STLU 4 REPORT ON THE SANITARY CONDITION, VITAL STATISTICS, &c„ OF THE Parish of St. Luke, Middlesex, FOR THE YEAR 1899. BY G. E. YARROW, M.D., Barrister-at-Law. DIPLOMATE IN PUBLIC HEALTH, ROYAL COLLEGE OF PHYSICIANS AND SURGEONS, LONDON. PAST PRESIDENT OF THE METROPOLITAN BRANCH OF THE INCORPORATED SOCIETY OF MEDICAL OFFICERS OF HEALTH. MEMBER OF THE SANITARY INSTITUTE. MEDICAL OFFICER OF HEALTH FOR THE PARISH AND DEPUTY CORONER FOR NORTH EAST LONDON. LONDON: Harmer & Harley, Ltd., 39 to 44, Cowper Street, Finsbury, E.C. 1900. 3 TO THE VESTRY OF THE PARISH OF ST. LUKE MIDDLESEX. Gentlemen, I present herewith my fifteenth Animal Report dealing with the Health, Sanitary Condition, Vital and other Statistics of the Parish for your consideration. The Sanitary District of St. Luke comprises an area of 239 acres, including Open Spaces, the Basin and Waterway of the Regent's Canal. The number of Inhabited Houses is now 3,529. The statistics of Marriages, Births and Deaths contained in this Report relate to the fifty-two weeks ending December 30th. 1899, and are calculated upon a population estimated to the middle of the year of 40,460, being a decrease upon the ascertained population at 1896 of 1,067 persons, and divided between the three Sub-Registration Districts as follows:— Estimated population at Midsummer, 1899. Population at Census, 1896. City Road District 29,747 29,897 Whitecross Street District 7,054 7,595 Finsbnry District 3,659 4,085 40,460 41,527 It will be seen from the above figures that the decrease which had hitherto affected the south side of Old Street, has now for the first time made itself manifest in the northern portion of the Parish also, but to a less degree. Marriages. The number of Marriages celebrated in St. Luke during the year was 417, the number of persons married being in proportion to 20.6 per 1,000 of the population. This is the highest rate it has ever been my duty to record. 4 The number of Marriages for the two previous years were 260 and 290 respectively. The Metropolitan marriage rate for 1899 was 18.4 per 1,000 of the population. Births. The Births registered in the Parish during the year numbered 1,810, 948 being boys and 862 girls: of the total number 556 were born in the City of London Lying-in Hospital, but as only 40 of the mothers were permanent residents in the Parish of St. Luke, a deduction of 516 has to be made from this number, leaving 1,294 as the actual figures which represent the Births to be credited to the Parish, and after allotting 40 to the several districts of the Parish in which the parents resided, the Births of the respective sub-districts were as fellow :— In the City Road Sub-Registration District there were 1,047, in the Whitecross Street Sub-Registration District there were 185, and in the Finsbury Sub-Registration District there were 62. In relation to the estimated population the figures stand as under:— s per 1,000 Inhabitants. For the whole Parish 31.98 City Road Sub-Registration District 35.23 Whitecross Street 26.22 Finsbury 16.94 The following table shows the number of Births belonging to the Parish for the past 7 years and rate per 1,000 ol the population Births. Rate per 1,000. 1893 1420 33.18 1894 1432 33.34 1895 1476 34.18 1896 1509 36.34 1897 1424 34.50 1898 1359 32.92 1899 1294 31.98 The number of Births in excess of the Deaths during the year 1899 amounted to 143. The number of Births registered in London amounted to 133,120, giving a rate of 29.4 per 1,000 of the population. This is the lowest London Birth-rate on record, still the excess of 5 Births over Deaths was 43,431, the average increment for the previous 10 years having been 47,836 per annum. Deaths. The Deaths from all causes registered during the year, belonging to St. Luke, numbered 1,151, and includes 495 parishioners who died in Institutions outside the Parish, but is exclusive of 121 non-parishioners who died within our parochial boundary. Of the 1,151 parishioners, 656 were males and 495 were females, a number which yields upon the estimated population a Deathrate equal to 28.44 per 1,000 persons living, being the highest Death-rate for 6 years, as shown by the following figures:— Deaths. Rate per 1,000. 1893 1277 29.84 1894 951 22.14 1895 1216 28.16 1896 1055 25.40 1897 1047 25.36 1898 1053 25.51 1899 1151 28.44 The Metropolitan Death-rate for the year was equal to 19.8 per 1,000 of the population, being one of the lowest London Death-rates hitherto recorded, the average Death-rate for 10 years having been 19.6. Infant Mortality: Of the 1,151 deaths of parishioners, 437, or 37.9 per cent., occurred to infants under 5 years of age. Mortality over 65 years of age:—239 parishioners were over 65 at the time of death, being at the rate of 20.1 per cent, of the total deaths recorded. The 121 deaths of non-parishioners occurred at the following Hospitals and other places in the Parish:— Royal Hospital for Diseases of the Chest 88 Royal London Ophthalmic Hospital 1 City of London Lying-in Hospital 15 St. Luke's Hospital for Lunatics 10 St. Mark's Hospital for Fistula 2 Sudden Deaths in the Street from Injuries or Disease 5 121 6 Hospitals, Asylums, Infirmaries, Workhouses, and other Institutions and places situated outside the Parish at which Parishioners died during the year:— Asylum for Imbeciles, Banstead 2 ,, ,, ,, Caterham 5 ,, ,, ,, Leavesden 3 ,, ,, Lunatics, Cane Hill 1 ,, ,, ,, Colney Hatch 3 ,, ,, ,, Dartford 3 ,, ,, ,, Hanwell 1 City of London Hospital for Diseases of the Chest 1 ,, ,, Infirmary, Bow 1 German Hospital, Dalston 1 Guards' ,, Rochester Row 1 Guy's „ 2 Holborn Union Infirmary, Archway Road 204 ,, Workhouses, Shepherdess Walk and Mitcham 137 Hospital for Sick Children, Great Ormond Street 4 ,, Women, Soho 1 King's College Hospital 1 London ,, 8 Metropolitan ,, 1 ,, Asylums Board Hospitals. 15 Middlesex Hospital 3 Mildmay ,, 1 River Thames 2 Royal Free Hospital, Gray's Inn Road 3 St. Anne's House, Stoke Newington 1 St. Bartholomew's Hospital 90 St. Luke's House, Osnaburgh Street 1 Temperance Hospital 1 In the Street, &c., Hackney 1 ,, ,, Hemmingford Road 1 In the Poplar Chemical Works 1 495 The above deaths are referred to in an early paragraph of this Report as those of parishioners who died in Institutions outside the Parish, and it will be seen that they constitute a considerable proportion of the total deaths, viz., 43.0 per cent. The list of such deaths is furnished to me weekly from the Registrar-General's office and is therefore official, nevertheless, I have from time to 7 time had reason to doubt its correctness, more especially of those persons who have died in the various establishments belonging to the Holborn Union, and who are for the most part simply described in the list as of "St. Luke's." The result of enquiries has been to prove that my doubts have been well founded, and that not more than 20 per cent, of the cases described as of