LAM 9 REPORT on the VITAL AND SANITARY STATISTICS of the BOROUGH OF LAMBETH DURING THE YEAR 1909. [With an account of the work done by the Sanitary Inspectors and the Health Visitor, and of the proceedings taken under the Food and Drugs, Factory and Workshops, and Public Health Acts] by Joseph Priestley, b.a., m.d., d.p.h., Medical Officer of Health. MERSER & SONS, printers, 268-270 KENNINGTON ROAD, LONDON, S.E. 3 Public Health Department, Lambeth Town Hall, Brixton Hill, S.W. March, 1910. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Lambeth. Mr. Mayor and Gentlemen, I have much pleasure in presenting the 1909 Annual Report on the Vital and Sanitary Statistics of the Borough of Lambeth, shewing a satisfactory decline in the mortality and zymotic rates, as compared with those previously tabulated for the old Parish, and for the new Borough. The infantile mortality-rate is again low. To the Chief Officers of the Council, and to the Public Health Staff, my thanks are due, as also to the Members of the Council for carrying out my suggestions, and acting upon my advice. I am, Mr. Mayor and Gentlemen, Your obedient Servant, Medical Officer of Health. 4 i. vital statistics. The Borough of Lambeth contains 4079.6 statute acres, exclusive of 82.1 tidal water, 0.8 inland water, and 31.8 foreshore, with an estimated total population of 324,188 persons to the middle of 1909, consisting of 153,505 males and 170,683 females, or an excess of 17,178 females. The total estimated increase (1908-1909) of the population is 2,844, but the "natural increment," i.e., the excess of births over deaths (uncorrected) is 3,569, so that an exodus of 725 in excess of those who came into the Borough during 1909 must be assumed. The estimated Populations of the Borough of Lambeth to the middle of 1909 may be tabulated as follow :— Estimated Populations. (Estimated, middle 1909.) I. Wards. Wards. Males. Females. Total. Marsh Cannot be sub-divided with sufficient accuracy on account of the New Borough Wards differing from the Old Parish Wards. Cannot be sub-divided with sufficient accuracy on account of the New Borough Wards differing from the Old Parish Wards. 25921 Bishop's 31259 Prince's 50343 Vauxhall 33288 Stockwell 34491 Brixton 46867 Herne Hill 35470 Tulse Hill 31027 Norwood 35522 Borough of Lambeth 153505 170683 324188 5 II. New Registration Sub-Districts. New Sub-Districts. Males. Females. Total. Waterloo Cannot be sub-divided with sufficient accuracy on account of the New Sub-Districts differing from the Old. Cannot be sub-divided with sufficient accuracy on account of the New Sub-Districts differing from the Old. 25921 Lambeth Church 26541 Kennington 55061 Stockwell 67779 Brixton 82337 Norwood 66549 Borough of Lambeth 153505 170683 324188 6 III. Age-Period. Age-Periods. Males. Females. Total. 0—1 3926 3919 7845 1—5 13535 13438 26973 Total under 5 17461 17357 34818 5—20 44678 46644 91322 20- 40 53620 60885 114505 40—60 28363 31865 60228 60—80 8861 12805 21666 80 upwards 522 1127 1649 Total over 5 136044 153326 289370 7 IV. Parliamentary Divisions (Old). Old Parliamentary Divisions. Males. Females. Total. North 28726 28756 57482 Kennington 41309 41326 82635 Brixton 37153 42967 80120 Norwood 45132 55658 100790 Parliamentary Area of Lambeth 152320 168707 321027 N.B.—The Parliamentary Divisions have not been altered by the London Government Act, 1899, nor by the Proceedings that fixed the Boundaries of the Metropolitan Boroughs, so that the above figures do not agree with those for the Borough as a whole, but are comparable with those of the old Parish of Lambeth given in previous Reports. V. Parliamentary Divisions (Adjusted). * Adjusted Parliamentary Divisions. New Wards. Total. North Marsh 57180 Bishop's Kennington Prince's 83631 Vauxhall Brixton Stockwell 81358 Brixton Norwood Herne Hill 102019 Tulse Hill Norwood * Adjusted Parliamentarv Area of Lambeth — 324188 *N.B.—By the adjustment of the old Parliamentary Division so as to be co-terminous with the new wards. 8 1909—Groups of Metropolitan Boroughs (corrected rates). Enumerated Population, 1891 (Census). Enumerated Population, 1901 (Census). Estimated Population, 1909 (middle of year). Birth-Rate. Death-Rate. Zymotic DeathRate. Deaths under 1 year to 1000 Births. London 4227988 4536379 4833938 24•2 14•0 1•30 108 South Group 1524472 1749956 1953306 24•6 13•5 1•25 103 West Group 770022 826985 881880 20•4 13•2 1•12 108 North Group* 1013378 1055908 1100860 22•1 13•4 0•97 99 Central Group 214464 187791 167284 24•2 18•2 1•69 123 East Group 705652 715739 730608 30•8 16•4 2•08 127 N.B.—This table has been again added for purposes of comparison with previous Lambeth Reports, but is unsatisfactory on account of the differences between the boundaries of the old Sanitary Districts, and the new Cities and Boroughs, of the Metropolis. •The populations in 1891 and 001 are corrected for the transfers between Hackney and Tottenham on April 1st, 1908. 9 Houses.* At the time of the Census, 1901, there were within the Borough of Lambeth 41,511 inhabited houses and 1,825 uninhabited (881 in occupation and 944 not in occupation), whilst 137 were in process of building. At the time of the 1891 Census, the inhabited' houses numbered 38,899. The estimated number of inhabited houses to the middle of 1909 is 43,666, which, with an estimated population (to the middle of 1909) of 324,188 gives an average of 7.4 persons per inhabited house. Rateable Value. The rateable value of the Borough for the year ending March 31st, 1909, was £1,968,216, and a 1d. rate per £1 is estimated to produce £7,607 net for the same year, in both cases inclusive of Government property. Statistics for the County of London (uncorrected). The Registrar-General returns the estimated population of London for the middle of the year 1909 as 4,833,938, consisting of 2,281,151 males, and 2,552,787 females, and states that there were registered during the year 38,176 marriages, 117,547 births (59,910 males and 57,637 females), and 70,682 deaths (36,354 males and 34,328 females). There were registered 6,385 deaths from the seven chief zymotic diseases.† The exccss of registered uncorrected births over deaths (i.e., the natural increment, is 46,865, and the estimated increase of population from the middle of 1908 to the middle of 1909 is 38,181. *The definition of a "house" laid down by the Registrar-General for Census purposes is ''any building that is separated from the next adjoining building by an unbroken party wall." This definition has not been strictly adhered to by the Enumerators in taking the Census. †(The figures are taken from the Annual Summary [Tables 1 and 19) of the Registrar-General. 10 TABLE A. Giving the number of Births and the Birth-Rates in each New Registration Sub-District of the Borough of Larnbeth during 1909 (arranged Quarterly). New Registration Sub-Districts. No. of Births. Total for the Year 1909. Rate per 1000 Inhabitants. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Waterloo* 393 370 361 360 1484 57•3 Lambeth Church 219 171 175 156 721 27•2 Kennington† 424 364 370 343 1501 27•3 Stockwell§ 496 516 503 424 1939 28•6 Brixton 406 407 372 416 1601 19•4 Norwood 293 306 319 281 1199 18•0 Borough of Lambeth 2231 2134 2100 1980 8445 26•4 *lncluding Lying-in Hospital (803 cases, of which 224 belong to Lambeth)—corrected rate (i.e., excluding non-Lambethian births) =34.9. †lncluding Workhouse (203 cases, of which 178 belong to Lambeth)—corrected rate (i.e., excluding non-Lambethian births) =26.8. §lncluding Maternity Hospital (469 cases, of which 111 belong to Larnbeth)—corrected rate (i.e., excluding non-Lambethian births)=23.3. Inner Districts, 33.1; Outer Districts, 20.6 per 1000—uncorrected (whole Borough = 26.4). Inner Districts, 27.5; Outer Districts, 19.7 per 1000—corrected (i.e., excluding non-Lambethian births, whole Borough =23.1.) N.B.—The births in Stockwell new Sub-District are divided equally between the Inner and Outer SubDistricts of the Borough for the purpose of calculating rates in this Table. 11 TABLE B. Shewing the Estimated Populations, Numbers of Inhabited Houses, Marriages, Births, and Corrected Deaths in the Borough of Lambeth during 1909, and in the Parish of Lambeth for ten years (1891-1900). Year. Estimated Population. Estimated No. of Inhabited Houses. Marriages. Registered Births. Corrected Number of Deaths. Deaths in Public Institutions in Lambeth (uncorrected) Total Ages. Under 1 Year. Under 5 Years. Deaths from 7 Chief Zymotic Diseases. New Boro 1909 324188 43666 2440 8445 4540 830 1250 402 1994 l891 276162 38634 2140 9097 5886 1387 2251 692 1438 Old Parish. 1892 280032 38950 2107 9226 5457 1250 2091 705 1578 1893 283936 39265 2233 9222 5219 1325 1925 748 1741 1894 287935 39580 2224 9232 4837 1223 1936 680 1484 1895 291970 39895 2220 9341 5559 1420 2187 732 1511 1896 296061 40210 2445 9592 5098 1313 2045 708 1588 1897 300048 40525 2445 9388 5251 1425 2096 734 1546 1898 304073 40840 2589 9256 5430 1426 2089 726 1543 1899 308108 41155 2523 9433 5886 1488 2198 782 1680 1900 312152 41470 2454 9467 5430 1328 1884 497 1576 Average 1891-1900 294049˙7 40052˙4 2338 9295˙4 5405˙3 1358˙5 2070˙2 700˙4 1568˙5 Note.—(a) Enumerated Population for old Parish at Census 1896 was 295,033, and the enumerated number of Inhabited Houses at Census 1891 was 38,556. (b) Enumerated Population for the new Borough at Census 1901 was 301,895, and the enumerated number of Inhabited Houses at the same Census, 41,511. 12 TABLE C. Shewing the number of persons per house, the Marriage-, Birth-, and Death-Rates (corrected), and proportion of Deaths in Public Institutions, in the Borough of Lambeth for the Year 1909, and in the old Parish of Lambeth for ten years (1891-1900). The Year. Marriage-rate per 1000 Population. Birth-Rate per 1000 Population. Corrected Death-Rate per 1000 Population. Corrected Deaths of Children under 1 year per 1000 total Births. Deaths of Children under 1 year per 1000 Deaths (corrected) Deaths of Children under 5 years, per 1000 Deaths (corrected) Corrected Zymotic DeathRate, per 1000 Population. Deaths in Public Institutions per 1000 total uncorrected Deaths. New Boro' 1909 15•0 26•4 14•0 98•3 182•8 275•3 1•2 408•9 Old Parish. 1891 15•5 32•9 21•3 152•5 235•6 382•4 2•5 236•6 1892 15•0 32•9 19•5 135•5 229•1 383•2 2•5 272•4 1893 15•7 32•5 18•4 143•7 253•9 368•8 2•6 305•9 1894 15•4 32•1 16•8 132•5 252•8 400•3 2•4 284•7 1895 15•2 31•9 19•0 152•0 255•4 393•4 2•5 257•9 1896 16•5 32•4 17•2 136•9 257•6 401•1 2•4 295•9 1897 16•3 31•3 17•5 151•8 271•4 400•1 2•4 281•7 1898 17•0 30•4 17•9 154•1 262•6 384•7 2•4 277•8 1899 16•3 30•6 19•1 157•7 252•8 373•4 2•5 277•1 1900 15•7 29•4 17•4 144•9 244•6 346•9 1•6 282•5 Average 1891-1900. 15•9 31•6 18•4 146•1 251•3 382•9 2•4 276•7 Note.-(a) Enumerated number of Inhabited Houses for the old Parish at Census 1891 was 38556. (b) Enumerated number of Inhabited Houses for the new Borough at Census 1901 was 41511. 13 the birth rate. The total number of Births registered' in the Borough of Lambeth during the year 1909 was 8,445. Of the total 8,445 births, 4,301 were males, and 4,144 females, showing an excess of 157 males. Of the total 8,445 births registered in the Borough of Lambeth, 803 took place in the Lying-in Hospital (York Road), and of these 224 belong to the Borough; 203 took place in the Workhouse (Brook Street), and of these 179 belong to the Borough; whilst 469 took place in the Maternity Hospital (Jeffrey's Road), and of these 111 belong to the Borough. Thus, there are 962 births belonging to other districts. The Lying-in Hospital, the Workhouse and the Maternity Hospital tend to abnormally increase the birthrates in Waterloo, Kennington and Stockwell Districts respectively, and the necessary corrections are, consequently, made in a footnote to Table A (see p. 10). The birth-rate for Lambeth is 26.4 per 1,000 inhabitants (28.02 for males, and 24.3 for females); whilst in the various Registration Sub-Districts the birth-rates work out as shown in Table A, from which it will be seen that the uncorrected birth-rate in the Inner Districts is 33.1, and that in the Outer Districts 20.6 per 1,000—the corrected birthrates (i.e., excluding Non-Lambethian births) being respectively 23.1 for the whole Borough, 27.5 for the Inner, and 19.7 for the Outer, Districts. Tables B and C show, for comparison, the number of births, and the birth-rates for 10 years (1891-1900) in the old Parish of Lambeth. The birth-rate for Lambeth (Parish and Borough) has been recently slowly, but steadily, declining. As has been previously noted, this decline is not peculiar to Lambeth, nor even to England', but is to be found in nearly all civilised countries. 14 The Notification of Births Act, 1907, was adopted throughout the Borough, and came into operation on March 9th, 1908. Further particulars will be found as to the notifications received under the Act and the appointment of the Health Visitor on pages 135-136. Returns of all Births (with addresses of mothers) that occur in Lambeth have been obtained from the District Registrars, and this information in conjunction with that obtained from the Notification of Births Act has again proved of great use in connection with the Borough Council's endeavours to lessen the high mortality amongst infants (under 1 year of age) by distributing pamphlets dealing with the proper management and feeding of infants, &c. The time allowed for birth registration is 42 days, but this delay is detrimental to satisfactory administrative procedure, and has been altered by the Notification of Births Act, 1907, which limits the time of notification to 36 hours from the time of birth. the marriage rate. The number of Marriages registered in the Borough of Lambeth during the year 1909 was 2,440 as compared with 2,411 during 1908, and a yearly average of 2,338 in the old Parish of Lambeth for the 10 years 1891-1900. The marriage-rate for Lambeth Borough during 1909 is therefore, 15.0 per 1,000 inhabitants, as compared with 15.8 for London. Tables B and C show the number of marriages and the marriage-rates for the last ten years in the old Parish ol Lambeth, and it will again be noticed that the marriage-rate has been gradually, but persistently, falling off during that period (as also during the previous decennium). Marriage statistics are of little value from a public health point ol view. 15 the death-rate. The total number of deaths registered in the Borough of Lambeth, during the year 1909, was 4,876, as compared with 4,692 during 1908, and a yearly average of 5716.7 in the old Parish of Lambeth for the 10 years 1891-1900. Of the total 4,876 deaths, 2,444 were males and 2,432 females, showing an excess of 12 males. The uncorrected death-rate for Lambeth is, therefore, 15.04 per 1,000 inhabitants (15.9 males and 14.3 females), as compared with 14.6 for London (15.9 males and 13.4 females). These rates are, however, uncorrected, and, on analysing the 4,876 deaths registered in the Borough of Lambeth, it is found that 826 represent deaths occurring within the Borough amongst persons not belonging thereto. These death's are to be deducted, but, on the other hand, there are 490 deaths registered outside the Borough of persons belonging thereto, and these must be added, giving a corrected number of deaths tor Lambeth during 1909 of 4,540, and a corrected death-rate of 14.0 per 1,000 inhabitants, as compared with 14.0 for London (the total corrected number of London deaths being 67,632). deaths in out lying institutions. The Outside Institutions, &c., where the 490 Lambethians died during 1909 may be grouped as follows:— I. General Hospitals. Charing Cross 15 Royal Free 2 Chelsea College 2 St. Bartholomew's 6 Guy's 28 St. George's 3 King's College 10 University 1 London 5 Westminster 52 Middlesex 9 16 II. Special Hospitals. Brompton 4 Royal Hospital for Incurables 1 Bethlem Royal Hospital 1 Central London Sick Asylum 1 Maida Vale 1 Hospital of St. John and Elizabeth 1 Cancer 7 Chelsea London Sick Asylum 1 National Hospital 4 Grove Hospital 11 Bethnal Green Hospital 1 Park Hospital 1 Evelina 39 London Fever 1 Freidenheim 3 Victoria Hospital 2 Great Northern 1 Infants' Hospital, Vincent Square 17 Grosvenor Hospital 1 Gt. Ormond Street 9 Italian 2 Hampstead 2 Royal Chest, City Road 2 Homœpathic 2 St. Joseph's Hospice 2 Medical and Surgical Home 1 St. Mary's 2 Victoria Hospital 3 Metropolitan 2 French 3 New Hospital for Women 2 St. Barnabas Home 2 Home for Children, Sydenham 2 Queen Charlotte's 1 St. John's Hospital 1 Lying - in Hospital, Endell Street 1 Samaritan Hospital 1 West End Hospital 1 III. Infirmaries and Workhouses. Battersea Infirmary 2 Southwark Infirmary 4 Bemondsey Workhouse 2 St. George's Infirmary 2 Camberwell Workhouse 1 Camberwell Workhouse 1 Belmont Workhouse 7 Wandsworth Workhouse 2 Children's Infirmary, Carshalton 2 Grove Park Workhouse 1 17 IV. Asylums. Banstead 16 Epileptic 1 Colney Hatch 4 Hanwell 4 Camberwell House 1 Epsom 12 Caterham 22 Leavesden 2 Cane Hill 24 Long Grove, Epsom 12 Claybury 6 Manor 6 Darenth 4 Peckham House 2 Dartford 11 Tooting Bec 36 V. Unclassified Places. Battersea Park 1 L. B. & S. C. Rly Peckham 1 Brought dead to Hospital 2 L. & S. W. Rly. Clapham Cutting 1 Private Houses 16 River Thames 3 Harrod's Stores 1 Streets 4 Factory, York Road, Battersea 1 Summary. I. General Hospital 133 II. Brought dead to Hospital 139 III. Infirmaries and Workhouses 25 IV. Asylums 163 V. Elsewhere (unclassifiable) 30 490 Whether the corrected or uncorrected death-rates for the Borough of Lambeth (as a whole) be taken they are very satisfactory for the year 1909, the ninth year of the existence of the newly-formed Borough. Sub-dividing the death-rates amongst the 6 new Registration Sub-Districts, it will be again noted that the Inner Districts, e.g., Waterloo, Lambeth Church, Kennington, and part of Stockwell, have, b 18 collectively and individually, suffered more than the Outer Districts, e.g., part of Stockwell, Brixton and Norwood. So, too, if the death-rates be sub-divided amongst tne 9 new Wards, it will be noted also that the Inner Wards, e.g., Marsh, Bishop's, Prince's and Vauxhall, have, collectively and individually, suffered' more than the Outer Wards, e.g., Stockwell, Brixton, Herne Hill, Tulse Hill, and Norwood. The reason for this difference is again to be noted in the fact that the Inner Districts and' Wards are more congested than the Outer. The status of the inhabitants and the general conditions (sanitary and otherwise) under which they live, are also matters to bear in mind when dealing with this subject. Taking the new Registration Sub-Districts (Table E), and the new Wards (Table F), into which the Borough is subdivided, the corrected death-rates for 1909 will be found to vary between the Inner and the Outer Districts as follows : 1909. New Registrations Sub-Districts and New Wards. Inner. Outer. General Death-rate (corrected) 17.2 11.6 Zymotic Death-rate (corrected) 1.9 0.8 Of the new Registration Sub-Districts, Lambeth Church has the highest, and Norwood the lowest, general and zymotic death-rates; whilst of the New Wards, Bishop's has the highest, and Tulse Hill the lowest, general and zymotic death-rates. 19 Tables G, H and I show the uncorrected returns (male and female) arranged as to new Registration Sub-Districts, age periods, and quarters respectively, and are given for comparison with similar tables in former Lambeth Reports. The place that the Borough of Lambeth takes during 1909 in the Registrar-General's corrected Returns amongst the Metropolitan Districts is satisfactory. There are 15 other Districts (out of 29) with a less general death-rate; 16 with a less zymotic death-rate, and 18 with a less infantile mortality-rate. Taking the 10 South Metropolitan Districts, Lewisham has the smallest general death-rate per 1000 of the population, viz. : 10.3, and Bermondsey the highest, viz.: 18.8, as compared with 14.0 for Lambeth, 13.0 for Battersea, 13.4 for Camberwell, and 16.8 for Southwark. London, as a whole, has a birth-rate of 24.2, a corrected death-rate of 14.0, a corrected zymotic (death-) rate of 1.3 per 1000 population and an infant mortality (corrected) of 108 per 1000 births; and England and Wales a birth-rate of 25.6, a death-rate of 14.5, a zymotic death-rate of 1,12 per 1000 population, and an infantile mortality of 109 per 1000 births; and the Registrar-General's 76 great towns of England and' Wales a birth-rate of 25.7, a death-rate of 14.7 (crude), a zymotic death-rate of 1.42 per 1000 population, and an infantile mortality of 118 per 1000 births. Age Periods of Corrected Deaths. The 4,540 corrected deaths during 1909 may be further analysed, and tabulated as follows :— 830, i.e., 18.3 per cent. of the total corrected deaths took place under 1 year of age. 420, i.e., 9.3 per cent,.between 1 and 5 years. 1250, i.e., 27.5 per cent. under 5 years. 208, i.e., 4.8 per cent,.between 5 and 20 years. 20 524, i.e., 11.5 per cent. 20 to 40 years. 932, i.e., 20.5 per cent. 40 to 60 years. 1268, i.e., 27.9 per cent. 60 to 80 years. 358, i.e., 7.9 per cent. 80 years and over. 3290, i.e., 72.5 per cent. over 5 years. i hese results may be compared with those for London given in the Table on p. 21, which shows the estimated mortalities per 1000 persons at each age-period for London during 1909, and the London averages for the 10 years 1881-90. 2 i TABLE. Shewing Mortalities in Lambeth Borough at different Age-periods during 1909, compared with (1) those for London 1909, and (2) the averages for London, 1881-90. Age-periods. LAMBETH. LONDON. Estimated Populations (middle 1909). Mortality Rates per 1000 Population 1909. Mortality Rates per 1000 Population, 1909 Uncorrected. Average of Ten Years, 1881—90, per 1000. Corrected. Uncorrected. 0—5 34818 35•9 40•2 38•9 68•4 5—20 91322 2•3 6•3 6•9 2•5 4•3 20—40 114505 4•6 4•8 7•7 40-60 60228 15•5 16•9 20•2 60—80 21666 2•1 69•7 70•3 62.3 63.3 80 and upwards 1649 217•1 214•2 206.3 *Under 1 year 7845 98.3 106•7 110•3 152.0 All Ages 324188 14•0 15•04 14•6 20.5 The Age-periods adopted in previous Lambeth Reports, are used for purposes of comparison, though it is considered more accurate to sub-divide as follows:—1-5, 5-15, 15-25, 25-35, 35-45, 45-55, 55-65, 65-75, 75-85, 85 and over. N.B.—The Rates (under 1 year) are given in terms of 1000 births. 22 23 TABLE D. TABLE D. Shewing the number of Births and Deaths, with Birth-and Death-rates in each of the Registration Sub-Districts of the Borough during 1909. The Deaths are from all causes, and from the chief zymotic diseases, and are corrected by adding Lambethians who die outside the Borough, by omitting strangers who die within the Borough, and by re-distributing persons (who die in Public Institutions) into the Districts from which they have been removed during illness. NEW REGISTRATION SUB-DISTRICTS. Estimated Population (middle 1909) Total Births (uncorrected). Birth-rate per 1000 of the Population. Total Deaths (corrected). General corrected Deathrate per 1000 of the Population. Total Deaths (corrected) from Total Zymotic Deaths. Zymotic Death-rate per 1000 of the Population (corrected). Zymotic Death rate per 1000 of the Total Deaths (corrected). Diarrhœa Death-rate per 10000 of the Population. Infantile Mortality per 1000 Births (uncorrected). Small Pox. Measles. Scarlet Kever. Diphtheria and Membranous Croup. Whooping Cough. Typhus. Typhoid or Enteric. Continued Fever. Cholera. Diarrhœa. Waterloo* 25921 1484 57•3 437 16•8 ... 23 2 4 8 ... ... ... ... 21 58 2•2 132•7 8•1 105•1 Lambeth Church 26541 721 27•2 495 18•6 ... 22 5 7 10 ... 1 ... ... 20 65 2•4 131•3 7•5 199•7 Kenningtoo† 55061 1501 27•3 981 17•6 ... 28 2 8 27 ... 3 ... ... 29 97 18 98•9 5•3 134•6 Stockwell § 67779 1939 28•6 893 13•2 ... 14 9 9 8 ... 3 ... ... 18 61 0•9 68•3 2•7 70•7 Brixton 82337 1601 19•4 1033 12•5 ... 14 7 19 23 ... 1 1 ... 20 85 1•03 82•3 2•4 102•4 Norwood 66549 1199 18•0 701 10•5 3 2 11 9 ... 1 ... ... 10 36 0•5 51•3 1•5 81•7 Borough of Lambeth 324188 8445 26•4 4540 14•0 ... 104 27 58 85 ... 9 1 ... 118 402 1•2 88•5 3•6 106•7 •Excluding all the Lying-in Hospital births, the corrected birth-rate = 26•3 per 1000. †Excluding all the the Workhouse births, the corrected birth-rate = 23•6 per 1000. §Excluding all the Maternity births, the corrected birth-rate = 21•7 per 1000. Of the 893 deaths in Stockwell New Registration Sub-District, 503 belong to the Inner and 390 to the Outer Districts. Inner Registration Sub-Districts—death rates (general 17•1, zymotic 1•9). Outer Registration Sub-Districts—death rates (general 11•6, zymotic 0•8). N.B.—Of the total deaths (corrected), 141 shew no addresses, and have been included in Kennington Sub-District—having occurred in the Workhouse (36), or in the Workhouse Infirmary (105). 24 TABLE E. BOROUGH OF LAMBETH. COMPARISON BETWEEN STATISTICS FOR 1908 AND 1909. New Registration Sub-Districts. New Registration Sub-Districts. Death-Rates. BirthRates. Infantile Mortality. Death-Rates. BirthRates. Infantile Mortality. General 1909. Zymotic 1909. 1909. 1909. General 1908. Zymotic 1908. 1908. 1908. Waterloo 16•9 2•2 57•3 105•1 16•8 1•4 61•8 87•4 Lambeth Church 18•7 2•4 27•2 199•7 17•9 2•1 29•5 225•5 Kennington 17•6 1•8 27•3 134•6 17•3 1•9 28•4 112•4 Stockwell 13•2 0•9 28•6 70•7 12•1 0•9 31•1 70•8 Brixton 12•5 1•03 19•4 102•4 11•9 0•9 20•6 124•9 Norwood 10•5 0•5 18•0 84•7 10•7 0•9 18•1 84•5 Borough of Lambeth 14•00 1•2 26•4 106•7 13•5 1•2 27•7 106•3 Inner Districts 17•2 1•9 33•1 122•1 16•3 1•5 35•6 113•3 Outer Districts 11•6 0•8 20•6 87•6 11•4 0•9 21•6 98•2 N.B.—The death-rates (general and zymotic) are corrected, and the birth- and infantile mortality-rates uncorrected. The death- and birth-rates are per 1000 of the population, and the infantile mortality-rates per 1000 total births. 25 TABLE F. BOROUGH OF LAMBETH. COMPARISON BETWEEN STATISTICS FOR 1908 AND 1909. New Wards. New Wards. Death-Rates (corrected) per 1000 population. Zymotic Incidence per 1000 population. Total Number of Deaths (corrected). Total Notified Cases. General. Zymotic. General 1909. Zymotic 1909. Zymotic 1909. 1909. 1908. 1909. 1908. 1909. 1908. Inner— 17•2 16•3 1•9 1•5 6•2 7•2 2416 264 875 Marsh 16•9 16•8 2•2 1•4 4•4 5•3 437 58 113 Bishop's 18•7 20•4 2•5 2•2 8•2 6•1 585 77 257 Prince's 17•7 15•6 1•7 1•8 6•9 6•6 891 85 349 Vauxhall 15•1 12•8 1•8 1•02 4•7 10•6 503 44 156 Outer— 11•6 11•4 0•8 0•9 5•1 3•3 2124 138 934 Stockwell 11•3 11•5 0•5 0•9 6•4 7•3 390 17 221 Brixton 12•9 12•9 1•04 0•9 5•4 6•5 603 49 255 Herne Hill 12•1 10•6 1•01 0•9 4•9 5•4 430 36 174 Tulse Hill 9•1 10•4 0•4 1•3 3•8 4•8 282 12 117 Norwood 11•8 10•9 0•7 0•6 4•7 4•6 419 24 167 Borough of Lambeth 14•0 13•5 1•2 1•2 5•6 6•4 4540 402 1809 26 TABLE G. Shewing the uncorrected Mortality (Male and Female) in the different New Regis ration Sub-Districts of the Borough of Lambeth (arranged Quarterly) during the year 1909. Sub-District. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total No. of Deaths in each District. M. F. Total M. F. Total. M. F. Total. M. F. Total. Waterloo 70 71 141 45 26 71 44 45 89 45 51 96 397 Lambeth Church 173 132 305 129 106 235 135 101 236 135 116 251 1027 Kennington 248 277 525 173 160 333 132 113 245 171 150 321 1424 Stockwell 120 121 241 79 89 168 73 60 133 79 73 152 694 Brixton 111 168 279 89 87 176 55 65 120 97 104 201 776 Norwood 85 118 203 47 79 126 53 52 105 56 68 124 558 Totals 807 887 1694 562 547 1109 492 436 928 583 562 1145 4876 27 TABLE H. Shewing the uncorrected Mortality (i.e. including that of Strangers) at different Ages in each New Registration Sub-District of the Borough of Lambeth during the year 1909. Sub-District. Under 1 year. 1 to 5 years. 5 to 60 years. 60 years and upwards Total. M. F. Total M. F. Total M. F. Total. M. F. Total. Waterloo 94 62 156 37 33 70 45 58 103 28 40 68 397 Lambeth Church 90 54 144 76 74 150 309 261 570 95 68 163 1027 Kennington 102 100 202 32 53 85 307 228 535 283 319 602 1124 Stock well 79 58 137 53 51 104 123 115 238 97 118 215 694 Brixton 80 84 164 35 34 69 118 106 224 119 200 319 776 Norwood 51 47 98 9 10 19 81 88 169 101 171 272 558 Totals 496 405 901 242 255 497 983 856 1839 723 916 1639 4876 28 TABLE I. Shewing the uncorrected Deaths (i.e., Parishioners and Strangers) that have been registered in the Borough of Lambeth, at various age periods, in each Quarter during the year 1909. Age-periods. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. M. F. Total. M. F. Total. M. F. Total. M. F. Total. Under 1 year 146 128 274 110 81 191 119 94 213 121 102 223 901 Between 1 and 5 yrs. 83 95 178 67 65 132 50 52 102 42 43 85 497 Between 5 and 60 yrs. 320 276 596 228 198 426 204 167 371 231 215 446 1839 60 yrs. and upwards 258 388 646 157 203 360 119 123 242 189 202 391 1639 Totals 807 887 1694 562 547 1109 492 436 928 583 562 1145 4876 29 INFANTILE MORTALITY, 1909. Of the 4,540 corrected deaths, 830 were infants under one year of age. The total number of births is 8445, and of these 579 occurred at the Lying-in Hospital, and belong to districts outside Lambeth Borough. 25 occurred at the Workhouse, and belong to districts outside Lambeth Borough, and 353 occurred at the Maternity Hospital and belong to districts outside Lambeth Borough. In this way, the corrected number of births for Lambeth Borough is 7483. The corrected infantile mortality (i.e., rate of corrected deaths under one year per 1000 corrected births) is, therefore, 110.9. In calculating this infantile mortality, it must be remembered that, whilst we subtract the births that belong to outside districts, we do not add the births of infants of Lambethian mothers who may happen to be residing outside the Borough at the time of such births. Taking the uncorrected births and' the corrected deaths under 1 year, the infantile mortality rate is 98.3. Taking the uncorrected number of births (8445) and the uncorrected number of deaths under 1 year of age (901), the uncorrected infantile mortality is 106.7, as compared with 106.7 during 1908 and an average of 150.5 for the old Parish of Lambeth during 10 years (1891-1900). The chief causes of these deaths were debility, atrophy and inanition, whooping-cough, bronchitis and other diseases of the respiratory organs, diarrhoea, premature births, and convulsions (vide p. 95 and Table V in the Appendix). Table J gives the infantile mortality in different towns in England and Wales, and in the London districts. In the Registration Sub-Districts of Lambeth the uncorrected infantile mortality varies from 199.7 per 1000 births in Lambeth Church to 70.6 in Stockwell (the low rates or 105.1 in Waterloo, 134.6 in Kennington, and 70.7 in Stockwell, being duc to the fact that these Sub-Districts contain 30 the General Lying-In Hospital, the Workhouse and the Maternity Hospital respectively), thus:— Total No. of Births (uncorrected). Total Deaths under 1 year (uncorrected). Infantile Mortality per 1,000 births (uncorrected). Waterloo* 1484 156 105.1 Lambeth Church 721 144 199.7 Kenningtont† l501 202 134.6 Stockwell‡ 1931 137 70.7 Brixton 1601 164 102.4 Norwood 1199 98 81.7 Lambeth 8445 901 106.7 Inner Districts—122.1, Outer Districts—87.6 *Excluding all the Lying-in Hospital births, the rate is 229.1. †Excluding all the Workhouse births, the rate is 155.6. ‡Excluding all the Maternity births, the rate is 93.2. N.B.—The births and deaths in Stockwell Registration Sub-Districts are divided equally between the Inner and Outer Districts for the purpose of calculating infantile mortality rates for such Districts in this Table. The Infantile Mortality is regarded as a sensitive index of the Sanitary state of a District, and, judged by this index, Lambeth Borough takes a good position amongst Sanitary Districts. Taking the Registrar-General's old 33 Large Towns of England and Wales, the uncorrected infantile mortalities vary from a minimum 80 in Croydon to a maximum 159 in Swansea, Lambeth and London being 106 and 108 respectively. Lambeth ranks eighth lowest in such list, 26 Towns having higher infantile mortality rates. Taking the Registrar-General's figures, the corrected rate for Lambeth is 97, and, of the 29 Metropolitan Districts, 7 have lesser rates than Lambeth Borough. Of the 10 South Metropolitan Districts, 3 have lesser rates than Lambeth. 31 The infantile mortality statistics for Lambeth Borough during 1909 are remarkable, and, even allowing tor the favourable meteorological conditions that existed, are worthy of note as shewing that the methods adopted throughout the Borough of Lambeth for the prevention of infantile mortality appear to be proving successful. In this connection, the systematic visiting of houses wherein births have been registered or notified, and the widespread distribution of pamphlets on infant-feeding, together with the influence of the Municipal Milk Depot in the Marsh Ward, must not be forgotten (vide Milk Depot pp. 136-144). The results should prove even more satisfactory as the Notification of Births Act, 1907, becomes more generally known. This Act came into force within the Borough of Lambeth on March 9th, 1908. (See Special Report on page 135.) 32 TABLE J. Shewing the uncorrected Intantile Mortalities in the Registrar-General's old 33 Larpe Towns or England and Wales (including London), and in Lambeth Borough, during 1909, with averages for 5 years (1904-1908). Deaths under one year per 1000 Births. Average Five Years, 1904—1908. England and Wales- (33 Large Towns.) Croydon 80 109 Huddersfield 95 120 Brighton 96 113 Portsmouth 90 125 Halifax 97 116 Bristol 100 122 Cardiff 103 132 London 108 127 Gateshead 112 151 Hull 114 152 Bradford . 116 146 Sheffield 1l8 154 Norwich 119 153 Newcastle-on-Tyne 119 140 Oldham 119 151 Leeds 122 149 Birkenhead 123 141 Derby 123 128 West Ham 124 145 Blackburn 126 159 Leicester 127 149 Bolton 128 154 Plymouth 131 140 Birmingham 134 162 Manchester 134 162 Sunderland 135 144 Preston 136 170 Wolverhampton 138 139 Salford 141 158 Liverpool 144 161 Nottingham 150 162 Burnley 156 194 Swansea 159 140 London Districts— Central ... 123 North ... 99 South ... 103 West 108 East 127 Lambeth 98.3 N.B.—The rates for London and London Districts (including Lambeth) are corrected (i.e., as to births and deaths under 1 year of age). The uncorrected rate for Lambeth is 106.7. 33 CLASS I.—ZYMOTIC DISEASES. Principal Zymotic Diseases. The principal Zymotic diseases are seven in number, viz.. smallpox, measles, scarlet fever, diphtheria (including membranous croup), whooping cough, "fevers" including typhus, typhoid, or enteric, and simple or continued), ana diarrhoea; and the zymotic death-rate is made up from the total deaths from these diseases. As a test of the sanitary condition of a Community, the zymotic death-rate is of approximate value, and the statistics for the Borough of Lambeth are very satisfactory for 1909, being 43.1 per cent. below the average (1891-1900 for the old Parish). In the Borough of Lambeth, during 1909, there were registered 449 deaths from the seven zymotic diseases, and of these 83 were strangers belonging to other districts, and 366 parishioners who died within the Borough. 36 parishioners, however, died from the seven zymotic diseases without the Borough. Subtracting the strangers, and adding on the parishioners who died without the Borough, there is a corrected total of 402, giving a zymotic corrected death-rate of 1.2 per 1000 inhabitants, the corrected rate for London being 1.31, varying in the different Metropolitan Districts, as shown on page 8. The zymotic death-rates (corrected) for the different new Registration Sub-Districts of the Borough of Lambeth vary also, as shown in Tables D and E, which in addition give the general death-rates and birthrates for comparison. Lambeth Church shows the highest, and Norwood the lowest, zymotic death-rates respectively. The corrected zymotic death-rate for the Inner Districts is 1.9, and for the Outer, 0.8—a difference explainable, as before, from the crowding and' absence of proper means of home isolation and nursing in the former, as compared with the latter, districts. Crowded districts naturally suffer more in this respect than those more sparsely populated. c 34 Similar conclusions are obtainable by comparing the zymotic death-rates and zymotic incidences for the different new Wards of the Borough, as shewn in Table F, from which it is seen that, of the 9 new Wards into which the Borough is now divided, Bishop's shows the highest and Tulse Hill the lowest, zymotic death-rates, and' zymotic incidences, respectively. During the year 1909, under the Notification Clauses of the Public Health (London) Act, 1891, 1809 cases of Infectious Diseases have been reported, and of this number 1554, i.e., 85.9 per cent., were removed to the Hospitals of the Asylums Board1, or to other Hospitals, and 255, i.e., 14.1 per cent., remained under treatment at their homes. It is again satisfactory to note the very large percentage (larger than ever before) of cases removed to Hospital, showing the growing favour with which the Isolation Hospitals are being looked upon, and pointing to the fact that it is coining to be more and more realised that infectious disease cannot be properly isolated, and, therefore, ought not to be isolated, in the homes of the people. The percentage removed during 1909 is well above the average. Thus since the introduction of the Public Health (London) Act, 1891, the percentage of notified infectious cases (excluding chicken-pox and cerebrospinal meningitis) removed from Lambeth are as follow :— 1891— -36.6, 1896—43.0, 1901—66.1, 1906—76.8 1892—33.7, 1897—49.0, 1902--70.3, 1907—81.6 1893—23.0, 1898—55.9, 1903—64.2, 1908—84.3 1894—33.9, 1899—61.2, 1904-69.8, 1909—86.02 1895—30.4, 1900—64.5, 1905—68.9, Examining the removals more in detail (e.g., nature oi disease), it is seen that during 1909, in the Borough ol Lambeth, the following are the percentages:— 35 Scarlet Fever 93.5 Typhoid 81.6 Diphtheria 92.6 92 8 Continued — Membranous Puerperal 43.8 Croup 66.7 Erysipelas 85.2 Cerebro-spinal Meningitis 71.4 No case of Smallpox was notified during 1909 within the Borough. Taking the total number of notified cases of infectious diseases during 1909, the zymotic incidence throughout the Borough of Lambeth is 5.6 per 1000 population, as compared' with an average of 9.04 for the old Parish of Lambeth during the 10 years 1891-1900, i.e., 38.1 per cent. less. There is again a decrease in the number of Diphtheria certificates received during 1909, i.e., 47.8 per cent. below the average of the statistics of the Parish of Lambeth for 10 years (1891-1900), and 5.6 per cent. below the average of the statistics of the Borough of Lambeth for 8 years (1901-08)* The 373 Diphtheria cases occurred in 341 infected houses, and in only 7.9 per cent. of these were the drains, on testing, found to be defective. The Membranous Croup notifications received were 88.5 per cent. below the average for 10 years (Parish of Lambeth), and represent 3 infected houses, of which none of the drains were found, on testing, to be defective. The Scarlet Fever notifications were 12.6 per cent. below the average of the Parish of Lambeth statistics for the 10 years 1891-1900. The 1164 cases occurred in 968 infected houses, and' in 7.5 per cent. of these the drains were, on testing, found defective. The Enteric Fever (or Typhoid) notifications received were 74.2 per cent. below the average for 10 years (Parish of Lambeth), and represent 49 infected houses, of which 8.2 per cent. of the drains were found, on testing, to be defective. *Diphtheria notification certificates received since the formation of the New Borough: 1901—511, 1902—459. 1903-329, 1904—317, 1905—439 1906—415, 1907—317, 1908—373. 36 No cases of plague, nor of suspected plague, nor of Asiatic cholera, nor of suspected Asiatic cholera, have been notified during 1909, within the Borough. In the case of each of the 1577 infected houses, an inspection was made, and the drains and sanitary fittings were tested with chemical, with the following results as tabulated:— (a) 112 (i.e., 7.1 per cent.) were found to have fective drains, i.e., gave results with the tests; (b) 843 (i.e., 53.5 per cent.) were found to have defective traps, fittings, or appliances; (c) 622 (i.e., 39.4 per cent.) showed no defects. It will be noted that only 7.1 per cent. of the total infected houses showed, with the test, defective drains, no results being obtained from the tests in the other cases; and 53.5 per cent. showed defective traps, fittings and appliances. Drains and sanitary fittings are tested, as a routine, in all infected houses, though it does not follow that, when defects are found, such defects are the direct causes of the diseases under investigation. They may indirectly be so. The test used as a routine is the chemical or smoke test, and when the result is obtained, the drain (tested) is tabulated as defective, but, when no result is obtained, it would be wrong to state that, therefore, the drain (tested) was sound. A negative result proves nothing with the chemical (or smoke) test. The hydraulic (water) and pneumatic (air) tests are the only reliable tests, but too severe for the routine testing of drains of old buildings. The pneumatic (air) test is comparatively new, and most delicate, but it is not much used in London at the present day. All new drains when laid are tested with water (hydraulic test), both in sections and as a whole. Bearing this explanation in mind, the statistics are still useful as showing that, year by year, the number ot defects 37 found decreases. Taking the statistics of the Parish ot Lambeth during 10 years (1891-1900), and those for the Borough of Lambeth during 8 year's (1901-8)*, it will be noticed that the percentage of houses showing defective drains (i.e., giving a result with the test) has decreased from 22.3 in 1891 to 7.1 in 1909. Table L gives particulars, with the averages for the 10 years worked out, for the old Parish of Lambeth, and comparing these with those of 1909 for the Borough of Lambeth, it will be seen that the latter show a decrease of 63.6 per cent. below the average for the old Parish (1891-1900) in respect of defective drains. Sub-divided according to the different notifiable diseases, the results show as follow:— Disease. No. of Infected Houses. Number shewing Defects as to Percentage shewing Total Defects. Percentage shewing no Defects. Drairs. Traps, Fittings and Appliances. Total. Smallpox - - - - - - Cholera - - Diphtheria 341 27 177 204 59.8 40.2 Membranous Croup 3 - 1 1 33.3 66.7 Erysipelas 185 6 78 84 45.4 54.6 Scarlet Fever 968 73 550 623 64.4 35.6 Typhus Typhoid 49 4 23 27 551 449 Continued or Relapsing 1 - - - 0.0 1000 Puerperal 16 2 5 7 43.8 56.2 Cerebro-spinal Meningitis 14 — 9 9 64.3 35.7 Totals 1577 112 843 955 60.6 39.4 *The percentages of houses shewing defective drains are:—1901—13.7; 1902-1202; 1903—14-6; 1904-12.1; 1905—117; 1906-12.6; 1907— 1103; 1908—9.2. 38 TABLE K. Shewing the number of Certificates for the Notifiable Zymotic Diseases received in the Rorough of Lambeth during 1909, and in the old Parish of Lambeth for the ten years 1891-1900. Disease. Parish of Lambeth. Annual Average of ioyrs. 1891-1900 (Parish). Borough of Lambeth Notifications received during 1900. 1891 1892 1893 ' 1894 1895 1896 1897 1898 18991900 Smallpox 3 22 99 26 51 16 2 - 1 - 22.0 - Cholera 4 26 23 10 16 6 18 7 3 2 11.5 - Diphtheria 330 504 789 521 614 652 701 813 1080 844 715.1 373 Membranous Croup 29 47 49 26 23 27 17 16 22 6 26.2 3 Erysipelas 258 420 587 315 355 352 325 294 330 234 347.0 189 Scarlet Fever 858 1832 2275 1198 1389 1550 1375 1009 1006 821 1331.3 1164 Typhus 1 3 3 2 — 1 — — 1 — 1.1 — Typhoid or Enteric 149 117 100 268 201 162 185 163 219 272 189.6 49 Continued or Relapsing 33 34 58 48 20 16 1-1 13 7 17 25.7 1 Puerperal 11 20 27 19 16 19 26 14 24 13 18.9 16 *Plague - - - - - - - - - - - — Cerebro-Spinal Meningitis - - - - - - - - - - - 14 Totals 1670 3025 4070 2433 2685 2801 2663 2329 2693 2209 2658.4 1809 Average per 1000 of population 61 10 9 14.5 86 9.4 9.5 8.9 7.7 8.7 7.1 9.04 5.6 The Health Department has also heard of, and dealt with, the following non-notifiable infectious diseases during 1900:—Chicken-pox, 708; Measles, 1601; Whooping Cough, 761; Consumption, 1152; Cancer, 5; other diseases (e.g., Mumps, Influenza, Pneumonia, Scabies, Gangrene, Dropsy, etc.), 154. *Plague was made notifiable on September 19th. 1900. 