HOL 14. The Metropolitan Borough of Holborn. REPORT FOR THE YEAR 1914 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 Metropolitan Branchy 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 Board of Works. London: DIPROSE, BATEMAN & CO., SHEFFIELD STREET, LINCOLN'S INN FIELDS, W C. 1915. 3418 INDEX. PAGE Introduction 5 Population and Houses 7 Estimated Population, 1914 7 Registered Births and Birth-Rates 7 Ditto Corrected 8 Mortality 8 Deaths Registered 8 Deaths in Public Institutions within the Borough 8 Ditto outside the Borough 9 Corrected Deaths and Death-rates 9 Infantile Mortality 9 Prevention of Infantile Mortality 10 (1) Care and feeding of Infants 10 (2) Notification of Births Act, 1907 10 (3) Modified Milk for Infants 11 (4) School for Mothers 11 (5) Dinner Tickets 12 Senile Mortality 12 Deaths from Epidemic Diseases 12 Ditto ditto during 1914 and ten preceding years 13 Ditto Measles 14 Ditto Whooping Cough 14 Ditto Diarrhoea and Enteritis 15 Ditto Phthisis 15 Ditto Influenza 15 Ditto Alcoholism 15 Ditto Cancer 15 Inquests 16 The Public Mortuary 16 Infectious Diseases 16 Notification of Infectious Diseases during 1914 and ten preceding years 17 Small Pox 18 Scarlet fever 18 Ditto Errors in Diagnosis 18 Ditto Secondary Cases 18 Ditto Return Cases 18 Diphtheria 18 Ditto Errors in Diagnosis 18 Ditto Secondary and Return Cases 19 Ditto Anti-Toxin 19 Enteric Fever 19 Cerebro-Spinal Fever 19 Polio-Myelitis and Encephalitis 19 Ophthalmia Neonatorum 19 Whooping Cough 20 Phthisis or Consumption 20 Ditto ditto Notification Public Health (Tuberculosis) Regulations. 1908, 1911 & 1912 21 National Insurance Act. 1911—Sanatorium Benefit—Tuberculosis Dispensary 22 Glanders, Anthrax and Hydrophobia in man 22 Bacteriology 23 Disinfections 23 Shelter during disinfection of houses 23 Cleansing of Persons Act, 1897—New Cleansing Station 23 Housing of the Working Classes Acts 24 Housing, Town Planning, &c., Act, 1909, Section 17 24 Underground Sleeping Rooms 24 Erection of Dwellings for Working Classes 25 a 2 4 page Premises closed voluntarily, demolished, rebuilt, &c. 25 Sanitary Work 27 House-to-house inspections 27 Water Supply to New Buildings 28 Ditto to Tenement Houses 29 By-laws as to Houses let in Lodgings 29 Revenue Acts 29 Overcrowding 29 Removal of House Refuse 30 Removal of Manure 30 Common Lodging Houses Acts, 1851 and 1853 31 Factories, Workshops and Workplaces 32 Bakehouses 32 Home Work 33 Places where Food is prepared for Sale 34 Slaughter House 34 Dairies, Cowsheds and Milkshops 34 Public Health (Milk and Cream) Regulations, 1912 34 Ice Cream 36 Unsound Food 36 Offensive fumes from factories 36 Smoke Abatement 37 Meteorology of London, 1914 37 APPENDIX. Table: I. Vital Statistics of whole Borough during 1914 and previous years 39 Table II. Cases of Infectious Disease notified during the year 1914 40 Table III. Causes of, and Ages at Death during the year 1914 41 Table IV. Infantile Mortality during the year 1914 42 Table V. Sanitary Inspectors' Work—Inspections, &c.43 Table VI. Ditto Notices served 44 Table VII. Proceedings during 1914 46 Table VIII. Factories, Workshops, Laundries, Workplaces and Homework 47 (1) Inspections 47 (2) Defects found 47 (3) Homework 48 (4) Registered Workshops 49 (5) Other matters 49 Table IX. Legal Proceedings—Public Health (London) Act, 1891 50 Table X. Ditto Sale of Food and Drugs Acts 50 Table XI. Meteorology of London, 1914 51 REPORT OF THE Medical Officer of Health For the Year 1914. 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 1914, the various statistics of the year refer to the fifty-two weeks ended Saturday, January 2nd, 1915, as adopted by the Registrar-General, and known as the Registration Year. The following are the principal statistics for the Census years 1901 and 1911, and for last year 1914. 1901. 1911. 1914. Death-rate per 1,000 20.0 15.2 15.8 Infantile Mortality per 1,000 births 126 (1905)* 113 88 Death-rate from the seven principal epidemic dieases 2.25 1.21 0.90 Death-rate from Phthisis 2.47 1.72 1.69 Number of notifications of Infectious diseases (excluding Tuberculosis, Chicken-pox, and Whooping Cough) 758 259 283 Notification-rate per 1,000 12.79 5.29 6.06 Until last year there had been a continuous fall in the death-rate since 1902. Since the adoption of the Notification of Births Act in March, 1908, the Infantile Mortality rate of the Borough has been less than that for London, and last year was considerably less, viz., only 88 per 1,000 corrected births in comparison with 104 for London. The death-rate from the seven principal epidemic diseases, was only 0'90 in comparison with 1.44 for London. The death-rate from Phthisis was 1.69 per 1,000 in comparison with l.60 in the preceding year, but the corresponding rate for London was also higher, viz., 1.39 compared with 1.30. 31.5 per cent. of the deaths from Phthisis were those of former inmates of Common Lodging Houses in the Borough who had been removed to Poor LawInstitutions. The notification-rate was only 6.06 per 1,000 in comparison with 9.15 for London. * Details of births, names and addresses of mothers, etc., were not supplied until the latter part of 1904. 6 At the Passmore Edwards Settlement School for Mothers (Baby Clinic) which was opened on the 29th September, 1913, at which the Clinic is held every Monday from 2 to 4.30 p.m., there is now also a Needlework and Instruction Class for Mothers every Wednesday from 2.30 to 4.30 p.m. Negotiations for the purchase of a site in Short's Garden for the erection by the Council of dwellings for the working classes were completed, but on account of the War the erection of the dwellings has been postponed. The Public Health Committee during the year have given much further consideration to the provision of a Tuberculosis Dispensary. Proposed schemes for the use of Tuberculosis Dispensaries at St. Bartholomew's, the Royal Free, and the University College Hospitals were discussed, and finally arrangements were made with the University College Hospital for the use of their Tuberculosis Dispensary, and the same was opened for our residents on the 2nd February, 1915. The Memorandum of the Insurance Committee for the County of London on the treatment of insured persons at Tuberculosis Dispensaries by Borough Councils was again under consideration, but with some of the proposals therein the Council did not concur. Only 25 genuine complaints respecting non-removal of house refuse were received from householders, more than two-thirds of which were received after the commencement of the War, and more than half of them in the last quarter, when a number of the dustmen had enlisted or had taken up other work, and much difficulty was experienced by the Contractors in maintaining an adequate supply of efficient dustmen. 113 notices were served for the provision of proper dust receptacles. The Contractors agreed to arrange without any additional charge for the daily collection of house refuse from Bedford Place, Upper Bedford Place, Montague Street, Upper Montague Street, and Torrington Square, provided that the house refuse was placed in small covered receptacles on the kerb or in an accessible position in the front area by 7.30 a.m. With the consent of the Committee I wrote to the occupiers of the houses in the above streets, asking whether they are prepared to co-operate if arrangements are made for the early daily removal of house refuse. From the occupiers of the first four streets the replies received were almost unanimous in favour of the same, in fact in two of the streets all the occupiers consented, and in one of the remaining two all but one had already consented at the time of my second report to the Committee. The early morning collection was accordingly begun on the 13th July. I desire to express my high appreciation of the 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. 7 POPULATION AND HOUSES. The enumerated Population at the Census taken on Sunday, April 2nd, 1911, was 49,357, a reduction of 10,048 on the previous census of 1901 or 16.9 per cent. During the previous decennium 1891-1901 there was a reduction of 7,376 or ll.0 per cent. The Borough is becoming less and less residential and more and more important as a business centre. The number of factories, workshops, workplaces and offices keeps increasing so that we have now a very large day population. The density of the population was 122 persons per acre in comparison with 61 for London. The number of inhabited buildings was 7,985 and uninhabited 1,393 and 38 were in course of erection. Further details were given in my Annual Reports for 1912 and 1913. REVISED ESTIMATES OF POPULATION, 1914. The population of England and Wales as a whole has hitherto been estimated on the assumption that the rate of increase during 1901-11 has continued, but in view of the fall in the rate of natural increase since 1911 and an increase in the loss by migration, a new estimate has been made for the middle of 1914 based upon the returns of births, deaths and migration. The populations of the Registration Areas of England and Wales have also been re-estimated. The following are the revised estimates of populations at the middle of the year 1914:— St. Giles and Bloomsbury 23,530 Holborn Sub-District 23,302 Holborn Borough 46,832 London 4,518,021 REGISTERED BIRTHS AND BIRTH-RATES. District. Males. Females. Both Sexes. Birth rate per 1,000 Legitimate. Illegitimate. Total. St. Giles and Bloomsbury 140 109 219 30 249 10.6 Holborn 235 219 442 12 454 19.5 Whole Borough 375 328 661 42 703 15.1 8 CORRECTED BIRTHS AND BIRTH-RATES. I received from the Registrar-General information of the births in outlying institutions in London of 72 legitimate infants and 31 illegitimate infants whose mothers were residents of the Borough. 28 of the 661 legitimate births and 13 of the 42 illegitimate births were infants of mothers who were non-residents of the Borough. The corrected numbers therefore are as follows:— District. Corrected number of Births of Residents. Corrected Birth-rate per 1000. Legitimate. Illegitimate. Total. 