pop 57 ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the SOUTH DISTRICT, Comprising the Parishes of All Saints Poplar, and Bromley Saint Leonard. To the Chairman and Members o/ the Board of Works for the Poplar District. Gentlemen, I had the honour to be elected Medical Officer of Health for the parishes of Poplar and Bromley on the 21st of March, 1893, and the appointment was sanctioned by the Local Government Board on the 30th day of the same month. This Report dates from and includes the 2nd of April, and comprises the last three quarters of the year 1893. The vital statistics of the Poplar parish for the first quarter of the year ending April 1st have been dealt with by my predecessor, Dr. Corner, his tables are appended to this Report, and his commentary as to the sanitary condition of the District for the like time has already appeared in his last Annual Report, 1892 to 1893. My colleague, Dr. Talbot, deals with the vital statistics of the Bromley parish for the same quarter, because he acted during that period as Medical Officer thereof. RE-ARRANGEMENT OF DISTRICT AND RE-ORGANISATION OF SANITARY DEPARTMENT. The first duty I was called upon to perform was to consider the re-arrangement of the divisions of the district, and the reorganisation of the work of the Sanitary Department. The Board, acting on my report to the Sanitary Committee, resolved to divide Poplar into two sub-districts, viz., South Poplar, F 58 taining the area south of the northern bridges of the East and West India Docks, known as the Isle of Dogs; North Poplar, the remainder of the parish, including the Orchard House and the adjoining neighbourhood. Bromley was also divided into two sub-districts by the Limehouse Cut, viz., North and South Bromley. Four Inspectors were subsequently appointed to these sub-districts—North Poplar, Mr. Shadrake; South Poplar, Mr. Foad; North Bromley, Mr. Anthony ; and South Bromley, Mr. Miners. Upon the decease of Mr. Shadrake, Mr. Dunn was appointed to North Poplar. All these officers hold office under the Sanitary Officers (London) Order, 1891. Mr. Raymond was re-appointed for the whole of the districts, under the same Order, to devote his attention to nuisances in Factories, Workshops, Smoke nuisances, the Outworkers in Factories, and the inspection of Canal Boats. I suggested that he should have an assistant for the Outworkers and for the taking of notes of the various chimneys connected with furnaces under notice to consume their own smoke. With regard to the re-organisation of the working of the Sanitary Department, when the Inspectors require men to test drains, to serve intimations and notices, &c., the Surveyor's Department is requisitioned, and for this last purpose I have introduced a form book with counterfoils, so that a record is kept of the work done. These men also assist in procuring samples under the Food and Drugs Act. All items of the work carried out in the Sanitary Department by the Board's Contractor, whether executed on behalf of the Board or done at the request of private individuals, are now entered by the Inspectors in a book, so that the details may be checked when the accounts are sent in. A new book has been introduced in order that complaints made either by letter or on personal application may be registered immediately. The Inspector, when the complaint is attended to, initials the book and enters his remarks, if necessary, in a column set apart for that purpose. Respecting the work of a clerical nature, Mr. Smith, the Sanitary Clerk, has now six journals to keep posted instead of four, the entries in each book being more numerous than formerly, in consequence of the Inspectors having less ground to cover; he also makes copies of all Intimations, Notices and 59 Summonses, and writes out the authorizations for the signatures of the Chairman of the Board or Sanitary Committee. Mr. Ward, the Clerk for General Purposes, keeps the Register of the Infectious Notifications. I have caused this book to be divided into three parts, in order that Poplar and Bromley may be kept separately, which is extremely convenient for reference. The Milk Supply is now registered, and likewise the date of removal, should the patient be admitted into one of the Metropolitan Asylums Board Hospitals. Mr. Ward, as formerly, makes a copy of each notification, which copy is sent to the Asylums Board, and should the patient be attending at a School, or should there be children in the house attending any Schools, copies of the Notification are forwarded to the teachers Recently Sunday Schools have been registered and notified. Mr. Ward also attends to and checks the notification fees and accounts, and since the disinfecting work has been under my immediate supervision, he helps me with the clerical work of that department. A Vital Statistic Street Ledger is now being kept for Bromley as well as for Poplar. On the 19th of September I addressed a letter to the Board, calling attention to the over-crowded condition and want of accommodation in the offices of the Sanitary Department; this subject has been discussed, and more rooms will be afforded as soon as possible. DISINFECTING DEPARTMENT. The Disinfecting Department I have taken under my immediate supervision. The work commences at six o'clock in the morning instead of at that hour in the evening, the men receiving a higher wage, the beer money being discontinued. I have introduced a system whereby orders are given to the disinfector as to the premises, and the clothing, &c. The articles before leaving any house are checked by the Board's men, and signed for by the owner when returned, so that in case of a dispute the Board would not suffer. The men who fetch and bring the clothing, &c., to and from the apparatus—in order that the wages sheet may be checked by me every week—keep a record book as to their journeys, and likewise as 60 to the heat and the time occupied in the disinfecting process. An account is kept of the disinfection of premises whence notifications have been received, so that information can readily be obtained in the event of any School applying for a clearance certificate. The disinfecting apparatus I have utterly condemned, as it is obsolete and worn out. I recommended the sure and quick process of disinfection by steam under pressure—dry steam in fact—and I also recommended that the present heavy, cumbrous iron vehicle which engages three men to draw it along, should be replaced by two small covered and closed light vans, one to fetch the infected clothing, &c., and the other to take the disinfected articles home again. These vehicles, I suggested, should be drawn by horses. With a view to purchasing a disinfecting apparatus and vehicles, the Committee visited George Yard, Whitechapel; Denzell Street, Strand; Cambridge Street, St. Pancras; and Paddington Street, Saint Marylebone At the present time Messrs. Lyons have an order for one of their Patent Steam Disinfectors; two vehicles of modern construction are also to be obtained. The following figures shew the number of premises disinfected, and the number of times the Board's ovens were used for the two parishes, some thousands of articles being baked. Private Premises. Board's Ovens. Poplar 578 552 Bromley 993 892 1571 1444 Disinfectants are only supplied on the orders of the Inspectors, and a record is kept of their distribution. Should any person make an application for a supply on account of a nuisance stated to exist, the complaint is entered in the proper book, and the nuisance inspected in due course. Disinfectants, &c. furnished to the Board's Offices by the Contractors are checked, and the vouchers filed in my office. 61 VITAL STATISTICS. I estimate to the middle of the year 1893 the population of the parishes as follows:—Poplar 56,634, being 48.6 persons to an acre. Bromley 71,336, being 117.3 persons to an acre. The reason why there are less people to an acre in Poplar is obvious—on account of the area taken up by the docks, &c. The Births during the 39 weeks were :— Males. Females. Totals. Poplar 671 740 1411 Bromley 939 897 1836 Totals 1610 1637 3247 Of these births 76 were illegitimate in Poplar, 35 males and 31 females. In Bromley there were 23 illegitimate births, 15 males and 8 females. The annual birth rate per 1000 living being 33.3 for Poplar, and 34.4 for Bromley. See Tables I. and II. on page 85. During the year the marriages of 1570 persons were registered in Poplar and Bromley, giving an annual rate of 12.2 per 1000 of the estimated population, the rate for England and Wales being 147 and for London i7'2. During the last three quarters of the year 1893, 785 deaths were registered in Poplar and 1594 in Bromley; from the 785 deaths which took place in Poplar there must be deducted 49 deaths of non-residents, and to the remainder must be added 264 deaths which occurred in outlying institutions, making a total of 1000 deaths of Poplar parishioners. Treating the 1594 registered deaths in Bromley in the same manner, viz.:—deducting 518 deaths of nonparishioners, and adding 146 deaths in outlying institutions, the deaths belonging to this parish will be found to be 1222. Males. Females. Totals. Poplar 589 471 1000 Bromley ... 635 ... 587 ... 1222 Totals 1164 1058 2222 62 The annual death rate per 1000 living being 23.6 for Poplar and 22.9 for Bromley. See Tables I. and II. on page 85. The births exceeded the deaths by 411 in Poplar and by 614 in Bromley, making a total excess of 1025. The male deaths in the two parishes exceeded those of the female by 106, and the female births exceeded those of the male by 27. The following table is of somewhat general interest:— Population (enumerated or estimated). Annual Rate 39 weeks per 1000 Persons living. Births. Deaths. Poplar 56,634 33.3 23.6 Bromley 71,336 34.4 22.9 Inner London 4,306,124 30.3 21.0 Greater London 5,849,707 30.1 19.5 33 Great Towns 10,326,040 31.4 21.4 Edinburgh 267,261 27.8 19.4 Glasgow 677,883 34.4 22.5 Dublin 349,594 28.6 26.6 Paris 2,424,705 24.9 21.0 Brussels (with 8 Faubourghs) 488,188 25.4 19.7 Copenhagen 334,000 30.7 20.3 Stockholm 249,246 28.1 18.6 Christiana 161,151 15.6 17.4 Moscow 753,469 — 36.5 Berlin 1,714,938 26.9 21.4 Hamburgh (State) 634,878 36.8 20.9 Breslau 353,551 34.9 30.3 Munich 380,000 36.3 27.9 Vienna (with Suburbs) 1,435,931 31.7 23.6 Prague 327,953 32.0 27.7 Buda-Pesth 539,516 35.9 26.3 Trieste 158,314 30.6 26.6 Venice 163,601 26.1 26.2 New York 1,875,385 — 23.1 Philadelphia 1,115,562 — 22.8 Calcutta (27 weeks) 466,460 — 20.9 Bombay (38 weeks) 821,764 18.9 28.6 Madras (32 weeks) 452,518 42.2 41.3 St. Petersburgh (23 weeks) 954,400 28.9 25.0 Cairo (38 weeks) 374,838 53.2 51.8 Alexandria (36 weeks) 231,396 44.4 37.6 63 ZYMOTIC DISEASES. The diseases comprising the principal Zymotic group are:—Smallpox, measles, scarlet fever, diphtheria (including membranous croup) whooping cough, fever (including typhus, typhoid or enteric, simple continued and ill-defined fevers), and diarrhoea (including gastro, enteric and intestinal catarrh). The annual death rate from this group of diseases per 1000 living was 3.63 in Poplar, and 4.69 in Bromley. See Tables I. and II. on page 85. A letter was received from the Ambulance Committee of the Metropolitan Asylums' Board, intimating that with the "view of "facilitating the prompt removal of patients and of avoiding every "possible delay in the preliminaries, instructions have been given to "their ambulance officials to accept as a medical certificate a copy "of the notification certificate endorsed by the Sanitary Authority." This I find is of great use in effecting the speedy removal and isolation of those patients suffering with the Zymotic diseases admissible into the Asylums' Board hospitals. Five cases of scarlet fever and one of typhoid fever were connected with milk shops in Bromley. The fact was communicated immediately to the County Council, and the businesses were discontinued until after the premises and utensils had been disinfected, either at the recovery or upon the removal of the patients. SMALL POX. The number of cases of small-pox notified during the last threequarters of the year 1893, were 35 in Poplar and 111 in Bromley. Six deaths from this disease were registered in Poplar and five in Bromley, being 0.14 per 1000 living in Poplar, and 0.09 per 1000 in Bromley. The measures I adopted for stamping out this fearful disease were as follow:—As soon as possible after the notification was received, the disinfector—who at my suggestion had been provided with a tricycle—took for signature the necessary removal form to the medical man notifying, and then he rode on and left at the infected house the certificate, which was given to the nurse in charge 64 of the ambulance when she called. After doing this he came on to the Board's offices, where the cases were telephoned or telegraphed to Norfolk House, Strand. The disinfector rode over on the same day and disinfected the rooms. Notices of urgent disinfecting work were left at his residence. The rooms were sulphured; the disinfector was provided with a brass syringe with which he damped the walls and ceilings so that the sulphurous acid might be absorbed; the walls were stripped of the paper, then together with the ceiling limewhited, and all the woodwork washed with carbolic acid. Vaccination and re-vaccination advised; the premises kept under constant daily supervision, and when the patient was found to work at any place I sent immediate information to his employers. During the last quarter of the year 1893, a very serious epidemic threatened the poor and densely populated region surrounding Hawgood Street. I communicated with the Clerk to the Guardians, with the result that the district was placarded with notices advising the inhabitants to avail themselves of vaccination or re-vaccination, handbills were distributed in the infected districts, and also left by the Sanitary Inspectors and the Disinfector at theinfectedhouses. I informed as soon as possible the Vaccination Officer, Public Vaccinator and District Medical Officer of the existence of any case. The disease was no doubt spread by the utter carelessness and disregard of the inhabitants who visited one another when there was sickness in the house ; this visiting did not apply only to Hawgood Street and its surroundings, but to other parts of Bromley and Poplar, for in tracing out the origin of the cases it was generally found to be brought about in this manner. I am indeed thankful to report that by adopting all the above-mentioned measures and precautions the disease was stamped out, and I consider that special thanks are due to the District Medical Officer, Dr. Lightburne, who visited the Homes without waiting for the Relieving Officer's orders, thereby expediting the speedy removal and the isolation of the patients. Two of the Board's men engaged in the disinfecting work contracted the disease, but I am pleased to say they both recovered and are at work again. 