HOL 11 The Metropolitan Borough of Holborn. Report for the Year 1909 OF The Medical Officer of Health, WILLIAM ARTHUR BOND, M.A., M.D., D.P.H. Camb., Bach. Surgery Camb., M.R.C.P. Lond. Fellow, Member of Council and late President of the Metropolitan Branch, of the 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 Royal Sanitary Institute ; late Medical Officer of Health of the St. Olave District, Southwark, and the Holborn District Boards of Works. London; DIPROSE, BATEMAN & CO., SHEFFIELD STREET, LINCOLN'S INN FIELDS, W.C. 1910. CONTENTS. page. Introduction 5 Registration Year 5 Birth-rates 6 Death-rates 6 Epidemic Death-rates. 6 Consumption, Death-rate 6 Public Health (Tuberculosis) Regulations, 1908 6 Infectious Diseases. Prevalence of 6 ,, Notification-rate 6 Cerebro-spinal Fever 7 Glanders, Anthrax and Hydrophobia 7 Royal Commission on Tuberculosis 7 Housing Accommodation for the Working Classes 7 House Refuse, Removal of 7 Manure, Removal of 7 London County Council (General Powers) Act, 1908 7 Outbreak of illness due to Contaminated Milk 7 Inspections, etc. 8 Area, Houses and Population 9 Estimated Population, 1909 9 Rateable Value, 1909 10 Number of Tenements 10 Births and Birth-rates 10 Ditto ditto corrected 10 Mortality 11 Deaths Registered 11 Deaths in Public Institutions within the Borough 11 Ditto ditto outside the Borough 12 Corrected deaths and death-rates 12 Infantile Mortality 12 Prevention of Infantile Mortality 13 Care and Feeding of Infants 13 Notification of Births Act, 1907 13 Modified Milk for Infants 14 Senile Mortality 15 Deaths from Epidemic Diseases 15 Ditto ditto during 1909 and ten preceding years 16 Ditto Measles 17 Ditto Whooping Cough 18 Ditto Diarrhoea 18 Ditto Phthisis 18 Ditto Influenza 18 Ditto Alcoholism 18 Ditto Cancer 18 Sudden and Violent Deaths 18 Inquests 19 The Public Mortuary 19 Infectious Diseases 19 Notification of Infectious Diseases during 1909 and ten preceding years 20 Small Pox 21 Scarlet Fever 21 Ditto Secondary Cases 22 Ditto Return Cases 22 Ditto Errors in Diagnosis 22 Diphtheria 22 Ditto Secondary and Return Cases 22 Ditto Errors in Diagnosis 22 Enteric Fever 22 Continued Fever 23 a 2 4 page Infectious Diseases:— Cerebro-Spinal Fever 23 Phthisis or Consumption 23 Ditto ditto Voluntary Notification 24 Ditto ditto Public Health (Tuberculosis) .Regulations, 1908 24 Ditto ditto Royal Commission on Tuberculosis 25 Glanders, Anthrax and Hydrophobia in Man 26 Bacteriology 26 Disinfections 26 Shelter 26 Cleansing of Persons Act, 1897 27 Housing of the Working Classes Acts 27 Housing accommodation for Working Classes 28 Housing, Town Planning, &c., Bill, 1909 28 Premises Closed Voluntarily, Demolished, Rebuilt, etc. 29 Sanitary Work 31 House to House Inspections 31 Water Supply to New Buildings 32 Ditto to Tenement Houses 32 By-laws as to Houses let in Lodgings 32 Revenue Acts 32 Overcrowding 33 Removal of House Refuse 33 Removal of Manure 33 Common Lodging Houses 33 Factories, Workshops and Workplaces 34 Bakehouses 35 Home Work 36 Industrial Employment of Women 36 Places where Food is prepared for Sale 37 Slaughter House 37 Dairies, Cowsheds and Milkshops 38 London County Council (General Powers) Act, 1908 88 Illness due to Contaminated Milk 39 Ice Cream 39 Unsound Food 89 Offensive fumes from factories 39 Smoke Abatement 40 Meteorology 40 APPENDICES. Table I. Vital Statistics of whole Borough during 1909 and previous 10 years 41 Table II. Vital Statistics of whole Borough and Separate Localities in 1909 and previous 10 years 42 Table III. Cases of Infectious Disease notified during the year 1909 43 Table IV. Causes of, and Ages at Death during the year 1909 44 Table V. Infantile Mortality during the year 1909 45 Table VI. Sanitary Inspectors' Work—Inspections, &c. 46 Table VII Ditto Notices, &c. 47 Table VIII. Proceedings during 1909 49 Table IX. Factories, Workshops, Workplaces and Homework 50 (1) Inspections 50 (2) Defects found 50 (3) Homework 51 (4) Registered Workshops 52 (5) Other matters 52 Table X. Legal Proceedings under the Public Health (London) Act, 1891 53 Table XI. Legal Proceedings under the Sale of Food and Drugs Acts 54 Table XII. .Meteorology 54 The Metropolitan Borough of Holborn. REPORT of the Medical Officer of Health For the Year 1909. PUBLIC HEALTH DEPARTMENT, 197, HIGH HOLBORN, W.C. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Holborn. Gentlemen, In this Annual Report for the year 1909, the various statistics for the year refer to the fifty-two weeks ended Saturday, January 1st, 1910, as adopted by the Registrar-General, and known as the Registration year. The death statistics do not exactly correspond with those of the RegistrarGeneral for the following reasons: The Holborn Union includes the area of the old Holborn District Board of Works, Clerkenwell and St. Luke's. In many of the deaths registered in outlying public institutions the only address given is that of the Union, and from enquiries respecting 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. This information is afterwards sent to the Registrar-General's Department. The various birth and death rates have been corrected as far as possible by the exclusion of births and deaths of "non-residents" occurring in the Borough, and the inclusion of those of "residents" occurring in institutions outside the Borough. 6 The Holborn birth-rate was 18.3 per 1,000 in comparison with 19.2 for the preceding year. The London rate was 24.2 in comparison with 25.2 for the preceding year. The Holborn death-rate was 15.0 per 1,000, the lowest reported, in comparison with 15.7 for the preceding year. The London death-rate was 14.0 per 1,000 in comparison with 13.8 for 1908. The lowest death-rates in previous years in Holborn were 16.6 in 1907, 16.9 in 1905, and 17.0 in 1906. The average death-rate for the preceding decennium was 18.8 per 1,000, and for London 16.2 per 1,000. I may point out that in Holborn there is a very much larger proportion of Common Lodging House accommodation than in any other Metropolitan Borough, 125 of the total of 807 deaths were of persons removed from those houses to Infirmaries, &c. Excluding the Common Lodging House population from London, the Holborn death-rate was only 13.1 per 1,000 compared with 13.8 for London. The corrected infantile mortality (deaths of infants under 1 year of age) was 101 per 1,000 births, compared with 108 for London, which are both the lowest recorded. Last year these rates were 111 and 113 respectively. For both years the Holborn rates were lower than those for London. The death-rate from epidemic diseases in Holborn was again very low, and for the seventh year in succession, below that for London, viz.: 0.78 in comparison with 1.31 for London. Both are less than the preceding year, and it is the lowest rate recorded for Holborn. The corrected death-rate from phthisis was l.76 per 1,000 in comparison with 166 for 1908 and 233 for the preceding decennium. More than 30 per cent. of the deaths were of persons who had been removed to Infirmaries from common lodging houses. The London rate was 1.31, the lowest recorded and l.56 for the preceding decennium. The Local Government Board issued an Order — The Public Health (Tuberculosis) Regulations, 1908—which came into force at the beginning of the year. This provides for the notification to Medical Officers of Health of Sanitary Authorities, of cases of pulmonary tuberculosis occurring amongst the inmates of Poor Law Institutions, and amongst persons under the care of District Medical Officers, and for the taking of certain measures in such cases; and a Memorandum respecting the latter was issued by the Medical Officer of that Board. The number of notifications of infectious diseases was again small, having been only 207 in comparison with a decennial average of 408. The notification rate for Holborn was again lower than for London generally, being 3;8 per 1,000 in comparison with 6'1 for London. For each of the past eight years the Holborn notification rate has been lower than the London rate. 7 The London County Council, with the approval of the Local Government Board, made an order for the extension of the notification of cases of cerebrospinal fever (epidemic cerebro-spinal meningitis) for a further period of 12 months, and a further order has since been issued extending the notification for 12 months from March 13th, 1910. The London County Council also made an order requiring the notification of cases of glanders, anthrax and hydrophobia in man. The Third Interim Report of the Royal Commission on Human and Animal Tuberculosis gives details of a series of experiments which show that not only cows with tuberculosis of the udder but all tuberculous cows should be excluded from cowsheds. Questions respecting the housing of the working classes have received much attention during the year, and a table is given which gives an abstract of a detailed report respecting the existing housing accommodation in the Borough, and the rents charged for the various tenements. The Housing, Town Planning, etc., Bill, 1909, was passed at the latter part of the year. The removal of house refuse was again satisfactorily carried out during the year, and very few complaints were received. For the third year in succession no complaint was received respecting the non-removal of manure. The enquiry as to the industrial employment of women and infant mortality, commenced in 1908, was completed and a detailed report has since been sent to the Home Office. Under the London County Council (General Powers) Act, 1908, power was given to remove from, or refuse to enter on, the register, the names of dairymen if the premises are, in the opinion of the Sanitary Authority (Borough Councils), unsuitable for the sale of milk therein. The matter received very careful consideration, and during the year 14 purveyors of milk were removed from the register, and 7 applications for registration were refused. In 10 cases the premises were afterwards made suitable and the applications of the dairymen for re-registration were granted. In a number of other cases applicants for registration, or purveyors of milk already on the register, at once agreed to make the necessary alterations to make the premises suitable, and in those cases, therefore, it was not found necessary to refuse the applications or remove names from the register. An abstract is given of a detailed enquiry respecting an outbreak of illness amongst the staff of a large restaurant in the Borough, found to be due to contaminated milk. All the patients suffered from severe vomiting, diarrhoea and fever. 8 During the year 22,318 inspections were made, 1,255 Intimation Notices, and 270 Statutory Notices for sanitary defects were served; 653 notices for the cleansing of lodging houses and 279 notices for breaches of by-laws. The market streets were inspected daily, including Saturday nights and Sunday mornings. For further details see the various headings of the Report. 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. 