HAMP 15 THE Metropolitan Borough of Hampstead. REPORT FOR THE YEAR 1907 OF THE Medical Officer of Health. G. F McCLEARY, B.A., M.D., D.P H. CONTENTS. PAGES Vital Statistics 9-26 Infantile Mortality 27-44 Infectious Diseases 45-68 General Sanitary Administration 69-102 Factory and Workshop Act, 1901103-118 Report on Analytical Work 119-122 Legal Proceedings 123-132 Appendix — Tables 133-150 Index 151-153 5 PUBLIC HEALTH COMMITTEE, NOVEMBER, 1906-7. Ex-Officio. His Worship The Mayor (Mr. Councillor C. Hendrick) Chairman. Mr. Councillor J. P. R. Lyell. Mr. Alderman E. C. Andrews, M.D. Mr. Councillor G. Buckle. „ C. W. Cunnington, M.R.C.S., D.P.H. ,, K. J. Dougall, L.R.C.P., L.F.P.S. „ L. Farmer. „ J. I. Fraser. ,, C. L.Jupp. „ T. H. Nunn. „ J. T. Osier. W. R. Rider. „ E. C. Taylor, M.D. HOUSING COMMITTEE, NOVEMBER, 1906-7. Ex-Officio. His Worship The Mayor (Mr. Councillor C. Hendrick) Chairman. Mr. Councillor A. W. Blessley. Mr. Councillor T. E. Ashenden. „ A. Frampton. „ C. L. Jupp. C. B. King. „ F. G. Neave. „ W. Pocock. „ C. S. Preston. W. J. Spriggs. „ I. A. Symmons. 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT, 1907. Senior Sanitary Inspector. W. G. Kershaw. Divisional Sanitary Inspectors. R. Geary, No. 1 District (Wards 1 and 2). J. Grimsley, No. 2 District (Wards 3 and 7). A. Peverett, No. 3 District (Wards 4 and 5). W. H. Edmonds, No. 4 District (Ward 6). Special Sanitary Inspectors. F. H. Hudson. Mrs. T. Fisher, M.A. Assistants to Inspectors. G. Rowe. W. Larken. A. J. Brown. Public Mortuary Keeper. W. Larken. Disinfectors. T. H. Rider. G. Allaway. R. Bell. Clerks. W. Sell, First Clerk. F. S. Hill, Second Clerk. P. T. Roberts, Third Clerk. Clerk-Draughtsman. E. J. Cooper. Public Analyst. A. W. Stokes, F.C.S., F.I.C. Medical Officer of Health. G. F. McCleary, B.A., M.D., D.P.H. 7 To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hampstead. Mr. Mayor, and Gentlemen, I have the honour to place before you my Annual Report for the year 1907. The death-rate for the year 1907 is the lowest ever recorded in Hampstead, and it is considerably lower than that of any other of the Metropolitan Boroughs. The vital statistics generally afford evidence of the excellent sanitary work that has been done in Hampstead in recent years. But when attention is given to the varying conditions in different parts of the Borough, it becomes evident that although much has already been done in Hampstead, much still remains for future achievement. The main public health needs of the Borough at the present time appear to be (i) a purer milk supply, (ii) the closer supervision of tenement houses, and (iii) the development of health visiting in relation to consumption and to infantile mortality. As to the milk supply, the bacteriological examinations that have so far been made on behalf of the Borough Council have revealed the fact that about sixteen per cent. of the milk consumed in Hampstead contains virulent tubercle bacilli. This, it need hardly be said, is a very serious matter, the more so as the Council are powerless to prevent the entrance of tuberculous milk into the Borough. The Government have undertaken to deal with the question of milk supply on a national basis this Session, but at the time of writing the promised Bill has not been introduced. The supervision of tenement houses and the extension of the work of health visiting are matters falling within the province of the Council, and there is much need of further efforts to develop the work that is now being done in these important branches of public health administration; but, as I have explained in the Report, this object cannot be secured without some increase in the Staff of the Public Health Department. 8 I am glad to acknowledge the excellent work of the Staff of the Department throughout the year. My thanks are due also to the Chairman and the Members of the Public Health Committee for their continued support, which I have greatly valued. I have the honour to be, Gentlemen, Your obedient Servant, G. F. McCLEARY, Medical Officer of Health. April 30th, 1908. Vital Statistics. 11 Summary of Vital Statistics for 1907. Population estimated to middle of 1907 91,137 Density „ „ „ 402 persons per acre Births 1,341 Birth-Rate 14.7 Marriages 646 Marriage-Rate 14.2 Deaths 817 Death-Rate 9.0 Infantile Mortality 73 per 1000 births Notifiable Infectious Diseases Attack-Rate 5.5 Notifiable Infectious Diseases Death-Rate 0.16 Death Rate from the Seven Principal Epidemic Diseases 0.45 Population at Census, 1901 81,942 Inhabited Houses „ „ 11,294 Area of Borough 2,265 acres „ „ (excluding area covered by water) 2,253 acres B 2 13 POPULATION. The population of Hampstead at the middle of 1907 was estimated by the Registrar-General to be 91,137. The Registrar-General's estimate has been adopted in this report, and it forms the basis upon which the various rates have been calculated. The following is an approximate estimate of the population of the various Wards of the Borough:— Ward 1 (Town) 13,940 „ 2 (Belsize) 14,410 „ 3 (Adelaide) 10,860 „ 4 (Central) 10,397 „ 5 (West End) 14,090 „ 6 (Kilburn) 16,310 „ 7 (Priory) 11,130 The Borough 91,137 The area of the Borough (including the area, twelve acres in extent, covered by water), is 2265 acres, and the estimated number of persons to the acre is 40.2. The proportion of persons to the acre at the Census, 1901, was 36.17. At the Census of 1881 the number of persons per acre was 23; and in 1891 it was 30. MARRIAGES. According to the Returns of the Registrar-General, 646 marriages were registered in the Borough during 1907; they were distributed in the four quarters of the year as follows:— 1st quarter 121 2nd „ 160 3rd „ 199 4th „ 166 Total 646 14 The total number of persons married in Hampstead during 1907 was 1292, which is equivalent to a rate of 14.2 per 1000 of the population, and is an increase on that for the year 1906, when the marriages of 1156 persons were registered, equivalent to a rate of 12.9 per 1000 of the population. The following Table gives the marriage rates for the years 1897— 1906, and the average rate for the decade:— Year. No. of persons married per 1000 of the population. 1897 13.2 1898 15.2 1899 14.0 1900 13.4 1901 13.2 1902 15.0 1903 14.0 1904 14.4 1905 13.6 1906 12.9 Average for the decade 13.9 1907 14.2 BIRTHS. During the year, 1,341 births were registered, a decrease of 96 as compared with the number, 1,437, registered in the previous year. Of the total births, 703 were of male, and 638 of female children. The following Table gives the number of births, in each Ward of the Borough, registered during each quarter of the year, together with their sex-distribution:— 15 BIRTHS REGISTERED, 1907. Quarter of Year. Ward No.1 (Town). Ward No.2 (Belsize). Ward No.3 (Adelaide). Ward No.4 (Central). Ward No.5 (West End). Ward No.6 (Kilburn). Ward No.7 (Priory). The Borough. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. Males. Females. Total. First 26 24 50 33 29 62 7 14 21 10 10 20 26 29 55 60 50 110 14 18 32 176 174 350 Second 30 17 47 29 28 57 10 8 18 16 19 35 37 31 68 62 46 108 11 21 32 195 170 365 Third 25 18 43 22 20 42 6 9 15 11 21 32 39 19 58 47 49 96 16 12 28 166 148 314 Fourth 27 18 45 23 21 44 15 6 21 10 11 21 30 39 69 45 32 77 16 19 35 166 146 312 1907 108 77 185 107 98 205 38 37 75 47 61 108 132 118 250 214 177 391 57 70 127 703 638 1341 16 Weekly lists have been received from the Medical Officer of Health of the County of London, containing information of confinements attended by midwives, and also of births of children whose mothers entered institutions from Hampstead addresses. From this source, the births of 15 children have been ascertained, who may correctly be described as Hampstead children. One of these was also notified by the Medical Officer of Health of the borough in which the birth took place. In the returns of outlying deaths which are received from the General Register Office, there were the deaths of three children who were allotted to Hampstead. As all three children died within 12 hours from birth, it would seem that the births as well as the deaths should be credited to Hampstead, and this would bring the total number of Hampstead births that occurred outside Hampstead to at least 18. The total births belonging to Hampstead should, therefore, be not less than 1359. It must be borne in mind, however, that there are a number of births of this kind of which I receive no information, so that the above figure must be taken as a minimum. In calculating the birth-rates and the infantile mortality rates, the official tables of the Local Government Board have been taken as a basis, and these tables take no account of births occurring outside the district. For this reason the births that have occurred outside Hampstead have been neglected, and the rates calculated on the number of births actually registered in the Borough. Illegitimate Births.—Out of the total of 1341 births registered in Hampstead, 43, or 32 per 1000, were those of illegitimate children. The following table shows the Ward and sex-distribution of these illegitimate births, the births being allocated according to the home addresses of the mothers. 17  Males. Females. Total. Ward 1 (Town) 6 4 10 „ 2 (Belsize) 5 1 6 „ 3 (Adelaide) 1 2 3 „ 4 (Central) — — — „ 5 (West End) 4 1 5 „ 6 (Kilburn) 9 7 16 ,, 7 (Priory) 2 1 3 The Borough 27 16 43 Birth-rate. The Birth-rate was 14.7 per 1000 of the population, as compared with the rate of 16.0 per 1000 in 1906, and 17.9, the average for the years 1897—1906. The following Table shows the birth-rates in 1907 for England and Wales, the 76 Great Towns, the 142 Smaller Towns, England and Wales less these 218 Towns, London and Hampstead:— Birth rate per 1000 of the population. England and Wales 26.3 76 Great Towns 27.0 142 Smaller Towns 25.7 England and Wales less the 218 Towns 25.6 London 25.6 Hampstead 14.7 The Table on page 149, shows the birth-rates for Hampstead as compared with those for England and Wales since 1875, and it will be noted that the rate for the year under review is the lowest recorded since that date. c 18 The following Table shows the Ward and sex-distribution of these 1341 births, and the birth-rate for each Ward:— Ward. Births. Birth rate per 1000 of the population. Males. Females. Total. No. 1 (Town) 108 77 185 13.3 No. 2 (Belsize) 107 98 205 14.2 No. 3 (Adelaide) 38 37 75 6.9 No. 4 (Central) 47 61 108 10.4 No. 5 (West End) 132 118 250 17.7 No. 6 (Kilburn) 214 177 391 24.0 No. 7 (Priory) 57 70 127 11.4 The Borough 703 638 1341 14.7 The Natural Increase of the population, i.e., the excess of births over deaths, was 524 in 1907, as compared with 587 in 1906. DEATHS. The total deaths occurring in Hampstead during the year amounted to 1056. Of these, however, no less than 330 were of persons not belonging to the Borough, while 91 residents of Hampstead died in outlying districts. The total number of deaths, therefore, amongst persons belonging to Hampstead amounted to 817. This is the lowest number of Hampstead deaths occurring in any year since 1894, when the number of deaths was 798. In that year, however, the population of Hampstead was less by nearly 20,000 persons than it was in 1907. Death-Rate. The crude death-rate, that is, the rate calculated upon the total number of deaths (whether of resident or non-resident persons) occurring in the Borough during the year, was 11.6 per 1,000 of the population; but after subtracting from the total deaths registered the deaths of non-resident persons dying in Hampstead, and adding the deaths of Hampstead residents who died outside the district, 19 the recorded death-rate is found to be 9.0 per 1,000 of the population, as compared with the rate of 9.5 per 1,000 of the population in 1906. The average recorded death-rate for the 10 years 1897-1906 was 10.6. This is the lowest death-rate ever recorded in Hampstead, the next lowest being that of 9.3 in 1905. The following table shows the death-rates in 1907, for England and Wales, the 76 Great Towns, the 142 Smaller Towns, England and Wales less these 218 Towns, London, and Hampstead:— Death-rate per 1,000 of the population. England and Wales 15.0 76 Great Towns 15.4 142 Smaller Towns 14.5 England and Wales, less the 218 Towns 14.7 London 14.6 Hampstead 9.0 The following are the death-rates for each of the wards:— WARD. Death-rate per 1,000 of the population. No. 1 (Town) 10.9 No. 2 (Belsize) 7.9 No. 3 (Adelaide) 7.9 No. 4 (Central) 6.5 No. 5 (West End) 8.1 No. 6 (Kilburn) 11.0 No 7 (Priory) 8.4 In the table on page 149 the death rates of Hampstead may be compared with those of England and Wales since 1875. The following table, which is issued by the Registrar-General, shows the death-rate of Hampstead as compared with the rates of the County of London, the City of London, and the other Metropolitan Boroughs. c 2 20 Table showing the Death-Rates from All Causes in the County of London, the City of London, and the Metropolitan Boroughs during the 52 Weeks of 1907, as calculated by the Registrar-General. DISTRICT. Death rate from all causes. Hampstead 9.0 Stoke Newington 11.5 Lewisham 11.5 Wandsworth 12.3 Woolwich 12.5 Greenwich 12.7 City of Westminster 13.0 Fulham 13.2 Battersea 13.3 Paddington 13.5 Hackney 13.6 Kensington 13.7 Camberwell 13.9 Deptford 14.1 Hammersmith 14.3 Lambeth 14.6 Islington 14.7 Chelsea 15.0 St. Marylebone 15.0 St. Pancras 15.0 Stepney 15.9 City of London 16.8 Poplar 16.9 Holborn 17.4 Bethnal Green 17.5 Southwark 18.0 Bermondsey 18.3 Finsbury 18.7 Shoreditch 20.5 County of London 14.6 21 Outlying Deaths. The deaths of patients formerly resident in districts outside London, who have died in Hampstead Institutions, are reported to the Medical Officer of Health of the district to which they belong, immediately upon receipt of the Registrar's weekly return. In the case of deaths belonging to other metropolitan districts this procedure is not necessary, for the information is circulated by the Registrar-General. Information concerning 85 such deaths has been transmitted to the following extra-metropolitan districts. Bakewell. Hendon. Barnes.Hornsey. Beckenham.Hove. Bognor. Leyton. Bracknell. Lower Ballinderry. Brentwood. New Barnet. Brighton. Newbury. Bushbury. Ratoath. Chiswick. Ramsgate. Clacton-on-Sea. St. Albans. Colby. Sandrock. Coll-by-Oban. Shepperton. Corsham. Sheringham. Croydon. Shorncliffe. Cuckfield. Southend-on-Sea. Deal. Taunton. Dover. Tottenham. Ealing. Tunbridge Wells. East Ham. Watford. East Liss. West Ham. Eastbourne. Westcliff-on-Sea. Edgware. Whitby. Edmonton. Willesden. Egham. Wimbledon. Finchley. Wood Green. Folkestone. Woodford. Hartlepool. Worthing. 22 Information as to the deaths of Hampstead residents was received from the Medical Officers of Health of the following districts, in which the deaths had occurred:— Glasgow. Hampton Wick. The number of deaths of Hampstead residents that occurred in public institutions was 233, or 28.5 per cent. of the total deaths, and the number of deaths occurring in workhouses or workhouse infirmaries was 87 or 10.6 per cent. of the total deaths. A list of the institutions in which the deaths occurred is given on page 23. Deaths at Various Ages. The following table shows the number of deaths at the various age periods, the causes of such deaths being shewn in Tables IV. and V., pages 140 and 141. Age Periods. Under 1 year. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards At all Ages Deaths 98 56 29 22 309 303 817 23 Deaths of Hampstead Residents in Public Institutions Institution. Total. Group Totals.  Infirmaries and Workhouses:— Hampstead Infirmary — 87 Hospitals:— Bethlem Hospital 1 84 British Home and Hospital for Incurables, Norwood 1 Brompton Hospital 1 Charing Cross Hospital 1 Chest Hospital, Victoria Park 1 Children's Hospital. Gt. Ormond Street 3 Children's Hospital, Paddington Green 3 Friedenheim Hospital, Upper Avenue Road 3 German Hospital, Dalston 2 Hampstead General Hospital 22 Home Hospital, 16, Fitzroy Square 2 Hospital of St. John & St. Elizabeth, St. Marylebone 1 Infants' Hospital, Vincent Square 1 London Hospital 1 London Temperance Hospital 3 Maternity Hospital, Hackney 1 Middlesex Hospital 8 Mount Vernon Hospital 1 Queen Charlotte's Hospital 2 Royal Free Hospital 1 St. Bartholomew's Hospital 4 St. Joseph's Hospice, Hackney 1 St. Mary's Hospital 10 St. Peter's Home 1 St. Thomas's Hospital 1 University College Hospital 6 Westminster Hospital 2 Metropolitan Asylums Board's Hospitals:— North Western Hospital 12 12 County and other Asylums:— Banstead Asylum 3 15 City of London Asylum, Stone 1 Claybury Asylum 5 Colney Hatch Asylum 1 Dartford Heath Asylum 1 Hanwell Asylum 2 Horton Asylum 1 Tooting Bee Asylum 1 Elsewhere 35 233 The names of the Institutions that are situated in Hampstead are printed in heavy type 24 Senile Mortality. The deaths of persons of 65 years of age and upwards numbered 303, as compared with 322 in 1906. Of these, 50 attained the age of 85 years and upward. CAUSES OF DEATH. The causes of death are given in Table IV. of the Local Government Board's series of tables, see page 140, and are set out in more detail in the extended table on the opposite page. The mortality from the various communicable diseases is given in the section of the Report devoted to those diseases. The following causes of death require special mention. Cancer. The following table gives the number of deaths from cancer, and the death-rate per 1000 population in each of the seven years 1901-07. Year. No. of Deaths from Cancer. Death-rate per 1000 of the population. 1901 77 0.93 1902 91 1.09 1903 105 1.23 1904 85 0.98 1905 73 0.83 1906 93 1.04 1907 69 0.76 The next table gives the anatomical distribution of the disease in each sex. It will be noted that a large proportion of the patients, 52 out of a total of 69 cases, were females. In 28 cases the patients were over 65 years of age. Situation. Males. Females. Totals. Oesophagus1 — 1 Stomach 4 6 10 Liver 2 4 6 Intestines 1 1 2 Pancreas1 2 3 Rectum — 6 6 Other abdominal organs, &c. 3 13 16 Breast — 8 8 Uterus — 5 5 Other situations 5 7 12 Totals 17 52 69 25 Alcoholism. In 7 cases death was certified to be due to Alcoholism, and 10 persons died from Cirrhosis of the Liver, a disease usually attributed to the consumption of alcohol. The total number of deaths recorded as due to alcohol was, therefore, 17, as compared with 14 in 1906, but this is certainly an under-statement of the total mortality that may be directly attributed to this drug. Deaths due to alcoholism, especially those occurring in the higher social ranks, are often certified to be due to some less invidious condition. If death certificates, instead of being handed to the patient's relatives, were sent by the certifying practitioner direct to the Registrar, there is little doubt that the recorded mortality from alcoholism and certain other diseases would soon show a marked increase. During the year it was decided to reprint the Council's placard on Alcoholism in the form of a handbill. A copy of the handbill was sent to every minister of religion and every medical practitioner in Hampstead with an intimation that further copies for distribution would be sent if required. Many requests for copies were received, and in this way over 6,000 handbills were distributed. The handbill is in the following terms:— BOROUGH OF HAMPSTEAD. Physical Deterioration and Alcohol. The report of the Committee on Physical Deterioration, presented to Parliament by command of His Majesty, emphasises the following facts:— The abuse of alcoholic- stimulants is a most potent and deadly agent of physical deterioration. If the mother as well as the father is given to drink the future of the race is imperilled. Abstinence from alcohol is conducive to full physical strength and activity. Alcoholic persons are specially liable to consumption and all inflammatory diseases. 26 Alcohol is really a narcotic, and often its first effect is to weaken a man's self-control while his passions are excited; hence the number of crimes which occur under its influence, as well as the spreading of vice and disease. Lunacy figures show a large and increasing number of men and women admitted to asylums through drink. Alcoholism perverts the moral nature, affects the judgment, and weakens the memory; it creates an enormous loss to the community through destroying the productiveness of the worker. This handbill is issued by order of the Borough Council. CHARLES HENDRICK, Mayor. ARTHUR P. JOHNSON, Town Clerk. G. F. McCLEARY, M.D., Medical Officer of Health. Town Hall, Hampstead, June, 1907. Diseases of the Circulatory System. These accounted for 138 deaths, as compared with 134 in 1906. Diseases of the Respiratory System. The total mortality from these diseases was 138, as compared with 118 in 1906. 34 deaths occurred in children under five years of age, and 60 in persons from 65 years upwards. Of the total deaths 63 were due to Pneumonia, 59 to Bronchitis, 5 to Pleurisy, and 11 to other diseases of the respiratory organs. Accident. 18 deaths were classified under this heading, as compared with 19 in 1906. 6 were due to falls, 4 to suffocation, 1 to poison, 1 to drowning, 2 on railways, 3 ran over in street, and 1 to another accident. Suicide. Twelve persons committed suicide as against 7 in 1906. In 4 cases the cause of death was poisoning, 4 deaths were due to drowning, 1 to shooting, 2 to hanging, and 1 to cut throat. Infantile Mortality. 29 INFANTILE MORTALITY. The number of deaths under one year registered in Hampstead was 111, but of these 16 deaths occurred in children not belonging to the Borough, while 3 infants belonging to Hampstead died in public institutions in other parts of London. The number of deaths of Hampstead infants was therefore 98, a decrease of 13 as compared with the previous year. In the following table, these infantile deaths are distributed in Wards, under their respective causes. CAUSE OF DEATH. WARDS. Totals. No. 1 (Town). No. 2. (Belsize) No. 3 (Adelaide). No. 4 (Central). No. 5 (West End) No. 6. (Kilburn). No. 7 (Priory). Non-distributable. i. Common Infectious Diseases. 1 Small-pox .. .. .. .. .. .. .. .. .. 2 Chicken-pox 1 1 .. .. .. .. 1 .. 3 3 Measles .. .. .. .. .. .. .. .. .. 4 Scarlet Fever .. .. .. .. .. .. .. .. .. 5 Diphtheria (including Membranous Croup .. .. .. .. .. .. .. .. .. 6 Whooping Cough .. 1 .. .. 2 3 .. .. 6 ii. Diarrhœal Diseases. 7 Diarrhœa, all forms .. 2 .. .. .. 2 .. .. 4 8 Enteritis,Muco-enteritis, Gastro-enteritis .. 1 1 1 .. 1 1 .. 5 9 Gastritis, Gastrointestinal Catarrh .. .. .. 1 .. .. .. .. 1 iii. Wasting Diseases. 10 Premature Birth 3 1 2 2 2 4 .. .. 14 11 Congenital Defects 1 .. .. .. 2 2 .. .. 5 12 Injury at Birth .. .. .. .. .. .. 1 2 3 13 Want of Breast-milk, Starvation .. .. .. .. 1 .. .. .. 1 14 Atrophy, Debility, Marasmus 1 .. .. .. 2 5 .. .. 8 iv. Tuberculous Diseases 15 Tuberculous Meningitis 1 .. .. 1 .. 2 .. .. 4 16 Tuberculous Peritonitis Tabes Mesenterica .. 1 1 .. .. .. .. .. 2 17 Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. v. Other Causes. 18 Erysipelas .. .. .. .. .. .. .. .. .. 19 Syphilis .. .. .. .. .. .. .. .. .. 20 Rickets 2 .. .. .. .. .. .. .. 2 21 Meningitis (not Tuberculous) .. .. .. .. 1 .. .. .. 1 22 Convulsions .. .. .. .. .. .. .. .. .. 23 Bronchitis .. 3 .. 1 2 .. .. .. 6 24 Laryngitis .. .. .. .. .. .. .. .. .. 25 Pneumonia 2 .. 1 .. 4 5 .. .. 12 26 Suffocation, overlying 1 1 .. 1 .. 1 .. .. 4 27 Other Causes 3 2 3 2 .. 3 4 .. 17 Totals 15 13 8 9 16 28 7 2 98 30 The "Infantile Mortality," i.e., the number of deaths under one year per 1000 births registered was 73. This is lower than the corresponding figure in 1906, which was 77, and is in fact the lowest infantile mortality ever recorded in Hampstead. The average rate for the years 1897-1906 was 104. The following table shows the infantile mortality of Hampstead in each year since 1880:— 1880 140 1894 113 1881 136 1895 135 1882 99 1896 123 1883 98 1897 127 1884 143 1898 125 1885 110 1899 129 1886 131 1900 100 1887 107 1901 102 1888 110 1902 88 1889 122 1903 87 1890 122 1904 111 1891 104 1905 94 1892 122 1906 77 1893 102 1907 73 The following table shows a comparison of the infantile mortality rates in 1907 for England and Wales, the 76 Great Towns, the 142 Smaller Towns, England and Wales less these 218 Towns, London, and Hampstead:— Deaths of Infants under 1 year per 1,000 births. England and Wales 118 76 Great Towns 127 142 Smaller Towns 122 England and Wales less the 218 Towns 106 London 116 Hampstead 73 31 The following are the infantile mortality rates for each of the Wards:— WARD. Deaths of Infants under 1 year per 1,000 births. No. 1 (Town) 81.1 No. 2 (Belsize) 63.4 No. 3 (Adelaide) 106.7 No. 4 (Central) 83.3 No. 5 (West End) 64.0 No. 6 (Kilburn) 71.6 No. 7 (Priory) 55.1 The following table, which is issued by the Registrar-General, shows the infantile mortality in each of the Metropolitan Boroughs and in the County of London. 