tuberculosis in Hospitals) Regulations, 1911, and the Public Health (Tuberculosis) Regulations, 1911. These Regulations came into operation on February 1st, 1913, and were printed in my last Annual Report. During last year your Committee on my recommendation gave instructions for sputum outfits to be supplied to medical practitioners attending suspected cases of tuberculosis who are not in a position to pay for the pathological examination of sputum. Arrangements have been made with the Lister Institute of Preventive Medicine to carry out the work. Five orders were given in response to the applications received during the three months the arrangement was in force last year. 25 The following table shows the number of Notifications of males and females at various age periods from pulmonary and non-pulmonary tuberculosis, received since the commencement of the Public Health (Tuberculosis) Regulations, 1912, until the end of the year January 3rd, 1914. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from 1st February, 1913, to the end of the week ending on the 3rd January, 1914. Age Periods. Number of Notifications on Form "A." Number of Notifications on Form " B." Number of Notifications on Form ' C." Primary Notifications. Total Notifications (i.e., including cases previously notified by other doctors.) Primary Notifications. Total Notifications (i e, including cases previously notified by other doctors.,) Poor Law Institutions. Sanatoria. 0 to 1. 1 to 5- 5 to 10. 10 to 15- 15 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 1 5 25 9 17 19 59 52 34 22 7 250 3041 680 1 1 1 11 99 30 Pulmonary, Females 1 8 17 18 10 24 51 31 20 13 7 200 253 1 - 1 1 39 27 Non-pulmonary, Males 3 10 15 7 2 6 5 3 1 2 54 59 4 1 5 5 4 11 Non-pulmonary, Fi males 1 11 11 5 10 5 5 4 3 2 1 58 2 1 3 4 4 1 26 TUBERCULOSIS DISFEN SARY. The Sub-Committee appointed by the Public Health Committee to confer with the Sub-Committee of the West London Hospital with the object of providing a Tuberculosis Dispensary for this Borough, have met on several occasions but no definite conclusion has yet been reached as to the provision of such Dispensary. LICENSED SLAUGHTER HOUSES. The whole of the licensed slaughter houses in the Borough were under inspection by the Inspector for offensive trades. At the annual inspection of slaughter houses in October, 1913, I had received notices that 8 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 8 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 LICliNSEE. 185 Uxbridge Road John Mullet Allwright 40 Goldhavvk Road John Trayling I38 V 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 27 BAKEHOUSES. The 62 bakehouses in the Borough were under a regular half-yearly inspection by the Factory Inspector. Eighty-seven 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. |i25 Uxbridge Road H. Hemmings 121 Askew Road Not in use *242 Goldhawk Road G. Lousden 1*32 Norland Road L. Nau t*74 Goldhawk Road R. Steele *128 Askew Road H. Hernig *75 Uxbridge Road ]. ]. Sauer *216 Uxbridge Road F. C. Stiles t74 Askew Road C. Stein metz t*i Kenmont Terrace, Harrow Road H. T. Rogers *2 Hunt Street Not in use t*4 St. Helen's Terrace W. Allinson *55 Melina Road W. Tompkins 1*167 Askew Road H. Reinders *126 Uxbridge Road H. Seaborne 41 Gayford Road t*39 St. Ann's Road Not in use E. Tomlin *106 Goldhawk Road A. J. Wills 104 Latimer Road Not in use 166 Goldhawk Road J. Pendry 7 Market Place, Askew Road J. Miller 165 Askew Road J. Cummings 28 CENTRE DISTRICT. Wards Nos. 2 and J. 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 H. Guthiel "31 Goldhawk Road |ohn 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 t*84 Shepherd's Bush Road F. T. Ries 70 Glenthorne Road F. Booker 24 Brad more Park Road J. Heide & Son *77 Brackenbury Road W. Jennings *134 Shepherd's Bush Road C.Jacobs *1 Masboro' Road W. Lorenz *98 Blythe Road P. Puhl *17 Kilmarsh Road L. Lorenz *7 Shepherd's Bush Road A. Royston *192 Dalling Road Not in use t*i Aldensley Road H. Stumm *67 Masboro' Road J. Teague *47 Milson Road W. Warwick *33 Glenthorne Road E. Winstone t* Cadby Hall, Hammersmith Road J. Lyons & Co. |i The Grove Palmer's Stores, Ltd. 316 King Street W. Lines *6 Beaconsfield Terrace Road Not in use 29 SOUTH DISTRICT. Ward No. I. address. name. 65 Bridge Road W. Bass 188 Queen Street Not in use fi 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 t Great Church Lane Fullers, Limited 7 St. Peter's Road W. Holmes * Underground Bakehouses, t Factory Bakehouses. 3° 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 ... 