The Metropolitan Borough of holborn. REPORT FOR THE YEAR 1906 OF The medical Officer of Health, WILLIAM ARTHUR BOND, M.A., M.D. Camb., D.P.H. Camb., M.R.C.P. Lond. ilow, 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, Southward, and the Holborn District, Boards of Works. Lonon: E. Mitchener, 26 & 27, Eversholt Street, Camden Town, N.W. 1907. CONTENTS. page Introduction 5 Death Statistics 5 Birth-rates 5 Death-rates 6 Infantile Mortality 6 Infectious Diseases Notifications 6 Isolation Hospitals 6 Sanatoria for Consumptive Patients 6 Modified Milk for Infants 7 Registration of Births 7 Warner Street (Italian Colony) Area 7 Cleansing of Persons Act, 1897 7 House Refuse—Removal of 7 Area, Houses and Population 8 Estimated Population, 1906 8 Rateable Value, 1906 9 Births and Birth-rates 9 Ditto ditto corrected 9 Mortality 10 Deaths Registered 10 Deaths in Public Institutions within the Borough 10 Ditto ditto outside the Borough 11 Corrected deaths and death-rates 12 Infantile Mortality 12 Care and Feeding of Infants 13 The Earlier Registration of Births 14 Modified Milk for Infants 15 Senile Mortality 16 Infectious Diseases 16 Deaths from Zymotic Diseases 16 Ditto ditto during 1906 and ten preceding years 17 Notifications of Infectious Diseases ditto ditto 18 Small Pox 20 Scarlet Fever 20 Ditto Secondary Cases 20 Ditto Return Cases 20 Ditto Errors in Diagnosis 20 South-Western Fever Hospital—Cubicle Wards 21 Diphtheria 22 Ditto Secondary Cases 22 Ditto Return Cases 22 Ditto Errors in Diagnosis 22 Enteric Fever 23 Ditto Errors in Diagnosis 23 Measles 23 School Closure 24 Exclusion from School—Regulations 24 Whooping Cough 25 Diarrhœa 25 Phthisis or Consumption 26 Ditto ditto Voluntary Notification 26 Ditto ditto Royal Commission on Tuberculosis 27 Ditto ditto Sanatoria 27 Influenza 28 An Outbreak simulating Influenza 28 4 page Alcoholism 29 Cancer 29 Sudden and Violent Deaths 30 Inquests 30 The Public Mortuary 30 Disinfections 30 Shelter 31 Cleansing of Persons Act, 1897 31 Bacteriology 31 Housing of the Working Classes Acts 32 Ditto ditto Part I. Warner Street (Italian Colony) Area 32 Ditto ditto „ Union Buildings Area 36 Ditto ditto Part III. Beid's Brewery Site 36 Premises Closed Voluntarily, Demolished, Bebuilt, &c. 36 Sanitary Work 38 House to House Inspections 38 Water Supply to New Buildings 40 Ditto to Tenement Houses 40 By-laws as to Houses let in Lodgings 40 Overcrowding 41 Houses infested with Vermin 41 Bemoval of House Befuse 41 Bemoval of Manure 42 Common Lodging Houses 42 Factories, Workshops and Workplaces 43 Bakehouses 44 Examination of Food 44 Places where Food is Prepared for Sale 45 Slaughter Houses 45 Dairies, Cowsheds and Milk Shops 45 Ice Cream 46 Unsound Food 46 Smoke Abatement 46 Meteorology 47 APPENDICES. Table I. Vital Statistics of whole Borough during 1906, and previous ten years 48 Table II. Vital Statistics of whole Borough and separate Localities in 1906 and previous ten years 49 Table III. Cases of Infectious Disease notified during the year 1906 50 Table IV. Causes of, and Ages at Death during the year 1906 51 Table V. Infantile Mortality during the year 1906 52 Table VI. Sanitary Inspectors' Work—Inspections, &c. 53 Table VII. Ditto ditto Notices, &c. 54 Table VIII. Proceedings during 1906 55 Table IX. Factories, Workshops, Laundries, Workplaces and Homework— (1) Inspections 56 (2) Defects found 56 (3) Homework 57 (4) Begistered Workshops 58 (5) Other matters 58 Table X. Legal Proceedings under the Public Health (London) Act, 1891 59 Table XI. Legal Proceedings under the London County Council (General Powers) Act, 1902 59 Table XII. Legal Proceedings under the Sale of Food and Drugs Acts 59, 60 Table XIII. Meteorology 60 The Metropolitan Borough of holborn. REPORT of the Medical Officer of Health For the Year 1906. 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 1906, the various statistics for the year refer to the fifty-two weeks ended Saturday, the 29th December, 1906, 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 inquiries 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. The Registrar-General gave permission at the early part of the year 1904 for the details of births to be supplied by the Sub-Registrars. The births of infants whose mothers were non-residents have since then been excluded, and I have been able to give corrected birth-rates for the past two years. Although the London birth-rate, viz., 26.5 per 1000 is the lowest recorded, the Holborn corrected birth-rate, viz , 20.6 is rather higher than for the year 1905, when it was 20.3 per 1000. 6 The Holborn death-rates for the past two years, whieh were practically the same, viz., 17.0 and 16.9 per 1000, are the lowest death-rates recorded for Holborn; the average death-rate for the preceding decenniura having been 20.3 per 1000. The lowest death-rates for previous years were 17.9 in 1904, 18.4 in 1903, and 20.0 in 1901. The London death-rate was 15.1 per 1000, the same as for 1905. The corrected infantile mortality was 128 deaths under one year per 1000 births in comparison with 131 for London; in each case slightly higher than in 1905, when the numbers were 126 and 129 respectively. The death-rate from zymotic diseases in Holborn was again very low and below that for London, viz., 1.51 in comparison with 193. The death-rate from phthisis (consumption) has again diminished from 2.65 per 1000 to 2.12 per 1000. On the other hand the London rate has slightly increased from l.42 to 1.44. The number of notifications of infectious diseases, excluding the voluntary notification of consumption, was only 276. The notification rate for Holborn was again much less than that for London generally, having been 4.9 per 1000 in comparison with 7.5 per 1000. In previous Annual Reports, under the heading Scarlet Fever, I have emphasised the importance of every isolation hospital being well supplied with small isolation wards, in fact that fever hospitals should be constructed so as to secure strict isolation as far as possible as contrasted with segregation in large wards, on account of the great difficulties of diagnosis in many fever cases, and the co-existence of two or more infectious diseases in the same patient, and in my report for 1905 I gave details of the excellent results that had been obtained at the Pasteur Hospital, Paris, in which the cubicle system has been adopted. I am therefore very pleased to report that the Metropolitan Asylums Board has had two of the large wards of the South-Western Hospital converted into cubicle wards, and I gladly availed myself of the kind invitation of the Chairman of the Board to inspect them. Some details of these are given under the heading Scarlet Fever, Errors in Diagnosis, on pages 20-22. In my Annual Report for the year 1903, I reported that the Metropolitan Asylums Board had considered the question of the proposed establishment of sanatoria for consumptive patients and had referred the matter to the Local Government Board. The latter, in a letter of the 22nd March, 1906, stated that, having given the matter the most careful consideration, the Board were of opinion that the information then before them did not appear to afford sufficient justification for the very heavy outlay which would be involved in the proposal. Further details respecting consumption and the voluntary notification thereof are given on pages 26-28. 7 On pages 12-15 some details are given respecting the important question of infantile mortality and the measures that have been taken to prevent infantile illnesses and deaths. I may briefly mention that as the proper feeding of infants who cannot be breast-fed is a most important problem, and as a Municipal milk depot would, in Holborn, be very costly, I fortunately was able to arrange with the Express Dairy Co., Ltd., who have various depots in and near the Borough, to supply modified milk for infants of the working classes for about' the same charges as at Municipal milk depots, and the arrangements have been in force since June, 1906. The use of the modified milk is advised by the lady Sanitary Inspector in suitable cases, and the satisfactory results that have generally been obtained have been much appreciated by the mothers, who often recommend it to their friends. The arrangements are thus gradually becoming more known and more frequently used. I give a short report on the desirability of a much earlier registration of births than six weeks after their occurrence which is allowed by the existing law (pages 14, 15). The Local Government Board decided to hold an Inquiry respecting the Warner Street (Italian Colony) Area which was represented by me in July, 1901, as an unhealthy area under Part I. of the Housing of the Working Classes Act, 1890. As a result of the Inquiry the houses of all the courts in the area have been demolished, affording increased light, ventilation, and air space to the remaining houses. The underground rooms have been discontinued for living purposes, and the repairs, alterations and renovations agreed upon have been carried out. As a result, pending the promised further development of the area, a very considerable improvement has been made. Further details respecting the area are given on pages 32-36. Under the Cleansing of Persons Act during the year, 261 men and one woman infested with vermin or parasites had their bodies cleansed and clothing disinfected free of charge. As mentioned in my last Annual Report, 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. The Contractor was again, as in the year 1905, fined £100 for breaches of the Contract respecting the bi-weekly removal of house refuse during the months of June and July. 8 AREA, HOUSES AND POPULATION. Area. From the report of the Census, 1901, the area of the Borough is 405.1 acres. Housfs. The number of inhabitated 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 1728 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, 1906. The following are the estimated populations at the middle of the year 1906: — Bloomsbury and St. Giles 29,543 Holborn Sub-District 26,322 Holborn Borough 55,865 London 4,721,217 England and Wales 34,547,016 United Kingdom 43,659,121 9 RATEABLE VALUE, 1906. Bloomsbury and St. Giles £592,652 Holborn £457,480 Holborn Borough £1,050,132 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 one or two rooms, and 60.l per cent. of the population lived in tenements of one to four rooms. There were 3,725 tenements of 1 room. ,, 3,834 „ 2 rooms. ,, 2,224 ,, 3 „ ,, 989 „ 4 „ REGISTERED BIRTHS AND BIRTH-RATES. District. Males. Females. Both Sexes. Legitimate. Illegitimate. Total. Birth rate per 1,000. St. Giles and Bloomsbury 518 502 949 71 1,020 34.6 Holborn 324 296 611 9 620 23.6 Whole Borough 842 798 1,560 80 1,610 29.7 CORRECTED BIRTHS AND BIRTH-RATES. The Registrar-General gave permission at the later 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 1,020 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 497 were of infants whose mothers were non-residents in the Borough. 10 The corrected numbers are as follows :— District. Corrected number of Births of Residents. Corrected Birth-rate per 1000. Legitimate. Illegitimate Total. 1906. 