LAM 63 REPORT on the VITAL AND SANITARY STATISTICS of the BOROUGH OF LAMBETH DURING THE YEAR 1908 [ With an account of the work done by the Sanitary Inspectors and the Health Visitor, and of the proceedings taken under the Food and Drugs, Factory and Workshops, and Public Health Acts] by Joseph Priestley, b.a., m.d., d.p.h., Medical Officer of Health. London: Printed by Merser & Sons, 268-270 Kennington Road, S.E. 3 Public Health Department, Lambeth Town Hall, Brixton Hill, S.W. March, 1909. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Lambeth. Mr. Mayor and Gentlemen, I have much pleasure in presenting the 1908 Annual Report on the Vital and Sanitary Statistics of the Borough of Lambeth, shewing a most satisfactory decline in the mortality and zymotic rates, as compared with those previously tabulated for the old Parish, and for the new Borough. The infantile mortality-rate is exceedingly low, especially so in connection with the infants fed upon the Council's Milk Depot, which has again more than justified its existence. Calling for special remark is the fact that the Council during 1908 adopted the Notification of Births Act, 1907, which came into operation throughout the Borough on March 9th, 1908, whilst the results of the work done during 1908 by the Council's Health Visitor in connection therewith prove a most encouraging record, which would have been much better, had her health been more satisfactory . To the Chief Officers of the Council, and to the Public Health Staff, my thanks are due, as also to the Members of the Council for carrying out my suggestions, and acting upon my advice. I am, Mr. Mayor and Gentlemen, Your obedient Servant, Joseph Priestly Medical Officer of Health. 4 I. VITAL STATISTICS. The Borough of Lambeth contains 4079.6 statute acres, exclusive of 82.1 tidal water, 0.8 inland water, and 31.8 foreshore, with an estimated total population of 321344 persons to the middle of 1908 consisting of 152159 males and 169185 females, or an excess of 17026 females. The total estimated increase (1907-1908) of the population is 2806, but the "natural increment," i.e., the excess of births over deaths (uncorrected) is 4214, so that an exodus of 1408 in excess of those who came into the Borough during 1908 must be assumed. The estimated, Populations of the Borough of Lambeth to the middle of 1908 may be tabulated as follow:— Estimated Populations. (Estimated middle 1908.) I. Wards. Wards. Males. Females. Total. Marsh Cannot be sub-divided with sufficient accuracy on account of the New Borough Wards differing from the Old Parish Wards. Cannot be sub-divided with sufficient accuracy on account of the New Borough Wards differing from the Old Parish Wards. 26085 Bishop's 31878 Prince's 49992 Vauxhall 33056 Stock well 34217 Brixton 46436 Herne Hill 34816 Tulse Hill 30596 Norwood 34768 Borough of Lambeth 152159 169185 321344 5 II. New Registration Sub-Districts. New Sub-Districts. Males Females. Total. Waterloo Cannot be sub-divided with sufficient accuracy on account of the new Sub-Districts differing from the Old. Cannot be sub-divided with sufficient accuracy or account of the New Sub-Districts differing from the Old. 26085 Lambeth Church 26641 Kennington 54729 Stockwell 67273 Brixton 81252 Norwood 65364 Borough of Lambeth 152159 169185 321344 6 III. Age-Period. Age-Periods. Males. Females. Total. 0—1 3891 3885 7776 1—5 13417 13320 26737 Total under 5 17308 17205 34513 5—20 44287 46234 90521 20—40 53148 60351 113499 40—60 28115 31585 59700 60—80 8784 12693 21477 80 upwards 517 1117 1634 Total over 5 134851 151980 286831 7 IV. Parliamentary Divisions (Old). Old Parliamentary Divisions. Males. Females. Total. North 28846 28861 57707 Kennington 41001 41074 82075 Brixton 36832 42677 79509 ' Norwood 44272 54647 98919 Parliamentary Area of Lambeth 150951 167259 318210 NB.—The Parliamentarv 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 57463 Bishop's Kennington Prince's 83048 Vauxhall Brixton Stockwell 80653 Brixton Norwood Heme Hill 100180 Tulse Hill Norwood * Adjusted Parliamentary Area of Lambeth — 321344 *N.B.—By the adjustment of the old Parliamentary Division so as to be co-terminous with the new wards. 8 1908—Groups of Metropolitan Boroughs (corrected rates). Enumerated Population, 1891 (Census). Enumerated Population, 1901 (Census). Estimated Population, 1908 (middle of year). Birth-Rate. Death-Rate. Zymotic DeathRate. Deaths under 1 year to 1000 Births. London 4227988 4536379 4795757 25.2 13.8 1.35 113 South Group 1524472 1749956 1927719 25.5 13.2 1.27 110 West Group 770022 826985 874843 21.7 12.9 10.2 112 North Group* 1013378 1055908 1094955 22.8 13.2 10.5 104 Central Group 214464 187791 169725 25.6 17.8 1.58 126 East Group 705652 715739 728515 32.0 16.6 2.39 130 N.B.—This table has been again added for purposes of comparison with previous Lambeth Reports, but is unsatisfactory on account of the differences between the boundaries of the old Sanitary Districts, and the new Cities and Boroughs, of the Metropolis. *The populations in 1891 and 1901 are corrected for the transfers between Hackney and Tottenham on April 1st, 1908. 9 Houses.* At the time of the Census, 1901, there were within the Borough of Lambeth 41511 inhabited houses and 1825 uninhabitated (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 1908 is 43405, which, with an estimated population (to the middle of 1908) of 321344 gives an average of 7.3 persons per inhabited house. Rateable Value. The rateable value of the Borough for the year ending March, 31st, 1908, was £1966874, and a 1d. rate per £1 is estimated to produce £7681 net for the same year, in both cases inclusive of Government property. Statistics for the County of London (uncorrected). The Registrar-General returns the estimated population of London for the middle of the year 1908 as 4795757, consisting of 2263285 males, and 2532472 females, and states that there were registered during the year 38209 marriages, 123844 births (63147 males and 60697 females), and 70380 deaths (36487 males and 33893 females). There were registered 6725 deaths from the seven chief zymotic diseases. The excess of registered births over deaths, i.e., the natural increment, is 53464, and the estimated increase of population from the middle of 1907 to the middle of 1908 is 37539. *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. 10 TABLE A. Giving the number of Births and the Birth-Rates in each New Registration Sub-District of the Borough of Lambeth during 1908 (arranged Quarterly). New Registration Sub-Districts. No. of Births. Total for the Year 1908. Rate per 1000 Inhabitants. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Waterloo* 394 410 385 424 1613 61.8 Lambeth Church 231 196 197 161 785 29.5 Kennington† 405 384 373 386 1548 28.4 Stockwell§ 522 531 508 542 2103 31.1 Brixton 414 409 418 403 1674 20.6 Norwood 277 302 315 289 1183 18.1 Borough of Lambeth 2273 2232 2196 2205 8906 27.7 *Including Lying-in Hospital (803 cases, of which 193 belong to Lambeih)—corrected rate i.e., excluding non-Lambethian births) — 38.5. †Including Workhouse (194 cases, of which 179 belong to Lambeth)—corrected rate i.e., excluding non-Lambethian bitths)=28.01. §Including Maternity Hospital (472 eases, of which 134 belong to Lambeth)—corrected rate i.e., excluding non-Lambethian births)—26.2. Inner Districts, 35.6; Outer Districts, 21.6 per 1000—uncorrected (whole Borough = 27.7). Inner Districts, 29.9; Outer Districts, 20.7 per 1000—corrected i.e., excluding non-Lambethian births, whole Borough = 24.7.) N.B.—The births in Stockwell new Sub-District are divined equally between the Inner and Outer SubDistricts of the Borough for the purpose of calculating rates. TABLE B. Shewing the Estimated Populations, Numbers of Inhabited Houses, Marriages, Births, and Corrected Deaths in the Borough of Lambeth during 1908, 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. Old Parish. New Boro' 1908 321344 43405 2411 8906 4341 829 1263 397 2011 1891 276162 38634 2140 9097 5886 1387 2251 692 1438 1892 280032 38950 2107 9226 5457 1250 2091 705 1578 1893 283956 39265 2233 9222 5219 1325 1925 748 1741 1891 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 1545 1898 304073 41840 2589 9256 5430 1426 2089 726 1543 1899 308108 41155 2523 9433 5886 1188 2198 782 1680 1900 312152 41470 2454 9467 5430 1328 1884 497 1576 Average 1891-1900 294049.7 40052.4 2338 9295.4 5405.3 1358.5 2070.2 700.4 1568.5 Note.—(a) Enumerated Population for old Parish at Census 1896 was 295,033, and the enumerated number of Inhabited Houses at Census 1891 was 38,556. (b) Enumerated Population for the new Borough at Census 1901 was 301,895, and the enumerated number of Inhabited Houses at the same Census, 41,511. 12 TABLE C. Shewing the number of persons per house, the Marriage-, Birth-, and Death-Rates (corrected), and proportion of Deaths in Public Institutions, in the Borough of Lambeth for the Year 1908, 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 vears, per 1000 Deaths (corrected) Corrected Zymotic DeathRate, per 1000 Population. Deaths in Public Institutions per 1000 total uncorrected Deaths. New Boro 1908 7.3 15.0 27.7 13.5 93.1 193.3 2909 1.2 428.6 1891 7.3 15.5 32.9 21.3 152.5 235.3 382.4 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 31.9 190 152.0 255.4 393.4 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 1899 16.3 30.6 19.1 157.7 252.8 373.4 2.5 277.1 1900 15.7 294 17.4 144.9 244.6 346.9 1.6 282.5 Average 1891-1900. 7.3 15.9 31.6 18.4 146.1 251.3 382.9 2.4 2767 Note.-(a) Enumerited 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. 3 the birth rate. The total number of Births registered in the Borough of Lambeth during the year 1908 was 8906. Of the total 8906 births, 4531 were males, and 4375 females, shewing an excess of 156 males. Of the total 8906 births registered in the Borough of Lambeth, 803 took place in the Lying-in Hospital (York Road), and of these 193 belong to the Borough; 194 took place in the Workhouse (Brook Street), and of these 179 belong to the Borough; whilst 472 took place in the Maternity Hospital (Jeffrey's Road), and of these 134 belong to the Borough. Thus, there are 963 births belonging to other districts. The Lying-in Hospital, the Workhouse and 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. 10). The birth-rate for Lambeth is 27.7 per 1000 inhabitants (29.8 for males, and 25.9 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 35.6, and that in the Outer Districts 21.6 per 1000—the corrected birth-rates (i.e., excluding Non-Lambethian births) being respectively 24.7 tor the whole Borough, 29.9 for the Inner, and 20.7 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. 14 The Notification of Births Act, 1907, was adopted throughout the Borough during 1908, and came into operation on March 9th. Full details will be found in future Reports as to the working of the Act and the results of the Health Visitor's visits, when the Act has been in force for 12 months. Returns of all Births (with addresses of mothers) that occur in Lambeth have been obtained from the District Registrars, and this information in conjunction with that obtained from the Notification of Births Act (3473 births) has again proved of great use in connection with the Borough Council's endeavours to lessen the high mortality amongst infants (under 1 year of age) by distributing pamphlets dealing with the proper management and feeding of infants, &c. The time allowed for birth registration is 42 days, but this difficulty in administrative procedure has been altered by the Notification of Births Act, 1907, which limits the time of notification to 36 hours from the time of birth. the marriage rate. The number of Marriages registered in the Borough of Lambeth during the year 1908 was 2411 as compared with 2501 during 1907, 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 1908 is therefore, 15.0 per 1000 inhabitants, as compared with 15.9 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 off during that period (as also during the previous decennium). Marriage statistics are of little value from a public health point of view. 15 the death-rate. The total number of deaths registered in tne Borough 01 Lambetn, during the year 1908, was 4692, as compared with 4926 during 1907, and a yearly average of 5716.7 in the old Parish of Lambeth for the 10 years 1891-1900. Of the total 4692 deaths, 2413 were males and 2279 females, showing an excess of 134 males. The uncorrected death-rate for Lambeth is, therefore, 14.6 per 1000 inhabitants (15.9 males and 13.5 females), as compared with 14.7 for London (16.1 males and 13.4 females). These rates are, however, uncorrected, and, on analysing the 4692 deaths registered in the Borough of Lambeth, it is found that 863 represent deaths occurring within the Borough amongst persons not belonging thereto. These deaths are to be deducted, but, on the other hand, there are 512 deaths registered outside the Borough of persons belonging thereto, and these must be added, giving a corrected number of deaths tor Lambeth during 1908 of 4341, and a corrected death-rate of 13.5 per 1000 inhabitants, as compared with 13.8 for London (the total corrected number of London deaths being 67353). deaths in out-lying institutions. The Out-side Institutions, etc., where the 512 Lambethians died during 1908 may be grouped as follows— I. General Hospitals. Charing Cross 16 Chelsea Hospital 1 Guy's 30 National Hospital 1 King's 9 West London 1 London 7 German 1 Middlesex 12 Queen Charlotte's 1 Royal Free 1 Children's, Paddington 1 St. Bartholomew's 9 St. George's 9 East London 1 University Gordon Hospital 1 Westminster 49 Seamen's, Greenwich 1 16 11. Special Hospitals. St. John's and St. Elizabeth 1 Bolingbroke 2 Brompton 9 Bethnal House, Bethnal Green 2 Cancer 5 Central London Throat 1 Dr. Barnardo's Home 1 St. Anne's House, Stoke Newington 1 Women's, Soho 1 Infants', Vincent Square 12 Hostel of God Italian 8 1 New Hospital for Women 1 Metropolitan 1 St. Joseph's Hospice 1 Chest Hospital 1 St. Luke's 2 Queen Alexandra Military Hospital 1 St. Mary's 1 St. Peter's 1 Maternity Hospital 1 Victoria Hospital 6 Evelina ... ... 24 Grosvenor Hospital 2 Fever. Gt. Ormond Street 9 Gore Farm 1 Heart Hospital, Soho 1 Grove 17 Homoepathic I Fountain 4 Royal Ear ... 1 Western 1 Sick Asylum, Cleveland Street 1 South Eastern 1 Park 1 II. Infirmaries and Workhouses. Battersea Infirmary 1 Whitechapel Infirmary 1 Bermondsey Infirmary 1 Camberwell Infirmary 3 St. Pancras Workhouse 1 Chelsea Infirmary i Hackney Infirmary 1 Hammersmith Workhouse 1 Islington Infirmary 1 Southwark Infirmary 4 Strand Workhouse l Wandsworth Infirmary 2 Asylum 1 Aged Pilgrims' Asylum 1 Lewisham Infirmary 1 17 IV. Asylums. Banstead 12 Dartford 11 Bethlem Royal 1 Epileptic 1 Belmont 1 Han well 8 Colney Hatch 4 Horton Asylum, Epsom 20 Camberwell House 4 Caterham 30 Leavesden 7 Cane Hill 21 Long Grove, Epsom 14 City of London 1 Manor 3 Claybury 5 Peckham House 2 Darenth 4 Tooting Bee 28 Unclassified Places. Brought dead to Hospital 2 L. & S.W. Railway (Battersea) 1 0Private Houses 20 Public Lavatory 1 River Thames 7 Victoria Station 1 Streets 6 Nine Elms Goods Yard 1 L. B. & S.C. Railway (Dulwich) 1 Summary. I. General Hospitals 151 II. Special and Fever Hospitals 124 III. Infirmaries and Workhouses 20 IV. Asylums 177 V. Elsewhere (unclassifiable) 40 512 Whether the corrected or uncorrected death-rates for the Borough of Lambeth (as a whole) be taken, they are very satisfactory for the year 1908, the eighth 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 the Inner Districts, e.g., Waterloo, Lambeth Church, Kennington, and part of Stockwell, have, b 18 lectively and individually, suffered more than the Outer Districts, e.g., part of Stockwell, Brixton and Norwood. So, too, if the death-rates be sub-divided amongst 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 they live, are also matters to bear in mind when dealing with this subject. Taking the new Registration Sub-Districts (Table E), and the new Wards (Table F), into which the Borough is subdivided, the corrected death-rates for 1908 will be found to vary between the Inner and the Outer Districts as follows : 1908. New Registration Sub-Districts and New Wards. Inner. Outer. General Death-rate (corrected) 16.3 11.4 Zymotic Death-rate (corrected) 1.5 0.9 Of the new Registration Sub-Districts, Lambeth Church has the highest, and Norwood the lowest general and zymotic death-rates; whilst of the New Wards, Bishop's has the highest, and Tulse Hill the lowest, general death-rates, and Marsh the highest, and Stockwell the lowest, zymotic deathrates. 19 Tables G, H and 1 shew the uncorrected returns (male and female) arranged as to new Registration Sub-Districts, age periods, and quarters respectively, and are given for comparison with similar tables in former Lambeth Reports. The place that the Borough of Lambeth takes during 1908 in the Registrar-General's corrected Returns amongst the Metropolitan Districts is satisfactory. There are 14 other Districts (out of 29) with a less general death-rate; 14 with a less zymotic death-rate, and only 4 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. : 11.0, and Bermondsey the highest, viz. :18.8, as compared with 13.5 for Lambeth, 12.2 for Battersea, 12.7 for Camberwell, 16.3 for Southwark, and 13.8 for Deptford. London, as a whole, has a birth-rate of 25.4, a corrected death-rate of 13.8, a corrected zymotic (death-) rate of 1.35 per 1000 population, and an infant mortality (corrected) of 113 per 1000 births; and England and Wales a birth-rate of 26.5, a death-rate of 14.7, a zymotic death-rate of 1.29 per 1000 population, and an infantile mortality of 121 per 1000 births; and the Registrar-General's 76 great towns of England and Wales a birth-rate of 27.0, a death-rate of 14.9, a zymotic death-rate of 1.59 per 1000 population, and an infantile mortality of 128 per 1000 births. Age Periods of Corrected Deaths. The 4341 corrected deaths during 1908 may be further analysed, and tabulated as follow:— 829, i.e., 19.1 per cent, of the total corrected deaths took place under 1 year of age 434, i.e., 9.9 ,, between 1 and 5 years. 1263, i.e., 29.1 ,, under 5 years. 172, i.e., 3.9 „ between 5 and 20 years. 20 500, i.e., 11.5 per cent. 20 to 40 years. 923, i.e., 21.3 ,, 40 to 60 years. 1151, i.e., 26.5 ,, 60 to 80 years. 332, i.e., 7.6 ,, 80 years and over. 3078, i.e., 70.9 ,, over 5 years. These results may be compared with those for London given in the Table on p. 21, which shows the estimated mortalities per 1000 persons at each age-period for London during 1908, and the London averages for the 10 years 1881-90. 21 TABLE. Shewing Mortalities in Lambeth Borough at different Age-periods during 1908, compared with (1) those for London 1908, and (2) the averages for London, 1881-90. Age-Periods. LAMBETH. LONDON. Estimated Populations (middle 1908). Mortality Rates per 1000 Population 1908. Mortality Rates per 1000 Population, 1908 Uncorrected. Average of Ten Years, 1881—90, per 1000. Corrected. Uncorrected. 0-5 34513 36.6 42.2 41.05 68.4 5-20 90521 1.9 6.05 6.6 2.6 6.6 4.3 20-40 113499 4.4 4.9 7.7 40-60 59700 15.5 16.5 20.2 60-80 21477 53.6 64.2 64.7 60.3 70.7 63.3 80 and upwards 1634 203.2 209.3 206.3 *Under 1 year ... 7776 93.1 106.7 115.4 152.0 All Ages 321344 13.5 14.6 14.7 20.5 The Age-periods adopted in previous Lambeth Reports, are used for purposes of comparison, though it is considered more accurate to sub-divide as follows:—1-5, 5-15, 15-25,25-35,35-45,45-55,55-65, 65-75, 75-85, 85 and over. *N.B.—The Rates (under 1 year) are given in terms of 1000 births. 22 TABLE D. Shewing the number of Births and Deaths, with Birth- and Borough during 1908. The Deaths are from all causes, and Lambethians who die outside the Borough, by omitting persons (who die in Public Institutions) into the Districts NEW REGISTRATION SUB-DISTRICTS. Estimated Population (middle 1908) 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* 26085 1613 61.8 439 16.8 ... 10 Lambeth Church 26641 785 29.5 477 17.9 ... 9 Kennington† 54729 1548 28.4 94.6 17.3 ... 29 Stockwell§ 67273 2103 31.1 815 12.1 ... 20 Brixton 81252 1674 20.6 967 11.9 ... 18 Norwood 65364 1183 18.1 697 10.7 ... 15 Borough of Lambeth 321344 8906 27.7 4341 13.5 ... 101 *Excluding all the Lying-in Hospital births, †Excluding all the Workhouse births, §Excluding all the Maternity births, Of the 815 deaths in Stockwell New Registration Sub-District, Inner Registration Sub-Districts—death rates Outer Registration Sub-Districts—death rates N.B.—Of the total deaths (corrected), 150 shew no addresses, and the Workhouse (29 or in the 23 TABLE D. Death-rates in each of the Registration Sub-Districts of the from the chief zymotic diseases, and are corrected by adding strangers who die within the Borough, and by re-distributing from which they have been removed during illness. Total Deaths (corrected) from Total Zymotic Deaths. Zymotic Death-rate per 1000 of the Population (corrected). Zymotic Death-rate per 1000 of the Total Deaths (corrected). Diarrhoea Death-rate per 10000 of the Population. Infantile Mortality per 1000 Births (uncorrected). Scarlet Fever. Diphtheria and Membranous Croup. Whooping Cough. Typhus. Typhoid or Enteric. Continued Fever. Cholera. Diarrhoea. 2 4 10 ... ... ... ... 10 36 1.4 81.9 3.8 87.4 5 3 8 ... 2 ... ... 29 56 21 117.4 10.9 225.5 11 8 12 ... 1 ... ... 43 104 1.9 109.9 7.9 112.4 8 8 3 ... ... ... 1 25 65 0.9 80.9 3.9 70.8 9 16 8 ... 4 ... ... 18 73 0.9 75.5 2.2 124.9 7 7 9 ... 1 ... ... 24 63 0.9 90.4 3.7 84.5 42 46 50 ... 8 ... 1 149 397 1.2 91.4 4.6 106.7 the corrected birth-rate = 31.1 per 1000. the corrected birth-rate = 24.7 per 1000. the corrected birth-rate = 24.2 per 1000. 423 belong to the Inner and 392 to the Outer Districts. (general 16.3, zymotic, 1.5). (general, 11.4, zymotic, 0.9). have been included in Kennington Sub-District—having occurred in Workhouse Infirmary (121). 24 TABLE E. BOROUGH OF LAMBETH. COMPARISON BETWEEN STATISTICS FOR 1907 AND 1908. New Registration Sub-Districts. New Registration Sub-Districts, Death-Rales. BirthRates. Infantile Mortality. Death-Rates. BirthRates. Infantile Mortality. General 1908. Zymotic 1908. 1908. 1908. General 1907. Zymotic 1907. 1907. 1907. Waterloo 16.8 1.4 61.8 87.4 21.3 2.2 56.6 114.3 Lambeth Church 17.9 2.1 29.5 225.5 22.02 2.1 28.1 245.7 Kennington 17.3 1.9 28.4 112.4 16.03 1.5 29.2 128.7 Stockwell 12.1 0.9 31.1 70.8 13.5 1.2 30.1 77.7 Brixton 11.9 0.9 20.6 124.9 12.6 0.8 20.2 138.2 Norwood 10.7 0.9 18.1 84.5 11.2 0.7 18.4 88.6 Borough of Lambeth 13.5 1.2 27.7 106.7 14.6 1.2 27.2 120.7 Inner Districts 16.3 1.5 35.6 113.3 18.2 1.8 34.3 131.7 Outer Districts 11.4 0.9 21.6 98.2 11.8 0.7 21.5 106.8 N B.—The death-rates (general and zymotic) are corrected, and the birth- and infantile mortality-rates uncorrected. The death- and birth-rates are per 1000 of the population, and the infantile-and mortality-rates per 1000 total births. 25 TABLE F. BOROUGH OF LAMBETH. COMPARISON BETWEEN STATISTICS FOR 1907 AND 1908. New Wards. New Wards. Death-Rates (corrected) per 1000 population. Zymotic Incidence per 1000 population. Total Number of Deaths (corrected). Total N otified Cases. Zymotic 1908. General. Zymotic. G eneral Zymotic 1907. 1908. 1907. 1908. 1907. 1908. 1908. 1908. Inner— 18.2 16.3 1.8 1.5 8.02 7.2 2285 230 1008 Marsh 21.8 16.8 2.2 1.4 8.3 5.3 439 36 139 Bishop's 22.3 20.4 2.1 2.2 6.9 6.1 641 69 192 Prince's 15.2 15.6 1.5 1.8 6.8 6.6 782 91 329 Vauxhall 16.1 12.8 1.5 1.02 10.8 10.6 423 34 348 Outer— 11.8 11.4 0.7 0.9 5.7 3.3 2056 167 1048 Stockwell 10.9 11.5 0.5 0.9 10.2 7.3 392 31 250 Brixton 12.6 12.9 0.8 0.9 4.5 6.5 598 43 304 Herne Hill 12.7 10.6 0.9 0.9 5.9 5.4 369 30 187 Tulse Hill 10.9 10.4 0.9 1.8 4.7 4.8 318 41 146 Norwood 11.5 10.9 0.6 0.6 3.5 4.6 379 22 161 Borough of Lambeth 14.6 13.5 1.2 1.2 6.7 6.4 4341 397 2056 20 TABLE G. Shewing the uncorrected Mortality (Male and Female) in the different New Registration Sub-Districts of the Borough of Lambeth (arranged Quarterly) during the year 1903. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total No. of Deaths in each District. M. F. Total. M. F. Total. M. F. Total. M. F. Total. Waterloo 53 53 106 44 41 85 40 46 86 42 38 80 357 Lambeth Church 129 19 228 161 92 253 169 105 274 151 92 243 998 Kennington 187 198 385 175 141 316 150 137 287 159 160 319 1307 Stockwell 91 94 185 81 80 161 67 69 135 91 98 189 670 Brixton 115 140 255 103 105 208 76 72 148 94 117 211 822 Norwood 60 101 161 48 68 116 57 51 108 70 83 153 538 Totals 635 685 1320 612 527 1139 559 479 1038 607 588 1195 4692 27 TABLE H. Shewing the uncorrected Mortality (i.e , including that of Strangers) at different Ages in each New Registration Sub-District of the Borough of Lambeth during the year 1908. Sub-District. Under 1 year. 1 to 5 years. 5 to 60 years. 60 years and upwards Total. M. F. Total. M. F. Total. M. F. Total. M. F. Total. Waterloo 79 62 141 32 28 60 44 63 107 24 25 49 357 Lambeth Church 109 68 177 74 54 128 331 191 522 96 75 171 998 Kennington 88 86 174 51 40 91 252 213 465 280 297 577 1307 Stock well 95 54 149 54 46 100 111 111 222 70 129 199 670 Brixton 118 91 209 47 37 84 124 132 256 99 174 273 822 Norwood 60 40 100 18 27 45 81 85 166 76 151 227 538 Totals 549 401 950 276 229 508 943 798 1738 645 851 1496 4692 28 TABLE I. Shewing the uncorrected Deaths (i.e., Parishioners and Strangers) that have been registered in the Borough of Lambeth, at various age periods, in each Quarter during the year 1908. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Totals. M. F. Total. M. F. Total. M. F. Total. M. F. Total. Under 1 year 141 96 237 125 78 203 152 129 281 131 98 229 950 Between 1 and 5 yrs. 48 64 112 83 68 151 71 59 130 74 41 115 508 Between 5 and 60 yrs. 250 226 476 243 208 451 205 156 361 245 205 450 1738 60 yrs. and upwards 196 299 495 161 173 334 131 135 266 157 244 401 1496 Totals 635 685 1320 612 527 1139 559 479 1038 607 588 1195 4692 29 INFANTILE MORTALITY, 1908. Of the 4341 corrected deaths, 829 were infants under one year of age. The total number of births is 8906, and of these 610 occurred at the Lying-in Hospital, and belong to districts outside Lambeth Borough, 15 occurred at the Workhouse and belong to districts outside Lambeth Borough, and 338 occurred at the Maternity Hospital and belong to districts outside Lambeth Borough. In this way, the corrected number of births for Lambeth Borough is 7943. The corrected infantile mortality (i.e., rate of corrected deaths under one year per 1000 corrected births) is, therefore, 104.3. In calculating this infantile mortality, it must be remembered that, whilst we subtract the births that belong to outside districts, we do not add the births of infants of Lambethian mothers who may happen to be residing outside the Borough at the time of such births. Taking the uncorrected births and the corrected deaths under 1 year, the infantile mortality rate is 93.1. Taking the uncorrected number of births (8906) and the uncorrected number of deaths under 1 year of age (950), the uncorrected infantile mortality is 106.7, as compared with 120.2 during 1907, and an average of 150.5 for the old Parish of Lambeth during 10 years (1891-1900). The chief causes of these deaths were debility, atrophy and inanition, whooping cough, bronchitis and other diseases of the respiratory organs, diarrhoea, premature births, and convulsions (vide p. 92 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 225.5 per 1000 births in Lambeth Church to 70.8 in Stockwell (the low rates of 87.4 in Waterloo, 112.4 in Kennington, and 70.8 in Stockwell, being due to the fact that these Sub-Districts contain 30 the General Lying-in Hospital, the Workhouse and the Maternity Hospital respectively), thus:— Total No. Total of Births deaths under InfantileMortality per (uncorrected). 1 year 1,000 births (uncorrected), (uncorrected). Waterloo* 1613 141 87.4 Lambeth Church 785 177 225.5 Kenningtont 1548 174 112.4 Stockwell‡ 2103 149 70.8 Brixton 1674 209 124.9 Norwood 1183 100 84.5 Lambeth 8906 950 106.7 Inner Districts—113.3; Outer Districts—98.2. *Excluding all the Lying-in Hospital births, the rate is 107.4. †Excluding all the Workhouse births, the rate is 128.5. ‡Excluding all the Maternity births the rate is 91.4. N.B.—The births and deaths in Stockwell Registration SubDistricts are divided equally between the Inner and Outer Districts for the purpose of calculating infantile mortality rates for such Districts. 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 99 in Croydon and Portsmouth respectively to a maximum 200 in Burnley, Lambeth and London being 106 and 113 respectively. Lambeth ranks fifth lowest in such list, 29 Towns having higher infantile mortality rates. Taking the RegistrarGeneral's figures, the corrected rate for Lambeth is 93, and of the 29 Metropolitan Sanitary Districts, 4 only have lesser rates than Lambeth Borough. 31 The infantile mortality statistics lor Lambeth Borough during 1908 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 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 or notified, 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, pp. 155-162). The results should prove even more satisfactory as the Notification of Births Act, 1907, becomes more generally known. This Act came into force within the Borough of Lambeth on March 9th, 1908. (See Special Report on page 101). National Conference on Infantile Mortality. The second Conference* on Infantile Mortality was held in 1908 (March 24th), at the Caxton Hall, Westminster, and the Medical Officer attended as the Council's delegate. The matters dealt with were:— 1. Parental inefficiency, due to (a) ignorance, (b) poverty, (c) neglect. 2. Foods in relation to Infantile Mortality. The suggested remedies are :—(1) the education of girls in the duties of motherhood and their education for motherhood (actual and potential); (2) the helping of mothers, who are below the poverty line, and the care of "Poor Law" babies, illegitimates, and "nursed out" children; (3) improving the habits of the parents (more especially those addicted to drink) ; (4) the regulation and control of Foods and Drugs for the use of Infants. *The First Conference was held in London in 1906—the Chairman and Vice-Chairman of the Public Health Committee and the Medical Officer of Health being the delegates. 32 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 1908, with averages for 10 years (1898-1907). England and Wales— (33 Large Towns.) Deaths under one year per 1000 Births. Average Ten Years, 1898—1907. Croydon 99 126 Portsmouth 99 147 Halifax 101 132 Brighton 104 138 Huddersfield 111 131 Derby 112 144 London 113 143 Norwich 1l6 170 Cardiff 125 143 Bristol 126 132 West Ham 128 162 Plymouth 129 155 Leicester 131 166 Wolverhampton 132 159 Birkenhead 136 159 Newcastle-on-Tyne 136 160 Leeds 137 164 Sheffield 140 175 Liverpool 141 174 Bradford 143 155 Birmingham 144 175 Nottingham 145 177 Hull 145 163 Sunderland 146 161 Gateshead 148 166 Bolton 148 160 Blackburn 149 177 Manchester 151 177 Swansea 151 159 Salford 152 180 Preston 153 198 Oldham 159 162 Burnley 200 206 London Districts— Central 126 North 104 South 110 West 112 East 130 Lambeth 93 N.B.—The rates for London and London Districts (including Lambeth) are corrected {i.e., as to births and deaths under 1 year of age). The uncorrected rate for Lambeth is 106.7. 33 CLASS I.—ZYMOTIC DISEASES. Principal Zymotic Diseases. The principal Zymotic diseases are seven in number, viz., smallpox, measles, scarlet fever, diphtheria (including membranous croup), whooping cough, "fevers" (including typhus, typhoid or enteric, and simple or continued), and diarrhoea; and the zymotic death-rate is made up from the total deaths from these diseases. As a test of the sanitary condition of a Community, the zymotic death-rate is of approximate value, and the statistics for the Borough of Lambeth are very satisfactory for 1908, being 43.8 per cent. below the average (1891-1900). In the Borough of Lambeth, during 1908, there were registered 437 deaths from the seven zymotic diseases, and of these 87 were strangers belonging to other districts, and 330 parishioners who died within the Borough. 47 parishioners, however, died from the seven zymotic diseases without the Borough. Subtracting the strangers, and adding on the parishioners who died without the Borough, there is a corrected total of 397, giving a zymotic corrected death-rate of 1.2 per 1000 inhabitants, the corrected rate for London being 1.35, varying in the different Metropolitan Districts, as shown on page 8. The zymotic death-rates (corrected) for the different new Registration Sub-Districts of the Borough of Lambeth vary also, as shown in Tables D and E, which in addition give the death-rates and birth-rates for comparison. Lambeth Church shows the highest, and Norwood the lowest, zymotic death-rates respectively. The corrected zymotic death-rate for the Inner Districts is 1.5, and for the Outer, 0.9—a difference explainable, as before, from the crowding and absence of proper means of home isolation and nursing in the former, as compared with the latter, districts. Crowded districts naturally suffer more in this respect than those more sparsely populated. c 34 Similar conclusions are obtainable by comparing the zymotic death-rates and zymotic incidences for the different new Wards of the Borough, as shewn in Table F, from which it is seen that, of the 9 new Wards into which the Borough is now divided, Bishop's shows the highest, and Norwood the lowest, zymotic death-rates, and Vauxhall the highest, and Norwood the lowest, zymotic incidences, respectively. During the year 1908, under the Notification Clauses ot the Public Health (London) Act, 1891, 2056 cases of Infectious Diseases have been reported, and of this number 1724, i.e., 83.8 per cent., were removed to the Hospitals of the Asylums Board, or to other Hospitals, and 332, i.e., 16.2 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, and, therefore, ought not to be isolated, in in the homes of the people. The percentage removed during 1908 is well above the average. Thus, since the introduction of the Public Health (London) Act, 1891, the percentages of notified infectious cases (excluding chicken-pox and cerebrospinal meningitis) removed from Lambeth are as follow:— 1891—36.6, 1896—43.0, 1901—66.1, 1906—76.8 1892—33.7, 1897—49.0, 1902—70.3, 1907—81.6 1893—23.0, 1898—55.9, 1903—64.2, 1908—84.3 1894—.33.9, 1899—61.2, 1904—69.8, 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 1908, in the Borough of Lambeth, the following are the percentages:— 35 Scarlet Fever 91.2 Typhoid 76.2 Diphtheria 88.4 Continued 66.7 Membranous 87.9 Puerperal 50.0 Croup 75.0 Erysipelas 32.04 Cerebro-spinal Meningitis 92.9 No case of Smallpox was notified during 1908 within the Borough. Taking the total number of notified cases of infectious diseases during 1908, the zymotic incidence throughout the Borough of Lambeth is 6.1 per 1000 population, as compared with an average of 9.04 for the old Parish of Lambeth during the 10 years 1891-1900, i.e., 29.2 per cent. less. There is again a marked decrease in the number of Diphtheria certificates received during 1908, i.e., 55.3 per cent, below the average of the statistics of the Parish of Lambeth for 10 years (1891-1900), and 19.6 per cent, below the average of the statistics of the Borough of Lambeth for 7 years (1901-07).* The 320 Diphtheria cases occurred in 301 infected houses, and in only 8.3 per cent, of these were the drains, on testing, found to be defective. The Scarlet Fever notifications were 6.8 per cent, above the average of the Parish of Lambeth statistics for the 10 years 1891-1900. The 1428 cases occurred in 1228 infected houses, and in 9.4 per cent, of these the drains were, on testing, found defective. The Enteric Fever (or Typhoid) notifications received were 66.8 per cent, below the average for 10 years (Parish of Lambeth), and represent 62 infected houses, of which 14.5 per cent, of the drains were found, on testing, to be defective. *Diphtheria notification certificates received since the formation of the New Borough: 1901—511,1902—459, 1903—329, 1904—317 1905— 439, 1906—415, 1907-317. 36 No cases of plague, nor of suspected plague, nor of Asiatic cholera, nor of suspected Asiatic cholera, have been notified during 1908, within the Borough. In the case of each of the 1829 infected houses, an inspection was made, and the drains and the sanitary fittings were tested with chemical, with the following results as tabulated:— (a) 168 (i.e., 9.2 per cent.) were found to have defective drains, i.e., gave results with the tests; (b) 974 (i.e., 53.3 per cent.) were found to have defective traps, fittings, or appliances; (c) 687 (i.e., 37.5 per cent.) showed no defects. It will be noted that only 9.2 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 53.3 per cent, showed defective traps, fittings and appliances. Drains and sanitary fittings are tested, as a routine, in all infected houses, though it does not follow that, when defects are found, such defects are the direct causes of the diseases under investigation. They may indirectly be so. The test used as a routine is the chemical or smoke test, and, when the result is obtained, the drain (tested) is tabulated as defective, but, when no result is obtained, it would be wrong to state that, therefore, the drain (tested,) was sound. A negative result proves nothing with the chemical (or smoke) test. The hydraulic (water) and pneumatic (air) tests are the only reliable tests, but too severe for the routine testing of drains of old buildings. The pneumatic (air) test is comparatively new, and most delicate, but it is not much used in London at the present day. All new drains when laid are tested with water (hydraulic test), both in sections and as a whole. 