39 TABLE L. Giving number of Infected Houses, with percentages of (1) General Defects, and (2) Defective Drains, throrgout the Borough during 1909, and throughout the old Parish during ten years 1891-1900. 1891 1892 1893 189 4 1895 1896 Number of Infected Houses 1117 2430 3179 2012 2111 2417 N umber of Houses with defects 903 1474 1641 1089 995 1177 found = 63.7% =60.7% = 15.6% = 54.1% = 47.04% = 48.7% Number of Houses with de- 316 720 658 464 392 423 fective drains found = 22.3% = 24. 7% = 20.6% = 23.06% = 18.6% = 17.5% Number of Houses with no 514 956 1538 923 1118 1240 defects found = 36.3% =89.3% =48.4% = 45.9% = 52.96% =51.3% 40 TABLE L—continued. Giving number of Infected Houses, with percentages of (1) General Defects, and (2) Defective Drains, throughout the Borough during 1909, and throughout the old Parish during ten years 1891-1900. 1897 1898 1899 1900 Average for ten years 1891-1900. 1909 Number of Infected Houses 2374 2094 2435 1992 2246.1 1577 Number of Houses with defects 1210 1044 1163 886 1158.0 955 found =50.9% = 49.9% =47.5% = 44.5% =5.6% =60.6% Number of Houses with de- 390 351 384 285 438 3 112 fective drains found = 16.4% = 16.9% = 15.8% = 14.3% = 19.5% =7.1% Number of Houses with no 1164 1050 1272 1106 1088.1 622 defects fo.und =49.1% = 50.1% = 52.5% =55.5% =48.4% =39.4% N.B.—Only 7.1 per cent. of the houses in 1909 shewed, with the test, defective drains, no. results being obtained therefrom in the other cases. 41 TABLE M. Shewing corrected zymotic seasonal variations (deaths) in the Borough of Lambeth in the different New Registration Sub-Districts during 1909. New Registration Sub-District. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year 1909. Zymotic Death-rate per 1000 inhabitants. Waterloo 24 6 22 6 58 2.2 Lambeth Church 20 18 20 7 65 2.4 Kennington 34 25 26 12 97 1.8 Stockwell 11 20 20 10 61 0.9 Brixton 20 23 27 15 85 1.03 Norwood 7 13 12 4 36 0.5 Borough of Lambeth 116 105 127 54 402 1.2 Inner Districts 1.9 ; Outer Districts 0.8 per 1000 inhabitants. 42 TABLE N. Shewing the total cases notified under the Compulsory Notification Clauses of the Public Health (London) Act, 1891, in the Borough of Lambeth during 1909 (arranged Quarterly). 1st Quarter. 2nd Quarter 3rd Quarter. 4th Quarter. Total for 1909. Smallpox - - - - - Scarlet Fever 238 271 299 356 1164 Diphtheria 98 93 81 101 373 Membranous Croup 1 — — 2 3 Typhus — — — — — Typhoid 10 12 1 1 16 49 Continued Fever — 1 1 Erysipelas 52 45 42 50 Puerperal 6 3 3 4 16 Cerebro-Spinal Meningitis 6 6 — 2 14 Cholera — — — — — Plague — - •— - — Totals 411 430 436 532 1809 43 TABLE O. Deaths from Zymotic diseases (Strangers deducted), 1909. For the 4 weeks ending January. February. March. April. May. June. July. August. September. October. | November. December. Total. Smallpox - - - - - - - - - -_ __ - Measles 15 14 21 18 11 9 3 8 3 2 - - 104 Scarlet Fever 1 3 6 3 3 2 3 4 1 1 27 Diphtheria 3 9 8 4 7 2 4 1 7 2 5 5 57 Membranous Croup - 1 — - 1 Whooping Cough 3 11 16 12 15 6 3 2 4 3 5 5 85 Typhus - — - - - - - — — — — — — Enteric 1 2 1 1 1 1 — — 1 1 — 9 Continued Fever - — - — - — — — 1 — — — 1 Diarrhoea 1 4 — 3 1 3 5 31 48 13 5 4 118 Total of Seven Chief Zymotic Diseases 22 40 50 44 38 24 16 44 66 26 17 15 402 Erysipelas 1 - 2 1 - 3 2 — 1 1 — — 11 Puerperal Fever — 1 1 — - 2 — — — 2 1 1 8 Cerebro-spinal Meningitis — - 4 — 3 1 - — - - - - 8 44 45 TABLE P. Shewing the number of Deaths (corrected) from the 7 principal zymotic diseases in the old Parish of Lambeth and in London, in the ten years 1891—1900, and in the new Borough of Lambeth and in London during 1909. Disease. 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 Annual average of ten years 1891 —1900 (old Parish). Proportion of Deaths to 1000 total Deaths (corrected) in 10 yrs. Total (corrected) Deaths in 1909. Proportion of Zymotic Deths to 1000 Total Deaths (corrected) 1909 Smallpox — 1 5 1 2 Diphtheria 76 127 172 138 103 2 - — — — 1.1 0 .2 — — Membranous Croup 2 9 11 4 9 129 138 108 153 101 124.5 23.03 57 12.6 Scarlet Fever 46 76 69 64 53 11 7 7 6 2 68 1.3 1 0.2 Fever Typhus 1 — 1 — — 63 42 30 25 20 48.8 9.03 27 59 Typhoid or Enteric 28 22 36 46 26 1 — — — — 0.3 0.06 — — Simple Continued 7 2 4 0 2 24 26 35 50 54 34.7 64 9 — Measles 128 187 113 182 151 1 - — — 1 1.7 0.3 1 0.2 Whooping Cough 239 135 151 110 132 185 139 133 169 69 145.6 26.9 104 1.9 Diarrhœa (and Cholera) 166 167 205 142 263 140 144 159 130 97 143.7 26.6 85 18.7 Borough of Lambeth 693 726 767 687 741 152 238 254 249 153 198.9 36.8 118 25.9 County of London 9675 11983 13223 11544 11467 708 734 726 782 497 706.1 130.6 402 88.5 14009 11525 12482 11147 10136 11575.3 130.8 6285 92.9 46 The seasonal mortality (corrected) from the .different important zymotic diseases during 1909 is well shown by arranging the deaths quarterly, thus:— 1909. Smallpox. Measles. Whooping Cough. Scarlet Fever. Diphtheria. Membranous Croup. FEVER. Diarrhœa. Cholera. Erysipelas. Puerperal Fever. Influenza. Total. Typhus. Typhoid. Continued. 1st Qr. — 50 31 4 20 — — 3 - 8 — 4 2 32 154 2nd Qr. — 38 33 11 13 — — 3 — 7 - 4 2 17 128 3rd Qr. — 14 9 6 12 - — 1 1 84 — 2 — 2 131 4th Qr. — 2 12 6 12 1 — 2 — 19 — 1 4 15 74 Totals — 104 85 27 57 1 — 9 1 118 — 11 8 66 487 Taking the zymotic diseases collectively, it is noticed that the 1st quarter showed the highest mortality, and the 4th quarter the lowest. Measles, Diphtheria and Influenza reached their maxima in the 1st quarter; Whooping Cough and Scarlet Fever in the 2nd; Diarrhoea in the 3rd; and Puerperal Fever in the 4th. Typhoid Fever and Erysipelas reached their maxima in both the 1st and 2nd quarters respectively. Table M shews the symotic seasonal variations in the different New Registration Sub-Districts, while Table O gives the monthly mortalities from the zymotic diseases. Table P gives the deaths registered in the Borough of Lambeth from the seven principal zymotic diseases during 1909, and for ten years (1891-1900) in the old Lambeth Parish. For comparison, the deaths registered in London for the same period are also given. 47 SMALLPOX. During 1909 no single case of genuine Smallpox was notified, nor was a single death from Smallpox registered within the Borough. One doubtful case at James Place, Murphy Street, and' two at Foreign Street proved to be chickenpox, and the patients were, consequently, returned to their homes from the South Wharf, Rotherhithe, after re-vaccination. 18 "contacts" were watched for 16 days each within the Borough during 1909, in connection with (a) persons arriving by vessels from abroad, such vessels coming from Smallpoxinfected places, or being themselves Smallpox-infected' by cases on board, e.g., S.S. '"Virginian," "Canada," "Monmouth," "Englishman" (from Montreal) 6, S.S. "Sardinia" (Calcutta) 4, S.S. "Aragon" (South America) 1, R.M.S. "Avan" (Vigo) 1; and (b) persons in contact with the disease abroad (2) and at home (4). In no single instance did Smallpox develop amongst the "contacts."* In London, 21 cases of Smallpox were notified, and 2 deaths (uncorrected) were registered from the same disease during 1909, giving a case-mortality of 9.5 per cent. (uncorrected). Vaccination. The Vaccination Returns of the Local Government Board for the Borough of Lambeth are to be found in Tables Q and R, dealing with the whole year 1908, and the first half of 1909, respectively. † These Returns are obtained' from the Vaccination Officers. The total number of conscientious objectors who have obtained certificates during 1909, irrespective of the dates of birth of the children to which they relate, is 853, whilst the total number of certificates of successful primary vaccinations at all ages received during 1908 and 1909 are 6449 and 5878 respectively. *3 of the " contacts " could not be traced, wrong addresses having been given. †The yearly returns are not made up by the Local Government Board until August of the following year, so that only the Returns for the first half of the year 1909 can be given in this Report. 48 TABLE Q. VACCINATION RETURNS (LAMBETH BOROUGH), 1908. New Registration Sub-Districts. No. of Births. (uncorrected). Successfully Vaccinated. Insusceptible to Vaccination. Dead Unvaccinated. Conscientious Objectors. Removed to other Parishes Removed to places unknown. Postponed by Doctors. Waterloo* 1595 841 - 184 35 356 215 14 Lambeth Church 771 511 — 77 36 13 122 9 Kennington† 1521 1127 — 110 64 8 196 12 Stockwell‡ 2508 1285 4 137 197 202 225 8 Brixton 1653 1112 9 88 149 30 225 32 Norwood 1167 803 8 74 178 25 44 30 Lambeth 9215 5679 21 620 659 634 1027 105 *Hospital cases (792) included. †Workhouse (200) cases included. ‡Maternity cases (462) included. N.B.—The new Registration Sub-Districts were adopted by the Registrar-General for statistical purposes on October 1st, 1906. 49 TABLE R. VACCINATION RETURNS (LAMBETH BOROUGH) FOR THE FIRST HALF-YEAR, 1909. New Registration Sub-Districts. No. of Births (corrected). Successfully Vaccinated. Insusceptible to Vaccination. Dead Unvaccinated. Conscientious Objectors. Removed to other Parishes (known or unknown). Postponed by Doctors. Waterloo* 751 342 2 49 30 306 17 Lambeth Church 387 256 22 33 69 17 Kennington† 781 540 61 104 104 24 Stockwell‡ 1014 620 3 52 113 213 11 Brixton 807 501 1 46 82 109 59 Norwood 601 370 — 36 113 46 21 Lambeth 4341 2629 6 266 475 847 149 50 EPIDEMIC CEREBRO-SPINAL MENINGITIS. On March 12th, 1907, epidemic cerebrospinal meningitis (cerebrospinal fever) became a compulsoriiy notifiable infectious disease throughout the administrative County of London, in accordance with the provisions of Scction 56 of the Public Health (London) Act, 1891. This disease haa taken on epidemic proportions in Belfast and Glasgow, and it was thought advisable to make it notifiable throughout London, so as to prevent it being introduced and spreading there. Up to the end of 1908, a total of 238 cases were notified in London (27 in Lambeth Borough), whilst during 1909 a total of 111 cases have been notified in London (14* in Lambeth Borough). Of the 14 cases notified in Lambeth during 1909, 3 occurred in Waterloo, 2 in Lambeth Church, 3 in Kennington, 2 in Stockwell, 1 in Brixton and 3 in Norwood, Registration Sub-Districts. Of the 14 cases notified, 8 d'ied., i.e., 57.1 per cent. In all the cases notified in the Borough of Lambeth, precautionary measures have been taken as to disinfection, the rooms being also stripped of their wall papers and thoroughly cleansed. In no single instance has the disease spread amongst the inmates of a house wherein the disease has first appeared. Systematic enquiries have been made in each case, and the results tabulated. CHICKEN-POX. Chicken-pox was not compulsoriiy notifiable during 1909, but through the Head Teachers of the various schools 801 cases were brought to the notice of the Council, and the necessary disinfection was carried out in connection therewith. *Of the 14 notified cases, 10 were removed to Hospital, 6 from the Inner and 4 from the Outer Districts. 51 SCARLET FEVER. During 1909, in the Borough of Lambeth, 1164 cases ot Scarlet Fever were notified, and 27 deaths registered, giving a case-mortality of 2.3 per cent.—2.1 for the Inner, and 2.5 for the Outer Districts. In 1908, there were 1428 cases notified and 42 deaths registered, i.e., a case-mortality of 2.9^ per cent.—3.5 for the Inner, and 2.5 for the Outer Districts. The annual averages for 10 years (1891-1900) in the old Parish of Lambeth are (1) notified cases 1331.3, and (2) deaths 53.6. Of the 1164 persons notified in the Borough of Lambeth during 1909, 1088* (i.e., 93.5 per cent.) were removed' to Hospital, and of these 25 died (i.e., 2.3 per cent.), whereas 76 (i.e., 6.5 per cent.) were treated at home, and of these 2 died' (i.e., 2.6 per cent.) The attack-rate and death-rate of Scarlet Fever per 1000 of the population have been steadily decreasing during the last few years in Lambeth Parish, and are below the average during 1909 in the Borough—a satisfactory condition of things, which seems to point to the value of isolation (following notification) as an important preventive measure in this disease. The age and sex incidence and mortality for the 1164 Scarlet Fever cases notified in Lambeth Borough during 1909 are as follow:— *Of the 1088 cases of Scarlet Fever removed to Hospital, 58 proved at Hospital not to be suffering from that disease, including 16 cases connected with an outbreak of suspected Scarlet Fever which occurred at the Licensed Victuallers' Schools (Upper Kennington Lane). The cases were removed to Hospital, and the schools closed for disinfection and cleansing. After further observation, the Hospital Authorities came to the conclusion that the disease was not really Scarlet Fever, but atypical rubella. The outbreak occurred during June. 52 Age. Number of Cases notified. Deaths. Death Rate per 100 Notified. M. F. Total M. F. Total Total. Under 1 year 7 8 15 1 - 1 6.7 1 to 2 26 24 50 1 2 3 6.0 2 to 3 36 34 70 2 2 2.9 3 to 4 41 57 98 2 2 4 4.1 4 to 5 52 55 107 1 2 3 2.8 5 to 6 53 66 119 3 1 4 3.4 6 to 7 50 66 116 — 2 2 1.7 7 to 8 47 62 109 — 2 2 1.9 3 to 9 36 49 85 2 2 2.4 9 to 10 30 36 66 2 — 2 3.03 Over 10 years 124 205 329 2 2 0.6 Total 502 662 1164 12 15 27 54 It will be noted that, of the total 1164 persons reported as suffering from Scarlet Fever during 1909 within the Borough of Lambeth, 340 (i.e., 29.2 per cent.) were under five years of age, and 824 (i.e., 70.8 per cent.) under 10 years of age: whilst the mortality was greatest amongst those between 1 and 2 years of age. Of the 329 persons over 10 years of age, 2 (i.e., 0.6 per cent.) died. In London, during 1909, there were registered 384 deaths (uncorrected) out of a total of 17251 cases of Scarlet Fever notified, giving a case-mortality of 2.2 per cent. (uncorrected). 53 The distribution of the cases of, and the mortality from, Scarlet Fever amongst the different New Registration SubDistricts of the Borough of Lambeth during 1909 is seen from the following:— Registration Sub-Districts. Total No. of Cases Notified. Cases treated at Home. Cases removed to Hospital. No. of Deaths. Case Mortality per 100. Rate of Persons Notified per 1000 Inhabitants. At Home. In Hospital. Total. Waterloo 58 2 56 1 1 2 3.4 2.2 Lambeth Church 162 2 160 — 4 4 2.5 6.1 Kennington 248 3 245 — 2 2 0.8 4.5 Stockwell 251 19 233 — 10 10 4.0 3.7 Brixton 276 26 250 — 7 7 2.5 3.4 Norwood 169 24 145 1 1 2 1.2 2.5 Borough of Lambeth 1164 76 1088 2 25 27 2.3 3.6 Rate of Persons notified per 1000 inhabitants—4.02 Inner Districts, and 3.2 Outer Districts, Of the 1088 cases removed to Hospital 50.7 per cent. were from the Inner, and 49.3 per cent. from the Outer Districts. Four Schools, viz.: Stockwell College (Junior), St. Michael's (Halstead Street), Upper Kennington Lane (Infants, A E F), and Mayfield College (Barston Road), were disinfected on account of outbreaks of Scarlet Fever amongst the inmates. One school was closed on account of Scarlet Fever during 1909, viz.: Stockwell Church School, Lingham Street, Inlants' Department (Classroom H), 4 cases of Scarlet Fever having occurred amongst the scholars during the two weeks ended June 25th, 1909. The Classroom was disinfected. 54 Milk-Bourne Scarlet Fever Outbreak. During 1909, an interesting Scarlet Fever milk-borne outbreak occurred, affecting Lambeth Borough and other Districts. In June, upwards of 400 persons living in districts in London and Surrey and consuming milk obtained from a particular milk company were attacked by Scarlet Fever. The chief incidence of the outbreak was at Kingston, Merton, Worcester Park, Coombe, Wimbledon and Croydon, though Chelsea, Westminster, Wandsworth and Lambeth were affected slightly. The Lambeth outbreak appears to have been limited to a public institution, and would have been more widely extended therein, had it not been for the fact that all milk used by the institution was Pasteurised before use in a Pott's Pasteuriser, except such milk as was to be used for cooking purposes. The inmates and patients of the institution escaped infection, although there were many susceptible persons (e.g., children, invalids, etc.), who partook of the milk at the time, and it was the Members of the Nursing Staff alone who were affected, viz., 5 Nurses and 1 Kitchenmaid. The Nursing Staff occupies the Nurses' Home, away from the rest of the institution. Enquiry showed that the milk used by the Nursing Staff was not pasteurised, although that fact was unknown to the management of the institution at the time, and that had it been so, as was the case with the rest of the milk consumed by the inmates of the institution, even these six cases of Scarlet Fever would, doubtlessly, have been prevented. The infected milk was traced to a farm in a county far removed from London, and it appears that the infection arose, not from a human source, but from the cows which were found to be afflicted with diseases of the teats and udders, some of the cows having recently calved. The facts as detailed are interesting, and point to the value of all milk being pasteurised or sterilised before being 55 consumed—milk being specially liable to inlection both from human and animal sources. Outbreak of Scarlet Fever at the Lambeth Workhouse and Infirmary. An outbreak of Scarlet Fever occurred during December, 1909 at the Lambeth Workhouse and Infirmary, a total of 18 cases, and of these, 13 (12 children of the age of 3 years or under and 1 child of the age of 8 years) were connected with the Workhouse (Nurseries H and J), and 5 with the Infirmary Wards (H3, H2, 11, and 12). The 13 workhorse cases started from infection outside, brought in through "ins and outs" mothers, and', afterwards, spread in the workhouse itself, from children to children. The children had been in the workhouse nurseries for over a month (the last admission being on 18th November, 1909), but the mothers appear to have been allowed to go in and out, and, in that way, io have carried in the infection of scarlet fever. The Infirmary cases (5 in number) included a sister and 2 nurses. A letter was sent to the Guardians, suggesting the advisability of methods being adopted for the prevention, or for the minimising, of the risks of similar outbreaks, by the institution of a form of quarantine (say, three weeks), for all outside admissions into the nurseries.* MEASLES AND WHOOPING COUGH. These two non-notifiable infectious diseases cause more deaths than all the notifiable infectious diseases together. In the Borough of Lambeth, during 1909, 104 and 85 *The Guardians approved on June 16th, 1909, of a Scheme for such a purpose, in connection with the Annexe to the Home for Aged Poor at the Guardians' Norwood premises (Elder Road, West Norwood), on the lines of a Report by Dr. Quarry and Mr. Salmon (Master of the Renfrew Road Workhouse), dated June 1st, 1909. The Scheme docs not appear to have been carried out as yet (February, 1910). 56 rected deaths were registered from Measles and Whooping Cough, giving corrected death-rates per 10,000 of the population of 3.2 and 2.6 respectively. In London, during 1909, there were registered 2,324 and 1,246 total corrected deaths from Measles and Whooping Cough, giving corresponding corrected death-rates of 4.8 and 2.6 per 10,000 of the population respectively. Taking the Lambeth new Registration Sub-District it will be seen that Waterloo and Lambeth Church suffered most, and Norwood and Brixton least, from Measles; whilst Kennington and Lambeth Church suffered most, and Stockwell and Norwood least, from Whooping Cough (vide page 61). The Inner Districts suffered (deaths per 10,000 of the population) more than the Outer Districts, thus:— Inner. Outer. Whooping Cough 3.7 1.8 Measles 6.2 0.9 Comparing the Borough statistics for 1909 with those for the old Parish for 10 years (1891-1900), it will be seen that there has been a saving during 1909 of 41 deaths from Measles over the average for that decennium, and a saving of 58 deaths from Whooping Cough over the average during the same period. Measles. With regard to Measles, extra precautions are taken in connection with disinfection of Measles-infected houses, exclusion of children (both infected children and also children from infected houses) from schools, the closing of classes or whole schools on account of outbreak of Measles, the distributing of leaflets and posters, and the educating of parents to regard Measles as a serious or dangerous infectious disease, and not a trivial complaint of childhood. 57 Measles is not compulsorily notifiable, but, through Schools, 1,616 cases (during 1909) were reported to the Borough Council. Measles being chiefly a "School" Disease, this voluntary system of notification is most desirable (vide Appendix). Of the 104 deaths from Measles in Lambeth Borough during 1909, 100 (i.e., 96.2 per cent.) occurred amongst children under 5 years of age, showing that Measles is a disease of young children, and especially fatal to such. 21 of the deaths (i.e., 20.2 per cent.) occurred amongst infants under 1 year of age. During 1909 in the Borough of Lambeth disinfection has been carried out in connection with 1601 Measles-infected houses as compared with 1504, 1998, 836, 1970, 1294, 1346, 364, 728 and 941 during 1908, 1907, 1906, 1905, 1904, 1903, 1902, 1901 and 1900 respectively. Measles is spread chiefly through Schools, especially Infants' Departments' and during 1909 special precautions have been taken in respect thereto in the way of (a) School or Class Closure; or (b) Exclusion of all "Unprotected" Children, i.e., those who have not previously had an attack of the disease—the latter method securing the minimum interference with School attendance, and being, therefore, a useful alternative to School or Class Closure. In addition all known cases of Measles are excluded as well as the inmates of affected houses in accordance with the Code. The details of the closure or exclusion during 1909 are as follow:— (a) School or Class Closure. 1. Walnut Tree Walk School.- The Infants' Department (Classroom C) was closed from February 1st to February 12th, 1909, on account of an outbreak of 58 Measles amongst the scholars (4 cases in all), with the result that there was a decline in the number of Measles cases. 2.—Stockwell College Practising School.—The Infants' Department (Classes I. and II.) was closed on April 2nd, 1909, until after the Easter holidays, a total of 17 cases having occurred amongst the scholars (8 in Class I. and' 9 in Class II.) In connection with Class II., exclusion of 49 children was tried first, viz.: from March 26th to April 2nd, 1909. 3.—Rosendale Road School.—The Infants' Department (Classrooms B and D) was closed from May 28th to June 11th, 1909, on account of an outbreak of Measles amongst the scholars (7 cases in all), with the result that there was a decline in the number of Measles cases. Prior to closure, 27 scholars were absent from Classroom B and 42 from Classroom D on account of the outbreak. 4.—Vallifield College, Private School.—The first case commenced on November 9th, 1909, and the outbreak spread to 8 other children, out of a total in attendance of 34. The School was closed on November 23rd, 1909, until after the Christmas vacation. 5.—Stockwell College Practising School.—The infants Department (Classrooms A, B and C) was closed from December 10th, 1909, until after the Christmas Holidays, on account of an outbreak of Measles amongst the scholars (4 cases in all), with the result that there was a decline in the number of Measles cases. N.B.- In the above 5 cases, disinfection of the Classrooms was carried out. 59 (b) Exclusion of "unprotected" children. Names of Schools. Classrooms Infants. Periods of Exclusion. Numbers of Measles Cases. Number of Unprotected Children excluded. 1. Vauxhall Street G Jan. 21st to 25th 5 19 2. Walnut Tree Walk. A Feb. 11th to 19th 1 33 3. St. Michael's, Halstead Street A Feb. 11th to 19th 1 13 4. Upper Kennington Lane VI. Feb. 20th to 27th 1 14 5. Upper Kennington Lane VII. Feb. 20th to 27th 4 18 6. Lollard Street D&E March 4th to 19th 2 41 7. Stockwell College Practising School II. March 26th to April 2nd 5 49 8. Lyham Road F March 29th until after Easter Holidays 5 6 9. St. Anne's, Harleyford Road D May 6th to 14th 1 7 10. St. John-the-Divine, Camberwell New Road F May 18th to 24th 6 16 11. St. Peter's, Vauxhall B May 18th to 28th 1 20 12. Springfield, Fountain Street C May 24th to June 24th 1 9* 13. St. John with All Saints, Exton Street, Waterloo Road E May 24th to June 4th 2 11 14. Rosendale Road C May 24th to 28th 2 25* 15. Springfield, Fountain Street C June 10th to 24th 2 9* 16. Lollard Street B June 10th to 18th 3 8 17. Johanna Street A June 14th to 18th 3 26 18. St. Jude's, Railton Road 3 June 14th to 25th 2 17 19. Church Street A June 16th to 23rd 2 17 20. Addington Street C July 8th until after Summer Holidays 29 14 21. Priory Grove B(1) Oct. 29th to Nov. 12th 10 38 22 Upper Kennington Lane VII. Dec. 8th to 17th 2 14 * Under the age of 5 years. 60 Stockwell College (Mixed), St. Michael's (Halstead Street), Stockwell Practising School (Infants), Stockwell Road L.C.C. School (Classroom E), and Lyham Road L.C.C. School (Infants), were also disinfected during 1909 in connection with cases of measles. Whooping Cough. Whooping Cough is also a serious disease, especially to young children. Of the 85 deaths registered in Lambeth Borough during 1909 from this disease, 82 (i.e., 96.5 per cent.) occurred in children under 5 years of age, and 44 of the deaths (i.e., 51.8 per cent.) occurred amongst infants under 1 year of age. It is, therefore, a disease of childhood, and its prevention is being systematically attempted, chiefly in the way of disinfection of Whooping Cough-infected houses, exclusion from school of children (both infected and from infected houses), and the educating of parents up to the dangerous nature of the disease and the importance of careful nursing of the patients when suffering from this complaint. Unfortunately, Whooping Cough, like Measles, is, at present, regarded as a harmless complaint of childhood, and the ignorance displayed, and the apathy shown, in regard to these diseases are well known to all who visit amongst the poorer classes. During 1909, in the Borough of Lambeth, disinfection has been carried out in connection with 761 Whooping Coughinfected houses, as compared with 319, 748, 455, 440. 380, 325, 110, 72 and 126 during 1908, 1907, 1906, 1905, 1904, 1903, 1902, 1901 and 1900 respectively; and leaflets (dealing with the dangers and treatment of this disease) have been left at all known Whooping Cough-infected houses.* *Whooping Cough is not a compulsorily-notifiable disease, but 763 cases were voluntarily notified during 1909 by School Teachers (vide Appendix). 61 No school was closed during 1909 on account of Whooping Cough, but one private school (Mayfield College) was disinfected. Details of the incidences of Measles and Whooping Cough in the different Registration Sub-Districts of Lambeth Borough during 1909 are as follow:— New Registration Sub-Districts. Number of Deaths from Whooping Cough. No. of Deaths from Measles. Whooping Cough Deaths per 10000 Inhabitants. Measles Deaths per 1000 ) Inhabitants. Waterloo 8 23 3.1 8.9 Lambeth Church 10 22 3.8 8.3 Kennington 27 28 4.9 5.1 Stockwell 8 14 1.2 2.1 Brixton 23 14 2.8 1.7 Norwood 9 3 1.4 0.5 Borough of Lambeth 85 104 2.6 3.2 CHOLERA AND PLAGUE. In Lambeth Borough, during 1909, no case of Plague, suspected or otherwise, was notified, and no death from Plague was registered. No case of Cholera was notified, and no death from Cholera was registered, during 1909. 52 Cholera "contacts" arriving from abroad (18 from Russia and 34 from Rotterdam) had to be watched during 1909, but in connection therewith no case of Cholera arose.* *4 of the "contacts" could not be traced, wrong addresses having been given. 62 The 52 "contacts" arrived in England by the following steamships:-(a) s.s. "Kurgan'' 9, s.s. '"Irkutsk" 3, s.s. "Wclogda" 1, s.s. "Waliva" 3, s.s. "Novo" 1, s.s. "Sergee" 1—all from Russia; and (b) s.s. "Batavia" 26, s.s. ''Batavia II." 3, "Copenhagen" 3. s.s. "Immingham" 1, s s. "Munich" 1—all from Rotterdam. No case of Plague, and no case of Cholera, were notified nor were any deaths registered, in London during 1909. DIPHTHERIA. During 1909, 57 deaths were registered in the Borough of Lambeth from Diphtheria, and a total of 373 cases were notified, giving a case-mortality of 15.3 per cent. Of the 373 cases notified, 316* (i.e., 92.8 per cent.) were removed to Hospital, and 57 died, giving a case-mortality of 16.5 per cent. amongst the cases treated in Hospital; whilst 27 (i.e., 7.2 per cent.) were treated at home, and 2 died, giving a case-mortality of 7.4 per cent. amongst the patients treated at home. The case-mortality rate for the whole of the Borough of Lambeth during 1909 is low, pointing to (1) the mildness of the majority of the cases notified, and (2) the great value of antitoxin in the treatment of Diphtheria, especially in the very early stages of the disease. † The decrease in the number of Diphtheria deaths throughout the new Borough of Lambeth during 1909 is again remarkable, as it was during 1908, 1907, 1906, 1905, 1904, 1903, 1902 and 1901, and will be seen, on comparison with the yearly mortality average of the 10 years (1891-1900) for the old Parish of Lambeth. This yearly average is 124, so that during 1909 there has been a decrease in the mortalityrate, in comparison, of 54.03 per cent. So, too, if the *Of the 346 cases of Diphtheria removed to Hospital, 16 proved at Hospital not to be suffering from that disease. †59 bottles of antitoxin have been gratuitously distributed in Lambeth Borough during 1909. 63 number of notification of Diphtheria received during 1909 in the Borough of Lambeth be compared with the yearly average of the 10 years (1891-1900) for the old Parish of Lambeth, i.e., since the Notification Clauses of the Public Health (London) Act, 1891, came into force, a similar decrease will be noticed, viz., a decrease of 47.8 per cent.—the yearly average of notification for the old Parish being 715, and the number received during 1909 for the Borough 373. Fortunately the comparison can be extended further, and made for many years past, as the statistics for Diphtheria have been worked out in connection with the old Parish, as well as the new Borough, and are shewn below, as far as mortality from the disease is concerned. Even allowing for the slight fallacy that may arise from comparing statistics of the old Parish with those of the new Borough of Lambeth, the extraordinary sudden decrease in the mortality from Diphtheria is again most remarkable, and, when taken in conjunction with the equally extraordinary and equally sudden decrease in the number of notifications of the same disease received, points to a marked decline in the prevalence of Diphtheria throughout the Borough of Lambeth during 1909, as well as during 1908, 1907, 1906, 1905, 1904, 1903, 1902 and 1901; and that, too, although Diphtheria has been rising slowly but surely in epidemic proportion for the previous 20 years ending 1900 (vide table on page 64). The statistics for London, as a whole, are no less remarkable. During 1909, no school was closed on account of Diphtheria. 64 Quinquennial Period. Population (estimated). Number of Deaths. Death-rate per million living. Old Parish of Lambeth. 1863—1867 902119 148 164 1868—1872 1021165 96 94 1873—1877 1132106 184 163 1878-1882 1245913 255 205 1883—1887 1313211 365 278 1888—1892 1367734 537 393 1893—1897 1443857 683 483 1898-1900 924333 362 392 Boro' 1901-5 1538750 194 126 1906 315774 49 155 1907 318538 47 147 1908 321344 44 137 1909 324188 57 176 The age and sex incidence and mortality from Diphtheria cases notified in the Borough of Lambeth during 1909 are as follow:— Diphtheria. Ages. No. of Cases Notified. Deaths. Death Rate per 100. M. F. Total. M. F. Total. Under 1 year 5 6 11 1 3 4 36.4 1 to 5 83 73 156 16 17 33 21.2 5 to 10 57 70 127 8 10 18 14.2 10 to 20 24 34 58 1 1 2 3.6 20 to 40 4 14 18 — — — o.o 40 to 60 2 1 3 — — — o.o 60 and over - - - - - - - Total 175 198 373 26 31 57 15. 3 65 The distribution of the disease in the different new Registration Sub-Districts of the Borough of Lambeth, together with the numbers of deaths amongst both hospital-, and home-treated patients, etc., during 1909 are as follows: New Registration Sub-Districts. Total No. of Cases Notified. Cases treated at Home. Cases removed to Hospital. No. of Deaths. Case Mortality per 100. Rate of Persons Notified per 1000 Inhabitants. At Home. In Hospital. Total. Waterloo 30 - 30 - 4 4 13.3 1.2 Lambeth Church 30 — 30 - 7 7 23.3 1.1 Kennington 79 5 74 - 8 8 10.3 1.4 Stockwell 68 1 67 - 7 7 10.3 1.0 Brixton 97 9 88 - 20 20 20.6 1.2 Norwood 69 12 57 2 9 11 15.9 10.3 Borough of Lambeth 373 27 346 2 55 57 15.3 1.2 Rate of persons notified per 1000 inhabitants—1.2 Inner Districts, and 1.1 Outer Districts. Of the 346 cases removed to Hospital, 46.8 per cent. were from the Inner, and 53.2 per cent. from the Outer, Districts. 551 swabs from suspected diphtheria throats were examined at the Bacteriological Laboratory during 1909, and, of these, 20 i.e., 3.6 per cent., showed the presence of the true Klebs-Læffer (diphtheria) bacilli (vide p. 191). The value of antitoxin* as a remedy for Diphtheria is now acknowledged, more especially when used in the early stages of the disease, e.g., first or second days. During 1909, 59 vials have been distributed gratuitously in Lambeth Borough by the Council for use by Medical Practitioners—a procedure now officially approved by the Local Government Board. *Antitoxin first gratuitously distributed in Lambeth by the late Vestry on August 3rd, 1899. E 66 MEMBRANOUS CROUP. During 1909, in the Borough of Lambeth, 3 cases were notified from Membranous Croup, and 1 death was registered (giving a case-mortality of 33.3 per cent.), as compared with a yearly average of 26 cases notified and 8 deaths registered throughout the old Parish of Lambeth during 10 years (1891-1900).* 2 cases were removed' to Hospital. In London, during 1909, there were registered 614 deaths (uncorrected) out of a total of 6685 cases of Diphtheria and of Membranous Croup notified (uncorrected), giving a casemortality of 9.2 per cent. † (uncorrected). TYPHOID FEVER. During 1909, 9 deaths were registered in the Borough of Lambeth from Typhoid (Enteric Fever), and a total of 49 cases notified, giving a case-mortality of 18.4 per cent. Of the 49 cases notified, 40‡ (i.e., 81.6 per cent.) were removed to Hospital, and 7 died, giving a case-mortality of 17.5 per cent. amongst the patients treated in Hospital; whilst 9 (i.e., 18.4 per cent.) were treated at home, and 2 died, giving a case-mortality of 22.2 per cent. amongst the patients treated at home. If a comparison be made between the number of cases of Typhoid notified, and the number of deaths from Typhoid registered, in the Borough of Lambeth during 1909, and the yearly averages for 10 years (1891-1900) in the old Parish of Lambeth, it will be noted that there is a remarkable decrease. The yearly average of cases notified in the Parish is 189.6 *Membranous Croup Notification Certificates received since the formation of the New Borough:—1901—13, 1902—15, 1903—9. 1904-11 l905 —11, 1906-11, 1907—13, 1908—12. †In London Statistic, Diphtheria and Membranous Croup are now grouped together by the Registrar-General. † Of the 40 cases of Typhoid Fever removed to Hospital 12 proved at Hospital not to be suffering from that disease. 67 and the yearly average of deaths registered is 34.7, as compared with 49 and 9 respectively as the numbers of notified cases and deaths in the Borough of Lambeth during 1909, giving decreases of 74.2 and 73.8 per cent. respectively. The age and sex incidence and mortality for Typhoid cases notified in Lambeth Borough during 1909 are as Ages. Number of Cases Notified. Deaths. Deathrate per 100. M. F. Total. M. F. Total. Under 1 year - - - - - - - 1 to 5 - - - - - - - 5 to 10 2 3 5 — — - 0.0 10 to 20 5 6 11 — 1 1 9.1 20 to 40 14 9 23 5 1 6 26.1 40 to 60 8 1 9 2 — 2 22.2 60 and over 1 - 1 - - — 0.0 Total 30 19 49 7 2 9 18.4 It will be noted that there was no case notified, and no death registered, in infants under 1 year of age; no case notified, and no death registered, amongst children between 1 and 5 years of age; whilst the greatest numbers of both cases and deaths occurred amongst ptrsons between 20 and GO vears of age. Details as to the incidence of the disease during 1909 upon the different New Registration Sub-districts of the Borough of Lambeth are as follow :— 68 New Registration Sub-Districts. Total No. of Cases Notified. Cases treated at Home. Cases removed to Hospital. No. of Deaths. Case Mortality per 100. Rate of Persons Notified per 10000 Inhabitant. At Home. In Hospital. Total. Waterloo 5 1 4 - - - 0.0 1.9 Lambeth Church 5 — 5 — 1 1 20.0 1.9 Kennington 9 1 8 1 2 3 33.3 1.6 Stockwell 11 2 9 1 2 3 27.3 1.6 Brixton 7 2 5 — 1 1 14.3 0.9 Norwood 12 3 9 - 1 1 8.3 1.8 Borough of Lambeth 49 9 40 2 7 9 18.4 1.5 Rate of persons notified per 1,000 inhabitants, 0.7 Inner Districts, and 0.1 in Outer Districts. Of the 49 Typhoid-infected houses 27 (i.e., 55.1 per cent.) showed, on inspection, defective drains, traps, fittings or appliances. In 4 (i.e., 8.2 per cent.), the drains themselves were found to be defective. 16 cases out of the 49 were traced to sources outside the Borough, and 7 were secondary cases, i.e., derived from previous cases in the Borough. No case could be traced definitely and conclusively to infected ice-creams, water, milk, shell-fish, or watercress. There was a history in 8 cases of shell-fish (oysters, mussels, or periwinkles), having been eaten by the patients notified 1 to 3 weeks previous to the disease developing, though, in this connection, the number of persons who eat shell-fish, and do not get typhoid, during the same period under review, must be remembered. 69 Seven Typhoid "contacts," per S.S. "Dongola" from India were watched for a period of 21 days (incubation), out not one sickened with the disease. 32 samples of blood were examined at the Bacteriological Laboratory during 1909 (see p. 191) for the Widal Reaction of Typhoid, and in 11 cases (i.e., 34.4 per cent.) such reaction was obtained. In so far as Typhoid Fever is regarded as a sanitary index of a district, the statistics for Lambeth Borough during 1909 are, in that respect, of a most satisfactory character. In London, during 1909, there were registered 154 deaths (uncorrected) out of a total of 1042 cases of Typhoid notified (uncorrected), giving an uncorrected case-mortality of 14.8 per cent. CONTINUED AND TYPHUS FEVERS. During 1909, one case of Continued Fever was notified in the Borough of Lambeth, and one death was registered, as compared with yearly averages for 10 years (1891-1900) in the Parish of Lambeth of 25.7 and 2.2 respectively. The case was not removed to Hospital. In London, 20 cases (uncorrected) were notified and 2 deaths (uncorrected) registered from Continued Fever during 1909, giving a case-mortality of 10 per cent. (uncorrected). No case of Typhus was notified during 1909 in Lambeth Borough. 7 cases of Typhus were notified in London (no deaths). 70 PUERPERAL FEVER. During 1909, in the Borough of Lambeth, 8 deaths were registered from Puerperal Fever (a disease or child-bed), and 16 cases notified, giving a case-mortality of 50 per cent. 7 of the patients (3 from the Inner and 4 from the Outer Districts) were removed to Hospital. The annual averages for 10 years (1891-1900) in the Parish of Lambeth are (1) notified cases, 18.9; and (2) deaths, 11.5; whilst, in the Borough of Lambeth during 1908, 10 cases were notified, and 6 deaths registered. Puerperal Fever is a preventable disease, and is caused through want of care on the part of the nurse, or the medical practitioner, attending upon a lying-in woman. 8445 births were registered in the Borough of Lambeth during 1909, and in only 16 cases was Puerperal Fever notified —a most satisfactory fact to be able to report. In each case enquiries were made, and the Midwives (when in attendance) were visited at their homes, their rooms (or houses) and clothes disinfected, and their other patients (being attended at the time) followed up and watched for periods varying from 2 to 3 weeks each as required. One Midwife was cautioned, but in no instance was it found necessary to take legal action against any Midwife, during 1909. In London, during 1909, there were registered 170 deaths (uncorrected) out of a total of 287 cases of Puerperal Fever notified (uncorrected), giving a case-mortality of 59.2 per cent. (uncorrected). 71 ERYSIPELAS. During 1909, in the Borough of Lambeth, 189 cases ol Erysipelas were notified, and 11 deaths registered, giving a case-mortality of 5.8 per cent. Of the 189 cases 61 (i.e., 32.3 per cent.) were removed to Hospital, and of these fcl cases, 46 (i.e., 75.4 per cent.) came from the Inner, and 15 (i.e., 24.6 per cent.) from the Outer Districts. The yearly averages for the 10 years (1891-1900) in the Parish of Lambeth are (lj notified case, 347 ; and (2) deaths, 17.5. In London, during 1909, there were registered 176 deaths(uncorrected) out of a total of 4194 cases of Erysipelas notified (uncorrected), giving a case-mortality of 4.2 per cent, (uncorrected). The advantages from the notification of Erysipelas are few, and the majority of cases notified as Erysipelas are not such as were contemplated by the framers of the Notification Act. The details as to the incidence of the two diseases, Puerperal Fever and Erysipelas, in the different New Registration Sub-Districts of Lambeth Borough during 1909 arc as follow : — 72 New Registration SubDistricts. PUERPERAL FEVER. ERYSIPELAS. Number of Cases Notified. Number of Deaths. Case Mortality per 100. Number of Cases Notified. Number of Deaths. Case Mortality per 100. Waterloo — — — 21 — 0.0 Lambeth Church — — — 28 1 3.6 Kennington 3 2 66.6 43 3 6.9 Stockwell 5 1 20.0 41 4 9.8 Brixton 3 1 33.3 34 1 2.9 Norwood 5 4 80.0 22 2 9.1 Borough of Lambeth 16 8 50.0 189 11 5.8 { Puerperal Fever-0.4 Inner Districts, 0.5 Outer Districts. Rate of persons notfied per 10000 inhabitants {Erysipelas-8.02 Inner Districts, 4.1 Outer Districts. 73 DIARRHŒA. During the year 1909, there were registered in the Borough of Lambeth, 118 deaths from Diarrhœa, as compared with 150, 71, 272, 178 and 260 during 1908, 1907, 1906, 1905 and 1904 respectively (vide p. 92, deaths from Enteritis). Taking the statistics of the old Parish of Lambeth for 10 years (1891-1900), it will be seen that the annual average lor Diarrhoea (and Cholera) is 198.9, so that the figures for 1909 for the Borough are 40.7 per cent. less. Of these 118 deaths, 112 (i.e., 94.9 per cent.) were in children under 5 years, and 99 (i.e., 83.9 per cent, in infants under 1 year of age. August, September and October were the most fatal months (see Table S). In this connection, it is again interesting to note that the mean monthly air temperature registered was, in June, 54.8 deg.; in July, 61.3 deg.; in August 62.7 deg.; in September, 55.2 deg.; and in October, 52.5 deg.; whilst the 4-ft. earth thermometer registered 56 deg. F. on July 5th, rising to a maximum (about 63 deg. F. on August 17th or 18th, and sinking to 56 deg. F. again on October 10th (about). 56 deg. F. is the socalled "critical" earth temperature for Diarrhœa, i.e., the temperature at which the germs of this disease begin to multiply, and prove themselves dangerous.* Hence its importance statistically, in connection with this disease, which, though it kills chiefly young children, attacks at times persons of all ages—a fact not generally recognised. *The 4-ft. earth temperatures were taken in Regent's Park, and thanks are due to Mr. Wm. Marriott, of the Royal Meteorological Society, 70 Victoria Street, S.W., for the information in connection therewith. 