SHOR 17 REPORT on the HEALTH AND SANITARY CONDITION of the Metropolitan Borough of Shoreditch, IN THE COUNTY OF LONDON, FOR THE YEAR 1906, by LEWIS T. FRASER BRYETT, M.D. (Lond.), Medical Officer of Health; Diplomate in Public Health, Royal Colleges of Physicians and Surgeons; Fellow of the Incorporated Society of Medical Officers of Health; and of the Royal Institute of Public Health, &c. [Printed by Order of the Health Committee.] printed by a.t.roberts, son and co., ltd., hackney road, n.e. CONTENTS. Page. Alcoholism 7 Artizans' dwellings 32 Appendicitis, mortality from 7 Bacteriological examinations 25 Bakehouses 39 Births in sub-districts 2 Birth rates 3 Cancer 7 Cerebro-spinal fever 23 Coffeehouses 40 Cookshops 40 Common lodging-houses 34 Cow-houses 35 Customs and Inland Revenue Acts 34 Dairies 35 Deaths in sub-districts 3 Death rate 3 Deaths, ages at 6 Deaths, causes of 7 Deaths in public institutions 8 Deaths in outlying institutions 8 Diarrhoea 21 Diphtheria 15 Disinfection 25 Enteric fever 17 Erysipelas 20 Factories and Workshops Act, 1901 36 Factories, workshops and workplaces—sanitary work 27 Food condemned and destroyed 41 Food and Drugs Acts 41 Fried fish shops 40 Gas Works, Whiston Street 36 Houses closed 30 Houses let in lodgings 31 Houses occupied by working classes, demolition of 31 Ice cream shops 39 Infectious cases, number certified 11 Infectious cases, number removed to hospitals 11 Infectious diseases, age periods 9 Infectious diseases, deaths from 10 Infectious diseases, death rate 10 Infectious diseases, number of cases notified from schools 24 Influenza 22 Institutions, deaths in 8 Legal proceedings 28 Margarine Act, proceedings under 44 Marriages 3 Measles 22 Milk-shops 35 Milk premises, cowsheds, etc., on register 35 Mortality, infant 4 Mortuary 26 Offensive business 36 Outworkers 38 Population 1 Puerperal fever 21 Sanitary work 26 Scarlet fever 14 Scarlet fever, return cases of 12 Schools, closure for infectious disease 25 Page. Shelter 26 Sickness amongst the poor 9 Slaughter-houses 35 Small-pox 13 Smoke nuisance 34 Staff 45 Street markets and food 40 Tetanus 23 Tuberculosis 23 Vaccination returns 13 Verminous houses 35 Violence, mortality from 7 Water supply 26 Whooping cough 22 Workshops on register 36 Zymotic diseases, deaths from 9 Zymotic death rate 9 APPENDIX. Statistical Tables:— For whole district during 1906 and previous years (Table I.) 48 For separate localities in 1906 (Table II.) 49 Cases of infectious disease notified during 1906 (Table III.) 50 Causes of, and ages at, death during year 1906 (Tables IV. and VI.) 51,54 Infantile mortality during 1906 (Table V.) 52 Notes to Tables IV. and V. 53 Comparison of London and Shoreditch birth a nd death rates in 1906 (Table VII.) 60 Cases treated by District Medical Officer in 1906 (Table VIII.) 61 Summary of proceedings under Public Health (London) Act, 1891 (Table IX.) 62 Factory and Workshop Act—Summary of work (Tables 1, 2, 3, 4 and 5) 63-65 Metropolitan Borough of Shoreditch. ANNUAL REPORT of the MEDICAL OFFICER of HEALTH. Health Department, Town Hall, Old Street, E.C. January, 1907. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Shoreditch. Sir and Gentlemen, This report deals with the public health, sanitary condition and vital statistics of the Borough of Shoreditch during the year ending December 31st, 1906. POPULATION. The number of persons in the Borough is estimated for the year under consideration at 116,506, as compared with 116,939 for 1905, 117,360 for 1904, 117,740 for 1903, and 117,948 for 1902. The estimated populations in the registration sub-districts are as follows: Shoreditch South, comprising Moorfields, Church and Hoxton Wards 43,586, Shoreditch North-West, comprising Wenlock and Whitmore Wards 36,972, and Shoreditch North-East, comprising Kingsland', Haggerston and Acton Wards, 35,948. The estimated populations in the eight wards of the Borough are as follows: Ward. Population. Ward. Population. Moorfields 5,681 Whitmore 18,370 Church 19,923 Kingsland 11,188 Hoxton 17,982 Haggerston 12,384 Wenlock 18,602 Acton 12,376 2 The population of Wenlock Ward includes the inmates of the Holborn Union Workhouse, which is situate in this locality. These, estimated at 1,376, are, for certain statistical purposes, not regarded as persons belonging to Shoreditch, and are, for these purposes, excluded in estimating the population of the Borough, which therefore becomes 115,130, whilst that of the ward becomes 17,226. In the following table are given the areas of the wards in acres, and the estimated populations per acre: Ward. Area in acres. Population per acre. Ward. Area in acres. Population per acre. Moorfields 71 80 Whitmore 76 241 Church 106 138 Kingsland 72 155 Hoxton 78 233 Haggerston 66 187 Wenlock 90 191 Acton 83 149 In the above table the areas of the water-ways of the Regent's Canal and of the site occupied by the Holborn Union Workhouse have not been taken into account. BIRTHS. The number of births registered in the Borough was 3,802, of which 1,905 were of males and 1,897 of females. The number corrected by the inclusion of the births occurring in public institutions outside Shoreditch, the parents being residents of the Borough, and the exclusion of those occurring in public institutions within the Borough, the parents not being residents of Shoreditch, was 3,870, of which 1,945 were of males, and 1,925 of females. The distribution of the corrected births in the eight wards of the Borough is given below: Ward. Males. Females. Total. Moorfields 66 64 130 Church 331 337 668 Hoxton 320 344 664 Wenlock 316 280 596 Whitmore 299 287 586 Kingsland 207 216 423 Haggerston 193 193 386 Acton 213 204 417 Totals 1,945 1,925 3,870 3 From information supplied by the Medical Officer of Health of the London County Council, it appears that 768 of the births during 1906 belonging to Shoreditch were attended by midwives registered under the Midwives Act, 1902, and of these, 50 were hospital confinements. The birth-rate for the Borough was 33.6 per 1,000 inhabitants, as compared with 34.2 in 1905. The birth-rates for the eight wards of the Borough are contained in Table VII. (Appendix). The births for the whole of England and Wales during 1906 were at the rate of 27.0 per 1,000 population; for 76 great towns they averaged 27.9, and for 142 smaller towns 26.5 per 1,000 population. The birth-rate of the metropolis in 1906 was 26.5 per 1,000 inhabitants. MARRIAGES. The marriages in Shoreditch during 1906 numbered 1,074 as compared! with 1,068 in 1905, 1,066 in 1904, 1,146 in 1903, 1,156 in 1902, 1,073 in 1901, and 1,157 in 1900. The number of persons married was at the rate of 18.6 per 1,000, as compared with 17.1 for the whole of London. DEATHS. The deaths numbered 2,289, as compared with 2,296 in 1905 and 2,392 in 1904. They were distributed amongst males and females in the eight wards of the Borough as shown in the following table:— Ward. Males. Females. Total. Moorfields 44 35 79 Church 206 197 403 Hoxton 190 164 354 Wenlock 172 164 336 Whitmore 231 223 454 Kingsland 100 120 220 Haggerston 97 111 208 Acton 127 108 235 Totals 1,167 1,122 2,289 The deaths of males were 45 in excess of the number of females who died. The death-rate for 1906 was the same as for 1905, namely, 19.8* per 1,000 inhabitants, as compared with 20.6 in 1904, and 19.6 in 1903, and was markedly below the average for the previous ten years. The death-rate of the metropolis for 1906 was 15.1, of England and Wales 15.4, and of 76 great towns 16.0 per 1,000 inhabitants. *Corrected for age and sex distribution, the death-rate was 20.7 per 1,000. 4 Tables I., II., IV., V., VI., and VII. (see Appendix) give the causes of death and the death-rates for the whole Borough and its eight wards, together with other information bearing upon the mortality amongst the inhabitants of Shoreditch during the year. A comparison of the rates in the several wards will show that the deathrate varied very considerably in the different localities. As last year, the rate was highest in the Whitmore Ward and lowest in Moorfieldis, being 24.7 per 1,000 in the former and 13.9 in the latter. This great difference is doubtless to be accounted for by Whitmore Ward containing a larger proportion of the poorest of th; inhabitants of the Borough, and being about three times as thickly populated as Moorfields Ward. The death-rate for the Borough was above the mean rate for the year during the first four months. It was below the mean from about the middle of May until the end of July. The lowest point reached was in the last week of July, the rate recorded for that week being 9.8 per 1,000 inhabitants. With the beginning of August the death-rate rose rapidly and was above the mean until the last week of September, the highest point for the year being reached during the second week in September, when the death-rate amounted to 28.5 per 1,000. The rate was below the mean again from the beginning of October until the second week in December, when it rapidly went up above the mean, being for two weeks over 28 per 1,000. The high rate during August and September was due to the prevalence of summer diarrhœa, which resulted in numerous deaths during that period. The rise during the last few weeks of the year was the result of an increased number of deaths from diseases of the respiratory organs. The deaths of infants under the age of one year numbered 651 of which 340 were of males and 311 of females. They amounted to a little over 28 per cent. of the total number of deaths at all ages. The proportion of infants under one year dying during the year to the total number of births belonging to Shoreditch registered during the same period was at the rate of 168 per 1,000, which, although somewhat higher than that for 1905, is nevertheless considerably below the average for the previous twelve years. The infantile mortalitv in the Borouerh is greater amongst males than females. In the subjoined table are given the infantile mortalities for the sexes for the years 1901-06 inclusive: Years. 1901 1902 1903 1904 1905 1906 Deaths of male infants under 1 year per 1,000 male births during year 211 207 179 207 179 175 Deaths of female infants under 1 year per 1,000 female births during year 190 153 173 177 150 161 The above figures give an average of 193 as the infantile mortality for males, and 167 for females, which shows that during the period referred to, the infantile mortality amongst males was about 15 per cent. higher than amongst females. 5 The chief causes of death amongst infants under the age of one year were diarrhoea, enteritis, and other disorders of the stomach and intestines, prematurity, congenital defects and weakness at birth, whooping cough, pneumonia, bronchitis, various forms of tuberculosis, and suffocation in bed. In Table V. (Appendix) is contained a statement of the causes of death of infants under one year, the ages in weeks and months being given. In the subjoined table the causes of death amongst infants under one year of age are given for each of the eight wards of the Borough . Cause of Death. Moorfields Ward. Church Ward. Hoxton Ward. Wenlock Ward. Whitmore Ward. Kingsland Ward. Haggerston Ward. Acton Ward. Totals. Measles ... 1 3 2 2 1 2 1 12 Diphtheria ... ... ... ... 1 ... 1 ... 2 Whooping Cough ... 5 4 2 2 1 ... 4 18 Diarrhœa (all forms) 3 27 25 31 23 14 16 18 157 Enteritis ... 7 9 7 14 1 5 3 46 Gastritis and Gastro Intestinal Catarrh ... ... ... ... 1 2 ... ... 3 Premature Birth 3 14 14 14 13 3 8 8 77 Congenital Defects 1 3 3 2 ... ... 2 2 13 Injury at Birth ... ... ... 1 ... ... ... ... 1 Want of Breast Milk ... ... ... 1 2 ... ... 1 4 Atrophy, Debility and Marasmus 2 16 9 14 12 16 8 5 82 Tuberculous Meningitis ... 3 3 2 1 1 2 1 13 Tuberculous Peritonitis and Tabes Mesenterica ... 3 3 4 6 ... 2 ... 18 Other Tuberculous Diseases ... 2 2 2 2 2 4 ... 14 Erysipelas ... ... ... 1 ... ... ... ... 1 Syphilis ... 1 2 2 1 2 1 2 11 Rickets ... ... ... ... 1 ... ... ... 1 Meningitis (not Tuberculous) ... 2 2 1 5 1 ... ... 11 Convulsions ... 2 ... 4 2 1 2 ... 11 Bronchitis ... 5 10 6 8 3 3 8 43 Pneumonia ... 7 11 6 9 3 10 7 53 Suffocation, overlying 1 6 3 6 7 4 ... 2 29 Other causes 1 4 4 5 7 4 2 4 31 Totals 11 108 107 113 119 59 68 66 651 A comparison of the infantile mortalities in the wards is contained in Table VII. (Appendix). The infantile mortality was least in Moorfields Ward, where it only amounted to 85 per thousand births, and highest in Whitmore Ward, where the mortality was 203 per thousand. In connection with this, it is to be noted that Moorfields Ward is the least densely populated locality in the Borough, whilst Whitmore 6 Ward is the most densely populated, and, moreover, contains a larger proportion of the poorer inhabitants of the Borough. The deaths of children aged from one to five years numbered 357, of which 63 were attributed to measles, 40 to whooping cough, 15 to scarlet fever, and 10 to diphtheria, 49 to various forms of tuberculosis, 21 to bronchitis, 72 to pneumonia, 21 to diarrhcea, and 6 to accident or negligence. Altogether, of the total number of deaths for the year, 1,008, or just over 44 per cent., were of children under the age of five years. Of children aged between five and fifteen years, 75 died, the chief causes being tuberculosis, which accounted for 25, other infectious diseases which resulted in 18, and accident or negligence, which was the cause of 7 deaths. Of persons aged between fifteen and twenty-five years there were 70 deaths, of which 29, including 26 from consumption, resulted from tuberculosis. Of persons aged from twenty-five to thirty-five years there died 113, the chief causes being consumption, which accounted for 39 deaths, diseases of the respiratory organs, kidneys, and heart. Cancer was given as the cause of 2 deaths, and alcoholism of 2 deaths. Violence resulted in four deaths, one of which was due to suicide and another to homicide. The deaths of persons aged between thirty-five and forty-five years numbered 207, of which 75 were caused by consumption, 14 by diseases of the nervous system, 10 by valvular heart disease, 11 by bronchitis, 17 pneumonia, 7 disease of the kidneys, and 13 by violence, including one due to homicide and four to suicide. Six deaths were attributed to alcohol, six to cirrhosis of the liver, and six to cancer. Of 243 deaths amongst persons aged between forty-five and fifty-five years, 54 were attributed to consumption, 27 to cancer, 5 to alcoholism, 18 to diseases of the nervous system, 15 to valvular heart disease, 20 to bronchitis, 18 to pneumonia., 24 to disorders of the digestive organs, including 11 from cirrhosis of the liver, 10 to kidney disease, and 14 to violence, including one through homicide and seven through suicide. Of 213 deaths amongst persons aged between fifty-five and sixty-five years. 16 were attributed to consumption, 18 to cancer, 4 to alcoholism, 10 to diseases of the nervous system, 15 to valvular heart disease, 41 to bronchitis,- 19 to pneumonia, 5 to cirrhosis of the liver, 18 to kidney disease, and 12 to violence, including three due to suicide. Of persons aged between sixty-five and seventy-five years there died 192, the chief causes of death being cancer, which accounted for 16, old age for 30, apoplexy 15, valvular heart disease 6, bronchitis 42, pneumonia 15, kidney disease 16, and other diseases of the urinary organs 5. 7 Of 134 deaths amongst persons aged between seventy-five and eighty-five years, 5 resulted from cancer, 60 from old age, 9 from apoplexy, 6 valvular heart disease, 10 bronchitis, 7 pneumonia, 4 kidney disease, and three from violence. Of the 34 persons who died aged 85 years and upwards, one succumbed to influenza, 22 to the results of old age, one to apoplexy, and one to another disease of the nervous system, one to senile gangrene, 5 to pneumonia, 2 to diseases of the urinary organs, and one to the results of a fall. An old lady died who was 102 years of age. The chief causes of death during the year were: tuberculosis, which, including 233 from consumption or phthisis, accounted for 347 deaths; pneumonia, which caused 231 deaths; bronchitis, 194; diseases of the heart and blood vessels, 153; diarrhcea, 194; enteritis, 62; whooping cough, 59; measles, 74; cancer, 74; Bright's disease, 67; apoplexy, 52; atrophy, debility, and marasmus, 75; prematurity, 72; old age, 115; and cirrhosis of the liver and alcoholism, 47. Of the 74 deaths from cancer, 27 were of males and 47 of females. Most of the deaths were of persons aged between 45 and 75 years. Eight persons under the age of 45, and 5 over the age of 75, were certified to have died of cancer. Nine deaths during the year were attributed to malignant disease, which in some instances may have been cancer. Five of these were of males, and four of females. The death-rate due to cancer was 0.64 per 1,000 inhabitants, as compared with 0.70 in 1905, 0.69 in 1904, 0.66 in 1903, 0.74 in 1902, 0.63 in 1901, 0.56 in 1900, 0.63 in 1899, 0.58 in 1898, 0.51 in 1897, 0.45 in 1896, 0.50 in 1895, 0.65 in 1894, and 0.54 in 1893. The deaths from malignant disease have not been included in estimating the above rates. The figures indicate that the death-rate from cancer in Shoreditch shows a tendency to increase. Of the deaths attributed to alcoholism and cirrhosis of the liver, 19 were of males and 28 of females. As has been stated in previous reports, the deaths registered as due to alcoholism and cirrhosis of the liver are far from representing the actual number of deaths directly or indirectly caused by the abuse of alcohol. The deaths attributed to appendicitis numbered 19, as compared with 4 in 1905, 7 in 1904, 5 in 1903, 4 in 1902, and 2 in 1901. As to whether there has really been an increase in the number of deaths in the Borough due to appendicitis is not free from doubt, for it is not improbable that deaths which were formerly attributed to peritonitis may have been of late years attributed to appendicitis. In connection with this, it is to be noted that the average yearly number of deaths from peritonitis during the six years ending 1906 is considerably less than it was for the previous six years. Violence, in its various forms, resulted in 100 deaths, of which 63 were of males and 37 of females. Accident or negligence occasioned 81, the chief causes being through horses and vehicles, which resulted in 10 deaths, burns and scalds in 11, falls —chiefly old people—in 17, and suffocation in infants, mainly through overlying, which was the cause of 27 deaths. There were three cases of homicide, and 16 persons, all of whom were males, committed suicide. 