HAMP 17 THE Metropolitan Borough of Hampstead. REORT FOR THE YEAR 1910 of the Medical Officer of Health. G. F. McCLEARY, B.A., M.D., D.P.H. CONTENTS. PAGES Vital statistics 11-24 Infantile Mortality 27-34 Infectious Diseases 37-61 General Sanitary Administration 65-87 Factory and Workshop Act, 1901 91-100 Report on Analytical Work 103 Legal Proceedings 108-112 Appendix—Tables 115-129 Index 131-133 5 PUBLIC HEALTH COMMITTEE, NOVEMBER, 1909-10. Ex- Officio. His Worship The Mayor (Mr. Alderman E. Todd), Chairman. Mr. Councillor J. I. Fraser. Mr Alderman E. C. Andrews, M.D. Miss Councillor M. E. Balkwill. Mr. Councillor G. Buckle. ,, C. W. Cunnington, M.R.C.S., D.P.H. ,, L. Farmer. ,, C. J. Higginson (from March, 1910). ,, T. F. Hobson (until March, 1910). „ J. H. North. „ T.H. Nunn. ,, E. A. O'Bryen. ,, E. S. Payne. ,, A. B. Weaver. 6 STAFF OF THE PUBLIC HEALTH DEPARTMENT, 1910. Senior Sanitary Inspector. W. G. Kershaw. Divisional Sanitary Inspectors. R. Geary, No. 1 District (Wards 1 and 2). C. H. Taylor, No. 2 District (Wards 3 and 7). A. Peverett, No. 3 District (Wards 4 and 5). J. Grimsley, No. 4 District (Ward 6). Special Sanitary Inspectors. F. H. Hudson. Mrs. T. Fisher, M.A. Miss E. G. Moynihan. Assistants to Inspectors. W. Larken. E. Stratton. A. Edwards. Public Mortuary Keeper. W. Larken. Disinfeetors. T. H. Rider. G. Allaway. R. Bell. Clerks. W. Sell, First Clerk. F. S. Hill, Second Clerk. P. T. Roberts, Third Clerk. C/erk- Draughtsman. A. Narramore. Public Analyst. A. W. Stokes, F.C.S., F.I.C. Deputy Medical Officer of Health. Frank E. Scrasc, F.R.C.S., L.R.C.P., D.P.H. Medical Officer of Health. G, F. McCleary, B.A., M.D., D.P.H, To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hampstead. Mr. Mayor, Madam, and Gentlemen, I have the honour to place before you my Annual Report for the year 1910. The vital statistics set forth in the Report may, on the whole, be considered highly satisfactory; they indicate that the public health work of the Council is continuing to be fruitful in results. I would particularly draw attention to the remarkably low rate of infantile mortality reached in 1910. That rate is well below what some authorities on the subject have regarded as the minimum rate to which it is possible to attain. The figures relating to tuberculosis are much loss satisfactory, and I regard the adoption of further preventive measures against this disease as the most pressing public health need in Hampstead at the present time. In the Report an attempt has been made to indicate the measures most required. I am glad to acknowledge the excellent work of the Stall' of the Public Health Department throughout the year. To the Chairman and the Members of the Public Health Committee my thanks are also due for their continued support. I have the honour to be, Mr. Mayor, Madam, and Gentlemen, Your obedient servant, G. F. McCLEARY, Medical Officer of Health. Vital Statistics. 11 Summary of Vital Statistics for 1910. Population estimated to middle of 1910 95729 Density ,, „ „ 42.3 persons per acre Births 1340 Birth-Rate 14.0 Marriages 631 Marriage-Rate 13.2 Deaths 829 Death-Rate 8.6 Infantile Mortality 60 per 1000 births Notifiable Infectious Diseases Attack-Rate 2.4 Notifiable Infectious Diseases Death-Rate 0.13 Death-Rate from the Seven Principal Epidemic Diseases 0.47 Population at Census 1901 81942 Inhabited Houses 11294 Area of Borough 2265 acres „ „ (excluding area covered by water) 2253 acres 13 POPULATION. The population of Hampstead at the middle of 1910 was estimated by the Registrar-General to be 95,729. The Registrar-General's estimate has been adopted in this Report, and it forms the basis upon which the various rates have been calculated. It is arrived at by assuming that since the last census the population has increased at the same rate as in the last inter-censal period, and therefore it is based on the census returns of 1891 and 1901. Estimates of population have only an approximate value, and are likely to be more erroneous in the later years of an inter-censal period. The census that was taken on April 2nd of the present year will show how far the estimate of the Registrar-General has approached to accuracy, but the results of the census have not been published in time to be available for this Report. The following is an approximate estimate of the population of the various Wards of the Borough:— Ward 1 (Town) 15100 „ 2 (Belsize) 15200 ,, 3 (Adelaide) 11000 „ 4 (Central) 10869 „ 5 (West End) 14900 „ 6 (Kilburn) 17260 ,, 7 (Priory) 11400 The Borough 95729 The area of the Borough (including the area, twelve acres in extent, covered by water) is 2,265 acres, and the estimated number of persons to the acre is 42.3. 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. 14 MARRIAGES. According to the returns of the Registrar-General, 631 marriages were registered in the Borough during 1910; they were distributed in the four quarters of the year as follows:— 1st quarter 136 2nd „ 164 3rd „ 191 4th „ 140 Total 631 The total number of persons married in Hampstead during 1910 was 1,262, which is equivalent to a rate of 13.2 per 1000 of the population, and is a decrease on that for the year 1909, when the marriages of 1,300 persons were registered, equivalent to a rate of 14.4 per 1000 of the population. The following Table gives the marriage rates for the years 1900—1909 and the average rate for the decade:— Year. No. of persons married per 1000 of the population. 1900 13.4 1901 13.2 1902 15.0 1903 14.0 1904 14.4 1905 13.6 1906 12.9 1907 14.2 1908 13.4 1909 14.4 Average for the decade 13.8 1910 13.2 15 BIRTHS. During the year 1,270 births were registered in Hampstead, a decrease of 12 as compared with the number—1,282—registered in the previous year. Of the total births 632 were of male and 638 of female children. In addition, 78 births of children whose mothers were Hampstead residents occurred in the principal lying-in institutions in other metropolitan boroughs, and eight of the births registered in Hampstead belonged to other districts, and should be deducted from the total. After these corrections have been made, the total number of births belonging to Hampstead is found to be 1,340, and, in accordance with the practice of the Registrar-General, I have taken this number as a basis for the various rates that depend on the number of births occurring during the year. Illegitimate Births.—Out of the total of 1,270 births registered in Hampstead, 36, or 28 per 1000, were those of illegitimate children. Birth-Rate. The birth-rate calculated on the number of births registered in the Borough was 13.2 per 1000 of the population, as compared with the rate of 13.6 per 1000 in 1909, and 16.4 the average for the years 1900—1909. But when the birth-rate is calculated on the total number of births belonging to Hampstead, including those that took place without as well as within the Borough, the rate is found to be 14.0. This is slightly higher than the rate—13.9—in 1909, which is the lowest birth-rate ever recorded in Hampstead, the lowest rate in any previous year being 14.7, in 1907. The following table shows the birth-rates in 1910 for England and Wales, the 77 Great Towns, the 136 Smaller Towns, England and Wales less these 213 Towns, London, and Hampstead:— Birth-rate per 1000 of the population. England and Wales 24.8 77 Great Towns 25.0 136 Smaller Towns 23.7 England and Wales less the 213 Towns 25.0 London 23.6 Hampstead 14.0 16 The highest birth-rate recorded in Hampstead was in the year 1878, when the rate was 24.5. Since then the rate has steadily declined. In England and Wales there has also been a marked reduction in the birth-rate, but the Hampstead figures show a greater proportionate decline. The following table shows the Ward and sex-distribution of the births, and the birth-rate for each Ward:— Ward. Births. Birth-rate per 1000 of the population. Males. Females. Total. No. 1 (Town) 91 108 199 13.2 No. 2 (Belsize) 104 103 207 13.6 No. 3 (Adelaide) 48 48 96 8.7 No. 4 (Central) 47 58 105 9.7 No. 5 (West End) 109 107 216 14.5 No. 6 (Kilburn) 188 191 379 22.0 No. 7 (Priory) 80 58 138 12.1 The Borough 667 673 1340 14.0 The Natural Increase of the population—i.e. the excess of births over deaths—was 511 in 1910. DEATHS. The total deaths occurring in Hampstead during the year amounted to 1,071. Of these, however, no less than 350 were of persons not belonging to the Borough, while 108 residents of Hampstead died in outlying districts. The total number of deaths, therefore, amongst persons belonging to Hampstead amounted to 829. Death-Rate. The death-rate, calculated upon the total number of deaths (whether of resident or non-resident persons) occurring in the Borough during the year, was 11.2 per 1000 of the population; but after subtracting 17 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, the recorded death-rate is found to be 8.6 per 1000 of the population, as compared with the rate of 8.9 per 1000 of the population in 1909. The average recorded death-rate for the 10 years 1900-1909 was 9.8. The following table shows the death-rates in 1910 for England and Wales, the 77 Great Towns, the 136 Smaller Towns, England and Wales less these 213 Towns, London, and Hampstead:— Death-rate per 1000 of the population. England and Wales 13.4 77 Great Towns 13.4 136 Smaller Towns 12.4 England and Wales less the 213 12.7 Towns 13.6 London 12.7 Hampstead 8.6 The following are the death-rates for each of the Wards:— WARD. Death-rate per 1,000 of the population. No. 1 (Town) 7.8 No. 2 (Belsize) 7.8 No. 3 (Adelaide) 7.1 No. 4 (Central) 7.5 No. 5 (West End) 8.1 No. 6 (Kilburn) 11.1 No. 7 (Priory) 9.7 In the table on page 129 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 Metropolitan Boroughs:— 18 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 1910, as calculated by the Registrar-General. DISTRICT. Death-rate from all causes. Hampstead 8.6 Lewisham 9.6 Wandsworth 10.2 Woolwich 10.5 Fulham 10.5 Stoke Newington 11.0 Battersea 11.3 City of Westminster 11.4 Greenwich 11.6 Hackney 11.7 Paddington 11.8 Kensington 11.9 Camberwell 12.1 Hammersmith 12.2 Lambeth 12.5 Chelsea 12.6 St. Marylebone 12.8 Islington 12.9 Stepney 13.7 St. Pancras 13.8 Deptford 14.0 Holborn 14.9 Poplar 15.2 Bethnal Green 15.3 City of London 15.5 Southwark 15.9 Shoreditch 16.7 Finsbury 17.6 Bermondsey 17.7 County of London 12.7 19 The death-rate in Hampstead in 1910—8.6—was lower than in 1909, when it was 8.9. This is the lowest death-rate ever recorded for Hampstead, with the exception of the rate in 1908, which was 8.5. Deaths of Non-Residents. 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 95 deaths has been transmitted to the following extra-metropolitan districts :— Aldershot. Great Berkhampstead. Anglesey. Harrow. Aylesbury. Hendon. Barnet. Hereford. Bath. Heston and Isleworth. Beckenham. Hoddesdon Berkhampstead. Hornsey. Bexley. Kingston-on-Thames. Boxmoor. Leyton. Brighton. Maidenhead. Broadstairs. Norton-sub-Hamdon. Bromley. Norwich. Brotton. Richmond. Buckhurst Hill. Romford. Cambridge. Sidcup. Cheltenham. Southall. Chertsey. Stevenage. Croydon. Stratford. Enfield. Timsbury. Epping. Torquay. Epsom. Tottenham. Erith. Walsall. Feltwell. Walthamstow. Finchley. Watford. Friern Barnet. West Ham. 20 Whitchurch. Wokingham. Willesden. Wood Green. Windsor. Worthing. Winchester. Yardley. Woking. Information as to the deaths of 5 Hampstead residents was received from the Medical Officers of Health of the following districts, in which the deaths had occurred:— Birmingham. Willesden. Tottenham. The number of deaths of Hampstead residents that occurred in public institutions was 259, or 31.2 percent, of the total deaths, and the number of deaths occurring in workhouses or workhouse infirmaries was 100, or 12.1 percent, of the total deaths. A list of the institutions in which the deaths occurred is given on page 21. Deaths at Various Ages. The following table shows the number of deaths at the various age periods, the causes of such deaths being shown in Tables IV. and V., pages 120 and 121. Age Periods. Under 1 year. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. At all Ages. Deaths 81 51 20 29 304 344 829 21 Deaths of Hampstead Residents in Public Institutions. Institution. Totals. Group Totals. Infirmaries and Workhouses— Hampstead Workhouse 97 100 Lambeth Infirmary, Brook Street 1 St. Giles Workhouse 1 St. Pancras Infirmary, South 1 Hospitals— Alexandra Nursing Home. 2, Turle Road. Islington 1 98 17, Beaumont Street, St. Marylebone 1 Cancer Hospital, Chelsea 1 Chest Hospital, Victoria Park 1 Children's Hospital, Carshalton 3 Children's Hospital, Paddington Green 6 German Hospital 2 Home for Incurables, 1, Highbury Terrace. 1 Home Hospital 1 Home of Compassion, 51, Warrington Crescent 1 Hospital of St, John and St. Elizabeth 2 Jewish Home for Incurables 1 Kensington and Fulham General Hospital 1 King's College Hospital 1 London Hospital 3 London Temperance Hospital 3 Middlesex Hospital 5 Peckham House 1 New Hospital for Women 1 70, Newhall Street, Private Hospital, Birmingham 1 Priory, The, Putney 1 Royal Hospital, Waterloo Road 1 St. Bartholomew's Hospital 2 St. Luke's House, Kensington 4 St. Mary's Hospital 10 St. Monica's Hospital 1 St. Thomas' Hospital 2 University College Hospital 7 Western Hospital 1 Westminster Hospital 1 Hampstead Hospital 26 St. Peter's Home 1 Friedenheim Hospital, Upper Avenue Road 3 Hospital for Incurable Children 1 Metropolitan Asylums Board's Hospitals— North Western Hospital 9 10 Northern Fever Hospital, Winchmore Hill 1 County and other Asylums— Brook House, Upper Clapton 1 26 Banstead Asylum 2 Camberwell House Asylum 3 Caterham Asylum 2 Claybury Asylum 2 City of London Asylum, Stone 1 Colney Hatch Asylum 2 Dartford Heath Asylum 1 Hanwell Asylum 4 Leavesden Asylum 1 Long Grove Asylum 2 Manor Asylum, Epsom 1 Tooting Bee Asylum 4 Elsewhere 25 259 The names of the Institutions that are situated in Hampstead are printed in heavy type. 22 Senile Mortality. The deaths of persons 65 years of age and upwards numbered 344, as compared with 326 in 1909. Of these 57 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 120, 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. As regards the other causes of death, the following 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 ten years 1901-10: 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 1908 84 0.91 1909 85 0.90 1910 90 0.94 The next table gives the anatomical distribution of the disease in each sex. It will be noted that a large proportion of the patients—58 out of a total of 90 cases—were females. In 42 cases the patients were over 65 years of age. 23 Situation. Males. Females. Total. Tongue 3 3 Larynx — 1 1 Breast — 10 10 Thorax 2 — 2 Œsophagus 1 2 3 Liver 4 5 9 Stomach 4 2 6 Bladder 2 1 3 Pancreas 3 1 4 Uterus — 13 13 Intestines 6 12 18 Other abdominal organs — 6 6 Other situations 7 5 12 Totals 32 58 90 Alcoholism. In 3 cases death was certified to be due to alcoholism, and 11 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, 14, as compared with 12 in 1909, 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. Diseases of the Circulatory System. These accounted for 153 deaths, as compared with 141 in 1909. Diseases of the Respiratory System. The total mortality from these diseases was 130, as compared with 170 in 1909. Sixteen deaths occurred in children under five years of age, and 66 in persons aged from 65 years upward. 24 Of the total deaths 63 were due to pneumonia, 56 to bronchitis, 4 to pleurisy, and 7 to other diseases of the respiratory organs. Accident. Twenty deaths were classified under this heading, as compared with 18 in 1909; 5 were due to falls, 4 to suffocation (3 being infants overlaid in bed), 4 to burns and scalds, 2 to street accidents, and 5 to other accidents. Suicide. Eight persons committed suicide, as against 6 in 1909. In 3 cases the cause of death was poisoning, 2 persons were killed by trains, 1 death was due to a fall from a window, and 2 were due to other causes. Infantile Mortality. 27 INFANTILE MORTALITY. The number of deaths under one year registered in Hampstead was 110, but of these 31 deaths occurred in children not belonging to the Borough, while 2 infants belonging to Hampstead died in public institutions in other parts of London. The number of deaths of Hampstead infants was therefore 81, a decrease of 18 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). i. Common Infectious Diseases 1 Small-pox .. .. .. .. .. .. .. .. 2 Chicken-pox .. .. .. .. .. .. .. .. 3 Measles .. .. .. .. 1 .. .. 1 4 Scarlet Fever .. .. .. .. .. .. .. .. 5 Diphtheria (including Membranous Croup) .. .. .. .. .. .. .. .. 6 Whooping Cough .. .. .. .. 2 3 .. 5 ii. Diarrhœal Diseases 7 Diarrhœa, all forms .. .. .. 1 2 2 .. 5 8 Enteritis, Muco-enteritis,) Gastro-enteritis) 1 .. .. .. 1 .. .. 2 9 Gastritis, Gastrointestinal Catarrh) 1 .. .. 1 .. 1 .. 3 iii. Wasting Diseases 10 Premature Birth 4 3 1 2 4 5 2 21 11 Congenital Defects .. 12 Injury at Birth 1 1 1 3 13 Want of Breast-milk, Starvation .. .. .. .. .. .. .. .. 14 Atrophy, Debility, Marasmus 3 2 .. .. .. 2 •• 7 iv. Tuberculous Diseases 15 Tuberculous Meningitis .. .. .. .. .. .. .. .. 16 Tuberculous Peritonitis Tabes Mesenterica) .. .. .. .. .. .. .. .. 17 Other Tuberculous Diseases .. .. .. .. .. .. .. .. v. Other Causes 18 Erysipelas .. .. .. .. .. .. .. .. 19 Syphilis .. 1 .. .. .. .. .. 1 20 Rickets .. .. .. 1 .. .. .. 1 21 Meningitis (not Tuberculous) .. .. 1 1 1 .. .. 3 22 Convulsions 2 1 .. .. .. .. 1 4 23 Bronchitis .. .. .. 1 1 1 .. 3 24 Laryngitis .. .. .. .. .. .. .. .. 25 Pneumonia .. 2 .. .. 2 3 1 8 26 Suffocation, overlying .. .. .. .. 3 .. 3 27 Other Causes 3 .. .. 