HOL 67 The Metropolitan Borough of Holborn. REPORT FOR THE YEAR 1913 or The Medical Officer of health, WILLIAM ARTHUR BOND, M.A., M.D., D.P.H. Camb., Bach. Surgery Camb., M.R.C.P.Lond. Fellow, Member of Council and late President of Metropolitan Branch, of the Society of Medical Officers of Health; Fellow, and Member of Council, late Hon. Sec. of the Royal Institute of Public Health; Member, late Lecturer and Demonstrator, of the Royal Sanitary Institute; late Medical Officer of Health of the St. Olave District, Southwark, and the Holborn District Board of Works. London: DIPROSE, BATEMAN & CO., SHEFFIELD STREET, LINCOLN'S INN FIELDS, W.C. 1914. 24a CONTENTS. Page Introduction 6 Population and Houses 6 Number of Tenements 7 Number of Foreigners 8 Estimated Population, 1913 8 Registered Births and Birth-Rates 8 Ditto Corrected 8 Mortality 8 Deaths Registered 9 Deaths in Public Institutions within the Borough 9 Ditto outside the Borough 9 Corrected Deaths and Death-rates 10 Infantile Mortality 10 Prevention of Infantile Mortality 11 (1) Care and feeding of Infants 11 (2) Notification of Births Act, 1907 12 (3) Modified Milk for Infants 12 (4) School for Mothers 13 (5) Dinner Tickets 13 Senile Mortality 14 Deaths from Epidemic Diseases 14 Ditto ditto during 1913 and ten preceding years 15 Ditto Measles 15 Ditto Whooping Cough 16 Ditto Diarrhoea and Enteritis 16 Ditto Phthisis 16 Ditto Influenza 16 Ditto Alcoholism 17 Ditto Cancer 17 Inquests 17 The Public Mortuary 17 Infectious Diseases 17 Notification of Infectious Diseases during 1913 and ten preceding years 18 Small Pox 19 Scarlet Fever 19 Ditto Errors in Diagnosis 19 Ditto Secondary Cases 19 Ditto Return Cases 19 Diphtheria 19 Ditto Errors in Diagnosis 20 Ditto Secondary and Return Cases 20 Ditto Anti-Toxin 20 Enteric Fever 20 Cerebro-Spinal Fever 20 Polio-Myelitis and Encephalitis 20 Ophthalmia Neonatorum 21 Phthisis or Consumption 21 Ditto ditto Notification Public Health (Tuberculosis) Regulations, 1908, 1911 & 1912 22 National Insurance Act, 1911—Sanatorium Benefit—Tuberculosis Dispensary 23 Glanders, Anthrax and Hydrophobia in man 23 Bacteriology 24 Disinfections 24 Shelter during disinfection of houses 24 Cleansing of Persons Act, 1897—New Cleansing Station 25 Housing of the Working Classes Acts 25 Housing, Town Planning, &c., Act, 1909, Section 17 25 Underground Sleeping Rooms 26 Erection of Dwellings for Working Classes 26 Premises closed voluntarily, demolished, rebuilt, &c. 26 A 2 4 PAGE Sanitary Work 29 House-to-house inspections 29 Water Supply to New Buildings 80 Ditto to Tenement Houses 30 By-laws as to Houses let in Lodgings 31 Revenue Acts 31 Overcrowding 31 Itemoval of House Refuse 31 Removal of Manure 32 Common Lodging Houses Acts, 1851 and 1853 32 Factories, Workshops and Workplaces 33 Bakehouses 33 Home Work 34 Places where Food is prepared for Sale 34 Slaughter House 35 Dairies, Cowsheds and Milkshops 35 Public Health (Milk and Cream) Regulations, 1912 35 Ice Cream 37 Unsound Food 37 Offensive fumes from factories 37 Smoke Abatement 37 Meteorology of London, 1913 38 APPENDIX. Table I. Vital Statistics of whole Borough during 1913 and previous years 39 Table II. Cases of Infectious Disease notified during the year 1913 40 Table III. Causes of, and Ages at Death during the year 1913 41 Table IV. Infantile Mortality during the year 1913 42 Table V. Sanitary Inspectors' Work—Inspections, &c. 43 Table VI. Ditto Notices served 44 Table VII. Proceedings during 1913 46 Table VIII. Factories, Workshops, Laundries, Workplaces and Homework 47 (1) Inspections 47 (2) Defects found 47 (3) Homework 48 (4) Registered Workshops 49 (5) Other matters 49 Table IX. Legal Proceedings—Public Health (London) Act, 1891 60 Ditto London County Council (General Powers) Act, 1902 50 Table X. Ditto Sale of Food and Drugs Acts 60 Table XI. Meteorology of London, 1913 51 The Metropolitan Borough of Holborn. REPORT OF THE Medical Officer of Health For the Year 1913. 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 1913, the various statistics of the year refer to the fifty-three weeks ended Saturday, January 3rd, 1914, as adopted by the Registrar-General, and known as the Registration year. The following statistics for the Census years 1901 and 1911, and for last year, 1913, indicate the very great improvement that has taken place in the sanitary and hygienic condition of the Borough since the formation of the Holborn Borough. 1901. 1911. 1913. Death-rate per 1,000 20.0 15.2 14.4 Death-rate from the seven principal epidemic diseases 2.25 1.21 0.61 Death rate from Phthisis 2.47 1.72 1.60 Number of notifications of Infectious diseases (excluding Tuberculosis and ChickenPox) 758 259 232 Notification-rate per 1,000 12.79 5.29 4.86 Infantile Mortality per 1,000 births 126 (1905)* 113 100 Much work has again been done during the year under the Housing, Town Planning, etc., Act, 1909, and the Housing Regulations of September, 1910. Since the issue of these Housing Regulations more than 300 of the worst houses in the Borough have been reported on in detail and action taken thereon. In the great majority of cases the owners at once agreed to carry out the necessary work to make the premises fit for human habitation, in a number of cases the owners agreed to close the premises for reletting on building leases, and in only four cases it has been necessary to make closing orders. A large number of other houses were also inspected by me, but were not reported to the Housing of the Working *Details of births, names and addresses of mothers, etc., were not supplied until the latter part of 1904. 6 Classes Committee as they did not appear to me to be in a state so dangerous or injurious to health as to be unfit for humau habitation, or in which any alterations could reasonably be required. Negotiations for the purchase of a site in Short's Gardens for the erection by the Council of dwellings for the working classes are now practically completed. The compulsory notification of all forms of tuberculosis came into force on the 1st February, 1913. The Public Health Committee during the year have given much further consideration to the provision of a Tuberculosis Dispensary. Proposed schemes for the use of tuberculosis dispensaries at St. Bartholomew's, the Royal Free, and the University College Hospitals, have been discussed, and the Council is now awaiting a reply from the Middlesex Hospital respecting the use of their dispensary by this Council. The Memorandum of the Insurance Committee for the County of London on the treatment of insured persons at tuberculosis dispensaries was adjourned by our Public Health Committee, pending the report of a conference of delegates of Metropolitan, City and Borough Councils on the subject. Further details respecting these and other matters will be found under their respective headings. I desire to express my high appreciation of the assistance and hearty co-operation that I have received from the staff of the Public Health Department during the year. I have the honour to be, Gentlemen, Your obedient Servant, W. A. BOND. POPULATION AND HOUSES. The enumerated Population at the Census taken on Sunday, April 2nd, 1911, was 49,357, a reduction of 10,048 on the previous census of 1901 or 16.9 per cent. During the previous decennium 1891-1901 there was a reduction of 7,376 or ll.0 per cent. The Borough is becoming less and less residential and more and more important as a business centre. The number of factories, workshops, workplaces and offices keeps increasing so that we have now a very large day population. The density of the population was 122 persons per acre in comparison with 61 for London. The number of inhabited buildings was 7,985 and uninhabited 1,393 and 38 were in course of erection. Further details were given in my last Annual Report. During the past twelve months a number of volumes giving further details respecting the Census, 1911 have been published from which the following information has been obtained:- NUMBER OF TENEMENTS At the Census, 1911, the total number of Tenements in the Holborn Borough was 10,584 in comparison with 13,790 at the Census 1901. The following table gives details of the Tenements of one, two, three and four rooms:— Tenements with Number of Tenements. Percentage of all Tenements. Total Occupants. Percentage of Population in each group of Tenements. Average Occupants per room. Overcrowding. No. of 1-4 room Tenements with more than two Occupants per Room. Number of Occupants of such Rooms. Percentage of Population in such Tenements. 1911 1901 1911 1901 1911 1901 1911 1901 1911 1901 1911 1901 1911 1901 1911 1901 One room 2398 3725 22.6 27.0 4945 8502 10.0 14.3 2.06 2.28 611 1267 2382 4916 4.83 8.28 Two rooms 3447 3834 32.6 27.8 11412 13787 23.1 23.2 1.65 1.80 755 1126 4506 6747 9.13 11.36 Three rooms 2177 2224 20.0 16.1 8713 9175 17.7 15.4 1.18 1.38 262 328 2110 2603 4.27 4.38 Four rooms 999 989 9.4 7.2 4295 4260 8.7 7.2 1.07 1.08 54 62 545 609 1.10 1.03 Total 9021 10772 85.2 78.1 29365 35724 59.5 60.1 1.48 1.62 1682 2783 9543 14875 19.33 25.05 The word "overcrowding" is used in the sense that the Tenements were occupied by more than two persons per room, and not in the legal sense, for of the 1,683 "overcrowded'' Tenements there were probably comparatively few for which the Council could take action to abate overcrowding. The table shows that 59.5 per cent. of the population of the Borough lived in Tenements of one to four rooms, and that 33.1 per cent. lived in only one or two rooms. 8 NUMBER OF FOREIGNERS. The number of persons living in the Holborn Borough at the Census 1911 who were born abroad or at sea was 5,614; of these 202, 85 males and 117 females, were British subjects; 189 persons, 122 males and 67 females, were naturalised British subjects; 5,223 persons, of whom 3,477 were males and 1,746 females, were foreigners. Of the 5,223 foreigners 1,488 were born in Italy, 956 in Germany, 709 in France, 487 in Russia, 294 in Austria and Hungary, and 288 in Switzerland. The number of persons living in the County of London at the Census 1911 who were born abroad or at sea was 175,528; of these 12,607, 4,674 males and 7.843 females, were British subjects; 9,793 persons, 6,094 males and 3,699 females, were naturalised British subjects; 153,128, of whom 87,407 were males and 65,721 females, were foreigners; 11,668 were born in Italy, 27,290 in Germany, 13,803 in France, 63,105 in Russia, 9,030 in Austria and Hungary, and 5,342 in Switzerland. ESTIMATED POPULATION, 1913. The following are the estimated populations at the middle of the year 1913:— St. Giles and Bloomsbury 23,638 Holbcrn Sub-District 23,311 Holborn Borough 46,949 London 4,518,191 REGISTERED BIRTHS AND BIRTH-RATES. District. Males. Females. Both Sexes. Birth rate per 1,000 Legitimate. Illegitimate. Total. St. Giles and Bloomsbury 215 214 383 46 429 17.9 Holborn 198 242 430 10 440 18.5 Whole Borough 413 456 813 56 869 18.2 CORRECTED BIRTHS AND BIRTH-RATES. The British Lying-in Hospital, Endell Street, was removed from the Borough about the 1st May, 1913. The number of births in the Borough this year was, therefore, much less, and the number of those whose mothers were non-resident in the Borough is also much less, viz., 157. I received from the Registrar-General information of the births of 63 legitimate infants and 23 illegitimate infants whose mothers were resident in the Borough, but which took place in outlying institutions in London. 