1914. 1918. Whole Borough 705 60 765 16.4 16.7 In London the corrected number of births was 109,667, or a rate of 24.3 per 1,000, in comparison with 24.5 for 1913. MORTALITY. The following deaths have been registered in the Borough (1914):— St. Giles and Bloomsbury. Holborn. Total. Males 108 873 481 Females 100 307 407 Total 208 680 888 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 12 — 4 — French Hospital 4 1 36 — Children's Hospital 5 8 — 339 National Hospital 1 — 54 London Homœopathic Hospital 5 13 71 Italian Hospital 2 3 — 21 Alexandra Hospital — — — 1 Private — — 27 5 Total 28 26 67 491 9 There were 408 deaths of "Residents" in various Workhouses, Infirmaries, Asylums, Hospitals, &c., outside the Borough, 110 of whom were removed from Common Lodging Houses in the Borough. Of the total, 203 formerly resided in St. Giles and Bloomsbury, and 205 in the Holborn District. CORRECTED DEATHS AND DEATH-RATES, 1914. 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, 1914. Death Rate for 1914. Corresponding period 1913. In Borough. Beyond Borough. St. Giles and Bloomsbury 208 57 67 12 203 355 15.1 14.0 Holborn Sub-District 680 525 491 1 205 383 16.5 14.8 Whole Borough 888 582 558 — 408 738 15.8 14.4 Registration London 64,994 14.4 14.2 INFANTILE MORTALITY. 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. Holborn Borough 67 95 82 150 88 London 11,395 — — — 104 Death-rate per 1,000 corrected births in 1914 and in seven preceding years during which details respecting births have been supplied. 1907. 1908. 1909. 1910. 1911. 1912. 1913. 1914. Whole Borough 131 111 101 100 113 78 100 88 London 116 118 108 103 129 91 105 101 From the above table it will be seen that since the adoption of the Notification of Births Act in March, 1908, the infantile mortality of the Borough has been less than that for London. B 10 Eight of the 67 infants that died under one year of age were known to be illegitimate children. A newly-born infant found in Queen Square was also probably illegitimate. Of the 67 deaths of infants during the year the Lady Sanitary Inspector was able to obtain further details respecting 64. Of these 11. principally cases of premature birth, died before taking food; only 29 were breast fed, and 24 artificially fed. In 9 of these the mothers worked in factory or workshop, 6 were engaged in charing or other work outside the home, and 3 were in domestic service. There were 9 deaths from diarrhœal diseases. 8 of these took place in the third or summer quarter. Of the 67 deaths 31 were from prenatal causes and 36 from postnatal causes. The principal causes of death of these 67 children under one year of age are given in Table IV. 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. During the year 509 first visits were made. In 19 cases for various reasons enquiries could not be carried out. In the remaining 490 cases, 5 children did not live long enough to take any food, 35 were being artificially fed, and 450 were being 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 total number of births notified in the Borough during the registration year 1914, was as follows:— Notified once only (a) By Doctors or Medical Students . 380 (b) „ Midwives 259 (c) „ Parents and others 15 11 Notified twice (a) By Doctors and Parents 4 (b) „ „ „ Midwives 2 Total 660 During the same period 703 births were registered in the Borough; the corrected number of births of residents was 765. (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 52 new certificates were issued, of which 49 were used. Including 16 children who were taking the milk at the beginning of the year 1914, the milk was used by 65 children during the year, in comparison with 85 during the previous year. In the majority of cases the infants thrived well on the milk. In a number of cases the use of the milk was after various periods and for various reasons discontinued. There were 4 deaths of the 65 infants who had been taking prepared milk during the year, all of which were at 7 months old and upwards, the causes of death being:—1 whooping cough, and the other 3 took place in the summer quarter from broncho-pneumonia followed by diarrhoea, which occurred in two cases after they had been removed to Hospital. Councillor Walter Hazell, J.P., has for a number of years very kindly assisted poor parents who cannot afford to pay the whole amount. Of the 65 children who were taking prepared milk during the year, the parents of as many as 45 children were so assisted. (4) The Passmore Edwards Settlement School for Mothers (Baby Clinic)- In my Annual Report for 1913, I gave an account of the above which was opened on the 29th September, 1913. The Clinic is held every Monday from 2 to 4.30 p.m., and there is now also a needlework and instruction class for mothers every Wednesday from 2.30 to 4.30 p.m. The Lady Sanitary Inspector regularly attends to render assistance, and also frequently visits the mothers at their homes. b 2 12 During the year there where 92 new infants entered whose mothers resided in the Borough, of whom 54 attended fairly regularly, and, in addition 22 who entered in 1913, so that 76 mothers with their infants were fairly regular attendants during the year, Some of the mothers ceased attending after a few visits— some on account of leaving the Borough. * (5) Dinner Tickets for Poor, Deserving Mothers. In order to encourage a continuance of breast feeding, 111 dinner tickets were distributed amongst a few poor, deserving mothers, to enable such mothers to obtain a sixpenny dinner at a restaurant in the Borough. Councillor Walter Hazell, J.P., also paid for these tickets which were by arrangement secured at a reduced rate. SENILE MORTALITY. The number of deaths of persons 65 years of age and upwards was in:— St. Giles and Bloomsbury 107 Holborn Sub-District 109 Holborn Borough 216 St. Giles and Bloomsbury. Holborn Sub-District. total. Of these the numbers were— 65 years and under 70 35 30 65 70 ,, „ 75 28 34 62 75 „ „ 80 20 22 42 80 ,, ,, 85 15 12 27 85 „ „ 90 6 5 11 90 „ ,, 95 2 5 7 95 ,, „ 100 1 1 2 100 years of age and. upwards — — — 107 109 216 DEATHS 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 was only 42 in comparison with a decennial average of 59. The death-rate for the Borough was only 0.90 in comparison with 1.44 for London. 13 Number. Epidemic Death-Rate. St. Giles and Bloomsbury 15 0.64 Holborn Sub-District 27 1.16 Holborn Borough 42 0.90 And for London 6,503 1.44 The following are the number of deaths from the separate diseases:— St. Giles and Bloomsbury. Holborn Sub-District. Holborn Borough. London. Small-pox — — — — Measles 3 8 11 1,385 Scarlet Fever 2 2 316 Diphtheria and Membranous Croup 2 1 3 706 Whooping Cough 3 6 9 918 Typhoid Fever 4 2 6 147 Typhus — — — — Diarrhoea (under 2 years of age) 3 8 11 3,031 Total 15 27 42 6,503 DEATHS FROM EPIDEMIC DISEASES OCCURRING IN THE BOROUGH DURING THE YEAR 1914 AND DURING THE PRECEDING TEN YEARS. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. Total. Number. Rate per 1000. Number. Rate per 1000. Number. Kate per 1000. Number. Rate per 1000. Number. Rate per 1000. Number. Rate per 1000. Number. Rate per 1000. Number. Rate per 1000. 1904 2 0.04 43 0.76 — — 7 0.12 8 0.14 4 0.07 35 0.62 99 1.75 1905 — — 11 0.20 3 0.05 4 0.07 15 0.27 4 0.07 22 0.40 59 1.07 1906 — — 25 0.46 2 0.04 7 0.03 10 0.18 1 0.02 39 0.72 84 1.55 1907 — — 13 0.34 3 0.06 10 0.19 27 0.51 2 0.04 16 0.30 71 1.34 1908 — — 10 0.18 6 0.06 5 0.09 7 0.13 4 0.08 26 0.49 58 1.09 1909 — — 14 0.27 3 0.08 3 0.06 15 0.29 1 0.02 7 0.14 43 0.84 1910 — — 13 0.26 — — 4 0.08 16 0.32 4 0.08 6 0.12 43 0.86 1911 — — 15 0.31 3 0.06 3 0.06 3 0.06 2 0.04 33* 0.67* 59 1.21 1912 — — 25 0.52 0 0.00 6 0.13 7 0.15 1 0.02 8* 0.17* 47 0.98 1913 — — 7 0.15 0 0.00 4 0.08 6 0.13 0 0.02 12* 0.25* 29 0.61 Average for 10 years 19041913. 0.2 000 17.6 0.34 2.0 004 5.3 0.11 11.4 0.21 2 3 0.01 20.4 0.38 59.2 1.13 1914 — — 11 0.24 2 0.04 3 0.06 9 0.19 6 0.13 11* 0.24* 42 0.90 London, 1914. — — 1,385 0.31 316 0.07 706 0.16 918 0.20 147 0.03 3031* 0.67* 6,503 1.44 * The Registrar General since 1911 has taken the deaths from Diarrhoea and Enteritis under two years of age. 14 MEASLES. We received information of 203 cases in comparison with 75 in 1913, 202 in 1912, 101 in 1911, 234 in 1910, 139 in 1909, and 86 in 1908. There were only 11 deaths or a rate of 0.24 per thousand in comparison with a decennial rate of 0.34. Of these only 3 belonged to St. Giles and Bloomsbury and 8 to the Holborn District. Seven of the eleven were under 2 years of age. 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:— St. Alban's Class Boom C. January 27th to 6th February. Do. „ C. March 13th to 27th. Do. „ A. March 26th to 8th April. Do. „ C. May 1st to 15th. Rosebery Avenue „ A. February 17th to 13th March. Do. „ B. & D. February 27th to 13th March. Do. „ C. March 2nd to 13th. Do. „ B. May 18th to 29th. Do. „ A. June 19th to 3rd July. Do. „ A. B. &D. July 2nd to 22nd. St. John-the-Evangelist „ C. March 12th to 20th. Do. „ C. June 8th to 19th. Christ Church „ under5years July 15th to 22nd. Since the Measles Order of the Local Government Board of the 30th May, 1911, in addition to Poor Law cases, persons that cannot be satisfactorily isolated and nursed at home can be removed to hospitals of the Metropolitan Asylums Board, on the recommendation of the Medical Officer of Health, provided accommodation is available. Nine cases were so removed during the year. WHOOPING COUGH. Whooping cough was returned as the cause of 9 deaths during the year, in comparison with 6 in the preceding year and 3 in 1910. 3 of the deaths were in St. Giles and Bloomsbury and 6 in the Holborn District. All were children under 5 years of age, 6 being under 2 years. The death-rate was 0.19 per 1,000 in comparison with the decennial average of 0.21. 