HoL21 The Metropolitun Borough of Holborn. REPORT FOR THE YEAR 1904 OF THE MEDICAL OFFICER OF HEALTH WILLIAM ARTHUR BOND, M.A., M.D. CAMB.,♦ D.P.H. Camb., M.R.C.P. Lond. Fellow, and Member of Council of the Incorporated Society of Medical Officers of Health; Fellow, and Member of Council, late Hon. Sec. of the Royal Institute of Public Health; Member, late Lecturer and Demonstrator, of the Sanitary Institute; late Medical Officer of Health to the St. Olave District, Southwark, and the Holborn District Boards of Works. LONDON: DIPROSE, BATEMAN & CO., 9 & 10, SHEFFIELD STREET, LINCOLNS INN FIELDS. 1905. CONTENTS. Introduction 5 Death Statistics 5 Birth-rates and Death-rates 5 Changes in Administration and work of the Public Health Department 6 Lady Sanitary Inspector 6 Consumption—Voluntary Notification of 6 "The Care and Feeding of Infants" Leaflet 6 Births—details of 6 Underground Bakehouses 6 London County Council (General Powers) Act 1904 6 Estimated Population, 1904 6 Rateable Value, 1904 6 Births and Birth-rates 7 Mortality 7 „ Deaths registered in the Borough 7 „ Deaths in Public Instutitions etc., within the Borough 7 ,, Deaths of Residents in Public Institutions outside the Borough 8 ,, Corrected deaths and death-rates 8 Infantile Mortality 9 Ditto Deaths under one year per 1.000 births 9 Ditto Principal causes of Deaths of Children under one year 9 Senile Mortality 9 Infectious Diseases 10 Deaths from Zymotic Diseases 10 Ditto during the year 1901 and the preceding ten years 10 Notifications of Infectious Diseases in the Borough duiing 1904 and the preceding ten years 11 Small-pox 12 Chicken-pox 13 Scarlet Fever 13 Ditto Secondary Cases 13 Ditto "Return" Cases 13 Diphtheria 13 Ditto Secondary and " Return" Cases 13 Enteric and Continued Fever 14 Measles 14 Whooping Cough 15 Diarrhœa 15 Phthisis or Consumption 15 Ditto ditto Voluntary Notification of Consumption 16 Ditto ditto Sanatoria 16 Ditto ditto Spitting 16 Influenza 17 Alcoholism 17 Cancer 17 Sudden and Violent Deaths 17 Inquests 17 The Public Mortuary 17 Disinfections 18 Bacteriology 18 4 page Housing of the Working Classes Act 18 Ditto Part I. Italian Colony 18 Ditto ,, Union Buildings Area 19 Ditto Part II. Representations 19 Ditto Part III. Rcid's Brewery Site 19 Ditto ,, Ilerbrand Street Site 20 Houses Closed Voluntarily, Demolished, Rebuilt, etc. 20 Water Supply to New Buildings 22 Revenue Acts 22 Sanitary Work 23 House to House Inspections 23 Bye-laws as to Houses let in Lodgings 24 Overcrowding 24 Common Lodging Houses 24 Factories, Workshops and Workplaces 25 Bakehouses 26 Underground Bakehouses 27 Places where Food is prepared for Sale 28 Other Shops where Food is Sold 28 Slaughter Houses 28 Other Offensive Businesses 28 Dairies, Cowsheds and Milk Shops 29 Ice Creams 29 Unsound Food 29 Smoke Abatement 29 Meteorology 29 APPENDICES. page Table I. Vital Statistics of whole Borough during 1904, and previous 10 years 31 Table II. Vital Statistics of whole Borough and separate Localities in 1904 and previous 10 years 31 Table III. Cases of Infectious Disease notified during the year 1904 32 Table IV. Causes of, and Ages at Death during the year 1904 32 Table V. Sanitary Inspectors' Work 33 Table VI. Proceedings during 1904 34 Table VII. Factories, Workshops and Workplaces:—35 (1) Inspections 35 (2) Defects found 36 (3) Other matters 36 Table VIII. Legal Proceedings under the Public Health (London) Act, 1891 37 Table IX. Legal Proceedings under the Factory and Workshop Act, 1901 38 Table X. Legal Proceedings under the Sale of Food and Drugs Acts 38 Table XI. Meteorology 39 5 The Metropolitan Borough of Holborn. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1904. PUBLIC HEALTH DEPARTMENT, 190, HIGH HOLBORN, W.C. To the Mayor, Aldermen, and Councillors of the Metropolitan Borough of Holborn. Gentlemen, In this Annual Report for the year 1904, the various statistics for the year refer to the fifty-two weeks ended Saturday, December 31st, 1904, as adopted by the Registrar-General, and known as the Registration year. The death statistics do not exactly correspond with those of the Registrar-General for the following reasons: The Holborn Union includes the area of the old Holborn District Board of Works, Clerkenwell and St. Luke's. In many of the deaths registered in outlying public institutions the only address given is that of the Union, and from enquiries which I have made of the authorities of the public institutions I have ascertained that the previous addresses of the deceased before removal to the public institutions were not in this Borough, and these deaths, although returned by the Registrars as belonging to this Borough, have therefore been excluded. The London birth-rate was only 27.9 per 1,000, which is again the lowest recorded. The Holborn birth-rate was 28.6 in comparison with 28.1 for the previous year. The Holborn death-rate was only 17.9, the lowest death-rate recorded for Holborn, the average death-rate for the preceding decennium being 21.3 per 1,000. The lowest death-rates in previous years have been 18.3 in 1903, 20.0 in 1901, and 20.4 in the years 1894 and 1897. It is very satisfactory that the Holborn death-rate has diminished, although the London death-rate has increased from 15.2 in 1903 to 16.1 in 1904. The deaths from zymotic diseases in Holborn were also very low, viz.: 1.73 per 1,000, in comparison with 2.14 for London generally. 6 The death-rate from phthisis (consumption) diminished from 2.94 to 2.75, although the London rate increased from 1.55 in 1903 to 1.6 in 1904. The number of notifications of infectious diseases (excluding the voluntary notification of consumption) was only 276, the lowest recorded for this Borough. The preceding year, when the number of notifications was 348, was the next lowest. The following are the principal changes that have taken place in tie administration and work of the Public Health Department during the year. The appointment of Miss F. N. F. Lovibond as Lady Sanitary Inspector (who began her duties on December 28th, 1903) has led to greater attention being given to factories, workshops, and workplaces where females are employed; also to increased work in connection with the prevention of consumption, measles, and infantile diarrhoea. The voluntary notification of consumption was begun on the 1st January, 1904, and during the year 344 voluntary notifications were received. Further details are given in my report on Phthisis. With a view to diminishing preventable infantile mortality in the Borough, a leaflet on "The Care and Feeding of Infants" was prepared, and great assistance was received from the Clergy of all denominations and various Philanthropic Agencies, through whom about 3,000 copies were distributed. The Registrar-General gave permission at the latter part of the year for details of births to be supplied by the Sub-Registrars. These details were at once supplied to us from the beginning of December, so that houses of the working classes where births have taken place are now visited by the Lady Sanitary Inspector, and one of the above leaflets left if thought desirable. After carrying out works required by the Council, which in the majority of cases involved much structural alterations of the twenty-seven underground bakehouses now in occupation, certificates as required by the Factory and Workshop Act, 1901, were granted by the Council. Only seven were completed by the end of the year 1903, as required by the Act; the remaining twenty certificates were granted during the year 1904. For five of the underground bakehouses the certificate was refused. In three cases the premises have since been demolished, and in the other two they are no longer used as underground bakehouses. The principal Public Health legislation during the year was included in the London Countv Council (General Powers) Act, 1904, which gives powers for the cleansing, purification or destruction of filthy, dangerous or unwholesome articles; for the cleansing of houses infested with vermin; for the removal or alteration of sanitary conveniences which are so placed or constructed as to be a nuisance or offensive to public decency; and for fixed ashpits to be removed where movable ashpits are provided. It also gave power to the County Council to cause any cow suffering from tuberculosis of the udder to be slaughtered, after the payment of compensation. ESTIMATED POPULATION, 1904. The following are the estimated populations at the middle of the year 1904:— Bloomsbury and St. Giles 30,272 Holborn Sub-District 26,916 Holborn Borough 57,188 London 4,648,950 England and Wales 33,763,434 United Kingdom 42,786,466 RATEABLE VALUE, 1904. Bloomsbury and St. Giles £494,359 Holborn £456,922 Holborn Borough £951,381 7 BIRTHS. During the 52 weeks ending Saturday, December 31st, 1904, the number of births registered was:— Bloomsbury and St. Giles. Holborn. Total. Males *504 319 823 Females *487 322 809 Total *991 641 1,632 In London the number of births was 129,335 In England and Wales do. 944,703 BIRTH-RATES FOR THE YEAR. Bloomsbury and St. Giles *32.8 per thousand. Holborn Sub-Division 23.9 99 99 Holborn Borough *28.6 99 99 London 27.9 99 99 England and Wales 27.9 99 99 MORTALITY. The following deaths have been registered in the Borough (1904):— Bloomsbury and St. Giles. Holborn. Total. Males 189 412 601 Females 153 380 533 Total 342 792 1,134 Of these deaths the following occurred in Public Institutions, &c., within the area of the Borough :— INSTITUTION. Residents. Non-Residents. St. Giles and Bloomsbury. Holborn. St. Giles and Bloom sbury. Holborn. St. Giles Workhouse 33 - 14 - French Hospital 2 — 34 — British Lying-in Hospital 2 1 15 — Children's Hospital 1 20 3 56 National Hospital 1 2 — 57 London Homoeopathic Hospital — 6 — 31 Italian Hospital 1 1 — 16 Alexandra Hospital — — — 2 Private - - - 1 Total 40 30 63 463 *The births in Bloomsbury and St. Giles include all that take place at the British Lying-in Hospital, Endell Street, many of which are those of non-residents. Further details were not supplied by the Registrar-General, nor by the District Registrar until December, 1904. 