POP 3 Board of Works for the Poplar District. REPOET 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, 1895. 1896. POP 3 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, This report is for the year 1895, and is the third annual report on the vital statistics and sanitary condition of the parishes of Poplar and Bromley, which I have had the honour of presenting to your Board:— VITAL STATISTICS. I estimate the populations of the parishes to the middle of the year 1895 to be as follows:—Poplar 57,508, being 49.4 persons to an acre, and Bromley 72,658 being 119.5 persons to an acre. Poplar, North 36,928 Bromley, North 33,733 „ South 20,580 „ South 38,925 Total 57,508 Total 72,658 A 2 North and South Poplar (for purposes of statistics) are those portions of the parish respectively North and South of the Northern bridges of the West India Dock. Bromley is divided by the Limehouse Canal into North and South. Each of the above divisions also constitutes a district allotted to a Sanitary Inspector. As the parishes of Poplar and Bromley form part of the Metropolis, and their boundaries are clearly defined, and their various statistics are compared with those of other Metropolitan parishes and with the Metropolis itself, I do not estimate their populations by means of logarithms, which I consider ought only to be used in estimating the populations of a locality, the area of which is not built over but has an extending nucleus. I estimate the above populations by taking the actual census of 1881 and the same of 1891, and calculating these per million to the actual population of the Metropolis for those years. This will show the proportion of the rate of change in ten years, which of course may be either an increase or decrease. Assuming this rate of change to be maintained for the ensuing ten years, multiply the rate of change by the number of years and one quarter (as the Registrar General makes his statistics up to the middle of the year, and the census it will be remembered is taken at the end of the first quarter) and this will give the rate of change for the year from the census under observation. Either subtract or add this rate of change (according as to whether there was found to be a decrease or increase per million in 1891) from the figure ascertained to be per million of the population of the Metropolis for the year 1891, and proportion the "remainder" or "sum" (as the case may be) to the estimated population of the Metropolis for the year under observation. As there is to be a quinquennial census for the Metropolitan sanitary areas during the year 1896, I shall be able to correct the figures obtained by this means of calculation. The births during the 52 weeks were:— 3 Males. Females. Totals.[/$$$] Poplar 1057 941 1998 Bromley 1365 1284 2649 Totals 2422 2225 4647 Of these births 78 were illegitimate in Poplar, 49 males and 29 females. In Bromley there were 20 illegitimate births, 13 males and 16 females. The annual birth rate per 1000 living being— 1894. 1895 Poplar 33.3 34.7 Bromley 35.2 36.4 During the year the marriages of 1748 persons were registered in Poplar and Bromley, giving an annual rate of 13.4 per 1000 of the estimated population, the rate for England and Wales being 15.0, and for London 17.1. The marriage rate for Poplar and Bromley for the previous year was 13.8. In the 52 weeks 1182 deaths were registered in Poplar and 2061 in Bromley; from the 1182 deaths which took place in Poplar there must be deducted 66 deaths of non-residents, and to the remainder must be added 308 deaths which occurred in outlying institutions, making a total of 1424 deaths of Poplar parishioners. Treating the 2061 registered deaths in Bromley in the same manner—viz. deducting 675 deaths of non-parishioners, and adding 202 deaths in outlying institutions, the deaths to be assigned to this parish will be found to be 1588 The 1424 deaths in Poplar included 33 illegitimate children—21 male and 12 female—and the 1588 deaths in Bromley included 84 illegitimate children—71 male and 13 female. Males. Females. Totals. Poplar 775 649 1424 Bromley 819 769 1588 1594 1418 3012 4 The annual death rate per 1000 living being:— 1894. 1895 Poplar 19.4 24.7 Bromley 18.6 21.8 The excess of births over deaths was as follows :— Males. Females. Total gain. Poplar 282 292 574 Bromley 546 515 1061 828 807 1635 The male deaths in the two parishes exceeded those of the female by 176, and the male births exceeded those of the female by 197. The death rates per 1000 living from the seven principal Zymotic diseases (see Tables pages 14 and 15) and Respiratory diseases were:— Poplar. Bromley.  1894. 1895. 1894. 1895. Respiratory Diseases 3.39 5.25 4.20 5.82 Zymotic Diseases 2.28 4.38 3.29 3.93 The cause of the increase in the various death rates, by a study of Charts I., II., and IV., will, I trust, be easily explained. In Chart I. the unprecedented cold at the beginning of the year is clearly shown, and in Chart II., during the corresponding period, the general death rate is seen to be steadily going up, whereas the zymotic death rate remains steady, and if anything is lower than usual. The increase of the death rate in the first quarter of the year was due to diseases of the respiratory organs. In the third quarter of the year the death rate again ran up, and it will be seen that the zymotic death rate went up also. Referring to Charts I. and IV. the deaths from diarrhoea and enteritis will be seen to have gone up tremendously. In London there were nearly 1200 deaths in three weeks. I shall touch upon the probable cause of diarrhoea under the heading of that disease. It is clear that 5 the rise in the zymotic death rate was due to diarrhoea, for the deaths from the miasmatic diseases, as shown in Tables VI. and VII., pages 12 and 13, are seen to be higher in the second than in the third quarter of the year. There were 380 deaths of children under one year belonging to Poplar, and 489 deaths under one year belonging to Bromley, giving rates per 1000 births of 190 and 184 respectively. The infantile mortality rate in 1894 was 152 for each parish. The excessive cold and heat during the year 1895 causing respiratory disease and diarrhoea, respectively, no doubt account for the increase in this rate. The Table V. on page 11 gives the comparison with the other Metropolitan areas, and I consider that Poplar and Bromley stand well in respect to the eastern districts. The number of deaths over 65 years was 238 belonging to Poplar, and 207 to Bromley. It is interesting to see how the cold weather affected the children under one year and the old people over 65 years. Poplar. Bromley. Under one year. Over 65 years. Under one year. Over 65 years. 1 st Quarter 97 105 121 82 2nd „ 80 48 112 48 3rd „ 121 41 170 33 4th „ 82 44 86 44 Total 380 238 489 207 From this it will be seen that infants under one year died mostly in the third quarter, and people over 65 in the first quarter of the year, the causes being diarrhoea in the first instance and respiratory diseases in the second. Two parishioners belonging to Poplar died at the age of over one hundred years, being 103 and 104 respectively. 6 TABLE (A) Table of Deaths during the year 1895, in the POPLAR according to Diseases, 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 At all Ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under i5. 25 and under 65. 65 and upwards. Smallpox. Scarlatina. Diphtheria. Membranous Croup (a) (b) (c) (d) (e) (f) (g) (h) (i) 1 2 3 4 Poplar 1035 362 244 42 24 222 141 Under 5 .... 5 22 5 5 upwds. .... 4 9 1 Poplar Union Workhouse 98 11 2 .... .... 32 51 Under 5 .... .... .... .... 5 upwds. .... .... ... .... Millwall Docks 14 .... .... .... 1 11 2 Under 5 .... .... .... .... 5 Upwds .... .... .... .... East India Docks 4 .... .... 1 1 2 .... Under 5 .... .... .... .... 5 upwds. .... .... .... .... West India Docks 4 .... .... .... 2 1 1 Under 5 .... .... .... .... 5 upwds. .... .... .... .... South-West India Docks. 1 .... .... .... .... .... 1 Under 5 .... .... .... .... 5 upwds. .... .... .... .... Poplar Dock 2 .... .... .... .... 2 .... Under 5 .... .... .... .... 5 upwds. .... .... .... .... Limehouse Cut 1 .... .... 1 .... .... .... Under 5 .... .... .... .... 5 upwds. .... .... .... .... River Thames 17 .... .... 3 6 8 .... Under 5 .... .... .... .... 5 upwds. .... .... .... .... Poplar Highway 5 1 2 2 Under 5 .... .... .... .... 5 upwds. .... .... .... .... Scandinavian Home 1 .... .... .... .... 1 .... Under 5 .... .... .... .... 5 upwds. .... .... .... .... Totals 1182 373 246 47 37 281 198 Under 5 .... 5 22 5 5 upwds. .... 4 9 1 The subjoined numbers have also been taken into account Deaths occurring outside the Division or District among persons belonging thereto. 308 14 46 23 18 143 64 Under 5 .... 8 11 .... 5 upwds. .... 3 7 .... Deaths occurrirg within the Division or District among persons not be[???] thereto. 66 7 1 5 7 22 24 Under 5 .... .... .... .... 5 upwds. .... .... .... .... 7 I. Division of the Metropolitan Sanitary District of Poplar, classified Ages and Localities. from subjoined causes, distinguishing deaths ok children under five Years of Age. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Influenza. Phthisis. Bronchitis, Pneumonia & Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Typhus. Enteric, or Typhoid. Continued. Relapsing. Puerperal. 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 ... 2 ... ... ... ... ... 75 30 48 ... 1 1 127 3 14 273 606 ... 5 ... ... 2 ... ... 3 ... 1 7 13 56 96 53 13 166 429 ... ... ... ... ... ... ... ... ... 2 ... ... ... 2 ... ... 9 13 ... 1 ... ... 1 ... ... ... ... 1 ... ... 10 27 8 1 36 85 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 10 1 14 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... 2 1 1 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 ... 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 16 ... 17 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 3 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 2 ... ... ... ... ... 75 30 50 ... 1 1 129 3 14 282 619 ... 6 ... ... 4 ... ... 3 ... 2 7 13 66 125 65 51 207 563 in judging of the mortality of this Division of the Sanitary District. ... ... ... ... ... ... ... 4 l ... ... ... 5 6 ... 3 22 60 ... 5 ... ... ... ... ... ... ... ... 1 ... 45 45 14 17 111 248 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... ... 6 8 ... 1 ... ... 1 ... ... ... ... ... ... ... 3 14 7 18 14 58 8 TABLE Table of Deaths during the year 1895, in the BROMLEY according to Diseases, 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 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. (a) (b) (c) (d) (e) (f) (g) (h) (i) 1 2 3 4 Bromley 1216 452 293 53 35 246 137 Under 5 ... 6 23 ... 5 upwds. ... 1 13 1 Sick Asylum 539 37 47 10 17 300 128 Under 5 ... ... 1 ... 5 upwds. ... ... ... ... City of London Union Infirmary 123 5 5 ... 2 74 37 Under 5 ... ... ... ... 5 upwds. ... ... ... ... Stepney Union Workhouse 108 6 1 ... 2 38 61 Under 5 ... ... ... ... 5 upwds. ... ... ... ... Poplar Hospital 60 1 6 8 3 36 6 Under 5 ... ... 1 ... 5 upwds. ... ... 1 ... North London Railway 1 1 ... ... ... ... ... Under 5 ... ... ... ... 5 upwds. ... ... ... ... Bromley Highway 3 1 ... ... 1 1 ... Under 5 ... ... ... ... 5 upwds. ... ... ... ... Limehouse Cut 6 ... ... ... 4 2 ... Under 5 ... ... ... ... 5 upwds. ... ... ... ... River Lea 4 ... ... ... 1 3 ... Under 5 ... ... ... ... 5 upwds. ... ...... ...... ...... Bow Cemetery 1 1 ... ... ... ... ... Under 5 ... ... ... ... 5 upwds. ... ... ... ... Total 2061 504 352 71 65 700 369 Under 5 ... 6 25 ... 5 upwds. ... 1 14 1 The subjoined numbers have also been taken into account in Deaths occurring outside the Division or District among persons belonging thereto. 202 20 55 28 17 54 28 Under 5 ... 8 16 ... 5 upwds. 1 4 10 ... Deaths occurring within the Division or District among persons not be- 675 35 45 14 23 368 190 Under 5 ... ... 1 ... 5 upwds. ... ... 1 ... 9 II. Division of the Metropolitan Sanitary District of Poplar, classified Ages and Localities. from subjoined causes, distinguishing deaths of children under five Years of Age. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Influenza. Phthisis. Bronchitis, Pneumonia & Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Typhus. Enteric, or Typhoid. Continued. Relapsing. Puerperal. 5 6 7 8 9 1o 11 12 13 14 15 16 17 18 19 20 21 22 ... ... ... ... ... ... 1 98 25 50 ... 3 1 192 8 16 322 745 ... 6 ... ... 1 1 ... 1 2 4 1 8 68 140 58 8 158 471 ... ... ... ... ... ... ... 17 2 ... ... ... 3 17 ... ... 44 84 ... 3 ... ... ... ... ... 1 ... ... ... ... 117 109 36 12 177 455 ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 8 10 ... ... ... ... ... ... ... ... ... 3 1 1 16 19 18 ... 55 113 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 6 7 ... ... ... ... ... ... ... ... ... 2 ... 2 6 23 15 1 52 101 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 1 7 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 3 42 6 53 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ...... ... 2 ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ...... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 ... 6 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 115 27 50 ... 3 5 211 8 23 382 856 ... 9 ... ... 1 *1 ... 2 2 9 2 11 208 291 132 73 448 1205 judging of the mortality of this Division of the Sanitary District. ... 1 ... ... ... ... 2 2 ... ... ... 3 17 ... 2 24 75 ... 5 ... ... 2 ... ... ... ... ... ... ... 12 13 8 6 66 127 ... ... ... ... ... ... ... 13 2 ... ... ... 3 14 ... 5 42 80 ... 1 ... ... ... ... ... 1 ... 5 1 3 125 117 60 46 235 595 * English Cholera. 10 TABLE III. The year 1895. Population estimated to the middle of the Year 1895. Persons to an Acre (1895) Births. Deaths The Deaths registered include Deaths of Deaths from Inquest Cases. Deaths in Public Institutions. Infants under Year of Age. Persons aged 65 Years and upwards Principal Zymotic Diseases Sma11pox. Measles Scarlet Fever. Diphtheria. Whooping Cough. Fever. Diarrhoea. Violence. Towns . 10,591,530 35.3 330,896 218,165 60,254 — 29,957 120 5623 1883 3735 3888 2115 12,593 7809 15,470 42,148 London 4,392,346 58.8 133,715 86,937 22,173 — 11,544 55 2632 829 2316 1483 629 3600 3407 7516 23,283 Poplar 57,508 49.4 1998 1424 380 238 252 0 82 20 55 31 12 52 67 222 347 Bromley 72,658 119.5 2649 1588 489 207 286 1 105 19 64 29 14 56 53 220 340 TABLE IV. The year 1893. 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 1 to 65 Years. Aged 65 Years and upwards Inquest Cases. Deaths in Public Institutions. 33 Great Towns 31.3 20.6 2.84 0.01 0.53 0.18 0.35 0.36 0.20 1.19 0.74 182 — — 7.1 19.3 London 30.5 19.8 2.63 0.01 0.60 0.19 0.53 0.34 0.14 0.82 0.78 165 — — 8.7 27.0 Poplar 34.7 24.7 4.38 0.00 1.42 0.34 0.95 0.53 0.20 0.90 1.16 190 14.01 4.13 15.5 24.3 Bromley 36.4 21.8 3.93 0.01 1.44 0.26 0.88 0.40 0.19 0.77 0.72 184 12.27 2.84 13.8 21.4 11 TABLE V. Sanitary Areas. Estimated Population in the middle of 1895. 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 4,392,346 9.5 2.6 19.4 165 West Districts. Paddington 122,756 6.9 1.7 17.2 164 Kensington 167,671 7.7 1 '9 16.5 172 Hammersmith 108,429 6.9 2.1 16.7 166 Kulham 117,745 7.7 2.9 18.7 187 Chelsea 99,930 10.8 2.2 19.2 168 St. George Hanover Square 74,037 7.0 1.6 15.9 138 Westminster 54,003 6.5 2.1 21.3 185 St. James Westminster 23,149 6.7 1.3 17.8 144 North Districts. Marylebone 137,392 8.9 1.7 20.8 138 Hampstead 77,592 7.1 1.0 12.0 135 St. Pancras 233,543 9.6 3.2 20.5 174 Islington 335,929 8.7 2.0 17.2 143 Stoke Newington 35,234 7.1 1.1 13.4 116 Hackney 215,623 9.9 2.5 17.4 154 Central Districts. St. Giles 37,654 8.3 2.1 22.9 160 St. Martin.in.the.Fields 13,536 6.1 1.8 18.1 265 Strand 22,586 8.8 2.2 25.3 175 Holborn 32,188 9.8 2.8 25.2 212 Clerkenwell 66,036 9.9 3.9 23.0 192 St. Luke 40,763 9.0 5.5 30.2 184 City of London 33,824 7.5 1.6 21.4 157 East Districts. Shoreditch 122,932 9.4 3.8 23.3 199 Bethnal Green 130,061 13.6 3.4 21.4 162 Whitechapel 75,820 13.8 3.3 24.1 157 St. George in-the-East 45,227 14.4 5.5 29.5 196 Limehouse 56,885 13.1 4.6 27.3 202 Mile End Old Town 108,443 13.8 3.9 22.5 165 Poplar (Parish) 57,508 13.6 4.3 24.7 190 Bromley (Parish) 72,658 11.4 3.9 21.8 184 South Districts. St. Saviour Southwark 26,570 8.0 2.9 25.5 205 St. George Southwark 60,168 7.5 3.2 25.4 198 Newington 119,358 8.0 3.4 24.1 201 St. Olave Southwark 13,065 4.9 2.4 24.1 206 Bermondsey 83,861 6.7 3.2 22.3 162 Rotherhithe 40,713 13.8 2.7 19.3 i48 Lambeth 284,883 9.7 2.6 19.6 152 Battersea 165,130 10.0 2.7 17.4 177 Wandsworth 185,956 7.1 1.3 14.8 132 Camberwell 252,737 9.7 2.6 18.3 164 Greenwich 175,183 12.4 2.7 18.9 150 Lewisham (excluding Penge) 82,410 6.5 1.5 14.4 135 Woolwich 42,768 7.9 1.7 17.5 153 Lee 38,832 7.0 1.4 14.5 140 Plumstead 61,494 12.5 2.5 15.2 133 Port of London 12 TABLE VI. POPLAR. 1st Quarters. 4th Total. 2nd 3rd Miasmatic Diseases 56 67 44 33 200 Influenza 10 2 1 1 14 Diarrhæal 4 5 40 3 52 English Cholera 0 0 0 0 0 Malarial 0 0 0 0 0 Zoogenous 0 0 1 0 1 Venereal 2 1 0 0 3 Septic 1 1 1 1 4 Parasitic Diseases 2 0 0 0 2 Privation and Alcoholism 0 1 0 0 1 Constitutional Diseases 66 61 49 49 225 Developmental Diseases. 45 22 22 21 110 Diseases of Nervous System 48 40 22 33 143 Diseases of Organs of Special Sense 0 1 0 1 2 Diseases of Circulatory System 23 22 20 19 84 Diseases of Respiratory System 134 62 44 62 302 Diseases of Digestive System 13 10 28 18 69 Diseases of Lymphatic System 0 0 0 0 0 Diseases of Gland-like Organs of Uncertain Use 0 0 1 0 1 Diseases of Urinary System 12 8 7 5 32 Diseases of Organs of Generation 0 1 0 1 2 Accidents of Childbirth 0 2 1 0 3 Diseases of Bones and Joints 2 0 0 0 2 Diseases of Integumentary System 1 2 3 1 7 Accident or Negligence 18 11 15 18 62 Homicide 0 0 0 0 0 Suicide 2 0 1 2 5 Ill-Defined and not Specified Causes 33 15 32 18 98 Total 472 334 332 286 1424 13 TABLE VII. BROMLEY. 4st. Quarters. 4th. Total. and. 3rd. Miasmatic Diseases 43 82 71 34 230 Influenza 9 1 0 1 11 Diarrhœal 3 1 46 6 56 English Cholera 0 1 0 0 1 Malarial 0 0 0 0 0 Zoogenous 0 0 0 0 0 Venereal 2 1 0 1 4 Septic 2 3 0 0 5 Parasitic Diseases 0 0 1 0 1 Privation and Alcoholism 1 4 2 1 8 Constitutional Diseases 47 57 57 49 210 Developmental Diseases 25 30 16 22 93 Diseases of Nervous System 47 36 36 34 153 Diseases of Organs of Special Sense 0 1 2 1 4 Diseases of Circulatory System 30 24 19 23 96 Diseases of Respiratory System 176 111 72 64 423 Diseases of Digestive System 20 11 27 17 75 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 7 7 4 4 22 Diseases of Organs of Generation 2 4 2 1 9 Accidents of Childbirth 1 0 3 0 4 Diseases of Bones and Joints 1 1 0 2 4 Diseases of Integumentary System 1 1 0 0 2 Accident or Negligence 11 13 11 12 47 Homicide 0 0 0 1 1 Suicide 1 1 1 2 5 Ill-Defined and not Specified Causes 35 18 48 23 124 Total 464 408 418 298 1588 14 TABLE VIII. POPLAR. Showing Mortality from certain groups of Diseases, and Proportions to 1000 of Population, and to 1000 Deaths, during the year ended 28th December, 1895, 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 57,508 Deaths from all causes 1424 Division I. (Adults.) Total Deaths. Deaths per 1000 of population. Proportion of deaths to 1000 deaths. 1. Seven principal Zymotic Diseases 252 4.38 176.9 2. Respiratory (other than Phthisis) 302 5.25 212.0 3. Tubercular Diseases 178 3.09 125.0 Division II. (Infants under one year.) Total Deaths. Deaths per 1000 of Births. (Births 1998) Deaths per 1000 of total deaths under one year. (380) 4. Wasting Diseases of Infants 118 59.05 310.5 5. Convulsive Diseases of Infants 38 19.01 100.0 NOTE. 1. Includes Small Pox, Measles, Scarlet Fever, Whooping Cough, Fever Diphtheria, and Diarrhoea. 3. Includes Phthisis, 114; Scrofula and Tuberculosis, 34; Rickets, 9; and Tabes, 21. 4. Includes Marasmus, Atrophy and Debility, 82; Want of Breast Milk, 0; and Premature Birth, 36. 5. Includes Hydrocephalus, 0; Infantile, 10, and Tubercular Meningitis, 2; Convulsions, 22; and Teething, 4. 15 TABLE IX. BROMLEY. Showing Mortality from certain groups of Diseases and Proportions to 1000 of Population, and to 1000 Deaths, during the year ended 28th December, 1895, 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 72,658 Deaths from all causes 1,588 Division I. (Adults.) Total Deaths. Deaths per 1000 of population. Proportion of deaths to 1000 deaths. 1. Seven principal Zymotic Diseases 286 3.93 180.0 2. Respiratory (other than Phthisis) 423 5.82 266.3 3. Tubercular Diseases 155 2.13 97.6 Division II. (Infants under one year.) Total Deaths. Deaths per 1000 of Births. (Births 2649) Deaths per 1000 of total deaths under one year. (489) 4. Wasting Diseases of Infants 159 60.00 325.1 5. Convulsive Diseases of Infants 51 19.24 104.3 NOTE. 1. Includes Small Pox, Measles, Scarlet Fever, Whooping Cough, Fever, Diphtheria, and Diarrhoea. 3. Includes Phthisis, 100; Scrofula and Tuberculosis, 19; Rickets, 5; and Tabes, 31. 4. Includes Marasmus, Atrophy and Debility, 109; Want of Breast Milk, 6; and Premature Birth, 44. 5. Includes Hydrocephalus, 1; Infantile, 8, and Tubercular Meningitis, 1; Convulsions, 34 ; and Teething, 7. 16 TABLE X. POPLAR. List of Deaths of Parishioners which occurred in Public Institutions and certain Localities during the year 1895. Banstead Asylum 4 Ilford Asylum 8 Colney Hatch Asylum 7 Leavesden Asylum 6 Caterham Asylum 2 London Hospital 22 Cane Hill Asylum 1 Metropolitan Hospital 1 Consumption Hospital 1 North Western Fever Hospital i City of London Chest Hospital. 1 North Eastern do. 4 Charing Cross Hospital ... 1 Poplar Hospital 12 Childrens' Hospital, Shadwell ... 