9 AREA, HOUSES AND POPULATION. Area. From the report of the Census, 1901, the area of the Borough is 4051 acres. Houses. The number of inhabited houses 4,703 The number of houses occupied for business purposes only 989 The number of houses not in occupation 219 The number of houses building 29 Population. Males 29,489 Females 29,916 Total 59,405 Density of population 147 persons per acre. „ „ for London 61 „ „ Details for the different parts of the Borough, and details of the changes in the population due to changes in the boundaries under the London Government Act, were given in the Annual Report for the year 1901. Details of the age and sex distribution of the population were given in the Annual Report for the year 1902. The number of persons of foreign nationality in the Borough at the last Census was 5,706; 3,978 males and 1,728 females. Of these 2,029 were Italians, 1,098 Germans and 660 French. In the County of London the total number of foreigners was 135,377; 79,804 males and 55,573 females. Other details were given in the Annual Report for the year 1902. ESTIMATED POPULATION, 1909. The following are the estimated populations at the middle of the year 1909 :— Bloomsbury and St. Giles 28,480 Holborn Sub-District 25,457 Holborn Borough 53,937 London 4,833,938 England and Wales 35,756,615 United Kingdom 45,004,384 b 10 RATEABLE VALUE, 1909. Bloomsbury and St. Giles £591,713 Holborn £483,299 Holborn Borough £1,075,012 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. Birth rate per 1,000. Legitimate. Illegitimate. Total. St. Giles and Bloomsbury 474 443 874 43 917 32.3 Holborn 254 265 506 13 519 20.5 Whole Borough 728 708 1,380 56 1,436 26.7 CORRECTED BIRTHS AND BIRTH-RATES The Registrar-General gave permission at the latter part of the year 1904 for details of births to be supplied by the Sub-Registrars. These details were at once supplied to us, so that I have been able since then to exclude the births of infants whose mothers were "non-residents." Of the 917 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 494 were of infants whose mothers were non-residents in the Borough. In addition I received information of the births in outlying Institutions of 44 infants whose mothers were residents of the Borough. 11 The corrected numbers are as follows:— District. Corrected number of Births of Residents. Corrected Birth-rate per 1000. Legitimate. Illegitimate. Total. 1909. 1908. St. Giles and Bloomsbury 372 29 401 14.1 15.0 Holborn 563 22 585 23.1 24.0 Whole Borough 935 51 986 18.3 19.2 In London the corrected number of births was 116,559, or a rate of 24.2 per 1,000. In England and Wales the number of births was 914,017, or a rate of 25.6 per 1,000. MORTALITY. The following deaths have been registered in the Borough (1909):— St. Giles and Bloomsbury. Holborn. Total. Males 147 445 592 Females 110 365 475 Total 257 810 1,067 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 43 – 8 French Hospital 1 – 27 – British Lying-in Hospital – – 12 – Children's Hospital 3 12 – 435 National Hospital 1 – –- 55 London Homoeopathic Hospital ... 2 12 – 46 Italian Hospital 2 3 – 31 Alexandra Hospital – – – 3 Private – – 14 6 Total 52 27 61 576 B 2 12 There were 377 deaths of "Residents" in various Workhouses, Infirmaries, Asylums, Hospitals, &c., outside the Borough, 125 of whom were removed from Common Lodging Houses in the Borough. Of these, 178 formerly resided in St. Giles and Bloomsbury, and 199 in the Holborn District. CORRECTED DEATHS AND DEATH-RATES, 1909. District. Total Deaths at all ages registered in District. Deaths in Public Institutions in District. Deaths of nonresidents of Borough registered in District. Deaths of Residents registered beyond the District. Deaths at all ages. Nett. Death Rate for 1909. Corresponding period 1908. In Borough. Beyond Borough. St. Giles and Bloomsbury 257 92 62 7 178 379 13.4 14.1 Holborn Sub-District 810 604 575 1 199 428 16.9 17.4 Whole Borough 1,067 696 637 – 377 807 15.0 15.7 Registration London 67,632 14.0 13.8 England and Wales 517,782 14.5 14.7 The average death-rate of the Borough, for the preceding decennium was 18'8 per 1,000. The lowest death-rates in previous years were 15.7 in 1908, 16.6 in 1907, 17.0 in 1906, 16.9 in 1905, and 17.9 in 1904. INFANTILE MORTALITY. The corrected number of deaths of children under five years of age was:— St. Giles and Bloomsbury 63 Holborn Sub-District 92 Holborn Borough 155 The number of deaths of children under one year of age, and the number of deaths of children under one year of age per 1,000 total registered births and per 1,000 corrected births, were the following for:— Deaths under 1 year of age. Deaths under 1 year per 1,000 registered births. Deaths under 1 year per 1,000 corrected legitimate births. Deaths under 1 year per 1,000 corrected illegitimate births. Deaths under 1 year per 1,000 corrected births. St. Giles and Bloomsbury 40 44 86 241 100 Holborn Sub-District 60 116 98 227 103 Holborn Borough 100 70 93 235 101 London 12,582 — — — 108 13 Of the 100 deaths of infants under one year of age, 12 were illegitimate. It will be seen from the above Table that the deaths under one year of age per 1,000 corrected births were only 101 per 1,000, which is again the lowest recorded infantile mortality in the Borough, the preceding year being 111 per 1,000. The deaths of legitimate children under one year of age per 1,000 corrected births were only 93 per 1,000; on the other hand the deaths of illegitimate children were 235 per 1,000. Of the 100 deaths of infants during the year the Lady Sanitary Inspector was able to obtain further details respecting 90. In some cases, especially in the cases of illegitimate births, the mothers could not be found owing to changes of address, or incorrect addresses having been given. Of the 90 deaths respecting which further details were obtained, 20, principally cases of premature birth, died before taking food; only 36 were breast fed, and 34 were artificially fed. In 12 of these the mothers worked in factory or workshop, 10 were engaged in charing or other work outside the home, 4 were engaged in home work (tailoring), and 4 were in domestic service. There were only 8 deaths of infants from diarrhoeal diseases, all but one being artificially fed. Of the 100 deaths 44 were from prenatal causes and 42 from postnatal causes, the remaining 14 being unascertained or doubtful. The principal causes of death of these 100 children under one year of age are given in Table V. of the Appendix. PREVENTION OF ' INFANTILE MORTALITY. (1) Care and Feeding of Infants. In previous Annual Reports I have given details respecting visits and inquiries made by the Lady Sanitary Inspector, with a view to improving the health of infants and diminishing the infantile mortality in the Borough. 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 found. During the year 796 first visits were made. In 54 cases the mothers could not be traced. In the remaining 742 cases, 17 children did not live long enough to take any food, 58 were partly or entirely artificially fed, and 667 were breast fed at the time of the first visit, about a fortnight after birth. A large number of revisits were made, particularly in the cases of children who were not breast fed, and especially those who were feeding on modified milk. (2) Notification of Births Act, 1907. The Local Government Board consented to the adoption of the Act and fixed Monday, the 9th March, 1908, as the day on which the adoption came into operation. 14 On account of this Act the great majority of the visits are made much earlier than was possible prior to the passing of the Act. As doctors and midwives object to visits being made until after they have ceased attendance on the patient, the first visits are now made when the children are about a fortnight old. The total number of births notified in the Borough during the registration year 1909, was as follows:— Notified once only (a) By Doctors 1073 (b) „ Midwives 172 (c) „ Parents and others Notified twice 68 (a) By Doctors and Parents 7 (b) „ Midwives and Parents 1 Total 1,321 During the same period 1,436 births were registered. During the year, Miss Orange made 796 primary visits respecting newlyborn children. She found that in 711 cases the births had been notified and in 85 eases not notified. Of the 85 cases not notified, 48 were attended by doctors, 4 by midwives, 23 by students and 1 by a neighbour; in 5 cases wrong addresses were registered, and in 4 cases the person in attendance on the mother at the time of the birth could not be ascertained. I wrote in most cases requesting th e reasons for non-notification. From the doctors I had replies giving reasonable grounds for their not having done so. In the cases of midwives and students of hospitals, the reasons generally given were that the students, or midwives, had only been recently appointed, and were not aware of the Act, or that the notification had accidently been omitted. In all cases where the births had not been notified, Miss Orange informed the mothers that it was the duty of the father, and of any person in attendance on the mother at the time of, or within six hours after the birth, to notify the same. The mothers always replied that their husbands were ignorant of the Act. (3) Modified Milk for Infants. In my Annual Report for 1906 I gave a detailed report respecting this matter and the arrangements made with the Express Dairy Company, who have various depots in and near the Borough to supply modified milk for infants of the working classes at the reduced rate of 4d. per day on production of a certificate from me. During the year 51 new certificates were issued of which 8 were not used for various reasons. Including 13 children who were taking the milk at 15 the beginning of the year 1909, the milk was used by 56 children during the year, in comparison with 41 during the previous year. In the majority of cases the mothers were very well satisfied and the infants thrived well on the milk, in 8 cases however the milk was not suitable. In a number of cases the use of the milk was for various reasons discontinued; in five cases on account of the mothers leaving the Borough. Of the 56 children, five died. One from meningitis, one from spasm of the glottis, two from congenital malformation, and one from diarrhoea. In the last case the child was illegitimate, and, although it had been neglected, was healthy until nine months old, when death occurred after only a few days' illness. The death-rate for the Borough was only 0.78 in comparison with 1.31 for London. Number. Epidemic Death-Rate. St. Giles and Bloomsbury 14 0.49 Holborn Sub-District 28 1.10 Holborn Borough 42 0.78 And for London 6,285 1.31 SENILE MORTALITY. The number of deaths of persons 65 years of age and upwards was in — St. Giles and Bloomsbury 120 Holborn Sub-District 127 Holborn Borough 247 St. Giles and Bloomsbury. Holborn Sub District. Total. Of these the numbers were— 65 years and under 70 44 47 91 70 „ „ 75 27 39 66 75 „ „ 80 23 15 38 80 „ ,, 85 13 16 29 85 „ „ 90 12 8 20 90 years of age — 2 2 93 „ 1 — 1 120 127 247 DEA.THS FROM EPIDEMIC DISEASES. The following tables give details respecting the number of deaths, and the deathrates, from the seven principal epidemic diseases, viz.:—Small-pox, Measles, Scarlet Fever, Diphtheria (including Membranous Croup), Whooping Cough, Fever (including Enteric or Typhoid, Typhus and Continued), and Diarrhoea. It will be seen that the number is only 43 in comparison with a decennial average of 96. 