LIM 3 REPORT ON THE Sanitary Condition of the Limehouse District (Comprising the Parishes of Limehouse, Shadwell, and Wapping, and the Hamlet of Ratcliff), FOR THE YEAR 1899. BY DANIEL LEWIS THOMAS, Medical Officer of Health and Public Analyst. 1900, Offices of the Board): WHITE HORSE STREET, COM M ERCIAL ROAD EAST, E, LIM3 TO THE BOARD OF WORKS FOR THE LIMEHOUSE DISTRICT. Gentlemen, I have the honour to submit to you my Annual Report on the Health of the District, during the year 1899. POPULATION.— The population estimated to the middle of 1899 was 58,807 distributed as follows: — Limehous 33.390 Ratcliff 14,966 Shadwell and Wapping 10,451 BIRTHS.— The births registered during the year numbered 1933 of which: — 1144 were registered in Limehouse, or at the rate of 34.2 per 1,000. 463 Ratcliff „ 30.9 „ 326 „ Shadweli and Wapping „ 31.1 „ This corresponds to a birth rate of 32.8 per 1,000 of the population for the year for the whole district; the average for the last ten years being 33.5 per 1000. 4 The birth rate is 3.5 per 1,000 more than that of London as a whole. The biVth rate for 1899 was a trifle higher than that for 1898 ; otherwise it has been regularly declining since 1895. In 1895 the birth rate was 35.5 per 1,000 of the population. „ 1896 ,, 34.6 „ „ „ 1897 „ 34.1 „ „ „ 1898 „ 32.5 „ „ „ 1899 „ 328 „ „ MARRIAGES.— The marriages during the year numbered 422. The annual average for the last ten years was 410. The proportion of persons married was 14.5 per 1,000 of the population. The proportion of persons married in the whole of London was 18.4 per 1,000. DEATHS.— The registered deaths exclusive of those nonresidents which occurred in the Public Institutions situated in the District, but inclusive of those residents which occurred in outlying Institutions, numbered 1,500. This corresponds to a death rate of 25.5 per 1,000, or exactly the same as the average for the last ten years. The death rate for the whole of London was 19.7 per 1,000 of the population. These deaths were distributed over the District as follows: — Limehouse 532 Ratcliff 238 Shadwell and Wapping 170 East London Children's Hospital 253 1193 Deaths occurring outside the District among persons belonging thereto 491 1684 Deduct deaths occurring within the District among persons not belonging thereto 184 1500 5 The death rate in the various parishes after adding those who died in outlying Institutions were: — Limehouse 23.7 per 1,000 of the population. Ratcliff 28.5 „ ,, Shadwell and Wapping 26.0 „ ,, Compared with 1898, the causes of death were:— 1898. 1899. Increase. Decrease Scarlet Fever 5 I — 4 Diphtheria 25 30 5 — Membranous Croup 1 — — 1 Enteric Fever 8 21 13 — Continued Fever 1 - - 1 Measles 57 53 — 4 Whooping Cough 62 24 — 38 Diarrhoea and Dysentery 90 54 — 36 Cholera Infantum 1 — — 1 Rheumatic Fever 2 3 1 — Phthisis 136 135 — 1 Bronchitis, Pneumonia and Pleurisy 219 284 65 —— Heart Disease 96 105 9 — Influenza 19 18 — 1 Injuries 70 84 14 — All other Diseases 598 688 90 — 1390 1500 197 87 The excess of births over deaths was 433. The following is a list of the outlying Institutions and other places where residents of the Limehouse District died during the year:— Sick Asylum 202 Caterham Asylum 1 Stepney Workhouse 108 London Hospital 76 St. Anne's House, Stoke Newington 4 Middlesex Hospital 1 Dying in the Street outside the District 8 Leavesden Asylum 5 St. George's Hospital 1 6 Regent's Canal 1 South Eastern Fever Hospital 13 Homerton Fever Hospital 11 Park Fever Hospital 2 Brook Fever Hospital 1 Ilford Asylum 6 Seamen's Hospital 2 River Thames 1 Poplar Hospital 5 South Western Fever Hospital 1 North Western Fever Hospital 1 Hanwell Asylum 6 St. Bartholomew's Hospital 2 St. George's Infirmary 3 City of London Chest Hospital 4 Colney Hatch Asylum 7 Claybury Asylum 1 West London Hospital 1 Cane Hill Asylum 1 Charing Cross Hospital 1 Millwall Docks 1 Mothers' Home, Commercial Road, E. 2 Banstead Asylum 3 Islington Infirmary 1 Hospital for Women, Soho 1 St Luke's House 1 Metropolitan Hospital 1 Bethnal House Asylum 1 Guy's Hospital 2 Mile End Infirmary 2 East London Hospital 69 560 SMALL POX.— No case of Small Pox has occurred in the District during the year. Two children suffering from Scarlet Fever were removed from this District to the Homerton Fever Hospital; about live weeks afterwards, they contracted Small Pox from a case that was accidentally admitted into the ward. The children were removed from the Fever Hospital to the Small Pox Hospital Ship. This district has been entirely free from Small Pox for the last four years. Lim 3 CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER, DURING 1899. CURVE SHOWING THE TOTAL NUMBER OF INFECTIOUS DISEASES IN LIMEHOUSE, RATCLIFF, SHADWELL AND WAPPING, DURING 1899. CURVE SHOWING THE TOTAL NUMBER OF INFECTIOUS CASES NOTIFIED WEEK BY WEEK DURING 1899. 7 SCARLET FEVER.— The corrected number of deaths was I. The annual average for the last 10 years was 19.4. 161 cases were reported during the year, of which 118 were removed to Hospital. This is a decrease of 30 from the number reported in 1898, and 259 from that in 1897. 96 occurred in Limehouse, 37 in Ratcliff and 28 in Shadwell and Wapping. The death rate was .01 per 1,000 of the population. The death rate for the whole of London from Scarlct Fever was .09 per 1,000. DIPHTHERIA.— The corrected number of deaths was 30, the annual average for the last 10 years being 34. 125 cases were notified and 99 were removed to Hospital; this is a decrease of 9 from the previous year and 55 from that in 1897. 68 occurred in Limehouse, 47 in Ratcliff and IO in Shadwell and Wapping. The death rate was .51 per i,ooo, that for the whole of London being .43 per 1,000 of the population. MEMBRANOUS CROUP.— Two cases were reported, one having occurred in Ratcliff and the other in Shadwell. Neither proved fatal. TYPHUS FEVER.— No case was reported during the year. ERYSIPELAS.— There were no deaths from Erysipelas. 78 cases were reported and 15 were removed to different Hospitals and Infirmaries. 34 occurred in Limehouse, 23 in Ratcliff and 21 in Shadwell and Wapping. PUERPERAL FEVER.— 3 cases were reported but none proved fatal. 2 occurred in Limehouse and one in Shadwell. ENTERIC FEVER.— The corrected number of deaths was 21, the average annual number for the last 10 years was 8. 130 cases were reported and 109 were removed to Hospital. 78 occurred in Limehouse, 23 in Ratcliff, and 29 in Shadwell and Wapping. The mortality was 16.1 per cent, of those attacked, that is, out of every 100 that suffered from Enteric Fever, 16 died. In all cases where it was possible, the source of the 8 infection was traced, but on account of the long incubation period and the insidious onset of the illness, this has in the majority of cases been impossible. By referring to the Charts, you will observe that: — 21 occurred in the first quarter of the year. 4 „ second quarter „ 24 „ third quarter „ 81 „ fourth quarter „ According to the returns of the Metropolitan Asylums Board, Typhoid Fever is not common under 10; nearly 50 per cent, of the cases occur between 15 and 25 years of age. In our District: — 27.7 per cent, of the persons attacked were under 10 years of age. 22.2 „ „ ,, were between 10 and 15 „ 32.3 „ „ „ were between 15 and 25 „ 17.7 „ „ were over 25 „ „ The disease is supposed to be far more fatal amongst children and old people, than amongst strong, healthy young people. Here again it differed in our District. The mortality in persons up to 15 years of age was at the rate of 6.1 per cent. From 15 to 30 years of age it was at the rate of 26.4 per cent, and from 30 to 45 years of age it was at the rate of 27.2 per cent. No person over 45 years of age was attacked with Typhoid Fever during the year. WHOOPING COUGH.