With the Medical Officer of health's Compliments. Public Health Department Town Halll, Haverstock Hiill, Hampstead, n.w. HAMP 20 THE Metropolitan Borough of Hampstead. REPORT for the Year 1915 of the Medical Officer of Health, FRANK E. SCRASE, F.R.C.S. (Eng.). L.R.C.P. (Lond.), D.P.H. (Lond.) CONTENTS. pages SECTION A.—Natural and Social Conditions of the Borough (including a review of the Vital Statistics, etc.) 5 —11 „ B.—Sanitary Administration and Circumstances of the Borough II—23 C.—Prevalence of and Control over Acute Infectious Diseases 23—27 ,, D.—Prevalence of and Control over Tuberculosis 27—33 „ E.—Means for preventing Mortality in Children 33—35 „ F.—Vital Statistics of the Borough, etc. 36—45 „ G.—Legal proceedings 46 APPENDIX. —Report of the Public Analyst on the Analytical Work of the Year 47 2 PUBLIC HEALTH COMMITTEE, NOVEMBER, 1914—15. Ex-officio: HIS WORSHIP THE MAYOR (Mr. Alderman E. A. O'Bryen, J.P.). Chairman: Mr. Councillor R. J. J. Willis. Miss Councillor M. E. Balkwill. Mr. Councillor G. Buckle. Mr. ,, C. W. Cunnington, „ „ A. W. George, m.r.c.s., d.p.h, m.r.c.s., l.r.c.p. „ J. I. Fraser. „ „ C. J. Higginson. T. H. Nunn. „ „ E. S. Payne. „ „ W. H. Warner. „ „ A. B. Weaver. Staff of the Public Health Department: Sanitary Inspectors: W. G. Kershaw, Senior Inspector. R. Geary (Wards 1 & 2) *W. F. Horniblow (Wards 3 & 7 Divisional A. Peverett (Wards 4 & 5) *J. Griinsley (Ward 6) Inspectors. F. H. Hudson, Sale of Food and Drugs Acts and Factory and Workshop Acts. *A. C. Townsend, Housing of the Working Classes, and Housing, Town Planning, &c., Acts. Mrs. T. Fisher, m.a., Factory and Workshop Acts: Infectious Disease and Tuberculosis Regulations. Mrs. K. Roche, Notification of Births Act and Infectious Disease. Assistants to Inspectors: *Edwards, *Deverell. Public Mortuary : *W. Larken, 63, Flask Walk, Keeper. E. Stratton, Deputy Keeper. Disinfecting and Cleansing Stations : *T. Rider, G. Allaway and R. Bell, Disinfectors. Mrs. Rider, Attendant at Cleansing Room. A. L. Gibbons, Temporary Disinfector. Tuberculosis Dispensary: J. F. Halls Dally, m.d., m.r.c.p. (London), m.r.c.s., l.r.c.p. (Lond.), Tuberculosis Medical Officer. *Miss G. Goodchild, Nurse. Miss M. Taylor, Temporary Nurse. Clerical Staff: W. Sell, Clerk. *F. Hill, Clerk. *B. Harley, Clerk. *B. C. Harley, Clerk. *R. Pollock, Clerk-Draughtsman. C. Brown, Temporary Clerk. E. Blakeman, Miss, Temporary Clerk. Public Analyst: A. W. Stokes, f.c.s., f.l.C. Medical Officer of Health : Frank E. Scrase, f.r.c.s. (Eng.), l.r.c.p. (Lond.), d.p.h. (Lond.). * These members of the Staff are on Service with His Majesty's Forces. 3 Public Health Department, Town Hall, Haverstock Hill, Hampstead, N.W. 1st June, 1916. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Hampstead. Mr. Mayor, Madam, and Gentlemen, I have the honour to submit to you the Annual Report for the year 1915. In presenting this review of the work of the Public Health Department for 1915 I wish to thank the Council and the Chairman and Members of the Public Health Committee for the kindly support and encouragement they have ever given me. I desire also to express my appreciation of the earnest efforts of the members of the staff of the Department whilst according me their assistance and able co-operation. I have the honour to be, Mr. Mayor, Madam, and Gentlemen, Your obedient Servant, FRANK E. SCRASE, Medical Officer of Health. 4 INDEX. page Acute Polio-myelitis or Polioencephalitis 25 Alcoholism 38 Analytical Work, Report on 47 Anti-toxin 24 Area of Borough 5 Bacteriological Work 24, 33 Bakehouses 15 Births 6, 7, 33 Cancer 9 Cerebro-Spinal Meningitis 25 Cleansing Station 13 Complaints 13 Customs and Inland Revenue Acts 13 Dairies 14,18 Deaths 7, 8, 9, 10, 11, 38 Diarrhœa and Enteritis 27 Diphtheria 24 Disinfection 26 Drainage Work 12 Enteric Fever 25 Erysipelas 25 Factories 20, 21,22, 23 Food Premises and Food Inspection 14 Fried Fish Vendors 15 Health Visiting 33, 34 Ice Cream 15 Infantile Mortality 33, 34, 35, 39 Infectious Diseases 23, 27, 37 Legal Proceedings 19, 20, 46 PAGE Marriages 6 Measles 26 Milk Supply and Milkshops 14, 18 Mortuary, Public 13 Opthalmia Neonatorum 25 Outworkers 22 Population 6 Public Health Committee 2 Puerperal Fever 25 Respiratory System, Diseases of 38 Restaurant Kitchens, etc. 16 Sale of Food and Drugs Act 16, 17, 18 Sanitary Inspections, etc. 11, 12, 13, 14 Scarlet Fever 25 Slaughterhouses 16 Small-pox 24 Smoke Nuisances 13 Staff of Public Health Department 2 Tenement Houses 14, 19, 20 Tuberculosis 27, 28, 33 Tuberculosis Dispensary 31, 32, 33 Underground Rooms 12, 19 Vaccination 24 Verminous Premises & Persons 13 Vital Statistics 28, 29, 32, 34 to 45 Water Supply 20 Whooping Cough 27 Workshops & Workplaces 20, 21, 22,23 Young Children, Mortality among 34 5 Section A. NATURAL AND SOCIAL CONDITIONS OF THE BOROUGH. SUMMARY OF VITAL STATISTICS FOR 1915. Population estimated to middle of 1915 81,760 Density „ „ „ 36.9 persons per acre Births 1,327 *Birth-Rate 15.3 Marriages 951 Marriage-Rate 23.22 Deaths 994 Death-Rate 12.1 Infantile Mortality 76.1 per 1000 births Notifiable Infectious Diseases Attack-Rate (excluding Tuberculosis) 5.1 Notifiable Infectious Diseases Death-Rate „ .2 Death-Rate from the Principal Epidemic Diseases 44 Death-Rate from Pulmonary Tuberculosis 58 Death-rate from All Forms of Tuberculosis 86 CENSUS, 1911. Population 85,495 Buildings used as Dwellings 11,976 Ordinary Dwelling Houses 10,062 Area of Borough 2265 acres „ „ (excluding area covered by water) 2253 acres * By direction of the Registrar-General this rate has been calculated upon the 1914 population, which was 86,731. 6 POPULATION. The Registrar-General's provisional estimate of the population of Hampstead at the middle of 1915, based upon the Censuses of 1901 and 1911, together with the returns made under the National Registration Act, 1915, was 81,760. This estimate has been adopted in this Report and, with the exception of the birth rates, it forms the basis upon which the various rates have been calculated. By the direction of the Registrar General the birth rates have been calculated upon the estimated population at the middle of 1914, which was 86,731. MARRIAGES. According to the return kindly furnished to me by the Superintendent Registrar of Hampstead, it appears that 951 marriages were registered in the Borough during 1915. The following Table gives the marriage rates for the years 1904-1915:— Year. Rate. Year. Rate. 1904 15.0 1910 14.8 1905 14.4 1911 16.3 1906 13.8 1912 15.0 1907 15.3 1913 14.9 1908 14.7 1914 19.0 1909 16.0 1915 23.2 BIRTHS. During the year 1,222 births were registered in Hampstead, an increase of 9 as compared with 1,213 registered in the previous year. In addition 105 births of children, whose mothers were Hampstead residents, occurred outside the Borough in Lying-in Institutions, etc. 2 births registered in Hampstead belonged to other Districts and must be subtracted from the total. After these corrections have been made the net number of births belonging to Hampstead was 1,327, as compared with 1,273 in 1914, an increase of 54. This increase is largely accounted for by the fact that 90 were children of Belgian Refugees born in a Lying-in Home for Belgians situated in the Borough. The following table shows the Ward and sex-distribution of the live-births, and the birth-rate for each Ward, calculated upon the estimated population of 1914:— Ward. Births. Birth-rate per 1000 of the population. Males. Females. Total. No. 1 (Town) 81 76 157 10.9 No. 2 (Belsize) 171 146 317 22.4 No. 3 (Adelaide) 35 42 77 7.9 No. 4 (Central) 44 47 91 9.04 No. 5 (West End) 102 116 218 16.6 No. 6 (Kilburn) 162 167 329 21.5 No. 7 (Priory) 66 72 138 13.7 The Borough 661 666 1327 15.3 7 Illegitimate Births. Of the total 1,327 births, 81 or 61.0 per 1,000 were those of illegitimate children. 47 of these were born outside the Borough, chiefly in Lying-in Institutions. The following Table shows the illegitimate births which have occurred in the Borough during the years 1902-1915:— Year. Number of illegitimate births. Illegitimate birth rate per 1,000 births registered. 1902 39 25•7 1903 42 28•9 1904 42 29•1 1905 35 24•6 1906 34 24•0 1907 43 32•0 1908 29 21•0 1909 43 33•0 1910 36 28•0 1911 37 29•0 1912 76 59•3 1913 73 55•1 1914 55 43•2 1915 81 61•0 DEATHS. The death rate, calculated upon the total number of deaths (whether resident or non-resident persons) registered in the Borough during the year, was 14.5 per 1,000 of the population, but after subtracting those of non-resident persons dying in the Borough and adding the deaths of Hampstead residents who died outside the District, the recorded death-rate is found to be 12.1 per 1,000 of the population. The average death-rate for five years 1910 to 1914 was 10.2. The following are the death-rates for each of the Wards:— Ward. Death-rate per 1,000 of the population. No. 1 (Town) 10•8 No. 2 (Belsize) 10•8 No. 3 (Adelaide) 11•4 No. 4 (Central) 9•6 No. 5 (West End) 12•1 No. 6 (Kilburn) 15•9 No. 7 (Priory) 13•2 The Borough 12•1 In the table on page 45 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, and the Metropolitan Cities and Boroughs:— 8 Table showing the Death-rates from All Causes in the County of London, the City of London, and the Metropolitan Boroughs during 1915, as calculated by the Registrar-General. District. Death-rate from all causes. Hampstead 12•4 Lewisham 12•4 Wandsworth 12•5 Hackney 14•7 Stoke Newington 14•7 Camberwell 14•8 Kensington 15•2 Woolwich 15•3 Hammersmith 15•3 Fulham 15•3 St. Marylebone 15•4 City of Westminster 15•5 Paddington 15•9 Lambeth 16•4 St. Pancras 16•6 Chelsea 16•6 Holborn 16•7 Islington 16•8 Bethnal green 17•3 Stepney 17•6 Greenwich 17•6 Deptford 17•7 City of London 18•8 Poplar 18•9 Shoreditch 19•5 Finsbury 19•6 Southwark 20•1 Bermondsey 20•2 County of London 16•1 NOTE :—The rate stated by the Registrar-General differs from that as calculated by me. This is accounted for by the fact that the Registi ar-General's figures have not yet been completely corrected for transferable deaths and it is also based on 1914 population. 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 III. & IV. ###]Periods. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 1 5 years. 15 and under 25 years. 25 and under 45 years. 4 5 and under 65 years. 65 and upwards. All Ages. Deaths 101 22 21 29 34 115 260 412 994 It is interesting to note the increasing age of the population. The proportion of deaths at ages of 25 and upwards have also increased in recent years. 9 Deaths at Ages. Year. Under 25. 25 and upwards. Totals. 1911 209 638 847 1912 190 671 861 1913 209 742 951 1914 187 726 913 1915 207 787 994 Deaths in Institutions. The number of deaths of Hampstead Residents which occurred in Institutions was 307 or 30.8 per cent. of the total deaths of residents. 