ST JAM 6 REPORT FOR THE YEAR 1898, MADE TO THE Destry of Saint James's, WESTMINSTER, BY JAMBS EDMUNDS, M.D., Member of the Royal College of Physicians of London. Member of the Society of Public Analysts. Fellow of the Chemical Society. &c., &c., &c. MEDICAL OFFICER OF HEALTH AND PUBLIC ANALYST FOR ST. JAMES'S, WESTMINSTER. London: PRINTED BY GEORGE PULMAN & SONS, LTD., Thayer Street, Manchester Square, W. 1899. CONTENTS. I.—PUBLIC HEALTH. PAGES. General Report for the year 1898 5-35 Area and Population—Deaths, Gross and Net Mortality, Death RateUse of Public Mortuary — Outlying Deaths in Persons removed from St. James's—Cases of Infectious Disease and their Removal - Births in St. James's—Epidemics—Visitation and Registration of Tenement Houses. Water Supplies—Examination of Samples - Cleansing of CisternsAmendment of Regulations suggested—An Improved Air-tight Cistern. Tubercular Disease—The Tuberculin Test on Cattle—Extermination of Tuberculous Cattle—Maintenance of Resisting Power in the Community — Sterilization of Milk and other Dairy Products by Heat—Cowhouses and Slaughterhouses in St. James's. Disinfection—Dustbins in Tenement Houses - Disinfection and Cleansing of Apartments in Houses after Infectious Disease—Removal and Disinfection of Bedding and Portable Articles by High-Pressure Steam in Public Disinfector—Incineration of certain articles—Corrosive Chemicals, their misapplication as Disinfectants to Closet and Sanitary Appliances. Ventilation-Currents of Air produced by Fires and by Mechanical Force—Volume of Air carried out of House by each Fire-Counterpart Supplies of incoming Air—Provision of General Inlet in Basement— Apartments or Workshops best ventilated by Inlet over Doorway, conveying clean, warm Air from Staircase into upper part of Apartment in order to supply up draught of Chimney—Difference between Ventilation and Draught—Detailed Provisions for the Ventilation of Workshops and Apartments—Cause of Smoky Chimneys—Ventilation by Electric VaneVentilation must be continuous—In-draughts must be so directed as not to strike the Persons of Inmates. Permanent Improvements- The Carlton Hotel—Outside or Inside Soil-Pipes—Abrogation of the Bye-Law of London County Council as to always placing Soil-Pipes outside in New Buildings—Discussion of the Question—Difference of Treatment required as between large and complicated Buildings and ordinary Dwelling Houses—Legal Proceedings— The Water Seal of Closet Pans—The Sloping Arms of Soil-Pipes—The Vertical Lines of Soil-Pipe—Objections to horizontal stretches of SoilPipe; Obstruction; Imperfect Ventilation of Dead-ends; Perforations in Upper Segment of Horizontal or Sloping Soil-Pipes—Corrosion by Chemical Disinfectants—Destruction of Outside Soil-Pipes by Diurnal Contraction and Expansion due to large ranges cf Temperature and rigidly soldered Seams—Obstruction by Frost in loftv Buildings—Outside Soil-Pipes in cold weather becoming Downcast Shafts for Soil-Pipe Air —The Jointing of Lead Work—Desirability of welding together Lead Work so as to eliminate solder, and thereby to get rid of the galvanic corrosion arising from the contact of two dissimilar metals ; and to set rid also of the deforming expansion and contraction caused by the hard seams of solder. Sanitation up to date—Sketch of Sanitary Works at the new Carlton Hotel. Unfavourable conditions — North-East Quarter of St. James's—Its tortuous narrow Streets—Worn-out short-leased old Buildings now traded in as Tenement Houses—Rough Foreign Workmen—Scheme for New Street—Model Artizans' Dwellings, Chamber - Workshops, and Model Dining Halls for Workpeople—Cheap Trains and Trams and the Development of Suburban Townships better than Block Dwellings upon costly sites in central London—Large area of land now unprofitably occupied by old Workhouse, and unsuitable situation of old Brewery in St. James's —Enlargement of Pall Mall Electric Light Works and other reconstructions now proceeding without replanning of the narrow old tortuous streets. Appendix of Tables. PAGES. 1. Summary of Causes of Death (Tables A and B) 36-39 2. Cases of Notifiable Infectious Diseases 40-47 3. Sanitary Inspectors' Work 48-50 4. Summary of Sanitary Inspectors' Work 51 5. Underground Rooms cleared of Occupants 52 II.—PUBLIC ANALYSIS. Report on Articles Analysed during the year 1898 53 Appendix. Table of Articles and Results of Analyses 54-58 5 TO THE CHAIRMAN AND MEMBERS OF THE Vestry of Saint James's, Westminster. Mr. Chairman and Gentlemen, I submit my Annual Report for the year 1898, upon the Public Health of the Parish of St. James's, Westminster. This Report is the twenty-fifth which I have had the honour to prepare for the Parish of St. James's. Eighteen . Annual Reports had previously been prepared by Dr. Edwin Lankester, F.R.S.—my predecessor in this office. The area and population, to which this Report relates, are summarized in the following table: — Population. Mean Density of Population per Acre. Area in Acres162 Census, 1831 37,053 229 ,, 1841 37,398 231 ,, 1851 36,406 225 ,, 1861 35,326 218 ,, 1871 33,619 214 ,, 1881 29,865 184 ,, 1891 24,995 154 ,, 1896 23,050 142 In Registration London the average density of the population for 1896 is given by the Registrar-General as 59.2 persons per acre. 6 During the year 1898, the net mortality of the district of St. James's has been 408 deaths. Taking the population as enumerated in the census of 1896, we have 20,053 persons, with 408 deaths—a death-rate of 2035 for each 1,000 persons sleeping in St James's. The figures for the net mortality of St. James's are obtained by taking the deaths registered in St. James's, adding to this number the deaths in Outlying Institutions and places of persons removed from St. James's, and then subtracting the deaths registered in St. James's of persons who were noted as non-parishioners by the Registrar. This procedure is as follows : — 315 + 125 — 32 = 408 net mortality. These mortality data are shown in greater detail in the following figures: — The deaths registered as having occurred in St. James's for the four quarters of the year 1898, were as follows: — First Quarter 107 Second Quarter 64 Third Quarter 73 Fourth Quarter 71 Deaths registered in St. James's during the year 315 Add Outlying deaths among persons removed from St. James's 125 440 Deduct deaths of persons reported as Non- Parishioners ;— Dying in the Union House 29 Dying elsewhere 3 32 Net mortality of St. James's for the year 1898 408 7 Of the 32 deaths of non-parishioners, 3 were of children under one year of age, and 19 were of persons ranging from 65 to 95. During the year 1898, 16 bodies were removed into the Mortuary. Thirteen inquests were held upon bodies lying in the Mortuary, and 13 post-mortem examinations for judicial purposes were made in the Examination Room adjoining the Mortuary. The following Table gives a summary of the certified causes of death, during the year 1898, among persons dying in outlying places, after having been removed from the district of St. James, Westminster:— Accidental Injury 3 Apoplexy 5 Brain Disease 5 Bronchitis 6 Cancer 10 Diphtheria 5 Enteric Fever 1 Heart Disease 15 Hernia 1 Insanity 3 Intus-susception 2 Kidney Disease 8 Liver Disease 3 Meningitis 5 Old Age 3 Other Diseases 12 Paralysis 4 Phthisis 22 Pneumonia 6 Poisoning 1 Scarlet Fever 2 Spinal Disease 2 Tuberculosis 1 125 8 The following Table shows the periods of life, and the seasonal variations of the Mortality in St. James's, during the Seven years 1890-1896 inclusive. Under 1 Year of Age. 1 and under 5. 5 and under 20. 20 and under 40. 40 and under 60. 60 and under 80. 80 and upwards. All Ages. 1890 First Quarte 23 9 5 15 15 23 1 91 Second Quarter 26 11 1 10 13 12 3 76 Third Quarter 27 6 2 11 15 27 3 91 Fourth Quarter 22 9 3 18 34 20 5 111 Totals 98 35 11 54 77 82 12 369 1891 First Quarter 16 6 5 16 24 34 4 105 Second Quarter 18 16 3 12 35 55 9 147 Third Quarter 25 12 1 9 19 15 5 88 Fourth Quarter 17 7 2 9 17 21 3 78 Totals 76 41 11 46 95 125 21 418 1892 First Quarter 19 19 4 15 33 47 10 147 Second Quarter 18 14 6 6 25 12 2 83 Third Quarter 17 12 2 7 15 11 3 67 Fourth Quarter 17 3 2 12 20 25 8 87 Totals 71 48 14 40 93 95 23 384 1893 First Quarter 14 8 3 15 28 29 6 103 Second Quarter 14 11 4 11 25 34 9 98 Third Quarter 21 8 4 6 15 17 5 77 Fourth Quarter 21 9 4 11 22 32 2 101 Totals 80 36 15 43 90 102 22 379 1894 First Quarter 17 13 3 11 18 36 3 101 Second Quarter 17 12 ... 3 7 21 4 64 Third Quarter 16 6 4 4 15 16 3 64 Fourth Quarter 24 6 1 19 15 19 5 89 Totals 74 37 8 37 55 92 15 318 1895 First Quarter 26 8 4 10 34 48 10 140 Second Quarter 18 5 4 8 11 17 7 68 Third Quarter 20 2 1 8 14 10 3 58 Fourth Quarter 15 9 3 13 11 23 3 77 Totals 77 24 12 39 70 98 23 343 1896 First Quarter 27 20 2 4 13 24 3 92 Second Quarter 17 9 4 9 16 25 7 87 Third Quarter 16 6 3 8 13 18 5 69 Fourth Quarter 9 4 4 17 16 43 1 94 Totals 69 39 13 38 58 110 16 342 9 ZYMOTIC DEATHS REGISTERED IN ST. JAMES'S DURING THE 25 YEARS—1872-96 INCLUSIVE. 1872 1873 1874 1875 1876 1877 1878 1879 1880 1881 1882 1883 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 Smallpox 6 1 1 3 1 3 1 Measles 24 20 1 4 21 8 19 6 26 10 17 2 10 8 10 8 4 18 7 2 9 3 11 1 27 Scarlet Fever and Diphtheria 6 13 19 14 7 20 15 20 10 11 3 7 2 5 4 5 3 2 5 6 1 2 Whooping Cough 30 18 14 28 14 7 19 14 18 8 12 1 3 2 6 5 3 11 7 6 7 9 3 Diarrhcea 28 29 11 21 19 13 21 9 23 15 12 12 16 19 15 10 8 7 11 8 7 6 3 7 9 Typhus and Typhoid Fever 8 9 6 3 7 12 9 4 6 5 5 1 4 3 5 1 2 3 1 3 6 2 1 Cholera 1 Total 102 77 45 75 76 50 89 48 93 51 57 18 38 36 27 29 26 31 26 26 25 23 33 20 42 During the 25 years, 1872-96 inclusive, the deaths from these Zymotics were 1,171, being an average yearly mortality of 46.84. 10 Of the notifiable Infectious Diseases, 99 cases came under notice during the year 1898. Of these 99 cases, 31 were of Scarlet Fever; 41 were of Diphtheria; 20 were of Erysipelas; 6 were of Enteric Fever; and 1 was of Membranous Croup. Of the 99 cases, 61 were removed to Extra-Parochial Hospitals; 38 of the cases were not removed. Details of these 99 cases are appended in Table II. (pages 40 to 47). Tables of the causes of death and other data for the year 1898 are appended. The births registered in St. James's during the year 1898 were 446. Of these 446 births, 32 occurred in the Union House. The Parish has been visited by no epidemic during the year 1898. During the year 1898, 230 houses in the poorer quarters of St. James's have been visited and inspected—mostly apart from any direct complaint against these particular houses. In no case has admission been refused. Tenement houses about which any difficulty occurs as to their sanitary condition are registered so as to be kept under efficient control. Mr. John Percy Folland and Mr. Thomas Winter Calverley, the Sanitary Inspectors, have given me cordial and efficient assistance in sanitary work. During the year 1898, the sanitary work of the Parish has been efficiently done. The duties of Medical Officer of Health have been discharged by me throughout the whole of the year. I have to thank the Vestry of St. James's, and its Public Health Committee, for a generous continuance of the encouragement and support always given to me in the sanitary work of the Parish, and in the administrative questions which arise. II WATER SUPPLIES. The water supplies of the Parish of St. James come from the Grand Junction, Chelsea, West Middlesex, and New River Companies. The whole of the supplies are on