AC E3 4353 Metropolitan Borough of St. Marylebone. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1909. Including the Report of the Public Analyst and the Report on Factories and Workshops. CHARLES PORTER, M.D., B.Sc., M.RC.P. (Ed.) Of the Middle Temple, Barrister-at-Law. London: Geo. Pulman & Sons, Ltd., Printers. 1910. Metropolitan Borough of St. Marylebone. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1909. Including the Report of the Public Analyst and the Report on Factories and Workshops. CHARLES PORTER, M.D., B Sc., M R C P. (Ed.) Of the Middle Temple, Barrister-at-Law. London: Geo. Pulman & Sons, Ltd., Printers. 1910. London: George Pulman & Sons, Ltd., printers, london and wealdstone Public Health Office,11th March, 1910. To the Mayor, Aldermen ami Councillors of the Metropolitan Borough of St. Marylebone. Mr. Mayor and Gentlemen, The accompanying report on the public health and sanitary condition of the Borough of St. Marylebone for the year 1909, is submitted in accordance with the instructions of the Local Government Board with regard to annual reports of Medical Officers of Health. For that portion relating to the part of the year between 1st January and 1st June, Dr. Meredith Young, who left the service of the Council at the end of May to take up the position of Medical Officer of Health to the County Council of Cheshire, is responsible. The responsibility for the remaining portion is mine. For the sake of convenience the Annual Report of the Public Analyst, Dr. Wynter Blyth, is included under the heading Sale of Food and Drugs Acts, which will be found at page 45. I wish most sincerely to thank the Chairman (the Rev. J. A Beaumont, M. A.) and the Members of the Public Health Committee for the kindness and consideration they have shown me personally, and the support and encouragement they have given me in carrying out the work of the department. Thanks are especially due to Alderman J. Lea-Smith, Chairman of the Dust Sub-Committee, for valuable assistance and advice in connection with questions relating to the removal of house refuse, and to water supply of tenements. A word of praise is also merited by the staff of the department and I wish to record my appreciation of the loyal way in which they have worked and helped me throughout the period 1 have been in office. I am, Mr. Mayor and Gentlemen, Your obedient Servant, CHARLES PORTER, Medical Officer of Health. TABLE OF CONTENTS. Part I. Statistical. page Population 7 Births (a), Registration (£), Notifications 7, 8 Deaths and Death Rates 8, 9 District Births and Deaths 10 Institution Deaths 10,11 Causes of, and Ages at, Death 11, 12 Infantile Mortality 12, 13. 14 Prevention of Infantile Mortality 14, 15 Home Office Enquiry 16, 17 Deaths in relation to Disease 17 Diarrhoeal Diseases 17 Infectious Diseases, Phthisis, &c., Respiratory Diseases 18 Zymotic Diseases 18 Phthisis and other Tubercular Diseases 18 Respiratory Diseases 19 Cancer and Malignant Disease 19 Alcoholism 20 Accident and Suicide 20 page Records of Diseases 20 Notifications 21 Discharge Notices 22 Diphtheria and Membranous Croup 22 Scarlet Fever 22 Enteric Fever 23 Cerebro Spinal Fever 23 Erysipelas 23 Puerperal Fever 24 Measles 24 Glanders 24 Phthisis 24 Phthisis Notifications 25 Phthisis Deaths 25 Phthisis Preventive Measure 26 Disinfection 28 Bacteriological Examinations 29 Part II. Departmental. page Protection of Food Supply 33 Food Inspection 33 Food Prosecutions 34 Slaughterhouses 35 Milk Supply 36 Cowhouses 36 Milkshops, etc. 36 Examination of Milk 38 Ice Cream Premises 39 Butter, Margarine, etc. 39 Restaurants, Food Stalls, etc. 39 Offensive Trades 39 Bakehouses 40 Sale of Food and Drugs Acts 40 Analysis Reports 41-47 Bacteriological Examination of Food 48 Water Supply 48 Housing 49 Houses Let in Lodgings 50 Common Lodging Houses 50 House to House Inspection 51 Overcrowding 51 page Underground