POP 2 Board of Works for the Poplar District. REPORT on The Sanitary Condition of the Parishes of POPLAR and BROMLEY within the Poplar District with Vital Statistics, by FREDK. WM. ALEXANDER, Diplomate in Public Health, Medical Officer. YEAR ENDING DECEMBER 31st, 1894. POP2 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 of the Board of Works for the Poplar District. Gentlemen, I have the honour to present to you my second Annual Report for the Parishes of Poplar and Bromley, this report being for the year 1894. Tables of Vital Statistics form a large part of all health reports : they no doubt are uninteresting to the casual reader, but to the statistician and for the sake of reference they are of great value. During the year the work of the Sanitary Department has gone steadily on, in order that the District might be thoroughly inspected thioughout. The bye-laws of the London County Council, as well as those of the Board of Works for the Poplar District, have been enforced A 2 with much benefit and comfort to the public health. The work of the Sanitary department had increased to such an extent, that in the early part of the year an additional appointment was made by the election of Mr. W. Raymond, as Assistant Sanitary Clerk. There has also been afforded increased office accommodation, so as to relieve the over-crowded condition of the rooms devoted to the Sanitary officers. In my report to the Committee on June 28th, I pointed out, that if the number of inspections as carried out by the Inspectors be maintained, it would take three years to complete the inspection of the District. I suggested to the Committee, that, should this space of time not meet with their approval, additional Inspectors be appointed. There was no resolution passed to the effect that the Committee was not satisfied with the amount of work executed. Many important structural alterations have taken place in the District for the good of the public health. The houses in Duffs Fields have been demolished, and those on the east side of Robinhood Lane have been pulled down, to give space for the gradient to the new Blackwall Tunnel, the boring of which under the Thames is rapidly nearing completion; several houses have been demolished at the eastern extremity of the East India Dock Road, to afford room for the new street made by the County Council, leading from the southern end of the Abbott Road behind Lea Place. New model buildings have been erected by the London County Council on land facing the river Thames, and the occupied portion of Arnold's Buildings (67 tenements) has been closed by a Magistrate's order. The Local Government Board have decided that the area known as the Ann Street area is an insanitary one, the official inquiry it will be remembered having been held in June 1893. A sewer connected with the main drainage system has been laid down in the Orchard House District, to prevent the sewage of that region being discharged into the rivers Lea and Thames. The County Council, at the Abbey Mills Station, have erected two new pop2 3 pumps with triple expansion cylinders, to assist their existing beam pumps, and also to pump the sewage of the new sewer which they are laying down in order to relieve the main low level sewer. This new sewer will take the Isle of Dogs and Hackney Wick branches in St. Leonard's Street, and will tend to minimise the risk of flooding of the districts drained by these branches. I reported to the Sanitary Committee the insanitary condition of the ditch which begins at the Thames in the Deptford Ferry Road, and after a winding course empties itself into the sewer near the Glengall Road end of Stebondale Street. This ditch is in the most part of its course uncovered, and receives not only the drainings from the mounds formed of the dredgings from the Millwall Docks, but also is used as a general receptacle for dead animals and vegetable garbage. I suggested abolishing the ditch by keeping the penstock shut down, and thus preventing the water flowing in from the river. The Committee inspected the ditch and agreed with me that it was in a most insanitary state. The County Council's portion was cleansed, and in order to prevent the escape of gas in the vicinity of the houses, a trap was fixed to the mouth of the sewer where the ditch empties itself. I also inspected the mounds mentioned above during the hot weather, but failed to find any nuisance arising from them ; no doubt the compressed air method adopted for blowing the dredgings on to the mound, causes aeration and lessens the danger of putrefaction. Poplar being a riparian district, the condition of its river is of the highest sanitary importance to its inhabitants. The purity of the Thames water has continued to improve. At the instigation of the Chairman of the Drainage Committee of the County Council, a test was carried out, which consisted in trawling the river with a small net off Erith. It was reported that there were captured in the net specimens of Whitebait, Jelly-fish and Shrimp. It will also be remembered that in the House of Commons, in April last, a question 4 was asked of the Secretary of State for War, whether the Chief Engineer of the Works Department at Woolwich Arsenal had on several occasions lately found the tubes of his condensers choked with whitebait, and whether he would cause an endeavour to be made to prevent fish from being so sacrificed and the machinery from being blocked. Mr. Campbell-Bannerman replied, that these facts were true, and that measures were being taken to prevent any such occurrence in future. This improved condition in the Thames is due to the satisfactory measures which of late years have been adopted in the treatment and disposal of the sewage at the Barking and Crossness outfalls. On June 5th it was reported to the County Council, that the condition of the river Thames continued to be in every way satisfactory. The analysis of the samples collected at high and low water off the outfalls, show, "that although the quantity of sea water present is steadily increasing, and therefore the downward movement of sewage matter proportionately decreasing, still the aeration is high and the evidence of pollution low." On June 12th a sturgeon was caught in the Thames, weighing 280 lbs. Dace, clean living fish, were found at Greenwich and Westminster Bridge. The Chairman of the County Council, in his annual review of work done and progress made in 1893-94, stated, that the offensive black mud banks had disappeared arid given place to clean shores, consisting of gravel, clay or river mud; he also stated that 2,102,000 tons of sludge had been sent to sea. I have no doubt that the Thames would quickly regain its name of "silvery" if the West Ham sewage ceased to be discharged into the Lea and Thames—but was pumped into the northern outfall—and increased sewer accommodation for the Metropolis were afforded by the London County Council, so as to obviate the necessity for the numerous storm outlets, and if all other great sources of pollution were prevented.* *Mr. Dibdin, the Chemist to the London County Council, in his report to the Main Drainage Committee, 27th September, 1894, on the Results of the examination 5 DISINFECTING DEPARTMENT. A Washington Lyon Disinfecting Apparatus has been supplied, and is at the Board's depot, waiting to be fixed in the building, which at the present time is being erected on those premises. Two closed vans have also been procured, one to fetch infected articles, and the other to return them home. Each van is drawn by a horse, and takes the place of the old iron vehicle dragged along by men. Until the new premises are completed the best possible use is being made of the present disinfecting oven in Bickmore Street, and one of the new vans is used, its interior being disinfected every time before taking the disinfected articles home. Space and accommodation at the existing apparatus will not allow both van; being used. The following figures give the number of premises disinfected, and the number of times the Board's oven was used lor the two parishes, some thousands of articles being baked. Private Premises. Board's Oven. Poplar 471 393 Bromley 634 612 Total 1105 1005 Disinfectants are still supplied on the orders of the Inspectors, and a record kept of their distribution. of the character of the Water of the River Thames, states:—"Of The 516 tons of oxygen required to oxidize the matters in solution in the area of maximum impurity, only about 52 tons are required by the London effluent, so that it is evident that the multitudinous other sources of pollution, such as sewage outfalls, docks, factories, floating population, flotsam and jetsam, &c., are very largely responsible for the total impurities present in the river." 7 TABLE 1. (A)Table of Deaths during the year 1894., in the POPLAR Division 0f the Metropolitan Sanitary District of Poplar, classified according to Diseases, Ages and Localtties. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. Mortality from all Causes. at subjoined ages. Mortality from subjoined causes, distinguishing deaths of children under five Years of Age. At all Ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia & Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Ty phus. Enteric, or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i) i 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Poplar 798 270 145 32 34 222 95 Under 5 ... 2 11 2 ... 2 ... ... ... ... 4 55 14 15 ... 1 64 ... 16 229 415 5 upwds. ... 5 5 ... ... 1 ... ... ... ... 2 1 ... 2 4 ... 62 70 40 16 167 383 Poplar Union Workhouse 57 8 1 ... 3 18 27 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 1 5 9 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 8 3 ... 32 48 Highway (Poplar) 1 ... ... ... ... 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 Limehousc Canal 1 ... ... ... ... 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 North London Railway 1 ... ... ... ... 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 River Thames 21 ... ... ... 8 13 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... .. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 20 ... 21 River Lea 2 ... ... ... 1 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 Millwall Dock 10 ... ... ... 1 9 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 9 ... 10 South-West India Dock 2 ... ... ... ... 1 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 2 East India Dock 3 ... ... ... ... 3 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 2 ... 3 West India Dock 3 ... ... ... ... 3 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... .... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 3 Totals 899 278 146 32 47 273 123 Under 5 ... 2 11 2 ... 2 ... ... ... ... 4 55 14 15 ... ... 1 67 ... 17 234 424 5 upwds. ... 5 5 ... ... 1 ... ... 2 ... 2 1 2 4 ... 68 85 44 55 201 475 The subjoined numbers have also been taken into account in judging of the morality of this Division of the Sanitary District. Deaths occurring outside the Division or District among persons belonging thereto. 292 18 33 12 11 152 66 Under 5 1 5 3 ... ... ... ... ... ... ... ... 2 2 1 ... ... ... 10 ... 4 23 51 5 upwds. ... ... 1 1 ... 7 ... ... ... ... ... ... ... 2 1 ... 31 37 20 29 120 241 Deaths occurring within the Division or District among persons not belonging thereto. 76 0 ... ... 13 42 15 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 1 3 6 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 8 4 36 18 70 6 8 9 TABLE II. (A) Table of Deaths during the year 1894, in the BROMLEY Division of the Metropolitan Sanitary District of Poplar, classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; public institutions being shown as separate localities. Mortality from all Causes, at subjoined ages. Mortality from subjoined Causes, distinguishing Deaths of Children under Five Years of Age. At all Ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia & Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Typhus. Enteric, or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i') 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Bromley 1000 355 228 50 29 239 99 Under 5 ... 8 14 1 ... ... ... ... .. ... 3 81 30 25 ... ... 1 122 3 16 279 583 5 upuds ... 3 3 ... ... 5 1 3 ... ... 7 ... 3 4 ... 65 99 48 16 160 417 Sick Asylum 601 38 43 10 25 343 142 Under 5 ... ... ... ... ... ... ... ... ... ... ... 14 4 ... ... ... ... 16 ... ... 47 81 5 upwds. ... ... ... ... ... 1 ... ... ... ... 1 1 3 ... ... 115 101 72 10 216 520 City of London Infirmary 106 6 7 ... 1 52 40 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1? 13 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 16 9 9 1 58 93 Stepney Union Workhouse 93 4 1 ... ... 31 57 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 5 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 13 12 1 59 88 Poplar Hospital 43 2 11 3 3 19 5 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 10 2 13 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 25 4 30 River Lea 4 ... ... 1 1 2 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... 4 Limehouse Canal 1 ... ... 1 ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 Police Station 1 . ... ... ... 1 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 Total 1849 405 290 65 59 687 343 Under 5 ... 8 14 1 ... ... ... ... ... ... 3 95 34 26 ... ... 1 139 3 26 345 395 5 upwds. ... 3 3 ... ... 6 1 ... 3 ... 1 8 ... 6 4 ... 200 222 142 58 197 1154 The subjoined numbers have also been taken into account in judging of the mortality of this Division of the Sanitary District. Deaths occurring outside the Division or District among persons belonging thereto. 182 19 41 30 14 60 18 Under 5 1 6 14 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 13 ... 2 23 60 5 upwds 3 5 9 ... 7 ... ... ... ... ... ... ... ... 1 ... 9 10 15 18 45 122 Deaths occurring within the Division or Distric among persons not belonging thereto. 687 37 46 9 25 365 205 Under 5 ... ... 1 ... ... ... ... ... ... ... ... 8 2 1 ... ... ... 13 7 51 83 5 upwds. ... ... ... ... 1 ... ... ... ... 1 ... ... 2 ... ... 109 93 82 36 280 604 TABLE III. The year 1894. The Deaths registered include Population estimated to the middle of the Year 1893- Persons to an Acre (1894.) Births. Deaths Deaths of Principal Zymotic Diseases Smallpox. Measles Scarlet Fever. Deaths from Fever. Diarrhoea. Violence. Inquest Cases. Deaths in Public Institutions. Infants under Year of Age. Persons aged 65 Years and upwards Diphtheria. Whooping Cough. 33 Great Towns 10,458,442 34.9 320,497 189,007 48,863 — 25,417 454 6552 2179 3982 5030 1997 5223 7123 13,862 38,912 London 4,349,166 58.2 130,553 77,051 18,733 — 11,549 93 3292 964 2673 2094 653 1780 3146 6663 22,129 Poplar 57,226 49.1 1907 1115 290 174 141 2 58 12 23 16 10 20 59 174 285 Bromley 72,026 118.4 2540 1344 387 156 236 4 95 23 40 32 14 29 61 189 300 TABLE IV. The year 1894. Annual Rate per 1000 Persons Living. Deaths under Year to 1000 Births. Annual Death Rate per 1000 living. Percentage to Total Deaths. Births. Deaths from all causes. Deaths from Principal Zymotic Diseases. Smallpox. Measles Scarlet Fever. Diphtheria. Whooping Cough. Fever. Diarrhoea Violence. Aged to 65 Years. Aged 65 Years and upwards Inquest Cases. Deaths in Public Institutions. 