constant service. Frequent samples of the waters, taken from the mains of the various companies, have been examined during the year 1898. These samples have been bright, of good colour, and free from pollution. There has been no ground for supposing that any of the six cases of typhoid which were notified in the district of St. James during the year 1898 arose from polluted water supplies. Printed papers calling attention to the necessity for periodical cleansing of cisterns have been freely circulated through the district during the year. But it is difficult to secure good administration on the part of all householders in respect to the care of their own water cisterns; and in some points the regulations of the water companies, requiring an overflow warning-pipe, but allowing no standing waste of any sort, make it impossible to clean out the cistern by direct flushing. This regulation should be modified. In no case ought a cistern to be so constructed that it cannot be emptied except through the drinkingwater taps. It is very difficult to effectively clean out a cistern except through a standing waste, so inserted as to completely empty the cistern, and to allow it to be flushed out effectively by the supply-tap while a soft hand-broom lightly sweeps down the sides and bottom of the cistern. The pipe for the service of the drinking-water taps should in all cases rise to an inch above the bottom of the cistern, so as to allow a thin layer of sediment to subside below the level of the drinking-water outlet. This condition alone renders it impracticable to efficiently flush out sediments through the drinking-water taps. A standing waste leading to the warning-pipe is the best arrangement. In case of overflow the proper warning is then given; while by simply lifting the standing waste the cistern can at once be flushed out perfectly. Of course the 12 standing waste must in no case have any sort of communication with a drain-pipe. A rubber garden hose-pipe may be attached to the end of the warning-pipe while the cistern is being flushed out, and in that way the flushing water can be discharged over a trapped gulley at a convenient point. Storage cisterns sufficient for a temporary supply, in the event of accident to the mains or supplypipe, should be in every house ; and certificates are not granted by the Vestry of St. James's unless the house is provided with adequate storage cisterns.* TUBERCULAR DISEASE. The dissemination of tubercular disease through the medium of milk and cream derived from tuberculous cows is a danger which, of late, has exercised the public mind. Taking tuberculous disease of the lungs (phthisis), it will be seen that during the year 1898 the deaths certified for St. James's as due to phthisis were 47, as against 53 in the year 1897. There has been a general and continuous reduction in the mortality from tubercular diseases—a reduction due probably to improved sanitary and dietetic conditions, which have increased the resisting power of the people. But it is most important to exclude from our food altogether, if possible, the infection of tubercular germs. This may be achieved in two ways: one by exterminating tuberculous cattle, the other by sterilizing the milk and other cattle products which are used as food. The extermination of tuberculous cattle is the real desideratum. But this will be difficult to realise. In 1898 her Majesty ordered the 40 non-pedigree cows which served the dairy of Windsor to be destroyed, because, on being * An improved" self-cleansing air-tight cistern" has been devised by Mr. Hugh Alexander, Chief Sanitary Inspector for Shoreditch. This cistern is expensive, but it is undoubtedly a valuable improvement in domestic water cisterns. It has been adopted in the design premiated by the London County Council for its new model dwellings at Millbank. It is a most excellent and practical cistern. In filling water-bottles the tap should be allowed to run for a moment, so as to flush sediment out from the leaden pipe, before the bottles are filled. Bright water direct from the iron cistern is then obtained. 13 tested with tuberculin, 36 of them were found to be tuberculous. Now, the premises in which these cows of the Royal herd had been kept were probably the best in the Kingdom. In regard to cubic space, light, ventilation, cleanliness, and feeding there had been nothing to be desired. The cows, moreover, were in good condition, and apparently healthy. But, as a mere matter of precaution, and in order to exclude from the dairy any cow or cows which might be found to react to tuberculin, this test was used in September, 1898. No less than 36 out of this splendid herd of 40 cows were found to react. These 36 cows were ordered to be slaughtered, and submitted to a careful post-mortem examination. Subsequently it was thought that the value of the investigation would be greatly increased if the other four cows also were slaughtered and examined at the same time. Of the 36 cows, the bodies of 35 were found to exhibit tuberculous lesions, and the thirty-sixth cow was found to be suffering from another form of internal disease. The four cows which did not react to the tuberculin were found to be free from disease, with one exception. In this splendid and perfectly-cared-for herd of 40 dairy cows, therefore, 36 were found to be tuberculous, one was the subject of another visceral disease, and three were healthy. The results of this entirely unimpeachable investigation show that the trading dairyman often deserves our sympathy when tuberculosis shows itself among his cows. It also indicates that the meat and milk used by the public must come from tuberculous cattle to a much larger extent than has ever been surmised. It seems, therefore, to follow that the tubercular germs take effect rather upon persons who lack resisting power, and that predisposing as well as exciting causes must combine—so as to work together in order to effectuate the dissemination of tuberculosis. Otherwise, all persons who drink milk or eat meat would become tuberculous. The facts yielded by this investigation of the Royal herd of non-pedigree dairy cows indicate the practical impossibility of exterminating 14 all the cattle which are affected by tuberculosis. They also suggest that in the cultivation of a high standard of personal vitality lies our present chief defence against infection by tubercular and other germs. The establishment of large dairies using only cows which have been tested and proved free from tubercular disease will doubtless be a powerful factor in the future improvement of our supplies of milk and meat. It is obvious that such dairies, so soon as they are in vogue, will command the public custom for milk, and will supersede small dairies which are not scientifically supervised, and from which questionable cows are not sacrificed. Meanwhile there is the very practical device of sterilizing the milk. Several useful and effective forms of patent saucepan sterilizers* have been introduced, and are in large and increasing demand. But the principle by which sterilization of milk is effected is very simple and intelligible. Sterilization can be done perfectly by the use of a bottle to contain the milk, and an ordinary saucepan to contain water in which the bottle of milk can be immersed up to a level with the top of the milk. All that is then needed is to heat the water in the saucepan slowly until it boils, and to boil it for five minutes. It can then be set aside to cool down slowly, while the bottle of milk remains in the water. It is only necessary to raise the milk nearly to the temperature of boiling water, and to keep it at that temperature for 10 minutes. This makes the milk safe by killing any tubercular or other germs which may be present—as a similar exposure to the boiling water would kill an egg. An ordinary glass-stoppered bottle (perfectly clean) to receive the milk, may safely be exposed to this method of heating in any ordinary iron saucepan ; but in order to protect the bottom of the bottle from the direct heat of the fire and to prevent the milk from being burnt, a disc of thick wire netting should be placed upon the bottom of the saucepan, and on this the * Aymard's Patent Milk Sterilizer is simple and effective. 15 bottle should stand. A wire teapot-stand, or a wire frame like an old-fashioned decanter-stand, is a satisfactory support, made so as to give a half-inch space for the water to boil freely in beneath the bottom of the bottle. The milk may remain in the unopened stoppered bottle until it is wanted for use. Its flavour will be but slightly changed. This simple treatment will reduce practically to nothing the danger of receiving milk from a cow suffering from latent tuberculosis. To stamp out tubercle would be the greatest of all the triumphs of sanitary science. There are no cowhouses nor slaughterhouses in St. James's. DISINFECTION. In the autumn of 1897 the Vestry of St. James ordered the use of some form of disinfectant for the dust-bins of the registered tenement-houses and some other parts of the parish. The smell of chloride of lime was objected to, and Sanitas powder was recommended by me for the purpose of sprinkling the contents of these dust-bins. Of this Sanitas powder 55 cwt. was used during the year 1898. For the routine disinfection of apartments after the occurrence of infectious disease, liquid sulphurous acid (sulphur dioxide) is used. This gas is that produced by the burning of sulphur, and its use is facilitated by reduction to a liquid by means of pressure and cold. The liquid gas is stored in tin cases, each containing the amount required for an ordinary disinfection ; and, after sealing up the apartment, the gas at once issues upon cutting off the end of a small short leaden tube. Its use is safe and free from risk of fire from the burning of sulphur. The liquid gas gives a full and satisfactory application of the old sulphur fumigation. After the full fumigation of the apartment, careful washing with soap and water should be given to door handles, door plates, hand-rails, and all paint work which is liable to be touched. The walls, ceiling, and floor should be carefully swept. In some cases extensive renovations are required. But, short of actual incineration by 16 fire, it is impossible to draw any line at which the absolute disinfection of an infected house would be secured. Bedding, clothing, and other removable articles which have been infected by cases of disease are disinfected with high-pressure steam by means of a Washington Lyon's patent steam disinfector at the stoneyard in Dufours Place. This steam disinfection is safe, easy, and effective. But boots, hats, and some other articles are spoiled by high-pressure steam, and when necessary such articles are burnt. The ordinary use of disinfecting chemicals is to be discommended except in special cases. As a general rule, properly constructed drains and plumbing arrangements require nothing but proper flushing and the application of the squeegee in order to insure the highest level of sanitation. Inside a house the chronic use of disinfectants spells bad drainage, unsound plumbing apparatus, want of ventilation, or bad housekeeping. Here the proper remedy is to correct one or all of these causes. The putting disinfectants down water-closets corrodes the metal pipes and sanitary appliances. These corrosive substances also eat away the Portland cement which joints together