Rooms 51 Customs and Inland Revenue Acts 51 Factories and Workshops 52 Inspection 53 Defects Found 53 Home Work 54 Registered Workshops 55 Nuisances- Work of Sanitary Inspectors 55 Legal Proceedings 57 Drain Plans and Drainage 60 Combined Drainage 61 Black Smoke Nuisances 61 Removal of House Refuse 62 Verminous Persons Baths 63 Cleansing of Persons Act, 1897 64 The Shelter 65 Public Mortuary 65 Public Sanitary Conveniences 66 Sanitary Inspection 66 Statistics—Comparative Statement 69 Tables I.V. 70, 74 Part I. STATISTICAL Curve showing the number of cases of Scarlet Fever, Diphtheria and Typhoid Fever, notified week by week during the year 1909. 7 POPULATION. At the middle of 1909 the population of St. Marylebone, estimated by the Registrar General's method, was 126,027, the population of the Sub-registration Districts being:— All Souls 33,460 St. Mary 35,878 Christ Church 37,379 St. John19,310 126,027 The estimated decrease since 1908, when the population was estimated at 126,867, is 840, and the decrease since the census 7,274. As was pointed out in the Annual Report of 1908, the estimate that the population of the Borough is decreasing by something like 1,000 per annum is to be accepted with some reserve, but as the date of the next census—1911—is drawing near, it is perhaps unnecessary to enter into any discussion on this point. The reason for the decrease, if there actually is a decrease, is probably emigration of persons tempted by improved means of transit to remove to the suburbs, or displaced by the demolition of small houses which are being replaced by flats. BIRTHS. (a) Registration. The number of births registered during 1909 was 2,534,* being 25 below the number for 1908. Male births numbered 1,312, and female 1,222. The birth rate per 1,000 was 20'0. The accompanying table compares the rates in the several registration sub-districts with those of 1908:— 1908 1909. All Souls 13.6 20.1 St. Mary 16.3 13.9. Christ Church 29.4 27.8 St. John 20.7 16.4 The rate for the Borough in 1908 was 20 2 per 1,000, and the average rate for the previous 10 years is 21.5, so that there still continues the decline to which attention was specially directed in the Report of 1908. For the extraordinary increase in the birth rate of All Souls it is impossible to offer any explanation. Christ Church, which in 1908 showed an increase of nearly 3 per 1,000 over the rate for 1907, in 1909 shows a decrease of 1.6. This figure is exclusive of births occurring in the Borough to persons usually non-resident therein. 8 (b) Notifications. The Notification of Births Act, 1907, which came into force in the Borough on the 15th June, 1908, has continued to work smoothly during 1909. The total number of notifications received within the time named in the Act (36 hours of the birth) was 3,224, or 94.24 per cent, of the total—3421 All persons failing to notify, whose names and addresses were revealed by the returns of the district registrars, were either visited or written to and requested to give an explanation of the failure to comply with the requirements of the Act. In practically all cases the reason given was ignorance of the existence of the Act and of the fact of its adoption by the Borough Council. It is believed that as a result of the work during 1909, the visits by women inspectors and the reminder letters sent out, great improvement will be noted in the future in connection with notifications under the Act, large numbers of persons having been made aware of the requirement to notify. The Public Health Committee having instructed the Medical Officer of Health to endeavour by other means to make known the existence of the Act in the Borough, no prosecutions were instituted during the year against persons failing to comply with its provisions. The following are the sources of the notifications received during the year:— From Parents 386 or 11.28 percent. „ Doctors 400 