LAM 62 REPORT ON THE VITAL AND SANITARY STATISTICS OF THE Borough of Lambeth DURING THE YEAR 1907 [ With an account of the work done by the Sanitary Inspectors, 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. London: Printed by Fredk. Tarrant & Co., Ltd., 108 & no, Camberwell Road, S.E. 3 Public Health Department, 333, Kennington Road, S.E. March, 1908. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Lambeth. Mr. Mayor and Gentlemen, In presenting the 1907 Report, dealing with the Vital and Mortal Statistics of the Borough of Lambeth, it is my privilege to be able to chronicle the lowest mortality and zymotic rates in the history of the Borough, or of the old Parish. The infantile mortality rate is extraordinarily low—a fact due in part to the favourable meteorological conditions that existed during the year, and in part to the precautionary measures that are being taken by the Council for the prevention of Infantile Mortality, more especially the influence of the milk depot and the systematic visiting of houses wherein births have occurred, or deaths of infants under one year of age. Calling for special congratulation are the decisions arrived at during 1907 by the Council (1) to appoint a Health Visitor, and (2) to adopt the Notification of Births Act, 1907, throughout the Borough. The Registrar-General's alterations of the registration subdistricts, which now practically coincide, and are co-terminous, with the Wards, are adopted in this Report, and will be adopted in all future Reports. 4 To the Chief Officers of the Council, and to the Public Health Staff, my thanks are due for help readily accorded at all times in carrying out my duties as Medical Officer of Health, 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. 5 I. VITAL STATISTICS. The Borough of Lambeth contains 4079.6 statute acres, exclusive of 82T tidal water, 0.8 inland water, and 31.1 foreshore, with an estimated total population of 318538 persons to the middle of 1907, consisting of 150830 males and 167708 females, or an excess of 16878 females. The total estimated increase (1906-1907) of the population is 2764, but the "natural increment," i.e., the excess of births over deaths (uncorrected) is 3724, so that an exodus of 960 in excess of those who came into the Borough during 1907 must be assumed. The estimated Populations of the Borough of Lambeth to the middle of 1907 may be tabulated as follow:— Estimated Populations. (Estimated, Middle 1907.) 1. 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. 26251 Bishop's Prince's 31500 49647 Vauxhall Stockwell 32828 33946 Brixton 46011 Heme Hill 34167 Tulse Hill 30169 Norwood 34019 Borough of Lambeth 150830 167708 318538 6 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. 26251 Lambeth Church 26743 Kennington 54404 Stockwell 66774 Brixton 80178 Norwood 64188 Borough of Lambeth 150830 167708 318538 7 III. Age-Periods. Age-Periods. Males. Females. Total. 0—1 3857 3851 7708 1—5 13300 13204 26504 Total under 5 17157 17055 34212 5—20 43900 45831 89731 20—40 52685 59823 112508 40—60 27869 31309 59178 60—80 8707 12582 21289 80 upwards 512 1108 1620 Total over 5 133673 150653 284326 8 IV. Parliamentary Divisions (Old). Old Parliamentary Divisions. Males. Females. Total. North 29001 28999 58000 Kennington 40742 40871 81613 Brixton 36555 42437 78992 Norwood 43465 53703 97168 Parliamentary Area of Lambeth 149763 166010 315773 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 57751 Bishop's Kennington Prince's 82475 Vauxhall Brixton Stockwell 79957 Brixton Norwood Herne Hill Tulse Hill 98355 Norwood *Adjusted Parliamentary Area of Lambeth — 318538 * N.B.—By the adjustment of the old Parliamentary Divisions so as to be co-terminous with the new wards. 9 1907-— Groups of Metropolitan Boroughs (corrected rates). Enumerated Population, 1891 (Census). Enumerated Population, 1901 (Census). Estimated Population, 1907 (middle of year). Birth-Rate. Death-Rate. Zymotic DeathRate. Deaths under 1 year to 1000 Births. London 4228317 4536541 4758218 25.6 14.6 1.42 116 South Group 1524472 1749956 1902396 26.1 14.1 1.38 114 West Group 770022 826985 867913 21.8 13.6 1.18 117 North Group 1013707 1056070 1089231 23.2 13.9 1.15 108 Central Group 214464 187791 172176 24.5 18.1 1.53 128 East Group 705652 715739 726502 32.6 17.1 2.17 128 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. 10 Houses.* At the time of the Census, 1901, there were within the Borough of Lambeth 41511 inhabited houses and 1825 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 38899. The estimated number of inhabited houses to the middle of 1907 is 43143, which, with an estimated population (to the middle of 1907) of 318538 gives an average of 7.3 persons per inhabited house. Rateable Value. The rateable value of the Borough for the year ending April 6th, 1907, was £1956137, and a 1d. rate per is estimated to produce £7660 net for the year ending March 31st, 1907, 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 1907 as 4758218 consisting of 2245748 males, and 2512470 females, and states that there were registered during the year 40541 marriages, 122205 births (62304 males and 59901 females), and 72127 deaths (30995 males and 35132 females). There were registered 6800 deaths from the seven chief zymotic diseases. The excess of registered births over deaths, i.e., the natural increment, is 50078, and the estimated increase of population from the middle of 1906 to the middle of 1907 is 37001. * 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. II Alterations in constitution of the Sub-Districts of the Lambeth Registration District. On July 19th, 1906, the Registrar-General addressed a letter to the Local Government Board suggesting a re arrangement of the Sub-Districts of the Lambeth Registration District, with due regard to the Boundaries of the Wards of Lambeth Metropolitan Borough—a desirable improvement. The sanction of the Board was given under the provisions of Section 21 of 37 and 38 Vict, c. 88, by the issuing of an Order to effect such re-arrangement, in the following manner:— 1. The present Waterloo Road Sub-District having in 1901 a population of 27,440 to remain as at present constituted (viz., of Marsh Ward), but to be re-named Waterloo; 2. —A Sub-District to be called and known as Lambeth Church Sub-District, and to consist of the whole of Bishop's Ward, except that part of it situate on the east of the centre of Kennington Road, together with the two small parts of Prince's Ward situated to the north of the centre of Broad Street and Prince's Road. The population of this Sub-District according to the census of 1901, would be about 27,440 ; 3.—A Sub-District to be called and known as Kennington Sub-District, and to consist of the whole of Prince's Ward except the two small parts of it proposed to be included in Lambeth Church Sub-District together with the part of Bishop's Ward not proposed to be comprised in Lambeth Church Sub-District. The population of this Sub-District, according to the census of 1901, would be about 52,518 ; 4.—A Sub-District to be called and known as Stockwell Sub- 12 District and to consist of the whole of Vauxhall and Stockwell Wards, the population of which, in 1901, was 63,826; 5.—A Sub-District to be called and known as Brixton SubDistrict, and to consist of the whole of Brixton and Heme Hill Wards, the population of which, in 1901, was 73,673; 6.—A Sub-District to be called and known as Norwood SubDistrict, and to consist of the whole of Tulse Hill and Norwood Wards, the population of which, in 1901, was 56.998. It was represented to the Registrar-General that, if entire Wards were taken to constitute the proposed Lambeth Church and Keunington Sub-Districts, (a) the boundary between them would not be so well understood as if it were made the centre of Broad Street and Prince's Road, and (b) that Lambeth Workhouse and Infirmary would be divided between the two SubDistricts. For these reasons it has been decided to depart in these instances from the general principle that each Sub-District shall consist of an entire Ward or of entire Wards of Lambeth Metropolitan Borough. The Registrar-General's proposals received the entire concurrence of the Lambeth Board of Guardians and of the Lambeth Borough Council, and are adopted in the present 1907 Report. TABLE A. Giving the number of Births and the Birth-Rates in each New Registration Sub-District of the Borough of Lambeth during 1907 (arranged Quarterly). Registration Sub-Districts. No. of Births. Total for the Year 1907. Rate per 1000 Inhabitants. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Waterloo* 384 376 349 378 1487 56.6* Lambeth Church 197 204 186 162 749 28.1 Kennington† 405 398 385 401 1589 29.2† Stockwell§ 531 516 489 471 2007 301§ Brixton 425 410 396 390 1621 20.2 Norwood 310 313 284 290 1197 18.4 Borough of Lambeth 2252 2217 2089 2092 8650 27.2 * Including Lying-in Hospital (718 cases, of which 187 belong to Lambeth)—corrected rate (i.e., excluding non-Lambethian births) = 36.4. † Including Workhouse (220 cases, of which 200 belong to Lambeth)—corrected rate (i.e., excluding non-Lambethian births) = 28.8. § Including Maternity Hospital (458 cases, of which 106 belong to Lambeth)—corrected rate (i.e., excluding non-Lambethian births) = 24.8. Inner Districts, 34.3; Outer Districts, 21.5 per 1000—uncorrected (whole Borough=27.2). Inner Districts, 30.4; Outer Districts, 21.5 per 1000—corrected (i.e., excluding non-Lambethian births, whole Borough =25.1). 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. 14 TABLE B. Shewing the Estimated Populations, Numbers of Inhabite 1 Houses, Marriages, Births, and Corrected Deaths in the Borough of Latibeth during 1907, 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 1907 318538 43143 2501 8650 4652 941 1458 379 1923 1891 276162 38634 2140 9097 5886 1387 2251 692 1438 Old Parish. 1892 280032 38950 2107 9226 5457 1250 2091 705 1578 1893 283956 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 11900 312152 41470 2454 9467 5430 1328 1884 497 1576 Average 1891-1900 2940497 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. 15 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 1907, and in the old Parish of Lambeth for ten years (1891-1900). The Year Estimated No. of Persons per house. 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 1907 7.3 15.7 27.2 14.6 108.8 202.3 313.4 1.2 309.4 f 1891 73 J 15.5 32.9 21.3 152.5 235.6 382.4 2.5 236.6 Old Parish 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 2.4 295.7 1897 16.3 31.3 17.5 151.8 271.4 400.1 2.4 281.8 1898 17.0 30.4 17.9 154.1 262.6 384.7 2.4 277.1 18:19 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 73 159 316 184 1461 2513 382.9 2.4 2767 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. 16 THE BIRTH-RATE. The total number of Births registered in the Borough of Lambeth during the year 1907 was 8650. Of the total 8650 births, 4396 were males, and 4254 females, showing an excess of 142 males. Of the total 8650 births registered in the Borough of Lambeth, 718 took place in the Lying-in Hospital (York Road), and of these, 187 belong to the Borough; 220 took place in the Workhouse (Brook Street), and of these, 200 belong to the Borough; whilst 458 took place in the Maternity Hospital (Jeffrey's Road), and of these 106 belong to the Borough. Thus, there are 903 births belonging to other districts. The Lying-in Hospital, the Workhouse and the Maternity Hospital tend to abnormally increase the birth-rates in Waterloo, Kennington and Stockwell Districts respectively, and the necessary corrections are, consequently, made in a footnote to Table A (see p. 13). The birth-rate for Lambeth is 27.2 per 1000 inhabitants (29T for males, and 25.4 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 34.3, and that in the Outer Districts 21.5, per 1000—the corrected birth-rates being respectively 25.1 for the whole borough, 30.4 for the Inner, and 21.5 for the Outer, Districts. Tables B and C shew, 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, and is greater in reality than would appear on the surface; for it must be remembered that pari passu with this declining birth-rate is a declining death-rate. 17 Returns of all Births (with addresses of mothers) that occur in Lambeth are now obtained from the District Registrars, and this information is 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 amongst the mothers and others responsible, pamphlets dealing with the proper management and feeding of infants—a routine that has been carefully followed throughout the year. The time allowed for birth registration is 42 days, but this difficulty in administrative procedure will be altered by the Notification of Births Act, 1907, which will be in force within the Borough early in the year 1908. THE MARRIAGE RATE. The number of Marriages registered in the Borough of Lambeth during the year 1907 was 2501 as compared with 2489 during 1906, and a yearly average of 2338 in the old Parish of Lambeth for the 10 years 1891-1900. The marriage-rate for Lambeth Borough during 1907 is therefore, 15.7 per 1000 inhabitants, as compared with 17.04 for London. Tables B and C show the number of marriages and the marriage-rates for the last ten years in the old Parish of Lambeth, and it will again be noticed that the marriage-rate has been gradually, but persistently, falling during that period (as also during the previous decennium). Marriage statistics are of little value. THE DEATH-RATE. The total number of deaths registered in the Borough of Lambeth, during the year 1907, was 4926 as compared with 5028 during 1906, and a yearly average of 5716.7 in the old Parish of Lambeth for the 10 years 1891-1900. Of the total 4926 deaths, 2457 were males and 2469 females, showing an excess of 12 males. b 18 The uncorrected death-rate for Lambeth is, therefore, 15.5 per 1000 inhabitants (16.3 for males and 14.8 for females), as compared with 15.2 for London (16.5 for males and 13.9 for females). These rates are, however, uncorrected, and, on analysing the 4926 deaths registered in the Borough of Lambeth, it is found that 748 represent deaths occurring within the Borough amongst persons not belonging thereto. These deaths are to be deducted, but, on the other hand, there are 474 deaths registered outside the Borough of persons belonging thereto, and these must be added, giving a corrected number of deaths for Lambeth during 1907, of 4652, and a corrected death-rate of 14 6 per 1000 inhabitants, as compared with 15.1 for London (the total corrected number of London deaths being 69268). The outside Institutions, &c., where the 474 Lambethians died during 1907, may be grouped as follows:— I. General Hospitals. Charing Cross 22 Cheyne, Chelsea 1 Guy's 38 Alexandra, Holborn 1 King's 9 French 2 London 2 German 2 Middlesex 8 Queen Charlotte's 1 Royal Free 2 Children's, Paddington 1 St. Bartholomew's 11 East London 1 St. George's 3 Great Northern 1 University 5 Seaman's, Greenwich 1 Westminster 40 II. Special Hospitals. Bolingbroke 4 Evelina 11 Brompton 6 Grosvenor Hospital 5 Cancer 2 Gt. Ormond Street 5 Central London Sick 3 Heart Hospital, Soho 2 Homæpathic 1 19 II. Special Hospitals—continued. Hostel of God 6 St. Luke's Italian 1 St. Mary's 3 Metropolitan 1 St. Peter's 1 St. Joseph's Hospice 3 Victoria Hospital 3 Fever. Gore Farm 2 North Eastern 1 Grove 12 South Eastern 1 Fountain 1 Eastern 1 II. Infirmaries and Workhouses. Battersea Infirmary 1 Whitechapel Infirmary 1 Bermondsey Infirmary 1 St. Pancras Infirmary 3 Camberwell Infirmary 1 Hammersmith Chelsea Infirmary 2 house 1 Hackney Infirmary 1 Hampstead Southwark Infirmary 2 house 1 Fulham Infirmary 1 Strand Workhouse 1 Wandsworth Infirmary 2 Grove Park 1 City Infirmary 1 Aged Pilgrims' Asylum 1 IV. Asylums. Banstead 18 Epileptic 2 Bethlem Royal 3 Hanwell 3 Camberwell House 4 Horton Asylum, Caterham 21 Epsom 23 Cane Hill 31 Leavesden 8 City of London 1 Long Grove, Epsom. 2 Clay bury 8 Manor 5 Darenth 8 Peckham House 3 Dartford 16 Tooling Bee 28 20 Unclassifiable Places. Brought dead to Clapham Junction Station 1 Hospital 2 Private Houses 15 Walworth Road Station (S.E. & C. Rly.) 1 Clapham Common 2 River Thames 10 Streets 4 River Lea 2 In Motor Omnibus 1 Dulwich Common 1 Surrey Canal 1 Summary. I. General Hospitals 151 II. Special and Fever Hospitals 78 III. Infirmaries and Workhouses 21 IV. Asylums 184 V. Elsewhere (unclassifiable) 40 474 Whether the corrected or uncorrected death-rates for the Borough of Lambeth (as a whole) be taken, they are very satisfactory for the year 1907, the seventh year of existence of the newly-formed Borough. Sub-dividing the death-rates amongst the 6 new Registration Sub-Districts, it will be again noted that he Inner Districts, e.g., Waterloo, Lambeth Church, Kennington, and part of Stockwell, have, collectively and individually, suffered more than the Outer Districts, e.g., part of Stockwell, Brixton and Norwood. So, too, if the death-rates be subdivided amongst the 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 Taking the Registration Sub-Districts (Table E), and the new Wards (Table F), into which the Borough is sub-divided, the corrected death-rates for 1907 will be found to vary between the Inner and the Outer Districts as follows:— 1907. New Registration Sub-Districts. New Wards. Inner. Outer. Inner. Outer. General Death-rate (corrected) 18.2 11.8 18.2 11.8 Zymotic Death-rate (corrected) 1.8 0.7 1.8 0.7 Of the new Registration Sub-Districts, Lambeth Church has the highest, and Norwood the lowest, general death-rates, and Waterloo the highest, and Norwood the lowest, zymotic deathrates; whilst of the New Wards, Bishop's has the highest, and Tulse Hill and Stockwell the lowest, general death-rates, and Marsh the highest, and Stockwell the lowest, zymotic death rates. Tables G, H and I shew the uncorrected returns (male and female) arranged as to Registration Sub-Districts, age periods, and quarters respectively, and are given for comparison with similiar tables in former Lambeth Reports. The place that the Borough of Lambeth takes during 1907 in the Registrar-General's corrected Returns amongst the Metropolitan Districts is satisfactory, there being 15 other districts (out of 29) with a less general death-rate, 12 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.: 11.5, and 21 they live, are also matters to bear in mind when dealing with this subject. 22 Bermondsey the highest, viz.: 18.8, as compared with 14.6 for Lambeth, 13.3 for Battersea, 13.9 for Camberwell, and 18.0 for Southwark. London, as a whole, has a birth-rate of 25.6, corrected deathrate of 14.6, a corrected zymotic (death-) rate of 1.4 per 1000 population, and an infant mortality (corrected) of 116 per 1000 births; and England and Wales a birth-rate of 26.3, a death-rate of 15.0, a zymotic death-rate of 13 per 1000 population, and an infantile mortality of 118 per 1000 births; and the RegistrarGeneral's 76 great towns of England and Wales a birth-rate of 27.0, a death-rate of 15.4, a zymotic death-rate of 1.5 per 1000 population, and an infantile mortality of 127 per 1000 births. Age-Periods of Corrected Deaths. The 4652 corrected deaths during 1907 may be furti er analysed, and tabulated as follow:— 941, i.e., 20.2 per cent. of the total (corrected) deaths too place under 1 year of age. 517, i.e., 1l.l ,, between 1 and 5 years. 1458, i.e., 313 ,, under 5 years. 226, i.e., 4.9 ,, between 5 and 20 years. 529, i.e., 11.4 ,, 20 to 40 years. 904, i.e., 19.4 ,, 40 to 60 years. 1187, i.e., 25.5 ,, 60 to 80 years. 348, i.e., 7.5 ,, 80 years and over. 3194, i.e., 68.7 ,, over 5 years. These results may be compared with those for London given in the Table on p. 23 which shows the|estimated mortalities per 1000 persons at each age-period for London during 1907 and the London averages for the 10 years 1881-90. 23 TABLE Shewing Mortalities in Lambeth Borough at different Age-periods during 1907, compared with (1) those for London 1907, and (2) the averages for London 1881-90. Age-Periods. LAMBETH. LONDON. Estimated Populations (middle 1907). Mortality Rates per 1000 Population, 1907. Corrected. Uncorrected. Mortality Rates per 1000 Population, 1907. Uncorrected. Average of Ten Years, 1881 - 90, per 1000. 0—5 34212 42.6 47.8 43.9 68.4 5—20 89731 2.5 6.3 6.8 2.8 4.3 20—40 112508 4.7 5.04 7.7 40—60 59178 15.3 16.9 20.2 60—80 21289 55.8 67.0 66.4 59.6 63.3 80 and upwards 1620 214.8 211.1 206.3 *Under 1 year (Births) 8650 108.8 l20.7 117.9 152.0 All Ages 318538 14.6 15.2 15.2 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. 24 TABLE D. • Shewing the number of Births and Deaths, with Birth- and Borough during 1907. The Deaths are from all causes, and Lambethians who die outside the Borough, by omitting strangers (who die in Public Institutions) into the Districts from which REGISTRATION SUBDISTRICTS. Estimated Population (middle 1907). Total Births (uncorrected). Birth-rate per 1000 of the Population. Total Deaths (corrected). General corrected Deathrate per 1000 of the Population. Small Pox. Measles. Waterloo* 26251 1487 56.6* 559 21.3 ... 19 Lambeth Church 26748 749 28.1 589 22.02 ... 19 Kennington† 54404 1589 29.2† 872 16.03 ... 33 Stockwell§ 66774 2007 30.1§ 900 13.5 ... 15 Brixton 80178 1621 20.2 1012 12.6 ... 12 Norwood 64188 1197 18.4 720 11.2 ... 9 Borough of Lambeth 318538 8650 27.2 4652 14 6 ... 107 * Excluding all the Lying-in Hospital births, † Excluding all the Workhouse births, § Excluding all the Maternity births, Of the 900 deaths in Stockwell New Registration Sub-District, Inner Registration Sub-Districts— death rates Outer Registration Sub-Districts—death rates 25 TABLE D. Death-rates in each of the Registration Sub-Districts of the from the chief zymotic diseases, and are corrected by adding who die within the Borough, and by re-distributing persons they have been removed during illness. Total Deaths (corrected) from Total Zymotic Deaths. Zymotic Death-rate per iooo of the Population (corrected). Zymotic Death rate per iooo of the Total Deaths (corrected). Diarrhoea Death-rate per ioooo ot the Population. Infantile Mortality per 1000 Births (uncorrected). Scarlet Fever. Diphtheria and Membranous Croup. Whooping Cough. Typhus. Typhoid or Enteric. Continued Fever. Diarrhoea. 3 2 20 1 13 58 2.2 107.8 5.4 114.3 7 7 9 1 12 55 2.1 95.1 4.2 245.7 7 8 19 ... 2 15 84 1.5 95.5 2.6 128.7 16 9 16 ... 1 ... 11 68 1.2 75.3 1.5 77.7 3 17 27 ... ... ... 9 68 0.8 66.3 1.3 138.2 2 4 20 ... ... 11 46 0.7 63.4 1.7 88.6 38 47 111 5 71 379 1.2 81.5 2.2 120.7 the corrected birth-rate = 29.3 per 1000. the corrected birth-rate = 25.2 per 1000. the corrected birth-rate = 23.2 per 1000. 528 belong to the Inner and 372 to the Outer Districts. (general 18.2, zymotic 1.8). {general 11.8, zymotic 0.7). 26 TABLE E. BOROUGH OF LAMBETH. COMPARISON BETWEEN STATISTICS FOR 1906 and 1907. Old (1906). Registration Sub-Districts. New (1907). Death-Rates. BirthKates. Infantile Mortality. Death-Rates. BirthRales Infan ile Mortality. General 1906. Zymotic 1906. 1900. 1906. General 1907. Zymotic 1907. 1907. 1907. Waterloo 220.5 2.6 53.9 110.1 21.3 2.2 56.6 114.3 Waterloo. Lambeth Church 1st 16.9 2.4 30.7 237.3 22.02 2.1 28.1 245.7 Lambelh Church, Lambeth Church 2nd 21.3 3.2 37.1 173.4 16.03 1.5 29.2 128.7 Kennington. Kennington 1st 14.5 1.2 33.7 82.4 Kennington 2nd 14.4 1.2 22.2 213.3 13.5 1.2 30.1 77.7 Stock well. Brixton 12.1 1.2 20.9 105.5 12.6 0.8 20.2 138.2 Brixton. Norwood 10.4 1.1 18.6 101.4 11.2 0.7 18.4 88.6 Norwood. Borough of Lambeth 14.9 1.7 28.4 132.4 14.6 1.2 27.2 120.7 Borough of Lambeth. Inner Districts 26.5 2.9 41.1 157.7 18.2 1.8 34.3 131.7 Inner Districts. Outer Districts 12.8 1.2 23.3 116.3 11.8 0.7 21.5 106.8 Outer Districts. N.B.—The death-rates (general and zymotic) are corrected, and the birth- and infantile mortali y-rates uncorrected. The death- and birth-rates are per 1000 of the population, and the infantile- and mortality-rates per 1000 total births. 27 TABLE F. BOROUGH OF LAMBETH. COMPARISON BETWEEN STATISTICS FOR 1906 AND 1907. New Wards. New Wards. Death-Rates (corrected) per 1000 population. Zymotic Incidence per 1000 population. Total Number of Deaths (corrected). Total Notified Cases. Zvmotic General. Zymotic. General. Zymotic. 1906. 1907. 1906. 1907. 1906. 1907. 1907. 1907. 1907. Inner— 18.4 18.2 2.3 1.8 7.5 8.02 2548 247 1124 Marsh 24.7 21.3 2.2 2.2 10.1 8.3 559 59 218 Bishop's 20.8 22.3 3.1 2.1 8.2 6.9 704 65 216 Prince's 16.2 15.2 2.1 1.5 7.04 6.8 757 73 336 Vauxhall 14.8 16.1 1.7 1.5 5.3 10.8 528 50 354 Outer— 12.1 11.8 1.2 0.7 5.8 5.7 2104 132 1016 Stockwell 12.2 10.9 1.5 0.5 8.1 10.2 372 18 345 Brixton 13.2 12.6 1.1 0.8 4.5 4.5 579 37 208 Heme Hill 11.8 12.7 1.1 0.9 6.2 5.9 433 31 202 Tulse Hill 10.1 10.9 0.9 0.9 4.3 4.7 330 27 143 Norwood 12.9 11.5 1.3 0.6 6.3 3.5 390 19 118 Borough of Lambeth 14.9 14.6 1.7 1.2 6.6 6.7 4.652 379 2140 28 TABLE G. Shewing the uncorrected Mortality (Male and Female) in the different New Registration Sub-Districts of the Borough of Lainbeth (arranged Quarterly) during the year 1907. 1st Quarter. 2nd Quarter. 3rd Quarter. 4 th Quarter. Total No. of Deaths in each District. M. F. Total. M. F. Total. M. F. Total. M. F. Total. Waterloo 47 90 137 51 46 97 27 37 64 49 61 110 408 Lambeth Church 174 109 283 169 102 271 143 105 248 117 97 214 1016 Kennington 218 177 395 148 163 311 163 149 312 183 193 376 1394 Stockwell 127 117 244 73 75 148 65 65 130 71 89 160 682 Brixton 116 144 260 79 113 192 58 90 148 99 127 226 826 Norwood 98 113 211 57 89 146 53 65 118 72 53 125 600 Totals 780 750 1530 577 588 1165 509 511 1020 591 620 1211 4926 29 TABLE H. Shewing the uncorrected Mortality (i.e., including that of Strangers) at different Ages in each Ntw Registration Sub-District of the Borough of Lambeth during the year 1907. Sue-District, Under 1 year. 1 to 5 years. 5 to 60 years. 60 yrs. & upwards. Total. M. F. Total. M. F. Total. M. F. Total. M. F. Total. Waterloo 75 94 169 27 30 57 37 84 121 35 26 61 408 Lambeth Church 108 76 184 77 65 142 327 198 525 91 74 165 1016 Kennington 113 91 204 66 54 120 283 228 511 250 309 559 1394 Stock well 93 63 156 66 60 126 103 120 223 74 103 177 682 Brixton 124 101 225 41 52 93 97 131 229 90 189 279 826 Norwood 66 40 106 21 31 52 82 80 162 111 169 280 600 Totals 579 465 1044 298 292 590 929 842 1771 651 870 1521 4926 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 1907. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total. M. F. Total. M. F. Total. M. F. Total. M. F. Total. Under 1 year 187 133 320 128 105 233 124 111 235 140 116 256 1044 Between 1 and 5 years 81 88 169 83 74 157 65 70 135 69 60 129 590 Between 5 and 60 years 292 238 530 228 201 429 194 183 377 215 220 435 1771 60 years and upwards 220 291 511 138 208 346 126 147 273 167 224 391 1521 Totals 780 750 1530 577 588 1165 509 511 1020 591 620 1211 4926 30 31 INFANTILE MORTALITY, 1907. Of the 4652 corrected deaths, 941 were infants under one year of age. The total number of births is 8650, and of these 531 occurred at the Lying-in Hospital, and belong to districts outside Lambeth Borough, 20 occurred at the Workhouse and belong to districts outside Lambeth Borough, and 352 occurred at the Maternity Hospital and belong to districts outside Lambeth Borough. In this way, the corrected number of births for Lambeth Borough is 7747. The corrected infantile mortality (i.e., rate of corrected deaths under one year per 1000 corrected births) is, therefore, 121"5. In calculating this infantile mortality, it must be remembered that, whilst we substract 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 108.8. Taking the uncorrected number of births (8650), and the uncorrected number of deaths under 1 year of age (1044), the uncorrected infantile mortality is 120.2, as compared with 132.1 during 1906, and an average of 150.5 for the old Parish of Lambeth during 10 years (1891-1900). The chief causes of theee deaths were debility, atrophy and inanition, whooping cough, bronchitis and other diseases of the respiratory organs, diarrhoea, premature births, and convulsions (vide p. 85 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 245.7 per 1000 births in Lambeth Church to 77.7 in Stockwell (the rates of 114.3 in Waterloo, 128.7 in Kennington, and 77.7 in Stockwell, being due to the fact that these Sub-Districts contain the General Lying-in Hospital, the Workhouse and the Maternity Hospital respectively), thus:— 32 Total No. of Births (uncorrected) Total Deaths under 1 year (uncorrected) Infatile Mortality per 1,000 births (uncorrected) Waterloo 1487 170 114.3 Lambeth Church 749 184 245.7 Kennington† 1589 204 128.7 Stockwell‡ 2007 156 77.7 Brixton 1621 224 138.2 Norwood 1197 106 88.6 Lambeth 8650 1044 1207 Inner Districts=131.7 ; Outer Districts=106.8. *Excluding all the Lying-in Hospital births, the rate is 2211 †Excluding all the Workhouse births, the rate is 149.01. ‡Excluding all the Maternity births the rate is 100.7. N.B.—The births and deaths in Stockwell Registration Sub-District are divided equally between the Inner and Outer Districts for the purpose of calculating infantile mortality rates. 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 94 in Croydon, to a maximum 165 in Nottingham, Lambeth and London being 120 and 116 respectively. Lambeth ranks ninth lowest in such list, 25 Towns having higher infantile mortality rates. Taking the RegistrarGeneral's figures, the rate for Lambeth is 120, and of the 29 Metropolitan Sanitary Districts, 18 have lesser rates than Lambeth Borough, but the corrected rate for Lambeth is 109. The infantile mortality statistics for Lambeth Borough during 1907 are remarkable—the lowest ever registered, and, even allowing for the favourable meteorological conditions that existed, are worthy of note as shewing that the methods adopted 33 throughout the Borough of Lambeth for the prevention of infantile mortality are proving successful. In this connection, the systematic visiting of all houses wherein births have been registered and the widespread distribution of pamphlets on infant-feeding, together with the influence of the Municipal Milk Depot, must not be forgotten (vide Milk Depot, page 154). The results should prove even more satisfactory when the Notification of Births Act, 1907, is in working order within the Borough. This Act received the Royal Assent on August 28th, 1907, and is an Adoptive Measure, i.e., it is not in force in any district until adopted by the Local Authority—the council of a Borough, including Metropolitan Boroughs, or the Council of an Urban or Rural District, but the Local Government Board has power, by Order, to declare that the Act shall be in force in the area of any Local Authority which has not adopted it, if the Board think it expedient to do so. The object of the Act is to secure the early notification of Births (within 36 hours) in connection with the prevention of infantile mortality, and it is anticipated that this early notification will prove of the greatest value, enabling prompt visits to be made to houses wherein births have taken place, pamphlets dealing with the proper treatment and management of infants to be left with the parents, and advice to be given as may be found necessary. The Lambeth Borough Council at a special meeting held on October 17th, 1907, adopted the Act throughout the area of the Metropolitan Borough of Lambeth, in pursuance of a Special Notice given to every member of the Council, on September 14th, 1907. This fact was duly advertised in 4 papers circulating within the Borough, as laid down in the Schedule to the Act, and notices were given to all persons concerned of the resolution of adoption by posting the same at church and chapel doors, and in other public places. *The Local Government board approved ot the adoption ot the Notification of Births Act, 1907, throughout the Borough of Lambeth from Mouday, March 9th, 1908. c 34 TABLE J. Shewing the uncorrected Infantile Mortalities in the Registrar-General's old 33 Large Towns of England and Wales (including London), and in Lambeth Borough, during 1907, with averages for ten years (1896-1905). England and Wales— (33 Large Towns.) Deaths under one year per 1000 Births. Average Ten Years, 1897—1906. Croydon 94 130 Huddersfield 97 135 Bristol 100 187 Halifax 103 136 Birkenhea 110 164 Plymouth 110 163 Brighton 113 141 London 116 148 Derby 121 149 Portsmouth 123 151 Newcastle-on-Tyne 123 166 Bradford 124 160 Norwich 125 177 Hull 127 169 Sunderland 130 165 Wolverhampton 130 168 Leeds 130 170 Cardiff 131 145 Leicester 131 174 West Ham 131 166 Swansea 182 160 Gateshead 136 169 Salford 140 188 Liverpool 144 180 Oldham 144 166 Sheffield 145 180 Manchester 146 182 Bolton 146 156 Birmingham 147 182 Blackburn 158 182 Preston 158 208 Burnley 158 212 Nottingham 165 181 London Districts— Central 128 North 108 South 114 West 117 East 128 Lambetr 108.8 N.B.—The rates for London Districts (including Lambeth) are corrected as regards the deaths under I year of age. The uncorrected rate for Lambeth is 35 CLASS I.—ZYMOTIC DISEASES. Principal Zymotic Diseases. The principal Zymotic diseases are seven in number, viz., smallpox, measles, scarlet fever, diphtheria (deluding membranous croup), whooping cough, "fevers" (including typhus, typhoid or enteric, and simple or continued), and diarrhœa; 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 1907, being 46.3 per cent, below the average (1891-1900). In the Borough of Lambeth, during 1907, there were registered 425 deaths from the seven zymotic diseases, and of these 75 were strangers belonging to other districts, and 350 parishioners who died within the Borough. 29 parishioners, however, died without the Borough. Subtracting the strangers, and adding on the parishioners who died without the Borough, there is a corrected total of 379, giving a zymotic corrected death-rate of 1.2 per 1000 inhabitants, the corrected rate for London being 1.4, varying in the different Metropolitan Districts, as shown on page 9. 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 death-rates and birth-rates for comparison. Waterloo shows the highest, and Norwood the lowest, zymotic death-rates respectively. The corrected zymotic death-rate for the Inner Districts is 1.8, and for the Outer, 0.7—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. 36 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, Marsh shows the highest, and Stockwell the lowest, zymotic death rates, and Vauxhall the highest, and Norwood the lowest, zymotic incidences respectively. During the year 1907, under the Notification Clauses of the Public Health (London) Act, 1891, 2140 cases of Infectious Diseases have been reported, and of this number 1746, i.e., 81.6 per cent were removed to the Hospitals of the Asylums Board, or to other Hospitals, and 394, i.e., 18*4 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 coming to be more and more realised that infectious diseases cannot be properly isolated ill the homes of the people. The percentage removed during 1907 is well above the average. Thus, since the introduction of the Public Health (Lcndon) Act, 1891, the percentages of notified infectious cases (excluding chicken-pox and cerebro-spinal 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, 1894—33.9, 1899—61.2, 1904—69.8, 1895—30.4, 1900—64.5, 1905—68.9, Examining the removals more in detail (e.g., nature of disease), it is seen that during 1907 in the Borough of Lambeth, the following are the percentages:— Scarlet Fever 91.7 Typhoid 71.4 Diphtheria 84.2 Continued 66.7 Membranous 82.4 Puerperal 36.4 Croup 38.5 Erysipelas 22.5 Cerebro-spinal Meningitis 100.0 37 No case of Smallpox was notified during ]907 within the Borough. Taking the total number of notified cases of infectious diseases during 1907, it will be noticed that the zymotic incidence throughout the Borough of Lambeth is 19.5 per cent, less than the average 1891-1900 for the old Parish of Lambeth. There is again a marked decrease in the number of Diphtheria certificates received during 1907, i.e., 55.7 per cent, below the average of the statistics of the Parish of Lambeth for 10 years (1891-1900), and 22.9 per cent, below the average received in the Borough during 1901-5.* The 317 Diphtheria cases occurred in 298 infected houses, and in only 7.7 per cent, of these were the drains, on testing, found defective. The Scarlet Fever notifications were 11.3 per cent, above the average of the Parish of Lambeth statistics for the 10 years 1891-1900. The 1481 cases occurred in 1288 infected houses, and in 12.2 per cent, of these, the drains were, on testing, found defective. The Enteric Fever (or Typhoid) notifications received were 70.4 per cent, below the average for 10 years (Parish of Lambeth), and represent 53 infected houses, of which 13.2 per cent, of the drains were found, on testing, to be defective. No cases of plague, nor of suspected plague, nor of cholera, nor of suspected cholera, have been notified during 1907, within the Borough. In the case of each of the 1922 infected houses, an inspection was made, and the drains and the sanitary fittings tested with chemical, with the following results as tabulated:— (a) 212 (i.e., 1103 per cent.) were found to have defective drains. *Excluding the 64 notified cases in connection with the Norwood Parochial Schools during 1905. 38 (b.) 1036 (i.e., 53.9 per cent.) were found to have defective traps, fittings, or appliances. (c.) 674 (i.e., 35.1 per cent.) gave no results with the tests. It will be noted that only 11 03 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 53'9 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 a result is obtained, the drain (tested) is tabulated as defective, but, when no result is obtained, it would be unsa'e 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 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 of defects found decreases. Taking the statistics for the Parish of Lambeth during 10 years (1891-1900), and those for the Borough of Lambeth during 6 years (901.7), it will be noticed that the percentage of houses showing defective drains has decreased from 22.3 in 1891 to 11.03 in 1907. Table L gives full particulars, with the averages for the 10 years worked out, for the old Parish 39 of Lambeth, and comparing these with those for 1907 for the Borough of Lambeth, it will be seen that the latter show a decrease of 50.1 per cent, below the average for the old Parish (1891-l900) in respect of defective drains. Sub-divided according to the different notifiable diseases, the results show as follow:— Disease. No. of Infected Houses. Numbers shewing Defects as to Percentage shewing Total Defects. Percentage shtwing no Defects. Drains. T raps, Fittings and Appliances. Total. Smallpox — - - - - - Cholera — — — — — — Diphtheria 298 23 165 188 63.1 36.9 Membranous Croup 13 2 6 8 61.6 38.4 Erysipelas 228 19 114 133 58.3 41.7 Scarlet Fever 1288 157 702 859 66.7 33.3 Typhus. 1 — — — — — Typhoid 53 7 26 33 62.3 37.7 Continued or Relapsing 6 1 2 3 50.0 50.0 Puerperal 22 2 12 14 63.7 36.3 Cerebro-spinal Meningitis 13 1 9 10 76.9 23.1 Totals 1922 212 1036 1248 64.9 35.1 4° TABLE L. Giving number of Infected Houses, with percentages of (1) General Defects, and (2) Defective Drains, throughout the Borough during 1907, and throughout the old Parish during ten years (1891-1900). 1891 1892 1893 1894 1895 1896 Number of Infected Houses 1417 2430 3179 2012 2111 2417 Number of Houses with defects found 903 1474 1641 1089 993 1177 = 63.7% =60.7% = 15.6% = 54.1% = 47.04% = 48.7% Number of Houses with defective drains found 316 720 658 464 392 423 = 22.3% =24.7% = 20.6% = 23.06% = 18.6% = 17.5% Number of Houses with no defects found 514 956 1538 923 1118 1240 =36.3% =39.3% = 48.4% =45.9% = 52.96% = 51.3% N.B.—Only 11.03 per cent, of the houses in 1907 shewed, with the test, defective drains, no results being obtained in the other cases. 41 TABLE L—continued. Giving number of Infected Houses, with percentages of (1) General Defects, and (2) Defective Drains, throughout the Borough during 1907, and throughout the old Parish during ten years (1891-1900). 1897 1898 1899 1900 Average for ten years 1891-1900. 1907 Number of Infected Houses 2374 2094 2435 1992 2246.1 1922 Number of Houses with defects found 1210 1044 1168 886 1158-0 1248 = 50.9% =49.9% =47.5% = 44.5% = 51.6% = 64.9% Number of Houses with defective drains found 390 351 384 285 438-3 212 = 16.4% = 16.9% = 15.8% = 14.3% = 19.5% = 11.03% Number of Houses with no defccts found 1164 1050 1272 1106 1088 1 674 =49.1% = 50.1% = 52.5% = 55.5% =48.4% = 35.1% N.B.—Only 1103 per cent, of the houses in 1907 shewed, with the test, defective drains, no results being obtained in the other cases. 42 TABLE M. Shewing corrected zymotic seasonal variations (deaths) in the Borough of Lambeth in the different • Registration Sub-Districts during 1907. New Registration Sub-District. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year 1907. Zymotic Death-rate per 1000 inhabitants. Waterloo 20 18 12 0 59 2.2 Lambeth Church 7 14 21 12 54 2.1 Kennington 16 23 29 16 84 1.5 Stockwell 7 24 18 19 68 1.2 Brixton 15 25 18 10 68 0.8 Norwood 12 15 10 9 46 0.7 Borough of Lambeth 77 119 108 75 379 1.2 Inner Districts 1.8; Outer Districts 0.7 per 1000 inhabitants. 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 1907 (arranged Quarterly). 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total for 1907. Smallpox - - - - - Scarlet Fever 236 252 378 615 1481 Diphtheria 73 57 80 167 317 Membranous Croup 4 4 3 2 13 Typhus — 1 — — 1 Typhoid 82 13 9 12 56 Continued Fever 1 — 3 2 6 Erysipelas 55 45 63 68 231 Puerperal 6 5 10 1 22 Cerebro-Spinal Meningitis 1 8 2 2 13 Cholera - - - - - Plague - - - - - Totals 398 385 548 809 2140 43 TABLE O. Deaths from zymotic diseases (Strangers deducted), 1907. For the 4 weeks ending January. February. March. April. May. June. July. August. September. October. November. December. Total. Smallpox - - - - - - - - - - - - - Measles — 1 9 11 14 33 12 11 8 3 2 3 107 Scarlet Fever 1 3 1 1 2 4 4 1 6 4 8 3 38 Diphtheria 5 2 7 1 2 5 3 3 8 3 3 4 47 Membranous Croup — — — — — — — — — — — — — Whooping Cough . 