THE VESTRY of the Parish of Saint George, HANOVER SQUARE. MEDICAL OFFICER'S REPORT for the YEAR ENDED 25th MARCH, 1885. JUNE 1885. LONDON: PRINTED BY PHIPPS & CONNOR, 13 & 14, TOTHILL STREET, WESTMINSTER. 1885. REPORT on THE SANITARY CONDITION of the Parish of St. George, Hanover Square, FOR THE YEAR 1884. by W. H.CORFIELD, M.A., M.D. (OXON.), F.R.C.P. (LOND.), Professor of Hygiene and Public Health in University College, London, Medical officer of health and public analyst. (BEING HIS THIRTEENTH ANNUAL REPORT.) To the Vestry of Parish of St. George, HANOVER SQUARE. My Lords and Gentlemen, During the year 1884 the healthy condition of the Parish has been attested by a very low death-rate, though, as I anticipated, not so low as the altogether exceptional one of 1883. 2 Table I. year. Gross Total of Deaths. Deaths in Public Institutions. Proportional Share of Deaths in Public Institutions. Corrected Total of Deaths (52 weeks). Corrected Death-rate per 1,000 per annum (52 weeks). 1874 (53 weeks) 1,694 345 355 1,679 18.56 1875 1,8.67 502 460 1,727 19.05 1876 1,868 573 362 1,675 18.20 1877 1,729 522 383 1,590 17.46 1878 2,007 741 392 1,658 18.17 1879 (53 weeks) 2,058 759 402 1,669 18.26 1880 1,855 713 347 1,489 16.64 1881 1,932 812 394 1,514 16.91 1882 1,867 730 361 1,498 16.73 1883 1,845 829 390 1,406 15.70 Average during ten years, 1874—1883 . 1,872 653 386 1,691 17.67 Year (53 weeks] 1884 . . . 1,873 769 384 1,460 16.30 Average during ten years, 1876—1884 . 1,890 695 388 1,669 17.34 As will be seen from Table I., the gross total of deaths registered in the Parish during the 53 weeks ending 3 Saturday, January 3rd, 1885, was 1,873, or only one more than the average gross total of deaths during the 10 years 1874 to 1883, of which 10 years 8 were years of 52 weeks. Of these deaths 769 (or 60 less than in 1883) occurred in the Public Institutions in the Parish, while our share, according to population, of the deaths occurring in all the Public Institutions in London was only 384. Our total of deaths, corrected for the deaths in Public Institutions and also corrected to 52 weeks, was 1,460, or 131 less than the annual average for the preceding 10 years. This corrected total is equivalent to a death-rate of only 16.30 per thousand per annum, the lowest death-rate yet recorded for the Parish, except that of 1883, and more than 1¼ per thousand lower than the average death-rate of the preceding 10 years. The average corrected death-rate during the 5 years 1880-84 inclusive has been only 16.456 per thousand per annum, so we may regard 16½ per thousand per annum as the present normal death-rate of the Parish. I have calculated the above death-rate in the same manner as during previous years, viz., by allotting to this Parish a share of the deaths in Public Institutions in London in proportion to the population of the Parish, but during 1884 we have, for the first time, been able to ascertain the actual number of Parishioners dying in the Public Institutions in London outside the Parish, and so we are able to ascertain the exact number of Parishioners who have died in Public Institutions; it is 377, viz., 282 in the Public Institutions in the Parish, and 95 in the other Public Institutions in London. As this number 377 is only 7 less than the number calculated according to population, I have thought it preferable this year to adhere to the latter number in my calculations, so that the results may be accurately comparable with those of previous years. Taking the actual number of deaths in Public Institutions instead 4 of the calculated number, the death-rate for the Parish would be 16.22 instead of 16.30 per thousand per annum. Of the 95 Parishioners who died in Public Institutions outside of the Parish, 19 were from Hanover Square SubDistrict; 11 from Mayfair; and 65 from Belgravia. Table Ia. Death-rates per 1,000 per annum. N.B.—Those for 1877-1880 have been recalculated on the Revised Estimates of Population. 1877. 1878. 1879. ]880. 1881. 1882. 1883. 