33 Great Towns 30.7 18.1 2.43 0.04 0.62 0.21 0.38 0.48 0.19 0.50 0.68 152 — — 7.3 20.6 London 30.1 17.7 2.66 0.02 0.76 0.22 0.61 0.48 0.15 0.41 0.72 143 — — 8.6 28.8 Poplar 33.3 19.4 2.28 0.03 1.00 0.20 0.40 0.27 0.17 0.34 1.03 152 11.37 3.04 15.6 25.5 Bromley 35.2 18.6 3.29 0.05 1.31 0.30 0.55 0.44 0.19 0.40 0.84 152 11.12 2.16 14.0 22.3 11 TABLE V. POPLAR. 1st Quarters. 4th Total. 2nd 3rd Miasmatic Diseases 33 27 28 33 121 Influenza 4 1 1 1 7 Diarrhlœl 5 1 10 4 20 Malarial 0 0 0 0 0 Zoogenous 0 0 0 0 0 Venereal 2 0 1 1 4 Septic 2 2 3 1 8 Parasitic Diseases 0 2 0 1 3 Privation and Alcoholism 0 1 1 6 8 Constitutional Diseases 59 47 48 57 211 Developmental Diseases 27 27 27 35 116 Diseases of Nervous System 29 26 33 23 111 Diseases of Organs of Special Sense 1 1 0 0 2 Diseases of Circulatory System IS 14 20 17 66 Diseases of Respiratory System 75 41 29 49 194 Diseases of Digestive System 16 13 18 17 64 Diseases of Lymphatic System 0 0 0 0 0 Diseases of Gland like Organs of Uncertain Use 0 0 0 0 0 Diseases of Urinary System 5 6 5 12 28 Diseases of Organs of Generation 1 0 0 2 3 Accidents of Childbirth 2 0 2 0 4 Diseases of Bones and Joints 2 0 1 1 4 Diseases of Integumentary System 2 1 0 0 3 Accident or Negligence 19 12 9 12 52 Homicide 0 0 0 0 0 Suicide 0 1 2 4 7 Ill-Defined and not Specified Causes 25 23 17 14 79 Total 324 246 255 290 1115 I 2 TABLE VI. BROMLEY. 1St. Quarters. 4th. Total. 2nd. 3rd. Miasmatic Diseases 66 72 43 26 207 Influenza 4 1 1 1 7 Diarrhœal 2 2 21 4 29 Malarial 0 0 0 0 0 Zoogenous 0 0 0 0 0 Venereal 0 2 1 1 4 Septic 2 1 2 2 7 Parasitic Diseases 0 0 0 0 0 Privation and Alcoholism 0 0 1 0 1 Constitutional Diseases 45 46 49 53 193 Developmental Diseases 22 10 17 23 81 Diseases of Nervous Sytem 36 30 36 33 135 Diseases of Organs of Special Sense 0 2 0 0 2 Diseases of Circulatory System 30 16 23 17 86 Diseases of Respiratory System 107 68 47 81 303 Diseases of Digestive System 17 17 32 12 78 Diseases of Lymphatic System 1 0 0 1 2 Diseases of Gland-like Organs of Uncertain Use 0 0 0 0 0 Diseases of Urinary System 4 7 6 6 23 Diseases of Organs of Generation 3 1 2 0 6 Accidents of Childbirth 1 1 1 2 5 Diseases of Bones and Joints 0 3 4 0 7 Diseases of Integumentary System 1 1 1 1 4 Accident or Negligence 16 13 13 9 61 Homicide 0 0 0 0 0 Suicide 1 4 3 2 10 Ill-Defined and not Specified Causes 21 26 37 19 103 Total 379 332 340 293 1314 13 TABLE VII. POPLAR. Showing Mortality from certain groups of Diseases, and Proportions to 1000 of Population, and to 1000 Deaths, during the year ended 29th December, 1894, excluding non-Parishioners an I 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 under one year. Estimated Population 57,226 Deaths from all causes 1115 Division I. (Adults.) Total Deaths. Deaths per 1000 of population. Proportion of deaths to iooo deaths. 1. Seven principal Zymotic Diseases 141 2.28 126.4 2. Respiratory (other than Phthisis) 194 3.39 173.9 3. Tubercular Diseases 146 2.55 130.9 Division II. (Infants under one year.) Total Deaths. Deaths per 1000 of Births. (Births 1907) Deaths per 1000 of total deaths under one year. (290) 4. Wasting Diseases of Infants 105 55.06 362.0 5. Convulsive Diseases of Infants 30 15.73 103.4 NOTE. 1. Includes Small Pox, Measles, Scarlet Fever, Whooping Cough, Fever Diphtheria, and Diarrhoea. 3. Includes Phthisis, 96; Scrofula and Tuberculosis, 29; Rickets, 2; Tabes, 19. 4. Includes Marasmus, Atrophy and Debility, 62; Want of Breast Milk, 2; and Premature Birth, 41. 5. Includes Hydrocephalus, 1; Infantile, 5; and Tubercular Meningitis, 5; Convulsions, 15; and Teething, 4. 14 TABLE VIII. BROMLEY. Showing Mortality from certain groups of Diseases and Proportions to 1000 of Population, and to 1000 Deaths, during the year ended 29th December, 1894, excluding non-Parishioners, and 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 under one year. Estimated Population 72,026 Deaths from all causes 1,344 Division I. (Adults.) Total Deaths. Deaths per 1000 of population. Proportion of deaths to 1000 deaths. 1. Seven principal Zymotic Diseases 236 3.29 175.5 2. Respiratory (other than Phthisis) 303 4.20 225.4 3. Tubercular Diseases 139 1.92 103.4 Division II. (Infants under one year.) Total Deaths. Deaths per 1000 of Births. (Births 2540) Deaths per 1000 of total deaths under one year. (387) 4. Wasting Diseases of Infants 121 47.60 312.6 5. Convulsive Diseases of Infants 58 22.83 149.8 NOTE. 1. Includes Small Pox, Measles, Scarlet Fever, Whooping Cough, Fever, Diphtheria, and Diarrhoea. 3. Includes Phthisis, 101; Scrofula and Tuberculosis, 25; Rickets, 4; and Tabes, 9. 4. Includes Marasmus, Atrophy and Debility, 80; Want of Breast Milk, 1; and Premature Birth, 40. 5. Includes Hydrocephalus, 0; Infantile, 10; and Tubercular Meningitis, 3; Convulsions, 35 ; and Teething, 10. 15 TABLE IX. POPLAR. List of Deaths of Parishioners which occurred in Public Institutions and certain Localities during the year 1894. Banstead Asylum 1 Hospital for Women, Euston Bethnal House Asylum 5 Road 1 Brompton Hospital 1 Ilford Asylum 8 Caterham Asylum 1 King's College Hospital 1 Cane Hill Asylum 2 Leavesden Asylum 9 Childrens' Hospital, Shadwell 9 Limehouse Cut 1 Childrens' Hospital, Great Ormond Street 1 London Hospital Middlesex Hospital 26 1 City of London Throat and Ear North West Fever Hospital 1 Hospital 1 Poplar Hospital 12 City of London Chest Hospital 1 River Thames 6 Darenth Asylum 5 Sick Asylum 134 Dock, East India I Stepney Union 1 Dock, Millwall 1 St. Bartholomew's Hospital 5 German Hospital 1 St. Thomas' Hospital 1 Grove Hall Asylum 3 Union Workhouse 20 Guys Hospital ] University Hospital 1 Harwell Asylum 2 Whitechapel Infirmary 1 Homerton Fever Hospital 14 Hospital Ship "Atlas" 2 281 TABLE X. BROMLEY. List of Deaths of Parishioners which occurred in Public Institutions and certain Localities during the year 1894. Bethnal House Asylum 1 Limehouse Cut 1 Brompton Hospital 1 Licensed Victuallers' Asylum, Peckham 1 Cane Hill Asylum 1 Children's Hospital, Shadwell 26 London Hospital 42 Charing Cross Hospital 1 Metropolitan Hospital 1 Cheyne House Asylum 1 Mile End Infirmary 1 City of London Chest Hospital 1 North West Fever Hospital 10 Colney Hatch Asylum 3 Police Station 1 Darenth Imbecile Asylum Poplar Hospital 7 South West India Dock 1 River Lea 5 Friedenheim 1 River Thames 5 Grove House Home 1 Sick Asylum 121 Guy's Hospital 1 St. Bartholomew's Hospital 1 Hanwell Asylum 1 Stepney Union 3 llomerton Fever Hospital 26 St. Joseph's Home 1 Hospital Ship "Atlas" 3 Union Workhouse 21 Hospital Ship "Castalia" 2 Ilford Asylum 4 300 Leavesden Asylum 2 16 VITAL STATISTICS. I estimate to the middle of the year 1894 the populations of the parishes as follows:—Poplar, 57,226, being 49.1 persons to an acre, and Bromley 72,026, being 118.4 persons to an acre. I have also estimated the populations to the middle of the year 1894 of each of the four divisions of my district, by means of the enumerated populations at the Census of 1891 of the various Ecclesiastical parishes into which Bromley is split, and the Wards for rating purposes into which Poplar is divided. I find South Poplar, or that portion of the parish south of the northern bridges of the West India Dock, almost corresponds, so far as the population is concerned, with the South Ward, which is now divided into two. The East and West Wards constitute North Poplar. The two Ecclesiastical parishes of St. Mary, and All Hallows, Bow Common Lane, which are situated practically north of the Limehouse Canal, form North Bromley, and the three which lie south of the Canal namely, the Ecclesiastical parishes of St. Gabriel, St Michael and All Angels, and All Hallows, East India Dock Road, constitute South Bromley. The estimated populations being as follows :— Poplar—North—36,747 Bromley—North—33,439 South—20,479 South—38,587 ——— Total 57,226 Total 72,026 By finding the estimated populations of these sub-districts, I have been able to work out the rates of the Diphtheria and Typhoid Fever cases occurring in them. At the last Census there were 7844 houses in Poplar, and 9332 in Bromley, giving with the present enumerated populations an average of about 7.3 persons per house in Poplar, and about 7.7 in Bromley; 17 dividing these figures into the estimated populations of the respective sub-districts, will give approximately the number of houses in each sub-district under the charge of a Sanitary Inspector Houses. Houses. Poplar— North—5036 Bromley—North—4332 South—2808 South—5000 Total 7844 Total 9332 It is stated that no Sanitary Inspector should be responsible for more than 2500 houses, in order no doubt that he might inspect the whole of them once every year. The numbers stated by me will account for the information in my report to the Committee on June 28th—see page 2 of this Report—that it would take three years to inspect the whole of the houses in the district.* The births during the 52 weeks were:— Males. Females. Totals. Poplar 949 958 1907 Bromley 1313 1227 2540 Totals 2262 2185 4447 * In a report prepared by the Medical Officer of the London County Council, 10th December, 1894, it appears that each Inspector in the Poplar District is credited with 3140 houses. Dr. Shirley Murphy does not include the uninhabited houses, which numbered for the whole district (three parishes) 1017, at the last Census. I have brought into consideration these premises, as they would also come from time to time under the supervision of the Inspector. Dr. Murphy has evidently considered the Inspector of Nuisances in factories as an Inspector of houses—this is not the case. He has also averaged his figures, and has not dealt with the three parishes separately, or else he would have found that Bow has two Inspectors for 5823 houses. I have given the Poplar and Bromley figures, therefore 3140 houses under each Sanitary Inspector in the Poplar District is incorrect. B 18 Of these births, 83 were illegitimate in Poplar, 34 males and 49 females. In Bromley there were 44 illegitimate births, 18 males and 26 females. The annual birth rate per 1000 living being 33.3 for Poplar, and 35.2 for Bromley. During the year the marriages of 1790 persons were registered in Poplar and Bromley, giving an annual rate of 13.8 per 1000 of the estimated population, the rate for England and Wales being 15.0, and for London 17.0. In the 52 weeks 899 deaths were registered in Poplar, and 1849 in Bromley; from the 899 deaths which took place in Poplar there must be deducted 76 deaths of non-residents, and to the remainder must be added 292 deaths which occurred in outlying institutions, making a total of 1115 deaths of Poplar parishioners. Treating the 1849 registered deaths in Bromley in the same manner, viz.:— deducting 687 deaths of non-parishioners, and adding 182 deaths in outlying institutions, the deaths belonging to this parish will be found to be 1344. Males. Females. Totals. Poplar 540 575 1115 Bromley 716 628 1344 Totals 1256 1203 2459 The annual death rate per 1000 living being 19.4 for Poplar, and i8-6 for Bromley. The births exceeded the deaths as follows:— Males. Females. Total gain. Poplar 409 383 792 Bromley 597 599 1196 Totals 1006 982 1988 The male deaths in the two parishes exceeded those of the female by 53, and the male births exceeded those of the female by 77. 19 INFANTILE MORTALITY. The number of deaths under one year of age was 290 in Poplar, and 387 in Bromley, giving death rates per 1000 births, which I have compared with other Eastern districts and London, as follows:— Deaths all Deaths under Ages per 1000 one year living. per 1000 births. Poplar 19.4 152 Bromley 18.6 152 Shoreditch 19.9 160 Bethnal Green 20.4 151 Whitechapel 21.4 154 St. George-in-the-East 26.4 185 Limehouse 24.7 174 Mile End Old Town 21.1 156 London 17.7 143 The infantile death rate for the two parishes is the same, exceeding the London rate by 9, and of all the Eastern districts is the lowest except that of Bethnal Green. In the month of August a letter was received from H. M. Superintending Inspector of Workshops stating —By Sec. 17, of the Factory and Workshop Act, 1891:—"An occupier of a factory or workshop shall not knowingly allow a woman to be employed therein within four weeks after she has given birth to a child." The communication went on to state that it was proposed to extend this period from one to three months, and to establish creches. I was requested to forward statistics as to the infantile mortality in my district, which I complied with by sending a copy of my annual report for 1893 (39 weeks), and when the rates were :— 33 Great Towns 194 Inner London 176 Poplar 192 Bromley 189 20 21 TABLE XI. (b)table of Population Births, and of New Cases of Infectious Sickness coming to the knowledge of the Medical Officer of Health, during the year 1894, in the Metropolitan Sanitary District of Poplar (POPLAR), classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions being shown as separate localities. Population at all Ages. Aged under 5 or over 5. New Cases of Sickness in each Knowledge of the Medical Locality, coming to the Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Census 1891. Estimated to middle of 1894. Registered Births. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Fevers. Cholera. Erysipelas. Total. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers Cholera. Erysipelas. Total. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) 1 2 3 4 s 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 Poplar 5,6317 57,226 1832 Under 5 4 79 36 13 ... 9 ... ... ... ... 10 151 3 14 3 8 ... 9 ... ... ... ... ... 30 5 upwds. 22 151 92 ... ... 60 2 ... 4 ... 107 438 21 43 6 10 ... 21 ... ... ... ... ... 101 Poplar Union Workhouse ... ... 75 Under 5 ... 3 ... ... ... ... ... ... ... ... 1 4 ... 3 ... ... ... ... ... ... ... ... ... 3 5 upwds. ... 6 ... ... ... 3 ... .. ... ... 7 16 ... 6 ... ... ... 2 ... ... ... ... ... 8 Totals 56317 57,226 1907 Under 5 4 82 38 13 ... 9 ... ... ... ... 11 155 3 17 3 8 ... 2 ... ... ... ... ... 33 5 upwds. 22 157 92 ... ... 63 2 ... 4 ... 114 454 21 49 6 10 ... 23 ... ... ... ... ... 109 "Notification of Infectious Disease" has been compulsory in the District since October 31st, 1889. The Isolation Hospitals are the Hospitals of the Metopolitan Asylums Board, and occasionally for Typhoid Fever cases the General Metropolitan Hospitals, see page 30. TABLE XII. (B) Table of Population, Births, and of New Cases of Infectious Sickness coming to the knowledge of the Medical Officer of Health during the year 1894, in the Metropolitan Sanitary District of poplar (BROMLEY), classified according to Diseases, Ages and Localities. Names of Localities adopted for the purpose of these Statistics; Public Institutions being shown as separate localities. Population at all Ages. Registered Births. Aged under 5 or over 5. New Cases of Sickness in each Locality, coming to the Knowledge of the Medical Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Census 1891. Estimated to middle of 1894. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Fevers Cholera. Erysipelas. Total. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Total. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) 1 2 3 4 5 6 7 8 ... 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 Bromley 70,002 72,026 2516 Under 5 4 114 67 20 ... 