65 Mr. Hitchins, the Vaccination Officer, has kindly given me the following statistics as to the number of vaccinations effected during the year. January to June, 1893. Births. Vaccinations. Insusceptible. Poplar 985 702 10 Bromley 1368 831 17 July to December, 1893. Births. Vaccinations. Insusceptible. Poplar 943 538 2 Bromley 1230 561 4 SCARLET FEVER. During the last 39 weeks of the year 1893, 552 cases of scarlet fever were notified in Poplar and 763 in Bromley; 35 deaths were registered in Poplar and 31 in Bromley, being at the rate of 0.82 per 1000 living in Poplar and 0.58 per 1000 in Bromley. The epidemic which was general throughout the Metropolis, was also spread over the whole of my district. The origin of it I could not trace, the milk being obtained from various sources. I have no doubt that the disease was kept rife by the want of accommodation at the Asylums' Board Hospitals, and it will be remembered that this subject was a matter of discussion in the press. The complaint was also disseminated by infected children mingling with other children in the streets during the desquamating stage, and in some instances the disease was in so slight a form as not to be recognised, and no isolation measures adopted. Names of urgent cases were forwarded daily to the Asylums' Board during the period of the want of accommodation, and in the needy cases waiting to be admitted the friends were advised to apply to the parish for medical aid and relief. I caused constant enquiries to be made at those outstanding cases from which no post cards had been received, so that should the patients be recovered the premises and bedding might be disinfected. An enormous amount of work was entailed upon the Sanitary Department 66 during this epidemic. At the end of the year 1893, the notifications of this disease had considerably lessened. DIPHTHERIA AND TYPHOID FEVER. One hundred and seventy-eight cases of diphtheria and 66 of typhoid fever were reported in Poplar; 349 cases of diphtheria and 207 of typhoid fever were notified in Bromley; 19 deaths through diphtheria and 12 on account of typhoid fever occurred in Poplar; 45 deaths from diphtheria and 31 through typhoid fever were registered as belonging to Bromley. The tables on page 85 shew the death rate per iooo living. In these tables—to make them comparable with those of the Registrar-General—diphtheria includes also membranous croup; typhoid fever with typhus, simple continued and ill-defined fevers are included under the one heading of Fever. As soon as possible after the receipt of the notification of a case of typhoid fever or diphtheria the Inspector inspects the premises and tests the drains. This plan is carried out in all infectious cases. I think that the exceptionally hot and dry summer was the cause of a great many cases on account of the rapid evaporation of water, whereby many gullies became untrapped. In one of my reports to the Sanitary Committee I drew attention to the condition of the street gullies, and in consequence of this report and of another which I presented to the Board at the desire of the Finance Committee,* a Committee went round the district inspecting the said Note:—Extract from my Report to the Board, September 1st, 1893:—" Indeed, the fact is proved beyond the possibility of doubt; for in a number of instances, on the testing of drains in private houses by means of the various tests, smoke and fumes have been found to escape out of the gullies in the public streets, demonstrating the absence of a proper trap, and the certainty of emanation of sewer gas. In other cases, on examination, gullies are found to be of obsolete construction; and others, 4jin. in thickness, built of porous bricks, which, as well as the surrounding earth, have become sodden with sewage: providing a fair nidus for the growth of putrefactive germs productive of disease and death." From this condition I saw that there was a possibility of polluted ground air being drawn into those houses whose sites were not covered with an impermeable layer of asphalte or concrete, and that the air of the houses in the vicinity of the gullies would also become contaminated from them in many ways. The new or re-constructed street gullies are now faced internally with cement. 67 gullies, with the result, that a large number were recommended to be repaired and re-constructed. Pending the carrying out of this work, I advised during the continuance of the drought that those gullies which were not properly trapped, or which became dry through any cause, should be flushed with a strong solution of disinfectant. I also ordered to be flushed with the same solution the closet pans and drains of the houses in the Bow Common Lane districts, whence a large number of diphtheria and typhoid fever notifications had been received. 1 recommended the men engaged in the work of flushing to instruct the inhabitants that they must constantly flush the drains. I may add that I consider two gallons of water to be insufficient to flush a closet and drain, the quantity ought to be at the least three gallons. I trust the Water Company will be made ,to allow this amount. About the time that a large number of cases were reported from the above-mentioned district the sewer was being cleansed in Whitethorn Street, near a public school. The Sanitary Department had to contend with the same difficulty with the typhoid fever and diphtheria cases as with those of scarlet fever, viz.—want of accommodation at the Asylums' Board Hospitals. Many typhoid fever patients were admitted into the Metropolitan General Hospitals. The Asylums' Board upon receipt of our notice of removal would communicate with these institutions; 11 cases of typhoid fever were treated at Guy's Hospital, io over and one under five years. Seven of these patients were admitted through the Asylums Board and four were brought to the hospital by friends. Five cases of typhoid fever were admitted into St. Bartholomew's Hospital, all over five years of age. I have not been able to obtain the number of persons suffering with notifiable diseases admitted into the other hospitals, but a large number were treated in the London Hospital. A record is now being kept of all infectious cases admitted into the General Metropolitan Hospitals. TYPHUS FEVER. One case in Bromley of typhus lever in a child was notified, and 68 the complaint proved fatal. I visited the patient, as the Medical attendant wrote to me. The origin of the disease could not be traced. INFLUENZA. Four deaths from influenza were registered in Poplar, and 17 in Bromley during the 39 weeks. MEASLES AND WHOOPING COUGH. The number of deaths from measles and whooping cough, and the death rates per iooo living are given in the tables on page 85. I have arranged these tables so that the death rates may be compared with those of the 33 great towns in England and of Inner or Registration London. Should I learn that measles is occurring, at any time in an epidemic form, I will bring under the notice of the Sanitary Committee the fact that the Board has the power to make an order to include this infectious and frequently fatal complaint among the list of notifiable diseases, and that such order may be either permanent or temporary. DIARRHŒA. The deaths from diarrhoea and the rate per iooo living are given in the tables on page 85. It will be observed that although the death rates exceed that of London, they do not exceed that of the 33 great towns. CHOLERA. A letter referring to cholera, dated the 22nd of June, 1893, was received from the Local Government Board, calling attention to their circular letter of the 25th of August, 1892. The Committee referred the matter to my colleague and myself. On the 20th day of July I presented to the Sanitary Committee the following special report on " Cholera Precautions." "July 13th, 1893. " Mr. Chairman and Gentlemen, "There being no accommodation in the Asylums' Board Hospitals in consequence of the present epidemic of Fever, together 69 with the fact that the Managers of the Asylums' Board are utilizing any accommodation that may be obtained in the General Hospitals and Infirmaries for the first cases of Cholera which may appear, and that their Hospital accommodation will probably be limited to this, it will devolve upon the Poplar Board to provide hospital accommodation in the event of a visitation of Cholera to this district; but in any case it is for this Board to provide places of refuge for persons not actually sick but whom it might be right to keep under observation, or to accommodate while their home was either under disinfection or was devoted to a sick person who could not properly be removed. The London Hospital is at too great a distance for this district to remove patients thereto, and at the present time the Poplar Hospital is closed, therefore, the Poplar District must rely on its own resources. "It is to be observed that the amount expended by any local authority in providing any building for use as a hospital, or as a place of refuge, under regulations issued by the Local Government Board will, to such extent as may be determined by that Board, together with two-thirds of the salaries or remuneration of any officers or servants employed in any such building, be repaid to them from the Metropolitan Common Poor Fund, and will consequently be a charge on the whole Metropolis. "I have been in communication, and have had interviews, respecting land at Millwall, Cottage Row, and the region known as the Copperas land, but it appears to me that there is a difficulty in pursuing negotiations because the land is not asked for definitely. I have interviewed the manager of the East and West India Dock Company, and he offers a site south of the South Dock Basin, near Judkin Street, which the Directors might be willing to let at a rental. I have received a letter from the manager of the Millwall Dock Company, saying that the Company have no land to let. "I called upon Mr. Hooper, of Millwall, who writes saying that his Principal would not object to endeavour to find a site or sites, and in his letter he suggests several on the Island, and should the 70 emergency arise, he says, he has a building 97 feet by 30 feet at the Mill and Forge Works, Millwall Iron Works. "After an interview I had with Mr. Harston, he writes, saying, that 'We shall be prepared to consider the question of letting a part or the whole of the Clippingdale Cottage Row Estate, two and a quarter acres, and the half acre Rifle Street property, as sites for Cholera Hospitals when your Board are prepared to go into the matter, providing that we have not in the meantime otherwise dealt with them.' He goes on to say, 'but if the object of your Board is to obtain and reserve an option to claim the right to their use, we are willing now to consider the terms on which our clients should rent such option. This is the course being adopted by other local Boards. As an instance of one case: The Board of Works for the Wandsworth District paying £100 for the option of one site for two years, and will pay £100 per annum in addition as rent, should they exercise the option.' "The following is a copy of the recommendation: 'That the offer of Messrs. Glasier & Sons to recommend their clients to reserve to the Board for two years acres of land on the Wimbledon Park Estate as a site for a Cholera Hospital for the joint use of Putney and Wandsworth, if required, on payment by the Board of a sum of £100 for such reservation, if the land is used the Board to pay a rent of ^100 per annum, to erect a close boarded fence not less than 6 feet high, to leave such fence at the end of the term, not to cut more turf than is absolutely necessary, and to metal the roadway over the portion of Standen Road which they would use (the agreement to be prepared by the Surveyor's Solicitor at the Board's expense) be accepted; and that all costs in connection with the proposed hospital be charged to the two parishes in equal proportions.' "I have visited the works of Messrs. Humphreys, Limited, Knightsbndge, and have inspected one of their iron hospital buildings. The one I viewed was to house 12 patients, 6 male and 6 female, 71 with provision for erecting bath, washing and closet accommodation, kitchen, scullery, store-room, and room for the matron. The building is nearly 100 feet long and 40 feet broad, and allows 1400 cubic feet for each patient; cost £280; and would take one week to erect; but then the fittings for firing, washing, cooking, and lighting, together with drainage, must be considered. I have interviewed Messrs. Atkinson, of Westminster Bridge Road, who would undertake the furnishing. Tents could be erected if necessary. Messrs. Piggott Brothers & Company, 57, 58 and 59 Bishopsgate Street Without, write that they could supply tents at a day's notice (if they were not pressed with orders), but tents could be only used during the warm weather, and then there would be the difficulty about fittings, &c., and the disposal of the sewage. I have also written concerning tents, to Mr. Thomas Briggs, of 2, Budge Row, Victoria Street, "The most important primary point for the Committee's urgent consideration is—what is to be done for the isolation of sporadic or individual cases in order to prevent an epidemic. Immediate accommodation must be found, so that, should a case of Cholera occur at any moment, it can be at once isolated, or the people in the house removed and housed. I therefore would urge the Committee to rent for the next 6 months houses for isolation or refuge purposes. In taking houses in