HAML 19 VESTRY OF THE HAMLET OF MILE END OLD TOWN. ANNUAL REPORT UPON THE PUBLIC HEALTH AND Sanitary Condition of the District, FOR THE YEAR 1897, BY THOMAS TAYLOR. Medical Officer of Health. LONDON: PRINTED BY W. J. HASTED & SON, 306, MILE END ROAD, E. 1898. The Annual Report of the MEDICAL OFFICER OF HEALTH. For the Year 1897. To the Chairman and Members of the Vestry of the Hamlet of Mile End Old Town. Gentlemen, Acting under the instructions of the Local Government Board, I now have the honour to submit my Eleventh Annual Report on the sanitary conditions of the Hamlet of Mile End Old Town, and also on the various works carried out under my direction during the year 1897. I venture to say that the general sanitary condition of the Hamlet at the present time is much more satisfactory than it has ever been during my experience. It will be seen by this report that a considerable amount of very useful and practical work has been accomplished, with, I am glad to say, a minimum amount of friction, owing to a great extent to the tact and discretion exercised by your officers. In those cases in which police-court proceedings have been taken to enforce the orders of the Vestry, every latitude was allowed before resorting to extreme measures, but when proceedings have been taken the magistrates have, in all cases, made the necessary orders. Vital Statistics. In spite of the fact that during the last 15 years comparatively few new buildings have been erected, the population of Mile End Old Town continues to steadily increase, as will be seen by the following figures 4 The Population, according to the Census was— In 1881 102,573 „ 1891 107,565 „ 1896 111,360 Estimating the present population on the same ratio of increase, the number of inhabitants in the middle of the year 1897, now under notice, was 111,883. This clearly indicates that many houses formerly occupied by only one family are now tenanted by a number of families, and it points to the conclusion that the increase is due to the migration of people of the poorer classes into the district, whilst those of the middle classes are moving into the suburbs. Births and Birth Rate. The number of births that have taken place during the year was 4,255, giving a birth-rate of 38^0 per 1,000. Deaths and Death Rate. The number of deaths that have occurred from all causes in Mile End Old Town during the past twelve months was 1,815. To this number should be added the deaths ol Mile End people which took place in hospitals, asylums, &c., outside the district, and deduction made for those belonging to other parishes who died in Mile End. Thus, the actual number of deaths during the period was 2,085. The population being as stated above 111,883, the death-rate for 1897 was 187 per 1,000, whilst that of the metropolis was 17.7 per 1,000 of an estimated population of 4,463,169, and that of the Eastern Districts, 21*9 per 1,000 of a population of 718,824. Taking into consideration the fact that the proportion of the poorer classes is much greater in this district than in most other metropolitan parishes, it will be seen that we compare very favourably with London as a whole. The rate also compares very well with that of the-other Eastern Districts, in fact, the death-rate for Mile End was the lowest of them, and has been for the last five vears, as the Table annexed indicates. v ' TABLE 1. STATISTICS AS REQUIRED BY THE LOCAL GOVERNMENT BOARD. TABLE OF DEATHS during the Year 1897, in the Sanitary District of Mile End Old Town, classified according to DISEASES, AGES and LOCALITIES. Names of Localites adopted for the purpose of these Statistics; public institutions being shown as separate localities. Mortality from all causes, at subjoined ages. (i) Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. At all ages. under 1 year 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upwards 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diptheria. Membranous Croup. fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhœa & Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) Mile End Old Town 1492 564 270 37 40 396 185 Under 5 5 23 4 2 1 54 49 69 2 152 3 1 469 834 5 upwds. 8 11 2 1 1 3 8 3 94 114 96 2 315 658 Mile End Infirmary 227 12 3 2 11 92 107 Under 5 1 6 3 5 15 5 upwds. I 1 2 30 35 38 105 212 City of London Union 40 2 2 1 2 9 24 Under 5 3 1 4 5 upwds. 5 3 4 24 36 South Grove Workhouse 39 9 30 Under 5 5 upwds. 5 7 5 22 39 Trinity Almshouses 4 4 Under 5 Moses' Almshouses 5 upwds. 4 4 Jews' Hospital 6 6 Under 5 5 upwds. 3 3 6 East End Mothers' Home 7 5 1 1 Under 5 5 5 5 upwds. 1 1 2 Totals 1815 583 275 40 54 507 356 Under 5 5 23 4 2 1 55 49 75 2 158 3 1 480 858 5 upwds. 8 12 3 1 1 3 10 3 134 159 147 2 474 957 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the district among persons belonging thereto. 375 60 74 36 21 151 33 Under 5 6 20 3 2 1 3 27 2 70 134 5 upwds. 1 5 8 1 1 24 15 35 3 148 241 Deaths occurring within the district among persons not belonging thereto. 105 9 2 1 3 19 71 Under 5 5 6 11 5 upwds. 1 11 11 13 58 94 TABLE 2. STATISTICS AS REQUIRED BY THE LOCAL GOVERNMENT BOARD. Table of Population, Births, and of new Cases of Infectious Sickness, coming to the knowledge of the Medical Officer of Health, during the year 1897, in the Hamlet of Mile End Old Town Sanitary District; classified according to DISEASES, AGES, and LOCALITIES. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. Population at all Ages. Registered Births. Aged under 5 or over 5 New Cases of Sickness in each Locality coming to the knowledge of the medical officer of health. Number of such cases removed from their homes in the several localities for treatment in isolation Hospital 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 Smallpox. Scarlatina. Diphtheria. Membranous Croup. fevers. Cholera. Erysipelas. Smallpox. Scarlatina. Diphtheria. Membranous Croup. fevers. Cholera. Erysipelas. Census 1891. Estimated to middle of 1896. Typhus. Enteric or Typhoid. Continued Relapsing Puerperal Typhus. Enteric or Typhoid. Continued Relapsing Puerperal (a) (b) (c) (d) (e) Mile End Old Town 111060 111883 4255 Under 5 254 115 11 4 8 86 45 1 1 5 upwds. 412 215 1 54 4 102 194 77 1 16 Mile End Infirmary Under 5 5 upwds. 10 3 10 10 London Hospital Under 5 51 32 2 3 38 23 2 5 upwds. 49 39 15 17 38 32 12 Children's Hospital, Shadwell Under 5 5 13 2 5 12 5 upwds. 9 7 4 3 5 4 St. Bartholomew's Hospital Under 5 5 upwds. 1 1 1 Eastern Hospital, Homerton Under 5 6 1 1 6 1 1 5 upwds. 6 6 6 6 North Western Hospital, Haverstock Hill Under 5 1 1 5 upwds Tower Hamlets Dispensary Under 5 3 1 2 5 upwds 2 1 2 South Grove Workhouse Under 5 5 upwds. 1 Totals Under 5 319 162 11 6 15 137 82 1 3 1 5 upwds. 