LIM 4 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 1900. BY DANIEL LEWIS THOMAS, Medical Officer of Health and Public Analyst. THE ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE LIMEHOUSE DISTRICT, For the Year 1900. To the Mayor, Aldermen & Councillors of the Metropolitan Borough of Stepney. Gentlemen, I have the honour to submit to you my Annual Report on the health of that part of the Borough which was formerly administered by the Board of Works for the Limehouse District, and included the parishes of Limehouse, Shadwell and Wapping, and the Hamlet of Ratcliff. 4 Population. The population estimated to the middle of 1900 was 58,944 distributed as follows:— Limehouse 33,444 Ratcliff 14,932 Shadwell and Wapping 10,568 Births. The number of births in the year was 1,839—945 males and 894 females. This corresponds to a birth rate of 31.1 per 1,000 of the population, the average for the preceding 10 years being 33.5 per 1,000. Per 1,000 of the population. 1,125 births ??? in Limehouse with a birth rate of 33.8 401 ,, „ Ratcliff „ „ „ 27.5 313 „ ,, Shadwell and Wapping ,, 29.6 The birth rate for the whole of the district is 2.5 per 1,000 above that of London as a whole, but is lower than that of 1899. In fact the birth rate has been gradually declining since 1895. In 1895 the birth rate was 35.5 per 1,000 of the population. 1896 ,, ,, 34 „ ,, ,, 1897 ,, „ 34 „ „ ,, 1898 ,, ,, 32.5 „ ,, ,, 1899 ,, ,, 32.8 „ ,, ,, 1900 ,, ,, 31.1 ,, ,, ,, Marriages. There were 370 marriages during the year, the average number for the previous 10 years being 410. The proportion 5 of persons married was 12.5 per 1,000 of the population. The proportion of persons married in the whole of London was 17.6 per 1,000. Deaths. The registered deaths exclusive of those non-residents that occurred in the District, but inclusive of those residents that died in Out-lying Institutions, numbered 1,529. This corresponds to a death rate of 25.9 per 1,000 of the population, the average for the previous 10 years being 25.5 per 1,000. These deaths were distributed over the District as follows Limehouse 612 Ratcliff 224 Shadwell and Wapping 170 East London Children's Hospital 302 1308 Deaths occurring outside the District among persons belonging thereto 462 1770 Deaths occurring within the District among persons not belonging thereto 241 1529 The death rate after distributing those deaths that occurred in the Out-lying Institutions to the various parishes that they belonged to, was:— Limehouse 25.8 per 1,000 of the population Ratcliff 25.8 „ „ „ Shadwell and Wapping 26.3 ,, „ ,, 6 Compared with 1899, the causes of death were:— DISEASES. 1899. 1900. Increase. Decrease. Scarlet Fever 1 11 10 ... Diphtheria 30 19 ... 11 Membranous Croup ... 5 5 ... Enteric Fever 21 7 ... 14 Measles 53 79 26 ... Whooping Cough 24 48 24 ... Diarrhæa, Dysentery, Enteritis, etc. 54 133 79 ... Rheumatic Fever 3 2 ... 1 Phthisis 135 141 6 ... Other Tubercular Diseases 63 54 ... 9 Bronchitis, Pneumonia, and other Respiratory Diseases 284 280 ... 4 Heart Disease 105 103 ... 2 Influenza 18 35 17 ... Injuries 84 62 ... 22 Wasting Diseases 113 86 ... 27 Convulsive Diseases 67 66 ... 1 Old Age 78 98 20 ... All other Diseases 367 300 ... 67 1500 1529 187 158 The excess of births over deaths was 310. 7 The following is a list of the Out-lying Institutions and the number of residents of the Limehouse District that died in them during the year:— Poplar and Stepney Sick Asylum 180 Hanwell Asylum 2 Ilford „ 6 Colney Hatch Asylum 8 Grove Hall „ 1 Banstead ,, 2 Bethnal House ,, 2 Leavesden „ 5 Cane Hill ,, 2 Claybury ,, 1 Caterham „ 2 Stepney Workhouse 122 St. George's-in-the-East Infirmary 4 Mile End ,, 3 St. Olave's ,, 1 Holborn ,, 1 Wandsworth ,, 1 London Hospital 70 St. Bartholomew's Hospital 4 St. George's ,, 2 King's College „ 1 St. Thomas's ,, 1 South Eastern Fever ,, 13 Park ,, „ 8 Eastern ,, ,, 3 North Eastern ,, ,, 2 North Western ,, ,, 1 West London Hospital 1 German ,, 1 City of London Chest Hospital 3 Middlesex ,, 1 Poplar ,, 1 Millwall Dock 1 H.M.S. Prison, Holloway 1 St. Pelagra's Creche 1 Mother's Home, Commercial Road 3 Oxygen Home Hospital, Fitzroy Square 1 462 8 Small Pox. No case of Small Pox has occurred in the District during the year, though there were 64 cases in London, with 4 deaths. This is the fifth year in succession that the district has been free from this disease. This result is highly satisfactory when we consider (a) The Sailors' Homes that there are in the district and the large number of foreign sailors that stay in these places from time to time. (b) That in this district is situated one of the largest free shelters in London, where from 400 to 450 men sleep every night. The people that sleep in this shelter constitute a lower class even than that which frequents the casual wards in the various workhouses, and which proved to be the main cause of spreading Small Pox during the last epidemic that occurred in London a few years ago. (c) The large number of children that are unvaccinated in the district. Scarlet Fever. The corrected number of deaths was 11. Ten of these occurred in the Fever Hospitals of the Metropolitan Asylums Board. The annual average for the preceding 10 years was 16.8. 145 cases were notified during the year, of which 119 were removed to the various Fever Hospitals; 63 occurred in Limehouse, 50 in Ratcliff, and 32 in Shadwell and Wapping. The Death rate was .18 per 1000 of the population, the Death rate for the whole of London being .o8 per 1000. Diphtheria. The corrected number of deaths was 19, the annual average for the preceding 10 years being 32.9. 169 cases were notified and 133 were removed to Hospital. 87 occurred in Limehouse, 43 in Ratcliff, and 39 in Shadwell and Wapping. The Death rate was .32 per 1,000 of the population, that for the whole of London being .34 per 1,000. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER, DURING 1900. CURVE SHOWING THE TOTAL NUMBER OF INFECTIOUS DISEASES IN LIMEHOUSE, RATCLIFF, SHADWELL AND WAPPING, DURING 1900. CURVE SHOWING THE TOTAL NUMBER OF INFECTIOUS CASES NOTIFIED WEEK BY WEEK, DURING 1900. 9 Membranous Croup. No case of Membranous Croup was reported during the year, but there were five deaths from Croup, which were not notified as Membranous Croup. Typhus Fever. No case was reported during the year. Erysipelas The number of deaths from Erysipelas was 11; 103 cases were notified and 29 were removed to various general Hospitals and Infirmaries. This is a great increase, on the previous year when there were only 78 cases notified and no deaths. 