22 South Eastern Fever Hospital 2 Darenth Asylum ... River Lea 1 Dock, Royal Albert i Royal Free Hospital 1 Dock, St. Katherine 1 Sick Asylum 143 East London Railway 1 Shoreditch Infirmary 1 Friern Barnet Lunatic Asylum 1 St. Bartholomew's Hospital 17 German Hospital 4 Seamans Hospital, Greenwich 3 Guys Hospital Union Workhouse, Poplar 39 Hanwell Asylum 2 University Hospital 1 Hospital for Women, Soho 1 347 Hackney Infirmary 1 Homerton Fever Hospital 25 TABLE XI. BROMLEY. List of Deaths of Parishioners which occurred in Public Institutions and certain Localities during the year 1895. Alexandra Hospital 1 Limehouse Cut 3 Bethnal House Asylum 2 Lewisham Infirmary 1 Bow Railway Station 1 Middlesex Hospital 4 Brompton Hospital 3 North Western Fever Hospital 3 Banstead Asylum 4 North Eastern do. 3 Childrens' Hospital, Great Ormond Street 2 Poplar Hospital 6 St. Pelagais Creche 1 Children's Hospital, Shadwell 32 South Eastern Fever Hospital 5 Convent Home 1 Royal Free Hospital 1 City of London Chest Hospital 1 River Lea 1 Caterham Asylum 1 St. Thomas' Hospital 1 Colney Hatch Asylum 2 St. Bartholomew's Hospital 8 Darenth Asylum 1 Samaritan Free Hospital 1 Guy's Hospital 3 Sick Asylum 135 Hanwell Asylum 1 Union Workhouse, Poplaf 22 Homerton Fever Hospital 32 University Hospital 1 Ilford Asylum 6 Whitechapel Infirmary 1 Leavesden Asylum 3 340 London Hospital 47 17 ZYMOTIC DISEASES. Notifications and Hospital Accommodation, Outworkers and Port Sanitary Authorities Notifications. There were 785 notifications of infectious diseases in Poplar and 832 in Bromley; these totals do not include 61 second notifications forwarded for the two parishes. The notification rate per 1000 living being— 1894. 1895 Poplar 10.6 13.6 Bromley 12.5 11.4 Of the above 1617 notifications, 1559 were with regard to 1305 premises, 635 in Poplar and 670 in Bromley. The drains of the 1305 premises were tested by the Inspectors, and 447 were found to be defective. The remaining notifications, 58 in number, were connected with the public institutions in the two parishes. Four of the infectious cases, viz., three of diphtheria and one of typhoid fever, were notified from premises where milk was sold. The County Council was immediately informed, and the sale of milk discontinued until the premises were declared free, and disinfected together with the utensils. From the month of June until December great difficulty was experienced in obtaining the prompt isolation of fever patients, on account of want of accommodation at the Hospitals. A letter was received from the Metropolitan Asylums Board asking that preference might be given to the removal to the Board's Hospitals of those patients who in consequence of their surroundings and conditions of life were most in need of hospital treatment. In order to fall in with this suggestion of the Asylums Board, a large amount of work was thrown upon the Sanitary Department. B 18 Each evening a letter notifying the outstanding cases was forwarded to the Clerk of the Asylums Board. The outstanding cases were telephoned every morning, and the fresh cases immediately they were notified; and in caseswhere the relatives were unable to pay for medical attendance pending the removal of the patient, they were referred to the Relieving Officer. The homes were visited every day, and on Sundays (when Norfolk House is closed) a list of the outstanding cases was taken over to the Eastern Ambulance Station. No doubt much misery was caused in the homes of the patients waiting removal. In one instance a patient, aged seven years, who had been waiting removal for some days, was too ill to be removed when the ambulance did arrive, and in the meantime his sister, aged two years, was notified as suffering from the disease. The first patient ultimately died. This want of accommodation, which has arisen from time to time, is a most serious state of affairs, the working classes having no means for isolating patients, and thus tends to disseminate contagion. On the initiative of the Marylebone Vestry a Conference of Representatives of the Metropolitan Vestries and District Boards was held on December 3rd. The Asylums Board had been invited to send members to the Conference, but did not do so. The following resolution was unanimously adopted:— " That a communication should be addressed to the Asylums Board strongly urging them to take steps to immediately open the vacant beds at the Gore Farm Hospital at Darenth for the purpose of providing the temporary accommodation required by the local authorities for scarlet fever patients." By a majority of 24 votes a second resolution: "That in the opinion of this Conference the authorities making the rate to raise the funds for the requirement of the Metropolitan Asylums Board should be entitled to be directly and adequately represented upon that Board." The resolutions of 19 the Conference were to be presented to the President of the Local Government by a deputation of representatives of the local authorities, who appointed delegates to attend the Conference. After the above Conference the Gore Park Farm (Convalescent Smallpox) Hospital was opened for fever cases, and the difficulty for the time being was tided over. Twenty-one notifications, 5 in Poplar and 16 in Bromley, dealt with cases of outworkers. The usual notices were served upon the persons giving out the work, and the work was discontinued until the premises were free from infection. Seven passengers coming into the district were notified from various Port Sanitary Authorities. They were visited and found to be in good health. Three people taken off s.s. "Condor" were notified from Whitechapel as coining to this district. The address given could not be found. The fact was communicated to the superintendent of the shelter who had notified the cases. Note.—Mr. Potts has kindly given me the following figures which are the sums paid during the years as set out to medical practitioners on behalf of notifications of infectious diseases— £. s. d. 1892-3 258 9 0 1893-4 462 13 0 1894-5 336 4 0 1895-6 246 13 0 20 TABLE (B) Table of Population Births, and of New Cases of Infectious year 1895, in the Metropolitan Sanitary District of Poplar Names of Localities adopted (or 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 Knowledge of the Medical Census 1891. Estimated to middle of 1895. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Typhus. Enteric or Typhoid. Continued. (a) (b) (c) (d) (e) 1 2 3 4 5 6 7 Poplar 5,6317 57,508 1944 Under 5 ... 135 79 12 ... 11 1 5 upwds. 7 205 153 8 ... 44 2 Poplar Union Wokhouse ... ... 54 Under 5 ... 1 ... ... ... ... ... 5 upwds. ... 2 ... ... ... 1 ... Scandinavian Home ... ... ... Under 5 ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... Totals 56317 57,508 1998 Under 5 ... 136 79 12 ... 11 1 5 upwds. 7 207 153 8 ... 45 2 " Notification of Infectious Disease " has been compulsory in the District Metopolitan Asylums Board, and occasionally for Typhoid Fever cases the TABLE (B) Table of Population, Births, and of New Cases of Infectious year 1895, in the Metropolitan Sanitary District of Poplar 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 Knowledge of the Medical Census 1891. Estimated to middle of 1895. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Typhus. Enteric or Typhoid. Continued. (a) (b) (c) (d) (e) 1 2 3 4 5 6 7 Bromley 70,002 72,658 2625 Under 5 ... 113 112 15 ... 6 ... 5 upwds. 13 216 136 7 ... 73 4 Sick Asylum ... ... 3 Under 5 ... ... ... 5 upwds. 1 3 ... 1 ... Stepney Union Workhouse ... ... 16 Under 5 ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... 1 ... Poplar Hospital ... ... ... Under 5 ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... City Infirmary ... ... 5 Under 5 ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... Totals 70,002 72,658 2649 Under 5 ... 113 112 15 ... 6 5 upwds. 18 217 189 7 ... 74 5 " Notification of Infectious Disease " has been compulsory in the District Metropolitan Asylums Board, and occasionally for Typhoid Fever cases the 2 I XII. Sickness coming to the knowledge of the Medical Officer of Health, during the (POPLAR), classified according to Diseases, Ages and Localities. Locality, coming to the Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Fevers. Cholera. Erysipelas. Total. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers Cholera. Erysipelas. Total. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 ... ... ... 12 250 ... 29 21 ... ... 1 ... ... ... ... ... 51 ... 2 ... 100 521 7 58 30 ... ... 19 ... ... ... ... ... 114 ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 ... 2 ... 7 12 ... 2 ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 251 ... 30 21 ... ... 1 ... ... ... ... ... 52 ... 5 ... 107 534 7 60 30 ... ... 19 ... ... ... ... ... 116 since October 31st, 1889.The Isolation Hospitals are the Hospitals of the General Metropolitan Hospitals, see page 26. XIII. Sickness coming to the knowledge of the Medical Officer of Health during the {BROMLEY), classified according to Diseases, Ages and Localities. Locality, coming to the Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Fevers. Cholera. Erysipelas. Total. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Total. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 ... ... ... 6 252 ... 33 34 ... ... 3 ... ... ... ... ... 70 ... 1 ... 60 565 16 76 48 ... ... 33 ... ... ... ... ... 173 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 10 ... 1 ... ... ... 1 ... ... ... ... ... 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 6 252 33 34 ... ... 8 ... ... ... ... ... 70 ... 1 ... 69 580 16 77 51 ... ... 34 ... ... ... ... ... 178 since October 31st, 1889. The Isolation Hospitals are the Hospitals of the General Metropolitan Hospitals, see page 27. 22 SMALL POX. Seven cases of small pox were notified in Poplar during the year, they were all removed, but two patients were returned as not having the disease. Eighteen cases of small pox were notified in Bromley, and of these 16 were removed and two were treated at home. One of the patients removed was returned, as he had not the complaint. The Lancet in an article on the errors of diagnosis states:— "It is right that we should be reminded in these reports of the occurrence of errors of diagnosis. We have had occasion before to observe that the largest number of errors noticed was at the Eastern Hospital. The ascertained errors here were 3.7 per cent. of cases of certified scarlet fever, 17.5 percent of certified diphtheria, and 25.8 per cent. of enteric fever. The last is a large proportion of error, but it is touched upon kindly and somewhat apologetically by Dr. Goodall who remarks on the difficulty of an early diagnosis and the danger of a late removal. Granting that an early removal is desirable when the disease is ascertained, we still think that an error of 25 per cent. is one which should be largely reduced, and that while early diagnosis is an urgent duty there is no excuse for excessive haste. Some illustrations given of errors of diagnosis in small pox are important. Eleven of these were—rotheln 2, varicella 2, measles 1, acne 1, impetigo 1, erythema 1, syphilide 1, exfoliative dermatitis 1, and no symptom of disease 1. In some cases the disease was not diagnosed. It would be wrong not to emphasise such facts and to impress on all medical men that, though errors of diagnosis are occasionally inevitable, they should be reduced to a minimum for the credit of the profession and the benefit of our patients. We cannot conclude our consideration of these reports without a word of praise for the care with which they are drawn up, and a word of sympathy for the medical officers and the staff, who work at no small personal risk, as the reports show. The Chaplain of the South-Eastern Hospital died 23 from scarlet fever, and Dr. MacCombie was laid aside for four and a half months suffering from diphtheria." The following is the list of cases with the origin of the complaint in each instance so far as this was obtainable:— POPLAR. Date. Number and Name of Street. Age of Patient. Sex. Disease—how contracted. Treated at Home (H) orRemoval (R) 3 January 14, Rook Street ... 28 F Not known R 12 August 7, Gough Street 14 F >» j> R 26 October 19, Rook Street 15 F a n R 3 December 30, Chilcot Street ... 25 M a > t R 10 ,, 11, Grove Villas ... 38 M *» ,, R BROMLEY. Date. N umber and Name of Street. Age of Patient. Sex. Disease—how contracted. Treated at Home (H) orRemoval <R) July 29 1, Spanby Road 35 M Not known R 30 166, Grundy Street 21 M ,, ,, R } i 81 63, Fairfoot Road ... 19 F ,, ,, R August 2 165, ,, ,, ... 21 M ,, ,, R 14 1, Spanby Road ... 28 M From brother (2nd case)... R a )> 18, Wellington Road 29 F Visiting sister at Rotherhithe ... R »> 111 63, Fairfoot Road . 11 F From sister (2nd case) ... R „ ■> < J> 50 F From daughter (3rd case) R 5 > 21 1, Spanby Road 63 M From son (3rd case) R Septr. 1 3, „ „ ... 39 M 1, Spanby Road (next door) R 2 63, Fairfoot Road .. 18 F From mother (4th case) ... R >> 17 58, Tetley Street ... 34 M Not known I< >» 27 158, Grundy Street 21 M ,, ,, H Octr. 11 58, Tetley Street ... 28 F From lodger (2nd case) ... R Novr. 9 365, East India Road 16 F Not known H >> 19 158, Abbott Road ... 21 M ,, ,, R Deer. 6 165, Fairfoot Road 44 M ,, ,, (2nd case 1st case R 2nd Aug.) Only one of the above cases died, the male aged 63 years with confluent small pox, removed from 1, Spanby Road. Two communications were received from the Local Government Board, dated 2nd and 13th August, respecting the increase of smallpox in the Metropolis. The first letter stated that the " The cir- 24 cumstance is the more noteworthy since at this season of the year small pox in London is, as a rule, at its lowest ebb." During the week ended July 6th, 35 cases of small pox were admitted into the Asylums Board's Hospitals from the Metropolis. The Local Government Board attached very great importance to the most energetic measures being taken in connection with the cases which were occurring, with the view of preventing the spread of infection. The letter gave details as to visiting cases, &c., which the Board desired and went on to state, "The Board deem it desirable that the Authority should, as regards each case, be informed precisely of the measures which have been taken by the Medical Officer of Health; and they will be glad to be furnished with copies of the reports which are made by him on the subject" The second letter stated that the Local Government Board were desirous of receiving information as to the precautions that were being taken where one or more of the patients had not been removed to the Small-pox Hospital Ships. The letter requested that the Medical Officer should prepare a report on the subject, and that a copy of the report should be forwarded to the Board at as early a date as practicable. The measures I adopted were, to have the cases removed as quickly as possible, and then to have the walls and ceilings of the rooms where the cases occurred damped with water and fumigated with sulphur, and the walls stripped of their papers, and, together with the ceilings, lime-whited, and the woodwork washed with a solution of carbolic acid. The paper stripped from the walls—in some cases many layers—was burnt in the back yard, or where it amounted to large quantities, it was removed in the disinfecting van and burnt in the Boards depot under the shaft. The clothes, bedding, etc., were disinfected by the steam apparatus. Vaccination and re-vaccination were advised, handbills relating to vaccination being left at the houses, but it was very difficult to get the inmates to undergo the operation. The premises where cases occurred were kept under constant supervision. The Clerk to the Guardians was apprised of every case, and he made arrangements for the vaccination of inmates of any infected house who 25 so desired. Where the patients were the bread winners of the family, I informed Mr. Lough, so that the wives, and in one instance a widow lodger taking in work (which was stopped), might obtain parish relief for themselves and children without applying at the Guardian's offices, and waiting among a number of persons and thereby likely to spread infection. I suggested to Mr. Lough that the district should be placarded with notices—as was done on a former occasion—advising the inhabitants to avail themselves of vaccination or re-vaccination, and stating the time and place where it was performed gratis. I revaccinated those officials of the Sanitary Department and men engaged in disinfecting who were desirous of availing themselves of my services. I have no doubt that the above measures were the means of stopping the spread of the disease. *January to June, 1895. Births. (Notified.) Dead. Vaccinations. Insusceptible. Poplar 1053 130 655 2 Bromley 1334 126 717 3 July to December, 1895. Births. (Notified.) Dead. Vaccinations. Insusceptible. Poplar 945 76 376 4 Bromley 1320 94 500 5 scarlet fever. There was an increase in the number of scarlet fever cases notified in the year 1895, compared with the year 1894, the increase being in Poplar, and the statistics are as follows:- 1894. Cases notified. Deaths. Death rate per 1000 living. Poplar 239 12 0.20 Bromley 331 22 0.32 Totals 570 34 0.26 *Note.—Mr. Hitchins, the Vaccination Officer, kindly furnished me with these statistics. 26 1895. Poplar 343 20 0.34 Bromley 330 19 0.26 Totals 673 39 0.30 In the last three quarters of the year 1893 there were 1315 cases notified in the two parishes, with 66 deaths, giving a death rate of 0.69 per 1000 living. Ninety cases were removed to the Fever Hospitals from Poplar, and 110 cases from Bromley. One case removed in Bromley was returned from the hospital, as the patient was found to be suffering from measles. CONTINUED AND TYPHOID FEVERS. Three cases of continued fever were notified in Poplar, and five cases in Bromley. No deaths occurred from this disease. The typhoid fever cases were:- 1894. 1895. Poplar 72 56 Bromley 84 80 Twenty cases in Poplar and 37 (including one from the Sick Asylum) in Bromley, were removed to various hospitals as follows:— Poplar. Under 5 5 upwards. Asylums Boards' Hospitals I 9 London Hospital 0 4 Children's Hospital (Shadwell) 0 1 Guy's Hospital 0 2 Charing Cross 0 1 German Hospital 0 1 St. Bartholomews 0 1 1 19 27 Bromley. Under 5. 5 upwards. Asylums Boards' Hospitals 2 26 London Hospital 0 4 St. Bartholomew's 0 4 King's College Hospital 1 0 3 34 Twelve Poplar parishioners died from typhoid fever, and fourteen fatal cases occurred in Bromley. Under the heading of diphtheria will be found information as to the distribution, etc., of the typhoid fever cases. DIPHTHERIA (INCLUDING MEMBRANOUS CROUP). That a very large percentage of cases notified as diphtheria is not such, is clearly proved by the following article in the Lancet, nth January 1896:- "The Metropolitan Asylums Board have published a pro"visional report by Dr. Sims Woodhead on the cases of diph"theria which were sent to the laboratories of the Conjoint "Board of the Royal Colleges of Physicians (London) and "Surgeons (England) for bacteriological examination from 'January 1st to August 31st, 1895.—So long as the diagnosis of "diphtheria was based on the gross physical signs and symptoms "of the disease it is evident that all statistics on the question are "subject to most serious error, owing to the inclusion or ex"clusion of the milder throat cases, according to the individual "judgment of the person charged with making the diagnosis.— "The importance, also, of preventing non-diphtheritic cases "being kept apart and thus obviating their exposure to the in"fection by being placed in the same wards as the diphtheria "patients must be quite evident. Perhaps, however, the most "important role which the bacteriological diagnosis has to play "in this relation is in determining when the throat in convalescent 28 "cases has become free from diphtheria bacilli, and the patient "can be discharged with safety and no longer be a centre of "fresh infection.—The number of examinations made were "6408, and as these were obtained from 2936 cases "it is apparent that a considerable number of re-examinations "had been carried out, either for the purpose of making abso"lutely certain of the bacteriological diagnosis where it seemed "at variance with the clinical, or for the purpose of determining "when a convalescent case might be discharged with safety.—It "is interesting to observe how far the clinical diagnosis agreed "with the bacteriological in the different hospitals, This will be "seen in the following table, in which we have computed the "percentage of cases which were recognised bacteriologically as "diphtheria from among those which were returned as clinically "doubtful or in which no diagnosis was given b) the hospital " authorities:— Per cent. " North-Eastern Hospital 38 " North-Western Hospital 71 " South-Eastern Hospital 68 " South-Western Hospital 56 "Eastern Hospital 61 "Fountain Hospital 69 "Western Hospital 60 "The above figures sufficiently clearly indicate the necessity for "a bacteriological diagnosis and proves to what an extent the "opinions of experts may vary as to what is clinically "diphtheria." From the above there can be no doubt as to the wise step the Metropolitan Asylum's Board has taken in this matter. The cases notified and the condition of the drains of the premises where they existed were as follow:- 29 Poplar. Number of premises Notifications. from which notified. Diphtheria 232 177 Membranous Croup 20 16 Typhoid Fever 56 48 Totals 308 241 Drains defective 101 " negative 140 241 Bromley. Number of premises Notifications. from which notified. Diphtheria 301 247 Membranous Croup 22 18 Typhoid Fever 80 68 Totals 403 333 Drains defective 117 " negative 216 333 It must be remembered that smoke was used in testing these drains, but I have pointed out in former reports that the water test is the only crucial test. At the present time we have a drain under the water test; it had been tested with smoke giving negative results, and now a flusher has been sent into the sewer, which is a large one, and a plug placed into the end of the drain, water has been allowed to flow into the pipes, but it is found to soak away very quickly, clearly from this there is no telling how much of the earth has been polluted. I am still of an opinion that diphtheria, membranous croup and the sore throats which are returned as diphtheria, are due to emanations from sewers and from polluted ground air. 30 1893. Rain-fall. Difference from average of 78 years — 4.98. Estimated population to middle of year 1893. Diphtheria. 