15 10 15 14 17 7 6 8 5 4 2 5 111 Typhus — — — — — — — — — — — — — Enteric — 2 — 1 — 1 1 — — — — — 5 Continued Fever — — — — — — — — — — — — — Diarrhoea 4 2 — 2 3 2 4 8 17 19 7 3 71 Total of Seven Chief Zymotic Diseases 25 20 32 30 38 52 30 31 44 33 22 18 379 Erysipelas 3 2 2 1 1 3 1 1 2 - 15 Puerperal Fever - - - 1 2 3 - 2 1 - - - 9 44 45 The seasonal mortality (corrected) from the different important zymotic diseases during 1907 is well shown by arranging the deaths quarterly, thus:— 1907. Smallpox Measles. Whooping Cough. Scarlet Fever. Diphtheria. Membranous Croup. FEVER. Diarrhoea. Erysipelas. Puerperal Fever. Cholera. Influenza. Total. Typhus. Typhoid. Continued. 1st Qr. — 9 40 5 13 — 2 — 8 3 — — 20 100 2nd Qr. — 58 37 7 8 — 2 — 7 4 5 — 8 136 3rd Qr. — 32 22 10 10 — - 1 — 27 5 4 — 1 118 4th Qr. — 8 12 16 10 — — — — 29 3 — — 10 88 Totals. — 107 111 38 47 — — 5 — 71 15 9 - 39 442 Taking the zymotic diseases collectively, it is noticed that the 2nd quarter shewed the highest mortality, and the 4th quarter the lowest. Whooping Cough and Influenza reached their maxima in the 1st quarter; Measles and Puerperal Fever in the 2nd; Erysipelas and Diphtheria in the 3rd; and Scarlet Fever and Diarrhoea in the 4th. Typhoid reached its maximum in the 1st and 2nd quarters. Table M shews the zymotic 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 1907, 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. 46 TABLE P. Shewing the number of Deaths (corrected) from the 7 principal in the ten years 1891—1900, and in the new Disease. 1891 1892 1893 1894 1895 Smallpox — 1 5 1 2 Diphtheria 76 127 172 138 103 Membranous Croup 2 9 11 4 9 Scarlet Fever 46 76 69 64 53 Fever Typhus 1 — 1 — — Typhoid or Enteric 28 22 36 46 26 Simple Continued 7 2 4 0 2 Measles 128 187 113 182 151 Whooping Cough 239 135 151 110 132 Diarrhoea (and Cholera) 166 167 205 142 263 Borough of Lambeth 693 726 767 687 741 County of London 9675 11983 13223 11544 11467 47 TABLE P. zymotic diseases in the old Parish of Lambeth and in London, Borough of Lambeth and in London during 1907. 1896 1897 1898 1899 1900 Annual Average of ten years 1891—1900 (old Parish). Proportion of Deaths to 1000 Total Deaths (corrected) in 10 years. Total (corrected) Deaths in 1907. Proportion of Zymotic Deaths to 1000 Total Deaths (corrected) 1907. 2 - 1.1 0.2 - 129 138 108 158 101 124.5 23.03 47 10.1 11 7 7 6 2 6.8 1.3 — — 63 42 30 25 20 48.8 9.03 38 8.2 1 — — — — 0.3 0.06 — — 24 26 35 50 54 34.7 6.4 5 1.08 1 — — — 1 1.7 0.3 — — 185 139 133 169 69 145.6 26.9 107 28.0 140 144 159 130 97 143.7 26.6 111 23.8 152 238 254 249 153 198.9 36.8 71 15.3 708 734 726 782 497 706.1 130.6 379 81.5 14009 11525 12482 11147 10136 11575.3 130.8 6720 97.01 48 SMALLPOX. During 1907 no single case of genuine Smallpox was notified, nor was a single death from Smallpox registered, within the Borough. 7 doubtful cases were reported to the Medical Officer of Health, who visited the patients and found them to be suffering from Erythema (1), Echthyma (1), Pemphigus (1), Chicken-pox (3), and Measles (1); whilst one patient (from Brighton Terrace) was removed to the hospital, but was found there not to be suffering from Smallpox, but from Chicken-pox. 5 "contacts" were watched for 16 days within the Borough during 1907, in connection with Smallpox cases that had occurred on board vessels arriving from abroad as follows:—S.s. "Araguaya" (South America) 2; and s.s. "Egypt" (Bombay) 3, but in no single instance did Smallpox develop amongst these " contacts." In London, 4 cases of Smallpox were notified, but no deaths were registered from the same disease, during 1907. 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 1906, and the first half of 1907, respectively. ? The total number of conscientious objectors who have obtained certificates during 1907, irrespective of the dates of birth of the children to which they relate, is 167, whilst the total number of certificates of successful primary vaccinations at all ages received during 1906 and 1907 are 7280 and 7525 respectively. *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 1907 can be given in this Report. 49 TABLE Q,, VACCINATION RETURNS (LAMBETH BOROUGH), 1906. Old Registration Sub-Districts. No. of Births, (corrected). Successfully Vaccinated. Insusceptible to Vaccination. Dead Unvaccinated. Conscientious Objectors. Removed to other Parishes Waterloo* 1438 923 1 131 16 326 Lambeth Church 1st 4847 3479 7 425 70 480 Lambeth Church 2nd† Kennington 1st‡ Kennington 2nd Brixton 1904 1378 3 161 50 46 Norwood 863 714 3 51 21 14 Lambeth 9052 6494 14 668 157 866 * Hospital Cases (598) included. †Workhouse (217) cases included. ‡Maternity cases (437) included. N.B.—The new Registration Sub-Districts were adopted by the Registrar-General for statistical purposes on October 1st, 1906, so that the 1906 Returns cannot be given separately for each Sub-District as in former Reports. 50 TABLE R. VACCINATION RETURNS (LAMBETH BOROUGH) FOR THE FIRST HALF-YEAR, 1907. New Registration Sub-Districts. No. of Births (corrected). Successfully Vaccinated. Insusceptible to Vaccination. Dead Unvaccinated. Conscientious Objectors. Removed to other Parishes. Waterloo* 748 448 - 65 2 153 Lambeth Church 399 440 — 49 6 57 Kennington† 791 1151 1 59 8 105 Stockwell‡ 1034 676 2 81 21 99 Brixton 816 586 — 56 16 16 Norwood 620 495 2 41 18 13 Lambeth 4408 3796 5 271 71 443 The Yearly Returns are not made up for the Local Government Board until the August in the following year. *Hospital cases (351) included. fWorkhouse cases (91) included. jMaternity cases (256) included. 51 EPIDEMIC CEREBROSPINAL MENINGITIS. On March 12th, 1907, epidemic cerebro-spinai meningitis (cerebrospinal fever) became a compulsorily notifiable infectious disease throughout the administrative County of London, in accordance with the provisions of Section 56 of the Public Health (London) Act, 1891. This disease had taken on epidemic proportions in Belfast aud 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 1907 a total of 153 cases have been notified as having occurred throughout the County, and of these 13 belong to Lambeth Borough. The disease is "an acute, epidemic disease, characterised by profound disturbance of the central nervous system, indicated by the onset chiefly of shivering, intense headache or vertigo, or both, and persistent vomiting; subsequently by delirium, often violent, alternating with somnolent, or a state of apathy or stupor; an acutely painful condition with spasm—sometimes tetanoid—of certain groups of muscles, especially the posterior muscles of the neck, occasioning retraction of the head; and an increased sensitiveness of the surface of the body. Throughout the disease there is marked depression of the vital powers, not unfrequently collapse; and in its course an eruption of vesicles, petechice, or purpuric spots, or mottling of the skin, is apt to occur. If the disease tends to recovery, the symptoms gradually subside without any critical phenomena, and convalescence is protracted ; if to a fatal termination, death is almost invariably preceded by coma. After death the enveloping membranes of the brain and spinal cord are found in a morbid state, of which the most notable signs are engorgement of the blood vessels, usually excessive, and an effusion of sero-purulent matter into 52 the meshes of the pia mater and beneath the arachnoid. Kernig's sign "and the tache cerebrale | are also present." The disease appears at times in an anomalous form, giving rise to difficulty in diagnosis. Further, the symptoms may vary from the mildest to the most severe ("fulminant" variety)—in the latter death ensuing rapidly. The germ that is generally regarded as the specific cause of cerebro-spinal fever is known as the diplococcus meningitidis intracellularis of Weichselbaum, and is to be found in the cerebrospinal fluid, which can be withdrawn from the lower part of the spinal canal by lumbar puncture. 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 under the following headings agreed upon by the medical officers of the different Metropolitan Districts in consultation with the County Medical Officer of Health :— District—name—-address—occupation—date of beginning of present illness with symptoms in their order of development, e.g., character of onset, vomiting, headache, delirium, coma, tache cerebrale and evidence of muscular rigidity, retraction of head, Kernig's sign—recent illnesses of patient, including discharges from ear or nose, enlarged glands, etc.—whether away from London *To obtain this sign the patient is placed so that the hip-joint is semiflexed, and while the hip-joint is retained in this position, the knee-joint is extended passively. A contraction of the ham-strings then sets in, which causes resistance to the extension. †A congested streak produced by drawing the finger-nail gently over the patient's thigh, abdomen, or face—such streak appearing earlier (within 30 seconds), lasting longer (8, 10, or 15 minutes), and being broader and of deeper colour than in healthy persons. 53 during past month, and, if so, where ?—date of appearance of any eruption and character and distribution of eruption—number of families occupying house—names and ages of other members of patients family—ages and sex of other inmates of house—sanitary condition of house, e.g., whether verminous—health of other inmates of house, especially noting whether any presented symptoms resembling those of cerebrospinal meningitis, or of influenza, sore throat, pneumonia, nasal catarrh—whether patient has been associated elsewhere with other suspicious cases of illness, and whether any evidence of infection from fomiles—whether removed to Hospital, and if so where ?—bacteriological examination and if diplococcus is found, state whether (a) it is Gram negative; (b) it fails to grow on "Nasgar" at temperature below 25° c.— result of post.mortem examination if made. In London, during 1907, 25 deaths were registered from cerebro.spinal fever and 153 cases of the disease were notified during the period from March 12th to December 31st, 1907. CHICKEN.POX. Chicken.pox was not compulsorily notifiable during 1907, but through the Head Teachers of the various schools 799 cases were brought to the notice of the Council, and the necessary disinfection was carried out in connection therewith. SCARLET FEVER. During 1907, in the Borough of Lambeth, 1481 cases of Scarlet Fever were notified, and 36 deaths registered, giving a case. mortality of 2.6 per cent.—3.6 tor the Inner, and 1.4 for the 54 Outer Districts. In 1906, there were 1268 cases notified and 28 deaths registered, i.e., a case-mortality of 2.2 per cent.—3.1 for the Inner, and 1.8 for the .Outer Districts. The annual averages for 10 years (1891.1900) in the old Parish of Lambeth are (1) notified cases 133T3, and (2) deaths 53.6. Of the 1481 persons notified in the Borough of Lambeth during 1907, 1357* (i.e., 91.7 per cent.) were removed to Hospital, and of these, 36 died (i.e., 2.6 per cent.), whereas 124 (i.e., 8.3 per cent.) were treated at home, and of these, 2 died (i.e., l.6 per cent.). This difference in case-mortality as between Hospital. and Home-treated patients is to be explained by the greater severity of the cases sent to Hospital. 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 1907 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. * *Of the 1481 cases of Scarlet Fever removed to Hospital, 113 proved at Hospital not to be suffering from that disease. 55 The age and sex incidence and mortality for the 1481 Scarlet Fever cases notified in Lambeth Borough during 1907®are as follow:— Age. Number of Cases Notified. Deaths. Death Rate per 100 Notified. M. F Total. M. F. Total. Under 1 year 8 8 16 1 1 6.3 1 to 2 22 28 50 1 3 4 8.0 2 to 3 42 46 88 3 1 4 4.5 3 to 4 61 56 117 7 5 12 12.3 4 to 5 83 65 148 1 1 2 1.4 5 to 6 77 87 164 2 1 3 1.8 6 to 7 64 59 123 — — 0.0 7 to 8 51 66 117 2 3 5 4.3 8 to 9 44 86 110 0.0 9 to 10 38 68 106 — — — 0.0 Over 10 years 187 255 442 4 3 7 1.6 Total 677 804 1481 21 17 38 2.6 It will be noted that, of the total 1481 persons reported as suffering from Scarlet Fever during 1907 within the Borough of Lambeth, 419 (i.e., 28.3 per cent.) were under five years of age, and 1039 (i.e., 70.2 per cent.) under 10 years of age : whilst the mortality was greatest amongst those between 3 and 4 years of age. Of the 442 persons over 10 years of age, 7 (i.e., 1.6 per cent.) died. 56 The distribution of the cases of, and the mortality from, Scarlet Fever amongst the different Registration Sub.Districts of the Borough of Lambeth during 1907 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 138 3 135 3 3 22 5.3 Lambeth Church 146 25 121 1 6 7 4.8 5.5 Kennington 207 3 204 — 7 7 34 3.8 Stockwell 436 1 435 — 16 16 3.7 6.5 Brixton 378 55 323 1 2 3 0.8 4.7 Norwood 176 37 139 _ 2 2 1.1 2.7 Borough of Lambeth 1481 124 1357 2 36 38 2.6 4.6 Rate of Persons notified per 1000 inhabitants—5.8 Inner Districts, and 3.7 Outer Districts. Of the 135V cases removed to Hospital, 57.9 per cent, were from the Inner, and 42.1 per cent, from the Outer, Districts. In London, during 1907, there were registered 645 deaths (uncorrected) out of a total of 25936 cases of Scarlet Fever notified, giving a case.mortality of 2.5 per cent, (uncorrected). As far as could. be traced, no Scarlatinal Milk outbreak occurred in the Borough of Lambeth during 1907, but three schools (St. Gabriel.s College, Sussex Road and Santley Street L.C.C. Schools) had to be disinfected on account of outbreaks of Scarlet Fever amongst the inmates. 57 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 1907, 107 and 111 deaths were registered from Measles and Whooping Cough, giving death.rates per 10000 of the population of 3.4 and 3.5 respectively. In London, during 1907, there were registered 1810 and 1800 total deaths from Measles and Whooping Cough, giving corresponding death.rates of 3.8 and 3.8 per 10000 of the population respectively. Taking the Lambeth new Registration Sub.Districts it will be seen that Waterloo and Lambeth Church suffered most, and Norwood and Brixton least, from Measles; whilst Waterloo suffered most, and Norwood least, from Whooping Cough (vide page 61). The Inner Districts suffered (deaths per 10000 of the population) more than the Outer Districts, thus :— Inner. Outer. Whooping Cough 4.2 2.9 Measles 5.8 1.4 Comparing the Borough statistics for 1907 with those for the old Parish for 10 years (1891.1900), it will be seen that there has been a saving during 1907 of 38 deaths from Measles over the average for that decennium, and a saving of 32 deaths from Whooping Cough over the average duiing 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 58 houses) from schools, the closing of classes or whole schools on account of outbreaks 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 as a trivial complaint of childhood. Measles is not compulsorily notifiable, but, through L.C.C. Schools, 2770 cases (during 1907) were reported to the Borough Council. Measles being chiefly a "School" Disease, this voluntary system of notification is most desirable, and will, it is hoped, be, in the future, extended (vide Appendix). Of the 107 deaths from Measles in Lambeth Borough during 1907, 104 (i.e., 97.2 per cent.) occurred amongst children under 5 years of age, shewing that Measles is a disease of young children, and especially fatal to such. 26 of the deaths (i.e., 24.3 per cent.) occurred amongst infants under 1 year of age. During 1907 in the Borough of Lambeth disinfection has been carried out in connection with 1998 Measles.infected houses as compared with 836, 1970, 1294, 1346, 364, 728, and 941 during 1900, 1905, 1904, 1903, 1902, 1901 and 1900 respectively. Measles is spread chiefly through Schools, especially Infants. Departments, and during 1907 special precautions have been taken in respect thereto, as follows :— St. Johns Schools, Canterbury Road (Infants. Department).— The Infants. Department (babies' class.room) was closed for 18 days on June 6th, 1907, on account of an outbreak of Measles amongst the scholars (rising epidemic), an average of 15 per cent, of the infants being absent suffering from the disease. The usual disinfection was carried out. Result of closure was a decline in the number of Measles cases. No action was taken in respect to the other two class.rooms of the Infants. Department. 59 Vauxhall Street School (Infants' Department).—The Infants' Department (Class.room G) was closed for 14 days on April 27th, 1907, on account of an outbreak of Measles amongst the scholars (rising epidemic), an average of 35 per cent, of the infants being absent suffering from the disease. The usual disinfection was carried out. Result of closure was a decline in the number of Measles cases. Special investigations were also undertaken in connection with the following Schools on account of Measles outbreaks, but none of them were closed, it being found that the numbers of scholars affected were too small or that the epidemics were declining :— (1) St. John's Schools, Canterbury Road (Infants. ment, Classrooms 2 and 3). (2) St. Mary's Infants. Schools, Prince's Road. (3) St. Mark's Infants. Schools, Kennington Oval. (4) Licensed Victuallers. School, Upper Kennington Lane. (5) St. Gabriel's College, Cormont Road, (6) Two Private Schools (Brixton Hill and Clapham Road). Accommodation for the treatment of Measles is still much needed for London, and if provided would tend to lessen the present high mortality from that disease, which, in the generality of cases requires only proper nursing and attention to secure a favourable convalescence. In many homes such nursing and attention is impossiole. Whooping Cough. Whooping Cough is also a serious disease, especially to young children. Of the 111 deaths registered in Lambeth Borough. 6o during 1907 from this disease, 107 (i.e, 96.4 per cent.) occurred in children under 5 years of age, and 45 of the deaths (i.e., 40.5 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 1907, in the Borough of Lambeth, disinfection has been carried out in connection with 748 Whooping Cough.infected houses, as compared with 455, 440, 380, 325, 110, 72 and 126 during 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.* No School nor Class was closed during 1907 on account of Whooping Cough, but disinfection was carried out at Mayfield College, Barston Road, West Norwood, on account of several cases of Whooping Cough amongst the scholars. Details of the incidences of Measles and Whooping Cough in the different Registration Sub.Districts ot Lambeth Borough during 1907 are as follow:— *Whooping Cough is not a compulsorily.notifiable disease, but 887 cases were voluntarily notified during 1907 by L.C.C. School Teachers (vide Appendix). CHOLERA AND PLAGUE. In Lambeth Borough, during 1907, no case of Plague, suspected or otherwise, was notified; and no . contacts . or . suspects . had to be watched in connection with the disease. No case of Cholera was notified, and no death from Cholera registered, during 1907, nor had any .contacts. or .suspects. to be watched in connection with.the disease. No case of Plague, and no case of Cholera, were notified, nor were any deaths registered, in London during 1907. DIPHTHERIA. During 1907, 47 deaths were registered in the Borough of Lambeth from Diphtheria, and a total of 317 cases notified, giving a case.mortality of 14.8 per cent. Of the 317 cases notified, 61 New Registration Sub.Districts. Number of Deaths from Whooping Cough. Number of Deaths from Measles. Whooping Cough Deaths per 10000 Inhabitants. Measles. Deaths per 10000 Inhabitants. Waterloo 20 19 7.6 72 Lambeth Church 9 19 3.4 7.1 Kennington 20 34 3.7 6.2 Stockwell 15 15 22 2.2 Brixton 27 11 3.4 1.4 Norwood 20 9 3.1 1.4 Borough of Lambeth. 111 107 3.5 3.4 62 267* (i.e., 84.2 per cent.) were removed to Hospital, and 46 died, giving a case.mortality of 17.2 per cent, amongst the patients treated in Hospital; whilst 50 (i.e., 15.8 per cent.) were treated at home, and 1 died, giving a case.mortality of 2 per cent, amongst the patients treated at home. The difference in the mortality rate as between Hospital. and Home.treated cases is explainable by the severity of the cases removed to Hospital. The case.mortality rate for the whole of the Borough of Lambeth during 1907 is low, pointing to (1) the mildness of the majority of cases notified, and (2) the great value of antitoxin in the treatment of Diphtheria, especially in the very early stages of the disease.† The sudden decrease in the number of Diphtheria deaths throughout the new Borough of Lambeth during 1907 is again remarkable, as it was during 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 1907 there has been a decrease in the mortality.rate, in comparison, of 62.2 per cent. So, too, if the number of notifications of Diphtheria received during 1907 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 55.7 per cent.—the yearly average of notifications for the old Parish being 715, and the number received during 1907 for the Borough 317. Fortunately the comparison can be extended further, and made for many years past, as the statistics for Diphtheria have been worked out in *Of the 267 cases of Diphtheria removed to Hospital, 19 proved at Hospital not to be suffering from that disease. t40 bottles of antitoxin have been gratuitously distributed in Lambeth Borough during 1907 as compared with 59 during 1906. 63 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 1907, as well as during 1906, 1905, 1904, 1903, 1902 and 1901 ; and that, too, although Diphtheria had been rising slowly but surely in epidemic proportions for the previous 20 years ending 1900 (vide table below). The statistics for London, as a whole, are no less remarkable. During 1907, no school was closed on account of Diphtheria. 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—18S2 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 64 The age and sex incidence and mortality from Diphtheria cases notified in the Borough of Lambeth during 1907 are as follow:— Diphtheria. Ages. No. of Cases Notified. Deaths. Death Hate per 100. M. F. Total. M. F. Total. Under 1 year 5 5 10 2 1 3 30.0 1 to 5 54 65 119 16 16 32 26.9 5 to 10 45 65 110 4 5 9 8.2 10 to 20 21 22 43 1 1 2 4.7 20 to 40 11 19 30 1 — 1 3.3 40 to 60 1 3 4 — — — o.o 60 and over 1 - 1 — — — o.o Total 138 179 317 24 23 47 14.8 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 1907, are as follows :— 65 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 32 2 30 - 2 2 6.3 1.2 Lambeth Church 34 1 33 — 7 7 20.6 1.3 Kennington 58 13 45 1 7 8 13.8 1.1 Stockwell 62 — 62 — 9 9 14.5 0.9 Brixton. 90 21 69 — 17 17 18.9 1.1 Norwood 41 13 28 — 4 4 9.8 0.6 Borough of Lambeth 317 50 267 1 46 47 14.8 0.9 Rate of persons notified per 1000 inhabitants—1.2 Inner Districts, and 0 9 Outer Districts. 538 swabs from suspected diphtheria throats were examined at the Laboratory during 1907, and, of these, 26, i.e., 4.8 percent., shewed the presence of the true Klebs.Loeffler (diphtheria) bacilli (vide p. 172). 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 1907, 40 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 1907, in the Borough of Lainbeth, 13 cases were notified from Membranous Croup, but no deaths were registered, 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). 5 cases were removed to Hospital. In London, during 1907, there were registered 795 deaths (uncorrected) out of a total of 8761 cases of Diphtheria and of Membranous Croup notified, giving a casemortality of 9T per cent.* (uncorrected). TYPHOID FEVER. During 1907, 5 deaths were registered in the Borough of Lambeth from Typhoid (Enteric) Fever, and a total of 56 cases notified, giving a casemortality of 8.9 per cent. Of the 56 cases notified, 40† (i.e., 71.4 per cent.) were removed to Hospital, and 4 died, giving a casemortality of 10 per cent, amongst the patients treated in Hospital ; whilst 16 (i.e., 28.6 per cent.) were treated at home, and 1 died, giving a casemortality of 8.3 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 1907, 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, and the yearly *In London Statistics, Diphtheria and Membranous Croup are now grouped together by the RegistrarGeneral. tOf the 40 cases of Typhoid Fever removed to Hospital, 11 proved at Hospital not to be suffering from that disease. 67 average of deaths registered is 34.7, as compared with 56 and 5 respectively as the numbers of notified cases and deaths in the Borough of Lambeth during 1907, giving decreases of 70.5 and 85.6 per eent. respectively. In addition, 11 of the 40 cases removed to Hospital as suffering from Typhoid Fever were found, on further examination, not to be suffering from that disease. The age and sex incidence and mortality for Typhoid cases notified in Lambeth Borough during 1907 are as follow:— Ages. Number of Cases Notified. Deaths. Death. rate per 100. M. F. Total. M. F. Total. Under 1 year — I to 5 1 1 2 — 1 1 50.0 5 to 10 1 2 3 — — — o.o 10 to 20 5 9 14 — — — o.o 20 to 40 . 20 11 31 1 1 2 6..5 40 to 60 5 1 6 2 — 2 33.3 60 and over — — Total 32 24 56 3 2 5 8.9 It will be noted that there was no case notified, and no death registered, in infants under 1 year of age ; two cases notified, and one death registered, amongst children between 1 and 5 yt ars of age; whilst the greatest numbers of both cases and deaths occurred amongst persons between 10 and 40 years of age. The incidences of the disease per 1000 inhabitants in the Inner and Outer Districts respectively during 1907 are 2.1 and 1.5 respectively. 68 Details as to the incidence of the disease during 1907 upon the different New Registration Subdistricts of the Borough of Lambeth are as follow :— 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 Inhabitants. At Home. In Hospital. Total. Waterloo. 7 7 1 1 1 4.3 2.7 Lambeth Church 6 2 4 1 — 1 16.7 2.2 Kennington 11 2 9 — 2 2 18.2 2.02 Stockwell . 9 1 8 — 1 1 111 1.3 Brixton 14 2 12 — — — 0 0 1.7 Norwood . 9 9 — — — — o.o 1.4 Borough of Lambeth 56 16 40 1 4 5 8.9 1.8 Of the 53 Typhoid.infected houses 33 (i.e., 62.3 per cent.) showed, on inspection, defective drains, traps, fittings or appliances. In 7 (i.e., 13*2 per cent.), the drains themselves were found to be defective. 19 cases out of the 56 were traced to sources outside the Borough, and 9 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, oysters or watercress. There was a history in 11 cases of shellfish 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, must be remembered. 48 samples of blood were examined at the Bacteriological Laboratory during 1907 (see p. 172) for the Widal Reaction 69 of Typhoid, and in 12 cases (i.e., 25 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 1907 are, in that respect, of a most satisfactory character. In London during 1907 there were registered 203 deaths (uncorrected) out of a total of 1396 cases of Typhoid notified, giving an uncorrected casemortality of 14.6 per cent. CONTINUED AND TYPHUS FEVERS. i)uring 1907, six cases of Continued Fever were notified in the Borough of Lambeth, but no 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. Four of the cases were removed to Hospital.* In London, 35 cases were notified and 4 deaths registered from Continued Fever during 1907, giving a casemortality of 11.4 per cent, (uncorrected). One case of Typhus was notified during 1907 in Lambeth Borough, viz., in Catherine Street, but no other case arose therefrom. 3 cases of Typhus were notified in London (no deaths). PUERPERAL FEVER. During 1907, in the Borough of Lambeth, 9 deaths were registered from Puerperal Fever (a disease of childbed), and 22 cases notified, giving a casemortality of 40.8 per cent. 8 of the patients were removed to Hospital. *Of the 4 cases of Continued Fever removed to ho.pital, 1 proved at hospital not to b suffering from that disease. 7° The annual averages for 10 years (18911900) in the Parish of Lambeth are (1) notified cases, 18.9 ; and (2) deaths, 11.5; whilst, in the Borough of Lambeth during 1906, 27 cases were notified, and 12 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 lyingin woman. 8650 births were registered in the Borough of Lambeth during 1907, and in only 22 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 cases (being attended at the time) followed up and watched for periods varying from 2 to 3 weeks each as required. Three Midwives were cautioned, but in no instance was it fouud necessary to take legal action against any Midwife. In London, during 1907, there were registered 152 deaths (uncorrected) out of a total of 257 cases of Puerperal Fever notified, giving a case.mortality of 59.1 per cent, (uncorrected). ERYSIPELAS. During 1907, in the Borough of Lambeth, 231 cases of Erysipelas were notified, and 15 deaths registered, giving a case. mortality of 6.5 per cent. Of the 231 cases, 52 (i.e. 22.5 per cent.) were removed to Hospital. The yearly averages for the 10 years (18911900) in the Parish of Lambeth are (1) notified cases, 347 ; and (2) deaths, 17.5. During 1906, 263 cases were notified, and 12 deaths registered from Erysipelas, within the Borough of Lambeth. 71 In London, during 1907, there were registered 189 deaths (uncorrected) out of a total of 4511 cases of Erysipelas notified, giving a casemortality of 4.2 per cent, (uncorrected). The advantages from the notification of Erysipelas are Ifew, 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 1 907 are as follow :— • to PUERPERAL FEVER. ERYSIPELAS. New Registration SubDistricts. Number of Cases Notified. Number of Deaths. Case Mortality per 100. Number of Cases Notified. Number of Deaths. Case Mortality per 100. Waterloo 4 3 75.0 32 1 3.25 Lambeth Church 4 — — 22 1 4.5 Kennington 2 — — 47 5 10.6 Stockwell 5 1 20.0 42 2 4.8 Brixton 5 3 60.0 48 4 8.3 Norwood 2 2 100.0 40 2 5.0 Borough of Lambeth 22 9 40.9 231 15 6.5 73 DIARRHCEA. During the year 1907 there were registered in the Borough of Lambeth 71 deaths from Diarrhoea, as compared with 272, 178 and 260 during 1906. 1905 and 1904 respectively (vide p. 82, 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 for Diarrhoea (and Cholera) is 198.9, so that the figures for 1907 for the Borough are 64.3 per cent. less. Of these 71 deaths, 65 (i.e., 91.5 per cent.) were in children under 5 years, and 58 (i.e., 81.7 per cent.) in infants under 1 year of age. August, September, October and November 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, 57.8 deg.; in July, 60.0 deg.; in August, 61.6 deg.; in September, 58.7 deg. ; and in October, 51T deg. ; whilst the 4.ft. earth thermometer registered 56 deg. F. on June 29th, rising to a maximum 60 deg. F. on August 15th to 20th, and sinking to 56 deg. F. again on October 13th. 56 deg. F. is the socalled "critical" earth temperature for Diarrhoea, i.e., the temperature at which the germs of this particular 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 In London there were registered, during 1907, 1543 deaths from Diarrhoea, giving an uncorrected rate of 3.2 per 10000 living, and one of 2*1 per cent, of total deaths (uncorrected). The details as to the Diarrhoea incidence (mortality) during 1907 upon the different New Registration Sub.Districts of Lambeth Borough are as follow Age mortalities from Diarrhoea were as follow :— Age. Total Deaths. Percentage of Total Deaths from Diarrhoea. M. F. Total. Under 1 year 32 26 58 81.7 1 to 5 4 3 7 9.8 5 to 20 — — — — 20 to 40 1 — 1 1.4 40 to 60 — 2 2 2.8 Over 60 3 3 4.2 Total 37 34 71 100.0 75 In the Inner New Registration Sub-districts, the Diarrhoea death-rate per 10000 inhabitants was 3.4 as compared with 1.3 for the Outer Districts i.e., 2.6 to I—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 will be noted that the 4.ft. earth temperature had a low register during 1907, and, as a natural consequence, the Diarrhoea deaths were diminished in numbers. 94 deaths were registered from .Enteritis The yearly average number of deaths from Enteritis in the old Parish of Lambeth for the 10 years 1891.1900 is 101.8. During recent years there has been a marked improvement in the diagnosis of deaths from diarrhceal diseases, so that, to obtain comparable figures, attention should be paid not only to diarrhoea 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 108.8 per 1000 births (vide p. 31). The female Inspectors have visited every house wherein a death has taken place from Diarrhoea, 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 Diarrhoea Mortality in Lambeth Borough in each month during the year 1907. NewRegistration Sub-Districts. Jan. Feb. Mar. Apr. May. June. July. Aug. Sept. Oct. Nov. Dec. Total Waterloo 3 — - - — 1 — 1 3 4 1 — 13 Lambeth Church. — — 1 — — 2 — 2 2 2 2 1 12 Kennington - - - - - 1 l 2 6 5 — 1 16 Stockwell. — — 1 — 1 — — 1 4 2 1 — 10 Brixton . — 1 — — 1 — 2 — 1 1 2 — 8 Norwood . 1 1 — — 1 — — 1 1 5 1 1 12 Total 4 2 2 — 3 4 3 / 7 17 19 7 3 71 77 The large decrease in the Diarrhoea deaths during 1907 must be read in connection with the remarks under Infantile Mortality. Whilst it is true that meteorological conditions were favourable during 1907 to a low infantile mortality rate from diarrhoeal diseases, the influence of the Council's precautionary measures and the Milk Depot must be taken into account. TUBERCULOSIS. During 1907, 465 deaths were registered in Lambeth Borough as due to phthisis (tuberculosis of the lungs),.85 as due to tabes mesenterica and tuberj alar meningitis, and 63 as due to other forms of tuberculosis, making a total of 613 deaths from tuberculosis (all forms)— i.e., 13.2 per cent, of the total deaths (corrected) registered from all causes. The total deaths within the Borough during 1906, 1905, 1904, 1903, 1902 and 1901 from all forms of tuberculosis were 562, 582, 621, 639, 701 and 695 respectively. Sub-dividing the tuberculosis deaths during 1907 amongst the different Registration New Sub-Districts, it is found that 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 forms Tuber culosis. Waterloo 58 5 9 71 2.7 Lambeth Church. 63 14 10 87 3.03 Kennington 118 21 14 153 2-8 Stockwell 82 15 13 110 1.6 Brixton 92 22 11 125 1.6 Norwood 52 8 6 66 l.3 Borough of Lambeth 465 85 63 613 1.9 (Inner Districts—2"7 per 1000 living. ) Outer Districts—1'3 per 1000 living. In addition to the usual precautionary measures taken in connection with registered deaths from tuberculosis (disinfection, distribution of leaflets, etc.), the voluntary notification of consumption (with tuberculous expectoration) has also been in vogue during 1907 (having been commenced by the Borough Council on June 1st, 1902)—322 cases having been notified in 1907 as compared with 332 in 1906, 293 during 1905, 306 durinsr 1904^ 339 during 1903, and 315 during the seven months from June 1st to December 31st, 1902. In each notified case, disinfection has been carried out as required, and leaflets distributed, and in that way there is every reason to believe that much good is accruing in preventing not only the spread of the disease but also its development in susceptible persons. Meanwhile, it may be noted that the tuberculosis rates per 1000 living during 1907 and 1906 are 1*9 and 1'8 as compared with 1*9 and 2 during 1905 and 1904 respectively. 79 190 samples of sputum were examined bacteriologically during 1907, and in 48, i.e., 25'3 per cent, tubercle bacilli were found (vide p. 171). The distribution of the disease in Lambeth Borough, judging by the voluntary notifications received during 1902-7, will be seen from an examination of Tables I. and II. following, dealing with (a) Wards and (b) Registration Sub-Districts :— I.—CONSUMPTION NOTIFICATIONS, 1902-7. (Arranged in Wards so as to shew the varying incidences.) Wards. Total 1902-6 Incidence Rate per 1000 Population 1902-6 1907 Incidence Rate per 1000 Population 1907 Marsh 293 2.2 62 2.4 Bishop's 434 2.7 69 2.2 Prince's 358 1.5 92 1.9 Vauxhall 191 1 .2 20 0.6 Total Inner Wards 1276 1.8 243 1.7 Stockwell 85 0.5 10 0.3 Brixton 145 0.6 24 0.5 Herne Hill 99 0.6 14 0.4 Tulse Hill 52 0.4 13 0 .4 Norwood 59 0.4 18 0.5 Total Outer Wards 440 0 .5 79 0.4 Borough of Lambeth 1716 1.1 322 1.01 N.B.—Voluntary Notification came into force on June 1st, 1902, so that the returns for that year have been calculated by adding on 5/2t hs to the notifications received during the 7 months of that year. 80 II.—CONSUMPTION NOTIFICATIONS, 1902-7. (Arranged in Registration Sub-Districts so as to shew the varying incidences). Old Sub-Districts. 1902-6 Incidence Rate per 1000 Population 1907 Incidence Rate per 1000 Population 1907 New Sub-Districts. Waterloo Rd. 1st 140 2.2 62 2.4 Waterloo Waterloo Rd. 2nd 153 Lambeth Ch. 1 st 287 2.6 72 2.6 Lambeth Church Lambeth Ch. 2ad 468 2.3 89 1.5 Kennington Total Inner Districts 998 23 243 17 Total Inner Districts Kennington 1st 268 0.9 31 0.5 Stockwell Kennington 2nd. 169 0.8 Brixton 217 0.5 39 0.5 Brixton Norwood 57 0.3 29 05 Norwood Total Outer Districts 718 0.6 79 0.4 Total Outer Districts Boro' of Lambeth 1716 1.1 322 1.01 Boro' of Lambeth N.B.—The Inner Districts consist of the following new registration Sub-DistrictsWaterloo, Lambeth Church, Kennington, and part of Stockwell. It will be seen from the voluntary notifications received that the disease appears to have a greater incidence on the Inner than on the Outer Districts (whether Registration Sub-Districts or Wards). This result was to be expected, bearing in mind the more crowded conditions (persons in houses or houses over area) that exist in the Inner as compared with the Outer Districts and the different status of the inhabitants—the patients notified being chiefly of the artisan and working class. It must be remembered; however, that the notification of consumption is voluntary, and that only a percentage of the cases are heard of. 81 Voluntary notification of consumption obtains in 18 Metropolitan Districts (including Lambeth), and the time appears ripe, as stated in previous reports, for the extension of such a voluntary system to the 11 remaining Metropolitan Districts, and for making it compulsory upon the authorities of Metropolitan Hospitals and Dispensaries to notify all phthisical patients (names and addresses) attending their institutions to the medical officers of the sanitary authorities concerned. This would be a useful step in advance. Arrangements should also be made for the isolation or segregation in sanatoria of all advanced cases, which are a source of such danger to others living in the same rooms. This isolation or segregation might, with advantage, be made compulsory by new legislation. A conference was held at the Paddington Town Hall on June 6th, 1907, when a series of resolutions were passed, dealing with the notification of tuberculosis and preventive measures to be taken (vide Appendix). EPIDEMIC INFLUENZA. During 1907, 39 deaths were registered from Influenza in the Borough of Lambeth, as compared with 42 during 190K, and an average of 107*5 for ten years (1891-1900) in the old Parish of Lambeth. Of the 39 deaths, 8 were registered during the first, 1 during the second, 10 during the third, and 20 during the fourth quarter, of the year. In London, there were registered 967 deaths (uncorrected) from Influenza during 1907. Reviewing the past ten years' history of the old Parish of Lambeth in relation to Epidemic Influenza, it will be seen that the disease has been practically epidemic since 1891, rising to the 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 1907 statistics for the new Borough of Lambeth show a sub-epidemic state. f 82 Table shewing the number ot deaths from Epidemic Influenza in Lambeth Borough, and London, during 1907, and during ten years (1891-1900) in Lambeth Parish and London. Old Parish of Lambeth. Average for 10 years. (Ib91-1900) 2 Borough of 3 Lambeth. 1891 1892 1893 1894 1895 1896 1897 1898 189!- 1900 Lambeth 131 142 85 44 148 51 45 126 151 152 107.5 39 London (including Lambeth). 2336 2264 1526 750 2156 496 671 1283 1817 1950 1524. 9 967 N.B.—The term "Influenza" is too indefinite in medical practice to permit of any satisfactory deductions being drawn from the above statistics. The 44 deaths from venereal affections (Syphilis, etc.) are the only other point calling for note in the class of Zymotic Diseases. Classes II. and III.—Parasitic and Dietetic Diseases. 26 deaths were registered in these classes from chronic Alcoholism and 1 from Delirium Tremens. Class IV.—Constitutional Diseases. Of the total 1043 deaths under this class, 326 were due to Cancer, 465 to Phthisis, and 148 to Tubercular Meningitis and other forms of Tuberculosis. Class V.—Developmental Diseases. The total number of deaths in this class was 318, consisting of 163 from Premature Birth, 116 from Old Age, and 34 from Atelectasis and Congenital Malformations. Class VI.—Local Diseases. 1. Diseases of the Nervous-System caused 391 deaths, including 36 from Convulsions, 187 from Apoplexy, and 20 from Epilepsy. 2. 517 deaths were due to diseases of the Circulatory System. 3. The diseases of the Respiratory Organs caused 932 deaths (480 from Bronchitis, and 142 from Pneumonia). 4. Diseases of the Digestive Organs caused 280 deaths, of which 94 were due to Enteritis, 6 to Peritonitis, 55 to diseases of the Liver and 30 to Dentition. 83 5. Diseases of the Urinary System caused 213 deaths. 6. Diseases of the Reproductive System, Integumentary System, Locomotive System, Lymphatics, Organs of Special Senses, etc., caused together 84 deaths. Class VII.—Deaths from Violence. 190 deaths in all, including 153 from Accidents, 26 from Burns and Scalds, 14 from Drowning, 25 from Suffocation in bed (21 being infants under 1 year) and 32 from Suicide. Cltjss VIII.—Other Causes. 