9 5 ... ... ... 18 237 4 28 16 2 ... 4 ... ... ... ... ... 54 5 upwds. 42 210 183 5 ... 70 5 ... 2 ... 113 630 36 93 26 ... ... 39 ... ... ... ... ... 194 Sick Asylum ... ... 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. 2 1 ... ... ... 5 ... ... ... ... 15 23 2 1 ... ... ... 4 ... ... ... ... ... 7 City of London Infirmary ... ... 6 Under 5 ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... Stepney Union Workhouse ... ... 16 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds. 1 ... ... ... ... ... ... ... 1 ... 4 6 1 ... ... ... ... ... ... ... ... ... ... 1 Poplar Hospital ... ... ... Under 5 ... 2 2 ... ... ... ... ... ... ... ... 4 ... 2 ... ... ... ... ... ... ... ... ... 2 5 upwds. ... 3 ... ... ... ... ... ... ... 2 5 ... 3 ... ... ... ... ... ... ... ... ... 3 Totals 70,002 72,026 2540 Under 5 4 117 69 20 9 5 ... ... ... 18 242 4 30 16 2 .... 4 ... ... ... ... ... 56 5 upwds. 45 214 183 5 75 5 ... 3 ... 135 665 39 97 26 ... ... 43 ... ... ... ... ... 205 "Notification of Infectious Disease" has been compulsory in the District since October 31st, 1889. The Isolation Hospitals are the Hospitals of the Metropolitan Asylums Board, and occasionally for Typhoid Fever cases the General Metropolitan Hospitals, see page 30. 22 The following Table is of great general interest:— Sanitary Areas. Estimated Population in the middle of 1894. Notifications. Annual rate per 1000 persons living Zymotic Deaths. Annual rate per 1000 persons living. From all Causes. Death.rate per 1000 living. Deaths of Infants under one year to 1000 births. LONDON 4,349,166 9.4 2.6 17.7 143 West Districts. Paddington 121,583 7.4 2.4 15.1 137 Kensington 167,350 5.8 2 1 15.9 173 Hammersmith 105,696 6.5 2.4 16.2 147 Fulham 110,993 9.8 3.8 17.1 149 Chelsea 99,052 8.4 2.3 16.4 131 St. George Hanover Square 75,033 6.6 1.4 14.5 115 Westminster 54,414 5.6 2.0 18.3 138 St. James Westminster 23,571 6.4 2.2 16.7 144 North Districts. Marylebone 138,554 11.5 2.4 19.3 130 Hampstead 75,443 6.2 1.4 10.6 113 St. Pancras 233,739 11.0 2.2 18.3 145 Islington 331,900 9.6 2.6 15.9 130 Stoke Newington 34,172 5.5 0.9 9.8 86 Hackney 211,493 10.1 2.6 15.4 127 Central Districts. St. Giles 38,144 6.2 2.1 19.9 132 St. Martin-in-the-Fields 13,783 5.1 2.0 19.4 210 Strand 23,179 5.1 2.7 22.7 179 Holborn 32,438 8.2 2.5 20.4 180 Clerkenwell 65,312 8.7 2.7 19.1 145 St. Luke 41,168 7.7 2.1 23.5 123 City of London 34,832 5.7 1.1 19.5 160 East Districts. Shoreditch 123,186 9.0 2.8 19.9 160 Bethnal Green 129,840 12.2 3.5 20.4 151 Whitechapel 75,498 8.0 3.1 21.4 154 St. George in-the-East 45,360 12.6 5.0 26.4 185 Limehouse 57,000 12.5 4.3 24.7 174 Mile End Old Town 108,242 11.3 4.1 21.1 156 Poplar (Parish) 57,226 10.6 2.2 19.4 152 Bromley (Parish) 72,026 12.5 3.2 18.6 152 South Districts. St. Saviour Southwark 26,712 8.9 3.3 21.0 145 St. George Southwark 60,060 9.8 3.6 23.1 186 Newington 118,512 9.8 2.8 20.0 158 St. Olave Southwark 12,984 6.6 2.8 20.7 128 Bermondsey 84,053 9.7 3.3 20.7 146 Rotherhithe 40,365 15.9 3.3 19.0 161 Lambeth 282,574 8.8 2.4 17.2 133 Battersea 161,558 11.2 3.1 16.0 146 Wandsworth 179,518 8.1 1.8 12.4 114 Camberwell 248,893 8.6 2.8 16.3 148 Greenwich 173,128 12.1 3.1 17.2 138 Lewisham (excluding Penge) 79,903 7.3 1.9 13.8 128 Woolwich 42,309 8.3 2.6 17.8 136 Lee 38,172 7.5 1.7 12.4 94 Plumstead 59,233 11.7 2.1 12.5 94 Port of London — — — - - 23 The cause for this enquiry was that the Secretary of State had read the report of the Medical Officer of Health for Blackburn, and had found that the death rate under one year was 241 per 1000 births. About the month of November, a deputation of the Parliamentary Committee of the British Medical Association waited on the Home Secretary, who in reply stated, "though he deeply regretted the great increase in large towns of infant mortality, the deputation had not completely to his satisfaction proved that this was due to the employment in factories of mothers too soon after childbirth." I find that in the Demographical Division of the Eighth International Congress of Hygiene and Demography, held at Budapest, it was stated that:—"It was also very essential not to forget that in England during the great cotton famine, the mortality of children among the Lancashire cotton weavers and spinners was not so high as usual. This was due to the fact that mothers being no longer able to work at the cotton mills, had more time to attend to their children." ZYMOTIC DISEASES. Of notifications of infectious diseases there were 609 in Poplar and 907 in Bromley; these totals do not include 46 second notifications forwarded for the two parishes. The notification rate per 1000 living being:— Poplar 10.6 Bromley 12.5 The mortality from the zymotic diseases as classified by the Registrar.General, being 2.28 for Poplar and 3.29 for Bromley. Three of the infectious cases, viz., two diphtheria and one scarlet fever, were connected with milk shops. The County Council was immediately informed, and the sale of milk discontinued until the premises were declared free and disinfected, together with the utensils. The facility offered by the Asylums' Board for the prompt removal of infectious cases to their hospitals, by accepting as a medical 24 certificate a copy of the notification endorsed by the Sanitary Authority, was taken advantage of many times during the past year, so that any great delay was obviated. Some medical practitioners in notifying a case which they desire to be removed, write to that effect on the notification itself, and under the old regime that doctor would have to be sought for in order to obtain a separate certificate. But now, a copy of the notification is made immediately, and sent forthwith to the patient's house. A circular letter was received from the London School Board respecting the granting of certificates after the disinfection of premises, so that the teachers might know when to re.admit with safety, the children who had been excluded from infected houses. The School Board was anxious that there should be a uniform system with the various Sanitary Authorities. I informed the Sanitary Committee that my practice is to give certificates or information to the head teacher or parents when they make application. On several occasions batches of addresses had been forwarded to me from Board Schools, and 1 had returned the list with the disinfected premises marked. I suggested to the Committee that if they would recommend to the School Board Authorities that each school should send in a weekly list to be dealt with in this manner, the matter would be entirely met. Together with your Chairman, Mr. Main, and Mr. Christie, the Chairman of the Sanitary Committee, I attended a Conference held on July 19th at the County Hall, Spring Gardens, to consider whether means could be adopted to prevent the spread of infectious disease by vagrants. Delegates from Poor.law and Local Authorities, together with Medical Officers of Health, came from all parts of the country. The Chairman, Sir John Hutton, stated that the object of the Conference was rather to lay down general principles than to discuss the particular mode in which those principles were to be carried out. The following resolutions were discussed and carried:— 1. That common shelters, which are not subject to the law relating to common lodging houses, should be made subject to such law. 25 2. That there should be power in the hands of the Local Authorities to require medical examination of all persons entering common lodging houses and casual wards, and that each inmate should be supplied with a bath of fresh water. 3. That the Local Authority should have power to order the keeper of a common lodging house in which there has been infectious disease, to refuse fresh admissions for such time as may be required by the Authority. 4. That the Local Authority should be empowered to require the temporary closing of any common lodging house in which infectious disease has occurred. 5. That the Local Sanitary Authorities should have power to require the detention of any inmate of a common lodging house or casual ward who may reasonably be suspected of being liable to convey infectious disease. 6. That means should be provided for the detention and isolation of any vagrant found wandering in a public place, if reasonably suspected of being liable to convey infectious disease. 7. That the Local Authority should have full power to require the disinfection of the person and clothes of any person in a common lodging house or casual ward, whether infected or exposed to infection. 8. That arrangements should be made by which the occurrence of infectious disease in common lodging houses or casual wards should be made known by the Local Authority of the district to the Local Authorities of other districts. 9. That Local Authorities should be empowered to require the vaccination or re.vaccination of persons in common lodging houses or casual wards, who are exposed to the infection of small pox. SMALL POX. Twenty.six cases of small.pox were notified in Poplar during the year. Twenty.four patients were removed to the hospitals, but one was returned as the patient was found not to be suffering from the complaint. Deducting this case and adding one notified from the 26 Poplar and Stepney Sick Asylum, admitted from 39, Plevna Street, there still remain 26 cases, 24 of which were removed to the hospitals. In Bromley 49 cases of small.pox were notified, and 43 of them removed to the hospitals. One of these cases was notified from the Stepney Union Workhouse, having been admitted into the Receiving Ward. Two occurred at the Sick Asylum, one patient was a nurse in the Institution, and the other a Poplar case, living at 39, Plevna Street; so that during the year 47 cases of small.pox were notified from Bromley. Six patients were treated at home and the remainder removed. The following is the list of cases, with the origin of the complaint in each instance, so far as I was able to obtain it. It will be seen that probably the cause of 37 cases (50 per cent.) out of 73 has been accounted for:— POPLAR. Date. Number and Name of of Street. Age of Patient Sex. Disease—how contracted. Treated at Home (H) or Removal (R) January 15 76, High Street 15 F At St. Dunstan's Rd., Mile End Old Town R „ 20 5, Burford's Court 55 M Not known R „ 26 76, High Street 12 M Sister R ,, ,, ,, ,, ,, 6 F ,, R ,, ,, ,, ,, ,, 4 M 76, High Street R 27 5, Bickmore Street 14 M R „ 28 ,, ,, ,, 18 F Sister R February 3 5, Union Street 38 F Nursing patient at 5, Burford's Court R ,, ,, ,, ,, ,, 16 M Mother R „ 15 ,, ,, ,, 39 M Wife R „ 23 33, Rook Street 32 F 76, High Street R March 7 68, East India Road 22 F Not known R April 5 69, Bath Street 21 F Not known. A domestic servant sent home from Hampstead R „ 30 41, Manilla Street 22 M From a house in Canning Town H May 3 76, Upper North St. 23 M Not known R ,, ,, 12, Chilcot Street 39 M ,, ,, R ,, ,, ,, ,, ,, 13 M ,, ,, R ,, ,, ,, ,, ,, 9 M ,, ,, R ,, ,, ,, ,, ,, 7 M ,, ,, R ,, ,, ,, ,, ,, 5 F ,, ,, R ,, ,, 16, Coldharbour 39 F ,, ,, R ,, 12 14, Chilcot Street 2 M 12, Chilcot Street (next door) R „ 19 22, Sophia Street 16 M Not known R June 5 39, Plevna Street 13 F ,, ,, removed from Sick Asylum R ,, ,, 78. Augusta Street 4 F ,, ,, H July 10 Lodging House Cotton Street 21 M ,, ,, R 27 BROMLEY. Date. Number and Name of Street. Age of Patient. Sex. Disease—how contracted. Treated at Home (H) or Removal (R) January 1 Sick Asylum 24 F (Nurse at Asylum) R ,, 2 308 St. Leonard's Rd. 9 M 8, Hawgood Street R ,, 3 24, Three Mill Lane 8 M Brother R ,, 3 18 M Not known R February 16 Stewart's Cottages 27 F ,, ,, R March 30 94, Blair Street 25 M ,, ,, R ,, 12 1, Chiltern Road 65 M ,, ,, H April 4 240 St Leonard'sRd. 39 M Working near Plaistow Hospital R ,, 9 14, Tibbatt's Road 6 M Not known R ,, 14 90, Bruce Road 23 F ,, ,, R „ 16 83, Wellington Road 32 F ,, ,, R ,, 17 2, Westons Street 2 F ,, ,, R „ 18 9, Egleton Road 24 F ,, ,, R ,, 19 190, Abbott's Road 25 F ,, ,, R ,, 21 78 ,, ,, 44 F ,, ,, R ,, 23 74, Quickett Street 14 F ,, ,, R ,, 30 2, Weston Street 4 M Brother R ,, ,, 51 Ida Street F Jupp Road, West Ham R May 7 78, Abbott's Road F Mother R ,, ,, ,, ,, ,, 7 F ,, R ,, ,, 44, Eleanor Street 44 M Finches Court H ,, ,, 158, St. Leonard'sSt. 42 M Not known R ,, ,, 3, Washington Street 12 M Finches Court R ,, ,, 34, Tetley Street 5 F 51, Ida Street R ,, 8 75, Willis Street 18 M Not known R „ 12 52. Wyvis Street 23 F ,, ,, R ,, ,, Receiving WardStep. ney Union Workh'se 25 M ,, ,, R „ 19 24, Abbott Road 47 M ,, ,, H .. 21 3, Washington Street 14 M Brother R ,, ,, ,, ,, ,, 10 F ,, R ,, ,, ,, ,, ,, 8 M ,, R ,, 24 31 ,, ,, 24 F Not known H ,, 25 3 ,, 32 F Cases downstairs R June 2 78 Abbott Road 11 F Sister R ,, 4 26 „ 23 F Next door to 24, Abbott Road R „ 5 3 Washington St. 5 M Sixth case from same house R ,, 8 17, Gurley Street 39 M Not known R „ 10 31, Washington St. 23 F Case upstairs R ,, ,, 52, Wyvis Street 4mths. F ,, ,, R „ 15 51 M Case in house month previously R ,, 16 12, St. Leonard's Avenue 13 M Not known R ,, 20 85, Guilford Road 10 F ,, ,, H ,, 22 33, Gurley Street 23 F 17, Gurley Street R 33, Wyvis Street 171, Chrisp Street 41 M Not known R July 10 37 M Case down stairs R August 16 15 M Not known R Septr. 25 31, St. Leonard's St. 6 F ,, ,, H Deer. 13 166, Brunswick Rd. 34 M ,, ,, R 28 In as much as I communicated at once with the Metropolitan Asylums Board, being anxious to obtain speedy removal of these cases, as soon as possible after receiving the notifications, I am not able to make any definite statement with respect to the vaccination marks; this matter, I have no doubt, will be commented upon in the reports of the Medical Officers of the Small Pox Hospitals. I must re.iterate in this report, what I stated in my last one, concerning the immense value of the use of a tricycle in the Sanitary Department, viz.—that it affords speedy communication with infected premises, medical attendants, and the office of the Sanitary Authority, thereby affecting the immediate means for the isolation of the patient, and stopping the spread of the disease. All the usual steps respecting the disinfection and watching of infected premises were adopted. I informed the Clerk to the Guardians of the cases as soon as they came to my knowledge. Of the twenty.six cases belonging to Poplar, there were two deaths. —A male aged 55 years, 5, Burfords Court, confluent smallpox, vaccinated in infancy, showing one bad scar; the other fatal case was a child aged two years, 14, Chilcot Street, confluent smallpox and diarrhoea, unvaccinated; both these cases had been removed to the ships. There were four deaths among the 47 cases belonging to Bromley. A female child aged one year, 78, Abbotts Road, confluent smallpox, not vaccinated; male aged 40 years, 17, Gurley Street, confluent smallpox; male aged 51 years, 52, Wyvis Street, hemorrhagic smallpox—in these last two cases no statement was made as to vaccination on the death return; male aged 37 years, 33 Wyvis Street, confluent smallpox, vaccinated in infancy. All these cases died at the Hospital Ships. Mr. Hitchins, the Vaccination Officer, has kindly given me the following statistics as to the number of vaccinations effected during the year. 29 january to june, 1894. Births. Vaccinations. Insusceptible. (Notified.) Poplar 985 680 10 Bromley 1288 778 8 July to December, 1894.. Births. Vaccinations. Insusceptible. Poplar 947 433 7 Bromley 1262 494 8 SCARLET FEVER. There was a great diminution in the number of Scarlet Fever cases notified during the year 1894, as compared with cases notified in the last three quarters of the preceding year. The statistics are as follow:— 1893. (39 Weeks.) Cases Notified. Deaths. Death Rate per 1000 living. Poplar 552 35 0.82 Bromley 763 31 0.52 Total 1315 66 0.69 1894. (52 Weeks.) Poplar 239 12 0.20 Bromley 331 22 0.32 Totals 570 34 0.26 Sixty-six cases were removed to the Fever Hospitals from Poplar, and one hundred and twenty-seven from Bromley. The cases were scattered over the whole district. I was not able to attribute any of them to one particular milk supply. We were not pushed by the want of accommodation at the Asylums Boards' Hospitals as during the year 1893, and those cases on behalf of which application was made for admission into the hospitals, were removed without delay. 