AC 4342 1 "NO BODY CAN BE HEALTHFULL WITHOUT EXERCISE." Telephone No. LORD VERULAM. GRAY'S INN . Enc. Holborn 7440. The Metropolitan Borough of holborn. C.W. H UTT,M.A,M.D,M.R.C.P.,D.P.H. Medical Officer of Health. ALL COMMUNICATIONS TO BE ADDRESSED TO THE MEDICAL OFFICER OF HEALTH. Town Hall, WC.l. PUBLIC HEALTH DEPARTMENT. 19th February, 1931. achd. Dear Sir, I have your letter of the loth instant asking for copies of the Annual Reports of the Medical Officer of Health of this Borough from 1867 onwards. I may inform you that this Borough was formed in the year 1900. Prior to that the area of the present Holborn Borough was under the municipal control of two Boards of Works. I regret that there are no spare copies of the reports of the respective medical officers of health of the two districts concerned. I am able however to supply you with copies of all the annual reports of the medical officers of health of the present Borough from the year 1900 up to the last published report, that of 1929, the only exception being the War years when the reports were not printed only the necessary official and file copies being made. I have also given instructions that in future copies of the Annual Reports as published are to be sent to you. Yours faithfully, The Librarian, Royal College of Surgeons, Lincolns Inn Fields, W.C.2. hol2 The Metropolitan Borough of Holborn. REPORT FOR THE YEAR 1905 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., SHEFFIELD STREET, LINCOLNS INN FIELDS, W.C. 1906 CONTENTS. page Introduction 5 Death Statistics 5 Birth-rates 5 Birth-rates and Death-rates 6 Infectious Diseases Notifications 6 Special Investigation and Re-organisation Committee, Report of 6 House Refuse, Removal of 7 Modified Milk for Infants 7 Sanitary Inspectors' Residences 8 Cleansing of Persons Act, 1897 8 Water supply in Tenement Lodging Houses 8 Area, Houses and Popuulation 8 Estimated Population, 1905 9 Rateable Value, 1905 9 Births and Birth-rates 10 Ditto ditto corrected 10 Care and Feeding of Infants 11 Mortality 12 Deaths registered in the Borough 12 Deaths in Public Institutions, etc., within the Borough 12 Deaths of Residents in Public Institutions outside the Borough 13 Corrected deaths and death-rates 14 Infantile Mortality 14 Ditto Modified Milk for Infants 15 Senile Mortality 16 Infectious Diseases 16 Deaths from Zymotic Diseases 16 Ditto during the year 1905 and the preceding ten years 17 Notifications of Infectious Diseases in the Borough during 1905 and the preceding ten years 18 Small-pox 20 Scarlet Fever 20 Ditto Secondary Cases 20 Ditto "Return" Cases 20 Ditto Errors in Diagnosis 21 Diphtheria 24 Ditto Secondary and "Return" Cases 24 Ditto Errors in Diagnosis 24 Enteric and Continued Fever 25 Measles 25 Whooping Cough 25 Diarrhoea 26 Phthisis or Consumption 26 Ditto ditto Voluntary Notification of Consumption 27 Ditto ditto Spitting 28 Influenza 28 Alcoholism 28 Cancer 28 A 2 4 page Sudden and Violent Deaths 29 Inquests 29 The Public Mortuary 29 Disinfections 29 Cleansing of Persons Act, 1894 30 Bacteriology 30 Housing of the Working Classes Act 31 Ditto Part I. Italian Colony 31 Ditto „ Union Buildings Area 34 Ditto Part II. Representations 35 Ditto Part III. Reid's Brewery Site 35 Premises Closed Voluntarily, Demolished, Rebuilt, etc. 35 Sanitary Work 38 House to House Inspections 38 Water Supply to New Buildings 39 Ditto to Tenement Houses 40 By-laws as to Houses let in Lodgings 40 Overcrowding 41 Removal of House Refuse 41 Removal of Manure 41 Common Lodging Houses 42 Factories, Workshops and Workplaces 43 Home Workers' Order 44 Bakehouses 44 Places where Food is prepared for Sale 45 Slaughter Houses 45 Other Offensive Businesses 46 Dairies, Cowsheds and Milk Shops 46 Ice Cream 46 Unsound Food 47 Smoke Abatement 47 Meteorology 47 APPENDICES. Table I. Vital Statistics of whole Borough during 1905 and previous 10 years 48 Table II. Vital Statistics of whole Borough and separate Localities in 1905 and previous 10 years 49 Table III. Cases of Infectious Disease notified during the year 1905 50 Table IV. Causes of, and Ages at Death during the year 1905 51 Table V. Infantile Mortality during the year 1905 52 Table VI. Sanitary Inspectors' Work—Inspections, &c. 53 Table VII. Ditto Notices, &c. 54 Table VIII. Proceedings during 1905 55 Table IX. Factories, Workshops, Workplaces and Homework 56 (1) Inspections 56 (2) Defects found 56 (3) Other matters 56 Table X. Legal Proceedings under the Public Health (London) Act, 1891 58 Table XI. Legal Proceedings under the London County Council (General Powers) Act, 1902 58 Table XII. Legal Proceedings under the Sale of Food and Drugs Acts 59 Table XIII. Meteorology 60 The Metropolitan Borough of holborn. REPORT of the Medical Officer of Health For the Year 1905. 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 1905, the various statistics for the year refer to the fifty-two weeks ended Saturday, December 30th, 1905, as adopted by the Registrar-General, and known as the Registration year. The death statistics do not exactly correspond with those of the RegistrarGeneral 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 respecting some of these deaths 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. I am now able for the first time to give a corrected birth-rate as the RegistrarGeneral gave permission at the latter part of the year 1904, for details of births to be supplied by the Sub-Registrars. If the births of infants whose mothers were nonresidents are excluded, the corrected birth-rate is reduced from 28.4 to 20.3 per 1,000. Of the 988 registered births in St. Giles and Bloomsbury, a large proportion of which took place at the British Lying-in Hospital, Endell Street, as many as 465 were of infants whose mothers were non-resident in the Borough. 6 The Holborn death-rate was only 16.9, the lowest death rate recorded for Holborn, the average death-rate for the preceding decennium having been 21.0 per 1,000. The lowest death-rates of previous years were 17.9 in 1904, 18.3 in 1903, 20.0 in 1901 and 20.4 in 1897. The London death-rate was 15.1 in comparison with 16.1 for the previous year. The corrected infantile mortality was 126 deaths under one year, per 1,000 births, in comparison with 129 for London. The death-rate from zymotic diseases in Holborn was again very low, and below that for London, viz., 1.06 per 1,000 in comparison with l.70. The death-rate from phthisis (consumption) has again diminished from 2.75 to 2.65 per 1,000. The London rate decreased from 1.62 to 1.42. The number of notifications of infectious diseases, excluding the voluntary notification of consumption, was only 263, the lowest recorded for the Borough; the preceding year when the number of notifications was 276, was the next lowest. The notification rate was 4.65 per 1,000 in comparison with 4.83 for the preceding year. The London rate was 7.0 per 1,000 compared with 6.0 for the preceding year. Under the heading of Scarlet Fever I again emphasise the importance of every Isolation Hospital being well supplied with small isolation rooms or wards, in fact that fever hospitals should be constructed so as to secure strict isolation as far as possible. I again allude to the Pasteur Hospital, Paris, in which the ideal system of hospital construction, viz., the cubicle system exists to a large extent, and show that some of the wards of existing hospitals could with advantage, at a small outlay, be adapted to the cubicle system. I also give some details respecting the excellent results that have been obtained there for the prevention of the spread of infection from patient to patient. Of 2,745 admissions infection was conveyed in less than 3 per 1,000. On the other hand from the Annual Reports of the Metropolitan Asylums Board 1900-1904 inclusive, of a total of 61,245 scarlet fever admissions, as many as 4,800 also suffered from other infectious diseases during their stay in hospital, i.e., more than 78 per 1,000. I also give a report of the Hospitals Committee of the Metropolitan Asylums Board respecting the accommodation of patients and errors of diagnosis. The Special Investigation and Reorganisation Committee of the Council, which was appointed to carefully investigate the various departments of the Council and to recommend such reorganisation of the staff and administration as they might consider desirable, reported to the Council on the 28th June, 1905, respecting the Public Health Department, as follows:— "We have most carefully considered the working of this Department with "reference to the number of staff employed; and are of opinion that, in view of "the amount of detail work to be performed, we cannot recommend any reduction "in number. 7 "The administration of this department of the Council's work is, we are pleased to say, very satisfactory, and, with the exception of a few suggestions, "relating principally to the duties of the Sanitary Inspectors, whom we have "interviewed, we have no recommendations to make." One of the principal changes in the Works Department, affecting the administration and work of the Public Health Department, which has taken place during the year on account of the above investigation, was the transference of the supervision of the removal of house and trade refuse from the Borough Surveyor's Department to the Public Health Department, as was also suggested in my report to that Committee. The Borough Surveyor used to have two dust inspectors; these were not transferred to this department; so that the work has to be done by this department without any increased staff. The change took place on the 26th June, 1905. Soon afterwards I reported to the Public Health Committee that there had been many breaches of the contract respecting the bi-weekly removal of refuse, and on the 26th July, the Council adopted the recommendation of the Public Health Committee, "that the Council do impose the penalty under his contract on the "contractor for neglecting or failing to remove house refuse from houses in the "Borough at least twice weekly as required by the contract." In consequence of this the contractor was fined £100, and after this the contract was carried out much more satisfactorily. The other principal changes during the year were:— Information giving details of births were supplied by the Sub-Registrars, so that houses of the working classes where births had taken place are now visited by the Lady Sanitary Inspector with a view to the reduction of preventable infantile mortality by greater care and attention to the feeding of infants, and one of our leaflets is left if thought desirable. In order to reduce the large amount of preventable illness and the enormous sacrifice of infant life due to improper feeding, modified milk has been provided in a great many towns in European countries and America. In England various milk depots have been established. Those in London being Battersea, Fulham, Lambeth and Woolwich, the last of which is not yet completed. As a supply of modified milk by this method in Holborn would be very costly, I endeavoured to arrange with the Express Dairy Company, Limited, to supply modified milk for infants of the working classes for about the same charges as at municipal milk depots. After much consideration the Company agreed to supply it at the reduced rate of 4d. (instead of 6d.) per day per infant. This prepared milk is supplied as at municipal milk depots in bottles in a basket, each bottle contains sufficient milk for one meal, the number of bottles and the modification of the milk varying with the age of the child. The milk is thus kept clean and free from infection or contamination. 8 The Public Health Committee and the Council have recently agreed for this to be supplied at the Company's depots in and near the Borough, on the production of a certificate to be obtained from the Medical Officer of Health. On the 12th July, 1905, the Council agreed to the following recommendation of the Public Health Committee:—"That in order that their services may be readily "available in cases of emergency, the three male Sanitary Inspectors in the employ "of the Council be required to reside within the Borough, and that in order to "enable them to comply with the foregoing requirement, their salaries be increased "£25 per annum." Prior to this, although inspections were made of the market streets on Saturday evenings and Sunday mornings no arrangements had been agreed to for the attendance of the Sanitary Inspectors at the Municipal Offices on Saturday evenings and Sundays to deal with infectious disease notifications or other matters of urgency. During the year there was a very large increase in the number of persons who were cleansed under the Cleansing of Persons Act, 1897. As many as 600 men and 13 women had free baths at the Casual Wards, and their articles of clothing, amounting to 3,470 articles were disinfected in the Council's steam apparatus. During the previous three years the number of persons cleansed under the Cleansing of Persons Act, 1897, were:—1902, 22; 1903, 16; and 1904, 9. The reason for this great increase was the publicity by means of hand-bills, announcing that free baths for men and women and facilities for the disinfection of clothing are provided by the Council. These hand-bills were issued in the month of June, and were placed in common lodging houses, Salvation Army shelters, underground conveniences, police stations, public libraries, dispensaries, and the out-patient departments of hospitals, including hospitals for the treatment of skin diseases. In consequence of the decision of the magistrate at the Woolwich Police Court, further steps were taken to secure the provision of a proper and sufficient supply of water for the tenants of houses let in lodgings. It was decided to deal in the first instance with the worst houses in which the only water supply was in the basement, and legal proceedings were not taken if an additional water supply was provided about midway between the ground and top floors. In only two cases legal proceedings had to be taken, and in each case the magistrate made an order for the work to be carried out. AREA, HOUSES AND POPULATION. Area. From the report of the Census, 1901, the area of the Borough is 405.l acres. 