— The corrected number of deaths was 24. The average number of deaths for the last 10 years was 48.1. The death rate was .4 per 1,000 of the population. The death rate for the whole of London was .47 per 1,000. DIARRHCEA.— The corrected number of deaths was 54. The annual average for the last 10 years was 49.3 per 1,000. This is a great improvement, taking into consideration the very warm summer we had. The warmer the summer, the higher is the mortality from Diarrhoea. The death rate was .91 per 1,000 of the population, that for the whole of London being .92 per 1,000, 9 MEASLES — The corrected number of deaths was 53, but in addition to this, there were 9 cases of Broncho-Pneumonia, which were sequela; to Measles. The annual average for the last 10 years was 52.7 The death rate was .9 per 1,000. The death rate for the whole of London was .47 per 1,000. The deaths from Zymotic diseases numbered 182, and correspond to a death rate of 3 per 1,000 of the population. The Zymotic death rate for the whole of London was 2.46 per 1,000. Such deaths include Small Pox, Measles, Scarlet Fever, Diphtheria, Membranous Croup, Whooping Cough, Puerperal Fever, Enteric and Simple Continued Fevers, and Diarrhoea. The number of deaths from Inflammatory Affections of the Lungs was 284, and corresponds to a death rate of 4.8 per 1,000 of the population. 135 deaths were due to Phthisis, which is equal tot a death rate of 2.2 per 1,000. The death rate for the whole of London was 1.82 per 1,000. In addition there were 63 deaths from other Tubercular diseases. The death rate for diseases of a Tubercular nature was 3.3 per 1,000; so that 9 per cent, of all the deaths were due to the Tubercle Bacillus. As you know a Society has been formed within the last two years for the purpose of trying to diminish the deaths from this terrible disease, and several districts have had instructions printed in a pamphlet form and distributed amongst consumptive patients through their Medical attendants. A similar thing was carried out by this Board in 1894, when 50 pamphlets were sent to each medical practitioner in the district, requesting them to five them to those persons where they considered it would be beneficial. The medical men were informed that further copies could be had if they required them, but no one applied for a second lot. 78 deaths were due to old age. This corresponds to a death rate of 13 per 1,000 of the population. 37 deaths were those of persons found drowned. 10 During the year 501 notifications were received, of which 161 referred to Scarlet Fever, 125 to Diphtheria, 2 to Membranous Croup, 130 to Typhoid Fever, 3 to Puerperal Fever, 78 to Erysipelas, and 2 to Small Pox, which, as previously mentioned, did not really occur in the district. This number on account of the increase in the Typhoid Fever, exceeds that of 1898, but it is very much less than in any other year since notification of Infectious Disease has been made compulsory. In 1892 the number of notifications was 771 1893 „ „ „ 1298 „ 1894 „ ,, 1, 719 „ 1895 „ „ „ 755 „ 1896 „ „ „ 764 „ 1897 „ „ „ 754 „ 1898 „ „ „ 461 „ 1899 „ „ 501 At the request of the Board I have made arrangements with the Bacteriologist of the London Hospital, to have all doubtful cases of Diphtheria and Typhoid Fever, bacteriologically examined. During the two months that the arrangements have been in force, swabs from the throats of 3 doubtful cases of Diphtheria were examined, with positive results in 2, and a negative result in 1 case. Widal's test was tried in 3 doubtful cases of Typhoid Fever with a positive result in 1 and negative results in 2 cases. INFANT MORTALITY.— During the year 418 infants died before they were a twelvemonth old, and 642 before they were 5 years of age. The number of deaths of infants under 1 year of age was 216 per 1,000 births, the number being 166 in the whole of London. In my last Annual Report, I gave the results of a special inquiry which I made during the year, of the deaths of all children under 2 years of age who died during the year 1898. To reduce the high Infant Mortality in the district, I recommended the Board to employ a nurse who would also be a qualified Sanitary Inspector, to visit the homes and give instructions where necessary in the care and management of children. This has been done in many Provincial Towns with great success. 11 The Board referred the matter to a Sub-Committee. The Sub-Committee recommended the Board to adopt the following which was subsequently done:— 1. That a Lady Sanitary Inspector be appointed for twelve months, to visit homes where there are infants, to give instructions when necessary, in the feeding, care and nurture of infants, and to act generally for this purpose, under the supervision of the Medical Officer of Health. 2. That copies of the instructions to mothers on the management of children be furnished to the Local Registrars for distribution by them whenever infants births are registered, and in addition, copies be also supplied to persons holding Mothers Meetings, and that the medical men in the district be asked if they will undertake to distribute copies in suitable cases. 3. That the other District Boards and Vestries in the Metropolis be informed of the action taken by the Board, and that a copy of the notes referred to, be forwarded to each of them. Unfortunately, the Registrar General refused to sanction the distribution of the Instructions by the local registrars, as it would be quite outside their province. The following correspondence took place between this Board and the Local Government Board on the subject: — Board's Offices, White Horse Street, Commercial Road East, E. 28th July, 1899. Sir, I am directed to state that the Board of Works for the Limehouse District proposes to appoint a female Sanitary Inspector for the District, for a period of twelve months, and T am to apply for the approval of the Local Government Board thereto. The District Board has for some time past given special attention to the question of the adoption of means to reduce the present high rate of infant mortality existing in 12 the District, and it is proposed that some portion of the time of the female Sanitary Inspector should be devoted to visiting homes where there are children and giving instruction, when necessary, in the feeding, care and nurture of infants. It is intended to pay a salary of about £100 per annum, and the officer would be required to devote her whole time to the services of the Board. I am Sir, Your Obedient Servant, S. G. RATCLTFF. Clerk to the Board. The Secretary, Local Government Board. Local Government Board:, Whitehall, S.W. 12th September, 1899. Sir, I am directed by the Local Government Board to advert to your letter of the 28th July, with reference to the proposal of the Limehouse District Board of Works to appoint a female Sanitary Inspector, with the duty of visiting homes where there are children and giving instruction, when necessary, in the feeding, care and nurture of infants. In reply, I am to state that the Board have had this proposal under consideration, and that while they sympathise with the desire of the District Board of Works to take steps