37 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 of the Parish of Lambeth during 10 years (1891-1900), and those for the Borough of Lambeth during 7 years (1901-7)*, it will be noticed that the percentage of houses showing defective d,rains (i.e., giving a result with the test) has decreased from 22.3 in 1891 to 9.2 in 1908. Table L gives full particulars, with the averages for the 10 years worked out, for the old Parish of Lambeth, and comparing these with those of 1908 for the Borough of Lambeth, it will be seen that the latter show a decrease of 52.3 per cent, below the average for the old Parish (1891-1900- in respect of defective drains. Sub-divided according to the different notifiable diseases, the results show as follow:— Disease. No. of Infected Houses. Number shewing Defects as to Percentage shewing Total Defects. Percentage shewing no Defects. Drains. Traps, Fittings and Appliances Total. Smallpox - - - - - - Cholera - - - - - - Diphtheria 301 25 156 181 60.1 39.9 Membranous Croup 11 2 5 7 63.3 36.7 Erysipelas 200 13 90 103 51.5 48.5 Scarlet Fever 1228 115 692 807 65.7 34.3 Typhus — — — — — Typhoid 62 9 23 32 51-6 484 Continued or Relapsing 8 - 2 2 66.7 33.3 Puerperal 10 2 — 2 50.0 50.0 Cerebro-spinal Meningitis 14 2 6 8 57.1 42.9 Totals 1829 168 974 1142 62.5 37.5 * The percentage of houses shewing defective drains are:— 1901—13.7; 1902—12.02; 1903—14.6; 1904—12.1; 1905—11.7; 1906 —12.6; 1907—11.03. 38 TABLE K. Shewing the number of Certificates for the Notifiable Zymotic Diseases received in the Borough of Lambeth during 1908, and in the old Parish of Lambeth for the ten years 1891-1900. Disease. Parish of Lambeth. Annual Average of 10 yrs. 1801 — 1900 (Parish). Borough of Lambeth. Notifications ved during1908. 1891 1892 1893 1894 18951896 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 330 504 789 521 614 652 701 813 1080 844 715.1 320 Membranous Croup 29 47 49 26 23 27 17 16 22 6 26.2 12 Erysipelas 258 420 587 315 355 352 325 294 330 234 347.0 206 Scarlet Fever 858 1832 2275 1198 1389 1550 1375 1009 1006 821 1331.3 1428 Typhus 1 3 3 2 - 1 - - 1 - 1.1 - Typhoid or Enteric 149 117 160 268 201 162 185 163 219 272 1896 63 Continued or Relapsing 33 34 58 48 20 16 11 13 7 17 25.7 3 Puerperal 11 20 27 19 13 19 26 14 24 13 18.9 10 *Plague - - - - - - - - - - - - Cerebro-Spinal Meningitis - - - - - - - - - - - 14 Totals 1676 3025 4070 2433 2685 2801 2663 2329 2693 2209 2658.4 2056 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 6.4 The Health Department has also heard of, and dealt with the following non-notifiable infectious diseases:—Chicken-pox, 602; Measles, 1504; Whooping Cough, 319; Consumption, 749; Cancer, 30; other diseases (e.g., Mumps, Ringworm, Influenza, Pneumonia, etc.), 32. *Plague was made notifiable on September 19th, 1900. 39 TABLE L. Giving number of Infected Houses, with percentages of (1) General Defects, and (2) Defective Drains, throughout the Borough during 1908, 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 =63.7% 1474 = 60.7% 1641 = 15.6% 1089 = 54.1% 993 =47.04% 1177 =48.7% Number of Houses with defective dr:iins found 316 =22.3% 720 = 24.7% 658 =20.6% 464 = 23.06% 392 = 18.6% 423 =17.5% Number of Houses with no defects found 514 = 36.3% 956 = 39.3% 1538 =48.4% 923 =45.9% 1118 =52.96% 1240 =51.3% N.B.—Only 9.2 per cent, of the houses in 1908, shewed, with the test, defective drains, no results being obtained therefrom in the other cases. 40 TABLE L—continued. Giving number of Infected Houses, with percentages of (1) General Defects, and (2) Defective Drains, thronghout the Borough during 1908, and throughout the old Parish during ten years 1891-1900. 1897 1898 1899 1900 Average for ten years 1891-1900. 1908 Number of Infected Houses 2374 2094 2435 1992 2246.1 1829 Number of Houses with defects found 1210 = 50.9% 1044 =49.9% 1163 =47.5% 886 =44.5% 1158.0 =51.6% 1142 =62.5% Number of Houses with defective drains found 390 = 16.4% 351 = 15.8% 384 =15.8% 285 = 14.3% 438.3 = 19.5% 168 =9.2% Number of Houses with no defects found 1164 = 49.1% 1050 =50.1% 1272 = 52.5% 1106 = 55.5% 1088.1 =48.4% 687 =37.5% N.B.—Only 9.2 per cent, of the houses in 1908 shewed, with the test, defective drains, no results being obtained therefrom in the other cases. 41 TABLE M. Shewing corrected zymotic seasonal variations (deaths) in (he Borough of Lambeth in the different New Registration Sub-Districts during 1908. New Registration Sub-District. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year 1908. Zymotic Death-rate per 1000 inhabitants. Waterloo 12 8 9 7 36 1.4 Lambeth Church 8 10 28 10 56 2.1 Kennington 8 26 56 14 104 1.9 Stock well 14 12 25 14 65 0.9 Brixton 19 14 26 14 73 0.9 Norwood 8 20 19 16 63 0.9 Borough of Lambeth 69 90 163 75 397 1.2 Inner Districts 1.7; Outer Districts 0.9 per 1000 inhabitants. 42 TABLE N. Shewing the total cases notified under the Compulsory Notification Clauses of the Public Health (London) Act, 1891, in the Borough of Lambeth during 1908 (arranged Quarterly). 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Total for 1908. Smallpox — — — — — Scarlet Fever 406 302 351 369 1428 Diphtheria 66 69 76 109 320 Membranous Croup 5 3 1 3 12 Typhus — — — — — Typhoid 7 7 20 29 63 Continued Fever — 2 1 — 3 Erysipelas 44 38 57 67 206 Puerperal 1 3 3 3 10 Cerebro-Spinal Meningitis 3 5 4 2 14 Cholera — — — — — Plague — — — — — Totals 582 429 513 582 2056 43 TABLE O. Deaths from Zymotic diseases (Strangers deducted), 1908. For the 4 weeks ending January. February. M arch. April. May. June. July. August. September. October. November. December. Total. Smallpox — — — — — — — — — — — — — Measles 2 7 12 14 14 10 16 6 4 2 5 9 101 Scarlet Fever 8 — 6 2 6 6 2 — 4 4 2 2 42 Diphtheria 3 3 3 2 1 4 1 4 5 2 11 5 44 Membranous Croup — — — — — 1 — — — — 1 — 2 Whooping Cough 2 7 6 11 9 3 3 4 4 — — 1 50 Typhus — — — — — — — — — — — — — Enteric — — — 1 — — 1 — 4 — 1 1 8 Continued Fever — — — — — — — — — — — — — Diarrhœa 7 4 0 1 1 4 10 48 45 21 6 1 150 Total of Seven Chief Zymotic Diseases 22 21 29 31 31 28 33 62 66 29 26 1 397 Erysipelas 1 1 2 — 1 — — 2 1 3 — — 11 Puerperal Fever — — — 1 1 — — 1 1 1 — 1 6 Cerebro-spinal Meningitis 1 — — — 3 2 2 — — — 1 1 10 44 45 TABLE P. TABLE P. Shewing the number of Deaths (corrected) from the 7 principal zymotic diseases in the old Parish of Lambeth and in London, in the ten years 1891—1900, and in the new Borough of Lambeth and in London during 1908. Disease. 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 Annual average of ten years 1891 —1900 (old Parish). Proportion of Deaths to 1000 total Deaths (corrected) in 10 yrs. Total (corrected) Deaths in 1908. Proportion of Zymotic Deaths to 1000 Total Deaths (corrected) 1908 Smallpox – 1 5 1 2 2 — – — — 1.1 0.2 — — Diphtheria 76 127 172 138 103 129 138 108 153 101 124.5 23.03 44 10.1 Membranous Croup 2 9 11 4 9 11 7 7 6 2 6.8 1-3 2 0.5 Scarlet Fever 46 76 69 64 53 63 42 30 25 20 48.8 9.03 42 9.7 Fever Typhus 1 – 1 – – 1 – — — — 0.3 0.06 — — Typhoid or Enteric 28 22 36 46 26 24 26 35 50 54 34.7 6.4 8 1.8 .Simple Continued 7 2 4 0 2 1 – – – 1 1.7 0.3 — — Measles 128 187 113 182 151 185 139 133 169 69 145.6 26.9 101 23.2 Whooping Cough 239 135 151 110 132 140 144 159 130 97 143.7 26.6 50 11.5 Diarrhœa (and Cholera) 166 167 205 142 263 152 238 254 249 153 198.9 36.8 150 34.6 Borough of Lambeth 693 726 767 687 741 708 734 726 782 497 706.1 130.6 397 91.5 County of London 9675 11983 13223 11544 11467 14009 11525 12482 11147 10136 11575.3 130.8 6599 97.9 46 The seasonal mortality (corrected) from the different important zymotic diseases during 1908 is well shown by arranging the deaths quarterly, thus:— 1908. Smallpox. Measles. Whooping Cough. Scarlet Fever. Diphtheria. Membranous Croup. FEVER. Diarrhœa. Cholera. Erysipelas. Puerperal Fever. Influenza. Total. Typhus. Typhoid. Continued. 1st Qr. — 18 15 13 10 — — — — 13 — 4 — 42 115 2nd Qr. — 41 23 13 6 — — 1 — 6 — 1 2 14 107 3rd Qr. — 26 11 8 10 1 — 4 — 103 — 3 2 2 170 4th Qr. — 16 1 8 18 1 — 3 — 27 1 3 2 7 84 Totals. — 101 50 42 44 2 — 8 — 149 1 11 6 65 476 Taking the zymotic diseases collectively, it is noticed that the 3rd quarter shewed the highest mortality, and the 4th quarter the lowest. Influenza and Erysipelas reached their maxima in the 1st quarter; Whooping Cough and Measles in the 2nd; Diarrhœa and Typhoid in the 3rd; and Diphtheria in the 4th. Scarlet Fever 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 1908, and for ten years (1891-1900) in the old Lambeth Parish. For comparison, the deaths registered in London for the same period are also given. 47 SMALLPOX. During 1908, no single case of genuine Smallpox was nonfied, nor was a single death from Smallpox registered, within the Borough. 40 "contacts" were watched for 16 days each within the Borough during 1908, in connection with persons arriving by vessels from abroad, such vessels coming from Smallpoxinfected places (India, &c.) or being themselves Smallpoxinfected by cases on board, e g., H.M.T. "Dongola" 8, H.M.T. "Plassy" 1, R.M.S. "Avon" 25, R.M.S. "Severn" 1, S.S. "Namur" 1, S.S. "Macedonia" 3, and S.S "Egypt" 1; but in no single instance did Smallpox develop amongst these "contacts." In London, 4 cases of Smallpox were notified, but no death was registered from the same disease, during 1908. 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 1907, and the first half of 1908, respectively.* These Returns are obtained from the Vaccination Officers. The total number of conscientious objectors who have obtained certificates during 1908, irrespective of the dates of birth of the children to which they relate, is 71a, whilst the total number of certificates of successful primary vaccinations at all ages received during 1907 and 1908 are 6611 and 6449 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 1908 can be given in this Report. 48 TABLE Q. VACCINATION RETURNS (LAMBETH BOROUGH), 1907. New Registration Sub-Districts. No. of Births. (uncorrected). Successfully Vaccinated. Insusceptible to Vaccination. Dead Unvaccinated. Conscientions Objectors. Removed to other Parishes Postponed by Doctors. Waterloo* 1490 850 – 149 17 464 9 Lambeth Church 756 519 – 88 14 129 5 Kennington† 1600 1160 3 146 41 243 6 Stockwell ‡ 2027 1353 2 146 74 440 6 Brixton 1621 1131 1 119 76 265 21 Norwood 1201 908 3 85 79 102 19 Lambeth 8395 5921 9 733 301 1643 66 *Hospital cases (650) included. †Workhouse (210) cases included. ‡Maternity cases (490) included N.B.— The new Registration Sub-Districts were adopted by the Registra-General for statistical purposes on October 1st, 1906. 49 TABLE R. VACCINATION RETURNS (LAMBETH BOROUGH) FOR THE FIRST HALF-YEAR, 1908. New Registration Sub-Districts. No. of Births (corrected). Successfully Vaccinated. Insusceptible to Vaccination. Dead Unvaccinated. Conscientious Objectors. Removed to other Parishes (known or unknown) Postponed by Doctors. Waterloo* 806 395 – 61 14 315 18 Lambeth Church 424 275 1 46 20 71 9 Kennington† 783 563 2 55 29 117 11 Stockwell‡ 1043 638 — 60 107 227 9 Brixton 850 578 5 40 69 111 38 Norwood 582 391 7 30 92 39 19 Lambeth 4488 2840 15 292 331 880 104 The Yearly Returns are not made up for the Local Government Board until the August in the following year. *Hospital cases (382) included. †Workhouse cases (103) included. ‡Maternity cases (232) included. 50 EPIDEMIC CEREBROSPINAL MENINGITIS. On March 12th, 1907, epidemic cerebro-spinal 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 and Glasgow, and it was thought advisable to make it notifiable throughout London, so as to prevent it being introduced and spreading there. Up to the end of 1907, a total of 153 cases were notified in London (13 in Lambeth Borough), whilst during 1908 a total of 85 cases have been notified in London (14* in Lambeth Borough). Of the 14 cases notified in Lambeth during 1908, 3 occurred in Waterloo, 3 in Lambeth Church, 7 in Kennington and 1 in Brixton, Registration SubDistricts. Of the 14 cases notified, 10 died. 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, petechiæ, 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 *Of the 14 notified cases, 13 were removed to Hospital, and of these one was found at Hospital not to be suffering from that disease. 51 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 the meshes of the pia mater and beneath the arachnoid. Kernig's sign* and the tâche cérèbrale† 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 intracellulars of Weichselbaum, and is to be found in the cerebro-spinal 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. In London, during 1908, 12 deaths were registered from cerebro-spinal fever, and 85 cases of the disease were notified. *To obtain this sign the patient is placed so that the hip-joint is semi-flexed, and while the hip-joint is retained in this position, the knee-joint is extended passively. A contraction of the hamstrings 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. d 2 52 CHICKEN-POX. Chicken-pox was not compulsorily notifiable during 1908, but through the Head Teachers of the various schools 1039 cases were brought to the notice of the Council, and the necessary disinfection was carried out in connection therewith. Two schools were disinfected during 1908 in connection with Chicken-pox outbreaks, viz.: Vauxhall Street L.C.C. and Stockwell Practising School (Junior and Senior). SCARLET FEVER. During 1908, in the Borough of Lambeth, 1428 cases of Scarlet Fever were notified, and 42 deaths registered, giving a case-mortality of 2.9 per cent.—3.5 for the Inner, and 2.5 for the Outer Districts. In 1907, there were 1481 cases notified and 36 deaths registered, i.e., a case-mortality of 2.6 per cent.—3.6 for the Inner, and 1.4 for the Outer Districts. The annual averages for 10 years (1891-1900) in the old Parish of Lambeth are (1) notified cases 1331.3, and (2) deaths 53.6. Of the 1428 persons notified in the Borough of Lambeth during 19,08, 1303* (i.e., 91.2 per cent.) were removed to Hospital, and of these 41 died (i.e., 3.1 per cent.), whereas 125 (i.e., 8.8. per cent.) were treated at home, and of these 1 died (i.e., 0.8 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 *Of the 1428 cases of Scarlet Fever removed to Hospital, 40 proved at Hospital not to be suffering from that disease. 53 during 1908 in the Borough—a satisfactory condition of things, which seems to point to the value of isolation (following notification) as an important preventive measure in this disease. The age and sex incidence and mortality for the 1428 Scarlet Fever cases notified in Lambeth Borough during 1908 are as follow:— Age. Number of Cases Notified Deaths. Death Rate per 100 Notified. M. F. Total M. F. Total Under 1 year 9 6 15 — — — — 1 to 2 23 26 49 3 5 8 16.3 2 to 3 39 37 76 3 2 5 6.6 3 to 4 47 50 97 4 5 9 9.3 4 to 5 68 63 131 2 2 4 3.05 5 to 6 71 77 148 2 2 4 2.7 6 to 7 70 78 148 1 3 4 2.7 7 to 8 60 59 119 — 1 1 0.8 8 to 9 47 54 101 1 1 2 1.9 9 to 10 34 44 78 — 1 1 1.3 Over 10 years 172 294 466 1 3 4 0.9 Total 640 788 1428 17 25 42 2.9 It will be noted that, of the total 1428 persons reported as suffering from Scarlet Fever during 1908 within the Borough of Lambeth, 368 (i.e., 25.8 per cent.) were under five years of age, and 962 (i.e., 67.4 per cent.) under 10 years of age: whilst the mortality was greatest amongst those between 1 and 2 years of age. Of the 466 persons over 10 years of age, 4 (i.e., 0.9 per cent.) died. The distribution of the cases of, and the mortality from, Scarlet Fever amongst the different New Registration Sub- 54 Districts of the Borough of Lambeth during 1908 is seen from the following:— Registration SubDistricts. Total No. of Cases Notified. Cases treated 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 69 – 69 – 2 2 2.9 2.6 Lambeth Church 106 20 86 – 5 5 4.7 3.9 Kennington 207 5 202 – 11 11 5.3 3.8 Stockwell 463 28 435 – 8 8 1.7 6.9 Brixton 357 32 325 1 8 9 2.5 4.4 Norwood 226 40 186 – 7 7 3.1 3.5 Borough of Lambeth 1428 125 1303 1 41 42 2.9 4.4 Rate of Persons notified per 1000 inhabitants— 4.7 Inner Districts, and 4.3 Outer Districts. Of the 1303 cases removed to Hospital, 49.4 per cent. were from the Inner, and 50.6 per cent. from the Outer, Districts. In London, during 1908, there were registered 548 deaths (uncorrected) out of a total of 22072 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 1908. Two schools, viz., St. John's L.C.C. (Warham Street) and Mayfield College (Barston Road), were disinfected on account of outbreaks of Scarlet Fever amongst the inmates. Two schools were closed on account of Scarlet Fever during 1908, viz., (1) Santley Street L.C.C. Infants' School 55 (Classroom B) from July 15th to the end of the summer holidays—12 cases of Scarlet Fever or Suspected Scarlet Fever, i.e. 26 per cent. of an average attendance of 45; (2) a slight outbreak of Scarlet Fever occurred in December, 1908, in connection with the Junior, Mixed and Infants' Departments of the Gipsy Road School—7 cases in all, 6 in the former and 1 in the latter. The cases appear to have arisen from a child attending class-room E of the Junior Mixed Department from December 1st to December 5th, whilst suffering from an unrecognised attack of scarlet fever. Three cases arose therefrom in class-room E and 3 in connection with other class-rooms of the Junior Mixed Department, whilst 1 case arose in connection with the Infants' Department. The usual disinfection of the two Departments (16 rooms in all and 2 corridors) was carried out. An interesting case arose in connection with one of the L.C.C. artisans' buildings, the patient being certified by the medical attendant as "unfit for removal to Hospital" (i.e., from a point of view of the patient's health). Application could not, therefore, be made to a Magistrate for compulsory removal under section 66 of the Public Health Act, 1891, in view of such certificate, whilst-there was a difficulty as to the exact interpretation to be put upon the words of the section, viz., "without proper lodging or accommodation"— it having been held by the Courts that the words quoted have reference only to the patient and not to other persons in the house. On broad ground it may be stated that a patient suffering from a dangerous infectious disease is not properly isolated in a tenement of an L.C.C. Artisans' Buildings, such patient being a danger to persons living in the other immediate tenements in the same Block, if not to other persons in other tenements also. Instant removal to Hospital of all infectious patients becomes desirable from such tenements, and the L.C.C. Housing Department, thoroughly alive to such a necessity, 56 insert a clause in the agreements with their tenants that all infectious patients shall be removed forthwith to Hospital. The case referred to in Lambeth was finally removed to a private Convalescent Scarlet Fever Hospital, and the necessary disinfection carried out. No other case arose. Another interesting case was connected with the removal of a scarlet fever infected boy from a well-known Southern watering-place to London (Lambeth Borough) by train. The boy had been examined by a Medical Practitioner at the watering-place and declared to be suffering from scarlet fever. Despite this fact, the mother took her boy by train back to London, and in so doing was guilty of exposing an infectious person, contrary to section 126 of the Public Health Act, 1875. She was summoned before the Magistrates who fined her £5 and costs. The Railway Company also took out a summons against the mother for infringing the Company's Bye-laws, and she was fined £2 and costs. After much difficulty, the train (section of carriages) in which the boy had travelled was traced and disinfected. The Council decided, on March 5th, 1908, to ask the Local Government Board to hold an enquiry into the cause of Scarlet Fever, and as to the further means (if any) that can be adopted for its prevention. The question of hospital isolation in London is important. There are, at present, 14 Hospitals provided by the Metropolitan Asylums Board for the reception and treatment of fever and diphtheria patients, with a total of 8166 beds. The costs of the sites of these hospitals is returned at £234104, and the cost of the buildings and equipment to Michaelmas, 1906 (the latest official return), as £2905659. From 1890 to 1906, the cases of scarlet fever admitted into the hospitals yearly has risen from 6537 in 1890 to 17983 in 1906—the percentages of admissions to notifications received being 42.6 and 88.5 respectively. The annual revenue expenses have gone up proportionately during the same period, viz., from £112420 57 in 1890 to £351408 in 1906—the mortality figures for scarlet fever (per cent. of patients treated in hospital) being reduced from 7.9 in 1890 to 2.9 in 1906, and those for diphtheria from 33.5 in 1890 to 8.8 in 1906. 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 1908, 101 and 50 deaths were registered from Measles and Whooping Cough, giving uncorrected death-rates per 10000 of the population of 3.1 and 1.6 respectively. In London, during 1908, there were registered 1539 and 999 total uncorrected deaths from Measles and Whooping Cough, giving corresponding uncorrected death-rates of 3.2 and 2.1 per 10000 of the population respectively. Taking the Lambeth new Registration Sub-Districts it will be seen that Kennington and Waterloo suffered most, and Norwood and Brixton least, from Measles; whilst Waterloo and Lambeth Church suffered most, and Brixton and Stockwell least, from Whooping Cough (vide page 63). The Inner Districts suffered (deaths per 10000 of the population) more than the Outer Districts, thus:— Inner. Outer. Whooping Cough 2.3 0.9 Measles 4.1 2.4 Comparing the Borough statistics for 1908 with those for the old Parish for 10 years (1891-1900), it will be seen that there has been a saving during 1908 of 44 deaths from Measles over the average for that decennium, and a saving of 93 deaths from Whooping Cough over the average during the same period. Measles. With regard to Measles, extra precautions are taken in connection with disinfection of Measles-infected houses, ex- 58 clusion of children (both infected children and also children from infected 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 a trivial complaint of childhood. Measles is not compulsorily notifiable, but, through L.C.C. Schools, 1998 cases (during 1908) 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 101 deaths from Measles in Lambeth Borough during 1908, 98 (i.e., 97.03 per cent.) occurred amongst children under 5 years of age, shewing that Measles is a disease of young children, and especially fatal to such. 16 of the deaths (i.e., 15.8 per cent.) occurred amongst infants under 1 year of age. During 1908 in the Borough of Lambeth disinfection has been carried out in connection with 1504 Measles-infected houses as compared with 1998, 836, 1970, 1294, 1346, 364, 728 and 941 during 1907, 1906, 1905, 1904, 1903, 1902, 1901 and 1900 respectively. Measles is spread chiefly through Schools, especially Infants' Departments, and during 1908 special precaution in the way of closure have been taken in respect thereto, as follows (the usual disinfection of the Schoolrooms being also carried out):— Vauxhall Street School (Infants' Department).—The Infants' Department (class-room G) was closed from February 14th, 1908, to February 24th, 1908 (rising epidemics, 6 cases), an average of 6.7 per cent. of the infants being absent suffering from Measles. Result of closure was a decline in the number of Measles cases. 59 St. Saviour's Schools, Salamanca (Infants' Department).— The Infants' Department was closed from May 25th until after the Whitsuntide Holidays (rising epidemic), 19 infants absent suffering from Measles, i.e., 37.3 per cent. of the average attendance. Result of closure was a decline in the number of Measles cases. Cancell Road School (Infants' Department).—The Infants' Department was closed from May 26th until after the Whitsuntide Holidays (rising epidemic), 50 infants absent suffering from Measles, i.e., 34.2 per cent. of the average attendance. Result of closure was a decline in the number of Measles cases. Kennington Road School (Infants' Department).—The Infants' Department (class-room A) was closed from June 29th to July 13th, 1908 (rising epidemic)—7 infants absent suffering from Measles, i.e., 15 per cent. of the average attendance. Result of closure was a decline in the number of Measles cafes. St. Anne's Roman Catholic School (Infants' Department). —The Infants' Department (class-room B) was closed from June 29th to July 13th, 1908 (rising epidemic)—10 infants absent suffering from Measles, i.e., 31 per cent. of the average attendance. Result of closure was a decline in the number of Measles cases. St. Luke's School, Elder Road (Infants' Department).— The Infants' Department (class-room B) was closed from July 9th to July 20th (rising epidemic)—5 infants suffering from Measles, i.e., 7.1 per cent, of the average attendance. Gipsy Road School (Infants Department).—The Infants' Department (class-room A) was closed from October 1st to October 12th, 1908 (rising epidemic)—10 infants absent suffering from Measles, i.e., 20.4 per cent. of the average attendance. Result of closure was a decline in the number of Measles cases. 100 Upper Kennington Lane School (Infants' Department).— The Infants' Department (class-room 7) was closed from October 21st to November 2nd, 1908 (rising epidemic)—9 infants absent suffering from Measles, i.e., 18.4 per cent. of the average attendance. Result of closure was a decline in the number of Measles cases. Special investigations were also undertaken during 1908 in connection with the following Schools, on account of Measles outbreaks, the class-rooms not being closed, but simply the "unprotected" scholars (i.e., those who have not had an attack of Measles previously) being excluded and disinfection carried out as required:— 1. Upper Kennington Lane School (Infants' Department, class-rooms 4 and 7)—17 children excluded out of a total of 147. 2. Woodland Road School (Infants' Department, Classroom B)—27 children excluded out of a total of 275. 3. St. Michael's School, Halstead Street (Infants' Department, class-room A)—9 children excluded, out of a total of 47. 4. Waterloo Road School (Infants' Department, classroom A)—14 children excluded out of a total of 30. 5. Archbishop Sumner's School (Infants' Department, class-room D)—27 children excluded out of a total of 62. 6. Hackford Road School (Infants' Department, classroom C)—20 children excluded out of a total of 50. Measles Outbreak at the Lambeth Schools, Norwood.— From October 25th to November 11th, 1908, a slight epidemic of Measles arose in connection with the Norwood Schools, Elder Road. The epidemic appeared to start with 6 children attending the Gipsy Road L.C.C. Infants' School, (class-room A) which was closed from October 1st to October 12th, on account of an outbreak there. 101 A total of 51 cases of Measles occurred at the Norwood Schools, Elder Road, but there was not a single death connected therewith. The ages were as follows:— Ages. Cases. Deaths. 1—2 years 0 0 2—5 „ 37 0 5—6 „ 5 0 6—10 „ 9 0 10 and over 0 0 Total 51 0 The absence of deaths calls for attention, especially when compared with a similar outbreak of Measles at the same Schools from October, 1902, to February, 1903—a total of 68 cases with 11 deaths, as follows:— Ages. Cases. Deaths. 1—2 years 6 1 2—5 „ 54 10 5—6 „ 4 0 6—10 „ 3 0 10 and over 1 0 Total 68 11 Whooping Cough. Whooping Cough is also a serious disease, especially to young children. Of the 50 deaths registered in Lambeth Borough during 1908 from this disease, 49 (i.e., 98 per cent.) occurred in children under 5 years of age, and 19 of the deaths (i.e., 38 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 62 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 1908, in the Borough of Lambeth, disinfection has been carried out in connection with 319 Whooping Coughinfected houses, as compared with 748, 455, 440, 380, 325, 110, 72 and 126 during 1907, 1906, 1905, 1904, 1903, 1902, 1901 and 1900 respectively; and leaflets (dealing with the dangers and treatment of this disease) have been left at all known Whooping Cough-infected houses.* Infants' Department (2 classes) of the Stockwell Practising School was closed from March 28th, 1908, until after the Easter Holidays, on account of the prevalence of Whooping Cough (few cases also of Chicken-pox and Measles) amongst the scholars—the average attendance of the 2 class-rooms being reduced respectively from 67 to 59 and 40 to 33. On April 10th, 1908, the Senior and Junior Schools of the Stockwell College were closed until after the Easter Holidays in connection with the same outbreak. Disinfection was carried out in the College and the Practising School. Details of the incidences of Measles and Whooping Cough in the different Registration Sub-Districts of Lambeth Borough during 1908 are as follow:— *Whooping Cough is not a compulsorily-notifiable disease, but 311 cases were voluntarily notified during 1908 by L.C.C. School Teachers (vide Appendix). 63 New Registration Sub-Districts. Number of Deaths from Whooping Cough. No. of Deaths from Measles. Whooping Cough Deaths per 10000 Inhabitaats. Measles Deaths per 10000 Inhabitants. Waterloo 10 10 3.8 3.8 Lambeth Church 8 9 3.003 3.4 Kennington 12 29 2.2 5.3 Stockwell 3 20 0.4 2.9 Brixton 8 18 0.9 2.2 Norwood 9 15 1.4 2.3 Borough of Lambeth 50 101 1.6 3.1 CHOLERA AND PLAGUE. In Lambeth Borough, during 1908, no case of Plague, suspected or otherwise, was notified; but one "contact," arriving by s.s. "Blythswood," had to be watched in connection with the disease, which did not develop. No case of Cholera was notified, but one death was registered from Cholera Nostras, during 1908. During the year 1908, in view of the appearance of Asiatic Cholera in Russia, the L.C.C. arranged again for bacteriological examinations by Dr. Klein of any doubtful material from suspected patients within the Administrative County of London. No doubtful case was dealt with officially in Lambeth Borough. 17 Cholera "contacts" arriving from abroad (Russia) had to be watched during 1908, but in connection therewith no case of Cholera arose. The 17 "contacts" arrived in 64 land by the following steamships: s.s. "Viking" 5, s.s. "Sperbia" 1, s.s. "Zara" 3, s.s. "Wologda" 5, s.s. "Romeo" 2, and s.s. "Schwalbe" 1. No case of Plague, and no case of Cholera, were notified, nor were any deaths registered, in London during 1908. DIPHTHERIA. During 1908, 44 deaths were registered in the Borough of Lambeth from Diphtheria, and a total of 320 cases were notified, giving a case-mortality of 13.8 per cent. Of the 320 cases notified, 283* (i.e., 88.4 per cent.) were removed to Hospital, and 38 died, giving a case-mortality of 13.4 per cent. amongst the cases treated in Hospital; whilst 37 (i.e., 11.6 per cent.) were treated at home, and 6 died, giving a case-mortality of 16.2 per cent. amongst the patients treated at home. The difference in the mortality rate as between Hospital- and Home-treated cases is probably to be explained by the fact that antitoxin is more generally used in Hospital treatment. The case-mortality rate for the whole of the Borough of Lambeth during 1908 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 1908 is again remarkable, as it was during 1907, 1906, 1905, 1904, 1903, 1902 and 1901, and will be seen, on comparison with the yearly mortality average of the 10 years (1891-1900) for *Of the 283 cases of Diphtheria removed to Hospital, 14 proved at Hospital not to be suffering from that disease. †43 bottles of antitoxin have been gratuitously distributed in Lambeth Borough during 1908, as compared with 40 during 1907. 65 the old Parish of Lambeth. This yearly average is 124, so that during 1908 there has been a decrease in the mortalityrate, in comparison, of 64.5 per cent. So, too, if the number of notifications of Diphtheria received during 1908 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 55.2 per cent.—the yearly average of notifications for the old Parish being 715, and the number received during 1908 for the Borough 320. Fortunately the comparison can be extended further, and made for many years past, as the statistics for Diphtheria have been worked out in connection with the old Parish, as well as the new Borough, and are shewn below, as far as mortality from the disease is concerned. Even allowing for the slight fallacy that may arise from comparing statistics of the old Parish with those of the new Borough of Lambeth, the extraordinary sudden decrease in the mortality from Diphtheria is again most remarkable, and, when taken in conjunction with the equally extraordinary and equally sudden decrease in the number of notifications of the same disease received, points to a marked decline in the prevalence of Diphtheria throughout the Borough of Lambeth during 1908, as well as during 1907, 1906, 1905, 1904, 1903, 1902 and 1901; and that, too, although Diphtheria has been rising slowly but surely in epidemic proportions for the previous 20 years ending 1900 (vide table below). I he statistics for London, as a whole, are no less remarkable. During 1908, no school was closed on account of Diphtheria. E 66 Quinquennial Period. Population (estimated). Number of Deaths. Death-rate per million living. Old Parish of Lambeth. 1863—1867 902119 148 164 1868—1872 1021165 96 94 1873—1877 1132106 184 163 1878—1882 1245913 255 205 1883—l887 1313211 365 278 1888—1892 1367734 537 393 1893—1897 1443857 683 483 1898 -1900 924333 362 392 Bolo' 1901-5 1538750 194 126 1906 315774 49 155 1907 318538 47 147 1908 321344 44 137 The age and sex incidence and mortality from Diphtheria cases notified in the Borough of Lambeth during 1908 are as follow:— Diphtheria. Ages. No. of Cases Notified. Deaths. Death Rate per 100. M. F. Total. M. F. Total. Under 1 year 6 2 8 1 1 2 250 1 to 5 68 55 123 15 7 22 17.9 5 to 10 44 69 113 8 8 16 14.2 10 to 20 20 27 47 2 1 3 6.4 20 to 40 4 19 23 1 - 1 4.3 40 to 60 - 5 5 - - - - 60 and over - 1 1 - - - - Total 142 178 320 27 17 44 13.8 67 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 1908 are as follows:— New Registration Sub-Districts. Total No. of Cases Notified. Cases treated at Home. Cases removed to Hospital. No. of Deaths. Case Mortality per 100. of Persons Notified per 1000 Inhabitants. At Home. In Hospital. Total. Waterloo 40 2 38 - 4 4 10.0 1.5 Lambeth Church 27 — 27 — 3 3 11.1 1.01 Kennington 67 — 67 — 8 8 11.9 1.2 Stockwell 78 7 71 2 6 8 10.3 1.1 Brixton 56 12 44 2 12 14 25.0 0.6 Norwood 52 19 36 2 0 7 13.5 0.8 Borough of Lambeth 320 37 283 6 38 44 13.8 0.9 Rate of persons notified per 1000 inhabitants—1.2 Inner Districts, and 0.9 Outer Districts. 507 swabs from suspected dipththeria throats were examined at the Laboratory during 1908, and, of these, 13, i.e., 2.6 per cent., shewed the presence of the true KlebsLœffler (diphtheria) baclli (vide p. 171). 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 1908, 43 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. 68 One private school was closed in November 1908, for 3 weeks on account of an outbreak of Diphtheria (3 cases in an average attendance of 25). 4 schools were disinfected during 1908 in connection with outbreaks of Diphtheria, viz., Cormont Road L.C.C., Stockwell College, Stockwell Practising School, and Stockwell Practising School Senior. 4, 3 and 2 cases of Diphtheria respectively occurred in 1908 in connection with the scholars attending Classroom D of Archbishop Sumner's School (Girls'), Classroom B of the Infants' Department of Stockwell College, and Class-room D of the Stockwell Road Schools (Infants). All cases of sore throat were excluded, and not re-admitted until certified as free from infection (the certificates based on bacteriological examinations). No further cases occurred in any of the 3 Schools. As showing the value of baqteriological examinations in connection with cases of sore throats and diphtheria, mention may be made of two interesting outbreaks:— (a) Two cases of diphtheria occurred in a Children's Ward of a Hospital in Lambeth during 1908 (December). The throats and noses of all the inmates of the Ward, including the nursing and cleansing staff, a total of 35, were bacteriologically examined, with the result that the two diphtheria cases amongst the children were traced to a Ward Attendant, whose throat showed the presence of attenuated or modified diphtheria or pseudo-diphtheria germs, pointing to a mild (unrecognised) diphtheria attack some weeks before. The Ward was emptied and disinfected, and no other case arose. (b) A case of uncertified death occurred at a milk shop in Lambeth (Stockwell Ward) during 1908 (November), and bacteriological examination of the throat of the dead child showed the presence of the true Klebo-Loeffler diphtheria germs, pointing to the death being due to diphtheria—a diagnosis confirmed afterwards in the Coroner's Court. 69 Three other patients developed diphtheria contracted from the dead child, who, though ill for six days, was unattended medically. The selling of the milk was stopped, the milk found on the premises destroyed, and disinfection of the whole house carried out, with the result that no other case arose, either at the shop or in connection with the customers, all of whom were watched. MEMBRANOUS CROUP. During 1908, in the Borough of Lambeth, 12 cases were notified from Membranous Croup, and 2 deaths were registered (giving a case-mortality of 16.7 per cent.), as compared with a yearly average of 26 cases notified and 8 deaths registered throughout the old Parish of Lambeth during 10 years (1891-1900).* 9 cases were removed to Hospital. In London, during 1908, there were registered 736 deaths (uncorrected) out of a total of 8002 cases of Diphtheria and of Membranous Croup notified, giving a case-mortality ot 9.2 per cent. † (uncorrected). TYPHOID FEVER. During 1908, 8 deaths were registered in the Borough of Lambeth from Typhoid (Enteric) Fever, and a total of 63 cases notified, giving a case-mortality of 12.7 per cent. Of the 63 cases notified, 48‡ (i.e., 76.2 per cent.) were removed to Hospital, and 8 died, giving a case-mortality of 16.7 per *Membranous Croup Notification Certificates received since the formation of the New Borough:—1901—13, 1902—15, 1903—9, 1904—11, 1905—11, 1906—11, 1907—13. † In London Statistics, Diphtheria and Membranous Croup are now grouped together by the Registrar-General. The notified cases 1908 are Diphtheria 7850 and Membraneous Croup 152. ‡ Of the 48 cases of Typhoid Fever removed to Hospital, 14 proved at Hospital not to be suffering from that disease. 