u. THE SANITARY CHRONICLES OF THE Parisb of St Darglebone BEING THE ANNUAL REPORT OF THE MEDICAL OFFICER OF HEALTH, FOR THE YEAR 1899. BY ALEXANDER WYNTER BLYTH, Medical Officer of Health, and Analyst of Food and Drugs for the Parish of St. Marylebone. Barrister-at-Law of Lincoln's Inn; Fellow of the Institute of Chemistry; &c., &c. VOL. XIX. XoitOon: Printed bt George Pulman k Sons, Ltd., 24-26, Thayer Stbeet, Manchester Square, W. PREFACE. The following lieport is a brief summary of disease, mortality, and sanitary administration in the Parish of St. Marylebone during 1899. The arrangement is the same as that of previous Annual Statements. The Court House, St. Marylebone, January 10th 1900. CONTENTS. page. Meteorological Summary . 7—9 Births and Deaths 9 Scarlet Fever 13 Diphtheria 13 Typhoid Fever 13 Tuberculosis 13—16 Prosecutions under the Public Health Act 16—17 Housing of Working Classes Acts 17 St. Marylebone Shelter . 18 Disinfection 18 Cleansing of Persons Act 19 Sanitary Legislation 20—23 The Laboratory; Sale of Food and Drugs Act 23 "Water Supply 24 Practical Sanitary Work 24—25 Clerical Work of Sanitary Department 25 Factory and Workshops Acts 26 Mortuary Keeper's Report 27 Appendix—Tables 28—33 Index to Monthly Reports 35 Index to Annual Report . 38 A REPORT of the METEOROLOGY, MORTALITY, AND SICKNESS of the PARISH OF ST. MARYLEBONE FOR. THE YEAE 1899, By A. Wyntek Blyth. METEOROLOGICAL SUMMARY. March Quarter. January was a wet month of moderate temperature and free from fog. There was but little sunshine; winds for the most part S.W. ; 4.52 inches of rain fell in 24 days. Minimum temperature, 29°.0 ; maximum, 55°.0 ; mean, 43°1. February was cool and foggy ; sunshine was deficient. There were six rainy days, giving a rainfall of 1.15 inch. Minimum temperature, 26°-0 ; maximum, 65°-0 ; mean, 41°.6. March was cold with a good deal of frost: on only one day rain fell (0.09 inch). The sky was generally overcast, and sunshine deficient. Minimum temperature, 21°-3 ; maximum, 6l°.0 ; mean, 40o,4. June Quarter. April was changeable, wet and cool. There were 17 rainy days giving a rainfall of 2.9(5 inches. Minimum temperature, 36°0 ; maximum, 60°,5 ; mean, 55°2 ; sunshine from 17 to 27 per cent. 8 May was a fairly bright moist month of moderate temperature. There were 12 rainy days, giving a rainfall of 0-76 inch. The sunshine varied from 19 to 32 per cent. Minimum temperature, 36° 0 ; maximum, 69o,0 ; mean, 53°3. June was a bright, dry, warm month ; rain fell on three days only (0.29 inch). The sunshine varied from 14 to 82 per cent. Minimum temperature, 37°.0 ; maximum, 83°.2 ; mean, 65°.5, September Quarter. July was a fine hot sunny month. There were seven rainy days, giving a rainfall of 2 inches. The sunshine varied from 29 to 41 per cent. Minimum temperature, 46°.5 ; maximum, 86°.2; mean, 68°.1. August was also a sunny, dry month. On only one day rain fell (0.04 inch). The sunshine varied from 38 to 64 per cent. Minimum temperature, 40o.5 ; maximum, 86°.8 ; mean, 710.9. September was wet and unsettled. There were 13 rainy days, giving a rainfall of l.8 inch. The sunshine varied from 20 to 37 per cent. Minimum temperature, 43° 0 ; maximum, 79°-2 ; mean, 62°.5 In the official report of the Registrar-General the following remarks occur :—" The weather from the beginning of the quarter until September 9th was generally fine, bright, and warm ; three remarkably hot periods occurred, extending from 6tli to 22nd July, from 29th July to 27th August, and from 3rd to 8th September respectively. From 10th September until the end of the quarter there was frequent rain, the amount at several stations being exceptionally heavy, but the temperature was above the average, except on 10th, 11th, 20th, 21st, and from 27th to 30th of the month The duration of bright sunshine was above the average during each month of the quarter, the excess amounting to 79.9 hours in July, 110.2 hours in August, and 40.5 hours in September." 9 December Quarter. October was a cool, damp month, with a few morning fogs. There were 13 rainy days, giving a total rainfall of 2.31 inches. Sunshine varied from 3 to 29.7 per cent. Minimum temperature 34°.0 ; maximum 66°.0 ; mean 49°.2. The first part of the month was wet, the latter part dry and foggy. There were 10 days of heavy rain, giving a rainfall of 4.53 inches. The sunshine attained a maximum of 21.6 per cent. Minimum temperature 33°.9; maximum 61°.0 ; mean 47°.1. December was cold, foggy, and almost sunless. There were nine rainy days, with some snow, giving a rainfall of 0.69 inch. Minimum temperature 22°.0 ; maximum 54°.0 ; mean 38°.9. BIRTHS AND DEATHS. The number of births registered during the 52 weeks ending December 23rd, 1899, when all essential corrections have been made, was 3,106. The number of deaths (corrected) of parishioners was 2,576. This gives a birth-rate of 22 0, a death-rate of 18"2 per thousand. The birth and death rates for 1899 of the • sub-districts were as follows : — All Souls, birth-rate 17 6; death rate 138. Rectory, birth-rate 21.4 ; death-rate 24.9. St. Mary, birth-rate 22.9 ; death-rate 20.5. Christ Church, birth-rate 23.5 : death-rate 18.7. St. John, birth-rate 25.2; death-rate 18.2. The following is a statement of the average birth and death rates of St. Marylebone, and its subdivisions, for five years, viz., from 1893 to 1898 :— All Souls, birth-rate 15.3 ; death-rate 10.4. Rectory, birth-rate 24.8 ; death-rate 23.8. St. Mary, birth-rate 23.5; death-rate 19.0. Christ Church birth-rate 26.2 ; death-rate 21.8. St. John, birth rate 26.2; death-rate 19.6. St. Marylebone, birth-rate 23.9 ; death-rate 20.1. 10 The following table gives the distribution of the deaths of parishioners dying in various extra-parochial institutions, all of which are included in the mortality statistics :— St. Marylebone Infirmary, Notting Hill 503 North-Western Fever Hospital 33 South-Western Fever Hospital 1 Western Fever Hospital 10 Eastern Fever Hospital 2 Northern Fever Hospital 2 Ship " Castalia" 1 St. Thomas's Hospital 2 University Hospital 16 London Fever Hospital 1 King's College Hospital 2 St. Mary's Hospital 52 St. Bartholomew's Hospital 3 Charing Cross Hospital 6 St. George's Hospital 6 North-West London Hospital 1 West London Hospital 2 Children's Hospital, Great Orinond Street. 