to reduce the high rate of infant mortality existing in the District, they must point out that the particular work which it is proposed to give to the female Sanitary Inspector, is not among the duties assigned to such an Inspector by the Sanitary Officers (London) Order, 1891, and therefore no part of the salary paid for that work, could be repaid out of the County Fund. 13 The District Board of Works might perhaps appoint in additional Sanitary lnpector, part only of whose time would be devoted to the duties of that office, and the remainder to those referred to in your letter. In that case, separate salaries should be assigned to each set of duties, and the time to be allotted to each should be broadly indicated. If the District Board of Works decide to adopt this course, the Board will be ready to consider any proposal that may be made to them on the subject. The Board think it right to point out, however, that the work of visiting the homes of parents for the purpose of giving instructions to mothers in the feeding, care and nurture of infants, is not only a work of a delicate nature, but it is one which requires special training of a high order, if it is to be carried out with any advantage. Such a training does not come within the experience which a Sanitary Inspector is necessarily required to obtain, and the possession of the certificate which the Sanitary Institute grants to Sanitary Inspectors is no evidence that its possessor has had any such training. The Board would observe, further, that if a duly qualified person is found to undertake the duty, it should be under the direct control of the Medical Officer of Health. I am, Sir, Your Obedient Servant, JOHN LITHIBY, Assistant Secretary. The Clerk to the Limehouse District Board of Works. As the proposal could not be carried out in the manner specified in the Board's resolution upon the subject, it was decided not to appoint the Health Visitor, but to distribute the following instructions as decided previously; which has been done. 14 ADVICE TO MOTHERS AND OTHERS HAVING THE CUSTODY OR CARE OF CHILDREN. 1.—Cleanliness.— Wash the infant all over with warm water daily. 2.—Clothing.— Keep the child warm. Let the clothing be of some warm material such as flannel (not flannelette). The garment should not fit tightly but should come well up to the neck, and the sleeves should reach to the wrists. Stockings should cover the knees, and a flannel belly binder should be worn until the child is able to wear knickerbockers or flannel drawers. Even in warm summer weather, infants should not be exposed to chances of chill with bare arms and necks, etc. During the year 1898, in the Limehouse District, there were 65 deaths of infants from Bronchitis and Inflammation of the Lungs, which were probably due to improper or insufficient clothing. Nourishment under seven months.— In 1898 in this District alone, the number of deaths of infants under 1 year of age was 388. Of these, 145 or nearly one-half were due to diseases of the digestive organs, so that it is most important to give infants the proper nourishment. 3.— The mother's milk is the natural and proper food for infants. She should therefore suckle her child, if she has plenty of milk, and give it no other food whatever, until it is at least seven months old. 4. It must be suckled every two hours during the first month, and the interval gradually increased until at the end of three months the child is suckled every three hours during the day, and every four hours during the night. Too frequent suckling is a common cause of vomiting in infants, therefore do not give the child the breast at odd hours merely for the sake of keeping it quiet. 5.— If the mother has only a little milk, let the child have it, and in addition, cow's milk, and water as directed in paragraphs 12 and 13. It is a good plan if the mother has only a little breast milk, for her to drink a cupful of cow's milk half an hour before suckling the baby. 6.— Except when ordered for special reasons by a doctor, do not on any account give the child oatmeal, arrowroot, baked flour, corn flour, nursery biscuits, tops and bottoms, or any so called "infant's food" before it is seven months old. LIM 3 15 7.—The infant should sleep by itself in a cot or cradle by the side of the parent's bed, and on no account to sleep with the parents or other children. In 1898 in the Limehouse District alone, 17 inquests were held on children that had died from overlaying. 8.—The breast to be given the child before placing it in a cot and in the night the child should be returned to the cot each time after taking the breast. 9.—The child should be put to rest as early in the evening as convenient, and never be kept up until the parents retire to rest. 10.—The infant should not be handed over to the care of a young child, but always kept under the care of the mother, or some other responsible person. How to bring up entirely by hand.—11.—If the child must be brought up by hand, it should be fed out of a bottle with cow's milk warmed and diluted with water, or better still, barley water. Get the milk fresh from the dairy twice a day. Always boil the milk before using it. 12.—At birth and for the first month, the milk must be diluted with twice as much water, or better still, give equal parts of fresh cow's milk, lime water and barley water. A small quantity of white sugar must be added to each bottle. 13.—As the child grows older, begin to use more milk and less water until it is given:— At six weeks old, equal parts of cow's milk and barley water. At three months old, 2 parts of cow's milk and 1 part of barley water. At six months old, 3 parts of cow's milk and 1 part of barley water. 14—On no account must the milk that remains after the child has finished, be used again. A fresh quantity must be prepared for each time of feeding. 16 15.—The best kind of. bottle is the old fashioned straight one, with an india-rubber teat and without any tube at all. It is quite impossible to prevent corks and tubes from becoming foul and turning the milk sour. When the child has finished its meal, the bottle must be rinsed and placed in clean water, with a little soda in it until required again. Once a day it should be carefully cleansed with hot water in which a little soda has been added. 16.—The child should have its milk at regular hours—every two hours for the first two months, and every three hours afterwards. 17.—If cow's milk cannot be digested after a fair trial, "then condensed milk may be given—one teaspoonful to four or five tablespoonfuls of water that has been boiled. Do not continue to give condensed milk for long, but after a month or two, try cow's milk again. Read carefully the label on the tin of condensed milk, and if it states that it is condensed "separated or skimmed" milk, do not give it to the child, as it is quite unsuitable; only use condensed "whole" "milk. If the tin is "blown" throw it away, as the contents will be injurious to the child. 18.—Food when seven months old, and after.—When seven months old, the child may have one or two meals a day, slightly thickened with Robinson's groats, Chapman's entire wheaten flour, rusks, or one of the other of the following malted foods, viz.:— Allen and Hanbury's, Mellins, Savory and Moore's or Squires. Whichever is used, the pap should be thin enough to go easily through the bottle. The other meals should still be of milk and barley water only. As the child grows older, the pap may be used oftener and thicker. 