1 3 3 1 11 Totals 15 9 2 8 17 24 6 81 28 The "Infantile Mortality"—i.e., the number of deaths under one year per 1000 births—was 60, as compared with the rate of 74 per 1000 births in 1909, this figure being calculated on the total number of births belonging to Hampstead, including those that occurred in lying-in institutions outside Hampstead. The average rate for the years 19001909 was 87. The following table shows the infantile mortality of Hampstead in each year since 1880 :— 1880 140 1896 123 1881 136 1897 127 1882 99 1898 125 1883 98 1899 129 1884 143 1900 100 1885 110 1901 102 1886 131 1902 88 1887 107 1903 87 1888 110 1904 111 1889 122 1905 94 1890 122 1906 77 1891 104 1907 69 1892 122 1908 69 1893 102 1909 74 1894 113 1910 60 1895 135 The following table shows a comparison of the infantile mortality rates in 1910 for England and Wales, the 77 Great Towns, the 136 Smaller Towns, England and Wales less these 213 Towns, London, and Hampstead:— Deaths of Infants under 1 year per 1000 births. England and Wales 106 77 Great Towns 115 136 Smaller Towns 104 England and Wales less the 213 Towns 96 London 103 Hampstead 60 29 The following are the infantile mortality rates for each of the Wards:- WARD. Deaths of Infants under 1 year per 1000 births. No. 1 (Town) 75.4 No. 2 (Belsize) 43.5 No. 3 (Adelaide) 20.8 No. 4 (Central) 76.2 No. 5 (West End) 78.7 No. 6 (Kilburn) 63.3 No. 7 (Priory) 43.5 The infantile mortality rate in 1910 was the lowest ever recorded in Hampstead, the lowest figure in any previous year being 69, which was recorded in 1907 and in 1908. This satisfactory result must be attributed in a considerable measure to the preventive work that has been carried on during recent years, for though the summer of 1910 was cold and wot, and therefore favourable to a low mortality, it was not more so than previous summers were. The figure now reached is very low when compared with previous years, but it is still too high, and with a continuance of our ameliorative work we may hope to bring about a considerable further reduction. The deaths from the diarrhceal diseases, which frequently form a large proportion of the whole were only 10 in number, the chief cause of death being premature birth, a cause which is not easy to bring within the scope of preventive effort. The following table, which is issued bv the Registrar-General, shows the infantile mortality in each of the Metropolitan Boroughs and in the County of London. It will be noted that Hampstead occupies a very favourable position when compared with other districts or with the whole of London:— 30 Table showing the Infantile Death-Rates of the County of London, the City of London, and the Metropolitan Boroughs during the 52 Weeks of 1910, as calculated by the RegistrarGeneral. DISTRICT. Deaths under 1 year to 1000 Births. Hampstead 60 Stoke Newington 64 City of London 66 Wandsworth 78 Lewisham 80 City of Westminster 84 Woolwich 85 Camberwell 94 Islington 94 Lambeth 94 Paddington 96 Battersea 97 Hackney 98 Hammersmith 99 Chelsea 101 St. Pancras 102 Holborn 103 Kensington 106 Fulham 107 Greenwich 107 St. Marylebone 108 Stepney 112 Southwark 116 Poplar 118 Deptford 122 Bethnal Green 123 Finsbury 123 Bermondsey 126 Shoreditch 146 County of London 103 31 The attack 011 infantile mortality is carried out by preventive measures, which may be formed into two groups—one consisting of the measures of general sanitation that are described in other sections of this report, the other of measures more specially directed to the preservation of infant life. The latter are more concerned with personal hygiene than the hygiene of environment, and are chiefly educational in character, the object being to assist mothers in various ways to bring up their babies successfully. The most important department of work of this kind is a comprehensive system of health visiting, working on the information furnished by the Notification of Births Act, 1907. This Act, which provides that all births shall be notified to the Medical Officer of Health within 36 hours of their occurence, is essential to the effective operation of any scheme of healthvisiting on a large scale. The Notification of Births Act came into operation in Iiampstead in March, 1908, and the year 1910 is the second for which we possess a complete annual record of the working of the Act. The number of births notified in 1910 was 1,192, including 21 still-births, the number of livebirths notified being 1,171. The total number of live-births occurring in Hampstead in 1910 was 1,270, so that the number of live-births notified formed 91.5 per cent. of the number that actually occurred. 285 births were notified by medical practitioners, 128 by midwives, 704 by parents, and 75 from other sources. The proportion of births notified in Iiampstead is high—considerably higher than in most other districts. The obligation to notify imposed by the Act is in addition to, and not in substitution for, the obligation to register a birth which is imposed by the Registration Act. The notification must be made within 36 hours of the birth, while registration may be delayed for as long as six weeks after, and is inadequate to supply the timely information necessary for effective health-visiting. In Hampstead a system of health-visiting under the Act is carried out on well-defined lines by the Council's lady sanitary inspectors, and by a body of voluntary visitors organised by the Hampstead Health Society. The first visit is paid by one of the lady inspectors, the voluntary visitors are responsible for subsequent visits, and the infants are kept under supervision during the whole of the first year of life. Periodical meetings of the visitors are held, where cases are discussed and future work arranged. The mothers are encouraged to bring their babies regularly to be weighed. The 32 weighing takes place once a week at the Hampstead and North St. Pancras Day Nursery, 29, Pond Street, and at the Brondesbury and West Hampstead Day Nursery, 36, Hemstal Road. The weighing is carried out by the lady inspectors, assisted by the voluntary visitors, and, at Heinstal Road, by Nurse Burnett, of the Ranyard Nurses, whose help has been found most valuable. One of the chief objects of the health visitors is to encourage breastfeeding, but in the poorer parts of Hampstead instances have been found where the mother, although anxious to continue nursing her baby, is unable to do so, owing to the fact that through poverty she herself is insufficiently nourished. To meet cases of this kind the West Hampstead Infants' Committee of the Hampstead Health Society have formed a fund to supply nursing mothers with milk and other food. This assistance, which is only given on certain conditions, one being that the baby must be brought regularly to be weighed, has been found of great value in our work in Hampstead for the prevention of infantile mortality. The effect on the baby, as ascertained by periodical weighing, of the improved nutrition of the mother, has in many cases been marked. Maternal nutrition is an important factor in infant welfare, and it is through improving the nutrition and general health of the mothers in the poorer districts that we may most confidently hope to effect further reductions in the amount of ill-health and mortality among infants. A further development of this side of preventive work was made during the latter part of 1910 by Mrs. George Seaton, who made arrangements for supplying dinners for expectant and nursing mothers at the Day Nursery, 36, Hemstal Road. The dinners, which consist of meat, two vegetables, and a pudding, arc served every week day except Saturday, and any eligible woman with a proper recommendation may avail herself of this on payment of twopence. Some of the women are unable to pay even this small sum, and arrangements have been made for them to be supplied with free dinner tickets by health visitors and other responsible persons. 537 newly-born infants were visited by the lady inspectors during 1910, and 711 re-visits were paid. In my Annual Report for the year 1907 particulars Were given of ail inquiry, instituted at the suggestion of the Home Secretary, on the relation of the industrial employment of married women to infantile 33 mortality. The object of the inquiry was to keep a number of children under observation during the first twelve months of life, with a view to ascertain, among other things, how the infants of mothers employed industrially compared with those of mothers not fo employed. The inquiry was prosecuted in a large number of districts, under the direction of the respective Medical Officers of Health, and the results forwarded to the Home Office to be collated and published in a complete form. The Home Office has not yet issued the complete results, but those of a considerable number of districts have been published separately by the Medical Officers of Health concerned, and it may be useful to give the experience of Hampstead. The visits in connection with the inquiry were made by Mrs. Fisher, and the number of infants visited was 270, but owing to removals from Ilampstead it was found impracticable to keep more than 202 under observation for a whole year. The infants were all born in 1908, but as each child was supervised for a year the inquiry was not concluded until the end of 1909, and owing to pressure of other woik it was not possible to prepare the results for publication in time for the Annual Report for the year 1909. Care was taKen to ensure that the mothers dealt with should be of the same class and circumstances, and the inquiry was therefore limited to the following streets:—Netherwood Street, Palmcrston Road, Linstead Street, Loveridge Road, Lowfield Road Ivelson Street, Ravenshaw Street, Broomslcigh Street, Fleet Road, and the northern end of Upper Park Road, together with a few of the mews in the poorer parts of the Borough. The number of infants whose mothers were industrially employed was 83; 10 mothers were employed at home, 6 in factories or workshops, and 61 elsewhere—chiefly as charwomen. The number of infants of mothers not industrially employed was 119. Of the 83 infants whose mothers were industrially employed 0 died before completing the first year of life: this is equivalent to an infantile mortality rate of 72 per 1000 births. Of the 119 infants whose mothers were not industrially employed 16 died in infancy: equivalent to an infantile mortality of 133 per 1000 births. The infantile mortality among the wage-earning mothers was little more than one-half of that of the mothers not industrially employed. The total number of infants concerned in the inquiry in Ilampstead is small, and therefore the mortality rates must be received with caution 34 but the results do not dilfer substantially from those obtained in other districts, and it is evident that the popular idea that infantile mortality is largely due to the industrial employment of married women stands much in need of revision. The disadvantages of the mother's abscnce from home seem more than counterbalanced by the advantages accruing from the increase in the family income owing to the employment of the mother. In the Hampstead inquiry it was found that whereas the average family income in the case of the mothers not industrially employed was 22s. 8d., it varied from 27s. 6d. among the women industrially employed at home to 26s. 6d. among women employed in factories anil workshops, and 26s. 2W among women employed elsewhere. Moreover, it must not be forgotten that the wage-earning woman has an income of her own, and is not altogether dependent on what her husband allows her. It may be that she is better nourished both before and after childbirth than the mother who is not industrially employed, but further evidence is required before a definite statement can be made on this point. The employment of the mother is obviously harmful if it involves the premature weaning of the infant; but it by no means follows that it need necessarily have this result. In Hampstead a considerable proportion of mothers continued to suckle their babies after returning to work. The complete results of the Home Office inquiry will, no doubt, throw light on these difficult questions; but from the evidence so far adduced it is clear that the question of the relation of infantile mortality to the industrial employment of married women is much more complex than has hitherto been believed. Infectious Diseases. 37 NOTIFIABLE INFECTIOUS DISEASES. The list of infectious diseases notifiable in London during 1910 is as follows:— Small-pox Typhoid Fever Cholera Typhus Fever Diphtheria Relapsing Fever Membranous Croup Continued Fever Erysipelas Puerperal Fever Scarlet Fever Anthrax occurring in man Epidemic Cerebro-spinal Hydrophobia meningitis Glanders Plague The total cases of infectious disease notified numbered 233. This is equivalent to an attack-rate of 2.4 per 1000 of the population. The following: shows the number of cases of each disease notified :— Scarlet Fever 135 Enteric Fever 16 Diphtheria and Membranous Croup 48 Puerperal Fever2 Erysipelas32 Two cases of anthrax and two cases of epidemic cerebro-spinal meningitis were notified during the year, but inquiry showed that in each case the diagnosis was mistaken. The sanitary condition of the 214 houses in which the cases occurred was thoroughly investigated, and in 120 instances defects were found to exist. 38 The number of fatal cases was 13, equal to 5.5 per cent, of the cases notified. The deaths were distributed as follows: — DISEASE. WARDS. No. 1 (Town). No. 2 (Belsize). No. 3 (Adelaide). No. 4 (Central). No. 5 (West End). No, 6 (Kilburn), No. 7 (Priory). Totals. Scarlet Fever l I .. .. .. l .. 3 Enteric Fever .. 1 l 1 .. .. . . 3 Diphtheria and Membranous Croup .. .. .. .. 4 2 .. 6 Erysipelas .. .. .. 1 .. .. .. 1 Totals l 2 l 2 4 3 .. 13 The death-rate from the notifiable infectious diseases was 0-13 per 1000 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 1891-1910:— 39 TABLE showing the attack-rate and death-rate for tho Borough from Small-pox, Diphtheria and Membranous Croup, Scarlet Fever, and Enteric Fever during the years 1891-1910. Year. Small-pox. 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 .4 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 0.06 1900 — — 1.88 0.37 0.60 0.01 2.72 0.05 0.60 0.1l 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 — 113 0.07 0. 63 0.01 3.45 0.05 0.21 0.02 1908 — — 0.59 0.05 0.36 — 2.86 0.07 0.26 0.04 1909 — — 0.35 0.05 0.31 0.01 2.56 0.04 0.19 0.05 1910 - — 0.50 0.06 0.33 0.01 1.41 0.03 0.17 0.03 40 Cases of Infectious Disease occurring in each Month during 1910. Disease. months. Totals. January. February. March. April. May. June. July. August. September. October. November. December. Scarlet Fever 13 15 13 15 8 14 9 4 14 11 12 7 135 Enteric Fever .. 1 1 .. 3 1 1 2 2 3 1 1 16 Diphtheria and Membranous Croup 2 3 .. 4 3 2 4 3 4 8 7 8 48 Puerperal Fever .. .. .. 1 .. .. .. .. .. .. .. 1 2 Erysipelas 3 3 1 3 2 3 3 2 .. 4 5 3 32 Totals 18 22 15 23 16 20 17 11 20 26 25 20 233 41 Cases of Infectious Disease occurring in each Ward during 1910. 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 9 35 17 12 20 35 7 135 Enteric Fever 2 5 2 2 1 3 1 16 Diphtheria and Membranous Croup 4 3 2 8 22 9 .. 48 Puerperal Fever .. 2 .. .. .. .. .. 2 Erysipelas .. 10 4 1 6 1 5 5 32 Totals 25 49 22 28 44 52 13 233 42 Smallpox. No case of small-pox occurred during the year. Hampstead has been free from small-pox since April, 1907, when a case occurred in the person of a manager of a shipping company, who was infected in Maderia. Previously no case had occurred since October, 1903. 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. Percentage of Births Registered. Unvaccinated. 13 (Cols.6,8,& 9) 10.0 9.2 9.5 9.2 9.2 10.4 12.3 15.1 16.9 - Not finally accounted for (including cases postponed). 12 (Cols. 8 eft 9) 7.4 7.4 7.4 6.8 6.4 8.0 7.8 5.7 5.2 - Exempted by " Conscientious Objection " Certificates. 11 (Col. 6) 2.6 | 1.8 2.1 2.4 2.8 2.4 4.5 9.6 11.7 - Successfully Vaccinated. 10 (Col. 3) 81.7 82.7 82.0 82.8 83.1 82.3 81.3 77.8 76.9 - Remaining. 9 104 102 ! 96 90 77 97 99 66 63 139* Vaccination Postponed. 8 7 11 11 8 14 18 5 6 5 1 32 Died Unvaccinated. 7 111 104 106 100 91 93 80 78 61 54 Number in respect of whom Certificatetes of "Conscientious Objection'' have been received. 6 39 27 30 35 40 35 60 127 151 216 Had Small-pox. 5 .. .. .. .. .. .. .. .. .. .. Insusceptible of Vaccination. 4 15 18 19 16 18 12 7 16 19 14 Successfully Vaccinated. 3 1232 1255 1190 1197 1181 1183 1090 1028 996 814 Births. 2 1508 1517 1452 1446 1421 1438 1341 1321 1295 1269 Year. 1 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 Note.—The number of births given as o2curring in each year differs slightly from tho3s statad elsewhere in this Report, but for all practical purposes the difference is negligible. * In this figure are included 67 births in respect of which no legal action a3 to vaccination has yet been takan ; the rates for Columns 10-13 have therefore not been calculated. 43 Scarlet Feyer. The number of cases of scarlet fever notified in each of the last ten years is set out below. Year. No, of Cases Notified. 1901 214 1902 251 1903 165 1904 159 1905 170 1906 385 1907 314 1908 265 1909 241 1910 135 The deaths from scarlet fever in 1910 wore 3, as compared with 4 in the previous year. The number of cases and the number of deaths per 1000 of the population were 1.41 and 0.03 respectively, and the casemortality, or percentage of deaths to cases, was 2.2. The corresponding figures in 1909 were 2.56, 0*04, and 16 respectively. Of the cases notified, 99, or 73 per cent., were removed to hospital. The corresponding percentage in 1909 was 87. The total number of houses attacked was 114. Ten houses had 2 cases each, 2 houses had 3 cases, 4 cases occurred in one house, and 5 cases in another. In all these instances the subsequent cases took the infection directly or indirectly from the primary case. Throughout the year the type of scarlet fever in Hampstead was very mild, as is shown by the low case-mortality. In many cases the disease gave rise to little more discomfort than a common cold. Scailet fever at the present time is far from being the fatal and dreaded disease it was over 30 years ago. It now exists in a mild form, but it must not be assumed that it will remain indefinitely in this form. The comparatively trivial character of the symptoms in many of the cases is a source of some danger, for it makes it difficult to recognise the disease, and so leads to "missed" cases. It is much to be regretted that bacteriology is not yet sufficiently developed to afford the help in the diagnosis of scarlet fever that is available in the case of diphtheria. 44 Careful inquiries were made in each case, with a view to ascertaining the source of infection, and in 43 cases it was found that the patient had been infected by a previous case. Ten cases were infected outside Ilampstead. Three cases wore discovered by the Medical Officer of Health in consequence of information supplied by school teachers, The fol in the varioi lowing is ward able sh s:—- iws the uuinbc) of case s occur ng eacl month Month, WARDS, Totals- No. 1 (Town). No. 2 (Belsize). No. 3 (Adelaide). No- 4 (Central). No. 5 (West End). No 6 (Kilburn)i No. 7 (Priory). January 1 2 4 l 4 — — 13 February 1 8 — — — 6 - 15 March 1 2 1 2 3 4 - 13 April — 5 3 1 1 5 — 15 May — 2 — 1 2 3 - 8 June — 7 — — 1 6 — 14 July — 4 2 — 2 1 - 9 August 1 1 1 — — 1 - 4 September 1 3 — 2 2 4 2 14 October 3 — 1 4 — 2 1 11 November — — 4 1 4 1 2 12 December 1 1 1 — 1 2 1 7 Totals 9 35 17 12 20 35 7 135 45 Diphtheria and Membranous Croup. The number of cases notified in 1910 was 48 as compared with 33 in 1909, the attack-rate, or number of cases notified per 1000 population, being 0-50. The number of fatal cases was 6, or 12'5 per cent, of the cases notified. The death-rate per 1000 population was 0-06; 39 patients, or 81 per cent. of the total cases notified, were removed to hospital. The following table shows the number of cases occurring each month in the various Wards:— Months. WARDS. Totals. No. 1 (Town). No. 2 (Belsize). No. 3 I Adelaide). No. 4 (Central). No. 5 West End). No. 6 (Kilburn). No. 7 (Priory). January — l — l — — — 2 February 2 — — — l — — 3 March — - - - - - - - April 1 — l — 2 — — 4 May 1 — — l 1 — — 3 June - l — l — - — 2 J ulv - — - — 1 3 — 4 August — — l l 1 — — 3 September — — — l 3 — — 4 October — — — l 3 4 — 8 November — 1 — — 0 — — 7 December — — — 2 4 2 — 8 Totals 4 3 2 8 22 9 — 48 One of the most satisfactory features of the Ilampstead health etat'stics in recent years is the diminished prevalence of diphtheria. 