9 The corrected numbers are as follows:— District. Corrected number of Births of Residents. Corrected Birth-rate per 1000. Legitimate. Illegitimate. Total. 1913. 1912. St. Giles and Bloomsbury 277 35 312 13.0 14.5 Holborn 466 20 486 20.5 23.2 Whole Borough 743 55 798 16.7 18.8 In London the corrected number of births was 112,637, or a rate of 24.5 per 1,000, the same rate as for 1912. MORTALITY. The following deaths have been registered in the Borough (1913):— St. Giles and Bloomsbury. Holborn. Total. Males 121 372 493 Females 86 331 417 Total 207 703 910 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 26 - 4 - French Hospital 3 - 35 - British Lying-in Hospital - - 1 - Children's Hospital 2 11 - 357 National Hospital - — — 54 London Homoeopathic Hospital - 15 - 76 Italian Hospital 1 3 — 23 Alexandra Hospital — — — 4 Private - — 23 6 Total 32 29 63 520 There were 358 deaths of "Residents" in various Workhouses, Infirmaries, Asvlums, Hospitals, &c., outside the Borough, 92 of whom were removed from Common Lodging Houses in the Borongh. Of the total, 190 formerly resided in St. Giles and Bloomsbury, and 168 in the Holborn District. B 10 CORRECTED DEATHS AND DEATH-RATES, 1913. 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, 1913. Death Rate for 1913. Corresponding period 1912 In Borough. Beyond Borough. St. Giles and Bloomsbury 207 69 63 2 190 335 14.0 12.8 Holborn Sub-District 703 546 520 1 168 350 14.8 17.1 Whole Borough 910 615 583 - 358 685 14.4 14.9 Registration London ... ... ... ... ... 65,030 14.2 13.6 INFANTILE MORTALITY. The number of deaths of children under one year of age, and the number of deaths of children under one year of age per 1,000 total registered births and per 1,000 corrected births, were the following for:— Deaths under 1 year of age. Deaths under 1 year per 1,000 registered births. Deaths under 1 year per 1,000 corrected legitimate births. Deaths under 1 year per 1,000 corrected illegitimate births. Deaths under 1 year per 1,000 corrected births. St. Giles and Bloomsbury 24 56 72 114 77 Holborn Sub-District 56 128 110 250 118 Holborn Borough 80 92 96 164 100 London 11,869 - - - 105 Death-rate per 1,000 corrected births in 1913 and in seven preceding years during which details respecting births have been supplied. 1906. 1907. 1908. 1909. 1910. 1911. 1912. 1913. St. Giles and Bloomsbury 130 122 116 100 91 98 68 77 Holborn Sub-District 126 138 107 103 106 123 84 118 Whole Borough 128 131 111 101 100 113 78 100 London 131 116 113 108 103 129 91 105 11 From the above table it will be seen that since tbe adoption of the Notification of Births Act in March, 1908, the infantile mortality of the Borough has been less than that for London. Eight of the 80 infants that died under one year of age were known to be illegitimate children. A newly-born infant with injury to skull found on vacant land was also probably illegitimate. Of the 80 deaths of infants during the year the Lady Sanitary Inspector was able to obtain further details respecting 72. Of the remaining 8 cases, 2 had removed, 1 was above class visited, 4 were foreigners, and in the remaining one the mother could not be found at home. Of the 72 deaths respecting which further details were obtained, 19, principally cases of premature birth, died before taking food; only 23 were breast fed, and 30 artificially fed. In 8 of these the mothers worked in factory or workshop, 5 were engaged in charing or other work outside the home, and 8 were in domestic service. There were only 7 deaths from diarrhœal diseases. Only 2 of these took place in the third or summer quarter, 3 occurring in the last two months of the year. Of the 80 deaths 40 were from prenatal causes and 38 from postnatal causes, and 2 doubtful. The principal causes of death of these 80 children under one year of age are given in Table IV. of the Appendix. PREVENTION OF INFANTILE MORTALITY. (1) Care and Feeding of Infants. In previous Annual Reports I have given details respecting visits and inquiries made by the Lady Sanitary Inspector with a view to improving the health of infants and diminishing the infantile mortality in the Borough. If thought desirable, instructions are given respecting the care and feeding of the child and a leaflet left. Babies that are not thriving are periodically weighed. Notices are also served for any sanitary defects found. I am glad to report that additional means for the promotion of the above objects were inaugurated during the year by the opening of the Passmore Edwards Settlement School for Mothers. Details respecting this are given in Section (4). During the year 530 first visits were made. In 41 cases for various reasons enquiries could not be carried out. In the remaining 497 cases, 5 children did B 2 12 not live long enough to take any food, 39 were being artificially fed, and 453 were being breast fed at the time of the first visit, about a fortnight after birth. A large number of revisits were made, particularly in the cases of children who were not breast fed, and especially those who were feeding on modified milk. (2) Notification of Births Act. 1907. The total number of births notified in the Borough during the registration year 1913, was as follows:— Notified once only (a) By Doctors or Medical Students 586 (b) „ Midwives 191 (c) „ Parents and others 16 Notified twice (a) By Doctors and Parents 1 (b) „ Midwives and Parents 1 Total 795 During the same period 869 births were registered in the Borough; the corrected number of births of residents was 798. (3) Modified Milk for Infants. In my Annual Report for 1906 I gave a detailed report respecting this matter and the arrangements made with the Express Dairy Company, who have various depots in and near the Borough to supply modified milk for infants of the working classes at the reduced rate of 4d. per day on production of a certificate from me'. During the year 65 new certificates were issued, of which 58 were used. Including 27 children who were taking the milk at the beginning of the year 1913, the milk was used by 85 children during the year, in comparison with 86 during the previous year. In the majority of cases the infants thrived well on the milk. In a number of cases the use of the milk was after various periods and for various reasons discontinued. There were 7 deaths of the 85 infants who had been taking prepared milk during the year, 5 of which were at 9 months old and upwards, the causes of death being:—Of 2 measles, 1 tneningitis, 1 pneumonia, and 1 bronchitis. The remaining 2 died at 3 months old, 1 of marasmus, the other of enteritis. 13 Councillor Walter Ha/ell, J.P., has for a number of years very kindly assisted poor parents who cannot afford to pay the whole amount. Of the 85 children who were taking prepared milk during the year, the parents of as many as 60 children were so assisted. (4) The Passmore Edwards Settlement School for Mothers (Baby Clinic). The provision of a School for Mothers or Baby Clinic for this Borough has been under my consideration for some time, and Councillor Walter Hazell, J.P., promised to render financial and other practical assistance. I had from time to time endeavoured to find suitable premises in the Borough, and was very glad, therefore, to find that the matter had been considered by a Committee of the Passmore Edwards Settlement, and had been postponed because further financial assistance was required. Arrangements were made for the formation of a Committee consisting of representatives of the Passmore Edwards Settlement, of this Borough, and of St. Pancras, as it was thought that a Clinic was also required for the southern part of that Borough. Councillor Hazell, who had again offered assistance, was elected Chairman, and the Lady Sanitary Inspector and I were the other Holborn representatives. The Authorities of the Settlement kindly offered to allow the use of part of their premises free of charge. Dr. R. S. Frew, M.D., etc., Assistant Physician, East London Hospital for Children, Clinical Assistant Medical Out-Patients, Great Ormond Street Hospital for Sick Children, was appointed Medical Officer, and Miss E. D. Colles, who is also Lady Superintendent of the North St. Pancras School for Mothers, was appointed Lady Superintendent. The Clinic was opened on the 29th September, 1913. The Clinic is held every Monday, 2 to 4.30 p.m. The Lady Sanitary Inspector also regularly attends to render assistance. She also frequently visits the mothers at their homes. During the six months ended March 30th, 1914, there were 481 attendances of mothers with babies, of which 341 resided in Holborn and 140 in St. Pancras. The total number of entries to this date of mothers with infants was 100, of which 64 resided in Holborn and 36 in St. Pancras. (5) Dinner Tickets for Poor, Deserving Mothers. In order to encourage a continuance of breast leeding amongst a number of poor, deserving mothers, 96 dinner tickets were distributed to enable such mothers to obtain a sixpenny dinner at a restaurant in the Borough. Councillor Walter Hazell, J. P., also paid for these tickets which were by arrangement secured at a reduced rate. 14 SENILE MORTALITY. The number of deaths of persons 65 years of age and upwards was in:— St. Giles and Bloomsbury 104 Holborn Sub-District 81 Holborn Borough 185 St Giles and Bloomsbury. Holborn Sub-District. Total. Of these the numbers were— 65 years and under 70 24 23 47 70 „ „ 75 32 21 53 75 „ „ 80 21 21 42 80 „ „ 85 17 10 27 85 „ „ 90 7 5 12 90 years of age and upwards 3 1 4 104 81 185 DEATHS FROM EPIDEMIC DISEASES. The following tables give details respecting the number of deaths, and the deathrates, from the seven principal epidemic diseases, viz.:—Small-pox, Measles, Scarlet Fever, Diphtheria (including Membranous Croup), Whooping Cough, Fever (including Enteric or Typhoid, Typhus and Continued), and Diarrhoea. It will be seen that the number was only 29 in comparison with a decennial average of 63. The death-rate for the Borough was only 0.61 in comparison with 132 for London. Number. Epidemic Death-Rate. St. Giles and Bloomsbury 8 0.17 Holborn Sub-District 21 0.44 Holborn Borough 29 0.61 And for London 6,201 1.32 The following are the number of deaths from the separate diseases:— St. Giles and Bloomsbury. Holborn Sub-District. Holborn Borough. London. Small-pox - - - - Measles 1 6 7 1,570 Scarlet Fever - - - 188 Diphtheria and Membranous Croup 3 1 4 431 Whooping Cough 3 3 6 800 Typhoid Fever - - - 114 Typhus - - - - Diarrhœa (under 2 years of age) 1 11 12 3,098 Total 8 21 29 6,20l 15 DEATHS FROM EPIDEMIC DISEASES OCCURRING IN THE BOROUGH DURING THE YEAR 1913 AND DURING THE PRECEDING TEN YEARS. Year. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Enteric Fever. Diarrhœa. Total. Number. Rate per 1000. Number. Rate per 1000. Number. Rate per 1000. Number. Rate per 1000. Number. Rate per 1000. Number. Rate per 1000. Number Rate per 1000. Number. Rate per 1000. 1903 - - 17 0.30 4 0.07 7 0.12 15 0.26 5 0.09 22 0.38 70 1.22 1904 2 0.04 43 0.76 - - 7 0.12 8 0.14 4 0.07 35 0.62 99 1.75 1905 - - 11 0.20 3 0.05 4 0.07 15 0.27 4 0.07 22 0.40 59 1.07 1906 - - 25 0.46 2 0.04 7 0.13 10 0.18 1 0.02 39 0.72 84 1.55 1907 - - 13 0.34 3 0.06 10 0.19 27 0.51 2 0.04 16 0.30 71 1.34 1908 - - 10 0.18 6 0.11 5 0.09 7 0.13 4 0.08 26 0.49 58 1.09 1909 - - 14 0.27 3 0.08 3 0.06 15 0.29 1 0.02 7 0.14 43 0.84 1910 - - 13 0.26 - - 4 0.08 16 0.32 4 0.08 6 0.12 43 0.86 1911 - - 15 0.31 3 0.06 3 0.06 3 0.06 2 0.04 33* 0.67* 59 1.21 1912 — — 25 0.52 0 0.00 6 0.13 7 0.15 1 0.02 8 0.17* 47 0.98 Average for 10 years 19031912. 0.2 0.00 18.6 0.36 2.4 0.05 5.6 0.11 12.3 0.23 2.8 0.05 21.4 0.40 63.3 1.19 1913 — — 7 0.15 — 0.00 4 0.08 6 0.13 — 0.02 12* 0.25* 29 0.61 London, 1918. — — 1,570 0.34 188 0.04 431 0.09 800 0.17 114 0.02 3098* 0.66* 6,201 1.82 *The Registrar General since 1911 has taken the deaths from Diarrhœa and Enteritis under two years of age. MEASLES. Measles was less prevalent than during any of the preceding ten years, especially in the St. Giles and Bloomsbury Division. We received information of 75 cases in comparison with 202 in 1912, 101 in 1911, 231 in 1910, 139 in 1909, and 86 in 1908. There were only 7 deaths or a rate of 0.15 per thousand in comparison with a decennial rate of 0.36. Of these only 1 belonged to St. Giles and Bloomsbury and 6 to the Holborn District. Seven of the eight were under 2 years of age. During the year the Education Department of the London County Council excluded all the unprotected children from certain classes, in the Infants' Department, of the undermentioned schools from and up to the dates specified:— Rosebery Avenue, Class Room A. 6th to 14th February. St. John-the-Evangelist „ C. 4th to 21st February. Do. „ A. 7th to 28th „ Princeton Street „ B. 7th to 19th March. Wild Street „ D 7th to 19th „ 16 Since the Measles Order of the Local Government Board of the 30th May, 1911, in addition to Poor Law cases, persons that cannot be satisfactorily isolated and nursed at home can be removed to hospitals of the Metropolitan Asylums Board, on the recommendation of the Medical Officer of Health, provided accommodation is available. 14 cases were so removed during the year. WHOOPING COUGH Whooping cough was returned as the cause of 6 deaths during the year, in comparison with 7 in the preceding year and 3 in 1910. 3 of the deaths were in St. Giles and Bloomsbury and 3 in the Holborn District. All were children under 5 years of age, 5 being under 2 years. The death-rate was 0.13 per 1,000 in comparison with the decennial average of 0.23. On the 9th August, 1912, the Local Government Board issued an Order providing for the admission of any person who is not a pauper to a hospital of the Metropolitan Asylums Board on the recommendation of the Medical Officer of Health, provided more accommodation is available than is required for pauper patients. Three cases were so removed during the year. DIARRHŒA AND ENTERITIS The number of deaths from diarrhoea and enteritis was only 15. 2 belonged to St Giles and Bloomsbury and 13 to the Holborn District. 12 were children under 2 years of age, 7 being under 1 year of age. The Registrar-General in 1911 introduced a change in the method of classification of diarrhœal deaths. He takes the deaths from diarrhoea and enteritis under two years of age, instead of deaths at all ages from cholera, dysentery and diarrhoea. In estimating rates, he takes the number of deaths per 1,000 births instead of per 1,000 of the population. In the Borough this rate was only 15 01 per 1,000 births, in comparison with 27.50 for London with 3,098 deaths under two years of age. Only 6 of our deaths and 1,500 London deaths occurred during the summer quarter, in comparison with 33 and 4,310 respectively during the exceptionally hot one of 1911. PHTHISIS. For details see pages 21 to 23. INFLUENZA. During the year there were 8 deaths registered as due to influenza, in comparison with 9 in 1912. 17 ALCOHOLISM. Only 18 deaths were assigned to alcoholism or cirrhosis of liver, 14 in St. Giles and Bloomsbury and 4 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. 50 deaths were registered as due to cancer or malignant disease, 32 belonging to St. Giles and Bloomsbury and 18 to the Holborn District. OTHER CAUSES OF DEATH. Further details as to causes of and ages at death are given in Table III. of the Appendix. INQUESTS. Coroner: Walter Schroder, Esq., Office, Manor Place, Paddington Green, W. Inquiry Officer: Mr. Richard Powell, 58, Hemingford Eoad, Barnsbury, N. The following inquests on the bodies of Parishioners were held :— District. Total Number. Cause of Death. Natural. Accidents. Suicide. Murder. St. Giles and Bloomsbury 26 16 7 3 — Holborn 32 13 15 4 — Total 58 29 22 7 — THE PUBLIC MORTUARY, GOLDSMITH STREET. 73 bodies were received (44 being parishioners), and on these 49 inquests (22 of parishioners) were held, and 38 post-mortems (17 of parishioners) made. While alterations and improvements were being carried out at our Mortuary during February, March and April, 17 body were taken for this Council at the Finsbury Mortuary, and on these 16 inquests were held and 11 post-mortems made. NOTIFICATIONS OF INFECTIOUS DISEASES. Excluding duplicate notifications and 204 notifications of Phthisis, the number of notifications of infectious diseases in the Borough during 1913 was 232 in comparison with a decennial average of 267. The notifications per 1,000 of the population were less than for London, namely 4.86 per 1,000 in comparison with 6.96 for London. For further details, see the following Table and Table II, of the Appendix. G NOTIFICATIONS OF INFECTIOUS DISEASES IN THE BOROUGH DURING 1913, AND DURING THE PRECEDING TEN YEARS, AND RATES PER 1,000. Year. Small-pox. Diphtheria and Membranous Croup. Scarlet Fever. Enteric Fever. Continued Fever. Erysipelas. Puerperal Fever. Typhus Fever. Ophthalmia Neonatorum. Cerebrospinal Fever Acute Polio-myelitis. Total. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. No. Rate per 1000. 1903 2 0.03 53 0.93 144 2.52 53 0.93 2 0.03 90 1.57 4 0.07 0 0.00 - - - - - - 348 6.08 1904 6 0.11 46 0.82 99 1.76 41 0.73 0 0.00 77 1.37 7 0.12 0 0.00 - - - - - - 276 4.91 1905 1 0.02 47 0.85 156 2.82 21 0.38 1 0.02 35 0.63 2 0.03 0 0.00 - - - - - - 263 4.76 1906 0 0.00 66 1.22 137 2.53 15 0.28 0 0.00 56 1.03 2 0.03 0 0.00 - - - - - - 276 5.10 1907 0 0.00 64 1.21 156 2.94 14 0.26 0 0.00 40 0.75 1 0.02 1 0.02 - - 2 0.03 - - 278 5.24 1908 0 0.00 50 0.94 193 3.64 25 0.47 0 0.00 46 0.87 2 0.03 0 0.00 - - 0 0.00 - - 316 5.96 1909 1 0.02 47 0.92 98 1.92 16 0.31 1 0.02 41 0.80 3 0.06 0 0.00 - - 0 0.00 - - 207 4.06 1910 0 0.00 45 0.90 68 1.36 25 0.50 0 0.00 42 0.81 0 0.00 0 0.00 - - 1 0.02 - - 181 3.62 1911 0 0.00 85 1.74 120 2.45 10 0.20 0 0.00 37 0.76 2 0.04 0 0.00 5 0.10 0 0.00 0 0.00 259 5.29 1912 0 0.00 88 1.83 113 2.36 12 0.25 0 0.00 48 1.00 0 0.00 0 0.00 5 0.10 1 0.02 0 0.00 267 5.56 Average for 10 years 1903-1912. 1.0 0.02 59.1 1.14 128.4 2.43 23.2 0.43 0.4 0.01 51.2 0.96 2.3 0.04 0.1 0.00 1.0 0.02 0.4 0.01 0 0.00 267.1 5.06 1913 0 0.00 59 1.23 131 2.75 7 0.15 0 0.00 29 0.61 1 0.02 0 0.00 3 0.06 0 0.00 2 0.04 232 4.86 London, 1913 3 0.00 7,668 1.70 17,568 3.89 762 0.17 14 0.00 4,159 0.92 354 0.08 5 0.00 641 0.14 93 0.02 147 0.03 31,414 6.96 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; and in 1911, from 22nd March to 21st June, during which period 101 notifications were received. Anthrax, nil; Glanders, nil; Hydrophobia, nil; There were also the following voluntary notifications of Phthisis:— 1911 Voluntary 3 1913 Private 58 1904 344 1908 152 „ Hospital 81 „ Hospitals 73 1905 208 1909 Voluntary 16 „ Poor Law 104 „ Poor Law 73 1906 191 „ Poor Law 326 188 1907 171 342 1912 Private 36 204 1910 Voluntary 16 „ Hospital 79 „ Poor Law 154 „ Poor Law 96 170 210 19 SMALL POX. There was 1 notification of small-pox in the Borough during the year. The patient, an Italian, aged 26 years, was removed to the South Wharf, but was at once returned home, as he was found to be suffering from chicken-pox. The doctor who notified it wrote requesting the withdrawal of the notification and stated that the patient was in a dark shed, and had only a tallow candle for light. SCARLET FEVER. Excluding duplicates, the number of notifications of scarlet fever was 131 in comparison with 113 in the year 1912. Of these 58 belonged to St. Giles and Bloomsbury and 73 to the Holborn District. All but 2 of the cases were removed to hospital. The number of notifications was equal to 2.75 per 1,000 in comparison with 3.89 for London. The average for the preceding decennium in the Borough was 2.43 per 1,000. Five of the cases were nurses at hospitals in the Borough. Errors in Diagnosis. During the year 2 cases were returned as not suffering from scarlet fever, or 1.5 per cent. of the notifications. Secondary Cases of Scarlet Fever. Excluding the above 2 cases, of the remaining 129 notifications, 89 occurred in houses in which there was no secondary case. In 6 houses 2 cases occurred, in 6 including 1 public institutions 3 cases occurred, in 1, 4 cases, and in a Boys' Home 6 cases occurred. Return Cases of Scarlet Fever. Of the above 26 secondary cases, 6 were "Return" cases, i.e., cases which occurred in a house soon after the return home of a patient from hospital. Of the 5 infecting cases, 1, apparently, was the cause of 2 "Return" cases. DIPHTHERIA. The number of cases of diphtheria was 59 in comparison with 88 in the year 1912. Of these 28 belonged to St. Giles and Bloomsbury and 31 to the Holborn District. All but two in each district were removed to Hospital. The notification rate was 1.23 per 1,000 in comparison with l.70 per 1,000 for London. The average for the preceding decennium for the Borough was 114 per 1,000. Four of the cases were nurses at hospitals in the Borough, 3 being at the same hospital c 2 20 Errors in Diagnosis. Four of the patients were returned from the Hospitals of the Metropolitan Asylums Board as not suffering from diphtheria, or 6.8 per cent. of the cases notified. Secondary Cases. Excluding the above 4 cases and the 4 nurses at Hospitals, of the remaining 51 cases 44 occurred in houses in which there was no secondary case. In one house 3 cases occurred and in 2 houses 2 cases each. Return Cases. There was no "return" case during the year. Diphtheria Anti-toxin. Diphtheria Anti-toxin was supplied free of charge in 6 cases ENTERIC FEVER. Excluding duplicates there were 7 notifications in comparison with 12 in the preceding year. 1 belonged to St. Giles and Bloomsbury District and 6 to the Holborn District. All were removed to Hospital. These notifications corresponded to a rate of 0.15 per 1,000 in comparison with 0.17 for London. Errors in Diagnosis. Three cases were returned from the Hospitals of the Metropolitan Asylums Board not suffering from enteric fever, or 42.8 per cent. of the cases notified. Of the remaining 4 cases one was probably not contracted in the Borough. One was a nurse who had been previously nursing enteric fever patients. In the remaining two the patients had been in the habit of frequently eating mussels, and, in one case, oysters also. CEREBRO-SPINAL FEVER. (Epidemic Cerebro-Spinal Meningitis.) No case was notified during the year. 93 cases were notified in London. POLIO-MYELITIS AND ENCEPHALITIS. Two notifications were received during the year. There were 147 notifications in London. One patient was removed to the National Hospital and the other to the Hospital for Sick Children. In each case the diagnosis was confirmed and the children both survived. 