9 Houses. The number of inhabited houses 4,703 The number of houses occupied for business purposes only 989 The number of houses not in occupation 219 The number of houses building 29 Population. Males 29,489 Females 29,916 Total 59,405 Density of population 147 persons per acre. „ „ for London 61 „ „ Details for the different parts of the Borough, and details of the changes in the population due to changes in the boundaries under the London Government Act, were given in the Annual Report for the year 1901. Details of the age and sex distribution of the population were given in the Annual Report for the year 1902. The number of persons of foreign nationality in the Borough at the last Census was 5,706; 3,978 males and 1,728 females. Of these 2,029 were Italians, 1,098 Germans and 660 French. In the County of London the total number of foreigners was 135,377; 79,804 males and 55,573 females. Other details were given in the Annual Report for the year 1902. ESTIMATED POPULATION, 1905. The following are the estimated populations at the middle of the year 1905:— Bloomsbury and St. Giles 29,905 Holbcrn Sub-District 26,617 Holborn Borough 56,522 London 4,684,794 England and Wales 34,152,977 United Kingdom 43,219,788 RATEABLE VALUE, 1905. Bloomsbury and St. Giles £537,028 Holborn £432,446 Holborn Borough £969,474 b 10 NUMBER OF TENEMENTS. At the Census of 1901, the total number of tenements in the Holborn Borough was 13,790. As large a proportion as 37.5 per cent of the population lived in tenements of only one or two rooms, and 60.1 per cent. of the population lived in tenements of one to four rooms The following table gives details of tenements of 1, 2, 3 and 4 rooms:— Tenements with No. of Tenements. Percentage of all Tenements. Total Occupants. Percentage of Population in each Group of Tenements.[/### 1 room. 3,725 27.0 8,502 14.3 2 rooms 3,834 27.8 13,787 23.2 3 „ 2,224 16.1 9,175 15.4 4 „ 989 7.2 4,260 7.2 Total 10,772 78.1 35,724 60.1 REGISTERED BIRTHS AND BIRTH-RATES. Both Sexes. District. Males. Females. Legitimate. Illegitimate. Total. Birth rate[/### per 1,000. St. Giles and Bloomsbury Holborn 529 317 459 296 922 602 66 11 988 613 33.2 23.1 Whole Borough 846 755 1,524 77 1,601 28.4 CORRECTED BIRTHS AND BIRTH-RATES. The Registrar-General gave permission at the latter part of the year 1904 for details of births to be supplied by the Sub-Registrars. These details were at once supplied to us, so that I am now able to exclude the births of infants whose mothers were "non-residents." Of the 988 registered births in St. Giles and Bloomsbury, a large proportion of which take place at the British Lying-in Hospital, Endell Street, as many as 465 were of infants whose mothers were non-residents in the Borough. 11 The corrected numbers are as follows:— District. Corrected number of Births of Residents. Corrected Birth-rate per 1000. Legitimate. Illegitimate. Total. St. Giles and Bloomsbury 468 34 502 16.8 Holborn 630 11 641 24.1 Whole Borough 1,098 45 1,143 20.3 In London the number of births was 126,620, or a rate of 27.1 per 1,000. In England and Wales the number of births was 929,457, or a rate of 27.2 per 1,000. CARE AND FEEDING OF INFANTS. With a view to diminishing the preventable infantile mortality in the Borough a leaflet on the Care and Feeding of Infants was prepared in the early part of 1904, and great assistance was received from the Clergy of all denominations and various Philanthropic agencies through whom about 3,000 copies were distributed. On account of the information respecting births supplied by the Sub-Registrars from the beginning of December 1904, in 348 of the 1,143 births of residents of the Borough, where the mothers lived in lodging houses or tenements, visits have been made by the lady Inspector and one of the above leaflets left if thought desirable. The Sub-Registrars now give us the following information respecting births:— When and where born; name and sex of the child; name and surname of the father ; name and maiden surname of the mother, and the occupation of the father; The lady Inspector obtains the following additional information:—Position and number of rooms occupied in lodging house or tenement; number of other children that have been born, including the number that have died; nature of the food given to infant and method of feeding; whether the child sleeps in a cot or not; occupation of the mother. If thought desirable instructions are given respecting the care and feeding of the child and a leaflet left. Notices are also served for any sanitary defects that may be found. Of the 348 that were visited during the year, 290 were naturally fed or 833 per cent., and the remainder, 58 or 16.7 per cent. were artificially fed. Of the 58 artificially fed, in 37 cases boat bottles were used, in 20 tube bottles, and in one no bottle was used. Of these 58 cases the mother was physically unable to nurse in 25 cases, the B 2 12 child unable to suck in 5 cases, the child removed to hospital in 5 cases, the mother obliged to work in 21 cases, the mother objected to breast milk in one case and the mother removed to hospital in one case. In a large majority of the cases the child was not two months old at the time of the visit. This accounts for the high percentage of naturally fed children. Only 53 mothers had employment at the time of being visited other than attending to their homes and children. The following table gives details of their employment, and the number oi children artificially of naturally fed. Kind of Employment. Number of Mothers. Children Artificially fed. Naturally fed. Laundress 6 1 5 Charing 16 5 11 Selling 11 3 8 Tailoring (Home-workers) 13 1 12 Other Home-work 2 0 2 Theatrical 2 2 0 Factory or Workshop 3 3 0 Total 53 15 38 MORTALITY. The following deaths have been registered in the Borough (1905):— Bloomsbury and St. Giles. Holborn. Total Males 157 463 620 Females 153 358 511 Total 310 821 1,131 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 Bloomsbury. Holborn. St. Giles Workhouse 42 3 9 — French Hospital 4 — 29 — British Lying-in Hospital 1 1 9 — Children's Hospital 9 20 — 413 National Hospital 2 1 — 64 London Homoeopathic Hospital 4 4 — 47 Italian Hospital 1 2 — —- 14 Orthopædic Hospital — — — 1 Private — — 14 4 Total 63 31 61 543 13 The following deaths of Parishioners occurred in Public Institutions outside the Borough:— institution. Number. St. Giles and Bloomsbury. Holborn. Holbom Workhouse 1 51 Holborn Workhouse, Mitcham — 14 Holbom Infirmary 1 84 Central London Sick Asylum 85 3 Banstead Asylum 3 1 Camberwell Asylum 1 — Cane Hill Asylum 3 3 Caterham Asylum 4 4 Claybury Asylum 1 — Colney Hatch Asylum 2 1 Tooting Bec Asylum 1 1 Hanwell Asylum 8 — Horton Asylum 4 1 L.C.C. Asylum, Norwood — 2 L.C.C. Asylum, Dartford 1 1 London County Asylum, Leavesden 2 1 Friern Barnet Asylum 1 — Grove Hall Asylum 1 — Westminster Workhouse 2 1 Strand Union Workhouse, Edmonton 1 — Islington Infimary 1 — Kensington Infirmary 1 1 Hackney Union 1 — North-Western Fever Hospital 3 4 Eastern Hospital — 3 Cancer Hospital, Chelsea — 1 Guy's Hospital 1 1 St. George's Hospital 1 1 Central London Ophthalmic — 1 Charing Cross Hospital 22 3 King's College Hospital 14 16 Middlesex Hospital 10 4 London Temperance Hospital 1 — Royal Free Hospital 2 7 Heart Hospital. Soho Square — 1 Belgrave Hospital for Children 2 — Evelina Hospital — 1 St. Peter's House, Pembridge Square 1 — St. Peter's House, Lambeth 1 — St. Bartholomew's Hospital 2 10 Friedenheim Hospital 1 — University College Hospital 5 2 Great Northern Hospital 1 — Aged Pilgrims Asylum, Islington St. Thomas's Hospital — 1 — 1 German Hospital — 2 St. Barnabas Home, Clerkenwell — 1 Private Nursing Homes, &c 4 1 River Thames — 3 Public Way — 2 H.M. Prison, Pentonville 1 — Total 192 235 14 CORRECTED DEATHS AND DEATH-RATES, 1905. 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 Bate for 1905. Corresponding period 1904. In Borough. Beyond Borough. Bloomsbury and St. Giles 810 98 61 15 192 452 15.2 14.7 Holborn Sub-District 821 582 453 4 235 502 18.9 21.5 Whole Borough 1,131 680 604 427 954 16.9 17.9 Registration London 70,442 15.1 16.1 No. of Deaths. Death-Rate. Bloomsbury and St. Giles 452 15.1 Holborn Sub-District 502 18.9 Holborn Borough 954 16.9 London 70,442 15.1 England and Wales 519,939 15.2 The death-rate for the year 1905 was only 16 9 per 1,000—the lowest death-rate recorded for Holborn—the average death-rate for the preceding decennium having been 21.0 per 1,000. The lowest death-rates in previous years having been 17.9 in 1904, 18.3 in 1903, 20.0 in 1901, and 20.4 in 1897. INFANTILE MORTALITY. The number of deaths of children under five years of age was:— St. Giles and Bloomsbury 88 Holborn Sub-District 132 Holborn Borough 220 The number of deaths of children under one year of age, and the number of deaths of children under one year of age per 1,000 total registered births and per 1,000 corrected births, were the following for:— Deaths under 1 year of age. Deaths under 1 year per 1,000 births. Deaths under 1 year per 1.000 corrected births. St. Giles and Bloomsbury 61 62 121 Holborn Sub-District 84 137 131 Holborn Borough 145 91 126 London 16,324 129 The principal causes of death of these 145 children under one year of age are given in table V. of the Appendix. 15 Of the 145 deaths of infants during the year it was possible for the lady Inspector to make enquiries and obtain details respecting 123. Sixty-two out of the 123 or just over 50 per cent. were artificially fed. Of these, only 11 were fed with tube bottles. This great diminution in the use of tube bottles is partly due to a cheap boat bottle now obtainable, and partly to an increased realisation of the danger of tube bottles. Only 7 mothers worked in a factory or workshop during the child's life; 15 others did charing, selling flowers or other work outside the home, and 5 were engaged in home work. Only 20 were prevented by their work from properly attending to their children. 22 of the children died in hospital or infirmary, the majority of whom were already in a dangerous condition when taken to the hospital. Of the 19 deaths from diarrhoea and enteritis respecting which enquiries were made, only 3 of the infants had been naturally fed, in 5 cases tube bottles were used, in 8 cases boat bottles, and in the remaining 3 cases patent food was used. In the months of July, August and September, 1904, out of 46 enquiries respecting the deaths of infants under one year of age, it was found that as many as 36 or nearly 80 per cent. were artificially fed, and as many as 24 of the deaths were from summer diarrhoea. In order to reduce the large amount of preventable illness, and the enormous sacrifice of infant life due to the improper feeding, modified milk has been provided in a great many towns in European countries and America. In England, various milk depots have been established. Those in London being Battersea, Fulham, Lambeth and Woolwich, the last of which is not yet completed. As a supply of modified milk by this method in Holborn would be very costly, I endeavoured to arrange with the Express Dairy Company, Limited, to supply modified milk for infants of the working classes for about the same charges as at municipal milk depots. After much consideration, the Company agreed to supply it at the reduced rate of 4d. (instead of 6d.) per day per infant. This prepared milk is supplied as at municipal milk depots in bottles in a basket, each bottle contains sufficient milk for one meal, the number of bottles and the modification of the milk varying with the age of the child. The milk is thus kept clean and free from infection or contamination. The Public Health Committee and the Council have recently agreed for this to be supplied at the Company's depots in and near the Borough, on the production of a certificate to be obtained from the Medical Officer of Health. As instructed, a leaflet has been printed and is about to be circulated advising the use of prepared milk for infants who cannot be breast fed and giving information as to the facilities offered for obtaining such milk at a low price. 16 SENILE MORTALITY. The number of deaths of persons 65 years of age and upwards was in:— Bloomsbury and St. Giles 110 Holborn Sub-District 117 Holborn Borough 227 Bloomsbury and St. Giles. Holborn Sub-District. Total. Of these the numbers were— 65 years and under 70 41 40 81 70 „ „ 75 26 26 52 75 „ „ 80 19 26 45 80 „ „ 85 14 20 34 85 „ „ 90 9 5 14 91 years of age 1 — 1 110 117 227 INFECTIOUS DISEASES. The number of notifications of infectious diseases in the Borough during 1905 was again very small in comparison with any of the preceding ten years. The number of notifications being only 263 in comparison with a decennial average of 543. 