St. Luke's really belong to this Parish. Inquests. One hundred and thirty-six Inquests were held on the bodies of parishioners during the year, being at the rate of 11.8 per cent, of the total deaths. Eighty-seven enquiries (6 being as to the cause of death of non-parishioners) took place at the Coroner's Court belonging to this Parish, and the cause of death was ascertained by post-mortem examination in 63 instances. The remaining 49 enquiries were held at Hospitals and Institutions outside our parochial area. Of the total Inquests the verdicts were recorded as follows:— Deaths due to Natural Causes 68 ,, Exposure and Privation 3 Accident or Neglect— Deaths due to Injuries the result of blows, falls, &c. 13 ,, ,, from burns, scalds, &c. 8 ,, ,, ,, being run over 5 ,, Accidental Poisoning 2 „ Drowning 1 ,, ,, Bone in Gullet 1 ,, Misadventure while under Chloroform 1 ,, Suffocation—while in bed with parents 14 ,, Alcoholic excesses 16 Suicide by Poison 1 ,, Rifle Shot 1 ,, Throwing herself from window 1 Murder by Strangulation 1 136 8 Returns of Sickness and Mortality. On pages 16 to 28 the following tables will be found: No. 1, giving the population, births, and cases of infectious disease which have come to my knowledge during the year 1899. No. II., the deaths which have been registered in the Parish, including also the deaths of parishioners in hospitals and other institutions outside the Sanitary District, classified according to diseases, ages, and localities. These tables are prepared in accordance with the requirements of the Local Government Board, in order to ensure greater uniformity in the reports of Medical Officers of Health than formerly existed. No. III. is of a more comprehensive character, and shows the deaths registered from all causes, inclusive of the deaths of parishioners at hospitals and public institutions outside the District, but exclusive of the deaths of non-parishioners at public institutions within the Parish. No. IV. is a summary of the population, births and deaths with rates per 1,000 of persons living in the Parish for the ten years 1890 to 1899 inclusive. No. V. is a return prepared by Mr. Bell, the Vaccination Officer, setting forth the number of cases of successful vaccination, so far as relates to children whose births were registered during the year ending June 30th, 1899. The figures show that those not yet found in consequence of removals, &c., number 195 out of a total of 1,856, being 10.5 per cent., a deficiency somewhat less than in former years. It will be seen from this Return that in 8 cases only was exemption claimed under Sec. 2, known as the Conscientious Objection Clause of the Vaccination Act. Sickness and Deaths due to the Principal Zymotic or Communicable Diseases. Small-pox.—For the fifth successive year I am in a position to report that no death from this cause has occurred to any parishioner of St. Luke, nor has any case of sickness from the disease been notified. The Metropolis furnished 3 deaths from Small-pox against 1 for 1898 and 16 for the year 1897. 9 Scarlet Fever was the registered cause of deaths in London in 398 instances, being the smallest number recorded from this disease since 1891, and being at the rate of 0.09 per 1,000 of the population living as compared with 0.21, the average rate in the 10 years immediately preceding; of these 398 deaths, 329 or nearly 83 per cent, occurred in public institutions. Belonging to our own district 7 deaths were certified, 5 of which took place in the Metropolitan Asylums Board Hospitals. This is a more favourable return than for the year 1898, when the deaths numbered 17. The returns of sickness from the same cause were also less, the numbers being 158 for 1899 and 197 for 1898 and 234 for 1897. Notwithstanding this improvement in the Registrar General's Annual Summary jnst issued, St. Luke is classed amongst the London Sanitary Areas which during the past year yielded the highest death-rate from Scarlet Fever, viz., 0.20 per 1,000 and was only exceeded by Fulham with 0.25 and in Rotherhithe with 0.27. Diphtheria caused the deaths of 8 parishioners against 21 for each of the two preceding years, and is in point of fact the smallest number of deaths from this disease that it has ever been my duty to record, and bears favourable comparison with the adjoining Sanitary Districts. 1,964 deaths occurred in London from Diphtheria during the year, being equal to a death-rate of 0.43 per 1,000 against 0.39 and 0.50 for the two previous years respectively ; the death-rate for St. Luke was 0.25. Fever.—Under this heading 5 deaths were registered as belonging to the Parish, all being ascribed to Enteric or Typhoid Fever. One of the cases died in the City Road District, one in St. Bartholomew's Hospital and was removed from the Whitecross Street District, and three in the Metropolitan Asylums Board Hospitals, all of which belonged also to the City Road District. The table of infectious sickness shows a considerable increase under the head of Fever compared with the previous year, 31 cases of Enteric and 1 of Puerperal Fever being notified. During the year 1898 17 cases in all were certified. 10 Admissions and deaths at the Metropolitan Asylums Board Hospitals, the Highgate Small-pox Hospital, and the London Fever Hospital of persons suffering from Small-pox, Scarlet Fever, Diphtheria and Enteric Fever, 1890-1899:— Years. Small-pox. Scarlet Fever. Diphtheria. Enteric Fever. Admissions. Deaths. Admissions. Deaths. Admissions. Deaths. Admissions. Deaths. 1890 25 4 6,991 521 965 317 518 95 1891 67 8 5,601 860 1,330 399 759 108 1892 366 38 13,686 850 2,021 584 430 65 1898 2,546 190 15,312 918 2,853 866 544 110 1894 1,226 108 11,892 725 3,691 1,041 538 96 1895 971 65 11,800 601 3,688 824 661 119 1896 211 8 16,627 674 4,580 956 600 96 1897 73 13 15,550 628 5,726 993 664 124 1898 5 — 12,456 521 6,615 996 869 143 1899 18 3 13,744 359 8,758 1,193 1,536 241 Whooping Cough was the cause of 13 deaths, being a smaller number than it has been my duty to record for the past 10 years. During the previous two years respectively 24 and 27 deaths were certified. The deaths from this disease in London numbered 1,720, aud was equal to a death-rate of 0.38 per 1,000 living, the mean rate for the ten years 1889-98 having been 0.54 per 1,000. Whooping Cough not being a notifiable disease, I am unable to state the amount of sickness due to it during the year. Measles.—For the same reason as that mentioned in reference to whooping cough the degree of Measles can only be judged by 11 the number of deaths ascribed to it, but it is satisfactory to note that it is credited with having been the cause of 25 deaths only against 37 deaths in 1898 and 34 in 1897. The Registrar General's Report shows that Measles was the certified cause of 2,143 deaths in the Metropolis, against 3,075 for 1898, and 1,929 for 1897. The Metropolitan death-rate was equal to 0.47 per 1,000 as compared with 0.62, the decennial average rate. Influenza.