70 cent. amongst the patients treated in Hospital; whilst 15 (i.e., 23.8 per cent.) were treated at home, and none died. 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 1908, 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 average of deaths registered is 34.7, as compared with 63 and 8 respectively as the numbers of notified cases and deaths in the Borough of Lambeth during 1908, giving decreases of 66.8 and 76.9 per cent. respectively. In addition, 14 of the 48 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 1908 are as follow:— Ages. Number of Cases Notified. Deaths. Deathrate per 100. M. F. Total. M. F. Total. Under 1 year - - - - - - - 1 to 5 - - - - - - - 5 to 10 3 3 6 - - - - 10 to 20 11 3 14 - - - - 20 to 40 16 13 29 2 1 3 10.3 40 to 60 7 6 13 3 1 4 30.8 60 and over - 1 1 - 1 1 100.0 Total 37 26 63 5 3 8 12.7 It will be noted that there was no case notified, and no death registered, in infants under 1 year of age; no case 71 notified, and no death registered, amongst children between 1 and 5 years of age; whilst the greatest numbers of both cases and deaths occurred amongst persons between 20 and 60 years of age. The incidences of the disease per 1000 inhabitants in the Inner and Outer Districts respectively during 1908 are the same, viz., 0.2. Details as to the incidence of the disease during 1908 upon the different New Registration Sub-districts 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 5 2 3 - - - - 1.9 Lambeth Church 7 — 7 - 2 2 28.6 2.6 Kennington 13 2 11 - 1 1 7.7 2.4 Stockwell 8 — 8 - — — — 1.2 Brixton 18 — 18 3 1 4 22.2 2.2 Norwood 12 11 1 1 - 1 8.3 0.3 Borough of Lambeth 63 15 48 4 4 8 127 l.9 Of the 62 Typhoid-infected houses 32 (i.e., 51.6 per cent.) showed, on inspection, defective drains, traps, fittings or appliances. In 9 (i.e., 14.5 per cent.), the drains themselves were found to be defective. 21 cases out of the 63 were traced to sources outside the Borough, and 3 were secondary cases, i.e., derived from previous cases in the Borough. No case could be traced 72 definitely and conclusively to infected ice-creams, water, milk, shell-fish, or watercress. There was a history in 10 cases of shell-fish (oysters, mussels, or periwinkles), having been eaten by the patients notified 1 to 3 weeks previous to the disease developing, though, in this connection, the number of persons who eat shell-fish, and do not get typhoid, during the same period under review, must be remembered. 39 samples of blood were examined at the Bacteriological Laboratory during 1908 (see p. 171) for the Widal Reaction of Typhoid, and in 11 cases (i.e., 28.2 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 1908 are, in that respect, of a most satisfactory character. In London, during 1908, there were registered 243 deaths (uncorrected) out of a total of 1357 cases of Typhoid notified, giving an uncorrected case-mortality of 17.9 per cent. CONTINUED AND TYPHUS FEVERS. During 1908, three 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. Two of the cases were removed to Hospital.* In London, 13 cases were notified and 2 deaths registered from Continued Fever during 1908, giving a case-mortality of 15.4 per cent. (uncorrected). No case of Typhus was notified during 1908 in Lambeth Borough. Four cases of Typhus were notified in London (no deaths). *Of the 2 cases of Continued Fever removed to Hospital, one proved at Hospital not to be suffering from that disease. 73 PUERPERAL FEVER. During 1908, in the Borough of Lambeth, 6 deaths were registered from Puerperal Fever (a disease of child-bed), and 10 cases notified, giving a case-mortality of 40.8 per cent. 5 of the patients were removed to Hospital. The annual averages for 10 years (1891-1900) in the Parish of Lambeth are (1) notified cases, 18.9; and (2) deaths, 11.5; whilst, in the Borough of Lambeth during 1907, 22 cases were notified, and 9 deaths registered. Puerperal Fever is a preventable disease, and is caused through want of care on the part of the nurse, or the medical practitioner, attending upon a lying-in woman. 8906 births were registered in the Borough of Lambeth during 1908, and in only 10 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 attendeed 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 found necessary to take legal action against any Midwife. In London, during 1908, there were registered 137 deaths (uncorrected) out of a total of 228 cases of Puerperal Fever notified, giving a case-mortality of 60.1 per cent. (uncorrected). The Council wrote in 1908 to the Local Government Board and the Metropolitan Asylums Board, suggesting the advisability of provision being made by means of new legislation for the reception into Hospital of cases of Puerperal Fever and Erysipelas for isolation and treatment, and to avoid the necessity, as at present, of such cases being treated in the Poor Law Infirmaries. 74 ERYSIPELAS. During 1908, in the Borough of Lambeth, 206 cases of Erysipelas were notified, and 11 deaths registered, giving a case-mortality of 5.3 per cent. Of the 206 cases 66 (i.e., 32.04 per cent.) were removed to Hospital. The yearly averages for the 10 years (1891-1900) in the Parish of Lambeth are (1) notified cases, 347; and (2) deaths, 17.5. During 1907, 231 cases were notified, and 15 deaths registered, from Erysipelas, within the Borough of Lambeth. In London, during 1908, there were registered 160 deaths (uncorrected) out of a total of 4203 cases of Erysipelas notified, giving a case-mortality of 3.8 per cent. (uncorrected). The advantages from the notification of Erysipelas are few, and the majority of cases notified as Erysipelas are not such as were contemplated by the framers of the Notification Act. The details as to the incidence of the two diseases, Puerperal Fever and Erysipelas, in the different New Registration Sub-districts of Lambeth Borough during 1908 are as follow:— 75 New Registration SubDistricts. PUERPERAL FEVER. ERYSIPELAS. Number of Cases Notified. Number of Deaths. Case Mortality per 100. Number of Cases Notified. Number of Deaths. Case Mortality per 100. Waterloo 1 1 100.0 19 1 5.3 Lambeth Church — — — 27 3 11.1 Kennington — — — 53 3 5.7 Stockwell 1 2 50.0 42 — — Brixton 4 2 50.0 49 2 4.1 Norwood 1 1 100.0 16 2 12.5 Borough of Lambeth 10 6 60.0 206 11 5.3 76 DIARRHŒA. During the year 1908, there were registered in the Borough of Lambeth, 150 deaths from Diarrhœa (including one death from Cholera Nostras), as compared with 71, 272, 178 and 260 during 1907, 1906, 1905 and 1904 respectively (vide p. 89, 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 1908 for the Borough are 24.6 per cent. less. Of these 150 deaths, 145 (i.e., 96.7 per cent.) were in children under 5 years, and 118 (i.e., 78.7 per cent. in infants under 1 year of age. August, September and October were the most fatal months (see Table S). In this connection, it is again interesting to note that the mean monthly air temperature registered was, in June, 60.4 deg.; in July, 63.1 deg.; in August, 60.7 deg.; in September, 57.0 deg.; and in October, 54.5 deg.; whilst the 4-ft. earth thermometer registered 56 deg. F. on June 4th, rising to a maximum 63.5 deg. F. on August 6th and 8th, and sinking to 56 deg. F. again on October 22nd. 56 deg. F. is the so-called "critical" earth temperature for Diarrhcea, i.e., the temperature at which the germs of this disease begin to multiply, and prove themselves dangerous.* Hence its importance statistically, in connection with this disease, which, though it kills chiefly young children, attacks at times persons of all ages—a fact not generally recognised. *The 4-ft. earth temperatures were taken in Regent's Park, and thanks are due to Mr. Wm. Marriott, of the Royal Meteorological Society, 70 Victoria Street, S.W., for the information in connection therewith. 77 Age mortalities from Diarrhoea were as follow:— Age. Total Deaths Percentage of Total Deaths from Diarrhoea. M. F. Total. Under 1 year 66 52 118 78.7 1 to 5 10 17 27 18.0 5 to 20 1 — 1 0.7 20 to 40 — — — — 40 to 60 — — — — Over 60 3 1 4 2.7 Total 80 70 150 100.0 In London there were registered, during 1908, 2658 deaths from Diarnhœa, giving an uncorrected rate of 5.5 per 10000 living, and one of 3.7 per cent. of total deaths (uncorrected). The details as to the Diarrhoea incidence (mortality) during 1908 upon the different New Registration Sub-Districts of Lambeth Borough are as follow:— Borough of Lambeth. New Registration Sub-Districts. Number of Deaths. Diarrhoea Death-rate per 10000 Population. Waterloo 10 3.8 Lambeth Church 29 10.9 Kennington 43 7.9 Stockwell* 26 3.9 Brixton 18 2.2 Norwood 24 3.7 Borough of Lambeth 150 4.7 *Including a death from Cholera Nostras. 78 In the Inner New Registration Sub-Districts, the Diarrhœa death-rate per 10000 inhabitants was 6.9 as compared with 2.9 for the Outer Districts, i.e., 2.4 to 1—a condition of things which is generally found to obtain, and which is readily understood when the crowded state of the Inner Districts is remembered. It may be noted that the 4-ft. earth temperature had a low register during 1908, and, as a natural consequence, the Diarrhecea deaths were diminished in numbers. 62 deaths were registered from "Enteritis." The yearly average number of deaths from Enteritis in the old Parish of Lambeth for 10 years, 1891-1900, is 101.8. During recent years there has been a marked improvement in the diagnosis of deaths from diarrhœal 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 93.1 per 1000 births (vide p. 29). The female Inspectors have visited every house wherein a death has been registered as having taken place from Diarrhcea, 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. 79 TABLE S. Shewing the Diarrhoea Mortality in Lambeth Borough in each month during the year 1908. New Registration SubDistricts. Jan. Feb. March April. May. June. July. Aug. Sept. Oct. Nov. Dec. Total. Waterloo - 1 - 1 - - 1 2 3 1 1 - 10 Lambeth Church 2 - - - - - 2 14 7 4 - - 29 Kennington 1 — — — — 2 4 17 13 6 — — 43 Stockwell* 3 1 2 — 1 — 1 7 7 3 1 - 26 Brixton - - - - - 1 1 3 8 4 1 - 18 Norwood 1 2 - - - 1 1 5 3 4 4 - 24 Total 7 4 2 1 1 4 10 48 45 21 7 - 150 *N.B.— Including one case of Cholera Nostras in November. 80 The large decrease in the Diarrhœa deaths during 1907 and 1908 must be read in connection with the remarks under Infantile Mortality. Whilst it is true that meteorological conditions during these periods were favourable to a low infantile mortality rate from diarrhceal diseases, the influence of the Council's precautionary measures and the Milk Depot must be taken into account. TUBERCULOSIS. During 1908, 441 deaths were registered in Lambeth Borough as due to phthisis (tuberculosis of the lungs), 72 as due to tabes mesenterica and tubercular meningitis, and 88 as due to other forms of tuberculosis, making a total of 601 deaths from tuberculosis (all forms)—i.e., 13.9 per cent. of the total deaths (corrected) registered from all causes. The total deaths within the Borough during 1907, 1906, 1905, 1904, 1903, 1902 and 1901 from all forms of tuberculosis were 613, 562, 582, 621, 639, 701 and 695 respectively, i.e., an average of 630 for the 7 years, 1901-7. Sub-dividing the tuberculosis deaths during 1908 amongst the different New Registration Sub-Districts, it is found that the numbers of deaths and the rates (per 1000 living) vary as follows:— 81 New Registration Sub-Districts. Deaths from Phthisis. Tabes. Mes. and Tub. Men. Other form Tuberculosis. Total Deaths Tuberculosis. Rate per 1000 living. Waterloo 56 8 13 77 2.9 Lambeth Church 59 6 10 75 2.8 Kennington 101 20 20 141 2.6 Stockwell 73 16 21 110 1.1 Brixton 104 16 15 135 1.8 Norwood 48 6 | 9 63 0.7 Borough of Lambeth 441 72 88 601 1.7 Inner Districts—2.6 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, &c.), the* voluntary notification of consumption (with tuberculous expectoration) has also been in vogue during 1908 (having been commenced by the Borough Council on June 1st, 1902)—373 cases having been notified in 1908 as compared with 322 in 1907, 332 in 1906, 293 in 1905, 306 in 1904, 339 in 1903, and 315 during the seven months from June 1st to December 31st, 1902, i.e., an average of 318 for the 5 years 1903-7. In each notified case, disinfection has been carried out as required, and leaflets have been 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 tubercu- *The Brompton Consumption Hospital Authorities notify voluntarily all cases of pulmonary tuberculosis at the Hospital, with the consent of the patients. F 82 losis rate per 1000 living during 1907 is 1.7 as compared with 1.9, 1.8, 1.9 and 2.0 respectively during 1907, 1906, 1905 and 1904. 163 samples of sputum were examined bacteriologically during 1908, and in 42, i.e., 25.8 per cent., tubercle bacilli were found (vide p. 170). The distribution of the disease in Lambeth Borough, judging by the voluntary notifications received during 19028, will be seen from an examination of Tables I. and II. following, dealing with (a) New Wards and (b) New and Old Registration Sub-Districts:— I.—CONSUMPTION NOTIFICATIONS, 1902-8. (Arranged in New Wards so as to shew the varying incidences.) New Wards. Total 1902-6 Incidence Rate per 1000 Population 1902-6. 1908 Incidence Rate per 1000 Population 1907-8 Marsh 293 2.2 75 2.6 Bishop's 434 2.7 82 2.4 Prince's 358 1.5 88 1.8 Vauxhall 191 1.2 38 0.9 Total Inner Wards 1276 1.8 283 1.9 Stockwell 85 0.5 17 0.4 Brixton 145 0.6 24 0.5 Herne Hill 99 0.6 26 0.6 Tulse Hill 52 0.4 11 0.4 Norwood 59 0.4 12 0.4 Total Outer Wards 440 0.5 90 0.5 Borough of Lambeth 1716 1.1 373 1.1 N.B.—Voluntary Notification came into force on June 1st, 1902, so that the returns for that year have been calculated by adding on 5/12ths to the notifications received during the 7 months of that year. 83 11. —CONSUMPTION NOTIFICATIONS, 1902-8. (Arranged in Registration Sub-Districts so as to shew the varying incidences.) Old Sub-District. Total 1902-6 Incidence Rate per 1000 Population 1902-6. 1908 Incidence Rate per 1000 Population 1907-8. New Sub-District. Waterloo Road 1st 149 2.2 75 2.6 Waterloo Waterloo Road 2nd 153 75 2.8 Lambeth Church Lambeth Ch. 1st 237 2.6 95 1.7 Kennington Lambeth Oh. 2nd 468 2.3 38 09 Stockwell (part) Total Inner Districts 998 2.3 283 1.9 Total Inner Districts Kennington 1st 268 0.9 17 0.4 Stockwell (part) Kennington 2nd 169 0.8 Brixton 217 0.5 50 0.6 Brixton Norwood 57 0.3 23 0.4 Norwood Total Outer Districts 718 0.6 90 0.5 Total Outer Districts Boro' of Lambeth 1716 11 373 11 Boro' of Lambeth N.B.—The Inner Districts consist of the following new Registration Sub-Districts:—Waterloo, 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 SubDistricts 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 84 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. Public Health (Tuberculosis) Regulations, 1908. An *Order of the Local Government Board, dated December 18th, 1908, has been issued,' making it compulsory for all cases of pulmonary tuberculosis occurring amongst poor people who are in receipt of either indoor or outdoor relief, to be notified by a Poor Law Officer to the Medical Officer of Health, and for the taking of certain measures in such cases. The Order is issued in pursuance of Section 130 of the Public Health Act, 1875, as amended and extended by the Public Health Act of 1891, and the Public Health Act of 1896. The Notifications are to be sent in within 48 hours after the first recognition by notifying the Medical Officer of the symptoms of pulmonary tuberculosis, giving, in the case of inmates of Poor Law Institutions, the address at which the person notified resided immediately before becoming an inmate of such Institution. The Order lays down also— (1) That it shall be the duty of the Superintending Officer of a Poor Law Institution to post to the Medical Officer, on a printed form, of the actual, or intended, place of destination, and the address of that place or any person in respect of whom a notification has already been sent to the Medical Officer of Health, by the Medical Officer of the Institution. This notification must be posted within 48 hours of the departure of the person to whom it relates, to the Medical Officer of Health of the Sanitary District in which the intended destination of the person is situated ; *The Order came into force on January 1st, 1909. 85 (2) That it shall be the duty of a Relieving Officer to notify any change of address (other than admission to a Poor Law Institution) of a person in respect of whom a notification has been made by a District Medical Officer, such notification to be posted within 48 hours after the Relieving Officer has obtained accurate information with respect to the change of residence. The rate of remuneration under the Order is, for Medical Officers of Poor Law Institutions, or District Medical Officers, Is. for every notification, but when in relation to any one case, two or more, notifications, have been posted by the Medical Officer to the same Medical Officer of Health, the remuneration will be at the rate of sixpence for every such notification after the first notification; whilst, in the case of all Superintending Officers of Poor Law Institutions, or of Relieving Officers, the remuneration shall be at the rate of threepence for every notification. The remuneration is to be paid by the Council of the Sanitary District for which the Medical Officer acts. The object of this compulsory notification of Poor Law patients is to enable the Medical Officer of Health, on behalf of the Sanitary Authority, to take preventive measures against the spread of the disease. The Local Government Board has, however, stipulated that nothing in the Regulations shall have effect so as to apply, or so as to authorise or require anyone to put in force with respect to a person in relation to whom a notification has been made, any enactment which renders him or any other person liable to a penalty or subjects him to any restriction, prohibition or disability affecting himself or his employment, occupation, means of livelihood, or residence, on the ground of his suffering from pulmonary tuberculosis. Subject to this proviso, the Hoard points out that it is desirable that Sanitary Authorities, acting on the advice of their Medical Officers, should 86 utilise their powers for the purpose of preventing the spread of infection from tuberculosis, e.g., by 1. The destruction and disinfection of infected articles, or the cleansing, or disinfecting of premises; 2. The safe disposal, or destruction, of infectious material produced and discharged as the result of pulmonary tuberculosis and the taking of all other necessary measures for the prevention of infection from any such material; 3. The obviating, or removing, or diminishing, the risk of infection arising from the conditions affecting the use or occupation of any room when used or occupied by the poor person as a sleeping apartment; 4. The furnishing for the use of the poor person, on loan, or otherwise, any appliance, apparatus, or utensil which will be of assistance for the purpose ot any precaution against infection; 5. The providing and publishing or distributing in the form of placards, handbills, or pamphlets suitable summaries of information on instructions respecting pulmonary tuberculosis and the precautions to be taken in preventing the spread of that disease. These preventive measures have been in vogue within the Borough of Lambeth for some time past, whilst a voluntary system of notification of all cases (Poor Law and others) has been in existence since 1st June, 1902. The only difference that the new Order of the Local Government Board will make will be due to the notification of Poor Law cases being now compulsory, not only as regards the patients, but also as regards their movements from houses to Poor Law Institutions, or otherwise. In this way, it is expected that the numbers of notification certificates received will be considerably increased. 87 GLANDERS. On January 1st, 1908, the London (Notification of Glanders) Order, 1907, came into force throughout the Administrative County of London and the City of London. By the terms of the Order, information of outbreaks of Glanders is to be communicated to the Medical Officer of the Sanitary District concerned, and the London County Council as the Authority under the Glanders, or Farcy, Order, 1907, and the regulations made thereunder, have arranged tor their Veterinary Inspectors to forward particulars of all notifications as the outbreaks of disease occur. All necessary steps to be taken in connection with the slaughtering of diseased animals, and the cleansing and disinfecting of infected premises, are to be carried out by, and under the supervision of, the London County Council's Veterinary Inspectors. Glanders may be contracted by human beings. During 1908, 41 notifications have been received in Lambeth. EPIDEMIC INFLUENZA. During 1908, 65 deaths were registered from Influenza in the Borough of Lambeth, as compared with 39 during 1907, and an average of 107.5 for ten years (1891-1900) in the old Parish of Lambeth. Of the 65 deaths, 42 were registered during the first, 14 during the second, 2 during the third, and 7 during the fourth quarter, of the year. In London, there were registered 1350 deaths (uncorrected) from Influenza during 1908. Reviewing the ten years' history (1891-1900) ot the old Parish of Lambeth in relation to Epidemic Influenza, it will be seen that the disease was practically epidemic during that decennium, rising to a maximum in 1892, 1895, 1899 and 1900. The yearly average for ten years (1891-1900) in the old Parish of Lambeth is 107.5, so that the 1908 statistics for the new Borough of Lambeth show a subepidemic state. 88 Table shewing the number of deaths from Epidemic Influenza in Lambeth Borough, and London, during 1908, and during ten years (1891-1900) in Lambeth Parish and London. Old Parish of Lambeth. Average for 10 years. (1891-1900). Borough of Lambeth. 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1908 Lambeth 131 142 85 44 148 51 45 126 151 152 107.5 65 London (including Lambeth). 2336 2264 1526 750 2156 496 671 1283 1817 1950 1524.9 1350 N.B.—The term "Influenza" is too indefinite in medical practice to permit of any satisfactory deductions being drawn from the above statistics. The 31 deaths from venereal affections (Syphilis, etc.) are the only other point calling for note in the class of Zymotic Diseases. Classes 11. and 111.—Parasitic and Dietetic Diseases. 29 deaths were registered in these classes from chronic Alcoholism and 1 from Delirium Tremens. Class IV.—Constitutional Diseases. Of the total 1031 deaths under this class, 338 were due to Cancer, 441 to Phthisis, and 160 to Tubercular Meningitis and other forms of Tuberculosis. Class V.—Developmental Diseases. The total number of deaths in this class was 296, consisting of 134 from Premature Birth, 113 from Old Age, and 49 from Atelectasis and Congenital Malformations. 89 Class VI.—Local Diseases. 1. Diseases of the Nervous System caused 365 deaths, including 22 from Convulsions, 189 from Apoplexy, and 20 from Epilepsy. 2. 472 deaths were due to diseases of the Circulatory System. 3. The diseases of the Respiratory Organs caused 816 deaths (383 from Bronchitis, and 156 from Pneumonia). 4. Diseases of the Digestive Organs caused 241 deaths, of which 62 were due to Enteritis, 12 to Peritonitis, 67 to diseases of the Liver and 15 to Dentition. 5 Diseases of the Urinary System caused 191 deaths. 6. Diseases of the Reproductive System, Integumentary System, Locomotive System, Lymphatics, Organs of Special Senses, and Gland-like Organs of uncertaine use, caused together 77 deaths. Class Vll.—Deaths from Violence. 149 deaths in all, including 110 from Accidents or Negligence, 11 from Burns and Scalds, 8 from Drowning, 7 from Suffocation in bed (6 being infants under 1 year), 36 from Suicide, and 3 from Homicide. Class VIII.—Other Causes. 138 deaths were registered in this class, consisting of deaths from Dropsy, Tumours, Haemorrhages, Debility, Atrophy, and Inanition, or other ill-defined or nonspecified 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 90 T gives also the deaths from the chief Infantile Diseases, expressed in terms of the Infantile population (or number of Births). Allowing for the slight differences between the corrected and uncorrected death returns, it will be noted that, in regard to both infantile and other diseases, Lambeth again compares favourably with London (vide Table U). Allowing for the favourable meteorological conditions during 1908, favourable in so far as infantile life was concerned, the statistics for Lambeth Borough throughout the year 1908 are satisfactory—the corrected infantile mortality rate, as a whole, being 93. 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 Borough Council is to be congratulated upon the extraordinary low rate of infantile mortality—the lowest on record either for the new Borough or the old Parish. 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 dep6t, the distribution of pamphlets dealing with the proper feeding and management of infants, etc., and the special work done by the Council's newly-appointed Health Visitor. 91 TABLE T. Shewing Classification of Causes of deaths (corrected) in the Borough of Lambeth during 1907 and 1908. A.—Total Deaths from all causes and at all ages with percentages of deaths to total deaths (corrected). Class of Disease. Borough 1908. Borough. 1907. No. of Deaths (corrected). Percentage of Total Deaths (corrected). No. of Deaths (corrected). Percentage of Total Deaths (corrected). I.—Zymotic Diseases 529 i2.2 502 10.8 Seven Principal 397 9.1 379 8.1 Influenza 65 1.5 39 0.8 II.—Parasitic 2 0.05 3 0.06 III.—Dietetic 34 0.8 36 0.8 IV.—Constitutional i031 23.8 1043 22.4 Cancer 338 7.8 326 7.01 Phthisis 441 10.2 465 9.9 Tubercular Diseases, cluding Phthisis 160 3.7 148 3.2 Rheumatism (Acute and Chronic) and Gout 23 0.5 45 0.9 V.—Developmental 296 6.8 313 6.7 Old Age 113 2.6 110 2.5 VI.—Local Diseases 2162 49.8 2417 51.9 Circulatory System 472 10.9 517 11. 1 Bronchitis 383 8.8 480 10.3 Pheumonia and Broncho- Pneumonia 318 7.3 338 7.3 Pleurisy and monia 54 1.2 48 1.03 Respiratory System, cluding Phthisis 816 18.8 932 20.03 VII.—Violence 139 3.2 190 4.1 Suicide 36 0.8 32 0.7 VIII.—Other Causes 138 3.2 148 3.2 92 TABLE T— continued. B.—Death (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 1908. 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 829 103.2 941 120.5 Diarrhœa 118 14.7 58 7.4 Convulsions 21 2.6 30 3.8 Respiratory Diseases 140 17.4 193 24.7 Premature Births 134 16.7 163 20.9 Tubercular Diseases (including Phthisis) 53 6.6 52 6.7 Measles 16 1.9 26 2.3 Whooping Cough 19 2.4 45 5.8 Suffocation in Bed 6 0.7 21 2.7 Enteritis 31 3.9 51 6.5 Dentition 9 1.1 16 2.05 N.B.—The Registrar-General gives the corrected births for 1907 and 1908 as 7806 and 8035 respectively. 93 TABLE U. Shewing Classification of Certain Causes of Deaths (uncorrected) in the Borough of Lambeth, compared with London, during 1907 and 1908, giving in percentages of the total uncorrected deaths. A.—Deaths at all Ages. Lambeth. London. Percentage of total Deaths (uncorrected) Percentage of total Deaths (uncorrected) 1908. 1907. 1908. 1907. 1. Principal Zvmotics 9.3 8.6 9.6 9.4 Influenza 1.4 0.8 1.9 1.3 Measles 2.1 2.2 2.2 2.5 Whooping Cough 0.9 2.3 1.4 2.5 Diarrhœa and Dysentery (including Cholera) 3.9 1.6 3.8 2.1 II. Rheumatic Fever and Heart Rheumatism 0.3 0.5 0.3 0.4 III. Diseases of Circulatory System 10.5 10.5 13.4 13.4 IV. Bronchitis, Pneumonia and Pleurisy 16.3 17.9 17.5 19.1 Phthisis 8.8 8.9 9.4 9.5 V. Injuries 3.7 3.9 4.3 3.2 B—Deaths under 1 Year of Age (per1000 Births uncorrected). All Causes 106.7 120.7 115.4 117.9 94 95 TABLE V. TABLE V. [Local Government Board Old Table A] Table of DEATHS during the year 1908 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 1 2 3 4 5 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Membr nous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Influenza. Injuries. All other Diseases. Total. Puerperal. Relapsing Continued Enteric or Typhoid. Typhus. (a) (b) (c) (d) (e) (f) (g) (h) (i) Royal Infirmary (Women and Children) 74 34 23 4 1 11 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 11 ... 1 12 ... ... 1 32 57 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 ... 14 17 General Lying-in-Hospital, York Road 50 45 ... ... ... 5 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 42 45 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 5 Remainder of Waterloo 233 62 37 4 7 88 35 Under 5 ... ... ... ... ... ... ... ... ... ... ... 5 8 4 ... ... 30 ... 1 2 49 99 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 24 31 17 1 11 50 134 St. Thomas's Hospital 743 83 100 72 63 368 57 Under 5 ... 1 9 ... ... ... ... ... ... ... 2 2 ... 35 ... 1 27 3 ... 15 88 183 5 upwds. ... ... 2 ... 4 ... ... 3 ... ... 5 ... ... 1 3 13 21 71 ... 49 388 560 Remainder of Lambeth Church 255 94 28 5 4 78 46 Under 5 ... ... ... ... ... ... ... ... ... ... ... 5 6 16 ... 1 35 1 ... ... 58 122 5 upwds. ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 21 23 25 1 12 50 133 Lambeth Workhouse 121 5 3 ... ... 15 98 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 7 8 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 8 32 35 3 ... 34 113 Lambeth Infirmary 716 49 38 9 21 370 229 Under 5 ... ... ... ... ... ... ... ... ... ... 1 18 ... 5 ... 7 14 ... ... ... 42 87 5 upwds. ... ... ... ... 1 ... ... ... ... ... 5 ... ... ... ... 141 94 102 2 16 268 629 St. Peter's House 36 ... ... ... ... 4 32 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 10 2 ... 14 36 Remainder of Kennington 434 120 50 6 14 147 97 Under 5 ... ... ... ... ... ... ... ... ... ... ... 21 10 22 ... 1 30 ... ... 1 85 170 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 40 65 44 5 9 99 264 South-Western Hospital 96 10 49 19 3 15 ... Under 5 ... 23 28 ... ... ... ... ... ... ... 1 1 ... ... ... ... 1 ... ... ... 5 59 5 upwds. ... 10 9 ... ... ... ... 10 ... ... ... ... ... ... ... ... 4 ... ... ... 4 37 Clapham Maternity 15 12 ... ... 2 1 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 11 12 5 upwds. ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 3 Remainder of Stockwell 559 127 51 12 16 182 171 Under 5 ... ... 1 ... ... ... ... ... ... ... ... 16 3 21 1 37 2 3 4 89 178 5 upwds. ... ... 1 ... 1 ... ... ... ... ... 1 ... 1 2 42 77 46 8 14 188 381 96 97 TABLE V. — continued. TABLE V.—continued. [Local Government Board Old Table A—continued]. Table of DEATHS during the year 1908 in the Borough of Lambeth, classified according to Diseases and Localities-continued. Names or Localities adopted for the purpose of these Statistics, Public institutions being shewn as separate localities. Mortality from all causes at subjoined ages. Mortality from subjoined causes, djstingijishing deaths of children undhr flve years of age. 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 At all ages Under 1 year. 1 and under. 5 and under 15. 15 and under 25 25 and under 65. 65 and upwards. 1 2 3 4 Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Influenza. Injuries. All other Diseases. Total. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Pueperal. Relapsing Continued Enteric or Typhoid, Typhus. (a) (b) (c) (d) (e (f) (g) (h) (i') Belgrave Hospital 152 95 43 14 ... ... Under 5 ... ... 1 ... ... ... ... ... ... ... ... ... ... 30 ... 4 28 ... ... 4 71 138 ... ... 2 ... ... 1 ... 1 10 14 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... Remainder of Brixton 670 114 41 9 23 258 225 Under 5 ... ... 1 ... ... ... ... 3 ... ... 1 15 8 14 3 2 23 ... 1 6 84 155 ... ... ... ... ... 1 ... 76 95 70 16 12 234 515 5 upwds. ... i 1 2 1 ... ... ... Lambeth Workhouse Schools 1 ... 1 ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... British Home of Incurables 7 ... ... ... ... 2 5 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7 7 5 upwds. ... ... ... ... ... ... ... 1 ... Remainder of Norwood 530 100 44 6 17 172 191 Under 5 ... ... 1 ... ... ... ... ... ... ... ... 14 9 20 ... ... 20 ... 1 3 76 144 1 ... 1 1 34 59 66 21 12 187 386 5 upwds. ... ... 1 ... 1 ... ... ... ... ... 1 Totals 4692 950 508 160 171 1716 1187 Under 5 ... 24 41 ... ... ... ... ... ... 1 5 97 44 178 ... 18 258 7 6 39 710 1458 17 ... ... 12 2 1 8 12 399 511 489 61 136 1553 3234 5 upwds. ... 11 14 2 9 ... ... The subjoined number have also to be taken into account in juging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto 512 57 45 29 26 261 92 Under 5 ... 8 3 ... ... ... ... ... ... ... ... 2. 5 12 ... 1 15 ... ... 2 51 102 ... 1 ... ... ... 41 38 57 2 32 222 410 5 upwds. ... 5 9 ... ... ... ... 2 ... ... Deaths occurring within the district among persons not belonging thereto 863 178 119 71 62 351 92 Under 5 ... 5 20 ... ... ... ... ... ... ... 3 1 ... 46 ... 3 37 3 ... 11 167 297 4 ... ... 11 ... ... 3 ... ... ... 3 15 30 78 4 49 365 566 5 upwds. ... 1 3 ... 98 99 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 1908, 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 1908. New Cases of Sickness in each Locality, coming to the knowledge of the Medical Officer of Health during 1908. Number of such Cases removed from their Homes in the several Localities for Treatment in Isolation Hospital during 1908. Census 1901. Estimated to middle of 1908. 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 Smallpox. Scarlatina. Diphtheria. Membranous, Croup. Fevers. Fevers. Cerebro-Spinal Meningitis. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Typhus. Fevers. Puerperal. Cholera. Erysipelas. Cerebrospinal Meningitis. Typhus. Typhoid or Enteric. Continued. Relapsing. Puerperal Cholera. Erysipelas. Enteric or Typhoid. Continued. Relapsing. (a) (b) (c) (d) Waterloo 27440 26085 1613 - 69 40 2 — 5 — - 1 - 19 3 - 69 38 2 - 3 — — 1 — 9 2 Lambeth Church 27440* 26641 785 106 27 — - 7 1 - - - 27 3 - 86 27 — — 7 — — — — 10 3 Kennington 52518* 54729 1548 — 207 67 2 — is 1 - - - 53 7 - 202 67 1 — 11 1 — 1 - 19 7 Stockwell 63826 67273 2103 — 4«3 78 3 — 8 — - 4 - 42 - - 435 71 3 — '8 — — 1 - 15 — Brixton 73673 81252 1674 — 357 56 5 — 18 1 - 4 - 49 1 - 325 44 3 — 18 1 — 2 - 9 1 Norwood 56998 65364 1183 — 226 52 — - 12 — - 1 - 16 - - 186 36 — — 1 — — — - 4 — Totals 301895 321344 8906 - 1428 320 12 - 63 3 - 10 - 206 14 - 1303 283 9 — 48 2 — 5 - 66 13 *The Census 1901 populations tor Lambeth Church and Kennington New Sub-Districts are approximate only. G 2 100 BOROUGH OF LAMBETH. SUMMARY OF VITAL AND MORTAL STATISTICS, etc., FOR 1908. 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 coextensive, but the new Registration Sub-Districts and the new Wards are. Population—estimated middle of 1908—321344 (males 152159, females 169185). Density—78.8 persons per acre (exclusive of tidal water and fcreshore). Inhabited Houses—41511 at Census, 1901. Rateable Value—1966874 for year ending 31st March, 1908. Marriages—2411, being 15.0 per 1000. Births—8906, being 27.7 per 1000. Deaths (corrected)—4341, being 13.5 per 1000. Infantile Mortality—829 deaths (corrected) under 1 year being 93.1 per 1000 total uncorrected births. Zymotic—Death-rate, 1.2 per 1000 (total deaths, 397). Estimate increase of Population 2806 but the natural increase or increment (i.e., excess of Births over deaths) is 4184 (uncorrected). 101 NOTIFICATION OF BIRTHS ACT. The Notification of Births Act, 1907, was adopted by the Council and came into operation throughout the Lambeth Borough on March 9th, 1908. A circular letter was sent round to every Medical Practitioner and every Midwife known to be practising within the Borough, pointing out the provisions of the Act, and giving particulars as to the notification letter-cards (addressed and stamped) to be used. The adoption of the Act within the Borough was opposed by the Lambeth Division of the Metropolitan Counties' Branch of the British Medical Association, in a letter, dated February 11th, 1908, on the grounds:— (1) That it imposes a violation of professional fidence ; (2) That early interference by strangers is likely to be more harmful than beneficial to the patient, and, if considered necessary, would be of more value at the ordinary registration period; (3) That, in certain unfortunate cases, mothers would be likely to avoid professional aid, when associated with compulsory publicity, thereby running grave risks to themselves, and their offspring ; (4) That it is unreasonable and inequitable that any public work should be demanded under penalty from the profession, unless the services rendered to the State are fully recognised and paid for. The petition was not successful, the Council still expressing the opinion that the Act was a most useful one, and one from which it was anticipated that much good would accrue in connection with the important subject of the prevention of infantile mortality—an anticipation that has been more than realised, judging by the results of the first 10 months working (vide pp. 135-136). 102 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, 1908. Total number of Notices 14258 NOTIFIABLE INFECTIOUS DISEASES. (Public Health, London, Act). No. of Notices served 2056 No. of Infected Houses 1829 Smallpox - Scarlet Fever 1228 Typhoid 62 Typhus - Continued Fever 3 Diphtheria 301 Membranous Croup 11 Puerperal Fever 10 Erysipelas 200 English Cholera - Cerebro-Spinal Meningitis 14 103 PARTICULARS OF SANITARY WORK. Carried out in Lambeth Borough during 1908, 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. 1908 14258 9561 3645 ) 1900 10065 10291 2303 Old Parish of Lambeth. 1899 10583 10042 2273 1898 10469 9905 2224 1897 11088 9058 1884 1896 7475 6702 982 1895 7645 8581 1104 1894 6975 7672 1911 1893 8769 9207 2046 1892 7173 6931 2190 1891 5557 7232 3173 1890 5588 5053 3251 1889 6854 4192 2662 1888 4891 2969 1922 1887 4565 2430 2135 1886 4504 2433 2071 1885 3567 1459 2108 1884 3727 1621 1621 2106 1883 3000 1294 1766 1882 3239 1267 1972 1881 3730 1298 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. 