19.—At eight months old, give the child one meal a day of broth or beef tea in addition to the milk. Weaning.—20.—Wean the child gradually from the breast when it is nine months old, and remove it entirely when it is eleven months old. 21.—At twelve months give an egg lightly boiled, or beaten up, or a little milk pudding. 22.—At eighteen months give a little very finely minced or scraped beef, or a little mashed potato with gravy. L\HZ 17 Ventilation.—23.—Open the windows at least twice a day, and send the children out whenever the weather is fine. Improper food.—24.—Beer, wine, spirits, tea, cheese, pastry and other food, such as grown up people take are very bad for young children, and should never be given to them. 25.—Sleeping draughts, cordials, or any other kind of medicine should never be administered without medical advice. Recipes.—To make Barley Water.—Put two teaspoonfuls of pearl barley into a pint of cold water, and boil down to two-thirds of a pint, and strain through muslin. Keep this in a cool place. Make it twice a day, as it will not keep. To make Beef Tea.—Take one pound of beef, remove all fat and gristle, cut up into small pieces and place in a jar or stew pan with one pint of cold water, and half a teaspoonful of salt; allow the jar to stand in a saucepan full of water, which must simmer (but not boil) for at least four hours, and then strain. UNSOUND FOOD, Several seizures were made during the year:— 1.—February 2nd, accompanied by the Inspector for the No. 3 District, I seized a large number of tinned goods, lying at No. 3, Sage Street, Shadwell. Knowing that the owner, who was a wholesale merchant, had been previously prosecuted by a neighbouring Vestry, but had, unfortunately, been discharged, I decided that I should carefully sort each individual tin before proceeding before the magistrate to have them condemned. My plan was this: to divide a parcel of goods into four, allot one parcel to each of the three Sanitary Inspectors, and to sort the fourth myself. Then I carefully examined each tin that had been rejected by the Inspectors so that I could inform the magistrate that each tin which I had seized had been examined by me personally. They included 3,971 tins of Milk, Salmon, Sardines, Soup, Rabbits, Compressed Beef, Vegetables, etc. It was proved conclusively at the Police Court that he was in 18 the habit of buying rejected canned goods from importers, etc., for tne purpose ot teeding pigs. In fact, the invoices that were produced were marked "pigs' food," but he failed to show that he had ever sold a tin in his life for pigs' food. The tins, when the contents are bad, become bulged or blown from the formation of the gas produced during putrefaction. These tins were pricked to let out the gas, resoldered, and fresh labels pasted over. The result was that the tins would appear good, and would remain apparently good for two or three weeks. When I made the seizure, several men were employed putting on these labels. The case lasted five days, ana Mr. Dickenson having found him guilty, sentenced him to five months hard labour. It was a very severe sentence, but not too severe, considering the amount of injury the man could do, and has undoubtedly done. 2.—March 20th, accompanied by the Inspector for the No. 2 District, I seized about a hundredweight of meat belonging to a butcher in White Horse Street. It was exposed for sale and was unsound and quite unfit for human consumption. It was condemned by the magistrate and the owner was fined £5 and costs. 3.—July 17th the Sanitary Inspector for the No. 3 District saw two vans containing 117 tubs of strawberries, in Devonport Street, Ratcliff. He thought they appeared suspicious and detained them until I arrived. After examining and finding them unsound and quite unfit for human consumption, 1 seized them and took them before the magistrate at the Thames Police Court to have them condemned. The magistrate refused to grant an order for their destruction, as no evidence was produced that they were exposed for sale at the time of the seizure, though they had been offered for sale and refused by a jam manufacturer in Ratcliff half an hour previously. The owner admitted that they were unsound, and afterwards made an application for them to be destroyed as trade refuse. They were accordingly destroyed at the owner's expense. Section 47 of the Act, under which I made the seizure is as follows:—(1) Any Medical Officer of Health or Sanitary Inspector may at all reasonable times enter any premises, and inspect and examine (b) any article, whether solid or liquid, intended for the food of man, and sold, or exposed for sale, or deposited in any place for the purpose of sale or preparation of sale, the proof that the same was not exposed or deposited for any such purpose, or was not intended for the food of man, resting with 19 the person charged; and if any such article appears to such Medical Officer or Sanitary Inspector to be diseased, unsound or unwholesome or unfit for the food of man, he may seize and carry away the same himself, or by an assistant in order to have the same dealt with by a justice. (2) If it appears to a justice that any article which has been seized, or is liable to be seized under this section, is diseased, or unsound or unwholesome, or unfit for the food of man, he shall condemn the same and order it to be destroyed. As most London magistrates take a different view of the law on the subject, the Board resolved that an application be made to the Court for a mandamus, to compel the magistrate to state a case. The case was heard before a Divisional Court towards the end of the year. Mr. H. Sutton who showed cause, contended that the magistrate was justified in finding that at the time the strawberries were seized, they were not intended for the food of man. Mr. Muir, who appeared for the Board, said that a condemnation order was a condition precedent to taking out a summons against the owner of the article, and contended that all the magistrate had to do upon the application for a condemnation order was to satisfy himself that the article in question was unfit for the food of man, and that it was not until a summons had been issued that he had jurisdiction to enquire whether the article was intended for the food of man or not. This was a point of law and the magistrate was bound to state a case for the opinion of the High Court upon it. The court was of this opinion, and gave judgment in favour of this contention. The magistrate will therefore have to state a case to be argued before the High Court. MORTUARY.—The number of bodies deposited in the Mortuary during the year was 261. 189 were removed to the Mortuary by the Coroner's orders. 49 by the Police, 14 by the Medical Officer of Health, 7 by Relieving Officers, 2 by friends for the sake of convenience. 9 bodies were deposited in the part of the Mortuary set apart for Infectious Cases; 6 of the deaths were due to Diphtheria, 3 from Typhoid Fever. 241 Inquests were held and 32 post mortem examinations 20 were made. The deaths of the above were due to the following causes:— Alcoholism 5 Convulsions 32 Diarrhœa 4 Drowning 38 Diseases of the Heart 43 Influenza 2 Improper feeding 2 Premature births 5 Still born 12 Suffocation while in bed with the parents 20 Died under an Anaesthetic whilst being operated upon 2 Rickets 2 Pneumonia and Bronchitis 16 Cerebral Haemmorrhage, Effusions, etc. 14 Phthisis 12 Gastro-Enteritis 4 Violence, Accidents, etc. 13 Peritonitis 3 Collapse of the Lungs 8 Rupture of aneurism of Aorta 2 Inanition 1 Whooping Cough 1 Cut throats 1 Drowning 4 Carbolic Acid poisoning 1 Hanging 2 And other causes unknown 12 261 SHELTER.