94 deaths took place in Workhouses or Workhouse Infirmaries, equivalent to 30.6 per cent, of the deaths in institutions or 9.4 per cent, of the total deaths of Hamustead residents. Causes of Death. The causes of death are given in Table 3 at the end of the Report. The deaths from Cancer call for special consideration. The following Table gives the number of deaths from Cancer and the death-rate per 1,000 of the population in each of the years 1903—1915. Year. No. of Deaths from Cancer Death-rate per 1000 of the population. Year. No. of Deaths from Cancer. Death-rate per 1000 of the population. 1903 105 1•27 1910 90 1•06 1904 85 1•02 1911 86 1•00 1905 73 0•87 1912 102 1•19 1906 93 1•11 1913 100 1•14 1907 69 0•82 1914 114 1•31 1908 84 0•99 1915 118 1•44 1909 85 1•00 Of the 118 deaths from Cancer, 76 were females and 42 males. On this point it must be borne in mind that the population of the Borough was found at the Census to consist of 52,688 females and 32,807 males. In 46 cases the patients were over 65 years of age. The next Table gives the anatomical distribution of the disease in each sex. Situation. Males. Females. Total. Buccal cavity 11 4 15 Stomach, Liver, &c. 15 21 36 Peritoneum, Intestines and Rectum 13 18 31 Genital Organs 2 14 16 Breast — 15 15 Other, or unspecified, organs 1 4 5 Totals 42 76 118 10 The following is a list of the Institutions and the number of deaths which occurred in each :— Deaths of Hampstead Residents in Institutions. Institution. Total. Infirmaries and Workhouses. Hampstead Workhouse Infirmary 35 St. Pancras Infirmary 6 St. Marylebone Infirmary 53 Hospitals, Sanatoria, Nursing Homes. 148 Abbey Road 1 73 Belsize Park Avenue 1 26 Belsize Avenue 1 188 Belsize Road 2 33 Belsize Square 1 34 Belsize Square 2 55 Beaumont Street1 Bethlem Royal Hospital 3 Bethnall House 1 Camberwell House 3 City of London Lying-in Hospital 1 6 Colosseum Terrace 1 Connaught Hospital, Farnboro' 1 Convalescent Home for Children, Grosvenor Place 1 Children's Hospital, Great Ormonde Street 1 Children's Hospital, Paddington Green 6 Charing Cross Hospital 1 Cottage Hospital, Harlesden Road 2 Downs Sanatorium 1 80 Fordwych Road 2 German Hospital, Dalston 4 Grove Hospital 1 Guy's Hospital 2 Hampstead General Hospital 22 Home Hospital, Fitzroy Square 1 Homoepathie Hospital1 Hospital for Women, Soho 1 Hospital for St. John & St. Elizabeth 4 The Hostel, Hindhead 1 Infants' Hospital, Vincent Sq„ W. 3 King's College Hospital 1 7 Knaresboro' Place, Kensington 1 12 Lancaster Place 1 London Temperance Hospital 2 3 Mandeville Place, St. Marylebone 1 9 Mandeville Place, St. Marylebone 1 Institution. Total. Hospitals, &c., continued. Mount Vernon Hospital, Northwood 1 Middlesex Hospital 12 National Hospital, Finchley 1 7 Osnaburgh Terr., St. Marylebone 1 Otto House, Fulham 1 189 Page Street, Westminster 1 Queen Charlotte's Hospital 6 10 Rosslyn Hill 2 Royal Free Hospital 1 Royal Alexandra Hospital 1 St. Catherine's Hospital, Ramsgate 1 St. Columba's Hospital 7 St. George's Hospital 1 St. Luke's House 2 14 Pembridge Square, W. St. Mary's Hospital 10 St. Mark's Square, St. Pancras 1 St. Peter's Home 4 St. Thomas's Hospital 1 95 South Hill Park 1 97 South Hill Park 1 Samaritan Free Hospital 3 7 The Terrace, St. Pancras 1 Thanet Isolation Hospital 1 University College Hospital 7 Victoria Hospital 1 Westminster Hospital 1 29 Wimpole Street 1 3 York Place, St. Marylebone 1 M.A.B. Hospitals. North Western 14 Asylums. Claybury 3 Colney Hatch 11 Fountain Temperance Asylum 2 Hanwell 6 Hospital for Insane, Barnwood 1 Leavesden 6 Long Grove 3 Manor 2 Tooting Bee 12 West Ham Borough Asylum 1 TOTALS. Infirmaries and Workhouses 94 Hospitals, Sanatoria, Nursing Homes, &c. 152 M.A.B. Hospitals 14 Asylums 47 307 II Violent Deaths (excluding Suicide). 32 deaths were classified under this heading as compared with 25 in 1914. 2 were due to wilful murder ; 3 to burns ; 11 to falls ; 7 to injuries caused by being knocked down by motor vehicles; 3 to injuries by horse vehicles ; 1 to a bomb dropped from an enemy airship ; 1 to drowning and 4 to suffocation. Of the 4 deaths due to suffocation, 3 were those of children in bed with their parents, the ages being five months, four months and two months respectively. Suicide. 8 persons committed suicide as compared with 8 in 1914. In 2 cases the cause of death was poisoning, 2 deaths were due to strangulation, 2 to bullet wounds from pistols or revolvers, 1 to drowning and 1 jumped under a train. Section B. SANITARY ADMINISTRATION AND CIRCUMSTANCES OF THE BOROUGH. SANITARY INSPECTIONS, &c. 1915 Number of Inspections 9534 „ Re-inspections 9399 „ Intimation Notices issued 533 „ Statutory Notices issued 454 „ Notifications sent to " Head Teachers " of Schools respecting notified cases of infectious disease 480 „ Notifications sent to Medical Officers of Health of other Boroughs respecting Hampstead children attending schools in their districts 72 „ Notifications sent to " Head Teachers " of Schools respecting cases of Measles 498 12 The following is a tabulated statement of the sanitary work, &c., carried out during the year, so far as that work admits of tabulation :— General Conditions— Houses, or parts, cleansed 218 Dampness in houses, or parts abated 150 Dilapidated houses, or parts of houses, repaired 105 Overcrowding— Cases of. abated (rooms) after service of notice 2 Cases of, abated (rooms) without service of notice 3 Underground rooms — Illegal occupation discontinued 14 Structural works carried out 8 Below floors— Spaces below floors in basement or ground floors ventilated 158 Roofs repaired 297 Gutterings repaired or renewed 134 Rainwater pipes— Repaired or renewed 154 Disconnected from drains 18 Disconnected from soil pipes 5 Sinks disconnected from drains ... 1 Sinks trapped 375 Sinks repaired or renewed 200 Sinks unstopped 3 Lavatories disconnected from drains 1 Lavatories trapped 193 Lavatories repaired or renewed 100 Baths disconnected from drains 7 Baths trapped 152 Baths repaired or renewed 114 Water supply re-instated 12 Water and sinks provided to upper floors of tenement houses 89 Water cisterns repaired or renewed 3 Removed from improper positions 11 Cleansed 64 Fitted with close-fitting covers 37 Water-closet accommodation provided 2 Additional accommodation provided 15 Removed from improper positions 7 Provided with proper and sufficient external ventilation 3 Improperly constructed apparatus removed and new provided 7 Apparatus repaired or renewed 529 Apparatus unstopped 10 Apparatus cleansed 20 Apparatus provided with proper water supply 25 Flushing cisterns repaired or renewed 189 Manholes repaired or renewed 394 Drains repaired or renewed 609 Drains cleansed 44 Drains unstopped 32 Drains ventilated 80 Ventilating pipes of drains— Carried to a sufficient height above windows 12 Repaired or renewed 48 Fresh-air inlets repaired or renewed 95 Soil pipes repaired or renewed 246 Gullies and surface drains— Gully traps removed from improper positions 11 Gully traps cleansed 10 Inlets or surface drains trapped 4 Paving and draining washhouses, areas, yards, &c.— Washhouse or scullery paving repaired or renewed 19 Areas cleansed 4 Area paving repaired or renewed 110 Areas drained 9 Yards or other open spaces paved 176 Paving of yards or other open spaces repaired or renewed 135 Yards or other open spaces drained 12 Floors of buildings in which horses, &c. are kept, paved or repaired 2 Refuse and receptacles— Dustbins provided 230 Fixed ashpits removed 32 Accumulation or deposits of refuse removed 222 Manure receptacles provided 2 Manure receptacles amended 1 Nuisances from the improper deposit of trade refuse abated 5 Animals— Nuisances from the improper keeping of animals abated 8 Nuisances from ballast burning abated 1 Drainage Work. Since the Bye-laws of the London County Council which require the deposit of plans and particulars came into operation in August 1903, 598 plans for the drainage of new buildings and 8255 plans for the alteration and reconstruction of drains in existing premises have been received. During 1915, 528 Notices of drainage work were received. 477 of these necessitated the deposit of plans and particulars. 164 related to the entire reconstruction of the drainage system and in 266 cases the work was carried out voluntarily. 13 Cleansing Station. During 1915,522 school children and 14 children under school age and 2 adults were cleansed at the Cleansing Station by the Council's Attendant, and while this was in progress their clothes were thoroughly disinfected. The figures are more than double those of the previous year. Customs and Inland Revenue Acts. During the year applications for certificates under these Acts were received in respect of 21 dwellings, this number being 4 more than the number for which applications were made in 1914. Smoke Nuisances. During the year observations were made in 14 instances by the Sanitary Inspectors. One Intimation Notice was sent and one Statutory Notice served. Public Mortuary. During the year the bodies of 103 persons were brought to the mortuary—73 by order of the Coroner, 15 by the Police, and 15 at the request of friends of deceased persons. In 27 instances inquests only were held, and in 62 instances post mortem examinations were made and inquests followed. The following table indicates the causes of death or the persons whose bodies were received into the Mortuary:— Number of Bodies Received. Cause of Death or Verdict. Deaths from Natural Causes 54 Accidental Deaths 20 Suicide 15 Misadventure 8 Wilful Murder 2 Open Verdict 4 Total 103 Complaints. During 1915, 658 complaints were made of the existence of insanitary conditions, relating to 801 nuisances as follows:- Accumulations 53 Brought forward 523 Animals improperly kept 14 Smells on premises 42 Animals dead 7 Smells from sewer ventilators 32 Dampness in premises 39 Smells from drains, &c 5 Dirty and dilapidated premises 33 Smells from water-closets 1 Drains defective 49 Smells from manure 10 ,, stopped 37 Smoke nuisances 8 Dust, non-removal 90 Verminous conditions 7 Dust receptacles, foul or dilapidated 44 Water, absence of 64 „ absence of, or insufficient 33 Water, leakage of 17 Water-cisterns, dirty &c. 2 Insanitary condition of premises 33 Water-closets, insufficent or absence of 2 Illness attributable to insanitary conditions 6 Water-closets, defective 26 Manure not removed 25 Water-closets, stopped 6 Overcrowding 17 Yards, unpaved and existing paving defective 6 Rats, nuisance from 6 Roofs and gutters, defective and leaky 30 Miscellaneous 35 Food, unsound 7 Rubbish Nuisance from burning 7 Water, supply contaminated 11 Carried forward 523 Total 804 14 Houses Let in Lodgings. The number of houses let in lodgings on the Register at the end of 1915 was 405. The alterations in the Bye-laws governing these premises' rendered necessary in view of Section 16 of the Housing, Town Planning, &c., Act, 1909, are still the subject of negotiation between the Borough Council and the Local Government Board. 199 Inspections and re-inspections have been made during the year of the houses on the Register. Milk Supply. 