74 Age mortalities from Diarrhoea were as follow:— Age. Total Deaths Percentage of Total Deaths from Diarrhœa. M. F. Total. Under 1 year 52 47 99 83.9 1 to 5 6 7 13 11.1 5 to 20 — — — — 20 to 40 1 — 1 0.8 40 to 60 1 2 3 2.5 Over 60 2 — 2 1.7 Total 62 56 118 100.0 In London there were registered, during 1909, 1626 deaths (uncorrected) from Diarrhæa, giving an uncorrected rate of 3.4 per 10000 living, and one of 2.3 per cent. of total deaths (uncorrected). The details as to the Diarrhæa incidence (mortality) during 1909 upon the different New Registration Sub-Districts of Lambeth Borough are as follow:- Borough of Lambeth. Number of Deaths. Diarrhœa Death-rate per 10000 Population. New Registration Sub-Districts. Waterloo 21 8.1 Lambeth Church 20 7.5 Kennington 29 5.3 Stockwell 18 2.7 Brixton 20 2.4 Norwood 10 1.5 Borough of Lambeth 118 3.6 75 In the Inner New Registration Sub-Districts, the Diarrhœa death rate per 10000 inhabitants was 5.8 as compared with 2.02 for the Outer Districts, i.e., 2.9 to 1—a condition of things which is generally found to obtain, and which is readily understood when the crowded state of the Inner Districts is remembered. It may be noted that the 4-ft. earth temperature had a low register during 1909, and, as a natural consequence, the Diarrhæa deaths were diminished in numbers. 57 deaths were registered during 1909 from "Enteritis." The yearly average number of deaths from Enteritis in the old Parish of Lambeth for 10 years, 1891-1900, is 101.S. During recent years there has been a marked improvement in the diagnosis of deaths from diarrhæal diseases, so that, to obtain comparable figures, attention should be paid not only to diarrhæa deaths certified, but also to all deaths arising from diseases of an enteritic nature, i.e., those in which the intestines are affected. Comparison must be made with the corrected infantile mortality rate for the Borough, which is 98.3 per 1000 births (vide p. 29). The female Inspectors have visited every house wherein a death has been registered as having taken place from Diarrhæa, with the result that valuable statistics are being tabulated in connection therewith, and from these statistics (when in sufficient numbers) important deductions may be able, hereafter, to be drawn. 76 TABLE S. Shewing the Diarrhœa Mortality in Lambeth Borough in each month during the year 1909. New Registration SubDistricts. Jan. Feb. March April. May. June. July. Aug. Sept. Oct. Nov. Dec. Total Waterloo - 2 - - 1 1 - 4 10 2 - 1 21 Lambeth Church - 1 - — - - 2 4 8 4 — 1 20 Kennington - — - 1 - 1 - 13 10 1 2 1 29 Stockwell - — - 1 - - - 2 9 2 3 1 18 Brixton - 1 - — - - 1 7 8 3 — — 20 Norwood 1 - - 1 - 1 2 1 3 1 - - 10 Total 1 4 — 3 1 3 5 31 48 13 5 4 118 77 The large decrease in the Diarrhœa deaths during 1909 as during the previous two years must be read in connection with the remarks under Infantile Mortality. Whilst it is true that meteorological conditions during these periods were favourable to a low inlantile mortality rate from diarrhœal diseases, the influence of the Council's precautionary measures must be taken into account. TUBERCULOSIS. During 1909, 428 deaths were registered in Lambeth Borough as due to phthisis (tuberculosis of the lungs), 71 as due to tabes mesenterica and tubercular meningitis, and 68 as due to other forms of tuberculosis, making a total of 567 deaths from tuberculosis (all forms)—i.e., 12.5 per cent. of the total deaths (corrected) registered from all causes. The total deaths within the Borough during 1908, 1907, 1906, 1905, 1904, 1903, 1902 and 1901 from all forms of tuberculosis were 601, 613, 562, 582, 621, 639, 701 and 695 respectively, i.e., an average of 627 for the 8 years, 1901-8. Sub-dividing the tuberculosis deaths during 1909 amongst the different New Registration Sub-Districts, it is found that the numbers of deaths and the rates (per 1000) living vary as follows:— 78 New Registration Sub-Districts. Deaths from Total Deaths Tuberculosis. Rate per 1000 living. Phthisis. Tabes. Mes. and Tub. Men. Other form Tuberculosis. Waterloo 50 6 7 63 2.5 Lambeth Church 51 13 10 74 2.9 Kennington 82 14 17 113 2.1 Stockwell 106 13 12 131 1.9 Brixton 77 15 11 103 1.3 Norwood 50 10 10 70 1.1 No address given 12 — 1 13 — Borough to Lambeth 428 71 68 567 1.7 Inner Districts—2.3 per 1000 living. Outer Districts—1.3 per 1000 living. N.B.—When the address is not given, the deaths (13) have been distributed equally amongst the Sub-Districts, whilst the deaths in the Stockwell Sub-District have been equally divided between the Inner and Outer Districts for the purpose of calculating rates in this Table. The tuberculosis mortality rate per 1000 living during 1909 is 1.7, as compared with ].7, 1.9, 1.8, 1.9 and 2.0 during 1908, 1907, 1906, 1905 and 1904, respectively. 186 samples of sputum were examined bacteriologicaily during 1909, and in 71, i.e., 38.2 per cent., tubercle bacilli were found (vide p. 190). The distribution of consumption or pulmonary phthisis, as a disease, can be guaged from the notifications that have been received from all sources, viz.: (1) under (a) the voluntary Lambeth Notification (Consumption) Scheme, 1902, and (b) the compulsory Poor Law Scheme, i.e., Public Health (Tuberculosis) Regulations, 1908 and (2) other sources 79 don County Council Education Department, private benevolent or philanthropic associations, Hospitals (general and special), the Army (discharged soldiers), Charity Organization Society, etc. These notifications are set out in Tables I., II., 11I., 1V. and V., dealing with (i.) New Wards and (it.) New Registration Sub-Districts, in so far as the year 1909 is concerned. Comparing these figures with those published in former Reports, it will be noted that the total number of cases of consumption or pulmonary phthisis voluntarily notified by medical men during 1909 in Lambeth, under the Lambeth Voluntary Notification (Consumption) Scheme is smaller than in previous years, viz., 117, as compared with 373 during 1908, and a total of 2397 for the 8 years, during which this voluntary (Lambeth) scheme has been in force (1902-1909). This decrease is due to the introduction of the Compulsory Notification of Poor Law Cases under the Public Health (Tuberculosis) Regulations, 1908, which came into force. throughout the Borough (and the rest of London) on January 1st, 1909. Under these Regulations, there are 4 sets of notifications (pulmonary tuberculosis, i.e., consumption or phthisis) compulsory, viz.:- Form A—Patients admitted into the Poor Law Institutions; Form B—Patients receiving Poor Law Medical Relief outside the Poor Law Institutions; Form C—Inmates (previously notified) of the Poor Law Institutions, when leaving; Form D—Changes of addresses of persons (previously notified), receiving Poor Law Medical Relief outside the Poor Law Institutions. The Voluntary (Lambeth) Notification Scheme came into force on June 1st, 1902, and includes cases notified from the Brompton Consumption and other Hospital Medical Staff. 80 Forms A and B are the Medical Notifications, and include also re-notifications of patients moving into the Institutions from outside or leaving the Institutions to continue Poor Law medical treatment outside. Forms C and' D are nonmedical notifications, sent in by Superintending Officers of Poor Law Institutions and Relieving Officers respectively. During 1909, a total of 904—785 notifications and 119 renotifications, have been received, viz. : 493 under Form A (119 re-notifications), 227 under Form B, and 184 under Form C. No notification has been received under Form D (Relieving Officers). Under the other sources of notification may be mentioned specially the London County Council Education Department (Medical Officer)—23 communications during 1909, dealing with 31 cases of scholars suffering from (a) consumption of lungs (18); (b) general tuberculosis (9); and (c) suspected consumption of the lungs (4). Other details will be found in Tables I., II. and V. In each case notified, from whatever source, disinfection is carried out at the premises as required, and leaflets are distributed. In this way, there is reason to believe that much good is accruing in preventing not only the spread of the disease but also its development in susceptible persons. Taking all the notifications received during 1909—a total cf 1093, the disease (consumption of the lungs) appears to have a greater incidence upon the Inner than the Outer Districts (Registration and Wards), viz., 805 to 288. This is due to (1) the more crowded conditions, persons in houses and houses over area, and (2) the different (poorer) status of the inhabitants, that exist in the former as compared with the latter. Taking all the notifications received from medical men during 1909, and excluding the re-notifications (119 in 81 ber), the incidence-rates of consumption of the lungs per 1000 of the Population in the new Wards and new Registration Sub-Districts are as follow:- (1) New Wards— Inner—3.7, viz.: Marsh 3.6, Bishop's 5.7, Prince's 2.7, Vauxhall 3.4; Outer—1.1., viz.: Stockwell 1.2, Brixton 0.9, Hene Hill 0.8, Tulse Hill 1.1, Norwood 1.8. (2) New Registration Sub-Districts— Inner—3.7, viz.: Waterloo 3.6, Lambeth Church 4.8, Kennington 3.4, Inner Stockwell 1.6; Outer—1.1., viz.: Outer Stockwell 0.5; Brixton 1.1, Norwood 0.3. Borough of Lambeth=2.3. 82 TABLE I.—CONSUMPTION NOTIFICATIONS*. Notification certificates received during 1909 (a) under the Voluntary Lambeth Scheme, 1902, and (b) from Private Sources. New Wards. PRIVATE SOURCES. Totals. Lambeth Scheme 1902 Full Totals. Army. Charity Organisation. Jewish Guardians. Lady Margaret Settlement Hospitals, Lady Almoners Marsh - - - 4 - 4 8 12 Bishop's 1 - - 4 - 5 23 28 Prince's 1 - — 5 4 10 22 32 Vauxhall — - - - — — 8 8 Total Inner Wards 2 — — 13 4 19 61 80 Brixton - 3 - - - 3 9 12 Stockwell 1 7 — — 1 9 10 19 Heme Hill — 5 - — 1 8 11 19 Tulse Hill — 15 — — — 15 8 23 Norwood — — — — '— — 18 18 Total Outer Wards 1 30 2 — 2 35 56 91 Boro' of Lambeth Totals 3 30 2 13 6 54 117 171 N.B—Voluntary Notification Scheme came into force in Lambeth Borough on June 1st, 1902. 83 TABLE II.—CONSUMPTION NOTIFICATIONS. Notification certificates received during 1909 (a) under the Voluntary Lambeth Scheme, 1902, and (b) from Private Sources. New Registration Sub-Districts. PRIVATE SOURCES. Totals. Lambeth Scheme 1902. Full Totals. Army. Charity Organisation. Jewish Guardians. Lady Margaret Settlement. Hospitals, Lady Almoners. Waterloo - - - 4 - 4 8 12 Lambeth Church 1 — — 4 — 5 23 28 Kennington 1 — — 5 4 10 22 32 Stockwell (Inner) — — — — - - 8 8 Total Inner Districts 2 — - 13 4 19 61 80 Stockwell (Outer) 1 7 - — 1 9 10 19 Brixton — 8 2 — 1 11 20 31 Norwood — 15 — - — 15 26 41 Total Outer Districts 1 30 2 — 2 35 56 91 Boro' of Lambeth Totals 3 30 2 • 13 6 54 117 171 N.B.—Voluntary Notification Scheme came into force in Lambeth Borough on June 1st, 1902. 84 85 TABLE 111.— CONSUMPTION NOTIFICATIONS. Notification Certificates (Forms A, B, C and D), received during 1909 (a) quarterly under the Public Health (Tuberculosis) Regulations, and yearly from the L.C.C. Education Department (Medical Officer). NEW WARDS. New Wards. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS. L.C.C. Education Department Total 1909. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total 1909. 1909. Form A. Form B. Form C. Form D. Total. Form A. Form B. Form C. Form D. Total. Form A. Form B. Form C. Form D. Total. Form A. Form B. Form C. Form D. Total. Medical. NonMedical. Total. Medical Officer. Marsh 27 15 7 - 49 17 7 16 - 40 11 6 5 - 22 9 8 6 - 23 100 34 134 5 Bishop's 60 20 14 - 94 36 15 21 - 72 19 8 20 - 47 30 9 8 - 47 197 63 260 - Prince's 29 18 3 - 52 22 15 9 - 46 18 5 7 - 30 18 13 3 - 34 138 24 162 4 Vauxhall 23 5 6 - 34 23 7 11 - 41 24 10 14 - 48 20 5 7 — 32 117 38 155 5 Total Inner Wards 139 58 32 - 229 98 44 57 — 199 72 29 46 — 147 77 35 24 136 552 159 711 14 Stockwell 7 5 1 - 13 2 1 1 - 4 1 4 - - 5 11 8 1 - 20 39 3 42 1 Brixtor 7 7 1 - 15 4 4 1 - 9 8 1 2 - 11 1 3 1 - 5 35 5 40 1 Herne Hill 4 5 1 - 10 3 2 3 - 8 1 - 1 - 2 3 3 - - 3 21 5 25 - Tulse Hill 3 3 2 - 8 5 1 2 - 8 6 - 1 - 7 2 3 3 - 8 23 8 31 2 Norwood 10 7 1 - 18 14 3 - - 17 14 1 1 - 16 1 - 2 - 3 50 4 54 - Total Outer Wards 31 27 6 — 64 28 11 7 — 46 30 6 - -- 41 18 17 7 — 42 168. 25 '93 4 Borough of Lambeth 170 85 38 — 293 126 55 64 — 245 102 35 51 — 188 95 52 31 — 178 720 184 904 18 The L.C.C. Education Department (Medical Officer) reported, 5, Prince's, 2, Vauxhall, 1 and Brixton, 1, and 4 cases of Suspected Under the Public Health (Tuberculosis) Regulations, 119 Re-notifications in addition, during 1909,9 cases of General Tuberculosis, viz., Marsh, Consumption (Phthisis), viz., Marsh, 1, Prince's, 1, Vauxhall, 2. are included. 86 87 TABLE IV.— CONSUMPTION NOTIFICATIONS. Notification Certificates (Forms A, B, C and D) received during 1909 (a) quarterly, under the Public Health (Tuberculosis) Regulations, 1908, and yearly from the L.C.C. Education Department (Medical Officer). NEW REGISTRATION DISTRICTS. New Registration Sub-Districts. 1909. PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS. L.C.C. Education Department Total 1909. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total 1909. Form A. Form B. Form C. Form D. Total. Form A. Form B. Form C. Form D. Total. Form A. Form B. Form C. Form D. Total. Form A. Form B. Form C. Form D. Total. Medical. NonMedical. Total. Medical Officer. Waterloo 27 15 7 - 49 17 7 16 - 40 11 6 5 - 22 9 8 6 - 23 100 34 134 5 Lambeth Church 29 19 6 - 54 19 14 12 - 45 13 8 5 - 26 17 7 2 - 26 126 25 151 - Kennington 60 19 13 - 92 39 16 18 - 73 24 5 22 — 51 31 15 9 - 55 209 62 271 4 Stockwell (Inner) 23 5 6 - 34 23 7 11 - 41 24 10 14 - 48 20 5 7 - 32 117 38 155 5 Total Inner Districts 139 58 32 — 229 98 44 57 - 199 72 29 40 - 147 77 35 24 — 136 552 159 711 14 Stockwell (Outer) 7 5 1 - 13 2 1 1 - 4 1 4 - - 5 11 8 1 - 20 39 3 42 1 Brixton 11 12 2 - 25 7 6 4 - 17 9 1 3 - 13 4 6 1 — 11 56 10 66 1 Norwood 13 10 3 - 26 19 4 2 - 25 20 1 2 - 23 3 3 5 - 11 73 12 85 2 Total Outer Districts 31 2 6 - 64 28 11 7 — 46 30 6 5 41 .8 17 7 — 42 168 25 193 4 Borough of Lambeth 170 85 38 — 293 126 55 64 — 245 102 35 51 - 188 95 52 31 — 178 720 184 904 18 The L.C.C. Education Department (Medical Officer) reported, in addition, during 1909, 9 cases of General Tuberculosis viz., Waterloo, 5, Kennington, 2, Inner Stockvvell, 1, and Brixton, 1, and 4 cases of Suspected Consumption (Phthisis), viz., Waterloo, 1, Kennington, 1, and Inner Stockwell, 2. Under the Public Health (Tuberculosis) Regulations, 119 Re-notifications are included. 88 TABLE V.—CONSUMPTION RE-NOTIFICATIONS. Re-notification Certificates (Form A) received during 1909—(a) quarterly under the Public Health (Tuberculosis) Regulations, 1902. NEW WARDS AND REGISTRATION SUB-DISTRICTS. Wards. 1st Qr. Form A. 2nd Qr. Form A. 3rd Qr. Form A. 4th Qr. Form A. Total. New Sub-districts. 1 st Qr. Form A. 2nd Qr. Form A. 3rd Qr. Form A. 4th Qr. Form A. Total. Marsh 6 7 3 4 20 Waterloo 6 7 3 4 20 Bishop's 8 17 6 10 41 Lambeth Church 2 13 3 5 23 Prince's 6 9 4 9 28 Kennington 12 13 7 14 46 Vauxhall 3 7 4 4 18 Stockwell (Inner) 3 7 4 4 18 Total Inner Wards 23 40 17 27 107 Total Inner Districts 23 40 17 27 107 Stockwell 1 3 - 2 6 Brixton - - 2 — 2 Heme Hill 2 - — — 2 Stockwell (Outer) 1 3 — 2 6 Tulse Hill - - — — - Brixton 2 — 2 — 4 Norwood 2 - — - 2 Norwood 2 — — — 2 Total Outer Wards 5 3 2 2 12 Total Outer Districts 5 3 2 2 12 Borough of Lambeth 28 43 19 29 119 Borough of Lambeth 28 43 19 29 119 89 Sanatorium Treatment for Consumption. The Lambeth Council, during 1909, again approved of the principle of the Metropolitan Asylums Board using the vacant Isolation Hospitals for the reception of consumptive patients for Sanatorium treatment, if practicable, and addressed a letter to the Local Government Board, urging them to allow the Asylums Board so to act. The need for sanatoria lor consumptives is admitted, as are also the good effects that would accrue from the taking away, at least temporarily, from crowded localities of houses of all consumptive patients who are a danger to others living in the same houses or rooms. The educational value of such sanatoria must not be forgotten, even in the cases of patients who remain under treatmen there a few months only. When they return to their homes, they continue to carry out the rules under which they have lived whilst in the Sanatoria. Tuberculosis Exhibition, London, 1909. During June, 1909, the National Association for the Prevention of Consumption and other forms of Tuberculosis organised an Exhibition and Conference at the Art Gallery, Whitechapel, and the Chairman of the Public Health Committee and the Medical Officer of Health were appointed delegates to attend on behalf of the Council. Educationally these Exhibitions effect much good, in bringing to the knowledge of the people the nature and dangers of the disease, and the simple methods for its prevention. GLANDERS. On January 1st, 1908, the London (Notification ot Glanders) Order, 1907, came into force throughout the Administrative County of London and the City of London. By the terms of the Order, information of outbreaks of animal Glanders is to be communicated to the Medical 90 Officer of the Sanitary District concerned, and the London County Council, as the Authority under the Glanders, or Farcy, Order, 1907, and the regulations made thereunder, have arranged for their Veterinary Inspectors to forward particulars of all notifications as the outbreaks of disease occur. All necessary steps to be taken in connection with the slaughtering of diseased animals, and the cleansing and disinfecting of infected premises, are to be carried cut by, and under the supervision of, the London County Council's Veterinary Inspectors. Glanders may be contracted by human beings from animals, and an Order* has been made by the London County Council, requiring the notification of all cases of Glanders occurring in human beings throughout the Administrative County of London. The Order has been approved by the Local Government Board, and came into force from (and including) April 26th, 1909. During 1909, 26 notifications of animal glanders have been received in Lambeth, as compared with 41 during 1908, but no case of human glanders has been notified.† EPIDEMIC INFLUENZA. During 1909, 66 deaths were registered from Influenza in the Borough of Lambeth, as compared with 65 during 1908, and an average of 107.5 for ten years (1891-1900) in the old Parish of Lambeth. Of the 66 deaths. 32 were registered during the first, 17 during the second, 2 during the third, and 15 during the fourth quarter of the year. In London, there were registered 1202 deaths (uncorrected) from Influenza during 1909. *The Order includes also Anthrax and Hydrophobia occurring in human beings. †In London, 4 cases of Anthrax and 2 cases of Glanders, but no cases of Hydrophobia have been notified since these diseases became notifiable on April 26th, 1909. One case of Anthrax (human) was notified under section 73 ot the Factory and Workshop Act, 1901 in Lambeth, during 1909, viz., in February, at 2 Kibworth Street, the patient being a catsmeat man. 91 Reviewing the ten years' history (1891-1900) of the old Parish of Lambeth in relation to Epidemic Influenza, it will be seen that the disease was practically epidemic during that decennium, rising to a maximum in 1892, 1895, 1899 and 1900. The yearly average for ten years (1891-1900) in the old Parish of Lambeth is 107.5, so that the 1909 statistics for the new Borough of Lambeth show a sub-epidemic state. Table showing the number of deaths from Epidemic Influenza in Lambeth Borough, and London, during 1909, and during ten years (1891-1900) in Lambeth Parish and London. - Old Parish of Lambeth. Average for 10 years. (1891-1900.) Borough of Lambeth. 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1909 Lambeth 131 142 85 44 148 51 45 126 151 152 107.5 66 London (including Lambeth) 2336 2264 1526 750 2156 496 671 1283 1817 1950 1524.9 1202 N.B.—The term " influenza " is too indefinite in medical practice to permit of any satisfactory deductions being drawn from the above statistics. The 42 deaths from venereal affection (Syphilis, etc.) are the only other point calling for note in the class of Zymotic Diseases. Classes II. and III.—Parasitic and Dietetic Diseases. 12 deaths were registered in the classes from cnronic Alcoholism, but no death was registered from delirium tremens. Class IV.—Constitutional Diseases. Of the total 1036 deaths under this class, 377 were due to Cancer, 428 to Phthisis, and 139 to Tubercular Meningitis and other forms of Tuberculosis. 92 Class V.—Developmental Diseases. The total number of deaths in this class was 307, consisting of 131 from Premature Birth, 132 from Old Age, and 44 from Atelectasis and Congenital Malformations. Class VI.-—Local Diseases. 1. Diseases of the Nervous System caused 377 deaths, including 33 from Convulsions, 192 from Apoplexy, and 20 from Epilepsy. 2. 487 deaths were due to diseases of the Circulatory System. 3. The diseases of the Respiratory Organs caused 995 deaths (464 from Bronchitis, and 198 from Pneumonia). 4. Diseases of the Digestive Organs caused 249 deaths, of which 57 were due to Enteritis, 10 to Peritonitis, 74 to diseases of the Liver and 19 to Dentition. 5. Diseases of the Urinary System caused 168 deaths. 6. Diseases of the Reproductive System, Integumentary System, Locomotive System, Lymphatics, Organs of Special Senses, and Gland-like Organs of uncertain use, caused together 83 deaths. Class VII.—Deaths from Violence. 131 deaths in all, including 106 from Accidents or Negligence, 18 from Burns and Scald's, 5 from Drowning, 9 from Suffocation in bed (6 being infants under 1 year), 24 from Suicide and 1 from Homicide. Class VIII.—Other Causes. 139 deaths were registered in this class, consisting of deaths from Dropsy, Tumours, Haemorrhages, Debility, Atrophy, and Inanition, or other ill-defined or aonspecified causes. 93 Different rates of mortality from different diseases and groups of diseases are given in terms of the total deaths (corrected1 and uncorrected) in Tables T and U; whilst Table T gives also the deaths from the chief Infantile Diseases, expressed in terms of the Infantile population (or number of Births). Allowing for the slight differences between the corrected and uncorrected death returns, it will be noted that, in regard to both infantile and other diseases, Lambeth again compares favourably with London (vide Table U). Alllowing for (the favourable meteorological conditions during 1909, favourable in so far as infantile life was concerned, the statistics for Lambeth Borough throughout the year 1909 are satisfactory—the corrected infantile mortality rate, as a whole, being 98 per 1000 births, i.e., taking the corrected number of deaths of infants under 1 year of age, and the uncorrected number of births registered. Comparing the Lambeth statistics with those for the large Provincial Towns or the separate Metropolitan Districts, the Lambeth Borough is to be congratulated upon the extraordinary low rate of infantile mortality. In this connection, the influence of the precautionary measures that are being taken in Lambeth must be remembered, e.g., the systematic visiting of houses wherein births and deaths of infants under 1 year of age have been registered, the milk depot, the distribution of pamphlets dealing with the proper feeding and management of infants, etc., and the special work done by the Council's Health Visitor. 94 TABLE T. Shewing Classification of Causes of deaths (corrected) in the Borough of Lambeth during 1908 and 1909. A.—Total Deaths from all causes and at all ages with percentages of deaths to total deaths (corrected). Class of Disease. Borough. 1909. Borough 1908. No. of Deaths (corrected). Percentage of Total Deaths (corrected). No. of Deaths (corrected). Percentage of Total Deaths (corrected). I.—Zymotic Diseases 548 12.1 529 I2.2 Seven Principal 402 8.9 397 9.1 Influenza 66 1.5 65 1.5 II.—Parasitic 2 0.04 2 0-05 III. —Dietetic 18 0.4 34 0.8 IV.—Constitutional 1036 22.8 1031 23.8 Cancer 377 8.3 338 7.8 Phthisis 428 9.4 441 10.2 Tubercular Diseases, excluding Phthisis 139 3.1 160 3.7 Rheumatism (Acute and Chronic) and Gout 26 o.6 23 0.5 V.—Developmental 307 6.8 296 6.8 Old Age 132 2.9 113 2.6 VI.—Local Diseases 2359 51.9 2162 49.8 Circulatory System 487 10.7 472 10.9 Bronchitis 464 10.2 383 8.8 Pneumonia and BronchoPneumonia 375 8.3 318 7.3 Pleurisy and Pleuro-Pneumonia 68 1.5 54 1.2 Respiratory System, excluding Phthisis 995 21.9 816 18.8 VII.—Violence 131 2.9 139 3.2 Suicide 24 0.5 36 0.8 VIII.—Other Causes 139 3.1 138 3.2 95 TABLE T—continued. B.—Deaths (corrected) of Infants under One Year of age from the chief infantile diseases, and from all causes, expressed in terms of 1000 births (corrected). Borough 1909. Borough 1908. Total Deaths under One Year (Corrected). Proportion to 1000 Births (Corrected).* Total Deaths under One Year (Corrected). Proportion to 1000 Births (Corrected).* From all causes 830 109.5 829 103.2 Diarrhœa 99 13.1 118 14.7 Convulsions 29 3.7 21 2.6 Respiratory Diseases 152 20.1 140 17.4 Premature Births 131 17.3 134 16.7 Tubercular Diseases (including Phthisis) 41 5.4 53 6.6 Measles 21 2.8 16 1.9 Whooping Cough 44 5.8 19 2.4 Suffocation in Bed 6 0.8 6 0.7 Enteritis 13 1.7 31 3.9 Dentition 13 1.7 9 1.1 * N.B.—The Registrar-General gives the corrected Lambeth births for 1908 and 1909 as 8035 and 7578 respectively. 96 TABLE U. Shewing Classification of Certain Causes of Deaths (uncorrected) in the Borough of Lambeth, compared with London, during 1908 and 1909, given in percentages of the total uncorrected deaths. A.—Deaths at all Ages. Lambeth. London. Percentage of total Deaths (uncorrected) Percentage of total Deaths (uncorrected) 1908. 1909. 1908. 1909. 1. Principal Zymotics 9.3 9.2 9.6 9.03 Influenza 1.4 1.4 1.9 1.7 Measles 2.1 2.1 2.2 3.3 Whooping Cough 09 1.6 1.4 1.8 Diarrhœa and Dysentery (including Cholera) 3.9 2.6 3.8 2.3 II. Rheumatic Fever and Heart Rheumatism 0.3 0.3 0.3 0.3 III. Diseases of Circulatory System 10.5 10.1 13.4 13.1 IV. Bronchitis, Pneumonia and Pleurisy 16.3 18.8 17.5 19.6 Phthisis 8.8 8.5 9.4 8.9 V. Injuries 37 3.4 4.3 3.8 B—Deaths under 1 Year of Age (per 1000 Births uncorrected). All Causes 106.7 106.7 115.4 110.3 97 BOROUGH OF LAMBETH. SUMMARY OF VITAL AND MORTAL STATISTICS, etc., FOR 1909. Area of Borough—4080 statute acres (exclusive of tidal water 82.1, and foreshore 31.1 statute acres respectively) divided' into 6 new Registration Sub-Districts, 4 Parliamentary Divisions, and 9 new Wards. The Parliamentary Divisions and new Wards are not coextensive, but the new Registration Sub-Districts and the new Wards are. Population—estimated middle of 1909—324188 (males 153505, females 170683). Density—79.5 persons per acre (exclusive of tidal water and foreshore). Inhabited Houses—41511 at Census, 1901. Rateable Value—£1,968,216 for year ending 31st March, 1909. Marriages—2440, being 15.0 per 1000. Births—8445, being 26.4 per 1000. Deaths (corrected)—4540, being 14.0 per 1000. Infantile Mortality—830 deaths (corrected) under 1 year being 98.3 per 1000 total uncorrected births. Zymotic—Death-rate, 1.2 per 1000 (total deaths, 402). Estimated' increase of Population is 2844 but the natural increase or increment (i.e., excess of Births over deaths) is 3569 (uncorrected). o8 99 TABLE V TABLE V. Local Government Board Old Table A] Table of DEATHS during the year 1909 in the Borough of Lambeth classified according to Diseases, Ages, and Localities. Names or Localities adopted for the purpose of these Statistics, public institutions being shewn as separate localities. Mortality from all causes at subjoined Ages. Mortality from Subjoined causes, distinguishing deaths of children under five Years of Age. At all ages Under 1 year. 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Men,branous Croup. Fevers. Erysipe'as. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Influenza. Injuries. Cerebro Spinal Fever. All other Diseases. Total. Puerperal. Relapsing Continued Enteric or Typhoid. Typhus. (a) (b) (c) (d) (e) (f) (e) (h) (i) Royal Infirmary (Women and Children) 112 66 26 4 2 13 1 Under 5 ... ... 1 ... ... ... ... ... ... ... ... ... 4 ... 2 23 ... ... ... ... 62 92 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 6 1 ... ... 12 20 General Lying-in-Hospital, York Road 24 19 ... ... 1 4 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 17 19 5 upwds. ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... 1 5 Remainder of Waterloo 261 71 44 7 4 80 55 Under 5 ... ... ... ... ... ... ... ... ... ... 21 5 20 ... 1 24 ... 2 ... ... 41 115 5 upwds. ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... 19 51 21 1 14 ... 39 146 St. Thomas's Hospital 746 71 96 79 64 372 64 Under 5 ... 1 21 ... ... ... ... ... ... 3 1 ... 14 ... 2 24 3 ... 16 4 78 167 5 upwds. ... ... 1 ... 3 ... ... 4 ... 2 ... ... 2 2 14 30 57 ... 50 ... 414 579 Remainder of Lambeth Church 281 73 54 11 11 84 48 Under 5 ... ... 2 ... ... ... ... ... ... ... 19 9 14 ... ... 26 1 ... 4 ... 52 127 5 upwds. ... 1 ... ... ... ... ... ... ... ... 1 ... 1 ... 22 38 23 3 10 ... 55 154 Lambeth Workhouse 146 15 ... ... ... 29 102 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 14 15 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... 1 5 67 27 ... ... ... 31 131 Lambeth Infirmary 721 45 25 8 23 422 198 Under 5 ... ... 2 ... ... ... ... ... ... 1 5 9 5 ... ... 8 ... ... ... ... 40 70 5 upwds. ... ... ... ... ... ... ... 5 ... 6 ... ... ... 3 157 99 86 ... 14 ... 281 651 St. Peter's House 43 ... ... ... ... 3 40 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 14 5 ... ... ... 24 43 Remainder of Kennington 514 142 60 9 17 143 143 Under 5 ... ... ... 1 ... ... ... ... ... ... 25 16 17 1 49 ... ... 5 ... 88 202 5 upwds. ... ... ... ... 1 ... ... 1 ... 1 ... 2 ... 1 41 76 60 4 9 ... 116 312 South-Western Hospital 112 10 55 31 3 12 ... Under 5 ... 20 37 ... ... ... ... ... ... ... 2 ... 4 ... ... ... ... ... ... ... 2 65 5 upwds. ... 15 16 ... ... ... ... 5 ... ... 1 ... ... ... ... 3 1 ... ... ... 6 47 Clapham Maternity 10 9 ... ... ... 1 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 9 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Remainder of Stockwell 572 118 40 13 25 186 181 Under 5 ... ... ... ... ... ... ... ... ... ... 13 8 14 ... 1 30 1 1 1 ... 98 167 5 upwds. ... ... ... ... ... 1 ... ... ... ... 1 3 53 94 44 16 11 ... 182 405 100 101 TABLE V.—continued. [Local Government Board Old Table A—continued]. Table of DEATHS during the year 1909 in the Borough of Lambeth, classified according to Diseases, Ages, and Localities. Names or Localities adopted for the purpose of these Statistics, Public institutions being shewn as separate localities. Mortality from all causes at subjoined ages. Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. At all ages. Under 1 year. 1 and under. 5 and under 15. 15 and under 25 25 and under 65. 65 and upwards. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysenters. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Influenza. Injuries. Cerebro Spinal Fever. All other Diseases. Totals. Puerperal. Relapsiug. Continued. Enteric or Typhoid. Typhus. (a) (b) (c) (d) (e) (f) (g) (h) (i) Belgrave Hospital 66 33 28 5 ... ... ... Under 5 ... ... 1 ... ... ... ... ... ... 1 ... ... 7 ... 1 13 ... 1 ... 2 35 61 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... ... ... 2 5 Remainder of Brixton 710 131 41 8 21 241 268 Under 5 ... ... ... ... ... ... ... ... ... ... 12 20 13 ... ... 28 1 1 3 ... 94 172 5upwds. ... ... ... ... 1 ... 1 ... ... ... ... 1 1 4 56 122 90 19 15 ... 228 538 Lambeth Workhouse Schools 7 4 1 1 1 ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... 3 5 5 upwsd. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 2 British Home of Incurables 7 ... ... ... ... 3 4 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 6 7 Remainder of Norwood 544 94 18 11 14 180 227 Under 5 ... 1 1 ... ... ... ... ... ... ... 3 9 9 ... 1 20 1 ... 1 ... 66 112 5 upwds. ... ... 1 ... 2 ... ... ... ... 1 ... ... ... 2 38 74 62 19 12 ... 221 432 Totals 4876 901 497 188 186 1773 1331 Under 5 ... 23 65 1 ... ... ... ... ... 5 101 76 121 ... 10 248 7 5 31 6 699 1398 5 upwds. ... 16 18 ... 8 ... 1 16 ... 10 3 3 5 16 407 671 486 63 135 ... 1620 3478 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto 490 65 44 21 16 242 100 Under 5 ... 1 5 ... ... ... ... ... ... ... 1 6 10 ... ... 27 ... ... 2 ... 57 109 5 upwds. ... 3 7 ... 2 ... ... ... ... 1 1 ... 2 ... 30 42 56 1 18 ... 218 381 Deaths occurring within the district among persons not belonging thereto . 826 136 121 64 53 346 104 Under 5 ... 11 33 ... ... ... ... ... ... 3 2 ... 19 ... 1 38 1 1 8 ... 140 257 5 upwds. ... 5 5 ... 2 ... ... 7 ... 2 ... ... 1 1 18 43 61 2 47 ... 375 569 102 103 TABLE W. TABLE W. Table of Population, Births, and of New Cases of Infectious Sickness, coming to the knowledge of the Medical Officer of Health, during the year 1909, in the Metropolitan Borough of Lambeth, classified according to Diseases and Localities. [Local Government Board Old Table B.] New Registration Sub-Districts. Population at all Ages. Registered Births 1909. New Cases of Sickness in each the knowledge of the Medical during Locality, coming to Officer of Health 1909. Number of such Cases removed from their Homes in the several Localities for Treatment in Isolation Hospital during 1909. Census 1901. Estimated to middle of 1909. 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Fevers. Cholera. Erysipelas. Cerebro-Spinal Meningitis. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Typhus. Fevers. Epysipelas. Cerebro-spinal Meningitis. Typhus. Typhoid or Enteric. Continued. Relapsing. Puerperal. Enteric or Typhoid. Continued. Relapsing. Puerperal. Cholera. (a) (b) (c) (d) Waterloo 27440 25921 1484 - 58 30 - - 5 - - - - 21 3 — 56 30 — — 4 — — — - 9 2 Lambeth Church 27440* 26541 721 - 162 30 — — 5 — - — — 28 2 — 160 30 — — 5 — — — — 13 2 Kennington 52518* 55061 1501 — 248 79 2 — 9 — - 3 — 43 3 — 245 74 1 — 8 — — — — 17 2 Stockwell 63826 67779 1939 - 251 68 — — 11 — — 5 — 41 2 — 232 67 — — 9 — — 3 — 12 1 Brixton 73673 82337 1601 — 276 97 — — 7 1 — 3 — 34 1 — 250 88 — — 5 — — 2 - 6 — Norwood 56998 66549 1199 — 169 69 1 - 12 — — 5 — 22 3 — 145 57 1 — 9 — — 2 — 4 3 Totals 301895 324188 8445 — 1164 373 3 - 49 1 — 16 — 189 14 — 1088 346 2 — 40 — — 7 — 61 10 *The Census 1901 populations for Lambeth Church and Kennington New Sub-Districts are approximate only. CLASS II.—SANITARY WORK. Return shewing the total number of Notices served in the Borough of Lambeth, from the 1st January to the 31st December, 1909. Total number of Notices 12764 NOTIFIABLE INFECTIOUS DISEASES. (Public Health, London, Act). No. of Notices served 1809 No. of Infected Houses 1577 Smallpox Scarlet Fever 968 Typhoid 4.9 Typhus - Continued Fever 2 Diphtheria 341 Membranous Croup 3 Puerperal Fever 16 Erysipelas 185 English Cholera - Cerebro-Spinal Meningitis 14 105 PARTICULARS OF SANITARY WORK. Carried out in Lambeth Borough during 1909, and for 24 years (1877-1900) in Lambeth Parish (for comparison). Year. Total Number of Notices (excluding those under Housing of the Working Classes Act). Sanitary Works, Structural and Permanent. Sanitary Works, not Structural. Borough of Lambeth. 1909 12764 8219 3323 1900 10065 10291 2303 Old Parish of Lambeth. 1899 10583 10042 2273 1898 10469 9905 2224 1897 11088 9058 1884 1896 7475 6702 982 1895 7645 8581 1104 1894 6975 7672 1911 1893 8769 9207 2046 1892 7173 6931 2190 1891 5557 7232 3173 1890 5588 5053 3251 1889 6854 4192 2662 1888 4891 2969 1922 1887 4565 2430 2135 1886 4504 2433 2071 1885 3567 1459 2108 1884 3727 1621 2106 1883 3000 1294 1766 1882 3239 1267 1972 1881 3730 1293 2437 1880 3259 1106 21 53 1879 3075 960 2115 1878 3310 1169 2211 1877 3563 1299 2264 Average for 24 years, 1877 - 1900) 59446 4756.9 2135.9 N.B.—The increase in the numbers since 1896 is due to the increased Inspectorial Staff. 106 A. Public Health (London) Act and Metropolis Local Management Acts. Notices (Preliminary and Statutory) 10955 Works, Structural Drainage Defective 1027 Intercepting Traps with Fresh Air Inlets required 145 Ventilating Pipes required 165 Indoor Sinks connected with the Drain 260 Rain Water Stack Pipes connected' with the Drain 604 Bath Waste connected with the Drain 76 Traps Defective, or of Obsolete Pattern 695 Closet Pan and Connections Defective 987 Water Supply to Closet Defective 741 Closet Dilapidated 695 Draw-off from Main for Drinking Purposes required 201 Dust Bins Defective 760 Premises Dilapidated 291 Ventilation under Floors required 86 Roofs Dilapidated 287 Soil Pipes Defective 89 Paving Defective 1006 Damp and Unwholesome Houses 86 Dung Receptacles required 18 Works, Not Structural:— Cisterns Dirty 108 Manure Accumulations 149 Underground Rooms occupied 8 Animals Improperly Kept 36 Stopped Drains 391 Overcrowding 21 Foul Urinals 39 Refuse Accumulations 56 No Water Supply or Defective Water Supply 496 Dirty Premises 2019 11542 107 B. Infectious Diseases Notification. Notices served (1577 infected houses) 1809 SUMMARY OF WORK DONE BY THE SANITARY INSPECTORS DURING 1909. Inspections 8689 Re-inspections 61221 House to House Inspections 2149 Complaints attended to 6564 Case of Infectious Disease notified 1809 (a) Cases under treatment at Home 721 (b) Cases removed to Hospital 1088 Cases of Non-Notifiable Diseases dealt with 4278 House disinfected 1649 Rooms disinfected' 5654 Bedding, etc., disinfected 3839 Bed'ding etc., destroyed 51 Dust Yards, Manure Depots and Brickfields, inspections of 312 Drains tested (with chemical, water, or both 9108 Sanitary Works completed 5606 Plans of drainage reconstructions received and approved 521 Premises the Drains of which have been totally or partly reconstructed 617 Articles procured' for the Analyst— (a) Food and Drugs 1800 (b) Water - New Workshops inspected and registered 229 New Factories inspected' and registered 26 Bakehouses inspected (including 79 underground) 214 Cowhouses inspected 14 Slaughter houses inspected' 24 Milkshops (new) inspected and registered 15 Restaurants (new) inspected and registered 18 Outworkers' Rooms (new) registered 250 108 Common Lodging Houses inspected 6 Tenements inspected (Revenue Act) 71 Bacteriological Examinations made 781 Houses let in lodgings inspected 372 Notices— Sanitary Work (Preliminary and Statutory) 10930 Infectious Diseases (Public Health Act, 1891) 1809 Housing of Working Classes Act — Metropolis Local Management Act 25 Sanitary nuisances abated— (a) Structural 8219 (b) Non-structural 3323 Persons received at the Shelters — Summonses issued— Public Health Act 29 Food and Drugs Act 76 Convictions obtained— Public Health Act 11 Food and Drugs Acts 59 MALE SANITARY INSPECTORS. During 1909, a change has taken place in the personnel of the Male Inspectorial Staff. Inspector Bott (aged 67 years) having resigned after 38 years' service and having been awarded a pension of £133 2s. 6d. per annum. His position has been filled by the appointment on May 12th, 1909, of Mr. Arthur Farran,* who commenced his duties on June 1st, 1909, his appointment having been confirmed by the Local Government Board by letter dated May 21st, 1909. The work carried out by the Staff is shown by the numbers of inspections, re-inspections, etc., tabulated *Arthur Farran was Inspector of Nuisances at Edmonton from 1900-1909, and previously was a foreman builder (1895-1900). He possesses certificates of the Royal Sanitary Institute (1897) and for Building Construction (1901). 109 throughout the Report. It is again satisfactory to note that during 1909 in but very few cases (0.2 per cent. of the total notices served) has it been found necessary to resort to legal proceedings before the Court in connection with sanitary work carried out under the Public Health and Metropolis Management Acts—29 summonses, which resulted in £3 in penalties and £5 10s. costs, as follow:— Convictions (penalties) 3, orders (to do the work) 7, closing order 1, withdrawn (work done) 9, withdrawn (payment of costs) 5, withdrawn (new summons granted) 1, no order (agreement come to) 1, and adjourned sine die (pending another offence) 2. Combined Drainage. Many combined drainages have been reconstructed by the Borough Council during 1909, such drainages being "sewers," as the direct result of inspections carried cut by the Inspectors in the course of their daily routine duties. The law, as it at present stands, throws the responsibility upon the Borough Council of repairing certain combined drainages as "sewers," and as the property of the Sanitary Authority, but a large number of combined drainages are relaid by private owners as the result of voluntary work or of the service of notices by Inspectors. In these latter cases, the owners are either responsible, by virtue of the Sanitary Authority possessing a plan or application (or both), in connection with the combined systems of drainage, or they prefer that the combined drains should be regarded as "drains" and not as "sewers." House to House Inspections. A house to house inspection of the district is a duty laid upon Sanitary Authorities by section 1 of the Public Health (London) Act, 1891, and section 30 of the Housing of the Working Classes Act, 1890. The duty is an important one, but such work can only be carried out with a sufficiently 110 large Sanitary staff. Within the Borough, during 1909, a total of 2149 house to house inspections have been made, dealing with the following streets (whole or part):— Marsh Ward.— Asa Place, Addington Street, Brad Street, Bazon Street, Burdett Buildings, Cornwall Place, Cornwall Road, Cosham Place, Commercial Road, Doon Street, Eaton Street, Ethelm Street, Frazier Street, Gray Street, Johanna Street, Lower Marsh, Lydia Buildings, Little Thomas Street, Murphy Street, Oakley Street, Paris Gardens, Peabody Buildings, Stamford Street, Salutation Place, Secker Street, St. Andrew's Place, Tower Street, Victoria Place, Waterloo Road, Wootton Place, Wootton Street. Bishop's Ward.— Grays Place, High Street, Karl Place, Over Place, Old Palace Buildings, St. Albans Buildings, Stone's Buildings, Sidford Place, The Parade, Waxwell Terrace, Wake Street, Whitgift Street. Prince's Ward.— Courtenay Street, Catherine Street, Esher Street, Grove Cottages, Heyford Avenue, Henry Street, Hanover Gardens, Hunt Street, Neville Street, Rita Road, Trigon Grove, The Grove, Tyers Street, Trigon Road, Wickham Street. Vauxhall Ward.— Albert Cottages, Brooklands Road, Brooklands Street, Crimsworth Road, Heyford Terrace, Milton Place, New Road, Neptune Street, Neptune Cottages, Old South Lambeth Road, Priory Grove, Richmond Place, Spring Gardens, South Lambeth Road, Victoria Place, Wandsworth Road. 111 Stockwell Ward.— Bythorn Street, Broomgrove Road, Glendall Street, Love Lane, Mary's Cottages (Eastcote Street), Seneca Road, Stockwell Cottages, Tandridge Place. Brixton Ward.— Akerman Road, Baker Street, Bolton Street, Bramah Road, Commerce Mansions, Coldharbour Lane, Holland Road, Loughborough Road, Langton Road, Mostyn Road, Patmos Road, Paulet Road, St. Agnes' Place, Smith Street, Treherne Road, Thornton Street, Tindal Street, Warham Street. Herne Hill Ward.— Bavent Road, Bengeworth Road, Cambria Road, Effra Terrace, Hardess Street, Hurst Street, Rymer Street, Regent Road, Railton Road, Vining Street. Tulse Hill Ward.— Bartley Street, Birkbeck Road, Brandon Road', Cornwall Road, Mauleverer Road, Margate Road, Mandrell Road, Strathleven Road. Norwood Ward.— Auckland Place, Beadman Street, Beaconsfield's Cottages, Change Alley, Crown Villas, Dunbar Street, Dibden's Cottages, East Street, East Place, Froggart's Cottages, Knight's Hill Square, Longmead Square, Paxton Place, Park Place, Railway Cottages, Walton Cottages, Wood Street. A total of 2149 houses have been inspected during 1909, and in 216 (i.e., 10.05 per cent.) a result was obtained from the chemical test applied to the drains. A total of 3096 nuisances were found to exist in 1564 houses (i.e., 72.8 per cent. of the total houses inspected), but many were of a trilling nature, and not in any sense dangerous to the health of the inmates of the houses concerned. 