—Thirty deaths were ascribed to Influenza during the year, a number three times as great as the record for 1898. There was a marked increase also in the number of deaths from Influenza in London, during the year the figures being 1,817, and the greatest number recorded since 1895. Phthisis.— I regret to say that the improvement I was able to record in my last Report with respect to the deaths from Phthisis has not been maintained during the past year, and that St. Luke again is among the highest in the list of London Sanitary Districts with respect to deaths from this cause. The number of deaths which occurred in the Parish from this disease was 114, of which 54 took place at the Royal Hospital for Diseases of the Chest, and 49 of these being non-parishioners may be deducted. On the other hand, 79 parishioners died from the malady in Institutions outside the parochial area, making a total of 144 belonging to St. Luke; equal to a death-rate of 3.55 per 1,000 living, the next highest being St. George the Martyr, Southwark, with 3.53 per 1,000, while of the more highly favoure 1 districts Hampstead furnished 0.84 and Stoke Newington 0.88 per 1,000. In continuation of the work commenced at the early part of 1898 enquiries have been made respecting every death certified as due to Phthisis during the past year, the scope of such enquiry having relation to the occupation, habits and environment of the deceased person. The co-operation of Medical men practising in the District has also been solicited and an offer made in every case of death due to this, as in every other infectious case, to disinfect the rooms, bedding, clothing, &c.,but such offer has only been accepted in five instances out of 144 deaths from the disease. 12 Of the 144 deaths 98 occurred to males and 46 to females, 9 were children under 5 years, and 135 were above that age. The occupations were of such diverse character as to defy tabulating. In 26 cases a family history of consumption was stated to exist. Habits of intemperance were admitted in 27 cases, and in only 2 instances was such overcrowding found to exist as to justify notices for its abatement being served. Copies of the following circulars have been freely circulated in and about the District:— No. 1 being addressed to Medical Men and No. 2 to the General Public. [No. 1.] VESTRY OF ST. LUKE, MIDDLESEX. PUBLIC HEALTH DEPAETMENT. Vestry Hall, City Road, E.C. 9 Dear Sir, I have the satisfaction to inform you that the Vestry is now prepared, upon application being made at this office, to disinfect, free of charge, rooms, bedding, &c., of any Resident who has died from Phthisis, also rooms which have been occupied by patients who have been removed while suffering from that disease, and the Vestry trust that in the interest of Public Health they will have your support in their effort to check the spread of this distressing disease. I am, yours truly, G. E. YARROW, Medical Officer of Health. Dr. 13 [No. 2.] ST. LUKE, MIDDLESEX. PREVENTION OF CONSUMPTION. Under the term Tuberculosis is included the several forms of tubercular disease of which the chief are Phthisis, or Consumption, Tabes Mesenterica (Consumption of the Bowels), Tubercular Meningitis (Inflammation of the Membranes of the Brain), and Hydrocephalus (Water on the Brain), and one or more of these forms of the disease are found to exist in upwards of 70,000 of the deaths which occur each year in Great Britain alone. It is infectious in all its forms, spreading from person to person, or by means of tuberculous food, and is due to the existence of a germ, microbe or bacillus, the propagation of which is favoured by the existence of dampness, darkness and dirt, especially if these are combined with overcrowding or illventilated dwellings. The most infectious form of the disease is that known as Phthisis, or Consumption of the Lungs, which is spread by inhalation of air containing the specific bacilli. The phlegm coughed up by persons suffering from Phthisis contains an immense number of these germs, and, while moist, it is harmless, but when it becomes dry the germs pass into the atmosphere in the form of dust, and thus infect those who breathe it. Persons least able to resist the attack of Phthisis germs are those who are suffering from constitutional weakness or from diseases which lower the standard of general health, persons of intemperate habits, those engaged in dusty occupations or living in overcrowed rooms or under other insanitary conditions, while the maintenance of the body in good health, temperance and efficient sanitary surroundings form the best defence against infection, and it cannot, therefore, be too strongly impressed that fresh air and daylight (especially sunlight) promptly destroy the bacillus or germ. GENERAL PRECAUTIONS. Tuberculosis is not confined to human beings, but is common amongst the lower animals, especially cows and pigs, 14 the flesh of which when eaten, if not thoroughly cooked, is capable of giving rise to the disease, and milk obtained from cows suffering from Tuberculosis, particularly if the udder be the seat of the disease, is very often the means by which infection is conveyed, especially when milk forms the chief article of food, as in the case of infants and invalids. Milk should, therefore, always be boiled before use. All sleeping and other rooms used by a consumptive patient should be well ventilated and well lighted, a window left partly open both day and night. If a draught be feared this may be avoided by the use of a screen or by placing a piece of wood 6 inches wide beneath the lower sash and shutting the window on to it, thus allowing air to pass up between the middle rails of the window. A patient suffering from Phthisis should occupy a separate bed, and, if possible, a separate room. A patient should not spit about the house or work place or in public vehicles or even the street, but should use a spit cup, wide-mouth bottle or basin containing a small quantity of disinfectant, and the contents should be thrown down the w.c. or drain twice a day, and the vessel should be washed out with boiling water. Pieces of paper or rag may be used to spit into, provided they are at once burnt or washed down the w.c. Should, however, a handkerchief be used, it should be kept moist until it can be boiled or washed in some disinfectant. A consumptive patient should not swallow the phlegm, as it may infect the bowels or other parts of the body. It is dangerous for a consumptive person to be kissed on the mouth. Cups, spoons, knives, forks, &c., used by consumptive persons should be washed in boiling water immediately after use, and the remains of food left by such persons should be destroyed. Dusting of rooms should be done by damp dusters, which should afterwards be washed in boiling water. Carpets and 15 floors should be sprinkled with tea leaves or wet sawdust before sweeping, in order to avoid raising the dust, and the sweepings should he immediately burnt. The rooms occupied by consumptive persons should be kept scrupulously clean, and when vacated by the removal of a patient or by death, should be thoroughly disinfected, cleansed, whitewashed and re-papered; all articles of bedding, clothing, carpets, &c., should be disinfected as after other infectious diseases. Disinfection is done free of cost on application to the Public Health Department, at the Vestry Hall, City Road. Lastly, it should be well understood that although Consumption is an infectious disease, it is not only preventable but curable in some of its stages and capable of relief in all. Further, a consumptive patient is rendered perfectly harmless to others if the foregoing precautions are thoroughly observed. G. E. YARROW, Medical Officer of Health. Public Health Department, Vestry Hall, City Road. July, 1899. 