21 OPHTHALMIA NEONATORUM. Ophthalmia Neonatorum is an infectious inflammation of the eyes in newlyborn children, and is the most common cause of blindness beginning in infancy. Three cases were notified in the Borough during the year, 2 in St. Giles and Bloomsbury and 1 in the Holborn District. These cases were visited by the Lady Sanitary Inspector. 1 of the infants was attended at an Ophthalmic Hospital, 1 by a private doctor, and 1 was removed to the Central London Sick Asylum, all having nurses also in attendance. PHTHISIS OR CONSUMPTION. The number of deaths from phthisis during the year was 89, or a death-rate of 1.87 per 1,000, or 1.60 if corrected for sex and age distribution. Of these 41 belonged to St. Giles and Bloomsbury, a death-rate of 1.70, and 48 to the Holborn District, or a death-rate of 2.03 per 1,000. Although the death-rate from phthisis is still high in the Borough there has been a satisfactory reduction in the death-rates during the past 10 years, as is shown in the table given below, the last 5 years having been much less than the first 5 years of that decennium. It must also be remembered that in Holborn there is a much larger proportion of persons living in common lodging houses than in any other Loudon Borough. In Holborn the rate is as many as 355 beds per 10,000 of the population; whereas in Hampstead there are no common lodging houses, and 12 Boroughs have less than one-tenth the proportion of Holborn. During the seven years 1904-1910 the average death-rate in common lodging houses in Holborn per 1,000 beds was about 20. Also during those years more than 30 per cent. of the deaths from phthisis in Holborn had been residents in common lodging houses in the Borough. During the past year of the 89 deaths, 20 had been removed to infirmaries from common lodging houses in the Borough, that is about 22.5 per cent. and less than usual, 17 from St. Giles and Bloomsbury, and only 3 from the Holborn District. The corrected number of deaths in London was 5,981, equal to a rate of 1.30 per 1,000, compared with 1.35 for 1911 and 1912. The following table gives the number of deaths in the Holborn Borough and the death-rates per 1,000 (crude and corrected for sex and age distribution of the Holborn population in comparison with London) and the corresponding rates for London, for the 11 years 1903-1913, inclusive. 22 Year Holborn Borough. London. Rate per 1,000 Deaths. Death-Rate per 1,000. Crude. Corrected. 1903 170 2.98 2.62 1.57 1904 157 2.80 2.46 1.65 1905 149 2.71 2.38 1.46 1906 118 2.18 1.92 1.49 1907 125 2.36 2.07 1.46 1908 105 1.97 1.73 1.39 1909 108 2.11 1.85 1.40 1910 98 1.96 1.72 1.23 1911 96 1.96 1.72 1.35 1912 95 1.98 1.74 1.35 1913 89 1.87 1.60 1.30 Notification of Consumption. Public Health (Tuberculosis) Regulations, 1908, 1911, & 1912. The Voluntary Notification of Consumption which had been in force from the 1st January, 1904, and had been partly superseded by the Public Health (Tuberculosis) Regulations, 1908 (Poor Law Cases), and the Public Health (Tuberculosis in Hospitals) Regulations, 1911, was finally and completely superseded by the Public Health (Tuberculosis) Regulations, 1911, which came into force on the 1st January, 1912. These Tuberculosis Regulations of 1911 were superseded by the Public Health (Tuberculosis) Regulations, 1912, which made compulsory the notification of all forms of tuberculosis, and came into force on the 1st February, 1913. Excluding duplicates the total number of notifications received was 204, of which 58 were private cases, 73 hospital cases, and 73 poor-law cases. Of the total number 56, or 27.4 per cent., were residents of common lodging houses, and were all but 1 at once or soon afterwards removed to workhouse infirmaries. With few exceptions the remaining 148 lived in tenement houses, and 60 of these were removed to infirmary or hospital, 89 remaining at home, but some of these had previously been in infirmaries, hospitals or sanatoria. In previous annual reports I have given details of the action that is taken and the various results that were obtained from the enquiries made. After death, or removal to infirmary or hospital, disinfection is advised. Consent for this was obtained in 33 cases. 23 National Insurance Act. Sanatorium Benefit—Tuberculosis Dispensary. In my last Annual Report I gave details respecting the above and the Report of the Departmental Committee on Tuberculosis. The provision of a Tuberculosis Dispensary has again received much consideration during the year. The Public Health Committee recommended that, subject to the satisfactory settlement of details, the Council should approve a proposed scheme for the establishment of a Tuberculosis Dispensary at St. Bartholomew's Hospital, in accordance with a scheme submitted by the Sanitary Committee of the City of London. That scheme also included the Borough of Finsbury. This recommendation, however, was referred back for further consideration, after consultation with the Holborn District Insurance Committee when constituted. The Borough of Finsbury, however, decided to provide a separate Municipal Dispensary, and the matter was then deferred until the report of the London County Council on the provision of Tuberculosis Dispensaries in London had been considered. Proposed schemes for the use of Tuberculosis Dispensaries at the Royal Free Hospital and the University College Hospital have also been considered, and the Council is now awaiting a reply from the Middlesex Hospital respecting the use of their Tuberculosis Dispensary by this Council. The Memorandum of the Insurance Committee for the County of London on the treatment of insured persons at Tuberculosis Dispensaries provided by Borough Councils is also now under consideration. During the year I received information from the London Insurance Committee that 25 of a number of insured persons who applied for sanatorium benefit had been admitted to sanatoria or hospitals for consumption. I received information of the discharge of 24 of these after periods of residence varying from 14 days to 4 months. In 17 of these cases the only information supplied was the date of admission and the date of discharge. Of the remaining 7 one did not return from special leave, in 3 cases the symptoms were quiescent and the patients were fit for light work, and the remaining 3, in 2 of which it was stated there were still tubercle bacilli in their sputum, were discharged, 2 to continue tuberculin treatment at a dispensary or hospital and the other for domiciliary treatment. At least 3 of the patients died during the year; one 15 days after admission and the other two 5 days and 17 days respectively after discharge. GLANDERS, ANTHRAX AND HYDROPHOBIA IN MAN. No notifications were received. 24 BACTERIOLOGY. The following table gives details of the examinations made by the Royal Institute of Public Health during the year. Diphtheria. Enteric Fever. Consumption Gonococci. Number Submitted. Result of Examination. Number Submitted. Result of Examination. Number Submitted. Result of Examination. Number Submitted. Result of Examination. 59 50 bacilli not found 4 4 Negative 115 85 bacilli not found 2 1 Negative 9 bacilli found - Positive 30 bacilli found 1 Positive DISINFECTIONS. During the 53 weeks ended January 3rd, 1914. District. Rooms. Bedding, &c. Number of Articles. Number of Persons using Shelter. St. Giles and Bloomsbury 244 2,240 - Holborn 179 2,031 9 Whole Borough 423 4,271 9 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 Holhorn, was demolished in July, 1906, the Council made arrangements with the adjoining Borough of Finsbury for the use of their shelter. As the disinfectors work very early and very late, if required, it was only necessary to use the shelter during the year for the accommodation of 2 families consisting of 9 persons. CLEANSING OF PERSONS ACT. During the last eight months of the year 42 persons (36 men and 6 women) infested with vermin had their bodies and clothing disinfested free of charge. All had their bodies cleansed in the new Cleansing Station at the Public Mortuary, and 360 articles were disinfested in the Council's steam apparatus. 25 The Casual Wards were taken over by the Metropolitan Asylums Board on the 1st April, 1912, and new arrangements for the cleansing of persons were considered by the Public Health Committee. The Coroner's Court, which used to be on the ground floor of the Public Mortuary was transferred to the Court Room on the completion of the new Council Offices in 1908. Various plans and suggestions for the alteration of the Mortuary to include a Cleansing Station for men and women were submitted to the Public Health Committee, and the alterations and improvements were completed by May, 1913. Under the London County Council (General Powers) Act, 1907, powers are given to that Council for the compulsory cleansing of verminous children attending any of the Council's schools, and verminous inmates of any common lodging house. The latter, however, are cleansed at our Cleansing Station. HOUSING OF THE WORKING CLASSES ACTS. Housing, Town Planning, &c., Act, 1909. Proceedings under Section 17. Houses Inspected. Represented by MediealOfficer of Health. Defects Remedied without Closing Orders. Closed Voluntarily. General Character of Defects. Remarks. Short's Gardens, 40 and 42 Yes (in 1912) No - Insufficient light and ventilation of rooms, staircase and W.C.'s. Defective roofs, dampness and dilapidations Closing order made January, 1913. Closing order determined 23rd April, 1913. Leather Lane Buildings Yes - — ditto Closing order made. Verulam Street, 27 and 28 No Yes — ditto — Upper Montague Mews, Nos. 1 to 28 No Yes — ditto - Torrington Mews, No. 20 No — Yes ditto - Red Car Yard, No. 4 No — Yes. ditto — Old North Street, Nos. 1, 2, 3, 4, 8, 9 and 10 No Yes — ditto — Theobald's Road, No. 12, 28, 36, 38 and 42 No. 38 Yes — ditto - Evelyn Buildings Yes In hand — ditto Pending. Gower Mews, Nos. 1 to 20 No Yes - ditto - Total 67 (including 1 in 1912). 