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 Diarrhœa, was only 59 during the year in comparison with a decennial average of 136. DEATHS FROM ZYMOTIC DISEASES. During the year 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, and the death-rate from these diseases were: — Number. Zymotic Death-Rate. Bloomsbury and St. Giles 23 0.77 Holborn Sub-District 36 1.36 Holborn Borough 69 1.06 And for London 7,894 1.70 17 The following are the numbers of deaths from the separate diseases :— Bloomsbury anil St. Giles. Holborn Sub-District. Holborn Borough. Small-pox - - - Measles 3 8 11 Scarlet Fever 1 2 3 Diphtheria and Membranous Croup - 4 4 Whooping Cough 6 9 15 Typhoid Fever 3 1 4 Typhus - - - Diarrhœa 10 12 22 Total 23 36 59 DEATHS FROM ZYMOTIC DISEASES OCCURRING IN THE BOROUGH DURING THE YEAR 1905 AND DURING THE PRECEDING TEN YEARS. St. Giles and Bloomsbury. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. 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 1904 2 12 — 4 2 2 10 32 Average for 10 years 1895-1904. 5.9 15.1 3.5 6.3 9.3 4.5 17.7 62.3 1905 — 3 1 — 6 3 10 23 Holborn Division. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. 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 1904 — 31 — 3 6 2 25 67 Average for 10 years 1895-1904. 2.1 22.9 2.3 8.2 12.1 3.1 23.0 73.7 1905 — 8 2 4 9 1 12 36 c 18 Whole Borough. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. 1895 1 58 11 20 21 2 54 167 1898 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 10 12 42 133 1902 46 30 8 11 27 6 14 142 1903 — 17 4 7 15 5 22 70 1904 2 43 — 7 8 4 35 99 Average for 10 years 1895-1904. 7.8 38.0 5.8 14.5 21.4 7.6 40.7 136.0 1905 — 11 3 4 15 4 22 59 NOTIFICATIONS OF INFECTIOUS DISEASES IN THE BOROUGH DURING 1905, 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. 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 1904 5 19 37 22 — 38 4 - 125 Average for 10 years 1895-1904. 34.0 44.9 110.5 25.2 .2 62.3 1.5 .1 278.7 1905 1 10 68 14 — 20 1 — 114 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 the following voluntary notifications of Phthisis:—1904 157. 1905 99. 19 Holborn District. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Totals. 1895 31 60 160 20 - 61 1 - 333 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 1904 1 27 62 19 — 39 8 — 151 Average for 10 years, 1895-1904. 14.5 77.9 106.4 21.2 .3 42.4 1.7 .1 264.5 1905 — 37 88 7 1 15 1 — 149 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 the following voluntary notifications of Phthisis:—1904 187. 1905 109. Whole Borough. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 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 — 348 1904 6 46 99 41 77 7 — 276 Average for 10 vears 1895-1904. 48.5 122.8 216.9 46.4 .5 104.7 3.2 .2 543.2 1905 1 47 156 21 1 35 2 - 263 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 the following voluntary notifications of Phthisis: —1904 344. 1905 208. C 2 20 SMALL-POX. There was no small-pox in the Borough during the year, for the only notification (received during April) was that of a medical student who had been attending the out-patients' department of one of the large hospitals, and who was soon afterwards found to be really suffering from chicken-pox. SCARLET FEVER. During the 52 weeks ended Saturday, December 30th, 1905, the number of scarlet fever notifications, excluding duplicates, was 156; 68 belonging to St. Giles and Bloomsbury, and 88 to the Holborn Division. In the St. Giles District all the cases were removed to hospital, and in the Holborn District all except six. In 1904 the number was 99, and in 1903, 144. The decennial average was 216. The disease was most prevalent in the Borough between the latter part of March and the middle of May, and again from the middle of September to the end of November. The principal school affected in the former period was St. George, Bloomsbury, and in the latter period Christ Church School, Herbrand Street. There were 12 cases of scarlet fever notified amongst the children attending the latter school, eleven of them in the Infant's Department out of an average attendance of 111. After a consultation with the Medical Officer of the Education Department of the London County Council, the Infants' Department was closed for rather more than a fortnight, viz., from the 24th November to the 11th December, 1905. The whole of the Infants' Department of the school and the cloak rooms, lavatories and waterclosets were thoroughly disinfected. After the closure of the school there were no further cases of scarlet fever notified amongst any of the children attending the school. In the months of April and May there was an outbreak of scarlet fever at the Holborn Infirmary. Nine of the cases had been resident in this Borough and were therefore notified to me. Secondary Cases of Scarlet Fever. Of the 156 cases of scarlet fever, 133 occurred at different houses in which there was no secondary case. In eight houses there were two cases, in one house there were three cases, and in one large tenement house there were four cases, so that in all there were thirteen secondary cases. Return Cases op Scarlet Fever. During the year there was one return case, i.e. a secondary case in which the illness began on the 21st day after the return from hospital of the primary case. The 21 primary case had been in hospital seven weeks and had had a slight discharge from the ears for three days which had however entirely ceased fourteen days before his leaving the hospital, and there had been no recurrence, and the patient had been in every way quite well since his return from hospital. He was removed to the fever hospital from a General Hospital where he had attended as an out patient. One of the secondary cases mentioned above began to suffer from scarlet fever on the 51st day, or more than seven weeks after the removal of the primary patient to hospital. The primary case was not discharged until more than three weeks after this, but if he had happened to have been discharged from hospital after a stay of seven weeks or less, this secondary case would also have been considered a "return" case, although the primary patient in this case would not have been the source of infection. There was also another secondary case which began to suffer from scarlet fever on the 37th day or more than five weeks after the removal of the primary patient to hospital, and the primary case was not returned home until three weeks after the removal of the secondary case. Errors in Diagnosis. During the year three patients were returned from the Metropolitan Asylums Board Hospitals as not suffering from scarlet fever. One was returned forthwith to the hospital from which it had been removed ; one after a stay of eight days; and the third after a stay of 28 days. As the number of cases notified was 156, the errors of diagnosis were less than 2 per cent., and were less than the general average for the whole of London which in the year 1904 was 6-7 per cent., and in the year 1903, 7*0 per cent. The Council desired to ascertain whether a Conference on the subject between the various Metropolitan Boroughs and the Metropolitan Asylums Board could, with advantage, be held to discuss the matter, and a suggestion was made that the Medical Officer of Health should be required to confirm the diagnosis of the Medical Practitioner in all cases prior to removal. To this the Metropolitan Asylums Board replied that the following report of the Hospitals Committee had been approved and adopted by the Board. Extract from Report op Hospital Committee. "2nd November, 1905. "(1) Accommodation of patients.—On the 14th October last, the Board referred to us for report a letter from the Council of the Metropolitan Borough of Holborn, dated 18th September, 1905, in which they call attention to an alleged expenditure amounting, according to their estimate, to about £60,000, which they say has been 22 occasioned by the admission during the last five years into the Board's hospitals of some 10,000 cases not suffering from diseases for which these hospitals are provided, and suggest a conference between the Board and the several Metropolitan Borough Councils to consider the subject. "As regards the financial statement, the Holborn Borough Council seems to have been misled. The Accountant of the Board has estimated that the extra cost to which the Board has been put by the admission of these patients would not exceed an average sum of £3,200 per annum. "As regards the matter which it is proposed to discuss, it is undeniable that in the earlier stages of many cases of infectious disorder there can be no absolute certainty of diagnosis, and that to detain at home every patient until such certainty is attained must frequently result in the spread of infection, the prevention of which is the primary object of the Board's hospitals. "It must, therefore, be always wiser to remove a doubtful case than to leave it outside with the danger of infecting others, which, if done, would of necessity increase the number of admissions, and thus cause a very considerable expenditure of the rates. "The business of the Managers is to receive cases which are certified by a qualified practitioner, provide proper accommodation, and then leave them in the experienced hands of the medical superintendents. "In our opinion, the Managers would be going quite beyond the scope of their functions if they took any step which would have the effect of discouraging medical practitioners from freely exercising their judgment in seeking for their patients admission to the Board's hospitals. "The suggestion that the Medical Officer of Health should confirm the diagnosis is not one for the Board; but in our opinion it is very doubtful whether such a proceeding would be of any value, and it certainly would be attended with distinct disadvantages. "We do not see that any useful purpose would be served by such a conference as the Borough of Holborn suggest, and we cannot recommend the Managers to take any part therein." The Public Health Committee finally decided not to hold the Conference, and the matter was referred to the Metropolitan Borough Councils Association, who after due consideration gave a similar reply to that of the Metropolitan Asylums Board. I fully agree with the opinion of the Metropolitan Asylums Board and the Metropolitan Borough Councils Association, as I have always been in the habit of seeing doubtful cases when asked to do so by doctors in attendance, and therefore fully appreciate the extreme difficulty and sometimes impossibility of making a certain diagnosis. 23 In my Annual Report for the year 1903, I suggested various means that I was of opinion would reduce the number of "Return" cases and reduce the length of the stay of patients in hospitals. I emphasised the importance of every infectious hospital being well supplied with small isolation wards, that general wards for scarlet fever, diphtheria and measles should, if possible, be small rather than large so as to lessen the risk of the spread of other infectious diseases accidentally introduced. In fact that fever hospitals should be constructed so as to secure isolation as far as possible. I mentioned that the ideal system of hospital construction, viz., the cubicle system exists at the Pasteur Hospital, Paris, which is in connection with the Pasteur Institute. Even this hospital, however, is not wholly ideal, for on each floor, in addition to 12 cubicles there is also a common ward containing 12 beds for convalescents. In March, 1904, Dr. Louis Martin, resident physician of the Pasteur Hospital, published a paper in Le Bulletin Medical, giving details of the structure of the hospital, and the study of 2,000 consecutive cases treated at the hospital. From the 1st October, 1900, to the 17th April, 1903, the 2,000 patients received at the hospital were:— 524 Small-pox. 55 Chicken-pox. 443 Diphtheria. 166 Non-diphtheritic throat affections. 126 Measles. 92 Scarlet fever. 163 Erysipelas. 20 Tonsilitis. 7 Rabies. 26 Anti-rabies treatment. 7 Preventive anti-diphtheritic treatment. 192 Mothers of sick childrea or children of sick mothers. 179 Other illnesses not included under the above headings. Although the convalescents are treated in wards containing twelve beds, and more than one-fourth of the patients were suffering from small-pox, infection was conveyed to other patients in only six cases, viz., 4 small-pox and 2 erysipelas—i.e., only 3 per 1,000. At the time of Dr. Martin's report, 745 fresh patients had been received, and there had been only two new infections, viz., one small-pox and one convalescent from scarlet fever had contracted diphtheria. Therefore, of 2,745 admissions infection was conveyed in less than 3 per 1,000. From the Annual Reports of the Metropolitan Asylums Board for five years, 1900 to 1904 inclusive, of a total of 61,245 scarlet fever admissions, as many as 4,800 also suffered from other infectious diseases during their stay in hospital—i.e., rather more than 78 per 1,000. 