8 DEATHS IN PUBLIC INSTITUTIONS. The numbers and distribution of the deaths of persons belonging and not belonging to the Borough in the public institutions situate in Shoreditch are as set out in the subjoined table:— Institution. Persons belonging to Shoreditch. Persons not belonging to Shoreditch. Total. Holborn Union Workhouse 4 268 272 Shoreditch Workhouse 461 21 482 Royal Chest Hospital 6 47 53 Convent Hospital 2 7 9 Total 473 343 816 Elsewhere than in public institutions, seventeen persons not belonging to Shoreditch died within the Borough. In the subjoined table are set forth the various public institutions outside Shoreditch with the numbers of persons belonging to the Borough dying therein:— Asylums. No. of Deaths. General Hospitals—continued. De No. of Deaths. Banstead 7 North Eastern (Children) 53 Belmont 2 Paddington (Children) 1 Cane Hill 2 Royal Free 1 Caterham 2 St. Bartholomew's 84 Claybury 17 St. George's 1 Colney Hatch 14 University College 1 Darenth 1 Westminster 1 Dartford Heath 4 Hospitals foe Special Diseases, &c. Consumption Hospital, Brompton 1 Hanwell 3 Horton 2 Leavesden 5 Manor 1 Cancer Hospital, Chelsea 3 Middlesex County 1 Lying-in, City of London 4 St. Luke's 1 Chest Hospital, Bethnal Green 2 Tooting Bee 7 Epileptic Colony, Epsom 1 Mount Vernon 1 Hospitals foe Infectious Disease. National 2 Eastern 11 Infirmaries and Workhouses. Northern 1 North Eastern 22 Bethnal Green Infirmary 6 South Eastern 1 Bishop Stortford Workhouse 2 General Hospitals. Islington Infirmary 2 Holborn Infirmary 4 Charing Cross 1 Hackney Infirmary 3 East London 2 St. Pancras Infirmary 1 German 8 St. George's Infirmary 2 Gt. Ormond Street (Children) 28 Whitechapel Infirmary 2 Friedenbeim 2 Central London Sick Asylum 1 Hampstead (Children) 1 Other Institutions. Italian 1 King's College 1 St. Joseph's Hospice 5 London 25 Hostel of God 1 Metropolitan 100 St. Anne's House 1 Mildmay 4 9 Of 473 persons belonging to Shoreditch dying in public institutions situate beyond the limits of the Borough, 325 died in general hospitals, including 93 in hospitals for children; 35 died in the fever hospitals of the Metropolitan Asylums Board; 69 died in asylums; 14 in hospitals for special diseases; 23 in workhouses and infirmaries, and 7 in other institutions. Elsewhere than in public institutions 18 persons belonging to Shoreditch died beyond the limits of the Borough. Altogether 946 persons belonging to Shoreditch died in public institutions. Including the eighteen persons who did not die in public institutions, 964 persons belonging to the Borough died elsewhere than in their homes. SICKNESS AMONGST THE POOR. The cases coming under the treatment of the district medical officers in connection with the poor law dispensary during 1906, numbered 4,107, as compared with 4,014 in 1905. An analysis of the cases is contained in Table VIII. (Appendix). The diseases classed as infectious accounted for 662 of the cases, chiefly of consumption, diarrhoea, influenza, measles and whooping cough. Diseases of the respiratory system, which are to a very large extent the result of infection, were responsible for 1,043 cases, of which 913 were of bronchitis and 61 of pneumonia. There were 296 cases of rheumatism and 94 of gout. Dyspepsia, and other disorders of the digestive system accounted for 430 cases. Cases of cancer were more numerous than usual, numbering 43, as compared with 37 in 1905, 27 in 1904, 30 in 1903, 12 in 1902, 31 in 1901, 33 in 1900, 18 in 1899, 9 in 1898, 15 in 1897, 21 in 1896, 15 in 1895, 27 in 1894, and 23 in 1893. INFECTIOUS DISEASES. The infectious diseases included under the headings numbered 1 to 35 in Table VI. (Appendix) resulted in 776 deaths, as compared with 717 in 1905, 791 in 1904, 762 in 1903, 767 in 1902, and 762 in 1901. The deaths from these diseases were, during 1906, somewhat above the average for the previous five years, and they amounted to nearly 34 per cent. of the deaths from all causes. The increase in the number of deaths from these infectious diseases for last year mainly resulted from the larger number of deaths from diarrhoea. Deaths from consumption and the other forms of disease caused by the tubercle bacillus made up from forty to fifty per cent. of the whole, and of the remainder, diarrhoea, measles, and whooping cough accounted for the major portion. The death-rate from these infectious diseases was 6.7 per 1,000 inhabitants, as compared with 6.2 in 1905, 6.8 in 1904, and 6.5 in 1903. In the subjoined table the deaths from the infectious diseases referred to above have been grouped according to age: Age period. Under 1 1-5 5-10 10-15 15-20 20-25 25-35 35-45 45-55 55-65 65-75 75-85 85 and upwards. No. of deaths 249 209 31 12 14 21 49 86 64 26 12 2 1 10 More than half of these deaths from infectious disease were of children under five years of age, and taking the total mortality amongst children under five years of age from all causes, over 45 per cent. of the deaths resulted from these infectious diseases. In the case of infants under one year, diarrhoea was the most fatal of these diseases, whilst amongst children aged from one to five years, measles and whooping cough claimed most victims. In both of these age groups tuberculosis was also a fruitful cause of death. Consumption was the chief cause of the mortality between the 20 to 65 years' age periods. Deaths from small-pox, measles, scarlet fever, diphtheria, including membranous croup, whooping cough, enteric fever, and diarrhœa—the principal zymotic diseases —numbered 365, the death-rate being 3.1 per 1,000 inhabitants, as compared with 2.8 in 1905, 3.2 in 1904, 2.8 in 1903, 3.6 in 1902, 2.9 in 1901, 3.1 in 1900, 3.6 in 1899, 4.1 in 1898, 4.2 in 1897, 4.3 in 1896, 3.8 in 1895, 2.8 in 1894, and 4.7 in 1893. A comparison of the zymotic death-rates of London and Shoreditch and the eight wards of the Borough is contained in Table VII. (Appendix). The zymotic death-rate was lowest in Moorfields and highest in Wenlock and! Whitmore Wards. The cases of notifiable infectious disease numbered 951, being 200 less than in 1905. 1905. The numbers of cases annually certified since 1889, and the attack-rates per 1,000 inhabitants are contained in the following table:— Year. Number of cases. Attack-rate per 1,000 inhabitants. 1890 1158 9.4 1891 862 7.0 1892 1478 12.0 1893 1987 16.2 1894 1104 9.0 1895 1157 9.4 1896 1473 12.1 1897 1331 10.9 1898 960 7.8 1899 1116 9.2 1900 989 8.1 1901 1146 9.8 1902 1239 10.5 1903 664 5.6 1904 776 6.6 1905 1151 9.8 1906 951 8.2 The cases of notifiable infectious disease certified in the metropolis numbered 35,343, the attack-rate being 7.5 per l,000 population. 11 Subjoined is a list of the infectious diseases which are notifiable to the Medical Officer of Health, showing the numbers of cases certified in the Borough for each of the four quarters of the year, and the numbers and percentages of such cases which were removed to hospital for treatment:— Disease First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Deaths. Small Pox ... ... ... ... ... ... Scarlet Fever or Scarlatina 73 136 224 193 629 20 Diphtheria & Membranous Croup 40 27 34 32 133 14 Typhus Fever ... ... ... ... ... ... Cholera ... ... ... ... ... ... Enteric (Typhoid) Fever 7 8 8 16 39 4 Continued Fever ... ... ... ... ... ... Relapsing Fever ... ... ... ... ... ... Puerperal Fever ... 2 3 1 6 3 Erysipelas 21 24 43 56 144 2 Totals 144 197 312 298 951 43 Numbers and percentages of cases removed to hospitals 121 165 263 232 781 84% 84% 84% 80% 82% As compared with the figures for 1905, there were marked decreases in the numbers of cases of scarlet fever and diphtheria. The deaths from notifiable infectious disease are the fewest so far recorded for any year. The deaths from the principal zymotic diseases which are notifiable, namely, small-pox, scarlet fever, diphtheria, and enteric fever, were at the rate of 0.3 per 1,000 population, as compared with a rate of 2.8 for the principal zymotic diseases which are not notifiable, namely, measles, whooping cough, and diarrhœa. METROPOLITAN ASYLUMS BOARD. Most of the cases of infectious disease removed to hospital were taken to the hospitals of the Metropolitan Asylums Board. The infectious diseases cases of which are receivable into the Board's hospitals are small-pox, scarlet fever, diphtheria, and enteric fever. The number of cases of these diseases certified was 801, the number removed to hospital 769, giving a percentage of 96, which is the highest recorded for any given year in Shoreditch. The figures for previous years are contained in the last Annual Report. 12 RETURN CASES During the year 14 instances where "return" eases of scarlet fever occurred came under observation. The particulars are briefly as follows:— Number of Cases. Length of time in Hospital. Interval between the return of the primary (infecting) case and the occurrence (invasion of) the secondary or return case Lesions observed in the primary case on return from hospital. Number of cases resulting from Primary case. Remarks. 1 51 days. 4 days Discharge from nose and ears. 1 Primary ease, a female Doubtful—probability of infection from another source. 2 60 „ 4 „ Enlarged tonsils. 1 Primary case, a female. Was herself a "reiurn" case. 3 44 „ 7 „ 1 Primary case, a female. Doubtful — probability of infection from another source. 4 54 „ 27 „ 3 Primary case, a male. Doubtful—probability of infection from another source. 5 98 „ 7 „ 1 Primary case, a male. Doubtful—probability of infection from another source. 6 49 „ 4 „ Left tonsil enlarged. 1 Primary case, a female. 7 41 „ 21 „ 1 Primary case, a female. Two days after her return from hospital she possibly had a second attack of scarlet fever. 8 61 „ 2 „ Discharging sore by right thumb nail. Nasal discharge after return. 1 Primary case, a female. 9 58 „ 3 „ Nasal discharge. Scab below left ear. 1 Primary case, a male. 10 61 „ 2 „ Slight discharge from ears. 1 Primary case, a male. 11 45 „ 9 „ Discharge from nose after return home. 1 Primary case, a female. 12 68 „ 27 „ 1 Primary case, a male. Doubtful—probability of infection from another source. 13 50 „ 8 „ Nasal discharge after return. Desquamating fingers and toes. 2 Primary case, a male. 14 59 „ 3 „ Chapped lips. Subsequently developed sty on one of her eyelids. 3 Primary case, a female. 13 In five of the foregoing there were reasons for doubting whether the recurrence of the disease actually resulted from infection through the return of patients from hospital. The percentage of the return cases with respect to the cases removed was approximately 2.3, but is reduced to 1.5 if the doubtful cases are excluded. One instance came under observation in which the interval between the return of the infecting and the appearance of symptoms in the return case was so short as to preclude all probability of direct infection. The case is not included in the foregoing; the particulars are briefly as follows: May B—, aged 6, was removed to hospital with scarlet fever on June 7th, returning home on October 10th, at 2 p.m. She appeared in good health, without signs of discharge from noise of ears, excoriations of the skin, or other lesions. On the day of her return John B—,a brother, aged 4½ was noticed to be ill about 3.30 p.m., and was certified to have scarlet fever the same evening. Two instances came under notice where the recurrence of scarlet fever in houses took place shortly before the return of scarlet fever convalescents : Mary T , aged 3, was removed to hospital on October 9th, 1905, and returned home on January 10th, 1906. Robert T , aged 6, attending school, was taken ill on January 6th, and Lily T , aged 14 months, on the following day. These children were certified to have scarlet fever on January 9th and removed to hospital. Richard H , aged 3, was removed to hospital on April 26th, and was to have been discharged on June 15th.. He was, however, not allowed to leave the hospital on account of a discharge from his nose. Lily H , a sister, attending school, was taken ill on June 20th, and certified to have scarlet fever on June 21st. Richard H did not return home until after the removal of his sister. One instance of a return case of diphtheria came under notice. The returning patient developed a " sore throat " shortly after arriving home, and subsequently a discharge from the nose was observed. SMALL-rOX. No cases of small-pox were certified during the year in Shoreditch. Only about 30 cases were notified for the whole of London, and no deaths were registered. VACCINATION. The latest official figures published, so far as I am aware, are those contained in the report of the Medical Officer of the Local Government Board for 1904-05, and relate to the year 1903. In Shoreditch the number of children not finally accounted for as regards vaccination during that 11 year amounted to 36 per cent, of the children born during the year, as compared with 36.1 in 1902 fnd 44.4 in 1901. The cases in which vaccination was postponed are included in calculating these percentages. Conscientious objection certificates were granted in respect to 23 children, or 0.6 per cent. of the births during the year, as compared with 0.3 per cent. for the previous two years. SCARLET FEVER. The cases certified during 1906 numbered 629, as compared with 789 in 1905, 343 in 1904, and 255 in 1903. In 34, or 5.4 per cent., intimations were received from the Metropolitan Asylums Board that the patients were not suffering from scarlet fever, the diagnosis being tonsillitis in 6, measles 5, erythema 6, enteric fever 2, Rotheln 2, nephritis 1, rhinorrhœa 1, and not scarlet fever or not notifiable in 11 instances. The corrected number of cases was, therefore, 595, as compared with 771 in 1905, 320 in 1904, and 237 in 1903. The distribution of the cases certified and the deaths amongst males and females during the year in the Borough and its eight wards is as shown in the subjoined table:— Wards. SCARLET FEVER. Notifications. Fatal Cases. Male. Female. Total. Male. Female. Total. Moorfields 10 17 27 1 ... 1 Church 46 44 90 1 1 2 Hoxton 59 56 115 4 2 6 Wenlock 58 62 120 ... 1 1 Whitmore 63 60 123 6 ... 6 Kingsland 25 32 57 2 ... 2 Haggerston 18 37 55 ... 1 1 Acton 25 17 42 ... 1 1 Total for Borough 304 325 629 14 6 20 The cases are grouped according to ages in Table III. (Appendix). Of the cases certified, 612, or 97.4 per cent., were removed to hospital, as compared with 97 per cent. in 1905 and 96 in 1904. The percentages for previous years are given in the report for 1903. The cases certified were at the rate of 5.3 per 1,000 inhabitants, as compared with 6.7 in 1905, 2.9 in 1904, 2.1 in 1903, 2.1 in 1902, 4.7 in 1901, and 2.7 in 1900. The cases were most numerous and the attack-rates highest in Whitmore, Wenloek and Hoxton Wards, and lowest in Acton and Haggerston Wards. The deaths numbered 20( as compared with 27 in 1905 and 13 in 1904, and the death-rate was 0.17, as 15 compared with 0.23 in 1905, 0.11 in 1904, and, 0.05 in 1903. The case-mortality was at the rate of 3.1 per cent. of the cases certified, as compared with 3.4 in 1905, 3.8 in 1904, 2.7 in 1903, 3.3 in 1902, 3.5 in 1901, and 5.4 in 1900. Amongst children under five years of age there were 247 cases, with 15 deaths, the mortality being just over 6 per cent. (allowing for cases not regarded as scarlet fever at the hospitals, 6.6 per cent.), as compared with 7.7 per cent in 1905, 7.8 per cent. in 1904, 2.7 per cent. in 1903, 5.3 in 1902, 6.8 in 1901, and 12 in 1900. Among persons over five years, there were 382 cases with 5 deaths, the mortality being 1.3 per cent. of the oases (allowing for cases not regarded as scarlet fever, nearly 1.4 per cent.), as compared with 1 per cent. in 1905, 1.8 in 1904, 2.7 in 1903, and 1.7 in 1901. The cases of scarlet fever certified in the metropolis during 1906 numbeTed 20,345, the attack-rate being 4.3 per 1,000 inhabitants, as compared with 4.1 in 1905, 2.8 in 1904, 2.7 in 1903, 3.9 in 1902, 4.4 in 1901, and 3.0 in 1900. The deaths in the metropolis from this disease numbered 533, as compared with 549 in 1905, 365 in 1904, 361 in 1903, 560 in 1902, 584 in 1901, and 361 in 1900, the death-rate being 0.11 per 1,000, as compared with 0.11 in 1905, 0.08 in 1904, 0.07 in 1903, 0.12 in 1902, 0.13 in 1901, and 0.08 in 1900. DIPHTHERIA (INCLUDING MEMBRANOUS CROUP). The cases certified numbered 133, being 44 fewer than the number for last year. Of these, 43, or 32 per cent., were not regarded as diphtheria cases at the hospitals of the Metropolitan Asylums Board, the diagnosis being in 20 cases tonsillitis, in 5 Vincent's Angina, 4 scarlet fever, 3 laryngitis, 1 enteric fever, 1 stomatitis, and in 9 not diphtheria or not notifiable. The numbers of cases and the deaths amongst males and females in the Borough and its eight wards are given in the subjoined table:— Ward. DIPHTHERIA (Including Membranous Croup.) Cases Certified. Fatal Cases. Male. Female. Total. Male. Female. Total. Moorfields 4 3 7 ... 1 1 Church 10 10 20 1 1 2 Hoxton 5 12 17 ... ... ... Wenlock 7 10 17 1 4 5 Whitmore 11 12 23 2 ... 2 Kingsland 3 8 11 ... 1 1 Haggerston 6 12 18 1 1 2 Acton 8 12 20 1 ... 1 Total for Borough 54 79 133 6 8 14 These cases are grouped according to ages in Table III. (Appendix). 16 Of the cases certified, 91 per cent. were removed to hospital, as compared with 93 per cent. in 1905, 94 per cent. in 1904, 88 in 1903, 84 in 1902, 83 in 1901, 86 in 1900, 80 in 1899, 77 in 1898, 67 in 1897, and 65 in 1896. The cases certified were at the rate of 1.1 per 1,000 inhabitants in the Borough, the rate varying from 1.6 in Acton Ward to 0.9 in Hoxton, Kingsland and Wenlock Wards. The deaths numbered 14, the death-rate being 0.12 per 1,000, as compared with 0.14 in 1905, 0.16 in 1904, 0.18 in 1903, 0.18 in 1902, 0.23 in 1901. 