15 On the 9th August, 1912, the Local Government Board issued an Order providing for the admission of any person who is not a pauper to a hospital of the Metropolitan Asylums Board on the recommendation of the Medical Officer of Health, provided more accommodation is available than is required for pauper patients. 19 cases were so removed during the year. DIARRHŒA AND ENTERITIS The number of deaths from diarrhœa and enteritis was only 11. Three belonged to St. Giles and Bloomsbury and 8 to the Holborn District. All were children under 2 years of age, 9 being under 1 year of age. The Registrar-General in 1911 introduced a change in the method of classification of diarrhœal deaths. He takes the deaths from diarrhoea and enteritis under two years of age, instead of deaths at all ages from cholera, dysentery and diarrhœa. In estimating rates, he takes the number of deaths per 1,000 births instead of per 1,000 of the population. In the Borough this rate was only 14.3 per 1,000 births, in comparison with 27.64 for Loudon with 3,031 deaths under two years of age. 10 of our deaths and 1,944 London deaths occurred during the summer quarter, in comparison with 33 and 4,310 respectively during the exceptionally hot one of 1911. PHTHISIS. For details see pages 20 to 22. INFLUENZA. During the year there were 4 deaths registered as due to influenza, in comparison with 8 in 1913. ALCOHOLISM. Only 16 deaths were assigned to alcoholism or cirrhosis of liver, 7 in St. Giles and Bloomsbury and 9 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. 64 deaths were registered as due to cancer or malignant disease, 33 belonging to St. Giles and Bloomsbury and 31 to the Holborn District. 16 OTHER CAUSES OF DEATH. Further details as to causes of and ages at death are given in Table III. of the Appendix. INQUESTS. Coroner: Walter Schroder, Esq., Office, Manor Place, Paddington Green, W. Inquiry Officer: Mr. G. Stabb, 46, Baker Street, King's Cross Boad. The following inquests on the bodies of Parishioners were held:— District. Total Number. Cause of Death. Natural. Accidents. Suicide. Murder. St. Giles and Bloomsbury 34 17 12 5 —. Holborn 50 26 20 4 — Total 84 43 82 9 — THE PUBLIC MORTUARY, GOLDSMITH STREET. 76 bodies were received (49 being parishioners), and on these 48 inquests (29 of parishioners) were held, and 33 post-mortems (21 of parishioners) made. NOTIFICATIONS OF INFECTIOUS DISEASES. Excluding duplicate notifications and 135 notifications of Phthisis, and 77 notifications of Whooping Cough, the number of notifications of infectious diseases in the Borough during 1914 was 283 in comparison with a decennial average of 256. The notifications per 1,000 of the population were less than for London, namely 6.06 per 1,000 in comparison with 915 for London. For further details, see the following Table and Table II, of the Appendix NOTIFICATIONS OF INFECTIOUS DISEASES IN THE BOROUGH DURING 1914, AND DURING THE PRECEDING TEN YEARS, AND RATES PER 1,000. Year. Small-pox. Diphtheria and Membranous Ctonp. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Ophthalmia Neonatorum. Cerebrospinal Fever Acute Polio-myelitis. Total. 1904 No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. Ho. Rate per 1000. No. Kate per 1000. No. Rate per 1000.[/###+] 6 0.11 46 0.82 99 1.76 41 0.73 0 0.00 77 1.37 7 0.12 0 0.00 — — — — — — 276 4.91 1905 1 0.02 47 0.85 156 2.82 21 0.38 1 0.02 35 0.63 2 0.03 0 0.00 — — — — — — 263 4.76 1906 0 0.00 66 1.22 137 2.53 15 0.28 0 0.00 56 1.03 2 0.03 0 0.00 — — — — — — 276 5.10 1907 0 0.00 64 1.21 156 2.94 14 0.26 0 0.00 40 0.75 I 0.02 1 0.02 — — 2 0.03 — — 278 5.24 1908 0 0.00 50 0.94 193 3.64 25 0.47 0 0.00 46 0.87 2 0.03 0 0.00 — — 0 0.00 — — 316 5.96 1909 1 0.02 47 0.92 98 1.92 16 0.31 1 0.02 41 0.80 3 0.06 0 0.00 — — 0 0.00 — — 207 4.06 1910 0 0.00 45 0.90 68 1.36 25 0.50 0 0.00 42 0.84 0 0.00 0 000 — — 1 0-02 — — 181 3.62 1911 0 0.00 85 1.74 120 2.45 10 0.20 0 0.00 37 0.76 2 0.04 0 0.00 5 0.10 0 0.00 0 0.00 259 5.29 1912 0 0.00 88 1.83 113 2.36 12 0.25 0 0.00 48 1.00 0 0.00 0 0.00 6 0.10 1 0.02 0 0-00 267 5.56 1913 0 0.00 59 1.23 131 2.75 7 0.15 0 0.00 29 0.61 1 0.02 0 0.00 3 0.06 0 0.00 2 0—04 232 4.???6 Average for 10 years 1904-1913. 0.8 0.02 59.7 1.17 1271 2.45 18.6 0.35 0.2 0.00 45.1 0.87 2.0 0.04 0.1 0.00 1.3 0.03 0.4 0.01 0.2 0.00 255.5 4 .94 1914 0 0.00 63 1.35 173 3.71 15 0.32 0 0.00 22 0.47 4 0.09 0 0.00 6 0.13 0 0.00 0 0.00 283 6.06 London,1914 3 0.00 9,118 2 03 25,015 5.54 779 0.18 18 0.00 4,970 1.09 393 0 09 1 0.00 885 0.20 73 0.02 93 0.02 41,348 9.15 Chicken-pox was notifiable from October 19th, 1901, to January 6th, 1903, inclusive, during which time 282 notifications were received, and from Aprii 8th to November 6th, 1904, inclusive, during which time 61 notifications were received; and in 1911, from 22nd March to 21st June, during which period 101 notifications were received. Anthrax, nil; Glanders, nil; Hydrophobia, nil'. There were also the following voluntary notifications of Phthisis ■ 1911 Voluntary ... 3 1913 Private 58 1904 344 1908 152 ,, Hospital 81 ,, Hospitals ... 73 1905 208 1909 Voluntary... 16 ,, Poor Law ... 104 „ Poor Law ... 73 1906 191 „ Poor Law ... 326 188 204 1907 173 342 1912 Private 35 1914 Private ... 42 1910 Voluntary ... 16 ,, Hospital 79 „ Hospitals ... 49 „ Poor Law .. 154 170 „ Poor Law .. 96 210 „ Poor Law ... 44 135 Also 77 nocincations or Whooping Cough which was made notifiable in Holborn tor 5 years trom 1st April, 1914. 18 SMALL POX. There was no notification of small-pox in the Borough during the year. SCARLET FEVER. Excluding duplicates, the number of notifications of scarlet fever was 173 in comparison with 131 in the year 1913. Of these 95 belonged to St. Giles and Bloomsbury and 78 to the Holborn District. All but 5 of the cases were removed to hospital. The number of notifications was equal to 3.79 per 1,000 in comparison with 5"54 for London. The average for the preceding decennium in the Borough was 2-45 per 1,000. Five of the cases were nurses at hospitals in the Borough. Errors in Diagnosis. During the year 6 cases were returned as not suffering from scarlet fever, or 3.5 per cent. of the notifications. Secondary Cases of Scarlet Fever. Excluding the above 6 cases, of the remaining 167 notifications, 116 occurred in houses in which there was no secondary case. In 15 houses 2 cases occurred, in 5 houses 3 cases occurred, and in 2 institutions 4 cases. In a few cases the primary case was in the latter part of the preceding year. Return Cases of Scarlet Fever. Of the above 53 secondary cases, 9 were "Return" cases, i.e., cases which occurred in a house soon after the return home of a patient from hospital. Of the 8 infecting cases, 1, apparently, was the cause of 2 "Return" cases. DIPHTHERIA. The number of cases of diphtheria was 63 in comparison with 59 in the year 1913. Of these 29 belonged to St. Giles and Bloomsbury and 34 to the Holborn District. All but 3 were removed to Hospital. The notification rate was l.35 per 1,000 in comparison with 2.03 per 1,000 for London. The average for the preceding decennium for the Borough was 1.17 per 1,000. Five of the cases were nurses at a hospital in the Borough. Errors in Diagnosis. Five of the patients were returned from the Hospitals of the Metropolitan Asylums Board as not suffering from diphtheria, or 7.9 per cent. of the cases notified. 19 Secondary Cases. Excluding the above 5 cases and the 5 nurses at a Hospital, of the remaining 53 cases 43 occurred in houses in which there was no secondary case. In 5 houses 2 cases each. Return Cases. There was only one "return" case during the year. In a house in which the two cases were treated at home, the second case occurred after the primary case was supposed to be free from infection. Diphtheria Anti-toxin. Diphtheria Anti-toxin was supplied free of charge in 8 cases. ENTERIC FEVER. Excluding duplicates there were 15 notifications in comparison with 7 in the preceding year. 11 belonged to St. Giles and Bloomsbury District and 4 to the Holborn District. All but one were removed to Hospital. These notifications corresponded to a rate of 0.32 per 1,000 in comparison with 0.18 for London. Errors in Diagnosis. One case was returned from the Hospitals of the Metropolitan Asylums Board not suffering from enteric fever, or 6.7 per cent. of the cases notified. Of the remaining 14 cases 8 were not, and 2 probably not contracted in the Borough. Of the other 4 cases one had been in the habit of frequently eating oysters, and two, fried fish. CEREBRO-SPINAL FEVER. (Epidemic Cerebro-Spinal Meningitis.) No case was notified during the year. 73 cases were notified in London. POLIO-MYELITIS AND ENCEPHALITIS I No notification was received during the year. There were 93 notifications in London. C 2 20 OPHTHALMIA NEONATORUM Ophthalmia Neonatorum is an infectious inflammation of the eyes in newlyborn children, and is the most common cause of blindness beginning in infancy. Six cases were notified in the Borough during the year, 3 in St. Giles and Bloomsbury and 3 in the Holborn District. These cases were visited by the Lady Sanitary Inspector. 1 of the infants was treated at an Ophthalmic Hospital, 4 by doctors, and 1 by the midwife in attendance. WHOOPING COUGH. The Public Health Committee directed the attention of the Council to the difficulty of preventing children suffering with whooping cough associating, not only with members of their own family, but with other children to whom they might convey the infection, and expressed the opinion that in order to ensure more complete and earlier information respecting cases of whooping cough, and with a view to further effort being made to minimise its spread, the disease should be added to the list of notifiable diseases. The Local Government Board approved this provided that the notification was limited to a period of five years and only Sections 55, 66 and 68 (1) (a) and (b) of the Public Health (London) Act, 1891, were applied to the disease. These three sections deal with notification, removal to hospital, and penalty on exposure of infected persons respectively. This was agreed to by the Council and the Order came into operation on the 1st day of April, 1914. 