HOL 65 The Metropolitan Borough of Holborn. REPORT FOR THE YEAR 1908 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 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 to the St. Olave District, Southwark, and the Holborn District Boards of Works. London: DIPROSE, BATEMAN & CO., SHEFFIELD STREET, LINCOLN'S INN FIELDS, W.C. 1909. CONTENTS. page. Introduction 5 Registration Year 6 Birth-rates 6 Death-rates 6 Zymotic Death-rates 6 Consumption, Death-rate 6 Infectious Diseases. Prevalence of 6 ,, Notification-rate 6 Anti-Diptherittc serum 6 Cerebro-spinal Fever 6 Glanders, Anthrax and Hydrophobia 6 lloyal Commission on Tuberculosis 6 Notification of Births Act, 1907 7 Cleansing of Persons Act, 1897 7 Union Buildings Area 7 London County Council (General Powers) Act, 1907 7 House Refuse, Removal of 7 Manure, Removal of 7 London County Council (General Powers) Act, 1908 7 Inspections, &c 7 Area, Houses and Population 7 Estimated Population, 1908 8 Rateable Value, 1903 9 Number of Tenements 9 Births and Birth-rates 9 Ditto ditto corrected 9 Mortality 10 Deaths Registered 10 Deaths in Public Institutions within the Borough 10 Ditto ditto outside the Borough 11 Corrected deaths and death-rates 11 Infantile Mortality 11 Care and Feeding of Infants 12 Notification of Births Act, 1907 12 Modified Milk for Infants 14 Senile Mortality 15 Deaths from Zymotic Diseases 15 Ditto ditto during 1908 and ten preceding years 16 Ditto Influenza 17 Ditto Alcoholism 17 Ditto Cancer 17 Sudden and Violent Deaths 17 Inquests 17 The Public Mortuary 18 Infectious Diseases 18 Notification of Infectious Diseases during 1908 and ten preceding years 19 Small Pox 20 Scarlet Fever 20 Ditto Secondary Cases 20 Ditto Return Cases 21 Ditto Errors in Diagnosis 21 Diphtheria 21 Ditto Secondary Cases 21 Ditto Return Cases 21 Ditto Errors in Diagnosis 21 Ditto Anti-toxin 21 Enteric Fever 22 A 2 4 P age Infectious Diseases— Cerebro-Spinal Fever 22 Measles 22 Whooping Cough 23 Diarrhoea 23 Phthisis or Consumption 23 Ditto ditto Voluntary Notification 24 Ditto ditto Public Health (Tuberculosis) Regulations, 1908 24 Ditto ditto Royal Commission on Tuberculosis 24 Disinfections 25 Shelter 25 Bacteriology 26 Cleansing of Persons Act, 1897 26 Housing of the Working Classes Acts. Union Buildings Area 26 Premises Closed Voluntarily, Demolished, Rebuilt, etc. 27 Sanitary Work 29 House to House Inspections 29 Water Supply to New Buildings 30 Ditto to Tenement Houses 30 By-laws as to Houses let in Lodgings 30 Overcrowding 31 Removal of House Refuse 31 Removal of Manure 31 Common Lodging Houses 32 Factories, Workshops and Workplaces 33 Bakehouses 33 Home Work 34 Industrial Employment of Women 34 Places'where Food is prepared for Sale 35 Slaughter House 35 Dairies, Cowsheds and Milkshops 85 Ice Cream 36 Unsound Food 36 Smoke Abatement 36 Meteorology 37 APPENDICES. Table I. Vital Statistics of whole Borough during 1908 and previous 10 years 38 Table II. Vital Statistics of whole Borough and Separate Localities in 1908 and previous 10 years 39 Table III. Cases of Infectious Disease notified during the year 1908 40 Table IV. Causes of, and Ages at Death during the year 1908 41 Table V. Infantile Mortality during the year 1908 42 Table VI. Sanitary Inspectors' Work—Inspections, &c 43 Table VII. Ditto Notices, &c. 44 Table VIII. Proceedings during 1908 46 Table IX. Factories, Workshops, Workplaces and Homework 47 (1) Inspections 47 (2) Defects found 47 (3) Homework 48 (4) Registered Workshops 49 (5) Other matters 49 Table X. Legal Proceedings under the Public Health (London) Act, 1891 50 Table XI. Legal Proceedings under the Sale of Food and Drugs Acts 50 Table XII Meteorology 52 The Metropolitan Borough of Holborn. REPORT of the Medical Officer of Health For the Year 1908. 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 1908, the various statistics for the year refer to the fifty-three weeks ended Saturday, January 2nd, 1909, 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. 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 19.2 per 1,000 in comparison with 18.3 for the preceding year. The London rate was 25.2 in comparison with 25.6 for the preceding year. The Holborn death-rate, 15.7, and the London death-rate 13'8 per 1,000 are both the lowest death-rates recorded. 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 19.5 per 1,000, and for London 16.7 per 1,000. The corrected infantile mortality was 111 compared with 113 for London, which are both the lowest recorded. Last year these rates were 131 and 116 respectively. The death-rate from zymotic diseases in Holborn was again very low, and for the sixth year in succession, below that for London, viz.: 1.02 in comparison with 1.35 for London. Both are less than the preceding year, and it is the lowest rate recorded for Holborn. The death-rate from phthisis was 1.89 per 1,000 in comparison with 132 per 1,000 for London. Both rates were also the lowest recorded. In Holborn nearly 30 per cent, of the deaths were of persons who had been removed to Infirmaries from common lodging houses. The rates of the preceding decennium were 2.66 in Holborn and 1.56 in London. Although there was increased prevalence of scarlet fever and enteric fever, the number of notifications was again small, having been 316 in comparison with a decennial average of 425. The notification rate for Holborn was again lower than for London generally being 5.8 per 1,000 in comparison with 7.5 for London. For each of the past seven years the Holborn notification rate has been lower than the London rate. The Council agreed, with the sanction of the Local Government Board, to supply anti-diphtheritic serum free of charge to the poor inhabitants of the Borough on the application of medical practitioners. 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, 1909. The London County Council has also recently 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. 7 The Council adopted the Notification of Births Act, 1907. The Local Government Board afterwards gave its consent and fixed 9th March, 1908, as the day on which such adoption came into operation. During the year, under the Cleansing of Persons Act, 235 persons (217 men 9 women and 9 children) infested with vermin, had their bodies and clothing disinfected free of charge. The erection of houses for the working classes on the site of the Union Buildings Area (Bourne Estate) which was begun in August, 1906 was completed in October, 1908. Under Section 78 of the London County Council (General Powers) Act, 1907, which came into force on the 1st day of January, 1908, and provides for the provision of a water supply in tenement houses for families on separate fioors, 403 notices were served during the year. The removal of house refuse was again satisfactorily carried out during the year. The number of complaints received from householders, which in the previous year had been very much diminished, was still further reduced. For the second year in succession no complaint was received respecting the non-removal of manure. Under the London County Council (General Powers) Act, 1908, power is 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. Power is also given to appoint Health Visitors; to enforce sufficient and suitable accommodation for the cooking of food in new tenement houses; and increased powers for the sanitary regulation of premises used for the sale or preparation for sale of food for human consumption. Power is also given to the London County Council and the City Corporation to make by-laws with respect to the businesses of a vendor of fried fish, fish curer, or rag and bone dealer. During the year 22,990 inspections were made, 1,422 Intimation Notices, and 270 Statutory Notices for sanitary defects were served; 675 notices for the cleansing of lodging houses and 273 notices for breaches of by-laws. The market streets are inspected daily, including Saturday nights and Sunday mornings. For further details see the various headings of the Report. AREA, HOUSES AND POPULATION. Area. From the report of the Census. 1901, the area of the Borough is 405 1 acres. 8 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 9 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, 1908. The following are the estimated populations at the middle of the year 1908 Bloomsbury and St. Giles 28,830 Holbcrn Sub-District 25,742 Holborn Borough 54,572 London 4,795,757 England and Wales 35,348,780 United Kingdom 44,539,593 9 RATEABLE VALUE, 1908. Bloomsbury and St. Giles £594,456 Holborn £459,061 Holborn Borough £1,053,517 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 60T 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. Both Sexes. District. Males. Females. Legitimate. Illegitimate. Total. Birth rate per 1,000. St. Giles and Bloomsbury 509 457 902 64 964 33.0 Holborn 295 282 564 13 577 22.1 Whole Borough 801 739 1,466 77 1,543 27.8 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 966 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 527 were of infants whose mothers were non-residents in the Borough. B 10 The corrected numbers are as follows:— District. Corrected number of Births of Residents Corrected Birth-rate per 1C00. Legitimate. Illegitimate. Total. 