46 The number of cases of this disease notified in 1910, viz., 48, was smaller than the corresponding number in any previous year except 1909. That the number of cases in 1910 was larger than in 1909 was due in some measure to the fact that in the former year the Council greatly extended the facilities of medical practitioners for obtaining the bacteriological examination of specimens from patients suspected to be suffering from diphtheria. The number of specimens examined was largely increased in 1910, and no doubt this brought to light cases that otherwise would have gone undiscovered. The total number of specimens examined was 51, of which 18 gave a positive and 33 a negative result. The following figures show the number of cases of diphtheria in Hampstead each year since 1890, the year in which the disease first became notifiable. Year. No. of cases notified. Year. No of cases notified. 1890 96 1901 142 1891 88 1902 85 1892 136 1903 79 1893 158 1904 55 1894 96 1905 63 1895 112 1906 97 1896 189 1907 103 1897 100 1908 55 1898 131 1909 33 1899 106 1910 48 1900 153 The decrease becomes more apparent when, instead of the number of cases, the attack-rate, or proportion of cases notified per 1000 population, is taken, as in the following table:— Years. No. of cases notified per 1000 population. 1890—94 1.61 1895—99 1.63 1900—04 1.22 1905—09 0.77 1910 0.50 In August, 1910, the Local Government Board made an Order, the Diphtheria Anti-toxin (London) Order, 1910, empowering London sanitary authorities to arrange for the supply of anti-toxin and of medical assistance in connection therewith for the poorer inhabitants of the district. In accordance with this Order the Council obtained a 47 supply of anti-toxin from a firm of wholesale chemists, and the following letter was sent by the Medical Officer of Health to all the medical practitioners practising in Hatnpstead. Five applications for anti-toxin were received before the end of the year. Public Health Department, 7, Belsize Park Gardens, Hampstead, N.W. Dear Sir, In accordance with a recent Order of the Local Government Board, the Ilampstead Borough Council have arranged for the free supply of diphtheria anti-toxin to medical practitioners for use among the poorer inhabitants of Ilampstead The Local Government Board attach great importance to the prompt treatment of diphtheria by anti-toxin. You are aware that the beneficial effect of anti-toxin in the treatment of diphtheria depends greatly upon the stage of the disease in which it is administered; it has been conclusively shown that patients treated on the first or second day can almost invariably be cured, and hence it is most important that anti-toxin should be administered in cases where diphtheria may reasonably be suspected, without waiting for bacteriological confirmation of the diagnosis. In order to facilitate the early use of anti-toxin, I have been empowered by the Borough Council to supply it to medical practitioners making application to the Public Health Department, 7, Belsize Park Gardens, N.W. The application should be in writing, and should state the name and address of the patient for whom the anti-toxin is required. The supply of anti-toxin is not, of course, intended as a substitute for removal to hospital of a patient suffering from diphtheria, or as implying that a patient to whom anti-toxin has been administered may properly be retained for treatment at home unless means are available for his efficient isolation. I am, Dear Sir, Yours faithfully, G. F. McCleary. Enteric Fever. The number of cases notified was 16 as compared with 13 in 1909 and 21 in 1908. The attack-rate per 1000 population was 0.17. The number of fatal cases was 3, or 18.7 per cent. of the cases notified. The death-rate per 1000 population was 0.03; 8 patients, or 50 per cent. of the total cases notified, were removed to hospital. 48 Four specimens of blood from patients suspected to be suffering from enteric fever were submitted by the doctors in attendance for bacteriological examination, two specimens proving positive and two negative. 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 - - - - - l — l March — - 1 - — — — l April - - - - - - - - May 1 2 — — — — — 3 June — — l — — — — l July 1 - - - - - - l August — 1 — 1 — — — 2 September — — — — l l — 2 October — 1 — — — l 1 3 November — 1 - - - - - l Decembcr - — - 1 - — — l Totals 2 5 2 2 l 3 l 16 A careful inquiry was made as to the source of infection in each case. In five instances it was found that the patient had clearly been infected outside Hampstead; one of these patients was infected ill India, one in Canada, one in Germany, and two elsewhere. In two 49 coses tlicrc was reason to think the infection had been conveyed by shell-fish. In the remaining instances the source of infection could not be traced. Puerperal Feyer, Two eases were notified, neither of which proved fatal, as compared with 5 cases and 3 deaths in 1909. Both of the cases occurred in No. 2 (Belsize) Ward. One of the eases was removed to the llampstead Workhouse Infirmary. Erysipelas. Thirty-two eases were notified, and 1 death occurred, as compared with 29 cases and 1 death in 1909. The attack-rate per 1000 of the population was 0-33. Of the cases notified, 10, or 31 per cent., were removed to the llampstead Workhouse Infirmary. The Metropolitan Asylums Board do not provide hospital accommodation for cases of erysipelas or puerperal fever, and the patients suffering from these diseases are unable to obtain hospital treatment except in Poor Law Infirmaries or Workhouses. Epidemic Cerebro-Spinal Meningitis. This disease, which is popularly known as " Spotted Fever," was made notifiable throughout London by an Order of the London County Council made in 1907, and subsequently renewed from time to time, but neither in that year nor 1908 was any case notified in llampstead. In 1909, however, 4 cases were notified, all of which proved fatal. In 1910 two cases were notified and both patients died, but the post-mortem examination in each case showed that the disease was not epidemic cerebro-spinal meningitis. 50 SEVEN PRINCIPAL EPIDEMIC DISEASES. The total number of deaths from these diseases amounted to 45, and 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. C (Kilburn) No. 7 (Priory) Small-pox - - - - - - - - Measles — 4 — — 3 7 - 14 Scarlet Fever 1 1 — — — 1 - 3 Diphtheria and Membranous Croup 1 1 - - 4 2 - 6 Whooping Cough — 2 — — 3 5 1 11 Fever — 1 l 1 — — 3 Diarrhœa — - 1 1 3 2 1 8 Totals l 8 2 2 13 17 2 45 The death-rate from the seven principal epidemic diseases was therefore, 0'4? per 1000 of the population. In the following table a comparison is given of the annual death rates from these diseases in Hampstead, London, England and Wales, the 77 Great Towns, the 136 Smaller Towns, and England and Wales less these 213 Towns, during 1910 :— 7 Principal Epidemic Diseases. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Fever. Diarrhoea. England and Wales 0.99 0.00 0.23 0.06 0.12 0.24 0.05 0.29 77 Great Towns 1.23 0.00 0.31 0.08 0.12 0.29 0.05 0.38 136 Smaller Towns 0.88 0.00 0.16 0.06 0.11 0.24 0.05 0.26 England and Wales lens the 213 Towns 0.74 0. 00 0.15 0.05 0.12 0.17 0.05 0.20 London 1.14 — 0.41 0.04 0.09 0.28 0.04 0.28 Hampstead 0.47 — 0.15 0.03 0.06 0.11 0.03 0.08 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. 5l Detailed information concerning small-pox, scarlet fever, diphtheria, and fever will be found under the heading of Notifiable Infectious Diseases, on pages 42-49, but particulars concerning measles, whooping cough, and diarrhoea, to which notification does not apply, are given here :— Year. Seven Principal Epidemic Diseases. Death-rate per 1000 of the population. Measles. Death-rate per 1000 of the population. Whooping Cough. Death-rate per 1000 of the population. Diarrhoea. Death-rate per 1000 of the population. 1901 0-77 0-12 0-29 0-04 1902 C'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 1900 0-55 011 0-02 0-21 1907 0-45 0-12 0-13 0-05 1908 0-40 0-04 0-05 0-12 1909 0-51 012 0-19 0-03 1910 0-47 0-15 011 0-08 Measles. Fourteen deaths were recorded from this disease, as compared with 11 in 1909. The mortality Was (Ho per 1000 population, the mortality in 1909 being 0*12. Measles is now included amongst the dangerous infectious diseases, to which Sections 60-0-3, 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. 52 But although measles is not a notifiable disease, many cases are reported to the Medical Officer of Health by school teachers, parents and others. During- the year 11)10, 612 cases were reported, as compared with 28in 1901). The sources of information were as follows :— Cases notified by medical practitioners 8 „ parents or guardians 141 ,, school teachers 433 „ employers and others 50 „ Metropolitan Asylums Board 4 Death Returns 6 642 The 642 cases occurred in 377 houses: — In 214 houses there was one case in each house. In 91 „ „ were 2 cases „ In 55 ,, ,, ,, 3 ,, ,, In 10 ,, „ ,, 4 ,, ,, In 3 ,, „ ,, 5 ,, ,, In 3 ,, „ ,, 6 ,, ,, In 1 ,, „ ,, 8 ,, ,, 53 The following table shows the number of reported cases of Measles occurring each month in the various Wards:— Month. Ward 1 (Town) Ward 2 (Belsize) Ward 3 (Adelaide) Ward 4 (Central) Ward 5 (West End) Ward 6 (Kilburn) Ward 7 (Priory) Totals. January 5 l 2 3 24 275 4 314 February 6 5 - 18 102 41 5 177 March 7 2 1 — 7 — — 17 April 3 — — 2 1 — 2 8 May 3 — 3 2 — — 3 11 June — 2 — 2 2 1 3 10 July — 4 1 3 — — 2 10 August - — 1 — 1 — — — 2 September 2 15 — 1 — 1 — 19 October - 1 41 4 — — — — 46 November — 10 5 — — 1 — 16 December — 10 — — — 2 12 Totals 27 91 16 32 136 321 19 642 During the first two months of 1910 measles was unusually prevalent in Hampstead, especially in the Kilburn and West End Wards, where the great majority of the cases occurred. In the last quarter of the year the disease attacked the Fleet Road area, and became prevalent in the Town Ward in the early part of the present year. Unfortunately, measles is an extremely difficult disease to control. It is highly infectious even in the early stage before the appearance of the rash, when the symptoms very much resemble those of a common cold, for which complaint measles is usually mistaken. Until the fourth day of the disease, when the rash appears, measles can only be recognised by a 54 highly-skilled observer, and consequently in the great majority of cases measures of isolation are not adopted until the patient has been spreading infection for three days. For these reasons comparatively little can be done under present conditions to check the spread of measles. But a good deal can be done to lessen the fatality of an outbreak by educating the public to a proper appreciation of the seriousness of the disease, so that the patients may receive due care and attention. For this purpose health-visiting is of great value. All the cases reported in 1910 were visited by the lady inspectors, who gave instruction to the mothers in the precautions to be observed in nursing the patients. That these measures are needed is apparent from the fact that in 165 of the cases visited no doctor was in attendance on the patient, which is striking evidence of the failure of many of the public to appreciate that measles is a serious disease. Hospital accommodation is badly needed for patients in the poorer districts for whom proper treatment is not available in their own homes. Up to the present year (1911) the only hospitals open to these patients were the workhouse infirmaries, but since February, 1911, hospital accommodation for measles cases has been provided by the Metropolitan Asylums Board. At first admission was only given to Poor Law patients, but later the Board, on the suggestion of the Local Government Board, agreed to receive cases of measles other than Poor Law cases, on the recommendation of the Medical Officer of Health of the district concerned. Hospital treatment for measles on any practicable scale cannot be expected to exercise much effect in checking the spread of the disease, but it may do much to lessen the mortality by saving the lives of those patients for whose recovery skilled nursing, plenty of good food and healthy surroundings are necessary, and who are unable to obtain these necessities in their own homes. Whooping Cough. There were 11 deaths from this disease in 1910, as compared with 18 in 1909 and 5 in 1908. The mortality per 1000 population was 0.11. Like measles, whooping cough tends to become complicated by pneumonia, and the patients require to be carefully looked after, but unfortunately it is popularly regarded as a disease of slight importance. Hospital treatment is much needed in certain cases of whooping cough, and the Metropolitan Asylums Board now provide hospital accommodation for patients admitted through the Poor Law, 55 Diarrhœa. The number of deaths from this cause was 8, as compared with 3 in 1909. The death rate per 1000 of the population from this disease was 0'08. These deaths occurred as follows:—1 in No. 3 (Adelaide) Ward in September, 1 in No. 4 (Central) Ward in October, 3 in No. 5 (West End) Ward in May, June and September, 2 in No. 6 (Kilburn) Ward in December, and 1 in No, 7 (Priory) Ward in May. F ive of these deaths occurred among children under one year of age. TUBERCULOSIS. The number of deaths from tuberculosis in 1910 was 80. Of these, 58 deaths were due to pulmonary tuberculosis or phthisis, 10 to tubercular meningitis, and 12 other forms of tuberculosis. 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. Deathrate per 1000 population. Phthisis deaths. Deathrate 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 1908 84 0.91 74 0.78 1909 75 0.80 53 0.56 1910 80 0.83 58 0.60 56 The deaths from phthisis during 1910 were distributed among the Wards as follows:— Ward. Area (Acres). Estimated Population middle of 1910. Phthisis Deaths. Phthisis Death-rale per 1000 of the Population. No. 1 (Town) 686 15100 6 0.40 ,, 2 (Belsize) 271 15200 8 0.53 ,, 3 (Adelaide) 325 11000 5 0.45 ,, 4 (Central) 312 10869 3 0.28 ,, 5 (West End) 247 14900 11 0.74 ,, 6 (Kilburn) 195 17260 16 0.93 „ 7 (Priory) 229 11400 8 0.70 The Borough 2265 95729 58* 0.60 * 1 death from phthisis was non-distributable, The following table shows the age distribution of the patients dying from consumption in Hampstead in the eight years 1903-1910:— Year. Age Period. 0—5 5—15 15—25 25—65 65— All Ages. 1903 - 1 14 46 6 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 1908 — 2 14 55 3 74 1909 1 1 12 37 2 53 1910 1 1 12 37 7 58 Totals. . 6 8 97 3/o 29 515 In 1902 a system of voluntary notification of phthisis was adopted in Hampstead, and on January 1st, 1909, the Public Health (Tuberculosis) Regulations of the Local Government Board, which provide for the compulsory notification of cases of phthisis occurring 57 in Poor Law patients, cainc into operation. The following table gives the number of patients notified in each year since 1902:— Year. No. of pati»nt3 notified. 1902 51 1903 34 1904 39 1905 27 1906 35 1907 55 1908 30 1909 67 1910 77 The total number of Hampstead patients notified during 1910 was 77, but 13 of these had been previously notified—1 in 1906, 2 in 1907, 1 in 1908, and 9 in 1909 ; the number of new patients notified was 64, and of those 33 were males and 31 females. The increase in the number of patients notified in the last two years is due to the operation of the instalment of compulsory notification provided by the Public Health (Tuberculosis) Regulation, 1908. The total number of notification certificates received during 1910, including duplicates, was 135, relating to 89 cases, of which 12 belonged to districts outside Hampstead. The number of certificates relating to Hampstead patients was 123, and of these 33 were made under the voluntary system, and 90 under the Regulations. The notifications were received from the following sources:— Private Practitioners 14 Hospitals and Dispensaries 19 Hampstead District Poor Law Medical Officers 28 Medical Officer, Hampstead Workhouse 38 Medical Officers of outlying Poor Law Institutions on admission of Hampstead patients 5 Master of Hampstead Workhouse on discharge of patients 14 Masters of outlying Poor Law Institutions on the discharge of patients to Hampstead addresses 5 123 58 The foregoing figures refer exclusively to Hampstead patients. In addition, 12 notifications relating to patients belonging to other districts were received from the following sources: — Medical Officer of Hampstead Workhouse on admission of patients from Mount Vernon or Freidenheim, belonging to other districts 5 Medical Officers of outlying Poor Law Institutions on removal of patients to Hampstead Institutions 2 Masters of outlying Poor Law Institutions on removal of patients to Hampstead Institutions 4 Medical Officer of outlying Workhouse on the admission of patient from Hampstead Institution 1 The notified patients are visited by Mrs. Fisher, the lady sanitary inspector, who gives the necessary instruction in the precautions that a consumptive patient should observe to prevent the spread of the disease to others, and inquires into the source of infection. Mrs. Fisher made 287 visits to the homes of consumptive patients in 1910. To assist the work of the lady inspector a body of voluntary visitors, organised by the Joint Phthisis Committee of the Hampstead Health Society and the Hampstead Council of Social Welfare, works in close co-operation with the Public Health Department. In previous Annual Reports reference has been made to the valuable work of the Joint Committee, which is of special value in providing sanatorium treatment and material assistance in various ways for consumptive patients. Disinfection is carried out by the Public Health Department after a death from consumption, and, as occasion requires, during the life of a patient. The total number of premises disinfected in 1910 was 128. The Council arrange for the bacteriological examination of specimens from suspected cases of consumption. In 1910 the total number of specimens examined was 14, of which 4 were positive and 10 negative. Tuberculosis causes nearly one-tenth of the total mortality of Hampstead, and although the death-rate from the disease is declining the decline is not so marked as it ought to be, considering that tuberculosis is preventable, and that an appropriate technique of prevention has already been fairly extensively worked out. Measures of general sanitation, such as the prompt removal of refuse, the sanitary construction of dwellings and workshops, &c., undoubtedly have a considerable 59 effect in reducing the mortality from tuberculosis, but more special measures are necessary to secure an effective control of the disease. The most common and destructive form of tuberculosis is tuberculosis of the lungs or consumption, and it is against this form that preventive measures should chiefly be directed. In considering what should be done to attack consumption, two propositions should be borne in mind: — 1.