46 occurred in Limehouse, 30 in Ratcliff and 27 in Shadwell and Wapping. Puerperal Fever. Two cases were notified but neither proved fatal. Both occurred in Limehouse. Enteric Fever. The number of deaths was 7, the average annual number for the preceding 10 years was 9.3. 67 cases were notified and 51 removed to Hospital. 39 occurred in Limehouse, 17 in Ratcliff and 11 in Shadwell and Wapping. This is a great improvement on the previous year, when there were 130 cases notified with 21 deaths. It is very difficult to trace the origin of Enteric Fever, partly on account of the long Incubation period (from 10 to 21 days), and partly on account of the gradual onset of the disease, the patient being unable to state definitely when he began to feel ill. In all probability though, the increased number in 1899, occurring as it did in the fourth quarter, and following the drought in that summer, was due to to the imperfect filtration of the water. The Death rate was .11 per thousand of the population. 10 Whooping Cough. The number of deaths was 48, the average number for the preceding 10 years being 48.2. The Death rate was .81 per 1000 of the population, that for the whole of London being .43 per 1000. Diarrhæa. The number of deaths from Diarrhoea—which includes Epidcmic and Zymotic Enteritis, Dysentery and Dysenteric diarrhoea, Cholera and Choleraic diarrhoea, was 57. The annual average for the previous 10 years was 50. The Death rate was .96 per 1000 of the population, that for the whole of London being .78 per 1000. Measles. The number of deaths was 75, the annual average for the previous 10 years being 56. The Death rate was 1.2 per 1000 of the population, that for the whole of London being .42 per 1000. The question whether Measles should be made a notifiable disease is a difficult problem. It is more difficult in London than in Provincial towns where Notification has been tried, and in a few instances given up. To schedule it in London and enforce isolation and removal to Fever Hospitals would entail such a large expenditure, especially in increased Hospital accommodation, that one ought to be perfectly satisfied of the ultimate value before recommending such a course. The arguments in its favour are that Measles is a preventible disease, and that it caused last year in our district alone, 75 deaths, and that the other deaths from notifiable diseases numbered 48 only. On the other hand, 70 of these were children under 2 years of age, and 29 were under 1 year of age; whereas of the 11 deaths from Scarlet Fever, 1 only was under a twelvemonth old, 7 were between 2 and 5 years of age, and 3 were over 5 years of age. It would be very difficult to remove children to Hospital, under 2 years of age; and under the age 11 of 1, it would be practically impossible. I take it for granted that children under 3 do not attend school, but other children from the same families attend school, and may possibly carry the infection to the schools. Notification would be useful in giving early information and preventing the other children from attending school and spreading the disease. Where it is known that the children are suffering from Measles, or that they come from houses where children are so infected, they are excluded from attending school, and the School Board Authorities inform me of the fact. This information is of value, as it gives me an opportunity of knowing the full extent of the epidemic and also of recommending the closing of the school if necessary. It would be as well if all voluntary schools adopted a similar method. Measles is very infectious in its earlier stages before it can be diagnosed with certainty, but Scarlet Fever is most infectious in, its later stages when the child is peeling. Scarlet Fever can therefore be isolated before it can do much harm, but Measles cannot. Parents unfortunately regard Measles as a "necessary evil," and that the sooner a child has the Measles the better off it is. Therefore, the mothers, instead of keeping the children away from the sick child, bring them together as much as possible, as they consider it will be more convenient to have them laid up at the same time than one after the other. This is the experience of nearly every Medical Practitioner in our district. By making it a notifiable disease it is probable that the parents would regard it more seriously, and the penalty for allowing the children to be exposed in the streets would result in fewer complications such as Bronchitis and Pneumonia, and thus in a fewer number of deaths. The drawback to this would be, that a large number of children would have the disease so slight that no Medical man would be called in, and therefore would be unreported. In addition to the expenditure involved in increased Hospital accommodation, the notification fees would necessarily be a very large item, and the Sanitary Staff would have to be materially increased. Personally, I am of opinion that if Female Health Visitors were appointed, notification even without Hospital isolation would be of great 12 benefit. These Visitors—who would be trained nurses as well as qualified Sanitary Inspectors—would instruct the mothers to properly nurse the sick child, and by frequent visits, would prevent the child from being exposed to conditions that render it liable to complications which are mainly responsible for a fatal termination. The deaths from Zymotic diseases numbered 222, and correspond to a death rate of 3.7 per thousand of the population. The Zymotic death rate for the whole of London was 2.19 per 1,000, such deaths include Small Pox, Measles, Scarlet Fever, Diphtheria, Croup, Whooping Cough, Puerperal Fever, Enteric Fever and Diarrhoea. The number of deaths from Inflammatory affections of the Lungs was 266, and corresponds to a death rate of 4.5 per 1,000 of the population. 