—10 families occupied the Shelter during the year, while their homes were disinfected. The families consisted of 30 children and 18 adults. 21 INCINERATOR.—The following articles were destroyed in the Incinerator:—1 Sheep 184 Sacks of Paper 30 Beds 18 Pillows 45 Mattresses Clothing etc., from the Mortuary. THE SALE OF FOOD AND DRUGS ACT. A Sale of Food and Drugs' Act was passed during the year which amends and supplements the previous Act in the following particulars:— Section 1.— Imposes penalties on importers of margarine, margarine cheese, adulterated or impoverished butter, milk or cream, condensed, separated or skimmed milk, unless the same be imported in packages or receptacles conspicuously marked with the name or description indicating the nature of the contents. Sections 2 and 3.—Give power to the Local Government Board or Board of Agriculture to appoint officers to procure samples of food for analysis, and to act in default of Local Authority. Section 4.—Gives power to the Board of Agriculture to make regulations as to the standards for the analysis of milk, cream, butter or cheese. Section 5.—Extends the provision of the Margarine Act, to Margarine Cheese. Section 6.—Provides that packages of margarine and margarine cheese should be suitably labelled and not solely by a ticket or label attached thereto. The article must be delivered in a wrapper marked margarine or margarine cheese, and no other printed matter is to appear on the wrapper. 22 Section 7.—Provides that manufacturers of and wholesale dealers in margarine and margarine cheese are to be registered, and they must also keep a register showing the quantity imported and sold by them. Section 8.—Makes it illegal to make or sell mixtures containing more than 10 per cent. of butter. Section 9.—Provides that every person must have his name and address on every vehicle, can, or other receptacle where he sells milk or cream from. Section 10.—Gives directions as to division of samples taken in the course of delivery. Section 11.—Provides that every tin of condensed milk from which cream has been abstracted, must bear a label with the words "Machine Skimmed Milk" or "Skimmed Milk" as the case may require, printed in large and legible type. Section 12.—Directs that notice of mixtures must be legibly printed on the labels and must not be obscured by any other matter. Section 13.—Provides that when an article is bought for analysis it must be divided into 3 parts, one part to be delivered to the Public Analyst, one part to be retained by the Inspector for future comparison, one part to be given to the vendor if he asks for it. Section 14.—Provides that samples of articles may be taken in the course of delivery, at the request of or consent of the purchaser or consignee. Section 16.—Any person wilfully obstructing an Inspector in the execution of his duty, is liable to heavy penalties. Section 17.—Gives a list of the penalties which are very much heavier than in the 1875 Act. Section 26.—Food shall include every article used for food or drink by man, other than drugs or water, and any article which ordinarily enters into or is used in the composition or preparation of human food; and shall also include flavouring matters and condiments. 23 The total number of articles analysed during the year was 147; of which 144 were submitted by the Board's Inspectors and 3 by the Ratcliff Workhouse. This number consisted of go milks, 16 butters, 8 coffees, 8 mustards, 7 peppers, 2 gins, 1 whisky, 2 porters, 5 breads, 3 flours, 4 oatmeals, and 1 cocoa. Of these, 71 milks, 14 butters, 6 coffees, the mustards, peppers, gins, whisky, porters, breads, flours, oatmeals and cocoa were genuine. 40 milks were taken on Sundays, and these were more adulterated than the others. Article. Extent of Adulteration. Result. Milk Contained at least 17 per cent. of added water Fined 5s. and 23s. costs. Milk Contained at least 9 per cent. of added water Fined 20s. and 23s. costs. Milk At least 35 per cent. of cream abstracted Fined £2 10s. and 23s. costs. Milk At least 10 per cent. of cream abstracted Vendor cautioned. Milk At least 11 per cent. of cream abstracted Vendor cautioned. Milk Contained at least 4 per cent. of added water Vendor cautioned. Milk Contained at least 4 per cent. of added water Vendor cautioned. Milk Contained at least 3 per cent. of added water Vendor cautioned. Milk Contained at least 4.3 per cent. of added water Vendor cautioned. Milk Contained at least 4.7 per cent. of added water Vendor cautioned. Milk Contained at least 22 per cent. of added water Fined 30s. and costs. Milk Contained at least 47 per cent. of added water Fined £3 and costs. Milk Contained 5 per cent. of added water Vendor cautioned. Milk Contained 5 per cent. of added water Vendor cautioned. Coffee Contained 25 per cent. of chicory Fined 30s. and costs. 24 Article. Extent of Adulteration. Result. Coffee Contained 25 per cent. of chicory Informality of purchase. Milk Contained 37 per cent. of added water Vendor gave wrong address, and could not afterwards he found. Milk Contained 32 per cent. of added water Fined £1 and no costs. Milk Contained 12 per cent. of added water, and had 18 per cent. of cream abstracted Fined £1 1s. and 23s. costs. Milk Contained 10 per cent. of added water Fined £l and 23s. costs. Milk At least 10 per cent. of cream abstracted Vendor cautioned. Butter Contained at least 87 per cent. of foreign fat Fined £3 and 23s. costs. Total of Penalties and Costs, £30 18s. The Inspectors have performed their duties to my satisfaction, and I have to express my thanks to them for the manner in which they have assisted me in carrying out the duties of my office. I have the honour to remain, Gentlemen, Your most obedient Servant, D. L. THOMAS, Medical Officer of Health and Public Analyst. Board's Offices:— White Horse Street, May 4th, 1900. 25 TABLE I. Table shewing the Population, Marriages, Births, and Deaths for the Year 1899, and 10 years preceding. The Year. Estimated Population. Marriages. Registered Births. Corrected No. of Deaths. Deaths in Public Institutions. Total all Ages. Under One Year. Under Five Years. 1899 58,807 427 1933 1500 418 642 253 1898 58,728 419 1912 1390 388 649 355 1897 58,508 459 1997 142 386 715 342 1896 58,300 419 2012 1385 368 663 262 1895 57,600 378 2050 1575 456 736 255 1894 .. 382 1911 1396 327 616 .. 1893 .. 402 1954 1597 394 610 .. 1892 .. 417 1940 1468 366 674 .. 1891 .. 387 1998 1500 349 564 .. 1890 .. 411 1851 1609 387 785 .. 1889 .. 411 2109 1363 336 582 .. Average of 10 yrs. 1889-98 408 1973 1474 375 662 .. 26 TABLE II. Table shewing the Annual Birth and Death Rates, Death Rates of Children in a Thousand Deaths for the Year 1899, and 10 Years preceding. In the Year. Birth Rate per 1,000 of the Population. Corrected Death Rate per 1,000 of the Population. Deaths of Children under 1 year; per 1,000 of Registered Births. Deaths of Children under 1 year; per 1,000 of Total Deaths. s of Children under 5 years; per 1,000 of Total Deaths. 1899 32.8 25.5 216 278 428 1898 32.5 23.7 208 280 438 1897 34.1 25.1 193 264 420 1896 34.6 23.7 182 265 478 1895 35.3 27.3 222 289 466 1894 33.1 24.2 161 234 441 1893 33.9 27.7 201 247 400 1892 33.6 25.5 188 249 459 1891 34.6 26.0 174 232 376 1890 30.8 26.8 209 240 445 1889 35.0 22.7 159 246 427 Average of 10 years, 1889-98. 