16 17 No. I. Table of Population, Births, and of new cases of Infectious Sickness, coming to the knowledge of the Medical Officer of Health, during the year 1899, in the St. Luke, Middlesex, Sanitary District; classified according to Diseases, Ages and Localities. Names ok Localities adopted for the purpose of these Statistics ; Public Institutions being shown as separate localities. Population at all Ages. Aged under 5 or over 5. New Cases of Sickness in knowledge of the each Locality coming to the Medical Officer of Health. Number of such Cases Removed from their Homes in the several Localities for Treatment in Isolation Hospital. Last Census. Estimated to middle of 1899. Registered Births. 1 2 3 4 5 6 7 8 9 10 11 12 13 I 2 3 4 5 6 7 8 9 10 11 | 12 13 Small-Pox. Scarlatina. Diphtheria. Membranous Croup Fevers fevers. Cholera- Erysipelas. Small Pox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) City Road Sub-Registration District 29897 29747 1008 Under 5 ... 56 45 4 ... ... ... ... ... ... 7 ... ... ... 52 37 ... ... ... ... ... ... ... ... ... ... 5 upwds ... 64 33 ... ... 25 ... ... 1 ... 37 ... ... ... 59 24 ... ... 11 ... ... ... ... ... ... ... Whitecross Street SubRegistration District 7595 7054 179 Under 5 ... 4 3 ... ... ... ... ... ... ... 3 ... ... ... 4 3 ... ... ... ... ... ... ... ... ... ... 5 upwds ... 20 7 ... ... 1 ... ... ... ... 9 ... ... ... 20 6 ... ... 1 ... ... ... ... ... ... ... Finsbury Sub-Registration District 4035 3659 61 Under 5 ... 2 4 ... ... ... ... ... ... ... ......... ... ... ... 1 3 ... ... ... ... ... ... ... ... ... ... 5 upwds ... 12 4 ... ... 5 ... ... ... ... 6 ... ... ... 10 3 ... ... 4 ... ... ... ... ... ... ... City of London Lying-in Hospital ... ... 556 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Royal Hospital for Diseases of the Chest ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Royal London Ophthalmic Hospital ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... St. Luke's Hospital for Lunatics ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... St. Mark's Hospital for Fistula, &c. ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Totals 41527 40460 1804 Under 5 ... 62 52 4 ... ... ... ... ... ... 10 ... ... ... 57 43 ... ... ... ... ... ... ... ... ... ... 5 upwds ... 96 44 ... ... 31 ... ... 1 ... 52 ... ... ... 89 33 ... ... 16 ... ... ... ... ... ... ... 18 19 No. II. Table of Deaths, during the Year 1899, in the St. Luke, Middlesex, Sanitary District; Classified according to Diseases, Ages and Localities. Names of Localities Adopted for the purpose of these Statistics: Public Institutions being shown as separate localities. mortality from all causes, at subjoined ages. mortality from subjoined causes. distinguishing deaths of children under five years of age. At all Ages. Under 1 Year. 1 and under 5 5 and under 15 15 and under 25 25 and under 65 65 and upward 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Small-Pox. Scarlatina. Diphtheria. Membranous Crop fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Phthisis. bronchitis, Pneumonia, and Pleurisy. Heart Disease Influenza. Injuries. All other Diseases. Total. Typhus. Enteric or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i) City Road Sub-Registration District 501 199 78 10 12 147 55 Under 5 ... 1 3 3 ... ... ... ... ... ... ... 14 9 24 ... 5 64 1 6 13 134 277 5 upwds ... 1 ... ... ... l ... ... ... ... ... ... ... 1 2 41 66 29 10 4 69 224 Whitecross Street SubRegistration District 115 33 20 2 2 41 17 Under 5 ... ... ... ... ... ... ... ... ... ... ... 8 2 4 ... 3 13 ... ... 1 22 53 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... 2 ... 6 18 8 2 ... 26 62 Finsbury Sub-Registration District 32 10 4 1 1 10 6 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 1 3 ... ... 3 ... ... ... 7 14 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4 4 1 1 2 6 18 City of London Lying-in Hospital 18 17 ... ... ... 1 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 17 17 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Royal Hospital for Diseases of the Chest J99 ... 4 7 19 69 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... 1 4 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 53 4 20 ... 1 17 95 Royal London Ophthalmic Hospital 1 ... ... ... ... ... 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... 1 St. Luke's Hospital for Lunatics 9 ... ... ... ... 7 2 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... ... 7 9 St. Mark's Hospital for Fistula, &c. 2 ... ... ... ... 1 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2 2 Totals 777 259 106 20 34 276 82 Under 5 ... 1 3 3 ... ... ... ... ... ... ... 22 12 31 ... 9 82 1 6 14 181 365 5 upwds ... 1 ... ... ... 1 ... ... ... ... ... ... ... 3 2 105 94 59 13 7 127 412 The subjoined numbers have also to be taken into account in judging of the above records of mortality. Deaths occurring outside the District among persons belonging thereto 495 31 58 19 20 213 154 Under 5 ... 5 5 ... ... ... ... ... ... ... ... 3 1 7 1 24 1 ... 5 37 89 5 upwds ... ... ... ... ... 4 ... ... ... ... 1 ... ... 6 ... 78 98 40 11 20 148 406 Deaths occurring within the District among persons not belonging thereto... 121 15 2 8 17 75 4 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 2 ... ... ... 14 17 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 48 6 21 ... 1 27 104 20 TABLE III. Deaths registered from all causes, inclusive of the Deaths of Parishioners at Hospitals and Public Institutions outside the District, but exclusive of the Deaths of Non-Parishioners at Public Institutions within the Parish. causes of death ages. Total under 5 years of age. Grand Total all Ages. 0 to 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. CLASSES. I. Specific Febrile or Zymotic Diseases 49 51 6 1 21 15 100 143 II. Parasitic Diseases ... ... ... ... ... ... ... ... III. Dietic Diseases 1 ... ... ... 9 ... 