3° CONTINUED AND TYPHOID FEVERS. There were two cases of Continued Fever notified in Poplar, and ten in Bromley. One of the Bromley cases proved fatal. There was a decided falling off of the Typhoid Fever cases notified in Bromley. 1893. (39 weeks.) 1894. (52 weeks.) Poplar 66 72 Bromley 207 84 Under the heading of Diphtheria, and in stating statistics as to the existence of that disease in the sub-divisions of my district, I have also given the number of Typhoid Fever cases and the notifications per 1000 living, as it is my firm conviction that Diphtheria like Typhoid Fever is due to bad drainage and insanitary surroundings. Twenty-five cases in Poplar (including two from the Poplar Union), and 47 (including 4 from the Sick Asylum) in Bromley, were removed to various hospitals, as follow:— Poplar. Under 5. 5 upwards. Asylums Boards' Hospitals 2 16 London Hospital 0 5 St. Bartholomew's 0 1 King's College 0 1 Total 2 23 Bromley. Under 5. 5 upwards. Asylums Boards' Hospitals 2 24 London Hospital 1 15 St. Bartholomew's 0 3 Children's Hospital, Shadwell 1 1 Total 4 43 There were 10 deaths from Typhoid Fever registered as belonging 31 to Poplar, and 14 deaths to Bromley, giving respective death rates of 0.17 and 0.18 per 1000 living. I will not criticise the statement as to whether the eating of oysters is a cause of Typhoid Fever, but I would most strongly advise everybody who partakes of water.cress to see that it is well washed, as it has been stated that several cases have occurred after partaking of this popular green stuff, which had been grown in polluted water. I think the same advice for obvious reasons applies to the eating of celery. DIPHTHERIA (INCLUDING MEMBRANOUS CROUP). The notified cases of Diphtheria (including Membranous Croup), were much less during 1894 than in 1893, as the figures stated below will show. I have no doubt that a very large percentage of cases notified as diphtheria are not such. To what extent non.diphtheritic cases are contagious I am not prepared to state; but I am of an opinion that they are due to insanitary conditions like the graver disease. A very mild affection of the throat may be true diphtheria; but, on the other hand, a throat covered with membrane may contain no diphtheric bacilli, and would be notified as diphtheria. In my annual report for the year 1893, I stated that the drought during the exceptionally hot weather was the cause of a large number of cases, on account of the gullies in the streets and elsewhere becoming untrapped and allowing the sewer gas to escape. My firm conviction is that diphtheria is due to emanations, either from sewers or drains, or from ground polluted with sewage. Sewers should be ventilated at an elevation instead of on a level with the pavement, and the houses should be the means by which shafts should be carried up, and no owner should be allowed the right to refuse. No grating should be permitted in the roadway level, even if there be up.shafts, inasmuch as the latter may become down.shafts. 32 All sewers become coated with a thin layer of sewage, which is not removed by the flushing of water. The same applies to the sides of street gullies; and as diphtheria did not prevail to such an extent during 1894 as during 1893, this might be due partly to the increased rainfall keeping the gullies trapped and the sides of the sewers moist, thereby preventing the germs escaping through the ventilators. Should sea water ever be pumped up to London for Municipal purposes, it could be used at all times and plentifully for flushing sewers, as well as for the watering of roads, and extinguishing fires, etc. In a special report on the cause of Diphtheria, presented to the Sanitary Committee on September 27th, 1894, I pointed out that the complaint prevailed greatest in those sub.divisions of the district which lie furthest from the Thames: and that the Isle of Dogs, which is the dampest portion of the district, suffers the least; and that North Bromley and Bow—the latter being the district of my colleague—suffered the most; and my opinion for the disease showing itself in this manner was due to the inadequacy of the County Council's main sewers, which run through these sub.divisions; and that these sub.districts are liable to become flooded with sewage during rainfalls, and to have the soil polluted by unknown soak. age on account of defective drain pipes, so that highly.polluted ground air would escape from the soil, either through meteorological influences or by the drawing of fires into those dwellings, the sites of which are not covered by an impermeable material. I also made mention in the special report of the careless manner in which drain pipes were laid and jointed in former years; I stated my experience of the results of the various drain tests—viz., that they are all, except the water test (which is difficult to apply) not to be relied upon, as they will not determine in pipes deeply laid whether there is an escape of sewage. By drains being declared sound when they are really unsound, I believe to be one of the chief reasons why many high authorities are misled in thinking that diphtheria is not Board of Works for the Poplar District. H7. high street Poplar. E. april 24 1885 annal Report sir, please substitute 391 for 259 on page 33 so that last paragraph but one at its end reads- "that of london being 391" the figure 259 is the average for ten years samsir yours faithfully Twaleyander Medical officer of Health. To the Editor of the British medical from sbranch 33 due to defective drains. They state that Typhoid Fever (which doubtless, is caused through defective drains) has diminished, and diphtheria has increased since more drainage work has been carried out. True, typhoid fever cases have lessened, but then, what about impure water causing this complaint ? Certainly our water supplies and storages are better supervised now than in former years. The germ of typhoid fever will exist in water, but the diphtheritic one has great difficulty in living in it, which in fact will destroy the bacillus, unless it be very polluted water. There is no telling how many house traps may be forced by the pressure of sewer gas, more especially when the main sewer is rushing full, and backwash taking place into the branches of those sewers which are not ventilated. I pointed out that the Isle of Dogs suffered severely after the floodings of 1888 and 1890, but that since an increased number of outfalls into the Thames have been made by the London County Council, in order to allow the pumps to discharge into the river above high tide, floodings have been obviated and diphtheria lessened on the Island. At the moment of writing this report the Council are connecting the Hackney Wick and Isle of Dogs sewers at St. Leonard's Street with their new sewer, laid down to relieve the main low level one. In the year 1889, after the flooding, the Diphtheritic death rate of the Island was 1700 per million living, that of London being 259. The following tables will show the incidence of Diphtheritic cases in the various sub.divisions of the districts. I also give the Typhoid Fever cases in order to compare the two complaints. The rates per 1000 living are shown. Both diseases will be seen to exist greatest in North Bromley, which lies farthest away from the Thames, and has the inadequate and often surcharged low level main sewer running through it, C 34 Nov. 1889 to March 1890. 1890 (another flooding during this year). 1891 (increased pumping accommodation at Isle of Dogs Station). 1892. Isle of Dogs or South Poplar 54 130 24 28 North Poplar 27 113 63 63 1893. Diphtheria very general throughout the Metropolis. Rain.fall. Difference from average of 78 years- 4-98 inches. Estimated population to middle of year 1893. Diphtheria. Notifications per 1,000 living. Isle of Dogs or South Poplar 20,267 88 4.3 North Poplar 36,367 126 3.4 South Bromley 38,218 189 4.9 North Bromley 33,118 217 6.5 Parish of Bow 41,143 506 12.4 1894. Rain-Jail. Difference from average of 79 years + 1.84 inches. * Estimated population to middle of year 1894. Diphtheria. Typhoid Fever. Diphtheria. Notifications per 1,000 living. Typhoid Fever. Notifications per 1,000 living. Isle of Dogs or South Poplar 20,479 48 30 2.3 1.4 North Poplar 36,747 93 42 2.5 1.4 South Bromley 38,587 109 32 2.8 0.82 North Bromley 33,439 168 52 5.0 1.55 *With this rainfall the sides of the sewers and gullies would be kept moist, and floodings to any great extent obviated by the increased pumping accommodation. 35 It is stated that females suffer from diphtheria more than males, and in support of this statement having analysed the notifications received during 1894, I give the following figures:— Males. Females. South Poplar 15 33 North Poplar 46 47 South Bromley 51 58 North Bromley 74 94 Totals 186 232 Possibly the cause of females suffering more than males is due to little girls and women nursing children. This has been pointed out by Dr. Thome, the Medical Officer of the Local Government Board. As to the well.known fact that it is to the influence of school attendance that we must look for the main cause of the increase in diphtheria notifications, Dr. Thome states:— " In what does this influence consist? First of all it brings together the most susceptible members of the community which are peculiarly favourable to this kind of infection. The children are close to each other, and in saying or intoning their lessons they have facility for breathing into the faces and mouths of their neighbours. Consequently any child : with a trace of diphtheria can easily infect other susceptible children. The Education Department requires so much floor space per child, but if you have ever been to an infant's school, for example, you will have observed that of available floor space some two.thirds are often monopolised by the teacher it being necessary to aggregate the children at one end of the room. The greater the want of ventilation, the greater the risk. Then too, children of young age are very fond of passing sweets from mouth to mouth, and of drinking out of the same unwashed cup, thereby offering every opportunity for serial infection." 36 The school age may be taken as from 3 years to to years. The figures for 1894 are as follows:— Males. Three to ten years. School age cases. Females. Total. Per 100 cases notified. South Poplar 5 10 15 31.2 North Poplar 11 16 27 29.0 South Bromley 20 26 46 42.2 North Bromley 40 39 79 47.0 Totals 76 91 167 39.9 Bacteriological examination is the only sure means for accurate diagnosis of this disease, and also for determining when a case is free from infection, as the bacilli or germs remain in the throat for considerable periods after the disappearance of the membrane and during convalescence, and no doubt such cases are the cause of the spread of the disease, and no case ought to be considered free until examined bacteriologically. Thirty to fifty per cent, of the cases examined by the Health Department of New York—which was the first Sanitary Authority to place at the disposal of the medical profession opportunities for bacteriological examinations of suspected cases of diphtheria— were found not to be diphtheria. This Health Department diagnoses all cases bacteriologically before admission to the hospital wards; reliable conclusions can be given in from twelve to twenty.four hours. Accurate diagnosis is really most important, for a non.diptheritic case upon admission to a ward where there are a number of patients suffering from true diphtheria, runs a great risk of developing the graver disease with its constitutional symptoms—more especially it has been found after the tracheotomy operation. The Metropolitan Asylums' Board, recognising that many of the patients sent to their hospitals as suffering from diphtheria have not that disease, and in order to afford their medical officers facilities for 37 the early and only accurate diagnosis of diphtheria by means of bacteriological examinations of the deposit on the throats of persons removed to their hospitals, approached the Royal College of Surgeons of England. Doubtless it was felt that those patients who are sent to hospitals and are found not to have the disease should be returned home, thus making room for fresh cases; and should the anti.toxin treatment come into general use the true cases retained would undergo this specific treatment, "a form of treatment which is claimed to be successful in proportion to the early recognition." The Laboratories Committee of the Royal College of Surgeons England, in its report of December 13th, stated, that on October 26th a communication was received from the Metropolitan Asylums' Board inquiring " whether the Royal College of Physicians and Surgeons could afford the managers facilities for the bacteriological investigation of doubtful cases of diphtheria which may be sent to the Board's hospitals from time to time." The Committee agreed to undertake the investigation on the following conditions:—(1.) That the investigation be carried out by special persons to be appointed by the Laboratories' Committee under the superintendence of the director, Dr. G. Sims Woodhead. (2.) That the Metropolitan Asylums' Board defray the expenses of the investigation, including the salaries of those occupied in the work. The expenses, including the salary of a bacteriologist and two assistants, were estimated to amount to about £750 per annum. The Metropolitan Asylums' Board have agreed to these conditions as a temporary arrangement for the period of six months, and it is understood that the work will be commenced on January 1st next. A daily average of twenty cases to be examined and reported upon. On November 9th a further communication was received from the Asylums' Board, asking whether the Royal Colleges of Physicians and Surgeons would be willing to supply, and if so, when and on what terms, diphtheria anti.toxin for use in the hospitals of the Board. The Committee informed the Board that they would 38 be willing to supply the anti-toxin serum on the following conditions —viz., that the Metropolitan Asylums' Board would afford accommodation on one of their farms near London for the required number of horses, such accommodation to include the services of the necessary stable attendants and the keep of the animals, and that other expenses entailed in the preparation of the serum should be defrayed by the Metropolitan Asylums' Board, with the exception of the initial cost of the horses, which would be provided by the Royal Colleges. INFLUENZA. Seven deaths from Influenza were registered in Poplar and seven in Bromley. WHOOPING COUGH. There were registered 16 deaths from Whooping Cough belonging to Poplar and 36 to Bromley, giving respective rates of 0^27 and 0^44 per 1000 living. MEASLES. Fifty-six deaths were registered from Measles in Poplar, and two deaths were reported from outlying institutions, making a total of 58, and giving a death rate of ro per 1000 living. Of the 58 deaths 57 were under the age of five years. 