crowded districts it is a happy fact to know that the limitation of this fatal disease to the sufferer can be brought about by the proper disinfection of any matter which comes away from the patient: it is by the discharges not being rendered innocuous that the disease is spread. "The site of the houses must be considered, as it is not advisable to remove Cholera patients long distances on account of the painnerve depression, and failure of circulation. I have been in communication with several persons, and I have a number of houses for the consideration of the Committee, and from which to choose. I have interviewed and written to the officials of the County Council respecting the temporary letting of certain houses at present in the 72 hands of the Council. I am given to understand that my communication went before the Bridges Committee, who will report to the Council that these houses be let to the Poplar Board for the next six months for public health purposes at a merely nominal sum. I have also written to the Solicitors concerned re the letting of the vacant Distillery in St. Leonards Street. "If the Committee should decide to take any houses or buildings I would recommend that the Contractor to the Board be ordered to overhaul the drainage, and imbed all the drain-pipes in a good layer of cement, so that there could be no possible escape and soakage into the ground of choleraic discharges. The water supply must not be stored, but be direct from the main. "I have had an interview with the Clerk to the Metropolitan Asylums' Board, and he informed me that his Board will find all the litters, ambulances, and the men to wheel or carry them. I have arranged with the Medical Officer of the Asylums' Board, who is organizing the ambulance stations, that one depot where the ambulances and litters can be kept should be on the little piece of land belonging to the Poplar Board just off St. Leonard's Street at Coventry Cross; a temporary shed would, however, have to be erected. A second depot can be at Hale Street Yard, and a third one at the Police Station in the Manchester Road. In the event of an epidemic the whole district would be posted, informing the inhabitants where the litters were kept. "Should we have a visitation of Cholera I propose that the Bromley and Poplar parishes should be divided into seven districts, and that the boundaries of these should be the boundaries of the Poor Law Relief and Medical Officers Districts, viz.: East, West, Middle, Bromley, and South Districts, but that the two last-named districts should each be divided again into two, the Bromley District by the North London Railway, and the South District by the Millwall and North Greenwich Railway as far as the Millwall Dock, and then the division to be continued by the East Ferry Road: that the Board 73 should retain the services of a Medical Practitioner for each district, to attend the cases, prescribe and dispense medicines. I have written to, and received replies from, Medical Practitioners in the districts who would be willing, in the event of a visitation of Cholera, to give their services at a weekly fee. I have also written to, and received replies from chemists who would be willing to dispense medicines, and on the recommendation of the appointed Medical Officer serve out ice, brandy, port wine, beef tea, &c. The chemists should deliver also on any medical order, disinfectants for swabbing the floors, soaking soiled wearing apparel, &c., and disinfecting the discharges before they are emptied into the sewer. "The disinfectant I propose to use is the one recommended by the Medical Officer of the Local Government Board: it is cheap and effectual. "In answer to my enquiries Mr. Lough, Clerk to the Poplar Guardians, writes that the Guardians regret they are quite unable to place a ward at the Board's disposal, and that the Dispensary is not large enough for their own requirements, and therefore could not be available as a central drug store. I trust, nevertheless, should there be a cholera epidemic, that two more dispensaries would be formed by giving assistance to the dispensers at the Poplar Union and the Stepney Sick Asylum. "Should there be the least sign of a visitation large bills should be freely and conspicuously posted, informing the public of the precautions necessary to be taken, and handbills should be delivered at every house. Each district should be posted with bills informing the inhabitants of the name and address of the medical practitioner and chemist where attendance and medicine could be procured free if any person had the least sign of diarrhoea. "I feel confident that there would be neither lack of nurses nor difficulty in obtaining them, for they would be only too eager to undertake the nursing of cholera cases, and I would recommend, G 74 should there be an appearance of this dire disease, that, apart from the hospital nursing, one or more nurses be appointed in each of the seven districts, to attend to those cases which might be too ill to be removed. % "In the event of a cholera epidemic arrangements would have to be made for the destruction of clothing, &c , and the speedy interment of the dead. "I have written to Messrs. Manlove, Alliott & Co., Limited, of Nottingham, and have interviewed their agent here, concerning their 'Incinerator,' which is a furnace specially adapted for the destruction or purification by fire of either fluid or solid refuse (excreta, bedding, &c.); cost £75 to £85, according to the size of the hopper. It would take two weeks to erect; the Board would, however, have to make the concrete foundations. "I would recommend the Committee, as soon as they settle upon the kind of disinfecting apparatus to be adopted, that they give the order at once to the makers, in case they have not one in stock, as it will take some time to make. I have pointed out to the Committee in a former report the advantages accruing from a proper disinfecting apparatus. "I have had post cards printed, which are already left at the houses notified to us by the various Port Sanitary Authorities where the arrivals from abroad are about to reside. Directions are to be given that these post cards be at once forwarded to me in case of sickness in the house. "I am, Mr. Chairman and Gentlemen, "Your obedient Servant, "FREDK. WM. ALEXANDER, "Medical Officer of Health, "Bromley and Poplar." 75 Subsequent to writing this report a letter was received from the Metropolitan Asylums' Board enclosing a list of that Board's Cholera Ambulance Stations, and of the Hospitals and Infirmaries which had promised to provide accommodation for patients. The list shewed another ambulance station for Bromley at the Poplar Hospital. The letter also stated that ambulances would not be placed at the said stations, unless cholera actually appeared in an epidemic form in London, any isolated cases would be removed by the ordinary ambulance service. Another letter was received from the Asylums Board, stating that" for some weeks past the number of deaths "registered in London as from cholera had been considerably in "excess of the number of cases of that disease notified under the "provisions of section 55 of the Public Health (London) Act. This "seems to suggest that there is a general impression amongst " medical practitioners that cholera is not a notifiable diseasethe letter also asked that" the attention of all medical practitioners "should be drawn to the matter, and that the Clerk to the Board " would be glad to hear what action the Poplar Board proposed to "take." I reported this letter to the Sanitary Committee, but no resolution was passed to the effect that choleraic diarrhoea should be included among the notifiable diseases. A letter was also received from the Medical Officer of the London County Council, saying that the Council had authorised him to send to Dr. Klein for the purposes of bacteriological examination, material from cases which it is desirable should be thus investigated, and he asked that he might have early information of such cases, and the result of the examination would be communicated back at the earliest possible moment. No case of Asiatic cholera was notified either in Poplar or Bromley. A male adult suffering with choleraic diarrhoea was admitted into St. Bartholomew's Hospital. The patient was taken from a barge at Blackfriars. I first learnt of this case through the daily papers, and telephoned to the hospital for the sufferer's address. I found that he had not been in Poplar for seven days prior to his illness. The patient, I believe, subsequently recovered. A death 76 occurred in Poplar from English cholera, in a female child aged two years; other deaths took place from choleraic diarrhoea in the public institutions in the district, but they were in non-resident patients. The Board's tricycle used by the disinfector was of great use during the cholera scare, as it assisted him materially in making for me speedy enquiries of the Medical practitioners as to the rumour of any suspicious cases. Cholera first appeared on the Continent in April, 1892—its origin could not be traced—at Nanterre; afterwards, it spread to Paris and then to Rouen and Havre. The epidemic which over-ran the greater part of Russia came from Asia, across the Caspian Sea, making its appearance at Baku in June, 1892. Cholera then appeared in Germany, Holland, Belgium and Austro-Hungary. The mortality was as follows :— Russian Empire 269,075 German Empire 8,500 France 4.542 During the winter of 1892 the epidemic dwindled. In the beginning of the year 1893 cases were reported from many parts of the Continent. The disease reached its minimum in May. In the middle of the year it revived again, and every country in Europe was affected except Norway and Sweden. It made its first appearance in England in the Tyne towards the end of June; later on it arrived in the Thames, the Humber and the Mersey. During September and October cases were reported from many towns in England: Grimsby seemed to form the centre of contagion. In London cases were reported, but, upon bacteriological examination, only four turned out to be Asiastic cholera, and all these four cases proved fatal. They all occurred during the month of September, one in each of the following districts—Fulham, Lambeth, Southwark and Westminster; in the last named district the patient was engaged as a sweeper in the House of Commons. As winter advanced the 77 cholera disappeared. The mortality during the year 1893 was low. I think possibly that the reason why cholera obtained no hold in this country was due to the long and continued drought. PORT SANITARY AUTHORITIES NOTIFICATIONS. Pursuant to Article 3 of the Local Government Board's Order, No. 28,924, dated September 6th, 1892, information was received from various Port Sanitary Authorities respecting the place of destination in the Poplar and Bromley parishes of 287 passengers who had been allowed to leave the ships. 236 persons were found to have arrived, and to be in good health, one individual was ill with malarial fever, and the remainder did not arrive. I prepared a circular letter which was sent to the Medical Officers of the respective Port Sanitary Authorities, acquainting them of the non-arrivals, in case mistakes had been made in the addresses notified. Post cards were left at the houses at the time of the visits of the Board's officers, and these cards were to be forwarded to me in the event of any illness occurring in the houses. When the wrong parishes were notified to this district the papers were forwarded on to the proper destination at once. INQUESTS AND DEATHS FROM VIOLENCE. Inquests and Deaths from violence during the last three quarters of the year 1893, were as follow:— Number of Inquests held in the parishes. Deduct Inquests held on nonparishioners. Add Inquests held on parishioners from outlying districts. Total Inquests belonging to each parish. Verdict from Violence. Verdict from Natural Causes. Poplar 146 25 25 146 41 105 Bromley 190 45 18 163 49 114 Totals 336 70 43 309 90 219 For annual rates of deaths from Violence per 1000 persons living, 78 and the percentages of inquest cases to the total deaths—.see tables, page 85. OUTWORKERS. The outworkers have received the attention of Mr. Raymond, who keeps the outworkers' register. At my suggestion a numbered alphabetical street index was made; every day the addresses on the notifications of infectious diseases are compared with this index, in order to find out whether an outworker resides in the house where the complaint exists; by adopting this plan, 4 outworkers in Poplar were found in connection with the notifications, and 22 in Bromley. Mr. Raymond made the necessary enquiries and served notices on the occupiers of the factories or workshops, intimating to them the existence of the disease, in order that they should discontinue the supply of work. SLAUGHTER-HOUSES AND COW-HOUSES. Eleven slaughterhouses and 6 cowhouses in Poplar, 6 slaughterhouses and 11 cowhouses in Bromley, had their licenses renewed. These premises were visited by the Inspectors and myself. I interviewed the Medical Officer of the County Council, and forwarded to him a list of defects found to exist; in no case did I advise the Board to oppose the license. On one occasion, at the request of the Sanitary Committee, I attended a Committee of the County Council in order to support a cowhouse license; the premises had changed hands, and the purchaser had neglected to apply for his license at the proper time. The Council wished to treat his applicacation as one for a new license, but I explained to the Committee of the Council that the cowhouse had existed for years, and it was one of the best in the districts. It was eventually agreed to grant the license after certain repairs were carried out. I am informed that at the next annual Licensing Committee the Council will oppose all licenses, should there not be proper manure receptacles in conformity with their Bye-laws. I trust that in the near future the County Councils throughout 79 the Kingdom will appoint District Veterinary Surgeons who will periodically examine the cows of milksellers, and that if any animal be found affected with tuberculosis, or to be suffering from any other disease, it will