620. *Notiflcations 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 1894. Rainfall. Difference from average of 79 years + 1.84. Estimated population to middle of year 1894. Diphtheria. 418. Typhoid Fever. 136. Diphtheria. Notifications per 1000 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 1895. Rain-fall. Difference from average of 80 years — 5.33. 1st Quarter. —1.68 2nd Quarter. —3.79 3rd Quarter. —0.83 4th Quarter. +0.97 • Estimated population to middle of year 1894 Diphtheria. 879. Typhoid Fever. 136. Diphtheria. Notifications per 1,000 living. Typhoid Fever. Notifications 1,000 living. Isle of Dogs or South Poplar 20,580 74 27 3.59 1.31 North Poplar 36,928 178 29 4.82 0.78 South Bromley 38,925 173 35 4.44 0.89 North Bromley 33,733 150 45 4.44 1.33 *It is well to remember that where the Notification Act exists, the notification rate and not the death rate should be taken as the gauge for determining the existence of the disease. In overcrowded poor districts such as Bethnal Green, 31 Males. Females. South Poplar 30 44 North Poplar 86 92 South Bromley 70 103 North Bromley 66 84 252 323 This bears out the statement that females suffer more than males from diphtheria, and such was also found to be the case in the previous year. Looking at the report on rainfall and sewers, page 66, it will be seen that during the past year there were some heavy downfalls of rain, but no serious cases of flooding were reported. The great good done by the London County Council's new sewer and pumps is manifest. Diphtheria, as per notifications during the years 1893 and 1894, existed to the greatest extent in North Bromley, but in the past year it has shewn itself most rife in North Poplar, and under ordinary circumstances in the Poplar District, one would consider perhaps North Poplar, from the character of its inhabitants, to be the region where diphtheria, when prevalent, would exist to the greatest extent. Studying Chart III. it will be seen that the diphtheria notifications for the week ended the 15th June, were the highest for any given week in Poplar and Bromley. Chart I. for the Metropolis also shews the notifications for the same disease on the increase. The notifications in Poplar and Bromley are seen to be low in the month of July, but in August they run up again. The notifications in the Metropolis do not drop until the end of July. As a possible explanation, I think the rainfall had a great influence over the cause of diphtheria at this period of the year. Whitechapel, and St. George-in-the-East, the mortality per 1000 living and the case mortality are sure to be greater than in the Poplar District, although—for reasons which I have endeavoured to explain in former reports—diphtheria has existed enormously in this last-named district, 32 As to the school age, 3 to 10 years, Chart III., I do not doubt that crowding children together in badly ventilated school-rooms causes the spread of the disease ; but as during the hot weather the schools are well ventilated, doors and windows being thrown open, I do not think that the crowding together during the hot weather can be regarded as a source of danger. 3 to 10 years. Total. School age cases. Males. Females. Per 100 cases notified. South Poplar 19 16 35 47.2 North Polar 49 47 96 53.9 South Bromley 40 47 87 50.2 North Bromley 36 37 73 48.6 Totals 144 147 291 50.6 The months of May and June from Chart I. were remarkably dry, hence the sewer were not properly flushed, and their sides, which are always coated witn a thin layer of sewage, were not kept moist, so that the germs of disease were not prevented from escaping through the sewer ventilators. The street gullies (see page 72) also became untrapped, and no doubt also a large number of house gullies had their traps unsealed and allowed the sewer gas to escape. The rain came in the beginning of July, 0.30, 0.13, 0.46, and 1.66 inches in the 1st, 2nd, 3rd and 4th weeks respectively. Now, remembering that in the conjoint report of Sir Benjamin Baker and Mr. Binnie on the main drainage of London, presented to the County Council, and in reporting upon the low level sewer, these two gentlemen state:- "But the periods and duration of the overflows are of course dependent upon the rainfall, and probably the sewer becomes surcharged whenever the fall exceeds one-tenth of an inch per diem," it stands to reason that the low level sewer and also the middle level sewer would be well cleansed in their course through the Poplar district, inasmuch as they would be flushed by the collected rainfall of that portion of the Metropolis drained by these sewers, hence the 33 decrease in the notifications in Poplar and Bromley upon the first rainfall. The sewers of the Metropolis generally would not be well flushed until the last week in July, when there was a heavy down fall of rain, and then the diphtheria notifications for the Metropolis are seen to have dropped. There was a rise in the notifications in the third week of August, both in the Metropolis and in Poplar and Bromley, and I think this may be due to the large amount of rainfall in the preceding three weeks saturating the earth and displacing the ground air, the barometer also falling would cause the ground air to rise. Professor Wynter Blyth has stated that:- "A fall of an inch in the barometer will cause the abstraction of 57 cubic inches of the ground air, and a difference of temperature 1 F. from the same amount of space, either an inflow or an outflow of three and a half cubic inches." The two last weeks of August were dry, and in September hardly an inch of rain fell, the difference from average of 80 years of rainfall in September was -1.39 inch; the month of September was excessively hot, on the 24th September the maximum temperature for the day, 87.3° F. was the highest recorded during the year, and it was also higher than any temperature recorded at that time during the period 1841-94. Diphtheria notifications during the month of September for the Metropolis ran up, but they did not do so in Poplar and Bromley. The large amount of sunshine and the excessive heat would cause the sides of the Metropolitan main sewers to become dry, but these sewers as they pass through the Poplar district would again be flushed on account of the collected rainfall they carried. At the beginning of the fourth quarter of the year another meteorological factor comes into play, viz., the temperature of the earth. It C 34 is shewn on Chart I. in orange colour, and is taken at 3 feet below the surface, and it must be remembered that as depicted it is not the maximum nor the minimum temperature, but, like the barometric reading on this chart, it is the mean for the week. As shewn, I think it clearly explains the fact that in the cooler months the earth is warmer than the atmosphere, hence the soil and atmospheric airs interchange. At this period of the year typhoid fever is seen to prevail. Roads and pavements being covered for the most part with impermeable materials, the ground air, stagnant and possibly polluted, would be drawn from great distances, entering those houses the sites of which are not covered over with concrete. One has only to look at the unpaved portion of the back yards in houses of the poor where fowls, etc., are kept, and vegetable matter, etc., are thrown, to think of how much ground pollution exists. The London County Council's bye-law prohibiting any manure receptacle being below the surface of the ground is certainly wise. The bye-law relating to ash-pits is likewise highly salutary. The provision of adequate or ample underfloor ventilation is also good, more especially where the site of the premises is not covered with an impermeable material. As to wood pavement, I think after the report of the Analyst of Marylebone Vestry to that body, that without a doubt wood pavement more or less contaminates the air. In his report he states:—" That wood blocks are by no means impervious, but get in time more or less saturated with impurities—the centre of the road showing the least contamination, the channels most contamination. It is curious to observe that the centre block shows most ammonia in the top layer, the amounts decreasing as you pass to the bottom; while the channel block shows the reverse. The explanation is, I believe, this : that the old wood blocks allow in the interstices between them water to percolate on to the impervious sheet on which they are 35 embedded, and that there is a layer of foul water flowing beneath the blocks and gravitating into the channels, and of course saturating the bottom slice or layer of the channel wood blocks. It may be interesting to add that 45 wood blocks go to the square yard, and that if we reckon an average of 9 grains of ammonia per block, 1000 square yards would yield 9000 grains, or over a pound and a quarter." The best pavement is asphalte, more especially as I have pointed out for market places such as Chrisp Street, as it can be easily washed, but are we right in paving roads, foot-paths, fore courts and yards with impermeable materials, and leaving the sites of the houses unpaved and the only outlet for ground air? I certainly think the site of the house is the most important. INFLUENZA. Fourteen deaths in Poplar occurred from influenza, 14 deaths from the same disease also happened in Bromley, but three of the persons who died belonged to another district. WHOOPING COUGH. Thirty deaths were registered in Poplar and one from an outlying institution, making a total of 31 deaths from whooping cough, and they all occurred in children under five years. In Bromley 29 deaths occurred, but two of these did not belong to the parish, and there were two deaths registered outside Bromley belonging thereto. So that 29 deaths from whooping cough must be credited to Bromley, 27 of which were in-patients under five years, and two over that age For death rates see Table IV., page 10. MEASLES. Seventy-eight deaths from measles were registered in Poplar and four in outlying institutions; 117 deaths were registered in Bromley, 14 of which did not belong to the parish, and there were two deaths registered in outlying institutions. 36 1894. 1895. Poplar 58 82 Bromley 95 105 Total 153 187 Measles has not been made a notifiable disease in this district, so that one can only judge from the number of deaths as to the actual prevalence of the disease. In the month of April the head teachers of St. Paul's Road Board School, in accordance with their regulations, notified to me the names and addresses of children, some 169 in number, who had been excluded from the school on account of measles occuring at their homes. I interviewed the teachers and learned that a number of children in the Limehouse and Mile End Old Town districts were also absent. I caused enquiries to be made at the 31 houses to which the excluded children belonged, and communicated with the Medical Officer of Mile End Old Town, in whose district the school is situated, in order that he might take steps under the 88th Section of the Educational Code. This was done and the school closed. For death rates see Table IV., page 10. DIARRHŒA. Quarters. 1st. 2nd. 3rd. 4th. Total. Total. 1895. 1894. Poplar 4 5 40 3 52 20 Bromley 3 1 46 6 56 29 London 166 316 2655 463 3600 1780 The above figures being the actual number of deaths from diarrhœa, they indicate that an immense number of cases must have occurred during the year. Chart I. shews that nearly 1200 deaths occurred in London in three weeks, viz.. the two last weeks in July and the first week in August. Chart IV. shews that the prevalence of diarrhœa 37 in Poplar and Bromley was co-existent with the disease in the Metropolis. In the six weeks ended 24th August, the 34th week, the deaths were as follow:- Under one year. Between one and five years. Over five years. Total. Poplar 25 5 1 31 Bromley 29 6 1 36 Total 54 11 2 67 From these figures one must admit that diarrhœa has been appropriately termed "the infant's destroying angel." The high or low temperature of the air and of the soil, and the amount of rainfall, have come to be considered as the conditions causing diarrhœa. That one of the causes of the disease is due to the processes of germ life going on in the upper layers of the soil appears to be a fact proved from research, and that warmth is a necessary factor, in order that the germs in the soil may propagate, cannot be doubted. The disease will prevail in those places where the soil is polluted with organic matter, e.g., houses built upon ground made with all kinds of refuse, and built without having the site covered with concrete, or without any underfloor ventilation, and the ground where defective sewers and drains exist will form a suitable bed for the germs to grow. Dr. Ballard has shewn that when the earth four feet from the surface reaches a temperature of 56° F., and so long as this temperature is maintained the epidemic prevalence of diarrhœa continues, and commonly reaches its highest point about the same time as the four feet earth temperature, but he points out exceptions to this, we may say, rule, which need not be entered into here. Rainfall will affect the temperature of the soil, as the earth will reach a higher temperature in dry weather than in wet. From Chart I. 38 it appears that the above-mentioned conditions prove to be correct. It has also been stated that the greatest diarrhœa mortality occurs in the months in which the minimum atmospheric temperature attains its highest average. This from Chart I. (see Corrigenda) appears to be correct, for if diarrhoea were due to a high atmospheric temperature alone, the disease ought to have prevailed also in September. It has been stated that certain cases of diarrhœa are communicable from person to person. It is not to be wondered at that the deaths from diarrhoea were excessive during the diminished water supply of the East London Water Company, although in the water inquiry the evidence adduced or given failed to show that the short supply had any deleterious influence upon the public health. I may say that I have had many years experience as a District Medical Officer in one of the poorest districts or quarters of London, and I have been astonished at the quantity of discharge which comes from the bowels of children suffering with diarrhoea, and I know how the poor mothers are driven to their wits end to obtain articles whereupon to catch this discharge, and if there be no water in which to put such saturated articles, the same will simply remain in a corner of the room (and this too often a living room), a foetid and festering accumulation. The remarks I used at the end of my present report upon diphtheria equally apply to diarrhoea. Keep the back yards and gardens free from organic matter, manure the ground once or twice a year and dig it in, so as to allow nitrification to take place, by this is meant the process by which animal and vegetable matter are rendered harmless and form food for vegetable life; then plant flowers, trees, evergreens, vegetables, a pastime not only conducive to health but also a source of relaxation and pleasure. If the surface of the earth of back yards and gardens be sodden with filth and vegetable garbage, as sure as the hot weather appears the germs in this polluted soil will multiply, get into the air through 39 various causes, and then settle upon food, and in such food start chemical changes and form a virulent poison which, taken into the human frame by way of the food, causes diarrhœa. CHOLERAIC DIARRHOEA. In Bromley a death from choleraic diarrhœa occurred in a man aged 65 years, after three days' illness. The probable cause of the complaint was the eating of mackerel and roast pork during the hot weather. A letter was received from the Medical Officer of the London County Council asking to be informed of any suspected case of Asiatic cholera, in order that material, whenever the circumstances of the case made it desirable, might be examined by Dr. Klein. DISINFECTING DEPARTMENT. A Washington Lyon Disinfecting Machine has been fixed at the Board's depot, and has been in full work since June. The apparatus is the steam disinfector which Dr. Parsons, Assistant Medical Officer to the Local Government Board, stated in his exhaustive report to that body as giving the best results of any in their respective classes. He reported that "the penetration of the heat into articles exposed to steam took place more quickly than into the same articles when exposed to dry heat." The superior efficacy of steam under pressure more especially when super-heated, in penetrating badly conducting materials, and dstroying infective matters, is clearly proved in his report. The steam in the chamber is in fact super-heated and dried by the steam in the jacket of the apparatus. The wetting effect of the steam is diminished by having the chamber surrounded with a jacket containing steam at a higher pressure. I instructed the men that with badly-conducting materials, such as feather beds, it is necessary to relax the pressure of steam in the chamber from time to time whereby the penetrative power of the steam—by the ordinary laws of 40 nature—is increased by displacing the cold air remaining in the interstices of the material; otherwise the interchange of air and steam particles, and of temperature, would take place comparatively slowly. A large feather bed should be in the apparatus at least an hour, and the steam relaxed three or four times. In experiments tried by me this method answered most satisfactorily, the temperature in the interior of a featherbed reaching 212° F. on one occasion, and 225° F. on another. The time given in the old apparatus was three hours, and its heating powers totally inadequate to penetrate beds. Flock beds require to be under steam for about half an hour. Blankets, woollen articles, and garments must not be exposed to the steam for more than fifteen minutes, the pressure being relaxed once, as with such articles there is the danger of felting together and loss of elasticity and fluffiness. This elasticity depends upon the presence of the natural grease (suint) of the wool. Leather and fur articles must not be subjected to steam in the chamber, but to that in the jacket for an hour or more. The working temperature of the jacket is 268° F., and that of the chamber 260° F. The contagia of the ordinary infectious diseases of mankind are not likely to withstand an exposure of an hour to dry heat of 220° F., or one of five minutes to boiling water or steam of 212° F. Increased ventilation was given to the disinfecting house as it became exceedingly hot, and the apparatus, with the boiler, was coated with a non-conducting material to prevent the loss of heat, and to lessen the expense for fuel. A condenser has also been erected to obviate the steam from being discharged into the atmosphere, and taps have been fixed at all junctions and bends of pipes to run any water away before leaving off work, so that freezing, with its concomitant dangers, might be prevented during the prevalence of frost. The following figures give the number of premises disinfected, and the number of times the Board's apparatus was used for the two parishes, some thousands of articles being disinfected. 41 Private Premises Board's apparatus. Poplar 634 521 Bromley 608 544 Total 1242 1065 Disinfectants are still supplied on the orders of the Inspectors, and a record kept of their distribution. INQUESTS AND DEATHS FROM VIOLENCE. Inquests and Deaths from violence during the year 1895 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 222 34 34 222 67 155 Bromley 288 82 14 220 53 167 Totals 510 116 48 442 120 322 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 2 0 1 By Vehicles and Horses 2 5 1 1 Ships, Boats and Docks (exclusive of drowning) 2 6 2 0 Building Operations 0 4 0 0 Conflagrations 0 0 0 0 Burns, Scalds and Explosions 1 12 0 1 Drowing (accidental not suicidal) 31 8 2 1 Suffocation in Bed 10 9 0 0 Poisons or Poisonous Vapours 2 0 0 0 Other and not stated Causes 14 41 1 3 Homicide 0 1 0 0 Suicide 3 8 1 0 Total 65 96 7 7 42 MODEL DWELLINGS. Grosvenor, County Council, and Hanbury Buildings. Last year the actual number of inhabitants of Grosvenor Buildings was ascertained to be 1764 persons in 512 tenements. This year, at the time of my enquiry, 514 tenements were occupied out of a total of 542, so that we will take the number of inhabitants this year as 1770. The County Council Buildings contain 50 tenements, and at the end of the year 48 were occupied with 175 inhabitants (93 adults. 82 children). Hanbury Buildings contain 34 two-roomed tenements, of which 25 were occupied at the end of the year with 162 inhabitants (55 adults and 107 children). The inhabitants of the three buildings would be, therefore, 2107. The notifications of infectious diseases and the removals were as follow:- Aged under 5 or over 5. Notifications. Removals. Small-pox. Scarlatina. Diphtheria. Continued Fever. Erysipelas. Small-pox. Scarlatina. Diphtheria. Grosvenor Buildings Under 5 ... 6 2 ... 1 ... 1 2 5 upwds. 1 2 5 1 4 1 1 2 Council ,, Under 5 ... ... 1 ... ... ... ... 1 5 upwds. ... 1 ... ... ... ... 1 ... Hanbury ,, Under 5 ... ... ... ... ... ... ... ... 5 upwds. ... ... ... ... ... ... ... ... The total being 24 notifications, giving an annual rate of 11.3 per 1000 living. Compare with Table, page 11. 