112 Summary. Number of houses inspected 2149 Number of houses in which a result was obtained from test (chemical) applied to drains 216 Number of houses in which nuisances were found to exist 1564 Nature of Nuisances found and dealt with under the Public Health (London) Act, 1891. Dirty walls and ceilings of rooms 703 Defective roofs or rain water pipes 308 Defective or dirty yard paving 338 Defective flushing apparatus in water closets 142 Water closet pan foul 60 Drinking water tap defective, making walls damp 23 Gully or drains stopped 107 Floors defective 45 No dust-bins (or dust-bins defective or dilapidated) 229 Damp Premises 175 Overcrowding 15 Defective water closets 148 Defective Drains 297 Defective or deficient vent pipes or soil pipes 44 Defective sink wastes (or not under trapped) 97 Defective manhole covers 55 Animals improperly kept 7 Cisterns uncovered or dirty 15 Improper water supply 55 Forecourts insufficiently paved or unpaved 34 Water closets insufficiently lighted or ventilated 3 Want of ventilation under floors 86 Want of proper dung receptacles 1 Underground rooms illegally occupied 5 Accumulation of manure 31 Defective traps 11 113 Sinks connected direct to drains 6 Mica valves defective 50 Defective ceiling 1 Dirty W.C. Premises 5 Total 3096 Inspection of Market Thoroughfares. During 1909, the market thoroughfares have been under bi-weekly special inspections by the Sanitary Inspectors, 2 inspectors being on duty at a time —Saturday nights (9 to 12) and Sunday mornings (9 to 12). The market thoroughfares are Atlantic Road, Wandsworth Road, New Cut, Lower Marsh, and Lambeth Walk. No unsound food had to be seized by the Inspectors under the sections of the Public Health (London) Act, 1891, but in several instances vendors were cautioned, and unsound food was voluntarily surrendered. These systematic inspections are, of great value in securing wholesome food being exposed, on stalls and in the shops, for sale. At the commencement of the summer, a circular letter was sent round to the greengrocers throughout the Borough, reminding them of the necessity of having all refuse (greens, etc.), removed forthwith, so as to prevent a nuisance from its decomposition due to heat. Outside Urinals of Public Houses. During 1909, the outside urinals connected with public houses have been under inspection, and notices have been served as required. h 114 Unsound Food. During 1909, the following consignments of unsound food have been inspected, condemned and destroyed, under the supervision of the Sanitary Inspectors :— February 4th.—6 bags of green vegetables. March 12th.—100 boxes of pears (containing 24 pears in each box). March 12th.—9 boxes of pears (containing 50 pears in each box). April 14th.—Carcase of a sheep (died in lamb birth*). July 19th.—2 sacks of pigs' heads (each sack containing 20 heads). September 20.—17 bags of potatoes (14½ cwt.) September 22nd.—I trunk of haddocks. October 3rd.—Winkles (2 gallons). October 11th.—2 boxes of grapes. October 22nd.—1 box of mackerel. October 29th. — 1 box of plaice. In February, 1909, information was received from the Port Sanitary Authority that some damaged butter (4 tons) was to be delivered at the premises of a Lambeth firm. The butter was found to have been damaged with water and smoke from burning wood and sulphur, the hold in which the butter was stored in the vessel having caught fire at sea. In this way the butter was rendered unfit for human consumption, and was consequently used for the purpose of soap-making only. *The carcase was consigned to a butcher in Lambeth Borough from a farm at Cotterstock, Oundle. The farmer was cautioned by letter, and he sent a written apology stating that the carcase had been sent to London in error. He paid to the Council the costs of removal and destruction. 115 In March, 1909, a communication was received from the Bermondsey Borough Council to the effect that 200 qrs. of damaged maize had been purchased by a firm in Lambeth Borough. Enquiries showed that the maize was not intended for human food in any way and a guarantee in writing was given to that effect by the firm in question. In May, 1909, information was received from the Port Sanitary Authority that some damaged flour (3 bags) was to be delivered at the premises of a Lambeth firm. The flour was found to have been damaged with sewage, being thereby rendered unfit for human consumption, and was, consequently, returned to the brokers (City) to be disposed of through their Surveyor, on the understanding that such flour was not to be used for human consumption, a certificate to be given to the purchasers to that effect, when sold. In June, 1909, a communication was received from the Medical Officer of Health, Southampton (through the Local Government Board), stating that a consignment of green bacon, landed at Southampton, had been forwarded to Lambeth in error, the Medical Officer of Southampton having given instructions for the bacon to be kept back for examination on account of its being discoloured in many places (as the result of wetting) and otherwise damaged. The consignment of bacon which had been delivered in Lambeth Borough was found to consist of 600 sides, but careful inspection and examination failed to discover anything wrong warranting condemnation or seizure. No further action was taken, and the Local Government Board and the Medical Officer of Southampton were so informed. In July, 1909, a communication was received from the Port Sanitary Authority that some damaged wheat (eight quarters), lying in the Docks, was to be delivered at the premises of a Lambeth firm. On arrival, the wheat was found to be unfit for human consumption, and a guarantee was obtained in writing from the consignees that the wheat would only be "used for poultry food and not for human food " 116 Duchy of Cornwall Property—Marsh Ward. During 1909, attention was drawn to the dirty and dilapidated condition into which many of the houses had recently fallen in connection with that portion of the Duchy of Cornwall Estate which is situated in the Marsh Ward, and comprises the whole of the premises on the east side of Waterloo Road, extending from St. John's Church to the river, including the whole of the premises in Stamford Street (lying within the ecclesiastical Parish of Lambeth), portions of Commercial Road and Cornwall Road, the whole of Doon Street and Aquinas Street, Coin Street and Bazon Street, together with the Courts leading from such Streets, e.g., Cornwall Place, Salutation Place, Peer's Cooperage, Milan Place, Elizabeth Place, Bond Place, and Cage Place, The condition of the property comprised in this area has undergone considerable alteration during the past 6 to 12 months, owing to the falling in of a large number of leases, and whilst some of the houses have been thoroughly renovated, re-built or reconstructed, others are in a dirty, dilapidated and dismantled condition, being, consequently, unfit for habitation. The facts may be summarised as follows :— 1. Waterloo Road—Some of the houses have been thoroughly renovated, whilst others are in a very dirty and dilapidated condition; 2. Stamford Street—The Duchy has inaugurated a scheme for converting houses into self-contained flats (with baths and lavatories, and with hot and cold water), and some of these are now completed and occupied, and are a decided sanitary improvement, but many of the remaining houses are in a dirty and dilapidated condition, whilst in the front 1 117 areas of some of the unoccupied houses deposits and accumulations of refuse are found from time to time; 3. Aquinas Street.—The whole of the houses on the north-west side have been demolished, and the Duchy are erecting blocks of flats upon the cleared site, whilst on the south-east side, some of the houses are unoccupied, and are in a dilapidated condition, owing to wilful damage done by unknown persons; 4. Doon Street—Some of the houses have been verted into flats, but others are dirty and dilapidated ; 5. Courts—In Bond' Place there are 12 houses at present unoccupied, and these are in a dilapidated and dirty condition; the houses in Cage Place and Milan Place are rapidly becoming vacant; in Cornwall Place 6 houses are unoccupied and in a dilapidated and deplorable condition; whilst, in connection with Peer's Cooperage and Elizabeth Place, all the houses have been vacated and closed, and the entrances to the Courts boarded up. It was thought advisable for all the houses, as they became vacant, to be closed forthwith and boarded up, together with the entrances to Courts, when the houses comprising such Courts have been closed, and a letter was sent to that effect to the Duchy of Cornwall, drawing attention to the state of dilapidation, etc., into which certain of the houses within the area were falling, and suggesting that the Duchy should take steps forthwith to close such houses and board them up, and also to board up the entrances to Courts, of which the houses had been closed, in the same way as had already been done in connection with Peer's Cooperage and Elizabeth Place. 118 At the same time approval was given, on general lines, to the improvements that the Duchy are gradually making within the area (e.g., Stamford Street Flats, Aquinas Street Blocks of Tenements, etc.) To this letter the Duchy replied as follows:— Duchy of Cornwall Office, Buckingham Gate, S. W. 27th May, 1909. Sir, Kennington—Prince's Meadows. In reply to your letter of the 22nd instant, I beg to inform you that the Duchy of Cornwall is very anxious to close the places referred to in your letter at the earliest possible moment, but that owing to the difficulty in obtaining vacant possession of the houses, due to the reluctance of the occupiers to move, it has been found impossible to proceed more rapidly without inflicting very great hardship on those poor tenants who find it difficult to find new houses. The date of the expiration of these leases was the 5th April last, and already one-half of Aquinas Street has been pulled down and new dwellings are being erected of the same kind and with the same conveniences as those recently erected at Nos. 142-152 Lower Kennington Lane, adjoining the "Roebuck" Public House, Kennington Cross. Peer's Cooperage and Elizabeth Place have already been closed and boarded up, and the sites will be dealt with along with the adjoining property. Cage Place will be closed immediately, and the site of the houses will be added to the area of the houses in Commercial Road and Doon Street which will then be improved for occupation by existing tenants and others who have had to leave the premises about to be demolished. The Duchy has acted as rapidly as due consideration for those families who must be disturbed would allow, and within a very few months this area will show a vast improvement to the state in which it was received by the Duchy in April last. 119 With the property in a state of transition, many of the houses are almost necessarily in a dilapidated condition, but instructions have been given to have all the remaining Courts closed and boarded up a soon as vacant possession is obtained. I am, Sir, Your obedient Servant, (Signed) Walter Peacock. The Town Clerk. Lambeth Town Hall, Brixton Hill, S.W. Great changes are taking place in the Marsh Ward' in the way of pulling down old buildings and replacing by new up-to-date ones. The following Courts have been closed by the Duchy owing to them being, in the opinion of the Lambeth Council, too confined to be capable of being made use of: Cage Place, Bond Place, Cornwall Place, Salutation Place, Elizabeth Place, Milan Place, Perry Place, Henry Place, and Peer's Cooperage. Routine Work of Male Inspectors. During 1909, 617 houses have been re-drained throughout or in part; and 521 plans (representing the 617 houses) have been received in connection therewith. The drainage work is carried out under the personal supervision of the Sanitary Inspectors, the drains being in every case water-tested. 9108 tests (hydraulic, smoke or chemical) have been made by the Sanitary Inspectors during 1909. 91 Water Certificates (representing 154 houses separate or in blocks) have been issued during 1909, in accordance with Section 48 of the Public Health (London) Act 1891; and in this connection, it is to be noted that a Water Certificate is not granted until all the drainage work also is completed satisfactorily. 120 In addition to drain-testing and supervision, other duties fall to a Sanitary Inspector, and, as fairly representing the work carried out, the numbers of (1) notices served, and (2) inspections and re-inspections made, are a fair criterion'. In Lambeth Borough, during 1909, 12532 notices have been served under the Public Health Act (7158 preliminary, 3772 statutory and 1577 in connection with infectious diseases), and 25 under the Metropolis Management Acts, making a total of 12532, dealing with 8219 structural, and 3323 nonstructural, defects. 6564 complaints were attended to during 1909. The numbers of inspections and re-inspections carried but during 1909 by the Male Sanitary Inspectors were 8689 and 61221 respectively, and to these must be added the summary of work carried out by the Female Sanitary Inspectors, and the Female Health Visitor (vide pages 120-127 and 135-136). Other Inspections. The special work in connection with disinfection, smoke abatement, inspection of factories and workshops, bakehouses, restaurants and dining (coffee) rooms, and the carrying out of the Food and Drugs Acts, is dealt with under special headings in this Report (vide pp. 120-134, 146-166 post). FEMALE SANITARY INSPECTORS. 1909 is a year's record of work carried out my the two Female Sanitary Inspectors (Miss Dawson and Miss Gamble)* in connection with (a) Factories, Workshops (Work-places), Shops, Out-Workers' Homes, Laundries, *Miss Gamble was elected on October 3rd, 1901, and Miss Dawson on September 21st, 1908, vice Miss Pearson, resigned. 121 *Restaurants, etc., wherein women and girls are employed; (b) Underground Conveniences (belonging to the Council), and other Ladies' Sanitary Conveniences (Railway Stations, Hospitals, etc.); (c) Houses wherein births have occurred or deaths amongst infants under 1 year of age, or deaths from infantile diarrhœa; (d) schools wherein there nave been infectious disease outbreaks; etc. The year's work, 1909, may be tabulated as follows:— Work carried out by the two Female Sanitary Inspectors during the year 1909, and during the preceding three years 1906-8 (for comparison). 1909 1908 1907 1906 Workshops† visited and inspected- (a) Dressmakers 316 108 85 143 (b) Milliners 51 18 4 37 (c) Laundries 176 63 28 117 (d) Tailors 60 44 15 42 (e) Upholsterers 5 6 1 9 (f) Dyers 5 6 - 3 (g) Others 103 78 32 66 Work rooms inspected 1487 693 311 703 Workshops† re-inspected 123 109 85 188 Workrooms re-inspected 111 143 114 256 Workshops†: workrooms therein measured 482 475 313 360 Workshops† removed from Register 352 165 37 118 Workshops† reported to H.M. Inspector 36 37 36 27 Workshops† reported by H.M. Inspector 2 43 95 47 Workshops† newly discovered and registered 104 93 100 120 §Premises visited but no females found employed, or no workers, &c. (including 904 out-workers, 450 workshops, 25 restaurants, 326 private houses and 7 schools) 1712 1055 1471 1041 † Workshops include Workplaces. §Including houses where the business plate, or the local directory, or advertisements in newspapers, or other sources of information implied a probability that female workers would be employed, but at which none were found at the time of visit. 122 Female Conveniences visited and inspected— 1909 1908 1907 1906 Public (visits paid) 489 599 569 597 Private (visits paid) — 16 — 15 Schools visited— Public 23 27 7 25 Private 2 2 — 5 Special places visited and inspected— (a) Restaurants and Hotels, etc. 103 — — — (b) Private Houses 907 705 1310 1341 (c) Out-workers 483 202 178 181 (d) Others* 109 — — — Restaurants, Out-workers, Private Houses reinspected ‡362 373 558 523 Written intimations and Statutory Notices served 174 341 424 647 No. of Workshops, etc., in which no defects were found on inspection 1740 †918 1205 1255 No. of Workshops in which defects were found on inspection 511 †376 †459 †764 Particulars of defects found. Work rooms— Overcrowded 6 13 22 20 Damp 5 38 28 36 Dirty 158 136 173 295 Ill-ventilated 2 6 4 13 Otherwise 4 2 5 8 Defects— Yards 36 34 52 75 Floors 7 14 10 27 Roofs 15 9 26 17 Windows — 3 1 5 Ceilings 33 34 50 33 Rain Water Pipes 3 2 5 13 Premises generally 45 2 10 17 Sanitary Appliances: Waterclosets— Dirty 115 150 105 219 Ill-lighted — 5 — 2 Unventilated 3 4 4 17 Choked 18 22 20 37 Defective 42 53 45 67 *Moffatt Institute, 89: Depot 20. †Excluding the 1055, 1471 and 1041 premises respectively wherein no female hands were found to be employed. ‡Restaurants, 1, out-workers, 97, and private houses. 264. 123 Sanitary Appliances : Waterclosets— 1909 1908 1907 1906 Defective Flushing Tanks and Water Supply 110 69 81 137 No separate suitable accommodation for the sexes 6 4 7 14 Drainage— Defective, unventilated, etc. 10 2 22 23 Dustbins— Wanting 27 17 51 69 Defective 70 52 68 120 Lavatories— Defective or dirty — 17 21 3 Miscellaneous defects (not included above)— Animals improperly kept — 1 1 7 Accumulations in yards — 3 — 11 Sink wastes defective 13 12 6 10 Otherwise 1 — — 1 Nuisance referred to M.O.H. for attention by Male Inspectors (defective drains, w.c.s, etc.) 55 66 55 154 The Female Inspectors have, during 1909, inspected 103 Restaurant Kitchens (one re-inspection), whilst Z5 visits have been paid to Restaurants, and the premises found empty or the tenants out; and in connection with Outworkers, 483 inspections and 97 re-inspections have been made, together with 904 visits to Out-workers' premises, which were found empty or the Out-workers not at work. A total of 1289 visits have been paid to factories and workshops (716 inspections, 123 re-inspections and 450 calls where the workshops were found empty or the workers not at work). Miss Dawson also paid 89 visits to the Moffatt Institute (connected with the distribution of the Council's milk), and 20 to the Milk Depot (York Road). The Female Public Conveniences are under constant supervision by the Female Inspectors, 489 visits having been paid thereto during 1909. The Female Inspectors have during 1909 been engaged in visiting 122 houses wherein deaths from infantile (summer) diarrhoea have been reported as having occurred, with a view 124 to helping to further elucidate the predisposing causes r.f this disease; in inspecting schools (25), and the homes of the scholars, in connection with outbreaks of disease (more especially measles); and in visiting 1049 private houses, wherein births have been notified or registered, with a view to educating the mothers and others concerned now best to feed' their infants (785 inspections and 264 re-inspections*). It will be noted, in connection with the inspections and re-inspections of workshops and workplaces (where women are employed), that the principal defects found are dirty workrooms, dirty sanitary appliances, defective flushing tanks to closets, defective closets and defective dust-bins, overcowding was only found in 6 cases. Summary. The total number of workplaces inspected during 1909 by the Female Inspectors was 2694, consisting of 2209 inspections and 485 re-inspections, as follow : — Inspections. Re-inspections. Workshops and Factories 716 123 Restaurants 103 1 Out-workers 483 97 Private Houses 907 264 Totals 2209 485 *326 visits were paid to private houses, but no one found at home. 125 OUT WORKERS. The work commenced by the Female Inspector in 1903, and continued since, connected with the visiting and inspecting of out-workers' premises and homes (situated within the Borough of Lambeth), has been further continued during 1909. This is a special duty devolving upon the Borough Council under Sections 107-110 of the Factory and Workshop Act, 1901, under which Orders (known as the Home-work Orders) have been made by the Home Secretary (vide Annual Reports, 1903, pp. 118-122 and 1905 pp. 125-126). The latest Order is 1907 (May 23rd), replacing the Order of August 15th, 1905, and enlarging the list of special trades to which Sections 107-110 of the Factory and Workshop Act, 1901, apply, by the addition of the following: Artificial flowers, nets, other than wire nets; tents; sacks; covering of racquet or tennis balls; boxes of cardboard, ship, or similar material; pea-picking; feather sorting; the carding boxing, or packeting of buttons, hooks and eyes, pins and hair-pins; and baskets. During 1903-9, a total of 1197 new out-workers' premises have been notified under the Home-work Orders, inspected and registered (250 during 1909), connected with the following trades and businesses :— 1903 1904 1905 1906-7 1908 1909 Mantles 6 12 20 17 12 6 Blouses and Skirts 10 14 24 43 22 31 Ties and Belts and Braces 24 19 14 28 15 31 Baby Clothing 6 4 4 5 2 2 Children's Underclothing and Costumes 5 10 9 13 4 5 126  1903 1904 1905 1906-7 1908 1909 Women's Underclothing 5 2 7 15 18 25 Tailors 10 15 8 62 17 34 Upholsterers 1 - 1 2 2 3 Embroidery 9 3 9 15 15 8 Dressing Gowns 2 5 3 1 3 1 Shirts 13 7 7 4 — 1 Aprons and Overalls 1 — 2 — 1 1 Waistcoats 4 3 4 34 15 5 Jerseys 2 — 1 1 — — Hosiery 1 — — 1 — 2 Widows' Caps 1 — — 1 — — Men's Caps 1 1 1 3 — 3 Vamp Reader 1 — 1 1 — — Wigs 2 — — — — — Incandescent Mantles 1 — — — — — Boots and Shoes 1 4 2 18 23 9 Umbrellas 1 — — 2 — — Dresses — 9 7 2 8 1 Waterproofs — — — 2 — — Millinery — 2 5 6 6 10 Collars — 5 3 5 7 7 Sacks — 1 — — — — Paper Bags — 2 2 8 5 10 Boxes — 4 2 27 8 8 Mattresses — 1 — — — — Lace — 2 1 1 — 3 Pinafores — 1 — — — — Sheets & Pillow Cases — 4 — 2 — — Smocking — 2 1 4 — — Needlework — 1 1 1 — 3 Curtains and Blinds — — — 2 — — Carpets — 1 1 — — — Brushes — — — 6 5 5 Dyers and Cleaners — — 1 2 1 — 127  1903 1904 1905 1906—7 1908 1909 Buttonhole Making — — 1 2 — 4 Book Folding — — — 1 — — Straw Hats — — 1 — — 1 Bottle Covering — — 1 — — — Fur Pulling — — 1 3 4 — Artificial Flowers — — — 11 4 2 Silk Hats — — — 4 — 2 *Unclassified — — — 4 5 27 Totals 107 134 145 359 202 250† The New Wards in which the houses (wherein these 1197 out—workers were found to be working during 1903—9) are situated, are as follows:— 1903 1904 1905 1906—7 1908 1909 Marsh 12 14 8 75 15 22 Bishop's 10 16 29 33 20 26 Prince's 38 13 18 73 32 57 Vauxhall 12 4 5 17 15 22 Stockwell 18 9 19 34 29 26 Brixton 17 37 42 71 46 50 Herne Hill — 26 12 31 25 31 Tulse Hill — 10 8 11 13 11 Norwood — 5 4 14 7 5 Totals 107 134 145 359 202 250† *Stringing Bags, 24, Helmets, 1, Fancy Paper, 2. †In addition to the 250 out—workers premises added during 1909 to the Register and inspected, 233 out—workers inspections and 97 re—inspections have been made, and visits paid to 904 premises in connection with which the out—workers were found to have removed or to be out, or no longer taking in work, &c. 216 lists were received from Sanitary Authorities relating to 924 out—workers' premises. 128 WORKSHOPS. During 1909, 229† new Workshops have been added to the Register,‡ consisting of the following:— Name of Trade or Business. No. of Workshops. Dressmakers 56 Laundries 22 Milliners 11 Tailors 26 Blouses 20 Sacks and Tarpaulins 2 Mantles 1 Dressing Gowns 1 Cabinet Making 1 Underclothing 7 Rag Sorting and Marine Stores 2 Paper Sorting 1 Ties and Belts 5 Embroiderers and Kilters 2 Flowers 4 Doll Dressing 2 Boots and Shoes 7 Babies' Dresses 7 Metal Workers 6 Smiths, Builders, File Cutters, etc. 18 Fancy Goods 6 Paper Bags 2 Not Classified 20 Total 229 †Excluding 26 factories, viz.:—7 laundries, 3 printing, I wood-turning, 2 gas-making, 1 dyer and cleaner, 1 file-making, 1 box-making, 1 rubber works, 1 brush-making, 2 varnish, &c., 1 electro-plating, 2 timber merchants, 1 motors, 1 electrician and 1 blouse maker. ‡The Register contains (up to the end of 1909) a total of 1769 work shops and 2939 workrooms, but, of these, only 668 workshops (110 factories) are in use (1674 workrooms), the remainder being empty, demolished, or no longer in use as workplaces. 129 Full particulars concerning these 229 Workshops have been entered up in the Register, and it is found that there are connected therewith 390 workrooms, in which were working at the time of inspection 1422 persons—461 males and 961 females (females alone being employed in 65 workshops), as follow:— M. F. Total. Children — — — Young Persons 22 188 210 Adults 439 773 1212 461 961 1422 36 Notices as to "protected persons" (i.e., children young persons, and women) employed were sent on during 1909 to the Factory Inspectors, from time to time, as required (i.e., where no Abstract under the Act was found to have been posted up in a workplace). 105 Notices of occupation (representing 105 workshops) have been received during 1909 by the Borough Council from the Factory Inspector, as compared with 34 during 1908, 69 during 1907, 39 during 1906, 16 during 1905, 28 during 1904, 62 during 1903, 25 during 1902, and 32 during 1901, and 3, 32, 60, 31 and 29 received by the late Vestry during the five years 1886—1890 respectively. 10 written Notices have been received during 1909 by the Borough Council from the Factory Inspectors with reference to contraventions of the Public Health Acts in connection with Factories and Workshops, and all such nuisances have been abated, as found necessary, and due notices sent to the Factory Inspectors as to action taken in each case. The number of notices received in 1908, 1907, 1906, 1905, 1904, 1903, 1902 and 1901, were 9, 11, 17, 9, 10, 9, 5 and 17, as compared with 16, 8, 27, 25 and 66 received by the late Vestry during the five years 1886—1890 respectively. 130 In connection with the 229 new workshops inspected during 1909, the following insanitary conditions were met with at the time of inspections :— 1. As to Ventilation and Warming and Lighting. In none of the 229 workshops was the ventilation found to be unsatisfactory, and, with 1 exception, all the workrooms, at the time of inspection were found to be reasonably warmed by open fire-places, open or closed stoves, gas jets, steam pipes, etc., and sufficiently lighted. 2. As to Cleanliness. In 19 workshops (i.e., 8.1 per cent.), the workrooms were found to be dirty and to require cleansing. 3. As to Sanitary Appliances. In 17 (i.e., 7.4 per cent.), the sanitary fittings and appliances were found to be bad. The w.c.'s were outside in 35.8 per cent., inside in 28.4 per cent., and outside and inside in 32.7 per cent., whilst in 7 instances (i.e., 3.1 per cent.), there were no w.c.'s provided. The soil pipes were found to be unventilated, or insufficiently ventilated', in 16 cases (i.e., 7.5 per cent.) a condition of things which may, or may not, be a nuisance; but in no case was there found to be direct communication between w.c.'s and workrooms. In 16 instances (i.e., 6.9 per cent.) there were no soil pipes. 4. As to Dampness. In 1 workshop (i.e., 0.4 per cent.) a workroom was found to be damp. 5. As to Overcrowding. The cubic capacities of the different workrooms were, naturally, found to vary considerably, and in 6 workrooms (i.e., 1.5 per cent.), over-crowding was found to exist. 131 In addition to inspecting the above workshops wherein females were employed, the special work done by the Female Inspectors in connection with outworkers, etc., is dealt with on pages 120-127. The inspections made during 1909 in connection with the 26 factories were made with a view to seeing if the requirements of the Acts as to w.c. accommodation for the employees had been complied with. This is the only duty in regard to factories that falls to the Sanitary Inspector. In the 26 factories there were found to be 83 workrooms, wherein were employed, at the time of inspection, 569 persons—37 young persons (11 males and 26 females) and 532 adults (231 males and 301 females). In addition to the 26 factories and 229 new workshops added during 1909 to the Register and inspected, 461 other workshop inspections and 123 re-inspections have been made, and visits paid to 450 workshops in connection with which the occupiers were found to have removed, or no workers to be at work. The importance of workshops and workplaces being kept under constant supervision is now admitted by all, and the details tabulated in the present Report go to shew the great increase of work thrown upon a Sanitary or Health Authority in the systematic carrying out of the provisions of the Factory and Workshop Acts. In this connection, the value of the work of the Female Sanitary Inspectors is noteworthy (vide Special Report dealing with this particular work, pp. 120-124). 132 WORKSHOPS:—Details as to Sanitary Conditions and Defects found in 1909. Details as to Sanitary Conditions and Defects found: Old Parish Districts, and the Inspectors in charge thereof. Marsh. Bishop's and Prince's. Vauxhall and Stockwell. Brixton. Tulse Hill, Norwood. Totals. Farran. Clements. Hooper. Jones. Howes. Scorrer Baxter. Gavin. Jackson. Wallis. Smith. Barfoot. Ventilation satisfactory 15 11 11 6 20 8 28 51 18 11 28 22 229 not ... ... ... ... ... ... ... ... ... ... ... ... ... Cleanliness satisfactory 14 11 11 3 19 4 25 49 16 10 28 20 210 not 1 ... ... 3 1 4 3 2 2 1 ... 2 19 Workrooms damp ... 1 ... ... ... ... ... ... ... ... ... ... 1 not 15 10 11 6 20 8 28 51 18 11 28 22 228 Workrooms warm 15 11 11 5 20 8 28 51 18 11 28 22 228 not ... ... ... 1 ... ... ... ... ... ... ... ... 1 State of Sanitary fittings,&c. good 15 10 10 4 19 7 27 50 17 9 22 22 212 bad ... 1 1 2 1 1 1 1 1 2 6 ... 17 Soil pipe ventilated 15 7 11 ... 20 6 26 46 13 8 23 22 197 not ventilated ... ... ... 4 ... 1 2 2 3 2 2 ... 16 no soil pipe ... 4 ... 2 ... 1 ... 3 2 1 3 ... 16 Position of W.C. outside 7 4 8 4 8 5 7 16 9 2 6 6 82 inside 5 3 1 1 8 3 7 13 4 4 8 8 65 outside and inside 3 3 2 4 ... 14 22 3 5 11 8 75 No W.C. ... 1 ... 1 ... ... ... ... 2 ... 3 ... 7 Separate W.C. accommodation Yes 4 9 1 1 10 ... 17 26 7 5 14 12 106 No 11 2 10 5 10 8 11 25 11 6 14 10 123 Communication (direct) between W.C.s and rooms Yes ... ... ... ... ... ... ... ... ... ... ... ... ... No 15 11 11 6 20 8 28 51 18 11 28 22 229 N,B.—The Wards of the old Parish of Lambeth are retained so that this The above 229 Workshops with 56 exceptions were *in only 12 of these 123 cases was separate W.C. accommodation required 133 Table may be comparable with those in previous Reports (1897-1908). inspected by the Female Sanitary Inspectors. persons of one sex only being employed in the other 111 cases. 134 WORKSHOP REGISTERED DURING 1909. Number of Rooms and Persons Employed. New Wards and Male Inspectors in charge thereof. No. of Workshops. No. of Workrooms. Children. Young Persons. Adults. TOTALS. M. F. M. F. M. F. M. F. . Marsh Farran 15 24 ... ... ... 4 62 58 62 62 124 Clements 11 16 ... ... ... ... 45 12 45 12 57 Bishop's Hooper 11 20 ... ... 2 1 45 19 47 20 67 Prince's Howes 20 31 ... ... 2 27 24 82 26 109 135 Jones 6 6 ... ... ... 2 ... 24 ... 26 26 Vauxhall Scorrer 8 16 ... ... ... ... 25 2 25 2 27 Stockwell Baxter 28 39 ... ... ... 46 25 138 25 184 209 Brixton Gavin 51 92 ... ... 6 37 65 180 71 217 288 Jackson 18 30 ... ... 1 9 10 57 11 66 77 Tulse Hill Wallis 11 17 ... ... ... 14 3 42 3 56 59 Smith 28 45 ... ... ... 33 29 92 29 125 154 Norwood Barfoot 22 54 ... ... 11 15 106 67 117 82 199 Total 229 390 ... ... 22 188 439 773 461 961 1422 N.B.—With 56 exceptions, the inspections were made in connection with the above 229 Workshops by the Female Inspectors. 135 FEMALE HEALTH VISITOR AND THE NOTIFICATION OF BIRTHS ACT. Miss Virtue commenced her duties as Health Visitor on March 1st, 1909, and from that date, up to the end of 1909, paid 1722 visits, and 665 re-visits, connected with births, together with 288 special visits connected with the Milk Depot—making a total of 2675. Prior to Miss Virtue's appointment, Miss Lawrence acted as Health Visitor from January 1st to December 31st, 1908, off and on, as her health permitted. *Both Miss Virtue's and Miss Lawrence's appointments were temporary, but the experience gained goes to prove the necessity for the office of Health Visitor to the Borough being permanently constituted. Section 6 of the London County Council (General Powers) Act, 1908, empowers a Sanitary Authority in London to appoint suitable women (to be known as Health Visitors) for the purpose of giving persons advice as to the proper care of young children and the promotion of cleanliness and such other duties (if any) as may be assigned to them in accordance with the provisions of such Section. Under the Section, the Local Government Board has issued an Order, dated September 4th, 1909, known as the Health Visitors (London) Order, 1909, and this Order prescribes qualifications, mode of appointments, duties, salary and tenure of Health Visitors appointed under it, and directs that no appointment of Health Visitors shall be made, otherwise than in accordance with such Order; and states that, if a Health Visitor is appointed by a Sanitary Authority, with the approval of the Local Government Board, the London County Council may pay, out of the County Fund, any sum, by way of contribution, towards the salary of a Health Visitor appointed under the Order, not exceeding, in any case, one half of the amount, though the Board considers that such a salary should not be less than £100 per annum. *Miss Lawrence was appointed on October 3rd, 1907, and Miss Virtue on January 21st, 1909. 136 Under the Notification of Births Acts, 1907, which came into force on March 9th, 1908, the following Notifications of Births have been received:— 1908 (10 months) 3473 1909 (12 months) 5143 These Notifications have given rise to a large amount of work, clerical and inspectorial. The practice adopted, on the receipt of a notification is for the house to be visited and information given, as required, in connection with the proper rearing and management of young children, except in such cases where the infants are under the care of a Medical man, or qualified nurse, or where the status of the mothers is such as to render a visit undesirable. A second visit is also paid after an interval of three or four months (i.e., about the time when it is expected, from experience, that the mothers will have commenced to wean their children, from one cause or another), as far as practicable. The addresses of all infants registered under the Registration of Births Act, are also received weekly from the Registrars, so that the Notification Returns can be corrected from time to time. MUNICIPAL MILK DEPOT. The Council's Milk Depot, situated at 66 York Road, Westminster Bridge Road, has again effected good during 1909. 219 new infants and children have been entered upon the Register and fed during 1909, their ages being:— Under 3 months 108* 3—6 months 64 6—9 months 19 9—12 months 19 Over 12 months 9 *27 were aged a fortnight or under, viz: 1, 1, 2, 2, 2, 3, 3, 3, 3, 3, 4, 8, 8, 10, 12, 12, 13, 14. 14, 14, 14, 14, 14, 14, 14, 14, 14, days respectively. 137 These 219 infants and children may be classified, as to their states of health at the time of being put upon the Depot milk, as follows:—Healthy (i.e., showing no sign of wasting or disease, though below par constitutionally) 42, wasting 106, moribund 8, diiseased 63, total 219. The diseases from which the 63 infants and children were actually suffering at the time of being put upon the Depot milk were:—Diarrhoea and sickness 19, tuberculosis 3, lung diseases 15, prematurity 7, indigestion 8, diseases of nose and ear 2, cleft palate 2, meningitis 2, anæmia 1, inflammation of the bowels 1, eczema 1, thrush 1, and blight 1. The periods during which the 219 inlants and children continued to use the Depot milk were: — 26 weeks and over 21 13—26 weeks 59 6—13 weeks 49 4—6 weeks 27 Under 4 weeks— 2-4 weeks 32 Under 2 weeks 31* 63 219 It will be noted that 58.9 per cent. used the milk for period's extending from 6 to 26 weeks and over, whilst 28.8 per cent. used the milk for short varying periods under 4 weeks. The reasons assigned for discontinuing the Depot milk after varying intervals were:—(1) leaving the neighbourhood; (2) unable, or too far, to send; (3) by order of medical attendant; (4) unable to pay; (5) unsuitable. In connection with those parents who were unable to pay, the private voluntary benevolent fund which has been opened at the Depot was found useful, though small in amount, several deserving cases being assisted therefrom *1, 1, 1, 1, 1, 2, 2, 2, 3, 3, 3, 3, 4, 5, 5, 6, 7, 7, 7, 7, 8, 8, 8, 8, 9, 10, 10, 10, 11, 13 and 13 days respectively. 138 The average weekly number of infants and children fed upon the Depot milk during 1909 is 80.4, varying from a minimum 61 to a maximum 101, and the total number of bottles of milk distributed during the year was 197669, giving a weekly average of 3801, and a daily average of 543. Amongst the 219 new infants and children fed upon the Depot milk there have been 21 deaths, but these require careful analysis. Thus, of the 21 infants and children who died, the periods during which they had been fed upon the Depot milk varied from a minimum 1 day to a maximum 40 weeks, thus:— Length of time during which Milk was used previous to death. No. of Infants & children fed No. of deaths. Mortality rate per 1000. (a) Infants and children fed for 26 weeks and over 21 2 (b) Infants and children fed 13—26 weeks 59 7 (c) Infants and children fed 6—13 weeks 49 4 (d) Infants and children fed 4—6 weeks 27 - 83.3 Infants and children fed under 4 weeks— 2—4 weeks 32 2 under 2 weeks 31 6 63 8 126.9 Totals 219 21 95.9 • 1, 2, 2, 3, 5, 8 days respectively. 139 i.e., the longer an infant or child is fed upon the Depot milk, the better its chance of living. Of class (e) the periods during which the 8 infants and children who died had been fed upon the Depot milk were 21, 20, 8, 5, 3, 2, 2 and 1 days respectively, so that these deaths cannot fairly be classified as deaths connected with the Depot. Including all deaths, the mortality-rate for 1909 amongst the new Depot-fed infants and children is 95.9 per 1000, and this rate is much lower than the infantile mortality-rates for the Borough of Lambeth in general, and for Marsh Ward (where the Milk Depot is situated), the other Inner Wards in particular. If the mortality-rate is calculated only on infants and children who have been fed upon the Depot milk for continuous periods of 4 weeks and over, the rate is 83.3 per 1000, whilst the mortality-rate amongst infants and children fed upon the Depot milk for periods of less than 4 weeks is 126.9 per 1000. Thus, the rates for 1909 may be tabulated as follows, quinquennial rates being added for comparison:— Depot-fed infants 83.3 to 126.9 Whole Borough 134* Marsh 187* Inner Wards 158* In connection with these mortality-rates, allowance must be made for the difficulties of strictly comparing the rates amongst infants and' children fed upon the milk and under observation for varying periods, with the rates for the whole, or portions, of the Borough, for a year or period of years. To be statistically correct, only those infants or children who have been fed upon the Depot milk for continuous lengthened periods should be tabulated, whilst the numbers •These are quinquennial rates. 140 of deaths that occur during any given period less than a year should be increased pro rata, when dealing with rates for a year or period of years. It is assumed that the rates that are found to exist for short periods would be maintained during longer periods—an assumption that, in practice, is found to be warranted. The infants who are placed upon the Depot milk are, as a rule, unhealthy and below par constitutionally, if not actually diseased, at the time of commencing the milk, and the longer they use the milk, the better their chances of life. Thus, of the 219 infants and children brought to the Depot, 177 (i.e., 80.8 per cent.) were wasting, moribund, or diseased, and of these 18 died (i.e., 10.2 per cent.), whilst the remaining 42 (i.e., 19.2 per cent.) were, though tabulated as "healthy," with few exceptions, constitutionally below par, and of these 3 died. If children die during the first month of taking the milk, it would be misleading to assume that all children would die at the same rate during the succeeding eleven months. The most conclusive proof of the value of a Milk Depot, in so far as the children fed are concerned, is to be found in the medical histories of individual cases, when it can be shewn again and again that infants who appear to be moribund at the time of commencing the milk, actually recover. The causes of the 21 deaths amongst the Depot-fed infants and children deserve attention, and may be tabulated as follows:—Diarrhæa and sickness 9, pneumonia and bronchitis 3, measles 1, whooping cough 1, marasmus and inanition 3, tuberculosis 2, abscess of brain 1 and convulsions 1. The particulars of the 21 deaths are as follow : — 141 Name Age when put on Milk (months). State of Health when put on Milk. Length of time on Milk. (in days). Stated cause of Death. E.S. 3 Weakly 280 Inflammation of lungs and pneumonia, catarrh of bowel (inquest) E.M 5 Diseased nose 245 Pneumonia W.D. 4 days Weakly 172 Measles D.F. 1½ Good 139 Bronchitis epidemic diarrhæa F.H. 5 Wasting 121 Abscess of brain B.L. 2 Wasting cleft palate 95 Diarrhæa H.C. 2 Moribund 3 Convulsions S.F. 2 Good 125 Whooping cough A.B. 2 days Premature 86 Epidemic diarrhæa F.R. 3 Delicate 105 Marasmus bronchitis M.S. 3 Wasting 45 Consumption of bowels H.F. 1 Moribund 2 Inanition H.G. 5 Weakly 132 Epidemic diarrhoea J.A. 3 Marasmus 5 Epidemic enteritis A.S. 2 Good 84 Bronchopneumonia 142 Name. Age when put on Milk (months) State of Health when put on Milk. Length of time on Milk (in days). Stated causes of death. L.E. 1 Wasting 86 Marasmus M.M. 6 Moribund 2 Sickness and diarrhæa W.S. 1 Moribund 1 Zymotic enteritis R.C. 2 Moribund 21 Epidemic enteritis L.J. 10 Consumption marasmus 20 Consumption A.C. 10 days Acute indigestion 8 Acute indigestion (Sickness and diarrhæa) TABLE Showing number of Infants fed, and number of bottles distributed weekly during the year 1909. Week ending. Number Of Infants on the Register. Number of Bottles distributed. Sundry Persons. Number of Bottles distributed. Guardians. January 2 76 3360 126 „ 9 77 3507 126 „ 16 75 3374 126 „ 23 80 3494 293 „ 30 84 3746 293 February 6 85 3773 287 „ 13 82 3654 287 „ 20 88 3479 287 „ 27 92 4039 287 March 6 91 3885 259 „ 13 95 4200 301 „ 20 101 4256 301 „ 27 101 4284 301 143 Week ending. Number of Infants on the Register. Number of Bottles distributed. Sundry Persons. Number of Bottles distributed. Guardians. April 3 90 3836 301 „ 10 85 3696 301 „ 17 95 4641 217 „ 24 93 4305 217 May 1 86 3737 211 „ 8 83 3868 171 „ 15 81 3878 171 „ 22 80 3609 171 „ 29 77 3427 143 Juue 5 83 3871 84 „ 12 80 3850 84 „ 19 91 4378 84 „ 26 87 3899 84 July 3 86 3608 84 „ 10 91 3997 84 „ 17 87 3962 84 „ 24 90 4478 72 „ 31 90 4473 42 August 7 89 4172 42 „ 14 85 4144 42 „ 21 84 4158 42 „ 28 81 3913 42 September 4 82 4004 42 „ 11 76 3668 42 „ 18 70 3514 42 „ 25 66 3246 42 October 2 66 3073 42 „ 9 64 2947 ... „ 16 64 2898 ... „ 23 61 2793 ... „ 30 61 2793 ... November 6 64 3007 ... „ 13 66 3017 ... „ 20 70 3073 ... „ 27 67 3008 ... December 4 70 3345 ... „ 11 72 3388 ... „ 18 69 3255 ... „ 25 71 3451 ... Totals (52 weeks) 4180 191432 6237 144 The net expenditure upon the maintenance of the Milk Depot, during the year 1909, is stated by the Borough Accountant to have been £315 8s. 8d., viz. :— (a) Expenditure £665 18 9 (b) Income £350 10 1 i.e., Expenditure in excess of Income £315 8 8 PUBLIC HEALTH OFFICERS' BILL, 1909. During 1909, the Council had under consideration the provisions of the Public Health Officers Bill, the main objects of which are to ensure that none but those properly qualified shall be appointed as Medical Officers of Health or Sanitary Inspectors, and to give all such Officers and Inspectors similar security of their tenure of office to that enjoyed by Poor Law Medical Officers and Metropolitan Medical Officers of Health. The Bill concerns the Metropolitan Borough Councils in that it affects the existing qualifications for Medical Officers of Health and Sanitary Inspectors in London, and provides that a Sanitary Inspector shall be removable from his office only subject to an appeal to the Local Government Board. It is proposed to repeal Section 108, Sub-Section (2) of the Public Health (London) Act, 1891, which contains provisions as to the qualifications of Medical Officers of Health and Sanitary Inspectors, one existing" alternative qualification being that in the case of a Medical Officer, he shall have served as the Medical Officer of Health in a district of 20,000 inhabitants for three consecutive years prior to 1892, and in the case of a Sanitary Inspector, as such in a similar district for three years prior to 1895. The Bill proposes in substitution for these qualifications, three years 145 prior to the 29th September, 1909, for both Medical Officers and Sanitary Inspectors, and is, therefore, a retrograde step and a reduction in the standard of the qualification required for London Officers. At present, Sanitary Inspectors are under the control of the Metropolitan Borough Councils, who can dismiss them at pleasure, but the Bill seeks to make their removal subject to an appeal to the Local Government Board. The Bill also proposes, by Clause 2, that a Medical Officer or Sanitary Inspector shall not hold office nor be appointed tor a limited period only, thereby preventing Sanitan Authorities from appointing temporarily Medical Officers and Sanitary Inspectors during the absence on leave, or through sickness, of their permanent Medical Officers and Sanitary Inspectors, and in time of epidemic. In so far as London is concerned the provision is unnecessary, as the present conditions under the Public Health (London) Act, 1891, have worked and are still working satisfactorily. The Lambeth Council resolved to petition against the Bill, with a view to opposing the application of the Bill to London on the grounds that (1.) There is a proposed reduction in the standard of the qualifications required for London Medical Officers of Health and Sanitary Inspectors. (2.) That the Sanitary Inspectors are to be taken from under the control of the Metropolitan, City and Borough Councils, by making their removals subject to an appeal to the Local Government Board; and (3.) That the temporary appointments of Medical Officers of Health and Sanitary Inspectors should be allowed. A communication was also addressed to the Local Government Board calling attention to the above-mentioned objectionable features of the Bill. 146 DISINFECTING DEPARTMENT. During 1909, good work has been done by the Staff (individually and collectively) in connection with the Disinfecting Department—5654 infected rooms and 23982 infected articles (bedding, etc.) having been disinfected, as compared with 5158 and 22646 respectively in 1908. A total number of 1809 notifiable infectious diseases (including 14 cases Cerebro-Spinal Meningitis) have been reported during the year 1909, but a large amount of disinfection has also been carried out in connection with cases of Measles (1601), Whooping Cough (761), Tuberculosis (1152), Chicken-pox (708), Cancer (56), Verminous Houses and Persons (148), and other Diseases (154). Full details are to be found on pp. 150-152. The whole of the 1809 compulsorily notifiable diseases (representing 1577 infected houses) have been dealt with, whilst 16 schools have been disinfected in connection with outbreaks of infectious disease, viz., Measles 8, Scarlet Fever 5, Whooping Cough 1, ana Mumps 2. Particulars as to disinfection carried out in the Borough of Lambeth during 1909. Total No. of rooms disinfected by Council 5654 Cases in which bedding has been disinfected at home 1197* Do. do. do. at Chamber 2642 Do. do. do. destroyed 51 Premises disinfected and disinfectants supplied 12666 *The number is increased, compared with previous years, owing to bedding no longer being removed to the disinfecting station in the cases of Measles, Chicken-pox and Whooping Cough. 