8 The following deaths of Parishioners occurred in Public Institutions outside the Borough:— INSTITUTION. Number. St. Giles and .Bloomsbury. Holborn. Holborn Workhouse 2 47 Holborn Workhouse, Mitcham 11 Holborn Infirmary — 109 Central London Sick Asylum 88 1 St. Pancras Sick Asylum 1 — Strand Sick Asylum 1 — Banstead Asylum 1 1 Camberwell Asylum 1 — Cane Hill Asylum 3 1 Caterham Asylum 2 2 Claybury Asylum — 2 Colney Hatch Asylum 2 — Tooting Bee Asylum 1 — Hanwell Asylum 2 2 Horton Asylum 4 — L.C.C. Asylum, Norwood — 1 London County Asylum — 3 Friern Barnet Asylum — 1 Westminster Hospital — 2 Brompton Hospital 1 — St. George's Hospital 2 — North-Western Fever Hospital 1 2 Joyce Green Hospital 1 — Charing Cross Hospital 12 3 King's College Hospital 23 15 Middlesex Hospital 8 7 London Temperance Hospital 2 — Royal Free Hospital — 13 Heart Hospital, Soho Square 1 — Long Reach Hospital, Dartford 1 — Royal Chest Hospital, City Road — 1 St. John and Elizabeth Hospital — 1 St. Bartholomew's Hospital 2 8 Friedenheim Hospital 1 1 University College Hospital 4 — Great Northern Hospital — 1 Infants' Hospital, Hampstead — 1 St. Thomas's Hospital 3 — German Hospital — 2 Royal Hospital for Incurables, Wandsworth 1 — Private Nursing Homes, &c. 5 5 River Thames — 2 Public Way 1 3 H.M. Prison, Wormwood Scrubs 1 — Total 178 248 CORRECTED DEATHS AND DEATH-RATES, 1904. District. Total Deaths at all ages registered in District. Deaths in Public Institutions in District. Deaths of nonresidents of Borough registered in District. Deaths of Residents registered beyond the District. Deaths at all ages. Nett. Death Rate for 1904. Corresponding period 1903 (52 weeks). In Borough. Beyond Borough. Bloomsbury and St. Giles 342 103 76 3 178 444 14.7 16.0 Holborn Sub-District 792 493 464 3 248 576 21.5 20.8 Whole Borough 1,134 596 540 426 1,020 17.9 18.3 Registration London 74,555 16.1 15.2 No. of Deaths. Death-Rate. Bloomsbury and St. Giles 444 14.7 Holborn Sub-District 576 21.5 Holborn Borough 1,020 17.9 London 74,555 16.1 England and Wales 549,393 16.2 The death-rate for the year 1904 was only 17.9 per 1,000—the lowest death-rate recorded for Holborn—the average death-rate for the preceding decennium having been 21.3 per 1,000. The lowest death-rates in previous years having been 20.0 in 1901, 20.4 in the years 1894 and 1897, and 18.3 in 1903. 9 INFANTILE MORTALITY. The number of deaths of children under five years of age was:— Bloomsbury and St. Giles 103 Holborn Sub-District 174 Holborn Borough 277 The number of deaths of children under one year of age, and the number of deaths of children under one year of age per thousand registered births, were the following for:— Deaths under 1 year of age. Deaths under 1 year per 1,000 births. Bloomsbury and St. Giles 78 79 Holborn Sub-District 101 157 Holborn Borough 179 109 London 18,600 144 The principal causes of death of these 179 children under one year of age were:- Premature Birth 23 Malnutrition, debility, &c. 41 Bronchitis 19 Pneumonia and Pleurisy 27 Tubercular Diseases 7 Respiratory Diseases 3 Measles 7 Whooping Cough 4 Erysipelas 1 Diarrhœa 28 Enteritis 4 Venereal Diseases 1 Septic Disease 3 Heart Disease 2 Suffocation in bed and accidental 9 179 During the last six months of the year the Lady Inspector made enquiries respecting the 86 infants under one year of age who had died in the Borough, and found that only 18 had been wholly breast-fed. A leaflet on the Care and Feeding of Infants was prepared and distributed in the Borough. SENILE MORTALITY. The number of deaths of persons 65 years of age and upwards was in:— Bloomsbury and St. Giles 98 Holborn Sub-District 124 Holborn Borough 222 Bloomsbury and St. Giles. Holborn Sub-District. Total. Of these the numbers were— 65 years and under 70 30 42 72 70 „ „ 75 21 21 42 75 „ „ 80 26 36 62 80 „ ,, 85 16 13 29 85 „ „ 90 4 9 13 90 years of age 1 1 2 95 „ „ — 1 1 96 „ „ — 1 1 98 124 222 10 INFECTIOUS DISEASES. The number of notifications of infectious diseases in the Borough during 1904 was very small in comparison with any of the preceding ten years. The number of notifications being only 276 in comparison with a decennial average of 562. The number of deaths from the seven principal zymotic diseases, viz.:—Smallpox, Measles, Scarlet Fever, Diphtheria (including Membranous Croup), Whooping Cough, Fever (including Enteric or Typhoid, Typhus and Continued Fever), and Diarrhoea, was only 99 during the year in comparison with a decennial average of 144. DEATHS FROM ZYMOTIC DISEASES. During the year the number of deaths from the seven principal Zymotic Disease, viz.:- Small-pox, Measles, Scarlet Fever, Diptheria (including Membranous Croup), Whooping Cough, Fever (including Enteric or Typhoid, Typhus and Continued Fever), and Diarrhœa, and the death- rate from these diseases were:- Number. Zymotic Death -Rate. Bloomsbury and St. Giles 32 1.06 Holborn Sub-District 67 2.50 Holborn Borough 99 1.73 And for London 9,906 2.14 The following are the numbers of deaths from the separate diseases:— Bloomsbury and St. Giles. Holborn Sub-District. Holborn Borough. Small-pox 2 2 Measles 12 31 43 Scarlet Fever — — Diphtheria and Membranous Croup 4 3 7 Whooping Cough 2 6 8 Typhoid Fever 2 2 4 Typhus — — — Diarrhœa 10 25 35 Total 32 67 99 DEATHS FROM ZYMOTIC DISEASES OCCURRING IN THE BOROUGH DURING THE YEAR 1904 AND DURING THE PRECEDING TEN YEARS. St. Giles and Bloomsbury. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. 1894 1 15 2 13 29 11 9 80 1895 1 13 5 13 13 2 30 77 1896 41 7 5 13 4 17 87 1897 9 7 6 18 6 17 63 1898 — 26 2 6 9 5 22 70 1899 — 16 — 4 1 4 30 55 1900 — 11 4 9 13 6 20 63 1901 19 9 1 6 4 7 18 64 1902 37 11 6 5 11 5 5 80 1903 — 3 3 5 9 4 8 32 Average for 10 years 1894-1903. 5.8 15.4 3.7 7.2 12.0 5.4 17.6 67.1 1904 2 12 — 4 2 2 10 32 11 Holborn Division. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. 1894 — 21 — 37 22 6 13 99 1895 — 45 6 7 8 24 90 1896 1 32 9 26 5 19 92 1897 — 8 4 17 19 5 35 88 1898 — 36 2 21 12 2 29 102 1899 11 3 5 12 7 26 64 1900 — 20 3 4 10 3 25 65 1901 11 13 2 8 6 5 24 69 1902 9 19 2 6 16 1 9 62 1903 — 14 1 2 6 1 14 38 Average for 10 years 1894-1903. 2.1 21.9 2.3 11.6 13.7 3.5 21.8 76.9 1904 — 31 — 3 6 2 25 67 Whole Borough. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. 1894 1 36 2 50 51 17 22 179 1895 1 58 11 20 21 2 54 167 1896 1 73 7 14 39 9 36 179 1897 17 11 23 37 11 52 151 1898 — 62 4 27 21 7 51 172 1899 27 3 9 13 11 56 119 1900 31 7 13 23 9 45 128 1901 30 22 3 14 30 12 42 133 1902 46 30 8 11 27 6 14 142 1903 — 17 4 7 15 5 22 70 Average for 10 years 1894-1903. 7.9 37.3 6.0 18.8 25.7 8.9 39.4 144.0 1904 2 43 — 7 8 4 35 99 NOTIFICATIONS OF INFECTIOUS DISEASES IN THE BOROUGH DURING 1904, AND DURING THE PRECEDING TEN YEARS. St. Giles and Bloomsbury. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 1894 7 40 84 33 — 63 — — 227 1895 13 63 147 24 — 63 1 311 1896 — 60 180 21 83 1 — 345 1897 4 56 207 31 — 94 2 — 394 1898 — 39 65 23 72 1 — 200 1899 28 76 23 56 1 — 184 1900 — 58 98 31 49 1 — 237 1901 158 60 150 17 58 1 1 445 1902 159 44 90 24 45 2 364 1903 1 22 55 36 2 65 1 — 182 Average for 10 years 1894-1903. 34.2 47.0 115.2 26.3 .2 64.8 1.1 .1 288.9 1904 5 19 37 22 — 38 4 — 125 Diarrhœa in persons over 1 year of age was notifiable from August 11th to September 29th, 1894, inclusive, during which time 98 notifications were received. Chicken-pox was notifiable from October 19th, 1901, to January 6th, 1903, inclusive, during which time 114 notifications were received, and from 8th April to November 6th, 1904, inclusive, during which time 27 notifications were received. There were also 157 voluntary notifications of Phthisis. 12 Holborn District. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 1894 16 59 65 24 — 74 — — 238 1895 31 60 160 20 61 1 — 338 1896 1 67 114 29 1 65 2 1 280 1897 — 158 114 25 — 42 — — 339 1898 138 96 9 — 38 2 — 283 1899 63 117 32 2 43 1 — 258 1900 — 65 96 24 — 40 — — 225 1901 53 101 104 22 — 31 1 — 312 1902 58 69 112 15 — 40 4 — 298 1903 1 31 89 17 — 25 3 — 166 Average for 10 years, 1894-1903. 16.0 81.1 106.7 21.7 .3 45.9 1.4 .1 273.2 1904 1 27 62 19 — 39 3 — 151 Chicken-pox was notifiable from October 19th, 1901, to January 6th, 1903, inclusive, during which time 168 notifications were received, and from 8th April to November 6th, 1904, inclusive, during which time 34 notifications were received. There were also 187 voluntary notifications of Phthisis. Whole Borough. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 1894 23 99 149 57 — 137 — — 465 1895 44 123 307 44 — 124 2 — 644 1896 1 127 294 50 1 148 3 1 625 1897 4 214 321 56 136 2 733 1898 — 177 161 32 — 110 3 — 483 1899 — 91 193 55 2 99 2 — 442 1900 — 123 194 55 — 89 1 — 462 1901 211 161 254 39 — 89 2 1 757 1902 217 113 202 39 85 6 — 662 1903 2 53 144 53 2 90 4 — 343 Average for 10 years 1894-1903. 50.2 128.1 221.9 48.0 .5 110.7 2.5 .2 562.1 1904 6 46 99 41 — 77 7 — 276 Chicken-pox was notifiable from October 19th, 1901, to January 6th, 1903, inclusive, during which time 282 notifications were received, and from 8th April to November 6th, 1904, inclusive, during which time 61 notifications were received. There were also 344 voluntary notifications of Phthisis. SMALL-POX. During the year I received only six notifications of small-pox, five of which were genuine cases. The remaining case was removed to the South Wharf by the doctor in attendance before the notification was received by us, and on the patient's return home I found that she was suffering from chicken-pox, which had been contracted on a visit to some friends in the country. One patient had tramped from the north of England, and had slept for only one night in a common lodging-house in this Borough. There were two deaths, one a woman, age 26, who was stated to have been vaccinated (slightly successfully) in infancy, hut there were no scars and refused to be vaccinated when a case in the same house was notified. The other, a woman age 22, had not been vaccinated at all. 13 During the year I was asked by doctors to see eleven doubtful cases, which in my opinion were not small-pox ; all but one being chicken-pox. In London there were 489 notifications of small-pox during the year. CHICKEN-POX. Chicken-pox was only notifiable from the 7th April to November 6th, 1904, inclusive, during which time 61 notifications were received, 27 belonging to St. Giles and Bloomsbury and 34 to the Holborn Division. SCARLET FEVER. During the 52 weeks ended Saturday, December 31st, 1904, the number of scarlet fever notifications, excluding duplicates, was only 99, 37 belonging to St. Giles and Bloomsbury, and 62 in the Holborn Division. In the Holborn District all the cases were removed to hospital, and in the St. Giles and Bloomsbury District all except three. This is the smallest number of notifications of scarlet fever received in any year on record. In 1903 the number was 144, and in 1902 202, and the decennial average is 222. The largest number of notifications occurred in the month of July, when there were twelve notifications in four weeks. Nearly all occurred during the last ten days of the month, when there was a small outbreak amongst the children attending the St. John's School. Eight of the children attended this school, and a ninth was a young child who contracted it from a brother attending the school. SECONDARY CASES OF SCARLET FEVER. Of the 99 cases, 82 cases occurred at different houses in which there was no secondary case. In five houses there were two eases. In one large tenement house there were three cases, and in another four cases, so that in all there were ten secondary cases. RETURN CASES. During the 3'ear there were no "return" cases, i.e., cases occurring in a house after the return of a patient from hospital. DIPHTHERIA. The number of cases of diphtheria notified was only 46, of which 19 belonged to St. Giles and Bloomsbury and 27 to the Holborn Division. All but one patient was removed to hospital. The average number of notifications for the preceding decennium was 128, 47 for St. Giles and Bloomsbury, and 81 for the Holborn Division. During the year there were seven deaths, four belonging to St. Giles and Bloomsbury, and three to the Holborn Division. There was no special outbreak during the year. The disease was most prevalent in the Borough in the month of June, however in the five weeks of that month there were only 9 notifications. SECONDARY AND RETURN CASES. In one house there were two cases notified on the same day, and in the remaining houses there was no spread of the disease, so that there were no secondary and no return cases. 