16 The following are the number of deaths from the separate diseases:— St. Giles and Bloomsbury. Holborn Sub-District. Holborn Borough. Small-pox – – – Measles 3 11 14 Scarlet Fever 2 1 3 Diphtheria and Membranous Croup 2 1 3 Whooping Cough 3 12 15 Typhoid Fever – 1 1 Typhus – – – Diarrhœa 4 2 6 Total 14 28 42 DEATHS FROM EPIDEMIC DISEASES OCCURRING IN THE BOROUGH DURING THE YEAR 1909 AND DURING THE PRECEDING TEN YEARS. St. Giles and Bloomsbury. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. 1899 – 16 – 4 1 4 30 65 1900 – 11 4 9 13 6 20 63 1901 19 9 1 6 4 7 18 64 1902 37 11 6 5 11 5 5 80 1903 – 3 3 5 9 4 8 32 1904 2 12 – 4 2 2 10 32 1905 – 3 1 – 6 3 10 23 1906 – 8 2 1 4 1 10 26 1907 – 2 1 5 7 1 6 22 1908 – 4 1 1 3 – 10 19 Average for 10 years 1899-1908. 5.8 7.9 1.9 4.0 6.0 3.3 12.7 42.6 1909 – 3 2 2 3 — 4 14 Holborn Division. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. Total. 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 1906 – 17 – 6 6 – 29 58 1907 – 11 2 5 20 1 10 49 1908 – 6 5 4 4 4 16 39 Average for 10 years 1899-1908. 2.0 15.0 2.0 4.7 9.5 2.5 19.0 54.7 1909 – 11 1 1 12 1 2 28 17 Whole Borough. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. Total. 1899 – 27 3 9 13 11 56 119 1900 – 31 7 13 23 9 45 128 1901 30 22 3 14 10 12 42 133 1902 46 30 8 11 27 6 14 142 1903 – 17 4 7 15 5 22 70 1904 2 43 – 7 8 4 35 99 1905 – 11 3 4 15 4 22 59 1908 – 25 2 7 10 1 39 84 1907 – 13 3 10 27 2 16 71 1908 – 10 6 5 7 4 26 58 Average for 10 years 1899-1908. 7.8 22.9 3.9 8.7 15.5 68 31.7 96.3 1909 – 14 3 3 15 1 7 43 MEASLES. Measles, although more prevalent than in the year 1908, was again much less prevalent than in the year 1906. We received information of 139 cases in comparison with 86 in 1908, and 370 in 1906. The schools principally affected were St. Giles and Princeton Street. Of the 139 cases notified, 15 were found not to be suffering from measles. In 95 other cases in which inquiries were made, it was found that 81 were attending school, 14 were under school age, and 3 of these contracted measles from other children in the family attending school. In only 17 cases was there no doctor in attendance. Fifty-six cases occurred in tenements of only one or two rooms. There were only 14 deaths in comparison with a decennial average of 23. Of these 3 belonged to St. Giles and Bloomsbury and 11 to the Holborn District. During the year the Education Department of the London County Council excluded all the unprotected children from certain classes, in the Infants' Department, of the undermentioned schools from and up to the dates specified:— Wild Street, Class E—18th February to 1st March. Do. do. 29th April to 7th May. Princeton Street, Class A—5th May to 18th May. Saffron Hill, Class A—11th May to 18th May. Tower Street, Class A—17th May to 25th May. Bosebery Avenue, Class B—26th May to 1st June. St. George-the-Martyr, Class C—30th June to 7th July. c 18 WHOOPING COUGH. Whooping cough was more prevalent during the year, there having been 15 deaths registered in comparison with 7 in the preceding year and a decennial average of 15.5. Three of the deaths were in St. Giles and Bloomsbury and 12 in the Holborn District. All were children under 5 years of age. DIARRHEA. The number of deaths from diarrhoea was only 6, in comparison with a decennial average of 32. Four belonged to St. Giles and Bloomsbury and 2 to the Holborn District. All were children under 5 years of age, 5 being under 1 year of age. PHTHISIS. For details see pages 23-25. INFLUENZA. During the year there were 15 deaths registered as due to influenza, 5 in St. Giles and Bloomsbury and 10 in the Holborn District. ALCOHOLISM. Only 25 deaths were assigned to alcoholism or cirrhosis of liver, 10 in St. Giles and Bloomsbury, and 15 in the Holborn District. These represent only a portion of the deaths really caused by alcoholism as they are frequently registered under the headings of other secondary causes. CANCER. Sixty-two deaths were registered as due to cancer or malignant disease, 29 belonging to St. Giles and Bloomsbury and 33 to the Holborn District. SUDDEN AND VIOLENT DEATHS. Inquests. The following inquests on the bodies of Parishioners' were held:— Coroner: Dr. G. P. Danford Thomas, Paddington Mortuary, Paddington. Inquiry Officer: Mr. Richard Powell, 58, Hemingford Road, Barnsbury, N. 19 District. Total Number. Cause of Death. Natural. Accidents. Suicide. Murder. St. Giles and Bloomsbury Holborn 32 41 24 25 6 14 2 2 – – Total 73 49 20 4 – THE PUBLIC MORTUARY, GOLDSMITH STREET. 97 bodies were received (34 being non-parishioners), and on these 56 inquests were held, and 46 post-mortems made. District. Bodies Received. Inquests held. Post-mortems. Son- Parishioners. St. Giles and Bloomsbury 39 28 26 14 Holborn 58 28 20 20 Total 97 56 46 34 Further details as to the causes of and ages at death are given in Table IV. of the Appendix. NOTIFICATIONS OF INFECTIOUS DISEASES. The number of notifications of infectious diseases in the Borough during 1909 was again small, having been only 207 in comparison with a decennial average of 408. During the past seven years the notifications per 1,000 of the population have been less than for London, and last year were 3.8 per 1,000 in comparison with 6.l for London. This rate of 3.8 is the lowest recorded for the Borough, and much less than the lowest rate recorded for London. c 2 20 NOTIFICATIONS OF INFECTIOUS DISEASES IN THE BOROUGH DURING 1909, AND DURING THE PRECEDING TEN YEARS. St. Giles and Bloomsbury. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 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 1906 – 14 74 9 – 22 1 – 120 1907 – 32 58 6 – 18 – 1 115 1908 – 21 81 12 – 28 2 144 Average for 10 years 1899-1908. 32.4 30.8 78.7 19.4 .2 39.0 1.4 .2 203.0 1909 1 15 44 6 1 21 2 – 90 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. Cerebro-Spinal Meningitis was notifiable from March 12th, 1907. There were also the following voluntary notifications of Phthisis:— 1904 157 1908 61 1905 99 1909 9 1906 98 „ Poor Law 107 1907 74 — 116 Holborn District. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 1899 – 63 117 32 – 43 1 258 1900 – 65 96 24 2 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 1906 – 62 63 6 – 34 1 – 156 1907 – 32 98 8 – 22 1 – 161 1908 – 29 112 13 – 18 – – 172 Average for 10 years. 1899-1908. 11.8 50.6 94.1 16.3 .3 30.7 1.5 .0 204.8 1909 – 32 54 10 – 20 1 – 117 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. Cerebro-Spinal Meningitis was notifiable from March 12th, 1907; notifications received, 1907, 2; 1908, nil. There were also the following voluntary notifications of Phthisis:— 1904 187 1905 109 1906 93 1907 97 1908 91 1909 7 „ Poor Law ... 219 — 226 21 Whole Borough. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 1899 — 91 193 55 2 99 2 — 442 1900 — 123 194 55 — 89 1 — 462 1901 — 161 254 39 — 89 2 1 757 1902 211 113 202 39 — 85 6 — 662 1903 217 53 144 53 2 90 4 — 348 1904 2 46 99 41 — 77 7 — 276 1905 6 47 156 21 1 35 2 — 263 1906 1 66 137 15 — 56 2 — 276 1907 — 64 156 14 — 40 I 1 276 1908 — 50 193 25 — 46 2 — 316 Average for l0 years 1899-1908. 43.7 81.4 172.8 35.7 .5 70.6 2.9 .2 407.8 1909 1 47 98 16 1 41 3 — 207 Chicken-pox was notifiable from October 19th, 1901, to January 6th, 1903, inclusive, during which time 28: notifications were received, and from April 8th to November 6th, 1904, inclusive, during which time 6 notifications were received. Cerebro-Spinal Meningitis was notifiable from March 12th, 1907; notifications were received, 1907, 2; 1908, nl. There were also the following voluntary notifications of Phthisis:— 1904 344 1908 152 1905 208 1909 16 1906 191 ,, Poor Law 326 1907 171 342 SMALL POX. There were two notifications of small pox in the Borough during the year. One was withdrawn by request of the doctor after I had examined the patient and found that he was suffering from chicken pox and not small pox. The other patient was a visitor, who contracted small pox when travelling in the Mediterranean with a resident of the Borough. The patient was unvaccinated, being the son of an anti-vaccinator; on the other hand his friend had, fortunately, been revaccinated less than eight years previously. The "contacts," disinfecting men and I were all revaccinated and there was no spread of the disease. SCARLET FEVER. During the 52 weeks ended January 1st, 1910, the number of scarlet fever notifications, excluding duplicates was only 98, 44 belonging to St. Giles and Bloomsbury and 54 to the Holborn District. In St. Giles District 43 cases were removed to hospital, and in the Holborn District the whole 54. The number of notifications was only 1.8 per 1,000 in comparison with 3.6 for London. 22 Secondary Cases of Scarlet Fever. Of the 98 notifications, 86 occurred in houses in which there was no secondary case. There were only 6 secondary cases in 6 different houses, no houses during the year having more than 2 cases of scarlet fever. Ketukn Cases of Scarlet Fever. Of the secondary cases of scarlet fever, two were " return " cases, i.e., cases which occurred in a house soon after the return home of a patient from hospital. One was probably not a true " return " case as the illness occurred more than six weeks afterwards, and the primary case was quite well, and had no discharge from nose or ears after return home. The true return case apparently infected a relative who lived in a neighbouring house. Errors in Diagnosis. During the year 6 patients were returned home from the hospitals of the Metropolitan Asylums Board reported as not suffering from scarlet fever, or 61 per cent, of the notifications. DIPHTHERIA. The number of cases of diphtheria was 47, of which 15 belonged to St. Giles and Bloomsbury and 32 to the Holborn District. All but two were removed to hospital. The average number of notifications for the preceding decennium was 81, 31 for St. Giles and Bloomsbury and 51 for the Holborn District. Secondary and Return Cases of Diphtheria. Two of the above cases occurred after the return home of primary cases that had been removed to hospital the previous year. In one case the illness began a week after the return home of the primary case and the other about three months afterwards. Errors in Diagnosis. Seven patients were returned from the hospitals of the Metropolitan Asylums Board not suffering from diphtheria, or 14'9 per cent, of the patients notified. ENTERIC FEVER. There were, excluding duplicates, only 16 notifications in comparison with 25 for the preceding year, and a decennial average of 36. Six belonged to St. Giles and Bloomsbury, and 10 to the Holborn District. All but one of the cases were removed to hospital. 