24 As in my Annual Report for 1903, I will again quote from Professor Simpson's paper on infectious hospitals (Journal of State Medicine, September, 1903). "It appears to me that in future hospitals for infectious disease the cubicle system is the one to be adopted. I do not advocate the absence of classification of cases which characterises the Pasteur Hospital, but I do advocate that a patient sent for treatment to an infectious hospital shall be isolated, and not segregated with others, to the disadvantage of both. And in regard to the existing hospitals, many wards could with advantage be converted into the cubicle system. Glass is now made as strong as ordinary walls, and there would be no difficulty in having the lower part opaque while the upper part was transparent for purposes of administration and light. One set of cubicles could be used for the admission of patients until it was determined whether two diseases co-existed. In th6 event of co-existent diseases, they could be treated in the cubicle until well; while in the event of it turning out to be the disease for which it was sent to hospital, the patient could be drafted after a certain time into a suitable common ward where the cases were classified. Another set of cubicles would provide isolation rooms for all patients suffering from discharges, thus preventing any possibility of spreading to other cases, and avoiding the danger of remaining in a ward in which infectious material could be engrafted on the discharges. In this manner some of the advantages of the cubicle system could be secured in hospitals already built." DIPHTHERIA. The number of cases of diphtheria notified was only 47, of which 10 belonged to St. Giles and Bloomsbury and 37 to the Holborn Division. All but two patients were removed to hospital. The average number of notifications for the preceding decennium was 122; 44 for St. Giles and Bloomsbury, and 77 for the Holborn Division. During the year there were four deaths, all belonging to the Holborn Division. There was no special outbreak during the year. The disease was most prevalent in the Borough in the month of October, during which month there were 11 notifications. Secondary and "Return" Cases. There were four secondary cases all of which were notified about a week after the primary case. There were no return cases. Ekboks in Diagnosis. Only one patient was returned from hospital as not suffering from diphtheria on the thirteenth day after admission. The remarks under the heading of scarlet fever apply in a similar manner to diphtheria. 25 ENTERIC FEVER. Excluding duplicates, there was only 21 notifications of enteric fever in comparison with 41 the previous year; of which 14 belonged to St. Giles and Bloomsbury and 7 to the Holborn Division. The average number of notifications for the preceding decennium was 46; 25 in St. Giles and Bloomsbury and 21 in the Holborn Division. All the cases were removed to hospital. Four of the patients were returned from hospital as not suffering from enteric fever. Of the remaining 17 cases 5 were not contracted in the Borough, and two of the patients, who were notified the same day, were nurses at one of the hospitals in the Borough. Of the 17 cases 4 died from enteric fever. MEASLES. Measles was only prevalent in St. Giles and Bloomsbury during the months of January, February and March, and in the Holborn Sub-division in the months of May, June and July. I had information from various sources, principally from schools, of only 164 cases, excluding those subsequently found not to be measles, in comparison with as many as 444 cases in the preceding year. Of the 40 cases of which I received information during the month of January, 36 lived in St. Giles and Bloomsbury and as many as 32 occurred in families who had children attending the Christ Church School, Herbrand Street. Most of them had contracted the disease at a party at the school on the 21st December, 1904. Other children attending the school who lived in St. Pancras were also attacked. The outbreak in the Holborn Division during the months of May, June and July, was principally amongst children attending the St. George-the-Martyr, Saffron Hill and Princeton Street Schools. There were only 11 deaths from measles registered during the year in comparison with 43 for the preceding year. Of these. 3 belonged to St. Giles and Bloomsbury and 8 to the Holborn Division. All were young children under five years of age. The decennial average was 38; 15 for St. Giles and Bloomsbury, and 23 for the Holborn Division. All the cases were investigated and reported upon and revisited until recovery or death and endeavours made to prevent the spread of infection principally by the lady Sanitary Inspector. WHOOPING COUGH. During the year there were 15 deaths from whooping cough, the same as for the preceding year, in comparison with an average for the preceding decennium of 21. D 26 Of the 15 deaths, 6 occurred in the St. Giles and Bloomsbury and 9 in the Holborn Division. All were of children under five years of age. The decennial average for the two divisions was 9 and 12 lespectively. DIARRHŒA. The number of deaths from diarrhcea during the year was 22, in comparison with an average of 40 during the previous decennium, the lowest being 14 in the year 1902 and the highest 56 in the year 1899. Of the 22 deaths, 10 belonged to St. Giles and Bloomsbury, and 12 to the Holborn Division. The decennial averages for these divisions of the Borough were 18 and 23 respectively. Twenty-one of the 22 deaths were of children under 5 years of age, 20 being children under one year; 16 of the 22 deaths occurred in the third or summer quarter of the year, all but one being children under one j'ear of age. There were also 11 deaths from enteritis during the year, only two of which occurred during the summer quarter. Of 19 deaths of young children under one year of age from diarrhceal diseases respecting which inquiries were made by the lady Sanitary Inspector, as many as 16, or more than 84 per cent, were artificially fed. Nine of the mothers were engaged in work outside the home, and one of the mothers was dead. PHTHISIS OR CONSUMPTION. The number of deaths from phthisis during the year 1905 was 149, equivalent to a death-rate of 2.65 per 1,000, of these 79 belonged to St. Giles and Bloomsbury, being a death-rate of 2.65 per 1,000, and 70 to the Holborn District or a death rate of 2.65 per 1,000. The corrected number of deaths for London was 6,622, the corresponding deathrate being 1.42 per 1,000. The number of deaths from other tubercular diseases was 32; of these 13 belonged to St. Giles and Bloomsbury, and 19 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, 1896 to 1905, inclusive. Year. Holborn Borough. London. Kate per 1,000 Deaths. Rate per 1,000. 1896 215 3.03 1.68 1897 197 2.87 1.72 1898 220 3.26 1.74 1899 207 3.12 1.86 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 1905 149 2.65 1.42 27 VOLUNTARY NOTIFICATION OE CONSUMPTION. The voluntary notification of consumption which was in the first instance put into force for a period of 12 months from the 1st January, 1904, the fees to be paid being the same as for the notifiable diseases, was extended to the year 1905, and has since been further extended for the three years 1906-1908 inclusive. Excluding a few duplicates there were 208 cases notified, 99 belonging to St. Giles and Bloomsbury and 109 to the Holborn Division. The cost of the notifications was £13. 2s. During the year 1904, there were 344 cases notified, 157 belonging to St. Giles and Bloomsbury, and 187 to the Holborn Division. About 70 per cent, of the persons notified, viz., 142 had been living in common lodging houses and these were all at once or soon afterwards removed to infirmaries. With a few exceptions the remaining 66 lived in tenement houses and 45 of them were soon removed to infirmaries or hospitals so that only 21 remained at home. In the majority of cases which were at once removed to infirmaries from common lodging houses the patients could not be seen to obtain any details respecting their illness. It was possible, however, to obtain details respecting 94 cases. 36 cases were visited at the St Giles Workhouse, of which 28 came from common lodging houses and 8 from tenement houses. In a few cases the patients were too ill to obtain any details. 41 homes were visited after the removal or death of patients, 17 after removal to infirmary and 24 after death. 23 homes were visited during the life of the patient. In the 94 cases respecting which details were obtained: — No relative known to have had phthisis 69 Relative or relatives had had phthisis over five years ago 21 Ditto. less than five years ago 4 Total 94 Length of illness. Under one year 54 One year and under five 20 Over five years 18 Unascertained 2 Total 94 d 2 28 Previous Infirmary or Hospital treatment or not:— No previous infirmary or hospital treatment 49 Previous treatment at one hospital or infirmary 33 Do. two do. 10 Do. three do. 2 Total 94 If the patient has not been removed to hospital or infirmary this is advised if thought desirable. A copy of our leaflet is left with the patient, which gives brief general directions for the prevention of the spread of the disease. The premises also are inspected and notice served for any sanitary defects that are found. After death or removal to infirmary or hospital, disinfection is advised. Consent for this was, however, obtained in only 80 cases. SPITTING. During the year 1904, 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. INFLUENZA. During the year there were only 7 deaths registered as due to influenza—1 in St. Giles and Bloomsbury, and 6 in the Holborn Division. ALCOHOLISM. Only 21 deaths were assigned to alcoholism or cirrhosis of the liver, 12 in St. Giles and Bloomsbury and 9 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. Forty-nine deaths were registered as due to cancer or malignant disease, 30 belonging to St. Giles and Bloomsbury and 19 to the Holborn Division. Further details as to the causes of and ages at death are given in Table IV. of the Appendix. 29 SUDDEN AND VIOLENT DEATHS. Inquests. The following inquests on the bodies of Parishioners were held:— Coroner : Dr. G. P. Danford Thomas, Paddington Mortuary, Paddington. Inquiry Officer : Mr. Richard Powell, 58, Hemingford Road, Barnsbury, N. Total Number. Cause of Death. Natural. Accidents. Suicide. Execution by Law. St. Giles and Bloomsbury 49 29 14 5 1 Holborn 65 30 17 8 - Total 104 59 31 13 1 THE PUBLIC MORTUARY, GOLDSMITH STREET. 153 bodies were received (31 being non-parishioners), and on these 81 inquests were held, and 31 post-mortems made. District. Bodies Received. Inquests held. Post-mortems. Jfon- Parishioners. St. Giles and Bloomsbury 64 36 29 12 Holborn 89 45 29 19 Total 153 81 58 31 DISINFECTIONS. During the 52 weeks ended December 30th, 1905. District. Rooms. Bedding, &c. Number of Articles. N umber of Persons using Refuge. St. Giles and Bloomsbury 200 3,742 - Holborn 199 3,250 3 Whole Borough 399 6,992 3 30 CLEANSING OF PERSONS ACT, 1897. During the year there was a very large increase in the number of persons who were cleansed under the above Act. As many as 600 men and 13 women had free baths at the Casual Wards, and their articles of clothing, amounting to 3,470 articles, were disinfected in the Council's steam apparatus. During the previous three years the number of persons cleansed under the above Act were :—1902, 22; 1903, 16; and 1904, 9. The reason for this great increase was the publicity by means of hand-bills announcing that free baths for men and women and facilities lor the disinfection of clothing are provided by the Council. These hand-bills were issued in the month of June, and were placed in common lodging houses, Salvation Army shelters, underground conveniences, police stations, public libraries, dispensaries, and the out-patient departments of hospitals, including hospitals for the treatment of skin diseases. In my report to the Public Health Committee respecting the matter, I informed them that I had inspected the baths at the Casual Wards and found that there were five baths on the ground floor for the use of men and the same number on the top floor for women, so that there is ample accommodation for the cleansing of a much larger number of persons than had hitherto made application. I also pointed out the following advantages which would be obtained by making use of the baths at the Casual Wards:— No outlay for the provision of baths would be required. These baths will not be affected by any change or extension, if any, of the Council's offices. The baths adjoin the Council's stone yard, in which are the steam disinfectors. This is the method that has been adopted since the passing of the Act, and sanction for the use of the baths was given by the Guardians of the Poor for St. Giles and Bloomsbury. On account of alterations which were carried out at the St. Giles and Bloomsbury Casual Wards during the latter part of the year the cleansing of persons had to be limited to those resident in the Borough, and arrangements were made with the Holborn Guardians for not more than six persons of each sex per day, resident either in this Borough or in the Borough of Finsbury, to have free baths and their clothing disinfected at the Casual Wards, Little Grays Inn Lane. BACTERIOLOGY. Facilities have for many years been afforded to Medical Practitioners for the bacteriological examination of material in suspected cases of diphtheria and enteric fever. In 1904 when the voluntary notification of consumption was adopted facilities were also afforded by the Council for the bacteriological examination of sputum from suspected cases of consumption. 