6 Children's Hospital, Paddington 13 Cancer Hospital, Chelsea 1 Brompton Hospital 7 London Temperance Hospital 7 North London Consumption Hospital 2 Hanwell Asylum 32 Leavesden Asylum 23 Ilford Asylum 9 Dartford Asylum 1 St. Luke's Hospital 2 Bethnal House Asylum 1 Hoxton Asylum 1 Banstead Asylum 6 Bethlem Hospital 1 Colney Hatch Asylum 17 Cane Hill Asylum 4 City of London Asylum, Stone 1 St. Peter's Home 1 French Hospital 3 11 German Hospital 2 Cleveland Street Asylum 1 Central Sick Asylum 4 Heart Hospital, Soho 2 Friedeuheim . . 4 City Aims-Houses, Brixton 1 Aged Blind Home 1 St. Pelagia's Creche 1 St. Marylebone Workhouse, Gray's Inn Road 4 Holborn Workhouse 2 Paddington Workhouse 1 Paddington Infirmary 1 St. George's Infirmary . . 1 Islington Infirmary 1 Hackney Infirmary 1 Westminster Union Workhouse 3 St. Anne's House, Stoke Newington 1 St. Joseph's Home 1 St. Mark's Hospital 1 Royal Chest Hospital 1 Butchers' Aims-Houses, Fulham 1 Various other places 20 Total 836 12 The following table gives facilities for comparing the relative mortality from certain classes of disease and proportion to 1,000 deaths from all causes: TABLE I. SHOWING THE COMPARATIVE MORTALITY DURING THE FIFTY-TWO WEEKS ENDING DECEMBER 23rd, 1899, FROM CERTAIN CLASSES OF DISEASE AND PROPORTION TO 1,000 DEATHS FROM ALL CAUSES :- Total Deaths. 52 weeks ending Dec. 23rd, 1899. Proportion oftbedeaths to 1,000 deaths from all causes. 52 weeks ending Dec. 23,1899. Rate per 1,000 of the population. Mean rate per 1,000 population for corresponding period 1893-1898. 1. Deaths from the chief Zymotic Diseases 402 156 2.82 2.59 2. Pulmonary, other than Phthisis 517 201 3.63 4.25 3. Tubercular 307 119 2.16 2.08 4. Wasting Diseases of Infants . 108 42 0.76 1.14 5. Convulsive Diseases of Infants 103 40 0.75 0.83 NOTES. 1, includes Smallpox, Measles, Scarlet Fever, Diphtheria, Influenza, Whooping Cough, Erysipelas, Croup, Fever, and Diarrhoea. i 3, includes Phthisis, Scrofula, Rickets, and Tabes. 4, includes Marasmus, Atrophy, Debility, Want of Breast Milk, and Premature Births. 5, includes Hydrocephalus, Infantile Meningitis, Convulsions, and Teething. 13 SCARLET FEVER. Scarlet Fever, in its seasonal distribution, w,as somewhat peculiar. Up to the end of May the notifications were below the average, but they then rose above the average and reached a maximum in the fourth week of June. The cases then declined up to the first week of October; from October to the early part of December, Scarlet Fever was about the average, and at the latter end of December but little prevalent. The total number of cases notified was 385, and of these 24 died, giving a case mortality of 6 per cent. DIPHTHERIA. The curve opposite page 28 shows that Diphtheria pursued its usual course, and on the whole the number of cases was about the average. The notifications of Diphtheria amounted to 188, and the deaths were 29, this gives a case mortality of 15.4 per cent. The pressure on the accommodation at the Asylums Board was so great during the latter part of the year, that some delay was frequently experienced in getting suitable cases admitted. TYPHOID FEVER. Typhoid Fever was generally above the average, particularly during August, September, and up to the first week of November. In all 113 cases were notified, 23 of these cases died, giving a case mortality of a little over 20 per cent. In each case, as far as possible, the origin was traced. Only the minority belonged, properly speaking, to the district. In several cases there appeared to be good evidence that the infection was taken in with such foods as oysters, mussels, or other shell fish. TUBERCULOSIS. In the Annual Report for 1898, the writer stated that the average death-rate of Phthisis in this district, was a little over 2 per thousand. During the past year it was 2.08 per thousand. The actual number of deaths being 307. The rate is unequally distributed, being for 1899 as follows:—All Souls, 1.64; Rectory, 3.58; St. Mary, 2.90; Christ Church, 1.96 ; St. John, 1.65. 14 In other words, the sub-districts in which the different forms of Tubercle ere most rife or most fatal were the Rectory and St. Mary. There is no significance whatever to be ascribed to the high rate for the Rectory because it contains the Workhouse, and a good proportion of the deaths in the Workhouse cannot be assigned to the sub-districts to which they properly belong. In the early part of the year the writer was requested by the Sanitary Committee to make a report as to what steps, if any, could be taken by the Sanitary Authority to prevent the spread of Consumption. The report was published in the Monthly Report for February. The measures recommended were briefly as follows: — A system of voluntary notification. Hospital provision for cases urgently in need of isolation and medical attention, in one or more of the excellent public institutions already existing for the study and cure of Consumption, by means of an annual payment to such institutions. Free disinfection of rooms or matters presumed to be infected with tuberculous matters. The distribution of a leaflet containing simple directions relating to the malady. The establishment of a bacteriological laboratory at the Court House, for the purpose of examining, bacteriologically, such articles of food as milk, and also for general purposes. The Sanitary Committee reported in favour of all these proposals, but they did not come definitely before the Vestry until quite the end of the year. After a long discussion it was agreed to disinfect free of charge, to print a leaflet of instructions as to the prevention of Consumption, and to invite the medical practitioners to voluntarily notify. The subscriptions to Consumptive Hospitals, and the establishment of a bacteriological Laboratory were both negatived; nevertheless a large number of the Members of the Local Authority were evidently in favour of the whole scheme. 15 With regard to the leaflet of instructions, the writer proposes to adopt one which was drawn up by Dr. Niven, the Medical Officer of Health for Manchester, and which for several years has been distributed in that important city. It is as follows: — PRECAUTIONS AGAINST THE COMMUNICATION OF CONSUMPTION. 1. Consumption is an infectious disease, liable to be communicated more particularly in damp, badly ventilated, and badly lighted houses and workshops. 2. It is usually communicated by the matters coughed up by consumptive people, which get dried and dispersed as dust, thus reaching the lungs of those susceptible to the disease. 3. Such matters should, therefore, never be allowed to get dry. For that reason they should not be spat on the floors of a house, but either into pieces of rag or paper, which should be at once burned, or into a hand-vessel containing water. This vessel should be emptied into the drains outside the house once a day, and then scalded and re-charged with water. 