104 A. Public Health [London] Act and Metropolis Local Management Acts. Notices (Preliminary and Statutory) 12202 Works, Structural:— Drainage Defective 1256 Intercepting Traps with Fresh Air Inlets required 178 Ventilating Pipes required 210 Indoor Sinks connected with the Drain 389 Rain Water Stack Pipes connected with the Drain 708 Bath Waste connected with the Drain 91 Traps Defective, or of Obsolete Pattern 881 Closet Pan and Connections Defective 1142 Water Supply to Closet Defective 876 Closet Dilapidated 701 Draw-off from Main for Drinking Purposes required 202 Dust Bins Defective 910 Premises Dilapidated 311 Ventilation under Floors required 71 Roofs Dilapidated 280 Soil Pipes Defective 78 Paving Defective 1187 Damp and Unwholesome Houses 79 Dung Receptacles required 41 Works Not Structural:— Cisterns Dirty 121 Manure Accumulations 156 Underground Rooms occupied 21 Animals Improperly Kept 48 Stopped Drains 476 Overcrowding 31 Foul Urinals 71 Refuse Accumulations 39 No Water Supply or Defective Water Supply 365 Dirty Premises 2317 13236 105 B. Infectious Diseases Notification. Notices served (1829 infected houses) 2056 SUMMARY OF WORK DONE BY THE SANITARY INSPECTORS DURING 1908. Inspections 9497 Re-inspections 64580 Infectious Houses visited 1829 Complaints attended to 6641 Cases of Infectious Disease notified 2056 (a) Cases under treatment at Home 322 (b) Cases removed to Hospital 1734 Cases of Non-Notifiable Diseases dealt with 3287 Houses disinfected 1944 Rooms disinfected 5158 Bedding, etc., disinfected 3810 Bedding, etc., destroyed 36 Dust Yards, Manure Depots and Brickfields, inspections of 312 Drains tested (with chemical, water, or both) 10117 Sanitary Works completed 6317 Plans of drainage reconstructions received, and approved 480 Premises the Drains of which have been totally or partly reconstructed 709 Articles procured for the Analyst— (a) Food and Drugs 1800 (b) Water — New Workshops inspected and registered 93 Bakehouses inspected (including 79 underground) 214 Cowhouses inspected 14 Slaughter-houses inspected 24 Milkshops (new) inspected and registered 21 Restaurants (new) inspected and registered — Outworkers' Rooms (new) registered 202 106 Notices— Sanitary Work (Preliminary and Statutory) 12139 Infectious Diseases (Public Health Act, 1891) 2056 Housing of Working Classes Act Metropolis Local Management Acts 13 Sanitary nuisances abated— (a) Structural 9591 (b) Non-structural 3645 Persons received at the Shelters Summonses issued 133 Convictions obtained— Public Health Act 9 Food and Drugs Acts 76 MALE SANITARY INSPECTORS. During 1908, 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, re-inspections, etc., tabulated throughout the Report. It is again satisfactory to note that during 1908 in but very few cases (0.2 per cent of the total notices served) has it been found necessary to resort to legal proceedings before the Court in connection with sanitary work carried opt under the Public Health and Metropolis Management Acts—24 summonses* in all. Combined Drainage. Many combined drainages have been reconstructed by the Borough Council during 1908, such drainages being "sewers," as the direct result of inspections carried out by the Inspectors in the course of their daily routine duties. *Withdrawn (work done) 14, caution by Magistrate 1, convictions (penalties) 3, orders made to do the work 4, defendants to pay costs 1, closing order (no water supply) 1 107 The law, as it at present stands, throws the responsibility upon the Borough Council of repairing certain combined drainages, as sewers, and as the property of the Sanitary Authority, but a large number of combined drainages are relaid by private owners as the result of voluntary work or of the service of notices by Inspectors. In these latter cases, the owners are either responsible, by virtue of the Sanitary Authority possessing a plan or application (or both), in connection with the combined systems of drainage, or prefer that the combined drains should be regarded as "drains" and not as "sewers." House to House Inspections. A house to house inspection of the district is a duty laid upon Sanitary Authorities by section 1 of the Public Health (London) Act, 1891, and section 30 of the Housing of the Working Classes Act, 1890. The duty is an important one, but such work can only be carried put with a sufficiently large Sanitary staff. Within the Borough, during 1908, a total of 2520 house to house inspections have been made, dealing with the following streets (whole or part):— Marsh Ward.— Asa Place, Burdett Chambers, Commercial Road, Cornwall Place, Cosham Place, Coin Street, Campbell Buildings, Cory Square, Druce Place, Elizabeth Place, Henry Place, Howley Place, Lydia Buildings, Lower Marsh, Lambeth Square, New Cut, Peabody Buildings, Perry Place, Peartree Street, Prince's Buildings, Stamford Street, Secker Street, Sapphire Place, Tower Street, Tenison Street, Ufford Street, Waterloo Road. Bishop's Ward.—Bishop's Terrace, Carlisle Buildings, Clayton Buildings, Ethelred Street, High Street, Over Place, Paris Street, St. Alban's Buildings, St. Olave's Gardens, St. Mary's Square, Stangate Chambers, Walcot Square, Waxwell Terrace. 108 Prince's Ward.— Bonnington Square, Cardigan Street, Claylands' Road, Courtney Street, Dante Road, Durham Street, Holyoake Road, Langley Lane, Mancroft Cottages, Vauxhall Mansions, Wickham Street. Vauxhall Ward.— Camelia Street, Heyford Avenue, Hook's Cottages, Milton Place, Pleasant Place, Riverhall Street, Simpson Street, Tradescant Road, Thorne Street, Walberswick Street. Stockwell Ward.— Bedford Court, Broomsgrove Road, Ducie Street, Fenwick Place, Garden Row, Seneca Road, Stockwell Park Road, Tintern Street. Brixton Ward.— Alders' Cottages, Bolton Street, Belinda Road, Camberwell New Road, Canterbury Mews, Cumberland Cottages, Camberwell Place, Myatt's Road, Milbrook Road, St. Agnes Place, St. Mark's Road, Sellman's Cottages, Thornton Street, Valentia Road, Warham Street. Heme Hill Ward.— Mayall Road, Railton Road, Sussex Road. Tulse Hill Ward.— Allington Street, Brandon Road, Cornwall Road, Effra Parade, Ellerslie Road, Mauleverer Road, Prague Street, Tregenna Street, Vicary Street. Norwood Ward.— Beardman Street, Canterbury Grove, Chapel Place, Chapel Road, Curnick's Lane, Denmark Place, Durham Road, Eden Road, Ladas Road, Langmead square, Lynton Grove, Orchard Cottages, St. Louis Road, Victoria Place, Weaver's Cottages, Woodcote Place. A total of 2520 houses have been inspected during 1908, and in 373 (i.e., 14.8 per cent.) a result was obtained from the chemical test applied to the drains. A total of 4174 109 nuisances were found to exist in 1733 houses (i.e., 68.8 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 2520 Number of houses in which a result was obtained from test (chemical) applied to drains" 373 Number of houses in which nuisances were found to exist 1733 Nature of Nuisances found and dealt with under the Public Health (London) Act, 1891. Dirty walls and ceilings of rooms 898 Defective roofs or rain water pipes 290 Defective or dirty yard paving 320 Defective flushing apparatus in water closets 210 Water closet pan foul 69 Drinking water tap defective, making walls damp 23 Gully or drains stopped 105 Floors defective 88 No dust-bins (or dust-bins defective or dilapidated) 271 Damp premises 221 Overcrowding 24 Defective water closets 231 Defective drains 314 Defective or deficient vent pipes or soil pipes 178 Defective sink wastes (or not undertrapped) 286 Defective manhole covers 17 Animals improperly kept 17 Cisterns uncovered or dirty 23 Improper water supply 100 Forecourts insufficiently paved or unpaved 151 Water closets insufficiently lighted or ventilated 30 Want of ventilation under floors 178 110 Want of proper dung receptacles 5 Underground rooms illegally occupied 6 Accumulation of manure 11 Defective traps 22 Sinks connected direct to drains 23 Mica valves defective 34 Rain-water pipes direct to drain 9 4174 Inspection of Market Thoroughfares. The Market Thoroughfares have been, during 1908, under bi-weekly special inspection by the Sanitary 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 1908, 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. After much negotiation, it has been decided to reconstruct the urinal at the "White Horse" Public House, Brixton Road, by Loughborough Road. The reconstructed urlrtal will contain 4 stalls, and will be furnished with two entrances from the Loughborough Road. The estimated cost is £157, of which the Cannon Brewery Company, Limited, the owners of the premises are to pay £75. Thie Council will rhaihtaih the urinal, and will pay also a ndminal rent bf 1/0 per annum for the land on which thie Urinal will be built. 111 Unsound Food. During 1908, the following consignments of unsound food have been inspected, condemned and destroyed, under the supervision of the Sanitary Inspectors:— Jan. 4th—18 boxes of-tomatoes. Jan. 21st—7 barrels of white Almeria grapes. Feb. 4th—1 trunk of "cat" fish. Feb. 6th—24 lb. boxes of dates. March 21st—10 twenty-lb. boxes of grapes. March 30th—940 pears in boxes. April 3rd—1| bushels of apples. April 4th—1640 pears in boxes. April 18th—1 barrel of skate (15 stones). April 24th—83 boxes of grapes. May 15th—24 Cape cray fish. May 25th—60 soles. June 22nd—1 trunk of 80 haddocks. Oct. 23rd—1 box of iced meagre soles (2 cwt. in weight). Dec. 2nd—5 stones weight of whiting in box. Routine Work of Male Inspectors. During 1908, 709 houses have been re-drained throughout or in part; and 480 plans (representing the 709 houses) have been received in connection therewith. The drainage work is carried out under the personal supervision of the Sanitary Inspectors, the drains being in every case water-tested. 10117 tests (hydraulic, smoke or chemical) have been made by the Sanitary Inspectors during 1908. 62 Water Certificates (representing 169 houses separate or in blocks) have been issued during 1908, in accordance with Section 48 of the Public Health (London) Act, 1891; and in this connection, it is to be noted that a Water Certificate is not granted until all the drainage work also is completed satisfactorily. 112 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 1908, 14258 notices have been served under the Public Health Act (8047 preliminary, 4142 statutory and 2056 in connection with infectious diseases), and 13 under the Metropolis Management Acts, making a total of 14258, dealing with 9591 structural, and 3645 nonstructural, defects 6641 complaints were attended to during 1908. The numbers of inspections and. re-inspections carried out during 1908 by the Male Sanitary Inspectors were 9497 and 64580 respectively, and to these must be added the summary of work carried out by the Female Sanitary Inspectors, and the Female Health Visitor (vide pages 128-133 and 135-136). 24 summonses were taken out, and 14 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 special work in connection with disinfection, smoke abatement, inspection of factories and workshops, bakehouses, restaurants and dining (coffee) rooms, and the carrying out of the Food and Drugs Acts, is dealt with under special headings in this Report (vide pp. 113-147 post). Public Health Department. The new Lambeth Town Hall, Brixton Hill, S.W., was opened on April 29th, 1908, and the 'Public Health Department is now located in suitable rooms in the main building —the Medical Officer and the Sanitary Clerks on the Ground Floor (3 rooms) and the Sanitary Inspectors in the Basement (2 rooms). The Sanitary Inspector's office at Norwood has been closed. 113 DISINFECTING DEPARTMENT. During 1908, good work has been done by the Staff (individually and collectively) in connection with the Disinfecting Department—5158 infected rooms and 22646 infected articles (bedding, etc.) having been disinfected, as compared with 4881 and 24891 respectively in 1907. A total number of 2056 notifiable infectious diseases (including 14 cases Cerebro-Spinal Meningitis) have been reported during the year 1908, but a large amount of disinfection has also been carried out in connection with cases of Measles (1504), Whooping Cough (319), Tuberculosis (749), Chicken-pox (602), Cancer (30) Verminous Houses and Persons (51), and Other Diseases (32). Full details are to be found on pp. 117-119. The whole of the 2056 compulsorily notifiable diseases (representing 1829 infected houses) have been dealt with, whilst 21 Schools have been disinfected in connection with outbreaks of infectious disease, viz., Measles 13, Scarlet Fever 3, Diphtheria 4, and Verminous 1. Particulars as to disinfection carried out in the Borough of Lambeth during 1908. Total No. or rooms disinfected by Council 5158 Cases in which bedding has been disinfected at home 1120 Do. do. do. at Chamber 2690 Do. do. do. destroyed 36 Bedding replaced by the Council 1 Premises disinfected and disinfectants supplied 11575 Jnfected cabs disinfected — *The number is increased, compared with previous years, owing to bedding no longer being: removed to the disinfecting station in the cases of Measles, Chicken-pox and Whooping Cough. h 114 No. of Cleansing Notices served in connection with infected houses 1944 Certificates of Medical Practitioners received in lieu of disinfection by the Council 26 South Eastern & Chatham Railway Carriages disinfected 2 Schools disinfected 21 Certificates of disinfection left with occupiers of disinfected premises 3179 Library Books disinfected* 252 Articles of bedding, etc., disinfected. Beds 1604 Bolsters 1416 Pillows 3824 Mattresses 1174 Palliasses 130 Chair Cushions 563 Clothing 4152 Sheets 1833 Blankets 3696 Rugs and Mats 140 Counterpanes and Eiderdown Quilts 1578 Carpets 171 Extras (i.e., articles not mentioned in above) 2365 Total 22646 Articles of bedding, etc., destroyed. Beds 27 Bolsters 7 Blankets 7 Pillows 16 *220 Public Library and 32 L.C.C. School Library Books. 115 Quilt 1 Mattresses 16 Palliasses Sheet 1 Chair Cushions 12 Clothing 40 Carpets 4 Sundries 93 Total 231 Practically all the disinfection was carried out by the Council's officers—only 26 certificates being received from Medical Practitioners during 1908 as compared with 33 during 1907. Particulars as to the 26 certificates (received during 1908) 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 5 7 10 3 25 5 7 10 4 26 Refuges. There are 2 Refuges in the Borough, one at Wanless Road, and the other at the Wharf (Belvedere Road). Neither h 2 116 Refuge has been used during 1908—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, at a Disinfection Station, or elsewhere. Arthur Morris, the Superintendent of the Disinfecting Department, resigned in September, 1908, on account of ill-health (rheumatic gout complicated with heart disease), after 26 years' service in the employ of the late Vestry and the present Borough Council, and his resignation was accepted by the Council with regret—a superannuation allowance of £l 8s. 4d. per week being grant?d. W. I.ockver has been temporarily appointed in his place as Superintendent. 17 DISINFECTION STATISTICS. For eight years prior, and seventeen years subsequent, to the passing of the Notification of Infectious Diseases Act; and for the year 1908. 1882 1883 1884 1885 1886 1887 1888 1888 Yearly average for 8 years pieceding the Notification Act. 1908 No. of Cases in which Bedding, etc., has been disinfected. At Home 332 258 278 10 62 52 7 144 1428 1120 At Chamber 85 56 162 503 23? 722 802 851 4528 2690 No. of Cases in which Bedding, etc., has been destroyed. 37 23 62 52 8 57 48 78 457 36 No of Articles of Bedding, etc., 1526 1437 1885 2275 816 3078 3121 3778 21532 22646 No. of Articles of Bedding, etc., destroyed 63 104 114 144 58 82 61 267 1130 231 Premises Disinfected and Disinfectants Supplied. 727 680 657 727 736 1276 1255 1277 816 8 11575 Infectious diseases dealt with. Notifiable — — - — — — — - — 2056 Non-notifiable — — — — — — - — 3204 †vide footnote on page 118. §vide footnote on page 118. 118 DISINFECTION STATISTICS—continued. 1890 to 1892 1893 1891 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 V early average for 18 yrs. succeeding the Notification Act. 1908 No. of cases in which Bedding, etc., has been disinfected. -At Home 1018 343 177 251 368 217 132 81 62 37 20 19 6 1 881§ 1096 261.6 1120 At Chamber 5501 3042 2206 2472 2447 2126 2424 2998 2450 3040 3702 3253 3107 3583 2484 4781 2756.4 2690 No. of cases in which Bedding, etc., has been destroyed. 774 224 119 6 49 39 27 41 59 75 134 62 53 47 33 44 99.4 36 No. of Articles of Bedding, etc., disinfected. 19669 11513 8022 13516 20349 21487 21597 27923 27528 27265 41029* 26957 26359 51552 22850 24891 21805.9 22646 No. of Articles of Bedding, etc., destroyed. 1405 674 544 186 178 162 126 326 1783 959 1006* 587 479 519 419 200 530.7 231 Premises disinfected and disinfectants supplied. 6695 5836 5742 7146 7210 8715 8441 9146 9124 9522 12607 10984 12367 13212 11735 11808 8352.8 11575 Infectious Diseases dealt with— Notifiable† 4701 4070 2433 2685 2801 2663 2329 2693 2209 2025 4273 1587 1938 1853 2074 2140 2510.2 2056 Non-Notifiablet - - - - 20 87 144 1339 1702 1376 1094 2269 2638 3927 2388 4047 25859 3204 *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 1906, 1907 and 1908 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 1901-8 refer to Borough Council; those for all previous years, to the late Vestry. U9 NON-NOTIFIABLE INFECTIOUS DISEASES, ETC 1900—1908. 1st Q. 2nd Q. 3rd Q. 4th Q. Total 1908 1907. 1906. 1905. 1904. 1903. 1902. 1901 & 1900. Yearly average 8 years (1900-1907). Measles 233 177 266 228 1504 1998 836 1970 1294 1346 364 1669 1184.6 Whooping Cough 84 138 55 42 319 748 455 440 380 325 110 198 332.0 Chicken-pox 248 176 57 121 602 600 354 733 305 356 1525 166 517.4 Consumption* 174 180 156 239 749 677 592 598 659 269 488 1007 536.3 Cancer 6 6 10 8 30 24 18 16 20 13 34 38 20.4 745 1277 544 638 3204 4047 2255 3757 2658 2309 2621 3078 2590.6 *Consumption voluntarily notifiable throughout the Borough since June 1st, 1902. N.B.—32 other diseases (not classified i.e., Mumps, Eczema, Influenza, Scabies, Pneumonia, Blood Poisoning, Diseases not stated, etc., and 51 Verminous Houses and Persons, were also dealt with during 1908. 120 SMOKE ABATEMENT. During 1908, observations and enquiries have been made in connection with smoke abatement throughout the Borough, and 41 smoke notices have been served. In no case was it found necessary to proceed to a summons. Special observations were made during 1908 with reference to City & South London Electric Railway Generating Station (Clapham Road), Messrs. Beaton & Co. (33 Chapel Road, West Norwood), Hyde's Bird Food Factory (Lilford Road), Washington Laundry (Frederick Crescent), and New London Brewery (Durham Street). 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—12 letters dealing with leged smoke nuisances connected with: Beaton and Co. (Chapel Road, West Norwood); Beattie and Co. (39 Lower Kennington Lane); 66a Brixton Road (Bakery); Causton & Clo. (Clapham ,Road); Fife Laundry (39-41 Southville); 60 Glasshouse Street (Bakery); Guardians' Infirmary (Brook Street); Jews' Hospital (West Norwood); 25 Kenbury Street (Bakery); New London Brewery (Durham Street); Rogers & Cook Laundry (South Lambeth Road); Sunnybank Laundry (South Lambeth Road); South London Electricity Supply Company (Bengeworth Road); Union Jack Club (Waterloo Road). 2. Coal Smoke Abatement Society—7 letters dealing with alleged smoke nuisances connected with: Charing Cross & Strand Electricity Supply Company (Commercial Road); Dewar's Wharf (Commercial Road); Holloway Brcs. (Belvedere Road); Lion Brewery (Belvedere Road); Doulton (Albert Embankment); Meredith & Co. (Belvedere Road); L. & S. W. Railway (Waterloo Station). 121 WORKSHOPS.* During 1908, 93† new Workshops have been added to th Register,‡ consisting of the following:— Name of Trade or Business. No of Workshops. Dressmakers 29 Laundries 21 Milliners 3 Tailors 10 Blouses 8 Furrier 1 Mantles 2 Clothing Cleaners 1 Dressing Gowns 1 Packing 1 Upholstery 1 Horse Shoe Pads 1 Underclothing 2 Rag Sorting and Marine Stores 2 Corsets 1 Paper Sorting 1 Ties and Belts 2 Embroiderers 1 Shirts 1 Waistcoat Makers 2 Doll Dressing 1 Box Making 1 Total 93 *The new Factory and Workshop Act, 1901, came into force on January 1st, 1902, and entails much extra work, e.g., outworkers, etc. 4Excluding 13 factories, viz.:—6 laundries, 3 printing, 1 wood-chopping, 1 theatrical properties, 1 dyer and cleaner, and 1 blouse maker. ‡The Register contains (up to the end of 1908) a total of 1530 workshops with 2549 workrooms. 122 Full particulars concerning these 93 Workshops have been entered up in the Register, and ic is found that there are connected therewith 141 workrooms, in which were working at the time of inspection 242 persons—49 males and '293 females (females alone being employed in 49 workshops). There were found being employed— M. F. Total. Children — — Young Persons 4 51 55 Adults 45 242 287 49 293 342 37 Notices as to "protected persons" (i.e., children, young persons, and women) employed were sent on during 1908 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). 34 Notices of occupation of 33 workshops have been received during 1908 by the Borough Council from the Factory Inspectors, as compared with 69 during 1907, 39 during 1906, 16 during 1905, 28 during 1904, 62 during 1903, 25 during 1902, and 32 during 1901, and 3, 32, 60, 31, and 29 received by the late Vestry during the five years 1886-1890 respectively. 9 written Notices have been received during 1908 by the Borough Council from the Factory Inspectors with reference to contraventions of the Public Health Acts in ccnnection with Factories and Workshops, and all such nuisances have been abated, and due notice sent to the Factory Inspectors within one month as to action taken in each case. The number of notices received in 1907, 1906, 1905, 1904, 1903, 1902 and 1901, were 11, 17, 9, 10, 9, 5 and 17, as compared with 16, 8, 27, 25 and 66 received by the late Vestry during the five years 1886-1890 respectively. 123 In connection with the 93 new workshops inspected during 1908, the following insanitary conditions were met with at the time of inspections:— 1. As to Ventilation and Wanning and Lighting. In 1 out of the 93 workshops (i.e., 1.1 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 10 workshops (i.e., 10.8 per cent.), the workrooms were found to be dirty and to require cleansing. 3. As to Sanitary Appliances. In 13 (i.e., 13.9 per cent.), the sanitary fittings and appliances were found to be bad. The w.c.'s were outside in 48.4 per cent., inside in 29.03 per cent., and outside and inside in 22.6 per cent. The soil pipes were found to unventilated, or insufficiently ventilated in 17 cases (i.e., 18.3 per cent.) a condition of things which may, or may not, be a nuisance; but in no case was there found to be direct communication between w.c.'s and workrooms. 4. As to Dampness. In 1 workshop (i.e., 1.1 per cent.), the workroom was found to be damp. 5. As to Overcrowding. The cubic capacities of the different workrooms were, naturally, found to vary considerably, and in 13 workrooms (i.e., 9.2 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 124 Inspectors in connection with outworkers, etc., is dealt with on pages 128-133. The inspections made during 1908 in connection with the 13 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 13 factories there were found to be 49 workrooms, wherein was employed, at the time of inspection, 396 persons—15 young persons (females) and 381 adults (76 males and 305 females). The importance of workshops and workplaces being kept under constant supervision is new admitted by all, and the details tabulated in the present Report go to shew the great increase of work thrown upon a Sanitary or Health Authority in the systematic carrying out of the provisions of the Factory and Workshop Acts. In this connection, the value of the work of the Female Sanitary Inspectors is noteworthy (vide Special Report dealing with this particular work, pp. 128-133). 125 WORKSHOPS REGISTERED DURING 1908. Number of Rooms and Persons Employed. New Wards and Male Inspectors in change thereof. No. of Workshops. No. of Workrooms. Children. Young Persons. Adults. TOTALS. M F. M. F. M. F. M. F. Total. Marsh Scorrer 5 12 - - - 1 3 20 3 21 24 Clements 7 10 — — — 3 3 4 3 7 10 Bishop's Hooper 9 16 — — — 6 9 27 9 33 42 Prince's Howes 5 6 — — — 22 — 10 — 32 32 Jones 14 24 — — — — 2 34 2 34 36 Vauxhall Jackson 6 11 - - - - - 28 28 28 Stockwell Baxter 10 12 — — — 2 — 32 — 34 34 Brixton Gavin 15 16 — — 2 9 19 36 21 45 66 Bott 8 14 — — — 2 4 18 4 20 24 Tulse Hill Wallis 5 8 — — 2 1 2 8 4 9 13 Smith 6 7 — - - 5 1 21 1 26 27 Norwood Barfoot 3 5 — — — — 2 4 2 4 6 Total 93 141 - — 4 51 45 242 49 293 342 N.B,—With 2 exceptions, the Inspections were made in connection with the above 93 Workshops by the Female Inspectors. 126 12 7 WORKSHOPS:—Details as to Sanitary Conditions and Defects found during 1908. Details as to Sanitary Conditions and Defects found. • Old Parish Districts, and the Inspectors in charge thereof. Totals. Marsh. Bishop's and Prince's Vauxhall and Stockwell. Brixton. Tulse Hill, No wood. Scorrer. Clements. Hooper. Jones. Howes. Jackson. Baxter. Gavin. Bott. Wall is Smith. Barfoot Ventila- tion satisfactory 5 7 9 14 5 6 10 15 8 5 6 2 92 not — — — — — - - - - - - 1 1 Cleanli ness satisfactory 5 7 9 13 4 6 6 14 7 4 6 2 88 not — — — 1 1 — 4 1 1 1 — 1 10 Workrooms damp - - 1 — — - - - - - - - 1 not 5 7 8 14 5 6 10 15 8 5 6 3 92 Workrooms warm 5 7 9 12 5 6 10 15 8 5 6 3 91 not — — — 2 — — — — — — — — 2 State of sani tary fittings, & C, good 5 6 9 14 5 6 8 13 4 4 5 2 80 bad — 2 — - — — 2 2 4. 1 1 1 13 Soil pipe ventilated 3 4 7 6 2 5 8 10 6 4 6 2 63 not ventilated 1 3 1 7 2 1 1 - - - - 1 17 no soil pipe 1 - 1 1 1 - 1 5 2 I - - 13 Position of W.C. outside 4 5 5 9 3 3 2 5 4 1 2 2 45 inside - 1 3 3 - 3 3 6 - 4 4 - 27 outside and inside 1 1 1 2 2 - 5 4 4 - - 1 21 No W.C— — — — —- — - - - - - - - - Separate W.C accommodation Yes 4 7 7 8 3 5 4 7 4 1 2 1 53 No 1 — 2 6 2 1 6 8 4 4 4 2 40* Communicatication (direct) between W.C.s & roon Yes - - - - - - - - - - - - - No 5 7 9 14 5 6 10 15 8 5 6 3 93 N.B.—The Wards of the old Parish of Lambeth are retained so that this Table may be comparable with those in previous Reports (1897-1907). The above 93 Wtrkshops (with 2 exceptions) were inspected by the Female Sanitary Inspectors. *In only one of these 40 cases was separate W.C. accommodation required —persons of one sex only being employed in the otl er 39 cases. 128 FEMALE SANITARY INSPECTORS. 1908 is a year's record of useful wcrk carried out by the Female Sanitary Inspectors (Miss Dawson, Miss Gamble and Miss Pearson)* in connection with (a) Factories, Workshops (Work-places)t, Shops, Out-Workers' Homes, Laundries, eic., wherein women and girls ar<: employed; (b) Underground Conveniences (belonging to the Council), and other Ladies' Sanitary Conveniences (Railway Stations, Hospitals, etc.); (c) Houses wherein births have occurred, or deaths amongst infants under 1 year of age, or deaths from infantile diarrhoea; (d) schools wherein there have been infectious disease outbreaks; etc. The year's work, 1908, may be tabulated as fellows :— Summary of work carried out by Female Sanitarv Inspectors during the year 1908, and during the preceding six years 1902-7 (for comparison). 1908 1906 1905 1904 1903 1902 Workshops† visited and inspected— 1907 (a) Dressmakers 108 228 103 80 157 142 (i) Milliners 18 41 21 14 12 20 (c) Laundries 03 145 17 37 72 70 (d) Tailors 44 57 22 7 22 14 (e) Upholsterers 6 10 1 — — 1 ( f) Dyers 6 3 1 2 2 1 (g) Others 78 98 59 23 48 32 Workrooms inspected 693 1014 330 495 669 325 Workshops† re-inspected 109 273 81 98 163 333 Word rooms re-inspected 143 370 90 113 214 305 Restaurants, etc., re-inspected 373 1081 — — 87 118 Workshops† workrooms therein measured 475 673 314 265 450 318 Workshops† removed from Register 165 155 32 9 19 29 Workshops†reported to H.M. Inspector 37 63 63 31 19 48 Workshops† repored by H.M. Inspector 43 142 22 13 46 3 Workshops† newly discovered & registered 93 220 ‡92 69 152 102 § Premises visited but no female hands found to be employed (including Out-workers) 1055 2512 259 135 231 80 * Miss Gamble was elected on October 3rd, 1901, Miss Pearson, on December 8th, 1905 (resigned September 30th, 1908), and Miss Dawson, on September 21st, 1908. t Workshops include Workplaces. t Including 13 factories. Female Conveniences visited & inspected— 1908 1906-7 1905 1904 1903 1902 Public (visits paid) 599 1116 577 597 343 276 Private (visits paid) 16 15 — — 5 35 Schools visited— Public 27 32 18 13 20 10 Private 2 5 1 2 — 1 Special places visited and inspected— (/z) Restaurants and Hotels, etc. - - 1 - 22 220 (6) Private Houses 705 2651 224 322 218 199 (c) Out-workers 202 359 145 134 107 — Others — — — — 3 5 Written Intimations and Statutory Notices served 341 1071 194 200 198 262 No. of Workshops, etc., in which no defects were found on inspection †918 2460 507 508 371 382 No. of Workshops in which defects were found on inspection †376 1223 245 254 292 322 Particulars oj defects found. Work rooms— Overcrowded 13 42 14 11 16 4 Damp 38 64 9 10 13 7 Dirty 136 468 135 184 217 208 III-ventilated 6 17 2 1 5 7 Otherwise 2 13 3 — — 3 Defects— Yards 34 127 11 12 19 29 Floors 14 37 4 11 18 19 Roofs 9 43 5 6 13 7 Windows 3 6 — 1 — 4 Ceilings 34 83 6 9 23 17 Rain Water Pipes 2 18 4 5 9 13 Premises generally 2 27 — 4 5 9 Sanitary Appliances: Waterclosets — Dirty 150 324 83 64 83 86 III-lighted 5 2 1 — — 1 Unventilated 4 21 7 1 16 5 Choked 22 57 5 3 3 16 Defective 53 112 44 28 51 44 Defective Flushing Tanks and Water Supply 69 218 39 35 43 91 No separate suitable accommodation for the sexes 4 21 7 1 8 Drainage— Defective, unventilated, etc. 2 45 2 6 7 9 Excluding the 1055 premises wherein no female hands were found to be employed. 129 I 130 $$$]Dustbins— 1908 1906-7 1905 1904 1903 1902 Wanting 17 120 25 31 49 72 Defective 52 188 23 21 33 34 Lavatories— Defective or dirty 17 24 12 2 8 Miscellaneous defects (not included above)— Animals improperly kept 1 8 1 1 3 20 Accumulations in yards 3 11 9 7 2 Sink wastes defective. 12 16 — — 8 Otherwise - 1 — — 1 — Nuisance referred to M. O. H. for attention by Male Inspectors (defective drains, w.c.s, etc.) 66 209 48 59 86 68 Miss L. M. H. Pearson, who was appointed on November 23rd, 1905, as Sanitary Inspector to the Borough, resigned her position on July 13th, 1908, owing to her appointment as one of His Majesty's Inspectors, under the Home Office, and ceased her duties in Lambeth on August 31st, 1908. The Council on September 31st, 1908, appointed Miss F. M. Dawson, of Bradford Corporation, as Sanitary Inspector for the Borough vice Miss L. M. H. Pearson, resigned, and she commenced her duties in Lambeth on November 1st, 1908 (her appointment having beefi confirmed by the Local Government Board on October 21st, 1908). The Female Public Conveniences are under constant supervision by the Female Inspectors, 599 visits having been paid thereto during 1908. The Female Inspectors have during' T908 be'en etlgaged in visiting 136 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 (29), and.the homes of the scholars, in connection with outbreaks "of d:sease (more especially measles)i- It will be noted, in connection with the inspections and re-inspections of workshops and workplaces (where women 131 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 13 cases—in each instance being slight. OUT-VVORKEKS. The work commenced by the Female Inspector in 1903, and continued during 1904, 1905, 1906 and 1907 connected with the visiting and inspecting of out-workers premises and homes (situated within the Borough of Lambeth), has been further continued during 1908. This is a special duty devolving upon the Be rough 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. The 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, ship, or similar mater'al; pea-picking ; feather sorting ; the carding, boxing, or packeting of buttons, hooks anl eyes, pins and hairpins; and baskets. During 1903-8, a total of 947 out-workers' premises have been inspected and registered (202 during 1908), connected with the following trades and businesses :— i 2  1903 1904 1905 1906-7 1908 Mantles 6 12 20 17 12 Blouses and Skirts 10 14 24 43 22 Ties and Belts and Braces 24 19 14 28 15 Baby Clothing 6 4 4 5 2 Children's Underclothing and Costumes 5 10 9 13 4 Women's Underclothing 5 2 7 15 18 Tailors 10 15 8 62 17 Upholsterers 1 — 1 2 2 Embroidery 9 3 9 15 15 Dressing Gowns 2 5 3 1 3 Shirts 13 7 7 4 — Aprons & Overalls 1 — 2 — 1 Waistcoats 4 3 4 34 15 Jerseys 2 — 1 1 — Hosiery 1 — — 1 — Widows' Caps 1 — — 1 — Men's Caps 1 1 1 3 — Vamp Beader 1 — 1 1 — Wigs 2 — — - — Incandescent Mantle? 1 - — — — Boots and Shoes 1 4 2 18 23 Umbrellas 1 — — 2 — Dresses — 9 7 2 8 Waterproofs — - — 2 — Millinery — 2 5 6 6 Collars — 3 3 5 7 Sacks — 1 — — — Paper Bags — 2 2 8 5 Boxes — 4 2 27 8 Mattresses — 1 — — — Lace — 2 1 1 — 132 133  1903 1901 1905 1906-7 1908 Pinafores — 1 — — — Sheets & Pillow Cases — 4 — 2 Smocking — 2 1 4 — Needlework — 1 1 1 — Curtains and Blinds — — — 2 — Carpets — 1 1 — — Brushes — — — 6 5 Dyers and Cleaners — — 1 2 1 Buttonhole Making — — 1 2 — Book Folding —- — — 1 — Straw Hats — — 1 - — Bottle Covering — — 1 —. .— Fur-pulling — — 1 3 4 Artificial Flowers - — — 11 4 Silk Hats — — - 4 — *Unclassified - - — 4 5 Totals 107 131 145 359 202 The New Wards in which the houses (wherein these 947 out-workers were found to be woiking during 1903-8) are situated, are as follows :— 1903 1904 1905 1906-7 1908 Marsh 12 14 8 75 15 Bishcp's 10 16 29 33 20 Prince's 38 13 18 73 32 Vauxhall 12 4 5 17 15 Stockwell 18 9 19 34 29 Brixton 17 37 42 71 46 Heme Hill — 26 12 31 25 Tulse Hill — 10 8 11 13 Norwood — 5 4 14 7 Totals 107 134 145 359 202 * Pyjamas 2, initialing linen 1, chair caning 2. 134 UNDERGROUND CONVENIENCES. The conveniences have been kept under regular inspection during 1908—the male conveniences by the male inspectors and the female conveniences by the female inspectors. Mrs. Luckett, one of the attendants, has resigned, on account of ill-health, after 14 years' service, and has been awarded an allowance of 5/2 per week. She is 65 years cf age. The new Underground Convenience (Males and Females) CDnstruded at Brockwell Park (Heme Hill Entrance) was opened to the public on October 2nd, 1908. The total cost was ^2,310 15s. 2£d. The proposed new Underground Convenience (Males and Females), to be constructed at Kennington Gate, in the detached triangular portion of Kennington Park, has been abandoned during 1908 on account of the L.C.C. requiring 2 free w.c.'s for each sex to be provided. The proposed new Underground Convenience (Males and Females), to be constructed at the Crystal Palace Parade, has also* been abandoned—at least, temporarily, owing to want of agreement amongst the 4 Sanitary Authorities concerned (Camberwell, Lambeth, Croydon, and Penge), but an overground one has been temporarily provided for males on the western side of the Parade, and was opened to the public on December 1st, 1908. The total cost of constructing this Overground Urinal was ^121 8s. 7d. (^52 8s. 5d. being for drainage work). Conjoint Underground (and other) Conveniences outside, but near, the Borough Boundaries.—At the instigation of the Lambeth and other Metropolitan Borough Councils, the London County Council, on October 20th, 1908, decided to apply to Parliament in the Session 1909 for powers to be given to Metropolitan Borough Councils to contribute to the construction and maintenance of public urinals c>r conveniences outside but near the Borough boundaries. 135 The Council gave its consent for notices to be fixed in each of the Female Underground Conveniences of the Borough, directing young women and girls, strangers in the Metropolis, where to apply for advice, or shelter, in case of need. The notices are framed in oak, and have been supplied by the London Female Preventive and Reformatory Institution, of 200 Euston Road, N.W. FEMALE HEALTH VISITOR. Miss Hilda Hewitt Lawrence, of Lincoln, who was appointed by the Council, on October 3rd, 1907, as Female Health Visitor for a temporary period of 12 months, commenced her duties on January 1st, 1908, working throughout the year, off and on, as her health permitted. Unfortunately, Miss Lawrence found her health unsatisfactory and the duties too arduous for her physical capabilities, so that the Council decided, on December 10th, 1908, to allow her temporary 12 months' appointment to elapse ot the end of the 12 months, and to appoint another candidate* for a further temporary period of 12 months from January 1st, 1909, under the same terms, viz., a salary of ^80 per annum, with a nurse's uniform, estimated at (about) ;£,5, the Council to be then in a better position to determine whether the office should be permanently constituted. The report of the year's work of Miss Lawrence is not satisfactory, having regard to the many interruptions arising from her ill-health and consequent absence from duty, the work getting into arrears. These facts must be borne in mind in connection with the work done under the Notification of Births Act, 1907, which was adopted, and came into force on March 9th, 1908, throughout the Borough of Lambeth—giving rise to a very large increase of work, clerical and inspectorial. A total of 3473 *Miss Isabella Sarah Virtue, of Blackburn Corporation, was elected as Health Visitor on January 21st, 1909, commencing her duties on March 1st, 1909. She has had 10 years' experience in private nursing and 4 months in midwifery practice, and is highly qualified (Central Midwives Board and Royal Sanitary Institute certificates). 