0.45 in 1900, and 0.52 in 1899. (Appendix, Table VII.) The case-mortality was lower than in 1905, being 10.5 per cent. of the cases certified (15.5 allowing for the cases not regarded as diphtheria at the fever hospitals), as compared with 15.2 per cent. in 1905 and 10.3 per cent. in 1904. The mortalities for previous years were: 13.6 in 1903, 10.7 in 1902, 8.8 in 1901, 15.3 in 1900, 17.0 in 1899, 17.3 in 1898, 22.1 in 1897, 21.0 in 1896, 24.1 in 1895, 24.0 in 1894. and 29.0 in 1893. Of the 14 deaths in 1906, 12 were of children under five years, the mortality being 16 per cent. of the cases certified amongst children under that age (21.4 allowing for cases not regarded as diphtheria at the hospitals), as compared with 14.7 in 1905, 16.3 in 1904, 23.8 in 1903, 20,5 in 1902, 15.4 in 1901, 22.7 in 1900, 34.2 in 1899, 29.5 in 1898, 36.0 in 1897, 31.8 in 1896, 47.5 in 1895, 43.0 in 1894, and 61.0 in 1893. The case mortality amongst persons over five years of age amounted to 3.4 per cent. of the cases certified, but deducting the cases not regarded as diphtheria, the mortality was nearly 6 per cent. The usual enquiries were made as to the circumstances attending the occurrence of diphtheria in the Borough. With respect to 107 of the cases certified during the year, they were distributed amongst males and females at certain age periods as set out in the subjoined table:— Age Period. Male. Female. Total. Under 1 year 2 1 3 Prom 1 to 2 years 5 4 9 ,, 1 ,, 3 ,, 9 6 15 ,, 3 ,, 4 ,, 6 9 15 ,, 4 ,, 5 ,, 6 10 16 ,, 5 ,, 10 ,, 7 21 28 „ 10 „ 13 „ 4 4 8 Over 13 years 4 9 13 Total 43 64 107 In 46 of the cases the patients were children attending school, and in 35 they were at school within one week of being certified to have diphtheria. In a few instances the patients were attending school whilst actually suffering from diphtheria 17 before the nature of their disorder was recognised. In 48 other instances, although the patients were not attending school, other children resident in the same houses as the patients were. In 13 instances there had been cases of "sore throat" amongst the inmates of the patients' houses, and in 12 instances evidence as to infection from previous cases of diphtheria was obtaned. In 73 cases the houses were occupied by more than one family, in 24 by single families, and in 10 instances the cases were in blocks of artizans' dwellings. In 56 the cases occurred in houses whioh were in a satisfactory sanitary condition, in 25 in houses the condition of which was fair, and in 26 in houses which were not satisfactory from a sanitarv point of view. The figures as to the occupation and the sanitary condition of the houses in which diphtheria cases occur were commented upon in my last Annual Report. The cases certified as diphtheria in the metropolis numbered 7,916, as compared with 6,482 in 1905, the attack-rates per 1,000 poulation being 1.6 and 1.3 respectively. The deaths numbered 691. as compared with 546 in 1905, the death-rate being 0.14 and 0.12 per 1,000 population respectively. ENTERIC OR TYPHOID FEVER. The cases certified numbered 39, including one regarded as paratyphoid fever, five which were not regarded subsequently as having been enteric fever, and one which was looked upon as doubtful. With respect to the cases which were not enteric fever one was erysipelas, one chronic nephritis and ulcerative endocarditis, and three were stated to be not enteric or not notifiable. The numbers of cases certified year by year since 1889 are set out in the subjoined table:— Year. Number of Cases. Year. Number of Cases. 1890 202 1899 171 1891 111 1900 122 1892 91 1901 96 1893 111 1902 149 1894 85 1903 101 1895 99 1904 48 1896 114 1905 36 1897 10 7 1906 39 1898 91 The cases certified were at the rate of 0.3 per 1,000 population, as compared with 0.3 in 1905, 0.4 in 1904, and 0.8 in 1903. With one exception, which was not regarded as enteric fever the cases certified were all in patients over five years of age. The deaths numbered 4, and the death-rate was 0.03 per 1,000 inhabitants, as 18 pared with 0.01 for 1905, 0.07 for 1904, 0.11 in 1903, 0.20 in 1902, 0.08 in 1901, 0.11 in 1900, 0.20 in 1899, 0.14 in 1898, and 0.15 in 1897. The death-rate was, although not so low as for last year, very much below the average. The mortality was at the rate of 10 per cent. of the cases certified, but deducting the doubtful case and those which were not regarded as enteric fever, one of which proved fatal, the case-mortality was 9 per cent. The mortalities for previous years are given in the report for last year. During the past two years, the mortality from typhoid fever has been much below the average. The distribution of the cases certified and deaths amongst males and females in the Borough and the eight wards thereof during 1906 is shown in the subjoined table:— Wards. ENTERIC FEVER. Notifications. Fatal Cases. Male. Female. Total. Male. Female. Total. Moorfields 1 ... 1 1 ... 1 Church 6 1 10 ... ... ... Hoxton ... 4 4 ... ... ... Wenlock 3 1 4 ... 1 1 Whitmore 4 2 6 ... ... ... Ringsland 1 1 2 ... ... ... Haggerston 4 4 8 1 1 2 Acton 4 ... 4 ... ... ... Total for Borough 23 16 39 2 2 4 The cases are grouped according to ages in Table III. (Appendix). Of the cases certified, 36, or nearly 95 per cent., were removed to hospital for treatment. The usual enquiries were made as to the circumstances attending the occurrence of the cases. The following instances came under observation where infection appeared to have resulted from previous cases within the Borough:— Florence D—, of No. 4, W— Street, who was certified to be suffering from enteric fever on December 5th, 1905, was treated) at home, being nursed by her mother, with the help of a nurse who attended daily. Cecil D—, aged 20, a brother of above patient, residing in the same house, was taken ill about January 26th and certified to have enteric fever on February 8th and removed to hospital. 19 Nurse T—,aged 25, residing at 80, N—Square, was taken ill about January 29th and certified to have enteric fever on February 11th. Nurse T— began to help in the nursing of Florence D— about January 15th. No. 4, W— Street, was in a satisfactory sanitary condition. The following cases occurred at Nos. 76 and 101 G— Buildings:— Arthur James E—, aged 19, of 76, G— Buildings, appeared to have been ailing since October 14th, possibly a few days before. He was certified to have enteric fever on November 5th. This patient was a great friend of Thomas P—aged 19, of 101, G— Buildings, who was token ill on the evening of October 24th and certified to have enteric fever on November 3rd. Both of these young men were fond of fried fish, and their relatives were inclined to attribute their illness to fried fish from a particular shop, but no evidence could be obtained to support this view from other sources. Caroline P—, aged 10, sister to Thomas P——, was noticed to be ill on November 20th, and! was certified to be suffering from enteric fever on November 29th. All three cases were removed to hospital. As to whether fried fish was concerned in any way it is impossible to say, but the probability appears to be that Arthur James E—infected Thomas P—, who was the means of passing the infection on to his sister. The dwellings occupied by these three patients were in a very fair sanitary condition. The following cases occurred at No. 8, W— Street, a house in which the sanitary arrangements were defective:— Fred P—, aged 14, was ailing from about October 19th; he was taken to St. Bartholomew's Hospital on November 16th, and certified to have enteric fever on November 19th. He took to his bed on November 2nd. The lad was fond of whelks. Emily P——, aged 12, sister of above patient, first complained of illness on December 3rd. was taken to St. Bartholomew's Hospital on December 7th, and certified to have enteric fever five days later. With respect to the remainder of the cases, nothing definite was ascertained to throw light upon the source of infection. In eleven instances the patients were in the habit of eating shell-fish, in two fried fish, and in three ice-cream. In three instances watercress was mentioned. In one case the patient was a man employed in drain 20 laying. In the great majority, the houses in which the cases occurred were in a satisfactory or fairly satisfactory sanitary condition. In three instances the drains were found defective. The cases of enteric fever certified in the metropolis numbered 1,608, and the deaths 260, the attack-rate and death-rate being 0.3 and 0.05 per 1,000 respectively. ERYSIPELAS. The cases certified as erysipelas numbered 144, as compared with 138 in 1905, 183 in 1904, 147 in 1903, and 172 in 1902. The deaths numbered 2, as compared with 3 in 1905, 5 in 1904, 7 in 1903, 8 in 1902, 6 in 1901, 10 in 1900, 16 in 1899, 11 in 1898, 5 in 1897, 3 in 1896, 5 in 1895, 5 in 1894, and 15 in 1893. The cases and deaths amongst males and females in the Borough and its eight wards were distributed as set out below:— Ward. ERYSIPELAS. Cases Certified. Fatal Cases. Male. Female. Total. Male. Female. Total Moorfields 3 6 9 ... ... ... Church 12 11 23 ... ... ... Hoxton 9 12 21 ... ... ... Wenlock 8 12 20 ... 2 2 Whitmore 7 13 20 ... ... ... Kingsland 5 14 19 ... ... ... Haggerston 4 11 15 ... ... ... Acton 7 10 17 ... ... ...... Total for Borough 55 89 144 ... 2 2 The death-rate was 0.01 per 1,000 inhabitants, as compared with 0.02 in 1905, 0.04 in 1904, 0.06 in 1903, 0.06 in 1902, 0.05 in 1901, 0.08 in 1900. and 0.13 in 1899. The deaths were at the rate of 1.3 per cent. of the cases certified, as compared with 2.1 per cent. in 1905, 2.6 in 1904, 4.7 in 1903, 4.6 in 1902, 4.2 in 1901, 5.8 in 1900, and 8 per cent. in 1899. Pyæmia and Septicaemia (blood poisoning) were given as the cause of 14 deaths, 4 of males and 10 of females. Infective endocarditis (a form of heart disease) resulted in three deaths. There were also six deaths attributed to other septic diseases allied to the foregoing. 21 PUERPERAL FEVER. Six cases, with three deaths, were certified, the attacks per 1,000 births being at the rate of 1.5, as compared with 2.2 in 1905, 1.3 in 1904, 1.7 in 1903, 2.2 in 1902, 1.7 in 1901, and 2.5 in 1900. The death-rate due to puerperal fever calculated per 1,000 births was 0.8, as compared with 1.0 in 1905, 0.5 in 1904, 0.2 in 1903, 0.7 in 1902, and 0.5 in 1901. DIARRHCEA. The mortality from diarrhoea during 1906 was higher than usual in the Borough The deaths were distributed throughout the year as follows:—2 were registered in January, 3 in February, 2 in March, 2 April, 1 May, 7 June, 9 July, 58 in August, 88 September, 12 October, 7 November, and 3 in December. The deaths were most numerous during August and September, and caused a marked elevation of the death-rate, especially in the middle of the latter month. Altogether, the deaths from diarrhoea numbered 194, not including 62 deaths, chiefly of infants under one year, attributed to enteritis or gastro-enteritis. Of the deaths from diarrhoea, 156 were of infants under one year, 28 of children under five years, one was of a child aged between five and ten years, and the remainder were of persons over twenty years of age. The death-rate due to diarrhoea was 1.68 per 1,000 inhabitants, as compared with 1.30 in 1905, 163 in 1904, 1.23 in 1903, 1.12 in 1902, 1.30 in 1901, 1.40 in 1900, 1.75 in 1899, 1.79 in 1898, and 1.74 in 1897. The distribution of the deaths in the wards of the Borough, and the death-rates are shown in Tables VI. and VII. (Appendix). The deaths from diarrhoea in the metropolis numbered 4,507, of which 3,340 were registered during the months of August and September. The diarrhoea death-rate was 0.93 per 1,000 inhabitants in the metropolis, as compared with 0.72 in 1905, 1.07 in 1904, 0.64 in 1903, 0.53 in 1902, and 0.85 in 1901. The mortality from diarrhoea amongst infants under one year in Shoreditch during 1906 was at the rate of 40.3 per 1,000 births registered during the year, as compared with 30.6 for 1906. The figures for the metropolis were 27.3 and 20.79 respectively for the two years. A table giving a comparison of these rates for previous years is contained in the report for last year. During the diarrhœa season, enquiries were made in respect to 89 deaths from diarrhoea amongst infants under 8 months old in Shoreditch. In eleven instances the infants were stated to have been breast-ted when they were taken ill, but it is open to doubt whether they were solely fed on the breast; in the remaining 76, or 88 per cent., they were artificially fed. Infants at the breast run comparatively little risk of dying from summer diarrhoea, and those fed solely upon the breast practically none at all. 22 MEASLES. Measles caused 74 deaths, all of children under five years of age, of whom 33 were males and 41 females. The mortality was highest in Church and lowest in Haggerston Ward, the death-rates being 0.90 and 0.32 per 1,000 respectively. The deathrate for the whole Borough was 0.64 per 1,000, as compared with 0.52 in 1905, 0.69 in 1904, 0.85 in 1903, 0.72 in 1902, and 0.64 in 1901. Although not so low as for last year, it was somewhat below the average for the past five years. The deaths were most numerous during the months of March, April, May, and June. None were registered during January, September,. October and November. The deaths from measles in the metropolis numbered 1,909, as compared with 1,715 in 1905, the death-rate being 0.40 per 1,000, as against 0.36 in 1905. The houses brought to the notice of the Health Department as being infected through measles numbered 449, as compared with 470 in 1905 and 454 in 1904. The information mostly came from the school authorities. In 54 instances, on enquiry, the illness appeared to be something other than measles, and in 38 instances the oases could not be traced. Altogether, 361 rooms in 350 premises were disinfected, and the usual steps were taken by the sanitary authority with respect to bedding and textile articles which had been exposed to infection. In 7 instances the measures as to disinfection were carried out by the occupiers of the premises to the satisfaction of the medical practitioners attending the cases. WHOOPING COUGH. Whooping cough caused 59 deaths, 24 males and 35 of females. With two exceptions, they were all of children under five years of age. The death-rate was 0.51 per 1,000 inhabitants, as compared with 0.73 in 1905, 0.51 in 1904, 0.35 in 1903, 0.63 in 1902, and 0.49 in 1901. A comparison of the death-rates in the eight wards of the Borough is given in Table VII. (Appendix). Deaths occurred during every month of the year, but they were most numerous in March and April. The deaths from whooping cough in the metropolis numbered 1,226, as compared with 1,507 in 1905, and the death-rate was 0.26, as against 0.32 in 1905. INFLUENZA. Influenza was given as the cause of 17 deaths, as compared with 11 in 1905, 14 in 1904, 19 in 1903, 14 in 1902, 16 in 1901, 52 in 1900, and 35 in 1899. The figures for previous years are contained in the Annual Report for 1901. No deaths were certified during the months of May. July, September and November. They were most numerous during December, the disease being more prevalent than usual at the close of the year. 23 The deaths from influenza in the metropolis numbered 895, as compared with 664 in 1905, 707 in 1904, 644 in 1903, 1,036 in 1902, 664 in 1901, and 1,950 in 1900. The deaths were most numerous during March, April and December. TUBERCULOSIS. Tuberculosis (see Appendix, Table VI., Nos. 29 to 34 inclusive) resulted in 347 deaths, as compared with 321 in 1905, 365 in 1904, 376 in 1903, 295 in 1902, 363 in 1901, and 343 in 1900. The deaths from tuberculosis amounted to 15 per cent, of the deaths from all causes during the year. The death-rate from tuberculosis was 3.0 per 1,000 inhabitants, as compared with 2.7 in 1905, and 3.1 in 1904. Phthisis or consumption, the form of the disease affecting the lungs, accounted for 233 deaths, the death-rate being 2.0 per 1,000 inhabitants. Of the persons dying from phthisis, 138 were males and 95 females, the great majority being in the wage-earning period of life. Some 6,775 persons died from consumption in the metropolis, yielding a death-rate of 1.4 per 1,000 population. The figures indicate that the mortality from phthisis amongst persons belonging to Shoreditch during 1906 was over 40 per cent, higher than in London as a whole. Disinfection after phthisis cases is undertaken by the Sanitary Authority, and was carried out in connection with 80 houses in which phthisis cases had occurred during the year. TETANUS, OR LOCKJAW. Two cases of the above disease came under notice during the year. One of the cases was that of a man aged 42, who scratched one of his feet with a nail in the boot, about the middle of February. The scratch began to give him pain about February 20th, which caused him to poultice it. Five days later he was suffering from pains and stiffness in his back, neck and chest, and was removed to hospital, where he died on February 26th. The second had been in poor health for several months. In the early part of May, whilst attending to his horse, he scratched the little finger of his left hand, and about a week or ten days later he began to complain of his neck being stiff and painful. He was admitted to the Shoreditch Infirmary on May 17th, and died four days later. In each of these cases the cause of death was certified to have been tetanus. CEREBRO SPINAL FEVER. There were no deaths certified as due to the above disease, nor were any cases of illness brought under our notice as cerebro spinal fever. The deaths certified as due to meningitis not stated to be tuberculous, numbered eighteen, and were below the average for the past five years. 24 INFECTIOUS DISEASES AND SCHOOLS. In the following table are set forth the numbers of children belonging to Shoreditch who were suffering from infectious diseases or were residing in houses in which infectious diseases existed, concerning whom intimations of exclusion from school were received from the head-teachers of the schools they attended in accordance with the requirements of the school management code of the London County Council:— School. Enteric Fever. Small Pox. Diphtheria. Scarlet Fever. Measles. Chicken Pox. Whooping Cough. Mumps. Other diseases. Total. Baltic Street . . . 4 8 1 . 1 . 14 Bath Street . . . . 1 . . . . 1 Canal Road . . 1 1 22 4 . 1 2 31 Catherine Street . . 3 12 2 . . . 1 18 Central Street . . . . . 1 5 1 2 9 Chatham Gardens. . . . 5 . . . . 12 17 Christ Church . . 1 . 1 . . . 6 8 Coleman Street Ward . . . . 3 8 . . . 11 Curtain Road . . . 4 14 12 2 8 28 68 Daniel Street . . . . 2 . . . . 2 Fellows Street . . . 2 43 7 1 22 6 81 Gopsall Street . . 5 6 68 2 7 27 56 171 Haggerston Road . . 4 5 55 21 75 13 34 207 Hammond Square. . . 4 6 50 9 19 6 37 131 Hugh Myddleton Deaf Centre . . . . 1 . . . . 1 Maidstone Street . . . 10 17 8 . 31 27 93 Napier Street . . 15 118 120 30 . . 1 284 Queens Road . . . . 1 . . . 1 2 Redvers Street . . 2 9 13 3 3 3 44 77 Rochelle Street . . . . . . . . 1 1 St. Columbia . . . . 13 . 9 . 1 23 St. John's National . . 2 5 17 2 . . . 26 St. John's Road . . 7 25 57 29 . 4 40 162 St. Joseph's . . . . . . . . 1 1 St. Mark's . . . . 6 3 . 1 1 11 St. Monica . . . . 5 . . . . 5 St. Paul's . . 5 2 1 . . . . 8 St. Saviour's . . 1 11 18 1 . . 7 38 St. Thomas, Charterhouse . . . 1 . . . . . 1 Scawfell Street . . 12 31 67 22 18 10 81 243 Scrutton Street . . 3 3 19 1 . . 1 27 Shap Street . . 3 73 71 4 16 3 77 249 Shepperton Road . . . 2 . . . . . 2 Teesdale Street . . . 2 . . . . . 2 Tottenham Road . . 3 . . . . . 3 Trinity Place . . . 19 33 15 8 1 8 84 Wenlock Road . . 5 5 31 1 . . 2 44 Total 4 . 76 361 759 184 163 132 477 2156 25 The exclusions were markedly fewer during 1906 than in 1905, chiefly on account of the decrease in the number from scarlet fever, measles, chicken-pox, and whooping cough. They were most numerous during the months of March, May and June, and least in January, not taking into account August, when the summer holidays occur. During the year, attention was especially directed to the following schools:— Catherine Street School.