—Consumption is an infectious disease, but the infection can readily be controlled if the patient can be brought to live under proper conditions. 2,—Living under such conditions will not only-prevent the spread of the disease to others, but will also promote the recovery of the patient, for consumption is a curable as well as a preventable disease. The main object of preventive effort is to see to it that consumptive patients adopt a proper mode of life, and the essentials of such a life are (1) abundance of fresh air, (2) a sufficient amount of good food, (3) habits of scrupulous cleanliness. But before a Public Health Authority can do anything for a consumptive patient it is necessary that the patient should be known to the authority —in other words, a system of notification is necessary. Voluntary notification of consumption has been in operation in Hampstead since 1902, but the number of notified cases has been small, probably considerably less than one-sixth of the total cases, and many of the patients have been notified only when in the last stage of the disease. The instalment of compulsory notification introduced by the Public Health (Tuberculosis) Regulations, 1908, has increased the number of notified cases, and a further increase will result from the Public Health (Tuberculosis in Hospitals) Regulations, 1911, which came in force on May 1st, and provide for the compulsory notification of cases of consumption occurring in hospital patients. In the majority of cases, however, the patient is not notified until he is in an advanced stage of the disease. Consumption comes on insidiously; the patient often does not suspect what is the matter with him, and puts off seeing a doctor until he may be seriously ill. What is wanted is some means of identifying the disease in the early stage, and for this purpose it is important that a medical examination should be made of the members of a family in which a case of consumption has 60 occurred. Consumptives frequently infect the persons with whom they live, and a systematic medical examination of the family of a consumptive patient will frequently bring to light other cases in the incipient stages, when a cure may be confidently expected if proper treatment be adopted. Efforts are made by the health visitors, in cases where infection is suspected, to induce the suspected patient to be medically examined, but usually without success, for he is often too poor to consult a private doctor, and the out-patient departments of Mount Vernon and the Brompton Hospital are too far off to be readily available for Hampstead patients. Provision is required, not only for the discovery of cases, but also for the regular medical supervision of the patients. It was formerly thought that proper supervision could only be secured in a sanatorium, and that the most effective means of prevention was the establishment of sanatoria. It has now been shown that consumptives can be successfully treated at home, provided that they are subject to systematic medical supervision, and that sanatoria are chiefly of value as affording the patients a preliminary training in the habits and ways of living necessary for their own recovery and for the prevention of infection to other persons. The most effective and inexpensive method of attacking consumption is by means of the dispensary system. The work of the tuberculosis dispensary consists in the supervision of the open-air treatment of consumptives in their own homes, and the detection of cases of consumption in persons who have been exposed to infection by living with a consumptive patient. The dispensary requires no elaborate buildings, an ordinary house can readily be adapted for the work, and in a district like Hampstead the staff need not consist of more than a doctor and a nurse. The dispensary can readily co-operate with other organisations, such as sanatoria and relief agencies, and is, indeed, necessary for their proper development. Tuberculosis dispensaries are now being established all over the country. A dispensary was started in Paddington two years ago, one began work in St. Marylebone last year, and others are on the point of beginning work in other parts of London. It was of consumption that King Edward asked the question: "If preventable, why not prevented?"— a question that has never been answered—and I think the Borough Council could set up no more appropriate or useful memorial to his late Majesty than a tuberculosis dispensary, 61 DISINFECTION. Number of articles disinfected:— Beds 207 Mattresses 525 Palliasses 4 Bolsters 393 Pillows 1122 Blankets 1404 Sheets 600 Counterpanes 555 Articles of Clothing 2170 Carpets 56 Linen articles 1563 Books 198 Miscellaneous 840 Total 9637 Number of premises disinfected 831 „ rooms, &c., disinfected 1008 In addition to the foregoing, the following were destroyed upon request of the owners:— Beds 7 Mattresses 6 Palliasses 13 Bolsters 4 Pillows 11 Blankets 4 Sheets 1 Counterpanes 3 Articles of Clothing 82 Carpets 1 Linen articles 10 Miscellaneous 32 Total 174 During 1909 732 premises, 1055 rooms, &c., and 13,588 articles Were disinfected, while 108 articles were destroyed. General Sanitary Administration. 65 Sanitary Works Carried Out. The following is a tabulated statement of the sanitary work, etc. carried out during the year, so far as that work admits of tabulation:— General Conditions— Houses, or parts of houses, cleansed 153 Dampness in houses, or parts of houses, abated 78 Dilapidated houses, or parts of houses, repaired 49 Overcrowding— Cases of, abated (rooms) after service of notice 4 „ ,, „ without service of notice 3 Underground rooms— Ceased to be occupied as separate dwellings 2 Entirely ceased to be occupied as dwellings 60 Below floors— Spaces below floors in the basement or ground floors ventilated 85 Roofs— Repaired . 113 Gutterings— Repaired or renewed 84 Rainwater pipes— Repaired or renewed 135 Disconnected from drains 58 „ „ soil pipes 15 Waste pipes— Waste pipe of sinks disconnected from drains 1 ,, ,, ,, trapped 479 „ „ „ repaired or renewed 355 ,, ,, ,, unstopped 3 ,, „ of lavatories disconnected from drains 1 „ ,, „ trapped 208 „ „ „ repaired or renewed 233 „ „ of baths disconnected from drains 4 ,, ,, ,, trapped 151 „ „ „ repaired or renewed 160 Water supply— Reinstated 15 Water provided to upper floors of tenement houses 99 Water supplies used for domestic purposes disconnected from cisterns for flushing w.c.'s 10 66 Water cisterns— Repaired or renewed 3 Removed from improper positions 43 Cleansed 39 Fitted with close-fitting covers 13 Water-closets— Accommodation provided 20 Additional accommodation provided 7 Separate and sufficient accommodation provided for persons of each sex 16 Removed from improper positions 33 Provided with proper and sufficient external ventilation 14 Improperly constructed apparatus removed and new provided 9 Apparatus repaired or renewed 574 „ unstopped 11 „ cleansed 33 „ provided with proper water supply 2 Flushing cisterns repaired or renewed 211 Manholes— Repaired or renewed 84 Drains— Repaired or renewed 838 Cleansed 80 Unstopped 38 Ventilated 61 Ventilating pipes of drains — Carried to a sufficient height above windows 7 Repaired or renewed 37 Fresh-air inlets repaired or renewed 19 Soil pipes— Repaired or renewed 378 Ventilated 20 Gullies and surface drains— Gully traps removed from improper positions 21 ,, „ cleansed 12 Inlets or surface drains trapped 1 Paving and draining Washhouses, Areas, Yards, &c.— Washhouse or scullery paving repaired or renewed 10 Areas cleansed 7 67 Paving and draining Washhouses, Areas, Yards, &c.—con. Area paving repaired or renewed 95 Areas drained 16 Yards or other open spaces paved 115 Paving of yards or other open spaces repaired or renewed 97 Yards or other open spaces drained 29 Floors of buildings in which horses, &c., are kept, paved or repaired 9 Refuse and Receptacles— Dustbins provided 176 „ repaired 2 Fixed ashpits removed 22 Accumulations or deposits of refuse removed 128 Manure receptacles provided 5 „ „ amended 1 Animals— Nuisances from the improper keeping of animals abated 1 Number of Inspections, &c., Made; Notices Served; and Letters, &c., Issued. 1909. 1910. Number of Inspections 9237 8650 ,, Re-inspections 12707 12757 „ Intimation Notices issued 781 762 „ Statutory Notices issued 660 682 ,, Letters issued 5937 5493 „ Notifications sent to "Head Teachers" of Schools respecting notified cases of infectious disease 494 332 „ Notifications sent to Medical Officers of Health of other Boroughs respecting Hampstead children attending schools in their districts . . 110 96 „ Notifications sent to "Head Teachers" of Schools respecting cases of measles 163 285 68 Certificates as to Water Supply. The number of certificates issued during the year was 30, as compared with 71 in 1909. Drainage Work. The by-laws of the Loudon County Council that require that plans and written particulars of drainage construction and alteration shall be deposited with the Sanitary Authority came into operation in August, 1903, and from that date to the end of 1910 the Council have approved of 401 plans for the drainage of new buildings, and 4547 plans for alterations, etc., to drains of existing premises. During the year 1910, 927 notices of drainage reconstruction or alteration were received, and in 838 cases the work necessitated the deposit of plans and written particulars. In 516 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 838 notices of drainage alterations, etc., requiring the deposit of plans, 335 related to work that involved the entire reconstruction of the drainage system. In 503 of the 838 drainage cases the work was carried out voluntarily, the number of instances in which voluntarily complete reconstruction was carried out being 135. 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. Iron pipes are now chiefly used in drainage constructions and reconstructions in Hampstead. Of the 335 reconstructions in 1910 iron pipes were used in no less thau 288 cases; in only 47 cases were the drains reconstructed with stoneware pipes. It has been found that iron drains are much more durable; in several cases in 1910, iron drains that were laid upwards of 15 years ago were found perfectly water tight on application of the water test. Combined Drainage. During the year several claims were made by owners of property that certain defective combined drains were not legally "drains" for 69 which the owners of the property were responsible, but "sewers" which the Council were under obligation to repair at the cost of the ratepayers. An idea is prevalent that a combined drain is necessarily a sewer, but this is not so. If it can be shown that the combination has been made in accordance with an order of the local authority, the combined drain is legally a "drain" and not a "sewer." Usually the only way of proving that the combination was authorised is by producing the drainage plans that show that the combination was approved by the local authority. In Hampstead the Council is fortunate in possessing an exceptionally full set of drainage records, and consequently the cost of repairing drains, which from lack of a proper record have become "sewers," is small compared with the sums expended in other districts. In 1910, however, four claims were made which for various reasons could not be resisted, and the drains were reconstructed at the cost of the Council, the total sum expended during the year being £150 9s. 6d. Houses Let in Lodgings. The number of houses registered as bouses let in lodgings at the 1910 was 364, no houses being added to the register in 1910. The registered houses are situated chiefly in the following streets:— Bolton Road. Linstead Street Dunboyne Street. Lowfield Road. Fairfax Mews. Netlierwood Street. Fleet Road. Palmerston Road. Kelson Street. The number of tenement houses in Hampstead that might with advantage be dealt with under the by-laws relating to houses let in lodgings is considerably in excess of the number actually registered; but hitherto the staff of inspectors has been inadequate to deal with a greater number. When the new inspector has begun his duties it will be possible to carry out a more effective administration of the by-laws, and to add to the number of houses on the register. 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 70 the occupants. During the year application for certificates under these Acts were received in respect of 51 dwellings, this number being 45 less than the number for which applications were made in 1909. The number of dwellings certified was 17. 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 constructed hood and shaft. The following is a list of the dwellings certified:— Premises. No. of Dwellings. 86, Palmerston Road 3 1.6, Laurel Mansions, Lyncroft Gardens 6 1-6, New End Flats, New End 6 1, Belsize Parade, Haverstock Hill 2 Underground Rooms. The Public Health (London) Act, 1891, contains special provisions relating to underground rooms, an underground room being defined as a room the floor of which is more than three feet below the surface of the footway of the adjoining street, or of the ground adjoining or nearest to the room. An underground room that is not occupied in conjunction with a room on any other floor of the same house must comply with certain conditions that are set out in detail in the Act; must, for instance, be sufficiently protected against damp, properly lighted and ventilated, and provided with a fireplace with a proper chimney or flue, &c. An underground room that does not comply with these requirements is illegally occupied. During 1910, as in previous years, special attention was paid to the inspection of underground rooms, 71 and 115 were found to be illegally occupied. These rooms were situated in the following streets: — Belsize Road Langland Gardens Bolton Road Mill Lane Boundary Road Nether wood Street Hemstal Road Palmerston Road Honey bourne Road Heath Villas, Yale of Health. King's College Road Of these rooms, 53 were altered to comply with the Public Health Act, 2 were in process of alteration at the end of the year, and 60 were vacated. In 2 cases the tenants were able to occupy a room on an upper floor in conjunction with the underground rooms, which in this way were removed from the operation of the Act. In two cases it was found necessary to take legal proceedings to enforce compliance with the Act. In each case the defendant was convicted. The powers of sanitary authorities in relation to underground rooms are greatly strengthened by Section 17, Sub-section 7, of the Housing, Town Planning, &c., Act, 1909, which enables the sanitary authority to close an underground room that is habitually used as a sleeping place, unless the room is on an average at least seven feet high and complies with the regulations which the sanitary authority are empowered to make for securing the proper sanitary condition of such rooms. This new power will be useful in dealing with underground rooms, which, although used as sleeping places, are occupied with rooms on upper floors, and are therefore exempt from the special requirements for underground rooms in the Public Health Act. Under the Housing, Town Planning, &c. Act, 1909, the Council drafted a set of regulations relating to underground sleeping rooms, and submitted them to the Local Government Board for approval. The regulations, which are set out in full on page 75 have not yet been approved by the Board. Housing, Town Planning, etc., Act. This Act imposes upon Sanitary Authorities certain duties of great importance. One of the most important of these is the duty laid upon every Sanitary Authority by Section 17 (1) of the Act "to cause to be made from time to time inspection of their district with a view to ascertain whether any dwelling-house therein is in a state so dangerous 72 or injurious to health as to be unfit for human habitation, and for that purpose it shall be the duty of the Local Authority, and of every Officer of the Local Authority, to comply with such regulations and to keep such records as may be prescribed by the Local Government Board." On September 2nd, 1910, the Board made an Order prescribing the regulations referred to in Section 17 of the Act. These regulations are in the following terms :— Article I.—(1) The local authority shall, as early as practicable after the date of this Order, take into consideration the provisions of Sub section (1) of Section 17 of the Act of 1909, and shall determine the procedure to be adopted under these Regulations to give effect to the requirements of that sub section in regard to the inspection of their district from time to time. (2) The local authority shall, as part of their procedure, make provision for a thorough inspection to be carried out from time to time according to the varying needs or circumstances of the dwelling-houses or localities in the district of the local authority. (3) The local authority shall cause to be prepared from time to time by the Medical Officer of Health, or by an Officer designated by them but acting under his direction and supervision, a list or lists of dwelling-houses the early inspection of which is, in the opinion of the Medical Officer of Health, desirable. The list or lists may, if thought fit, relate to the dwelling-houses within a defined area of the district without specifying each house separately therein. Article II.—The inspection under and for the purposes of Sub-section (1) of Section 17 of the Act of 1909 shall be made by the Medical Officer of Health, or by an Officer designated by the local authority but acting under his direction and supervision, and the Officer making inspection of any dwelling-house shall examine the state of the dwelling-house in relation to the following matters, namely:— (1) The arrangements for preventing the contamination of the water supply. (2) Closet accommodation. (3) Drainage. (4) The condition of the dwelling-house in regard to light, the free circulation of air. dampness, and cleanliness. (5) The paving, drainage, and sanitary condition of any yard or out-houses belonging to or occupied with the dwelling-house. (6) The arrangements for the deposit of refuse and ashes, 73 (7) The existence of any room which would in pursuance of Subsection (7) of Section 17 of the Act of 1909 be a dwelling-house so dangerous or injurious to health as to be unfit for human habitation. (8) Any defects in other matters which may tend to render the dwelling-house dangerous or injurious to the health of an inhabitant. Article III.