141 deaths were due to Phthisis which is equal to a death rate of 2.4 per 1000. The death rate for the whole of London was i'75 per 1000. In addition to the deaths from Phthisis there were 54 deaths due to other Tubercular diseases. There were therefore 195 deaths due to the Tubercle Bacillus. This corresponds to a death rate of 3.3 per thousand of the population, and is exactly the same number as that in the previous year. About the middle of the year, the Stepney Branch ot the Charity Organization Society called a public meeting with the object of trying to reduce the high mortality from this disease, by educating the people as to the best means of preventing this disease. A Committee was formed, and one of the recommendations of that Committee was that the pamphlets issued by this Board in 1894 should be re-printed after being brought up to date, and circulated widely amongst the inhabitants of the district. The Board agreed to this, and a large number of copies of the following was distributed:— 13 Suggestions for the Guidance of Consumptive Patients. 1. In early stages, many cases of Consumption are curable. 2. It is certain that the material (or "phlegm") coughed up by persons suffering from Consumption contains the seeds of the disease. 3. The phlegm, therefore, should not be swallowed, such a habit may lead to Consumption of the Bowels. 4. Consumptives should not, when indoors, spit on the floors, but should spit into special spitting cups (or pots) half full of water. The Phlegm is most dangerous when it dries and becomes dust. 5. The spitting cups should be emptied into a bright fire or into the pan of the water-closet, but never anywhere else, and especially not into the dust heap. Out of doors a pocket handkerchief may be used, but all soiled handkerchiefs should be boiled for at least five minutes when they are being washed. 6. The room in which a Consumptive lives by day or night should be well-aired, and the windows should be thrown wide open as soon as the patient leaves it. The windows should always be kept a little open at the top, both day and night. The chimneys should not be stopped up, but should be freely open for the passage of air. The floors of the rooms should be kept very clean, and great care should be taken that no dust remains upon them. They should be cleaned with a wet cloth. 7. Consumptive patients ought to sleep by themselves. 8. Mothers who are consumptive should not suckle their children, and should not themselves make use of the children's cups, spoons, etc. 9. Clothing and rooms that have been occupied by consumptive people can be disinfected free of charge on application to the Medical Officer of Health. These suggestions are not made for the benefit of sufferers from Consumption alone, but also in the interests of the family, for by adopting these means the spread of Consumption may be prevented. 14 Table shewing the number of Deaths from the principal Zymotic Diseases, including Influenza, in 10 years, 1890 to 1899, and in the year 1900. Disease. 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 Annual Average of 10 years, 1890—1899. Total Deaths in 1900. Proportion of Deaths to 1,000 Deaths in 1900. Small Pox ... ... ... 7 1 1 ... ... ... ... .9 ... ... Measles 92 14 63 16 72 8l 49 63 57 53 56.0 75 49.0 Scarlet Fever 15 5 27 31 41 17 14 12 5 1 16.8 11 7.1 Diphtheria 25 15 28 62 42 41 35 26 25 30 32.9 19 12.4 Croup ... ... ... ... ... ... 2 3 1 ... .6 5 3.2 Whooping Cough 70 59 59 49 28 42 52 37 62 24 48.2 48 31.3 Influenza ... ... ... ... ... ... 5 5 19 18 4.7 35 22.8 Typhus ... ... ... 1 ... ... ... ... ... ... .1 ... ... Enteric 14 6 ... 16 6 10 3 4 8 21 8.8 7 4.5 Simple contin'd ... ... 6 ... ... ... ... ... 1 ... .7 ... ... Puerprl ... ... ... ... ... ... 1 1 ... ... .2 ... ... Diarrhœa 52 49 27 56 22 49 40 61 90 54 50.0 57 37.2 Totals 268 148 210 238 212 241 201 212 268 201 219.9 257 167.5 15 Infant Mortality. During the year, 429 infants died before they were a twelvemonth old, and 665 before they were 5 years of age, that is, of all the deaths during the year, more than one-third were those of children under 5 years of age. The number of deaths of infants under one year of age was 227 per thousand births. With only one exception this is the highest of any District in London. The number for the whole of London was 160 per 1000 births. 35 deaths were due to Influenza. These occurred mostly in the first quarter of the year. 98 deaths were due to old age. This corresponds to a death rate of 1.5 per thousand of the population. Notification of Infectious Disease. 486 Notifications were received during the year of which 169 referred to Diphtheria, 103 to Erysipelas, 145 to Scarlet Fever, 67 to Enteric Fever and 2 to Puerperal Fever. This number is very satisfactory when we compare it with the number in previous years. There is a sudden drop in the number for 1898 and I can account for it partly for this reason, that when I was appointed by the Board at the end of 1897, the method of carrying out the disinfection of rooms was not satisfactory, In 1892 the number of notifications was 771 „ 1893 „ „ „ 1298 „ 1894 „ „ „ 719 „ 1895 „ „ „ 755 „ 1896 ,, „ „ 764 „ 1897 ,, „ ,, 754 „ 1898 „ „ „ 461 „ 1899 ,, „ „ 501 „ 1900 ,, „ „ 486 In all doubtful cases of Diphtheria, swabs from the throats, and the blood in Typhoid Fever were examined Bacteriologically free of charge to the General Practitioners. During the year 17 doubtful cases were so examined, with 6 positive results and ii negative. 16 This Table shows the number of Deaths at all ages in 1900, 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 222 37 145 2. Pulmonary Diseases 266 4.5 174 3. Principal Tubercular Diseases 195 3.3 127.5 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 86 46.7 200 5. Convulsive Diseases 66 35.8 153.8 NOTICE. 1. Includes Small Pox, Measles, Scarlet Fever, Diphtheria, Membranous Croup, Whooping Cough, Typhus, Puerperal, Enteric (or Typhoid), and Simple Continued Fevers, and Diarrhoea. 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. 