—Class-room II., in the infants' department, was closed on account of measles amongst the children by the Medical Officer (education); also Gopsall Street School.—Class-room A, in the infants' department, for the same disease. T'he usual instructions as to disinfection were given, and the necessary precautions taken. Hammond Square School.—Class-room C, in the infants' department, came under observation chiefly on account of measles. The attendance had fallen off a. great deal, but as it was showing signs of improving, no action was taken. Trinity Place School.—On two occasions this school was visited on account of children from scarlet fever infected houses attending. On one of these a little boy was found desquamating in the infants' department. The usual steps as to disinfection were taken. BACTERIOLOGICAL EXAMINATIONS. Bacteriological examinations were made by Dr. Bulloch, at the London Hospital Medical School, in 34 cases of suspected infectious disease. In 25 instances the disease suspected,' was diphtheria, in 8 typhoid fever, and in one consumption. The results were all negative. DISINFECTION. During 1906 some 1,328 premises were disinfected. The number of articles removed and disinfected at the Borough disinfecting station was 26,693, as compared with 33,745 in 1905, 14,063 in 1904, 8,911 in 1903, 55,025 in 1902, and 17,226 in 1901. The articles disinfected included 1,469 beds, 1,798 mattresses, 3,110 pillows, 1,249 bolsters, and 19,007 miscellaneous articles, including clothing, linen, carpets, curtains and the like. In some instances infected bedding is found to be so contaminated or in such a worn and filthy condition that its destruction is necessary. During the year four such beds and 6½ mattresses were destroyed, being burnt at the disinfecting station. The articles destroyed were replaced with new. No complaints were received as to any damage caused! by the measures taken for disinfection during the year. 26 THE SHELTER. The shelter at Reeve's Place was not used during the year on account of infectious disease. On two occasions one of the baths was used for purposes under the Cleansing of Persons Act. THE PUBLIC MORTUARY. The dead bodies received into the public mortuary in St. Leonard's Churchyard during 1906 numbered 405, as compared with 417 in 1905 and 460 in 1904. The bodies of five persons dead of infectious disease were removed to the mortuary by the sanitary authority, as compared with three in 1905. A specially constructed iron shell is used for the reception of infectious bodies. The inquests held numbered 295, as against 290 in 1905 and 336 in 1904. The number of post-mortem examinations made in the post-mortem room at the mortuary numbered 226, as compared with 223 in 1905 and 251 in 1904. The figures relating to the use of the mortuary in years previous to 1904 are contained in the report for 1903. WATER SUPPLY. The figures contained in the reports of Dr. Houston, Director of water examinations to the Metropolitan Water Board show that the rainfall for the year 1906 measured at Oxford amounted to 24.2 inches. Taking the mean rainfall for 35 years, there was a deficiency of about an inch. Most rain fell during the month of October, and least in April, the amounts being 4.133 and 0.352 respectively. No complaints were received as to the quality of the water, nor as to the quantity supplied in the Borough during the year, and there was no reason for suspecting the occurrence of any water-borne disease. In accordance with the requirements of section 49 of the Public Health (London) Act, 1891, communications as to water supplies to houses being cut off were received in respect to 86 premises, 22 on the East London district and 64 on that of the New River. In many of these the intimations referred to premises which had been vacated. SANITARY WORK. Preliminary notices as to insanitary conditions were served in respect to 2,689 premises,. of which 249 were dealt with under the supervision of the chief inspector, 535 under that of Inspector Lear, 467 under Inspector Firth, 521 under Inspector Jordan, 442 under Inspector Langstone, and 474 under Inspector Pearson. In connection with the work 872 letters were written to owners of property, builders, and other parties concerned. Nearly 26,000 visits of inspection were made during the year, not including those made by the Medical Officer of Health and Chief Inspector. The premises inspected included milkshops, cow-sheds, slaughterhouses, cook-shops and eatinghouses, factories, workshops, and other premises including dwelling houses and tenement buildings. (Appendix.) 27 In the subjoined table is contained a summary giving an idea as to the nature of the work done for the abatement of nuisances and for improving the dwellings of the people in Shoreditch, which has been compiled from the abstracts of their work prepared by the sanitary inspectors:— Chief Insp. Insp. Lear. Insp. Firth. Insp. Jordan. Insp. I.angstone. Insps. Pearson. Total New drains constructed 1 . 11 19 26 39 96 Drains re-constructed or repaired 24 24 75 39 35 22 219 Sink waste pipes trapped and disconnected . 6 42 35 19 24 126 Stack pipes re-instated 21 38 56 8 42 44 209 Eaves gutters re-instated 23 38 71 13 35 44 224 Stack pipes disconnected from drains 4 1 18 7 7 13 50 Accumulations of sewage dealt with 7 12 4 13 15 24 75 Cesspools abolished . . . . . 2 2 New water closets constructed 18 4 1 121 10 17 171 Old water closets re-constructed or repaired 19 41 77 84 87 107 415 Water closets cleansed and white-washed 13 300 69 296 63 125 866 Water closet flushing apparatus repaired 2 7 1 45 24 47 126 Obstructions in water closets removed . 45 16 12 28 58 159 Overcrowding in houses abated . 12 37 5 46 17 117 Damp courses in houses provided . 3 6 . 1 . 10 Walls pointed 16 7 12 5 6 19 65 Roofs repaired 34 65 61 38 96 62 356 Stairs repaired 35 17 36 9 22 7 126 Floors repaired 36 35 39 35 34 26 205 Ventilation under floors provided 5 3 14 4 13 4 43 Doors repaired 30 12 12 14 4 4 76 Door cills provided 38 19 17 11 19 9 113 Sashes repaired 29 78 11 7 21 12 158 Houses cleansed throughout 41 22 11 56 35 22 187 Houses cleansed in part 51 96 215 20 160 153 695 Total number of rooms cleansed 374 701 557 602 637 408 3279 Yards or areas lime-washed 8 262 23 131 37 62 523 Yards paved 16 56 84 33 69 87 345 Areas or forecourts paved 3 14 2 3 3 6 31 New areas constructed . . . . 1 2 3 Sculleries paved 44 14 14 . 7 9 88 Dust receptacles provided 20 59 65 48 58 55 305 Dung receptacles provided 2 . 6 . . 1 9 Insanitary cisterns removed . 2 5 . 3 1 11 In connection with the above, it may be mentioned that six old brick drains were removed, and in 45 instances nuisance and annoyance arising from the presence of rats on premises, mainly through sewer or drain defects, were dealt with. In 101 instances water was restored to premises, the supplies having been cut off for various reasons, and on 155 premises leaking water-pipes were repaired. Two new urinals were constricted, and 30 were cleansed and repaired. Foul accumulations on 109 premises 28 vvere dealt with for the removal or prevention of nuisance. On 22 premises animals were found to be stabled under conditions giving rise to nuisance, and in 14 instances stables were properly paved under the supervision of the sanitary officers. The foregoing summary includes the work done in connection with the drains of new buildings, and alsoi that carried out. in pursuance of the Factory and Workshop Act, 1901. By far the major portion of the work done was carried out for the compliance with preliminary notices setting forth the insanitary conditions and the works required to remedy them. In 248 instances, however, it was necessary to specially direct the Health Committee's attention to the circumstances connected with the cases, and in these statutory notices under the Public Health (London) Act, 1891, were served by the Sanitary Authority upon the parties responsible with a view to enforcing the abatement of the nuisances existing. For non-compliance with the requirements of the Sanitary Authority, police-court proceedings were, taken under the Public Health (London) Act, 1891, and the bye-laws made thereunder as set out below:— Premises. Result of Proceedings. Alfred Place, No. 9 Order to do work, 10/- costs allowed Council. Alma Street, No. 39 Summons dismissed, no costs. Avebury Street, No. 3 Order to abate overcrowding. Clift Street, No. 4 Order to do work, 3/- costs allowed Council. ,, ,, ,, 5 ,, ,, ,, ,, Cropley Street, No. 24 Breach of milk regulations, fine 5/-, with 23/- costs. Govan Street, No. 1 Summons withdrawn, 3/- costs allowed Council. ,, ,, ,, 2 ,, ,, ,, ,, ,, ,, ,, 3 ,, ,, ,, ,, ,, ,, ,, 4 ,, ,, ,, ,, ,, ,, ,, 5 ,, ,, ,, ,, Grange Street, No. 61 ,, ,, ,, ,, Lee Street, No. 42 Order to do work, 2/- costs allowed Council. ,, ,, ,, 42 Fine 40/-, with 2/- costs, for not obeying orders. Loanda Street, No 6 London County Council Bye-laws, dismissed, £3 3s. costs. Westmoreland Place, No. 52 Order to do work, £1 1s. costs allowed Council. ,, ,, ,, 68 Order to do work. Weymouth Terrace, No. 73 Summons withdrawn, 3/- costs allowed Council. The summons in. respect of No. 9, Alfred Place, was taken out against the owner by Inspector Firth, in consequence of the continuance of a nuisance arising through a blockage of the drain upon the premises. The owner was ordered to abate the nuisance in fourteen days. 29 With respect to No. 39, Alma Street, the drain of this house crossed the area in front of No. 37, the adjoining house, to reach the sewer. The portion of the drain under the area was found to be defective, and the owner of No. 39 was served with a statutory notice to abate the nuisance arising from the defect. The magistrate held that he was unable to make an order because there was no authority for the owner of No. 39 to enter upon the premises at No. 37 Alma Street for the purpose of abating a nuisance. The summons was, therefore, dismissed without costs. The defective portion of drain was, however, subsequently rectified. With respect to the houses in Clift Street, the summonses were taken out by Inspector Langstone, in consequence of a drain being defective. The magistrate ordered the necessary work to be carried1 out for the abatement of the nuisance in three weeks. The summons in respect to No. 24, Cropley Street, was taken out against the proprietor of a milk business carried on at the premises for failure to register as a purveyor of milk in accordance with the requirements of the regulations as to dairies, cow-sheds, and milk-shops. The summonses in respect to the houses in Govan Street were taken out by Inspector Firth, the houses being in a dirty and dilapidated state. When the cases came before the magistrate the works required were in progress. The summonses were therefore adjourned and eventually withdrawn, the statutory notices having been complied with. The house in Grange Street was in such a state as to be a nuisance. The magistrate, instead of making an order, allowed the summons to be adjourned for three weeks for the necessary work to be carried out for the abatement of the nuisance. This having been done, the summons was withdrawn upon payment of the Council's costs in respect to the same. With regard to No. 42, Lee Street, this house was in a very dirty and dilapidated condition, and in such a state as to be a nuisance. The owner was summoned for not complying with a statutory notice for the abatement of the same. An order was made by the magistrate, giving the owner six weeks to> do the necessary work to comply with the notice. This he failed to do, and was again summonsed for not obeying the order, and fined £2, with costs. Very little of the work was at the end of the year carried out, and the case remains under consideration. The owner of No. 6, Loanda Street, was summoned for a breach of the bye-laws of the London County Council, made under section 39 (1) of the Public Health (London) Act, 1891. It was contended by the Council that a new long hopper watercloset pan had been fixed, and that no notice in writing had been given to the clerk to the Sanitary Authority as required by bye-law No. 14. The contention of the owner was that a new pan had not been fixed, but that the old one had been taken out, cleaned and replaced and that the bye-laws had not therefore been contravened. The owner's builder bore witness to the correctness of this contention. The evidence of 30 three witnesses, called on behalf of the Council, was to the effect that the old pan, which was cracked, had been removed, and a new long hopper pan substituted. One of these witnesses stated that fragments of the old pan had been seen in the yard. The magistrate, however, believed the owner and his witness, and dismissed the summons with £3 3s. costs against the Council. The summons in respect to Nos. 52 and 68, Westmoreland Place, which are houses let in lodgings, were taken out by the Chief Inspector against the owner for non-compliance with statutory notices for the abatement of nuisances, the houses being in a very dirty and generally insanitary condition. The magistrate ordered the necessary work to be carried out in three weeks. The summons in respect to No. 73, Weymouth Terrace, was taken out by Inspector Pearson, the house being without a proper water supply. The water was restored after the summons had been served. Upon the owner producing satisfactory evidence that the delay in the restoration of the water supply was not due to any fault on his part, the summons was withdrawn. HOUSES CLOSED. The following houses were closed during the year, upon the service of sanitary notices, either on account of being unfit for habitation or in order to enable the works necessary to put them in a satisfactory sanitary condition to be carried out in a proper and efficient manner:— Bristow Street, No. 30. Reeves Place, Nos. 15 and 16. Brunswick Street, Nos. 73, 75, and 77. Ware Street, No. 2. Cropley Street, No. 66. Westmoreland Place, No. 2. Pritchards Road, No. 103. Wilmer Gardens, No. 92. It may also be mentioned that Nos. 1 to 6, Bath Place, were closed towards the end of 1906 and the beginning of the current year. These six houses belong to the Borough Council (Electricity Department) having been acquired about two years ago. They were in a dirty and dilapidated condition, and the sanitary arrangements generally were bad. The houses in Bristow and Cropley Streets were closed voluntarily by the owners in order that they might be dealt with thoroughly throughout, the houses needing general cleansing and repairs. The houses in Brunswick Street were closed in consequence of the service of sanitary notices by Inspector Pearson, in respect to the drains, which were in an extremely defective and offensive condition. There were also general dilapidations which had to be dealt with, and! it was therefore though advisable for the houses to be vacated whilst the necessary works were being carried out. 31 The house in Pritchards Road was closed by the owner upon receipt of a sanitary notice from Inspector Firth, the drains being defective and the house generally dirty and dilapidated. The houses in Reeves Place were closed by the owner on receipt of sanitary no— tices from Inspector Pearson; they were dirty and dilapidated, and the drainage arrangements had to be reconstructed. The house in Ware Street was in a dirty and dilapidated condition, and required to be thoroughly dealt with. It was closed upon receipt of a sanitary notice by the owner. The house in Westmoreland Place was closed by the owner on receipt of a sanitary notice from Inspector Lear. It was in a very dirty, dilapidated, and generally insanitary condition. The house in Wilmer Gardens was closed by the owner on receipt of a sanitary notice from Inspector Pearson. It was overcrowded and1 in a dirty and dilapidated state. DEMOLITION OF HOUSES OCCUPIED BY PERSONS OF THE WORKING CLASS. The following houses came under notice during the year as being closed for demolition: Underwood Street, Nos. 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12. These were six-roomed houses; they were demolished! during the year. Clifton Street, Nos. 39 and 41. These were eight-roomed houses, and have been demolished. Brunswick Place, Nos. 20, 22, 24, and 26. These were eight-roomed houses, and have been demolished. These houses were occupied as dwellings by persons of the working class. Their sites are being, or are going to be, utilized for warehouses and other business premises. HOUSES LET IN LODGINGS. The following houses were registered during the year, under the bye-laws as to houses let in lodgings or occupied by members of more than one family:— Bath Place, Nos. 5 and 6. Britannia Street, Nos. 55 and 56. Little Essex Street, Nos. 1, 4, 10, 14 and 16. Westmoreland Place, Nos. 19, 21, 40, 46, 48, 56, 59, 75, 77, 80, and 82. 32 The number place upon the register during the year was 20, making a total of 303 since the bye-laws came into operation. The actual number of houses on the register after making deductions for duplication consequent upon change of ownership and for houses which have been demolished since registration is 266. ARTIZANS' DWELLINGS. The artizans' dwellings in the Borough were under observation during the year. They comprise some 45 blocks, mostly situate in the Shoreditch south registration subdistrict. A list of them is contained in the report for last year. To the list has been added Crondall Dwellings, containing 16 tenements. The general sanitary condition of the dwellings was remarked upon in my last report. Taking the dwellings as a whole, from a sanitary point of view they are satisfactory, although in some instances they could bo improved. For the purposes of comparison, they have been divided into two classes, A and B; class A including those occupicd on the whole by persons in comfortable or fairly comfortable circumstances, and class B those occupied by people apparently in very poor circumstances. The numbers of tenements, rooms, and persons in the dwellings estimated for the year 1906 are contained in the subjoined table:— Number of blocks. Number of tenements. Number of rooms. N umber of persons. Class A 30 1499 3867 5983 Clas3 B 15 383 917 1849 Total for the whole 45 1882 4784 7832 The conditions associated with residence in the class A are, from a sanitary point of view, superior to those in the class B dwellings. The births registered during the year, and the birth-rates in the dwellings as a whole, and the two classes into which they have been divided are shown below:— The whole of the Dwellings. Class A. Class B. Number. Bate per 1,000 Inhabitants. Number. Rate per 1,000 Inhabitants. Number. Bate per 1,000 Inhabitants. 