32 Table showing the Infantile Death Rates of the County of London, the City of London, and the Metropolitan Boroughs during the 52 Weeks of 1907, as calculated by the Registrar General. DISTRICT. Deaths under 1 year to 1000 Births Registered. Hampstead 69 Lewisham 90 City of London 94 Wandsworth 99 Greenwich 100 Stoke Newington 100 St. Marylebone 101 City of Westminster 102 Deptford 108 St. Pancras 108 Paddington 109 Hackney 112 Woolwich 112 Battersea 114 Camberwell 115 Islington 116 Hammersmith 117 Stepney 117 Lambeth 120 Chelsea 122 Fulham 122 Bermondsey 123 Poplar 124 Kensington 128 Finsbury 130 Holborn 131 Bethnal Green 138 Southwark 138 Shoreditch 150 County of London 116 33 It will be seen from the foregoing table that the RegistrarGeneral's infantile mortality figure is lower than that calculated by me. This is because the Registrar-General takes account of the Hampstead births that occur in public institutions outside Hampstead. This I am unable to do, first, because I am not informed of many of these births, and secondly, because all my statistics are based on the official tables of the Local Government Board, which do not take account of births occurring outside the district. Infantile mortality in the country generally, as well as in Hampstead, was low in 1907, and though this may be to some extent attributed to the special preventive efforts that have been put forth during the last few years, there can be no doubt that it is largely due to the favourable weather conditions. A series of hot, dry summers, such as marked the last ten years of the last century would undoubtedly raise the infantile mortality rates all over the country, although probably not to the same extent, in spite of what has been done in the way of prevention. Our low infantile mortality in 1907 should not therefore be taken as a reason for relaxing preventive measures, but rather as a stimulus to increased effort. In my last annual report I dealt at some length with the subject of the prevention of infantile mortality, and indicated certain measures which were likely to be useful. Two of these were specially recommended for the prevention of summer diarrhœa, which is one of the most fatal diseases of infancy; one was the impervious paving of the carriageways of certain streets, the other the paving of backyards. There are many streets in the Kilburn Ward that would be greatly improved if the carriageways were paved with an impervious substance such as asphalte or tarred macadam, and it is to be hoped that steps will be taken in this direction. The impervious paving of backyards and forecourts is an important measure in this connection. The late Vestry made a bye-law dealing with this matter in 1893, but after some recent decisions in the High Court it became doubtful whether the byelaws then made could be enforced. In 1907 the Council prepared a set of paving bye-laws which were finally approved and adopted on October 10th, and allowed by the Local Government Board on November 30th. These bye-laws are in the following terms. D 34 BYE-LAWS Made by the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hampstead, as to the paving of yards and open spaces in connection with dwelling-houses in the said Borough. 1.—Throughout these bye-laws the expression "the Council" means the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hampstead. 2.—The following buildings shall be exempt from the operation of these bye-laws:— (а) Any building in His Majesty's possession, or employed or intended to be employed for His Majesty's use or service : (b) Any county or borough lunatic asylum, and any building or part of a building belonging to the council of any county, city or borough, and used or intended to be used for the detention of any prisoners : (c) Any gaol, house of correction, bridewell, penitentiary, or other prison, and any building occupied or intended to be occupied by any prison officer for the use of such prison and contiguous thereto: (d) Any building erected or to be erected according to plans previously approved by the Land Commissioners for England, or the Board of Agriculture, or the Board of Agriculture and Fisheries under the Improvement of Land Act, 1864, or other Act or Acts for the improvement of land : (e) Any building which may not be exempt by the operation of any of the preceding clauses of this bye-law, and which may be erected or may be intended to be erected in accordance with such plan and in such manner as may be approved or directed in pursuance of any statutory provision in that behalf by one of .His Majesty's Principal Secretaries of State: (f) Any building erected or intended to be erected for use solely as a temporary hospital for the reception and treatment of persons suffering from any dangerous infectious disorder. 3.—Subject to the provision hereinafter specified, the Owner of every dwelling-house in connection with which there is any yard or open space shall, where it is necessary for the prevention or remedy of insanitary conditions that all or part of such yard or open space shall be paved, forthwith cause the same to be properly paved with a hard, durable, and impervious pavement, evenly and closely laid upon a bed of good concrete not Jess than four inches thick, or other equally suitable foundation, 35 and so sloped to a properly constructed channel as effectually to carry off all rain or waste water therefrom; and he shall cause such pavement to be kept in proper repair. He shall cause all concrete used in connection with any such pavement to be composed of clean gravel, hard brick broken small, or other suitable ballast, with a sufficient quantity of sand, or grit, well mixed with good Portland cement in the proportion by measure of not less than one part of cement to six parts of other material. Provided that proceedings shall not be taken against the owner of any dwelling-house for an offence against this bye-law unless and until the owner, after service upon him of a notice in writing by the Council requiring him within such reasonable time as is specified in the notice to comply with the bye-law, has failed to comply with the bye-law within the time so specified. 4.—Every person who shall offend against the foregoing bye-law numbered 3 (three) shall be liable for every such offence to a penalty of five pounds, and in the case of a continuing offence to a further penalty of forty shillings for each day after written notice of the offence from the Council. Provided, nevertheless, that the justices or court before whom any complaint may be made or any proceedings may be taken in respect of any such offence may, if they think fit, adjudge the payment as a penalty of any sum less than the full amount of the penalty imposed by this bye-law. 5.—From and after the date of the confirmation of these bye-laws the bye-law as to the paving of yards and open spaces in connection with dwelling-houses, numbered 10 (ten) in the series of bye-laws approved and adopted by the Vestry of the Parish of St. John, Hampstead, on 22nd June, 1893, and confirmed by the Local Government Board on 17th August, 1893, under section 16, sub-section 1, of the Public Health (London) Act, 1891, shall be repealed. These bye-laws are now being applied in certain parts of the borough where they are needed, and have already been proved to be of considerable value. Turning now to another aspect of the infantile mortality question, I am able to report that the system of health visiting, official and voluntary, that I described in my last annual report, continued to operate in 1907 with beneficial results. The number D 2 36 of newly born infants visited by Mrs. Fisher was 320, including 125 babies born under the care of midwives and 15 born in lying-in hospitals outside Hampstead; 73 babies were re-visited, the number of re-visits being 129, and in addition to these, 34 re-visits were paid to 21 infants born in 1906. Of the 320 babies born in 1907 that were visited by Mrs. Fisher, 92 were visited within the first fortnight after birth, 61 in the second fortnight and 136 in the second month. Of the 289 babies visited within the first two months after birth, 253 were found to be entirely breast-fed, 24 to be partially breast-fed, and 12 entirely hand fed ; 42 of the babies visited lived in tenements of one room, 138 in tenements of two rooms, 96 in tenements of three rooms, 30 in tenements of more than three rooms, while in 14 cases the number of rooms was not ascertained. Infant visiting was also undertaken by a body of voluntary health visitors working in connection with the Hampstead Health Society, and under the supervision of the Medical Officer of Health. These voluntary health workers visited 120 babies during the year. In 13 cases the parents did not wish the visits to continue, in 10 other cases visiting was found to be unnecessary, 13 infants removed from Hampstead, and one infant died (of bronchitis) at the age of four months; 83 babies were under supervision at the end of the year. In my last report reference was made to the difficulties attending infant visiting, owing to the lack of timely intimation of the fact of birth. This difficulty has since been removed by the Notification of Births Act, 1907, which was adopted by the Hampstead Borough Council on December 5th. The consent of the Local Government Board to the Council's adoption of the Act was given on February 26th, 1908, and the Act came into operation on March 9th, 1908. The chief provisions of the Act are contained in section 1, which is in the following: terms:— (1). In the case of every child born in an area in which this Act is adopted it shall be the duty of the father of the child, if he is actually residing in the house where the birth takes place at the time of its occurrence, and of any person in attendance upon the mother at the time of, or within six hours after the birth, to give notice in writing of the birth to the Medical Officer of Health of the District in which the child is born in manner provided by this section. 37 (2). Notice under this section shall be given by posting a prepaid letter or postcard addressed to the Medical Officer of Health at his Office or Residence, giving the necessary information of the birth within thirty-six hours after the birth, or by delivering a written notice of the birth at the Office or Residence of the Medical Officer within the same time; and the Local Authority shall supply without charge addressed and stamped postcards containing the form of notice to any Medical Practitioner or Midwife residing or practising in their area, who applies for the same. (3). Any person who fails to give notice of a birth in accordance with this section shall be liable on summary conviction to a penalty not exceeding twenty shillings: Provided that a person shall not be liable to a penalty under this provision if he satisfies the court that he had reasonable grounds to believe that notice had been duly given by some other person. (4). The notification required to be made under this Act shall be in addition to and not in substitution for the requirements of any Act relating to the registration of births; and any registrar of births and deaths whose sub-district or any part thereof is situate within any area in which this Act is adopted shall at all reasonable times have access to notices of births received by the Medical Officer of Health under this Act, or to any book in which those notices may be recorded, for the purpose of obtaining information concerning births which may have occurred in his sub-district. (5). This section shall apply to any child which has issued forth from its mother after the expiration of the twenty-eighth week of pregnancy, whether alive or dead. The relation of the industrial employment of married women to infantile mortality is a question that has been much discussed of late years. At one time it was thought that the employment of married women in factories and workshops was a very important cause of infantile mortality, but the evidence that has so far been adduced in support of this view is far from conclusive, and there is now a tendency to regard the industrial employment of married women as but a minor factor in the causation of infantile mortality. During 1907, the Home Secretary took steps to elicit some adequate information on this subject, and on November 6th, Mr. Herbert Samuel, M.P., held a conference at the Home Office with a large number of Medical Officers of Health, when the whole question was discussed from various points of view. At this conference it was decided to institute an enquiry on definite lines in certain districts, 38 and the scope and method of this enquiry is made clear in the following letter which I received from Mr. Herbert Samuel on December 21st, 1907. Home Office, Whitehall, 11th December, 1907. Sir, I have laid before the Secretary of State a report of the proceedings at the recent Conference with Medical Officers of Health, at the Home Office, on the subject of the industrial employment of women before and after child-birth, and I am desired by him to express his satisfaction that the Conference was so largely attended, and that a general agreement was arrived at with regard to the lines which the proposed inquiry should follow. It may be convenient for subsequent reference briefly to record the chief results of the proceedings. The questions relating to infantile mortality were considered under the following heads:— I. The information to be obtained : II. The area of the inquiry: III. The period of the inquiry, and IV. The method of collecting the information. A discussion followed on some of the economic and social aspects of the subject. As regards the inquiry the Conference arrived at the following conclusions. I— INFORMATION TO BE OBTAINED. (1). Classification of groups of women.—The classification suggested in the Home Office Circular of 10th May was accepted, with a modification, as follows:—(a) women employed in factories and workshops; (b) those employed in industrial work at home; (c) other workers, e.g., charwomen and hawkers, and (d) those unoccupied, i.e., engaged only in domestic duties; but it was agreed that the information collected should be such as to admit of the groups of women industrially employed being further sub-divided according to trades and (where the particular process on which the woman was engaged involves special risk to health) according to the process. For this purpose the Visitor should be directed to ascertain in each case the woman's precise occupation and the disagree of severity of the work, and to note any conditions involving special danger or special fatigue, e.g., exposure to lead, pedal-work, or excessive standing. Subject to these suggestions, the particulars as to employment should be as simple as possible. On the question of classifying the women according to agegroups, the Conference considered that such a division should not 39 be regarded as essential, but that it was certainly desirable to ascertain the age of the mother, and even more desirable to obtain particulars as to her previous history. (2). Illegitimates.—It was agreed that notwithstanding certain difficulties in the way, the distinction between cases of legitimacy and illegitimacy should if possible, be made. (3). Miscarriages.—Information on this point would be desirable if practicable, but it must be left to the Medical Officer of Health to decide what information (if any) should be collected in cases in his district. (4). Feeding of child.—There was a general consensus that information should be obtained as to the feeding of the child during the first six months of life, and that a clear distinction should be drawn between entire and partial breast-feeding. (5). Age of infant at death.—It was agreed that in each case the exact age should be ascertained, with a view to tabulation in age-groups. (6). Cause of death of infant.—The inclusion of this information in the returns should be optional. (7). Nationality and race of mother.—The inclusion of this information, though no doubt of importance, might also be left to the discretion of the Medical Officer of Health. II.—AREA OF THE INQUIRY. The Conference fully concurred in the view expressed in the Home Office letter of the 7th October that it was essential that the inquiry in each case should be limited to homogeneous districts, and should not be extended so as to embrace areas which include appreciable variations in the social character of the population. The statistics collected by the Medical Officer of Health must relate to women of the same class and circumstances. This was a point of the greatest importance, as, in the event of this condition being overlooked, the statistics would be vitiated and lose almost all their value. Several suggestions were made as to the manner in which suitable areas might be selected, as e.g.. that streets might be taken as the unit (on the ground that a given street in an industrial district usually contains houses of a uniform character, occupied by workers of the same class), or that only houses up to a certain rental should be included ; but it was understood that in this matter every Medical Officer of Health taking part in the inquiry would require to exercise his discretion. 40 It was further recognised that while parallel observations from rural and agricultural districts would be of great general interest, they would hardly admit of comparison with the statistics collected in industrial districts. In this connection the Secretary of State may point out that it is not necessary in each case that the area of inquiry should be very large—a moderate area containing a fair number of women industrially employed will furnish useful results—but of course the more numerous the births occurring in the area selected, the more certain will be the conclusions arrived at with regard to the effects of the industrial employment of women in that area. III.—PERIOD OF THE INQUIRY. The Conference was asked to determine whether the inquiry should be made in respect of children born between 1st January and 31st December, 1907, i.e., should be retrospective, or whether it should be in respect of children born between 1st January and 31st December, 1908. The question was eventually put to the vote when it was resolved that the inquiry should be in regard to children born in the year 1908. It follows that, as the inquiry is to cover the whole of the first year of life, it cannot be completed till the expiration of the first year of life for children born on 31st December, 1908, i.e., not till 31st December, 1909. IV.—METHOD OF COLLECTING INFORMATION. It was agreed that the employment of trained women visitors, such as the Health Visitors who already make such inquiries in several towns, would be necessary. At the end of the discussion on the inquiry, the Conference nominated, at the request of the Home Office, certain Medical Officers of Health to form a Committee to assist the Home Office in drawing up a Form for the use of Medical Officers of Health and their staff in recording in a convenient manner the information agreed or recommended to be obtained in respect of each case. I enclose herewith a copy of the Form which has been drafted in consultation with this Committee, and, in view of the great importance of conducting the inquiry on uniform lines, I am to express a strong hope that the Medical Officers of Health who are willing to take part in the inquiry will adopt this Form for their returns. It need hardly be said that the adoption of this Form will not in any way preclude any Medical Officer of Health from providing for the collection of additional particulars by the Visitors. The intention is that each Medical Officer of Health should arrange— 41 subject to the conclusions arrived at by the Conference—for the particulars specified in the Form to be collected on the spot in whatever manner (e.g., by cards or notebooks) he may think most convenient, but that for each case a Form should subsequently be completed, and that when the Medical Officer of Health sends in his report of the results of the inquiry in his district, all the Forms should be forwarded at the same time to the Home Office for the purposes of such further collation, if any, as may be desired. As the Forms will have to be preserved for two years and more, it will be advisable to file them in covers. When all the particulars in respect of births in 1908 are complete it is desired that you will work up into a report the particulars contained in the returns, together with any information you may have been able to collect from other sources (e.g., lying-in homes, hospitals, &c.). It may be possible for the Secretary of State to suggest later a form of tables (on the lines of that given in the Home Office circular of the 10th May last) in which the statistical results can be uniformly presented. As stated by me at the Conference, it is the intention of the Secretary of State at the completion of the inquiry to publish in a blue book to be presented to Parliament the reports on the subject which he receives from the Medical Officers of Health. In conclusion the Secretary of State would remind you that the two main objects of the inquiry are:— (1) to determine the effect of employment of women before and after childbirth on the health of mother and child, and particularly, by means of a comparison between women who have been at work in a factory or workshop and women who have been otherwise employed or engaged only in domestic duties, whether employment in a factory or workshop has any specially prejudicial effect, and. (2) so far as the Medical Officer of Health may be able to collect material bearing on the question, to gauge the social and economic effects which further restrictions on the employment of women in factories and work-shops before and after childbirth would entail and in particular whether such restrictions would or would not have indirect effects prejudicial to infant life, either (a) by adding to the economic burden of child-bearing and so leading to a further fall in the birth-rate, or (b) by increasing the poverty of the household, and so—through worse feeding, &c.—leading to an increase in the infant death rate. Mr. Gladstone will now be very glad to hear that you are prepared to conduct an inquiry (commencing on 1st January, 1908) on the lines indicated, in your district, and to be informed at your 42 earliest convenience whether yon desire a supply of the Forms to be sent to you, and if so, what number you expect to require. He hopes that the present circular, taken together with the previous circulars, sufficiently deals with the various points which the inquiry involves, but he need hardly add that he will be very happy to afford any Medical Officer of Health any further explanation required, and to advise at any time with regard to any difficulties which may arise in the course of the inquiry. I am, Sir, Your obedient Servant, HERBERT SAMUEL. The following form for use in the enquiry was drawn up by a special Committee appointed at the Conference at the Home Office on November 6th:— No. of Case Date of first Visit Sanitary District Date of last Visit Mother. Name Address Age Race and Nationality Living with Husband. Living apart. Widowed. Unmarried. General Health. Good. Indifferent. Bad. Character of Confinement Doctor. Midwife Institution. Previous History. No. of Miscarriages Still Births Children born alive Now living Died in 1st year of life Description of work before present pregnancy Other information Note.