31 The following table gives details of the examinations made by the Lister Institute of Preventive Medicine during the year. District. Diphtheria. Enteric Fever. Consumption. Number Submitted. Result of Examination. Number Submitted. Result of Examination. Number Submitted. Result of Examination. St. Giles and Bloomsbury 11 9 bacilli not found 11 f4 Positive 1 (1 bacilli not found 2 bacilli found 7 Negative - bacilli found Holborn 2 2 bacilli not found 7 4 Positive 2 2 bacilli not found -bacilli found 3 Negative - bacilli found Whole Borough 13 11 bacilli not found 18 8 Positive 3 3 bacilli not found 2 bacilli found 10Negative - bacilli found HOUSING OF THE WORKING CLASSES ACT. Under Part I. of the Act. WARNER STREET AREA (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 situate between Warner Street on the north, the backs of the houses fronting Clerkenwell Road on the south, Back Hill on the east, and the backs of the houses in Eyre Street Hill, Eyre Court and Red Lion Yard on the west. It is about two acres (1*86 acres) in extent and comprises about 125 houses and premises; thirty-eight of the houses are in five small courts. The population of the area was about 1,170, almost all of whom are Italians of the labouring classes. The density of the population was therefore 629 per acre, in comparison with 147 for the Holborn Borough, and 61 for the whole of London. In 1901, soon after the representation was made, Nos. 26 to 31 inclusive, Eyre Street Hill, were demolished and rebuilt as factories, and in January, 1904, all the houses in Summers Court were voluntarily closed. During 1905, Nos. 7 and 8, Summers Street were voluntarily closed, when legal proceedings for their closure under Part II. of the Act were being initiated, and notwithstanding repeated promises of development of the area, the houses were repaired and reoccupied by October, 1905. Nos. 1 and 2, Eyre Terrace, were closed by Magistrate's order under Part II. of the Act. 32 On account of these changes the population of the area has been diminished, and at a census taken by this department in the early part of the year 1905, the population was found to be 947, of which 168 were under 10 years of age. The death-rate of the area during 1905 was 26.5 per 1,000 in comparison with 16'9 for the whole Borough; the zymotic death-rate was 3.17 per 1,000 in comparison with 1.06 for the whole Borough; the death-rate from phthisis was 3.17 in comparison with 2.65 for the whole Borough, and the infantile death-rate was 167 per 1,000 births in comparison with 126 for the whole Borough. I estimated the average death-rate of the area for the previous five years, 19001904 inclusive, at 25.7 in comparison with 19.9 for the whole Borough. These death-rates would be still higher if corrections were made for sex and age distribution. During the same five years the zymotic death-rate in the area was 4.15 in comparison with 1.92 for ttie Holborn Borough, on the other hand, the phthisis deathrate was only 1.32 in comparison with 2.86 for the Holborn Borough. In connection with the low death-rate from phthisis it must be remembered that the Italians are principally employed in out-door occupations, and that when they are suffering from such a chronic disease as consumption they often return home to Italy and die there, in fact, doctors practising in the neighbourhood have frequently given medical certificates for Italians so suffering, in order that their return fares may be paid or partly paid by the Italian Consul. Moreover, all the death-rates of the Italian Colony are probably higher than the above high rates, because in many of the returns received from the Registrar-General of deaths in outlying Public Institutions, no exact address is given but only "of Holborn" or "St. Andrew, Holborn." In more recent years the Registrar-General's Department has also furnished the names of such deceased persons and some of them are Italians. On the other hand, the death-rates of the Holborn Borough are too high, because the Holborn Union also includes almost the whole of the Metropolitan Borough of Finsbury, with a population about double that of the Holborn part of the Union; and in recent years, from enquiries made of the Poor Law Authorities, I have been able to ascertain that many of these deaths were of persons not resident in the Holborn Borough. The deaths of all persons removed from the Casual Wards to the workhouse or infirmaries are returned as belonging to Holborn because the Casual Wards are in the Holborn Sub-Division of the Union. There is a very large number of common lodging houses in the Holborn Borough, there were as many as 42 such houses in the Borough in 1901, and the death-rate of persons residing in common lodging houses, especially from consumption, is exceedingly high as was shown by the Medical Officer of Health for the London County Council in his last Annual Report for 1904. I may also give the following additional statistics. 33 The following are the death-rates, corrected for sex and age distribution, for the five years 1896-1900 inclusive, being the five years immediately preceding the Representation :— Deaths from all causes The Area. 29.2 Hoi born. 24.0 London. 19.7 And for the last five years 1901-1905 inclusive :— Deaths from all causes The Area. 29.2 Holborn. 20.9 London. 17.2 The Zymotic death-rates for ten years 1896-1905 inclusive (from the seven principal zymotic diseases as given by the Registrar-General) are as follows:— I give the details for ten years because the number of deaths from zymotic diseases in comparison with the deaths from all causes is small, and in dealing with comparatively small populations, it is more satisfactory to take the average of as large a number of vears as possible. Deaths from Zymotic diseases The Area. 4.95 Holborn. 1.98 London. 2.31 The Phthisis death-rates for the ten years were:— Deaths from Phthisis The Area. 2.08 Holborn. 2.95 London. 1.66 As last year was the first year in which the addresses of the mothers and other details respecting births were supplied to me by the Registrar-General, I can only give the infantile mortality for that year. One would expect the infantile mortality in the area, apart from its being an insanitary area, to be very low, as the Italian mothers almost invariably suckle their infants, and the infants do not sleep with the mothers but in separate cots, so that there are no deaths from overlaying. Since the representation was made the Council has sent several communications to the London County Council urging that Council to proceed with the area but on the 10th November, 1903, the London County Council, in adopting a report of its Housing of the Working Classes Committee, although admitting the accuracy of the representations made by the Medical Officer of Health, and that prima facie the area was one which should be dealt with by an improvement scheme under Part I. of the Act, suggested that in consequence of its being the alleged intention of the freeholders of the estate to themselves redevelop the property for commercial purposes, it was a proper case to leave to the Home Secretary to decide whether he would order the Local Authority to prepare and carry into effect a scheme either under Part I. or Part II. of the Act of 1890. In various communications to this Council, and on the 18th April, 1904, to the Home Office, the freeholders of the greater part of the area stated that a small portion of the area had been built upon and it was their intention to develop the remainder E 34 shortly. On account of the procrastination in the voluntary closing of the houses in Eyre Court and Eyre Terrace, the Housing of the Working Classes Committee instructed me to represent those houses under Part II. of the Act, and the summonses were heard on the 4th April, 1905. After viewing the houses the Magistrate only made closing orders for Nos. 1 and 2, Eyre Terrace and stated that in his opinion Eyre Court generally might be dealt with as an unhealthy area and that as Nos. 7 and 8, Summers Street were then unoccupied, closing orders for those houses were unnecessary. On the 11th October, 1905, the Council adopted a report of the Housing of the Working Classes Committee recommending:— (a) That the Town Clerk be instructed to address a communication to the Local Government Board informing them of the various steps taken for dealing with the area from the representation to the present time, and requesting the Local Government Board, having regard to the failure of the freeholders to proceed with the development of the property, to direct a local enquiry to be held in accordance with Section 10 of The Housing of the Working Classes Act, 1890. (b) That the Town Clerk be instructed to address a communication to the London County Council pointing out that, although over four years have elapsed since the official representation was made, and notwithstanding the promises of the freeholders to develop the property, the area is still practically in the same condition, and urging the London County Council to reconsider their decision and proceed with the preparation of a scheme for dealing with the area. I may add that the Local Government Board have now, in a letter of the 24th April, 1906, informed the Council that they have decided that they must direct a local enquiry to be held and that the enquiry will take place as soon as the arrangements of the Board's Inspectors will permit. UNION BUILDINGS AREA. Aylesbury Place, Clebkenwell, and Union Buildings, Holbobn, Impbovement 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. By the end of the year 1905, the majority of the houses in the area had been closed, and the demolition had been begun, and by March, 1906, the demolition of the whole area was practically completed. The plans for the new buildings to be erected have been prepared and approved. 35 Under Part II. of the Act. Under Part II. of the Act, Section 30, the following were represented as unhealthy dwelling houses:— 7 & 8, Summers Street. 1 to 12 inclusive, Eyre Court. 1, 2 & 3, Eyre Terrace. See observations under Part I. of the Act. Under Part III. 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 all for 2,614 persons exclusive of shops. In my Annual Report for 1903, I gave details of the buildings proposed to be erected on the site, and the work is now nearly completed. PREMISES DEMOLISHED, CLOSED OR REBUILT. St. Giles and Bloomsbuky. Alfred Place, Nos. 8 to 19. New premises. ,, „ „ 33 to 38. New warehouses built. Betterton Street, Nos. 8 to 10. New warehouses built. „ ,, No. 12. New warehouses built. Bloomsbury Street, Nos. 7 to 19. Rebuilding as Cranston's " Ivanhoe Hotel." Castle Street, Nos. 38 to 40. New warehouse built. Chapel Yard. Nos. 1, 2 and two stables. Demolished. Coram Street, Nos. 6 and 7. Premises rebuilt (boarding house). „ No. 23 ,, ,, Eagle Street, Rebuilding Tollard Royal Hotel. „ No. 2. Rebuilt as warehouse. Francis Street, Nos. 14, 15, 16, 17 and 18. Premises demolished. Gate Street, Nos. 1, 22, 23 and 24. Still vacant. Goldsmith Street, No. 9. Still closed. Great Queen Street, Nos. 1 and 2. Still vacant. ,, „ Nos. 19, 20 and 21. Rebuilt. „ ,, Nos. 72, 73, 74, 75 and 76. Demolished. e 2 36 Great Russell Street, Nos. 29 to 34. Rebuilding as Cranston's "Ivanhoe Hotel." Great St. Andrew Street, No. 11. Premises rebuilt. „ „ „ Nos. 44, 45 and 47. Closed to be demolished. Great White Lion Street, Nos. 1, 2 and 3. Premises closed. Halls Yard, Nos. 1 to 10. Demolished. High Holborn, Nos. 111, 112 and 113. Rebuilt. ,, ,, Nos. 223 to 228, part of Kingsway portion of site vacant. ,, „ Museum Station, C.L.R. Offices being built over. Huntley Street. Site still vacant. Keppel Street, Nos. 8 and 9. Closed. „ ,, Nos. 10, 11 and 14. Partly demolished. ,, ,, Nos. 15 to 19. Demolished. ,, ,, Nos. 24, 25, 26, 27, 28, 29 and 30. Demolished. Kingsway and Parker Street. Corner premises built (not yet numbered). Montague Place, Nos. 3 to 16 (inclusive). Demolished. Neal Street, No. 20. Crown and Anchor. Premises rebuilt. ,, „ Nos. 22 and 24. New warehouse built. New Compton Street, No. 28. Premises closed Great Queen Street, Nos. 19, 20 and 21. Rebuilt in conjunction with Nos. 1, 2 and 3, Queen's Place. Russell Mews, Nos. 1 and 2. Demolished. Russell Square, Nos. 61, 62, 63 and 64. Demolished and rebuilding (Hotel). Sardinia Place, Nos. 2 to 16. Demolished. ,, „ No. 9. Closed. Sardinia Street, Nos. 1, 3, 15, 17, 18, 19 and 21 ; 8, 10, 12, 14, 16, 18 and 28. Demolished. „ „ No. 6. Closed. Shaftesbury Avenue, Nos. 171 and 175. Premises closed. „ ,, Nos. 228, 230, 232 and 204. Rebuilt shops and flats. Short's Gardens, No. 25 (formerly No. 14 Queen Street) with No. 25 Neal Street. Rebuilt as business premises. „ ,, Nos. 50, 52 and 54 (old Nos. 11, 12 and 13). New warehouse built. Southampton Row. Rebuilding Tollard Royal Hotel. ,, ,, Nos. 62 to 70. Rebuilt. South Crescent, No. 6 Premises closed. „ „ No. 11 and 12. New shops and premises built. Store Street, No. 18. New public house built. „ „ Nos. 19, 20, 21, and 21a. New shops and dwelling house built. „ ,, Nos. 23 and 24. New shops and premises built. Torrington Mews East. Nos. 1, 2, 3, 4 and 5. Closed. Torrington Street, Nos. 2, 3 and 4. Premises demolished. 