77 notifications of the disease were received from this date to the end of the year. PHTHISIS OR CONSUMPTION. The number of deaths from phthisis during the year was 92, or a death-rate of 1.97 per 1,000, or 1.69 if corrected for sex and age distribution. Of these 45 belonged to St. Giles and Bloomsbury, a death-rate of 1.92, and 47 to the Holborn District, or a death-rate of 2.02 per 1,000. During the past year of the 92 deaths, 29 had been removed to infirmaries from common lodging houses in the Borough, that is about 31.5 per cent., 20 from St. Giles and Bloomsbury, and only 9 from the Holborn District. The corrected number of deaths in London was 6,281, equal to a rate of 1.39 per 1,000, compared with l.30 for 1913. The following table gives the number of deaths in the Holborn Borough and the death-rates per 1,000 (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 1904-1914, inclusive. 21 Year. Holborn Borough. London. Rate per 1,000 Deaths. Death-Rate per 1,000. Crude. Corrected. 1904 157 2.80 2.46 1.65 1905 149 2.71 2.88 1.46 1906 118 2.18 1.92 1.49 1907 125 2.36 2.07 1.46 1908 105 1.97 1.73 1.39 1909 108 2.11 1.85 1.40 1910 98 1.96 1.72 1.23 1911 96 1.96 1.72 1.35 1912 95 1.98 1.74 1.35 1913 89 1.87 1.60 1.30 1914 92 1.97 1.69 1.39 Notification of Consumption. Public Health (Tuberculosis) Regulations, 1908, 1911, & 1912. The Voluntary Notification of Consumption which had been in force from the 1st January, 1904, and had been partly superseded by the Public Health (Tuberculosis) Regulations, 1908 (Poor Law Cases), and the Public Health (Tuberculosis in Hospitals) Regulations, 1911, was finally and completely superseded by the Public Health (Tuberculosis) Regulations, 1911, which came into force on the 1st January, 1912. These Tuberculosis Regulations of 1911 were superseded by the Public Health (Tuberculosis) Regulations, 1912, which made compulsory the notification of all forms of tuberculosis, and came into force on the 1st February, 1913. Excluding duplicates the total number of notifications received was 135, of which 42 were private cases, 49 hospital cases, and 44 poor-law cases. Of the total number 37, or 27.4 per cent., were residents of common lodging houses, and were all but 2 at once or soon afterwards removed to workhouse infirmaries. With few exceptions the remaining 98 lived in tenement houses and 32 of these were removed to infirmary or hospital, 66 remaining at home, but some of these had previously been in infirmaries, hospitals or sanatoria. In previous annual reports I have given details of the action that is taken and the various results that were obtained from the enquiries made. After death, or removal to infirmary or hospital, disinfection is advised Consent for this was obtained in 21 cases. 22 National Insurance Act. Sanatorium Benefit — Tuberculosis Dispensary, etc. In preceding Annual Reports I gave details respecting the above and the Report of the Departmental Committee on Tuberculosis. The provision of a Tuberculosis Dispensary has again received much consideration during the year. The Public Health Committee recommended that, subject to the satisfactory settlement of details, the Council should approve a proposed scheme for the establishment of a Tuberculosis Dispensary at St. Bartholomew's Hospital, in accordance with a scheme submitted by the Sanitary Committee of the City of London. That scheme also included the Borough of Finsbury. The Borough of Finsbury, however, decided to provide a separate Municipal Dispensary, and the matter was then deferred until the report of the London County Council on the provision of Tuberculosis Dispensaries in London had been considered. In addition to other proposals that had been previously considered, proposed schemes for the use of Tuberculosis Dispensaries at the Royal Free Hospital and the University College Hospital also received the careful attention of the Committee. Finally arrangements were made with University College Hospital for the use of their Dispensary as the Borough Tuberculosis Dispensary, and the same was opened for our residents on February 2nd, 1915. The Memorandum of the Insurance Committee for the County of London on the treatment of insured persons at Tuberculosis Dispensaries provided by Borough Councils was again under consideration, but with some of the proposals therein, the Council did not concur. During the year I received information from the London Insurance Committee respecting 21 insured persons who had been admitted to sanatoria or hospitals for consumption. I received information of the discharge of 20 of these, and also of three admitted in 1913. Four of the 23 discharges were stated to be chronic or advanced cases not likely to improve further at the institution. In 13 cases the symptoms were quiescent and the patients were stated to be fit for ordinary work in 8 cases and for light work in 4 cases. One patient was discharged for disobedience to instructions and was recommended for domiciliary or dispensary treatment. In 3 cases patients were discharged at their own request and two were found not to be tuberculous. Three of the patients died during the year. GLANDERS, ANTHRAX AND HYDROPHOBIA IN MAN. No notifications were received. 23 BACTERIOLOGY. The following table gives details of the examinations made by the Royal Institute of Public Health during the year. Diphtheria. Enteric Fever. Consumption. Gonococci. Number Submitted. Result of Examination. Number Submitted. Result of Examination. Number Submitted. Result of Examination. Number Submitted. Result of Examination. 53 44 bacilli not found 2 1 Negative 112 85 bacilli not found 1 1 Negative 9 bacilli found 1 Positive 27 bacilli found - Positive DISINFECTIONS. During the 52 weeks ended January 2nd, 1915. District. Rooms. Bedding, &c. Number of Articles. Number of Persons using Shelter. St. Giles and Bloorasbury 242 3,818 - Hollborn 181 2,892 3 Whole Borough 423 0,710 3 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, 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 1 family consisting of 3 persons. CLEANSING OF PERSONS ACT. During the year 79 persons (68 men and 11 women) infested with vermin had their bodies and clothing disinfested free of charge. All had their bodies cleansed in the new Cleansing Station at the Public Mortuary, and 627 articles were disinfested in the Council's steam apparatus. 24 HOUSING OF THE WORKING CLASSES ACTS. Housing, Town Planning, &c., Act, 1909. Proceedings under Section 17. Houses Inspected. Represented by Medical Officer of Health. Defects Remedied without Closing Orders. Closed Voluntarily. General Character of Defects. Remarks. Leather Lane Buildings Yes (in 1913) No — Insufficient light and ventilation of rooms, staircase and W.O.'s. Defective roofs, dampness and dilapidations Closing order made April 1913. Demolition order made February, 1915 Evelyn Buildings Yes (in 1913) No — ditto Closing order made. ditto. determined February, 1915. Kingsway Mansions, Princeton Street Yes Yes — ditto — Eed Lion Passage, No. 14 Yes No — ditto Closing order made. Great Queen Street, Nos.86 and 37 No — — ditto Deferred. King's Mews, Nos. 1, 2, 3, 5, 6a, 11, 14, 22 and 23 No Yes — ditto — Total 15 (including 2 in 1913). 4 (including 2 from 1913) 10 — — 3 closing orders (including 1 in 1913. 2 pending. A large number of other houses were inspected by me, but were not reported to the Housing of the Working Classes Committee, as they did not appear to me to be in a state so injurious or dangerous to health as to be unfit for human habitation. It was necessary to make two closing orders during the year—viz., for Evelyn Buildings, which was subsequently determined, when the premises had been made fit for human habitation, and for 14, Red Lion Passage, which is still closed, but the work required has been nearly completed. Underground Booms habitually used as Sleeping Places. In accordance with the Sub-Section 7 of the same Section (17) of the Act, I again prepared and submitted suggested regulations. These were approved by the Council, and after minor verbal alterations received the consent of the Local Government Board, February 2nd, 1915. 25 Erection of Dwellings for the Working Classes. The erection of dwellings for the working classes under Part 3 of the Housing of the Working Classes Act, 1890, has received much consideration during the year. From time to time, and in previous years also, I inspected and reported upon proposed sites. In May, 1913, the Committee considered the island site in Short's Gardens, bounded on the east by Nottingham Court and on the west by Neal Street, the most suitable site of three sites then considered. Negotiations were at once entered into for the purchase of the site, and in July the Council made an order for compulsory purchase. Negotiations for the purchase of the site were completed during the year. Several reports respecting the construction and plans for proposed new dwellings were prepared by the Borough Surveyor, and received the careful consideration of the Housing of the Working Classes Committee. One of these was finally selected and agreed to by the Council in February, 1914. On account of the War the erection of the dwellings has been postponed. list of premises closed, demolished oR rebuilt during 1914. St. Giles and Bloomsbury. Alfred Mews, Nos. 18, 19 and 20. Premises still closed, to be demolished. Alfred Place, No. 29. Site still vacant. Betterton Street, Nos. 15 and 16. Sites still vacant. Do. No. 31. Now used as a warehouse. Drury Lane, Nos. 192 and 193. Site still vacant. Goldsmith Street, Nos. 3, 5 and 7. Site still vacant. Gower Street, Nos. 22 to 42. Site still vacant. Do. Nos. 