the stoneware drain-pipes, and thus produce leakage of foul drainage-water into the subsoil of the basement of the house. Such leakage into the subsoil is the cause of damp basements; and with a foul, damp basement, no house can be sweet. Broadly, it may be said that no house in which disinfectants need be used is fit to live in. It is not too much, also, to say that to put chloride of lime daily down the closets is to corrode and ruin the most costly and perfect system of plumbing in a year. It is to this use of disinfectants chiefly that we owe the perforated soil-pipes through which foul air is drawn into houses. VENTILATION. Many houses are ventilated only by air currents coming in through the water-closets and drains, and down the cold chimneys. It must be realized that each fire carries up its chimney an average of 40 cubic feet of air per 17 minute, and that this large body of air cannot go out up the chimney unless counter-provision be made for its entrance into the room. If provision for the entrance of clean, warm air, to this extent into the room be not made, the necessary air is sucked into the room through the crevices of the doors and windows, through the cracks in the floor, and through all the dirty crannies that are permeable. Every house should have in its basement a constantly open inlet for fresh air—a general-inlet with an area sufficient to supply all the working fireplaces. The incoming air can be filtered if necessary. But such air will deposit most of its blacks in the basement passages, and it loses its chill while rising up through the staircase to supply the house. Each room should have, leading from the staircase, an inlet over its doorway, guarded by a louvred opening to deflect the indraught towards the ceiling and make it travel along the upper part of the room so as not to impinge upon the persons of the inmates. An in-current which takes this course is ventilation ; the same in-current, when it strikes the persons in the room, is a draught. Raw, cold, black-laden air from the street should not be taken into a living-room during the winter. It is through the staircase that successful and clean ventilation of living-rooms can best be effected ; and the motive-power of the fire must be utilized in order to suck clean, warm air in over the doorway, while it drives the products of combustion up the chimney. For want of these simple provisions ventilators do not work, or they, very naturally, work the wrong way, and are at once pasted up. In order to secure that each workshop, or each room of a house, is continuously and adequately ventilated, the following provisions must be made : — i. The inlet over each chamber doorway should have for its air-way a minimum cross-section of half a square foot—i.e., 72 square inches. Its chamberface should be furnished with a louvre so shaped as to deflect the in-draught obliquely towards the 18 ceiling, so that the fresh air may diffuse itself into the upper part of the chamber, and not drop down upon the heads of the inmates. If the inlet have an air-way too large to meet the suck of the chimney, the in-draught will enter the room so sluggishly as to pour directly down upon the inmates. The size of the inlet, therefore, must be such as to adequately provide for the suck of the chimney, but yet to make the air enter with such momentum as will carry it across the top of the room and make the current break up against the opposite wall. 2. The staircase face of the inlet should be guarded by a silk flap-valve. This works without noise. Being very light, it rises instantly under the suction of the fire and allows air to pass freely from the staircase into the room. But when no fire is alight the silk flap-valve falls down and closes the inlet. This prevents reflux into the staircase, which would be attended by a down-draught through the chimney into the room. 3. As to the general-inlet in the basement, this is intended to supply the staircase with a volume of air equal to that which is driven up the working chimneys by all the fires which may be alight. In winter, therefore, when many fires are alight, this inlet must be more widely open than it need be in the summer, when there are no fires in the living-rooms, and when also open windows and doors are available. If the basement general-inlet be negligently or perversely closed, the fires are not able to draw freely, and smoking is easily produced in chimneys which have fires alight. So far as the lighted fireplaces then do draw, they get their air through crevices—as previously described. Part of this supply comes from the staircase of the house, and this cannot be drawn from the staircase unless an adequate counter-current enters the staircase. If the basement general-inlet be closed, the cold bedroom chimneys have to serve as downcast shafts and they fill the staircase and bedrooms with smuts, which ruin the carpets and furniture. The question, therefore, is not whether air is to be admitted to supply the lighted fireplaces—the 19 question only is, whether the air shall be let in through a proper basement inlet, or shall be sucked in through dirty crevices. If air be not admitted by counter-currents from somewhere, then the chimneys smoke. If air be admitted by a skylight, a cold draught falls down into the staircase, while all the warm air of the honse at once flows out into the atmosphere. 4. The principle of providing proper inlets for air to the fireplaces being realised, a word must be added as to the motive-power which produces the necessary current in the air. In winter, with fires alight, the moving force is given by the heat of the fire. But in concert-rooms, theatres, and large workshops, at times when fires do not give movement, mechanical force must be used. Here the best motor is an electric vane, and this is set in or out of motion as easily as an electric lamp is switched on or off. Such vane drives air at will out of the room, or into it, and at any rate that may be required. This means of mechanical ventilation answers perfectly for all ordinary houses or workshops. If these principles are duly regarded, there is no difficulty in securing perfect and uniformly acting ventilation for every workshop and for every room in any house. But the ventilation, to be effective, must be continuous; and, when fires are not alight, movement must be obtained by mechanical force— unless doors and windows are freely open. PERMANENT IMPROVEMENTS. Among the changes which have taken place in the southern part of St. James's, I have to record the construction of the Carlton Hotel—one of the most splendid of the modern stone buildings of London. This hotel has been erected at a cost of some half a million sterling, and in expectation of surpassing all other hotels in London. It is undoubtedly a great improvement to St. James's, and, among other benefits, it has swept away the last portion of the old arched corridors, while it has considerably widened the vista and opened up the atmospheric effect 20 of the eastern portion of Pall Mall. It was found that, in the original plans of this hotel, the sanitary arrangements had been provided upon an inadequate scale, and that for its large number of guests and working staff more than one hundred extra water-closets, besides baths, handbasins, and other sanitary comforts would be needed in order to make perfect the sumptuous suites of apartments and the palatial restaurants that were being constructed. The question was as to how the necessary soil-pipes were to be planned and where they were to be placed. In the bye-laws made by the London County Council, under the Public Health (London) Act, 1891, section 39 (1), the wording runs as follows: — " 4.—Any person who shall provide a soil-pipe in " connection with a building to be hereafter erected " shall cause such soil-pipe to be situated outside such " building; and any person who shall provide, or con" struct, or refit a soil-pipe in connection with an exist" ing building shall, whenever practicable, cause such " soil-pipe to be situated outside such building, and " in all cases where such soil-pipe shall be situated " within any building, shall construct such soil-pipe in " drawn lead, or of heavy cast-iron, jointed with " molten lead and properly caulked." In this case the building had already been erected and its drainage plans had passed the Works Committee and had been finally sanctioned by the Vestry. It might, therefore, have been contended that the additional soil-pipes came under the second part of the bye-law, as "constructed in connection with an existing building1." But this technical point was not taken, and it came to this: either this large aggregate of wealthy guests was to be deprived of the extra closets that were needed for their suites of apartments; the soil-pipes were to be trained up over the stone facades of the hotel; or long horizontal stretches of soil-pipe would have to be carried through the interior of the building, in order to reach the various well-holes and areas in which the 21 original soil-pipes had been provided for. As to the esthetics of the matter, the Crown Surveyor refused to allow soil-pipes to be trailed up over the beautiful stone facades of the hotel. And such an exhibition of soil-pipes would have been a notable eye-sore in Pall Mall and the Haymarket. As to the sanitation, external soil-pipes would have had to be trained in and out over the stone cornices, or these stone cornices would have had to be mutilated in order to make way for the soil-pipes. Horizontal stretches of soil-pipe inside the building meant bad sanitation by unventilated dead-ends; the certainty of frequent obstruction and nuisance; and, further, the probable formation of latent perforations in the upper segments of the horizontal pipes —so as to let soil-pipe-air into the hotel. Thereupon I had to point out that this bye-law, while of general utility in ordinary dwelling-houses, was for large and complicated buildings, often a bad bye-law, and I advised the Public Health Committee to offer no objection to the soil-pipes being put inside the building— provided that the soil-pipes were arranged to their satisfaction as to plan, materials, and workmanship. I submitted that if it were necessary to enforce this unsuitable bye-law upon this special building, that painful duty might be left to the London County Council. This course was recommended by the Public Health Committee. But, in the Vestry, objection was taken to allowing the bye-law to lapse under any circumstances whatever, and the discussion of the question was prejudiced by the ungenerous suggestion that a wealthy Company was receiving more consideration than an ordinary householder. Pending the prolonged discussion which ensued, the works at the Carlton Hotel went on, and the soil-pipes were completed. In order then to vindicate the byelaw, a prosecution was instituted and the Magistrate inflicted a nominal fine of forty shillings upon the understanding that no further penalties were to be asked for. Meanwhile it had been realized by the Vestry that the 22 literal enforcement of this bye-law would raise serious difficulties in other cases where new buildings had to be erected upon valuable sites in St. James's, such sites often having been long entirely covered by their old buildings. A few weeks, after the decision in the Carlton Hotelcase, this bye-law was abrogated—chiefly in consequence of representations which came