136 births have been notified up to the end of 1908 (10 months), and in connection therewith visits have been paid by the Health Visitor to the houses of the parents, for the purpose of advising the mothers as to the proper rearing of infants by breast or natural feeding, or failing breast fetding, by suitable artificial feeding; or pamphlets, dealing with the same subjects, have been sent to the parents by post. No visits were paid to the houses by the Council's Health Visitor until after the iMedical man or Midwife had ceased professional attendance, and such visits bv the Health Visitor have been much appreciated by the mothers of the babies. Births notified in connection with Lying-in Hospitals, Workhouses, &c., were not dealt with, no visits being made nor pamphlets sent. Full statistical details will be published in future Reports, as to the results obtained from the enquiries made under the notification of Births Act, when the Act has been in force over 12 months. ANALYSIS OF FOOD AND DRUGS, WATER, &c. 1.—Food and Drugs. During the year 1908, 1800 samples have been purchased within the Borough of Lambeth, and submitted to the Public Analyst for analysis. Of the 1800 samples, 153 (i.e., 8.5 per cent.) were reported by the Analyst to be adulterated, varying quarterly as follows:—1st quarter, 9.4 per cent. ; 2nd, 8.2 per cent. ; 3rd, 10.9 per cent. ; and 4th, 5.8 per cent. ; and 109 summonses were issued, with the result that 76 convictions were obtained, together with ;£88 4s. 6d. in penalties, and £72 lis. 7d. in costs. In 12 cases the vendors were cautioned. Full details are to be found on pp. 144-147, and in the Appendix (pp. 27-50). Taking the average of 10 years (1891-1900), the annual number of samples taken in the old Parish of Lambeth is 137 501, 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, 1500, and 1800 samples were taken during 1901, 1902, 1903, 1904, 1905, 1906, and 1907, respectively. During 1908, no samples were submitted to the Public Analyst by private purchasers. Particulars of the 1800 articles submitted by the Food and Drugs Inspector during 1908 are as follows :— (a) Milk. 838 samples were taken, and of these 78 (i.e., 9.3 per cent.) were declared by the Analyst to be adulterated. 2 of the samples were purchased as "separated" milks (none adulterated). The 78 adulterations found were as follows :— (1) Extraneous water (31), varying from a minimum 2 to a maximum 22 per cent., viz., 2, 2, 2, 3, 3, 3, 3, 4, 4, 4, 4, 5, 5, 5, 5, 5, 6, 6, 7, 7, 8, 9, 9, 9, 10, 12, 13, 14, 20, 22, 22, respectively. (2) Deficiency in milk-fat (43), varying from a minimum 1 to a maximum 38 per cent, viz.—1, 3, 3, 4, 4, 4, 4, 5, 5, 5, 5, 6, 6, 6, 7, 7, 7, 7, 8, 9, 9, 10, 10, 10, 10, 11, 11, 12, 12, 12, 13, 13, 13, 14, 16, 16, 18, 19, 20, 22, 23, 33, and 38 respectively. (3) Extraneous water and deficiency in milk-fat (4), viz. —2 and 5, 4 and 6, 5 and 6, and 7 and 22 per cent, respectively. In 78 samples of milk adulteration, 67 summonses were taken out, and in 41 cases convictions were obtained, with penalties varying from a minimum 3/6 (with 16/6 costs) to a maximum £10 (with 16/6 costs). In 4 cases, no penalty was inflicted, but simply costs were allowed. 138 In the remaining 26 cases, the results of the summonses were as follows :— (a) Summonses dismissed (15), on account of the following legal technicalities: warranties proved, 8*; third sample bottle burst, 1 ; contrary proved, 3 ; defective cooler, 2 ; and summonses wrongly worded (together with difference in Somerset House sample), 1. (b) Summonses withdrawn (10), on account of the following legal technicalities : Contrary proved, 7; doubt about warranty, 1 ; late service of summons, 1; and defective cooler, 1. (c) Summonses adjourned sine die (1), on account of the following legal technality, viz. : Defendant having left his address before the hearing of the summons. In 11 cases no summonses were taken out for the following reasons : (1) amounts of adulteration too small (10); (a) extraneous water, 2, 2, 3, 5 and 6 per cents, respectively; (b) fat deficiency, 1, 3, 4, 5 and 8 per cents, respectively; (2) milk consigned to Liverpool Street Station, outside the Borough of Lambeth. The total fines amounted to ^,49 4s. with ^46 8s. 4d. costs. (b) Butter. 614 samples of butterf were taken, and of these 38 (i.e., 6.2 per cent.) were declared by the Analyst to be adulterated —the adulterations consisting of (1) added margarine (26), varying from a minimum 10 per cent, to a maximum 100 per cent., viz. : 10, 45, 46, 55, 60, 76, 80, 86, 86, 88, 90, 90, 93, 93, 93, 94, 94, 95, 96, 96, 97, 99, 100, 100, 100, 100, respectively; (2) margarine exposed for sale without properly labelling the same (11); (3) added preservative to extent of 28 grs. of boric crys. acid per lb. (1). "With £5 5s. costs against the Council in one instance, tlncluding 12 test samples of Irish Butter (3 adulterated, but no summonses taken out). 139 In 38 samples of butter adulteration, 21 summonses were taken out, and in 19 cases convictions were obtained with penalties varying from a minimum 5s. (with 16s. 6d. costs) to a maximum £5 (with 16s. 6d. costs). In the remaining two cases, the results of the summonses were as follows :— (a) Summons dismissed (1)—Defendant being convicted the same day in connection with another case. (b) Summons adjourned sine die (1)—Defendant ill, and afterwards leaving his shop. In six cases no summonses were taken out tor the following reasons, viz. : (1) Article served in printed wrapper (1); (2) defendant left the neighbourhood after the service of the summons (1); (3) test samples (3); (4) added preservative (28 grs. per lb. of boric acid) being below the amount suggested by the Departmental 1901 Committee (1). The total fines amounted to ^'37 10s. 6d. (with ^,"22 19s. 3d. costs). (c) Margarine. 24 samples of Margarine were taken, and of these 1 (i.e., 4.2 per cent.) was declared by the Analyst to be adulterated, with 27 per cent, of Butter. The vendor was ordered to pay 16/6 costs. (d) (Coffee. 165 samples were taken, and of these 3 (i.e., 1.8 per cent.) were declared by the Analyst to be adulterated—the adulterations consisting of added chicory to the extent of 17, 45 and 72 per cent., respectively. Summonses were applied for, and convictions obtained, in 2 of the cases with 10/0 penalty and 16/6 costs in one, and 16/6 costs in the other—total 10/0 penalties and ;£l 13s. 0d. costs. 140 In the other adulterated case (17 per cent. Chicory) no action was taken, the article being served in a printed marked wrapper. Two samples were purchased as French Coffee, and in these cases no summonses were applied for, although the Analyst declared them to contain, respectively, Chicory 66 and 40 per cent, (not in adulteration). (e) Other Groceries. 25 samples of Mustard, 35 of Pepper, 3 of Demarara Sugar; but none were declared by the Analyst to be adulterated. (/) Drugs. 3 samples were taken, and of these 1 (i.e., 33.3 per cent.) was declared by the Analyst to be adulterated, viz., Decoctum Aloes Co. being deficient in Alcohol to the extent of 64 per cent. A summons was taken out, but withdrawn on a legal technicality, i.e., the Analyst's certificate being irregular. (g) Other Articles- 26 samples of Lard, 5 Vinegar (1 malt), 3 Oatmeal, 2 Pea Flour, 1 Wheaten Flour, 3 Ground Rice, I Bread, and 1 Sweetmeats were taken, but not one was declared by the Anaylst to be aduterated; whilst, in addition, 42 samples ot German Sausage (30 adulterated), 5 Brawn (1 adulterated), and 2 Pork Sausages (1 adulterated) were also taken. The Samples of Sausage and Brawn were declared by the Analyst to be adulterated as follows :— Brawn (1)—3 grs. Crys. Boric Acid per lb.; Pork Sausage (1)—14 grs. Crys. Boric Acid per lb. ; German Sausage (30) 1½, 1½, 1½, l½, 1½, 2½, 2½, 3½, 4, 4, 5½, 6, 6, 8, 8½, 10, 10, 11, 13, 16, 16½, 18, 18½, 19. 20, 141 22, 29, 30, 32½, and 33 grs. Crys. Boric Acid per lb., respectively. 5 summonses were taken out in connection with 5 samples of German Sausage, containing 20, 22, 30, 32½, and 33 grs. Crys. Boric Acid per lb-, respectively, with the following results :— 20 grs.—Dismissed, with ^15 15s. costs against the Council, no harmful adulteration proved; 22 grs.—Dismissed, no harmful adulteration proved; 30 grs.—Dismissed under section 15 of the Food and Drugs Act, 1875 ; 32J grs.—;£l penalty and 14/6 costs; 33 grs.-—Dismissed under section 15 of the Food and Drugs Act, 1875. In the other 27 adulterated samples, the amounts of adulteration were too small. The total fines amounted to £l with 14/6 costs. Summary oi- Legal Proceedings taken under the Sale of Food and Drugs Acts. Of the total 109 summonses taken out, there were convictions in 76 cases, whilst in the remaining 33, the results were as follows :— 20 summonses dismissed— (a) Warranty proved satisfactory, 8; (b) Amount of adulteration (preservative) not harmful, 2 ; (c) Under sections of the Food and Drugs Act, 1875, 2 ; (d) Contrary proved satisfactorily, 3 ; (e) Defective cooler proved, 2 ; 142 (/) Summons wrongly worded, and Somerset House analysis disagreeing as to amount ot adulteration, l; (g) 3rd sample bottle burst in Court, 1 ; (h) Defendant convicted the same day in another Food and Drugs case, 1. 11 summonses withdrawn— (a) Contrary proved satisfactorily, 7; (b) Analyst's certificate irregular, 1 ; (c) Defective cooler proved, 1; (d) Dcubt as to warranty, 1; (e) Legal technicality (28 days limit exceeded), 1. 2 summonses adjourned sine die— (a) Defendant having left the neighbourhood, 1 ; (b) Defendant having been taken ill and having, afterwards, left the neighbourhood, 1- Names of Milk-Blended Butters. During 1908, the following names have been approved by the Board of Agriculture and Fisheries, as required by section 9 of the Butter and Margarine Act, 1907, with reference to milk-blended butter:—Alimo, Bradlac, Brenco, Camlaw, Casa, Casana, Casmon, Casoa, Casora, Casova, Consumo, Dalphine, Debeco, Esselbee, Froco, Fromaid, Iveldale, Iveldene, Ivelette, Ivelmore, Jensa, Kingstyle, Maldar, Me-no, Nolax, Pearks' Breadmate, Pearks' Bredspred Pearksown, Samaline, Seeandwi, Ve-vo, and Vivum. Sampling under the Sale of Food and Drugs Acts, , 1875 to 1907. Section 2 of the new Butter and Margarine Act of 1907, which came into force on January 1st, 1908, gives power to the Officers of a Local Authority, who are authorised to 143 procure samples under the Sale of Food and Drugs Acts, like powers of entry, inspect:on and sampling as regards any premises registered with the Authority as a Butter Factory, if such Officers are specially authorised on that behalf by the said Authority. The Council, therefore, gave this authority to the 15 Sanitary Inspectors, and, at the same time, authorised the performance of all duties under the Sale of Food and Drugs Acts, 1875 to 1907, under the direction of the Med cal Officer of Health as is the case with the Sanitary Inspectors' other duties, as laid down in Article 19 of the Sanitary Officers (London) Order, 1891, made under the Public Health (London Act, 1891. Warranties under the Food and Drugs Acts. On October 1st, 1908, the Council resolved to write to the Local Government Board and the Board of Agriculture and Fisheries, drawing attention to the present anomalous and unsatisfactory state of the law in respect to warranties under the Food and Drugs Acts, and asking that steps shall be taken to place the law in a clearer and more equitable position. Expenses of carrying out the Food and Drugs Acts. The total expenses connected with the carrying out of the Food and Drugs Acts in Lambeth Borough during 1908 amounted to £84 14s. 6d., and are made up as follow:— £28 8s. 8d. for samples, £21 9s. for assistant, ,£,11 7s. for witnesses, ;£l7 14s. 1d. for travelling expenses (including £8 7s. 6d. for cabs) and £5 15s. 9d. 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 18s.) are not included. For comparison, the total expenses during the past few years are tabulated as follows :— 144 Year. Total Expenses. Numbers of Samples. £ s. d. 1903 81 0 5 1010 1904 89 19 10 1200 1905 84 2 0 1200 1906 98 9 2 1500 1907 55 4 1* 1800 1908 84 14 6 1800 II. WATER. No samples of water were officially examined chemically during 1908 (vide Bacteriological Report, p.172). SALE OF FOOD AND DRUGS ACTS. Samples procured, together with the results of Analyses, during the year 1908. Samples. Number Analysed. Number Adulterated Milk 836 78 Separated Milk 2 — Bulter 602 35 „ Irish 12 3 Coffee 165 3 •Work done by District Inspectors and Female Inspectors, during the 9 months illness of the Food and Drugs Inspector. 145 Samples. Number Analysed. Number Adulterated German Sausage 42 30 Pepper 35 — Lard 26 — Margarine 24 1 Mustard 25 — Brawn 5 1 Vinegar 4 — Demarara Sugar 3 — Ground Rice 3 — Oatmeal 3 Drugs 3 1 Pork Sausage 2 1 Pea Flour 2 — Sweetmeats 1 — Wheaten Flour 1 — Bread 1 — Malt Vinegar 1 — French Coffee 2 — Totals 1800 153 k 146 Shewing percentage of different adulterated Samples during 1908 (Borough), and in ten years 1891-1900 (Parish). Year. Milk. Butter. Coffee. Bread and Flour. Cocoa and Chocolate. Cheese and Lard Other Groceries. Sundries. Spirits. Brandy. Gin. Rum. Whisky. Ale and Porter. Wines. Aerated Waters. Drugs. Boro' Council 1908 9.3 6.2 1.8 0.0 - 0.0 0.0 * 41.8 - - - - - - - - 33.3 Late Vertry. 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 13.6 14.5 10.3 - 0.0 0.0 0.0 0.0 11.1 - 0.0 50.0 5.9 - - - 18.8 1897 10.5 7.3 3.03 0.0 0.0 0.0 2.0 11.1 17. 7 - 25.0 18.2 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 21.05 14.7 26.4 - 0.0 0.0 0.0 16.6 16.0 - 12.5 25.0 - . 0.0 0.0 12.5 1894 27.6 22.4 30.0 - 0.0 0.0 5.3 0.0 0.0 0.0 0.0 0.0 0.0 - - - 0.0 1893 30.4 35.04 11.1 0.0 18.2 0.0 3.3 0.0 8.7 20.0 0.0 0.0 11.1 - - - 0.0 1892 31.3 36.4 18.4 - 66.7 0.0 2.1 0.0 0.0 0.0 0.0 0.0 - 0.0 - - 0.0 1891 47.8 5.0 3.8 0.0 - - 2.6 0.0 0.0 0.0 0.0 - 0.0 0.0 . 0.0 0.0 0.0 means that all samples were reported to be genuine and unadulterated.—means that no samples were taken during the year. *The Sundries include, German Sausage, Brawn, Pork Sausage, Vinegar, Sweetmeats, and Margarine. 147 Particulars as to samples analysed, and proceedings taken, during 1908 (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 1908 1800 153 8.5 109 76 12 £ s. d. £ s. d. 88 4 6 72 11 7 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. 20 Summonses were dismissed, 2 adjourned sine die, and 11 withdrawn, during 1908 148 HOUSES LET IN LODGINGS. The 372 registered houses have been visited regularly, but no new house has been registered under the Bye-laws during 1908. COMMON LODGING HOUSES. The 6 Common Lodging Houses (for men), situated within the Borough of Lambeth, have been inspected during 1908, a broken w.c. pan being found at 90-92 Westminster Bridge Road and defective drains at 106 (formerly 126) Wandsworth Road, and these defects having been remedied, have been again licensed by the L.C.C. at the Annual Licensing Meeting held June 22nd, 1908, in accordance with the requirements of Section 46 of Part IX. of the London County Council General Powers Act, 1902:— Authorised Date when registered. Situation. No.of Lodgers. 27th January, 1905 10a | Belvedere crescent 99 18th July, 1900 108 Lambeth walk (c.h.) 39 (house in rear) 30th October, 1890 55 Belvedere road 49 21stDecember, 1883 90-92 Westminster bridge 197 road 24th October, 1885 89 & 91 Wandsworth road 188 12th February, 1887 106 Wandsworth road 133 HOUSING OF THE WORKING CLASSES. No house has been condemned during 1908 under the Housing of the Working Classes Acts, but in this connection it must be remembered that, in respect of dwelling houses, many notices have been served under the Public Health Act, and that, had these notices not been complied with, 149 ceedings 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 1908, 363 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, 92 have been granted unconditionally, 21 have been granted conditionally, i.e., subject to certain alterations and improvements being carried out, and 250 have been refused. Certificates granted unconditionally. Address. Blocks or Houses. Tenements. Coldharbour Lane, 105 1 3 Gipsy Road, 130 to 172 and 176 to 180 (even Nos.) 25 50 Hamilton Terrace, Shakespeare Road, 20, 21, 22 3 6 Lambeth Walk, 79 l 3 (1 shut-up shop) Lollard Street, 74 to 79 6 12 Northlands Street, 3 1 3 Saunders Street, 20, 21, 22, 23, 24, 25 6 12 Wandsworth Road, 132a, 132b, 132c 1 3 Totals 44 92 150 Certificates granted conditionally. Address. Blocks or Houses. Tenements Bonnington Square, 57 1 3 Grove, The, 15 1 3 Rosendale Road, 18, 20, 35 3 13 Strathleven Road, 49, 49a 1 2 Totals 6 21 Certificates refused. Dante Road, 6 to 42 (even Nos.) 19 76 Holvoake Road, 1 to 19 (odd Nos.) and 2 to 72 (even Nos.) 46 174 Totals 65 250 BAKEHOUSES. There are 214 Bakehouses (135 above ground and 79* underground) situated within the Borough of Lambeth, and these have been inspected during 1908, and the necessary annual white-washing and cleaning carried out. OFFENSIVE TRADES. During 1908, 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. 151 1. Fat Melters—Upper Marsh (Messrs. J. C. & J. Field). 2. Tallow Melters—144 Broadwall (Messrs. Harris, Blackman & Sons). 3. Soap Boilers—Upper Marsh (Messrs. J. C. & J. Field). 4. Soap Boilers—144 Broadwall (Messrs. Harris, Black- man & Sons). 5. Tripe Boilers—103 Lambeth Walk (Messrs. Bennett, Son & Co.) 6. Tripe Boilers—115 Lower Marsh (Messrs. Bennett, Son & Co.) SLAUGHTER-HOUSES. There were within the Borough of Lambeth at the end of 1907, 24 registered Slaughter-houses, and at the annual Licensing of the London County Council, held on October 26th, 1908., the licenses were all renewed. LIST OF THE 24 SLAUGHTER-HOUSES LICENSED IN THE BOROUGH OF LAMBETH DURING 1908. Ward. Situation of Premises. Name of Licensee. Marsh 99 Lower Marsh* Holdstock, Jno. Thos. „, 106 ,, ,, Thomas, Robert Edwin Bishop's 151 Lambeth Walk Wright, Samuel Prince's 4 Clapham Road Holdsworth,Chas. ,, 60 Kennington Park Road Grellier,Frederick •Small cattle only to be killed. 152 Ward. Situation of Premises. Name of Licensee. Prince's 406 Kennington Road Parsons, Bernard William ,, 171 Lower Kennington Lane Clark, Arthur Vauxhall 152 Clapham Road Lawrence Bros. ,, 302 Clapham Road Holdsworth, Geo. ,, 18 Paradise Road (rear of) Smith, Wm. Geo. ,, 1 Lansdowne Road, Clapham Road Wheeler, Sydney Beaumont (Manager for Mrs. Minnie Mary Copeman) Stockwell 27 Bedford Road, Clapham Rd. Pooley, John Peed Brixton Near Railway Hotel Brewery, Electric Lane, Brixton Elphick, Edwin ,, 263 Brixton Road* Snelling, Ernest William Brixton 10 Foxley Road* Maiden, Robert Levers ,, Industry Terrace (yard leading to), Canterbury Road Warren, James Edward Herne Hill 207 Coldharbour Lane Clark, Albert John ,, ,, 309 ,, Ford, Hy., & Co., Ltd. ,, ,, 77 Dulwich Road Atkin, Jim Cook •Small cattle only to be killed. 153 Ward.] Situation of Premises. Name of Licensee. Tulse Hill 12 Lower Tulse Hill Haydon, William ,, ,, 45 New Park Road Beaumont, Edith Mary (trading as Martin & Beaumont) Norwood 125 Hamilton Road Forss, Thomas Lionel ,, 120 High Street*+ Bull, Mary Ann ,, 121 „ „ (rear of) Griffiths, Fredk. † Special conditions laid down. 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 result. Inspection of the Slaughter-houses within the Borough is now carried out by the officers of the Borough Council, who are responsible for the due enforcement of all 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 1908, minor sanitary defects have been found as follows:-defective paving (1), and dirty premises (3). One slaughter-house has changed hands during 1908, viz: 1 Lansdowne Road, Clapham Road, which is now licensed to Sydney Beaumont Wheeler, Manager for Mrs. Minnie Mary Copeman, the widow of the former licensee (Walter George Copeman). 154 COWHOUSES. There were, within the Borough of Lambeth, at the end of 1907, 14 registered Cowhouses, and at the Annual Licensing of the London County Council, held on October 26th, 1908, the licenses were all renewed. LIST OF THE 14 COWHOUSES LICENSED IN THE BOROUGH OF LAMBETH DURING 1908. Ward. Situation and Premises. No. of Sheds. No. of cows kept Marsh 6 Coral Street, Lower Marsh 1 10 Bishop's 24 Distin Street 2 9 ,, Cambria Cottage, 36 Tracey Street 1 13 Prince's 30 Upper Kennington Lane 1 7 Vauxhall 9 Dawlish Street 1 12 ,, 38 Hartington Road 1 22 Brixton 34 Ingleton Street 1 5 Tulse Hill 196 Norwood Road 1 20 Norwood . 93 Clive Road, West Norwood 1 4 ,, 15Croxted Road, West Dulwich 1 3 ,, Elder Road Dairy, West Norwood 2 35 Norwood 156 Hamilton Road, West Norwood 3 26 ,, 76 and 78 Gipsy Hill 3 27 ,, 67 Rosendale Road 1 10 20 203 Sanitarily, these 14 Cowhouses are in good condition, and they have been inspected during 1908, and the drains in each case tested with the chemical test, and a result obtained in 2 instances, viz., from a broken ventilation pipe and a defective rain water drain, respectively. A few minor sanitary defects were found, e.g., defective paving (1) and dirty premises (4). 155 The Borough Council is now responsible for the periodical inspection of the Cowhouses, and the due enforcement of all Bye-laws and Regulations which have been made in connection therewith under the Dairies, Ccwsheds, 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 1908, no action has been taken in regard to infringement of Byelaws before the Magistrate. Two Cowhouses have changed hands during 1908, viz., 34 Ingleton Street to Frederick and Sarah Amelia Baker (vice Henry Baker, deceased), and 93 Clive Road, West Ncrwood to Wraight, Dumbrill & Co., Ltd. (vice Sidney Adna Benjafield). DAIRIES, MILK SHOPS AND MILKSTORES. 21 new Milk-shops and Milk-stores have been registered during 1908, as compared with 33 during 1907, and all existing ones have been, from time to time, under inspection, as required. The total number registered up to date is 544. MUNICIPAL MILK DEPOT. The Council's Milk Depot, situated at 66 York Road, Westminster Bridge Road, has again effected much good during 1908. 180 new infants and children have been entered upon the Register and fed during 1908, their ages being:— Under 3 months 92 3—6 months 54 6—9 months 19 9—12 months 13 Over 12 months 2 180 156 These 180 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) 48, wasting 101, moribund 6, diseased 25, total 180. The diseases from which the 25 infants and children were actually suffering at the time of being put upon the Depot milk were:—Diarrhoea and sickness 6, bronchitis 4, sickness 7, diarrhoea, 1, crippled 1, consumption of the bowels 2, constipation 1, convulsions 1, and hernia 2. The periods during which the 180 infants and children continued to use the Depot milk were :— 26 weeks and over 19 13—26 weeks 35 6—13 weeks 50 4—6 weeks 19 Under 4 weeks 57 180 It will be noted that 57.8 per cent. used the milk for periods extending from 6 to 26 weeks and over, whilst 31.7 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 pay, the private voluntary benevolent fund which has been opened at the Depot was found useful, though small in amount, several deserving cases being assisted therefrom. The average weekly number of infants and children fed upon the Depot milk during 1908 is 74, varying from a minimum 60 to a maximum 95), and the total number of bot- 157 tles of milk distributed during the year was 179601, giving a weekly average of 3454, and a daily average of 493* Amongst the 180 new infants and children fed upon the Depot milk there have been 8 deaths, but these require careful analysis. Thus, of the 8 infants and children who died, the periods during which they had been fed upon the Depot milk varied from a minimum 3 days to a maximum 13 weeks, thus:— Length of time during which milk was used previous to death. No. of Infants & children fed. No. of deaths. Mortality rate per 1000. (a) Infants and children fed for 26 weeks and over 19 0 nil (b) Infants and children fed 13—26 weeks 35 0 nil (c) Infants and children fed 6—13 weeks 50 1 20 (d) Infants and children fed 4—6 weeks 19 1 53 (e) Infants and children fed under 4 weeks 57 6 105 180 8 44 i.e., the longer an infant or child is fed upon the Depot milk, the better its chance of living. Of class (e), the periods during which the 6 infants and children who died had been fed upon the Depot milk were 24, 12, 7, 4, 4 and 3 days respectively, so that these deaths cannot fairly be classified as deaths connected with the Depot. *See Footnote to Table on pp. 160-161. 158 Including all deaths, the mortality rate for 1908 amongst the new Depot-fed infants and children is 44 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 16 per 1000, whilst the mortality rate amongst infants and children fed upon the Depot milk for 13 weeks and over is nil. The mortality rate amongst infants and children fed upon the Depot milk for periods less than 4 weeks is 105. Thus the rates per 1000 births for 1908 may be tabulated as follows, quinquennial rates being added for comparison: — Depot-fed Infants 44 Whole Borough 134* Marsh 187* Inner Wards 158* The causes of the 8 deaths amongst the Depot-fed infants and children deserve attention, and may be tabulated as follows:—consumption of bowels and brain abscess, 1; marasmus, 32; congenital malformations, 1; bronchitis, 1; and diarrhoea and sickness, 2 Further, of the 18U infants and children brought to the Depot, 132 (i.e., 73.3 per cent.) were wasting, moribund or diseased, and of these 8 died (i.e., 6.1 per cent.), whilst the remaining 48 (i.e., 26.7 per cent.) were, though tabulated as "healthy," with few exceptions, constitutionally below par, and of these none died. These facts must be taken into account in dealing with the mortalitv returns. 'These are quinquennial rates 159 The particulars of the 8 deaths are as follow:— Name Age. State of Health when put on Milk. Length of time on Milk. Registered cause of Death. L.K. 9 months Moribund, diarrhoea 4 days Diarrhœa Exhaustion W.S. 2 Moribund, brain abscess and consumption of bowels 3 days Brain abscess consumption of bowels V.G. 4 „ Wasting sickness 24 days Marasmus sickness J.L. 3 „ Moribund bronchitis 7 days Bronchitis B.D. 2 ,, Wasting 90 days Sickness, diarrhœa W.N. 1 week Marasmus Convulsions 30 days Marasmus A.L. 2 days Moribund prematurity 12 days Prematurity E.D. 1 month Moribund congenital malformations 4 days Congenital malformations, convulsions 16o TABLE Showing number of Infants fed, and number of bottles distributed, weekly during the year 1908. wek ending. Number of Infants on the Register. Number of Bottles distributed Sundry Persons Number of Bottles distributed. Guardians. January 4 95 4326 84 ,, 11 95 4242 84 ,, 18 95 4312 84 25 84 3983 84 February 1 77 3864 84 M 8 77 3647 84 ,, ] 5 72 3346 84 ,, 22 72 3437 84 ,, 29 76 3539 84 March 7 76 3376 84 ,, 14 78 3500 84 ,, 21 76 3484 84 ,, 28 74 3553 84 April 4 77 3598 84 ,, 11 74 3253 84 ,, 18 72 3451 84 ,, 25 72 3156 84 May 2 70 3395 84 ,, 9 70 3365 84 ,, 16 69 3269 84 ,, 23 75 3514 84 ,, 30 73 3474 60 June 6 70 3353 42 ,, 13 69 3269 42 ,, 20 72 3432 42 ,, 27 70 3437 42 July 4 66 2968 42 ,, 11 64 2877 42 ,, 18 62 2249 42 ,, 25 61 2590 42 August 1 60 2732 42 ,, 8 60 2555 42 ,, 15 60 2415 42 ,, 22 62 2688 42 ,, 29 62 2791 42 161 Week ending. Number of Infants on the Register. Number of Bottles distributed. Sundry Persons Number of Bottles distributed, Guardians. September 5 68 3098 24 „ 12 66 3122 - „ 19 69 3130 - „ 26 67 2989 October 3 68 3227 - „ 10 73 3444 - „ 17 81 3941 - „ 24 81 3570 - „ 31 74 3054 - November 7 80 3696 - „ 14 81 3619 - „ 21 85 3885 - „ 28 86 3913 - December 5 89 4466 - „ 11 78 3831 54 „ 19 79 3640 126 „ 26 79 3836 126 Totals (52 weeks) 3841 176901* 2700 The net expenditure upon the maintenance of the Milk Depot, during the year 1908, is stated by the Borough Accountant to have been £283 16s. 7d., viz.:— (a) Expenditure £597 4 1 (b) Income £313 7 6 i.e., Expenditure in excess of Income £283 16 7 *The numbers of bottles distributed during 1908, (a total of 179601) were used for the feeding of children (under 2 years) but also include 2142 for 17 nursing mothers (varying from 6 to 98 days), 858 for 2 invalids (varying from 14 to 77 days), 558 for 9 children over 2 years of age (varying from 7 to 35 days), and 333 lor the fnfants and children in the Creche at the Olympia Exhibition (from October 9th, to October 24th 1908) l 162 Miss Hartley, the Milk Depot Manageress, was allowed by the Council, at the request of the Countess of Aberdeen, on behalf of the Women's National Health Association of Ireland, to visit Dublin for a few days to superintend the opening of the new Pasteurized Milk Depot there. The Dublin Milk Depot has been modelled upon the lines of the Lambeth Milk Depot. THE CLEANSING OF VERMINOUS PERSONS. Sections 36 and 37 of the L.C.C. General Powers Act, 1907, refer to the cleansing of verminous school children or occupiers of Common Lodging Houses, separate arrangements being required for men and women, and also for boys and girls. When the Act was a Bill these suggested clauses were opposed by the Borough Council on the ground that the powers were being sought for by the County Council instead of being left for the Borough Councils to carry out. Parliament decided in favour of the County Council, and the Bill became an Act—the Borough Councils not even being granted concurrent powers. The County Council then applied to the Borough Councils to carry out the work for them, practically putting the expenses upon the Borough, instead of the County rate. To this suggestion, the Lambeth Council objected, for the reason mentioned above, and having regard to the fact that the Common Lodging Houses and the Public Elementary Schools are both under the jurisdiction and control of the County Council; and this objection was given to the County Council in writing on April 3rd, 1908, the limited accommodation at present at the disposal of the Borough Council for cleansing in connection with infected diseases (at Wanless Road and Belvedere Road) being also pointed out. l63 IMPORTANT DRAINAGE CASES. 1. Drainage Work Improperly Carried Out. (a) 23 Victoria Road, Gipsy Hill. A letter was received from the occupier of 23 Victoria Road, Gipsy Hill, stating that certain sanitary work had been carried out there on Friday, 8th May, 1908, in such a way as to be a nuisance, a broken pipe having been mended by placing slates over the holes and covering them over with cement. An examination was made by the Council's men on Wednesday, 13th May, 1908, after having given 24 hours' notice, in writing, to the occupier, of the Council's intention to have the ground opened up and the drains examined, in accordance with the requirements of Section 42 of the Public Health (London) Act, 1891, and it was found that the report contained in the occupier's letter was substantially correct, and that the work had been done in such a way in connection with the drains as to be a nuisance and injurious to health, viz.: 4 inch surface and bath waste drains had been broken into in two places, and the sides and crown cf the drain repaired with slate and cement, the invert of the drain being also cracked, allowing the water to soak freely into the subsoil. The owners of the premises and the builder were communicated with—no notice having been given to the Sanitary Authority by either. It was stated by the builder that the work was only temporary, until he had received instructions from the owner as to the relaying of the drains. Under these circumstances, a cautionary letter was sent to both the owner and to the builder. (b) 330 and 330a Brixton Road. A case of Puerperal Fever was notified at 330 Brixton Road, which, on examination on November 12th, 1908, was found to be in such a state as to be injurious to health, on account of sanitary work having been carried out there in an l 2 164 improper manner, consisting of the reconstruction of the water closet and the soil-pipe (in part), and the abolition of a large water cistern from the roof of the water closet, and the substitution therefor of a two-gallon flushing tank. It was also discovered that, in connection with 330a Brixton Road (a Garage, let to a separate occupier), a twogallon flushing tank, and a water closet and seat had been newly constructed; no notice had been given to the Sanitary Authority previously in connection with any of the work, and the alterations effected in respect of the water closet and soilpipe had been carried out in such a way as to be a nuisance, or injurious or dangerous to health; whilst the work in connection with the construction of the new water closet at 330a Brixton Road, had been carried out contrary to the by-laws of the London County Council. The patient notified as suffering from Puerperal Fever being ill, no further action was taken in the way of a second examination (including a careful testing of the drains and sanitary appliances, with smoke), until Saturday, December 12th, 1908, after the patient had, unfortunately, died. This further examination proved the accuracy of the former examination; whilst the smoke test applied to the drains in connection with the newlyconstructed water closet at 330a Brixton Road (the Garage), shewed a serious leaking from the soil pipe and rain water pipe connected with 330 Brixton Road, permitting the smoke to escape from the drain into the window of the adjoining water closet of 330 Brixton Road, and so into the bedroom in which the patient had been attended during her confinement. The rain water pipe was connected direct with the drain, with the result that the smoke from the drain of 330a Brixton Road (the Garage) passed directly up such rain water pipe and escaped from an open junction that had been left, and which, apparently, had previously been connected with the overflow pipe from the water closet cistern at 330 Brixton Road. Drain air, passing directly through the 165 window of the water closet at 330 Brixton Road, and gaining entrance indirectly into the lying-in chamber, would be a danger to a lying-in patient; whilst the the fact that the drain does not appear to be intercepted from the sewer would make matters worse, by allowing sewer air also to escape and enter, through the same channel, into the lying-in chamber. There were 3 offences under the Acts:— (1) The construction and repairing of a water closet and drain (soil pipe) at 330 Brixton Road, in such a way as to be a nuisance, or injurious, or dangerous to health (contravention of section 42 of the Public Health (London) Act, 1891); (2) 1 he construction of a new water closet at 330a Brixton Road, in such a manner as to be contrary to the By-laws of the London County Council; (3) The carrying out of sanitary work in connection with 330 and 330a Brixton Road, without giving previous Notice to the Sanitary Authority, as required under the By-laws of the London County Council. Summonses were taken out against the owner and against the 2 workmen who had carried out the work, and the Magistrate inflicted a penalty of £2 and 4/0 costs upon the owner (the summonses against the 2 workmen being withdrawn, the owner paying their ccsts 8/0). 2. Appeal to the London County Council re 130 Clapham Road—Drainage. The owner of 130 Clapham Road appealed against a Notice of the Council, dated November 11th, 1908, requiring the drains to be put into proper order and condition, in accordance with the L.C.C. By-laws. The grounds of the Appeal were stated to be:— 166 (1) That the said drains were in good order and dition. (2) That the said drains, being combined, are, in fact, a "sewer." The drains by consent were opened up and exposed before the Appeal was heard, and were found to be defective. Further, a record was found in the shape of a plan and application, dated September 5th, 1857, shewing a combined drainage scheme for 130 and 132 Clapham Road. Under these circumstances, the Appeal was withdrawn on December 14th, 1908. CONTRAVENTIONS OF THE L.C.C. BY-LAWS. Removal of Offensive Matters. (a) On June 2nd, 1908, about 1.45 p.m., the Sanitary Inspector discovered that offensive dung litter was being removed from North's Stables, in Distin Street, by being loaded into a one-horsed open van. The dung was in a putrid state, being mixed with straw, but not in such a quantity as to prevent a nuisance. Summonses were taken out against the owner of the van and the carman, and the Magistrate inflicted a penalty of 8/0 (with 2/0 costs) upon the owner and cautioned the carman. (b) On June 17th, 1908, about 4.55 p.m., the Sanitary Inspector discovered a van being loaded in Seldon Mews, at the rear of 198 Lambeth Walk (a fried fish shop) with fish cracklings, and potatoes that had been fried in oil. A cautionary letter was sent to the contractors, who, in reply, stated that the material complained of is not offensive, it being sweet when collected, and remaining so for weeks, 167 without any appreciable change. The nuisance appeared to be connected with the van itself, which was dirty. No action was taken before the Magistrate, as the contractors promised to abate the nuisance forthwith. (c) On September 12th, 1908, about 7 p.m., the Sanitary Inspector discovered a nuisance connected with the removal of offensive matter (dust sortings or "tottings") in Distin Street, at the premises of a rag and bone merchant, next door to a Dairy and opposite to a School. Summonses were taken out against the Contractor and the carman, and the Magistrate inflicted a penalty of 10/0 (with 2/0 costs) upon the carman—the contractor to pay 2/0 costs. Cautionary Notices to Greengrocers. During 1908, as in previous years, the following circular letter was sent round, at the approach of the hot summer weather (July), to the Greengrocers throughout the Borough : Public Health Department, Lambeth Town Hall, July 1st, 1908. Sir (or Madam), Re Waste from Vegetable Refuse. Complaints are received from time to time at this office of nuisance arising from waste vegetable matter, more especially during the hot weather. I write, therefore, to ask you to take such precautionary measures, at all times, as will prevent any nuisance arising in this way upon your premises. Yours faithfully, Joseph Priestley, Medical Officer of Health. 