19 to 21. Houses converted into a club. New billiard room at rear. Great Queen Street, Nos. 77 and 77b. Being rebuilt. Great St. Andrew Street, Nos. 40, 41 and 42. Demolished. New extension to Shaftesbury Hotel being built. High Holborn, Nos. 171 to 181. Site still vacant. Do. Nos. 295 to 302. Rebuilt. Keppel Mews (North). Nos. 43 and 44. Site still vacant. Do. Nos. 49 and 58 do. Keppel Street (North Side). New premises built on part of site. Do. (South Side). Site still vacant. d 26 Kings way. Queen's House. Built. Do. Site between "West African House and Central House. Being built upon. Do. West African House. Built. Do. Windsor House. do. Do. Regent House. do. Do. (East Side). Corner site of North Side of Sardinia Street. Being built. Public Trustee's Offices. Little Earl Street, Nos. 11, 12 and 13. Demolished. Lincoln's Inn Fields, Nos. 53, 54, 55 and 56. Being rebuilt. Public Trustee's Offices. Lumber Court, Nos. 1, 2, 3 and 4. New Theatre being built. Malet Street. New Theatre being built. Do. New Offices being built. Montague Place (North side). Site still vacant. Neal Street, Nos. 34 to 46. Site still vacant. New Oxford Street, Nos. 118 to 128. New shops built. Nottingham Court, Nos. 13 to 16. Site still vacant. Parker Street, No. 53. Rebuilding stopped on account of proposed widening. Eussell Mews. Site still vacant. Bussell Square No. 30. New premises built. Short's Gardens, Nos. 30 and 32. Site still vacant. Torrington Mews, Nos. 1 to 23. Site still vacant. Do. (East), Nos. 7 and 8. Still closed. Tottenham Court Eoad, Nos. 200 and 203. Site still vacant. Do. Nos. 193 and 195. New extension to Messrs. Heal & Co's premises being built on part of site. Tower Street Nos. 14, 15, 16 and 17. New Theatre being built. Upper Bedford Place, Nos. 43 to 51. National Hotel being built. West Street, Nos. 10, 12, 14 and 16. New Theatre being built. Woburn Mews, No. 23. Site still vacant. ' * Do. Nos. 14 to 22. National Hotel being built. Woburn Place, Nos. 42-53. Site still vacate. Holborn. Beagle Court, Eagle Street. Eebuilt. Beauchamp Street, Nos. 1, 2, 3 and 3a. Demolised and being rebuilt. Bishop's Head Court, No. 1. Still unoccupied. Boswell Court, Nos. 8 to 9. Demolished. Do. Nos. 10 to 13. Site still vacant. 27 Brooke Street, Nos. 13, 14, 15 and 16. Demolished and being rebuilt. Cockpit Yard, No. 10. Premises still closed. Cross Street, Nos. 15, 16 and 17. Being rebuilt. Devonshire Street, Nos. 44, 45, 46 and 47. Site still vacant. Dorrington Street (North Side), Nos. 1 to 12. Being rebuilt. Drake Street, No. 10. Reconstructed internally. Dunstable Court. Site still vacant. Eagle Street, Nos. 21, 22 and 23. Rebuilt. Do. Nos. 42 and 43. Rebuilding. Do. No. 53. Premises still closed. East Street, Nos. 39 and 40. Site still vacant. Emerald Street, No 30. Premises still closed. Greville Street, Nos. 2 and 3. Rebuilt. Do. Nos. 10 and 11. Demolished and being rebuilt. Harpur Mews, Nos. 12 and 13. Premises still closed. Hatton Garden, No. 7. Demolished and being rebuilt. Do. No. 36. Demolished and rebuilt. Henry Street, No. 5. Site still vacant. High Holboru, Nos. 73, 74. 75, 76, 77 and 78. Demolished. Lamb's Conduit Passage, Nos. 14 to 20. Site still vacant. Lamb's Conduit Street, Nos. 10 and 12. Site still vacant. Leather Lane, No. 50. Bebuilt Long Yard, No. 10. Closed. Millman Street, No. 66. Closed. New North Street, Nos. 14a and 15. Site still vacant. Do. Nos. 20 to 28. Site still vacant. Old Gloucester Street, No. 6. Site still vacant. Bed Lion Street, No. 48. Site still vacant. Bose Alley, Eagle Street. Bebuilt. Southampton Buildings, Nos. 43, 44, 45 and 46. Rebuilt. Star Yard, Lamb's Conduit Street, Stables and dwelling-house. Demolished. Theobald's Road, Nos. 116 and 118. Front portion rebuilt as offices, etc. Yorkshire Grey Yard (East side). Closed. SANITARY WORK. HOUSE TO HOUSE INSPECTIONS, 1914. St. Giles and Bloomsbury. Alfred Place. Broad Street. Arthur Street. Betterton Street. Bainbridge Street. Castle Street. Bernard Mews. Clark's Buildings. d2 28 St. Giles and Bloomsbury—continued. Denmark Place. Drury Lane. Dyott Street. Endell Street. Goldsmith Buildings. Goldsmith Street. Grape Street. Great Earl Street. Great Queen Street (part of). Great Russell Street (part of). Great St. Andrew Street. Great White Lion Street. Herbrand Street. Kenton Street. Little Earl Street. Little St. Andrew Street. Little White Lion Street. Lumber Court. Neal Street. New Compton Street. New Oxford Street. New Turnstile. Nottingham Court. Phoenix Street. Ridgmount Street. Shaftesbury Avenue (part of). Short's Gardens. Smart's Buildings. Southampton Row (part of ). Stacey Street. Tottenham Court Road. Tower Street. Wild Court. Wild Street. Woburn Mews. Holborn. Albion Buildings. Back Hill. Beauchamp Street. Chapel Street. Charles Street. Cockpit Yard. Dane Street. Devonshire Street. Eagle Street. East Street. Emerald Street. Evelyn Buildings. Eyre Street Hill. Featherstone Buildings. Fox Court. Great James Street. Hatton Yard. Lamb's Conduit Passage. Lamb's Conduit Street. Laystall Street. Little Bath Street. Little Gray's Inn Lane. Little James Street. Mount Pleasant. New North Street. Old Gloucester Street. Old North Street. Ormond Yard. Pooles Buildings. Portpool Buildings. Princeton Street. Red Lion Passage. Robert Street. Sandland Street. Summer Street. Verulam Street. Vine Street. Warner Street. WATER SUPPLY TO NEW BUILDINGS. During the year I inspected and gave certificates for the following premises:— 29 43 to 46, Southampton Buildings. 37 and 38, Hatton Garden. Pearl Assurance Company, 248 to 251, High Holborn. Lincoln House, 296 to 302, High Holborn. Windsor House, Kingsway. Regent House, Kingsway. 2 and 3, Greville Street. 24 and 26, Great Queen Street. 34, 36 and 38, Parker Street. WATER SUPPLY TO TENEMENT HOUSES. In accordance with the Public Health Act, and Section 78 of the London County Council (General Powers) Act, 1907, 10 notices were served for the provision of additional water supply in tenement houses. BY-LAWS AS TO HOUSES LET IN LODGINGS. At the end of the year, 637 houses were registered under these By-laws, of these, 312 are in St. Giles and Bloomsbury, and 325 in the Holborn District; 16 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, and 12 were added to the Register, During the year, there were 1,012 inspections of these premises, excluding a very large number of periodical inspections and re-inspections. 17 notices were served for 34 overcrowded rooms, and 209 notices for other breaches of the By-laws, exclusive of 658 notices that were served for annual cleansing as required by the By-laws. REVENUE ACTS. Nine applications were received during the year for Certificates from me under the above Acts. The houses comprised 59 tenements (flats), the remaining parts being let at too high a rental or used for business purposes. The Certificates were granted for all except three basement fiats. OVERCROWDING. The number of dwelling rooms found to be overcrowded was 66, 34 of these were dealt with as breaches of the By-laws as to houses let in lodgings. 30 REMOVAL OF HOUSE REFUSE. In accordance with the Contract, all house refuse has to be removed at least twice a week, and oftener if required by the Medical Officer of Health. In the main thoroughfares there is a daily collection before 10 a.m. 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 25 genuine complaints respecting non-removal of house refuse were received from householders, more than two-thirds of which were received after the commencement of the War, and more than half of them in the last quarter, when a number of the dustmen had enlisted or had taken up other work, and much difficulty was experienced by the Contractors in maintaining an adequate supply of efficient dustmen. 113 notices were served for the provision of proper dust receptacles. The Contractors agreed to arrange without any additional charge for the daily collection of house refuse from Bedford Place, Upper Bedford Place, Montague Street, Upper Montague Street, and Torrington Square, provided that the house refuse was placed in small covered receptacles on the kerb or in an accessible position in the front area by 7.30 a.m. With the consent of the Committee I wrote to the occupiers of the houses in the above streets, asking whether they are prepared to co-operate if arrangements are made for the early daily removal of house refuse. Prom the occupiers of the first four streets the replies received were almost unanimous in favour of the same, in fact in two of the streets all the occupiers consented, and in one of the remaining two all but one had already consented at the time of my second report to the Committee. The early morning collection was accordingly begun on the 13th July. 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 generally carried out satisfactorily, only two genuine complaints were received, and in the three preceding years no complaints. Posters requiring the periodical removal of manure and other refuse matter from all stables or other premises in the Borough not less frequently than every 48 hours were again posted in the various mews in the Borough. 31 COMMON LODGING HOUSES ACTS, 1851 and 1853. The Secretary of State, by a Provisional Order which came into operation on the 1st November, 1894, transferred to the London County Council the powers of the Commissioner of Metropolitan Police in respect of common lodging houses. The following is a list of the Common Lodging Houses registered in this Borough at the end of the year 1914:— Of these 14 are in St. Giles and Bloomsbury for 1,060 lodgers. „ 7 „ Holborn District for 622 „ Total 21 in the Borough for 1,682 „ 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 1-7, Macklin Street 96 M 2, Kennedy Court 8 W 19, do. 40 W 3, do. 10 w 21, do. 26 W 4, do. 19 w Parker Street Municipal 345 M 5, do. 8 w 7, 9, and 11, Short's Gardens, and 311 M 6, do. 8 w 7, do. 9 w 3, Neal's Yard 8, do. 34 w 6 and 7, Wild Court 63 M 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, OrdeHall Street 22 m 40, Eagle Street 50 m 39, Queen Square 52 m 4, Greville Street 53 m 12 and 13, Took's Court 110 m 29, Hatton Wall 94 m 32 FACTORIES, WORKSHOPS AND WORKPLACES. During the year there were 229 inspections of factories, 679 inspections of workshops and 2,339 of workplaces. 