from St. James's The proviso, " whenever practicable," as to placing the soil-pipes outside, will, in future, apply to all buildings, whether old or new. This abrogation of the bye-law vindicates the practical wisdom of the Public Health Committee in making the recommendation which it did. It should here be pointed out that the sloping arms, which run more or less horizontally from the closet-pan to the vertical soil-pipe, were not regarded under this old byelaw as " soil-pipes," and that, practically, these arms could not be so regarded. To include these arms as " soil-pipes," under this bye-law, would involve putting the water-closets also outside the building. This, while the most excellent way for the perfect elimination of the risk of smell in the interior of a house, would be absurd. It is clear that the chill and discomfort involved in leaving the house night and day when the closet is required would cause more serious risk to health than the having a well-constructed water-closet inside the house. It is well known to working sanitarians that the two weakest parts of the soil-pipe channel are the water-seal in the trap of the closet and the upper segment of the sloping arm of the soil-pipe, and that, if these parts can be kept sound, the vertical pipe will be injured only by the strain of diurnal alternations of temperature. In fact, a socketed drawn or cast-lead rain-water pipe put together without solder is practically imperishable, and, unless mechanically injured by battering, it will outlast any ordinary building. In this construction the top of each length of pipe is enlarged in its diameter a quarter of an inch for some four inches distance, in order to receive the lower end of the next length of pipe above. The pipe 23 is thus made up with easy, telescope-like joints, and these joints give play for a small to and fro sliding movement under the influence of heat and cold—the upper pipe never being rammed down solidly on to the shoulder of the pipe below. These pipes, being wholly of pure lead, are unpuckered by the rigid bands of solder with which soil-pipes are jointed; they therefore expand and contract freely and uniformly all over, and they never tear. They also escape the corroding action of the galvanic current which is set up wherever dissimilar metals come into contact Pipes thus put together endure for hundreds of years, as do the old cast lead water-cisterns that used to be constructed without solder. But when we come to the arms which connect the closet-pans with the vertical part of the soil-pipe, new and altogether different elements of weakness come in. The trap beneath the closet-pan is liable to be stopped up by cloths which careless servants drop in, by entire newspapers which slovenly people put down, and by various objects which children and malicious persons throw down. If the closet be disused for a few weeks, the water dries out of the trap and the trap becomes a channel for laying on a stream of soil-pipe air into the room to which the closet belongs. Then the perforations which so frequently conduct soil-pipe air into houses are always found in the upper segment of the more or less horizontal soil-pipe arm. As I have already stated (page 16), these perforations in the aerial half of this pipe are generally produced by the corrosive vapours of disinfectants, such as chloride of lime, which ignorant housewives industriously put down the closets. It therefore seems that to insist upon putting the vertical part of the soil-pipe outside the building, while the more vulnerable closet syphon and sloping arm of the soil-pipe are left inside, is an illusory provision. It also seems clear that the endurance of the vertical part of the soil-pipe is lessened by putting it outside the building, while the countervailing advantage is very questionable 24 THE JOINTING OF LEAD WORK. The chief cause of the failure of lead-work is the use of solder. If the use of solder could be got rid of, wellconstructed lead-work would last indefinitely. If old soldered cisterns be examined, the lead will be found to be eaten away all along the edges of the soldered seams, while elsewhere the lead remains sound. In soil-pipes and other lead-work which is put outside and exposed during the day to the hot sun and during the night to severe cold, the pipe cracks along the edge of the soldered joints. These cracks are caused by the pipe not contracting and expanding uniformly, and at the rigid seams of solder the lead tears itself away, leaving a crack, through which leakage of soil-water and offensive smells come. Cracks of this kind never occur in the leaden rain-water pipes which are socketed into each other and left with sliding play, as I have already described. The cracks in lead-work by the edges of seams of solder are also started by corrosion due to the galvanic action which is set up by the contact of dissimilar metals. In chemical factories, so marked is this destructive action of solder upon the lead, that the tanks, if soldered, would leak very soon. Here solder has long been completely eliminated, the joints being made by fusing one piece of lead to another as one piece of iron is welded to another. There is no reason why this process should not be generally used in domestic and sanitary plumbing. Lead-work would then endure for hundreds of years. This getting rid of solder is the greatest improvement that remains to be made in sanitary work. OUTSIDE SOIL-PIPES. While soil-pipes are best outside the house in all cases where the plan, materials, and workmanship are not of the highest character, there are many large and complicated buildings in which the highest level of sanitation is not secured by placing the soil-pipes outside. To train soil-pipes in and out up over the stone facade of a 25 building like the Carlton Hotel, is a barbarous expedient; and, as a matter of esthetics, would be ruinous to the appearance of such a building. External soil-pipes which serve a large number of closets—as in the Carlton Hotel, and lofty buildings—such as blocks of flats and artizans' dwellings, become a source of intolerable insanitary conditions if frozen during a hard winter. In one large block of artizans' dwellings in London the recent severe winter froze the external soilpipes and blocked the stacks of water-closets above, so that for want of an outlet below, large numbers of families had their water-closets choked and overflowing into the staircases. The only remedy was to construct braziers around the lower part of these stack pipes—which in this case were, fortunately, of cast iron—and to keep (ires alight so as to thaw the pipes from below. This was done. It is obvious that such a condition occurring suddenly during a severe frost in a lofty building like the Carlton Hotel, would be a serious matter. And where, as in the Carlton Hotel, these soil-pipes are of costly leadwork, they could not safely be thawed by the use of brazierfires. Nor could such fires be set up on the pavement in Pall Mall. Soil-pipes outside, again, are exposed to a much greater range of temperature and to a consequent large daily expansion and contraction of the metal, which is much more serious than when such work is put inside the house. Inside the building the range of temperature is comparatively small, the hot sun during the day and the cold at night are avoided, and the perpetual strain upon the metal work is minimised. The result is that work of this large and complicated character is more difficult to keep sound when placed outside than when placed inside the building. In addition to the mechanical disadvantages, there is a physical disadvantage. Vertical pipes for soil and soapywater, when placed inside the house, are kept uniformly warm—warmer than the outside air. This ensures, if the 26 pipes are properly planned, a continuous up-draught through all the pipes. The pipe is thus kept ventilated perfectly, and—acting like a heated chimney—it sends all smell up into the atmosphere above the roof-ridge. On the other hand, the same pipes, when placed outside the building, get very cold at night, and they then become down-cast shafts. This reverses the ventilation-current and brings the soil-pipe air and soapy-water smells down into the basement of the house. This is a serious insanitary defect. That the soil-pipes can be made air-tight and watertight is unquestionable. The heavy drawn leaden pipe, united by the plumber's solid joint, can be made as sound and tight as a leaden service water-pipe, and, when protected from a large diurnal range of temperature, will last as long. In the case of the Carlton Hotel, there was no proposal to sacrifice the highest level of sanitation to esthetic considerations, by putting the soil-pipes inside. The greatest permanence and security, and the working simplicity and perfect ventilation of vertical tubes were thus obtained in conjunction with those esthetic considerations which were so desirable. It is only due to the Carlton Hotel Company, to say that the sanitary work of their hotel has been done without regard to expense, and that it has been carried out in a way which could not have been excelled, either in plan, materials, or workmanship. The works have been in the hands of Messrs. Waring and Sons. The Carlton Hotel is probably the most perfectly sanitated building in London. Its future depends now only upon its administration. SANITATION UP TO DATE. The extreme complexity of modern apparatus for the water-supplies, drainage, ventilation, and warming of large and complicated buildings may be usefully indicated by the following sketch of the works at the Carlton Hotel. 1. Large cisterns are provided in the roof, and 27 mediate cisterns on the third floor, sufficient to store water for the supplies of the hotel during any accident to the water company's supply-pipe These cisterns have service-pipes and overflow warning-pipes. One set of cisterns has to be provided for the drinking-water, baths, and lavatories; a second separate set for the service of waterclosets, urinals, and slop-sinks exclusively. 2. Cold water service-pipes have to be led to all baths, basins, sinks, and draw-off taps; also from the second set of cisterns to all water-closets, urinals, and slop-sinks. All water supplies, hot and cold, are provided with duplicate guard-taps, as well as outlet-taps. The fire hydrants are served by tank on roof, and also by company's main direct. 3. Hot-water mains (flow and return) are carried up from heaters in the basement, and branches are led to all baths, basins, sinks, and draw-off taps. The double sets of mains (flow and return) are necessary in order to keep the water in the pipes always in circulation and actually hot at its outlet. 