1905. St. Giles and Bloomsbury 457 27 484 16.4 16.8 Holborn 649 16 665 25.3 24.2 Whole Borough 1106 43 1149 20.6 20.3 In London the number of births was 124,880 or a rate of 26.5 per 1000. In England and Wales the number of births was 934,391, or a rate of 27.0 per 1000. MORTALITY. The following deaths have been registered in the Borough (1906) :— Bloomsbury and St. Giles. Holborn. Total. Males 178 494 672 Females 135 405 540 Total 313 899 1212 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 35 4 16 — French Hospital 3 — 23 — British Lying-in Hospital 1 4 10 — Children's Hospital 7 13 — 502 National Hospital — — — 41 London Homœpathic Hospital 3 12 — 50 Italian Hospital — 1 — 16 Orthopoedic Hospital — 1 — 3 Private — 1 8 4 Total 49 36 57 616 11 The following deaths of Parishioners occurred in Public Institutions outside the Borough :— INSTITUTION. Number. St. Giles and Bloomsbury. Holborn. Holborn Workhouse 1 44 Holborn Workhouse, Mitcham — 8 Holborn Infirmary 2 81 Central London Sick Asylum 95 3 Banstead Asylum 2 3 Darenth Asylum — 1 Cane hill Asylum 1 2 Caterham Asylum 3 5 Claybury Asylum 2 1 Colney Hatch Asylum 2 1 Hoxton Asylum 1 — Hanwell Asylum 1 1 Horton Asylum 2 1 Manor Asylum, Epsom 1 — London County Asylum, Dartford 2 1 London County Asylum, Leavesden 1 — St. Pancras Workhouse 1 — Westminster Workhouse 2 — Strand Union Workhouse, Edmonton 5 2 Islington Infirmary — 1 St. Pancras Infirmary 2 1 Hackney Infirmary — 1 North-Western Fever Hospital 2 3 North-Eastern Fever Hospital — 1 Eastern Hospital — 1 Cancer Hospital, Chelsea 2 2 Guy's Hospital — 1 St. George's Hospital — 1 Samaritan Free Hospital 1 — Charing Cross Hospital 9 2 King's College Hospital 20 15 Middlesex Hospital 13 3 Royal Chest Hospital — 2 Royal Free Hospital — 7 Heart Hospital, Soho Square — 1 St. Mary's Hospital 1 — German Hospital .. 1 — Home for the Blind, Hanley Road 1 — Infants' Hospital, Hampstead — 1 St. Bartholomew's Hospital — 13 Friedenheim Hospital — 2 University College Hospital 3 4 Metropolitan Hospital, Hackney 1 St. Joseph's Hospice, Mare Street 1 — North-Eastern Hospital for Children, Hackney Road — 1 St. Anne's Home, Stoke Newington — 1 Private Nursing Homes, &c. 4 1 River Thames 1 2 Public Way 1 — St. Luke's House, Pembridge Square — 1 Royal Hospital for Incurables, Wandsworth — 1 Total 186 224 12 CORRECTED DEATHS AND DEATH RATES, 1906. District. Total Deaths at all ages registered in District. Deaths in Public Institutions in District. Deaths of nonresidents of Borough regist ered in District. Deaths of Residents registered beyond the District. Deaths at all ages. Nett. Death Rate for 1906. Corresponding eriod 1605. In Borough. Beyond Borough. Bloomsbury and St. Giles 313 96 57 10 186 443 15.0 15.2 Holborn Sub-District 899 649 616 9 224 506 19.3 18.9 Whole Borough 1212 745 673 410 949 17.0 16.9 Registration London 71,155 151 151 No. of Deaths. Death-Rate. Bloomsbury and St. Giles 443 15.0 Holborn Sub-District 506 19.3 Holborn Borough 949 17.0 London 71,155 15.1 England and Wales 530,715 15.4 The death-rate for the year 1905 was only l6.9 per 1000—the lowest death-rate recorded for Holborn—the average death-rate for the preceding decenniuni having been 20.3 per 1000. The lowest death-rates in previous years having been 17-9 in 1904, 18 3 in 1903, and 20 0 in 1901. INFANTILE MORTALITY. The number of deaths of children under five years of age was:— St. Giles and Bloomsbury 92 Holborn Sub-District 135 Holborn Borough 227 The number of deaths of children under one year of age, and the number of deaths of children under one year of age per 1000 total registered births and per 1000 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 63 62 130 Holborn Sub-District 84 135 126 Holborn Borough 147 90 128 London 16,307 131 The principal causes of death of these 147 children under one year of age are given in table V. of the Appendix. 13 Of the 147 deaths of infants during the year, inquiries were made and details obtained by the lady Inspector respecting 121. Of the 121, 19 died, principally from premature birth and congenital defects, before food, or very little food was taken. Of the remaining 102, 55 or 53.9 per cent. were artificially fed. Of these only 10 were fed with tube bottles, 39 with boat bottles, and 6 with a spoon. Only 7 mothers worked in factory or workshop ; 14 others did charing, selling flowers, or other work outside the home, and 7 were engaged in homework; the remaining 93 being engaged only in their own household duties. Of the 37 deaths from diarrhœal diseases during the year, all but 5 are reported to have been artificially fed, and of these 5, three were 10 months old, and one 9 months at death, and these probably had some artificial feeding. In the summer months, July to September inclusive, out of 39 inquiries respecting deaths of infants under one year of age, 6 died within a day or two of birth on account of premature birth or congenital defects; 11 were naturally fed, and of these 4 died from measles, 1 from whooping cough, 3 from bronchopneumonia, and the remaining 2 from diarrhœa, one aged 10 months and the other one month. The remaining 22 were artificially fed, i.e., 66.7 per cent. of the 33 who survived more than a day or two were artificially fed. Of the 20 deaths from diarrhceal diseases, 18 or 90 per cent. were artificially fed. Care and Feeding of Infants. With a view of diminishing the preventable infantile mortality in the Borough, in 548 of the 1149 births of residents of the Borough, where the mothers lived in lodging houses or tenements, visits have been made by the lady Sanitary Inspector, and inquiries made as to the number and condition of the rooms occupied; the number of other children that have been born, including the number that have died; the nature of food given to the infant, and the method of feeding; whether the child sleeps in a cot or not, and the 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 548 that were visited during the year only 69, or 12.4 per cent., were being artificially fed. of the 69 that were artificially fed :— 17 were so fed from birth. 13 before the end of the second week. 10 partly so fed before the end of the second week, i.e., in 40 out of 69, or 58 per cent., artificial feeding was begun before the end of the second week. 14 Of 548 births visited only 53 were registered before the end of the second week, and of the 69 that were artificially fed, as many as 51, or 73.9 per cent., could not be visited until more than six weeks after birth, as, in the present state of the law, it is compulsory for births to be registered within as long a period as six weeks after birth, and although in many cases registration is not effected until some weeks even after this, legal proceedings are not taken by the Registrar-General. The Earlier Rkgistration of Births. The Registrar-General in his 67th Annual Report, for the year 1904, expressed the opinion that, after serious consideration of the situation as it presents itself to him, he has come to the conclusion that whilst it would be unwise at present to disturb the existing organization of birth registration, a well devised system of early notification of births locally, and working in conjunction with the present registration system on the one hand, and with sanitary administration on the other, might, along with other motive forces, serve as a most effective and lasting barrier with which to stem the tide of infant mortality. The Huddersfield Corporation recently obtained statutory powers to enforce, under a penalty, the notification of every birth occurring in the Borough within 48 hours after the occurrence, and a provision is made to pay 1/- for each such notification, the notification to be made by the father or person in attendance on the mother. The St. Pancras Borough Council resolved to adopt, tentatively, a system of voluntary notification of births during a period of three months, and to pay to the father, or failing him to the doctor, midwife, student, or other person attending on the mother, the sum of 1/- for notifying a birth within 48 hours of its occurrence in the Borough. As an example of how infantile mortality may be largely reduced by extra care and attention being given to infants, I may mention the results obtained at Longwood, Huddersfield, where the Mayor offered to pay one sovereign for every child born during his mayoralty that survived one year. Of 112 births that were notified between the 9th November, 1904, and the 9th November, 1905, 107 survived one year. The average infantile mortality at Longwood for the ten years ending 1905 was 122 per 1000. This infantile mortality was reduced to only 44 per 1000 in the case of the 112 births mentioned above, notwithstanding a serious epidemic of whooping cough and measles during the period in question. There is no Milk Depot and no creche in Huddersfield, but during the period under consideration lady visitors and, from the 25th October, 1905, Municipal Health Visitors (Lady Doctors) were employed to visit the mothers. 15 It is undoubtedly desirable that there should be a much earlier notification of births, and legislation should be prompted to provide that births should be registered within 48 hours of occurrence, or, at most, within five days as is required in case of death. Modified Milk for Infants. The proper feeding of infants, who cannot be breast fed, is a most important problem. In order to reduce the large amount of preventable illness, and the enormous sacrifice in infant life due to improper feeding, modified milk has been provided in a great many towns in European countries, and in America. In England various milk depots have been established; those in London being Battersea, Fulham, Lambeth, and Woolwich. As a supply of modified milk by this method in Holborn would be very costly, I endeavoured to arrange with the Express Dairy Company, Ltd., who have various depots in and near the Borough, 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, on the production of a certificate to be obtained from the Medical Officer of Health. 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 Council agreed to this on the 19th May, 1906. As instructed, a leaflet was printed and circulated in suitable cases, 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. During the remainder of the year only 13 certificates were asked for, and of these only seven were used. Of the seven children who took the milk one had only a day's supply as the child was very ill when the use of the milk was begun, and was taken back to the hospital the following day, dying also on that day. In another case the milk was supplied for only one week, as the child was removed from the Borough at the end of that period. In the third case the child was very ill at the time the use of the milk was begun, and its use was discontinued because the child again went into hospital where it afterwards died. The remaining four children took the milk for seven months and progressed very satisfactorily. During the first two months of the present year (1907) 19 certificates have been issued, and the milk has been used in 15 cases. 16 SENILE MORTALITY. The number of deaths of persons 65 years of age and upwards was in :— Bloomsbury and St. Giles 124 Holborn Sub-District 143 Holborn Borough 267 Bloomsbury and St. Giles. Holborn Sub-District. Total. Of these the numbers were— 65 years and under 70 43 52 95 70 „ „ 75 28 31 59 75 „ „ 80 21 25 46 80 „ „ 85 24 19 43 85 „ „ 90 5 12 17 90 years of age 2 1 3 91 „ — 2 2 92 „ — 1 1 94 „ 1 — 1 124 143 267 INFECTIOUS DISEASES. The number of notifications of infectious diseases in the Borough during 1906 was again very small, the number of notifications being only 276 in comparison with a decennial average of 505; and only 4.9 per 1000 compared with 7 5 for London. The number of deaths from the seven principal zymotic diseases, viz. :— Smallpox, Measles, Scarlet Fever, Diphtheria (including Membranous Croup), Whooping Cough, Fever (including Enteric or Typhoid, Typhus and Continued Fever), and Diarrhoea, was 84 during the year in comparison with a decennial average of 125. 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 26 0.88 Holborn Sub-District 58 2.21 Holborn Borough 84 1.51 And for London 9,047 1.91 17 The following are the number of deaths from the separate diseases:— Bloomsbury and St. Giles. Holborn Sub-District. Holborn Borough. Small-pox — — — Measles 8 17 25 Scarlet Fever 2 — 2 Diphtheria and Membranous Croup 1 6 7 Whooping Cough 4 6 10 Typhoid Fever 1 — 1 Typhug — — — Diarrhœa 10 29 39 Total 26 58 84 DEATHS FROM ZYMOTIC DISEASES OCCURRING IN THE BOROUGH DURING THE YEAR 1906 AND DURING THE PRECEDING TEN YEARS. Sr. Giles and Bloomsbury. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. Total. 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 61 1902 37 11 6 5 11 5 5 80 1903 — 3 3 5 9 4 8 82 1904 2 12 — 4 2 2 10 32 1905 — 3 1 — 6 3 10 23 Average for 10 years 1896-1905. 