—Records of the inspection of dwelling-houses made under and for the purposes of Sub-section (1) of Section 17 of the Act of 1909 shall be prepared under the direction and supervision of the Medical Officer of Health, and shall be kept by the Officer of the local authority making the inspection or by some other Officer appointed or employed for the purpose by the local authority. The records may be kept in a book or books or on separate sheots or cards, and shall contain information, under appropriate headings, as to:— 1. The situation of the dwelling-house, and its name or number, 2. The name of the Officer who made the inspection, 3. The date when the dwelling-house was inspected, 4. The date of the last previous inspection and a reference to the record thereof, 5. The state of the dwelling-house in regard to each of the matters referred to in Article II. of these Regulations, 6. Any action taken by the Medical Officer of Health, or other Officer of the local authority, either independently or on the directions of the local authority, 7. The result of any action so taken, 8. Any further action which should be taken in respect of the dwelling-house. Article IV.—The local authority shall, as far as may be necessary, take into consideration at each of their ordinary meetings the records kept in pursuance of Article III. of these Regulations, and shall give all such directions and take all such action within their powers as may be necessary or desirable in regard to any dwelling-house to which the records relate, and a note of any directions so given and the result of any action taken shall be added to the records. Article V.—The Medical Officer of Health shall include in his Annual Report information and particulars in tabular form in regard to the num ber of dwelling-houses inspected under and for the purposes of Section 17 of the Act of 1909, the number of dwelling-houses which on inspection were considered to be in a state so dangerous or injurious to health as to be unfit for human habitation, the number of representations made to the 74 local authority with a view to the making of closing orders, the number of closing orders made, the number of dwelling-houses the defects in which were remedied without the making of closing orders, the number of dwelling-houses which after the making of closing orders were put into a fit state for human habitation, and the general character of the defects found to exist. He shall also include any other information and particu. lars which he may consider desirable in regard to the work of inspection under the said Section. Article VI.—The Medical Officer of Health and any other Officer of the local authority shall observe and execute all lawful orders and directions of the local authority in regard to or incidental to the inspection of the district of the local authority under and for the purposes of Section 17 of the Act of 1909, and the execution of these Regulations. Article VII.—In these Regulations "the Act of 1909" means the Housing, Town Planning, Ac., Act, 1909. Article VIII.—These Regulations may be cited as the Housing (Inspection of District) Regulations, 1910. On the 17th November the Council considered the regulations, and decided that the present staff of the Public Health Department was inadequate to carry out the duties imposed by the regulations, and that it would be necessary to appoint an additional inspector for that purpose. Mr. A. C. Townsend, of Bermondsey, was appointed, but his appointment was not made and confirmed until April, 1911. One house, namely, No. 83, Palmerston Road, was represented under Section 17 of the Act as unfit for habitation, and on January 12th the Council made a closing order on the house. The owner appealed against the closing order to the Local Government Board, but at the time of writing the appeal has not been decided. One of the most important provisions of the Act is that relating to underground rooms. Under the Public Health Act underground rooms cannot be occupied separately as dwellings unless they comply with certain provisions which are specified in detail in the Act. These, however, do not apply if the rooms are occupied with a room or rooms on an upper floor. The new Act provides that every underground room that is habitually used as a sleeping place must be at least seven feet in height on an average from floor to ceiling, and must comply wth such regulations as the Sanitary Authority, with the consent of the Local Government Board, may make, 75 On 16th June the Council adopted the following draft regulations, which were submitted to the Local Government Board for approval. These regulations are in effect the requirements of the Public Health (London) Act relating to underground rooms occupied separately as dwellings: — (a) The room shall have at least three feet of its height above the surface of the street or ground adjoining or nearest to the room : Provided that, if the width of the area hereinafter mentioned be not less than the height of the room from the floor to the said surface of the street or ground, the height of the room above such surface may be less than three feet, but it shall not in any case be less than one foot, and the width of the area need not in any case be more than six feet. (b) Every wall of the room shall be constructed with a proper damp course, and, if in contact with the soil, shall be effectually secured against dampness from that soil. (c) There shall be outside of and adjoining the room and extending along the entire frontage thereof and upwards from six inches below the level of the floor thereof an open area, properly paved, at least four feet wide in every part thereof: Provided that in the area there may be placed steps necessary for access to the room, and over and across such area there may be steps necessary for access to any building above the underground room, if the steps in such case be so placed as not to be over or across any external window. (d) The said area and the soil immediately below the room shall be effectually drained. (e) If the room has a hollow floor, the space beneath it shall be sufficiently ventilated to the outer air. (/) Any drain passing under the room shall be properly constructed of a gas-tight pipe. (g) The room shall be effectually secured against the rising of any effluvia or exhalation, and for that purpose the site of the room shall be covered with a layer of good concrete, at least six inches thick, and smoothed on the upper surface. The concrete must be composed of clean gravel, broken hard brick, "properly burnt ballast, or other approved hard material, well mixed with cement in the proportion of one of cement to eight of the other material. {h) The room shall be effectually ventilated. (i) The room shall have a fire-place with a proper chimney or flue. (j) The room shall have one or more windows opening directly into the external air with a total area clear of the sash-frames equal to at least one-tenth of the floor area of the room, and so constructed that one-half at least of each window of the room can be opened, and the opening in each case extends to the top of the window. 76 The Board took exception to some of these provisions, chiefly to that relating to the width of the area. They suggested that it was unnecessary to require a width of four feet in every part, and that the case would be met by prescribing a minimum width of three feet, and a mean width of four feet. To this the Council replied that the minimum width of four feet was already required by the Public Health Act, and the introduction of another and a lower standard would lead to misunderstanding and difficult}' in administration. At the time of writing the regulations still require the confirmation of the Board. The Water Supply of Tenement Houses. In former Annual Reports an account was given of the action taken to improve the water supply of tenement houses under the powers conferred upon London sanitary authorities bv Section 78 of the London County Council (General Powers) Act, 1907, which empowers the sanitary authority to require a proper and sufficient supply of water on each storey of a tenement house that is separately occupied. In many London tenement houses the only water supply available is from a tap in the basement or yard, and it is not surprising that in such houses the tenants of the upper floors practice a strict economy in the use of water, even to the extent of falling short of any decent standard of cleanliness. A plentiful supply of pure water is one of the first requisites of a healthy life, but in many tenement houses this requisite is not fulfilled, nor until the General Powers Act of 1907 was passed had sanitary authorities any power to insist on its fulfilment. This Act, however, has led to a considerable improvement. The number of houses dealt with in Hampstead during the last three years is as follows : - 1908 24 1909 85 1910 99 In each house a water-tap and a glazed earthenware sink were provided on each floor. These alterations have been greatly appreciated by the tenants, and have had a beneficial effect in improving the general sanitarv condition of the houses. 77 Public Mortuary. During the year the bodies of 87 persons were brought to the Mortuary, as against 85 last year—46 by order of the Coroner, 19 by the Police, and 22 at the request of friends of the deceased persons. In 63 instances, or 72 per cent, of the bodies admitted, inquests were held, and in 39 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 48 Accidental deaths 15 Suicide 14 Neglect at birth 1 Misadventure 6 Total 84 Three of the bodies received at the Mortuary were those of stillborn children. 78 MORTUARY RECORD FOR THE YEAR, 1910. Bodies Admitted. No. of Post-Mortems. No of Inquests. No. of Funerals from Mortuary. Month. Males. Females. Totals. Males. Females. Totals. January 3 4 7 2 1 3 6 7 February 3 4 7 2 2 4 6 7 March 6 4 10 2 2 4 5 10 April 3 2 5 1 2 3 2 5 May 5 2 7 1 2 3 5 7 June 9 — 9 1 — 1 7 9 July 2 1 3 1 1 2 2 3 August 1 — 1 1 — 1 1 1 September 5 4 9 2 2 4 7 7 October 5 3 8 1 1 2 7 8 November 5 5 10 4 3 7 8 9 December 5 6 11 1 4 5 7 11 Totals 52 35 87 19 20 39 63 84 79 Food Inspection. No seizures of unsound and diseased food were made during the year, but the following articles were voluntarily surrendered to the Inspectors. Date. Premises. Food seized or surrendered. May 25th Fortune Green Road 1 trunk Hake (59 lbs.) June 24th Peebles Mews 8 stone Plaice Slaughterhouses. There are four slaughterhouses in the Borough, situated as follows:—40, England's Lane; 17, High Street; 69, High Street; 6 Fairfax Mews. The slaughterhouses were regularly inspected during the year, the number of inspections being 59. In December it was found that, the quarterly lime-washing had not been carried out, and that at one slaughterhouse the offal was left in uncovered receptacles. Notices were served, and the necessary work was carried out by the end of the month. The number of slaughterhouses in 1909 was five, including one at 242, Belsize Road, but the occupier of this slaughterhouse having been convicted in January, 1910, of a contravention of the London County Council (General Powers) Act, 1908, decided to discontinue the use of the premises as a slaughterhouse, and did not apply for the renewal of his licence. In 1899 there were 7 slaughterhouses in Hampstead, and the number at the present time is only 4. A similar reduction in the number of slaughterhouses has taken place in the other parts of London, the total number in the County having fallen from 411 in 1899 to 264 in 1909. Milk Supply. The number of persons registered as purveyors of milk at the end of 1910 was 85, and the number of premises on which milk is sold was 107. The difference in the two numbers was accounted for by the fact that some of the milksellers occupy more than one shop. 80 The premises on which milk is sold are as follows:— Dairies 50 Bakehouses and Confectioners 20 Restaurants and Coffee Shops 16 General Shops 21 Four of the registered milksellers do not occupy shops, two being registered in reference to refreshment tents on Hampstead Heath on Bank Holidays, and two have milk rounds in the Borough hut no shops. During the year 495 inspections were made of premises where milk is sold, and the following works were carried out:— Premises or parts of premises repaired, cleansed, and limewashed 18 Water cisterns cleansed or covered 5 Drains repaired or reconstructed 10 Drains unstopped 2 Drain inlets inside premises abolished 4 Soil pipes repaired or reconstructed 6 Water-closets repaired or renewed. 15 Water-closets cleansed 9 Roofs repaired 4 Gutters and rainwater pipes repaired or renewed 6 New sinks fixed 5 Waste pipes of sinks trapped, repaired or renewed 12 Yard paving repaired or renewed 12 Dustbins provided 5 Gullies cleansed 2 Section 5 of the London County Council (General Powers) Act, 1908, empowers sanitary authorities in London to remove from the register of milksellers any cowkeeper, dairyman, or purveyor of milk who is carrying on his trade on premises unsuitable for the sale of milk, and to refuse to enter any such person upon the register. As a result of an inspection that was made in 1909 and the early part of 1910, the Public Health Committee recommended the Council in April, 1910 to remove 20 milkshops from the register as being unsuitable for the sale of milk. All these places were general shops in which milk was sold with a variety of articles, the presence of which rendered the milk liable to contamination. The Committee's recommendation was not adopted by the Council, and the shops remain upon tie register, except two that changed in occupation during the year, and are now used for other trades. 81 Three general shops, in addition to those included in the Committee's report, changed occupation during the year, one was used for another trade, and the new occupiers of the other two were refused registration by the Council. The number of general shops selling milk was in this way reduced from 26 in 1909 to 21 in 1910. Ice Cream. The sale of ice cream in London is controlled by Sections 42 and 43 of the London County Council (General Power) Act, 1902. There are 83 shops in the Borough in which ice cream is sold, and 289 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 at premises where ice cream is sold :— Premises or parts of premises repaired, cleansed and limewashed 9 Drains repaired or reconstructed 5 Drains unstopped 3 Soil pipes reconstructed 4 Water-closets renewed 8 „ cleansed 5 Flushing cisterns to water-closets repaired 4 New sinks provided 3 Waste pipes of sinks trapped, repaired, or renewed 14 Roofs repaired 4 Rainwater pipes repaired 3 Yards paving repaired 3 Dustbins provided 1 Other defects remedied 10 Food Premises. Section 8 of the London County Council (General Powers) Act, 1908, contains provisions that considerably increase the power of sanitary authorities to regulate the sanitary condition of places where food is prepared or sold. The section, which has been set out in full in previous Annual Reports, provides, among other things, that there shall be no drain inlet in any room where food is prepared or sold, that no sanitary convenience shall be within such a room or in direct communication with it, and that such a room shall be kept clean and not used as a sleeping place. 82 During 1909 and 1910 a systematic inspection of these places was made, and in a considerable number of cases conditions in contravention of the Act, were found. In 1909 the total number of premises altered in order to comply with the Act was 19, as set out in the Report for that year. In 1910 the number of premises dealt with was 52. Of these places 39 were found to have drain inlets in rooms where food was prepared or sold, in 39 premises the drains were defective, in 15 structural defects of various kinds were present, and 38 premises needed cleansing. The places were dealt with as follows:—in 36 instances the drains were entirely, and in 3 instances partially, reconstructed; in 39 instances improperly placed drain inlets were removed, with or without re-drainage; in 15 instances more or less extensive structural alterations, other than drainage alterations, were carried out; and 38 premises were thorougly cleansed under notice. Two premises were pulled down, and in 7 cases the use of the premises for the sale or preparation of food was discontinued. The trades carried on and the alterations made on the premises dealt with in 1910 were as follows:— Trades. DRAINAGE. PREMISES. No. of Premises Entire reconstruction Partial reconstruction Drain openings removed. Cleansed Structurally altered. iscontinued. Butcher 8 6 - 6 6 2 2 Confectioner 7 2 — 3 2 5 1 Dairy 3 3 — 1 3 — — Fishmonger 4 3 - 4 4 2 — Greengrocer 11 6 - 7 8 2 4 Grocer & Provision Merchant 9 8 1 9 9 1 — Restaurants 4 3 1 4 4 2 — Other Trades 6 5 1 5 2 1 — Totals 52 36 3 39 38 15 7 83 The General Powers Act of 1908 has been found of considerable value in Hampstead in enabling the Sanitary Authority to require a reasonable standard of sanitation in places where food is prepared and sold, but it is chiefly of value in so far as it deals with structural conditions. There is still need for further powers to regulate the daily ordering of these places in order to secure a proper standard of cleanliness. Unfortunately, many of the persons engaged in the preparation of food have little appreciation of the importance of scrupulous cleanliness in their work, and not infrequently there is a striking contrast between the place where the food is shown to the public for sale and the place where it is prepared for sale. Slaughterhouses are not only regulated by a code of by-laws, but are also subject to annual licensing, and an important advance in sanitation would be secured if similar provisions were made to apply to bakehouses, dairies, restaurant kitchens, and other food premises. Modern research in sanitary science, based on the information furnished by a long and rapidly increasing series of food outbreaks in various parts of the country, tends to emphasize more and more the importance of the food factor in disease and the necessity for the stringent regulation of places where food is prepared for human consumption. Inspection of Premises where Food is Prepared or Stored (other than Bakehouses, Milk Shops, Eating Houses and Slaughterhouses). The premises inspected during the year, together with the nature of the business carried on, were as follows:— Butchers and Pork Butchers 65 Confectioners 106 Grocers 76 Provision and Cheesemongers 52 Greengrocers and Fruiterers 86 Fishmongers 33 Fried Fish Shops 12 General Shops 27 457 731 inspections were made of these premises during the year and 155 notices were served. 