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 ... I42.551 33,925 Bermondsey ... 125,903 28,032 Chelsea 66,385 15,936 Islington 327,403 79,902 Bethnal Green 128,183 27,755 Shoreditch 111,390 24,801 Stepney 279,804 56,949 St. Marylebone 118,160 28,509 Southwark 191,907 44.453 St. Pancras ... 218,387 52,994 City of Westminster ... 160,261 35,984 Finsbury 87,923 21,239 Holborn 49,357 11,030 31 Table Showing extent in Acres, and Number of Persons to the Acre, at Census, 1911. Name of District. Extent in Acres, Census, 1911. Number of Persons to the Acre, Census 1911. Woolwich 8,2766 14-66 Lewisham 7,0144 2292 Greenwich 3,8517 24-96 Wandsworth ... 9>i07'4 34**9 Hampstead ... 2,265-0 3774 Hammersmith 2,286-3 5315 Camberwell ... 4,480-0 58'33 Stoke Newington 8635 58-66 City of Westminster ... 2,502-7 64-03 Hackney 3,287-8 6707 Poplar 2,3277 69-78 Deptford 1,5627 70-06 Lambeth 4,08o*4 73'°4 Kensington ... 2,2911 75'21 Battersea 2,1603 7764 St. Marylebone 1,4728 8O*22 St. Pancras ... 2,694-4 8098 Bermondsey ... 1,4996 8395 Fulham i>7°3'5 89-98 Chelsea 6596 IOO-64 Paddington ... I,356 I I05-II Islington 3,°9i-5 IO59O Holborn 405-1 i2i-83 Finsbury 5866 149-87 Stepney I,765"6 I58-47 Bethnal Green 759'3 168-81 Shoreditch 6576 169-38 Southwark 1,1315 169-59 32 CUSTOMS AND INLAND REVENUE ACTS. During the year 11 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 con dition. 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. 7 to jo, Rosedale Terrace 4 Houses 8 8 — — 52, Sinclair Road 1 House 2 2 — — 1-8, Blue Hall Mansions 1 Block 8 - — 8 (not completed) 21 to 40, Sinclair Mansions 2 Blocks 20 20 — 48 to 62, Tunis Road 5 Houses 10 — — 10 (not completed) 1 to 4 Marchmont Court 1 Block 4 - - 4 (not completed) 54, 56, 58a, 58b. 58c, 61, 63, and 65, Vespan Road 6 Houses 13 — — 13 (not completed) 1 to 20, Sinclair Mansions 2 Blocks 20 - - 20 (not pleted) 15, 17, Shaftesbury Road 2 Houses 4 — - 4 (not completed) 1 and 31, Brewster Gardens 2 Houses 4 - - 4 (not completed) Carried forward 26 93 30 — 63 33 Name and Situation of Property. * No. of Houses and blocks for which applications were received. No. of Tenements therein. No. of Tenements for which Certificate was granted. No. of Tenements for which Certificate was refused. No. of Tenements for which Certificate was deterred. Brought forward 26 93 30 — 63 31. 37. 39, 41, 45, Addison Gardens 5 Houses 10 — — 10 (not completed) 96, Sinclair Road 1 House 2 2 — — 3> 4, 5. 6, 7, Huglienden Road 5 Houses 10 - - 10 (not completed) 13, Dalgarno Gardens 1 House 2 - - 2 (not 7, 11, 19, 27, 29, 47, 61, 52, 42, 25, 10, Bracewell Road 11 Houses 22 — — pleted) 22 (not completed) 27 to 31, Bassein Park Road 3 Houses 6 6 — — 113 to 117, Stanlake Road 3 Houses 6 - - 6 (not completed) 4'.43.45.47.49.5i,S3 and 14 Mall Road 8 Houses 16 16 - - 1 to 19, Lanark Mansions 2 Blocks 19 - - 19 (not completed) 90 to 98, Oaklands Grove 5 Houses 10 10 - — 39, Maclise Road 1 House 2 2 — — 52 and 52A, Rayleigh Road 2 Houses 4 - - 4 (not completed) 1 to 6, Rosedale Terrace 6 Houses 12 12 — — 11 and 12, Caithness Road 2 Houses 4 - - 4 (not completed) 27, Boscombe Road 1 House 3 - - 3 (not completed) 117 to 121, Sinclair Road 3 Houses 6 - - 6 (not completed) Totals 85 227 78 - 149 Fifty Notices were served in reference to defects found to exist in certain of the above premises, and seventy-eight Notices were complied with. 34 The following is a list of the premises certified by me during the year:— 7 to 10, Rosedale Terrace. 52, Sinclair Road. 21 to 40, Sinclair Mansions. 96, Sinclair Road. 27 to 31, Bassein Park Road. 41 to 53, and 14, Mall Road. 90 to 98, Oaklands Grove. 39, Maclise Road. 1 to 6, Rosedale Terrace. 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 247 " houses let in lodgings or occupied by the members of more than one family," making a total with those previously registered of 2,701 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 184 houses have been removed from the list, leaving a total number now on the Register of 2,517. During the year 755 notices were served and 803 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 1,955 preliminary notices were reported as having been^dealt with by your four District Sanitary Inspectors having for their object the removal or prevention of nuisances or insanitary conditions, against 1,657 the previous year, and during last 35 year 1,921 preliminary notices were reported as having been complied with, against 1,546 in the previous year. It was found necessary by your four District Inspectors to serve 88 Statutory Notices during the year, 87 of which have been complied with. The House-to-House