5.8 14.1 3.1 5.0 8.6 4.6 15.7 56 9 1906 — 8 2 1 4 1 10 26 Holborn District. Year. Smallpox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. Total. 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 1905 — 8 2 4 9 1 12 36 Average for 10 years 1896-1905. 2.1 19.2 1.9 7.9 12.2 3.2 21.8 68.3 1906 — 17 — 6 6 — 29 58 18 Whole Borough. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. 1896 1 73 7 14 39 9 36 179 1897 — 17 11 23 37 11 52 151 1898 — 62 4 27 21 7 51 172 1899 — 27 3 9 13 11 56 119 1900 — 31 7 13 23 9 45 128 1901 30 22 3 14 10 12 42 133 1902 40 30 8 11 27 6 14 142 1903 — 17 4 7 15 5 22 70 1904 2 43 — 7 8 4 35 99 1905 — 11 3 4 15 4 22 59 Average for 10 years 1896-1905. 7.9 33 3 50 12.9 20.8 7.8 37.5 125.2 1906 — 25 2 7 10 1 39 84 NOTIFICATIONS OF INFECTIOUS DISEASES IN THE BOROUGH DURING 1906, AND DURING THE PRECEDING TEN YEARS. St. Giles and Boomsbury. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever Typhus Fever. Total. 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 1905 1 10 68 14 - 20 1 - 114 Average for 10 years 1896-1905. 32.8 39.6 102.6 24.2 .2 58.0 1.6 .1 259.0 1906 - 14 74 9 - 22 1 - 120 Chicken-pox was notifiable from October 19th, 1901, to January 6th, 1903, inclusive, during which time 114 notifications were received, and from April 8th 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. 1906 98. 19 Holborn District. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 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 — 65 117 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 3 — 151 1905 — 37 88 7 1 15 1 — 149 Average for 10 years, 1896-1905. 11.4 75.6 99.2 19.9 .4 37.8 1.7 .1 246.1 1906 — 52 63 6 — 34 1 — 156 Chicken-pox was notifiable from October 19th, 1901, to January 6th, 1903, inclusive, during which time 168 notifications were received, and from April 8th 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. 1906 93. Whole Borough. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 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 1905 1 47 156 21 1 35 2 — 263 Average for 10 years, 1896-1905. 44.2 115.2 201.8 44.1 .6 95.8 3.2 .2 505.1 1906 — 66 137 15 — 56 2 — 276 Chicken-pox was notifiable from October 19th, 1901, to January 6th, 1903, inclusive, during which time 282 notifications were received, and from April 8th 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. 1906 91. 20 SMALL-POX. There was no small-pox in the Borough during the year. SCARLET FEVER. During the 52 weeks ended Saturday, December 29th, 1906, the number of scarlet fever notifications, excluding duplicates, was 1.37; 74 belonging to St. Giles and Bloomsbury, and 63 to the Holborn District. In the St. Giles District 65 cases were removed to hospital, and in the Holborn District 59. In 1905 the number was 156, in 1904—99, and 1903—144. Secondary Cases of Scarlet Fever. Of the 137 cases of scarlet fever, 98 occurred at houses in which there was no second case. In twelve houses there were two cases, in one of which the primary case occurred the preceding year. In four houses there were three cases, and in one Institution there were four cases notified. In the majority of instances the secondary cases occurred, because the primary case was isolated at home, or was not promptly notified and removed to hospital. Return Cases or Scarlet Fever. Of the secondary cases of scarlet fever six were "Return" cases, i.e., cases which occurred in a house soon after the return home of a patient from hospital. In two of the cases the patients had been at the hospital for more than 12 weeks. In the year 1905 there was only one return case, and in the year 1904 there was no return case. Of the five patients giving rise to the six "return" cases, one had a small sore on the scalp, and a sore nose with a watery discharge the day following his return from hospital, and another had a sore nose about a week after his return from hospital. The other three patients had been apparently well since their return. In each of the houses disinfection was satisfactorily carried out, and in no case could any other source of infection be ascertained. Errors in Diagnosis. During the year seven patients were returned from the Metropolitan Asylums Board hospitals as not suffering from scarlet fever; four of them on the same or the day following their admission, and the remaining three after an interval of a fortnight to a month. In previous Annual Reports I pointed out the great need there is for increased isolation accommodation in contradistinction to segregation in large 21 wards, on account of the great difficulties of diagnosis in many fever cases, and the co-existence of two or more infectious diseases in the same patient; and in my report for 1905 I gave details of the excellent results that had been obtained at the Pasteur Hospital, Paris, in which the cubicle system has been adopted. I am, therefore, very pleased to report that the Metropolitan Asylums Board has had two of the large wards at the South Western Hospital converted into cubicle wards, and I gladly availed myself of the kind invitation of the Chairman of the Board to inspect these. The following are the details supplied by the Medical Superintendent, Dr. Caiger. South Western Fever Hospital, Stockwelt.—Cubicle Wards. The conversion of two large wards into cubicles at the South Western Hospital is designed to supplement the existing isolation accommodation. Each ward, which originally contained 18 beds, is divided by glass partitions framed in iron, and reaching to a height of 7 feet above the floor level, into 16 cubicles. The proportion of total floor space per bed is 175 square feet, and of this about 120 square feet are enclosed within the cubicle. The ward is ventilated as a whole by means of large fanlights placed above the windows, and the partitions are so disposed as to provide each cubicle with a separate window. Every cubicle is furnished with a fixed basin, the waste pipe from which is carried through the wall, and over it is fixed a tepid spray worked by a pedal action. Separate overalls are hung in each of the cubicles which are worn by the medical and nursing staff when attending to that particular patient; while a sterilised towel hung in proximity to the spray affords convenient opportunity for ablution of the hands immediately before leaving the cubicle. A bathroom attached to each of the wards is furnished with a portable enamelled iron bath, which can easily be run into the cubicles, while a gas heated copper steriliser, furnished with a hot water supply and a controllable waste, provides facilities for sterilising every article which has been used for the patient's treatment. In the scullery attached to the ward is a second steriliser, of larger size, for the disinfection of the plates, mugs, knives, forks, and spoons, etc., after they have been removed from the cubicles. 22 It is believed that for certain cases, sufficient protection is furnished by the relative isolation afforded by cubicles, provided scrupulous care is exercised by the attendants, both medical and nursing, who are entrusted with their administration. The principle underlying the system is, of course, "aseptic" in its conception. By means of the cubicles now installed, it is hoped that in each of the two wards it will be possible to provide the manifest advantages of separate and individual isolation for 18 patients (16 in the ward, and 2 in an adjoining room), at an expenditure of 5, or at most 6, nurses, both day and night staff inclusive. This should represent a material economy in the cost of isolation. For the present, the cubicles will be exclusively utilized for the temporary isolation of doubtful or anomalous cases, and for certain recognized attacks which are believed to be unattended with a high degree of infectivity. DIPHTHERIA. The number of cases of diphtheria notified was 66, of which 14 belonged to St. Giles and Bloomsbury, and 52 to the Holbo: n District. All but 8 patients were removed to hospital. The average number of notifications for the preceding decennium was 115; 39 for St. Giles and Bloomsbury, and 75 for the Holborn District. Four of the above cases were nurses or servants at hospitals in the Borough. The disease was most prevalent in the Borough in the months of October and November; the increase in October being due to an outbreak in the infants' department of the Rosebery Avenue (Laystall Street) School, and the increase in November was partly caused by a small outbreak at the London Homoeopathic Hospital. Secondary Cases. There were four secondary cases, one of which was notified as long as a month after the primary case. This child had apparently been suffering from a mild and chronic attack of the disease for six weeks, and was probably the cause of her sister's illness more than a month previously, and of the outbreak at the Rosebery Avenue (Laystall Street) School. Return Cases. There were no return cases during the year. Errors in Diagnosis. Seven patents were returned from hospital as not suffering from diphtheria, at varying intervals of one to three weeks after admission. In one case the 23 diphtheria bacilli had been isolated by the Lister Institute prior to removal to hospital. It was therefore apparently a mild case which quickly recovered. ENTERIC FEYER. Excluding duplicates there was only 15 notifications of enteric fever, in comparison with 21 the previous year; of which 9 belonged to St. Giles and Bloomsbury, and 6 to the Holborn District. The average number of notifications for the preceding decennium was 44; 24 in St. Giles and Bloomsbury, and 20 in the Holborn District. All but one of the cases were removed to hospital. Of the 15 patients, in one case the disease was certainly contracted out of the Borough; in one the disease was apparently caused from the consumption of oysters, and in two others apparently from the consumption of watercress. One patient was a nurse at a hospital, another at a nursing home, and three belonged to the staff of another hospital. The only death registered during the year as belonging to the Borough occurred at an Asylum where the patient had been for many years. Errors in Diagnosis. Of the above 15 cases I had information that two were not suffering from enteric fever; one patient died from acute tuberculosis, and the other was suffering from broncho-pneumonia. MEASLES. Measles was principally prevalent in the Borough during the months of February to June inclusive, by far the largest number of cases occurring in the months of May and June, and was more prevalent in St. Giles and Bloomsbury than in the Holborn Sub-district. Of 370 cases reported on by the Lady Sanitary Inspector, the source of information in 235 cases was from the school, and in 122 the information was obtained during her visits and revisits. In February, the school principally affected was Saffron Hill; in March, St. John Fisher Street and Charing Cross Road; in April, Princeton Street; in May, Tower Street, Endell Street, Wild Street, Macklin Street, and Castle Street; in June, Endell Street, Christ Church Herbrand Street, and Rosebery Avenue; and in July there was a small outbreak at Princeton Street. Of the 370 cases, 196 were attending school, and 174 did not attend school; three being over 14 years of age, and 171 under school age, 14 being infants under one year. 24 Of 255 children under five years of age, 84 were attending school, 127 were not at school, hut contracted the illness from a child who was attending school, and 44 cases were apparently not due to school infection. In only 32 of the 370 cases was there no doctor in attendance. Of the 370 cases, 117 occurred in tenements of only one or two rooms, 95 of them being single room tenements. Isolation was therefore practically impossible in about half of the cases. There were 25 deaths of measles registered during the year in comparison with only 11 for the preceding year. Of these 8 belonged to St. Giles and Bloomsbury, and 17 to the Holborn District; 23 of the 25 were young children under five years of age. The decennial average was 33; 14 for St. Giles and Bloomsbury, and 19 for the Holborn District. School Closures on account of Measles. On account of the large number of exclusions on account of measles at the Tower Street School, the Medical Officer of the London County Council, Education Department, agreed to have the Infants' Department closed from the 10th to the 28th May. On the re-opening of the department on the 28th May, as there was not only a very small attendance, but two or three children also came who were in the early stages of measles, I advised that the closure should be farther extended, and it was arranged that the department should be further closed until June 6th. Arrangements were made with the same department for closure of the Infants' Department of the Macklin Street School on the 25th May, from that date to the 5th June. Arrangements were also made for the closure of the babies' classes of the Christ Church School, Herbrand Street, and the St. Giles School, Endell Street, from the 8th to the 25th June. Class "D" in the Infants' Department of the Rosebery Avenue School was closed by the Medical Officer of the Education Department of the London County Council, from the 15th June to the 2nd July. New Regulations with regard to the exclusion of Children from School on account of Measles. The following alterations of Article 111 of the School Management Code, issued by the London County Council Education Department, were adopted in April, 1906:— "Children suffering from measles must be excluded for at least one month. 