1884. Twenty Large English Towns 23.7 24.2 23.2 22.7 21.7 *22.3 *21.6 *21.6 London 21.5 23.0 22.7 21.6 21.2 21.4 20.4 20.3 St. George's, Hanover Sq 17.46 18.17 18.25 16.04 16.91 16.73 15.70 16.30 * Twenty-eight towns. The death-rate of London proper, with an estimated population of 4,019,361, was 20.3, the lowest death-rate for London on record—that of 1883 having been 20.4— and being nearly one per thousand lower than any previously recorded rate. The death rate of Greater London (estimated population 5,093,995) was the same as that of 1883, viz., 19.7 per thousand per annum, being 17.5 in the Outer Ring, and, as before stated, 20.3 in London proper; or, when corrected for the deaths in the three Middlesex County Lunatic Asylums, 17.1 in the Outer Ring. As usual, the deathrate of this Parish was much lower than that of either of the 28 large English towns; the nearest to it were the following:— 5 Brighton 18.0 Bristol 8.4 Derby 8.4 Portsmouth 19.4 Birkenhead 19.6 Huddersfield 19.6 Bradford 20.1 London 20.3 The average death-rate of the 28 large English towns was 21.6, or 5.3 per thousand higher than the death-rate of this Parish. The highest death-rates among the large towns in England were those of Preston with 27.3, Manchester with 26'4, and Liverpool with 25.2. The average death-rate of 50 large town districts in England was 20.3, or exactly the same as that of London. Of these town districts only 5 had a lower death-rate than this Parish, viz.:— Barrow-in-Furness 12.5 Burton-on-Trent 15.1 Darlington 15.7 Hastings 15.9 Maidstone 16.2 The highest death-rate of these town districts was that of Wigan, which was 26.1. The death-rate of Glasgow was 26.9, being decidedly lower than in 1883, when it was 28.2, but still higher than it was in 1882, viz., 25.4. That of Dublin was also lower than in 1883, being 27.5, as against 29.2 in that year. Our death-rate compares even more favourably than in 1883 with the death-rates of foreign cities; the lowest 6 among these being Christiania 19.5, Baltimore 20.4, Philadelphia 20.6, and Brooklyn 21.8; and the highest, Madras 50.7, Alexandria 34.8, and Trieste 34.5. Table II. year. Registered Births. Birth.rate per 1,000 per annum (52 weeks). Deaths or Children under 1 Year. Total. Percentage to Registered Births. Percentage to Total Deaths (uncorrected). 1873 2,144 23.76 333 15.53 22.70 1874 (53 weeks) 2,200 24.59 333 14.69 19.57 1875 2,191 24.12 345 15.75 18.48 1876 8,174 23.88 328 15.09 17.56 1877 2,138 23.48 309 14.45 17.87 1878 2,172 23.85 309 13.04 15.40 1879 (53 weeks) 2,108 23.26 298 13.75 14.48 1880 2,140 23.91 310 14.49 10.71 1881 2,092 23.36 280 13.38 14.49 1888 1,935 21.61 271 14.01 14.52 1883 1,878 20.97 287 15.28 15.56 1884 (53 weeks) 1,933 21.18 259 13.40 13.83 From Table II. it will be seen that the corrected birthrate of the Parish was 2118, or a little over that in 1883. The birth-rate in London proper was 33.7, the lowest recorded since 1860. In Greater London the birth-rate was 33.9, and in the outer ring 349. The average birth-rate of the 28 large English towns was 34.6, or almost exactly the same as in 1883, the highest birth-rates being those of Sunderland 42.6, and 7 Cardiff 42.4; and the lowest those of Bradford 29.2, and Halifax and Huddersfield each 29.5. From the same table it will be seen that the total number of deaths under one year during the 53 weeks was 259, or considerably lower than the lowest number recorded in any previous year. The percentage of these deaths to the registered births was 13.40, being decidedly less than in either of the two preceding years, and the percentage of these deaths to the total deaths (uncorrected) was 13.83, or decidedly less than in either of the preceding 10 years. The mortality of children under 1 year was, therefore, 134 to 1,000 births, while in London it was 155; and the average for the 28 largest English towns was 168, the highest being Nottingham 196, Preston 222, and Leicester 226 deaths of children under 1 year of age per thousand births. The only one of the 28 largest towns which had a smaller number of deaths of infants under 1 year of age to a thousand births was Portsmouth, which had only 128; whereas in 1883 twelve of these towns had lower numbers than this Parish. Table III. year. A. Persons aged sixty years and upwards. B. Violence. B. Inquest Cases. D. Uncertified. Percentages to Gross Total of Deaths. A. B. C. D. 1874 445 76 93 26.95 4.60 5.6 1875 469 84 112 25.20 4.50 60 1876 455 108 148 24.36 6.78 7.9 1877 441 82 114 25.51 4.74 6.6 1878 558 91 123 27.83 4.53 6.1 1879 625 89 120 30.37 4.32 5.8 1880 531 97 126 28.63 5.23 6.8 1881 582 107 129 31 30.12 5.54 6.7 1.60 1882 525 80 102 29 28.12 4.29 5.5 1.55 1883 537 93 126 27 29.11 5.05 6.8 1.46 1884 543 106 132 31 28.99 5.66 7.0 1.66 London 1884 117,057 2,958 5,753 1,050 20.54 3.56 6.9 1.26 8 From Table III. it appears that the total number of deaths of persons aged 60 years and upwards was 543, or 28.99 per cent, of the total deaths, almost