14 ENTERIC FEVER. Excluding duplicates, the number of notifications of enteric fever was 41, of which 22 belonged to St. Giles and Bloomsbury and 19 to the Holborn District. The average number of notifications for the preceding decennium was 48, 26 in St. Giles and Bloomsbury and 22 in the Holborn District. All but four of the cases were removed to hospital, and I had information that as many as ten of the cases were not enteric fever. Of the remaining 31 cases four were not contracted in the Borough, and four others probably not contracted in the Borough. One a boy aged 10 years, contracted the disease by eating raw cockles whilst staying at Whitstable, and another youth age 16, probably contracted the disease from eating raw mussels; one case was probably contracted from eating oysters, two cases from fried fish and one from watercress. Of the 31 patients four died. MEASLES. Measles was very prevalent during the year. We had information from various sources, principally from the schools, of as many as 444 cases after excluding those subsequently found not to be measles; 199 belonged to St. Giles and Bloomsbury and 245 to the Holborn Division. There were a few cases in January which rapidly increased in February, and attained a maximum in the month of March, when half the total cases occurred. During the last three months of the year there were no cases. There were 43 deaths from measles registered during the year, of these 12 belonged to St. Giles and Bloomsbury and 31 to the Holborn Division. All but one were young children under five years of age. In the year 1903 there were only 17 deaths from measles in the Borough and the decennial average is 37. All the 444 cases were investigated and reported upon, the large majority viz., 399 by Miss Lovibond. Of the 399 cases, 219 or 55 per cent. attended school; 23 or about 6 per cent. were under one year of age; 253 or about 63 per cent. were one year and under five years of age; 117 or about 29 per cent. were over five and under seven years of age; five were seven and under fourteen years and one was 22 years of age. Thus there were 276 under five years of age, i.e., under the age of compulsory school attendance and in 211 of these the infection was due to school, that is in over three-fourths of the children under five years of age the infection was due directly to schools. Moreover, many other children although not themselves suffering from measles have to be excluded on account of measles in the house. We had information of as many as 602 such cases. In many of the schools there was a very large reduction in the attendance, especially in the Infants' Departments. On this account I advised that several of the Infant Departments of schools should be closed. St. Giles National School, Infants' Department, was closed from the 5th March until after Easter, and there was only one subsequent case. St. Mary's, Gate Street, Infants' Department, was closed from 9th March to the 9th April, inclusive, with only one subsequent case. Great Wild Street, Babies' class only, was closed from 17th March until after Easter, and there was no subsequent case. Laystall Street, Infants' Department, was closed from the 19th May until the 2nd June, and there was also no subsequent case. All the schools were closed for the Easter holidays from the afternoon of the 31st March till the 10th April inclusive. 15 In all cases more than half the children were absent at the closure of the Infants' Departments, and in the Babies' class at Great Wild Street only 12 were present out of a roll of 62. 132 premises were disinfected by the Council, and in the remainder the premises were disinfected by the householder to the satisfaction of the medical attendant, or the rooms and the patient's clothing were thoroughly cleansed by the householders. WHOOPING COUGH. During the year there were only 8 deaths from whooping cough in comparison with an average for the previous decennium of 26. Of the 8 deaths 2 occurred in the St. Giles and Bloomsbury district and 6 in the Holborn Division. All were of children under five years of age. The decennial averages for the two divisions were 12 and 14 respectively. DIARRHŒA. The number of deaths from diarrhoea during the year was 35, in comparison with an average of 39 during the previous decennium, the lowest being 14 in the year 1902 and the highest 56 in the year 1899. Of the 35 deaths, 10 belonged to St. Giles and Bloomsbury, and 25 to the Holborn Division. The decennial averages for these divisions of the Borough were 18 and 22 respectively. Thirty-two of the 35 deaths were of young children under 5 years of age, 28 being children under 1 year; 29 of the 35 deaths occurred in the third or summer quarter of the year. There were also 6 deaths from enteritis during the year, only one of which occurred during the summer quarter. Of the 25 deaths of young children under 1 year of age, it was found that only three were breast-fed; 19 were fed with bottle alone, and three partly by bottle. Nine of the mothers were engaged in work outside the home. PHTHISIS OR CONSUMPTION. The number of deaths from phthisis during the year 1904 was 157, equivalent to a death-rate of 2.75 per 1,000, of these 75 belonged to St. Giles and Bloomsbury, being a death-rate of 2.48 per 1,000, and 82 to the Holborn District or a death-rate of 3.06 per 1,000. The corrected number of deaths for London was 7,526, the corresponding death rate being 1.62 per 1,000. The number of deaths from other tubercular diseases was 24, of these 12 belonged to St. Giles and Bloomsbury, and 12 to the Holborn District. The following table gives the number of deaths in the Holborn Borough, and the rate per 1,000 and the corresponding rate for London for the ten years, 1895 to 1904, inclusive. Year. Holborn Borough. London. Rate per 1,000 Deaths. Rate per 1,000. 1895 225 3.19 1.77 1896 215 3. 03 1.68 1897 197 2.87 1.72 1898 220 3.26 1.74 1899 207 3.12 1.85 1900 193 2.96 1.74 1901 166 2.81 1.66 1902 182 3.06 1.60 1903 170 2.94 1.55 1904 157 2.75 1.62 16 VOLUNTARY NOTIFICATION OF CONSUMPTION. In December, 1903, it was agreed that the voluntary notification of consumption should in the first instance be put into force for a period of twelve months, from the 1st January, 1904, the fees to be paid being the same as for the notifiable diseases, and last December the Council agreed to the continuance of the voluntary notification for another year. During the year 1904 there were 344 cases notified, 157 belonging to St. Giles and Bloomsbury and 187 to the Holborn Division. The cost of the notifications was £20. 8s. 6d. More than half of them, viz., 180, had been living in common lodging houses. All but two of these were soon removed to Infirmaries. All the remaining 164 lived in tenement houses, and 94 of them were soon removed to Infirmaries or Hospitals so that only 72 remained at home. In the majority of the cases that were at once removed to infirmary from common lodging houses, we were unable to see the patient to obtain any details respecting the illness. It was possible, however, to obtain details respecting 170 cases. No relative known to have had phthisis 85 Relatives have had phthisis over five years ago 32 Ditto. less than five years ago 16 Direct infection from other persons, not relatives 6 Unascertained 31 Total 170 Length of illness. Under one year 54 One year and under five years 61 Over five years 29 Unascertained 26 Total 170 Previous Infirmary or Hospital treatment or not ? No previous infirmary or hospital treatment 72 Previous treatment at one hospital or infirmary 32 Do. two do. 18 Do. three do. 3 Do. four do. 3 Do. five do. 2 Unascertained 40 Total 170 If the patient is not about to be removed to infirmary or hospital this is advised if it is thought desirable. A copy of our leaflet is left with the patient which gives brief general directions for the prevention of the disease and special warning is given respecting spitting and the disinfection of sputum. The premises are inspected and notice served for any sanitary defects which are found. An attempt is made after every death or removal to infirmary or hospital to secure disinfection. This was carried out in 134 cases. SANATORIA. I reported on this subject in my last Annual Report. SPITTING. During the year, cards of warning requesting abstention from the dangerous and objectionable habit of spitting were sent to all the Common Lodging Houses and Public Houses in the Borough, and to all the workshops in which more than ten people were employed. 17 In May, 1904, an important Interim Report was issued by the Royal Commission appointed to consider the relation of Bovine to Human Tuberculosis. The report stated that as the result of extensive experiments, it was shown that human tubercle could give rise in the bovine animal to tuberculosis identical with ordinary bovine tuberculosis. There is therefore no justification for any relaxation of the precautions hitherto employed to prevent the infection of human beings with tuberculosis of animal origin. INFLUENZA. During the year there were only 8 deaths registered as due to influenza—4 in St. Giles and Bloomsbury, and 4 in the Holborn Division. ALCOHOLISM. Only 23 deaths were assigned to alcoholism or cirrhosis of the liver, 12 in St. Giles and Bloomsbury and 11 in the Holborn Division. These represent only a small proportion of the deaths really caused by alcoholism as they are frequently registered under the headings of other secondary causes. CANCER. Fifty-four deaths were registered as due to cancer or malignant disease, 28 belonging to St. Giles and Bloomsbury and 26 to the Holborn Division. Further details of the causes of and ages at death are given in Table 4 of the Appendix. SUDDEN AND VIOLENT DEATHS. Inquests. The following inquests on the bodies of Parishioners were held:— Coroner: Dr. G. P. Danford Thomas, 20, Brunswick Square. Inquiry Officer: Mr. Richard Powell, 58, Hemingford Road, Barnsbury, N. Total Number. Cause of Death. Natural. Accidents. Suicide. Bloomsbury and St. Giles 44 30 11 3 Holborn 53 31 15 7 Total 97 61 26 10 THE PUBLIC MORTUARY, GOLDSMITH STREET. 