103 deaths occurred in Bromley, eight of the deceased were non-parishioners, so that 95 deaths belong to Bromley, and these occurred in patients under the age of five years. The death rate from this disease in Bromley was 1.31 per 1000 living. In my report to the Sanitary Committee on the 12th of April, I called the Committee's attention to 25 deaths from measles having occurred in Bromley during the past month. 1 mentioned the fact that it was in the power of the Board to make an order to include measles among the list of notifiable diseases, and that such order may be permanent or temporary, so that in either case copies of the 39 cations received would be forwarded to the schools, and the children attending from infected houses would be excluded until after the disinfection of the premises. No resolution was passed to include measles among the list of notifiable diseases. I asked the Committee to recommend that the Registrars be instructed to give me immediate information, as they do with certain other contagious and infectious diseases, of deaths from measles, in order that steps might be taken to induce the relatives or friends of the deceased to allow the premises and clothing to be disinfected, This recommendation was adopted, and the premises, &c., after a death are disinfected where the friends can be induced to give their permission. It is strange that of all diseases, measles is the only disease for which there is no hospital accommodation. I must confess that even if measles were included among the notifiable diseases, that only so far as excluding the children in the same house from school no other benefit would accrue until cases of measles are admitted into the Asylums Boards' hospitals, inasmuch as the treatment for measles, like that of all other diseases, requires hygienic surroundings, and these unfortunately are not met with in the over-crowded homes of the poor. DIARRHŒA. The deaths from Diarrhoea were as follow:— Quarters. Total. 1st 2nd 3rd 4th Poplar 5 1 10 4 20 Bromley 2 2 21 4 29 Total 7 3 31 8 49 From these figures it will be seen that diarrhoea was most prevalent during the hottest quarter of the year. The Board at its meeting, 4° held 25th of July, in answer to a circular letter, did not then consider it necessary to add diarrhoea to the list of notifiable diseases, and a communication to this effect was sent to the Local Government Board. CHOLERA. A letter was received from the Medical Officer of the London County Council, stating that the Council had authorized him to send to Dr. Klein material from suspected cases of Asiatic Cholera, and that information might be sent to him concerning any suspected case. Dr. Klein likewise sent a letter requesting to be informed of any death from choleraic illness. I suggested to the Committee that a circular letter should be sent to the practitioners, requesting them to send me immediate information ol any case of choleraic illness, but the Committee considered that under present arrangements the necessary information would reach me with sufficient promptitude. Fortunately there has been no cholera scare during the past year. PORT SANITARY AUTHORITIES NOTIFICATIONS. Information was received from various Port Sanitary Authorities of 52 passengers coming into my district. Forty persons arrived and were in good health, the remaining twelve did not put in an appearance. I communicated this fact to the various Port Medical Officers, in case a mistake had been made as to the address. Twenty seven immigrants were notified as coming from a shelter in Whitechapel to this district. These persons were visited, and they were requested to send to the offices immediate information if any case of sickness should occur. 4i INQUESTS AND DEATHS FROM VIOLENCE. Inquests and Deaths from violence during the year 1894 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 189 51 36 174 59 115 Bromley 242 85 32 189 61 128 Totals 431 136 68 363 120 243 For annual rates of deaths from violence per 1000 persons living and the percentages of inquest cases to total deaths, see tables, page 10. Violent deaths which actually occurred in Poplar and Bromley, not deducting non-residents, were as follow. Deaths occurring entirely outside Poplar and Bromley belonging thereto. Poplar. Bromley. Poplar. Bromley. By Railway 0 0 0 0 By Vehicles and Horses 1 10 0 1 Ships, Boats and Docks (exclusive of drowning) 4 6 2 0 Building Operations 0 0 0 0 Conflagrations 0 0 0 0 Burns, Scalds and Explosions 3 12 0 2 Drowning (accidental not suicidal) 30 3 1 5 Suffocation in Bed 8 8 0 0 Poisons or Poisonous Vapours 1 1 1 0 Other and not stated Causes 12 33 1 3 Homicide 0 0 0 0 Suicide 13 11 0 1 Total 72 84 5 12 OUTWORKERS. Twenty outworkers were connected with the Infectious Notifications received. Mr. Raymond made enquiries and served the necessary notices. 42 At a meeting of the Sanitary Committee on the 19th of July, I reported that several outworkers on the register had moved out of the district, and that steps were being taken to have a fresh list of outworkers made out, so that from the register and alphabetical street index the names of those who had left the district might be deducted and any new ones added. On September 27th I reported that the present system was not considered a good one by me. Employers are constantly changing their hands, and either adding to or decreasing their staffs to meet the exigencies of trade. The result is that a correct list of outworkers can never be kept unless the Inspector calls at the factories and workshops daily to inspect the lists. I stated that in my opinion the difficulty would be met, if the occupiers of such factories and workshops were compelled to give immediate notice to the various local authorities of any addition or alteration to their lists of outworkers. I suggested that a letter should be sent to the Secretary of State expressing these views : the Committee directed accordingly. However, it must not be lost sight of that the Inspectors, when they visit premises upon the receipt of a notification of an infectious disease, make enquiries as to work carried out on the premises, so that one of the chief aims of the outworkers order is thus met. SLAUGHTER-HOUSES AND COW-HOUSES. Thirty-two licenses were applied for at the Licensing Committee of the London County Council. Slaughter-houses, 11 in Poplar and 5 in Bromley; Cow-houses, 6 in Poplar and 10 in Bromley. I in no case advised the Board to oppose the license. All these premises were inspected and the drains tested. The bye-laws as to properly-constructed manure receptacles were enforced, and the yard paving in several instances improved. BAKEHOUSES. Together with Mr Raymond I inspected the Bakehouses in the district, and so far as is known there are 44 in Poplar and 56 in Bromley. The drains of all these premises were tested. Four 43 houses were found to be in a most insanitary condition, and the drains in a great number of instances were defective. In nearly all the bakehouses 1 complained that the bakers brush the scrapings and sweepings under the troughs, and allow this waste, which becomes sour, to accumulate before removal. I insisted upon the space under the troughs being swept out, but I am sure this cannot be properly carried out unless the troughs are made moveable. The defective drains and gullies were all rectified, and in two instances drainage reconstruction was carried out. Structural alterations were brought about in one case so as to admit of more air and light. Defective floors were also repaired, and in all the bakehouses the repairs intimated were made good. A circular letter was received from the Local Government Board, dated 22nd May, 1894, stating that questions had been raised in Parliament as to the sanitary condition of bakehouses in London, and as to the steps taken by the Sanitary Authorities to enforce the law on this subject, and that the Board deemed it desirable to draw the special attention of Sanitary Authorities to their powers and duties in this matter. The question of bakehouse registration and regulations as to the conduct of the business also engaged the attention of the London County Council. The Public Health Committee drew up a code of regulations and presented the same to the Council at their meeting on June 26th, when it was argued that the Council ought to be the licensing authority and make the bye-laws, as it would not be at all satisfactory for the licensing of bakehouses in London to be in the hands of forty or more different authorities—the actual inspection of the premises to be carried out by the Local Authorities. Application, I understand, was made on behalf of the Council to the President of the Local Government Board, to move for an amendment of the law on the subject. At the invitation of the Vestry of St. George-the-Martyr, Southwark, 44 I was appointed one of the delegates in conjunction with Messrs. Christie and Stephens, from the Poplar Board, to attend a Conference of the Vestries and Districts Boards, as to amendment of law regulating bakehouses, when the following resolutions were carried:— (1) That uniform Metropolitan bye-laws regulating bakehouses be made by the London County Council, and be confirmed by the Local Government Board, and that the duty of enforcing these bye-laws shall devolve upon the various Local Sanitary Authorities. (2) That the portions of the bye-laws regulating the structure of bakehouses do not apply to existing bakeries. (3) That the London County Council be empowered to frame bye-laws for the construction of underground bakehouses, that all bakehouses erected after the passing of such byelaws shall conform thereto. The last resolution was an amended suggested resolution moved by the Delegates of the Vestry of St. Marylebone. The feeling in that parish was, that on account of the closely-built condition of the Metropolis it would be impossible to do away with bakehouses built below the level of the street; hence the necessity for special byelaws for such premises. To bring the bakehouse question up to date, it is just as well to mention that at a meeting of the County Council, January 29th, 1895, the Housing Committee stated that the deputation received by the President of the Local Government Board were informed that the Home Secretary was about to introduce a new Factory Bill, but that it was impossible that any clause could be inserted dealing with London bakehouses only. The President suggested that the Council should itself introduce a Bill. 45 WATER SUPPLY TO NEWLY-BUILT HOUSES—EXEMPTION FROM HOUSE DUTY. On the authorisation of the Sanitary Committee twelve certificates were given under Section 48 of the Public Health (London) Act, certifying that there was a proper and sufficient water supply at certain newly-built premises. An application was made to me under the Inland Revenue Acts, 1890 and 1891, in respect of model dwellings (16 tenements) at Millwall, in order that relief of house duty might be obtained. I could not grant the necessary certificate as the premises did not conform to the conditions drawn up by me. MODEL DWELLINGS. County Council, Grosvenor, and Arnold Buildings. The County Council opened their block of dwellings in Yabsley Street to accommodate 60 families about the end of May, and hearing that buildings of similar character are likely to be erected by that body on the vacant land in Cotton Street, and the housing of the working classes being always'a subject of great interest, I have ascertained the vital statistics and infectious notifications relating to Grosvenor Buildings. Grosvenor Buildings consists of 542 tenements. Mr. Chatterton, the Assistant-Surveyor, informs me that the area occupied is as follows:— Acres. Roods. Perches. Average of Buildings 1 0 2 „ Yards 0 3 31 Total area 1 3 33 The actual census I ascertained, at about the end of the year 1894, to be adults 986, children 778, total 1764. At the time that the population was taken, 512 tenements were occupied, consisting of 206 one room, 133 two rooms, 166 three rooms, and 7 four rooms. 46 Each tenement has a scullery or kitchen (which may be used as a living room), and a w.c. attached. The rooms are 9 feet high, and of varying cubic capacity. The rooms with scullery and w.c. let as follow:—one room 2s. to 3s 6d.; two rooms 4s. 6d. to 5s. 6d.; three rooms 5s. 6d. to 6s. 6d.; four rooms 6s. 6d. to 8s. 6d. I find by looking through the Medical Registers at the Guardians' offices, that 77 medical orders were issued by the Relieving Officers. The notifications received were: Scarlet Fever, 8 (2 under 5 years) removed 5; Diphtheria, 5 (3 under 5 years) removed 1; Typhoid Fever 2, removed 2; and Erysipelas, 9 (1 under 5 years), making a total of 24, and giving a rate per 1000 living of 13.6. Thirty-two deaths actually occurred in the buildings, and 13 deaths took place in outlying institutions, making a total of 45, and giving a death rate of 25.5; 11 of the 45 deaths were children under one year, and add seven to the 11 deaths will give the total deaths under 5 years. There were 5 deaths from Zymotic diseases as classified by the Registrar-General, giving a rate of 2.8 per 1000 living. Registered Cause of Death among the Residents of Grosvenor Buildings. From Zymotic Diseases 4 „ Diarrhœa 1 „ Constitutional Diseases 13 „ Premature Birth and Old Age 1 „ Diseases of the Nervous System 1 „ „ Circulatory 3 ,,. „ Respiratory 13 „ „ Digestive „ 1 Urinary „ 1 „ „ Generative ,, 0 Accident of Childbirth 0 Disease of the Integumentary System 1 Accidental Deaths 2 Other Diseases 4 Total 45 47 The outlying Institutions in which deaths happened were :— Sick Asylum 6 Poplar Hospital 1 London Hospital 3 Homerton Fever Hospital 2 Children's Hospital, Shadwell 1 Total 13 By comparing the various rates with those given in the Table on page 22 the notification and death rates will be found to stand high, but then it must be borne in mind that the number of inhabitants of model dwellings will vary from time to time. I examined the water supply of the Council Buildings, and gave the necessary certificate. I have likewise caused to be inspected the 105 cisterns which store the water for the supply of Grosvenor Buildings. I wrote to the owner, forwarding him a copy of the Board's Bye-laws and informing him that the cisterns required cleansing ; this matter was immediately put in hand. I also called his attention to the covers of the cisterns not fitting accurately, these he will also have rectified. At the beginning of the year the 542 sink waste pipes were disconnected from the soil traps, trapped and made to discharge over gullies by ventilated pipes. The occupied portion of Arnold's Buildings (67 tenements) being unfit for human habitation, I attended at the Police Court with Mr. Dunn, the Sanitary Inspector, when the Magistrate made a closing order. Constant complaints had been received concerning the state of these dwellings, and the County Council in a letter to the Board suggested that they might be placed under the bye-laws of houses, let in lodgings. COMMON LODGING HOUSES. During the year some 671 common lodging houses in London 48 were placed under the supervision of the London County Council. The common lodging houses in Poplar and Bromley are as follow:— Street or Place. Authorised number of Lodgers. 