exactly the same as in 1883. The percentage of such deaths to the total deaths in London was 20.54, or, as usual, considerably less than in this Parish, showing that in this Parish a much larger proportion of persons attained an advanced age than in London generally; but if we consider the proportion of such deaths per thousand persons living, we find that it is only 60.62, while in London it is 66.5; and the lowest numbers among the 28 largest English towns are Plymouth 62.5, Norwich 62.7, and Portsmouth 62.4, the highest being Blackburn 89.1 and Manchester 90.4, and the average of these 28 towns 71-0. The total number of violent deaths during the 53 weeks was 106, or 5.66 per cent, of the total deaths, a rather higher percentage than any recorded since 1876, and, as usual, considerably higher than the percentage for London generally. This, as I have pointed out before, is due to the fact that part of the Serpentine is in the Parish, and that part of the Parish is on the bank of the river. The numbers of deaths uncertified as to cause were for Hanover Square 8, Mayfair 2, and Belgravia 21; total 31, or 1.66 per cent, of the total deaths, as against l.26 per cent, for London generally. 9 Table IV. SUB-DISTRICT. Population at middle of 1884. Births (53 weeks). Birth-rate (corrected, 52 weeks). Total Deaths (53 weeks). Deaths in Public Institutions. Share of Deaths in Public Institutions of London. Correction for Deaths in Public Institutions. Deaths (corrected, 52 weeks). Death-rate (corrected, 52 weeks). Hanover Square . 16,862 283 1646 222 0 45 + 45 262 15.54 Mayfair 13,491 209 15.20 428 345 88 - 257 168 12.44 Belgravia. 59,220 . 1,441 23.87 1,223 424 251 - 173 1,030 17.40 Whole Parish. 89,573 1,933 21.18 1,873 769 384 - 385 1,460 16.30 10 TABLE IVA. BIRTH.RATES. DEATH.RATES. 1875. 1876. 1877. 1878. 1879. 1880. 1881. 1882. 1883. 1884. 1875. 1876. 1877. 1878. 1879. 1880. 1881. 1882. 1883. 1884. Hanover Sq. 20.55 17.97 18.86 19.81 19.05 19.45 17.85 17.26 17.08 16.46 18.36 17.97 16.58 17.07 19.05 16.90 17.44 15.84 14.65 15.54 Mayfair. 16.54 21 53 19.45 21.49 19.49 20.84 19.12 16.83 16.61 15.20 13.40 13.06 13.04 13.26 13.59 12.39 11.79 11.87 11.34 12.44 Belgravia. 26.93 26.27 25.76 25.50 25.32 25.87 25.80 23.03 23.07 23.87 20.52 19.46 18.70 19.57 19.01 17.53 17 92 18.00 16.99 17.40 Whole Parish 34.12 23.88 23.48 23.85 23.26 23.91 23.36 21.61 20.07 21.18 19.05 18.20 17.46 18.17 18.25 16.64 16.91 16.73 15.70 16.30 11 Turning to Tables IV. and IVa. we find that the corrected birth-rates were all, as usual, very low, those of the Hanover Square and Mayfair Sub-Districts being the lowest yet recorded, while that of the Belgravia Sub-District was higher than that for 1883, but lower than that of any previous year, the same being the case for the birth-rate of the whole Parish; and that the corrected death-rates are also very low, those of Hanover Square and Belgravia being lower than those of any previous year except 1883, and the same being the case with the death-rate of the whole Parish, while that of Mayfair is rather higher than it has been since 1879. As usual, both the birth-rate and death-rate of Mayfair are decidedly lower than those of either of the other two Sub-Districts, those of Belgravia being the highest. From the birth-rates and death-rates in Table IVa., I have calculated the mean duration of life in the Parish and in each of the Sub-Districts during the year 1884, and found them as follows:— Mean Duration of Life. Hanover Square Sub-District - 62.92 years. May fair 72.70 „ Belgravia 49.02 „ Whole Parish 53.78 „ The mean duration of life in this Parish during the last 10 years has been as follows:— In 1875 it was 46.67 years „ 1876 „ 47.96 „ 1877 „ 49.52 , „ 1878 „ 48.03 „ 12 In 1879 it was 48.55 years. „ 1880 „ 58.01 „ „ 1881 „ 50.26 „ „ 1882 „ 52.56 „ „ 1883 „ 55.09 „ „ 1884 „ 53.78 „ So that the mean duration of life in this Parish during those 10 years has averaged just over 51 years. The mean duration of life in London during the last 7 years has been, according to my calculations, as follows:— In 1878 it was 34.24 years. „ 1879 „ 34.23 „ „ 1880 „ 35.17 „ „ 1881 „ 35.87 „ „ 1882 „ 36.82 „ „ 1883 „ 37.88 „ „ 1884 „ 38.08 „ So that the mean duration of life in this Parish has been increased by more than 7 years since 1875, and that in London by more than 3 4/5 years since 1879. From Table V. it appears that the total number of deaths from the principal infectious diseases and diarrhoea in the 53 weeks of 1884 was 185, or a higher actual number than in any year since 1875, although the numbers for 1878 and 1880, 183 and 182 respectively, being only for 52 weeks, really represent a higher number of deaths in the same time. The 185 deaths are equal to 2 06 per thousand persons living, while the rate for London was 3.34, and that for the 28 largest towns 3.50. Of these towns, 8 had a lower rate than this Parish, the lowest being Brighton with 1.72. The other 20 towns had higher rates than ours, the 13 Table V. Showing the number of Deaths in each of the ten years, 1874 to 1883, from the principal infectious Diseases and Diarrhoea, and the number in 1884. DISEASE. 