1908. 1907. St. Giles and Bloomsbury 412 27 489 15.0 13.9 Holborn 608 10 627 24.0 23.2 Whole Borough 1,020 4fi 1,066 19.2 18.3 In London the corrected number of births was 122,898, or a rate of 25.2 per 1,000. In England and Wales the number of births was 942,611, or a rate of 26.5 per 1,000. MORTALITY. The following deaths have been registered in the Borough (1908):— St. Giles and Bloomsbury. Holborn. Total. Males 169 441 600 Females 126 336 464 Total 287 777 1,064 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 54 1 7 French Hospital 2 1 28 __ British Lying-in Hospital 2 — 13 — Children's Hospital 8 16 — 414 National Hospital 1 — — 40 London Homaepathic Hospital — 9 — 45 Italian Hospital 2 4 — 15 Alexandra Hospital — — — 7 Private 1 — 18 12 Total 70 31 66 533 11 There were 403 deaths of "Residents" in various Workhouses, Infirmaries, Asylums, Hospitals, &c., outside the Borough. Of these, 182 formerly resided in St. Giles and Bloomsbury, and 221 in the Holborn District. CORRECTED DEATHS AND DEATH-RATES, 1908. 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 1908. Corresponding period 1907. In Borough. Beyond Borough. St. Giles and Bloomsbury 287 108 66 11 182 412 14.1 14.3 Holborn Sub-District 777 561 533 2 221 456 17.4 19.1 Whole Borough 1,064 669 599 • 403 868 15.7 16.6 Registration London 67,353 13.8 14.6 England and Wales 521,643 14.7 15.0 The average death-rate of the Borough for the preceding decennium was 19.5 per 1,000. The lowest death-rates in previous years were 16 6 in 1907, 17.0 in 1906, 16 9 in 1905, 17.9 in 1904, and 18.3 in 1903. INFANTILE MORTALITY. The number of deaths of children under five years of age was:— St. Giles and Bloomsbury 82 Holborn Sub-District 107 Holborn Borough. 189 The number of deaths of children under one year of age, and the number of deaths of children under one year of age per 1,000 total registered births and per 1,000 corrected births, were the following for:— Deaths under 1 year of age. Deaths under 1 year per 1,000 births. Deaths under 1 year per 1,000 corrected births. St. Giles and Bloomsbury 51 53 116 Holborn Sub-District 67 116 107 Holborn Borough 118 76 111 London 13,943 - 113 The principal causes of death of these 118 children under one year of age are given in Table V. of the Appendix. b 2 12 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 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. On account of the Notification of Births Act a large number of visits were made much earlier than in previous years. As doctors and midwives object to visits being made until after they have ceased attendance on the patient, the first visit is now made when the child is about a fortnight old. Of the 913 first visits made full inquiries were able to be made in 828 cases. Excluding 16 still births and 8 children who did not live long enough to take any food, of the remaining 804 children, 697 were found to be naturally fed, 107 to be partly or entirely artificially fed at the time of the first visit. A large number of revisits were made, particularly in the cases of children who were not breast fed. 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. The Act provides:— "In the case of every child born in an area in which this Act is adopted it shall be the duty of the father of the Child, if he is actually residing in the house where the birth takes place at the time of its occurrence, and of any person in attendance upon the mother at the time of, or within six hours after the birth, to give notice in writing of the birth to the Medical Officer of Health of the District in which the child is born." Notice is to be given by posting a prepaid letter or post-card addressed to the Medical Officer of Health, Council Offices, 197, High Holborn, giving the necessary information of the birth within 36 hours after the birth, or by delivering a written notice of the birth at the Office of the Medical Officer of Health within the same term. The Council is to supply, without charge, addressed and stamped post-cards containing the form of notice to any Medical Practitioner or Midwife residing or practising in the Borough who applies for the same. Any person who fails to give notice of a birth in accordance with the Act will be liable to a penalty not exceeding 20s. 13 The notification is in addition to, and not in substitution for, the requirements of any Act relating to the registration of births. The Act applies to any child which has issued forth from its mother after the expiration of the twenty-eighth week of pregnancy, whether alive or dead. It will be seen that deaths under one year of age per 1,000 corrected births were only 111 which is the lowest recorded infantile mortality in the Borough. The deaths of legitimate children under one year of age per 1,000 corrected births were 104, and the deaths of illegitimate children under one year per 1,000 corrected births were 261. The principal causes of death of these 118 children (of which 12 were illegitimate) under one year of age are given in Table V. of the Appendix. Of the 118 deaths of infants during the year further details were able to be obtained by the Lady Sanitary Inspector respecting 111. In some cases, particularly in the case of illegitimate births, the mothers could not be found owing to change of address or an incorrect address having been given. In a few eases, also, details were not obtained, as the infants had only lived a few hours. Of the 118 deaths, 19 died before taking food; 55 were naturally fed including one that was artificially fed from seven months old; 42 were artificially fed and in two cases no information could be obtained. Of the 42 artificially fed, 30 used boat bottles, 7 were spoon fed and only 5 used tube bottles. Eleven of the mothers worked in factories or workshops, 13 did charing or other work outside the home, 3 were in domestic service, 1 engaged in homework (tailoring), 3 mothers died and the remainder were engaged in household duties. Of the 20 deaths of infants from diarrhceal diseases all but 2 had been artificially fed. The total number of births notified in the Borough from 9th March, 1908 to the end of the registration year 1908, was as follows:— Notified once only (a) By Doctors 842 (b) „ Midwives 143 (c) „ Parents and others 54 Notified twice (a) By Doctors and Parents 15 (b) „ Midwives and Parents 4 1,058 During the same period 1,264 births were registered. From the 9th March, 1908, to the end of the year, Miss Orange made 627 primary visits respecting newly-born children. She found that in 526 cases the 14 births had been notified and in 101 cases not notified. Of the 101 cases not notified, 16 were attended by doctors, 17 by midwives, 22 by students and 2 by neighbours. In 12 cases wrong addresses were registered, and in 2 cases the person in attendance on the mother at the time of the birth could not be ascertained. I wrote to the various doctors who had not notified and had replies giving reasonable grounds for their not having done so. In the cases of midwives and students of hospitals the reasons given were that the students or midwives had only been recently appointed and were not aware of the Act. 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. 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 39 new certificates were issued of which 9 were not used for various reasons, in comparison with 48 that were used during the year 1907. Including 11 children who had taken the milk at the beginning of the year 1908, the milk was used by 41 children during the year. In the majority of cases the mothers were very well satisfied and the infants thrived well on the milk. In seven cases it was for various reasons discontinued; in five cases on account of the mothers leaving the Borough. Of the 41 children, two died. One child had taken prepared milk for six months. It was much wasted when it began to do so at three months old, but improved rapidly, and just before its death in September, from enteritis, was a healthy well-developed child of nine months. The patient lived over a stable. The other was an illegitimate child, who took the milk for three weeks until seven weeks old. The patient was taken to hospital and died of diarrhoea three weeks after the beginning of the illness. Councillor Walter Hazell, J.P., has kindly continued to assist those parents who cannot afford to pay the whole amount. Twenty-two such cases were assisted during the year. 15 SENILE MORTALITY. The number of deaths of persons 65 years of age and upwards was in:— St. Giles and Bloomsbury 122 Holborn Sub-District 111 Holborn Borough 233 St. Giles and Bloomsbury. Holborn Sub-District. Total. Of thrse the numbers were— 65 years and under 70 36 21 67 70 „ „ 75 34 31 65 75 „ „ 80 23 30 53 80 „ „ 85 17 14 31 85 „ ,, 90 10 5 15 93 years of age 1 — 1 95 „ 1 — 1 " 122 111 233 DEATHS FROM ZYMOTIC DISEASES. The following tables give details respecting the number of deaths, and the deathrates, from the seven principal zymotic 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 58 in comparison with a decennial average of 108. The death-rate for the Borough was only 1.02 in comparison with 1.35 for London. Number. Zymotic Death-Rate. St. Giles and Bloomsbury 19 0.65 Holborn Sub-District 39 1.45 Holbom Borough 58 1.02 And for London 6,599 1.35 The following are the number of deaths from the separate diseases:— St. Giles and Bloomsbury. Holborn Sub-District. Holborn Borough. Small-pox — — — Measles 4 6 10 Scarlet Fever i 5 6 Diphtheria and Membranous Croup 1 4 5 Whooping Cough 3 4 7 Typhoid Fever — 4 4 Typhus — — — Diarrhoea 10 16 26 Total 19 39 58 16 DEATHS FROM ZYMOTIC DISEASES OCCURRING IN THE BOROUGH DURING THE YEAR 1908 AND DURING THE PRECEDING TEN YEARS. St. Giles and Bloomsbury. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. 1898 - 26 2 6 9 5 22 70 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 Average for 10 years 1898-1907. 5.8 10.1 2.0 4.5 6.6 3.8 14.9 46.7 1908 — 4 1 1 3 — 10 29 Holborn Division. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. Total. 1898 - 36 2 21 12 2 29 102 1899 - 11 3 5 12 7 26 64 1900 - 20 8 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 190iS - 17 - 6 6 — 29 58 1907 — 11 2 5 20 1 10 49 Average tor 10 years 1898-1907. 2.0 18.0 1.7 6.4 10.3 2.3 20.3 61.0 1908 — 6 5 4 4 4 16 39 17 Whole Borough. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhoea. Total. 1898 - 62 4 27 21 7 51 172 1899 - 27 3 9 13 11 56 119 1900 - 31 7 13 23 9 45 128 1901 30 22 3 14 10 12 42 133 1902 46 30 8 11 27 6 14 142 1903 — 17 4 7 15 5 22 70 1904 2 43 — 7 8 4 35 99 1905 — 11 3 4 15 4 22 59 1906 — 25 2 7 10 1 39 84 1907 — 13 3 10 27 2 16 71 Average for 10 years 1898-1907. 7.8 28.1 3.7 10.9 17.9 6.1 3.42 107.7 1908 — 10 6 5 7 4 26 58 INFLUENZA. During the year there were 25 deaths registered as due to influenza, 16 in St. Giles and Bloomsbury and 9 in the Holborn District. ALCOHOLISM. Only 25 deaths were assigned to alcoholism or cirrhosis of liver, 13 in St. Giles and Bloomsbury. and 12 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. Fifty-three deaths were registered as due to cancer or malignant disease, 32 belonging to St. Giles and Bloomsbury and 21 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. C 18 District. Total Number. Cause of Death. Natural. Accidents. Suicide. Murder. St. Giles and Bloomsbury 46 23 16 7 — Holborn 45 16 23 6 — Tota 91 39 39 13 — THE PUBLIC MORTUARY, GOLDSMITH STREET. 146 bodies were received (43 being non-parishioners), and on these 81 inquests were held, and 51 post-mortems made. District. Bodies Received. Inquests held. Post-mortems. Non- Parishioners. St. Giles and Bloomsbury 69 41 28 24 Holborn 77 40 23 19 Total 146 81 51 43 Further details as to the causes of and ages at death are given in Table IV. of the Appendix. INFECTIOUS DISEASES The number of notifications of infectious diseases in the Borough during 1908 was again small, having been only 316 in comparison with a decennial average of 424. During the past six years the notifications per 1,000 of the population have been less than for London, and last year were 5.8 per 1,000 in comparison with 7.5 for London.. 19 NOTIFICATIONS OF INFECTIOUS DISEASES IN THE BOROUGH DURING 1908, AND DURING THE PRECEDING TEN YEARS. St. Giles and Bloomsbury. Year. Small-pox. Diphtheria and Membranous Ccoup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 1898 — 39 65 23 — 72 1 — 200 1899 — 28 76 23 — 56 1 — 184 1900 — 58 98 31 — 49 1 — 237 1901 158 60 150 17 — 58 1 1 445 1902 159 44 90 24 — 45 2 — 364 1903 1 22 55 36 2 65 1 — 182 1904 5 19 37 22 — 38 4 — 125 1905 1 10 68 14 — 20 1 — 114 1906 — 14 74 9 — 22 1 — 120 1907 — 32 58 6 — 18 — 1 115 Average for 10 years 1898-1907. 32.4 32.6 77.1 20.5 .2 44.3 1.3 .2 208.6 1908 — 21 81 12 — 28 2 — 144 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 :—1901 157. 1905 99. 1906 98. 1907 74. 1908 61. Holborn District. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total. 1898 — 138 96 9 — 38 2 — 283 1899 — 63 117 32 2 43 1 — 258 1900 — 65 96 24 — 40 — — 225 1901 53 101 104 22 — 31 1 — 312 1902 58 69 112 15 — 40 4 — 298 1903 1 31 89 17 25 3 — 166 1904 1 27 62 19 — 39 3 — 151 1905 — 37 88 7 1 15 1 — 149 1906 — .52 63 6 — 34 1 — 156 1907 — 32 98 8 — 22 1 — 161 Average for 10 years, 1898-1907. 11.3 61.5 92.5 15.9 .3 32.7 1.7 .0 215.9 1908 — 29 112 13 — 18 - — 172 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 notifi ble 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. 20 Whole Borough. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Total.[##] 1898 — 177 161 32 — 110 3 — 483 1899 — 91 193 55 2 99 2 — 442 1900 — 123 194 55 — 89 1 — 462 1901 211 161. 254 39 — 89 2 1 757 1902 217 113 202 39 — 85 6 — 662 1903 2 53 144 53 2 90 4 — 348 1904 6 46 99 41 — 77 7 — 276 1905 1 47 156 21 1 35 2 — 263 1906 — 66 137 15 — 56 2 — 276 1907 — 64 156 14 — 40 1 1 276 Average for 10 Tears 1898-1907. 43.7 941 169.6 36.4 .5 77.0 3.0 .2 424.5 1908 — 5 -+0 193 25 — 46 2 — 316 Chicken-pox was notifiable from October 19th, 1901,to January 6th, 1903, inclusive, during which time 282 notifications were received, and from April 8th to November 6th, 1904, inclusive, during which time 61 notifications were received. Cerebro-Spinal Meningitis was notifiable from March 12th, 1907 ; notifications were received, 1907,2; 1908, ml. There were also the following voluntary notifications of Phthisis 1904 344. 1905 208. 1906 191. 1907 171. 1908 152. SMALL POX. There was no notification of small-pox in the Borough during the year. SCARLET FEVER. During the 53 weeks ended Saturday, January 2nd, 1909, the number of scarlet fever notifications, excluding duplicates, was 193, 81 belonging to St. Giles and Bloomsbury and 112 to the Holborn District. In St. Giles District 79 cases were removed to hospital, and in the Holborn District 111. The number of notifications was only 3.5 per 1,000 in comparison with 4.6 for London. Secondary Cases of Scarlet Fever. Of the 193 notifications, 145 occurred at houses in which there was no secondary case. In two houses there were four cases, including three cases which occurred in the preceding year. There were four cases amongst the staff of the Hospital for Sick Children. In five houses there were three cases, and in twelve houses two cases. 21 Return Cases of Scarlet Fever. Of the secondary cases of scarlet fever, six were "return" cases i.e. cases which occurred in a house soon after the return home of a patient from hospital. There was also another case in which the primary case was removed to hospital from a house outside the Borough. Errors in Diagnosis. During the year only seven patients were returned home from the Metropolitan Asylums Board Hospitals reported as not suffering from scarlet fever, or only 3.6 per cent. DIPHTHERIA. The number of cases of diphtheria notified was 50, of which, 21 belonged to St. Giles and Bloomsbury, and 29 to the Holborn District. All but one were removed to hospital. The average number of notifications for the preceding decennium was 94, 33 for St. Giles and Bloomsbury, and 61 for the Holborn District. Three of the cases were on the nursing staff of the Hospital for Sick Children. Secondary Cases. In one house three secondary cases occurred all notified within a week of the first case. At another house two secondary cases occurred, notified three days after the primary case. At one house there was one secondary case which occurred after the return home from the hospital of the primary case. Return Cases. There was only one return case being the one mentioned above. Errors in Diagnosis. Five patients were returned from the hospitals of the Metropolitan Asylums Board as not suffering from diphtheria, or 10 per cent. of the patients removed. Diphtheria Anti-toxin. With a view of diminishing the mortality from, and severity of, the disease, in persons suffering from diphtheria it is desirable that anti-toxin serum should be administered as early as possible. In many doubtful cases 22 the doctors in attendance do not like to have the patient removed to hospital until the diagnosis has been confirmed or otherwise by bacteriological examination. If there is a reasonable suspicion that the case is one of diphtheria, an injection of anti-toxin should be given at once. The Council therefore, with the sanction of the Local Government Board agreed to supply anti-toxin serum free of charge to the poorer inhabitants of the Borough on the application of medical practitioners. Tubes containing 500 c.c. of the serum, prepared by the Lister Institute, were accordingly obtained, and information of these arrangements was sent to all the medical practitioners practising in the Borough. Only four such tubes were asked for during the year. ENTERIC FEVER Although below the average for the preceding decennium, enteric fever was rather more prevalent than during the preceding two years. There were, excluding duplicates, 25 notifications in comparison with 14 the previous year. 12 belonged to St. Giles and Bloomsbury, and 13 to Holborn District. All but three of the cases were removed to hospital. Of the 25 cases two were afterwards returned as not suffering from enteric fever. Of the remainder, four were nurses who had been attending patients suffering from the disease; four were certainly not contracted in the Borough, and four were probably contracted from the eating of oysters, cockles or mussels. CEREBRO-SPINAL FEVER. Epidemic Cerebro-Spinal Meningitis. No case was notified during the year. MEASLES. Measles was again much less prevalent than it was in the year 1906. We received information of only 86 cases in comparison with 370 in 1906. The schools principally affected were St. Martin, St. Giles, Tower Street, Christ Church and Princeton Street. Of the 86 cases, 77 were children attending school, and of the remaining nine,four were traced to school infection. In only 10 cases was there no doctor in attendance. Seventy-five cases occurred in tenements of only one or two rooms. There were only 10 deaths in comparison with a decennial average of 28. Of these, four belonged to St. Giles and Bloomsbury and six to the Holborn District. 