37 Tottenham Court Road, Nos. 192 and 196. Premises demolished. „ „ „ „ 213 to 215. New premises. ,, „ ,, ,, 227 to 233. „ ,, Vine Street (now Grape Street), Nos. 1, 3, 5 and 7. Rebuilt shops and flats. Wild Court, Nos. 8, 9, 10, LI, 12, 13 and 14. Warehouses closed, a portion of No. 8 demolished and rebuilt in connection with the Masonic Hall, Great Queen Street. Wild Street, Mission Chapel. Built. Holborn. Beauchamp Street, Nos. 15, 16 and 17. Rebuilt. Brooke's Market, Nos. 18 and 19. Rebuilt. Charles Street, No. 19a. Rebuilt. Dorrington Street, Nos. 16 and 17. Rebuilt. Eagle Street, Nos. 31 and 32. Rebuilt. „ „ Nos. 42 and 43. Site still vacant. Eyre Terrace, Nos. 1 and 2. Closed. (Closing order H.W.C. Act.) Fisher Street. Rebuilding "Tollard Royal Hotel." ,, ,, No. 12Reopened (dining rooms.) Gloucester Street, No. 10. Demolished and rebuilding. Hatton Garden, No. 40. Being rebuilt. High Holborn. Offices over Chancery Lane Station built. Kirby Street, Nos. 16, 17, 28 and 29. Being rebuilt. Lamb's Conduit Street, Nos. 10 and 12. Still closed. Little Grays Inn Lane. Site of old Casual Ward. Building completed. Little Bath Street, No. 7. Being rebuilt. Mount Pleasant, Nos. 65, 67, and 69. Rebuilt. Ormond Yard, No. 33. Site still vacant. Princeton Street, Nos. 22 and 24. Reopened. Red Lion Passage, No. 8. Rebuilt. ,, ,, No. 9. Closed. ,, ,, Nos. 16 and 17. Being rebuilt. „ ,, No. 18. New shops and tenements completed. Red Lion Street, Nos. 60 and 61. New shops and tenements completed. Robin Hood Yard, Nos. 19 and 20. Demolished and being rebuilt. Rosebery Avenue, No. 8. Rebuilt. South Square, No. 10. Demolished and being rebuilt. Summer Court, Nos. 1 and 2. Demolished. Took's Court, No. 18. Rebuilt. Warner Street, No. 24. Rebuilt. Union Buildings. Insanitary area all closed by end of 1905, and demolition completed soon afterwards:— Baldwin's Place, Nos. 1 to 8 inclusive. 38 Dove Court, Nos. 1, 2, 3 and 4. Half Moon Court, Nos. 1 to 9 inclusive. Leather Lane, sixteen houses between No. 49 (new number) and Portpool Lane. Portpool Lane, Nos. 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21 and 23. Providence Place, Nos. 1, 2, 3, 4, 5, 6, 7, 8 and 9. Union Buildings, Nos. 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10. Union Terrace, 1 to 26, cowshed and stables. Verulam Street, Nos. 15, 16, 17, 18, 19, 20 and 21. SANITARY WORK. HOUSE TO HOUSE INSPECTIONS, 1905. St. Giles and Bloomsbuby. Alfred Place (part of). Little Wild Street. Arthur Street. Lloyds Court. Betterton Street. Lumber Court. Bucknall Street. Marchmont Street (part of). Castle Street. Neal Street. Charing Cross Eoad (part ofj. Neal's Yard. Chenies Street. New Compton Street. Clark's Buildings. New Oxford Street (part of). Clark's Mews. New Turnstile. Denmark Street. New Yard. Drury Lane. Nottingham Court. Dyott Street. Parker Street. Goldsmith Street. Phoenix Street. Gower Mews (part of). Queen Street. Great Earl Street. Bidgmount Street. Great Queen Street. Sardinia Place. Great Eussell Street. Shaftesbury Avenue (part of). Great St. Andrew Street. Short's Gardens. Great WhiteJLion Street. Smart's BuildiDgs. Great Wild Street (part of). J Stacey Street. Herbrand Street. Stedham Chambers. High Street. Store Street. Kenton Street. Tottenham Court Eoad (part of). Little Earl Street. Tower Street. Little St, Andrew Street. Wild Court. Little White Lion Street. Woburn Mewe. 39 Holborn. Albion Buildings, Back Hill. Back Hill. Baldwin's Place. Beauchamp Street. Bishop's Head Court (part of). Boswell Court (South side). Castle Court. Chapel Street. Charles Street. Clerkenwell Road (part of). Cross Street. Dean Street. Devonshire Street. Dove Court. Dunstable Court. Eagle Street. East Street. Emerald Street. Evelyn Buildings. Eyre Court. Eyre Place. Eyre Street Hill. Eyre Terrace. Farringdon Eoad (part of). Featherstone Buildings (part of). Fleet Row. Fox Court. Gloucester Street. Grays Inn Road (part of). Great James Street. Great Ormond Street. Great Saffron Hill (part of). Half Moon Court. Hand Court. Hatton Garden. Hatton Wall. Hatton Yard. High Holborn (part of) Holborn Place. Kirby Street. Lamb's Conduit Passage. Lamb's Conduit Street. Laystall Street. Leather Lane Buildings Leigh Street. Little Bath Street. Little Grays Inn Lane. Little Saffron Hill. Millman Street. Millman Place. Mount Pleasant. New North Street. Old North Street. Orange Street (now Parton Street) Ormond Yard. Poole's Buildings. Princeton Street. Eatcliffe Buildings. Red Lion Passage. Red Lion Square (part of). Red Lion Street. Robert Street. Sandland Street. Summer Street. Theobald's Road. Verulam Street. Vine Street. Warner Street. WATER SUPPLY TO NEW BUILDINGS. During the year I inspected and gave certificates for the following premises:— Castle Street, "The Crown and Anchor" public house. Nos. 6 and 7, Coram Street. Nos. 22 and 23, Coram Street. Nos. 175 and 176, Drury Lane. 40 Grape Street and Shaftesbury Avenue, Queen Alexandra Mansions. Nos. 112 and 113, High. Holborn. Nos. 62 to 105, Radcliff Buildings, Bourne Estate. Nos. 8 and 18, Red Lion Passage. Nos. 60 and 61, Red Lion Street. Nos. 6, 27, 28, 49, 50, 71, 72, 93, 94, 115, 1 16 and 127, Redman Buildings, Bourne Estate. Nos. 62, 64, 66, 68 and 70, Southampton Row. Nos. 18, 19, 20, 21 and 22, Store Street. Many new premises, such as factories, workshops offices, etc., were inspected, but a certificate is not required. WATER SUPPLY TO TENEMENT HOUSES. In December, 1904, a letter was received from the London County Council calling the attention of the Council to the decision of the Magistrate at the Woolwich Police Court, on the 16th December, 1904, to the effect that the supply of water from a tap in the yard is not a proper and sufficient supply of water to tenement houses within the meaning of section 48 of the Public Health (London) Act, 1891, and expressing the London County Council's hope that the Borough Council will take all possible steps to secure the provision of a proper and sufficient supply of water for the tenants of every floor of a tenement house. After consideration of this by the Public Health Committee I was instructed to take steps for the service of notice wherever necessary with a view to securing the provision of a proper and sufficient supply of water accordingly. Many Intimation Notices (about 120) were therefore served during the year. It was, however, afterwards decided to serve Statutory Notices and take legal proceedings for tenement houses in which the only water supply was in the basement. I also advised that legal proceedings should not be taken if an additional water supply were provided about midway between the ground and top floors. Fifteen such houses were provided with additional water supply. In two cases legal proceedings had to be taken, and in each case the Magistrate made an order for the work to be carried out. BY-LAWS AS TO HOUSES LET IN LODGINGS. At the end of the year, 759 houses were registered under these by-laws. Of these 399 are in St. Giles and Bloomsbury, and 360 are in the Holborn Division. During the year 7 houses let in lodgings, all in the Holborn Division, have been 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. 41 During the year there were 1,465 inspections of these premises, excluding a very large number of periodical inspections and re-inspections. Notices were served for 29 overcrowded rooms, and for 167 other breaches of the by-laws, exclusive of more than 600 formal notices that were served for annual cleansing as required by the by-laws. OVERCROWDING. The number of dwelling-rooms found to be overcrowded during the year was 60, in comparison with 123 during the preceding year; 29 of these were dealt with as breaches of the by-laws as to houses let in lodgings. In each case the overcrowding was abated without resort to legal proceedings. There were no night inspections during the year. REMOVAL OF HOUSE REFUSE. The supervision of the removal of house refuse was transferred from the Borough Surveyor's Department, to the Public Health Department on the 26th June, 1905. In accordance with the Contract all house refuse has to be removed during the months April to October inclusive, at least twice a week and oftener if required by the Medical Officer of Health, and in the remaining months, November to March, at least once in each week and oftener if required. In the main thoroughfares there is a daily collection. At the meeting of the Public Health Committee on the 18th July, 1905, I reported that there had been many breaches of the Contract respecting the bi-weekly removal, and the Committee recommended the Council to impose the penalties under his Contract on the Contractor for neglecting or failing to remove the house refuse from the houses in the Borough at least twice weekly as required by the Contract. This recommendation was approved by the Council and the Contractor was fined ill 00. After this the Contract was carried out much more satisfactorily. REMOVAL OF MANURE. In July, 1905, I called the attention of the Public Health Committee to the complaints which I had received, that manure is not regularly removed from some of the stables in the Borough, and that very offensive smells occur during its removal, and although in some cases I had been able to secure a more frequent and more regular removal I advised :— (a) That notice be given by public announcement in the district or otherwise, requiring the periodical removal of manure, or other refuse matter from all stables, cow houses, or other premises in the Borough not less frequently than every 48 hours. (b) That the Medical Officer of Health be instructed to serve notices on the occupiers of stables requiring compliance with such announcement. ♦ F 42 During the year 56 notices were served requiring the provision of manure receptacles in accordance with the by-laws, and in two cases it was necessary to take legal proceedings before the manure receptacles were provided. 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 1905 :— Of these 23 are in Bloomsbury and St. Giles for 1,330 lodgers. „ 11 „ Holborn District for 790 „ Total 44 in the Borough for 2,120 ,, 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 8, Kennedy Court 34 W 16, Castle Street 31 M 14, Lumber Court 68 M 25, Drury Lane 34 W 1-7, Macklin Street 96 M 9, Dyott Street 28 M 19, do. 40 W 25, Great Queen Street 26 M 21, do. 26 W 36, Parker Street 83 M Parker Street Municipal 345 M 2, Kennedy Court 8 M 20 & 21, Queen Street... 118 M 3, do. 10 M 22-25, do. 159 M 4, do. 19 M 3, Neal's Yard 39 11 5, do. 8 W 6, Wild Court 28 M 6, do. 8 w 7, do. 35 M 7, do. 9 w A total of 23 Common Lodging-houses registered for 1,330 lodgers. Holbokn 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 19, Hatton Wall 94 M 25, Charles Street 241 M 28, Orde Hall Street ... 22 M Field Lane Refuge ( 32 M 52 M 1 17 W 28, Red Lion Square ... 72 M 40, Eagle Street 50 M 12, Took's Court 61 M 4, Greville Street 54 M 13, do. 49 M A total of 11 Common Lodging-houses registered for 790 lodgers. 43 Since the increased powers respecting Common Lodging-houses conferred on the London County Council by the London County Council (General Powers) Act of 1902, a number of the Common Lodging-houses in the Borough have been closed because they failed to carry out the alterations required in order to secure a renewal of their licenses. The details of those closed in 1903 and 1904 were given in the Annual Reports for those years. During the year 1905, five more Common Lodging-houses were closed, viz. : Nos. 8 and 10, Parker Street which had been licensed for 72 women lodgers; and 18, 19, and 20, Fulwood's Rents, which had been licensed for 118 women lodgers and 58 men lodgers. FACTORIES, WORKSHOPS AND WORKPLACES During the year there were 1,059 inspections of factories and workshops, and 1,752 inspections of workplaces, 101 Intimation Notices for sanitary defects were served and 28 Statutory Notices. There were also 172 inspections of home workers premises for which 28 Intimation Notices for sanitary defects were served, and 4 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. Inspection or Factories, Workshops and Workplaces. Number of Places. Number of Notices 1905. Number of Prosecutions 1905. Class of Work. On Register at end of 1904. Added in 1905. Removed in 1905. On Register at end ol 1905. Number of Inspections. 