489 267 1 74 7 131 254 120 1 32 TABLE 3. TABLE 3—continued. RETURNS OF MORTALITY IN THE HAMLET OF MILE END OLD TOWN FOR 1897. Including the Deaths occurring in the Workhouse Infirmary and excluding the Deaths in the Jewish Home, Stepney Green; Moses Alms Houses, Devonshire Street; Trinity Alms Houses; City of London Union; The East End Mothers Home; and South Grove Workhouse. Deaths of Parishioners of Mile End old Town which occurred in Public tutions outside the Hamlet, such as Hospitals, Asylums, &c. Total Deaths from all causes. DISEASES. AGES. AGES. AGES. 0 1 5 15 25 65 0 1 5 15 25 65 0 1 6 15 25 65 1 5 l5 25 65 90 1 5 15 25 65 90 1 5 15 25 65 90 Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlatina 1 4 ... ... ... ... ... 6 1 ... ... ... 1 10 1 ... ... ... Diphtheria 1 22 7 ... 1 ... 4 16 5 ... ... ... 5 38 12 ... 1 ... Membranous Croup ... 4 ... ... ... ... ... ... ... ... ... ... ... 4 ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric or Typhoid Fever ... 2 1 1 10 ... ... ... 1 2 5 ... ... 2 2 3 15 ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing do. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal do. ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... ... 3 ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 1 ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... 1 Measles 18 37 1 ... ... ... 1 2 1 ... ... ... 19 39 2 ... ... ... Whooping Cough 22 27 3 ... ... ... ... 2 ... ... ... ... 22 29 3 ... ... ... Diarrhœa and Dysentery 62 13 1 ... 5 3 1 ... ... ... 1 ... 63 13 1 ... 6 3 Rheumatic Fever ... ... ... 1 2 ... ... ... ... ... ... ... ... ... ... 1 2 ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... .... ... ... ... Phthisis 1 1 2 24 95 2 1 2 2 1 21 ... 2 3 4 25 116 2 Bronchitis, Pneumonia and Pleurisy 61 92 4 5 74 65 10 17 1 ... 11 3 71 109 5 5 85 68 Heart Disease 3 ... 2 5 83 44 ... ... 6 5 20 4 3 ... 8 10 103 48 Injuries 1 ... ... ... 1 1 ... 2 1 ... 2 ... 1 2 1 ... 3 1 All other Diseases 403 71 18 15 214 169 43 27 18 13 91 26 446 98 36 28 305 195 574 273 39 51 488 285 60 74 36 21 151 33 634 347 75 72 639 318 CHART SHEWING WEEK BY WEEK THE NUMBER OF CASES OF SCARLET FEVER. Notified by Medical Practitioners as having occurred in the CHART SHEWING WEEK BY WEEK THE NUMBER OF CASES OF DIPHTHERIA AND TYPHOID FEVER, Notified by Medical Practitioners as having occurred in the HAMLET OF MILE END OLD TOWN DURING THE YEAR 1897, Hasted & Son, 306, Mile Knd Road, E. 17 ZYMOTIC DISEASES. The principal zymotic diseases are small pox, scarlet fever, typhoid fever and diphtheria, and Table 4 is an analysis of these diseases, giving the number of cases of each since the passing of the Notification Act, with the mortality per 1,000 of the cases notified. Small Pox. Although we have had no cases of small pox in our district during the year, there have been 101 in London with a mortality of 16, the largest number, 32, occurring in Camberwell. In 16 other districts there were no cases. The much-vexed question of vaccination, in connection with this disease, is far from being settled, but I understand that a Bill to amend the law on this subject is about to be introduced into Parliament, with the view to determining the matter. At the present time there are many persons and parents of children who do not conform to the provisions of the present Act, particularly in this district. It is an interesting fact that Gloucester, at one time one of the towns most antagonistic to vaccination, since the epidemic of small pox in 1896, has become one of the best vaccinated towns in England. Scarlet Fever. There were 816 cases of this disease notified to me during the year, only 12 of which proved fatal. The death-rate was *oi per 1,000, and this is the lowest death-rate in respect to this disease that we have experienced since the Notification Act came into operation. The cases were scattered all over the district, and were, generally speaking, of a mild character, the very fact of the mildness of the disease helping its spread. In a number of cases we found parents careless in the manner of isolation and medical supervision. It is not uncommon for some, after ascertaining that the case is one of fever, to neglect to obtain further medical attendance; they then use their own discretion as to the time when the 18 children are allowed to mix with others, and this is one means of the disease spreading. In July, September, and October, the hospital accommodation of the Metropoliton Asylums Board was insufficient to take all the cases requiring removal, and a number of patients had to wait day after day without proper isolation at their homes. This has occurred on many previous occasions. I am aware that it is a difficult matter to prepare for prospective epidemics, but at the same time, as the deficiency in accommodation has occurred year after year, it is to be hoped that adequate measures will be taken in the near future to prevent a repetition of what has been felt by some to be a serious slur on the administration of the Board. Diphtheria. In spite of all the improvements that have been carried out in the way of sanitation in London, this disease continues to increase. In 1895 there were 11,426 cases, and in 1897 13,192 cases, but whilst the numbers have increased, the mortality has decreased. In 1895, for London, the case mortality was 20*0 per cent., and in 1897 this was reduced to 16*9 per cent. This has been largely due to more effective isolation and more skilful treatment. The antitoxin treatment is now largely adopted both by the medical men in the Isolation Hospitals and also in private practice, with the most beneficial results. In this district the number of cases notified during the past year was 445, as against 537 in the year 1896, whilst the case mortality per cent, has fallen from 14*5 in 1896, to 13*9 in 1897. There is no doubt that school attendance bears a singular relation to the spread of this disease, as it has been many times observed during the past few years that as soon as the school holidays begin, the disease declines until the schools resume work, when it again increases. In all the cases that were notified to us measures were taken to prevent any children in the infected premises attending school, until the patient had recovered, or had been removed to a hospital, and also in all cases where possible disinfection of the premises was carried out by the officers of the Vestry. In 19 all premises where the disease occurred, the drains were tested, for although it is impossible to say that the disease is caused by the inhalation of sewer gases, it is undoubtedly the lact that where drains are defective and sewer gases enter dwelling houses, the normal standard of the vitality of all individuals is much reduced, and so persons living under these conditions are more susceptible to this disease. In 327 instances the drains were tested, 92 of which were found to be defective. In these cases prompt measures were taken to have them