be either destroyed or isolated, the owner compensated, and the milk utensils immediately sterilized. Such periodical examinations of cows might, at the least, tend to lessen the dangers of our milk supply, and possibly diminish the prevalence of tubercular diseases. BAKEHOUSES. So far as is known there are 38 bakehouses in Poplar and 48 in Bromley. These premises were visited in the early part of the year by Mr. Raymond, and again at the end of the year, and on this last occasion I accompanied him. Many of these bakehouses are underground; this is an outcome of overcrowding districts with buildings; they have existed for years, and are in a fairly good condition. NUISANCES IN FACTORIES AND WORKSHOPS. I only on one occasion advised the Committee that a summons should be obtained in order to abate a nuisance existing in a workshop; this was in the case of a sack-drying works in Chrisp Street. A general complaint having been made by the surrounding inhabitants, and accompanied by Mr. Raymond, I visited the premises; I also made enquiries at the houses in the immediate neighbourhood, and came to the conclusion that a nuisance existed which was injurious and dangerous to health. A summons was taken out against the firm, but was ultimately withdrawn on their undertaking to discontinue the sack drying, and to pay the costs. Another firm in the same district engaged in a like business discontinued the work without any proceedings being commenced. OFFICIAL INQUIRY re HOUSING OF THE WORKING CLASSES. (Ann Street Area.) On the 23rd June, 1893, an Official Inquiry was held at the Board Room, by an Inspector of the Local Government Board, under 80 Part I. of the Housing of the Working Classes Act, with reference to the insanitary condition of the locality known as the Ann Street Area, the London County Council having taken the initiative. My colleague, Dr. Talbot, was the Medical Officer who was called to give evidence at the said inquiry on behalf of the Board. POLICE COURT PROCEEDINGS. Together with the Inspectors I attended at the Thames Police Court in support of summonses authorised to be taken out under the Public Health (London) Act. Abatement orders were issued in 9 cases in Poplar and 7 in Bromley, and closing orders were made by the Magistrate for 11 houses in Poplar and 1 in Bromley. The nuisances having been abated in four instances in Bromley, the summonses were withdrawn after the costs had been paid. On account of the dangerous condition of the drains at a house in Venue Street, and the non-compliance of the owner with the intimation, the tenant complained to me, and I advised her to apply for a summons under the Public Health (London) Act, section 12. Mr. Miners, the Sanitary Inspector, accompanied the complainant to the Court. A summons was immediately granted and made returnable for the same day, when the Magistrate made an abatement order. I reported this mode of procedure to the Sanitary Committee, who approved of my action, and I asked their permission to be allowed to advise and to help to carry it out in any future urgent cases. No objection was raised on their part, and I have since suggested to several aggrieved tenants to apply to the Magistrate, and the Sanitary Officers would render them every assistance. The closing orders of the houses in Silver Lion Court were cancelled by the Magistrate on my certificate, and I refused to give a like one to the owner of Simpson's Cottages. SANITARY INSPECTORS' WORK. Much very important work has been carried out by the Inspectors. Their reports are appended and they speak for themselves. The Bye- 81 laws of the County Council as well as our own under the Public Health (London) Act have been enforced bv them on behalf of the Board. As a typical example of the aim of the Sanitary Department in causing premises to be placed in a proper sanitary condition those situated in Silver Lion Court might be named. The closing orders of these premises were cancelled after the fore-courts and back yards had been concreted and cemented, gullies trapped, rain water and sink pipes disconnected, damp courses inserted through the whole thickness of the walls, floors of sculleries paved with an impermeable material, the earth under the floor boards removed and replaced by concrete, and under and through ventilation made. A chamber built with an interceptor (fitted with a clearing arm) shutting off the sewer gas, and fresh air inlet and outlet up shaft fixed at the lower and the upper ends of drain respectively. The Inspectors endeavour to cause all drains to be imbedded in concrete, and to be made readily accessible by inspection chambers with gas-tight covers. The water closet pans are recommended to be of the short straight back rim flush hopper type. The drinking water is advised not to be stored but to be drawn direct from the main. INSPECTION OF SCHOOLS. The schools of the districts have been inspected whereby the re-drainage of several has been brought about. In addition to trying to bring about the same sanitary conditions as mentioned in the case of the premises situated in Silver Lion Court, the Sanitary Department also endeavoured to cause all the closets to be well ventilated, the latrines to be cleansed or replaced by glazed earthenware ones, and to be fitted with hinged seats and automatic flushing tanks. The following is the list of the Schools in Poplar and Bromley, so far as is known:— POPLAR. no defects found: Manchester Road Board School. 82 work completed: All Saints Church School, Bow Lane. All Saints Church School, Newby Place. British Street Board School, Millwall. George Green High School, East India Dock Road. Glengall Road Board School. Hale Street Wesleyan. Howrah House, Roman Catholic, East India Dock Road. National Church School, High Street. Ricardo Street Board School. St. John's Church Schools, Millwall. St. Luke's Church School, Millwall. St. Matthias Church School, Grundy Street. St. Saviour's Church School and Mission, Northumberland St. St. Stephen's Church School, North Street. Wade Street Roman Catholic. Woolmore Street Board School. work not completed: St. Edmunds Catholic School, Millwall: work in progress. Orchard House Place Board School: no plan received yet waiting for settlement of question re drainage of the Orchard House District. Upper North Street Board School: work commenced. BROMLEY. no defects found: Bromley High Street Board School. work completed: Bromley National School, Love Lane. Brunswick Road Board School. Byron Street and Bright Street Board School. Campbell Road Private School. Coopers' Company Girls' School, Bow Road. 83 Department of Priory Street Board School, Bruce Road. St. Agnes, Roman Catholic, Devons Road (paving to be done). St. Gabriels Church School, Morris Road. Tomlins Grove Private School. Wesley an Devons Road. work not completed: Alton Street Board School: plans being prepared. Bromley Hall Road Board School: plan submitted. Devons Road Roman Catholic: New building being erected in Bow Common Lane. Marner Street Board School: tenders accepted. Oban Street Board School: additional offices being built and plans approved for the existing building. St. Leonard's Road Board School: plans being prepared. to be inspected: Cawdor Street Private School. Dewberry Street Private School. Glaucus Street Board School. Knapp Road Board School. St. Leonard's Road Private School. HOUSE-TO-HOUSE VISITATION. Should no epidemic of an infectious character occur during the year 1894, so that the Inspectors will not have their inspections at distances from one another as during the year 1893, I have no doubt that house to house inspection will be carried on very extensively. INSPECTION OF FOOD, FISH, MEAT, &c. EXPOSED FOR SALE. Constant inspection was exercised by the Inspectors over articles of food exposed for sale, the fish, meat, fruit and vegetable stalls in Chrisp Street, Devons Road, Bow Common Lane, West Ferry Road, &c., receiving special attention. One seizure of unsound food was made during the 39 weeks. Mr. Dunn discovered in an ice chamber 84 in Chrisp Street, a quantily of rabbits unfit for human food; he seized them, and took the same immediately before the Magistrate for condemnation. A summons was granted, and the Defendant was fined, and had to pay costs. During the excessively hot weather many fishmongers made application to the Sanitary Officers for certificates to the effect that the fish purchased by them at the market was unfit for human food. The fish was examined, and when found unsound, was treated with disinfecting fluid, then sent to the Fish Manure Company, and the desired certificate given. Assuring the Board and the Sanitary Committee of my sincere appreciation of the courtesy I have at all times received at their hands, and of the assistance rendered by the several members of the staff, I beg to remain, Gentlemen, Your obedient servant, FREDERICK WILLIAM ALEXANDER, Diplomate Public Health (England), Medical Officer of Health, South District. December 31 st, 1893. TABLE I. Last Three Quarters of the year 1893. Population estimated to the middle of the Year 1893. Persons to an Acre (1893.) Births. Deaths The Deaths registered include Deaths of Deaths from Inquest Cases. Deaths in Public Institutions. Infants under 1 Year of Age. Persons aged 65 Years and upwards Principal Zymotic Diseases Small- pox. Measles Scarlet Fever. Diphtheria. Whooping Cough. Fever. Diarrhæa. Violence. 33 Great Towns 10,326,040 34.5 242,981 165,579 47,167 — 27,653 576 3,316 2,343 3,493 3,742 2,128 12,055 5,528 0,813 31,391 London 4,306,124 57.6 97,839 67,843 17,259 — 11,052 168 1,344 1,261 2,626 1,799 614 3,240 2,490 5,409 18,221 Poplar 56,634 48.6 1,411 1,000 272 150 154 6 10 35 21 18 12 52 41 126 316 Bromley 71,336 117.3 1,836 1,222 347 147 250 5 18 31 53 30 32 81 49 163 296 TABLE II. Last Three Quarters of the year 1893. Annual Rate per 1000 Persons Living. Deaths under 1 Year to 1000 Births. Annual Death Rate per 1000 living. Percentage to Total Deaths. Births. Deaths from all causes. Deaths from Principal Zymotic Diseases. Small- pox. Measles Scarlet Fever. Diphtheria. Whooping Cough. Fever. Diarrhæa Violence. Aged 1 to 65 Years. Aged 65 Years and upwards Inquest Cases. Deaths in Public Institutions. 33 Great Towns 31.4 21.4 3.58 0.77 0.43 0.30 0.45 0.48 0.27 1.56 0.71 194 — — 6.5 19.0 London 30.3 21.0 3.43 0.05 0.42 0.39 0.81 0.56 0.18 1.01 0.77 176 — — 7.9 26.9 Poplar 33.3 23.6 3.63 0.14 0.23 0.82 0.49 0.42 0.28 1.22 0.96 192 13.65 3.54 12.6 31.6 Bromley 34.4 22.9 4.69 0.09 0.33 0.58 0.99 0.56 0.60 1.51 0.92 189 13.65 2.75 13.3 24.2 86 TABLE III. Classification of Cause of Death (last three quarters of the year 1893). POPLAR. Miasmatic Diseases 102 Influenza 4 Diarrhœal 52 English Cholera 1 Malaria 0 Zoogenous 0 Venereal 2 Septic 16 Parasitic Diseases 3 Privation and Alcoholism 6 Constitutional Diseases 176 Developmental Diseases 76 Diseases of Nervous System 109 Diseases of Organs of Special Sense 4 Diseases of Circulatory System 51 Diseases of Respiratory System 188 Diseases of Digestive System 66 Diseases of Lymphatic System 0 Diseases of Gland-like Organs of Uncertain Use 0 Diseases of Urinary System 21 Diseases of Organs of Generation 2 Accidents of Childbirth 5 Diseases of Bones and Joints 4 Diseases of Integumentary System 4 Accident or Negligence 37 Homicide 1 Suicide 3 Sunstroke 0 Ill-Defined and not Specified Causes 67 Total 1000 37 TABLE IV. BROMLEY. Miasmatic Diseases 152 Influenza 17 Diarrhœal 81 English Cholera 0 Malarial 0 Zoogenous 0 Venereal 4 Septic 11 Parasitic Diseases 0 Privation and Alcoholism 4 Constitutional Diseases 173 Developmental Diseases 63 Diseases of Nervous System 132 Diseases of Organs of Special Sense 3 Diseases of Circulatory System 60 Diseases of Respiratory System 302 Diseases of Digestive System 56 Diseases of Lymphatic System 0 Diseases of Gland-like Organs of Uncertain Use 0 Diseases of Urinary System 18 Diseases of Organs of Generation 3 Accidents of Childbirth 7 Diseases of Bones and Joints 4 Diseases of I ntegumentary System 5 Accident or Negligence 40 Homicide 0 Suicide 7 Sunstroke 2 Ill-Defined and not Specified Causes 78 Total 1222 88 TABLE V. POPLAR. Showing Mortality from certain groups of Diseases, and Proportions to woo of Population, and to 1000 Deaths, during the last three quarters of the year ended joth December, 1893, including deaths in outlying Institutions. Also the number of Deaths of Infants under one year of age from other groups of Diseases and proportions to 1000 Births and to 1000 Deaths from all causes undei one year. Estimated Population 56,634 Deaths from all causes 1000 Division I. (Adults.) Total Deaths. Deaths per 1000 of population. Proportion of deaths to 1000 deaths. 1. Seven principal Zymotic Diseases 154 3.63 154.0 2. Respiratory (other than Phthisis) 188 4.44 188.0 3. Tubercular Diseases 113 2.67 113.0 Division II. (Infants under one year.) Total Deaths. Deaths per 1000 of Births. Deaths per 1000 of total deaths under one year. 4. Wasting Diseases of Infants 72 51.02 264.7 5. Convulsive Diseases of Infants 34 24.09 125.0 NOTE. 1. Includes Small Pox, Measles, Scarlet Fever, Whooping Cough, Fever, Diphtheria, and Diarrhœa. 3. Includes Phthisis, 60; Scrofula and Tuberculosis, 23; Rickets, 4; Tabes, 26. 4. Includes Marasmus, Atrophy and Debility, 57; Want of Breast Milk, 0; and Premature Birth, 15. 5. Includes Hydrocephalus, 1; Infantile, 8; and Tubercular Meningitis, 8; Convulsions, 11; and Teething, 6. 89 TABLE VI . BROMLEY. Showing Mortality from certain groups of Diseases and Proportions to 1000 of Population, and to 1000 Deaths, during the last three quarters of the year ended joth December, 1893. Also the number of Deaths of Infants under one year of age from other groups of Diseases, and Proportions to 1000 Births and to 1000 Deaths from all causes under one year. Estimated Population 71,336 Deaths from all causes 1,222 Division I. (Adults.) Total Deaths. Deaths per 1000 of population. Proportion of deaths to 1000 deaths. 1. Seven principal Zymotic Diseases 250 4.69 204.58 2. Respiratory (other than Phthisis) 302 5.66 247.13 3. Tubercular Diseases 118 2.21 96.56 Division II. (Infants under one year.) Total Deaths. Deaths per 1000 of Births. Deaths per 1000 of total deaths under one year. 4. Wasting Diseases of Infants 97 52.83 279.53 5. Convulsive Diseases of Infants 40 21.78 115.27 NOTE. 1. Includes Small Pox, Measles, Scarlet Fever, Whooping Cough, Fever, Diphtheria, and Diarrhœa. 