Soug 007 Southgate Urban District Council. REPORT OF THE Medical Officer of Health, FOR THE YEAR 1908, BY A. SIDNEY RANSOME, B.A., M.B., B.C., D.P.H., Cantab., Fellow of the Royal Institute of Public Health, Member of the Incorporated Society of Medical Officers of Health, MEDICAL OFFICER OF HEALTH. BARNET: E. Cowing & Son, Printers, "Press" Office. 1909. To the Members of the Southgate Urban District Council. Gentlemen, I have the honour to present to you my Report for the year 1908, to which is appended the Report of the Sanitary Inspector, Mr. J. W. H. Brown, which, as usual, constitutes an excellent record of good and useful sanitary work done by him and his assistants during the year, and to whom my thanks are due for valuable assistance in compiling this Report. I should also like to tender my thanks to the Health and Hospital Committee for their unfailing courtesy and support throughout the year. I am, Gentlemen, Your obedient Servant, A. SIDNEY RANSOME. February, 1909. 4 DESCRIPTION AND TOPOGRAPHY OF THE DISTRICT. THE Urban District of Southgate is formed by a number of hamlets, previously—and some of them even now —called " villages." It is partly situated on what is sometimes called the Northern Heights, about eight miles from London, and is rapidly becoming essentially suburban in character. The District comprises an area of 3,596 acres, and may be said to consist of three valleys, running from west to east, the northern areas being somewhat higher than the southern, and the whole consisting of very undulating ground dipping off to a rather flat area on the eastern boundary, adjoining the Edmonton district. The highest Ordnance level is on the Enfield Road, and is 302 feet; whilst the lowest is near the south-eastern boundary, and is 61 feet. The subsoil consists of various clays with large pockets of gravel and sand. On the south side is a bed of brick earth overlying a deep bed of gravel, which forms excellent building land, on which a building estate has recently been opened. Beneath these strata are beds of London clay, black sand, and chalk, more or less water-bearing, and from which the deep wells and borings of the New River Company derive their supply. The District may be roughly divided into four localities; (l) Southgate, (2) Winchmore Hill, (3) a large part of New Southgate and Bounds Green, and (4) Palmers Green and a large part of Bowes ; hitherto more of less distinct localities, but which, by continually and rapidly growing and extending, are gradually overlapping and becoming merged one into the other, more especially the two latter. The District is now, however, more conveniently dealt with in the two county divisions of North and South Southgate, the dividing line of which passes from the Edmonton boundary in Hedge Lane, along Hedge Lane, and up Bourne Hill to Chase Side Corner, Southgate. This is a more or less natural boundary line, with the major part of Southgate and Winchmore Hill, the more rural part of the District, on the north side of the line, and Palmers Green, Bowes Park, and New Southgate, the more urban part of the District, on the south side. For the purposes of local administration the District was in 1906 divided into four wards, which correspond roughly with the four localities above-mentioned, two wards, in North Southgate and two in South Southgate. 5 POPULATION. The census returns of 1901 showed that in this District the number of inhabitants to each occupied house averaged from 5.1 to 5.3, according to the locality. Taking this as the basis of calculation, the population at Midsummer, 1908, was 32,000, an increase of 3,500 over that of the previous year. This increase is chiefly accounted for by the number of new houses occupied during the year, of which there were 151 in North Southgate and 516 in South Southgate. The natural increase of the population by excess of births over deaths was 419, as against 388 in the previous year. The population of North Southgate was 10,300, and that of South Southgate was 21,700. BIRTH —BIRTH-RATE. During the year 659 births were registered, an increase of 54 over the preceding year. This gives a birth-rate of 20'6 per 1,000 of the population, a decrease of '6 per 1,000 on the preceding year. The average rate for the previous 10 years was 22.6. The birth-rate for North Southgate was 21.3, and that for South Southgate 20'2. The birth-rate in England and Wales was 26.5, which is 0'2 above the rate in 1907, which was the lowest rate on record ; compared with the average of the previous 10 years the birth-rate in 1908 showed a decrease of 1.6. MORTALITY. General Mortality and Death-rate.—The number of deaths which occurred in the District during the last year was 207. To these must be added the deaths of 41 "residents" who died in Institutions outside the district—12 in Edmonton Union; 5 in Napsbury Asylum; 5 in the Great Northern Hospital, Holloway; 3 in the Passmore Edwards' Hospital, Wood Green; and 16 in various London Hospitals and Institutions ; whilst the death of 8 " non-residents " who died in the District—4 in the Metropolitan Asylums Board Hospital, Winchmore Hill, and 2 in the Isolation Hospital, Palmers Green, and 2 elsewhere—must be subtracted, leaving a nett total of deaths belonging to the District of 240. 6 The crude or recorded death-rate was therefore 7.5 per 1,000 of the population. In order to obtain the corrected death-rate for the purposes of accurately comparing the death-rate with that of other Districts, it is necessary, in addition to the above corrections, to take into consideration the age and sex distribution of the population. The " factor for correction" for this District is 1.045. The corrected rate is obtained by multiplying the crude or recorded death-rate by this factor. The corrected death-rate was 7.8, a decrease of 1 per 1,000 on the rate of the preceding year, and 2'3 below the average corrected rate for the previous 10 years. This is the lowest death-rate on record for this District. As compared with the preceding year, there was a considerable increase in the rate of deaths from Phthisis, Cancer, Heart Diseases, and Scarlet Fever, and a slightly increased rate of deaths from Diphtheria, Infantile Diarrhoea, and Influenza ; but otherwise there was a general slight decrease. In the case of Scarlet Fever, besides the fact that the disease was very prevalent throughout the district all through the year, the type of the disease was decidedly more severe than has been the case of late years, many of the cases admitted into the Isolation Hospital