222 Intimation Notices for sanitary defects were served and 24 Statutory Notices. The following table gives the changes that have taken place during the year, details of the number of premises on the Register at the end of the year, number of inspections, etc. Inspections of Factories, Workshops and Workplaces. Class of Work. Number of Places. Number of Inspections, 1914. Number of Notices 1914. Number of Prosecution 1914. On Register at end of 1913. Added in 1914. Removed in 1914. On Register at end of 1914. Premises. Rooms. Intimations. Statutory. Factories. ‡ Factory Laundries 3 — — 3 — 4 — — — Factory Bakehouses 4 1 — 5 — 31 — — — Other Factories — — — — — 194 15 2 — Workshops. Workshop Laundries 10 — — 10 30 12 1 — — Workshop Bakehouses 28 — 1 27 — 191 4 — — Other Workshops 1,163 10 37 1,136 1,889 476 76 9 — Workplaces. Home workers' Premises * 251 39 49 241 — 159 3 — — Places where Food is prepared for Sale † 397 60 99 358 — 1,958 56 4 — Workplaces other than the above § — — — — — 222 70 9 — Total 1,856 110 186 1,780 1,919 3,247 225 24 — * 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 1914, and notices served where necessary. § There is a very large number of workplaces other than the above, the registration of which is not required, and many of them were inspected and notices served where necessary. BAKEHOUSES. At the end of the year 1914, there were 32 bakehouses in the Borough, of which 13 were in St. Giles and Bloomsbury and 19 in the Holborn District. 33 The following is a list of the bakehouses in the Borough all of which are underground except those marked *:— St. Giles and Bloomsbury. *2 Bloomsbury Court. 10 Bury Street. • 164 Drury Lane. 155 High Holborn. 217 & 218 High Holborn (Holborn Restaurant). 63 High Street. 19 Little Earl Street (Factory). 5 Little St. Andrew Street. 21 Marchmont Street. 77 Marchmont Street. 8 Museum Street. 200 Shaftesbury Avenue. *15 Torrington Place. Holborn. 158 Clerkenwell Road. *9 Cosmo Place. 13 Dane Street. *4a East Street (Factory). *51 Farringdon Road (Factory). 33 Great Ormond Street. 1 Greville Street. *91 Leather Lane (Factory). *6 Lamb's Conduit Street. 50 Lamb's Conduit Street. *28 Lamb's Conduit Street. *55 Mount Pleasant. 19 Red Lion Street. 50 Red Lion Street. *74 Red Lion Street. 92 Theobald's Road. 124 Theobald's Road. *Viaduct Buildings, also 17 Charter house Street (Factory). 36 Warner Street. During the year, in addition to my inspections, there were 222 inspections of bakehouses, including 31 inspections of the factory bakehouses. Four notices were served for sanitary defects. During the year machinery was installed at No. 19, little Earl Street, so that it became a Factory Bakehouse. HOME WORK. Details are given in the preceding Table, and in Table VIII. 3 of the Appendix. Many inspections of homeworkers' 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 home work are given in Table VIII. (1, 2, 3, 4 and 5) of the Appendix. e 34 PLACES WHERE FOOD IS PREPARED FOR SALE. Under this head are included kitchens of hotels, restaurants and eatinghouses 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 a previous page. The number of these places on the Register at the end of 1914 was 358; 1,958 inspections were made, and 60 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 803 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 10 occasions during the year. Only sheep are killed. DAIRIES, COWSHEDS AND MILKSHOPS. The number of registered dairies and milkshops in the Borough at the end of the year was 187, of which 75 were in St. Giles and Bloomsbury and 112 in the Holborn District. In all 9 dairies and milk shops were newly registered, 3 belonging to St. Giles and Bloomsbury and 6 to the Holborn District, and 10 were removed from the Register. In addition to my inspections the Sanitary Inspectors made 664 inspections of these premises, and 6 notices were served for sanitary defects or breaches of regulations, and in some cases alterations were carried out without the service of notices. PUBLIC HEALTH (MILK & CREAM) REGULATIONS, 1912. The following particulars of proceedings taken in the year 1914, under the above Regulations, made in pursuance of the Public Health (Regulation of Food) Act, 1907, are given in the form suggested by the Local Government Board in their circular letter dated 27th October, 1913, and a copy was sent to the Board in January, 1915. 35 1.—Milk, and Cream not sold as Preserved Cream. Number of samples examined for the presence of preservatives. Number in which a preservative was reported to be present. Milk 223 3 (a) Cream 8 6 (b) Nature of Preservative found and Action taken. (a) Milk. (1) Boric Acid 4.6 grains per pint. Prosecution under Sale of Food & Drugs Acts.—Fine 40s. (2) Boric Acid 5.86 grains per pint. Ditto ditto.—Fine £10. (3) Boric Acid 3.86 grains per pint. Pending. (b) Cream. (1) Boric Acid 0.035 per cent. No Proceedings. (2) Boric Acid 0.318 per cent. Proceedings under Sale of Food & Drugs Acts.—Warranty pleaded—Summons dismissed— Wholesale Dealer cautioned. (3) Boric Acid 0.086 per cent. No Proceedings—Same Vendor as (2). (4) Boric Acid 0.205 per cent. Eetail Dealer fined £3. 3s. and £2. 2s. costs. Wholesale Dealer—Summons dismissed. (5) Boric Acid 0.198 per cent. Vendor cautioned. (First offence). (6) Boric Acid 0.032 per cent. Informal sample—Same Vendor as (5). 2.—Cream sold as Preserved Cream. (a) Instances in which samples have been submitted for analysis to ascertain if the statements on the labels as to preservatives were correct:— (I.) Correct statements mads 6 (II.) Statements incorrect - Total 6 (b) Determination made of milk fat in cream sold as preserved cream:— (I.) Above 35 per cent. 6 (II.) Below 35 per cent. - Total 6 e 2 36 (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream in Article V. (1) and the proviso in Article Y. (2) of the Regulations have not been observed:— None. 3.—Thickening Substances. Any evidence of their addition to cream or to preserved cream. Action taken where found. None found. 4.—Other observations, if any:— None. ICE CREAM. During the year there were 65 premises in the Borough where ice cream was manufactured or sold, and in addition to my inspections 128 inspections of these premises were made. 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. 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:— 424 tins Preserved Fruits (assorted). 35 bottles Do. 6 tins Preserved Vegetables. 1 bottle Do. 28 tins Sardines. 2 tins Tinned Fish. 13 cases, bottles and tins Assorted Foods. 28 lbs. Skate. OFFENSIVE FUMES FROM FACTORIES. Only one complaint of nuisances from offensive fumes was received during the year. At these premises, a large refinery of gold and other precious metals, many additions and improvements to the plant had been recently effected, including large new plant for refining by means of electrolysis. 37 SMOKE ABATEMENT. The smoke shafts in the Borough were frequently kept under observation, and in 108 eases the inspections were recorded, but in very few cases were smoke nuisances discovered. Very few complaints of smoke nuisances were received during the year. Seven Intimation Notices were served, but in no case, was it necessary to serve a Statutory Notice. For further details of Sanitary Work and Legal Proceedings see Tables V., VI., VII., VIII., IX. and X. METEOROLOGY OF LONDON, 1914. The mean temperature of the year was 51.5 , and was 2.0° above the average for the preceding 70 years as deduced from observations at Greenwich, under the superintendence of the Astronomer Royal. The rainfall was 23.85 inches, and was 0.27 inches below the average of the preceding 65 years. The daily mean duration of bright sunshine was 4.54 hours, and was 0.39 hours above the average of the preceding 18 years. It was 37 per cent. of the total possible sunshine. Further details are given in Table XI. of the Appendix. 39 APPENDIX. TABLE I. Vital Statistics of Whole District during 1914 and Previous Years. Name of District—The Metropolitan Borough of Holborn. Year. 1 Population estimated to Middle to each Year. 2 Births. Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District. Under 1 Year of Age At all Ages. Uncorrected N umber. 3 Nett. Number. 6 Rate. 7 of Nonresidents registered in the District. 8 of Residents not registered in the District. 9 Number. 10 Rate per 1,000 Births. 11 Number. 12 Rate. 13 Number. 4 Rate. 5 1908† 52,224 1,543 1,066 20.1 1,064 20.1 599 403 118 111 868 16.4 1909 51,191 1,435 986 19.3 1,067 20.9 637 377 100 101 807 15.8 1910 50,148 1,352 1,017 20.3 913 18.9 567 392 102 100 768 15.4 1911 49,092 1,273 920 18.8 923 18.9 588 407 104 113 742 15.2 1912 48,026 1,250 901 18.8 907 18.9 549 357 70 78 715 14.9 1913f 46,949 868 797 16.7 910 19.9 583 358 80 100 685 14.4 1914 46,832 703 765 16.4 888 19.0 558 408 67 88 738 158 Area of District in acres (exclusive of area covered by water) 405??? Total population at all ages 49,357 at Census of 1911. Number of inhabited houses 7,895 „ „ Average number of persons per house 6.2 „ „ N.B.—In the above Table the populations, birth-rates and death-rates have all been estimated from the Census Populations of 1901 and 1911. † 53 weeks in Registration year. 40 TABLE II. Cases of Infectious Disease notified during the year 1914. Name of District—Holborn. Notifiable Disease Number of Cases Notified. Total Cases notified in each Locality (e.g. Parish or Ward) of the District. Total Cases Removed to Hospitals. At all Ages. At Ages—Years. St. Giles and Bloomsbury. Holborn. Under 1. 1 to 5 6 to 16. 