1905. Premises. Rooms intimations. Statutory. Factories. ‡ Factory Laundries 3 1 — 4 — 4 0 0 — Factory Bakehouses 1 — 1 — 10 2 0 — Other Factories — — — — — Included under Work shops. Workshops. Workshop Laundries 19 1 1 19 38 56 4 0 — Workshop Bakehouses 33 — 33 — 234 8 1 — Other Workshops 746 92 13 825 1,359 660 87 28 — Workplaces. Home workers' Premises * 99 70 20 149 206 172* 29 4 — Places where Food is prepared for Sale † 318 85 5 398 — 1,610 135 19 3 Workplaces other than the the above § 142 Included in other Work shops. Total 1,219 249 39 1,429 — 2,888 265 52 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. Slaughter Houses, Tripe, Offal, and other Meat Shops, Fried Fish, Eel, and other fish Shops, Ice Cream 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 1905, and notices served where necessary. § 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. F 2 44 Further details of defects which were found and other matters are given in Table IX. (1), (2) and (3) of the Appendix. HOMEWORK ORDER OF 15th AUGUST, 1905. By order dated the 15th August, 1905 (which revokes orders of a similar kind dated 11th December, 1901, and 14th July, 1902), the provisions of Section 107 of the Factory and Workshop Act, 1901, relating to lists of outworkers have been applied to the following classes of work :— The making, cleaning, washing, altering, ornamenting, finishing, and repairing of wearing apparel and any work incidental thereto ; The making, ornamenting, mending, and finishing of lace and of lace curtains and nets; Cabinet and furniture making and upholstery work; The making of electro-plate ; The making of files; Fur-pulling; The making of iron and steel cables and chains ; The making of iron and steel anchors and grapnels; The making of cart gear, including swivels, rings, loops, gear buckles, mullin bits, hooks, and attachments of all kinds; The making of locks, latches, and keys; The making of covers for, and the covering, finishing, altering or repairing of, umbrellas, sunshades, parasols, and articles of a similar character, and any work incidental thereto; The making of paper bags and of paper boxes; Brushmaking; and The making of stuffed toys. 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 Bloomsbury. 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 Bow. 6 Torrington Place. 45 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. 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. During the year, in addition to my inspections, there were 244 inspections of the above bakehouses excluding 10 inspections of the factory bakehouse in Farringdon Road. In my Annual Report for 1904, I gave details of the 7 underground bakehouses that had received the certificate during the year 1903, as required by the Factory and Workshop Act, 1901, and of the 20 that had received the certificate during 1904, and of the five underground bakehouses in which no certificate was granted and which were therefore no longer used as underground bakehouses. PLACES WHERE FOOD IS PREPARED FOR SALE. Under this head are included kitchens of hotels, restaurants, and eating houses of all sorts, slaughter houses, tripe, offal, and other meat shops, fried fish, eel and other fish shops, premises where ice cream is made, 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 1905 was 398 ; 1610 inspections were made, and 30 notices were served during the year for sanitary defects found. In addition to the above inspections of places where food is prepared for sale, there were also 705 inspections of market streets, each of which includes a number of stalls at which meat, fish, fruit and vegetables are sold. These streets are also regularly inspected on Saturday evenings and Sunday mornings. SLAUGHTER-HOUSE. The license for the slaughter-house at Yorkshire Grey Yard, Eagle Street, was not renewed, so that there is now only one slaughter-house in the Borough, viz., 29, Red Lion Street, which was inspected on 26 occasions during the year. 46 OTHER OFFENSIVE BUSINESSES. The only other offensive business in the Borough is that of a tripe dresser and boiler at 67 and 68 Leather Lane (old numbers.) These premises were frequently inspected. They are included in the Union Buildings Area and were closed during the year, and have since been demolished with the remainder of the Area. DAIRIES, COWSHEDS AND MILKSHOPS. The number of registered dairies and milkshops in the Borough at the end of the year was 180, of which 72 were in St. Giles and Bloomsbury, and 108 in the Holborn District. During the year 29 dairies and milkshops were newly registered, 9 belonging to St. Giles and Bloomsbury, and 20 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 1,152 inspections of these premises; and two notices were served for breach of the regulations for preserving the purity of milk, and for protecting it against infection or contamination. There is now only one cowshed in the Borough, which is at 4, Goldsmith Street, and was frequently inspected during the year. The Public Health Committee in March, 1905, considered the advisability of taking further steps to secure the purity of milk sold within the Borough, and instructed me to recommend milk sellers within the Borough to cover the receptacles in which milk was kept with metal covers. The following letter was therefore addressed to each purveyor of milk in the Borough :— " The Public Health Committee have recently considered the possibility " of taking further steps to secure the purity of milk sold within the Borough, " and have requested me to inform you that all receptacles used in connection " with the storage or sale of milk must be so covered as to prevent the access " of dust and dirt, and advise that a metal cover should be used. In the majority of cases the recommendation of the Committee was adopted and the necessary metal covers provided. ICE CREAM. At the end of the year there were 67 premises in the Borough where ice cream was manufactured or sold, and 245 inspections of these premises were made. As ice cream is often made in the early morning, inspections between 6 and 9 a.m. are also occasionally made in order to ascertain whether there are any infringements of the London County Council (General Powers) Act, 1902. 47 During the year there were two prosecutions, one for making ice cream in a hedroom, for which the defendant was fined 20s. and 2s. costs, and the other for failure to exhibit name on ice cream barrow for which the defendant was fined 2s. and 2s. costs. 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 :— 1,400 eggs. 6 fowls. 2 crates herrings. 1 cwt. dabbs. 1 trunk haddocks. 1 trunk whiting. 233 single cases bananas. 119 double cases bananas. 20 lbs. black currants. 2 sacks radishes. SMOKE ABATEMENT. The smoke shafts in the Borough were frequently kept under observation, and in 258 cases the inspections were recorded. Twenty Intimation Notices and six Statutory Notices were served. For further details of Sanitary Work see Tables VI., VII., VIII., IX., X., XI., and XII. METEOROLOGY. The mean temperature of the year was 49.9 which is 0.8 higher than for the preceding 50 years. The rainfall was 23.03 inches, and was 1.50 inches below the average for the preceding 50 years. In the year 1903 there was the large amount of 35.54 inches. The total amount of bright sunshine recorded was 1,420 hours, out of a total possible 4,460 hours, and it was 40 hours above the average for the preceding 15 years. The mean hourly horizontal movement of the air was 12.3 miles per hour. In the year 1903, it was 13.3 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 XIII. 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. 48 APPENDIX. TABLE I. Vital Statistics of Whole District during 1905 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 1895 68,349 1,941 28.5 359 185 1,546 22.7 526 355 470 1,661 24.4 1896 (53 weeks) 67,785 1,959 28.5 331 169 1,366 19.8 509 380 457 1,443 21.0 1897 67,074 1,772 26.5 289 163 1,335 20.0 568 447 478 1,366 20.4 189S 66,371 1,840 27.8 336 183 1,467 22.2 605 461 477 1,483 22.4 1899 65,677 1,867 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 (53 weeks) 58,542 1,646 27.7 213 129 1,283 21.9 627 517 494 1,260 21.2 1903 57,861 1,621 28.1 154 95 1,088 18.8 587 496 462 1,054 18.3 1904 57,188 1,632 28.6 179 109 1,134 19.8 596 540 426 1,020 17.9 Averages for years 1895-1904 163,307 1,769 27.9 267 149 1,319 20.8 573 456 472 1,336 21.0 1905 56,522 1,601 28.4 145 91 1,131 20.1 680 604 427 954 16.9 * 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 1895 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 „ „ 49 TABLE II. Vital Statistics of separate Localities in 1905 and previous years. Names of Localities. Holborn Borough. Blooksbury and St. Giles. Holborn Scb-District. Tear. Population estii mated 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. 1895 68,349 1,941 1,661 359 36,974 1,120 851 185 31,376 821 810 174 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 1,027 746 168 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 1904 57,188 1,632 1,020 179 30,272 991 444 78 26,916 641 576 101 Averages of Years 1895 to 1904 63,307 1,769 1,336 267 34,086 1,036 654 124 29,221 733 682 143 1905 66,522 1,601 954 145 29,905 988 452 61 26,617 613 502 84 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 1895 to 1900 refer to the old areas of the St. Giles and Holborn District Boards of Works. G 50 TABLE III. Cases of Infectious Disease notified during the year 1905. 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. At Ages—Years. Bloomsbury and St. Giles. Holborn. Bloomsbury and St. Giles. Holborn. Under 1. 1 to 5 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox 1 — — — — 1 — 1 — 1 — Cholera — — — — — — — — — — Diphtheria and Membranous Croup 47 1 12 20 10 4 — 10 37 8 37 Erysipelas 35 — 2 — 4 26 3 20 15 9 2 Scarlet Fever 156 2 54 75 20 5 — 68 88 68 82 Typhus Fever — — — — - — — — — — — Enteric Fever 21 1 2 3 9 6 — 14 7 14 7 Relapsing Fever — — — — — — — — — — — Continued Fever 1 — — — 1 — — — 1 — 1 Puerperal Fever 2 — — — 1 1 — 1 1 1 — Plague — — — — — — — — — — — Totals 263 4 70 98 45 43 3 114 149 101 129 Note.—The Isolation Hospitals are those of the Metropolitan Asylums Board. There were also 208 voluntary notifications of Phthisis (Consumption), 99 belonging to St. Giles and Bloomsbury, and 109 to the Holborn Division. 51 TABLE IV. Causes of, and Ages at, Death during the year 1905. Causes or Death. Deaths at the Subjoined Ages op " Residents" whether occurring in or beyond the District. Deaths at all Ages of " Residents "belonging to Localities whether occurring ih or beyond the district. Total Deaths whether op " residents " or " nonresidents " in Public Institutions in the District. All Ages. Under 1. 1 and under 6. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Bloomsb ury and St. Giles. Holborn. Small-pox — — — — — — — — Measles 11 2 9 — — — — 3 8 5 Scarlet Fever 3 — 3 — — — — 1 2 X Whooping Cough 15 7 8 — — — - 6 9 36 Diphtheria and Membranous Croup 4 1 2 1 — — — — 4 11 Croup — — — — — Fever Typhus — — — — — — — — — — | Enteric 4 — — 1 1 2 — 3 1 5 Other Continued — — — — — — — — — — Epidemic Influenza 7 — — — — 4 3 1 6 1 Cholera — — — — — — — — — — Plague — — — — — — — — — — Diarrhoea 22 20 1 — — 1 — 10 12 56 Enteritis 11 6 2 — 1 2 — 7 4 24 Puerperal Fever — — — — — — — — — — Erysipelas — — - — — — — — — 1 Other Septic Diseases 15 1 — 1 1 10 2 8 7 16 Phthisis 148 — 2 2 9 120 15 80 68 45 Other Tubercular Diseases 32 8 12 4 2 6 — 13 19 99 Cancer, Malignant Disease 49 — 1 — — 38 10 30 19 19 Bronchitis 98 8 3 1 — 34 52 32 66 15 Pneumonia 96 23 12 1 4 37 19 44 52 55 Pleurisy 6 - — — — 4 2 6 — 2 Other Diseases of Respiratory Organs 8 — 1 — — 5 2 3 5 13 Alcoholism Cirrhosis of Liver 21 — — — — 19 2 12 9 9 Venereal Diseases 9 8 — — — 1 — 3 5 6 Premature Birth 12 12 — — — — — 4 8 10 Diseases and Accidents of Parturition 4 — — — 2 2 — 1 3 1 Heart Diseases 84 2 — 1 6 43 32 39 45 30 Accidents 26 8 6 — 1 7 4 11 15 3 Suicides 15 — — — 1 14 — 7 8 2 All other causes 254 39 13 5 5 108 84 128 127 217 All causes 954 145 75 17 33 457 227 452 502 682 G2 52 TABLE V. Infantile Mortality dijking the Year 1905. Deaths from stated Causes in Weeks and Months under One Year of Age. Cause of Death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Certified. Causes Uncertified 21 10 5 1 37 22 11 10 10 13 6 5 7 7 12 5 145 — — — — — — — — — — — — — — — — — Common Infectious Diseases. Small Pox — — — — — — — — — — — — — — — — — Chicken Pox — — — — — — — — — — — — — — — — — Measles — — — — — — — — — — — — 1 1 — — 2 Scarlet Fever — — — — — — — — — — — — — — — — — Diphtheria:Croup — — — — — — — — — — — — — — — — 1 Whooping Cough — — — — — 2 1 — 1 1 1 1 — — — — 7 Diarrheal Diseases. Diarrhoea, all forms ... — 1 — — 1 1 — 2 2 6 2 — 3 2 1 — 20 Enteritis (not Tuberculous) — 2 — — 2 3 — — 1 — — — — — — — 6 Gastritis, Gastro- intestinal Catarrh — — — — — — 1 — — — — — — — — — 1 Wasting Diseases. Premature Birth 7 1 2 — 10 2 — — — — — — — — — — 12 Congenital Defects 6 2 — — 8 1 1 1 — — — — — — — — 11 Injury at Birth — — — — — — — — — — — — — — — — — Want of Breast-milk — — — — — — — — — — — — — — — — — Atrophy, Debility, Marasmus 4 1 — — 5 1 2 2 2 1 — — — — — — 13 Tuberculous Diseases. Tuberculous Meningitis — — — — — — — — — — — — — — 2 1 3 Tuberculous Peritonitis: Tabes Mesenterica — — — — — — — — — — — — — — 1 — 1 Other Tuberculous Diseases — — — — — — — — — — — — 1 — 2 1 4 Erysipelas — — — — — — — — — — — — — — — — — Syphilis — — — — — 2 1 3 — — — — — 1 1 — 8 Rickets — — Meningitis (not Tuberculous) — — — — — — — — — 1 — 1 — — 1 — 3 Convulsions 2 1 1 4 2 1 1 2 — 10 Bronchitis — 1 1 2 1 1 1 1 1 8 Laryngitis — — — Pneumonia 2 2 — 4 3 3 1 1 2 1 1 3 2 2 23 Suffocation, overlaying — — — — 3 3 1 1 8 Other causes — 2 — — 2 — 1 — — — 1 — — — — — 4 21 10 5 1 37 22 11 10 10 13 6 5 7 7 12 5 145 Births in the year legitimate, total registered 1,524 ; " Residents " 1098. illegitimate do. 77: do. 45. Deaths from all Causes at all Ages 954. Population estimated to middle of 1905, 56,522. 53 TABLE VI. Sanitary Inspectors' Work.—Inspections, &c. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Lovibond Whole Borough. Complaints 79 77 84 15 255 Inspections. 