43 The case of small pox was returned, the patient not having the disease. The deaths were as follow:- Residents. Outlying. Grosvenor Buildings 23 7 Council „ ,, 3 0 Hanbury „ ,, 2 1 28 8 Giving a total of 36, and an annual rate of 17.0 per 1000 living. The registered causes of death being— From Zymotic Diseases 3 „ Influenza 1 „ Diarrhœa 0 „ Venereal 1 ,, Constitutional Diseases 7 „ Premature Birth and Old Age 2 ,, Diseases of the Nervous System 5 „ „ Circulatory 1 „ „ Respiratory 11 „ Digestive 2 ,, ,, Urinary 0 „ „ Generative 0 Accident of Childbirth 0 Disease of the Integumentary System 0 Accidental Deaths 1 Other Diseases 2 Total 36 The outlying Institutions in which the deaths happened were— Ilford Asylum 1 Poplar Hospital 1 Poplar Union 1 Sick Asylum 5 Total 8 44 Only one parish medical order was issued for the Council Buildings, the patient being a destitute seaman who had been given shelter by a resident. From the Medical Registers at the Guardians' Offices I find that 22 orders were issued for Hanbury Buildings and 103 for Grosvenor Buildings, against 77 medical orders for these last buildings in the year 1894. ANN STREET AREA. At the request of the Solicitor of the London County Council, and with the consent of the Sanitary Committee, I inspected and made a detailed report to the Council of the condition of 8, 14, and 17 Ann Street, 1 and 3 Brunswick Road, 6, 8a, 8, and 9 Tavern Court, and 2, Prospect Place. These premises, with the last-mentioned Court, were included in the Ann Street Area. The owners demanded £2336 8s. for the ten houses, and their respective shares of the Court and Place, and would not come to terms with the County Council. 1 attended on March 2nd and 9th at the Surveyor's Institute, before Lawson Walton, Esq., Q.C., M.P., the arbitrator between the parties. Mr. Miners also attended in order to produce all documents, and the entries in the journals relating to the past sanitary condition of the premises in question. The arbitrator's award was £1230. BAKEHOUSES. The Committee on 28th March considered the resolution of the Vestry of Bromley Saint Leonard, urging upon the Board to look after the sanitary condition of all bakehouses, and the Committee recommended that the Vestry be informed that the matter received the constant attention of the Medical Officers and the Inspector of Nuisances in manufactories. The bakehouses are inspected twice a year by me, accompanied by Mr. Raymond. There are 101 known bakehouses in Poplar and 45 Bromley, and at the beginning of the present year 95 of these premises were inspected, the remaining six not being in use. in use. not in use. total. Poplar. Bromley. Poplar. Bromley. Poplar . Bromley. (1) Rear 31 33 2 3 33 36 Semi-underground 3 2 0 0 3 2 Underground 8 18 1 0 9 18 Total 42 53 3 3 45 56 Poplar. Bromley. (2) Drains inside (trapped gullies) 9 10 (including (including one iron D trap) one bell trap) (3) Sinks inside (trapped) 2 2 (4) Water from main in occupied houses All All except 1 except 2 The troughs were also examined, and in four instances the attention of the bakers was called to the fact that these utensils required cleansing. Intimations as to limewhiting, &c., were served by Mr. Raymond. The Factory and Workshops Act, 1895, came into operation on the 1st day of January, 1896. Section 27 (1) enacts that—Sections 34 and 35 of the Principal Act shall apply to every bakehouse, and repeals so much of those Sections as limits the operation to bakehouses in localities of more than 5000 persons. This Sub-section does not alter matters in Poplar and Bromley, as these parishes have over 5000 people, and consequently have already been subjected to all the provisions of Sections 34 and 35 of the Principal Act relating to limewashing. painting, and washing of the 46 interior of bakehouses, and provisions as to sleeping-places near bakehouses. I called the Committee's attention to Sub-section (2) as it appeared to affect the 23 bakehouses in the parishes which have drains and connected sinks inside, and is as follows : in Section 15 of the Factory and Workshops Act, 1883, the words, "which was not so let or occupied before the 1st day of June, One thousand eight hundred and eighty-three," shall be repealed. Section 15 of the 1883 Act reads—"It shall not be lawful to let or suffer to be occupied as a bakehouse, or to occupy as a bakehouse any room or place which was not so let or occupied before the 1st day of June, One thousand eight hundred and eighty three, unless the following regulations are complied with." This section, by the Factory and Workshop Act of 1895, will read: "It shall not be lawful to let or suffer to be occupied as a bakehouse, any room or place, unless the following regulations are complied with : (i.) No water closet, earth-closet, privy, or ash-pit, shall be within or communicate directly with the bakehouse. (ii.) Any cistern for supplying water to the bakehouse shall be separate and distinct from any cistern for supplying water to a water-closet. (iii ) No drain or pipe for carrying off fœcal or sewage matter shall have an opening within the bakehouse. Any person who lets or suffers to be occupied, or who occupies any room or place as a bakehouse in contravention of this Section shall be liable on summary conviction to a fine not exceeding forty shillings, and to a further fine not exceeding five shillings for every day during which any room or place is so occupied after a conviction under this Section." It will be seen that there was no power to cause these openings to 47 be abolished (as the bakehouses were occupied before 1883). Owners of bakehouses, of which the inside traps and gullies were found defective, were compelled to go to the expense of having them properly trapped under Section 16 of the 1883 Act, which Section enacts the penalty for a bakehouse being unfit on sanitary grounds for use as a bakehouse; but now, by the 1895 Act, all such openings it seems must be abolished, and owners thereby put to further expense. It appears from observation that a well-trapped gully in a bakehouse, the floor of which is concreted (as in several instances in the districf) is conducive to sanitation, as the bakers can wash down he floors readily, and swill under the troughs. SLAUGHTER-HOUSES AND COW-HOUSES. The owners of slaughter-houses, 11 in Poplar, 6 in Bromley; cowhouses, 5 in Poplar, 8 in Bromley, asked the County Council to renew their licenses. The usual notice was given to the Board, the premises were inspected, and any defects found were notified to the Medical Officer of the licensing authority. In no case did I advise the Board to oppose the license. MUD FIELD, EAST FERRY ROAD, The following letter will speak for itself as to the steps I advised respecting the Mud field:- " BOARD OF WORKS FOR THE POPLAR DISTRICT, "117, High Street, Poplar, E. "30th January 1896. " To the Chairman and Directors of the Millwall Dock Company. "Re Mud-heap East Ferry Road. —Suggested Scheme.— "Willow Growing. "Gentlemen,— "For some time I have had under consideration the mud-heap alongside of the East Ferry Road, belonging to your Company, as to 48 whether this accumulation of mud is a nuisance or injurious to the public health. I have inspected the heap with your engineer, Mr. Duckham, who has afforded me every information respecting the method adopted in the depositing of the dredgings as well as to the disinfectants used. Early this year [meaning 1895] the idea suggested itself to me that the mud-heap with its banks (about 30 to 40 acres) instead of lying barren, might be utilised for planting quick growing trees, e.g., willows, etc., after the same manner as a sewage farm, and if willows, etc., could be grown it would save your Company the expense of using disinfectants; the ground would be purified by natural processes and a new industry created in the district, to say nothing of the financial benefit to your Company. I communicated with the distinguished botanist, the Rev. G. Henslow, lecturer on botany to St. Bartholomew's Hospital, and described to him the mudheap. The Rev. G. Henslow kindly forwarded my letter to Messrs. James Veitch & Sons, Royal Exotic Nursery, 544, King's Road, Chelsea. Messrs. Veitch answered my letter, and I opened communications with them but they wrote stating that it was too late in the season to think about planting willows. In October I renewed the subject with Messrs. Veitch, and I interviewed Mr. Duckham. It was arranged that Messrs. Veitch's responsible nurseryman, Mr. Howard, should meet your engineer and myself to view the mudheap, as to whether it was suitable for willow growing. This meeting and inspection took place on 21st October, and on the 28th of October Mr. Howard wrote, 'I am strongly of opinion that the waste land or sewage land may be utilised for willow growing and return a profit; but before going into any great expense I should advise the directors to make an experiment of about two acres and see the results. If it turns out a success large quantities may be cut annually, and the time for doing this should be in the spring time.' In a postscript he asks that about a quarter of a hundred weight of the mud might be forwarded to Messrs. Veitch to see if there were any injurious matter contained therein to affect plant life. I communicated with Mr. Duckham who sent Messrs. Veitch some of the soil. The 49 soil was placed by Messrs. Veitch under artificial means, with several varieties of willow cuttings, with the result that after the lapse of a month a communication was received stating that a sample of willow cuttings had been sent (these were duly received) which had just begun to take root in the soil, and which showed well for their being a success, and there seemed nothing poisonous in the soil for willow growing. Upon hearing this I wrote to Mr. Duckham, and pending the bringing of this matter before the directors, I suggested that the disinfectants should be discontinued. Messrs. Veitch were again communicated with, and the reply is as follows:— "For supplying and planting 10,000 willow plants at three feet apart each way on two acres of land at the Isle of Dogs will cost the sum of forty pounds (£40). "It will be absolutely necessary for us to have skilled labour at the price quoted, so fear we shall not be able to use local labour. "We recommend that the plants be grown on until the autumn and then cut back, and the sets or cuttings put in to thicken up the rows to a foot and a half. "Should it be decided to carry out the planting this season, we should be glad to receive instructions as soon as possible, as the work should be put in hand without delay, and we are holding the plants with that view. "Sir Thomas Crawford has pointed out that the planting of osiers on a large scale in North Western India had assisted to stamp out malaria in a notoriously unhealthy valley covered with stagnant pools, and the system had proved remarkably conducive to public health. From a business point of view the Directors must well know that hampers, baskets, and all kinds of wicker ware are constantly called for, and there is a brisk demand for willow cuttings, and consequently foreign made articles are imported, so that if they adopt the idea they will not only improve their finances but save the expense of using D 50 disinfectants which should be discontinued, and they will render profitable a spot which would otherwise be left waste, and they will further strengthen the banks of the mud-heap. I would point out that unpeeled willow wands for basket making fetch from £2 10s. to £3 10s. per ton, and the annual yield of 20,000 cuttings on an acre of land is from six to seven tons, which we will say will give a value of £20 per acre, and as there are 30 to 40 acres of dredgings there would be a return of £600 per annum. "I trust that the Directors will see their way to try the experiment of having two acres planted, so that the public health may be improved, and a new industry created which will cause labour and at the same time improve the finances of their Company. "I am, Gentlemen, "Your obedient Servant, "FREDK. WM. ALEXANDER, "Medical Officer of Health, "Poplar and Bromley. "P.S.—The planted two acres (the initial expense) would form the nucleus from which cuttings could be taken to plant further acres. I shall be only too pleased to forward to the Directors all the correspondence." I am pleased to state that the Dock Company adopted my scheme, and have had two acres of the mud-field planted with 10,000 trees, 6000 for coarse basket work, and 4000 for fine articles. I learn that there are 50 not 40 acres of land, so that the return will be greater than stated in the above letter. BOARD SCHOOLS. The work of re-drainage has been completed at St. Leonard's Road, Alton Street, Oban Street, and Bromley High Street Board Schools. Knapp Road Board School is waiting to be re-drained, and new 51 schools are being erected at Orchard Place, and on the Old Palace site St. Leonard's Street. During the exceedingly severe weather at the commencement of the year my urgent attention was called to the need of warming the class-rooms at the Byron and Bright Street Board Schools. I visited the School, and found that some of the rooms were very inadequately heated—so much so that several were not able to be used; the children, more especially the infants, were crowded together into other rooms which were not sufficiently warmed. I was informed that many parents refused to send their children to the School. One of the Managers gave me a copy of the report of the Inspector of the Educational Department, and from this report it appeared that the Inspector had complained in 1893, and again in 1894, of the defective warming. I wrote an urgent letter to the Clerk of the School Board, calling his attention to the report of the Inspector. New stoves were procured and fixed in the Infant School, and the heating of the class-rooms was thereby much improved. I requested the Inspectors to inspect from time to time the latrines, etc., of all Board Schools, Voluntary Schools, and Sunday Schools. Visiting some of these places I found the latrines and their seats not over clean; soil was smeared over the seats, and remained on the back of the latrine above the water. I suggested to the Committee that a letter should be sent to the School Board requesting that authority to order all their School care-takers to daily mop and cleanse the latrines, and where necessary scrub the seats. ICE CREAM. A communication was received at the begining of the year from the Vestry of Islington, respecting the manufacture and sale of ice cream. The samples collected by their Medical Officer were found to be a compound of flour, milk, eggs, sugar, and flavouring essences, none of which were of an unwholesome character, the eggs were blown by the mouth, the empty shells being used as objects to be shot at in 52 shooting galleries. Specimens of the "ice cream" and of the glass washing water were submitted to Dr. Klein for bacterioscopic examination, and this gentleman stated that numberless microbes were found in the "cream" and in the water. The most conspicuous microbe was one which is "a normal inhabitant of the bowels of men and animals," and therefore "water which contains this microbe had in all probability been polluted with excremental matter." The microbe of putrid decomposition was also present. Dr. Klein likewise found another microbe of a kind which he had recently isolated from the intestinal contents of a child who had died from acute diarrhoea. Microbes resembling those causing typhoid fever also existed. These germs would undergo incredible multiplication when taken into the system. No doubt the cause of the presence of these microbes in the "ice cream" was due to the uncleanly habits of the individuals who manufactured it, and to their insanitary surroundings. The ices may have been left standing for hours in the foulest atmosphere. In a number of the Lancet it was stated that it was found that "ice creams" were mixed—sometimes boiled—in the same saucepans and cauldrons employed to cleanse dirty linen. Dr. Klein's opinion was that these people "should no longer be allowed the license of distributing the germs of disease broadcast." In 1892, an outbreak of typhoid fever occurred in the south-east of London, which was attributed to the eating of infected ice creams made by Italians living in that district. The water used for diluting the article was taken from a water closet cistern, a person reputed to be suffering from enteric fever being in the house at the time. The Public Health Committee of the London County Council, under whose notice this outbreak came, felt that to regulate the sale of a particular article of food raised a question of great magnitude, but that the proper remedy was the efficient application of the general provisions of the Public Health (London) Act. I instructed the Inspectors to inspect all places, more especially confectioners' premises, where ice creams were likely to be made. In one of the 53 premises visited the tins were found to be stored near the water closet in a covered yard leading from the sleeping room. It seems to be a practice with ice cream vendors to collect ice from the docks, canals, and ditches for freezing purposes ; but it has transpired that ice forms an ingredient of what is known as " water ice," which is also sold in the streets. In two of the premises large quantities of ice were found to be stored in cellars : the ice in one of these cellars I visited had been taken from the Millwall Docks; it was very dirty, and looked like pieces of coal, and it occurred to me that should any of it—which was very likely—be mixed with the ice cream that there would be pollution at once. The Vestry of Islington, in face of the report of Dr. Klein, desired the co-operation of all other Sanitary Authorities in memorialising the Local Government Board to introduce legislation which would empower local authorities to register the vendors of ice creams, and to make bye-laws for regulating the conditions under which ices are made and sold. From the Lancet, February 2nd, it appeared that the Local Government Board was about to appoint a Select Committee to inquire into the advisability of instituting legislative action, and had written to certain Metropolitan Sanitary Authorities. REMOVAL OF OFFENSIVE REFUSE AND NUISANCE FROM FISH SHOPS IN CHANNELS OF ROADWAYS. On the 26th September I reported to the Sanitary Committee that on the 2nd and 16th September offensive material (bones) was being removed in a van within prohibited hours. The bye-laws of the London Connty Council (which it is the duty of every sanitary authority to enforce) state that "Every person . . . fœcal or offensive or noxious matter or liquid, whether such matter or liquid shall be in course of removal or carriage from within or without or through London, shall not remove or carry such matter or liquid in or through London, except between the hours of 4 o'clock and 10 o'clock in the forenoon, during the months of March, April, May, June, July, August, September, and October—The penalty for offending 54 against this bye-law is five pounds, and in case of a continuance of the offence to a further penalty of forty shillings for each day after written notice of the offence from the sanitary authority. In the above two cases it did not seem even possible to cover the "carriage" so as to prevent any nuisance arising therefrom, which was another infringement of the same bye-law. It appeared from complaints that the bye-law respecting the removal of offensive material was being evaded; the "carriages or vessels" removing such material were not properly covered so as to keep in the effluvia, and the material was not removed within the prescribed hours. Between the hours of 4 and 5 o'clock in the afternoon many vehicles carrying decaying and noxious material were passing down the Bow Road, leaving a most offensive smell behind. The material in some cases was simply covered by a tarpaulin or carried in open tubs; the vehicles were driven at such a pace that it would be difficult to stop them to obtain the name and address of the owner without the aid of the police. Section 229 of the Metropolis Local Management Act, 1855, in the case of "transient offenders" empowers" any officer or servant of . . . any Vestry or District Board, and for any police-constable . . . to seize and detain any person who has committed any offence against the provisions of this Act or any bye-law made in pursuance thereof, and whose name and residence shall be unknown to such officer or servant or policeconstable, and convey him . . before some justice," etc., etc. The Public Health (London) Act, section 16 (under which the bye-law in question has been made), by its sub-section 4 enacts :—" Except as otherwise provided by the bye-laws, a constable may arrest without warrant and take before a justice any person whom he finds committing an offence against such bye-laws, and who refuses to give his true name and address." The 1855 Act enacts that any officer or servant of a Vestry or District Board, or any police-constable, can seize and detain any offender whose name and residence shall be unknown; but from the 1891 Act a constable is only mentioned as being able to seize and detain an offender against a bye-law made 55 under the Act. Under these circumstances, although the sanitary authority is to enforce the bye-laws, I suggested to the Committee that a letter should be sent to the Chief Commissioner of Police from the Board, seeking his aid, so that the nuisance arising from improperly constructed fish offal carts might be stopped. It seemed feasible that the police should help sanitary authorities in this matter, for when owners knew that they were being watched in the main roads they would most likely drive through the district by the smaller streets, which could ill afford to bear offensive smells, and the police, being constantly on duty, would be able to catch the offenders at all points. The Committee referred the matter to the Clerk to take the necessary legal proceedings to cause abatement of the nuisance complained of, and also to communicate with the