—In cases where the woman has been engaged only in domestic duties at home, either before or after childbirth, "Nil' should be written across the part inapplicable. Work during pregnancy. How long ceased before birth Precise occupation Carried on at home. In factory or workshop. Elsewhere. Weekly earnings Nature of work. Heavy. Light. Special conditions Work after birth. Resumed weeks after birth. Why resumed Precise occupation Carried on at home In factory or workshop Elsewhere. Weekly earnings Nature of work. Heavy. Light. Special conditions 43 Child. Full Name Date of birth Male. Female. Legitimate. Illegitimate. Firstborn. Premature. Full Time. Condition at first visit at last If death occurs, age at death Cause of death Feeding during first six months of life. Breast entirely for weeks. Artificial food partly since Why Artificial food entirely since Why Nursing. By Mother. By other person at home Put out, where Father. Occupation Weekly earnings Race and Nationality. Health. Good. Indifferent. Bad. Home. Rent No. of rooms Condition No. of family at home Weekly income of family No. of lodgers Remarks. It will be seen from the above form that the enquiry the Home Secretary has instituted is searching and comprehensive, and it should elicit a mass of most valuable material. A number of streets in Hampstead have been selected for the enquiry, which is now being carried on by Mrs. Fisher and by a few of the voluntary workers. As will readily be understood the enquiry in each case occupies a considerable amount of time. The work of health visiting in Hampstead has been much facilitated by the Notification of Births Act, but the work at present suffers for want of workers. Mrs. Fisher continues to work exceedingly well, but she has other important duties to perform and can only devote a comparatively small amount of time to infant visiting. The work of the voluntary visitors is valuable, but voluntary visitors cannot take the place of trained and experienced health officers, and it is surprisingly difficult to obtain anything like an adequate number of voluntary visitors, even in Hampstead, where there is no lack of leisured ladies who might be expected willingly to take up useful social occupation of this kind. There is much need of a second lady inspector in Hampstead, and I would strongly recommend that one be appointed during the present year in order that the Borough may reap the full benefit of the Notification of Births Act, and secure a continuance of the fall in our infantile mortality that is recorded in this report. Infectious Diseases. 47 NOTIFIABLE INFECTIOUS DISEASES. The total cases of infectious diseases notified numbered 498. This is equivalent to an attack-rate of 5.5 per 1,000 of the population. The following shows the number of cases of each disease notified:— Small Pox 1 Scarlet Fever 314 Enteric Fever 19 Diphtheria and Membranous Croup 103 Puerperal Fever 4 Erysipelas 57 The number of fatal cases was 15, equal to 3.0 per cent. of the cases notified. The deaths were distributed as follows:— DISEASE WARDS. Totals. No. 1 (Town). No. 2 (Belsize). No. 3 (Adelaide). No. 4 (Central.) No. 5 (West End). No. 6 (Kilburn). No. 7 (Priory). Scarlet Fever ... 2 ... ... 3 ... ... 5 Enteric Fever ... 1 ... 1 ... ... ... 2 Diphtheria and Membranous Croup 1 ... ... 1 1 3 ... 6 Puerperal Fever ... ... 1 ... ... ... ... 1 Erysipelas 1 ... ... ... ... ... ... 1 Totals 2 3 1 2 4 3 ... 15 The death rate from the notifiable infectious diseases was, therefore, 0.6 per 1,000 of the population. The following table shows the attack and death rates from Smallpox, Diphtheria and Membranous Croup, Erysipelas, Scarlet Fever and Enteric Fever, for the period 1891-1907:— 48 TABLE shewing the attack rate and death-rate for the Borough from Smallpox, Diphtheria and Membranous Croup, Scarlet Fever, and Enteric Fever, during the years 1891-1907. Year. Smallpox. Diphtheria and Membranous Croup. Erysipelas. Scarlet Fever. Enteric Fever. Attack rate per 1000 of the population. Death rate per 1000 of the population. Attack rate per 1000 of the population. Death rate per 1000 of the population. Attack rate per 1000 of the population. Death rate per 1000 of the population. Attack rate per 1000 of the population. Death rate per 1000 of the population Attack rate per 1000 of the population. Death rate per 1000 of the population. 1891 0.03 - 1.27 0.19 0.64 0.04 2.32 0.10 0.49 0.10 1892 0.01 - 1.92 0.38 0.73 0.04 4.51 0.07 0.69 0.03 1893 0.17 0.03 2.18 0.52 1.03 0.03 7.05 0.28 0.51 0.11 1894 0.23 0.04 1.31 0.27 0.91 0.03 3.15 0.14 0.67 0.07 1895 0.03 — 1.51 0.19 0.71 0.05 4.14 0.11 0.83 0.12 1896 — — 2.48 0.38 0.67 0.01 3.82 0.09 0.72 0.09 1897 — — 1.27 0.22 0.47 0.08 2.86 0.06 0.42 0.06 1898 - - 1.62 0.24 0.51 0.05 2.95 0.04 0.61 0.12 1899 — — 1.31 0.19 0.63 - 3.52 0.07 0.51 0.05 1900 — — 1.88 0.37 0.60 0.01 2.72 0.05 0.60 0.11 1901 0.09 0.02 1.72 0.21 0.58 0.03 2.60 0.04 0.54 0.08 1902 0.20 0.02 1.01 0.11 0.66 - 2.99 0.08 0.52 0.11 1903 0.01 - 0.92 0.12 0.47 0.01 1.93 0.03 0.28 0.02 1904 — — 0.63 0.06 0.62 0.04 1.83 0.02 0.30 0.06 1905 - - 0.71 0.03 0.48 0.03 1.93 0.07 0.19 0.02 1906 - - 1.08 0.12 0.58 0.03 4.30 0.06 0.22 0.03 1907 0.01 — 1.13 0.07 0.63 0.01 3.45 0.05 0.21 0.02 49 Cases of Infectious Disease occurring in each Month during 1907. Disease. MONTHS. Totals. January. February. March. April. May. June. July. August. September. October. November. December. Small Pox ... ... ... 1 ... ... ... ... ... ... ... ... 1 Scarlet Fever 27 36 30 19 26 16 21 27 37 20 27 28 314 Enteric Fever ... 3 1 1 ... 5 2 ... 2 1 2 2 19 Diphtheria and Membranous Croup 12 12 10 14 9 6 7 6 9 4 7 7 103 Puerperal Fever ... 1 ... ... 1 1 1 ... ... ... ... ... 4 Erysipelas 6 3 3 9 4 3 4 5 5 4 4 7 57 Totals 45 55 44 44 40 31 35 38 53 29 40 44 498 50 Cases of Infectious Disease occurring in each Ward during 1907. Disease. WARDS. Totals. No. 1 (Town) No. 2 (Belsize) No. 3 (Adelaide) No. 4 (Central) No. 5 (West End) No. 6 (Kilburn) No. 7 (Priory) Small Pox ... 1 ... ... ... ... ... 1 Scarlet Fever 64 32 13 19 115 52 19 314 Enteric Fever 5 1 ... 6 3 4 ... 19 Diphtheria and Membranous Croup 24 21 6 4 30 14 4 103 Puerperal Fever 1 1 1 ... ... 1 ... 4 Erysipelas 11 7 9 4 5 15 6 57 Totals 105 63 29 33 153 86 29 498 51 Small-pox. One case of small-pox was notified during the year, this being the first case of small-pox that has occurred in Hampstead since October, 1903. The patient, a manager of a Shipping Company, was residing in Upper Park Road when he was taken ill. The first symptoms began on April 18th, the rash appearing on April '21st. The patient was staying in Madeira from April 1st to April 7th, leaving on the latter date by a vessel coming from South America to England. He landed at Liverpool on April 15th, and at once proceeded to Hampstead. The rash in small.pox usually appears on the 15th day from the date of infection, and, therefore, the patient was probably infected either at Madeira or on the voyage home. The patient was promptly removed to hospital, the premises, bedding, etc., were disinfected, and the contacts were re.vaccinated and kept under supervision for three weeks after exposure to infection. No subsequent case occurred. E 2 52 Vaccination. The table below gives some idea of the working of the Vaccination Act in Hampstead since 1900. I am indebted to the Vaccination Officer for the statistics in this table. Vaccination Statistics. Year. Births. Successfully Vaccinated. Insusceptible of Vaccination. Had Smallpox. Number in respect of whom Certificates of "Conscientious Objection" have been received. Died Unvaccinated. Vaccination Postponed. Remaining. Percentage of Births Registered. Successfully Vaccinated. Exempted by" Conscientious Objection" Certificates. Not finally accounted for (including cases postponed). Unvaccinated. 1 2 3 4 5 6 7 8 9 10 11 12 13 1900 1623 1323 13 ... 37 108 11 131 (Col. 3) 81.5 (Col. 6) 2.3 (Cols. 8 & 9) 8.7 (Cols. 6, 8, &9) 11.0 1901 1508 1232 15 ... 39 111 7 104 81.7 2.6 7.4 10.0 1902 1517 1255 18 ... 27 104 11 102 82.7 1.8 7.4 9.2 1903 1452 1190 19 ... 30 106 11 96 82.0 2.1 7.4 9.5 1904 1446 1197 16 ... 35 100 8 90 82.8 2.4 6.8 9.2 1905 1421 1181 18 ... 40 91 14 77 83.1 2.8 6.4 9.2 1906 1438 1186 12 ... 35 93 16 96 82.5 2.4 7.8 10.2 1907 1341 1023 7 ... 60 74 33 144* ... ... ... ... Note.—The number of births given as occurring in each year differs slightly from those stated elsewhere in this Report, but for all practical purposes the difference is negligible. * In this figure are included 78 births, in respect of which no legal action as to vaccination has yet been taken. The rates for Columns 10-13 have therefore not been calculated. 53 Scarlet Fever. The number of cases of Scarlet Fever notified in each of the last seven years is set out below. Year. No. of Cases Notified. 1901 214 1902 251 1903 165 1904 159 1905 170 1906 385 1907 314 The deaths from Scarlet Fever in 1907 were 5 only, as compared with 5 in the previous year. The number of cases and the number of deaths per 1000 of the population were 3.45 and 0.05 respectively, and the case mortality, or percentage of deaths to cases, was 1.6. The corresponding figures in 1906 were 4.30, 0.06, and 1.6 respectively. Of the cases notified, 263, or 84 per cent., were removed to hospital. The corresponding percentage in 1906 was 87. The sanitary condition of every house in which a case of Scarlet Fever occurred was thoroughly investigated, and the following defects were discovered:— Drains defective 45 Soil pipes defective 26 Water supplies defective. 21 Other defects 78 The following table shows the number of cases occurring each month in the various wards: — 54 Month. WARDS. Totals. No. 1 (Town). No. 2 (Belsize). No. 3 (Adelaide). No. 4 (Central). No. 5 (West End). No. 6 (Kilburn). No. 7 (Priory). January — 1 1 4 14 7 — 27 February 4 — 1 2 20 8 1 36 March — 2 1 5 18 3 1 30 April 1 1 — 2 10 3 2 19 May 2 2 2 1 10 4 5 26 June 1 1 — 1 8 1 4 16 July 2 3 — 1 7 8 — 21 August 16 4 1 — 2 3 1 27 September 22 4 2 1 6 1 1 37 October 3 5 1 — 7 3 1 20 November 5 5 1 1 6 7 2 27 December 8 4 3 1 7 4 1 28 Totals 64 32 13 19 115 52 19 314 An important outbreak of scarlet fever occurred in the latter half of the year in a boarding school in Hampstead. On August 29th I visited the school, which is a philanthropic institution, at the request of the school doctor to examine a number of children whom he suspected to be suffering from scarlet fever. On examining these patients I found that nine were undoubtedly so suffering, and these were immediately removed to hospital and the rooms they had occupied thoroughly disinfected. Two of these patients were taken ill on August 27th and the other seven on August 28th. I suspected that the patients had been infected by some inmate of 55 the institution who had taken the disease in so mild a form, that it had not been recognised, and a careful examination was, therefore, made of all the children and all the staff. No evidence of scarlet fever could be discovered, nor could the most careful enquiries in other directions elicit any information that threw light on the source of infection. The medical examination of the inmates of this institution was repeated on each of the three following days, but nothing could be found to explain the cause of the outbreak until September 1st, by which time seven additional children had been attacked. On September 1st during the daily medical examination of the inmates, a boy, T.M., was found to be desquamating. He had been carefully examined every day since August 29th, and it was not until September 1st that he showed the slightest sign of desquamation, or of anything else that suggests scarlet fever. It appears that this boy returned to school on August 16th, and that he was not then in robust health, having suffered during the holidays from what was thought to be "bronchitis." I examined the boy before he was removed to the isolation hospital, and I have no doubt that he was peeling after an attack of scarlet fever, and that he was the cause of the outbreak. By the time this boy was discovered to be infectious the disease had got a good grip on the school, and further cases occurred, the total number being 39, all the patients being scholars of the school. The total number of scholars at that time was 62, 56 boys and 16 girls, so that nearly two.thirds of the whole were attacked. School outbreaks of infectious disease, due to unrecognised cases, are of common occurrence, but it is rare even in boarding schools for so large a proportion of the children to be attacked as was the case in this outbreak. In the great majority of the cases the disease took a mild form and no case was fatal. The following is a list of the patients with dates of onset. The onset in the case of those patients whose initials are printed in italics was not definitely ascertained. These patients had indefinite symptoms, for which they were isolated in an isolation ward during the early part of the outbreak, and it was not until they had begun to desquamate that a diagnosis of scarlet fever could be made. 56 Initials of Patient. Age. Sex. Date of Onset. Date of Removal to Hospital. R. L. 6 M August 27th August 29th F. K. 7 ,, ,, ,, ,, ,, H. R. 7 „ „ 28th ,, ,, F B 7 ,, ,, ,, ,, ,, S D. 7 ,, ,, ,, ,, ,, A. R. 5 ,, ,, ,, ,, F.A. 5 ,, ,, ,, ,, F.C. 7 ,, ,, ,, ,, J.P. 6 ,, ,, ,, ,, M. R. 7 F „ 29th „ 30th L. H. 6 ,, ,, ,, ,, 31st A. C.6 M „ 30th „ 30th R. R. 4 ,, ,, ,, ,, ,, H. H. 7 „ „ „ „ 31st S. P. 5 „ „ 31st „ „ C. S. 1 „ „ ,, September 1st F.D. 7 „ September 1st ,, 2nd A. R. 5 ,, ,, 2nd ,, ,, W. F. 7 „ „ „ „ 3rd T. M. 5 „ „ „ J. B. 5 ,, ,, 3rd ,, ,, J. J. 4 ,, ,, ,, ,, ,, E. C. 4 F „ 4th „ 4th M. D. 3 „ „ 5th „ 5th R. D. 6 M „ „ „ 11th C.W. 7 „ „ 6th „ 19th H. P. 7 „ „ 7th „ 7th H. M. 4 „ ,, „ „ 17th W. T. 6 „ „ 8th „ 8th M. W. 2 F „ 10th „ 10th W. B. 6 M „ 13th „ 13th V. H. 6 F „ 16th „ 17th G. A. 6 „ „ 19th „ 19th E.W. 4 M „ 25th A. R. 6 „ „ 27th M.W. 7 F ,, ,, O. R. 5 ,, ,, ,, R. F. 7 M October 5th A. P. 8 ,, December 16th December 18th Diphtheria and Membranous Croup. The number of cases notified in 1907 was 103 as compared with 97 in 1906, the attack-rate or number of cases notified per 1,000 population being 1.13. The number of fatal cases was 6, or 5.8 per 57 cent. of the cases notified. The death-rate per 1,000 population was 0.07; 81 patients, or 79 per cent. of the total cases notified, were removed to hospital. A thorough examination was made of the sanitary condition of every house in which a case of diphtheria occurred, and the following defects were discovered:— Drains defective 21 Soil pipes defective 12 Water supply defective 7 Other defects 25 The following table shows the number of cases occurring each month in the various wards :— Month. WARDS. Totals. No. 1 (Town). No. 2 (Belsize). No. 3 (Adelaide). No. 4 (Central). No. 5 (West End). No. 6 (Kilburn). No. 7 (Priory). January 7 — — 2 3 — — 12 February 4 — — — 7 1 — 12 March 2 — — 1 7 — — 10 April 2 3 1 — 5 2 1 14 May 1 1 2 — 3 2 — 9 June 1 2 — 1 — 2 — 6 July 3 2 — — — 1 1 7 August 1 1 — — 1 2 1 6 September — 5 3 — — 1 — 9 October — 3 — — — 1 — 4 November 2 1 — — 3 1 — 7 December 1 3 — — 1 1 1 7 Totals 24 21 6 4 30 14 4 103 58 Enteric Fever. The number of cases notified was 19 as compared with 20 in 1906 and 17 in 1905. The attack rate per 1000 population was 0.21. The number of fatal cases was 2 or 10.5 per cent. of the cases notified. The death.rate per 1000 population was 0.02 ; 6 patients, or 32 per cent. of the total cases notified, were removed to hospital. The sanitary condition of each house in which a case of Enteric Fever occurred was investigated and the following defects were discovered:— Drains defective 5 Soil pipes defective 4 Water supply defective 2 Other defects 4 The following table shows the number of cases occurring each month in the various wards:— Month. WARDS. Totals. No. 1 (Town) No 2 (Belsize) No. 3 (Adelaide) No. 4 (Central) No. 5 (West End) No. 6 (Kilburn) No. 7 (Priory) January — — — — — — — — February 1 1 — 1 — — — 3 March — — — — 1 — — 1 April 1 — — — — — — 1 May — — — — — — — — June — — — 4 — 1 — 5 July — — — 1 1 — — 2 August — — — — — — — — September 2 — — — — — — 2 October — — — — — 1 — 1 November — — — — — 2 — 2 December 1 — — — 1 — — 2 Totals 5 1 — 6 3 4 — 19 59 A careful inquiry was made as to the source of infection in each case. In 3 instances it was found that the patient had clearly been infected outside Hampstead. Two other patients were medical practitioners, one of whom was infected while working with the typhoid bacillus in a laboratory. In the remaining instances the source of infection could not be definitely traced. Puerperal Fever. 4 cases were notified, 1 of which proved fatal, as compared with 2 cases in 1906. The ward distribution of the cases is as follows, 1 in each of the following :—Town, Belsize, Adelaide and Kilburn. Erysipelas. 57 cases were notified, and 1 death occurred, as compared with 52 cases and 3 deaths in 1906. The case mortality was 1.7 per cent. The attack rate per 1000 of the population was 0.63 and the death rate 0.01. Of the cases notified, 8 or 14 per cent. were removed to hospital. Five patients were removed to the Hampstead Workhouse Infirmary, one was removed to the German Hospital, and one to a nursing home. In each case an examination was made of the sanitary condition of the house, and in 34 instances defects of various kinds were discovered. 60 The following table shows the number of cases occurring each month in the various wards:— Month. WARDS. Totals No. 1 (Town.) No. 2 (Belsize) No. 3 (Adelaide) No. 4 (Central) No. 5 (West End) No. 6 (Kilburn) No. 7 (Priory) January 1 1 1 1 1 — 1 6 February — — 1 — — 1 1 3 March 1 — — — — 2 — 3 April 3 1 1 — 1 3 — 9 May 1 — 1 — — 1 1 4 June 1 1 1 — — — — 3 July 2 — — 1 — — 1 4 August — 1 — — 1 3 — 5 September — 1 1 — 2 1 — 5 October 2 — — 1 — — 1 4 November — — 1 — — 3 — 4 December — 2 2 1 — 1 1 7 Totals 11 7 9 4 5 15 6 57 SEVEN PRINCIPAL EPIDEMIC DISEASES. The total number of deaths from these diseases amounted to 41, and were distributed as follows:— 61 DISEASE. WARDS. Totals. No. 1 (Town) No. 2 (Belsize) No. 3 (Adelaide) No. 4 (Central) No. 5 (West End) No. 6 (Kilburn) No. 7 (Priory) Small-pox - - - - - - - - Measles 2 4 1 - 1 2 1 11 Scarlet Fever — 2 — - 3 — - 5 Diphtheria and Membranous Croup 1 - - 1 1 3 - 6 Whooping Cough — 2 - - 4 5 1 12 Fever — 1 - 1 — — - 2 Diarrhoea — 2 - - — 3 - 5 Totals 3 11 1 2 9 13 2 41 The death rate from the seven principal epidemic diseases was, therefore, 0.45 per 1000 of the population. In the following table a comparison is given of the annual death rates from these diseases in Hampstead, England and Wales, the 7(5 Great Towns, the 142 Smaller Towns, and England and Wales less these 218 Towns, during 1907:— 7 Principal Epidemic Diseases. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fever. Diarrhœa. England and Wales 1.26 0.00 0.36 0.09 0.16 0.29 0.07 0.29 76 Great Towns 1.54 o.oo 0.43 0.12 0.17 0.35 0.07 0.40 142 Smaller Towns 1.29 o.oo 0.41 0.08 0.15 0.29 0.07 0.29 England and Wales 0.91 o.oo 0.25 0.06 0.15 0.21 0.06 0.18 less the 218 Towns London 1.42 - 0.38 0.14 0.16 0.38 0.04 0.32 Hampstead 0.45 - 0.12 0.05 0.07 0.13 0.02 0.05 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. Detailed information concerning Small-pox, Scarlet Fever, Diphtheria, and Fever will be found under the heading of Notifiable 62 Infectious Diseases on pages 47.59, but particulars concerning Measles, Whooping Cough, and Diarrhoea, to which notification does not apply, are given here. Year. Seven Principal Epidemic Diseases. Measles. Whooping Cough. Diarrhoea. Death rate per 1000 of the population. Death rate per 1000 of the population. Death rate per 1000 of the population Death rate per 1000 of the population. 1901 0.77 0.12 0.29 0.04 1902 0.69 0.17 0.11 0.04 1903 0.49 0.09 0.18 0.05 1904 0.55 0.17 0.09 0.15 1905 0.43 0.09 0.11 0.02 1906 0.55 0.11 0.02 0.21 1907 0.45 0.12 0.13 0.05 Measles. Eleven deaths were recorded from this disease, as compared with 10 in 1906. The mortality was 0.12 per 1000 population. Measles is now included amongst the dangerous infectious diseases to which Sections 60.65, 68.70, and 72.74 of the Public Health (London) Act, 1891, apply. These sections extend the provisions relating to isolation and disinfection to measles, but they do not make the disease compulsorily notifiable. During the year 1907, 347 cases were brought to the knowledge of the Department, as compared with 333 in 1906. The sources of information were as follows:— Cases notified by medical practitioners 14 „ parents or guardians 88 „ school teachers 214 „ employers and others 17 „ M.A.B. when removing cases 5 Death Returns 9 347 63 In 46 cases it was found, on enquiry, that no doctor was in attendance. These 347 cases occurred in 233 houses :— In 162 houses there was 1 case in each house. In 45 „ „ were 2 cases „ In 13 „ „ „ 3 „ „ In 9 „ „ „ 4 „ „ In 4 „ „ „ 5 „ ,, The following table shows the number of reported cases of measles occurring each month in the various wards:— Month. WARDS. Totals. No. 1 (Town) No. 2 (Belsize) No. 3 (Adelaide) No. 4 (Central) No. 5 (West End) No. 6 (Kilburn) No. 7 (Priory) January 2 5 1 4 1 6 8 27 February — 6 — — — 6 3 15 March 7 44 2 1 3 — — 57 April 8 6 6 3 6 3 8 40 May 20 6 — — 9 40 10 85 June 3 4 1 8 2 56 5 79 July 2 1 1 — 2 12 — 18 August — 4 1 — 2 — 1 8 September 1 — — 2 2 — 2 7 October - - - - - 1 — 1 November — 1 1 — . — — 2 December — 8 - - - - - 8 Totals 43 85 13 18 27 124 37 347 64 Whooping Cough. There were 12 deaths from this disease in 1907, as compared with 2 in 1906. The mortality per 1000 population was 0.13. Diarrhoea. The number of deaths from this cause was 5, as compared with 19 in 1906. The death rate per 1000 of the population from this disease was 0.05. In the following table these deaths are arranged in month and Wards:— Month. WARDS. No. 1 (Town) No. 2 (Belsize) No. 3 (Adelaide) No. 4 (Central) ' No. 5 (West End) No. 6 (Kilburn) No. 7 (Priory) Totals January — — — — — — — — February — — — — — — — — March — — — — — 1 — 1 April — — — — — — — — May — 1 — — — — — 1 June — — — — — — — — July — — — — — 1 — 1 August — — — — — — — — September — 1 — — — — — 1 October — — — — — — — — November — — — — — 1 — 1 December — — — — — — — — Totals — 2 — — — 3 — 5 Of these deaths 4 occurred among children under one year of age, the other being that of an adult of over 65 years of age. 65 TUBERCULOSIS. The number of deaths from Tuberculosis in 1907 was 92. Of these, 61 deaths were due to pulmonary tuberculosis or phthisis, 16 to tubercular meningitis, 8 to intestinal tuberculosis, 2 to tuberculosis of the larynx, and 5 to other forms of the disease. The following table shows the number of deaths and the death. rates from tuberculosis, and from phthisis respectively since 1899. Year. Total deaths from Tuberculosis. Death rate per 1000 population. Phthisis deaths. Death rate per 1000 population. 1899 98 1.21 81 0.98 1900 92 1.13 69 0.85 1901 118 1.43 73 0.88 1902 97 1.16 73 0.87 1903 90 1.06 66 0.77 1904 102 1.18 73 0.84 1905 95 1.08 73 0.83 1906 79 0.88 57 0.64 1907 92 1.01 61 0.67 The deaths from phthisis were distributed among the Wards as follows:— 1907. Ward. Area (Acres). Estimated Population middle of 1907. Phthisis Deaths. Phthisis Death Rate per 1000 of the Population. No. 1 (Town) 686 13940 13 0.93 „ 2 (Belsize) 271 14410 10 0.69 „ 3 (Adelaide) 325 10860 2 0.18 „ 4 (Central) 312 10397 5 0.48 „ 5(West End) 247 14090 9 0.64 „ 6 (Kilburn) 195 16310 16 0.98 „ 7 (Priory) 229 11130 6 0.54 The Borough 2265 91137 61 0.67 f 66 The following table shows the age distribution of the patients dying from consumption in Hampstead in the five years 1903.1907. Year. Age Period. All Ages. 0—5 5—15 15—25 25—65 65— 1903 — 1 14 46 5 66 1904 1 1 15 53 3 73 1905 1 — 12 57 3 73 1906 1 — 8 45 3 57 1907 1 2 10 45 3 61 Totals 4 4 59 246 17 330 In 1902 a system of voluntary notification of Phthisis came into operation in Hampstead. The following table gives the number of patients notified in each year since 1902:— Year. No. of patients notified. 1902 51 1903 34 1904 39 1905 27 1906 35 1907 55 Five of the notification certificates received during 1907 related to patients who had already been notified; the number of new cases notified was, therefore, 50, and of these 18 were males and 32 females. The notifications received were from the following sources:— Patients notified by the Poor Law Medical Officers . 