4 (including 1 from 1912) 62 2 — 2 closing orders. 1 pending. D 26 A large number of other houses were inspected by me, but were not reported to the Housing of the Working Classes Committee, as they did not appear to me to be in a state so injurious or dangerous to health as to be unfit for human habitation. It was necessary to make two closing orders during the year—viz., for Nos. 40 and 42, Short's Gardens, which was subsequently determined, when the premises had been made fit for human habitation, and for Leather Lane Buildings, which are still closed. I made lists of dwelling-houses, including the above 67, the early inspection of which was in my opinion desirable, and keep adding to these lists from time to time. Underground Rooms habitually used as Sleeping Places. In accordance with the Sub-Section 7 of the same Section (17) of the Act, I again prepared and submitted suggested regulations, and after careful consideration by the Committee the matter was adjourned for the present. Erection of Dwellings for the Working Classes. The erection of dwellings for the working classes under Part 3 of the Housing of the Working Classes Act, 1890, has received much consideration during the year. From time to time, and in previous years also, I inspected and reported upon proposed sites. In May, 1913, the Committee considered the island site in Short's Gardens, bounded on the east by Nottingham Court and on the west by Neal Street, the most suitable site of three sites then considered. Negotiations were at once entered into for the purchase of the site, and in July the Council made an order for compulsory purchase. Negotiations for the purchase of the site are now practically completed. Several reports respecting the construction and plans for proposed new dwellings were prepared by the Borough Surveyor, and received the careful consideration of the Housing of the Working Classes Committee. One of these was finally selected and agreed to by the Council in February, 1914. LIST OF PREMISES CLOSED, DEMOLISHED OR REBUILT DURING 1913. St. Giles and Bloomsbury. Alfred Mews, South Side. New show rooms, offices and Telephone Exchange completed. Alfred Mews, Nos. 18, 19 and 20. Premises closed, to be demolished. 27 Alfred Place, Nos. 30 and 31. New extension to Emily Harris Homes built. Do No. 19. New extension to Messrs. Caley's premises completed. Do. No. 29. New premises being built. Betterton Street, Nos. 15 and 16. Site still vacant. Do. No. 22. New warehouses completed. Do. No. 31. Closed. Chenies Street, No. 7. New cabinet factory completed. Drury Lane, Nos. 192 and 193. Demolished. Francis Street, Nos. 14 to 18. New temporary Police Court completed. Goldsmith Street, Nos. 3, 5 and 7. Site still vacant. Gower Street, Nos. 22 to 42. Site still vacant. Great Queen Street. South-east corner site rebuilt. Regent House. Do. Nos. 24, 24a, 25 and 26. Rebuilt. Do. Nos. 77 and 77b. Demolished. High Holborn, Nos. 171 to 181. Demolished. Do. Nos. 249, 250, 251, 252, 253, 254 and 255. Built. Pearl Assurance Company's Office. Do. Nos. 295 to 302. Being rebuilt. Keppel Mews (North). Nos. 43 and 44. Site still vacant. Do. Nos. 49 and 58 do. Keppel Street (North Side). New premises being built. Do. (South Side). Site still vacant. Kingsway. Queen's House. Being built. Do. West African House, do. Do. Windsor House. do. Do. Regent House. do. Do. (East Side). Corner site of North Side of Sardinia Street. Being built. Official Receiver's Offices. Little Earl Street, Nos. 9, 10 and 12. Closed to be demolished. Lincoln's Inn Fields, .Nos. 53, 54, 55 and 56. Being rebuilt. Official Receiver's Offices. Lumber Court, Nos. 13 and 14. New Theatre built. Malet Street. New Theatre being built. Montague Place (North side). Site still vacant. Neal Street, Nos. 34, 36, 38, 40, 42, 44 and 46. Demolished. New Yard, No. 12. Rebuilt. North Crescent, Nos. 1 to 14. New Show rooms, Offices and Telephone Exchange. Built. Nottingham Court, Nos. 13, 14, 15 and 16. Demolished. Parker Street, Nos. 34, 36 and 38. Rebuilt. Do. Nos. 51 and 53. Being rebuilt. Red Lion Yard. Workshops. Rebuilt. Pearl Assurance Company's Offices. d 2 28 Russell Mews. Site still vacant. Russell Square, Nos. 65 and 66. Rebuilt, as the Imperial Hotel extension. Do. No. 30. New premises being built. Short's Gardens, Nos. 30 and 32. Closed. Do. No. 19. Unoccupied. Converted into a Warehouse. South Crescent, Nos. 1 to 5. New Garage built. Store Street, No. 24. Torrington Mews, Nos. 11 to 19, 21, 22 and 23. Site still vacant. Do. Nos. 1, 2 and 20. Demolished. Do. (East), Nos. 7 and 8. Closed. Tottenham Court Road, Nos. 203 and 208. New Factory, Offices, &c., built. Do. Nos. 193 and 195. Site still vacant Tower Street Nos. 11, 12 and 13. New Theatre built. West Street, Nos. 20, 22 and 24. New Theatre built. Whetstone Park. Nos. 38 and 39, and Carter's Seed Warehouse. Rebuilt for the Pearl Assurance Company's offices. Woburn Mews, Nos. 15-34. New National Hotel being built. West side. Woburn Place, Nos. 42-53 do. Holborn. Beadle Court, Eagle Street. Being built. Bishop's Head Court, No. 1. Still unoccupied. Do. Nos. 2 to 11. Rebuilt. Boswell Court, Nos. 10 to 13. Site still vacant. Brooke Street, Nos. 23, 25 and 27. Rebuilt. Chancery Lane, Nos. 50, 51 and 52. Rebuilt. Cockpit Yard, No. 10. Premises still closed. Cross Street, Nos. 15, 16 and 17. Demolished. Devonshire Street, Nos. 44, 45, 46 and 47. Site still vacant. Dorrington Street (North Side), between No. 11 and St. Ursula's Home. Being rebuilt. Dunstable Court. Site still vacant. Eagle Street, Nos. 21, 22 and 23. Being rebuilt. Do. No. 42. Site still vacant. Do. No. 43. Rebuilding. Do. No. 53. Closed. Do. Nos. 56, 57 and 58. Rebuilt as Warehouses, &c. East Street, Nos. 39 and 40. Demolished. Emerald Street, Nos. 14 to 24. Rebuilt as Factory. Do. No 30. Premises still closed. Gloucester Street, No. 6. Site still vacant. 29 Greville Street, Nos. 2 and 3. Being rebuilt. Harpur Mews, Nos. 12 and 13. Premises closed for demolition. Hatton Garden, Nos. 37 and 38. Rebuilt. Do. No. 17. Rebuilt. Henry Street, No. 5. Site still vacant. Lamb's Conduit Passage, Nos. 14 to 20. Site still vacant. Lamb's Conduit Street, Nos. 10 and 12. Site still vacant. Leather Lane, No. 50. Being rebuilt New Nortli Street, Nos. 14a and 15. Site still vacant. Do. Nos. 20 to 28. Site still vacant. Red Lion Square, Nos. 6 and 7. Demolished and rebuilt as warehouses, Red Lion Street, No. 48. Site still vacant. Rose Alley, Eagle Street. Being rebuilt. Southampton Buildings, Nos. 22 and 23. Rebuilt. Do. Nos. 43, 44, 45 and 46. Being rebuilt. Theobald's Road, Nos. 116 and 118. Premises demolished and rebuilding Cinema. SANITARY WORK. HOUSE TO HOUSE INSPECTIONS, 1913. St. Giles and Bloomsbury. Arthur Street. Herbrand Street. Bainbridge Street. High Street. Bernard Mews. Kenton Street. Broad Street (part of). Lawrence Street. Betterton Street. Little Earl Street. Castle Street. Little St. Andrew Street. Charing Cross Road. Little White Lion Street. Church Passage. Lumber Court. Clark's Buildings. Neal Street. Clark's Mews. New Compton Street. Denmark Place. New Turnstile. Denmark Street. Nottingham Court. Drury Lane. Phoenix Street. Dyott Street. Shaftesbury Avenue (part of). Endell Street. Short's Gardens. Goldsmith Buildings. Smart's Buildings. Goldsmith Street. Stacey Street. Great Earl Street. Tower Street. Great Queen Street (part of). Upper Montague Mews. Great Russell Street (part of). West Street. Great St. Andrew Street. Wild Court. Great White Lion Street. Wild Street. 30 Holborn. Albion Buildings. Little Bath Street. Back Hill. Little Gray's Inn Lane. Beauchamp Street. Millman Place. Brownlow Street. Millman Street. Chapel Street. Mount Pleasant. Charles Street. New North Street. Charterhouse Street (part of). Old Gloucester Street. Cross Street. Old North Street. Dane Street. Ormond Yard. Devonshire Street. Parton Street. Eagle Street. Pooles Buildings. East Street. Portpool Buildings. Emerald Street. Princeton Street. Evelyn Buildings. Eed Lion Passage. Eyre Street Hill. Eed Lion Square (part of). Hatton Garden. Red Lion Street. Henry Street. Robert Street. High Holborn. Summer Street. Lamb's Conduit Passage. Theobalds Road. Lamb's Conduit Street. Verulam Street. Laystall Street. Vine Street. Leather Lane Buildings. Warner Street. WATER SUPPLY TO NEW BUILDINGS. During tho year I inspected and gave certificates for the following premises:— Imperial Hotel Extension, Southampton Row. 9, Little Turnstile. 190, Drury Lane. 17, Hatton Yard. Lincoln's Inn House, 40 and 42, Kingsway. 30 and 31, Alfred Place. 51 and 52, Chancery Lane, and 22 and 23, Southampton Buildings. WATER SUPPLY TO TENEMENT HOUSES. In accordance with the Public Health Act, and Section 78 of the London County Council (General Powers) Act, 1907, 15 notices were served for the provision of additional water supply in tenement houses. 31 BY-LAWS AS TO HOUSES LET IN LODGINGS. At the end of the year, 641 houses were registered under these By-laws, of these, 316 are in St. Giles and Bloomsbury, and 325 in the Holborn District; 6 such houses were removed from the Register principally on account of the closing or demolition of the houses, and in some cases because the houses are now occupied only by members of one family, and 41 were added to the Register, During the year, there were 901 inspections of these premises, excluding a very large number of periodical inspections and re-inspections. 17 notices were served for 24 overcrowded rooms, and 222 notices for other breaches of the By-laws, exclusive of 630 notices that were served for annual cleansing as required by the By-laws. REVENUE ACTS. Two applications were received during the year for Certificates from me under the above Acts. The houses comprised five tenements, the remaining parts being used for business purposes. The Certificates were refused. OVERCROWDING. The number of dwelling rooms found to be overcrowded was 39, the same as 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 at least twice a week, and oftener if required by the Medical Officer of Health. In the main thoroughfares there is a daily collection before 10 a.m. / As usual, much attention was given to securing the regular removal of house refuse. A large number of inspections were made by me and the inspectors, including early morning inspections, of the streets in which there is a daily removal. Only 7 genuine complaints respecting non-removal of house refuse were received from householders. 106 notices were served for the provision of proper dust receptacles. During the year a number of applications1 were received for the removal of trade refuse for which the Contractor is paid by tbe owners in accordance with Section 33 of the Public Health (London) Act, 1891. In March, 1913, the Council resolved that the London County Council and the Metropolitan Boroughs Standing Joint Committee be informed that it is desirable that local authorities should be empowered to compel occupiers of premises to place house refuse in proper receptacles in such convenient positions for removal as may be required by the sanitary authority, and that the Public Health (London) Act, 1891, and the bv-laws made thereunder should be amended accordingly. 