17 Prosecution of an Unqualified Practitioner. An unqualified man residing in Galt Street, called at the office in February and asked for notification forms as he desired to notify three cases of Diphtheria. The forms—which are for the sole use of Qualified Medical men—were duly filled in by him, and he afterwards informed the Sanitary Clerk that there was no need for the Inspector to visit the premises as the children were properly isolated. Knowing that the man was unqualified, I at once communicated with the Registrar of the General Medical Council, who advised me to visit the patients as if they had not been notified at all. I did so, and found the three children notified in bed in a small room. In addition there was a fourth child in the same bed who was also suffering from Diphtheria. On making inquiries I found that another child, who was the original cause of the disease was in the kitchen recovering from the disease. On the following day a sixth child was taken ill, and the six were removed to the Fever Hospital. I reported the matter to the Sanitary Committee, and the Board was advised that no proceedings could be taken by them against the man that had notified the disease. The General Medical Council were unable also to take any steps in the matter, and, at my suggestion, the Society of Apothecaries were communicated with. The Secretary informed me that the Society would take proceedings provided I would undertake to procure the necessary evidence. This I accordingly did, and a summons was taken out at the Bow County Court, and (he defendant was fined £20. Plague Precautions. In October, I was informed that a man residing in York Buildings, Maroon Street, was suffering from a disease resembling Plague. After visiting him, I informed the Medical Officer of Health to the London County Council that it was a case requiring further investigation, and Dr. Cantlie—an 18 pert retained for the purpose by the London County Council— visited the patient. He was unable to decide whether it was a case of Plague or not until a Bacteriological examination had been made of the patient's blood. This, of course, would take a little time, and in the meantime the patient was removed to premises belonging to the County Council in Butcher Row. The result of the Bacteriological examination fortunately proved that it was not Plague. About two months before this happened, the Board—recognising the fact that this district comprises a long river frontage and that a large number of dock labourers and others coming in direct contact with ships coming from abroad, live in this district—issued a circular to Medical Practitioners residing or practising in the district. In this circular their attention was called to the fact that several cases of Plague had occurred in this country, and as the absence of opportunity of studying the clinical aspects of the disease, the Board desired to submit for their information, the various modes of onset of the disease in as concise a form as possible. I may add that the London County Council issued pamphlets of a similar nature, two months after the Board had distributed theirs. Housing of the Working Classes. The King John's Court Area is now cleared of the houses and is ready to be built upon. It has taken several years to have this area cleared. During 1893 and the early part of 1894, the area was visited by the Sanitary Committee on several occasions. In July, 1894, the Board passed a resolution that the closeness, narrowness, and bad condition of the buildings, and the want of light, air, proper conveniences and other sanitary defects in the buildings, rendered the Area dangerous to the health of the inhabitants. That the demolition and rearrangement of the buildings were necessary to remedy the evils, and that the site was too small to be dealt with as an unhealthy area under Part I. 19 The Board directed a scheme to be carried out under Part II. The Local Government Board was petitioned for an order sanctioning the scheme, and after the legal formalities had been observed, and the necessary notices served, an inquiry was held by a Local Government Board Inspector at the Board's Offices in October, 1897. Before the scheme was granted, the Inspector required information as to the number of empty houses in the immediate neighbourhood where the people displaced could be temporarily housed. I had no difficulty in satisfying him on this point, because since 1894 a large number of the houses had tumbled down, or were in such a condition as to be uninhabitable, and the scarcity of houses was not so acute as at the present time. At this juncture 23 of the houses were still standing, but ten were unoccupied and the remainder had 55 people in them. The scheme was approved of in 1898, and steps were at once taken to compensate the owners and to have the houses taken down. In February, of this year, a resolution was passed at the Board meeting that I should report to the Sanitary Committee the desirability of having a scheme prepared under Part I. of the Act for that part of the district known as Limehouse Fields. On making enquiries, I found that the number of cases of Infectious Diseases, the death rate from Zymotic Diseases, Tuberculosis and other causes was below that for the whole of the district. Furthermore, the arguments used by the members in favour of the scheme were, that the gardens and open spaces at the rear of the houses were too large and could be better utilized by having them built upon. Under these circumstances it was impossible for me to make an official representation under the 4th Section of the Act, though most anxious to have suitable dwellings for the working classes, and well knowing the great and increased demand there is for houses in the neighbourhood. What is the cause of the scarcity of houses and of overcrowding in our district, and what is going to be the 20 remedy ? Personally, I have no hesitation in stating that the cause is due almost entirely to the immigration of pauper aliens. It is only in certain parts of our district that I find the foreigner pushing his way, and in that neighbourhood the overcrowding is at its worst. On account of poverty, a man with a large family, and who ought to take a whole house, will only take two rooms. He can well afford to pay a shilling or two a week more than the former tenant, as even then these two rooms will be cheaper than if he had to house his family properly. Furthermore, he differs as a rule from the British workman in that he often uses his living room both as a workroom and as a sleeping room. On account of his poverty, therefore, parodoxical as it may appear, he is able to pay a higher rent than the Englishman, and the Englishman has to go. Very often our sanitary notices result in higher rents, and the opportunity for the introduction of the foreigner. To give an example, notices were served on the owner of 17 houses in Twine Court, Shadwell, with the result that notices