23 Of the 16 cases two were afterwards returned as not suffering from enteric fever. Of the remainder five were certainly, and one probably, not contracted in the Borough. One case was apparently contracted from the eating of infected oysters. CONTINUED FEVER. One doubtful case of enteric fever was notified as continued fever and removed to hospital, but was afterwards found to be suffering from pneumonia. CEREBRO SPINAL FEVER. (Epidemic Cerebro-Spinal Meningitis). No case was notified during the year. There were, however, five deaths attributed to this disease amongst "non-residents" who had been admitted to the Hospital for Sick Children. PHTHISIS OR CONSUMPTION. The number of deaths from phthisis during the year was 108, or a death-rate of 2.01 per 1000, or 1.76 if corrected for sex and age distribution. Of these 41 belonged to St. Giles and Bloomsbury, a death-rate of 1.44, and 67 to the Holborn District or a death-rate of 2.64 per 1000. Although the death-rate from phthisis is still high in the Borough there has been a satisfactory reduction in the death-rates during the past ten years as is shown in the table given below. Athough Holborn up to the year 1905 had the highest corrected phthisis death-rates of all the London Boroughs, since that year several other Boroughs have had higher death-rates, and in 1909, Finsbury, City of London, Shoreditch, Berniondsey and Southwark had higher death-rates, and Stepney's corrected death-rate was the same as Holborn. It must also be remembered that in Holborn there is a much larger proportion of persons living in common lodging houses than in any other London Borough. In Holborn the rate is as many as 355 beds per 10,000 of the population; whereas in Hampstead there are no common lodging houses, and 12 Boroughs have less than one-tenth the proportion of Holborn. During the five years 1904-1908 the average death-rate in common lodging houses in Holborn per 1000 beds was 20. Also during the past five years more than 30 per cent. of the deaths from phthisis in Holborn had been residents in common lodging houses in the Borough. 24 Excluding the common lodging houses the corrected phthisis death-rate for the remaining population in Holborn was l.44 per 1000. The corrected number of deaths in London was 6337 equal to a rate of 1.31 per 1000, being the lowest recorded. The following table gives the number of deaths in the Holborn Borough and the death-rates per 1000 (crude and corrected for sex and age distribution of the Holborn population in comparison with London) and the corresponding rates for London, for the 11 years 1899-1909. Year. Holborn Borough. London. Rate per 1,000 Deaths. Death Rate per 1,000. Crude. Corrected. 1899 207 3.12 2.74 1.85 1900 193 2.96 2.60 1.74 1901 166 2.81 2.47 1.66 1902 182 3.06 2.69 1.60 1903 170 2.94 2.58 1.55 1904 157 2.75 2.42 1.62 1905 149 2.65 2.32 1.42 1906 118 212 1.86 1.44 1907 125 2.28 2.00 1.40 1908 105 1.89 1.66 1.32 1909 108 2.01 1.76 1.31 VOLUNTARY NOTIFICATION OF CONSUMPTION. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1908. The Voluntary Notification of Consumption 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; it has been extended from time to time, on the last occasion for three years 1909-11 inclusive. On the 18th December, 1908, the Local Government Board, with a view to affording facilities for the extension of administrative action for the prevention of tuberculosis, issued an order—The Public Health (Tuberculosis) Regulations, 1908—in pursuance of Section 130 of the Public Health Act, 1875, as amended and extended by the Public Health (London) Act, 1891, and the Public Health Act, 1896, to provide for the notification to Medical Officers of Health of Sanitary Authorities, of cases of pulmonary tuberculosis occurring amongst the inmates of Poor Law Institutions, or amongst persons under the care of District Medical Officers, and for the taking of certain measures in such cases. As a large proportion of the voluntary notifications formerly received were Poor Law cases, the great majority are now compulsory notifications under the 25 Public Health (Tuberculosis) Regulations, 1908. Excluding a few duplicates, there were only 16 cases voluntarily notified; 9 belonging to St. Giles and Bloomsbury and 7 to the Holborn District. The corresponding numbers for the year 1908 were respectively 152, 61 and 91. Of the total number 335 notifications received, 240, or 72 per cent. were residents of common lodging houses, and were all at once or soon afterwards removed to workhouse infirmaries. With few exceptions the remaining 93 lived in tenement houses. 77 of these were soon removed to infirmaries or hospitals so that only 16 remained at home, and some of these had previously been in sanatoria or infirmaries. In previous Annual Reports for 1904-5 I gave details as to the action that is taken and the various results that were obtained from the enquiries made. I may, however, remind the Council that a printed leaflet on the Prevention of Consumption, giving instructions for measures to be taken to prevent the spread of the disease, is left in all cases occurring in tenement houses. After death, or removal to infirmary or hospital, disinfection is advised. Consent for this was, however, obtained in only 62 cases. ROYAL COMMISSION ON TUBERCULOSIS (HUMAN AND BOVINE). The Third Interim Report of the Royal Commission appointed to inquire into the relations of human and animal tuberculosis was published in January, 1909. This further report contains an account of certain experiments which have been carried out regarding the infectivity of the milk and fæces of naturally infected tuberculous cows, i.e. cows that had contracted the disease in the ordinary way. These experiments show that the presence of tubercle bacilli in the milk of cows, clinically recognisable as tuberculous, confirms the opinion expressed in the Second Interim Report, that the milk of such cows must be considered dangerous for human beings. The experiments with regard to the infectivity of the feces of tuberculous cows were dictated by knowledge of the fact that dirt of various kinds from cows and the cowshed is almost constantly present in milk as it reaches the consumer. Cows suffering from extensive tuberculosis of the lungs must discharge considerable numbers of bacilli from the air passages in the act of coughing, and some of the bacilli thus expelled may find their way into the milk. But the experiments indicate that the excrement of cows obviously suffering from tuberculosis of the lungs or alimentary canal must be regarded as much more dangerous than the matter discharged from the mouth or nostrils. It was found that even in the case of cows with slight tuberculous lesions tubercle bacilli in small numbers are discharged in the feces, whilst as regards cows clinically tuberculous, the experiments show that the fæces, contain large numbers of living and virulent tubercle bacilli. d 26 The presence of tuberculous cows in company with healthy cows in the cowshed is therefore distinctly dangerous, as some of the tubercle bacilli which escape from their bodies in the excrement are almost certain to find their way into the milk. GLANDERS, ANTHRAX AND HYDROPHOBIA IN MAN. In April the London County Council issued an order, which was approved by the Local Government Board, requiring the notification in the County of London, from and including the 26th April, 1909, of cases of glanders, anthrax and hydrophobia in man. 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 5 4 bacilli not found 1 1 Negative 5 4 bacilli not found 1 bacilli found 1 bacilli found Holborn 6 4 bacilli not found 1 1 Positive 2 2 bacilli not found 2 bacilli found Whole Borough 11 8 bacilli not found 2 1 Negative 7 6 bacilli not found 3 bacilli found 1 Positive 1 bacilli found DISINFECTIONS. During the 52 weeks ended January 1st, 1910. District. Rooms. Bedding, &c. Number of Articles. Number of Persons using Shelter. St. Giles and Bloomsbury 113 2,605 8 Holborn 179 1,955 8 Whole Borough ... 292 4,560 11 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, 27 1906, the Council made arrangements with the adjoining Borough of FinsBury for the use of their shelter. As the disinfectors work very early and very late, if required, it was only necessary to use the shelter during the year, for the accommodation of eleven persons. CLEANSING OF PERSONS ACT. During the year 219 persons (210 men and 9 women) infested with vermin, had their bodies and clothing disinfected free of charge. Of the 219 persons, 218 had their bodies cleansed in the baths of the St. Giles and Bloomsbury Casual Wards in Goldsmith Street, and 1,423 articles were disinfected in the Council's steam apparatus. The remaining 1 had his body cleansed in the baths of the Holborn Casual Wards, Little Gray's Inn Lane, and 8 articles of clothing disinfected in the steam apparatus at that Casual Ward. On account of the large number of persons applying in the latter part of 1905, the cleansing of persons had to be limited to those living in the Borough. Under the London County Council (General Powers) Act, 1907, powers are given for the compulsory cleansing of verminous children attending any of the Council's schools, and verminous inmates of any common lodging house. HOUSING OF THE WORKING CLASSES ACTS, 1890-1909 I reported respecting a site which might be available and suitable for acquisition by the Council for the erection of dwellings for the working classes under Part III. of the Principal Act. Some of the houses had already been demolished, and the leases of others were about to expire. Since my report the remainder of the houses have been demolished, the number of persons displaced being about 450. In connection with this matter I also reported as to the necessity existing in the Borough for increased better housing accommodation for the working classes. The following is a brief abstract of the report: — Although from a purely public health point of view there is at present necessity existing in the Borough for better housing accommodation for members of the working classes, many other factors have to be taken into consideration by the Council. These factors have to be considered not only in connection with Holborn in particular, but with the housing question of Lonaon as a whole. They include the outward movement of the population from central London districts; cheaper and better housing accommodation in suburban districts; increased facilities for cheap travelling and locomotion; the increased importance of Holborn as a business centre, with its large increase of factories, workshops, and other business premises, and its convenient position as a centre for visitors to D 2 28 London. The probable changes that will take place in the Borough, and the cost of the erection and maintenance of working class dwellings, especially as many of the large dwellings in central districts of London—on account of the high value of the sites—have led to heavy charges on the rates. On account of these various factors, very many of the houses that originally were generally well constructed for and occupied by one family are now occupied by many families. In Holborn we have a very large number of such houses, as many as 861 of them at the beginning of the year 1909 being on our register of houses let in lodgings. These houses have not been altered or adapted for suitable occupation by separate families. These changes have also led to a general increase in the value of land in Holborn, and it becomes increasingly difficult to find suitable sites for the erection of working class houses without any charge on the rates. I also presented a detailed report respecting the existing housing accommodation in the Borough for the working classes and the rents charged for the various tenements, an abstract of which is given in the following table:— LC.C. Dwellings. Other Dwellings. Older Dwellings (less satisfactory). Total. Tenements—Number of 1 Room 55 336 99 490 2 Rooms 522 772 22 1316 3 Rooms 324 385 1 710 4 Rooms 98 2 — 100 Total Tenements 999 1495 122 2616 Tenements Vacant Nil 38 8 46 Percentage of Vacancies Nil 2.5 6.5 1.8 Rents— 1 Room 3/6 — 5/- 1/9 — 7/6 2/6 — 6/- 2 Rooms 6/- — 8- 4/6 — 10/6 6/6 — 8/6 3 Rooms 8/-— 10/6 5/- —14/- 8/- 4 Rooms 11/- — 13/- 11/- —12/6 — Details as to the large number of common lodging houses in the Borough, providing accommodation for 1,967 lodgers, are given on page 34. These questions were from time to time fully considered by the Committee, but no recommendation thereon was made to the Council. HOUSING, TOWN PLANNING, ETC., BILL, 1909. This Bill was carefully considered by the Housing of the Working Classes Committee, and a Special Joint Committee, who reported fully thereon, and submitted various recommendations, which, after some modifications, were adopted by the Council. The Bill was passed on December 3rd, 1909. 