4. Everyone affected with a chronic cough should take the same precautions as a consumptive person. 5. The same precautions should be observed in a workshop as at home. 6. Consumptive people should not spit into a pocket-handkerchief, as both the handkerchief and their clothes are thus made infectious. 7. No one should spit on the ground inside any building or in a public conveyance. 8. The bowel discharges of consumptive people should be disinfected by being passed into a 15 per cent, solution of carbolic acid, or simply into water, and the vessel, when emptied, should be at once scalded. Soiled clothing should be at once removed, disinfected, and afterwards boiled. 9. When it is settled that anyone is consumptive, the house should be thoroughly disinfected, and the patient should be thenceforward confined to certain parts of the house. On a request made in writing to the Sanitary Department, disinfection will be carried out by the Department free of charge. 16 10. The rooms occupied by a consumptive person should be kept well ventilated and well lighted. This will aid greatly in destroying the infection. 11. No one is more liable to inhale the dust from matters coughed up than the consumptive himself. The removal of infectious matter is, therefore, calculated to promote his recovery. Moreover, if these precautions are strictly carried out, he need not be a source of danger to anyone. 12. It is the duty of the attendant to see that the above precautions in regard to the phlegm and discharges are observed, and also to see that every obstacle to sufficient lighting and ventilation is removed. 13. In case of death, the house will be disinfected by the Sanitary Authority, if this is desired. A new tenant should not enter a house previously occupied by a consumptive person until such house has been thoroughly disinfected. 14. Amongst the agencies which act powerfully in causing Consumption are damp dwellings and workshops, overcrowding, defective ventilation, occupations which involve the inhaling of irritating dust, and alcoholic excess. These should be avoided. 15. The milk from consumptive cows is very dangerous, especially to children. All milk should be boiled before use. As many animals suffer from Consumption, all meat should be thoroughly cooked. A. WYNTER BLYTH, Medical Officer of Health. The Court House, S/. Marylebone, January, 1900. PROSECUTIONS UNDER THE PUBLIC HEALTH (LONDON) ACT. During the year there were some important prosecutions with regard to the emission of black smoke. The Great Central Railway Company were prosecuted for permitting black smoke to escape from their shaft in the Grove Road, and were fined £22 12s.; the Metropolitan Electric Supply Company were also prosecuted for a similar offence and 17 fined £10. In December the writer had again to call the attention of the Vestry to renewed offences, and the Vestry ordered proceedings; immediately such proceedings were ordered the two Companies abated the nuisance, and therefore no further legal action was taken. The removal of manure at regular intervals was enforced more strictly than in former years, and a number of summonses, all leading to convictions, were taken out against the occupiers of certain premises in York Terrace Mews, Spring Mews, John's Yard, and Brook's Yard. It is to be hoped that this action of the Vestry will have a good effect in causing strict observance of the law during 1900. Four persons were summoned and fined for removing hog-wash during prohibited hours. The owner of a rag shop was proceeded against for not carrying on his business in a proper maimer, but the Magistrate, after hearing much evidence for and against, dismissed the summons without costs. The owner of three kitchens in Hereford Street was summoned for allowing the said kitchens to be illegally occupied; the owner of 10, Linhope Street for overcrowding; the owner of 10, Henry Street for not complying with a drainage notice; the owner of 123, Princess Street for not abating certain nuisances; and the owner of some houses in Violet Hill for not providing a proper water supply. HOUSING OF THE WORKING CLASSES ACT. No. 48, Linhope Street, and No. 6, Harrow Street, were condemned under the Housing of the Working Classes Act, and closed under Magistrates' orders. A satisfactory arrangement was made between the London County Council and the Freeholder (Lord Portman), with regard to the clearing of the Nightingale Street area, and the construction thereon of Artisans' Dwellings. It is to be hoped that in the course of 1900 this very desirable improvement will be accomplished. 18 THE SHELTER. The St. Marylebone Shelter, established for the purpose of receiving for short periods families temporarily turned out of their homes during the operation of disinfection, has been used 11 times, and has afforded accommodation for 21 adults and 28 children, in all 49 persons. The following is the complete return: — No. of hours Date. in Disease. No. of Persons. Shelter. 2nd February 8 hours Scarlet Fever 2 adults and 2 children 20th March 8 hours Scarlatina 1 adult and 3 children 9th June 15 hours Diphtheria 2 adults and 3 children 4th and 5th 24 hours Scarlet Fever 2 adults and 4 October children xoth and nth 16 hours Scarlet Fever 2 adults and 1 October child 25th and 26th 16 hours Diphtheria 2 adults and 3 October children 1st November 16 hours Diphtheria 2 adults 3rd and 4th 28 hours Diphtheria 2 adults and 3 November children 7th and 8th 18 hours Diphtheria 2 adults and 2 November children 6th and 7th 36 hours Diphtheria 2 adults and 6 December children 6th and 7th 30 hours Diphtheria 2 adults and 1 child December DISINFECTION. The steam disinfector has been continuously at work during 1899, and has disinfected over 39,000 articles, as against 26,702 articles the previous year. The increase is mainly due to work connected with the Cleansing of Persons Act. Besides which the Vestry has been able to assist the neighbouring district of Hampstead during necessary repairs and alterations to the Hampstead apparatus. During 1900 the pressure on the steam disinfector will be relieved by a second apparatus, which is to be .reserved for the disinfection of the clothing of those using the Cleansing Baths. 