32 REMOVAL OF MANURE. The removal of manure was again carried out satisfactorily. No genuine complaint was received. Posters requiring the periodical removal of manure and other refuse matter from all stables or other premises in the Borough not less frequently than every 48 hours were again posted in the various mews in the Borough. 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 1913:— Of these 14 are in St. Giles and Bloomsbury for 1,060 lodgers. ,, 7 „ Holborn District for 622 „ Total 21 in the Borough for 1,682 „ St. Giles and Bloomsbury. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. Situation of Common Lodging House. Authoi ised No. of Lodgers. Sex of Lodgers. 6, Betterton Street 83 M 1-7, Macklin Street 96 M 2, Kennedy Court 8 W 19, do. 40 W 3, do. 10 W 21, do. 26 W 4, do. 19 W Parker Street Municipal 345 M 5, do. 8 W 7, 9, and 11, Short's Gardens, and 311 M 6, do. 8 W 7, do. 9 w 3, Neal's Yard 6 and 7, Wild Court 63 M 8, do. 34 w Holborn District. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. Situation of Common Lodging House. Authorised No. of Lodgers. Sex of Lodgers. 25, Charles Street 241 M 28, Orde Hall Street 22 M 40. Eaffle Street 50 M 39, Queen Square 52 M 4, Greville Street 53 M 12 and 13, Took's Court 110 M 29, Hatton Wall 94 M 33 FACTORIES, WORKSHOPS AND WORKPLACES. During the year there were 242 inspections of factories, 793 inspections of workshops and 2,536 of workplaces. 264 Intimation Notices for sanitary defects were served and 38 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, 1913. Number of Notices 1913. Number of Prosecutions 1913. On Register at end of 1912. Added in 1913. Removed in 1913 On Register at end of 1913 Premises. Rooms. Intimations. Statutory. Factories.‡ Factory Laundries 3 - - 3 - - - - - Factory Bakehouses 4 - - 4 — 33 - — — Other Factories — — — — — 209 18 2 — Workshops. Workshop Laundries 10 - - 10 30 6 - - - Workshop Bakehouses 28 — — 28 — 200 5 — — Other Workshops 1,171 38 46 1,163 1,849 587 122 23 — Workplaces. Home workers' Premises * 239 55 43 251 - 207 4 - - Places where Food is prepared for Sale† 379 23 5 397 2,095 58 3 3 Workplaces other than the above§ — — — — — 234 57 10 — Total 1,834 116 94 1,856 1,879 3,571 264 38 — * 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 1913, 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 aud notices served where necessary. BAKEHOUSES. At the end of the year 1913, there were 32 bakehouses in the Borough, of which 13 were in St. Giles and Bloomsbury and 19 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. 19 Little Earl Street. 10 Bury Street. 5 Little St. Andrew Street. 164 Drury Lane. 21 Marchmont Street. 155 High Holborn. 77 Marchmont Street. 217 & 218 High Holborn (Holborn 8 Museum Street. Restaurant). 200 Shaftesbury Avenue. 63 High Street. *15 Torrington Place. Holborn. 158 Clerkenwell Road. *28 Lamb's Conduit Street. *9 Cosmo Place. *55 Mount Pleasant. 13 Dane Street. 19 Red Lion Street. *4a East Street (Factory). 50 Red Lion Street. *51 Farringdon Road (Factory). *74 Red Lion Street. 33 Great Ormond Street. 92 Theobald's Road. 1 Greville Street. 124 Theobald's Road. *91 Leather Lane (Factory). *Viaduct Buildings, also 17 Charter- *6 Lamb's Conduit Street. house Street (Factory). 50 Lamb's Conduit Street. 36 Warner Street. During the year, in addition to my inspections, there were 233 inspections of bakehouses, including 33 inspections of the factory bakehouses. Five notices were served for various sanitary defects. HOME WORK. Details are given in the preceding Table, and in Table VIII. 3 of the Appendix. Many inspections of homeworkers' premises are also made during house to house and periodical inspections of lodging houses and dwelling houses in which homeworkers reside. Further details respecting factories, workshops, laundries, workplaces, and home work are given in Table VIII. (1, 2, 3, 4 and 5) of the Appendix. PLACES WHERE FOOD IS PREPARED FOR SALE. Under this head are included kitchens of hotels, restaurants and eatinghouses of all sorts, slaughter-houses, tripe, offal and other meat shops, fried 35 fish, eel and other fish shops, premises where ice cream is made, and other places where food is prepared for sale, excluding bakehouses which are given on a previous page. The number of these places on the Register at the end of 1913 was 397; 2,095 inspections were made, and 58 notices were served during the year for sanitary defects found. In addition to the above inspections of places where food is prepared for sale, there were also 838 inspections of market streets, each of which includes a number of stalls at which meat, fish, fruit and vegetables are sold. These streets are also regularly inspected on Saturday evenings and Sunday mornings. SLAUGHTER-HOUSE. There is now only one slaughter-house in the Borough, viz., No. 29, Red Lion Street, which, in addition to my inspections, was inspected on 13 occasions during the year. Only sheep are killed. DAIRIES, COWSHEDS AND MILKSHOPS. The number of registered dairies and milkshops in the Borough at the end of the year was 188, of which 76 were in St. Giles and Bloomsbury and 112 in the Holborn District. In all 13 dairies and milk shops were newly registered, 8 belonging to St. Giles and Bloomsbury and 5 to the Holborn District, and 9 were removed from the Register. In addition to my inspections the Sanitary Inspectors made 704 inspections of these premises, and 6 notices were served for sanitary defects or breaches of regulations, and in some cases alterations were carried out without the service of notices. PUBLIC HEALTH (MILK & CREAM) REGULATIONS, 1912 The following particulars of proceedings taken in the year 1913, under the above Regulations, made in pursuance of the Public Health (Regulation of Food) Act, 1907, are given in the form suggested by the Local Government Board in their circular letter dated 27th October, 1913, and a copy was sent to the Board in January, 1914. e 2 36 1.—Milk, and Cream not sold as PreservedCream. Number of samples examined for the preserve of preservatives. Number in which a preservative was reported to be present. Milk 225 One (a) Cream 4 One (b) Nature of Preservative found. (a) Milk. Boric Acid 11.46 grains per pint. Insufficient evidence to prove wilful neglect either against vendor or wholesale dealer. Full report respecting this sample sent to Local Government Board. (b) Cream. 0.173 per cent. Boric Acid. Vendor cautioned. (First offence). 2.—Cream sold as Preserved Cream. (a) Instances in which samples have been submitted for analysis to ascertain if the statements on the labels as to preservatives were correct:— (I.) Correct statements made 9 (II.) Statements incorrect - Total 9 (b) Determination made of milk fat in cream sold as preserved cream:— (I.) Above 35 per cent. 9 (II.) Below 35 per cent. - Total 9 (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream in Article V. (1) and the proviso in Article V. (2) of the Regulations have not been observed:— None. 3.—Thickening Substances. Any evidence of their addition to cream or to preserved cream. Action taken where found. None found. 4.—Other observations, if any:— None. 37 ICE CREAM. During the year there were 54 premises in the Borough where ice cream was manufactured or sold, and in addition to my inspections 163 inspections of these premises were made. As ice cream is often made in the early morning, inspections between 6 and 9 a.m. were also occasionally made in order to ascertain whether there were any infringements of the London County Council (General Powers) Act, 1902. Three such infringements were found, two being the making of ice cream in a bedroom, and one the making of ice cream in a living room. In each of the two former the defendants were convicted and ordered to pay 40s. fine and 2s. costs, and in the latter the defendant was convicted and ordered to pay 2s. costs. 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:— 36 baskets Plums. 1 mould of Jelly. 44 lbs. Strawberries. 11 tins Sardines. 452 tins Preserved Fruits (assorted). 24 tins Tinned Fish. 21 bottles Do. 6 boxes Fish. 7 tins Preserved Vegetables. 1 bag Potatoes. 7 bottles White Wine Vinegar. 47 tins Condensed Milk. 10 bottles Anchovy Vinegar. 4 boxes Dates. 15 bottles Herbs. OFFENSIVE FUMES FROM FACTORI S. Complaints are occasionally received of nuisances from offensive fumes from premises which have been dealt with in former years. These are now generally only due to some accident or temporary defect, and the nuisances are soon abated. At one of these premises, a large refinery of gold and other precious metals, many additions and improvements to the plant have been effected, including large new plant for refining by means of electrolysis. SMOKE ABATEMENT. The smoke shafts in the Borough were frequently kept under observation, and in 108 cases the inspections were recorded, but in very few cases were smoke nuisances discovered. 38 Very few complaints of smoke nuisances were received during the year. Three Intimation Notices were served, and in one case, in which several complaints had been received and recurring nuisances had been observed, Statutory Notice was served. Since the service of the Statutory Notice only slight nuisances of very short duration have been observed. For further details of Sanitary Work and Legal Proceedings see Tables V., VI., VII., VIII., IX. and X. METEOROLOGY OF LONDON, 1913. The mean temperature of the year was 51.3, and was 1.8° above the average for the preceding 70 years as deduced from observations at Greenwich, under the superintendence of the Astronomer Royal. The rainfall was 22.44 inches, and was 1.68 inches below the average of the preceding 65 years. J The daily mean duration of bright sunshine was 3.63 hours, and was 0.52 hours below the average of the preceding 16 years. It was 30 per cent. of the total possible sunshine. Further details are given in Table XI. of the Appendix. 39 APPENDIX. TABLE I. Vital Statistics of Whole District during 1913 and Previous Years. Name of District—The Mktropolitan Borough of Holborn. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District. Under 1 Year of Age At all Ages. Uncorrected Number. Nett. Number. Rate. of Nonresidents registered in the District. of Residents not registered in the District. Number. Rate per 1,000 Births. Number. Rate. 1 2 3 Number. 