23 WHOOPING COUGH. Whooping cough was little prevalent during the year there having been only seven deaths registered in comparison with 27 in the preceding year and a decennial average of 17. Three of the deaths were in St. Giles and Bloomsbury and four in the Holborn District. All were children under five years of age. DIARRHEA. The number of deaths from diarrhoea was 26, in comparison with a decennial average of 34. Ten belonged to St. Giles and Bloomsbury and 16 to the Holborn District. All but one were children under five years of age, 20 being under one year of age. As desired by the Local Government Board, under the heading Diarrhoea, as regards children under one year of age, all the deaths classified as diarrhœal diseases in Table V. have been included. PHTHISIS OR CONSUMPTION. The number of deaths from phthisis during the year was 105, or a death rate of 1.89 per 1,000, the lowest recorded for the Borough. Of these, 35 belonged to St. Giles and Bloomsbury, a death rate of 1.19, and 70 to the Holborn District or a death-rate of 2.68 per 1,000. Of the 105 deaths, 29 were of persons who had been removed to Infirmary from Common Lodging Houses in the Borough, 17 from St. Giles and Bloomsbury and 12 from the Holborn District. The corrected number of deaths in London was 6,419 equal to a rate of 1.32 per 1,000, being the lowest recorded. The following table gives the number of deaths in the Holborn Borough, and the rate per 1,000, and the corresponding rates for London, for the 10 years 1899-1908 inclusive:— Year. Holborn Borough. London Deaths. Rate per 1,000. Rate per 1,000 1899 207 3.12 1.85 1900 193 2.96 1 74 1901 166 2.81 1.66 1902 182 3.06 1.60 1903 170 2.94 1.55 ] 904 157 2.75 1.62 1905 149 2.65 1.42 1906 118 2.12 1.44 1907 125 2.28 1.40 1908 105 1.9 1.32 24 VOLUNTARY NOTIFICATION OF CONSUMPTION. The Voluntary Notification of Consumption, which was in the first instance put into force for a period of 12 months from the 1st January, 1904, the fees to be paid being the same as for the notifiable diseases, was extended to the year 1905, further extended for the three years 1906-08, and has since been still further extended for the three years 1909-11 inclusive. Excluding a few duplicates there were 152 cases notified, 61 belonging to St. Giles and Bloomsbury and 91 to the Holborn District. The corresponding numbers for the year 1907 were respectively 171, 74 and 97. Of the 152 cases notified, 85 or 57 per cent., had been living in common lodging houses, and these were all, at once or soon afterwards, removed to infirmaries. With a few exceptions the remaining 67 lived in tenement houses, and 55 of them were soon removed to infirmaries or hospitals, so that only 12 remained at home. 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, and I think it is now unnecessary to repeat these. 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 70 cases. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1908. 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 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. 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, 25 1909. This further report contains an account of certain experiments which have been carried out regarding the infectivity of the milk and faeces 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 faeces 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 faeces, whilst as regards cows clinically tuberculous, the experiments show that the faeces, contain large numbers of living and virulent tubercle bacilli. 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. DISINFECTIONS. During the 53 weeks ended January 2nd, 1909. District. Rooms. Bedding, &c. Number of Articles. Number of Persons using Shelter. St. Giles and Bloomsbury 190 4.290 - Holborn 235 3,520 - Whole Borough 425 7,810 — 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, D 26 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 not necessary to use the shelter during the year. BACTERIOLOGY. The following table gives details of the examinations made by the Lister Institute of Preventive Medicine during the year. Diphtheria. Enteric Fever. Consumption. District. Number Submitted. Result of Examination. Number Submitted. Result of Examination. Number Submitted. Result of Examination. St. Giles and Bloomsbury 10 8 bacilli not found 1 1 Positive 6 4 bacilli not found 2 bacilli found 2 bacilli found Holborn 6 3 bacilli not found 1 1 Positive 3 1 bacilli not found 3 bacilli found 2 bacilli found Whole Borough 16 11 bacilli not found 2 2 Positive 9 5 bacilli not found 5 bacilli found 4 bacilli found CLEANSING OF PERSONS ACT- During the year 235 persons (217 men, 9 women, and 9 children), infested with vermin, had their bodies and clothing disinfected free of charge. Of the 235 persons, 214 had their bodies cleansed in the baths of the St. Giles and Bloomsbury Casual Wards in Goldsmith Street, and 1,211 articles were disinfected in the Council's steam apparatus. The remaining 21 had their bodies cleansed in the baths of the Holborn Casual Wards, Little Gray's Inn Lane, and their 168 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 ACT, 1890- Action under Part I. of the Act. UNION BUILDINGS AREA. Aylesbury Place, Clerkenwell, and Union Buildings, Holborn. Improvement Scheme, 1890. Details of the action taken and progress made each year have been given in successive Annual Reports. 27 The erection of houses for the working classes on the site of this area was begun in 1906 and was completed in October, 1908. LIST OF PREMISES CLOSED, DEMOLISHED OR REBUILT DURING 1908. St. Giles and Bloomsbury. Alfred Place, Nos. 20-27. New factories built. do. No. 32. New premises (Home for Jewish Working Girls) being rebuilt, nearly complete. Bloomsbury Square, Nos. 42 and 42a. Demolished and part rebuilding. Broad Street, No. 11. New premises built. Chenies Street, Nos. 12-14. New factories built. Francis Street, No. 14-18. Site still vacant. Gate Street, Nos. 22, 23, 24 (Great Northern, Piccadilly and Brompton Railway). Offices over built. Grape Street. New premises built. Great St. Andrew Street, Nos. 43-47. Site still vacant. Great White Lion Street, Nos. 1, 2, 3, 4. Site still vacant. Gower Street Nos. 82, 84, 86, and Tavistock Place. New shops and flats built. High Holborn, Nos. 162, 163, 164, 168, 169. Closed. Do. Nos. 193 to 196. Rebuilt. Do. Nos. 210 and 211. Demolished. Do. Nos. 223-228. Offices over. High Street, No. 24a. Partly demolished, to be rebuilt. Keppel Street (South side). No. 12 standing, 11 and 13 part demolished, remained demolished. Kingsway (south side of Gate Street). Building in progress. Do. Lincoln House, north-east corner of Great Queen Street. Built. Do. north side of Lincoln House extending through to Gate Street). Building in progress. Little Russell Street, Nos. 5-8a. Rebuilt. Montague Place (north side). All demolished except Nos. 17, 18, 19. Do. (south side). Do. and rebuilding except Nos. 1 and 2. Museum Street, No. 60. Closed. Macklin Street School and Convent. Rebuilt. New Compton Street, Nos. 26-30. Demolished. North Crescent, Nos. 2, 3, 4, 5, 7 and 12. Closed to be demolished Shaftesbury Avenue, Nos. 166-177. Demolished. Short's Gardens, No. 62. New generating station being built. d 2 28 South Crescent, Nos. 1 to 5. New premises built at rear; front portion of site still vacant. Southampton Row, Nos. 12 to 42. Rebuilt. „ Nos. 23 to 35. Rebuilding. „ Rear of. Demolished and part re-building. Store Street, Nos. 24, 25 and 25a. New premises built at rear; front portion of site still vacant. Torrington Mews, Nos. 2 to 9. Demolished and part rebuilding. „ East, Nos. 7 and 8. Closed. Torrington Square, Nos. 70. and 71. Demolished and part rebuilding. Tcrrington Street, No. 4. Demolished and part rebuilding. Tottenham Court Road, Nos. 193-5. Site still vacant. „ No. 205. Closed to be demolished. Vernon Place, South Side. Rebuilding. Wild Court, Nos. 8 to 11. Being rebuilt. Holborn Sub-District. Bourne Estate— Buckridge Buildings Kirkeby „ Built. Nigel „ (Nos. 28 to 71) Castle Court, Nos. 5, 6 and 7. Demolished. Charles Street, Nos. 29, 30 and 31. Being demolished. Dunstable Court, Nos. 1, 2, 3, 4, 10, 11 and 12. Closed. Fulwood's Rents, Nos. 19, 20 and 21. Demolished. „ No. 18. Closed. Gloucester Street, No. 3. Rebuilt (shops with flats above). Great Ormond Street, No. 46. Rebuilt. „ No. 58. Closed for demolition. Hatton Garden, No. 57. Rebuilt. „ Nos. 26 and 27. Demolished. Hatton Yard, No. 7. Rebuilt. Harpur Mews, Nos. 3 and 4. Demolished. Kirby Street, No. 1. Demolished. Laystall Street, Nos. 17 and 18. Rebuilt. Leather Lane, No. 10. Rebuilt. Little Saffron Hill, Nos. 11, 12 and 13. Rebuilt. May's Yard, Eagle Street. Part rebuilt. Powis Place, No. 10. Rebuilt. Queen Square, Nos. 34, 35 and 36. Closed for demolition. Red Lion Street, No. 18. Demolished. 