84 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 506, and the number certified by the Public Analyst to be adulterated was 12, or 2.3 per cent. of the total number. The corresponding percentage in 1909 was 3.9; in 1908 it was 3'5. In addition, 17 samples were certified to be of low quality. 402 samples were purchased from Hampstead tradesmen, and 104 from persons residing without, but trading within, the Borough. The percentages of adulterated samples in these two classes were 1.9 and 3.8 respectively. Seventeen samples were taken on Ilampstead Ileath on Bank Holidays, and of these 4, or 23.5 per cent, were adulterated, and one was of poor quality. Forty-five samples were taken on Sundays ; one of this number was found to be adulterated and two were of low quality. 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:— Articles. Number taken. Adulterated. Low Quality. Butter 73 1 – Camphorated Oil 6 — – Cheese 17 — — Cocoa 14 - — Coffee 29 — — Cod Liver Oil 5 — — Dripping 6 — — Glycerine 7 — — Lard 24 — — Margarine 5 - — Milk 310 11 17 Mustard 2 - — Peas, Preserved 1 — — Pepper 2 — — Sausages 5 - — Tea 1 - - Totals 506 12 17 85 The following table shows the number of samples analysed during each year from 1904 to 1910, 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.  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 1908 508 18 3·5 12 1 0 1909 506 20 3·9 29 4 6 1910 506 12 2·3 25 6 0 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) 67 l 1·4 No. 2 (Belsize) 68 4 5·8 No. 3 (Adelaide) 18 1 5·5 No. 4 (Central) 21 — — No. 5 (West End) 86 — — No. 6 (Kilburn) 89 1 1·1 No. 7 (Priory) 53 1 1·8 Totals 402 8 1·9 86 The following table shows the articles adulterated, nature of adulteration and the result of proceedings taken:— No. of Sample. Article. How adulterated. Result of proceedings.  40 Milk 6 per cent. deficient in butter-fat. Dismissed. Vendor proving warranty. £ s. d. s. d. 49 Butter 59 9/10 grains of boric acid per pound Fine 0 10 0 Costs 12 6 53 Milk 25 per cent. deficient in butter-fat „ 0 10 0 „ 12 6 127 Milk 2½ per cent. added water Cautioned by order of Public Health Committee. £ s. d. s. d. 136 Milk 16 per cent. added water Fine 1 0 0 Costs 12 6 169 Milk 31 per cent. added water „ 10 0 0 including costs 171 Milk 93 per cent. deficient in butter-fat „ 2 0 0 ,, 172 Milk 9 per cent. deficient in butter-fat 1 0 0 Costs 14 6 173 Milk 10 per cent. added water „ 1 1 0 „ 21 0 210 Milk 14 per cent. deficient in butter-fat „ 2 0 0 „ 12 6 222 Milk 11 per cent. added water „ 1 0 0 „ 12 6 275 Milk 26 per cent. deficient in butter-fat ,, 0 10 0 „ 17 0 In addition to the samples hitherto described, three informal samples of butter were taken, two of which proved to be adulterated. 87 Complaints. During 1910 755 complaints were made of the existence of insanitary conditions. A list of the matters of which complaint was made is given below:— Accumulations, offensive 7 „ of garden and other refuse 11 Animals, improperly kept 15 „ dead 2 Dampness in premises 23 Dirty premises 19 Drain, bad condition of 17 „ defective 21 „ stopped 18 Dust, non-removal 59 Dust receptacles, foul or dilapidated 30 „ absence of, or insufficient 12 Insanitary condition of premises 35 Illness attributable to insanitary conditions 11 Manure not removed 8 Overcrowding and improper mixing of sexes 29 Rats, nuisance from 10 Roadways, bad condition of 7 Roofs and Gutters, defective and leaky 9 Rubbish, nuisance from burning 6 Smells 18 „ on premises 20 „ from road gullies 6 „ „ sewer ventilators 64 „ „ stables 4 ,, „ drains, &c 28 „ „ water-closets 10 „ ,, manure 5 Smoke nuisances 5 Underground rooms illegally occupied 4 Unsound food 5 Vacant land, insanitary state of 9 Verminous condition of premises 9 Water, absence of 194 „ leakage of 11 Water cisterns, dirty, &c. 3 Water-closets,accommodation insufficient or absence of 3 „ defective or insanitary 24 „ stopped 5 „ without water 4 „ „ proper flush 10 Yards unpaved and existing paving defective 4 Miscellaneous 55 Total 849 Factory and Workshop Act, 1901. 91 Factory and Workshop Act, 1901. This part of the 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 1910 there were 468 workshops on the register, o which 38 were domestic workshops. Excluding the latter, there were employed in the workshops 706 males and 1,040 females. Dressmaking is the trade chiefly carried on in the Hampstead workshops, and next in order of frequency come bootmaking, baking, tailoring and millinery. The following table shows the number of each class of workshops' the number of workrooms, and the number of persons of each sex employed. Workshops, and Domestic Workshops. Trade or Business. Workshops other than Domestic Workshops. Domestic shops. Total number of shops.  Number of Workshops. Number of Workrooms. Number of Employees. Males. Females. Bakers 35 41 128 - - 35 Blindmakers 4 7 10 10 — 4 Bootmakers 45 49 90 - — 45 Builders and carpenters 24 27 42 - — 24 Cabinetmakers and polishers 2 4 3 — — 2 Carriage builders 7 16 40 — — 7 Cycle makers and repairers 5 9 16 — — 5 Dressmakers and ladies' tailors 107 131 3 511 18 125 Embroiderers 4 5 1 10 — 4 Engineers 2 2 4 — — 2 Florists 2 3 12 13 — 2 Harness makers 5 6 12 — — 5 Ironmongers 13 13 30 — — 13 Laundresses 7 20 5 49 — 7 Mantlemakers 2 5 — 15 — 2 Milliners 30 31 — 110 1 31 Monumental masons 2 2 15 — — 2 Motor makers 3 4 12 — — 3 Outfitters' 7 28 5 198 — 7 Pianoforte makers 2 4 26 — — 2 Picture frame makers 10 12 16 1 — 10 Sign writers 2 3 8 — — 2 Smiths 11 11 29 — — 11 Tailors 34 42 80 59 10 44 Upholsterers 14 20 26 17 4 18 Watchmakers and jewellers 15 16 31 — — 15 Wigmakers 12 19 16 27 — 12 Miscellaneous 24 35 46 20 5 29 Totals 430 565 706 1040 38 468 92 Workshop Inspection. The following particulars relate to the workshop inspections made during 1910, bakehouse inspections being omitted. The total number of inspections made during the year was 594; this number is slightly lower than the corresponding number in 1909, owing to the fact that Miss Moynihan, one of the Workshop Inspectors, resigned during 1910, and her successor did not enter upon her duties until the following year. Cleanliness. Eleven workrooms were found on inspection to require cleansing; 5 of these were cleansed on the request of the Inspector, and in 6 cases it was necessary to serve a notice before the work was carried out. Ventilation and Warming. Two workshops were found to be without windows or any means of ventilation other than the door opening into the workshop. In both cases the lighting was so defective that it was necessary to use artificial light while work was being carried on. In 8 other workshops the means of ventilation were inadequate. In all these cases proper means of ventilation were provided. Eight workshops were found to be warmed by gas stoves 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 5 cases suitable means of warming were provided, 2 cases were reported to the Factory Inspector, and one case was under notice at the end of the year. 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 workroom. During 1910 47 new workrooms were measured. 93 Overcrowding was found in 14 instances. In 9 cases the overcrowding was abated at the request of the Inspector, but in 5 cases it was found necessary to serve a written notice. 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 workshop, and in such other parts thereof " as the factory inspector may direct; and Section 183 of the Act provides that " when any women, 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." The object of this section is to secure that all new workshops in which protected persons are employed, discovered by the officers of the local authority shall be brought to the notice of the Factory Inspector, who supplies the occupiers of workshops with the abstracts of the Act. The occupier of a workshop is under legal obligation to give notice of his occupation of the workshop to the1 Factory Inspector within a month after it has begun, but owing to ignorance of the law, and for other reasons this obligation is frequently left unfulfilled, and the inspector is informed of the occupation by the local Medical Officer of Health. Pursuant to this section 25 workshops were notified to II.M. Inspector of Factories as being without the abstract as required. Bakehouses. At the end of 1910 there were 38 bakehouses on the register, 22 being underground, and 16 above ground. Three of the bakehouses situated above ground use power and are therefore factories. Three inspections were made in respect of the factory bakehouses, and 70 inspections in respect of the workshop bakehouses. In a considerable number of bakehouses, particularly those where confectionery is made, the standard of cleanliness is not high, although the conditions are hardly serious enough to constitute a contravention of the Act. Bakehouses, like other places where food is prepared for hnman consumption, need to be regulated by by-laws formulating in detail the conditions as to cleanliness, &c., that should be observed. 94 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 f 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. 45, South End Road. (3) (late 2, Heathurst Road). No. 3 (Adelaide) Ward— *44, England's Lane. *90, Haverstock Hill. *2, King's College Road. (3) No. 4 (Central) Ward. *64, Belsize Lane. *225, Finchley Road. *289, do. †307, do. *98, West End Lane (6) †2, Broadhurst Gardens. No. 5 (West End) Ward. †60, Cricklewood Broadway. 110, 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 (Kilhurn) Ward. "63, Hemstall 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 16 Total 38 95 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, coffee-houses, etc., and the number of these places in Hampstead in 1909 was 62. During 1910, 7 restaurant kitchens were added to the register, and 3 were removed, leaving a total of 66 on the register at the end of the year. These premises are kept under regular supervision. 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. 57, do. 63 & 65, do. 70, do. 100, do. 108, 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. 11, South End Road. 17, do. 45, do. (late 2, Heathhurst Road). Railway Tavern, South End Green. 19, Southampton Road (11) No. 3 (Adelaide) Ward— 1, Adelaide Road. 143, Adelaide Road. 97, Haverstock Hill. 11, King's College Road. Cosy Nook, Regent'sPark Road. Winchester Hotel, Winchester Road (6) No. 4 (Central) Ward— 72, Belsize Lane. 90, do. 159, Broadhurst Gardens. 1a, Canfield Place. 104, Finchley Road. 225, do. 289, do. 100, West End Lane. 272, do. 280, do. (10) No. 5 (West End) Ward— 106, Cricklewood Broadway. 92, Fortune Green Road. 106, Mill Lane. 251, West End Lane. 291, do. 295, do. 327, do. 351, do. (8) 96 Restaurant Kitchens in Wards.—continued. No. 6 (Kilburn Ward)— 132, High Road, Kilburn. 188, do. do. 272, do. do. 308, do. do. 354, do. do. 145, Iver.son Road. Towers' Coffee Rooms, Love- ridge Road 96, Palmerston Road (8) No. 7 (Priory) Wakd— 121, Abbey Road. 21, Alexandra Road. No. 203, Belsize Road. 264 do. 274 do. 36, Boundary Road. 114, do. 65, Fairfax Road. 98, Finchley Road. 115, do. 34, High Road, Kilburn. 48, do. do. Steer's Restaurant, Upper Avenue Road (13) Total 66 The number of inspections of the above premises made during the year was 239 and 21 notices were served. Home Work. The Factory Act provides that in certain trades, to be specified by the Home Secretary, the iemployers 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 number of lists received from employers was 158 and the number of addresses contained in the lists was 415. In 355 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 40. The total number of outworkers' premises in Hampstead is 84. Of these 5 are factories, 51 are workshops (19 of these being domestic workshops), 2 are workplaces, and in 26 cases only a single worker is employed on the premises. 97 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:— Art Metal Workers 2 Dairymen 2 Bakehouses 2 Laundries 6 Bootmakers 7 Motor Workers 4 Builders 4 Printers 9 Butchers 8 Other trades 18 Carpet Beaters 2 69 Coffee Roasters 5 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, WORKPLACES AND HOMEWORK. 1,—Inspection of Factories, Workshops, and Workplaces. Including Inspections made by Sanitary Inspectors. Premises. (1) Number of Inspections. (2) Written Notices. (3) Prosecutions. (4)  Factories (Including Factory Laundries) 78 — — Workshops (Including Workshop Laundries) 763 22 — Workplaces (Other than Outworkers' premises included in Part 3 of this Report 1010 23 — Total 1851 45 — 98 2.—Defects found in Factories, Workshops, and Workplaces. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H. M. Inspector. (1) (2) (3) (4) (5)  Nuisances under the Public Health Act:— Want of cleanliness 23 22 — — Want of ventilation 10 9 — — Overcrowding 14 14 — — Want of drainage of floors — — — — Other nuisances 45 43 — — insufficient 2 2 — — Sanitary accommodation unsuitable or defective 5 5 — — not separate for sexes — — — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (s. 101) - - - - Breach of special sanitary requirements for bakehouses (ss. 97 to 100) - - - - Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report.) - - - - Total 99 95 — — Column (2) in the above table gives the number of defects found, and column (3i 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, and column (3) includes some defects which were found at the end of 1909, and remedied in the following year. 99 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. Notices served on piers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110). Sending Twice in the year. Sending Once in the year. Received from other Councils. Forwarded to other Councils. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Lists. Outworkers. Contractors. Workmen. Contractors. Workmen. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 10 17 18 19  Wearing Apparel- (1) making. etc. 96 59 180 10 1 19 40 239 - - - 61 - - - - - - (2) cleaning and washing 14 30 1 1 5 — — 33 — — - 1 - - - - — — Lace, lace curtains and nets 10 3 8 1 — 1 — 1 — — - - - - — - — - Artificial flowers - - - - - - - - - - - - - - - - - - Nets, other than wire nets - - - - - - - - - - - - - - - - - - Tents - - - - - - - - - - - - - - - - - - Sacks - - - - - - - - - - - - - - - - - - Furniture and upholstery 14 18 32 2 1 2 — 31 — — - 11 - - — - — — Fur pulling - - - - - - - - - - - - - - - - - - Feather sorting - - - - - - - - - - - - - - - - - - Umbrellas, etc. — 8 — — — 1 — 9 — - - 2 - - — - — — Carding, etc., of buttons, etc. - - - - - - - - - - - - - - - - - - Paper bags and boxes 2 — 37 - - - - 34 - - - 3 - - - - - - Basket making - - - - - - - - - - - - - - - - - - Brush making - - - - - - - - - - - - - - - - - - Racquet and tennis balls - - - - - - - - - - - - - - - - - - Stuffed toys — — - 1 - 2 - 1 - - - 2 - - - - — — File making - - - - - - - - - - - - - - - - - - Electroplate 6 6 — 1 1 - - - - - - - - - - - - - Cables and chains - - - - - - - - - - - - - - - - - - Anchors and grapnels - - - - - - - - - - - - - - - - - - Cart gear - - - - - - - - - - - - - - - - - - Locks, latches and keys - - - - - - - - - - - - - - - - - - Pea picking - - - - - - - - - - - - - - - - - - Total 142 124 258 16 8 25 40 355 - - - 80 - - - - - - * In several of the lists that were sent in the occupiers gave out work of more than one of the classes specified in Column 1. These lists have been included in columns 2 or 5 against the principal class only, but the outworkers have been assigned in columns 3 and 4 or 6 and 7 into their respective classes. 100 4.-Registered Workshops. Workshops on the Register (s. 131) at the end of the year. Number (1) (2)  Bakehouses 35 Bootmakers 45 Dressmakers and ladies' tailors 125 Laundries 7 Milliners 31 Tailors 44 Watchmakers and jewellers 15 Wigmakers 12 Other 154 Total number of workshops on Register 468 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) 25 Action taken in matters referred by H. M. Inspector as remediable under the Public Health Act, but not under the Factor and Workshop Act (s. 5) Notified by H. M. Inspector 1 Reports (of action taken) sent to H. M. Inspector 1 Other 12 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 1910, by ALFRED W. STOKES, F.C.S., F.I.C., Public Analyst. 103 Analytical Laboratory, Town Hall, Paddington, W. 9th January, 1911. A short abstract of the analytical work of the year 1910 may be of interest. A total of 509 samples were analysed. These comprised Milk 310, Butter 76, Groceries 60, Lard 24, Cheese 17, Drugs 17, and Margarine 5. Of the Milk samples only 11 samples, or 3½ per cent., were adulterated, while in London generally the proportion of adulterated samples was about 10 per cent. The 76 samples of Butter contained only 3 adulterated samples, or 4 per cent, as against the 9 per cent, in London generally. These were the only articles adulterated. The Groceries, Drugs, &c., were all genuine and of good quality. Contrasted with the food supply of the Metropolis generally, which shows about 8½ per cent, of adulterated samples, Hampstead comes out very well indeed, since it shows only 2¾ per cent, of adulterated samples. ALF. W. STOKES, F.C.S, F.I.C., Public Analyst. Legal Proceedings. 107 Legal Proceedings. Legal proceedings were taken by the Council in connection with the work of the Health Department in 54 cases during tire year. The chief facts relating to these proceedings are set out on pages 108-112, and are summarised below. The facts relate only to the cases that were heard Olid decided in 1910. Statute or By-law. Number of Prosecutions. Fines. Costs. £ s. d. £ s. d. Public Health (London) Act, 1891, and By-laws made thereunder 27 29 6 0 10 0 0 Metropolis Management Acts, and By-laws made thereunder 14 60 0 17 11 8 Sale of Food and Drugs Acts 12 19 10 0 5 0 0 London County Council (General Powers) Act, 1908 1 — 0 12 6 Totals 54 54 16 0 33 4 2 108 Public Health (London) Art, 1891, and By-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. 7 1909. 29th .1 uly 1910. 21st Jan. Marylebone Police Court, Mr. Plowden E. H. W., St. Marylebone Nuisance Work done, 10s. (3d. costs paid and summons withdrawn 3 1910. 13th Jan. 4th Feb. Do. W. J. P., City Non-compliance with Notice Work done, 10s. 6d. costs paid, and summons withdrawn 6 Do, 11th Feb. Do. J. H., Hampstead Nuisance Order made to abate within one month, and 6s. costs granted 5 1st Mar, 9th Mar. Hampstead Petty Sessional Court, Justices F. W. R., Hampstead Repairing drain so as to be a nuisance Fined £20 and 6s. 6d. costs 2 10th Feb. 18th Mar. Marylebone Police Court, Mr. Plowden J. C. H., Islington Non-compliance with Order of Council Work done and summons withdrawn on payment of 10s. 6d. costs 7 12th April 29th April Do. H. C., Hampstead Nuisance Order made to abate within seven days and 6s. costs allowed 7 21st April 10th June Marylebone Police Court, Mr. Denman D. G., Hampstead Allowing underground room to be illegally occupied Fined 40s. and 2s. costs 7 Do. Do. Do. H. B., Hampstead Illegally occupying underground room Ordered to pay 2s. costs 7 12th April Do. Do. H. C., Hampstead Non-compliance with Magistrate's Order to abate nuisance Fined 20s. and £,2 2s. costs 6 7th April Do. Do. W. S., Willesden Nuisance Order made to abate within 14 days and 6s. costs allowed 2 2nd June 22nd June Hampstead Petty Sessional Court, Justices A. J. M. Hampstead Selling milk without being registered Fined 5s.. including costs 1 Do. Do. Do. E. L., Willesden Selling milk without being registered 2s. Costs allowed 109 Public Health (London) Act, 1891, and By-Laws made thereunder—con. Ward No. Date when proceedings ordered. Date of Hearing. Court, and Name of Magistrate. Initials and District of Defendant. Offence. Result of Hearing. 