14 Patients notified from the Hampstead General Hospital 3 Patients notified from the Mount Vernon Hospital Out Patient department 25 Patients notified by private practitioners 13 67 Nine of the patients notified died during the year. In 2 cases death occurred within a month from the date of notification. The homes of the patients notified are visited by Mrs. Fisher, who leaves a card of instructions as to the prevention of consumption, supplementing the printed directions with oral advice. Disinfection of rooms and bedding was carried out at the homes of 33 of the patients notified, and in 3 instances the disinfection was repeated during the year. Disinfection is offered after the death of a phthisical patient whether the patient has been notified or not. The total number of premises disinfected during the year was 94. DISINFECTION. Number of articles disinfected :— Beds 411 Mattresses 944 Palliasses 18 Bolsters 630 Pillows 1893 Blankets 2481 Sheets 1482 Counterpanes 1026 Articles of Clothing 4332 Carpets 150 Linen articles 5454 Books 846 Miscellaneous 1648 Total 21315 Number of premises disinfected - 873 „ rooms, etc., disinfected 1253 During 1906, 963 premises, 1348 rooms, &c., and 21,374 articles were disinfected. F 2 68 In addition to the foregoing, the following were destroyed upon request of the owners:— Beds 6 Mattresses 14 Palliasses 4 Bolsters 2 Pillows 7 Blanket 1 Sheets 2 Counterpanes 2 Articles of Clothing 28 Miscellaneous 24 Total 90 General Sanitary Administration. 71 The following is a tabulated statement of the sanitary work, etc., carried out during the year, so far as that work admits of tabulation:— Sanitary Works Carried Out. Houses or parts of houses cleansed 258 Dampness in houses or parts of houses abated 30 Dilapidated houses or parts of houses repaired 33 Inlets or surface drains trapped 12 Improperly constructed water closets altered 17 Defective water closets repaired or renewed 569 Water closets unstopped 10 Improperly placed water closets removed 12 External ventilation provided to water closets 16 Water closet accommodation provided 14 Soil pipes repaired, renewed, or ventilated 315 Improperly placed gully traps removed 5 Gully traps cleansed 49 Yards drained 36 Waste pipes of sinks disconnected from drains, trapped, or renewed 277 Waste pipes of lavatories disconnected from drains, trapped, or renewed 137 Waste pipes of baths disconnected from drains, trapped, or renewed 123 Water cisterns repaired or renewed 26 Accumulations or deposit's of refuse, manure, &c., removed 296 Foul or defective dustbins or ashpits abolished 39 Foul drains cleansed 89 Defective drains amended or reconstructed 717 Drains unstopped 50 Rainwater pipes disconnected from drains 131 Rainwater pipes disconnected from soil pipes 17 Rainwater pipes repaired or renewed 96 Water supplies used for domestic purposes disconnected from the cistern for flushing the water closet 2 Houses provided with proper water supply 136 Roofs repaired 73 Gutterings repaired or renewed 32 Areas cleansed 3 Areas drained 7 Washhouse pavings repaired or renewed 3 Scullery pavings repaired or renewed 2 Animals ceased to be kept in such a manner as to be a nuisance 9 Cases of overcrowding abated 8 Underground rooms ceased to be occupied as dwellings 2 72 Tents, vans, sheds, or similar structures in such a state as to be injurious or dangerous to the health of the inmates, dealt with 11 Spaces below floors in the basement or ground floors ventilated 6 Ventilating pipes of drains carried to a sufficient height above windows 8 Fresh air inlets repaired or renewed 40 Separate and sufficient water closet accommodation provided for persons of each sex 2 Water closets cleansed 60 Water closets provided with a sufficient water supply 46 Flushing cisterns to water closets repaired or renewed 242 Water closets provided with means of constant ventilation 6 Sufficient water closet accommodation provided 4 Yard pavings repaired or renewed 136 Area pavings repaired or renewed 55 Defective or improper manure receptacles abolished 2 Manure receptacles provided 8 Dust receptacles provided 199 Covers to dust receptacles provided 4 Water cisterns cleansed 62 Water cisterns fitted with close fitting covers 34 Improperly placed water cisterns removed 6 Stable pavings repaired or renewed 16 Number of Inspections, &c., Made; Notices Served; and Letters, &c., Issued. 1907. Number of Inspections 9056 „ Re-inspections 12044 ,, Intimation Notices issued 901 „ Statutory Notices issued 331 „ Letters issued 5372 Certificates as to Water Supply. The number of Certificates issued during the year was 77, as compared with 102 in 1906. Drainage Work. The bye-laws of the London County Council that require that plans and written particulars of drainage construction and alteration shall be deposited with the Sanitary Authority, came into operation 73 in August, 1903, and from that date to the end of 1907 the Council have approved of 262 plans for the drainage of new buildings, and 2324 plans for alterations, etc., to drains of existing premises. During the year 714 notices of drainage reconstruction or alteration were received, and in 555 cases the work necessitated the deposit of plans and written particulars. In 381 of these latter cases the work could not be delayed until the Council's approval of the plans had been received ; in each of these cases the prescribed " urgency " notice was, therefore, submitted by the builders, the work put in hand forthwith and the plans, etc., deposited at a later date. Of the 555 notices of drainage alterations, etc., requiring the deposit of plans, 272 related to work that involved the entire reconstruction of the drainage system. In 353 of the 555 drainage cases the work was carried out voluntarily, the number of instances in which voluntary complete reconstruction was carried out being 130. The voluntary work was chiefly done in connection with the larger houses in Hampstead, and in many cases the voluntary drainage reconstructions were of a very extensive character. The supervision of work of this kind occupies much of the Inspectors' time, and it is partly for this reason that it is found impossible to carry out a systematic house-to-house inspection. In many of the metropolitan boroughs, considerable sums of the ratepayers' money are expended every year in the repair of combined drains, which by a legal technicality have become " sewers " for which the ratepayers are responsible. In Hampstead, fortunately, no loss of public money occurred in this way during 1907. Many claims were made but all were successfully resisted. In two cases the claimants carried the matter to the Courts before they could be convinced that their claims against the Council could not be maintained. Both these cases call for special mention, as each raised a point of unusual interest. The first case was heard at the County of London Sessions on July 12th, before Mr. Robert Wallace, K.C. and the other Justices. It was an appeal against a decision of Mr. Plowden, who found that the combined drain at 74 Nos. 11 and 13, Birchington Road was defective and a nuisance, and made an order on the appellant to abate the nuisance. Mr. H. Courthope Munroe, who appeared for the Council, stated that the facts, about which there was no dispute, were as follows:—In July, 1878, two applications, accompanied by plans, were made by Mr. Yerburgh, a builder, to the Vestry of St. John, Hampstead, to drain, at his own expense, and in accordance with the regulations of the Vestry, two groups of six houses each in Birchington Road. The first application related to six houses that were shown to drain by a combined operation into the brick sewer in Mutrix Road, which runs at right angles to Birchington Road ; the second related to six houses that were shown to drain similarly into the brick sewer crossing Birchington Road. The Surveyor to the Vestry reported on these two applications, and stated that although the rule was to drain each house separately and directly into the sewer, an exception could in the present case be made with advantage because the proposed system excluded all drains from the interior of houses, and at the same time did not lessen their efficiency. The Vestry accordingly made their order by passing a resolution that the Surveyor's report be approved and adopted. The first application, as has been said, showed six houses in Birchington Road, draining by a combined drain into the sewer in Mutrix Road, but it appeared that in carrying out the work, only two of these houses, namely Nos. 11 and 13, the houses concerned in this case, were drained in this way and that the remaining four houses had been drained in the opposite direction into the main line of sewer crossing Birchington Road. Mr. Munroe contended that the test to be applied in matters of this kind was this: Had the work which was in fact done, as distinguished from that which was authorised, thrown any additional burden of drainage upon the pipe in question ? If not, then the pipe remained a drain and not a sewer. Mr. Poley, who appeared for the appellant, contended that the fact that only two houses drained into the sewer in Mutrix Road, whereas the plan, as sanctioned, showed that six houses should so drain, constituted a material deviation from the order of the Vestry, and therefore that the pipe in question was a sewer, although he admitted that the pipe had no added burden of sewage to carry in consequence of this deviation, but that, on the contrary, it had a less burden to carry than it would have had if the order had been strictly complied with. 75 The learned Chairman, in giving judgment, said that the order of the Vestry, so far as it concerned the first two houses in question had been complied with, and therefore the pipe was a drain and not a sewer. If the remaining houses had never been built it could not be contended that the pipe thereby became a sewer, and the position in this case was exactly similar. He agreed that the true test was that suggested by Mr. Munroe,viz: that in the absence of any increase in the burden of sewage on the pipe it became and remained a drain and not a sewer. The appeal was, therefore, dismissed with costs the learned Chairman refusing to state a case for the High Court. The second combined drainage case in which the Council was concerned in 1907 was heard at the Hampstead Petty Sessions on December 4th. In this case the Council made a complaint against the owners of the stables in the rear of Lested Lodge, and forming a part of Weatherall Stables, Christ Church Road, for allowing the drains of the stable to be in a defective condition. The defendants admitted the defects, but alleged that the pipe in question was not a drain but a sewer for which the Council was responsible. When Weatherall Stables (of which the premises formed a part) were originally built and drained, they undoubtedly formed one house structurally, and were in one occupation. Some years later various internal alterations were carried out, and the stables were divided into two by the blocking up of an internal door, and they then were separately occupied and in different ownerships. The pipe that drained the portion of the stables in question carried also the drainage of the remaining portion of the stables, and the defendants contended that these portions were separate buildings, and that the pipe was a sewer as defined by the Metropolis Local Management Act, 1855. It was contended by Mr. Turner on behalf of the Council that the whole of Weatherall Stables formed one building only, and the cases of Humphrey v. Young and Hedley v. Webb were quoted in support of this view. The Justices decided in favour of the Council, and made an order on the defendants to abate the nuisance. This case was not taken to a higher Court. In June, 1907, a letter was received from the Middle Classes Defence Organisation, in which objections were raised to the bye. laws of the London County Council that require the deposit of plans and descriptions of sanitary work with the sanitary authority. From 76 this letter it appeared that the Organisation wished to alter bye. law (2), which relates to the re.drainage of existing premises, in such a way as to provide that two days' notice of intention to begin drainage work should be accepted in lieu of the fifteen days' notice now required; and also that the deposit of plans relating to drains or pipes above ground should not be required. This letter was referred to the Public Health Committee, who reported on the matter to the Council. The following is an extract from this report:— The present bye.law provides that at least 15 days before drainage work is begun, plans and written descriptions of the work shall be deposited with the Sanitary Authority. But it is also provided that in cases of urgency the work can be begun at once if an urgency notice is sent to the Sanitary Authority. This is clearly set out in Bye.law 3, which is in the following terms:— ALTERATIONS OF DRAINS IN CASES OF URGENCY. (1) "In any case in which an alteration of the drains must be carried out at once, every person who is about to carry out such alteration shall, in lieu of depositing the plans, sections, and particulars referred to in these bye.laws, forthwith send to the Sanitary Authority of the district a notice in writing of any such proposed alteration." (2) "He shall also within two weeks of the commencement of such alteration make the deposits required by these bye.laws." It would obviously be contrary to the interests of the public health to delay important sanitary work (such for instance as the repair of a defective drain running under a house, and of a defective internal soil.pipe which is freely discharging foul air into a house) for 15 days. In urgent cases it is of great importance that the work should be begun, not after two days notice, as is suggested by the Middle Classes Defence Organisation, but at once. Under the existing bye.law this can be done, and as a matter of fact most of the redrainage work in Hamp. stead is carried out immediately after an urgency notice has been filled in. In 1906, out of 578 cases where plans were deposited, 389 were cases where the work was done at once 77 under urgency notices. It is a common occurrence for the drainage sub.committee to find that the plans submitted to them for approval are plans of works that have not only been begun, but completed. Most redrainage work is urgent and should, therefore, be carried out as quickly as possible. When, however, the work is not urgent it is important that the plans, etc., should be received not less than 15 days before the work is put in hand. This provision ensures that such work shall not be begun until it has received the approval of the Health Committee, which meets once a fortnight. If it were not for this provision the approval of practically all the drainage work in the Borough would pass from the Committee to the Officers, and this, we apprehend, would hardly be in accordance with the wishes of the Middle Classes Defence Organisation. With regard to the second suggestion we would point out that it is important that the Sanitary Authority should be in possession of drawings showing the positions of soil.pipes, waste.pipes, etc. The position of the open end of a soil.pipe in relation to the nearest windows is a matter which receives special attention from the drainage sub.committee. If no plans were submitted the committee would be obliged to rely entirely for their information upon the reports of the officers. At the present time plans of all drainage works are brought before the sub.committee which has been specially appointed to examine such plans, and each plan is separately considered by the committee. Moreover the plans are required in order that the sanitary inspectors may exercise a proper supervision over the work, and also that a permanent record of the work may be in possession of the Council, and to this permanent record we attach the greatest possible importance. Owing to the failure to preserve such records in the past the ratepayers of London have been compelled to pay large sums for the repair of combined drains. We would point out that many combined drainage cases have been decided by the position of a rainwater pipe, and that a rainwater pipe in certain circumstances has been held to be a sewer. The expense of preparing the plans required by the Sanitary Authority has been largely exaggerated. It is the 78 practice of some architects to send in elaborate and expensive plans, but this is quite unnecessary and is not required by the Bye.laws. Most of the plans submitted to the drainage subcommittee are very simple and inexpensive drawings. The plans submitted by one builder who does a considerable amount of drainage work in Hampstead are prepared by one of his labourers. It has never been the general practice to insist upon the deposit of plans where nothing is contemplated but the fixing of a new apparatus to replace an old one, but only where the work involves a new pipe or drain. We have given the whole question our careful consideration and we are strongly of opinion that it would be inadvisable in the public interest to alter the Bye.laws in the manner suggested by the Middle Classes Defence Organisation. This report was adopted by the Council on July 18th, 1907. Housing. In May, 1907, I was instructed by the Housing Committee to prepare some tables setting out the chief vital statistics of two areas, one the Netherwood Street area in the Kilburn Ward, the other the Kilburn Vale area in the Priory Ward. The appended tables were prepared, which give, for the years 1902.6, the general death.rate, the phthisis death.rate, and the infantile mortality for each area, and for the respective wards, the Borough of Hampstead, and the County of London. The Netherwood Street area comprises Netherwood Street, Palmerston Road, Kelson Street, Linstead Street and Lowfield Road. The Kilburn Vale area comprises Kilburn Vale, Munden Cottages, William Terrace, Providence Place, King's Cottages, Edward Terrace, and portions of Abbey Lane and West End Lane. The chief mortality rates relating to these two areas are given in the following tables:— 79 Netherwood Street Area. Population of Area, Census 1901, 3,049 persons. Year. NETHERWOOD ST. AREA. KILBURN WARD. THE BOROUGH. COUNTY OF LONDON. Death Rate. Infantile Mortality. Phthisis Death Rate. Death Rate. Infantile Mortality. Phthisis Death Rate. Death Rate. Infantile Mortality. Phthisis Death Rate. Death Rate. Infantile Mortality. Phthisis Death Rate. 1902 22·3 169·0 1·64 14·5 103·4 1·05 10·7 87·7 0·87 17·2 139 1·60 1903 14·8 98·4 1·97 11·9 93·5 1·17 9·8 86·7 0·77 15·2 130 1·55 1904 22·0 205·9 3·28 13·2 132·3 1·41 10·3 111·4 0·84 16·1 144 1·62 1905 15·1 112·0 3·28 10·8 117·4 1·65 9·3 93·6 0·83 15·1 129 1·42 1906 19·3 124·0 1·64 12·3 92·0 0·94 9·5 77·2 0·64 15·1 131 1·44 1902-6 18·7 139·5 2·36 12·5 112·7 1·25 9·9 91·3 0·79 15·7 135 1·53 80 Kilburn Vale Area. Population of Area at a special census taken May, 1903, 360 persons. Year. KILBURN VALE AREA. PRIORY WARD. the borough. COUNTY OF LONDON. Death Rate. Infantile Mortality. Phthisis Death Rate. Death Rate. Infantile Mortality. Phthisis Death Rate. Death Rate. Infantile Mortality. Phthisis Death Rate. Death Rate. Infantile Mortality. Phthisis Death Rate. 1902 22·2 300·0 2·78 10·5 98·7 0·65 10·7 87·7 0·87 17·2 139 1·60 1903 16·7 200·0 - 10·5 108·2 0·46 9·8 86·7 0·77 15·2 130 1·55 1904 19·4 111·1 2·78 11·0 85·5 0·82 10·3 111·4 0·84 16·1 144 1·62 1905 27·8 363·6 — 9·3 105·3 0·63 9·3 93·6 0·83 15·1 129 1·42 1906 13·9 222·2 2·78 8·4 60·0 0·72 9·5 77·2 0·64 151 131 1·44 1902-6 20·0 240·7 1·67 9·9 92·3 0·66 9·9 91·3 0·79 15·7 135 1·53 81 The tables and the condition of the areas generally, were considered by the Housing Committee, and subsequently at a joint meeting of that Committee and the Health Committee. It was decided that the best way of dealing with the Netherwood Street area, was to add to the number of houses in the area that are on the register of houses let in lodgings, and to enforce the bye-laws relating to registered houses. As to the Kilburn Vale area, it was thought that further steps might with advantage be taken. This area has already been the subject of much discussion. On June 8th, 1903, Dr. Herbert Littlejohn, who was then Medical Officer of Health, represented the area to the London County Council, under section 4 of the Housing of the Working Classes Act, 1890. Dr. Littlejohn's representation was to the effect that "the generally bad arrangement of the houses and groups of houses, the want of light, air, ventilation, proper conveniences, and the closeness and bad arrangement of such houses and groups of houses are dangerous or injurious to the health of the inhabitants of the buildings in the area"; and he expressed the opinion that these evils could not be effectually remedied otherwise than by an improvement scheme. This representation was considered by the London County Council, who, on November 10th, 1903, resolved "That the case of the houses and courts comprised in the Kilburn Vale area, in relation to which the Medical Officer of Health of the Metropolitan Borough of Hampstead has made an official representation, dated June 8th, 1903, under Part I. of the Housing of the Working Classes Act, 1890, is not of general importance to the County of London, and should be dealt with under Part II. of the Act." The matter was further discussed by the Borough Council, who on March 16th, 1905, passed the following resolution:—"That the London County Council be approached with a view of ascertaining whether in the event of this Council's dealing with the area in question, they would be willing to contribute towards the cost of a scheme under Part II. of the Housing of the Working Classes Act, 1890." On April 27th, 1905, the County Council replied declining to make any contribution. Since that time no further effort was made by the Council to deal with the area by means of a scheme, G 82 but certain individual houses were improved under the provisions of the Public Health Act, and two of the worst were demolished. The above facts were reported to the Joint Public Health and Housing Committee at their meeting on May 28th, 1907, and it was decided that a sub.committee consisting of three members from each committee should view the Kilburn Vale area. The subcommittee made their inspection on June 3rd, and their report was considered by the Joint Committee on July 9th. Following the lines of the sub.committee's report the Joint Committee reported to the Council on July 18th, stating— (a) That the Joint Committee have had under their careful consideration the question of the sanitary condition of that portion of the Borough known as the "Kilburn Vale Area." (b) That they have viewed the area in question and instructed the Medical Officer of Health to make a systematic house. to.house inspection of the premises therein. (c) That the Medical Officer of Health has reported that the sanitary condition of all the premises has been investigated, the drains tested, and the number of persons inhabiting each house ascertained; that the total number of premises in the area is 66, and of persons 318. (d) That the condition of the area has improved since it was reported to the London County Council in 1903, but that it is generally in a very unsatisfactory condition; that probably the most effective method of dealing with it would be by means of a scheme under the Housing of the Working Classes Act, but that such a scheme would be costly. The Committee therefore recommended— That the defective premises be dealt with individually by means of notices under the Public Health (London) Act, 1891, and that the Medical Officer of Health be instructed accordingly. The Committee's recommendation was adopted by the Council, and steps were at once taken to improve the houses on the area. 83 Notices were served under the Public Health Act specifying certain alterations, and a substantial improvement in the area has already been secured. One house has been demolished and rebuilt from the foundations by the owner, and the owner of 4 of the worst houses in the area is carrying into effect a scheme for demolishing those houses and replacing them by proper dwellings. Several houses have been extensively renovated, and others are now being dealt with on similar lines. As to the Netherwood Street area, it was decided to increase the number of houses registered as houses let in lodgings, and accordingly 63 houses were added to the register during the year. With the present staff, however, it is not possible to exercise a really effective supervision over the tenement houses, and it is to be feared that without an increase of staff the area will not be substantially improved. Houses Let in Lodgings. The number of houses registered as houses let in lodgings at the end of 1907, was 315 as against 239 in 190G. The registered houses are situated chiefly in the following streets :— Fleet Road. Dunboyne Street. Fairfax Mews. Bolton Road. Netherwood Street. Linstead Street. Lowfield Road. Kelson Street. The condition of these houses has improved since they have been placed upon the register, but the beneficial effect of registration will not be secured until the houses are more frequently inspected, and this will not be practicable without an increase in the sanitary staff. The number of tenement houses in Hampstead that need to be dealt with under the bye-laws relating to houses let in lodgings is over 800, but unless these houses can be periodically inspected, nothing is gained by placing them on the register. The " Living -in " System. During the year several cases of scarlet fever occurred among a number of shop assistants who were employed on the "living-in" system. An inspection was consequently made of the premises in G 2 84 which these assistants were housed, and so many defects were discovered that it seemed desirable to carry out a systematic inspection of all similar premises in Hampstead. It is questionable whether there is any legal power for the Council or any other authority to insist on the inspection of premises that are used for the purpose of affording living and sleeping accommodation for shop assistants who are "living.in." It has been suggested that such premises are registrable under Section 94 of the Public Health (London) Act, 1891, as "houses let in lodgings or occupied by members of more than one family," and can therefore be brought within the operation of the Bye.laws relating to registered houses. This would give the sanitary authority power to inspect. The point has never been raised in the Courts, but the opinion of the legal advisers of the Local Government Board is that such premises are not registrable. But in spite of the absence of legal powers it was found possible for the workshop inspectors, Mrs. Fisher and Mr. Hudson to make a fairly thorough inspection of the "living-in" premises in Hampstead last year. The employers for the most part voluntarily admitted the inspectors to the premises, but not infrequently a second call had to be made before the inspection could be carried out. The number of firms whose premises were inspected was 44, and the number of houses in which "living-in" accommodation was provided was 103. The number of sleeping rooms was 280. The assistants living in these premises numbered 612, of which 213 were males and 399 females. It is very exceptional for the assistants to have separate bedrooms, and no less that 62 female assistants slept two in a bed. The lack of privacy that these arrangements entail is objectionable, and there is reason to think that it is distasteful to the assistants themselves. Speaking generally it may be said the sanitary condition of many of the premises was found to be fairly satisfactory, but it must not be forgotten that in many cases the occupiers were prepared for the inspection, because the inspector at the first visit had been refused admittance. In a considerable number of instances, however, the visit of the sanitary inspector was needed, and the results of the inspection generally have shown that "living-in" premises should be subject to systematic supervision by the authorities responsible for the public health. 