136 bodies were received (28 being non-parishioners), and on these 77 inquests were held, and 53 post-mortems made. District. Bodies Received, Inquests held. Post-mortems. Non-Parishioners. Bloomsbury and St. Giles 54 37 30 8 Holborn 82 40 23 20 Total 136 77 53 28 18 DISINFECTIONS. During the 52 weeks ended December 31st, 1904. District. Rooms. Bedding, &c. Number of Articles. number of Persons using Refuge. Persons cleansed under the Cleansing of Persons Act. St. Giles and Bloomsbury 218 4,791 5 5 Holborn 267 3,677 1 4 Whole Borough 485 8,468 6 9 BACTERIOLOGY. District. Diphtheria. Enteric Fever. Consumption. Number Submitted. Result of Examination. Number Submitted. Result of Examination. Number Submitted. Result of Examination. St. Giles and Bloomsbury 8 7 bacilli not found 8 7 Positive 5 3 bacilli not found 1 bacilli found 1 Negative 2 bacilli found Holborn 8 2 bacilli not found 2 -Positive — — 6 bacilli found 2 Negative Whole Borough 16 9 bacilli not found 10 7 Positive 5 3 bacilli not found 7 bacilli found 3 Negative 2 bacilli found HOUSING OF THE WORKING CLASSES ACT. Under Part I. of the Act. ITALIAN COLONY Details of this area which was represented by me in July, 1901, were given in my Annual Report for that year. I may briefly state that the area is situated between Warner Street and the backs of the houses fronting Clerkenwell Road. It is about two acres in extent and comprises some 120 houses and premises. 37 of the houses are in five small courts. The population of the area is about 1,170, almost all of whom are Italians of the labouring classes. The death rate from all causes in the area was 29•2 per 1,000. Since the representation was made, Nos. 27 to 31 inclusive, Eyre Street Hill, have been demolished and rebuilt as warehouses, and during the year 1904, all the houses in Summer Court were voluntarily closed. The Council sent several communications to the London County Council urging that Council to proceed with the area. On the 10th November, 1903, the London County Council resolved that no improvement scheme could be made. The Housing of the Working Classes Committee of the London County Council, in their Report admit the accuracy of the representations made by the Medical Officer of Health, they agree that the streets are narrow, that a number of the houses are situated in courts whose only approach is by means of covered arches, that in many cases inadequate, and in some cases no back yards are provided, that in some of the courts the waterclosets are placed in front of the houses ; and recognising these facts the County Council admitted that prima facie the area is one that should be dealt with by an improvement 19 scheme under Part I. of the Act of 1890; but they suggested that in consequence of its being the alleged intention of the freeholders of the estate to themselves re-develop the property for commercial purposes, it is a proper case to leave to the Home Secretary to decide whether he will order the County Council to prepare and carry into effect a scheme, either under Part I. or Part II. of the Act of 1890. Our Council requested the Secretary of State to direct a Local Enquiry to be held into the subject of the Representation. The Home Office subsequently agreed to receive a Deputation, and the Chairman of the Housing of the Working Classes Committee, Councillor E. H. Keen, accompanied by the Mayor and Councillor Walter Hazell, J.P., and attended by the Town Clerk, waited upon the Permanent Under-Secretary of State for the Home Department on the 12th July. Mr. J. F. Remnant, M.P., was kind enough to accompany the Deputation and introduce them. The matter was very fully discussed, and at the close the Under-Secretary of State promised that a further communication should be made to the London County Council upon the subject and the result communicated to the Council in due course. No further communication has since been received from the Home Office. Although the Freeholders of the greater part of the area long ago stated that it was their intention to develop the area shortly, nothing has since been done. UNION BUILDINGS AREA. Aylesbury Place, Clerkenwell, and Union Buildings, Holborn, Improvement Scheme, 1899. After local enquiry in the year 1900, a Provisional Order was made by one of Her Majesty's principal Secretaries of State and an Act confirming the Provisional Order was afterwards passed. Some of the houses have since been closed under Part II. of the Act, and many others have since been closed voluntarily. It is anticipated that the houses in the area will be demolished during this year (1905) and the erection of the new buildings begun. Under Part II. of the Act. Under Part II. of the Act, Section 30, the following were represented as unhealthy dwelling houses:— 9, Eagle Street. 22, Princeton Street. 24, Princeton Street. 4, East Street. In all cases the premises were made fit for human habitation. Under Part 111. of the Act. REID'S BREWERY SITE. The Reid's Brewery Site was purchased by the London County Council for the erection of working class houses for 1,681 of the 3,700 persons of the working class that would be displaced by the new Holborn to the Strand street (Kingsway). The original scheme has been extended so as to include accommodation in ail for 2,614 persons exclusive of shops. In my Annual Report for 1903, I gave details of the buildings proposed to he erected on the site, and the work is now nearly completed. 20 HERBRAND STREET SITE. This site was acquired in 1901, for the purpose of providing for 680 of the 3,700 persons of the working class displaced by the new Holborn to the Strand street (Kingsway), and the building operations were begun about August, 1902, and continued during 1903. The three blocks Coram, Dickens and Thackeray Buildings were completed by March, 1904. PREMISES DEMOLISHED, CLOSED OR REBUILT. St. Giles and Bloomsbury. Alfred Place, Nos. 1 to 7. Rebuilding completed. ,, „ „ 8 to 19. Premises being rebuilt. „ ,, No. 31. Closed for demolition. ,, ,, „ 32. Occupied by caretaker only—to be demolished. ,, ,, Nos. 33 to 38. Demolished. New warehouses being built. Betterton Street, Nos. 8, 10 and 12. Demolished. New warehouses being built. Bloomsbury Street, Nos. 7 to 19 (with 29 to 34 Great Russell Street). Demolished and being rebuilt as the "Ivanhoe Hotel." Castle Street, Nos. 38 and 40. Demolished. New public house being built on site. Chapel Yard. Demolished. Charles Street, No. 3 (with No. 5, Robin Hood Yard). Dairy and dwelling house. Rebuilding completed. Charles Street, No. 19a. Being rebuilt. Chenies Street, Nos. 8 and 10. Rebuilding completed. Coptic Street, No. 7. Rebuilt. Coram Street, Nos. 6 and 7. Flats being erected. „ ,, No. 23 (with No. 27 Kenton Street). New boarding house being erected, Cosmo Place, Nos. 2, 4 and 6 (with 126 and 128, Southampton Row). Rebuilt as the "Cosmo Hotel." Drury Lane, Nos. 175 and 176. Premises rebuilt as shops and flats. Endell Street, Nos. 33 and 35. Premises rebuilt. Francis Street, No. 18. Site still vacant. Gate Street, Nos. 1, 22 to 24. Premises still vacant. Great Queen Street, Nos. 19, 20 and 21. Being rebuilt. ,, „ Nos. 1 and 2. Demolished. Great Russell Street, Nos. 29 to 34 (with 9 to 19, Bloomsbury Street). Premises being rebuilt as the " Ivanhoe Hotel." Great White Lion Street, No. 3. Still closed. Goldsmith Street, No. 9. Closed. Goldsmith Street Buildings, Nos. 1, 2 and 3. Factories erected. Gower Mews, Nos. 18, 19 and 20. Premises re.occupied. Herbrand Street (with corner of Bernard Street). New flats completed. Herbrand Street— Coram Buildings Dickens „ Thackeray ,, New Dwellings for the Working Classes erected. High Holborn, Nos. 111, 114, 115, 127, 128 and 129. New premises erected. ,, ,, „ 112 and 113. Neiv premises being rebuilt. ,, ,, ,, 223 to 228. Premises demolished for the new Kingsway. Kenton Street, No. 27 (with 23 Coram Street). New "Boarding House" being erected. Keppel Mews North, Nos. 2 to 5 inclusive. Demolished. Whole area Nos. 2 to 10, now vacant. Keppel Street, Nos. 20 to 23 inclusive. Demolished. „ ,, „ 34 to 40. Demolished. Kingsway, Craven House. New offices erected. Montague Place, 3 to 16. Demolished. 21 Neal Street, Nos. 20 and 22. Demolished. New Public House being built on site. New Compton Street, No. 28. Closed. Queen's Place, Nos. 1, 2, 3 (with 19, 20 and 21, Great Queen Street). New premises being erected. Queen Street, No. 14. New warehouse erected. Red Car Yard, Nos. 1 and 2. Still partly demolished. Russell Square. No. 30. Demolished. Sardinia Street, Nos. 1, 3, 15, 17, 18, 19 and 21. Closed. ,, „ Nos. 5, 7, 9, 11 and 13. Demolished. Shaftesbury Avenue, Nos. 171 and 175. Closed, „ ,, (corner of Vine Street). New shops and flats being erected. Short's Gardens, Nos. 11, 12 and 13. New warehouses being erected. ,, ,, „ 20, 21 and 22. Site being used for storage of goods. South Crescent, Nos. 11 and 12. Demolished. New warehouses being erected. ,, ,, „ 6, 7, 9 and 10. Closed for demolition. Southampton Row, Nos. 14 to 42 even and Nos. 13 to 35 odd inclusive. Demolished. „ ,, „ 62 to 70. New premises being erected. ,, ,, ,, 78. New premises erected. „ ,, ,, 126 and 128 (with 2, 4 and 6, Cosmo Place). Rebuilt as "Cosmo Hotel." Southampton Street, No. 12. Rebuilt. Store Street, No. 18. Demolished except bar and cellar. ,, ,, „ 19, 20, 21, 21a and 23. Demolished. New warehouses being erected. „ ,, ,, 24. Closed for demolition. Torrington Mews East, Nos. 11 to 18. Demolished. Tottenham Court Road, Nos. 209 to 212. New premises erected. ,, ,, „ ,, 213 to 215. New premises being erected. „ „ ,, ,, 216 to 226. New premises erected. „ ,, ,, „ 227 to 233. Demolished and new premises being built. Vine Street (with corner of Shaftesbury Avenue). Demolished. Shops and flats being erected. Vernon Place, Nos. 4 and 5. Demolished. Holborn. Beauchamp Street, No. 17. Demolished. Brooke's Market, Nos. 18 and 19. Demolished. Charles Street, No. 3 (with 5, Robin Hood Yard). Rebuilt as a dairy and dwelling house. Charles Street, No. 19a. Premises being rebuilt. Dorrington Street, Nos. 16 and 17. Demolished. Eagle Street, Nos. 63, 64, 65, 66 (with 2 to 6, Fisher Street). Premises rebuilt as electric power station. Do. No. 42. West half of premises demolished. Do. „ 43. Demolished. Do. ,, 44, 45 and 46. Warehouses and workshops erected. Do. ,, 47. Re-opened. Do. ,, 31. Closed Emerald Street, Nos. 11 to 15. Warehouses erected. Ely Buildings. Offices erected. Ely Place, Nos. 15 to 20. Offices erected. Ely Mews. Offices erected. Fisher Street, Nos. 2 to 6. (with 63 to 66, Eagle Street). Electric power station erected. Fisher Street, Nos. 13, 14, 15, 16. New premises erected (Messrs. Parkinson). Do. No. 12½. Occupied by caretaker only. Fulwood's Rents, Nos. 1 and 2 (with 35, High Holborn). Rebuilding as refreshment rooms, completed. Half Moon Court, No. 6. Closed. Hatton Garden, No. 109. Premises rebuilt. 