33.7 25.7 189 254 435 27 TABLE III. Shewing the number of Deaths at all ages in 1899, from certain groups of Diseases, and proportions to 1000 of Population, and to 1000 Deaths from all causes; also the number of Deaths of Infants under one year of age from other groups of Diseases, and proportions to 1000 Births and to 1000 Deaths from all causes under one year. DIVISION I. (ADULTS). Total Deaths. Deaths per 1000 of population at all ages. Deaths per 1000 of total deaths at all ages. 1. Principal Zymotic Diseases 182 3 121.3 2. Pulmonary Diseases 284 4.8 189.4 3. Principal Tubercular Diseases 198 3.3 132 DIVISION II. (Infants under One Year). Total Deaths. Deaths per 1000 of Births. Deaths per 1000 of total deaths under one year. 4. Wasting Diseases 113 58 270 5. Convulsive Diseases 67 34 81 NOTICE. 1. Includes Small Pox, Measles, Scarlet F ever, Diphtheria, Membranous Croup, "Whooping Cough, Typhus, Puerperal, Enteric (or Typhoid), and Simple Continued Fevers, and Diarrhœa; 37 of the deaths occurred in Hospitals situated beyond the limits of the District. 3. Includes Phthisis, Scrofula, Tuberculosis, and Tabes. 4. Includes Marasmus, Atrophy, Debility, Want of Breast Milk, and Premature Birth. 5. Includes Hydrocephalus, Infantile Meningitis, Convulsions, and Teething. 28 TABLE IV. Table shewing the Number of Deaths from the principal Zymotic Diseases, in 10 years, 1889 to 1898, and in the year 1899. Disease. 1889 1890 1891 1892 1893 1894 1895 1896 1897 1898 Annual Average of 10 years, 1889—1898. Total Deaths in 1899. Proportion of Deaths to 1,000 Deaths in 1899. Small Pox. . .. .. .. .. 7 1 1 .. .. .. •9 .. .. Measles 20 92 14 63 16 72 81 49 63 57 52.7 53 35.3 Scarlet Fever 27 15 5 27 31 41 17 14 12 5 19.4 1 •6 Diphtheria 41 25 15 28 62 42 41 35 26 25 34.0 30 20.0 Membranous Croup .. .. .. .. .. .. .. 2 3 1 •6 .. .. Whooping Cough 23 70 59 59 49 28 42 52 37 62 48.1 24 16 Influenza .. .. .. .. .. .. .. 5 5 19 2.9 18 12 Fever Typhu 1 .. .. .. 1 .. .. .. .. .. •2 .. .. Enteric- 13 14 6 .. 16 6 10 3 4 8 8.0 21 14 Simple contn'd 1 .. .. 6 .. .. .. .. .. 1 •8 .. .. Puerprl .. .. .. .. .. .. .. 1 1 .. 2 .. .. Diarrhœa 47 52 49 27 56 22 49 40 61 90 49.3 54 36 Totals 173 268 148 210 238 212 241 201 212 268 217.1 201 133.9 29 SPECIAL RETURNS required by the LOCAL GOVERNMENT BOARD. AEEA OF DISTRICT 562 Acres. POPULATION in 1891 57,599 „ Enumerated in 1896 58,305 „ Estimated to middle of 1899 58,807 TABLE V. —TABLE OF DEATHS during the Year 1899, in the Metropolitan Sanitary District of Limehouse, classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown 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. (b) Under 1 Year. (c) 1 and under 5 (d) 5 and under 15 (e) 15 and under 25 (f) 25 and under 65 (g) 65 and upwards (h) (i) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 ( Columns for Population and Births are in Table B.) (a) Small Pox. Scarlatina Diphtheria Membranous Croup Fevers. Cholera. Erysipelas Measles Whooping Cough Diarrhœa and Dysentery Rheumatic Fever Phthisis Bronchitis Pneumonia and Pleurisy Heart Disease Influenza Injuries All Other Diseases Total. Typhus Enteric or Typhoid Continued Relapsing Puerperal Limehouse 532 198 87 18 12 152 65 Under 5 5 upwds. .. .. 6 .. .. .. .. .. .. .. .. 26 12 18 .. 3 40 2 1 16 161 285 .. .. 2 .. .. 4 .. .. .. .. .. 3 .. .. .. 27 64 22 12 12 101 247 Ratcliff 238 84 36 5 8 77 28 Under 5 5 upwds. .. 1 2 .. .. .. .. .. .. .. .. 8 3 17 .. .. 30 2 .. 2 55 120 .. .. .. .. .. 2 .. .. .. .. .. .. .. 1 .. 20 32 20 2 5 36 118 Shadwell and Wapping 170 68 24 5 7 54 12 Under 5 5 upwds. .. .. .. .. .. .. .. .. .. .. .. 5 2 4 .. 1 27 1 ... . 1 51 92 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 15 13 11 2 5 30 78 East London Children's Hospital 253 117 109 27 .. .. .. Under 5 5 upwds. .. .. 6 .. .. 1 .. .. .. .. .. 1 3 27 .. .. 75 2 .. 7 104 226 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 4 4 .. 4 12 27 Totals 1193 467 256 55 27 283 105 Under 5 5 upwds. .. 1 14 .. .. 1 .. .. .. .. .. 40 20 66 .. 4 172 7 1 26 371 723 .. .. 2 .. .. 6 .. .. .. .. .. 3 .. 1 2 65 113 57 16 26 179 470 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto 560 68 77 26 35 249 105 Under 5 5 upwds. .. .. 13 .. .. .. .. .. .. .. .. 11 7 12 .. 3 24 1 .. 7 66 144 .. .. 7 .. .. 15 .. .. .. .. .. .. .. 2 1 66 54 46 1 36 188 416 Deaths occurring within the district among persons not belonging thereto 184 80 85 19 .. .. .. Under 5 5 upwds. .. .. 5 .. .. 1 .. .. .. .. .. 1 1 15 .. .. 61 1 .. 3 77 165 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 4 3 .. 1 9 19 TABLE VI.— TABLE OF POPULATION, BIRTHS, and of NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, during the year 1899, in the Limehouse District; classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities Population at all Ages. Registered Birlhs. Aged under 5 or over 5. New Cases of Sickness in each Locality coming to the knowledge of the Medical Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. Last Census. Estimated to middle of 1899. 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 Small Pox Scarlatina Diphtheria Membranous Croup Fevkhs. Cholera Erysipelas Small Pox Scarlatina Diphtheria Membranons Croup fevers Cholera Erysipelas Typhus Ent< l ie or Typhoid Continued Relapsing Puerperal Typhus Enteric or Typhoid Continued Relapsing Puerperal (a) (b) (c) (d) (e) Limehouse 32917 33390 1144 Under 5 5 upwds. .. 35 32 .. .. 5 .. .. .. .. 2 .. 23 24 .. .. 5 .. .. .. .. .. *1 61 36 .. .. 73 .. .. 2 .. 32 1 44 28 .. .. 62 .. .. .. .. 6 Ratcliff 14954 14966 463 Under 5 5 upwds. 15 20 1 5 13 15 i . . . . 2 .. 22 27 .. .. 23 .. .. .. .. 18 .. 16 22 .. .. 18 .. .. .. .. 3 Shadwell and Wapping 10434 10451 326 Under 5 5 upwds. .. 6 5 1 .. .. .. .. .. .. 2 .. 6 5 1 .. .. .. .. .. .. .. *1 22 5 .. .. 29 .. .. 1 .. 19 1 16 5 .. .. 24 .. .. 1 .. 4 Totals 58305 58807 1933 Under 5 5 upwds. .. 56 57 2 .. 5 .. .. .. .. 9 .. 42 44 2 .. 5 .. .. .. .. 2 *2 105 68 .. .. 125 .. .. 3 .. 69 2 76 55 .. .. 104 .. .. .. .. 13 * These two did not contract the Disease in the District, hut in the Eastern Fever Hospital, where they had been for over a month, and were recovering from Scarlet Fever for which they had been removed. Board of Works for the Limehouse District, Public Health Department, To Dr. D. L. Thomas, Medical Officer of Health, and Public Analyst. Sir, We have much pleasure in submitting our tabulated statement showing the amount of work performed by us during the past year, the details of which came under your notice and supervision. Diligent attention has been given throughout the year to the Meat, Fruit and Vegetables exposed for sale in the Shops and thoroughfares in the District. The cases of Infectious Disease have had our immediate attention, occasionally calling us out at night, and frequently on Sundays. We are, Yours obediently, JOHN WILLIAM JOHNSON, GEORGE OSBORNE PAVITT, EDWIN THOMAS CROOK. 