being of a virulent nature; this accounts for the increased rate of mortality from this disease. As to the cause of the increased mortality from the other diseases enumerated above I am unable to give any reason. The death-rate in England and Wales was 14.7, which was 0'3 below the rate in 1907, and the lowest rate on record ; compared with the average rate of the previous 10 years the death-rate in 1908 showed a decrease of 1.7. Infantile Mortality. —There were 37 deaths of infants under 1 year of age, which gives an infantile death-rate of 56'1 per 1,000 births registered, as against 72'7 in the preceding year, 104.9 in 1906, and 77.7 in 1905. The average rate for the 10 years 1898-1907 was 97.4. This is by far the lowest infantile death-rate on record in this District, and is 16'6 below that of the previous year, which was the previous lowest rate on record for the District, and 41.3 below the average rate of the previous 10 years. This continually falling infantile death-rate is in itself very satisfactory, and although it is in part no doubt due to the constantly improving sanitation of the district, and to the fact 7 that the vary poor and ignorant form but a very small proportion of the population, which is chiefly a residential one, yet it must be borne in mind that the birth-rate is also steadily declining, and that there is, of course, a close relation between the two. In Table V. are set forth the causes of deaths of infants under one year of age, in weeks and months. The infantile death-rate of North Southgate was 59, and that of South Southgate 54.5. The infantile death-rate in England and Wales was 121 which is 3 per 1,000 above the rate in 1907, which was the lowest rate on record. Senile Mortality.—Among persons of 70 years of age and over, 61 deaths occurred, and of these 20 were 80 years of age and over. This is a proportion of 25 per cent, of the total number of deaths at all ages as against 25 per cent, in the preceding year, and 19 per cent. in 1906. The percentage of deaths of persons of 70 years of age and over in North Southgate was 30, and in South Southgate 22. Zymotic Mortality.—This includes the deaths from the seven principal zymotic diseases, viz. :—Smallpox, Scarlet Fever, Diphtheria, Typhoid Fever, Measler,Whooping Cough, and Diarrhoea. The rate affords useful evidence as to the general healthiness of the District, and as to the efficiency of its sanitary administration. There were 23 deaths from these diseases, as follows:—Diphtheria, 6; Scarlet Fever 6; Measles, 1 ; Whooping Cough, 2; and Diarrhoea, 8. The Zymotic death-rate was therefore 71 per 1,000 of the population, as against 63 in the preceding year, 1.8 in 1906 and •71 1905. The average rate for the 10 years, 1898 to 1907 was 1'2. The rate for North Southgate was 1.0, and that for South Southgate 59. The zymotic death-rate in England and Wales was 1.29. The Public Mortuary.—During the year 17 bodies were deposited in the Mortuary, as against 14 in the preceding year, and 12 in 1906. Inquests held during the year 1908 on Deaths occurring in the District. No. Month. Sex. Age. Condition of Life. Cause of Death. 1 January Male 20 .. Suffocation. 2 January Female 68 Widow.. Accidental. 3 March Male 14 — .. Natural Causes. 4 April Male 51 Builder Found Drowned. 5 May Male 13 months Infant Natural Causes. 6 June Male Newly-born — Found Drowned. 7 June Female Newly-born — Murder by some unknown person. 8 June Female Newly-born — Open Verdict. 9 June Female 76 Widow Natural Causes. 10 July Male 39 Bootmaker Suicide—temporary insanity. 11 July Male 55 Gardener Natural Causes. 12 August Male 43 Groundman Natural Causes. 13 August Male 53 Labourer Natural Causes. 14 October Male 8 months — Natural Causes. 15 October Male 52 Labourer Natural Causes. 16 October Male 75 Carpenter Natural Causes. 17 November Female 5 months .. Natural Causes. 9 TABLE I. Vital Statistics of Whole District daring 1908 and previous Tears. Year. Population estimated to Middle of each Year. Births. total deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Non-residents registered iu Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all aokb Belonginq to the District. Under 1 Year of Age. At all Ages. Number. Rate.* Number. Rate per 1,000 Births registered. Number. Rate.* Number. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1898 14,000 310 22.1 37 119 161 11.5 11 11 † 150 10.7 1899 14,500 366 25.2 51 140 192 13.2 10 10 .. 182 12.5 1900 15,000 320 21.3 38 118 153 10.2 2 2 .. 151 10.0 1901 15,200 375 24.6 35 93 140 9.2 6 6 8 142 9.3 1902 15,800 396 25.0 33 83 166 10.5 7 7 4 163 10 3 1903 17,000 367 21.5 32 87.1 142 8.3 3 3 7 146 8.5 1904 19,000 441 23.4 35 79.3 181 9.5 10 10 11 182 9.5 1905 22,400 463 20.6 36 77.7 162 7.2 13 13 29 178 7.9 1906 25,500 562 22.0 60 104.9 234 9.1 8 8 47 276 10.8 1907 28,500 605 21.2 44 72.7 187 6.5 8 8 38 217 7.6 Averages for years 1898-1907 18,690 420 22 6 40 97.4 171 9.5 7.8 7.8 •• 178 9.7 1908 32,000 659 20.6 37 561 199 6.2 12 6 41 240 7.5 * Rates in Columns 4, 8, and 13 calculated per 1,000 of estimated population . 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 or division. 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. 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 " to be 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 the next page. Area of District in acres (exclusive of area covered by water). 3,590 Total population at all ages 15,200 Number of inhabited houses 2,980 Average number of persons per house 5'1 j AtCeususof1901 t No returns received until 1901, and then only those relating to the Edmonton Union. Pull returns relating to all deaths of " residents " outside the District not received until 1905. I. II. III. Institutions within the District receiving sick and infirm persons from outside the District. Institutions outside the District receiving sick and infirm persons from the District. Other Institutious, the deaths in which have been distributed among the several localities in the District. Metropolitan Asylum Board Hospital, Winchmore Hill. Edmonton Union. Middlesex Asylum, Napsbury. Southgate Isolation Hospital. Great Northern Hospital, Holloway. Palmers Green Nursing Institute. Passmore Edwards Hospital, Wood Green. Etc. The Union Workhouse is outside the District. TABLE III. 11 Cases of Infectious Disease Notified during the Year 1908. Notifiable Disease. Cases Notified in the Whole District. Total Cases Notified in Each Locality. No. of Cases Removed to Hospital from Each Locality. At all Ages. At Ages—Years. North Southgate. South Southgate. North Southgate. South Southgate. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards Small-pox .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. Diphtheria 48 .. 13 29 2 4 .. 26 22 15 8 Membranous Croup .. .. .. .. .. .. .. .. .. .. .. Erysipelas 14 .. .. .. 1 13 .. 7 7 .. .. Scarlet Fever 185 2 48 105 17 13 .. 93 92 81 59 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. Continued Fever .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 1 .. .. .. .. 1 .. 1 .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. Totals 243 2 61 134 20 31 .. 127 121 96 67 Isolation Hospital—Tottenhall Road, Palmers Green (in the District), provided by the Southgate Urban District Council. TABLE 111a. Cases of Infectious Disease Notified each Month of the Year 1908. Notifiable Diseases. Smallpox. Scarlet Fever. Diphtheria. Typhoid Fever. | Puerperal Fever. Erysipelas. Totals. January .. 20 7 .. 1 2 30 February .. 35 4 .. .. 2 41 March .. 21 6 .. .. 2 29 April .. 24 4 .. .. .. 28 May .. 15 .. .. .. 2 17 June .. 17 3 .. .. 1 21 July .. 23 1 .. .. •• 24 August .. 7 4 .. .. 1 12 September .. 8 1 .. .. .. 9 October .. 6 1 .. .. 1 8 November .. 3 15 .. .. 1 19 December .. 6 2 .. .. 2 10 Totals .. 185 48 .. 1 14 248 12 TABLE IV. Causes of and Ages at Death during the Teak 1908. Causes of Death. Deaths at subjoined ages of " Residents" whether occurring in or beyond the District. Deaths at all ages of " Residents " belonging to localities whether occurring in or beyond the District. Total deaths whether of "Residents "or "Non-Residents" in Public Institutions in the District. All ages. Under 1 year. 1 and under 5. 5 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. North Southgate. South Southgate. Small Pox .. .. .. .. .. .. .. .. .. .. Measles 1 .. .. 1 .. .. .. .. 1 .. Scarlet Fever 6 .. 3 3 .. .. .. 4 2 9 Whooping Cough 2 1 1 .. .. .. .. .. 2 .. Diphtheria (including Membranous Croup) 6 .. 3 3 .. .. .. 4 2 3 Croup 1 .. 1 .. .. .. .. .. 1 .. Enteric Fever .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 6 .. 1 .. 1 3 1 2 4 .. Cholera .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. Diarrhea 8 6 2 .. .. .. .. 3 5 .. Enteritis 1 1 .. .. .. .. .. .. 1 .. Puerperal Fever 1 .. .. .. .. 1 .. 1 .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. Phthisis (Pulmonary Tuberculosis) 18 .. 1 .. 3 14 .. 6 12 .. Other Tuberculous Diseases 9 2 6 1 .. .. .. 1 8 .. Cancer (malignant disease) 31 .. .. 1 1 14 15 12 19 .. Bronchitis 9 2 1 1 .. 1 4 6 3 .. Pneumonia 12 2 3 1 2 2 2 7 5 .. Pleurisy .. .. .. .. .. .. .. .. .. .. Other Diseases of Respiratory Organs 1 .. .. .. .. 1 .. .. 1 .. Alcoholism—Cirrhosis of Liver 3 .. .. .. .. 3 .. 1 2 .. Venereal Diseases .. .. .. .. .. .. .. .. .. .. Premature Birth 7 7 .. .. .. .. .. 2 5 .. Diseases and Accidents of Parturition 2 2 .. .. .. .. .. 1 1 .. Heart Diseases 28 .. .. 1 .. 14 13 13 15 .. Accidents 4 .. .. .. 2 1 1 1 3 .. Suicides 2 .. .. .. .. 2 .. 1 1 .. Senile Decay 22 .. .. .. .. .. 22 7 15 .. Diseases of Nervous System, including Apoplexy and Convulsions 16 1 1 1 .. 6 7 8 8 .. Bright's Disease 4 .. .. .. .. 2 2 1 3 .. Wasting and Debility from Birth, including Developmental Defects 10 10 .. .. .. .. .. 2 8 .. All other causes 30 3 .. 3 2 17 5 6 24 .. All causes 240 37 23 16 11 81 72 89 151 12 N.B.—As to the meaning of " Residents " and " Non-Residents" and as to "Public Institutions to be taken into account for the purposes of this Table, see note on Table I. 14 TABLE IVa. Showing the Causes of Death during each of the Four Quarters of the Year, 1908. Cause of Death. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Measles 1 .. .. .. Scarlet Fever 3 2 1 .. Whooping Cough .. 1 1 .. Diphtheria and Croup 2 .. 2 3 Enteric Fever .. .. .. .. Influenza 3 1 1 1 Diarrhoea .. .. 5 3 Enteritis .. 1 .. .. Puerperal Fever 1 .. .. •• Erysipelas .. .. .. .. Other Septic Diseases .. .. .. .. Phthisis 5 5 4 4 Other Tubercular Diseases 4 2 2 1 Cancer 9 9 5 8 Bronchitis 5 1 .. 3 Pneumonia 3 2 1 1 Pleurisy .. .. .. .. Other Diseases of the Respiratory Organs .. .. .. 1 Alcoholism—Cirrhosis 1 .. .. 2 Premature Birth 1 2 1 3 Diseases & Accidents of Parturition .. 2 .. .. Heart Disease 8 8 6 6 Accidents 4 .. .. .. Suicides .. 1 .. 1 Senile Decay 12 2 2 6 Diseases of Nervous System, including Apoplexy and Convulsions 4 5 4 3 Bright's Disease .. .. .. 4 Wasting and Debility from Birth, including Developmental Defects 4 1 .. 5 All other Causes 5 8 7 10 All Causes 80 53 42 65 240 15 TABLE V. Infantile Mortality during the year 1907. Deaths from Stated Causes in Weeks and Months under One Year of Age. CAUSE OF 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—1C Months. 10—11 Months. 11—12 Months. Total Deaths under 1 Year. All Causes— Certified 13 3 3 .. 19 3 1 1 2 2 2 2 2 3 .. .. 37 Uncertified .. .. .. .. .. .. .. .. .. .. .. .. .. .. i. Common Infectious Diseases— Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria (including Membranous Croup) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. ii. Diarrhceal Diseases— Diarrhoea, all forms .. .. 1 .. 1 .. .. .. .. .. 1 2 1 1 .. .. 6 Enteritis, Muco-Enteritis, Gastro-Enteritis .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 Gastritis, Gastro-Intestinal Catarrh .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. iii. Wasting Diseases— Premature Birth 6 1 .. .. 7 .. .. .. .. .. .. .. .. .. .. .. 7 Congenital Defects 3 2 .. .. 5 .. .. 1 .. 1 .. .. .. .. .. .. 7 Injury at Birth.. 2 .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. 2 Want of Breast-milk,Starvat'n Atrophy, Debility, Marasmus 1 .. 1 .. 2 .. 1 .. .. .. .. .. .. .. .. .. 3 iv. Tuberculosis Diseases— Tuberculous Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tuberculous Peritonitis: Tubes Mesenterica .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 v. Other Causes— Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rickets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Convulsions .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 Bronchitis .. .. 1 .. 1 .. .. .. .. 1 .. .. .. .. .. .. 2 Laryngitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Pneumonia .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. 2 Suffocation, overlying .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Causes 1 .. .. .. 1 1 .. .. 1 .. .. .. .. .. .. .. 3 13 3 3 .. 19 3 1 1 2 2 2 2 2 3 .. .. 