148 deaths were registered in this class, consisting of deaths from Dropsy, Tumours, Haemorrhages, or other ill-defined or non-specified causes. Different rates of mortality from different diseases and groups of diseases are given in terms of the total deaths (corrected 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 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). Allowing for the favourable meteorological conditions during 1907, favourable in so far as infantile life was concerned, the statistics for Lambeth Borough throughout the year are satisfactory—the corrected infantile mortality rate, as a whole, being 108'9 per 1000 births, i.e., taking the corrected number of deaths of infants under 1 year of age and the corrected number of births registered. Comparing the Lambeth statistics with those for the large Provincial Towns or the separate Metropolitan Districts, the Lambeth Council 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 Borough 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 influence of the milk depot and the distribution of pamphlets dealing with the proper feeding and management of infants, &c. 84 TABLL T. Shewing Classification of Causes of deaths (corrected) in the Borough of Lambeth during 1906 and 1907. A.—Total Deaths from all causes and at all ages with percentages of deaths to total deaths (corrected). Borough 1906. Borough 1907. Class of Disease. No. of Deaths corrected). Percentage of Total Deaths. No. of Deaths (corrected). Percentage of Total Deaths (corrected). I.—Zymotic Diseases 641 13.6 502 10.8 Seven Principal 522 11.1 379 8.1 Influenza 42 0.9 39 0.8 II.—Parasitic 1 0.02 3 0.06 III.—Dietetic 45 0.9 36 0.8 IV.—Constitutional 983 20.9 1043 22.4 Cancer 297 6.3 326 7.01 Phthisis 411 8.7 465 9.9 Tubercular Diseases, excluding Phthisis 151 3.2 148 3.2 Rheumatism (Acute and Chronic) and Gout 42 0.9 45 0.9 V.—Developmental 320 6.8 313 6.7 Old Age 119 2.5 116 2.5 VI.—Local Diseases 2404 51.1 2417 51.9 Circulatory System 546 11.6 517 11.1 Bronchitis 402 8.5 480 10.3 Pneumonia and BronchoPneumonia 305 6.5 338 7.3 Pleurisy and Pleuro-Pneumonia 55 1.2 48 1.03 Respiratory System, excluding Phthisis 837 17.7 932 20.03 VII.—Violence 164 3.5 190 4.1 Suicide 34 0.7 32 0.7 VIII.—Other Causes 151 3.2 148 3.2 85 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 1906. Borough 1907. 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 1088 131.3 941 120.5 Diarrhœa 217 26.2 58 7.4 Convulsions 40 4.8 30 3.8 Respiratory Diseases 150 18.1 193 24.7 Premature Births 152 18.4 163 20.9 Tubercular Diseases (including Phthisis) 42 5.1 52 6.7 Measles 19 2.3 26 3.3 Whooping Cough 33 3.9 45 5.8 Suffocation in Bi d 15 1.1 21 2.7 Enteritis 82 9.9 51 6.5 Dentition 17 2.1 16 2.05 N.B.—The Registrar-General gives the corrected births for 1906 and 1907 as 8270 and 7806 respectively. 86 TABLE U. Shewing Classification of certain Causes of Deaths (uncorrected) in the Borough of Lambeth, compared with London, during 1900 and 1907, 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) 1906. 1907. 190R. 1907. I. Principal Zymotics 11.4 8.6 12.4 9.4 Influenza 0.9 0.8 1.2 1.8 Measles 1.7 2.2 2.6 2.5 Whooping Ccugh 1.4 2.3 1.7 2 .5 Diarrhœa aud Dysentery (including Cholera) 5.3 1.6 6.1 2.1 II. Rheumatic Fever and Heart Kheumatism 0.5 0.5 0.4 0.4 III. Diseases of Circulatory System 11.2 10.5 12.5 13.4 IV. Bronchitis, Pneumonia and Pleurisy 15.4 17.9 16.4 19.1 Phthisis 7.8 8.9 9.4 9.5 V. Injuries 3.9 3.9 4.1 3.2 B.—Deaths under 1 Year of Age (per 1000 Births uncorrected). All Causes 132.4 1207 132 .6 117.9 87 BOROUGH OF LAMBETH. SUMMARY OF VITAL AND MORTAL STATISTICS, &c., FOR 1907. Area of Borough—4080.4 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 co-extensive, but the new Registration Sub-Districts and the new Wards are Population—estimated middle of 1907—318538 (males 150830, females 167708). Density—78.1 persons per acre (exclusive of tidal water and foreshore). Inhabited Houses—41511 at Census, 1901. Rateable Value—£ 1956137 for year ending April 6th, 1907. Marriages—2501, being 15.7 per 1000. Births—8650, being 27.2 per 1000. Deaths (corrected)—4652, being 14.6 per 1000. Infantile Mortality—941 deaths (corrected) under 1 year being 108.8 per 1000 total uncorrected births. Zymotic—Death-rate, 1.2 per 1000 (total deaths, 379). Estimated increase of Population 2764, but the natural increase or increment (i.e., excess of Births over Deaths) is 3724 (uncorrected) 88 89 TABLE V. TABLE V. [Local Government Board Old Table A.] Table of DEATHS during the year 1907 in the Borough of Lambeth, classified according to Diseases, Ages, and Localities. Names of 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. (i) 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. Puerperal. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Influenza. Injuries. All other Diseases. 1 . Relapsing Continued. Enteric or Typhoid. Typhus. (a) (b) (c) (d) (e) (f) (g) (h) Royal Infirmary (Women and Children) 47 18 10 5 3 10 1{ Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 6 ... ... 8 ... ... ... 14 28 ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 6 ... ... 12 19 ... General Lying-in Hospital, York Road 50 45 ... ... 2 3 ...{ Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... 43 45 ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 5 ... Remainder of Waterloo 311 107 46 10 5 99 44{ Under 5 ... ... ... ... ... ... ... ... ... ... ... 18 17 7 ... 2 36 ... ... 7 66 153 ... 5 upwds. ... ... ... ... 2 ... ... ... ... ... ... ... 1 ... 1 23 40 28 2 8 53 158 ... St. Thomas's Hospital 696 79 94 64 71 335 53 Under 5 ... ... 19 ... ... ... ... ... ... ... 2 6 2 13 ... 1 21 ... ... 21 88 173 ... 5 upwds. ... ... 1 ... 3 ... ... 2 ... ... 2 ... ... 1 2 9 18 56 1 55 373 523 ... Remainder of Lambeth Church 320 105 49 11 6 95 54 Under 5 ... ... ... ... ... ... ... 1 ... ... ... 17 8 8 8 3 41 1 ... 5 69 154 ... 5 upwds. ... 1 ... ... ... ... ... ... ... ... ... 2 ... ... 3 19 36 22 2 17 64 166 ... Lambeth Workhouse ... 125 9 ... ... ... 10 106 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 8 9 ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 23 42 ... 1 38 116 ... Lambeth Infirmary 712 58 31 7 33 368 215 Under 5 ... ... ... ... ... ... ... ... ... ... 2 2 5 2 ... 3 24 ... ... 1 50 89 ... 5 upwds. ... ... ... ... 2 ... ... 2 ... ... 6 ... ... 1 3 162 84 111 1 8 243 623 ... St. Peter's House 34 ... ... ... ... 3 31 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 18 4 ... ... 11 34 ... Remainder of Kennington J523 137 90 11 12 158 115 Under 5 ... ... 1 ... ... ... ... ... ... ... ... 31 16 7 ... 1 54 ... ... 2 115 227 ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 53 60 55 5 5 116 296 ... South-Western Hospital 104 4 63 22 7 8 ... Under 5 ... 30 33 ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 2 67 ... 5 upwds. ... 13 15 ... ... ... ... 4 ... ... ... ... ... ... ... "3 ... ... ... 2 37 ... Clapham Maternity 25 25 ... ... ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 24 25 ... o upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Remainder of Stockwell 553 127 63 14 16 192 141 Under 5 ... ... ... ... ... ... ... ... ... ... ... 15 13 8 ... 2 45 ... 2 7 98 190 ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... 3 46 85 43 10 11 165 363 ... 90 91 TABLE V.—continued. TABLE V -continued. [Local Government Board Old Table A—contimied.] Table of deaths during the year 1907 in the Borough of Lambeth, classified according to Diseases, Ages, and Localities—continued. Names of Localities adopted for the purpose of these Statistics, public institutions being shewn as separate localities. Mortality from all causes, at subjoined AGES. Mortality fro* subjoined causes, distinguishing deaths of Children under Five Years or 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 a 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Puerperal. Fevers. Cholera. Erysipelas. Measles. Whooping Cuugh. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis. Pneumonia and Pleurisy. Heart Disease. Influenza. Injuries. All other Diseases. Total. Relapsing. Continued. Enteric or Typhoid. Typhus. (a) (b) (C) (d) (e) (f) (g) (h) (i) Belgrave Hospital 107 66 32 9 ...{ Under 5 ... ... 1 ... ... ... ... ... ... ... 1 ... 2 6 ... 1 28 ... ... ... 59 98 ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... ... 1 5 9 ... Remainder of Brixton 719 158 60 18 23 24 2 218 | Under 5 ... ... ... ... ... ... ... ... ... ... ... 8 26 6 2 47 1 ... 8 119 218 ... 5 upwds. ... 1 ... ... ... ... ... 1 ... ... 2 1 ... 2 7 54 94 71 10 23 233 501 ... 'Lambeth Workhouse Schools 14 2 5 7 ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 5 7 ... 5 upwds. v ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... ... 3 7 ... British Home of Incurables } 9 ... ... ... ... 5 4{ Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 ... ... 6 9 ... Remainder of Norwood 577 104 47 11 16 167 232| Under 5 ... ... ... ... ... ... ... ... ... ... ... 9 17 10 ... ... 34 2 1 5 73 151 ... 5 upwds. ... ... ... ... ... ... ... ... ... ... 1 ... 3 2 41 80 73 6 b 214 426 ... Totals 4926 1044 590 189 194 1695 1214 Under 5 ... 30 54 ... ... ... ... 1 ... ... 5 107 107 75 3 15 340 4 3 57 833 1634 ... 5 upwds. lb 16 10 ... ... 9 ... ... 11 3 4 4 24 423 545 514 36 135 1543 3292 ... 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 474 36 38 27 34 246 93 Under 5 ... 3 7 ... ... ... ... ... ... ... ... 1 4 5 1 2 11 1 ... 10 29 74 ... 5 upwds. ... 3 3 ... 1 ... ... ... ... ... 1 ... ... 3 3 43 32 61 1 37 212 400 ... Deaths occurring within the district among pet sons not belonging thereto 748 139 111 67 61 286 84 Under 5 ... 10 26 ... ... ... ... ... ... ... ... 4 4 15 ... 2 27 ... ... 10 152 250 ... 5 upwds. ... 3 7 ... 1 ... ... 5 ... ... 2 ... ... 1 3 16 35 63 1 39 321 498 ... 92 93 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 1907, 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. New Cases of Sickness in each the knowledge of the Medical Locality, coming to Officer of Health. Number of such Cases removed from their Homes in the several Localities for Treatment in Isolation Hospital. Census 1901. Estimated to middle of 1907. 1 2 3 4 5 6 7 8 9 10 ii 12 1 2 3 4 5 6 7 8 9 10 ii 12 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Fevers. Cholera. Erysipelas. Cerebro-Spinal Meningitis. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Typhus. Fevers. Cholera. Erysipelas. Cerebro-Spinal Meningitis. Typhus. Typhoid or Enteric. Continued. Relapsing. Puerperal. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) Waterloo 27440 26251 1487 - 138 32 2 — 7 — — 4 — 32 3 — 135 30 1 — 7 — — 1 — 8 3 Lambeth Church ... 27440* 26743 749 - 146 34 — — 6 1 — 4 — 22 2 — 121 33 — — 4 1 — 1 — 6 2 Kennington 52518* 54404 1589 - 207 58 3 1 11 3 — 2 — 47 5 — 204 45 1 — 9 2 — — — 8 5 Stockwell ... 63826 66674 2007 - 436 62 4 — 9 1 — 5 — 42 1 — 435 62 1 — 8 1 — 3 — 15 1 Brixton 73673 80178 1621 — 378 9u 4 — 14 - — 5 — 48 1 — 323 69 2 — 12 — — 3 — 8 1 Norwood ... ... 56998 64188 1197 — 176 41 — — 9 1 — 2 — 40 1 — 139 28 — — — — — — — 7 1 Totals 301895 318538 8650 — 1481 317 13 1 56 6 - 22 — 231 13 — 1357 267 5 — 40 4 — 8 — 52 13 • The Census 1901 populations for Lambeth Church and Kennington Sub-Districts are approximate only. 94 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, 1907. Total number of Notices 14883 NOTIFIABLE INFECTIOUS DISEASES. (Public Health, London, Act.) No. of Notices served 2140 No. of Infected Houses 1922 Smallpox - Scarlet Fever 1288 Typhoid 53 Typhus 1 Continued Fever 6 Diphtheria 298 Membranous Croup 13 Puerperal Fever 22 Erysipelas 228 English Cholera — Cerebro-Spinal Meningitis 13 95 PARTICULARS OF SANITARY WORK Carried out in Lambeth Borough during 1907, 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. 1907 14883 9902 3252 Old Parish of Lambeth. 1900 10065 10291 2303 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 2115 1886 4504 2433 2071 1885 3567 1459 2108 1884 3727 1621 2106 1883 3000 1294 1766 1882 3239 1267 1972 l881 3730 1293 2437 1880 3259 1106 2153 1879 3075 960 2115 1878 3310 1169 2211 1877 3563 1299 2264 Average for 24 years, 1877-1900 ) 5944.6 4756.9 2135 .9 N.B.—The increase in the numbers since 1896 is due to the increased Inspectorial Staff. 96 A. Public Health (London) Act and Metropolis Local Management Acts. Notices (Preliminary and Statutory) 12743 Works, Structural :— Drainage defective 1401 Intercepting Traps with Fresh Air Inlets required 196 Ventilating Pipes required 251 Indoor Sinks connected with the Drain 468 Rain Water Stack Pipes connected with the Drain 771 Bath Waste connected with the Drain 86 Traps Defective, or of Obsolete Pattern 843 Closet Pan and Connections Defective 1076 Water Supply to Closet Defective 951 Closet Dilapidated 656 Draw-off from Main for Drinking Purposes required 196 Dust Bins Defective 846 Premises Dilapidated 241 Ventilation under Floors required 64 Roofs Dilapidated 378 Soil Pipes Defective 91 Paving Defective 1256 Damp and Unwholesome Houses 96 Dung Receptacles required 35 Works not Structural :— Cisterns Dirty 114 Manure Accumulations 68 Underground Rooms occupied 14 Animals Improperly Kept 36 Stopped Drains 390 Overcrowding 37 Foul Urinals 51 Refuse'Accumulations 56 No Water Supply or Defective Water Supply 225 Dirty Premises 2261 13154 97 B. Infectious Diseases Notification. Notices served (1922 infected houses) 2140 SUMMARY OF WORK DONE BY THE SANITARY INSPECTORS DURING 1907. Inspections 9359 Re-inspections 61494 Infectious Houses visited 1922 Complaints attended to 6545 Cases of Infectious Disease notified 2140 (a) Cases under treatment at Home 394 (b) Cases removed to Hospital 1746 Cases of Non-Notifiable Diseases dealt with 4047 Houses disinfected 1956 Rooms disinfected 4881 Bedding, etc., disinfected 24891 Bedding, etc., destroyed 200 Dust Yards, Manure Depots and Brickfields, inspections of 312 Drains tested (with chemical, water, or both) 10565 Sanitary Works completed 6352 Plans of drainage reconstructions received and approved 514 Premises the Drains of which have been totally or partly reconstructed 707 Articles procured for the Analyst— (a) Food and Drugs 1800 (b) Water 3 Special Smoke observations and enquiries 580 New Workshops inspected and registered 100 Bakehouses inspected (including 79 underground) 214 Cowhouses inspected 15 Slaughter-houses inspected 27 Restaurants (new) inspected and registered Outworkers' Rooms visited 178 g 98 Notices— Sanitary Work (Preliminary and Statutory) 12728 Infectious Diseases (Public Health Act, 1891) 2140 Housing of Working Classes Act — Metropolis Local Management Acts15 Sanitary nuisances abated— (a) Structural 9902 (b) Non-structural 3252 Persons received at the Shelters — Summonses issued 125 Convictions obtained— Public Health Act 10 Food and Drugs Acts 80 MALE SANITARY INSPECTORS. During 1907, no change has taken place in the personnel of the Male Inspectorial Staff, which, individually and collectively has worked well, as shewn by the results of inspections, reinspections, &c., tabulated throughout the Report. It is again satisfactory to note that during 1907 in but very few cases (0.1 per cent, of the total notices served) has it been found necessary to resort to legal proceedings before the magistrate in connection with sanitary work carried out under the Public Health and Metropolis Management Acts—17 summonses in all. Combined Drainage. Many combined drainages have been reconstructed by the Council during 1907, at a cost amounting to £ 1334 13s. 4d. (estimated), as the direct result of inspections carried out 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 99 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 prefer that the combined drains should be regarded as "drains," and not as "sewers." On December 6th, 1907, an important Conference of Metropolitan Sanitary Authorities was held at the St. Pancras Town Hall (23 Metropolitan Authorities, including the City of London, being represented), A Bill to amend the Metropolis Management Acts with respect to sewers and drains has been drafted, approved and adopted, and a copy sent round to each of the City and Metropolitan Borough Councils, asking them to bring the Draft Bill before the Members of Parliament representing their respective districts, with a view to obtaining their support and co-operation in the promotion of the Bill through the various stages of the House. Clause I., defining the meaning of the word "drain" in the Draft Bill, is as follows :— In and for the purposes of the Metropolis Management Acts, 1855 to 1899; and the Public Health (London) Act, 1891, or any Act or Acts amending the same, the word "drain" shall be deemed to include any sewer or drain whether constructed before or after the passing of this Act with which two or more houses or premises are at the date of the passing of this Act, or may at any time thereafter be connected or which is used or capable of being or intended to be used for the conveyance of the drainage of such houses or buildings directly or indirectly to any sewer which has been approved as such by the Metropolitan lOO Commissioners of Sewers, the Metropolitan Board of Works or the London County Council, but shall not include any sewer so approved as aforesaid. House to House Inspections. A house to house inspection of the district is a duty laid upon Sanitary Authorities hy 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 large sanitary staff. Within the Borough, during 1907, a total of 2308 house to house inspections have been made, dealing with the following streets (whole or part) :— Marsh Ward.—Broadwall, Cage Place, Campbell Buildings, College Street, Commercial Road, Cornwall Place, Ethelm Street, Grindal Street, Johanna Street, Murphy Street, Paris Gardens, Peabody Buildings (Duke Street), Robert's Court, Sidwell Place, Tanswell Street, Thomas Place, Ufford Street, Wootton Street. Bishops s Ward.—Bird Place, Bird Street, By well Place, Longhope Place, Richmond Street, Stewart's Place. Prince's Ward.—Dunmow Place, Durham Street, Farnham Royal, Garden Cottages, Kennington Oval, Lyric Place, Laptord Place, Meadow Road, Meadow Row, Montford Place, Neville Street, St. Oswald's Place, Shepherd's Place, St. George's Cottages, Tate Street, Tyers Street, Tyers Terrace, Vauxhall Street, Wickham Street, Windmill Row, Vauxhall Ward.—Archer Street, Assay Street, Bond Street, Bradley Street, Dawlish Street, Gladstone Place, Horace Street, Hook's Cottages, Luscombe Street, Meadow Place, Meadow Road, Miles Street, Pleasant Place, Thorne Street. 101 Stockwell Ward.—Acre Lane, Broomsgrove Road, Clark'-, Row, Eastcote Street, Garden Row, Milstead Street, lngleton Street, Lingham Street, Northall Street, Stockwell Cottages, Stockwell Grove, Stockwell Mansions. Brixton Ward.—Baker Street. Bolton Street, Bishop's Road, Danes Road, Farrar Street, Hackford Road, Industry Terrace, Ivan's Place, Belgrave, Commerce, Grosvenor, Kenyon, Loughboro' and Prince's Mansions (Coldharbour Lane), St. Mark's Road. Heme Hill Ward.—Anstey Road, Cambria Road, Clarewood Mews, Geneva Terrace, Heron Road, Probert Road. Tulse Hill Ward.— -Bankton Road, Bartley Street, Brandon Road, Cornwall Koad, EfTra Terrace, Mill Lane, Milstead Street, Stewart's Place, Thomas Place, Tregenna Street. Norwood Ward.—Benton's Lane, Beaconsfield Cottages, Carnac Street, Charlotte Place, Change Alley, Dibden's Cottages, Durham Terrace, East Place, East Street, Gipsy Road, Gladstone Terrace, Hamilton Grove, Knight's Hill Square, Railway Cottages, Rommany Road. A total of 2308 houses have been inspected during 1907, and in 297 (i.e., 12.9 per cent.), a result was obtained from the chemical test applied to the drains. A total of 3547 nuisances were found to exist in 1529 houses (i.e., in 66.2 per cent, of the total houses inspected), but many were of a trifling nature, and not in any sense dangerous to the health of the inmates. Summary. Number of houses inspected 2308 Number of houses in which a result was obtained from test (chemical) applied to drains 297 Number of houses in which nuisances were found to exist 1529 102 Nature of Nuisances found and dealt with under the Public Health (London) Act, 1891. Dirty walls and ceilings of rooms 840 Defective roofs or rain water pipes 265 Defective or dirty yard paving 345 Detective flushing apparatus in water closets 205 Water closet pan foul 54 Drinking water tap defective, making walls damp 32 Gully or drains stopped 59 Floors defective 49 No dust-bins (or dust-bins defective or dilapidated) 282 Damp premises 216 Overcrowding 11 Defective water closets 135 Defective drains 332 Defective or deficient vent pipes or soil pipes 57 Defective sink wastes (or not undertrapped) 143 Defective manhole covers 14 Animals improperly kept 16 Cisterns uncovered or dirty 44 Improper water supply 35 Forecourts insufficiently paved or unpaved 135 Water closets insufficiently lighted or ventilated 8 Want of ventilation under flogrs 149 Want of proper dung receptacles 7 Underground rooms illegally occupied 5 Accumulations of manure 10 Defective traps 5 Sinks connected direct to drains 38 Mica valves defective 25 Urinal foul 2 W.C. dilapidated 5 Verminous rooms 4 Skylight defective 1 Dust accumulations 19 Total 3547 103 Drainage of Casual Wards in Wincott Street. The drainage at the casual wards was found to be waterlogged, rendering the basement of the premises liable to flooding. The Guardians suggested the removal of the laundry and the w.c.s from the basement to the ground floor level, so as to avoid this flooding, but the Local Government Board demurred to this proposal on the ground of expense and the amount of work proposed to be done. The Council decided to deepen the sewer in Wincott Street, so as to give a better fall to the drains of the casual wards and of other houses fronting on to this street, which are constructed with basements and which are liable to flooding in time of storm. The estimated cost was £1000. Approaches to Arches, IIerne Hill. During 1907, complaints were received in connection with the passageway at the backs of arches fronting Railton and Millbrook Roads. This passageway was found to be unventilated, unpaved and badly lighted, and, on account of want of proper light, was found to be used as an urinal, or for other undesirable purposes. Two of the shops abutting oil the passageway were occupied by a greengrocer and a fishmonger, so that the nuisance was accentuated when any of the trade refuse was left about, even for a short time, and notices were consequently served upon the London, Chatham and Dover Railway Company to properly pave, drain, light and ventilate the passageway; whilst a suggestion was also made to keep the gate, which is provided at the entrance, locked, night and day—the several occupiers (who have a right-of-way) to be provided with keys. The result of the Council's action has been that the Company have arranged to carry out the following works :— 1. Fix five new gas lamps; 2. Cleanse and limewhite the walls and root of the passageway; 3. Arrange for the cleansing of the passageway twice per week, and prevent the depositing thereon of any rubbish by the occupiers using such passageway; 4. The paving and draining of the passageway. 104 Inspection of Market Thoroughfares. The Market Thoroughfares have been, during 1907, under bi-weekly special inspection by the Inspectors (2 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. Outside Urinals of Public Houses. During 1907, the Outside Urinals connected with Public Houses have been under inspection, and notices have been served in those instances where the Inspectors reported a nuisance. Unsound Food. One legal seizure of unsound food has been found necessary during 1907, viz., at Woodcote Place, West Norwood, on March 18th, a truck-load of herrings. An order was made by the Magistrate on the same day for the destruction of the unsound food, but difficulties afterwards arose in taking out a summons, which is consequently still in abeyance. In 5 instances voluntary surrenders have been made by the vendors, and the food destroyed, as follows :— (1) 1 case rabbits; (2) 65 cases preserved peas, containing 3200 quart tins, and 50 pint tins of peas; (3) 11 one-lb. tins condensed milk, which was "blown "; (4) 28 lbs. oxtails; (5) 4 stones of plaice and cod. Routine Work of Male Inspectors. During 1907, 707 houses have been re-drained throughout or in part; and 514 plans (representing the 707 houses) have been received in connection therewith. The drainage work is carried out under the personal supervision of the Inspectors the drains being in every case water-tested. 105 10565 tests (hydraulic, smoke or chemical) have been made by the Sanitary Inspectors during 1907. 64 Water Certificates (representing 174 houses separate or in blocks) have been issued during 1907 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 is completed satisfactorily also. 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 1907, 14868 notices have been served under the Public Health Act (8243 preliminary, 4485 statutory and 2140 in connection with infectious diseases), and 15 under the Metropolis Management Acts, making a total of 14883, dealing with 9902 structural, and 3252 non-structural, defects. 6545 complaints were attended to during 1907. The numbers of inspections and re-inspections carried out during 1907 by the Male Inspectors were 9359 and 61494 respectively, and to these must be added the summary of work carried out by the Female Inspectors and Smoke Inspector (vide pages 122-127 and 112-114). 17 summonses were taken out, and 7 were withdrawn— the owners having, meanwhile, done the works necessary to comply with the notices as originally served, whilst, in the remaining 10, convictions were obtained. Other Inspections. The work in connection with disinfection, smoke abatement, 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 post). 106 DISINFECTING DEPARTMENT. During 1907 good work has been done by the Staff (individually and collectively) in connection with the Disinfecting Department—4881 infected rooms and 24891 infected articles (bedding, etc.) having been disinfected, as compared with 4061 and 22850 respectively during 1906. A total number of 2140 notifiable infectious diseases (including 13 cases Cerebrospinal Meningitis) have been reported during the year 1907, but a large amount of disinfection has also been carried out in connection with cases of Measles (1998), Whooping Cough (748), Tuberculosis (677), Chicken-pox (600), Cancer (24), Verminous Houses and Persons (71), and Other Diseases (131). Full details are to be found on pages 109-111. The whole of the 2140 compulsorily notifiable diseases (representing 1922 infected houses) have been dealt with, whilst 12 Schools have been disinfected in connection with outbreaks of infectious disease, viz., Measles 8, Scarlet Fever 8, and Whooping Cough 1 Particulars as to disinfection carried out in the Borough of Lambeth during 1907. Total No. of rooms disinlectfd by Council 4881 Cases in which bedding has been disinfected at home 1096* Do. do. do. at Chamber 4781 Do. do. do. destroyed 44 Bedding replaced by the Council Nil Premises disinfected and disinfectants supplied 11808 Infected cabs disinfected 4 No. of Cleansing Notices served in connection with infected houses 2263 Certificates of Medical Practitioners received in lieu of disinfection by the Council 33 * This number is increased, compared with previous years, owing to bedding no longer being removed to the Disinfecting Chamber in the cases of Measles, Chicken-pox and Whooping Cough. 107 Certificates of disinfection left with occupiers of disinfected premises 3349 Library Books disinfected 253* Articles of bedding, etc., disinfected. Beds 1825 Bolsters 1588 Pillows 4371 Mattresses 1422 Palliasses 118 Chair Cushions 664 Clothing 4714 Sheets 2166 Blankets 4078 Rugs and Mats 76 Counterpanes and Eiderdown Quilts 1767 Carpets 40 Extras [i.e. articles not mentioned in above) 2062 Total 24891 Articles of bedding, etc., destroyed. Beds 23 Bolsters 7 Blankets 5 Pillows 15 Quilts 2 Mattresses 22 Palliasses 33 Sheets 9 Chair Cushions 9 Clothing 63 Carpets 3 Sundries 9 Total 200 * 206 Public Library and 47 L.C.C. School Library books. 108 Practically all the disinfection was carried out by the Council's officers — only 33 certificates being received from Medical Practitioners during 1907, as compared with 31 during 1906. Particulars as to the 33 certificates (received during 1907) 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 Q. Total. For Rooms only — 1 — — 1 For Bedding only — — — — — For Rooms and Bedding 4 13 9 6 32 4 14 9 6 33 Refuges. There are 2 Refuges in the Borough, one at Wanless Road, and the other at the Wharf (Belvedere Road). Neither Refuge has been used during 1907—a fact that is understood, when it is remembered that the old method of sulphur fumigation for the disinfection of houses has given place to the new one of formalin spray, which can be carried out without trouble to the occupiers, taking only an hour or so to complete. The temporary housing of occupiers is unnecessary. 109 NON-NOTIFIABLE INFECTIOUS DISEASES, ETC. 1900—1907. 1st Q. 2nd Q. 3rd Q. 4th Q. Total. 1907. 1906. 1905 1904. 1903. 1902. 1901. 1900. Yearly average 7 years (1900-1906). Measles 219 1102 544 133 1998 836 1970 1294 1346 364 728 941 1068.4 Whooping Cough 302 307 103 36 748 455 440 380 325 110 72 126 272.6 Chicken-pox 190 129 71 210 600 354 733 305 356 1625 78 88 505.6 Consumption* 122 208 178 169 677 592 598 659 269 488 483 524 516.1 Cancer 4 6 7 7 24 18 16 20 13 34 15 23 19.9 837 1752 903 555 4047 2255 3757 2658 2309 2621 1376 1702 2382.6 •Consumption voluntarily notifiable throughout the Borough since June 1st, 1902. N.B.—131 other diseases (not classified) i.e., Mumps, Ringworm, Influenza, Scabies, Pneumonia, Glanders, Diseases not stated, etc., and 71 Verminous Houses and Persons, were also dealt with during 1907. 110 DISINFECTION STATISTICS. For eight years prior, and seventeen years subsequent, to the passing of the Notification of Infectious Diseases Act; and for the year 1907. 1882. 1883. 1884. 1885. 1886. 1887. 1888. 1889. Yearly average for 8 years preceding the Notification Act. 1907./###] No. of Cases in which Bedding, At Home 332 258 278 10 62 52 7 144 142.8 1096§ etc., has been disinfected. At Chamber 85 56 162 509 236 722 902 951 452.8 4781 No. of Cases in which Bedding, etc., has been destroyed. 37 23 62 52 8 57 48 79 45.7 44 No. of Articles of Bedding, etc., disinfected. 1526 1437 1895 2275 916 3078 3121 3778 2153.2 24891 No. of Articles of Bedding, etc., destroyed. 63 104 114 114 59 92 61 267 113.0 200 Premises Disinfected and Disinfectants Supplied. 727 680 657 727 736 1276 1255 1277 916.8 11808 Infectious diseases dealt with. Notifiable† - - - - - - - ~~ - 2140 Non-notifiable† — — — — — — — — — 4047 † vide footnote on page 111. § vide footnote on page 111. 111 DISINFECTION STATISTICS—continued 1890 to 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1902 1904 1906 1906 Yearly average for 17 yrs. succeeding the Notification Act. 1907 No. of cases in which Bedding, etc., has been disinfected.—At Home... 423 593 343 177 251 368 217 132 81 62 37 20 19 6 1 881 § 170.8 1096§ At Chamber 2961 2541 3042 2206 2472 2447 2126 2424 2998 2450 3040 3702 3253 3107 3583 2484 2653.2 4781 No. of cases in which Bedding, etc., has been destroy ed. 466 314 224 119 6 49 39 27 44 59 75 134 62 53 47 33 106.8 44 No. of Articles of Bedding, etc., disinfected. 9760 9909 11513 8022 1351 20349 21487 21597 27923 27528 27265 41029* 26957 26359 51552 22850 215469 24891 No. of Articles of Bedding, etc., destroyed 800 605 674 544 186 178 162 126 326 1783 959 1006* 587 479 519 419 558.4 200 Premises disinfected and dis intectants supplied 3538 3157 5896 5742 7146 7210 8715 8441 9146 9124 9522 12607 10984 12367 13212 11735 7925.4 11808 Infectious Diseases dealt wiih Notifiable† 1676 3025 4070 2433 2685 2801 2663 2329 2693 2209 2025 4273 1587 1938 1853 2074 2550.7 2140 Non-Notifiable† - — - — — 20 87 144 1339 1702 1376 1094 2269 2638 3927 2388 1469.6 404 7 * 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, 1892, and previous to 1896 practically no attention was paid to disinfection in connection with the non-notifiable infectious diseases. § This number is increased for 1905 and 1907 on account of bedding, etc., 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 19017 refer to the Borough Council; those for all previous years, to the late Vestry. 11 2 SMOKE ABATEMENT. During 1907 there have been made 580 special observations and enquiries in connection with smoke abatement throughout the Borough, as compared with 560, 600, 540, 720, 679 and 620 during 1906, 1905, 1904, 1903, 1902 and 1901 respectively. This is an important duty, and one that a Sanitary Authority is right in carrying out rigorously. During 1907, 64 smoke notices have been served and the nuisances abated. In four cases it was necessary to proceed to summonses, and the magistrate inflicted a penalty of £2 and 2s. costs against the Manager of the Lion Brewery Company, of Belvedere Road, and a penalty of 4 and 12s. costs against the Manager of the Bon Marche Company, Brixton. The smoke observations were made during the year throughout the Borough, special attention being paid to the chimneys of firms whose premises are situated in Belvedere and Commercial Roads and along the Albert Embankment (Potteries of Messrs. Doulton and Stiff). In connection with the last named (the Potteries) there is a total of 37 shafts, one or all of which may become a nuisance at any time by sending forth black smoke. It is satisfactory to be able to report that during 1907 there have been practically no nuisances observed in connection with these 37 shafts—a fact explainable inter alia by the care taken by the two firms (Messrs. Doulton and Stiff) in employing private smoke inspectors of their own to observe hourly the chimney shafts, and by the system of a bonus distribution once or twice a year to those stokers against whom there are no complaints of neglect. 113 Street (Kenniugton) and Elder Road (West Norwood) respectively, as follows :— (1) Brook Street—emission of smoke and grit from the chimney shaft at rear of the Guardians' premises (Brook Street). The Guardians decided to use small coke instead of coke breeze for the Infirmary boilers. The existing boiler power is insufficient for the extra demands made upon it since the erection of the Nurses' Home and the new Offices. The chimney is low and ill close proximity to, neighbouring houses. (2) Elder Road—smoke from a chimney shaft at the rear of the Norwood Schools, and which, by its low position, is apt to become a nuisance at times to the surrounding houses, which are situated on higher ground, so that the top of the shaft is about level with the eaves of the houses and about 60 feet away. Babbington coal was in use as fuel at the time of the complaints, and this was changed to coke, with the use of best Welsh smokeless coal during the process of cleaning out the boilers The nuisances complained of have been abated. Other special smoke nuisances dealt with by the Council during 1907 were :— (а) Laundries.—Beulah, South Lambeth Road. Belvedere, Acre Lane. Halstead, West Norwood. Arlington, Wanless Road. Sunnybank, South Lambeth Road. Wellington, Washington, Frederick Crescent. Rogers & Cook, South Lambeth Road. (б) Breweries —Norwood, Chapel Road. Hammerton's, Stockwell Green. New London Brewery, Durham Street. Barrett's, Wandsworth Road. Fremlin, Dane's Road. H 114 (c) Electricity Supply Companies.—Charing Cross, West End and City—Commercial Road. City and South London— Clapham Road. South London—Bengeworth Road. City and Waterloo—Launcelot Street. Electric Light Works, Electric Avenue. (d) Other businesses, etc.—Jews' Hospital, West Norwood ; Bakehouse, 94, High Street, West Norwood ; Meyer and Co., Vauxhall ; L.C.C. Works Department, Belvedere Road ; Cornell's Yard, Loughborough Junction ; Sharwood & Co., Offley Road ; G. Jennings, Limited, Lambeth Palace Road ; Bakehouse, 120, Acre Lane ; Green-house, rear of 67, St. James' Road ; Out-house, rear of 85, Dulwich 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—7 letters dealing with alleged smoke nuisances connected with : 115, Acre Lane (bakehouse) ; Causton & Co. (Clapham Road); 16, China Walk (bakehouse) ; 223, Coldharbour Lane ; Charing Cross and Strand Electricity Supply Corporation (Commercial Road); Doulton (Albert Embankment); Jews' Hospital (West Norwood) ; Nightingale & Co. (Glasshouse Street) ; Sunnybank Laundry (South Lambeth Road); South Loudon Electricity Sugply Company (Bengeworth Road). 2. Coal Smoke Abatement Society—9 letters dealing with leged smoke nuisances connected with : Peter Brotherhood (Belvedere Road); Charing Cross and Strand Electricity Supply Company (Commercial Road) ; Lion Brewery (Belvedere Road); Doulton (Albert Embankment); Meredith & Co. (Belvedere Road).; H. Meyer & Co. (Vauxhall); Phoenix Wharf (Commercial Road) ; Stiff and Co. (High Street); Walker, Parker & Co. (Belvedere Road). 115 WORKSHOPS*. During 1907, 100† new Workshops have been added to the Register,‡ consisting of the following:— Name of Trade or Business. No. of Workshops. Dressmakers 40 Laundries 6 Milliners 3 Tailors 15 Blouses 6 Furrier 1 Mantles 1 Clothing Repairers 1 Fancy Goods 2 Packing 1 Upholstery 1 Mattress Weaving 1 Cycle Making 1 Underclothing 1 Surgical Instruments 1 Boots and Shoes 4 Rag Sorting and Marine Store 1 Babies Clothes. 3 Postcard Colouring 2 Wafer Making 1 Ties 2 Brush Making 1 Shirts 2 * The new Factory and Workshop Act, 1901, came into force on January 1st, 1902, and entails much extra work, e.g., outworkers, etc. † Excluding 10 factories, viz.:—4 laundries, 2 bookbinding, 1 box making, 1 shirt making, I pickling, and 1 onion peeling. ‡ The Register contains (up to the end of 1907) a total of 1437 workshops with 2403 workrooms. 116 Name of Trade or Business. No. of Workshops. Waistcoat Makers 1 Doll Dressing 1 Cigarette Making 1 Total 100 Full particulars concerning these 100 Workshops have been entered up in the Register, and it is found that there are connected therewith 150 workrooms, in which were working at the time of inspection 416 persons—59 males and 357 females (females alone being employed in 77 workshops). There were found being employed— M. F. Total. Children — — — Young Persons 6 64 70 Adults 58 293 346 59 357 416 Notices as to the " protected persons" (i.e , children, young persons, and women) employed were sent on 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). 69 Notices of occupation of 95 workshops have been received during 1907 by the Borough Council from the Factory Inspectors, as compared with 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. 11 written Notices have been received during 1907 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, and due notice sent to the Factory Inspectors within one 117 month as to action taken in each case. The number of notices received in 1906, 1905, 1904, 1903, 1902 and 1901, were 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. In connection with the 100 new workshops inspected during 1907, the following insanitary conditions were met with at the time of the inspections :— 1.. As to Ventilation and Warming and Lighting. In 1 out of the 100 workshops (i.e., 1 per cent.), the ventilation was found to be unsatisfactory, and, with 2 exceptions, all the workrooms, at the time of inspection, were found to be reasonably warmed by open fireplaces, open or closed stoves, gas jets, steam pipes, etc., and sufficiently lighted. 2. As to Cleanliness. In 7 workshops (i.e., 7 per cent.) the workrooms were found to be dirty, and to require cleansing. 3. As to Sanitary Appliances. In 13 (i.e., 13 per cent.), the sanitary fittings and appliances were found to be bad. The w.c.s were outside in 41.4 per cent., inside in 35.4 per cent., and outside and inside in 23.2 per cent. The soil pipes were found to be unventilated, or insufficiently ventilated, in 24 cases (i.e., 24 percent.), a condition of things which may, or may not, be a nuisance; and in 2 cases there was found to be direct communication between w.c.s and workrooms. 4. As to Dampness. In 2 workshops (i.e. 2 per cent.), the workrooms were found to be damp. 118 5. As to Overcrowding. The cubic capacities of the different workrooms were, naturally, found to vary considerably, and in G workrooms (i.e., 4 per cent.) over-crowding was found to exist. In addition to inspecting the above workshops wherein females were employed, the special work done by the Female Inspectors is dealt with on pages 122-126. The inspections made during 1907 in connection with the 10 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 10 factories there were found to be 33 workrooms, wherein were employed, at the time of inspection, 466 persons—107 young persons (11 males and 96 females) and 359 adults (40 males and 319 females). 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 Female Sanitary Inspectors is noteworthy (vide Special Report dealing with this particular work, pp. 122-127). "9 WORKSHOPS REGISTERED DURING 1907. 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. Total. Marsh Scorrer 5 6 - - 1 2 1 5 2 7 9 Bishop's Clements 9 14 — — 2 2 6 25 8 27 35 Hooper 8 13 — — — 5 8 7 8 12 20 Prince's Howes 16 22 — — 2 19 11 38 13 57 70 Jones 7 17 — — — 3 5 45 5 48 53 Vauxhall Jackson 13 3 — — — 1 — 9 — 10 10 Stock well Baxter 5 7 — — 1 3 2 10 3 13 16 Brixton Gavin 15 27 — — — 9 6 57 6 66 72 Bott 7 9 — — — 5 3 37 3 42 45 Tulse Hill Wallis 7 9 — — — 10 1 20 1 30 31 Smith 8 9 — — — 2 7 17 7 19 26 Norwood Barfoot 10 14 — — — 3 3 23 3 26 29 Total 100 150 — — 6 64 5 3 293 59 357 416 N.B.—With 5 exceptions, the Inspections were made in connection with the above 100 Workshops by the Female Inspectors. 120 121 WORKSHOPS,:—Details as to Sanitary Conditions and Defects found during 1907. Old Parish Districts, and the Inspectors in charge thereof. Details as to Sanitary Conditions and Defects found. Marsh. Bishop's and Prince's. Vauxhall & Stockwell. Brixton. Tulse Hill, Norw'd. Totals. Scorrer. Clements. Hooper Jones. Howes. Jackson. Baxter. Gavin. Bott. Wallis Smith. Barfoot. Ventilation satisfactory 5 9 8 7 16 3 5 14 7 7 8 10 99 not — — — — — — — 1 — — — — 1 Cleanliness satisfactory 5 8 8 7 14 3 4 15 7 6 6 10 93 not — 1 — — 2 — I — — 1 2 7 Workrooms damp — 2 — — — — — — — — — 2 not ... 