19 The list of articles is as follows:— Beds 386 Mattresses 542 Bolsters 526 Pillows 1,380 Sheets 917 Blankets 2,315 Sundries 33,417 39483 The disinfecting vans have been used 580 times. The disinfection for Hampstead Vestry from July 24th to 1st November amounted to 261 bundles. CLEANSING OF PERSONS ACT. The facilities afforded by the Vestry, under the Cleansing of Persons Act, in the shape of free hot baths and simultaneous disinfection of the clothing, have been taken advantage of by about 3,000 males, the actual number of baths given being 4,341. The majority of the 3,000 had one bath only, but 28 per cent had at least two baths, and a few as many as fifteen baths. No rule has been laid down as to the number of baths in a given period an applicant is permitted to take. It is, indeed, obvious that one cleansing operation is quite temporary in its good effect, and that it is not wise or practicable to lay down any hard and fast rule. The applicants were, for the most part, extremely dirty, swarming with parasites, and a good percentage suffered from affections of the skin, produced and aggravated by the unfortunate conditions under which they exist. Nearly all give as addresses such places as the Salvation Army Shelter in Burne Street, and the various common lodging-houses in the Parish. The new building giving more bath accommodation and extending the privileges to women is now (January, 1000) complete, so that the benefits conferred by the Act will be available to a larger class of persons. 20 SANITARY LEGISLATION, 1899. Among the 51 General Statutes of 1899, there are several important sanitary measures, either directly or indirectly affecting the District of St. Marylebone, as follows:— Metropolis Water Act (62 and 63 Vict., ch. 7)—This is an Act enabling and requiring the Metropolitan Water Companies to supply each other with water in cases of emergency. It is to be put in force, when the emergency arises, by the Local Government Board. Infectious Disease (Notification) Extension Act (62 and 63 Vict., ch. 8).— This Act compels notification of certain infectious diseases in Districts which have not adopted the Notification Act. London Government Act, 1899 (62 and 63 Vict., ch. 74)—This, the most important Act respecting the Government of the Metropolis ever passed, altering areas, creating new bodies, and at once simplifying and adding new dignity to local administration, will cause the following minor changes in matters under sanitary control: It will be the duty of the St. Marylebone Council to enforce the bye-laws and regulations for the time being in force, with respect to dairies and milk, and with respect to slaughter houses, knackers' yards, and offensive businesses. Sect, 6 (4). The registration of Dairymen, hitherto a duty of the London County Council, will now be transfered to the Local Authorities. (Schedule 2, part 1.) Under Schedule 2, Part II. is given the power of adopting Part III. of the Housing of the Working Classes Act, 1890, that LSj of acquiring, building, or providing Lodging Houses for the Working Classes. Metropolis Management Acts (Amendment) ByeLaws Act (62 and 63 Vict., ch. 15)—This Act gives power to the 1, on don County Council to make bye-laws, compelling persons constructing new drains to deposit a plan with the Local Authority before commencing the work. 21 Seats for Shop Assistants Act (62 and 63 Vict., ch. 21)— This Act compels the provision of seats for female assistants in retail shops. The seats are to be in the proportion of not less than one seat to every three female attendants. The Act is put in force by the London County Council. Small Dwellings Acquisition Act (62 and 63 Vict. ch. 44)— An Act giving power to a Local Authority to advance money to residents in a house of moderate value, enabling the applicant to acquire the ownership of that house, provided that "any advance shall not exceed (a) Four-fifths of that, which, in the opinion of the Local Authority, is the market value of the ownership: or (b) Two hundred and forty pounds, or, in the case of a fee simple or leasehold of not less than ninety-nine years unexpired at the date of the purchase, three hundred pounds, and an advance shall not be made for the acquisition of the ownership, where, in the opinion of the Local Authority, the market value of the house exceeds four hundred pounds." The interest is to be low for it will not exceed 10s. above the rate at which the Local Authority can at the time borrow from the Public Works Loan Commission, the repayment is to be made within a time agreed upon, not to exceed thirty years. There are certain conditions of proprietorship to be observed, such as residence in the house, insurance against fire, and keeping it in good sanitary condition. The value of property, both freehold and long leasehold, in this District is so considerable, that it is doubtful whether the Act can be taken any advantage of. Sale of Food and Drugs Act, 1899 (62 and 63 Vict., ch. 51)— This Act considerably amends the Sale of Food and Drugs Acts. Margarine, margarine cheese, adulterated or impoverished butter, milk, or cream, condensed, separated, or skimmed milk, are not to be imported into the United Kingdom save they bear labels indicating what they are, or 22 how they have been treated; the importer being subject, on conviction, to a fine, for the first offence of £20 or less, for the second offence up to £50, and for subsequent offences up to £100. The Local Government Board or the Board of Agriculture may send an officer, under certain circumstances, to take samples of food and have them analysed by the local analyst, for which analysis the Local Authority will have to pay (Sect. 2). Local Authorities are bound to carry out the Sale of Food and Drugs Acts, if they do not do so, the Local Government Board or the Board of Agriculture have power to carry it out for them, and at the expense of the Local Authority (Sect. 3). The Board of Agriculture is to have power to fix standards for butter, milk, cream or cheese (Sect. 4). Margarine is not to be imported, manufactured or sold, the fat of which contains more than 10 per cent. of butter fat (Sect. 8). A person selling milk or cream in a public place must have his name and address conspicuously printed or painted on the vehicle or receptacle (Sect. 9). Tins or other receptacles containing condensed, separated, or skimmed milk, must be labelled "Machineskimmed Milk" or "Skimmed Milk," as the case may require (Sect. 11). The Act contains many other matters of detail, but the above are the more important Sections. So far as the Act goes it is a distinct advance in practical legislation. Two important legal decisions were given