85 Insanitary or Uninhabitable Dwellings. The following is a list of dwellings that were found, during the year, to be so insanitary that extensive structural alterations were necessary to make them fit for human habitation. Most of the premises were, as was the case in former years, stable dwellings. One of the houses in the following list was closed over two years ago by a closing order, and it was not until the end of last year that the owner could be induced to carry out the necessary work. 1, 2, 11, Abbey Lane. 12, Albert Mews. 12b, 16, 17, Alexandra Mews. 2, 3, Burdett's Yard. 25, 27, Canfield Place. 28, 35, 41, Fairfax Mews. 3, Fairfax Yard. 3, Flask Cottages. 1, King's College Mews West. 1, Ravenshaw Street. 12, West Hampstead Mews. 4, Williams Mews. Customs and Inland Revenue Acts. These Acts provide that the owners of premises that are let in dwellings of a certain class may claim exemption or abatement from inhabited house duty on producing a certificate from the Medical Officer of Health that the dwellings afford proper sanitary accommodation for the occupants. During the year applications for certificates under these Acts were received in respect of 100 dwellings, this number being 8 more than the number for which applications were made in 1906. Upon receipt of an application for a certificate a detailed sanitary survey is made of the premises, and should any of the dwellings fail to reach the required standard of sanitation, a list of requirements is drawn up and sent to the owner, and the certificate is only granted when these requirements are fulfilled. In every case the drains are required to stand the water test, and all gas stoves must be well ventilated into the open air by means of a properly 86 constructed hood and shaft. The inspections necessitated by these applications throw a good deal of work upon the staff of the Health Department, but the improvements obtained are valuable. The Acts afford the means whereby the Council are able to secure a standard of wholesomeness in certain dwellings that could not be obtained in any other way. In 1907 the number of dwellings certified was 12, as compared with 71 in 1906. The following is a list of the dwellings certified, with the date of the certificate. Premises. No. of Dwellings. Date of Certificate. 1907. 1, 2, Holmdale Mansions, Holmdale Road 2 25th April. 1, Kenmare Mansions, Gondar Gardens 1 4th May. 4, 5, South Mansions, Gondar Gardens 2 4th May. 3, 5, 6, 7, 8, Holmdale Mansions, Holmdale Road 5 7th May. 6, Kenmare Mansions, Gondar Gardens 1 30th July. 6, Soutn Mansions, Gondar dens 1 30th July. Underground Rooms. Nine underground rooms were found to be illegally occupied during 1907, the streets in which the rooms were found being as follows:— West End Lane Finchley Road Heath Street Willow Terrace Netherwood Street Two of these rooms were closed, four were altered to fulfil the requirements of the Public Health Act relating to underground rooms, and three became the subject of legal proceedings which have been taken to the High Court for a decision. Seven of the 87 underground rooms were occupied by the caretakers of flats. As was stated in my last annual report it is unfortunately by no means uncommon to find the caretakers of flat dwellings illegally put into occupation of underground rooms. When the flats are constructed, these rooms are stated to be intended as store rooms, but subsequently a caretaker is found in occupation. The Removal of Dust Chutes. Considerable progress was made during 1907 in the removal of dust chutes in flat dwellings. These structures are a constant source of nuisance, and a large number has been abolished in Hampstead in the last few years. There are many unsatisfactory ways of dealing with house refuse, but the practice of casting it down an evil.smelling brick shaft into a still more offensive receptacle below is probably one of the worst. Eleven blocks of flats were dealt with during the year, and 18 brick dust chutes were removed and 27 sanitary dust bins supplied in their stead. Complaints as to Sewer Ventilators. During the year, 60 complaints of smells from surface ventilators were received, as compared with 86 in 1906. This number does not include those complaints which were sent direct to the Borough Engineer. Copies of these 60 complaints were sent to the Borough Engineer. During the year Webb's Patent Sewer Gas Destructor Lamps were fixed in the following situations :— Branch Hill, opposite Lower Terrace. Broadhurst Gardens, by Canfield Gardens. Cannon Place, by Christ Church. Frognal Lane, opposite Road to Hall Oak. Sumatra Road, opposite No. 80. Public Mortuary. During the year the bodies of 84 persons were brought to the Mortuary as against 87 last year—38 by older of the Coroner, 19 by the Police, and 27 at the request of friends of the deceased persons. 88 In 57 instances, or 68 per cent. of the bodies admitted, inquests were held, and in 38 instances, or 45 per cent., post-mortem examinations were made. The following table indicates the causes of death of the persons whose bodies were received into the Mortuary:— Cause of Death or Verdict. Number of Bodies received. Deaths from natural causes 50 Accidental deaths 12 Suicide 13 Felo-de-se 2 Neglect at birth 3 Misadventure 3 Total 83 One of the bodies received at the Mortuary was that of a stillborn child. 89 MORTUARY RECORD FOR THE YEAR, 1907. Bodies Admitted No. of Post-Mortems. No. of Inquests. No. of Funerals from Mortuary. Month. Males. Females. Totals. Males. Females. Totals. January 5 4 9 3 1 4 6 9 February 2 4 6 1 3 4 5 5 March 4 3 7 3 1 4 5 6 April 4 — 4 3 — 3 3 4 May 5 8 13 4 2 6 7 7 June 1 1 2 1 1 2 2 2 July 2 4 6 1 — 1 3 5 August 3 1 4 — — — 3 4 September 8 1 9 2 1 3 7 8 October 4 6 10 1 4 5 8 7 November 6 2 8 3 1 4 6 8 December 3 3 6 — 2 2 2 6 Totals 47 37 84 22 16 38 57 71 90 Food Inspection. No seizures of unsound and diseased food were made during the year, but the following articles were voluntarily surrendered to the inspectors. In no case had any attempt been made to sell the food. Date Premises. Food seized or surrended 1907. Jan. 11th Finchley Road ½ bushel Pears. March 20th West End Lane ½ bushel Apples. April 27th Cricklewood Broadway 2 hind quarters Pork. May 29th Kelson Street 4 lbs. Bananas. June 14th Fortune Green Road 2 lbs. Cherries. July 17th Netherwood Street 4 lbs. Cherries. Sept. 7th Cricklewood Broadway 1 box Mackerel (60 lbs.) Oct. 25th Finchley Road 22 lbs. Apples. Nov. 6th do. 15 tins Potted Fish. Nov. 7th Broadhurst Gardens 1 Duck. Nov. 20th High Road, Kilburn 1 trunk Skate (about 1 cwt.) Slaughter Houses. There are five slaughter houses in the Borough, and these have been regularly inspected during the year, the number of inspections made being 117. On the 8th October, the annual inspection by the Public Health Committee was made, in view of the approach of the licensing session, as a result of which it was decided that no opposition should be offered to any of the licenses. The following is a list of the existing slaughter houses in the Borough:— 40, England's Lane; 17, High Street; 69, High Street; 242, Belsize Road; 6, Fairfax Mews. Milk Supply. The number of persons in Hampstead registered as purveyors of milk is 93, and the number of premises on which milk is sold is 114. 91 The difference in the two numbers is accounted for by the fact that some of the milk sellers occupy more than one shop. The premises on which milk is sold are as follows:— Dairies 54 Bakehouses and Confectioners 25 Restaurants and Coffee Shops 11 General Shops 24 Two of the registered milk sellers do not occupy shops, one sells milk from a refreshment tent on Hampstead Heath on Bank Holidays, while the other has a milk round, but no shop. Three milk purveyors were prosecuted and fined for selling milk without being registered, and one was fined two pounds and costs for selling milk in dirty glasses. The latter was an itinerant trader selling milk on the Heath, and the other three defendants were non-resident traders. During the year 421 inspections were made of premises where milk is sold, and the following sanitary works were carried out at the request of the Inspector. Premises or parts of premises repaired, cleansed and lime washed 13 Lumber and refuse removed from premises 2 Water supply disconnected from cistern and connected direct to main pipe 3 Water cisterns cleansed 4 Water cisterns covered 1 Improperly placed cisterns removed 1 Drains reconstructed or repaired and ventilated 4 Soil pipes reconstructed 4 Water closets repaired or renewed 5 Water closets cleansed 5 Rain water pipes repaired or renewed 3 New sinks provided 1 Waste pipes to sinks repaired or renewed and trapped 6 Yard and wash-house paving repaired or renewed 9 Dustbins provided 4 Cool rooms built for storing milk 1 92 Particulars as to milk adulteration will be found in the section relating to the Sale of Food and Drugs Acts. During the year 1907, public interest in the question of the milk supply was stimulated by the issue of the second interim report of the Royal Commission on Tuberculosis, which appeared in February. This Commission was appointed largely in consequence of a remarkable statement by Professor Koch at the Tuberculosis Congress in 1901. This statement was to the effect that the danger arising from the consumption of tuberculous milk is so slight that it is not worth while to take steps to guard against it. The Royal Commission after a prolonged and careful study of the subject have arrived at a very different opinion. Their conclusions are as follows :— There can be no doubt but that in a certain number of cases the tuberculosis occurring in the human subject, especially in children, is the direct result of the introduction into the human body of the bacillus of bovine tuberculosis ; and there also can be no doubt that in the majority at least of these cases the bacillus is introduced through cows' milk. Cows' milk containing bovine tubercle bacilli is clearly a cause of tuberculosis and of fatal tuberculosis in man. A very considerable amount of disease and loss of life, especially among the young, must be attributed to the consumption of cows' milk containing tubercle bacilli. The presence of tubercle bacilli in cows' milk can be detected, though with some difficulty, if the proper means be adopted, and such milk ought never to be used as food. There is far less difficulty in recognising clinically that a cow is distinctly suffering from tuberculosis, in which case she may be yielding tuberculous milk. The milk coming from such a cow ought not to form part of human food, and indeed ought not to be used as food at all. Our results clearly point to the necessity of measures more stringent than those at present enforced, being taken to prevent the sale or the consumption of such milk. In view of the report of the Royal Commission, the Public Health Committee decided to ascertain how far the milk supply of Hampstead was tuberculous, and 25 samples of milk were taken 93 during the year and submitted to the Lister Institute of Preventive Medicine for bacteriological examination. There are no cowsheds or cows in Hampstead, consequently the whole of the milk sampled came into the borough from outside. 14 samples were taken on arrival at railway stations in Hampstead, 6 on delivery at three important hospitals, 2 on arrival at dairies, and 3 from the barrows of milk vendors. Of the 25 samples taken, 4 or 16 per cent. were found to contain virulent tubercle bacilli. One of the tuberculous samples was taken from a churn which was delivered to one of the Hampstead hospitals, and another was from the supply of a firm of repute, which in its numerous advertisements claims to observe strict precautions against contamination. When I received the report on the first sample of milk that contained tubercle bacilli, the London County Council (General Powers) Act, 1907, was not in force, and no London Authority could take any legal action to stop the supply of this milk. But I at once communicated with the Medical Officer of Health of the district in Oxfordshire from which the milk came. The reports relating to the other three tuberculous samples reached me after the Act had become law, and I at once communicated the facts to the Medical Officer of Health of the County of London, who is empowered by the Act to take certain steps to prevent tuberculous milk from entering the County. In view of the results obtained by the examination of the 25 samples taken last year, the Public Health Committee decided to take an additional 50 samples in the present year. These are now being taken, and so far the percentage of tuberculous samples is much the same as in the samples taken last year. Ice Cream. The sale of ice cream in London is controlled by sections 42 and 43 of the London County Council (General Powers) Act, 1902, which provides as follows :— Any person being a manufacturer of or merchant or dealer in ice creams or other similar commodity who within the County— (a) Causes or permits ice creams or any similar commodity to be manufactured sold or stored in any cellar shed or room in which there is any inlet or opening to a drain or which is used as a living room or sleeping room ; 94 (b) In the manufacture sale or storage of any such commodity does any act or thing likely to expose such commodity to infection or contamination or omits to take any proper precaution for the due protection of such commodity from infection or contamination; or (c) Omits on the outbreak of any infectious disease amongst the persons employed in his business or living or working in on or about the premises in or on any part of which any such commodity as aforesaid is manufactured sold or stored to give notice thereof forthwith to the Medical Officer of the Sanitary District in which such business is carried on or such premises are situate ; shall be liable for every such offence on conviction in a Court of Summary Jurisdiction to a penalty not exceeding Forty Shillings. Every itinerant vendor of any such commodity as aforesaid shall if not himself the manufacturer thereof exhibit in a legible manner on a conspicuous part of his barrow a notice stating the name and address of the person from whom he obtains such commodity and if such vendor is himself the manufacturer of such commodity he shall in the same manner exhibit his own name and address. Every such itinerant vendor who shall fail to comply with the provisions of this Section shall be liable for each offence on conviction as aforesaid to a penalty not exceeding Forty Shillings. There are 78 shops in the borough in which ice cream is sold, and 177 inspections at these premises were made during the year. In addition to these, the barrows which stand in the streets, and on Hampstead Heath on Bank Holidays have been inspected. Table of sanitary work carried out:— Premises or parts of premises cleansed and limewashed . 3 Lumber removed from premises 1 Covers provided to dustbins 2 Drains re.constructed 2 Soil pipes reconstructed 1 Paving repaired 2 Sink waste pipes renewed and trapped 1 Gutters repaired 1 Flushing cisterns to water closets repaired 1 Rain-water pipes repaired 2 95 Inspection of Premises where Pood is Prepared or Stored (other than Bakehouses, Milk Shops, Eating Houses, and Slaughter Houses). The premises inspected during the year, together with the nature of the business carried on, were as follows:— Butchers and Pork Butchers 64 Confectioners 64 Grocers 77 Provision and Cheesemongers 46 Greengrocers and Fruiterers 70 Fishmongers 27 Fried Fish Shops 9 General Shops 23 380 586 Inspections were made of these premises during the year, and 19 Notices were served. No prosecutions were instituted. Sale of Food and Drugs Acts. The number of samples taken for analysis under the Sale of Food and Drugs Acts during the year was 407. The number certified by the Public Analyst to be adulterated was 36, or 8.8 per cent. of the total number. The corresponding percentage in 1906 was 4.8; in 1905 it was 1.9. 340 samples were purchased from Hampstead tradesmen, and 67 from persons residing without, but trading within the Borough. The percentages of adulterated samples in these two classes were 7.1 and 17.9 respectively. 22 samples were taken on Hampstead Heath on Bank Holidays, and of these 8, or 36 per cent., were adulterated. 31 samples were taken on Sundays, and one of this number was found to be adulterated. The following table shows the articles of which samples were taken during the year, and the number found to be adulterated or of low quality :— 96 Article. No. Taken. Adulterated. Low Quality. Black Pudding 1 — — Bread 2 — — Butter 45 1 — Camphorated Oil 4 — — Cheese 10 — — Cocoa 4 — — Coffee 8 — — Cream 6 4 — Flour 3 — — Glycerine 2 — — Iodine, Liniment of 2 — — Lard 8 — — Margarine 1 — — Milk 274 21 6 Mustard 1 — — Paregoric 2 — — Paregoric Drops 2 — — Pepper 1 — — Pork Pies 6 5 — Sausages, Pork 3 1 — Sausages, Beef 4 2 — Saveloys 2 2 — Sulphur, Flowers of 2 — — Sulphur, Milk of 2 — — Sweets 2 — — Tartar, Cream of 4 — — Tartaric Acid 4 — — Tea 2 — — Totals 407 36 6 The following Table shows the number of samples analysed during each year, from 1901 to 1907, the number and percentage of the adulterated samples, and the fines and costs recovered in legal proceedings. Year. Samples analysed. Number adulterated. Percentage adulterated. Fines and costs. £ s. d. 1901 306 6 1·9 13 15 0 1902 315 15 4·7 42 7 6 1903 366 14 3·8 37 3 0 1904 406 8 1·9 35 8 6 1905 414 8 1·9 33 15 0 1906 413 20 4·8 50 8 6 1907 407 36 8·8 49 18 6 97 This table shows that the percentage of adulterated samples was much higher in 1907 than in previous years. The increase in the number of milk samples from 200 in 1906 to 274 in 1907 partly accounts for this fact, because milk is a food which is specially subject to adulteration. In the case of 14 samples other than milk the adulteration consisted of the addition of a preservative—boric acid, which in 10 of these cases was present in such comparatively small amounts as to make it extremely unlikely that legal proceedings could be taken with any hope of success. It has not been the practice in previous years to take samples of this kind, and these facts should be borne in mind in considering the increase in the percentage of adulterated samples in 1907. The following table shows a comparison of the wards in the Borough in respect of the samples purchased from Hampstead tradesmen. Ward. Samples. analysed. Number adulterated Percentage adulterated. No. 1 (Town) 63 3 4·7 No. 2 (Belsize) 49 1 2·0 No. 3 (Adelaide) 17 — — No. 4 (Central) 20 3 15·0 No. 5 (West End) 73 6 8·2 No. 6 (Kilburn) 72 5 6·9 No. 7 (Priory) 46 6 13·0 Totals 340 24 7·1 Legal proceedings in respect of adulteration were instituted in 27 cases. Of these, 19 came before the court and convictions with penalties were obtained; in two cases the summons was dismissed, the defendants successfully raising the warranty defence. In two cases the summons could not be served owing to the disappearance of the defendant, two cases were adjourned pending a decision in the High Court, and two were withdrawn upon payment of costs. Of the two defendants who absconded, one was an itinerant vendor whose milk was sampled while he was selling milk on h 98 Hampstead Heath on August Bank Holiday. He gave a false name and address and could not be traced. This is unfortunately a not uncommon occurrence on such occasions, and there is need for further legal powers to deal with itinerent vendors who give false names and addresses. The other absconding defendant was engaged in the " country butter" fraud to which I adverted in my last annual report. For some time a London firm has been conducting a lucrative business in margarine, which they sell as country butter. The actual selling is done by agents who receive good salaries and whose fines are paid by their employers. One of these agents was convicted, in respect of a sample taken in Hampstead, at the Marylebone Police Court in 1906, and was fined £10. A sample was taken from another agent in 1907 and was found to be adulterated, but the man gave, as usual, a false name and address, and has so far eluded all the efforts that have been made to trace him. In this present state of the law, this kind of fraud is extremely difficult to deal with, and the profits from such trading are much too great for the traders to be deterred by fines of ten pounds or similar penalties. Six samples of cream were taken during the year and all were found to contain boric acid. In two cases the quantity of the preservative did not exceed that which the Departmental Committee on Food Preservatives recommended should be permitted in cream, and consequently no action was taken. In the four other cases this quantity was exceeded; in two cases the excess was slight and the vendors were cautioned, but in the remaining cases the quantity was equivalent to 29 grains per pound, and proceedings were instituted. The cases, however, were adjourned pending the decision of the High Court in some similar cases in which proceedings had been taken by another metropolitan borough. Samples were taken of the following articles of food: pork pies, pork sausages, beef sausages, saveloys and black pudding. The total number of samples was 16, and 10 were found to contain boric acid. In eight of these the quantity of preservative was small, but in two samples, one of which was a beef sausage, and one a saveloy, the quantities were equivalent to 191/2 and 213/4 grains per pound respectively. Proceedings were instituted in respect of these two 99 samples, but the cases were withdrawn on payment of two guineas costs; each vendor, at the same time, giving a written undertaking that he would abstain from the use of preservatives. One of the cases of milk adulteration calls for special mention. On September 7th I received private information that a certain milk carrier made a practice of adding to his milk every morning a quantity of water from the horse trough at the corner of Willow Road and Christ Church Road. On a subsequent morning two sanitary inspectors watched for this man, and at 7.40 a.m. they saw him wheel his barrow up Willow Road accompanied by a boy. Having passed the horse trough the boy took a two.quart can from the barrow and went back to the trough. After carefully looking round to see that the coast was clear, the boy plunged the can into the trough, filled it with water and then overtook the man near the corner of Gayton Crescent and Willow Road. The barrow was then pushed round Gayton Crescent as far as the bend, when the milkman stopped the barrow and emptied the can of water into the churn, and then proceeded to serve his customers. The inspectors, who were concealed during these operations, took two samples of the milk, one from the churn and one from a hand.can on the barrow, to which the water from the trough had not been added. The Public Analyst found that both samples were well above the legal standard of purity laid down in the Sale of Milk Regulations of the Board of Agriculture, but he also found that if he took the presumably genuine milk in the hand.can as a standard, the milk in the churn contained two per cent. of added water, and he made out his certificate on that basis. Proceedings were accordingly instituted and the defendant, who alleged that the water in the horse trough was clean and fit for the purpose for which he used it, was fined five pounds. The case well illustrates the inadequacy of the present law relating to adulteration. If it had not been for the fact that in this case, it was possible to take another sample of milk as a standard, a conviction could not have been secured, although the Inspectors actually witnessed a deliberate act of adulteration. In the present year the Council decided to increase the number of samples taken under the Food and Drugs Acts to 500. h 2 100 Complaints. During 1907, 931 complaints were made of the existence of insanitary conditions. A list of the matters of which complaint was made is given below :— Accumulations, offensive 6 ,, of garden and other refuse 21 Animals, keeping of 13 „ dead 3 Carpet beating 2 Dampness in premises 25 Dirty premises 19 Drains, bad condition of 26 ,, defective 30 ,, stopped 20 Dust, non-removal 88 Dust receptacles, foul or dilapidated 101 ,, absence of, or insufficient 26 ,, improperly placed 4 Gipsies 1 Insanitary condition of premises 25 Illness attributable to defective drains 12 Manure not removed 7 Overcrowded premises 18 Rats, nuisance from 7 Roadways, condition of 7 Roofs and gutters, defective 9 Rubbish, nuisance from burning 9 Smells 23 ,, on premises 19 ,, from road gullies 11 ,, „ sewer ventilators 60 ,, ,, stables 2 ,, „ drains, &c. 15 ,, ,, water closets 4 ,, ,, manure 6 Smoke nuisances 4 Urinals, condition of 7 Unsound food 2 Vacant land, insanitary state of 6 Verminous condition of premises 2 Water closets, accommodation insufficient or absence of 7 ,, defective or insanitary 19 „ stopped 3 without water 2 ,, „ proper flush 3 101 Water, absence of 1 „ cut off 258 ,, leakage of 6 Water cisterns, dirty, &c. 2 Yard paving defective 2 Miscellaneous 56 Total 999 Factory and Workshop Act, 1901. 