inspection has been continued during the year. This Inspector reports that during the year he has inspected 2,257 houses and other premises in the borough, against 1642 houses in the previous year. As a result of his inspection, defects were discovered in 763 houses, and 763 Intimation Notices were served by the House-to-House Inspector. These cases were subsequently dealt with by the four District Inspectors. Three hundred and forty-eight 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 2,989 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 46 premises on which insanitary conditions existed. HOUSING AND TOWN PLANNING ACT, 1909. Regulations of Local Government Board. The Local Government Board made an order dated 2nd September, 1910, under Section 17 of the Housing and Town Planning Act, 1909. Sanitary Inspector Cosson reports that he has made 622 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 248 Intimation Notices were served and 244 complied with, a list of which follows:— INSPECTION OF FACTORIES, Etc. Your Factory Inspector has during the year served 287 notices under the Factory and Workshop Act, and during the same period 281 notices have been complied with. During the previous year there were 273 notices served and 260 complied with. Ihe following is a list of the Factories and Workshops upon the Register:— Restaurants, Hotels, &c. 186 Bakehouses (5 not used at present as Bakeries) 67 Bootmakers 72 Motor and Cycle Makers and Engineers 51 Dressmakers and Milliners 269 Laundries 305 Letterpress Printers and Bookbinders 32 Electrical and Mechanical Engineers 50 Smiths, Wheelwrights and Coachbuilders 33 Tailors 61 Bottle Washing Works 14 Dry Cleaning, Dyeing, and Carpet Beating Works 18 Firewood Cutters 15 Builders and Joiners (Machine) 31 Outworkers 588 Miscellaneous 122 1.914 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. 37 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) 1,043 69 — Workshops ... (including Workshop Laundries) 1,133 118 1 Workplaces (other than out-workers premises included in Part III of this report) 1,117 88 - Total 3.293 275 1 38 2.—DEFECTS FOUND IN FACTORIES, WORKSHOPS AND WORKPLACES. Particulars. Number of Defecls. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. Nuisances under lite PublicHealth Acts:—* Want of Cleanliness 91 80 ... ... Want of Ventilation 1 1 ... ... Overcrowding 1 1 ... ... Want of Drainage of Floors 14 12 ... ... Other Nuisances 149 137 ... ... Sanitary Accommodation. insufficient 6 6 ... ... unsuitable or defective 30 29 ... 1 not separate for sexes 1 1 ... ... Offences wider the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) ... ... ... ... Breach of special Sanitary requirements, for bakehouses (SS. 97 to 100) 85 85 ... ... Other Offences (excluding offences relating to outwork, which are included in Part 3 of this report.) 14 12 ... 1 Total ... 392 364 I * Including those specified in Sections 2, 3, 7 and 8 of the Factory and Workshop Act as remediable under the Public Health Acts. 39 3.—HOME WORK. Nature of Work*. Outworkers' List, Section 107. Outwork in Unwholesome Premises. Sec. 108. Outwork in Infected Premises. Sees, 100,110 Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. no). Prosecutions (S. 109, no). Twice in the year. Once in the year. bailing to keep or permit inspection of Lists. Failing to| send Lists. Lists, † Outworkers, † Lists. Outworkers, † Conractors Workmen. Contractors. Workmen. (i) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing apparel— (i) making. &c 58 70 98 16 12 20 ... ... ... 12 12 ... ... ... ... (2) cleaning and washing 12 12 ... ... 2 4 ... ... ... ... ... ... ... ... ... 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 ana 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 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cosaques, Christmas cracker Christmas stockings, &c ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Textile weaving ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Total 70 82 98 16 14 24 ... ... ... 12 12 ... ... 1 ... •If an occupier gives out work of more than one of the classes specified in column i, and subdivides his list in such a way as to show the number of workers in each class of work, the list should be included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers should be assigned in columns 3 and 4 (or 6 and 7) into their respective classes. A footnote should be added to show that this has been done. † The figures required in columns 2, 3, and 4 are the total number of the lists received from those employers who comply strictly with the statutory duty of sending two lists each year and of the entries of names of outworkers in those lists. The entries in column 2 must necessarily be even numbers, as there will be two lists for each employer; in some previous returns odd numbers have been inserted. The figures in columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. • 40 4.