15 to 25. 26 to 45 45 to 65. 65 and upwards. Small-pox — — — — Cholera — — — — — — — — — — — Diphtheria (including Membranous Croup) 63 3 17 24 12 6 1 — 29 34 61 Erysipelas 22 — 1 1 2 9 6 3 11 11 8 Scarlet Fever 173 2 45 97 25 4 — — 95 78 168 Typhus Fever — — — — — — — — — — — Enteric Fever 16 — I 2 4 6 1 1 11 4 14 Relapsing Fever — — — — — — — — — — — Continued Fever — — — — — — — — — — — Puerperal Fever 4 — — — 2 2 — — 1 3 2 Pulmonary Tuberculosis 115 — 1 4 11 62 31 6 73 42 63 Other forms of Tuberculosis 20 1 5 4 5 1 4 — 12 8 14 Ophthalmia neonatorum 6 6 — — — — — — 3 3 — Cerebro spinal fever — — — — — — — — — — — Polio-myelitis — — — _ — — — — — — — Glanders — — — — — — — — — — — Anthrax — — — — — — — — — — — Hydrophobia — — — — — — — — — — — *Whooping Cough 77 8 42 27 — — — — 17 60 18 Totals 495 20 112 159 61 90 43 10 252 243 338 * Whooping Cough was made notifiable in Holborn for five years from 1st April, 1914. 41 TABLE III. Cause of, and ages at, Death. Causes of Death. Net Deaths at the Subjoined Ages of "Residents" whether occurring within or without the district Deaths in Localities (at all ages). Total Deaths whether of "Residents" or "non" Residents" in Institutions in the District. All Ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 and under 65 years. 65 and upwards. St. Giles and Bloomsbury. Holborn. All causes Certified 738 67 23 19 13 28 132 210 216 355 383 582 Uncertified — — — — — — — — — — — — Enteric Fever 6 — — — — 2 2 1 1 4 2 — Small-pox — — — — — — — — — — — — Measles 11 1 6 2 1 1 — — — 3 8 2 Scarlet Fever 2 2 — — — — — — — — 2 1 Whooping Cough 9 4 2 3 — — — — — 3 6 22 Diphtheria and Croup 3 — — 1 2 — — — — 2 1 7 Influenza 4 — — — — 1 — 1 2 2 2 — Erysipelas 1 — — — — — 1 — — 1 — — Phthisis (Pulmonary Tuberculosis) 92 — — 1 — 10 45 34 2 45 47 27 Tuberculous Meningitis 8 1 1 3 2 — 1 — — 4 4 34 Other Tuberculous Diseases 3 — 1 1 — — 1 — — 1 2 23 Cancer, Malignant Disease 61 — — — — — 7 36 20 33 31 30 Rheumatic Fever 3 — — — — — 2 1 — 2 1 4 Meningitis 1 1 — — — — — .— — 1 — 13 Organic Heart Disease 69 — — — 2 3 11 25 28 34 35 24 Bronchitis 80 4 — — — — 4 25 47 39 41 9 Pneumonia (all forms) 67 12 9 3 — 2 10 20 11 26 41 50 Other Diseases of Respiratory Organs 4 — 1 — — — — 2 1 2 2 5 Diarrhoea and Enteritis 11 9 2 — — — — — — 3 8 66 Appendicitis &Typhlitis — — — — — — — — — — — — Cirrhosis of Liver 11 — — — — — 5 5 1 4 7 1 Alcoholism 5 — — — — — 3 2 — 3 2 1 Nephritis and Bright's Disease 26 — — — — — 4 15 7 15 11 15 Puerperal Fever 3 — — — — 1 2 — — 1 2 — Other accidents and diseases of Pregnancy and Parturition 1 — — — — — 1 — — — 1 — Congenital Debility and Malformation, including Premature Birth 17 17 — — — — — — — 8 9 49 Violent Deaths, excluding Suicide 30 5 — 1 3 2 4 10 5 11 19 11 Suicide 9 — — — — 1 3 4 1 5 4 1 Other Defined Diseases 198 11 1 4 3 4 26 59 90 103 95 187 Diseases, Ill-Defined or Unknown — — — — — — — — — — — — All causes 738 67 23 19 13 28 132 240 216 355 383 582 f 42 TABLE IV. Infantile Mortality during the Year 1914. Nett Deaths from stated causes at various Ages under One Year of Age. Cause of Death. Under 1 Week 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 Weeks. 4 Weeks and under 3 Months 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under One Year. All Causes. Certified 14 5 6 2 27 8 9 12 11 67 Uncertified — — — — — — — — — — Small Pox — — — — — — — — — — Chicken Pox — — — — — — — — — — Measles — — — — — — — — 1 1 Scarlet Fever — — — — — — — — 2 2 Diphtheria and Croup — — — — — — — — — — Whooping Cough — — — — — — 2 2 4 Diarrhœa — — — — — — 1 — 1 2 Enteritis — — — — — 1 4 1 1 7 Tuberculous Meningitis — — — — — — — 1 — 1 Abdominal Tuberculosis — — — — — — — — — — Other Tuberculous Diseases — — — — — — — — — — Congenital Malformations — — 1 — 1 — — — — 1 Premature Birth 10 1 2 1 14 1 — — — 15 Atrophy, Debility, Marasmus — 1 — — 1 — — — — 1 Atelectasis 1 — — — 1 — — — — 1 Injury at birth 2 — — — 2 — — — — 2 Erysipelas — — — — — — — — — — Syphilis — — — — — 1 — 1 — 2 Pickets — — — — — — — — — — Meningitis (not Tuberculous) — — — — — 1 — — — 1 Convulsions 1 — 1 — 2 — — — 1 3 Gastritis — — — — — — — — — — Laryngitis — — — — — — — — — — Bronchitis — — 1 — 1 1 1 1 — 4 Pneumonia (all forms) — 1 1 — 2 1 2 4 3 12 Suffocation, overlying — 1 — 1 2 1 1 — — 4 Other causes — 1 — — 1 1 — 2 — 4 14 5 6 2 27 8 9 12 11 67 Nett Births in the year legitimate, 705 illegitimate 60 Nett Deaths in the year of legitimate infants 58. illegitimate „ 9. 43 TABLE V. Sanitary Inspectors' Work.—Inspections, &c. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange. Whole Borough Inspections. Infectious Diseases 71 92 117 225 505 Dwelling Houses 112 240 112 5 469 Lodging Houses 336 241 252 183 1,012 Common Lodging Houses — 13 9 — 22 Dairies, Cowsheds and Milkshops 83 278 303 — 664 Ice Cream—Manufacture or Storage 9 22 97 — 128 Slaughter-house — 10 — — 10 Market Streets 209 70 464 — 803 Butchers' Shops 601 188 272 — 961 Bakehouses 35 88 99 — 222 Other Food Shops 191 187 481 — 869 Laundries 3 2 2 9 16 Other Workshops 114 161 82 119 476 Out-Workers' Rooms and Registers 21 47 34 159 261 Other Workplaces 79 77 65 1 222 Factories (excluding Bakehouses and Laundries) 29 15 41 1 86 Smoke shafts 6 21 81 — 108 Urinals 1 44 11 — 66 Miscellaneous 172 42 180 39 433 Periodical Inspections* 1,336 2,110 2,610 91 6,147 Dust† 48 218 59 — 325 Mews 130 103 37 — 270 Maternity — — — 629 529 Total Inspections 3,546 4,269 5,408 1,361 14,584 No. of Re-Inspections 806 1,486 903 597 4,989 Do. do. Maternity — — — 1,197 Visits other than Inspections and Re-Inspections 385 705 771 228 2,204 Do. do. Maternity — — — 112 Total 4,737 6,460 7,085 3,495 21,777 * The majority of these are weekly inspections of Registered Lodging Houses, † A large number of inspections respecting the removal of Refuse is also made during General and Periodical Inspections of houses. F 2 44 TABLE VI. Sanitary Inspectors' Work.—Notices served. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange. Total. Intimation 'Notices—Total served 137 319 298 128 882 Houses 99 234 213 109 655 The house or part of the house in a dirty condition 88 48 46 16 158 The house or part of the house in a damp condition — 4 5 4 13 The house in a dilapidated condition 7 20 27 3 57 The watercloset so foul as to he a nuisance 3 20 13 22 58 Do. without a water supply 7 11 17 1 36 Do. with a deficient supply of water 1 14 3 — 18 Do. improperly constructed — — — — — Do. so defective as to he a nuisance 5 16 28 25 74 Do. stopped 6 36 33 17 92 Do. placed in an improper position — — — — — Insufficient external ventilation to watercloset 1 — 1 — 2 Insufficient watercloset accommodation 1 3 — 2 6 Absence of watercloset accommodation — — — — — Absence of proper watercloset accommodation for persons of each sex See under Workshops &c. The soil pipe defective — — 1 — 1 Do. unventilated — — — — — Do. improperly ventilated — — — — — The yard paving defective 8 1 — 15 Do. dirty 1 13 7 4 25 Do. undrained — — — — — The area improperly paved — — — — — Do. dirty — 12 13 — 25 Do. undrained — — — — — The inlet of surface drain improperly trapped — — — — — A gully trap improperly placed within the house — — — — — The waste pipe of sink improperly connected with the drain 10 10 Do. do. improperly trapped — — — — — Do. do. untrapped — — — — — Do. of lavatory improperly connected with the drain Do. do. improperly trapped — . 1 — — 1 Do. do- untrapped 1 8 8 2 19 Do. of bath directly connected with the drain — Do. do. improperly trapped — — — — — Do. do. untrapped — — — — — The water cistern so foul as to be a nuisance 11 4 2 9 26 Do. being without a close fitting cover — 5 4 2 11 Do. being placed in an improper position — Do. defective — 9 — — 9 An accumulation or deposit of refuse 1 18 27 17 63 The absence of proper ashbin 21 13 16 7 57 The ashbin defective 8 11 9 4 32 The drain foul — — — — — Do. defective 3 11 8 1 18 Do. choked or stopped 4 30 14 7 65 Do. unventilated — — 1 — 1 45 TABLE VI.—continued. Sanitary Inspectors' Work.—Notices served.—continued. Inspector Bennett. Inspector Clark. Inspector Lorard. Inspector Orange. Total. Houses—continued. The rainwater pipe in direct communication with the drain — 1 — — 1 Do. do. do. with the soil pipe — 1 — — 1 Do. do. defective 1 10 1 2 14 The water supply used for domestic purposes connected with the cistern which is used for flushing the watercloset — — — — — The absence of proper water supply 1 4 3 2 10 The roof defective 8 16 32 6 60 The guttering defective — 1 4 — 5 The paving of wash-house defective — 4 1 — 5 The want of proper manure receptacle 2 1 — — 3 An animal kept in such place or manner as to be a nuisance 3 1 2 — 6 The house or part of the house overcrowded 2 7 2 4 15 An underground room occupied as a dwelling contrary to the provisions of the Act 1 7 — 6 14 The space below floor in the basement or ground floor being unventilated — 1 — — 1 Do. improperly or insufficiently ventilated — 1 — — 1 A chimney sending forth black smoke in such quantity as to be a nuisance See under Workshops A urinal improperly constructed, drained or offensive — 1 — — 1 Do. with do supply of water — 2 — — 2 Other nuisances 6 16 9 5 36 *Factories, Workshops and Work Places 38 85 85 19 227 Dirty 10 24 20 8 62 Waterclosets, defective or dirty 9 29 14 4 56 Do. insufficient — 1 — 1 2 Do. absence of separate accommodation for sexes — 3 3 1 7 Drains, soil pipes, &c., defective 5 7 17 — 29 Improperly ventilated 1 — 3 — 6 Overcrowded — 1 — — 1 Chimney sending forth black smoke 2 1 4 7 Other nuisances 8 14 23 6 61 Ashbins 5 12 3 — 20 Breach of Bye-laws or Regulations— † Lodging-houses 24 81 33 88 226 1 Dairies, cowsheds, milkshops and slaughterhouses — 1 — — Keeping of animals 2 1 — — 3 Removal of Refuse — 12 14 — 26 London County Council (General Powers) Acts Urinals — — — — — Verminous Rooms 4 15 22 19 60 Ashpits — 4 — — 4 Foodshops — — 1 — 1 Statutory Notices 5 36 65 25 131 * 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." 