1874. 1875. 1876. 1877. 1878. 1879. 1880. 1881. 1882. 1888. Annual Average of ten years, 1874—1883. Proportion of Deaths to 1,000 Deaths in ten years, 1874—1883. 1884. Proportion of Deaths to 1,000 Deaths in 1884. Small.pox 0 0 2 12 5 0 0 9 1 0 2.9 1.5 2 1.1 Measles 17 30 21 30 11 34 16 21 30 13 22.3 11.9 40 21.3 Scarlet Fever 32 40 22 19 9 36 40 18 13 11 240 12.8 7 3.7 Diphtheria 2 16 3 9 4 14 18 14 15 27 12.2 6.5 25 13.3 Whooping Cough 22 42 45 19 64 33 50 15 63 21 37.4 20.0 43 22.9 Typhus Fever 2 4 2 1 3 0 0 1 0.6 Enteric (or Typhoid) Fever 28 37 33 17 24 12 15 20 21 211 26.0 13.9 22 11.7 Simple Continued Fever 6 4 2 2 1 0 8 1 0.5 Diarrhoea 61 60 47 35 54 32 39 33 34 27 42.2 22.6 44 23.4 Cholera 2 2 1 2 4 1 1 2 2 1 1.8 1.0 0 0.0 Total 161 227 174 151 183 166 182 136 179 129 168.8 90.2 185 98.4 14 highest being Preston with 5.16, or exactly 2½ times the zymotic death-rate of this Parish. The unusually high number of deaths from zymotic diseases in this Parish during 1884 was due to the epidemics of Measles and Whooping Cough; diseases over which the Sanitary Authority has but little control, although we were able to put a stop to a wide-spread epidemic of Measles in Belgravia, by obtaining the closing of certain of the Infants' Schools for three weeks. To consider these diseases separately:— Small Pox caused 2 deaths in the Parish, one of which was that of a non-parishioner, and there were 4 deaths of Parishioners from this disease in Public Institutions outside of the Parish, and also 1 from Pneumonia after Small Pox. Measles caused no less than 40 deaths during the 53 weeks, a higher number than that recorded in either of the previous 10 years and nearly double the annual average. It will be observed that this increase in the number of deaths from Measles followed a year in which the number of deaths from this disease was remarkably small. Scarlet Fever caused only 7 deaths, a smaller number than that recorded in either of the preceding 10 years, and less than a third of the annual average. One of these deaths was that of a non-Parishioner, while, on the other hand, a death of a Parishioner occurred from this disease in one of the Public Institutions outside of the Parish. (One of the deaths from Scarlet Fever was registered as from "Brain Fever ") Diphtheria caused 25 deaths, or 2 less tnan in 1883, but still more than twice the annual average for the preceding 10 years. Of these 25 deaths however, no less than 12 were those of non-Parishioners in St. George's Hospital, and only one death of a Parishioner occurred in a Public Institution outside of the Parish. Diphtheria was (as in 15 1883) very prevalent in London generally, and caused 339 deaths above the annual average for the preceding 10 years. Whooping Cough caused 43 deaths, or just over twice as many as in 1883, but only a little over the annual average for the preceding 10 years. It will be noticed that the large number of deaths from this disease in 1884 followed a small number in 1883, just as the larger number in 1882 followed a still smaller number in 1881. Typhus Fever.—One death was registered as being from this disease, but it was that of a doubtful case, and was probably in reality from Puerperal Fever. Enteric (Typhoid) Fever.—Twenty-two deaths were registered as from this disease, against 20 in 1881 and 21 in each of the years 1882 and 1883, so that the number of deaths from this disease has been remarkably steady during the last 4 years. Of these 22 deaths, however, 6 were those of non-Parishioners in St. George's Hospital, and one was that of a case known to have been imported into the Parish. One of the deaths registered as from Whooping Cough would have been better registered as from Enteric Fever, as this disease followed the Whooping Cough, and really caused the death of the patient. There were also 2 deaths from Enteric Fever, in Public Institutions outside of the Parish, of persons removed from this Parish, but one of these was that of a case known to have been imported into the Parish. Simple Continued. Fever.