3. Includes Phthisis, 73; Scrofula and Tuberculosis, 23; Rickets, 2; and Tabes, 20. 4. Includes Marasmus, Atrophy and Debility, 69; Want of Breast Milk, 2; and Premature Birth, 26. 5. Includes Hydrocephalus, 1; Infantile, 8; and Tubercular Meningitis, 0; Convulsions, 27; and Teething, 4. H 90 TABLE VII. POPLAR. List of Deaths of Parishioners which occurred in Public Institutions and certain localities during the last three quarters of the year 1893. Banstead Lunatic Asylum 1 Middlesex Hospital 1 Bethnal House Lunatic Asylum 2 North East Fever Hospital 2 Brompton Hospital 2 Northern Fever Hospital 1 Cane Hill Asylum 2 North West Fever Hospital 1 Caterham Imbecile Asylum 2 Poplar Hospital 1 Children's Hospital, Shadwell 25 Poplar Union Workhouse 47 City of London Chest Hospital 1 Ratcliff Hamlet 1 City of London Infirmary 1 River Thames 3 Colney Hatch Asylum 5 Royal Albert Dock Basin 1 Darenth Imbecile Asylum 7 St. Anns Home 1 East End Mothers' Home 2 St. Bartholomews Hospital 1 German Hospital 2 St. Olaves Infirmary 1 Guys Hospital 1 St. Pelagias Creche 1 Hanwell Lunatic Asylum 2 St. Peters Hospital for Stone 1 Homerton Fever Hospital 8 St. Thomas Hospital 1 Hospital Ship, Atlas 7 Seamens Hospital 2 Leavesden Imbecile Asylum 4 Sick Asylum 117 Limehouse Cut 4 South Eastern Fever Hospital 1 London County Asylum, Claybury 4 316 London Hospital 49 Lunatic Asylum, Friern Barnet 1 TABLE VIII. BROMLEY. List of Deaths of Parishioners which occurred in Public Institutions and certain localities during the last three quarters of the year 1893. Banstead Lunatic Asylum 1 North East Children's Hospital 3 Belgrave Hospital 1 North East Fever Hospital 7 Cane Hill Lunatic Asylum 1 Northern Fever Hospital 1 Charing Cross Hospital 1 North West Fever Hospital 5 Childrens Hospital, Gt. Ormond St. 1 North London Railway 1 Childrens Hospital, Shadwell 14 Poplar Highway 1 City of London Chest Hospital, Victoria Park 8 Poplar Hospital 6 Poplar Union Workhouse 8 Colney Hatch Lunatic Asylum 1 River Lea 3 Darenth Imbecile Asylum 1 River Thames 3 East India Dock 1 St. Bartholomews Hospital 2 German Hospital 1 St. Georges Hospital 1 Guys Hospital 1 St. Thomas Hospital 1 Homerton Fever Hospital 11 St. Georges in the East Infirmary 1 Hospital Ship, Atlas 4 Seamens Hospital 1 Hospital Ship, Castalia 1 Sick Asylum 139 Ilford Lunatic Asylum 2 Stepney Union Workhouse 2 Limehouse Cut 4 Wandsworth Workhouse 2 London Hospital 53 296 London Temperance Hospital 1 Lunatic Asylum, Friern Barnet 1 91 TABLE IX. Table of Deaths during the last three quarters of the year 1893, in the POPLAR Division of the Metropolitan Sanitary District of Poplar, classified according to Diseases, Ages and Localities. Mortality from all Causes at subjoined Ages. Names of Localities adopted for the purpose 0f these Statistics; Public Institutions being shown as separate localities. 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 Poplar 689 244 114 33 30 178 90 Poplar Union Workhouse 74 12 ... ... ... 25 37 Millwall Dock 4 ... ... ... 2 2 ... East India Dock 1 ... ... ... ... 1 ... West India Dock 6 ... ... ... 5 1 ... Limehouses Cut 3 ... ... ... 2 1 ... River Thames 6 ... ... ... 3 3 ... West India Dock Station G. E.R. 1 ... ... ... ... 1 ... Scandinavian Sailors' Home 1 ... ... ... ... 1 ... Totals 785 256 114 33 42 213 127 Deaths occurring outside the Division or District among persons belonging thereto 264 22 29 19 18 141 35 Deaths occurring within the Division or District among persons not belonging thereto 49 6 ... 2 9 20 12 TABLE IX.—continued. Mortality from Subjoined Causes, distinguishing Deaths of Children under Five years of age. Diseases. Poplar. Poplar Union. Millwall Dock. East India Dock. West India Dock. Limehouse Cut. River Thames. West India Dock Station G.E.R. Scandinavian Sailors' Home Totals. Deaths occurring outside division or district, among persons belonging thereto. Deaths occurring within the division or district among persons not belonging thereto un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 5 ... ... Scarlatina 23 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 23 5 3 4 ... ... Diphtheria 9 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9 4 4 2 ... ... Membranous Croup 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... F evers—Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric or Typhoid 3 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 2 ... 7 ... ... Continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal ... 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... ... ... ... Cholera 1* ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1* ... ... ... ... ... Erysipelas 2 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 5 1 2 ... ... Measles 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 ... 4 ... ... ... Whooping Cough 14 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 14 1 3 ... ... ... Diarrhœa and Dysentery 40 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 40 7 3 2 ... ... Rheumatic Fever ... 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 ... ... ... ... Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis 1 33 ... 7 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 40 1 19 ... 1 Bronchitis, Pneumonia & Pleurisy 63 63 1 25 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 64 88 7 36 1 8 Heart Disease 1 25 ... 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 29 2 17 ... 2 Injuries 11 12 ... 3 ... 4 ... 1 ... 6 ... 3 ... 6 ... 1 ... 1 11 37 1 12 ... 20 All other Diseases 182 165 11 23 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 193 188 21 107 5 12 Totals 358 331 12 62 ... 4 ... 1 ... 6 ... 3 ... 6 ... 1 ... 1 370 415 51 213 6 43 * English Cholera. 93 TABLE X. Table of Deaths during the last three quarters oj the year 1893, in the BROMLEY Division of the Metropolitan Sanitary District of Poplar, classified according to Diseases, Ages and Localities. Mortality from all Causes at subjoined Ages. Names of Localities adopted for the purposes if these Statistics; Public Institutions being shown as separate localities. 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 Bromley 920 322 179 50 47 216 106 Sick Asylum 497 35 39 14 24 278 107 Cily of London Infirmary 79 2 1 ... ... 46 30 Stepney Union Workhouse 72 7 ... ... 2 20 43 Poplar Hospital 15 ... 2 4 1 7 1 River Lea 4 ... ... 2 ... 2 ... Limehouse or Lea Cut 6 ... ... 1 2 2 1 North London Railway ] 1 ... ... ... ... ... Totals 1594 367 221 71 76 571 288 Deaths occurring outside the Division or District among persons belonging thereto 1146 13 28 23 17 57 8 Deaths occurring within the Division or District among persons not belonging thereto 518 33 28 10 21 277 149 TABLE X.—continued. Mortality from Subjoined Causes, distinguishing Deaths of Children under Five years of age. Diseases. Bromley Sick Asylum City of London Infirmary Stepney Union Workhouse Poplar Hospital River Lea Limehouse or Lea Cut North London Railway Totals Deaths occurring outside division or district, among persons belonging thereto Deaths occurring within division or district, among persons not belonging thereto un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 Smallpox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 2 ... ... Scarlatina 12 10 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 10 6 3 ... ... Diphtheria 27 8 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 27 8 7 3 ... ... Membranous Croup 6 1 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 6 2 ... ... ... ... Fevers — Typhus, ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... Enteric or Typhoid 1 14 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 15 1 14 ... ... Continued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal ... 1 ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... 3 ... ... ... 2 Cholera ... ... ... ... ... ... ... 2* ... ... ... ... ... ... ... ... ... 2* ... ... ... 2* Erysipelas 1 4 ... 4 ... 2 ... 1 ... ... ... ... ... ... ... ... 1 11 ... ... ... 5 Measles 5 ... 7 ... ... ... ... ... ... ... ... ... ... ... ... ... 12 ... ... ... 6 ... Whooping Cough 26 1 6 ... 1 ... ... ... ... ... ... ... ... ... ... ... 33 1 1 ... 5 ... Diarrhœa and Dysentery 69 8 8 4 ... 1 ... ... ... ... ... ... ... ... ... ... 77 13 1 ... 6 4 Rheumatic Fever ... 6 ... 1 ... 2 ... ... ... ... ... ... ... ... ... ... ... 9 ... ... ... 2 Ague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phthisis 8 35 ... 68 ... 12 ... 12 ... ... ... ... ... ... ... ... 8 127 2 11 ... 75 Bronchitis, Pneumonia & Pleurisy 115 116 17 99 ... 8 ... 7 ... ... ... ... ... ... ... ... 132 230 6 15 11 88 Heart Disease 1 29 ... 43 ... 6 ... 4 ... 1 ... ... ... ... ... ... 2 83 ... 7 1 37 Injuries 9 14 1 10 ... ... ... ... 2 11 ... 4 ... 6 1 ... 13 45 ... 13 1 21 All other Diseases 221 171 35 192 2 44 6 39 ... ... ... ... ... ... ... ... 264 446 14 37 31 221 Totals 501 419 74 423 3 76 7 65 9 13 ... 4 ... 6 1 ... 588 1006 41 105 61 457 * English Cholera. 95 TABLE XI. Table of Population, Births, and of New Cases of Infectious Sickness coming to the knowledge of the Medical Officer of Health, during the last three Quarters of the year 1893, in the Metropolitan Sanitary District of Poplar, (POPLAR) classified according to Diseases, Ages and Localities. (a) Localities. Poplar. Poplar Union Workhouse. Totals. Population at all Ages:— (b) Census 1891 56,317 ... 56,317 (c) Estimated to middle of 1893 56,634 ... 56,634 (d) Registered Births 1,360 51 1,411 New Cases of Infectious Sickness in each Locality coming to the knowledge of the Medical Officer of Health. Diseases. Poplar. Poplar Union Workhouse. Totals. Under 5. Over 5. Under 5. Over 5. Under 5. Over 5. Small Pox 2 31 ... 2 2 33 Scarlatina 180 370 ... 2 180 372 Diphtheria 33 145 ... ... 33 145 Membranous Croup 5 4 ... ... 5 4 Fevers— Enteric or Typhoid 6 60 ... ... 6 60 Continued 2 3 ... ... 2 3 Puerperal ... 5 ... ... ... 5 Erysipelas 16 154 ... 6 16 160 Number of such cases removed from their Homes in the several Localities for Treatment in Isolation Hospital. Diseases. Poplar. Poplar Union Workhouse. Totals. Under 5. Over 5. Under 5. Over 5. Under 5. Over 5. Small Pox 2 22 ... 2 2 24 Scarlatina 25 67 ... 2 25 69 Diphtheria 6 10 ... ... 6 10 Fevers— Enteric or Typhoid ... 12 ... ... ... 12 TABLE XII. Table of Population, Births, and of New Cases of Infectious Sickness coining to the knowledge of the Medical Officer of Health, during the last three Quarters of the year 1893, in the Metropolitan Sanitary District of Poplar (bromley), classified according to Diseases, Ages and Localities. (a) Localities. Bromley. Sick Asylum. City of London Infirmary Stepney Union Workhouse Poplar Hospital. Totals. Population at all Ages— (b) Census 1891 70,002 ... ... ... ... 70,002 (c) Estimated to middle of 1893 71,336 ... ... ... ... 71,336 (d) Registered Births 1,820 4 ... 12 ... 1836 New Cases of Infectious Sickness in each Locality coming to the knowledge of the Medical Officer of Hialth. Diseases. Bromley Sick Asylum City of London Infirmary Stepney Union Workhouse Poplar Hospital Totals. un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 OV. t un. 5 ov 5 Smallpox 19, 84 1 10 ... ... ... 4 ... ... 13 98 Scarlatina 939 521 ... 1 ... 1 ... ... ... 1 239 524 Diphtheria 96 252 ... 1 ... ... ... ... ... ... 96 253 Membranous Croup 14 3 ... ... ... ... ... ... ... ... 14 3 Fevers. Typhus ... 1 ... ... ... ... ... ... ... ... ... 1 Enteric or Typhoid 19 185 ... 3 ... ... ... ... ... ... 19 188 Continued 7 17 ... ... ... ... ... ... ... ... 7 17 Relapsing ... ... ......... ... ... ... ... ... ... ... ... ... Puerperal ... 2 ... ... ... ... ... ... ... ... ... 2 Cholera ... ... ... ... ... ... ... ... ... ... ... ... Erysipelas 14 151 ... 22 ... 5 ... ... ... ... 14 178 Number of such cases removed from their Homes in the several Localities for Treatment in Isolation Hospital. Diseases. Bromley Sick Asylum Stepney Union Workhouse Poplar Hospital. Totals. un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 un. 5 ov. 5 Smallpox 11 65 1 10 ... 4 ... ... 12 79 Scarlatina 43 112 ... 1 ... ... ... 1 43 114 Diphtheria 11 26 ... 1 ... ... ... ... 11 27 Membranous Croup ... ... ... ... ... ... ... ... ... ... ! F evers Typhus ... ... ... ... ... ... ... ... ... ... Enteric or Typhoid 2 36 ... 3 ... ... ... ... 2 39 Continued ... ... ... ... ... ... ... ... ... ... Relapsing ... ... ... ... ... ... ... ... ... ... Puerperal ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... Erysipelas ... ... ... ... ... ... ... ... ... ... 97 Summary of Notices and Improvements carried out at the differen. Manufactories and Workshops in the Poplar and Bromley District, for the year ending December, 1893. Nature of Nuisance. Number of Notices served. Cause of Nuisance. How Remedied. Smoke Nuisance 37 Burning of inferior fuel, and absence of smoke consuming apparatus. A better class of fuel is now used. Smelting Works 2 Fumes from antimony smelting discharged into atmosphere. In each case the works have been cleansed Smoke holes 2 Smoke nuisance from defective smoke holes. The smoke holes have been repaired. Insufficient latrine accommodation in factories and workshops 16 In each case the latrine accommodation was insufficient. Latrines on the most approved principle have been erected. Fish skin drying 3 Nuisance caused by scraping and drying fish skins. In each case the works have been closed. Colour Works 1 Fumes from drying kilns, discharged into the atmosphere. A condensing apparatus has been fitted up. Chemical Works 1 Large escape of sulphurous and nitrous gases from main shaft. Extra condensing apparatus has been fitted. Chaff Cutting 1 Dust from chaff cutting allowed to escape into the atmosphere. The works have been closed for the present. Sack drying 2 Vapours from sack drying allowed to escape into the atmosphere. In each case the works have been closed. Burning refuse 1 Vapours and dust from dust destructor. A set of cells has been fitted with a view to prevent any further escape. 