Commissioners of Police with a view to capture of the offenders. I also called the attention of the Committee to a bye-law under Section 16 (1) of the Public Health (London) Act, made by the Poplar Board, which prohibits filth or other like matter or thing being deposited or cast upon any street. This, no doubt, applied to any water running off fish or meat stalls into the channels of the streets, of which there were many complaints. Under Section 16 (4) the police can interfere in this at any time that they see the offence being actually committed. The channels opposite certain fish shops were constantly running with water from off the stalls, and possibly from out of the shops (which was another offence under the bye-law). In some instances the channels of the road had been washed away, so that the water remained and became offensive; hence the complaints from the neighbours. The bye-law and the amount of the penalty for its infringement were printed, and the handbills left at fishmongers' shops, etc. Whilst waiting in the Thames Police Court, I was much interested in hearing Mr. Dickinson give his decision in respect to a summons 56 for removal of offensive material within prohibited hours. The defence was that the material was not offensive. Mr. Dickinson dismissed the summons, as he did not consider from the evidence that the material was offensive, and I think it was shown that on account of the London County Council bye laws, material that is likely to soon become offensive is removed more quickly since the bye-laws have come into operation than previously, as the contractors cannot conveniently effect the removal within the prescribed hours, so that this bye-law clearly has the effect of preventing material being kept so as to become offensive. SANITARY INSPECTORS' WORK, &c., AND POLICE COURT PROCEEDINGS. At the beginning of the year, during the severe weather, sanitary work was at a standstill, as work requiring cement could not be undertaken. Only a small amount of drain testing was carried out in consequence of the want of water. In several instances, on account of work being covered over before being passed by the Inspector, the Committee authorised that the ground be opened, in order, if the drain had been improperly repaired, proceedings might be taken under the Public Health (London) Act, Section 42. The penalty for violation of the Act is twenty pounds. During the year, 4246 intimations, 1348 statutory notices, 368 final notices (complimentary) were served, 3379 drains were tested, 6322 inspections and 20,287 re-inspections were made. The Inspectors' reports are appended to this report. The names of informants as to the existence of nuisances are now omitted from the Inspectors' Journals and General Complaint Book. This matter of the omission of names was brought before the Sanitary Committee, as some of the inhabitants who were owners had inspected the journals under section 107, (3) of the Public Health (London) Act, 57 and then the informants had complained that their names had been divulged. Under Section 48 of the Public Health (London) Act, certificates that there were proper and sufficient water supplies, were given for the Casual Wards, St. Leonard's Street, and the newly-erected houses in Cottage Street. I gave a certificate respecting a case of overcrowding; the Inspector found two adults and three children in one room, the air-space being 242 cubic feet for the adults (reckoning two children as one adult). The Committee ordered a statutory notice to be served, and the inmates of the room went into the Union. The Poplar Hospital authorities have built a new mortuary, therefore the Inspector, on behalf of the Board, is relieved from the responsibility of seeing the bodies removed upon the plea of there being no fit and proper accommodation Bye-laws with respect to houses let in lodgings, or occupied by members of more than one family, have been made by the Board, and have received the sanction of the Local Government Board. It is interesting to know that at the North London Police Court the Magistrate decided a case as to power of entry of the Sanitary Authority by their officers. The defendant contended that the Vestry conld not send an officer to demand admission to his house, unless he had a warrant from a Magistrate, or a complaint as to the existence of a nuisance, or knowledge that a case of infectious disease existed there. The Magistrate explained that the warrant for entry is only when forcible entry is required, and he pointed out that the Sanitary Authority could enter, not as the defendant supposed, " in the event of a nuisance being known to exist." but also for the purpose of ascertaining as to the existence of any nuisance under Section 10 of the Public Health (London) Act, 1891, which gives the right of entry for this object. The defendant was fined twenty shillings, the maximum penalty being five pounds. 58 No. of Street and Premises. Nature of Complaint. Date of hearing Summonses at Police Courts. Result. Name of Inspector. 67, Dee Street Damp walls ground floor front room 16 Jany. Adjourned 2 weeks. Work'completed Mr. Miners. 69, Dee Street As above 16 „ As above 51, Bow Common Lane Defective drain. Yard and forecourt not properly paved. No under floor ventilation. Wall of ground floor front room damp. Walls and ceiling of first floor back room dirty ... 22 „ Closing order. £l 19s. costs Mr. Anthony 53, Bow Common Lane Defective drain Yard and forecourt not properly paved. No under floor ventilation. Ground floor front rooms damp 22 „ Closing order „ 55, Bow Common Lane Same as No. 51, with defective eaves, guttering and rain water-pipes 22 „ As above „ 57, Bow Common Lane Almost the same as above, with dirty wash-house 22 „ As above „ 59, Bow Common Lane Almost the same as above 22 „ As above „ 61, Bow Common Lane Almost the same as above, with defective roof. 22 „ As above „ 63, Bow Common Lane Almost same as No. 55 ... 22 „ As above „ 65, Bow Common Lane Almost same as No. 51 22 „ As above „ 67, Bow Common Lane Defective drain. Yard and forecourt not properly paved. Walls and ceilings of first floor rooms and staircase dirty. Walls of ground floor room damp. Roof, rain water pipes, eaves and guttering defective. No under floor ventilation 22 „ As above (All the above mentioned houses in Bow Common Lane have since been demolished, and nine cottages erected on site) „ 26, Gale Street Mr. Anthony summoned as defendant 5 Feby. Closing order cancelled „ 28, Gale Street As above 5 „ As above „ 78, Fairfoot Road Defective drain 19 March 14 days' abatement order, £l 13s. 6d costs „ 80, Fairfoot Road Defective drain. Yard not properly paved. Drinking water improperly stored. Sink, waste and rain waterpipes improperly connected with drain 19 „ 14 days' abatement order „ 82, Fairfoot Road Same as above, with the exception of sink waste pipe 19 „ As above „ 84, Fairfoot Road Same as No. 80 19 „ As above „ 86, Fairfoot Road As above, with the exception of the drinking water 19 „ As above „ 88, Fairfoot Road Drain defective 19 „ As above „ Mr. Dunn, 31, Sophia Street Obstructed drain 22 „ 5 days' abatement order, 6s. costs 2, Ammiel Terrace Defective drain. No proper water supply to W.C. Walls and ceilings of house throughout dirty and damp. Water-closet dilapidated 9 April Closing order, 12s. 6d. costs Mr. Anthony 3, Ammiel Terrace Defective drain. No water supply apparatus to watercloset. Walls of rooms damp 9 ,, As above „ 59 4, Ammiel Terrace Drain defective. No proper water supply to W.C. Roof and eaves gutters defective. Walls of rooms damp 9 „ As above „ 5, Ammiel Terrace Drain defective. No water supply for sanitary or domestic purposes. Defective rain water-pipe. Damp walls of rooms 9 „ As above „ 7, Ammiel Terrace Defective drains and eaves gutters. No water supply to W.C. Walls of rooms damp 9 „ Closing order, 2s. costs „ 2, Ammiel Street Drain and Yard paving defective. No water supply to W.C. Walls of rooms damp.. 9 „ As above „ 3, Ammiel Street Same as above, with the exception of yard paving 9 „ As above „ 4, Ammiel Street As above, with absence of eaves gutters 9 „ As above „ 5, Ammiel Street Defective drain. No water supply for sanitary and domestic purposes. House dirty, dilapidated and damp throughout 9 „ As above „ 13, Ammiel Street Defective drain and ceiling of basement. Stairs broken. Walls of rooms damp 9 „ As above „ 15, Ammiel Street Defective drains. No water supply to W.C. Walls of rooms damp. Flooring of passage and ground floor front room broken 9 „ As above „ 16, Ammiel Street Defective drain. No water supply to W.C. House 9 „ As above „ dirty, damp and dilapidated throughout „ 21, Ammiel Street Defective drain. Damp walls. No water supply for domestic and sanitary purposes 9 „ As above „ 23, Ammiel Street Drain defective. No water supply to W.C.. Roof and gutters defective. Walls of basement damp, and ceiling broken. 9 „ As above „ 4, Bird-in-Hand Court No water supply to W.C. Walls of ground floor rooms damp, yard not properly paved, and insufficient under floor ventilation 9 „ 14 days' abatement order, 12s. 6d. costs „ 6, Bird-in-Hand Court No water supply to W.C. Walls of ground floor rooms damp. Insufficient under floor ventilation 9 „ 14 days' abatement order, 2s. costs „ 13, Violet Road Obstructed drains (combined system) 10 „ Obstruction relieved, summons withdrawn „ 15, Violet Road ,, ,, 10 „ „ 17. Viole Road ,, ,, 10 „ „ „ „ „ 19, Violet Road ,, ,, 10 „ „ „ „ „ 18, Shepherd Street ,, ,, 10 „ „ „ „ „ 20, Shepherd Street ,, ,, 10 „ „ „ „ „ 22, Shepherd Street ,, ,, 10 „ „ „ „ „ 19, St. Leonard's Road Soil pan not properly set and trapped with drain, and without water supply. Defective and deficient eaves 23 „ As above Mr. Miners. 6o No. of Street and Premises. Nature of Complaint. Date of hearing Summonses at Police Courts. Result. Name of Inspector. gutters and rain water-pipes. Yard not properly paved. Premises damp 21, St. Leonard's Road W.C., no proper seat. Soil pan not properly set or trapped with drains,and without water supply. Rain water-pipes and eaves gutters defective and deficient 23 „ As above Mr. Miners. 25, St. Leonard's Road As above, with defective drains, and yard not properly paved 23 „ As above „ 27, St. Leonard's Road Premises without proper means of drainage 9 July Adjourned 7 days, owner since deceased. Summons withdrawn for fresh proceedings to be instituted „ 8, Newcastle Street No water supply for sanitary and domestic purposes 16 „ Adjourned 7 days. Water re-instated. Summons withdrawn Mr. Foad. 120, High St., Bromley Defective drain. Walls and ceilings of basement rooms dirty and damp 16 „ Closing order. (No owner to be be found. Tenants living rent free Mr. Anthony 122, High St., Bromley Defective drain. Basement rooms damp. Yard not properly paved 16 „ As above „ 126, High St., Bromley As above 16 „ As above „ 128, High St., Bromley As above 16 „ As above „ 130, High St., Bromley As above 16 „ As above „ 132, High St., Bromley As above, with the exception of yard paving ... 16 „ As above „ 134, High St., Bromley Same as No. 120 16 „ As above 2, Plimsoll Street 4, Plimsoll Street 6, Plimsoll Street 8, Plimsoll Street 10, Plimsoll Street 12, Plimsoll Street 14, Plimsoll Street 16, Plimsoll Street 18, Plimsoll Street 20, Plimsoll Street Presbyterian Church Combined drainage system in bad order and condition 16 „ Adjourned to 24th July, and then adjourned sine die. Summons dismissed 2nd December, with costs against the Board, as the conduit could not be proved to be a drain. No proper "order" for its construction having been given by the Metropolitan Commissioners of Sewers Mr. Dunn. 4, Prospect Place No water supply for sanitary or domestic purposes 20 „ Closing order. (No owner could be found. Tenants living rent free) Mr. Miners. 27, St. Leonard's Road Drain in bad order and condition 30 „ Adjourned sine die. (Same case as above, 9th July.) Work since completed by Board and owner respectively „ 61 6, Joshua Street Drains defective. Drinking water badly stored 3 Septr. Work completed. Summons withdrawn. 2s. costs „ 4, Joshua Street Drinking water improperly stored 3 „ As above „ 18, Havannah Street Drain defective. Rain water-pipe connected directly with drain. (Hopper head near a window) 18 „ 7 days' abatement order. 6s. costs Mr. Foad. 1, Totness Cottages Mr. Foad summoned as defendant 11 Octr. Closing orders cancelled „ 2, Totness Cottages 3, Totness Cottages 4, Totness Cottages 497, Manchester Roac Combined system of drainage in bad order and condition (four owners summoned, as one owner would not agree) 499, Manchester Road 501, Manchester Road 2 Novr. Adjourned by Magistrate three weeks. Since completed „ 503, Manchester Road 505, Manchester Road 507, Manchester Road 43, Stainsby Road Plan submitted for re-drainage of premises and not carried out according to conditions of Board. Summons taken out under 25 & 26 Vict., c. 102, sect. 61 2 „ Adjourned. Work since carried out as per plan, submitted and sanctioned by Board Mr. Dunn. 57, Venue Street Roof defective and root water-tight 14 „ Adjourned 7days. Work completed, Summons withdrawn Mr. Miners. 26, Wellington Street Roof not water-tight. Premises damp. Wash-house and W.C. walls damp and defective 14 „ As above „ 11, Bartlett Street Owner summoned for infringement of bye-law made under Public Health (Lond.) Act, 1891, sect. 16. relating to the paving of yards and open spaces 14 „ £3 3s. penalty. 23s. costs. Work since completed „ 56, Arcadia Street Builder and workman summoned under sect. 42 of the Public Health (Lond.) Act, 1821, for improper repair to water-closet 14 „ Adjourned to 21 November ,, 29 ,, Mr. Dunn. Magistrate, (Mr.Dickinson) inspected work 30 November. Builder fined 20s., and 2s. costs. Workman 2s. costs 54, Arcadia Street As above 14 „ As above. Builder fined ₤7, and £6 6s. costs. Workman, 2s. costs „ 25, Eagling Road Defective drain. No under floor ventilation. Yard not properly paved 31 Dec. Adjourned 21 days. Since completed. Summons withdrawn, 3s. costs ... Mr. Anthony. 27, Eagling Road As above 31 „ As above ,, 29, Eagling Road As above 31 „ As above ,, 31, Eagling Road As above, except yard paving 31 „ As above ,, 33, Eagling Road As above 31 „ As above ,, 35, Eagling Road Yard not property paved. No under floor ventilation 31 „ As above ,, 62 EAST LONDON WATER SUPPLY. FROST, DROUGHT, AND FLUSHING CISTERNS. During the months of March and April, 376 premises had their water supplies cut off by the East London Water Works Company, on account of defective fittings, and the Company duly notified in writing under the Public Health (London) Act, Section 49, each case to the Sanitary Authority. There is no doubt that the defects in the water fittings were due to the freezing of the water through the severe and almost unprecedented cold penetrating the earth. Intimations were served by the Sanitary Inspectors on the owners, informing them that their premises had no water supply, and therefore were unfit for human habitation under the Public Health (London) Act, 1891 Constant enquiries were made at the premises, orders for disinfectants supplied where necessary, and post cards left with the tenants to be posted to the offices of the Board as soon as the water supply had been reinstated. The Sanitary Committee directed that no action against the owners should be taken as the supplies were being reinstated as soon as possible. Great difficulty was experienced in obtaining plumbers, in consequence of the constant demand upon them, There was also much delay in taking up paving and excavating the ground, because unskilled men could not be relied upon, as they would be liable to break paving, and not every man can get out earth within a small compass. The foremen and turncocks used their best endeavours to mend the burst mains, working on Sundays, etc., and up to late hours in the evening. Then came the drought, in consequence of which the East London Water Works Company, during the month of June found it necessary to reduce the supply of water pumped, and they further restricted the supply from July 13th in three-fourths of their district to two or three hours daily. The effect was that a large number of houses in the poorer districts, not being provided with cisterns, the inhabitants were naturally placed to serious inconvenience and water-closets and drains were unable to be flushed. On account 63 of the increase in the volume of the River Lea after a fall of rain, the Company issued posters on the 29th July, intimating to the public that they were enabled to extend the hours of service. At a meeting of the Sanitary Committee held the 18th July, the Committee recommended—" That a Conference be promoted by the Board of Delegates rom the various Authorities having jurisdiction over the area supplied by the East London Water Works Company, to consider the default of the Company to perform their statutory obligations." On the 29th August I reported to the Sanitary Committee that — "The East London Waterworks Company are causing notices to be left at houses in the district— That proper and sufficient storage cisterns must be fixed to all supplies as required by the Company's Acts of Parliament, and that the removal of existing cisterns is illegal.' I also stated that 'the removal of cisterns is never asked for, unless disused and so placed and in such dilapidated condition as to be a nuisance.' "The Inspectors intimate, and notices are served, that a fit and "proper supply should be afforded for domestic purposes, and it is "stated in the document served that the best way to do this is to "draw from the rising main, as the cisterns in the majority of cases "are found to be badly situated, uncovered, and otherwise defective, " etc." On Tuesday, 1st October, at the Hackney Town Hall, a Local Government Inquiry lasting five days was instituted to report upon the alleged inadequacy of the water supply of the East London Company during the summer months. Colonel W. M. Ducat, R.E., and Dr. F.W. Barry represented the Local Government Board. In accordance with the resolution of the Board I attended and gave evidence at the Inquiry. I prepared charts as to the general and Zymotic death, rates of London, Poplar and Bromley for the corresponding periods of the years 1893, 1894 and 1895. I also made charts for the same periods respecting the deaths from diarrhoea and enteritis. I made 64 diagrams of the rainfall in the months of July and August for the years 1893, 1894, and 1895, and gave my opinion of the salutary effect of the providential rainfall upon the public health during the period of the short water supply. Going back to the Sanitary Committee held the 28th March, the Committee considered the resolution of the Wandsworth District Board of Works to the effect that " the provision in the regulations " made under the Metropolis Water Act, 1871, requiring that the " waste preventing apparatus of a water closet shall not be capable of " discharging more than two gallons of water at each flush should be " altered so that the discharge should be not less than two nor more " than three and a half gallons, and the Committee recommend that " such resolution be agreed to, but that its operation should not be " retrospective, and that the London County Council be requested " to take steps with the view of obtaining an amendment of the " regulations accordingly." At a meeting of the London County Council, the Public Health and Housing Committee submitted the following report:—" On October 9th, 1894, we reported to the Council the result of our correspondence with the London Water Companies with regard to the alterations which the Council had asked them to make in their regulations under the Metropolis Water Act, 1871, and in view of the refusal of the Companies to make the most important alterations suggested, viz. :—To increase the maximum capacity of water-closet flushing cisterns from two to three gallons, and of their failure to alter the regulations in the other points suggested—the Council decided to ask the Local Government Board to appoint a person of engineering knowledge and experience to report to them on the subject as provided for in section 19 of the Act. We have now to report that the Board has appointed Colonel Ducat, R.E., one of the engineering inspectors, to hold an enquiry. The enquiry will take place on October 31st, and we have instructed a solicitor to conduct the Council's case. We have also requested the engineer, the 65 architect, and the medical officer to place any information in their possession at the disposal of the solicitor, and if required, to give evidence at the enquiry. As it may be necessary to retain Counsel, to obtain the evidence of experts, and otherwise to incur expenditure in supporting the Council's views on this important question at the enquiry, we recommend that the Committee be authorised to expend a sum not exceeding £250 in connection with the enquiry :—" This was agreed to, and the Council adjourned. The result of the first inquiry dated nth November, was presented to the Local Government Board, and the two Inspectors on page 16 of the report, briefly summarized as follows :— I.—That the scarcity of water in the East London Water Company's area during the summer of 1895 was due to the following causes:— (a) Exceptional waste, beyond the undue waste of ordinary years of water owing (1) to non-repair of fractures in the consumers' pipes, brought about during the unusually long and severe frost of the previous winter, and (2) to excessive garden watering during the drought in May and June. (b) Decrease in the volume of the River Lea due to the unprecedented drought which occurred during first six months of 1895. (c) Means of storage possessed by the East London Water Company inadequate to enable them to meet the combined waste and deficiency of water noted under headings (a) and (b), We would also note under this heading that in our opinion the inconvenience experienced by consumers was much aggravated by the want of proper means for domestic storage of water. E 66 II.