—Only one death was registered in the Parish from this disease during the year 1884, while there were 8 in 1883, so that if we take Enteric and Simple Continued Fever together there were 23 deaths from these two diseases in 1884 as against 29 in 1883, but it must be noted that 4 of the deaths registered as from Simple Continued Fever in 1883 were " merely cases of disease accompanied by fever." 16 Diarrhœa.—No less than 44 deaths were registered from this disease in 1884, being a larger number than any recorded since 1878, but still only a little above the annual average. No death from English Cholera or Choleraic Diarrhoea was registered. Small Pox in London. The number of deaths from Small Pox in London, which had been 2,371 in 1881, 431 in 1882, and 134 in 1883, rose to 913 in the 53 weeks of 1884. Sanitary Work. For the Tear ending March 31st, 1885. The following Table has been compiled for me by Mr. Joseph Snook, your Sanitary Inspector, from the Report Book:— Table VI. Various kinds of Complaints of Nuisances, &c., from April lst, 1884, to March 31st, 1885. Total number of Complaints 619 Notices served 112 Houses and premises limewhited 63 Houses disinfected after infectious diseases 114 Old brick drains abolished, and glazed stoneware pipes substituted 29 New drains constructed 17 Drains unstopped and repaired 72 Drains trapped and ventilated, sinks disconnected, &c. 73 Closets supplied with water and repaired . 27 Closets unstopped 63 Roofs repaired 1 17 New dust bins provided 8 Dust bins renewed, repaired, new covers, &c. 12 Cisterns repaired, new covers, &c. 31 New cisterns provided 10 Waste pipes disconnected 54 Removal of animals improperly kept (cases of) 5 Meat, fish, &c., condemned (cases of) 4 Overcrowding abated 3 Cesspools abolished 11 Accumulation of dung, straw, &c., removed 21 Various nuisances removed 60 No cause for complaint 41 Legal proceedings taken 1 Cases could not assist 8 Cases referred to Surveyor 21 Cases referred to Police 4 Licensed cow-houses 4 Licensed slaughter-houses 7 Cases removed to Hospitals 109 Inspection of houses after cases of infectious diseases, viz.— Typhoid and low fever . 16 Typhus fever (doubtful) 1 Scarlet fever 64 Small-pox 74 Diphtheria 22 The articles disinfected in the hot-air disinfecting chamber belonging to the Parish were as follows:— 104 Beds 136 Mattresses 50 Palliasses 142 Quilts 260 Blankets 44 Waistcoats 35 Trousers 85 Carpets 40 Hearth-rugs 7 6 Curtains 18 221 Sheets 125 Bolsters 198 Pillows 40 Dresses 35 Shawls 77 Coats 100 Towels 65 Cushions 35 Table Covers 38 Rugs 40 Suits of Clothing And a quantity of sundry articles. The total number of complaints attended to and of notices served was rather less than in 1883, having been 619, as compared with 678 in that year. The only case in which it was necessary to take legal proceedings was that of 4 houses in Ranelagh Grove, where the owner failed to carry out the necessary sanitary improvements. He was condemned to pay 23s. costs and to carry out the works required within 14 days, which was done to my satisfaction. The markets have been regularly inspected and kept in good order, so that it has only been nesessary to condemn food exposed for sale in 4 cases. The slaughter-houses and cow-sheds have been also regularly inspected and kept in good condition. No application for a license has been opposed, but licenses were not applied for in the cases of 2 slaughter-houses, viz.:—those at 48, South Audley Street (Messrs. Scarlett & Co.), and 42, North Audley Street (.Mr. Charles May). The number of articles, clothing, bedding, &c., disinfected has been much higher than in 1883 on account of the epidemic of Small Pox, and the new disinfecting apparatus has been found to work quite satisfactorily. The President of the Local Government Board having directed that the 35th section of the Sanitary Act, 1866, and the 47th section of the Sanitary Laws Amendment Act, 1874, should be put in force throughout the Metropolis, and 19 the Local Government Board having issued Model Regulations for the guidance of the Vestries in preparing Byelaws for the regulation of houses let in lodgings, the Vestry instructed me to prepare a code of Bye-laws on the subject and appointed a Committee, with Sir Arthur (now Lord) Hobhouse as Chairman, to consider them. The Committee held several meetings, including an interview with a representative of the Local Government Board, and ultimately the following Regulations were agreed to and confirmed by the Local Government Board. Lodging-House Regulations. Made by the Vestry of the Praish of St. George, Hanover Square, and confirmed by the Local Government Board, for Houses in the said Parish which are Let in Lodgings or occupied by members of more than one family, Id Pursuance of the Statutes 29 & 30 Vie., Cap. 90, Sec. 35, and 37 & 38 Vic., Cap. 89, Sec. 47. 