46 TABLE VII. Proceedings during 1914. PREMISES. NUMBER OF PLACES— Number of Inspections 1914. Number of Notices 1914. Number of Prosecution 1914. On register at end of 1913. Added in 1914. Removed in 1914. On register at end of 1914. Milk premises 188 10 9 187 664 6 0 Cowsheds 0 0 0 0 0 0 0 Slaughter-houses 1 0 0 1 10 0 0 Other offensive trade premises 0 0 0 0 0 0 0 Ice Cream premises 64 21 10 65 128 1 0 Registered houses let in lodgings 641 12 16 637 1012 (a)* 17 (a)* 0 (b)* 209 (b)* 0 * (a) For overcrowding. * (6) For other conditions. Total number of Intimation notices served for all purposes 882 Overcrowding, 1914— Number of Dwelling Rooms overcrowded 32 Number remedied 32 Number of prosecutions 0 Underground Rooms- Illegal occupation dealt with during year 14 Number of rooms closed 14 Insanitary Houses— Number closed under the Public Health (London) Act, 1891 0 „ „ „ „ Housing and Town Planning Act 1 Ice Cream— Proceedings under London County Council (General Powers) Act, 1902 0 Verminous Rooms— Numbers of premises cleansed under Section 20 of the London County Council (General Powers) Act, 1904 60 Shelters provided under Section 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 3 Revenue Acts— Number of houses for which applications were received during the year 9 Number of dwellings comprised therein 59 Number of tenements for which certificates were (a) granted 66 ; (6) refused 3; (c) deferred 0 Housing, Town Planning, etc., Act, 1909, Section 35— Number of applications for certificates 0 „ „ beds comprised therein 0 „ ,, certificates granted, 0; refused, 0; 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 (f) As to cesspools and privies, removal and disposal of refuse, etc 0 ( g) For securing the cleanliness of tanks, cisterns, etc 0 (h) With respect to water closets, earth closets, etc. 0 (i) With respect to sufficiency of water supply to water closets 0 (j) With respect to drainage, etc. (Metropolis Management Act, Section 202) 0 (k) With respect to deposit of plans as to drainage, etc. (Metropolis Management Act, Section 202) 0 Mortuaries— Total number of bodies removed 76 Total number of infectious bodies removed 1 47 TABLE VIII. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—Inspection. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Intimations. Statutory. Factories (including Factory Laundries) 229 15 2 Workshops (including Workshop Laundries) 679 81 9 — Workplaces 2,339 129 13 — Total 3,247 225 24 — 2.—Defects Found. Particulars. Number of Defects. r of Prosecutions. Found. Remedied. Referred to h.m. Inspector. *Nuisanoes under the public health acts:— Want of cleanliness 62 62 Want of ventilation 6 6 Overcrowding 1 1 — — Want of drainage of floors — — — — 107 107 — — Sanitary accommodation insufficient 2 2 — unsuitable or defective 56 56 — not separate for sexes 7 7 — — 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) — — — — Other offences (excluding offences relating to outwork which are included in Part 3 of this (Report) — — — — Total 241 241 — — * Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act as remediable under the Public Health Acts. TABLE VTTT-—continued. 3.—Home Work. NATURE OF WORK.* (1) Outworkers' Lists, Section 107. Outwork in Unwholesome Premises. Section 108. Outwork in Infected Premises, Sections 109, 110. Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. (8) Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 11<>) Sending twice in the year. Sending once in the year. Failing to keep or permit inspection of lists. (9) Failing to send lists. (10) Lists, † (2) Outworkers.f Lists. (5) Outworkers. Contractors. (3) Workmen. (4) Contractors (4) Workmen. (7) (11) (12) (13) (14) (15) (16) Wearing Apparel— (1) Making, &c. 138 206 499 9 18 18 146 — — — — — — — — (2) Cleaning and washing — — — — — — — — — — — — — — — Household Linen — — — — — — — — — — — — — — — Lace, Lace Curtains and Nets — — — — — — — — — — — — — — — Curtains and Furniture Hangings — — — — — — — — — — — — — — — Furniture and Upholstery — — — — — — — — — — — — — — — Electro Plate — — — — — — — — — — — — — — — File making — — — — — — — — — — — — — — — Brass and Brass Articles — — — — — — — — — — — — — — — Fur pulling — — — — — — — — — — — — — — — Cables and Chains — — — — — — — — — — — — — — — Anchors and Grapnels — — — — — — — — — — — — — — — Cart Gear — — — — — — — — — — — — — — — Locks, Latches and Keys — — — — — — — — — — — — — — — Umbrellas, &c. — — — — — — — — — — — — — — — Artificial Flowers — — — — — — — — — — — — — — — Nets, other than Wire Nets — — — — — — — — — — — — — — — Tents — — — — — — — — — — — — — — — Sacks — — — — — — — — — — — — — — — Racquet and Tennis Balls — — — — — — — — — — — — — — — Paper Bags and Boxes 2 — 19 — — — 2 — — — — — — — — Brush making 2 — 2 — — — 2 — — — — — — — — Pea Picking — — — — — — — — — — — — — — — Feather sorting — — — — — — — — — — — — — — — Carding, &c., of Buttons, &c — — — — — — — — — — — — — — — Stuffed Toys — — — — — — — — — — — — — — — Basket making — — — — — — — — — — — — — — — Total. 142 266 520 9 18 18 150 — — — — — — — — * If an occupier gives out work of more than one of the classes specified in column 1, and subdivides bis 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 assigned 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. 49 TABLE VIII continued. 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, may be enumerated here. Laundries (including 3 factory laundries) 13 Bakehouses (including 4 factory bakehouses) 32 Other Workshops 1,136 Total number of workshops on Register 1,181 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) 5 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 35 Report (action being taken) sent to H.m. Inspector 35 Other — Underground Bakehouses (s. 101): — Certificates granted during the year — In use at the end of the year 21 G 50 TABLE IX. LEGAL PROCEEDINGS. Public Health (London) Act, 1891. Date. Name. Premises. Offence. Result. 1914. Jan. 29 Mrs. Bodien 49, Eagle Street Nuisance. Water closet without a water supply Order to prevent recurrence with 108. 6d. costs. TABLE X, LEGAL PROCEEDINGS. Sale of Food and Drugs Acts. Date. Name. Address. Offences. Result. 1914. Feb. 3 Henry Hanson 11, New Yard Selling milk containing 6.1 per cent. added water Warranty proved. Summons dismissed. „ 6 Alice j. Cardon 30, New North Street Selling milk containing 5.1 per cent. added water Defendant convicted and fined 10s. 6d. and 12s. 6d. costs. April21 Hambrook, Eliza 37, Short's Gardens ... Selling milk containing 7.7 per cent. added water Defendant convicted and fined 5s. and 12s. 6d. costs. May 15 j. Lyons, Ltd. 316, High Holborn Selling milk 12.6 per cent. deficient in fat Warranty proved. Summons withdrawn. 29 Williams Zaccheus 73, Mount Pleasant Selling butter containing 85 per cent. foreign fat Defendant convicted and fined £1 and 12s. 6d. costs. July 3 Fitzgerald, M. 8, Laystall Street Selling milk 8.6 percent. deficient in fat Warranty proved. Summons dismissed. 7 Rudulf, Ltd. 43, Theobald's Road Selling butter containing 50 per cent. of foreign fat Fined £2. Costs 12s. 6d. Aug. 14 Express Dairy Co., Ltd. Tavistock Place Selling milk containing boron trioxide Warranty proved. Summons dismissed. „ 18 James, Emma.. 16, Gate Street Selling milk 9.6 per cent. deficient in fat Fined £1. Costs 12s. 6d. „ 18 Hunt, Annie 16, Dyott Street Selling milk containing 6.8 per cent. added water Fined £1. Costs 12s. 6d. Aug. 21 Terroni, Luigi. 188, Clerkenwell Road Selling milk containing boron trioxide Fined £2. Costs 12s. 6d „ 21 do. do. Selling butter containing water in excess of standard Fined 12s. 6d. „ 21 Matthias, a. 22, Cross Street Selling milk containing 7.4 per cent. added water Warranty proved. Summons dismissed. „ 25 Daunton, G. S. 1, Guilford Street Selling milk containing boron trioxide Fined £10. Costs 12s. 6d 51 TABLE X —continued. LEGAL PROCEEDINGS.—continued. Sale of Foods and Dkugs Acts.—continued. Date. Name. Address. Offences. t. 1914. Oct. 23 Williams, Z. 73, Mount Pleasant Selling milk 6.6 per cent. deficient in fat Warranty proved. Summons dismissed. „ 30 Ellman, Annie 49, Lamb's Conduit St. Selling butter containing 81 cent. of foreign fat Fined £7. Costs 12s. 6d. „ 30 do. do. Selling margarine without a label Summons withdrawn. Deo. 4 Lodge, Hannah 20, Marchmont Street Selling golden syrup containing 70 per cent. of glucose syrup Fined £1. Costs 12s. 6d. „ 4 Bewells, Ltd. 101, Leather Lane Soiling sweet spirit of nitre deficient in ethyl nitrite Defendant ordered to pay 33s 6d. costs. „ 11 Boutalls, Ltd 150, Southampton Row Selling sweet spirit of nitre deficient in ethyl nitrite Fined £5 6s. 6d. Costs 33s. 6d. TABLE XI. Meteorology of London, 1914. (Deduced from observations at Greenwich under t he superintendence of the Astronomer Royal.) 1914. Air Temperature. Bright Sunshine Rain and other forms of precipitation. Mean of— Mean of A. and B. Difference from Average.* Daily Mean. Difference from Average.* Per cent, of possible. Total fall. Difference from Average.* Maximum A. Minimum. B. ° f ° f ° f ° f hrs. hrs. % ins. ins. January 42.5 34.3 38.4 -0.2 0.65 - 0.70 8 0.50 -1.38 February 51.7 38.2 44.9 +5.4 3.79 + 1.58 38 2.46 +0.98 March 51.0 37.4 44.2 + 2.4 2.84 -0.45 24 3.91 +2.39 April 61.1 40.0 50.5 + 3.4 7.73 + 2.46 66 1.11 -0.46 May 63.7 43.8 53.7 + 0.7 6.74 + 0.32 43 1.63 -0.29 June 71.5 49.2 60.4 + 1.2 8.90 + 2.23 54 1.34 -0.70 July 74.5 53.9 64.2 + 1.8 5.77 - 1.07 36 1.41 -0.99 August 74.4 53.6 64.0 +2.5 5.94 -0.51 41 1.17 - 1.17 September 68.9 47.6 68.3 + 1.2 6.80 + 1.57 54 0.73 -1.42 October 59.4 44.7 52.0 + 1.9 2.16 -0.94 20 0.96 - 1.82 November 61.1 40.0 45.5 + 2.0 2.13 + 0.40 24 2.67 + 0.45 December 47.0 37.3 42.1 +2.1 1.29 + 0.19 17 5.96 +4.13 Year 59.7 43.3 51.5 +2.0 4.54 + 0.39 37 23.85 -0.27 * The averages used are obtained from observations extending over 65 years for Rain, 70 Temperature, and 18 years for Sunshine. .........