1 1910. 2nd June 1910. 22nd June Hampstead Petty Sessional Court, Justices G. A . Camberwell (i.) Selling milk without being registered (ii.) Using dirty utensils (i.) Withdrawn (ii.) Fined 5s. 1 Do. Do. Do. F. W., Camberwell (i.) Selling milk without being registered (ii.) Using dirty utensils (i.) Withdrawn (ii.) Fined 5s. 1 Do. 29th June Do. A. M., Camberwell (i.) Selling milk without being registered (ii.) Not having name and address on vehicle (i.) Fined 1s. and 2s. costs (ii.) Fined 1s. and 2s. costs 6 22nd June 1st July Marylebone Police Court, Mr. Plowden W. W., Hampstead Nuisance Work done, 5s. costs paid and summons withdrawn 5 5th July 20th July Hampstead Petty Sessional Court, Justices D. W., Hampstead Repairing drain so as to be a nuisance Fined £5 and 6s. costs 5 21st April 29th July Marvlebone Police Court, Mr. Paul Taylor G. B., Hampstead Overcrowding Order made to abate within 14 days and 10s. 6d. costs granted 4 20th Oct. 4th Nov. Do H. M.. Hampstead Nuisance Premises vacated and summons withdrawn 3 17th Nov. 9th Dec. Marylebone Police Court, Mr. Plowden T. H.. Westminster Contravention of By-law 14, sec. 39 (i.) Fined 14s. and 23s. costs 3 22nd Nov. Do. Do. F. W., St. Marylebone Premises without a water supply Closing order made, and 6s. costs allowed 5 27th Sept. 16th Dec. Do. R. E., Hendon Nuisance Work done, summons withdrawn, 10s.6d. costs paid 5 Do. Do. Do. R. E., Hendon Nuisance Work done and summons withdrawn 110 Metropolis Management Acta, and By-Laws made thereunder. Ward No. Date when ings ordered. Date of Hearing, Court, and Name of Magistrate. Initials and District of Defendant. Offence. Result of Hearing. 1 1910. 18th Jan. 1910. 20th J an. Hampstead Petty Sessional Court, Justices H. S., Hampstead (i.) Failing to deposit plans, etc. (ii.) Contravention of Drainage By-law 8. Plans, etc., deposited, work altered, 10s. 6d. costs paid and summon see withdrawn 1 1909. 2nd Dec. 2nd Feb. Do. 8.N., City Non-compliance with Order of Council Dismissed, without costs 6 1910. 10th Feb. 1st April Marylebone Police Court, Mr. Plowden W. H.. Hampstead Failing to deposit plans, etc. Plans, etc., deposited, 10s. 6d. costs paid and summons withdrawn 4 1809. 21 st Oct. 15th April Do. W. B. M., Hampstead Failing to deposit plans, etc. Plans, etc,, deposited. 5s. costs paid and summons withdrawn 5 1910. 10th Mar. Do. Do. D. D., Willesden Failing to deposit plans, etc. Plans, etc., deposited, 5s. costs paid and summons withdrawn 1 19th May 20th July Hampstead Petty Sessional Court, Justices R. & W.t St. Pancras Failing properly to ventilate traps Fined t'l 5 6th Oct. 4th Nov. Marylebone Police Court, Mr. Paul Taylor D. D., Willesden Failing to deposit plans, etc. Plans deposited, 10s. Gd. costs paid, and summonses withdrawn 7 Do. 11th Nov. Marylebone Police Court, Mr. Plowden J. & P., Hackney (i.) Non-compliance with notice under sec. 73 (ii.) Ditto under Sec. 85 ii.) Fined 40s. and 2s. costs (ii.) Fined 20s. and £2 2s. costs and ordered to pay £3 12s. 6d. cost of opening up 5 5th July Do. Do. R. E., Hendon Failing to deposit plans, etc. Plans, etc., deposited. 5s. costs paid and summons withdrawn 3 17th Nov. 2nd Dec. Marylebone Police Court. Mr. Plowden T. H., Westminstei Failing to deposit plans, etc. Plans, etc.. deposited, summons withdrawn, and 23s. costs allowed 1ll Metropolis Management Acta, and By-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. 4 1910. 17th Nov. 1910. 21st Dec. Hampstead Petty Sessional Court. Justices E. O., Hampstead (i.) Erecting a ventilating pipe contrary to the Act (ii.) Non-payment of cost of altering work (i.) Fined 40s. and £5 5s. 0d. costs (ii.) Order made for payment of debt(£3 0s.8d.) and costs Sale of Food and Drugs Acts. 7 1909. 7th Dec. 1910. 7th Jan. Marylebone Police Court, Mr. Plowden A. E. F., Hampstead Selling cream containing 28 7-10 grains per pound of boric acid Fined 10s. and 1s. 6d. costs 2 1910. 7th April 13th April Hampstead Petty Sessional Court, Justices W.L.D.Co., Paddington Selling milk containing 25 per cent. less than the proper amount of butter-fat. Fined 10s. and 16s. costs 3 7th April 15th April Marylebone Police Court. Mr. Plowden E. D. C.. St. Pancras Selling milk containing 6 per cent. less than the proper amount of butter-fat Warranty proved and summons dismissed 2 Do. Do. Do. E. H , Hampstead Selling butter containing 53 9-10 grains of boric acid per lb. Fined 10s. and 12s. 6d. costs 6 21st April 27th May Marylebone Police Court, Mr. Denman H. H., Hampstead Selling milk containing 16 per cent of added water Fined 20s. and 12s. 6d. costs 2 2nd June 22nd June Hampstead Petty Sessional Court, Justices A.J. M., Hampstead Selling milk containing 31 per cent. of added water Fined £'10. including costs, or 14 days imprisonment 1 Do. Do. Do. E. L., Willesden Selling milk containing 9 per cent. less than the proper amount of butter-fat Fined 20s. and 14s. 6d. costs 1 Do. Do. Do. G. A., Camberwell Selling milk containing 93 per cent. less than the proper amount of butter-fat Fined £l 112 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. 1 1910. 2nd June 1910. 22nd June Hampstead Petty Sessional Court, Justices F. W. Camberwell Selling milk containing 93 per cent. less than the proper amount of butter-fat Fined £l 1 Do. 29th June Do. A. M , Camberwell Selling milk containing 10 per cent of added water Fined 20s. and 17s. costs 7 30th June 22nd July Marylebone Police Court, Mr. Denman E. H., Hampstead Selling milk containing 14 per cent. less than the proper amount of butter-fat Fined 10s. and 12s. 6d. costs 2 Do. Do. Do. W. E., Hampstead Selling milk containing 11 per cent. of added water Fined 20s. and 12s. 6d. costs 1 28th July 3rd Aug. Hampstead Petty Sessional Court, Justices N. E., Ltd., Westminster Selling milk containing 26 per cent. less than the proper amount of butter-fat Fined 10s. and 17s. costs London County Council (General Powers) Act, 1908. 7 1910. 13th Jan. 1910 21st Jan. Marylebone Police Court. Mr. Plowden G. J. B., Hampstead Using slaughterhouse for preparation of food contrary to the Act Order made for workk to be done within 14 days and 12s. 6d. costs allowed Appendix. Tables. 115 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 1910 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 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 14.53 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 93 1906 89633 1437 16.0 139 96.8 1104 12.3 494 364 110 850 9.5 1907 91137 1341 14.7 114 85.0 1056 11.6 472 330 91 817 9.0 1908 92654 1355 14.4 104 76.7 995 10.6 442 311 119 803 8.5 1909 94185 1282 13.6 111 92.8 1057 11.1 466 334 116 839 8.9 Averages for years 1900-1909 87486 1438 16.4 147 102.2 1108 12.7 469 352 100 856 9.8 1910 95729 1270 13.2 110 86.7 1071 11.2 501 350 108 829 8.6 * Rates 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 within 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" is 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 purposes 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 at all ages, 81,942. } At Census Number of inhabited houses, 11,294. Average number of persons per house, 7.2. of 1901. 116 TABLE I. (continued). I. II. III. Other Institutions, the deaths in which have been distributed among the several localities in the Borough. Institutions within the Borough receiving sick and infirm persons from outside the Borongh. Institutions outside the Borough receiving sick and infirm persons from the Borough. Consumption Hospital, Mount Vernon Alexandra Nursing Home, 2, Turle Road, Islington Banstead Asylum 6, Dennington Park Road 26, Belsize Avenue 17, Beaumont Street, St. Marylebone Hampstead Workhouse, 32, Belsize Lane Camberwell House Asylum Cancer Hospital, Chelsea New End 73, Belsize Park Gardens Caterham Asylum Chest Hospital, Victoria Park Children's Hospital,Carshalton 33, Belsize Square Children's Hospital, Paddington Green Hospital for Incurable Children, 30, College Crescent City of London Asylum, Stone Claybury Asylum Colony Hatch Asylum Dartford Heath Asylum 4, Crossfield Road German Hospital Hanwell Asylum Hampstead General Hospital, Hampstead Green Home for Incurables, 1, Highbury Terrace Home Hospital Home of Compassion, 57, King Henry's Road 51, Warrington Crescent Hospital of St. John and North-Western Fever Hospital, Lawn Road St. Elizabeth Jewish Hospital for Incurables Kensington and Fulham St. Peter's Home, Mortimer Road General Hospital King's College Hospital Lambeth Infirmary, Hampstead Workhouse, New End Brook Street Leavesden Asylum London Hospital 32, Parkhill Road London Temperance Hospital Long Grove Asylum 10, Rosslyn Hill Manor Asylum, Epsom Middlesex Hospital 117 TABLE I. (continued). I. II. III. Other Institutions, the deaths in which have been distributed among the several localities in the Borough. Institutions within the Borough receiving sick and infirm persons from outside the Borough, Institutions outside the Borough receiving sick and infirm persons from the Borough. 97, South Hill Park New Hospital for Women 70, Newhall Street, Private Erskine House, Spaniards Road Hospital, Birmingham Northern Fever Hospital, Winchmore Hill Friedenheim, Upper Avenue Road Peckham House Private Lunatic Asylum, Brook House, Upper Clapton Priory. The, Putney Royal Hospital, Waterloo Road St. Bartholomew's Hospital St. Giles Workhouse St. Luke's House, Kensington St. Mary's Hospital St. Monica's Hospital St. Pancras Infirmary, South St. Thomas' Hospital Tooting Bec Asylum University College Hospital Western Hospital Westminster Hospital 118 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 1910 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. j 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. 1900 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1901 11944 ... 142 96 12968 ... 139 99 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 435 919 15 10940 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 93 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 93 15790 496 171 50 11040 133 103 14 1906 13590 205 131 91 14190 187 127 8 10840 97 92 10 10123 95 83 3 13790 9.59 115 14 16030 444 197 41 11070 150 93 9 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 1908 14190 217 108 11 14770 203 126 8 10860 88 78 6 10584 102 82 6 14370 9,44 121 26 16670 380 186 30 11210 121 93 10 1909 14560 189 140 15 14990 197 130 16 10940 80 88 4 10735 112 63 3 14650 230 118 13 17010 330 182 37 11300 144 111 11 Averages } of Years } 1900 to} 1909 } ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1910 15100 189 118 15 15200 197 119 9 11000 92 78 2 10869 100 82 8 14900 203 121 17 17260 356 192 24 11400 132 111 6 Note —The following deaths were not able to be classified in wards owing to a definite address not having been registered:— 1901 The deaths of 9 Dersons over 1 year of ace. and — infantile deaths. 1902 „ 4 „ „ ,, — „ „ 1903 „ 16 „ „ „ 1 „ „ 1904 „ 13 „ ,, „ 5 „ „ 1905 „ 8 „ „ „ — „ „ 1906 ,, 7 ,, „ ,, 5 „ „ 1907 „ 8 ,, „ ,, 2 „ „ 1908 „ 9 „ „ „ — „ „ 1909„ 7 „ „ „ — „ „ 1910 : 8 „ „ — „ „ 119 TABLE III. (Required by the Local Government Board to be used in the Annual Report of the Medical Officer of Health.) Cases of Infectious Disease Notified during the Year 1910. NOTIFIABLE DISEASE. Cases notified in whole Borough. Total Cases Notified in each Locality. Number of Cases Removed to Hospital 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 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphther a (including Membranous Croup) 48 .. 11 27 7 3 .. 4 3 2 8 22 9 .. 3 3 1 5 18 9 .. 39 Erysipelas 32 .. .. .. 3 23 6 10 4 1 6 1 5 5 4 1 1 3 .. .. 1 10 Scarlet Fever 135 1 26 87 11 10 .. 9 35 17 12 20 35 7 7 29 11 3 13 32 4 99 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 16 .. .. 2 4 10 .. 2 5 2 2 1 3 1 .. 3 2 .. .. 3 .. 8 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. • • Puerperal Fever 2 .. .. .. .. 2 .. .. 2 .. .. .. .. .. .. 1 .. .. .. .. .. 1 Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 233 1 37 116 25 48 6 25 49 22 28 44 52 13 it 37 15 11 31 44 5 157 The Workhouse is within the Borough and is situate at New End in No. 1 (Town) Ward. Isolation Hospitals are provided by the Metropolitan Asylums Board, and residents of Hampstead suffering from infectious disease are usually sent to the North-Western Hospital, which is within the Borough, and is situate at Lawn Road, in No. 2 (Belsize) Ward. 120 TABLE IV. (Required 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 1910. cause 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). VVard No. 3 (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 13 14 15 16 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 14 ... 12 1 ... ... ... ... 4 ... ... 3 7 ... 8 Scarlet Fever 3 ... 2 1 ... ... ... ... 1 ... ... ... 1 ... 28 Whooping Cough 11 5 6 ... ... ... ... ... 2 ... ... 3 5 1 2 Diphtheria (including Membranous Croup) 6 ... 4 2 ... ... ... ... ... ... ... 4 2 ... 25 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fever {Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... {Enteric 3 ... ... ... ... 1 ... ... ... 1 1 ... ... ... 2 Other continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Epidemic Influenza 13 2 ... ... ... 6 5 2 1 3 ... ... 3 4 ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea ... 8 5 3 ... ... ... ... ... ... 1 1 3 ... 1 4 Enteritis 7 5 ... ... ... ... 2 2 1 ... 1 1 1 1 1 Gastritis 3 ... 1 ... ... 1 1 ... ... ... 1 1 1 ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 1 ... ... ... ... 1 ... ... ... ... 1 ... ... ... 2 Phthisis (Pulmonary Tuberculosis) 58 ... 1 1 12 37 7 6 8 5 3 11 16 8 100 Other Tuberculous Diseases 22 ... 7 5 2 4 4 6 1 2 ... 7 5 1 21 Cancer, malignant disease 90 ... ... ... 1 47 42 10 15 13 10 11 22 7 63 Bronchitis 56 3 2 ... ... 15 36 5 11 4 9 5 10 11 18 Pneumonia 63 8 3 ... 2 23 27 6 10 4 5 11 18 8 20 Pleurisy 4 ... ... ... ... 3 1 ... 1 ... ... ... 3 ... 2 Other Diseases of Respiratory Organs 7 ... ... ... 1 4 2 ... 3 ... 1 1 ... 2 2 Alcoholism, Cirrhosis of Liver 14 ... ... ... ... 8 6 1 2 2 ... 2 3 4 2 Venereal Diseases 2 1 ... ... ... ... 1 ... 1 ... ... ... 1 ... 3 Prematui e Birth' 21 21 ... ... ... ... ... 4 3 1 2 4 5 2 3 Diseases and Accidents of Parturition 1 ... ... ... ... 1 ... ... ... ... ... ... 1 ... 1 Heart Diseases 35 ... ... 1 ... 18 16 7 1 6 2 6 9 4 17 Accidents 20 3 2 2 1 4 8 3 2 1 2 2 7 3 13 Suicides 8 ... ... ... 1 7 ... ... 1 1 2 1 1 2 9 All other causes 359 27 8 7 7 124 186 65 50 34 41 45 69 52 118 All causes 829 81 51 20 29 304 344 118 119 78 82 121 192 111 501 Note.—It will be noted that the total number of deaths in the Ward distribution is 8 less than the total number of deaths at the age periods. This is accounted for by the fac that in these cases a definite address was not registered. (Sec note at foot o TABLEII.) Schedule A. EXTENDED TABLE IV. Causes of, and Ages at, Death during the 52 weeks ended 31st December, 1910. No. Cause of Death. Ages. All Ages. Wards. Total Deaths whether of " Kesidents" or "Nonresidents" 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 and 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 1 12 1 ... ... ... ... ... ... ... ... ... ... 14 ... 4 ... ... 3 7 ... ... 8 3 Scarlet Fever ... 2 ... 1 ... ... ... ... ... ... ... ... ... 3 1 1 ... ... ... 1 ... ... 28 5 Epidemic Influenza 2 ... ... ... ... ... ... ... 1 5 3 1 1 13 2 1 3 ... 3 4 ... ... 6 Whooping Cough 5 6 ... ... ... ... ... ... ... ... ... ... ... 11 ... 2 ... ... 3 5 1 ... 2 7 Diphtheria ... 4 2 ... ... ... ... ... ... ... ... ... ... 6 ... ... ... ... 4 2 ... ... 25 8 Enteric Fever ... ... ... ... 1 1 ... 1 ... ... ... ... ... 3 ... 1 1 1 ... ... ... ... 2 10 Diarrhoea, Dysentery 3 3 ... ... ... ... ... ... ... ... ... ... ... 6 ... ... l 1 2 1 1 ... 2 11 Epidemic Enteritis 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... 1 1 ... ... 2 12 Other Allied Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 15 Tetanus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 18 Syphilis 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ...... 3 21 Erysipelas ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... 1 ... ... ... ... 2 23 Pysemia ... ... 1 ... ... ... 2 ... ... 1 1 ... ... 4 1 ... l ... 1 1 ... ... ... 24 Infective Endocarditis ... ... ... ... 1 1 2 1 ... 1 ... ... ... 2 2 ... ... 1 1 ... ... 6 25 Other Allied Diseases ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... 4 27 Rheumatic Fever ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 1 ... ... ... ... ... ... ... ... 29 Tuberculosis of Brain ... 5 2 1 1 ... ... ... 1 ... ... ... ... 10 2 ... ... ... 5 3 ... ... 10 31 Phthisis ... 1 ... 1 4 8 7 7 17 6 7 ... ... 58 6 8 5 3 11 16 8 1 100 32 Abdominal Tuberculosis ... 1 1 1 ... ... 1 1 ... ... ... ... ... 5 ... 1 1 ... 2 1 ... ... 4 33 General Tuberculosis ... ... ... ... ... ... ... ... 1 ... 3 ... ... 4 3 ... ... ... ... 1 ... ... 1 34 Other Forms Tuberculosis ... 1 ... ... ... 1 ... ... ... ... 1 ... ... 3 1 ... 1 ... ... ... 1 ... 6 42 Chronic Alcoholism ... ... ... ... ... ... ... ... ... 1 1 ... ... 3 ... 1 1 ... ... 1 ... ... 1 45 Osteo-Arthritis ... ... ... ... ... ... ... ... ... 1 1 1 ... 3 ... ... ... ... 1 2 ... ... ... 46 Gout ... ... ... ... ... ... ... ... ... ... 1 1 ... 2 ... ... 1 ... ... ... 1 ... ... 47 Cancer ... ... ... ... ... 1 5 3 17 22 30 12 ... 90 10 15 13 10 11 22 7 2 63 48 Diabetes Mellitus ... ... ... ... ... ... 1 1 ... 6 2 1 ... 11 1 1 ... 3 2 3 1 ... 3 51 Anæmia ... ... ... ... ... ... ... 1 2 1 ... 1 ... 5 2 ... ... ... 1 1 1 ... 2 52 Lymphadenoma ... ... ... ... 1 ... ... 1 ... ... ... 1 ... 3 1 ... ... 1 ... 1 ... ... ... 53 Premature Birth 21 ... ... ... ... ... ... ... ... ... ... ... ... 21 4 3 1 2 4 5 2 ... 3 54 Injury at Birth 3 ... ... ... ... ... ... ... ... ... ... ... ... 3 1 ... ... ... ... 1 1 ... ... 55 Debility at Birth 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 1 ... ... 1 ... ... ... ... 1 56 Atelectasis 4 ... ... ... ... ... ... ... ... ... ... ... ... 4 ... ... ... ... 2 2 ... ... 1 57 Congenital Defects 2 1 ... ... ... ... ... ... ... ... ... ... ... 3 ... 1 ... ... 1 ... 1 ... 3 59 Atrophy, Debility, Marasmus 7 3 ... ... ... ... ... ... ... ... ... ... ... 10 4 3 ... ... ... 3 ... ... 13 60 Dentition 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 61 Rickets 1 2 ... ... ... ... ... ... ... ... 