24th February, 1885. PART I. General. 1.—Definitions. "Owner" means the person receiving the rent of a house let in lodgings, whether on his own account, or as agent or trustee for some other person. "Keeper" means the person (whatever may be the nature or extent of his interest in the premises) by whom or on whose behalf a house or part of a house is let in lodgings or for occupation by members of more than one family, or who for the time being receives, or is entitled to receive, the profits arising from such letting. "Lodging-house" means a house or part of a house 20 which is let in lodgings or occupied by members of more than one family. "Medical Officer" means the Medical Officer of Health acting on behalf and under the authority of the Vestry of the aforesaid Parish. "Inspector" means any person appointed by the said Vestry for the purpose of the above-mentioned enactments and of these Regulations. 2.— Every owner, keeper, and occupant of a lodginghouse, or of any part thereof, shall be bound, so far as his power or interest goes, to admit the Medical Officer or the Inspector, and to afford him all facilities for inspecting such house or part thereof at any hour between 9 a.m. and 6 p.m. 3.—Every owner and keeper of a lodging-house, if served with a notice in writing, signed by the Vestry Clerk, requiring him to supply the information necessary for the registration of such house, shall be bound within a period of fourteen days after such service to attend, either personally or by his agent duly authorised, at the Office of the Vestry during office hours, and then and there to furnish and sign a true statement of— (a) The total number of rooms in such house. (b) The manner in which each room is used. (c) Such other particulars within his knowledge as the Vestry may require for the registration of of suih house. 4.—The Vestry may cause any lodging-house to be entered in a register to be kept in their office for that purpose. They may also, for due cause, remove a house from the register. So long as a house remains on the register it shall be a registered lodging-house, and shall be subject to the regulations hereinafter made applicable to registered lodging houses. 21 PART II. Regulations for Registered Lodging-Houses. 5.—No keeper or lodger shall permit a room in a registered lodging-house used exclusively for sleeping to be occupied by any number of persons greater than will afford a space of 300 cubic feet for each person. 6.—No keeper or lodger shall permit a room in a registered lodging-house used both for sleeping and for other general purposes of life to be occupied by any number of persons greater than will afford a space of 350 cubic feet for each person. 7.—Two children under 10 years of age shall be reckoned as one person. 8.—Every keeper of and lodger in a registered lodginghouse shall admit the Medical Officer or the Inspector to examine his premises, and shall afford all facilities for such examination at all times between 8 a.m. and 9 p.m., and also at all other times, except that the Inspector shall not be entitled to demand admission at such other times without a written authority signed by the Medical Officer. 9.—The owner af a registered lodging house shall provide sufficient drainage, water-closets at the rate of at least one for every 12 lodgers, sufficient means of ventilation, sufficient water supply, and a covered dust box or bin, and shall cause the waste-pipes of sinks and overflow-pipes of cisterns to be disconnected from the drains, the gullies to be properly trapped, the soil pipes to be ventilated, and the yard to be properly paved. 10.—The keeper of a registered lodging-house shall cause the walls and ceilings of every room, and of the staircase, water closets, and passages, and the walls of the yards, to be thoroughly cleansed or limewhited, at least once every year, in the month of March or April. 22 11.