32 INSPECTORS' REPORT OF THE SANITARY WORK, &c. Completed in the year ending December 31st, 1899. Sanitary Work, &o. No. 1 District. No. 2 District. No. 3 District. Total. Houses, Premises, &c., inspected 1149 1203 1094 *3446 Orders issued for amendments 2148 1940 1654 5742 Houses cleansed and whitewashed 127 204 205 536 Rooms disinfected, stripped and cleansed 84 67 69 220 Drains repaired, cleansed and trapped 441 224 240 905 Drains new and reconstructed 115 124 115 354 Yards paved, and paving repaired 187 267 175 629 Water closets cleansed and repaired 332 207 315 854 Closets and urinals supplied with water 51 158 70 279 New closets supplied 16 53 2 71 Water supply laid on 27 82 20 129 Cisterns cleansed and covered, and defective water fittings 203 138 150 491 Waste and stack pipes disconnected from drains 51 15 25 91 Dust-pails supplied 461 554 291 1306 Dust removal complaints attended to 17 15 14 46 Removal of accumulations, &c. 7 9 3 19 Dead bodies removed to mortuary 1 6 5 12 Canal boats inspected 25 .. .. 25 Flooring, stairs, window sashes and eaves gutters provided, and roofs repaired 439 420 200 1059 Overcrowding abated 1 9 20 30 Notices to schools 113 182 71 366 Factory Inspections 5 1 120 126 33 Factory nuisances abated 5 1 10 16 Bake-houses inspected 40 28 26 94 Licensed Slaughter-houses inspected 8 2 .. 10 Legal Proceedings, i.e., Summonses 8 38 25 71 Houses closed, unfit for habitation .. 11 5 16 Houses demolished .. 4 1 5 Notices given to London County Council of dangerous and dilapidated premises 20 52 15 87 Drain test used 768 678 388 1834 Improved ventilation in houses 52 13 30 95 Basements discontinued to be used as dwellings .. 4 3 7 Drinking water supplies separate from the w.c.'s 2 .. 1 3 Animals removed .. 7 .. 7 Cesspools abolished 1 1 .. 2 Free Shelters inspected 8 10 6 24 New dung pits provided 4 .. 2 6 Water closets discharging into the river Thames .. .. 8 8 Notices to provide crossings, area gratings, flaps and trap doors in footways 3 5 9 17 Samples taken under Sale of Food and Drugs' Act 48 52 48 148 Dust-bins defective .. 2 .. 2 Licensed Cow-sheds inspected 6 3 6 15 Smoke nuisances abated 2 .. 10 12 * This does not include re-inspection to premises to ascertain works in progress; such, if added would probably treble the number. In addition to this, we have had destroyed, as unfit for human food, during the year, the following articles, viz.:—1 cwt. Meat, 1 Sheep, quantity of Oranges. JOHN WILLIAM JOHNSON, GEORGE OSBORNE PAVITT, EDWIN THOMAS CROOK. 34 LIST OF ARTICLES DISINFECTED IN THE APPARATUS, From January 1st to December 31st, 1899. Articles. January. February. March. April. May. June. July. August. September. October. November. December. Total. Beds 20 34 70 29 28 16 36 29 56 69 105 71 563 Sheets 26 34 47 34 30 35 30 22 65 74 65 67 529 Blankets 29 38 32 26 32 23 45 40 80 61 92 62 560 Bolsters 12 27 65 20 16 12 29 17 71 53 60 40 422 Pillows 41 70 88 36 42 30 60 51 63 90 170 82 823 Quilts 14 18 40 10 22 9 19 11 20 45 74 53 335 Mattresses 10 20 62 19 46 26 47 27 80 87 53 98 575 Sundries 200 350 412 206 112 204 165 502 216 507 703 310 3887 Total 352 591 816 380 328 355 431 699 651 986 1322 783 7694 35 TABLE VII. Showing the Localities in which certain Diseases of a Zymotic character occurred during the year 1899, with total number of deaths from all causes. Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina. Enteric Fever. Puerperal Fever. Total No. of Cases. Total No. of Deaths from all Causes. Abbott's-cottages .. .. .. .. .. .. .. 3 Acland-street .. .. .. 4 .. .. 4 1 Agnes-street .. .. .. .. .. .. .. 1 Albert-street .. .. 1 .. 4 .. 5 10 Albert-square .. .. 1 .. 1 .. 2 3 Ann-street 1 .. 1 .. .. .. 2 9 Amoy-place .. .. .. .. .. .. .. 1 Albert-terrace .. .. .. .. .. .. .. 1 Albany-street .. .. .. .. .. .. .. 1 Arno-place .. .. .. .. .. .. .. 1 Aston-street 2 .. 1 2 1 .. 6 13 Barnes-street .. .. .. 1 .. .. 1 12 Balls-buildings .. .. .. .. .. .. .. 4 Batson-street .. .. .. .. .. .. 1 1 Belgrave-street .. .. 2 1 .. .. 3 19 Beachcroft-buildings 2 .. .. .. .. .. 2 4 Ben Jonson-road 1 .. .. 6 .. .. 7 10 Bewley Street-buildings 1 .. .. 1 .. .. 2 5 Beccles-street 1 .. .. .. .. .. 1 2 Birchfield-street .. .. .. .. .. .. .. 3 Blount-street 2 .. 1 1 .. .. 8 18 Black Bull-court .. .. 1 .. .. .. 1 Bower-street 1 .. .. .. .. .. 1 1 Brenton-street 1 .. .. 6 .. .. 7 19 Bromley-street 3 .. .. 4 .. .. 7 14 Broad-street .. .. .. 2 .. .. 2 9 Brook-street 2 .. 2 1 3 .. 8 34 Brunswick-place .. .. .. .. .. .. .. 1 Brunton-place .. .. 1 .. .. .. 1 2 Burdett-road .. .. .. .. .. .. .. 9 36 Table VII.—Continued. Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina. Enteric Fever. Puerperal Fever. Total No. of Cases. Total No. of Deaths from all Causes. Bere-street 1 .. .. .. .. .. 1 3 Brewhouse-lane .. .. .. .. .. .. .. 1 Beards-place .. .. .. .. .. .. .. 2 Burgess-street 2 .. .. 6 .. .. 8 16 Butcher-row .. .. .. .. 1 .. 1 2 Cable-street 1 .. 1 3 4 .. 9 22 Caroline-street 1 .. 1 3 2 .. 7 10 Carr-street 1 .. 1 1 1 .. 4 13 Cayley-street .. .. .. .. .. .. .. 7 Chaseley-street 2 .. .. .. 1 .. 3 1 Chivers-court 1 .. .. .. .. .. 1 7 Chancery-place .. .. .. .. .. .. .. 1 Church-row .. .. 1 2 2 .. 5 13 Clemence-street 2 .. 1 1 1 .. 5 10 Commercial-road .. .. 1 2 .. .. 3 21 Coleman-street .. .. .. 1 .. .. 1 4 Collingwood-street 2 .. .. .. 2 .. 4 5 Conder-street 3 .. .. 4 4 .. 11 12 Copenhagen-place 5 .. 1 1 2 .. 9 16 Coshs-buildings 2 .. 2 1 1 .. 6 23 Caroline-place .. .. .. .. .. .. .. 1 Copos-buildings .. .. .. .. .. .. .. 1 Cross-street 2 .. .. .. .. .. 2 1 Claydens-buildings 2 .. 1 .. .. .. 3 1 Dalgleish-street 1 .. .. .. .. .. 1 6 Dalgleish-place .. .. .. .. .. .. .. 1 Dakin-street .. .. .. .. .. .. .. 1 Devonport-street .. .. .. .. 1 .. 1 8 Devonshire-place .. .. .. .. .. .. .. 1 Dellow Street-buildings .. .. 2 .. 2 .. 4 4 Dixon-street 1 .. .. .. .. .. 1 6 Dora-street .. .. .. 1 .. .. 1 11 Dorset-street .. .. 1 1 .. .. 2 10 Dod-street .. .. .. .. .. .. .. 3 37 Table VII.— Continued. Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina Enteric Fever. Puerperal Fever. Total No. of Cases. Total No. of Deaths from all Causes. Dr. Barnardo's Home .. .. .. .. .. .. .. 18 Drews-buildings .. .. .. 3 .. .. 3 2 Drewton-street .. .. .. .. .. .. .. 5 Dupont-street .. .. .. .. 1 .. 1 11 Dundee-street .. .. .. .. .. .. .. 10 Durham-row .. .. .. 1 .. .. 1 6 Eastfield-street 3 .. 2 6 5 .. 16 31 East India Dock-road .. .. .. .. .. .. .. 7 East London Hospital 1 .. .. 3 2 .. 6 .. Ebenezer-place .. .. .. .. .. .. .. 2 Elbow-lane .. .. .. .. .. .. .. 1 Elsa-street 6 .. .. 2 4 .. 12 40 Emanuel's Almshouses .. .. .. .. .. .. .. 2 Endive-street .. .. .. .. 1 .. 1 1 East-pier .. .. .. .. .. .. .. 1 Earrance-street .. .. 2 3 .. .. 5 11 Galt-street .. .. .. .. .. .. .. 5 Gill-place 1 .. 1 .. .. .. 2 1 Gill-street 4 .. 1 .. .. .. 10 33 Glasshouse Fields 1 .. .. .. .. .. 1 2 Glamis-road .. .. .. .. .. .. 1 3 George-street .. .. 2 1 .. .. 3 7 Gloucester-court .. .. .. .. .. .. .. 3 Gould's-hill .. .. .. .. .. .. .. 4 Grove-court .. .. .. .. .. .. .. 3 Grenade-street 1 .. .. .. .. .. 2 9 Georgina-place .. .. .. .. .. .. .. 1 Gun square .. .. .. .. 1 .. 1 4 Grocers-court .. .. .. .. .. .. .. 2 Giles-place 1 .. .. .. .. .. 1 .. 38 Table VII.—Continued. Locality. Diphtheria. Membranous Croup. Erysipelas. Scanatma Enteric Fever. Puerperal Fever. Total No. of Cases. Total No. of Deaths from all Causes. Halley-street .. .. .. .. 2 .. 2 10 Harding-street 1 .. .. 2 .. .. 3 2 Havering-street 1 .. .. 1 .. .. 2 13 High-street, Shadwell 1 .. 5 5 2 .. 13 40 High-street, Stepney .. .. .. .. .. .. .. 2 High-street, Wapping .. .. 1 .. 1 .. 2 7 Hilton-street .. .. .. .. .. .. .. 4 Hope-place .. .. .. 1 .. .. 1 1 Holkar-place .. .. .. .. .. .. .. 2 Harads-place .. .. 1 .. 1 .. 2 5 Island-row .. .. .. .. .. .. .. 1 James-place 2 .. 1 1 2 .. 6 11 James-street .. .. .. .. .. .. .. 1 Jamaica-passage .. .. .. .. .. .. 3 Juniper-street 2 .. 1 7 3 1 14 27 Johnson's-buildings .. .. .. .. .. .. .. 