during the year, the one (Mary Vines v. the North London Collegiate School and Camden School for Girls), laying down that the right of entry, under the Public Health (London) Act, of a Sanitary Officer can only be exercised on reasonable grounds and when there is a definite reason to suspect a nuisance. Premises cannot be entered legally upon general grounds. Hence there can be no house to house inspection of an absolutely complete character; should any Local Authority desire to cause a house to house inspection of their district, only those premises registered as tenement dwellings, or those 23 where by the courtesy of the occupiers or owners the Inspector is permitted to enter, can be inspected. Since, however, it is rare that admission is refused, practically a fairly complete house to house inspection can be made under the existing law. The second case (Warwick v. Graham), settles the meaning of the words "Proper lodging and accommodation" in reference to compulsory removal to hospital of persons certified to be suffering from any of the notifiable diseases. The Court held that the words were clearly directed to the protection of persons from infection, and not only to the protection of the sick person himself. So that although the sick person may have excellent nursing and in every respect "proper lodging and accommodation" from the patient's point of view, yet, if the patient is liable to communicate and spread the malady, the Sanitary Authority may obtain a Magistrate's Order for his compulsory removal. THE LABORATORY. SALE OF FOOD AND DRUGS ACTS. During the year 1899 the large number of 506 samples were examined for adulteration (a full list is given in Table VI.). Of these only 20 were certified to be adulterated. The 20 comprised 5 samples of milk and 15 of butter. The 5 samples of milk were either watered milks or both watered and skimmed; one sample had, in addition, no less that 80 grains of borax to the pint. The vendors were prosecuted and fined. The 15 samples of butter were simply margarine sold as butter, and containing from 60 to 95 per cent. of fat other than that of butter fat. A sample of bottled gooseberries was found to be heavily coloured with a green aniline dye. The sample was submitted by a private purchaser. A very large number of canned fruits and bottled fruits were specially examined for preservatives, but none were detected. 24 WATER SUPPLY. Month by month the water supply of the Parish has been examined. In the early part of the year there were evidences of some local contamination of certain water supplies, and a correspondence took place between your officer and the Company. There is no evidence of contamination either of the Grand Junction or of the West Middlesex supply in the chief mains, but contamination of water does, as a fact, from time to time occur locally. The chief sources of such contamination are; the dead ends of mains; defects in service pipes and in-suction of foul matter from the soil or from leaky drains; foul cisterns. The method by which the Grand Junction Officers take a sample is to let so large a volume of water flow out of the pipe, previous to filling the bottle, that an ordinary consumer, if he followed the same practice, would be liable to be summoned for waste of water. The sample thus obtained represents fairly the composition of water in that particular main, but it does not represent the quality of the water that the consumer drinks. The consumer rarely lets water run from the tap more than a second or two before filling any receptacle. A Sanitary Authority is quite as much interested in the purity of the water actually consumed, than in what condition it may be in the mains. The writer believes that the duty of Water Companies is not only to filter efficiently the water and to keep the main service pure, but the Special Acts under which they possess large powers also places upon them various responsibilities far beyond the purity of the water in the mains, and makes them responsible for defective service pipes and defective fittings generally, affecting even locally the water supply. PRACTICAL SANITARY WORK, 1899. At page 33 will be found a summary of the work carried out by the Sanitary Inspectors. Complaints of insanitary condition varied in the previous years from 1,129 to 1,198. During 1899 complaints amounted to 1,158. The number of inspections of all 25 kinds during the year amounted to a little over 17,000, as compared, in round numbers, to 16,000 in 1898. The number of notices issued by the direct authority of the Vestry were 353, the majority of the insanitary conditions being at once remedied after a simple written communication; 1,137 of these written communications have been sent, relative to various nuisances. There has been no change in the male inspectorial staff, but a female inspector was appointed for a period of six months. The Vestry elected for this purpose Miss O'Kell. The duties Miss O'Kell has performed are those under the Sale of Food and Drugs Acts, the Factory Acts, the inspection of establishments or institutions inhabited by women and children, and various miscellaneous duties. She has proved to be zealous, painstaking, and efficient. The Sanitary Inspectors generally have attended to their duties with great assiduity. CLERICAL WORK OF THE SANITARY DEPARTMENT. The clerical work of the Sanitary Department continues to be somewhat heavy, and fully occupies the time of Mr. James Curtis, the Senior Clerk of the Department, and Mr. W. J. Howe. Mr. Howe was appointed in February, 1899, succeeding Mr. Carr. A great deal of the work performed by the Clerical staff scarcely admits of tabulation; that which it is possible to state numerically is appended below. The Clerical staff has worked with great assiduity, fidelity, and ability, during the year. REGISTER OF CLERICAL WORK, 1899. Number of Notifications of Infectious Diseases entered in Register, copied, and sent to Metropolitan Asylums Board and Schools, receipt acknowledged and filed 1,022 Number of Complaints of Nuisances received, entered in Nuisance Register and filed 1,134 Number of letters despatched from Department 1,981 Number of Vestry Orders issued 204 Number of Meetings of Sanitary and Sewers Committee prepared for, attended, and Minutes drafted and written 21 26 Number of Reports from Committee to Vestry prepared 17 Number of Meetings of Sub-Committees prepared for, attended, and Minutes drafted and written 10 Number of Workrooms registered under Factory and Workshops Acts, with particulars as