249 31.7 189 31.5 60 32.4 The birth-rate amongst the inhabitants of the dwellings in 1906 was much lower than in 1905. It was also lower than that of the Borough. The decrease was due to the marked reduction of the births in the Class A dwellings. The number of births 33 and the birth-rate for the class B dwellings was the same as in 1905. The proportion of deaths attributed to prematurity was much lower than for last year, being 12 per 1,000 births, as compared with 27.5 in 1905. In class A, the deaths from prematurity amounted to 16 per 1,000 births, whilst in the class B dwellings they were nil. For the whole Borough, the deaths from prematurity amounted to 19.3 per 1,000 births. The infantile mortality was 97 per 1,000 births, as compared with 140 for last year, the rates being 84 for the class A, and 133 for the class B dwellings, as compared with 134 and 166 respectively for last year. The infantile mortality during 1906 in the dwellings was, therefore, greatly below the average for the Borough, even in the class B dwellings. In the subjoined table are given the deaths and death-rates from certain causes for the dwellings and the corresponding death-rates for the whole Borough, so that they may be compared:— Cause of Death. The whole of the Dwellings. Class A. Class B. The Borough. Number of deaths. Rate per 1,000 inhabitants. Number of deaths. Rate per 1,000 inhabitants. M umber of deaths. Rate per 1,000 inhabitants. Rate per 1,000 inhabitants. All causes 121 15.4 88 14.7 33 17.8 19.8 Principal Zymotic diseases 22 2 9 18 30 5 2.7 3 1 All forms of Tuberculosis 20 2.5 15 2.5 5 2.7 30 Phthisis 12 1.5 9 1.5 3 1.6 2 0 Bronchitis 14 1.7 13 2.1 1 0.5 1.6 Pneumonia 13 1.6 8 1.3 5 2.7 2.0 The deaths of residents of the dwellings in public institutions numbered1 41, being 28 for the class A, and 13 for the class B dwellings. The percentages of the total deaths of residents in the dwellings was 33.9, being 31.8 for class A, and 39.4 for class B, as compared with 34.6, 30.4, and 47.6 for 1905. The percentages of deaths in public institutions for the whole Borough and for the wards are given in Table VII. (Appendix). The figures indicate, especially with respect to class A, that proportionately fewer persons seriously ill are removed from the dwellings to hospitals and other institutions than is the case with respect to the Borough as a whole. The cases of notifiable infectious disease numbered 73, of which 58 were in the class A, and 15 in the class B dwellings. The attackrates per 1,000 population were respectively 9.3, 9.7 and 8.1, as compared with 8.2 for the whole Borough. There were 49 cases of scarlet fever, 10 of diphtheria, 5 of enteric fever, 8 of erysipelas, and 1 of puerperal fever. 34 The numbers of cases and the attack-rates per 1,000 inhabitants with respect to scarlet fever, diphtheria, enteric fever, and erysipelas are set out below:— Scarlet Fever. Diphtheria. Enteric Fever. Erysipelas. Cases. Rate. Cases. Rate. Cases. Rate. Cases. Rate. Class A 41 6.8 6 1.0 5 0.8 6 1.0 Class B 8 4.3 4 2.1 - - 2 10 The whole of the dwellings 49 6.2 10 1.2 5 0 6 8 1.0 The attack-rates for the whole Borough were 5.3 per 1,000 inhabitants for scarlet fever, 1.1 for diphtheria, 0.3 for enteric fever, and 1.2 for erysipelas. Briefly, the foregoing figures indicate, in respect to the artizans' dwellings in the Borough, that during 1906, the mortality from all causes was markedly lower than in the Borough generally, and such was especially the case as regards the class A dwellings. The infantile mortality was also' greatly below that of the Borough. The incidence of attacks of notifiable infectious disease was greater in the dwellings than in the Borough as a whole, and was higher in the class A than in the class B dwellings. COMMON LODGING HOUSES. The subjoined is. a list of the common lodging-houses in the Borough:— Aubert Buildings, Boot Street. Kingsland Road, No. 23. Boot Street, No. 6. Kingsland Road, No. 277. Dunloe Street, No. 31. St. John's Road, Nos. 33, 35, and 37. Eagle Wharf Road, No. 53. Wilmer House, Wilmer Gardens. The above are licensed by the London County Council and afford accommodation for men only. CUSTOMS AND INLAND REVENUE ACTS. No applications were received for certificates under the above Acts as to> the sani. tarv fitness of dwellings for the purpose of obtaining exemption from the payment of inhabited house duty. SMOKE NUISANCE. During the year, 12 communications were received from the London County Council as to the emission of black smoke in respect to eight premises In all cases the particulars as to the complaints received were brought to the notices of the parties re- 35 sponsible, and the necessary steps were taken for securing the abatement of the nuisances complained of. In one instance the facts were reported to the Health Committee, and a statutory notice under the Public Health (London) Act, 1891, was served upon the person responsible, but it was not necessary to take the case before a magistrate. It may be stated that from observations in the Borough during the past fewyears there have been markedly fewer instances of the emission of black smoke in such quantities as to be a nuisance. VERMINOUS HOUSES. In 103 instances houses more or less infested by bugs were dealt with, the walls of the rooms affected being stripped of paper, stopped and cleansed. The work" was carried out upon the service of intimation notices, and it was not necessary to take any legal action for enforcing the provisions of the London County Council (General Powers) Act, 1904, for freeing houses from vermin. SLAUGHTER-HOUSES. The number licensed at the end of the year was 9, as compared with 12 at the end of 1905. The slaughter-houses which ceased to exist as such were those situate at Nos. 23. Broadway, London Fields. 53, Pitfield Street, and 64, New North Road. In the case of that at No. 23, Broadway, the licence was refused by the London County Council, the slaughter-house not having been properly maintained and no slaughtering having taken place therein for more than nine months. Tn the cases of the other two the licences were allowed to lapse. Slaughtering is only regularly carried on in three or four of the slaughter-houses. The rest are made use of occasionally. Verv few bullocks are now killed in the Borough. The slaughter-house premises were inspected: from time to time during the year, and were found to be kept in a satisfactory sanitary condition. COW-SHEDS, DAIRIES, AND MILK-SHOPS. The number of cow-houses on the register at the end of 1906 was seven, remaining the same as for the previous two years. The number of cows kept in the Borough were found at an inspection made a short time before the licensing in October, to be 74, as compared with 86 in 1905, 95 in 1904. 101 in 1903, 103 in 1902, 110 in 1901, 114 in 1900, and 135 in 1899. The cow-houses weTe periodically inspected during the vear, and their generally sanitarv condition may be reported upon as satisfactory. The number of dairymen and milk purveyors on the register at the end of the year was 288, as compared with 289 in 1905, 294 in 1904. 300 in 1903, and 304 in 1902. In 20 instances the sale of milk was discontinued, in 19 it was commenced, in connection with which applications for registration were duly received, and in 68 instances milk purveyors' premises changed hands. 36 The cow-sheds, dairies, and milk-shops in the Borough were under inspection by the sanitary staff throughout the year, some 3,651 visits being made by them. No warnings as to want of cleanliness in respect to milk utensils were necessary. In seven instances sanitary notices were required : in one on account of defect in drains, in two for cleansing, and in the remainder mostly minor sanitary defects. Three cases of infectious disease occurred in connection with milk purveyors' premises, and the usual steps were taken. In one instance (No. 24 Cropley Street) police-court proceedings were taken, owing to non-registration of the premises for the sale of milk. (Ante p. 28.) OFFENSIVE BUSINESS. The tripe-boiling establishment, situate at No. 69, Haggerston Road1, wras under observation during the year. There was a change in the proprietorship, and under the new management the conditions prevailing were at first not so satisfactory as here1tofore. Special attention and more frequent visits from the sanitary inspector were therefore necessary until the desired sanitary improvement was effected. WHISTON STREET GAS WORKS. Serious complaints were made by a number of inhabitants dwelling in the vicinity of the above works owing to the nuisance and annoyance occasioned by smoke andi dust emitted from the works. The matter came under the notice of the Health Committee in July, who gave instructions with a. view to securing the abatement of the nuisance. After some correspondence and an interview with the Chief Engineer to the Company, steps were taken which stopped the nuisance, and no further complaints were received. FACTORY AND WORKSHOP ACT, 1901. The number of workshops, exclusive of bakehouses, which are considered separately, on the register at the end of 1906, was 1,278, 189 having been added and 129 removed. The numbers for previous years were 1,218 in 1905, 1,133 in 1904, 1,133 in 1903, and 1,081 in 1902. A classification of the workshops registered is contained in the summary of proceedings under the Factory and Workshops Act, which is appended herewith. The workshops on the register were subject to the usual inspection during the course of the year, attention being specially directed to those which were not found in a satisfactory sanitary condition. These were kept under observation until the necessary sanitary improvements had been effected. Some 3,711 visits of inspection were made in connection with workshops, and 71 in connection with factories, wherein insanitary conditions were brought to our notice, 37 Some 23 communications were received from the factory inspector as to the establishment of 93 new workshops in the Borough. These were mainly for the purposes of the various branches of the furniture and clothing trades. On inspection, 78 were found to' be in a fair or satisfactory sanitary condition, three were unoccupied, one was already on the register, one had been demolished, and the remainder were more or less unsatisfactory from a sanitary point of view, and required attention. Written intimations were received from the factory inspector to the number of 77, referring to insanitary conditions and infringements of the law relating to public health in connection with 129 workshops and workplaces. The chief insanitary conditions to which the factory inspector directed attention, were: want of proper attention to cleanliness, walls and ceilings being in a dirty state in 90 instances, a dirty and dilapidated state of the workshop in 8 instances, defective or insufficient water-closet accommodation in 10, want of proper separate sanitary accommodation for the sexes in 5, overcrowding in 2, and other defects in 14 instances. These workshops were all inspected by th.e officers of the Borough Council, and the necessary steps were taken, to remedy the sanitary defects to which attention was directed as well as a. number of other insanitary conditions which came under the observation of the sanitary inspectors when visiting the premises. The results of the action thus taken upon their intimations were reported to the factory inspectors from time to time throughout the year. Including the premises brought under the notice of the sanitary authority by the factory inspectors, some 454 workshops, exclusive of bakehouses and places where food is prepared for sale, were dealt with, and 361 sanitary notices were served upon the parties responsible by the sanitarv inspectors. In a number of instances defects common to more than one workshop were dealt with on a single notice. The following is an abstract of the sanitary work carried out in compliance with the notices served in connection with workshops referred to above during the year 1906:— Drains relaid 1 Urinals repaired and cleaned 6 Stack pipes disconnected 2 Water supply laidi on or restored 9 Stack pipes reinstated 6 Leaking water-pipes repaired G Eaves gutters reinstated 9 Rooms cleansed and whitewashed 420 Sink waste pipes disconnected 1 Yards „ „ ,, 105 Yards paved 5 Areas ,, ,, ,, n i Scullery paved 1 Roofs repaired 32 Water-closets re-constructed 11 Floors „ 13 New water-closets constructed 2 Stairs ,, 5 Water-closets cleansed and limewashed 242 Doors ,, 3 Sashes „ 5 Light and ventilation provided or improved: in water-closets 5 Dust receptacles provided 11 Foul accumulations removed 3 Obstructions removed from waterclosets 13 Overcrowding abated 2 Water-closets flushing apparatus repaired 23 38 In 37 cases it was necessary for the Health Committee to order the service of statutory notices under the Public Health (London) Act, 1891, which were complied with without the necessity of appealing to a magistrate. The number of factories under observation during the year was 24, in connection with which 9 sanitary notices were served. The sanitary works carried out in connection with factories included the construction or reconstruction of drains in 3 instances, the constiuction or reconstruction of water-closets in 8. the disconnection and ventilation of sink waste-pipes in 2, the abatement of nuisances due to sewage accumulating in one and to rats in 2 instances, besides other matters. It was not necessary to serve any statutory notices for the abatement of nuisances in connection with these factories. During the year 61 lists of out-workers were received from employers in Shoreditch, 13 during the first half-year and 48 in the second. These lists contain the names of 976 outworkers, of whom 594 were not resident in Shoreditch. The addresses of the non-residents were forwarded to the authorities of the sanitary districts to which they belonged. Communications were received from other sanitary authorities as to 1,877 outworkers who were residents in the Borough, and 122 who were residents of other sanitary districts. The addresses of the latter were forwarded to the authorities concerned. The number of outworkers brought to our notice in 1906 was 2,975, of which 2,259 were residents of Shoreditch. With respect to these figures, it is to be noted that in many instances the name and address of the outworker is duplicated, owing to lists of outworkers being sent in twice a year. Moreover, in a number of instances, it has been observed that the same outworker is employed by more than one firm. The numbers given above, therefore, are far from representing the actual numbers of individual outworkers. Some 1,495 visits of inspection were made to places where home work was carried on, and in 128 instances sanitary notices were required. The works carried out in consequence thereof included, amongst others, the reconstruction of drains in 8 instances, the reinstatement of stack-pipes and eaves gutters in 18, the paving of yards in 17 the reconstruction of water-closets in 10, and in several other instances repairs in connection with water-closets were effected, 14 houses were cleansed throughout, and 58 were cleansed in part, and altogether 246 rooms, 31 yards, 4 areas, and 42 water-closets were cleansed and whitewashed; in 24 instances roofs were repaired, and in a number of others minor sanitary defects received attention ; in three cases ventilation under the floors was provided, and in four instances overcrowding was abated. Some 539 visits of inspection were required in connection with the supervision of the works referred to, so that altogether 2,034 visits were made by the inspectors to premises where home work was done, A table, which will give an idea as to the distribution of outworkers in the various classes of work, the number of lists sent by employers, and other information in respect to outworkers, is contained in the Appendix (p. 64) in a form requested by the Secretary of State. 39 During the year 86 cases of notifiable infectious disease occurred in houses at which home work was carried on, as follows:— Clothing.—34 cases of scarlet fever, 7 diphtheria, 1 typhoid fever, and 12 of ensipelas. Paper bags and boxes.—20 cases of scarlet fever, 9 diphtheria, and 2 of erysipelas. Brush-making.—One case of scarlet fever. In all cases the usual steps were taken to prevent the work done at home being a means of spreading infection, and in most instances the temporary cessation of work was necessary. In no case was it necessary to take action under sections 108-110 of the Factory and Workshop Act, 1901. BAKEHOUSES. The number on the register at the end of the year was 73, including four factory bakehouses. Of these, 29 are above and 44 below the ground level. As the result of the inspection made during the year, their general sanitary condition may be said to be satisfactory. In 18 instances limewashing was required, and in a few others some minor sanitary defects required attention. In one instance serious defects were found in connection with the drains, which had to be reconstructed. The necessary sanitary notices were served and complied with. In one instance the bakehouse premises were found in a very dirty and insanitary state, and it was necessary to bring them under the notice of the Health Committee. A statutory notice under the Public Health (London) Act, 1891, was served and complied with. Later in the year this bakehouse ceased to be used as such. The bakehouses situate at 183, City Road;. 189, High Street, and 30, Pitfield Street, which are above ground, were closed, and also the underground bakehouse at 82, East Road, and were not in use at the end of the year. A new bakehouse, situate at.132, Curtain Road, was opened towards the end of the year. ICE-CREAM SHOPS. The following summarises the results of the work of the inspectors in connection with the above premises in 1906:—Inspector Lear had 16 under observation, of which four required more or less cleansing. Inspector Firth visited 10; three required limewashing and one was overcrowded. Inspector Jordan had 19 under inspection; in one instance the paving of the yard was defective, two were dirty and overcrowded and otherwise insanitary, and the remainder were in a cleanly and satisfactory condition. Inspector Langstone visited 23; in one instance the w.c. was defective, and in another there was overcrowding; the remainder were satisfactory. On Inspector Pearson's district 11 were under observation, two were dirty, and in one, the place where the ice-cream was stored was unsatisfactory. 