29 Robin Hood Yard, No. 3. Rebuilt. „ Nos. 6 and 7. Closed. Verulam Street, Nos. 20 and 21, through to Baldwin's Place. Rebuilt Factory. Vine Street, Nos. 13, 15, 17 and 19. Being rebuilt. SANITARY WORK. HOUSE TO HOUSE INSPECTIONS, 1908. St. Giles and Bloomsbury. Alfred Place. Arthur Street. Betterton Street. Bucknall Street. Castle Street. Charing Cross Road (part of). Clark's Buildings. Clark's Mews. Denmark Place. Denmark Street. Drury Lane (part of). Dyott Street. Endell Street. Goldsmith Buildings. Goldsmith Street. Great Earl Street. Great St. Andrew Street. Great White Lion Street. High Street. Kenton Street. Little Denmark Street. Little Earl Street. Little St. Andrew Street. Little White Lion Street. Lumber Court. Neal Street. New Compton Street. New Oxford Street (part of). Nottingham Court. Phoenix Street. Ridgmount Street. Shaftesbury Avenue (part of). Short's Gardens. Smart's Buildings. Stacey Street. Tottenham Court Road (part of). Tower Street. West Street. Wild Court. Wild Street. Holborn. Back Hill. Beauchamp Street. Bishop's Head Court. Boswell Court (South Side). Chapel Street. Charles Street. Cross Street. Cockpit Yard. Dane Street. Devonshire Street. Eagle Street. Emerald Street. Evelyn Buildings. Eyre Street Hill. Farringdon Road (part of). Fox Court. Gloucester Street. Gray's Inn Road (part of). Hatton Garden. Hatton Wall. Hatton Yard. Kirby Street. John's Mews. Lamb's Conduit Passage. Lamb's Conduit Street. Leather Lane Buildings. Little Gray's Inn Lane. Little James Street. Mount Pleasant. New North Street. Old North Street. Ormond Yard. Poole's Buildings. Red Lion Passage. Robert Street. Summer Street. Verulam Street. Vine Street. Warner Street. 30 WATER SUPPLY TO NEW BUILDINGS. During the year I inspected and gave certificates for the following premises:— Great Ormond Street. Hospital for Sick Children, Nurses' Dormitories. Laney Buildings, Nos. 1-26, 27-44, 45-62, 63-71. Kirkeby Buildings, Nos. 1-10, 11-30, 31-45. Nigel Buildings, Nos. 28-49, 50-71. High Holborn, Nos. 193-196, Municipal Offices. Buckridge Buildings, Nos. 1-10, 11-30, 31-40. Gloucester Street, No. 3. WATER SUPPLY TO TENEMENT HOUSES. In accordance with Section 78 of the London County Council (General Powers) Act, 1907:— "For the purposes of Section 48 (provision as to houses without proper water supply) of the Public Health (London) Act, 1891, a tenement house shall be deemed to be a house without a proper and sufficient supply of water unless there shall be provided on the storey or one of the storeys in which the rooms or lodgings in the separate occupation of each family occupying such house are situate a sufficient provision for the supply of water for domestic purposes: "Provided that with respect to any building existing and in use as a tenement house at the passing of this Act this section shall not come into operation until the 1st day of January, 1908." In accordance with the above 403 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. BY-LAWS AS TO HOUSES LET IN LODGINGS. At the end of the year, 681 houses were registered under these By-laws, of these, 361 are in St. Giles and Bloomsbury, and 320 in the Holborn District. During the year, there were 1,436 inspections of these premises, excluding a very large number of periodical inspections and re-inspections. 17 notices were served for 24 overcrowded rooms, and 229 notices for other breaches of the By-laws, exclusive of 675 notices that were served for annual cleansing as required by the By-laws. 31 During the year, it was necessary to take legal proceedings for breaches of the By-laws respecting cleansing of 14 houses let in lodgings. In one case, fines amounting to £15 and £2. 2s. costs were inflicted. Further details are given in the Appendix, Table 11. OVERCROWDING. The number of dwelling rooms found to be overcrowded was 46, in comparison with 44 in the previous year. 24 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. In the main thoroughfares Police regulations prohibit the removal of house refuse after 10 a.m. The occupiers of many of the shops in the main thoroughfares do not live on the premises and many of the shops are not open until after 9 a.m. With a view of having all refuse removed as early as practicable, the Council resolved that the occupiers of premises in thoroughfares where a daily removal of refuse is in force should be required to place the refuse on the footway in proper receptacles not later than 9.30 a.m. Public announcement of this was given by means of printed notices attached to the public lamp posts and by hand bills left at every house. During the year, 17,203 loads of house refuse were removed. Only 31 complaints were received from householders as to the non-removal of house refuse and 173 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 second 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. 32 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 1908:— Of these 17 are in St. Giles and Bloomsbury for 1,273 lodgers. „ 8 „ Holborn District for 694 „ Total 25 in the Borough for 1,967 „ 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 9, Dyott Street 28 M 14, Lumber Court 68 M 25, Great Queen Street 117 M 1-7, Macklin Street 96 M and 19, do. 40 W 36, Parker Street 21, do. 26 W 2, Kennedy Court 8 W Parker Street Municipal 345 M 3, do. 10 W 7, 9, and 11, Short's 311 M 4, do. 19 w Gardens, and 5, do. 8 w 3, Neal's Yard 6, do. 8 w 6 and 7, Wild Court 63 M 7, do. 9 w A total of 17 Common Lodging Houses registered for 1,273 lodgers. Holborn District. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. 25, Charles Street 241 M 28, Orde Hall Street 22 M 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 A total of 8 Common Lodging Houses registered for 694 lodgers. 33 FACTORIES, WORKSHOPS AND WORKPLACES. During the year there were 126 inspections of factories, 968 inspections of workshops and 2,538 of workplaces. 301 Intimation Notices for sanitary defects were served and 42 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. 1908. Number of Notices 1908. Number of Prosecutions 1908. On Register at end of 1907. Added in 1908. Removed in 1908. On Register at end of 1908. Premises. Rooms. Intimations. Statutory. Factories.‡ Factory Laundries 3 1 – 4 – 4 – – – Factory Bakehouses 2 – – 2 – 42 – – – Other Factories – – – – – 80 31 3 – Workshops. Workshop Laundries 13 – 2 11 30 17 3 – – Workshop Bakehouses 31 – 2 29 – 274 14 1 – Other Workshops 952 44 8 988 1,615 677 90 21 – Workplaces. Home workers' Premises* 168 57 39 186 226 188 9 – – Places where Food is prepared for Sale† 359 35 6 388 – 2,117 70 8 1 Workplaces other than the the above § – – – – – 233 84 9 – Total 1,528 137 57 1,608 1,871 3,632 301 42 1 *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 1908, 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 1908, there were 31 bakehouses in the Borough, of which 15 were in St. Giles and Bloomsbury and 16 in the Holborn District. e 34 The following is a list of the bakehouses in the Borough, all of which are underground except those marked*:— St. Giles and Bloomsbury. *2 Bloomsbury Court. 10 Bury Street. 166 Drury Lane. 155 High Holborn. 217 & 218 High Holborn (Holborn Restaurant). 63 High Street. 19 Little Earl Street. 5 Little St. Andrew Street. 21 Marchmont Street. 77 Marchmont Street. 8 Museum Street. 24, 26 and 28 New Oxford Street. 200 Shaftesbury Avenue. *88 Southampton Bow. 6 Torrington Place. Holborn. 172 Clerkenwell Road. 9 Cosmo Place. 49 to 57 Farringdon Road (Factory). 33 Great Ormond Street. 1 Greville Street. *91 Leather Lane. *6 Lamb's Conduit Street. 50 Lamb's Conduit Street. 13 Leigh Street. 19 Red Lion Street. 50 Red Lion Street. *74 Red Lion Street. 92 Theobald's Road. 124 Theobald's Road. *Viaduct Buildings, also 17 Charterhouse Street (Factory). 36 Warner Street. During the year, in addition to my inspections, there were 316 inspections of bakehouses, including 42 inspections of the factory bakehouses. Fourteen 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 IX. of the Appendix. INDUSTRIAL EMPLOYMENT OF WOMEN 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. 