29 LIST OF PREMISES CLOSED, DEMOLISHED OR REBUILT DURING 1909. St. Giles and Bloomsbury. Alfred Place, No. 32. New Home for Jewish Working Girls built. Bloomsbury Square, Nos. 42 and 42a. Partly rebuilt. Broad Street, Nos. 13, 14, 15, 16 and 17. Closed. Denmark Street, 28. Demolished and new premises being built. Dyott Street, Nos. 19, 20 and 21. Closed. High Holborn, Nos. 162, 163, 164, and 168. Closed. Do. Nos. 210 and 211. Being rebuilt. High Street, No. 24a. New shops and premises built. Do. No. 60. Demolished and new premises being built. Keppel Mews (North). Nos. 43 and 44. Demolished. Do. 41 Nos. 49 and 58. do. Keppel Street (South side). Site still vacant. Do. do. Demolished. Kingsway. Hampden House. Rebuilt. Do. Holy Trinity Church. Demolished. Do. Kingsway Hall. Built. Do. Lincoln's Inn House. Built. Do. St. Anselm and St. Cecilia Catholic Church. Built. Lincoln's Inn Fields, Nos. 70, 71. Rebuilt. Montague Street (North side). Site still vacant. Do. (South side). Rebuilding. Museum Street, No. 60. Closed. New Compton Street, Nos. 26-30. New Premises being built on site. North Crescent, Nos. 1, 2, 3, 4, 5, 6, 7, 8, 12, and 13. Closed. Russell Square, No. 9. Demolished. Shaftesbury Avenue, Nos. 166-177. New premises being built on Site. Do. Nos. 174-176. New extension to French Hospital being built. Do. No. 206. Closed. Short's Gardens, No. 62, 64 and 66. New Electric generating station built. Sicilian Avenue. Newly constructed offices and shops. Partly built. Southampton Row, Nos. 25-35 do. do. Do. Nos. 88, 90, 94. Closed. Torrington Mews, Nos. 3 to 10. Demolished. Do. East, Nos. 7 and 8. Closed. Do. do. Nos. 1, 2, 3, 4 and 5. Demolished. Torrington Place, Nos. 2, 3, 4, 5 and 6. Demolished. Torrington Square, Nos. 70 and 71. Demolished. 30 Tottenham Court Eoad. New premises being built for Y.M.G.A., also fronting to Gt. Russell Street, Bedford Avenue and Caroline Street. Do. No. 205, 206. Closed. Vernon Place, South Side. Partly rebuilt. Wild Court, Nos. 8 to 11 (incl.) Rebuilt extension of Masonic Institute, Great Queen Street. Woburn Mews, Nos. 15 to 34 (incl.) Demolished. Woburn Place, 42 to 53 (incl.) do. Holborn. Baldwin's Place, Factory in. Rebuilt. Bedford Row, No. 45 (with 2 and 2a, Hand Court). Rebuilt. Charles Street, No. 4. Rebuilt. do. Nos. 29, 30, 31. Rebuilt. Cosmo Place, Nos. 8-10. Demolished and being rebuilt, extension of Cosmo Hotel. Devonshire Street, Nos. 30 and 31. Demolished. Dunstable Court, all 12 houses. do. Gloucester Street, No. 37. Closed. Great Ormond Street, No. 58. Demolished, rebuilding. Do. Nos. 67, 69. Demolished. Hand Court, No. 2, 2a. Rebuilt. Harpur Mews, Nos. 3 and 4. Rebuilt. Hatton Garden, Nos. 26 and 27. Rebuilt. Do. No. 93. Being demolished. Do. No. 102. do. High Holborn, Nos. 62a, 63. Rebuilt. Kirby Street, No. 1. Rebuilt. Do. No. 44. Being rebuilt. New North Street, Nos. 20 to 28 (inclusive). Demolished. Queen Square, Nos. 34, 35 and 36. Demolished and rebuilding. Red Lion Street, No. 18. Rebuilding. Do. No. 70. Being rebuilt. Robin Hood Yard, Nos. 6, 7 and 8. Rebuilt. Sandland Street, No. 45. Rebuilt. Southampton Buildings, Nos. 43, 44 and 45. Partly demolished. Do. No. 46. Closed. Verulam Street, Nos. 19, 20 and 21. Rebuilt. Vine Street, Nos. 15, 17 and 19. do. 31 SANITARY WORK. HOUSE TO HOUSE INSPECTIONS, 1909. St. Giles and Bloomsbury. Arthur Street. Betterton Street. Bueknall Street. Castle Street. Charing Cross Eoad (part of). Church Passage. Clark's Buildings. Clark's Mews. Denmark Place. Denmark Street. Drury Lane (part of). Dyott Street. Goldsmith Buildings. Goldsmith Street. Great Earl Street. Great Queen Street (part of). Great St. Andrew Street. Great White Lion Street. Holborn Place. Kenton Street. Lawrence Street. Little Denmark Street. Little Earl Street. Little St Andrew Street. Little White Lion Street. Lumber Court. Neal Street. New Compton Street. Nottingham Court. Parker Street. Phoenix Street. Redcar Yard. Ridgmount Street. Shaftesbury Avenue (part of). Short's Gardens. Smart's Buildings. Stacey Street. Torrington Place. Tower Street. West Street. Wild Court. Wild Street. Holborn. Back Hill. Beauehamp Street. Bishop's Head Court. Boswell Court (South Side). Chapel Street. Dane Street. Devonshire Street. Eagle Street. East Street. Emerald Street. Evelyn Buildings. Eyre Street Hill. Featherstone Buildings Fox Court. Gloucester Street. Gray's Inn Eoad (part of). Hand Court. Harpur Street. Hatton Garden (part of). Hatton Wall. Hatton Yard. Lamb's Conduit Passage. Leather Lane Buildings. Little Gray's Inn Lane. Mount Pleasant. New North Street. Old North Street. Ormond Yard. Poole's Buildings. Bed Lion Passage. Bed Lion Street (part of). Bobert Street. Sandland Street. Summer Street. Yerulam Street. Viaduct Buildings. Vine Street. Warner Street. 32 WATER SUPPLY TO NEW BUILDINGS. During the year I inspected and gave certificates for the following premises:— 11-16, Torrington Place. 32, Alfred Place. 70 and 71, Lincoln's Inn Fields. 25 and 26, Red Lion Street. WATER SUPPLY TO TENEMENT HOUSES. In accordance with Section 78 of the London County Council (General Powers) Act, 1907, 70 notices were served for the provision of additional water supply in tenement houses, and in the majority of cases the work required was completed during the year. In cases where the lease of the premises expired within twelve months the notices were allowed to stand over. In the year 1908, when the above section first came into operation 403 such notices were served. BY-LAWS AS TO HOUSES LET IN LODGINGS. At the end of the year, 637 houses were registered under these By-laws, of these, 344 are in St. Giles and Bloomsbury, and 293 in the Holborn District. 44 such houses were removed from the Register principally on account of the closing or demolition of the houses, and in some cases because the houses are now occupied only by members of one family. During the year, there were 1,051 inspections of these premises, excluding a very large number of periodical inspections and re-inspections. 15 notices were served for 28 overcrowded rooms, and 248 notices for other breaches of the By-laws, exclusive of 653 notices that were served for annual cleansing as required by the By-laws. During the year, it was necessary to take legal proceedings in only one case for breaches of the By-laws respecting cleansing. A penalty of 25s. costs was inflicted. REVENUE ACTS. Applications were received during the year for Certificates from me under the above Acts for 5 houses containing 101 tenements. Certificates were given for 4 of them containing 94 tenements, and refused for the remaining one containing 7 tenements. 33 OVERCROWDING. The number of dwelling rooms found to be overcrowded was 56, in comparison with 46 in the previous year. 28 of these were dealt with as breaches of the By-laws as to houses let in lodgings. REMOVAL OF HOUSE REFUSE. In accordance with the Contract, all house refuse has to be removed during the months of 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 before 10 a.m. In consequence of a Memorial from some of the occupiers of houses in Ely Place requesting a daily collection of house refuse, etc., necessary steps were taken to secure this. During the year, 21,934 loads of house refuse were removed. As usual, much attention was given to securing the regular removal of house refuse. A large number of inspections were made by me, and the inspectors, including early morning inspections of the streets in which there is a daily removal. Only 45 genuine complaints respecting non-removal of house refuse were received from householders. 147 notices were served for the provision of proper dust receptacles. During the year, a number of applications were received for the removal of trade refuse for which the Contractor is paid by the owners in accordance with Section 33 of the Public Health (London) Act, 1891. REMOVAL OF MANURE. The removal of manure was again carried out satisfactorily For the third successive year no complaint was received. Posters requiring the periodical removal of manure and other refuse matter from all stables, cowhouses, or other premises in the Borough not less frequently than every 48 hours were again posted in the various mews in the Borough. COMMON LODGING HOUSES ACTS 1851 AND 1853. The Secretary of State by a Provisional Order which came into operation on the 1st November, 1894, transferred to the London County Council the powers of the Commissioner of Metropolitan Police in respect of common lodging houses. E 34 The following is a list of the Common Lodging Houses registered in this Borough at the end of the year 1909:— Of these 15 are in St. Giles and Bloomsbury for 1,177 lodgers. „ 8 „ Holborn District for 694 „ Total 23 in the Borough for 1,871 „ The Common Lodging houses at 9, Dyott Street and 14, Lumber Court were closed during the year. St. Giles and Bloomsbury. 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, Great Queen Street and 36, Parker Street 117 M 1-7, Macklm Strett 96 M 19, do. 40 W 21, do. 26 W 2, Kennedy Court 8 W Parker Street Municipal 345 M 3, do. 10 W 7, 9, and 11, Short's Gardens, and 3, Neat's Yard 311 M 4, do. 19 W 5, do. 8 W 6, do. 8 W 6 and 7, Wild Court 63 M 7, do. 9 W 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 40, Eagle Street 50 M 39, Queen Square 52 M 4, Greville Street 53 M 28, Red Lion Square 72 M 29, Hatton Wall 94 M 12 and 13, Took's Court 110 M FACTORIES, WORKSHOPS AND WORKPLACES. During the year there were 123 inspections of factories, 1,100 inspections of workshops and 2,317 of workplaces. 336 Intimation Notices for sanitary defects were served and 65 Statutory Notices. 35 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. 