or 11.69 „ „ Midwives 696 or 20.34 „ „ Other persons 35 or 102 „ „ Hospitals,etc. 1904 or 55.68 „ Of the total births notified, 39 referred to still-births (17 males and 22 females); 1,718 took place at Queen Charlotte's Hospital, and 207 at the Middlesex Hospital; 1,452 were born at home, and 35 were born in other Boroughs. Of those notified as having occurred in St. Marylebone, 1498 belonged to other Boroughs. DEATHS AND DEATH RATES. Deaths to the number of 1,849 were registered during the year. This figure is inclusive of persons who, though normally resident in the Borough, died in institutions, etc., outside, but exclusive of persons who, though they died in St. Marylebone, were ordinarily residents in other districts. The death rate calculated with this figure and the estimated population to the middle of 1909 and corrected for age and sex distribution by multiplying by the RegistrarGeneral's factor 1.0652, works out at 1 5.4 per 1,000. 9 The necessity for this "correction" is, of course, due to the fact that differences in death rates in various areas are not entirely dependent upon the sanitary conditions existing in these areas, but also on the constitution (age and sex) of the population. A population consisting of aged persons would show more deaths than one consisting entirely of young and vigorous adults: a population made up of a large number of males and a small number of females has more deaths and a higher death rate than one in which the females outnumber the males The death rates of such populations are not comparable the one with the other nor with those of populations differently constituted. The Registrar-General's factors do away with all difficulty in comparing death rates, and all which have been corrected by his method may be safely examined side by side. The corrected death rates of other London Boroughs are given in the accompanying table and may be compared with that for St. Marylebone. Borough. Birth Rate. Corrected Death Rate. Death Rates from Infant Mortality per 1,000 Registered Births. Seven chief Zymotic Diseases. Phthisis. Pulmonalis. Battersea 23.9 13.0 1.27 1.16 107 Bermonsdey No r eturn Bethnal Green No r eturn Camberwell No return Chelsea 18.7 14.5 1.20 1.44 107 Deptford 26.8 14.1 1.63 1.48 103 Finsbury 35.9 19.0 2.49 2.28 105 Greenwich 22.1 12.2 0.99 1.01 102 Hammersmith — 14.1 1.6 125 Hampstead 13.6 8.9 0.51 0.56 74 Holborn 18.3 15.0 0.80 2.01 70 Islington 23.3 14.0 1.19 1.21 103 Kensington 18.6 14.6 1.03 0.93 112 Lambeth 26.1 14.0 1.2 1.4 97 Lewisham 21.8 10.3 0.47 0.78 75 City of London 13.4 16.0 0.44 1.36 106 Paddington 20.0 12.9 0.76 1.06 102 Poplar 30.1 16.4 2.2 1.3 130 St. Marylebone 200 15.4 0 89 1.58 102 St. Pancras 22.1 14.8 0.95 1.58 109 Shoreditch 32.4 20.1 2.7 1.7 138 Southwark 27.1 16.7 1.66 1.79 124 Stepney 30.3 15.2 1.66 1.65 118 Stoke Newington 18.3 11.5 0.63 0.80 84 Wandsworth 20.6 10.9 0.36 0.82 86 City of Westminster 15.9 12.7 0.60 1.30 93 Woolwich 22.9 12.4 1.06 1.17 82 The average death rate for the preceding 10 years is 16.8. The rates in the several registration sub¬districts for the last three years were as under:— 1907. 1908. 1909. All Souls 12.3 13.2 12.6 St. Mary 13.7 14.9 12.8 Christ Church 18.3 19.0 18.2 St. John 16.0 13.4 146 I0 District births and deaths for the fifty-two weeks ending ist January, are given in the following table (Table I.) while vital statistics of separate localities for 1909, and the ten preceding years will be found in Table II. of the Loca' Government Board series on page 71. TABLE I. District Births and Deaths for the fifty-two zueeks ended Ist fanuary, 1910. Sub District. Population estimated to middle of year 1909. Births. Deaths. Males. Females. Total. Males. Females. Total. All Souls 33,460 364 310 674 203 221 424 St. Mary 35,878 257 245 502 241 220 461 Christ Church 37,379 530 511 1,041 342 339 681 St John 19.310 161 156 317 121 162 283 Totals 126,027 1,312 1,222 2,534 907 942 1,849 Institution Deaths.