—The keeper of a registered lodging-house shall, except as hereinafter provided, cause the floors, passages, and stairs of the house, together with the ash-pits, waterclosets, yards, and premises, to be kept at all times in a cleanly and wholesome state. Provided always that in every case where a lodger in a lodging-house is entitled to the exclusive use of any floor, passage, staircase, ash-pit, water-closet, or yard, such lodger shall cause such floor, passage, staircase, ash-pit, watercloset, or yard to be kept at all times in a cleanly and whole some condition. 12.—The keeper of a registered longing-house, or any part thereof, shall, as soon as he is aware that any person in the premises of which he is keeper, and any lodger in such house shall as soon as he is aware that any person in any room which has been let to such lodger, is suffering from Small-Pox, Scarlet Fever, Scarlatina, Measles, Diphtheria, Whooping Cough, Typhus, Relapsing, Enteric or Typhoid, Gastric, Low or Simple Continued Fever, or Cholera, or any other dangerously infectious or contagious disease, give immediate notice to the Clerk of the Yestry at the Yestry Offices. PART III. 13.—Every person who offends against any of these Regulations shall be liable to a penalty not exceeding 20s. for each offence, with an additional penalty not exceeding 10s. for every day during which his default shall continue; and every person who offends a second time, or who offends after written notice from the Medical Officer of Health warning him against such offence, shall be liable to a penalty not exceeding 40s. for each offence, with an additional 23 penalty not exceeding 20s. for every day during which his default shall continue. Seal affixed by order of the Vestry, 19th February, 1885. J. H. Smith, Vestry Clerk. Seal of the Vestry of St.George, Hanover Square. Confirmed by the Local Government Board, this Twenty-fourth day of February, 1885. Hugh Owen, Charles W. Dilke, Secretary. President. Seal of the L oal Government Board. Cholera. In view of the prevalence of Cholera in Egypt and some parts of Europe, I considered it desirable, as stated in my last Report, to obtain the promise of a site for a temporary Cholera Hospital in the Parish, and the Duke of "Westminster kindly gave permission for the use for this purpose of a piece of land near the river. Up to the present time, however, this has fortunately not been required. I also prepared, at the request of the Committee of Works, a circular, which it has not yet been considered necessary to issue, but the following notice has been sent to every house in the Parish:— Notice. To prevent Summer Diarrhœa and Cholera. Keep cisterns clean. See that the overflow pipes of cisterns discharge into the open air. Have no bell-traps in your houses. 24 Flush closets and drains well, and keep them clean. Burn animal and vegetable refuse—do not put it in the dust-bin. Avoid eating unripe or over-ripe fruit. In this connection I may mention that a very large number of bell-traps have been removed from the yards and basements of houses, and stoneware siphon-gullies fixed in their stead. A complaint having been brought before the notice of the Committee of the nuisance occasioned by the manner of collecting and removing organic refuse matters from the larger houses in the Parish, I drew up, by direction of the Committee of Works, the following circular, which was, by their orders, sent to a large number of houses in the Parish:— Hog-wash. The present method of storing and collecting the organic refuse matters from the kitchens and sculleries of the larger houses in this Parish, and generally throughout London, by means of uncovered wooden tubs and open carts is very objectionable; especially as these refuse matters are allowed to accumulate for several days before being removed, and so —especially in hot weather—become extremely offensive. These matters should be collected in covered galvanised iron pails with handles. The contents of the pails should be removed daily, between the hours of 6 and 8 o'clock in the morning; the pail being carried from the house to the conveyance outside with its lid on, and emptied into the receptacle in the conveyance, which should also be covered. But a better plan still would be, if it be found practicable, for each house to have two pails; the one to be taken away full, and the clean one to be left in its place, as then the pails would not require to be emptied either in the house or in the street. 