40 Altogether 79 premises whereon ice-cream was manufactured or sold came under observation during the year. In 10 instances ice-cream was not being sold at the time the premises were visited. Of the premises inspected, 64 were found in a satisfactory sanitary condition. With respect to the remainder, want of proper attention to cleanliness was the chief fault, and in 14 instances sanitary notices were necessary. The condition of the premises, as compared with that of 1905, shows improvement. COOK-SHOPS AND COFFEE-HOUSES. Inspector Lear visited 28; fourteen required cleansing. Thirteen were under inspection on Inspector Firth's district; in two some cleansing was required, and in one a proper dust receptacle was necessary. Inspector Jordan had 90 under observation. This figure includes the kitchens of 13 public-houses at which dinners are provided. Of these kitchens, only one required attention, being dirty. With respect to the remainder, 45 were in a satisfactory sanitary condition, 21 required1 cleansing, in 6 there were defects of more or lees serious nature in respect to the drains and sanitary arrangements, and in the remaining five the defects were of minor importance. Inspector Langstone visited 29, which, with one exception, where the premises required cleansing, were in a. satisfactory condition. Inspector Pearson visited 17, including the kitchens of two public-houses where dinners are provided; three of them, including one of the public-house kitchens, required cleansing. Certain premises upon which brawn is made were also under observation and required a good deal of attention from time to time on account of want of proper attention to cleanliness. Altogether, 178 cook-shops and eating-houses, including 15 public-houses, were under inspection during the year, as compared with 182 for 1905, and 55 sanitary notices were served in connection with them. FRIED-FISH SHOPS. The number of fried-fish shops under observation was 48; in twelve, more or less cleansing was required, in one the sanitary arrangements were defective, and in two others some minor sanitary defects required attention. Some 15 sanitary notices were served in connection with these premises. STREET MARKETS AND FOOD. The usual supervision was exercised by the sanitary officers in connection with the street markets and the food-stuffs exposed for sale in the Borough, and frequent inspections were made with a view to the detection of food unfit for human consumption. The following articles were destroyed as unfit for food:— 41 Fish.—One trunk of rock-salmon, 1 box of codling, 5 barrels 1 trunk and 2 cases of skate, besides about 15 stone of loose fish of the same kind, 51 dozen pairs of kippered herrings, 20 stone of dabs, 6 stone of plaice, 1 cwt. of haddocks, and 1| bushels of whelks. Meat.—About 40 lbs. of beef, 56 lb®, of veal, 176 lbs. of mutton, and 8 cwt. 2 qrs. 4 lbs. of rabbits. Preserved foods.—Meat, fish, game, etc., about 7½ tons. Vegetables.—About 19 cwt. of greens, 13 boxes of tomatoes, 1 crate of bananas, and 3½ barrels of grapes. With respect to the preserved food's, on December 17th an intimation was received from the liquidator in the case of a firm in liquidation in the Borough that there was, on the premises lately occupied by the firm, a large quantity of preserved food-stuffs in tins, glass jars, and other receptacles, which was probably unsound. Inspector Jordan accordingly visited the premises and took possession of all the food-stuffs thereon. After an. examination of a large number of samples, the conclusion was arrived at that the bulk was unfit for food. The liquidator was communicated with and informed of the result of our examination, and that it would be necessary to take the unsound goods before a magistrate unless he was prepared to leave the matter entirely in our hands to deal with the food-stuffs as might be thought expedient. This he was prepared to do, and had no objection to what was condemned as unfit for food by the Medical Officer of Health being destroyed. Thereupon a careful examination of the food-stuffs upon the premises was made, which resulted in the destruction of nearly the whole as unfit for food. Altogether, some 19,449 tins, bottles, glass jars, and other receptacles were spiked, broken, or otherwise spoilt, and after treatment with disinfectants were removed as trade refuse by the Highways Department. The revelations in respect to the Chicago canned meat trade had a markedly prejudicial effect upon the sale of preserved meats in the Borough during the year. Enquiries made in June at 126 shops where canned meats were sold, showed that whilst there had. been no complaints as to the quality of the meat, the sale had' greatly decreased. In fact, in several instances it had altogether ceased, and not only was the sale of American meats affected, but of Australian and other brands also. A number of samples of canned meats were examined at the shops, but there was nothing to indicate that they were likely to be injurious. SALE OF FOOD AND DRUGS ACTS. The reports of the Public Analyst, Sir Thomas Stevenson, show that during the year 520 samples were submitted for analysis under the above Acts. This number is at the rate of one sample for every 224 persons in the Borough, and gives a rate of 4.4 per 1.000 inhabitants per annum. Each of the inspectors took 108 samples, except Inspector Pearson, who took 88. The latter did not commence sampling until the end of February. The inspectors each take on an average four samples every fortnight. 42 The results of the year's work are summarised in the following table:— Quarter of the year 1906. Number of Samples taken. Number of Samples Adulterated. Percentage Adulterated. Number of Prosecutions Instituted. Prosecutions withdrawn because of Warranties, &c. Prose utions proceeded with. Number of successful Prosecutions. Fines and Costs. Amount paid to Analyst for samples analysed. £ s. d. £ s. d. 1st. 123 21 17.0% 11 1 10 9 45 1 6 61 10 0 2nd. 134 22 16.4% 8 1 7 7 12 13 0 67 0 0 3rd. 100 31 31.0% 13 — 13 7 18 10 6 50 0 0 4th. 163 48 29.4% 12 — 12 11 30 7 6 81 10 0 Total for Year 520 122 23.4% 44 2 42 34 106 12 6 260 0 0 The samples taken comprised 344 of milk, 135 butter, 11 jam, 9 margarine, 7 corned beef, 5 lard, 3 coffee, 2 cheese, 1 dripping, 1 sausage, 1 tinned roast beef, and 1 mince meat. Of the milk samples, 96, or 27.9 per cent., were found not to be genuine, as compared with 20.8 in 1905, 23.5 in 1904, and 22.0 per cent, in 1903. In the subjoined table are shown the numbers of samples of milk taken during the four quarters of the year, with the numbers and percentage of those found not to be genuine:— Quarter of the year. Number of Samples. Number not genuine. Percentage not genuine. 1st. 82 12 14.6% 2nd. 89 20 22.4% 3rd 67 24 35.8% 4th. 106 40 37.7% In 55 of the milk samples water had been added. Taking the Board of Agriculture standard, in 18 the amount was over, and in 37 it as under 5 per cent. In 24 samples the milk was deficient in fat, the deficiency being over 5 per cent, in 15 and under in the remainder. In 9 samples there was both an excess of water and a deficiency of fat. In seven instances samples contained boric acid or a preparation thereof; in three of these that was all that was found amiss. The largest amount of boric acid found in any of the samples was 4¼ grains per pint. It may be mentioned that in a circular letter, dated June 11th, 1906, drawing attention to the recommen- 43 dation of the Departmental Committee on preservatives and colouring matter in food, that no preservative should be used in respect to milk, the Local Government Board suggested that the Council should notify milk traders, by circular or otherwise, that action will be taken under the Sale of Food and Drugs Acts in cases where preservatives are reported in milk. In accordance with this suggestion, letters of warning are now sent in cases where preservatives are stated to be present in milk samples, flirecting attention to the liability of vendors being proceeded against where samples are found to contain boric acid. None of the samples analysed during the year appear to have contained formic aldehyde as a preservative. In three instances, besides being below standard, milk samples were found to contain traces of colouring matter, and in four other samples the presence of colouring matter was the only thing noted by the Analyst. Legal proceedings were taken in 33, or a little over 34 per cent, of the cases in which the samples of milk were below standard. In 23 of these convictions were obtained In two instances summonses were withdrawn, and in seven they were dismissed by reason of the production of warranties. In one case the summons was adjourned sine die. With respect to the remainder, in which the samples were below standard, it was not deemed advisable to prosecute as the percentages of abstraction of fat and addition of water were mostly small in amount. In one case a false address was given, and the vendor, who was selling from a barrow in the street, could not be traced. In six instances letters of caution were sent to the vendors. In the cases in which convictions were obtained, the penalties for milk adulteration amounted to £38 13s. Od., which is equivalent to 5.6 percent, of the full amounts of the penalties to which the defendants were liable, as compared with 7.8 per cent, in 1905, 6 per cent, in 1904, 8 in 1903, and 13.5 in 1902. Taking fines and costs, which together amounted to £49 10s. 0d., the average amount paid by a defendant upon conviction was £2 9s. 6d., as compared with £2 19s. 3d. in 1905, £2 6s. lOd. in 1904, £1 18s. 6d. in 1903, and £2 18s. 4d. in 1902. Of the samples of butter taken, 15, or slightly in excess of 11 per cent., as compared with 14 per cent, in 1905, were not genuine. The numbers of samples and percentages of those found adulterated during the four quarters of the year as shown below:— Quarter of the year. Number of Samples. Number not genuine. Percentage adulterated. 1st. 37 8 21.6% 2nd. 42 2 4.7% 3rd 22 1 4.5% 4th. 34 4 11.7% 44 Of the adulterated samples sold as butter, 13 were margarine, one was a mixture of margarine and butter, and one contained a slight excess of water, as compared with the standard amount allowed in butter. Legal proceedings were taken in 10 instances, or 66 per cent, of the cases in which the samples were adulterated. In each case a conviction was obtained. With respect to the remaining five, four were investigated by the Health Committee, who decided that they were not cases which ought to be taken before a magistrate. The fifth was the case of excess of water. The amount of this excess was so small that it was not thought advisable to prosecute. Nine samples were taken under the Margarine Act. Four of these were found to contain small quantities of starchy matter, the largest amount being 1.5 per cent. In one instance the vendor was proceeded against for selling margarine in an unstamped wrapper, but the magistrate would not convict. He allowed the Council 12s. 6d. costs, however. The penalties inflicted in the cases in which convictions were obtained for infringements of the Sale of Food and Drugs Acts in respect to butter and margarine amounted to £51 10s. 0d., which was equivalent to 12 per cent, of the maximum penalties to which the defendants were liable, as compared with 17 per cent, in 1905, 10 per cent, in 1904, 18 in 1903, and 17 in 1902. Including costs, the amounts imposed by the magistrates for each conviction averaged £5 3s. Od., as compared with £7 1s. Od. in 1905, £3 1s, Od. in 1904, £4 10s. Od. in 1903, and £4 10s. Od. in 1902. During the first quarter of the year one sample of sausage was taken which was found to contain 25 grains of boric acid per pound. No further samples were taken, pending the Tesult of the appeal referred to in my last Annual Report. This appeal not having been proceeded with by the end of the year, the matter again came before the Health Committee, who gave instructions for a letter to be sent to the traders concerned in the Borough, warning them as to the liability of proceedings being taken under the Sale of Food and Drugs Acts in cases where samples of sausages are found to contain boric acid. Five of the samples of tinned corned beef and the sample of tinned roast beef contained small quantities of tin and zinc, the largest amount found being 0.39 grains of tin per pound. The samples of jam, lard coffee, cheese, dripping and minced meat were all genuine. 45 The subjoined table shows a comparison of the results of the work under the Food and Drugs Acts during the years 1902-6 inclusive:— Year. Number of Samples. Number of persons in the Borough to each sample. Number of samples adulterated. | Percentage of samples adulterated. Number of prosecutions instituted. Summonses withdrawn on account of warranties, &c. Prosecutions proceeded with. Number of successful prosecutions. Fines and Costs. Amounts paid to Public Analyst. £ s. d. £ s. d. 1902 281 420 71 253 54 2 52 48 117 9 0 140 10 0 1903 707 166 112 15.8 60 5 55 51 173 11 6 353 10 0 1904 612 189 110 17.9 55 6 50 46 128 5 0 306 0 0 1905 536 215 98 18 2 57 2 51 47 233 18 0 267 0 0 1906 520 224 122 23.4 44 2 42 34 106 12 6 260 0 0 The marked increase during 1906 in the percentage of samples adulterated as shown in the above table was chiefly due to a larger proportion of the milk samples deviating from the standard of the Board of Agriculture, to such a small extent, however, as to render legal proceedings inadvisable. SANITARY STAFF. During the first two months of the year the department was short of the services of one inspector, owing to Mr. J. H. Pearson, who was appointed to fill the post vacated by Mr. J. H. Clements, being unable to commence his duties in Shoreditch until 26th February. As far as practicable the work on the vacant district during that time was attended to by the inspectors of the adjacent districts in the Borough. The manner in which the officers of the Health Department have carried out their duties during the year has been to my satisfaction, and I have to express my appreciation of the assistance I have received from them in connection with the work of the department. My thanks are also due to the Chairman and members of the Health Committee for the consideration and help they have afforded me in my official work during the year. I have the honour to be, Mr. Mayor and Gentlemen, Your obedient Servant, LEWIS T. FRASER BRYETT, Medical Officer of Health. 1 APPENDIX TO THE REPORT of the MEDICAL OFFICER OF HEALTH. containing Statistical Tables and a Summary op Sanitary Proceedings under the public Health and factory and workshop acts, during the Year 1906. Tables I., II., Ill,, IV. and V. are forms required by the Local Government Board. 48 TABLE I. BOROUGH OF SHOREDITCH. Vital Statistics of whole District during 1906 and previous Years. Year. Population estimated to middle of each Year. Births. Total Deaths Registered ix the District. Total Deaths in Public Institutions in the District Deaths of Nonresidents registered in Public Institutions in the D'strict. Deaths Of residents registered in Public Institutions beyond the District. Net Deaths at all Ages belonging to the District. Number Rate* under one Year of Age at all Ages. Number. Rate* Number. Rate per 1000 Births registered. Number Rate* 1 2 3 4 5 6 7 8 9 10 11 12 13 1896 122308 4364 36.0 786 183 2620 21.6 686 367 369 2622 21.6 1897 122058 4325 35.0 789 186 2662 21.8 783 392 356 2626 21.7 1898 121740 4281 35.1 846 199 2709 22.2 761 371 366 2704 22.4 1899 121530 4131 33.7 854 210 2982 24.5 905 429 358 2911 24.2 1900 121335 4023 32.9 741 187 2689 22.2 790 472 350 2576 21.4 1901 118550 4120 34.3 812 201 2652 22.6 883 427 365 2596 22.1 1902 117948 3992 33.3 704 181 2383 20.2 836 387 432 2441 20.9 1903 117740 3932 33.3 676 176 2232 18.9 832 337 383 2280 19.6 1904 117360 3763 32.0 706 190 2315 19.6 811 366 434 2392 20.6 1905 116939 3894 33.3 652 165 2234 19.1 867 391 451 2296 19.8 Averages for years 1896tol905 119750 4082 33.8 756 1187 2547 21-2 815 393 386 2544 21.4 1906 116506 3802 ‡ 32.6 651 168 2158 18-5 816 343 473 2289 19.8 § * Rates in Columns 4, 8, and 13 are calculated per 1,000 of estimated population. ‡ Total registered in the Borough, including the births in the Holborn Workhouse. § The population in the Holborn Workhouse is excluded in calculating this rate. Note.—The deaths included in column 7 of this table are the whole of those registered during the year as having actually occurred within the district. The deaths included in column 12 are the number in column 7, corrected by the subtraction of the number in column 10 and the addition of the number in column 11. During 1906 seventeen persons not resident in Shoreditch died within the district, and 18 residents of Shoreditch died beyond the district, but not in public institutions, these have to be added to the figures in columns 10 and 11 respectively in order to get the net deaths. By the term " non-residents '' is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there; and by the term "residents " is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The "public institutions'' taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses and lunatic asylums. A list of the institutions in respect of the deaths in which corrections have been made is given on page 8 of the Report. Report. Area of District in acres (exclusive of area covered by water) 612.5 Total population at all ages, 118,637 Number of inhabited houses, 12,743 Average number of persons, per house 9.3 AtCensus of 1901. 49 TABLE II. BOROUGH OF SHOREDITCH. Vital Statistics of separate Localities in 1906, and in the previous Year. 1—Moorfields Ward. 2—Church Ward. 3—Hoxton Ward. 4—Wenlock Ward. 5—Whitmore Ward. 6-Kingsland Ward. 7— Haggerston Ward. 8—Acton Ward. Year. Population estimated to middle of year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of year. births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of year, Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of year. Births registered. Deaths at all ages. Deaths under 1 year. Population estimated to middle of year. Births registered. Deaths at all ages. Deaths under 1 year, Population estimated to middle of year. Births registered. Deaths at all ages. | Deaths under 1 year. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. 