98 Nature of Nuisance. Number of Notices served. Cause of Nuisance. How Remedied. Chemical refuse 1 Refuse from naphthaline stills discharged into sewer. The refuse is now run off into receivers. Oil boiling 1 Large escape of offensive vapour from oil boiling plant. The furnace has been put into thorough repair. Bakehouses 47 The whole of the bakehouses have been inspected twice during the year, and, where necessary, notices have been served for cleansing same. In each case the terms of the notice have been complied with. C. W. RAYMOND, Inspector of Nuisances in Factories and Workshops. 99 BOARD OF WORKS FOR THE POPLAR DISTRICT. Sanitary Department, 31st December, 1893. To the Medical Officer of Health. Poplar and Bromley. Sir, This being my first Annual Report, I have to lay before you a summary of nuisances abated and sanitary improvements carried out under my supervision in the Northern Division of Poplar, since the 8th August last. 656 premises have been inspected, 279 being on account of notifi cations of infectious diseases, 304 in response to complaints of nuisances, the remaining 73 being house-to-house visitation, viz., all the occupied houses in Norfolk Street (9), the whole of Harrow Lane (12), a section of Jeremiah Street (19), and a section of the east side of Bygrove Street (33). Of the above inspections made, sanitary amendments were found to be necessary in 527 instances; this has caused the service of 402 written intimations, and 126 statutory notices, in accordance with the "Public Health (London) Act, 1891." For particulars of works carried out see appended list. In 214 instances, on receipt of notifications from the Port Sanitary Authorities, of passengers proceeding from Continental Ports to destinations in North Poplar, I have inspected the premises given, and in many cases interviewed the passengers; 173 were found to have arrived apparently in good health and free from infection, whilst the remaining 41 were unknown, although I attempted by every means to discover their destinations. All the cow and slaughterhouses were inspected before the time 100 for the renewal of the annua! licenses in October, and found in fair condition. The market places and stalls have been regularly inspected, but only one seizure has been made. On the 18th September, the stock of a shopkeeper in Chrisp Street was examined, and 4 dozen unsound rabbits, discovered in an ice chamber, were seized, immediately taken before the Sitting Magistrate at the Thames Police Court, and ultimately destroyed. At the hearing of the summons on the 22nd September, the defendant was fined £ 3 and 2s. costs. With regard to the house-to-house visitation, both at Norfolk Street and Harrow Lane, the drains were found in a very bad state. In the former case they have been entirely reconstructed. In the latter case an old very defective brick barrel was found running under the kitchens of the houses; steps are being taken for its demolition, and for providing a suitable pipe drain with sufficient means of access and ventilation. The inspection of the Schools had all been made by Inspector Foad, before my appointment, but the works at the Hale Street Wesleyan School have since been completed, and at the Upper North Street Board School the works are in good progress. On account of proposed structural alterations at the Orchard House Board School, the works are in abeyance, but the more serious defects have been remedied. Under the "Sale of Food and Drugs Act," 12 samples have been taken for analysis by the Public Analyst. Legal proceedings were taken in 3 cases, 2 on account of milk adulterated with 20 per cent, of water, and 1 for milk deficient in cream to the extent of 44 per cent. In the two former cases, penalties of 305. and 2s. costs were inflicted, and in the latter 40s. and 2s. costs. In each house where an infectious case has occurred, the premises have been thoroughly inspected with a view of detecting insanitary conditions, the drains tested, and disinfectants supplied. 101 All the works carried out have necessitated continued re-inspection and strict supervision. I beg to remain, Sir, Your obedient Servant, JAMES S. DUNN. Assoc. Brit. Inst, of Pub. Health and of the San. Inst. Sanitary Inspector and Inspector under the Sale of Food and Drugs Act. Poplar North Division. List of Sanitary Works carried out in Poplar North Division, from 8th August to 31st December, 1893. Walls and Ceilings of Premises cleansed throughout 12 Do. do. do. partially 130 Yards, areas, and forecourts, properly paved and drained 113 Drains reconstructed 18 Obstructed drains cleared 67 Existing drains efficiently trapped, or otherwise improved 300 Bath, sink or lavatory wastes, or rain water pipes properly trapped or disconnected from drains 51 New water closets constructed 2 Existing water closets cleansed, repaired, trapped or otherwise improved 84 Water supply to soil pans provided or reinstated 41 Water supply for dietetic purposes altered or improved 72 Water service reinstated 41 Offensive urinals cleansed and improved 2 Roof, gutters, or rainwater pipes repaired 94 Nuisances from inundations abated 13 Dampness remedied 45 Ventilation improved 29 Overcrowding abated 3 Dung, fish, vegetables, or other offensive refuse removed 17 Unsound food destroyed by owners' permission 5 Unburied dead body removed to Mortuary 1 JAMES S. DUNN, Assoc. Brit. Inst. Pub. Health and of the San. Inst. Sanitary Inspector and Inspector under the Sale of Food and Drugs Acts, Poplar North Division. 102 To the Medical Officer of Health for Poplar and Bromley. December 31st, 1893. Sir,— I have to submit my Annual Report of the Sanitary Work executed under my supervision from the 25th March to 31st December, 1893. For the first three months my work consisted entirely of house-tohouse and school inspection in the North and South Divisions of Poplar. On the 27th June I was appointed Sanitary Inspector, No. 1 District, South Division of Poplar, comprising the whole of the Isle of Dogs. From that date I have taken over the duties imposed by the various Acts of Parliament and Order of the Local Government Board. The streets and schools inspected for the year are as follows :— The whole of Bedford Street Sections of East Ferry Road. ,, „ Shirbutt Street „ West Ferry „ „ „ Chapel House Street „ Manchester ,, ,, „ Pier Street „ Woodstock „ „ ,, Launch Street „ Hind Street. ,, „ South Dock Cottages „ Rigden , ,, „ Marsh House ,, „ Alton „ „ „ Northumberland „ „ Tetley , ,, „ Totnes „ „ Ellesmere „ „ „ Devonshire Terrace ,, Cordelia „ „ „ Goodliffe Place „ Stewart „ „ „ Deptford Ferry Road „ Samuda „ „ „ Wharf Road „ Seyssell „ „ Marshfield „ Wells , „ Newcastle „ 103 Schools. Board Schools. Denominational Schools. Glengall Road Board School. St. Saviour's. British Street „ „ St. Stephen's. Cubitt Town „ „ St. Matthias. Wool more Street „ „ All Saints, Bow Lane. Ricardo Street „ „ All Saints, Newby Place. Upper North Street „ „ St. Luke's. Orchard House Place „ „ St. John's. St. Edmund's. Wade Street. Hale Street. Boys National. High-Class Schools. Howrah House Convent School, East India Road. George Green School „ „ Since my appointment, 357 complaints of nuisances and 355 notifications of infectious diseases have been received and dealt with, according to your direction. In 31 instances, on receipt of notifications from the Port Sanitary Authorities of persons proceeding from cholera infected Continental ports to destinations in my district, I have visited the addresses given, and with the exception of 4 cases (where the persons named were not known and could not be found), all had been medically examined previously, and were pronounced free from infection. Out of the 1490 total inspections made, 255 premises were found to be in fair condition; 83 per cent. required various works of sanitary improvement; 219 drains were proved defective and not gas tight by the Board's smoke drain-test, and in 166 instances the test revealed no defects The whole of the schools inspected (with the exception of Cubitt Town Board School, practically a new school with modern sanitary appliances) required various and in some cases extensive works of sanitary amendment. The work required at the 104 Upper North Street Board School has been referred to, and is progressing under the supervision of Mr. Dunn, Sanitary Inspector for Poplar North Division. The nature of the works executed, sanitary improvements made, nuisances abated, &c., during the year, are shewn in the lists appended. Result of Inspections from 25th March to date of appointment, No. I District. Drains reconstructed, repaired or amended 77 Inlets to drains trapped with suitable stoneware traps 106 Sink waste pipes properly disconnected from drain 96 Rain-water pipes do. do. do. 108 W. C. soil pans furnished with suitable sufficient water supplies 74 Do. do. renewed, cleansed or trapped 60 Water-closets repaired and cleansed 58 Do. do. ventilated 3 Ventilation of rooms improved 7 Yards, areas, forecourts, washhouses paved and drained 125 Internal surfaces of premises repaired and cleansed throughout 22 Do. do. do. partially 73 Water service to premises improved 7 Drinking-water cisterns cleansed and covered or draw taps from main provided 108 Defective water fittings,burst pipes, &c., repaired 13 Dampness remedied 16 Roofs, rain-water pipes and gutters repaired 73 Basement room used separately as a dwelling discontinued 2 Nuisances from improper keeping of animals abated 4 Various nuisances from offensive accumulations, dilapidations, &c., abated 69 Result of School Inspections. Drains reconstructed, repaired or amended 13 Inlets trapped with suitable stoneware traps 53 Cesspools abolished 1 Sink, lavatory, and other water pipes disconnected from drain so as to discharge in open air over suitable stoneware gullies 11 Rain-water pipes do. do. 59 105 Foul, improperly flushed, trough closets replaced by stoneware latrines, and furnished with automatic flush tanks 14 Do. do. troughs enamelled, trapped, and water flush improved 6 Foul pan-closet apparatus replaced by improved pans and traps, furnished with suitable water flush 6 Defective soil pipes repaired 2 Exhaust drain ventilating shaft heightened 1 Draw taps from main provided 12 Filters abolished 5 Watercloset ventilation improved 17 Additional waterclosets provided 5 Foul urinals repaired and cleansed 3 Defective paving repaired 2 Internal surfaces of rooms, passages, &c., cleansed 2 Result of Inspections since appointment to South Division of Poplar. Drains reconstructed, repaired, cleansed and amended 327 Inlets trapped with suitable stoneware traps 271 Soil pipes repaired 2 Sink waste pipes disconnected from drain 106 Rain water pipes do. do. 117 W.C. soil pans furnished with suitable water supplies 143 Do. renewed, cleansed or trapped 173 Yards, forecourts, areas, washhouses, &c., paved and drained 229 Roofs, rain-water pipes or gutters repaired 248 Defective water service fittings, burst pipes, &c., repaired 11 Water supplies to premises improved 9 Drinking water cisterns repaired and cleansed, or draw taps from main provided. 85 Waterclosets repaired and ventilated 9 Do. rebuilt 7 Foul public house urinals repaired and cleansed 4 Overcrowding abated 3 Underground room occupied separately as a dwelling (cellar dwelling) 1 Dead body removed to Board's Mortuary 1 Internal surfaces of premises cleansed and repaired throughout 79 Do. do. do. partially 178 Various nuisances from improper keeping of animals, dilapidations, floodings, &c 118 I 106 In addition to the above, dampness has been remedied at 1 to 8, Totnes Terrace, i to u, Shirbutt Street, 7 to 11, Barqtie Street, 196 to 206, West Ferry Road, 74 to 80, Glengall Road, 8, Newcastle Street, 77, Stebondale Street, and 1 to 7, Brig Street, by the insertion of damp-proof courses, concreting ground area, providing and ventilating suitable air space beneath ground floors. The drain systems of the following premises have been intercepted, ventilated and made accessible by the provision of clearing arms and channelled, and hermetically sealed chambers. 1 to 7, Griffin's Cottages, and 3 to 6, Chapel House Street. 15, Newcastle Street. Newcastle Arms, P.H. Wade Street Schools. St. Edmund's „ Hale Street „ Hanbury Buildings (in this case a 50-gallon automatic flush tank has been connected with head of drain to increase flow). 485, 487, Manchester Road. 383, 385, 387, West Ferry Road. 68 to 74, Manchester Road. 246 to 252 „ „ 284 ,, ,, 374 to 378 „ „ 354, 356 ,, ,, 1 to 8, Totnes Terrace. 2 to 8, Cromwell Terrace. 17 to 25, Chipka Street. 131, East Ferry Road. 1 to 7, Pier Street. 9 to 11 ,, ,, In accordance with the provisions of the Public Health (London) Act, 1891, the above works of sanitary improvement necessitated the service of 959 written intimations, 315 statutory notices; 20 107 summonses were applied for at the Thames Police Court; 11 premises were closed by Magistrate's order as unfit for human habitation; 9 abatement orders were made, requiring the execution of the work specified on the Board's notices within seven days, with costs and penalties in the Board's favour. By the direction of the Board's Analyst, Mr. Young, I have procured 24 samples of food and drugs for analysis; 7 were certified to be so adulterated, that legal proceedings were ordered by the Clerk to the Board. Summonses were taken out against the respective vendors, and fines (varying from 4s. to £3 3s.) inflicted in each case. Six notices of intention to apply for renewal of slaughter-house and cow-house licenses have been received from my district. The premises were forthwith inspected and various works executed on the service of the Board's notice. The food stores of the district have been regularly inspected with a view of detecting diseased and unwholesome food, but no seizures were necessary nor made since my appointment. I am, Sir, Your obedient Servant, CEPHAS FOAD. Assoc. of the San. Inst. Sanitary Inspector and Inspector under Sale of Food and Drugs Acts. No. 1 District, Poplar Board of Works. To the Medical Officer of Health for Poplar and Bromley. December 31st, 1893. Sir,— I beg to submit for your information the following statement of sanitary work carried out in my district (Bromley North Division), since my appointment, from June 28th to December 31st, 1893. 