remedied. In one case of diphtheria which occurred in a house in Oxford Street, Stepney, it was ascertained that the bedding used by the patient had been removed and pawned without first being disinfected; this matter was brought to the notice of the Vestry who directed a summons to be taken out against the offending person. Your officer attended at the police-court, and after proving the case the magistrate said this was a very serious offence, and the officers of the Vestry were quite right in bringing the matter before him; he would, however, take into consideration the fact of defendant being in custody for some days previously, and would bind defendant over in recognizances to come up for judgment when called upon. In another case of the disease, the patient, who was being treated at the London Hospital, wilfully walked through the streets to her home, without waiting for the ambulance, and although she had been warned of the consequences; the matter was brought to the notice of the Sanitary Committee who administered a caution. Typhoid or Enteric Fever. There has been no serious epidemic of this disease in this district during 1897, the number of cases being 82, and as will be seen from the chart they did not occur in any particular month of the year or in any particular part of the district. I regret to say that the case mortality per cent, was by far the largest of any year since 1890, it being 27.7, which clearly shows that the disease must have been of a severe type As with diphtheria the drains of infected premises were tested, and in 20 cases were found defective. TABLE 4. Table shewing the number of the principal infectious diseases notified since the passing of the Notification Act, 1889, together with the case mortality during the same period. No. notified. Case mortality per cent. No. notified. Case mortality per cent, No. notified. Case mortality per cent. No. notified. Case mortality per cent. No. notified. Case mortality per cent. No. no tified. Case mortality per cent. No. notified. Case mortality per cent. No. notified. Case mortality per cent.[//###] 1890. 1890. 1891. 1891. 1802. 1892. 1893. 1893. 1894. 1894. 1895. 1895. 1896. 1896. 1897. 1897. Small Pox — — 6 33.3 10 10.0 116 6.8 42 9.5 49 2.0 1 — — — Scarlet Fever 403 6.8 232 5.1 936 3.8 1,199 3.3 578 6.0 685 3.6 763 4.9 808 1.4 Diphtheria 138 31.9 103 31.3 256 32.0 356 22.4 325 23.6 502 20.7 537 14.5 441 13.9 Typhoid Fever 127 17.3 101 21.7 78 21.7 152 19.0 103 14.5 84 17.8 115 13.9 81 27.7 TABLE 5. Shewing the Death-rate per 1000 persons living, from the undermentioned causes in London, the Eastern Districts of London, and Mile End Old Town, 1893 to 1897. LONDON. EASTERN DISTRICTS. MILE END OLD TOWN. 1893. 1894. 1895. 1896. 1897. Average for the Five Years. 1893. 1894. 1895. 1896. 1897. Average for the Five Years. 1893. 1894. 1895. 1896. 1897. Average for the Five Yeais. Principal Zymotic Diseases 3.0 2.6 2.6 3.1 2.5 2.7 3.7 3.5 4.0 3.6 3.2 3.6 3.6 4.0 3.9 3.6 2.6 3.5 Small Pox .04 .02 .01 .002 ... .01 .06 .03 .01 ... .7 ... 0.7 .03 ... ... ... ... Measles .3 .7 .6 .8 .4 .5 .5 1.1 1.1 .9 .1 .8 .3 1.1 1.0 .7 .5 .7 Scarlet Fever .3 .2 .2 .2 .1 .2 .4 .2 .2 .2 .6 .2 .3 .3 .2 .3 .1 .2 Diphtheria .7 .6 .6 .5 .3 .5 .9 .8 .7 .6 .4 .7 .7 7 1.0 .8 .5 .7 Whooping Cough .5 .4 .3 .6 .4 .4 .9 .6 .4 .8 .9 .6 .7 .6 .4 .7 .4 .5 Typhoid Fever .1 .1 .1 .1 .1 .1 .2 .1 .1 .1 .1 .1 .2 .1 .1 .1 .1 .1 Diarrhoea .7 .4 .8 .7 .9 .7 1.1 .5 1.0 .9 1.5 1.0 1.1 .6 1.0 .8 .7 .8 Deaths from all causes 20.8 17.4 19.4 18.2 17.7 18.5 25.8 21.8 24.3 21. 7 21.9 23.1 22.8 21. 1 22.5 19.9 18.7 21.0 Deaths under one year to 1000 Births registered 164 142 165 160 158 157 181 161 180 164 173 171 150 155 165 157 149 155 TABLE 6. Table shewing Deaths from all causes, and also from the principal Zymotic Diseases, in the various Metropolitan Districts as well as Mile End Old Town, during the year 1897. Name of District. Deaths from all causes. Small-pox. Measles. Scarlet Fever. Diphtheria. * Whooping Cough. Typhus Fever. Enteric Fever. Other continued Fevers. Diarrhoea. Annual Rate per 1,000 living. Death rate per 1000 living. Registration London 78972 16 1927 779 2240 1837 ... 557 8 4089 3.57 17.7 Paddington 1814 ... 2 21 64 44 ... 9 1 102 1.94 14.4 Kensington 2677 ... 32 30 81 19 ... 21 1 120 1.78 15.7 Hammersmith 1760 ... 6 11 30 28 ... 8 1 128 1.99 16.7 Fulham 2034 ... 51 26 63 61 ... 12 1 148 3.04 17.0 Chelsea 1713 ... 18 17 54 41 ... 14 ... 100 2.55 17.8 St. George, Hanover Sq. 1059 ... 17 7 16 13 ... 10 ... 25 1.09 13.2 Westminster 1004 ... 26 13 24 16 ... 6 ... 47 2.49 18.9 St. James, Westminster 393 ... 13 8 3 6 ... 3 ... 9 1.87 17.5 Marylebone 2672 ... 9 9 46 41 ... 14 ... 108 1.61 18.3 Hampstead 911 ... 9 6 17 25 ... 5 ... 28 1.16 11.8 St. Pancias 4518 1 87 24 114 124 ... 38 ... 209 2.47 18.7 Islington 5387 1 99 61 129 134 ... 45 1 184 1.91 15.8 Stoke Newington 488 ... 7 2 19 15 ... 10 ... 19 21.2 14.3 Hackney 3573 ... 127 37 134 97 ... 35 1 196 2.90 16.5 St. Giles, Bloomsbury 697 ... 9 7 7 18 ... 6 ... 14 1.63 18.5 St. Martin-in-the-Fields 206 1 1 2 3 6 ... 1 ... 2 1. 9 16.3 Strand 500 2 10 3 6 6 ... 4 ... 18 2.06 21.3 Holborn 703 ... 6 4 16 19 ... 5 ... 35 2.79 23.1 Clerkenwell 1459 1 49 14 48 49 ... 11 ... 66 3.61 22.1 St. Luke, Middlesex 1056 ... 40 13 21 28 ... 4 ... 51 3.82 25.7 City of London 642 1 7 8 10 10 ... 9 ... 5 1.66 21.3 Shored itch 2628 1 116 30 78 63 ... 20 ... 189 4.07 21.6 Bethnal Green 2761 ... 114 25 84 57 ... 17 1 140 3.41 21.4 Whitechapel 1623 ... 45 15 34 16 ... 8 1 53 2.16 20.4 St. George in-the-East 1262 ... 68 14 28 24 ... 10 ... 60 4.27 26.4 Limehouse 1462 ... 63 12 29 37 ... 4 ... 61 3.54 25.1 Mile End Old Town 2085 ... 60 12 56 54 ... 22 ... 86 2.70 18.7 Poplar 3353 ... 83 28 120 83 ... 30 ... 175 3.06 19.8 St. Saviour, Southwark 611 ... 32 7 12 12 ... 2 ... 26 3.66 24.6 St. George, Southwark 1426 1 67 14 28 32 ... 10 ... 109 4.35 23.7 Newington 2588 ... 85 33 65 82 ... 9 ... 165 3.59 21.2 St. Olave, Soutlwark 253 ... 6 2 2 8 ... 1 ... 15 2.96 22.1 Bermondsey 1883 ... 76 34 62 62 ... 13 ... 124 4.35 22.1 Rotherhithe 766 ... 21 22 21 17 ... 2 ... 49 3.26 18.9 Lambeth 5247 ... 140 42 144 144 ... 26 1 295 2.65 17.5 Battersea 2734 ... 79 47 106 79 ... 19 1 140 2.79 16.2 Wanda worth 2606 ... 27 29 111 42 ... 16 ... 144 1.91 13.4 Camber well 4276 6 141 32 170 111 ... 31 ... 260 2.91 16.6 Greenwich 3068 2 35 32 70 57 ... 29 1 180 2.27 17.2 Lewisham (exclu.Penge) 1099 ... 17 9 36 19 ... 7 ... 59 1.71 12.8 Woolwich 732 ... 2 8 33 8 ... 4 1 50 2.54 17.7 Lee 516 ... 6 3 17 5 ... 3 ... 22 1.43 13.2 Plumstead 837 ... 3 6 24 22 ... 3 ... 