37 Population (estimated to the middle of 1908) 32,000 Births in the year legitimate 655 illegitimate 4 Deaths in the year of legitimate infants 37 illegitimate infants 0 Deaths from all causes at all ages 240 TABLE VI. Comparison op the Rates of the Southgate District with thosf. of England and Wales, the 76 Great Towns, and England and Wales less the 218 Largest Towns. Rates per 1,000 of the Population. Birth-rate. Death-rate (corrected). Deaths under 1 year per 1,000 Births. Zymotic Death-rate. Enteric Fever. Scarlet Fever. Diphtheria. Measles. Whooping Cough. Diarrhoea. England and Wales 26.5 14.7 121 1.29 0.07 0.08 0.15 0.22 0.27 0.50 76 Great Towns 27.0 15.8 128 1.59 0.08 0.10 0.16 0.31 0.29 0.65 England and Wale less 218 Largest Towns 26.2 13.8 110 0.99 0.07 006 015 0.13 0 25 0.33 Southgate District .. 20.6 7.8 58.1 0.71 0.00 0.18 0.18 0.03 0.06 0.25 1G 17 INFECTIOUS DISEASES AND THE MEANS TAKEN TO PREVENT THEIR SPREAD. It will be seen from Table III. that 248 cases of infectious diseases were notified during the year, as compared with 192 in the preceding year, 214 in 1906, and 122 in 1905. Of these, 185 ware Scarlet Fever, 48 Diphtheria, 1 Puerperal Fever, and 14 Erysipelas. Of these, 127 were notified from North Southgate, and 121 from South Southgate. These 248 cases represent infection in 183 houses, all of which were subsequently disinfected by the Sanitary Authority. In all cases disinfectants were supplied, instructions given as to the carrying out of isolation as efficiently as possible in cases of non-removal to the hospital, and the sanitary condition of the premises inspected. In 23 houses sanitary defects were found, consisting chiefly of defective water-closets and defective yard pavings. These defects have all been remedied under the supervision of the Sanitary Authority. The notification of these diseases was, therefore, the means of causing the inspection, apart from the ordinary inspections, of 183 premises, and the remedy of insanitary condition in 23. One hundred and sixty-three cases were removed to the Isolation Hospital at Palmers Green. Of these, 140 were Scarlet Fever and 23 Diphtheria. Four cases were removed to the Liverpool Road Hospital, Islington, and two cases to the Enfield Hospital. The Infectious Sickness Rate of the District was 7'7 per 1,000 of the population, as against 6'7 in the preceding year, 8'3 in 1906, and 5'4 in 1905. The rate for North Southgate was 12'3, and that for South Southgate was 5'5. This marked difference between the rates of North and South Southgate was not due to any epidemic in North Southgate, but to the fact that, in proportion to its population, both Scarlet Fever and Diphtheria were far more prevalent throughout most of the year than in South Southgate, as was the case in the preceding year also. There is no evidence to accouut for this, and I am unable to offer any satisfactory explanation. 18 Daring the year, 182 specimens were sent and reports received as follows : Diseases Suspected. Report. Total. Positive. Negative. Diphtheria 45 113 158 Typhoid Fever — 9 9 Phthisis 4 11 15 Total 49 133 182 Mathods of Disinfection.—(l) For disinfection of rooms, Formalin is used fa) by spraying and (b) with Paraform " tablets in the " Alformant " lamp. (2) Bedding, etc , is disinfected in the steam disinfecting apparatus established on the premises of the Isolation Hospital. For taking the bedding, etc., to and fro, special vans are kept, one for the infected and the other for the disinfected articles. (3) After rooms have been disinfected, the wall papers are stripped from the walls and burnt, and ceilings, walls, and all surfaces are thoroughly washed. Diagnosis Outfits.—The diagnosis outfits provided by the Council for the use of the medical practitioners in the District for sending morbid specimens from suspected cases of Diphtheria, Typhoid Fever, and Phthisis to St. George's Hospital for bacteriological examination and report have been made extensive use of, and continue to prove of great service in establishing a correct diagnosis in these diseases, to the advantage of the general public health, as well as of those more immediately concerned. 19 Diphtheria Antitoxin.—The supply of diphtheria antitoxin provided by the Council and kept available for use at anytime at the Council's Offices has been made full use of as occasion required, to the great advantage of those suffering from the disease and the public in general. Handbills Concerning Infectious Diseases. -Handbills giving instructions as to the danger of, and precautions to be taken to avoid spreading infection in, cases of Phthisis, Measles, and Whooping Cough—not being notifiable diseases —are always kept in readiness, and have been left at all houses where it came to my knowledge that these diseases were present; and, in the case of the two latter, have also been distributed to all other houses in the immediate neighbourhood. The necessary knowledge as to where the two latter diseases are present is supplied to me chiefly by the School Attendance Officers and the School Authorities. This system of notification of non-notifiable diseases by the School Attendance Officers and the School Authorities, instituted in 1898, continues to work as satisfactorily as can be expected. 5MALL-P0X. No cases were notified. With regard to the provision of accommodation for the effective isolation of cases of Small-pox, Southgate is one of the thirteen Councils comprised in the district of the Middlesex Joint Small-pox Hospital Board by which the Clare Hall Small-pox Hospital has been purchased for the use of the inhabitants of the constituent district. SCARLET FEVER. There were 185 cases notified from 130 houses, as against 148 in the preceding year, 85 in 1906, and 69 in 1905. Of these, 93 were notified from North Southgate, and 92 from South Southgate. In 18 houses sanitary defects were found. Six of the cases were ' imported," 17 were "secondary'' cases, occurring in 15 houses, from which previous cases had been notified ; and 23 were " return " cases from 13 houses, to which previous cases had returned directly or indirectly after discharge from the Isolation Hospital. One-hundred-and-forty cases were removed to the Isolation Hospital, and 4 cases to the Liverpool Road Hospital, Islington. 