218, East India Dock Road 35 220, „ ,, 26 274, High Street, Poplar 11 329, East India Dock Road 8 65, Bow Lane 51 207, High Street, Poplar (house in rear) 420 93, „ „ (Coffee-house) 4 11 and 13, Jeremiah Street 11 97, High Street, Poplar 15 38, Pennyfields 54 42, „ 17 It is very important to know the common lodging houses in a district, so that in the event of any infectious disease occurring, the Licensing and Inspecting Authority may be informed at once. SANITARY INSPECTORS' WORK AND POLICE COURT PROCEEDINGS. During the year, 4500 intimations, 2196 statutory notices, and 621 final notices (complimentary) were served, 3358 drains were tested, 5817 inspections and 18,274 re-inspections were made. The Inspectors' reports are appended to this Report, and speak for themselves as to the work which has been carried out in the district. I attended at the Thames Police Court to support all summonses where the work had not been completed at the date of the hearing. Appearing at the Police Court is the most unpleasant part of Sanitary Officers' duties, but it must be done in order to enforce the Public Health Act with its Bye-laws. I give a list of the summonses with results, &c., which have been taken out at the Thames Police Court. 49 No. of Street and Premises. Nature of Complaint. Date of hearing| summonses at Police Courts. Result. Name of Inspector. St. Edmunds R. C. Schools, Millwall 15, Swaton Road 50, Merchant Street 14, Ailsa Street 85, Teviot Street 49 to 53, Railway Street 14, Chadbourn Street 26, Gale Street 28. Gale Street 20, Franklin Street 1 to 8, Totnes Terrace 16, Broomfield Street 24, Broomfield Street 23, Chadbourn Street 211, St. Leonard's Road 6, Lochnagar Street Defective drain. Gully in playground not trapped. Rain water pipes connected with drain. Paving of playground defective. Insufficient W.C. accommodation yard and stables not properly paved and drained. Rain water-pipe connected with drain Defective drain. Gullies not trapped. Sink wastepipe connected with drain. Drinking water improperly stored Improper repair of drain. P.H. (Lond.) Act, sec. 42 As above Obstructed drains. Combined system. Obstruction caused by adjoining owner cutting off this system No water supply As above Defective drain. Rain water pipe and roof. Yard not properly paved Mr. Foad summoned as the defendant Defective drains and inlet not properly trapped. Premises damp. Forecourt not paved. Eaves, gutters, and rain water-pipes defective. No under floor ventilation. Closet walls dirty, pan foul Drains defective and inlet not properly trapped. W.C. walls and floor damp. No proper water supply and apparatus to W.C. Roof not watertight. Eaves, gutters defective. Ground floor rooms damp. Forecourt not paved Yard paving defective. Forecourt not paved so as to to carry off drainage. No under floor ventilation Drains defective, also eaves, gutters. Yard paving in bad order. Surface drainage remains Ground floor front room damp. Forecourt not paved Jany. 30 „ 30 „ 30 ,, 30 „ 30 Feby. 13 March 13 „ 13 „ 13 „ 17 „ 20 „ 20 „ 20 „ 20 „ 20 Adjourned sine die, owing to a technical point in the summons relating to the ownership of the premises. Work since completed Dismissed for same reason as above. Work since completed 7 days abatement order. 27/-costs. Nominal line of 5/- being the first case under the Act As above Adjourned one week, Defendants applying for injunction against adjoining owner. Re-adjourned sine die. Since completed Closing order. 3/-costs As above 7 days abatement order. 24/- costs. Closing orders cancelled Work being done at date of hearing, adjourned 7 days, re-adjourned 7 days, summons withdrawn. Work completed As above Work proceeding, adjourned 14 days summons withdrawn. Work completed As above Adjourned 7 days, work proceeding, summons withdrawn. Work com pleted Mr. Foad. Mr. Anthony. ,, Mr. Miners. ,, ,, Mr. Anthony. it it Mr. Foad. Mr. Miners. ,, ,, ,, ,, 50 51 No. of Street and Premises. Nature of Complaint. Date of hearing summonses at Police Courts. Result. Name of Inspector. 9, Bartlett Street 25, Chadbourn Street 41, St. Leonard's Road 11, Furze Street 13, Furze Street 26, Furze Street 28, Furze Street 30, Furze Street 34, Furze Street 145, Upper North St. 147, Upper North St. 151, Upper North St. 153, Upper North St. 7, Creek Side 8, Phœbe Street Arnold's Buildings, Emmett Street, 67 tenements 9, Stebondale Street. 11, Stebondale Street 13, Stebondale Street 15, Stebondale Street 17, Stebondale Street 19, Stebondale Street 48, Merchant Street 49, Merchant Street 51, Merchant Street 4, Gale Street 25, Rounton Road 27, Rounton Road 37, Rounton Road 20, Franklin Street 4, Knapp Road 4, Newcastle Street 6, Newcastle Street 173, Brunswick Road 30, Furze Street 34, Furze Street 231, St. Leonard's Road 51, Southill Street 5, Brabagon Street 102, West Ferry Road 124, Devons Road W.C. walls and roof defective and no proper water supply. Yard not properly paved Yard paving defective. Surface drainage remains No proper water supply for drinking purposes No proper and sufficient water supply or supply apparatus to W.C. As above Yard not properly paved. Surface drainage remains Yard not properly paved. Drain inlet not trapped. Walls and ceiling of first floor rooms in a dirty condition Drinking water improperly stored. Sink waste-pipe connected with drain. Yard not properly paved. Inlet to drain not trapped. Roof not watertight, etc. Defective drain. Sink waste and rain water-pipes connected with drain. Yard not properly paved and no inlet to carry off surface water. Portions of the the house in dirty condition. Stable at rear requires cleansing, paving and draining. Walls and ceiling of staircase, passage and shop in a dirty unwholesome condition. Yard not properly paved Yard improperly paved Yard improperly paved. Rain water-pipe defective ... Yard improperly paved Defective drains. Yard improperly paved Yard and washhouse, defective paving. Insufficient supply of water for sanitary and domestic purposes Defective drain. Premises dilapidated and damp As above As above As above As above As above Defective drain. Sink, waste and rain water-pipes connected with drain. No water to W.C. Defective drain. Sink, waste and rain water-pipes connected with drain. Insufficient water supply to W.C. Yard not properly paved, etc., etc. Gully in yard not properly trapped. Sink, waste and rain water-pipes connected with drain No water to W.C. Flushing apparatus defective Yard and forecourt not properly paved As above. Yard not properly paved Owner summoned by Mr. Anthony for non compliance with Magistrate's order, March 13th Improper repair of drain. P.H. (Land) Act, sec. 42 Defective rain water gutters, causing dampness to walls, unwholesome condition of top floor rooms Defective drain, roof, rain water-pipes, and gutters. _ Unwholesome condition of top floor rooms, etc. Yard not properly paved (back room and kitchen damp) Owner summoned by Mr. Anthony for non-compliance with Magistrate's order, April 3rd As above Forecourt improperly paved. Rain water-pipes defective Forecourt not paved with an impermeable material causing dampness Forecourt not paved with an impermeable material. No under floor ventilation No water supply Defective drain. Yard not properly paved. Forecourt unpaved. No ventilation beneath ground floor rooms. Wash-house and W. C. in dirty condition. Accumulation of rubbish in yard March 20 „ 20 „ 20 April 3 ,, 3 ,, 3 ,, 3 ,, 3 „ 3 „ 17 ,, 17 „ 17 „ 17 ,, 17 ,,17 ,, 17 ,, 24 „ 24 „ 24 „ 24 „ 24 ,, 24 24 „ 24 „ 24 „ 24 ,, 24 ,, 24 „ 24 May 8 „ 8 „ 15 ,, 15 ,, 15 „ 15 „ 15 „ 15 May 5 „ 5 „ 20 June 12 As above Work completed, summons withdrawn 7 days abatement order, 10/6 costs.. Nuisance abated, summons withdrawn As above Summons not served, owner removed As above 7 days abatement order, 10/6 costs.. As above Work completed, summons with drawn As above As above As above 7 days abatement order, 12/6 costs. Adjourned 1 week, re-adjourned days, summons withdrawn. Work completed Closing order. 23/-costs 14 days abatement order As above As above As above Closing order 14 days abatement order 7 days abatement order, 6/- costs As above As above As above Adjourned 7days for owner to appear: 14 days abatement order made. 10/6 costs As above As above 30/- penally 40/- penalty 7 days abatement order, 10/6 costs As above As above 30/- penalty As above Adjourned 7 days for owner to appear, re-adjourned 14 days as work was in progress, since completed As above Adjourned 7 days, work since completed Closing order, 21/- costs Abatement order 14 days, 10/6 costs Mr. Miners. ,, ,, Mr. Anthony. ,, ,, ,, ,, ,, Mr. Dunn. ,, ,, ,, ,, ,, ,, ,, Mr. Foad. ,, ,, Mr. Foad. ,, ,, Mr. Anthony. ,, ,, ,, ,, ,, ,, Mr. Foad. ,, Mr, Miners. Mr. Anthony. ,, Mr. Miners. ,, ,, Mr. Foad. Mr. Anthony. 52 53 No. of Street and Premises. Nature of Complaint. Date of hearing summonses at Police Courts. Result. Name of Inspector. 116, Devons Road 118, Devons Road 120, Devons Road 126, Devons Road 67, Augusta Street 35, Wade Street 36, Wade Street 40, Wade Street 48, Merchant Streel 49, Merchant Stree 51, Merchant Streel 26, Furze Street 28, Furze Street 20, Kurdett Street 18, Burdett Street 26, Grundy Street 26 and 28, Furze Street 20, Franklin Street 1 to 14, Hincks Place 20, Franklin Street 36, Tidey Street 19, Tidey Street 20, Tidey Street 42, Tidey Street 233, Brunswick Road 33, Cawdor Street 150, Kerby Street 152, Kerby Street 10, Alton Street 38, Follett Street 36, Follett Street 69, Kerby Street Water supply to W.C. unsuitable. Vard improperly paved. Forecourt unpaved. No under floor ventilation. Walls of wash-house are dirty and damp. Accumulation of refuse in yard Yard not properly paved. Forecourt unpaved. Insufficient ventilation beneath ground floor. Flushing apparatus to W. C. out of order. Rain water-pipe defective. Wash house wall damp. Accumulation of refuse in yard Defective drain. No ventilation beneath ground floor rooms. Yard not properly paved. Forecourt unpaved. Walls and ceiling of wash-house dirty, damp and defective Defective drain. Yard not properly paved. Forecourt unpaved. Accumulation of rubbish in yard. Walls and ceiling of first floor rooms dirty. Walls of washhouse damp. Roof not watertight. Insufficient ventilation beneath ground floor rooms Drain not gas tight No means of drainage (drain had been cut off) As above As above The owner summoned for non-compliance with Magistrate's order, April 24th Yard and wash-house paving defective. W.C. soil-pan broken. W.C. and wash-house walls dirty a dilapidated. Faves, guttering and rain-water pipe defective Yard and wash-house paving defective. Wash-hot roof, eaves, guttering and rain-water pipe defectiv also sink waste pipe Drinking water improperly stored. Insufficient water to W.C. As above Defective drains The owner summoned by Mr Anthony for non-compliance with Magistrate's order, July 24th Wash-house paving defective (pool of putrid water) Drains defective. Forecourts and yards (in houses where they exist) badly paved. No underground floor ventilation, etc., etc Owner summoned for not obeying Magistrate's abatement order of September 18th No water to W.C. Eaves guttering defective Defective drain. Rain-water pipe connected Defective drain. Rain-water pipe connected. Walls of ground floor front room damp Defective drain. Drinking water improperly stored. Yard badly paved Defective drain. No proper water supply to W.C. Defective drain. No proper water supply to W.C. Closet and wash-house walls damp. Forecourt not properly paved, making ground-floor room damp. Yard paving in bad order. Rain-water pipe connected with drain. Drain inlet not properly trapped Forecourt not properly paved, making ground-floor room damp. Yard badly paved. Drain defective. No proper water supply to W.C. Defective drain Yard paving defective. No proper water supply to W.C. Roof not watertight. Eaves, gutters, and rain water-pipes defective. No under ventilation, etc. Roof not watertight. Rain water pipes and eaves, gutters defective. Defective roof. Insanitary condition of walls and ceilings of first floor rooms, staircase, and kitchen ... June 12 „ 12 „ 12 „ l2 ,, 19 ,, 19 ,, 19 ,, l9 July 24 ,, 24 ,, 24 „ 24 ,, 24 Septr. 