61 1.97 13.7 *Including deaths from membranous croup. TABLE 6—continued. Cases of Infectious Disease notified, to the several Metropolitan Medical Officers of Health, under the provisions of the Public Health (London) Act, 1891, in the Fifty-two weeks ending 30th December, 1897. Name of District. Small-pox. Scarlet Fever. Diphtheria. * Typhus Fever. Enteric Fever. Other Continued Fevers. Puerperal Fever. Erysipelas. Cholera. Totals. Estimated Population in the middle of 1896. Registration London 104 22850 13192 4 3106 65 264 5796 38 45419 4463169 Paddington 1 489 324 ... 46 ... 8 136 1 1005 126161 Kensington ... 747 332 ... 116 5 16 237 1 1454 171427 Hammersmith ... 396 154 ... 45 4 8 92 1 700 105959 Fulbam ... 759 388 ... 53 5 14 134 1 1354 120040 Chelsea ... 488 312 ... 52 1 4 98 ... 955 96692 St. George, Hanover Sq. 1 177 120 ... 39 2 1 51 ... 391 80330 Westminster ... 181 111 ... 28 1 4 66 1 392 53027 St. James, Westminster 3 131 50 ... 13 2 I 24 ... 224 22576 St. Marylebone 4 307 221 ... 88 1 5 254 2 972 140808 Hampstead ... 224 107 ... 32 2 2 40 ... 407 77275 St. Pancras 3 942 542 ... 223 8 15 388 3 2124 242205 Islington 3 1577 733 ... 259 1 27 313 1 2914 341134 Stoke Newington 2 108 54 ... 37 1 3 23 ... 228 34136 Hackney 3 1373 780 ... 209 5 11 273 ... 2654 216698 St. Giles, Bloomsbury 3 209 56 ... 33 ... 2 94 ... 397 37840 St. Martin-in-the-Fields 1 44 14 ... 5 ... ... 17 ... 81 12711 Strand 6 126 41 ... 20 ... ... 18 ... 213 23552 Holborn ... 119 161 ... 25 ... ... 46 ... 351 30493 Clerkenwell ... 366 349 ... 63 ... 2 99 ... 879 66162 St. Luke, Middlesex ... 238 186 ... 41 ... 2 85 ... 552 41279 City of London 2 95 68 ... 23 ... 2 26 2 213 30228 Shoreditch 1 625 371 ... 107 2 2 226 1 1335 121883 Bethnal Green 2 723 549 1 106 ... 7 383 1 1772 129098 Whitechapel ... 500 301 1 55 ... 4 119 ... 980 79724 St. George-in-the-East 1 242 191 ... 43 1 3 85 ... 566 47917 Limehouse ... 427 193 ... 52 ... 4 87 ... 763 58508 Mile End Old Town ... 808 441 ... 82 ... 7 146 ... 1484 111883 Poplar 9 1041 704 ... 195 3 12 261 1 2226 169811 St. Saviour, South wark ... 131 104 ... 16 ... ... 28 ... 279 24919 St. George-the-Martyr 1 381 191 ... 40 1 1 88 ... 703 60388 Newington ... 769 331 ... 79 ... 16 159 ... 1354 122191 St. Olave, South wark 1 88 29 ... 10 ... 1 10 ... 139 11480 Bermondsey 1 507 278 ... 62 ... 1 94 ... 943 85629 Rotherhithe ... 288 86 ... 24 ... 4 73 ... 475 40643 Lambeth 2 1388 741 ... 184 10 27 322 17 2691 300048 Battersea 5 1585 621 ... 93 ... 7 211 1 2624 168877 Wandsworth 1 1024 573 ... 98 6 9 239 ... 1950 195612 Camberwell 32 1191 1170 ... 150 1 14 297 ... 2855 257575 Greenwich 1 818 600 ... 144 2 10 239 ... 1814 178367 Lewisham (exelu. Penge) ... 298 219 ... 46 ... 2 81 ... 646 86152 Woolwich 2 224 148 ... 18 1 2 36 ... 431 41409 Lee 1 210 110 ... 17 ... 1 51 ... 390 39215 Plumstead ... 373 135 ... 25 ... 3 46 4 586 61057 Port of London 10 15 4 1 9 ... ... 2 ... 41 ... * Including membranous croup of which there were 11 in Mile End. 24 Disinfection. Disinfection after infectious disease is a matter of great public importance, and during the last few years many new disinfectants have been introduced. It has been usual in the past to fumigate the infected rooms by vaporizing sulphur, but recent experiments have shown that this is not the best method; in fact, some bacteriologists have gone so far as to affirm that it is useless. During the Sanitary Congress held at York in September last, it was shown that a substance called Formalin is more efficacious. It has been proved that Formalin will destroy the most potent germs of disease without damaging the contents of the rooms. Before adopting this in our district, I think it will be well to wait until further experiments, which are now being made, have been completed. The disinfection of the clothing of patients after infectious disease requires most careful attention, and there is no question that steam under proper conditions is the best germ destroyer known for this purpose, although it cannot be used in the homes of the patients. In a district like Mile End where but few can afford to burn infected clothing, let alone mattresses and bedding, it is essential that we should possess the best apparatus obtainable for ridding these articles of the germs of disease. This matter has been brought to the notice of the Vestry by me in previous reports, but I regret to record the fact that we have as yet no efficient apparatus for this work. Partly from apathy and partly from economy the matter has not received the attention which it undoubtedly should. The present Sanitary Committee, however, after making careful investigation by visiting and inspecting the systems adopted in various other districts of London, have realized the necessity of providing proper apparatus, and contemplate bringing the matter before the Board with a view of improving the arrangements which they are of opinion are far from suitable for our present requirements. 25 Sanitary Work carried out during the Year. From the accompanying Table it will be gathered that a vast amount of very important work has been carried out by the officers of my department, work that has been thoroughly done and that will have a lasting effect. The house-to-house inspection has been steadily progressing, and a large number of streets have been inspected and reinspected during the year. In 1095 instances the drains have been tested, and where they have been found to be defective care has been taken to have them properly remedied. It is this part of the work which occupies a considerable portion of the inspectors' time, and I venture to say that it is time well spent, for the well-being of people so greatly depends on the efficient drainage of dwelling houses. What is more injurious to health than the escape of noxious sewer gas? It is to prevent this that strenuous efforts have been made to systematically overhaul the drainage of houses in the Hamlet. This work will take a considerable time to accomplish, but that is our fixed purpose. I feel sure that the importance of it will be appreciated by the Vestiy, and we trust that we have their hearty support and approval in this matter. The investigation of complaints of any infringements of the Public Health Acts, which are made from time to time by inhabitants and various bodies, have been carefully enquired into. The number of those made by individual inhabitants was 255, while 44 have been made by London County Council, 63 by the Mansion House Council, 16 by the Jewish Board of Guardians, 39 by the East London Water Company, and 27 by the Factory Inspector re Workshops. A large percentage of these were of a trivial character, whilst others necessitated the serving of notices to remedy the complaints in which instances re-inspections had to be made. The workshops have been kept under constant supervision; the cowhouses and slaughterhouses have been regularly visited; the bakehouses have periodically been inspected, and a great deal of other important work has been done in this department, as will be seen in detail in the annexed