25 "Children coming from houses where measles exist, but who are not themselves suffering from the disease, should be dealt with as follows:— "(1) A child attending other than an Infants' School, who has had measles, need not be excluded from attendance at school. "(2) A child attending other than an Infants' School, who has not had measles, must be excluded from attendance at school until the Monday following the expiration of 14 days from the occurrence of the first case. "(3) A child attending an Infants' School, whether or not it has had measles, must be excluded from attendance at school until the Monday following the expiration of 14 days from the occurrence of the last case." The following note has recently been added:— "Note.—If a Medical Attendant or the Medical Officer of Health should certify in any special case, that periods of exclusion should be extended, teachers are to observe their instructions, and to at once communicate with the Medical Officer (Education)." WHOOPING COUGH. During the year there were only 10 deaths from whooping cough in comparison with 15 the preceding year. The average for the preceding decennium was 31. Of the 10 deaths 4 occurred in St. Giles and Bloomsbury and 6 in the Holborn District. All were children under 5 years of age. The decennial average for the two districts was 8 and 12 respectively. DIARRHŒA. The Local Government Board has requested that under the heading "Diarrhoea," as regards children under 1 year of age, all diseases classified as "Diarrhoea diseases " in table V. shall be included. The number of deaths from diarrhoea during the year was 39, in comparison with 28 in the previous year with the inclusion, as just stated, of the deaths from infantile diarrhœal diseases. 38 of the 39 deaths were of children under 5 years of age, 37 being children under 1 year; 21 of the 39 deaths occurred in the third, or summer quarter of the year, all but one being children under 1 year of age. 26 There were also 3 deaths from enteritis during the year, exclusive of the 7 deaths of children under 1 year of age which are now included under the heading diarrhœa. The temperature of the third quarter was 2.8 above the average, and the rainfall was as much as 3.3 below the average. Of the 20 deaths from diarrhœal diseases during the summer months 18, or 90 per cent., were artificially fed. PHTHISIS OR CONSUMPTION. The number of deaths from phthisis during the year 1906 was 118, equivalent to a death rate of 2.12 per 1,000; of these 66 belonged to St. Giles and Bloomsbury, being a death-rate of 2.24 per 1,000, and 52 to the Holborn District, or a deathrate of l.98 per 1,000. The corrected number of deaths in London was 6,775, the corresponding death-rate being l.44 per 1,000. The number of deaths from other tubercular diseases was 29; of these 13 belonged to St. Giles and Bloomsbury, and 16 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, 1897 to 1906, inclusive. Holborn Borough. London. Year. Deaths. Rate per 1,000. Rate per l,000 1897 197 2.87 1.72 1898 220 3.26 1.74 1899 207 3.12 1.85 1900 193 2.96 1.74 1901 166 2.81 1.66 1902 182 3.06 1.60 1903 170 2.94 1.55 1904 157 2.75 1.62 1905 149 2.65 1.42 1906 118 2.12 1.44 VOLUNTARY NOTIFICATION OF 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 1906-08. Excluding a few duplicates there were 191 cases notified, 98 belonging to St. Giles and Bloomsbury and 93 to the Holborn District, The corresponding 27 numbers for the year 1905 were respectively 208, 99, and 109. The cost of the notification was £11 16s. 0d. Of the 191 cases notified, 114, or 60 per cent., had been living in common lodging houses, and these were all, at once or soon afterwards, removed to infirmaries. With a few exceptions the remainiug 77 lived in tenement houses, and 55 of them were soon removed to infirmaries or hospitals, so that only 23 remained at home. In my two previous Annual Reports I have given details as to the action that is taken and the various results that were obtained from the enquiries made, and I think it is now unnecessary to repeat this. After death or removal to infirmary or hospital disinfection is advised. Consent for this was, however, obtained in only 60 cases. SANATORIA. In my Annual Report for the year 1903 I reported that in November of that year the following resolution was passed by the Metropolitan Asylums Board:— "That the Managers having duly considered the question of the proposed establishment of sanatoria for consumptive patients, and the letters received from the Local Government Board and the various Metropolitan Authorities and Medical Officers of Health in regard thereto, are of opinion that the matter is one of such vital and farreaching importance to the community at large, and one which, if adopted by the Managers, would entail so considerable extension of their duties and responsibilities, and so large an increase in their expenditure, as to call for some authoritative expression of opinion by the Chief Health Authority of the country, viz., the Local Government Board, before the Managers are asked to take any definite action in the matter or to make any further inquiries in regard thereto, and that the Local Government Board, the several Boards of Guardians, the Borough Councils and the Medical Officers of Health be so informed." The matter was carefully considered by the Local Government Board, and in a letter dated the 22nd March, 1906, the Board informed the Managers of the Metropolitan Asylums Board that the information at present before them dces not appear to afford sufficient justification for the very heavy outlay which would be involved in the proposal. ROYAL COMMISSION ON TUBERCULOSIS (HUMAN AND BOVINE). The Second Interim Report of the Royal Commission appointed to inquire into the relations of Human and Animal Tuberculosis was recently published. 28 It contains a large mass of detail respecting the various experiments which have been carried out and the conclusions which have been deduced from them. Many of these conclusions are of the greatest importance with a view to the prevention of consumption. I will therefore give a few of the principal results at which the Commission has already arrived. The fact that the bacillus of bovine tuberculosis can readily, by feeding as well as by subcutaneous injection, give rise to generalised tuberculosis in the anthropoid ape so nearly related to man, and indeed seems, so far as our few experiments go, to produce this result more readily than in the bovine body itself, has an importance so obvious that it need not be dwelt upon. There can be no doubt that in a certain number of cases the tuberculosis occurring in the human subject, especially in children, is the direct result of the introduction into the human body of the bacillus of bovine tuberculosis; and there also can be no doubt that in the majority at least of these cases the bacillus is introduced through cows' milk. Cows' milk containing bovine tubercle bacilli is clearly a cause of tuberculosis, and of fatal tuberculosis, in man. Of the total sixty cases investigated by us, twenty-eight possessed clinical histories indicating that in them the bacillus was introduced through the alimentary canal. These facts indicate that a very large proportion of tuberculosis contracted by ingestion is due to tubercle bacilli of bovine source. A very considerable amount of disease and loss of life, especially among the young, must be attributed to the consumption of cows' milk containing tubercle bacilli. The presence of tubercle bacilli in cows' milk can be detected, though with some difficulty, if the proper means be adopted, and such milk ought never to be used as food. There is far less difficulty in recognising clinically that a cow is distinctly suffering from tuberculosis, in which case she may be yielding tuberculous milk. The milk coining from such a cow ought not to form part of human food, and indeed ought not to be used as food at all. Our results clearly point to the necessity of measures more stringent than those at present enforced being taken to prevent the sale or the consumption of such milk. INFLUENZA. During the year there were only 15 deaths registered as due to influenza— 7 in St. Giles and Bloomsbury, and 8 in the Holborn District. AN OUTBREAK SIMULATING INFLUENZA IN AN INSTITUTION. My attention was called to an outbreak of illness at the St. Giles in the Fields and St. George Bloomsbury Receiving Home for Children through being 29 asked to give my opinion respecting one of the patients whose illness simulated enteric fever. I took a sample of the patient's blood and the Widal re-action was negative. On making further inquiries respecting the outbreak, which began on the 21st October, 1906, I found that of 36 children who were then in the home 19 had had well marked symptoms, and the majority of the remaining 17 had not been really well although they had had no treatment for any particular symptoms. Of the staff of five, the Matron was the only one who had well marked symptoms. Two of the patients were removed to the Infirmary supposed to be suffering from measles; one of them, however, on admission to the Infirmary was thought to be suffering from scarlet fever, and was so notified and removed to one of the hospitals of the Metropolitan Asylums Board. He was returned at the end of a month as not suffering from scarlet fever. The origin of the outbreak was the admission of 18 children to the home, on the 17th October, from the Holborn Workhouse, Shepherdess Walk. From inquiries that I made at this Workhouse, I found that amongst the children that were sent out there had been eases of illness similar to those occurring at the home. I read a paper on this outbreak at the Epidemiological Society (15th March, 1907), giving details of the illness of the twenty patients, and comparing them with similar outbreaks of influenza or illnesses resembling influenza. I also quoted various authorities respecting the various rashes that had been described as being present at such outbreaks, and on the pathology and bacteriology of such outbreaks, which indicated that this probably was really influenza. ALCOHOLISM. Only 22 deaths were assigned to alcoholism or cirrhosis of liver, 13 in St. Giles and Bloomsbury, and 9 in the Holborn District. 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 District. Further details as to the causes of and ages at death are given in Table IV. of the Appendix. 