20 The disease was very prevalent, in common with many other parts of the Metropolitan area, during the first seven months of the year throughout the District, more especially in North Southgate, although at no time did it assume anything like an epidemic form. The type of the disease was more severe than has been the case for some years, and there were 6 deaths. DIPHTHERIA. There were 48 cases notified from 39 houses, as against 32 in the preceding year, 31 in 1906, and 23 in 1905. Of these, 26 were notified from North Southgate, and 22 from South Southgate. Three ware " secondary " cases occurring in 2 houses from which cases had previously been removed to the Isolation Hospital, and one was an " imported " case. In 5 houses sanitary defects were found. Twenty-three cases were removed to the Isolation Hospital, and 2 cases to the Enfield Hospital. There were 6 deaths. TYPHOID FEVER. No cases were notified. This is the first year on record in which no cases of Typhoid Fevei have been notified, although in the preceding year and in 1900 only one case was recorded. This is very satisfactory, and affords good evidence as to the efficiency of the general sanitation of the District. DIARRHCEA. This disease was again little in evidence, although rather more so than in the previous year, and was the cause of 8 deaths. This is a rate of -25 per 1,000 of the population, as against 14 in the preceding year, 10 in 1906, and 35 in 1905. TUBERCULOSIS. During the year there were 27 deaths from Tubercular diseases, 18 of these being from Phthisis. 21 In all cases of Phthisis that have come to my knowledge, leaflets have been left pointing out fully the nature and danger of the disease, and the means to be taken for the prevention of the spread of infection to others; and where rooms occupied by consumptive persons have been evacuated by death or otherwise, a visit has been paid by one of the sanitary officials, and an offer to disinfect, free of cost, by the Sanitary Authority has been made, and in most cases carried out. The provisions of the Public Health (Tuberculosis) Regulations, 1908, should prove of valuable assistance (1) in bringing to my knowledge the occurrence of Phthisis amongst those seeking Poor Law medical relief; and (2) in conferring upon you the power under certain conditions of taking all such measures with regard to the destruction and disinfection of infected articles, and the cleansing and disinfection of infected premises, as are authorised in any case of infectious disease. ISOLATION HOSPITAL. The Hospital is built on a site of nine acres of land situated in Tottenhall Road, Palmers Green. It is a fine open and airy site, admirably adapted for the purpose. Only a portion of the site is at present occupied by the Hospital premises, the remainder being let off in allotments. The Hospital premises are entirely closed by a close-boarded fence, and there is one entrance only, in Tottenhall Road. The Hospital was opened in January, 1902, and consists of (l) an administrative block for the Staff; (2) a ward block ; (3) an isolation block; (4) a laundry block with steam disinfecting apparatus and mortuary attached; and (5) an entrance lodge. The following amounts were sanctioned by the Local Government Board to be borrowed for the purpose of the Hospital: — (1) Purchase of land £2,500 (2) Fencing, draining, etc., of site, and building entrance lodge 1,600 (3) Erecting Hospital Buildings 8,400 (4) Furniture 600 £13,100 22 The ward block is used entirely for Scarlet Fever cases, and consists of two wards, one 36ft. by 26ft. and 13ft. in height, for women and children, and the other 26ft. by 24ft. and 13ft. in height, for men, with a nurses' duty room between them, arranged so that the nurse-in-charge can look through a small fixed window into each ward. The male ward vras designed to accommodate four beds and one cot, and the female ward six beds and one cot. But the air and floor space allowed was so ample that I find I can put up several extra beds and cots in each ward and still maintain sufficient air space. Lavatory and w.c. accommodation are provided at the ends of each ward, accessible from the ward only, but provided with a cross ventilation lobby. The wards are lighted and ventilated by large windows reaching to the ceiling on each side of the wards, and provided with fanlights which open inwards. Thorough cross ventilation is thus obtained. The wards are heated by special stoves in the centre of each, having downward flues carried under the floors to external chimney shafts attached to the building. The floors are of two kinds, that of one ward consisting of Terazzo, and the other of pitch-pine blocks. The walls are distempered with Duresco, with a dado of oil paint. There is also in this block a store cupboard for linen, bedding, etc., and a bath room, arranged with a door leading outside, enabling it to be used as a discharging room. The bath is a portable one, and mounted on rubber wheels. The nurses' duty room is fixed with a kitchen stove with hot water apparatus, a sink, small larder, large cupboard, kitchen dresser, medicine cupboard, and a telephone communicating with the administration block. The Isolation Block is used for Diphtheria and Typhoid Fever, and consists of two wards, or half a block ; the other half to be completed when more accommodation is required. Each ward is 24ft. by 18ft. and 13ft. in height, and accommodates three beds and a cot in each ward. A duty room similar to that of the ward block is provided between the wards. The sanitary accommodation is outside and separate from the block, but is under a verandah which runs along one side of the block. The doors of the wards and duty rooms open on to verandah only. These wards are heated by open regenerating grates, and lighted and ventilated by windows similar to those of the ward block. 23 All angles of walls, floors, ceilings, and woodwork in both blocks are constructed with rounded surfaces. The Administrative Block contains dispensary, Matron and Nurses' sitting room, store room, kitchen, scullery, coal store, and bedrooms for nine persons—the nursing staff and servants. The building is so designed that it can readily be enlarged to accommodate an increased staff. The Laundry Block is supplied with a high-pressure boiler, which supplies steam for boiling all water required in the Laundry. All steeping and washing of clothes is done in glazed stoneware troughs. A set of clothes-horses on runners are provided in a special chamber, heated with steam, for drying and airing clothes and linen when outdoor drying is unavailable. The same boiler also supplies steam for the steam disinfecting apparatus. Adjoining the Laundry is a Mortuary. The Entrance Lodge contains a parlour, kitchen-livingroom, with enclosed sink and bath, and one bedroom with usual accommodation, all under one roof and on the ground floor. The sanitary arrangements of the whole premises are perfect. Provision is made for thoroughly flushing all the foul-water drains, and special ventilating shafts have been erected. All refuse is either burned or disposed of on the enclosed area. The water supply passes through a meter on a bye-pass into a 4-in. main with 3-in. branches, and is provided with a 4-in. sluice valve which would be open to supply the three hydrants in case of fire. The Medical and Nursing Staff consist of Medical Superintendent (non-resident), Matron (nursing), two Staff Nurses, and one Probationer N urse ; and the Domestic Staff of Cook, Wardmaid, Laundrymaid, Housemaid, and Entrance Lodge Porter and his wife. The Medical Superintendent's residence is connected with the Hospital by telephone. The Porter's duties consist of looking after the Entrance Lodge, checking all entries and exits, and working the steam disinfector, etc. His spare time is spent in the gardens. 