147 No. of Cleansing Notices served in connection with infected houses1649 Certificates of Medical Practitioners received in lieu of disinfection by the Council l34 Schools disinfected* 16 Certificates of disinfection left with occupiers of disinfected premises 3491 Library Books disinfected† 161 Mattresses re-tabbed by Council 513 Articles of bedding, etc., disinfected. Beds 1626 Bolsters 1387 Pillows 3841 Mattresses 1183 Palliasses 127 Chair Cushions 602 Clothing 4824 Sheets 2096 Blankets 3788 Rugs and Mats 201 Counterpanes and Eiderdown Quilts 1856 Carpets 266 Extras (i.e., articles not mentioned in above) 2185 Total 23982 Articles of bedding, etc., destroyed. Beds 33 Bolsters 9 Blankets 7 *Measles 8, Scarlet Fever 4, Mumps 2, Whooping Cough 1, and Scarlet Fever and Measles 1. †136 Public Library and 25 Private Books. 148 Pillows 19 Quilts and Counterpanes 9 Mattresses 15 Palliasses 20 Sheets 4 Chair Cushions 14 Clothing 33 Carpets 4 Sundries 52 Total 219 Practically all the disinfection was carried out by the Council's officers—only 34 certificates being received from Medical Practitioners during 1909 as compared with 26 during 1908. Particulars as to the 34 certificates (received during 1909) are as follow:— Medical Certificates accepted in lieu of Disinfection being carried out by the Borough Council. Nature of Certificate. 1st Q. 2nd Q. 3rd Q. 4th Qr. Total For Rooms only ... 2 2 3 7 For Bedding only ... ... ... 2 2 For Rooms and Bedding 9 7 5 4 25 9 9 5 9 34 149 Refuges. There is now one Refuge in the Borough, at Wanless Road, the other at the Wharf (Belvedere Road) having been given up in connection with the New County Hall Improvement Scheme. Two of the disinfecting vans (Nos. 2 and 3), which had been in use for 10 years previously, were repaired, repainted and varnished, at estimated costs of £10 5s. and £8 12s. respectively, during 1909. Three new sets of harness were provided for the disinfecting van horses during 1909. William Lockyer (one of the disinfecting men) was permanently appointed Superintendent of the Disinfecting Department at Wanless Road vice Arthur Norris, resigned, on May, 27th, 1909, at a salary of 37/0 net per week, together with the use of the upper rooms at Arlington Lodge, with rent, rates and taxes, fuel and light free. The Disinfecting Staff consists of 1 Superintendent, 4 disinfectors, 4 drivers, 1 boiler attendant, and 1 yard and stable attendant.* *George Foxall was appointed temporarily on May 28th, 1909, vice Wm. Lockyer, promoted. 150 DISINFECTION STATISTICS. For eight years prior, and seventeen years subsequent, to the passing of the Notification of Infectious Diseases Act; and for the year 1909. 1882 1883 1884 1885 1886 1887 1888 1889 Yearly average for 8 years preceding the Notification Act 1909 No. of Cases in which Bedding, etc., has been disinfected. At Home 332 258 278 10 62 52 7 144 142•8 1197 At Chamber 85 56 162 509 236 722 902 951 452•8 2642 No. of Cases in which Bedding, etc., has been destroyed. 37 23 62 52 8 57 48 79 45•7 51 No. of Articles of Bedding, etc., disinfected. 1526 1437 1895 2275 916 3078 3121 3778 2153•2 23982 No. of Articles of Bedding, etc., destroyed. 63 104 114 144 59 92 61 267 1130 219 Premises fected and infectants Supplied. 727 680 657 727 736 1276 1255 1277 916•8 12666 Infectiousdiseases dealt with. Notifiablet† - - - - - - - - - 1809 Non-notifiable § - - - - - - - - - 4278 † vide footnote on page 151. § vide footnote on page 151. 151 DISINFECTION STATISTICS—continued. 1890 to 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 Yearly average or 19 yrs. succeeding the Notification Act. 1909 No. of cases in which Bedding, etc., has been disinfected. -At Home 1361 177 251 368 217 132 81 62 37 20 19 6 1 8816 1096 1120 306•8 1197 At Chamber 8543 2206 2472 2447 2126 2424 2998 2450 304 3702 3253 3107 3583 2484 4781 2690 2752•9 2042 No. of cases in which Bedding, etc., has been troyed. 998 119 6 49 39 27 4 59 75 134 62 53 47 33 41 36 96•1 51 No. of Articles of Bedding, etc., disinfected. 31182 8022 13516 20349 21487 21597 27923 27528 27265 41029* 26957 26359 51552 22850 24891 22646 21850•2 2392 No. of Articles of Bedding, etc., destroyed. 2079 544 186 178 162 126 326 1783 959 1006* 587 479 519 419 202 231 514•9 219 Premises disinfected and disinfectants supplied. 12591 5742 7146 7210 8715 8441 9146 9124 9522 11607 10984 12367 13212 11735 11808 11575 8522•4 12666 Infectious Diseases dealt with— Notifiable† 8771 2433 2685 2801 2663 2329 263 2209 2025 4273 1587 1938 l853 2074 2140 2056 2343•7 1809 Non-Notifiable† — — — 20 87 144 1339 1702 1376 1094 2269 2638 3927 2388 4047 3204 1864•2 1278 *Including 26145 and 355 Smallpox articles disinfected and destroyed respectively in 1902. † The Notification Clauses of the Public Health (London) Act, 1891, came into force on January 1st, 1802, and previous to 1896 practically no attend on was paid to disinfection in connection with the non-notifiable infetious diseases. § This number is increased for 1906, 1907, 1908 and 1909 on account of bedding no longer being: removed to the Disinfection Station as a routine in connection with Measles, Whooping Cough and Chicken-pox. N.B.—The Statistics for 1901-9 refer to Borough Council; those for all previous years to the late Vestry. 152 NON-NOTIFIABLE INFECTIOUS DISEASES, ETC., 1900-1909. 1st Q. 2nd Q. 3rd Q. 4th Q. Total 1909. 1908. 1907. 1906. 1905. 1904. 1903 & 1902. 1901 & 1900. Yearly average 9 years (1900-1908). Measles 522 749 162 168 1601 1504 1998 836 1970 1294 1710 1669 1220•1 Whooping Cough 195 427 67 72 761 319 748 455 440 380 435 198 330•6 Chicken-pox 133 131 87 357 708 602 600 354 733 305 1981 166 526•8 Consumption* 386 327 152 287 1152 749 677 592 598 659 757 1007 559•9 Cancer 13 17 14 12 56 30 24 18 16 20 47 38 21•4 1249 1651 482 896 4278 3204 4047 2255 3757 2658 4930 3078 2658•8 * Consumption voluntarily notifiable throughout the Borough since June 1st, 1902. N.B. - 154 other diseases (not classified) i.e., Mumps, Gangrene, Influenza, Scabies, Pneumonia, Dropsy, Diseases not stated, etc.. and 148 Verminous Houses and Persons were also dealt with during 1909. 153 SMOKE ABATEMENT. During 1909, observations and enquiries have been made in connection with smoke abatement throughout the Borough, and 32 smoke notices have been served. In no case was it found necessary to proceed to a summons. Special observations were made during 1909 with reference to St. Thomas's Hospital (Embankment), Sir Joseph Causton, Ltd. (Clapham Road), Messrs. Beaton & Co. (33 Chapel Road, West Norwood), Hyde's Bird food Factory (Lilford Road), Washington Laundry (Frederick Crescent), Messrs. Hayes & Sons, Ltd. (129 Coldharbour Lane), Messrs. Sharwood & Co., Ltd. (Offley Road), and the South London Electric Supply Corporation, Ltd. (Bengeworth Road). In addition to the work carried out by the Council's Inspectors, the L.C.C. and the Coal Smoke Abatement Society, reported nuisances as follows:— 1. London County Council—15 letters dealing with alleged smoke nuisances connected with:— The Arlington Laundry Co. (Cambria Road); Messrs. Beaton & Co. (33 Chapel Road, West Norwood); Sir Joseph Causton, Ltd. (Clapham Road); City & South London Railway Generating Station (195 Clapham Road); Messrs. Dewar & Co. (Commercial Road); Messrs. Doulton & Co. (High Street); General Motor Cab Co. (Brixton Road); Messrs. Hayes & Son, Ltd. (129 Coldharbour Lane); Lambeth Baths and Wash-houses (Kennington Road); Lion Brewery Co., .Ltd. (Belvedere Road); Mr. R. K. Knapman (12 Treherne Road); New London Brewery (Durham Street); 154 Messrs. McGaw & Co. (York Road); Messrs. Sharwood & Co., Ltd. (Offley Road); Messrs. Rogers & Cook, Ltd. (South Lambeth Road); Washington Laundry Co., Ltd., 30 Langton Road; Webbs' Dye Works (254 Brixton Hill); South - London Electric Supply Corporation, Ltd. (Bengeworth Road). 2. Coal Smoke Abatement Society— 4 letters dealing with alleged smoke nuisances connected with:— Messrs. Brotherhood & Sons (Belvedere Road); Charing Cross and Strand Electricity Supply Co. (Commercial Road); Messrs. Doultom & Co., Ltd. (High Street); Messrs. Holloway Bros. (Belvedere Road); Messrs. Meredith & Co. (Belvedere Road); Messrs. Sharwood & Co, Ltd. (Offley Road); Messrs. Walker, Parker & Co. (Belvedere Road). Proposed Smoke Legislation. The London County Council convened a Conference of Metropolitan Sanitary Authorities, on the subject of proposed legislation dealing with smoke nuisance in London. The Conference* was held on March 12th, 1909, and the following resolutions were passed:— That Section 24 (b) of the Public Health (London) Act, 1891, which provides that "any chimney (not being the chimney of a private dwelling house) sending forth black smoke in such quantities as to be a nuisance" shall be a nuisance liable to be dealt with summarily under the Act, should be amended by the deletion of the word "black." That the word "chimney" in section 24 (b) of the Public Health (London) Act, 1891, should be deemed to include:— * The Medical officer ot Health was the Lambeth Delegate. 155 (i.) Openings through which smoke is emitted from buildings or places in which processes of manufacture are carried on and the chimneys of any building or place where furnaces are used in operations carried on under statutory powers. (ii.) The chimneys of any Government Workshop or Factory. That in special cases of nuisance arising under sections 23 and 24 of the Public Health (London) Act, 1891, the proceedings in respect of any nuisance may, at the request of and by agreement with the sanitary authority, be taken by the London County Council in such special cases. UNDERGROUND CONVENIENCES. The conveniences have been kept under regular inspection during 1909—the male conveniences by the male inspectors and the female conveniences by the female inspectors. It has been decided, during 1909, to construct an Underground Convenience at Westow Hill, subject to the three other Local Authorities, whose districts meet at the site, viz.: the Corporation of Croydon, the Camberwell Borough Council and the Penge Urban District Council, agreeing to contribute one-fourth of the estimated cost of construction (£2000), and also one-fourth of the cost of its maintenance (£400 per annum) exclusive of fees received. During 1909, the Underground Conveniences previously lighted by gas have been lighted by electricity, and, in connection with the Brixton conveniences, two electricallv-lighted signs, bearing the words "Ladies" and "Gentlemen" have been fixed. These signs are plainly seen both by daylight and at night. 156 An application (dated January 3rd, 1909) was received from the male attendants asking for extra (double) payment for Bank Holidays, instead of time off, but the request was not granted, the Council, on April 2nd, 1908, having decided that all the Council's employees required to work on Bank Holidays, Good Friday or Christmas Day should be allowed another day's holiday. Three attempts of burglary* were made during June, September and October, 1909, at the Vauxhall Park Ladies' Convenience (overground), and in one instance (September), 2 men were arrested on suspicion, tried at the Sessions, found guilty and sent to prison for 9 and 12 months respectively. There has been no change during 1909 in the personnel of the attendants. Messrs. James Skitterall (aged 38 years), William C. Jolly (aged 34 years), and Arthur Carrett (aged 32 years), have been placed on the permanent list of employees, having been temporarily employed since October 2nd, 1908. ANALYSIS OF FOOD AND DRUGS, WATER, etc. 1.—Food and Drugs During the year 1909, 1800 samples have been purchased within the Borough of Lambeth, and submitted to the Public Analyst for analysis. Of the 1800 samples 88 (i.e., 4.9 per cent.) were reported by the Analyst to be adulterated, varying quarterly as follows:—1st quarter, 5.2 per cent.; 2nd, 6.2 per cent.; 3rd, 2.5 per cent. and 4th, 5.2 per cent.; and 76 summonses were issued, with the result that 59 convictions were obtained, together with £86 10s. in penalties, and £48 9s. 8d. in costs. Full details are to be found on pp. 163-165, and in the Appendix (pp. 27-42). Taking the average of 10 years (1891-1900), the annual number of samples taken in the old Parish of Lambeth is 501, of which 74 (i.e., 14.8 per cent.) were found, on analysis * Two previous attempts were made at the Vauxhall Park Convenience in December, 1906. 157 to be adulterated; whilst the annual average number of summonses issued is 53, with 52 convictions, and £104 5s. 5d. in penalties, and _£35 0s. 3d. in costs. In the Borough, 710, 704, 1010, 1200, l500, 1500, 1800 and 1800 samples were taken during 1901, 1902, 1903, 1904, 1905, 1906, 1907, and 1908 respectively. During 1909, no samples were submitted to the Public Analyst by private purchasers, but 2 informal samples (1 mustard and 1 olive oil) were taken by the Inspector. Particulars of the 1800 articles submitted by the Food and Drugs Inspector during 1909 are as follows:— (a) Milk. 741 samples were taken, and of these 64 (i.e., 8.6 per cent.) were declared by the Analyst to be adulterated. 2 of the samples were purchased as "separated" milks (one adulterated) and 2 as "skimmed" milks (none adulterated). The 64 adulterations found were as follows:— (1) Extraneous water (24) varying from a minimum 2 to a maximum 25 per cent., viz.: 2, 2, 3, 3, 3, 3, 4, 5, 5, 6, 6, 6, 7, 7, 7, 9, 9, 11, 11, 12, 18, 21 and 25 respectively. (2) Deficiency in milk-fat (38) varying from a minimum 1 to a maximum 18 per cent., viz. : 1, 1, 2, 3, 3, 3, 4, 5, 5, 5, 5, 6, 6, 6, 6, 7, 7, 7, 7, 7, 7, 8, 8, 9, 10, 10, 11, 12, 12, 13, 13, 14, 14, 14, 14, 15, 17 and 18 respectively.* (3) Extraneous water and deficiency in milk fat (2); viz.: 3 and 2 per cent. in a sample of milk, and 13 per cent. extraneous water added to a separated milk, deprived of half its natural fat. * One sample of milk was deficient in 8 per cent. of milk fat, and also contained 0 001 per cent. of formaldehyde (vide Appendix, p. 39) 158 In 61 samples of milk adulteration, 52 summonses were taken out, and in 36 cases convictions were obtained, with penalties varying from a minimum 5/0 (with 16/6 costs) to a maximum £10 (with 16/6 costs). In 5 cases, no penalty was inflicted, but simply costs were allowed. In the remaining 16 cases, the results of the summonses were as follows: — (a) Summonses dismissed (10) on account of the following legal technicalities: warranties proved, 5, and contrary proved 5. (b) Summonses adjourned sine die (1) on account of the following legal technicality, viz: Defendant in hospital. (c) Summonses withdrawn (5) on account of the following legal technicalities: contrary proved, 3; and by order of the Public Health Committee and Council, 2. The 2 summonses, in connection with which the Council decided to take no action, refer to samples 103 and 108 milk (taken from a farmer's consignment). The samples on analysis were certified by the Public Analyst to be deficient in milk fat to the extent of 9 and 7 per cent. respectively—the percentages of milk fat and milk solids other than milk fat being 2.73 and 9.13 (total solids 11.86) and 2.79 and 9.03 (total solids 11.82). These analyses shew that, whilst the milk fat in each case falls below the minimum 3 per cent. mentioned in the Milk Regulations of the Board of Agriculture, the total milk solids and the solid's other than milk fat were above the normal. A letter has been written to the Board of Agriculture, asking for its instructions in connection with such cases, and the Board replied that the two paragraphs of the Sale of Milk Regulations referring to (1) milk fat, and (2) 159 milk solid's other than milk fat, are independent, and that their operation is independent of any question as to the total solids, though the Board states that the amount of the total solids may reasonably be taken into consideration by a Local Authority in determining whether a prosecution should be instituted. A letter was received from the defendant's solicitors, suggesting that the summonses should be withdrawn, so as not to put their client to the expense of bringing his farm hands and the guards of the train to the Court; more especially, having regard to the comparatively large amounts of total solids and milk solids other than miik fat found, and also having regard to the fact that two other samples taken at the same time in connection with the same consignment (separate churns) were returned by the Public Analyst as "genuine," and the two summonses were, consequently, withdrawn. In 12 cases, no summonses were taken out on account of the amounts of adulteration being too small, viz., (a) extraneous water, 2, 2, 3, 3, 3 and 3 per cents. respectively ; (b) fat deficiencies 1, 1, 2, 3, 3 and 3 per cents. respectively. The total fines amounted to ,£66 5s. Od'. with £'32 16s. 2d. costs. (b) Butter. 634 samples of butter were taken, and of these 18 (i.e., 2.S per cent.) were declared by the Analyst to be adulterated, the adulterations consisting of (1) added margarine (16) varying form a minimum 20 per cent. to a maximum 100 per cent. viz. : 20, 43, 51, 90, 90, 90, 91, 92, 94, 96, 98, 100, 100, 100, 100 and 100 respectively; (2) Margarine exposed for sale without properly labelling the same (2). In 18 samples of butter adulteration, 18 summonses were taken out, and in 18 cases convictions were obtained with penalties varying from a minimum of 5/0 (with 16/6 costs) to a maximum £.3 (with 16/6 costs). 160 The total fines amounted to £14 5s. (with £,14 Os. fid. costs). (c) Margarine. 28 samples of margarine were taken, but none were declared by the Analyst to be adulterated. Two of the samples were purchased as "Pearksown" (non-adulterated). (d) Coffee. 129 samples of Coffee were taken, but none were declared by the Analyst to be adulterated. (e) Mustard. 35 samples of mustard were taken, and of these 2 (i.e., 5.7 per cent.) were declared by the Analyst to be adulterated — both with 10 per cent. wheaten flour. One sample was "informal" sample and no action was taken in connection therewith, but a summons was taken out in respect of the other adulterated sample, with the result that the defendant was fined' £,"1 0s. Od. and 16/6 costs. (f) Other Groceries. One sample of sago, 3 of chocolate powder, 50 of pepper, and I of Demarara sugar were taken, but none were declaredI by the Analyst to be adulterated. (g) Spirits. 2 samples of rum and 1 of whisky were taken, and of these, one (rum) was declared by the Analyst to be adulterated with 9 degrees below the legal limit of 25 degrees, under proof, allowed. The summons was dismissed, on account of a notice being proved to have been exhibited at the time in the bar parlour (though such notice was not seen by the Inspector). (h) Drugs. 19 samples of drugs were taken, but none were declared by the Analyst to be adulterated. 161 (i) Other Articles. 100 samples of lard, 1 of lardine, 9 of vinegar, 5 cf oatmeal, 7 of pea flour, 4 of wheaten flour, 5 of ground rice, 7 of ground mace, 1 of whole mace, 1 of sweetmeats, 4 of olive oil, 1 of salad oil, 1 of ground almonds, and 6 of baking powder were taken, but none were declared by the Analyst to be adulterated, except the one salad oil and two lard samples, the salad oil with 100 per cent. cotton seed oil, and the two lards with 100 per cent. cocoanut stearine each respectively. No action was taken in connection with (1) the sample of salad oil (on account of its being an "informal" sample), and (2) one sample of lard (on account of its being served both from packages and in a wrapper marked "Nut Lard." Summary of Legal Proceedings taken under the Sale of Food and Drugs Acts. Of the total 73 summonses taken out, there were convictions in 56 cases, whilst in the remaining 17 the results were as follows :— 11 summonses dismissed— (a) Warranty proved satisfactory, 5; (b) Contrary proved satisfactorily, 5; (c) Notice exhibited in bar, 1. 5 summonses withdrawn— (a) Contrary proved satisfactorily, 3; *(6) By order of the Public Health Committee, 2. 1 summons adjourned sine die— (a) Defendant being in hospital, 1. *Vide pp. 155-156. l 162 Expenses of carrying out the Food and Drugs Act. The total expenses connected with the carrying out of the Food and Drugs Acts in Lambeth Borough during 1909 amounted to £,77 1s. 4d., and' are made up as follow: — £28 8s. 3d. for samples, £22 10s. Od. for assistant, £4 13s. for witnesses, ,£16 12s. l1d. for travelling expenses (including £6 17s. 6d. for cabs) and £4 17s. 2d. for sundries. The salary of the Food and Drugs Inspector (£.120, rising by £,10 annual increases to £200), and the costs of the summonses (£9), are not included. For comparison, the total expenses during the past few years are tabulated as follows:— Year. Total Expenses. Numbers of Samples. £ s. d. 1903 81 0 5 1010 1904 89 19 10 1200 1905 84 2 0 1200 1906 98 9 2 1500 1907 55 4 1* 1800 1908 84 14 6 1800 1909 77 1 4 1800 II. Water No samples of water were officially examined chemically during 1909. * Work done by District Inspectors and Female Inspe tors during 9 months illness ot the Food and Drugs Inspector (Perrin). 163 SALE OF FOOD AND DRUGS ACTS. Samples procured, together with the results of Analyses, during the year 1909. Samples. Number Analysed. Number Adulterated. Milk 737 63 Separated Milk 2 1 Skimmed Milk 2 — Butter 634 18 Pearksown 2 — Margarine 26 — Coffee 129 — Pepper 50 — Mustard 35 2 Lard 100 2 Ground Rice .5 — Oatmeal 5 — Drugs* 21 — Pea Flour 7 — Demarara Sugar 1 — Baking Powder 6 — Wheaten Flour 4 — Vinegar 9 — Sago 3 — Ground Mace 7 — Whole Mace 1 Lardine 1 - Sweetmeats 1 Rum 2 1 Whisky 1 — Olive Oil 4 - Salad Oil 1 1 Ground Almonds 1 Chocolate Powder 3 — Totals 1800 88 * Cream of Tartar 8, Tartaric Acid 7, Milk of Sulphur 3, Camphorated Oil 2, and Eucalyptus Oil 1. 164 Shewing percentage of different adulterated Samples during 1909 (Borough), and in ten years 1891-1900 (Parish) Year. Milk. Butter. Coffee. Bread and Flour. Cocoa and Chocolate. Cheese and Lard. Other Groceries. Sundries. Spirits. Brandy. Gin. Rum. Whisky. Ale and Porter. Wines. Aerated Waters. Drugs. Boro' Council. 1909. 8•6 2•8 00 0•0 0•0 2•0 2•2 6•0* 33•3 — — 50•0 0•0 — — — 0•0 1900 14•0 11 •0 17•8 - - 0•0 3•5 0•0 0•0 — - - 0•0 0•0 - - 0•0 Late Vestry. 1899 10•9 14•5 6•9 — — 0•0 2•7 0•0 21•4 33•3 - 0•0 20•0 — - 0•0 0•0 1898 13•6 14•0 10•3 — 0•0 0•0 0•0 0•0 11•1 — 0•0 50•0 5•9 — - — 18•8 1897 10•5 7•3 3•03 0•0 0•0 0•0 2•0 11•1 17•7 — 25•0 18•0 0•0 — - — 14•3 1891 11•06 17•7 15•1 0•0 0•0 — 0•0 0•0 0•0 0•0 0•0 0•0 0•0 — - 0•0 0•9 1895 21•05 14•7 26•4 — 0•0 0•0 0•0 16•6 16•0 — 12•5 25•0 — — 0•0 0•0 12•5 1894 27•6 22•4 30•0 — 0•0 0•0 5•3 0•0 0•0 0•0 0•0 0•0 0•0 — — — 0•0 1893 30•4 35•04 11•1 0•0 18•2 0•0 3•3 0•0 8•7 20•0 0•0 0•0 11•1 — — — 0•0 1892 31•3 36•4 18•4 — 66•7 0•0 2•1 0•0 0•0 0•0 0•0 0•0 — 0•0 — — 0•0 1891 47•8 5•0 3•8 0•0 - - 2•6 0•0 0•0 0•0 0•0 - 0•0 0•0 - 0•0 0•0 0.0 means that all samples were reported to be genuine and unadulterated. — means that no samples were taken during the year. * Th Sundries include Vinegar. Sweetmeats, Margarine, Mace, Baking Powder, Ground Almonds, Olive Oil, Oatmeal, Flour, and Ground Rice. 165 Particulars as to samples analysed, and proceedings taken, during 1909 (Borough), and during the ten years 1891-1900 (Parish). Year. No. of Samples analysed. No. of Samples adulterated. Percentage of Samples adulterated, No. of Summonses issued. No. of Convictions. Penalties. Costs. Borough Council. 1909 1800 88 4•9 76* 59 £ s. d. £ s. d. 86 10 0 48 9 8 Late Vestry. 1900 603 73 12•1 57 52 104 10 0 42 6 6 1899 600 65 10•8 52 49 76 10 0 29 12 6 1898 602 74 12•3 57 54 69 0 0 34 9 0 1897 546 41 7•5 7 21 48 0 0 24 5 0 1896 549 66 12•02 66 60 93 0 0 35 11 6 1895 500 87 17•4 64 62 149 15 0 41 18 0 1894 495 107 21•6 81 79 199 0 0 45 11 0 1893 498 120 24•09 79 79 207 17 0 48 19 0 1892 332 65 19•5 43 43 66 8 6 32 9 0 1891 292 48 16•4 25 24 28 13 6 15 1 0 Average of 10 years, 1891—1900. 501•7 74•6 15•1 53•1 52•5 104 5 5 35 0 3 Inspector Perrin commenced his duties on February 21st, 1898, vice Inspector Wiggs, who did the woik from August, 1892 to November, 1897. * 11 Summonses were dismissed, 1 was adjourned sine die. and 5 were withdrawn, during 1909. 166 HOUSES LET IN LODGINGS. The 372 registered houses have been visited regularly, but no new houses have been registered under the by-laws, during 1909. Proposed Legislative Control over Furnished Rooms by Sanitary Authorities. A letter, dated June 18th, 1909, was received from the London County Council, in connection with the question of the necessity for exercising increased control over a certain type of furnished rooms, the practice of letting such rooms for short periods, at a rate not exceeding 10/0 per week, having recently become more general in various parts of- the County of London. The County Council pointed out that this class of room appeared to be occupied by persons who are, if anything, of a more degraded character than those frequenting common lodging houses, that the rent is paid daily, and that the appointments of the rooms are mostly of a very scanty and dilapidated nature, the beds being, in many instances, verminous. The County Council further points out that the by-laws, which have been made under section 94 of the Public Health (London) Act, 1891, do not confer upon Sanitary Authorities adequate powers for dealing with rooms of the above description; whilst considerable difficulty is experienced in putting into operation the provisions of Part 4 of the London County Council (General Powers) Act, 1904, as to the destruction of filthy or unwholesome articles, owing to the frequency with which disputes, as to the amount of compensation for articles destroyed, arise. New legislation is, therefore, proposed in respect of furnished- rooms so let, to ensure that they be maintained with due regard to sanitation, including greater supervision and control. The Lambeth Council agreed to the necessity for exercising increased control over the type of furnished rooms 167 mentioned, and a letter was sent to the County Council asking for the investing of the Local Sanitary Authorities with full powers to inspect and enforce a certain standard of requirements, authority being given to the London (. ounty Council, with the consent of the Local Government Board, to act, in default of action by the Sanitary Authorities. The suggestion of the County Council that there should be an annual licensing of all persons letting such furnished rooms—such licenses to be granted by the County Council in the same manner as is done in regard to Common Lodging Houses, was not agreed to. COMMON LODGING HOUSES. The 6 Common Lodging Houses (for men), situated within the Borough of Lambeth, have been inspected during 190!), a broken w.c. pan being found at 55 Belvedere Road, a defective w.c. trap and defective urinal at 89-91 Wandsworth Road, and a defective down service water pipe joint to pan of w.c. at 108 Lambeth Walk. These defects have been remedied, the Common Lodging Houses, again licensed' by the London County Council at the Annual Licensing Meeting held June 28th, 1909, in accordance with the requirements of Section 46 of Part IX. of the London County Council General Powers Act, 1902 :— Date when registered. Situation. Authorised No. of Lodgers. 27th January, 1905 10a Belvedere crescent 99 18th July, 1900 108 Lambeth walk (c.h.) (house in rear) 39 30th October, 1890 55 Belvedere road 49 21st December, 1883 90-92 Westminster bridge road 197 24th October, 1885 89 & 91 Wandsworth road 188 12th February, 1887 106 Wandsworth road 133 168 REVENUE ACT, 1903. During 1909, 85 certificates under the Revenue Act, 1903, in connection with tenements (or dwellings) so constructed as to afford suitable separate accommodation for each of the families inhabiting the same have been applied for, and, of these 2 have been granted unconditionally, 40 have been granted conditionally, i.e., subject to certain alterations and improvements being carried out, and 43 have been refused. (1) Certificates granted unconditionally. Blocks or Houses. Tenements. 28 Flaxman Road 1 2 Total 1 2 (2) Certificates granted conditionally. 80 Bonnington Square 1 3 5 Dulwich Road 1 2 26-30 Flaxman Road 2 4 7, 9, 11, 13, 15, 17, 19, 21 and 23 Mauleverer Road 9 18 62 Saltoun Road 1 2 96 and 98 Strathleven Road 2 4 125, 127, 129 and 131 Strathleven Road 2 4 97 Westminster Bridge Road 1 3 (and 1 Shop) Totals 19 40 (and 1 Shop) 169 (3) Certificates Refused. Blocks or Houses. Tenements. 78-79 Bonnington Square 2 6 39 Lyham Road 1 2 30-32 Morval Road 2 4 1. 3, 5, 7, 9 Rushcroft Road 5 15 62, 64, 66, 68, 70, 72, 79 Thor- parch Road 7 14 54 The Grove, Vauxhall 1 4 Totals 18 45 HOUSING OF THE WORKING CLASSES. No house has been condemned, during 1909, under the Housing of the Working Classes Acts, but in this connection it must remembered that, in respect of dwelling houses, many notices have been served under the Public Health Act, and that, had these notices not been complied with, proceedings would have been taken in the usual way for the closing of the houses. The Housing Acts are only brought into use in extreme cases. BAKEHOUSES. There are 214 Bakehouses (135 above ground and 79* underground) situated within the Borough of Lambeth, and these have been inspected during 1909, and the necessary annual white-washing and cleaning carried out. OFFENSIVE TRADES. During 1909, no nuisance has been reported in connection with the 6 Offensive Trades, which exist in the Borough of Lambeth, and which are now under the supervision of the Borough Council :— * 72 have been certified as " suitable," for occupation as underground bakehouses. 170 1. Fat Melters—Upper Marsh (Messrs. J. C. & J. Field). 2. *Tallow Melters—144 Broadwall (Messrs. Harris, Blackman & Sons). 3. Soap Boilers—Upper Marsh (Messrs. J. C. & J. Field). 4. *Soap Boilers—144 Broadwall (Messrs. Harris, man & Sons). 5. Tripe Boilers—103 Lambeth Walk (Messrs. Bennett, Son & Co.) 6. Tripe Boilers—115 Lower Marsh (Messrs. Bennett, Son & Co.) The Council's attention was drawn during 1909 to the existence of a nuisance connected with an offensive trade (fat melting or fat extracting) at the Arches, 69-71 Lilfora Road, such offensive trade having apparently been established without the written consent of the London County Council as required by Section 19 of the Public Health (London) Act, 1891. For further particulars see pp. 184-18"). Proposed By-Laws regulating the Businesses of Fried Fish Vendors, Fish Curers and Kag and Bone Healers. A letter dated' April 12th, 1909, was received from the London County Council, enclosing draft by-laws for regulating the conduct of the businesses of (1) a vendor of fried fish, (2) a fish curer, and (3) rag and bone dealer, with a view to the Metropolitan City and Borough Councils considering the same, and suggesting any amendments, cr alterations, that might be thought necessary. The by-laws are made by the London County Council under section 9, sub-section 1 of the London County Council (General Powers) Act, 1908, under which draft copies are to be sent to the Metropolitan Borough Councils in accordance with section 114 of the Public Health (London) Act, 1891, application to be made in due course, for confirmation, to the Local Government Board. Under the by-law, existing fish curers and fried fish vendors' premises are exempt. (Vide By-law 16.) * Premises closed (1909). 171 Suitable by-laws for fried fish vendors, fish curers, and rag and bone dealers are much needed, but, in connecti0n with the draft by-laws submitted by the London County Council, objection was taken during 1909 by the Lambeth Borough Council on account of the suggested dual control as between the London County Council and the Borough Councils, not only as regards the giving of notice of any such businesses being carried on, but also in relation to access to any part of the premises by officers of the County Council, and the provision of a daily penalty, after notice of any offence, a dual system being unnecessary and likely to cause friction and useless expense. Further, the Lambeth Borough Council, in connection with the draft by-laws spproved of the following two suggested amendments :— (1) The term "vendor of fried fish" to be defined, with a view to removing any possible doubt as to whether the person carrying on the business of a restaurateur, or other similar business, in which (ried fish is sold, is included in such term ; (2) The draft by-law, relating to the business of a rag and bone dealer, to include "dust-bins." DAIRIES, MILKSHOPS AND MILK STORES. 11 new milkshops and milk stores have been inspected during 1909 with a view to registration, and all existing ones have been, from time to time, under inspection, as required. SLAUGHTER HOUSES. There were within the Borough of Lambeth at the end of 1908, 24 registered Slaughter-houses, and at the Annual Licensing of the London County Council, held on October 25th, 1909, the licenses were all renewed. 172 LIST OF THE 24 SLAUGHTER-HOUSES LICENSED IN THE BOROUGH OF LAMBETH DURING 1909. Ward. Situation of Premises. Name of Licensee. Marsh ... 99 Lower Marsh* Holdstock, Jno. Thos. ” ... 106 „ „ Thomas, Robert Edwin Bishop's 151 Lambeth Walk Milton, Robert William Prince's 4 Clapham Road Holdsworth, Chas. ” ... 60 Kennington Park Road Grellier, Frederic ” ... 406 Kennington Road Parsons, Bernard William ” ... 171 Lower Kennington Lane Clark, Arthur Vauxhall. 152 Clapham Road Lawrence Bros. ” ... 302 Clapham Road Holdsworth, Geo. ” ... 18 Paradise Road (rear of) Smith, Wm. Geo. ” ... 1 Lansdowne Road, Clapham Road Copeman, Minnie Mary Stockwell 27 Bedford Road, Clapham Rd. Pooley, John Peed Brixton Near Railway Hotel Brewery, Electric Lane, Brixton Elphick, Edwin ” ... 263 Brixton Road* Snelling, Ernest William and John Arthur (trading as Snelling Brof.) *Small cattle only to be killed. 173 Ward. Situation of Premises. Name of Licensee. Brixton 10 Foxley Koad* Maiden, Robert Levers ” Industry Terrace (yard leading to), Canterbury Road Warren, James Edward Heme Hill 207 Coldharbour Lane Clark,Albert John ” 309 „ „ Ford, Hy., & Co., Ltd. ” 77 Dulwich Road Atkin, Jim Cook Tulse Hill 12 Lower Tulse Hill Rooksby, Walter ” „ 45 New Park Road Beaumont, Edith Mary (trading as Martin & Beaumont) Norwood 125 Hamilton Road Forss, Thomas Lionel ,, 120 High Street* † Bull, Mary Ann „ 121 „ „ (rear of) * Small cattle only to be killed †Special conditions laid down. Griffiths, Fredk. i Sanitarily, these 24 Slaughter-houses are in good condition, and the chemical test, which was applied to the drains in each case, gave a result in one instance only, viz.: defective fresh air inlet and manhole cover. Inspection of the Slaughter-houses within the Borough is now carried out by the officers of the Borough Council, who are responsible for the due enforcement of all By-laws and Regulations made in pursuance of the Slaughter-houses, etc. (Metropolis) 174 Act, 1874, and the Local Government Act, 1888—an important duty which was formerly carried out by the officers of the London County Council. During 1909, minor sanitary defects have been found as follows:—defective paving (2), dirty premises (3), defective fresh air inlet and manhole cover (1); whilst at 106 Lower Marsh (voluntary repairing of premises, new roof, etc.); and at 151 Lambeth Walk the roof was defective, and the District Surveyor had served notices under the Building Act. Four Slaughter-houses have changed hands during 1909, viz. : 12 Lower Tulse Hill to Mr. Walter Rooksby, of 2.23 Rye Lane, Peckham (vice Mr. William Haydon); 151 Lambeth Walk to Mr. Robert William Milton (vice Mr. Samuel Wright); 1 Lansdowne Road to Mrs. Minnie Mary Copeman (vice Mr. Sydney Beaumont Wheeler, Manager for Mrs. Copeman); and 263 Brixton Road to Messrs. Ernest William and John Arthur Snelling (trading as Snelling Bros.), vice Mr. Ernest William Snelling. S COWHOUSES. There were, within the Borough of Lambeth, at the end cf 1908, 14 registered Cowhouses, and at the Annual Licensing of the London County Council, held on October 25th, 1909, the licenses were all renewed, except that for 196 Norwood Road. 175 LIST OF THE 13 COWHOUSES LICENSED IN THE BOROUGH OF LAMBETH DURING 1909. Ward. Situation of Premises. No. of Sheds. No. of Cows kept. Marsh *6 Coral Street, Lower Marsh 1 10 Bishop's 24 Distin Street 2 9 „ ... Cambria Cottage, 36 Tracey Street 1 13 Prince's 30 Upper Kennington Lane 1 7 Vauxhall 9 Dawlish Street 1 12 „ 38 Hartington Road 1 22 Brixton 34 Ingleton Street 1 5 Norwood 93 Clive Road, West Norwood 1 4 „ 15 Croxted Road, West Dulwich 1 3 „ Elder Road Dairy, West Norwood 2 35 „ 156 Hamilton Road, West Norwood 3 26 „ 76 and 78 Gipsy Hill 3 27 „ 67 Rosendale Road 1 10 19 183 Sanitarily, these 13 Cowhouses are in good condition, and they have been inspected during 1909, and the drains in each case tested with the chemical test, and a result obtained in 1 instance, viz., from a broken manhole cover. A few minor sanitary defects were found, e.g., defective paving (1), dirty premises (1), and defective manhole cover (1); whilst at 24 Distin Street the flank wall was voluntarily rebuilt, and at Elder Road Dairy improved washing arrangements were introduced. I he Borough Council is now responsible for the periodic.)! inspection of the Cowhouses, and the due enforcement of all * Objection was taken to the renewal of the license of 6 Coral Street, on the ground that milk is occasionally stored and milk utensils are generally cleansed in the covered hauling way leading to the cowshed in which the dung and g'ain receptacles are situated. Arrangements were made to use No. 9 Coral Street for such purposes in future. 176 By-laws and Regulations which have been made in connection therewith under the Dairies, Cowsheds, and Miik-shops Orders, 1885-86-99. Such duties were carried out by the London County Council previous to the passing of the London Government Act, 1899. During 1909, 110 action has been taken in regard to infringement of By-laws before the Magistrate. Two Cowhouses have changed hands during 1909, viz., 6 Coral Street to William Owen, and 36 Tracey Street to Mrs. Annie Evans. DRAINAGE CASES. 1. Drainage Work Improperly Carried Out. (a) 68 York Road, Westminster Bridge Road. At 68 York Road, Westminster Bridge Road, a soil pipe was reconstructed, contrary to the by-laws of the London County Council, in that the soil pipe was not properly ventilated and that no notice had been given to the Sanitary Authority of the proposed work. The owner was communicated with, and a letter was received from him expressing regret for the action of his builders, who appeared to have acted bona-fide and in ignorance of the by-laws. The work has since been altered and carried out in accordance with the by-laws and to the satisfaction of the Sanitary Inspector, and under the circumstances no further action was taken. (b) 31 Lothian Road, Brixton. A ventilating pipe was constructed at No. 31 Lothian Road, in such a way as to contravene the by-laws of the London County Council, but the work was done in ignorance. the joints were leaded so that it would be possible to take the pipe down without breaking it. A letter was sent to the builder, stating that no further action would be taken in the 177 matter for the present, but that the Council reserved to itself to require the alteration of such pipe, at any time, on serving upon the person responsible 24 hours' notice to do so, should such a course be found necessary. (c) 129 Dulwich Road, Heme Hill. A w.c. pan and trap was reconstructed in connection with 129 Dulwich Road, without previous notice having been given to the Sanitary Authority in accordance with the by-laws. A letter was sent to the builder, who replied apologising for the contravention of the by-laws. No further action was taken on the matter under the circumstances. (d) 4 Mary's Cottages, Eastcote Street. On account of a drain stoppage, a notice was served by the Inspector. The yard gully was found to have been broken and a new one substituted. The new gully was attached to a drain, which had, without notice given, been repaired. On opening up this newly-repaired' branch drain for examination, it was found that a drain pipe had been broken during the fixing of the new gully, and that this broken pipe had been improperly repaired by means of a piece of pipe fixed on the top of the broken pipe, and in such a manner as to cause stoppages in the drain. The builder and the man who actually carried out the work were written to, and replies were received from both apologising for carrying out drainage work improperly and without giving previous notice to the Sanitary Authority. Under the circumstances, no further action was taken. (e) 23 Bramah Road, Brixton. A complaint was received as to stoppages in the outside w.c. at 23 Bramah Road, and, on examination, it was found that the drain was defective. On exposing this drain, it was found to have been repaired improperly, and in such a m 178 manner as to be a nuisance, viz., a piece of tile having been placed over the opening made in the drain pipe and cemented in. The work had been carried out without notice to the 'Sanitary Authority. A cautionary letter was- sent to the owner and an apology received. The drain was relaid. Under the circumstances, no further action was taken. (/) 7 Gray Street, Blackfriars. A w.c. pan and trap was fixed at No. 7 Gray Street, without the necessary notice being previously given as required under the by-laws—a second offence by the same builder. A letter was written to him and he replied stating that, in future, he would take care that proper notice was given to the Authorities, and apologising for the trouble and inconvenience caused'. Under the circumstances no further action was taken. 