22 High Holborn, No. 35, (with 1 and 2, Fulwood's Rents). Refreshment rooms. Rebuilding completed. High Holborn, Chancery Lane Station, Central London Railway. Offices over station being built. Lamb's Conduit Street, Nos. 10 and 12. Closed. Leather Lane, Nos. 64 and 66. Still closed. „ Nos. 56, 57 and 58. New buildings for the working classes (Ratcliffe Buildings) erected. Leather Lane, Nos. 66, 68, 68a, and 71. Closed. Little Grays Inn Lane. (Site of old Casual Ward.) New premises being erected. Mount Pleasant, Nos. 65, 67, and 69. New premises being erected. Ormond Yard, No. 16. Demolished and rebuilt. Portpool Lane, Nos. 1, 3, 5, 7, and 13. Still closed. Providence Place, Nos. 5, 6, and 8. Still closed. Princeton Street, Nos. 22 and 24. Closed. Rosebery Avenue, No. 8. Business premises erected. Red Lion Passage, No. 7. Demolished and rebuilt (fried fish shop and dwelling house). ,, ,, Nos. 17 and 18. Demolished. ,, Street, Nos. 60 and 61. Premises being rebuilt. Reid's Brewery Site—" Bourne " Estate:— Redman Buildings Scrope „ Frewell ,, Denys „ Skipwith „ Ratcliffe ,, New Dwellings for the Working Classes erected. Robin Hood Yard, No. 5. with No. 3, Charles Street. Dairy and dwelling house rebuilt. Summer Court, Nos. 1 to 6 (inclusive). Closed. look's Court, No. 18. Premises being rebuilt. Union Buildings, Nos. 3, 6, and 7. Closed. ,, „ Cowshed. Closed. ,, ,, Nos. 1, 9, and 10. Closed. Verulam Street, Nos. 18, 19, 20, and 21. Still closed. REVENUE ACTS. During the year certificates have been granted under the Revenue Acts that the following premises are so constructed as to afford suitable accommodation for each of the families or persons inhabiting them, and that due provision is made for their sanitary requirement, viz.:— Coram Buildings, Herbrand Street, 50 tenements. Dickens Buildings, Herbrand Street, 60 tenements. Thackeray Buildings, Herbrand Street, 50 tenements. Nos. 1 to 25 Radcliff Buildings.} Nos. 26 to 43 „ ,,} 61 tenements. Nos. 44 to 61 „ ,,} Municipal Lodging House, Parker Street, 345 tenements. A certificate was also requested for Nos. 1 to 48 Redman Buildings but was deferred. WATER SUPPLY TO NEW BUILDINGS. During the year I have given certificates that the following premises which have been newly erected or rebuilt have a proper and sufficient supply of water:— Coram Buildings, Herbrand Street. Dickens Buildings, Herbrand Street. Thackeray Buildings, Herbrand Street. Bernard Street Mansions. 23 Nos. 1 to 25, Radeliff Buildings, Bourne Estate. Nos. 26 to 43, Radeliff Buildings, Bourne Estate. Nos. 44 to 61, Radeliff Buildings, Bourne Estate. No. 66, Theobald's Road. No. 3, Charles Street. "Cosmo Hotel," Southampton Row. No. 44, Bedford Row and Nos. 17, 18, 19, 20 and 21, Sandland Street. Nos. 1 to 48, Redman Buildings, except Nos. 6, 27 and 28. Nos. 51 to 94, Redman Buildings, except Nos. 71 and 72. Nos. 95 to 126, Redman Buildings, except Nos. 115 and 116. Many new premises, such as factories, workshops, offices, etc., were inspected but a certificate is not required. SANITARY WORK. HOUSE TO HOUSE INSPECTIONS, 1904. St. Giles and Bloomsbury.. Arthur Street. Betterton Street. Brokers Alley. Bucknall Street. Castle Street. Charing Cross Road (part of). Chenies Street. Clark's Buildings. Denmark Place. Denmark Street. Drury Lane. Dyott Street. Endell Street. Goldsmith Street. Great Earl Street. Great Queen Street. Great St. Andrew Street. Great White Lion Street. Great Wild Street. Kennedy Court. Kenton Street. Keppel Mews North Lawrence Street. Little Denmark Street. Little Earl Street. Little St. Andrew Street. Little White Lion Street. Little Wild Street. Lloyds Court. Lumber Court. Macklin Street. Marchmont Street (part of). Neal Street. New Compton Street. New Oxford Street (part of). Newton Street. New Turnstile. Nottingham Court. Parker Street. Phœnix Street. Queen Street. Sardinia Place. Shaftesbury Avenue (part of). Short's Gardens. Smart's Buildings. Stacey Street. Store Street. Tottenham Court Road (part of). Tower Street. Upper Montague Mews. West Street. Wild Court. Holborn. Back Hill. Baldwin's Place. Beauchamp Street. Bishop's Head Court. Boswell Court (South side). Castle Court. Chapel Street. Charterhouse Street. Clerkenwell Road (part of). Cross Street. Devonshire Street. Dove Court. Dunstable Court. Eagle Street. East Street. Ely Place. Emerald Street. Evelyn Buildings. Eyre Court. Eyre Place. Eyre Street Hill Eyre Terrace. Farringdon Road (part of). Fleet Row. Grays Inn Passage. Half Moon Court. Hand Court. Harpur Street. Hatton Garden. Hatton Wall. High Holborn. Kirby Street. Lamb's Conduit Passage. Lamb's Conduit Street. Laystall Street. Leather Lane. Leather Lane Buildings, Leigh Street. Little Bath Street. Little Grays Inn Lane. Little James Street. Long Yard. Mount Pleasant. New North Street. Old North Street. Poole's Buildings. Princeton Street. Providence Place. Red Lion Passage. Red Lion Square (part of). Red Lion Street. Robert Street. Robin Hood Yard. Sandland Street. Shene Buildings. Summer Street. Verulam Street. Vine Street. Warner Street. 24 BY-LAWS AS TO HOUSES LET IN LODGINGS. At the end of the year, 767 houses were registered under these by.laws. Of these 410 are in St. Giles and Bloomsbury, and 357 are in the Holborn Division. During the year 28 houses let in lodgings, all in the Holborn Division, have been added to the register. During 1903, as many as 296 houses all in the Holborn Division were added to the register. Other houses formerly on the register have been closed for demolition during the year, and some are now occupied by members of only one family. During the year there were 1,228 inspections of these premises, excluding a very large number of frequent periodical inspections and re.inspections. Notices were served for 67 cases of overcrowding and for 117 other broaches of the by.laws, exclusive of more than 600 formal notices that were served for annual cleansing as required by the by.laws. The number of prosecutions was 26, 11 of which were for overcrowding and the remaining 15 for other breaches. OVERCROWDING. The number of dwelling rooms found to be overcrowded during the year, was 123, 67 of which were dealt with as breaches of the by.laws as to houses let in lodgings. A midnight inspection was made of Leather Lane Buildings in the early morning of the 23rd November, and 22 rooms were found to be overcrowded. During a day inspection of these buildings on the 7th November, 11 of the rooms were found to be overcrowded. Summonses were therefore taken out for these 11 rooms. The owner at once took steps for the abatement of the overcrowding, and the summonses were withdrawn on the payment of costs. A midnight inspection was also made in the early morning of the 3rd December, of the houses in Red Lion Passage in which overcrowding was considered most probable. Overcrowding had been found on several occasions during the year and had been abated. At the night inspection, overcrowding was only found in one room of each of two houses, and was abated soon after service of the notices. COMMON LODGING HOUSES ACTS 1851 AND 1853. The Secretary of State by a Provisional Order which came into operation on the 1st November, 1894, transferred to the London County Council the powers of the Commissioner of Metropolitan Police in respect of common lodging.houses. The following is a list of the Common Lodging.houses registered in this Borough at the end of the year 1904:— Of these 25 are in Bloomsbury and St. Giles for 1,402 lodgers. ,, 14 „ Holborn District for 966 „ Total 47 in the Borough for 2,368 „ Bloomsbury and St. Giles. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. 6, Betterton Street 83 M 14, Lumber Court 68 M 16, Castle Street 31 M 1-7, Macklin Street 96 M 25, Drury Lane 34 W 19, do. 40 W 9, Dyott Street 28 M 21, do. 26 W 25, Great Queen Street 26 M 8, Parker Street 26 W 30, Parker Street 83 M 10, do. 46 W 2, Kennedy Court 8 M Parker Street Municipal 345 M 3, do. 10 M 20 & 21, Queen Street 113 M 4, do. 19 M 22-25, do. 159 M 5, do. 8 W 3, Neal's Yard 39 M 6, do. 8 W 6, Wild Court 28 M 7, do. 9 w 7, do. 35 M 8, do. 34 w A total of 25 Common Lodging.houses registered for 1,402 lodgers. 25 Holborn Division. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. 7, Castle Court 46 M 4, Greville Street 54 M 25, Charles Street 241 M 29, Hatton Wal 94 M Field Lane Refuge 32 M 28, Orde Hall Street 22 M 17 W 39, Queen Square 52 M 40, Eagle Street 50 M 28, Red Lion Square 72 M 18, Fulwood's Rents 41 w 12, Took's Court 61 M 19, do. 77 W 13, do 49 M 20, do 58 M A total of 14 Common Lodging.houses registered for 966 lodgers. In June 1903, I presented a detailed Report respecting all common lodging houses in the Borough, and advised the Council to oppose the renewal of the licenses for 11, 12 and 13 Short's Gardens, 20, 21 and 22, Short's Gardens, 13, Sardinia Street, 15, Sardinia Street (which was occupied with Nos. 27, 28, 29 and 30, Vere Street in the City of "Westminster), and 3, Neal's Yard which forms part of a large common lodging house, Nos. 20 to 25, Queen Street inclusive. Nos. 11, 12 and 13, Short's Gardens were closed and demolished in 1903 and new warehouses were erected in 1904. Nos. 20, 21 and 22 Short's Gardens were closed in 1903 and demolished in 1904. 13, Sardinia Street was closed and demolished in 1904. 15, Sardinia Street was closed in 1904 and has since been demolished. Many alterations were carried out at Nos. 20 to 25, Queen Street, and 3, Neal's Yard, and the premises were made suitable for occupation as a common lodging house. In the great majority of the remaining common lodging houses many alterations were made, including adequate means for escape in the case of fire, in order to obtain a renewal of the licenses, and in the remainder there were only a few defects which were easily remedied. During the year, 84 inspections of common lodging houses were made, a lodging house consisting of 2 to 7 registered houses being considered as one inspection, and 8 notices for sanitary defects were served. The Field Lane Refuge, Vine Street, Clerkenwell Road was newly registered by the London County Council for 32 males and 17 females. FACTORIES, WORKSHOPS AND WORKPLACES. During the year there were 1,189 inspections of factories and workshops, and 1,046 inspections of workplaces, 227 Intimation Notices for sanitary defects were served and 62 Statutory Notices, and there were three prosecutions. There were also 125 inspections of home workers premises for which 20 Intimation Notices for sanitary defects were served, and 6 Statutory Notices. The following table gives the changes that have taken place during the year, details of the number of premises on the Register at the end of the year, number of inspections, etc. The following table gives the changes that have taken place during the year, details of the number of premises on the Register at the end of the year, number of inspections, etc. 26 Inspection of Factories, Workshops and Workplaces. Class of Work. Number of Places ‡ Number of Inspections. 