Summary. TABLE 7. SUMMARY OF WORKS CARRIED OUT DURING THE YEAR BY THE SANITARY INSPECTORS IN THEIR RESPECTIVE DISTRICTS. No. 1 District. North Ward, North East Ward, South East Ward, c. COX. No. 2 District. North West Ward and East and West Centre Wards. F. H. LYON. No. 3 District. The whole of the South and West Wards. J. TWAITS. totals. Houses and premises inspected 1798 1037 1856 4691 „ ,, reinspected 2905 1481 2918 7304 „ „ cleansed 37 43 58 138 Bakehouses inspected and reinspected 23 40 30 93 Bakehouses cleansed 3 2 4 9 Workshops inspected and reinspected 65 39 351 455 Workshops ventilated 5 0 5 5 „ cleansed 4 2 17 23 „ overcrowding in, abated 3 0 2 5 Workshops, additional W.C.'s provided to, for use of workpeople 6 2 10 18 Intimations of Nuisances served under Public Health Act 597 210 699 1506 Statutory notices served re Sanitary amendments 152 76 267 495 Notices re infectious diseases 381 304 392 1077 Drains tested 374 245 476 1095 „ found defective 173 86 134 393 „ reconstructed 89 103 231 423 „ cleansed and repaired 120 44 91 255 „ trapped (new stoneware gullies) 130 147 229 506 Drains provided to areas 53 19 98 170 „ „ stables and stable yards 2 2 7 11 Sanitary closets provided in accordance with London County Council Bye Laws 248 170 358 776 W.C.'s provided with water and water supplies to closets reinstated 2 74 35 111 W.C.'s ventilated and lighted 2 23 12 37 „ new provided 2 4 8 14 „ water supply disconnected from domestic cistern 17 3 0 20 W.C.'s removed from unsuitable positions 0 0 3 3 TABLE 7—continued. SUMMARY OF WORKS CARRIED OUT DURING THE YEAR BY THE SANITARY INSPECTORS IN THEIR RESPECTIVE DISTRICTS, No. 1 District. North Ward, North East Ward, South East Ward. C. COX. No. 2 District. North West Ward and East and West Centre Wards. F. H. LYON. No. 3 District. The whole of the South and West Wards. J. TWAITS. TOTALS. New soil pipes fixed and ventilated 0 1 2 3 Cisterns cleansed 1 1 O 2 Yards paved 164 91 165 420 Washhouses paved 14 9 22 45 Areas paved 1 5 93 99 Forecourts paved 26 1 22 49 Stables and stable yards paved 2 2 1 5 Bakehouses, floors concreted, etc. 2 0 0 2 Sanitary dust receptacles provided 68 44 164 276 Manure receptacles provided in accordance with London County Council Bye Laws 1 1 2 4 Sink waste pipes disconnected from direct connection with drains 33 33 36 102 Rain water pipes disconnected from direct connection with drains 22 53 27 102 Houses ventilated under floors 11 12 74 97 Separate occupation of underground rooms discontinued 0 0 1 1 Overcrowding in dwellings abated 0 0 4 4 Offensive accumulations removed 3 8 4 15 Miscellaneous repairs, floors, roofs, gutters, &c. 61 47 63 171 Removal of animals improperly kept 0 1 0 1 Cowhouses and slaughterhouses inspected 7 7 15 29 Smoke observations 1 4 O 5 Smoke nuisances abated 1 1 0 2 Summonses taken out under Public Health Act 24 10 7 41 Magistrates' orders obtained 16 6 4 26 TABLE 8. TABLE 8—continued. PROCEEDINGS TAKEN UNDER PUBLIC HEALTH (LONDON) ACT, 1891. Situation of Premises. Nature of Complaint. Date of Vestry's Order. Date of Summons. Result. Name of Inspector. 2, Nelson Street Drains defective. 1896 Jan. 20 1896 Mar. 4 Order to abate nuisance within 14 days. Mr. Twaits. 1, Lindley Street Part of house dirty and dilapidated, drain defective, no uuderfloor ventilation, no proper dust acle, flooring defective. Nov. 11 „ ditto „ 152, Charles Street The drain connections defective, W.C. foul and defective, yard paving defective. Dec. 2 „ Adjourned and ultimately withdrawn on work being completed. „ Kate Tickner, 121, Oxford Street Exposing infected articles of clothing and bedding. 1897 Mar. 31 1897 Apr. Bound over, case proved and deferred, to come up for judgment when called upon, having been in custody 7 days for another offence. Dr. Taylor. P. Sheehan, 2, Raymouth Road, Rotherhithe Conveying fish offal in an unsuitable carriage, and also for carrying the same through the street after the hours specified in the Bye-laws of L.C.C. „ Apr. 2 Fined £2 Mr. Cox. 1, Lomas Buildings House and premises being in such a condition as to be a nuisance, or injurious, or dangerous to health. Apr. 7 Apr. Work done, summons withdrawn. „ 2, „ ditto ditto „ ditto „ 4. „ ditto ditto „ ditto „ 6, ,, ditto ditto „ ditto „ 18, „ ditto ditto „ Order to close premises in 7 days. „ 20, „ ditto i „ ditto „ 22, „ ditto ditto „ ditto „ 25, „ ditto ditto „ ditto „ 26, „ ditto ditto „ ditto „ 29, „ ditto ditto „ ditto „ 12, „ ditto ditto „ May 14 Order to abate nuisance within 14 days. „ 13, „ ditto ditto „ „ ditto „ 14, „ ditto ditto „ „ ditto „ 15, „ ditto ditto „ „ ditto „ 12, 13,14, & 15, „ Non-compliance with Magistrate's order. - July 16 Summons adjourned for 14 days and subsequently withdrawn, work being completed „ TABLE 8—continued. 1 TABLE 8—continued. PROCEEDINGS TAKEN UNDER PUBLIC HEALTH (LONDON) ACT, 1891. Situation of Premises. Nature of Complaint. Date of Vestry's Order. Date of Summons. Result. Name of Inspector. Manor House, Stepney Green W.C. defective and unsuitable, and without a water supply-, basement damp and dirty, wash-house paving defective: 1897 June 9 1897 July 16 Order to abate nuisrnce within7 days. Mr. Lyon. 54, West Street Drains defective, W.C. defective, and unsuitable roof defective. July 21 Sep. 21 ditto „ 56, „ Drains defective, W.C. defective, and unsuitable roof defective, also house in a dirty condition. „ „ ditto „ 77, Cephas Street Drains defective, W.C. defective and unsuitable back, area gully improperly trapped, yard paving is inadequate, no dust receptacle. July 28 „ Order to abate nuisance within 14 days. „ 250, Mile End Road Drain connections defective, W.C. defective, and unsuitable gully in covered yard improperly trapped, the ditto ditto paved. „ Oct. 15 ditto „ King's Yard, Assembly Passage Failure to provide a receptacle for manure as required by Section 25 of the Bye-laws of L.C.C. - „ Adjourned 14 days and subsequently withdrawn, on byelaws being complied with. „ 2, King John Street Defective condition of drains. July 21 „ Work done, summons withdrawn. „ 3, Philpot Street Drain connections to W.C. defective. Sep. 22 „ ditto Mr. Twaits. 119, Jubilee Street No water supply for domestic and other purposes. Sep. 15 „ Order to close premises. „ 11, Salmen Street Roof defective, rain-water pipes and guttering defective May 26 Oct. 28 ditto Mr. Cox. 12, „ House in a dirty condition. „ „ ditto „ 12, Carter Street Defective condition of closet. Oct. 6 „ Order to abate nuisance within 7 days. „ 14, „ ditto ditto „ „ ditto „ 16, „ ditto ditto „ „ ditto „ 156, Jubilee Street Defective condition of drains. July 7 Nov. 25 Work done, summons withdrawn. Mr. Twaits. 