1 10 IV. Constitutional Diseases 16 17 9 15 141 13 33 211 V. Developmental Diseases 27 ... ... ... ... 35 27 62 VI. Local Diseases 120 91 14 16 232 157 211 630 VII. Deaths from Violence 16 5 5 1 11 9 21 47 VIII. Deaths from ill-defined and not specified Causes 88 2 ... ... 4 4 40 48 267 166 34 33 418 233 433 1151 I. Specific Febrile or Zymotic Diseases. 1. Miasmatic Diseases. Small Pox, Vaccinated ... ... ... ... ... ... ... ... „ Unvaccinated ... ... ... ... ... ... ... ... „ No Statement ... ... ... ... ... ... ... Measles 8 17 ... ... ... ... 25 25 Scarlet Fever 1 5 1 ... ... ... 6 7 Typhus ... ... ... ... ... ... ... ... Whooping Cough. 5 8 ... ... ... ... 13 13 Diphtheria 2 6 ... ... ... ... 8 8 Simple Continued or Ill-defined Fever ... ... ... ... ... 1 ... 1 Enteric or Typhoid Fever ... ... 4 ... 1 ... ... 5 Other Miasmatic Diseases ... ... ... ... ... ... ... ... 21 TABLE III.—continued. causes of death. ages. Total under 5 years of age. Grand Total all Ages. 0 to 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Specific Febrile or Zymotic Diseases—continued. 2. Diarrhœal Diseases. Simple Cholera ... ... ... ... ... ... ... ... Diarrhoea, Dysentery 27 12 ... ... 3 5 39 47 3. Malarial Diseases. Remittent Fever ... ... ... ... ... ... ... ... Ague ... ... ... ... ... ... ... ... 4. Zoogenous Diseases. Cowpox, and effects of Vaccination ... ... ... ... ... ... ... ... Other Diseases (e.g., Hydrophobia, Glanders, Splenic Fever) ... ... ... ... ... ... ... ... 5. Venereal Diseases. Syphilis 3 ... ... ... ... ... 3 3 Gonorrhœa, Stricture of the Urethra ... ... ... ... ... ... ... ... 6. Septic Diseases. Erysipelas ... ... ... ... ... 1 ... 1 Pyaemia, Septicæmia ... ... ... ... 2 ... ... 2 Puerperal Fever ... ... ... ... 1 ... ... 1 Influenza 3 3 1 1 14 8 6 30 49 51 6 1 21 15 100 143 II. Parasitic Diseases. Thrush, and other Vegetable Parasitic Diseases ... ... ... ... ... ... ... ... Worms, Hydatids and other Animal Parasitic Diseases ... ... ... ... ... ... ... ... 22 TABLE III.—continued. causes of death. ages. Total under 5 years of age. Grand Total all Ages. 0 to 1. 1 to 5. 5 to 15. 15 to 25 25 to 65. 65 and upwards. III. Dietic Diseases. Want of Breast Milk, Starvation 1 ... ... ... 1 ... 1 2 Scurvy ... ... ... ... ... ... ... ... Chronic Alcoholism ... ... ... ... 6 ... ... 6 Delirium Tremens ... ... ... ... 2 ... ... 2 1 ... ... ... 9 ... 1 10 IV. Constitutional Diseases. Rheumatic Fever, Rheumatism of the Heart ... ... ... ... 2 ... ... 2 Rheumatism ... ... ... ... 2 2 ... 4 Gout ... ... ... ... 1 ... ... 1 Rickets 1 2 ... ... ... ... 3 3 Cancer, Malignant Disease ... 1 ... ... 17 8 1 26 Tabes Mesenterica 4 1 ... ... 1 ... 5 6 Tubercular Meningitis, Hydrocephalus 2 2 2 ... ... ... 4 6 Phthisis 4 5 8 15 111 3 9 141 Other forms of Tuberculosis, Scrofula 5 6 4 ... 3 ... 11 18 Purpura, Hæmorrhagic Diathesis ... ... ... ... ... ... ... ... Anaemia, Chlorosis, Leucocytbæmia ... ... ... ... 3 ... ... 3 Glycosuria, Diabetes Mellitus ... ... ... ... 1 ... ... 1 Other Constitutional Diseases ... ... ... ... ... ... ... ... 16 17 9 15 141 13 33 211 23 TABLE III.—continued. causes of death. AGES. Total under 5 years of age. Grand Total all Ages. 0 to 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. V. Developmental Diseases. Premature Birth 24 ... ... ... ... ... 24 24 Atelectasis 1 ... ... ... ... ... 1 1 Congenital Malformation 2 ... ... ... ... ... 2 2 Old Age ... ... ... ... ... 35 ... 35 27 ... ... ... ... 35 27 62 VI. Local Diseases. 1. Diseases of Nervous System. Inflammation of Brain or Membranes 4 4 2 ... 2 1 8 13 Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis ... ... ... ... 21 12 ... 33 Insanity, General Paralysis of the Insane ... ... ... ... 3 2 ... 5 Epilepsy ... ... 1 ... 2 1 ... 4 Convulsions 15 1 1 ... ... ... 16 17 Laryngismus Stridulus (Spasm of Glottis) ... ... ... ... ... ... ... Disease of Spinal Cord, Paraplegia, Paralysis Agitans ... ... ... ... 1 ... ... 1 Other Diseases of Nervous System ... ... ... ... 2 ... ... 2 2. Diseases of Organs of Special Sense. Diseases of Organs of Special Sense, e.g., of Ear, Eye, Nose ... 1 ... ... ... ... 1 1 3. Diseases of Circulatory System. Pericarditis ... ... ... ... 2 ... ... 2 Acute Endocarditis ... ... ... ... 1 ... ... 1 Valvular Diseases of Heart ... ... 1 3 12 7 ... 23 Other Diseases of Heart 2 ... 1 2 32 23 2 60 Aneurism ... ... ... ... 2 ... ... 2 Embolism, Thrombosis ... ... 1 ... ... 1 ... 2 Other Diseases of Blood Vessels ... ... ... ... ... ... ... ... 24 TABLE III.—continued. CAUSES OF DEATH. AGES. Total under 5 years of age. Grand Total all Ages 0 to 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Local, Diseases—continued. 4. Diseases of Respiratory System. Laryngitis ... 2 ... ... ... ... 2 2 Croup 1 4 ... ... ... ... 5 5 Emphysema, Asthma ... ... ... ... ... ... ... ... Bronchitis 25 25 1 2 58 75 50 186 Pneumonia 20 35 1 1 39 12 55 108 Pleurisy ... ... ... ... 5 1 ... 6 Other Diseases of Respiratory System ... ... ... ... ... ... ... ... 5. Diseases of Digestive Organs. Dentition 2 3 ... ... 1 ... 5 6 Sore Throat, Quinsey ... ... ... ... ... ... ... ... Diseases of Stomach 2 2 1 1 4 ... 4 10 Enteritis 46 11 1 1 2 ... 57 61 Obstructive Diseases of Intestines ... ... ... ... 2 2 ... 4 Peritonitis ... 2 ... 2 1 2 2 7 Ascites ... ... ... ... ... ... ... ... Cirrhosis of Liver ... ... ... ... 10 5 ... 15 Jaundice, and other Diseases of Liver ... ... ... ... 1 1 ... 2 Other Diseases of Digestive System ... ... ... ... ... ... ... ... 6. Diseases of Lymphatic System. e.g., of Lymphatics and of Spleen. ... ... 1 ... ... 1 ... 2 7. Diseases of Glandlike Organs of Uncertain Use. e.g., Bronchocele, Addison's Disease ... ... ... ... ... ... ... ... 8. Diseases of Urinary System. Nephritis ... 1 1 2 16 5 1 25 Bright's Disease, Albuminuria ... ... ... ... 6 2 ... 8 Disease of Bladder or of Prostate 1 ... ... ... 1 ... 1 2 Other Diseases of the Urinary System ... ... ... ... ... ... ... 25 TABLE III.—continued. CAUSES OF DEATH. AGES. Total under 5 years of ag . Grand Total all Ages. 0 to 1. 1 to 5. 5 to 15. 15 to 95. 25 to 65. 65 and upwards. Local Diseases—continued. 9. Diseases of Reproductive System. Male Organs ... ... ... ... ... ... ... ... Female Organs ... ... ... ... ... ... ... ... Abortion, Miscarriage 1 ... ... ... ... ... 1 1 Puerperal Convulsions ... ... ... ... ... ... ... ... Placenta Prævia, Flooding ... ... ... ... ... ... ... ... Other Accidents at Childbirth ... ... ... 1 2 ... ... 3 10. Diseases of Bones and Joints. Caries, Necrosis ... ... 1 1 1 ... ... 3 Arthritis, Ostitis, Periostitis ... ... ... ... ... 4 ... 4 Other Diseases of Bones and Joints ... ... ... ... 1 ... ... 1 11. Diseases of Integumentary System. Carbuncle, Phlegmon ... ... ... ... 1 ... ... 1 Other Diseases of Integumentary System 1 ... ... ... 1 ... 1 2 120 91 14 16 232 157 211 630 VII. Deaths from Violence. 