2. Trough Closets at Salters Hill London County Council School. In the Girls' and Infants' Departments of the Salters Hill London County Council School, trough closets were found to be in such a condition as to require replacement by adequate water closets. A letter was, consequently sent to the London County Council (as the Education Authority) on May 4th, 1909, asking for this work to be carried out, but a reply was received to the effect that the County Council was "unable to give effect to the suggestion," claiming that such water closets were in good condition. A further letter was sent on behalf of the Borough Council on June 10th, 1909, pointing out (1) that schools belonging to so important a Body as the County Council should be kept, as far possible, up to date as regards their sanitary fittings, and (2) that the three trough closets (with boxed-in seats) in the Girls' Department were defective and leaking, shewing the existence of cracks whit 1 had recently been smeared over 179 with cement, worm-eaten and sodden woodwork around the trough closets, burrowings of rats in the surroundings, loose burnt ballast, etc. A statutory notice under the Public Health (London) Act, 1891, was served upon the County Council, who repaired the trough closets by filling in the seats at the backs and fronts with concrete, rendered in cement, making good the damage done by rats (stopping up the rat-runs), and improving the flushing apparatus. Trough closets are obsolete, and quite unsuited for schools, judging by present day modern requirements and ideas on sanitary matters. A letter, dated November 1st, 1909, was received from the County Council, stating "instructions have been given for the provision of separate pans and traps, when the existing troughs are worn out." CONTRAVENTIONS OF THE LONDON COUNTY COUNCIL BY-LAWS. 1. Removal of Offensive Matters. (a) On April 24th, 1909, the Sanitary Inspector found offensive matter (stinking bones) being removed during prohibited' hours (12 noon) and in an improper receptacle (barrow) within the Borough, thereby contravening the bylaws. A letter was written to the contractor, who has since written apologising, and stating that, on account of one of his horses having become lame, it was necessary for a man to be sent round on that date to collect the refuse. Under these circumstances, no summons was taken out for infringement of the by-laws of the London County Council. (b) On May 29th and July 8th, 1909, at 12.30 p.m. and 4.45 p.m., respectively, the Sanitary Inspector found' that offensive refuse was being collected in a covered van in 180 Lambeth Mews, thereby contravening the by-laws. A letter was sent to the firm on each occasion, warning them that, in any further case, action would be taken before the Magistrate, and letters were received, in reply, offering an apology, and stating that, in each case, it was an accident due to lameness developing in the horse. Under these circumstances, no further action was taken for the infringement of the by-laws of the London County Council. 2. Suggested Alteration of London County Council By-Laws. A letter, dated July 19th, 1909, was received from a firm of fish offal contractors, suggesting that they should be allowed to remove fish offal, in hermetically-sealed drums and by a covered van, late on Saturday evening, so as to obviate the offal remaining on premises from the collections on Saturday mornings until Monday mornings, the time stated (Saturday evenings) is outside that mentioned in the London County Council By-laws, and a letter was sent to the contractors, in reply, stating that the London County Council By-laws must be carried out. 3. Important Legal Decision on London County Council By-Laws. An important Appeal (Kershaw v. Brooke) came before the Divisional Court during 1909, by way of special case from the decision of Mr. Plowden, the Metropolitan Police Magistrate, sitting at the Marylebone Police Court, dismissing certain summonses issued (1) under the Plans By-laws, and (2) under the Drainage By-laws respectively made by the London County Council. The question for the decision ot the Divisional Court was as to who was the proper persons to be brought before the Magistrate for the infringement of these By-laws, the Borough Council concerned (Hampstead) having summoned' the responsible person actually carrying 181 out the work, and the summonses having been dismissed by the Magistrate, on the ground that they should have been issued against the persons who ordered the work to be done. The Divisional Court sustained the decision of the Metropolitan Magistrate, with the result that the hitherto invariable practice of proceeding against the responsible person who actually carries out the works is no longer open to the Metropolitan Borough Councils, but enquiries must be made as to who is the responsible person or persons for the work being done (i.e., who has given the order). The Hampstead Borough Council regarding this decision as of serious importance, communicated with the London County Council with a view to the London County Council amending its By-laws so as to validate the practice which has hitherto existed, and to make it clear, as suggested by the Lord Chief Justice in his Judgment, either by an interpretation clause, or otherwise, that a builder or contractor in control of the works shall, in addition to the existing remedy against the owner, be responsible in cases of breaches of the By-laws. The London County Council communicated with the Local Government Board as to the advisability of securing such amendment, and the Board states that it will be prepared to consider the terms of any By-law prepared to meet the decision given in the case of Kershaw v. Brooke. The Board, however, points out that it is not satisfied that it is necessary to amend the By-laws, the effect of the decision in the case of Kershaw v. Brooke and in that of Brown v. Edmonton (45 J. P. 553) being to shew that the applicability of the By-law to a particular person must be judged by the facts in each case. The London County Council, consequently, addressed a letter (dated October 20th, 1909) to the various Metropolitan and City Borough Councils, asking to be favoured with the views of those Bodies on the opinion expressed by the Local Government Board, and Lambeth Borough Council decided to take no action having regard to the views expressed' by the Local Government Board (as printed above in italics). 182 REFUSE AND MANURE DEPOTS. The 13 Public Depots, situated in Lambeth Borough, have been under constant (daily, during the summer months) supervision during 1909. Deposit of Offensive Refuse on St. John's Villa Estate, West Norwood. Complaints were received during 1909 with reference to the depositing of offensive refuse on the St. John's Villa Estate, and, in connection therewith, special inspections were carried out by the Sanitary inspector, who reported that, on April 6th and 7th, offensive black slop was deposited' by a contractor on the St. John's Villa Estate. A further depositing of black offensive slop on the same estate took place on the 14th and 15th April. The smell arising from the black slop, when first deposited, was reported by the Sanitary Inspector to be very offensive. A letter was written to the Contractor, who replied, apologising and stating that the nuisance should not occur again. Under these circumstances, no further action was taken. Removal of Offensive Matter (a) On January 5th, 1909, the Sanitary Inspector discovered horse dung that had been mixed with litter (other than straw) and other refuse (decaying vegetable matter) being removed from Canterbury Mews in such a way as to contravene the by-laws of the London County Council 2 summonses were taken out against (a) the occupier of the mews, and (b) the man removing the refuse, and these summonses were adjourned sine die pending a further offence by the defendants. Non-removal of House Refuse. (b) The occupier of the 1st floor tenement at 98 Strathleven Road (no yard being provided in connection with such 183 tenement) refused to carry his domestic (house) refuse down to the ground floor for removal by the Council with the result that there was an accumulation on a flat roof used as a yard—such accumulation being a nuisance and' injurious to health. A summons was taken out against the occupier, but was finally withdrawn, the magistrate granting the defendant a cross summons (heard the same day) against the Council for non-removal of domestic refuse, under Section 30 of the Public Health (London) Act 1891. On hearing this cross-summons, the magistrate decided to make no Order, subject to the following conditions being carried out: (a) occupier to bring refuse down to ground floor (front forecourt) twice weekly at 7.30 a.m. in a small bin (to be provided' by the owner); and (b) Council to remove the refuse from the ground floor twice weekly, Tuesdays and Fridays at 8 a.m. EFFLUVIUM NUISANCES. 1. Hospital for Animals (149 Wandsworth Road). Complaints were received' in February, 1909, as to offensive smells proceeding at times from the chimney shaft at 149 Wandsworth Road, a hospital for animals. The chimney is about 30 feet above the ground level and connected with furnaces used for heating purposes and for the destruction of carcases of animals (about 400 annually). The nearest dwelling houses are 50 feet away from the chimney shaft. A letter was written suggesting the advisability of (1) raising the chimney not less than 20 feet higher, or (2) arranging for no animals to be burnt in the furnaces in future. The later alternative was adopted by the management of the Hospital, and no further complaints have been received. 2. S. E. & C. Railway Sidings (Shakespeare Road). A complaint was received in May, 1909, drawing attention to an effluvium nuisance caused by the burning of waste 184 paper, old flow cloth and other matters on the South Eastern and Chatham Railway Siding, Shakespeare Road —the complaint being signed' by several inhabitants of the neighbourhood. A letter was sent to the contractor concerned, and the nuisance was abated in consequence. 3. Messrs. Hyde & Sons' Factory (Arches 69 and 71 Lilford Road). A memorial signed by 14 householders and ratepayers of the Borough of Lambeth was received in July, 1909, calling attention to the very serious, and objectionable, and obnoxious smell arising from the manufacture of puppy cakes or other specialities in the railway arches in the occupation of Messrs. Hyde & Co. The said arches are situated' between and at the rear of the houses known as 69 and 71 Lilford Road, and the nuisance was stated to cause nausea, depression of spirits and other general lowering of the conditions of health of the memorialists and other inhabitants, within a considerable radius of the premises, where the aforesaid' trade is carried on. The arches (three in number) are situated in a triangular portion of ground bounded by Lilford Road and1 Flaxman Road and Red'an Terrace, and are surrounded on all sides by houses in close proximity, and the difficulties of properly ventilating arches is well known, even when such arches are not closely surrounded by houses. The business methods consist of the making of puppy biscuits from matters which may be, more or less, offensive, and during the process of manufacture, there is no doubt but that an effluvium- nuisance may be at times caused, or the business process itself may be an offensive trade under Section 19 of the Public Health (London) Act, 1891. Section 19 of the Public Health (London) Act, 1891, deals with the establishing anew of offensive trades, and', as the 185 London County Council is the Sanctioning Authority, a letter was sent to them, and a reply obtained' to the following effect: (1) that the manufacturing process carried cut at Lilford Road arches was an offensive trade under 'Section 19 of the Public Health (London) Act, 1891, viz. : the trade of a fat melter or fat extractor, as defined in the Order made by the Metropolitan Board of Works on 12th April, 1878; and (2) that action should be taken against the occupiers by the Borough Council lor the establishing anew of such an offensive trade, without the sanction or consent (in writing) of the London County Council. Counsel's opinion was taken by the Borough Council, as to the authority to take proceedings under section 19 of the Public Health (London) Act, 1891, and' his opinion coincided with the opinion expressed by the London County Council. A letter was, consequently, sent to Messrs. Hyde & Sons, drawing their attention to the matter, and pointing out that the Borough Council would take action unless the offensive trade were forthwith discontinued.* In connection with the memorial which was received, action, if taken, would have to be taken under Section 21 of the Public Health (London) Act, 1891, the memorial being signed by more than ten inhabitants. 4. Private Houses (3, 5 and 7 Hercules Road). Complaints were received in September, 1909, irom the occupiers of 3, 5 and 7 Hercules Road, with reference to an alleged' serious effluvium nuisance connected with their premises. The drains ol the houses were tested, but no result was obtained from such tests. On further inspection, the nuisance was traced to No. 5 Hercules Road, where it * Messrs. Hyde and Sons promised by letter (dated Feb. 25th) 19)0) to remove the offensive trade (fat melting or fat extracting), into the country. No further action was, consequently, taken by the Council, under Section 19 of the Public Health (London) Act, 1891. 186 was discovered that, in a cupboard underneath the staircase, a number of boxes containing cheescs (known as "Mayence"--a German delicacy) were stored. These cheeses were stored at No. 5 Hercules Road for the occupier of a shop in the immediate neighbourhood, and on examination, it was found that they could not be condemned as unfit for food, having regard' to the fact that this particular brand of cheese is much sought after by Germans and others, by whom it is considered to be a great delicacy. The owner of the cheeses was communicated' with, and they were removed, with the result that no further complaints were received. 5. South London Electric Supply Corporation, Ltd. (Bengeworth Road). Complaints were received during September, 1909, with reference to an alleged nuisance due to the issuing of fine particles of coke, coal-dust and smoke from the chimney shaft of the Generating Station of the 'South London Electric Supply Corporation, Ltd. (Bengeworth Road), affecting the surrounding houses. A letter was sent to the manager with the result that the nuisance ceased. The nuisance complained of was probably due to the careless use ot fine coal, containing a quantity of dust, which, when put upon the fires, is carried by the strong drafts out into the open air, through the chimney flues, in a burnt or half-burnt condition. 6. Messrs. Hayes & Sons' Laundry Co. (129a Cold- harbour Lank). In connection with nuisance No. 5 (see above), observations were kept during 1909 (September to December) upon the chimney of the laundry belonging to Messrs. Hayes & Sons, Ltd., situated at 129a Coldharbour Lane, in close proximity to the premises of the South London Electric 187 Supply Corporation, Ltd., with the result that a nuisance was discovered. A cautionary letter was sent to the proprietors, with the result that an apology was received and arrangements were made for more careful stoking, and' the provision of a jet of steam in the chimney stack. The furnaces are provided with smoke prevention appliances. (Vide also Smoke Abatement pp. 153-155.) REMOVAL OF SNOW. During 1909, the question was raised as to the danger to health from the practice of removing snow by the usage of salt, and the Town Clerk made a systematic enquiry, on the instruction of the Council, into the various systems that prevailed in different English Corporations and in certain Continental cities for the removal of snow by methods other than the usage of salt. The replies received varied' considerably, and the practice was condemned, from the point of view of public health, by but few Medical Officers of Corporations and other Sanitary Authorities. The clearing away of snow by means of the formation of a mixture of salt and snow, which may reach several degrees below zero in the public roads may be, undoubtedly, a decided' danger to health, remembering the ill-shod condition of the workpeople (men, women and' children) who are compelled to walk through such mixture, and, afterwards, to stand' in their boots all day. If the resultant slush can be removed forthwith, by means of hosing or squeegeeing the mixture into the sewers, the danger and inconvenience to passengers (human and animal) will be considerably lessened. Everything depends upon the quickness with which the whole process is effected—the thawing of the snow by means of salt, and its subsequent removal from the road. The Council took no action in the matter as the result of the Town Clerk's enquiries. 188 CONFERENCE ON THE MEAT SUPPLY. A Conference (convened by the Greenwich Borough Council) of Metropolitan Borough Councils to consider the meat supply of the kingdom, and the present restrictions of the importation of live cattle for slaughter, was held' at Caxton Hall, on Tuesday, October 12th, 1909, and a large number (34) of delegates were present. Lambeth was not represented. It was decided to send copies of the subjoined resolutions to all Members of Parliament representing Metropolitan Constituencies, to the Corporation of the City of London, the County Council and to the Corporations of Birmingham, Liverpool, Manchester and Glasgow, and' to the City Corporations and Municipalities with a population exceeding 100,000, and to the Association of Municipal Corporations :— 1. The Conference, after carefully considering the Information at its disposal, and bearing in mind the conclusions arrived at by the Departmental Committee appointed to enquire into combinations in the meat trade, and also the serious rise which has taken place in the price of beef in the past two years, is of opinion that the meat supply of the Metropolis is in an extremely unsatisfactory position. 2. This Conference is further of opinion that owing to the failure of the home supply to increase in proportion to the national demand, the decrease in numbers of live cattle imported and the increased necessity of depending upon supplies of chilled and frozen meat, it is easier for the trade to be effectually controlled by large and powerful Trusts or Combinations of Companies. 3. This Conference is further of opinion that time has arrived when the needs of large Urban Communities, which have to rely to a great extent upon imported meat, call for a relaxation of the present restrictions upon the importation of foreign cattle for immediate slaughter in 189 order that channels, other than those now available, may be opened up in supplying this country with meat. 4. That the Prime Minister be asked to receive a deputation on the subject, in order that the Conference may place its views before the Government. The Prime Minister was unable to receive the Deputation, and it was decided to call together again the Conference early in 1910.* FOOD SOLD BY COSTERMONGERS. During 1909, a letter (dated June 28th) was received from the London County Council, stating that, whilst section 8 of the London County Council (General Powers) Act, 1908, regulates the sanitary condition oT premises on which food is sold or prepared' for sale, and premises (such as yards, stables, and arches) where is stored food to be sold by costermongers on barrows, it does not apply to vehicles on which food' is exposed for sale. A large amount of food stuff is sold in such a manner from barrows and stalls, which should, consequently, be under supervision and' control, and the Lambeth Council resolved to ask the London County Council to seek, and obtain, legislative powers for Sanitary Authorities, so as to ensure the observance of proper Sanitary Regulations in regard' to articles of food exposed, or deposited, for sale in the streets and other places, to which the provisions of Section 8 of the London County Council (General Powers) Act of 1908 do not apply. * The Conference met, and decided to again approach the Prime Minister with a view to the Deputation being received. The London Borough Councils were asked to join the Deputation (if received). 190 BACTERIOLOGICAL LABORATORY. The Bacteriological Laboratory has proved of great service during 1909—a total of 781 examinations having been carried' out. The local and central position of the Laboratory is specially advantageous, enabling the results of examinations to be quickly obtained at a minimum cost. The Laboratory was originally fitted up by the late Vestry in 1899, and since then (up to the end 1909) *7929 examinations have been made, viz.:—Tuberculosis 1907, Typhoid Fever 742, Diphtheria 5160 and Others 120. The total 781 bacteriological examinations carried' out during 1909 deal with 186 sputa (suspected consumption), 32 bloods (suspected typhoid fever), 551 throat and nose membranes and discharges (suspected diphtheria) and 12 other materials, e.g., milk 6, hairs 4, urine 1 cerebrospinal fluid 1. Details are as follow : Tuberculosis :— 186 samples of sputa from doubtful tuberculosis cases have been examined, and in 71 (i.e., 38.2 per cent.) tubercle bacilli have been found, in 2 cases mixed with pus cells, in 1 with blood cells, in 1 with elastic tissue, and in 1 with elastic tissue and pus, respectively. In 115 cases (i.e., 61.8 per cent.), no tubercle bacilli were found, but in 2 instances the pneumococcus (Friedlanderi), in 2 blood in 5 pus, and in 4 elastic tissue and pus were found. Consumption (with tuberculous expectorations) was made voluntarily notifiable throughout the Borough on (and after) June 1st, 1902. By means of bacteriological examinations, greater exactitude in diagnosis is secured. *1899—389; 1900—703; 1901—479; 1902-466; 1903—525; 1904—447; 1905 — 1874; 1906—761; 1907—786; 1908—710; 1909—781. Total— 7929. 191 Typhoid Fever— 32 samples of blood from suspected Typhoid cases have been examined, and in 11 (i.e., 34.4 per cent.) the characteristic Widal reaction was obtained, although in all cases but slightly marked. In 21 cases (i.e., 65.6 per cent.) no reaction was obtained. A high dilution of blood-serum is used (1-60 to 1-100). Diphtheria— 551 samples of throat and nose membranes and secretions from doubtful diphtheria cases have been examined, and in 20 (i.e., 3.6 per cent.), the true (Klebs-Lœffler) bacilli have been obtained. Of these 20 cases, 10 (i.e., 50 per cent.) showed the Klebs-Loeffler bacilli in pure cultivation—i.e., without admixture with other bacilli, whereas in the remaining 10 (i.e., 50 per cent.) the Klebs-Lueffler bacilli were found combined with staphylococci (6), pseudo bacilli (3), and staphylococci and' streptococci (1). In 531 (i.e., 96.4 per cent.) of the total number of throat and nose samples examined, the Klebs-Lueffler bacilli were not isolated, but other bacilli were found, e.g., staplylococci, streptococci, torulœ micrococci, sarcinuœ, ana pseudo (Hoffmann) bacilli. The last-named was found in pure cultivation in 14 instances, mixed with staphylococci in 17, with streptococci in 3, with staphylococci and streptococci in 2, and' with staphylococci and sarcinœ in 1. Other Examinations— 12 samples of other materials were examined, viz.: milk 6, hairs (tinea tonsurans) 4, cerebro-spinal fluid, 1, and urine (pus) 1. The samples of milk were sterilised and proved to be so, by failing to show any lactic acid or butryic acid' fermentation after exposure to a temperature of 37 degrees C. for lengthened periods. 192 No meningococci were found in the sample of cerebrospinal fluid. The sample of urine showed the presence of pus. Antitoxin. The Borough Council has distributed during 1909, free of cost to medical practitioners practising in Lambeth Borough, 59 vials of antitoxin. 1909. Sputa— Tub. Bac. found. *Bloods— Typhoid reaction obtained. Throat and Nose Membranes and Discharges— Klebs, Lceffler Bac. found. Yes. No. Total. Yes. No. Total. Yes. No. Total. January 6 11 17 ... ... ... 1 28 29 February 3 9 12 ... ... ... ... 38 38 March 9 15 24 1 3 4 ... 27 27 Afril 7 8 15 ... 3 3 ... 28 28 May 10 15 25 ... ... 3 42 45 June 9 7 16 ... 2 2 2 104 106 July 5 9 14 1 ... 1 1 28 29 August 1 3 4 2 4 6 3 20 23 September 2 10 12 3 2 5 3 94 97 October 6 9 15 1 3 4 3 39 42 November 7 9 16 2 4 6 ... 41 41 December 6 10 16 1 ... 1 4 42 46 TOTALS 71 115 186 11 21 32 20 531 551 *In 11 samples (i.e., 34.4 per cent.) ot Typhoid Fever blood, in connection with which there was a reaction, the reaction was slightly (or feebly) marked. N.B;- 12 other samples were also examined during 1909, viz.:—Hairs, 4 Urine 1, Milks 6, Cerebrospinal fluid 1, 193 MORTUARIES AND CORONERS' COURTS The total number of bodies received at the two Borough Mortuaries (High 'Street and Wanless Road) during 1909 was 369, as compared with 382 during 1908, and an annual average for the old Parish of Lambeth for 5 years (18961900) of 450. Of the 369 bodies, 260 were received' at High Street and 109 at Wanless Road. 34 bodies were brought in by the Police (22 to High Street and 12 to Wanless Road), and the rest by undertakers or private persons. The Coroners' Court sat 44 times at Wanless Road, 109 times at High Street. During 1909 two infectious bodies (diphtheria, 1 male and 1 female) were received at Wanless Road Mortuary. For comparison, details are given in tabular form of the work carried out by the late Vestry of Lambeth m connection with the Wanless Road and High Street Mortuaries during 5 years (1896-1900). Taking the average, it will be seen that the total number of bodies received during 1909 in connection with the new Borough is 81 less than this yearly average (450). The number of post-mortems conducted for the Borough during 1909 is 226, as compared with 208 during 1908, and with 253, 281 , 275, 285, and 267 respectively during 5 years (1896-1900) for the old Parish, i.e., 17.1 per cent, less tuan the yearly average (272.5) during the same quinquennium. Of the post-mortems, 62 took place at Wanless Road1, and 164 at High Street. The London County Council now pay a rent of £100. instead of £80, per annum for the use of the High Street Coroners' Court, such increased rental to cover the new decorations, heating and ventilation of the Court itself, and the New Waiting Room. The Mortuary for Norwood has not yet been provided, but it has been arranged for such a mortuary to be built in a small part of the freehold site in Rommany Road, which is being developed by the Council for a Dust Depot. 194 Numbers of bodies received at the Lambeth Borough Mortuaries during 1909 and at the Lambeth Parish Mortuaries during 5 years (1896-1900). 1909. January. February. March. April. May. June. July. August. September. October. November. December. Total. Yearly Average forl8961900./###] 1909 1900 1899 1898 1897 1896 High Street Males 16 12 17 16 14 11 9 10 9 12 10 9 145 237 239 222 218 221 227.4 Females 18 18 18 7 5 6 3 3 11 9 8 9 115 142 126 143 109 152 134.4 Wanless Rd. Males 6 6 5 5 7 3 1 3 4 5 10 7 62 58 71 72 41 — 60.5 Females 11 6 4 3 4 4 — 2 2 1 5 5 47 62 47 58 32 .- 49.75 Totals 51 42 44 31 30 24 13 18 26 27 33 30 369 499 483 495 400 373 450 N B The new Wanless Road Mortuary Was opened on Apr il 12th. 1907, and is under the superintendence of Mr. Joshua Fazey—High Street Mortuary being under Mr. S. G. Albin. Mr. Pierce is the Deputy Mortuary Keeper. 195 Ages of bodies received at the Lambeth Borough Mortuaries, 1909, and at the Lambeth Parish Mortuaries dining 5 years (1896-1900). Registered Ages of Bodies. 1909. Boro Parish. Yearly Average for 1896-1900. High Street. Wanless Road. Total 1909. 1900 1899. Total. 1898. 1897. 1896. 0—1 49 30 79 133 121 160 101 121 127.2 1—5 27 6 33 47 44 50 39 22 40.4 5-10 10 1 11 12 22 17 9 12 14.4 10—20 10 5 15 17 13 8 18 9 13.0 20—30 16 5 21 31 29 26 26 24 27.2 30—40 21 10 31 43 50 45 35 35 43.3 40—50 41 11 52 80 67 64 48 37 59.2 50—60 31 14 45 61 53 42 59 46 52.2 60—70 23 17 40 50 47 39 30 35 40.2 70—80 20 7 27 16 19 32 22 22 21.8 80—90 11 3 14 6 8 5 9 7 7.0 90 upwards — — — — 1 1 — 3 1.0 Age not stated 1 - 1 3 - 6 6 - 3.0 Totals 260 190 369 499 483 495 400 373 450 196 Particulars as to cases of D> owning, Accidental Death and Suicide that have occurred in the Borough of Lambeth during 1909, and in the old Parish during 5 years (1896-1900). High Street. Wanless Road. Boro' Parish of Lam cth. Average 5 years 18961900. Total 1909. Total 1900. Total 1899. Total 1898. Total 1897. Total 1896. M. F. Total. M. F. Total. Suicides 13 5 18 7 4 11 29 14 13 21 6 13 13.4 Drowning 9 4 13 ... ... ... 13 6 1 1 13 16 7.4 Poisoning ... ... ... 1 2 3 3 3 4 3 4 4 3.6 Hanging 1 ... 1 2 1 3 3 4 3 9 ... 2 3.6 Throat cutting 2 ... 2 1 1 2 4 3 4 5 1 2 3.0 Jumping off heights and in front of trains ... ... ... 2 ... 2 2 1 ... ... ... 2 0.6 Shooting 1 1 2 1 ... 1 3 2 1 4 1 3 2.2 Railway Accidents 3 ... 3 ... ... ... 3 4 4 1 1 3 2.6 Accidental Death (sudden) ... ... ... 6 1 7 7 6 1 12 ... ... 3.8 Street Accidents (run over) 3 3 6 1 ... 1 7 3 9 7 4 3 5.2 Murder ... ... ... ... 1 1 1 1 2 ... 2 2 1.4 Burning 1 1 2 1 1 2 4 1 2 3 1 ... 1.4 Falling ... ... ... 5 11 16 16 1 1 4 4 ... 2.6 Bicycle Accidents ... ... ... ... ... ... ... 2 ... 1 ... ... 0.6 Suffocation (false teeth) ... ... ... 1 2 3 3 ... ... ... ... ... ... Found Dead ... 2 2 ... ... ... 2 ... ... ... ... ... ... Bursting Blood Vessel ... ... ... ... ... ... ... ... ... ... ... ... ... Killed ... ... ... ... ... ... ... ... ... ... ... ... ... Manslaughter ... ... ... ... ... ... ... ... ... ... ... ... ... Fits ... ... ... ... ... ... ... ... ... ... ... ... ... Under Chloroform ... ... ... ... ... ... ... ... ... ... ... ... ... N.B.—Two bodies (diptlitheria, 1 male and 1 female) were admitted during 1909 into the special room provided for infectious bodies at Wanless Road. 197 INQUESTS. During the year 1909, within the Borough of Lambeth, 357 Lambeth cases were submitted to the Coroner (who, in 30 instances, decided that no further inquiries were necessary, the deaths being due to natural causes). In the remaining 327 cases inquests were held with the following results: — I. Natural Causes ... 187 II. Accidental Causes ... 114 Burns and Scalds 19 Drowning 5 Run over 18 Falls, etc. 26 Suffocation 8 Fracture 7 Misadventure 13 Crushed 4 Blood Poisoning 3 Ptomaine Poisoning 1 Alcoholic Poisoning 2 Improper Feeding 5 Want of Attention at Birth 3 III. Homicidal Causes ... 26 Suicide 25 Murder 1 Manslaughter — — IV. Open Verdicts ... — Found Drowned — Total ... 327 198 CLERICAL STAFF. The permanent Clerical Staff consists of 4 Clerks—1 first class (W. R. Lawrence), 2 seconed class (Messrs. A. 1.. Baxter and W. J. Lawrence), and 1 boy clerk (Albert E. Ruel), but an extra temporary boy clerk (VV. E. Croley) has been employed during the year 1909 on account of the increased clerical work thrown upon the Department in connection with the new Offices at the New Town Hall (Public Health Department), the Notification of Births Act, the Public Health (Tuberculosis) Regulations and the duties of the Health Visitor. The Clerical work in connection with the Department during 1909, is again given in the form of a Statement, showing certain items of work done in the Borough during 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908 and 1909, as compared with the yearly average for the old Parish of Lambeth during 5 years (1896-1900). 1909. 1908. 1907. 1906. 1905. 1904-3. 1902-1. Average 5 years (18961900). Parish. Borough. Letters, etc., received (entered in letter book) 10169 9731 9616 8875 8540 15284 18177 8611.4 Letters, etc-, sent out (entered in postal book) 20732 21896 17427 16411 15830 30982 41212 26096.6 Notices served— Infectious Diseases 1577 1829 1922 1900 1594 3017 4278 2290.2 Public Health Acts (Preliminary) 7158 8047 8243 8193 7446 14872 16324 7812.0 199  1909. 1908. 1907. 1906. 1905. 1904-3. 1902-1 Average . 5 years (18961900). Parish. Borough. Public Health Acts (Statutory) 3772 4142 4485 4490 3990 6895 7895 2015.0 Metropolis Management Acts 25 13 15 11 23 37 41 20.0 Housing of the Working Classes Acts — — — — 2 9 27 43 6 Letters typed 4682 4576 3928 4357 5271 9965 10683 546.0 Complaints entered in Complaint book 6564 6641 6545 7540 6650 12819 9799 5474.0 APPENDIX. 2 Local Government Board. Table i. VITAL STATISTICS OF LAMBETH BOROUGH DURING 1900, AND OF LAMBETH PARISH DURING 10 YEARS (1891-1900). Year 1 Population estimated to middle of each Year. 2 Total Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. 9 Deaths of Nonresidents registered in Public Institutions in the District. 10 Deaths of Residents registered in Public Institutions beyond the District. 11 Nett Deaths at all Ages belonging to the District. Number. 3 Rate.' 4 Under 1 Year of Age. At all Ages. Number. 12 Rate.* 13 Number. 5 Rate per iooo Births registered. 6 Number. 7 Rate.* 8 Parish. 1891 276162 9097 32.9 1433 157.2 6073 21.9 1438 539 351 5886 21.3 1892 280032 9226 32.9 ]303 141.2 5794 20.7 1578 651 314 5457 19.5 1893 283956 9222 32.5 1415 148.5 6165 21.7 1741 811 338 5219 18.4 1894 287935 9231 32.1 1264 136.9 5213 18.1 1484 775 399 4837 16.8 1895 291970 9341 31.9 1470 157.4 5857 20.6 1511 702 404 5559 19.0 1896 296061 9592 32.4 1371 142.9 5370 18.1 1588 705 433 5098 17.2 1897 300048 9388 31.3 1459 155.4 5486 18.3 1546 664 429 5251 17.5 1898 304073 9256 30.4 1447 156.3 5567 18.3 1543 592 455 5430 17.9 1899 308108 9433 30.6 1527 161.9 6064 19.7 1680 663 485 5886 19.1 1900 312152 9167 29.4 1350 147.3 5578 17.9 1576 606 458 5430 17.4 Averages for years 1891-1900 294049.7 9295.3 31.6 1403.9 151.03 5716.7 19.4 1563.5 670.8 4066 5405*3 18.4 Boro' 1909 324188 8445 26.4 901 106.7 4876 15.04 1994 826 490 4540 14.0 *Rates in Columns 4, 8 and 13 are calculated per 1000 of estimated population. Note.—The deaths included in column 7 of this table are the whole of those registered during the year as having actually occurred within the Borough of Lambeth. The deaths included in column 12 are the numbers in column 7, corrected by the subtraction of ihe numbers n column 10 and the addition of the numbers in column 11. By the term "Non-Residents" is meant persons brought into the District on account of sickness or infirmity, and dying in public institutions there; and by the term "Residents" is meant persons who have been taken out of the Ditrict on account of sickness or infirmity, and have died in public institutions elsewhere. The "Public Institutions "(taken into ac ount for the purpose of these tables) are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses and lunatic asylums. A list of the institutions in respect of th deaths in which corrections have been made, will be found on pp. 15-17, 98-101 of the Report. The Union Workhcus s are situated within the District. Area of Lambetb Borough in acres Total population at all ages 301895 (exclusive of area covered by water)6 Statute Acres. Number of inhabited houses 41511 At Census of 1901. Average number of persons per house 73 3 Local Government Board. Table ii. VITAL STATISTICS OF REGISTRATION SUB-DISTRICTS (OLD AND NEW) OF LAMBETH BOROUGH DURING 1909, AND OF LAMBETH PARISH DURING 10 YEARS (1891-1900). Names of Old Sub-Districts. 1.—WaterLoo. 2.—Lambeth Church 1st. 3.—Lambeth Church 2nd. (including Workhouse) Year Population estimated to middle of each year. Births registered. Deaths at all Ages (corrected) Deaths under 1 year (uncorrected). Population esrimated to middle of each year. Births registered. Deaths at all Ages (corrected). Deaths under 1 year (uncorrected). Population estimated to middle of each year. Births registered. Deaths at all Ages (corrected). Deaths under 1 year (uncorrected). Pansh. a b c d a b c d a b c d 1891 28657 1431 866 230 18110 605 41)8 158 39191 1630 987 299 1892 28601 1473 687 179 18249 610 432 160 39571 1639 907 259 1893 28545 1521 688 222 18388 610 4J8 165 39951 163-2 858 272 1894 284^9 1505 691 203 18522 624 384 139 40331 1553 789 266 1895 28433 1516 755 212 18666 618 457 189 40711 1629 995 284 1896 28377 1445 642 201 18805 649 364 169 41091 1687 930 262 1897 28333 1397 683 203 18917 597 442 188 41476 1595 934 301 1898 28282 1381 715 193 19090 581 438 175 41864 1613 853 265 1899 28232 1398 733 189 19234 627 436 151 42252 1517 1048 315 1900 28183 1348 678 202 19377 582 423 153 42642 1543 840 266 Averages 1 of Years 1891-1900. 28413.2 1441.5 713.8 203.4 18739.3 610.3 4292 164.7 40908.0 1603.8 914.1 278 9 Horough 1909 Nambs of New Sub-Districts. 25921 1484 437 156 26541 721 495 144 55061 1501 1981 1202 1.—Waterloo. 2. - Lambeth Church. 3.—Kennington including Workhouse. 4 Table ii.—continued. Names of Old Sub-Districts. 4.—Kennington 1st. 5.—Kennington 2nd. 6. Brixton. 7.—Norwood. Year. Population estimated to middle of each year. Hirths registered. Deaths at all Ages (corrected). Deaths under 1 year (uncorrected). Population estimated to middle of each year. Births registered. Deaths at all Ages (corrected). Deaths under 1 year (uncorrected). Population estimated to middle of each year. Births registered. Deaths at all Ages (corrected). Deaths under 1 year (uncorrected). Population estimated to middle of each year. Births registered. Deaths at all Ages (corrected). Deaths under 1 year (uncorrected). -c . m a. a b c a a b c d a b c d a b c d 1891 c.0681 1722 1092 252 40065 1609 802 136 73707 2014 1335 291 25751 626 336 67 1892 51002 1733 1008 226 40695 1058 756 123 75431 2051 1305 287 26483 662 362 69 1893 51241 1759 953 270 41004 1059 719 127 77812 2002 1182 281 27015 639 371 73 1894 51721 1802 871 212 41713 1053 672 107 79507 2037 1050 258 27647 657 380 79 1895 52201 1736 969 263 42222 1099 742 169 81267 2093 1259 276 28470 650 382 77 1896 52581 1886 902 232 43429 1125 747 157 82267 2139 1174 281 29511 6«2 339 69 1897 52971 1859 952 249 44136 1110 721 132 83946 2131 1135 286 30239 699 384 100 1898 53361 1888 989 259 44852 1009 727 141 85647 2143 1274 334 30977 641 434 80 1899 53753 1871 1086 309 45570 1089 812 154 87350 2179 1342 296 31717 752 429 113 1900 54146 1856 1018 233 46289 990 732 123 89057 2112 1283 279 32458 736 456 94 Averages of Years 1891 I to 1900 533658 1811'2 9840 250-5 42997 5 10661 743-0 136-9 815991 20901 1233 9 287-4 29026 8 672-4 387 3 821 Boro', 1909 Names of New Sub Districts. ^ ... 67779 1939 893 137 82337 1601 1033 164 66549 1199 701 98 4.—Stock weli.. 5—Brixton. 6.—Norwood. Notes.—(a) Deaths of residents occurring in public institutions beyond the district are included in sub columns (c) of the table, and those of the non-residents iegistered in public institutions in the district are excluded. (See note on Table i. as to meaning of terms "resident "and "non-residents.") (b) Deaths of residents occurring in public institutions, whether within or without the district, are allotted to the respective localities according to the addresses of the deceastd. (c) Deaths under I year are not corrected, and the gross total of sub columns d agrees with the total of column 5 in Table 5 Local Government Board. Table iii. CASES OF INFECTIOUS DISEASE NOTIFIED WITHIN THE BOROUGH OF LAMBETH DURING THE YEAR 1909. notifiable diseases. cases notified in whole district. total cases notified in each new locality. no. of cases removed to hospital from each new locality. At all Ages. At Ages—Years. Waterloo. Lambeth Church. Kennington. Stockwell. Brixton. Norwood. Waterloo. Lambetn Church. Kennington. Stockwell. Brixton. Norwood. Under 1 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 373 11 156 168 26 12 ... 30 30 79 68 97 69 30 30 74 67 88 57 Membranous Croup 3 ... 2 1 ... ... ... ... 2 ... ... 1 ... ... 1 ... ... 1 Erysipelas 189 8 10 21 16 112 22 21 28 43 41 34 22 9 13 17 12 6 4 Scarlet Fever 1164 15 319 099 75 56 ... 58 162 248 251 276 169 56 160 245 232 250 145 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 49 ... ... 10 16 23 ... 5 5 9 11 7 12 4 5 8 9 5 9 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever 1 ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... Puerperal Fever 16 ... ... ... 1 15 ... ... ... 3 5 3 5 ... ... 2 3 ... 2 Cerebro-Spinal Meningitis 14 6 8 ... ... ... ... 3 2 3 2 1 3 2 2 2 1 ... 3 Totals 1808 40 495 899 134 219 22 117 227 387 378 419 281 101 210 349 324 349 221 Note.— (a) The localities adopted for this table are the same as those in Tables ii. and iv. (b) Patients are removed to the Isolation Hospitals of the Metropolit n Asylums Board, one of wh ch is situated in Brixton Regis'ra'ior. Sub-district. 6 7 Local Government Board Table iv. CAUSES OF, AND AGES AT, DEATH (CORRECTED) DURING THE YEAR 1909. Name of District—BOROUGH OF LAMBETH. CAUSES OF DEATH. DEATH IN OR BELONGING TO WHOLE DISTRICT AT SUBKOINED AGES. DEATH IN OR BELONGING TO REGISTRATION SUB-DISTRICT (AT ALL AGES). TOTAL DEATHS IN PUBLIC INSTITUTIONS IN DISTRICT (UNCORRECTED.) All ages. Under 1 year. 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards. Waterloo. Lambeth Church. Kennington. Stock well. Brixton. Norwood District not stated. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Small-pox — — — — — — — — — — — — — — — Measles 104 21 79 4 — — — 23 22 27 14 14 3 1 9 Scarlet Fever 27 1 12 12 1 1 — 2 5 2 9 7 2 — 36 Whooping Cough 85 44 38 3 — — — 8 10 24 8 23 9 3 9 Diphtheria and Membranous Croup 58 4 34 19 1 — — 4 7 8 9 19 11 — 79 Croup 1 — 1 — — — — — — — — — 1 — — Fever Typhus — — — — — — — — — — — — — — — Enteric 9 — — — 3 6 — — 1 3 3 1 1 — 14 Other cont. 1 — — — — 1 — — — — 1 — — — Epidemic Influenza 66 3 1 2 3 24 33 3 3 5 17 20 18 — 5 Cholera Nostras — — — — — — — — — — — — — — — Diarrhœa 118 99 13 — — 5 1 21 20 29 18 20 10 — 36 Enteritis 57 13 7 9 2 22 4 3 7 10 11 9 12 5 — Puerperal Fever 8 — — — 1 7 — — — 2 1 1 4 — 4 Erysipelas 11 2 — — — 7 2 — 1 3 4 1 2 — 13 Other Septic diseases 10 1 2 3 — 3 1 4 — 1 4 — — 1 — Phthisis 428 2 7 9 56 323 31 50 51 82 106 77 50 12 183 Other Tubercular diseases 139 39 43 22 5 26 4 13 23 31 25 26 20 1 — Cancer, Malignant disease 377 1 2 1 3 206 164 17 37 54 84 87 87 11 — Bronchitis 464 48 19 — 2 124 271 68 37 92 90 102 62 13 286 Pneumonia 198 18 21 2 8 95 54 25 31 27 36 46 24 9 Pleurisy 7 2 — — 1 2 2 1 2 2 — 1 1 — — Other diseases of Respiratory Organs 325 84 62 8 4 88 79 32 45 65 66 66 41 10 — Alcoholism 12 — — — — 12 — 2 2 — 1 4 3 — — Cirrhosis of Liver 49 — — — — 40 9 6 9 6 7 15 6 — — Venereal diseases 42 28 4 — — 9 1 9 5 9 2 9 3 5 — Premature Birth 131 101 — — — — — 17 12 21 30 30 21 — — Diseases and Accidents of partruition 21 — — — 1 20 — — 1 5 7 5 3 — — Heart diseases 360 2 4 13 16 156 169 29 34 66 55 97 63 16 189 Accidents 108 15 10 9 3 48 21 12 11 22 17 25 17 2 — Suicides 24 — — — 2 19 3 6 1 2 5 5 4 1 81 All other causes 1302 302 64 29 39 423 478 82 118 181 224 260 208 51 1053 All causes 4543 830 423 145 151 1667 1327 437 495 840 893 1033 701 141 1994 8 9 Local Government Board. TABLE V. BOROUGH OF LAMBETH. INFANTILE MORTALITY (CORRECTED) DURING THE YEAR, 1909. Deaths from stated causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 week. 1—2 Weeks. 