105 Factory and Workshop Act, 1901. The following part of this report is made pursuant to section 132 of the Factory and Workshop Act, 1901, which provides that "The Medical Officer of Health of every District Council shall in his Annual Report to them, report specifically on the administration of this Act in workshops and workplaces, and he shall send a copy of his Annual Report, or so much of it as deals with this subject, to the Secretary of State." At the end of 1907 there were 504 workshops in Hampstead, including 39 domestic workshops.* Of these workshops 200 employ women only, 263 employ men only, and in 41 both men and women are employed. By far the most prevalent trade in these workshops is dressmaking; next in the order of frequency come bootmaking, baking, millinery, and tailoring, in the order named. The number of workplaces was 197, and there were 59 factories. The number of outworkers' premises was 75. The sanitary condition of all these premises is supervised by Mrs. Fisher and Inspector Hudson. A series of statistical tables has been framed by the Secretary of State" for the guidance and convenience of Medical Officers of Health in preparing that part of their Annual Report which relates to factories, workshops, workplaces, and home work." The tables will be found on pages 115-118. The following tables show the number of each class of workshops in each Ward of the Borough, the number of workrooms in the various workshops, and the number of persons of each sex employed therein:— * A "domestic workshop" is defined by section 115 of the Act to "mean a private house, room or place which, though used as a dwelling, is by reason of the work carried on there a workshop within the meaning of this Act, and in which neither steam, water, nor other mechanical power is used in aid of the manufacturing process carried on there, and in which the only persons employed are members of the same family dwelling there." 106 Workshops, Domestic Workshops, Workplaces, etc., in Wards. WARDS. Trade or Business No. 1 (Town) No. 2 (Belsize) No. 3 (Adelaide) No. 4 (Central) No. 5 (West End) No. 6 (Kilburn) No. 7 (Priory) Totals. Art metal workers - 1 - - - - - 1 Bakers 4 3 3 4 8 6 7 35 Blind makers 3 1 1 5 Bootmakers 12 15 6 2 12 23 12 82 Builders and carpenters 2 4 2 5 4 8 6 31 Cabinet makers and polishers 3 2 — 1 1 — — 7 Carriage builders 3 1 — 1 1 1 3 10 Cycle makers and repairers 1 2 2 1 2 2 1 11 Dressmakers and ladies tailors 28 15 12 18 30 58 28 189 Dyers and cleaners 1 1 2 Embroiderers 1 1 — 1 1 4 Engineers — 1 — 2 — — 1 4 Harness makers 2 – 3 1 1 — 1 8 Ironmongers 5 — 2 2 5 3 — 17 Lace makers and cleaners — — — 2 2 Laundries (Hand) 10 4 — 4 7 7 32 Mantlemakers — — — — 2 2 Milliners 7 3 5 7 4 7 6 39 Miscellaneous 5 5 2 5 4 10 7 38 Monumental masons — — — — 2 1 3 Motor manufacturers — 2 1 1 1 5 Needlewomen 2 — 1 2 2 7 Organ builders — — 1 1 Outfitters — — — 4 — 3 3 10 Pianoforte key makers 2 - - - - - 2 Pianoforte makers — 4 — — 4 Picture frame makers 3 1 1 3 2 — 3 13 Smiths 3 2 — 1 1 3 1 11 Stained glass workers 1 — — — — 1 — 2 Tailors 4 6 4 4 6 20 7 51 Trunk makers 1 1 Umbrella makers and repairers 1 - - - 1 1 1 4 Upholsterers 4 1 1 1 5 2 3 17 Watchmakers and jewellers 2 1 2 4 3 4 3 19 Wigmakers — - 1 3 2 - - 6 Totals 103 75 47 77 104 164 105 675 107 Workshops, Domestic Workshops, Workplaces, etc. Table showing Number of Businesses, Character of Workshops and Number of Persons employed. Trade or Business. No. of Premises. Workshops (other than Domestic Workshops). Number of Workrooms. No. of Employees. Domestic Workshops, Workplaces, etc. Males. Females Art metal workers 1 1 1 2 - - Bakers 35 35 47 128 1 Blind makers 5 4 7 12 9 1 Bootmakers 82 47 55 96 - 35 Builders and carpenters 31 28 32 48 - 3 Cabinet makers and polishers 7 5 5 7 - 2 Carriage builders 10 9 15 36 1 Cycle makers and repairers 11 9 13 25 2 Dressmakers and ladies' tailors 189 118 147 1 623 71 Dyers and cleaners 2 1 1 1 1 1 Embroiderers 4 3 3 10 1 Engineers 4 4 4 6 Harness makers 8 7 7 19 1 Ironmongers 17 16 16 29 1 Lacemakers and cleaners 2 1 1 2 1 Laundries (Hand) 32 6 20 3 43 26 Mantlemakers 2 1 2 13 1 Milliners 39 32 34 85 7 Miscellaneous 38 27 42 76 20 11 Monumental masons 3 3 3 17 Motor manufacturers 5 5 6 15 Needlewomen 7 7 Organ builders 1 1 1 4 - Outfitters 10 10 37 12 198 Pianoforte key makers 2 1 1 1 1 Pianoforte makers 4 4 7 32 Picture frame makers 13 12 15 21 1 Smiths 11 9 9 25 2 Stained glass workers 2 2 3 4 Tailors 51 29 33 64 26 22 Trunk makers 1 1 1 4 Umbrella makers and repairers 4 — — — 4 Upholsterers 17 12 20 29 7 5 Watchmakers and jewellers 19 17 19 35 2 Wigmakers 6 5 6 10 5 1 Totals 675 465 613 762 1043 210 Inspection of Workshops (other than Bakehouses). The number of workshop inspections in 1907 was 1,003. Cleanliness. 10 workrooms were found on inspection to require cleansing; seven of these were cleansed on the request of the Inspector, but in 108 three cases it was necessary to serve a notice before the work was carried out. Ventilation and Warming. The chief difficulty in regard to ventilation is not to secure the provision of a sufficient number of ventilating openings, but to induce the workers to keep the ventilators open. Considerable difficulty has been experienced in this respect, but in 1907, Mrs. Fisher was able to report some improvement, especially in the case of the younger women workers. Nine workshops were found to be warmed by gas stoves that were unprovided with flues to carry off the products of combustion. This is a contravention of section 6 of the Factory Act, in which it is laid down that the measures which in every factory and workshop " must be taken for securing and maintaining a reasonable temperature in each room in which any person is employed, . . . must not interfere with the purity of the air of any room in which any person is employed." In one case in which this defect was found, the use of the workroom was discontinued; in 7 other cases the warming arrangements were made satisfactory by the provision of fires or of gas stoves fitted with proper flues; the remaining case is being dealt with by H.M. Inspector. Overcrowding. All the workrooms in the workshops are measured by the inspectors and the cubic space in each room is ascertained. The maximum number of workers that can legally occupy the room is then calculated and this information set out on a card, supplied by the Council, which is hung up in each room. The number of legal occupants varies according as overtime is worked, or whether the room is used as a sleeping-room as well as a work-room. During 1907, 66 new work-rooms were measured. Overcrowding was found in 7 instances. In 4 cases, the overcrowding was abated immediately on the request of the Inspector, but in 3 cases this was not done until a written notice had been served. Abstract of the Act. Section 128 of the Factory Act provides that an Abstract of the Act " shall be affixed at the entrance of every factory and work-shop, 109 and in such other parts thereof" as the factory inspector may direct, and section 133 of the Act provides that " when any woman, young person, or child is employed in a workshop in which no abstract of this Act is affixed as by this Act required, and the Medical Officer of Health of the District Council becomes aware thereof, he shall forthwith give written notice thereof to the Inspector for the district." Pursuant to this section 40 workshops and one factory were notified to H.M. Inspector of Factories. Illegal Hours of Labour. The prevention of illegal overtime is not dealt with by the Health Department, but by the Factory Inspectors. Occasionally, however, complaints of this kind are brought to notice, and are communicated to the Factory Inspectors. A bad case occurred at the end of the year. On Christmas Eve, Mrs. Fisher was informed that the female assistants in the employ of a florist in South Hampstead, had been at work on the previous Sunday from 8 a.m. till midnight, not having a full hour for dinner or any time for tea. She was also informed that they had started work on the Monday, December 23rd, at 8 a.m., had worked all that day and through the night and the next day, December 24th, and that they were expecting to work all day on Christmas Day. Mrs. Fisher immediately reported the matter to the Factory Inspector, who subsequently instituted legal proceedings against the employers. The case was heard at the Marylebone Police Court before Mr. Paul Taylor, and it was proved that the assistants worked from 8 a.m. on December 23rd to 10 p.m. on December 24th, a period of 38 hours. For the defence it was urged that although the hours were long the work was pleasant, but the Magistrate remarked that it was a bad case and that such employment must be strenuously put down, and he fined the defendants six pounds with sixteen shillings costs. Bakehouses. At the end of 1907 there were 37 Bakehouses on the Register, 22 being underground, and 15 over ground. No Bakehouse was closed. The Bakehouses have been kept under constant supervision during the year, and 170 inspections were made. Four notices were 110 served during the year, but it was not found necessary to take legal proceedings to obtain compliance with them. The usual cleansing has been duly carried out twice in the year, and any defects found have been remedied. The following is a list of the Bakehouses on the Register at the end of the year:— Bakehouses in Wards. Those marked * are underground bakehouses. Those marked t are factory bakehouses. No. 1 (Town) Ward— 57, Heath Street. 3, High Street. 67, do. 19, New End. (4) No. 2 (Belsize) Ward. 6, Fleet Road. *65, do. 2, Heathhurst Road. (3) No. 3 (Adelaide) Ward— *44, England's Lane. *90, Haverstock Hill. *2, King's College Road. (3; No. 4 (Central) Ward— *10, Belsize Park Terrace. *225, Finchley Road. *289, do. +307, do. *98, West End Lane. (5) No. 5 (West End) Ward— 160, Cricklewood Broadway. 110, do. do. 553, Finchley Road. Field Lane School, Hillfield Road. *43, Mill Lane. 44, do. 4, Munro Terrace, Fortune Green. 251, West End Lane. *279, do. (9) No. 6 (Kilburn) Ward— *63, Hemstal Road. *94, High Road, Kilburn. *354, do. *4, Kelson Street. 67, Kingsgate Road. *99, Palmerston Road. (6) No. 7 (Priory) Ward— *202, Belsize Road. *228, do. *98, Boundary Road. *55, Fairfax Road. *93, do. *7, Fairhazel Gardens. *137, Finchley Road. (7) Bakehouses—Underground 22 „ Above ground 15 Total 37 111 Workplaces. This term is not defined in the Factory Act, nor in the Public Health Act, and it is sometimes exceedingly difficult to decide whether certain premises are or are not " workplaces." Among the more important workplaces are the kitchens of restaurants, coffeehouses, etc., and the number of these places in Hampstead in 1906 was 48. During 1907, two premises were removed from the register of kitchens, and 13 were added, leaving a total number of 58 on the register at the end of the year. These premises are kept under regular supervision by Inspector Hudson. The following is a list of the restaurant kitchens in the various wards of the Borough :— Restaurant Kitchens in Wards. No. 1 (Town) Ward— Jack Straw's Castle, Hampstead Heath. 37, Heath Street. 63 & 65, do. 70, do. 100, do. 106, do. 109, do. 3, High Street. 67, do. Bull & Bush, North End. (10) No. 2 (Belsize) Ward— 2, Elm Terrace, Constantine Road. 2, Fleet Road. 25, do. 98, do. 106, do. 210, Haverstock Hill. 2, Heathhurst Road. 11, South End Road. 17, do. (9) No. 3 (Adelaide) Ward— I, Adelaide Road. 143, do. 97, Haverstock Hill. II, King's College Road. WinchesterHotel, Winchester Road. (5) No. 4 (Central) Ward— 14, Belsize Park Terrace. 17, do. 159, Broadhurst Gardens. 1, Canfield Place. 104, Finchley Road. 225, do. 289, Finchley Road. 100, West End Lane. 280, do. 1, Central Parade, do. (10) 112 Restaurant Kitchens in Wards—continued. No. 5 (West End) Ward— 106, Cricklewood Broadway. 92, Fortune Green Road. 10G, Mill Lane, West End Coffee House, West End Lane. 327, West End Lane. (5) No. 6 (Kilburn) Ward— 132, High Road, Kilburn. 188, do. do. 272, do. do. 308, do. do. 354, do. do. 368, do. do. Towers' Coffee Rooms, Loveridge Road. 96, Palmerston Road. (8) No. 7 (Priory) Ward— 121, Abbey Road. 21, Alexandra Road. 203, Belsize Road. 264, do. 274, do. 36, Boundary Road. 114, do. 65, Fairfax Road. 115, Finchley Road. 34, High Road, Kilburn. 43, Loudoun Road. Steer's Restaurant, Upper Avenue Road. (12) Total 59 The number of inspections of the above premises made during the year was 130, and three notices were served. No prosecutions were instituted. Home Work. The Factory Act provides that in certain trades, to be specified by the Home Secretary, the employers shall send to the sanitary authority, twice a year, lists giving the names and addresses of the out-workers employed by them. The Home Secretary has from time to time specified certain trades to which these provisions apply, the latest list being that contained in the Home Work Order of May 23rd, 1907. The trades,specified in this order, areas follows:— The making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel and any work incidental thereto; The making, ornamenting, mending, and finishing of lace and of lace curtains and nets; Cabinet and furniture making and upholstery work; The making of electro-plate; The making of files; 113 Fur pulling; The making of iron and steel cables and chains; The making of iron and steel anchors and grapnels; The making of cart gear, including swivels, rings, loops, gear buckles, mullin bits, hooks, and attachments of all kinds; The making of locks, latches, and keys ; The making or repairing of umbrellas, sunshades, parasols, or parts thereof; The making of artificial flowers; The making of nets other than wire nets; The making of tents ; The making or repairing of sacks ; The covering of racquet or tennis balls ; The making of paper bags ; The making of boxes or other receptacles or parts thereof made wholly or partially of paper, cardboard, chip, or similar material; The making of brushes ; Pea picking; Feather sorting; The carding, boxing, or packeting of buttons, hooks and eyes, pins and hair pins. The making of stuffed toys; The making of baskets ; And any process incidental to the above. The number of lists received from employers was 127, and the number of addresses contained in the lists was 450. In 382 instances it was found that the addresses were outside Hampstead and in accordance with the Act they were sent to the Medical Officers of Health of their respective districts. The number of addresses of persons stated to be Hampstead workers received from the Medical Officers of Health of the districts in which the employers of these workers carried on business was 54, but only 35 of these were really addresses of Hampstead outworkers. The total number of outwotkers' premises in Hampstead is 75. Of these 2 are factories, 43 are workshops (18 of these being domestic workshops), 1 is a workplace, and in 29 cases only a single worker is employed on the premises. 114 Seven cases of infectious disease occurred in houses inhabited by outworkers. 3 were cases of scarlet fever, 3 of diphtheria and 1 of erysipelas. All the patients except the one with erysipelas were immediately removed to hospital and the premises disinfected, and in no case was it found necessary to make an order to prohibit work from being given out to the premises. The Home Office table relating to outworkers will be found on page 117. The outworkers premises in Hampstead are kept under regular supervision. They are usually found to be in a satisfactory condition, and any defects that are discovered are promptly remedied. Factories. The sanitation of factories is largely controlled by the Factory Inspectors, but duties of considerable importance relating to general sanitation devolve upon the Borough Council, who are responsible among other duties, for the administration of section 38 of the Public Health (London) Act, 1891. The section imposes upon the Council the duty of securing " suitable and sufficient accommodation in the way of sanitary conveniences " for the persons of both sexes employed in the Hampstead factories, workshops and workplaces. The following is a list of the different classes of factories in Hampstead :— Factories. Art Metal Workers 2 Bakehouses 2 Boot makers 2 Brewers 1 Builders 4 Butchers 5 Carpet beaters 2 Chaffcutters 1 Cigarette makers 1 Coach builders 1 Coffee roasters 4 Corn chandlers 1 Dairymen 2 Engineers 1 Joiners and plasterers 1 Laundries 6 Manufacturing stationers 1 Monumental masons 1 Opticians 1 Photographic paper manufacturers 1 Pianoforte makers 1 Pianoforte string makers 1 Picture frame makers 1 Printers 10 Provision merchants 2 Stained glass makers 1 Steel grinders 1 Upholsterers 2 59 115 The five tables that follow have been framed by the Home Secretary " for the guidance and convenience of Medical Officers of Health in preparing that part of their Annual Report which relates to factories, workshops, workplaces, and homework." Factories, Workshops. Laundries, Workplaces and Homework. 1.—Inspection. Including Inspections made by Sanitary Inspectors. Premises. (1) Number of Inspections. (2) Written Notices. (3) Prosecutions (4) Factories (Including Factory Laundries) 132 3 — Workshops (Including Workshop Laundries) 1100 29 — Workplaces (Other than Outworkers' premises included in Part 3 of this Report) 635 19 - Total 1867 51 — 12 116 2.—Defects Found. Particulars. Number of defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts :— Want of cleanliness 33 32 - - Want of ventilation 1 1 - - Overcrowding 8 8 - - Want of drainage of floors 1 1 - - Other nuisances 91 90 - - Sanitary accommodation insufficient 2 — - — unsuitable or defective 16 16 - - (not separate for sexes 2 2 - - Offences under the Factory and Workshop Act;— Illegal occupation of underground bakehouse (S. 101) - — - - Breach of special sanitary requirements for bakehouses (SS. 97 to 100) - — - - Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report) 10 7 2 - Total 164 157 2 - Column (2) in the above table gives the number of defects found, and column (3) the number remedied during the year. The corresponding figures in the two columns are not identical, because in the case of some of the defects discovered near the end of the year, the work necessary to remedy the defects had not been completed. 117 3.—Home work. NATURE OF WORK. Outworkers' Lists, Section 107 Inspections of Outworkers' premises. Outwork in unwholesome premises,Sec. 108 Outwork in infected premises Sections 109, 110 Lists received from Employers. ; Addresses of Outworkers. Prosecutions. Instances. Not:ces served. Prosecuions. Instances. Orders made (S.110). Prosecutions (Sections 109, 110). Twice in the year. Once in the year. Received from other Councils. For warded to other Councils. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Lists. Outworkers. Contactors Workmen. Contractor Workmen. 1 2 3 4 6 6 7 8 9 10 11 12 13 14 15 16 17 18 Wearing apparel— (1) making, etc. 90 14 241 6 1 7 54† 228 — — 79 — — — — (2) cleaning and washing 6 25 3 1 3 — - 29 - - - - - - - - Lace, lace curtains and nets 2 — 5 - - - - 5 - - 2 - - - - - - Artifical flowers - - - - - - - - - - - - - - - - - Nets, other than wire nets - - - - - - - - - - - - - - - - - Tents - - - - - - - - - - - - - - - - - Sacks - - - - - - - - - - - - - - - - - Furniture and upholstery 8 16 49 4 5 3 50 13 Fur pulling - - 4 - - - - 4 - - - - - - - - - Feather sorting — — — — - - - - - - - - - - - Umbrellas, etc. 4 12 2 2 3 1 16 - 1 — — Carding, etc., of buttons, etc — — — — — — — - — — — — — — — — Paper bags and boxes 2 — 40 — — — - 36 3 — Basket making - - 2 2 - - - - - Brush making — — 1 — — — — 1 — — — — — — — Racquet and tennis balls - - - - - - - - - - - - - - - - - Stuffed toys - - 1 — — — — 1 - - - - - - - - - File making - - — - - - - - - - - - - - - - - Electro-plate 2 1 11 — — — — 10 — 1 — — — — — Cables and chains - - - - - - - - - - - - - - - - - Anchors and grapnels - - - - - - - - - - - - - - - - - Cart gear - - - - - - - - - - - - - - - - - Locks, latches and keys - - - - - - - - - - - - - - - - - Pea picking - - - - - - - - - - - - - - - - - Total 114 68 359 13 12 11 54 382 101 — — — - * In 8 of the lists that were sent in the occupiers gave out work of more than one of the class* s specified in Column 1, but the lists were subdivided in such a way as to show the number of workers in each class of work. These lists have been included in column 2 aga:nst the principal c ass only, but the outworkers have been assigned in columns 3 and 4 into their respective classes. + This number includes 10 addresses not in Hampstead, 3 addresses of persons who no longer take homework, 5 addresses of persons who had removed and whose new address could not be found, and one address of a deceased person. 118 4.