to cubic capacity, ventilation, etc. 305 FACTORY AND WORKSHOPS ACTS. Since 1895 the details in relation to these Acts have been under the special superintendence of Mr. Phillips, and he has carried out his duties with zeal, ability, and discretion. During the latter part of the year he has been much assisted by Miss O'Kell. During 1899 considerable attention was given to the sections of the Factory Act of 1891 relating to out-workers. The number of outdoor workrooms registered in the Parish amounts to 116, representing 42 employers, mostly tailors and outfitters. There has also been much work in compiling the lists of out-workers who live out of the Parish, but work for employers in the Parish, the number of these out-workers is 311. The addresses of each of these out-workers have been sent to the Local Authorities of the districts in which they reside. Bakehouses also come under the Factory Acts. The effect of recent legislation appears to have diminished their number. The bakehouses on the register for 1899 number 93, while in 1898 they numbered 105. The following is a tabular statement of certain matters which admit of tabulation; much of the work relating to factories and workshops does not admit of this method of expression:— 1895 1896 1897 1898 1899 Measurement of cubic space, registering same, etc., and investigating ventilation 212 456 1460 362 305 Inspection of bakehouses 254 228 119 114 305 Smoke Inspections 23 26 18 391 435 27 REPORT OP MORTUARY KEEPER FOR THE YEAR, 1899. Number of bodies received from January 1st to December 31st. Males. Females. Males. Females. January 13 21 Brought up 125 121 July 19 23 February 24 25 August 26 16 March 19 29 September 17 23 April 24 14 October 31 17 May 17 12 November 14 16 June 28 20 December 41 35 125 121 Total 524 273 251 Number of Inquests from January 1st to December 31st. January 13 Brought up 112 July 17 February 20 August 12 March 18 September 14 April 21 October 20 May 15 November 14 June 25 December 37 112 Total 226 INFECTIOUS CASES RECEIVED. Diphtheria 9 Typhoid Fever 2 Total 11 28 TABLE II.— District Births and Deaths for the 52 weeks ending December 23rd, 1899. Population in 1891. Population in 1896. Births. Deaths. Males. Fmls. Males. Fmls. All Souls 37,713 36,595 237 308 258 248 Rectory 20,024 19,798 211 212 249 245 St. Mary 19,239 19,637 225 225 204 208 Christ Church 33,327 32,547 389 377 287 321 St. John 32,101 32,611 427 395 244 312 Total 142,404 141,188 1589 1517 1242 1334 Note— In the above the births and deaths have all been properly corrected, strangers have been eliminated, and extra-parochial deaths and others have been allotted to their proper sub-district. 1899. CURVE SHOWING THE NUMBER OF CASES NOTIFIED WEEK BY WEEK OF SCARLET FEVER, DIPHTHERIA, AND TYPHOID FEVER DURING 1899, AS COMPARED WITH A FIVE YEARS' AVERAGE. 29 TABLE III— TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, in the Sanitary District of ST. MARYLEBONE, during 1899; classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals Population at all Ages. (b) Census 1896 36,495 19,798 19,637 32,547 32,611 141,188 (c) Registered Births 645 423 450 766 822 3,106 (d) Aged under 5 or over 5. Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 upwards Under 5 5 upwards Under 5 5 upwards New Cases of Sickness in each Locality coming to the knowledge of the medical Officer of Health. 1. Smallpox .. 1 .. 1 .. .. .. .. .. .. .. 2 2. Scarlatina 18 92 20 49 10 34 26 51 32 53 106 279 3. Diphtheria 12 26 3 12 17 27 15 28 14 34 61 127 4. Membranous Croup .. .. .. .. 1 .. 2 .. .. .. 3 .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 39 .. 6 .. 17 .. 17 2 31 3 110 7. Continued .. 1 .. .. .. .. .. .. .. .. .. 1 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 2 .. .. .. .. .. 1 .. 3 .. 6 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas 4 29 .. 38 .. 27 5 61 1 30 10 185 Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospitals. 1. Smallpox .. 1 .. 1 .. .. .. .. .. .. .. 2 2. Scarlatina 12 76 14 38 7 30 22 41 21 45 76 230 3. Diphtheria 9 17 2 10 14 17 12 22 12 20 49 86 4. Membranous Croup .. .. .. .. .. .. 1 .. .. .. 1 .. Fevers. '5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 26 .. 8 .. 13 .. 10 2 14 3 71 7. Continued .. .. .. .. .. .. .. .. .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. .. .. .. .. .. .. .. .. .. .. .. 10. Cholera .. .. .. .. .. .. .. .. .. .. .. .. 11. Erysipelas .. 8 .. 23 .. 7 .. 26 .. 8 .. 72 30 TABLE IV.— Giving the Causes of Deaths during the 52 Weeks ending Dec. 23rd, 1899, at the Middlesex Hospital, Queen Charlotte's Lying-in Hospital, Samaritan Hospital, the Workhouse, and the Marylebone Infirmary, Notting Hill, W. Middlesex Hospital. Queen Charlotte's Hospital. Samaritan Hospital. Workhouse Notting Hill. Infirmary. Influenza ... ... ... ... ... Scarlet Fever ... ... ... ... ... Diphtheria 5 ... ... ... 1 Typhoid Fever 14 ... ... ... 2 Diarrhœa 6 2 ... ... 12 Erysipelas 1 ... ... ... 4 Pneumonia and Pleurisy 39 1 ... 1 18 Pyæmia 1 ... ... ... ... Syphilis 1 ... 1 ... 7 Cancer 122 ... 3 ... 34 Phthisis and Tuberculosis 33 ... ... 5 126 Rheumatism 1 ... ... ... 6 Apoplexy 7 ... ... 8 12 Paralysis ... ... ... ... 18 Bronchitis 14 ... ... 27 77 Asthma ... ... ... ... ... Peritonitis 6 1 ... ... 2 Disease of Brain ... ... ... 4 1 ,, Heart 28 2 ... 12 39 ,, Kidney 16 ... 1 ... 20 „ Liver 8 ... ... ... 8 ,, Uterus ... ... 4 ... ... „ Ovary 1 ... 10 ... ... Parturition ... 4 ... ... ... Diabetes ... ... ... ... ... Fractures and Injuries 31 ... ... 1 8 Old Age ... ... ... 3 17 Low Vitality, Infants 2 ... ... 3 3 Premature Birth ... 12 ... 1 1 Other causes 47 1 2 7 87 Total *382 †23 ‡21 72 503 * Of the 382 deaths in the Middlesex Hospital, 298 were those of non-parishioners. † Of the 23 deaths in Queen Charlotte's Hospital, 20 were those of non-parishioners. ‡ The 21 deaths in the Samaritan Hospital were those of non-parishioners. 31 TABLE V.— TABLE OF DEATHS in the Sanitary District of ST. MARYLEBONE during the 52 weeks ending December 23rd, 1899, classified according to Diseases, Ages, and Localities. (a) All Souls Rectory St. Mary Christ Church St. John Totals The subjoined numbers have been taken into account in judging of the records of mortality. Deaths occurring outside the district among persons belonging thereto. Deaths occurring with in the district among persons not belonging thereto. Mortality from all causes at subjoined ages. (b) At all ages 506 494 412 608 556 2576 836 489 (c) Under 1 year 102 65 80 148 135 530 42 31 (d) 1 and under 5 36 21 24 59 41 181 54 21 (e) 5 and under 15 9 13 10 13 19 64 35 15 (f) 15 and under 25 20 13 10 17 20 80 22 27 (g) 25 and under 65 219 206 174 242 211 1052 438 341 (h) 65 and up wards 120 176 114 129 130 669 245 54 (i) Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 5 upwards Under 5 | 5 upwards Under 5 5 upwards Under 5 5 upwards Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. 