2-3 Weeks. 3—4 Weeks. Total under 1 month. 1—2 Months. 2—3 Months. 3—4 Months. 4—5 Months. 5—6 Months. 6-7 Months. 7—8 Months. 8-9 Months. 9 — 10 Months. 10—11 Months. 11 — 12 Months. Total Deaths under One Year. All Causes— Certified 156 32 36 26 250 85 63 64 54 33 40 53 39 27 37 35 780 Uncertified 10 2 2 1 15 9 4 5 2 5 1 1 1 3 1 3 50 Common Infectious Diseases— Chicken Pox ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Measles ... ... ... ... ... ... ... ... ... ... 1 4 3 ... 6 7 21 Scarlet Fever ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 Diphtheria: Croup ... 1 ... ... 1 1 ... 1 ... 1 ... ... ... ... ... ... 4 Whooping Cough ... ... ... ... ... ... 4 6 3 1 2 6 6 7 5 4 44 Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœal Diseases— Diarrhœa, all forms, including Cholera and Dysentery ... 1 2 3 6 7 19 15 10 8 10 8 4 6 1 5 99 Enteritis, Muco-Enteritis, Gastro-Enteritis ... ... 1 ... 1 1 1 2 3 ... 2 2 1 ... ... ... 13 Gastritis, Gastro-intestinal Catarrh, Ileo-Colitis ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... 2 Wasting Diseases— Premature Birth 102 7 5 5 119 9 1 2 ... ... ... ... ... ... ... ... 131 Congenital Defects 12 ... 1 4 17 3 1 3 1 1 ... 1 2 1 ... ... 30 Injury at Birth ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Want of Breast-Milk, Starvation ... 1 1 ... 2 ... ... ... ... ... ... ... 1 ... 1 ... 4 Atrophy, Debility, Marasmus 24 9 10 5 48 20 12 9 14 6 3 4 3 2 1 2 124 Tubercular Diseases— Tuberculous Meningitis ... ... ... ... ... 2 ... 1 1 ... 1 ... ... 2 4 1 12 Tuberculous Peritonitis: Tabes Mesenterica ... ... ... ... ... 2 ... 5 1 1 1 1 2 ... ... ... 13 Other Tuberculous Diseases ... ... ... 1 1 2 ... 2 3 ... 1 2 4 ... ... 1 16 Other Causes— Influenza ... ... 1 ... 1 ... ... ... ... ... 1 ... ... 1 ... ... 3 Erysipelas ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... ... 2 Syphilis 1 3 1 ... 5 6 7 4 1 ... ... 1 2 ... 1 1 28 Rickets ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... 2 ... 5 Meningitis (not Tuberculous) ... ... ... 1 1 ... 1 1 1 ... 2 1 ... ... 2 ... 9 Convulsions 4 3 2 ... 9 5 4 3 1 4 1 2 ... ... ... ... 29 Bronchitis 1 ... 4 2 7 8 3 4 5 1 3 5 2 5 2 3 48 Pneumonia 1 ... 1 2 4 1 1 3 3 ... 2 1 ... ... ... 3 18 Suffocation, over-lying 2 1 2 ... 5 1 ... ... ... ... ... ... ... ... ... ... 6 Pleuro-Pneumonia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Broncho-Pneumonia ... 2 1 2 5 12 6 2 2 9 3 10 4 4 12 5 74 Dentition ... ... ... ... ... ... ... ... ... ... 1 3 3 1 1 4 13 Eczema ... ... 2 ... 2 ... ... ... ... ... ... ... ... ... ... 2 Intestinal Obstruction ... 1 ... ... 1 2 1 1 ... ... ... 1 ... ... ... ... 6 Jaundice and other diseases of the liver ... ... 1 ... 1 2 ... ... ... ... ... ... ... ... ... ... 3 Accident (other than suffocation) 2 2 ... 1 5 ... 1 ... 1 ... 1 ... 1 ... ... ... 9 Atelectasis 5 1 ... ... 6 2 ... ... ... ... ... ... ... ... ... ... 8 Causes not classified above 12 2 3 1 18 8 4 4 5 5 3 2 ... 1 ... 2 52 166 34 38 27 265 94 67 69 56 38 41 54 40 30 38 38 830 10 11 LAMBETH BOROUGH.—Deaths Registered from all Causes during the Year 1909. Note.—The Deaths of Non-Residents occurring in Public Institutions situated in the District are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the District are included. Sub-Districts. Sub-Districts. Total. Waterloo. Lambeth Church. Kennington. Stockwell. Brixton. Nor wood. No Address. All Ages. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. I. Specific Febrile, or Zvmotic Diseases 39 37 40 34 46 69 47 45 63 54 27 37 3 7 265 283 548 II. Parasitic Diseases ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 1 2 III. Dietetic Diseases 3 1 1 2 ... 1 2 ... 2 2 2 2 ... ... 10 8 18 IV. Constitutional Diseases 47 35 66 50 95 87 134 94 110 114 92 87 16 9 560 47 1036 V. Developmental Diseases 18 8 10 11 24 29 44 27 30 52 21 23 4 6 151 156 307 VI. Local Diseases 110 107 114 136 201 229 224 229 262 285 156 215 52 39 1119 1240 2359 VII. Deaths from Violence 15 3 11 1 13 11 14 8 17 14 13 8 2 1 85 46 131 VIII. Deaths from Ill-defined and not specified Causes 10 4 13 6 18 16 17 7 19 9 8 10 1 1 86 53 139 397 443 483 410 503 530 319 382 78 63 2277 2263 4540 Totals 242 195 255 240 1.-Specific Febrile or Zymotic Diseases. 1.—Miasmatic Diseases. Small-pox Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Unvaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No Statement ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 10 13 12 10 9 18 9 5 9 5 1 2 ... 1 50 54 104 Whooping Cough 4 4 4 6 10 14 2 6 13 10 4 5 1 2 38 47 85 Scarlet Fever 1 1 1 4 1 1 4 5 3 1 1 ... ... 12 15 27 Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Simple Continued and Ill-defined Fever ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 Enteric or Typhoid Fever ... ... ... 1 2 1 3 ... 1 ... 1 ... ... ... 7 2 9 Diphtheria 3 1 4 3 1 6 3 6 7 12 8 3 ... ... 26 31 57 Membranous Croup ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 Influenza 1 2 2 1 1 4 10 7 10 10 5 13 ... ... 29 37 66 Other Miasmatic Diseases 2 ... ... ... ... 1 1 2 ... 1 1 ... ... ... 4 4 8 2.—Diarrhœal Diseases. Cholera Nostras ... ... ... ... ... ... ... Cholera Asiatica ... ... ... ... ... 14 9 9 10 10 4 6 62 56 ... Diarrhœa Dysentry 12 9 12 8 15 118 3.—Malarial Diseases. Remittent or Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ague ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 4.-Zoogenous Diseases. Cowpox and effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases (e.g., Hydrophobia, Glanders, Splenic Fever) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5.—Venereal Diseases. Syphilis 2 6 4 1 1 7 1 ... 5 2 2 1 2 3 17 20 37 Gonorrhœa, Stricture of Urethra 1 ... ... ... 1 ... 1 ... 2 ... ... ... ... ... 5 ... 5 6. Septic Diseases. Erysipelas ... ... 1 ... 2 1 1 3 1 ... ... 2 ... ... 5 6 11 Pyæmia, Septicæmia 3 1 ... ... 1 ... 3 1 ... 1 ... ... ... 1 7 3 10 Puerperal Fever ... ... ... ... ... 2 ... 1 ... 1 ... 4 ... ... ... 8 8 12 13 LAMBETH BOROUGH-Deaths Registered from all Causes during the Year 1909 —continued. Note-The Deaths of Non-Residents occuring in Public Institutions situated in the District are excluded, and the Deaths of Residents occuring in Public Institutions situated beyond the limits of the District are included. Sub-districts. Sub-Districts. Total. Waterloo. Lambeth Church. Kennington. Stockwell. Brixton. Norwood. No Address. All Ages. M. F. m F. M. F. M. f. M. F. M. f. M. F. M. F II Parasitic Diseases. Thrush, and other Vegetable Parasitic Diseases ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 Worms, Hydatids, and other Animal Parasitic Diseases ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 1 III.—Dietetic Diseases. Want of Breast Milk, Starvation 2 ... 1 ... ... 1 1 ... ... ... 1 ... ... ... 5 1 6 Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chronic Alcoholism 1 1 ... 2 ... ... 1 ... 2 2 1 2 ... ... 5 7 12 Delirium Tremens ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... IV.— Constitutional Diseases. Rheumatic Fever ... ... ... ... 1 2 2 1 1 5 2 1 ... ... 6 9 15 Rheumatism of the Heart ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Rheumatism ... ... ... ... ... ... ... 1 ... ... 1 2 ... ... 1 3 4 Gout ... ... ... ... 2 ... 1 ... 1 ... ... 2 ... ... 4 2 6 Rickets ... ... 1 ... 2 1 1 1 ... 3 1 ... ... 1 5 6 11 Cancer, Malignant Disease 3 14 17 20 28 26 39 45 42 45 39 48 6 5 174 203 377 Cancum Oris (Noma) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tabes Mesenterica 1 1 4 2 3 4 2 4 3 2 2 3 ... ... 15 16 31 Tubercular Meningitis, Hydrocephalus 2 2 5 2 4 3 2 5 5 5 3 2 ... ... 21 19 40 Phthisis 36 14 31 20 42 40 75 31 40 37 29 21 10 2 263 165 428 Scrofula ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other forms of Tuberculosis 3 4 6 4 10 7 9 3 8 3 7 3 ... 1 43 25 68 Purpura, Hæmorrhagic Diathesis ... ... ... ... 1 1 ... ... ... 1 ... ... ... ... 1 2 3 Anaemia, Chlorosis, Leucocythæmia ... ... 1 ... 1 ... ... 1 2 ... 4 1 ... ... 8 2 10 Glycosuria, Diabetes Mellitus 2 ... ... 1 ... 2 2 1 7 6 4 2 ... ... 15 12 27 Other Constitutional Diseases ... ... ... 1 1 1 1 1 1 7 ... 2 ... ... 3 12 15 v — Developmental Diseases. Premature Birth 12 5 5 7 13 8 22 8 14 16 12 9 ... ... 78 53 131 Atelectasis 2 ... ... ... 1 2 1 ... ... 2 ... ... ... ... 4 4 8 Congenital Malformations 1 1 4 3 2 4 5 2 4 7 2 1 ... ... 18 18 36 Old Age 3 2 1 1 8 15 16 17 12 27 7 13 4 6 51 81 132 VI.-Local Diseases. 1.—diseases of Nervous System. Inflammation of Brain or Membranes 1 3 4 ... 2 5 1 3 4 2 2 ... ... 1 14 14 28 Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis 5 4 7 13 16 11 17 27 16 30 16 22 5 3 82 110 192 Insanity, General Paralysis of the Insane ... 1 2 ... 7 1 1 3 4 4 5 ... 6 5 25 14 39 Epilepsy ... ... 1 1 1 3 2 2 1 1 3 2 2 1 10 10 20 Convulsions 4 1 1 3 2 2 5 1 5 4 2 3 ... ... 19 14 33 Laryngismus Stridulus (Spasm of Glottis) ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... 2 2 Disease of Spinal Cord, Paraplegia, Paralysis Agitans 1 2 2 3 ... 2 1 6 3 3 4 1 ... 18 10 28 Other Diseases of Nervous System 1 2 ... 2 3 1 3 6 9 2 3 2 1 ... 20 15 35 2. Diseases of Organs of Special Sense. (e.g., of Ear, Eye, Nose) 1 ... 1 1 ... 1 1 1 4 1 ... 2 ... ... 7 6 13 14 15 LAMBETH BOROUGH-Deaths Registered from all Causes during the year 1909-continued. Note.—The Deaths of Non-Residents occurring in Public Institutions situated in the District are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the District are included. Sub-Districts. Sub-Districts. Total. Waterloo. Lambeth Church. Kennington. Stock- well. Brixton. Norwood. No Address. All Ages. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 3.-Diseases of Circulatory System. Pericarditis 1 ... ... ... ... ... ... 1 1 ... ... ... ... ... 1 1 2 Acute Endocarditis 2 1 1 ... 2 3 ... 1 1 1 ... 3 2 ... 8 9 17 Valvular Diseases of Heart 3 9 6 10 17 20 12 14 18 25 13 16 2 5 71 104 175 Other Diseases of Heart 4 9 7 10 7 17 8 14 18 34 12 19 1 6 57 109 166 Aneurism ... ... ... ... ... 1 ... 1 4 1 1 ... ... 1 5 4 9 Embolism, Thrombosis ... ... 1 1 1 3 4 3 2 3 ... 4 2 ... 10 14 24 Other Diseases of Blood Vessels 3 2 4 4 15 7 13 6 14 9 5 8 2 2 56 38 94 4.—Diseases of Respiratory System. Laryngitis ... ... ... ... ... 1 1 1 1 1 1 ... ... ... 3 3 6 Croup ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 1 Emphysema, Asthma ... ... 2 ... 4 ... 5 2 3 4 2 2 ... ... 16 8 24 Bronchitis 33 35 14 23 31 61 38 52 36 66 25 37 10 3 187 277 464 Pneumonia 13 12 17 14 13 14 22 14 31 15 6 18 6 3 108 90 198 Pleurisy ... 1 2 ... 2 ... ... ... 1 ... ... 1 ... ... 5 2 7 Bronchopneumonia 13 6 14 19 17 24 11 11 22 17 4 13 4 2 85 92 177 Pleuropneumonia 9 2 2 2 6 5 13 5 5 4 2 4 2 ... 39 22 61 Other Diseases of Respiratory System 1 1 5 1 7 1 11 6 5 4 7 6 1 1 37 20 57 5.—Diseases of Digestive System. Dentition 1 1 ... ... 1 5 2 4 2 2 1 ... ... ... 7 12 19 Sore Throat, Quinsy 1 ... ... ... 1 ... ... 2 1 ... ... ... ... ... 3 2 5 Diseases of Stomach 1 1 2 2 4 2 6 3 6 3 4 3 ... ... 23 14 37 Enteritis 1 2 4 3 5 5 6 5 6 3 7 5 3 2 32 25 57 Obstructive Diseases of Intestine 2 ... 2 1 5 3 5 2 6 3 2 4 ... ... 22 13 35 Peritonitis ... ... ... ... ... ... ... 3 1 2 ... 2 ... 1 1 9 10 Ascites ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver 1 5 3 6 4 2 5 2 4 11 4 2 ... ... 21 28 49 Jaundice and other Diseases of Liver 1 3 3 1 1 4 1 3 1 4 1 2 ... ... 8 17 25 Diseases of the Pancreas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Digestive system ... ... 1 ... 1 2 4 ... 3 1 ... ... ... ... 9 3 12 6.-Diseases of Lymphatic System. (e.g., of Lymphatics and of Spleen) ... ... ... ... ... ... 1 ... ... ... 4 3 ... ... 5 3 8 7.-Diseases of Gland-like Organs of Uncertain Use. (e.g., Bronchocele, Addison's Disease) ... 1 ... ... ... ... ... 1 ... 1 ... ... ... 1 ... 4 4 8.—Diseases of Urinary System. Nephritis ... ... ... 2 4 2 2 5 5 3 3 3 1 ... 15 15 30 Bright's Disease, Albuminuria 7 3 5 7 10 9 14 5 13 10 13 15 1 ... 63 49 112 Disease of Bladder or of Prostate ... ... ... 1 3 ... 3 2 1 ... 3 2 ... ... 10 5 15 Calculus (Stone) ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 2 2 Other Diseases of the Urinary System ... 1 ... 1 3 1 1 ... ... ... ... 1 ... 1 4 5 9 9.—Diseases of Reproductive System. a. Of Organs of Generation. Male Organs ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 Female Organs ... 1 ... ... ... 4 ... 1 ... 4 ... 1 ... ... ... 11 11 16, 17 LAMBETH BOROUGH-Deaths Registered from all causes during the Year 1909—continued. Note.-The Deaths of Non-Residents occurring in Public Institutions situated in the District are excluded, and the Deaths of Residents occurring in Public Institutions situated bey and the limits of the District are included. Sub-Districts. Kennington. Stockwell. Brixton Norwood. No dress. All Ages. Total. Waterloo. Lambeth Church. B. Of Parturition. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Abortion, Miscarriage ... ... ... ... ... ... ... 1 ... 2 ... ... ... ... ... 3 3 Puerperal Convulsions ... ... ... ... ... 1 ... 3 ... ... ... ... ... ... ... 4 4 Placenta prævia, Flooding ... ... ... 1 ... ... ... 1 ... ... ... 1 ... ... ... 3 3 Other Accidents of Child Birth ... ... ... ... ... 4 ... 2 ... 3 ... 2 ... ... ... ... 11 10.—Diseases of Bones and Joints. Caries, Necrosis ... ... ... ... 1 ... ... ... ... ... 2 ... ... ... 3 ... 3 Arthritis, Ostitis, Periostitis ... ... 1 ... ... 2 ... 1 ... ... ... ... ... ... 1 3 4 Other Diseases of Bones and Joints ... ... ... ... 1 ... ... ... ... 1 ... ... ... ... 1 1 2 11.—Diseases of Integumentary System. Carbuncle, Phlegmon ... ... ... 1 1 ... 3 1 3 ... ... ... ... ... 7 2 9 Other Diseases of Integumentary System ... ... ... 3 ... 2 ... 1 ... ... ... ... ... 1 ... 7 7 VII.— Deaths from Violence. 1.—accident or Negligence. Fractures and Contusions 4 1 3 1 3 ... 4 1 5 2 6 1 1 ... 26 6 32 Gunshot Wounds ... ... ... 3 ... ... ... ... ... ... 1 ... ... ... 1 ... 1 Cut, Stab ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 2 ... 2 Burn, Scald 1 ... 2 ... 1 6 1 ... 2 3 ... 2 ... ... 7 11 18 Poison ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... 2 ... 2 Drowning 1 ... 1 ... 1 ... 1 ... ... ... 1 ... ... ... 5 ... 5 Suffocation ... ... 2 ... 1 2 ... ... 1 ... 1 2 ... ... 5 4 9 Otherwise 4 1 2 ... 6 2 5 5 3 5 2 1 1 ... 23 14 37 2.—Homicide. Manslaughter ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Murder ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 3—Suicide. Gunshot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cut, Stab 1 ... ... ... 1 ... ... ... 1 1 ... ... ... ... 3 1 4 Poison ... 1 1 ... ... ... ... 1 ... 1 2 1 ... ... 3 4 7 Drowning ... ... ... ... ... ... 1 ... ... 1 ... 1 ... 1 1 3 4 Hanging 2 ... ... ... ... 1 2 1 1 ... ... ... ... ... 5 1 6 Otherwise 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 3 4.—Execution. Hanging ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... VIII.—Deaths from Ill-Defined and not Specified Causes. Dropsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Debility, Atrophy, Inanition 10 4 13 6 16 14 15 6 17 9 8 10 1 1 80 50 130 Mortification ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tumour ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 1 Abscess ... ... ... ... 2 ... ... ... 2 ... ... ... ... ... 4 ... 4 Hæmorrhage ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sudden Death (cause not ascertained) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not specified, or Ill-defined ... ... ... ... ... 1 2 1 ... ... ... ... ... ... 2 2 4 18 19 LAMBETH BOROUGH.—Deaths Registered from all Causes during the Year 1909. Note.—The Deaths of Non-Residents occurring in Public Institutions situated in the District are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the District are included. AGES. AGES. Total. Under 1 Year 1-5 Under 5 Years. 5-10 10-15 15-20 20-25 25-40 40-60 60-65 65-80 80 and over. Over 5 Years. All Ages. M. F. M. F. M. F. M. F. M. F. M. F. M F M F. M. F. M F M F M. F M. F. M. F. I. Specific Febrile, or Zymotic Diseases 101 107 85 101 186 208 21 17 4 1 2 1 3 3 9 11 18 13 6 7 10 18 6 4 79 75 265 283 548 II. Parasitic Diseases 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 2 III. Dietetic Diseases 3 1 ... ... 3 1 ... ... ... ... ... ... ... ... 4 1 2 5 ... 1 1 ... ... ... 7 7 10 8 18 IV. Constitutional Diseases 21 28 29 29 50 57 14 10 6 11 14 14 22 18 110 89 200 119 45 31 92 107 7 20 510 419 560 476 1036 V. Developmental Diseases 96 73 2 1 98 74 ... ... 1 ... ... ... ... ... 1 1 1 1 1 1 21 28 51 53 82 151 156 307 VI. Local Diseases 138 117 78 78 216 195 19 11 8 13 17 11 24 16 82 107 288 244 96 104 290 384 79 155 903 1045 1119 1240 2359 VII. Deaths from Violence 10 5 6 4 16 9 4 2 2 1 4 ... 1 13 8 28 12 2 5 11 6 4 3 69 37 85 46 131 VIII. Deaths from Ill-defined and not specified Causes 84 45 1 6 85 51 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... 1 1 2 86 53 139 Totals 454 376 201 219 655 595 58 40 21 26 37 26 51 37 219 217 537 395 150 149 425 544 124 234 1622 1668 2277 2263 4540 1.—Specific Febrile or Zymotic Diseases. 1.—Miasmatic Diseases. Small-pox Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Unvaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No Statement ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 10 11 37 42 47 53 3 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 1 50 54 104 Whooping Cough 21 23 14 24 35 47 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 38 47 85 Scarlet Fever 1 ... 4 8 5 8 7 5 ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... 7 7 12 15 27 Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Simple Continued and Ill-defined Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 ... 1 Enteric or Typhoid Fever ... ... ... ... ... ... ... ... ... ... ... 1 2 ... 3 1 2 ... ... ... ... ... ... ... 7 2 7 2 9 Diphtheria 1 3 16 17 17 20 8 10 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 9 11 26 31 57 Membranous Croup ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Influenza 2 1 ... 1 2 2 ... 1 1 ... 1 ... ... 1 3 2 6 6 2 5 8 16 5 4 27 35 29 37 66 Other Miasmatic Diseases 2 3 2 1 4 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 4 8 2.—Diarrhœal Diseases. Cholera Nostras ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera Asiatica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa Dysentry 52 47 6 7 58 54 ... ... ... ... ... ... ... ... 1 ... 1 2 1 ... 1 ... ... ... 4 2 62 56 118 3.—Malarial Diseases. Remittent or Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 ... 1 4.—Zoogenous Diseases. Cowpox and effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases (e.g., Hydrophobia, Glanders, Splenic Fever) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5.—Venereal Diseases. Syphilis 12 16 3 1 15 17 ... ... ... ... ... ... ... ... 1 1 1 1 ... 1 ... ... ... ... 2 3 17 20 37 Gonorrhœa, Stricture of Urethra ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 ... ... ... 1 ... 5 ... 5 ... 5 6. Septic Diseases. Erysipelas ... 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 4 2 ... 1 1 1 ... ... 5 4 5 6 11 Pyæmia, Septicaemia ... 1 2 ... 2 1 ... ... 3 ... ... ... ... ... 1 ... 1 1 ... ... ... 1 ... ... 5 2 7 3 10 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 6 ... 1 ... ... ... ... ... ... ... 8 ... 8 8 20 21 LAMBETH BOROUGH — Deaths Registered from all Causes during the Year 1909 —continued. Note.-The Deaths of Non-Residents occurring in Public Institutions situated in the District are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the District are included. AGES. AGES. Total. Under 1 Year. 1-5 Under 5 Years. 5-10 10-15 15-20 20-25 25-40 40-60 60-65 65-80 8 and over. Over 5 Years. All Ages. II.—Parasitic Diseases M. F. M. F. M. F. M. F. M. F M. F. M. F M. F M. F. M. F. M. F. M. F. M. F. M. F Thrush, and other Vegetable Parasitic Diseases 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Worms, Hydatids, and other Animal Parasitic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 1 III.—Dietetic Diseases. Want of Breast Milk, Starvation 3 1 ... ... 3 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 2 ... 5 1 6 Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chronic Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 1 2 5 ... 1 ... ... ... ... 5 7 5 7 12 Delirium Tremens ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... IV.—Constitutional Diseases. Rheumatic Fever ... ... ... ... ... ... ... ... ... 2 ... ... 1 1 1 1 1 3 ... ... ... ... ... ... 6 9 6 9 15 Rheumatism of the Heart ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 ... 1 Rheumatism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 3 ... ... 1 3 1 3 4 Gout ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 3 2 ... ... 4 2 4 2 6 Rickets 2 3 3 3 5 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 6 11 Cancer, Malignant Disease 1 ... ... 2 1 2 1 ... ... ... 1 ... 2 ... 5 16 61 71 32 21 64 78 7 15 173 201 174 203 377 Cancum Oris (Noma) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tabes Mesenterica 6 7 3 4 9 11 1 2 1 1 ... ... 1 ... 1 1 ... 1 1 ... 1 ... ... ... 6 5 15 16 31 Tubercular Meningitis, Hydrocephalus 6 6 8 10 14 16 4 2 1 1 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... 7 3 21 19 40 Phthisis ... 2 4 3 4 5 1 2 ... 6 9 14 16 17 91 63 119 39 7 4 16 11 ... 4 259 160 263 165 428 Scrofula ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other forms of Tuberculosis 5 9 11 7 16 16 4 2 2 1 2 ... 1 ... 9 1 8 1 ... 2 1 2 ... ... 27 9 43 25 68 Purpura, Hæmorrhagic Diathesis 1 1 ... ... 1 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 1 2 3 Anæmia, Chlorosis, Leucocythæmia ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 4 ... 1 1 1 ... ... ... 8 2 8 2 10 Glycosuria, Diabetes Mellitus ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... 1 5 4 1 3 2 4 4 ... ... 15 12 15 12 27 Other Constitutional Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 3 1 1 1 7 ... 1 3 12 3 12 15 V.—Developmental Diseases. Premature Birth 78 53 ... ... 78 53 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 78 53 131 Atelectasis 4 4 ... ... 4 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 4 8 Cogenital Malformations 14 16 2 1 16 17 ... ... 1 ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... 2 1 18 18 36 Old Age ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 1 21 28 28 51 51 81 51 81 132 VI.—Local Diseases. 1.—Diseases of Nervous System Inflammation of Brain or Membranes 6 3 5 7 11 10 ... ... ... ... ... ... 2 1 1 2 ... 1 ... ... ... ... ... ... 3 4 14 14 28 Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis 1 1 ... ... 1 1 ... ... ... ... ... ... 1 1 ... 3 20 26 13 10 36 51 11 18 81 109 82 110 192 Insanity, General Paralysis of the Insane ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 6 3 15 5 ... ... 1 3 2 3 25 14 25 14 39 Epilepsy ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 5 3 2 4 ... 2 3 ... ... ... 10 10 10 10 20 Convulsions 16 13 3 1 19 14 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 19 14 33 Laryngismus Stridulus (Spasm of Glottis) ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 2 Disease of Spinal Cord, Paraplegia, Paralysis Agitans ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 3 8 2 2 1 5 3 ... 1 18 10 18 10 28 Other Diseases of Nervous System ... ... 1 ... 1 ... 2 ... ... ... 1 1 3 ... 5 4 8 5 ... 2 ... 3 ... ... 19 15 20 15 35 2. Diseases of Organs of Special Sense. (e.g., of Ear, Eye, Nose) ... ... 2 3 2 3 2 ... ... ... 1 1 ... ... 2 ... ... ... ... ... ... 2 ... ... 5 3 7 6 13 22 «3 LAMBETH BOROUGH—Deaths Registered from all Causes during the year 1909—continued. Note.—The Deaths of Non-Residents occurring in Public Institutions situated in the District are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the District are included. AGES AGES. Total. Under I Year. 1-5 Under 5 Years. 5-10 10-15 15-20 20-25 25-40 40-60 60-65 65-80 5 and over. Over 5 Years. All Ages. M. F. M F. M. F. M. F M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M F. 3.—Diseases of Circulatory System. Pericarditis ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 1 1 2 Acute Endocarditis ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... 1 6 5 ... ... 1 2 ... ... 8 9 8 9 17 Valvular Diseases of Heart ... ... ... 2 ... 2 ... 2 2 6 2 2 6 3 9 8 22 28 11 10 16 40 3 3 71 102 71 104 175 Other Diseases of Heart 1 1 1 1 2 2 ... 1 1 ... ... ... 1 ... 1 7 12 19 2 14 32 46 6 20 55 107 57 109 166 Aneurism ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 4 2 ... 1 ... 1 ... ... 5 4 5 4 9 Embolism, Thrombosis ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... 1 4 4 ... 3 2 2 2 4 10 14 10 14 24 Other Diseases of Blood Vessels ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 7 3 6 ... 30 18 13 16 56 38 56 38 94 4.—Diseases of Respiratory System. Laryngitis ... 1 1 1 1 2 1 ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 2 1 3 3 6 Croup ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Emphysema, Asthma ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 4 ... 8 2 1 1 2 5 ... ... 16 8 16 8 24 Bronchitis 23 25 10 9 33 34 ... ... ... ... ... ... 1 1 8 3 31 28 24 30 68 123 22 58 154 243 187 277 464 Pneumonia 6 12 10 11 16 23 2 ... ... ... 2 ... 2 4 13 10 37 23 8 4 25 16 3 10 92 67 108 90 198 Pleurisy 2 ... ... ... 2 ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 ... ... 1 ... 1 3 2 5 2 7 Bronchopneumonia 38 36 23 29 61 65 1 2 ... 1 ... 1 ... ... 2 1 7 6 3 2 9 12 2 2 24 27 85 92 177 Pleuropneumonia ... ... 2 1 2 1 1 ... ... ... 1 ... ... ... 3 8 17 4 1 2 13 5 1 1 37 21 39 22 61 Other Diseases of Respiratory System 9 ... 4 1 13 1 1 ... ... ... ... ... ... ... 2 2 6 4 1 ... 11 7 3 6 24 19 37 20 57 5.—Diseases of Digestive System. Dentition 6 7 1 5 7 12 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 12 19 Sore Throat, Quinsy 1 ... 1 ... 2 ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 3 2 5 Diseases of Stomach 9 2 2 ... 11 2 ... ... ... ... ... ... ... 1 1 4 8 4 1 1 ... 2 1 12 12 23 14 37 Enteritis 6 7 5 2 11 9 3 2 3 1 1 ... 1 ... 4 3 6 5 1 3 2 1 ... 1 21 16 32 25 57 Obstructive Diseases of Intestine 6 ... 2 1 8 1 ... ... 1 ... 1 ... 1 ... ... 1 1 6 2 ... 6 3 2 2 14 12 22 13 35 Peritonitis 1 ... ... 1 1 1 ... 2 ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... 8 1 9 10 Ascites ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver ... ... ... ... ... ... ... ... ... ... ... ... ... ... .3 4 10 16 6 1 2 7 ... ... 21 28 21 28 49 Jaundice and other Diseases of Liver 1 2 2 ... 3 2 ... 1 ... ... ... ... ... ... ... 1 2 3 1 4 2 5 ... 1 5 15 8 17 25 Diseases of the Pancreas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Digestive System 2 ... 1 ... 3 1 1 ... ... ... ... ... ... ... ... 1 5 1 1 1 ... ... ... ... 2 2 9 3 12 6.—Diseases of Lymphatic System. (e.g., of Lymphatics and of Spleen) 2 1 1 ... 3 1 1 ... ... ... ... ... ... ... 1 ... ... ... ... 2 ... ... ... ... 2 2 5 3 8 7.—Diseases of Gland-like Organs of Uncertain Use. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... (e.g., Bronchocele, Addison's Disease) ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 1 ... ... ... 1 ... ... ... 4 ... 4 4 8.—Diseases of Urinary System. Nephritis ... 1 1 ... 1 1 1 ... ... 1 ... 2 1 1 ... 1 8 3 2 1 2 3 ... 2 14 14 15 15 30 Bright's Disease, Albuminuria ... ... ... ... ... ... 1 ... ... ... 3 1 1 ... 5 10 25 10 8 6 16 18 4 4 63 49 63 49 112 Disease of Bladder or of Prostate ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 ... 1 1 3 2 3 1 10 5 10 5 15 Calculus (Stone) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 2 ... 2 2 Other Diseases of the Urinary System ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 2 4 ... ... 2 ... ... ... 4 5 4 5 9 9.—Diseases of Reproductive System. A. Of Organs of Generation. Male Organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 1 ... 1 Female Organs ... 1 ... ... 1 ... ... ... ... ... ... ... 1 ... 2 ... 5 ... ... ... 2 ... ... ... 10 ... 11 11 24 25 LAMBETH BOROUGH—Deatns Registered From all Causes during the year 1909-continued. Note.—The Deaths of Non-Residents occurring in Public Institutions situated in the District are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the District are included. AGES. AGES. Total. Under 1 Year. 1-5 Under 5 Years. 5-10 10-15 15-20 20-25 26-40 40-60 60-65 65-80 5 and over. Over 5 years. All Ages. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. B. Of Parturition. Abortion, Miscarriage ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... ... ... ... ... 3 ... 3 3 Puerperal Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 1 ... ... ... ... ... ... ... 4 ... 4 4 Placenta prævia, Flooding ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... ... ... ... ... 3 ... 3 3 Other Accidents of Child Birth ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 8 ... 2 ... ... ... ... ... ... ... 11 ... 11 11 10.—Diseases of Bones and Joints. Caries, Necrosis ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... ... ... ... ... ... ... ... ... ... ... 3 ... 3 ... 3 Arthritis, Ostitis, Periostitis ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 2 ... ... ... ... ... ... 1 2 1 3 4 Other Diseases of Bones and Joints ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 1 2 11 —diseases of Integumentary System. Carbuncle, Phlegmon 2 1 ... ... 2 1 ... ... ... ... ... ... ... ... 1 ... 4 1 ... ... ... ... ... ... 5 1 7 2 9 Other Diseases of Integumentary system ... 2 ... 1 ... 3 ... ... ... ... ... ... ... ... ... 1 ... 2 ... ... ... 1 ... ... ... 4 ... 7 7 VII — Deaths from Violence. 1.—accident or Negligence. Fractures and Contusions 1 ... 1 ... 2 ... 2 ... ... ... 3 ... ... ... 4 ... 8 2 1 1 4 i 2 2 24 6 26 6 32 Gunshot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 ... 1 Cut, Stab ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 2 ... ... ... 2 Burn, Scald ... 1 4 4 4 5 1 1 ... ... ... ... ... ... ... 1 1 1 ... 1 ... 2 1 ... 3 6 7 11 18 Poison ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 2 ... 2 ... 2 Drowning 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 3 ... ... ... ... ... ... ... 4 ... 5 ... 5 Suffocation 4 2 ... ... 4 2 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... 1 ... 1 2 5 4 9 Otherwise 4 2 1 ... 5 2 1 1 1 1 ... ... ... ... 4 1 8 4 ... 2 4 2 ... 1 18 12 23 14 37 2.—Homicide. Manslaughter ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Murder ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 1 3.—Suicide. Gunshot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cut, Stab ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 1 ... ... ... ... ... ... 3 1 3 1 4 Poison ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 3 2 1 ... ... ... ... ... ... 3 4 3 3 7 Drowning ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... 1 ... ... ... ... 1 3 1 3 4 Hanging ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... 1 1 ... ... 1 ... ... ... 5 1 5 1 6 Otherwise ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... 1 ... ... ... 1 1 ... ... 2 1 2 1 3 4.—Execution. Hanging ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... VIII.—Deaths from Ill-Defined and not Specified Causes. Dropsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Debility, Atrophy, Inanition 80 44 ... 6 80 50 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 80 50 130 Mortification ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tumour ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 1 Abscess 2 ... 1 ... 3 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 4 ... 4 Hæmorrhage ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sudden Death (cause not ascertained) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not specified, or Ill-defined 2 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 2 2 26 Summary of Total Corrected Deaths in Lambeth Borough during 1909. No. of Deaths. Total. No. of Deaths Total. M. F. M. F. I.—Specific Febrile, or Zymotic Diseases Brought forward 1996 2036 4032 1. Miasmatic Diseases 168 190 358 VI.—Local Diseases—continued 2. Diarrhœal „ 62 56 118 3. Malarial „ 1 ... 1 6. Diseases of Lymphatic System 5 3 8 4. Zoogenous „ ... ... ... 7. Diseases of Gland-like Organs of Uncertain use ... 4 4 5. Venereal „ 22 20 42 6. Septic „ 12 17 29 8. Diseases of Urinary System 92 76 168 9. Diseases of Reproductive System II.—Parasitic Diseases 1 1 2 (a) Diseases of Organs of Generation 1 11 12 III.—Dietetic Diseases 10 8 18 (b) Diseases of Parturition ... 21 21 10. Diseases of Bones and Joints 5 4 9 IV.—Constitutional Diseases 560 476 1036 11. Diseases of integumentary System 7 9 16 V.—Developmental Diseases 151 156 307 VII. —Violence. VI.—Local Diseases 1. Accident or Negligence 71 35 106 1. Diseases of Nervous System 188 189 377 2. Homicide ... 1 1 2. Diseases of Organs of Special Sense 7 6 13 3. Suicide 14 10 24 4. Execution ... ... ... 3. Diseases of Circulatory System 208 279 487 4. Diseases of Respiratory „ 480 515 995 VIII.—ill-defined and not Specified Causes 86 53 139 5. Diseases of Digestive „, 126 123 249 Carried forward 1996 2036 4032 Total 2277 2263 4540 27 Offences under the Food and Drugs, and Public Health Acts, during 1909. NATURE OF OFFENCES AND AMOUNTS OF PENALTIES AND COSTS IN EACH CASE. 28 29 SALE OF FOOD AND DRUGS ACTS.—SUMMONSES, 1909. Offence. Penalty. Costs. £ s. d. £ s. d. On 15th February, two summonses were taken out, re selling Milk deficient in Milk Fat to the extent of 9 per cent. [sample 103]. Summons withdrawn - - Re selling Milk deficient in Milk Fat to the extent of per cent, [sample 108] Summons withdrawn (N.B.—Summonses 103 and 108 were withdrawn by order of the Public Health Committee, having regard to the comparatively large amounts of total solids and solids other than Milk Fat found, and also having regard to the fact that two other samples taken at the same time in connection with the same consignment (separate churns) were returned by the Analyst as "Genuine.") - - On 17th March, a summons was heard before Mr. Hopkins, at Lambeth Police Court, for seling Butter containing Margarine (not Butter) 90 parts [sample 133] 1 0 0 0 16 6 On 24th March, three summonses were heard before Mr. Cecil Chapman, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 14 per cent. [sample 186] - - Re selling Milk deficient in Milk Fat to the extent of 15 per cent. [sample 171 ] - - Re selling Milk deficient in Milk Fat to the extent of 8 per cent. [sample 175] These three summonses were dismissed, the Magistrate being satisfied with the evidence for the defence. - - On 31st March, eight summonses were heard before Mr. Cecil Chapman, at Lambeth Police Court, re selling Milk containing added water to the extent of 21 per cent, [sample 280] 2 0 0 0 16 6 Re selling Butter containing Margarine (not butter) 90 parts [sample 265] 3 0 0 0 16 6 Carried forward 6 0 0 2 9 6 30 31 Sale of Food and Drugs Acts.—Summonses, 1909—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 6 0 0 2 9 6 Re selling, Butter containing Margarine (not Butter) 80 parts [sample 261] - 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 3 per cent, and containing extraneous water 2 per cent [sample 226] 1 0 0 0 16 6 Re selling Butter containing Margarine (not butter) 92 parts [sample 221] 1 0 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 14 per cent, [sample 217] 1 0 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 14 percent. [sample 214] 1 0 0 0 16 6 Re exposing a parcel of Margarine for sale by retail without having label attached and marked in printed capital letters not less than 11/2 inches Margarine [sample 225] - 0 16 6 On 14th April, two summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 10 per cent, [sample 306] 1 0 0 0 16 6 Re selling Butter containing Margarine (not butter) 90 parts [sample 286] 1 0 0 0 16 6 On 28th April, a summons was heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk containing added water to the extent of 4 per cent. [sample 362] 2 0 0 0 16 6 On 10th May, four summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk containing extraneous water to the extent of 5 per cent. [sample 498] 3 0 0 0 16 6 Re selling Milk containing extraneous water to the extent of 5 per cent. [sample 488] 3 0 0 0 16 6 Carried forward 20 0 0 11 11 0 32 33 Sale of Food and Drugs Acts.—Summonses, 1909—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 20 0 0 11 11 0 Re selling Milk deficient in Milk Fat to the extent of 18 per cent. [sample 516] 3 0 0 0 16 6 Re selling Milk containing extraneous water to the extent of 6 per cent. [sample 517] 'Summons dismissed owing to warranty being proved satisfactory - - On 2nd June, a summons was heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk containing extraneous water to the extent of 11 per cent. [sample 584]. Summons dismissed owing to warranty being proved satisfactory - - On 23rd June, four summonses were heard before Mr. Cecil Chapman, at Lambeth Police Court, re selling Butter containing Margarine (not butter) 96 parts [sample 703] 0 10 0 0 16 6 Re selling Milk containing extraneous water to the extent of 3 per cent. [sample 724] 0 10 0 0 16 6 Re selling Butter containing Margarine (not butter) 100 parts [sample 749] - 0 16 6 Re exposing a parcel of Margarine for sale by retail without having label attached and marked in printed capital letters 11/2 inches Margarine [sample 681] 2 0 0 0 16 6 On 14th July, five summonses were heard before Mr. Horace Smith, at Lambeth Police Court, re selling Mirk deficient in Milk Fat to the extent of 6 per cent. [sample 750] 0 5 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 10 per cent. [sample 852] 0 5 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 13 per cent. [sample 837] (Defendant produced Warranty, which Magistrate accepted, although notice of such Warranty had not been sent to the Lambeth Borough Council.) - 0 16 6 Carried forward 26 10 0 18 3 0 34 35 Sale of Food and Drugs Acts.—Summonses, 1909—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 26 10 0 18 3 0 Re selling Butter containing Margarine (not butter) 100 parts [sample 833] 0 10 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 5 per cent. [sample 811]. Summons withdrawn, upon payment of costs - 0 12 6 On 21st July, two summonses were heard before Mr. Horace Smith, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 11 per cent. [sample 862]. Magistrate dismissed summons, the contrary being proved. (No costs allowed.) - - Re selling Milk deficient in Milk Fat to the extent of 5 per cent. [sample 856]. Magistrate dismissed summons, the contrary being proved. (No costs allowed.) - - On 25th August, six summonses were heard before Mr. Horace Smith, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent ol 12 per cent. [sample 889] 0 10 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 14 per cent. [sample 890] 0 10 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 13 per cent, [sample 891] 0 5 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 5 per cent [sample 902] 0 5 0 0 16 6 Re selling Separated Milk which has been deprived of half its natural fat, and to which 13 per cent of water has been added [sample 907] 10 0 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 20 per cent. [sample 881] 0 5 0 0 16 6 Carried forward 38 15 0 24 11 0 36 37 Sale of Food and Drugs Acts.—Summonses, 1909—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 38 15 0 24 11 0 On 1st September, three summonses were heard before Mr. Horace Smith, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 6 per cent. [sample 934] - 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 7 per cent. [sample 952J 0 5 0 0 16 6 Re selling Butter containing Margarine (not butter) 43 parts [sample 953] 0 5 0 0 16 6 On 15th September, a summons was heard before Mr. Horace Smith, at Lambeth Police Court, re selling Milk containing extraneous water to the extent of 6 per cent. [sample 1057] 0 5 0 0 16 6 On 22nd September, two summonses were heard before Mr. Cecil Chapman, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 7 per cent. [sample 792]. Summons withdrawn on payment of costs, the contrary being proved - 0 17 8 Re selling Milk deficient in Milk Fat to the extent of 6 per cent. [sample 773]. Summons withdrawn on payment of costs, the contrary being proved - 0 17 8 On 6th October, a summons was heard before Mr. Cecil Chapman, at Lambeth Police Court, re selling Milk containing extraneous water to the extent of 7 per cent. [sample 1109]. Summons dismissed owing to warranty being proved satisfactory - - On 3rd November, a summons was heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk containing extraneous water to the extent of 9 per cent. [Sample 1232] 2 0 0 0 12 6 Carried forward 41 10 0 30 4 10 38 39 Sale of Food and Drugs Acts.—Summonses, 1909—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 41 10 0 30 4 10 On 24th November, four summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk containing extraneous water to the extent of 18 per cent. [sample 1294] 2 0 0 0 16 6 Re selling Butter containing Margarine (not Butter) 51 parts [sample 1318] - 0 16 6 Re selling Butter containing Margarine (not butter) 100 per cent. [Sample 1323] 2 0 0 0 16 6 Re selling Butter containing Margarine (not butter) 98 parts [Sample 1327] 1 0 0 0 16 6 On 8th December, a summons was heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 17 per cent. [Sample 1382] 3 0 0 0 16 6 On 14th December, two summonses were heard before Air. Hopkins, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 8 per cent. [Sample 1351] 5 0 0 0 9 3 Re selling Milk mixed with an ingredient so as to render the article injurious to health, it containing 0.001 per cent. Formaldehyde [Sample 1351] (The two summonses relate to same sample). 5 0 0 0 9 3 On 29th December, a summons was heard before Mr. Cecil Chapman, at Lambeth Police Court, re selling Butter containing Margarine (not butter) 100 parts. [Sample 1477] - 0 16 6 On 5th January, 1910, a summons was heard betore Mr. Hopkins at Lambeth Police Court re selling Milk containing extraneous water to the extent of 3 per cent. [Sample 1516] The Magistrate adjourned the summons sine die, the defendant being in hospital. - - On 19th January, 1910, 2 summonses were heard before Hopkins, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 7 per cent. ['Sample 1470]. Adjourned for 3rd sample to be sent to Somerset House Authorities, who declared the adulteration to be 8 per cent. Milk Fat deficient 1 0 0 0 16 6 Carried forward 60 10 0 36 18 10 40 41 Sale of Food and Drugs Acts.—Summonses, 1909—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 60 10 0 36 18 10 Re selling Milk deficient in Milk Fat to the extent of 7 per cent. [Sample 1571] 0 10 0 0 16 6 On 9th February, 11 summonses were heard before Mr. Baggallay, at Lambeth Police Court, re selling Milk containing extraneous water to the extent of 3 per cent. [Sample 1708] 5 0 0 0 16 6 Re selling Mirk, containing extraneous water to the extent of 12 per cent. [Sample 1696] 2 0 0 0 16 6 Re selling Rum diluted with water to the extent of 9 degrees below the legal limit of 25 degrees under proof. [Sample 1698]. Dismissed, a notice being exhibited in the Bar. (No costs allowed) - - Re selling Butter containing Margarine (not butter) 91 parts [sample 1684] 3 0 0 0 16 6 Re selling Lard, containing Cocoanut Stearine 100 parts [sample 1655] 5 0 0 0 16 6 Re selling Milk containing extraneous water to the extent 3 per cent. [sample 1714] 5 0 0 4 18 10 Re selling Milk containing extraneous water to the extent of 5 per cent. [sample 1715] 0 10 0 - Re selling Milk containing extraneous water to the extent of 7 per cent. [sample 1729] 0 10 0 - Re selling Milk containing extraneous water to the extent of 7 per cent. [sample 1730] 0 10 0 - Re selling Milk containing extraneous water to the extent of 2 per cent. [sample 1731] 0 10 0 - Re selling Milk containing extraneous water to the extent of 9 per cent. [sample 1732] 0 10 0 - Carried forward 83 10 0 46 0 2 4 2 43 Sale of Food and Drugs Acts.