4 ,, 11 „ 4 „ 18 „ 18 Octr. 9 Decr. 5 „ 5 „ 5 „ 5 ,, 5 „ 5 „ 5 „ 5 ,, 5 „ 5 „ 5 ,, 5 As above As above As above As above Adjourned 7 days, work since completed As above As above As above 40/- penalty 20/- penalty 20/. penalty Abatement order 7 days As above Summons withdrawn, work completed Abatement order 7 days, 9/- costs Withdrawn, work completed Adjourned twice, work completed, summons withdrawn Abatement order 4 days, 27/- costs. Abatement order 21 days, 10 guineas costs 40/- penalty, work since completed 7 days abatement order, 12/6 costs. Work completed, summons withdrawn As above As above As above As above As above As above As above As above As above Premises vacated, summons adjourned sine die Mr. Anthony. ,, ,, Mr. Dunn. ,, ,, ,, Mr. Anthony. ,, ,, ,, ,, Mr Dunn. Mr. Anthony. ,, ,, ,, ,, ,, Mr. Miners. ,, ,, ,, ,, ,, Mr. Dunn. 54 In the Court of Queen's Bench on April 14th, before Mr. Justice Charles and Mr. Justice Collins, the Queen v. Mead, one of the Metropolitan Police Magistrates, the point at issue was whether it was sufficient to leave the summonses under the Public Health (London) Act at the house or premises addressed to "the owner." Mr, Mead, the Magistrate dismissed the summons (15 Swaton Road, Bromley) on the ground that it had not been properly served on the owner of the premises; he contended that notices and summonses ought to be served on the owner by name at the last known address, and that a summons was not included as a document under section 128. A rule nisi for a mandamus was obtained. The Judges decided that the summons was properly issued and served, and that the Magistrate ought to have proceeded upon it. In serving notices and summonses the utmost diligence is used by the Inspectors, in order to find out owners' names and addresses, i.e., the persons who receive the rent, whether as agents or otherwise. Section 116 (3) enacts, that the occupier of any premises is liable to a fine of £5 if he wilfully refuses to disclose the name of the owner; but the difficulty of finding out who is the owner, sometimes, is very great, as the tenants are really not able to furnish the necessary information. I have known a case where the rents of a number of houses were collected by a poor woman living in an adjoining terrace, and although she paid over the collected money to a man, she did not even know his name and address, inasmuch as any receipt given by him was signed by his initials, and letters forwarded to her were signed in his Christian name only. In several instances the Rate Book has had to be consulted, in which the names of the occupier and the person paying the rates are given. As a rule the person collecting the rent pays the rates, but we 55 have found in some cases the person who pays the rates does not collect the rent. Notices have been served on the person whose name appeared on the Rate Book as paying the rates, and they have been returned with a letter stating another person to be the owner, and this individual has also repudiated his liabilities, and in the meantime the nuisance remained unabated; hence the necessity of serving documents on the premises addressed to "the owner," in order that the tenant,—who would have to be subpoenaed in the event of legal proceedings,—may give them to the person who collects the rent. It is clear that the object of the PublicHealth (London) Act is to provide for the summary remedy of nuisances. INSPECTION OF SCHOOLS AND SUNDAY SCHOOLS. In my last annual report I gave the work carried out in the Board and private Schools of the district; since that report all the Board Schools have been inspected, as well as all the known private and Sunday Schools. Drainage work of an extensive nature has been carried out at the Upper North Street, Marner Street and Bromley Hall Road Board Schools; work of a similar nature is being done at the Oban Street, Alton Street, and St. Leonard's Road Board Schools. Plans have been submitted for the re-drainage of Bromley High Street Board School. Glaucus Street and Knapp Road Board Schools have been inspected, the first-named school was found to be in good order, and the last is to be re-drained and enlarged. New Board Schools are to be erected in the Orchard House district, and then the work at the 18 Board Schools in Poplar and Bromley will have been completed. The Inspectors' reports will show the work executed in the private and Sunday Schools. INSPECTION OF FOOD, FISH, MEAT, &c., EXPOSED FOR SALE The meat, food, fruit and vegetable stalls have been constantly inspected. In the month of November, together with the Inspectors, 56 I seized in Chrisp Street 43 tins of condensed milk. The man who had care of the barrow, when charged before the Magistrate, stated that he was not the owner of the milk, and upon information given by him the premises of the owner were entered by the Medical Officer of Mile End, he being armed with a search warrant, and a seizure was made of a large quantity of tinned milk and articles of food. The results of the ultimate police-court proceedings were, the man in charge of the barrow was fined 5s., the owner £5 and 2s. costs, and the firm who sold the milk in the first place were fined £20 and £5 5s. costs, the penalty in the last instance being inflicted under the Public Health (London) Act, Section 47 (3), which is a new provision. Three hundred and ninety-two tins of lobster were seized by Mr. Miners in Chrisp Street. The owner was fined £5 and 30s. costs, or 21 days' imprisonment. Legal technicalities arose at the hearing of this last case before the Magistrate, and I learnt so very important a lesson, that I wrote the following letter, which was published in the Lancet and British Medical Journal:— "When sanitary officers are about to seize unsound food, more especially that which is tinned, I should like to point out a legal technicality which has arisen through the decision recently given in the case of Regina v. Dennis. This decision, it will be remembered, is the result of the appeal decided by eleven judges. The case is reported at some length in the Justice of the Peace, September, 29th. The conviction against Dennis was quashed, ten judges assenting. Mr. Justice Mathew, the only dissenting judge, in giving his opinion, stated: 'I do not see why, if the notice in question should be held to exonerate the seller, a notice to the same effect set up in the shop or on the barrow of the buyer should not be equally available to him as an answer to proceedings for seizure, condemnation, or punishment under the statutes.' I will now explain how this statement has 57 bearing upon a seizure recently made in my district. On the night of November 30th, 392 tins containing lobster were seized in Chrisp Street, Poplar. At the time of seizure fifteen tins were opened on the barrow; 156 tins were also opened, but placed under the barrow, and the remainder were unopened on the barrow. On the barrow was exhibited a good-sized card stating, 'Fresh lobsters, 1½d. a tin; all bad ones changed.' The 392 tins were taken next day (December 1st) before Mr. Dickinson, the Magistrate sitting at the Thames Police Court, who requested that all the unopened ones should be opened, and then he made the order for the contents of the whole number seized to be destroyed. The owner was summoned on December 7th for the exposure of the lobster. The defendant's solicitor pleaded that the contents of the tins under the barrow were not exposed for sale, but were placed there in order to be destroyed, and that the contents of the only tins exposed for sale were those of the fifteen opened ones on the barrow; and he argued that so far as the unopened tins on the barrow were concerned the defendant covered himself by exhibiting the notice, 'All bad ones changed.' When I was giving my evidence I was asked: 'Did I see these fifteen tins apart from all the other opened tins?' My answer was in the negative, for when the Sanitary Inspector sent for me to go to Poplar Police Station the fifteen opened tins were mixed with the other opened ones taken from under the barrow; but I explained that these fifteen opened tins could not have been good because there was not one good tin among the whole number seized. The defendant was fined £5 and 30s. costs. Now, Sirs, as I was unable to pick out the fifteen tins, I feel certain that a conviction would not have been obtained if the whole number of opened tins had not been bad. This shows from the recent decision, in order to obtain a conviction for exposure, the importance of keeping separate at the time of seizure of tinned food any tins exposed on a barrow or stall. This may seem a trivial point to write about, but I have had some little experience in seizing tinned food in the streets, and I may say the duty is not a pleasant one, especially in a crowded 58 market street late at night, when one is liable to be hustled and the tins mixed." Appended are the reports of the Inspector of Nuisances in Workshops and Factories, and the Sanitary Inspectors. I am, Gentlemen, Your obedient Servant, FREDERICK WILLIAM ALEXANDER, Diplomate Public Health (England), Medical Officer of Health, Offices of the Board, Poplar and Bromley. 117, High Street, Poplar, 31st December, 1894. 59 To the Medical Officer of Health for Poplar and Bromley. December 31st, 1894. Sir,— I beg to lay before you my second Annual Report of the Sanitary work carried out in my district (Bromley North Division), during the year 1894. 1690 premises have been inspected, 425 being on account of notifications of infectious diseases, 655 in response to complaint of nuisances, the remaining 610 being house-to-house inspections. Of the above inspections made, sanitary improvements were found to be necessary in 1502 instances; this has caused the service of 1485 written intimations, and 840 Statutory notices in accordance with the Public Health (London) Act, 1891. I have also inspected the whole of the under-mentioned streets:— Weston Street Burdett Street Tibbatts Road Priscella Road Reeves Road Ireton Street House-to-House Inspection. Sections of the under-mentioned Streets. Whitethorn Street Empson Street Devons Road Botolph Road Rounton Road Donald Street. Priory Street Tidy Street Devas Street Powis Road Campbell Road Marner Street Swaton Road High Street, Bromley Fairfoot Road Box Street Spanby Road Fern Street Knapp Road Thomas Street Raverley Street Franklin Street Gurley Street River Street Tomlin Grove Eagling Road Colin Street 60 Plans submitted for Drainage of Houses and other premises. Bow Fire Station 3 to 45 Marner Street. 83 Marner Street. 2 to 38 Priory Street 96 to 104 Campbell Road White Swan B. H. Devons Road. 1, 3, 5, Shepherd Street. 74 to 90 Campbell Road. 93 to 103 St. Leonard Street. 69 to 83 Campbell Road. Board School, High Street Bromley. Drains re-constructed on the old lines. 108, 110 and 112 Fairfoot Road 155 to 169 Fairfoot Road. 1 to 45 Priscilla Road. 9, 11, 13, 15, Powis Road, n6 to 126 Devons Road 2, 4, 6, 8, Eastward Street. 26, 28 Furze Street. 3, 4. 5. 6, 7, 8, Perring Street. 80, 82, 84, 86, and 88 Empson Street. 58, 60, 62, 64, and 66 Empson Street. 95, 97, 99, 63, 65, 67 Fairfoot Road. 6 Whitethorn Street. 106 Fern Street. I have also inspected the under-mentioned Schools— Bromley, High Street. Berger Hall. Bruce Road Congregational Church Tryphena Mission Hall. By directions of Mr. Young, the Public Analyst, I have obtained 61 45 samples of food and drugs for analysis. Legal proceedings were instituted against 10 of the respective vendors, and on these 10 cases convictions were obtained, the penalties inflicted by the presiding Magistrate, varying from fifteen shillings to ten pounds. The Market and Stalls 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 Slaughter Houses in my district. The Licensed Slaughter Houses number 4 The Licensed Cowhouses 7 List of Sanitary Works carried out in Bromley, North Division, from 1st January, 1894, to 29th December, 1894. Houses or other premises inspected 1690 Walls and ceilings of premises cleansed throughout 50 Do. do. do. partially 355 Drains opened and cleansed 292 Inlets to drains trapped with stoneware gullies 334 Drains re-constructed, repaired, or amended 682 Sink waste pipes properly disconnected from drain 212 Rain water pipes do. do. do. 238 Roofs made water-tight 144 Eaves, gutters, and rain water pipes repaired 290 Water laid on to soil pans of W.C.'s 354 New soil pans provided 516 Foul soil pans cleansed 146 Soil pans trapped 22 Water supplies reinstated to houses 61 Water service altered so as to draw direct from main 230 Defective water fittings repaired 46 Yards, forecourts, and areas paved 757 Do. do. do. drained 87 Accumulations of dung and other refuse removed 57 Other nuisances remedied 487 62 Drains tested by the application of smoke test 1193 W.C.'s properly ventilated 10 Foul public-house urinals, properly cleansed 3 Overcrowdings abated 4 Dampness been remedied 125 Breaches of L.C.C. Bye-laws 5 Summonses applied for 54 Re-inspections made 5170 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. BOARD OF WORKS FOR THE POPLAR DISTRICT. Sanitary Department, 31st December, 1894. To the Medical Officer of Health. Poplar and Bromley. Sir, I beg to submit for your information the following statement of nuisances abated and sanitary improvements carried out under my supervision in the Southern Division of Bromley, during the year ending December 31st, 1894. I have inspected 1479 premises, 357 being on account of notifications of infectious diseases, 869 in response to complaints of nuisances, the remaining 253 being house-to-house inspection of the undermentioned streets. 63 The whole of Bartlett Street Sections of Cordelia Street „ „ Dunbar Cottages „ Culloden „ „ „ Glencoe Street „ Dee „ „ „ Hack „ „ Kerbey „ „ „ Moness „ „ St. Leonard's Road „ „ Uamvar „ „ Zetland Street „ „ St. Leonard's Avenue „ „ Thomas Place The drains of 941 premises have been tested with the Board's smoke test, 444 were proved defective (not gas tight) and in 497 instances the test revealed no defects. Out of the 1479 total inspections made, 153 premises were found to be in fair condition; and in the remainder the following sanitary works have been carried out. (See Appendix.) During the year 22 summonses have been taken out under the Public Health (London) Act, against owners for non-compliance with notices served: 13 were withdrawn, the work having been completed before the day of hearing, 8 were adjourned sine die, as proceedings were being commenced in a higher Court by one of the persons summoned, and one case the Magistrate made an Abatement Order with ten shillings and sixpence costs. Two summonses were taken out against workmen for improper construction or repair of drains, and they were each fined five shillings with costs. The market places and stalls have been regularly inspected, but only one seizure has been made. On the 30th November 392 tins of potted lobster were seized from off a barrow in Chrisp Street. The Magistrate made the condemnation order, granted summonses and fined one man (the owner) £5 and 30 shillings costs; the summons against his assistant was withdrawn, it being proved he was not responsible. The penalty and costs not having been paid, a 64 commitment warrant was granted on my application to the Magistrate, and the Defendant was committed to prison for 21 days. I have on several occasions, on the vendors' application, examined the fruit, fish, etc., etc., purchased by them at the market, and when found unsound, had the same destroyed as unfit for food, and have given the necessary certificate to that effect. The drains in connection with the following premises have been re-constructed. Albert Street, No. 25. Bloomsbury Street, Nos. 1, 2, 7, 8, 11, 18, 19, 26, 27, 31. Brabazon Street, No. 34 (main drain without its branches). Brunswick Road, Nos 232, 234, 236, 238. Byron Street, No. 29. Chrisp Street, No. 73. Cobden Street,No. 14(main drain,branchesamended previously). Chadbourn Street, Nos. 1, 2, 3, 4, 14 15, 16, 17, 18, 19, 20, 21. Desart Street, 16. East India Road, 341, 417, 455. Ellesmere Street, 13, 37 (main drain, without its branches). Grundy Street, 154, 156. Ida Street, 65, 62. Kerbey Street, 135, 137, 139, 141, 143. Mauve Street, 18, 20. Prospect Place, 1, 2, 3, 4, 5, 6, 7. Railway Street, 49, 50, 51, 52, 53. Rowlett Street, 1, 15,16, 17, 25, 26, 29, 30, 31,32, 33, 34, 35 36 St. Leonards Road, 13, 15, 17, 19, 21, 23, 25, 30, 32, 33, 34, 35. 36. 37. 47, 122, 124, 126, 128, 130, 132, 134. 136, 138, MO. 142, 144. 146, 148. 150, 229, 231, 233, 241, 243, 245, 247, 327, 329, 331, 333, 335, 337, 339, 341 St. Leonards Street, 138, 140, 142, 144. 65 St. Leonards Avenue, 21, 23, 25, 27. Tetley Street, 16, 21, 23, 25, 27, 29, 31, 33, 49, 51, 53, 55, 57, 59. Wellington Street, 1, 1A., 2, 3, 4. Willis Street, 18, 33, 35, The execution of the above works of Sanitary improvement necessitated the submitting to the Board plans for 106 premises. Since my last annual report the Sanitary works in connection with the following schools have been finished:— Bromley Hall Road Board Schools. Oban Street Board Schools, unfinished, (nearly completed). Alton Street Board Schools. St. Leonard's Road Board Schools. The schools inspected for the year are as follows:— Baptist Sunday Schools, Zetland Street. Felstead Mission, Church Sunday Schools, 274, St. Leonard's Road. City Mission, Sunday Schools, 130, Grundy Street, Primitive Chapel, Sunday Schools, Chrisp Street. 