4. In order to warm the corridors, hot-water radiators are placed at frequent points. These radiators have separate heaters in the basement and separate sets of mains (flow and return) to the radiators. In these radiators a constant circulation of very hot water is maintained by pumping. Three separate systems of drainage channels permeate all parts of the building, as follows: — 5. Excremental matters are allowed only to enter waterclosets, urinals, and slop-sinks. These excremental matters are conveyed away through a set of air and water-proof four-inch ten-pound leaden drawn pipes. All these pipes are carried up to the roof-ridge full-bore, and are open to the sky so as to ensure the continuous ventilation of their interior. Below, they unite their discharges, without trap, in the main drain of the hotel, and the main drain passes its contents off continuously into the public sewer through the general outfall. This general outfall is guarded by an interceptor, or trap, which allows free exit 28 to the drainage, but allows no reflux of gas nor of liquid from the public sewer into the hotel drain. The hotel drain, for several feet before discharging into the interceptor, is an open channel running at the bottom of an inspection chamber into which the engineer in charge of the drainage can at all times enter upon lifting an air-tight door. In the event of any stoppage at the interceptor or in the drain, the stoppage can at once be removed, and the drain can be swept out clean, from section to section, as if it were a chimney. Into this terminal inspection chamber there passes a continual in-draught of fresh air, from the atmosphere outside the basement of the hotel, and this in-draught at the basement end of the drain passes continually along the drain and up the soil-pipes and out at the roof ridge. This arrangement ensures a continuous fresh-air ventilation of the whole system ot drains and soil-pipes from the basement outfall to the roof-ridge. These soil-pipes, open to the sky full-bore, also can never accumulate gases under pressure so as to bubble through the water-seal in closet traps and enter the chambers to which these closets belong. These channels for excremental matters receive nothing except through a trap. Each water-closet, urinal, and slop-sink discharges into the leaden soil-pipe through a perfect water-seal, so that it is not possible to get any reflux of air or of liquid back from the soil-pipe into the closet, nor into any part of the chamber to which the closet belongs. This completes the apparatus for the reception, discharge, and immediate exclusion from the hotel of all excremental matters. The basement drains are of heavy cast-iron pipes jointed together with molten lead and caulked so as to be as tight as the street water mains. 6. Rain-water, and water occasionally escaping from warning and overflow-pipes or flushing apparatus, have also to be conveyed from all parts of the roof into the main drain. For this water there is a second separate system of pipes. This system is constructed of four-inch pipes of thick cast iron, jointed together with molten lead and 29 thoroughly caulked. In the basement these pipes discharge their contents in the open air over trapped gulleys, which convey the water into the main drain without the possibility of any reflux of air or liquid from the drain into the basement of the hotel. 7. Soapy water from baths, hand-basins, and sinks is not allowed to pass into the rain-water pipes nor into the soil-pipes, but is provided for by a third entirely separate system of pipes. Soapy water lines its channels with decomposing soap, which, though not dangerous to health, becomes offensive. Again the water from baths, and basins, and sinks sometimes passes down so hot that by frequent expansion and contraction it breaks up the joints of a leaden pipe in a few weeks if the pipe be of any considerable length. For this soapy water, short leaden wastepipes run from each bath, basin, and sink, and by means of a brass union are jointed into a three-inch cast-iron wastepipe, the latter being jointed together with molten lead and caulked. These three-inch iron soapy-water pipes descend to the basement, where they also discharge in the open air over trapped gulleys which pass their discharge through into the main drain, but so that no reflux of air nor liquid can occur from the drain. These soapy-water pipes therefore, like the rain-water pipes, have no traps in them, but at bottom are open to the air, while at top both sets of iron pipes are open to the sky. The warmth of the building through which such pipes pass ensures a constant updraught of air through them from basement to roof ridge. Leaden pipes have a large co-efficient of expansion when used for the carriage of hot water, and their meltingpoint is so near to the temperature of boiling water that, after expansion, they do not, on cooling, go back perfectly to their previous dimensions and shape. The result is a growing deformity and puckering of the pipe and a tendency to tear at the rigidly-soldered joints. With the castiron pipes the co-efficient of expansion is small, and the fusing-point of the cast-iron is so far removed from any temperature that hot water can bring, that the pipes on 30 cooling recover completely their proper shape and dimensions, and the distortion never becomes cumulative. This arrangement of cast-iron waste-pipes for hot water is the best and most permanent at present known, and their only drawback is that iron pipes corrode inside more rapidly than do lead pipes. But where soapy water or other organic matter passes, this corrosion is not rapid. With rain-water, corrosion is much more rapid. 8. These three sets of drainage-pipes, being all open full-bore to the sky above the roof and to the external air in the basement, there yet remains one more costly provision—i.e., that of trapping every bath, basin, and sink - waste so that its contents shall instantly run off, while no reflux of air nor of liquid can pass back from the main waste into the chamber to which the basin, bath, or sink belongs. This object is secured by a syphon-trap of lead or gunmetal, which is affixed to the waste of each basin, bath, or sink. But a difficulty here crops up. When numerous traps are connected successively to one long vertical mainwaste, it is found that the rush of water down the mainwaste when a bath or large basin is suddenly emptied, will pull the water out of the other traps on the same stack-pipe, and so leave these traps open to carry foul air from the main waste-pipe into the chamber to which the basin, etc., may belong. In a large building this would be a fatal defect. This reflux current of air would bring with it the smell of the rancid and decomposing soap which lines the main wastes. With the water-closet traps, where a series of successive floors of closets are served by the same soil-pipe, a similar reflux would be not only offensive, but dangerous. The difficulty has to be overcome by providing every trap in the building with an anti-syphonage airpipe. This anti-syphonage pipe is a leaden pipe ranging from 1½ to three inches in diameter, and connected with the pipe which discharges the trap into the main waste. This air-pipe prevents the water being sucked out of the the trap to which it belongs, and so ensures the trap 31 maining always sealed. But, then, as this air-pipe communicates with the main waste—or, in the case of closets, with the soil-pipe—direct, it cannot be left open. Therefore, to perfect this system of anti-syphonage pipes, an additional main pipe for each stack—an air main—has to pick up all these air-pipes and run up through the roof full-bore with its end open to the sky. Two sets of air mains and their branches are required—one for the soapy-water traps and one for the closet traps. g. In order to maintain a continuous supply of fresh air in the Carlton Hotel, a powerful pumping-apparatus is provided. This apparatus pumps into the hotel 60,000 cubic feet of air per minute. For the reception-rooms this air is filtered, warmed or cooled as the weather may demand, and, upon occasions, perfumed. The air thus supplied, upon the plenum principle, is led into every corridor, and finds its own way out by chimneys, doors, windows, etc. This is the most perfect system possible for ensuring efficient ventilation in a large hotel. It also reverses the ordinary draughts which are so dangerous in buildings where cold raw outside air is sucked into the building through the crevices of doorways and windows. In the large restaurants, and some other parts of the Carlton Hotel, reciprocating pumping is adopted, so as to insure the entrance of fresh air, and at the same time insure the direct extraction of air that has been used. 10. In the kitchen department, special and very interesting precautions have been taken in order to prevent the escape of heated air and cooking odours into the hotel; while, at the same time, they secure the highest degree of freshness and purity in the atmosphere of the kitchen. The kitchens are located just below the great restaurant, and, in order to isolate the restaurant from the heat of the kitchen, there intervene double asbestos ceilings. Into the space between these asbestos ceilings the fresh air is pumped on its way to descend into the kitchens; while, by reciprocating pumping, the heated air and cooking odours are extracted from the kitchen beneath by ducts, which convey it into 32 the furnaces of the boilers and instantly and absolutely cremate these food-odours. In order to accomplish this, the kitchen is treated as an inverted tank of which the bottom is formed by the lower of the two asbestos ceilings, while the walls are sealed air-tight down to a level of 6 feet 6 inches from the floor. Free ingress and egress upon the floor level are thus obtained, while above is a large air space, or inverted tank, into which the heated air and cooking odours rise, and out of which they are continually drained by the pumps and cremated. Not only does this arrangement protect the atmosphere of the hotel from the invasion of air unseasonably heated, and laden with the odours of other people's meals; it also secures a pure atmosphere in the kitchen, and thus enables the highest results to be attained for that delicate cooking which is intended to be made a prominent feature of the administration of the Carlton Hotel. In a foul, unventilated hotel kitchen, burdened with heat and with the smells of all sorts of meats and vegetables, the atmosphere has a professional stink which never arrives with the intermittent cooking of an ordinary gentleman's house. By means of this stink all delicate flavours are merged in an indistinguishable hotel - flavour—a flavour which destroys the individuality of all choice viands, and soon makes the guests long for their own home cooking. In some hotels the viands are all alike in this awful hotel flavour, but the guests do not see what it is that so soon makes them sicken of the elaborate cooking—nor do the cooks know what it is that blunts their perceptions so far as to prevent their reaching the highest successes of the culinary art. II. In order to provide against the possible contingency of fire occurring at a moment when the Water Company's pressure would not carry a full flow of water to the roof of so lofty a building as the Carlton Hotel, the Directors have had special pumping engines erected in the basement, by which the low-pressure main-water, which is always on hand in unlimited quantity, can at once be made to deluge the roof or upper floor of the Hotel, 33 and instantly extinguish a fire. This provision, taken with the fact that all the floors, staircases, and ceilings are fireproof, and that unintermittent supervision of the fire hydrants and Hotel will be maintained on the premises, seems to make the building as safe as possible against fire. 12. Electric light is used throughout the hotel. Bells are superseded by chamber-telephones, with a regular exchange in the hotel. On pressing a button in one's apartment, one is put into direct speaking communication with any other person in the hotel. This sketch will show how enormously