—Registered Workshops. Workshops on the Register (s 131) at the end of the year. Number. (1) (2) Bakehouses 35 Bootmakers 48 Dressmakers and ladies' tailors 137 Laundries 6 Milliners 33 Tailors 35 Watchmakers and jewellers 17 Other 193 Total number of workshops on Register 504 5.—Other Matters. Class Number. (1) (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) - 41 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 — Reports (of action taken) sent to H.M. Inspector - Other 2 Underground bakehouses (s. 101) :— Certificates granted during the year - — In use at the end of the year 22 Report on the Analytical Work of the Year 1907, BY ALFRED W. STOKES, F.C.S., F.I.C., Public Analyst. 121 Analytical Laboratory, Town Hall, Paddington, W. January 25th, 1908. A short abstract of the analytical work of the year 1907 may be of interest. The total number of samples was 407, comprising—Milk 274, Butter 45, Cheese 10, Cream 6, Lard 8, Drugs 24, Margarine 1, Groceries 16, Meat preparations 16, Flour 3, Bread 2 and Sweets 2. Of these 21 samples of Milk and 1 of Butter were adulterated ; 10 of the Meat preparations (sausages, &c.) and 4 of the Creams contained preservatives. This year the percentage of adulterated samples is 9.3 per cent, compared with 4"8 per cent, last year. The percentage of adulterated milks for each year is the same, 7 1/2 per cent. This year only 2 1/4 per cent, of the butter samples were adulterated, while the previous year 4 per cent, were adulterated. A total of £36 for fines and £13 18s. 6d. for costs was ordered to be paid into the Council's account during the year 1907. ALF. W. STOKES, F.C.S., F.I.C., Public Analyst. Legal Proceedings. 125 Legal Proceedings. Legal proceedings were taken by the Council in connection with the work of the Health Department in 58 cases during the year. The chief facts relating to these proceedings are set out on pages 126-131, and are summarised below. The facts relate only to the cases that were heard and decided in 1907. No. of Prosecutions. Fines. Costs. £ s. d. £ s. d. Public Health (London) Act, 1891, and Bye-laws made thereunder 18 6 18 6 3 3 6 Metropolis Management Acts, and Bye-laws made thereunder 16 41 5 6 9 8 0 Sale of Food and Drugs Acts 24 42 0 0 14 4 6 Totals 58 90 4 0 26 16 0 126 Public Health (London) Act, 1891; and Bye-laws made thereunder Ward No. Date when proceedings ordered. Date of Hearing. Court, and Name of Magistrate. Initials and District of Defendant. Offence. Result of Hearing. 5 1906. 24th July 1907. 1st Feb. Marylebone Police Court, Mr. Plowden McF. & H., Willesden Nuisance Abatement Order made and 6s. costs allowed. 6 11th Dec. 1907. Do. Do. F. S. R., City Do. Do. 2 19th Mch. 24th April Hampstead Petty Sessional Court, Justices R. T., Hampstead Contravention of Sec. 40 Withdrawn on payment of penalty of £2 2s. and 3s. 6d. costs 1 19th April 8th May Do. J.K., Islington Dirty milk utensils Fined £2 and 2s. costs. 6 30th April 24th May Marylebone Police Court, Mr. Plowden J. F. S., Hampstead Nuisance Abatement Order made and 6s. costs allowed. 5 22nd Jan. 26th June Hampstead Petty Sessional Court, Justices A. S., Elstree Do. Do. 5 14th May 5th July Marylebone Police Court, Mr. Denman W. T. S., Hackney Do. Do. 6 9th July 30th Aug. Do. G. G., Finchley Nuisances (2 premises) Ordered to pay the Surveyor's fee of £1 11s. 6d. and 6s. costs 1 13th Aug. 25th Sept. Hampstead Petty Sessional Court, Justices G .W., Kensington Non-registration as Purveyor of Milk Fined 2s. costs 1 Do. Do. Do. T. K., Camberwell Do. Fined 2s. 6d. and 2s. costs. 6 1st Oct. 25th Oct. Marylebone Police Court, Mr. Plowden H. F., Willesden Do. Fined 2s. costs 127 Public Health (London), Act 1891; and Bye-laws made thereunder—continued. Ward No. Date when proceedings ordered. Date of Hearing. Court, and Name of Magistrate. Initials and District of Defendant. Offence. Result of Hearing. 2 1907. 1st Oct. 30th Oct. Hampstead Petty Sessional Court, Justices T. S., Hampstead Executing sanitary work without giving notice (fixing w.c. apparatus) Fined £1 and 2s. costs. 1 23rd July Do. Do. H. S., Hampstead Nuisance Abatement and prohibition Order made, and 2s. costs allowed. 1 16th April 27th Nov. Do. E. O., Hampstead Allowing caretakers rooms (underground rooms) to be occupied contrary to Sec. 96 Dismissed (Justices' decision reversed in High Court, May, 1908) 7 9th July 28th Nov. Marylebone Police Court, Mr. Plowden M. W., Ellesmere Port, near Chester Nuisance Abatement Order made, and 12s. costs allowed 6 1st Oct. Do. Do. F. S. R., City Do. Adjourned sine die for work to be done 1 29th Oct. 4th Dec. Hampstead Petty Sessional Court, Justices H. G. P., Hampstead Do. Abatement Order made 1 16th April Do. Do. J. B., otherwise J. P. Non-registration as Purveyor of Milk Fined 2s. 6d. or 1 day 's imimprisonment Metropolis Management Acts, and Bye laws made thereunder. 5 1906. 11th Dec. 1907. 30th Jan. Hampstead Petty Sessional Court, Justices J. C. N.t St. Pancras (1) Constructing drains (at two premises) without giving notice and (2) Failing to deposit plans, &c. Fined £14 and 19s. costs. 1 27th Nov. 20th Feb. Do. R. P. B., Westminster Failing to deposit plans, &c. (two premises) Fined 40s. and 11s. costs on each summons 128 Metropolis Management Acts, and Bye-Laws made thereunder—continued. Ward No. Date when proceedings ordered. Date of Hearing. Court, and Name of Magistrate. Initials and District of Defendant. Offence. Result of Hearing. 1 1907. 16th April 1907. 29th May Hampstead Petty Sessional Court, Justices J. H., Paddington (1) Making drain without giving notice (2) Non deposit of plans, &c. (3) Drain made not watertight Fined £4 5s. and 15s. costs. 1 6th June 26th June Do. W. H. D., Hampstead (1) Placing building over sewer (2) Interfering with sewer Fined £5 on each and 12s. costs 5 14th May 5th July Marylebone Police Court, Mr. Denman F. H., St. Marylebone Failing to deposit plans, &c. Plans deposited and summons withdrawn on payment of fine of 10s. 6d. and 2s. costs. 6 23rd July 6th Sept. Marylebone Police Court, Mr. Plowden J. F. S., Hampstead Obstructing entry Withdrawn on undertaking to allow entry and payment of £4 4s. costs. 2 Do. 25th Sept. Hampstead Petty Sessional Court, Justices A. C., Hampstead (1) Failing to deposit plans, &c. (2) Contravention of Bye-law 10, Sec. 202 Fined £6 and 6s. costs. 5 1st Oct. 1st Nov. Marylebone Police Court Mr. Plowden T. K., Hampstead Failing to deposit plans, &c. Plans deposited and summons withdrawn on payment of costs of 10s. 5 Do. 27th Nov Hampstead Petty Sessional Court, Justices E. P., Hampstead Contravention of Bye-law 4, Sec. 202 Fined 10s. and 2s. costs 7 29th Oct. 28th Nov. Marylebone Police Court, Mr. Plowden J.B., St. Marylebone (1) Constructing drain without giving notice (2) Failing to deposit plans, &c. (1) Summons withdrawn on payment of penalty of £2 and 2s. costs (2) Plans deposited and summons withdrawn on payment of 2s. costs 129 Sale of Food and Drugs Acts. Ward No. Date when proceedings ordered. Date of Hearing. Court, and Name of Magistrate. Initials and District of Defendant. Offence. Result of Hearing. 7 1906. 11th Dec. 1907. 25th Jan. Marylebone Police Court, Mr. Plowden E. B., Hampstead Selling milk containing 20 per cent. of added water Ordered to pay £1 13s. 6d. costs. 5 1907. 8th Jan. 22nd Feb. Do. J. D., Willesden (1) Selling butter containing 86 per cent. of for eign fat, and (2) selling margarine in unmarked wrapper Fined 40s. and 12s. 6d. costs on each or 1 month. 7 19th Mar. 26th Apl. Do. T.E.G., Hampstead Selling milk containing 10 per cent. of added water Fined 10s. and 12s. 6d. costs. 1 19th Apl. 8th May Hampstead Petty Sessional Court, Justices A. Y., St. Pancras Selling milk containing 11 per cent. of added water Fined £5. 1 Do. Do. Do. J. K., Islington (1) Selling milk containing 13 per cent. of added water and with 8 per cent. less than the proper amount of butter fat Fined £10 and £1 1s. 6d. costs 1 30th Apl. 29th May Do. W. H., Hampstead Selling milk containing 34 per cent. less than the proper amount of butter fat Fined 10s, and 16s. 6d costs. 5 14th May 14th June Marylebone Police Court, Mr. Plowden W. P., Hampstead Selling milk containing 17 per cent. less than the proper amount of butter fat and 32½ grains of boric acid per gallon Fined £1 and 12s. 6d. costs. 1 28th May 26th June Hampstead Petty Sessional Court, Justices (1) A. N., Bethnal Green (2) J. S., Bethnal Green Selling milk containing 25 per cent. of added water (1) Dismissed. (2) Fined £2 and 17s. costs. K 130 Sale of Food and Drugs Acts—continued. Ward No. Date when proceedings ordered. Date of Hearing. Court, and Name of Magistrate. Initials and District of Defendant. Offence. Result of Hearing. 6 1907. 28th May 1907. 5 th July Marylebone Police Court, Mr. Denman F. W. R., Hampstead Selling milk with 28 per cent. less than the proper amount of butter fat Dismissed. Defendant's business having been turned into a Limited Company. 1 9th July 31st July Hampstead Petty Sessional Court, Justices W. U. D. L., Paddington Selling milk with 20 per cent. less than the proper amount of butter fat Dismissed. Warranty proved. 2 25th June 2nd Aug. Marylebone Police Court, Mr. Denman E. S., Hampstead Selling milk containing 14 per cent. of added water Fined 20s. and 12s. 6d. costs. 1 13th Aug 25th Sept. Hampstead Petty Sessional Court, Justices C. T., Willesden Selling milk with 26 per cent. less than the proper amount of butter fat Fined £1 and 12s. 6d. costs. 1 Do. Do. Do G. W., Kensington Selling milk containing 26 per cent. of added water. Fined £5 and 12s. 6d. costs, or 2 months' imprisonment. 1 Do. Do. Do. T. K., Camberwell Selling milk with 90 per cent. less than the proper amount of butter fat Fined £1 and 12s. 6d. costs. 1 23rd July Do. Do. R. H., Hampstead Selling milk with 10 per cent. less than the proper amount of butter fat Fined 10s. and 12s. 6d. costs, and 10s. 6d. Government Analyst's fee. 5 Do. 27th Sept Marylebone Police Court, Mr. Plowden A. E. Y., Hampstead Selling milk with 13 per cent. less than the proper amount of butter fat and 26 grains per gallon of boric acid Fined 10s and 12s. 6d. costs, 4 Do. Do. Do. C.S.& W.L , Westminster Selling milk with 9 per cent. less than the proper amount of butter fat Fined £1 and 12s. 6d. costs. 131 Sale of Food and Drugs Acts—continued. Ward No. Date when proceedings ordered. Date of Hearing. Court, and Name of Magistrate. Initials and District of Defendant. Offence. Result of Hearing. 6 1907. 1st Oct. 1907. 25th Oct. Marylebone Police Court, Mr. Plowden H. F., Willesden (1) Selling milk containing 78 per cent. less than the proper amount of butter fat (2) Can improperly inscribed (3) Selling skimmed milk from unlabelled utensils Fined 10s. and 2s. costs on each 1 Do 30th Oct. Hampstead Petty Sessional Court Justices J. P., Islington Selling adulterated milk Fined £4 7s. 6d. and 12s. 6d. costs, or one month's imprisonment. 1 Do. Do. Do. O. F. M. D. C. St. Pancras Selling milk from vehicle improperly inscribed Fined £1 and 2s. costs, including the Inspector's expenses of 15s. 1 Do. Do. Do. J. R., Hampstead Selling milk containing 43 per cent. less than the proper amount of butter fat Fined £2 and 12s. 6d. costs. 1 16th Apl. 4th Dec. Do. J. B., otherwise J. P. Selling milk containing 89 per cent. less than the proper amount of butter fat Fined 2s. 6d or one day's imprisonment. K 2 Appendix. Tables. TABLE I. (Required by the Local Government Board to be used in the Annual Report of the Medical Officer of Health.) Vital Statistics of Whole Borough during 1907 and Previous Years. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the Borough. Total Deaths in Public Institutions in the Borough. Deaths of Non-residents registered in Public Institutions in the Borough. Deaths of Residents registered in Public Institutions beyond the Borough. nett deaths at all Ages belonging to the Borough. Number. Rate.* Under 1 year of Age. At all Ages. Number. Rate.* Number. Rate per 1000 Births registered. Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1897 78549 1479 20.0 193 130.4 1219 15.5 472 397 89 911 11.6 1898 80623 1516 18.1 198 130.6 1296 16.0 552 460 81 917 11.4 1899 80926 1576 19.5 206 130.7 1262 15.5 487 398 62 926 11.4 1900 81230 1621 20.0 170 104.8 1200 14.7 458 372 94 922 11.3 1901 82280 1506 18.3 155 102.0 1196 14.5 532 424 101 873 10.6 1902 83743 1516 18.1 155 102.2 1199 14.3 482 390 95 904 10.7 1903 85197 1453 17.0 155 106.7 1049 12 .3 424 312 100 837 9.8 1904 86663 1445 16.7 200 138.0 1135 13.1 455 338 95 892 10.3 1905 88142 1421 16.1 169 118.9 1089 12.3 464 350 84 823 9.3 1906 89633 1437 16.0 139 96.8 1104 12.3 494 364 110 850 9.5 Averages for years 1897-1906 83699 1497 17.9 174 116.2 1174 14.0 482 380 91 885 10.6 1907 91137 1341 14.7 114 85.0 1056 11.6 472 330 91 817 9.0 135 *Rstes in Columns 4,8 and 13 calculated per 1000 of estimated population. Note - The deaths included in Column 7 of this Table are the whole of those registered during the year as having actually occurred withing the Borough. The deaths included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10, and the addition of the number in Column 11. By the term "Non-residents " is meant persons brought into the Borough on account of sickness or infirmity, and dying in public institutions there; and by the term "Residents" in meant persons who have been taken out of the Borough on account of sickness or infirmity, and have died in public institutions elsewhere. The "Public Institutions" taken into account for the purpose of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses and lunatic asylums. A list of the Institutions in respect of the deaths in which corrections have been made is given on the following pages. Area of Borough in acres (exclusive of area covered by water) 2253. Total population in all ages, 81,942. At Census Number of inhabited houses, 11,294. Average number of persons per house, 7.2. of 1901, 136 TABLE I. (continued.) I. Institutions within the Borough receiving sick and infirm persons from outside the Borough. II. Institutions outside the Borough receiving sick and infirm persons from the Borough III. Other Institutions, the deaths in which have been distributed among the several localities in the Borough. 165, Adelaide Road Banstead Asylum 39, Beaumont Street, W. 26, Belsize Avenue Bethlem Hospital 39, Boundary Road 11, Belsize Park Gardens British Home and Hospital for Incurables, Norwood 73, do. Brompton Hospital 28, Birchington Road Brooke House, Upper Clapton Consumption Hospital, Mount Vernon Charing Cross Hospital Chest Hospital, Victoria Park 18, Crossfield Road Childrens' Hospital, Gt. Ormond Street 8, Dennington Park Road Childrens' Hospital, Paddington Green. City of London Lunatic 4, Eton Road Asylum, Stone Claybury Asylum Friedenheim, Upper Avenue Road Colney Hatch Asylum Dartford Heath Asylum German Hospital, Hampstead General Hospital, Hampstead Green Dalston Hanwell Asylum "Ravenswood," Highgate Road Hampstead Workhouse, New End Hollies Street, St. Marylebone Home Hospital, Hospital for Incurable Children, College Villas Road 16, Fitzroy Square Home of Compassion of Jesus, 37,Warrington Crescent, Paddington Infants' Hospital, 7, Denning Road Horton Asylum Hospital of St. John and St. Elizabeth, North Western Fever Hospital, Lawn Road St. Marylebone 137 TABLE I (continued). i. Institutions within the Borough receiving sick and infirm persons from outside the Borough. II. Institutions outside the Borough receiving sick and infirm persons from the Borough. III Other Institutions, the deaths in which have been distributed among the several localities in the Borough. St. Peter's Home, Mortimer Road Infants' Hospital, Vincent Square London Hospital London Temperance Hospital Maternity Hospital, Hackney Middlesex Hospital 34, Nottingham Place, St. Marylebone Queen Charlotte's Hospital Royal Free Hospital St. Ann's House, Manor Road, N. St. Bartholomew's Hospital St. Joseph's Hospice, Hackney 116, St. Julian's Farm Road, Norwood St. Mary's Hospital St. Thomas' Hospital Tooting Bec Asylum University College Hospital Warrington Lodge, Warwick Avenue, Paddington Westminster Hospital The Workhouse is within the Borough and situate at New End in No. 1 (Town) Ward. TABLE II. (Required by the Local Government Board to be used in the Annual Report of the Medical Officer of Health.) Vital Statistics of Separate Localities in 1907 and Previous Years. Names of Localities. Ward No. 1 (Town). Ward No. 2 (Belsize). Ward No. 3 (Adelaide). Ward No. 4 (Central). Ward No. 5 (West End). Ward No. 6 (Kilburn). Ward No. 7 (Priory). Year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all ages. Deaths under 1 year. a. b. c. d. a. b. c. d. a. b. c d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. 1897 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1898 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1899 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1900 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1901 11944 .. 142 26 12968 .. 139 29 10438 .. 98 9 9137 .. 60 9 12222 .. 112 27 14838 .. 200 44 10733 .. 113 11 1902 12240 192 163 20 13280 239 135 18 10500 103 95 3 9233 110 71 11 12550 275 107 20 15100 435 219 45 10840 162 110 16 1903 12550 194 127 14 13520 211 121 13 10600 95 101 9 9357 99 60 8 12850 243 111 21 15370 417 184 39 10950 194 116 21 1904 12970 195 125 20 13660 217 141 23 10790 100 99 13 9503 90 62 11 13200 283 120 22 15550 408 206 54 10990 152 121 13 1905 13330 194 127 24 13840 209 131 13 10800 96 92 4 9762 113 60 5 13580 250 131 23 15790 426 171 50 11040 133 103 14 1906 13590 205 131 21 14190 187 127 8 10840 97 92 10 10123 95 83 3 13790 259 115 14 16030 444 197 41 11070 150 93 9 Averages of Years 1897 to 1906 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1907 13940 185 152 15 14410 205 114 13 10860 75 86 8 10397 108 68 9 14090 250 114 16 16310 391 179 28 11130 127 94 7 138 Note.—The following deaths were noi able to be classified in wards owing to a definite address not having been registered :— 1901 The deaths of 9 persons over 1 year of age 1902 ,, 4 ,, ,, 1903 ,, 16 ,, ,, and 1 infantile death 1904 ,, 13 ,, ,, 5 ,. deaths 1905 „ 8 „ ,, 1906 „ 7 „ ,, 5 „ ,, 1907 „ 8 „ ,, 2 ,, ,, TABLE III (Requied of infectious board to be is the annual of the medical officer of health.) cases of infectious desease notified during the year 1907. NOTIFIABLE DISEASE. Cases Notified in Whole Borough. Total Cases Notified in each Locality. No. of Cases Removed to Hospita from each Locality. At all Ages. At Ages—Years. Ward No. 1. (Town.) Ward No. 2. (Belsize.) Ward No. 3. (Adelaide.) Ward No. 4. (Central.) Ward No. 5. (West End.) Ward No. 6. (Kilburn.) Ward No. 7. (Priory.) Ward No. 1. (Town.) Ward No. 2 (Belsize.) Ward No. 3. (Adelaide.) Ward No. 4. (Central.) Ward No. 5. (West End.) Ward No. 6. (Kilburn.) Ward No. 7. (Priory.) Total Cases removed to Hospital. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox 1 .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria (including Membranous croup 103 .. 27 51 12 13 .. 24 21 6 4 30 14 4 22 16 3 3 24 10 3 81 Erysipelas 57 1 1 5 4 37 9 11 7 9 4 5 15 6 1 2 .. 2 1 1 1 8 Scarlet fever 314 .. 57 198 37 22 .. 64 32 13 19 115 52 19 57 22 6 11 110 47 10 263 Typhus fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric fever 19 .. .. 3 6 9 1 5 1 .. 6 3 4 .. 2 .. .. 2 1 1 .. 6 Relapsing fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal fever 4 .. .. .. .. 4 .. 1 1 1 .. .. 1 .. 1 1 .. .. .. 1 .. 3 Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 498 1 85 257 59 86 10 105 63 29 33 153 86 29 83 42 9 18 136 60 14 362 The Workhouse is within the Borough, and is situaie at New End in No. 1 (Town) Ward. 139 140 TABLE IV. (Rtquired by the Local Government Board to be used in the Annual Report of the Medical Officer of Health.) Causes of, and Ages at, Death during the Year 1907. Causes of Death. Deaths at the subjoined ages of "Residents" whether occurring in or beyond the Borough. Deaths at all ages of "Residents" belonging to Localities whether occurring in or beyond the Borough. Total Deaths whether of "Residents" or "Non-residents" in Public Institutions in the Borough. All ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Ward No. 1 (Town). Ward No. 2 (Belsize). Ward No. 4 (Adelaide). Ward No. 4 (Central). Ward No. 5 (West End). Ward No. 6 (Kilburn). Ward No. 7 (Priory). 1 2 3 4 5 6 7 8 9 10 11 12 14 14 l5 16 Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 11 4 7 1 .. .. .. 2 4 1 .. 1 2 1 16 Scarlet Fever 5 .. 2 1 .. 2 .. .. 2 .. .. 4 .. .. 63 Whooping Cough 12 6 6 .. .. .. .. .. 2 .. .. 4 5 1 4 Diphtheria (including Membranous Croup) 6 .. 3 3 .. .. .. 1 .. .. 1 1 3 .. 43 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fever Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric 2 .. .. .. .. 2 .. .. 1 .. 1 .. .. .. 3 Other continued .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Epidemic Influenza 14 1 .. .. 1 7 5 1 2 1 2 1 4 3 1 Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa 5 4 .. .. .. .. 1 .. 2 .. .. .. 3 .. 1 Enteritis 9 6 1 .. .. 2 .. .. 2 1 2 .. 2 2 3 Puerperal Fever 1 .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. Erysipelas 1 .. .. .. .. 1 .. 1 .. .. .. .. .. .. 1 Other Septic diseases 7 .. .. 1 1 2 3 .. .. 1 1 2 3 .. 3 Phthisis (Pulmonary Tuberculosis) 61 .. 1 2 10 45 3 13 10 2 5 9 l6 6 99 Other Tubercular diseases 31 6 14 3 .. 6 2 6 1 5 1 7 10 .. 11 Cancer, malignant disease 69 .. .. 1 .. 40 28 15 8 7 7 10 9 13 46 Bronchitis 59 6 2 .. .. 12 39 11 12 7 4 6 15 3 16 Pneumonia 64 12 14 2 2 19 14 9 11 8 2 7 21 5 17 Pleurisy 5 .. .. .. .. 3 2 1 1 .. 1 1 1 .. 2 Other Diseases of Respiratory Organs 11 .. .. .. .. 6 5 1 1 2 .. 4 1 2 3 Alcoholism, Cirrhosis of Liver 17 .. .. .. .. 15 2 3 1 3 .. 3 3 4 6 Venereal diseases 1 .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. Premature birth 14 14 .. .. .. .. .. 3 1 2 2 2 4 .. 1 Diseases and accidents of parturition 2 .. .. .. .. 2 .. .. .. .. 1 .. 1 .. .. Heart diseases 32 .. .. 3 2 13 14 3 6 5 1 5 9 3 13 Accidents 18 5 .. 2 1 5 5 3 4 .. 2 3 3 3 14 Suicides 12 .. .. .. 1 11 .. 4 2 1 .. 1 1 2 11 All other causes 348 35 6 10 4 113 180 75 41 39 35 43 63 46 93 Found drowned 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. All causes 817 98 56 29 22 309 303 152 114 86 68 114 179 94 472 Note.—It will be noted that the total number of deaths in the Ward distribution is 10 less than the total number of deaths at the age periods. This is accounted for by the fact that in these cases a definite address was not registered. (See note at foot of TABLE ii.) Schedule A EXTENDED TABEE IV. Causes of, and Ages at, Death during the Year 1907. No. Cause of Death. Ages. All Ages Wards. Total Deaths whether of "Residents" or "Non-residents" in Public Institutions in the Borough. Under 1. 1 and under 5. 5 and under 10. 10 and under 15. 15 and under 20. 20 and under 25. 25 and under 35. 35 aud under 45. 45 and under 55 55 and ; under 65. 65 and under 75. 75 and under 85. 85 and upwards. No. 1 (Town). No. 2 (Belsize). No. 3 (Adelaide). No. 4. (Central). No. 5. (West End) No. 6 (Kilburn). No. 7 (Priory). Non-distributable. 2 Measles 3 7 1 .. .. .. .. .. .. .. .. .. .. 11 2 4 1 .. 1 2 1 .. 16 3 Scarlet Fever .. 2 1 .. .. .. 1 .. 1 .. .. .. .. 5 .. 2 .. .. 3 .. .. .. 63 5 Epidemic Influenza 1 .. .. .. .. 1 .. .. 2 5 2 2 1 14 1 2 1 2 1 4 3 .. 1 6 Whooping Cough 6 6 .. .. .. .. .. .. .. .. .. .. .. 12 .. 2 .. .. 4 5 1 .. 4 7 Diphtheria .. 3 3 .. .. .. .. .. .. .. .. .. .. 6 1 .. .. 1 1 3 .. .. 43 8 Enteric Fever .. .. .. .. .. .. 1 .. 1 .. .. .. .. 2 .. 1 .. l .. .. .. .. 3 10 Diarrhœa, Dysentery 4 .. .. .. .. .. .. .. .. .. .. 1 .. 5 .. 2 .. .. .. 3 .. .. 1 12 Other Allied Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 18 Syphilis .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 21 Erysipelas .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 .. .. .. .. .. .. .. 1 22 Puerperal Fever .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 23 Pyæmia .. .. .. 1 .. .. 1 .. .. .. .. .. .. 2 .. .. .. 1 .. 1 .. .. 1 25 Other Allied Diseases .. .. .. .. .. 1 .. 1 .. .. .. 3 .. 5 .. .. 1 .. 2 2 .. .. 2 27 Rheumatic Fever .. .. .. 2 .. .. .. .. .. .. 1 .. .. 3 1 .. 1 .. .. .. 1 .. 1 28 Rheumatism of Heart .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 29 Tuberculosis of Brain 4 9 3 .. .. .. .. .. .. .. .. .. .. 16 6 .. 2 1 2 5 .. .. 5 30 Tuberculosis of Larynx .. .. .. .. .. .. 1 .. .. 1 .. .. .. 2 .. .. .. .. 1 1 .. .. .. 31 Phthisis .. 1 2 .. 5 5 20 13 10 2 3 .. .. 61 13 10 2 5 9 16 6 .. 99 32 Abdominal Tuberculosis 2 4 .. .. .. .. 1 .. 1 .. .. .. .. 8 .. 1 3 .. 1 3 .. .. 1 33 General Tuberculosis .. 