168 Meat Certification. The Local Government Board, with the consent of the Borough Council, appointed the Medical Officer of Health as Certifying Officer for the Borough of Lambeth of meat food products intended for export to Argentina, the United States of America, and the Philippine Islands. The rules laid down by the Board are contained in memoranda, dealing with (1) the requirements to be fulfilled by persons manufacturing or packing meat products, and (2) the conditions to be observed by certifying officers, and (3) the forms of declaration to be used. In connection with meat food products intended for export to the United States of America and the Philippine Islands, steps are to be taken to ensure the meat used being found, on adequate ante-mortem and post-mortem inspection, free from disease and suitable for human food. Regulations under the Public Health (Regulations as to Food) Act, 1907. The Local Government Board have made during 1908 two sets of Regulations under the Public Health (Regulations as to Food) Act, 1907, viz.: (1) the Public Health (First Series : Unsound Food) Regulations, 1908—taking effect on and after October 1st, 1908; and (2) the Public Health (Foreign Meat) Regulations, 1908—taking effect on and after January 1st, 1909. ALLEGED INSANITARY CONDITION OF NORWOOD CEMETERY. A letter was received during 1908, complaining of the alleged insanitary condition of Norwood Cemetery through overcrowding—especially the part bordered by Robson Road. 169 Inspections have been made by the Medical Officer of Health and the Inspectors from time to time, and the attention of the Cemetery Authorities has been called, as required, to mismanagement or negligence in opening the graves, but, speaking generally, there is no cause for complaint, and 10 nuisance with which the Public Health Committee or the Council have been advised to deal. The houses situated in the Robson Road have been under special inspection, but there is no nuisance, and certainly no danger to health at present to the tenants from the proximity of such houses to the Cemetery. The graves are well above the road level of Robson Road. INTERCEPTING TRAPS IN HOUSE DRAINS. During 1908, the Council deputed the Medical Officer and Borough Engineer to give evidence, as required, before the Departmental Committee, appointed to inquire into and report upon the use of intercepting traps in house drains. The terms of reference of the Committee are the consideration of the need or otherwise of the intercepting trap; of any disadvantages of the trap; of the effect on the community of emanations from sewers or drains; to some extent also, of the ventilation of sewers and drains; and of the bearing of existing conditions on the question. On February 2nd, 1905, the Lambeth Council passed a resolution (nem. con.), dealing with the subject ot ventilation of sewers and intercepting traps, to the effect that the provision of a suitable and efficient intercepting trap to every main drain, or ether drain, of a new building is necessary, and that the County Council's bye-law to that effect should not be rescinded or repealed. 170 BACTERIOLOGICAL LABORATORY. The Bacteriological Laboratory has proved of great service during 1908—a total of 718 examinations having been carried out. The local and central position of the Laboratory is specially advantageous, enabling the results of examinations to be quickly obtained at a minimum cost. The Laboratory was originally fitted up by the late Vestry in 1899, and since then (up to the end of 1908) 7148* examinations have been made, viz.:—Tuberculosis 1721, Typhond Fever 710, Diphtheria 4609, and Others 108. The total 718 bacteriological examinations carried out during 1908 deal with 163 sputa (suspected consumption), 39 bloods (suspected typhoid fever), 507 throat and nose membranes and discharges (suspected diphtheria) and 9 other materials, e.g., pus (gonococci) 1, deep well water 1, soda water 6, pus (tubercle) 1. Details are as follow: Tuberculosis— 163 samples of sputa from doubtful tuberculosis cases have been examined, and in 42 (i.e., 25.8 per cent.) tubercle bacilli have been found, in 2 cases mixed with blood cells and pus cells, respectively. In 121 instances (i.e., 74.2 per cent.), no tubercle bacilli were found, but in 2 instances the pneumococcus (Friedlanderi), in 1 the pneumococcus (Friedlanderi) and streptococci, in 3 lung tissue, in 1 blood, in 5 pus, and in 1 toruloe and sarcinœ, were found. Consumption (with tuberculous expectorations) was made voluntarily notifiable throughout the Borough and on (and after) June 1st, 1902. By means of bacteriolcgical examinations, greater exactitude in diagnosis is secured. *1899—389; 1900—703; 1901—479; 1902—466; 1905-525; 1904-447; 1905—1874; 1906—761; 1907—786; 1908—710. Total—7148. 171 Typhoid Fever— 39 samples of blood from suspected Typhoid cases have been examined, and in 11 (i.e., 28.2 per cent.) the characteristic Widal reaction was obtained, although in 10 of the cases (i.e., 90.9 per cent.) the reaction was but slightly (or feebly) marked. In 28 cases (i.e., 71.8 per cent.) no reaction was obtained. A high dilution of blood-serum is used (1-60 to 1-100). Diphtheria— 507 samples of throat and nose membranes and secretions from doubtful diphtheria cases have been examined, and in 13 (i.e., 2.6 per cent.) the true (Klebs-Lœffler) bacilli have been obtained. In 9 instances (i.e., 69.2 per cent. the KlebsLœffler bacilli were obtained in pure cultivation—i.e., without admixture with other bacilli, whereas in the remaining 4 (i.e., 30.8 per cent. the Klebs-Lœffler bacilli were found combined with staphylococci. In 494 (i.e., 97.4 per cent.) of the total number of throat and nose samples examined, the Klebs-Lœffler bacilli were not isolated, but other bacilli were found as follow:— Staphylococci 225 Streptococci 87 Staphylococci + streptococci 40 Staphylococci + torulœ 13 Staphylococci + streptococci + torulœ 1 Streptococci + torulœ 14 Torulœ 83 Steptococci + micrococci 2 Micrococci 4 Micrococci + torulœ 1 Sarcinœ 2 Pseudo (Hoffmann) bacilli 13 Pseudo (Hoffmann) bacilli + staphylococci 6 Pseudo (Hoffmann) bacilli + streptococci 2 Pseudo (Hoffmann) bacilli + torulœ 1 172 The Pseudo (Hoffman) bacilli were found in pure cultivation in 13 instances, mixed with staphylococci in 6, with streptococci in 2, and with torulœ in 1. Other Examinations— 9 samples of other materials were examined, viz., pus (tubercle) 1, pus (gonococci) 1, deep well water 1, soda water 6. In the 2 samples of pus, bacilli tuberculosis and gonococci, respectively, were inspected, but not found. In the sample of artesian (deep well) water, no bacteria resembling the bacillus coli were found, whilst the total number of bacteria found was less than 10 bacteria per 1 cubic centimetre. In the 6 samples of special soda water (3 made with deep well water and 3 with the Metropolitan Water Board's water), the full bacteriological results were as follow:— Soda Water (made with Company's Water). No. of Colonies (Organisms) found per cubic per cubic centimetre. No. of Colonies (Organisms) liquifying gelatine found per cubic centimetre. Sample 1 144 11 ,, 2 112 8 ,,3 135 9 Soda Water (made with Deep well Water.) Sample 1 35 1 2 78 2 3 42 1 The samples of deep well (artesian) water and special soda water were, bacteriologically, found to be clean and good. Antitoxin. The Borough Council has distributed during 1908, free of cost to medical practitioners practising in Lambeth Borough, 43 vials of antitoxin. 173 1908. SputaTub. Bac. found. *BloodsTyphoid reaction obtained Throat and Nose Membranes and Discharges— Klebs, Lœeffler Bac. found. Yes. No. Total. Yes. No. Total. Yes. No. Total. January 4 7 11 - 4 4 - 30 30 February 5 12 17 - 3 3 1 48 49 March 3 19 22 - 3 3 - 25 25 April 5 16 21 2 - 2 — 23 23 May 8 12 20 - — — — 76 76 June 1 12 13 1 1 2 — 49 49 July 3 8 11 1 3 4 — 19 19 August 1 4 5 - - — 2 22 24 September 2 11 13 1 3 4 1 36 37 October 8 9 17 3 7 10 4 54 58 November 1 6 7 3 2 5 5 74 79 December . 1 0 6 — 2 2 — 38 38 TOTALS 42 121 163 11 28 39 13 494 507 *In 10 samples (i.e., 90'9 per cent.) of suspected Typhoid Fever blood, in connectian with which there was a reaction, the reaction was slightly (or feebly) marked. N.B.—9 other samples were also examined during 1908, viz.:—pus (gonococci), 1; deep well water, 1 ; soda water, 6 ; pus (tubercle), 1. REFUSE AND MANURE DEPOTS. The 13 public depots, situated in Lambeth Borough, have been under constant (daily during the summer months) supervision during 1908. Dust Yards in Tinworth Street. In August, 1908, a letter was received by the Council from the Local Government Board, enclosing copy of a letter, 174 addressed to the Board by Mr. Nightingale, of the Albert Works, Albert Embankment, with reference to the dust and refuse yards (including the 2 destructor furnaces) in Tinworth Street, in the occupation of Messrs. Clarkson & Sons. Previous complaints have been received from time to time, but sufficient evidence has never been forthcoming to warrant legal proceedings being taken. In consequence of the letter from the Local Government Board, special (daily) observations have been kept by the Sanitary Inspector and the Medical Officer, but no definite nuisance was discovered with which the Council could be advised to deal with any prospect of success. There are difficulties in connection with this particular business of refuse destruction, which is not an offensive trade scheduled as such under section 19 of the Public Health (London) Act, 1891, and the removal and disposal of house refuse must of necessity be carried out by someone for the general benefit cf the inhabitants of the Borough concerned. Further, under section 21 of the same Act, the business is a "Protected" Trade, in that, although there may be a nuisance from effluvia, the Magistrate shall not convict if it can be shewn that the best practicable means have been used for abating the nuisance, or counteracting or preventing the effluvia. For the purposes of this section, a memorial signed by not less than 10 inhabitants is required before proceedings can be taken before the Magistrate. The destructor furnaces in use are built on what is known as the Martin Patent, and are provided with cremators, or secondary fires, at the backs of the furnaces. The object of these secondary fires is to complete the combustion of any offensive fumes or gases, organic or otherwise, which are given off frcm the burning refuse. On occasions, these fires have been found not to be in proper working condition, and the attention of Messrs. Clarkson & Sons have been drawn to the matter. At times, too, refuse is collected in the yards 175 and set fire to there, either intentionally or accidentally by stray sparks from passing engines over the adjoining lines of the L. & S. W. Rly. There can be no doubt but that at times, in certain states of the atmosphere, a nuisance from effluvia from the burning refuse takes place, affecting the immediate neighbourhood, and extending a considerable distance along the Embankment. This nuisance only occurs occasionally, and the owners of the premises claim that they have taken, and are taking, the best practicable means for counteracting the effluvia arising in connection with their business of destroying house refuse. The premises are kept under constant supervision. The Local Government Board was written to in the following terms:—"The nuisance complained of by Mr. Nightingale is an intermittent one, and the Town Clerk has not yet been able to get sufficient evidence to justify the applying to the Police Magistrate under the Public Health (London) Act, and up to this time there has not been a complaint signed by the number of ratepayers referred to in Section 21 of the Public Health (London) Act, 1891, which would justify the Town Clerk in complaining to the Court, whether the complaint was justified in the views of the Medical Officer of Health and his Inspector or not." Shot Tower Wharf Destructor. Complaints were again received in 1908, from Messrs. John Dewar & Sons, Limited, with respect to the recurrence of the nuisance in connection with the working of the destructor situated at Shot Tower Wharf, belonging to the City of Westminster, and, in relation thereto, the Medical Officer had an interview at the Wharf with the City of Westminster's Medical Officer and Deputy Engineer. The nuisance complained of appeared to be due, at least in part, to an alteration of the working of the destructor, by which the red hot clinker was placed directly into the contractor's barges—the contractor being bound by his contract (which began on September 1st, 1908) to damp down the red 176 hot clinker on its receipt into the barges. Further, it was found that the small holes, which had been made in the bepper covers of the cells for the purpose of stoking, were leaky, admitting the escape of large quantities of fumes and smoke on to the wharf. The Town Clerk of the City of Westminster was communicated with, with the result that the nuisance complained of was abated—the cooling of the clinker being carried out before discharging it into the barges, and the defective holes in the hopper covers being repaired. EFFLUVIUM NUISANCES (1) Nuisance from Fumes and Vapour Escaping from Motor Vehicle. On Friday, May 11th, at 9.20 a.m., the Sanitary Inspector noticed a motor van, belonging to Messrs. Hyde and Co., Bird Food Specialists, of Lilford Road, proceeding along Acre Lane towards Clapham, and emitting fumes in such large quantities as to obscure from view anything else in the roadway for at least 100 yards, and causing an offensive nuisance. There would appear to be no provision in the Public Health (London) Act, 1891, for dealing with such a nuisance, though a summons was taken out by a Metropolitan Authority in 1907, against a motor car driver, for allowing a quantity of "filth," i.e., refuse oil, to fall from the engine of his omnibus on to the roadway, and the Magistrate (Mr. Hopkins) at the Lambeth Police Court inflicted a nominal penalty on the driver, amounting to 5s. with 3s. costs. The Commissioner of Police has since given notice to the various Motor Omnibus Companies to the effect that the regulations with reference to dropping of oil from motor omnibuses on to the roads will be strictly enforced. In 1907 a case was also heard in the Appeal Court in connection with a summons against the owner of a motor car, charging an offence under Section 30 of the Highways and Locomotives Amendment Act of 1878, and the Magistrate's conviction was quashed on the ground that, as the nuisance was due to 177 carelessness of the driver and not to wrong construction of the motor car, there could be no conviction under Section 30 of the Highways and Locomotives (Amendment) Act, 1878, by virtue of Section 1 of the Locomotives and Highways Act, 1896, exempting vehicles propelled by mechanical power if under 3 tons in weight unladen. (2) Nuisance from Effluvia connected with the Premises of a Rag and Bone Merchant in Distin Street. A Memorial signed by 16 inhabitants of the neighbourhood was addressed to the Local Government Board, under date July 21st, 1908, and was referred by the Board to the Council, whose officers were unable to discover a nuisance with which they could deal under the Public Health (London) Act, 1891. Dust-carts, belonging to a contractor, are accustomed to call at the rag and bone shop for the purpose of disposal of the "tottings," etc., by the men, with the result that the dairy premises next door to the rag and bone shop, and the L.C.C. School on the opposite side of the road, are prejudicially affected, but not, in the opinion of the Medical Officer of Health, as regards the public health. Constant watch was kept in the street, and on September 12th, 1908, a nuisance connected with the removal of offensive matters was found and a summons taken out against the contractor and his carman, with the result that a penalty of 10s. (with 2s. costs) was inflicted upon the carman. The Board was informed of the Council's action, and of the opinion of the Council's officers as to there being no nuisance prejudicial to health connected with the rag and bone shop in Distin Street. (3) Nuisance from Effluvia connected with the Alleged Depositing of Refuse, etc., in Yard at Rear of Gardens of 79-91 Kenbury Street, and 103-111 Denmark Road. A Memorial signed by 14 inhabitants of the district was received, dated January 4th, 1908, complaining of a serious W 178 nuisance from the depositing of "tons of sewerage, refuse, etc." Careful inquiries and repeated inspections failed to discover any nuisance under the Public Health (London) Act, 1891, with which the Council could deal—the material deposited consisting of surplus earth from building excavations and brick rubbish. No further action was taken, in consequence, upon the Memorial. (4) Nuisance from Alleged Effluvia connected with the Depositing of Rags, etc., on the Premises situated at 10a, Mayall Road (Marine Store Dealer). A Memorial signed by 15 inhabitants of the district, was received on June 2nd, 1908, complaining of the "stench proceeding from the rag-shop at 10a, Mayall Road." The premises were inspected, but no nuisance was discovered connected with the rags and bones stored in the basement and elsewhere. Some offensive fat was found stored in a tub in the entrance to the shop, and this was found to be a nuisance and was at once removed. The premises were found to be dirty and dilapidated. Notices were served, and a cautionary letter was sent to the occupier, calling upon him, at the same time, to cleanse and purify the premises and to provide lidded receptacles (metallic) for offensive matters. This was done, and the nuisance thereby abated, and since then the premises have been closed. MORTUARIES AND CORONERS' COURTS The total number of bodies received at the two Borough Mortuaries (High Street and Wanless Road) during 1908 was 382, as compared with 350 during 1907, and an annual average for the old Parish of Lambeth for 5 years (1896-1900) of 450. Of the 382 bodies, 276 were received at High Street and 106 at Wanless Road. 34 bodies were brought in by the Police (24 to High Street and 10 to Wanless Road), and the rest by undertakers or private persons. 179 The Coroner's Court sat 39 times at Wanless Road, 112 times at High Street. During 1908 two infectious bodies (diphtheria, 1 male and 1 female) were received at Wanless Road Mortuary. For comparison, details are given in tabular form of the work carried out by the late Vestry of Lambeth in connection with the Wanless Road and High Street Mortuaries during 5 years (1896-1900). Taking the average, it will be seen that the total number of bodies received during 1908 in connection with the new Borough is 68 less than this yearly average (450). The number of post-mortems conducted for the Borough during 1908 is 208, as compared with 187 during 1907, and with 253, 281, 275, 285, and 267 respectively during 5 years (1896-1900) for the old Parish, i.e., 23.7 per cent. less than the yearly average (272.5) during the same quinquennium. Of the post-mortems, 64 tcok place at Wanless Road, and 144 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 New Waiting Room. The Mortuary has during 1908 been enlarged and brought up to date, from a sanitary point of view, at a total cost of £1,443, including £80 8s. 3d. for asphalting yard, quantity surveyor's fee, printing, etc. The Mortuary for Norwood has not yet been provided, but it has been arranged for such a mortuary to be built in a small part of the freehold site in Rommany Road, which is being developed by the Council for a Dust Depot. 180 Numbers of bodies received at the Lambeth Borough Mortuaries during 1908 and at the Lambeth Parish Mortuaries during 5 years (1896-1900). 1908. January. February. March. April. May. June. July. August. September. October. November. December. T't'l 1908 T't'l 1900 T't'l 1899 T't'1 1898 T't'l 1897 T't'l 1896 Yearly Average for l8961900. High Street Males 21 15 13 15 17 12 13 9 11 22 13 10 171 237 239 222 218 221 227.4 Females 9 10 14 9 11 6 9 7 5 8 10 7 105 142 126 143 109 152 134.4 Wanless Road Males 5 2 5 5 5 8 6 2 7 4 4 4 57 58 71 72 41 — 60.5 Females 8 — 4 5 3 1 2 1 8 7 4 6 49 62 47 58 32 49.75 Totals 45 27 36 34 36 27 30 19 31 41 31 27 382 499 483 495 400 373 450 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. 181 Ages of bodies received at the Lambeth Borough Mortuaries, 1908, and at the Lambeth Parish Mortuaries during 5 years (1896-19001. Registered Ages of Bodies. 1908. Boro' Parish. Yearly Average for 1896-1900. High Street. Wanless Road. Total 1908. Total 1900. Total 1899. Total 1898. Total 1897. Total 1896. 0—1 46 15 61 133 121 160 101 121 127.2 1-5 29 9 38 47 44 50 39 22 40.4 5-10 11 3 14 12 22 17 9 12 14.4 10-20 10 2 12 17 13 8 18 9 13.0 20-30 12 6 18 31 29 26 26 24 27.2 30-40 19 7 26 43 50 45 35 35 43.3 40-50 33 19 52 80 67 64 48 37 59.2 50-60 53 17 70 61 53 42 59 46 52.2 60-70 31 15 46 50 47 39 30 35 40.2 70-80 18 6 24 16 19 32 20 22 21.8 80-90 7 2 9 6 8 5 9 7 7.0 90 upwards 1 1 2 — 1 1 — 3 1.0 Age not stated 6 4 10 3 - 6 6 - 3.0 Totals 276 106 382 499 483 495 400 373 450 i82 Particulars as to cases off Drowning, Accidental Death and Suicide that have occurred in the Borough of Lambeth during 1908, and in the old Parish during 5 years (1896-1900). High Street. Wanless Road. Boro' Parish of Lambeth. Average 5 years 18961906. Total 1008. Total 1900. Total 1899. Total 1898. Total 1897. Total 1896. M. K. Total. M. K. Total. Suicides 14 13 21 6 13 13.4 Drowning ... 6 1 7 — — — 7 6 1 1 13 16 7.4 Poisoning 1 — 1 2 4 6 7 3 4 3 4 4 3.6 Hanging 4 1 5 1 — 1 6 4 3 9 - 2 3.6 Throat cutting 7 1 8 4 — 4 12 3 4 5 1 2 3.0 Jumping off heights and in front of trains - - - 1 I 2 2 1 - - - 2 o.6 Shooting - — 1 — — — 1 2 1 4 1 3 2.2 Railway Accidents 1 — 1 — — — 1 4 4 I I 3 2.6 Accidental Death (sudden) ... 5 1 6 — — — 6 6 1 12 — 3.8 Street Accidents (run over) ... 3 3 6 5 — 5 11 3 9 7 4 3 5.2 Murder ... ... ... • — — — — — — — 1 2 — 2 2 1.4 Burning (scalding) 2 4 6 2 — 2 8 1 2 3 1 — 1.4 Falling 1 — 1 4 5 9 10 1 1 4 4 — 2.0 Bicycle Accidents — — — — — — 2 — 1 — — 0.6 Suffocation in Sewer ... 1 — 1 — — — 1 — — 2 — - 0.4 Found Dead 1 — 1 — — — 1 — — — — — - Bursting Blood Vessel - - - - - - - - - - - - - Killed - - - - - - - - - - - - - Manslaughter ... - - - - - - - - - - - - - Fits - - - - - - - - - - - - - Under Chloroform - - - - - - - - - - - - - N.B.—Two bodies (diphtheria, i male and i female) were admitted during 1908, into the special room provided for infectious bodies at Wanless Road. 183 INQUESTS During the year 1908, within the Borough of Lambeth, 346 Lambeth cases were submitted to the Coroner (who, in 19 instances, decided that no further inquiries were necessary, the deaths being due to natural causes). In the remaining 527 cases inquests were held with the following results:— I. Natural Causes 182 II. Accidental Causes 100 Burns and Scalds 10 Drowning 4 Run over 17 Falls, etc. 36 Suffocation 7 Fracture 9 Misadventure 6 Crushed 4 Blood Poisoning 5 Mercurial Poisoning 1 Alcoholic Poisoning 1 III. Homicidal Causes 41 Suicide 37 Murder 3 Manslaughter 1 IV. Open Verdicts 4 Found Drowned 4 Total 327 OPEN SPACES. During 1908, the Council voted £1000 extra towards the acquisition of the West Norwood Park as a Public Park and Recreation Ground (£4,000 having been voted in 1907), and £2,000 towards the addition to Ruskin Park on the south-west side, for playing-fields £5,000 having been voted in 1906). 184 CLERICAL STAFF. The permanent 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. Rule), but an extra temporary boy (W. E. Croley) has been employed during the year 1908 on account of the extra clerical work thrown upon the Department in connection with the new Offices at the New Town Hall (Public Health Department), and with the Notification of Births Act, and the duties of the new Health Visitor. The Clerical work in connection with the Department during 1908 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, 1907, and 1908, as compared with the yearly average for the old Parish of Lambeth during 5 years (1896-1900). 1908. 1907. 1996. 1905. 1904. 1903. 1902. Average 1-5 years (18961900). Parish. Borough. Letters, etc., received (entered in letter book) 9731 9616 8875 8540 7476 7808 18177 8611.4 Letters, etc., sent out (entered in postal book) 21896 17427 16411 15830 14427 16555 41212 26096.6 Notices Served— Infectious Diseases 1829 1922 1900 1594 1681 1336 4278 2290.2 Public Health Acts (Preliminary) 8047 8243 8193 7446 6624 8248 16324 7812.0 Public Heath Acts (Statutory) 4142 4485 4490 3990 3463 3432 7895 2015.0 Metropolis Management Acts 13 15 11 23 10 27 41 20.0 Housing of the Working Classes Acts 2 9 27 43.6 Letters Typed 4576 3928 4357 5271 5052 4883 10683 546.0 Complaints entered in Complaint book 6641 6545 7540 6650 6630 6199 9799 5474.0 APPENDIX. 2 Local Government Board. Table i. VITAL STATISTICS OF LAMBETH BOROUGH DURING 1908, 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 Aqfs belonging to the District. Under 1 Year of Age. At all Ages. Number Rate.* Number. Rate.* Number. Rate per looo Births registered. Number. Rate.* 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 217 1741 811 338 5219 18.4 1894 287935 9231 32. 1 1264 136.9 5213 18.1 1484 775 399 4837 16.8 1895 291970 9341 31.9 1470 157 .4 5857 20.6 1511 702 404 5559 19.0 1896 296061 9592 32. 4 1371 142.9 5370 18.1 1588 705 433 5098 17.2 1897 300048 9388 31.3 1459 155.4 5486 18.3 1546 664 429 5251 17.5 1898 304073 9256 30.4 1447 156.3 5567 18.3 1543 592 455 5430 17.9 1899 308108 9433 30.6 1527 161. 9 6064 19.7 1680 663 485 5886 19.1 1900 312152 9167 29.4 1350 147.3 5578 17.9 1576 606 458 5430 17.4 Averages for years 11891-1900 294049.7 9295. 3 31.6 1403.9 151.03 5716 7 19 .4 1563.5 670.8 406.6 5405.3 18.4 Boro' 1908 321344 8906 27.7 950 106.7 4692 14.6 2011 863 512 4341 13.5 * 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 havine actually occurred within the Borough of Lambeth. The deaths included i 1 column 12 are the numbers in column 7, corrected by the subtraction of the numbers in column 10 and the addition of the numbers in column 11. By the term "Non-residents" is meant persons brought into the District on account of sickness or infirmity, and dying in public institutions there; and by the term "Residents" is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. 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 bean made, will be found on pp. 15-17, 94-97 of the Report. The Union Workhouses are situated within the District. Area of Lambeth Borough in acres Total population at all ages 301895 exclusiveof area covered by water 4079.6 Statute Acres. 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 1908, 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 esti- 1 mated to middle of each year. Births registered. Deaths at all Ages (corrected). Deaths under j 1 year (uncorrected) Population estimated to middle of each year. Births registered. Deaths at all Ages (corrected). Deaths under 1 year (uncorrected). Parish. a b c d a b c d a b c d 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 618 457 189 40711 1629 995 284 1896 28377 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 853 265 1899 28232 1398 733 189 19234 627 436 151 42252 1517 1048 315 1900 28183 1348 678 202 19377 582 423 153 42642 1543 840 266 Averages of Years 1891-1900. 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 1908 Names of New Sub-Districts. 26085 1613 439 141 26641 785 477 177 54729 1548 946 174 1.—Watkrloo. 2. —Lambeth Church. 3.—Kennington (including Workhouse). 4 Table ii.— continued. Names of Old Sub-Districts. 4.—Kennington 1st. 5.—Kennington 2nd. 6.— Brixton. 7.—Norwood. Year. Population estimated to middle of each year. 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). Population est:mated to middle of each year. Births-registered. Deaths at all Ages (corrected). Deaths under 1 year (uncorrected). Parish. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. 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 6 9 371 73 1894 51721 1802 871 212 41713 1053 672 107 79507 2037 1050 258 27647 657 380 79 1895 52201 1736 969 263 42222 1099 742 169 81267 2093 1259 276 28470 650 382 77 1896 52581 1886 9C2 282 43429 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 44352 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 ol Years 1891 \to 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,' 1908 — — — — 67273 2103 815 149 81252 1674 967 209 65364 1183 697 100 Names of New Sub-Districts. 4.—Stockwell. 5.—Brixton. 6.—Norwood. Notes.—(a) Deaths of residents occurring in public institutions beyond the district are included in sub-columns c of this table, and those of the i on residents registered in public institutions in the district are excluded. (See note on Table i. as to meaning of terms " resident' and non-resider.ts. ') (b) Deaths of residents occurring in public institutions, whether within or without the district, are alloted to the respective localitits 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 5 Local Government Board. Table iii. CASES OF INFECTIOUS DISEASE NOTIFIED WITHIN THE BOROUGH OF LAMBETH DURING THE YEAR 1908. NOTIFIABLE DISEASES. CASES NOTIFIED IN WHOLE DISTRICT. TOTAL CASES NOTIFIED IN EACH NEW LOCALITY. NO. OF CASES REMOVED TO HOSPITAL FROM EACH NEW LOCALITY. All Ages. At Ages—Years. Waterloo. Lambeth Church. Kennington. Stock weil. Brixton. Norwood. Waterloo. Lambeth Church. Kennington Stockwell. Brixton. Norwood. Under 1 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small-pox - - - - - - - - - - - - - - - - - - - Cholera - - - - - - - - - - — — — — — — — - - Diptheria 320 8 123 144 23 21 1 40 27 67 78 56 52 38 27 67 71 44 36 Membranous Croup 12 - 8 4 - - - 2 - 2 3 5 - 2 - 1 3 3 - Erysipelas 206 7 10 16 17 134 22 19 27 53 42 49 16 9 10 19 15 9 4 Scarlet Fever 1428 15 353 857 139 64 — 69 106 207 403 357 226 69 86 202 435 325 186 Typhus Fever — — - — — — — — — — — — — — — — — — — Enteric hever 63 — - 11 14 35 — 5 7 13 8 18 12 3 7 11 8 18 1 Relapsing Fever — — - — — — — — — — — — — — — Continued Fever 3 — 1 — 1 1 — — 1 1 — 1 - - - 1 — 1 — Puerperal Fever 10 — — — 4 6 — 1 — — 4 4 1 1 1 1 2 Cerebro—Spinal Meningitis 14 10 1 3 — — — 3 3 7 — 1 — 2 3 7 — 1 — Totals 2056 40 496 1038 198 261 23 139 171 350 598 491 307 124 133 309 533 403 227 Note.—(a) The localities adopted for this table are the same as those in Tables ii. and iv. (b) Patients are removed lo the Isolation Hospitals of the Metropolitan Asylums Board, one of which is situated in Brixton Registration Sub-district. 6 Local Government Board. Table V. CAUSES OF, AND AGES AT, DEATH (CORRECTED) DURING THE YEAR 1908. Name of District—BOROUGH OF LAMBETH. causes of death. death in or belonging to whole district at subjoined ages. death in or belonging to regristration 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. 35 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 101 16 82 2 - 1 - 10 9 29 20 18 15 - 21 Scarlet Fever 42 - 27 14 — 1 — 2 5 11 9 8 7 - 34 Whooping Cough 50 19 30 — — 1 — 10 8 12 3 8 9 - - Diphtheria and Membranous Croup 46 2 22 20 1 1 4 3 8 7 17 7 - 49 Croup 1 — 1 — — — — - - - — 1 — - - Typhus Fever Enteric Other continued - - - - - - - - - - - - - - 8 — — — 1 7 — - 2 1 — 4 1 - 13 — — — — — — — - - - - - - - — Epidemic Influenza 65 4 2 1 2 23 33 4 1 6 11 20 23 - 9 Cholera Nostras 1 1 - — — — - — — — 1 — — - — Diarrhœa 149 117 27 1 — — 4 10 29 43 25 18 24 83 Enteritis 62 31 3 2 3 15 8 6 9 16 10 9 9 3 — Puerperal fever 6 — — — 3 3 — 1 — — 2 2 1 — 6 Erysipelas 11 2 — — — 5 4 1 3 2 — 2 2 1 14 Other Septic diseases 11 — — 1 — 10 — 2 2 2 3 2 — — Phthisis 441 10 6 7 49 335 34 56 59 82 73 104 48 19 34 Other Tubercular diseases 160 43 60 19 6 30 2 21 16 36 37 31 15 4 — Cancer, malignant 29 20 46 72 91 66 14 — disease 338 — 1 1 2 208 126 Bronchitis 383 49 17 2 103 212 42 36 69 77 96 48 15 Pneumonia 156 16 15 8 8 78 31 19 25 29 25 31 20 7 214 Pleurisy 14 3 4 — 1 6 — — — 3 9 1 1 - Other diseases of Respiratory Organs 262 72 73 7 1 57 52 32 45 54 56 41 26 8 — Alcoholism 30 — — — — 26 4 1 3 5 6 10 4 1 — Cirrhosis of Liver 49 1 — 1 41 6 5 5 6 13 11 9 — — Venereal diseases 31 17 2 3 5 4 5 3 6 6 3 4 4 — Premature birth 134 134 - - - - - 18 20 23 23 25 25 — — Diseases and Accidents of partruition 15 — — — 1 14 — - 2 3 3 4 3 — — Heart diseases 354 2 2 5 20 179 146 29 26 65 59 93 73 9 225 Accidents 110 15 13 7 8 41 26 12 13 24 16 25 13 7 89 Suicides 36 — — — 3 29 4 4 5 3 9 7 8 — — All other causes 1675 275 47 21 34 407 491 116 103 212 241 284 234 58 1190 All causes 4341 829 434 118 147 1626 1187 439 477 796 815 967 697 150 2011 7 8 9 Local Government Board.] TABI.E V. BOROUGH OF LAMBETH. INFANTILE MORTALITY (CORRECTED) DURING THE YEAR, 1908. Deaths from stated causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 week. 1- 2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 month. 1—2 Months. 2—3 Months. 3 4 Months. 4-5 Months. 5-6 Months. 6-7 Months. 7—8 Months. 8-9 Months. 9—10 Months. 10—11 Months. 11—12 Months. Total Deaths under One Year. • All Causes— Certified 143 40 38 31 258 85 54 59 48 57 38 56 44 38 25 32 782 Uncertified 9 ... 2 3 14 5 4 5 5 1 ... 3 2 2 3 3 47 Common Infectious Diseases — Chicken Pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... 2 4 3 2 5 16 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria: Croup ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... 2 Whooping Cough ... ... ... ... ... 1 4 1 ... 1 ... 4 1 ... 1 6 19 Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhceal Diseases— Diarrhoea, all forms, including Cholera and Dysentery ... ... 4 5 9 12 6 9 13 17 11 13 11 8 5 5 118 Enteritis, Muco-Enteritis, Gastro-Enteritis ... 4 3 ... 7 2 4 4 1 5 2 1 3 2 ... 31 Gastritis, Gastro-intestinal Catarrh, Ileo-Colitis ... ... ... ... ... 1 2 ... 2 ... 1 ... ... ... ... ... 6 Wasting Diseases— Premature Birth 83 14 17 6 120 6 4 1 1 1 ... ... 1 ... ... ... 134 Congenital Defects 10 6 3 1 20 1 1 2 ... ... 1 1 1 ... ... ... 27 27 Injury at Birth 2 ... ... ... 2 1 ... ... ... ... ... ... ... ... ... ... 3 Want of Breast-Milk, Starvation ... ... ... ... ... 2 2 ... ... ... ... ... ... ... ... ... 4 Atrophy, Debility, Marasmus 16 4 7 11 38 30 10 16 7 5 5 3 1 1 1 3 120 Tubercu ar Diseases— Tuberculous Meningitis ... ... ... ... ... 2 1 1 3 2 1 l ] ... ] ... 13 Tuberculous Peritonitis: Tabes Mesenterica ... ... 1 ... 1 2 2 2 1 ... ... ] 2 ... ... 2 13 Utner luberculous Diseases ... ... ... ... ... ... ... 4 2 4 3 5 2 3 ... 4 27 Other Causes— 7 3 ... 1 11 3 ] ] 5 ] 1 3 3 2 4 2 37 Influenza ... ... ... ... ... 1 ... ... ... 1 ... 1 ... ... 1 4 4 Erysipelas ... ... ... ... ... ... ] ... ... ... 1 ... ... ... 2 2 Syphilis ... ... ... ... ... 4 4 5 ... 2 1 1 ... 17 Rickets ... ... ... ... ... ... ... ... ... ... 2 2 i ••• ... 7 Meningitis (not Tuberculous) ... ... ... ... ... 2 2 2 2 3 ... 2 1 1 ] 1 16 Convulsions 6 4 1 2 13 2 1 ... ... 3 2 ... 1 ... ... 21 Bronchitis ... ... 1 2 3 7 7 7 6 3 2 1 4 6 1 2 49 Pneumonia ... ... ... 1 1 ... 1 1 3 1 1 ... 1 2 2 2 16 Suffocation, overlying ... ... ... 1 1 4 ... 1 ... ... ... ... ... ... ... ... 6 Pleuro-Pneumonia ... ... ... ... ... ... ... ... ... ... ... ] ... ] ... 2 Broncho- „ 1 1 ] 3 6 5 5 5 5 6 5 6 8 8 3 ... 64 Dentition ... ... ... ... ... ... ... ... ... 1 1 3 ] 2 ... 1 9 Eczema ... ... ... ... ... 1 ... ... ... ] ... ... ... ... ... ... 2 Intestinal Obstruction 3 ... ... 1 4 ... ... 1 ... 1 ... 1 2 ... 1 ... 10 Jaundice and other diseases of the liver ] 2 ... ... 3 ... 1 ... ... ... ... ... ... ... ... ... 4 Accident (other than suffocation) 4 1 1 ... 6 ... ... ... 2 ... ... ... ... ... ... 1 9 Atelectasis 19 1 1 ... 21 ... ... ... ... ... ... ... ... ... ... ... 21 152 40 40 34 266 90 58 64 53 58 38 53 46 40 28 35 829 10 11 LAMBETH BOROUGH.—Deaths Registered from all Causes durirg the Year 1908. Note. 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. Water- loo. Lambeth Church. Kennington. Stockwell. Brixton. Norwood No Address. All Ages. M. F. VI. F. M. F. M. F. M. F. M. F. M. F. M. F. I. Specific Febrile, or Zymotic Diseases 23 28 39 26 58 66 46 40 54 49 42 53 4 1 266 263 529 II. Parasitic Diseases ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... 1 1 2 III. Dietetic Diseases 1 l 1 3 ... 5 4 3 1 10 2 2 l ... 10 24 34 IV. Constitutional Diseases 61 49 67 33 102 77 108 88 133 122 68 83 26 14 565 466 1031 V. lopamental Diseases 12 17 21 18 23 25 19 30 23 31 25 43 3 6 126 170 296 VI. Local Diseases 110 101 137 102 201 187 221 194 206 283 149 184 50 37 1074 1088 2162 VII. Deaths from Violence 10 7 11 7 19 8 16 11 20 12 12 9 3 4 91 58 149 VIII. Deaths from Ill-defined and not specified causes 8 11 10 2 12 12 24 11 15 7 16 9 ... 86 52 138 Totals 225 214 286 191 415 381 438 377 453 514 314 383 88 62 2219 2122 4341 1.—Specific Febrile or Zymotic Diseases. 1.—Miasmatic Diseases. Small-pox Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Unvaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No Statement ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 6 4 6 3 11 18 10 10 9 9 7 8 ... ... 49 52 101 Whooping Cough 3 7 3 5 5 7 1 2 5 3 1 8 ... ... 18 32 51 Scarlet Fever ... 2 2 3 6 5 3 6 3 5 3 4 ... ... 17 25 42 Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Simple Continued and III-denned Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric or Typhoid Fever ... ... 2 ... ... 1 ... ... 2 2 1 ... ... ... 5 3 8 Dinhthpria 2 2 2 1 5 3 3 4 13 2 3 4 ... ... 28 16 44 Membranous Croup ... ... ... ... ... ... ... ... 1 1 ... ... ... ... 1 1 2 Influenza 3 1 1 ... 4 2 6 5 7 13 9 l4 ... ... 30 35 65 Other Miasmatic Diseases 2 ... 2 ... 2 2 ... ... ... ... ... ... ... ... 6 2 8 2 —Diarrheal Diseases. Cholera Nostras ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 Cholera Asiatira ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhcea Dysentry 6 4 16 13 l8 25 16 9 10 8 13 11 ... ... 79 70 l49 3.—Malarial Diseases. Remittent or Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4._zoogenous Diseases. Cowpox and effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases (e.g., Hydrophobia, Glanders, Splenic Fever) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5.—Venereal Diseases. Syphilis ... 5 2 1 5 1 4 1 1 1 ... 2 2 1 14 12 26 Gonorrhoea, Stricture of Urethra ... ... ... ... ... ... 