—REGISTERED WORKSHOPS. Workshops 011 the Register (S. ij-i) at the end of the year. Number. bakehouses 6 2 Importantclassesof workshops such as workshop bake-, houses may be enumerated' here dressmakers 269 restaurants and dining-rooms 186 others 623 Total number of workshops on Register 1,140 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 12 Reports (of action taken) sent to H. M. Inspector 12 Other 40 1 Underground bakehouses (S. 101)— Certificates granted during the year ... — In use at the end of the year 27 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 March, 1912. 41 ICE CREAM DEALERS. The London County Council (General Powers) Act, 1902, which came into operation on the 1st November, 1902, by Part VIII., made provision for the regulation, manufacture, and sale of ice cream or other similar commodities. The duty of obtaining the necessary information for the registration of premises upon which ice creams are made was carried out by Sanitary Inspector S. Huggons Brown. At the present time there are 199 premises upon the register and 28 notices have been served, all of which have been complied with. The following is a table in reference to the above-named premises, etc. PROCEEDINGS DURING 1913. PREMISES. NUMBER OF PLACES. Number of inspections, 1913. Number of notices, I9I3- Number of prosecutions, 1913. On regis-1 ter at end j of 1912. Added in I9I3- ' Removed in i 19I3* On register at end of 1913. Slaughter-houses 8 nil. nil. 8 120 6 nil. Offensive trade premises nil. nil. nil. nil. nil. nil. nil. ce Cream premises 170 | 52 23 199 388 28 2 DAIRIES, COWSHEDS, AND MILKSHOPS ORDER, Etc. The registration of milk vendors and the inspection of milk premises situated in the Borough was carried out by Sanitary Inspector Gee. The following is a table in reference to the milk premises and cowsheds. PROCEEDINGS DURING 1913. PREMISES. NUMBER OF PLACES. Number of inspections, 19I3- Number of notices, I9I3- Number of prosecutions, 1913. On register at end of 1912. Added in I9I3- Removed in 1913. On register at end of 1913. Milk premises 333 36 31 338 88l 7 nil. Cowsheds nil. nil. nil. nil. nil. nil. nil. 42 These registered premises were under regular inspection. During the year three cases of infectious disease occurred upon premises where milk was sold. The regulations under the above Order appertaining to the stoppage of sale of milk, disinfection, and the granting of certificates were strictly enforced under my directions. There were 36 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. PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912. In accordance with the circular communications from the Local Government Board dated the 27th October and the 17th December, 1913, I present a tabular statement in the form prescribed by the Local Government Board in reference to the proceedings taken under the direction of your Committee during the year 1913, in connection with the Public Health (Milk and Cream) Regulations, 1912. 1. Milk ; and Cream not sold as Preserved Cream. {a) (b) Number of samples examined for the presence of a preservative. Number in which a preservative was reported to be present. Milk Nil. Nil. Cream 6 6 Nature of preservative in each case in column (b) and action taken under the Regulations in regard to it. (1) 0.347 per cent., or 24.3 grains per lb. of boric acid. No action under Regulations. (2) o'297 per cent., or 20.8 grains per lb. of boric acid. Summons issued: fined £1 and £1 13s. 6d. costs. (3) 0.0006 per cent., or ½ grain per lb. of boric acid. No action. Satisfactory explanation. 43 (5) C214 per cent., or 15 grains per lb. of boric acid. Summons under Food and Drugs Acts : fined 5s. with 3 guineas costs. Summons under Regulations: dismissed with 21s. costs. Case stated to High Court re decision under Food and Drugs Acts. (b) 0.36 per cent., or 25 grains per lb. of boric acid. Summons issued: wording on label half the size prescribed in the schedule of Regulations, 2s. costs. (7) 0.223 Percent., or I5.5 grains per lb. of boric acid. Summons issued under (Food and Drugs Acts) and Public Health (Milk and Cream) Regulations, 1912, for selling from large receptacle not labelled as per schedule of Regulations. Adjourned until the 22nd January, 1914, and further adjourned until High Court decision in case 5. 