30 SUDDEN AND YIOLENT 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. District. Total Number. Cause of Death. Natural. Accidents. Suicide. St. Giles and Bloomsbury 33 17 15 1 Holborn 52 22 24 6 Total 85 39 39 7 THE PUBLIC MORTUARY, GOLDSMITH STREET. 108 bodies were received (30 being non-parishioners), and on these 64 inquests were held, and 45 post-mortems made. District. Bodies Received. Inquests held. Post-mortems. Non-Parishioners. St. Giles and Bloomsbury 47 28 21 12 Holborn 61 36 24 18 Total 108 64 45 30 DISINFECTIONS. During the 52 weeks ended December 29th, 1906. District. Booms. Bedding, &c. Number of Articles. Number of Persons using Shelter. St. Giles and Bloomsbury 191 4276 - Holborn 167 4197 - Whole Borough 358 8473 - 31 SHELTER DURING DISINFECTION OF HOUSES. As the Council's Shelter for the accommodation of persons during the disinfection of their houses at No. 191, High Holborn, was demolished in July the Council made arrangements with the adjoining Borough of Finsbury for the use of their Shelter. CLEANSING OF PERSONS ACT. During the year 261 men and one woman infested with vermin or parasites had their bodies cleansed and clothing disinfected free of charge. Of the 262 persons, 235 had their bodies cleansed in the baths of the St. Giles and Bloomsbury Casual Wards in Goldsmith Street, and 1291 articles of clothing were disinfected in the Council's steam apparatus. The remaining 27 had their bodies cleansed in the baths of the Holborn Casual Wards, Little Gray's Inn Lane, and their 182 articles of clothing disinfected in the steam apparatus at that Casual Ward. In the year 1905 as many as 600 men and 13 women were cleansed under the above Act, in comparison with only 9 in 1904, 16 in 1903, and 22 in 1902. The reason for the great increase in the year 1905 was the publicity respecting the facilities that had been provided by the Council which had been given by means of hand-bills. These hand-bills were placed in common lodging houses, Salvation Army shelters, underground conveniences, police stations,public libraries, dispensaries and the out-patients' departments of hospitals, including hospitals for the treatment of skin diseases. On account of alterations carried out at the St. Giles and Bloomsbury Casual Wards during the latter part of the year 1905, the cleansing of persons had to be limited to those living in the Borough, and arrangements were made with the Holborn Guardians for similar free accommodation for a limited number of persons, resident either in this Borough or in the Borough of Finsbury, and these limitations as to residents have since been enforced. BACTERIOLOGY. 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 13 10 bacilli not found 5 2 Positive 2 1 bacilli not found 3 bacilli found 3 Negative 1 bacilli found Holborn 10 7 bacilli not found — — Positive 1 — bacilli not found 3 bacilli found —Negative 1 bacilli found Whole Borough 23 7 bacilli not found 5 2 Positive 3 1 bacilli not found 6 bacilli found 3 Negative 2 bacilli found 32 HOUSING OF THE WORKING CLASSES ACT, 1890. Under Part I, of the Act. WARNER STREET (ITALIAN COLONY) AREA. Details of this area which was represented by me in July, 1901, were given in my Annual Report for that year. In successive Annual Reports I have given details of the few changes that have taken place in the area, and of the correspondence that has taken place with the London County Council, the Home Office, the Local Government Board, and the principal freeholders respecting the matter. I may now add that the Local Government Board, in a letter dated 24th April, 1906, informed the Council that they had decided that they must direct a Local Inquiry to be held. This Local Government Board Inquiry was begun on the 12th June, 1906. It was held at the Council's Offices, 197, High Holborn, before F. J. Willis, Esq., Barrister-at-Law, and L.W. Darra Mair, Esq., M.D., Local Government Board Inspectors. The Inquiry was adjourned to June 25th, and after that day to October 15th, and again to April 15th, 1907. I may mention that the area included the following premises:— Eyre Court, Nos. 1 to 12, inclusive. 12 Eyre Terrace, Nos. 1, 2, and 3. 3 Eyre Place, Nos. 1 and 2. 2 Summers Court, Nos. 1 to 6, inclusive. 15 Fleet Row, Nos. 1 to 15, inclusive. 38 Eyre Street Hill, Nos. 6 to 31, inclusive, with No. 25a. 27 Little Bath Street, Nos. 1 to 9, inclusive, with No. 4½. 10 Summers Street, Nos. 1 to 20, inclusive. 20 Warner Street, Nos. 24 to 58, inclusive. 18 Warner Street—stables at the back of Nos. 42 and 48, which are approached by a covered way between Nos. 42 and 44. 1 Back Hill, Nos. 1a, 1, 2, 3, 4, 5, 11, 12, 13, 14, 15, 16, 17, and a covered shed. 13 (New numbers, 31 to 7 respectively, inclusive, odd numbers). 127 The area therefore comprised about 125 houses and premises; 38 being in the five small courts mentioned first in the above list. The area is about two (1.86) acres in extent. The population of the area at the time of representation was about 1170 persons, almost all of whom were Italians of the labouring class. 33 The density of the area was therefore about 630 persons per acre, in comparison with 147 for the Holborn Borough, and 61 for the whole of London. A few of the principal changes that have been made are the following:— 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. Daring 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 re-occupied by October, 1905. Nos. 1 and 2, Eyre Terrace were closed by Magistrate's order under Part II. of the Act. During 1905 the front walls of the majority of the houses facing the principal streets in the area were repointed. Before the Inquiry I again made a detailed inspection and report of all the houses and premises in the area, and prepared statistics and various death-rates for the preceding ten years; also details of sanitary notices that had been served for the year 1901 to the date of the Inquiry, inclusive; details respecting Italians in London, and various other statistics. I may briefly say that this detailed report showed:— (1) That a very large majority of the houses, courts, and alleys within the said area were more or less unfit for human habitation. (2) That the streets and houses, and groups of houses within the area were generally narrow, close, and badly arranged, and of bad condition, that many had want of light, air, and ventilation; that the great majority had no proper conveniences, and that a very large number of notices were yearly being served for sanitary defects, and I was of opinion that such causes were dangerous or injurious to the health of the inhabitants of the buildings in the said area. (3) The following evils and sanitary defects connected with such houses, courts, or alleys, were thus briefly summarised. In the area the houses generally were old and worn, and many were dangerously dilapidated. In many the landings and floors were slanting, sunken, and uneven, the walls were bulged, uneven, and out of the perpendicular, in some cases so dangerously so that they had to be supported by iron stays or ties. Many of the houses had no through ventilation, nor ventilation under the ground floors, many had no back areas, and many others but very small ones. Many of the rooms were dark and badly ventilated, and many were very low. The efficient ventilation of many of the rooms was very much impeded or prevented by the defective or broken window frames, sashes, and sashlines; many of 34 the upper portions of the windows had no sashlines at all, but only wooden hinged flaps, and in some the upper portions were quite fixed, and for these reasons many of the windows were seldom or never opened at the top. Many of the basements were used as living rooms, and were quite unfitted for this purpose, as they were dark and badly ventilated cellars, being only lighted and ventilated by means of small undrained box areas covered with small iron gratings. With scarcely any exception the houses were without a proper and sufficient supply of water, many had only a supply in the basement, the approach to which was by a narrow, steep and dark staircase. In many others the only water supply was in the back area, and many of the houses in the courts were only supplied by taps in the courts The drainage and sanitary conveniences of the great majority of the houses were not in accordance with modern requirements. About 20 of the houses were only supplied by old fashioned trough closets which were very near to some of the houses. Many of the water closets were in small back yards, either adjoining or very near the houses. Some were in basements, the access to which is by dark, steep and narrow staircases, and many were not properly lighted and ventilated. Many of the seats of the water closets were sodden and foul, as the seats were either fixed or not lifted up when used as a urinal or for slops. The evils and sanitary defects connected with such houses, courts, and alleys, could not therefore be effectually remedied otherwise than by an improvement scheme. The following summary shows the principal structural defects existing in the 111 dwelling houses occupied at the time of the Inquiry:— WARNER STREET (ITALIAN COLONY) AREA. Summary of Dwelling Houses occupied at the time of Inquiry. Total number of Dwelling Houses 111 Number of houses with no back yards 22 „ „ with small back yards 75 ,, „ with low rooms 7 ft. 6 in. or under 139 „ rooms with no through ventilation 97 „ houses with no thorough ventilation under floors 87 „ „ with dark rooms 55 „ rooms with no external ventilation 6 „ badly ventilated 46 35 Number of rooms badly ventilated by reason of window frames being dilapidated 73 „ stiarcases dark 23 „ „ not ventilated 18 ,, „ badly ventilated 23 „ houses with no water supply above the basement level 26 „ „ with water on ground floor only 71 „ „ with trough closets 18 „ „ with water closets in basement only 10 „ ,, with water closets in 6mall back yards 83 „ „ with landings and floorings sloping 59 „ „ with walls bulged and uneven 66 „ ,, with iron ties provided to walls 33 „ „ dilapidated 83 Many details respecting various death-rates in the area during 1905 and for the five years 1896-1900 inclusive, and for the five years 1901-1905 inclusive, were given in ray Annual Report for 1905. I may here briefly mention that the average death-rate from all causes in the area for the 10 years 1896-1905 inclusive was 29.2 per 1,000; and for the principal zymotic diseases 4.95 per 1,000 in comparison with 1.98 for the Holborn Borough. Although this area was generally known as the Italian Colony, at a census which we took in 1895 the population there was only 947, and in February, 1906, was 966. I handed in the statistics of the Census of 1901, which shows there was then 10,889 Italians scattered throughout the Metropolis and residing in greater or lesser numbers in each of the Metropolitan Boroughs. In the course of the Inquiry certain proposals for demolition, alterations and repairs were made by the owners of the greater part of the area, and, either at the Inquiry or as a result of correspondence, arrangements were made with the owners of the remaining parts of the area to carry out such alterations, repairs and renovations to the houses in their possession, as under all the circumstances of the case were considered necessary by the Medical Officers of Health of the London County Council and of this Borough. In addition, undertakings were given by the representatives of the owners to discontinue the use of the underground rooms on the area for living purposes. The property demolished is as follows:—Nos. 1, 2 and 3, Eyre Terrace, 1 to 12, Eyre Court, 1 to 15, Fleet Row, 4, 5 and 6, Summers Court, and 1 and 2, Eyre Place. Practically the whole of the centres of the three blocks comprised in the area have thus been cleared and left open, affording light, ventilation and air space. The underground rooms have been discontinued for living purposes, and the 36 repairs, alterations and renovations agreed upon have been carried out. As a result, pending the promised further development of the area, a very considerable improvement has been made. UNION BUILDINGS AREA. Aylesbury Place, Clerkenwell, and Union Buildings, Holborn, Improvement Scheme, 1899. After local enquiry in the year 1900, a Provisional Order was made by one of Her Majesty's principal Secretaries of State, and an Act confirming the Provisional Order was afterwards passed. 