1 ... 1 ... 2 ... 1 ... 5 ... 5 6. Septic Diseases. Erysipelas ... 1 3 ... 1 1 ... ... ... 2 2 ... 1 ... 7 4 11 Pyaemia, Septicaemia ... 1 ... ... 1 1 1 1 2 1 1 1 ... ... 6 5 11 Puerperal Fever ... 1 ... ... ... ... ... 2 ... 2 ... 1 ... ... ... 6 6 12 13 LAMBETH BORUUGH - Deatns Registerered from all Causes during the Year 1908—continued Note.—The Deaths of Non-Residents occurring in Public Institutions situated in the District are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the District are included. Sub-Districts. Sub-Districts. Water- loo. Lambeth Church Kennington. Stockwell. Brixton. wood No Adresss All Ages. Total. II.—Parasitic Diseases M. F. M. F.. M. F. M. F. M. F. M. F. M. F. M. F. Thrush, and other Vegetable Parasitic Diseases ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... 1 1 2 Worms, Hydatids, and other Animal Parasitic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... III.—Dietetic Diseases. Want of Breast Milk, Starvation 1 ... ... 1 ... ... 1 1 ... ... ... ... ... ... 2 2 4 Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chronic Alcoholism ... 1 1 2 ... 5 3 3 1 9 1 2 1 ... 7 22 29 Delirium Tremens ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 1 IV.—Constitutional Diseases. Rheumatic Fever ... ... ... ... ... 1 1 1 3 2 ... 1 ... ... 4 5 9 Rheumatism of the Heart ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rheumatism ... 1 ... ... 2 2 1 1 ... 1 ... 1 ... ... 3 6 9 Gout ... ... 2 ... 1 ... 1 ... ... ... 1 ... ... ... 5 ... 5 Rickets ... 1 ... ... 3 ... 1 1 3 ... 1 ... ... ... 8 2 10 Cancer, Malignant Disease 10 19 9 11 18 28 29 43 39 52 22 44 6 8 133 205 338 Cancum Oris (Noma) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tabes Mesenterica 2 ... 2 ... 3 2 3 1 3 3 1 3 1 ... 15 9 24 Tubercular Meningitis, Hydrocephalus 2 4 2 2 8 5 7 5 6 4 ... 2 1 ... 26 22 48 Phthisis 37 19 42 17 53 29 45 28 58 46 29 19 16 3 280 161 441 Scrofula ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other forms of Tuberculosis 8 5 9 1 12 6 16 5 10 5 4 5 1 1 60 28 88 Purpura, Haemorrhagic Diathesis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Anaemia, Chlorosis, Leucocythaemia 1 ... ... ... ... 3 2 ... 3 3 3 2 1 ... 10 8 18 Glycosuria, Diabetes Mellitus 1 ... 1 1 2 ... 2 3 7 3 6 4 ... 2 19 13 32 Other Constitutional Diseases ... ... ... 1 ... 1 ... ... 1 3 1 1 ... ... 2 6 8 V.—Developmental Diseases. Premature Birth 7 11 15 5 13 10 13 10 13 12 12 13 ... ... 73 61 134 Atelactasis 4 ... 1 5 .» 1 3 ... ... 1 ... 4 2 ... ... 11 10 21 Congenital Malformations ... 3 3 3 3 3 1 3 1 3 3 2 ... ... 11 17 28 Old Age I 3 2 5 6 9 5 17 8 16 6 26 3 6 31 82 113 VI.—Local Diseases. 1.—Diseases of Nervous System. Inflammation of Brain or Membranes l ... 3 4 4 4 3 2 2 3 1 1 ... ... 14 14 28 Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis 7 9 8 12 9 13 20 23 12 38 13 19 3 3 72 117 189 Insanity, General Paralysis of the Insane 1 1 3 ... 10 5 5 2 4 3 3 2 4 2 30 15 45 Epilepsy 1 ... 1 ... 2 ... 2 1 ... 3 2 3 5 ... 13 7 20 Convulsions 1 1 3 2 2 ... 2 2 5 3 1 ... ... ... 14 8 22 Laryngismus Stridulus (Spasm of Glottis) Disease of Spinal Cord, Paraplegia, Paralysis Agitans 2 1 ] 4 1 5 3 6 2 6 4 4 4 1 ... 28 15 43 Other Diseases of Nervous System ... ... ... 1 4 ... 2 1 ... 3 1 2 ... 1 7 8 15 2. Diseases of Organs of Special Sense. (e.g., of Ear, Eye, Nose) 1 ... 2 ... 1 3 1 1 3 3 1 1 1 ... 10 9 19 14 15 LAMBETH BOROUGH—Deaths Registered from all Causes during the Year 1908—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 sistuated beyond the limits of the District are included. Sub-Districts. Sub-Districts. Total. Waterl00. Lambeth Church. Kennington. Stockwell. Brixton. Norwood. No Address. 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 2 ... ... ... ... 1 ... 1 ... 2 2 ... ... 5 4 9 Acute Endocarditis 1 ... 1 1 3 2 2 ... 5 1 1 2 ... ... 13 6 19 Valvular Diseases of Heart 7 5 6 9 16 16 9 7 13 23 11 14 1 4 63 78 141 Other Diseases of Heart 7 6 7 2 9 19 22 18 25 25 18 23 1 3 89 96 185 Aneurism 2 ... 1 1 2 1 2 ... 1 1 1 ... ... ... 9 3 12 Embolism, Thrombosis ... ... ... ... 1 ... ... ... ... 1 1 ... ... 1 2 3 Other Diseases of Blood Vessels 6 5 9 5 9 6 13 6 9 12 8 7 5 3 59 44 103 4-diseases of Respiratory System. Laryngitis 1 ... ... ... ... ... 1 1 2 1 1 ... ... ... 3 4 7 Croup ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 Embolism, Thrombosis ... ... 1 21 1 3 4 3 2 1 1 ... ... ... 9 10 19 Bronchitis 15 27 25 11 33 36 36 41 34 62 14 34 9 6 166 217 383 Pneumonia 12 7 16 9 14 15 13 12 16 15 11 9 5 2 87 69 156 Pleurisy ... ... ... ... 2 1 6 3 1 ... ... 1 ... ... 9 5 14 Bronchopneumonia 14 11 20 1515 25 8 17 17 5 14 7 7 1 1 89 73 162 Pleuropneumonia 2 2 2 1 6 5 4 4 5 1 2 2 1 3 22 18 40 Other Diseases of Respiratory System 2 ... ... 4 6 2 4 1 4 5 2 2 ... 2 18 16 34 5— Diseases of Digestive System. Dentition 2 1 2 ... 1 ... ... 1 1 1 2 4 ... 8 7 15 Sore Throat, Quinsy ... ... ... ... ... 1 2 3 ... ... ... ... ... ... 2 4 6 Diseases of Stomach 3 1 1 1 ... 3 4 3 4 5 3 2 ... ... 15 15 30 Enteritis 3 3 5 4 8 8 8 2 5 4 7 2 2 1 38 24 62 Obstructive Diseases of intestine 1 2 1 2 3 2 4 2 2 4 1 2 2 ... 14 14 28 Peritonitis ... 2 ... ... ... ... 2 5 2 ... ... ... 1 ... 5 7 12 Ascites ... ... ... ... 1 ... ... ... ... ... ... ... ... ... I ... 1 Cirrhosis of Liver 3 2 2 1 3 2 4 5 8 1 10 5 4 ... ... 18 31 49 Jaundice and other Diseases of Liver ... ... ... 2 1 1 5 3 2 3 ... 9 9 18 Diseases of the Pancreas ... ... ... ... ... ... ... ... ... 2 1 ... ... ... ... ... ... Other Diseases of Digestive System ... ... 2 ... 1 1 4 1 3 3 ... 2 11 9 20 6.—Diseases of Lymphatic System. (e.g., of Lymphatics and of Spleen) ... 1 ... 1 ... ... ... ... ... 1 ... ... ... ... ... 3 3 7—Diseases of Gland-like Organs of Uncertain Use. (e.g., Bronchocele, Addison's Disease) ... ... ... ... 1 ... ... 1 ... 1 1 ... ... ... 2 2 4 8.—Diseases of Urinary System. Nephritis 2 ... ... ... 3 2 1 2 2 4 1 1 ... 1 9 10 19 Brieht's Disease, Albuminuria 9 7 7 5 10 12 10 10 15 10 9 14 5 2 65 60 125 Disease of Bladder or of Postate 2 ... 1 ... 2 2 3 1 5 2 5 3 3 ... 21 8 29 Calculus (Stone) ... ... ... ... ... 1 ... ... ... 1 2 ... ... ... 2 2 4 Other Diseases of the Urinary System 1 3 2 1 3 2 l ... l ... ... ... ... ... 8 6 14 9.—Diseases of Reproductive System, a. Of Organs of Generation. Male Organs ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 Female Organs ... ... ... 1 ... 1 ... 3 ... 4 ... ... ... ... ... 9 9 16 LAMBETH BOROUGH—Dealhs Registered from all Causes during the Year 1908—continued. Note-The Deaths of Non-Residents occurring in Public Institutions situated in the District are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the District are included. SUB-dISTRICTS. SUB-dISTRICTS. Waterl00 Lambeth Church. nington. well. Brixton. Norwood No Adress All ages. Total. B. Of Parturition. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. Abortion, Miscarriage ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 1 Puerperal Convulsions ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 Placenta, praevia, Flooding ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 2 2 Other Accidents of Child Birth ... ... ... 2 ... 2 ... 1 ... 3 ... 3 ... ... ... 11 11 10.—Diseases of Bones and Joints. Caries, Necrosis ... ... ... ... ... ... 1 ... 1 1 ... ... ... ... 2 1 3 Arthritis, Ostitis, Periostitis ... ... ... 1 ... ... ... ... ... 1 ... 1 ... ... ... 3 3 Other Diseases of Bones and Joints ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 1 1 2 11.—Diseases of Integumentary System. Carbuncle, Phlegmon ... ... ... ... 1 1 ... ... 4 1 ... ... ... ... 5 2 7 Other Diseases of Integumentary System ... 2 ... ... 2 2 ... ... ... 1 1 4 ... ... 3 8 11 VII.—Deaths from Violence. 1.—accident or Negligence. Fractures and Contusions 2 3 3 1 7 4 5 4 4 4 2 2 2 4 25 22 47 Gunshot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cut, Stab ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... Burn, Scald 1 1 2 3 ... 1 ... 2 ... 1 ... ... ... ... 3 8 11 Poison ... ... ... ... 1 1 1 ... 1 ... ... 1 ... ... 3 2 5 Drowning 1 ... 1 1 2 1 ... ... 1 ... ... ... 1 ... 6 2 8 Suffocation ... 1 ... ... 1 ... 1 ... 1 1 1 1 ... ... 4 3 7 Otherwise 2 1 1 1 5 1 2 1 6 5 4 2 ... ... 20 11 31 2.—Homicide. Manslaughter ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Murder 1 ... ... ... ... ... ... 2 ... ... ... ... ... ... 3 ... 3 3.—Suicide. Gunshot Wounds ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... 2 ... 2 Cut, Stab 1 ... 1 ... 2 ... 1 ... 2 ... 1 ... ... ... 8 ... 8 Poison ... 1 1 1 ... ... 2 2 2 ... 3 2 ... ... 8 6 14 Drowning 1 ... ... ... 1 ... 1 ... 1 ... ... ... ... ... 4 ... 4 Hanging 1 ... 1 ... ... ... 1 1 1 ... ... 1 ... ... 4 2 6 Otherwise ... ... ... ... ... ... ... 1 1 ... ... 1 1 2 4.—Execution. Hanging ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... VIII.—Deaths from Ill-Defined and not Specified Causes. ... ... ... ... ... ... ... ... ... ... ... ... ... Dropsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Debility, Atrophy, Inanition 7 9 10 2 10 11 22 10 14 7 15 9 1 ... 79 48 127 Mortification ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tumour 1 ... ... ... ... 1 ... ... 1 ... ... ... ... ... 2 1 3 Abscess ... 1 ... ... 1 ... 1 1 ... ... 1 ... ... ... 3 2 5 Haemorrhage ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sudden Death (cause not ascertained) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not specified, or Ill-defined ... 1 ... ... 1 ... 1 ... ... ... ... ... ... ... 2 1 3 17 18 19 LAMBETH BOROUGH. -Deaths Registered from all Causes during the Year 1908. 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 the limits of the District are included Ages. Ages. Total. Under 1 Year 1-5 Under 5 Years. 5-10 10-15 15-20 20-25 25-40 40-60 60-65 65-80 80 and over. Over 5 Years. All Ages. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. m F. I. Specific Febrile, or Zymotic Diseases 101 82 89 106 190 188 17 17 3 2 1 2 3 4 13 11 17 8 4 4 15 17 3 10 76 75 266 263 529 11. Parasitic Diseases 1 ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 1 2 III. Dietetic Diseases 2 2 ... ... 2 2 ... ... ... ... ... ... ... ... 1 4 5 12 2 2 ... 3 ... 1 8 22 10 24 34 IV. Constitutional Diseases 37 23 50 20 87 43 9 6 4 10 11 10 22 19 99 81 208 147 43 43 74 86 8 21 478 423 565 466 1031 V. Developmental Diseases 94 88 ... ... 94 88 ... ... ... ... ... ... 1 ... ... ... ... 1 1 1 12 34 18 46 32 82 126 170 296 VI. Local Diseases 160 102 78 69 238 171 14 15 7 5 16 10 20 16 89 89 265 211 96 92 253 336 76 143 836 917 1074 1088 2162 VII. Deaths from Violence 10 6 5 9 15 15 3 4 ... ... 3 1 5 2 13 5 30 15 6 2 14 11 2 3 76 43 91 58 149 VIII. Deaths from Ill-defined and not specified Causes 76 45 5 3 81 48 ... 1 ... 1 ... ... ... ... 1 1 3 1 ... ... ... ... 1 ... 5 4 86 52 138 Totals 481 348 227 207 708 555 43 43 14 18 31 23 51 42 216 191 528 395 152 144l 368 487 108 2241 1511 1567 2219 2122 4341 1.—Specif.c I ~ebrile or Zymotic Diseases. 1.—Miasmatic Diseases. Small-pox- Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Unvaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No Statement ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 9 7 38 44 47 51 2 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 2 1 49 52 101 Whooping Cough 9 10 9 21 18 31 ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 18 32 50 Scarlet Fever ... ... 12 15 12 15 4 7 2 ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 5 10 17 25 42 Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Simple Continued and III-defined Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric or Typhoid Fever ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 3 1 ... 1 ... ... ... ... 5 3 5 3 8 Diphtheria 1 1 15 7 16 8 9 7 2 ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... 12 8 28 16 44 Membranous Corup ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 1 2 Influenza 3 1 1 1 4 2 ... 1 ... ... 1 ... 1 ... 6 2 6 4 3 2 7 14 2 10 23 33 30 35 65 Other Miasmatic Diseases 3 2 3 ... 6 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 2 8 2.—Diarrhoeal Diseases. Cholera Nostras 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Cholera Asiatica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea Dysentry 65 52 10 17 75 69 1 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 1 ... 4 1 79 70 149 3.—Malarial Diseases. Remittent or Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4—Zoogenous Diseases. Cowpox and effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases {eg-, Hydrophobia, Glanders, Splenic Fever) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5.—Venereal Diseases. Syphilis 10 7 1 1 11 8 ... ... ... ... ... 1 1 1 2 ... ... 1... ... ... 1 ... ... 3 4 14 12 12 26 Gonorrhoea, Stricture of Urethra ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 3 ... ... ... 5 ... 5 ... 5 6. Septic Diseases. Erysipelas ... 2 ... ... ... 2 ... ... ... ... ... ... ... ... ... ... 4 ... ... 1 3 1 ... ... 7 2 7 4 11 Pvaemia. Septicemia ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 3 3 3 1 ... ... ... ... ... ... 6 5 6 5 11 Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 3 ... ... ... ... ... ... ... ... ... 6 ... 6 6 20 21 LAMBETH BOROUGH-Deaths Registered from all Causes during the Year 1908 - 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. 1. — Parasitic Diseases AGES. AGES. Total Under 1 Year. 1-5 Under 5 Years 5-10 10-15 15-20 20-25 25 40-60 60-65 65-80 80 and over. Over 5 Years All Ages. M. F. M F M. F. M. F. M. F M. F. M F M F M F. M F. M F M. F. M. F M. F. Thrush, and other Vegetable Parasitic Diseases 1 ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 1 2 Worms, Hydatids, and other Animal Parasitic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... III.—Dietetic Diseases. ... ... ... 4 Want of Breast Milk, Starvation 2 2 ... ... 2 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 29 Chronic Alcoholism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 5 12 2 2 ... 3 ... 1 7 22 7 22 1 Delirium Tremens ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... 1 ... IV.—Constitutional Diseases. ... ... ... ... 5 Rheumatic Fever ... ... ... ... ... ... ... ... ... 1 ... ... 1 1 1 2 2 1 ... ... ... ... ... ... 4 5 4 ... 9 Rheumatism of the Heart ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 ... Rheumatism ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 2 ... 3 1 1 ... ... 3 6 3 ... 9 Gout ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... 2 ... ... ... 5 ... 5 2 5 Rickets 5 2 3 ... 8 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8 ... ... 8 205 10 Cancer, Malignant Disease ... ... ... 1 ... 1 ... 1 ... ... 1 ... ... 1 6 0 60 80 22 30 39 64 5 ... 133 204 133 ... 338 Cancum Oris (Noma) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 ... I abes Mesenterica 7 6 3 1 0 7 1 ... 1 ... ... 1 ... ... ... 1 2 ... 1 ... ... ... ... ... 5 2 15 22 24 Tubercular Meningitis, Hydrocephalus 9 4 14 0 23 14 2 1 ... 5 ... ... ... ... ... 2 1 ... ... ... ... ... ... ... 3 8 26 151 48 Phthisis 5 5 4 2 9 7 1 2 2 2 8 8 18 15 83 54 124 52 5l 7 20 2 ... 2 271 154 280 ... 141 Scrofula ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 28 ... Other forms of Tuberculosis 1 6 26 6 37 12 5 2 ... 2 1 1 2 1 7 6 5 2 2 1 ... 1 1 ... 23 16 60 1 88 Purpura, Haemorrhagic Diathesis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 8 1 Anaemia, Chlorosis, Leucocythaemia ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 1 3 5 3 ... ... 2 1 ... ... 10 8 10 13 18 Glycosuria, Diabetes Mellitus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 7 5 1 1 10 3 1 1 19 13 19 6 32 Other Constitutional Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 1 ... 4 1 ... 2 6 2 8 V.—Developmental Diseases. ... ... ... Premature Birth 73 61 ... ... 73 61 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 73 51 134 Atelactasis 11 10 ... ... 11 10 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 11 10 21 Congenital Malformations 10 7 ... ... 0 17 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 11 17 28 Old Age ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 12 4 18 46 31 82 31 82 113 VI.— Local Diseases. 1 Diseases of Nervous System. Inflammation of Brain or Membranes 8 8 2 3 10 11 1 2 ... ... 1 ... ... ... ... 1 2 ... ... ... ... ... ... ... 4 3 14 14 28 Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis ... 2 1 ... 1 2 ... ... ... ... ... ... ... 2 3 3 19 29 9 10 31 50 9 21 71 115 72 117 189 Insanity, General Paralysis of the Insane ... ... ... ... ... ... ... ... ... ... 1 2 1 1 6 ... 18 5 ... 2 2 3 2 2 30 15 30 15 45 Epilepsy ... ... ... ... ... ... ... ... ... ... 2 1 2 ... 3 2 4 1 ... 2 2 1 ... 13 7 13 7 20 Convulsions 14 1 ... 1 14 8 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 14 8 22 Laryngismus Stridulus (Spasm of Glottis) Disease of Spinal Cord, Paraplegia, 2 ... 1 ... 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 3 Paralysis Agitans ... 1 1 ... 1 1 ... ... ... ... ... ... ... ... 3 3 10 4 2 2 11 4 1 1 27 4 28 5 43 Other Diseases of Nervous System 1 ... 1 1 2 1 1 ... 1 ... ... 1 ... ... 1 1 3 1 ... ... 3 ... ... 5 7 7 8 15 2. Diseases of Organs of Special Sense. {e.g., of Ear, Eve. Nose) 2 2 3 1 5 3 1 2 1 1 ... ... 1 ... 1 3 ... ... ... ... 1 ... ... ... 5 6 10 9 19 22 23 LAMBETH BOROUGH— Deaths Registered from all Causes during the Year 1908—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. Under 1 Year. 1-5 Under 5 Years. 5-10 10-15 15-20 20-25 25-40 40-60 60-65 65-80 80 and over. Over 5 Years. All Ages. Total M. F. M F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 3.—Diseases of Circulatory System. ... 2 3 1 3 1 ... 1 1 ... ... 5 3 5 4 9 Pericarditis ... ... ... 1 ... 1 1 ... ... ... ... ... ... ... 3 10 2 1 9 1 1 24 ... ... 13 6 13 6 19 Acute Endocarditis ... ... ... ... ... ... 1 1 1 ... 3 2 3 1 7 7 22 22 9 12 18 39 1 6 6 78 89) 78 141 Valvular Diseases of Heart ... 2 ... 1 ... 3 1 ... ... ... 1 ... 3 3 7 ... 32 16 ... 9 24 1 12 19 89 13 9 96 185 Other Diseases of Heart ... ... ... ... ... ... ... ... ... ... 3 ... 1 ... 2 ... 6 2 ... ... 1 1 ... ... 9 3 1 3 12 Aneurism ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 1 ... ... ... 1 2 59 2 3 Embolism, Thrombosis Other Diseases of Blood Vessels ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 6 1 3 3 34 32 16 17 59 14 3 44 103 4.—Diseases of Respiratory System. 2 3 2 3 ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 4 7 Laryngitis ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... 2 4 2 1 3 4 1 1 9 10 9 ... 1 Croup ... ... ... ... ... ... ... ... ... ... ... ... 5 5 24 30 22 17 55 12 20 45 127 l90 166 10 19 Emphysema, Asthma 32 17 7 10 39 27 ... 1 1 3 2 1 2 3 10 7 35 13 8 5 8 17 1 5 69 56 87 217 383 Bronchitis 12 4 6 9 18 13 2 2 1 ... ... ... 1 ... ... 1 2 2 1 ... ... ... ... ... 4 3 9 69 56 Pneumonia 12 1 3 1 5 2 ... ... ... ... ... ... 1 ... 2 1 4 3 1 1 ...) 10 1 6 12 24 89 5 14 Pleurisy 2 24 37 25 77 49 1 3 ... ... ... ... ... ... 7 2 5 3 2 3 2 8 1 ... 18 16 22 73 62 Bronchopneumonia 40 1 3 1 4 2 ... ... ... ... ... ... ... ... 1 1 4 5 ... 2 3 4 3 2 12 14 18 18 40 Pleuropneumonia 1 2 2 6 2 1 ... ... ... ... ... ... ... 3 16 34 Other Diseases of Respiratory System 4 ... 5.—Diseases of Digestive System. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... s(> ... 8 Dentition 5 4 3 3 8 7 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 2 2 2 2 7 15 Sore Throat, Quinsy ... 1 ... 1 ... 2 2 ... ... ... ... ... ... ... 7 1 2 5 ... 1 3 2 ... ... 12 11 15 4 6 Diseases of Stomach 1 1 2 3 3 4 ... ... 1 ... ... ... 1 2 4 1 6 2 2 ... 5 3 ... ... 20 8 38 15 30 Enteritis 16 15 2 1 8 16 1 ... ... ... ... ... ... ... ... 1 1 3 2 ... 3 4 ... 2 7 11 14 24 62 Obstructive Diseases of Intestine 7 3 ... ... 7 3 1 1 ... ... ... ... ... 2 2 ... 2 3 ... ... ... 1 ... ... 4 7 5 14 28 Peritonitis 1 ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... 1 7 12 Ascites ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 7 9 18 5 1 3 3 ... ... 18 30 18 ... 1 Cirrhosis of Liver ... 1 ... ... ... 1 ... ... ... ... ... ... 1 ... 1 1 2 3 2 ... 1 1 1 1 8 6 9 31 49 Taundice and other Diseases of Liver 1 3 ... ... 1 3 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 18 Diseases of the Pancreas ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 2 1 2 ... ... 3 ... 2 6 8 11 ... ... Other Diseases of Digestive System 5 1 ... ... 5 1 ... ... 9 20 6.—Diseases of Lymphatic System. (e.g., of Lymphatics and of Spleen) ... 1 ... 1 .. 2 ... ... ... ... ... ... ... .. ... ... ... ... ... ... 1 ... ... ... 1 ... 7.—Diseases of Gland-like Organs of Uncertain Use. (e.g., Bronchocele, Addison's Disease) ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 1 ... ... ... 1 ... ... 2 2 2 3 3 8.—Diseases of Urinary System. ... ... ... ... ... ... ... ... 5 5 2 3 2 1 ... ... 9 10 9 2 4 Nephritis ... ... ... ... ... ... ... 1 ... ... 2 2 1 ... 6 2 33 16 7 15 12 22 4 3 65 60 65 10 19 Bright's Disease. Albuminuria ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ...... ... 17 4 3 3 21 8 21 60 125 Disease of Bladder or of Postate ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 1 ... ... 1 2 2 2 8 29 Calculus (Stone) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 1 1 1 3 1 ... 1 6 5 8 2 4 Other Diseases of the Urinary System ... 2 1 ... ... 2 1 ... ... ... .... ... ... ... ... 6 14 9.—Diseases of Reproductive System, a. 01 Organs of Generation. 1 Male Organs ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Female Organs ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 7 ... ... ... ... ... 1 ... ... ... 9 ... 9 9 24 35 LAMBETH BOROUGH—Deaths Registered from all Causes during the Year 1908—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 and 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 ... ... ... ... ... ... ... ... ... 1 ... 1 1 Puerperal Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 1 Placenta, praevia, Flooding ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 2 Other Accidents of Child Birth ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 10 ... ... ... ... ... ... ... ... ... 11 ... 11 11 10.—Diseases of Bones and Joints. Caries, Necrosis ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... 1 ... ... ... ... ... ... ... 2 1 2 1 3 Arthritis, Ostitis, Periostitis ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 2 ... 3 3 Other Diseases of Bones and Joints ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... 1 1 1 1 ... 11.—Diseases of Integumentary System. Carbuncle, Phlegmon 2 ... ... ... 1 2 1 ... ... ... ... ... ... ... 1 ... ... ... 1 ... 1 ... ... 1 3 1 5 2 7 Other Diseases of Integumentary System 2 ... ... 1 2 1 ... ... ... 1 ... ... ... ... ... ... ... 2 ... ... 1 3 ... 1 1 7 3 8 11 VII.— Deaths from Violence. 1.—Accident or Negligence. Fractures and Contusions ... 1 1 1 1 2 2 2 ... ... ... 1 ... ... 2 ... 9 5 ... 1 10 9 1 2 24 20 25 22 47 Gunshot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cut, Stab ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 Burn, Scald 1 ... 1 5 2 5 ... ... ... ... ... ... ... 1 ... ... 1 2 ... ... ... ... ... ... 1 3 3 8 11 Poison ... ... 1 1 1 1 ... ... ... ... ... ... 1 ... 1 ... ... 1 ... ... ... ... ... ... 2 1 3 2 5 Drowning ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 ... 1 1 1 1 ... ... ... ... 6 2 6 2 8 Suffocation 3 1 1 ... 4 3 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 3 7 Otherwise 5 2 ... 2 5 4 ... 2 ... ... 1 ... 1 ... 3 ... 6 2 2 ... 2 1 ... 1 15 7 20 11 31 2.—Homicide. Manslaughter ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Murder 1 ... 1 ... 2 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 3 ... 3 3.—Suicide. Gunshot Wounds ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 ... 2 ... 2 Cut, Stab ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 4 ... 1 ... ... ... 1 ... 8 ... 8 ... 8 Poison ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 5 3... ... ... ... ... ... ... 8 6 8 6 14 Drowning ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... 1 ... ... ... ... ... 4 ... 4 ... 4 Hanging ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 2 1 ... ... ... 1 ... ... 4 2 4 2 6 Otherwise ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 1 1 2 4.—Execution. Hanging ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... VIII.-—Deaths from Ill-Defined and not Specified Causes. Dropsy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Debility, Atrophy, Inanition 75 45 4 3 79 48 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 79 48 127 Mortification ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tumour ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... 1 ... 2 1 2 1 3 Abscess ... ... 1 ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 3 2 5 Haemorrhage ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sudden Death (cause not ascertained) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not specified, or Ill-defined 1 ... ... ... 1 ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 1 3 26 Summary ok Total Corrected Deaths in Lambeth Borough during 1908. Vo. of Deaths. Total. No. of Deaths. Total. M. F. M. F. I.—Specific Febrile, or Zymotic Diseases Brought forward 1923 1882 3805 1. Miasmatic Diseases 154 166 320 VI.—Local Diseases—continued. 2. Diarrhoea! ,, 80 70 150 3. Malarial ,, ... ... ... 6. Diseases of Lymphatic System ... 3 3 4. Zoogenous „ ... ... .... 7. Diseases of Gland-like Organs of Uncertain use 2 2 4 5. Venereal ,, 19 12 31 6. Septic ,, 13 15 28 8. Diseases of Urinary System 105 86 191 9. Diseases of Reproductive System II.—Parsltic Diseases 1 1 2 (a) Diseases of Organs of Generation 1 9 10 III.—Dietetic Diseases 10 24 34 (b) Diseases of Parturition ... 15 15 10. Diseases of Bones and Joints 3 5 8 IV.—Constitutional Diseases 565 466 1031 11. Diseases of Integumentary System 8 10 18 V.—Developmental Diseases 126 170 296 VII.—Violence. VI.—Local Diseases 1. Accident or Negligenee 61 49 110 1. Diseases of Nervous System 181 184 365 2. Homicide 3 ... 3 2. Diseases of Organs of Special Sense 10 9 19 3. Suicide 27 9 36 4. Execution ... ... ... 3. Diseases of Circulatory System 239 233 472 4. Diseases of Respiratory ,, 404 412 816 VIII.—ill-defined and not Specified Causes 86 52 138 5. Diseases of Digestive ,, 121 120 241 Carried forward 1923 1882 3805 Total 2219 2122 4341 27 Offences under the Food and Drugs, and Public Health Acts, during 1908. NATURE OF OFFENCES AND AMOUNTS OF PENALTIES AND COSTS IN EACH CASE. 28 29 SALE OF FOOD AND DRUGS ACTS.—SUMMONSES, 1908. Offence. Penalty. Costs. £ s. d. £ s. d. On 12th February, five summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk containing added water 4 per cent. [sample 37] Summons withdrawn upon payment of costs. 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 38 per cent. [sample 16] 3 0 0 0 12 6 Re selling Milk containing added water 9 per cent. [sample 56] 2 0 0 0 16 6 Re selling Butter containing Margarine (not butter) 93 parts [sample 41]. 2 0 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 22 per cent. [sample 14]. Summons dismissed owing to warranty being proved satisfactory - - On 19th February, seven summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk containing added water 7 per cent. [sample 59 1 0 0 0 17 6 Re selling Butter containing Margarine (not butter) 94 parts [sample 58] 1 0 0 0 17 6 Re selling Butter containing Margarine (not butter) 93 parts [sample 80] 1 0 0 0 17 6 Re exposing a parcel of Margarine for sale by retail without having label attached and marked in printed capital letters, not less than l½-in. square— "Margarine" [sample 82] 1 0 0 0 17 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. square— "Margarine" [sample 89] - 0 12 6 Re selling Butter containing Margarine (not Butter) 90 parts [sample 83] 0 5 0 0 17 6 Carried forward 11 5 0 8 2 0 30 31 Sale of Food and Drugs Acts.—Summonses, 1908—continued. Offence. Penalty. Costs. Brought forward £ s. d. £ s. d. 11 5 0 8 2 0 Re selling Milk containing added water 5 per cent. [sample 97] 2 0 0 0 16 6 On 26th February, six summonses were heard before Mr. De Grey, at Lambeth Police Court, re selling Milk containing added water 9 per cent. [sample 100]. Summons dismissed owing to warranty being proved satisfactory - - 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. square— "Margarine" [sample 123] 1 0 0 0 16 6 Re selling Milk containing added water 10 per cent. [sample 119] 0 10 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 9 per cent. [sample 181]. Summons dismissed owing to warranty being proved satisfactory - - Re selling Milk deficient in Milk Fat to the extent of extent of 6 per cent. [sample 180]. Summons dismissed owing to warranty being proved satisfactory - - Re selling Milk deficient in Milk Fat to the extent of 10 per cent. [sample 177] 0 5 0 0 16 6 On 11th March, three summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 23 per cent. [sample 220] 0 10 0 0 16 6 Re selling Butter containing Margarine (not butter) 96 parts [sample 217] 0 10 0 0 16 6 Re selling Butter containing Margarine (not butter) 100 parts [sample 231] 0 10 0 0 16 6 Carried forward 16 10 0 13 17 6 32 33 Sale of Food and Drugs Acts.—Summonses, 1908—continued. Offence. Penalty. Costs. Brought forward £ s. d. £ s. d. 16 10 0 13 17 6 On 25th March, seven summonses were heard before Mr. Hopkins. at Lambeth Police Court, re selling Milk containing added water 3 per cent. [sample 135] 1 0 0 2 0 2 Re selling Butter containing Margarine (not butter) 80 parts [sample 270] 1 0 0 0 16 6 Re selling Milk containing added water 4 per cent. [sample 286] 2 0 0 0 16 6 Re selling Milk containing added water 14 per cent. [sample 271] 2 0 0 0 19 1 Re selling Milk containing added water 13 per cent. [sample 2731 2 0 0 0 19 1 Re selling Milk containing added water 12 per cent. [sample 2541 2 0 0 0 19 1 Re selling Milk containing added water 9 per cent. [sample 253] 2 0 0 0 19 1 On 1st April, four summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 7 per cent. [sample 306]. Sample submitted to Somerset House, who declared the adulteration to be only 3 per cent. of Milk Fat deficient. Summons was dismissed owing to difference of results of analysis - - Re selling Milk deficient in Milk Fat to the extent of 10 per cent. [sample 280]. Summons withdrawn owing to legal technicality (day late in service) Re selling Milk containing added water 20 per cent. [sample 308]. Summons withdrawn, wholesale dealer's cooler defective, causing water to mix with Milk Re selling Milk deficient in Milk Fat to the extent of 9 per cent. [sample 320] 1 0 0 0 16 6 Carried forward 29 10 0 22 3 6 34 35 Sale of Food and Drugs Acts.—Summonses, 1908—con tinned. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 29 10 0 22 3 6 On 15th April, two summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk deficient in Milk Fat 6 per cent. [sample 339] 0 10 0 1 0 6 Re selling Margarine containing butter 27 parts [sample 353] - 0 16 6 On '22nd April, six summonses were heard before Mr. Francis, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 13 per cent. [sample 389]. Summons withdrawn upon payment of costs, the contrary being proved - 0 17 6 Re selling Milk containing added water 5 per cent., and deficient in Milk Fat to the extent of 6 per cent. [sample 387]. Summons withdrawn upon payment of costs, the contrary being proved - 0 17 6 Re selling Milk containing added water 4 per cent. and deficient in Milk Fat to the extent of b per cent [sample 368]. - - Summons withdrawn upon payment of costs the contrary being proved - 0 17 6 Re selling Milk deficient in Milk Fat to the extent of 18 per cent. [sample 370]. Summons withdrawn upon payment of costs the contrary being proved - 0 17 6 Re selling Milk deficient in Milk Fat to the extent of 5 per cent. [sample 381]. Summons withdrawn upon payment of costs, the contrary being proved - 0 16 6 Re selling Milk containing added water 5 per cent. [sample 428] 0 10 0 0 16 6 On 7th May, a summons was heard before Mr. Cecil Chapman, at Lambeth Police Court, for selling Coffee containing added chicory 72 parts [sample 492]. The Magistrate was of opinicn that it was a genuine mistake, and ordered the Defendant to pay costs - 0 16 6 Carried forward 30 10 0 30 0 0 36 Sale of Food and Drugs Acts.—Summonses, 1908—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 30 10 0 30 0 0 On 14th May, three summonses were heard before Mr. Francis, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 16 per cent. [sample 572] 0 10 0 0 18 1 Re selling Milk deficient in Milk Fat to the extent of 13 per cent. [sample 560] 0 10 0 0 18 1 Re selling Milk containing added water 2 per cent. [sample 565] . Summons withdrawn upon payment of costs, the contrary being proved 0 16 6 On 27th May, a summons was heard before Mr. Horace Smith, at Lambeth Police Court, re selling Milk containing added water 22 per cent. [sample 590]. Whilst hearing the case, the 3rd sample burst in Court, and the summons was adjourned until the 3rd of June for the purpose of enabling the Magistrate to further consider the point. On re-hearing the case on the 3rd June, the Magistrate dismissed it, but without costs On 11th June, five summonses were heard before Mr. Cecil Chapman, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 5 per cent. [sample 542]. N.B.—Third sample sent to Somerset House, and the analysis confirmed 0 10 0 0 16 6 Re selling Milk containing added water 3 per cent. [sample 607] 0 10 0 0 16 6 Re selling drug (Decoctum Aloes Co.) deficient in Alcohol to the extent of 64 per cent. [sample 617]. Summons withdrawn, Analyst's certificate being irregular - - Re selling Milk deficient in Milk Fat to the extent of 7 per cent. [sample 654]. Magistrate dismissed summons, the contrary being proved - - Carried forward 32 10 0 34 5 8 37 38 Sale of Food and Drugs Acts.-Summonses, 1908—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 32 10 0 34 5 8 Re selling Milk deficient in Milk Fat to the extent of 7 per cent. [sample 656] Magistrate dismissed summons, the contrary being proved - - On 24th June, two summonses were heard before Mr. Francis, at Lambeth Police Court, re selling Coffee containing added chicory 45 parts [sample 687] 0 10 0 0 16 6 Re selling Butter containing Margarine (not butter) 100 parts [sample 675]. Magistrate dismissed summons, having already convicted Defendant the same day for another offence (see sample 676) - - On 1st July, a summons was heard before Mr. Horace Smith, at Lambeth Police Court, 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 676] 0 10 0 0 16 6 On 8th July, four summonses were heard before Mr. Horace Smith, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 10 per cent. [sample 720] 0 10 0 0 16 6 Re selling Butter containing Margarine (not butter) 100 parts [sample 726] 0 10 0 0 16 6 Re selling Milk containing added water 22 per cent. [sample 750] 0 10 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. square— "Margarine" [sample 748] 1 0 0 0 12 6 On 15th July, a summons was heard before Mr. Horace Smith, at Lambeth Police Court, re selling Butter containing Margarine (not Butter) 10 parts [sample 672]. N.B.—Third sample was sent to Somerset House, and the analysis confirmed 0 5 0 0 16 6 Carried forward 36 5 0 39 13 2 39 40 4 I Sale of Food and Drugs Acts.—Summonses, 1908—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 36 5 0 39 13 2 On 29th July, nine summonses were heard before Mr. Horace Smith, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 4 per cent. [sample 799] 0 5 0 1 5 8 Re selling Milk deficient in Milk Fat to the extent of 33 per cent. [sample 855] 1 0 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 20 per cent. [sample 836] 0 10 6 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 11 per cent. [sample 845]. Summons dismissed owing to warranty being proved satisfactory - - Re selling Butter containing Margarine (not butter) 99 parts [sample 857] 0 10 6 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 12 per cent. [sample 899] 0 3 6 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 7 per cent. [sample 891] Dismissed on payment of costs, the contrary being proved - 1 5 7 Re selling Milk containing added water 7 per cent. [sample 851]. Summons dismissed on payment of costs, leaking cooler being proved - 1 0 0 Re selling Milk containing added water 4 per cent. [sample 852]. Summons dismissed on payment of costs, leaking cooler being proved - 1 0 1 On 2nd September, three summonses were heard before Mr. Cecil Chapman, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 12 per cent. [sample 916] 0 10 0 0 16 6 Carried forward 39 4 6 48 7 0 42 43 Sale of Food and Drugs Acts.—Summonses, 1908—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 39 4 6 48 7 0 Re selling Milk deficient in Milk Fat to the extent of 11 per cent. [sample 933] 0 10 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 5 per cent. [sample 907]. Summons withdrawn on payment of costs, the contrary being proved - 0 15 1 Cn 10th September, eight summonses were heard before Mr. Cecil Chapman at Lambeth Police Court, re selling Milk containing added water 8 per cent. [sample 1012]. 1 0 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 6 per cent. [sample 979]. Adjourned sine die, defendant having removed. Re selling Butter containing Margarine (not butter) 76 parts [sample 973] 5 0 0 0 16 6 Re selling Milk deficient in Milk Fat to the extent of 16 per cent. [sample 966] 0 10 0 0 16 6 Re selling Milk containing added water 5 per cent. [sample 955] 1 0 0 0 16 6 Re selling Butter containing Margarine (not butter) 95 parts [sample 940] 3 0 0 0 16 6 Re selling German Sausage (under Section 3) containing an ingredient or material mixed so as to render the article injurious to health [sample 945]. Summons dismissed under Section 5. - - Re selling German Sausage (under Section 3) containing an ingredient or material mixed so as to render the article injurious to health [sample 975]. Summons dismissed under Section 5. - - Carried forward 50 4 6 54 1 1 44 45 Sale of Food and Drugs Acts.