costly and complicated are the sanitary appliances of a great building like the Carlton Hotel. It is obvious that such a building may often require to be treated differently from a small threestorey house in which the imposition of sanitary work of such a costly quality would be a serious hardship. UNFAVOURABLE CONDITIONS. As to conditions in the district of St. James which are dangerous to the public health, they continue to exist on the north-east side of Regent Street. These conditions are due to the tortuosity of the streets in that district, to the survival of worn-out and short-leased old buildings now traded in as tenement-houses, and to the influx of Polish Jews and other workmen. These foreign workmen have never seen a water-closet before being shipped to St. James's, and their ideas as to sanitation are utterly rudimentary. The landlords who take these people in as tenants have the greatest difficulty in reducing them to order, and in protecting the closets and drains from being stopped up. Sometimes the landlord is worried by a malicious tenant, or a reprimanded servant, who purposely stops up a closet, and then makes a formal complaint to the Sanitary Department. But the only practical course is to saddle the landlord with full responsibility for the neglect or misconduct of the tenants whom he harbours, at large rents, for his own profit; and, while this district remains occupied with old houses built upon 34 tortuous and narrow streets through which no stranger can find his way, it is obvious that the sites cannot be properly utilized, and that they must continue to be appropriated by workmen of a rough sort. In my annual report for the year 1896 (pages 21, 22, and 23) I submitted a full statement as to the evils which exist in this part of St. James's, as to the rental value of this area in the very centre of Western London and within one minute's walk of Regent Street, and as to how it could be opened up and improved. Nothing has been done as yet for the improvement of this part of St. James's. It is obvious that a new street—such as Baker Street—carried through from the north end of the Haymarket to Poland Street would enormously increase the value of the land in this district, and would profitably break up and transform this nest of old houses and tortuous streets. The gradual reconstruction of this old quarter is, however, continuously progressing. Warehouses and workshops are taking the place of the old tenement-houses; and the Pall Mall Electric Light Company have, under their new Act, obtained power to clear and absorb into their works a considerable area west of Broad Street, Golden Square. But these rebuildings, while a distinct improvement, are mostly cast in the old mould of these narrow and tortuous streets; and, in point of fact, they every year make more difficult that radical replanning of the district which is called for. Moreover, the extrusion of the working classes, which is increasingly taking place in some parts of this district gives rise to a fierce competition for the tenement-houses which remain. This is a serious and increasing evil. Meanwhile the local authorities own from three to four acres of land in the centre of this unparalleled London site, and these acres are occupied by an old Union House, where aged and infirm people are lodged under miserable surroundings. I again earnestly submit that these poor people would be infinitely better and happier in the country, and that upon the site of this old Workhouse and its surrounding old houses a 35 splendid area of model artizan dwellings, chamber-workshops, and workmen's dining-halls could be provided upon a basis which would combine a 3 per cent. dividend with an enlightened philanthropy. It would certainly be desirable to provide lodgings, or chamber-workshops, under proper sanitary regulations, for such workers as are connected with the great shops and warehouses of St. James's. But the development of new suburban villages—such as those of the Artizans' Dwellings Company at Queen's Park, Harrow Road; and at Noel Park, Wood Green—together with cheap trains and trams, will provide more health and comfort for the working classes than any possible block-dwellings upon costly sites in Central London. In the event of opening up this district by a new street, a question would arise as to the large site of the old brewery in Broad Street, Golden Square. It is obvious that a brewery is out of place in St. James's, in as much as it defiles the atmosphere, and burdens crowded streets of great importance with a vast amount of heavy traffic. The encumbering of large and valuable areas in the centre of London by old workhouses, where the aged and infirm poor are cooped up under miserable surroundings; and by breweries and other coarse factories, is becoming a question of large metropolitan importance. These are cases to which an equitable Parliamentary persuasion should be applied. Moreover, in breweries and some other factories, the highest quality of production cannot be obtained except in a pure atmosphere and in newly-planned aseptic buildings furnished with modern plant. I have the honour to remain, Mr. Chairman and Gentlemen, Your obedient Servant, JAMES EDMUNDS, 26, Manchester Square. 36 37 Table A.—DEATHS registered during the year 1898 in the Parish of St. James, Westminster—a Metropolitan District. Classified according to Diseases, Ages, and Localities. Localities. Mortality from all causes, at subjoined ages. Mortality from subjoined. causes -distinguishing deaths of children under five. At all Ages. Under 1. 1—5. 5-15. 15—25. 25—65. 65 and upwards. Ages. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Small-Pox. Scarlet Fever. ‡ Diphtheria. Membranous Croup. Typhus. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Cancer. * Injuries. All other Diseases. Total. Enteric. § Continued. Relapsing. Puerperal. (b) (c) (d) (e) (f) (g) (h) (i) Parish of St. James (minus Union-House and Throat Hospital) 236 67 26 5 9 86 43 Under 5. .. .. .. .. .. .. .. .. .. .. .. 11 1 7 .. 5 24 1 .. .. 45 94 5 upwds. .. .. .. .. .. .. .. .. .. .. .. 1 .. 2 1 17 47 29 9 3 33 142 Westminster UnionHouse, Poland St. 79 2 .. .. 1 23 53 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 2 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 5 13 33 2 .. 23 77 Throat Hospital, Golden Square .. .. .. .. .. .. .. Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Totals 315 69 26 5 10 109 96 Under 5 .. .. .. .. .. .. .. .. .. .. .. 11 1 7 .. 5 25 1 .. .. 46 96 5 upwds. .. .. .. .. .. .. .. .. .. .. .. 1 .. 3 l 22 60 62 11 3 56 219 The subjoined numbers have also to be taken into account in judging of the above records of Mortality. Deaths occurring outside 125 7 4 11 8 74 21 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. 6 11 the district among persons belonging thereto † 5 upwds. .. 2 2 .. .. 1 .. .. .. .. .. .. .. .. .. 20 15 25 10 3 36 114 Deaths occur'g within the district among persons 32 3 .. .. 1 9** 19 Under 5 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 2 3 not belonging thereto 5 upwds. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 5 7 .. 1 14 20 * In the model form the heading of column 19 is left blank for the insertion of any other disease which it may be thought desirable to record. I have inserted "Cancer." Two extra columns might well be devoted to the tabulation of "Malignant Growths," and of "Tuberculous Diseases"; but, for this, a greater precision is needed than at present obtains in the Certificates as to the Causes of Death. ‡ The term "Scarlatina" often suggests that the cases are not infectious. As this is a dangerous mistake, Scarlet Fever is the only term used. § Enteric Fever is also called "Typhoid." The term Typhoid arose from the supposition that this fever was akin to Typhus. It is now known to be a distinct fever, generally marked by an affection of the lining membrane of the intestine, which is as characteristic as is the affection of the skin in Small-Pox. It is described here as Enteric Fever. † More precisely, these figures are of "persons removed from St. James's." Some of these were more or less casually in the Parish, and are not fairly described as "belonging thereto." ** Including 1 death in Union House of a wandering person of unknown address. 38 39 Table B—POPULATION, BIRTHS, AND NEW CASES OF INFECTIOUS SICKNESS coming to the knowledge of the Medical Officer of Health, during the year 1898, in the Parish of St. James's, Westminster—a Metropolitan District. Classified according to Diseases, Ages, and Localities. Localities. Population at all Ages. Registered Births. Infectious Sickness Reported in each locality. Infectious cases removed to extra-parochial hospitals. Ages. 1 2 3 4 5 6 7 8 9 10 11 Totals. 1 2 3 4 5 6 7 8 9 10 11 Totals. Census 1891 Census 1896. Smallpox. Scarlet Fever. Diphtheria. Membranous Croup. Fevers. Fevers. Cholera. Erysipelas. Smallpox. Scarlet Fever. Diphtheria. Membranous. Croup. Fevers. Cholera. Erysipelas. Typhus. Enteric. Continued. Kelapsing. Puerperal. Typhus. Enteric. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) Parish of St. James (minus Union-House and Throat Hospital) ... ... 414 Under 5 ... 13 16 ... ... ... ... ... ... ... ... 29 ... 10 12 ... ... ... ... ... ... ... ... 22 5 upwards ... 18 25 1 ... 6 ... ... ... ... 20 70 ... 16 l6 ... ... 5 ... ... ... ... 2 39 Westminster Union House, Poland Street ... ... 32 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Throat Hospital, Golden Square ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Parish of St James's 24,995 23,050 446 Under 5 ... 13 16 ... ... ... ... ... ... ... ... 29 99 ... 10 12 ... ... ... ... ... ... ... ... 22 61 5 upwards ... 18 25 1 ... 6 ... ... ... ... 20 70 ... 16 16 ... ... 5 ... ... ... ... 2 39 "Notification of Infectious Disease" has been compulsory in the District since October, 1889. The Isolation Hospitals used by the sick are all outside the Parish. They are the various Hospitals of the Metropolitan Asylums Board. To these Isolation Hospitals 52 of the above removals took place, while 9 went to other extra parochial Hospitals (vide page 10 and Table II.). Many such cases in St. James's, again, are not completely described as "removed from their homes." To meet these facts and to increase the clearness of Tables A and B, I have slightly altered the wording of certain headings and the ruling of certain compartments. In the preparation of the above Tables A and B, as prescribed by Sec. 15 of Article 18 of the Order of the Local Government Board, I have given attention to the annotations which are endorsed upon the Model Forms.—J. E, 40 APPENDIX TO REPOET OF MEDICAL OFFICER OF HEALTH. Table II.-Cases of Infectious Diseases notifiable under the Public Health (London) Act, 1891, Sec. 55, and coming to the knowledge of the Medical Officer of Health during the year 1898. No of Case. Date. Address. Sex. Age. Disease. Removed to. Patient's Occupation. Parent's Occupation. Remarks. 