1. Smallpox .. .. .. 1 .. .. .. .. .. .. .. 1 .. 1 .. .. 2. Scarlatina 3 1 1 2 4 4 3 1 5 .. 16 8 9 4 .. .. 3. Diphtheria 3 1 1 1 1 9 3 4 6 18 11 8 11 5 .. 4. Membranous Croup .. .. .. .. 1 .. 1 .. .. .. 2 .. .. .. .. .. Fevers. 5. Typhus .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6. Enteric or Typhoid 1 6 .. 1 .. 4 .. 5 1 5 2 21 .. 12 .. 10 7. Continued .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. 8. Relapsing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 9. Puerperal .. 1 .. .. .. .. .. .. .. 1 .. 2 .. 1 .. .. 10. Cholera .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. 11. Erysipelas .. 1 .. 1 .. 1 .. .. .. 3 .. 6 1 3 .. .. 12. Measles 8 .. 5 .. 1 .. 2 .. .. .. 16 .. 4 .. 1 .. 13. Whooping Cough 8 .. 2 .. 3 .. 6 .. 8 2 27 2 .. .. 1 .. 14. Diarrhœa and Dysentery 37 6 12 4 22 2 13 6 44 4 158 22 8 7 5 1 15. Rheumatic Fever .. 4 .. 2 .. 1 .. 3 .. 1 .. 11 .. 3 .. .. 16. Ague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 17. Phthisis 3 53 4 63 1 52 7 53 2 48 17 269 3 160 3 24 18. Bronchitis, Pneumonia, & Pleurisy 21 88 16 87 16 50 41 91 34 71 131 387 8 110 9 41 19. Heart Disease .. 42 .. 54 2 46 .. 40 2 37 4 219 .. 54 1 33 20. Injuries 5 9 7 5 2 2 12 13 5 13 31 42 2 23 3 26 21. All other Diseases 49 157 38 186 51 145 80 186 71 188 289 862 53 361 24 302 Total 138 363 86 408 104 308 207 401 176 380 711 1865 96 740 52 437 32 TABLE VI.— Sale of Food and Drugs Act.— Total number of Samples analysed during the year ending December 31st, 1899. Genuine. Adulterated. Total. Dairy Produce: Milk 178 5 183 Butter 97 15 112 Condensed Milk 2 .. 2 Cheese 1 .. 1 Spirits: Brandy 13 .. 13 Gin 10 .. 10 Whisky 37 .. 37 Rum 9 .. 9 Beverages: Cocoa 2 .. 2 Coffee 13 .. 13 Tea 13 .. 13 Condiments: Mustard 15 .. 15 Pepper 6 .. 6 Vinegar 7 .. 7 Drugs: Potassium Iodide 4 .. 4 Morphine Hydrochlorate 3 .. 3 Quinine 2 .. 2 Aconite Preparations 3 .. 3 Miscellaneous: Custard Powder 1 .. 1 Bottled Fruits and Canned Goods 51 .. 51 Sugar 1 .. 1 Jam 5 .. 5 Carraway Seeds 1 .. 1 Olive Oil 2 .. 2 Lard 4 .. 4 Sweets 11 .. 11 Flour 1 .. 1 Lemon Squash 6 .. 6 Port Wine 7 .. 7 Ice Cream 1 .. 1 Total 506 20 526 33 REGISTER OF SANITARY WORK, Year ending 31st December, 1899. SANITARY DEPARTMENT. Mr. J. Hodges, No. 1 District. Mr. A. Perry, No. 2 District. Mr. T. Gorniot, No. 3 District. Mr. D. J. Andrews, No. 4 District. Mr. W. Yeo, No. 5 District. Mr. R. Phillips, Special Duties. Miss O'Kell, from September. Total. Number of Complaints received 133 125 313 255 252 52 28 1158 Inspections Of Dwelling Houses 351 274 332 393 327 533 57 2267 Kitchens (separately occupied) 71 ... 104 316 192 ... 381 1064 ,, Schools 2 23 8 1 ... ... 6 40 „ Houses registered under Public Health (London) Act, 1891 282 ... 232 241 322 ... ... 1077 „ Dairies and Cow-houses 24 12 4 3 3 ... ... 46 „ Bakehouses ... ... 2 1 ... 503 2 508 „ Slaughterhouses 24 15 5 11 8 ... ... 63 „ Miscellaneous Inspections 1826 2161 2218 1800 1743 1903 382 12033 Notices issued for Abatement of Nuisances, etc. 26 30 43 23 59 10 162 353 Letters written relating to Abatement of Nuisances 183 190 207 281 191 38 77 1167 Proceedings taken before Magistrates under Sanitary Acts 5 2 20 3 2 1 ... 33 Reports made to Medical Officer of Health 343 353 426 328 563 535 79 2627 Infectious Patients removed to Hospital 114 40 85 158 138 ... 22 557 Rooms Disinfected after Infectious Disease 156 136 163 192 268 ... 16 931 New Pipe Drains (feet) 12245 15496 13324 8614 15094 190 ... 64963 Houses where defects in Drainage have been detected and remedied 80 83 71 109 85 2 17 447 Unwholesome Food— Number of Seizures made 1 2 4 4 1 ... ... 12 Food Adulteration. Samples collected for Analysis 100 93 99 91 83 ... 29 495 Proceedings taken before Magistrates ... 1 2 ... 1 ... 1 5 Removal of Bodies to Mortuary 4 2 3 6 4 ... ... 19 35 INDEX TO MONTHLY REPORTS, 1899. A D page page Adams W., prosecution of, for milk adul- Deaths, Causes of— teration 37 January 12 All Souls, births and deaths— February 28 March 43 January Table IV. 11 March Quarter 44 February 27 April 56 March ,, V. 41 May 68 March Quarter ,, VII. 42 June 82 April ,, IV. 55 June Quarter 83 May ,, IV. 67 July 87 June ,, IV. 80 August 98 June Quarter ,, V. 80 September 104 July ,, IV. 86 September Quarter 105 August ,, VII. 101 October 120 September ,, VIII. 101 November 128 September Quarter ,, IX 102 October ,, IV. 119 Diarrhœa, Infantile 82-93 November ,, IV. 129 Diarrhœa and Milk 115 Diphtheria, deficient hospital accommodation for 114-126 Drainage, combined 23 B Dust Removal 36 Barnard, J., prosecution, for milk adulteration 77 E Barrett Street, Rag Shop in 114 Birth and Death Rate— Entry, powers of 4-8 January 2 February 17 March 35 April 50 A* May 60 June75 Female Inspector, Appointment of . 62-82 July 80 Fitz, J., prosecution of, for non-removal of manure90 of manure 83 September 90 October 113 November 124 Brooks' Yard, prosecution of occupiers, for non-removal of manure 83 Gooseberries artificially coloured . . .77 Grand Junction Water Coy., Water supply . 37 C Great Central Railway Coy., prosecution of, for smoke 76 Cleansing of Persons Act.62 Collins, prosecution of, for non-removal of manure 94 „ „ „ Hamilton, W., prosecution, for letting Christ Church, Births and Deaths— illegal kitchens 83 January Table IV. 11 „ February.... , IV 27 Harrow Street, No. 6, closing of, under March ,, V. 41 Housing of the Working Classes Act 83-93 March Quarter ,, VII. 42 Health of District during March Quarter 36 May ,, IV. 67 Henry Street, No. 10, prosecution of owner June ,, IV. 80 of, for disobedience of Vestry notice June Quarter... ,, V. 80 as drainage 125 July ,, IV. 86 Hereford Street, No. 10, prosecution of August ,, VII. 101 owner of, for letting illegal kitchens . 83 September ,, VIII. 101 September Quarter ,, IX. 108 Hill, John, prosecution of, for butter adul- October ,, IV. 119 teration 77 November ,,IV. 129 Hog Wash, removal of, in illegal hours . 