5 9 6 7 16 3 5 15 7 7 8 10 98 Workrooms warm 5 9 8 7 15 3 5 15 6 7 8 10 98 not — — — — 1 — — — 1 — — — 2 State of sanitary fittings, &c. good 5 9 8 7 15 3 3 13 5 6 6 7 87 bad — — — — 1 — 2 2 2 1 2 3 13 Soil pipe ventilated 4 8 6 6 10 3 4 11 6 3 7 8 76 not ventilated 1 1 — 1 — — 1 — — — 1 — 5 no soil pipe — — 2 — 6 — — 4 1 4 — 2 19 Position of W.C. outside 4 6 5 4 5 3 1 6 1 3 1 2 41 inside — 2 3 8 8 — 3 4 2 4 2 4 35 outside and inside 1 1 — — 3 — 1 5 4 — 4 4 23 No W.C. — — — — — — — — — — 1 — 1 Separate W.C. accommodation Yes — 3 4 2 7 1 2 5 4 1 2 5 36 No 5 6 4 5 9 2 3 10 3 6 6 5 64* Communication (direct) between W.C.s & rooms Yes — 1 — 1 — — — — — — — — 2 No 5 8 8 6 16 3 5 15 7 7 8 10 98 N.B.—The Wards of the old Parish or Lambeth are retained so that this Table may be comparable with those in previous Reports (1897-1905) The above Workshops (with 5 exceptions) were inspected by the Female Sanitary Inspectors. * In none of these cases was separate W.C. accommodation required- person of one sex only being employd 122 FEMALE SANITARY INSPECTORS. 1907 is a year's record of good work carried out by the Female Sanitary Inspectors (Miss Gamble and Miss Pearson*) in connection with (a) Factories, Workshops (Work-placest), Shops Out-Workers' Homes, Laundries, etc., wherein women and girls are employed ; (b) Underground Conveniences (belonging to the CounciH, and other Ladies' Sanitary Conveniences (Railway Stations, Hospitals, etc.) ; (c) Houses wherein births have occurred, or deaths amongst infants under 1 year of age : (d) schools wherein there have been infectious disease outbreaks ; etc. The year's work, 1907, may be tabulated as follows :— Summary of work carried out by Female Sanitary Inspectors during the year 1907, and duriug the preceding five years 1902-6 (for comparison). Workshopst visited and inspected— 1907 1906 1905 1904 1903 1902 (a) Dressmakers 85 143 103 80 157 142 (b) Milliners 4 87 21 14 12 20 (c) Laundries 28 117 17 37 72 70 (d) Tailors 15 42 22 7 22 14 (e) Upholsterers 1 9 1 — — 1 (/) Dyers — 8 1 2 2 1 (g) Others 32 66 59 23 48 32 Work rooms inspected 311 703 330 495 669 325 Workshopst re-inspected 85 188 81 98 163 333 Workrooms re-inspected 114 256 90 113 214 305 Restaurants, etc., re-inspected 558 523 — — 87 118 Workshops†: workrooms therein measured 313 360 314 265 450 318 Workshops† removed from Register 37 118 82 9 19 29 Workshops† reported to H.M Inspector 36 27 63 31 19 48 Workshopst reported by H.M. Inspector 95 47 22 13 46 102 Workshopstnewlydiscovered and registered 100 12O ‡92 69 152 3 §Premisesvisited but no femalehands found to be employed (including Out-workers) 1471 1041 259 135 231 80 * Miss Gamble was elected on October 3rd, 1901, and Miss Pearson on December 8th, 1905. † Workshops include Workplaces. ‡ Including 6 factories. § 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. 123 Female Conveniences visited & inspected— 1907 1906 1905 1904 1903 1902 Public (visits paid) 569 597 577 597 343 276 Private (visits paid) — 15 — — 5 35 Schools visited— Public 7 25 18 13 20 10 Private — 5 1 2 — 1 Special places visited and inspected— (a) Restaurants and Hotels, etc. — — 1 — 22 220 (6) Private Houses 1310 1341 224 322 218 199 (c) Out-workers 178 181 145 134 107 — (d) Others — — — — 3 5 Written Intimations and Statutory Notices served 424 647 194 200 198 262 No. of Workshops, etc, in which no defects were found on inspection 1205† 1255 507 508 371 382 No. ot Workshops in which defects were found on inspection 459† 764 245 254 292 322 Particulars of defects found. Workrooms— Overcrowded 22 20 14 11 16 4 Damp 28 36 9 10 13 7 Dirty 173 295 135 184 217 208 Ill-ventilated 4 13 2 1 5 7 Otherwise 5 8 3 — — 3 Defects— Yards 52 75 11 12 19 29 Floors 10 27 4 11 18 19 Roofs 26 17 5 6 13 7 Windows 1 5 — 1 — 4 Ceilings 50 33 6 9 23 17 Rain Water Pipes 5 13 4 5 9 13 Premises generally 10 17 — 4 5 9 Sanitary Appliances : Waterclosets— Dirty 105 219 83 64 83 86 Ill-lighted — 2 1 — — 1 Unventilated 4 17 7 1 16 5 Choked 20 37 5 3 3 15 Defective 45 67 44 28 51 44 Defective Flushing Tanks and Water Supply 81 137 39 35 43 91 No separate suitable accommodation for the sexes 7 14 7 1 8 _ Drainage— Defective, unventilated, etc. 22 23 2 6 7 9 † Excluding the 1471 premises wherein no female hands were found to be employed. 124 Dustbins— 1907 1906 1905 1904 1903 1902]/###] Wanting 51 69 25 34 49 72 Defective 68 120 23 21 33 34 Lavatories— Defective or dirty Miscellaneous defects (not included above)— 21 3 12 - 2 8 Animals improperly kept 1 7 — 1 1 3 Accumulations in yards — 11 9 7 2 20 Sink wastes defective 6 10 — — — 8 Otherwise — 1 — — 1 — Nuisance referred to M. O. H. for attention by Male Inspectors (defective drains, w.c.s, etc.) 55 154 48 59 86 68 The Female Public Conveniences are under constant supervision by the Female Inspectors, 569 visits having been paid thereto during 1907. The Female Inspectors have during 1907 been engaged in visiting 72 houses wherein deaths from infantile (summer) diarrhoea have been reported as having occurred, with a view to helping to further elucidate the predisposing causes of this disease; and in inspecting schools (7), and the homes of the scholars, in connection with outbreaks of disease (more especially measles). It will be noted, in connection with the inspections and reinspections 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 dustbins. Overcrowding was only found in 22 cases—in each instance being slight. Out-workers. The work commenced by the Female Inspector in 1903, and continued during 1904, 1905 and 1906 connected with the visiting and inspecting of out-workers' premises and homes (situated within the Borough of Lambeth), has been further continued during 1907. 125 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), and it replaces the Order of August 15th, 1905. This new Order enlarges 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, chip, or similar material; peapicking ; feather sorting; the carding, boxing or packeting of buttons, hooks and eyes, pins and hairpins ; and baskets. During 1903-7 a total of 745 out-workers'premises have been inspected and registered (178 during 1907), connected with the following trades and businesses : 1903. 1904. 1905. 1906. 1907. 1903-7. Mantles 6 12 20 11 6 55 Blouses and Skirts 10 14 24 24 19 91 Ties and Belts and Braces 24 19 14 17 11 85 Baby Clothing 6 4 4 — 5 19 Children's Underclothing and Costumes 5 10 9 9 4 37 Women's Underclothing 5 2 7 9 6 29 Tailors 10 15 8 42 20 95 Upholsterers 1 — 1 2 — 4 Embroidery 9 3 9 2 13 36 Dressing Gowns 2 5 3 — 1 11 Shirts 13 7 7 3 1 31 Aprons 1 — 2 — — 3 Waistcoats 4 3 4 14 20 45 Jerseys 2 — 1 1 — 4 Hosiery 1 — — 1 — 2 Widows'Caps 1 —" — 1 — 2 126  1903. 1904. 1906. 1906. 1907. 1903-7. Men's Caps 1 1 1 3 — 6 Vamp Beader 1 — 1 — 1 3 Wigs 2 — — — — 2 Incandescent Mantles 1 — — — — 1 Boots and Shoes 1 4 2 3 15 25 Umbrellas 1 — — — 2 3 Dresses — 9 7 1 1 18 Waterproofs - — — 2 — 2 Millinery — 2 5 5 1 13 Collars — 5 3 4 1 13 Sacks — 1 — — — 1 Paper Bags — 2 2 3 5 12 Boxes — 4 2 7 20 33 Mattresses — 1 — — — 1 Lace — 2 1 1 — 4 Pinafores — 1 — — — 1 Sheets & Pillow Cases — 4 — — 2 6 Smocking — 2 1 2 2 7 Needlework — 1 1 — 1 3 Curtains and Blinds — — — 1 1 2 Carpets — 1 1 — — 2 Brushes — — — 2 4 6 Dyers and Cleaners — — 1 2 — 3 Buttonhole Making — — 1 2 — 3 Book Folding — — — 1 — 1 Straw Hats — — 1 — — 1 Bottle Covering — — 1 — — 1 Fur-pulling — — 1 3 — 4 Artificial Flowers — — — 3 8 11 Silk Hats — — — • — 4 4 *Unclassified — — — — 4 4 Totals 107 134 145 181 178 745 * Envelope folding I, doll dressing I, chair caning 1, and fancy articles 1. 127 The Wards in which the houses (wherein these 745 outworkers were found to be working during 1903-7) are situated, are as follows :— 1903. 1904. 1905. 1906. 1907. 1903-7 Marsh 12 14 8 37 38 109 Bishop's 10 16 29 14 19 88 Prince's 38 13 18 42 31 142 Vauxhall 12 4 5 5 12 38 Stockwell 18 9 19 20 14 80 Brixton 17 37 42 32 39 167 Herne Hill — 26 12 18 13 69 Tulse Hill — 10 8 5 6 29 Norwood — 5 4 8 6 23 Totals 107 134 145 181 178 745 UNDERGROUND CONVENIENCES. The conveniences have been kept under regular inspection during 1907—the male conveniences by the male inspectors and the female conveniences by the female inspectors. The staff of attendants, individually and collectively, have given satisfaction. The new Waterloo Underground Convenience (Males and Females) constructed at the corner of York Road and Waterloo Bridge Road, was opened to the Fublic on May 22nd, 1907. The total cost was £3,364 Is. 10.1. A tender was accepted during 1907, for the construction of the convenience to be elected at Brockwell Park, Herne Hill, at a cost of £2,331 10s. 5d. 128 ANALYSIS OF FOOD AND DRUGS, WATER, &c. 1.—Food and Drugs. During the year 1907, 1800 samples have been purchased within the Borough of Lambeth, and submitted to the Public Analyst for analysis. Of the 1800 samples, 154 (i.e., 8.6 per cent.) were reported by the Analyst to be adulterated, varying quarterly as follows :—1st quarter, 5.9 per cent. ; 2nd, 9.4 per cent. ; 3rd, 8.2 per cent.; and 4th, 9.5 per cent. ; and 110 summonses were issued, with the result that 79 convictions were obtained, including one for obstructing the Inspector, together with £118 10s. in penalties, and £61 16s. in costs. In 18 cases the vendors were cautioned. Full details are to be found on pp. 141-144, and in the Appendix (pp. 27-48). 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, 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 16 cases (average), the vendors were cautioned. In the Borough, 710, 704, 1010, 1200, 1500 and 1500 samples were taken during 1901, 1902, 1903, 1904, 1905, and 1906 respectively. During 1907, nine samples of butter were submitted to the Public Analyst by private purchasers. Particulars of the 1800 articles submitted by the Food and Drugs Inspector during 1907 are as follows:— 129 (a) Milk. 827 samples were taken, and of these 95 (i.e., 11.5 per cent.) were declared by the Analyst to be adulterated. 11 of the samples were purchased as " separated " milks (none adulterated), and 7 as skimmed milks (2 adulterated). The 95 adulterations found were as follows :— (1) Extraneous water (27), varying from a minimum 2 to a maximum 23 per cent., viz.:—2, 2, 2, 3, 3, 4, 4, 4, 4, 4, 4, 5, 5, 6, 6, 6, 6, 6, 9, 10, 11, 14, 14, 18, 20, 21 and 23 respectively. (2) Deficiency in milk-fat (59), varying from a minimum 3 to a maximum 80 per cent., viz. :—3, 4, 4, 5, 5, 5, 5, 5, fi, 6, 6, 6, 7, 7, 7, 7, 7, 7, 9, 9, 10, 10, 10, 10, 10, 10, 11, 12, 12, 12, 12, 13, 14, 14, 14, 14, 14, 15, 16, 16, 16, 16, 16, 20, 20, 20, 20, 21, 22, 22, 23, 25, 30, 39, 43, 43, 52, 60 and 80 respectively. (3) Extraneous water and deficiency in milk fat (4), viz. :— 3 and 3, 3 and 7, 4 and 16, and 5 and 13 per cent, respectively. (4) Added preservatives (3), viz :—0 0002 per cent, formaldehyde, and 0.5 and l£ grains of boric acid per pint respectively. (5) Skimmed milk (2), viz.:—separated milk and 21 per cent, extraneous water respectively. In 71 samples of milk adulteration, 75 summonses were taken out, and in 51 cases convictions were obtained, with penalties varying from a minimum 5s. (with 12s. 6d. costs) to a maximum £20 (with 12s. 6d. costs). I 130 In the remaining 24 cases, the results of the summonses were as follows:— (n) Summonses dismissed (17), on account of the following legal technicalities:—warranties proved, 3 ; retailer already convicted for the same sample, 1 ; wrong service of summons on husband instead of on wife, 1 ; duplicate samples not having been sent to farmers in all cases, 8 ; amount of adulteration too small, 1 ; and delivery not made direct to Inspector by Guard of train, who placed the milk churn upon the platform where it remained 20 minutes before the Inspector took the sample, 3. (b) Summonses withdrawn (6), on account of the following legal technicalities:—amount of adulteration too small, 1 ; date of hearing of summons too early (a clear 14 days not having elapsed), 3 ; service of summons on local office instead of on Registered address of the Limited Liability Company, 1 ; and milk taken direct from same cow proving on analysis to be below the Government standard, 1. (c) Summons adjourned sine die(l), on account of the following legal technicality, viz:—summons served on the Secretary of a Limited Liability Company (this point being the subject of an appeal in another case). In 24 cases, no summonses were taken out for the following reasons:—(1) amounts of adulteration too small (17); (a) extraneous water, 2, 2, 2, 3 and 4 per cents, respectively; (b) fat deficiency, 3, 4, 5, 5, 5, 6, 6 and 10 per cents, respectively ; (c) extraneous water and fat deficiency, 3 and 7 per cents.; (id) added preservatives, £ and 1½ grains of crystallised boric acid per pint, and 0.0002 per cent, formaldehyde respectively • (2) special samples taken (7). (a) The sample was taken by the Inspector direct from a milk can furnished with a tap about up from the bottom—the can with milk in having stood overnight, and shewed, on 131 analysis, deficiency in fat to the extent of 80 per cent. ; (b) the samples of milk had been collected direct from the cow, 5 of thern actually in the presence of a Sanitary Inspector, and shewed, on analysis, deficiency in fat to the extent of 6, 15, 16, 16, 25 and 60 per cents, respectively. The total fines amounted to £80 15s. with £37 16s. costs. (b) Butter. 447 samples of butter were taken, and of these 25 (i.e., 5.6 per cent.) were declared by the Analyst to be adulterated—the adulterations consisting of (1) added margarine (21), varying from a minimum 20 per cent, to a maximum 100 per cent., viz. 20, 20, 20, 50, 55, 70, 90, 90, 93, 95, 95, 95, 96, 96, 96, 96, 98, 98, 98, 98, 100 respectively; (2) excess of water (1) viz., 9'7 per cent, beyond the natural 16 per cent, allowed; (8) margarine exposed for sale without properly labelling the same (3). In 72 samples of butter adulteration, 23 summonses were taken out, and in 19 cases convictions were obtained with penalties varying from a minimum 5s. (with 12s. 6d. costs) to a maximum £5 (with 19s, 6d. costs). In the remaining four cases, the results of the summonses were as follows :— (a) Summons dismissed (1)* Somerset House, on appeal, certifying the butter as genuine. (b) Summonses withdrawn (2)—in one instance the defendant having died between the issue and the hearing of the summons, and in the other the butter having been proved to be sold as " milk-blended butter." (c) Summons not served—the defendant having left the neighbourhood between the time of the Inspector taking the sample and the summons being applied for. * With £2 2s. costs against the Council. 132 In three cases no summonses were taken out for the following reason, viz., that the samples were wrapped in paper marked "Margarine" before being handed to the purchasers. The total fines amounted to £26 5s. with £11 12s. costs, whilst in the case of obstruction the defendant was fined £5 with £5 5s. costs. (c) Cocoa and Chocolate Powder. 45 samples of cocoa and 3 of chocolate powder were taken, and of these 1 (a sample of cocoa) was declared by the Analyst to be adulterated with starch and sugar. No summons was taken out, as the article was declared to be chocolate powder by the vendor before the purchase was completed. (d) Coffee. 140 samples were taken, and of these 5 (i.e. 3.6 per cent.) were declared by the Analyst to be adulterated—the adulterations consisting of added chicory varying from a minimum 8 to a maximum 57 per cent., viz., 8, 34, 48, 48 and 57 respectively. Summonses were applied for, and [convictions obtained, in 4 of the cases with penalties and costs varying from a minimum 10s. (with 12s. 6d. costs) to a maximum £2 (with 12s. 6d. costs)— total £3 penalties and £3 3s. 6d. costs. In one case no summons was taken out on account of the package being labelled as a mixture of coffee and chicory when handed over by the vendor to the purchaser. (e) Other Groceries. 65 samples of mustard were taken, and of these 1 (i.e. 15 per cent.) was declared by the Analyst to be adulterated with 20 per cent, of wheaten flour. No summons was taken out in view of the nature of the adulteration. 133 (f) Drugs. 62 samples were taken, and of these 6 {i.e. 9.7 per cent.) were declared by the Analyst to .be adulterated, the details being as follow:— Total samples. No. samples adulterated. Action taken. Beeswax 24 4 (=16.7%) Summons, £1 and 12s. 6d. costs. Summons, 12s. 6d. costs. Summons dismissed No action. Gregory powder 9 1 (=111%) Summons, 10s., and 12s. 6d. costs. Camphorated oil 13 1 (=7.7%) No action. Other drugs 16 0 - The adulterations in the beeswax cases consisted of the admixture of foreign ingredients, viz., paraffin, wax and resin, amounting to 25, 30, 55 and 95 per cent, respectively. In 3 cases summonses were taken out with the result that there were > 2 convictions, the other summons being dismissed on the ground that the beeswax was not divided properly into 3 parts as required by the Acts. In one case no summons was taken out, the sample being taken from an oil shop and not from a chemist. The Gregory powder was found to have been made with 67 per cent, of magnesium carbonate instead of oxide. A conviction was obtained in this case. The camphorated oil sample was found not to have been made with olive oil, but in this case no summons was taken out having regard to the nature of the adulteration, and the fact that the sample was purchased from an oil shop and not from a chemist. 134 (g) Added Preservatives. The following foods were found to be adulterated with added preservatives:— (a) Milk, 3—-0.0002 per cent, of formaldehyde. 0.5 grain per pint of crystallised boric acid. 1½ grains per pint of crystallised boric acid. No summonses were taken out in connection with these milks having regard to the small amounts of added preservatives. (b) Cream, 5—14-5, 9.5, 7.0, 4.0 and 4-0 grains per lb. of crystallised boric acid. No summonses were taken out in connection with these creams, having regard to the small amounts of added preservatives. (c) Foods 16—Brawn, 3—4, 11 and 11½ grains per lb. crystallised boric acid. Veal and ham, 1—2 grains per lb. boric acid. Potted ham and tongue, 1—3.5 grains per lb. crystallised boric acid. Bacon, 1—0.8 grain per lb, crystallised boric acid. Smoked sausage, 1—4 grains per lb. crystallised boric acid. Sausage, 3—10, 13 and 15 grains per lb. crystallised boric acid. German sausage, 6—2, 2½, 3, 4, 7 and 35 grains per lb. crystallised boric acid. In three cases (German sausage, 35 grains; sausage, 5 grains; and brawn, 11 grains) summonses were taken out, with the following results:— (a) German sausage, 35 grains—Conviction with £2 penalty and £2 2s. costs. (b) Sausage, 15 grains—Withdrawn, in view of the conviction in the previous case (a), the vendor being the same person. 135 (c) Brawn, 11 grains—Withdrawn, in view of the conviction in the previous case (a), the vendor being the same person. In the other 13 cases, no summonses were taken out, having regard to the small amounts of added preservatives present. (h) Other Articles. The other samples of foods and drugs not mentioned above 173 in number) were declared by the Analyst to be unadulterated Obstruction to Officer in Discharge of Duties. On June 18th, 1907, one of the Female Inspectors (through a deputy) purchased ¼-lb. of salt butter and one-pennyworth of milk at 148, Lambeth Walk, the goods being served by Mrs. Lewis. On completion of the purchases, the Inspector entered the shop and stated that the articles were being purchased for analysis by the Public Analyst. Mrs. Lewis thereupon snatched the parcel of butter from the Inspector, tore off the paper, and threw the butter on the side counter, and then proceeded to serve the Inspector with another sample of butter, saying that a mistake had been made, fresh butter having been served instead of salt butter. The Inspector demanded, several times, the return of the first sample of butter purchased, but with this request Mrs. Lewis would not comply. Thereupon the Inspector went round to the side counter and took up the butter in her gloved hand, and some of this butter was again snatched out of the Inspector's hand, an action which was repeated by a Mr. Sage (shopman) who, meanwhile, had come upon the scene. A traveller for a butter firm at that time entered the shop, and a good deal of discussion and explanation took place. during which Mrs. Lewis again came round to the Inspector with a cloth in her hand, and quickly wiped off some of the butter that remained on the Inspector's gloved hand, before the Inspector realised what was being done. Finally, the police, who were called in, asked to see the Council's authority under which the Sanitary Inspector acted. The 136 Inspector had to be content with the second sample of butter, but there was found, fortunately, a small, but sufficient, quantity of the first sample of butter on the Inspector's glove, and this, on analysis, proved to be margarine, as far as the analysis could be made, having regard to the small quantity of sample available. A summons was applied for at the Lambeth Police Court against Mrs. Lewis, for wilfully obstructing and impeding the Inspector in the course of her duties under the Sale of Food and Drugs Act, and the Magistrate (Mr. Curtis Bennett), on hearing the case on July 17th, 1907, fined Mrs. Lewis £5 with £5 5s. costs. The Food and Drugs Inspector (Inspector Perrin) was ill during 9 months of the year, and his special work under the Food and Drugs Acts was carried out during that time by the ordinary District Inspectors and the Female Inspectors, the latter being specially authorised to act in this way by resolution on May 13th, 1907.* For comparison, the results obtained may be tabulated as follows:— No. Samples taken. No. Adulterated. Expenses. £ s. d. 1st Quarter, 1907, Inspector Perrin 319 19 (=5.9%) 21 15 11 2nd, 3rd, and 4th Quarters, 1907, District and Female Inspectors 1481 135 (=9.1%) 33 8 2 Year 1907 1800 154 (=8.%) £55 4 1 *he Resolution of the Public Health Committee of May 13th, 1907, was formally approved by the Council on July 25th, 1907. 137 The total expenses connected with the carrying out of the Food and Drugs Acts in Lambeth Borough during 1907 amounted to £55 4s. 1d., as against £98 9s 2d. during 1906, and are made up as follows:—£27 11s. 7d. for samples, £10 19s. for Assistant (Deputy), £2 12s. 6d. for witnesses, £12 5s. 4d. for travelling expenses (including £2 11s. 6d. for cabs), and £1 15s. 8d. for sundries. The salary of the Food and Drugs Inspector (£120, rising by £10 annual increases to £200), and the costs of the summonses (£12 3s.) are not included in the above. Proposed Notification to Tradesmen of the Results of Analyses made under the Sale of Food and Drugs Acts. The Council, on June 13th, 1907, carefully considered a proposal to notify to tradesmen from whom a sample has been taken under the provisions of the Sale of Food and Drugs Acts, when such sample has been declared by the Analyst to be genuine, within 7 days of the receipt of the Public Analyst's certificate, but decided not to adopt it, having regard to the extreme difficulty of framing a notification which would not lend itself to any abuse. The statistics obtained from other Metropolitan Districts with regard to the practice there were as follows:— 1. No notification (22)—Battersea, Bermondsey, Bethnal Green, Camberwell, Chelsea, Deptford, Fulham, Hackney, Hammersmith, Hampstead, Holborn, Islington, Kensington, Lewisham, Paddington, St. Marylebone, Southwark, Stepney, Stoke Newington, Wandsworth, Westminster, Woolwich. 2. Modified notification (4)—Finsbury, Greenwich, Pcplar, and St. Pancras, thus:— (a) In Finsbury, when a sample has been found genuine, the following post card intimation is sent to the vendor, viz.:— 138 Dear Sir, 1 beg to inform you that no proceedings will be taken by the Borough Council in respect of the sample of purchased of you by the Inspector on the day of 190, . I am, yours faithfully, (b) In Greenwich a notice is sent to the vendor in the following terms:— Dear Sir, I have much pleasure in informing you that it is not the intention of this Council to take any further steps in reference to the samples numbered ,purchased on the I am, yours faithfully, This form has recently been adopted by Greenwich because it was found previously that when letters were sent to vendors stating that the samples were found to be genuine, the letter was sometimes used as an advertisement. (c) In the Borough of Poplar a verbal intimation is given to the vendor at the time of the purchase of the sample that if he hears nothing to the contrary within a month, the sample has been found to be genuine. (ci) In the Borough of St. Pancras the following resolution recently passed by the Council is observed, viz.:— "That in future where samples of food and drugs are purchased for aualysis from tradesmen in the Borough, they be informed at the time of purchase that on applying to the Medical Officer of Health after 28 days from that date they will be told whether the analysis is satisfactory or not." 139 3. Notification (1)—Shoreditch, as follows:—When a sample has been found to be genuine, a card, enclosed in an envelope, and bearing the following particulars, is sent to the trader, viz.: Date of dispatch of card. Sample No. And merely the word "Genuine "; whereas, in those cases in which a sample is not genuine but in which legal proceedings are not advisable, a somewhat Similar card is sent to the tradesman, but, instead of the word "Genuine," the words "No Action " are printed. With respect to the 22 Boroughs where no notification is given, there are 4, viz.:—Bermondsey, Camberwell, Fulham, and Holborn, in which a communication is made to the vendor where a sample has been found, on analysis, to be not genuine but the adulteration is not sufficiently large or serious to warrant proceedings, warning him as to the need of taking steps to ensure that the articles sold by him, in future, are free from adulteration. In the Borough of Bethnal Green it was formerly the practice to inform the tradesman the result of the analysis, but the practice "has been discontinued, as it was found that such communications were of no real service, and were only made use of as advertisements." In the Borough of Stepney also it was formerly the practice to send an intimation to vendors that legal proceedings would not be instituted, but the practice has quite recently been discontinued by the Public Health Committee. In the Borough of Wandsworth no notice is given to the traders, except "in the case of public institutions, when samples are taken of milk, in course of delivery, purchased under contract, the result of analysis is furnished on application." 140 Butter Bill. The Council, during 1907, opposed the suggested clause in the Butter Bill, extending the powers contained in the Margarine Act so as to enable the Metropolitan Inspectors of Weights and Measures to take the steps authorised by section 8 of that Act— such Inspectors being the officers of the London County Council. The Metropolitan Borough Councils are the Sanitary Authorities deputed by the Legislature to carry out the provisions of the Food and Drugs Acts (including the Margarine Act), subject to certain supervisory and concurrent powers by the Local Government Board and the Board of Agriculture and Fisheries, and the London Council have no powers under the Food and Drugs Acts. The opposition was successful, as the Butter and Margarine Act, 1907, contains the following section 12:— "Except in the administative County of London, section 8 of the Margarine Act, 1887, shall have effect as if the words "inspector of weights and measures" were inserted after the word "nuisances." II.—Water. Three samples of water were examined during 1907 for the presence of lead—the samples being taken from drinking water •cisterns, but in no instance was lead found. 141 SALE OF FOOD AND DRUGS ACTS. Samples procured, together with the results of Analyses, during the year 1907. Samples. Number Analysed. Number Adulterated *Milk 827 95 Butter 447 25 Cheese 5 — Margarine 2 — Flour 5 — Lard 2 — Bread and Butter 2 — Coffee 140 5 Mustard 65 1 Pepper 68 — Tea 2 — Ground Rice 13 — Oatmeal 4 - Olive Oil 6 — Arrowroot 8 — Baking Powder 3 — Vinegar 4 — Chocolate Powder 3 — Sago 10 — Cocoa 45 1 Ginger 1 — Nutmeg 1 — Ground Ginger 2 — Sugar 1 — Tapioca 12 — Linseed 2 — „ Meal 1 — Jam 1 — Cream 5 5 Condensed Milk 1 — Marmalade 1 — Bacon 1 1 Sausage 9 2 Brawn 10 3 German Sausage 9 6 142 Samples. Number Analysed. Number Adulterated Pressed Beef 1 - Collard Head 1 — Pork Pie 1 — Smoked Sausage 1 1 Breakfast Sausage 1 1 Potted Ham and Tongue 1 1 Veal and Ham 1 1 Black Pudding 1 — Cream Cheese 1 — Cayenne Pepper 1 — Worcester Sauce 1 — Yorkshire Relish 1 — Sauce 1 — Ground Cinnamon 1 — Ginger Wine 1 — Port Wine 1 — Demerara Sugar 4 — †Drugs 62 6 Totals 1800 154 * Separated milk 11. Skimmed milk 7. † The drugs were as follows:—Camphorated oil 13, beeswax 24, Gregory powder 9, almond oil 3, sugar of milk 2, Fuller's earth , prescriptions 3, lime water 1, cream of tartar 1, Blaud's pills 1, cod liver oil 1, tincture of iodine 1, and liquorice powder 1—total 62. The adulterated samples consisted of camphorated oil 1, beeswax 4, and Gregory powder 1. 143 Particulars as to samples analysed, and proceedings taken, during 1907 (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. No. of Cautions. Penalties. Costs. Borough Council. £ s. d. £ s. d. 1907 1800 151 8.6 110 79 18 118 10 0 61 16 0 Late Vestry. 1900 603 73 12.1 57 52 10 104 10 0 42 6 6 1899 600 65 10.8 52 49 6 76 10 0 29 12 6 1898 602 74 12.3 57 54 6 69 0 0 34 9 0 1897 546 41 7.5 7 21 2 48 0 0 24 5 0 1896 549 66 12.02 66 60 2 93 0 0 35 11 6 1895 500 87 17.4 64 62 23 149 15 0 41 18 0 1894 495 107 21.6 81 79 26 199 0 0 45 11 0 1893 498 120 24.09 79 79 41 207 17 0 48 19 0 1892 332 65 19.5 43 43 22 66 8 6 32 9 0 1891 292 48 16.4 25 24 23 28 13 6 15 1 0 Average of 10 years 1891—1900. 501.7 74.6 15.1 53.1 52.5 16.1 104 5 5 35 0 3 Inspector Perrin commenced his duties on February 21st, 1898, vice Inspector Wiggs, who did the work from August 1892, to November 1897. 19 Summonses were dismissed, 1 adjourned sine die, 1 not served, and 10 withdrawn, during 1907. 144 Shewing percentage of different adulterated Samples during 1907 (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. Aërated Waters. Drugs. Boro' Council 1907 11.5 5.6 3.6 0.0 2.1 — 0.5 0.0 — — — — — — 0.0 — 9.7 Late Vestry. 1900 14.2 11.0 17.8 - - 0.0 3.5 0.0 0.0 — — — 0.0 0.0 — — 0.0 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 136 14.5 10.3 - 0.0 0.0 0.0 0.0 11.1 — 0.0 50.0 5.9 — — — 18.8 1897 105 73 3.03 0.0 0.0 0.0 2.0 11.1 17.7 — 25.0 18.2 0.0 — — — 14.3 1896 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 2105 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 means that all samples were reported to be genuine and unadulterated. — means that no samples were taken during the year. 145 HOUSES LET IN LODGINGS. The 372 registered houses have been visited regularly, but no new house has been registered under the Bye-laws during 1907. COMMON LODGING HOUSES. The Common Lodging Houses (for men), situated within the Borough of Lambeth, have been inspected during 1907, sanitary defects, where found, being made good, and the following 6 licensed by the L.C.C. at the Annual Licensing Meeting held June 20th, 1907, in accordance with the requirements of Section 46 of Part IX. of the London County Council General Powers Act, 1902:— Author- Date when registered. Situation. NO. of Lodgers. 10a Belvedere-crescent 99 27th January, 1905 108 Lambeth-walk (C.H.) 36 18th July, 1900 (house in rear) 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 126 Wandsworth-road 133 HOUSING OF THE WORKING CLASSES. No house has been condemned during 1907 under the Housing of the Working Classes Acts, but in this connection it must be remembered that, in respect of dwelling houses, many notices k 146 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. REVENUE ACT, 1903. During 1907, 168 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, 68 have been granted unconditionally, 90 have been granted conditionally, i.e., subject to certain alterations and improvements being carried out; and 10 have been refused. Certificates granted unconditionally. Address. Blocks or Houses. Tenements. 1—8, St. James' Mansions, Kennington Road 1 8 99, 101, 103, 105, 107, 109, Knight's Hill Road, West Norwood 6 12 1—8, Wyke Gardens, Liberty Street 3 18 9—36, Wyke Gardens, Liberty Street 3 18 20, 21, 22, 23, 24, 25, Saunders Street 6 12 Totals 19 68 Certificates granted conditionally. 3—5, Branksome Road 2 4 16, 18, 18a, Brighton Terrace 3 19 Kenyon, Belgrave, Grosvenor, Princes, Loughborough and Commerce Mansions, Coldharbour Lane 6 48 147 Address. Blocks or Houses. Tenements. 2, 2a, Durham Street, Vauxhall 2 6 37—39, Shakespeare Road 2 4 41, Somerleyton Road 1 3 75, Somerleyton Road 1 2 82, Somerleyton Road 1 2 86, Somerleyton Road 1 2 Totals 19 90 Certificates refused. 6, Broadwall 1 8 167, Ferudale Road 1 2 Totals 2 10 BAKEHOUSES. There are 214 Bakehouses (135 above ground and 79* underground) situated within the Borough of Lambeth, and these have been inspected during 1907, and the necessary annual whitewashing and cleaning carried out. OFFENSIVE TRADES. During 1907, 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. 148 1. Fat Melters—Upper Marsh (Messrs. J. C. & J. Field). 2. Tallow Melters—144, Broadwall (Messrs. Harris, Black- man & Sons). 3. Soap Boilers—Upper Marsh (Messrs. J. C. & J. Field). 4. Soap Boilers—144, Broadwall (Messrs. Harris, Black- man & Sons). 5. Tripe Boilers—103, Lambeth Walk (Messrs. Bennett, Son & Co.) 6. Tripe Boilers—115, Lower Marsh (Messrs. Bennett, Son & Co.) The Council on February 28th, 1907, approved of proposed amended (revised) Byelaws having reference to the following offensive trades:—knacker, manure manufacturer and tallow melter, bone boiler, soap boiler, catgut maker or manufacturer, and gut scraper, fat melter or extractor, glue and size manufacturer and tripe boiler; and of new Byelaws with reference to the dressing of fish skins or fellmongering. The chief amendment is to require in future that all offensive processes shall be conducted in a closed chamber, provision being, moreover, made for the adequate ventilation of such chamber, and the destruction of offensive vapours. 149 SLAUGHTER-HOUSES. There were within the Borough of Lambeth at the end of 1906, 27 registered Slaughter-houses, and at the annual Licensing of the London County Council, held on October 21st, 1907, the licenses were renewed with the following exceptions:— (a) 165, Lambeth Walk—butcher's shop attached to slaughter house is closed, and the license was granted on the undertaking that the licensee's own cattle only were to be killed on the premises; (b) 97, Stockwell Road—business of a slaughterer of cattle is not being carried on at the premises by the applicant, who is not the occupier; (c) 172, Lambeth Walk—license not applied for. LIST OF THE 24 SLAUGHTER-HOUSES LICENSED IN THE BOROUGH OF LAMBETH DURING 1907. Ward. Situation of Premises. Name of Licensee. Marsh 106, Lower Marsh Thomas, Robert Edwin Horton, George „ 99 „ „ Holdstock, Jno. Thos. Bishop's 151, Lambeth Walk Wright, Samuel Prince's 406, Kennington Road Parsons, Bernard W. „ 60, Kennington Park Road Grellier, Frederick „ 171, Lower Kennington Lane Clark, Arthur „ 4, Clapham Road Holdsworth, Chas. 150 Ward. Situation of Premises. Name of Licensee. Vauxhall 302, Clapham Road Holdsworth, Geo. „ 152, „ Lawrence Bros. „ 18, Paradise Road (rear of) Smith, Wm. Geo. „ l,Lansdowne Road, Clapham Road Copeman, Walter George Stockwell 27, Bedford Road, Clapham Rd. Pooley, John Pied Brixton Near Railway Hotel Brewery, Electric Lane Elphick, Edwin „ 263, Brixton Road Snelling, Ernest W. „ 10, Foxley Road* 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 45, New Park Road Beaumont, Edith Mary (trading as Martin & Beaumont) „ 12, Lower Tulse Hill Haydon, Wm. Norwood 120, High Street*† Bull, Mary Ann „ 121, „ ,, (rear of) Griffiths, Fredk. „ 125, Hamilton Road Forss, Thomas Lionel * Small cattle only to be killed, † Special conditions laid down. 151 Sanitarily, these 24 Slaughter-houses are in good condition, and the chemical test, which was applied to the drains in each case, failed to give a single result. Inspection of the Slaughterhouses within the Borough is now carried out by the officers of the Borough Council, who are responsible for the due enforcement of all Bye-laws and Regulations made in pursuance of the Slaughter-houses, etc. (Metropolis) 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 1907 minor sanitary defects have been found as follows:— defective paving (2), choked gully (1) and dirty premises (4). One slaughter-house has changed hands during 1907, viz.: — 263 Brixton Road, which is now licensed to Ernest W. Snelling vice Albert Copp. COWHOUSES. There were, within the Borough of Lambeth, at the end of 1906, 14 registered Cowhouses, and at the Annual Licensing of the London County Council, held on October 21st, 1907, the licenses were renewed. LIST OF THE 14 COWHOUSES LICENSED IN THE BOROUGH OF LAMBETH DURING 1907. Ward. Situation of Premises. No. of Sheds. No. of Cows kept Marsh 6, Coral Street, Lower Marsh 1 10 Bishop's Cambria Cottage, 36, Tracey Street 1 13 „ 24, Distin Street 2 9 Prince's 30, Upper Kennington Lane 1 7 Vauxhall 38, Hartington Road 1 22 „ 9, Dawlish Street 1 12 Brixton 34, Ingleton Street 1 5 Tulse Hill 196, Norwood Road 1 20 152 Ward. Situation of Premises. No. of Sheds. No. of Cows kept Norwood 156, Hamilton Road, West Norwood 3 26 „ 76 and 78, Gipsy Hill 3 27 „ 67, Rosendale Road 1 10 „ 93, Clive Road, West Norwood 1 4 „ Elder Road Dairy, West Norwood 2 35 „ 15, Croxted Road, West Dulwich 1 3 20 203 Sanitarily, these 14 Cowhouses are in good condition, and they have been inspected during 1907, and the drains in each case tested with the chemical test, without a result being obtained in any single instance. A few minor sanitary defects were found, e.g., defective paving and channels (2), leaky roof (1), and manhole cover not properly sealed (1). The Borough Council is now responsible for the periodical inspection of the Cowhouses, and the due enforcement of all Byelaws and Regulations which have been made in connection therewith under the Dairies, Cowsheds, and Milk-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 1907 no action has been taken in regard to infringement of Byelaws before the Magistrate. One Cowhouse has changed hands during 1907, viz., 93, Clive Road, West Norwood, to Messrs. Wraight, Dumbrill & Co., Limited. 153 DAIRIES, MILKSHOPS AND MILK-STORES. 33 new Milkshops and Milk-stores have been registered during 1907, as compared with 10 during 1906, and all existing ones have been, from time to time, under inspection, as required. The total number registered up to date is 523. The importance of supervising Milk-shops, so as to preserve the purity of milk sold therein in small quantities, is admitted by all. At present a Sanitary Authority has no power to refuse to register an applicant as a milk seller, however unsuitable the premises may be wherein it is proposed that the milk shall be stored, nor is any power given to a Sanitary Authority to remove a milk seller from the Register if the milk-shop subsequently becomes unsuitable. Additional powers are needed, and the Council decided in 1907 to ask the London County Council to insert in their next General Powers Bill, provisions to confer powers on the Metropolitan Sanitary Authorities to enable them to prohibit the sale of milk on unsuitable premises.* Tuberculous Nursery Milk. The Council during 1907 addressed a letter to the Local Government Board, the Board of Agriculture and the London County Council, asking for powers to be given to the Metropolitan Borough Councils, under the Dairies, Cowsheds and Milkshops Orders of 1899 (Article 2) and 1885 (Article 15), to remove and place in quarantine any milch cow suspected of being diseased or tubercular, until the animal is released by a veterinary inspector under the Contagious Diseases (Animals) Acts, and to pay reasonable compensation for such quarantining or detention. This letter was the result of administrative difficulties in carrying out the Dairies, Cowsheds and Milkshops Orders in connection with milch cows that are suspected to be * The L.C.C. has introduced into their 1908 General Powers Bill the suggested provisions. 154 diseased or tuberculous. Chemical and bacteriological examinations of so-called nursery milks show, at times, the presence of pus and even tubercle bacilli therein—facts which may be unknown to the cowkeepers themselves. Existing powers have reference only to cows with diseased udders which are certified by veterinary surgeons to be tubercular. No provision is made in the Orders for the removal and quarantining of the cows. MUNICIPAL MILK DEPOT. The Council's Milk Depot, situated at 66, York Road, Westminster Bridge Road, has effected much good during 1907. 