—Summonses, 1908—continued. Offence. Penalty. Costs. Brought forward £ s. d. £ s. d. 50 4 6 54 1 1 On 23rd September, 6 summonses were heard before Mr. Cecil Chapman, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 10 per cent. [sample 801] 3 0 0 1 4 6 Re selling Milk deficient in Milk Fat to the extent of 4 per cent. [sample 921]. Defendant to pay costs 0 16 6 Re selling Milk containing added water 3 per cent. [sample 928]. Summons dismissed owing to warranty being proved satisfactory - - Re selling Butter containing Margarine (not butter) 97 parts [sample 923]. Adjourned sine die, defendant having left. Re selling Milk deficient in Milk Fat to the extent of 4 per cent. [sample 929]. Magistrate dismissed summons with £5 5s. costs against Council, owing to Milk being purchased under a warranty, and the warranty being satisfactorily proved. Re selling Milk deficient in Milk Fat to the extent of 19 per cent. [sample 1041]. 1 0 0 0 16 6 On 14th October, 5 summonses were heard before Mr. Cecil Chapman, at Lambeth Police Court, re selling Margarine, the fat of which contained more than 10 per cent. of butter fat, to wit—45 per cent. [sample 1108]. Defendant to pay costs. - 0 10 4 Re selling Butter containing Margarine (not butter) 55 per cent. [sample 1108] 2 0 0 0 10 4 Re selling Milk deficient in Milk Fat to the extent of 13 per cent. [sample 1107]. Defendant to pay costs. - 0 10 4 Carried forward 56 4 6 58 9 7 46 47 Sale of Fcod and Drugs Acts.—Summonses, 1908—continued. Offence. Penalty. Costs. Brought forward £ s. d. £ s. d. 56 4 6 58 9 7 Re selling Milk deficient in Milk Fat to the extent of 14 per cent. [sample 1199]. Defendant to pay costs. — 0 14 6 Re selling German Sausage containing a boric preservative equivalent to 32½ grains per lb. crystallised Boric Acid [sample 1200] 1 0 0 0 14 6 On 4th November, 3 summonses were heard before Mr. Francis, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 3 per cent. [sample 959]. Defendant to pay costs - 1 5 0 Re exposing a parcel of Margarine for sale by retail without having label attached and marked in orinted capital letters not less than 1½-in.—Margarine [sample 958] 1 0 0 0 2 0 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 957] 2 0 0 0 2 0 On 18th November, 3 summonses were heard before Mr. Francis, at Lambeth Police Court, re selling German Sausage containing a boric preservative equivalent to 22 grains Crystallised Boric Acid per lb. [sample 1105] Summons dismissed, amount of adulteration being harmless. - - Re selling Milk containing added water 4 per cent. [sample 1292] 0 10 0 0 16 6 Re selling German Sausage containing a boric preservative equivalent to 20 grains per lb. Crystallised Boric Acid [sample 1233]. Summons dismissed, with 15 guineas costs against the Council, amount of adulteration being harmless - - Carried forward 60 14 6 62 4 1 48 Sale of Fcod and Drugs Acts.—Summonses, 1908—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 60 14 6 62 4 1 On 2nd December, 2 summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Butter containing Margarine (not butter) 94 parts [sample 1333] 1 0 0 0 16 6 Re selling Milk containing added water 5 per cent. [sample 1331] 2 0 0 0 16 6 On 30th December, 5 summonses were heard before Mr. Hopkins, at Lambeth Police Court, 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 1496] 0 5 0 0 16 6 Re selling Butter containing Margarine (not butter) 86 parts [sample 1487] 2 0 0 0 16 6 Re selling Butter containing Margarine (not butter) 86 parts [sample 1557] 2 0 0 0 16 6 Re selling Butter containing Margarine (not butter) 96 parts [sample 1543] 5 0 0 0 16 6 Re exposing a parcel of Margarine for sale by retail without having label attached and marked in printed capital letters not less than 1½-in.—Margarine [sample 1565] 0 5 0 0 16 6 On 20th January, 3 summonses were heard before Mr. Hopkins, at Lambeth Police Court, re selling Milk deficient in Milk Fat to the extent of 5 per cent., and containing extraneous water 2 per cent. [sample 1620] Summons dismissed owing to warranty being proved satisfactory - - Re selling Milk containing extraneous water to the extent of 6 per cent. [sample 1655] 2 0 0 0 16 6 Re selling Butter containing Margarine (not butter) 93 parts [sample 1662] 1 0 0 0 16 6 Carried forward 76 4 6 69 12 7 49 5° Sale of Food and Drugs Acts.—Summonses, 1908—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward 76 4 6 69 12 7 On 3rd February, 1909, 4 summonses were heard before Mr. Hopkins, at Lambeth Police Court, 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 1661]. Defendant to pay costs - 0 12 6 Re selling Milk deficient in Milk Fat to the extent of 22 per cent., and containing extraneous water 7 per cent. [sample 1759] 10 0 0 0 16 6 Re selling Butter containing Margarine (not butter) 46 parts [sample 1754] 2 0 0 0 17 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 1727] - 0 12 6 £88 4 6 £72 11 7 5» PUBLIC HEALTH AND METROPOLIS MANAGEMENT ACTS.—SUMMONSES. Offence. Penalty. Costs. £ s. d. £ s. d. On 22nd January, a summons was taken out against the owner, for non-compliance with the notice of Council to cleanse staircase and walls of front top room, and Pothouse, and provide a new pan to the closet at "Crown and Thistle," South Lambeth Road. Summons was withdrawn, the work having been done meanwhile - 0 2 0 On 19th May, a summons was taken out against the owner, for non-compliance with notice of Council to abate nuisance from damp basement walls, providing drain in front area and ventilation under floors at 88 Barrington Road. Summons was withdrawn, the work having been done meanwhile - 0 2 0 Carried forward - 0 4 0 52 Public Health and Metropolis Management Acts.—Summonses.—continued. Offence. Penalty. Costs. £ s. d. £ s. d. Brought forward — 0 4 0 On 1st July, 2 summonses were heard before Mr. Horace Smith, (1) against the carman for removing offensive matter through Distin Street during prohibited hours, contrary to the by-laws of the L.C.C. Defendant was cautioned by Magistrate, and ordered to pay 2s. costs - 0 2 0 (2) Against the owner of the van for causing to be removed the above offensive matter through Distin Street during prohibited hours, contrary to the by-laws of the L.C.C. Defendant fined 8s. and 2s. costs 0 8 0 0 2 0 On 15th July, a summons was heard by Mr. Horace Smith, against the owner for keeping animals so as to be a nuisance and injurious to health. Summons withdrawn on payment of 2s. costs, the animals having been removed in the meanwhile — 0 2 0 On 5th August, a summons was heard before Mr. Horace Smith against the owner for non-compliance with notice of Council to cleanse the interior, disconnect sink, provide gully, and repair soil pipe and w.c. at 16 Kepler Road. Order made to do the work within 14 days, and defendant to pay 4s. costs. - 0 4 0 On 5th August, a summons was taken out against the owner for non-compliance with notice of Council to repair the roof at No. 31 Villa Road. Summons withdrawn on payment by defendant of 2s. costs, the work having been done meanwhile - 0 2 0 On 22nd September, 2 summonses were heard by Mr. Hopkins, (1) against the carman for removing through Distin Street offensive matter during prohibited hours, contrary to the by-laws of the L.C.C. Defendant fined 10s. and 2s. costs 0 10 0 0 2 0 (2) Against the owner of the van for causing to be removed through Distin Street offensive matter during prohibited hours, contrary to the by-laws ot the L.C.C. Defendant to pay 2s. costs — 0 2 0 Carried forward 0 18 0 1 0 0 53 54 Public Health and Metropolis Management Acts.-Summonses. continued. Offence. Penalty. Costs. Brought forward £ s. d. £ s. d. 0 18 0 l 0 0 On 28th September, a summons was taken out for partially re-constructing a drain at No. 36 Crawshay Road, and failing to deposit plans and particulars to comply with the by-laws of the L.C.C. Summons was withdrawn upon payment of 2s. costs, the plans having been deposited meanwhile — 0 2 0 On 3rd October, a summons was heard before Mr. Hopkins against the owner for non-compliance with notice of Council to provide a proper and sufficient receptacle for house refuse at 55 Vassall Road. Order made to provide a dustbin within 7 days, and defendant to pay 4s. costs — 0 4 0 On 14th October, a summons was heard before Mr. Cecil Chapman against the owner for non-compliance with notice of Council to put the drain and yard paving in order, and provide a dustbin at No. 27 Meadow Road. Order made to do work in 28 days, and defendant to pay 4s. costs - 0 4 0 On 12th October, a summons was heard before Mr. Hopkins against the tenant at 52 Branksome Road for non-compliance with notice of Council to provide a proper and sufficient supply of water. Closing order made, tenant promising to vacate the house 0 2 0 On 9th October, 4 summonses were taken out (1) against the owner of 19 Brooklands Street for non-compliance with notice of Council to cleanse and repair ceilings and walls, and repair yard paving - 0 2 0 (2) Against the owner of 45 Brooklands Street for noncompliance with notice of Council to provide dustbin, repair paving, and cleanse walls and ceilings at 45 Brooklands Street 0 2 0 (3) Against the owner of 15 Camelia Street for non-compliance with notice of Council to cleanse ceilings and walls of passage at 15 Camelia Street - 0 2 0 (4) Against the owner of 17 Camelia Street for non-compliance with notice of Council to cleanse walls and ceilings of passage, staircase and top floor rooms, and provide a dustbin - 0 2 0 These four summonses were withdrawn on payment by defendant of 8s. costs, the work having been done meanwhile. Carried forward 0 18 0 2 0 0 55 Public Health and Metropolis Management Acts.—Summonses.—continued. Offence. Penalty. Costs. Brought forward £ 0 s. 18 d. 0 £ 2 s. 0 d. 0 On 16th October, 4 summonses were taken out against the owner of 83 Newburn Street— (1) Non-compliance with notice of Council to put drain into proper order and condition — 0 2 0 (2) Non-compliance with notice of Council to pave the yard — 0 2 0 (3) Non-compliance with notice of Council to repair defective eaves gutter — 0 2 0 (4) Non-compliance with notice of Council to provide a sanitary dustbin These four summonses were withdrawn on payment by defendant of 8s. costs, the work having been done meanwhile. - 0 2 0 On 1st December, a summons was heard before Mr. Hopkins against the owner of No. 11 Warham Street for non-compliance with notice cf Council to put the drain into proper order and condition. Defendant ordered to do the work in six weeks, but no costs were allowed - - On 24th November, a summons was taken out against the owner of 2 Rose Cottages, Cumberland Place, for noncompliance with notice of Council to cleanse interior and repair defective paving. The summons was withdrawn on payment of 2s. costs, the work having been done meanwhile - 0 2 0 On 4th December, a summons was heard before Mr. Cecil Chapman for non-compliance with Magistrate's order to put the drain and yard paving in crder, and provide a dustbin at 27 Meadow Road. Defendant fined 40s. and 2s. costs 2 0 0 0 2 0 £2 18 0 £2 12 0 57 58 1908. 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. Scabies. Ophthalmia. Croup. Meningitis. Glass Pox. Tonsillitis. Impetigo. TOTALS. Addington Street 34 20 12 9 8 37 13 1 134 Archbishop Sumner's, Reedworth Street 35 16 13 1 9 74 on Archbishop Tenison's, High Street 19 3 2 1 LI 4 Aristotle Road 2 2 13 Beresford Street 2 2 4 3 1 1 3 Bonneville Road 3 Boundary Lane 2 2 Boundary Lane Church Street 12 5 53 1 2 73 Christ Church, Bear Lane 2 1 4 Christ Church Csncpll Road 84 5 1 9 17 116 Cormont Road 107 61 4 38 9 15 3 1 241 Crawford Street 7 14 1 1 1 24 Crampton Street 3 6 2 2 3 7 23 Dulwich Hamlet 1 1 2 Effra Parade 108 32 37 39 6 7 230 Faunce Street 4 1 4 3 2 1 15 Fountain Street 103 23 1 49 11 1 1 196 George Street 2 2 Gipsy Road 123 67 10 63 68 15 17 3 1 1 4 1 1 374 Grove Lane 6 3 9 Hackford Road 145 8 14 19 21 19 3 229 Hazelrigge Road 6 1 5 7 12 1 72 Hatfield Street 5 27 1 9 13 91 4 9 8 1 3 1 72 Hitherfield Road 12 7 1 7 12 1 40 Holland Street, Southwark 2 •.. 2 Holy Trinity, Carlisle Street 2 14 14 4 3 2 3 42 Holy Trinity, Lutheran Place 9 - ■ 15 Horseferry Road 1 1 Jessop Road 13 51 4 22 22 4 1 121 Jewish School, Heygate Street 2 2 1 5 Johanna Stree. 2 2 Kennington Road 22 13 9 2 5 2 53 Larkhall Lane 5 10 3 18 Lawn Lane 41 42 20 8 3 2 3 1 120 Leipsic Road 2 1 3 Lollard Street 10 2 9 2 5 4 1 33 Lyham Road 61 36 19 50 70 1 9 1 2 250 Marlboro Street 5 30 1 13 1 1 1 10 62 National School, Lingham Street 55 15 1 20 21 4 11 1 1 1 130 New Road 12 1 2 12 1 5 3 38 New Park Road 19 7 1 2 1 1 31 Old Kent Road 1 2 3 Penrose Street 1 3 1 5 Pocock Street 7 1 1 9 Priory Grove 68 35 38 25 8 11 1 2 192 Rosendale Road 5 1 25 19 1 5 56 St. Agnes, Farmer's Road 1 14 5 20 St. Anne's, Harleyford Road 50 3 2 1 3 2 1 62 St. Jude's, Colnbrook Street 1 2 3 St. Jude's, Railton Road 36 1 9 23 3 1 1 74 St. John's, Angell Town 4 2 1 1 8 St. John's, Camberwell New Road 1 1 St. John's, Exton Street 12 2 13 3 47 2 80 St. John Ruskin, Camberwell 2 2 4 St. Luke's, Elder Road 13 1 14 St. Mark's, Kennington Oval 4 19 5 25 12 6 6 1 1 79 St. Mary, Lambeth Road 1 11 4 25 1 41 St. Mary, Newington 1 1 St. Mary-the-Less, Prince's Road 7 1 13 2 1 3 27 St. Matthew, Church Road 18 5 5 1 4 33 St. Michael's, Halstead Street 67 18 20 4 14 5 1 129 St. Patrick's, Cornwall Road 1 2 19 2 - 24 59 6o CASFS OF ILLNESS, &c.,—continued. SCHOOLS. Measles. Chicken Pox. Whooping Cough. Scarlet Fever. Ringworm. Mumps. Diphtheria. Typhoid. Eczema. Blight. Itch. Erysipelas. Scabies. Ophthalmia. Croup. Meningitis. Glass Pox. Tonsillitis. Impetigo. TOTALS. St. Patrick's, Stamford Street 1 3 4 St. Paul's, Gye Street 24 68 3 10 4 5 3 1 2 3 1 124 St. Saviour's, Salamanca 24 24 St. Saviour's, Heme Hil 2 38 4 6 3 9 62 St. Stephen's, Dorset Road 2 18 11 3 6 1 41 St. Peter's, Vauxhall 42 15 11 9 8 12 2 2 7 4 1 113 Salter's Hill 91 53 2 22 25 24 2 16 3 6 244 Santley Street 78 61 8 42 8 9 9 1 216 South Lambeth Road 62 14 31 86 30 15 5 2 2 247 Sussex Road 38 9 1 20 19 85 4 2 1 179 Stock well Road 63 57 26 55 9 2 22 2 1 240 Stock well Practising School 10 28 18 5 2 3 66 Stock well Secondary School, Durand Gardens 2 2 Sydenham Hill Road 1 1 2 Tennyson Street, Battersea 2 2 Upper Kennington Lane 67 17 36 13 17 12 3 1 1 3 1 171 Vauxhall Street 65 10 1 38 4 4 14 2 19 7 1 166 Walnut Tree Walk 4 6 20 1 6 1 1 2 2 43 Waterloo Road 15 3 2 6 12 2 4 44 Wesleyan, Eden Road 10 1 2 2 6 21 West Square 22 8 6 14 11 3 1 65 Westminster Bridge Road 22 10 5 7 1 3 2 5 55 Wild Street, Holborn 3 3 Wurtemberg Street, Clapham 1 1 Woodland Road 28 25 2 1 9 1 1 67 Wycliffe Road, Battersea 1 1 2 1998 1039 311 1051 606 582 224 4 27 60 8 13 59 28 2 5 10 2 6 6035 61 Home Office. METROPOLITAN BOROUGH OF LAMBETH, 1908. 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.) 13 Workshops (Including Workshop Laundries) 341 Workplaces (Othe than Outworkers' Premises included in Part 3 of this Report, pp. 64-66) 805 Total 818 341 62 2.—Defects Found. Particulars. Number of Defects. Number of Prosecu tions. Found. Remedied. Referred to h.m. Inspector Nuisances under the Public Health Acts.:— Want of Cleanliness 136 136 Want of V entilation 6 6 Overcrowding 13 13 Want of drainage of floors Other nuisances 634 634 Sanitary accommodations insufficient unsuitable or defective not separate for sexes 303 4 303 4 Offences under the Factory and Workshops Acts:— 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 Totals 1096 1096 .Including those specified in Sections 2, 3, 7, and 8, of the Factory Act as remediable under the Public Health Acts. 63 4. —Registered Workshops. Workshops on the Register (s. 131) at the end of the year 1908. Number. (1) (2) Bakehouses 207 Restaurants 243 Laundries 232 Dressmakers 438 Tailors 96 Milliners and Mantle Makers 103 Blouse Makers 36 Other Businesses 625 Total number of workshops on Register 1980 5.—Other Matters. Class. (0 Number. (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 37 Action taken in matters re- ferred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) Notified by H.M. Inspector Reports (of action taken) sent to H.M. Inspector 8 8 Other Underground Bakehouses (s. 101):- Certificates granted during the year 72 In use at the end of the year 72 64 3.—HOME OUTWORKERS' LISTS, SECTION 107. Lists received from Employers. Address of Outworkers.§ (10) Notices served on Occupiers as to keeping or sending lists. NATURE OF WORK.. Twice in the year. Once in the year. (8) Received from other Councils. (9) Forwarded to other Councils. Outworkers.! Outworkt rs. (1) Lists.t (2) Contractors (3) Workmen. (4) Lists. (5) Contractors (6) Workmen. (7) Wearing apparel— (1) making, &c. 52 4 437 11 41 882 (2) cleaning and washing 1 1 1 Lace, lace curtains, and nets Artificial flowers 7 Nets, other than wire nets Tents Sacks Furniture and upholstery 4 8 2 5 1 Fur pulling Feather sorting Umbrellas, &c. Carding, &., of buttons, &c. Paper bags and boxes 8 4 51 1 19 17 Basket making Brush making 8 Racquet and tennis balls Stuffed toys 2 File making Electro-plate Cables and chains Anchors and grapnels Cart gear Locks, latches and keys Pea picking Total 64 8 496 15 66 918 351 79 .If an occupier gives out work of more than one of the classes specified in in each class of work, the list is included among those in column 2 (or 5 as the case columns 3 and 4 (or 6 and 7) into their respective classes. †The figures required in columns 2, 3 and 4 are the total number of the lists two lists each year and of the entries of names of outworkers in those lists. The entries in —in some previous returns odd numbers have been inserted. The figures in columns 3 and names are given, since in the February and August lists of the same employer the same §In view of the wide discrepancies found to exist between the totals in the two to give exact figures. Only those addresses should be counted which have actually been 65 WORK. OUTWORK in UNWHOLESOME PREMISES Sections 108. OUTWORK in INFECTED PREMISES Sections 109, 110. Prosecutions. Failing to keep or permit inspection of Lists. Failing to send Lists. Inspections of Outworkers' premises, Instances. Notices served. Prosecutions Instances. Orders made (S. 100). Prosecutions (Section 109, 110) (11) (12) (13) (14) (15) (16) (17) (18) (19) 6 Nil. Nil. Nil. Nil. Nil. Nil. Nil. 575 | 6 column 1, and subdivides his list in such a way as to show the number of workers may be) against the principal class only, but the outworkers are assigned in received from those employers who comply sttictly with the statutory duty of sending column 2 must necessarily be ev n numbers, as there will be two lists for each employer 4 will usually be (approximately) double of the number of individual outworkers whose outworker's name will often be repeated. columns when the returns are added together, it is desired that care may be taken received from or forwarded to other Councils during the year covered by the report. 66 DEATH-RATES (CORRECTED) IN METROPOLITAN BOROUGHS DURING 1908 PER 1000 PERSONS LIVING. All Causes. Principal Epidemic Diseases. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping-Cough Typhus. Enteric Fever. Pyrexia† (Origin uncertain). Diarrhoea. Phthisis. Deaths under 1 year to 1000 Births. County of London 13.8 1.35 0.31 0.11 0.15 0.20 0.05 0.00 0.53 1.32 113 West. Paddington 12.4 0.87 0.23 0.10 0 10 0.07 0.03 0.34 1.01 103 Kensington . 129 C.92 0.17 0.05 0.15 0.04 0.03 0 48 0.98 119 Hammersmith 14.0 1.09 0.12 0.09 0.10 0.15 0.04 0.59 1 .26 120 Fulham 12.4 1.59 0.41 0.10 0.18 0.19 0.06 0.65 1.14 116 Chelsea 14.5 1.18 0.16 0.10 0.16 0.22 0.07 0.47 1.27 107 City of Westminster 12.6 0.58 0.13 0.04 0.09 0.05 0.03 0.24 1.23 102 North. St. Marylebone 14.2 0.85 0.19 0.10 0.11 0.10 0.05 0.30 1.16 101 Hampstead 8.5 0.40 0.05 0.07 0.05 0.05 0.05 0.13 0 78 69 St. Pancras 14.7 1.06 0.19 0.08 0.09 0.29 0.04 0.37 1.51 107 Islington 13.2 1.01 0.23 0.09 0.16 0.16 0.05 0.32 1.24 102 Stoke Newington 12.3 0.82 0.18 0.09 0.02 0.11 0.07 0.35 1.07 92 Hackney 13.2 1.52 0.31 0.13 0.19 0.18 0.03 0.68 1.22 115 Central. Holborn 16.4 1.07 0.20 0.13 0.09 0.14 0.09 0.42 2.11 113 Finsbury 18.6 2.09 0.45 0.13 0.16 0 26 0.12 0.97 2.15 133 City of London 17.7 0.40 0.15 0.10 0.05 0.10 1.79 92 East. Shoreditch 17.4 2.09 0.44 0.25 0.11 0.20 0.09 1.00 2.00 139 Bethnal Green 17.1 2.48 0.78 0.30 0.21 0.32 0.10 0.77 1.61 132 Stepney 16.4 2.53 0.84 0.17 0.24 0.41 0.04 0.00 0.83 1.56 130 Poplar 15.9 2.26 0.47 0.21 0.19 0.42 0.08 0.89 1.34 123 South. Southwark 16.3 1.76 0.36 0.11 0.15 0.23 0.03 0.88 1.88 131 Bermondsey 18.8 2.30 0.82 0.19 0.18 0.17 0.09 0.01 0.84 1.89 144 Lambeth 18.3 1.18 0.31 0.13 0.14 0.15 0.02 0.43 1.45 104 Battersea 12.2 1.19 0.26 0.13 0.12 0.21 0.03 0.44 1.19 106 Wandsworth 11.6 0.93 0.15 0.07 0.13 021 0.02 0.35 0.96 97 Camberwell 12.7 1.06 0.19 0.08 0.14 0.19 0.02 0.44 1.12 104 Deptford 13.8 1.32 0.28 0.06 0.08 0.20 0.09 0.63 1.16 122 Greenwich 12.6 1.25 0.14 0.05 0.16 0.28 0.08 0.84 1.10 1.0 Lewisham 11.0 1.25 0.29 0.07 0.27 0.19 0.03 0.40 0.85 86 Woolwich 11.4 0.92 0.07 0.07 0.16 0.24 0.02 0.36 1.20 94 N.B.—0.00 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. INDEX. Index of Tables. PAGE A The number of Births and the Birth-Rates in each Registration Sub-District of Lambeth Borough during 1908 (arranged quarterly) 10 B The estimated Populations, numbers of Inhabited Houses, Marriages, Births, and corrected Deaths, for the year 1908 in Lambeth Borough, and for the ten years 18911900 in Lambeth Parish 11 C The number of persons per House, the Marriage-, Birth- and Death-Rates, and the proportion of deaths in Public Institutions per 1000 persons, for the year 1908 in Lambeth Borough, and for the ten years 1891-1900 in Lambeth Parish 12 D The number of Births and Deaths with Birth- and DeathRates in each of the Registration Sub-Districts of the Borough during 1908. [The deaths are from all causes and from the chief Zymotic Diseases, and are corrected by adding Lambethians who die outside the Parish, by omitting strangers who die within the Parish, and by re-distributing persons who die in Public Institutions into the districts from which they have been removed during illness.] 22—23 E Death-Rates, Zymotic Death-Rates, Birth-Rates and Infantile Mortality Rates in the Registration Sub-Districts of Lambeth Borongh during 1907 and 1908 24 F Death-rate®, Zymotic Death-Rates, and Zymotic IncidenceRates in the new Wards of Lambeth Borough during 1907 and 1908. 25 (iii.) PAGE Q 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 1908 26 H The uncorrected mortality (i.e., including that of Strangers) at different ages in each District of the Lambeth Borough during 1908 I The uncorrected Deaths (i.e., Parishioners and Strangers) at various age-periods in each Quarter of the year 1908 28 J The Infantile mortalities in the Registrar-General's old thirty-three large towns of England and Wales (including London), and in Lambeth Borough during 1908, and for ten years (1898-1907) 32 K The number of Certificates for the notifiable Zymotic Diseases received since the introduction of the Notification Act (i.e., for Lambeth Parish in the ten years 1891-1900) and for the Lambeth Borough in the year 1908 37 L The number of infected houses, with percentages of (1) General Defects and, (2) Defective Drains, in Lambeth Borough during the year 1908, and in Lambeth Parish during the ten years 1891-1900 39—40 M Zymotic seasonal variations in the different Registration Sub-Districts of Lambeth Borough during 1908, with the Zymotic Death-Rate per 1000 inhabitants 41 N Total cases notified under the Notification Clauses of the Public Health (London) Act, in Lambeth Borough during 1908 (arranged quarterly) 42 O Death from Zymotic Diseases (Strangers deducted), 1908 43 P The number of deaths from the principal Zymotic diseases within Lambeth Parish in the ten years, 1891-1900, and within the Lambeth Borough in the year 1908 44—45 (iv.) PAGE Q Vaccination Returns (Lambeth), 1907 48 R Vaccination Returns (Lambeth) for the first half-year, 1908 49 S The Diarrhœa Mortality in Lambeth Borough in each month during the year 1908 79 T The Classification of Causes of deaths in Lambeth Borough during 1908 as compared with 1907— (a) Death from all causes and at all ages, with percentages of deaths to total deaths (corrected) 91 (A) Deaths of infants under one year of age from the chief infantile diseases and from all causes, expressed in terms of 1000 births 92 U Table of Uncorrected Deaths during the years 1907 and 1908 classified according to Diseases, in the Borough of Lambeth and in London 93 V Table of Deaths during the year 1908, in the Lambeth Borough, Classified according to Diseases, Ages, and Localities. (Local Government Board old fable A) 94—97 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 1908, in the Metropolitan Borough of Lambeth, classified according to Diseases and Localities. (Local Government Board old Table B) 98—99 Five new tables of the Local Government Board, giving the— (1.) Vital Statistics of Lambeth Borough during 1908, 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 1908 and of the Parish of Lambeth in the ten years 1891—1900 Appendix 3—4 (iii.) Cases of Infectious Diseases notified within the Borough of Lambeth during the year 1908 Appendix 5 (v.) PAGE (iv.) Causes of, and ages at, death during 1908, within the Borough of Lambeth Appendix 6—7 (v.) Infantile Mortality in Lambeth Borough during 1908. 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 1908 sub-divided— (a) As to Registration Sub-Districts Appendix 10—17 (b) As to different Age-periods Appendix 18—26 Offences (with amount of penalties and costs)— (а) Food and Drugs Acts Appendix 27—50 (b) Public Health and Metropolis Management Acts Appendix 51—57 Cases of Illness notified from Schools to the Medical Officer of Health during 1908 Appendix 58—60 Factory and Workshops Acts—Home Office Tables, 1908— (i.) Inspection Appendix 61 (ii.) Defects found Appendix 62 (iii.) Home-Work Appendix 64—65 (iv.) Registered Workshops Appendix 63 (v.) Other matters Appendix 63 Death-rates (corrected) in Metropolitan Boroughs during 1908 per 1000 persons living Appendix 66-67 General Index. PAGE Abatement of Nuisances 102—112 „ „ Smoke 120 Accidental Deaths 89,178—183 Added Preservatives 140 —141 Adulteration of Butter 138—139 „ ,, Food and Drugs 136—147 Age-Distribution of Diarrhœa 77 „ „ „ Diphtheria 66 „ „ „ Scarlet Fever 53 „ „ „ Typhoid Fever 70 „ „ „ Deaths 21, 27, 28 ,, „ ,, Population (Lambeth) 6 Air Temperature and Diarrhœa 76 Alcoholism, Death from 88 Analysis of Food and Drugs 136—147 ,, „ Water 144 Antitoxin, Gratuitous Distribution of 67, 172 Apoplexy, Deaths from 89 Appeal (Drainage) L.C.C 165—166 Area (Lambeth) 4, 100 Atelectasis 88 Bacteriological Laboratory 170—173 Bakehouses 150 Bedding, etc., Disinfected 113, 117, 118 „ „ Destroyed 113, 117, 118 Births and Birth Rates 10, 11, 12, 13—14, 22 — 23, 98—99, 100 Births Notification Act, 1907, 14,101,135 — 136 Birth Rates in Sub-Districts 10 ,22—23 Bodies received in Mortuaries 178—182 Bronchitis, Deaths from 89 (vii.) PAGE Burns and Scalds, Death from 89, 182 Butters, milk blended 142 Butter Act, 1907 142—143 Byelaws, Contravention of 166—168 Cancer, Deaths from 88 Cautions (Food and Drugs) 136, 147 Cemetery, (Norwood) Condition of 168—169 Censal Population (Lambeth) 98 Censal Population (London) 8 Cerebro Spinal Meningitis 50—51 Certificates (Revenue Act) 149—150 Chicken-pox 52 Cholera 63—64 Circulatory Diseases, Deaths of 89 Clerical Work 184 Closure of Schools (Measles) 58—60 Common Lodging Houses 148 Combined Drainage 106—107 Complaints 103, 112 Contravention, Byelaws 166—168 Control of Drainage (supervision) 111 Conscientious Objectors 47, 48, 49 Congenital Malformations 88 Constitutional Diseases 88 Consumption (See Tuberculosis and Phthisis) Continued Fever 72 Conveniences (Underground) 134 Convictions under Public Health Acts Appendix 51—57 „ „ Food and Drugs Acts „ 27—50 Convulsions, Deaths from 89 Coroners' Courts 178—183 Costs, Food and Drugs Appendix 27—50 „ Public Health Acts „ 51—57 Cowhouses 154-155 „ List of 154 Critical Temperature (Earth) and Diarrhœa 76 Croup (See Membranous Croup) Customs and Inland Revenue Acts (See Revenue Act) Dairies (See Milkshops) (viii.) PAGE Deaths and Death-rates 15—100 Appendix, 2—4,6—26,66—67 „ Inner and Outer Wards 17—20, 24—25 „ (arranged quarterly) 26, 28 „ Metropolitan Boroughs Appendix 66—67 Deaths, Corrected 15, 17—25, 100 „ Uncorrected 15, 26—28, 94—97 ,, in Public Institutions 11—12, 15—17 „ Zymotic 11—12,33—90, 100 „ Under 1 year 11—12, 29—32, 100 Appendix 8—9 „ Under 5 years 11—12,28 Deaths from violence 89, 183 „ from ill-defined and non-specified causes 89 Delirium Tremens, Deaths from 88 Density per acre (Lambeth) 100 Dentition, Diseases of 89 Depositing (Refuse) 173 Depots (Refuse and Manure) 173 Depot (Milk) 155—162 Developmental Diseases 88 Diagnosis (Bacteriological) 170—173 Diarrhœa 76—80 „ Age Distribution of 77 „ Monthly Mortality 79 „ Inner and Outer Wards 78 „ Registration Sub-Districts 77 Dietetic Diseases 88 Digestive System, Diseases of 89 Diphtheria 64—69 „ Age Distribution of 66 „ Antitoxin in 67 „ Decrease of 64—66 „ Bacteriological Examination in 67, 171—173 „ Registration Sub-Districts 67 „ Pseudo-Bacilli 171—172 Disinfection, Details of 113—119 ,, Statistics 117—118 „ Certificates 115 Disinfecting Department 113—119 „ Refuges 115—116 (ix.) PAGE Distribution (free) of Antitoxin 67, 172 Drain Testing 36, 39, 40, 105, 111 „ „ with water 36, 111 Drainage Defects 37, 39—40, 105 „ Cases 163—166 „ Control of (supervision) 111 „ Combined 106—107 „ Legal Proceedings 112,163-166 Appendix 51—57 Dropsy, Deaths from 89 Drowning, Deaths from 89, 182 Dust Depots 173 Earth Temperatures and Diarrhœa 76 Effluvium Nuisances 176 Enteric Fever (See Typhoid) Enteritis 76, 78,89 Epidemic Cerebro-Spinal Meningitis 50—51 Epidemic Influenza 87—88 Epilepsy, Deaths from 89 Erysipelas 74, 55 Expenses (Food and Drugs Act) 143—144 Factory and Workshops 121—133 „ Home Office Tables Appendix 61—55 Female Sanitary Inspectors 128—133 Food and Drugs, Adulteration of 136—147 „ „ Convictions 136 Appendix 27—50 Food, Unsound 111 Glanders 87 Health Visitor 135 Homicide, Deaths from 89.182—183 Home Office Tables (Factory and Workshops) Appendix 61—65 House to House Inspections 107—110 Houses (Lambeth) 9 „ let in Lodgings 148 Housing of the Working Classes 148—149 Increase of Population (Lambeth) 4, 100 „ „ (London) 9 Infantile Mortality, 1908 29—32,100 Appendix 8—9 1, ,. (London and 33 large Towns of England and Wales) 32 (X.) PAGE Infected Houses 33—37, 102 ,, ,, and Drains 33—37 Infectious Cases removed 34, 98—99 „ „ notified 34, 98—99 Appendix 5, 58—60 ,, ,, ,, by Schools 58—60 Infectious Diseases Inspections 33—37 Influenza (Epidemic) 87—88 Inhabited Houses of Lambeth Borough 9, 100 Inner and Outer Districts and Wards—Deaths and Births 17—18, 24—25 Inquests 183 Inspections 103—106, 112, 128—130 „ House to House 107—110 „ Market Thoroughfares 110 Inspector. Females 128—133 „ Males 106—112 „ Food and Drugs 136—147 „ Smoke 120 Institution Deaths 11, 12, 15—17 Integumentary System, Diseases of 89 Intercepting Traps 169 Introductory Letter 3 Laboratory (Bacteriological) 170—173 Lambeth Statistics 4—99 Appendix 2—26 Lavatories (Underground) 134 Letters (sent and received) 184 Liver, Diseases of 89 Local Diseases—Nervous System, Heart, Respiratory Organs, Digestive and Urinary Systems and Reproductive System 89 Locomotive System, Diseases of 89 Local Government Board, Old Tables A and B 94—99 „ ,, „ New Tables i, ii.,iii., iv.,v., Appendix 2—9 Lodging-houses (Common) 148 London (County of), Vital Statistics, 1908 8, 9 „ No. of Births Deaths and Marriages, 1908 9 London Zymotic Deaths, 1908 44—45 Lymphatic System, Diseases of 89 Male Sanitary Inspectors 106—112 Manure Depots 173 „ Depositing of 173 (xi.) PAGE Market Thoroughfares (inspection) 110 Marriage and Marriage Rates (Lambeth 11, 12, 14, 100 Measles 57—61 „ Registration Sub-Districts 63 ,, and School Closure 58—60 „ Lambeth Schools 60—61 Membranous Croup 69 Meningitis (Tubercular) 88 ,, (Cerebro-Spinal) 50-51 Milk Depot (municipal) 155—162 „ Stores (See Milkshops) Milkshops 155 Mortality Rates, 1908 11, 15—100 „ Different Age Periods (Lambeth and London) 19, 21 Different Diseases (Lambeth Borough) 91—93 „ „ ,, (Lambeth and London) 93 „ under 1 year (London and Lambeth) 11—12, 27, 28, 92 „ Tables Appendix 10—26 ,, „ Sub-Districts 10—17 „ „ Age-Periods 18—26 Mortuary, High Street 178—182 „ Wanless Road 178-182 „ for Norwood 179 Mortuaries 178—182 ,, Keepers of 180 Natural Causes, Deaths from 183 „ Increment of Population (Lambeth) 4, 100 ,, ,, ,, ,, (London) 9 Nervous System, Diseases of 89 New Wards (Lambeth Borough) 4 , General Diseases, Deaths 25 „ Population (estimated) 4, 7 „ Tuberculosis 82 , Zymotic Diseases 25 „ Zymotic Incidence 25 Notices served 102—106, 111 —112, 129, 184 Non-notifiable Infectious Diseases 119 Notification Certificates received, 1908 34, 98—99 Appendix 5, 58-60 „ „ „ (Quarterly), 1908 42 (xii ) PAGE Notification (voluntary) of Consumption 81—84 „ of Births Act, 1907 14, 101, 135, 136 Nuisances Abated 102—106 „ from Effluvia 176—178 Observations (smoke) 120 Offences, Public Health Acts Appendix 27—50 ,, Food and Drugs Acts ,, 27—48, 51—57 Offensive Trades 150—151 Old Age, Deaths from 88 Open Spaces 183 Order, Home-work, 1908 131 Organs of Special Senses, Diseases of 89 Outer and Inner Wards, Deaths and Births 17—18, 25 Outside Urinals (Public Houses) 110 Outworkers 131—133 Parasitic Diseases 88 Parliamentary Divisions 7 Penalties Appendix 27—57 ,, Public Health Acts „ 51—57 „ Food and Drugs Acts „ 27—50 Peritonitis, Deaths from 89 Persons per House 9,100 „ Acre 100 Pertussis (See Whooping Cough) Phthisis, Deaths from 80—84, 88 „ Voluntary notification of 81—84 Plague 63—64 Plans of Drainage 105—111 Pneumonia, Deaths from 89 Population of Lambeth Borough, 1908 4, 100 „ „ „ „ Sub-Districts 5 „ „ „ ,, Parliamentary and New Wards 4,7 „ „ ,, Age Periods 6 Population of London, 1908 8, 9 „ „ „ Sub-districts (New) 8 Post-mortems 179 Premature Births (Deaths from) 88 Premises Disinfected 113 Preservatives (Added) 138—139, 140—141 Prosecutions Appendix 27—57 Public Health Acts 106,112 „ 51—57 (xiii.) PAGE Prosecutions, Food and Drugs Acts 106, 136—147 Appendix 27—50 Protected Persons (Workshops) 122, 125 Pseudo-Bacilli and Diphtheria 171—172 Public Houses, Urinals of 110 Public Institutions, Deaths 11, 12, 15—17 Public Health Acts (Convictions) Appendix 51—57 Public Health (Tuberculosis) Regulations 84—86 Puerperal Fever 73, 75 Quarterly Returns (Lambeth)— Births 10 Deaths (Zymotic and General) 26, 28, 41, 46 Notifiable Infectious Diseases 42 Disinfection Certificates 115 Rateable Value (Lambeth Borough) 9 Refuges 115—116 Refuse Depots 173 Refuse, Depositing of (Manure) 173 Registration Sub-districts (Lambeth Borough)— „ „ Births 10,22—24 „ „ Population (estimated) 5 „ „ General Diseases. Deaths 24, 26, 27 94—99 „ „ Infantile Mortality 30 „ „ Tuberculosis 81, 83 ,, ,, Zymotic 22—23, 41, 98 „ ,, Vaccination Returns 48—49 Re-inspections 105, 112 Removal of Infectious Diseases 34, 98—99 Reproductive System, Diseases of 89 Respiratory Diseases 89 Revenue Act, 1903 149—150 Routine Work (Inspectors) 111—112 Samples, Food and Drugs 136—147 Sanitary Defects 104—106 „ Inspectors 106—112, 128—133 „ Males 106—112 „ „ Females 128—133 „ Work 94—184. „ „ Structural 103—104 ,, „ Non-structural 103—114 (xiv.) PAGE Scalds, Deaths from 89, 182—183 Scarlet Fever 52—57 „ Age Distribution 53 „ Registration Districts 54 „ and School Attendances 54—55 „ and Milk 54 „ Outbreak at School 54—55 School Closure and Measles 58—60 „ Notifications (infectious disease) Appendix 58—60 Simple or Continued Fever 72 Slaughterhouses 151—153 „ List of 151-153 Smallpox 47 „ Contacts 47 Smoke Nuisance and Abatement 120 „ Obesrvations 120 Soda Water (bacteriological examination) 172 Spotted Fever (See Cerebro-Spinal Meningitis) Stables, Nuisance from Manure 173 Staffs — Clerical 184 Inspectorial (male) 106—112 „ (female) 128—133 Disinfecting 113 Health Visitor 135—136 Mortuary Attendants 178 Underground Conveniences 134 Suffocation in Bed 89 Suicide and Homicide, Deaths from 89, 182—183 Summary of Vital Statistics (Lambeth Borough), 1908 100 „ „ Sanitary Work 105—106 „ „ Work by Female Inspectors 128—133 „ „ Death Returns Appendix 2(1 Summonses 106 „ 27—53 Supervision (Drainage) 111 Syphilis 88 Tables (special)— Local Government Board (old) A and B 94—99 „ „ „ (new)i., ii.,iii., iv., v., Appendix 2—9 Home Office Factory and Workshops) „ 61—65 (XV.) PAGE Tables (special)— Mortality (Lambeth)— Registration Sub-Districts Appendix 8—15 Age-periods „ 16 -26 Temperature (Air and Earth) 76 Testing of Drains 36—37, 39—40, 105—112 Tuberculosis, Deaths from 80—81 „ and Bacteriological Examinations 82, 170, 173 „ Registration Sub-Districts and Wards 81—83 „ and Preventive Measures 80—86 „ Notification (voluntary) 81—86 „ Regulations 84—85 Typhoid Fever 69—72 „ Age Distribution of 70 „ Bacteriological Examinations 72, 171—173 „ Registration Sub-Districts 71 „ Inner and Outer Wards 71 „ Sources of Infection 71 — 72 Typhus 72 Underground Bakehouses 150 „ Conveniences 134 Unsound Food 111 Urinals (Pubic Houses) 110 Urinary Diseases, Deaths from 89 Vaccination 47—49 Varicella (see Chicken-pox) Veneral Diseases 88 Verminous Persons (Cleansing of) 162 Violent Deaths 89 Vital Statistics, London 8, 9, 19 „ „ Lambeth 4—101 Appendix 2—26 „ „ Summary (Lambeth) 100 Wards, Population (estimated) 4, 7 „ Deaths and Death-Rates 25 „ Zymotic Iucidence25 Warranties 143 Water Analysis 144 „ Certificates 111 Whooping Cough 61—63 (xvi.) PAGE Whooping Cough Registration Sub-Districts 63 Work of Sanitary Staff 102—184 Workplaces (see Workshops) Workshops 121—127, 128—133 „ Defects found 123, 126—127, 129—130 „ Female Inspector in 128—133 „ Outworkers 131—133 „ Overcrowding in 123, 129 „ Home Office Tables Appendix 61—65 „ Persons employed in 122,125 „ Protected Persons 122, 125 „ Trades, etc 121,132—133 Zymotic Diseases 33—88, 100 ,, Deaths, arranged Quarterly 41,46 „ ,, ,, Monthly 43 „ Incidence in New Wards 25 „ Incidence in Registration Sub-Districts 22—23, 41, 98—99 „ Principal Deaths (Lambeth) 44—45 „ Principal Deaths (London) 44—45 „ Seasonal Variations 41