24 The Porter's wife assists, when required, in the Laundry etc. Visitors are allowed to visit patients on Sundays from two to four o'clock, but are only allowed to communicate with the patients through the windows. If any patient is dangerously ill, special arrangements are made. The name of every person entering or leaving the premises, and the time of entry and exit, are entered in a book at the porter's lodge. Patients from outside districts are admitted when there is sufficient accommodation for them ; the authorities of the Districts from which they come paying the Southgate Council for their maintenance. The cost of feeding staff and patients varies from 8d. to 1/3 per head per day, according to the number of patients in Hospital. During the past year 186 cases were admitted ; of these, 160 were Scarlet Fever, and 26 Diphtheria. Twenty of the Scarlet Fever and 3 of the Diphtheria cases were admitted from Friern Barnet. There were 5 deaths from Scarlet Fever, and 3 from Diphtheria. The average times of detention in Hospital, excluding 7 cases, which were transferred to the Stanmore Convalescent Home for Scarlet Fever at the end of 3 weeks, and the 8 cases which ended fatally, were:—For Scarlet Fever, 48 days ; and for Diphtheria, 44 days. There were 12 instances of so-called "return" cases, i.e., fresh cases occurring in houses within four or five weeks of the return of patients discharged from the Hospital. This is a proportion of 7.5 per cent. of the total number of admissions of scarlet fever cases. The average time of detention in Hospital of these patients giving rise to return cases was 50 days, which, it may be noted, is two days longer than the average of the total number of scarlet fever cases. The following table shows the average number of patients in Hospital for each month of the year, together with the smallest and greatest number in at one time in each month:— 25 Number of Patients in Isolation Hospital during each Month, 1908. ] Average number. Lowest number. Greatest number. Jan 21 18 25 Feb 33 24 41 Mar 35 24 40 April 26 24 31 May 21 13 25 June 18 12 23 July 24 21 28 Aug 24 21 28 Sept. 16 11 21 Oct 18 14 22 Nov 16 14 19 Dec 17 14 21 Average for year 22.3 17.5 27 As will be seen from the above table, the past year has been more than ever a busy one at the Hospital, and especially so during the first eight months, when the Hospital has had to accommodate a very considerable greater number of patients than it was originally designed for. The number of patients admitted during the past year was very considerably in excess of those of any previous year, as will be seen from the following table:— Year. Population. No. of Patients Admitted. Average daily No. of Patients. 1902 15,800 62 8.0 1903 17,000 101 12.0 1904 19,000 99 12.0 1905 22,400 71 9.1 1906 25,500 132 14.2 (including 11 from outside district) 1907 28,500 134 15.8 (including 8 from outside district) 1908 32,000 186 22.3 (including 23 trom outside district) It is during the last 3 years that the accommodation afforded by the existing buildings has been so strained. This has not been due to the occurrence of any epidemics, but to rapid increase in the population of the district, and was anticipated. The pressing need for the enlargement of the Hospital in consequence of this rapid increase of the 26 tion, which is continually going on, has been more than ever forced upon me during the past year; and I am glad to learn that the Council has decided to take steps to obtain the sanction of the Local Government Board for the necessary borrowing of the money required. MISCELLANEOUS. Return of the Metropolitan Asylums Board.—During the past year 6,121 cases were admitted into this Hospital, situated at Winchmore Hill; of these, 5,861 were Scarlet Fever, and 260 Diphtheria. There were 4 deaths from Scarlet Fever. Sewerage and Sewage Disposal.—The District is drained by the dual system. The surface-water sewers discharge at convenient points into the nearest watercourses, and as the fields adjoining the smaller courses becomc converted into building land, suitable sewers and culverts arc provided. Where possible and necessary the surface-water sewers are laid at such depths as will enable the subsoil under cellars and basements to be drained and connected thereto, thus ensuring dry dwellings, and avoiding any accumulations of stagnant water inside any dwelling-house. The main foul sewers traverse as much as possible the natural valleys, and run from the higher lands on the east towards the west, where they join up to the sewers of the Edmonton District at three points along the boundary between the Southgate and Edmonton Districts. At each of these points is a specially designed chamber, entirely constructed underground, for gauging the quantity of sewage that passes through. By the Edmonton Local Board Separation Act, 1881, by which Southgate became a separate district, the Edmonton District is required to receive, convey, and dispose of the sewage of Southgate, payment being made according to the quantity ascertained by a monthly system of gauging. After the separation from Edmonton it was found that the main sewers were in a very bad condition, and these have since been reconstructed upon the most improved principles. Only one length of sewer, apart from culverts, is now constructed of brickwork, that one being the southern main joining the Edmonton sewers. The sewers are laid principally in open trenches, but as their depth is in some cases as much as 25 feet below the surface, the driving of short tunnels as headings is occasionally resorted to. Pymmes Brook is crossed in several places by means of inverted syphons. These have been constructed 27 with iron pipes from