—That although the scarcity of water undoubtedly gave rise to considerable inconvenience and hardship there is no evidence to show that it had any appreciable deleterious influence upon the public health within the area of the East London Water Company. III.—(a) That steps have already been taken by the East London Water Company, which should in our opinion afford sufficient water to meet any deficiency in the supply of water in their district for many years to come. (b) That for the protection of the consumer against unavoidable temporary intermissions of the supply, we consider that there would be distinct advantage in having properly designed means for storage of water in houses. RAINFALL, SEWERS, STREET GULLIES AND FRESH AIR INLETS. On the 23rd May 1 reported to the Sanitary Committee that— " It is more than interesting to learn that no cases of flooding were reported after the downpour of rain on April 25, 26, and 27, on which days respectively the rainfall was 0.49, 0.28, and 0.19 of an inch. It is to be remembered that in London the intercepting sewers were designed to receive 0.25 of an inch over the whole sewered area of the Metropolis in 24 hours, and this in addition to the sub soil water ordinarily finding its way into the sewers: so that numerous storm outflows into the Thames had to be constructed. The reason that there were no floodings on the above mentioned days is that the County Council have completed and have in use the new sewer, a nine-foot barrel, from St. Leonards Street to the Abbey Mills. The Isle of Dogs sewer is shut off by a penstock from the main low level sewer, and its sewage flows to the new pumps by this new sewer, which sewer is also so large that it acts like a reservoir to prevent the pumps, as it were, being taken by surprise. The new pumps are 67 worked by two pairs of triple expansion Worthington engines. The sewer cost £30,000, and the engine house, pumps, and boilers complete, £40,000. Each pair of engines pump 650 gallons per stroke, or 20 million gallons in 24 hours; and when the compounding of the beam engines (which pump from the main low level sewer) is finished the new pumps will be entirely for the district drained by the Isle of Dogs sewer—viz., Isle of Dogs, North Poplar, Sonth Bromley, and part of North Bromley—so that flooding will never take place except under very highly exceptional circumstances, and the risk of flooding of the district drained by the low level sewer and its branches minimised. Should the Committee visit the pumping station they will realize the magnitude of this working, which has the health and well-being of not only our own district at stake, but that of the Metropolis. Close to this station will also be seen the foundations of the new building in which pumps are to be erected which will deliver into the northern outfall the sewage of West Ham. That District having established its right to discharge into the metropolitan outfall, provision will be made to discharge into five sewers, viz., the three existing ones and the two to be built to relieve the high and middle levels ; so that pollution of the River Lea shall cease except when the sewage in the London sewers rises within six inches of the top of the storm overflow weir at Old Ford. Lately the Council have raised these weirs by six inches, and should they do away with them, and make fresh ones, as suggested, at Abbey Mills into the Channelsea tributary of the Lea, where a storm outlet from the West Ham district will be under the new system, the health of the Poplar District will be still further improved by the unavoidable storm metropolitan sewage being discharged into the tidal portion of the River Lea instead of at present above the locks. The cost of the West Ham sewage scheme will be about £73,000. Tenders have been received for pumping engines and gear, the estimate being £25,000. The County Council will make a new sewer to Barking for the Silvertown district, and the condition of the Thames will be still further improved. It has been singularly interesting to watch the Diphtheria 68 notifications in the Poplar and Bromley parishes for the past nineteen weeks, since the new sewer above mentioned has been in use. Prom February 5th until May 13th the London County Council have been cleansing the Isle of Dogs sewer, with its Limekiln Dock Branch (running down North Street) and its High Street, Poplar, branch. At various places openings have been made, nine in all. The cleansing necessarily has gone on at night time, when the flow of sewage is at its minimum, and then the pumps at the Isle of Dogs station, Manchester Road, have been at work. Although due care was taken the smell from the openings was bad. The County Council have very wisely decided to cease cleansing this sewer during the hot weather, so that emanations will not only cease from the shafts, but the river will also not be polluted at Blackwall at a time of the year when there is likely to be a scarcity of water in the stream to dilute the sewage. The cleansing will re-commence in October." No floodings of a serious nature were reported after the heavy rains on 21st, 24th, and 28th July, and 3rd and 10th August, on which days respectively 0.99, 0.44, 0.86, 0.33, and 0.34 inches of rain fell. No serious cases of flooding were reported after the extraordinary downfall of rain on the morning of 7th September, when 0.75 inches of rain fell in 32 minutes. My opinion having been asked at the Board meeting held 3rd September—there being a difference of opinion—respecting the size of the new pipe sewer which was being laid down in Sussex Street to prevent flooding of the houses, I supported the Surveyor in recommending 12 inch pipe. I communicated with the Astronomer Royal, who very kindly afforded me a large number of statistics and observations made at the Observatory as to rainfall. From the figures forwarded it will be seen that the greatest floods happened after prolonged rainfalls of some hours — no doubt from the ground having become saturated. 69 [copy]. Royal Observatory, Greenwich, London, S.E., Sir,— September 12, 1895. Referring to your letter of Sept. 4, I enclose a statement of the greatest rainfall in 15 minutes and in one hour respectively on 1895, July 21, 24, 28, and Aug. 3 and 10, as asked for by you, and also particulars of heavy rainfalls 1861-1895, including the storm of 1895, Sept. 7. All of these refer to Greenwich, and may not apply strictly to Poplar. You will see from these that 0.5 in. in an hour is quite an insufficient storm allowance, 0.52 in. having fallen in about eight minutes, and 0.93 in. in 30 minutes. Rainfalls of 3.58 in. in 10 hours, and of 2.5 in. in 13 hours, caused the greatest floods in this district in the period in question, from which it would seem that the total amount is an important factor as well as the rate per hour. I am, Sir, Yours faithfully, (Signed) W. H. M. Christie. F. VV. Alexander, Esq., Medical Officer of Health. Royal Observatory, Greenwich. Day 1895. Greatest Rainfall. In 15 Minutes. In 1 Hour. IN. IN. July 21 0.208 0.461 „ 24 0.105 0.241 „ 28 0.064 0.152 August 3 0.88 0.258 „ 10 0.195 0.340 1895, Sept. 12. W H. M. CHRISTIE 70 ROYAL OBSERVATORY, GREENWICH. Daily Rainfalls exceeding i inch in amount, 1861-95. in. in. 1861—May 11 1.065 1878—May 7 1.518 „ Nov. 13 1.287 „ June 13 1.051 „ Nov. 22 1.000 „ Aug 4 1.233 1862—April 9 1.098 1879—Aug. 23 1.167 Aug. 17 1.265 1880—Sept. 11 1.354 1863—June 19 1.456 „ Oct. 9 1.142 1865—Jan. 27 0.253 „ Oct. 10 1.224 May 23 1.033 1881—Aug. 12 1.306 June 30 1.392 1883—Sept. 11 1.370 „ Aug. 23 1.788 1884—June 5 1.024 „ Oct. 19 1.063 „ Sept. 4 1.089 ,, Oct. 22 1.1 14 1886—May 13 1.247 1866—Jan. 11 1.607 „ May 24 1.280 „ June 4 0.338 ,, Dec. 26 1.057 (snow) 1867—July 26 3.666 1887—Aug. 17 1.074 1868—Jan. 22 0.205 „ Nov. 3 1.007 „ May 29 1.076 1888—June 26 1.703 1871—July 11 1.278 „ July 30 2.491 „ Sept. 24 0.145 „ Aug. 1 1.441 1873—Oct. 12 1.055 1889—June 10 1.374 1874—July 11 1.030 1890—July 5 1.169 Oct. 30 1.117 „ July 17 1.192 1875—July 15 1.280 1893—July 12 1.010 Aug. 7 1.241 1894—July 10 1.010 1877—Aug. 22 1.054 „ Oct. 30 1.193 1878—April 11 2-510* *Great floods in Lee and Lewisham. 1895, Sept. 12. W. H. M. Christie, 7i ROYAL OBSERVATORY, GREENWICH. Excessive Rainfalls in Short Periods of Time, 1861-1895. Date. Amount and Period. 1865 —May 23 0.54 in. fell in 17 minutes. 1865—June 30 0.48 „ „ 17 „ 1865—August 23 1.09 „ „ 2½ hours = 150 m. 1867—July 26 3.58 ,, ,, 10 hours* 1868—May 29 0.52 ,, ,, 8 minutes. 1874—July 11 0.87 ,, ,, 25 1875—August 7 0.93 ,, ,, 30 „ 1877—August 22 0.70 ,, ,, 30 „ 1878—April 11 2.51 „ „ 13 hours* 1878—May 7 1.00 ,, ,, 50 minutes. 1878—June 13 0.65 „ ,, 30 „ 1888—June 26 1.10 „ „ 1 hour = 60 m. 1888—July 18 0.78 ,, ,, 30 minutes. 1888—July 30 1.70 ,, ,, 2 hours = 120 m 1890—July 17 0.73 ,, ,, 1 hour = 60 m. 1891—August 2 0.52 ,, ,, 30 minutes. 1893-July 12 0.64 ,, ,, 40 „ „ 1895—September 7 0.75 ,, ,, 32 „ *Great floods. 1895, Sept. 12. W. H. M. Christie. The area drained in Sussex Street is 180,000 superficial feet. The sewer has a fall of one foot in a hundred feet; therefore, the velocity of the sewage flowing will equal 275 feet per minute,* and the sewer * The formula used was :— V = 55 x (V D x 2 F) V = velocity in feet per minute. D = hydraulic mean depth. F = fall in feet per mile. Then if A = section area of current of fluid, VA = discharge in cubic feet per minute. The hydraulic mean depth is one-fourth the diameter in circular pipes. 72 will deliver 12,960 cubic feet per hour; and with a rainfall of half an inch per hour over the area to be drained it will only be called upon to deliver 7,500 cubic feet, but it is capable of taking 0.86 inch of rainfall over the area to be drained. If an 18 in. pipe had been substituted for the 12in. one with its present fall, there would have been a velocity of 330 feet per minute, and it would have delivered 15,540 cubic feet per hour—a gain of 2,580 cubic feet over the 12in. pipe. Under the above circumstance the 12in. pipe was much the better, for it will stand less chance of silting up and become an elongated cesspool in dry weather, when the flow through the sewer is only the aggregate flushing from the two-gallons w.c. tanks and slops from the 110 houses in the street; and it will be remembered that a cubic foot contains 6.23 gallons. The cesspools on the Cottage Street estate have been abolished and the houses draining into the same have been pulled down. The drains of the houses discharging into the sewer (combined drain) on the east side of Ferry Street, have been made good, aud at the time of writing this report, the re-draining of Dock Cottages (70 houses) is almost complete, and a scheme for the re-drainage of the houses on the east side of Plimsoll Street is under consideration. During the year plans were submitted for the drainage and re. drainage of 362 premises in Poplar and Bromley, and the Inspector's reports will give the number of houses which were re-drained on the old lines without the necessity of plans being presented. Numerous complaints in the hot weather reached the offices respecting the smell emanating from the street gullies, doubtless due to their traps becoming unsealed through the water evaporating. It was found that upon testing some house drains the smoke came up through the gullies. I reported this to the Committee, and two additional water carts were obtained. The wood pavement in the road outside the Poplar Hospital was kept watered with a solution of disinfectant during the hot weather. 73 The question as to the utility of fresh air inlets having been brought up before a Board meeting, the subject was referred to the Building and Drainage Committee. The two following reports were made by the Surveyor and myself to the Committee, and were afterwards presented to the Board :— June iqth, 1895. To the Chairman and Members of the Building and Drainage Committee. Gentlemen, We your Surveyor and Medical Officer of the South District, beg to report that we have experimented upon a "Fresh Air Inlet," to three houses, viz.:—122, 124 and 126, St. Leonards Road, the combined drainage of which premises is entirely rear, and is 50 feet in length. The Mica valve fitted on to a 4 inch pipe, is 21 feet from the invert of the drain and the top of the upshaft also a 4 inch pipe, is 39 feet from the invert of the drain. The distance from the intake to the outlet being 110 feet. The Anemometer was allowed to remain in the intake pipe on two separate occasions, for 74 and 72 hours respectively, on the first occasion (74 hours) it was found that it registered a velocity of 2,557 lineal feet, and on the second occasion (72 hours) it was found that the instrument registered a velocity of 17,720 lineal feet. These figures do not take into consideration the correction,—which for the instrument used, is to add "30 per minute to the observed reading of the Air Meter."From these results it is evident that a current of fresh air passed through the drain, and the velocity of the current depended upon the speed of the wind over the top of the upshaft. We think that the above observations, prove conclusively in this particular case, the utility of the system of house drainage ventilation. We are Gentlemen, Your obedient servants, (Signed) G. F. HOLT, Surveyor. FREDK. WM. ALEXANDER, Medical Officer of Health. Poplar and Bromley. 74 July 5th, 1895. To the Chairman and Members of the Building and Drainage Committee. Gentlemen, We your Surveyor and Medical Officer of the South District beg to further report respecting the utility of the " Fresh Air Inlet." On the 1st of July, together with Messrs. Riddall, Thurston, Gibbon, Puddefoot and T. McCarthy, forming a Sub-Committee, we inspected a number of " Fresh Air Inlets," in the district, and in all instances they were found to be working. At 126, St. Leonards Road, (the premises mentioned in our report of the 19th of June,) the air meter was so fixed in the air intake pipe of the drain that the figures on the dial could be easily read. It was found in 15 minutes air was drawn into the drain with a velocity of 700 lineal feet, this figure does not take into consideration the correction which for the instrument used is "30 per minute to the observed reading of the air meter," and in this instance would be 450 added to 700 making a total velocity of 1,150 lineal feet in 15 minutes. We also beg to report that the Anemometer was placed for 92 hours in the air intake pipe at 16, High Street, Poplar, and the instrument registered that air had passed in with a velocity of 29,516 lineal feet. The meter was replaced for 7 hours and a further velocity of 5,295 lineal feet was given. We are, Gentlemen, Your obedient servants, (Signed) G. F. HOLT, Surveyor. FREDK. WM. ALEXANDER, Medical Officer of Health, South District. P.S.—The correction is not taken into consideration in the last two instances. 75 COMBINED DRAINAGE. Combined drainage being a most serious question for the Board, I devoted a large amount of time in examining the records in charge of the London County Council, and I presented to the Board the following :— SPECIAL REPORT : " SEWER OR DRAIN." To the Chairman and Members of the Board of Works for the Poplar District. Gentlemen, At a meeting of the Sanitary Committee held 23rd May, 1895, I reported that I had been to the offices of the London County Council, and had inspected the drainage and sewer petitions and plans deposited with the Metropolitan Commissioners of Sewers from 1848 to 1855, when cesspools were abolished and compulsory drainage into sewers enforced, since which date plans of house drainage have been deposited with the respective local authorities. As the date on the petitions is the possible key to finding the orders of the Metropolitan Commissioners, the search through the minutes and Court papers, and minutes and papers of the various Committees, &c., is facilitated. I suggested to the Committee that the London County Council be asked to have these petitions properly indexed, and printed copies ot the index forwarded to each sanitary authority. Failing the Council complying with this request, I suggested as the petitions are all mixed and bound together, that the Poplar Board approach all the sanitary authorities included under the then head of the Tower Hamlets Division and the Poplar and Blackwall District—and ask them to combine together to appoint a skilled person to index the petitions, so that each local authority may have a copy. The expense of doing this would be trifling, the saving of time in searching would be very great, and, moreover, the petitions themselves would be preserved 76 from constant handling, and a record kept in case of their unhappy destruction by fire. I also stated that should the Committee agree to the suggestions, perhaps the local authorities generally might do likewise, so that there would be afforded greater facilities and ease for finding petitions, plans, and minutes of the Metropolitan Commissioners. The Committee recommended that an application be made to the Council to provide a proper index, as suggested. I beg to report that shortly after this meeting, together with some of the officials of your Board, I have had occasion to search through the petitions. I have also examined various documents in the Record Office of the Council. After conferring with your Clerk upon the information I had gathered, it was deemed advisable that I should make a special report to the Board, so that it might be circulated among the various Metropolitan Local Authorities, with a view to their co-operation for bringing about an amendment of the Law relating to Sewer or Drain, so that local authorities may not have to bear the burden and expense of keeping in order or re-constructing private sewers and combined drains between the years 1848 and 1856. It appears that the Metropolis was divided into eight divisions or districts, viz., Westminster, City, Holborn and Finsbury, St. Katharine, Tower Hamlets, Poplar and Blackwall, Surrey and Kent, and Greenwich. The Tower Hamlets Division petitions and plans are bound in fourteen volumes, some of which are of great thickness; and the first four volumes are sub-labelled " Poplar District, etc.," but the petitions are not confined to that district. Plans which are large— such as those of estates—are not always bound with the petitions, but are kept in another room. There are some thousands of petitions in the fourteen volumes, and only the last four volumes have any kind 77 of index; even this I was informed is not reliable. The subject of drain or sewer being of such vital importance to local authorities, the plans being continually asked for, and should such plans not be found among those deposited with local authorities, the officials of the authorities have to examine the petitions deposited with the Metropolitan Commissioners of Sewers, which involves a large amount of time, not only in searching, but in going to the offices of the London County Council. Moreover a petition may be overlooked which may be the very one required. The petitions from 1848 to 1855 are in charge of the Engineer. The minutes and Court papers, and minutes and papers of the various Committees, etc., are kept in the Record Office of the Council. The minutes of the Commissioners are not clearly indexed, and but for the kind and able assistance of the officers in the Record Office it would be impossible to make any headway. It is also a question whether the minutes of the Court (31 volumes) and those of the General Committee (25 volumes) are entered in detail, as no doubt the officials in those times did not anticipate the trouble as to sewer or drain which has arisen at the present day. Even in numerous instances the locality of the premises mentioned on the petition is not well defined, and the plan attached very crude, In the Record Office there is a most important Book, "The General Order Book," in which are entered the resolutions of the Court from December, 1847, to November, 1855, within which period the Metropolitan Commission of Sewers was six times superseded and six new and differently constituted Commissions were successively appointed. These short-lived bodies doubtless passed various resolutions. There are a number of resolutions relating to combined drainage. From examination of the records it is possible that the Court, by 11 and 12 Victoria, cap. 112, section 21, delegated certain powers to 78 the Works Committee of the Court, and afterwards to the General Committee, their minutes being simply laid on the table of the Court. It is also quite possible that the petitions up to a certain date may have been dealt with by the various Surveyors and Engineers, and no entry made in the minutes of the Court or General Committee. The petitions it will be found at the bottom are signed and certified by the various Engineers or Surveyors by the word " regular." I append an extract from the Works Committee's Minutes of the Metropolitan Commissioners of Sewers, under date 17th September, 1849:— "Read a report as follows: 'Metropolitan Sewers: Report to the Works Committee upon the necessity of issuing a public notice to all persons before laying down drains to apply to the Commissioners of Sewers.' "I beg leave to report that in our efforts to see a proper system of house drainage carried out we find that a great many are putting in drains without the sanction of the officers of the Commission, and constructing them in a very defective manner, which not only prevents the general adoption of a proper system, but likewise interferes with our subsequent proposed plans of operation. I therefore beg to recommend that advertisements be issued informing the public that it is contrary to the order of this Court to lay down any drain without first obtaining the sanction of the Surveyor to the Commissioners. 