1905 5831 137 84 17 20103 727 430 125 18216 674 389 130 18342 521 326 88 18461 647 446 105 11281 420 205 60 12314 413 208 75 12391 414 208 52 1906 5681 130 79 11 19923 668 403 108 17982 664 354 107 18602 59C 336 113 18370 586 454 119 11188 423 220 59 12384 386 208 68 12376 417 235 66 (a) Owing to the alteration in respect to the registration sub-districts referred to on page 1 of the report for the year 1905, it was necessary to select fresh localities for statistical purposes. The eight wards of the Borough were accordingly adopted as separate localities for the purposes of this table. If required the figures relating to the registration sub-districts may be obtained from this table, as Wards 1, 2 and 3 form the Shoreditch South Registration sub-district, 4 and 5 that of Shoreditch North-West, and 6, 7 and 8 that of Shcreditch North-East. (b) Deaths of residents occurring beyond the district are included in sub-columns c of this table, and those of non-residents registered in the district excluded. (See note on Table I. as to meaning of terms "resident" and " non-resident.") (c) Deaths of residents occurring in public institutions have been allotted to the respective localities according to addresses of the deceased. (d) The population of locality No. 4 includes the population in the Holborn Union Workhcuse, estimated at 1,376. 50 TABLE III. BOROUGH OF SHOREDITCH. Cases of infectious disease notified during the Year 1906. Notifiable Disease. Cases notified in Whole District. Total Cases notified in each Locality. No. of Cases removed to Hospital from each Locality. At all Ages. 1. 2. 3. 4. 5 6. 7. 8. 1. 2. 3. 4. 5. 6- 7. 8. Under 1. 1 to 5 5 to 15 15to25 25to65 65 and upwards Moor fields. Church. Hoxton Wenlock. Whitmore. Kingsland. 1 Har- gerston J Acton. 1 Moorfields. j Church Hoxton Wenlock. Whitmore. Kingsland. Haggerston Acton. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria 128 3 68 45 8 4 ... 7 19 17 17 23 9 17 19 6 19 17 13 22 8 17 17 Membranous croup 5 1 3 1 ... ... ... ... 1 ... ... ... 2 1 1 ... ... ... ... ... 1 ... 1 Erysipelas 144 6 9 14 14 89 12 9 23 21 20 20 19 15 17 1 1 1 1 2 3 ... 2 Scarlet fever 629 7 240 350 26 6 ... 27 90 115 120 123 57 55 42 27 89 112 115 122 57 53 37 Typhus fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric fever 39 ... 1 8 15 15 ... 1 10 4 4 6 2 8 4 1 10 3 4 6 2 6 4 Relapsing fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Continued fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal fever 6 ... ... ... 2 4 ... ... 1 ... ... ... ... 1 4 ... ... ... ... ... ... ... 1 Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 951 17 321 418 65 118 12 44 144 157 161 172 89 97 87 35 119 133 133 152 71 76 62 51 TABLE IV. BOROUGH OP SHOREDITCH. Causes of, and ages at, death during Year 1906. Causes of Death. Deaths in or belonging to whole District at subjoined Ages. Deaths in or belonging to Localities at all Ages. Total deaths In Public Institutions in the districts All Ages. Under 1. 1 and under 5 5 and under 15 15 and under 25. 25 and under 65. 65 and upwards Moorfields. Church. Hoxton. Wenlock. Whitmore Kingsland. Haggerston. Acton- 1 2 3 4 5 6 7 8 9 10 ii 12 13 14 lb 16 17 Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles 74 11 63 ... ... ... ... 3 18 10 13 12 5 4 9 9 Scarlet fever 20 ... 15 5 ... ... ... 1 2 6 1 6 2 1 1 ... Whooping-cough 59 17 40 2 ... ... ... 2 10 11 9 12 5 2 8 8 Diphtheria and membranous croup 14 2 10 2 ... ... ... 1 2 ... 5 2 1 2 1 ... Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Fever Typhus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric 4 ... ... 1 1 2 ... 1 ... ... 1 ... ... 2 ... ... Other contd. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Epidemic influenza 17 1 1 1 1 8 5 ... 4 1 5 5 ... ... 2 1 Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diarrhoea (see notes). 241 203 28 1 1 6 2 4 42 43 40 48 18 23 23 14 Enteritis (see notes). 15 ... 13 ... 1 1 ... ... 6 1 ... 3 2 3 ... 2 Puerperal fever 3 ... ... ... 1 2 ... ... ... ... ... ... ... 1 2 ... Erysipelas 2 1 ... ... ... ... 1 ... ... ... 2 ... ... ... ... 4 Other septic diseases 23 2 2 3 2 12 2 ... 5 1 3 5 5 1 3 4 Phthisis 233 3 8 7 26 184 5 13 40 30 26 53 211 26 25 119 Other tuberculous diseases 114 44 41 18 3 8 ... 2 20 23 16 20 11 10 12 15 Cancer, malignant disease 83 ... ... 1 1 58 23 4 13 10 10 13 11 10 12 50 Bronchitis 194 41 21 ... ... 76 56 7 32 45 25 37 17 16 15 98 Pneumonia 231 54 72 5 7 70 23 2 39 45 28 40 29 26 22 56 Pleurisy 2 ... ... 1 ... 1 ... ... 1 ... ... ... ... 1 ... 2 Other diseases of Respiratory organs 5 1 ... ... ... 3 1 ... 9 1 ... 1 1 ... ... 5 Alcoholism 47 ... ... ... ... 41 5 4 14 6 5 9 4 1 4 36 Cirrhosis of liver Venereal diseases 13 11 ... 1 ... 1 ... ... 2 3 2 1 2 1 2 3 Premature birth 75 75 ... ... ... ... ... 3 14 13 14 13 2 8 8 7 Diseases and accidents of parturition 6 ... ... ... 2 4 ... ... ... 2 1 1 ... 2 ... 1 Heart diseases 156 ... 1 6 7 102 40 9 30 20 21 31 12 11 22 68 Accidents 81 34 6 7 2 25 7 3 15 12 15 17 12 3 4 32 Suicides 16 ... ... ... 1 15 ... 1 3 3 2 ... 2 4 1 3 All other causes 561 150 36 14 14 157 190 19 89 68 92 125 59 50 59 279 All Causes 2289 651 357 75 70 776 360 79 403 354 336 454 220 208 235 816 52 TABLE V. BOROUGH OF SHOREDITCH. Infantile Mortality during the year, 1906, showing deaths from stated Causes in Weeks and Months under One Year of Age. CAUSE OP DEATH. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months 2-3 Months 3-4 Months 4-5 Months 5-6 Months 6-7 Months 7-8 Months 8-9 Months 9-10 Months 10-11 ! Month? 11-12 Months Total Deaths under 1 Year. All causes Certified 81 27 18 13 139 66 68 55 48 49 40 42 42 42 34 26 651 Uncertified ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... i. Common Infectious Diseases. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... ... ... ... ... 1 4 ... 3 2 2 12 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria: Croup ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 2 Whooping Cough ... ... ... 1 1 ... 1 ... 1 3 1 1 2 6 ... 2 18 ii. Diarrhœal Diseases. (See notes, &c. Tables iv. & v.) Diarrhoea, all forms ... ... ... 1 l 14 16 25 17 20 10 14 10 13 9 8 157 Enteritis, Muco-enteritis, ... ... ... 1 l 3 7 5 5 3 5 4 4 3 5 1 46 Gastro-enteritis Gastritis, Gastro-intestinal ... 1 ... ... 1 ... 1 1 ... ... ... ... ... ... ... ... 3 Catarrh ) iii. Wasting Diseases. Premature Birth 51 10 5 5 71 4 2 1 2 ... ... ... ... ... ... ... 77 Congenital Defects (See notes io Tables iv. & v.) 6 1 1 ... 8 2 ... ... 1 1 ... ... ... ... 1 ... 13 Injury at Birth 1 ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 Want of Breast-milk Starvation ... ... 1 ... 1 2 1 ... ... ... ... ... ... ... ... ... 4 Atrophy, Debility, Marasmus 16 6 3 ... 25 12 15 9 9 7 1 1 1 ... 1 1 82 iv. Tuberculous Diseases. Tuberculous Meningitis (See notes on Tables iv. & v.) ... ... ... ... ... ... ... 1 1 1 2 ... 5 ... 2 1 13 Tuberculous Peritonitis: Tabes Mesenterica ... ... ... 1 1 1 1 5 1 ... 4 1 ... 3 1 ... 18 Other Tuberculous Diseases (See notes on Tables iv. & v.) ... ... ... 1 1 1 3 ... ... 1 1 3 1 1 1 1 14 v. Other causes Erysipelas ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 Syphilis ... 1 ... 1 2 2 2 2 2 ... ... ... l ... ... ... ... Pickets ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... Meningitis (not Tuberculous) ... 1 ... ... 1 ... 1 ... ... 1 2 ... ... 1 4 1 11 Convulsions 1 1 1 ... 3 1 2 ... 1 ... 3 ... ... ... 1 ... 11 Bronchitis 1 3 2 1 7 4 6 1 1 ... 5 5 6 5 1 2 43 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ... 10 ... ... ... ... Pneumonia ... ... 2 ... 2 2 2 4 3 7 2 7 5 4 5 53 Suffocation, overlying 1 ... 1 ... 2 9 6 2 5 2 2 ... ... 1 ... ... 29 Other Causes 4 3 2 1 10 8 2 ... 1 3 1 1 2 1 1 1 31 81 27 18 13 139 66 68 55 48 49 40 42 42 42 34 26 651 Births in the year—Legitimate 3,809, illegitimate 61. Population, estimated to middle of 1906, 116,506. Deaths from all Causes at all Ages 2,289. 53 NOTES TO TABLES IV. AND V. (a) In Table IV., all deaths of "Residents" occurring in public institutions, whether within or without the district are included with the other deaths in the columns for the several age groups (columns 2-8). They are also, in columns 9-16 included among the deaths in their respective "Localities" acording to the previous addresses of the deceased as given by the Registrars. Deaths of " Nonresidents '' occurring in public institutions in the district are in like manner excluded from columns 2-8 and 9-16 of Table IV. •(b) See notes on Table I. as to the meaning of " Residents " and " Non-residents," and as to' the "Public Institutions" taken into account for the purposes of these Tables. The "Localities'' in Table IV. are the same as those in Tables II. and III. (c) All deaths occurring in public institutions situated within the district, whether of " Residents " or of " Non-residents," are, in addition to being dealt with as in note (a), entered in the last column of Table IV. The total number in this column equals the figures for the year in column 9, Table I. (d) The total deaths in the several "Localities" in columns 9-16 of Table IV. equal those for the year in the same localities in Table II., sub-columns c. The total deaths at all ages in column 21 of Table IV. equal the gross total of columns 9-16, and the figures for the year in column 12 of Table I. (e) Under the heading of " Diarrhcea " are included deaths registered as due to Epidemic diarrhcea, Epidemic enteritis, Infective enteritis, Zymotic enteritis, Summer diarrhcea, D\senterv and Dysenteric diarrhoea, Choleraic diarrhoea, Cholera and Cholera Nostras. In addition, and as regards deaths of children under one year of age, under the heading " Diarrhoea " in column 3 (Table IV.) are included all deaths classified as " Diarrhoea] diseases " in Table V. Under the heading of " Enteritis " in Table IV., are included only deaths over one year of age registered as due to Enteritis, Muco^enteritis, Gastro-enteritis, Gastric catarrh, Gastritis, and Gastro-intestinal catarrh. Deaths from diarrhoea secondary to some other well-defined disease have been included under the latter. (f) Under the headings of " Cancer " and " Puerperal fever " are included all tered deaths from causes comprised within these general terms. Thus : Under " Cancer " are included deaths from Cancer, Carcinoma, Malignant disease, Scirrhus, Epithelioma. Sarcoma, Villous tumour, and Papilloma of bladder, Rodent ulcer. Under " Puerperal Fever " are included deaths from Pyaemia,, Septicaemia, Sapraemia, Pelvic Peritonitis, Peri- and Endo-Metritig occurring in the Puerperium. (g) Under " Congenital Defects" in Table V. are included deaths from Atelectasis, Icterus neonatorum, Navel haemorrhage, Malformations and Congenital hydrocephalus. (h) Under " Tuberculous Meningitis " are included deaths from Acute hydrocephalus. (i) Under " Other Tuberculous Diseases " are included deaths from Tuberculosis, culosis of bones, joints and other organs, Lupus and Scrofula. (j) All deaths certified by registered Medical Practitioners and all Inquest cases are classed as "Certified''; all other deaths are regarded as "Uncertified." 54 55 TABLE VI. DEATHS FROM ALL CAUSES IN THE BOROUGH OF SHOREDITCH, AND IN EACH WARD DURING THE YEAR ENDING 31ST DECEMBER, 1906. Note.—The deaths of persons not belonging to Shoreditch occurring in Hospitals, &c., in the Borough are excluded; and the deaths of persons belonging to Shoreditch occurring in Hospitals, &c., situated in London beyond the limits of the Borough, are included. DEATHS IN EACH WARD FROM ALL CAUSES. CAUSES OF DEATH. AGES. Moorfields. Church. Hoxton Wenlock. Whitmore. Kingsland. Haggerston. Actcn. Male. Female. Total. U nder 1. 1 to 5. 5 to 10. 10 to 15. 15 to 20. 20 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to G5. 65 to 75. | 75 to 80. 1 85 and 1 upwards. 1 Small Pox- Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Unvaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... No statement ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 Measles 11 63 ... ... ... ... ... ... ... ... ... ... ... 3 18 10 13 12 5 4 9 33 41 74 3 Scarlet fever ... 15 3 2 ... ... ... ... ... ... ... ... ... 1 2 6 1 6 2 1 1 14 6 20 4 Typhus fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 Epidemic influenza 1 1 1 ... 1 ... ... 4 2 2 4 ... 1 ... 4 1 5 5 ... ... 2 9 8 17 6 Whooping cough 17 40 2 ... ... ... ... ... ... ... ... ... ... 2 10 11 9 12 5 2 8 24 35 59 7 Diphtheria, membranous croup 2 10 1 1 ... ... ... ... ... ... ... ... ... 1 2 ... 5 2 1 2 1 6 8 14 8 Enteric fever ... ... ... 1 1 ... ... 2 ... ... ... ... ... 1 ... ... 1 ... ... 2 ... 2 2 4 9 Asiatic cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10 Diarrhœa, dysentery 119 21 ... ... ... 1 ... 1 1 3 2 ... ... 4 28 22 22 29 13 15 15 78 70 148 11 Epidemic or zymotic enteritis 37 7 1 ... ... ... ... ... 1 ... ... ... ... ... 7 12 11 5 3 3 5 30 16 46 12 Other allied diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 13 Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 14 Glanders, farcy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 15 Tetanus 1 ... ... ... ... ... ... 1 1 ... ... ... ... ... ... ... 1 1 1 ... ... 3 ... 3 16 Anthrax, splenic fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 Cow-pox, accidents of vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 18 Syphilis 11 ... ... 1 ... ... ... ... ... 1 ... ... ... ... 2 3 2 1 2 1 2 9 4 13 19 Gonorrhœa ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 20 Phagedœna, hospital gangrene ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 21 Erysipelas 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 2 ... ... ... ... ... 2 2 22 Puerperal fever ... ... ... ... ... 1 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 3 3 23 Pyaemia, septicaemia 2 1 1 ... ... 1 2 1 3 1 1 1 ... ... 3 1 ... 3 3 1 3 4 10 14 24 Infective endocarditis ... ... ... ... 1 ... 1 1 ... ... ... ... ... ... 1 ... ... 1 1 ... ... 1 2 3 25 Other allied diseases ... 1 2 ... ... ... ... ... ... 3 ... ... ... ... 1 ... 3 1 1 ... ... 2 4 6 26 Malarial fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 27 Rheumatic fever ... 1 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 1 ... ... 1 2 3 28 Rheumatism of the heart ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tuberculosis: ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 29 Brain or meninges, acute hydrocephalus 15 15 9 1 ... ... ... ... ... ... ... ... ... ... 10 13 3 5 3 4 2 21 19 40 30 Larynx ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 31 Lungs 3 8 3 4 9 17 39 75 54 16 4 1 ... 13 40 30 26 53 20 26 25 138 95 233 32 Intestines, tabes mesenterica 16 5 1 ... ... 1 ... ... ... ... ... ... ... 1 5 3 4 4 ... 1 5 12 11 23 33 General, position undefined 10 20 3 1 2 ... 5 1 ... ... ... ... ... ... 5 6 6 7 8 5 5 22 20 42 34 Other forms, scrofula 3 1 2 1 ... ... ... ... 2 ... ... ... ... 1 ... 1 3 4 ... ... ... 5 4 9 35 Other Infective diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 36 Thrush ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 37 Actinomycosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 38 Hydatid diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 39 Scurvy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 40 Other diseases due to altered food ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 41 Acute alcoholism, delirium tremens ... ... ... ... ... ... 2 1 2 ... ... ... ... 1 ... 1 ... 2 1 ... ... 1 4 5 42 Chronic alcoholism ... ... ... ... ... ... 2 6 5 4 ... 1 ... 2 5 1 1 7 2 ... ... 9 9 18 43 Chronic industrial poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 44 Other chronic poisonings ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 45 Osteo-arthritis, rheumatoid arthritis ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 1 46 Gout ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... 1 ... 1 47 Cancer ... ... ... ... ... ... 2 6 27 18 16 5 ... 4 9 9 8 13 10 9 12 27 47 74 48 Diabetes mellitus ... ... ... ... ... ... ... ... 1 3 1 1 ... 1 2 1 ... ... 2 ... ... 2 4 6 49 Purpura bcemorrhagica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 50 Hœmophilia ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 1 51 Anaemia,lecucocvthœmia ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 56 57 DEATHS REGISTERED FROM ALL CAUSES DURING THE YEAR ENDING DECEMBER 31ST, 1906. DEATHS IN EACH WARD FROM ALL CAUSES. CAUSES OF DEATH. AGES. Moorfields. Church. Hoxton. Wenlock. Whitmcre. Kingsland. Haggerston. Acton. Male. Female. Total. Under 1. 1 to 5. 5 to 10. | 10 to 15. 15 to 20. 20 to 25. 25 to 35. 35 to 45. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 85 and upwards. 52 Lymphadenoma, Hodgkin's disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 53 Premature birth 75 ... ... ... ... ... ... ... ... ... ... ... ... 3 14 13 14 13 2 8 8 43 32 75 54 Injury at birth 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 55 Debility at birth 15 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 3 3 3 2 2 7 8 15 56 Atelectasis 4 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 1 2 2 4 57 Congenital defects 9 1 ... ... ... ... ... ... ... ... ... ... ... 1 2 2 3 ... ... 1 1 5 5 10 58 Want of breast milk 4 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 ... ... ... 2 2 4 59 Atrophy, debility, marasmus 70 5 ... ... ... ... ... ... ... ... ... ... ... 2 18 8 12 10 14 6 5 41 34 75 60 Dentition 4 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 1 ... 1 1 4 1 5 61 Rickets 1 7 ... ... ... ... ... ... ... ... ... ... ... ... 2 2 3 1 ... ... ... 5 3 8 62 Old Age, senile decay ... ... ... ... ... ... ... ... ... 3 30 60 22 6 15 11 19 35 9 6 14 49 66 115 63 Convulsions 12 2 ... ... ... ... ... ... ... ... ... ... ... ... 3 ... 4 3 2 2 ... 8 6 14 64 Meningitis 9 5 2 ... 1 ... 1 ... ... ... ... ... ... ... 4 3 2 6 1 1 1 6 12 18 65 Encephalitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 66 Apoplexy ... ... ... ... ... 1 ... 8 11 6 15 9 1 2 9 6 5 9 10 4 7 24 28 52 67 Softening of brain ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 ... 1 ... ... ... ... 2 2 68 Hemiplegia, brain paralysis ... ... ... ... ... ... ... ... 2 ... 2 2 ... 1 ... 1 ... 3 ... 1 ... 2 4 6 69 General paralysis of insane ... ... ... ... ... ... 3 5 2 ... ... ... ... ... 4 ... ... 4 2 ... ... 8 2 10 70 Other forms of insanity ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 71 Chorea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 72 Cerebral tumour ... ... ... ... 1 ... 1 ... ... 1 ... ... ... ... ... 1 1 1 ... ... ... 1 2 3 73 Epilepsy ... ... ... ... 1 ... 3 ... 1 1 ... ... ... ... ... 1 1 2 ... 2 ... 1 5 6 74 Laryngismus Stridulus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 75 Locomotor Ataxy ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 76 Paraplegia, diseases of spinal cord ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 77 Other diseases of brain or nervous system 1 ... ... ... ... ... 1 ... 2 1 1 2 1 ... ... 1 3 1 1 2 1 3 6 9 78 Otitis, otorrhœa 2 5 1 ... ... ... ... ... ... 1 ... ... ... ... 3 1 3 ... 1 ... 1 6 3 9 79 Diseases of nose, epistaxis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 80 Diseases of eye, ophthalmia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 81 Pericarditis ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 82 Endocarditis, valvular diseases of the heart ... ... ... 