1904. Number of Notices 1904. Number of Prosecutions 1904. On Register at end of 1903. Added in 1904. Removed in 1904. On Register at end of 1904. Premises. Rooms. Intimations. Statutory. Factories ‡ Factory Laundries 1 2 — 3 — — — Factory Bakehouses 1 — — 1 — 9 — Other Factories Included under Work shops. 2 Workshop Laundries 13 9 3 19 38 54 6 — — Workshops Workshop Bakehouses 37 — 4 33 — 272 § 17 — 1 Other Workshops 691 133 78 746 1,177 854 174 52 — Home workers' Premises* 113 29 43 99 144 125* 20 6 — Workplaces Places where Food is prepared for Sale † 313 43 31 318 — 925 30 10 — Workplaces other than the above || 121 Included in other Work shops. Total 1,169 216 166 1,219 1,359 2,360 247 68 3 * There were in addition, many inspections of Outworkers' Premises made during the house.to.house inspections of Lodging Houses and other Dwelling Houses. † Under this head are included the Kitchens of Hotels, Restaurants and Eating.houses of all sorts. Tripe, Offal, and other Meat Shops Fried Fish, Eel, and other fish Shops, and other places where food is prepared for sale, excluding Bakehouses which are given above. ‡ Registration of Factories is not required by the Factory and Workshop Act, 1901, but most of them were inspected during 1904, and notices served where necessary. § Many Inspections of Underground Bakehouses were also made by the Borough Surveyor and the Medical Officer of Health in connection with the requirements for the Council's Certificate. || There is a very large number of workplaces other than the above, the registration of which is not required, and many of them were inspected and notices served where necessary. Further details of defects which were found and other matters are given in Table VII. (1), (2) and (3) of the Appendix. BAKEHOUSES. At the end of the year 1904, there were 34 bakehouses in the Borough of which 17 were in St. Giles and Bloomsbury and 17 in the Holborn Division. The following is a list of the bakehouses in the Borough:— St. Giles and Bloomsburby. 2 Bloomsbury Court. 10 Bury Street. 166 Drury Lane. 155 High Holborn. 162 High Holborn. 217 & 218 High Holborn (Holborn Restaurant). 63 High Street. 19 Little Earl Street. 5 Little St. Andrew Street. 21 Marchmont Street. 77 Marchmont Street. 8 Museum Street. 60 Neal Street. 24, 26 and 28 New Oxford Street. 200 Shaftesbury Avenue. 88 Southampton How. 6 Torrington Place. Holborn. 172 Clerkenwell Road. 9 Cosmo Place. 49 to 57 Farringdon Road (Factory). 33 Great Ormond Street. 1 Greville Street. 91 Leather Lane. 6 Lamb's Conduit Street. 28 Lamb's Conduit Street. 50 Lamb's Conduit Street. 13 Leigh Street. 19 Red Lion Street. 50 Red Lion Street. 74 Red Lion Street. 92 Theobald's Road. 124 Theobald's Road. 136 Theobald's Road. 36 Warner Street. 27 All are underground with the exception of 2 Bloomsbury Court, 162 High Holborn, 88 Southampton Row, 74 Red Lion Street, 28 Lamb's Conduit Street, 6 Lamb's Conduit Street and 91 Leather Lane. As I mentioned in my Report last year, the bakehouses, especially the underground ones, occupied a good deal of the time of the Public Health Committee, the Town Clerk and the Borough Surveyor, as well as this Department. In addition to my inspections and detailed reports on various occasions and inspections and detailed reports by the Borough Surveyor, 272 inspections were made by the Sanitary Inspectors and 17 notices for minor defects were served during the year. The following seven underground bakehouses received the Certificate by the end of 1903, as required by the Factory and Workshop Act, 1901,:— Situation of Bakehouse. Date Certificate granted. 217 and 218, High Holborn, (Holborn Restaurant) 10th June, 1903 6, Torrington Place 10th June, 1903 63, High Street 29th July, 1903 77, Marchmont Street 29th July, 1903 92, Theobald's Road 14th October, 1903 9, Cosmo Place 25th November, 1903 21, Marchmont Street 25th November, 1903 The following twenty received the Certificate during the year 1904:— Situation of Bakehouse. Date Certificate granted. 50, Lamb's Conduit Street 13th January, 1904 5. Little St. Andrew Street 13th January, 1904 136, Theobald's Road 13th January, 1904 49 to 57, Farringdon Road 10th February, 1904 13, Leigh Street 10th February, 1904 172, Clerkenwell Road 24th February, 1904 1, Greville Street 9th March, 1904 155, High Holborn 9th March, 1904 8, Museum Street 9th March, 1904 60, Neal Street 9th March, 1904 24, 26 and 28. New Oxford Street 9th March, 1904 124, Theobald's Road 9th March, 1904 166, Drury Lane 13th April, 1904 19, Little Earl Street 13th April, 1904 36, Warner Street 13th April, 1904 200, Shaftesbury Avenue 27th April, 1904 10, Bury Street 22nd June, 1904 19 Red Lion Street 22nd June, 1904 33, Great Ormond Street 26th October, 1904 50, Red Lion Street 26th October, 1904 For the following five underground bakehouses no certificate was granted :. 8, High Holborn, which is no longer used as an underground bakehouse. 233, Tottenham Court Road. Not used as an underground bakehouse since December 31st, 1903, and the premises were demolished in 1904. 21, Sardinia Street. Was closed in October, 1904, and has since been demolished in connection with the new Kingsway. For this reason the Council allowed the occupation to be temporarily continued. 70, Leather Lane. Is included in the Union Buildings area. The Council refused the application for a certificate as the bakehouse did not comply with the Council's requirements, but at the request of the London County Council allowed the occupation of the underground bakehouse to be temporarily continued, as the London County Council was building a new bakehouse for this occupier on the site of an old bakehouse at No. 58, 28 Leather Lane (now No. 91). Legal proceedings for the closure of this bakehouse were subsequently taken, and the closure took place on the 12th December, 1904, when the new bakehouse, now 91, Leather Lane, was completed. 6, Lamb's Conduit Street. The certificate for the underground bakehouse was refused and the basement is no longer used as an underground bakehouse. PLACES WHERE FOOD IS PREPARED FOR SALE. Under this head are included kitchens of hotels, restaurants, and eating houses of all sorts, tripe, offal, and other meat shops, fried fish, eel and other fish shops, and other places where food is prepared for sale, excluding bakehouses, which are given above. The number of these places on the register at the end of 1904 was 318; 925 inspections were made, and 30 notices were served during the year for sanitary defects that were found. I suggested to the Public Health Committee that voluntary certificates should be granted for the kitchens of restaurants, eating houses, etc., that are found on inspection to be in a satisfactory sanitary condition, or, after alterations have been made, in accordance with our requirements. These voluntary certificates have been given in the City of London and the Borough of Southwark. The matter was carefully considered by the Committee, but they finally decided to take no action in the matter for the present. OTHER SHOPS WHERE FOOD IS SOLD. The inspection of other food shops includes 733 inspections of market streets, 19 provision merchants and cheesemongers, 69 fruiterers and greengrocers, and 4 grocers and general shops. SLAUGHTER.HOUSES. The two slaughter.houses in the Borough :— 29, Red Lion Street, and Yorkshire Grey Yard, Eagle Street, were inspected on 39 occasions during the year. Last July the Inspector and I, who were present together, found the slaughtering of sheep in progress at the slaughter.house in the Yorkshire Grey Yard, with the door of the slaughter.house open to the public, with a few youths standing close by. This slaughter.house, although in a public yard, is not visible from Eagle Street. I cautioned the occupier, and he promised that he would slaughter in future with the doors closed. I also wrote to the occupier giving him a copy of the by.law, and the penalties to which he was liable, and that legal proceedings would be taken if a breach of the by.law was again discovered. After my report the Committee also instructed the Town Clerk to address a communication to the Clerk to the London County Council drawing attention to the breach of the by.law, and intimating that while the Committee do not propose to offer any objection to the renewal of the licenses, they must not be taken as approving of the continued maintenance of slaughter.houses and cow.houses in crowded parts of the Metropolis. OTHER OFFENSIVE BUSINESSES. The only other offensive business in the Borough is that of a tripe dresser and boiler at Nos. 67 and 68 Leather Lane. These premises are frequently inspected. They are included in the Union Buildings Area and were acquired by the London County Council last year, and will soon be demolished in accordance with the scheme for improving that area. 29 DAIRIES, COWSHEDS AND MILKSHOPS. The number of registered dairies and milkshops in the Borough at the end of the year was 171, of which 67 were in St. Giles and Bloomsbury, and 104 in the Holborn District. During the year 18 dairies and milkshops were newly registered, 7 belonging to St. Giles and Bloomsbury, and 11 to the Holborn District. On application for registration under the Dairies, Cowsheds and Milkshops Order of 1885, the premises were also carefully inspected by me and notices served to remedy any sanitary defects. The Sanitary Inspectors made 1,160 inspections of these premises; and one notice was served for breach of regulations. Last year we had not so much difficulty in enforcing the covering of milk for preserving its purity, and for protecting it against infection or contamination; in several cases, however, the occupiers had to be cautioned. There is now only one cowshed in the Borough, which is at 4, Goldsmith Street, and was frequently inspected during the year. ICE CREAM. At the end of the year there were 42 premises in the Borough where ice cream was manufactured or sold, and 144 inspections of these premises were made. On account of the increased powers which we have by the London County Council (General Powers) Act, 1902, the premises where ice cream is manufactured or sold are now in a better condition. Many rooms and bedrooms which before the Act came into force were used for the manufacture, sale or storage of ice cream are no longer used for the purpose, and many rooms or other places have been specially fitted up and prepared for this business. UNSOUND FOOD. Applications were received for the removal and destruction as trade refuse, of the following articles of food, all of which were unsound and unfit for the food of man :— 6 cases tinned salmon. 13 cases oranges. 290 cases bananas. 16 bundles tomatoes. 