1. Accident or Negligence. Fractures and Contusions ... 1 2 1 8 9 1 21 Gunshot Wounds ... ... ... ... 1 ... ... 1 Cut, Stab ... ... ... ... ... ... ... Burn, Scald 2 3 2 ... ... ... 5 7 Poison ... ... ... ... 1 ... ... 1 Drowning ... ... ... ... 1 ... ... 1 Suffocation 14 ... 1 ... ... ... 14 15 Otherwise ... ... ... ... ... ... ... ... 26 TABLE III.—continued. causes of death. ages. Total under 5 years of age. Grand Total all Ages. 0 to 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. Deaths from Violence—continued. 2. Homicide. Manslaughter ... ... ... ... ... ... ... ... Murder ... 1 ... ... ... ... 1 1 3. Suicide. Gunshot Wounds ... ... ... ... ... ... ... ... Cut, Stab ... ... ... ... ... ... ... ... Poison ... ... ... ... ... ... ... ... Drowning ... ... ... ... ... ... ... ... Hanging ... ... ... ... ... ... ... ... Otherwise ... ... ... ... ... ... ... ... 4. Execution. Hanging ... ... ... ... ... ... ... ... 16 5 5 1 11 9 21 47 VIII. Deaths from Ill-defined & not specified Causes. Dropsy ... ... ... ... 1 ... ... 1 Debility, Atrophy, Inanition 37 2 ... ... 2 1 89 42 Mortification 1 ... ... ... ... 3 1 4 Tumour ... ... ... ... ... ... ... ... Abscess ... ... ... ... ... ... ... ... Haemorrhage ... ... ... ... 1 ... ... 1 Sudden Death (cause not ascertained) ... ... ... ... ... ... ... ... Causes not Specified or Ill-defined ... ... ... ... ... ... ... ... 88 2 ... ... 4 4 40 48 27 TABLE IV. SUMMARY of Population, Births and Deaths, with Rates per 1,000 of the Population for Ten Years. Population. Births. Rate per 1000. Deaths. Rate per 1000. No. of Deaths under 5 years. Deaths in outlying Institutions. 1890 42,880 1,575 86.7 1,277 29.7 536 equal to 41.9 percent. 377 equal to 29.5 per cent. of the whole 1891 42,440 1,533 36.1 1,277 300 537 „ 42.0 „ 404 „ 31.6 „ 1892 42,258 1,478 31.9 1,074 25.6 551 „ 51.3 „ 329 „ 30.6 „ 1893 42,076 1,420 33.7 1,277 30.3 576 „ 45.1 „ 492 „ 38.5 „ 1894 41,894 1,432 34.1 951 22.7 376 „ 39.5 „ 394 „ 41.5 „ 1895 41,712 1,476 35.1 1,216 29.1 591 „ 48.6 „ 401 „ 32.9 „ 1896 41,527 1,509 36.3 1,055 25.4 483 „ 36.3 „ 410 „ 38.8 „ 1897 41,272 1,424 34.5 1,047 25.3 458 „ 43.7 „ 396 „ 37.8 „ 1898 41,270 1,395 82.9 1,053 25.5 459 „ 43.5 „ 412 „ 39.1 „ 1899 40,460 1,294 31.9 1,151 28.4 437 „ 37.9 „ 495 „ 430 „ 28 TABLE V. Return respecting the Vaccination of Children whose Births were Registered between July 1st, 1898, and June 30th, 1899, in the Parish of St. Luke, Middlesex. registration sub-districts. Registered. Vaccinated. Certified as Insusceptible. Had Small-Pox. Died unVaccinated. Postponed by Medical Certificate. Removal to Districts, the Vaccination Officer of which has been duly apprized. Removal to Places Unknown and Cases not yet Found. Outstanding Cases. Consientious Objectors under Sec. 2. City Road 1592 433 6 — 186 36 195 277 453 6 Whitecross Street 199 87 3 — 27 3 — 21 56 2 Finsbury 65 30 — — 11 5 — 4 15 — Totals 1856 550 9 — 224 44 195 302 524 8 * These are Children born in the Lying-in Hospital, the Parents of whom belong to other Districts, the Officers of which have been furnished with the necessary information for enforcement of the Law. 29 PUBLIC HEALTH (LONDON) ACT, and WORK OF THE SANITARY DEPARTMENT. Notification of Infectious Diseases. The following Table gives the number and nature of the cases notified under Sections 55 and 56 of the Public Health Act during the 52 weeks ended December 30th, 1899, and indicates also where the same received treatment :— Total Number of Certificates from each cause. Treated at the Met ropolitan Asylums Board Hospital. Treated at General Hospitals and Infirmaries. Treated at the London Fever Hospital. Treated at their own Homes. Duplicate Certificates. Erroneously Diagnosed. Small-Pox ... ... ... ... ... ... ... Scarlet Fever 168 140 8 10 9 1 Diphtheria 105 68 10 7 11 9 3 Typhus Fever ... ... ... ... ... ... ... Enteric Fever 40 18 8 5 3 6 Continued Fever ... ... ... ... ... ... ... Membranous Croup 5 ... 2 ... 2 1 ... Puerperal Fever 1 ... ... ... 1 ... ... Erysipelas 73 ... 5 ... 57 9 2 Total number from all causes 392 226 25 15 86 81 12 The amount paid to the Medical practitioners for furnishing the above Certificates amounted to £35 8s. 6d. For the year 1898 the sum of £44 17s. 6d. was paid. The Vestry is recouped for this expenditure by the Metropolitan Asylums Board (out of the Metropolitan Common Poor Fund), to which Board a copy of each certificate is sent within 12 hours of the receipt of the same. 30 Houses Let in Lodgings. The Bye-laws made by the Vestry under Sec. 94 Public Health (London) Act, 1891, were sanctioned by the Local Government Board Order, 1898, were at once put into operation, and have been actively enforced during the past year. At the outset those houses only which were let to four or more families were placed upon the Register; this was afterwards extended to houses in which three families were resident. It will be manifest that the number of families occupying a house cannot be adopted as a standard of overcrowding, and that it may exist with two or even one family as its occupants, and such is occasionally found to be the case and they have been dealt with under Sec. 2 (e) of the Act. Experience shows that although registration considerably increases the work of the Sanitary Inspectors, it conduces to the better management and condition of tenement houses, and must tend to improve the comfort and health of the occupiers. The houses registered under the old Bye-laws numbered 16 Registered during 1899 125 Total now on Register 141 Housing of the Working Classes Act, 1890. Under part 2 of this Act the premises known as Lines Buildings, Richard's Place, Old Street, have been closed. The buildings have only been erected about ten years, but were of very faulty construction. They consist of two separate blocks, situated at the end of a cul-de-sac and about 6 ft. apart and connected on the first floor by a bridge. They have no back windows or means of through ventilation, and by reason of the height and close proximity of the two buildings the lower rooms are quite dark. They were originally intended to accommodate five families, but soon became overcrowded, and were registered as Tenement Houses under the Public Health Act; but the occupants could not be induced to obey the Bye-laws, and the premises soon became dirty and dilapidated and there appeared 31 110 other way of dealing with them but to prohibit their use for dwelling purposes, and a closing order was applied for and granted by the Magistrate in November last. Overcrowding.