1909. Number of Notices 1909. Number of Prosecutions 1909. On Register at end of 1908. Added in 1909. Removed in 1909. On Register at end of 1909. Premises. Rooms. Intimations. Statutory. Factories, ‡ Factory Laundries 4 — — 4 — 6 1 — — Factory Bakehouses 2 — 1 1 — 34 — — — Other Factories — — — — — 83 9 2 — Workshops. Workshop Laundries 11 — — 11 30 19 3 — — Workshop Bakehouses 29 3 1 31 — 260 9 1 — Other Workshops 988 82 10 1,060 1,698 821 122 18 1 Workplaces. Home workers' Premises * 186 43 33 196 230 188 8 1 Places where Food is prepared for Sale † 388 12 18 382 1,936 7 l 10 1 Workplaces other than the the above § — — — — — 193 114 33 — Total 1,608 140 63 1,685 1,958 3,540 316 65 2 * There were in addition, many inspections of Homeworkers' Premises made during the house-to-house and periodical 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 1909, and notices served where necessary. § There is a very large number of workplaces other than the above, the registration of which is no required, and many of them were inspected and notices served where necessary. BAKEHOUSES. At the end of the year 1909, there were 32 bakehouses in the Borough, of which 15 were in St. Giles and Bloomsbury and 17 in the Holborn District. The Bakehouse at 6, Torrington Place was demolished during the year, the Factory one at 49 to 55, Farringdon Road was closed, and new ones occupied at 4a, East Street, 15, Torrington Place, and 55, Mount Pleasant. The following is a list of the bakehouses in the Borough, all of which are underground except those marked *:— E 2 36 St. Giles and Bloomsbury. *2 Bloomsbury Court. 10 Bury Street. 166 Drury Lane. 155 High Holborn. 217 & 218 High Holborn (Holborn Bestaurant). 63 High Street. 19 Little Earl Street. 5 Little St. Andrew Street. 21 Marchmont Street. 77 Marchmont Street. 8 Museum Street. 24, 26 and 28 New Oxford Street. 200 Shaftesbury Avenue. *88 Southampton Bow. *15 Torrington Place. Holborn. 158 Clerkenwell Road. 9 Cosmo Place. 13 Dane Street. *4a East Street. 33 Great Ormond Street. 1 Greville Street. *91 Leather Lane. *6 Lamb's Conduit Street. 50 Lamb's Conduit Street. *55 Mount Pleasant. 19 Bed Lion Street. 50 Bed Lion Street. *74 Bed Lion Street. 92 Theobald's Boad. 124 Theobald's Boad. *Viaduct Buildings, also 17 Charterhouse Street (Factory). 36 Warner Street. During the year, in addition to my inspections, there were 294 inspections of bakehouses, including 34 inspections of the factory bakehouses. Ten notices were served for various sanitary defects. HOME WORK. All the out-workers' premises were inspected at least once during the year by the Lady Sanitary Inspector, details of which are given in the table. Many inspections of home-workers' premises are also made during house to house and periodical inspections of lodging houses and dwelling houses in which homeworkers reside. Further details respecting factories, workshops, laundries, workplaces and homework are given in Table TX. (1, 2, 3, 4 and 5) of the Appendix. ENQUIRY AS TO THE INDUSTRIAL EMPLOYMENT OF WOMEN AND INFANT MORTALITY. The present Factory and Workshop Act prohibits the employment of a woman or girl within four weeks after she has given birth to a child. Further regulation was recommended by the Physical Deterioration Committee in 1904, and the Conference on Infantile Mortality in 1906. 37 It appeared to the Secretary of State that a simultaneous and systematic inquiry into the subject, on uniform lines, by the Medical Officers of Health of a number of representative industrial centres would yield the best results. Co-operation in the enquiry was approved by the Council. This enquiry consisted of detailed investigation respecting every birth and still birth, numbering in all 460 cases, occurring in the poorest streets in the Borough in the year 1908. Details were obtained respecting the status and ages of the mothers, previous confinements, reasons for industrial employment, weekly earnings before and after confinement of mother and family, number of family, number of rooms and rent charged. Each child was visited at least twice, once soon after birth and the second time six months after birth. Of the 460 cases, 14 were still births. Of the 446 children born alive, 82 had removed from the Borough or could not be traced, and of the remaining 364, 55 are known to have died during the first year, that is a death-rate of at least 151 per 1,000. Of the 39 children of mothers who were employed at factories or workshops, 7 died in the first year (excluding still births), that is a death-rate of 179'5 per 1,000. Of the 102 children of mothers who were otherwise employed, and principally only part time, 17 died, that is a death-rate of 166.7 per 1,000. Of the 286 children of mothers who were not industrially employed 31 died, that is a death-rate of 108.4 per 1,000. 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 1909 was 382; 1,936 inspections were made, and 80 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 752 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 5 occasions during the year. Only sheep are killed, and there was but little slaughtering during the year. 38 DAIRIES, COWSHEDS AND MILKSHOPS. The number of registered dairies and milkshops in the Borough at the end of the year was 168, of which 70 were in St. Giles and Bloomsbury, and 98 in the Holborn District. Under the London County Council (General Powers) Act, 1908, Section 5, any Sanitary Authority may remove from, or refuse to enter on the Register, the name of any person carrying on, or proposing to carry on, the trade of a dairyman or purveyor of milk, upon premises which are in the opinion of such Sanitary Authority, for any reason unsuitable for the sale of milk therein. I made enquiries of the Medical Officers of Health of a number of large towns which have special milk clauses, as to their requirements and the action taken by them, and after very careful consideration prepared a paper on the subject (published in " Public Health," February, 1909), which formed the opening of a discussion at the Metropolitan Branch of the Society of Medical Officers of Health, and my paper and the recommendations of the Branch thereon comprised my detailed report to the Public Health Committee. All the dairies and milk shops in the Borough were carefully inspected by me, and this is the case also with all applications for registration. Under this new Act 14 purveyors of milk were removed from the register, and 7 applications for registration were refused. The premises were unsuitable for one or more of the following reasons: bedroom communicating directly with milk shop ; insufficient ventilation ; or, sale of offensive articles. In 10' cases the premises were made suitable, and the applications of the purveyors for re-registration were granted. In a number of other cases applicants for registration, or purveyors of milk already on the register, at once agreed to make the: necessary alterations to make the premises suitable, and in those cases therefore it was not found necessary to refuse the applications or remove names from the register. In all 27 dairies and milk shops were newly registered, 6 belonging to St. Giles and Bloomsbury, and 21 to the Holborn District. In addition to my inspections the Sanitary Inspectors made 542 inspections of these premises, and 22 notices were served for sanitary defects or breaches of regulations, and in many cases alterations were carried out without the service of notices. The only cowshed in the Borough was frequently inspected during the year, and no sanitary defects nor breaches of regulations were found. During the greater part of the year no cows were kept there, and the cowshed and adjoining dairy were finally closed at the early part of the year 1910. 39 OUTBREAK OF ILLNESS DUE TO CONTAMINATED MILK. I received information of the above from a doctor who was attending a waitress employed at a large restaurant in the Borough, who was seriously ill. I at once made detailed enquiries, and found that ten waitresses and two men of the kitchen staff were away ill. I visited them at their homes, which were mostly in the outlying parts of London, and from these detailed enquiries, and at the restaurant, I found that the only food, that all the persons who were ill had eaten in common, was milk, all of them, with one doubtful exception, having had it in the form of junket, or custard, or both. I found that the Dairy Company supplying the milk to this Branch, did not supply any other Branch, and that there had been no other similar illness at any other Branch. The Dairy Company informed me that they were unable to trace the farm from which the milk was obtained. All the patients suffered from severe vomiting, diarrhoea and fever. The milk food was eaten between 3 and 4 in the afternoon, and all the illnesses began the following day, some quite early in the morning. The milk was probably contaminated with sewage or horse dung, containing the bacillus enteritidis sporogenes, which has been the cause of similar outbreaks. ICE CREAM. During the year there were 41 premises in the Borough where ice cream was manufactured or sold, and in addition to my inspections, 92 inspections of these premises were made. One notice was served for sanitary defects. As ice cream is often made in the early morning, inspections between 6 and 9 a.m. were also occasionally made in order to ascertain whether there were any infringements of the London County Council (General Powers) Act, 1902. One such infringement was found, see Table XI. UNSOUND FOOD. Applications were received for removal and destruction as trade refuse of the following articles of food, all of which were unsound and unfit for the food of man:— 449 crates Bananas. 15 tins Peaches. 139 bundles Tomatoes. 10 14 lbs. Tins Eggs. 21 boxes Dried Fruits (assorted). 2 boxes Cod. 1 case Herrings. OFFENSIVE FUMES FROM FACTORIES. During the year four new oil engines were provided by an Electric Supply Company; much nuisance was caused by offensive fumes emitted from the chimney shaft receiving the exhaust pipes from these engines, and many complaints were received. 40 The matter received much careful attention, and various alterations were carried out by the Company, and finally the exhaust pipes were carried up more than 20 ft. above the top of the chimney shaft, and further alterations have been promised. In 1907 much nuisance was caused by the discharge into the sewer of effluent containing sulphuretted hydrogen, from the scrubbers of a water gas plant used for the production of electricity. The nuisance was afterwards abated by a solution of potassium permanganate being gradually mixed with the effluent before its discharge into the sewer. Complaints are now only occasionally received, and these are due to some temporary defect. The premises are frequently inspected in order to ascertain that the apparatus for preventing the nuisance is in proper working order. Complaints are occasionally received of offensive fumes from Refining Works. These are now only due to some accident or temporary defect, and the nuisances are soon abated. SMOKE ABATEMENT. The smoke shafts in the Borough were frequently kept under observation, and in 113 cases the inspections were recorded. 3 intimation notices and 1 statutory notice were served. For further details of Sanitary Work and Legal Proceedings see Tables VI., VII., VIII., IX., X. and XI. METEOROLOGY. The mean temperature of the year was 48 9 degrees, which is 1.2 degrees below the average for the preceding sixty-five years as taken by the Astronomer Royal. The rainfall was 25.72 inches, and was l.60 inches above the average for the preceding sixty-five years. The total amount of bright sunshine recorded was 1,642 hours out of a total possible 4,458 hours, or 37 per cent., and it was 140 hours above the average for the preceding ten years. The months of June, July, and September, were unusually cold, dull and wet. Further details are given in Table XII. 41 APPENDIX. TABLE I. Vital Statistics of Whole District during 1909 and Previous Years. Name of District—The Metropolitan Borough of Holborn. • Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all ages belonging to the District Under 1 Year of Age. (Nett.) At all Ages. Number. Rate. * Number. Rate per 1,000 Births registered Number. Rate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 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 190G 55,865 1,640 29.7 147 90 1,212 21.8 745 673 410 919 17.0 1907 55,215 1,570 28.6 132 84 1,131 20.6 685 606 387 912 16.6 1908 [53 weeks.) 