12th Sept., 1849. (Signed) J, L. Hale, Asst. Surveyor "Resolved:—That advertisements be issued in accordance with the suggestion of the Assistant Surveyor." 79 I also append a Minute of the Court itself (5th Commission?), dated Feb. 25th, 1852:— "Ordered:—That previously to the Surveyor's permitting parties who apply for leave to construct sewers, lay drains, etc., such applications be submitted to the Commissioners for approval." The Commissioners mentioned in this Minute may mean the General Committee. Bazalgette, in a paper on the main drainage of London, dated 1865, stated that from 1847, "within a period of about six years, thirty thousand cesspools were abolished." It is clear if the Surveyors and Engineers of the Metropolitan Commissions of Sewers dealt with the petitions prior to Feb. 25th, 1852, it is not right for local authorities that 25 and 26 Vict., cap. 102, section 112, should hold good:—"The word 'drain' shall be "deemed to apply to and include the subject matters specified in "the two hundred and fiftieth section of the firstly-recited Act, and "also any drain for draining a group or block of houses by a com''bined operation laid or constructed before the 1st day of January, "1856, pursuant to the order or direction, or with the sanction or " approval of the Metropolitan Commissioners of Sewers." Among the petitions searched for by your officials was one relating to the combined drains of Nos. 1, 2 and 3 Woolmore Street, which runs under 24, Robinhood Lane. No record has been found, and possibly this was a drain laid in without the knowledge of the officials in those days. The present state of the law is such that it is useless for the Board to take these cases into the police-court, and as the defective condition of the drain is very bad, and the remedying of the nuisance urgent, I would strongly recommend the Board to give 80 orders for the work to be done forthwith under their Surveyor, and at expense of the Board. I am, Gentlemen, Your obedient servant, FREDK. WM. ALEXANDER, Medical Officer of Health, 8th June, 1895. Poplar and Bromley. At a Sanitary Committee held 26th September, I asked the Committee to consider the advisability of recommending that some person be appointed temporarily, to extract from the drainage petitions and minutes of the old Commissioners of Sewers (these documents being in the keeping of the London County Council) all such matters as relate to the Poplar District. This had been done by another Sanitary Authority for their district. At the time of bringing the matter before the Committee there were several plans which could not be found at the Board's offices, waiting to be sought for among those in the keeping of the Council. The Inspectors were unable to find time to undertake the search, as it would have involved the neglect of the work of their respective districts, and prevented them from attending to the complaints for a week or more every time the question of sewer or drain cropped up. Where a combined drain is defective any delay such as prolonged searching for a plan is dangerous to the health of the inhabitants. I made this suggestion as I had read in a daily paper that a London Vestry was summoned on 13th September, for neglecting to repair and amend a combined system of drainage. The owner of the houses drained by the pipes, contended that as no plans could be found, the pipes constituted a sewer in the keeping of the Vestry. The Committee agreed to my suggestion, and referred the matter to the Clerk to make the necessary arrangements. Mr. Harrold Green was appointed to carry out the work. 81 On 15th October I presented a FURTHER SPECIAL REPORT UPON THE RECORDS OF THE METROPOLITAN COMMISSIONERS OF SEWERS. SEWER OR DRAIN. To the Chairman and Members of the Sanitary Committee of the Board of Works for the Poplar District: Gentlemen, I have been to the Record Office of the London County Council, making further research as to combined drainage. Mr. Harrold Green is at present searching for petitions and plans of combined drainage, which are urgently required, and then he will commence to make extracts and an index of the petitions which relate to the Poplar District. The officials of the Engineer's department are making him comfortable by giving him a desk, which is very necessary, in order to carry out the work. The accommodation also in the Record Office and strong room or vault is in the greatest degree unsatisfactory for any person who has to make a search through the records, some of which are bound into unwieldy volnmes, more especially the papers of the Courts and the various Committees. The London County Council, who have charge of these valuable documents, ought to afford the utmost facility, ease, and comfort to officials who have to search on behalf of their authorities in order to save the ratepayers money for remedying the bad combined house drainage laid down by owners in the days of the Metropolitan Commissioners of Sewers. The Council is awakening to the fact of value of these documents, as it is stated that the worn out or decayed bindings of any volumes (there being many of them) are to be repaired. This has been brought about, I understand, through a letter sent by your Clerk to the Clerk of the County Council. Mr. Green's work has already borne fruit. Among the urgently required list of combined drainages given to him was one for twelve houses in Oriental Terrace, Grundy Street. The owner stated that the drain was a sewer. Mr. Green found the petition F 82 and plan among those in the keeping of the Engineer, and is as follows:— "To the Rt. Hon. and Hon. the Commissioners of Sewers for the Tower Hamlets. "The application of George Joseph Gladstone, of 10, Brunswick Street, Blackwall, Shipwright, "For leave at his own expense to put down about 330 feet of sixinch stoneware pipe drain from six houses on the east side and six houses on the west side of Oriental Terrace, Grundy Street, Poplar, to communicate with and to have a current westward into the sewer crossing the west end of Grundy Street aforesaid, as shewn by plan presented herewith. "The applicant binds himself to abide by the regulations of the Commissioners, and hereby declares that he will not build any cesspool in or about the premises, and that he will fill up and destroy all existing ones. " Date, 21 st Oct., 1848. "(Signed) GEORGE JOSEPH GLADSTONE. "No objection "(Signed) J. PHILLIPS. "Plan attached. 21st Oct., 1848." The words "No objection, J. Phillips," are the writing and signature of the then Surveyor or Engineer to the Metropolitan Commissioners of Sewers. This document having been found I went to the Record Office to find the minute of the Court sanctioning the plan, for without this minute the petition is of no use. Mr. Dickens, of the Record Office, is always most kind in rendering valuable assistance, and but for his aid it would be impossible to make headway. With the help of Mr. Dickens, I think that I can throw further light as to the method of 83 finding any minute, and this fact may be of great use to saniiary authorities in London. It will be found that the Commissions with their Committees were as follow : Commission. Dates (Approximately). Committee (Powers delegated). Papers (How bound and Styled). *1 30th Nov., 1047, to 31st Dec., 1848 2 1st Jan., 1849, to 7th Oct., 1849 3 8th Oct., 1849, to 7th Oct., 1851 4 8th Oct., 1851, to 23rd July, 1852 5 24th July, 1852, to 19th July, 1854 6 20th July, 1854, to 21st Nov., 1854 7 22nd Nov., 1854, to 31st Dec., 1855. Ueneral rurpose Works General do. do. do. do. Court and Committee Papers bound together and called "Original Papers." Papers bound separately and styled "Court papers" and "Works Committee papers" respectively. Papers bound separately and styled " Court Papers" and " General Committee papers " respectively. do. do. do. do. Sanction to the petitions, from what one gathers without going through all the volumes, appears to be able to be found on the minutes either of the Court or the various Committees of the 1st, 2nd, 4th, 5th, 6th, and 7th Commissions, by the aid of their respective papers; but during the 3rd Commission—October, 1849, to October, 1851— so far as one can see at present, there are no minutes which can help as to sanctions, for there appear to be no entries in the Court or General Committees papers as to house drainage, petitions, only perhaps in respect to a particular contested case which might come before the Commissioners, and then become entered on the *It is a technical point whether this Commission comes under the head of " Metropolitan," as I find it styled " Consolidated," but the principle for the searching the records throughout the various commissions is the same. 84 minutes. The work during this 3rd Commission seems to have been left to the Surveyors, etc. (see my special report to the Board, " Sewer or Drain " dated 8th June, 1895). The usual periodical batches for house drainage appear not to have been presented. There are three books with petitions and plans—vols. 3, 4, and 5—in the Tower Hamlets Division for the 3rd Commission, containing 891 petitions in all, 141 of which relate to Poplar. The way to find a minute can be explained by taking as an example the case of the 12 houses in Oriental Terrace. The petition was found among those of the Tower Hamlets Division in the Engineer's department, vol. 1, petition 162, with plan attached dated 21st October, 1848, and was presented in the days of the 1st Commission. The next thing to do is to search in the Record Office through the various papers presented at the meetings of the Court or General Purpose Committee about the date of the petition. Lists of petitions, speaking generally, will be found either in the Court or General Purpose Committee, or Works Committee or General Committee papers, about the date on the petition (except during the 3rd Commission—October, 1849, to October, 1851), as reports from the various Surveyors ; and when this entry has been found, reference must be made to the minute of the Court or respective Committee. The minute, it will be seen as a rule does not enter into details, but merely sanctions either so many drains or such total length of drains to be laid down, or return of the length of sewers and the number of drains and flaps for which leave had been granted together with contributions paid, according to batch of list of petitions from the Surveyor or other official as presented in the papers, either of the Court or respective Committee of that date. It will be clearly seen that if any of the above items relating to petitions are entered on the minutes either of the Court or Committee, and the lists of localities of petitions are not presented in the papers of the Court or Committee (as appears to have happened in the time 85 of the 3rd Commission—October, 1849, to October, 1851), that it is impossible to trace in any way the sanction for the laying down of sewers or drains. It will be remembered that all combined drains laid down in the days of the Metropolitan Commissioners of Sewers were sewers until the passing of the Act of 25 & 26 Vict,, cap. 102, section 112. In the case of Oriental Terrace, from the above table it will be seen that the list would be found in the "Original Papers" (i.e., Court and General Purpose Committees papers bound together) about the 21st October, 1848. At a meeting of the Court held 14th December, 1848, among the papers presented is one under the following heading:— " Metropolitan Sewers. "Petitions presented in the Holborn and Finsbury Divisions from Nov. 1st to 30th, 1848, and reported by the Surveyor to be regular." (Here follow the petitions for those divisions.) Now comes the Tower Hamlets Division, and among a number of petitions under the same heading is found one from Mr. G. J. Gladstone, and is as follows :— Name. Drain. Sewers. Drains. Flaps. Place. Contributions paid. ft. No. No. £ s. d. G. J. Gladstone 300 1 Oriental Terrace Grundy Street Poplar — — — And under the heading of " Total " is entered :— 416 5585 104 2 42 16 0 This entry is to be found in a volume which is very bulky and dusty, and the cover greatly dilapidated. 86 It is as well to mention that the papers bound into various volumes have a tab. at the beginning of each set of papers relating to the respective meeting of the Court or Committee, but in some instances the tabs, through age or wear and tear, are absent, so that a searcher has to go through all the papers. It will also be found that an agenda of the business is found as a rule at the beginning of each set of papers. In the case of the meeting of the 14th December, 1848, the following is an extract : " Metropolitan Sewers. " Agenda, 14th December, 1848. " 2. Clerk of Accounts to report as contributions for sewers, drains and flaps. Ditto ditto for cleansing cesspools, etc." The minutes of the First Commission it will be found are printed, and those for each division of the Metropolis are printed separately, although the minutes of all the divisions are bound together and signed in writing by the Clerk. Turning to the minute book of the First Commission, the following is an exact copy of the minute of the Court, held 14th Dec., 1848 :— " sewers, At a Court of Sewers, holden at the Sewers Office, tower Greek Street, on Thursday, the 14th day of December, hamlets. 1848, before the Hon. Frederick Byng (in the Chair), Edward Chadwick, Esq., John Leslie, Esq., W. J. Broderip, Esq., Dr. Southwood Smith, Richard Lambert Jones, Esq., John Bullar, Esq., Rev. Wra. Stone, 87 Her Majesty's Justices and Commissioners of Sewers for the limits aforesaid, and all duly sworn : i. Orders upon the Treasurers andExpenditors for payments amounting to,£755 2s. id. were signed, the balance in hand on the 4th December being ,£4878 6s. 8d. 2. TheClerk of Accounts presented returns as follows : Amount of rates uncollected 31st October, 1848 1516 15 6 Collected in Nov £39 16 6 Do. previously to 30th Nov., 1847, omitted to be reported 6 5 8 46 2 2 Remains uncollected £1470 13 4 Return of the length of sewers and the number of drains and flaps for which leave had been granted, together with contributions paid during the last month : Sewers. Drains. Flaps. Contributions. Feet No. No £ s. d. 5585 104 2 42 16 0 Return of the number of cesspools cleansed and money received during the month of November, 1848 : Cesspools 5 Amount £ 3s. 0d. Adjourned to Thursday, the 21st day of this month, at this office, at 11 o'clock in the forenoon precisely. By the Court, (Signed) LOUIS C. HERTSLET, Clerk." 88 Compare the figures with the totals presented on the papers of the Court, and they will be found to agree, so that the details on the petition in question must be included among those entered on the minutes. It is also interesting to know that in the General Purposes Committee minute book, at a meeting held July 13th, 1848, is the following entry, which also relates to Oriental Terrace "Tower Hamlets, since 23RD June, 1848. That Mr. Gladstone be informed that the Surveyor will point out the necesssry steps to be taken to relieve his premises in Oriental Place, Grundy Street, Poplar, but that the remedy must be effected at his own expense." This will bear out what I have stated above, that individual cases sometimes are mentioned in the minutes, and which minute is found indexed under the heading of the particular locality in question ; but as a rule these single cases do not relate to the sanctioning of the petitions, which are brought up in batches and sanctioned in the manner previously stated. The Committee will see that the expense of maintaining the combined drain (no small item) of the 12 houses in Oriental Terrace will fall upon the owner, and not on the ratepayers. I have heard casually that one local authority is so disgusted that whenever "Sewer or Drain" comes up it does the work at once at the expense of the ratepayers. It is possible that they searched the minutes and papers during the period of the 3rd Commission — October, 1849, to 1851. This present special report must be read with my special report to the Board dated 8th June, 1895, in order to understand how the work was possibly done in the period of the 3rd Commission. "oriental place, poplar. 89 There is still room for further investigation to be made by anyone who has the time, as there appear to be the letter books and other volumes from which information might be gleaned as to how the Metropolitan Commissioners carried on their duties. So far as the records in charge of the Poplar District since 1856 (applications,plans—some7,5ooin number and bound in 49 volumes— and minutes) are concerned, the cry of Sewer or Drain has become lately so fierce among landlords who wish to throw the onus of their bad combined drainage upon the local authority that a large amount of time is spent by your officials almost every day in examining the records, and the Committee will see that it is of the utmost urgency that the plan should be sought for immediately as the responsibility of the danger from defective combined drainage falls upon the Board until the plans and minutes are found. I am happy to state that up to the present the application, plan and minute in nearly every instance have been found, and I trust that the outstanding ones will be found in the 14 volumes of the petitions relating to the Tower Hamlets, in charge of the London County Council. Mr. Green tells me that about 800 of the petitions relate to the Poplar District. This being a "special report," a copy will be sent to the London County Council, and it is hoped that that body will afford better accommodation to officials when they are engaged in searching their records in order to save the ratepayers' money. I am, Gentlemen, Your obedient Servant, FREDK. WM. ALEXANDER, Medical Officer of Health, Poplar and Bromley. 15th October, 1895. The following is a postscript to a report upon the drainage of certain houses which I brought before the Board on 9th November :— "P.S.—Since writing the above report 1 have again been to the 9° " Council's Offices, as Mr. Green informed me that he had found in " the 'Times Room ' many plans relating to the Poplar District. " Among those he examined is one which is urgently required in " certain legal proceedings which are now sub judice. I may mention " this plan is finely drawn, and shews combined drainage systems of " houses in a group of streets There is a sort of an index to the " plans in the ' Times Room,' but it ought not to be relied upon, as " the headings under which particular localities are entered are not " clearly defined, so that the plans themselves must be examined " singly. The covers of some of the volumes of plans in this room " are also dilapidated. The Council ought to have them rebound, '' as the plans and drawings are not only valuable, but beautifully " executed works of art, and also exceedingly interesting from an " antiquarian point of view, as some of them date from an early " period: e.g., there is one of North Poplar shewing the various estates " into which it was apportioned, viz., Wades, Kerbey, Duffs, &c. I " must repeat that the accommodation for searching in the vaults of " the Record Office of the London County Council, together with the " condition of certain volumes relating to the transactions of the " Metropolitan Commissioners of Sewers, is such that ought not to " exist in a City like London." At a meeting of the London County Council held 28th January, 1896, the Parliamentary Committee reported that:—"On 12th February, 1895, the Council resolved to apply to Parliament for an amendment of the definition of the words sewer and drain in the Metropolis Management Act in the way desired by the local authorities with whom the Main Drainage Committee had been in communication on the subject. It was at the same time referred to us to prepare a public Bill and take such other steps as might be necessary. A Bill was prepared and circulated among the local authorities, who arranged for a Conference to be held, to which representatives of the Council were nominated by the Main Drainage Committee and by us. Several meetings of the Conference took 91 place, and in the result a Bill was generally agreed upon and forwarded to us with a request that it should be adopted by the Council, with such revision as the parliamentary agent might advise to be necessary. We have received numerous letters from the local authorities endorsing this view, and asking the Council to endeavour to pass the Bill into law as speedily as possible. The agent has accordingly revised the Bill which has been settled by Counsel, and it seems to us in its present form to give effect to the wishes of the local authorities. We have directed a copy to be sent to each member of the Council, and we recommend :— That the Bill entitled " A Bill to amend the Metropolis Management Acts with respect to Sewers and Drains," be approved, and that the Committee be instructed to arrange for its introduction as a public Bill. On 28th March the Sanitary Committee considered the question of the principle of undertaking drainage work for private owners, and recommended that— " Excepting in urgent cases of nuisance, no work shall in the " future be executed to property of private owners, but the " necessary notices shall be served and legal proceedings " taken against such owners to compel a proper compliance " with the Public Health (London) Act; and in the case of " the opening of highways an estimate shall be made by the " Surveyor approximate to the expected outlay, and such " estimated sum shall be deposited before the work is " commenced." This recommendation was adopted by the Board. If, however, no records can be found of any combined drainage the Board does the work after notices are served under the Public Health (London) Act, 1891, Section 43. 