35 The latter Conference resolved (1) the extension of the period from one month to three months; (2) the prohibition of the employment of women advanced in pregnancy unless medically certified as fit for work. 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. The Holborn Borough Council approved of my co-operation and my attendance at a conference of representatives of the Home Office and Medical Officers of Health, held at the Home Office on the 6th November, 1907, at which the details of the form which the inquiry should take were agreed to. Details were being obtained during the year and will be completed by the end of the year 1909. 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 1908 was 388; 2,117 inspections were made, and 78 notices were served during the year for sanitary defects found. In addition to the above inspections of places where food is prepared for sale, here were also 740 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 11 occasions during the year, and one notice was served for sanitary defects found. DAIRIES, COWSHEDS AND MILKSHOPS. The number of registered dairies and milkshops in the Borough at the end of the year was 178, of which 76 were in St. Giles and Bloomsbury, and 102 in the Holborn District. During the year 15 dairies and milk shops were newly registered, 7 belonging to St. Giles and Bloomsbury, and 8 to the Holborn District. On application for e 2 36 registration under the Dairies, Cowsheds and Milkshops Order of 1885, the premises were also carefully inspected by me, and notices served to remedy any sanitary defects. In addition to my inspections the Sanitary Inspectors made 995 inspections of these premises, and 5 notices were served for sanitary defects or breaches of regulations. There is now only one cowshed in the Borough, at No. 4, Goldsmith Street. It was frequently inspected during the year, and no sanitary defects nor breaches of regulations were found. ICE CREAM. During the year there were 40 premises in the Borough where ice cream was manufactured or sold, and 187 inspections of these premises were made It was not found necessary for any notices to be 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. 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:— 7 Cod roes. 1 case Herrings. 5 boxes Kippers. 1 bag Mussels. 131 ½ lbs. Meat. 2 bushels Cherries. 32 bags Parsnips. 657 crates Bananas. 290 bundles Tomatoes. 12 boxes Grapes. 2 boxes Oranges. 124 half-sieves Plums. 57 sacks Potatoes. During the year there was one seizure of a quantity of unsound beef and mutton. The Defendant was convicted and fined £50. SMOKE ABATEMENT. The smoke shafts in the Borough were frequently kept under observation, and in 142 cases the inspections were recorded. 12 intimation notices and 1 statutory notice was served. For further details of Sanitary "Work and Legal Proceedings see Tables VI., VII., VIII., IX., X. and XI. 37 METEOROLOGY. The mean temperature of the year was 50.1 degrees, which is exactly the average for the preceding 65 years. The rainfall was 23.78 inches, and was 0.34 inches below the average for the preceding 65 years. In the year 1903 there was the large amount of 35.54 inches. The total amount of bright sunshine recorded was 1,634 hours, out of a total possible 4,458 hours or about 37 per cent., and it was 132 hours above the average for the preceding 10 years. Further details are given in Table XII. In conclusion, 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, Public Health Department, W. A. BOND. 197, High Holborn, W.C. 38 APPENDIX. TABLE I. Vital Statistics of Whole District during 1908 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 1898 66,371 1,840 27.8 336 183 1,467 22.2 605 461 477 1,483 22.4 1899 65,677 1,857 28.4 298 161 1,439 22.0 628 471 496 1,464 22.4 1900 64,990 1,762 27.2 311 177 1,326 20.5 516 412 514 1,428 22.1 1901 59,232 1,660 28.4 203 122 1,214 20.5 572 481 448 1,181 20.0 1902 (53 weeks) 58,542 1,646 27.7 213 129 1,283 21.9 627 517 494 1,260 21.2 1903 57,861 1,621 28.1 154 95 1,088 18.8 587 496 462 1,054 18.3 1904 57,188 1,632 28.6 179 109 1,134 19.8 596 540 426 1,020 17.9 1905 56,522 1,601 28.4 145 91 1,131 20.1 680 604 427 954 16.9 1906 55,865 1,640 29.7 147 90 1,212 21.8 745 673 410 949 17.0 1907 55,215 1,570 28.6 132 84 1,131 20.6 685 606 387 912 16.6 Averages for years 1898-1907 59,746 1,682 28.3 212 124 1,242 20.8 624 526 454 1,170 19.5 1908 (53 weeks.) 54,572 1,543 27.8 118 76 1,064 19.2 669 599 403 868 15.7 * 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 1898 to 1900 refer to the old areas of the St. Giles and Holborn District Boards of Works Area of District in acres (inclusive of area covered by water) 405.1 Total population at all ages 59,405 at Census of 1901. Number of inhabited houses 4,703 „ „ Average number of persons per house 12.6 ,, ,, 39 TABLE II. Vital Statistics of separate Localities in 1908 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. 1898 66,371 1,840 1,483 336 36,108 1,027 746 158 30,263 813 737 178 1899 65,677 1,857 1,464 298 35,824 1,132 748 136 29,853 725 716 162 1900 64,930 1,762 1,428 311 35,542 1,018 679 137 29,448 744 749 174 1901 59,232 1,660 1,181 203 31,401 1,040 575 88 27,831 620 606 115 1902 58,542 1,646 1,260 213 31,020 994 594 86 27,522 652 666 127 1903 57,861 1,621 1,054 154 30,644 991 490 68 27,217 630 564 86 1904 57,188 1,632 1,020 179 30,272 991 444 78 26,916 641 576 101 1905 56,522 1,601 954 145 29,905 988 452 61 26,617 613 502 84 1906 55,865 1,640 949 147 29,543 1,020 443 63 26,322 620 506 84 1907 55,215 1,570 912 132 29,184 1,014 416 49 26,031 556 496 83 Averages of Years 1898 to 1907 59,746 1,683 1,171 212 31,944 1,022 559 92 27,802 661 612 119 1908 54,572 1,543 868 118 28,830 966 412 51 25,742 577 456 67 Notes.—(a) The separate localities adopted for this table should be areas of which the populations are obtainable from the census returns, such as wards, parishes or groups of parishes, or registration sub-districts. Block 1 may, if desired, be used for the whole district; and blocks 2, 3, &c., for the several localities. In small districts without recognised divisions of known population this Table need not be filled up. (b) Deaths of residents occurring in public institutions beyond the district are to be included in sub-columns c of this Table, and those of non-residents registered in public institutions in the district excluded. (See note on Table I. as to meaning of terms "resident" and "non-resident.") (c) Deaths of residents occurring in public institutions, whether within or without the district, are to be allotted to the respective localities according to the addresses of the deceased. N.B.-The years 1898 to 1900 refer to the old areas of the St. Giles and Holborn District Boards of Works. 40 TABLE III. Cases of Infectious Disease notified during the year 1908. Notifiable Disease. Cases notified in whole District. Total Cases notified in each Locality. No. of Cases behoved to Hospital from each LoCALITT. At all Ages. At Ages—Years. 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 - - - - - - - - - - - Cholera — — — — — — — — — — — Diphtheria and Membranous Croup 60 4 19 15 1 5 — 21 29 20 29 Erysipelas 46 3 — 3 5 30 5 28 18 11 9 Scarlet Fever 193 1 61 96 23 12 — 81 112 79 111 Typhus Fever — — — — - — — — — — — Enteric Fever 25 - 1 2 10 12 — 12 13 10 12 Relapsing Fever - - - - - - - - - - - Continued Fever — — — — — — — — — — — Puerperal Fever 2 — — — 1 1 — 2 — 1 — Plague — — — — — — — — — — — Cerebro-Spinal Meningitis - - - - - - - - - - - Totals 316 8 81 116 46 60 5 144 172 121 161 Note.—The Isolation Hospitals are those of the Metropolitan Asylums Board, and the London Fever Hospital. A few cases are treated at General Hospitals. There wore also 152 voluntary notifications of Phthisis (Consumption), 61 belonging to St. Giles and Bloomsbury, and 91 to the Holborn Division. 41 TABLE IV. Causes of, and Ages at, Death during the year 1908. Causes of Death. Deaths at the Subjoined Ages of "Residents" whether occurring in or beyond the district. Deaths at ali. Aces of " Residents " belonging to Localities whether occurrino in or beyond the district. Total Deaths whether of "Residents" or "Nonresidents in Public Institutions in the District. All Ages. Under 1. 1 and under 5 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. St. Giles and Bloomsbury Holborn. Small-pox — — - - - - - - - Measles 10 — 9 1 — — — 4 6 1 Scarlet Fever 6 - 5 - 1 — — 1 5 — Whooping Cough 7 1 6 - — — - 3 4 39 Diphtheria and Membranous Croup 5 — 3 2 — — — 1 4 2 Croup — — — — — — — — — — Fever Typhus - - - - - - - — — — Enteric 4 — — — 2 2 — — 4 4 Other Continued — — — — — — — — — — Cerebro-Spinal Meningitis — — — — — — — — — 2 Epidemic Influenza 25 1 — 1 1 9 13 16 9 9 Cholera — — — — — — — — — — Plague — — — — — — — — — — Diarrhoea 26* 20* 5 — — — 1 10* 16* 74 Enteritis 2 — — — — — 2 — 2 9 Puerperal Fever 2 — — — — 2 — 1 1 1 Erysipelas 5 — - — 1 3 1 2 3 — Other Septic Diseases 11 1 — — — 6 4 5 6 20 Phthisis 105 — 3 1 7 87 7 35 70 30 Other Tubercular Diseases 25 6 9 4 — 6 — 8 17 106 Cancer, Malignant Disease 53 — — — — 34 19 32 21 19 Bronchitis 77 7 2 — — 21 47 38 39 15 Pneumonia 66 10 14 3 2 26 11 38 28 74 Pleurisy 4 1 — — — 3 — 4 — 3 Other Diseases of Respiratory Organs 6 1 1 — — 4 — 3 3 4 Alcoholism Cirrhosis of Liver 25 — — — — 22 3 13 12 7 Venereal Diseases 11 5 1 - - 4 1 5 6 5 Premature Birth 29 29 — — — — — 15 14 14 Diseases and Accidents of Paiturition 4 — — — — 4 — 3 1 1 Heart Diseases 74 1 — 1 4 38 30 35 39 24 Accidents 41 5 6 1 2 10 8 17 24 13 Suicides 14 — — — — 13 1 7 7 1 All other causes 231 30 7 7 3 99 85 116 115 192 All causes 868 118 71 21 23 402 233 412 456 669 *Under the heading Diarrhcea, as regards children under one year of age are included all deaths classified as Diarrhceal diseases in Table V. as requested by the Local Government Board. 