—What this phrase means cannot be answered categorically. The Public Health Act does not give a definition. Mr. Shirley Murphy in his Annual Report to the London County Council for 1898 classifies rooms occupied by more than two persons in houses of less than five tenements amongst the overcrowded. Your Vestry has adopted as a standard a minimum allowance of 300 cubic feet of space for sleeping purposes for each adult occupant, and 400 feet if the apartment is used for living as well as sleeping purposes, half the amount of space being allowed for children under 10 years of age. In view of the fact that for the maintenance of health a person requires a supply of 3,000 cubic feet of pure air per hour the above limit is small enough, but in a populated neighbourhood like St. Luke is all that can be for practical purposes demanded, and even with a space of 300 feet the renewal of air is required ten times in an hour to obtain the necessary standard. It therefore follows that what constitutes overcrowding largely depends upon ventilation. During the past year a number of cases of overcrowding have been discovered by the Sanitary Inspectors. A number also were reported by private persons. Upon investigation many of the latter were found to be unfounded complaints. The Sanitary Authorities being considered by some persons an excellent means by which troublesome or unpunctual tenants may be got rid of. In genuine cases it has not been found necessary to do more than serve the necessary notices, and at the date of this Report all the cases reported upon have been abated. The following figures give the whole of the cases reported:— Discovered by Inspectors 96 cases "Complaints by private persons 83 „ 179 Abated by notices 136 cases *Complaints found to be unfounded 43 „ 179 32 Temporary Shelter. Notwithstanding the fact that nearly 400 cases of Infectious Disease have been notified during the year, the accommodation provided by the Vestry, in accordance with the provisions of the Public Health Act for the temporary reception of persons during the time their own lodgings are undergoing disinfection, have not been once utilised during the past year; although upon receipt of each notification of the existence of infectious disease the premises have been at once visited aud a copy of the following notice handed to the occupier:— VESTRY OF SAINT LUKE, MIDDLESEX. Public Health Department, Vestry Hall, City Road, E.C. Infectious Disease. The Public Health Committee desires to give notice that, in cases where disinfection is carried out by the Vestry's Officials, there are provided for the use of those whose rooms are being disinfected, apartments at 41, Macclesfield Street, City Road, where every convenience is provided free of charge. Orders for admission can be obtained at the Vestry Hall, as above, between the hours of 9 and 6; Saturday, 9 till 2. G. E. YARROW, Medical Officer of Health. Disinfection of Infected Articles. Dr. Thresh's Current Steam Disinfector continues to act very satisfactorily. The number of articles disinfected by it during the year amounted to 5,047; included in which are 1.084 articles disinfected for Shoreditch Vestry during short periods while their own apparatus was undergoing repairs. 33 The number of rooms fumigated after the occurrence of cases of infectious sickness amounted to 419. Supply of Disinfectants. 424 persons were supplied with Carbolic Acid and Disinfecting Powder from the Mortuary upon presentation of orders for the same issued from this department. The Mortuary and Coroner's Court. During the twelve months under consideration 308 bodies have been received into the Mortuary, 87 Inquests were held in the Coroner's Court belonging to the Vestry, and 63 Post-mortem Examinations were made in the Post-mortem Room adjoining the Court. By arrangement with the London County Council the sum of £50 per annum is now received by the Vestry for the accommodation afforded by the Coroner's Court in lien of payment by fees as was wont to be the case. Public Health {London) Act, 1891. Food and Drugs Acts. The following is a list of the fines and costs incurred under the several Acts, also the nature and amount of adulteration where analyses were made:— Fines. Costs. Contravention of the London County Council Bye-laws - 1 5 0 Meat and milk deposited for the purposes of sale and being unfit for food 55 10 0 0 4 0 A short summary of the analytical work of the year 1899 may be of interest. 34 The total number of samples analysed was 258, comprising:— Milk, 93 samples; butter, 55; cheese, 7; margarine, 6; lard, 6; groceries, 61; spirits, 14; and disinfectants, 16. Of these there were found to be adulterated:—Milk, 17 samples; butter, 14; groceries, 4; disinfectants, 2; and margarine, 1; this last not being labelled. Article Sold as Extent of Adulteration. Fines. Costs. £ s. d. £ s. d. Butter 94 % of margarine 1 0 0 12 6 „ 61 % of foreign fat 10 c 12 6 „ Entirely margarine 1 i 0 12 6 Coffee 50 % chicory 12 6 Milk 14 % added water 10 0 12 6 „ 12 % „ 1 0 0 12 6 „ 18 % of cream abstracted 10 0 12 6 „ 17 % of added water 2 0 0 12 6 „ 11 % „ „ 1 0 0 12 6 „ 11 % „ „ 2 0 0 12 6 „ 44% „ „ 10 0 12 6 „ 13% „ „ 1 0 0 12 6 „ 8 % „ „ 3 0 0 2 0 Pepper 40 % of ground maize 1 0 0 12 6 £15 1 0 £8 4 6 Margarine Acts. Article Sold as Extent of Adulteration. Fines. Costs. £ s. d. £ s. d. Margarine Not properly labelled 5 0 0 12 6 „ „ „ „ 8 0 12 6 „ „ „ „ 1 0 12 6 „ „ „ „ ... 12 6 „ „ „ „ 3 0 12 6 „ „ „ „ 15 0 12 6 „ Refusing to serve Inspector 1 0 0 2 0 £1 7 0 £3 17 0 35 Canal Boats Acts.—The Sanitary Inspector in charge of the northern portion of the Parish has made frequent visits to that portion of the Regent's Canal which is situated within our Sanitary Area, and a detailed result of his inspections will be found in his RepOrt on page 40. Besides those already mentioned, I have made numerous Reports to your Public Health Committee on the various matters which have occupied its attention, and twice during the year I have visited and reported upon three slaughter-houses, two cowsheds, and 32 bakehouses situated in the Parish, with the result that notices to cleanse, whitewash, and remedy other sanitary defects were served upon the owners of two cowsheds and ten bakehouses. I have also visited 106 dwelling-houses, factories and workshops of which complaints were received, and in every instance iu which the Vestry's notice has not been complied with, and in such cases in which summonses have been granted, I have attended the police court in support of the same. I have the honour to be, Gentlemen, Your obedient servant, G. E. YARROW, M.D., D.P.H., &c. Vestry Hall, City Road, April, 1900. 36 Sanitary Inspectors' Report. To Dr. Yarrow, Medical Officer of Health. Sir, We beg to present the following report of our work in the Public Health Department during the year ending December 31st, 1899, as compared with the previous year:— 1899. 