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 April, 1906, the demolition of the whole area was completed. During the year plans for the new buildings to be erected were approved, and the erection was begun in August. 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, with the exception of some of the shops which are not yet occupied, was completed during the year 1906. LIST OF PREMISES CLOSED, DEMOLISHED, OR REBUILT DURING 1906. St. Giles and Bloomsbury. Alfred Place, Nos. 20 to 32. Closed. Bloomsbury Street, Nos. 7 to 19 (odd) with Nos. 29 to 34 Great Russell Street, Rebuilt (Ivanhoe Hotel.) Chenies Street, Nos. 12 and 14. Closed. Denmark Street, No. 11. New warehouse being built. Francis Street, Nos. 14 to 18. Site vacant. Gate Street, No. 1. Site still vacant. „ Nos. 22, 23 and 24 with Nos, 223 to 228 High Holborn. Station built (King's Cross and Hammersmith Railway), offices over being built, Gower Street, Nos. 82, 84 and 86. Being demolished, 37 Goldsmith Street, No. 9. Site still vacant. Grape Street, Nos. 9 to 15. Rebuilt. Great Queen Street, No. 3. Demolished. „ „ Nos. 1 and 2. Being rebuilt. ,, ,, Nos. 70 and 71. Demolished. „ „ Nos. 72 to 76. Demolished (part of Kingsway). Great Russell Street, Nos. 29 to 34 with Nos. 7 to 19 Bloomsbury Street. Rebuilt (Ivanhoe Hotel). Great St. Andrew Street, No. 15. Warehouse built. „ „ Nos. 43 to 47. Closed for demolition. Great White Lion Street, Nos. 1, 2, 3 and 4. Closed for demolition. High Holborn. Offices over station (Central London Railway) built. ,, „ Nos. 191 to 196. Demolished. „ „ Nos. 223 to 228 with Nos. 22, 23 and 24 Gate Street. Station built (King's Cross and Hammersmith Railway), offices over being built. High Holborn, Nos. 240 and 241. Demolished, being rebuilt. „ ,, Nos. 242 and 243. Rebuilt, "Holborn Empire." Huntley Street, Nos. 1 to 12. New flats built. Keeley Street, Nos. 11, 12, 13, 14 and 15. Being demolished. Keppel Mews North, Nos. 31 and 32. Closed. „ „ Nos. 23 to 27. Demolished. „ ,, Nos. 37 to 42. Closed. ,, „ Nos. 11 to 20. Demolished. Keppell Street, No. 31. Closed. „ „ Nos. 5, 8, 11 and 14. Tartly demolished. „ „ Nos. 3, 9 and 10. Demolished. New Compton Street, Nos. 27, 28, 29 and 30. Closed for demolition. Parker Street, No. 61. Being rebuilt. Russell Square, Nos. 61, 62, 63 and 64. Imperial Hotel being built. Sardinia Place, Nos. 7, 9, 11, 13, 15 and 17. Being demolished. ,, Street, Nos. 6, 20, 22, 24 and 26. Demolished. Shaftesbury Avenue, Nos. 167, 169, 171 and 175. Closed for demolition. Short's Gardens, Nos. 52 to 58. Warehouse built. South Crescent, Nos. 11 and 12. Warehouse built. Southampton Row. "Tollard Royal Hotel" built. „ ,, Training College and School of Arts and Crafts being built. „ „ No. 13. Being rebuilt. Torrington Square, No. 1. Demolished. ,, Street, Nos. 1, 2 and 3. Demolished. „ „ No. 4. Closed for demolition. Torrington Mews, No. 6 and 13. Closed. „ „ East, Nos. 1, 2, 3, 4, 5 and 7. Closed. 38 Tottenham Court Road, Nos. 192 to 196. Vacant site. Vernon Place, south side. Demolished. Wild Court, Nos. 8 and 14. Still closed. Wild Street Mission Hall. New wing being built. Holborn Sub-District. Eagle Street, Nos. 42 and 43. Site vacant. „ „ Mays Yard. Partly demolished. Eyre Court, Nos. 1 to 12. Being demolished. Eyre Place, Nos. 1 and 2. Being demolished. Eyre Terrace, Nos. 1, 2 and 3. Being demolished. Fleet Row, Nop. 1 to 15. Demolished. Gloucester Street, No. 10. Rebuilt. Hatton Garden, No. 40. Rebuilt. „ „ No. 39. Demolished, being rebuilt. ,, ,, Nos. 19, 20 and 21. Demolished and rebuilt. High Holbora, Nos. 315 to 318. Demolished, being rebuilt. John's Mews, No. 23 and No. 13 Little James Street. Rebuilt stables, &c. Kirby Street, Nos. 16, 17, 28 and 29. Rebuilt. Lamb's Conduit Street, Nos. 10 and 12. Closed. Laystall Street, Nos. 11 and 14. Demolished and rebuilt. Leather Lane, Nos. 13 and 15. Demolished and rebuilt. Little Bath Street, No. 7. Rebuilt. Little Gray's Inn Lane. Casual Ward being rebuilt. Ormond Yard, No. 33. Being rebuilt. Queen's Square, Nos. 10 and 12. Being rebuilt. Red Lion Passage, Nos. 16 and 17. Rebuilt. Robin Hood Yard, Nos. 19 to 24. Rebuilt. South Square, No. 10. Rebuilt. Union Buildings Area. Being rebuilt. Southampton Buildings, Nos. 1, 2 and 3. Demolished. SANITARY WORK. HOUSE TO HOUSE INSPECTIONS, 1906. St. Giles and Bloomsbury. Alfred Place (part of). Little White Lion Street. Arthur Street. Little Wild Street. Bainbridge Street. Lumber Court. Betterton Street. Marchmont Street (part of). Castle Street. Neal Street. Charing Cross Road (part of). New Compton Street. Clark's Buildings. New Turnstile. 39 Denmark Place. New Yard. Denmark Street. Nottingham Court. Drury Lane (part of). Parker Street. Dyott Street. Phœnix Street. Endell Street. Ridgmount Street. Goldsmith Buildings. Sardinia Place. Goldsmith Street. Shaftesbury Avenue (part of). Great Earl Street. Short's Gardens. Great Queen Street. Smart's Buildings. Great St. Andrew Street. Stacey Street. Great White Lion Street. Stedham Chambers. Great Wild Street (part of). Tottenham Court Road (part of). Hyde Street. Tower Street. Little Earl Street. Wild Court. Little Russell Street. West Street. Little St. Andrew Street. Whetstone Park. Holborn. Albion Buildings, Back Hill. Henry Street. Back Hill. High Holborn (part of). Beauchamp Street. Jockey's Fields. Bishop's Head Court. King's Mews. Boswell Court (South side). Lamb's Conduit Passage. Castle Court. Leather Lane Buildings. Chapel Street. Leigh Street. Charterhouse Street. Little Bath Street. Devonshire Street. Little Gray's Inn Lane. Dunstable Court. Little Saffron Hill. Eagle Street. Millman Street. East Street. Mount Pleasant. Emerald Street. New North Street. Eyre Court. Old North Street. Eyre Place. Poole's Buildings. Eyre Street Hill. Princeton Street. Eyre Terrace. Ratcliffe Buildings. Featherstone Buildings. Red Lion Passage. Fleet Row. Red Lion Street (part of). Fox Court. Robert Street. Gloucester Street. Robin Hood Yard. Great James Street. Summer Street. Great Ormond Street. Verulam Street. Greville Street. Vine Street. Hand Court. Warner Street. Harpur Mews. Warwick Court. Harpur Street. 40 WATER SUPPLY TO NEW BUILDINGS. During the year I inspected and gave certificates for the following premises:— Bloomsbury Street and Great Rust-ell Street.—Ivanhoe Hotel. Gloucester Street, No. 10. Great St. Andrew Street, No. 11. John's Mews, No. 25, and Little-James Street, No. 13. Kingsway, Craven House. Ormond Yard, No. 16. Southampton Row, Tollard Royal Hotel. 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 1905. 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. During the year 1906, 32 more houses were provided with additional water supply. On account of the difficulties that have frequently been experienced in securing a proper and sufficient water supply, the Public Health Committee made a recommendation which was adopted by the Council, "that the London County Council be urged to take the necessary steps to obtain an amendment of the existing law with a view to securing an adequate and accessible supply of water to floors in tenement houses." BY LAWS AS TO HOUSES LET IN LODGINGS. At the end of the year 690 houses were registered under these by-laws. Of these, 361 are in St. Giles and Bloomsbury, and 329 are in the Holborn District. 41 During the year, one house let in lodgings, viz., 16, Castle Street, which was formerly occupied as a common lodging house, was added to the register. Other houses formerly on the register have been closed for demolition during the year, and some are now occupied by members of only one family. During the year there were 1,397 inspections of these premises, excluding a very large number of periodical inspections and re-inspections. Thirteen notices were served for 23 over-crowded rooms, and 215 notices for other breaches of the by-laws, exclusive of more than 600 notices that were served for annual cleansing as required by the by-laws. OYER CROWDING. The number of dwelling rooms found to be over-crowded during the year was 60, in comparison with 60 during the preceding year. Twenty-three of these were dealt with as breaches of the by-laws as to houses let in lodgings. In each case the over crowding was abated without resort to legal proceedings. There were no night inspections during the year. HOUSES INFESTED WITH VERMIN. A number of rooms (at least 50) were freed from vermin during the year under section 20 of the London County Council (General Powers) Act, 1904. The majority, however, particularly in the Italian Colony, were carried out without the necessity of any formal notice being served. REMOYAL 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. On the 17th July I reported to the Public Hea'th Committee that there had been many breaches of the contract respecting the hi-weekly removal, and at an adjourned meeting the Committee recommended the Council to impose a minimum penalty of £100. The matter was referred by the Council to a joint meeting of the Works and General Purposes Committee and the Public Health Committee. The joint meeting recommended the Council to adopt the recommendation of the Public Health Committee. This recommendation was approved by the Council, and the contractor was fined £100. After this the contract was carried out much more satisfactorily. As mentioned in my Annual Report for 1905, the contractor was also fined £100 that year. 42 REMOVAL OF MANURE. The removal of manure was carried out more satisfactorily during the year. A further supply of posters requiring periodical removal of manure and other refuse matter from all stables, cow-houses, or other premises in the Borough not less frequently than every 48 hours was approved, and such posters were affixed in the various mews in the Borough. COMMON LODGING HOUSES ACTS, 1851 AND 1853. 'I he 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 1900:— Of these 22 are in Blooinsbury and St. Giles for 1,299 lodgers. „ 10 „ Holborn District for .. 744 „ Total 32 in the Borough for 2,043 ,, 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 25,Drury Lane 34 W 14, Lumber Court 68 M 9, Dyott Street 28 M 1-7, Macklin Street 96 M 25, Great Queen Street 26 M 19, do. 40 W 39, Parker Street 83 M 21, do. 26 W 2, Kennedy Court 8 M Parker Street Municipal 345 M 3, do. 10 M 5,7 & 9, Short's Gardens 159 M 4, do. 19 M 11 & 13, do. 113 M 5, do. 8 W 3, Neal's Yard 39 M 6, do. 8 W 6, Wild Court 28 M 7-, do. 9 W 7, do. 35 M A total of 22 Common Lodging-houses registered for 1,299 lodgers. Holborn District. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. 25, Charles Street 241 m 28, Orde Hall Street 22 m Field Lane Refugs 32 m 39, Queen Square 52 m 17 w 28, Red Lion ??? 72 m 40, Eagle Street 50 m 12, Took's Court 61 m 4, Greville Street 54 m 13, do. 49 m 19, Hatton Wall 94 m A total of 10 Common Lodging-houses registered for 744 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, fourteen 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, and some were afterwards demolished in connection with the new Kingsway and Sardinia Street. Details respecting these were given in my Annual Reports for the years 1903, 1904 and 1905. FACTORIES, WORKSHOPS AND WORKPLACES. During the year there were 1,077 inspections of factories and workshops, and 1,821 inspections of workplaces; 318 Intimation Notices for sanitary defects were served and 37 Statutory Notices. There were also 166 inspections of home workers' premises for which 22 Intimation Notices for sanitary defects were served, and 3 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. Inspections of Factories, Workshops and Workplaces. Class of Work. Number of Places. Number of Inspections, 1906. Number of Notices. 