260 infants and children have been fed, their ages being:— Under 3 months 128 3—6 months 69 6—9 months 21 9—12 months 25 Over 12 months 17 260 These 260 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) 110, wasting 75 moribund 10, diseased 65; total 260. The diseases from which the 65 infants and children were actually suffering at the time of being put upon the Depot milk were:—Diarrhoea and sickness 36, rickets 5, bronchitis 4, tuberculosis or consumption 4, indigestion 3, thrush and ulcerated mouth 3, meningitis 3, consumption of the bowels 3, constipation 1, convulsions 1, anaemia 1, and hernia 1. The periods during which the 260 infants and children continued to use the Depot milk were:— 155 26 weeks and over 26 13—26 weeks 49 6—13 weeks 57 4—6 weeks 37 Under 4 weeks 91 260 It will be noted that 50'8 per cent. used the milk for periods extending from 6 to 26 weeks and over, whilst 35 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 afford to pay; (5) unsuitable. In connection with those parents who were unable to afford to pay, the private voluntary benevolent fund which has been opened at the Depot was found useful, several deserving cases being assisted therefrom. The average weekly number of infants and children fed upon the Depot milk during 1907 is 78, varying from a minimum 61 to a maximum 100, and the total number of bottles of milk distributed during the year was 196240, giving a weekly average of 3,774 and a daily average of 540 Amongst the 260 infants and children fed upon the Depot milk there have been 18 deaths, but these require careful analysis. Thus, of the 18 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 25 weeks, thus:— No. of Mortality Length of time during which infants & No. of rate milk was used previous children deaths. per to death. fed. 1OOO. (a) Infants and children fed for 26 weeks and over 26 0 nil (b) Infants and children fed 4—26 weeks 143 9 63 (c) Infants and children fed under 4 weeks 91 9 99 Totals 260 18 69 156 i.e., the longer an infant or child is fed upon the Depot milk, the better its chance of living. Of class (c), the periods during which the 9 infants and children who died had been fed upon the Depot milk were 16, 14, 10, 8, 7, 7, 7, 3 and 1 days respectively, so that these deaths cannot fairly be classified as deaths connected with the Depot. Including all deaths, the mortality rate amongst the Depot-fed infants and children is 69 per 1000, and this rate is much lower than those for the Borough of Lambeth in general, and for Marsh Ward (where the milk Depot is situated) and Bishop's or 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 63 per 1000, whilst the mortality rate amongst infants and children fed upon the Depot milk for 26 weeks and over is nil. Thus the rates per 1000 births for 1907 may be tabulated as follows, quinquennial rates being added for comparison:— 1997. Quinquennial, (Corrected.) 1902-6. (Uncorrected.) Depot-fed Infants 53-69 — Whole Borough 109 134 Marsh 117 187 Inner Wards 101 158 The causes of the 18 deaths amongst the Depot-fed infants and children deserve attention, and may be tabulated as follows:Whooping-cough, 2; consumption, 2; convulsions, 1; bronchitis, 5; pneumonia, 1; and diarrhoea and sickness, 7. Further, of the 260 infants and children brought to the Depot, 150 (i.e., 58 per cent.) were wasting, moribund or diseased, and of these 13 died (i.e., 87 per cent.), whilst the remaining 110 (i.e., 42 per cent.) were weakly and constitutionally below par, and of these 5 died (i.e., 4.6 per cent.). These facts must be taken into account in dealing with the mortality returns. 157 The particulars of the 18 deaths are as follow:— Name. Age. State of Health when put on Milk. Length of time on Milk. Registered cause of Death. T.P. 2 mos. Weakly 22 weeks Whoopingcough C.S. 4 „ 6 months child, very delicate, sickness 2 „ Enteritis H.H. 10 „ Weakly, sickness 1 „ Bronchitis H. 6 „ Whooping-cough, moribund 10 days Whoopingcough B. 1 week Delicate 25 weeks Diarrhœa and sickness G.H. 3 mos. Wasting 15 „ „ „ J.M. 4½ „ Delicate 14 „ „ L.M. 4½ „ „ 14 „ „ „ W.L. 2 „ Tubercular 10 „ Consumption L.S. 1 Wasting 3 days Convulsions S.B. 2 „ Sickness and Diarrhoea 10 weeks Bronchitis J.C. 3 weeks Healthy (twin) 10 „ Pneumonia E.H. 7 mos. Wasting, sickness and diarrhoea 11 Bronchitis B. 2 „ Weakly, sickness and diarrhoea 1 day Diarrhoea and sickness J.S. 1 „ Consumption, rickets, moribund 7 „ Consumption C. 1 „ Sickness, moribund 8 „ Sickness R. 2 „ Bronchitis, thrush, moribund 7 „ Bronchitis W.F. 20 „ Bronchitis, moribund 16 „ „ „ 158 TABLE Showing number of Infants fed, and number of bottles distributed, weekly during the year 1907. Week ending Number of Infants on the Register. Number of Bottles distributed. Sundry Persons. Number of Bottles distributed. Guardians. January 5 71 3075 382 „ 12 74 3283 350 „ 19 77 3500 350 „ 26 74 3071 350 February 2 76 3570 350 „ 9 73 3150 308 „ 16 75 3206 210 „ 23 76 3458 210 March 2 78 3668 210 „ 9 76 3248 210 „ 16 74 3271 210 „ 23 70 3281 84 „ 30 67 3174 84 April 6 61 2797 84 „ 13 62 2952 168 „ 20 66 3107 168 „ 27 66 2954 168 May 4 70 3439 168 „ 11 66 3129 168 „ 18 67 3277 168 „ 25 67 3182 168 June 1 70 3283 168 „ 8 77 3633 168 „ 15 77 3594 168 „ 22 79 8994 168 „ 29 82 3963 168 July 6 84 3964 168 „ 13 82 3944 168 „ 20 83 3906 168 „ 27 84 4106 168 August 3 81 3596 168 „ 10 82 3809 125 „ 17 80 3494 125 „ 24 76 3319 125 „ 31 84 3822 84 159 Week ending Number of Infants on the Register. Number of Bottles distributed. Sundry Persons. Number of Bottles distributed. Guardians. September 7 80 3507 168 „ 14 79 3731 168 „ 21 81 3752 168 „ 28 83 3764 168 October 5 86 4075 168 „ 12 80 3624 168 „ 19 81 3632 168 „ 26 82 3876 168 November 2 84 3780 168 „ 9 83 3853 168 „ 16 94 4035 168 „ 23 100 4270 168 „ 30 96 4221 168 December 7 94 4066 168 „ 14 94 4125 168 „ 21 99 4261 168 „ 28 93 3946 108 Totals 4046 186737 9503 The net expenditure upon the maintenance of the Milk Depot, during the year 1907, is stated by the Borough Accountant to have been £206, viz.:— (а) Expenditure £580 (b) Income 374 i.e., Expenditure in excess of income £206 160 HEALTH SOCIETY FOR LAMBETH. The Council considered during 1907, the advisability of establishing a Health Society for the Borough of Lambeth, the object of such society being to popularise and propagate sanitary kuowledge amongst all classes, and to instruct or educate the people as to the best way in which to make use of the advantages provided by the Borough Council for their sanitary betterment, thereby supplementing the work of the Health Department. There are many ways in which sanitary knowledge can be popularised, and whereby health conditions can be improved, e.g., visiting and teaching mothers and others the simple laws of domestic hygiene (including the proper feeding and management of infants), temperance and thrift; the distribution of leaflets, dealing with the prevention of consumption; diarrhoea, infantile mortality, measles and whooping-cough; and the teaching and instruction of district visitors attached to the various churches and chapels throughout the Borough. The local clergy and others who are associated with the organisations and societies at present engaged in district visiting, expressed approval of the suggested scheme, but the Council did not agree, the Town Clerk stating the Council had no legal power to vote money out of the Rates for such a purpose as the establishment or inauguration of a Health Society. Such a Health Society would prove a most useful educational force in the Borough, and a valuable auxiliary to the Sanitary Authority. As an alternative scheme, the appointment was suggested of an official Health Visitor, acting under the Public Health Department, whose duties should consist of visiting houses in which births have been notified or registered, and ill which measles, whoopingcough and diarrhoea have broken out amongst the inmates, and 161 in attending mothers' meetings that are held in connection with the various churches and chapels, with a view to instructing the present voluntary workers ill domestic hygiene. The need for mothers (and others) being educated in the proper feeding and management of infants is admitted by all, and an opportunity will be afforded when the Notification of Births Bill becomes an Act. The Council agreed on June 13th, 1907, to the temporary appointment for one year as an experiment of a Female Health Visitor at a salary of £80 per annum with nurse's uniform—the duties of such Health Visitor to be as follows:— 1.—Visiting houses wherein births are notified, or registered; 2.—Visiting houses wherein deaths of children under one year of age have been registered; 3.—Visiting and teaching mothers (and others) the simple laws of domestic hygiene, temperance and thrift; 4.—Attending meetings as may be required, for the purpose of instructing voluntary workers in domestic hygiene and economy. It was further decided to select by advertisement for the position an educated woman, aged 25 to 35 years, single or widowed, properly qualified in nursing and sanitary knowledge, as shewn by the possession of a certificate or certificates, in nursing, midwifery and sanitary knowledge. In reply to this advertisement, 14 applications were received, and the Council at its meeting held on 3rd October, 1907, elected Miss Hilda Hewitt Lawrence, of the Education Department, Corporation of Lincoln, as Female Health Visitor for the Borough of Lambeth for a temporary period of 12 months—her duties to commence on January 1st, 1908. l 162 During 1907, the Council decided to take no action in connection with the proposal of the Corporation of Newcastle-on-Tyne to form a permanent Union of the Sanitary Authorities of the Kingdom into a supreme National Health Authority. INSPECTION OF SCHOOL CHILDREN. The Council, during 1907, considered the important question of the medical inspection of school children in relation to the spread of infectious disease and of public health generally, and agreed to the following principles;— 1. The systematic medical inspection of all school children on admission into school, and at intervals afterwards, for the discovery of general diseases and constitutional defects and the provision (if necessary) of school dispensaries or clinics. 2. The systematic periodical medical inspection of all school children with a view to the discovery of infectious and doubtful infectious diseases and the consequent exclusion of such children from school; 3. The advisability of such inspection of school children being carried out by the officers of existing Metropolitan Borough Health Officers' administrative staffs, with such additional help from medical practitioners as may be necessary. The above duties devolve upon Sanitary Authorities by Section 13 of the Education (Administrative Provisions) Act, 1907, which comes into force on January 1st, 1908. The Board of Education have issued a Memorandum, from which it appears that it is the Board's intention that the inspection of school children shall, as far as practicable, be part of existing Public 163 Health machinery, i.e., the administrative Public Health Departments of Sanitary Authorities, with such additional help as may be found necessary. The value of the systematic medical inspection of school children cannot be over-estimated from the point of view of public health, as, by such means, diseases or constitutional defects, in their early stages, will be detected, and can be, at such early stages, the better treated or dealt with. Ths result, in years to come, will undoubtedly be the improvement of the race, physically and mentally. That such systematic medical examination of children is needed is shown by the recent reports that have appeared, dealing with the results of the examinations of infants and others attending schools. For further particulars see special Report in the Appendix to this Report, p. 75. IMPORTANT DRAINAGE CASES. 1. Appeal to the London County Council against the Order of the Sanitary Department. Notice was given to the Town Clerk that Mr. Harrison (the owner of Nos. 3 and 13, Hercules Road) was appealing to the Committee of the London County Council with reference to Notices and Orders made upon him by the Lambeth Borough Council. Mr. Harrison stated that the Appeal, as regards the drains, was under Section 211 of the Metropolis Management Act of 1855, and, as regards the water closet, under Section 41 of the Public Health (London) Act, 1891. The Appeal was heard at the offices of the London County Council on Tuesday, 10th December, 1907, at eleven o'clock, when the Medical Officer attended, with the Sanitary Inspector, on behalf of the 164 Borough Council. The objection was raised, on behalf of the Borough Council, that there could be no Appeal to the London County Council on the two Intimation Notices which had been served under Section 2 of the Public Health (London) Act, 1891, in connection with the nuisances found to exist on inspection at Nos. 3 and 13, Hercules Road. The nuisances complained of had reference to the defective drains, dirty and dilapidated premises, overcrowding, defective water closet, and defective paving. On hearing Mr. Harrison and the Medical Officer, the Appeal Committee of the London County Council decided that it could make no Order, as the matters in dispute were matters which would have to be dealt with before the Magistrate, should such a course be necessary. 2. Combined Drainage. Two important cases connected with the questiou of combined drainage occurred during the year, and a record of the facts may be, with advantage, made in this Annual Report for future reference. (a) An owner purchased the lease of a house in Norwood Road in May, 1907, and finding that, for sanitary reasons, the water closet required removal from the wash-house, which was being enlarged, into the garden, proceeded to carry out the work voluntarily, and then made application to the Council, as the Sanitary Authority, for permission to alter the drain in accordance with the new proposed position of the W.C. The Inspector visited the premises at the request of the owner on June 10th and June 13th, 1907, and pointed out that if the drain, in the course of being altered, was shewn to be defective, such drain would have to be reconstructed. In any case, a plan would have to be submitted in the usual way. The owner opened up the drain and found the same to be "combined" and open-jointed and not laid on concrete. The premises were unoccupied at the time. The owner raised the 165 question of the Council's pliability for the combined drain as a "sewer," but no notices were jserved by the Inspector. The Council decided to resist any claim made against them for combined drainage 011 the grounds that (l)tthe work was voluntary, (2) the drain had been broken into by the owner and not as the result of a notice served, (3) the conditions found, viz.: clayjointed pipes not laid 011 concrete, were not necessarily a nuisance, and (4) that the premises were unoccupied and that, consequently, the Council's officers had 110 official locus standi. It would be manifestly unfair that an owner should be permitted to carry out voluntary work, and simply because, in the course of such voluntary work, he finds a combined drain not constructed up to modern requirements, to call upon the Sanitary Authority to reconstruct such combined drain, on the ground that it is a "sewer." (b) In connection with a combined drain in course of reconstruction by the owners at 131 and 133, Paulet Road, a gully drain from 133, Paulet Road was disconnected by the builder under the order of the Ssnitary Inspector, on account of the sealed gully connected therewith not being water-tight when the final water test was applied to the drainage system. The owner of 133, Paulet Road promised in a letter that the gully in the cellar of his house should be "sealed over with slate and cement, so as to stand the water test, and afterwards, left so sealed," but this promise was not kept. With the gully not sealed down there was a danger to the ihealth of the inmates of the house should the gully drain connected therewith be re-connected to the combined system, for, in the event of such gully being dry, there would be an escape of drain air, and, in the event of the combined drain being blocked, or choked, with sewage, there would be an escape of sewage into the cellar of 133, Paulet Road. The Council was threatened in a letter (dated 8th May, 1907) with an action for damages and for depriving the owner of 133 Paulet Road of his easement, and for committing a trespass 166 upon his property. Instructions were given for the branch gully drain to be re-connected, and the gully to be sealed and made water-tight. 3. Improper Occupation of a House before Completion. During 1907, proceedings had to be taken against the occupiers of an unfinished workshop, built at the rear of 32, Chryssell Road. At the time of the inspection, it was found that persons of both sexes were at work, carrying on the work of cigarette making, although the building was not completed, not being furnished with proper and suitable water closets, furnished with suitable and proper water supply and water supply apparatus, suitably trapped soil pans and other works and arrangements. There were simply two earth closets provided for the use of the work-people. This was an offence against section 37 of the Public Health (London) Act, 1891, and Notices were served, as required, followed by a summons, which was afterwards withdrawn on the payment by the Defendants of 20s. costs, the work having been satisfactorily carried out meanwhile. CONTRAVENTIONS OF L.C.C. BYELAWS. (a) Drainage. (1) A builder reconstructed 2 water closets at a house in Clapham Road without giving previous notice of his intention to do so to the Sanitary Authority. Further, the work was found, on inspection, to have been carried out contrary to the byelaws, inasmuch as (1) four joints in the iron soil-pipe were made of putty; (2) the soil-pipe, instead of being carried to a sufficient height to afford a safe outlet for foul air, terminated near two windows, 7 feet and 8 feet away respectively; (3) the ventilating portion of the soil-pipe had been constructed in light iron; (4) a long length of waste pipe that had been newly fixed, was 167 constructed of zinc, instead of lead or iron, and made to discharge into a gutter, and then into a newly fixed rain-water pipe; and (5) the drain pipes had been laid without a bed of concrete and otherwise improperly. The Magistrate inflicted penalties of £1 and 5s. respectively with 2s. costs in each case. (2) A builder carried out sanitary work at houses in Wake Street without giving previous notice of his intention to do so to the Sanitary Authority, whilst the ventilating pipe of the soil pipe had been reconstructed in light instead of heavy iron. The owner of the premises apologised, and stated that the builder had acted in ignorauce or carelessness. The work was re-done in such a way as to comply with the byelaws. No summons was taken out. (3) A builder fixed a new sink at a house in Albert Square, without giving previous notice to the Sanitary Authority. Further, the work, on inspection, was found to have been carried out in such a way as to be a nuisance and dangerous to health, in that the waste pipe had been taken into a disused cistern in the roof of the second floor w.c. (immediately under the landing), and thence, by an upright waste pipe, into a rain water pipe. In this way, there was an accumulation of waste matter from the sink, which gave off offensive smells from time to time, the cistern being practically converted into a cesspool. There is a penalty clause (section 42) in the Public Health (London) Act, 1891, in connection with carrying out work so as to be a nuisance, or injurious, or dangerous to health, but such clause restricts action being taken only in the cases of water closets and drains. Under the byelaws of the London County Council, this waste pipe should have been made to discharge into the open air over, or into, a properly trapped gully. Having regard to the seriousness of the offence, a letter was written to the builder, pointing out to him the seriousness of his action, and cautioning him 168 from carrying out work improperly in the future. The nuisance was abated and the work carried out in accordance with the byelaws. (b) Removal of Offensive Matters. (4) On June 27th, 1907, at 3.25 p.m., fat and other offensive matters were being removed from premises situated in Lambeth Walk, during prohibited hours, thereby infringing the byelaws of the London County Council. The contractor (living at Peckham) wrote apologising for the occurrence of the nuisance, which was due to the horse of the van being suddenly taken with lameness, and promising to take precautions in the future. No action was taken before the Magistrate. (5) On July 8th, 1907, at 2.55 p.m., a two-horsed van (tarpaulin covered with curtain flaps at the rear) was found standing outside premises in Bird Street, the premises being occupied by a rag and bone dealer. The two men in charge of the van were engaged at the time inside the van in weighing bones, etc., in sacks. The van belonged to a firm of soap boilers in Bow, E. Section 1 of the byelaws of the London County Council was contravened in that offensive matters were being removed at 2.55 p.m instead of between the hours of 4 a.m. and 10 a.m. during July. A similar offence was committed by the same firm on June 10th, 1907. at 3.15 p.m., in Ethelred Street, when the firm was warned in writing, and apologised. A summons was taken out with respect to the latter offence committed on July 8th, 1907, and the Magistrate fined the firm 10s. and 2s. costs, and the carman 8s. and 2s. costs. (6) On June 5th, 1907, at 3 p in., dung (mixed with peat litter) was being removed from the tramway stables. Loughborough junction, in an ordinary van—such dung being in an offensive condition at the time, the odour permeating for a considerable distance. The contractors (a firm living at Trinity Square, E.C.) 169 were written to, and letters were received in reply, apologising for the neglect, whereby the London County Council byelaws had been infringed in two ways, viz., the dung mixture (dung mixed with litter other than straw litter) was (1) removed in an improper vehicle, and (2) removed outside of the prescribed hours. No summons was taken out. SALE OF UNSOUND TINNED FOODS. The Council, during 1907, wrote to the Local Government Board, requesting the Board to take action, with a view to amending the existing Law with regard to unsound food, so that the retailers might be protected, and the wholesale dealers convicted, where it is proved that the latter are liable to prosecution for having sold to the former food that was, at the time of such sale and purchase, unsound and unfit for human consumption. This decision of the Council was the result of proceedings taken at the Lambeth Police Court by a neighbouring Borough Council in connection with the seizure of condensed tinned milk which had been seized, and the retail shop dealers, in whose possession they were found, afterwards convicted. Summonses were afterwards taken out against the middleman, from whom the retail dealers had purchased the milk. The difficulty arose in proving that when the food was sold to the retailers by the middleman it was at that time in such a condition as to be liable to be seized as unfit for food, and the Magistrate, recognising this difficulty, dismissed the summons against the middleman. 170 PROPOSED ASSIGNATION TO THE PORT OF LONDON SANITARY AUTHORITY OF CERTAIN POWERS UNDER THE PUBLIC HEALTH (LONDON) ACT, 1891. A letter was received by the Council from the Local Government Board,dated 24th July, 1907, stating that the Port of London Sanitary Authority had applied to the Board for the issue of an Order under Section 112 of the Public Health (London) Act, 1891, assigning to it the powers of a Sanitary Authority under Section 16, Sub-Section 1 (b. c. d.) 2 and 3, and Sections 17, 18, 19, 37 (omitting Sub-Section 5), 38, 39 and 49 of the Act. The Board held a Local Enquiry at the Guildhall and the Lambeth Council was represented, objecting to the granting of such powers as unnecessary. The powers sought by the Port of London Sanitary Authority dealt with the following matters:— 1. The making of byelaws by a Sanitary Authority, and by the London County Council, in respect of particular nuisances (Section 16, Sub-Section 1, b, c, d, 2 and 3). 2. The prohibition of the keeping of swine, or animals, in unfit places (Sections 17 and 18). 3. The prohibition of the establishing anew of certain offensive businesses, and the making of byelaws as to offensive businesses (Section 19). 4. The enforcing of the Regulations as to water closets, etc., sanitary conveniences for manufactories, etc., the making of byelaws with respect to water closets etc. (Sections 37, 38 and 39). 5. The giving of Notice by a Water Company in cases in which the water supply is cut off from any inhabited dwelling (Section 49). 171 BACTERIOLOGICAL LABORATORY. The Bacteriological Laboratory has proved of great service during 1907—a total of 786 examinations having been carried out. The local and central position of the Laboratory is specially advantageous, enabling the results of examination to be quickly obtained and at a minimum cost. The Laboratory was originally fitted up by the late Vestry in 1899, and since then (up to the end of 1907) 6430* examinations have been made, viz:—Tuberculosis 1558, Typhoid Fever 671, Diphtheria 4102, and Others 99. The total 785 bacteriological examinations carried out during 1907 deal with 190 sputa (suspected consumption), 48 bloods (suspected typhoid fever), 538 throat and nose membranes and discharges (suspected diphtheria) and 10 other materials, e.g., suspected anthrax 4, cancer growth 1, fceces (typhoid) 1, urines (tubercle) 3, and bath brush head 1. Details are as follow:— Tubcrculosis— 190 samples of sputa from doubtful tuberculosis cases have been examined, and in 48 (i.e., 25.3 per cent.) tubercle bacilli have been found. In 142 instances (i.e., 74.7 per cent.), no tubercle bacilli were found. In 2 instances the pneumococcus (Friedlanderi) was found, in 7 lung tissue, in 4 blood, and in 5 pus. 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. Total—6430. 172 Typhoid Fever— 48 samples of blood from suspected Typhoid Fever cases have been examined, and in 12 (i.e., 25 per cent.) the characteristic Widal reaction was obtained, although in 10 of the cases (i.e., 83.3 per cent.) the reaction was but slightly (or feebly) marked. In 36 cases (i.e., 75 per cent.) no reaction was obtained. A high dilution of blood-serum is used (1-60 to 1-100). Diphtheria— 538 samples of throat and nose membranes and secretions from doubtful diphtheria cases have been examined, and in 26 (i.e., 4'8 per cent.) the true (Klebs-Lceffler) bacilli have been obtained. In 21 instances (i.e., 80'8 per cent.) the KlebsLceffler bacilli were obtained in pure cultivation—i.e., without admixture with other bacilli, whereas in the remaining 5 (i.e., 19.2 per cent.) the Klebs-Lœffler bacilli were found combined with other well-known bacilli as follows:— Klebs-Lceffler bacilli + staphylococci 3 Klebs-Lceffler bacilli + pseudo (Hoffmann) bacilli + staphylococci 1 Klebs-Lceffler bacilli + pseudo (Hoffmann) bacilli + streptococci 1 In 512 (ie., 95.2 per cent.) of the total number of throat and nose samples examined, the Klebs-Lceffler bacilli were not isolated, but other bacilli were found as follow:— Staphylococci 228 Streptococci 90 Staphylococci + streptococci 63 Staphylococci + torulœ 43 Staphylococci + micrococci 1 Staphylococci + streptococci + micrococci 1 Staphylococci + streptococci + torulce ] 173 Streptococci + torulce 24 Torulce 22 Torulce + micrococci 13 Streptococci + micrococci 9 Streptococci + staphylococci + torulce 1 Streptococci + staphylococci + sarcince 1 Pseudo (Hoffmann) bacilli 1 Pseudo (Hoffmann) bacilli + staphylococci 6 Pseudo (Hoffmann) bacilli + streptococci 4 PseudD (Hoffmann) bacilli + torulce 1 Micrococci 1 Sarcince 1 The Pseudo bacilli (Hoffman) were found in pure cultivation in 1 instance, mixed with staphylococci in 6, with streptococci in 4, and with torulce in 1. Other Examinations. 10 samples of other materials were examined, viz, fœces (suspected typhoid) 1, urines (suspected tubercle) 3, cancer growth 1, suspected anthrax 4, and brush (bath) 1. The special bacteriological examination of a bath brush head (used in the Public Baths) proved interesting. It was made at the request of the Baths Committee. There was found a large number of micro-organisms embedded in and around the roots of the tufts of hairs, or bristles, which are fixed into holes in the wooden framework of the brush by means of wire. These micro-organisms were found to be mixed with dirt, skin-scales, hairs, organic matter, débris, soap, &c., and this dirt mixture forms an excellent breeding ground for the many different germs, which, on bacteriological examination, proved to be— (a) Liquefying, or putrefactive, bacteria; (b) Non-liquefying bacteria. 174 The inicro-organisms were separated by being grown cn nutrient gelatine for three days, and were found, on microscopic examination, to be the following:—Proteus Zenkeri, bacillus prodigiosus, proteus vulgaris, bacillus fluorescens, bacillus liquefaciens, micrococci, sarcince, torulce, staphylococcus, pyogenes aureus, streptococcus, bacillus coli, bacillus subtil is, various moulds, &c., &c. No specific pathological organisms, which are associated with the well-known infectious diseases, were found. 1907. 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 4 18 22 - 4 4 - 42 42 February 5 14 19 1 2 3 3 19 22 March 10 16 26 1 6 7 1 141 142 April 3 14 17 — 3 3 1 27 28 May 7 17 24 3 2 5 2 34 36 June 4 10 14 1 3 4 — 27 27 July 3 8 11 2 2 4 7 31 38 August 3 8 11 — 5 5 6 16 22 September 2 7 9 2 2 4 1 43 44 October 1 6 7 2 2 4 1 37 38 November 4 9 13 — 2 2 1 50 51 December 2 15 17 — 3 3 3 45 48 Totals 48 142 190 12 36 48 26 512 538 * In 10 samples (i.e., 83'3 per cent.) of suspected Typhoid Fever blood, in connection with which there was a reaction, the reaction was slightly (or feebly) marked. N.B.—10 other samples were also examined during 1907, viz.: foeces 1, urines 3, cancer growth 1, suspected anthrax discharges 4, andbrush head 1. 175 The condition of the brush head, submitted by the Baths Committee, can only be described, bacteriologically, as "filthy," and its use in a Public Bath is certainly undesirable, if not a danger to health. The thin wooden casing, nailed on the back of the brush head was found, on removal, to be corroded on the inside with a dirt-mixture, which, on examination, proved to be the same in composition as that found around the roots of the tufts of hairs, or bristles, of which the brush head is composed. The kind of brush required for use in a Public Bath is one made of an impermeable material, which can be readily cleansed and disinfected, and which will not harbour filth and germs. Antitoxin. The Borough Council has distributed during 1907, free of cost to medical practitioners, practising in Lambeth Borough, 40 vials of antitoxin. PROPOSED L.C.C. LEGISLATION. A letter was received in 1907 from the L.C.C. dealing with suggested legislation in connection with the following matters:— 1. To enable the Sanitary Authorities in London to refuse to register, or to remove from the register, cowkeepers, dairymen, or purveyors of milk, whose premises are unsuitable for the sale of milk thereon; 2. To regulate the sanitary conditions prevailing at premises on which food is sold, or prepared for sale; 3. To enable Sanitary Authorities to require the surrender, for the purpose of destruction of unsound food; 176 4. To enable the Sanitary Authorities to require the surrender of offensive trade refuse, and to arrange for the temporary storage and systematic removal thereof; 5. To enable the Council to make by-laws, to be enforced by Sanitary Authorities, with regard to the proper regulation of the businesses of a seller of fried fish, fish curer, and marine store dealer; 6. To enable the Council to pay one-half of the salaries of female health visitors appointed by Sanitary Authorities in London. In respect of No. 2, the regulations are to be drafted on the following suggested lines:— a. No sanitary convenience, or ash pit, shall be within, or directly communicate with, such room or place; b. Every cistern for supplying water to such room or place shall be separate and distinct from any cistern for supplying water to any sanitary convenience ; c. No drain or pipe for carrying off fcecal or sewage matter* shall have any inlet or opening within such room or place; d. No such room or place shall be used as a sleeping place, and, so far as may be reasonably necessary to prevent risk of the infection or contamination of any such article, no sleeping place shall adjoin and communicate directly with such room or place; e. Refuse or filth, whether solid or liquid, shall not be deposited, or allowed to accumulate, in any such room or place; f. No act or thing shall be done, or permitted, in any such room or place likely to expose any such article to infection or contamination. 177 REFUSE AND MANURE DEPOTS. The 18 public depots, situated in Lambeth Borough, have been under constant (daily during the summer months) supervision during 1907. EFFLUVIUM NUISANCES. (1) Star Omnibus Stables, Knight's Hill, West Norwood. A Memorial, signed by 21 persons, was received during 1907, drawing attention to the nuisance in connection with the removal of manure by the Star Omnibus Company from their stables, situated at Knight's Hill, West Norwood. The Council gave instructions for the nuisance to be abated forthwith, and a letter was, consequently, sent to the Company and to the Contractors concerned, with the result that arrangements were at once made for the manure to be placed directly into a van, and for the van (when full) to be removed, without disturbing its contents, and for an empty van to be put in its place. The nuisance was effectually abated, and no action was, therefore, taken under section 21 of the Public Health (London) Act, 1891. MORTUARIES AND CORONERS' COURTS. The total number of bodies received at the two Borough Mortuaries (High Street and Wanless Road) during 1907 was 350, as compared with 407 during 1906, and an annual average for the old Parish of Lambeth for 5 years (1896-1900) of 450. Of the 350 bodies, 245 were received at High Street and 105 at Wanless Road 29 bodies were brought in by the Police (20 to High Street and 9 to Wanless Road), and the rest by undertakers or private persons. M 17 8 The Coroner's Court sat 44 times at Wanless Road, 102 times at High Street. Wanless Road Mortuary alone is provided with a separate room for bodies dead from infectious disease, and during 1907 two infectious bodies (diphtheria and scarlet fever respectively) were received there. For comparison, details are given in tabular form of the work carried out by the late Vestry of Lambeth in connection with the Wanless Road and High Street Mortuaries during the 5 years (1896-1900). Taking the average, it will be seen that the total number of bodies received during 1907 in connection with the new Borough is 100 less than the yearly average (450) received in connection with the old Vestry during the 5 years (18961900). The number of post-mortems conducted for the Borough during 1907 is 187, as compared with 197 during 1906 and with 253, 281, 275, 285 and 267 respectively during the 5 years (1896-1900) for the old Parish, i e., 31.4 per cent. less than the yearly average (272"5) during the same quinquennium. Of the post-mortems, 48 took place at Wanless Road, and 139 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 Coroner's Court, such increased rental to cover the new decorations, heating and ventilation of the Court itself, and the erection of a New Waiting Room—work that has been carried out during 1907. A mortuary for Norwood will now be able to be provided on a small part of the freehold site (l 3/4 acres) in Romany Road, adjoining the Norwood Cemetery, which the Council has purchased for £2000. A separate mortuary for Norwood has long been wanted, and the principle has been agreed to, on several occasions, both by the late Vestry and by the present Borough Council, 179 Numbers of bodies received at the Lambeth Borough Mortuaries during 1907 and at the Lambeth Parish Mortuaries duriDg 5 years (1896-1900). 1907. January. February. March. April. May. June. July. August. September. October. November. December. Tot'l 1907 Tot'l 1900 Tot'l 1899 Tot.l 1898 Tot'l 1897 Tot'l 1896 Yearly Average for 18961900. High Street— Males 28 10 11 16 12 9 16 13 5 12 5 18 150 237 239 222 218 221 227.4 Females 12 7 10 7 5 5 3 14 11 5 8 8 95 142 126 143 109 152 134.4 Wattless Road— Males 9 5 5 10 4 4 3 2 5 4 5 1 57 58 71 72 41 — 60.5 Fen ales 3 5 4 3 6 3 2 2 3 5 2 10 48 62 47 58 32 — 49.75 Totals 47 27 30 36 27 21 24 31 24 26 20 37 350 499 483 495 400 373 450 N.B.—The new Wanless Road Mortuary was opened on April 12th, 1897, 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. 18o Ages of bodies received at the Lambeth Borough Mortuaries, 1907, and at the Lambeth Parish Mortuaries during 5 years (1896-1900). Registered Ages of Bodies. 1907. Boro' Parish. Yearly Average for 1896-1900. High Street. Wanless Road. Total 1907. Total 1900. Total 1899. Total 1898. Total 1897. Total 1896. 0-1 44 30 74 133 121 160 101 121 127.2 1—5 26 10 36 47 44 50 39 22 40.4 5—10 15 5 20 12 22 17 9 12 14.4 10—20 8 3 11 17 13 8 18 9 13.0 20—30 16 5 21 31 29 26 26 24 27.2 30—40 21 11 32 43 59 45 35 35 43.3 40—50 27 7 34 80 67 64 48 37 59.2 50—60 27 10 37 61 53 42 59 46 52.2 60—70 29 11 40 50 47 39 30 35 40.2 70—80 20 3 23 16 19 32 20 22 21.8 80—90 8 3 11 6 8 5 9 7 7.0 90 upwards 1 1 2 — 1 1 — 3 1.0 Age not stated 3 6 9 3 - 6 6 - 3.0 Totals 245 105 350 499 483 495 400 373 450 181 Particulars as to cases of Drowning, Accidental Death and Suicide that have occurred in the Borough of Lambeth during 1907, and in the old Parish during 5 years (1896-1900). High Street. Wanless Road. Boro' Parish of Lambeth. Average 5 years 18961900. Total 1907. Total 1900. Total 1899. Total 1898. Total 1897. Total 1896. M. F. Total. M. F. Total. Suicides 10 1 11 14 4 18 29 14 13 21 6 13 13.4 Drowning 8 1 9 1 — 1 10 6 1 1 13 16 7.4 Poisoning — — — 5 4 9 9 3 4 3 4 4 3.6 Hanging 1 — 1 6 — 6 7 4 3 9 — 2 36 Throat cutting 1 — 1 1 — 1 2 3 4 5 1 2 3.0 Jumping off heights and in front of trains - - - 1 - 1 1 1 - - - 2 0.6 Cutting Arteries — — — — — — — 1 1 — — — 0.4 Shooting — — — — — — — 2 1 4 1 3 2.2 Railway Accidents 2 — 2 1 — 1 3 4 4 1 1 3 2.6 Accidental Death (sudden) 1 — 1 2 1 3 4 6 1 12 — — 3.8 Street Accidents (run over) 2 — 2 1 1 2 4 3 9 7 1 3 5.2 Murder — 1 1 — 1 1 2 1 2 — 2 2 1.4 Burning (scalding) 2 2 4 2 2 4 8 1 2 3 1 — 1.4 Falling — — — 2 1 3 3 1 1 4 4 — 2.0 Bicycle Accidents 1 — 1 — — — 1 2 — 1 — — 0.6 Strangulation and Suffocation — — — — — — — — — 2 — — 0.4 Found Dead — 1 1 3 — 3 4 — — — — — — Bursting Blood Vessel - - - - - - - - - - - - - Killed — — — - — — — — — — — — — Manslaughter — — — — — — — — — — — — — Fits — — — — — — — — — — — — — Under Chloroform - - - - - - - - - - - - - N.B.—Two female bodies (one dead from diphtheria and one from scarlet fever) were admitted during 1907 into the special room provided for infectious bodies at Wanless Road. 182 INQUESTS. During the year 1907, within the Borough of Lambeth, 332 Lambeth cases were submitted to the Coroner (who, in 31 instances, decided that no further inquiries were necessary, the deaths being due to natural causes). In the remaining 301 cases inquests were held with the following results:— I Natural Causes '49 II. Accidental Causes 143 Burns and Scalds 23 Drowning 6 Run over 16 Falls, etc. 40 Suffocation 30 Fracture 10 Misadventure 10 Crushed 1 Blood Poisoning 1 Knocked down by train 3 Improper Feeding 3 III. Homicidal Causes 31 Suicide 27 Murder 3 Manslaughter 1 IV. Open Verdicts 9 Found Drowned 9 Total 332 Proposed Chapel of Rest. The Council on November 28th, 1907, instructed the Public Health Committee to consider and report as to the desirability 183 of erecting in the Inner Wards of the Borough a Public Mortuary, in addition to the Mortuaries that now exist primarily for the reception of bodies awaiting Coroner's Inquests, in view of the limited and insufficient accommodation in many of the houses of Lambeth. The matter is still under consideration, the Town Clerk having been instructed to bring up a report as to the Council's powers to provide a Chapel of Rest, and to ascertain what (if any) provision has been made in the Metropolitan Districts. CLERICAL STAFF. The Clerical Staff consists of 4 Clerks—1 first class (W. R. Lawrence), 2 second class (Messrs. A. L. Baxter and W. J. Lawrence), and 1 boy (Albert E. Ruel). The Clerical work in connection with the Department during 1907 is again given in the form of a Statement, shewing certain items of work done in the Borough during 1901, 1902, 1903, 1904, 1905 1906, and 1907, as compared with the yearly average for the old Parish of Lambeth during 5 years (1896-1900). 1907. 1906. 1905. 1904. 1903. 1902 1901. Average 5 years (18961900). Parish. Borough. Letters, etc., received (entered in letter book) 9616 8875 8540 7476 7808 8760 9417 8611.4 Letters, etc., sent out (entered in postal book) 17427 16411 15830 14427 16555 19504 21703 26096.6 Notices— Infectious Diseases 1922 1900 1594 1681 1336 2430 1848 2290.2 Public Health Acts (Preliminary) 8243 8193 7446 6624 8248 9113 7211 7812.0 Public Health Acts (Statutory) 4485 4490 3990 3463 3432 3921 3974 2015.0 Metropolis Managem't Acts 15 11 23 10 27 23 18 20.0 Housing of the Working Classes Acts - - 2 9 - 14 13 $$$] 184 Cases entered in Inspectors' Report Books 1907. 1906 . 1905. 1904. 1903. 1902. 