25 Table VII. Showing the results of the Analyses of the Water supplied by the Grand Junction and Chelsea Water Companies. Grand Junction Company's Water. month. Parts per 100,000. Parts per 100 Millions. Total Solid Residue. Chlorine Common Salt. Saline Ammonia. Organic Ammonia. April 1884 32.5 1.6 2.6 2.7 8.6 May „ 28.0 1.6 2.6 2.4 10.0 June „ 31.6 1.6 2.6 2.1 9.8 July „ 39.0 1.6 2.6 2.9 6.4 August „ 28.2 1.6 2.6 2.7 11.8 September „ 30.2 1.6 2.6 3.2 13.6 October „ 31.2 1.6 2.6 1.8 7.4 November „ 31.0 1.6 2.6 0.8 11.6 December „ 41.0 2.0 3.3 1.8 11.0 January 1885 36.0 1.8 3.0 2.1 16.0 February „ 32.0 1.8 3.0 2.7 15.0 March „ 36.0 2.0 3.3 2.8 13.6 Average . 33.1 1.7 2.8 2.3 11.2 Chelsea Company's Water. April 1884 32.0 1.6 2.6 0.8 8.6 May „ 28.0 1.6 2.6 2.1 8.2 June „ 25.5 1.6 2.6 2.7 9.6 July „ 27.0 1.6 2.6 2.1 6.6 August „ 31.0 1.6 2.6 1.9 12.6 September „ 27.6 1.6 2.6 2.1 14.0 October „ 27.6 1.6 2.6 1.9 8.2 November „ 29.0 1.6 2.6 1.3 11.0 December „ 36.0 1.8 3.0 2.1 9.8 January 1885 40.0 1.8 3.0 1.6 9.0 February „ 26.0 1.8 3.0 1.3 10.2 March „ 34.0 2.0 3.3 1.8 12.0 Average . . 30.3 1.7 2.8 1-8 10-0 Table VII. shows the results of my analyses of the water supplied by the two Companies in the Parish during each of the twelve months. In both cases the average quality was decidedly inferior to that of the preceding year. The London Gas Light Company being now under the control of the Board of Trade, the duty of the Vestry with 26 regard to the gas supply has ceased, and I have accordingly discontinued my testings. For the information of the Parishioners, I may mention that a hospital carriage for removing persons suffering from infectious diseases is kept at the Workhouse in Wallis's Yard, Buckingham Palace Road, and that the Ambulance belonging to the Metropolitan Asylums Board is kept at Seagrave Road, Fulham; but those who are in a position to bear the expenses of their support should apply to the London Fever Hospital, Liverpool Road, Islington; or, in case of small-pox, at the Highgate Small-pox Hospital, where they can be accommodated on favourable terms. I have the honour to be, My Lords and Gentlemen, Your obedient Servant, W. H. CORFIELD, M.A., M.D. (Oxon.), F.R.C.P. (London). 10, Bolton Row, Mayfair, W., June, 1885. 27 APPENDIX TO THE REPORT OF THE Medical Officer of Health. Summary of Analytical Work for the Year ending March 25th, 1885. name of sample. Genuine. Of doubtful Quality. Adulterated. Total. Bread 14 – – 14 Butter 3 – 2 5 Coffee – – 12 12 Flour 14 – – 14 Gin 3 – – 3 Milk 13 7 9 29 „ Condensed 4 – – 4 Mustard 3 – 14 16 Pepper 3 – 11 14 Sugar 12 – – 12 Tea 10 – 4 14 Vinegar 6 – – 6 Whisky 3 – – 3 87 7 53 146 Of these 146 samples, only five, viz., 4 samples of Butter and 1 of Milk, were bought by private purchasers; of the 4 samples of Butter, 2 were genuine, 1 contained 70 per cent. and the other 83 per cent. of foreign fats, and I gave certificates to that effect. The sample of Milk contained 7 per cent. of added water. 28 Of the 13 genuine samples of Milk, 3 were purchased with the view of prosecutions at shops where adulterated samples had previously been obtained; and 1 of those certified as of doubtful quality was purchased under similar circumstances. In this case the vendor was cautioned by order of the Committee of Works. Of the 9 samples of Milk certified as adulterated, 6 were purchased for information, 1 was the sample previously mentioned as brought by a private purchaser, and on the other 2 convictions were obtained as follows:— James Higgs, 9, Shepherd Street, Mayfair, for selling Milk containing 26 per cent. of added water. Fined 40s. and 2s. costs; this being his second conviction. Charles Arthur Bott, 57, Mount Street, fined 20s. and 2s. costs. The samples of Milk classed as "of doubtful quality" were poor or partly skimmed. The 2 adulterated samples of Butter were brought by private purchasers, as stated above. The samples of Tea classed as "adulterated" contained a few foreign leaves and lie tea, and in one instance exhausted leaves. All the samples of Coffee contained chicory, and most of them were labelled to that effect. The adulterated samples of Mustard contained wheat flour and turmeric. The adulterated samples of Pepper contained rice flour, and, in some instances, turmeric. Some of the samples of Sugar were dirty, containing fragments of cane, dust, &c. The samples of Spirits and of Vinegar examined were all genuine. W. H. CORFIELD, Fellow of the Institute of Chemistry, Public Analyst.