2 ... ... 3 ... 1 1 1 6 ... ... ... 2 62 Old Age, Senile Decay ... ... ... ... ... ... ... ... ... 1 2 12 26 41 5 2 7 5 6 6 3 2 12 63 Convulsions 4 ... ... ... ... ... ... ... ... ... ... ... ... 4 2 1 ... ... ... ... 1 ... 1 64 Meningitis 3 1 ... ... ... ... 2 ... ... ... ... ... ... 6 ... 1 1 2 1 ... 1 ... 3 66 Apoplexy ... ... ... ... ... ... ... ... ... 1 4 2 1 8 ... ... ... 3 2 1 2 ... 1 67 Softening of Brain ... ... ... ... ... ... ... ... ... ... 1 1 ... 2 ... 1 ... ... ... ... 1 ... 1 68 Hemiplegia ... ... ... ... ... ... ... ... ... ... 3 1 ... 4 ... 1 ... ... 1 1 1 ... ... 69 General Paralysis of Insane ... ... ... ... ... ... 1 2 4 ... ... ... ... 7 ... 1 2 1 1 ... 2 ... ... 70 Other forms of Insanity ... ... ... ... ... ... ... ... ... 2 ... ... ... 2 ... ... ... 1 1 ... ... ... 1 71 Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 72 Cerebral Tumour ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 2 73 Epilepsy ... ... ... ... ... ... ... ... ... 1 ... 1 ... 2 ... ... ... ... 1 1 ... ... ... 75 Locomotor Ataxy ... ... ... ... ... ... ... 1 1 ... ... ... ... 2 ... ... ... 1 1 ... ... ... ... 76 Paraplegia ... ... ... ... ... ... ... ... 5 3 3 1 ... 12 4 ... 3 ... ... 3 2 ... 3 77 Other forms, Brain Diseases ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... 1 ... ... ... ... ... 2 78 Otitis ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... 2 81 Pericarditis ... ... ... ... ... ... ... ... ... ... ... ••• ... 1 ... ... 1 ... ... ... ... ... 1 82 Endocarditis ... ... ... i ... 4 0 8 0 9 5 1 34 7 1 5 2 6 9 4 ... 16 84 Angina Pectoris ... ... ... ... ... ... ... ... 1 ... 3 ... 1 5 1 1 ... ... 1 1 1 ... 1 85 Aneurism ... ... ... ... ... ... 1 ... 2 1 ... ... ... 4 1 2 ... ... ... l ... ... ... 86 Senile Gangrene ... ... ... ... ... ... ... ... ... ... 3 2 1 6 1 2 ... ... ... 3 ... ... 1 87 Embolism, Thrombosis ... ... ... ... ... ... ... ... 1 2 ... 7 2 12 4 2 2 2 ... 2 ... ... 5 88 Phlebitis ... ... ... ... ... ... ... ... 1 1 ... ... ... 2 ... ... ... 1 ... ... 1 ... ... 90 Other Diseases, Heart and Vessels ... ... ... 1 ... 1 1 2 11 18 33 18 4 89 14 16 8 8 11 16 15 1 28 91 Laryngitis ... ... ... ... ... 1 ... ... 1 1 ... ... ... 3 ... 2 ... ... 1 ... ... ... 1 93 Other Diseases, Larynx and Trachea ... ... ... ... ... ... ... ... ... ... 1 ••• ... 1 ... ... ... ... 2 ... 1 ... 1 94 Acute Bronchitis 3 2 ... ... ... ... ... ... 1 ... 4 4 2 16 2 3 ... 1 2 4 4 ... 6 95 Chronic Bronchitis ... ... ... ... ... ... ... 1 3 10 9 11 6 40 3 8 4 8 3 6 7 1 12 96 Lobar Pneumonia ... ... ... ... 1 ... 2 2 5 3 1 5 ... 19 1 3 ... 5 2 7 1 ... 8 97 Lobular Pneumonia 5 2 ... ... ... 1 ... 3 2 2 4 4 1 24 1 4 2 ... 8 3 6 ... 13 98 Pneumonia 3 1 ... ... ... ... ... ... 2 2 6 3 3 20 4 3 2 ... 1 8 1 1 5 99 Emphysema, Asthma ... ... ... ... ... ... ... ... 1 ... ... 1 1 3 ... 1 ... 1 ... ... 1 ... ... 100 Pleurisy ... ... ... ... ... ... ... 1 ... 2 ... 1 ... 4 ... 1 ... ... ... 3 ... ... 2 101 Other Diseases, Respiratory System ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... 1 ... 1 102 Diseases of Mouth and Annexa ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... 1 1 ... ... 4 105 Ulcer of Stomach and Duodenum ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 106 Other Diseases of Stomach ... 1 ... ... ... ... ... ... 1 ... ... 1 ... 3 ... ... ... 1 1 1 1 ... ... 1 107 Enteritis 5 ... ... ... ... ... ... ... ... ... 1 1 ... 7 2 1 ... 1 1 1 1 ... 1 108 Appendicitis ... ... 1 2 ... 1 ... 1 2 2 1 ... ... 10 3 2 ... 2 ... 1 2 ... 11 109 Obstruction of Intestine ... ... ... 1 1 ... 1 1 1 2 3 2 ... 12 3 1 1 1 ... 4 2 ... 11 110 Other Diseases of Intestine ... ... .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... 1 111 Cirrhosis of Liver ... ... ... ... ... ... ... 1 1 4 3 2 ... 11 1 1 1 ... 2 2 4 ... 1 112 Other Diseases of Liver ... ... ... ... ... ... ... 1 ... 2 1 ... 4 1 1 ... ... ... ... 2 ... 1 113 Peritonitis ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... 115 Diseases, Lymphatic System and Glands ... ... ... 1 ... ... 1 ... 1 1 ... ... ... 4 1 ... 1 ... 1 1 ... ... 1 116 Acute Nephritis ... ... ... ... ... ... ... ... 1 1 1 1 1 5 3 ... ... 1 ... 1 ... ... ... 117 Bright's Disease ... ... ... ... ... 1 1 2 2 6 10 5 4 31 5 6 3 3 6 6 2 ... 10 118 Calculus ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... 1 ... 1 119 Diseases of Bladder and Prostate ... ... ... ... ... ... ... ... ... 1 4 4 1 10 1 1 1 2 ... 3 2 ... 2 120 Other Diseases, Urinary System ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... 1 i ... ... 2 122 Diseases of Ovaries ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... ... 123 Diseases of Uterus and Appendages ... ... ... ... ... ... ... ... 1 1 ... ... ... 2 ... 1 ... 1 ... ... ... ... ... 127 Puerperal Mania ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... 1 136 Pemphigus Accidents and Negligence. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 139 In Vehicular Traffic ... ... ... ... ... ... ... 1 ... ... 1 ... ... 2 ... ... ... 2 2 140 On Railways ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... 1 ... ... 1 142 In Building Operations ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 1 ... ... ... 145 Burns and Scalds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 146 Poisons, Poisonous Vapours ... 2 I ... ... ... ... ... ... ... ... 1 ... 4 1 1 ... ... ... ... 2 ... 2 147 Surgical Narcosis ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 151 Suffocation, Overlaid in Bed 3 ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... 3 ... ... ... 152 „ Otherwise ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 153 Falls, not specified ... ... ... ... ... ... 1 ... ... 1 1 1 1 5 1 1 1 1 1 ... ... ... 3 154 Weather Agencies ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... 1 ... 1 155 Otherwise, not stated Suicides. ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... ... ... 1 157 By Poison ... ... ... ... ... ... ... 1 1 1 ... ... ... 3 ... ... 1 1 1 ... ... ... 3 159 By Hanging and Strangulation ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... 1 ... ... ... ... 2 160 By Drowning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 161 By Shooting ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... I 162 By Cut or Stab ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... 1 ... 1 165 By Precipitation from Elevated Places ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... 1 ... ... 165 By other and unspecified methods ... ... ... ... ... 1 ... ... 1 ... ... ... ... 2 ... 1 ... ... ... 1 ... ... 1 167 Sudden Death, cause not ascertained ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 168 Ill-defined and unspecified causes ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 Totals 81 51 9 11 11 18 38 39 103 124 170 117 57 829 118 119 78 82 121 192 111 8 501 Note.—The omission of a number from the first column denotes that no death was registered from the cause of death to which the number relates. Note.—It will be noted that the total number of deaths in the Ward distribution is 8 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.) 121 TABLE V. [Required by the Local Government Board to be used in the Annual Report of the Medical Officer of Health.) Infantile Mortality during the Year 1910. 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. 0-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11 12 Months. Total Deaths under 1 Year. All Causes Certified 22 8 5 3 33 8 5 5 3 7 3 2 1 4 2 3 81 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... i. Common Infectious Diseases Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... 1 ... i 2 1 ... ... ... ... ... ... ... ... 1 5 ii. Diarrhœal Diseases Diarrhoea, all forms ... ... ... ... ... 1 1 ... ... 3 ... ... ... ... ... ... 5 Enteritis, Muco-enteritis, Gastroenteritis ... ... 1 ... 1 ... ... ... ... ... ... ... ... 1 ... ... 2 Gastritis, Gastro intestinal Catarrh ... ... 1 ... 1 ... ... 1 ... ... ... ... ... ... 1 ... 3 ... iii Wasting Diseases Premature Birth 13 3 ... ... 16 2 2 1 ... ... ... ... ... ... ... ... 21 Congenital Defects ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Injury at Birth 2 1 ... ... 3 ... ... ... ... ... ... ... ... ... ... ... 3 Want of Breastmilk. Starvation ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Atrophy, Debility Marasmus 1 1 ... ... 2 ... 1 1 2 1 ... ... ... ... ... ... 7 iv. Tuberculous Diseases Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculous Peritonitis Tabes Mesen{terica} ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... V. Other Causes Erysipelas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Rickets ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... i Meningitis (not Tuberculous) 1 ... ... ... 1 ... ... ... ... ... 1 ... ... 1 ... ... 3 Convulsions 2 ... ... ... 2 ... ... ... ... ... 1 ... ... ... 1 ... 4 Bronchitis ... ... ... 1 1 ... ... 1 ... ... ... 1 ... ... ... 3 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Pneumonia ... ... 1 1 2 2 ... ... ... ... ... ... ... 2 ... ... 8 Suffocation, overly ing 1 ... ... ... 1 1 ... ... 1 ... ... ... ... ... ... ... 3 Other causes 2 3 1 I 7 ... ... ... ... 2 ... 1 ... ... ... 1 11 22 8 5 3 38 8 6 5 3 7 3 2 1 4 2 3 81 Population estimated to middle of 1910, 95,729. , legitimate 1,233 legitimate infants, 71. Births in the year illegitimate, 36 Deaths in the year of illegitimate infants, 10. Deaths from all Causes at all Ages, 829. 122 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, 1910. Number of notices, 1910. Number of prosecutions, 1910. On register at end of 1909. Added in 1910. Removed in 1910. On register at end of 1910. Milk premises 115 6 14 107 495 38 - Cowsheds — - - - - - - Slaughterhouses 5 — 1 4 59 3 l Other offensive trade premises — — — — — — - Ice cream premises 78 12 7 83 289 27 — Registered houses let in lodgings 364 — — 364 103 — — Total number of Intimation Notices served for all purposes 762 Overcrowding— Number of dwelling rooms overcrowded 7 Number remedied 7 Number of notices issued 4 Number of prosecutions — Underground rooms — Number closed during year 60 Illegal occupation dealt with during year 115 Insanitary houses — Number closed under the Public Health (London) Act, 1S91 — ,, ,, Housing bf the Working Classes Act — Shelters provided under Sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year — 123 TABLE VI.—continued. Customs and Inland Revenue Acts— Number of houses for which applications were received 15 Number of dwellings comprised therein 51 Number of Certificates granted (houses) *4 refused ( „ ) — „ „ deferred ( „ ) †1l Number of prosecutions under By-laws wider 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 — (f) In connection with the removal of offensive matter, &c. — (f) As to cesspools and privies, removal and disposal of refuse, &c. _ (9) For securing the cleanliness of tanks, cisterns, &c. — (h) With respect to water-closets, earth-closets, &c. 1 (i) With respect to sufficiency of water supply to waterclosets — Number of prosecutions under Dairies, Cowsheds and Milkshops Orders— Dirty milk utensils — Number of prosecutions under By-lam under Metropolis Management Acts— (a) With respect to drainage, &c. 3 (b) With respect to deposit of plans as to drainage, &c. 8 London County Council (General Powers) Act, 1903, Part VIII.— Number of prosecutions for breach of by-laws as to conveyance of dead horse through street — * These 4 houses comprised 17 "dwellings." † „ 11 „ „ 39 „ 124 TABLE VI.-—continued. London County Council [General' Powers) Act, 1904, Part IV.— Number of filthy articles purified (Sec. 19) — „ „ „ destroyed (Sec. 19) 11 ,, verminous rooms cleansed (Sec. 20) 22 „ „ houses „ (Sec. 20) 12 „ sanitary conveniences altered (Sec. 22) — „ „ „ removed (Sec. 22) — „ fixed ashpits removed (Sec. 23) 22 Mortuaries — Total number of bodies removed 87 Total number of infectious bodies removed — London County Council (General Powers) Act, 1907, Part XII., and Sec. 48 Public Health (I.ondon) Act, 1891 — Number of tenement houses in which additional water taps and sinks have been provided (Sec. 78) 99 125 TABLE VII. Vital Statistics of the Borough. Number of occupicd houses 11,294 At Census 1901. Population 81,942 Average number of persons per house 725 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 86633 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 l6.0 850 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 1908 92651 1400 14.9 803 8.5 97 69.3 3.83 4.1 20 0.21 38 0.10 1909 941S5 1328 13.9 819 8.9 99 74.5 325 3.4 21 0.22 49 0.52 1910 95729 1310 14.0 829 8.6 81 60.4 233 2.4 13 0.13 45 0.47 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 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. Kate per 10C0 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 12551 194 15.4 127 10.1 14 72.1 38 3.1 1 0.08 10 0.79 11)04 ] 2970 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 0.15 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 1908 14190 225 15.9 103 7.6 11 48.8 65 4.6 1 0.07 5 0.35 1909 14560 196 13.5 140 9.6 15 76.5 53 3.6 4 0.27 8 0.55 1910 15100 199 13.2 118 7.8 15 75.4 25 1.6 1 0.07 1 0.07 126 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 bouse 816 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 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 7 049 1907 14410 205 14.2 114 7.9 13 63.4 63 4.4 3 0.21 11 0.76 1908 14770 205 13.9 126 8.5 8 39.0 81 5.5 1 0.07 4 0.27 1909 14990 204 13.6 130 8.7 16 78.4 88 5.9 5 0.33 8 0.53 1910 15200 207 13.6 119 7.8 9 43.5 49 3.2 2 0.13 8 0.53 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 1908 10860 93 8.6 78 7.2 6 64.6 30 2.8 2 0.18 4 0.37 1909 10940 83 7.6 88 8.0 4 48.2 16 1.5 2 0.18 4 0.37 1910 11000 96 8.7 78 7.1 2 20.8 22 2.0 1 0.09 2 0.18 127 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. Kate 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 1908 10584 104 9.8 82 7.7 6 57.7 33 3.1 1 0.09 2 0.19 1909 10735 116 10.8 63 5.9 3 25.9 29 2.7 2 0.19 5 0.47 1910 10869 105 9.7 82 7.5 8 76.2 23 2.6 2 0.18 2 0.18 TABLE VII. (5). Vital Statistics of No. 5 (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 259 188 115 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 1908 14370 254 17.7 121 8.4 26 102.4 68 4.7 10 0.69 12 0.84 1909 14650 239 16.3 118 8.0 13 54.4 51 3.5 2 0.14 7 0.48 1910 14900 216 14.5 121 8.1 17 78.7 41 2.9 4 0.27 13 0.87 128 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 Tear. 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 1900 15790 426 26.9 171 10.8 50 117.4 57 3.6 2 0.13 9 0.57 190(1 16030 441 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 1908 16670 393 23-6 186 11.1 30 76.3 72 4.3 4 0.21 9 0.54 1909 17010 341 200 182 10.7 37 108.5 67 3.9 6 0.35 10 0.59 1910 17260 379 22.0 192 11.1 24 63.3 52 30 3 0.17 17 0.98 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 1C00 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 10840 162 14.9 110 10.5 16 98.7 44 4.1 1 0.09 3 0.28 1903 10950 191 17.7 116 10.5 21 108.2 43 4.0 3 0.27 7 0.64 1901 10990 152 13.8 121 11.0 13 85.5 23 2.1 .. .. .. .. 1905 11010 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 1908 11210 126 11.2 93 8.3 10 79.3 34 3.0 1 0.09 2 0.18 1909 11300 149 132 111 9.8 11 73.8 21 1.9 .. .. 7 0.62 1910 11400 138 121 111 9.7 6 43.5 13 1.1 .. .. 2 0.17 129 Table VIII. Vital Statistics of Hampstead, compared with England and Wales. Year. Birth rate per 1000. Natural increase Hampstead. Seven Principal Epidemic Diseases deathrate per 1000. Notfiable 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 21.4 363 367 — 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 21.2 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 31.1 728 0.95 2.2 — 10.7 17.9 1890 21.9 30.2 613 1.5 21 — 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 16.2 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 10.1 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 1908 14.9 26.5 597 0.40 1.29 4.1 8.5 14.7 1909 13.9 25.6 489 0.52 1.12 3.4 8.9 14.5 1910 14.0 24.8 511 0.47 0.99 2.4 8.6 13.4 * Excluding Chicken-pox. INDEX. page Accident, Deaths from 24 Adulteration 84-86 Alcoholism 28 Analyses, Results of 84-86 Analytical Work, Report on 103 Applications for Re-drainage 68 Area of Borough 13 Bakehouses 93, 94 Birth-Rate 15 Births, Illegitimate 15 „ Number of 15 „ „ in Wards 16 Cancer 22, 23 Circulatory System, Diseases of 23 Combined Drainage 68, 69 Complaints Received 87 Consumption 55-60 Customs and Inland Revenue Acts 69, 70 Dairies 79-81 Deatth-Rate 16, 17 „ Infantile 28 Death Returns 19 Deaths, at various ages 20 „ Causes of 22-24 „ in Public Institutions 21 „ from seven principal Epidemic Diseases 50 „ Infantile 27 Non-resident 16, 19, 20 „ Number of 16 „ Outlying 16, 20 ,, Senile Mortality 22 Diarrhœa 55 Diphtheria 45-47 Disinfection 61 Drainage Work 68 Enteric Fever 47-49 Epidemic Cerebro-spinal Meningitis 49 Epidemic Diseases, Seven Principal, Death-Rate 50 „ „ Deaths from 50 Erysipelas 49 Factories 97, 98 Factory and Workshop Act, 1901 91,100 Fever 47-49 132 page Food Inspection 79 Food Premises 81-83 Food Shops, Inspection of 81-83 Health Visiting 31,32 Home Office Tables 97-100 Homework 96, 99 Houses Let in Lodgings 69 Housing, Town Planning, etc., Act, 1909 71-76 Ice Cream 81 Industrial Employment of Married Women, Inquiry re 32-34 Infantile Mortality 27-34 Infants, Advice as to Rearing of 31, 32 Infectious Diseases 37-61 „ „ Notifiable 37-49 „ „ „ Attack-Rate 37 „ „ „ Cases occurring 37 „ „ „ „ ,, in each Month 40 „ „ „ „ „ „ Ward 41 „ „ „ Death-Rate 38 „ ,, „ Deaths from 38 Inspections and Re-inspections of Premises 67 Laundries 91, 100 Legal Proceedings 108-112 Local Government Board Tables 117-123 Marriage Rates, 1900—1910 14 Marriages, Number of 14 Measles 51-54 Milkshops and Milk Supply 79-81 Mortuary, Public 77, 78 Natural Increase of Population 16 Non-resident Deaths 16, 19, 20 Notifiable Infectious Diseases 37-49 Notification of Births Act, 1907 31 Nuisances, Inspection of 67 Outlying Deaths 16, 20 Outworkers 96,99 Phthisis, Pulmonary 55-60 „ „ Voluntary Notification of 59 Population, Density of 13 „ Estimated to middle of 1910 13 „ In Wards 13 „ Natural Increase of 16 Principal Epidemic Diseases 50-55 ,, ,, ,, Death-Rate 50 Deaths from 50 133 page Public Health Committee 5 Public Health (Tuberculosis in Hospitals) Regulations, 1911 59 Puerperal Fever 49 Rearing of Infants 31, 82 Re-drainage Applications 68 Registered Houses 69 Respiratory System, Diseases of 23 Restaurant Kitchens 95, 96 Sale of Food and Drugs Acts 84-86 Sanitary Administration, General 65-87 Scarlet Fever 43, 44 Senile Mortality 22 Slaughterhouses 79 Small-pox 42 Staff of the Public Health Department 7 Suicide 24 Summary of Vital Statistics for 1910 11 Tenement Houses, Water Supply of 78 Tuberculosis 55-60 Underground Rooms 70, 71, 74-76 Vaccination 42 Vital Statistics 11-24 Water Supply, Certificates as to 68 „ „ of Tenement Houses 76 Whooping Cough 54 Workshops 91-93, 97, 98, 100 Workplaces 95-98