74 persons occupying 98 premises have been registered as purveyors of milk, comprising 52 dairies, 19 bakehouses and confectioners, 10 restaurants and coffee shops and 17 general shops. During the year 267 inspections were made, 9 Notices were served and the following works were carried out:— Drains repaired or re-constructed 7 Premises repaired, cleansed and limewashed 18 Water closets repaired or renewed 3 New sinks fixed 1 Waste pipes to sinks trapped and renewed 3 Yard paving repaired or renewed 5 Dustbins provided 1 Cisterns cleansed and covered 2 Other defects remedied 4 Other Foods. The following food was seized or voluntarily surrendered to the inspectors during the year :— Food Seized or Date. Premises. surrendered. August 28th South End Road 73-lbs. Whiting November 26th High Road 6 melons The food exposed for sale on Saturdays, Sundays and upon Bank Holidays is under the constant supervision of the Sanitary Inspectors. Food Premises. Section 8 of the London County Council General Powers Act, 1908, considerably increases the power of sanitary authorities to improve the conditions of places where food is prepared or sold. Iu 1915 the number of premises dealt with was 54. Of these 4 were found to have drain inlets inside; in 14 the drains were defective ; in 47 structural defects of various kinds were present ; 30 premises needed cleansing. To remedy these conditions, the following work was carried out:—In 8 instances the drains were entirely, and in 6 instances partially reconstructed ; in 4 instances drain inlets were removed ; in 47 instances minor defects were remedied and 30 premises were thoroughly cleansed under notice. 15 Fried Fish Shops. The following is a list of the Fried Fish Shops in the Borough. These are now kept under systematic inspection. Town Ward 7 Flask Walk and 2 New End Square. Belsize Ward 106 Fleet Road and 70 Upper Park Road. West End Ward 1a Broomsleigh Street; 86 Mill Lane and 1 Munro Terrace. kilburn Ward 132 High Road; 84 and 89 Kingsgate Road, 32 Netherwood Street and 95 Palmerston Road. Priory Ward 6a West End Lane. Ice Cream. There are 81 shops in the Borough in which Ice Cream is sold. In regard to these, 137 inspections and 12 notices were served during the year. In addition, the barrows standing in the street and on Hampstead Heath on Bank Holidays, have been inspected. The following Sanitary work has been carried out during the year: Premises repaired, cleansed or limewashed 19 Drains repaired or reconstructed 3 Soil Pipes ditto 1 Water closets repaired or renewed 2 „ cleansed 3 Waste pipes of sinks trapped, repaired or renewed 6 Yard paving repaired 4 Dustbins provided 1 Roofs, Gutters and rain water pipes repaired 5 Refuse removed 4 Other defects remedied 4 Bakehouses. At the end of 1915 there were 35 occupied bakehouses on the register, 20 being underground and 15 above ground. Four of the bakehouses situated above ground and two underground use power, and are therefore factories. Nineteen inspections were made in respect of the factory bakehouses, 66 inspections in respect of the workshop bakehouses and 4 notices were served. The following is a list of the occupied bakehouses on the Register at the end of the year :— Town Ward 3, & 67, High Street and 26, New End. Belsize Ward 6, & *65, Fleet Road and 45, South End Road. Adelaide Ward *†44, England's Lane, *90, Haverstock Hill and *2, King's College Road. Central Ward *64, Belsize Lane, *225, & †307, Finchley Road, *98, West End Lane and †2, Broadhurst Gardens. 16 West End Ward †60, & 110, Cricklewood Broadway, †553, Finchley Road, Field Lane School, Hillfield Road. *43, & 44, Mill Lane, 4, Munro Terrace, Fortune Green, and 251, & *279 West End Lane. kilburn Ward *63, Hemstal Road, *94, & *354, High Road, Kilburn, *4, Kelson Street, 67, Kingsgate Road and *†99, Palmerston Road. priory Ward *202. & *228, Belsize Road, *98, Boundary Road, *93, Fairfax Road, *7, Fairhazel Gardens and *137, Finchley Road. Those marked * are underground bakehouses. Those marked † are factory bakehouses. Bakehouses—Underground 20 „ Above ground 15 Total 35 Restaurant Kitchens, &c. The total number of these premises on the register at the end of 1915 was 68. They are kept under regular supervision. 75 inspections have been made and 5 notices served during the year. Meat Supply. The Meat Supply of the Borough is good and in no case has any unsound or diseased meat been found by the Sanitary Inspectors during the year. Slaughter Houses. There are 4 Licensed Slaughter Houses in the Borough, situated at 40, England's Lane, and 17 and 69, High Street and 6, Fairfax Mews. These have been regularly inspected during the year ; 51 inspections having been made. In addition to quarterly limewashing one broken ceiling was repaired and one foul W.C. cleansed. Sale of Food and Drugs Act. 506 samples were taken for analysis during the year. The number certified to be adulterated was 39 or 7.7 per cent, of the total number, as against 6.2 in 1914 and 3.7 in 1913. 9 samples were certified to be of low quality. 414 samples were purchased from Hampstead tradesmen and 92 from tradesmen coming from other districts. The percentage of adulterated samples in the two classes was 6.5 and 13.0 respectively. 32 samples were taken on Sundays :—2 or 6.2 per cent. were adulterated and 2 were of low quality. 17 The following table shows the articles of which samples were taken during the year:— Articles. No. taken. Adulterated. Low Quality. Apples 1 — — Butter 167 15 1 Cheese 5 — — Cocoa 8 — — Coffee 12 — — Cream 9 5 — Lard 31 — — Margarine 19 — — Milk 252 18 9 Sausages 2 1 — Totals 506 39 10 The following table shows the articles adulterated, nature of adulteration, and the results of proceedings taken:— f sample Article. How Adulterated. Result of Proceedings. 49 Butter 86% foreign fat Informal sample All these samples purchased from the same shopkeeper. 50 Butter 83% foreign fat Informal sample 62 Butter 84% foreign fat Informal sample 69 Butter 50% foreign fat Informal sample 76 Butter 55% foreign fat Fine £20. Also Fine £10 for sell- ing article in un- labelled wrapper 98 Sausages 6¼ grains of boric acid per lb Vendor written to 137 Milk 7% deficient in butter fat Summons dismissed. Warranty proved 138 Milk 6% deficient in butter-fat Summons dismissed. Warranty proved 140 Milk 8%deficient in butter-fat Summons dismissed. Warranty proved 158 Milk 12% added water Summons dismissed. Warranty proved 181 Milk 19% deficient in butter-fat Fine £2, Costs 12/6. 216 Milk 6% deficient in butter-fat Summons dismissed. Warranty proved 233 Milk 20% deficient in butter-fat Fine £1, Costs 10/6 241 Cream Trace of boric acid No action 243 Butter 68% foreign fat Informal sample All these samples purchased from the same vendor. 246 Milk 11 % added water Informal sample 248 Butter 85% foreign fat Informal sample 249 Milk 89% added water Informal sample 252 Milk 15% added water Informal sample 254 Milk 12% added water Informal sample 255 Butter 84% foreign fat Informal sample 261 Milk 4% added water & 10% deficient in butter-fat Informal sample 262 Milk 12% added water Informal sample 264 Butter 84½ % foreign fat Summons not served. Vendor left district 257 Cream Trace of boric acid No action 275 Cream Unweighable trace of boric acid No action 280 Cream 17½ grains of boric acid per lb. Vendor cautioned 289 Cream 17½ grains of boric acid per lb. Vendor cautioned 292 Butter 85% foreign fat Informal sample All these samples pur chased from the same vendor. 297 Milk 20% deficient in butter-fat Summons dismissed. Warranty proved 308 Butter 58% foreign fat Informal sample 309 Butter 60% foreign fat Informal sample 310 Butter 6796 foreign fat Informal sample 311 Butter 52% foreign fat Fine £5, Costs 10/6 313 Milk 10% deficient in butter-fat Fine 5/-, Costs 12/6 360 Milk 6% deficient in butter-fat Fine 5/-, No Costs 391 Milk 2½% added water No Fine, Costs 12/6 463 Butter 82% foreign fat Fine 1/-, Costs 12/6 502 Milk 6% deficient in butter-fat Fine 10/-, Costs 10/6 One Vendor was cautioned for selling margarine in an unlabelled wrapper. 18 Milk and Cream Regulations, 1912. The object of these Regulations is to secure that cream containing preservative shall be distinguished at all stages of sale from cream to which no preservative has been added. The following samples of Milk and Cream not sold as preserved cream, were taken during the year:— 1.—Milk; and Cream not sold as preserved Cream. (a)—Number of samples examined for the presence of a preservative. (b)—Number in which a preservative was reported to be present. Milk 252 Cream 6 5 three of these samples contained a trace of Bone Acid:—111 regard to these no action was taken. The other two each contained 17½ grs. per lb. Explanations were obtained and the vendors in each case were cautioned. 2.—Cream sold as Preserved Cream. (a) Samples submitted for analysis to ascertain if the statements on the labels as to preservatives were correct :■—1. Correct statements made, 3 ; 2. Statements incorrect, nil. (b) Determinations made of milk fat in cream sold as preserved cream :—1. Above 35 per cent., 3 ; 2. Below 35 per cent., nil. (c) Instances where (apart from analysis) the requirements as to labelling of preserved cream in Article V (1) and the proviso in Article V (2) of the regulations have not been observed :—nil. (d) Particulars of each case in which the regulations have not been complied with, and action taken :—nil. 3.—Thickening substances. (a) Addition to cream or to preserved cream, nil; (b) Action taken where found, nil. 4—Other observations (if any), nil. Percentage of Preservative found in each sample where this has been determined, and also the percentage indicated on the Statutory label:— ial No. Sample. Analyst's Report. Percentage on Statutory label. 241 Cream A trace of Boric Acid No label 257 Cream „ „ „ „ 275 Cream Unweighable trace of Boric Acid „ 280 Cream 0.25 % Boric Acid „ 289 Cream 0.25 % „ „ 271 Preserved Cream 0.13 % „ Not exceeding 0.5 % Boric Acid 274 „ „ 0.12% „ „ „ 304 „ „ Genuine „ „ 19 HOUSING. Dwellings unfit for Habitation. 