154 St. Leonards Road, Private School. 33, Cawdor Street „ „ 35, Rowlett Street „ „ 18 Dewberry Sreet „ „ The works in connection with above schools are finished, the Primitive Chapel and Sunday Schools, Chrisp Street, were found to be in fair condition at the time of my inspection. All the Cow and Slaughter-houses were inspected before the time for the renewal of the annual licenses in October, and found in fair condition. Licensed Slaughterhouses 2 Licensed Cowhouses 4 E 66 I have further to report that for the year ending December 31st, 1894, 45 bodies of persons who have died at the Poplar Hospital have been removed from that institution to the Poplar Mortuary, for the convenience of the relatives and the holding of inquests thereon, when needed. In no case has it been necessary to use the Board's Mortuary, Wellington Road, Bromley, for the retention of bodies, until such time or arrangements could be made (or the burial of same. By the directions of Mr. Young, the Public Analyst, I have obtained 51 samples of food &c. for analysis. Legal proceedings were taken against eight vendors, which resulted in penalties being inflicted as follow:— Two cases 30/- penalty and 2/- costs each, two cases of 40/- penalties and 2/- costs in one case, one case 20/- penalty and 2/- costs, and the remaining case 60/penalty without costs, and one case under the Margarine Act, 20/penalty and 3/- costs. I am, Sir, Your obedient Servant, RICHARD EUSTACE MINERS, Sanitary Inspector and Inspector appointed under the Sale of Food and Drugs Acts. APPENDIX. Table of Sanitary Works carried out for the year ending December 31st, 1894. Walls and ceilings of houses cleansed throughout 29 Do. do. do. partially 181 Yards and areas sufficiently or properly paved 339 Do. do. properly drained 119 Inlets to drains properly trapped 317 Drains freed from obstruction 249 Bath, sink, or lavatory waste pipes repaired, trapped or disconnected form drains 136 Rainwater pipes disconnected from drains 126 67 Soil pans, water supplies provided or reinstated 271 Soil pans reinstated where defective 95 Soil pans cleansed where in foul condition 182 Soil pans and drains in connection with same reinstated where found to be untrapped 32 Roof guttering and rainwater pipes reinstated 165 Roofs repaired or made watertight 93 Water supplies reinstated where cut off through defective fittings or other causes 63 Water supply fittings defective (causing nuisance from dampness) amended 44 Water supplies for domestic purposes altered or improved 183 Water closets means of ventilation improved 11 Water closets, newly constructed, and better situated 8 Nuisances from dampness abated 181 Nuisances from inundations abated 7 Dung and other offensive accumulations removed 23 Other nuisances abated, consisting principally of dilapidations, want of ventilation, &c. 249 Works carried out in compliance with London County Council's By-Laws relative to the fixing of soil pipes, ventilation of same, and furnishing of closets with pans, traps, and proper connections 13 I am, Sir, Your obedient Servant, RICHARD EUSTACE MINERS, Sanitary Inspector, South Bromley Division. BOARD OF WORKS FOR THE POPLAR DISTRICT. Sanitary Department, 31 st December, 1894. To the Medical Officer of Health. Poplar and Bromley. Sir, My second Annual Report is now due. During the past year 68 1199 premises have been inspected in the Northern Division of Poplar, 847 being in response to complaints, 247 through notifications of infectious diseases, the remaining 105 being house-to-house visitation, as follows:— The whole of Paris Terrace, Creek Side, Collins Place, Ivy Cottages and Bath Cottages and sections of Bygrove Street, Wells Street, West Street, Ashton Street and Orchard Place. In 157 premises inspected no insanitary conditions were discovered. Under the Public Health (London) Act 820 "Intimations," and in accordance with the Authorisations of the Sanitary Committee 480 "Statutory Notices" have been served. In 13 instances legal proceedings were instituted in order to enforce the abatement of the various nuisances, but in all but two cases the necessary works were either in progress or completed by the day of hearing, On April 16th an "Abatement Order" with costs was made by the Sitting Magistrate at the Thames Police Court in respect to No. 7 Creek Side, and on the same date an order was made with costs for the immediate closure of the whole of the occupied portion of Arnold's Buildings, as unfit for human habitation. The block comprised 67 tenements. For a long time previously these dwellings had been a source of great trouble and very difficult to deal with. The inhabitants were of the roughest and dirtiest class possible to imagine. The Market Places have been carefully watched throughout the year. On November 1st, with Inspector Miners, I assisted you in effecting a seizure of condensed milk in Chrisp Street. Further mention here would be superfluous. Upon several occasions fish, fruit and vegetables have been destroyed with the owners' consent. My work done under the "Sale of Food and Drugs Acts" with the results of legal proceedings, has been regularly reported to the Sanitary Committee throughout the year. 69 Appended is summary of nuisances abated and sanitary works carried out under my supervision. I beg to remain, Sir, Your obedient Servant, JAMES S. DUNN. Sanitary Inspector. Poplar North Division. APPENDIX. List of Sanitary Works carried out in Poplar North Division, for the Year ending 31st December, 1894. Walls and ceilings of Premises cleansed throughout 26 Do. do. do. partially 166 Yards, areas, and forecourts, properly paved and drained 319 Drains reconstructed 165 Obstructed drains cleared 256 Existing drains efficiently trapped, or otherwise improved 507 Bath, sink or lavatory wastes, or rain water pipes properly trapped or disconnected from drains 59 New water closets constructed 20 Existing water closets cleansed, repaired, or otherwise improved 230 Water supply to soil pans provided or reinstated 118 Water supply for dietetic purposes altered or improved 72 Water service reinstated 125 Offensive urinals cleansed and improved 5 Roof, gutters, or rainwater pipes repaired 286 Nuisances from inundations abated 31 Dampness remedied 127 Ventilation improved 79 Overcrowding abated 10 Dung, fish, or other offensive refuse removed 29 JAMES S. DUNN, Sanitary Inspector, Poblar North Division. 70 To the Medical Officer of Health for Poplar and Bromley. Sir,— December 31 st, 1894. I beg to submit my Annual Report of the Sanitary Work executed in the South Division of Poplar for the year ending December 31st, 1894. House-to-house inspections have been carried out as follows:— The whole of Manilla Street Sections of Stebondale Street. ,, „ Charles Terrace „ West Ferry Road. „ „ Stewart's „ „ Manchester „ „ „ Elizabeth Cottages „ Wharf „ „ Bradshaw „ „ Samuda Street. ,, „ Douglas Street „ Cahir „ „ „ Wiltshire Villas „ Chipka „ „ „ Albert Terrace „ Ferry „ „ „ Back Manchester Terrace „ Barque ,, „ „ Claude Street „ Strafford „ „ „ Gaverick „ „ Mellish „ „Havannah „ „ Davis „ Special inspections have also been made of the following Sunday Schools:— (1) Mission Hall and Sunday School. Stebondale Street. (2) „ „ „ Glengall Road. (3) Primitive Methodist Sunday School. Manchester Road. (4) „ „ „ Maria Street. (5) Wesleyan Sunday School. Stebondale Street. (6) „ „ „ Malabar „ (7) Christ Church Sunday School. Bilson ,, (8) ,, „ „ Ingelheim Place. (9) Salvation Army Barracks and Sunday School. Malabar Street. (10) Congregational Sunday School. West Ferry Road. (11) Presbyterian „ „ „ „ 71 In addition to the above, 594 complaints of nuisances and 245 notifications of inspectious diseases have been received and dealt with. In two instances on receipt of notifications from Port Sanitary Authorities of persons proceeding from Continental Ports to destinations in my District, I have visited the addresses given and found the persons named to be in apparently good health. Addressed cards were left with instructions to post same immediately should illness occur on the premises. During the year in response to the Hoard's intimations and notices served, the drainage systems of the under-mentioned premises have been re-constructed as follows:— (1) Nos. 1 to 13, Claude Street and 158 to 166, West Ferry Road. (2) 14 to 25, Claude Street, and 168 to 178, West Ferry Road. (3) 311 to 331, West Ferry Road, and 1 to 5, Ingelheim Cottages. (4) Mechanics' Arms P.H., West Ferry Road. (5) 1 to 9, Cahir Street, and 5 to 9, Bradshaw Cottages. (6) 1 to 4, Bradshaw Cottages. (7) 11 to 17, Cahir Street. (8) Mission Hall and Sunday School, Ingelheim Place, and 333, 335, West Ferry Road. (9) 337 to 359, West Ferry Road. (10) 220 to 224, „ „ (11) 22610236, „ „ (12) 41310421, „ „ (13) Glengall Arms P. H. „ (14) Presbyterian Sunday School, West Ferry Road. (15) 5 to 13, Manilla Street. (16) 38, ,, „ (17) 40, „ „ (18) 42, „ „ (!9) 44, „ „ (20) 46, „ „ (21) 19, 21, „ „ 72 (22) 12 to t8, East Ferry Road. (23) 13 to 19, „ „ (24) 2 to s, Seyssel Street. (25) 64 to 72, Mellish Street. (26) 74 to 78, „ „ (27) 1 to 13, Ship „ (28) 7, 8, 9, Johnson „ (29) 15 to 20, Samuda „ (30) i, 2, 3, 4, Northumberland Cottages. (31) 64 to 72, Stebondale Street. (32) 147. 149, „ „ (33) 1 to 4, Stewart's Terrace. (34) 26, Cuba Street (Beer House). (35) 42 to 60, Havannah Street. (36) 44, 46, Glengall Road. All the above were intercepted, ventilated, and means of access provided, and the drains of the under-mentioned premises were re-constructed on the old lines. (37) 9 to 15, Brig Street. (38) 45 to 51, Malabar Street. (39) 9 to 19, Stebondale ,, (40) 61, 63, Stebondale Street. (41) 77 to 87 „ „ (42) 89 to 97 „ „ (43) 103 to 123 „ „ (44) 361 to 365, West Ferry Road, and (45) 1 to 4, Elizabeth Cottages. (46) 20 to 28, East Ferry Road. (47) 7 to 12, Barque Street. (48) Mission Hall and Sunday School, Stebondale Street (49) 1, to 7, Strafford Street. (5°) 9, 11, „ „ 73 (51) 5 to 14, Stewarts Terrace. (52) 36 to 42, Glengall Road. (53) 36 to 42, Manchester Road. (54) "Ship" P.H. West Ferry Road. (55) 1 to 9, Albert Terrace. (56) 6, and 8, Newcastle Street, (57) 8a. to 10, Strafford Street. (58) 15, 17, Manilla Street. It was necessary for plans to be submitted in 35 of the above drain re-constructions, in accordance with the Board's regulations. Out of the 1375 total inspections made, 148 premises were found to be in fair condition; 89 per cent. required various works of sanitary improvement, 556 drains were proved defective and not gas-tight by the Board's smoke drain test, and in 206 instances the tests revealed no defects. The whole of the Sunday Schools inspected required various works of sanitary amendment. The nature of the works executed, sanitary improvements made, nuisances abated, &c., during the year are shewn in the appended list. 48 samples of food and drugs have been procured and submitted to Mr. Young for analysis; 3 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 of 30/- 40/and £7 respectively inflicted. 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 notices. The food stores of the district have been regularly inspected with 74 a view of detecting diseased and unwholesome food, hut no seizures were necessary nor made during the year. 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. APPENDIX. Nature of Work executed in Poplar, South Division, during the year ending 31st December, 1894. Inspections made 1372 On complaints of nuisances 594 On notifications of infectious diseases 245 House to house visitation 533 Details of Sanitary Works executed. Internal surfaces of premises cleansed throughout 77 Do. do. partially 265 Yards, areas, forecourts, and wash-houses paved and drained 363 Drains reconstructed, cleansed, repaired, or amended 732 Inlets to drains trapped with suitable stoneware traps 207 Drains tested, defects revealed 556 762 Do. negative results 206 Sink waste paper properly disconnected from drains 40 Rain-water pipes do. do. 90 W.C. soil pans furnished with suitable and sufficient water supplies 219 W.C. soil pans renewed, cleansed, or properly trapped 242 W.C.'s ventilated 37 Do. reconstructed 5 Cesspools abolished 2 Dung receptacles provided or repaired 4 Urinals (public-house) repaired and cleansed 4 Defective water fittings, burst pipes, &c., repaired 38 75 Drinking-water cisterns cleansed and covered, or draw taps from main provided 60 Water service reinstated when cut off by East London Water Company 79 Rain-water pipes and gutterings repaired 262 Roofs made water-tight 204 Dampness remedied 174 Floodings abated 9 Nuisances from improper keeping of animals abated 4 Ventilation of rooms improved 13 Overcrowdings abated 1 Various nuisances from offensive accumulations and dilapidations abated 213 Breaches of bye-laws rectified 12 Intimations served 958 Notices served 478 Do. (final) served 122 Re-inspections 4331 Summonses taken out 9 Abatement orders (Magistrate's) made 7 Closing orders do. do. 2 Do. rescinded 9 CEPHAS FOAD. Assoc. of the San. Inst. Sanitary Inspector and Inspector under Sale of Food and Drugs Acts, No. I District, Poplar Board of Works. 76 Summary of Notices and Improvements carried out at the different Manufactories and Workshops in the Poplar and Bromley District, for the year ending December, 1894. Nature of Nuisance. Number of Notices served. Cause of Nuisance. How Remedied. Smoke Nuisance 36 Burning of inferior fuel, and defective smoke consuming apparatus. A better class of fuel is now used. Insufficient latrine accommodation 14 In each case the latrine accommodation was insufficient. In each case the accomodation has been increased, and fitted up on the most improved principle. State of workshops 2 Walls and ceilings of workrooms in dirty and dilapidated condition. In each case the workrooms were thoroughly cleansed. Fish skin drying 1 Nuisance caused by scraping and drying fish skins. Nuisance discontinued. India Rubber Works 1 Nuisance caused by boiling India rubber clippings. The operation is now carried on in a closed vessel. Artificial Manure Works 1 Escape of noxious vapours from mixer. The apparatus has been repaired. Fat Melters 2 Nuisance caused by boiling refuse fat in open vessels. The process has been discontinued. Lead Works 1 Escape of lead fumes from main shaft. The premises complained of are stopped for the present. Oil boiling 1 Furnace defective. The furnace has been thoroughly repaired. Chemical Works 1 Escape of acid vapours. The condensing apparatus has been repaired. 77 Nature of Nuisance. Number of Notices served. Cause of Nuisance. How Remedied. Dust destructor 1 Offensive vapours and dust discharged in the atmosphere. Extra precautions taken to prevent dust, &c., escaping. Storage of Fish offal 1 Nuisance caused by an accumulation of offal at the depôt. The offal is now removed daily. Fish curing 1 Defective wooden smoke hole. The smoke hole has been pulled down. Bone glue 1 Vapours from bone glue department allowed to escape. Extra condensing power has been provided. Refuse in sewer 1 Oil and tar refuse discharged into sewer. The refuse is now sent away in casks. Bakehouses 50 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 carried out. C. W. RAYMOND, Inspector of Nuisances in Manufactories and Workshops.