to quit were served on all the tenants. The excuse given was, that the notices could not be complied with unless the houses were empty. After the houses had been satisfactorily repaired, they were let to foreigners at a rental of 4/- a week more, and in no instance was a former tenant allowed to occupy the house. This is not a solitary case but similar cases occur almost daily. It will continue, and overcrowding and want of proper housing accommodation will result till some means are taken to restrict the immigration of foreign aliens. Clearing slum areas and building palatial dwellings and the subsequent letting of rooms at double the rents that were paid for rooms in the area before it was cleared, will not abate overcrowding, but will be a factor in increasing overcrowding in the ineighbouring streets. When the King John Court area will be built upon, I am certain of this, that none of the tenants that formerly lived there, will be re-housed in the new houses, for one very excellent reason that they will not be able to pay the increased rent. 21 Smoke Nuisances. During the year, notices were served and, where necessary, proceedings were taken to prevent the sending forth of black smoke from factory and other chimneys in the district, with the result that smoke consumers were introduced in fifteen instances. In seven cases police court proceedings had to be resorted to before this desirable result was achieved. In each case the Magistrate granted a prohibition as well as an abatement order. In several other instances where efficient smoke consumers were in constant use, the nuisances were caused by the habitual carelessness of the stokers. Unsound Food. The following articles were condemned as unfit for human food and destroyed:— 1 van load of potted meat. 1 box of Mackerel. 1 box of Haddocks. 1 box of Eels. 2 cwt. of Meat. 68 tins of Pine Apple. 176 bags of Garlic. 18 boxes Oranges. 4 boxes of Herrings. 112 lbs. of Meat were seized on the premises of a butcher on a Sunday morning in June last. The meat was exposed for sale and was unsound and quite unfit for human consumption. It was taken before the Magistrate on the following morning and condemned. A summons was taken out against the owner, but as this was his second offence, he did not appear, and a warrant for his arrest was applied for and granted. In October, he gave himself up to the police and he was fined £12 and costs. 22 The Mortuary. The number of bodies depositied in the Mortuary during the year was 343. 278 were removed to the Mortuary by the Coroner's order, 40 by the Police, 16 by the Relieving Officers, 5 by the Medical Officer of Health, and 4 by the friends for the sake of convenience. Nine bodies were deposited in that part of the Mortuary set apart for infectious cases, 7 of the deaths were due to Diphtheria and 2 to Puerperal Fever. 318 Inquests were held and 30 post mortem examinations were made. The deaths of the above were due to the following causes: Alcoholism 4 Burns 4 Convulsions 50 Diarrhoea 4 Drowning 28 Heart Disease 56 Premature births 12 Still born 11 Suffocation while in bed with the parents 29 Strangulated Hernia 1 Suffocation due to vomiting 4 Suffocation due to a fit 1 Died under an anaesthetic 1 Bronchitis and Pneumonia 26 Cerebral Haemorrhage 21 Phthisis 14 Gastro Enteritis 3 Violence, Accidents, etc. 17 Peritonitis 2 Collapse of Lung 6 Rupture of Aneurism of Aorta 3 Bright's Disease 1 Hereditary Syphilis 1 Stricture of Oesophagus 1 Dropsy 1 Haemorrhage at birth 1 Inanition 5 Suffocation by Gas 2 Improper feeding 9 318 23 LIST OF ARTICLES DISINFECTED IN THE APPARATUS, From January 1st to December 31st, 1900. Articles. January. February. March. April. May. June. July. August. September. October. November. December. TOTAL. Beds 46 64 50 36 42 61 53 72 68 53 67 80 692 Sheets 55 57 67 48 51 251 68 75 92 150 110 103 1127 Blankets 52 43 45 65 58 235 57 68 53 95 146 96 1013 Bolsters 36 36 34 29 50 59 39 46 56 55 96 75 611 Pillows 100 82 78 88 87 186 48 49 86 96 185 103 1188 Quilts 51 33 36 49 43 144 37 37 46 56 87 79 698 Mattresses 64 47 44 51 74 114 66 63 56 67 200 190 1036 Sundries 119 206 174 167 95 1493 609 615 277 261 213 75 4304 Total 523 568 528 533 500 2543 977 1025 734 833 1104 801 10669 24 Incinerator. The following articles were destroyed in the Incinerator :— 171 Sacks of Paper. 1 Box of Mackerel. 13 Beds. 1 ,, Haddocks. 6 Quilts. 2 Cwt. of Meat. 4 Bolsters. 1 Box of Eels. 21 Sundries. 1 Van load of Potted 24 Mattresses. Meat. A large quantity of Clothing, etc., from Mortuary. The Shelter 12 families occupied the Shelter during the year whilst their homes were disinfected. These families consisted of 23 adults and 26 children. Sale of Food and Drugs Act. The total number of articles analysed during the year was 147. This number consisted of 86 Milks, 11 Butters, 2 Margarines, 6 Flours, 5 Mustards, 6 Peppers, 1 Whisky, 4 Coffees, 3 Oatmeals, 1 Cocoa, 1 Bread, and 1 Condensed Milk Of these, 67 Milks, 10 Butters, 3 Coffees, the Margarines, Flours, Mustards, Peppers, Oatmeals, Whisky, Cocoa, and Bread were genuine. I also analysed 8 Ales, 2 Bitter Ales, 7 Porters, and 3 sweets, but failed to detect any trace of Arsenic in any of them. Article. Extent of Adulteration. Results. Milk Contained at least 11 per cent. of added water, and 6 per cent. of cream abstracted Fined 40s. and 23s. costs. Milk Contained at least 9 per cent. of added water Fined 40s. and 23s. costs. Milk Contained at least 4 per cent. of added water Vendor cautioned. 25 Article. Extent of Adulteration. Results. Milk Contained at least 8 per cent. of added water Fined 1s. and 23s. costs. Milk Contained at least 3 per cent. of added water Vendor cautioned. Milk At least 10 per cent. of Cream abstracted Vendor cautioned. Milk Contained at least 13 per cent. of added water Fined £3 and 23s. costs. Milk At least 20 per cent. of cream abstracted Fined 40s. and 23s. costs. Butter Contained at least 84 per cent. of foreign fat Fined 40s. and 23s. costs. Milk At least 10 per cent. of cream abstracted Vendor cautioned. Milk At least 20 per cent. of cream abstracted Fined 40s. and 23s. costs. Milk Contained at least 8 per cent. of added water Fined 1s. Milk At least 6.5 per cent. of added water and 16 per cent. of cream abstracted Fined £5 and 23s. costs. Milk Contained at least 4 per cent. of added water Vendor cautioned. Coffee Contained 33 per cent. of Chicory Fined 40s. Condensed Milk Contained 1.1 per cent. of fat only. The sample was machine skimmed condensed milk, and ought to be labelled such according to the Act Fined 20s. Milk Contained 9 per cent. of added water Fined 20s. and 23s. costs. Milk Contained at least 4 per cent. of added water Vendor cautioned. Milk At least 6 per cent. of added water Vendor cautioned. Milk At least 10 per cent. of cream abstracted Vendor cautioned. Milk Contained at least 24 per cent. of added water Fined 5s. and 23s. costs. Milk Contained at least 4 per cent. of added water Vendor cautioned. 