83, Palmerson Road. This house was represented as being unfit for human habitation by my predecessor, Dr. MeCleary, on the 20th December, 1910,and a Closing Order was made by the Council on the 12th January, 1911, since when it has been the subject of continuous litigation. It has been referred to year by year in my previous reports. The following shows the further proceedings which have taken place during the year under review :— Jan. 8th. Summons against tenant for failing to vacate the premises restored and again adjourned pending the decision of the Local Government Board on Mr. Arlidge's appeal against refusal to determine Closing Order. Feb. 8th. Public Local Inquiry held by Inspector of the Local Government Board held at the Town Hall, upon appeal dated 28th May, 1912, by Mr. Arlidge against the refusal by the Council to determine Closing Order. Feb. 8th. Inspection of the premises by the Inspector of the Local Government Board accompanied by Mr. Arlidge, Mr. Harold Griffen and Mr. Hemmings, but Mr. Arlidge refused admission to the Senior Sanitary Inspector who attended on behalf of the Borough Council. Mar. 22nd. Order of the Local Government Board dismissing Mr. Arlidge's appeal and confirming the refusal by the Council to determine Closing Order. Mar. 29th. Further application by Mr. Arlidge to the Council to determine Closing Order. Apr. 23rd. Summons against the tenant restored and heard by Mr. Paul Taylor who made an order directing him to vacate the premises within 16 days and to pay £7 12s. 0d., costs. July 1st. Summons against the tenant for non-compliance with the Magistrate's order to vacate. Adjourned to 4th August by consent. July 7th. Writ of Summons in Chancery issued by Mr. Arlidge for an Injunction to restrain the Council from proceeding to enforce the Closing Order. July 30tb. Motion for Injunction heard and refused by Mr. Justice Neville. Aug. 4th. Notice of Appeal to Court of Appeal against decision of Mr. Justice Neville. Aug. 4th. Summons against tenant for non-compliance with order of Magistrate, further adjourned sine die. Aug. 6th. Notice of Application to Lord Justice Pickford for order restraining Council from taking into consideration question of demolition until appeal heard. Aug. 9th. Application to Lord Justice Pickford when on Council undertaking not to demolish the house, no order made. Costs in action. Aug. 10th. Question of demolition considered by Public Health Committee in accordance with powers delegated to them by the Council. Demolition order made. 20 Aug. 10th. Application of Mr. Arlidge to the Council to determine Closing Order refused. Aug. 17th. Notice of appeal to Local Government Board against refusal by Council to determine Closing Order. Sept. 1st. Notice of appeal to Local Government Board against refusal by Council to determine the Demolition Order. Sept. 30th. Matters reported to the Council and confirmed by them. 84 & 85, Palmerston Road. These houses belong to the same owner as No. 83, and the Council having authorised me to make survey and examination for the purpose of determining whether any powers under the Housing Act could be exercised in regard to the premises, I made several unsuccessful efforts to obtain admission to the premises. Proceedings were taken against the owner tor obstruction and he was fined 10/- with 10 guineas costs in regard to the obstruction at No. 81, and 10/- with 2 guineas costs in regard to the obstruction at No. 85, and the Magistrates made an order directing the owner to admit me to the premises. Against this decision the owner appealed to the High Court. His appeal came before the Divisional Court, composed of the Lord Chief Justice, Ridley and Mr. Justice Shearman. On the 22nd June, 1915, the Appeal was unanimously dismissed. An entry has not yet been made and as litigation in regard to No. 83 must govern the subsequent steps taken in regard to these houses, it is advisable that further action should not be taken until the pending action in regard to No. 83 has been finally disposed of. 1 & 7, Peebles Mews. On the 13th July, the Local Government Board held a Public Local Enquiry in reference to the Appeal of the Owner against the Demolition Orders made by the Council, and the Local Government Board intimated their willingness to quash the Orders providing certain essential works are carried out and the premises used for some purpose other than for human habitation. The following premises have been dealt with during 1915:— Premises. Represented. Closing Order. Remarks. 2, Bolton Road (Front basement room) 23.2.15 4.3.15 Order has now been determined 23, Worsley Road 23.3.15 15.4.15 „ 117, Abbey Road (2 basement rooms) 23.3.15 15.4.15 „ 4 Lowfield Road 4.5.15 13.5.15 Work in hand 5 & 6, Fairfax Yard 5.10.15 28.10.15 „ The Water Supply of Tenement Houses. During 1915, the powers conferred by Section 78 of the L.C.C. General Powers Act, 1907, have been exercised in regard to 89 houses, making a total of 770 houses which have been dealt with in Hampstead since the Act came into force. Factories and Workshops Act. Whilst maintaining careful supervision of the sanitary conditions of the workshops and workplaces, due regard has been paid to the altered conditions now pertaining. In many establishments women have taken the place of men, so that establishments are now employing 21 both sexes where they formerly employed one. The Local Government Board in a letter upon this subject dated 14th June, 1915, suggested that endeavours should be made to re-arrange things as to obviate the expense of providing double sanitary accomodation. These arrangements would be only temporary during the War. This suggestion was adopted and adhered to. At the end of 1915 there were 418 workshops on the Register, of which 31 were domestic workshops. Excluding these, there were 644 males and 760 females employed therein. During the year 737 inspections were made and 24 notices served. TRADE OR BUSINESS. No. of Workshops. Workshops other than Domestic Workshops. Domestic Workshops. Total No. of Workshops. No. of Workrooms. No. of Employees. Males. Females Bakers 29 34 118 2 — 29 Blindmakers 3 5 5 5 — 3 Bootmakers 37 41 56 — 7 Builders and Carpenters 18 21 23 — 18 Cabinet Makers and Polishers. 2 6 33 — 1 3 Carriage Builders 6 14 22 — — 6 Corset Makers 4 5 — 11 — 4 Cycle Makers and Repairers 4 7 10 2 — 4 Dressmakers & Ladies Tailors 85 101 6 333 11 96 Florists 3 4 10 5 — 3 Harness Makers 4 6 12 — — 4 Ironmongers 14 14 26 — — 14 Laundresses 5 14 5 23 — 5 Milliners 26 26 — 66 1 27 Monumental Masons 2 17 — — 2 Motor Makers 9 12 30 — — 9 Outfitters 10 6 1 180 1 11 Pianoforte Makers 2 4 27 — — 2 Picture Frame Makers 10 12 14 — — 10 Sign Writers 2 6 11 — — 2 Smiths 11 11 24 — — 11 Tailors 28 34 49 25 12 40 Upholsterers 18 24 44 15 1 19 Watchmakers and Jewellers 12 13 18 — — 12 Wigmakers 12 17 13 20 — 12 Miscellaneous 31 43 70 73 4 35 Totals 387 512 644 760 31 418 Inspections: (excluding bakehouses) 671 Cleanliness: Workrooms requiring cleansing 21 Warming and ventilation: Workshops inadequately ventilated 4 Gas stoves without flues 3 Warming unsatisfactory 4 Overcrowding: Workrooms overcrowded 2 Abstract and Factory Act not exhibited: Workshops 8 22 Workplaces. 1081 inspections of workplaces were made during the year and 44 notices were served. Home-Work. 99 lists of outworkers were received from employers. These contained 239 entries. There are 67 outworkers' premises in Hampstead. NATURE OF WORK. Outworkers' Lists, Section 107. Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Sending Twice in the year. Sending Once in the year. Failing to keep or permit in* spection of lists Failing to send lists. Listst Outworkers.† Lists Outworkers. Contractors. Workmen. Contractors. Workmen. 1 2 3 4 5 6 7 8 9 10 Wearing Apparel- (1) making, etc. 64 38 87 5 3 3 — — — (2) cleaning and washing 12 25 — — — — — — — Houshold linen 4 5 7 1 — 1 — — — Lace, lace curtains and nets and net — 2 2 — — — — — — Curtains & furniture hangings 8 1 12 — — — — — — Furniture and upholstery 2 5 17 1 1 — — — — Electro-plate — — 1 — — — — — — File-making — — — — — — — — — Brass and brass articles — 1 2 — 1 — — — — Fur pulling — — — — — — — — — Cables and chains — — — — — — — — — Anchors and grapnels — — — — — — — — — Cart gear — — — — — — — — — Locks, latches and keys — — 1 — — — — — — Umbrellas, etc. — 9 — — — — — — — Artificial flowers — — — — — — — — — Nets, other than wire nets — — — — — — — — — Tents — — — — — — — — — Sacks — — — — — — — — — Racquets and tennis balls — — — — — — — — — Paper, etc., boxes, paper bags 2 1 14 — — — — — — Brush making — — — — — — — — — Pea picking — — — — — — — — — Feather sorting — — — — — — — — — Carding, etc., of buttons, etc. — — — — — — — — — Stuffed toys — — — — — — — — — Basket making — — — — — — — — — Chocolates and sweetmeats Cosaques, Christmas Crackers, — — — — — — — — — Christmas Stockings, etc. — — — — — — — — — Textile weaving — — — — — — — — — Total 92 87 143 7 5 4 — — — Outwork in unwholesome premises, Sec. 108, Nil; Outwork in infected premises, Sees. 109110, Nil. * In the case of those occupiers who gave out work of more than one of the classes specified in Column 1, and subdivided their lists in such a way as to show the number of workers in each class of work, the list has been included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers have been assigned in columns 3 and 4 (or 6 and 7) into their respective classes. † The figures in columns 2, 3 and 4 are the total number of the lists received from those employers who comply strictly with the statutory duty of sending two lists each year, and of the entries of names of outworkers in those lists. 23 Registered Workshops. Workshops on the Register (s. 131) at the end. of year. no. Bakehouses 29 Bootmakers 37 Dressmakers and ladies' tailors 96 Laundries 5 Milliners 27 Tailors 40 Watchmakers and jewellers 12 Wigmakers 12 Other 160 Total number of workshops on Register 418 Other Matters. Class (1) NO. (2) Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Worshop Acts (s. 133, 1901) 8 Action taken in matters referred by H.M. Inspector as remediable under the Public Heath Acts, but not under the Factory and Workshop Acts (s. 5, 1901) :— Notified by H.M. Inspector 1 Reports (of action taken) sent to H.M. Inspector 1 Other 2 Underground Bakehouses (s. 101) in use at the end of the year 20 Section C. PREVALENCE OF & CONTROL OVER ACUTE INFECTIOUS DISEASES. NOTIFIABLE INFECTIOUS DISEASES (EXCLUDING TUBERCULOSIS). The list of Infectious Diseases notifiable in London during 1915, was as follows :— Small-pox. Typhoid or Enteric Fever. Cholera. Typhus Fever. Diphtheria. Relapsing Fever. Membranous Croup. Continued Fever. Erysipelas. Puerperal Fever. Scarlet Fever. Anthrax Epidemic CerebroHydrophobia Occurring in Man. Spinal Meningitis. Glanders Plague. Ophthalmia Neonatorum. Polio-Myelitis. Chicken-Pox. (From March 17th—June 30th, 1915.) 24 Bacteriological Work. The following is a Summary of the Bacteriological Work performed by the Lister Institute and at the Borough Council's Tuberculosis Dispensary:— Positive. Negative. Total. Diptheria 61 167 228 Enteric Fever — 3 3 Cases of Infectious Disease occurring in each month during 1915. disease. months. Totals. January February March April May June July August September October November December Diptheria and Membranous Croup 13 12 8 12 10 17 10 9 8 l6 13 10 138 Erysipelas 5 1 5 1 3 6 5 2 7 5 7 5 52 Scarlet Fever 17 18 15 16 17 11 11 17 23 19 14 14 192 Enteric Fever 1 2 — — — 1 1 - 1 1 3 2 12 Puerperal Fever 1 1 — 1 — — — — — — - — 3 Polio-Myelitis — — — — 1 — — — 1 — - - 2 Ophthalmia Neonatorum 3 - 4 1 4 1 - 2 - - - 1 16 Epidemic CerebroSpinal Meningitis - 3 2 3 2 - - - - - - - 10 Chicken-pox — — 7 10 3 19 1 - - - - - 40 Totals 40 37 41 44 40 55 28 30 40 41 37 32 465 Small-Pox. No cases of small-pox occurred in Hampstead during the year. Vaccination. Of the 1236 births recorded 613 were successfully vaccinated. In two cases the children were insusceptible of vaccination. In regard to 260, Certificates of Conscientious Objection were obtained; 60 died before vaccination was performed; 27 cases of vaccination were postponed and 274 remained to be dealt with. I am indebted to the Vaccination Officer for these statistics. Diphtheria and Membranous Croup. The number of cases notified in 1915 was 130, as compared with 224 in 1914. The attack rate, or number of cases notified per 1,000 of the population was 1.59 compared with the rate of 2.58 in the previous year. The number of cases notified proving fatal was 10, or 7'69 per cent. of the cases notified, as against 3.6 per cent. in 1914. The deathrate per 1,000 of the population, calculated on the total deaths was 0.12. 