54,572 1,513 27.8 118 76 1,064 19.2 669 599 403 868 15.7 Averages for years 1899-1908 158,566 1,653 28.3 190 113 1,202 20.5 630 540 447 1,109 18.8 1909 53,937 1,436 26.8 100 70 1,067 19.8 696 637 377 807 15.0 * 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 1899 and 1900 refer to the old areas of the St. Giles and Holborn District Boards of Work. 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 ,, ,, F 42 TABLE II. Vital Statistics of separate Localities in 1909 and Previous Years. Names of Localities. Holborn Borough. St. Giles and Bloomsbury. Holborn Sub-District. Year. Population estimated to middle of each year. Births Registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births Registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births Registered. Deaths at all Ages Deaths under 1 year. a. b. c. d. a. b. c. d. a. b. c. d. 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 26,916 641 676 101 1905 56,522 1,601 954 145 29,905 988 452 61 26,617 613 502 84 1906 55,865 1,640 949 147 29,543 1,020 443 63 26,322 620 606 84 1907 55,215 1,670 912 132 29,184 1,014 416 49 26,031 556 496 83 1908 54,572 1,543 868 118 28,830 966 412 51 25,742 577 456 67 Averages of Years 1899 to 1908 58,566 1,653 1,109 190 31,216 1,016 525 82 27,350 638 584 108 1909 53,937 1,436 807 100 28,480 917 379 40 26,457 519 428 60 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. (6) 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 1899 and 1900 refer to the old areas of the St. Giles and Holborn District Boards of Works. 43 TABLE III. Cases of Infectious Disease notified during the year 1909. Notifiable Disease. Cases notified is whole District. Total Cases notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. At AgesYears. St. Giles and Bloomsbury. Holborn. St. Giles and Bloomsbury. Holborn. Under 1. 1 to 5 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox 1 - - - 1 - - 1 - 1 - Cholera - - - - - - - - - - - Diphtheria and Membranous Croup 47 - 17 19 6 5 - 15 32 13 32 Erysipelas 41 2 1 2 3 26 7 21 20 9 10 Scarlet Fever 98 1 29 52 9 7 - 45 53 44 53 Typhus Fever - - - - - - - - - - - Enteric Fever 16 - 3 3 3 7 - 6 10 5 10 Relapsing Fever - - - - - - - - - - - Continued Fever 1 - - 1 - - - 1 - 1 - Puerperal Fever 3 - - - - 3 - 2 1 1 1 Plague - - - - - - - - - - - Cerehro Spinal Meningitis - - - - - - - - - - - Totals 207 3 60 77 22 48 7 91 116 74 106 Note.The Isolation Hospitals are those of the Metropolitan Asylums Board, and the London Fever Hospital. A few cases are treated at General Hospitals and Infirmaries. There were also 332 notifications of Phthisis (Consumption), 116 belonging to St. Giles and Bloomsbury, and 216 to the Holborn Division, f 2 44 TABLE IV. Causes of, and Ages at, Death during the year 1909. Causes or Death. Deaths at the Subjoined Ages of " Residents" whether occurring in or beyond the district. Deaths at all Ages or " residents" beiongin to Localities whether occurring in or beyond the district. Total Deaths whether of 'Residents" or Non-'Residents" in Public Insttution in the District All Ages. Under 1. 1 and under 5. 6 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. St. Giles and Bloomsbury Holboin. Small-pox — — — — — — — — — — Measles 14 2 12 — — — — 3 11 4 Scarlet Fever 8 — 1 1 — 1 — 2 1 — Whooping Cough 15 6 9 — — — — 3 12 43 Diphtheria and Membranous Croup 3 — 3 — — — — 2 1 6 Croup — — — — — — — — — — Fever Typhus — — — — — — — — — — Enteric 1 — — — — 1 — — 1 2 Other Continued — — — — — — — — — — ——Cerebro-Spinal Meningitis — — — — — — — — — 5 Epidemic Influenza 15 1 — — — 10 4 5 10 2 Cholera — — — — — — — — — — Plague — — — — — — — — — — Diarrhœa 6 5 1 — — — — 4 2 37 Enteritis 1 3 2 1 — 1 — 5 2 14 Puerperal Fever 1 — — — — 1 — — 1 1 Erysipelas 1 — — — — — 1 1 — — Other Septic Diseases 6 1 1 — — 3 1 2 2 17 Phthisis 108 — — 1 6 89 12 41 67 37 Other Tubercular Diseases 16 7 4 1 1 3 — 6 10 98 Cancer, Malignant Disease ... 62 — — — 1 40 21 29 33 33 Bronchitis 101 8 3 1 — 33 56 46 55 2c Pneumonia 89 14 11 — 4 32 28 49 40 7c Pleurisy 4 1 — — — — 3 1 3 2 Uther Diseases of Respiratory Organs 3 — — — — 3 — 3 — 9 Alcoholism Cirrhosis of Liver ) 25 — — — 1 21 3 10 15 1 Venereal Diseases 3 3 — — — — — — 3 2 Premature Birth 20 20 — — — — — 7 13 8 Diseases and Accidents of Parturition 1 — — — — 1 — — 1 2 Heart Diseases 71 — — 4 3 39 25 38 33 20 Accidents 20 2* 1 1 1 11 4 6 14 9 Suicides 4 — — — — 3 1 2 2 1 All other Causes 208 27 7 3 2 79 90 114 94 245 All causes 807 100 55 13 19 371 249 379 428 696 45 TABLE V. Infantile Mortality during the Year 1909. Deaths from stated Causes in Weeks and Months under One Year of Age. Cadse 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 Cadses. Certified... 24 3 7 1 35 6 12 11 4 2 9 2 1 2 u 5 100 Uncertified — — ■— — — — — — — — — — — — — — Common Infeotious Diseases. Small Pox Chicken Pox Measles — — — — — — — 1 1 2 Scarlet Fever ... Diphtheria (including 1 Membranous Croup ) Whooping Cough — — — — — 1 — 1 1 2 — — — — 1 6 Diariihceal Diseases. Diarrhoea, all forms ... — — — 2 1 1 1 5 Enteritis Muco- ") Enteritis, Gastro- >Enteritis J 3 Gastritis, Gastro- 1 intestinal Catarrh j Wasting Diseases. Premature Birth 14 1 4 1 2c 1 21 Congenital Defects 2 — — 2 — — 1 — — — — — — — — 3 Injury at Birth . . 2 2 Starvation j 1 1 — — 2 1 3 Atrophy, Debility, ) Marasmus j 3 — — — 3 — 1 — 2 — 1 — — — i — 8 Tuberculous Diseases. Tuberculous 1 Meningitis J 2 3 Tuberculous Peritonitis: Tabes >Mesenterica J — — — — — 1 1 ... 2 Other Tuberculous ) Diseases J — 1 — 2 Other Causes. Erysipelas __ _ Syphilis — 1 1 1 1 Rickets — — — Meningitis 1 (not Tuberculous) J 1 1 8 Convulsions 2 1 1 Bronchitis... 1 1 1 ?, 9 4 Laryngitis Pneumonia 1 1 2 1 3 1 j Suffocation, overlying ... Other causes — — — — 1 2 2 1 1 — — — 1 8 24 3 7 1 35 6 12 11 4 2 9 2 1 2 11 5 100 Births in the year legitimate, total registered 1,380 ; " Residents " 935. Deaths in the year of illegitimate do. 56; do. 51. "Residents" Corrected deaths of " Residents" from all Causes at all Ages 807 Population estimated to middle of 1909, 53,937. legitimate infants 88. illegitimate „ IS. 46 TABLE VI- Sanitary Inspectors' Wokk.—Inspections, &c. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange. Whole Borough.[/####} Complaints 65 91 72 12 240 Inspections. /Infectious Diseases 64 78 83 203 428 Dwelling Houses 111 172 201 45 532 Lodging Houses 367 196 229 259 1,051 Common Lodging Houses 1 23 39 — 63 Dairies, CowshedsandMilkshops. 160 134 248 — 542 Ice Cream—Manufacture or Storage 7 11 74 — 92 Slaughter-house — 5 — — 5 Market Streets 348 58 346 — 752 Butchers' Shops 355 191 274 — 823 Bakehouses 67 96 97 — 260 Other Food Shops 349 204 349 114 1,016 Laundries 1 — 3 16 19 Other Workshops 195 336 124 166 821 Out-Workers' Rooms and Registers 32 24 64 188 308 Workplaces 68 37 87 1 193 Factories 32 3 31 17 83 Schools 1 — 2 1 4 Smoke shafts 2 15 96 — 113 Urinals — 102 33 — 135 Miscellaneous 153 61 113 1 328 Periodical Inspections* 1,609 1,817 1,378 113 4,917 Dust† 39 117 49 1 206 Mews — 130 — — 130 Maternity — — — 734 734 Total Inspections 3,961 3,813 3,923 1,858 13,555 No. of Re-Inspections 1,249 1,743 1,180 924 6,000 Do. do. Maternity — — — 904 Visits other than Inspections and Re-Inspections 498 853 905 276 2,763 Do. do. Maternity — — — 231 Total 5,708 6,409 6,008 4,193 22,318 47 TABLE VII. Sanitary Inspectors' Work.—Notices served. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange. Total. Intimation Notices—Total served 265 420 385 185 1,255 Heuses 219 333 230 135 917 The house or part of the house in a dirty condition 48 33 78 49 208 The house or part of the house in a damp condition 1 1 8 12 22 The house in a dilapidated condition 6 16 15 5 42 The watercloset so foul as to he a nuisance . 10 20 9 7 46 Do. without a water supply 15 16 21 5 57 Do. with a deficient supply of water 22 23 1 2 48 Do. improperly constructed — 1 — — 1 Do. so defective as to be a nuisance 26 59 34 18 137 Do. stopped 29 74 45 12 160 Do placed in an improper position 2 — — — 2 Insufficient external ventilation to watercloset — — 1 — 1 Insufficient watercloset accommodation 1 11 5 5 22 Absence of watercloset accommodation — 1 — — 1 Absence of proper watercloset accommodation for persons of each sex See under Workshops &c. The soil pipe defective 7 3 — — 10 Do. unventilated 4 — 1 — 5 Do. improperly ventilated 1 1 — — 2 The yard paving defective 9 3 4 3 19 Do. dirty 1 11 6 1 19 Do. undrained — — — — — The area improperly paved 1 2 — — 3 Do. dirty — 13 7 — 20 Do. undrained — — — — — The inlet of surface drain improperly trapped — 1 — — 1 A gully trap improperly placed within the house — — — — — The waste pipe of sink improperly connected with the drain — — 9 1 10 Do. do. improperly trapped 1 — 1 — 2 Do. do. untrapped 2 10 5 — 17 Do. of lavatory improperly connected with the drain — 1 — — 1 Do. do. improperly trapped — — — — — Do. do. untrapped 1 — 1 — 2 Do. of bath directly connected with the drain 1 1 — — 2 Do. do. improperly trapped — — — — — Do. do. untrapped — 1 — — 1 The water cistern so foul as to be a nuisance 7 4 5 2 18 Do. being without a close fitting cover 4 4 3 2 13 Do. being placed in an improper position 1 — — — 1 Do. defective — 18 — 1 19 85 An accumulation or deposit of refuse 10 34 25 16 The absence of proper ashbin 27 56 17 3 103 The ashbin defective 15 16 9 4 4† The drain foul — — 2 — 2 Do. defective 7 10 12 2 31 Do. choked or stopped 9 33 18 4 64 Do. unventilated — — 2 — 2 48 TABLE VJI.—continued. Sanitary Inspectors' Work.—Notices served.—continued. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange. Total. Houses — continued. The rainwater pipe in direct communication with the drain 1 1 — 2 Do. do. do. with the soil pipe- — 1 — — 1 Do. do. defective 5 15 4 1 25 The water supply used for domestic purposes connected with the cistern which is used for flushing the watercloset — — — — — The absence of proper water supply 14 35 29 2 80 The roof defective 15 15 29 11 70 The guttering defective 1 3 3 — 7 The paving of wash-house defective 1 2 1 1 5 The want of proper manure receptacle 7 4 1 — 12 An animal kept in such place or manner as to be a nuisance — 3 1 — 4 The house or part of the house overcrowded — 10 9 9 28 An underground room occupied as a dwelling contrary to the provisions of the Act 6 24 2 2 33 The space below floor in the basement or ground floor being unventilated — — — — — Do. improperly or insufficiently ventilated — — — — — A chimney sending forth black smoke in such quantity as to be a nuisance See under Workshops A urinal improperly constructed, drained or offensive — — — — — Do. with no supply of water — — — — — Other nuisances 8 25 13 9 55 *Factories, Workshops and Work Places . 