1 1 3 8 10 15 15 6 5 ... 3 11 8 7 17 7 4 7 29 35 64 83 Hypertrophy of heart ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 84 Angina pectoris ... ... ... ... ... ... ... 1 ... ... 1 ... ... ... 1 ... ... 1 ... ... ... 1 1 2 85 Aneurism ... ... ... ... ... ... 1 ... 4 1 ... 1 ... ... 1 ... ... 3 1 2 ... 6 1 7 86 Senile gangrene ... ... ... ... ... ... ... ... 1 1 1 2 1 ... ... 1 ... 1 3 1 ... 3 3 6 87 Embolism, thrombosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 88 Phlebitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 89 Varicose veins ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 90 Other and ill-defined disease. of heart and circulatory system, including heart disease not stated to be valvular ... ... 3 2 2 1 2 18 12 21 16 12 ... 6 18 12 14 12 5 7 15 40 49 89 91 Laryngitis ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 1 92 Croup ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 93 Other diseases of larynx and trachea ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 94 Acute bronchitis 41 21 ... ... ... ... ... 3 4 7 3 ... ... 1 12 20 10 15 5 6 10 38 41 79 95 Chronic bronchitis ... ... ... ... ... ... 4 8 16 34 39 10 4 6 20 25 15 22 12 10 5 52 63 115 96 Lobar, croupous pneumonia 1 6 ... ... ... ... 4 4 5 4 4 3 ... 1 5 3 2 11 2 4 3 19 12 31 97 Lobular, broncho-pneumonia 42 45 3 ... ... 1 1 1 4 5 4 3 1 1 22 19 13 18 14 13 10 66 44 110 98 Pneumonia, form not stated 11 21 1 1 3 3 11 12 9 10 7 1 ... ... 12 23 13 11 13 9 9 54 36 90 99 Emphysema, asthma ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... 1 100 Pleurisy ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 ... 1 1 2 101 Other and ill-defined diseases of respiratory system 1 ... ... ... ... ... ... ... 1 1 1 ... ... ... 1 1 ... 1 1 ... ... 1 3 4 102 Diseases of mouth and annexa ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 103 Diseases of pharynx ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 104 Diseases of oesophagus ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 105 Ulcer of stomach and duodenum ... ... ... ... ... ... ... 1 4 ... ... 1 ... ... 1 1 ... 1 ... 1 2 3 3 6 106 Other diseases of stomach 3 1 ... 1 ... ... ... ... 1 ... 1 1 ... ... ... ... 1 2 1 2 2 2 6 8 107 Enteritis 47 13 ... ... ... 1 ... ... ... 1 ... ... ... ... 13 10 7 17 4 8 3 23 39 62 108 Appendicitis 1 2 3 3 3 1 ... 3 3 ... ... ... ... 2 ... 2 1 7 1 3 3 9 10 19 109 Obstruction of intestine 2 1 ... ... ... 1 1 ... 2 2 1 1 ... ... 3 1 2 1 1 1 2 4 7 11 110 Other diseases of intestine 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 1 111 Cirrhosis of liver 1 ... ... ... ... ... 1 7 11 5 2 2 ... 2 9 5 ... 2 ... 1 4 10 19 29 112 Other diseases of liver ... ... ... ... ... ... ... 1 2 2 ... ... ... ... 1 ... ... 1 ... 1 2 2 3 5 113 Peritonitis 1 1 ... ... ... 1 ... ... 1 ... ... ... ... ... ... 2 ... ... ... ... 2 2 2 4 114 Other and ill-defined diseases of digestive system ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 58 59 DEATHS REGISTERED FROM ALL CAUSES DURING THE YEAR ENDING DECEMBER 31ST, 1906. DEATHS IN EACH WARD FROM ALL CAUSES. CAUSES OF DEATH. AGES. Moorfields. Church. Hoxton. Wenlock. Whitmore. Kingsland. Haggeraton. Acton. Males. Females. Total. Under 1. 1 to 5. 5 to 10. 10 to 15. 15 to 20. 20 to 25. 25 to 35. 35 to 4 5. 45 to 55. 55 to 65. 65 to 75. 75 to 85. 80 and upwards 115 Diseases of Lymphatic System and ductless glands ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 116 Ac ite nephritis ... ... ... ... ... 1 2 ... ... 1 ... ... ... ... ... 1 2 1 ... ... ... 1 3 4 117 Brieht's disease 1 ... ... ... 1 ... 6 7 10 17 16 4 1 1 11 13 9 13 2 9 5 39 24 63 118 Calculus ... ... ... ... ... ... ... ... ... ... • • • ... ... ... ... ... ... ... ... ... ... ... ... ... 119 Diseases of bladder and prostrate ... ... ... ... ... ... ... ... 1 1 5 3 1 1 1 1 3 3 ... 1 1 11 ... 11 120 Other and ill-defined diseases of, urinary system, ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... ... ... ... ... ... ... 1 ... 1 12L Diseases of testis and penis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 122 Diseases of ovaries ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 123 Diseases of uterus and appendages ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 1 124 Diseases of vagina and external genital organs ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 125 Diseases of breast ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 126 Abortion, miscarriage ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 127 Puerperal mania ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 128 Puerperal convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 129 Placenta praevia, flooding ... ... ... ... ... 1 1 1 ... ... ... ... ... ... ... 2 ... ... ... 1 ... ... 3 3 130 Puerperal thrombosis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 131 Other and ill-defined accidents ana aiseases of pregnancy and childbirth ... ... ... ... ... 1 l 1 ... ... ... ... ... ... ... ... 1 1 ... 1 ... ... 3 3 132 Arthritis, ostitis, periostitis ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 1 133 Other and ill-defined diseases of osseous system 1 ... ... ... ... ... ... ... ... 2 ... ... ... ... 1 ... ... 1 ... ... 1 1 2 3 131 Ulcer, bedsore ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... .135 Eczema 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 1 ... ... 2 ... 2 135 Pemphigus 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 1 137 Other and ill defined diseases of integumentary system ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... By Accident or Negligence. 138 In mines and quarries ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 139 In vehicular traffic ... 2 1 ... ... ... ... 1 3 3 ... ... ... • • • 1 1 2 3 ... 2 1 7 3 10 140 On railways ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 1 141 On vessels & docks, excluding drowning ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 142 In building operations ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 148 By machinery ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... 1 1 ... ... ... ... ... 2 ... 2 144 By weapons and implements ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 145 Burns and scalds 2 2 1 1 ... 1 ... 1 2 ... ... 1 ... 1 3 ... 2 ... 5 ... ... 3 8 11 146 Poisons, poisonous vapours ... 1 ... ... ... ... ... 1 ... ... 1 ... ... ... 1 ... 1 1 ... ... ... 2 1 3 147 Surgical narcosis ... ... ... ... ... ... ... 2 ... ... ... ... ... ... ... 1 ... 1 ... ... ... 1 1 2 148 Effects of electric shock ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 149 ('orrosion by chemicals ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 150 Drowning ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... 2 ... 2 151 Suffocation, overlaid in bed 27 ... ... ... ... ... ... ... ... ... ... ... ... 1 5 2 5 8 4 ... 2 16 11 27 152 Suffocation, otherwise 2 ... ... ... ... ... ... 1 ... ... ... 1 ... ... 2 2 ... ... ... ... ... 2 2 4 153 Falls, not specified 1 1 1 ... 1 ... 1 2 1 5 2 1 1 ... 2 4 4 4 2 ... 1 9 8 17 154 Weather agencies ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 155 Otherwise, and not stated 2 ... ... ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... 1 1 2 156 Homicide ... ... ... ... ... ... 1 1 1 ... ... ... ... ... ... 1 2 ... ... ... ... 1 2 3 Suicides, all forms. 157 By poison ... ... ... ... ... 1 ... 1 2 2 ... ... ... ... 1 1 1 ... 2 ... 1 6 ... 6 158 By asphyxia ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 159 3y hanging and strangulation ... ... ... ... ... ... ... 1 3 ... ... ... ... ... ... 1 ... ... ... 3 ... 4 ... 4 160 By drowning ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... 1 161 Hy shooting ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 ... 1 162 By cut or stab ... ... ... ... ... ... ... 1 1 1 ... ... ... 1 1 1 ... ... ... ... ... 3 ... 3 163 By precipitation from elevatec places ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 164 By crushing 165 By other and unspecified methods ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 ... 166 Execution ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 167 Sudden death ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 168 Other ill-defined and not specified causes 5 1 1 ... ... ... ... 1 2 2 1 ... ... ... 4 1 3 1 1 ... 3 3 10 13 169 Malignant disease ... ... 1 ... 1 ... 1 1 1 2 2 ... ... ... 4 1 2 ... 1 1 ... 5 4 9 170 Abscess ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... 2 ... 2 171 Cerebro-spinal Meningitis ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 651 357 52 23 29 41 113 207 243 213 192 134 34 79 403 354 1 336 454 220 208 235 1167 1122 2289 GO TABLE VII. —ANALYSIS AND COMPARISON OF LONDON AND SHOREDITCH BIRTH AND DEATH RATES FOR THE YEAR ENDING 31ST DECEMBER, 1906. Districts. Estimated population 1906. births Annual Rate per 1000 persons living. Deaths under 1 year to 1000 Hirtlis. percentage to total deaths. deaths during the years: deaths during 1905 from Inquest Cases. Death* in Public Institutions. Uncertified Causes of Death. Principal Zymotic Diseases. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. ♦Fever. Diarrhoea. Tuberculous Disease. Violence. 1903. 1904. 1905. 1906. London 4,721,217 26.5 15.7 16.1 15.6 15.1 1.9 ... 0.41 0.11 0.15 0.26 00.6 0.94 2.0 0.6 131 9.8 38.2 019 Shoreditch § 115,130 33.6 19.6 20.6 19.8 19.8 3.1 ... 0.64 0.17 0.12 0.51 00.3 1.68 3.0 0.8 168 12.3 41.3 0.09 Wards. Moorfields 5,681 22.8 ... ... 14.4 13.9 2.0 ... 0.52 0.17 0.17 0.35 0.17 0.70 2.6 0.7 85 151 32.9 ... Church 19,923 33.5 ... ... 21.3 20.2 3.3 ... 0.90 0.10 0.10 0.50 ... 1.75 3.0 0.9 162 14.3 37.9 ... Hoxton 17,892 37.1 ... ... 21.3 19.6 3.3 ... 0.55 0.33 ... 0.60 ... 1.87 2.9 0.8 161 12.7 39.5 ... Wenlock §17,226 34.6 ... ... 17.7 19.5 3.5 ... 0.75 0.05 0.29 0.52 0.05 1.91 2.4 1.1 189 13.4 33.3 ... Whitmore 18,370 31.7 ... ... 24.1 24.7 3.5 ... 0.64 0.32 0.10 0.64 ... 1.83 3.9 0.9 203 12.1 53.9 ... Kingsland 11,188 37.8 ... ... 18.1 19.6 2.5 ... 0.44 0.17 0.09 0.44 ... 1.42 2.7 1.1 139 13.1 45.4 ... Haggerston 12,384 31.1 ... ... 16.8 16.7 2.3 ... 0.32 0.08 016 016 0.16 1.44 2.9 0.5 176 10.5 43.2 ... Acton 12,376 33.6 ... ... 16.7 18.9 3.1 ... 0.72 0.08 0.08 0.64 ... 1.60 2.9 0.4 158 6.8 35.7 ... * lever includes typhus, typhoid, and continued fevers. §The inhabitants of the Holborn Union Workhouse, which is situate in Wenlock Ward, and the deaths occurring in that institution are excluded. Note.—Where the deaths under any heading are too few to express as a rate per 1000 within two places of decimals, 0 00 is inserted; where no deaths have occurred, dots are placed in the space under the heading. 61 TABLE VIII. ANALYSIS ok the Cases Treated by the District Medical Officers of the Borough during the Year ending December 31st, 1906. Diseases. Diseases. All Causes 4,107 37 Atelectasis ... 38 Congenital malformations ... 39 Old age 149 I Small-pox ... 40 Apoplexy 3 2 Measles 98 41 Epilepsy 22 3 Scarlet fever 19 42 Convulsions 2 4 Typhus ... 43 Other diseases of brain and nervous system 254 5 Relapsing fever ... 6 Influenza 110 44 Diseases of organs of special sense 19 7 Whooping cough 32 8 Diphtheria 5 9 Simple, continued and illdefined fever 9 45 Diseases of circulatory system 185 46 Laryngitis 5 10 Enteric fever 3 11 Simple cholera ... 47 Bronchitis 913 12 Diarrhoea, dysentery 100 48 Pneumonia 61 13 Kemittent fever ... 49 Pleurisy 22 14 Hydrophobia ... 50 Other respiratory diseases 42 15 Glanders ... 51 Dentition 8 16 Cow pox and effects of vaccination ... 52 Quinzy, sore throat 41 53 Enteritis 48 17 Venereal affections 29 54 Peritonitis 3 18 Erysipelas 29 55 Diseases of liver 28 19 Pyaemia and septicemia 2 56 Other diseases of digestive system 302 20 Puerperal fever 1 21 Tabes mesenterica 2 22 Tuberculous meningitis 1 57 Diseases of lymphatic system and ductless glands 8 23 Phthisis 194 24 Scrofula, tuberculosis 12 25 Other zymotic diseases 16 58 Diseases of urinary system 30 26 Thrush ... 59 Diseases of generative system 27 27 Worms and other parasitic diseases 1 60 Accidents of childbirth 25 61 Diseases of locomotive system 206 28 Starvation, want of breast-milk 4 62 Diseases of integumentary 29 Alcoholism 14 system 131 63 Fracture and contusion 26 30 Rheumatic fever and rheumatism of heart 30 64 Gun shot wounds ... 65 Cut, stab 1 31 Rheumatism 296 66 Burns or scalds 5 32 Gout 94 67 Poison 4 33 Rickets 6 68 Drowning ... 34 Cancer 43 69 Suffocation ... 35 Other constitutional diseases 39 70 Otherwise 73 36 Premature birth 1 71 Other causes 274 62 PUBLIC HEALTH (LONDON) ACT, 1831. SUMMARY OF PROCEEDINGS DURING 1906. Table IX. PREMISES. NUMBER OF PLACES— Number of inspections, 1906. Number of notices, 1906. Number of prosecutions, 1906. On register at end of 1905. Added in 190G. Removed in 1906. On register at end of 1906. Milk premises 289 19 20 288 3651 7 1 Cowsheds 7 ... ... 7 20 ... ... Slaughter-houses 12 ... 3 9 42 ... ... Other offensive trade premises 1 ... ... 1 10 ... ... lee cream premises 72 7 10 69 113 14 ... Registered houses let in lodgings 283 20 37 266 418 49 2 Number of intimation notices served for all purposes 2403 Overcrowding:— Number of dwelling rooms overcrowded 117 Number remedied 117 Number of prosecutions 1 Number of premises dealt with under Section 20 of the London County Council (General powers) Act, 1891 103 Underground rooms:— Number dealt with during year 4 Insanitary houses:— Number closed under the Public Health (London) Act, 1891 ... 11 Shelter provided under sec. 60 (4) of the Public Health (London) Act, 1891:— Number of persons accommodated during the year Nil Customs and Inland Revenue Acts :— Number of houses for which applications were received during year Nil Number of prosecutions under By-laws under Public Health (London) Act, 1891:— With respect to water closets, earth closets, etc. 1 Mortuary:— Total number of bodies removed 405 Total number of infectious bodies removed 5 63 BOROUGH OF SHOREDITCH. Administration of the Factory and Workshop Act, 1901, in connection with FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—Inspection. Inspection made by Sanitary Inspectors. Number of Premises. Inspections. Written Notices. Prosecutions. (1) (2) (3) (4) Factories (Including Factory Lauodries.) 71 9 - Workshops (Including Workshop Laundries.) 3711 361 - Workplaces (Including Bakehouses and excluding Outworkers' premises dealt with in Table 3.) 623 107 - Total 4405 477 - 2.—Defects Found. Particulars. (1) Number of Defects. dumber of Trosecut.oriSt (5) Found. (2) Remedied (3) Referred to H.M. Inspector (4) Nuisances under the Public Health Acts:—* Want of cleanliness 470 470 — — Want of Ventilation 5 5 — — Overcrowding 4 4 — — Want of drainage of floors — — — — Other nuisances 39 39 — — Sanitary accommodation insufficient 2 2 — — unsuitable or defective 64 64 — — not separate for sexes.. 5 5 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) — — — — Breach of special sanitary requirements for bakehouses (Ss. 97 to 100) — — — — Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report.) — - - - Total 589 589 — — * Including those specified in Sections 2, 3, 7 and 8 ol the Factory and Workshop Act as remediable under the Public Health Acts. 64 3.—HOME WORK. Outworkers Lists, Section 107. Number of Inspections of Outworkers premises. Outwork in unwholesome premises, Section li8. Outwork in infected premises, Sec. 109 & 110. Nature of Work. Lists received from Employers. Number of Addresses of outworkers received from other Councils. Number of Addresses of outworkers forwarded to other Councils. Prosecutions. Instances. Notices servtd. Prosecutions. Instances. Orders Made (S. 1C9) Prosecutions (S. 109, 110). Failing t - keep or permit inspection of Lists- Failing to send lists. Twice in the year. Once in the year. Lists. Outworkers. Lists. Outworkers. (1) (2) 13) (1) (5) (6) (7) (8) (9) (10) (11) (12) (131 (14) (15) (16) Wearing Apparel, Making, &c. 20 462 16 168 1487 588 1317 69 69 — 54 — — Furniture and Upholstery — — 8 — - — 11 — — — — — — Fur Pulling — — — — 14 3 — — 9 — - — — — — Umbrellas — — — — 14 1 — — 24 — — — — — — Paper Bags and Boxes — — 25 346 389 123 — — 604 55 55 — 31 — — Brush Making — — — — 87 1 — — 69 4 4 — 1 — — Total 20 462 41 514 1999 716 — — 2034 128 128 — 86 — — (a) Names and addresses of outworkers were not received in respect to the following classes of work: Lace, lace curtains and nets, stuffed toys, file making, electro plate, cables and chains, anchors and grapnels, cart gear, locks, latches and keys. (b) The figures in columns 2 and 3 are the total number of lists received from employers who sent them both for February and gust, and of the entries of names of outworkers in those lists. They are, therefore, double the number of such employers, and approximately double the number of individual outworkers whose names are given since in the February and August lists of the same employers. The same outworker's name will oftentimes be repeated. (c) There were no prosecutions, but letters were sent to employers in 8 instances for failures to send lists of outworkers employed in making wearing apparel, etc., and in 25 instances for similar failures in connection with paper-bag and box making. 65 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. Number (1) (2) (l) Furniture, woodwork, fitting and other branches of the furniture trades .. 785 (a) Cabinet making 476 (b) French Polishing 80 (e) Upholstery 54 (d) Other workers 175 (2) Dress 213 (a) Tailoring 73 (e) Shirt making 8 (b) Mantles 9 (f) Boot & Shoe trades 62 (c) Dress 21 (g) Artificial Flowers 7 (d) Millinery 17 (h) Other workers 16 (3) Skin, leather, hair and feather trades 61 (a) Furriers 10 (b) Saddlery & Harness 22 (e) Feathers. 2 (d) Other workers 27 (4) Paper, printing, book, stationery and fancy goods trades:— 59 (a) Box & bag makers 42 (b) Other workers 17 (5) Laundry and Washing 33 (6) Food 7 (7) Metals, machines, implements and conveyances 56 (8) Precious metals, jewels, &c. 2 (9) Other trades than those mentioned above 62 Total number of workshops on Register 1278 Note.—A separate register is kept for bakehouses, the number of which at the end of the year was 73. 5.—OTHER MATTERS. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and WorkshoDS Act (s. 1331 Nil. Notified by H.M. Inspector 77 referring to 129 workshops Action taken in matters referred by H. M. Inspector as remediable under tha Public Health Acts, but not under the Factory and Workshop Act (s. 5). Reports (of action taken) sent to H.M. Inspector. 17 referring to 129 workshops Other 3 Underground Bakehouses (s. 101):— Certificates granted during the year In use at the end of the year Nil. 44