104 patients, or 80 per cent. of the cases notified were removed to hospital. In accordance with the Diphtheria Anti-toxin (London) Order, 1910, the Borough Council supply anti-toxin free to medical practitioners for use for the poorer inhabitants of the Borough. 25 Erysipelas. Fifty-two cases were notified, but no deaths occurred, as compared with 44 cases and 2 deaths in 1914. The attack rate, per 1,000 of the population, was .63. Of the cases notified 16, or 30 per cent. were removed to the Hampstead Workhouse Infirmary or Nursing Homes. Scarlet Fever. 192 cases or scarlet lever were notified during the year. The number of cases per 1,000 of the population was 2.34 ; the corresponding figure in 1914 being 3.20. 2 cases proved fatal. The death-rate per 1,000 of the population was .02. Of the cases notified 160 or 83 per cent. were removed to hospital. Enteric Fever. The number of cases notified was 12. The attack-rate per 1,000 of the population was .14. One of the cases notified proved fatal. 7 other deaths from this disease were allocated to Hampstead, but they were notified in other districts. Puerperal Fever. Three cases were notified, one of which proved fatal. The Ward Distributions of the cases was as follows :—Town 1, Belsize 1, West End 1. All the cases were removed from their homes for proper nursing. Epidemic Cerebro-Spinal Meningitis. This disease, popularly known as "spotted fever," was made notifiable on 15th August 1912. During 1915, 10 cases were notified, 4 of whom died. The mode of infection in this disease is not clear, although the disease is epidemic in character. 3 of the 10 cases notified were soldiers. The war would seem to have made the disease more prevalent and special care was taken of all the cases which occurred in the Borough. Acute Polio-Myelitis. Two cases of this disease occurred, no deaths. Ophthalmia Neonatorum. 16 cases were notified during the year. This is the first complete year that has transpired since the disease became notifiable. I consider this is a high incident for this disease, which will probably tend to become less when the disease is better understood. Some of the doctors have notified cases of inflamation of the eyes but they are not of the specific nature which the Regulations are designed to cover. Many of our cases were so. In none was there any evidence of really bad nursing and in no case was any permanent injury left. With proper nursing arrangements the complaint would rarely ever occur. Principal Epidemic Diseases. Enteric Fever. Whooping Cough. Scarlet Fever. Measles. Small-pox. Diphtheria. All of these, with the exception of measles and whooping cough, are notifiable diseases. The total number of deaths from the principal epidemic diseases amounted to 36 and the death-rate was 0.44 per 1,000 of the population. 26 Measles. Sixteen deaths were recorded from this disease as compared with 2 in 1914. The mortality was 0.19 per 1,000 of the population, the mortality in 1914 being 0.02. The following table shows the number of reported cases of measles occurring each month in the various Wards:— Month. No. 1 (Town). No. 2 (Belsize). No. 3 (Adelaide). No. 4 (Central). No. 5 (West End). No. 6 (Kilburn). No. 7 (Priory). Totals. January 1 — — — 2 1 — 4 February 8 — 1 2 16 25 6 58 March 15 7 9 1 24 43 3 102 April 22 15 — 6 11 75 15 144 May 24 14 1 3 — 46 5 93 June 4 — 1 4 4 15 8 36 July 2 5 1 2 26 7 4 47 August — - — — — — — — September — 1 — — 1 3 2 7 October — — — — — 3 1 4 November — — — — — 9 — 9 December 4 — — — 2 26 — 32 Totals 80 42 13 18 86 253 44 536 In 137 cases, or 25 per cent. of the reported cases, no doctor was in attendance. The total number of visits and re-visits paid to measles cases during 1915 by the two lady inspectors was 664. Disinfection. No. of Articles Disinfected. No. of Articles Destroyed. Beds 287 Beds 3 Mattresses 370 Mattresses 7 Palliasses 36 Bolsters 3 Bolsters 585 Pillows 11 Pillows 1769 Blankets 5 Blankets 2251 Sheets 9 Sheets 1137 Counterpanes 3 Counterpanes 932 Articles of Clothing 4 Articles of Clothing 7238 Linen Articles 12 Carpets 169 Miscellaneous 4 Linen Articles 3525 Books 351 Miscellaneous 983 Total 19633 Total 61 Number of premises disinfected 1398 „ rooms, &c., „ 1614 The amount of disinfection carried out by the Council has increased enormously in late years. In the near future the Council will undoubtedly have to consider the reorganisation of the arrangements and an increase in the disinfecting staff. 27 Whooping Cough. Eight deaths occurred from Whooping Cough as against 16 in 1914. The mortality rate per 1000 of the population was .09. The total number of visits paid to cases of Whooping Cough by the two Lady Sanitary Inspectors was 35. Diarrhœa and Enteritis. The deaths at all ages from diarrhœa and enteritis in Hampstead during 1915 numbered 18. Of these 14 occurred during the first year of life. The deaths in the 1st, 2nd, 3rd and 4th quarters of the year were as follows:—5, 4, 4, 1, The deaths from these diseases at various age periods in the last three years is as follows:— Year. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 years and upwards. All ages. 1912 2 — — — — 2 4 7 15 1913 13 1 2 — — 1 1 — 18 1914 7 2 1 1 — 1 2 2 16 1915 14 — 1 — — 2 — 1 18 Totals 36 3 4 1 — 6 7 10 67 The following are the deaths from diarrhœa and enteritis in recent years:— 1906 30 *1911 35 1907 14 1912 15 1908 22 1913 18 1909 11 1914 16 1910 15 1915 18 *This was a year of extra heat. Section D. PREVALENCE OF AND CONTROL OVER TUBERCULOSIS. The number of deaths from tuberculosis in 1915 was 71. Of these 48 deaths were due to pulmonary tuberculosis, 9 to tuberculous meningitis and 14 to other forms of tuberculosis. 28 The following table shows the number of deaths and the deathrates from all forms of tuberculosis and from consumption respectively since 1899:— Year. Total deaths from Tuberculosis. Deathrate per 1,000 population. Deaths from Consumption. Death-rate per 1,000 population. Cases of Consumption notified. 1899 98 1.21 81 0.98 - 1900 92 1.13 69 0.85 - 1901 118 1.44 73 0.89 - 1902 97 1.18 73 0.89 51 1903 90 1.09 66 0.80 34 1904 102 1.23 73 0.88 39 1905 95 1.14 73 0.87 27 1906 79 0.94 57 0.68 35 1907 92 1.09 61 0.72 55 1908 84 0.99 74 0.87 30 1909 75 0.88 53 0.62 67 1910 80 0.94 58 0.68 77 1911 70 0.82 56 0.65 113 1912 77 0.88 64 0.74 183 1913 61 0.81 49 0.56 300 1914 71 0.82 57 0.66 172 1915 71 0.86 48 0.58 172 The deaths from consumption and from all forms of tuberculosis during 1915 were distributed among the wards as follows:— Ward. Area (Acres). Estimated Population middle of 1915. Consumption. Tuberculosis (All Forms). Deaths. Death-rate per 1000 of the Population Deaths. Death-rate per 1000 of the Population No. 1 (Town) 686 13550 5 .36 6 .44 „ 2 (Belsize) 271 13250 5 .37 10 .75 „ 3 (Adelaide) 325 9150 2 .21 6 .65 „ 4 (Central) 312 9500 6 .63 8 .84 „ 5 (West End 247 12390 11 .88 14 1.13 „ 6 (Kilburn) 195 14440 12 .83 18 1.24 „ 7 (Priory) 229 9480 7 .73 9 .94 The Borough 2265 81760 48 .58 71 .86 29 The following table shows the age distribution of patients dying from Pulmonary Tuberculosis in Hampstead in the thirteen years 1903—1915. Year. Age Period. All Ages. 0-5 5-15 15-25 25-65 65 1903 — 1 14 46 5 66 1904 1 1 15 53 3 73 1905 1 — 12 57 3 73 1906 1 — 8 45 3 57 1907 1 2 10 45 3 61 1908 — 2 14 55 3 74 1909 1 1 12 37 2 53 1910 1 1 12 37 7 58 1911 1 1 5 44 5 56 1912 2 2 13 45 2 64 1913 — 1 4 39 5 49 1914 — 2 10 42 3 57 1915 — 1 7 37 3 48 Totals 9 15 136 582 47 789 The deaths from all forms of Non-Pulmonary Tuberculosis was 23 in 1915, distributed in age periods as follows :—0-5 5; 5-15 8; 5-25 5; 25-65 5. The total number of notification certificates (including duplicates) received during 1915, relating to Hampstead patients was 314, i.e. :—260 Pulmonary and 54 Non-Pulmonary cases. In accordance with the terms of the Regulations, a Register is kept in which the full particulars of each notification are set out. A weekly statement of these is sent to the County Medical Officer. The notes of investigations are indexed and filed and comprise a full record of Tuberculosis in the Borough. This is of great assistance in the efforts which are being taken to control the disease. The unsatisfactory home conditions found upon investigating the new cases of Pulmonary Tuberculosis notified in 1915 were as follows:— Unsatisfactory Home Conditions. Pulmonary Cases. Non-Pulmonary Cases. Overcrowding 2 1 Inadequate Ventilation 4 1 Inadequate Lighting 2 1 Dampness 10 2 Other Insanitary Conditions 17 5 30 Occupations. The following is an analysis of the occupation of the cases notified as tuberculous:— Occupation. Pulmonary. NonPulmonary. Occupation. Pulmonary. NonPulmonary. Accountant 1 — Machine Minder 1 — Arc Lamp Trimmer 1 — Manager 2 — Barmaid 1 — Mechanic 2 — Bootmaker 1 — Medical Practitioner (retired) 1 — Bricklayer 3 — Butcher — 1 Milk Carrier 1 — Caretaker 2 — Miner 1 — Charwoman 2 1 Naval Gunner (discharged) 1 — Chemist — 1 Clerk 7 — Needlewoman 3 — Coachman 1 — No occupation 10 14 Commercial Traveller 1 - Nurse Attendant 1 1 Packer 1 1 Companion 2 — Plumber's Mate — 1 Cutler 1 — Police Constable 2 — Domestic Servant 11 2 Porter 2 — Dressmaker 1 1 Restaurant Keeper 1 — Electrician — 1 Scaffolder 1 — Engineer 2 — School child 24 18 Factory Hand 1 — Shop Assistant 4 2 Farm Hand 1 — Silversmith 1 — Gardener 2 — Soldier 7 — House Decorator 1 — Solicitor 1 — Housekeeper 1 — Stock Exchange 1 — Housewife 29 1 Student 3 — Journalist 1 — Tailor — 1 Labourer 1 — Ticket Collector 1 — Laundress 2 — Tobacconist 2 — Lecturer 1 — Upholsterer 2 — Librarian — 1 Watchman 1 — Linesman 1 — No information 17 1 Total number of Pulmonary Cases 172 Total number of Non-Pulmonary Cases 48 Removal of Cases. Of the cases of Pulmonary Tuberculosis newly notified in 1915, 63 were removed : 36 to Sanatoria, 9 to Hospitals, 5 to Infirmaries and 13 to Nursing and other Homes. 21 of the newly notified cases of non-pulmonary tuberculosis were removed : 18 to Hospitals and Sanatoria and 3 to the Infirmary. Of the pulmonary cases notified prior to 1915, 17 were removed : 12 to Sanatoria, 1 to Hospital and 4 to the Infirmary. 3 cases of non-pulmonary notified in 1915 were removed to Hospitals, Homes, etc. Preventive and Curative Measures. The action taken by the Public Health Department during the year has followed the line indicated in my Annual Reports for 1912, 1913 and 1914. 