6 sacks potatoes. SMOKE ABATEMENT. The smoke shafts in the Borough were frequently kept under observation, and in 388 cases the inspections were recorded. Thirty Intimation Notices and 11 Statutory Notices were served. Two summonses were taken out against the same firm in March and November. In the first instance the defendants had to pay £2. 2s. costs, and in the second they were fined £2 and £2. 2s. costs. METEOROLOGY. The mean temperature of the year was 49.8, which is slightly higher than for the preceding 50 years. The rainfall was only 28.67 inches, and was 3.86 inches below the average for the preceding 50 years. In the year 1903 there was 35.54 inches. The total amount of bright sunshine recorded was 1,458 hours, out of a total possible 4,466 hours, and it was 140 hours above the average for the preceding 16 years. 30 The mean hourly horizontal movement of the air was 11.4 miles per hour. In the preceding year, 1903, it was 13.2 miles per hour, which was the highest recorded during the past 50 years, the lowest recorded being 9.3 per hour. Further details are given in Table 10. I desire to express my appreciation of the excellent assistance and hearty co.operation that I have received from the staff of the Public Health Department during the year. I have the honour to be, Gentlemen, Your obedient Servant, W. A. BOND. 31 APPENDIX. TABLE I. Vital Statistics of Whole District during 1904 and Previous Years. Name of District—The Metropolitan Borough of Holborn. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all ages belonging to the District. Under 1 Year of Age. (Nett.) At all Ages. Number. Rate. * Number. Rate per 1,000 Births registered, Number. Rate.* Number. Rate* 1 2 3 4 5 6 7 8. 9 10 11 12 13 1894 69,088 1,902 27.6 294 155 1,384 20.1 568 426 447 1,405 20.4 1895 68,349 1,941 28.5 359 185 1,546 22.7 526 355 470 1,661 24.4 1896 67,785 1,959 28.5 331 169 1,366 19.8 509 380 457 1,443 21.0 (53 weeks) 1897 67,074 1,772 26.5 289 163 1,335 20.0 568 447 478 1,366 20.4 1898 66,371 1,840 27.8 336 183 1,467 22.2 605 461 477 1,483 22.4 1899 65,677 1,857 28.4 298 161 1,439 22.0 628 471 496 1,464 22.4 1900 64,990 1,762 27.2 311 177 1,326 20.5 516 412 514 1,428 22.1 1901 59,232 1,660 28.4 203 122 1,214 20.5 572 481 448 1,181 20.0 1902 58,542 1,646 27.7 213 129 1,283 21.9 627 517 494 1,260 21.2 (53 weeks) 1903 57,861 1,621 28.1 154 95 1,088 18.8 587 496 462 1,054 18.3 Averages for years 1894-1903 64,496 1,796 27.8 278 153 1,344 20.9 570 444 474 1,374 21.3 1904 57,188 1,632 28.6 179 109 1,134 19.8 596 540 426 1,020 17.9 * Rates in columns 4, 8. and 13 calculated per 1,000 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 district or division. 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 district 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 district on account of sickness or infirmity, and have died in public institutions elsewhere. N.B.—The years 1894 to 1900 refer to the old areas of the St. Giles and Holborn District Boards of Works. Area of District in acres (exclusive of area covered by water) 405.1 Total population at all ages 59,405 at Census of 1901. Number of inhabited houses 4,703 ,, ,, Average number of persons per house 12.6 ,, ,, TABLE II. Vital Statistics of separate Localities in 1904 and previous years. Names of Localities. Holborn Borough. Bloomsbury and St. Giles. Holborn Sub-District. 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. 1894 69,088 1,902 1,405 294 37,268 1,070 745 144 31,820 832 660 150 1895 68,349 1,941 1,661 359 36,974 1,120 851 185 31,375 821 810 174 1896 67,785 1,959 1,443 331 36,683 1,064 734 162 31,102 895 709 169 1897 67,074 1,772 1,366 289 36,394 981 676 146 30,680 791 690 143 1898 66,371 1,840 1,483 336 36,108 1,027 746 158 30,263 813 737 178 1899 65,677 1,857 1,464 298 35,824 1,132 748 136 29,853 725 716 162 1900 64,990 1,762 1,428 311 35,542 1,018 679 137 29,448 744 749 174 1901 59,232 1,660 1,181 203 31,401 1,040 575 88 27,831 620 606 115 1902 58,542 1,646 1,260 213 31,020 994 594 86 27,522 652 666 127 1903 57,861 1,621 1,054 154 30,644 991 490 68 27,217 630 564 86 Averages of Years 1894 to 1903 64,497 1,796 1,375 279 34,786 1,044 664 131 29,711 752 690 148 1904 57,188 1,632 1,020 179 30,272 991 444 78 26,916 641 576 101 Notes..(a) The separate localities adopted for this table should be areas of which the populations are obtainable from the census returns, such as wards, parishes or groups of parishes, or registration sub.districts. Block 1 may, if desired, be used for the whole district; and blocks 2, 3, &c., for the several localities. In small districts without recognised divisions of known population this Table need not be filled up. (b) Deaths of residents occurring in public institutions beyond the district are to be included in sub-columns c of this Table, and those of non.residents registered in public institutions in the district excluded. (See note on Table I. as to meaning of terms "resident" and "non.resident.") (c) Deaths of residents occurring in public institutions, whether within or without the district, are to be allotted to the respective localities according to the addresses of the deceased. N.B.—The years 1894 to 1900 refer to the old areas of the St. Giles and Holborn District Boards of Works. 32 TABLE III. Cases of Infectious Disease notified during the year 1904. Notifiable Disease. Cases notified in whole District. Total Cases notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. Under 1. At Ages—Years. Bloomsbury and St. Giles. Holborn. Bloomsbury and St. Giles. Holborn. 1 to 5 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small.pox 6 — — — 3 3 — 5 1 5 1 Cholera — — — — — — — — — — — Diphtheria and Membranous Croup 46 — 18 14 9 5 — 19 27 19 26 Erysipelas 77 5 2 6 7 54 3 38 39 23 16 Scarlet Fever 99 — 38 49 6 6 — 37 62 34 62 Typhus Fever — — — — — — — — — — — Enteric Fever 41 — — 11 8 22 — 22 19 19 18 Relapsing Fever — — — — — — — — — — — Continued Fever — — .— — 1 — — — — — — Puerperal Fever 7 — — — 3 4 — 4 3 3 3 Plague — — — — — — — — — — — Chicken.pox 61 8 25 24 1 3 — 27 34 — — Totals 337 13 83 104 37 97 3 152 185 103 126 Note.—The Isolation Hospitals are those of the Metropolitan Asylums Board. There were also 344 voluntary notifications of Phthisis (Consumption), 157 belonging to St. Giles and Bloomsbury, and 187 to the Holborn Division. TABLE IV. Causes of, and Ages at, Death during the year 1904. Causes of Death. Deaths in or belonging to whole District at Subjoined Ages. Deaths in or belonging to Localities at all Ages. Total Deaths in Public Institutions in the District. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Bloomsbury and St. Giles. Holborn. Small.pox 2 — — — 1 1 — 2 — — Measles 43 7 35 1 — — — 12 31 4 Scarlet Fever — — — — — — — — .— 1 Whooping Cough 8 4 4 — — — — 2 6 27 Diphtheria and Membranous Croup 4 — 3 1 — — — 1 3 7 Croup — — — — — — — — — — Fever Typhus — — — — — — — — — — Enteric 4 — — 1 — 3 — 2 2 2 Other Continued — — — — — — — — — — Epidemic Influenza 8 — — 1 — 5 2 4 4 1 Cholera — — — — — — — — — — Plague — — — — .— — — — — — Diarrhœa 35 28 4 — — 2 1 10 25 52 Enteritis 6 4 1 — — — 1 1 5 5 Puerperal Fever 4 — — — 1 3 — 1 3 — Erysipelas 1 1 — — — — — 1 — — Other Septic Diseases 12 3 — — 1 6 2 6 6 28 Phthisis 157 — — — 18 130 9 75 82 43 Other Tubercular Diseases 24 7 11 2 2 2 — 12 12 79 Cancer, Malignant Disease 54 — — — — 36 18 28 26 20 Bronchitis 126 19 10 — 1 42 54 38 88 13 Pneumonia 86 27 15 — — 28 16 43 43 64 Pleurisy 5 — — — — 3 2 1 4 1 Other Diseases of Respiratory Organs 8 3 1 — 1 2 1 4 4 14 Alcoholism Cirrhosis of Liver 23 — — — — 23 — 12 11 10 Venereal Diseases 5 1 2 — — 2 — 3 2 1 Premature Birth 23 23 — — — — — 12 11 13 Diseases and Accidents of Parturition 2 — — — — 2 — 1 1 — Heart Diseases 79 2 1 3 5 45 23 34 45 23 Accidents 28 9 1 2 1 12 3 12 16 5 Suicides 10 — — — 2 6 2 3 7 — All other causes 263 41 10 4 12 108 88 124 139 183 All causes 1020 179 98 15 45 461 222 444 576 596 33 TABLE V Sanitary Inspectors' Work. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Lovibond. Whole Borough. Complaints 55 83 86 17 241 Inspections. Infectious Diseases 145 124 128 274 671 Dwelling Houses 210 228 308 110 856 Lodging Houses 431 278 320 199 1,228 Common Lodging Houses 29 13 42 — 84 Dairies, Cowsheds and Milkshops 420 275 465 — 1,160 Ice Creams — Manufacture or Storage 19 26 99 — 144 Slaughter.houses — 39 — — 39 Market Streets 363 67 303 — 733 Butchers' Shops 169 105 117 — 391 Bakehouses 87 107 77 1 272 Other Food Shops 175 97 201 61 534 Other Workshops 168 154 158 428 908 Out.Workers' Rooms and Registers 30 — 23 268 321 Workplaces 23 11 66 21 121 Schools — 1 1 5 7 Smoke shafts 141 35 212 — 388 Urinals 1 117 47 — 165 Miscellaneous 110 107 267 1 485 Periodical Inspections 482 952 979 — 2,413* Total Inspections 3,003 2,736 3,813 1,368 10,920 No. of Re.Inspections 1,359 1,957 801 946 5,063 Visits other than Inspections and Re-Inspections 598 924 1,040 986 3,548 Total 4,960 5,617 5,654 3,300 19,531 Intimation Notices Served 264 435 420 205 1,324 Houses 245 404 372 106 1,127 Waterclosets defective Gr dirty 68 162 176 47 453 ,, insufficient 11 38 14 4 67 Drains defective 33 39 36 9 117 Soil pipes or waste pipes defective 25 34 21 5 85 Gullies defective 4 — — 2 6 Ash.bins defective 12 13 8 11 44 ,, absence of 4 20 7 3 34 Water supply defective 3 4 — 1 8 ,, cistern dirty or defective 15 43 20 1 79 „ fittings defective — — — — — Yard or area paving defective 22 24 12 2 60 Roof or guttering defective 17 18 33 1 69 Accumulations 8 39 34 14 95 Premises dirty 125 127 92 38 382 „ overcrowded 14 25 13 4 56 ,, other defects 8 13 74 2 97 Underground rooms 1 10 — — 11 Animals improperly kept — 3 4 — 7 Smoke nuisances 8 5 22 — 30 Urinals 1 7 7 — 15 Other nuisances 8 25 2 2 37 Manure receptacles, absence of 23 12 1 — 36 Factories and Workshops 19 31 48 99 197 Dirty 18 9 32 60 119 Waterclosets, defective or dirty 2 6 14 27 49 ,, insufficient . 2 1 . 3 ,, absence of separate accommodation for sexes 1 1 2 2 6 Drains, soil pipes, &c., defective — 5 1 2 8 Improperly ventilated — 1 — 3 4 Overcrowded — 2 — 10 12 Other nuisances — 1 7 11 19 Breach of Bye.laws or Regulations. ‡ Lodging houses 13 72 28 4 117 Dairies, cowsheds, milkshops and slaughter-houses 1 — — — 1 Statutory Notices Served 37 178 136 51 402 * The majority of these are weekly inspections of Registered Lodging Houses. + Many nuisances at workshops, that are parts of dwelling houses, are included in the Intimation Notices served under" Houses." ‡ Many breaches of bye.laws are included in Intimation Notices served under "Houses." 