2. Cream sold as Preserved Cream. (а) Instances in which samples have been submitted for analysis to ascertain if the statements on the label as to preservatives were correct:— (1) Correct statements made 2 (2) Statements incorrect 0 Total 2 (б) Determinations made of milk fat in cream sold as preserved cream:— (1) Above 35 per cent 2 (2) Below 35 per cent. .0 Total 2 (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream in Article 5 (1) and the proviso in Article 5 (2) or the Regulations have not been observed:— (4) Cuplets not labelled neither was large can from which it was served. (8) Taken 011 delivery from wholesale vendor to dairyman. Not labelled in accordance with the schedule (printed matter incorrect size). (d) Particulars of each case in which the Regulations have not been complied with and action taken:— (4) Summonses were not served owing to vendor having sold his business and left for Australia. (8) Summons issued: fined 10s. and 12s. 6d. costs. 44 3. Thickening Svbslaitces. Any evidence of their addition to cream or to preserved cream. Action taken where found, nil. 4. Oilier Observations. Every vendor in the Borough has been supplied with a copy of the Regulations by the Borough Council. In all cases before proceedings have been instituted the Council has, in accordance with Article 6 of the Regulations, afforded the vendor an opportunity of furnishing an explanation in writing and in only one case (No. 3) was the explanation given considered satisfactory. RAG FLOCK ACT, 1911. The Rag Flock Regulations, 1912. During the year 5 samples of Flock were taken by your inspector and submitted to the Public Analyst for the purpose of analysis. Three samples were found to conform to the standard of cleanliness as required by the Regulations, one sample was found to be adulterated with 325 parts of soluble chlorine in the form of chlorides per 100,000 parts of flock, and one sample was found to be adulterated with 200 parts of soluble chlorine in the form of chlorides per 100,000 parts of flock. Summonses were taken out in both cases and a fine imposed with costs (see Summonses heard). SUMMONSES ORDERED. During last year your Council and the Public Health Committee gave authority for 23 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 45 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 seven summonses were taken out through the Public Health Department. SUMMONSES HEARD. SITUATION OF PREMISES,&C NATURE OF OFFENCE. RESULT OF PROCEEDINGS. Lingi Cassanella, Fulham Failing to exhibit name and address on ice cream barrow. Fined 8s. and 2s. costs. Rose Grego, Bramley Road Failing to exhibit name and address on ice cream barrow Fined 5s. and 2s. costs. 33, Paddenswick Road F'ailing to comply with sanitary notice. Summons withdrawn. 32 and 34, Manchester Road Failing to comply with sanitary notice. Summons adjourned for 5 weeks for work to be carried out. 334, Uxbridge Road Failing to comply with sanitary notice. Order made for necessary work to be carried out with 23s. costs. 18, Fulham Palace Road For having in his possession flock adulterated with 325 parts of soluble chlorine in the form of chlorides per 100,000 parts of flock. Fined £2 and 2s. costs. 18, Fulham Palace Road For having in his possession flock adulterated with 200 parts of soluble chlorine in the form of chlorides per 100,000 parts of flock. 25. costs. 46 PUBLIC MORTUARY. During last year 209 bodies were removed to the mortuary at Fulham Palace Road. There were 115 bodies brought to the mortuary by order of the Coroner or the Police; 51 bodies were taken from the West London Hospital, and 43 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. SMOKE ABATEMENT. During last year observations were made in reference to the amount of black smoke emitted from the under-mentioned premises. Five preliminary notices were served, six statutory notices were issued, and no summonses were taken out. 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 Chisvvick Laundry, British Grove. Gwynne's Iron Works, Hammersmith. Lyons & Company, Limited, Cadby Hall, Hammersmith. 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. 47 METEOROLOGY. The average mean temperature registered in London during last year was 51.3° Fahrenheit. The highest air temperature registered was 87.10 in June. The lowest air temperature was 24.2° in February. Rain fell on 168 days. The total amount of rainfall was 22.44 inches I am, Gentlemen, Your obedient servant, N. C. COLLIER, l.r.c.p., l.s.a., Medical Officer of Health.