1906. Number of Prosecutions, 1906. On Register at end of 1905. Added in 1906. Removed in 1906. On Register at end of 1906. Premises. Rooms. Intimations. Statutory. Factories. ‡ Factory Laundries 4 1 3 2 — 4 1 0 — Factory Bakehouses 1 1 — 2 — 10 2 1 — Other Factories — — — — — 183 24 2 — Workshops. Workshop Laundries 19 1 7 13 37 39 4 2 — Workshop Bakehouses 33 — 1 32 — 261 22 — — Other Workshops 825 63 7 881 1436 580 119 19 — Workplaces. Home workers' Premises* 149 38 27 160 174 166* 22 3 — Places where Food is prepared for Sale † 398 10 31 377 — 1672 93 7 1 Workplaces other than the above § — — — — — 149 43 6 — Total 1429 114 76 1467 — 3064 330 40 1 * There were in addition, many inspections of Homeworkers' 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 1906, 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. 44 BAKEHOUSES. At the end of the year 1905, there were 34 bakehouses in the Borough, of which 17 were in St. Giles and Bloomsbury and 17 in the Holborn District. During the year 1906 a new bakehouse was constructed and opened at Viaduct Buildings, and the one at 28, Lamb's Conduit Street was closed. The following is a list of the bakehouses in the Borough, all of which are underground except those marked *— 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 Row. 6 Torringrton Place. Holborn. 172 Clerkenwell Road. 9 Cosmo Place. 49 to 57 Farringdon Road (Factory). 33 Great Ormond Street. 1 Greville Street. *91 Leather Lane. *6 Lamb's Conduit Street. 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. *Viaduct Buildings (also 17 Charterhouse Street). 36 Warner Street. During the year, in addition to my inspections, there were 261 inspections of the above bakehouses, excluding 10 inspections of the factory bakehouse in Farringdon Road. REPORT ON THE EXAMINATION OF FOOD. I presented a long report to the Public Health Committee, giving various recommendations respecting the examination of various articles of food, including canned goods, butcher's meat, meat in tripe dressers' shops, dairy produce, ice cream, and other foods generally. I also pointed out various increased powers that are required in order to prevent the sale of diseased, unsound, and unwholesome food. The report was approved by the Public Health Committee and the Council, and as details were given in the minutes of the Council meeting of the 25th July, 1906, they need not be repeated here. 45 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 on previous page. The number of these places on the register at the end of 1906 was 377; 1672 inspections were made, and 93 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 711 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. There is now only one slaughter-house in the Borough, viz., No. 29, Red Lion Street, which, in addition to my inspections, was inspected on 13 occasions during the year. The Council adopted a report and recommendation of the Public Health Committee which includes the following:— "We have in former years repeatedly expressed the opinion that the existence of such establishments in crowded districts of central London is not desirable. " We are of opinion, however, having regard to all the circumstances, that the abolition of the slaughter-house in question would be of very little disadvantage to the occupier, and whilst we are not prepared to advise the Council to oppose the renewal of the license this year, we think that the facts set out in this report should be brought to the notice of the Licensing Authority, and we are of opinion that if the license is renewed, some intimation should be made to the applicant to the effect that it will not be again renewed, thus giving him 12 months' notice with a view to enable him to convert the slaughter-house to other purposes." DAIRIES, COWSHEDS, AND MILKSHOPS. The number of registered dairies and milkshops in the Borough at the end of the year was 187, of which 79 were in St. Giles and Bloomsbury, and 108 in the Holborn District. During the year 27 dairies and milkshop3 were newly registared, 15 belonging to St, Giles and Bloomsbury, and 12 to the Holborn District. On application for 46 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 881 inspections of these premises; and 14 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, ICE CREAM. At the end of the year there were 42 premises in the Borough where ice cream was manufactured or sold, and 139 inspections of these premises were made and 8 notices were served. 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. During the year there was a prosecution for making ice cream in a shed which was used as a living room. The Magistate, however, dismissed the summons on a point of law. 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:— 2 cwt. meat. 1 crate herrings. 3 boxes kippers. 2 cases small fish. 14 baskets strawberries. 878 crates bananas. 169 bundles tomatoes. 6 bushels apples. 2 cases potatoes. SMOKE ABATEMENT. The smoke shafts in the Borough were frequently kept under observation, and in 51 cases the inspections were recorded; 13 intimation notices and two statutory notices were served. For details of Sanitary Work see tables VI., VII., VIII., IX., X.; XI, and XII. 47 METEOROLOGY, The mean temperature of the year was 50.7 degrees, which is 1.2 higher than for the preceding 50 years. The rainfall was 24.72 inches, and was 0.18 above 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 1,734 hours, out of a total possible 4,459 hours, and it was 354 hours above the average for the preceding 15 years. 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 1906 and Previous Years. Name of District—The Metropolitan Borough of Holborn. Yeah. 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.) All Ages. Number. Rate.* Number. Rate per 1000 Births registered. Number. Rate.* Number. Rate*   1 2 3 4 5 6 7 8 9 10 11 12 13 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 1898 66,371 1,840 27.8 336 183 1,467 22.2 605 461 477 1,483 22.4 1899 65,677 1,857 28.4 298 161 1,439 22.0 628 471 496 1,464 22.4 1900 64,990 1,762 27.2 311 177 1,326 20.5 516 412 514 1,428 22.1 1901 59,232 1,660 28.4 203 122 1,214 20.5 572 481 448 1,181 20.0 1902 (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 1905 56,522 1,601 28.4 145 91 1,131 20.1 680 604 427 954 16.9 Averages for years 1896-1905 62,124 1,735 28.0 246 140 1,278 20.6 589 481 468 1,265 20.3 1906 55,865 1,640 29.7 147 90 1,212 21.8 745 673 410 949 17.0 * 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 1896 to 1900 refer to the old area of St. Giles and Holborn Districts Boards of Works. Area of District in acres (inclusive 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 1906 and previous years. Names of Localities. Holborn Borough. Bloomsbury and St. Giles. Holborn Sub-District. Yeah. Population estimated to middle of each year. Births Registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births Registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births Registered. Deaths at all Ages. Deaths under 1 year. a b c d a b c d a b c d 1896 67,785 1,959 1,443 331 36,683 1,064 734 162 31,102 895 709 169 1897 67,074 1,772 1,366 289 36,394 981 676 146 30,680 791 690 143 1898 66,371 1,840 1,483 336 36,108 1,027 746 158 30,263 813 737 178 1899 65,677 1,857 1,464 298 35,824 1,132 748 136 29,853 725 716 162 1900 64,990 1,762 1,428 311 35,542 1,018 679 137 29,448 744 749 174 1901 59,232 1,660 1,181 203 31,401 1,040 575 88 27,831 620 606 115 1902 58,542 1,646 1,260 213 31,020 994 594 86 27,522 652 666 127 1903 57,861 1,621 1,054 154 30,644 991 490 68 27,217 630 564 86 1904 57,188 1,632 1,020 179 30,272 991 444 78 26,916 641 576 101 1905 56,522 1,601 954 145 29,905 988 452 61 26,617 613 502 84 Averages of Years 1896 to 1905 62,124 1,735 1,265 246 33,379 1,023 614 112 28,745 712 652 134 1906 55,865 1,640 949 147 29,543 1,020 443 63 26,322 620 506 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 1896 to 1900 refer to the old areas of the St. Giles and Holborn District Boards of Works. 50 TABLE III. Cases of Infections Disease notified during the year 1906. Notifiable Diseases. 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 — — — — — — — — — — — Cholera — — — — — — — — — — — Diphtheria and Membranous Croup 66 4 27 25 5 5 — 14 52 10 48 Erysipelas 56 1 1 5 11 33 5 22 34 10 18 Scarlet Fever 137 2 42 69 12 12 — 74 63 65 59 Typhus Fever — — — — — — — — — — — Enteric Fever 15 — 1 1 3 10 — 9 6 8 6 Belapsing Fever — — — — — — — — — — — Continued Fever — — — — — — — — — — — Puerperal Fever 2 — — — — 2 — 1 1 1 1 Plague — — — — — — — — — — — Totals 276 7 71 100 31 62 5 120 156 94 132 Note.—The Isolation Hospitals are those of the Metropolitan Asylums Board, and the London Fever Hospital. A few cases are treated at General Hospitals. There were also 191 voluntary notifications of Phthisis (Consumption), 98 belonging to St. Giles and Bloomsbury, and 93 to the Holborn District. 51 TABLE IV. Causes of, and Ages at, Death during the year 1906. Causes of Death. Deaths at the Subjoined Ages of "Residents " whether occurring in or beyond the district. Deaths at all Ages of " .Residents " belonging to Localities whether occurring in or beyond the district Total Deaths whether of " Residents " or " NonResidents" in Public Institutions in the Distbict. All Ages. Under 1. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Bloomsbury and St. Giles. Hoiborn. Smallpox — — — — — — — — — — Measles 25 9 14 2 — — — 8 17 7 Scarlet Fever 2 — 2 — — — — 2 — 2 Whooping Cough 10 4 6 — — — — 4 6 42 Diphtheria and Membranous Croup 7 — 6 1 — — — 1 6 8 Croup — — — — — — — — — — Typhus — — — — — — — — — — Fever Enteric 1 — — — — 1 — 1 — — Other Continued — — — — — — — — — — Epidemic Influenza 15 — — — — 9 6 7 8 1 Cholera — — — — — — — — — — Plague — — — — — — — — — — Diarrhoea 39* 37* 1 — — — 1 10* 29* 116 Enteritis. 3* — — — — 2 1 1 2 27 Puerperal Fever 1 — — — — 1 — 1 — — Erysipelas 8 — — — — 1 2 1 2 4 Other Septic Diseases 12 4 1 — 2 2 3 7 5 22 Phthisis 118 — — — 11 102 5 66 52 29 Other Tubercular Diseases 29 3 16 5 — 5 — 13 16 110 Cancer, Malignant Disease 55 — — — — 39 16 31 24 18 Bronchitis 105 5 3 — — 30 67 40 65 12 Pneumonia 95 22 14 1 1 39 18 48 47 61 Pleurisy 2 — — — — 2 — 1 1 — Other Diseases of Respiratory Organs 14 3 — 1 — 6 4 7 7 15 Alcoholism Cirrhosis of Liver 22 — — — — 21 1 13 9 5 Venereal Diseases 2 1 1 — — — — 1 1 3 Premature Birth 15 15 — — — — — 7 8 11 Diseases and Accidents of Parturition 4 — — — 1 3 — 1 3 1 Heart Diseases 76 1 — 5 2 44 24 42 34 35 Accidents 36 7 4 3 2 12 8 15 21 7 Suicides 7 — — — 1 5 1 2 5 2 All other causes 251 36 12 4 6 84 109 113 138 198 All causes 949 147 80 22 26 407 267 443 506 745 * Under the heading Diarrhœa, as regards children under one year of aye are included all deaths classified as Diarrhœal diseases in Table V. as requested by the Local Government Board. 52 TABLE V. Infantile Mortality during the Year 1906. 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 Causes. Certified 21 6 5 2 34 12 7 8 12 10 15 6 8 13 13 10 147 Uncertified — — — — — — — — — — — — — — — — — Common Infectious Diseases. Small Pox — — — — — — — — — — — — — — — — — Chicken Pox — — — — — — — — — — — — — — — — — Measles — — — — — — — — — — 1 1 — 4 1 2 9 Scarlet Fever — — — — — — — — — — — — — — — — — Diphtheria: Croup — — — — — — — — — — — — — — — — — Whooping Cough — — — — — — — — — — — 1 2 1 — — 4 Diarrhœal Diseases. Diarrhoea, all forms — — — — — 3 4 4 1 4 3 2 3 1 3 2 30 Enteritis (not Tuberculous) — — — — — — — — 1 1 2 — — — 3 — 7 Gastritis, Gastrointestinal Catarrh — — — — — — — — — — — — — — — — — Wasting Diseases. Premature Birth 11 1 1 — 13 2 — — — — — — — — — — 15 Congenital Defects 6 — — — 6 — — — — — 1 — — — — — 7 Injury at Birth — — — — — — — — — — — — — — — — — Want of Breast-milk — — — 1 1 — 1 — — — — — — — — — 2 Atrophy, Debility, Marasmus 1 3 — 7 1 — — 3 1 — — — — — — 12 Tuberculous Diseases. Tuberculous Meningitis — — — — — — — — — — — — — — — — 2 Tuberculous Peritonitis: Tabes Mesenterica — — — — — — — — — — — — — — — — — Other Tuberculous Diseases — — — — — — — — — — — — — — — 1 1 Erysipelas — — — — — — — — — — — — — — — — — Syphilis — — — — — 1 — — — — — — — — — — 1 Rickets — — — — — — — — — — — — — — — — — Meningitis (not Tuberculous) — — — — — — — — 1 1 — — — — — — 2 Convulsions — — — 1 1 — — — — — — — — — 1 2 4 Bronchitis — — — — — — — 1 1 — 2 — — — 1 — 5 Laryngitis — — — — — — — — — — — — 1 — — — 1 Pneumonia — 1 — — 1 3 1 1 3 1 2 1 1 4 3 1 22 Suffocation, overlaying — — — — — 1 1 1 — — 1 — — — — — 4 Other causes 3 1 1 — 5 1 — 1 1 1 3 1 1 2 1 2 19 21 6 5 2 34 12 7 8 12 10 15 6 8 13 13 10 147 Births in the year legitimate, total registered 1,560; " Residents" 1,106. illegitimate do. 80; do. 43. Deaths from all Causes at all Ages 949. Population estimated to middle of 1906, 55,865. 