1901. Average 5 years (18961900). Parish. Borough. * 10565 11084 9404 8343 8372 8930 7821 8307.0 Complaints entered in book. 6545 7540 6650 6630 6199 4378 5421 5474.0 Copies of Infectious Diseases Notifications— (a) Entered in Notification Book 2140 2074 1853 2023 1587 4426 2025 2619.2 (b) Sent off to Asylums Board 2140 2074 1853 2023 1587 4426 2025 2619.2 Notices of Infectious Diseases sent to Schools 1908 1575 1359 1492 2117 3410 2425 1953.6 New Workshops (with full particulars) entered up in Register 100 121 92 82 162 105 69 144.6 New Milkshops (with full particulars) entered up in Register 33 10 7 5 5 5 458 - New Cowsheds (with full particulars) entered up in Register - - - - - - - 6.6 New Slaughter-houses (with full particulars) entered up in Register - - - - - - - 9.2 New Bakehouses (with full particulars) entered up in Register - - - - - - - 51.6 Water Certificates for new buildings given out 174 468 184 385 520 420 183 112.2 Disinfection Certificates given out 3175 2919 3212 3707 3036 5186 2710 1010.2 Reports to Committee (Fortnigluly) 21 21 21 21 20 20 21 20.2 Reports to Vrstry or Council (Quarterly) 4 4 4 4 4 4 4 4.0 Special Reports 6 16 14 13 13 15 12 12.2 Letters Typed 3928 4357 5271 5052 4883 5816 4867 4905.4 Bacteriological Reports 786 761 1874 447 525 466 479 546.0 Inland Revenue Certificates given out 158 155 446 375 715 2723 360 719.5 Summonses and Orders entered in Book 125 63 44 109 95 50 72 98.6 APPEN DIX N 2 Local Government Board. Table i. VITAL STATISTICS OF LAMBETH BOROUGH DURING 1907, AND OF LAMBETH PARISH DURING 10 YEARS (1891—1900). YEAR. Population estimated to Middle of each Year. Total Births. Total deaths Registered in the District. Total Deaths in Public Institutions in the district. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. NETT DEATHS AT ALL AGES BELONGING T0 THE DISTRICT. Number. Rate.* Under 1 Year of Age. At all Ages. Number. Rate.* Number. Bate per 1000 Births registered. Number. Rate.4 1 2 3 4 5 6 7 8 9 10 11 12 13 Parish 1891 276162 9097 32.9 1433 157.2 6073 21.9 1438 539 351 5886 21.3 1892 280032 9226 32.9 1303 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 18.5 1894 287935 9231 32.1 1264 136.9 5213 18.1 1484 775 399 4837 16.5 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 1568.5 670.8 406.6 5405.3 18.4 Boro' 1907 318538 8650 27.2 1044 120.2 4926 15.5 1923 748 474 4652 14.6 * 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 the numbers 111 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 district on account of sickness or infirmity, and have died in public The "Public Institutions" (taken into account 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 the deaths in which corrections have been made, will be found on pp. 18-20, 88-91 of the Report. The Union Workhouses are situated within the District. Area of Lambeth Borough in acres 4079.6 Statute Acres. (exclusive of area covered by water) Total population at all ages 301895 Number of inhabited houses 41511 Average number of persons per house 7.3 At Census of 1901. 3 Local Government Board. Table ii. VITAL STATISTICS OF REGISTRATION SUB-DISTRICTS (OLD AND NEW) OF LAMBETH BOROUGH DURING 1907, 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 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). a. b. c. d. a. b. c. d. a. b. c. d. Parish 1891 28657 1431 866 230 18110 605 468 158 39191 1630 987 299 1892 28601 1473 687 179 18249 610 432 160 39571 1639 907 259 1893 28545 1521 688 222 18388 610 448 165 39951 1632 858 272 1894 28489 1505 691 203 18522 624 384 139 40331 1553 789 266 1895 28433 1516 755 212 18666 618 467 189 40711 1629 995 284 1896 2S377 1445 642 201 18805 649 364 169 41091 1687 930 262 1897 28333 1397 683 203 18947 597 442 188 41476 1595 934 301 1898 28282 1381 715 193 19090 581 438 175 41864 1613 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 of Years 1891 to 1900 28413.2 1441.5 713.8 203.4 18739.3 610.3 429.2 164 .7 40908.0 1603.8 914.1 278.9 Borough 1907 26251 1487 559 170 26743 749 589 181 51404 1589 872 204 Names of New Sub-Districts. 1.—Waterloo. 2.—Lambeth Church. 3.—Kennington (including Workhouse). 4 Table ii.—continued. Names of Old Sub-Districts. 4.—Kennington 1st. 5.—Kensington 2nd. 6.—Brixton. 7.—Norwood. Year. Population estimated to middle of each year. Births registered. Deaths at all Aires (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. a. b. c. d. a. b. c. d. a. b. c. d. a. b c. d. Parish. 1891 50681 1722 1092 252 40065 1069 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 286 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 189G 52581 1886 902 232 48429 1125 747 157 82267 2139 1174 281 29511 662 339 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 1891to 1900 53365.8 1811.2 984.0 250.5 42997.5 1066.1 743.0 136.9 81599.1 2090.1 1233.9 287.4 29026.8 672.4 387.3 82.1 Boro', 1907 - — - — 66774 2007 900 156 80178 1621 1012 224 64188 1197 720 106 Names of New Sub-Districts. 4.—Stockwell. 5.—Brixton. 6.—Norwood. Notks—(a) Deaths of residents occurring in public institutions beyond the district are included in sub-columns c of this table, and those of the non-resident registered in public institutions in the district are excluded. (See note on Table i. as to meaning of terms " resident" and " non-residents.") (6) 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 deceased. (c) Deaths under 1 year are not corrected, and the gross total of sub-columns d agrees with the total of column 5 in Table i. 5 Local Government Board. Table iii. CASES OF INFECTIOUS DISEASE NOTIFIED WITHIN THE BOROUGH OF LAMBETH DURING THE YEAR 1907. notifiable disease. 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. Under 1. At Ages—Years. Waterloo. Lambeth Church. Kennington. Stock well. Brixton. Norwood. Waterloo. Lambeth Church. Kennington. Stockwell. Brixton. Norwood. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 317 10 119 136 27 24 1 32 34 58 62 90 41 30 33 45 62 69 28 Membranous Croup 13 ... 9 2 1 1 ... 2 ... 3 4 4 ... 1 ... 1 1 2 ... Erysipelas 231 6 15 15 20 154 21 2 22 47 42 48 40 8 0 8 15 8 7 Scarlet Fever 1481 16 403 870 132 60 ... 138 116 207 436 378 176 135 121 204 435 323 139 Typhus Fever 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... Enteric Fever 56 ... 2 8 20 26 ... 7 6 11 9 14 9 7 4 9 8 12 ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever 6 ... ... 2 1 3 ... ... 1 3 1 ... 1 ... 1 2 1 ... ... Puerperal Fever 22 ... ... ... 5 17 ... 4 4 2 5 5 2 3 2 6 1 1 1 Cerebro-Spinal Meningitis 13 4 8 1 ... ... ... 3 2 5 1 1 1 1 1 ... 3 3 ... Totals 2110 36 556 1084 207 285 22 218 215 337 560 540 270 185 108 274 526 418 175 Notes.—(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 Metropolitan Asylums Board, one of which is situated in Brixton Registration Sub-district. 6 7 Local Government Board. Table iv. CAUSES OF, AND AGES AT, DEATH (CORRECTED) DURING THE YEAR 1907. Name of District—BOROUGH OF LAMBETH. CAUSES OF DEATH DEATHS IN OR BELONGING TO WHOLE DISTRICT AT SUBJOINED AGES. DEATHS 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. Stockwell. Brixton. Norwood. District not stated. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Small-pox — — — — — — — — — — — — — — — Measles 107 26 78 3 — — — 19 19 33 15 12 9 — 9 Scarlet Fever 38 1 22 8 5 2 — 3 7 7 16 3 2 — 43 Whooping Cough 111 45 62 4 — — — 20 9 19 16 27 20 — 10 Diphtheria and Membranous Croup 47 3 32 10 1 1 — 2 7 8 9 17 4 — 69 Croup — — — — — — — — — — — — — — — Fever Typhus — — — — — — — — — — — — — — — Enteric 5 — 1 — 2 2 — 1 1 2 1 — — — 8 Other Continued — — — — — — — — — — — — — — — Epidemic Influenza 39 1 2 — 2 19 15 3 2 7 11 10 6 — 2 Cholera Nostras — — — — — — — — — — — — — — — Diarrhœa. 71 58 7 — — 4 2 13 12 15 11 9 11 — 31 Enteritis . 94 51 7 6 11 16 3 7 20 24 12 17 13 1 — Puerperal fever 9 — — — 2 7 — 3 — — 1 3 2 — 5 Erysipelas 15 5 — — 1 8 1 1 1 5 2 4 2 — 12 Other Septic diseases 8 3 1 2 — 2 — 2 2 1 1 2 — — — Phthisis 465 6 9 15 53 353 29 58 63 118 82 92 52 — 193 Other Tubercular diseases 148 46 45 21 10 20 6 14 24 35 28 33 14 — — Cancer, malignantdisease 326 — 3 3 1 204 115 27 33 42 63 84 62 15 — Bronchitis 480 78 32 1 4 105 260 56 55 82 104 97 72 14 233 Pneumonia 142 17 22 3 3 59 38 17 16 29 20 28 25 7 Pleurisy 17 1 3 — 2 7 4 1 2 5 2 5 2 — Other diseases of Respiratory Organs 293 97 87 10 4 59 36 32 39 64 56 53 42 7 — Alcoholism 27 — — — — 21 6 8 8 3 3 3 1 1 — Cirrhosis of Liver 39 — 1 1 — 27 10 2 2 4 9 14 8 — — Venereal diseases 44 34 1 — — 7 2 6 10 8 9 7 3 1 — Premature birth 163 163 — — — — — 25 24 28 26 38 21 1 — Diseases and Accidents of parturition 18 — — — 2 16 — 2 1 2 5 3 5 — — Heart diseases 517 2 3 18 15 206 273 58 53 95 73 118 97 23 222 Accidents 153 30 24 12 7 60 20 32 22 13 27 39 11 9 88 Suicides 32 — — — 2 25 5 2 1 1 6 13 8 1 — All other causes 1244 274 75 32 40 425 398 116 119 212 243 282 221 51 998 All causes 4652 941 517 149 j 167 1655 1223 530 552 862 851 1013 713 131 1923 8 9 Local Government Board. Table v. BOROUGH OF LAMBETH. INFANTILE MORTALITY DURING THE YEAR 1907. 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 Mouths. 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 172 44 38 41 295 89 71 81 49 53 40 39 38 4 32 41 870 Uncertified 17 3 6 2 28 9 8 8 6 1 1 3 4 2 ... 1 71 Common Infectious Diseases— Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... 1 2 1 4 2 7 4 5 26 Scarlet Fever ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... 1 Diphtheria : Croup ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 1 3 Whooping Cough ... ... ... ... ... 6 8 5 2 4 1 2 7 6 2 2 45 Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhceal Diseases— Diarrhoea, all forms, including Cholera and Dysentery 2 ... ... ... 2 4 6 9 7 5 8 2 2 4 5 4 58 Enteritis, Muco-enteritis, Gastro-enteritis 1 2 1 ... 4 6 4 8 5 9 3 2 3 4 ... 3 51 Gastritis, Gastro-intestinal Catarrh, Ileo-Colitis 1 ... 2 1 4 1 ... 2 3 2 ... ... ... 1 ... ... 13 Wasting Diseases— Premature Birth 111 8 12 12 143 11 3 2 2 ... ... ... ... 2 ... ... 163 Congenital Defects 3 1 1 1 6 4 ... 1 1 1 ... 1 ... ... 1 ... 15 Injury at Birth 9 ... ... ... 9 ... ... ... ... ... ... ... ... ... ... ... 9 Want of Breast-Milk Starvation ... 1 ... ... 1 2 ... 2 2 ... 2 ... ... ... ... ... 9 Atrophy, Debility, Marasmus 20 14 12 13 59 19 16 11 5 4 2 2 2 1 1 4 126 tuberculous Diseases— Tuberculous Meningitis ... ... ... 1 1 ... ... 5 1 2 3 1 0 1 1 1 18 Tuberculous Peritonitis: Tabes Mesenterica ... 1 ... ... 1 4 3 4 ... 3 ... ... 2 ... 1 ... 18 Other Tuberculous Diseases . ... ... ... ... ... ... 2 1 3 2 2 1 1 1 1 2 16 Other Causes— Influenza ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 Erysipelas ... ... ... ... ... 1 ... 1 ... ... 1 1 ... 1 ... ... 5 Syphilis 7 4 2 1 14 8 3 2 4 ... ... 1 ... 2 ... ... 34 Rickets ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 Meningitis (not Tuberculous) ... ... 1 ... 1 ... 1 2 ... 1 2 1 1 1 1 1 12 Convulsions 8 2 2 2 14 4 2 3 ... 2 ... 1 1 ... 1 ... 28 Bronchitis 1 4 4 4 13 11 9 12 9 5 2 6 2 2 3 4 78 Laryngitis ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... 2 Pneumonia ... ... ... 1 1 ... 1 1 1 3 2 ... 4 1 1 2 17 Suffocation, overlying 8 2 1 2 13 3 2 2 ... ... ... ... ... 1 ... ... 21 Pleuro Pneumonia ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Broncho ... 3 2 3 8 9 14 9 5 5 4 10 6 4 6 10 90 Dentition ... ... ... ... ... ... ... ... 1 1 4 1 4 2 2 1 16 Eczema ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 Intestinal Obstruction 1 1 ... ... 2 ... ... ... ... ... 1 ... ... ... ... ... 3 Jaundice and other diseases of the liver ... ... 1 ... 1 ... ... ... ... ... ... 1 ... ... ... ... 2 Accident (other than suffocation) 1 ... 1 ... 2 1 1 1 ... 1 ... ... 2 1 ... 1 10 Atelectasis 11 2 ... 2 15 ... ... ... ... ... ... ... ... ... ... ... 15 Meningeal Hæmorrage 1 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 Abscess in Neck ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 Arthritis (Septic) ... ... ... ... ... ... 1 ... ... ... ... 1 ... ... 1 1 4 Cerebro spinal Meningitis ... ... ... ... ... ... ... 2 ... 1 ... ... ... ... ... 3 Wilful Murder 2 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 Acute Mastæditis ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 Hæmorrhage from Bowels 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Found Dead 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Hydro Cephalus ... ... ... ... ... l 1 ... ... ... ... 1 ... ... 1 ... 4 Tracheitis ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 Tonsillitis ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Acute Nephritis ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Appendix Abscess ... ... ... ... ... ... ... ... ... ... ... ... 1 . ... ... 1 Syncope ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Dyspepsia ... ... ... ... ... ... l ... ... ... ... ... ... ... ... ... 1 Unclassified ... ... 1 ... 1 2 ... 3 ... ... 1 ... ... 1 ... ... 8 189 47 44 43 323 98 79 89 55 54 41 42 42 44 32 42 841 10 11 II LAMBETH BOROUGH.—Deaths Registered from all Causes during the Year 1907. 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. Norwood. Districts not stated. All Ages. I. Specific Febrile, or Zymotic Diseases M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 33 44 38 32 50 55 47 43 40 55 23 36 4 2 235 267 502 II. Parasitic Diseases ... ... ... ... ... ... ... ... 2 ... ... 1 ... ... 2 1 3 III. Dietetic Diseases 3 5 2 8 1 4 2 3 2 3 ... 2 ... l 10 26 36 IV. Constitutional Diseases 58 47 61 66 115 75 102 97 112 119 79 77 13 19 543 500 1043 V. Developmental Diseases 15 19 21 16 20 28 27 29 32 45 28 24 4 5 147 166 313 VI. Local Diseases 131 125 137 125 234 219 211 221 205 313 166 237 50 43 1134 1283 2417 VII. Deaths from Violence 22 12 16 7 10 6 26 9 31 21 14 5 9 2 128 62 190 VIII. Deaths from Ill-defined and not Specified Causes 9 7 12 8 22 5 22 10 18 14 15 6 ... ... 98 50 148 Totals 271 259 290 262 452 392 437 412 442 570 325 388 80 72 2297 2355 4652 I.—Specific Febrile, or Zymotic Diseases. 1.—Miasmatic Diseases. Small-pox Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... -Unvaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No Statement ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 11 8 11 8 17 16 7 8 5 6 2 7 ... 1 53 54 107 Whooping Cough 2 18 5 4 7 12 5 10 8 19 8 12 1 ... 36 75 111 Scarlet Fever 2 1 3 4 4 3 9 7 2 1 1 1 ... ... 21 17 38 Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Simple Continued and Ill-defined Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric or Typhoid Fever ... 1 ... 1 1 ... 1 ... ... ... ... 1 ... 3 2 5 Diphtheria l 1 5 2 3 5 4 4 8 9 2 2 1 ... 24 23 47 Membranous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza l 2 l 1 4 3 5 6 3 7 1 5 ... ... 15 24 39 Other Miasmatic Diseases 3 ... 1 ... 2 ... 1 ... ... 1 ... ... ... ... 7 1 8 2.—Diarrhceal Diseases. Cholera, Nostras ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera, Asiatica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhœa, Dysentery 7 7 5 6 7 7 6 4 5 5 7 4 ... 1 37 34 71 3.—Malarial Diseases. Remittent or Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4.—Zoogenous Diseases. Cow-pox and effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases (e.g., Hydrophobia, Glanders, Splenic Fever) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5.—Venereal Diseases. Syphilis 3 3 4 5 2 6 7 2 5 1 1 1 1 ... 23 18 41 Gonorrhœa, Stricture of Urethra ... ... 1 ... ... ... ... ... 1 ... 1 ... ... ... 8 ... 3 6.—Septic Diseases. Erysipelas 1 ... 1 ... 2 3 1 1 3 1 ... 2 ... ... 8 7 15 Pysemia, Septicemia 2 ... 1 1 1 ... 1 ... ... 2 ... ... ... ... 5 3 8 Puerperal Fever ... 3 ... ... ... ... ... 1 ... 3 ... 2 ... ... ... 9 9 12 13 LAMBETH BOROUGH.—Deaths Registered from all Causes during the Year 1907. Note. The Deaths of Non-Residents'occurring in Public Institutions situated in the 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. Districts not stated. All Ages. II.—Parasitic Diseases. Thrush, and other Vegetable Parasitic Diseases M. F. M. F.. M. F. M. M. F. M. F. M. F. M. F. ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 2 ... 2 Worms, Hydatids, and other Animal Parasitic Diseases ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 1 III.—Dietetic Diseases. Want of Breast Milk, Starvation ... ... 1 1 1 1 1 ... ... 2 ... 1 ... ... 3 5 8 Scurvy ... ... ... ... ... ... ... l ... ... ... ... ... ... ... 1 1 Chronic Alcoholism 3 5 ... 7 ... 3 1 2 2 1 ... l ... 1 6 20 26 Delirium Tremens ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 IV.—Constitutional Diseases. Rheumatic Fever 1 1 2 2 1 1 1 4 3 7 ... 5 ... ... 8 20 28 Rheumatism of the Heart ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rheumatism ... ... ... ... 1 ... ... 1 2 ... 1 2 ... ... 4 3 7 Gout ... ... 1 ... 2 ... ... 1 2 ... 2 ... ... ... 9 1 10 Rickets ... 1 ... ... 1 ... 1 1 ... ... ... ... ... ... 2 1 4 Cancer, Malignant Disease 16 11 12 21 21 21 39 24 28 56 29 33 5 10 150 176 326 Cancrum Oris (Noma) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tabes Mesenterica 1 1 3 6 5 3 3 1 3 5 ... 1 1 1 16 18 34 Tubercular Meningitis, Hydrocephalus 1 2 2 3 6 5 3 8 5 9 5 2 ... ... 22 29 51 Phthisis 83 25 40 23 68 36 39 43 60 32 32 20 6 8 278 187 465 Scrofula ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 1 Other forms of Tuberculosis 5 4 3 7 8 5 4 9 8 3 3 2 1 ... 32 30 62 Purpura, Hæmorrhagic Diathesis ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... 2 2 Anæmia. Chlorosis, Leucocythæmia ... ... ... 1 1 1 2 4 1 2 2 4 ... ... 6 12 18 Glycosuria, Diabetes Mellitus ... 2 1 1 ... 1 5 1 2 3 5 4 ... ... 14 12 26 Other Constitutional Diseases. 1 ... ... 2 ... ... 1 1 ... 2 ... 2 ... ... 2 7 9 V.—Developmental Diseases. Premature Birth. 11 14 17 7 14 14 14 12 21 17 15 6 1 ... 93 70 163 Atelectasis 1 3 1 4 1 2 2 ... 1 ... ... ... ... ... 6 9 15 Congenital Malformations 1 ... 2 ... 4 ... 4 2 3 1 ... 2 ... ... 14 5 19 Old Age 2 2 1 5 1 12 7 15 7 27 is 16 3 "5 34 82 116 VI.—Local Diseases. 1-—Diseases hp Nervous System. Inflammation of Brain or Membranes 2 2 3 2 3 6 2 3 4 4 2 3 ... ... 16 20 36 Apoplexy, Softening of Brain, Hemiplegia Brain Paralysis 7 5 10 13 7 19 16 18 18 29 11 26 6 2 75 112 187 Insanity, General Paralysis of the Insane 1 2 3 1 11 3 3 3 7 1 2 2 6 7 33 19 52 Epilepsy ... ... 2 ... 1 ... 1 ... 2 2 2 3 3 4 11 9 20 Convulsions 6 2 2 ... 6 2 2 1 5 1 5 4 ... ... 26 10 36 Laryngismus Stridulus (Spasm of Glottis) ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 Disease of Spinal Cord, Paraplegia, Paralysis Agitans ... ... 1 ... 1 2 7 1 3 3 3 4 ... ... 15 10 25 Other Diseases of Nervous System 1 1 1 1 4 4 2 5 1 7 2 4 1 ... 12 22 34 2.—Diseases of Organs of Special Sense. (e.g., of Ear, Eye, Nose) ... 1 ... ... 1 1 3 1 ... 1 1 ... ... ... 5 4 9 14 I 15 LAMBETH BOROUGH.—Deaths Registered from all Causes during the Year 1907. 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 bevond the limits of the District are included. Sub-Districts. Sub-Districts. Total. Waterloo. Lambeth Church. Kennington. Stockwell. Brixton. Norwood. District not stated. All Ages. 3.—Diseases of Circulatory System. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Pericarditis ... 1 1 ... ... ... ... 1 ... 2 ... ... ... ... 1 4 5 Acute Endocarditis ... ... ... ... 3 2 1 6 2 2 ... ... 5 11 16 Valvular Diseases of Heart 4 15 7 8 11 23 11 19 12 26 10 16 3 4 58 111 169 Other Diseases of Heart 8 11 7 10 13 11 10 16 16 27 17 27 2 2 73 104 177 Aneurism 3 ... ... 1 2 ... 2 ... 1 ... 1 ... 1 ... 10 1 11 Embolism, Thrombosis ... ... ... ... ... 2 ... ... ... 1 ... 2 ... ... ... 5 5 Other Diseases of Blood Vessels 10 6 8 11 13 15 8 5 10 17 9 11 2 9 60 74 134 4.—Diseases of Respiratory System. Laryngitis 1 ... ... ... ... ... 1 1 1 ... 1 1 ... ... 4 2 6 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Emphysema, Asthma 2 2 2 1 2 ... 1 4 2 3 1 2 ... ... 10 12 22 Bronchitis 28 28 28 27 41 41 48 56 32 65 26 46 9 5 212 268 480 Pneumonia 9 8 10 6 15 14 14 6 10 18 12 13 6 1 76 66 142 Pleurisy 1 ... 2 ... 3 2 1 1 2 3 ... 2 ... ... 9 8 17 Broncho-pneumonia 10 11 16 14 34 14 16 18 18 14 15 12 1 3 110 86 196 Pleuro-pneumonia 5 ... 2 ... 3 ... 6 4 ... 4 2 4 1 ... 19 12 31 Other Diseases of Respiratory System ... 1 2 2 4 7 3 2 7 4 ... 4 1 1 17 21 38 5.—Diseases of Digestive System. Dentition 3 3 ... 3 1 4 4 6 2 3 ... 1 ... ... 10 20 30 Sore Throat, Quinsy ... ... ... ... 1 1 3 1 2 1 ... ... ... ... 6 8 9 Diseases of Stomach 2 ... 1 1 1 6 3 5 2 2 1 3 ... ... 10 17 27 Enteritis 6 1 15 5 16 8 2 10 7 10 6 7 1 ... 53 41 94 Obstructive Diseases of Intestine 1 1 2 ... 2 1 6 3 1 4 5 4 1 ... 18 13 31 Peritonitis 1 ... ... ... ... 1 ... 2 ... 2 ... ... ... ... 1 5 6 Ascites ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver ... 2 2 ... 2 2 4 5 7 7 6 2 ... ... 21 18 39 Jaundice and other Diseases of Liver 1 1 ... 1 2 1 2 1 1 3 3 ... ... ... 9 7 16 Diseases of the Pancreas ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 Other Diseases of Digestive System 1 2 1 2 3 6 1 2 3 2 2 2 ... ... 11 16 27 6.—Diseases of Lymphatic System. (e.g., of Lymphatics and of Spleen) 2 ... ... ... 1 ... ... ... ... 2 ... ... ... ... 3 2 5 7. Diseases of Gland-Like Organs of Uncertain Use. (e.g.,Bronchocele, Addison's Disease) ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 2 2 8.—Diseases of Urinary System. Nephritis ... 1 1 1 3 3 2 3 2 4 ... 3 ... 1 8 16 24 Bright's Disease, Albuminuria 15 9 7 9 15 9 17 7 18 21 7 11 5 3 84 69 153 Disease of Bladder or of Prostate ... ... ... ... 5 1 4 ... 5 1 4 1 1 ... 19 3 22 Calculus (Stone) ... ... ... ... ... ... ... ... ... ... 3 ... ... 1 3 1 4 Other Diseases of the Urinary System ... ... 1 1 1 ... 1 ... 2 1 3 ... ... ... 8 2 10 9—Diseases of Reproductive System. A. Of Organs of Generation. Male Organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Female Organs ... 5 ... 1 .... 3 ... 1 ... 2 ... 6 ... ... ... l8 18 16 17 LAMBETH BOROUGH.-Deaths Registered , from all Causes during the Year 1907. 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 Districts are included. Sub-Districts. Sub-Districts Total. Waterloo. Lambeth Church. ton. Stockwell. Brixton Norwood District not stated All Ages B. Of Parturition. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Abortion, Miscarriage ... 2 ... ... ... ... ... ... ... 1 ... 1 ... ... ... 4 4 Puerperal Convulsions ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 Placenta Prævia, Flooding ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... 2 2 Other Accidents of Child Birth ... ... ... 1 ... 2 ... 3 ... 2 ... 3 ... ... ... 11 11 10.—Diseases of Bones and Joints. Caries, Necrosis ... ... ... ... ... 1 2 ... ... ... ... 2 ... ... 2 3 5 Arthritis, Ostitis. Periostitis 1 1 ... 1 ... 1 1 1 ... 2 ... 1 ... ... 2 7 9 Other Diseases of Bones and Joints ... 1 ... ... ... 1 ... ... ... ... ... 1 ... ... ... 3 3 11-—Diseases of Integumentary System. Carbunole, Phlegmon ... ... ... ... 2 ... ... 1 ... ... 1 ... ... ... 5 1 6 Other Diseases of Integumentary System ... ... ... ... 2 1 ... ... 2 2 3 1 ... ... ... 2 7 9 VII.—Deaths from Violence. 1.—Accident ok Negligence. Fractures and Contusions 8 3 4 2 3 1 6 2 4 3 ... 1 3 2 28 14 42 Gunshot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cut, Stab ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Burn, Scald 1 5 1 2 1 1 1 1 3 6 1 3 ... ... 8 18 26 Poison 1 ... 1 ... 1 ... 1 ... 1 4 ... ... ... ... 5 4 9 Drowning 4 ... 4 ... 4 ... 1 ... 2 1 ... ... 2 ... 13 1 14 Suffocation 2 3 2 2 ... 1 3 1 4 2 4 ... 1 ... 16 9 25 Otherwise 4 1 4 ... ... 1 9 2 7 2 2 ... 1 ... 31 6 37 2.—Homicide. Manslaughter ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 Murder ... ... ... ... ... 2 ... 1 ... ... ... ... 1 ... 1 3 4 3.—Suicide. Gunshot Wounds ... ... ... ... ... ... ... ... ... ... 2 ... 1 ... 3 ... 3 Cut, Stab ... ... ... ... 1 ... ... 1 ... ... 1 ... ... ... 4 ... 4 Poison ... ... ... ... 1 ... 3 ... 4 3 1 1 ... ... 6 5 11 Drowning 1 ... ... 1 ... ... 1 ... 1 ... 1 ... ... ... 4 1 5 Hanging 1 ... ... ... ... ... 1 ... 4 ... 2 ... ... ... 3 ... 8 Otherwise ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 4.—Execution. Hanging ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... VIII.—Deaths from Ill-Defined and not Specified Causes. Dropsy ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 Debility, Atrophy, Inanition 8 5 11 6 22 5 22 9 18 13 12 5 ... ... 93 43 136 Mortification ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 1 Tumour ... ... ... ... ... ... ... ... ... 1 1 1 ... ... 1 2 3 Abscess 1 1 1 ... ... ... ... ... ... ... ... ... ... ... 2 1 3 Hæmorrhage ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 Sudden Death (cause not ascertained) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not specified, or Ill-defined ... 1 ... 1 ... ... ... ... ... ... 1 ... ... ... 1 2 3 18 19 Lambeth Borough.-Deaths Registered from all Causes during the Year 1907. Note.-The deaths of Non-Residents occurring in Public Institutions situated in the Distriot are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the District are included. AGES. AGES. Total. 1 Under I 1 Year 1-5 Under 5 Years. I 5-10 10-15 15-20 20-25 25-40 40-60 60-65 65-80 80 & over Over 5 Years. All Ages. I. Specific Febrile, or Zymotic 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. 84 94 100 110 184 204 12 13 3 ... 2 4 3 5 8 11 14 9 4 6 5 11 ... 4 51 63 235 267 502 II. Parasitic Diseases 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 2 9fi7 502 III.Dieteric Diseases 3 5 ... ... 3 5 ... ... ... ... ... ... ... ... 2 8 1 9 2 ... 2 4 ... ... 7 21 10 1 IV.Constitutional Diseases 29 25 30 35 59 60 7 21 4 14 15 16 21 21 99 92 205 149 52 34 70 79 ... 14 484 440 543 1 • 3 V. Developmental Diseases 111 82 ... 2 111 84 1 ... ... ... ... ... ... ... ... ... ... 1 1 2 14 38 11 41 36 82 147 26 36 VI. Local Diseases 196 148 107 100 308 248 13 23 7 17 20 16 15 18 97 98 240 228 85 106 280 354 20 175 831 1035 1134 600 1043 VII. Deaths from Violence 18 15 14 10 32 25 6 2 4 ... 3 1 5 2 20 3 29 16 12 5 12 4 74 4 96 37 128 166 1283 313 2417 VIII. Deaths from Ill-Defined and Not Specified Causes 90 39 3 6 93 45 1 1 ... ... ... ... ... ... 1 ... 2 ... 1 2 ... 2 5 ... 5 5 98 62 50 190 148 Totals 53 408 254 263 787 671 40 60 18 31 40 37 44 46 227 212 491 413 157 155 383 492 110 238 1510 1684 2297 2355 4652 1.-Specific Febrile, or Zymotic Diseases. 1.—Miasmatic diseases Smallpox Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... « Unvaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No Statement ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 8 18 43 35 51 53 2 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 53 54 107 Whooping Cough 15 30 26 42 35 72 1 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 3 36 75 111 Scarlet Fever l ... 12 10 13 10 4 4 ... ... 2 2 ... 1 2 ... ... ... ... ... ... ... ... ... 8 7 21 17 38 Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Simple Continued and Ill-defined Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric or Typhoid Fever ... ... ... 1 ... 1 ... ... ... ... ... ... 1 1 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... Diphtheria 2 1 16 16 18 17 4 5 1 ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... 3 1 3 2 5 Membranous Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 6 24 23 47 Influenza ... 1 1 1 1 2 ... ... ... ... ... ... 2 ... 3 2 2 4 3 5 4 8 ... 3 ... ... ... ... Other Miasmatic Diseases 2 ... 4 ... 6 ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 14 22 15 24 39 2.-Diarrhœal Diseases Cholera, Nostras ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 7 1 8 Cholera, Asiatica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea, Dysentery 32 26 4 3 36 29 ... ... ... ... ... ... ... ... 1 ... ... 2 ... 1 ... 1 ... 1 1 5 37 34 71 3.—Malarial Diseases. Remittent or Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4. Zoogenous Diseases. Cow-pox and effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases (e.g.,Hydrophobia Glanders, Splenic Fever) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5. Venereal Diseases ... Syphilis 19 15 ... 1 19 16 ... ... ... ... ... ... ... ... ... ... 3 1 ... ... 1 1 ... ... 4 2 23 18 41 Gonorrhoea, Stricture of Urethra ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... ... ... 3 ... 3 ... 3 6.—Septic Diseases. Erysipelas 3 2 ... ... 3 2 ... ... ... ... ... ... ... 1 1 1 3 2 1 ... ... 1 ... ... 5 5 8 7 15 Pyæmia, Septicaemia 2 1 ... 1 2 2 1 ... 1 ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 3 1 5 3 8 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 7 ... ... ... ... ... ... ... ... ... 9 ... 9 9 20 21 Lambeth Borough.—Deaths Registered from Causes during the Year 1907—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 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 & over. Over 5 Years. All Ages II.—Parasitic Diseases. Thrush and other Vegetable 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. 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 Worms, Hydatids, and other Animal Parasitic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 1 III.—Dietetic Diseases. Want of Breast Milk, Starvation 3 5 ... ... 3 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 5 8 Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 1 Chronic Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 8 1 8 2 ... 2 4 ... ... 6 20 6 20 26 Delirium Tremens ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 IV.—Constitutional Diseases. Rheumatic Fever ... ... 3 1 3 1 1 3 ... 2 ... 2 1 1 1 5 .. 5 1 ... 1 1 ... ... 5 19 8 20 28 Rheumatism of the Heart ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rheumatism ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 2 1 ... 1 1 ... ... 4 3 4 3 7 Gout ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... 2 1 3 ... ... ... 9 1 9 1 10 Rickets ... 1 2 1 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 4 Cancer, Malignant Diseases ... ... 3 ... 3 ... ... l 1 1 1 ... ... ... 7 9 68 80 29 16 40 58 6 11 147 176 150 176 326 Cancrum Oris (Noma) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tabes Mesenterica 8 10 3 5 11 15 ... l ... ... 1 ... 1 ... ... ... 2 2 ... ... 1 ... ... ... 5 3 16 18 34 Tubercular Meningitis, Hydrocephalus 13 5 5 12 18 17 1 6 1 4 ... ... 2 ... ... 1 ... ... ... ... ... ... ... 1 4 12 22 29 51 Phthisis 3 3 3 6 6 9 2 6 2 5 10 11 16 16 85 69 126 50 14 9 14 10 3 2 272 178 278 187 465 Scrofula ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 1 1 Other forms of Tuberculosis 4 6 11 9 15 15 2 4 ... 2 3 1 ... 2 5 3 5 1 1 ... ... 2 1 ... 17 15 32 30 62 Purpura, Hæmorrbagic Diathesis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... 2 ... 2 2 Anxmia, Chlorosis. Leucocythaemia 1 ... ... l 1 1 ... ... ... ... ... ... ... 2 1 2 2 5 1 1 1 1 .. ... ... 11 6 12 18 Glycosuria, Diabetes Mellitus ... ... ... ... ... ... ... ... ... ... ... 2 1 ... ... 2 2 3 2 2 8 3 ... ... 14 12 14 12 26 Other Constitutional Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 3 1 2 ... ... 2 7 2 7 9 V.—Developmental Diseases. Premature Birth 93 70 ... ... 93 70 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 93 70 163 Atelectasis 6 9 ... ... 6 9 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 9 15 Congenital Malformations Old Acta 12 3 ... 2 12 5 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 2 ... 14 5 19 \JlSi Ago ... ... tt| ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 13 38 20 41 34 82 34 5 116 VI.—Local Diseases. 1.—Diseases op Nervous System. Inflammation of Brain or Membranes 6 6 7 10 13 16 1 1 ... 1 ... 1 ... ... 1 ... 1 ... ... ... ... 1 ... ... 3 4 16 20 36 Apoplexy, Softening of Brain, Hemiplegia. Brain Paralysis 2 ... ... ... 2 ... ... ... ... 1 ... ... ... ... 2 4 23 22 10 21 27 43 11 21 73 112 75 112 187 Insanity, General Paralysis of the Insane ... ... ... ... ... ... ... 1 ... 1 ... ... 1 ... 11 3 20 7 1 1 ... 3 ... 3 33 19 33 19 52 Epilepsy ... ... ... ... ... ... ... ... ... ... 2 2 ... 3 2 2 2 ... ... 3 3 1 ... 11 9 11 9 20 Convulsions 21 9 5 1 26 10 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 26 10 36 Laryngismus Stridulus (Spasm of' Glottis) 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Disease of Spinal Cord, Paraplegia, Paralysis Agitans ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... 6 ... 1 2 6 7 1 ... 15 10 15 10 25 Other Diseases of Nervous System 3 l ... ... 3 1 ... ... ... 2 ... ... ... 4 3 5 2 7 1 ... 1 2 2 1 9 21 12 22 34 2.—Diseases of Organs of Special Sense. (e.g., of Ear, Eye, Nose) 1 1 ... ... 1 1 ... 1 ... 1 2 ... ... .. 2 1 ... ... ... ... ... ... ... 4 3 5 4 9 22 23 Lambeth Borough.—Deaths Registered from all Causes during the Year 1907—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 80 & over. Over 5 Years. All Ages. 3.—Diseases of Circulatory System. 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. Pericarditis .. ... ... 2 ... 2 ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... 1 ... ... 1 2 1 4 5 Acute Endocarditis ... ... ... ... ... ... ... 1 ... 1 ... 2 ... ... 3 3 ... 3 ... ... 1 ... 1 1 5 11 5 11 16 Valvular Diseases of Heart ... ... ... 1 ... 1 4 4 2 3 2 4 1 1 10 20 17 33 3 9 18 28 1 8 58 110 58 111 169 Other Diseases of Heart ... 2 ... ... ... 2 ... ... ... 3 2 ... ... 2 6 6 22 18 9 11 26 43 8 19 73 102 73 104 177 Aneurism ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 6 1 2 ... 1 ... ... ... 10 1 10 1 11 Embolism, Thrombosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... 1 ... 2 ... 5 ... 5 5 Other Diseases of Blood-Vessels ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 7 2 7 2 35 33 11 35 60 74 60 74 134 4.—Diseases op Respiratory System. Laryngitis 1 ... 2 1 3 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 l 4 2 6 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Empuysema, Asthma ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... 5 3 ... ... 1 8 ... 1 10 12 10 12 22 Bronchitis 45 33 15 17 60 50 ... 1 ... ... 1 1 2 ... 5 3 36 27 11 23 73 108 24 55 152 218 212 268 480 Pneumonia 10 7 12 10 22 17 ... 3 ... ... 1 1 1 ... 10 7 19 12 5 6 16 15 2 5 54 49 76 66 142 Pleurisy 1 ... 2 1 3 l ... ... ... ... 1 ... ... 1 ... 1 2 1 1 2 2 1 ... 1 6 7 9 8 17 Broncho-pneumonia 51 39 46 30 97 69 1 4 ... ... ... 1 ... ... ... 2 5 3 1 2 5 3 1 2 13 17 110 86 196 Pleuro-pneumonia ... 1 2 2 2 3 1 1 ... ... ... ... ... 1 7 2 4 3 2 1 2 1 1 ... 17 9 19 12 31 Other Diseases of Respiratory System 2 3 ... 4 2 7 1 1 ... ... 1 ... 1 ... 5 ... 3 1 3 3 1 4 ... 5 15 14 17 21 38 5.—Diseases of Digestive System. Dentition 6 10 4 10 10 20 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 20 30 Sore Throat, Quinsy 1 ... 1 2 2 2 1 1 ... ... 1 ... ... ... 1 ... 1 ... ... ... ... ... ... ... 4 1 6 3 9 Diseases of Stomach 2 4 1 ... 3 4 ... ... ... ... ... 1 1 1 3 3 4 ... 1 2 1 ... 3 7 13 10 17 27 Enteritis 32 19 5 2 37 21 1 2 1 2 5 1 2 3 4 5 3 3 ... 1 ... 3 ... ... 16 20 53 41 94 Obstructive Diseases of Intestine 3 ... ... 1 3 1 1 ... ... ... 1 ... 1 ... 1 ... 5 1 2 1 4 6 ... '4 15 12 18 13 31 Peritonitis ... 1 ... ... ... 1 ... ... 1 ... ... ... ... 1 ... 1 ... 2 ... ... ... ... ... ... 1 4 1 5 6 Ascites ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cirrhosis of Liver ... ... 1 ... 1 ... 1 ... ... ... ... ... ... ... 2 2 10 9 1 3 6 4 ... ... 20 18 21 18 39 Jaundice and other Diseases of Liver 2 1 ... 1 2 2 ... ... 2 ... ... ... ... ... 1 ... 3 3 1 ... ... 2 ... ... 7 5 9 7 16 Diseases of the Pancreas ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 ... 1 Other Diseases of Digestive System l 8 1 1 2 9 1 ... ... ... ... 1 ... ... 2 ... 2 5 1 13 3 ... ... ... 9 7 11 16 27 6.—Diseases of Lymphatic System. 5 (e.g., of Lymphatics and of Spleen) ... 1 ... ... ... 1 ... ... ... ... 1 ... ... ... 1 ... 1 ... ... ... ... ... ... 1 3 1 3 2 7.—Diseases of Gland-Like Organs of Uncertain Use. 2 (e.g., Bronchocele, Addison's Disease) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 2 ... 2 2 8.—Diseases of Urinary System. Nephritis 1 ... 1 1 2 1 ... ... ... ... 1 ... 1 1 1 4 2 8 ... 1 1 1 ... ... 6 15 8 16 24 Bright's Disease, Albuminuria. ... ... ... 1 ... 1 ... ... 1 ... 1 ... ... ... 8 4 22 26 19 8 30 25 3 5 84 68 84 69 153 Disease of Bladder or of Prostate ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... 11 1 6 1 19 3 19 3 22 Calculus (Stone) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 2 1 1 ... ... ... ... ... 3 1 3 1 4 Other Diseases of the Urinary System 1 ... 1 ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 1 1 ... 3 3 ... ... 6 2 8 2 10 9.—Diseases of Reproductive System. A. Of Organs of Generation. Male Organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Female Organs ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... .... 8 ... 3 ... 1 ... 1 ... 18 ... 18 18 24 Lambeth Borough.—Deaths Registered from all Causes during the Year 1907—continued. Note.-The deaths of Non-Reisdents 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 & over. Over 5 Years. All Ages. B. Of Parturition. 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. Abortion, Miscarriage ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 ... ... ... ... ... ... ... ... ... 4 ... 4 4 Puerperal Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 1 Placenta prævia, Flooding ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... 2 ... 2 2 Qther Accidents of Child Birth ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 10 ... ... ... ... ... ... ... ... ... 11 ... 11 11 10.—Diseases of Bones and Joints. Caries, Necrosis ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 2 ... ... ... ... ... ... 2 3 2 3 5 Arthritis, Ostitis. Periostitis 2 1 ... ... ... 2 1 ... ... 1 ... ... ... ... ... ... ... ... ... 2 ... 3 ... ... ... 6 2 7 9 Other Diseases of Bones and Joints ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 2 ... 3 3 11.—Diseases of Integumentary System. Carbuncle, Phlegmon ... ... ... 1 ... 1 ... ... ... ... ... ... 1 ... ... ... 1 ... 1 ... 1 ... 1 ... 5 ... 5 1 6 Other Diseases of Integumentary System 1 ... 1 1 2 1 ... ... ... ... ... ... ... ... ... ... ... 3 ... 1 ... 1 ... 1 ... 6 2 7 9 VII.—Deaths from Violence. I-—Accident or Negligence. Fractures and Contusions ... 1 3 1 3 2 2 ... 2 ... 1 ... 2 ... 3 ... 6 6 3 1 4 8 2 2 25 12 28 14 42 Cunshot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cut, Stab ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Burn, Scald ... 2 6 8 6 10 1 2 ... ... ... ... ... ... 1 ... ... 2 ... 1 ... 1 ... 9 2 8 8 18 26 Poison 1 1 ... 1 1 2 ... ... ... ... ... ... ... ... ... ... 2 2 1 ... 1 ... ... ... 4 2 5 4 9 Drowning ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 3 1 8 ... ... ... ... ... ... ... 13 1 13 1 14 Suffocation 13 8 ... ... 13 8 ... ... ... ... 1 ... ... ... ... 1 ... ... 1 ... 1 ... ... ... 3 1 16 9 25 Otherwise 3 1 5 ... 8 1 2 ... 2 ... 1 ... 1 ... 7 ... 5 4 1 1 1 ... 3 ... 23 5 31 6 37 2.—Homicide. Manslaughter ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Murder 1 1 ... ... 1 1 ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 2 1 3 4 3.—Suicide. Gunshot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... 1 ... ... ... 3 ... 3 ... 3 Cut, Stab ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... 1 ... ... ... 4 ... 4 ... 4 Poison ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 2 2 2 2 ... ... ... ... 6 5 6 5 11 Drowning ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... 1 ... ... ... 1 ... ... ... 4 1 4 1 5 Hanging ... . ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 4 ... 1 ... ... ... 8 ... 8 ... 8 Otherwise ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 1 ... 1 4.—Execution. Hanging ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... VIII.-Deaths from Ill-Defined and Not Specified Causes. Dropsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 1 1 Debility, Atrophy, Inanition 90 36 3 5 93 41 ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 93 43 136 Mortification ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 Tumour ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... 1 2 1 2 3 Abscess ... 1 ... ... ... 1 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 2 ... 2 1 3 Hæmorrhage ... 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Sudden Death (cause not ascertained) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not specified, or ill-defined ... 1 ... 1 ... 2 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 2 3 26 Summary of Total Corrected Deaths in Lambeth Borough during 1907. No. of Deaths. Total. No. of Deaths. Total. M. F. M. F. I.—Specific Febrile, or Zymotic Diseases Brought forward 1935 2091 4026 1. Miasmatic diseases 159 196 355 2. Diarrhceal „ 37 34 71 VI.—Local Diseases—continued. 3. Malarial ,, ... 6. Diseases of Lymphatic System 3 2 5 4. Zoogenous ,, ... 7. Diseases of Gland-like Organs of Uncertain Use ... 2 2 5. Venereal ,, 26 18 44 6. Septic „ 13 19 32 8. Diseases of Urinary System 122 91 213 9. Diseases of Reproductive System II.—Parasitic Diseases 2 1 3 (a) Diseases of Organs of Generation. ... 18 18 III.—Dietetic Diseases 10 26 36 (b) Diseases of Parturition ... 18 18 10. Diseases of Bones and Joints 4 13 17 IV.—Constitutional Diseases 543 500 1043 11. Diseases of Integumentary System 7 8 15 V.—Developmental Diseases 147 166 313 VII.—Violence. VI.—Local Diseases 1. Accident or Negligene 101 52 153 1. Diseases of Nervous System 189 202 391 2. Homicide l 4 5 2. Diseases of Organs of Special 8ense 5 4 9 3. Suicide 26 6 32 4. Execution ... ... ... S. Diseases of Circulatory System 207 310 517 4. Diseases of Respiratory „ 457 475 932 VIII.— Ill-Defined and not Specified Causes. 98 50 148 5. Diseases of Digestive „ 140 140 280 Carried forward 1935 2091 4026 Total 2297 2355 4652 27 Offences under the Food and Drugs, and Public Health Acts, during 1907. NATURE OF OFFENCES AND AMOUNTS OF PENALTIES AND COSTS IN EACH CASE. 28 29 SALE OF FOOD AND DRUGS ACTS.—SUMMONSES, 1907. Offence. Penalty. Costs. £ s. d. £ S. d. On 30th January, two summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 24 per cent, [sample 1,375] 0 10 0 0 16 6 N.B.—This sample was purchased during December, 1906, but did not appear in the 1906 Report. Re selling Milk deficient in Milk Fat to the extent of 10 per cent, [sample 1,449]. ... ... Summons dismissed under Section 17 of the Summary Jurisdiction Acts, the magistrate being of opinion that there was no evidence of the Milk having been tampered with N.B.