special designs, which permit the smallest area of sewage being exposed in the manholes, and have worked satisfactorily. The sewers are also carried at several points under the New River, and recently the late New River Company insisted upon a special system being adopted, by which large cast-iron shield pipes are forced by means of powerful hydraulic jacks through the clay under the river, thus forming tunnels in which the sewer pipes are laid. In the case of new streets, not a pipe is permitted to be covered up until the work has been thoroughly inspected and the foul sewers tested with water. The pipes used have special joints, are made of the strongest stoneware clays, and laid upon a thick bed of cement concrete. In addition, they are laid to absolutely straight lines from point to point, and by means of manholes can be examined and seen through from end to end. At the head of every branch sewer means are provided by vertical shafts—lampholes and flushing chambers —through which thousands of gallons of clean water are systematically delivered in order to prevent any deposit within the sewers. There are upwards of 100 of these flushing chambers in the district. Fortunately, all the sewers in this district may be said to be self-cleansing, and within an hour or two of any foul matter being discharged into a drain or sewer it is delivered to the Edmonton Sewage Works. The sewers are ventilated by means of gratings over the manholes and by upcast shafts; but the gratings intended to be inlets for fresh air sometimes also discharge foul air, in consequence of which many of them have been closed in, and extra upcast shafts erected at points of vantage in their place. During the past sixteen years no drains of any house have been permitted to be connected to the sewers unless they have been provided with a chamber just within the boundary adjoining the street or road containing a trapped interceptor. Although the District is scattered over so large an area, there are very few houses which are not near a sewer, so that fortunately very few cesspools now exist, and they are becoming less every year. In the Districts there are now 41½ miles of foul sewers, and 37 miles of surface-water sewers, and no less than 34¾ miles of these have been constructed during the past 7 years. Sewers.—During the past year a total of 5,520 yards of sewers were laid as follows:— 28 New foul sewers Nil. New surface-water sewers 1,424 yards. New Estate Sewers. Foul sewers 1,768 ,, Surface-water sewers 2,328 ,, Water Supply.— Practically the whole District is now supplied by the Metropolitan Water Board. There are now only 10 wells left from which water is obtained for drinking. These are scattered about North Southgate. There was reason to analyse the water from 5 wells, 2 of which proved to be unsatisfactory, and were consequently closed. Watercourses.—Bounds Green Brook and Pymmes Brook remain in about the same condition. The periodical cleaning by the Middlesex County Council helps to keep them from getting very foul. House Refuse Collection. — Refuse and dust are collected from almost every house weekly, and taken to a shoot at Highfield Road. Rapid progress has been recently made with the Dust Destructor Works, and I am glad to report that the destructor may be expected to be in full working order early in the coming spring. Collection of Fish Offal. —Air-tight receptacles have been provided by the Council, in which fish offal is collected from the fish shops from one to three times a week, according to the weather and the quantity of fish consumed locally. It is then carted to a convenient shoot acquired by the Council for the purpose, and there disposed of. A small charge is made the fishmongers to cover the expenses. During the year 1,126 pails were collected, as against 919 in the preceding year. Roads.—In the District there are now over 44 miles of roads, made up as follows:— Miles. Yards. County Main Roads 4 1,356 Other Roads (repairable by the inhabitants at large) 28 1,708 Private Roads (repairable by the owners of property abutting on such Roads) 10 1,176 Total 44 720 29 The following roads were made up during the year:— College Road. Meadowcroft Road, Green Lanes. Windsor Road. „ ,, Wakefield Road. Nursery Road. Southgate. Hillside Grove. „ Housing of the Working Classes Act, 1890, — During the year one cottage in Church Hill, Winchmore Hill, and one in Hazelwood Lane, Palmers Green, were closed by the owner at my requests. The old insanitary cottages in the District are gradually becoming fewer in number, and I am glad to report that during the year a number of good-class cottages have been built by private enterprise. Public and Private Urinals. The Council has not provided public conveniences in the District. An inspection was made in 1906 of the whole of the sanitary conveniences attached to the various publichouses, with the result that many urinals have been rebuilt and put in a better sanitary condition. The Council also improved the lighting of a number of such urinals which are available for public use. This work was, however, done more as a temporary measure pending the time when public sanitary conveniences would be provided. The need of these in various parts of the District is being felt more and more each year. The Surveyor and Sanitary Inspector have reported on several positions in which public sanitary conveniences might advantageously be provided, and have also suggested the provision of those for both sexes in Broomfield Park, with access thereto from adjoining public highways. The question is under the consideration of both the Health and Park Committees. Dairies, Cowsheds, and Milkshops. —These have been inspected by the Sanitary Department. Veterinary Examination of Milch Cows. Correspondence has taken place between this Council and the Middlesex County Council in reference to the systematic veterinary examination of milch cows with a view to the discovery of any cases of tuberculous disease of the udder. 30 The Council have suggested that the County Council should endeavour to obtain concerted action in this matter by all local authorities in the county, and, failing this, that the work should be undertaken by the County Council. Bakehouses.—These have been inspected. Slaughter-houses.—There are eight slaughter-houses in the District. Several of these slaughter-houses, as mentioned in my last Annual Report, are in unsuitable positions owing to their close proximity to dwelling-houses. Frequent visits have been paid to them, and they have been kept in a satisfactory condition so far as cleanliness is concerned. 