4 Rate. 5 6 7 8 9 10 11 12 13 1907 53,247 1,570 1,008 19.0 1,131 21.3 606 387 132 116 912 17.2 1908† 52,224 1,543 1,066 20.1 1,064 20.1 599 403 118 111 868 16.4 1909 51,191 1,436 986 19.3 1,067 20.9 637 377 100 101 807 15.8 1910 50,148 1,352 1,017 20.3 913 18.9 567 392 102 100 768 15.4 1911 49,092 1,273 920 18.8 923 18.9 588 407 104 113 742 15.2 1912 48,026 1,250 901 18.8 907 18.9 549 357 70 78 715 14.9 1913† 46,949 868* 797 16.7 910 19.9 583 358 80 100 685 14.4 Area of District in acres (exclusive of area covered by water) 4050 Total population at all ages 9,357 at Census of 1911. Number of inhabited houses 7,895 „ „ Average number of persons per house 6.2 ,, ,, N.B.—In the above Table the populations, birth-rates and death-rates have all been estimated from the Census Populations of 1901 and 1911. *The British Lying-in Hospital was removed from the Borough about May 1st, 1913. † 53 weeks in Registration year. 40 TABLE II. Cases of Infectious Disease notified during the year 1913. Name of District—Holborn. Notifiable Disease. Number of Cases Notified. Total Cases notified in each Locality (e.g. Parish or Ward) of the District. Total Cases Removed To Hospitals. At all Ages. At Ages—Years. St. Giles and Bloomsbury. Holborn. Under 1. 1 to 5 6 to 15. 15 to 25. 25 to 45. 45to 65. 65 and upwards. Small-pox - - - - - - - - - - - Cholera — — — — - — — — — — — Diphtheria (including Membranous Croup) 59 3 17 25 9 8 2 — 28 31 57 Erysipelas 29 1 1 2 5 7 10 3 15 14 12 Scarlet Fever 131 2 27 71 22 8 1 — 58 73 129 Typhus Fever — — — — — — — — — — - Enteric Fever 7 — — — 3 4 — — 1 6 7 Relapsing Fever — — — — — — — — — — - Continued Fever — — - - - - - - - — - Puerperal Fever 1 — — — — 1 — — — 1 — Pulmonary Tuberculosis 169 — 1 9 20 82 53 4 76 93 84 Other forms of Tuberculosis 35 — 9 18 3 4 1 — 13 22 24 Ophthalmia neonatorum 3 3 - - — — — — 2 1 2 Cerebro spinal fever — — — — — — — — — — — Polio-myelitis 2 - 2 — — — — — — 2 2 Glanders — — — — — — — — — — Anthrax — — — — — — — — — — - Hydrophobia - - - - - - - - - - - Totals 436 9 57 125 62 109 67 7 193 243 317 41 TABLE III. Cause of, and ages at, Death. Causes of Death. Net Deaths at the Subjoined Ages op "Residents" whether occurring within or without the district Deaths in Localities (at all ages). Total Deaths whether or "Residents" or "NonResidents" in Institutions in the District. All Ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 23 and under 45 years. 45 and under 65 years. 65 and upwards. St. Giles and Bloomsbury. Holboru. All causes Certified 685 80 20 8 24 21 118 229 185 335 350 615 Uncertified - - - - - - - - - - - - Enteric Fever - - - - - - - - - - - 1 Small-pox — — — — — — — — — — — — Measles 8 5 2 1 — — — — — 2 6 1 Scarlet Fever — — — —- — — — — — —' — — Whooping Cough 6 3 2 1 — — — — — 3 3 24 Diphtheria and Croup 4 — 1 - 2 — - 1 — 3 1 5 Influenza 8 1 — — — — 4 2 1 3 5 - Erysipelas 1 1 - - - - - - - - 1 2 Phthisis (Pulmonary Tuberculosis) 89 - - - 1 8 45 32 3 41 48 24 Tuberculous Meningitis 8 1 1 2 4 — — - - 3 5 51 Other Tuberculous Diseases 8 1 - 1 - 1 - - - - 3 30 Cancer, Malignant Disease 50 - 1 - 6 28 15 32 18 37 Rheumatic Fever 2 - — - 1 1 - - - - 2 2 Meningitis 3 1 1 - 1 - - - - 1 2 8 Organic Heart Disease 39 — — — 2 2 4 22 9 25 14 14 Bronchitis 72 8 — — - — 3 25 36 34 38 13 Pneumonia (all forms) 65 10 5 1 - 4 9 19 17 28 37 48 Other Diseases of Respiratory Organs 8 - - - - - 2 3 3 5 3 9 Diarrhoea and Enteiitis 15 7 5 I — — 2 - - 2 13 57 Appendicitis & Typhlitis - — — - — — — - - - - - Cirrhosis of Liver 11 — — — — — 2 8 1 9 2 1 Alcoholism 7 — — — — — 4 2 1 5 2 5 Nephritis and Bright's Disease 12 - _ - 1 _ 6 8 7 13 9 12 Puerperal Fever 1 — — — — 1 — - - — 1 1 Other accidents and diseases of Pregnancy and Parturition 1 - - - - - 1 - - - 1 1 Congenital Debility and Malformation, including Premature Birth 30 30 - - - - - - - 10 20 60 Violent Deaths, excluding Suicide 21 4 - 1 3 - 3 4 6 6 15 8 Suicide 7 — — — — 1 1 5 - 3 4 1 Other Defined Diseases 202 7 3 - 8 3 26 69 86 106 96 192 Diseases, Ill-Defined or Unknown 2 1 — — - - - 1 - 1 1 2 All causes 685 80 20 8 24 21 118 229 185 335 350 615 42 TABLE IV. Infantile Mortality during the Year 1913. Nett Deaths from stated causes at various Ages under One Year of Age. Cause of Death. Under 1 Week 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 4 Weeks. 4 Weeks and under 3 Months 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under One Year. All Causes. Certified 19 5 4 3 31 14 15 5 15 80 Uncertified — — — - — — — — — — Small Pox — — — — — — — — — — Chicken Pox — — — — — — — — — — Measles — — — — — — — 1 4 5 Scarlet Fever — — — — — — — — — — Diphtheria and Croup — — — — - - - - - - Whooping Cough — — — - — — 2 — 1 3 Diarrhœa — — — - — 1 2 1 2 6 Enteritis — - — — — 1 — — — 1 Tuberculous Meningitis — - — — — — — — 1 1 Abdominal Tuberculosis — — — — — — — — 1 1 Other Tuberculous Diseases — — — — - - - - - - Congenital Malformations — — — — - - - - - - Premature Birth 13 3 1 — 17 3 — — — 20 Atrophy, Debility, Marasmus 1 1 — 1 3 3 3 — 1 10 Atelectasis - — — — - — — — — — Injury at birth — — — — — - — — - — Erysipelas — — 1 — 1 — — — — 1 Syphilis — — — — — — — — — — Rickets — — — — - - - - - - Meningitis (not Tuberculous) — — — — — — — — 1 1 Convulsions — — — — — 1 1 — - 2 Gastritis - — — — — — — — — — Laryngitis — — — — — — — — - — Bronchitis — — — — — 4 2 1 1 8 Pneumonia (all forms) 1 - 1 1 3 2 3 — 2 10 Suffocation, overlying — — 1 — 1 — 1 — 1 3 Other causes 4 1 — 1 6 — 1 1 — 8 19 5 4 3 31 11 15 5 15 80 Nett Births in the year legitimate, 742 illegitimate 55 Nett Deaths in the year of legitimate infants 71. illegitimate „ 8. deserted „ 1. 43 TABLE V. Sanitary Inspectors' Work.—Inspections, &c. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange. Whole Borough. Inspections. Infectious Diseases 73 109 79 149 410 Dwelling Houses 205 309 119 93 726 Lodging Houses 340 228 197 146 901 Common Lodging Houses 20 21 22 — 63 Dairies, Cowshedsand Milkshops 105 259 340 — 704 Ice Cream—Manufacture or Storage 18 39 106 — 163 Slaughter-house — 13 — — 13 Market Streets 344 59 435 — 838 Butchers' Shops 623 169 267 — 1,059 Bakehouses 42 108 83 — 233 Other Food Shops 257 131 461 11 860 Laundries 2 — 1 3 6 Other Workshops 156 176 108 147 587 Out-Workers' Rooms and Registers 28 38 35 207 308 Other Workplaces 88 55 88 3 234 Factories (excluding Bakehouses and Laundries) 30 23 46 2 101 Smoke shafts 19 6 83 — 108 Urinals — 50 4 — 54 Miscellaneous 183 34 102 — 319 Periodical Inspections* 1,739 2,026 2,411 51 6,227 Dust† 43 122 25 — 190 Mews 87 133 8 — 228 Maternity — — — 524 524 Total Inspections 4,392 4,108 5,020 1,336 14,856 No. of Re-Inspections 1,331 1,526 789 707 5,819 Do. do. Maternity — — — 1,466 Visits other than Inspections and Re-Inspections 431 772 851 240 2,465 Do. do. Maternity — — -1 171 Total 6,154 6,406 6,660 3,920 23,140 * The majority of these are weekly inspections of Registered Looping Houses. † A large number of inspections respecting the removal of Refuse is also made during General and Periodical Inspections of houses. F 2 44 TABLE VI. Sanitary Inspectors' Work.—Notices served. Inspector Bennett. Inspector Clark. Inspector Lirard. Inspector Orange. Total. Intimation Notices—Total served 163 357 278 145 943 Houses 130 255 168 126 679 The house or part of the house in a dirty condition 50 44 29 47 170 The house or part of the house in a damp condition 1 7 14 6 28 The house in a dilapidated condition 9 43 16 8 76 The watercloset so foul as to be a nuisance 6 11 21 4 42 Do. without a water supply 10 11 18 — 39 Do. with a deficient supply of water 6 5 4 — 15 Do. improperly constructed — — — — - Do. so defective as to be a nuisance 8 23 23 16 70 Do. stopped 5 31 34 7 80 Do. placed in an improper position 2 — — 1 3 Insufficient external ventilation to watercloset 12 14 2 — 28 Insufficient watercloset accommodation 5 7 2 14 28 Absence of watercloset accommodation — - 1 — 1 Absence of proper watercloset accommodation for persons of each sex See under Workshops &c. The soil pipe defective — 4 — 4 Do. unventilated 1 - 1 - 2 Do. improperly ventilated — — - — — The yard paving defective 6 10 7 2 25 Do. dirty 1 13 4 4 22 Do. undrained — - — - The area improperly paved — 1 1 — 2 Do. dirty 1 6 7 14 Do. undrained — - 1 1 The inlet of surface drain improperly trapped — — — — — A gully trap improperly placed within the house — — — — — The waste pipe of sink improperly connected with the drain 2 1 11 1 14 Do. do. improperly trapped — — — — - Do do. untrapped 5 10 5 — 20 Do. of lavatory improperly connected with the drain 1 - - - 1 Do. do. improperly trapped — — - - - Do. do. untrapped — 1 - — 1 Do. of bath directly connected with the drain - - - - - Do. do. improperly trapped — Do. do. untrapped 1 1 The water cistern so foul as to be a nuisance 17 9 7 9 42 Do. being without a close fitting cover 1 12 6 4 22 Do. being placed in an improper position - 3 1 - 4 Do. defective 2 2 _ 1 5 An accumulation or deposit of refuse 2 28 11 5 46 The absence of proper ashbin 12 15 5 3 35 The ashbin defective 8 15 3 7 33 The drain foul - - 1 - 1 Do. defective 2 10 2 14 Do. choked or stopped 6 24 9 6 45 Do. unventilated — — — — — 45 TABLE VI.—continued. Sanitary Inspectors' Work.—Notices served, —continued. Inspector Bennett. Inspector Clark. Inspector Larard. Inspector Orange. Total. Houses—continued. The rainwater pipe in direct communication with the drain - - - - - Do. do. do. with the soil pipe — — — — — Do. do. defective 1 6 7 14 The water supply used for domestic purposes connected with tho cistern which is used for flushing the watercloset - - - - - The absence of proper water supply 7 5 2 1 15 The roof defective 13 18 9 2 42 The guttering defective — 3 2 — 5 The paving of wash-house defective — 4 1 — 5 The want of proper manure receptacle 1 3 1 — 5 An animal kept in such place or manner as to be a nuisance - 1 1 - 2 The house or part of the house overcrowded 2 4 3 6 15 An underground room occupied as a dwelling contrary to the provisions of the Act - 13 1 5 19 The space below floor in the basement or ground floor being unventilated - - - 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 - 1 - - 1 Do. with no supply of water Other nuisances 19 24 6 2 51 *Factories, Workshops and Work Places 33 102 110 19 204 Dirty 14 31 35 10 90 Waterclosets, defective or dirty 9 25 25 1 60 Do. insufficient. 1 - 1 - 4 Do. absence of separate accommodation for sexes 1 3 4 5 13 Drains, soil pipes, &c., defective 2 5 13 20 Improperly ventilated 2 4 1 7 Overcrowded 1 2 2 3 8 Chimney sending forth black smoke 1 - 2 3 Other nuisances 4 21 32 2 59 Ashbins 2 21 11 1 35 Breach of Bye-laws or Regulations— †Lodging-houses 34 93 50 62 239 Dairies, cowsheds, milkshopsand slaughterhouses Keeping of animals 1 3 1 - 5 Removal of Refuse - 4 - — 4 London County Council (General Powers) Acts Urinals - - - - - Verminous Rooms 8 20 64 15 107 Ashpits — 2 — 2 Foodshops 1 1 1 — 3 Statutory Notices 2 - 36 31 1.5 * Many nuisances at workshops that are parts of dwelling houses, are included in the Intimation Notices served under "Houses." † Many breaches of bye-laws are included in Intimation Notices served under "Houses." 