—This sample was purchased during December, 1906, but did not appear in the 1906 Report. On 6th February, a summons was heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk containing added water 6 per cent, [sample 2] 1 0 0 0 12 6 On 27th February, a summons was heard before Mr. Hopkins, at Lambeth Police Court, re selling Coffee containing added Chicory 48 per cent, [sample 42] 0 10 0 0 12 6 On February 25th, a summons was taken out re selling Butter containing Margarine (not butter) 100 per cent, [sample 118]. ... ... The summons was not served owing to the defendant removing and not being able to be traced ... On 23rd May, three summonses were heard before Mr. Hopkins, at Lambeth Police Court, re exposing a parcel of Margarine for sale, by retail, without having a label attached and marked in printed capital letters, not less than i£ in. square—"Margarine" [sample 335] 5 0 0 0 19 6 Re selling butter containing Margarine (not butter) 90 per cent, [sample 335] Re selling Milk containing extraneous water to the extent of 4 per cent, [sample 471]. ... ... Summons withdrawn owing to legal technicality, the date of hearing being too short (12 days instead of 14 days), and a fresh summons taken out Carried forward 7 0 0 3 1 0 30 31 Sale of Food and Drugs Acts.—Summonses, 1907—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 7 0 0 3 1 0 On 29th May, five summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk containing added water 9 per cent, [sample 477] 3 0 0 0 12 6 Re selling sample of Milk deficient in Milk Fat 7 per cent, [sample 435] 0 5 0 0 12 6 Re selling sample of milk deficient in Milk Fat 5 per cent, [sample 424]. Summons withdrawn on account of the smallness of the deficiency in Milk Fat, the defendant to pay £1 1s. costs ... 1 1 0 Re selling sample of Milk deficient in Milk Fat to the extent of 4 per cent, [sample 446]. Summons withdrawn owing to legal technicality, the date of hearing being too short (12 days instead of 14 days), and a fresh summons taken out ... ... Re selling sample of Milk deficient in Milk fat to the extent of 10 per cent, [sample 449]. ... ... Summons withdrawn owing to legal technicality, the date of hearing being too short (12 days instead of 14 days), and a fresh summons taken out On 5th June, eight 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 200]. ... ... Re selling Milk deficient in Milk Fat to the extent of 39 per cent, [sample 196]. ... ... Re selling Milk deficient in Milk Fat to the extent of 22 per cent, [sample 195]. ... ... Re selling Milk deficient in Milk Fat to the extent of 12 per cent, [sample 194]. ... ... Re selling Milk deficient in Milk Fat to the extent of 16 per cent, [sample 192]. ... ... Re selling Milk deficient in Milk Fat to the extent of 20 per cent, [sample 187]. ... ... Re selling Milk deficient in Milk Fat to the extent of 43 per cent, [sample 186]. ... ... Re selling Milk deficient in Milk Fat to the extent of 6 per cent, [sample 172]. ... ... Carried forward 10 5 0 5 7 0 32 33 Sale of Food and Drugs Acts.—Summonses, 1907—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 10 5 0 5 7 0 The eight summonses were dismissed owing to legal technicalities, duplicate samples not having been sent to the farmer in all cases in which samples had been taken ... ... On 14th June, 10 summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling sample of Milk deficient in Milk Fat to the extent of 10 per cent, [sample 449]. ... ... Summons dismissed owing to warranty being proved satisfactory Re selling sample of Milk deficient in Milk Fat to the extent of 4 per cent, [sample 446]. ... ... Summons dismissed owing to the smallness of the percentage of fat being proved to be natural and not the result of abstraction Re selling sample of Milk containing extraneous water to the extent of 4 per cent, [sample 471]. ... 2 2 0 Summons withdrawn owing to legal technicality, the summons having been served at the wrong address (the local office and not the central registered office of the company), the defendant to pay £,2 2s. costs Re selling Butter containing Margarine (not butter) 76 per cent, [sample 540] 1 0 0 0 12 6 Re selling Butter containing Margarine (not butter) 98 per cent, [sample 547] 1 0 0 0 12 6 Re selling Milk deficient in Milk Fat 13 per cent, and containing extraneous water 5 per cent, [sample 537] 20 0 0 0 12 6 Re selling Butter containing Margarine (not butter) 96 per cent, [sample 544]. ... ... Summons withdrawn, the defendant having died between the issuing and hearing of the summons Re selling Milk containing added water to the extent of 10 per cent, [sample 509J 2 0 0 0 12 6 Re selling Milk containing added water to the extent of 21 per cent, [sample 506] 2 0 0 0 12 6 Carried forward 36 5 0 10 11 6 34 35 Sale of Food and Drugs Acts.—Summonses, 1907—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 36 5 0 10 11 6 Re selling Beeswax containing Resin 40 parts and Paraffin Wax 15 parts [sample 514] 1 0 0 0 12 6 On 19th June, seven summonses were heard before Mr. Hopkins, at Lambeth Police Court, re exposing a parcel of Margarine for sale, by retail, without having a label attached and marked in printed capital letters, not less than ii in. square—"Margarine" [sample 133] ... 0 12 6 Re exposing a parcel of Margarine for sale, by retail, &c. [sample 134] ... 0 12 6 Re selling Milk containing added water to the extent of 5 per cent, [sample 116] 0 10 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 16 per cent, [sample 252] 1 0 0 0 17 6 Re selling sample of Butter containing Margarine (not butter) 55 per cent, [sample 251] 1 0 0 0 12 6 Re selling Butter containing Margarine (not butter) 50 per cent, [sample 555] 2 0 0 0 12 6 Re selling Milk containing added water to the extent of 3 per cent, [sample 550] 1 0 0 0 12 6 On 8th July, six summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk containing added water to the extent of 4 per cent, [sample 647] 0 10 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 9 per cent, [sample 598] 0 5 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 5 per cent, [sample 616] ... 0 13 6 Re selling Milk deficient in Milk Fat to the extent of 7 per cent, [sample 605] ... 0 12 6 Re selling Butter containing Margarine (not butter) 95 per cent, [sample 696] 2 0 0 0 12 6 Carried forward 45 10 0 19 o 0 37 36 Sale of Food and Drugs Acts.—Summonses, 1907—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 45 10 0 19 0 0 Re selling Coffee containing Chicory 57 per cent, [sample 706] ... 1 6 0 On 17th July, 11 summonses were heard before Mr. Curtis Bennett, at Lambeth Police Court, re selling Milk deficient in Milk Fat 14 per cent, [sample 759] 2 0 0 0 12 6 Re selling Milk containing added water to the extent of 20 per cent, [sample 795] 3 0 0 0 12 6 Re selling Milk containing added water to the extent of 6 per cent, [sample 735] 2 0 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 23 per cent, [sample 773] 2 0 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 11 per cent, [sample 819] 2 0 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 7 per cent, [sample 818] 2 0 0 0 2 6 Re selling Butter containing Margarine (not butter) 93 per cent, [sample 765] 3 0 0 0 12 6 Re sample of Butter snatched from Inspector after the sample had been purchased for analysis under the Food and Drugs Acts 5 0 0 5 5 0 Re selling Beeswax containing Paraffin Wax 20 parts and Resin 5 parts [sample 779]. ... ... Summons dismissed owing to a legal technicality (the sample not having been strictly divided into three equal parts) Re selling Skimmed Milk, not Skimmed Milk, but Separated Milk [sample 734] 3 0 0 0 12 6 Re selling Milk containing added water to the extent of 4 per cent, [sample 669] 2 0 0 0 12 6 On 24th July, two summonses were heard before Mr. Curtis Bennett, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 16 per cent, and 4 per cent, added water [sample 800] 1 0 0 0 12 6 Carried forward 72 10 0 31 16 0 38 39 Sale of Food and Drugs Acts.—Summonses, 1907—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 72 10 0 31 l6 0 Re selling Milk deficient in Milk Fat to the extent of 14 per cent, [sample 799] ... 1 0 0 On 31st July, seven summonses were heard before Mr. Curtis Bennett, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 22 per cent, [sample 887] 1 0 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 4-3 per cent, [sample 880] ... 0 I 2 6 Re selling Butter containing Margarine (not butter) 08 per cent, [sample 888] 1 0 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 21 per cent, [sample 885] 1 0 0 0 12 6 Re selling Butter containing Margarine (not butter) 98 per cent, [sample 878] 1 0 0 0 1 2 6 Re selling Coffee containing added Chicory 48 per cent, [sample 874] 2 0 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 52 per cent, [sample 913] 2 0 0 0 12 6 On 7th August six summonses were heard before Mr. Francis at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 14 per cent. [sample 914] 1 0 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 14 per cent, [sample 914]. ... ... Summons dismissed, the retailer being held responsible and not the wholesale dealer, the defendant (vide previous case) Re selling Milk deficient in Milk Fat to the extent of 7 per cent, [sample 919] 0 5 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 7 per cent, [sample 920] Carried forward 81 15 0 38 8 6 40 41 Sale of Food and Drugs Acts.—Summonses, 1907—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 81 15 0 38 8 6 Re selling Milk deficient in Milk Fat to the extent of 12 per cent, [sample 923] ... ... Re selling Milk deficient in Milk Fat to the extent of 12 per cent, [sample 922] Three summonses dismissed on legal technicalities, the samples not being taken at time of delivery by the guard, but afterwards (25 minutes) On 28th August, nine summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 20 per cent, [sample 952] 0 10 0 0 12 6 Re selling Beeswax containing Paraffin Wax 30 parts [sample 1,027] ... 0 12 6 Re selling Butter containing Margarine (not butter) 95 parts [sample 1,009] 3 0 0 0 12 6 Re selling Milk containing extraneous water to the extent of 18 per cent, [sample 1,008] 3 0 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 10 per cent, [sample 1,024] 0 5 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 9 per cent, [sample 1,012] 0 5 0 0 12 fc Re selling Milk containing added water to the extent of 11 per cent, [sample 1,022] 3 0 0 0 12 6 Re selling Butter containing Margarine (not butter) 20 per cent, [sample 1,053] 1 0 0 0 12 6 Re selling Butter containing Margarine (not butter) 20 per cent, [sample 1,050] 1 0 0 0 12 6 On 25th September, two summonses were heard before Mr. Curtis Bennett, at Lambeth Police Court, re Gregory Powder containing Magnesium Carbonate, instead of Magnesium Oxide, 67 parts [sample 1,098] 0 10 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 12 per cent, [sample 1,108]. Carried forward 94 5 0 44 13 6 42 43 Sale of Food and Drugs Acts.—Summonses, 1907—continued. Offence. Penalty. Costs. £ S. d. £ s. d. Brought forward 94 5 0 44 13 6 Summons withdrawn, samples of the Milk drawn direct from the cow, by the Inspector, showing on analysis an amount of Milk Fat below the Government standard ... ... On 23rd October, four summonses were heard before Mr. Curtis Bennett, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 20 per cent, [sample 1,276] 1 0 0 1 3 0 Re selling Milk containing added water to the extent of 5 per cent, [sample 1,270] 1 0 0 1 3 0 Re selling Milk containing added water to the extent of 23 per cent, [sample 1,246] 1 0 0 1 3 0 Re selling Milk deficient in Milk Fat to the extent of 20 per cent, [sample 1,221] 1 0 0 1 3 0 On 30th October, two summonses were heard before Mr. Curtis Bennett, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 7 per cent, [sample 1.074] 2 0 0 0 12 6 Re selling Milk containing added water to the extent of 6 per cent, [sample 1,286] 1 0 0 0 12 6 On 6th November, a summons was heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 16 per cent, [sample 1,328] I 0 0 0 12 6 On 20th November, two summonses were heard before Mr. Hopkins, at Lambeth Police Court, re Butter containing Margarine (not butter) 20 parts [sample 1,363]. ... ... Summons dismissed with £2 2s. costs against the Council, Somerset House, on appeal, having certified that the Butter was genuine Re selling Milk containing extraneous matter to the extent of 4 per cent, [sample 1,354]. ... ... Summons dismissed owing to warranty being proved satisfactorily Carried forward 102 5 0 51 3 0 44 45 Sale of Food and Drugs Acts.—Summonses, 1907—continued) Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 102 5 0 51 3 0 On 27th November, three summonses were heard before Mr. Hopkins, at Lambeth Police Court, re Milk deficient in Milk Fat to the extent of 14 per cent, [sample 1,478] 0 10 0 0 12 6 Re selling Butter containing Margarine (not butter) 96 per cent, [sample 1,469] 1 0 0 0 12 6 Re selling Butter containing 97 per cent, excess of water over and above the 16 per cent, allowed [sample 1,474]. ... ... Summons withdrawn, the sample being sold as Milk Blended Butter (Pearke's) and the new Butter Act not coming into force until January 1st, 1908 On 4th December, five summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Brawn containing a boric preservative equivalent to 11 grains per lb. crystallised boracic acid [sample 1,537] ... ... Re selling Sausage containing a boric preservative equivalent to 15 grains per lb. crystallised boracic acid [sample 1,535] ... ... These two summonses were withdrawn on the magistrate convicting the same defendant for selling German Sausage containing a boric preservative equivalent to 35 grains per lb. crystallised boracic acid (see next case). Re selling German Sausage containing a boric preservative equivalent to 35 grains per lb. crystallised boracic acid [sample 1,540] 2 0 0 2 2 0 Re selling Milk containing added water to the extent of 14 per cent, [sample 1,528] 2 0 0 0 12 6 Re selling Milk containing added water to the extent of 4 per cent, [sample 1,500] 1 0 0 0 12 6 On 11th December, five summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 14 per cent, [sample 1,482] 1 0 0 0 12 6 Carried forward 109 15 0 56 7 6 46 47 Sale of Food and Drugs Acts.—Summonses, 1907—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 109 15 0 56 7 6 Re selling Milk deficient in Milk Fat to the extent of 13 per cent, [sample 1,553] 0 10 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 10 per cent, [sample 1,590] 1 0 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 3 per cent, and containing extraneous water to the extent of 3 per cent, [sample 1,409]. ... ... Summons adjourned sine die in view of a technicality as to irregular service, about which the magistrate had given leave to appeal in another case (viz.: whether or not the secretary to a limited company could be served) Ro selling Milk deficient in Milk Fat to the extent of 10 per cent, [sample 1,593]. ... ... Summons dismissed owing to warranty being proved satisfactorily On 1st January, 1908, five summonses were heard before Mr. Frances, at Lambeth Police Court, re selling Coffee containing added Chicory 8 per cent, [sample 1,685] 0 10 0 0 12 6 Re selling Butter containing Margarine (not butter) 96 parts [sample 1,703] 2 0 0 0 12 6 Re selling Milk containing added water to the extent of 6 per cent, [sample 1,692] 0 10 0 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 30 per cent, [sample 1,694]. ... ... Summons dismissed owing to legal technicality, Mr. instead of Mrs. Faulkner having been summonsed Re selling Milk containing added water to the exent of 14 per cent, [sample 1,687] 0 10 0 0 12 6 On 8th January, 1908, four summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Skimmed Milk* containing added water to the extent of 21 per cent, [sample 1,777] 2 0 0 0 12 6 Carried forward 1 l6 15 0 60 15 0 48 Sale of Food and Drugs Acts.—Summonses, 1907—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 116 15 0 60 15 0 Re selling Milk containing added water to the extent of 6 per cent, [sample 1,764] 1 0 0 0 12 6 Re selling Butter containing Margarine (not butter) 95 parts [sample 1,765] 1 0 0 0 12 6 Re exposing a parcel of Margarine for sale by retail without having label attached and marked in printed capital letters not less than 1½ in.—"Margarine" [sample 1,772] 0 5 0 0 12 6 119 0 0 62 12 6 Less two cases belonging to 1906 0 10 0 0 16 6 Totals, 1907 £118 10 0 6l 16 0 49 PUBLIC HEALTH AND METROPOLIS MANAGEMENT ACTS.—SUMMONSES. Offence. Penalty. Costs. £ s. d. £ s. d.  On January 16th, a summons was taken out against the owner for non-compliance with the notice of the Council to provide a proper dung receptacle at 56, Akerman Road. Summons was withdrawn, the work having been done meanwhile ... ... On February 15th, two summonses were taken out (1) against the owners for non-compliance with the London County Council Bye-laws requiring deposit of plans and particulars of drainage work in connection with 344, Coldharbour Lane. Summons withdrawn, the plans having been deposited meanwhile ... ... (2) Against the owner for non-compliance with the notice of the Council to abate nuisance caused by defective sink pipes and dirty condition of yard and area at 44, Eastlake Road. 51 Public Health and Metropolis Management Acts. Summonses—continued. Offence. Penalty. Costs. £ s. d. £ s. d.  Brought forward Summons withdrawn, the work having been done meanwhile ... ... On March 27th, a summons was taken out against the owner for non-compliance with the notice of the Council to make good defective drains at 131, Paulet Road. Summons withdrawn, the work having been done meanwhile ... ... On April 4th, a summons was taken out against the owner for non-compliance with the notice of the Council to make good defective drains at 45, Milbrook Road. Summons withdrawn, the work having been done meanwhile ... ... On June 18th, a summons was taken out against the owner for non-compliance with the notice of the Council to put the drains into proper order and condition at 37, Herne Hill Road The summons was withdrawn, the work having been done meanwhile ... ... On 24th July, two summonses were heard before Mr. Curtis Bennett (1) against the secretary of Edward Cook & Co., for removing offensive matter during prohibited hours, in contravention of Bye-laws of London County Council 0 10 o 0 2 0 (2) Against the carman for the same offence... 0 8 0 0 2 0 On 25th July, a summons was heard before Mr. Curtis Bennett against the owners for non-compliance with notice of Council to provide a sufficient and suitable W .C. accommodation at their workplace at the rear of 32, Chryssell Road. Summons withdrawn on payment by defendant of 20s. costs, the work having been done meanwhile ... 1 0 0 On 11th September, two summonses were heard before Mr. Hopkins (1) against the secretary, Lion Brewery Co., owing to a chimney, not being the chimney for a private dwelling-house, sending forth black smoke in such quantity as to be a nuisance • 2 0 0 0 2 0 - Carried forward 2 18 0 1 6 0 53 Public Health and Metropolis Management Acts. Summonses—continued. Offence. Penalty. Costs. £ s. d. £ s. d.  Brought forward 2 18 0 1 6 0 (2) Against secretary, Bon Marche, Ltd., for similar offence 2 0 0 0 2 0 On 25th September, two summonses were heard before Mr. Curtis Bennett against the owners for non-compliancc with notice of Council to put drains into proper order and condition at Nos. 20 and 22 Woodland Hill. Order made to complete work within one month, and pay 4s. costs 0 4 0 On 16th October, two summonses were heard before Mr. Curtis Bennett against the secretary of Bon Marche, Ltd., owing to chimneys, not being the chimneys of private dwelling-houses, sending forth black smoke in such quantities on two occasions as to be a nuisance 2 0 0 0 10 0 On 30th October, a summons was heard before Mr. Curtis Bennett against the owner for executing certain works at No. 216, Clapham Road, without first giving notice in writing to the Sanitary Authority (London County Council Bye-laws) 1 0 0 0 2 0 On 20th November, against the same owner for unlawfully constructing a Soil Pipe and reconstructing certain Drain Pipes at No. 216, Clapham Road (contrary to London County Council Bye-laws) 0 5 0 0 2 0 Totals £8 3 0 2 6 0 54 55 1907. 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. Eczema. Blight. Itch. Erysipelas. Influenza. Ophthalmia. Croup. Sore Heads. Glass Pox. Spotted Fever. Scabies. Pul. Phthisis. Sore Throat. Continued. TOTAL.  Archbishop Tenison's, High Street 14 7 2 14 2 4 1 1 1 13 ... 2 ... 1 ... 8 3 2 1 ... ... ... 76 Archbishop Sumner's, Reedworth St. 17 13 2 6 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 41 Addington Street 11 12 8 5 3 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 40 Boundary Lane 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Beresford Street 14 ... 2 2 1 ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 24 Bonneville Road 3 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Cormont Road 21 16 34 16 6 ... 7 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 101 Church Street 45 5 19 28 7 8 4 ... 1 1 ... ... ... 1 ... ... ... 1 1 ... ... ... 121 Crawford Street ... ... ... 8 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 Crampton Street 3 ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Christ Church, Cancell Road 36 26 13 10 2 ... 12 ... ... ... ... ... ... ... ... ... ... ... ... ... 6 ... 105 Christ Church, Bear Lane 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Christ Church, Union Grove ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Corpus Christi, Brixton Hill ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Dulwich Hamlet ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Durand Gardens Secondary School ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Effra Parade 83 70 88 48 37 19 12 ... 2 ... 1 ... ... ... ... ... 3 ... ... ... ... ... 363 Eden Road 2 ... 10 ... 1 14 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 27 Fountain Street 159 31 21 18 8 ... ... ... ... ... ... ... ... 7 1 1 2 ... 2 ... 5 ... 255 Faunce Street 4 3 2 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11 Gipsy Road 122 17 67 14 50 06 4 ... 3 ... ... 2 ... 1 ... 3 ... ... 2 ... ... ... 491 Grove Lane 3 ... ... 6 ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 11 Holy Trinity, Carlisle Street 60 8 3 8 4 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 85 Holy Trinity, Tulse Hill 10 1 1 1 4 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 18 Hazelrigge Road 11 2 2 10 3 ... 3 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 32 Hatfield Street 75 18 8 16 6 4 3 ... ... 5 ... 1 ... ... ... 3 ... ... ... ... ... ... 39 Hackford Road 27 26 28 37 27 9 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 159 Hitherfield Road 18 3 14 ... 4 24 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 63 Heygate Street ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Johanna Street ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Jessop Road 94 12 32 15 7 5 10 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 175 Kennington Road 90 40 5 19 8 3 ... ... ... 3 ... ... ... ... ... ... 1 4 ... ... ... ... 173 Larkhall Lane 9 2 3 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 Lingham Street 9 3 8 12 7 ... 2 ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... 43 Leipsic Road 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Lyham Road 74 13 18 44 29 2 15 ... ... ... ... ... ... ... ... ... ... ... 4 ... ... ... 199 Lollard Street 17 2 ... 9 1 ... 4 ... ... 6 ... 1 ... ... ... ... ... ... ... ... ... ... 40 Marlborough Street 45 ... 2 ... 4 3 1 ... ... 5 ... ... ... ... ... ... ... ... 2 ... ... ... 62 Manor Mount, Forest Hill ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 New Road 42 3 5 3 ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... 3 ... 59 New Park Road 4 2 ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... 6 Northampton Place ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Orange Street 2 ... ... 3 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 Priory Grove 214 50 26 30 29 2 5 ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 358 Pocock Street 3 ... ... ... 1 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 7 Penrose Street 3 1 ... 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... . 9 Rosendale Road 13 59 6 26 9 3 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 117 Reddins Road 1 ... ... .... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 St. Agnes', Kennington Park 3 1 1 3 1 ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 11 St. Andrew's, Wandsworth Road ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... 2 St. Andrew's, Roupell Street ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 St. Ann's, R C., Harleyford Road 20 2 1 9 1 2 ... ... 3 1 ... ... ... 5 ... ... ... ... ... ... ... ... 44 St. Jude's, Railton Road 61 20 25 12 12 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 137 St. Jude's, Colnbrook Street 15 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 St. John's, Canterbury Road 49 5 2 9 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 66 St. John's, Exton Street 91 11 17 3 7 2 1 ... ... 8 ... ... ... ... ... ... ... ... ... ... ... ... 142 St John's, Grosvenor Terrace 6 ... ... 3 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... 11 St. Luke's, Elder Road 32 ... 8 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 40 St. Mark's, Kennington Oval 36 ... 4 12 10 4 3 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 70 St. Mary's, Lambeth Road 43 7 9 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 61 St. Michael's, Halstead Street 61 14 12 4 3 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 99 St. Matthew's, Church Road 37 14 10 13 2 42 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 119 St. Mary-the-less, Prince's Road 41 1 2 16 ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 62 56 CASES OF ILLNESS, &c.—continued. SCHOOLS. Measles. Chicken Pox. Whooping Cough. Scarlet Fever. Ringworm. Mumps. Diphtheria, Typhoid. Eczema. Blight. Itch. Erysipelas. Influenza. Ophthalmia. Croup. Sore Heads. Glass Pox. Spotted Fever. Scabies. Pul. Phthisis. Sore Throat Continued. TOTAL.  St. Mary's R.C., Park Place 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 St. Paul's, Gye Street 47 12 52 9 7 5 4 ... 1 35 ... ... ... ... ... ... ... ... 4 ... 1 3 180 St. Paul's, Penton Place l ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 St. Patrick's, Cornwall Road 19 2 ... 2 ... ... 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 28 St. Patrick's, Stamford Street 7 3 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 11 St. Peter's, Vauxhall 12 8 4 3 9 1 5 ... 4 41 ... ... ... 6 ... ... ... ... 4 ... ... ... 99 St. Stephen's, Dorset Road 12 2 ... 8 ... 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 25 St. Saviour's, Salamanca 22 ... 6 2 1 1 ... ... ... 5 ... ... ... ... ... ... ... ... ... ... ... ... 37 St. Saviour's, Heme Hill Road 24 ... 16 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 60 St. Saviour's, Randall Row ... ... 18 108 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 19 South Lambeth Road 88 10 22 ... 14 5 4 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 257 Santley Street . 57 52 87 52 62 3 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 318 Salter's Hill 109 8 28 4 9 108 3 ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 271 Sussex Road 91 31 5 46 15 7 9 ... 4 1 ... ... ... ... ... ... ... ... ... ... 210 Stockwell Road 100 14 40 40 1 3 11 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 209 Stockwell College 37 13 2 13 1 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 68 Sleaford Street ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Turney Road 4 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Tower Street 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Upper Kennington Lane 87 41 33 14 11 16 1 ... 4 1 ... ... ... 6 ... ... ... ... ... ... ... ... 214 Vauxhall Street 120 58 35 54 5 9 6 ... ... 32 ... ... ... ... ... ... ... 1 ... ... ... ... 320 Woodland Road 36 17 8 ... 4 18 ... ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... 86 Walnut Tree Walk 10 6 5 9 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 31 Westminster Bridge Road 22 ... 2 2 2 2 2 ... ... 1 ... ... ... 3 ... ... ... ... 3 ... ... ... 39 West Square 6 2 3 9 3 ... 6 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 3° TOTAL 2770 799 887 912 448 555 170 3 27 165 1 8 ... 34 2 19 12 10 28 2 18 3 6873 57 TABLE K.* Shewing the number of Certificates for the Notifiable Zymotic Diseases received in the Borough of Lambeth during 1907, and in the old Parish of Lambeth for the ten years 1891-1900. Disease. Parish of Lambeth. Annual Average of 10 years 1891—1900 (Parish.) Borough of Lambeth. Notifications received during 1907.  1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 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 330 504 789 521 614 652 704 813 1080 844 715.1 317 Membranous Croup 29 47 49 26 23 27 17 16 22 6 26.2 13 Erysipelas 258 420 587 315 355 352 325 294 330 234 347.0 231 Scarlet Fever 858 1832 2275 1198 1389 1550 1375 1009 1006 821 1331.3 1481 Typhus 1 3 3 2 — 1 — — 1 — 1.1 1 Typhoid or Enteric 149 117 160 268 201 162 185 163 219 272 1896 56 Continued or Relapsing 33 34 58 48 20 16 11 13 7 17 25.7 6 Puerperal Plague 11 20 27 19 16 19 26 14 24 13 18.9 22 Cerebro-spinal Meningitis — — — — — — — — — — — 13 Totals 1676 3025 4070 2433 2685 2801 2663 2329 2693 2209 2658.4 2140 Average per 1000 of population 6.1 10.9 14.5 8.6 9.4 9.5 8.9 7.7 8.7 7.1 9.04 6.6 The Health Department has also heard of, and dealt with, the following non-notifiable infectious diseases:—Chicken-pox, 600; Measles, 1998; Whooping Cough, 748; Consumption, 677; Cancer, 24; other diseases (e.g. Mumps, Ringworm, Influenza, Pneumonia, etc.), 131. † Plague was made notifiable on September 19th, 1900, and Cerebro-spinal Meningitis on March 12th, 1907. * N.B.—Table K has been omitted by mistake from the main body of the Report, and is added here to the Appendix. 58 59 DEATH-RATES (CORRECTED) IN METROPOLITAN BOROUGHS DURING 1907 PER 1000 PERSONS LIVING. All Causes. PrincipalEpidemic Diseases. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping-cough. Typhus. Enteric Fever. Pyrexiat (Origin uncertain). Diarrhoea. Phthisis. Deaths under i year to 1000 Births.  COUNTY OF LONDON 14.6 1.42 ¯ 038 0.14 0.16 0.38 ¯ o.o4 0.00 0.32 1*40 116 Wist. Haddington 13.5 1.13 0.25 o.o9 0.13 0.35 ¯ 0.03 ¯ 0.28 1.09 109 Kensington 13.7 1.04 0.17 0.05 0.13 0.45 ¯ 0.03 ¯ 0.21 1.03 128 Hammersmith 14.3 1.16 ¯ 0.44 0.08 0.15 0.27 ¯ 0.05 ¯ 0.17 1.20 117 Fulham 13.2 1.73 ¯ 0.42 o.08 0.23 0.45 ¯ 0.05 — 0.50 1.19 122 Chelsea 15.0 1.44 ¯ 0.56 0.03 0.09 0.33 ¯ 0.04 ¯ 0.50 1.19 122 City of Westminster 13.0 0.72 — 0.11 0.07 o.lo 0.15 — 0.05 — 0.24 1.37 102 North. St. Marylebone 15.0 o.97 ¯ o.14 0.15 0.12 0.35 ¯ 0.02 ¯ 0.19 1.48 101 Hampstead 9.0 0.51 o.13 0.06 0.08 0.13 ¯ 0.02 ¯ 0.19 0.70 69 St. Pancras 15.0 1.17 ¯ 0.37 0.11 0.13 0.33 ¯ 0.02 ¯ 0.21 1.66 108 Islington 14.7 1.25 ¯ 0.38 0. 06 0.12 0.33 ¯ 0.04 — 0.29 1.32 116 Stoke Newington 11.5 0.02 ¯ 0.13 0.19 0.13 0.36 ¯ 0.06 000 0.15 0.94 100 Hackney 13.6 0.37 ¯ 0.26 0.19 0.20 0.29 ¯ o.o9 ¯ 0.34 1.17 112 Central. Holborn 17.4 1.28 — 0.22 0.04 0.18 0.51 — O.O4 — 0.29 2.58 131 Finsbury 18.7 1.83 — 0.51 0.l8 0.17 0.54 — 0.02 — 0.41 2.33 130 City of London 16.8 0.85 — 0.05 0.05 0.25 0.35 — 0.10 — 0.05 2.02 94 East. Shoreditch 20.5 30.1 — 1.03 0.24 0.17 0.88 — o.o5 — 0.64 2.10 150 Bethnal Green 175 1.96 — 0.54 0.33 0.14 o.46 — 0.05 — 0.44 1.90 138 Stepney 15.9 1.97 — 0. 50 0.27 0.30 0.33 — 0.07 — 0.50 1.56 117 Poplar 16.9 2.11 — 0.56 0.26 0.29 0.48 — 0.06 — 0.46 1.33 124 South. Southwark 18.0 1.90 — 0.54 0.17 0.17 0.49 — o.o5 — 0.48 2.03 138 Bermondsey 18.3 1.71 — 0.41 0.28 o. 16 o.43 — o.o5 — 0.38 123 Lambeth 14.6 1.28 — 0.34 0.l3 0.15 o.35 — 0.02 — 0.29 1.53 120 Battersea 13.3 1.34 — 0.38 0.10 0.21 0.38 — 0.02 — 0.25 1.25 114 Wandsworth 12.3 1.16 — 0.23 o.o9 0.14 o.4o — 0.o4 — 0.26 o.95 99 Camberwell 1.39 1.43 — 0.44 o.13 0.14 0.43 — o.o3 — 0.26 1.31 115 Deptford 14.1 1.47 — 0.46 o.l2 0.22 0.32 — 0.05 o.01 0.29 1.34 108 Greenwich 12.7 1.44 — 0.54 o.o9 0.17 0.24 — 0.05 — 0.35 1.08 100 Lewisham 11.5 0.85 — 0.11 0.08 0.12 0.34 — 0.01 — 0.19 o.93 90 Woolwich 12.5 1.38 — 0.56 0.11 0.12 0.29 — o.o3 0.01 0.26 1. 25 112 N.B.—o'oo indicates that the deaths were too few to give a rate of 0 005 ; where no death occurred, — is inserted. †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 Report. 60 Home Office. METROPOLITAN BOROUGH OF LAMBETH, 1907. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. I.—Inspection. Including Inspections made by Sanitary Inspectors. Premises. Number of Inspections. Written Notices. Prosecutions.  Factories (Including Factory Laundries.) 10 Workshops (Including Workshop Laundries.) 808 424 ... Workplaces Homeworkers Premises 182 Total 1000 424 ... 61 2.—Defects Found. Particulars. Number of Defects Number of Prosecutions  Found. Remedied Referred to h.m. Inspector Nutsances under the Public Health Acts* :— Want of Cleanliness 173 173 ... ... Want of Ventilation 4 4 ... ... Overcrowding 22 22 ... Want of drainage of floors ... ... ... ... Other nuisances 356 356 ... ... Sanitary accommodations insufficient ... ... ... ... unsuitable or defective 255 255 ... ... not separate for sexes 7 7 ... ... Offences under the Factory and Workshop A ct:— Illegal occupation of underground bakehouse (S. 101) ... ... ... ... Breach of special sanitary requirements for bakehouses (SS. 97 to 100) ... ... ... ... Failure as regard lists of outworkers (S. 107) ... ... ... ... Giving out work to be done in premises which are unwholesome (S. 108) ... ... ... ... infected (S. 110) ... ... ... ... Allowing wearing apparel to be made in premises infected by scarlet fever or smallpox (S. 109} ... ... .. ... Other offences ... ... ... ... Total 817 817 ... ... * Including those specified in Sections 2, 3, 7 and 8, of the Factory Act as remediable under the Public Health Acts. 62 3. Other Matters. Class. Number.  Matters notified to H.M. Inspectors of Factories:— Failure to affix Abstract of the Factory and Workshop Act (S. 133) 36 Action taken in matters referred by H.M. Inspectors as remediable under the Public Health Acts, but not under the Factory Act (S. 5) Notified by H.M. Inspector 35 Reports (of action taken) sent to H.M. Inspectors 35 Other •• Underground Bakehouses (S. 101) :— In use during 1906 72 Certificates granted in 1906 ... in 1907 ... In use at end of 1907 72 Number of Homework :— Lists. Outworkers. List of Outworkers (S. 107) :— Lists received 45 360 Addresses of outworkers forwarded to other Authorities 73 235 received from other Authorities 225 861 Wearing Apparel. Other. Homework in unwholesome or infected premises :— Notices prohibiting homework in unwholesome premises (S. 108) ... ... Cases of infectious disease notified in homeworkers' premises 9 ... Orders prohibiting homework in infected premises (S. 110) ... ... Workshops on the Register (S. 131) at the end of 1907 :— Bakehouses Underground 72 Above ground 135 Restaurants 243 Other Workshops 1437 Total number of workshops on Register 1887 63 SPECIAL REPORTS PRESENTED TO THE COUNCIL DURING 1907 BY THE MEDICAL OFFICER OF HEALTH. 64 SUGGESTED HEALTH SOCIETY FOR LAMBETH. (Special Report presented to the Council on January 7th, 1907.) For some time I have been considering the advisability of suggesting the establishment, for the Borough of Lambeth, of a Health Society. I have always felt that, throughout a large district like the Borough of Lambeth, there is a large amount of energy at present wasted by reason of want of proper organisation and administration amongst the hosts of excellent workers who are at present provided by Charitable and Philanthropic Institutions, University Settlements, Churches and Chapels, and other Bodies, etc. Union is strength, and an amalgamation of all forces, working in connection with and under the Health Department of the Borough Council, might have a far-reaching effect for good. Thus, all workers to-day recognise the importance of training mothers and others in Hygiene and Domestic Economy, thereby carrying out a large amount of routine health work other than the purely official work of a Health Department. Health conditions would be improved, more especially in the way of preventing (1) Infantile Mortality and Diarrhoea; (2) the spread of Consumption, Measles, and Whooping Cough; etc. It cannot be too much emphasised that, however advanced a Sanitary Authority may be (and Lambeth is in the front rank), there still remains the necessity for teaching the people how to make use of the municipal sanitary advantages provided for them. In this way, the work of a Sanitary Authority may be advantageously supplemented by personal dealings with the poor (and others) in their homes, and by teaching them how to keep their houses and children clean and healthy. This branch of health work is, like the training of mothers (and others) in Domestic Hygiene, outside the purely official work of a Health Department. My views have already been approved by many workers, to whom I have had the opportunity of explaining them, and I am sure that official enquiries amongst the Local Clergy and others, who already have charge of organisations carried out on similar lines, would prove that a Health Society is much needed for the Borough of Lambeth. 65 Object of the Health Society. The object of the proposed Health Society for the Borough of Lambeth may be briefly stated as the popularisation of sanitary knowledge amongst all classes. Method of establishing the Health Society. A meeting might be called by the Mayor at the Town Hall, and special invitations might be sent to attend this meeting to prominent Lambethians (and others) representing the Clergy of all Denominations, the Members of Parliament for the Borough, Medical Men, Members of the Borough Council and Board of Guardians, Governing Bodies of Philanthropic and Charitable Institutions, University Settlements, etc. In this way, the meeting would be attended by those who are at present interested in the subject, and who are anxious that such a Society should be formed within the Borough, and the success of the Meeting would be thereby ensured. At this meeting a resolution might be passed establishing a Health Society for the Borough of Lambeth, with the election of Officers and also of a temporary Committee, with power to take the necessary steps in connection therewith. It is, in my opinion, of the greatest importance that the Mayor should take the initial step in establishing the Health Society which would thereby have the moral sanction and support of the Borough Council as the Sanitary Authority. In this way it would be definitely understood that the Health Society (when established) was working in unison with, and supplementing, the Borough Council's good work, as at present carried out by the Public Health Department. Constitution of the Health Society. The Health Society might consist of (a) Officers (Patrons, Presidents, Vice-Presidents, an Hon.Treasurer and an Hon. Secretary or Hon. Secretaries); (b) a Central Executive Council for the whole Borough ; (c) Local Committees, representing the Outer and Inner Wards, individually and collectively. To one or other of these Committees all voluntarv district workers (religious or otherwise) might be attached and their work organised and co-ordinated. With all the Local Committees, and with the Central Executive Council, the Health Department of the Borough should be in touch at all times. r 66 The Executive Council might meet once or twice yearly, and the Local Committees once monthly. Work of the Health Society. Lectures and addresses (on health conditions ) might be systematically arranged for the workers, and "friendly talks" (dealing with the simple laws of domestic hygiene, thrift and temperance) for meetings occasionally. The distribution of the Council's pamphlets and cards of advice on simple health matters, and the visiting of mothers, both before and after confinement, might naturally fall to the duty of certain of the workers to be hereafter selected for their experience, practical knowledge of nursing and management of children, and tact, and these selected workers would act as Health Visitors and might note, at the time of their visiting houses, any simple insanitary conditions with a view to reporting such to the Health Department of the Borough Council. This work of Health Visiting is, at the present, legally outside the duties of Female Sanitary Inspectors, officially appointed, and is much needed in a large district like Lambeth. Conclusion. There would be a large amount of organisation required in establishing a Health Society for the Borough of Lambeth, but I am satisfied that much good would eventually accrue therefrom to the Public Health and the inhabitants of the Borough. The experience in practice of Health Societies already established goes to show that they in no way interfere with the actions of Sanitary Authorities, thereby hampering their freedom of operation, but, on the contrary, assist the work of public health. The present time is ripe for the establishment of such a Society, and I trust that the Public Health Committee and the Borough Council will see their way to give the Scheme their moral support. Everything would depend at first upon obtaining the services of a competent and energetic Hon. Secretary. Joseph Priestly. January 7th, 1907. 