53 TABLE VI. Sanitary Inspectors' Work.—Inspections, &c. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Lovibond. Whole Borough. Complaints 61 100 87 17 265 Inspections. Infectious Diseases 99 115 129 314 657 Dwelling Houses 197 307 183 490 1177 Lodging Houses 348 192 446 411 1397 Common Lodging Houses 59 34 66 — 159 Dairies, Cowsheds and Milkshops 310 220 451 — 881 Ice Cream—Manufacture or Storage 3 16 120 — 139 Slaughter-houses — 18 — — 18 Market Streets 339 54 308 10 711 Butcher 'Shops 231 84 141 3 459 Bakehouses 90 107 74 — 271 Laundries 8 — 2 29 39 Other Food Shops 362 246 314 134 1056 Other Workshops 282 109 97 92 580 Out-Workers' Rooms and Registers 30 15 41 166 252 Workplaces 31 21 95 2 149 Factories 29 8 63 36 136 Schools — — 1 — 1 Smoke Shafts 14 15 22 — 51 Urinals 4 98 38 — 140 Miscellaneous 175 130 103 4 412 Periodical Inspections 866 1823 1041 — 3730* Dust 21 194 9 39 263 Total Inspections 3498 3806 3644 1730 12678 No. of Re-Inspections 1328 1552 1053 1185 5118 Visits other than Inspections and Re-Inspections 583 925 834 802 3144 Total 5409 6283 5531 3717 20940 * 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 Lovibond. Whole Borough. Intimation Notices Served 223 452 424 167 1266 Houses 164 390 295 87 936 Water closets defective or dirty 77 182 103 28 390 „ insufficient 7 13 6 2 28 Drains defective 17 35 25 4 81 Soil pipes or waste pipes defective 15 38 15 1 69 Gullies defective — 4 9 1 14 Ash-bins defective 17 25 2 12 56 „ absence of 8 5 3 3 19 Water supply defective or insufficient 8 26 5 2 41 „ cistern dirty or defective 11 24 6 1 42 „ fittings defective — — — — — Yard or area or other paving defective 15 24 9 1 49 Roof or guttering defective 7 23 34 12 76 Accumulations 8 23 20 12 63 Premises dirty 48 89 89 22 248 „ overcrowded 9 7 19 2 37 „ other defects 3 30 86 4 125 Underground rooms 1 22 2 — 25 Animals improperly kept 1 — 2 1 4 Smoke nuisances 3 5 5 — 13 Urinals — 3 — — 3 Other nuisances — 1 — — 1 Manure receptacles, absence of 8 4 1 — 13 *Factories, Workshops, and Workplaces 59 62 129 80 330 Dirty 30 19 29 58 136 Waterclosets, defective or dirty 11 14 53 27 105 „ insufficient — — 4 — 4 „ absence of separate accommodation for sexes 1 1 8 2 12 Drains, soil pipes, &c., defective 5 9 28 1 43 Improperly ventilated — 3 1 1 5 Overcrowded — 2 1 2 5 Other nuisances 4 15 38 16 73 Breach of Bye-Laws or Regulations— † Lodging houses 52 112 17 44 225 Dairies, cowsheds, milkshops and slaughter-houses 9 5 — — 14 Statutory Notices Served 21 96 93 20 230 * Many nuisances at workshops, that are parts of dwelling houses, are included in the Intimation Notices served under " Houses." † Many breaches of by-laws are included in Intimation Notices served under " Houses," 55 TABLE VIII. Proceedings during 1906. PREMISES. NUMBER OF PLACES— Number of Inspections 1906. Number of Notices 1906. Number of Prosecutions, 1906. On register at end of 1905. Added in 1906. Removed in 1900. On register at end of 1906. Milk premises 180 27 20 187 881 18 0 Cowsheds 1 0 0 1 weekly 1 0 Slaughter-houses 1 0 0 1 18 0 0 Other offensive trade premises 0 0 0 0 0 0 0 Ice Cream premises 67 1 26 42 139 8 1 Registered houses let in lodgings 759 1 70 690 1,397 (a)* 13 (b)* 215 (a)* 0 (b)* 0 * (a) For overcrowding. * (b) For other conditions. Total number of Intimation notices served for all purposes 1,260 Overcrowding, 1906 — Number of Dwelling Rooms overcrowded 60 Number remedied 60 Number of prosecutions 0 Underground Booms— Illegal occupation dealt with during year 25 Number of rooms closed 25 Insanitary Houses- Number closed under the Public Health (London) Act, 1891 0 ,, ,, ,, Housing of the Working Classes Act 30 Ice Cream— Proceedings under London County Council (General Powers) Act, 1902 1 Verminous Rooms — Numbers of premises cleansed under section 20 of the London County Council (General Powers) Act, 1904 50 Shelters provided under Section CO (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 0 Revenue Acts— Number of houses for which applications were received during the year 10 Number of dwellings comprised therein 48 Number of tenements for which certificates were (a) granted, 0; (b) refused, 5; (c) deferred, 5 10 Number of prosecutions under By-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 0 (d) As to paving of yards, etc., of dwelling houses 0 (e) In connection with the removal of offensive matter, etc. 0 (f) As to cesspools and privies, removal and disposal of refuse, etc 0 (g) For securing the cleanliness of tanks, cisterns, etc 0 (h) With respect to water closets, earth closets, etc. 0 (i) With respect to sufficiency of water supply to water closets 0 (j) 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 108 Total number of infectious bodies removed 1 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) 197 27 3 — Workshops (including Workshop Laundries) 880 145 21 1 Workplaces (other than Outworkers' Premises included in Part 3 of this Report) 1,821 136 13 — Total 2,898 803 37 1 2.—DEFECTS FOUND. Particulars. Number of Defects Number of Prosecutions Found. Remedied. Referred to H.M. Inspector. *Nuisances under the Public Health Acts: Want of cleanliness 130 136 — 1 Want of ventilation 5 5 — — Overcrowding 5 5 — — Want of drainage of floors — — — — Other nuisances 142 142 — — Sanitary accommodation insufficient 4 4 — — unsuitable or defective 105 105 — — not separate for sexes 12 12 — — Offences under the Factory or Workshop Act :— Illegal occupation of underground bakehouse (S. 101) — — — — Breach of special sanitary requirements for bakehouses (SS. 97 24 24 — — Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) — — — — Total 433 433 — 1 *Including those specified in Sections, 2, 3, 7 and 8, of the Factory and Workshop Act as remediable under the Public Health Acts. 57 3.—HOME WORK. NATURE OF WORK * Outworkers' Lists, Section 107. Number of Inspections of Outworkers' premises. Outwork in Unwholesome Premises. Section 108. Outwork in Infected Premises, Sections 109. 110. Lists received from Employers. Numbers of Addresses of Outworkers received Councils Numbers of Addresses of Outworkers forwarded to other Prosecutions. In- stances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109,110) Twice in the year. Once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists.t Out- Lists. Out- (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Apparel— (1) making, &c 120 696 13 65 199 154 — — 158 — — — — — — (2) cleaning and washing — — — — — — — — — — — — — — — Lace, lace curtains and nets — — — — — — — — — — — — — — — Furniture and Upholstery — — — — 2 — — — 1 — — — — — — Fur pulling — — — — — — — — — — — — — — — Umbrellas — — — — — — — — — — — — — — Paper Bags and Boxes 6 33 1 3 4 20 — — 5 — — — — — — Brush making 2 8 — — — 3 — — 2 — — — — — — Stuffed Toys — — 1 6 — 6 — — — — — — — — — File making — — — — — — — — — — — — — — — Electro Plate — — 1 18 — 3 — — — — — — — — — Cables and Chains — — — — — — — — — — — — — — — Anchors and Grapnels — — — — — — — — — — — — — — — Cart Gear — — — — — — — — — — — — — — — Locks, Latches and Keys — — — — — — — — — — — — — — — Total 128 737 16 92 205 186 — — 166 — — — — — — 58 1.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. (1) Number. (2) Important classes of workshops, such as workshop, bakehouses, may be enumerated here. Laundries 13 Bakehouses 34 Other Workshops 881 Total number of workshops on Register 928 8.- OTHER MATTERS. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 15 Action taken in matters referred by H.M Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) Notified by H M. Inspector 15 Reports (of action taken) sent to H.M. Inspector 15 Other — Underground Bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 27 59 TABLE X, Legal Proceedings under Public Health (London) Act, 1891. Date. Premises. Offence. Result. 1906. April 10th 11, New North Street Nuisance, gully choked and foul, and premises dirty Order to abate in 7 days with 6s. costs. May 31st 55 and 56, Chancery Lane Nuisance, workshop dirty Order to abate in 14 days with 21s. costs. Oct. 17th 47, Red Lion Street Absence of proper and sufficient water supply Summons not served. Defendant " gone away." Premises closed. TABLE XI. Legal Proceedings under London County Council (General Powers) Act, 1902. Date. Premises. Offence. Result. 1906. Oct. 2nd 40 Warner Street Permitting ice cream to be stored in a shed used as a living room and in which there was an opening to a drain Summons dismissed. (Magistrate consented to state a case.) TABLE XII. Legal Proceedings under Sale of Food and Drugs Act. Date. Premises. Offence. Result. 1906. Jan. 4th 51, Great Ormond Street Selling milk at least 12.3 per cent. deficient in fat. Defendant convicted and fined 40s. and 12s. costs. Feb. 2nd 7, Vernon Place Selling brandy 38 per cent, deficient in ethers Defendant convicted and fined £3 and £3 3s. costs. Mar. 26th 10, Bury Street Selling milk 11. 6 per cent deficient in fat Defendant convicted and fined 20s. and 12s. 6d. costs. April 26th 15, Drury Lane Selling butter containing 83 per cent. foreign fat Defendant convicted and fined £10 and 12s. 6d. costs. „ „ 21, Little Earl Street Selling margarine without a label Defendant convicted and fined 40s. and £1 12s. 6d. costs. 60 TABLE XII—continued. Date. Premises. Offence. Result. 1906 May 16th 61, Red Lion Street Selling milk adulterated with 7 2 per cent. of added water Summons not served. „ „ 10, Bury Street Selling milk 28 per cent. deficient in fat Summons not served in the statutory period. June 6th and 13th 40, Warner Street Selling milk adulterated with at least 11.8 per cent. of added water Defendant convicted and fined 40s. and 12s. 6d. costs. July 12th 10, Bury Street Selling milk at least 34.6 per cent deficient in fat Warranty proved. Summons dismissed. Sept. 5th, 19th and 26th 9, Hand Court Selling milk 16.6 per cent. deficient in fat Defendant convicted and fined 20s. and 12s. 6d. costs Dec. 4th 13, Chapel Street Selling butter containing 3.5 per cent. excess of water Warranty proved. Summons dismissed. TABLE XIII. Meteorology of London, 1906. (Deduced from observations at Greenwich under the superintendence of the Astronomer Royal.) 1906 Air Temperature. Bright Sunshine. Rain and other forms of. Precipitation. Mean of— A. B.. Mean of A. and B. Difference from Average.* Total possible. Total observed. Difference from Average.* Number of Days, Total fall. Difference from Average.* Minimum. Maximum. o o o o hrs. January 37.4 46.9 42.2 + 3.7 259 54.9 +22.9 18 3.71 + 1.72 February 33.5 44.3 38.9 — 0.6 277 62.8 + 9.0 18 1.80 + 0.32 March 35.6 48.8 42.2 + 0.5 365 101.4 + 9.1 18 1.09 — 0.37 April 35.2 57.3 46.2 — 1.0 413 218.5 + 72.2 9 0.67 — 0.99 May 44.4 62.4 53.4 + 0.3 481 153.0 — 27.6 12 1.57 — 0.44 June 47.9 69.8 58.8 — 0.6 495 241.2 + 52.6 7 2.80 + 0.78 July 53.3 75.4 64.4 + 20 493 262.6 + 66.3 7 0.41 — 2.06 August 54.4 77.0 65.7 + 4.1 451 248.7 + 60.9 8 1.39 — 0.96 September 49.3 69.8 59.5 + 2.3 379 185.7 + 41.6 11 1.97 — 0.28 October 46.9 61.8 54.4 + 4.4 331 128.0 + 37.5 17 3.04 + 0.23 November 40.4 51.5 45.9 + 2.7 266 45.1 + 4.8 17 4.11 + 1.84 December 32.0 42.3 37.2 — 2.5 244 32.6 + 5.0 19 2.16 + 0.39 Year 42.5 58.9 50.7 + 1.2 4459 1734.5 + 354.3 161 24.72 — 0.18 * The averages used are obtained from observations extending over 50 years for Rain and Temperature, and 15 years for Sunshine.