1898. Premises inspected 3488 2624 Re-inspections for following up work 9435 8865 Houses cleansed and repaired 855 721 Dust receptacles provided and repaired 198 262 Yards and areas to houses paved and amended 252 321 Traps provided to yard and house drains 243 234 Water receptacles cleansed, provided with covers 67 150 Water supplies re-instated 20 18 Drains amended and obstructions removed 210 383 Premises provided with new pipe drains 64 272 Rain-water pipes disconnected from drains and repaired 121 95 Lavatory sink wastes disconnected from drains 64 90 Water closets re-constructed 311 165 ,, water supply re-instated 195 207 Soil pipes re-instated and ventilated 68 102 Water closet pans cleansed 81 173 Overcrowding abated 155 118 Illegal occupation of underground rooms abated 12 19 Roofs and gutters amended 169 240 Accumulations of manure removed 53 60 Accumulations of rubbish removed 20 — Manure receptacles provided 4 6 Damp walls (houses) abated 29 23 Cesspools abolished 3 5 Water closets provided with permanent ventilation 40 - Animals kept so as to be a nuisance, same abated 11 21 Miscellaneous nuisances, same abated 81 111 Wells abolished 2 1 Cisterns abolished and water supplied direct from main 51 20 No. of rooms fumigated 419 442 No. of sets of bedding and clothing disinfected 283 402 No. of intimations served 1113 1794 Dust accumulations reported to Scavenging Department 112 131 37 House to House Inspection. During the year a systematic inspection was made to ascertain the existence of nuisance. The following list shows the streets visited. We would respectfully point out here that house to house inspection necessarily takes a great portion of our time as every room must be inspected and the particulars obtained so as to form an opinion as to whether there is existence of overcrowding : No. 1 District. Peerless Street Cottage Lane Graham Street Bath Buildings York Road Hall Street Nelson Street Nelson Place Mason's Place Radsworth Street Wharf Road New Charles Street City Road No. 2 District. Bastwick Street Central Street Clarence Place Lewin's Court Ironmonger Row Wellington Place Lewin's Gardens Anchor Yard Whitly Court Seward Street Ironmonger Passage Ludlow Street John's Place Coleman's Buildings Roby Street Garden Row Ironmonger Street No. 3 District. Goswell Road (lower end) Middle Row Chiswell Street Lamb's Passage Finsbury Street Roscoe Street Young's Buildings Bayer Street Sycamore Street Featherstone Buildings Featherstone Street Banner Street Wilson Street Beckford Square Honduras Street Moor Lane In a number of these streets, as will be noticed, are large premises used as factories and workshops, and where a first visit was paid the premises were duly registered and notifications were sent to the Factory Inspector and the London County Couucil as to provisions of fire escapes. 38 Infectious Disease. Houses from which infectious disease had been notified were promptly inspected, and any defective sanitary arrangements put in order, with the necessary stripping and cleansing of walls, &c. Under the sections of the Public Health Act (London), 1891, relating to Nuisances, very little trouble was encountered, the various owners and their agents appearing to readily carry out the necessary requirements after service of Statutory Notices. As a proof, it was not found necessary to take a case in Court during the year. Factory and Workshops Act, 1895, and Public Health (London) Act, 1891. Under the above Acts a systematic inspection is still being carried on, and special attention being paid to the provision of proper and suitable sanitary conveniences to the factories and workshops in the Parish. We are pleased to state that as a rule we find the employers are very willing to carry out the necessary improvements when their attention is directed to the same. The following shows the work done in this direction during the year as compared with the previous year:— 1898. 1899. Number of visits to workshops 838 352 ,, ,, ,, workrooms 913 1156 ,, ,, ,, ,, required cleansing 468 470 ,, ,, ,, ,, found satisfactory 445 686 ,, ,, defective drains found in workshops 49 62 ,, ,, foul water closets and urinals 160 97 ,, ,, additional water closets provided 80 80 ,, ,, water closets reconstructed and amended 131 192 ,, ,, workrooms measured 60 10 ,, ,, ,, found overcrowded 10 13 Ventilation provided to workrooms 75 160 Drains cleared and amended — 18 Cisterns cleansed and covered — 11 Water supplies reinstated to water closets — 82 Soil pipes ventilated and amended — 39 New drains provided — 29 Waste, urinal and rain-water pipes disconnected and amended - 62 39 Sanitary Notices served. 1898. 1899. Written intimations 1794 1498 Statutory notices 696 440 Notices of summons 118 84 Contravention of London County Council Bye-Laws. During the year there was but one case for proceedings, viz.:—Failing to give notice and not carrying out work as specified. The offender completed the necessary work and tendered an apology, he paying the costs of summons and Solicitor's fee. Food and Drugs and Margarine Acts, 1875, 1879 and 1887. "We respectfully beg to lay before you a brief statement of facts concerning the working of above Acts. We find that adulteration of various food stuffs are slightly below other years, thus showing that constant application of the Acts tend to decrease the fraud. During the year 258 samples of various foods were collected and submitted to the Analyst, the results of such analyses showing there was an increase of adulteration in the milks. We reported last year that certain milk vendors were in the habit of declaring milk sold to inspectors was " milk and water." This statement is not now made, but still the practice of watering goes on. A great difficulty exists in this Parish ; owing to its small area and the number of shops being limited, our assistants become readily known. We are, Sir, Yours obediently, R. ADAMS, H. E. COX, G. E. J. DAVIS. 40 Canal Boats Acts, 1877 and 1884. The following particulars are submitted, showing the number of boats inspected and re-inspected during the year at the various wharves on the City Road Basin, there being very little waterway within the St. Luke's sanitary area, and no traffic passing through. Inspections under these Acts are included in the Inspector's duties for the District in which the canal is situate. No. of Boats inspected during the year 110 „ „ infringing the regulations 13 „ „ without certificate 2 „ „ improperly lettered and marked 2 „ „ overcrowded 2 „ „ want of ventilation - „ „ requiring painting 3 „ „ without proper water receptacles - „ „ without receptacles 2 „ „ with bilge water not removed - „ „ with infectious disease - „ „ refusal to inspect - „ „ faulty bulkheads, offensive cargo boats 1 „ „ with defective cabins, floors, etc. 4 „ „ change of master not notified - I am pleased to be able to state that the various complaint notices issued have in the majority of cases been complied with by the boat owners with very little delay, and generally speaking the boats are kept in a very clean condition. Respecting the notification of change of master, I find this is not necessary, as the Vestry is an Inspecting and not a Registering authority. GEORGE E. J. DAVIS, Inspector under Canal Boats Acts.