51, Raven Row ditto ditto - - Summons adjourned and ultimately withdrawn, work being completed. „ 9 TABLE 9. TABLE 9—continued. Table Showing Number of Workshops in Mile End Old I own, their situation and various Trades. Situation of Workshops. Tailors. Boot and Slipper Makers. Furriers. Mantle, Dressmakers and Milliners. Bakers. Laundries. Miscellaneous Trades. No. of Workshops. Inspector in whose District they are Situate. North Ward 2 3 — 2 5 2 4 18 Mr. Cox. North—East Ward 4 — — 10 5 2 2 23 „ South-east Ward 17 1 — 2 12 2 6 40 „ North-West Ward 1 3 — 2 7 — 4 17 Mr. Lyon. East Centre Ward 7 — — 1 14 4 — 26 „ West Centre Ward 5 5 — 2 8 — — 20 „ South Ward 8 — — - 16 — — 24 Mr. Twaits. Wet Ward 172 28 9 7 16 8 16 256 „ Totals 216 40 9 26 83 18 32 424 34 Workshops. Some two years ago it was my pleasure in submitting my annual report to include a considerable amount of information upon this subject, which was at that time the more interesting as the new Act relating to workshops had just come into effect. I refer to the Factory and Workshops Act, 1895, the principal heads of which, in a brief summary, I then laid before you. In my report of the year 1895, I also included a tabulated statement which indicated the localities of the workshops, together with the various trades carried on therein; this statement being prepared from the Register of Workshops kept by the Sanitary Inspectors. It has recently been found necessary, in consequence of the many removals of occupiers and new workshops being established, to prepare an amended register, which is now completed to date. In this report I now submit to you an analysis of the various trades carried on, together with the distribution of the workshops in the different wards throughout the Hamlet. By section 41 of the Factory and Workshops Act, 1895, the occupiers of every workshop are compelled to notify to the Factory Inspector the address at which his work is carried on. Such notice must be immediately forwarded to the Sanitary Authority of the district in which the workshop is situate. These notices have been duly received from time to time, but it is found that in almost every case the workshops notified are already under our supervision. By section 26 of the Public Health (London) Act, 1891, it is my duty to give written notice to the Factory Inspector of the district of any workshop in which any child, young person, or woman is employed; such notices have been duly forwarded. Under section 22 of the Factory and Workshops Act, 1895, laundries are now declared to be workshops, and consequently are under our supervision. This has caused a slight increase 35 in the total number on our new register. Retail bakehouses are also workshops within the meaning of the Act, but are subject to more frequent inspection by reason of the importance of absolute cleanliness in the preparation of food. The total number of workshops now under periodical inspection is 424. It will be gathered from the Table that a great majority of these workpeople are employed in the tailoring trade, and that the largest number of workshops are situated in the West Ward ; this part of the district being preferred probably on account of its close proximity to the City shops for which most of the work is done. Where, in a Workshop, on the visit of the Factory Inspector, any sanitary defect is observed, it is his duty to report the matter to the Sanitary Authority of the district, and it is the duty of that authority to inform the Factory Inspector of the proceedings taken in consequence of such notice within one month. These notices have been occasionally received and duly reported as the law directs. The principal duties of the Sanitary Authority in connection with workshops are:—the enforcement of cleanliness and adequate ventilation, the prevention of overcrowding, and the provision of separate and sufficient w.c. accommodation, where members of both sexes are employed. These duties have been strictly carried out by your officers during the past year, and in no case has it been found necessary to take legal proceedings to enforce the Vestry's order. The occupier being the person responsible for the cleanliness of his workshop no difficulty is experienced in enforcing this part of the Act. With regard to overcrowding, it was our practice, prior to the passing of the Factory and Workshops Act, 1895, whenever a new workshop was discovered, to at once measure the workshop and supply the occupier with a form, showing how many persons it should accommodate, allowing a minimum of 250 cubic feet of air space for each person. By the Act of 1895, 36 this minimum of 250 cubic feet per head was made compulsory, and it also requires a notice to be affixed by the occupier showing the number of persons employed in the workshop. It is, however, to be regretted that the affixing and properly filling in of this form has not in all cases been insisted upon by the Factory Authorities. On several occasions I have sent lists of workshops to H. M. Inspector where it has been found that this form was not filled in or affixed, especially in those cases where overcrowding was likely to occur. It is somewhat singular that where any other offence under the Factory Acts is discovered, summary proceedings can be at once instituted by the Factory Inspector and penalties enforced, but with regard to that part of the Act which relates to the overcrowding, it has to be dealt with as a nuisance under the Public Health (London) Act, 1891, by the Sanitary Authority. This involves the service of notices and subsequent re-inspections, and renders it exceedingly difficult to obtain a conviction. In my opinion, where a notice showing the number employed is filled in and signed by the employer, he should be bound by it, and should be liable to summary proceedings in the event of overcrowding being detected. The frequent inspection of the Home Office Inspectors, together with our periodical visits, have effected a marked improvement in the conditions and surroundings of the workpeople in our district during the last few years. We have been enabled by tact and courtesy to carry out our duties in connection with the workshops smoothly and with an entire absence of friction, this being largely due to a mutual desire on the part of the Factory Officials and ourselves to adminster the law in the least objectionable manner, and for the benefit of the persons affected. Housing of the Working Classes Act. A number of houses have been placed under the operation of this Act during the past year, and many structural alterations have been made to premises which were previously unfit for 37 human habitation. Several houses in White Horse Court have been closed permanently owing to their not having sufficient light and air. The Table annexed will show in detail the results of the various representations made under the provisions of this statute. With reference to the scheme of Lomas Buildings, which has been from time to time before you, I hoped