—Summonses, 1909—continued. Offence. Penalty. Costs. £ s d. £ s. d. Brought forward 83 10 0 46 0 2 On 16th February, 4 summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk containing extraneous water to the extent of 11 per cent. [sample 1760]. Dismissed—warranty proved satisfactory - - Re selling Butter containing Margarine (not butter) 100 parts [sample 1767] 1 0 0 0 16 6 Re selling Mustard containing Wheat Flour 10 parts [sample 1770] 1 0 0 0 16 6 Re selling Butter containing Margarine (not butter) 94 parts [sample 1768] 1 0 0 0 16 6 86 10 0 48 9 8 PUBLIC HEALTH AND METROPOLIS MANAGEMENT ACTS.—SUMMONSES. Offence. Penalty. Costs. £ s. a. £ s. a. On 20th January, 1909, six summonses were heard before Mr. Hopkins, at Lambeth Police Court: (1) Against the builder for constructing a water closet in connection with a building, No. 330a Brixton Road, without constructing a window in one of the walls opening to the external air, and without giving notice in writing to the Clerk of the Borough Council before executing the said works, contrary to the by-laws Nos. 2 and 14 of the L.C.C. 1 0 0 0 2 0 (2) Against a workman employed on the above work. Summons withdrawn, costs paid by the employer - 0 2 0 (3) Against another workman employed on the same work. Summons withdrawn, costs paid by the employer - 0 0 0 (4) Against the same builder for constructing and partially repairing a water closet and drain at No. 330 Brixton Road, as to be a nuisance or injurious or dangerous to health 1 0 0 0 2 0 Carried forward 2 0 0 0 8 0 44 45 Public Health and Metropolis Management Acts.—Summonses.— continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 2 0 0 0 8 0 (5) Against a workman employed on the above work. Summons withdrawn, costs paid by the employer. - 0 2 0 (6) Against another workman employed on the same work. Summons withdrawn, costs paid by the employer [N.B.—Vide Annual Report, 1908, pages 163-165.] - 0 2 0 On 24th February, three summonses were heard before Mr. Hopkins, at Lambeth Police Court:— - - (1) For removing from Canterbury Mews offensive matter to wit, horse dung mixed with litter (other than straw) and decaying vegetable refuse contrary to the by-laws of the London County Council. Summons adjourned sine die, pending further offence by defendant - - (2) Causing the same offensive matter to be removed. Summons adjourned sine die, pending further offence by defendant - - (3) Against the owner for non-compliance with Magistrate's Order made on 14th October, 1908, to put drains, etc., into proper order and condition at 27 Meaow Road Summons withdrawn on payment of costs - 0 2 0 On 20th April, a summons was heard before Mr. Hopkins, against the owner for non-compliance with Notice of Council to put the drains, w.c. fittings, water supply and paving of yard into proper order and condition and providing a dust bin at 56 Loughborough Road. Order made to do work in 14 days and pay 4/0 costs of summons and Order, and £1 1s. 0d. solicitor's fees - 1 5 0 On 7th April, two summonses were taken out—(1) Against the owner of 27a 'St. Louis Road for noncompliance with Notice of Council to repair the defective eaves gutter. Summons withdrawn on payment by defendant of 2/0 costs, the work having been done meanwhile - 0 2 0 Carried forward 2 0 0 2 1 0 46 47 Public Health and Metropolis Management Acts.—Summonses.— continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 2 0 0 2 1 0 (2) Against the owner lor non-compliance with Notice of Council to repair defective eaves gutter, waste pipe and yard paving at No. 25 St. Louis Road Summons withdrawn on payment by defendant of 2/0 costs, the work having been done meanwhile 0 2 0 On 27th April, a summons was heard before Mr. Hopkins, against the owner for non-compliance with Notice of Council to repair roof and gutter, cleanse walls and ceilings of rooms and staircase, and provide dust bin at 25 Gray Street. Order made to do the work within 14 days and defendant to pay 4/0 costs - 0 4 0 On 4th May, a summons was heard before Mr. Hopkins, against the owner for non-compliance with Notice of Council to remedy damp walls, sink, gully, and defective water supply at 22 Russell Grove. Summons withdrawn on payment of 2/0 costs, the work having been done meanwhile - 0 2 0 On 7th May, a summons was heard before Mr. Chapman, against the owner, for non-compliance with Notice of Council to provide a proper and sufficient supply of water at 298 Kennington Road. Closing Order made and defendant to pay 4/0 costs - 0 4 0 On 19th May, two summonses were heard before Mr. Chapman (1) Against the owner for non-compliance with Notice of Council to put drain into proper order and condition at No. 4 Frank Street. Defendant fined 20/0 for allowing the nuisance to continue after Notice from Council, and an Order made to abate nuisance within 14 days, and pay 6/0 costs 1 0 0 0 6 0 (2) Against the owner for non-compliance with Notice of Council to put drains into proper order and condition at No. 6 Frank Street. Order made to abate the nuisance within 14 days and pay 6/0 costs - 0 6 0 Carried forward 3 0 0 3 5 0 48 49 Public Health and Metropolis Management Acts.— Summonses.— continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 3 0 0 3 5 0 On 15th June a summons was heard before Mr. Chapman for non-compliance with Magistrate's Order to remedy dampness in the basement walls and provide a proper water supply for domestic purposes at 56 Loughborough Road. Summons withdrawn on payment by defendant of £1 7s. costs, the work having been done meanwhile - *1 7 0 On 22nd October, two summonses were taken out—(1) Against the owner, for non-compliance with Notice of Council to abate nuisance caused by damp state of living rooms in basement of No. 123 Loughborough Road. Summons withdrawn on payment by defendant, of 2/0 costs, the work having been done meanwhile - 0 2 0 (2) Against the owner, for non-compliance with Notice of Council to provide a proper receptacle for horse dung at No. 123 Loughborough Road. Summons withdrawn on payment of 2/0 costs, a dung receptacle having been provided - 0 2 0 *Including £1 1s. as Solicitor's costs. On 3rd November, a summons was taken out against the owner, for non-compliance with Notice of Council to repair apparati of closets, pave yard, and provide a sanitary dust bin at 123 Loughborough Road. Summons withdrawn on payment by defendant of 2/0 costs, the work having been done meanwhile - 0 2 0 On 17th November, two summonses were taken out— (1) Against the owner, for non-compliance with Notice of Council to put drain in order and disconnect sink, and rain water pipe from drain, and repair w.c. at No. 25 Thornton Street. Summons withdrawn on payment by defendant of 2/0 costs, the work having been done meanwhile - 0 2 0 (2) Against the owner for non-compliance with Notice of Council to put the drain into proper order and condition at No. 26 Thornton Street. Summons withdrawn on payment by defendant of 2s. costs, the work having been done meanwhile - 0 2 0 Carried forward 3 0 0 5 2 0 5° 5i Public Health and Metropolis Management Acts.—Summonses.— continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 3 0 0 5 2 0 On 8th December, 3 summonses were heard before Mr. Hopkins: (1) against the owner for non-compliance with Notice of Council to repair roof, and make good defective drains at 109 Vauxhall Street. The Magistrate made an order to do the work in 14 days and defendant to pay 2/0 costs - 0 2 0 (2) Against the owner for non-compliance with Notice of Council to cleanse the premises and make good defective drains at No. 111 Vauxhall Street. The Magistrate made an order to do the work in 14 days and defendant to pay 2/0 costs - 0 2 0 (3) Against the owner for non-compliance with Notice of Council to provide a proper water supply at 324 Kennington Road. The Magistrate made an Order for the water supply to be reinstated within 14 days and defendant to pay 4s. costs - 0 4 0 On 23rd December, two summonses were heard before Mr. Chapman: (1) against the first floor tenant of 98 Strathleven Road, for non-compliance with Notice of Council to remove an accumulation of house refuse on flat roof used as a yard in connection with the first floor tenement. Summons withdrawn, the defendant being granted a summons to be heard the same day against the Lambeth Borough Council (see below). - - (2) Against the Lambeth Borough Council, under section •SO, Public Health (London) Act, 1891, for non-removal of dust from the first floor tenement of 98 Strathleven Road. No order made, subject to the carrying out of the following conditions:—(a) occupier to bring refuse down to ground floor (front forecourt), twice weekly, at 7.30 a.m. in small bin (to be provided bv the owner) and (b) Council to remove the refuse from the ground floor twice weekly—Tuesdays and Fridays, at 8 a.m. - - Totals 3 0 0 5 10 0 52 53 1009. 1909. CASES OF ILLNESS NOTIFIED FROM L.C.C. SCHOOLS, &c., TO MEDICAL OFFICER OF HEALTH. Schools Measles Chicken Pox Whooping Cough Scarlet Fever Ringworm Mumps Diphtheria Typhoid Fever Eczema Blight Itch Erysipelas Influenza Scabies Ophthalmia Croup Sore Throat Glass Pox Impetigo Phthisis Sores Vermin St. Vitus Dance Cerebro Spinal Meningitis Tonsilitis Totals Addington Street 28 18 14 11 13 4 6 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 95 Aristotle Road ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Archbishop Sumner's, Reedworth Street 34 7 9 22 3 13 2 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 91 Archbishop Temple's, Lambeth Road ... ... ...... ... ... ... ... ... ... ... ... ... ... 5 ... ... ... ... ... ... ... ... ... ... ... 5 Archbishop Tenison's, High Street ... ... ... 10 ... 2 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 14 Beresford Street 2 ... ... 3 1 ... 1 ... ... 1 ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... 10 Bonneville Road 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 Boundary Lane ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Cavendish Road ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Christ Church, Cancell Road 7 50 29 5 6 ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 100 Christ Church, Christ Church Road ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Church Street 25 15 ... 8 8 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 57 Cormont Road 16 11 32 27 6 2 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 98 Crampton Street 13 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 15 Crawford Street 67 15 8 8 9 ... 2 ... 2 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 112 Dulwich Hamlet, S.E. ... ... ... 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 Effra Parade 67 29 39 26 30 17 12 ... ... ... ... ... ... ... 1 ... ... ... ... 2 ... ... ... ... ... 224 Faunce Street ... 3 ... 3 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 Fountain Street 34 26 38 9 17 1 2 ... ... ... ... ... ... ... 23 ... 2 ... ... ... ... ... ... ... ... 152 Gipsy Road 6 25 32 39 58 89 22 ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... 278 Grove Lane ... ... 3 9 1 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 Hackford Road 3 36 47 12 20 9 6 ... ... ... ... 1 ... 1 3 ... ... ... ... ... ... ... ... ... ... 138 Haselrigge Road 9 27 2 2 1 6 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 50 Hatfield Street 135 13 20 3 17 2 7 ... 5 8 2 ... 3 ... ... ... 1 ... 1 3 ... ... ... ... 220 Hitherfield Road 20 ... 6 1 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 31 Holv Trinity, Carlisle Street 31 2 5 6 2 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 49 Holy Trinity, Lutheran Place 1 4 ... 4 1 1 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 12 Jessop Road 56 8 25 20 20 28 3 ... ... ... ... ... ... 1 4 ... ... ... ... ... ... ... ... ... ... 160 Johanna Street ... ... ... 2 ... 1 1 ... ... ... ... ... ... 1 4 ... ... ... 1 ... ... ... ... ... ... 10 Kennington Road 5 3 1 7 3 ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 22 Larkhall Lane 2 1 11 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 15 Lawn Lane 69 23 25 12 5 39 7 ... 5 ... ... ... ... 3 4 ... ... ... ... ... 7 ... ... ... ... 199 Leipsic Road 5 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 Lollard Street 47 7 12 22 6 3 8 ... ... 11 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 117 Lyham Road 7 20 5 41 25 32 3 ... 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1???7 Marlborough Street 44 5 8 1 5 21 2 ... ... 3 ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... 92 Millbank 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 National, Lingham Street 6 7 6 18 12 43 7 ... 3 ... ... ... ... 4 ... ... ... ... ... .1 ... ... .1 ... ... 108 New Park Road 1 2 ... 2 1 15 1 1 ... ... ......... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 New Road ... 1 1 1 ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Old Kent Road ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Orange Street 54 55 CASES OF ILLNESS, &c.,-Continued. Schools. Measles Chicken Pox Whooping Cough Scarlet Fever Ringworm Mumps Diphtheria Typhoid Fever Eczema Blight Itch Erysipelas Influenza Scabies Ophthalmia Croup Sore Threat Glass Pox Impetigo Phthisis Sores Vermin St. Vitus Dance Cerebro Spinal Menine-itis Tonsilitis Totals Penrose Street 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... 1 Pocock Street ... ... ... ... 3 1 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 Priory Grove 84 21 34 6 23 59 2 ... ... 5 ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... 236 Rockingham Street ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Rosendale Road 137 25 7 21 16 87 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 299 St. Agnes', Farmers Road 3 2 6 ... 3 ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 St. Andrew's, Roupell Street 35 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 35 St Ann's Harleyford Road 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 St. Jon's Camberwell New Road 16 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 16 S. John's Angell Town 1 26 1 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 30 S. John's, Angell town 1 ... ... 4 ... 17 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 St. John's, Exton Street 20 ... ... 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 43 St. Jude's, Colnbrook Street ... ... 1 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 St. Jude's, Railton Road 39 41 23 10 9 12 3 1 ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... 142 St. Mark's, Kennington Oval 15 3 2 9 12 ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 52 St. Marv's, Lambeth Road 29 3 2 4 1 ... 39 St. Mary-the-Less, Pnnce s Koad St. Matthew's, Camberwell New Road 1 A 2 4 ... 1 1 81 St Matthew's, Church Road 37 21 1 Q J D 2 5 12 ] 3 2 53 St. Michael's, Halstead Street 8 Jo 7 1 1 2 St Patrick's. Cornwall Road x 1 1 5 St Patrick's, Stamford Street 2 QQ 9K 19 5 7 3 5 1 1 100 St. Paul's, Gye Street oo 9*7 A. 6 10 7 11 2 1 7 2 1 84 St Peter's, Vauxhall 2 2 2 2 ] ... 75 St Saviour's, Heme Hill Road 32 1 Q 33 2 10 1 ... 49 St. Stephen's, Dorset Koad iy i / 1 1 St. Andrew's Street I 16 76 8 j 14 11 5 "• 3 1 2 1 1 139 Salter's Hill 12 17 33 13 8 8 1 - 1 yy Santley Street 1 ... ••• 1 Sleaford Street 34 117 37 38 21 39 1 1 2 2 3 1 310 South Lambeth Road 68 a 12 2 2 7 | 1 2 O ... 98 Stock well College 2] 4 21 23 4 14 3 j Z 1 1 96 Stockwell Road 1 o I Sunnyhill Road 19 22 14 10 9 ! 2 l 1 2 o 1 1 115 Sussex Road 33 20 15 22 12 7 1 1 4 ] o ... j A 114 1 1 n Upper Kennington Lane 36 9 24 24 8 1 1 3 1 2 1 ** IJ o TO Vauxhall Street 30 7 8 21 2 1 t 1 1 15 i 1 i Z rro Walnut Tree Walk ' a 10 21 2 4 2 l ... OB Waterloo Road j i 2 1 2 10 1 2 •* "ir 17 Weslevan, Eden Road 7 6 4 3 2 ... ... ** 5 '• 1 38 Westminster Bridge Road 34 I 11 7 3 1 j 57 9 West Square • 2 ... ... j Z QQ Wirtenburg Street ; 3 ! 2 1 2 11 9 5 Oo i Woodland Road 1 •.. 9 1 11 Wycliffe Road ! 2 2 3 7 1 . * * ' j j i 'Schools not stated 161 6 801 763 676 477 683 189 6 31 52 7 5 8 40 66 2 12 7 4 3 20 2 1 4 1 5476 56 57 DEATH-RATES (CORRECTED) IN METROPOLITAN BOROUGHS DURING 1909 PER 1000 PERSONS LIVING. All Causes Principal Epide'ic Diseases Small-pox Measles Scarlet Fever Diphtheria Whooping-Cough Typhus Enteric Fever Pyrexia† (Origin uncertain) Diarrhœa Phthisis Deaths under 1 year 1000 Births West Crude Corrected* Paddington 12.9 18.8 0.91 ... 0.24 0.09 0.07 0.24 ... 0.03 ... 0.24 1.08 100 Kensington 13.3 14.4 1.00 ... 0.32 0.05 0.10 0.22 ... 0.04 ... 0.27 0.96 113 Hammersmith 14.3 14.9 1.7 ... 0.64 0.09 0.18 0.37 ... 0.04 ... 0.35 1.09 120 Fulham 12.0 12.6 1.57 ... 0.42 0.06 0.23 0.28 ... 0.02 ... 0.56 1.17 108 Chelsea 14.4 15.0 1.00 ... 0.32 0.08 0.20 0.17 ... 0.03 ... 0.20 1.45 107 City of Westminster 13.1 14.7 0.63 0.01 0.15 0.11 0.11 0.11 ... 0.04 ... 0.10 1.34 95 North St. Marylebone 14.6 15.6 0.83 ... 0.26 0.06 0.07 0.20 ... 0.01 ... 0.23 1.35 99 Hampstead 8.9 10.1 0.52 ... 0.15 0.04 0.05 0.19 ... 0.05 ... 0.04 0.61 75 St. Pancras 14.8 15.5 0.97 ... 0.44 0.07 0.11 0.13 ... 0.03 ... 0.19 1.61 102 Islington 14.0 14.6 1.22 ... 0.57 0.07 0.09 0.25 ... 0.04 ... 0.20 1.23 101 Stoke Newington 11.3 11.8 0.63 ... 0.18 0.06 0.04 0.26 ... 0.02 ... 0.07 0.83 80 Hackney 12.6 13.1 0.93 ... 0.24 0.04 0.08 0.22 ... 0.03 ... 0.32 1.22 102 Central Holborn 15.6 16.8 0.85 ... 0.26 0.06 0.06 0.28 ... 0.02 ... 0.17 2.05 102 Finsbury 19.2 19.9 2.36 ... 0.89 0.12 0.15 0.54 ... 0.03 ... 0.63 2.22 131 City of London 20.3 22.3 0.72 ... 0.33 - - 0.22 ... 0.06 ... 0.11 2.15 113 East Shoreditch 19.0 20.0 2.87 ... 1.14 0.08 0.19 0.63 ... 0.05 ... 0.78 1.75 140 Bethnal Green 16.8 17.0 1.99 ... 0.60 0.19 0.13 0.31 ... 0.03 ... 0.73 1.54 129 Stepney 15.3 16.0 1.68 0.00 0.76 0.08 0.16 0.22 ... 0.02 ... 0.44 1.67 119 Poplar 16.3 16.8 2.37 ... 0.91 0.13 0.12 0.49 ... 0.08 ... 0.64 1.29 129 South Southwark 16.8 17.5 1.67 ... 0.60 0.07 0.16 0.27 ... 0.03 ... 0.54 1.79 119 Bermondsey 18.8 19.2 2.74 ... 1.57 0.12 0.07 0.43 ... 0.02 ... 0.53 1.78 138 Lambeth 14.1 14.5 1.19 ... 0.32 0.08 0.18 0.26 ... 0.03 0.00 0.32 1.11 109 Battersea 13.0 14.0 1.29 ... 0.49 0.04 0.12 0.34 ... 0.04 ... 0.26 1.22 107 Wandsworth 11.9 12.5 0.96 ... 0.37 0.05 0.09 0.23 ... 0.02 0.00 0.20 0.93 86 Camberwell 13.4 13.9 1.08 ... 0.37 0.06 0.15 0.18 ... 0.02 ... 0.30 1.19 100 Deptford 13.6 14.3 1.51 ... 0.57 0.10 0.13 0.40 ... 0.05 ... 0.26 1.25 102 Greenwich 12.2 12.4 1.03 ... 0.34 0.08 0.06 0.18 ... 0.04 ... 0.33 0.99 100 Lewisham 10.3 10.8 0.57 ... 0.04 0.09 0.13 0.12 ... 0.01 ... 0.18 0.80 74 Woolwich 11.9 12.8 1.02 ... 0.41 0.14 0.20 0.11 ... 0.02 ... 0.11 1.20 82 County of London 14.0 14.7 1.31 0.00 0.48 0.08 0.13 0.26 ... 0.03 0.00 0.33 1.31 108 N.B.-0.00 indicates that the deaths were too few to give a rate of 0.005; where no death occurred, is inserted. * The Corrected death-rates represent the Crude death-rates multiplied by the respective factors for correction for difference of sex and age constitution of population. † Called Simple Continued Fever previous to 1901. The above table is taken from the Registrar General's Annual Summary, and the rates for Lambeth Borough differ slightly from those given in this Repor 58 Home Office. METROPOLITAN BOROUGH OF LAMBETH, 1909. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—Inspection of Factories, Workshops and Workplaces including inspections made by sanitary inspectors. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (Including Factory Laundries). 26 474 - Workshops (Including Workshop Laundries) 839 Workplaces (Other than Outworkers' Premises included in Part 3 of this Report, pp. 60-61) 104 Total 969 474 - N.B. In addition to the above inspections, visits were also made to 450 workshops and 25 workplaces, but the premises were found to be empty, or the workers not at work, with the result that no inspections could be made. 59 2.- Defects Found in Factories, Workshops and Work- places. Number of defects. No. of cutions. Particulars. Found. Remedied. Referred to H.M. Inspector. Nuisances under the Public Health Acts*: — Want of Cleanliness 158 158 ... ... Want of Ventilation 2 2 ... ... Overcrowding 6 6 ... ... Want of drainage of floors ... ... ... ... Other nuisances 158 158 ... ... Sanitary insufficient ... ... ... ... accommo- unsuitable or defective 288 288 ... ... dations. not separate for sexes 6 6 ... ... Offences under the Factory and Workshops Acts:— Illegal occupation of under- ... ... ... ... ground bakehouse (S. 101) Breach of special sanitary ... ... ... ... requirements for bake houses (SS. 97 to 100) Other offences ... ... ... ... (Excluding offences relating to outwork which are included in Part 3 of this Report) Totals 618 618 ... ... •Including those specified in Sections 2, 3, 7 and 8 of the Factory Act, remediable under the Public Health Acts. 60 61 3. — HOME WORK. NATURE OF WORK OUTWORKERS' LISTS, SECTION 107. Prosecutions OUTWORK in UNWHOLESOME PREMISES Sections 108: UTWORK n INFECTED PREMISES, Sections 109, 110. Lists received from Employers. Address of Outworkers.§ Notices served on Occupiers as to keeping or sending lists. Twice in the year. Once in the year. Received from other Councile. Forworded to other Councils. Inspections of Outworkers premises. Instances. Notices served Prosecutions Instances Orders made (S. 110). Prosecutions (Section 109, 110 Lists. Outworkers. ‡ Lists. Outworkers. Failing to keep or permit inspection of Lists. Failing to send Lists Contractors, Workmen. Contractors Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) Wearing apparel— (i) making, &c 26 8 222 22 ... 169 861 221 ... (2) cleaning and washing ... ... ... ... ... ... 1 ... ... 376 4 Lace, lace curtains, and nets ... ... ... ... ... ... 2 ... ... 1 ... Artificial flowers ... ... ... ... ... ... 6 ... ... 2 ... Nets, other than wire nets ... ... ... ... ... ... ... ... ... 6 ... Tents ... ... ... ... ... ... ... ... ... ... Sacks ... ... ... ... ... ... 1 ... ... ... Furniture and upholstery 2 ... 2 2 ... 9 1 4 ... 1 ... Fur pulling ... ... ... ... ... ... ... ... ... 12 ... Feather sorting ... ... ... ... ... ... ... ... ... ... Umbrellas, &c. ... ... ... ... ... ... 1 ... ... ... Carding, &c., of buttons, &c. ... ... ... ... ... ... ... ... ... 1 ... Paper bags and boxes 6 ... 127 ... ... ... 36 48 ... Nil. Nil. ... Nil. Nil. Nil. ... Nil. Nil. Basket making ... ... ... ... ... ... ... ... ... 163 ... Brush making ... ... ... ... ... 3 15 1 ... ... ... Racquet and tennis balls ... ... ... ... ... ... ... ... ... 18 ... Stuffed toys ... ... ... ... ... ... ... ... ... ... ... File making ... ... ... ... ... ... ... ... ... ... ... Electro-plate ... ... ... ... ... ... ... ... ... ... ... Cables and chains ... ... ... ... ... ... ... ... ... ... ... Anchors and grapnels ... ... ... ... ... ... ... ... ... ... ... Cart gear ... ... ... ... ... ... ... ... ... ... ... Locks, latches and keys ... ... ... ... ... ... ... ... ... ... ... Pea picking ... ... ... ... ... ... ... ... ... ... ... Total 34 8 351 25 ... 181 92 4 274 ... ... ... 580 ... ... ... 4 ... ... If an occupier gives out work of more than one of the classes the number of workers in each class of work, the list is included among specified in column 1, and subdivides his list in such a way as to show only, but the outworkers are assigned in columns 3 and 4 (or 6 and 7) those in column 2 (or 6 as the case may be) against the principal class † The figures required in columns 2, 3 and 4 are the total number of into their respective classes, statutory duty of sending two lists each year and of the entries of names ^ the lists received from those employers who comply strictly with the be even numbers, as there will be two lists for each employer—in some J of outworkers in those lists. The entries in column'2 must necessarily 3 and 4 will usually be (approximately) double of the number of individual previous returns odd numbers have been inserted. The figures in columns of the same employer the same outworker's name will often be repeated. outworkers whose names are given, since in the February and August lists § In view of the wide discrepancies found to exist between the totals care may be taken to give exact figures. Only those addresses should be in the two columns when the returns are added together, it is desired that Councils during the year covered by the report. counted which have actually been received from or forwarded to other N.B.—In addition to the inspections of 580 outworkers' premises, 904 to be at work, or the premises to be vancant. visits were also paid, but the outworkers' were found to have left or not 62 4— Registered Workshops. Workshops on the Register (s. 131) at the end of the year 1909. Number. (1) (2) Bakehouses 214 Restaurants 245 Laundries 126 Dressmakers 226 Tailors 50 Milliners and Mantle Makers 52 Blouse Makers 18 Other Businesses 312 Total number of workshops on Register 1237 5.—Other Matters. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories:- Failure to affix Abstract of the Factory and Workshop Act (s. 133) 36 Action taken in matters referred by H. M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) Notified by H.M. Inspector 10 Reports (of action taken) sent to H. M. Inspector- 10 Other ... Underground Bakehouses (s. 101):— Certificates granted during the year ... In use at the end of the year 72 INDEX. (ii.) Index of Tables. Page A The number of Births and the Birth-Rates in each Registration Sub-District of Lambeth Borough during 1909 (arranged quarterly) 10 B The estimated Populations, numbers of Inhabited Houses, Marriages, Births, and corrected Deaths, for the year 1909 in Lambeth Borough, and for the ten years 1891-1900 in Lambeth Parish 11 C The number of persons per House, the Marriage-, Birth- and Death-Rates, and the proportion of deaths in Public Institutions per 1000 persons, for the year 1909 in Lambeth Borough, and for the ten years 1891-1900 in Lambeth Parish 12 D The number of Births and Deaths with Birth- and Death- Rates in each of the Registration SubDistricts of the Borough during 1909. [The deaths are from all causes and from the chief Zymotic Diseases, and are corrected by adding Lambethians who die outside the Parish, by omitting strangers who die within the Parish, and by re-distributing persons who die in Public Institutions into the districts from which they have been removed during illness] 22—23 E Death-Rates, Zymotic Death-Rates, Birth-Rates and Infantile Mortality Rates in the Registration Sub-Districts of Lambeth Borough during 1908 and 1909 24 F Death-rates, Zymotic Death-Rates, and Zymotic Incidence-Rates in the new Wards of Lambeth Borough during 1908 and 1909 25 (iii.) Page. C The uncorrected mortality, Male and Female, in the different Districts, and a comparison of the number of Deaths in each Quarter within Lambeth Borough during the year 1909 26 H The uncorrected mortality (i.e., including that of Strangers) at different ages in each District of the Lambeth Borough during 1909 27 I The uncorrected Deaths (i.e., Parishioners and Strangers) at various age-periods in each Quarter of the year 1909 28 J The Infantile mortalities in the Registrar-General's old thirty-three large towns of England and Wales (including London), and in Lambeth Borough during 1909, and for five years (19041908) 32 K The number of Certificates for the notifiable Zymotic Diseases received since the introduction of the Notification Act (i.e., for Lambeth Parish in the ten years 1891-1900) and for the Lambeth Borough in the year 1909 38 L The number of infected houses, with percentages of (1) General Defects and, (2) Defective Drains, in Lambeth Borough during the year 1909, and in Lambeth Parish during the ten years 18911900 39—40 M Zymotic seasonal variations in the different Registration Sub-Districts of Lambeth during 1909, with the Zymotic Death-Rates per 1000 inhabitants 41 N Total cases notified under the Notification Clauses of the Public Health (London) Act, in Lambeth Borough during 1909 (arranged quarterly) 42 O Death from Zymotic Diseases (Strangers deducted) 1909 43 P The number of deaths from the principal Zymotic diseases within Lambeth Parish in the ten years, 1891-1900, and within the Lambeth Borough in the year 1909 44—46 (iv.) Page. Q Vaccination Returns (Lambeth). 1908 48 R Vaccination Returns (Lambeth) for the first half- year, 1909 49 S The Diarrhoea Mortality in Lambeth Borough in each month during the year 1909 76 I.—V. Consumption Notifications and Re-Notifications, in the Lambeth Borough, during 1909, in Wards and Registration Sub-Districts 82—88 T The Classification of Causes of deaths in Lambeth Borough during 1909 as compared with 1908— (a) Deaths from all causes and at all ages with percentages of deaths to total deaths (corrected) 94 (b) Deaths of infants under one year of age from the chief infantile diseases and from all causes, expressed in terms of 1000 births 95 U Table of Uncorrected Deaths during the years 1908 and 1909 classified according to Diseases, in the Borough of Lambeth and in London 96 V Table of Deaths during the year 1909, in the Lambeth Borough, Classified according to Diseases. Ages, and Localities. (Local Government Board- old. Table A) 98—101 W Table of Population, Births, and of new cases of Infectious Sickness coming to the knowledge of the Medical Officer of Health during the year 1909, in the Metropolitan Borough of Lambeth, classified according to Diseases and Localities. (Local Government Board old Table B) 102—103 Five new tables of the Local Government Board, giving the— (i.) Vital Statistics of Lambeth Borough during 1909, and of Lambeth Parish during the ten years 1891—1900 Appendix 2 (v.) Page. (ii.) Vital Statistics of Registration Sub-Districts of the Borough of Lambeth in 1909 and of the Parish of Lambeth in the ten years 1891—1900 Appendix 3—4 (iii.) Cases of Infectious Diseases notified within the Borough of Lambeth during the year 1909 , Appendix 5 (iv.) Causes of, and ages at, death during 1909. within the Borough of Lambeth Appendix 6—7 (v.) Infantile Mortality in Lambeth Borough during 1909, deaths from stated causes in weeks and months under one year of age Appendix 8—9 Mortality Tables showing Deaths (corrected) from all causes in I.ambeth Borough during 1909 subdivided— (a) As to Registration Sub-Districts Appendix 10—17 (b) As to different Age-periods Appendix 18—26 Offences (with amount of penalties and costs)— (a) Food and Drugs Acts Appendix 27—42 (b) Public Health and Metropolis Management Acts Appendix 43—51 Cases of Illness notified from Schools to the Medical Officer of Health during 1909 Appendix 52—55 Death-rates (corrected) in Metropolitan Boroughs during 1909, per 1000 persons living Appendix 56—57 Factory and Workshops Acts—Home Office Tables, 1909— (i.) Inspection Appendix 58 (ii.) Defects found Appendix 59 (iii.) Home-Work Appendix 60—61 (iv.) Registered Workshops Appendix 62 (v.) Other matters Appendix 62 General Index. PAGE. Abatement of Nuisances 104 108 „ „ Smoke 163—156 Accidental Deaths 92, 193—197 Adulteration of Butter 159—160 ,, ,, Food and Drugs 156—165 Age-Distribution of Diarrhoea 74 „ „ „ Diphtheria 64 ,, ,, „ Scarlet Fever 52 „ „ „ Typhoid Fever 67 ,, ,, „ Deaths 19 20, 21, 27, 28 ,, ,, ,, Population (Lambeth) 6 Air Temperature and Diarrhoea 73 Alcoholism, Deaths from 91 Alterations of By-laws (suggested) 180 Analysis of Food and Drug 156—165 ,, „ Water 162 Antitoxin, Gratuitous Distribution of 66, 192 Anthrax (Order 1909) 90 Apoplexy, Deaths from 92 Area (Lambeth) 4,97 Atelectasis 92 Bacteriological Laboratory 190—192 Bakehouses 169 Bedding, etc., Disinfected 146—151 „ ,, Destroyed 146—151 Births and Birth Rates 10,11, 12,13, 14, 22—23, 97, 102—103 Births Notification Act, 1907 14, 136—136 Birth Rates in Sub-Districts 10,22—23 Bodies received at Mortuaries 193—196 Bronchitis, Deaths from 92 Burns and Scalds, Deaths from 92,197 Butter, Adulteration of 159—160 (vii.) PAGE. By-laws, Alteration of (suggested) 180 ,, Contravention of 179—180 ,, Offensive Matters 179—180 ,, Decision (Legal) 180—181 Cancer, Deaths from 91 Censal Population (Lambeth) 102—103 Censal Population (London) 8, 9 Cerebro-Spinal Meningitis 50 Certificates (Revenue Act) 168—169 Cholera 61—62 Cholera Contacts 61—62 Circulatory Diseases, Deaths of 92 Clerical Work 198—199 Closure of Schools (Measles) 57—60 Closure of Courts (Marsh Ward) 116—119 Chicken-pox 50 Common Lodging Houses 167 Combined Drainage 109 Complaints 107, 120 Conference on Meat Supply 182—183 Contravention, By-laws 178—180 Control of Drainage (supervision) 119 Conscientious Objectors 47—49 Congenital Malformations 92 Constitutional Diseases 91 Consumption (See Tuberculosis and Phthisis) Contacts 47, 61—62, 69 Continued Fever 69 Conveniences (Underground) 155—156 Convictions under Public Health Acts Appendix 43—51 Convictions under Food and Drugs Acts Appendix 27—42 Convulsions, Deaths from 92 Coroners' Courts 193—196 Costermongers (Food sold by) 189 Costs, Food and Drugs Appendix 27—12 Costs, Public Health Acts Appendix 43—51 Courts (Closure of) 116—119 Cowhouses 174—176 Cowhouses, List of 175 Critical Temperature (Earth) and Diarrhæa 73 Croup (See Membranous Croup) Customs and Inland Revenue Acts (See Revenue Act) Dairies (See Milkshops) Deaths and Death-rates 15—103 Appendix, 2—4. 6—26, 56—57 ,, Inner and Outer Wards 17—18, 4—25 (viii.) PAGE. Deaths (arranged quarterly) 26,28 ,, Metropolitan Boroughs Appendix 56—57 „ Corrected 15, 17—25, 97 ,, Uncorrected 15,26—28,98—101 ,, In Public Institutions 11—12, 15—17 ,, Zymotic 11—12, 33—91, 97 ,, Under 1 year 11—12, 29—32, 97 Appendix 8—9 ,, Under 5 years 11—12, 28 ,, from violence 92, 197 ,, from ill-defined and non-specified causes 92 Delirium Tremens, Deaths from 91 Density per acre (Lambeth) 97 Dentition, Diseases of 92 Depositing (Refuse) 182 Depots (Refuse and Manure) 182 Depot (Milk) 136—144 Developmental Diseases 92 Diagnosis (Bacteriological) 190—192 Diarrhoea 73—77 ,, Age Distribution of 74 ,, Monthly Mortality 76 ,, Inner and Outer Wards 75 ,, Registration Sub-Districts 74 Dietetic Diseases 91 Digestive System, Diseases of 92 Diphtheria 62—65 „ Age Distribution of 64 ,, Antitoxin in 65 ,, Decrease of 62—64 ,, Bacteriological Examination in 65,190—192 ,, Registration Sub-Districts 65 ,, Pseudo-Bacilli 185 Disinfection, Details of 146—151 ,, Statistics 150—151 ,, Certificates 148 Disinfecting Department 146—151 ,, Refuges 149 Distribution (free) of Antitoxin 65. 186 Drain Testing 36—10, 107, 119 Drain Testing with Water 107,119 Drainage Defects 30—40, 107 ,, Gases 176—179 ,, Control of (supervision) 119 ,, Combined 109 (ix.) PAGE. Drainage, Legal Proceedings 109, 176—179 Dropsy, Deaths from 92 Drowning, Deaths from 92, 197 Duchy of Cornwall Property 116—119 Dust Depots 182 Earth Temperatures and Diarrhoea 73 Effluvium Nuisances 183—187 Enteric Fever (See Typhoid) Enteritis 73, 75, 92 Epidemic Cerebro-Spinal Meningitis 50 Epidemic Influenza 90—91 Epilepsy, Deaths from 92 Erysipelas 71—72 Expenses (Food and Drugs) 162 Factory and Workshops 128—134 Factory Home Office Tables Appendix 58—62 Female Sanitary Inspectors 120—134 Female Health Visitor 135—136 Food and Drugs, Adulteration of 156—165 ,, ,, Convictions 156, Appendix 27—42 ,, ,, Legal Proceedings (Summary) 161 Food, Unsound 114—115 Furnished Rooms, Proposed Legislation 166—167 Glanders 89—90 Glanders, Order (Notification) 90 Greengrocers (Circular Letter) 113 Health Visitor 135—136 Homicide, Deaths from 92, 197 Home Office Tables (Factory and Workshops) Appendix 58—62 House to House Inspections 109—113 Houses (Lambeth) 9 ,, let in Lodgings 166—167 ,, ,, ,, Proposed Legislation 166—167 Housing of the Working Classes 169 Hydrophobia (Order, 1909) 90 Increase of Population (Lambeth) 4, 9T ,, „ (London) 9 Infantile Mortality. 1909 29—32 , 97 Appendix 8—9 ,, „ (London and 33 large Towns of England and Wales) 32 Infected Houses 33—37,104 ,, ,, and Drains 33—37 Infectious Cases removed 34—3o, 102—103 „ ,, notified 34—35 Appendix 5, 52—55 ,, ,, ,, by Sch6ols 102—103 Appendix 52—55 (X.) PAGE. Infectious Diseases Inspections 33—37 Influenza (Epidemic) 90—91 Inhabited Houses of Lambeth Borough 9, 97 Inner and Outer Districts and Wards—Deaths and Births 17—18, 24—25 Inquests 197 Inspections 105—108, 120—124 ,, House to House 109—113 ,, Market Thoroughfares 113 Inspector, Females 120—134 ,, Males 108—120 ,, Food and Drugs 156—165 ,, Health Visitor 135—136 „ Smoke 153—155 Institution Deaths 11, 12, 15—17 Integumentary System, Diseases of 92 Introductory Letter 3 Laboratory (Bacteriological) 190—192 Lambeth Statistics 4—103 Appendix 2—26 Lavatories (Underground) 155—156 Letters (sent and received) 198 Licensed Victuallers School (rubella) 51 Liver, Diseases of 92 Local Diseases—Nervous System, Heart. Respiratory Organs, Digestive and Urinary Systems and Reproductive System 92 Locomotive System, Diseases of 92 Local Government Board, Old Tables A and B 98—103 ,, ,, ,, New Tables i., ii., iii., iv., Appendix 2—9 Lodging-houses (Common) 167 London (County of), Vital Statistics, 1909 8, 9 London, No. of Births. Deaths and Marriages, 1909 9 London Zymotic Deaths, 1909 44—45 Lymphatic System, Diseases of 92 Male Sanitary Inspectors 108—120 Manure Depots 182 Manure, Depositing of 187 Market Thoroughfares (inspection) 113 Marriage and Marriage Rates (Lambeth) 11, 12, 14. 97 Measles 55—60 ,, Registration Sub-Districts 61 ,, and School Closure 57—60 Meat Supply (Conference) 188—189 Membranous Croup 66 Meningitis (Tubercular) 91 (xi) PAGE. Meningitis (Cerebro-Spinal) 50 Milk Depot (municipal) 136—144 Milk and Scarlet Fever outbreak 54—55 Milk Stores (See Milkshops) Milkshops 1"1 Mortality Rates, 1909 12, 15—97 ,, Different Age Periods (Lambeth and London) 19—20, 21 ,, Different Diseases (Lambeth Borough) 94—96 ,, Different Diseases (Lambeth and London) 96 „ under 1 year (London and Lambeth) 11—12, 27, 28, 97 ,, Tables Appendix 10—26 ,, Tables, Sub-Districts ,, 10—17 ,, Tables, Age Periods ,, 18—26 Mortuary, High Street 194 ,, for Norwood 194 Mortuaries 193—196 ,, Keepers of 194 Natural Causes, Deaths from 197 ,, Increment of Population (Lambeth) 4, 97 „ „ „ (London) 9 Nervous System, Diseases of 92 New Wards (Lambeth Borough) 4 ,, General Diseases, Deaths 25 ,, Population (estimated) 4 ,, Tuberculosis 82, 84—85, 88 ,, Zymotic Diseases 25 ,, Zymotic Incidence 25 Notices served 104—108, 119 120, 122, 199 Non-notifiable Infectious Diseases 152 Notification Certificates received, 1909 34 , 38, 102— 103, Appendix 5 ,, Certificates received (Quarterly) 1909 42 „ (Voluntary) of Consumption 82—88 ,, (Compulsory) of Consumption 84—88 Notification of Births Act, 1907 135—136 Nuisances Abated 104—108 ,, from Effluvia 183—187 Observations (smoke) 153 Offences, Public Health Acts Appendix 43—51 ,, Food and Drugs Acts ,, 27—42 Offensive Matters (Depositing) 182 ,, ,, (Removal) 182 Offensive Trades 169—171 (xii.) PAGE. Old Age, Deaths from 92 Organs of Special Senses (Diseases of) 92 Outer and Inner Wards, Deaths and Births 17—18, 25 Outside Urinals (Public Houses) 113 Outworkers 125—127 Parasitic Diseases 91 Parliamentary Divisions 7 Penalties Appendix 27—51 ,, Public Health Acts ,, 43—51 ,, Food and Drugs Acts ,, 27—42 Peritonitis, Deaths from 92 Persons per House 9, 97 ,, Acre 97 Persons (Protected) 129 Phthisis, Deaths from 77—89, 91 „ Voluntary notification of 78—88 ,, Compulsory notification of 84—88 Plague 61—62 Plans of Drainage 107, 119 Pneumonia, Deaths from 92 Population of Lambeth Borough, 1909 4, 97 ,, ,, Sub-Districts o „ ,, ,, Parliamentary and New Wards 4, 7 ,, „ ,, Age Periods 6 Population of London, 1909 8, 9 „ ,, Sub-Districts (New) 8 Post-mortems 193—197 Premature Births (Deaths from) 92 Premises Disinfected 146 Preservatives in Milk 157 Prosecutions Appendix 27—51 „ Public Health Acts 108 ,, 43—51 ., Food and Drugs Acts 108. 156—165 Appendix 27—12 Protected Persons (Workshops) 129 Pseudo-Bacilli and Diphtheria 191 Public Houses, Urinals of 113 Public Institutions, Deaths 11—12, 15—17 Public Health Acts (Convictions) Appendix 43—51 Public Health Officers Bill 144—145 Public Health (Tuberculosis) Regulations, 1908 81—88 Puerperal Fever 70, 72 Quarterly Returns (Lambeth)— Births 10 (xiii.) PAGE. Quarterly Returns (Lambeth)— Deaths (Zymotic and General) 26, 28, 41, 46 Notifiable Infectious Diseases 42 Disinfection Certificates 148 Rateable Value (Lambeth Rorough) 9 Refuges 149 Refuse Depots 182 Refuse, Depositing of (Manure) 182 Registration Sub-Districts (Lambeth Rorough)- ,, ,, ,, Births 10, 22—23 ,, ,, ,, Population (estimated) 5 ,, ,, ,, General Diseases Deaths 22—23, 24, 26—27, 98—101 ,, ,, ,, Infantile Mortality 30 ,, ,, Tuberculosis (Deaths) 78 „ ,, ,, Tuberculosis (Notifications) 82—88 ,, ,, ,, Zymotic 22—23, 41, 98—101 ., ,, ,, Vaccination Returns 48—49 Re-inspections 107, 120 Removal of Infectious Diseases 34. 102—103 Removal of Snow 192 Reproductive System, Diseases of 92 Respiratory Diseases 92 Revenue Act, 1903 168—169 Routine Work (Male Inspectors) 119—120 Rubella (Licensed Victuallers' School) 51 Samples, Food and Drugs 156—165 Salter's Hill School (Troughs) 178—179 Sanatorium Treatment (Consumption) 89 Sanitary Defects 104—108 ,, Inspectors 108—124 „ Inspectors, Males 108—120 ,, Inspectors, Females 120—124 Work 104-198 ,, Structural 105—106 ,, Non-structural 105—106 Scalds, Deaths from 92, 197 Scarlet Fever 51—55 ,, Age Distribution 52 „ Registration Districts 53 ,, and School Attendances 53 ,, and Milk 54—55 ,, Outbreak at Workhouse 55 ,, Outbreaks at Schools 53 School Closure and Measles 57—60 Simple or Continued Fever 60 (xiv.) PAGE. Slaughterhouses 171—174 „ List of 172—173 Smallpox 47 „ Contacts 47 Smoke Nuisance and Abatement 153—155 ,, Observations 153—155 Snow (Removal of) 187 Spotted Fever (See Cerebro-Spinal Meningitis). Stables, Nuisance from Manure 182 Staffs— Clerical 198—199 Inspectorial (male) 108—120 ,, (female) 120—134 Health Visitor 135—136 Disinfecting 143 Mortuary Attendants 194 Underground Conveniences 155—156 Suffocation in Bed 92 Suicide and Homicide, Deaths from 92, 197 Summary of Vital Statistics (Lambeth Borough), 1909 97 „ ,, Sanitary Work 107—108 ,, ,, Work by Female Inspectors 124 ,, ,, Legal Proceedings (Food and Drugs) 161 ,, ,, Death Returns Appendix 26 Summonses 108 Appendix 27—51 Supervision (Drainage) 119 Syphilis 91 Tables (special)— Local Government Board (old) A and B 98—103 „ „ „ (new) i., ii., iii., iv., v. Appendix 2—9 Home Office (Factory and Workshops) Appendix 58—62 Tables (special)— Mortality (Lambeth)— Registration Sub-Districts Appendix 8—15 Age periods 16—26 Temperature (Air and Earth) 73 Testing of Drains 35—40, 107—108,119 Trades (Offensive) 169—171 Troughs (Salters Hill School) 178—179 Tuberculosis, Deaths from 77—78 ,, and Bacteriological Examinations 78, 184 „ Exhibition 89 „ Registration Sub-Districts 78 (xv). PAGE. Tuberculosis and Preventive Measures 77—89 ,, Notifications and Renotifications 78—88 ,, Regulations, 1908 84—88 ,, Sanatorium Treatment 89 Typhoid Fever 66—69 ,, Age Distribution of 67 ,, Bacteriological Examinations 69, 185 ,, Contacts 69 ,, Registration Sub-Districts 68 ,, Inner and Outer Wards 68 ,, Sources of Infection 68 Typhus 69 Underground Bakehouses 169 ,, Conveniences 165—156 Unsound Food 114—115 Urine, Bacteriological Examination of 191 Urinals (Public Houses) 113 Urinary Diseases, Deaths from 92 Vaccination 47—49 Varicella (See Chicken-pox). Venereal Diseases 91 Violent Deaths 92 Visitor, Health 135—136 Vital Statistics, London 8, 9, 19 „ „ Lambeth 4—103 Af-pendix 2—26 ,, ,, Summary (Lambeth) 97 Wards, Population (estimated) 4 ,, Deaths and Death-Rates 25 ,, Zymotic Incidence 25. Water Analysis 162 ,, Certificates 119 Whooping Cough 55—56,60—61 ,, ,, Registration Sub-Districts 61 Work of Sanitary Staff 104—198 Workhouse (Scarlet Fever) 55 Workplaces (See Workshops) Workshops 120—124,128—134 ,, Defects found in 121—123,130—133 ,, Female Inspector in 120—124 ., Outworkers 125—127 ,, Overcrowding in 122, 130, 132—133 ,, Home Office Tables Appendix 58—62 ,, Persons employed in 134 ,, Protected Persons 129 ,, Trades, etc. 125—128 (xvi.) PAGE Zymotic Diseases 33—91,97 „ Deaths, arranged Quarterly 41, 46 ,, ,, ,, Monthly 43 ,, Incidence in new Wards 25 ,, Incidence in Registration Sub-Districts 22—23 41, 102—103 „ Principal Deaths (Lambeth) 44—45 „ Principal Deaths (London) 44—45 „ Seasonal Variations 41