1 Jan. 6 9, Berwick street Female 56 years Erysipelas Not removed Wife of a Gasfitter Died Jan. 6 2 5 107, Wardour street Male 44 years Diphtheria Haverstock Hill Hospital Bootmaker 3 7 9, Green's court Female 9 years Scarlet Fever Fulham Hospital Scholar Butcher 4 10 13, Livonia street Male 25 years Enteric Fever Stockwell Hospital Printer 5 11 8, Green's court Male 14 years Diphtheria Fulham Hospital Printer's Assistant 6 13 17, Sherwood street Female 15 years Diphtheria Fulham Hospital Chorus Singer 7 18 72, Regent street Male 3 years Scarlet Fever Stockwell Hospital Nil Waiter 8 28 2, Hopkin street Male 4 years Diphtheria Stockwell Hospital Scholar Porter 9 29 18, Broad street Female 7 years Diphtheria Fulham Hospital Scholar Collector 10 Feb. 12 33, Marshall street Male 4 years 8 months Diphtheria Fulham Hospital Nil Tailor 11 14 Carlton Club, Pall Mall Male 16 years Scarlet Fever London Fever Hospital Lift Boy 12 12 65, St. James's residences, Little Pulteney street Female 11 months Diphtheria Hospital for Sick Children Gt. Ormond St. Nil Silversmith Died 41 13 Feb. 21 10, Portland street Male 1 year 9 months Diphtheria Haverstock Hill Hospital Nil Tailor 14 23 8, Denman street Female 6 years Membraneous Croup Not removed Scholar Musical Instrument Maker 15 25 5, Ingestre buildings, I ngestre place Female 8 years Diphtheria Not removed Scholar Boot Closer 16 Mar. 3 11, Denman street Male 7 years Diphtheria Haverstock Hill Hospital Scholar Tailor 17 9 10, Portland street Female 19 years Diphtheria Haverstock Hill Hospital Tailoress 18 12 66, King street, Regent street Female 6 years Diphtheria Haverstock Hill Hospital Scholar Tailor 19 14 66, King street, Regent street Female 3 years Diphtheria Haverstock Hill Hospital Nil Tailor 20 25 54, Carnaby street Male 3 years Diphtheria Fulham Hospital Nil Tailor 21 28 72, Regent street Female 11 months Scarlet Fever Stockwell Hospital Nil Waiter 22 31 30, Berwick street Male 10 months Diphtheria Not removed Nil Tailor 23 April 1 52 Ingestre buildings, Ingestre place Female 6 years Facial Erysipelas Not removed Scholar Police Constable 24 5 39, St. James's place Male 54 years Enteric Fever Not removed Gentleman 25 9 14, Cork Street Female 26 years Scarlet Fever Fulham Hospital Barmaid 26 15 41, Great Windmill street Female 11 years Scarlet Fever Stockwell Hospital Scholar Warehouseman 27 18 23, Great Pulteney street Female 46 years Erysipelas Not removed 28 23 29, St James's place Male 5½ years Scarlatina London Fever Hospital Scholar Housekeeper 42 APPENDIX TO REPORT OF MEDICAL OFFICES OF HEALTH. Table II.—Cases of Infectious Diseases notifiable under the Public Health (London) Act, 1891, Sec. 55, and coming to the knowledge of the Medical Officer of Health during the year 1898—continued. No of Case. Date. Address. Sex Age. Disease. Removed to. Patient's Occupation. Parent's Occupation. Remarks. 29 April 25 2, Noel street Male 8 years Scarlet Fever Stockwell Hospital Scholar Labourer 30 May 6 4, Edward street Female 3 years 8 months Diphtheria Not removed Nil French Polisher 31 9 33, Duke street Male 18 Scarlet Fever Fulham Hospital Servant ' 32 10 1, Silver place Male 4 years Scarlet Fever Stockwell Hospital Nil Tailor 33 10 56, Poland street Female 20 years Enteric Fever Stockwell Hospital Tailoress 34 17 16, Ingestre buildings, Ingestre place. Female 55 years Facial Erysipelas Not removed Tailoress 35 20 10, Sherwood street Male 5 years Diphtheria Not removed Nil Restaurant 36 21 266, Regent street Female 40 years Diphtheria Not removed Dressmaker Keeper 37 23 45, Poland street Female 2 years Diphtheria Not Removed Nil Tailor 38 27 3, Archer street Female 4 years Scarlet Fever Stockwell Hospital Nil Tailor 39 24 Norfolk House, St. James's square female 26 years Erysipelas Not removed Kitchenmaid 40 27 84, Berwick street Female 3 years Scarlet Fever Stockwell Hospital Nil Confectioner 43 41 31 90, Berwick street Male 5½ years Scarlet Fever Not removed Scholar Publican 42 June 1 29, Carnaby stree t Female 15 months Di phtheria Stockwell Hospital Nil Grocers' Assistant Died 43 3 11, Marlborough mews Male 52 years Erysipelas Not removed Police constable 44 7 15, Broad street Female 5 years Diphtheria Stockwell Hospital Scholar Mattress Maker 45 9 15, Broad street Female 3 years Diphtheria Stockwell Hospital Nil Mattress Maker 46 17 58, St. James's residences, Little Pulteney street Female 26 years Scarlet Fever Stockwell Hospital Wife of a tailor 47 20 11, Swallow street Female 23 years Typhoid Fever Stockwell Hospital Domestic Servant Died 48 30 35, Lexington street Female 47 years Facial Erysipelas Not removed Tailoress 49 July 4 10, West street Female 28 years Diphtheria Haverstock Hil Hospital Wife of a tailor 50 4 10, West street Male 4 years Diphtheria Haverstock Hill Hospital Nil Tailor 51 6 84, St. James's Residences, Little Pulteney street Female 58 years Erysipelas Not removed Tailoress 52 7 15, King street, Regent street Male 3 years Diphtheria Hospital for Sick Children, Gt. Ormond st. Nil Tailor 53 8 10, Golden square Male 44 years Diphtheria Not removed Tailor 54 14 5, Dufours place Male 38 years Diphtheria Homerton Hospital Tailor 55 19 49, Beak street Female 2½ years Scarlet Fever Not remove d Nil Publican 44 APPENDIX TO REPORT OF MEDICAL OFFICER OF HEALTH. Table 11.—Cases of Infectious Diseases notifiable under the Public Health (London) Act, 1891, Sec. 55, and coming to the knowledge of the Medical Officer of Health during the year 1898—continued. No.of Case. Date. Address. Sex. Age. Disease. Removed to. Patient's Occupation. Parent's Occupation. Remarks. 56 July 20 21 Gt. Pulteney-street Female 9 years Scarlet Fever Not removed Scholar Publican 57 21 United Service Club, Pall Mall Male 14 years Diphtheria Fulham Hospital Club Servant 58 25 32, Berwick street Female 60 years Diphtheria Fulham Hospital Charwoman Died 59 28 18, Sackville street Male 38 years Diphtheria Not removed Lodging-house keeper 60 29 2, Portland street Male 5 years 11 months Scarlet Fever Stockwell Hospital Scholar Tailor Died 61 Aug. 5 2, Portland street Female 7 years 11 months Scarlet Fever Stockwell Hospital Scholar Tailor Died 62 6 7, Livonia street Female 2 years 6 months Scarlet Fever Haverstock Hill Hospital Nil Tailor 63 9 31, Peter street Male 2 years 7 months Scarlet Fever Not removed Nil Porter 64 11 61, Poland street Female 33 years Erysipelas Not removed Tailoress 65 26 2, Little Marlborough st. Female 15 years Diphtheria Not removed Nil Plumber 66 29 7, Berwick street Female 54 years Erysipelas Not removed Widow 67 Sept. 1 11, Ryder street Male 23 years Diphtheria North-Western Hospital Store Keeper 45 68 Sept. 5 9, Green's-court Female 56 years Erysipelas Not removed Wife of a Labourer 69 6 12, Sherwood street Male 5 years Scarlet Fever Stockwell Hospital Scholar Tailor 70 17 7, King street, Regent street Female 9 years Diphtheria Not removed Scholar Cabinet Maker 71 22 22, Regent street Male 14 years Scarlet Fever London Fever Hospital Scholar Housekeeper 72 26 83, Berwick street Female 24 years Erysipelas Cleveland Street Asylum 73 27 9, Upper Rupert street Female 6 years Scarlet Fever Stockwell Hospital Scholar Whip Maker 74 Oct. 7 11, Sherwood-street Female 17 years Diphtheria North-Western Hospital Nil Newsagent 75 7 5, Upper John street Male 3 years Scarlet Fever Stockwell Hospital Nil Tailor 76 8 4, Rupert street Female 10 years Diphtheria Western Fever Hospital Scholar Carman 77 11 20, St. James's street Male 4 years Scarlet Fever Not removed Nil Tobacconist's Assistant 78 20 34, Broad street Female 2 years Scarlet Fever Fulham Hospital Nil Tailor 79 20 36, Broad street Female 4 years 3 months Scarlet Fever Fulham Hospital Nil Tailor 80 24 10, Marshall House, Marshall street Female 9 years Scarlet Fever. Tooting Hospital Scholar Tailor 81 Nov. 2 2, Hopkin street Female 7 years Facial Erysipelas Not removed Scholar Porter 82 4 18, Ormond yard' Female 3 years Scarlet Fever Fulham Hospital Nil Turncock 46 APPENDIX TO REPORT OF MEDICAL OFFICER OF HEALTH. Table II. —Cases of Infectious Diseases notifiable under the Public Health (London) Act, 1891, Sec. 55, and coming to the knowledge of the Medical Officer of Health during the year 1898—continued. No.of Case. Date. Address. Sex. Age Disease. Removed to. Patient's Occupation. Parent's Occupation. Remarks. 83 Nov. 7 7. Poland street Male 2 years Diphtheria Haverstock Hill Hospital Nil Tailor 84 9 119, St. James's residences, Broad street Female 17 years Erysipelas Not removed General Servant 85 11 17, Little Pulteney street Female 7½ years Diphtheria Not removed Scholar Foreman Silversmith 86 14 42, Broad street Male 51 years Erysipelas Cleveland Street Asylum Labourer 87 17 24, Brewer street Female 9 years Diphtheria University College Hospital Scholar Shoemaker Died. 88 18 7, Berwick street Male 15 years Typhoid Fever Fulham Hospital Errand Boy 89 18 24, Brewer street Male 4½ years Diphtheria Not removed Scholar Shoemaker 90 23 9, William and Mary yard Female 7 years Typhoid Fever Fulham Hospital Scholar Widow 91 Dec. 2 2, Peter street Male 20 years Scarlet Fever Fulham Hospital Butcher 92 3 209, Picadilly Male 45 years Erysipelas Not removed Caretaker 93 7 3, St. James's dwellings, Silver place Female 60 years Erysipelas Not removed Widow 47 94 Dec. 8 1, Kemp's court Female 50 years Erysipelas Not removed Wife of a Tailor 95 10 236, Regent street Male 21 years Erysipelas Not removed Draper's Assistant 96 13 13, Broad street Female 6 years Scarlet Fever Fulham Hospital Scholar Tailor 97 13 4, Harris place Male 2¼ years Diphtheria Middlesex Hospital Nil Foreman of Sweepers Died Dec. 17th, 1898. 98 13 27, Berwick street Male 65 years Erysipelas Not removed 99 21 47, Duke street Female 12 years Diphtheria Not removed Scholar Lodging-house Keeper 48 PARISH OF ST. JAMES, WESTMINSTER. APPENDIX TO REPORT OF MEDICAL OFFICER OF HEALTH. REPORT OF SANITARY INSPECTORS AS TO CONDITION OF BAKEHOUSES IN THE PAERISH DURING THE YEAR 1898. January 10th, 1899. To the Public Health Committee. Mb. Chairman and Gentlemen, We beg to report that the whole of the Bakehouses in the Parish (numbering 27) have been inspected by us during the year 1898. There has been considerable improvement in the general condition of the Bakehouses. In eight cases slight defects were found, and have been reported to you; but with these exceptions the Bakehouses have been well kept. During the past year one of the Underground Bakehouses has been closed, and will shortly be demolished. This reduces the number ot' Bakehouses in use at the present time to 26. We are, Mr. Chairman and Gentlemen, Your obedient servants, J. P. FOLLAND, T. W. CALVEELEY, Sanitary Inspectors. PARISH OF ST. JAMES, WESTMINSTER. APPENDIX TO REPORT OF MEDICAL OFFICER OF HEALTH. TABLE III.—ABSTBACT OF WORK DONE BY SANITARY INSPECTORS DUR1NG THE YEAR 1898. NUISANCES REMOVED OR AHATED. First Quarter. Second Quarter. 1 Third Quarter. Fourth Quarter. For the whole Year. Animals, Nuisances from, abated 0 0 1 0 1 Areas, whitewashed and cleansed 9 9 4 2 24 „ paving of, repaired 9 7 4 6 26 Basements, whitewashed and cleansed 25 16 10 19 70 „ floors, repaired and cleansed 5 8 5 7 25 „ lighted and ventilated 0 0 0 0 0 Baths, traps furnished to 0 0 0 0 0 Beds, disinfected 19 16 15 29 79 Bedclothes, disinfected 130 207 109 131 577 Bell traps, removed 0 19 14 16 49 Carpets, disinfected 2 2 1 0 5 Cisterns, cleansed 9 11 8 7 35 ,, new ones provided 0 0 0 0 0 „ covers furnished to 9 4 5 7 25 „ repaired generally 0 0 0 0 0 „ apparatus repaired 1 0 2 0 3 Cesspools, abolished 0 u 0 0 0 Drains, reconstructed with glazed pipes and ventilated 51 28 26 30 135 „ unstopped 6 2 2 2 12 „ repaired 3 3 2 5 13 traps furnished to 0 0 0 0 0 „ earthenware gully traps furnished to 7 2 0 0 9 ,, disconnected from sewer and ventilated 16 18 26 24 84 Dustbins, repaired 0 0 0 3 3 „ new ones provided 18 10 9 9 46 „ abolished 0 4 3 4 11 Dung pits abolished 0 0 0 0 0 ,, new provided 1 2 0 0 3 Foul matter removed 12 13 9 9 43 Food, unsound, seized and condemned 0 0 0 1 1 Gutters, cleansed and repaired 0 2 0 0 2 „ new ones furnished 3 0 0 0 3 Houses, furnished with water supply 0 0 0 0 0 „ water supply reinstated 0 0 0 0 0 ,, closed unfit for human habitation 0 0 0 0 0 „ ventilation improved 0 0 0 0 0 Kitchens, whitewashed 8 3 4 8 23 „ underground cleared of occupants 2 1 1 0 4 Lead flats, roofs cleansed 0 0 0 0 0 „ „ repaired 0 0 0 0 0 Mattresses, disinfected 11 19 9 13 52 Manure, removed 1 2 1 1 5 Miscellaneous articles disinfected 139 174 119 61 493 Passages, whitewashed and cleansed 1 4 1 3 9 „ floor of, repaired and cleansed 1 0 0 1 2 Pillows disinfected 61 58 44 57 220 Rain water pipes, new ones furnished 11 1 1 1 14 v „ unstopped, cleansed and repaired 0 3 1 6 10 „ disconnected from drain. 