2 King David-lane .. .. .. 2 .. .. 2 4 Kirks-place .. .. .. .. 1 .. 1 5 King John's-court .. .. .. .. .. .. .. 1 Lance-street .. .. .. .. 1 .. 1 3 Lee-street .. .. .. 1 .. .. 1 3 Limehouse Causeway 1 .. 2 1 2 .. 6 12 Little John-street .. .. .. 1 .. .. 1 1 Locksley-street .. .. 2 9 .. 1 12 10 Lockside .. .. .. .. .. .. .. 3 London-street 7 .. 1 1 1 .. 10 31 Love-lane .. .. .. 1 .. 1 13 Love-lane-square .. .. .. .. .. .. .. 2 Lowell-street .. .. .. .. .. .. .. 3 Lydbrook-street .. .. .. .. .. .. .. 1 39 Table VII.— Continued. Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina Enteric Fever. Puerperal Fever. Total No. of Cases. Total No. of Deaths from all Causes. London Docks .. .. .. .. .. .. .. 1 Lowood-street .. .. .. .. .. .. .. 1 Manning-street .. .. .. .. .. .. .. 7 Manor-court .. .. .. .. .. .. .. 1 Market-hill .. .. 2 .. .. .. 2 4 Market-street .. .. .. .. 1 .. 1 1 Market-buildings .. .. .. .. .. .. .. 4 Mays-cottages .. .. .. .. 5 .. 5 3 Maroon-street 3 .. .. 6 3 .. 12 32 Matlock-street .. .. .. 2 .. .. 2 3 Medland-street .. .. 1 .. 2 .. 3 13 Medland-hall .. .. .. .. .. .. .. 3 Mercer-street 1 .. .. .. .. .. 1 4 Middle Shadwell .. .. .. .. .. .. .. 1 Milk-yard .. .. .. .. .. .. .. 2 Monza-street .. .. .. .. 2 .. 2 4 Marchant's-row .. .. .. .. .. .. .. 1 Narrow-street .. .. .. .. .. .. .. 4 New Gravel-lane .. .. 1 .. .. .. 1 9 Neptune-street .. .. .. .. 1 .. 1 1 Nesbits-rents .. .. .. .. .. .. .. 3 Newtons-rents .. .. .. 1 .. .. 1 2 Nightingale-lane .. .. .. .. .. .. .. 2 Northey-street 2 .. 2 1 .. .. 5 19 Notgrove-street .. .. .. .. .. .. .. 3 Oak-lane .. .. .. .. .. .. .. 2 Park-street .. .. .. .. .. .. .. 4 Parnham-street .. .. .. .. .. .. .. 8 Painters-rents .. .. .. .. .. .. .. 2 Peabody-buildings 1 .. 2 1 1 .. 5 20 40 Table YII.— Continued. Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina. Enteric Fever. Puerperal Fever. Total No. of Cases. Total No. of Deaths from all Causes. Pelling-street .. .. .. .. .. .. .. 2 Periwinkle-street 4 .. .. .. .. .. 4 8 Phoebe-street .. .. .. .. .. .. .. 3 Pigott-street .. .. .. 1 .. .. 1 11 Pixley-street .. .. .. .. .. .. .. 1 Pope's-hill .. .. 1 1 .. .. 2 3 Portland-street .. .. .. .. .. .. .. 3 Princes-place .. .. .. .. 1 .. 1 1 Prosperous-place .. .. .. .. 1 .. 1 .. Prospect-place .. .. 1 .. .. .. 1 2 Queen's Head-alley .. .. .. .. .. .. .. 2 Railway-place .. .. .. 2 1 .. 3 1 Ratcliff Workhouse 1 1 .. .. .. .. 2 25 Red Lion-street .. .. 1 .. 1 .. 2 9 Reform-place .. .. .. .. .. .. .. 1 Regents-place .. .. .. 1 .. .. 1 .. Repton-street .. .. 1 1 .. .. 2 8 Rhodeswell-road .. .. 1 .. 2 .. 3 26 Rich-street .. .. .. 1 1 .. 2 4 Ronald-street .. .. .. .. .. .. .. 3 Robert-street .. .. 3 .. .. .. 3 3 Raby-street .. .. .. .. .. .. .. 2 Ropemakers-fields .. .. .. .. 8 .. 8 11 Rose-lane .. .. 1 .. .. .. 1 5 Rugg-street .. .. .. .. .. .. .. 1 Rectory-buildings .. 1 .. .. .. .. 1 • • Sage-street .. .. 1 .. 1 .. 2 7 Samuel-street 2 .. 2 2 5 .. 11 14 Salmon-lane 1 .. 1 4 1 .. 7 25 Salter-street .. .. .. .. .. .. .. 5 Sun Tavern-place .. .. .. .. .. .. .. 1 Sarah-street .. .. .. .. 1 .. 1 3 41 Table VII.—Continued. Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina Enteric Fever. Puerperal Fever. Total No. of Cases. Total No. of Deaths from all Causes. Selsey-street .. .. .. .. .. .. .. 5 Settles-cottages .. .. .. .. 1 .. 1 1 Shadwell-green .. .. .. .. 1 .. 1 2 South-street .. .. .. .. 1 .. 1 5 Silver-street .. .. .. 1 .. .. 1 .. Spencer-street .. .. .. .. .. .. 1 1 Spenlow-street .. .. .. .. .. .. .. 3 Spring Garden-place .. .. .. .. .. .. .. 1 St. Anne's-row .. .. .. .. .. .. .. 2 St. Anne's-street .. .. 2 .. .. .. 2 10 St. George's-street .. .. 1 .. .. 1 4 St. Paul's-road 3 .. .. 2 .. .. 6 3 Stainsby-road 1 .. .. 3 .. .. 4 10 Streatfield-street .. .. 2 .. .. 2 2 Stepney Causeway 5 .. 1 4 1 .. 11 15 Stepney Causeway-court .. .. .. .. .. .. .. 2 Spring-gardens .. .. .. .. .. .. .. 2 Taylor's-place .. .. .. 2 .. .. 2 4 Tenbury-place .. .. 2 .. 1 .. 3 2 Three Colt-street 1 .. .. .. 3 .. 4 14 Thirza-street .. .. .. 1 1 .. 2 3 Thomas-street, Ratcliff 2 .. .. 1 .. .. 3 8 Thomas-street, Limehouse .. .. .. .. 3 .. 4 12 Tower-buildings 1 .. .. .. 1 .. 2 1 Tomlin-terrace .. .. .. 1 .. .. 1 7 Turners-road 1 .. .. .. .. .. 2 15 Tile-yard .. .. .. .. .. .. .. 2 Twine-court .. .. .. .. .. .. .. 11 Thomas-rents .. .. .. .. .. .. .. 2 Upper Well-alley .. .. .. .. .. .. .. 1 Union-terrace .. .. .. .. 1 .. 1 1 Upper East Smithfield .. .. .. .. .. .. .. 4 42 Table VII.— Continued Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina Enteric Fever. Puerperal Fever. Total No. of Cases. Total No. of Deaths from all Causes. Walker-street 1 .. .. 2 1 .. 4 1 Waiter-street 1 .. .. .. .. .. 1 4 Wapping-wall .. .. .. 1 .. .. 1 8 Wallwood-street .. .. .. 1 .. .. 1 5 Waterloo-street .. .. .. .. .. .. .. 1 Warton-place .. .. 1 1 .. .. 2 5 Wellclose - square .. .. .. .. .. .. .. 2 West India Dock-road .. .. 1 3 .. .. 4 14 West Garden-buildings 1 .. .. .. .. .. 1 8 White Horse-street 4 .. 2 1 .. .. 9 18 Willow-row 1 .. .. .. .. .. 1 3 Williams-place .. .. .. .. .. .. .. 1 White Hall-place 2 .. .. .. .. .. 2 1 Warwick-place 3 .. .. .. .. .. 3 2 York-buildings .. .. .. .. .. .. .. 3 York-place 1 .. .. .. .. .. 1 1 York-road .. .. .. 1 .. .. 1 1 York-square 2 .. .. 1 .. .. 3 1 York-street .. .. .. .. .. .. 4 4 43 1890. BAKEHOUSES. LIMEHOUSE. names. Addresses. Mr. J. Rickert, 22, Gill-street ,, C. Baldwin, 821, Commercial-road ,, Toms, 341, Burdett-road ,, J. Draude, 31, Repton-street ,, M. Donaldson, 3, Repton-street „ Schwarz, 137, Eastfield-street (empty) 21, Halley-street ,, W. Living, 12, Parnham-street ,, P. Fiehl, 45, Thomas-street „ H. Zimmermann, 84, Locksley-street ,, J. Few, 132, Rhodeswell-road ,, W. Pearce, 131, Salmon-lane ,, H. Bretz, 145, Salmon-lane ,, J. Faber, 181, Salmon-lane ,, Miller, 209, Salmon-lane ,, C. Smeith. 71, Salmon-lane Messrs H. & E. Wagner, 7, Limehouse-causeway Mr. H. Haust, 40, Limehouse-causeway ,, Kuntz, 68, Limehouse-causeway ,, J. W. Domm, 146, White Horse-street (not used) 51, Three Colt-street ,, W. H. Pearce, 77, Three Colt-street ,, T. Slawson, 87, Three Colt-street ,, J. A. Siebert, 93, Three Colt-street Mrs. Hannus, 29, West India Dock-road Mr. Marks, 36, Three Colt-street RATCLIFF. Mr. Prummer, 105, White Horse-street „ A.S.Harding, 42, White Horse-street ,, Bader, 147, White Horse-street Mrs. Lee, 631, Commercial-road 44 Bakehouses— Continued. RATCLIFF. Names. Addresses. Mr. Weimer, 119, Broad-street ,, J. W. Newman, 27, Hardinge-street ,, C. Siebert, 415, Cable-street (not used) 59, Brook-street ,, Schwenk, 91, Brook-street ,, Schneider, 85, Brook-street „ M. Rosenberg, 436, Commercial-road ,, W. Herbert, 508, Commercial-road ,, Hahn, 13, Devonport-street SHADWELL. Mrs. Bock, 84, High-street Miss Green. 161, High-street Mr. Westrick, 47, High-street ,, Menzler, 5, King David-lane ,, G. D. Cannon, 278, Cable-street 1899. LICENSED COW HOUSES. LIMEHOUSE. Names. Addresses. Messrs. Abbott Bros., Batson-street Mr. J. Harris, 15, Maroon-street ,, J. Knight, 162, Rhodes well-road ,, David Thomas, 42 & 44, Ropemaker's fields 45 Licensed Cow Houses—Continued. RATCLIFF. Names. Addresses. Mr. Charles Warman, Railway Arch, Drewton-street ,, Charles Toms, 63, Brook-street „ James Allcock, 12, Hilton-street Messrs. J. & W. Morris, 37, White Horse-street SHADWELL. Mr. Thomas Williams, Sage-street SLAUGHTER HOUSES. LIMEHOUSE. Mr. W. Knightbridge, 26, Three Colt-street „ W. H. Phillips, 160, White Horse-street