92 A Bill to amend the Metropolis Management Acts with respect to sewers and drains has been prepared and brought in by Colonel Hughes, Sir Charles Hall, Mr, James Stuart, Mr. Harrison and Mr. Kimber. The Bill is to the effect that in addition to the meaning of "drains" in existing Acts it " shall also include any drain which has not been approved as a sewer either by the Metropolitan Commissioners or by the Metropolitan Board of Works or by the London County Council." FACTORY AND WORKSHOPS ACT, 1895. The Factories and Workshops Act, 1895, passed through the House of Lords in one day. The Lords adopted its provisions precisely as they left the House of Commons, and having received the Royal assent, it will come into operation at the beginning of 1896. The Bill was introduced by the late Home Secretary, to amend and extend the law relating to Factories and Workshops. The Act comprises 50 sections and three schedules. It introduces no new principle, but simply extends factory legislation, and will make preceding Acts more workable. For the first time in English law there is a statutory definition of overcrowding. Section 1 enacts that a factory or workshop is to be deemed overcrowded if every person within it is not provided with 250 cubic feet of air space, or with 400 cubic feet during any period of overtime. These amounts are subject to modification by the Secretary of State during the use of artificial light, other than electric light, and to increase in particular processes or handicrafts. Section 1 (3) enacts that "Section 78 of the principal Act (i.e. the Act of 1878) shall be read as if there were included among the notices required by that section to be affixed, a notice specifying the number of persons who may be employed in each room of the factory or 93 workshop by virtue of this Section." The 78th Section enacts, " In the event of a contravention of this Section in a factory or workshop, the occupier of the factory or workshop shall be liable to a fine not exceeding forty shillings." It will be seen further on in the Act, Section 22, that laundries carried on by way of trade or for purpose of gain are subject to the Factory Acts, and that laundries where there is no machinery are workshops, and therefore come under the inspection of the Sanitary Authority, who will have to enforce the Act in these premises. H.M. Inspector of Factories prosecutes under the Factory Act for the absence of the notice, and the sanitary authority prosecutes for the overcrowding under the Public Health (London) Act, therefore, it seems right that the officers of the local authority ought to inform H.M. Inspector whenever they find the necessary notices not affixed in workshops. The Section relating to overcrowding does not specify (1) the minimum of floor space, nor the maximum of height in the stated amount of cubic space to be provided for each person—(2) the minimum of height of any room to be used as a workshop ; and (3) the precise quantity of gas, oil, candle or other illuminant which shall count as one person in regard to vitiation of air. In calculating cubic space it is customary to assume that three gas burners count as one person, but considering that a common small gas burner will burn 3 feet per hour, and that a cubic foot of good coal gas produces about 2 cubic feet of carbonic acid, and other substances may also be formed, and whereas man in work exhales from 0.95 to 1.96 cubic feet of carbonic acid per hour, and in workshops there inay be large burners, prima facie, three gas burners counting as one person are certainly too many. In calculating cubic space in respect to overcrowding it is usual not to take into consideration any height over 14 feet. Section (2) Power is given to a Court of Summary Jurisdiction, on 94 the complaint of an inspector (under the Factory Act) that the condition of a factory or workshop causes danger to health, to prohibit its continued use until the necessary works have been executed, but this does not relieve Sanitary Authorities from taking proceedings under the provisions of the Public Health Act. Section (3) makes it "the duty of the Sanitary Authority to inform the Inspector" of Factories "of the proceedings taken" by them on any complaint made by him as to a factory or workshop under Section 4 of the Principal Act, 1878 (as regards any act, neglect or default in relation to any drain, water-closet, earth-closet, privy, ash-pit, water supply, nuisance or other matter in a factory or workshop, which is punishable or remediable under the law relating to public health, but not under the Factory Act. Section 3 (2) compels Sanitary Authorities "within a month" to comply with the notice of an inspector, or the inspector may take the like proceedings, it amends Section 2 (2) of the 1891 Act which enacts— Where notice of an act, neglect, or default is given by an inspector under the said Section 4—(of the 1878 Act)—as amended by this Act, to a sanitary authority, and proceedings are not taken " within a reasonable time " for punishing or remedying the act, neglect or default, the inspector may take the like proceedings for punishing or remedying the same as the sanitary authority might have taken, and shall be entitled to recover from the sanitary authority all such expenses in and about the proceedings as the inspector incurs, and recovered from any other person, and have not been incurred in any unsuccessful proceedings. Section (4) gives power, on complaint of a factory inspector to a Court of Summary Jurisdiction, to make order as to dangerous machinery. Section (5). If an employer or any contractor receives notice from 95 a factory inspector that the place where the work is done is dangerous or injurious to health, he is prohibited under a maximum penalty of £10 from giving out work to be done in that place after the expiration of one month from receipt of the notice. Section (6) imposes a penalty upon an occupier of a factory or workshop, or laundry, or of any place from which any work is given out, or any contractor employed by any such employer for allowing wearing apparel to be made, &c., in any dwelling-house or building occupied therewith, whilst any inmate of the dwelling house is suffering from scarlet fever or small-pox, unless he proves he was not aware of the existence of the illness. It seems strange that this clause does not include any of the other dangerous infectious diseases typhus and puerperal fevers, &c., specified in Section 55, Sub-section (8) of the Public Health (London) Act 1891. Section 10 (1) gives power to a Court of Summary Jurisdiction on complaint by the Inspector of Factories, to require the occupier of a factory or workshop to provide a sufficient number of moveable fire escapes for the safety of his employes. (2) Relates to immediately and easily unlocking, or unbolting, or unfastening of doors from the inside of an occupied factory or workshop. (3) The doors of every factory or workshop in which more persons than 10 are employed, shall, except in the case of sliding doors be constructed so as to open outwards. (4) Includes workshops in Sub-section 1 and 2 of Section 7 of the Act of 1891, in like manner as they apply to factories in provision against fire. In the application of Section 7 of the 1891 Act to the 96 tive County of London, the London County Council takes the place of the Sanitary Authority. Section 22 sub-section (1). Makes laundries subject to the Factory Acts; those in which " steam, water, or other mechanical power" is used being classed as factories, and the others as workshops. (2) In the case of every laundry worked by steam, water or other mechanical power— (a) A fan or other means of a proper construction shall be provided, maintained and used for regulating the temperature in every ironing-room, and for carrying away the steam in every wash-house in the laundry; and (b) All stoves for heating irons shall be sufficiently separated from any ironing-room, and gas irons emitting any noxious fumes shall not be used : and (c) The floors shall be kept in good condition and drained in such manner as will allow the water to flow freely. A laundry in which these provisions are contravened shall be deemed to be a factory not kept in conformity with the principal Act. By sub-section (3) there are certain exemptions as to laundries being made subject to this Act; among the exceptions is any laundry in which the only persons employed are members of the same family dwelling there, or in which not more than two persons dwelling elsewhere are employed. Exemption is also made with respect to laundries in certain public institutions and in institutions, conducted for charitable purposes. Sub-section (4) imposes certain restrictions as to women working overtime in laundries. Section (23) extends to docks, wharfs, quays and warehouses, and 97 any premises on which machinery worked by steam, water, or other mechanical power is temporarily used for the purpose of the construction of a building, or any structural work in connection with a building; certain provisions of the Factory Acts relating to the fencing of machinery, notice of register of accidents, and powers of inspectors, as if such dock, etc., were a factory, and the purpose for which the machinery used were a manufacturing process, and as if the user were the occupier of a factory. Section (24) substitutes the owner of tenement factory for occupier for certain purposes. Section (25) enacts regulations as to grinding and cutlery in a tenement factory. Section (26) relates to validity of certificate of fitness in tenement factory. Section 27 (1), Sections 34 and 35 of the principal Act shall apply to every bakehouse, and repeals so much of those Sections as limits the operation to bakehouses in localities of more than 5000 persons(2) repeals in Section 15 of the Factory and Workshops Act, 1883, the words " which was not so let or occupied before the first day of June One thousand eight hundred and eighty-three." This Section will now read as—It shall not be lawful to let or suffer to be occupied as a bakehouse or to occupy as a bakehouse any room or place unless the following regulations are complied with. (See page 46.) Now by the 1895 Act every bakehouse must comply with all these regulations. Prior to the passing of this Act, a bakehouse let or occupied before the 1st day of June, 1883, was exempted. Sub-section (3)prohibits the occupation of underground bakehouses which are not in occupation at the time of the commencement of the Act. G 98 Section 28 (1) Power to prohibit or restrict employment in dangerous trades, and Sub-section (2) extends this same power, as well as the special rules and requirements as to dangerous and unhealthy incidents of employment, to workshops conducted on the system of not employing any child, young person, or woman therein, i.e. a domestic workshop. All prohibitions and restrictions have to be certified by the Secretary of State under Section 8 (1) of the 1891 Act. The 29th Section contains one of the most important provisions in the Act, and requires medical practitioners to notify cases of lead, phosphorus or arsenical poisoning, or anthrax contracted in any factory or workshop. The notification is to be sent to the Chief Inspector of Factories at the Home Office, London ; the notice is to state name and full postal address of the patient and the disease, for which notification a fee of two shillings and sixpence will be paid. The notice is only to be sent when the case has not been previously notified, and differs from the notification of infectious diseases, under the Public Health (London) Act, under which Act every practitioner notifying a case is entitled to a fee. It is quite possible under this Section of the Factory Act 1895, that the medical practitioner may have no definite knowledge that the case has been notified before, and if any medical practitioner when required by this Section to send a notice fails forthwith to forward the same, he shall be liable to a fine not exceeding forty shillings. Written notice of the cases as if they were accidents are also to be sent to the Inspector and Factory Surgeon. Other diseases may be included by the Secretary of State. By Section (30) every factory or workshop where lead, arsenic, or any other poisonous substance is used shall be provided with suitable washing conveniences for the use of the persons employed in any department where such substances are used. Section (31) The Cotton Cloth Factories Act, 1889, shall apply to 99 every textile factory in which atmospheric humidity is artificially produced, with such modifications of the schedule with respect to the maximum limits of humidity as the Secretary of State may direct. Section (32). In every factory and workshop adequate measures shall be taken for securing and maintaining a reasonable temperature in every room in which a person is employed. This section does not state the temperatures that factories and workshops are to be maintained at. There is no doubt that great difficulty was experienced in arriving at a specified temperature on account of the heat during summer. I consider that a reasonable temperature is 60° F. and that by the wording of the section, gas burners intended for lighting purposes cannot be considered adequate means for maintaining the heat of factories and workshops. Section (33) enacts that section 36 of the principal Act (provision as to ventilation by fan in factories and workshops in any process by which dust is generated and inhaled by the workers) shall extend to any factory or workshop where any process is carried on by which any gas, vapour or other impurity is generated and inhaled by the workers to an injurious extent. Section (34). Every occupier of a factory or workshop shall on or before the 1st day of March in every year send to the inspector of the district a correct return specifying with respect to the year ending on the preceding 31st day of December, the number of persons employed in the factory or workshop, shewing the number of persons employed by him with particulars as to their age and sex. Section (41). Every person who is in occupation of a workshop at the commencement of this Act shall before the expiration of twelve months serve notice of the address of his workshop and the nature of the work to the factory inspector. Any notice so served shall be forthwith forwarded to the respective sanitary anthority. 100 Section (42). Lists of outworkers under section 27 of the 1891 Act shall be sent twice-a-year on or before the 1st days of March and September to the factory inspectors of the respective districts. Unfortunately there is nothing in this section making it compulsory that duplicate lists of outworkers should be sent to the sanitary authority. On page 42 of my annual report for the year 1894, under the heading of " Outworkers," it will be found that on account of certain difficulties I suggested to the Sanitary Committee on the 27th September, 1894, that a letter should be sent to the Secretary of State expressing particular views respecting outworkers, to the effect that lists of outworkers should be forwarded to local authorities, and the Committee instructed the Clerk to write accordingly. I think I have discussed the principal sections of the new Factory Act which immediately interest, and some of which must be enforced by the Sanitary Authority, but at the same time it must be remembered that the Act contains further restrictions and miscellaneous amend, ments calculated to safeguard the health and general well-being of workers. Memorandum from Home Office, 27th January, 1896. " For the various Acts to have the beneficial effect desired, it is absolutely necessary that there should be thorough co-operation between the Sanitary Authorities and H.M. Inspectors of Factories, and with that object in view I have requested H.M. Inspectors to have a conference with each Medical Officer in their respective districts. The administration of the sanitary provisions relating to workshops was transferred to the Local Authorities with the intention of relieving the Factory Inspectors to a great extent of the inspection of workshops so far as sanitary matters are concerned. By section 26, 1891, notices of the opening of new workshops, and by section 41, 1895, 0f all workshops, have to be sent to the Inspector of Factories, and when he receives such notices he is required to forthwith forward them to 101 the Sanitary Authority of the district in which the workshop is situate. "A very large proportion of workshops, especially in the boot and shoe trade, only employ men, and the Medical Officer of Health is required by section 3 (1891), whenever he becomes aware of any child, young person, or woman being employed in a workshop, forthwith to give written notice thereof to the Factory Inspector of the district. If in the course of his inspections the Inspector of Factories observes that any of the provisions of the Public Health Act are disregarded, he is required by section 4, 1878, to give notice in writing to the Sanitary Authority of the district, and such Sanitary Authority is to make inquiry into the complaint. The Act of 1895, section 3, makes it the duty of the Sanitary Authority to inform the Inspector of Factories as to the proceedings taken in consequence of the notice. But if within one month (Factory Act, 1895, section 3, and 1891, section 2), proceedings are not taken by the Sanitary Authority for punishing or remedying the act, neglect, or default, the Inspectors of Factories are authorised to take such proceedings and recover from the Sanitary Authority all expenses incurred in any successful proceedings except such as are recovered from any other person. "Section 1, by enacting definitely that 250 cubic feet must be allowed, will render the administration of the law with respect to overcrowding much easier of enforcement. The requirement of 400 cubic feet when working overtime remains as before. "Section 2, giving power to obtain an order from a court of summary jurisdiction as to dangerous parts of a factory or workshop, will enable H.M. Inspectors to secure the fencing of dangerous vats and tanks, and to guard against such evils as could not be remedied under the provisions of the law relating to public health. "With reference to section 6, it will be the duty of H.M. Inspectors to take proceedings if wearing apparel is made in factory or workshop 102 where any inmate in the building is suffering from scarlet fever or small-pox. "Under section 7, 1891, and section 10, 1895, it is the duty of the Sanitary Authority to visit the factories or workshops where more than 40 persons are employed, and ascertain that suitable provision is trade for escape in case of fire, and if the Sanitary Authority have neglected this duty, and it is evident that the means of escape are insufficient, it is the duty of H.M. Inspector to give notice to the Sanitary Authority. " Where in any factory or workshop the Inspector considers a moveable fire-escape necessary for the safety of the workers, H.M. Inspector should obtain an order from the magistrates for the occupier to supply the same under section 10, 1895. "Section 14 restricts overtime to women where overtime is worked under section 53, 1878, and has curtailed the number of days on which overtime can be worked. There are other restrictions as to overtime and hours of work in the same section. "Section 15 requires registers to be kept of children and young persons in workshops where overtime is worked under section 53, 1878, but it is not necessary in workshops to have certificates from the Certifying Surgeon. " It has been the custom in some factories and workshops to give women and young persons work to take home after having been employed in the works both before and after dinner ; this is now prohibited. In other cases they have employed them in the retail shop after the day's work in the factory or workshop. This is now allowed in the case of children, young persons, and women by section 16, provided the total number of hours does not exceed that allowed in the factory or workshop to each class of hands. Section 53, Sub-Section i. "Owner" is thus defined in section 4 of the Public Health Act, 1875, 38 & 39 Vict. c. 55:- 103 " 'Owner' means the person for the time being receiving the rackrent of the lands or premises in connection with which the word is used, whether on his own account or as agent or trustee for any other person, or who would so receive the same if such lands or premises were let at rack-rent. " 'Rack rent' means rent which is not less than two-thirds of the full net annual value of the properly out of which the rent arises ; and the full net annual value shall be taken to be the rent at which the property might reasonably be expected to let from year to year, free from all usual tenant's rates and taxes, and tithe commutation rentcharge (if any), and deducting therefrom the probable average annual cost of the repairs, insurance, and other expenses (if any) necessary to maintain the same in a state to command such rent. "R. E. SPRAGUE ORAM, " H.M. Chief Inspector of Factories. " Home Office, " January 10 th, 1896." In concluding this Report it affords me much pleasure to express my sincere appreciation of the kindness and consideration which the Board has always shewn towards the officers of the Sanitary Department, whose efforts to carry out their onerous duties have been uniformly supported by the members of the Board. I am, Gentlemen, Your obedient Servant, FREDERICK WM. ALEXANDER. Diplomate Public Health (EnglandJ, Medical Officer of Health, Offices of the Board. Poplar and Bromley. 117, High Street, Poplar, 31s/ December, 1895. 104 CORRIGENDA CHART I. Read Barometer— 12th Week, 29.83 instead of 29.71. 21 st Week, 29.67 instead of 30.16. Read Thermometer— 35th Week, minimum 45.7 instead of 57.1. 37th Week, minimum 41.2 instead 51.4. Maximum 81.7 instead 71.8. Read— 24 as 14 in figures relating to Plumstead and Woolwich.