46 87 155 50 338 Dirty 25 19 30 30 104 Waterclosets, defective or dirty 18 43 35 21 117 Do. insufficient 3 2 1 — 6 Do. absence of separate accommodation for sexes — 1 2 2 5 Drains, soil pipes, &c., defective 18 15 25 2 55 Improperly ventilated 2 — 2 7 11 Overcrowded 1 1 1 2 5 Chimney sending forth black smoke — 1 2 — 3 Other nuisances 21 40 85 12 158 Breach of Bye-laws or Regulations— † Lodging-houses 71 83 53 52 259 Dairies,cowsheds,milkshops and slaughterhouses 4 3 1 — 8 Keeping of animals 7 4 1 — 12 London County Council (General Powers) Acts Urinals — — — — — Verminous Rooms 4 9 12 6 31 Ashpits — — — — — Statutory Notices 12 102 117 39 270 * Many nuisances at workshops, that are parts of dwelling houses, are included in the Intimation Notices served under "Houses." †Many breaches of bye-laws are included in Intimation Notices served under "Houses." 49 TABLE VIII. Proceedings during 1909. PREMISES. NUMBER OF PLACES— Number of Inspections 1909. Number of Notices 1909. Number of Prosecutions 1909. On register at end of 1908. Added in 1909. Removed in 1909. On register at end of 1909. Milk premises 178 27 37 168 542 22 0 Cowsheds 1 0 0 1 weekly 0 0 Slaughter-houses 1 0 0 1 5 0 0 Other offensive trade premises 0 0 0 0 0 0 0 Ice Cream premises 41 2 4 39 92 1 1 Registered houses let in lodgings 681 0 44 637 1,051 (a)* 15 (a)* 0 (b)* 248 (6)* 1 * (a) For overcrowding. * (6) For other conditions. Total number of Intimation notices served for all purposes 1,255 Overcrowding, 1909— Number of Dwelling Rooms overcrowded 56 Number remedied 56 Number of prosecutions 0 Underground Rooms — Illegal occupation dealt with during year 33 Number of rooms closed 33 Insanitary Houses— Number closed under the Public Health (London) Act, 1891 0 „ „ ,, „ Housing of the Working Classes Act 0 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 26 Shelters provided under Section 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year .. 11 Revenue Acts— Number of houses for which applications were received during the year 4 Number of dwellings comprised therein 101 Number of tenements for which certificates were (a) granted 94 ; (6) refused 7 ; (c) deferred 0 Number of prosecutions under Bye-laws under Public Health (London) Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. 0 (b) For prevention of nuisance arising from offensive matter running out of any -manufactory, etc. 0 (c) For the prevention of keeping of animals in such a manner as to be injurious to health 0 (d) As to paving of yards, etc., of dwelling houses 0 (e) In connection with the removal of offensive matter, etc. 0 (/) As to cesspools and privies, removal and disposal of refuse, etc. 0 (g} For securing the cleanliness of tanks, cisterns, etc 0 (h) With respect to water closets, earth closets, etc. 0 (i') With respect to sufficiency of water supply to water closets (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 97 Total number of infectious bodies removed 0 G 50 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 Laandries) 123 10 2 Workshops (including Workshop Laundries) 1,100 134 19 1 Workplaces (other than Outworkers' Premises included in Part 3 of this Report) 2,129 184 43 1 Total 3,352 327 64 2 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 104 104 — — Want of ventilation 11 11 — — Overcrowding 5 5 — — Want of drainage of floors — — — — Other nuisances 216 216 — — Sanitary accommodation insufficient 6 6 — — unsuitable or defective 107 107 — — not separate for sexes 5 5 — — Offences under the Factory and Workshop Act :— Illegal occupation of underground bakehouse (S. 101) — — — — Breach of special sanitary requirements for bakehouses (SS. 97 to 100) 9 9 — — Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) — — — — Total 463 463 — — *Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act as remediable under the Public Health Acts. 3.Home Work. NATURE OF WORK.* Outworked' Lists, Section 107. Inspections of Outworkers' premises. Outwork in Unwholesome Premises. Section 108. Outwork in Infected Premises, Sections 109, 110. Lists received from Employers. Addi esses of Outworkers. § Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (8. no). Prosecutions (Sections 109, 110) Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Received from other Councils Forwarded to other Councils. Lists. † Outworkers, † Lists. Outworkers. Contractors. Workmen. Contractors Workmen. (1) (21 (3) (4) (5) (6) (j) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) Wearing Apparel (1) Making, &c. 120 93 647 4 — 13 274 462 130 — — 175 — — — — — — (2) Cleaning and washing — — — — — — — — — — — 1 — — — — — — Lace, lace curtains and nets — — — — — — — — — — — — — — — — — — Artificial Flowers — — — — — — — — — — — — — — — — — — Nets, other than Wire Nets — — — — — — — — — — — — — — — — — — Tents — — — — — — — — — — — — — — — — — — Sacks — — — — — — — — — — — — — — — — — — Furniture and Upholstery — — — — — — 4 — — — — 2 — — — — — — Fur pulling — — — — — — — — — — — — — — — — — — Feather sorting — — — — — — — — — — — — — — — — — — Umbrellas &c. — — — — — — — — — — — — — — — — — — Carding, &c., of buttons, &c. — — — — — — — — — — — — — — — — — — Paper Bags and Boxes . 4 — 25 — — — 5 19 4 — — 7 — — — — — — Basket making 2 — 4 — — — — 2 2 — — 1 — — — — — — Brush making 2 — 6 — — — 2 3 2 — — 2 — — — — — — Racquet and Tennis balls — — — — — — — — — — — — — — — — — Stuffed Toys — — — — — — — — — — — — — — — — — — File making — — — — — — — — — — — — — — — — — — Electro Plate — — — — — — — — — — — — — — — — — — Uables and Chains — — — — — — — — — — — — — — — — — — Anchors and Grapnels — — — — — — — — — — — — — — — — — — Cart Gear — — — — — — — — — — — — — — — — — — Locks, Latches and Keys — — — — — — — — — — — — — — — — — — Pea Picking — — — — — — — — — — — — — — — — — — Total 128 93 682 4 — 13 285 486 138 — — 188 — — — — — — * If an occupier gives out work of more than one of the classes specified in column ], and subdivides his list in such a way as to show the number of workers in each class of work, the list should be included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers should be assigued in column 3 and 4 (or 6 and 7) into their respective classes.; A footnote should be added to show that this has been done. † The figures required in columns 2, 3 and 4 are the total number of lists received from those employers who comply strictly with the statutory duty of sending two lists each year and of the entries of names of outworkers in those lists. The entries in column 2 must necessarily be even numbers, as there will be two lists for each employer-in some previous returns odd numbers have been inserted. The figures in columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the same employer the same outworker's name will often be repeated. § In view of the wide discrepancies found to exist between the totals in the two columns when the returns are added together, it is desired that care may be taken to give exact figures. Only those addresses should be counted which have actually been received from or forwarded to other Councils during the year covered by the report. 52 4.—Registered Workshops. Workshops on the Register (s. 131) at the end of the year. Number. (1) (2) Important classes of workshops, such as workshop, bakehouses, maybe enumerated here. Laundries 11 Bakehouses 31 Other Workshops 1,060 Total number of workshops on Register 1,102 5.—Other Matters. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories: — Failure to affix Abstract of the Factory and Workshop Act (s. 133) 12 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Acts (s. 5) Notified by H.M. Inspector 9 Report (action being taken) sent to H.M. Inspector 9 Other 6 Underground Bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 23 53 TABLE X. LEGAL PROCEEDINGS. Public Health (London) Act, 1891. Date. Name. Premises. Offence. Result. 1909. April 23rd A. J. Walke Evelyn Buildings Foul W.C. Work done. Summons withdrawn on Defendant paying £2. 2s. costs June 16 th and 28th A. J. Wilson C, New North Street Defective W.C. Defendant convicted and fined 5s. and £ 1. 1s. costs Aug. 10th Lee, Mrs. 2, Smart's Buildings Defective W.C. Fined 1s., £1. 8s. costs ,, ,, Morrell, Mr. 27, Gloucester Street Dirty premises Fined £5, £1. 1s. costs „ 17th Lee, Mrs. 4, Smart's Buildings Offensive accumulation Fined £2, £1. 1s. costs Sept. 24th Dixon, John 21, Gloucester Street Absence of proper water supply Order to abate, 20s. costs ,, ,, do. 11, do. Do. do. Order to abate, 10s. costs ,, ,, do. 39, do. Dirty premises Order to abate, 10s. costs ,, ,, do. 38, do. Dirty workshop Order to abate, 5s. costs Breach of Lodging House By-Laws. Date. Name. Address. Besult. 1909. Sept. 24th Dixon, John 18, Devonshire Street Order made. 25s. costs. London County Council (General Powers) Act, 1902. Date. Name. Premises. Offence. Result. 1909. June 8th and Aug. 31st Trocchia, Giacome 25, Back Hill Manufacturing ice cream in living room Summons withdrawn on payment of costs 54 TABLE XI. Legal Proceedings under Sale of Food and Drugs Acts. Date. Name. Premises. Offence. Result. 1909. Jan. 5th E. Edwards 16, Little Earl Street Selling butter containing 33 per cent. of foreign fat Defendant convicted and fined £2 and 12s 6d. costs. „ 18th J. K. Enfield 24, Great Queen Street Selling milk 30 6 per cent. deficient in fat Summons withdrawn on defendant giving undertaking not to repeat offence and paying 10s. 6d. costs May 11th Mrs. Green 5, Chapel Street Selling Coffee containing 35 per cent. of chicory Defendant convicted and fined £1 and 2s. 6d. costs. June 1st and 8th David Greig 86, Leather Lane Selling milk 15.3 per cent. deficient in fat Warranty proved. Summons dismissed. July 23rd Horstead, Wm. 5, Coptic Street Selling milk 7 per cent. deficient in fat Defendant convicted and fined £1 and 12s. 6d. costs. Aug.31st Greening, Mrs. 29, Newton Street Selling margarine unlabelled Defendant convicted and fined £1 and 12s. 6d. costs. Nov. 6th Alice Twinn 4, Emerald Street Selling milk 6.3 per cent. deficient in fat Defendant convicted and fined £1 and £1. 8s. costs. „ 26th Hannah J. Roberts 17, Red Lion Street Selling butter containing 80 per cent. of foreign fat Defendant convicted and fined £1 and 12s. 6d. costs. TABLE XII. Meteorot.ogy of London, 1909. (Deduced from observations at Greenwich under the superintendence of the Astronomer Royal.) 1909. Air Temperature. Bright Sunshine. Rain and other forks of Precipitation. Mean of— Mean of A. and B. Difference from Average. * Total observed. Difference from Average. * Per cent. of possible. Total fall. Difference from Average. * a. B. Maximum Minimum. o o O o hrs. hrs. % ins. ins. January 43.0 340 38.5 + 0.1 61 + 20 23 0.77 -1.11 Febuary 43.5 30.9 37.2 - 2.6 91 + 34 33 0.63 - 0.85 March 45.5 33.8 39.6 - 2.9 75 - 24 21 3.08 + 1.66 April 60.6 38.6 49.6 + 1.5 250 + 103 60 1.64 + 0.07 May 64.8 41.7 53.2 - 0.6 326 + 140 68 1.24 - 0.68 June 62.4 47.2 54.8 - 5 5 107 - 90 22 3-67 + 1*63 July 70.1 52-5 61.3 - 2.4 179 - 57 36 3.16 + 0.76 August 72.9 62.5 62.7 - 0.2 228 + 18 50 1.80 - 0.54 September 62.8 47.5 55.2 - 3.0 106 - 49 28 2.48 + 0.33 October 59.5 45.6 52.5 + 2.1 91 - 4 27 4.06 + 1.28 November 47.2 36.2 41.7 - 1.7 78 + 30 29 0.79 - 1.43 December 45.2 350 40.1 + 0 5 50 + 17 21 2.40 + 0.57 Year 56.5 41.3 43.9 - 1.2 1642 + 140 37 25.72 + 1.60 * The averages used are obtained from observations extending over 65 years for Rain and Temperature. and 10 years for Sunshine.