to be able to chronicle in this report that this insanitary area had been demolished, but I have, I regret to say, to allude to the fact that owing to the refusal of the Local Government Board to sanction it, the whole scheme has fallen through. This refusal was entirely due to the stipulation that new buildings should be erected to provide for the people who would be displaced. The present and past Sanitary Committees have, during the last few years, done all in their power to obtain the demolition. The County Council consented to contribute half the cost, the Vestry contributing the other half, and all that was wanting was the sanction of the Local Government Board, but that body has evidently laid down a hard and fast rule that in such cases new dwellings should be erected. It has been pointed out to that body that there is ample accommodation in the immediate locality for more than all these people, and that the Vestry was not prepared to erect new dwellings. This condition of affairs is much to be regretted, as this insanitary area is the greatest blot we have in the district. There is nothing which tends to demoralize the working classes more than narrow, badly lighted, and unventilated courts. TABLE 10. TABLE 10—continued. Proceedings taken under the Housing of the Working Classes Act. Date of Inspection. Situation of Property. Condition of Premises at time of Inspection. Time allowed to make premises habitable. State of Premises on Re-inspection. Date of Re-inspection. Subsequent action taken. Mar. 16 5, Whitehouse Court Insufficient light and ventilation; dirty and dilapidated 21 days Nothing done Apr. 23 „ 6, „ „ Ditto „ „ „ „ 7, „ „ Ditto „ Houses shut up May 13 Apr. 23 3, Apsley Street House dirty; no ventilation under floors, &c. „ Work done June 4 May 13 6, Coke Street Premises dilapidated; no ventilation under floors, &c. „ Premises now habitable July 5 June 1 1, Cornwall Place Walls, Passages and Ceilings defective and premises dilapidated „ Nothing done— Tenants have notice to quit July 20 „ 2, „ Ditto „ Work in hand Aug. 4 „ 3, „ Ditto „ „ „ „ 4, „ Ditto „ „ „ „ 5, „ Ditto „ „ „ July 21 21, James Street Premises dilapidated; ceilings, &c. defective „ Work done Aug. 15 „ 118, Old Church Road Ditto „ „ „ Oct. 19 10, Salman Street W.C. defective, premises dirty and dilapidated „ „ „ Nov. 6 2, Wade's Place Floor boards rotten; drains defective „ Negotiations taking place to do the necessary work. Dec. 30 „ 3, „ „ „ „ „ 4, „ „ „ „ „ 5, „ „ „ „ „ 7, „ „ „ „ „ 8, „ „ „ „ 40 Unsound Food. The protection of the public from consuming unsound food is a matter over which every local Sanitary Authority should exercise the utmost vigilance. Ample powers are provided by the Public Health Act for this purpose, and speaking for my own authority I must say that when distinct breaches of this portion of the Public Health Act are brought to their notice they take all necessary steps to prosecute the offenders. It is at all times a delicate and difficult matter for sanitary officials to bring transgressors to justice, for whilst we are aware that certain things are done which are contrary to the Act, it is not always possible to detect them or to take proceedings to prevent them. Our successful actions in the matter during the last few years have proved a serious warning to persons carrying on this nefarious trade, and particularly in regard to tinned foods. Several makers of tinned foods have left the district as they could not stand the constant supervision exercised over them. For some time previous to November, your inspector, Mr. Lyon, and myself, had under observation a biscuit and cake maker suspected of using unwholesome material in his business, and on the 24th November we visited the premises, and found the manufacture of biscuits in progress. Outside the bakehouse we found a large quantity of eggs; we broke a number of them and all were bad and unfit for food. On going into the bakehouse we found a quantity of dough recently made up, and we were informed, made with similar eggs to those outside the bakehouse. The smell of the eggs we broke was extremely offensive and permeated the bakehouse to such an extent that it was impossible to smell if the dough was made with bad eggs. We then seized the eggs on the premises, in all 1,645, and had them conveyed to the Thames PoliceCourt, where they were seen by the magistrate and condemned. At the magistrate's direction, the eggs were taken to the Vestry's depot and destroyed, and a summons was issued against the owner. After hearing all the evidence of Mr. 41 Lyon and myself, and examining the defendant, the magistrate said:— "I find the defendant guilty of the offence and a very bad one, and far worse than when a person sells bad fruit, for then one can see what he is buying. In this instance the defendant can so disguise the pastry that the public are deceived, they believe they are purchasing wholesome food, whereas they are buying what is almost poison. I must punish the defendant severely so as to teach him and others they cannot play such tricks on the public. Defendant will have to go to prison for 21 days with hard labour." This case has had a very good effect amongst a certain class of bakers and pastry-cooks throughout the metropolis. It appears to have been a custom for some bakers and small cake makers to use what is known in the trade as spot eggs. These are eggs which are not fit to be cooked for consumption in the ordinary way, but they can be so disguised by baking with flour, &c., as to conceal their condition, while of course they are none the less injurious to health. Another case was the seizure of a number of tins of meat suspected to be unsound, in a small general shop. Mr. Lyon and myself opened a number of the tins and had them conveyed to the Thames Police-Court, where an order was made by the magistrate to destroy them. A summons was subsequently taken out against the wholesale dealer, and the case was adjourned; so that for the present I am unable to enter into further particulars with regard to this matter. Milkshops. Although we have only 20 dairies in our district, there are 294 milkshops which are registered under the Dairy and Milkshops Order, an order which is enforced in London by the County Council. This order is of great importance to the general public, inasmuch as it insures the proper cleansing of utensils used in the purveying of milk, and to a great extent protects the public from the spread of infectious disease, which 42 is often conveyed through the medium of this article of food. Every purveyor or person selling milk by retail, who has an infectious or contagious disease within the building or upon the premises in which milk is kept, is required immediately to give notice of such disease to the Council, and to remove all milk for sale and all