108 1096 houses and other premises have been inspected: the results have been entered in the Information and Complaint Book. Sanitary improvements were found to be necessary in 926 instances; the particulars were reported monthly to the Sanitary Committee, and notices specifying the nature of the complaints, causes of nuisance and sanitary requirements served upon the owners or occupiers of the premises complained of, with the following results:— Houses or other premises inspected 1096 Walls and ceilings cleansed throughout 39 Do. do. partially 257 Drains opened and cleansed 131 Inlets to drains properly trapped 235 Defective drains repaired 384 Sink waste pipes properly disconnected from drains 103 Rain water pipes do. do. 112 Roofs made watertight 74 Gutters or rain water pipes repaired 104 Water laid on to soil pans of W.C.'s 141 New soil pans provided 81 Foul soil pans cleansed 81 Soil pans trapped 6 Water supplies reinstated to houses 27 Water service for domestic purposes Water service altered or improved Defective water fittings 32 Yards, forecourts and areas paved 246 Basement ventilation improved 14 Accumulation of dung and refuse removed 24 Other nuisances remedied 105 Drains tested by the application of the smoke drain test 697 W.C.'s insufficiently ventilated 11 Foul public house urinals 11 Overcrowding 3 Slaughter houses inspected 4 Cow houses do. 7 Number of samples obtained for analysis 24 Police Court proceedings in respect of adulteration 2 109 I have also made a house-to-house inspection of the undermentioned streets — Eastward Street 35 houses. Hawgood Street 22 ,, Box Street 35 „ Furze Street 19 ,, Gale Street 41 „ Perring Street 28 „ Sections of Whitethorn Street 33 „ I have also inspected the undermentioned Schools:— Bruce Road. St. Agnes Roman Catholic, Devon Road. Wtsleyan Schools, Devons Road. Marner Street Board School. Bromley National Schools, St. Leonard Street. Private School, 104, Campbell Road. „ „ 19, Tomlin Grove. In each of the above Schools intimations and notices were served and complied with. By the directions of Mr. Young, the Public Analyst, I have obtained 24 samples of food and drugs for analysis. Legal proceedings were instituted against 2 of the respective vendors, and on these two cases convictions were obtained, the penalties inflicted by the Magistrate were ,£4 and £3, with 2s. costs in each case. The markets, stalls, &c., have also been regularly inspected throughout the year, but in no instance was anything exposed for sale, at the time of my visit, in such a condition as to justify seizure. I have also made periodical inspections throughout the year of the cow and slaughterhouses in my district. The Licensed Slaughterhouses number 4 The Licensed Cowhouses „ 7 110 Summonses were also granted at the Thames Police Court, in November, against the owners of 14, Weston Street, 288, Devons Road, 310, Devons Road, 5 and 7, Norris Road, 1, 2, 3, 4 and 5, Hawgood Street, and orders made to carry out the requirements of the Board in each case, with costs against the owners. In the case of No. 1, Hawgood Street, a closing order was obtained. I am, Sir, Your obedient Servant, FREDK. J. ANTHONY Assoc. San. Inst. Sanitary Inspector, and Inspector under Sale of Food and Drugs Acts. Bromley North Division. December 31 st, 1893. To the Medical Officer of Health, Poplar and Bromley. Sir,— I beg to lay statement of sanitary works carried out in No. 2 district (April 1st to June 27th), and further report of works in South Bromley Division, commencing June 28th up to December 31st, 1893. Total number of inspections made, 1503, which were as follows Fair condition ... ... ... ... 212 House-to-houseDuff's Fields 14 Goodliffe Street 14 Clutton Street 14 - ... 83 Section, St. Leonard's Road 10 Chadbourn Street 25 Inspections made on Complaints ... ... 742 Inspections made on notifications of Infectious Diseases 678 111 In connection with the above, 1500 intimations and statutory notices were served, and in 3 cases it was found necessary to have recourse to legal proceedings, necessitating 4 attendances at the Thames Police Court. As directed, inspections were made of the following schools:— (1) Bromley Hall Road Board School. (2) Marner Street Board Schools. (3) Wesleyan Day and Sunday Schools. (4) Oban Street Board Schools. (5) St. Gabriels Day and Sunday Schools. (6) Alton Street Board Schools. (7) St. Leonards Road Board Schools. (8) Roman Catholic Day Schools and Mission, Devons Road. (9) Byron Street Board School. (10) Bright Street Board School. In the case of the Brunswick Road Board Schools, the work being unsatisfactorily proceeded with, and in pursuance of the Board's order the statutory notice was served. For description of sanitary defects, see report to Medical Officer Bow Division. Schools Nos. (1), (2), (3), (4), (5), (6) and (7)— The drains were tested, proved defective: inlets, untrapped or otherwise foul and offensive. Schools (1), (3), (4), (5), (6) and (7)— The drains were not properly ventilated; (3) and (5) were entirely without intercepting traps to cut off sewer gas, and access chambers for cleansing purposes. The access chambers in cases of (4) and (7) were improperly connected with chimney flues of caretaker's residences by means of 6-in. pipe branches for ventilating purposes. 112 Schools (i), (2), (4), (6) and (7)— Latrines, iron troughs, were in a foul and offensive condition, more particularly in cases (1) and (2). The seats were nearly all fixed, consequently the troughs were not easily accessible for cleansing purposes. The boys' latrine (1) school, the drains were proved untrapped. Schools (1). (2). (3), (4) and (5)— Closets—Teachers and scholars were not furnished with proper soil pans, water supplies and apparatus. The drains and soil pipes proved defective, and not ventilated in connection with same. School (4)— Slop closets, waste pipes connected with soil pipes, untrapped in connection with pan and without means of ventilation, (1) waste pipes not trapped nor ventilated. Schools (x), (2), (4), (5) and (6)— Sinks and lavatories-The waste pipes were not all trapped, disconnected or furnished with proper means of ventilation. Schools (1), (2) and (4)— Urinals—The drains and waste pipes were proved defective and untrapped. Schools (1), (2), (3), (5), (6) and (7)— The rain-water pipes were not all disconnected from drains and made to discharge in the open over gully drain inlets. The drains in connection with 10 (dwarf) down pipes in case (5) were choked and defective. School (8)— The closet accommodation was insufficient, yards badly paved, surface drain inlet imperfectly trapped. 113 Schools (3) and (4)— Water supply was drawn direct from Company's main. In cases (1), (2)> (5), (6), (7), (8), (9) and (10) the drinking water was drawn from storage cisterns and filters. The overflow pipe in storage cistern in caretaker's residence at the Alton Street Board School was connected direct with drains. I have further to report progress of sanitary works in connection with schools. Bromley Hall Road Board Schools.—Urgent nuisances abated, plans submitted to Board. Water supply now drawn direct from Company's main. Oban Street Board School.—Urgent nuisances abated, plans submitted to Board. Water supply drawn direct from Company's main. Additional closet accommodation provided. Alton Street Board School.—Urgent nuisances abated, plans submitted to Board. Water supply now drawn direct from Company's main. St. Leonards Road Board School. — Urgent nuisances abated, plans submitted to Board. Water supply now drawn direct from Company's main. Byron Street Board Schools. Bright Street Board School.—Water supplies now drawn direct from Company's main. Sanitary condition of these schools very fair; drains tested, negative results. St. Gabriels Church Schools.—Works completed. Water supply drawn direct from Company's main for drinking purposes. Brunswick Road Board Schools.—Works completed. Water supply drawn direct from Company's main. 114 On the appointment of Mr. F. J. Anthony, June 27th, 1893, for the North Bromley Division— Marner Street Board Schools, Roman Catholic Day Schools and Mission, Wesleyan Day and Sunday Schools were under his jurisdiction, and he will report on same. By the direction of Mr. Young, the Public Analyst, I have obtained 59 samples of food, &c., for analysis. Legal proceedings were instituted in one case against the vendor, who was fined £3 and 2s. costs. Table of Sanitary Defects. Walls and ceilings of houses cleansed throughout 50 Do. do. do. partially 209 Walls and ceilings of wash-houses and closets cleansed 90 Houses furnished with means of under-floor ventilation 38 Houses—means of ventilation improved 5 Drains reconstructed where old and defective 150 Drain inlets effectually trapped 150 Drains freed from obstruction 50 Drains furnished with intercepting traps for effectually cutting off sewer gas, access chambers with suitable iron covers and frames for cleansing purposes and fitted with fresh air inlets and ventilation upshaft pipes 30 Soil pans cleansed, reinstated where defective or unsuitable, and drains in connection with same trapped 80 Soil pans water supplies provided or reinstated 168 Soil pipes in connection with first floor closets reinstated 5 Soil pipe ventilated in accordance with L.C.C. bye-laws 5 Closet apparatus reinstated with suitable soil pans and traps 5 Water supplies reinstated where cut off through defective pipes, fittings, or other causes 40 Water supply fittings defective (causing nuisance from dampness) amended 63 Water supplies improved where insufficient 7 Water supplies for domestic purposes altered or improved 207 Water supply storage cistern waste pipes disconnected from drains, or flushing pipes in connection with soil pans 10 115 Bath, sink, or lavatory waste pipes repaired, trapped, or disconnected from drains 156 Rainwater pipes reinstated or disconnected from drains 148 Yards or areas paved 50 Stables paved 4 Washhouses paved 60 Yards and areas, means of drainage (20) provided to carry off surface water (7) 27 Roofs repaired or made watertight 134 Guttering repaired or reinstated 20 Dung and other offensive accumulations removed 20 Proper receptacles for dung provided 2 Dead body removed to Board's Mortuary 1 Stagnant water nuisances abated 3 Other nuisances abated consisting principally of structural dilapidations 50 Licensed Cow Houses under inspection 4 Licensed Slaughter Houses under inspection 2 The drain smoke test has been applied in 773 instances. In 481 cases defects were discovered. The market places have been regularly inspected throughout the three quarters ending December 31st, 1893, but in no instance was any articles of food exposed for sale at the time of my visits, in such a condition as to justify seizure. I am, Sir, Your obedient Servant, RICHARD E. MINERS, Assoc. San. Inst. Sanitary Inspector and Inspector under the Sale of Food and Drugs Acts. South Bromley Division. DR. CORNER'S VITAL STATISTICS FOR THE First Quarter of the Year ending April 1st, iSgj. 119 Quarter ending ist April, 1893. TABLE I. Males. Females. Total. Births— 248 269 517 TABLE II. Deaths— 133 99 232 Outlying Institutions 89 321 Deduct Non-Residents 25 Total Deaths 296 Excess of Births over Deaths 216 Birth Rate per 1,000 36.6 Death Rate per 1,000 20.9 TABLE III. Causes of Death Registered in the Parish of Poplar during the Quarter ending 1st April, 1893. Diseases. Deaths. Diseases. Deaths. Deduct Aliens. First Quarter Deduct Aliens. First Quartet Influenza ... 2 Other Bowel Diseases ... 2 Measles ... 2 Diseases of Liver ... 3 Scarlet Fever ... 4 Bright's Disease ... 2 Diphtheria ... 8 Diseases of Kidneys ... 4 Whooping Cough ... 6 Premature Birth ... 6 Typhoid Fever ... 1 Old Age ... 4 Puerperal Fever ... 1 Atrophy and Debility ... 13 Diarrhœa ... 2 Fractures and Contusions 2 6 Cancer ... 6 Burns and Scalds ... 1 Tabes Mesenterica ... 4 Poison (Lead) ... 1 Phthisis 1 25 Delirium Tremens ... 1 Hydrocephalus ... 2 Dropsy ... 1 Apoplexy ... 6 Child Birth ... 1 Paralysis ... 2 Drowning 10 11 Convulsions ... 8 Suffocation ... 3 Diseases of Heart l 11 Other Brain Diseases ... 4 Bronchitis 2 47 Total 25 232 Pneumonia 6 30 Other Lung Diseases 3 2 120 TABLE IV. Number of Deaths from all causes registered in the Parish of All Saints, Poplar, with Localities where such deaths occurred, also number of Deaths in Outlying Institutions, with Localities from which the persons dying in such Institutions were removed, for Quarter ending 1st April, 1893. Localities. Number of Houses. Deaths in Poplar. Deaths in outlying Institutions. Localities Number of Houses. Deaths in Poplar. Deaths in outlying Institutions. Alpha Road 75 2 1 High Street 326 4 1 Arcadia Street 5 3 2 Hind Street 113 2 ... Augusta Street 117 4 1 Havannah Street 47 3 ... Ashton Street 52 1 1 Hill Place Street 26 1 ... Bath Street 49 ... 1 Harrow Lane 12 1 ... Brunswick Pier ... ... 1 Hutchings Street ... 1 1 Bygrove Street 98 1 2 Janet Street 26 1 ... Brunswick Street 72 4 ... Kerbey Street 89 3 3 Billson Street 32 i ... King Street 16 1 1 Brig Street 12 1 ... Lindale Street ... 1 ... Byng Street 10 2 ... Langton Street 19 1 1 Cuba Street ... 4 ... Lead Street 16 1 ... Chilcot Street 37 1 ... Latham Street 23 1 1 Canton Street. 113 4 ... Malabar Street 61 2 ... Cotton Street 71 1 1 Morant Street 70 2 ... Cottage Street 61 1 ... Manchester Road 415 11 3 Cotall Street 32 ... 1 Manisty Street ... 6 4 Crews Street 22 1 ... Mellish Street 86 3 1 Charles Terrace 35 1 ... Maria Street 33 2 ... Claude Street 25 ... 1 Market Street 41 ... 1 Cahir Street 20 1 ... Manilla Street 62 ... 1 Docks and Wharves ... 15 ... Marshfield Street 43 ... 1 Duff Street 22 1 ... Newcastle Street 9 3 ... Dingle Lane 7 ... 1 Northumberland Street 71 2 2 East Ferry Road 130 1 ... North Street 23 3 1 East India Road 189 5 1 Naval Row 24 1 ... Ellerthorpe Street 36 1 ... Norfolk Street 12 1 ... Ellesmere Street 17 ... 2 Newby Place 18 1 ... Ferry Street 15 2 ... Orchard House 30 1 1 Gough Street 110 2 ... Pigott Street 11 1 ... Grundy Street 126 1 ... Prestage Street 38 3 ... Glengall Road 101 2 1 Pekin Street 95 2 1 Gaverick Street 27 2 ... Plevna Street 17 2 1 Giraud Street 68 1 1 Pennyfields 75 4 ... Galbraith Street 45 2 2 Park Street 70 ... ... Garford Street 42 2 ... Prestons Road 51 1 ... Gaselee Street 59 1 1 Phoebe Street 30 5 1 Hospitals (on way to) ... 