26 The total amount recovered in fines and costs was £33 17s. 0d- Adulteration was very much less than in previous years, both in the number of articles adulterated and in the degree of adulteration. The Inspectors have performed their duties to my satisfaction, and I have to express my thanks to them for the loyal manner in which they have assisted me in carrying out the duties of my office. I am looking forward with a great deal of pleasure and confidence to their support under the new Borough Council, and if the Inspectors from the other districts will give me similar assistance in the future, I am confident that the sanitary condition of the Borough of Stepney will improve from year to year. I have the honour to remain, Gentlemen, Your most obedient Servant, D. L. THOMAS, Medical Officer of Health and Public Analyst. Public Health Department, 43, White Horse Street. June 11th, 1901. 27 SPECIAL RETURNS required by the LOCAL GOVERNMENT BOARD. AREA OF DISTRICT 562 Acres. POPULATION in 1891 57,599 ,, Enumerated in 1896 58,305 ,, Estimated to middle of 1900 58,944 TABLE I —Table shewing the POPULATION, BIRTHS AND DEATHS for year 1900, and 10 years preceeding Year. Population estimated to middle of each Year. Births. Deaths under One Year of Age. Deaths at all ages. Total. Deaths in Public Institutions. Deaths of nonresidents registered in District. Deaths of Residents registered beyond District. Deaths at all ages Nett. Number. Rate.* Number. Rate per 1000 births registered. Number. Rate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1890 60000 1851 30.8 387 209 1498 24.9 289 233 344 1609 26.8 1891 57599 1998 34.6 349 174 1350 23.4 276 215 365 1500 26.0 1892 57599 1940 33.6 366 188 1365 23.7 275 224 327 1468 25.5 1893 57600 1954 33.9 394 201 1387 24.0 318 245 455 1597 27.7 1894 57600 1911 33.1 327 161 1188 20.6 325 262 470 1396 24.2 1895 57600 2050 35.3 456 222 1349 23.4 255 197 423 1515 27.3 1896 58300 2012 34.6 368 182 1216 20.8 262 210 379 1385 23.7 1897 58508 1997 34.1 386 193 1301 22.2 342 285 446 1462 25.1 1898 58728 1912 32.5 388 208 1262 21.4 355 273 401 1390 23.7 1899 58807 1933 32.8 418 216 1193 20.2 253 184 491 1500 25.5 Averages for years 1890.1899. 58234 1955 33.5 383 195 1310 22.4 295 232 410 1482 25.5 1900 58944 1839 31.1 428 233 1308 22.1 302 241 462 1529 25.9 * Rates calculated per 1,000 of estimated population. Note.—The deaths included in column 7 of this table are the whole of those registered during the year as having actually occurred within the district. The deaths included in column 12 are the number in column 7, corrected by the subtraction of the number in column 10 and the addition of the number in column 11. Bv the term "Non-residents" is meant persons brought into the district on account of illness, and dying there; and by the term "Residents" is meant persons who have been taken out of the district on account of illness, and have died elsewhere. Area of District (exclusive of area covered by water), 562 acres. Total population at all ages, 57,599. at Census of 1891. TABLE II. Names of Localities. LIMEHOUSE. RATCL1FF. SHADWELL and WAPPING. Year Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 Year. Population estimated to middle of each Year. Births Registered Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each Year. Births Registered. Deaths at all Ages. Deaths under 1 year. a. b. C. d. a. b. C. d. a. b. C. d. 1891 ... 1204 ... ... ... 464 ... ... ... 330 ... ... 1892 ... 1145 ... ... ... 468 ... ... ... 327 ... ... 1893 ... 1197 ... ... ... 446 ... ... ... 311 ... ... 1894 ... 1162 ... ... ... 434 ... ... ... 315 ... ... 1895 ... 1228 ... ... ... 502 ... ... ... 320 ... ... 1896 32717 1205 ... ... 14954 473 ... ... 10434 334 ... ... 1897 ... 1197 ... ... ... 471 ... ... ... 329 ... ... 1898 33243 1153 ... ... 14966 442 ... ... 10519 317 ... ... 1899 33390 1144 ... ... 11966 463 ... ... 10451 326 ... ... Averages of Years 1890 to 1899 1900 33444 1125 805 428 14932 401 886 109 10568 313 278 75 TABLE III. Cases of Infectious Disease notified during the year 1900. Notifiable Disease. Cases notified in whole District. Total cases notified in each Locality. Number of Cases removed to Hospital from each Locality. At all ages. At ages—Years. 1. 2. 3. 1. 2. 3. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Small Pox Cholera Diphtheria 169 4 84 68 9 4 87 43 39 68 30 35 Membranous Croup Erysipelas 103 5 4 12 15 63 4 46 30 27 13 8 8 Scarlet Fever 145 3 62 62 14 4 63 50 32 46 39 34 Typhus Fever Enteric Fever 67 5 25 16 21 39 17 11 26 15 10 Relapsing Fever Continued Fever Puerperal Fever 2 1 1 2 Plague Totals 486 12 155 167 55 93 4 237 140 109 153 92 87 TABLE IV.—Causes of, and Ages at, Death during the year 1900. CAUSES OF DEATH. DEATHS IN WHOLE DISTRICT AT SUBJOINED AGES. DEATHS IN LOCALITIES (AT ALL AGES). Deaths in Public Institutions. All ages. Under 1 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards 1. 2. 3. Small Pox ... ... ... ... ... ... ... ... ... ... ... Measles 75 29 45 1 ... ... ... 47 17 11 6 Scarlet Fever 11 1 7 3 ... ... ... 2 4 5 10 Whooping-cough 48 19 28 1 ... ... ... 28 12 8 6 Diphtheria and Membranous croup 19 2 10 7 ... ... ... 15 3 1 12 Croup 5 4 1 ... ... ... ... 3 2 ... ... Fever:—Typhus ... ... ... ... ... ... ... ... ... ... ... Enteric 7 ... ... 1 2 4 ... 4 3 ... 4 Other continued ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 35 ... ... ... 2 18 15 21 7 7 3 Cholera ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... Diarrhœa 57 40 13 1 ... 2 1 33 15 9 16 Enteritis 76 53 12 ... 1 7 3 48 16 12 12 Puerperal fever ... ... ... ... ... ... ... ... ... ... ... Erysipelas 11 3 ... ... ... 6 2 5 2 4 6 Other septic diseases 8 ... ... 1 2 4 1 4 3 1 5 Phthisis 141 ... ... 