31 ANNUAL REPORT On the Administration of the Factory and Workshop Act, 1901, in connection with Factories, Workshops, Laundries, Workplaces and Homework. 1.—INSPECTION. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of In spections. Written Notices. Prosecutions. (1) (2) (3) (4) Factories (including Factory Laundries) 10 1 Workshops (including Workshop Laundries) 127 13 Workplaces (other than Outworkers' premiseS, included in Part 3 of this lteport) 16 — — Total 153 14 — 2.—DEFECTS FOUND. Particulars. Number of Dcfects. Found. Reme' died. lieferred toH.M. Inspector. Number of Prosecutions. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts :— Want of Cleanliness 15 15 — — Want of Ventilation 1 1 — Overcrowding 1 1 Want of Drainage of Floors 2 o — — Other Nuisances 3 3 — t Sanitary Accommodation Insufficient — — — Unsuitable or Defective 4 4 — — Notseparate for sexes.. — — — — 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 26 26 — — * Including those specified in Sections 2, 3, 7, and 8 of the Factory and Workshop Act as remediable under the Public Health Acts. † Section 22 of the Public Health Acts (Amendment) Act, 1890, was adopted in 1890. 32 3.—HOME WORK. Nature op Work. (1) Outworkers Lists, Sf.ction 107. Inspections of Outworkers premises. (12) Lists received from Employers. Addresses of Prosecutions. Twice in the year. Once in the year. Received from other Councils. (8) Forwarded to other Councils. (9) Failing to keep or permit inspection of lists. (10) Failing to send lists. (11) Lists. (2) Outworkers. Lists. (5) Outworkers. Contractors. (3) Workmen. (4) Contractors. (6) Workmen. (7) Wearing Apparel— (1) Making, &c. 7 2 28 •• •• 20 30 40 4.—REGISTERED WORKSHOPS. 5.—OTHER MATTERS. Workshops on the Register (s. 131) at the end of year. (1) Number. (2) Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories :— Failure to affix Abstract of the Factory and Workshop Act (s. 133) Workshop Bakehouses 16 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5) Notified by H.M. Inspector 1 Laundries 14 Reports (of action taken) sent to H.M, Inspector l Other Workshops 87 Other Underground Bakehouses (s. 101) :— Total number of workshops on Register | 117 Certificates granted during the year In use at the end of the year 33 COUNTY OF MIDDLESEX—SANITARY WORK, 1908. DISTRICT OF SOUTHGATE. 3 Inspections. Notices. Dwelling Houses. Houses Let in Lodgings (Tenement Houses). Common Lodging Houses. Canal Boats used as Dwellings. Movable Dwellings, Caravans, Tents, &c. Number of Premises inspected on Complaint. Number of Premises Inspected in connection with Infectious Diseases. Number of Premises under Periodical Inspection. Houses Inspected from House-toHouse. Total Number of Inspections and Re-inspections made. Cautionary or Intimation NoticesGiven. Statutory Orders Issued. Summonses Served. Convictions Obtained. Houses, Premises, &c , Cleansed, Repaired, &c. Closed as Unfit tor Habitation. (a) Ah result of action under H. W.C. Acts, (b) Othfrwi'. Re-opened after Repairs, Alterations, &c. Demolished. Illegal Underground Dwellings Vacated. Number Registered under Byelaws. Number of Contraventions. Number Registered under Byelaws. Number of Inspections made. Number of Contraventions. Number Registered under the Acts. Number of Contraventions of Regulations. Number Observed during the Year. Number of Nuisances therefrom abated. Number Removed from District. 74 191 174 142 3075 228 10 Nil. Nil. 129 2(b) Nil. Nil. Nil Nil. Nil. Nil. Nil. Nil. Nil. Nil. 158 6 158 * N.B.—(3) Includes all classes of premises under periodical supervision, such as Cowsheds, Dairies, Slaughterhouses, Workshops, and Workplaces, &c. (5) Includes all visits and re-visits made by Sanitary Inspectors in connection with 14i. 34 County of Middlesex.—Sanitary Work, 1908. District of Southgate. 24 Hakehouses. Slaughterhouses. Cow-sheds. Dairies and Milk-shops. j Unsound Food. Adulterated Food. Offensive Trade*. Water Supply and Water Service. Wells. Percentage of Houses supplied from Public Water Service. Cisterns. Percentage of Houses supplied on Constant System. .Number of Samples obtained for analysis (a) from Local We1ls, (&) from Public Supply. Number in District. Contraventions of Factory Acts. Number on Register. Number of Inspections. Contraventions of Byelaws. Number on Register. Number of Inspections. Contraventions of Regulations. Number of Milch Cows in District. Number on Register. Number of Inspections. Contraventions of Regulations. (a) Animals seized. (b) Aiticles or Parcels seized. Condemned by Magistrate (a & b). Articles or Parcels surrendered. Samples taken (if any) by the District Local Authority. Found Adulterated. Number of Premises in District. Number of Inspections made. Contraventions of Byelaws. New Sunk. Cleansed, Repaired, &c. Closed as Polluted. New, Provided. Cleansed, Repaired, Covered, &c. Draw-Taps placed on Mains. 16 4 8 45 1 12 57 1 about 200 21 83 Nil. Nil. Nil. 2 Cases of Fish. Nil. Nil. Nil. Nil. Nil. Nil. Nil. 2 Practically all. Nil. 1 13 Practically all. 6(a) 35 County of Middlesex.—Sanitary Work, 1908. District of Southgate. 35 Drainage and Sewerage of existing Buildings. Water Closets. Percentage of Houses provided with Water Closets. Drains. Cesspools. Disinfection. Dust. Sundry Nuisances Abated Number of Water Closets substituted for Dry Receptacles. Repaired, Supplied with Water, or otherwise Improved. Examined, Tested, Exposed, &c. Unstopped, Repaired, Trapped, &c. Waste Pipes, Rain Water Pipes Disconnected, Repaired, &c. New Soil Pipes or Ventilating Shafts repaired. Existing Soil Pipes or Ventilating Shafts Repaired. Disconnecting Traps or Chambers Inserted. Reconstructed. Rendered Impervious, Emptied, Cleansed, &c. Abolished, and Drain connected to Sewer. Percentage of Houses Draining into Sewers. Rooms Disinfected (a) ordinary infectious diseases, (£) Phthisss. Rooms Stripped and Cleansed. Articles Disinfected or Destroyed, (a) Ordinary infectious disease, (b) Phthisis. New Bins provided. How frequently is Dust Removed from each house? Number of Complaints of Non-Removal received. Methods of Disposal (a) Destructor. (6) by Tipping, (c) Other, state method. Overcrowding. Smoke. Accumulations of Refuse. Foul Ditches. Pouds,&c and Stagnant Water. Foul Pigs and other Animals. Dampness. Yards Paved or Repaired. Other Nuisances. Nil. 94 Practically all. 62 23 81 43 2 53 48 5 Nil. Practically all. 266 a 17 b 203 1166 a 62 b 67 Weekly. 17 b 3 4 5 6 6 3 73 24 J. W. H. BROWN, Sanitary Inspector.