67 SUGGESTED FEMALE HEALTH VISITOR. (Special Report presented to the Council on April 15th, 1907.) In view of the Council's action in connection with the proposal to establish, within the Borough of Lambeth, a Health Society, I am of opinion that the only alternative scheme I can suggest is that the Council should appoint one or more Health Visitors to officially carry out the important work of instructing mothers in the best way to feed and manage their children, as the official duties of a Female Sanitary Inspector are held by the Local Government Board not to include health visiting. My original idea in recommending the formation of a Health Society was my knowledge of the need that exists throughout the Borough, and elsewhere, for the popularising of sanitary knowledge amongst all classes, and the educating of the people in the best way of making use of the advantages provided by the Borough Council for their sanitary betterment. I have long felt that much good still remains to be done in these directions throughout the Borough, e.g., the visiting and teaching of mothers (and others) the simple laws of domestic hygiene, including the proper feeding and management of infants, temperance and thrift; the distribution of leaflets dealing with the prevention of infantile mortality, diarrhoea, measles, whooping cough and consumption ; and the utilising of mothers' meetings for the dissemination of useful knowledge, etc. I am prepared to admit that this work, which is at present carried out to a greater or lesser extent by workers connected with different voluntary organisations, would be more satisfactorily carried out by official Health Visitors, acting under the Public Health Department of the Borough Council, if the Council are prepared to incur the expense. The idea of using existing voluntary agencies was suggested on economic considerations. If, however, the Council prefers to appoint official Health Visitors under their own control, rather than to make use of existing voluntary workers, I should welcome the addition to the Council's Public Health staff of one or more official Health Visitors. I would suggest the selection for such positions of educated women, properly qualified in nursing and sanitary knowledge. Work could easily be found at once for an official Health Visitor in the Borough 68 in connection with (1) births (over 9,000) that are yearly registered, and of which the Council receives information weekly from the Registrar-General; (2) cases of measles, whooping cough, diarrhoea, consumption, etc. (over 2,000) that are yearly brought to the knowledge of the Council through voluntary agencies; and (3) the large number of mothers' meetings that are held in connection with the various churches and chapels, and at which a Health Visitor might attend for the purpose of instructing voluntary workers in domestic hygiene and economy. Joseph Priestley. 15th April, 1907. 69 HOMEWORK REGULATION BILL, 1907. (Special Report presented to the Council on April 25th, 1907.) I have to draw (he attention of the Committee to the Homework Regulation Bill, 1907, which suggests important changes in connection with the carrying out of the sanitary administration of the Factory Acts in the Borough, more especially in connection with Out-workers. It is suggested in the Bill that all Out-workers are to be certified to the effect that the rooms they work in are suitable from a sanitary standpoint for such work, and particularly that they are adequately ventilated. It is proposed that such certificate should be renewed every six months and that the issuing of such certificates should rest with the Home Office, whose Inspectors would have to carry out the necessary inspection work which is at present efficiently done in Lambeth by the Council's Female Inspectors. Indeed, the whole of the Act is to be carried out by the Home Office Inspectors. When it is remembered that, in Lambeth alone, there are already registered a total of 567 Out-workers, a large army of Inspectors will have to be appointed by the Home Office, and their duties will tend to clash with those of your Council's Inspectors. I am of opinion that the six months' certification of Out-workers will prove both cumbersome and unprofitable, necessitating a considerable increase in clerical and routine work, without any corresponding advantage in improved sanitation; whilst the dual control of the Home Office and the Local Sanitary Authorities, must, sooner or later, lead to trouble. Under the circumstances, I recommend that the Public Health Committee make a representation to the General Purposes Committee to the above effect. Joseph Priestiey. April 15th, 1907. 70 PREVENTION OF PULMONARY TUBERCULOSIS (CONSUMPTION). (Special Report presented to the Council on June 23rd, 1907.) A Conference of representatives of the City and Metropolitan Borough Councils on the question of taking measures to limit the spread of Pulmonary Tuberculosis (Consumption) was held at the Town Hall, Paddington, on 6th June, 1907. The City and all the Metropolitan Borough Councils, with the exception of Chelsea, were represented. The following resolutions were carried :— 1. That it is desirable that the notification of Pulmonary Tuberculosis (Consumption) should be compulsory 2. That application be made to the Local Government Board for an Order to be made :— (i.) To include Pulmonary Tuberculosis (Consumption) among the diseases to be notified under Section 55 of the Public Health (London) Act, 1891 ; and (ii.) To extend the provisions of the following sections of the above Act to Pulmonary Tuberculosis (Consumption) :— Section 60.-—Cleansing and disinfection of premises, etc. Section 61.—Disinfection of bedding, etc. Section 62.—Infectious rubbish thrown into ashpits, etc., to be disinfected. Section 63.—Penalty on letting houses in which infected persons have been lodging. Section 64.—Penalty on persons letting houses making false statements as to infectious disease. Section 65.—Penalty on ceasing to occupy house without disinfection or notice to owner, or making false answer. 71 3. That it is desirable, in order to limit the spread of Tuberculosis, that provision should be made for public inspection and control at its several sources of the milk supply of England, and to ask the Local Government Board to take steps to secure efficient administration of the Dairies, Cow-sheds, and Milkshops Order of 1885 and Orders amending the same, by making compulsory regulations. 4. That application be made to the Local Government Board for an Order to be made to extend the provisions of Section 69 of the Public Health (London) Act to Pulmonary Tuberculosis, in so far as it relates to the milking of cows and to the sale and distribution of milk. 5. That the provision conferred by Section 7 (1) of the Factory and Workshop Act, 1901, namely, that in every room in any factory or workshop sufficient means of ventilation shall be provided and sufficient ventilation maintained, be rigidly enforced, and a similar provision extended to all places where people are assembled together for any lengthened period, with a view to restricting the spread of Pulmonary Tuberculosis. 6.—(a) That a Sanatorium is needed for the open-air treatment of poor persons suffering from Pulmonary Consumption, in the early stages of the disease, and should be provided by a Central Authority acting for the Metropolis as a whole. (b) That the Managers of the Metropolitan Asylums Board, are, by reason of their practical experience in the management of hospitals for infectious disease, eminently qualified for the position of such authority, and that the Local Government Board be requested to confer on or, if necessary, to obtain for, the said Managers power to act in that capacity. (c) That the Managers of the Metropolitan Asylums Board should also be empowered to use, for sanitorium purposes, the "Southern Hospital," recently erected by them at Carshalton, in the County of Surrey. 7. That this Conference appoint a deputation to wait upon the Government to urge the desirability of their providing a sum of money annually for the erection and 72 tenance of suitable Sanatoria for the treatment of early cases of consumption. 8. That the President of the Local Government Board be asked to receive a deputation from the Conference in support of the above resolutions. Councillor H. W. Brittain Councillor J. E. Wood. Joseph Priestley, Medical Officer. June 17th, 1907. 73 PROPOSED DEVOLUTION OF DUTIES. (Special Report presented to the Council on October 3rd, 1907.) The Metropolitan City and Borough Councils are the Sanitary Authorities for the Administrative County of London, and the London County Council is not a Sanitary Authority. All duties devolving upon the Sanitary Authorities under the various Acts relating to the Public Health, such as the Public Health (London) Act, 1891, the Sale of Food and Drugs Acts, 1875-1899, the Factory and Workshops Act, 1891, etc., should be left to the Metropolitan City and Borough Councils to carry out in so far as the Administrative County of London is concerned, powers to act in default being exercised by the London County Council (as regards the Public Health Act, 1891), the Local Government Board, and the Board of Agriculture and Fisheries (as regards the Sale of Food and Drugs Acts and the Factory and Workshops Act respectively). This principle was laid down again by the Legislature with respect to London, when the Local Government Act of 1899 became law, and an endeavour was made to simplify in this way administrative procedure by transferring from the London County Council further powers (vide Section 5 and Schedule 2, Part I, of the London Government Act of 1899). The powers of the London County Council which were transferred, had reference to the licensing of wooden structures, the removal of unauthorised sky signs and obstructions in streets, the registration of dairymen, and the supervision of common lodging houses, whilst the powers of the London County Council in Part 3 of the Housing of the Working Classes Act, 1890, were also given concurrently to the Metropolitan City and Borough Councils. Further, under Section 6, Sub-section 4, it is made the duty of the Metropolitan City and Borough Councils to enforce, within their respective districts, the bye-laws and regulations for the time being in force with respect to dairies and milk, made under the Dairies, Cowsheds and Milkshops Orders, and with respect to slaughter-houses, knackers' yards, and offensive businesses. 74 Power is also given under Section 5 to the Local Government Board, to transfer further powers from the London County Council to the Metropolitan City and Borough Councils, or vice versa, on the application of the London County Council, and the majority of the Borough Council, by means of a Provisional Order. In this way, it will be seen that, by the Local Government Act of 1899, important powers have already been transferred from the London County Council to the Metropolitan City and Borough Councils, dealing with the milk supply, and dairies, slaughter-houses, knackers' yards, and offensive businesses, the provision of lodging houses for the working classes, supervision of common lodging houses, etc. What is really wanted is for the principle already clearly laid down by the Legislature to be strictly adhered to, and for the London County Council or other Central Authority only to act in default. Apart from this, from an administrative point of view, the licensing of offensive trades, slaughterhouses, knackers' yards and cowsheds might be left with the Sanitary Authorities concerned, as is now the licensing of dairies, thereby avoiding the present dual control by the officers of two separate Authorities—dual control at all times tending to weaken administration. Joseph Priestley, July 15th, 1907. Medical Officer of Health. 75 INSPECTION OF SCHOOL CHILDREN. (Special Report presented to the Council on December 2nd,. 1907.) For many years past the question of the inspection of school children has engaged the attention of Medical Officers of Health, and others, but, until recently, the subject has been more of the nature of a counsel of perfection, rather than of a practical possibility. On the Continent, and in America, systematic inspection of school children takes place; and it would appear that England and Wales are about to follow suit, as a new Act of Parliament, the Education (Administrative Provisions) Act, 1907, which received the Royal Assent on 28th August last, states, in Section 13, that the powers and duties of a Local Education Authority, under Part iii., of the Education Act of 1902, shall include :— "the duty to provide for the medical inspection of "children immediately before, or at the time of, or as "soon as possible after, their admission to a public "elementary school, and on such other occasions as the "Board of Education direct, and the power to make "such arrangements as may be sanctioned by the Board "of Education for attending to the health and physical "condition of the children educated in public elementary "schools." This Section comes into force on the 1st January, 1908, and, as far as London is concerned, would appear to throw this important duty of compulsory medical inspection of children in elementary schools upon the London County Council, as the Education Authority for London, thereby introducing dual control again in administrative public health work. The Metropolitan Borough Councils are the Health Authorities for London, and with them should rest the responsibility for the systematic medical inspection, not only of school children in elementary schools, but also of pupils in secondary schools and training colleges. It is to be hoped that some scheme of harmonious working as between 76 the County and Borough Councils in London will be devised, and that the various Metropolitan Health Authorities will have some voice and some responsibility in carrying out in practice the powers given by the legislature under Section 13 of the Education (Administrative Provisions) Act, 1907. The medical inspection of school children will undoubtedly have far-reaching results, and the Board of Education has already issued a Memorandum, dealing with the subject in Counties, in County Boroughs, in non-County Boroughs, and in Urban Districts — London, unfortunately, not being specially dealt with, so that it is presumable (as stated before) that the Act is to be administered by the London County Council. The intention of the Board of Education, as shown in their Memorandum, is that the inspection of school children shall be part of existing public health machinery, i.e., the administrative Public Health Departments of Sanitary Authorities, and these, in London, are the Borough Councils, and should be utilised as far as practicable, by the London County Council, which is not a Sanitary Authority, but simply the Education Authority under the Education Acts. The value of the systematic medical inspection of school children cannot be over-estimated from the point of view of public health, as, by such means, diseases or constitutional defects, in their early stages, will be detected, and can be, at such early stages, the better treated or dealt with. The result, in years to come, will undoubtedly be the improvement of the race, physically and mentally. That such systematic medical examination of children is needed, is shown by a recent report dealing with the examination of infants attending schools throughout London. Taking the Lambeth schools (14 in all), varying from North Lambeth and Vauxhall, through Kennington to Brixton and Norwood, it was found that, of a total of 5,340 infants in attendance, 14.9 per cent. (nearly one in every seven) were selected as requiring detailed medical inspection. The medical defects found had reference to physique," tonsils and adenoids, vision, enlarged cervical glands, hearing, speech defects, mental defects and discharges from the ears—the first four mentioned being most often met with. As a matter of interest it may be mentioned that Walnut Tree Walk School showed the least number of defective infants (9.3 per cent.) and Lollard Street 77 the most (26.7 per cent.)—a fact difficult to satisfactorily explain. Eyes, ears, throats and noses, teeth and skins call for systematic and careful medical examination; whilst constitutional defects and physical want of vitality also require medical attention. Mentally defective, or feeble-minded, deaf, dumb, and blind children, epileptics, cripples, and those suffering from constitutional diseases, such as tuberculosis, syphilis, etc., should be separated out and dealt with as may be required. Only those children who are fit physically and mentally should be allowed to continue school work. In addition statistics should be collected dealing with anthropological observations of children (e.g., height, weight, girth of chest, acuity of hearing and vision, etc.). To obtain the greatest advantage from the systematic medical inspection of school children, treatment of a more or less simple nature must follow in school dispensaries, or school clinics (as they are called), wherein defects of vision can be corrected by glasses, teeth attended to, skin diseases treated, adenoids removed, and so on. So much for general diseases. What is equally important is the subject of infectious diseases — schools being now recognised media for the spread of such diseases as measles, whooping cough, chicken-pox, diphtheria, scarlet fever, etc. It is clear that systematic medical daily examinations would lead to the discovery of children commencing with infectious disease, and by the rigid exclusion from school, not only of such children, but also of all contacts with them, the spread of infection would be prevented. With the exception of the notifiable diseases, we depend for our knowledge of other infectious diseases upon the non-medical diagnosis of school teachers, attendance officers, etc., and this is not in practice satisfactory. Much more good would accrue if a systematic examination of all school children were made by medical men, and all doubtful cases of infectious diseases isolated and excluded from schools as also all contacts. This exclusion may be individual or collective, i.e., separate children, or a whole class or school—the latter for (a) infectious outbreaks, (b) disinfection purposes, or (c) insanitary conditions of school premises. In this connection, reference may be made to the abolition in March, 1903, of what was known as the Epidemic Grant, allowed under Article 101* of the Elementary Education 1901 Code. By this Article a grant 78 was made for all children excluded from attendance at school on account of epidemic disease, but, unfortunately, this salutary provision has been abolished, despite the protest, at the time, of practically all Sanitary Authorities, who thereby lost a most powerful lever in promoting the health of children attending public elementary schools, by keeping away all infectious and recently-convalescent scholars. To put the matter strongly, a premium is offered to keep the school attendances up at all costs, by compelling the attendance of children who may be found at the time to be suffering from doubtful illness, and whose presence in a school, or schools, may cause the spread of infectious disease. The "Epidemic Grant," as it was called, was regarded as a national insurance against school infection, and, as such, was a sanitary influence of very great practical value, being allowed to schools where the average atendance had been seriously diminished owing to the exclusion, under medical advice, of infected children, or children from infected houses. By its abolition, children now may return to school before they are completely convalescent from acute infectious disease, whilst it is exceedingly difficult to exclude from attendance at school children, who, although apparently in fair health themselves, are capable of spreading infection, either having themselves recently suffered from slight attacks, or because they have been recently in contact with cases of such disease. In this connection reference may also be made to the new amended regulations of the London County Council, and certain other Educational Authorities, with respect to the exclusion of children from infected houses — all children (except infants) who have already suffered from infectious disease being admitted to school from infected houses, the evidence of having so suffered being the hearsay evidence simply, in many cases, of the children's mothers. Another way in which infectious diseases are spread at some schools is through the attendance there of children under five years of age. The age limit of school attendance should be raised, as the present attendance of infants is regarded by most sanitarians as a waste of money and a danger to health—measles, whooping cough, and diphtheria being specially prevalent and dangerous amongst children under five years of age. The Education Acts have reference only to children of five years and upwards, but the method of giving grants also to children between three and five years of age — a method adopted by 79 the Education Department to encourage attendance at school of children of that age period — has resulted, during the past twenty years, in a very large number of children between three and five years of age having passed through the infants departments of the public elementary schools, and many outbreaks of disease, more especially measles and whooping cough, have resulted therefrom, as well as many deaths, and a very large amount of permanent ill-health. It is most desirable, from a public health point of view, that all children under five years of age should be excluded from public elementary schools, having regard to the amount of. infectious disease that occurs amongst children of that particular age period. It is estimated that about 40,000 children under five years of age are at present in attendance in public elementary schools throughout the Administrative County of London, and it is stated that, if the schools are closed against them, some other sort of accommodation will have to be found, at least, for some of them, viz.: créches, infants' nurseries, etc. In this connection, it must be remembered that the conditions of school life (crowded rooms, mental strain and fatigue) are such as would not obtain in a créche or infants' nursery, and the vital resistance of the young children will, consequently, be greater in the latter case. Finally, there is the question of the sanitary condition of the school premises, or buildings—an important consideration. Unless such buildings are kept in proper sanitary order and condition, illness amongst the scholars and teachers must of necessity follow. Lighting, ventilation, sanitary arrangements, amount of floor space and cubic space per child, etc., require careful attention both by the Board of Education and by the Local Education Authorities, as, when once the buildings have been erected within a district, they fall under the sanitary supervision of the Sanitarv Authority In the usual way. The importance of the Sanitary Authority, therefore, being consulted in connection with all plans of new school buildings goes without saying. Such, then, are the factors which require consideration in dealing with the medical inspection of schools and school children, and the Borough Council, as the Sanitary Authority, should have regard to the following headings:— 80 1. The systematic medical inspection of all school children on admission into school, and at intervals afterwards, for the discovery of general diseases and constitutional defects, and the provision (if necessary) of school dispensaries or clinics; 2. The systematic periodical medical inspection of all school children with a view to the discovery of infectious, or doubtful infectious diseases, and the consequent exclusion of such children from school; 3. The re-instating of Article 101* in the Elementary Education Code; 4. The exclusion from the public elementary schools of all infants and children under 5 years of age; 5. The proper sanitary construction and planning of school premises or buildings as to lighting, ventilation, etc. With respect to Nos. 1 and 2, the Council might, with advantage, await the action of the London County Council as to the proposed carrying out of Section 13 of the Education (Administrative Provisions) Act, of 1907, writing to the London County Council meanwhile, suggesting the advisability of the existing Metropolitan Borough Health Officers' Administrative staffs being used as far as practicable, with such additional help from medical practitioners as may be necessary. With regard to Nos. 3 and 4, as the Council has already dealt with these matters, letters might be again addressed to the Board of Education, and to the London County Council, drawing their attention to the need for (1) the reinstating forthwith of Article 101* in the Public Elementary Schools' Code; and (2) the exclusion of all infants and young children under the age of five years from the public elementary schools. In connection with No. 5, in so far as the drainage and sanitary fittings are concerned, this work is being carefully carried out in Lambeth Borough—a sanitary inspection having been, within the last few years, made of all public elementary schools throughout the Borough. Joseph Priestley. 2nd December, 1907. INDEX. S Index of Tables. PAGE A The number of Births and the Birth — Rates in each Registration Sub-District of Lambeth Borough during 1907 (arranged quarterly) '13 B The estimated Populations, numbers of Inhabited Houses, Marriages, Births, and corrected Deaths for the year 1907 in Lambeth Borough, and for the ten years 18911900 in Lambeth Parish 14 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 1907 in Lambeth Borough, and for the ten years 1891-1900 in Lambeth Parish 15 D The number of Births and Deaths with Birth and Death — Rates in each of the Registration Sub-Districts of the Borough during 1907. [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.] 24—25 E Death — Rates, Zymotic Death — Rates, Birth — Rates and Infantile Mortality Rates in the Registration Sub-Districts of Lambeth Borough during 1906 and 1907 26 Death — Rates, Zymotic Death — Rates and Zymotic IncidenceRates in the new Wards of Lambeth Borough during 1906 and 1907 27 (iii.) PAGE G 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 1907 28 H The uncorrected mortality (i.e., including that of Strangers) at different ages in each District of the Lambeth Borough during 1907 29 I The uncorrected Deaths (i.e., Parishioners and Strangers) at various age-periods in each Quarter of the year 1907 30 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 1907, and for ten years (1897-1906) 34 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 1907 [omitted from main body of Report by mistake] Appendix57 K The number of infected houses, with percentages of (1) General Defects, and (2) Defective Drains, in Lambeth Borough during the year 1907, and in Lambeth Parish during the ten years 1891-1900 40—41 M Zymotic seasonal variations in the different Registration Sub-Districts of Lambeth Borough during 1907, with the Zymotic Death — Rate per 1000 inhabitants 42 N Total cases notified under the Notification Clauses of the Public Health (London) Act, in Lambeth Borough during 1907 (arranged quarterly) 43 O Deaths from Zymotic Diseases (Strangers deducted), 1907 44 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 1907 46—47 Q Vaccination Returns (Lambeth), 1906 49 R Vaccination Returns (Lambeth) for the first half year, 1907 50 (iv.) S The Diarrhoea Mortality in Lambeth Borough in each month during the year 1907 76 T The Classification of Causes of Deaths in Lambeth Borough during 1907, as compared with 1906— (a) Deaths from all causes and at all ages, with percentages of deaths to total deaths (corrected) 84 (b) Deaths of Infants under one year of age from the chief infantile diseases and from all causes, expressed in terms of 1000 births 85 U Table of Uncorrected Deaths during the years 1906 and 1907, classified according to Diseases, in the Borough of Lambeth and in London 86 V Table of Deaths during the year 1907 in the Lambeth Borough, classified according to Diseases, Ages, and Localities. [Local Government Board old Table A) 88—91 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 1907 in the Metropolitan Borough of Lambeth, classified according to Diseases and Localities. (Local Government Board old Table B) 92—93 Five new Tables of the Local Government Board, giving the— (i.) Vital Statistics of Lambeth Borough during 1907, and of Lambeth Parish during the ten years 1891— 1900 Appendix 2. (ii.) Vital Statistics of Registration Sub-districts of the Borough of Lambeth in 1907 and of the Parish of Lambeth in the ten years 1891—1900 Appendix 3—4 (iii.) Cases of Infectious Disease notified within the Borough of Lambeth during the year 1907 Appendix 5 (iv.) Causes of, and ages at, death during 1907, within the Borough of Lambeth Appendix 6—7 (v.) (v.) Infantile Mortality in Lambeth Borough during 1907, 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 Lambeth Borough during I907|sub-divided— (а) As to Registration Sub-Districts Appendix 10—17 (b) As to different Age-periods Appendix 18—26 Offences (with amounts of penalties and costs)— (a) Food and Drugs Acts Appendix 27—48 (b) Public Health and Metropolis Management Acts Appendix 49—53 Cases of illness notified from Schools to the Medical Officer of Health during 1907 Appendix 54—59 Table K, number of notification certificates received 1891-1907 [omitted from main body of Report] Appendix 57 Death — Rates (corrected) in Metropolitan Boroughs during 1907, per 1000 persons living Appendix 58—59 Factory and Workshops Acts—Home Office Tables— (i.) Inspection Appendix 60 (ii.) Defects found Appendix 61 (iii.) Other matters Appendix 62 General Index. PAGE Abatement of Nuisances 94—105 „ „ Smoke 112—114 Accidental Deaths 83, 177—183 Added Preservatives 134—135 Adulteration of Butter 131—132 „ ,, Food and Drugs 128—144 Age-Distribution of Diarrhoea 74 ,, ,, ,, Diphtheria 64 ,, ,, ,, Batch3-1939 „ „ „ Scarlet Fever53 „ „ ,, Typhoid Fever67 ,, ,, ,, Deaths 22, 23, 29, 30 „ ,, ,, Population (Lambeth) 73 Air Temperature and Diarrhoea 73 Alcoholism, Deaths from 82 Alterations of Registration Districts 11 —12 Analysis of Food and Drugs 128—144 „ „ Water 140 Antitoxin, Gratuitous Distribution of 65, 175 Apoplexy, Deaths from 82 Appeal (Drainage) L.C.C. 163—164 Arches, Herne Hill 103, Area (Lambeth) 5,87 Atelectasis 82 Bacteriological Laboratory 171—175 ,, Examination, Bath Brush 173—174 Bakehouses 147 Bedding, etc., Disinfected 107,110—1ll „ ,, Destroyed 107,110—III Births and Birth Rates 13, 16—17, 24, 87, 92 —93 Births Notification Act, 1907 33,161 Birth Rates in Sub-Districts 13,124—25 (vii.) Bodies received in Mortuaries Bronchitis, Deaths from Brush Head (Bacteriological Examination) Burns and Scalds, Deaths from Butter, Adulteration of „ Bill 131-132 Byelaws, Contravention of 166-169 ,, „ Drainage 166-168 „ ,,Offensive Matters 168-169 Cancer, Deaths from 82 Casual Wards, Drainage of 103 Cautions (Food and Drugs) 128,143 Censal Population (Lambeth) 92 Censal Population (London) 9 Cerebro Spinal Meningitis51-53 Certifieates (Revenue Act)146-147 Chapel of Rest (Proposed)182-184 Cholera 61 Circulatory Diseases, Deaths of 82 Clerical Work 182-184 Closure of Schools (Measles) 58-59 Chicken-pox 53 Common Lodging Houses 145 Combined Drainage 98-100,164-166 Complaints 97,105 Contravention, Byelaws 97,105 Control of Drainage (supervision) 104 Conscientious Objectors 48-50 Congenital Malformations 82 Constitutional Diseases 82 Consumption (See Tuberculosis and Phthisis) Continued Fever 69 Conveniences (Underground) 127 Convictions under Public Health Acts appendix 49-53 ,, „ Food and Drugs Acts 27-48 Convulsions, Deaths from 82 Coroners' Courts-177-181 Costs, Food and Drugs appendix 27-48 „ Public Health Acts 49-53 Cowhouses 151-152 (viii.) PAGE Cowhouses, List of 151—152 Critical Temperature (Earth) and Diarrhoea 73 Croup (See Membranous Croup) Customs and Inland Revenue Acts (See Revenue Act) Dairies (See Milkshops) Deaths and Death-rates 17-86 Appendix, 2—4, 6—26, 58—59 ,, Inner and Outer Wards 20—22, 26—27 ,, (arranged quarterly) 28, 30 ,, Metropolitan Boroughs Appendix 58-59 Deaths, Corrected 18,20—27,87 „ Uncorrected 17—18,28—30,88—91 ,, In Public Institutions14—15,18—20 „ Zymotic 14—15, 35—82, 87 ,, Under 1 year ,14—15,31—34,87 Appendix 8—9 „ Under 5 years 14—15,30 Deaths from violence 83, 182 ,, from ill-defined and non-specified causes 83 Delirium Tremens, Deaths from* 82 Density per acre (Lambeth) 87 Dentition, Diseases of 82 Depositing (Refuse) 177 Depots (Refuse and Manure) 177 Depot (Milk) 154—159 Developmental Diseases 82 Devolution of Duties Appendix 73—74 Diagnosis (Bacteriological)171—175 Diarrhoea 73—77 ,, Age Distribution of 74 ,, Monthly Mortality 76 „ Inner and Outer Wards 75 „ Registration Sub-Districts 74 Dietetic Diseases82 Digestive System, Diseases of 82 Diphtheria 61—65 ,, Age Distribution of 64 ,, Antiioxin in* 65 ,, Decrease of 62—63 ,, Bacteriological Examination in 65, 171—*75 ,, Registration Sub-Districts 65 „ Pseudo-Bacilli 172—*73 (ix.) Disinfection, Details of 106-111 ,, Statistics 106-111 „ Certificates 108 Disinfecting Department106-111 ,, Refuges 108 Distribution (free) of Antitoxin 65-175 Drain Testing 37-41,97,105 „ „ with water97,105 Drainage Defects37-41,97 „ Cases 37-41,97 „ Control of (supervision) 104 ,, Combined 98-108,164-166 ,, Legal Proceedings 105,163-163 Dropsy, Deaths from 83 Drowning, Deaths from 83,182 Dust Depots 177 Earth Temperatures and Diarrhoea 73 Effluvium Nuisances 177 Enteric Fever (See Typhoid) Epteritis Epidemic Cerebro-Spinal Meningitis 51-53 Epidemic Influenza 81 Epilepsy, Deaths from 82 Erysipelas 70-72 Expenses (Food and Drugs Act) 136-137 Factory and Workshops 115-127 „ Home Office Tables appendix 60-62 Female Sanitary Inspectors 122-127 Food and Drugs, Adulteration of 128-144 „ „ Convictions 128 appendix 60-62 ,, ,, Obstruction to Officer 135-136 Food, Unsound 104 Health Society 160-162 Health Visitor 161 Homicide, Deaths from 83, 182 Home Office Tables (Factory and Workshops) appendix 60-62 Home Work Order, 1907 125 „ „ Regulation Bill, 1907 69 House to House Inspections 100-102 Houses (Lambeth) 10 ,, let in Lodgings 145 (x.) PAGE Housing of the Working Classes 145, 146- Increase of Population (Lambeth) 5, 87 ,, „ (London) 10 Infantile Mortality, 1907 31—34, 87 Appendix 8—9 ,, ,, (London and 33 large Towns of England and Wales) 34 Infected Houses 35—39, 94 „ „ and Drains 35—39 Infectious Cases removed 36,92—93 „ „ notified 36, 92—93 Appendix 5, 54—56, 57 ,, ,, ,, by Schools ,, 54—56 Infectious Diseases Inspections 35—39 Influenza (Epidemic) 81 Inhabited Houses of Lambeth Borough 10, 87 Inner and Outer Districts and Wards—Deaths and Births 17—19, 23—24 Inquests 182 Inspection of School Children 162—163 Appendix 75—80 Inspections 95 —98, 105, 122—123 ,, House to House 100—102 „ Market Thoroughfares 104 Inspector, Females 122—127 „ Males 98—105 ,, Food and Drugs 128—144 „ Smoke 112—114 Institution Deaths 14,15,18—20 Integumentary System, Diseases of 82 Introductory Letter 3 Laboratory (Bacteriological) 171—175 Lambeth Statistics 5—93 Appendix 2—26 Lavatories (Underground) 127 Letters (sent and received) 183 Liver, Diseases of 8? Local Diseases—Nervous System, Heart, Respiratory Organs, Digestive and Urinary Systems and Reproductive System 82 Locomotive System, Diseases of 83 Local Government Board, Old Tables A and B 88—93 ,, „ ,, New Tables i.; ii., iii., iv., v., Appendix 2—9 Lodging-houses (Common) 145 London (County of), Vital Statistics, 1907 9, 10 ,, No. of Births, Deaths and Marriages, 1907 10 (xi.) PAGE London Zymotic Deaths, 1907 46—47 Lymphatic System, Diseases of 82 Male Sanitary Inspectors 98—105 Manure Deòpts 177 ,, Depositing of 177 Market Thoroughfares (inspection) 104 Marriage and Marriage Rates (Lambeth) 14,15, 17, 87 Measles 57—61 ,, Registration Sub-Districts 61 „ and School Closure 58—59 Membranous Croup 66 Meningitis (Tubercular) 82 ,, (Cerebro-Spinal) 51-53 Milk Deôpt (municipal) 154—159 ,, Preservatives in 129—134 ,, Stores (See Milkshops) Milkshops 153 Milk (Tuberculous) 153—154 Mortality Rates, 1907 I4,17—87 „ Different Age Periods (Lambeth and London) 22, 23 ,, Different Diseases (Lambeth Borough) 84—86 „ „ „ (Lambeth and London) 86 „ under 1 year (London and Lambeth) 14—15,29, 30, 85 ,, Tables Appendix 10—26 ,, „ Sub-Districts 10—17 ,, ,, Age Periods 18—26 Mortuary, High Street 178 ,, for Norwood 178 Mortuaries 177—181 ,, Keepers of 179 Natural Causes, Deaths from 182 ,, Increment of Population (.Lambeth) 5,87 ,, „ „ ,, (London) I0 Nervous System, Diseases of 82 New Wards (Lambeth Borough) 5 ,, General Diseases, Deaths 27 ,, Population (estimated) 5 „ Tuberculosis 79 ,, Zymotic Diseases 27 „ Zymotic Incidence 27 (xii.) PAGE Notices served 94—98. 104—105, 123,183 Non-notifiable Infectious Diseases 109 Notification Certificates received, 1907 36, 92—93 Appendix 5, 57 ,, ,, ,, (Quarterly), 1907 43 ,, (voluntary) of Consumption 78—80 Notification of Births Act, 1907 33,161 Nuisances Abated 94—98 „ from Effluvia 177 Observations (smoke) 112—114 Obstruction to Officer (Food and Drugs) 135—136 Offences, Public Health Acts Appendix 49—53 „ Food and Drugs Acts„ 27—48 Offensive Trades 147—83 Officer, Obstruction of 135—136 Old Age, Deaths from 82 Order, Home-work, 1907 125 Organs of Special Senses (Diseases of) 83 Outer and Inner Wards, Deaths and Births 20—21, 27 Outside Urinals (Public Houses) 104 Outworkers 124—127 Parasitic Diseases 82 Parliamentary Divisions 8 Penalties Appendix 27—53 „ Public Health Acts,, 49—53 ,, Food and Drugs Acts 27—48 Peritonitis, Deaths from 82 Persons per House 10,87 ,, Acre 87 Phthisis, Deaths from 77—81,82 ,, Voluntary notification of 77—80 Plague 61 Plans of Drainage 97, 104 Pneumonia, Deaths from 82 Population of Lambeth Borough, 1907 5,87 „ ,, ,, ,, Sub-Districts 6 ,, ,, „ ,, Parliamentary and New Wards 5, 8 ,, ,, „ ,, Age Periods 7 Population of London, 1907 9, 10 „ „ Sub-districts (New) 9 Post-mortems 177—181 (xiii.) PAGE Premature Births (Deaths from) 82 Premises Disinfected 106 Preserved Foods (Tinned) 169 Preservatives (Added) 134—135 Preservatives in Milk 129, 134 Prosecutions Appendix 27—53 „ Public Health Acts 98 „ 49—53 „ Food and Drugs Acts 98, 128—144 „ 27—48 Protected Persons (Workshops) 116 Pseudo-Bacilli and Diphtheria 172—173 Public Houses, Urinals of 104 Public Institutions, Deaths 14—15, 18—20 Public Health Acts (Convictions) Appendix 49—53 Puerperal Fever 69—70,72 Quarterly Returns (Lambeth)— Births 13. Deaths (Zymotic and General) 28,30,42,45 Notifiable Infectious Diseases 43 Disinfection Certificates 108 Rateable Value (Lambeth Borough)10 Refuges 108 Refuse Depôts 177 Refuse, Depositing of (Manure) 177 Registration Sub-Districts (Lambeth Borough)— „ „ „ Alterations in11—12 „ 11 11 Births 13, 24—26 „ ,, ,, Population (estimated) 6 ,, ,, ,, General Diseases, Deaths 24—25, 26, 28—29, 87—89 „ ,, „ Infantile Mortality 32 „ „ „ Tuberculosis 78 „ ,, ,, Zymotic 24—25, 42, 87—89 ,, „ „ Vaccination Returns 49—50 Re-inspections 97,105 Removal of Infectious Diseases 36,92—93 Reproductive System, Diseases of 83 Respiratory Diseases 82 Revenue Act, 1903 146—147 Routine Work (Inspectors) 104—105 Samples, Food and Drugs 128—144 (xiv.) Sanitary Defects 96-98 „ Inspectors 98-105,122-127 ,, ,, Males 98-105 ,, ,, Females122-127 „ Work 94-184 ,, „ Structural 95-96 ,, ,, Non-structural 95-96 Scalds, Deaths from 82,182 Scarlet Fever 53-56 ,, Age Dis55tribution55 „ Registration Districts56 ,, and Sch00l Attendances 56 ,, and Milk 56 ,, Outbreak at School 56 School Children, Inspection of 162-163, Appendix 75-80 School Closure and Measles 58-59 Simple or Continued Fever 69 Slaughterhouses 149-151 ,, List of149-150 Smallpox 48 ,, Contacts 48 Smoke Nuisance and Abatement 112-114 ,, Observations 112-114 Special Reports appendix 63-80 Devolution of Duties ,, 73-74 Female Health Visitors ,, 67-68 Health Society for Lambeth ,, 64-66 Homework Regulation Bill, 1907 ,, 69 Inspection of School Children,, 75-80 Prevention of Tuberculosis (Conference),, 70-72 Spotted Fever (See Cerebro-Spinal Meningitis) Stables, Nuisance from Manure 177 Staffs— Clerical 183-184 Inspectorial (male) 98-105 ,, (female) 122-127 Disinfecting 106 Mortuary Attendants 179 Underground Conveniences 127 Sub-districts Registration (Alterations) 11-12 (xv.) PAGE Suffocation in Bed 82 Suicide and Homicide, Deaths from 82, 182 Summary of Vital Statistics (Lambeth Borough), 1907 87 ,, ,, Sanitary Work 97—98 ,, ,, Work by Female Inspectors 122—124 „ „ Death Returns Appendix 26 Summonses 98,, 27—53 Supervision (Drainage) 104 Syphilis 82 Tables (special)— Local Government Board (old) A and B 88—93 „ (new)i.,ii.,iii.,iv., v., Appendix 2—9 Home Office (Factory and Workshops) „ 60—62 Tables (special)— Mortality (Lambeth)— Registration Sub-Districts Appendix 8—15 Age periods„ 16—26 Temperature (Air and Earth) 73 Testing of Drains 37—41,97—105 Tinned and Canned Foods (Sale of) 169 Tuberculosis, Deaths from 77—81 ,, and Bacteriological Examinations 79,171—175 ,, Registration Sub-Districts and Wards 78—80 „ and Preventive Measures 78—79 Appendix 70—72 ,, Notification (voluntary) 78—80, 81 Tuberculous Nursery Milk 153—154 Typhoid Fever 66—69 ,, Age Distribution of 67 ,, Bacteriological Examinations 68—69, 171—175 ,, Registration Sub-Districts 68 ,, Inner and Outer Wards 67 ,, Sources of Infection 68 Typhus 69 Underground Bakehouses 147 „ Conveniences 127 Unsound Food 104 „ Tinned Food 169 Urine, Bacteriological Examination of 173,174 Urinals (Public Houses) 104 Urinary Diseases, Deaths from 82 (xvi.) t PAGE Vaccination 48—50 Varicella (See Chicken-pox) Venereal Diseases 82 Violent Deaths 82 Visitor, Health 161 Vital Statistics, London 9, 10, 22 „ „ Lambeth 5—93 Appendix 2—26 „ „ Summary (Lambeth) 87 Wards, Population (estimated) 5, 8 „ Deaths and Death-Rates 27 ,, Zymotic Incidence 27 Water Analysis 140 ,, Certificates 105 Whooping Cough 57—61 „ „ Registration Sub-Districts 61 Work of Sanitary Staff 94—184 Workplaces (see Workshops) Workshops 115—121, 122—127 „ Defects found 117—118,120—121,123—124 ,, Female Inspector in 122—127 „ Outworkers 124—127 „ Overcrowding in 118, 123 ,, Home Office Tables Appendix 60—62 ,, Persons employed in 116 „ Protected Persons 116 „ Trades, etc. 115—116,125—126 Zymotic Diseases 35—82, 87 „ Deaths, arranged Quarterly 42, 45 „ » Monthly 44 ,, Incidence in new Wards 27 „ Incidence in Registration Sub-Districts 24—25, 42, 92—93 „ Principal Deaths (Lambeth) 46—47 ,, Principal Deaths (London) 46—47 „ Seasonal Variations 42