82 36 INDEX TO THE MONTHLY RE PORTS— continued. PAGE PAGE Hospital, compulsory removal to 63-64 March Table III. 40 Hot Weather, effects of 82 Household Refuse 36 June ,, VI. 81 Housing of the Working Classes Act 83 September Quarter ,, III 118 October ,, III. 118 I November „ II. 127 Ines, Charles, prosecution of, for removing Nutford Place, illegal occupation of Hog Wash in prohibited hours 82 Kitchens 63 Infectious Disease, Notifications of,during— January 9 O February 25 March 39 O'Kell, Miss L. Marguerite, appointment of 82 April 53 Orchard Street, No. 29, prosecution of May 65 owner of 52 June 78 July 84 Oysters and Typhoid 94-95 August 98 September 99 P October 117 November 128 Pettitt,R., Prosecution of, for non-removal Influenza 17 of manure 82, 83, 94 Princess Street, No 123, prosecution of A owner, for disobedience of Vestry notice relative to nuisances . . . 125 Johns Yard, prosecution of occupiers, for Prosecutions under the Public Health non-removal of manure . . . 82-94 Act . . .52, 76, 82, 83, 93,94, 114, 125 Jones, James, prosecution of, for adulteration of butter 77 L Queen Charlotte's Hospital, Causes of Death in— January Table III. 10 Linhope Street, No. 10, prosecution of owner, February,, IH. 26 for overcrowding 93 March III. 40 Linhope Street, No. 48, Closing of, Under April III. 54 Housing of the Working Classes Act 83-93 May ,, III. 66 June IV. 81 MJuly III. 85 September Quarter ,, III. 118 October ,, III. 118 Manure, prosecutions relative to 76-82-83-94-125 November,, 11.127 Meteorology for— January 1 T> February 15 April 49 Rag Shop, prosecution of owner of . .114 May 59 Rectory, Causes of Death in— June 73 January . . . Table IV. 11 July 79 February . . . „ IV. 27 August 89 March.... ,, V. 41 September 90 March Quarter . ,, VII. 42 October Ill April.... ,. IV. 55 November 123 May.... IV. 67 Middlesex Hospital, causes of death in January Table III. 10 June Quarter ,, V. 80 February 26 July ,, VII. 101 March ,, III. 40 September ,, VIII. 101 April „ III. 54 September Quarter „ IX. 102 May ,, VI. 81 October IV. 119 June ,, VI. 85 NovemberIV-129 September Quarter . • III. 118 Richin, L., prosecution of, for removing October ,, III. 118 Hog Wash in prohibited hours . . 82 November ,, III. 127 Miller, C., prosecution of,for non-removal of S manure 83 Milk and diarrhœa 115 St. John, Births and Deaths in— N January Table IV. 11 N February ,,IV. 27 Notting Hill Infirmary, Causes of Death in— March „ V. 41 January Table III. 10 March Quarter ,, VII. 2 February ,, III. 26 April ,, IV. 55 37 INDEX TO THE MONTHLY 11EPORTS— continued. page page May Table IV. 67 June IV. 80 June Quarter ,, V. 80 Tuberculosis 17-23 July ,, IV. 86 Typhoid Fever 94-95 August ,, VII. 101 September ,, VIII. 101 Typhoid Fever, insufficient hospital September Quarter . „ IX. 102 accommodation 114-126 October „ IV. 119 November ,, IV. 129 St. Mary, Births and Deaths in— U January Table IV. 11 February ,, IV. 27 March ,, V. 41 Underground rooms, prosecutions of March Quarter „ VII. 42 owners for letting 63-83 April ,, IV. 55 May ,, IV. 67 June ,, IV. 80 June Quarter ,, V. 80 Y July ,, IV. 86 August ,, VII.101 Vines v. North London Collegiate September „ VIII. 101 school 4-8 September Quarter ,, IX. 102 October ,, IV. 119 Violet Hill, prosecution of owner for not November ,, IV. 129 providing certain houses with a St. Marylebone, Births and Deaths in— water supply 114 January Table IV. 11 February „ IV. 27 March „ V. 41 March Quarter ,, VII. 42 W April ,, IV. 55 May ,, IV. 67 Walker, William, prosecution of, for June ,, IV. 80 adulteration of milk 77 June Quarter. „ V. 80 july ,, IV. 86 Warwick v. Graham 64 August „ VII. 101 Water, Analysis of— September „ VIII. 101 January 13 September Quarter „ IX. 102 February 29-30 October IV. 119 March 46 November „ IV. 129 April 67 Sale of Food and Drugs Act— May 69 Work done under duringMarch Qr. X 36,45 June 85 June Quarter IX. 76,84 September 106 September Quarter „ II. 95,96 November 131 Winter season, effects of 4 Samaritan Hospital, Causes of Death m— January Table III. 10 Workhouse, Causes of Death in— February „ III. 54 January Table III. 10 March „ III. 40 February „ III. 54 April „ III. 54 March „ VI. 40 May ,, III. 66 April „ III. 54 June „ VI. 81 May „ III. 66 July ,, III. 85 June „ VI. 81 September Quarter ,, III. 97 July ,, III. 85 October ,, III. 118 September Quarter „ III. 97 November ,, III. 127 October ,, III. 118 November „ III. 127 Seymour Street, smell in 114 Shell Fish and Typhoid 94-95 Smallpox, case of 76 Y Smoke Prosecutions 76 Spring Mews, prosecution of owner of, York Terrace, D Mews, prosecutions of for non-removal of manure 76-83 | occupiers relative to manure 94-125 38 INDEX TO ANNUAL REPORT. A N page page All Souls, Birth and Death Rates 9 Nightingale Street Area 17 Notifications of Infectious Disease Table III., 29 B Notting Hill Infirmary, Causes of Death in, Table IV., 30 Bakehouses 26 Nuisances, Number of 24, 33 Birth and Deat h Rates 9 Births and Deaths Table II., 28 Butter Adulteration 23 o Overcrowding 17 C Outworkers 26 Canned Fruits 23 Christ Church, Birth and Death Rates of 9 Cleansing of Persons Act 19 P Clerical Work of Sanitary Department . 25 Prosecutions under the Public Health Act . 16 D Q Deaths, Causes of Table V., 81 Deaths in extra-Parochial Institutions 10-11 Queen charlotte's Hospital, Causes of Death Diphtheria 13 Disinfection 18 in, Table IV., 30 F R Factory and Workshops Acts 26 Rectory, Birth and Death Rates of 9 Female Sanitary Inspector, Appointment Register of Sanitary Work 33 of 25 G S Gooseberries, Coloured 23 St. John, Birth and Death Rates of 9 St. Mary, Birth and Death Rates of .9 St. Marylebone, Birth and Death Rates of . 9 W Sale of Food and Drugs Acts (Amendment) Act, 1899 21 Hampstead Vestry, Disinfection for . . 19 Sale of Food and Drugs Acts, Work under Hog-wash, Removal of . .17 2-3, Table VI. 32 Housing of the Working Classes Act . . 17 Samaritan Hospital, Causes of Death in, Howe, W. J., Appointment of 25 Table IV., 30 Sanitary Legislation during 1899 20 I Sanitary Work, Register of 33 Scarlet Fever 13 Infectious Disease (Notification) Extension Shelter for Housing Temporarily Families during Disinfection of their Rooms . 18 Small Dwellings' Acquisition Act 21 Smoke, Prosecutions as to 16 Kell, Miss O', Appointment of 25 T L Tuberculosis 13, 16 Typhoid Fever 13 London Government Act, 1899 20 M U Underground Rooms 17 Manure, Removal of 17 Meteorology— March Quarter 7 June 7 December 9 Vines v.. North London Collegiate School 22 Metropolis Management Acts (Amendment) Act 20 Metropolis Water Act 20 W Middlesex Hospital. Causes of Death in, Table IV., 30 Warwick v. Graham 23 Milk Adulteration 23 WaterSupply 24 Mortuary Keeper, Report of 27 Workhouse, Causes of Death in Table IV., 30