34 The following Tables VI. VII. VIII. and IX. are in the form suggested by the Medical Officer of Health for the London County Council with a view to securing uniformity of Statistics in the Metropolis. TABLE VI. Proceedings during 1904. PREMISES. NUMBER OF PLACES— Number of Inspections 1904. Number of Notices 1904. Number of Prosecutions 1904. On register at end of 1903. Added in 1904. Removed in 1904. On register at end of 1904. Milk premises 167 18 14 171 1.160 12 — Cowsheds 2 0 1 1 daily 3 — Slaughter-houses 2 0 0 2 39 1 — Other offensive trade premises 1 0 0 1 weekly — — Ice Cream premises 32 13 2 43 144 6 — Registered houses let in lodgings 775 28 36 767 1,228 (a)* 67 (b)* 117 (a)* 11 (b)* 15 * (a) For overcrowding. * (6) For other conditions. Overcrowding, 1904— Number of Dwelling Rooms overcrowded 123 Number remedied 123 Number of prosecutions 11 Underground Rooms— Illegal occupation dealt with during year 13 Number of rooms closed 11 Insanitary Houses— Number closed under the Public Health (London) Act, 1891 — „ „ ,, ,, Housing of the Working Classes Act 4 Shelters provided under Section 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 6 Revenue Acts— Number of houses for which applications were received during the year 8 Number of dwellings comprised therein 614 Number of tenements for which certificates were (a) granted 586; (4) refused —; (c) deferred 48 — Number of prosecutions under Bye.laws under Public Health (London) Act, 1891 (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. — (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc. — (c) For the prevention of keeping of animals in such a manner as to be injurious to health 2 (d) As to paving of yards, etc., of dwelling houses — (e) In connection with the removal of offensive matter, etc. — (/) As to cesspools and privies, removal and disposal of refuse, etc. — (g) For securing the cleanliness of tanks, cisterns, etc. — (A) With respect to water closets, earth closets, etc. — (i) With respect to sufficiency of water supply to water closets — (/) With respect to drainage, etc. (Metropolis Management Act, Section 202) — (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Act, Section 202) — Mortuaries— Total number of bodies removed 135 Total number of infectious bodies removed 1 35 TABLE VII. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—Inspection. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Intimations. Statutory. Factories (including Factory Laundries) 1,189 227 62 3 Workshops (including Workshop Laundries) Workplaces 1,046 Homeworkers' Premises 125 20 6 — Total 2,360 247 68 3 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to h.m. Inspector. *Nuisanoes under the Public Health Acts:— Want of cleanliness 128 128 — — Want of ventilation 4 4 — — Overcrowding 12 12 — — Want of drainage of floors — — — — Other nuisances 27 27 — 2 Sanitary accommodation insufficient 3 3 — — unsuitable or defective 48 48 — — not separate for sexes 6 6 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) 2 2 — 1 Breach of special sanitary requirements for bakehouses (SS. 97 to 100) — — — — Failure as regard lists of outworkers (S. 107) 106 106 — — Giving out work to be done in premises which are unwholesome (S. 108) — — — — infected (S. 110) — — — — Allowing wearing apparel to be made in premises infected by scarlet fever or small.pox (S. 109) — — — — Other offences — — — — Total 336 336 — 3 * Including those specified in Sections 2, 3, 7 and 8 of the Factory Act as remediable under the Public Health Acts. 36 3.—Other Matters. Class. Number. Matters notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (S. 133) 48 Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (S. 5) Notified by H.M Inspector 7 Reports (of action taken) sent to H.M. Inspectors. — Other — Underground Bakehouses (S. 101):— In use during 1903 32 Certificates granted in 1903 7 in 1904 20 In use at the end of 1904 27 Homework:— Number of Lists of Outworkers (S. 107):— Lists. Outworkers. Lists received 116 739 Addresses of outworkers forwarded to other Authorities 119 received from other Authorities 68 Homework in unwholesome or infected Premises:— Wearing Apparel. Other. Notices prohibiting homework in unwholesome premises (S. 108) — — Cases of infectious disease notified in homeworkers' premises — — Orders prohibiting homework in infected premises (S. 110) — — Workshops on the Register (S. 131) at the end of 1904:— Important classes of workshops, such as workshop bakehouses, may be enumerated here. Laundries 19 Bakehouses 33 Other 746 Total number of workshops on Register 798 37 TABLE VIII. Legal Proceedings under the Public Health (London) Act, 1891. Date. Premises. Offence. Result. 1904 January 28 9, Goldsmith Street Nuisance Prohibition order. 6s. costs February 2 8, Union Buildings do. Premises closed. Summons withdrawn March 11 and 18 121-128 Holborn Emission of black smoke Order to abate. Defendant to pay £2. 2s. costs May 3 38, Verulam Street Nuisance Prohibition order. 6s. costs „ 11 19, Long Yard do. Summons withdrawn. Change of ownership July 12 12, New North Street Breach of lodging.house bye-laws Breach abated. Costs paid. Summons withdrawn „ „ 1, Old North Street do. Defendant dead. Summons withdrawn „ „ 2, do. do. do. „ „ 21, do. do. Breach abated. Costs paid. Summons withdrawn „ „ 20, do do. do. „ „ 27, do do. do. „ „ 4, Dunstable Court do. do. „ „ 6, Short's Gardens do. do. „ „ 7, do do. do. „ „ 26, Red Lion Street do. Summons withdrawn „ „ 1, New North Street do. Breach abated. Costs paid. Summons withdrawn „ „ 9, do. do. do. „ „ 8, do. do. do. „ „ 53, Gloucester Street Nuisance Order to abate. £1. Is. costs ,, 14 26, New Compton Street Breach of lodging-house bye-laws Defendant convicted and fined £1 and 5s. costs „ „ 27, do. do. do. „ 26 24, New North Street Nuisance Nuisance abated. Costs paid. Summons withdrawn August 11 50, Eagle Street Insufficient W.C. accommodation Defendant convicted and fined 40s. and 2s. costs „ 15 31, Gloucester Street do. Defendant convicted and fined 1s. and 5s. costs 6, Long Yard Breach of bye.law. (Keeping of animals) Defendant convicted and fined 40s and 2s. costs ,, Hand 24, and September 21 25, New North Street Insufficient W.C. accommodation Defendant convicted and fined 40s. and 2s. costs November 8 10, Long Yard Breach of bye-law. (Keeping of animals) Defendant convicted and fined 40s. and 2s. costs " " 9, do Nuisance Order to abate in seven days. 6s. costs " 16 118-128 Holborn Emission of black smoke Defendant convicted and fined 40s. and £2. 2s. costs December 16 to January 13 1905 15, Leather Lane Buildings Overcrowding Overcrowding abated. Costs paid. Summons withdrawn „ „ 18, do do. do. „ „ 23, do. do. do. 38 TABLE VIII —(continued). Date. Premises. Offence. Result. December 16 to January 13 1905. 26, Leather Lane Buildings Overcrowding Overcrowding abated. Costs paid. Summons withdrawn „ „ 36, do. do. do. „ „ 38, do. do. do. „ „ 39, do. do. do. „ „ 40, do. do. do. „ „ 42, do. do. do. „ „ 44, do. do. do. „ „ 48, do. do. do. TABLE IX. Proceedings under the Factory and Workshop Act, 1901. Date. Premises. Offence. Result. 1904. Nov. 22nd and Dec. 14th. 70, Leather Lane Occupying underground bakehouse without a certificate Bakehouse closed, Summons withdrawn TABLE X. Proceedings under the Sale of Food and Drugs Act during the year 1904. Date. Name of Seller. Address of Seller. Offence. Result. 1904. January 6 Arnaldo Maffezzoni 1, Betterton Street Selling milk deficient in fat to the extent of 38 per cent. Defendant convicted and fined £5 and 12s. 6d. costs „ 7 Mrs. Buchanan 14, Tower Street Selling milk adulterated with 8.2 per cent, of added water Defendant convicted and fined 20s. and 12s. 6d. costs „ 15 Mrs. Colbey 3, Devonshire Street Selling butter containing 84 per cent, of foreign fat Defendant convicted and fined 20s. and 12s. 6d. costs February 16 Mr. H. Whelan 159, Drury Lane Selling milk deficient in fat to the extent of 19.3 per cent. Summons not served March 1 Mrs. Daniels 4, White Hart Yard Selling milk containing 17.1 per cent, of added water Warranty proved ; summons withdrawn „ „ Mr. R. Wakelin 15, Beauchamp Street Selling milk containing at least 7.7 per cent, of added water Defendant convicted and fined 40s. and 12s. 6d. costs ,, 31 and April 21 Farmer Cleveland Dairy Company Limited 13, East Street Selling milk containing at least 4.5 per cent of added water Summons dismissed Defendant's application for costs refused 39 TABLE X,—(continued). Date. Name of Seller. Address of Seller. Offence. Result. August 15 Mr. L. Bottell 61, Theobald's Road Selling preserved peas mixed with .0123 per cent, of copper Defendant convicted and fined 20s. and 2s. costs „ „ Do. Do. Selling preserved beans mixed with .0147 per cent, of copper Defendant convicted and fined 40s, and £2. 2s. costs „ 24 Mrs. A. Shepard 21, Full wood's Rents Selling milk containing 10 per cent, of added water Defendant convicted and fined 10s. and 12s 6d. costs October 8 Mrs. J. Daniells 3, White Hart Yard Selling milk adulterated with at least 19.0 per cent, of added water Defendant convicted and fined £5 and 12s. 6d. costs ,, 8 and 15 Arnaldo Maffezzoni 1, Betterton Street Selling milk from which 9.3 per cent, of fat had been abstracted Defendant convicted and fined £5 „ 24 David Jones 13, Chapel Street Selling milk containing 19.84 grains per gallon of boric acid Warranty proved; summons dismissed November 11 Mrs. Kerslake 8, Beaucbamp Street Selling margarine unlabel led Defendant convicted and fined 20s. and 12s. 6d. costs December 6 Barham & Marriage 9, High Holborn Selling brandy deficient in esters to the extent of at least 44 per cent. Defendant convicted and fined £5 and £10. 10s. costs „ „ F. J. Sanders 4, Southampton Buildings Selling brandy deficient in esters to the extent of at least 40 per cent. Defendant convicted and fined £2 and £2. 2s. costs „ „ R. C. Johnson 31, Newton Street Selling brandy deficient in esters to the extent of at least 68 per cent. Defendant convicted and fined £2 and £1. 1s. costs TABLE XI. Meteorology of London, 1904. (Deduced from observations at Greenwich under the superintendence of the Astronomer Royal.) 1904. Air Temperature. Bright Sunshine. Rain and other forms of Precipitation. Mean of— Mean of A. and B. Difference from Average. + Total possible. Total observed. Difference from Average + Number of days. Total fall. Difference from Average. + a. B. Minimum. Maximum. o o o Q hrs. hrs. hrs. ins ins. January 33.8 43.7 38.7 + 0.2 258 26.4 -2.9 16 2.51 + 0.52 February 34.5 44.4 39.4 - 0.1 287 50.9 - 1.9 19 2.55 + 1.07 March 33 .7 47.3 40.5 -1.2 367 85.0 -4.9 12 1.36 - 0.10 April 40.7 57.7 49.2 + 2.0 414 145.3 + 7.9 13 1.01 - 0.65 May 45.4 62. 0 53.7 + 0.6 482 135.8 - 46.0 14 1.92 - 0.08 June 486 68.4 58.5 - 0.9 494 198.2 + 15.3 8 0.87 -1.15 July 55.2 77 3 66.2 + 3.8 497 273.6 + 88.2 14 2.23 -0.24 August 51.8 73.0 62.4 + 0.8 450 232.9 + 60.8 8 1 34 - 1.11 September 46.9 64.7 55.8 - 1.4 378 164.7 + 30.0 11 1.34 -0.91 October 43. 6 57.5 50. 6 + 0.6 330 75.9 - 8 .7 16 1.74 - 1.07 November 36.7 47.5 42.1 - 1.1 265 46 0 + 3.4 11 1.65 - 0.62 December 35.6 44.9 40.3 + 0.6 244 23.9 - 1.1 23 2.25 + 0.48 Year 42.2 57.4 49.8 + 0.3 4,466 1458.6 + 140.1 165 20.67 - 3.86 + The averages used are obtained from observations extending over 50 years for Rain and Temperature, and 16 years for Sunshine . ' . . ' .