2 ... Rook Street 45 1 ... Hale Street 29 1 2 Robin Hood Lane 57 1 ... 121 TABLE IV.—continued. Localities. Number of Houses Deaths in Poplar. Deaths in outlying Institutions. Localities. Number of Houses. Deaths in Poplar. Deaths in outlying Institutions. Ricardo Street 36 1 ... Stevens Acre 14 ... 1 Rigden Street 8 ... 1 Stainsby Road 43 3 ... Stewart's Terrace 28 1 ... Samuda Street 29 ... 2 Suffolk Street 91 3 3 Ship Street 12 1 ... Sabbarton Street 52 2 1 Tobago Street 13 1 ... Stebondale Street 156 1 ... Tooke Street 49 2 ... Shipwright Terrace 12 ... 1 Union Workhouse ... 31 18 Southill Street 50 1 2 Union Street 19 1 ... Sophia Street 41 5 2 Wade Street 46 1 1 Susannah Street 40 3 ... West Ferry Road 354 9 3 Strafford Street 43 1 ... Woolmore Street 51 4 ... Shirbutt Street 14 1 1 West India Road 21 1 ... Sussex Street 106 3 ... Yabsley Street 6 1 ... Strattondale Street 43 1 ... ... 232 89 Seyssell Street 39 1 ... Total Deaths ... TABLE V. List of Deaths occurring in outlying Institutions during the Quatter ending \st April, 1893. Bromley Sick Asylum 52 North Eastern Hospital 2 London Hospital 6 Middlesex ,, 1 Children's ,, 10 King's College „ 1 Homerton ,, 3 Caterham Asylum 1 Poplar ,, 1 Darenth „ 2 St. Bartholomew's Hospital 1 Bethnal House,, 2 Colney Hatch ,, 3 Seamen's ,, 2 Total 89 Leavesden Asylum 2 TABLE VI. List of Aliens for the Quarter ending 1st April, 1893. Bromley 7 Hockley, Essex 1 Bow 4 Biscay, Spain 1 Unknown 3 Limehouse 1 Shadwell 1 Holborn 1 Canning Town 1 Pimlico 1 Deptford 1 St. George's-in the-East 1 Victoria Dock 1 Newcastle 1 Total 25 122 TABLE VII. Deaths at particular ages for the Quarter ending 1st April, 1893 Deaths in Poplar. Deaths in outlying Institutions. Under 1 year 43 7 From 1 and under 5 years 27 9 ,, 5 „ 10 7 4 „ 10 „ 15 3 3 ,, 15 „ 20 4 4 ,, 20 „ 30 13 4 „ 30 „ 40 14 9 ,, 40 ,, 50 24 15 ,, 50 ,, 60 28 14 „ 60 „ 70 30 12 „ 70 „ 80 26 6 ,, 80 and upwards 13 2 Total 232 89 Deaths in Poplar Union Workhouse during the quarter, 31. Number of Inquests held, 52. TABLE VIII. Notifications received during Quarter ending 1st April, 1893. Disease. Orchard House. Isle of Dogs. Remainder of Poplar. Total. e. Side. W.Side. Scarlet Fever 2 8 11 54 75 Typhoid or Enteric — 1 6 7 14 Erysipelas 1 12 6 8 27 Diphtheria - 1 2 8 11 Puerperal Fever — — 1 2 3 Membranous Croup — 2 - 4 6 Small Pox 14 14 Totals 3 24 26 97 150 123 TABLE IX. Deaths from Infectious Diseases under Notification Act during the Quarter ending 1st April, 1893. Disease. Orchard House. Isle of Dogs. Remainder of Poplar. Total. East. West. Scarlet Fever - 1 - 3 4 Typhoid or Enteric Fever - - - 1 1 Erysipelas — — — — — Diphtheria — — — 1 1 Puerperal Fever — — 2 — 2 Membranous Croup — 1 — 3 4 Small Pox — — — — — Totals - 2 2 8 12 TABLE X. Causes of Death of Persons removed from the Parish of Poplar and dying in Outlying Institutions during the quarter ending 1st April, 1893. Scarlet Fever 4 Hernia 1 Diarrhoea 3 Atrophy and Debility 2 Inflammation of Stomach 1 Childbirth 2 Inflammation of Bowels 1 Epilepsy 1 Bright's Disease 1 Diseases of Heart 1 Diseases of Kidneys 3 Diseases of Liver 9 Cancer 7 Old Age 3 Fractures and Contusions 1 Burns and Scalds 1 Phthisis 12 Acute Hydrocephalus 2 Bronchitis 9 Disease of Joints 2 Pneumonia 10 Other Diseases 4 Other Lung Diseases 3 Paralysis 6 Total 89 Insanity 1 124 TABLE XI. INFECTIOUS DISEASES NOTIFICATION ACT, 1889. Parish of All Saints', Poplar. Result of Inspection of Premises during Quarter ending 1st April, 1893. Diseases. No. of Premises Notified. Premises in good Sanitary condition. Premises with certain insanitary defects. Nature of Insanitary Defects. Total Defects. Walls and Ceilings dirty, dilapidated or unwholesome. Drinking waterimproperly stored or insufficient. Defective or untrapped Drains. Water Closets in bad order without water, &c. Waste pipes connected with drain or untrapped. Scarlet Fever 70 44 22 16 3 4 3 3 29 Typhoid Fever 13 8 5 3 — 3 1 1 8 Diphtheria 14 11 2 — — 3 — 2 5 Membranous Croup 5 — 5 3 — 2 — — 5 Puerperal Fever 1 — 1 1 — — — 1 2 Simple Continued Fever 1 — 1 1 — — — 1 2 Erysipelas 32 22 5 5 — 1 2 2 10 Small Pox 11 8 3 2 1 — 2 1 6 Total 147 93 44 31 4 13 8 11 67 N.B.—The number of Notifications of above-named Diseases during the three months were 179, shewing that in many instances two or more cases were notified from the same house. 125 Board of Works for the Poplar District. ANALYST'S REPORTS, During the Year ending 25th March, 1894. 26 th June, 1893. To the Chairman and Members of the Board of Works for the Poplar District. Gentlemen, I beg to report that during the quarter ended 24th June I have had submitted to me, by your Sanitary Inspectors, 72 samples. This number comprises the following articles, viz. : — Milk 36 Coffee 6 Butter 6 Cocoa 6 Bread 6 Pepper 6 Flour 6 Of the milks, 24 were genuine, 3 deficient in cream to the extent of 28, 28 and 68 per cent. respectively, and 9 adulterated with water in amounts ranging from 6 to 33 per cent. Of the butters, 2 were genuine and 2 adulterated with 65 and 93 per cent. of foreign fat respectively. The breads and flours were all genuine. Of the coffees, 5 were genuine and 1 adulterated with 67 per cent. of chicory. Of the cocoas, 5 were genuine and 1 adulterated with 70 per cent. of a mixture of sago and sugar. L 126 The peppers were all genuine. The particulars of the work done in the several Parishes are shewn in the following tables. Bow— Analysed. Adulterated. Milk 10 5 Bread 2 0 Flour 2 0 Coffee 2 1 Cocoa 2 0 Butter 2 1 Pepper 2 0 22 7 Bromley— Milk 14 2 Bread 2 0 Flour 2 0 Coffee 2 0 Butter 2 0 Cocoa 2 1 Pepper 2 0 26 3 Poplar— Milk 12 5 Bread 2 0 Flour 2 0 Coffee 2 0 Butter 2 1 Cocoa 2 0 Pepper 2 0 24 6 I have the honour to be, Gentlemen, Your obedient Servant, W. C. YOUNG, F.I.C., &c. 127 30th September, 1893. To the Members of the Board of Works for the Poplar District. Mr. Chairman and Gentlemen, I beg to report that during the last quarter I analysed 72 samples, all of which were purchased and submitted to me by your Sanitary Inspectors. This number includes the following articles, viz., 48 milks, 12 butters and 12 breads. Of the milks, 39 were genuine and mostly of excellent quality, 8 were adulterated with water, the amount found being 6, 7, 10, 18, 19, 21, 29 and 29 per cent. respectively and 1 deficient in cream to the extent of 84 per cent. Of the butters, 11 were genuine and 1 adulterated with 57 per cent. of foreign fat. The breads were all unadulterated. Details of the work done in the several parishes are shewn in the following tables. Bow— Analysed. Adulterated. Milk 16 2 Butter 4 1 Bread 4 0 24 3 Bromley— Milk 24 2 Butter 6 0 Bread 6 0 36 2 128 Poplar— Analysed. Adulterated. Milk 8 5 Butter 2 0 Bread 2 0 12 5 I have the honour to be, Gentlemen, Your obedient Servant, W. C. YOUNG, F.I.C., &c. 1st January, 1894. To the Members of the Board of Works for the Poplar District. Mr. Chairman and Gentlemen, I have to report that during the quarter ending December last, your Sanitary Inspectors have submitted to me 72 samples for analysis, comprising the following articles, viz. :— Milk 36 Condensed Milk 12 Gin 12 Whisky 12 Of the milks, 28 were genuine, 6 adulterated with water in the proportion of 9, 10, 14, 20, 20, and 39 per cent. respectively, 1 deficient in cream to the extent of 44 per cent., and 1 adulterated with 9 per cent. of water and also deficient in cream to the extent of 30 per cent. The condensed milks contained nothing but milk and sugar, and the condensation effected amounted to from one-third to one-fourth of the original bulk. In the printed directions for use on the labels of the various samples it was stated that for ordinary purposes the article was to be diluted with 4 to 5 parts of water. This would seem to imply that the samples were condensed to one-fifth or one-sixth of the original bulk, and the purchaser would no doubt expect that by mixing 4 or 129 5 parts of water with the condensed milk the original milk would be reproduced, plus the sugar added. My analysis showed me that this was not the case in any one of the samples, the highest degree of condensation indicated being to onefourth. It would be much to the interest of the consumers of this article if the manufacturers were compelled to state explicitly upon the tins the degree of condensation effected. Of the gins, 7 were genuine and 5 deficient in spirit to the extent of 1, 2.8, 2.9, 4 and 10.3 degrees under proof respectively. Of the whiskies, 9 were genuine and 3 deficient in spirit to the extent of 2.2, 47 and 10.9 degrees under proof respectively. The following Tables show the details of the work done in the several Parishes :— Bow— Analysed. Adulterated. Milk 12 2 Condensed Milk 4 0 Spirits 8 2 24 4 Bromley— Milk 12 2 Condensed Milk 4 0 Spirits 8 2 24 4 Poplar— Milk 12 4 Condensed Milk 4 0 Spirits 8 4 I have the honour to be, Gentlemen, Your obedient servant, W. C. YOUNG, F.I.C., &c. 130 31st March, 1804. To the Members of the Board of Works for the Poplar District. Mr. Chairman and Gentlemen, I beg to report that during the last quarter I have analysed 72 samples, all of which were purchased and submitted to me by your Sanitary Inspector. This number includes the following articles, viz. :— Milks 36 Butters 12 Breads 12 Flours 12 Of the milks, 26 were genuine and 10 adulterated by water, the amount found being 5, 5, 7, 7, 11, 19, 19, 20, 23 and 29 per cent. respectively. Of the butters, 5 were genuine and 7 adulterated with foreign fat to the extent of 47, 48, 52, 57, 60, 85, and 87 per cent. respectively. The Breads and the flours were unadulterated. Particulars of the work done in the several Parishes are shown in the following Table :— Bow— Analysed. Adulterated. Milk 12 1 Butter 4 3 Bread 4 0 Flour 4 0 24 4 Bromley— Milk 12 3 Butter 4 3 Bread 4 0 Flour 4 0 24 6 131 Poplar— Analysed. Adulterated. Milk 12 6 Butter 4 1 Bread 4 0 Flour 4 0 24 7 I have further to report that during the year just completed, the total number of samples analysed has been 288, and of these 59 or 20.5 per cent. were found to be adulterated. This result shows an increase in adulteration as compared with last year, and is the highest recorded for many years. I have the honour to be, Gentlemen, Your obedient Servant, W. C. YOUNG, F.I.C., &c. 132 NAMES AND ADDRESSES of the MEMBERS AND OFFICERS of the Board of Works for the Popular District, 1894-95. J. A. MAIN, Esq., J. I., Chairman. PARISH OF POPLAR. Ballard, George, 48, West Ferry Road 1896 Beck, Thomas, Prestons Road 1896 Bowkett, Thomas E., 145, East India Dock Road 1895 Bussey, John, 213, East India Dock Road 1897 Cahill, Joseph Z., Isle House, Cold Harbour 1895 Carpenter, John C., 2, Grundy Street 1896 Clarkson, William, 146, High Street 1897 Hodge, William Rundell, Union Iron Works, West Ferry Road 1896 Jones, Claude J., 76, East India Dock Road 1896 Kidd, Frederick B, 56, Stebondale Street 1897 Kimbel, Samuel, 130, East India Dock Road 1895 King, James, 41, Canton Street 1895 McCarthy, Thomas, 19, Cotton Street 1897 Morton, James, Naval Row 1896 Muggleton, Charles W., 176, High Street 1895 Newman, Robert, 67, East India Dock Road 1897 Ozanne, Charles John, I, Oriental Street. 1895 Randall, Charles George, 109, Upper North Street 1895 Riddall, John Chables, 154, High Street 1896 Rundell, Joshua, 52, High Street 1896 Skelly, William, 16, Brunswick Street 1897 Stephens, John, Cuba Street 1895 Wakefield, Charles, Orchard Place 1897 Webb, Francis Henry, 39, Stainsby Road 1897 133 PARISH OF BOW. Booth, Isaac James, 16, Addington Road 1896 Box, James Bromley, 26, Tredegar Road 1896 Bramham. William, 115, Bow Road 1897 Christie, William, 30, Addington Road 1895 Dalton, Mark, 520, Old Ford Road 1897 Elkington, John, 12, Ford Street 1897 Forbes, Henry Bracey, 28, Addington Road 1896 Good, Edward, 125, Bow Road 1896 Hills, Walter Augustus, 149, Bow Road 1895 Holman, George Edward, 109, Bow Road 1897 Howard, James Henry, 145, Bow Road 1895 Maguire, Thomas, 269, Roman Road 1897 Main, John Arthur, 48, Tredegar Road 1895 Malins, Alfred George, 112, White Post Lane 1895 Warburton, William, 77, Tredegar Road 1896 PARISH OF BROMLEY. Abrahams, Morris, 56, Bow Road 1896 Bird, Alfred S., 4, Powis Road 1895 Butler, Thomas W, 83A, Teviot Street 1897 Collier, John, 120, Bow Road 1895 Custard, William Bartley, 323, East India Dock Road 1896 Dore, James B., 44 Mornington Road 1897 Evans, James, 20, Bow Road 1897 Hambridge, Edward, 103, Campbell Road 1896 Hayns, Edwin C., 85, Devons Road 1897 Ives, George Devons Road 1896 Johnson, Ben, 56, Devons Road 1895 March, James, 138, Chrisp Street 1895 Martin, George, 49, St. Leonards Street 1896 McCarthy, Jerome, 21, St. Leonards Avenue 1897 Searle, George, 134, Bow Road 1897 Selby, Charles, 31, Campbell Road 1896 Smith, James, 9, Devons Road 1895 Toole, Richard, 26, High Street 1897 Warman, John T., 4, Brunswick Road 1896 Warn, George, 69, Brunswick Road 1895 Webb, Henry, 140, Campbell Road 1895 The dates affixed to the Names denote the year when the respective persons retire by effluxion of time. 134 Officers. Clerk to the Board WILLIAM HENRY FARNFIELD. Assistant Clerk and Controller—LEONARD POTTS. Medical Officers of Health :— Bow Division RUSSELL MAIN TALBOT, 155, Bow Road. Poplar and Bromley Divisions FREDERICK WILLIAM ALEXANDER, 11, Wellington Road, Bromley. Analyst WILLIAM CHARLES YOUNG. Surveyor GEORGE FREDERICK HOLT. Assistant Surveyor EDWARD STONHAM CHATTERTON. Clerk in the Surveyor's Department WALTER L. BLACK. Assistant ,, ,, DANIEL R. BOLT. Inspector of Canal Boats and Nuisances in Factories :— CLARENCE WILLIAM RAYMOND. Sanitary Inspectors— Poplar North Division JAMES STEPHEN DUNN. ,, South Division CEPHAS FOAD. Bromley North Division FREDERICK JOSEPH ANTHONY. South Division RICHARD EUSTACE MINERS, Bow East Division HUGH DANIEL RUGG. „ West Division WILLIAM BOYCE. Clerk of IVorks, Poplar, ROBERT GREIG. „ Bow and Bromley—BENJAMIN ROGERS. Clerk for General Purposes JOHN M. WARD. Sanitary Clerk PARIS SMITH. Junior Sanitary Clerk WILLIAM M. RAYMOND. Collector of Apportionments—JOHN KEMP COLEMAN. Messenger and Hall Keeper—THOMAS B. FOLKES. offices—117, HIGH STREET, POPLAR, E. Hours 9 to 4. Saturdays 9 to 2.