42 TABLE V. Infantile Mortality during the Year 1908. Deaths from stated Causes in Weeks and Months under One Year of Age. Cause of Death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months. 10-11 Months. 11-12 Months. Total Deaths under One Year. All Causes. Certified 28 7 8 3 46 15 12 10 6 4 1 2 5 4 5 8 118 Uncertified — — — — — — — — — — - — — — — — — Common Infectious Diseases. Small Pox - - - - - - - - - - - - - - - - - Chicken Pox - - - - - - - - - - - - - - - - - Measles - - - - - - - - - - - - - - - - - Scarlet Fever - - - - - - - - - - - - - - - - - Diphtheria (including Membranous Croup - - - - - - - - - - - - - - - - Whooping Cough - - - - - - - - - - - - - - 1 1 Diabrhctial Diseases. Diarrhoea, all forms - — - - - 2 1 6 1 1 - — 2 2 — 2 17 Enteritis MucoEnteritis, GastroEnteritis - - - - - - - - - - - - - - 1 — 2 Gastritis, Gastrointestinal Catarrh - - - - - - - - - - - - - - - - 1 Wasting Diseases. Premature Birth 20 2 2 — 24 4 1 - - - - - - - - - 29 Congenital Defects 1 1 1 1 4 1 1 1 - - - - - - - - - Injury at Birth - - - - - - - - - - - - - - - - - Want of Breast-milk, Starvation - - - - - - - - - - - - - - - - - Atrophy, Debility,Marasmus 1 1 3 1 6 — 2 1 1 - - - - - 1 — 11 Tuberculous Diseases. Tuberculous Meningitis - - - - - - - - - 1 - - - - - - 1 Tuberculous Peritonitis: Tabes Mesenterica — — — — — — 1 — 1 — — 1 — — 1 — 4 Other Tuberculous Diseases - - - - - - - - - - - - 1 - - - 1 Other Causes. Erysipelas - - - — — — — — — — - — — — — — — Syphilis 1 - 1 — 2 2 1 - — — - - - - - - 5 Kickets - — — — — — — - — — - — — — — — — Meningitis(not Tuberculous) — — - — — 1 — — — 1 — — 1 — — — 3 Convulsions 1 1 — — 2 — 1 — — 1 - — — — — — 4 Bronchitis - - - - - 2 2 1 — — - — — 1 — 1 7 Laryngitis - - - - - - - - - - - - - - - - 1 Pneumonia — — 1 — 1 1 — — — — 1 — 1 1 2 4 11 Suffocation, overlying 2 1 — — 3 1 - - 1 - - - - - - - 5 Other causes 2 1 — l 4 1 1 — 1 — - 1 — — — - 8 28 7 8 3 46 15 12 10 6 4 1 2 5 4 5 8 118 Birth in the year legitimate, total registered 1,466 Hesidents "1010. Date in the year of legitimate infants 106. Births in the year illegitimate do. 77; do. 46. Deaths in,1 theyearnfillegitimate „ 12. Deaths from all Causes at all Ages 868. Population estimated to middle of 1908, 54,572. 43 TABLE VI. Sanitary Inspectors' Work.—Inspections, &c. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange Whole Borough. Complaints 52 82 70 11 215 Inspections. Infectious Diseases 107 98 122 163 490 Dwelling Houses 189 312 98 566 1,165 Lodging Houses 341 215 249 689 1,494 Common Lodging Houses. 18 34 50 — 102 Dairies, Cowsheds and Milkshops 326 248 420 1 995 Ice Cream—Manufacture or Storage 19 13 155 — 187 Slaughter-houses — 11 — — 11 Market Streets 333 65 342 — 740 Butchers' Shops 275 281 316 — 872 Bakehouses 83 92 99 — 274 Laundries 2 3 1 11 17 Other Food Shops 399 251 262 135 1,047 Other Workshops 257 135 148 101 641 Out-Workers' Rooms and Registers 32 32 58 188 310 Workplaces 60 46 103 24 233 Factories 32 2 63 29 126 Schools — 1 — — 1 Smoke shafts 3 16 122 1 142 Urinals — 98 28 — 126 Miscellaneous 148 29 95 2 275 Periodical Inspections 1,252 1,583 1,317 — 4,151* Dust 62 144 44 — 250 Mews — 140 6 — 146 Total Inspections 3,938 3,849 4,098 1,910 13,795 No. of Re-Inspections 1,493 1,925 956 1,652 6,026 Visits other than Inspections and Re-Inspections 548 1,042 953 626 3,169 Total 5,979 6,816 6,007 4,188 22,990 *The majority of these are weekly inspections of Registered Lodging Houses. f 2 44 TABLE VII. Sanitary Inspectors' Work.—Notices served. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange. Total. Intimation Notices—Total served 336 502 398 186 1,422 Houses 282 443 245 151 1,121 The house or part of the house in a dirty condition 40 78 47 20 185 The house or part of the house in a damp condition 3 5 4 — 12 The house in a dilapidated condition 5 53 15 3 76 The watercloset so foul as to he a nuisance 15 27 31 3 76 Do. without a water supply 18 40 14 1 73 Do. with a deficient supply of water 8 19 — 4 31 Do. improperly constructed — — — — - Do. so defective as to he a nuisance 24 45 36 15 120 Do. stopped 40 76 45 7 168 Do placed in an improper position — — 1 — 1 Insufficient external ventilation to watercloset — 5 2 — 7 Insufficient watercloset accommodation 2 8 1 11 22 Absence of watercloset accommodation — — — — - Absence of proper watercloset accommodation for persons of each sex See under Workshops &c. The soil pipe defective 1 — 1 — 2 Do. unventilated 1 — — - 1 Do. improperly ventilated 1 — 1 — 2 The yard paving defective 14 3 2 — 19 Do. dirty 6 13 8 1 28 Do. undrained — - — — - The area improperly paved — 1 3 — 4 Do. dirty 1 21 4 - 26 Do. undrained — - — — - The inlet of surface drain improperly trapped — 3 — — 3 A gully trap improperly placed within the house — — — — - The waste pipe of Bink improperly connected with the drain 1 1 4 - 6 Do. do. improperly trapped 1 1 2 1 5 Do. do. untrapped 6 25 1 — 32 Do. of lavatory improperly connected with the drain - - - - - Do. do. improperly trapped — — — — - Do. do. untrapped — — 2 — 2 Do. of hath directly connected witn the drain - - - - - Do. do. improperly trapped — — 2 - 2 Do. do. untrapped 2 2 — - 4 The water cistern so foul as to be a nuisance 5 3 4 6 18 Do. being without a close fitting cover 5 3 3 - 11 Do. being placed in an improper position - - - - - Do. defective 1 6 1 1 9 An accumulation or deposit of refuse 5 28 24 4 61 The absence of proper ashbin 52 18 23 12 105 The ashbin defective 35 19 3 11 68 The drain foul — 2 3 - 5 Do. defective 8 10 10 1 29 Do. choked or stopped 8 36 15 12 71 Do. unventilated 2 2 — — 4 45 TABLE VII.—continued. Sanitary Inspectors' Work.—Notices served.—continued. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange. Total. House- The rainwater pipe in direct communication with the drain - 1 - - 1 Do. do. do. with the soil pipe 1 — 1 — 2 Do. do. defective 4 14 3 3 24 The water supply used for domestic purposes connected with the cistern which is used for flushing the watercloset - - - - - The absence of proper water supply 141 122 95 45 403 The roof defective 9 29 17 8 63 The guttering defective — 1 5 — 6 The paving of wash-house defective 1 3 1 — 5 The want of proper manure receptacle 1 5 2 — 8 An animal kept in such place or manner as to be a nuisance - - - - - The house or part of the house overcrowded 4 8 6 4 22 An underground room occupied as a dwelling contrary to the provisions of the Act 2 8 - 6 16 The space below floor in the basement or ground floor being unventilated - 1 - - 1 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 — — 2 — 2 Other nuisances — 39 8 3 50 *Factories, Workshops and Work Places 54 59 153 35 301 Dirty 24 5 34 27 90 Waterclosets, defective or dirty 12 20 25 14 71 Do. insufficient - 2 1 1 4 Do. absence of separate accommodation for sexes 2 1 3 6 12 Drains, soil pipes, &c., defective 9 9 24 1 43 Improperly ventilated — 4 1 2 7 Overcrowded - - - 2 2 Chimney sending forth black smoke 1 2 9 — 12 Other nuisances 11 20 28 5 64 Breach of Bye-laws or Regulations— †Lodging-houses 78 67 44 63 252 Dairies, cowsheds, milkshops and slaughterhouses — - 1 — 1 Keeping of animals 1 5 2 — 8 London County Council (General Powers Acts) Urinals — 1 — - 1 Vermioous Rooms 3 7 11 1 22 Ashpits 2 2 — - 4 Statutory Notices 28 115 98 29 270 *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." 46 TABLE VIII. Proceedings during 1908. PREMISES. KUMBER OF PLACES— Number of Inspections 1908. Number of Notices 1908. Number of Prosecutions 1908. On register at end of 1907. Added in 1908. Removed In 1908. On register at end ol 1908. Milk premises 178 15 15 178 995 5 0 Cowsheds 1 0 0 1 weekly 0 0 Slaughter-houses 1 0 0 1 11 0 0 Other offensive trade premises 0 0 0 0 0 0 0 Ice Cream premises 41 0 0 0 187 0 0 Registered houses let in lodgings 686 0 5 681 1,436 (a)* 17 (a)* 0 (b)* 229 1(6)* 14 *(a) For overcrowding. *(b) For other conditions. Total number of Intimation notices served for all purposes 1,420 Overcrowding, 1908— Number of Dwelling Rooms overcrowded 46 Number remedied 46 Number of prosecutions 0 Underground Rooms- Illegal occupation dealt with during year 16 Number of rooms closed 16 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 0 Verminous Rooms— Numbers of premises cleansed under Section 20 of the London County Council (General Powers) Act, 1904 22 Shelters provided under Section 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 0 Revenue Acts— Number of houses for which applications were received during the year 14 Number of dwellings comprised therein 229 Number of tenements for which certificates were (a) granted 229; (b) refused 0; (c) deferred 0 Number of prosecutions under Bye-laws under Public Health (London) Act, 1891— (a) For prevention of nuisance arising from snow, ice, salt, filth, etc 0 (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc 0 (c) For the prevention of keeping of animals in such a manner as to be injurious to health 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 146 Total number of infectious bodies removed 0 47 TABLE IX. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—Inspection. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Intimations. Statutory. Factories (including Factory Laundries) 126 31 3 - Workshops (including Workshop Laundries) 968 107 22 — Workplaces (other than Outworkers' Premises included in Part 3 of this Report) 2,850 154 17 1 Total 3,444 292 42 1 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. *Nuisances under the Public Health Acts:— Want of cleanliness 90 90 - - Want of ventilation 7 7 - - Overcrowding 2 2 — - Want of drainage of floors — — — - Other nuisances 64 64 - - Sanitary accommodation insufficient 4 4 - - unsuitable or defective 71 71 - — not separate for sexes 12 12 — — 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) 14 14 — - Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) — — — — Total 264 264 - — *Including those specified in Sections 2, 3, 7 aud 8, of the Factory and Workshop Act as remediable under the Public Health Acts. 3.—Home Work. NATURE OF WORK.* Outworkers' Lists, Section 107. Inspections of Outworkers premises. Outwork in Unwhole-some 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 (S. 110). 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. Work-men. Contractors Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) Wearing Apparel— (1) Making, &c 110 - 701 7 - 26 282 446 120 — - 174 — — — — — - (2) Cleaning and washing - - — — - — 1 — — — - 1 — — — — — - Lace, laee curtains and nets - - — — - — — — — — - — — — — — — - Artificial Flowers - - — — - — — — — — - — — — — — — - Nets, other than Wire Nets - - — — - — — — — — - — — — — — — - Tents - - — — - — — - — — - — — — — — — - Sacks - — — - — — — — — - — — — — — — - Furniture and Upholstery - - — — - — 3 — - — - 3 — — — — — - Fur pulling - - - - - - - - - - - - - - - - - - Feather sorting - - — — - — — — — — - — — — — — — - Umbrellas &c .- - - . — - — — — —- — - — — — — — — - Carding, &c., of buttons, &c. - - — — — — — — — - — — — — — — - Paper Bags and Boxes 4 - 28 — - — 8 16 4 — - 7 — — — — — - Basket making - - — — - — — — — — - 1 — — — — — - Brush making 2 - 6 — - — 1 4 2 — - 2 — — — — — - Racquet and Tennis balls - - - - - - - - - - - - - — — — — - Stuffed Toys - - — — - — — — - — - — — — — — — - File making — - — — - — — — — — - — — — — ' — — - Electro Plate — . - — — — — — — — - - — — — — — - Cables and Chains — - — — - — — — — — - - — — — — — - Anchors and Grapnels — - — — - — — — — — - — — — — — — - Cart Gear - —: — — - — — — — — - — — — — — — - Locks, Latches and Keys - — - — - — — — - - - — — — — — — - Pea Picking — — — — - — — — — — - — — — - — - - Total 116 — 735 7 — 26 290 466 126 — — 188 — — — — — - *If an occupier gives out work of more than one of the classes specified in column 1, and subdivides his list in sucli 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 iu tho;e 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. 49 4.—Registered Workshops. Workshops on the Register (s. 131) at the end of the year. Number. Important classes of workshops, such as work-shop, bakehouses, may be enumerated here. (1) (2) Laundries 13 Bakehouses 29 Other Workshops 988 Total number of workshops on Register 1,030 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) 19 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 12 Report (action being taken) sent to H.M. Inspector 15 Other 1 Underground Bakehouses (s. 101): — Certificates granted during the year — In use at the end of the year 24 G 50 TABLE X. Legal Proceedings under Public Health (London) Act, 1891. Date. Name. Premises. Offence. Result. 1908. Feb. 7th H. Busby 26, New North Street Nuisance W.C. stopped Order to abate nuisance. Defendant to pay 6s. costs. July 1st A. Newman 1 -8, Clark's Buildings Breach of lodging house by-laws Defendant dead; summons withdrawn. „ 1st, 8th and 18th A. H. Wilson 6, 20, 21 & 22, New North Street Do. do. Defendant convicted and fined £3 and £2. 2s. costs. Aug. 5th H. Morrell 27, Gloucester Street Insufficient water supply Defendant convicted and fined £3 and 3s. costs. ,, ,, Bullen & Debenham 7, Gloucester Street Do. do. Work done; summons withdrawn on payment of 10s. 6d. costs „ 19th and 25th Barry & Barry 11, Verulam Street Do. do. Defendant convicted and fined £3 and 2s. costs. Sept. 11th A. J. Walke Evelyn Buildings Breach of lodging house by-laws Defendant convicted and fined 10s. and 10s. 6d. costs „ 17th Edward Wright 67, Red Lion Street Unsound meat exposed for sale Defendant convicted and fined £50. Nov. 3rd Patman & Fotheiingham 11, New North Street Breach of lodging house by-laws Defendant convicted and fined £5 and a continuing penalty of £2 a day for five days and £2. 2s. costs. TABLE XI. Legal Proceedings under Sale of Food and Drugs Acts. Date. Name. Premises. Offence. Result. 1908. Mar. 10th G. Labram 8, Francis Street Selling whiskey 52.77 per cent, under proof Defendant convicted and ordered to pay £2. 2s. costs. „ 17th Eliza Williams 13, Dean Street Selling milk 6.6 per cent, deficient in fat Defendant convicted and fined 10s. and 12s. 6d. costs. „ 18th J. Chiappa 24, Eyre Street Hill Selling milk 12.3 per cent, deficient in fat Warranty produced. Summons withdrawn. Defendant to pay 10s. Cd. costs. „ 31st Julia Thwaites 11, Marchmont Street Selling milk 12.3 per cent, deficient in fat and containing 4 per cent, added water Defendant convicted and ordered to pay 12s. 6d. costs. 51 TABLE XI. —continued. Date. Name. Premises. Offence. Result. 1908. April 14th A. Terroni 138, Clerkenwell Road Selling butter containing 2.03 per cent. excess of water Defendant convicted and ordered to pay 2s. fine and l0s. 6d. costs. „ 14th and 28th T. Matthias 22, Cross Street Selling milk 10 per cent, deficient in fat Defendant convicted and fined £2 and 12s 6d. costs. May 26th D. Lloyd 73, Mount Pleasant Selling milk 9.6 per cent. deficient in fat Warranty pleaded. Summons withdrawn; defendant paying 10s. 6d. costs. „ 27th Alice Carden 30, New North Street Selling milk 27 per cent. deficient in fat Defendant convicted and fined 20s. and 12s. 6d. costs. July 8th James Millbourne 13, Beauchamp Street Selling milk containing 0.0038 per cent, of formaldehyde Defendant convicted and fined £1 and 12s. 6d. costs. Aug. 5th William Sharp 19a, Endell Street Selling margarine for butter Defendant convicted and fined £5 and 12s. 6d. costs. ,, ,, David Lott 33, Great Ormond Street Selling milk 5 per cent, deficient in fat Warranty pleaded. Summons withdrawn on payment of 14s. 6d. costs. „ 6th Julia Thwaites 11, Marchmont Street Selling milk 10 per cent, deficient in fat Defendant convicted and fined £3 and 12s. 6d. costs. „ 6th and 13th Thos. Matthias 22, Cross Street Selling milk containing 5.1 per cent, of added water Defendant convicted and fined £20 and 12s. 6d. costs. „ 10th Williamsons, Limited 111, High Holborn Selling milk 6.6 per cent, deficient in fat Warranty pleaded. Summons withdrawn on defendantpaying 10s. 6d. costs. „ 18th J. B. Cox 71, Theobald's Road Selling margarine for butter Defendant convicted and fined 20s. and 12s. 6d. costs. ,, ,, Ada Carter 22, West Street Selling milk 5 per cent, deficient in fat Defendant convicted and fined 20s. and 12s. 6d. costs. Sept. 8th and 29th David Lott 33, Great Ormond Street Selling milk containing 0.003 per cent, of formaldehyde Defendant convicted and fined £1. Is. and J5s. 6d. costs. 52 TABLE XII. Meteorology of London, 1908. (Deduced from observations at Greenwich under the superintendence of the Astronomer Royal.) 1908. Air Temperature. Bright Sunshine. Rain and other forms 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.* Minimum. A Maximum. B January º 30.9 º 41.7 º 36.3 º -2.1 hrs. 57 hrs. +16 % 22 ins. 1.51 ins. - 0.37 February 35.7 47.5 41.6 +1.8 63 +6 22 1.46 - 0.02 March 33.9 47.6 40.7 -1.8 102 +3 28 2.22 + 0.70 April 36.8 51.7 44.3 -3.8 137 -10 33 2.10 + 0.53 May 47.2 66.2 56.7 +2.9 200 +14 41 1.53 - 0.39 June 49.7 71.0 60.4 +0.1 262 + 65 53 2.07 +0.03 July 53.2 73.0 63.1 -0.6 202 -34 41 3.66 +1.26 August 51.4 70.1 60.7 -2.2 214 +4 48 3.28 +0.94 September 47.7 66.4 57.0 -1.2 165 +10 44 1.22 -0.93 October 460 02.9 51.5 +41 133 +38 40 197 -0.81 November 39.8 52.1 459 +.2 5 77 +29 29 0.76 -1.46 December 35.3 43.5 39.4 -0.2 22 -11 9 2.00 +0.17 Year 42.3 57.8 50.1 0.0 1634 +132 37 23.78 -0.34 *The averages used are obtained from observations extending over 50 years for Rain and Temperature. and 15 years for Sunshine.