4 23 111 3 72 44 25 73 Other tubercular diseases 54 19 26 6 1 1 1 29 14 11 22 Cancer, malignant disease 44 ... ... ... 1 31 12 26 7 11 19 Bronchitis 101 13 11 2 ... 39 36 46 24 31 26 Pneumonia 162 37 50 6 5 56 8 98 42 22 45 Pleurisy 3 ... ... ... ... 3 ... 2 1 ... 1 Other diseases of Respiratory organs 14 3 4 1 1 4 1 7 4 3 2 Alcoholism, Cirrhosis of liver 24 ... ... ... ... 21 3 13 8 3 9 Venereal diseases ... ... ... ... ... ... ... ... ... ... ... Premature birth 53 53 ... ... ... ... ... 29 15 9 7 Diseases and accidents of parturition 6 2 ... ... ... 4 ... 3 2 1 2 Heart diseases 103 4 2 4 9 58 26 66 16 21 35 Accidents 56 10 5 2 4 25 10 28 16 12 32 Suicides 6 ... ... ... 2 2 2 5 ... 1 ... Wasting disease, e.g., Marasmus, debility, &c. 86 78 8 ... ... ... ... 57 13 16 7 Convulsive diseases, e.g., Convulsions, Hydrocephalus, &c. 66 52 11 3 ... ... ... 42 9 15 3 Acute rheumatism 2 ... ... ... ... 2 ... ... 2 ... 1 Old age 98 ... ... ... ... ... 98 48 34 16 72 All other causes 158 7 3 5 13 93 37 84 51 23 96 All causes 1529 429 236 48 66 491 259 865 386 278 532 43 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 duriug 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, or in course of preparation for sale. The cases of Infectious Disease have had our immediate attention, occasionally calling us out at night, and frequently on Sundays. It is with great pleasure we take this opportunity of congratulating you upon your appointment as Medical Officer of Health to the Metropolitan Borough of Stepney. Having worked under your guidance since 1897, we know by experience that under your supervision the Public Health Department is advised by a most reliable and efficient officer. Trusting you will long be spared to be the Head of the Public Health Department. We are, Yours obediently, JOHN WILLIAM JOHNSON, GEORGE OSBORNE PAVITT, EDWIN THOMAS CROOK. 44 INSPECTORS' REPORT OF THE SANITARY WORK, &c., Completed in the year ending December 31st, 1900. Sanitary Work, &c. No. 1 District. No. 2 District. No. 3 District. Total. Houses, premises, &c., inspected 1215 1214 1010 *3439 Orders issued for amendments 2141 2273 1545 5959 Houses cleansed and whitewashed 135 258 230 623 Rooms disinfected, stripped and cleansed 76 73 74 223 Drains repaired, cleansed and trapped 438 231 270 939 Drains new and reconstructed 98 126 104 328 Yards paved, and paving repaired 152 353 149 654 Water closets cleansed and repaired 242 293 210 745 Closets and urinals supplied with water 106 195 96 397 New closets supplied 12 38 7 57 Water supply laid on 74 65 40 179 Cisterns cleansed and covered, and defective water fittings 218 128 140 486 Waste and stack pipes disconnected from drains 59 40 24 123 Dust pails supplied 496 484 171 1151 Dust removal complaints attended to 19 16 15 50 Removal of accumulations, &c. 14 15 3 32 Dead bodies removed to mortuary 2 3 4 9 Canal boats inspected 38 ... ... 38 Flooring, stairs, window sashes, and eaves gutters provided, and roofs repaired 468 450 247 1165 Overcrowding abated 3 16 14 33 Notices to schools 99 110 80 289 Factory inspections 12 2 135 149 This does not include re-inspection to premises to ascertain works in progress; such, if added, would probably treble the number. 45 INSPECTORS' REPORT OF THE SANITARY WORK—(cont.) Sanitary Work, &c. No. 1 District. No. 2 District. No. 3 District. Total. Factory nuisances abated 12 1 12 25 Bakehouses inspected 40 28 26 94 Licensed slaughter-houses inspected 8 2 ... 10 Houses closed unfit for human habitation ... 3 ... 3 Houses demolished 11 ... ... 11 Notices given to London County Council of dangerous and dilapidated premises 6 26 17 49 Drain test used 824 765 402 1991 Improved ventilation in houses 69 25 27 121 Basements discontinued to be used as dwellings 1 ... 2 3 Drinking water supplies separate from W.C.'s 1 ... 4 5 Animals removed 1 13 3 17 Cesspools abolished ... ... 3 3 Free shelters inspected 10 11 9 30 New dung pits provided 9 4 ... 13 Water closets discharging into the river Thames ... 2 8 10 Notices to provide crossings, area gratings, fiaps and trap doors in footways 22 ... ... 22 Samples taken under Sale of Food and Drugs Acts 47 48 48 143 Dust-bins defective ... 9 ... 9 Licensed cow-sheds inspected 6 3 3 12 Smoke nuisances abated 4 6 12 22 Legal proceedings, i.e., summonses 7 41 7 55 We have also had destroyed as unfit for human food during the year the following articles, viz.:—1 van load of Potted Meat; 1 box of Mackerel; 1 box of Haddocks; 1 box of Eels; 2 cwt. of Meat; 68 tins of Pineapple; 176 bags of Garlic; 18 boxes of Oranges; 4 boxes of Herrings. JOHN WILLIAM JOHNSON. GEORGE OSBORNE PAVITT. EDWIN THOMAS CROOK. 46 TABLE VII. Showing the localities in which certain Diseases of a Zymotic character occurred during the year 1900. Locality. Diptheria. Membranous Croup. Erysipelas. Scarlatina. Enteric Fever. Puerperal Fever. Total No. Cases. Acland-street ... ... ... 1 ... ... 1 Albert-street ... ... 1 ... ... ... 1 Albert-square ... ... ... 1 ... ... 1 Ann-street 1 ... ... ... ... ... 1 Albion-terrace 1 ... ... ... ... ... 1 Aston-street 3 ... 1 1 1 ... 6 Anchor-street ... ... ... ... ... ... 1 Batson-street ... ... ... 1 ... ... 1 Barnes-street 1 ... ... 1 1 ... 3 Belgrave-street ... ... ... 4 ... ... 4 Beachcroft-buildings 1 ... ... ... ... ... 1 Ben Johnson-road 1 ... 1 ... 1 ... 3 Blount-street 1 ... ... 2 2 ... 5 Black Bull-court 1 ... ... ... ... ... 1 Bower-street 1 ... ... ... ... ... 1 Brenton-street 6 ... 1 3 ... ... 10 Bromley-street ... ... 5 3 ... ... 8 Broad-street l ... ... 1 ... ... 2 Brook-street l ... ... 7 1 ... 9 Burdett-road ... ... 1 ... 1 ... 2 Burgess-street ... ... ... 2 2 ... 4 Butcher-row ... ... 1 ... ... ... 1 Cable-street 2 ... ... 2 2 ... 6 Caroline-street 1 ... 3 2 ... ... 6 Carr-street 1 ... 1 1 ... ... 3 Cayley-street 1 ... ... 4 ... ... 5 Chaseley-street ... ... 1 ... ... ... 1 Chivers-court ... ... ... ... ... 1 1 Church-row ... ... 1 2 ... ... 3 Clemence-street 4 ... ... 3 ... ... 7 Commercial-road 5 ... 2 1 1 ... 9 Collingwood-street ... ... ... 1 ... ... 1 47 Table VII.—Continued. Locality Diphtheria. Membranous Croup. Erysipelas Scarlatina Enteric Fever Puerperal Fever. Total No. of Cases. Conder-street 1 ... 1 4 4 ... 10 Copenhagen-place 1 ... ... ... ... ... 1 Cosh's-buildings 3 ... 2 1 2 ... 8 Cross-street ... ... 1 ... ... ... 1 Church-court ... ... ... 1 ... ... 