utensils for containing milk for sale, from such building, and to cease the sale of milk until the premises have been declared by the Medical Officer of Health for the district to be free from infection. The penalty for contravening this order is Five Pounds, and in the case of continuing the offence is Forty Shillings for each day after written notice of the offence from the Board. Several prosecutions of milk-sellers for contravening the order, have taken place in our district, and in cases where it has been necessary, the officers of my department have given evidence for the Council. Bakehouses. The bakehouses number 83, all of which have been inspected during the year, and when necessary lime whiting and cleansing has been done. They were generally found to be kept in a cleanly state free from effluvia and were ventilated. The owners we find most willing to carry out any suggestions we make from time to time in order to keep the premises in a good sanitary condition. Cowhouses and Slaughterhouses. It is illegal for persons to undertake the business of keepers of cows or slaughterers of cattle unless under license of the London County Council, and that body exercises a certain amount of supervision over such persons. Before the license is granted each year, every Sanitary Authority is supplied with a list of applications sent to the Council in its respective district, and are invited to send representatives to attend on the licensing day, and if it is considered necessary, to oppose the license being granted. We have at the present time 20 43 cowhouses and 10 slaughterhouses under inspection; they are kept in a cleanly condition, have proper manure receptacles, and generally speaking, conform to the requirements of the Sanitary Authority; we therefore did not this year offer any objection to any of the licenses being renewed. Water. The question of a pure water supply is one that is of great interest to all classes of the community, and the unfortunate experience at Maidstone seriously shows the necessity of a constant supervision being exercised over the sources from which the water supplies are derived, and also that the quality should be frequently examined by competent authorities. It may not be generally known to the members of the Vestry that the water in our district is sampled daily, for analysis as to its composition and quality, by Sir William Crookes and Professor James Dewar, independent scientific authorities. The results of such analyses are forwarded to the Vestry every month. Taking the reports for the year, the water has been pure and of clear colour. It will thus be seen that every care is taken to guard against impurity in the water supply. There is no other city in the world where such minute and incessant care is taken daily and almost hourly to detect and report on the slightest deviation from purity in the water supply. Although this year there was no drought during the summer months, there were many tenement dwellings in the East End of London where cisterns above the level of 40 feet from the ground level were not supplied with water, and this caused great inconvenience. There was a breakdown in the Thames main in August, which may have affected the supply. The Company state that they do not guarantee a supply of water at a higher level than 40 feet, but it is a well-known fact that there are many tenements in the East End of London which are situated at a much higher altitude than this, and require a proper supply of water. It appears to me that the Legislature should compel water companies to supply water at whatever level the public find it necessary to erect dwellings. 44 Mortuary. The number of bodies brought to the mortuary during the year was 189. A register of them is kept, which has to be signed, stating the name and address of the person depositing same; also that of the undertaker, before the body is allowed to be removed. In 177 of the cases inquests were held, and in 13 cases post-mortem examinations were made. There is every facility for properly conducting these operations, and the provision of the necessary instruments has, I believe, given satisfaction to the medical men in the district. There has been only one body deposited in the separate part of the mortuary, set aside for infectious diseases, during the past twelve months. Legislation during the Year. The Acts of Parliament which have been passed during the past year that are of interest to sanitarians are:—The Metropolis Water Act, the Cleansing of Persons Act, and the Infant Life Protection Act. The Metropolis Water Act, 1897, makes important amendments in the laws respecting the metropolitan water companies, and affects both the water companies and water consumers in London, and amongst others the East London Water Company. One of the most important sections is section 2, which enables a local authority to aid any water consumer in obtaining the determination of any question which appears to them to be of interest to water consumers within their district, with respect to the rights, duties, and liabilities of any water company under the Act, in reference to the quantity or quality of water supplied, or the charges made by them. Jurisdiction is conferred by the Act upon the Railway and Canal Commission to hear and determine complaints which may be made by water consumers or by local authorities, with respect to defaults of the water company. If this Act had been passed a few years ago, I fear the Commission would have been fully occupied during the late drought. 45 The Cleansing of Persons Act, as its name implies, is for the purpose, when application is made to the Sanitary Authority or Board of Guardians, if they think fit, of permitting any persons infested with vermin to have the free use of any apparatus which the Authority possesses, for cleansing the person and clothing. The Infant Life Protection Act is one of the most important Acts passed in recent years for the better protection of young children, and broadly speaking, it is for the prevention of children being farmed out in any numbers over one, without notification being given to the London County Council, which authority will have proper supervision over the premises used for this purpose. It will probably be a means of preventing loss of life in children of tender age. It is with much pleasure that I again conclude my report with an expression of gratitude to the Vestry for the consideration and kindness extended to my colleagues and myself during the past year, and also of my appreciation of the creditable manner in which the officers of my department have conducted their work. I can testify to the interest which they take in their duties and, further, to the thoroughness with which these duties have been performed. I am, Gentlemen, Your obedient servant, THOMAS TAYLOR.