46 TABLE VII. Proceedings during 1913. PREMISES. NUMBER OF PLACES— Number of Inspections 1913. Number of Notices 1913. Number of Prosecution 1913. On register at end of 1912. Added in 1913. Removed in 1913. On register at end of 1913. Milk premises 184 13 9 188 704 6 0 Cowsheds 0 0 0 0 0 0 0 Slaughter-houses 1 0 0 1 13 0 0 Other offensive trade premises 0 0 0 0 0 0 0 Ice Cream premises 35 22 3 54 163 0 0 Registered houses let in lodgings 606 41 6 641 901 (a)* 17 (b)* 222 (a)* nil (b)* 5 * (a) For overcrowding. * (b) For other conditions. Total number of Intimation notices served for all purposes 943 Overcrowding, 1913— Number of bwelling Rooms overcrowded 39 Number remedied 39 Number of prosecutions 0 Underground Rooms- Illegal occupation dealt with during year 19 Number of rooms closed 19 Insanitary Houses— Number closed under the Public Health (London) Act, 1891 0 ,, „ ,, ,, Housing and Town Planning Act 1 Ice Cream— Proceedings under London County Council (General Powers) Act, 1902 3 Verminous Rooms— Numbers of premises cleansed under Section 20 of the London County Council (General Powers) Act, 1904 57 Shelters provided under Section 60 (4) of the Public Health (London) Act, 1891 — Number of persons accommodated during the year 9 Revenue Acts— Number of houses for which applications were received during the year 2 Number of dwellings comprised therein 5 Number of tenements for which certificates were (a) granted 0; (6) refused 5; (c) deferred 0 Housing. Town Planning, etc., Act, 1909. Section 35— Number of applications for certificates 0 „ „ beds comprised therein 0 „ ,, certificates granted, 0; refused. 0; deferred 0 Number of prosecutions under Bye-laws under Public Health (London) Act, 1891- (a) For prevention of nuisance arising from snow, ice, salt, filth, etc. 0 (b) For prevention of nuisance arising from offensive matter running out of any manufactory, etc. 0 (c) For the prevention of keeping of animals in such a manner as to be injurious to health 0 (d) As to paving of yards, etc., of dwelling houses 0 (e) In connection with the removal of offensive matter, etc. 0 (f) As to cesspools and privies, removal and disposal of refuse, etc. 0 (g)For securing the cleanliness of tanks, cisterns, etc. 0 (h)With respect to water closets, earth closets, etc. 1 (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 90 Total number of infectious bodies removed 0 47 TABLE VIII. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—Inspection. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Intimations. Statutory. Factories (including Factory Laundries) 242 18 2 — Workshops (including Workshop Laundries) 793 131 22 — Workplaces 2,536 115 13 3 Total 3,571 264 37 3 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 8 8 Want of drainage of floors — — — — Other nuisances 114 114 - - Sanitary accommodation insufficient 4 4 — — unsuitable or defective 60 60 — — not separate for sexes 13 13 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) — — — — Breach of special sanitary requirements for bakehouses (SS. 97 to 100) — — — — Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) — — — — Total 296 296 - — * Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act as remediable under the Public Health Acts. TABLE VIII.—continued. 3.—HOME WORK. NATURE OF WORK.* Octworkers' Lists, Section 107. Outwork in Unwholesome Premises. Section 108. Outwork in Infected Premises, Sections 109, 110. Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. 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. Lists, † Outworkers.† Lists. Outworkers. Contractors. Workmen. Contractors Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) Wearing Apparel— (1) Making, &c. 122 244 501 15 35 30 130 - - - - - - - - (2) Cleaning and washing - — — - - - — — — — - — — - - Household Linen - — — - - - — — — — - — — - - Lace, Lace Curtains and Nets - — — - - — — — — — - — — - - Curtains and Furniture - — — - - — — — — — - — — - - Hangings - — — - - — — — — — - — — - - Furniture and Upholstery - — — - - - — — — — - — — - - Electro Plate — — — - - — — — — — - — — - - File making - — — - - — — — — — - — — - - Brass and Brass Articles - - - - - - — — — — - — — - - Fur pulling — — — - - — — — — — - — — - - Cables and Chains - — — - - — — — — — — — - - Anchors and Grapnels — — — - - — — — — — - — — - - Cart Gear - — — - - — — — — — — — - - Locks, Latches and Keys - — — - - — — — — — - — — - - Umbrellas, &c. - — — - - — — — — — - — — - - Artificial Flowers - — — - - — — — — — - — — - - Nets, other than Wire Nets - — — - - — — — — — - — — - - Tents - — — - - — — — — — - — — - - Sacks - — — - - — — — — — - — — - - Racquet and Tennis Balls — — - - — - — — - - — — - - Paper Bags and Boxes 2 — 16 1 - 9 3 — — - - — — - - Brush making 2 — 4 - - — 2 — — - - — — - - Pea Picking — — — - - — — — — - - — — - - Feather sorting — — — - - — — — — - - — — - - Carding, &c., of Buttons, &c — — — - - — — — — - - — — - - Stuffed Toys — — — - - — — — — - - — — - Basket making — — - - - - — — — - — — - - Total 126 244 521 16 35 39 135 — — — — — — — — * If an occupier gives out work of more than one of the classes specified in column 1, and subdivides his list in such a way as to show the number of workers in each class of work, the list should be included among those in column 2 (or 5 as the case may be) against the principal class only, but the outworkers should be 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 strictlj with the statutory duty of sending two lists each year and of the entries of names of outworkers in those lists. The entries in column 2 must necessarily be even numbers, as there will be two lists for each employer—in some previous returns odd numbers have been inserted. The figures in columns 3 and 4 will usually be (approximately) double of the number of individual outworkers whose names are given, since in the February and August lists of the sumo employer the same outworker's name will often be repeated. 49 TABLE VIII-—continued. 4.—Registered Workshops. Workshops on the Register (s. 131) at the end of the year. Number. (1) (2) Important classes of workshops, such as workshop bakehouses, may be enumerated here. Laundries (including 3 factory laundries) 13 Bakehouses (including 4 factory bakehouses) 32 Other Workshops 1,163 Total number of workshops on Register 1,208 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) 9 Action taken in matters referred by H.M. Notified by H.M. Inspector Inspector as remediable under the 29 Public Health Acts, but not under the Report (action being taken) sent Factory and Workshop Acts (s. 5) to H.M. Inspector 29 Other — Underground Bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 21 G 50 TABLE IX. LEGAL PROCEEDINGS. Public Health (London) Act, 1891. Date. Name. Premises. Offence. Result. 1913. June 20 Henry Morrell 8, Clark's Buildings W.O. defective and water cistern dirty. Cover defective. Nuisance abated. Summons withdrawn on payment of 3s. costs. Sept. 23 John Morrell 1, Clark's Buildings Breach of Lodging house Bylaws Defendant convicted, and fined 10s. and 2s. costs. ,, do. 2, do. do. do. ,, do. 4, do. do. do. ,, do. 6, do. do. do. ,, do. 8, do. do. do. Nov. 6 Mrs. Lee 7, Smart's Buildings Breach of L.C.C By-laws. Neglecting to supply sufficient water-closet accommodation. Defendaut convicted, and fined 40s. and 2s. costs London County Council (General Powers) Act, 1902. June 10 Felice Notaro 2, Little Bath Street Making ice cream in a living room Defendant convicted and ordered to pay 2s. costs. ,, Vitel Falo 11, Eyre Street Hill Making ice cream in a bed room Defendant convicted and fined 40s. and 2s. costs. ,, A. Esposito 25a, do. do. do. TABLE X, LEGAL PROCEEDINGS. Sale of Food and Drugs Acts. Date. Name. Address. Offences. Result. 1913. Jan. 3 Solomon Hamberger 80, Neal Street Selling butter containing 80 per cent. foreign fat Defendant convicted and fined 40s. and 12s. 6d. costs. Mar. 14 Dunham Dairies, Ltd. 76, Gray's Inn Road Selling butter containing 78 per cent. foreign fat Defendant convicted and fined £20 and 21s. costs. April 8 G. S. Daunton 1, Guilford Street Selling milk containing 11.2 per cent. added water Defendant convicted and ordered to pay 12s. 6d. costs. „ 9 George Wright 16, Great St. Andrew Street Selling butter containing 30 per cent. foreign fat Defendant convicted and fined 20s. and 23s costs. „ 18 David Mead 21, Newton Street Selline milk 17.0 per cent. deficient in fat Defendant convicted and fined 80s. and 12s. 6d. costs. 51 TABLE X—continued. LEGAL PEOCEEDINGS.—continued. Sale of Foods and "Drugs Acts.—continued. Date. X a me. Address. Offences. Result.[\###] 1913. April 25 ... Williams Bros. 73, Mount Pleasant ... Selling milk 27 percent, deficient in fat Warranty proved. Summons dismissed. May 1 ... George Jones.. 157 .Shaftesbury Avenue Selling butter containing 87 per cent, foreign fat Defendant convicted and fined £3 and 14s. costs. do. do. Selling margarine unlabelled ... Defendant convicted and ordered to pay 1 s. costs June 6 ... Annie Hunt ... 16, Dyott Street Selling milk 7 6 per cent, deficient in fat Defendant convicted and ordered to pay 12s 6d. costs. July 4 ... Margaret Fitzgerald 8, Laystall Street Selling milk 7'6 per cent, deficient in fat Defendant convicted and ordered to pay 12s fid. costs. 8 ... William Bates 172, Wardour Street .. Selling milk 70 per cent, deficient in fat Warranty proved. Summons dismissed. Aug. 1 ... Williams Bros. 73, Mount Pleasant ... Selling milk 6'3 per cent, deficient in fat do. „ 5 ... Charles Lutz ... 6, Lambs Conduit Street Selling milk 11-0 per cent, deficient in fat Defendant convicted and fined 20s. and 12s. 6d. costs. „ 6 ... do do. Selling milk containing 8-7 per cent of added water Summons withdrawn on payment of 2s. costs. Oct. 21 ... Charles W. Jones 1, Clark's Buildings... Selling butter containing 6!) per cent, foieign fat Defendant convicted and fined 30s. and 12s 6d. costs. TABLE XI. Meteorology of London, 1913. (Deduced from observations at Greenwich under the superintendence of the Astronomer Royal. 1913. Air Temperature. Bright Sunshine Rain and other forms of precipitation. Mean of— M ean of A. and B. Difference from Normal.* Daily Mean. Difference from Normal.* Per cent, of possible. Total fall. Difference from Normal,*[\###] Maximum ► Minimum. o o o o hrs. hrs. % ins ins. January 46.1 359 41.0 +2.4 1.76 +0.39 21 2.65 +0.77 February 46.7 35.6 41.1 + 1.7 2. 08 -0.05 21 0.81 -0.67 March 52.0 38.3 45.1 +3.3 2.98 -0.36 25 2.43 + 0.91 April 55.4 38.9 47.1 0.0 4.00 - 1.18 29 2.23 + 0.66 May 66.6 45.3 56.0 + 3.0 6.52 +0.12 42 1.16 -0.76 June 71.4 49.2 60.3 + 1.1 6.81 + 0.28 41 0.73 -1.31 July 68.2 51.8 60.0 -2.4 3.05 -4.08 19 2.12 -0 .28 August 71.1 52.0 61.6 +0.1 4.61 - 1.98 32 2.07 -0. 27 September 67.8 50.2 59.0 + 1.9 4.95 -0.19 89 1.25 -0.90 October 61. 2 45. 9 53.6 + 3.5 3.57 +0.43 34 3.58 +0.80 November 54 2 42.0 48.1 + 4.6 2.39 + 0.72 27 2.53 +0.31 December 45.9 37.7 41.8 + 1.8 0.87 -0.21 11 0.88 -0.95 Year 58. 9 43.6 61.3 + 1.8 3. 63 -0.52 30 22.44 - 1.68 * The averages used are obtained from observations extending over 65 years for Rain, 70 years for Temperature, and 16 years for Sunshine. g 2