1 .. .. .. .. .. .. .. .. 1 .. .. 2 .. .. .. .. 1 1 .. .. .. 31 Other forms Tuberculosis .. .. .. .. .. .. .. .. 1 1 1 .. .. 3 .. .. .. .. 2 .. .. 1 5 41 Acute Alcoholism .. .. .. .. .. .. .. 1 .. 1 .. .. .. 2 1 1 .. .. .. .. .. .. 2 42 Chronic Alcoholism .. .. .. .. .. .. 2 1 1 1 .. .. .. 5 .. .. 1 .. 1 1 2 .. 3 45 Osteo-arthritis .. .. .. .. .. . .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 1 .. .. 46 Gout .. .. .. .. .. .. .. 1 .. .. .. 1 .. 2 1 .. .. .. .. .. 1 .. 1 47 Cancer .. .. 1 .. .. .. 2 6 15 17 19 7 2 69 15 8 7 7 10 9 13 .. 46 48 Diabetes Mellitus .. .. .. .. .. .. 2 .. 2 3 5 1 .. 13 2 3 2 2 .. 1 3 .. 2 49 Purpura Hæmorrhagica 1 .. .. .. .. .. .. .. .. .. 1 .. .. 2 .. .. .. 1 .. .. 1 .. .. 51 Anæmia .. .. .. .. .. .. .. .. .. 2 3 .. .. 5 1 .. .. 1 2 .. 1 .. 1 52 Lymphadenoma .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 .. 1 53 Premature Birth 14 .. .. .. .. .. .. .. .. .. .. .. .. 14 3 1 2 2 2 4 .. .. 1 54 Injury at Birth 3 .. .. .. .. .. .. . .. .. .. .. .. 3 .. .. .. .. .. .. 1 2 .. 55 Debility at Birth 3 .. .. .. .. .. .. .. .. .. .. .. .. 3 .. .. 1 1 .. .. .. 1 56 Atelectasis 4 .. .. .. .. .. .. .. .. .. .. .. .. 4 1 2 .. 1 .. .. .. .. .. 57 Congenital Defects 5 1 .. .. .. .. .. .. .. .. .. .. .. 6 1 .. .. .. 2 3 .. .. 1 58 Want of breast milk 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. 59 Atrophy, Debility, Marasmus 8 .. .. .. .. .. .. .. .. .. .. .. .. 8 1 .. .. .. 2 5 .. .. 1 60 Dentition 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. .. .. .. .. 61 Rickets 2 .. .. .. .. .. .. .. .. .. .. .. .. 2 2 .. .. .. .. .. .. .. .. 62 Old Age, Senile Decay .. .. .. .. .. .. .. .. .. .. 6 20 22 48 15 5 2 1 7 10 5 3 20 64 Meningitis 1 1 1 1 .. .. .. 1 1 .. .. .. .. 6 2 2 .. .. 2 .. .. .. 7 66 Apoplexy .. .. .. .. .. .. .. 1 1 1 2 2 2 9 1 2 .. 2 1 3 .. .. .. 67 Softening of Brain .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. 1 .. .. .. .. .. .. .. 68 Hemiplegia .. .. .. .. .. .. .. .. .. .. .. .. 5 5 3 .. .. .. .. .. 2 .. .. 69 General Paralysis of Insane .. .. .. .. .. .. .. 2 1 .. 2 .. .. 5 .. .. .. .. 2 1 1 1 .. 70 Other forms of Insanity .. .. .. .. .. .. 1 .. 2 1 .. .. .. 4 .. 1 .. .. .. 3 .. .. 1 72 Cerebral Tumour .. .. .. 1 .. .. 1 1 .. .. .. .. .. 3 .. 1 .. 2 .. .. .. .. .. 74 Laryngismus Stridulus 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. 75 Locomotor Ataxy .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 .. .. .. .. .. .. .. .. 76 Paraplegia .. .. .. .. .. .. .. .. .. .. .. 2 .. 2 .. 1 .. .. .. .. 1 .. 1 77 Other forms, Brain Diseases .. .. .. 1 .. .. .. .. 1 1 1 2 .. 6 1 .. 3 .. .. .. 2 .. 1 78 Otitis .. .. 2 .. 1 .. .. .. .. .. .. .. .. 3 .. .. .. .. 1 1 1 .. .. 82 Endocarditis .. .. 2 1 1 1 .. 1 4 8 8 6 .. 32 3 6 5 1 5 9 3 .. 13 84 Angina Pectoris .. .. .. .. .. .. .. .. .. 1 1 2 .. 4 .. 1 1 1 .. 1 .. .. 1 85 Aneurism .. .. .. .. .. .. .. 1 2 2 1 .. .. 6 1 .. 2 1 1 1 .. .. .. 86 Senile Gangrene .. .. .. .. .. .. .. .. .. .. 1 1 .. 2 .. .. 1 .. .. 1 .. .. 1 87 Embolism, Thrombosis .. .. .. .. .. .. .. .. .. 2 4 1 3 10 2 1 .. 2 .. 2 3 .. 3 88 Phlebitis .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 90 Other Diseases, Heart and Vessels 1 .. .. 1 .. .. .. 3 9 17 29 20 3 83 15 12 12 7 11 15 11 .. 16 91 Laryngitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 94 Acute Bronchitis 6 2 .. .. .. .. 1 .. .. 4 5 5 2 25 4 5 3 2 4 7 .. .. 3 95 Chronic Bronchitis .. .. .. .. .. .. .. .. 3 4 13 11 3 34 7 7 4 2 2 8 3 1 13 96 Lobar Pneumonia .. .. 2 .. 1 1 .. 4 2 2 3 1 .. 16 2 3 4 1 .. 4 2 .. 5 97 Lobular Pneumonia 10 10 .. .. .. .. .. 1 2 2 2 3 .. 30 4 3 3 .. 6 13 1 .. 10 98 Pneumonia 2 4 .. .. .. .. 1 1 3 1 3 2 .. 17 3 5 1 1 1 4 2 .. 2 99 Emphysema, Asthma .. .. .. .. .. .. 1 1 1 1 3 1 1 9 1 1 1 .. 4 1 1 .. .. 100 Pleurisy .. .. .. .. .. .. .. .. 2 1 .. 2 .. 5 1 1 .. 1 1 1 .. .. 2 101 Other Diseases, Respiratory System .. .. .. .. .. .. 1 1 .. .. .. .. .. 2 .. .. 1 .. .. .. 1 .. 2 102 Diseases of Mouth and Annexa .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 103 Diseases of Pharynx .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 105 Ulcer of Stomach and Duodenum .. .. .. .. .. .. 1 1 3 4 1 1 .. 11 6 .. 1 2 .. .. 2 .. 9 106 Other Diseases of Stomach 1 .. .. .. .. .. .. .. .. .. 2 .. .. 3 .. .. 1 .. 1 1 .. .. .. 107 Enteritis 6 1 .. .. .. .. .. 1 1 .. .. .. .. 9 .. 2 1 2 .. 2 2 .. 3 108 Appendicitis .. 1 .. .. .. 1 4 1 2 .. 1 1 .. 11 2 2 1 3 1 2 .. .. 2 109 Obstruction of Intestine 1 .. .. .. .. .. .. .. 2 4 1 .. 8 1 1 1 1 2 2 .. .. 2 110 Other Diseases of Intestine 1 .. .. .. .. .. .. .. .. .. .. 1 .. 2 1 .. 1 .. .. .. .. .. .. 111 Cirrhosis of Liver .. .. .. .. .. .. .. 1 3 4 2 .. .. 10 2 .. 2 .. 2 2 2 .. 1 112 Other Diseases of Liver .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 .. .. .. .. .. .. ... 1 113 Peritonitis .. .. .. .. .. .. .. 1 1 .. .. .. .. 2 .. .. .. .. 1 1 .. .. 1 114 Other Diseases, Digestive System 1 .. .. .. .. .. .. .. .. .. 1 1 .. 3 2 .. .. 1 .. .. .. .. 1 115 Diseases, Lymphatic System and Glands .. .. .. .. .. 1 .. 1 .. .. .. .. .. 2 2 .. .. .. .. .. .. .. .. 116 Acute Nephritis .. .. 1 .. 1 .. 1 .. .. .. .. 1 .. 4 1 .. 1 1 .. 1 .. .. 1 117 Bright's Disease .. .. .. .. .. .. 1 .. 2 12 8 5 1 29 3 2 6 4 4 5 5 .. 5 118 Calculus .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. 119 Diseases of Bladder and Prostate .. .. .. .. .. .. .. .. .. .. 2 .. 3 5 2 1 .. .. 1 1 .. .. .. 120 Other Diseases, Urinary System .. .. .. .. .. .. .. 1 .. 1 .. .. .. 2 .. .. .. 1 1 .. .. .. 2 122 Diseases of Ovaries .. .. .. .. .. .. .. 1 .. 1 .. .. .. 2 .. 1 1 .. .. .. .. .. 3 123 Diseases of Uterus and Appendages .. .. .. .. .. .. 2 1 .. .. .. .. .. 3 .. 1 .. .. .. 1 1 .. 1 129 Placenta Prævia, Flooding .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. 131 Other diseases, Pregnancy and Childbirth .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. 132 Arthritis, Ostitis, Periostitis .. 3 .. .. .. .. .. .. .. .. .. .. .. 3 2 1 .. .. .. .. .. .. 1 133 Other Diseases Osscous System .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. Accidents and Negligence. .. .. 139 In Vehicular Traffic .. .. 2 .. .. .. .. .. .. 1 1 .. .. 4 1 1 .. .. .. 1 1 .. 4 140 On Railways .. .. .. .. .. 1 .. 1 .. .. .. .. .. 2 1 .. .. .. 1 .. .. .. 5 141 On Ships, Boats, etc , not drowning .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. 146 Poisons, Poisonous Vapours .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. 1 .. .. .. .. .. .. .. 151 Suffocation, Overlaid in Bed 3 .. .. .. .. .. .. .. .. .. .. .. .. 3 .. 1 .. 1 .. 1 .. .. .. 152 „ Otherwise 1 .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. 153 Falls not specified 1 .. .. .. .. .. l .. .. 1 .. 1 2 6 1 .. .. 1 2 1 l .. 5 Suicides. 157 By Poison .. .. .. .. .. .. 2 2 .. .. .. .. .. 4 1 1 .. .. .. 1 l .. 4 159 By Hanging and Strangulation .. .. .. .. .. 1 1 .. .. .. .. .. .. 2 .. .. 1 .. .. .. l .. .. 160 By Drowning .. .. .. .. .. .. 1 1 2 .. .. .. .. 4 2 .. .. .. 1 .. .. 1 4 161 By Shooting .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. 1 .. .. .. .. .. .. 1 162 By Cut or Stab .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. 1 165 By other and unspecified methods .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 169 Found Drowned .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. 1 •• Totals 98 56 21 8 9 13 57 55 86 111 144 109 50 817 152 114 86 68 114 179 94 10 472 Note.—The omission of a number denotes that no death was registered from that cause. 141 TABLE V. (Required by the Local Government Board to be used in the Annual Report of the Medical Officer of Health.) Infantile Mortality in the Borough during the Year 1907. Deaths from stated Causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under 1 year. All Causes. Certified 21 5 5 9 40 18 5 7 4 3 2 7 4 1 1 6 98 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. i. Common Infectious Diseases Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. 1 3 Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria (including Membranous Croup) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. 1 1 2 .. 1 .. 1 .. .. 1 .. .. .. 6 ii. Diarrhœal Diseases. Diarrhœa, all forms .. .. .. .. .. 2 .. .. 1 1 .. .. .. .. .. .. 4 Enteritis, Mucoenteritis, Gastroenteritis .. 2 .. .. 2 2 .. .. 1 .. .. .. .. .. .. .. 5 Gastritis, Gastrointestinal Catarrh .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 iii. Wasting Diseases Premature Birth 10 2 1 1 14 .. .. .. .. .. .. .. .. .. .. .. 14 Congenital Defects 2 .. 1 .. .. .. 1 .. .. .. 1 .. .. .. .. 5 Injury at Birth 3 .. .. .. 3 .. .. .. .. .. .. .. .. .. .. .. 3 Want of Breastmilk, Starvation .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 Atrophy,Debility Marasmus .. .. 1 1 2 1 .. 3 1 .. .. .. .. 1 .. .. 8 iv. Tuberculous Diseases. Tuberculous Meningitis .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. 2 4 Tuberculous Peritonitis: Tabes .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 2 Mesenterica Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. v. Other Causes. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rickets .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. 2 Meningitis (not Tuberculous) .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 Convulsions .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Bronchitis .. .. .. 1 1 3 .. 1 1 .. .. .. .. .. .. .. 6 Laryngitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pneumonia .. .. .. 3 3 2 3 .. .. .. .. 2 .. .. 1 1 12 Suffocation, overlying .. .. 1 1 2 .. .. 1 .. .. .. 1 .. .. .. .. 4 Other causes 6 1 1 1 9 4 2 .. .. .. .. .. .. .. .. 2 17 21 5 5 9 40 18 5 7 4 3 2 7 4 1 1 6 98 Population estimated to middle of 1907, 91,137. Births in the year {legitimate, 1,298 illigitimate, 43. Deaths in the year of {legitimate infants, 85. illigitimate infants, 13 Deaths from all Causes at all Ages, 817. 142 The following Table was suggested by the Medical Officer of Health to the County of London in order to secure uniformity of tabulation in the annual reports of the Medical Officers of Health of the Metropolitan Boroughs. TABLE VI. PREMISES NUMBER OF PLACES. Number of inspections, 1907. Number of notices, 1907. Number of prosecutions, 1907. On register at end of 1906. Added in 1907. Removed in 1907. On register at end of 1907. Milk premises 112 7 5 114 421 9 - Cowsheds — — — — — — — Slaughter-houses 5 — — 5 117 — — Other offensive trade premises - - - - - - - Ice cream premises 72 6 — 78 177 4 — Registered houses let in lodgings 239 76 — 315 527 34 — Total number of Intimation Notices served for all purposes 901 Overcrowding— Number of dwelling rooms overcrowded 8 Number remedied 8 Number of notices issued 7 Number of prosecutions — Underground rooms— Number closed during year 2 Illegal occupation dealt with during year 7 Insanitary houses— Number closed under the Public Health (London) Act, 1891 2 „ „ Housing of the Working Classes Act — Shelters provided under Sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year — 143 TABLE VI.—continued. Customs and Inland Revenue Acts—1 Number of houses for which applications were received during year 22 Number of dwellings comprised therein 100 „ Certificates granted (houses) *3 „ „ refused „ — „ „ deferred „ †22 Number of prosecutions under Bye-laws under Public Health (London) Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, &c. — (b) For prevention of nuisance arising from offensive matter running out of any manufactory, &c. — (c) For the prevention of keeping of animals in such a manner as to be injurious to health — (d) As to paving of yards, &c., of dwelling houses — (e) In connection with the removal of offensive matter, &c. 1 (f) As to cesspools and privies, removal and disposal of refuse, &c. — (g) For securing the cleanliness of tanks, cisterns, &c. — (h) With respect to water closets, earth closets, &c. 2 (i) With respect to sufficiency of water supply to water closets — Number of prosecutions under Dairies, Cowsheds and Milkshops Orders— Dirty milk utensils 1 Number of prosecutions under Bye-laws under Metropolis Management Acts— (а) With respect to drainage, &c. 11 (b) With respect to deposit of plans as to drainage, &c. 8 * These 3 houses comprised 12 "dwellings." † These 22 houses comprised 93 "dwellings." 144 London County Council (General Powers) Act, 1903, Part VIII.— Number of prosecutions for breach of by-laws as to conveyance of dead horses through streets London County Council (General Powers) Act, 1904, Part IV.— Number of filthy articles purified (Sec. 19) 92 „ verminous rooms cleansed (Sec. 20) 24 „ sanitary conveniences altered (Sec. 22) 2 „ „ „ removed (Sec. 22) „ fixed ashpits removed (Sec. 23) 84 Mortuaries— Total number of bodies removed 84 Total number of infectious bodies removed 145 TABLE VII Vital Statistics of the Borough. Number of occupied houses 11,294 At Census 1901. Population 81,942 Average number of persons per house 7.25 Year. Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases. 7 Principal Epidemic Diseases. Deaths. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 Births. Cases occurring (excluding Chicken-pox). Attack rate per 1000 of the Population. Deaths occurring. Death rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. 1902 83743 1516 18.1 904 10.7 133 87.7 460 5.4 33 0.39 58 0.69 1903 85197 1453 17.0 837 9.8 126 86.7 311 3.8 16 0.19 42 0.49 1904 86663 1445 16.7 892 10.3 161 111.4 301 3.5 20 0.23 48 0.55 1905 88142 1421 16.1 823 9.3 133 93.6 295 3.3 14 0.16 38 0.43 1906 89633 1437 16.0 850 9.5 111 77.2 557 6.2 22 0.25 49 0.55 1907 91137 1341 14.7 817 9.0 98 73.1 498 5.5 15 0.16 41 0.45 TABLE VII. (1). Vital Statistics of No. 1 (Town) Ward. Number of occupied houses 1,616 At Census 1901. Population 11,895 Average number of persons per house 7.36 Year. Population estimated to to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases. 7 Principal Epidemic Diseases. Deaths. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 Births Cases occurring (excluding Chicken-pox). Attack rate per 1000 of the Population. Deaths occurring. Death rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. 1902 12240 192 15.7 163 13.3 20 104.1 64 5.3 4 0.33 8 0.65 1903 12550 194 15.4 127 10.1 14 72.1 38 3.1 1 0.08 10 0.79 1904 12970 195 15.0 125 9.6 20 102.5 65 5.1 4 0.31 2 0.16 1905 13330 194 14.5 127 9.5 24 123.7 72 5.4 3 0.23 6 0.45 1906 13590 205 15.1 131 9.6 21 102.4 107 7.9 6 0.44 11 0.81 1907 13940 185 13.3 152 10.9 15 81.1 105 7.5 2 0.14 3 0.22 146 TABLE VII. (2). Vital Statistics of No. 2 (Belsize) Ward. Number of occupied houses 1,581 At Census 1901. Population 12,915 Average number of persons per house 8.16  Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases. 7 Principal Epidemic Diseases. Deaths. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number Rate per 1000 Births. Cases occurring (excluding Chicken-pox). Attack rate per 1000 of the Population. Deaths occurring. Death rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. 1902 13280 239 17.9 135 10.2 18 75.3 94 7.1 9 0.67 12 0.90 1903 13520 211 15.6 121 8.9 13 61.6 60 4.5 2 0.15 3 0.22 1904 13660 217 15.9 141 10.3 23 105.9 47 3.5 3 0.22 8 0.59 1905 13840 209 15.1 131 9.4 13 62.2 42 3.0 2 0.14 5 0.36 1906 14190 187 13.2 127 8.9 8 42.8 60 4.2 4 0.28 7 0.49 1907 14410 205 14.2 114 7.9 13 63.4 63 4.4 3 0.21 11 0.76 TABLE VII. 3). Vital Statistics of No. 3 (Adelaide) Ward. Number of occupied houses 1,657 At Census 1901. Population 10,395 Average number of persons per house 6.27 Year. Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases. 7 Principal Epidemic Diseases. Deaths. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 Births. Cases occurring (excluding Chicken-pox). Attack rate per 1000 of the Population. Deaths occurring. Death rate per 1000 of the Population. Number Estimated rate per 1000 of the Population. 1902 10500 103 9.8 95 9.0 3 29.1 40 3.8 2 0.19 2 0.19 1903 10600 95 8.9 101 9.4 9 94.7 22 2.1 1 0.09 1 0.09 1904 10700 100 9.3 99 9.2 13 130.0 36 3.4 2 0.19 2 0.19 1905 10800 96 8.9 92 8.5 4 41.7 27 2.5 1 0.09 1 0.09 1906 10840 97 8.9 92 8.5 10 103.1 29 2.7 ... ... 1 0.09 1907 10860 75 6.9 86 7.9 8 106.7 29 2.7 1 0.09 1 0.09 147 TABLE VII. (4). Vital Statistics of No. 4 (Central) Ward. Number of occupied houses 1,299 At Census 1901. Population 9,099 Average number of persons per house 7.00 year. Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable infectious Diseases. 7 Principal Epidemic Diseases. Deaths. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 Births. Cases occurring (excluding Chicken-pox). Attack rate per 1000 of the Population. Deaths occurring. Death rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. 1902 9233 110 11.9 71 7.7 11 100.0 40 4.4 .. .. .. .. 1903 9357 99 10.6 60 6.4 8 80.8 34 3.7 4 0.43 4 0.43 1904 9503 90 9.5 62 6.5 11 122.2 17 1.8 .. .. 2 0.21 1905 9762 113 11.6 60 6.1 5 44.2 24 2.5 1 0.10 1 0.10 1906 10123 95 9.4 83 8.2 3 31.6 34 3.4 .. .. 1 0.10 1907 10397 108 10.4 68 6.5 9 83.3 33 3.2 2 0.19 2 0.19 TABLE VII. (5). Vital Statistics of No. S (West End) Ward, Number of occupied houses 1,778 At Census 1901. Population 12,172 Average number of persons per house 6.84 Year. Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases. 7 Principal Epidemic Diseases. Deaths. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 Births. Cases occurring (excluding Chicken-pox). Attack rate per 1000 of the Population. Deaths occurring. Death rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. 1902 12550 275 21.9 107 8.5 20 72.1 102 8.2 6 0.48 10 0.79 1903 12850 243 18.9 111 8.6 21 86.4 55 4.3 2 0.16 2 0.16 1904 13200 283 21.4 120 9.1 22 77.7 70 5.4 3 0.23 8 0.61 1905 13580 250 18.4 131 9.6 23 92.0 29 2.1 2 0.15 11 0.81 1906 13790 259 18.8 115 8.3 14 54.1 168 12.2 5 0.36 9 0.65 1907 14090 250 17.7 114 8.1 16 64.0 153 10.9 4 0.28 9 0.64 148 TABLE VII. (6). Vital Statistics of No. 6 (Kilburn) Ward. Number of occupied houses 1,686 At Census 1901. Population 14,777 Average number of persons per house 8.76 Year. Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases. 7 Principal Epidemic Diseases. Deaths. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 Births. Cases occurring (excluding Chicken-pox). Attack rate per 1000 of the Population. Deaths occurring. Death rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. 1902 15100 435 28.8 219 14.5 45 103.4 76 5.1 11 0.73 23 1.52 1903 15370 417 27.1 184 11.9 39 93.5 59 3.9 3 0.19 15 0.97 1904 15550 408 26.2 206 13.2 54 132.3 43 2.8 8 0.51 25 1.61 1905 15790 426 26.9 171 10.8 50 117.4 57 3.6 2 0.13 9 0.57 1906 16030 444 27.7 197 12.3 41 92.0 128 8.0 5 0.31 16 1.00 1907 16310 391 24.0 179 11.0 28 71.6 86 5.3 3 0.18 13 0.80 TABLE VII. (7). Vital Statistics of No. 7 (Priory) Ward. Number of occupied houses 1,677 At Census 1901. Population 10,689 Average number of persons per house 6.38 Year. Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases. 7 Principal Epidemic Diseases. Deaths. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 Births. Cases occurring (excluding Chicken-pox). Attack rate per 1000 of the Population. Deaths occurring. Death rate per 1000 of the Populaticn. Number. Estimated rate per 1000 of the Population. 1902 10840 162 14.9 110 10.5 16 98.7 44 4.1 1 0.09 3 0.28 1903 10950 194 17.7 116 10.5 21 108.2 43 4.0 3 0.27 7 0.64 1904 10990 152 13.8 121 11.0 13 85.5 23 2.1 .. .. .. .. 1905 11040 133 12.0 103 9.3 14 105.3 44 3.9 3 0.27 5 0.45 1906 11070 150 13.5 93 8.4 9 60.0 31 2.8 2 0.18 4 0.36 1907 11130 127 11.4 94 8.4 7 55.1 29 2.6 •• •• 2 0.18 149 TABLE VIII. Vital Statistics of Hampstead, compared with England and Wales. Year. Birth rate per 1000. Natural increase Hampstead. Seven Principal Epidemic Diseases death rate per 1000. Notifiable Infectious disease rate per 1000. Hampstead. General death rate per 1000. Hampstead. England and Wales. Hampstead. England and Wales. Hampstead. England and Wales. 1875 22•6 35•4 394 3•4 12•5 22•7 1876 24•4 36•3 367 — 3•1 — 15•2 20•9 1877 24•0 35•0 413 — 2•7 — 13•7 20•3 1878 24•5 35•6 409 — 3•4 — 14•8 21•6 1879 22•8 34•7 365 — 1•9 — 13•2 20•7 1880 24•1 34•2 521 1•2 3•3 — 12•6 20•5 1881 23•8 33•9 502 2•0 2•3 — 12•7 18•9 1882 23•6 33•8 546 2•2 2•7 — 13•0 19•6 1883 23•8 33•5 685 1•8 2•3 — 11•2 19•5 1884 22•0 33•6 554 1•9 2•8 — 12•5 19•5 1885 21•0 32•9 593 1•4 2•2 — 11•5 19•0 1886 21•0 32•8 554 1•2 2•4 — 12•2 19•3 1887 21•9 31•9 628 1•1 2•4 — 11•0 18•8 1888 20•5 31•2 616 1•0 1•8 — 10•6 17•8 1889 21•0 311 728 0•95 2•2 — 10•7 17•9 1890 21•9 30•2 613 1•5 2•1 13•1 19•1 1891 21•5 31•4 670 1•0 1•9 4•5 12•2 22•5 1892 20•4 30•5 591 1•7 1•8 8•0 12•4 19•0 1893 20•5 30•8 547 1•3 2•47 11•1 12•9 19•2 1894 19•6 29•6 674 1•4 1•76 6•2 10•8 16•6 1895 19•8 30•2 452 1•0 2•14 7•3 13•4 18•7 1896 19•1 29•7 546 1•8 2•18 7•8 12•0 17•1 1897 20•2 29•7 568 1•1 2•15 5•1 11•6 17•4 1898 18•1 29•4 599 1•4 2•22 5•7 11•4 17•6 1899 19•7 29•3 650 1•1 2•21 6•0 11•4 18•3 1900 20•0 28•7 699 1•0 2•0 5•8 11•3 18•3 1901 18•3 28•5 633 0•77 2•05 5•6 10•6 16•9 1902 18•1 28•6 612 0•69 1•64 * 5•4 10•7 16•3 1903 17•0 28•4 616 0•49 1•46 * 3•8 9•8 15•4 1904 16•7 27•9 553 0•55 1•94 * 3•5 10•3 16•2 1905 16•1 27•2 598 0•43 1•52 3•3 9•3 15•2 1906 16•0 27•0 587 0•55 1•73 6•2 9•5 15•4 1907 14•7 26•3 524 0•45 1•26 5•5 9•0 15•0 * Excluding Chicken-pox. INDEX. PAGE. Accidents, Deaths from 26 Adulteration 95-99 Alcoholism 24 Analyses, Results of 95-99 Analytical Work, Report on 121 Applications lor Redrainage 73 Area of Borough 13 Bacteriological Examinations 92, 93 Bakehouses 109,110 Birth-Rate 17,18 Births. Illegitimate 16,17 ,, Number of 14-16 ,, ,, inWards 15 By-Laws, Drainage Plan 72-78 ,, Paving 33-35 Cancer 24 Circulatory System, Diseases of 26 Combined Drainage 73-78 Complaints received 100 Continued Fever 140 Customs and Inland Revenue Acts 85, 86 Dairies and Milkshops 90, 91 Death-Rate 18-20 „ Infantile 30-32 Death returns 21,22 Deaths, at various ages 22 ,, Causes of 24 ,, in Public Institutions 23 „ Infantile Death-Rate 30-32 „ Infantile Deaths 29 „ Non-resident 18,21 „ Number of 18 ,, Outlying 18,21,22 ,, Senile Mortality 24 Diarrhoea 64 Diphtheria 56, 57 Disinfection 67, 68 Drainage Plan, By-laws 72-78 Drainage Work72-78 Dust Chutes 87 Enteric Fever 58,59 152 PAGE. Epidemic Diseases, Seven Principal, Death Rate 61 ,, ,, Deaths from 60 Erysipelas 89, 60 Factories 114 Factory and Workshop Act, 1901105-118 Fever58, 59 Food Inspection 90 Foodshops, Inspection of 95 Health Visiting 35, 36, 43 Homework 112-114,117 Houses let in Lodgings 83 Housing 78 83 Housing Committee 5 Housing of the Working Classes Act, 1890 81,82 Ice Cream 93, 94 Illegal Hours of Labour 109 Industrial Employment of Married Women, Enquiry re 37-43 Infantile Mortality 29-43 Infants, advice as to rearing of 35, 36, 43 Infectious Diseases 47-68 ,, ,, Notifiable 47-60 „ ,, ,, Attack Rate 47 „ ,, ,, Cases occurring 47 „ ,, ,, „ „ in each Month 49 ,, „ „ „ „ Ward 50 „ „ „ Death Rate 47 „ „ „ Deaths from 47 Insanitary and Uninhabitable Premises 85 Inspections and Re-Inspections of Premises 72 Kilburn Vale Area 78-83 Laundries 106,107,114,115,118 Legal Proceedings 125-131 " Living-in" system 83-84 Local Government Board Tables 135-141 Marriage Rates, 1897-1907 14 Marriages, Number of 13 Measles 62, 63 Membranous Croup 56, 57 Middle Classes Defence Organisation 75-78 Milk Supply 90-93 Milkshops and Dairies 90, 91 Mortuary, Public 87, 89 Natural Increase of Population 18 Netherwood Street Area8-83 Non-resident Deaths 18, 21 Notifiable Infectious Diseases 47-60 Notification of Births Act, 1907 36,37,43 153 PAGE. Nuisances, Inspection of 72 Outlying Deaths, Returns of 21,22 Outworkers 112-114,117 Paving Bye-laws 53-35 Persons per Acre 13 Phthisis, Pulmonalis 65-67 ,, Voluntary Notification of 66,67 Physical Deterioration and Alcohol 25,26 Population, Density of 11 ,, Estimated to Middle of 1907 11 ,, InWards 11 ,, Natural Increase of 18 Preservatives in Food 97-99 Principal Epidemic Diseases 60-64 „ ,, ,, Death Rate 61 ,, „ „ Deaths from 60 Public Health Committee 5 Puerperal Fever 59 Rearing of Infants 35, 36, 43 Redrainage Applications 73 Registered Houses 83 Respiratory System, Diseases of 26 Restaurant Kitchens 111, 112 Sale of Food and Drugs Acts 95-99 Sanitary Administration, General 71-101 Scarlet Fever 53-56 Senile Mortality 24 Sewers, Condition and Ventilation of 87 Slaughter-houses 90 Small-pox 51 Staff of Public Health Department 6 Suicides 26 Summary of Vital Statistics for 1907 11 Tuberculosis 65-67 Underground Rooms 86,87 Uninhabitable and Insanitary Premises 85 Vaccination 52 Vital Statistics 11-26 Water Supply, Certificates as to 72 Whooping Cough 64 Workshops 107-110 Workplaces 111, 112