'Infectious Diseases 113 115 83 268 579 Dwelling Houses 186 364 189 427 1,166 Lodging Houses 377 292 430 366 1,465 Common Lodging Houses 77 32 85 — 194 Dairies, Cowsheds and Milkshops 359 330 463 — 1,152 Ice Creams — Manufacture or Storage 47 10 178 — 245 Slaughter-houses — 26 — — 26 Market Streets 325 58 312 10 705 Butchers' Shops 276 63 228 2 569 Bakehouses 82 97 55 — 234 Laundries 4 3 4 45 56 Other Food Shops 234 117 272 147 770 Other Workshops 179 102 164 215 660 Out-Workers' Rooms and Registers 16 40 82 172 310 Workplaces 32 52 45 13 142 Factories 14 3 66 20 103 Schools 1 2 1 — 4 Smoke shafts 115 40 103 — 258 Urinals 15 77 27 — 119 Miscellaneous 162 101 303 7 573 Periodical Inspections 476 1,171 961 — 2,608* Dust 107 656 31 5 799 Total Inspections 3,197 3,751 4,092 1,697 12,737 No. of Re-Inspections 1,537 1,847 820 1,302 5,506 Visits other than Inspections and Re-Inspections 553 906 798 756 3,013 Total 5,287 6,504 5,710 3,755 21,256 * The majority of these are weekly inspections of Registered Lodging Houses. 54 TABLE VII. Sanitary Inspectors' Work.—Notices, &c. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Lovlbond. Whole Borough. Intimation Notices Served 240 610 386 214 1,350 Houses 227 490 352 180 1,249 Waterclosets defective Gr dirty 62 213 117 68 460 ,, insufficient 16 13 4 3 36 Drains defective 21 32 20 8 81 Soil pipes or waste pipes defective 9 59 22 9 99 Gullies defective — 12 10 1 23 Ash-bins defective 17 15 8 16 56 „ absence of 10 21 23 8 62 Water supply defective or insufficient 25 70 25 — 120 ,, cistern dirty or defective 14 10 9 1 34 „ fittings defective — — — — — Yard or area paving defective 12 15 15 10 52 Roof or guttering defective 6 31 44 8 89 Accumulations 4 22 37 12 75 Premises dirty 47 95 69 57 268 „ overcrowded 7 13 8 3 31 „ other defects 11 27 35 27 100 Underground rooms 2 8 1 — 11 Animals improperly kept 2 2 2 — 6 Smoke nuisances 3 7 10 20 Urinals 4 9 6 19 Other nuisances 3 6 3 1 13 Manure receptacles, absence of 43 4 7 2 56 * Factories and Workshops 13 20 34 34 101 Dirty 9 8 26 14 57 Waterclosets, defective or dirty — 6 9 8 23 „ insufficient 1 1 „ absence of separate accommodation for sexes 4 1 7 12 Drains, soil pipes, &c., defective 1 1 — — 2 Improperly ventilated — 3 — 2 5 Overcrowded — 3 3 3 12 Other nuisances 2 1 6 3 12 Breach op Bye-laws or Regulations— f Lodging houses 21 89 28 49 187 Dairies, cowsheds, milkshops and slaughter-houses — — 2 — 2 Statutory Notices Served 59 133 91 40 323 * 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." 55 TABLE VIII. Proceedings during 1905. PREMISES. NUMBER OF PLACES— Number of Inspections 1905. Number of Notices 1905. Number of Prosecutions 1905. On register at end of 1904. Added in 1905. Removed In 1905. On register at end of 1905. Milk premises 171 29 20 180 1,152 47 0 Cowsheds 1 0 0 I weekly 0 0 Slaughter-houses 2 0 1 1 26 0 0 — Other offensive trade premises 1 0 1 0 weekly 0 0 Ice Cream premises 43 38 14 67 245 0 2 Registered houses let in lodgings 767 7 15 759 1,465 ( (a)* 20 (a)* 0 (b)* 167 (b)* 0 * (a) For overcrowding. * (b) For other conditions. Total number of Intimation notices served for all purposes 1,350 Overcrowding, 1905— Number of Dwelling Rooms overcrowded 60 Number remedied 60 Number of prosecutions 0 Underground Rooms— Illegal occupation dealt with during year XI Number of rooms closed n Insanitary Houses— Number closed under the Public Health (London) Act, 1891 0 „ „ ,, „ Housing of the Working Classes Act 4 Ice Cream— Proceedings under London County Council (General Powers) Act, 1902 2 Numbers of premises cleansed under Section 20 of the London County Council (General Powers) Act, 1904 8 Shelters provided under Section 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year. 3 Revenue Acts— Number of houses for which applications were received during the year 0 Number of dwellings comprised therein 0 Number of tenements for which certificates were (a) granted 0 ; (d) refused 0 ; (c) deferred 0 Number of prosecutions under Bye-laws under Public Health (London) Act, 1891 (a) For prevention of nuisance arising from snow, ice, salt, filth, etc 0 (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc. 0 (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 0 (e) In connection with the removal of offensive matter, etc. 0 (/) As to cesspools and privies, removal and disposal of refuse, etc. 0 (g) For securing the cleanliness of tanks, cisterns, etc 0 (A) With respect to water closets, earth closets, etc. 1 (i) With respect to sufiiciency of water supply to water closets 0 (/) With respect to drainage, etc. (Metropolis Management Act, Section 202) 0 (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Act, Section 202) 0 Mortuaries— Total number of bodies removed 1 53 Total number of infectious bodies removed 3 56 TABLE IX. 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) 103 — Workshops (including Workshop Laundries) 950 1 j 236 48 3 Workplaces 1,752 Homeworkers' Premises 172 29 4 — Total 2,977 265 52 3 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to h.m. Inspector. ♦Nuisances dnder the Public Health Acts :— Want of cleanliness 57 57 — — Want of ventilation 5 5 Overcrowding 9 9 — Want of drainage of floors Other nuisances 14 14 — Sanitary accommodation insufficient 1 1 — — unsuitable or defective 23 23 ( not separate for sexes 12 12 — — Offences dnder the Factory and Workshop Act :— Illegal occupation of underground bakehouse (S. 101) — — — — Breach of special sanitary requirements for bakehouses (SS. 97 to 100) 1 1 — — Failure as regard lists of outworkers (S. 107) 81 81 — — 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 starlet fever or small-pox (S. 109) — — — — Other offences — Total 20.'3 203 — — * Including those specified in Sections 2, 3, 7 and 8, of the Factory Act as remediable under the Public Health Acts. 57 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) 38 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 ... Reports (of action being taken) sent to H.M. Inspectors. 13 13 Other 1 Underground Bakehouses (S. 101) :— Certificates granted during the year — In use at the end of 1905 27 Homework :— Number of Lists of Outworkers (S. 107):— Lists. Outworkers. Lists received 125 848 Addresses of outworkers forwarded to other Authorities 134 received from other Authorities 208 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 8 — Orders prohibiting homework in infected premises (S. 110) — — . , Workshops on the Register (S. 131) at the end of 1905 :— Important classes of workshops, such as workshop bakehouses, may be enumerated here. Laundries 19 Bakehouses 33 Other 825 Total number of workshops on Register 877 h 58 TABLE X. Legal ProceediDgs under the Public Health (London) Act, 1891. Date. Premises. Offence. Result. 1905 February 20... 20 Endell Street Drain defective Order to abate within fourteen days. 6s. costs. April 18 and May 2 and 16 13 East Street Breach of London County Council By-laws (insufficient w.c. accommodation) Breach abated. Summons withdrawn. July 13 14 Woburn Mews Nuisance. Dirty premises ; waste pipe, roof and paving defective Order to abate in twenty-one days. 6s costs. " Do. Breach of By-laws (manure receptacle) Defendant convicted and fined 40s. and 2s. costs „ and August 24 25 Keppel Mews North Do. do. Breach abated. Costs paid. Summons withdrawn August 8 15 Theobald's Road Nuisance. Dirty premises Order to abate in fourteen days. 6s. costs October 14 ... 43 Devonshire Street Insufficient supply of water for tenants on each floor Do. do. ft ••• 67 Red Lion Street Exposing for sale unsound meat Defendant convicted and fined £;5 and £2. 2s. costs November 30 23 New North Street Insufficient supply of water for tenants on each floor Order to abate within fourteen days. 6s. costs. December 28 9 Eagle Street Nuisance. Dirty premises Order to abate in seven days. 6s. costs. TABLE XI. Legal Proceedings under London County Council (General Powers) Act, 1902. Date. Premises. Offence. Result. 1905 June 16 9 Fleet Row Failure to exhibit name on ice cream barrow Defendant convicted and fined 2s. and 2s. costs July 5 16 High Street Making ice cream in bedroom Defendant convicted and fined 20s. and 2s. costs 59 TABLE XII. Legal Proceedings taken under the Sale of Food and Drugs Acts. Date. Premises. Offence. Result. 1905. January 27... 91, Hatton Garden Selling gin 38 84 degrees under proof Defendant convicted and fined £5 and 2s. costs »» 11, Back Hill Selling whiskey 26.67 degrees under proof Defendant convicted and fined £3 and 2s. costs »» » 63, Lamb's Conduit Street Selling brandy deficient in esters to the extent of at least 41 per cent. Defendant convicted and fined £2 and £2. 2s. costs March 15 and 29 22, Cross Street Selling milk adulterated with 9.7 per cent, of added water Warranty proved. Summons dismissed »» 3, White Hart Yard Selling milk adulterated with 7.4 per cent, of added water Warranty proved. Summons dismissed April 3 6, Fox Court Selling milk adulterated by the extraction of fat to the extent of at least 5.6 per cent. Defendant convicted and ordered to pay 2s. costs May 17 45, Great Wild Street Selling milk adulterated by the extraction of fat to the extent of at least 15.0 per cent. Defendant convicted and fined 40s. and 12s. 6d. costs »» »> 1, Betterton Street Selling milk adulterated by the extraction of fat to the extent of at least 5.3 per cent. Defendant convicted and fined 20s. and 12s. 6d. costs June 16 16, Judd Street (purchased in street) Selling milk adulterated by the extraction of fat to the extent of at least 18.3 per cent. Defendant convicted and fined 40s. and 12s. 6d. costs July 5 81, New Oxford Street Selling milk adulterated with 12 2 per cent, of added water Defendant convicted and fined 40s. and 12s. 6d. costs „ 6 157, Shaftesbury Avenue Selling milk adulterated by the extraction of fat to the extent cf at least 21.6 per cent. Defendant convicted and fined 40s. and 12s. 6d. costs »» »» 62, High Street Selling milk adulterated by the extraction of fat to the extent of at least 10.6 per cent. Defendant convicted and fined 20s. and 12s. 6d. costs »» »» 1, Cambridge Circus Selling milk adulterated by the extraction of fat to the extent of at least 11.0 per cent. Warranty proved. Summons dismissed „ 14 1a, Portpool Lane Selling milk adulterated by the extraction of fat to the extent of at least 7.0 per cent, and 22 5 per cent, of added water Summons dismissed »» »» 28, Cross Street Selling milk adulterated by the extraction of fat to the extent of at least 7.6 per cent. Defendant convicted and fined 20s. and 12s. 6d. costs »» »» 1, Kirby Street Selling milk adulterated with 16.1 per cent, of added water Defendant convicted and fined 20s. and 12s. 6d. costs August 8 7, Lamb's Conduit Street Selling milk adulterated by the extraction of fat to the extent of at least 6*3 per cent. Warranty proved. Summons dismissed 60 TABLE XII.—continued. Date. Premises. Offence. t. 1905 August 8 9, Cursitor Street Selling milk adulterated by the extraction of fat to the extent of at least 6 6 per cent. Defendant convicted and fined 20s and 12s. 6d. costs " " " 163, Drury Lane Selling milk adulterated by the extraction of fat to the extent of at least 36.6 per cent. Defendant convicted and fined 40s. and 12s. 6d. costs „ 28 76, Red Lion Street Selling milk adulterated by the extraction of fat to the extent of at least 11.6 per cent. Warranty proved. Summons dismissed September 12 71, do. Selling milk adulterated with 4 6 per cent, of added water Warranty proved. Summons dismissed October 25 ... 9, Hand Court Selling milk adulterated by the extraction of fat to the extent of at least 17.6 per cent. Defendant convicted and fined 15s. and 12s. 6d. costs 18, Little James Street Selling milk adulterated by the extraction of fat to the extent of at least 12.6 per cent. Defendant convicted and fined 20s. and 12s. 6d. costs November 15 19, Eyre Street Hill Selling milk adulterated with 7.8 per cent, of added water Defendant convicted and ordered to pay 12s. 6d. costs " " Do. Selling butter containing 0.75 per cent, of boric acid Warranty pleaded. Summuns withdrawn December 19 73, Clerkenwell Road Selling milk adulterated with 7.4 per cent, of added water Defendant convicted and fined 20s. and 12s. fid. costs TABLE XIII. Meteorology of London , 1905. 'Deduced from observations at Greenwich under the superintendence of the Astronomer Royal.) 1905. Air Temperature. Bright Sunshine. Rain and other forms of Precipitation. Mean of— n c 08 < 'o § a 5* •M © tfl « « =: ! i o V u > ® —- 5 03 jg "5 CO O 04 -»-> o H • > || ■ ■ ■S o a o EH S s* 13" ca - 1. ® > o -■ 3 CO '$ •o o s & a 3 | 3 o H a 1*. ... 03 u SI s a. b. i J G 3 s 3 O o o o hrs. hrs. hrs. ins. ins. January 32-4 43-6 38-0 - 0-5 259 49-1 + 17-1 8 1-00 - 0-99 February 37-9 46-8 42-3 + 2-8 277 67 4 + 13-6 13 0-72 - 0-76 March 38-2 52-6 45-4 + 3-7 366 121-7 + 29-4 22 3-56 + 2-10 April 39-8 54-7 47-3 + o-i 414 96-7 - 49-6 17 1-70 + 0-04 May... 43-4 64-5 53-9 + 0-8 481 234-7 + 54-1 8 1-33 - 0-67 June 51-7 68-8 60-2 + 0-8 495 153-2 - 35-4 18 4-32 + 2-30 July 56-4 77'5 66-9 + 4'5 498 226-5 + 30-2 8 0-92 - 1-55 August 52-0 71-0 61-5 - 01 451. 192-3 + 4-5 13 2 54 + 0-19 September 49-2 64-0 56-6 - 0-6 379 110-6 - 33-5 13 2-31 + 0-06 October 38-2 52-4 453 - 4-7 330 90-1 - 0-4 15 0-91 - 1-90 November 35-3 47-2 41-2 - 2-0 266 54-6 + 14-3 18 3-12 + 0-85 December 35-7 44-6 40-1 + 0-4 244 23-3 - 4-3 8 0-60 - 1-17 Year 42-5 57-3 49-9 + 0-8 4,460 1420-2 + 40-0 161 23-03 - 1-50 * The averages used are obtained from observations extending over 50 years for Rain and Temperature. and 15 years for Sunshine.