31 The Municipal Tuberculosis Dispensary. The action taken by the Department during 1915 varies little from the preceding year. The same routine is gone through in each case. The Public Health Department supervises the preventive side and the Tuberculosis Dispensary the clinical side. Our efforts have been hindered by the absence of Nurse Goodchild on active service, but a temporary part-time nurse obtained from the Kilburn and West Hampstead District Nursing Association has been quite satisfactory. With the return of a full-time nurse I am of opinion the work of the district will be enhanced. During the year an agreement has been arrived at with Mount Vernon Hospital, for linking up the tuberculosis work of the Borough with that hospital. Briefly the agreement with Mount Vernon is as follows :— That in consideration of payments made by the Council to the hospital, the hospital undertakes : To nominate a junior member of their visiting staff as the tuberculosis medical officer of the Borough of Hampstead. This appointment to be annual. The officer will be a part time officer and will fulfil all the duties of the tuberculosis medical officer as outlined by the interim report of the Departmental Committee and the Order of the Local Government Board dated July 26th, 1912. He is responsible for all the clinical work of the Borough and is in charge of the Tuberculosis Dispensary. He undertakes all the bacteriological and pathological work necessary. Although clinically uncontrolled he is in all other respects under the direction of the Medical Officer of Health and forms part of his staff. During the existence of this agreement, the Hospital grants to the Council the use of their premises in Fitzroy Square as a consultation centre or for special pathological work or for special form of treatment which may be necessary, and the Tuberculosis Medical Officer has also the right of consulting with other members of the visiting staff of Mount Vernon Hospital in any case in which he deems a consultation would be of benefit to his patient. This arrangement has been at work during the latter months of 1915 and is proving satisfactory so far. It is the most promising scheme we have yet tried. Report on the work of the Hampstead Municipal Tuberculosis Dispensary from 1st January to 31st December, 1915. During the year 308 persons have applied for treatment, and of these 91 were found to be tuberculous and were dealt with at the Dispensary as their circumstances demanded. Table I. shows the number of applications for each individual month, and indicates the proportion of insured persons under the National Insurance Act who applied for treatment, and the number of those who were found to be tuberculous. 32 TABLE I. Total Number of Applications made during the Year 1915. Month. Tuberculous. Non-Tuberculous. Totals. Insured Non. Insured Total. Insured NonInsured Total. Insured NonInsured Total. January 2 1 3 4 22 26 6 23 29 February 1 5 6 3 23 26 4 28 32 March 4 1 5 2 28 30 6 29 35 April 1 3 4 1 15 16 2 18 20 May 3 3 6 1 20 21 4 23 27 June 3 11 14 3 11 14 6 22 28 July 2 3 5 4 7 11 6 10 16 August — — — 5 8 13 5 8 13 September 8 8 16 2 11 13 10 19 29 October 3 9 12 2 17 19 5 26 31 November 4 6 10 1 10 11 5 16 21 December 2 8 10 1 16 17 3 24 27 Totals 33 58 91 29 188 217 62 246 308 During the year 146 patients, new and old, have been treated at the Dispensary. Insured: Pulmonary, 32; Non.Pulmonary, 4; Total, 36. Non.Insured: Pulmonary, 85; Non.Pulmonary, 25; Total, 110. Details made up as follows :— TABLE II. Males. Females. Children under 14. Total. Pulmonary 26 55 36 117 Non-pulmonary 3 5 21 29 Totals 29 60 57 146 Attendances.—The attendances made by these patients during the year was 899. 137 by insured and 762 by non.insured persons. 73 attended for the purpose of observation, namely, 7 insured and 66 non.insured, who made 288 attendances, 25 by insured and 263 by non.insured. Contacts.—158 contacts were examined. Of these 11 were found to be suffering from Pulmonary and 5 from Non.Pulmonary Tuberculosis. These were treated at the Dispensary. Home Visits.—459 domiciliary visits have been made, 175 by the Tuberculosis Medical Officer and 284 by the Tuberculosis Nurse. Patients Discharged.—33 patients were discharged as follows :— Referred back to Panel Doctor, 1; Improved, 9; Much improved, 3; Arrested, 17; Found after observation to be non.tubercular, 12. 39 patients were dealt with as follows :—10 were sent to Sanatoria, Hospitals and Nursing Homes (other than Poor Law), 2 were sent to the Workhouse Infirmary, 6 left the district and 21 ceased attending. 33 Bacteriological Examination of Sputa.—154 specimens were examined in the laboratory, of which 40 proved to be positive and 114 negative. Total Attendances. January 120 July 142 February 139 August 72 March 138 September 119 April 125 October 214 May 108 November 186 June 128 December 192 Total 1683. Section E. MEANS FOR PREVENTING MORTALITY IN CHILDREN AND IN INFANCY. Notification of Births. By the Notification of Births Act 1907 all births are required to be notified to the Medical Officer of Health within 36 hours of their occurrence. This is in addition to the usual registration with the Registrar of Births. In 1915, 1,177 births were notified, including 18 still births. 294 were notified by medical practitioners, 223 by midwives, 496 by parents and 146 from other sources. In 858 cases the parents were visited and 179 re-visits were made. When the mother is able to get about she is visited by a Health Visitor employed by the Borough Council and invited to bring her baby to one of the three Weighing Centres which are at work in the Borough. The following are the addresses and days and hours of weighings :— Health Institute, Kingsgate Road Wednesdays, 2.30 to 4.30. Lyndhurst School, Lyndhurst Road Thursdays, 2.30 to 4. Emmanuel Hall, Broomsleigh Street Fridays, 2.30 to 4. At each Centre at these times a doctor is in attendance together with the Lady Health Visitor of the Borough Council and such voluntary helpers as are appointed for those days. The work of the Centres has increased materially during the year and quite a fair number of Belgian and French babies have attended the weighings. 34 The following Table gives briefly the work done at each Centre:— Health. Institute. Emanuel Hall. Lyndhurst Hall. Total. No. Weighed 410 58 174 642 Total Attendances 2226 285 851 3362 Average attendance 46 7 17 70 Highest attendance on one day 62 12 31 105 Maximum attendance of any one infant 44 17 30 91 Thus it will be seen that of the 1,177 births notified during 1915 no less than 642 attended the Weighings, which is undoubtedly a high percentage of the births of the Borough, considering that such a large number of our babies are born in well.to.do families. Mortality among Young Children. The following table shows the Infantile Mortality rate and the Death rate among children under five years of age. The latter rate is calculated upon a period of five years. Year. Deaths of Infants under 1 year of age. Deaths of Children under 5 years of age. No. Rate per 1000 Births. No. Rate per 1000 Children born in the year and in preceding 4 years. 1901 155 102 233 30·2 1902 133 88 195 25·2 1903 126 87 177 23·1 1904 161 111 226 30·0 1905 133 94 189 25·7 1906 111 77 171 23·5 1907 98 69 154 21·7 1908 97 69 122 17·3 1909 99 74 148 21·3 1910 81 60 132 19·2 1911 105 82 152 22·7 1912 79 62 131 19·8 1913 91 69 149 22·7 1914 91 72 129 20·0 1915 101 76 144 22·2 Infant Mortality. Our Infantile Mortality is, nevertheless, higher than the last three preceding years. This appears to be solely due to the large number of deaths of infants under one year of age, the cause of whose deaths has been certified as due to premature birth. The question of reducing deaths from this cause is under consideration and it is hoped that the ante.natal clinic now being organised will have the effect of reducing the infantile mortality, from this cause. 35 The number of deaths under one year per 1,000 births was 76.0, as compared with the rate of 72.0 in 1914. This rate is calculated upon the total number of births belonging to Hampstead, including those that occurred in Lying.in Institutions outside the Borough. The average rate for the years 1910.1915 was 68.9. Deaths among Legitimate and Illegitimate Infants. The death rate among illegitimate children is a matter of great difficulty to deal with. Illegitimate children seldom receive the same maternal care that is bestowed upon legitimate children, and that they should be looked after as well as circumstances will permit is important and to ensure this, special attention is now being given to all illegitimate births which come under our notice. I have prepared the following figures to show the great difference that exists in the infantile death-rates of legitimate and illegitimate children under one year of age. Year. Legitimate Infants. Infantile death-rate per 1,000 births. Illegitimate Infants. Infantile death-rate per 1,000 births. Births. Deaths. Births. Deaths. 1906 1403 106 75 34 5 147 1907 1298 85 65 43 13 302 1908 1326 87 66 29 10 345 1909 1239 88 71 43 11 256 1910 1233 71 57 36 10 278 1911 1239 94 76 37 11 297 1912 1207 68 56 74 11 149 1913 1252 73 58 73 18 246 1914 1218 77 63 55 14 254 1915 1246 82 65 81 19 234 36 Section F. VITAL STATISTICS OF THE BOROUGH, ETC. 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 1915 and Previous Years. Year. Population estimated to middle of each year. Births. Total Deaths Registered in the Borough. Transferable deatht Nett Deaths Belonging to the Borough. Uncorrected Number. Nett. Number. Rate. of Non-residents registered in the Borough. of Residents not registered in the Borough. Under 1 Year of age At all ages. Number. Rate. Number. Rate per 1,000 Nett Births. Number. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1910 85210 1270 1340 15·7 1071 12·6 350 108 81 60·4 829 9·7 1911 85599 1199 1276 14·9 1132 13·2 415 130 105 82·3 847 9·9 1912 85966 1224 1281 14·9 1106 12·9 387 142 79 61·7 861 10·0 1913 86346 1258 1325 15·0 1273 14·5 474 153 91 68·7 951 10·8 1914 86731 1213 1273 14·7 1145 13·2 420 188 91 71·5 913 10·5 1915 81760 1222 1327 16·2 1228 14·5 442 245 101 76·1 994 12·1 "Transferable Deaths" are deaths of persons who, having a fixed or usual residence in England or Wales, die in a district other than that in which they resided. Area of Borough in acres (exclusive of area covered by water), 2253. Total population at all ages, 85,495. Total number of buildings used as dwellings, 11,976. Average number of persons per house, 7.1. At Census of 1911. Number of ordinary dwelling houses, 10,062. Average number of persons per house, 6.7, 37 TABLE II. (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 1915. Number of Cases Notified. Total Cases Notified in each Ward. Total Cases removed to Hospital. Notifiable Disease. 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). Under 1. 1 & under 5. 5 & under 15 15 & under 25 25 & under 45 45 & under 65 65 and upwards. Small Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera, Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 130 3 34 58 21 11 3 ... 34 35 13 9 13 14 12 104 Erysipelas 52 2 2 ... 4 14 24 6 11 3 2 5 4 22 5 16 Scarlet Fever 179 1 40 96 26 16 ... ... 