16 11 17 14 58 Rooms, whitewashed and cleansed 106 95 33 48 282 „ disinfected 16 21 19 15 71 „ overcrowded, abated 3 1 0 2 6 „ floors of, repaired and cleansed 7 0 0 2 9 Carried forward 718 776 506 543 2543 PARISH OF ST. JAMES, WESTMINSTER. APPENDIX TO REPORT OF MEDICAL OFFICER OF HEALTH. TABLE III—ABSTRACT OF WORK DONE BY SANITARY INSPECTORS DURING THE YEAR 1898—continued. NUISANCES REMOVED OR ABATED. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. For the whole Year. Brought forward 718 776 506 543 2543 Roofs, repaired 8 6 1 8 23 Rooms, ventilation improved 0 0 0 0 0 Service pipes, new ones furnished 0 0 0 0 0 ,, ,, repaired 0 0 0 0 0 Sinks, traps furnished to 1 0 1 0 2 ,, and lavatories, waste pipes disconnected from drain 18 30 19 20 87 „ „ repaired 0 0 2 2 4 „ new pipes and traps furnished to 0 0 0 1 1 „ unstopped and cleansed 0 0 0 0 0 Staircases, whitewashed and cleansed 26 14 6 12 58 ,, steps of, cleansed 0 0 0 0 0 Stables, cleansed and whitewashed 1 0 0 0 1 „ paving of, cleansed and repaired 1 0 1 1 3 Smoke, nuisance from, abated 3 9 1 4 17 Urinals (private) whitewashed 0 0 0 0 0 „ cleansed 0 0 1 1 2 „ traps furnished to 0 0 0 0 0 „ furnished with water supply 0 1 1 1 3 „ abolished 0 0 0 0 0 „ reconstructed 0 0 0 0 0 „ repaired 0 1 0 2 3 Vaults, whitewashed 2 0 0 0 2 Water closets, cleansed generally 18 37 9 21 85 „ „ furnished with water 0 0 0 0 0 „ „ „ „ new apparatus 20 1 1 3 25 „ ,, apparatus repaired 3 5 4 5 17 „ „ new pans furnished to 24 5 13 15 57 ,, „ pans cleansed 5 13 10 18 46 „ „ water supply reinstated and increased 1 14 7 9 31 „ „ repaired generally 3 4 4 6 17 „ „ abolished 2 3 2 0 7 ,, „ soil pipes, new, furnished to 12 9 11 10 42 „ „ „ ventilated 2 9 10 9 30 „ „ reconstructed 1 8 3 5 17 ,, „ new, erected 14 8 7 5 34 „ „ light and ventilation improved 9 17 7 7 40 „ „ soil pipes unstopped and repaired 2 2 0 1 5 ,, ,, traps furnished to 1 0 0 0 1 „ „ unstopped 9 3 1 6 19 Yards, whitewashed 8 7 3 5 23 „ paving of, cleansed 1 0 1 1 3 „ „ repaired 11 7 6 9 33 ., „ new traps to drain 12 3 2 2 19 Water stopped from running as a nuisance 0 1 3 5 9 Wearing apparel disinfected 321 662 396 265 1644 Wash-houses, whitewashed and cleansed 5 1 0 2 8 ,, „ floors repaired 3 1 1 1 6 Workshops, whitewashed and cleansed 9 20 1 6 36 „ overcrowding abated 0 3 0 3 6 „ ventilation improved 0 0 0 0 0 Water, separate supply for drinking purposes provided 1 0 1 2 4 „ (drinking), disconnected from water-closet 1 2 1 0 4 Total 1276 1682 1043 1016 5017 51 PARISH OF ST. JAMES, WESTMINSTER. APPENDIX TO REPORT OF MEDICAL OFFICER OF HEALTH. TABLE IV.—SUMMARY OF WORK BY SANITARY INSPECTORS DURING THE YEAR 1898. NUISANCES REMOVED OR ABATED. First Quarter. Second Quarter Third Quarter. Fourth Quarter For the whole year. No. of Complaints received 116 112 99 117 444 „ Small Pox cases visited ... ... ... ... ... „ Scarlet Fever 4 10 9 8 31 „ Typhoid (Enteric) Fever cases visited 1 3 ... 2 6 „ Continued Fever cases visited ... ... ... ... ... „ Puerperal „ „ ... ... ... ... ... Relapsing „ „ ... ... ... ... ... „ Typhus „ „ ... ... ... ... ... „ Diphtheria „ „ 15 7 ii "8 41 „ Erysipelas „ „ 1 6 5 8 20 „ Cholera „ „ ... ... ... ... ... „ Membranous Croup „ 1 ... ... ... 1 „ Articles disinfected „ 683 1138 693 556 3070 „ Rooms disinfected „ 16 21 19 15 71 ,, Articles obtained for Analysis 19 15 19 31 84 „ Bodies received into Mortuary 4 4 6 2 16 JOHN PERCY FOLLAND, THOMAS WINTER CALVERLEY, Sanitary Inspectors. 52 PAEISH OF ST. JAMES, WESTMINSTEB. APPENDIX TO REPORT OF MEDICAL OFFICER OF HEALTH. Table, V.—Underground Rooms or Cellars cleared of Occupants, under the 96th Section of the Act, 54 and 55 Victoria, cap. 76, up to end of year 1898. 4 Archer street 3 Heddon court 11 Marshall street 5 do. 6 do. 25 do. 16 Berwick street 7 do. 29 do. 18 do. 8 do. 44 do. 26 do. 10 Heddon street 47 do. 28 do. 16 do. 2 Noel street 29 do. 1 Hopkin street, front 5 do. 30 do. 9 do. two rooms 13 do. front room 36 do. 10 do. 21 do. 39 do. 11 do. 11 Peter street 43 do. 1 Kemp's court 20 do. two rooms 45 do. 2 do. 21 do. 49 do. 3 do. 22 do. 50 do. 4 do. 26 do. 56 do. 7 King street, Regent st. 12 Poland street 58 do. 8 do. 14 do. 66a do. 20 do. two rooms 21 do. 79 do. 21 do. 22 do. 81 do. front room 26 do. 56 do. two rooms 89 do. 66 do. 57 do. do. 95 do. 12 Lexington street 58 do. 50 Brewer street 14 do. 59 do. 4 Broad street 16 do. 4 Portland street 12 do. 18 do. 7 do. 13a do. 22 do. 11 do. 31 do. 27 do. 15 do. 35 do. 28 do. 19 do. 43 do. two rooms 29 do. 31 do. 44 do. 30 do. 7 Rupert court 45 do. 31 do. 11 Rupert street 52 do. two rooms 32 do. 30 do. 4 Carnaby street 33 do. 31 do. 6 do. 44 do. back 49 do. 17 do. two rooms 47 do. 2 Rupert street, Upper 18 do. do. 3 Livonia street 7 do. do. 27 do. do. 5 do. 43 Shaftesbury avenue, front room 30 do. 7 do. 7 Denman street 10 do. 2 Silver place, two rooms 1 Dufour's place 12 do. 1 Smith's court 3 do. back 13 do. 2 do. 9 do. 14 do. 3 do. 10 do. two rooms 2 Lowndes court 7 Sherwood street 3 Edward street 1 Marlborough row, two rooms 16 do. 24 Foubert's-pl., one 1 West street room 2 do. do. 6 do. 1 Ganton street 3 do. do. 8 do. 2 do. 4 do. do. 12 do. 3 do. 5 do. do. 14 do. 5 do. 6 do. do. 15 do. 17 do. 7 do. do. 24 Windmill street, Great 19 do. 9 do. do. 18 do. do. 26 Great Pulteney street 10 do do. 30 do. do. back room 9 Marshall street 32 do. do. 7 Green's court 10 do. 41 do. front JOHN PEECT POLL AND, 1 Sanitary THOMAS WINTEE CALVEELEY, / Inspectors. 53 REPORT UPON ARTICLES ANALYSED DURING THE YEAR 1898, made to the Pestry of Saint James's, Westminster, by JAMES EDMUNDS, M.D., M.R.C.P.Lond., F.C.S., &c., Medical Officer of Health and Public Analyst. Mr. Chairman and Gentlemen, During the year 1898, under the provisions of the Sale of Food and Drugs Acts, 82 samples were examined, all which were procured for examination by the Vestry Officers. In none of these samples was any poisonous ingredient discovered. Among the samples submitted for examination, there were:— Milks 37 Cocoas 10 Coffees 9 Mustards 8 Peppers 6 Arrowroots 5 Butters. 4 Vinegars 3 82 Nothing, except the stipend paid by the Vestry, has been received by me in connection with these analyses. The results of the analyses are shown in the following Table:— 54 Table of 82 Samples submitted for examination during the year 1898. Note.—A good average milk should contain 12.5 % of Milk Solids. Milks containing 13 % and over are described as "Excellent." Milks containing from 12 to 13 % are described as " Good." Milks containing less than 12 % are described as " Poor." Milks containing less than 11.25 % are certified as adulterated with water; and, thereupon, the percentage of added water is calculated by comparison with a standard of fair average Milk containing 12.5 % of Milk Solids. The Government Laboratory, when certifying Milk as adulterated with added water, calculates the percentage of added water by the standard of bottom-limit Milk—i.e., Milk containing ll.25% of Milk Solids of which 2.75% are fat, and 8.5% are solids-not-fat. For general remarks on Standards, see my Report on Food Analysis for year 1896 (pages 48-50); also the special Report on Milk Analysis appended to my Annual Report for year 1897. No. Article. Quality. Principal Facts of Analysis. Remarks. 1 Milk Excellent Contained Milk solids 13.45 % 2 Milk Good Contained Milk solids 12.26 % 3 Milk Excellent Contained Milk solids 14.69 % 4 Milk Good Contained Milk solids 12.65 % 5 Milk Good Contained Milk solids 12.38 % 6 Milk Poor Contained Milk solids 11.58 % 7 Milk Poor Contained Milk solids 11.43 % 8 Milk Poor Contained Milk solids 11.44 % 9 Milk Good Contained Milk solids 12.28 % 10 Milk Good Contained Milk solids 12.81 % 11 Milk Good Contained Milk solids 12.32 % 55 12 Milk Poor Contained Milk solids 11.69 % 13 Coffee Genuine 14 Arrowroot Genuine 15 Cocoa Genuine 16 Milk Good Contained Milk solids 12.08 % 17 Butter Genuine 18 Butter Genuine 19 Butter Genuine 20 Butter Genuine 21 Milk Excellent Contained Milk solids 13.43 % 22 Milk Excellent Contained Milk solids 13.56 % 23 Milk Excellent Contained Milk solids 15.64 % 24 Milk Good Contained Milk solids 12.53 % 25 Milk Good Contained Milk solids 12.31 % 26 Milk Good Contained Milk solids 12.58 27 Vinegar Contained real Acetic Acid 5.24 % 28 Vinegar Contained real Acetic Acid 3.72 % 29 Vinegar Contained real Acetic Acid 4.32 % 30 Milk Contained 11.92 % of added water— fair average Milk being taken as containing 12.5% of Milk solids. Contained Milk solids 11.0 % Compared with bottom-limit Milk—11.25 % of Milk solids as standard, this Milk would be certified as containing 2.13 % of added water. Vendor warned. 31 Milk Good Contained Milk solids 12.11 32 Milk Excellent Contained Milk solids 13.01 % 56 Table of 82 Samples submitted for examination during the year 1898— continued. No. Article. Quality. Principal facts of Analysis. Remarks. 33 Milk Excellent Contained Milk solids 1469 % 34 Milk Good Contained Milk solids 12 48 % 35 Milk Good Contained Milk solids 12.32 % 36 Milk Good Contained Milk solids 12.04 % 37 Milk Good Contained Milk solids 12.12 % 38 Milk Good Contained Milk solids 12.06 % 39 Milk Poor Contained Milk solids 11.28 % 40 Milk Good Contained Milk solids 12.61 % 41 Milk Good Contained Milk solids 12.75 % 42 Milk Excellent Contained Milk solids 15.81 % 43 Milk Good Contained Milk solids 12.57 % 44 Milk Poor Contained Milk solids 11.31 % 45 Cocoa Genuine Contained a few granules of accidental foreign starch 46 Cocoa Genuine Contained a few granules of accidental foreign starch 47 Cocoa Genuine 48 Coffee Genuine 49 Coffee Genuine 50 Arrowroot Genuine 51 Pepper Genuine 52 Mustard Genuine 57 53 Arrowroot Genuine 54 Milk Good Contained Milk solids 12.13 % 55 Milk Poor Contained Milk solids 11.70 % 56 Milk Good Contained Milk solids 12.24 % 57 Cocoa Adulterated Contained 30 % of foreign starch, and 10 % of foreign sugar Fined 60/- & 2/- costs 58 Coffee Genuine 59 Pepper Genuine 60 61 Pepper Cocoa Genuine Genuine Contained a few granules of accidental foreign starch 62 Coffee Genuine 63 Mustard Genuine 64 Coffee Genuine 65 Mustard Genuine 66 Coffee Genuine 67 Arrowroot Genuine 68 Arrowroot Genuine 69 Cocoa Adulterated Contained 45 % of foreign starch, and 15 % of foreign sugar Fined 60/- and 2/- costs 70 Coffee Genuine 71 Mustard Genuine 72 Mustard Genuine 73 Coffee Genuine 74 Cocoa Genuine 58 Table of 82 Samples submitted for examination during the year 1898—continued. No. Article. Quality. Principal Facts of Analysis. Remarks. 75 Mustard Genuine 76 Pepper Genuine 77 Coffee Genuine 78 Pepper Genuine 79 Cocoa Genuine 80 Mustard Genuine 81 Pepper Genuine 82 Mustard Genuine