1 Dalgleish-street 3 ... 1 ... ... ... 4 Dakin-street 1 ... ... ... ... ... 1 Deven port-street 2 ... 1 1 ... ... 4 Devonshire-place ... ... ... ... 1 ... 1 Dellow Street-buildings 1 ... 2 2 ... ... 5 Dora-street 2 ... 1 1 ... ... 4 Dorset-street ... ... ... 1 ... ... 1 Dod-street 2 ... 1 ... ... ... 3 Dr. Barnardo's Home 1 ... ... ... ... ... 1 Drewton-street 1 ... ... 2 1 ... 4 Dupont-street ... ... 1 1 1 ... 3 Dundee-street 1 ... ... ... ... ... 1 Eastfield-street 3 ... 1 1 1 ... 6 East India Dock-road 2 ... ... ... ... ... 2 East London Hospital 1 ... 1 ... ... ... 2 Ebenezer-place 1 ... ... ... 1 ... 2 Elbow Lane-buildings ... ... 1 ... ... ... 1 Elsa-street 3 ... ... 2 1 ... 6 Endive-street 1 ... ... ... 1 ... 2 Farrance-street 3 ... ... ... ... ... 3 Gait-street 8 ... 2 ... ... ... 10 Gill-street 1 ... 3 2 1 1 8 Glasshouse Fields ... ... 1 1 ... ... 2 Glamis-road 2 ... 2 ... ... ... 4 George-street 1 ... 1 ... ... ... 2 Grenade-street ... ... 1 ... ... ... 1 Grocers-court ... ... 1 ... ... ... 1 48 Table VII.—Continued. Locality Diphtheria. Membranous Croup. Erysipelas. Scarlatina. Enteric Fever. Puerperal Fever. Total No. of Cases. Halley-street ... ... 1 1 ... ... 2 Hardinge-street 2 ... ... ... ... ... 2 Havering-street 1 ... 3 1 ... ... 5 High-street Shadwell 4 ... 3 2 1 ... 10 High-street Wapping 2 ... ... ... ... ... 2 Hope-place ... ... 1 ... ... ... 1 Island-row 1 ... ... ... ... ... 1 James-place ... ... 1 1 ... ... 2 Jamaica-passage ... ... ... ... 1 ... 1 Juniper-street 9 ... 1 10 2 ... 22 John's-gardens ... ... 1 ... ... ... 1 King David-lane 1 ... 1 ... ... ... 2 Kirks-place ... ... ... ... 1 ... 1 Lee-street 1 ... ... 1 ... ... 2 Limehouse Causeway 1 ... ... ... 1 ... 2 Little John-street ... ... ... ... 1 ... 1 Locksley-street 2 ... 1 1 1 ... 5 Lockside ... ... 1 ... ... ... 1 London-street 5 ... 2 2 1 ... 10 Love-court 2 ... ... ... ... ... 2 Love-lane ... ... 2 ... ... ... 2 Lowell-street ... ... ... ... 1 ... 1 Lydbrook-street 1 ... ... ... ... ... 1 Lufton-place ... ... 1 ... ... ... 1 Market-buildings 1 ... 1 ... ... ... 2 Mays Cottages 1 ... ... ... ... ... 1 Maroon-street 7 ... 5 1 1 ... 14 Medland-street 1 ... ... 3 4 ... 8 Mercer-street 1 ... 2 1 1 ... 5 Middle Shadwell 1 ... ... ... ... ... 1 Monza-street 1 ... ... ... ... ... 1 Monmouth-street 1 ... ... 1 ... ... 2 49 Table VII.—Continued. Localities Diphtheria. Membranous Croup. Erysipelas. Scarlatina. Enteric Fever. Puerperal Fever. Total No. of Cases. Narrow-street 1 ... ... 1 1 ... 3 New Gravel-lane ... ... 2 ... ... ... 2 Nesbitts-rents ... ... ... ... 4 ... 4 Newtons-rents 2 ... ... ... 1 ... 3 Northey-street 1 ... 3 1 ... ... 5 Oak-Lane 1 ... ... ... ... ... 1 Orchard, The ... ... ... 1 ... ... 1 Park-street ... ... ... ... 1 ... 1 Peabody-buildings 1 ... 1 6 1 ... 9 Pelling-street ... ... 1 ... ... ... 1 Pigott-street ... ... ... 2 ... ... 2 Pope's-hill ... ... ... 1 ... ... 1 Portland-street 1 ... ... ... ... ... 1 Prosperous-place ... ... 1 1 ... ... 2 Eatcliff Workhouse ... ... 2 8 1 ... 11 Red Lion-street 2 ... 1 ... 1 ... 4 Repton-street 2 ... ... ... 1 ... 3 Rhodeswell-road 4 ... 1 4 ... ... 9 Rich-street 2 ... ... 2 ... ... 4 Ronald-street 1 ... ... ... ... ... 1 Robert-street ... ... 1 ... ... ... 1 Raby-street ... ... l ... ... ... 1 Ropemakers'-fields ... ... l 1 3 ... 5 Rose-lane ... ... ... ... 1 ... 1 Ropner-place ... ... ... 1 ... ... 1 Sage-street 1 ... ... 2 ... ... 3 Salmon-lane 1 ... 1 7 ... ... 9 Sarah-street ... ... 1 ... ... ... 1 Selsey-street 1 ... ... 2 ... ... 3 South-street ... ... 2 ... 1 ... 3 50 Table VII.—Continued. Locality. Diphtheria. Membranous Croup. Erysipelas. Scarlatina. Enteric Fever. Puerperal Fever. Total No. of Cases. Spencer-street ... ... ... 1 ... ... 1 Spring-garden-place 1 ... ... ... ... ... 1 St. Paul's-road ... ... ... ... 1 ... l Stainsby-road 1 ... ... ... ... ... 1 Stepney-causeway 1 ... 1 2 2 ... 6 Stephen's-cottages ... ... ... 1 ... ... 1 Spring-gardens 1 ... ... ... ... ... 1 Stepney Causeway-court ... ... 1 ... ... ... 1 Tenbury-place ... ... ... ... 1 ... 1 Three-colt-strest ... ... 1 ... 1 ... 2 Thirza-street ... ... 1 1 ... ... 2 Thomas-street, Ratcliff 2 ... ... 1 ... ... 3 Tower-buildings, New ... ... ... 1 ... ... 1 Tomlin-terrace 2 ... ... ... ... ... 2 Turners-road 1 ... 2 1 ... ... 4 Twine-court 1 ... 1 2 l ... 5 Three-compass-court ... ... 1 ... ... ... 1 Upper East Smithfield ... ... ... 1 ... ... 1 Walker-street 1 ... ... 1 ... ... 2 Walter-street ... ... 1 1 ... ... 2 Wapping-wall ... ... 1 ... 1 ... 2 Wallwood-street ... ... ... ... 1 ... 1 West India Dock-road 1 ... ... ... ... ... 1 White-horse-street 4 ... 2 2 ... ... 8 Willow-row 1 ... 1 ... ... ... 2 Wright's-buildings ... ... ... 1 ... ... 1 York-place ... ... ... ... 1 ... 1 York-road 1 ... ... ... ... ... 1 York-square 3 ... ... 1 ... ... 4 York-street 1 ... ... 1 ... ... 2 5i 1900. BAKEHOUSES. LIMEHOUSE. NAMES. ADDRESSES. Mr. J, Rickert, 22, Gill-street. „ C. Baldwin, 821, Commercial-ioad. ,, J. Draude, 31, Repton-street. ,, M. Donaldson, 3, Repton-street. ,, Schwarz, (empty) 137, Eastfield-street. 21, Halley-street. ,, W. Living, 12, Parnham-street. ,, P. Fiehl, 45, Thomas-street. ,, H. Zimmerman, 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. ,, W. H. Pearce, 77, Three Colt-street. ,, T. Slawson, 87, Three Colt-street. ,, J. A. Siebert, 93, Three Colt-street. Mrs. Hannus, 78, West India Dock-road. Mr. Marks, 36, Three Colt-street. 5- Bakehouses—continued. RATCLIFF. NAMES. ADDRESSES. Mr. Prummer, 105, White Horse-street. ,, A. S. Harding, 42, White Horse-street. ,, Bader, 147, White Horse-street. Mrs. Lee, 631, Commercial-road Mr. Weimer, 119, Broad-street. ,, J. W. Newman, 27, Hardinge-street. ,, C. Siebert, 415, Cable-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. 1900. LICENSED COW HOUSES. LIMEHOUSE. Messrs. Abbott Bros., Batson-street. Mr. J. Harris. 15, Maroon-street. ,, J. Knight, 162, Rhodeswell-road. ,, David Thomas, 42 & 44,Ropemakers-fields 53 Licensed Cow Houses—continued. SLAUGHTER HOUSES. LIMEHOUSE. Mr. W. Knightbridge, 26, Three Colt-street. „ W. H. Phillips, 160, White Horse-street RATCLIFF. NAMES. ADDRESSES. Mr. Charles Warman, Railway Arch, Drewton-st ,, James Allcock, 63, Brook-street. ,, James Allcock, 12, Hilton-street. Messrs. J. & W. Morris, 37, White Horse-street. SHADWELL. Mr. Thomas Williams, Sage-street.