36 16 11 10 48 42 16 147 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 11 ... ... 1 4 5 1 ... ... 2 ... 6 2 1 ... 8 Relapsing Fever (Continued Fever) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 3 ... ... ... 2 1 ... ... 1 1 ... ... 1 ... ... 3 Cerebro-spinal Meningitis 8 ... 1 ... 3 3 ... 1 ... 1 4 1 ... 2 ... 4 Polio-Myelitis 2 ... ... 1 1 ... ... ... ... 1 ... ... ... 1 ... ... Ophthalmia Neonatorum 16 16 ... ... ... ... ... ... 3 1 ... ... 3 9 ... 1 Pulmonary Tuberculosis (1) 172 ... 2 25 30 80 33 2 21 24 24 13 23 50 17 63o Other forms of Tuberculosis (2) 48 2 10 16 9 9 2 ... 5 6 3 ... 7 21 6 21o Chicken Pox 40 1 7 25 6 1 ... ... 11 15 1 3 2 1 7 ... Totals 661 25 96 222 106 140 63 9 122 105 58 47 103 163 63 367 Isolation Hospitals are provided by the Metropolitan Asylums Board, and residents of Hampstead suffering from infectious disease (excluding Tuberculosis) were chiefly removed to the North.Western Fever Hospital, which is within the Borough, and is situate at Lawn Road, in No. 2 (Belsize) Ward. Persons suffering from Pulmonary Tuberculosis were removed to institutions in various farts of the country. * These figures relate only to cases notified for the first time in 1914. (1) Of these 142 cases, 124 were notified on Form A, 8 on Form C, and 10 on Form D. (2) Of these 30 cases, 25 were notifed on Form A, 4 on Form C, and 1 on Form D. 38 TABLE III. (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 year 1915. Causes of Death. Nett Deaths at the subjoined ages of "Residents," whether occuring within or without the Borough. Total Deaths,whether of "Residents" or Non-residents" in Institutions in the Borough. All ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 4 5 years. 45 and under 65 years. 65 years and upwards. 1 2 3 4 5 6 7 8 9 10 11 All causes Certified (a) 994 101 22 21 29 34 115 260 412 519 Uncertified ... ... ... ... ... ... ... ... ... ... 1 Enteric Fever 1 ... ... ... ... ... 1 ... ... 8 2 Small-pox ... ... ... ... ... ... ... ... ... ... 3 Measles 16 4 9 1 1 ... ... 1 ... 16 4 Scarlet Fever 2 ... 1 1 ... ... ... ... ... 49 5 Whooping-cough 8 3 2 2 1 ... ... ... ... 2 6 Diphtheria and Croup 9 ... ... 4 4 ... 1 ... ... 96 7 Influenza 23 1 ... ... ... ... 3 8 11 ... 8 Erysipelas ... ... ... ... ... ... ... ... ... ... 9 Phthisis (Pulmonary Tuberculosis) 48 ... ... ... 1 7 21 16 3 63 10 Tuberculous Meningitis 9 ... ... 3 4 1 1 ... ... 7 11 Other Tuberculous Diseases 14 ... ... 2 4 4 2 2 ... 15 12 Cancer, malignant disease 118 ... ... ... ... 2 9 61 46 65 13 Rheumatic Fever 4 ... ... ... 1 1 ... 2 ... 1 14 Meningitis (b) 7 1 1 ... 2 ... 1 2 ... 14 15 Organic Heart Disease 123 ... ... ... 1 3 11 44 64 32 16 Bronchitis 73 5 ... ... ... ... 1 16 51 10 17 Pneumonia (all forms) 82 13 6 4 1 4 8 16 30 28 18 Other Diseases of Respiratory Organs 7 ... ... ... ... ... ... 4 3 4 19 Diarrhœa and Enteritis (c) 14 14 ... ... ... ... ... ... ... 5 20 Appendicitis and Typhlitis 7 ... ... ... 2 1 1 3 ... 2 21 Cirrhosis of Liver 8 ... ... ... ... ... 3 4 1 ... 21a Alcoholism 3 ... ... ... ... ... ... 3 ... ... 22 Nephritis and Bright's Disease 38 ... ... ... ... 1 4 16 17 10 23 Puerperal Fever 1 ... ... ... ... ... 1 ... ... 4 24 Other accidents and diseases of Pregnancy and Parturition 4 ... ... ... ... ... 4 ... ... ... 25 Congenital Debility and Malformation, including Premature birth 50 48 ... 1 ... ... 1 ... ... 8 26 Violent Deaths, excluding Suicide 33 4 1 1 1 4 8 4 10 17 27 Suicides 11 ... ... ... ... ... 9 1 1 6 28 Other Defined Diseases 77 8 2 1 6 5 24 56 175 57 29 Diseases ill-defined or unknown 4 ... ... 1 ... 1 1 1 ... ... Sub-Entries, included in above figures. 14 (a). Cerebro-spinal Meningitis 994 101 22 21 29 34 115 260 412 519 4 ... 1 ... ... ... 1 2 ... 7 28 (a). Poliomyelitis ... ... ... ... ... ... ... ... ... ... All "Transferable Deaths" of residents, i.e., of persons resident in the Borough who died outside it, have been included with the other deaths in columns 2.10. Transferable deaths of non.residents, i.e.. of persons resident elsewhere in England and Wales who died in the Borough bave in like manner been excluded from these columns. (a) All deaths certified by registered Medical Practitioners and all Inquest cases are classed as " Certified " : all other deaths are regarded as " Uncertified." (b) Exclusive of "Tuberculous Meningitis" (see title JO), but inclusive of Cerebro.spinal Meningitis. (c) Title 19 is used for deaths from Diarrhoea and Enteritis at all ages. TABLE IV. (Required by the Local Government Board to be used in the Animal Report of the Medical Officer of Health.) INFANT MORTALITY, 1915. Nett Deaths from Stated Causes at various Ages under One Year of Age. Causes of Death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 weeks. 4 weeks and under 3 months 3 months and under 6 months 6 months and under 9 months 9 months and under 12 months. Total Deaths under 1 year. All Causes Certified 29 6 4 2 41 16 21 12 11 101 Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... 1 ... 1 ... ... ... 3 4 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 1 ... 1 1 3 Diphtheria & Croup ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... ... ... ... ... Abdominal Tuberculosis (a) ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... ... Meningitis (not Tuberculous) ... ... ... ... ... ... 1 ... ... 1 Convulsions ... ... ... ... ... 1 1 ... ... 2 Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... 1 ... ... 1 1 2 ... 1 5 Pneumonia (all forms) ... ... ... ... ... 2 5 3 3 13 Diarrhœa ... ... ... ... ... 3 2 1 1 7 Enteritis ... ... ... ... ... 2 2 3 ... 7 Gastritis ... ... ... ... ... ... ... ... ... ... Syphilis ... ... ... ... ... 1 ... ... ... 1 Rickets ... ... ... ... ... ... ... ... 1 1 Suffocation, overlying ... ... ... ... ... ... 3 ... ... 3 Injury at Birth ... ... ... ... ... ... ... ... ... ... Atelectasis 4 1 ... ... 5 ... ... ... ... 5 Congenital Malformations (b 2 ... ... ... 2 1 ... ... ... 3 Premature Birth 13 3 1 2 19 ... 1 ... ... 20 Atrophy, Debility, Marasmus 8 1 2 ... 11 3 3 3 ... 20 Other causes 2 ... ... ... 2 1 1 1 1 6 Totals 29 6 4 2 41 16 21 12 11 101 Nett Births in the year: legitimate, 1246 ; illegitimate 81. Nett Deaths in the year of: legitimate infants, 8 4; illegitimate infants, 17. (а) Under Abdominal Tuberculosis have been included deaths from Tuberculosis Peritonitis and Enteritis and from Tabes Mesenterica. (б) The total deaths from Congential Malformations, Premature Birth, Atrophy, Debility and Marasmus, equal the total in Table III, under the heading Congential Debility and Malformation including Premature Birth. "Want of Breast Milk has been included under Atrophy and Debility. 39 40 TABLE V. (This 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.) PREMISES. Number on register at end of 1914. Number added in 1915. Number removed in 1915. On register at end of 1915. Number of inspections 1915. Number of prosecutions, 1915, Cowsheds - - - - - - Milkshops 98 - - 98 267 - Houses let in lodgings 405 - - 405 920 - Ice cream premises 83 - 2 81 137 - Slaughter.houses.—Number of inspections, 52; notices, 2. Offensive Trades.—Number of inspections, nil; notices, nil. Smoke Nuisances.—Number of observations, 14; nuisances and complaints, 8; notices, 2; summonses, nil. Housing of the Working Classes.—Number of houses inspected, 27; dealt with under section 15 of the Housing, Town Planning, etc., Act, 1909, nil; representations, 3; closing orders, 3; houses remedied without closing orders, 23; remedied after closing orders, 2; houses demolished, nil; in respect of which closing orders had been made, empty at end of year, nil. Underground Rooms.—Number illegally occupied, 26; closed or illegal occupation discontinued, 15; where necessary works completed or in hand, 11. Overcrowding.—Number of rooms overcrowded, 8; remedied, 8; prosecutions, nil. Cleansing.—Number of adults cleansed, 2; children cleansed, 536; rooms cleansed, 38; premises cleansed, 20. Water Supply to Tenement Houses.—Number of premises supplied, 89; prosecutions, nil. Inland Revenue Act (applications for certificates).—Number of houses, 24; tenements included therein, 48; applications granted, 14—houses comprising 14 dwellings: refused, nil; deferred or withdrawn, 17. Sale of Food,—Number of premises used, other than ice.cream premises, milkshops and cowsheds, 54 ; inspections, 288. Disinfection Shelter.—Number of persons accommodated, nil. Mortuary.—Number of bodies received, 103; infectious bodies, 3. 41 TABLE VI. Vital Statistics of the Borough. Number of ordinary dwelling houses 10,062 At Census 1911. Population 67,146 Average number of persons per house 6.7 In these Tables the Birth-rate is calculated upon the 1914 Population. Year. Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases (excluding Tuberculosis.) Pulmonary Tuberculosis. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 Births. Cases Notified (excluding Chicken-pox). Attack-rate per 1000 of the Population. Deaths occuring. Death-rate per 1000 of the Population. Deaths. Death-rate per 1000 of the Population. 1902 82,380 1,516 18.4 904 11.0 133 87.7 460 5.6 33 0.40 73 0.89 1903 82,730 1,453 17.6 837 10.1 126 86.7 311 3.7 16 0.19 66 0.80 1904 83,080 1,445 17.4 892 10.7 161 111.4 301 3.6 20 0.24 73 0.89 1905 83,430 1,421 17.0 823 9.9 133 93.6 295 3.5 14 0.17 73 0.87 1906 83.780 1,437 17.1 850 10.1 111 77.2 557 6.6 22 0.26 57 0.68 1907 84,130 1,359 16.1 817 9.7 98 73.1 498 5.9 15 0.18 61 0.72 1908 84,480 1,400 16.6 803 9.5 97 69.3 383 4.5 20 0.24 74 0.88 1909 84,830 1,328 15.6 839 9.9 99 74.5 325 3.8 21 0.25 53 0.62 1910 85,210 1,340 15.7 829 9.7 81 60.4 233 2.8 13 0.16 58 0.68 1911 85,599 1,276 14.9 847 9.9 105 82.3 345 4.0 25 0.29 56 0.65 1912 85,966 1,281 14.9 861 10.0 79 61.7 320 3.7 25 0.29 64 0.74 1913 86,346 1,325 15.0 951 10.8 91 68.7 374 4.3 13 0.15 49 0.56 1914 86,731 1,273 14.7 913 10.5 91 71.5 583 6.7 23 0.26 57 0.66 1915 81,760 1,327 15.3 994 12.1 101 76.1 425 5.1 17 0.20 48 0.58 TABLE VI. (1). Vital Statistics of No. 1 (Town) Ward. Year Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases (excluding Tuberculosis.) Pulmonary Tuberculosis. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 Births. Cases notified (excluding Chicken-pox). Attack-rate per 1000 of the Population. Deaths occurring. Death-rate per 1000 of the Population. Deaths. Death-rate per 1000 of the Podulation. 1902 12,120 192 15.8 163 13.4 20 104.1 64 5.3 4 0.33 17 1.40 1903 12,310 194 15.7 127 10.3 14 72.1 38 3.l 1 0.08 11 0.89 1904 12,500 195 I5.6 125 10.0 20 102.5 65 5.2 4 0.32 13 1.04 1905 12,690 194 15.3 127 10.0 24 123.7 72 5.7 3 0.24 9 0.79 1906 12,870 205 15.9 131 10.2 21 102.4 107 8.3 6 0.47 5 0.39 1907 13,070 185 14.1 152 11.6 15 81.1 105 8.0 2 0.15 13 0.99 1908 13,250 225 17.0 108 8.1 11 48.8 65 4.9 1 0.07 7 0.53 1909 13,430 196 14.6 140 10.4 15 76.5 53 3.9 4 0.30 6 0.45 1910 13,610 199 14.6 118 8.7 15 75.4 25 1.8 1 0.07 6 0.44 1911 13,820 207 15.0 133 9.6 19 91 .8 71 5.1 7 0.51 7 0.51 1912 14,040 183 13.0 135 9.6 12 65.5 47 3.3 2 0.14 5 0.36 1913 14,250 201 13.8 161 11.l 11 54.7 61 4.3 3 0.21 11 0.76 1914 14,400 152 10.5 130 9.1 14 92.1 131 9.1 6 0.42 5 0.35 1915 13,550 157 10.9 147 10.8 17 108.2 86 6.3 1 0.07 5 0.36 42 TABLE VI. (2). Vital Statistics of No. 2 (Belsize) Ward. Year. Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases (excluding Tuberculosis). Pulmonary Tuberculosis. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 births. Cases notified (excluding Chicken.pox). Attack rate per 1000 of the Population. Deaths occurring. Death-rate per 1000 of the Population. Deaths. Death-rate per 1000 of the Population. 1902 13,030 239 18.3 135 10.4 18 75.3 94 7.2 9 0.69 15 1.15 1903 13,110 211 16.1 121 9.2 13 61.6 66 4.6 2 0.14 13 0.99 1904 13,200 217 16.4 141 10.7 23 105.9 47 3.6 3 0.23 12 0.91 1905 13,280 209 15.7 131 9.9 13 62.2 42 3.2 2 0.15 10 0.75 1906 13,370 187 14.0 127 9.5 8 42.8 60 4.5 4 0.30 13 0.97 1907 13,450 205 15.2 114 8.5 13 63.4 63 4.7 3 0.22 10 0.74 1908 13,530 205 15.1 126 9.3 8 39.0 81 6.0 1 0.07 l6 1.18 1909 13,610 204 15.0 130 9.5 16 78.4 88 6.5 .5 0.37 8 0.59 1910 13,710 207 15.1 119 8.7 9 43.5 49 3.6 2 0.14 8 0.58 1911 13,780 189 13.7 135 9.7 17 90.0 78 5.7 2 0.14 10 0.72 1912 13,830 188 13.6 127 9.2 8 42.5 62 4.5 4 0.29 7 0.51 1913 14,000 214 15.0 126 8.8 16 74.7 52 3.7 5 0.35 5 0.35 1914 14,100 195 13.8 141 10.0 9 46.1 89 6.3 6 0.42 11 0.78 1915 13,250 317 22.4 144 10.8 12 37.8 65 4.90 4 0.30 6 0.45 TABLE VI. (3). Vital Statistics of No 3 (Adelaide) Ward. Year. Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases (excluding Tuberculosis). Pulmonary Tuberculosis. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 births. Cases notified (excluding Chicken-pox). Attack-rate per 1000 of the Population. Deaths occurring. Death-rate per 1000 of the Population. Deaths. Death-rate per 1000 of the Population. 1902 10,350 103 9.9 95 9.6 3 29.1 40 3.9 2 0.19 7 0.68 1903 10,310 95 9.2 101 9.8 9 94.7 22 2.1 1 0.10 1 0.10 1904 10,260 100 9.7 99 9.6 13 130.0 36 3.5 2 0.19 8 0.78 1905 10,220 96 9.4 92 9.0 4 41.7 27 2.6 1 0.10 4 0.39 1906 10,170 97 9.5 92 9.0 10 103.1 29 2.8 ... ... 5 0.49 1907 10,120 75 7.4 86 8.5 8 106.7 29 2.9 1 0.10 2 0.20 1908 10,070 93 9.2 78 7.7 6 64.6 30 3.0 2 0.20 4 0.40 1909 10,040 83 8.3 88 8.8 4 48.2 16 1.6 2 0.20 3 0.30 1910 10,000 96 9.6 78 7.8 2 20.8 22 2.2 1 0.10 5 0.50 1911 9,950 82 8.2 99 9.9 6 73.2 19 1.9 3 0.30 3 0.30 1912 9,930 117 11.8 77 7.7 6 51.3 24 2.4 1 0.10 9 0.91 1913 9,780 97 9.7 99 9.9 9 92.8 27 2.8 ... ... 4 0.40 1914 9,730 88 9.0 99 10.2 5 56.8 28 2.9 ... ... 2 0.20 1915 9,150 77 7.9 104 11.3 5 64.9 30 3.2 2 0.21 2 0.2I 43 TABLE VI. (4). Vital Statistics of No. 4 (Central) Ward. Year. Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases (excluding Tuberculosis.) Pulmonary Tuberculosis. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 Births. Cases Notified (excluding Chicken-pox). Attack-rate per 1000 of the Population. Deaths occuring. Death-rate per 1000 of the Population. Deaths. Death-rate per 1000 of the Population. 1902 9,190 110 12.0 71 7.7 11 100.0 40 4.3 ... ... 5 0.54 1903 9,260 99 10.7 60 6.5 8 80.8 34 3.7 4 0.43 4 0.43 1904 9,330 90 9.6 62 6.6 11 122.2 17 1.8 ... ... 1 0.11 1905 9,400 113 12.0 60 6.4 5 44.2 24 2.5 1 0.11 6 0.64 1906 9.470 95 10.0 83 8.8 3 31.6 34 3.6 ... ... 2 0.21 1907 9.540 108 11.3 68 7.1 9 83.3 33 3.4 2 0.21 5 0.52 1908 9,610 104 10.8 82 8.5 6 57.7 33 3.4 1 0.10 7 0.73 1909 9,680 116 12.0 63 6.5 3 25.9 29 3.0 2 0.21 3 0.31 1910 9,770 105 10.7 82 8.4 8 76.2 28 2.9 2 0.20 3 0.31 1911 9,859 92 9.3 75 7.6 8 87.0 25 2.5 1 0.10 3 0.30 1912 9,876 97 9.8 76 7.7 4 41.2 29 2.9 1 0.10 6 0.6l 1913 9,996 91 8.9 84 8.2 6 65.9 38 3.8 ... ... ... ... 1914 10,061 84 8.3 76 7.5 4 47.6 26 2.6 2 0.20 6 0.60 1915 9,500 91 9.0 92 9.7 4 42.5 34 3.5 2 0.21 6 0.62 TABLE VI. (5). Vital Statistics of No. 5 (West End) Ward. Year Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases (excluding Tuberculosis.) Pulmonary Tuberculosis. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per l000 Births. Cases notified (excluding Chicken-pox). Attack-rate per 1000 of the Population. Deaths occurring. Death-rate per 1000 of the Population. Deaths. Death-rate per 1000 of the Population. 1902 12,250 275 22.4 107 8.7 20 72.1 102 8.3 6 0.49 6 0.49 1903 12,320 243 19.7 111 9.0 21 86.4 55 4.5 2 0.16 12 0.97 1904 12,380 283 22.8 120 9.7 22 77.7 70 5.6 3 0.24 8 0.65 1905 12,450 250 20.1 131 10.5 23 92.0 29 2.3 2 0.16 11 0.88 1906 12,510 259 20.7 115 9.2 14 54.1 168 13.4 5 0.40 8 0.64 1907 12,580 250 19.9 114 9.1 l6 64.0 153 12.2 4 0.32 9 0.71 1908 12,640 254 20.1 121 9.6 26 102.4 68 5.4 10 0.79 9 0.71 1909 12,700 239 18.8 1l8 9.3 13 54.1 51 4.0 2 0.16 6 0.47 1910 12,770 216 16.9 121 9.5 17 78.7 44 3.4 4 0.31 11 0.86 1911 12,850 216 16.8 102 7.9 15 69.4 44 3.4 5 0.39 10 0.78 1912 12,890 226 17.5 126 9.8 13 57.5 65 5.0 10 0.77 12 0.93 1913 13.050 240 18.0 145 10.9 11 45.8 59 4.5 1 0.07 7 0.53 1914 13,100 256 19.5 140 10.7 18 70.3 68 5.2 1 0.08 14 1.07 1915 12,390 218 16.6 151 12.1 13 59.6 72 5.8 3 0.24 11 0.88 44 TABLE VI. (6). Vital Statistics of No. 6 (Kilburn) Ward. Year. Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases (excluding Tuberculosis). Pulmonary Tuberculosis. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 births. Cases notified (excluding Chicken-pox). Attack rate per 1000 of the Population. Deaths occurring. Death-rate per 1000 of the Population. Deaths. Death-rate per 1000 of the Population. 1902 14,790 435 29.4 219 14.8 45 103.4 76 5.l 11 0.74 l6 1.08 1903 14,800 417 28.2 184 12.4 39 93.5 59 4.0 3 0.20 18 1.22 1904 14,810 408 27.5 206 13.9 54 132.3 43 2.9 8 0.54 22 1.48 1905 14,820 426 28.7 171 11.5 50 117.4 57 3.8 2 0.13 26 1.75 1906 14,840 444 29.9 197 13.3 41 92.0 128 8.6 5 0.34 15 1.01 1907 14,850 391 26.3 179 12.0 28 71.6 86 5.8 3 0.20 16 1.08 1908 14,880 393 26.4 186 12.5 30 76.3 72 4.8 4 0.27 21 1.41 1909 14,890 341 22.9 182 12.2 37 108.5 67 4.5 6 0.40 17 1.14 1910 14,900 379 25.4 192 12.9 24 63.3 52 3.5 3 0.20 16 1.07 1911 14,920 347 23.2 179 12.0 31 89.3 82 5.5 6 0.40 16 1.07 1912 15,000 353 23.5 188 12.5 26 73.6 70 4.7 6 0.40 14 0.93 1913 15,200 354 22.8 213 13.7 25 70.6 110 7.2 3 0.19 18 1.16 1914 15,300 385 25.2 212 13.8 25 64.9 186 12.1 6 0.40 13 0.85 1915 14,440 329 21.5 230 15.8 40 121.5 98 6.7 3 0.20 11 0.76 TABLE VI. (7). Vital Statistics of No. 7 (Priory) Ward. Year. Population estimated to middle of year. Births. Deaths. Infantile Deaths. Notifiable Infectious Diseases (excluding Tuberculosis). Pulmonary Tuberculosis. Number. Estimated rate per 1000 of the Population. Number. Estimated rate per 1000 of the Population. Number. Rate per 1000 births. Cases notified (excluding Chicken-pox). Attack-rate per 1000 of the Population. Deaths occurring. Death-rate per 1000 of the Population. Deaths. Death-rate per 1000 of the Population. 1902 10,650 162 15.2 110 10.3 l6 98.7 44 4.1 1 0.94 7 0.66 1903 10,620 194 18.3 116 10.9 21 108.2 43 4.0 3 0.28 5 0.47 1904 10,600 152 14.3 121 11.4 13 85.5 23 2.2 ... ... 9 0.85 1905 10,570 133 12.6 103 9.7 14 105.3 44 4.2 3 0.28 7 0.66 1906 10,550 150 14.2 93 8.8 9 60. 0 31 2.9 2 0.19 8 0.76 1907 10,520 127 12.1 94 8.9 7 55.1 29 2.7 ... ... 6 0.57 1908 10,500 126 12.0 93 8.8 10 79.3 34 3.2 1 0.09 7 0.67 1909 10,480 149 14.2 111 10.6 11 73.8 21 2.0 ... ... 8 0.76 1910 10,450 138 13.2 111 10.6 6 43.5 13 1.2 ... ... 8 0.76 1911 10,420 143 13.7 115 11.0 9 63.0 26 2.5 1 0.09 5 0.48 1912 10,400 117 11.1 115 10.9 7 59.8 28 2 .2 1 0.09 10 0.96 1913 10,070 128 12.5 117 11.4 12 93.7 27 2.7 1 0.10 3 0.29 1914 10,040 113 11.2 117 10.9 16 141.6 55 5.5 2 0.20 5 0.50 1915 9,480 138 13.7 126 13.2 10 72.4 40 4.2 2 0.21 7 0.73 45 TABLE VII. Vital Statistics of Hampstead, compared with England and Wales. Year. Birth-rate per 1000. General death-rate per 1000. Natural increase Hampstead. Notifiable Infectious disease rate per 1000. †Hampstead. Hampstead. England and Wales. Hampstead. England and Wales. 1875 22.6 35.4 12.5 22.7 394 — 1876 24.4 36.3 15.2 20.9 367 — 1877 24.0 35.0 13.7 20.3 413 — 1878 24.5 35.6 14.8 21.6 409 — 1879 22.8 34.7 13.2 20.7 365 — 1880 24.1 34.2 12.6 20.5 521 — 1881 23.8 33.9 12.7 18.9 502 — 1882 23.6 33.8 13.0 19.6 546 — 1883 23.8 33.5 11.2 19.5 685 — 1884 22.0 33.6 12.5 19.5 554 — 1885 21.2 32.9 11.5 19.0 593 — 1886 21.0 32.8 12.2 19.3 554 — 1887 21·9 31.9 11.0 18.8 628 — 1888 20·5 31.2 10.6 17.8 616 — 1889 21·0 31.1 10.7 17.9 728 — 1890 21·9 30.2 13.1 19.1 613 — 1891 21·5 31.4 12.2 22.5 670 4.5 1892 20·4 30.5 12.4 19.0 591 8.0 1893 20·5 30.8 12.9 19.2 547 11.1 1894 19·6 29.6 10.8 16.6 674 6.2 1895 19·8 30.2 13.4 18.7 452 7.3 1896 19·1 29.7 12.0 17.1 546 7.8 1897 20·2 29.7 11.6 17.4 568 5.1 1898 18·1 29.4 11.4 17.6 599 5.7 1899 19·7 29.3 11.4 18.3 650 6.0 1900 20·0 28.7 11.3 18.3 699 5.8 1901 18·3 28.5 10.6 16.9 633 5.6 1902 18·4 28.6 11.0 16.2 612 *5.6 1903 17·6 28.4 10.1 15.4 616 *3.8 1904 17·4 27.9 10.7 16.2 553 *3.6 1905 17·0 27.2 9.9 15.2 598 3.5 1906 17·1 27.0 10.1 15.4 587 6.6 1907 16·1 26.3 9.7 15.0 524 5.9 1908 16·6 26.5 9.5 14.7 597 4.5 1909 15·6 25.6 9.9 14.5 489 3.8 1910 15·7 24.8 9.7 13.4 511 2.7 1911 14·9 24.4 9.9 14.6 429 *4.0 1912 14·9 23.8 10.0 13.3 420 3.7 1913 15·0 23.9 10.8 13.7 374 4.3 1914 14·7 23.8 10.5 14.0 360 6.7 1915 * 15·3 21.8 12.1 14.8 333 *5.1 • Excluding Chicken.pox, which was notifiable during certain periods of these years, †Excluding notifications of Pulmonary Tuberculosis 1902-1913, and all forms of Tuberculosis since 1913. 46 Section G. LEGAL PROCEEDINGS. Legal proceedings were taken by the Council in connection with the work of the Health Department in 41 cases during the year. The chief facts relating to these proceedings are summarised below. The facts relate only to the cases that were heard and decided in 1915. Statute or Byelaw. Number of Prosecutions. Fines. Costs. £ s. d. £ s. d. Public Health (London) Act, 1891, and Bye-laws made thereunder 10 3 0 0 3 10 0 Metropolis Management Acts, and Bye-laws made thereunder2 1 0 1 0 6 Sale of Food and Drugs Act 20 40 0 0 3 12 6 Housing, Town Planning, etc., Act, 1909 9 1 0 0 20 2 0 Totals 41 44 1 0 28 5 0 47 Appendix. REPORT OF THE PUBLIC ANALYST ON THE ANALYTICAL WORK OF THE YEAR. Analytical Laboratory, Town Hall, Paddington, W. January 25th, 1916. A resume of the analytical work of the year 1915 may be of interest. A total of 506 samples was analysed. These comprised Milk 252 samples, Butter 167, Lard 31, Margarine 19, Coffee 12, Cream 9, Cocoa 8, Cheese 5, Sausages 2 and Apples 1. The adulterated samples were 18 of Milk and 15 of Butter, while 4 samples of Cream and 1 of Sausages were found to contain Boric Acid as a preservative. The total adulteration this year reached to 7½ per cent.; the previous year it was 6¼ per cent. The most adulterated article this year was Butter, 9 per cent; the previous year it was per cent. Milk this year shows 71/10 of the adulterated samples as against 8 per cent, the previous year. The general public do not avail themselves of the Adulteration Acts; all the samples were procured by your Inspector. I have the honour to remain, Yours obediently, ALF. W. STOKES, Public Analyst.