—Very many of the deaths of St., Marylebone residents occur in institutions either within or without the Borough, and the accompanying table which shows where deaths occurred during 1909 is of interest. Attention may be directed to the large number of nursing and surgical homes in which deaths are recorded as having occurred. The number shown is, of course, only a fraction of the total number in existence in the Borough. Institutions within the District receiving sick and infirm persons from outside the District.Institutions outside the District receiving sick and infirm persons from the District. Nursing and Surgical Homes within the District, in which deaths of residents and non-residents have occurred. All Saints Home, Margaret Street Aged Pilgrims Asylum, Upper Holloway 3, Beaumont Street Christian Union Almshouses, John Street Banstead Asylum 5, do. Home for Incurables, 6l, Wey¬mouth Street Bethnal Green Asylum12, do. Hospital for Epilepsy and Paralysis, Maida Vale Barnet Cottage Hospital 13, do. Hospital of St. John ard St. Elizabeth, Loudon Road Camberwell House Asylum 14, do. London Throat Hospital, 204, Great Portland Street Cancer Hospital, Chelsea 17, do. Middlesex Hospital Cane Hill Asylum 18, do. Queen Charlotte's Hospital Catholic Nursing Home, 6o, Lambeth Road 19, do. Royal National Orthopcedic Hospital, Gt. Portland Street Street Central Iondon Sick Asylum 20, do. St. Maiylebone Almshouses Charing cross Hospital 21, do. St. Marylebone Workhouse Chest Hospital, Bethnal Green 22, do. St. Peter's Harbour, Greville Place Children's Hospital, Gt. Ormond Street 33, do. Samaritan Free Hospital Children's Hospital, Paddington Green 37, do. West End Hospital, 73, welbeck Street Children's Infirmary, Cashalton 40, do. Claybury Asylum 41, do. coloney Hatch Asylum 49, do. Dartfor Health Asylum 52, do. East London Hospital 53, do. Epileptic Colony, Epsom 54, do. freidenheim Hospital, Hampstead 57, do. French Hospital, shaftesbury Avenue 5, Bentinck Street 13, Bulstrode Street 14, do. 15, do. 12, Devonshire St., Portland Place 23, do. II Institutions within the district receiving sick and infirm persons from outside the district. Institutions outside the District receiving sick and infirm persons from the district. Nursing and Surgical Homes within the District, in which deaths of residents and non¬residents have occurred. General Hospital, Hampstead 24, Devonshire Street, Portland Place German Hospital 30, do. Grosvenor Hospital 36, do. Hanwell Asylum 45. do. Holborn Infirmary 54, do. Homœopathic Hospital 11, Duchess Street Home of Compassion, Warrington Crescent 12, do. Home for Illegitimate Children, Sutton 90, Harley Street Horton Asylum 14, Henrietta Street Infants' Hospital, Vincent Square 15, do. Italian Hospital do. (Netley House) Leavesden Asylum 12, Hinde Street London Fever Hospital 12, Holles Street London Hospital Home of Rest for Christian Workers, 10A, Finchley Rd. Long Grove Asylum 18, Manchester Street London Temperance Hospital 19, do. Lying¬in Hospital, Endell Street 3, Mandeville Place Manor Asylum, Epsom 7, do. Metropolitan Benefit Society Asylum, Balls Pond Road 9, do. Metropolitan Hospital St. elizabeth's Home, 59, Mortimer Mount Vernon Hospital 2, Nottingham Place North¬western Fever Hospital 3, do. Paddington Infirmary 11, do. Private Lunatic Asylum, Brook House, Upper Clapton 4, Upper Wimpole Street Queen's Hospital 14A, do. Royal Asylum, Edinburgh 6, Vere Street Royal chest Hospital, City Road 8, Welbeck Street Royal London Ophthalmic Hospital, City Road 15, do. St. Anne's House, Manor Road 51, do. St. Bartholomew's Hospital 55, do. St. George's Hospital 56, do. St. George's Infirmary, Chelsea 21, weymouth Street St. Giles Workhouse 50, do. St. Joseph's Home, Kensington 59, do. st. Joseph's Hospice, Mare Street, E. 29, wimpole Street St. Luke's House, Kensington 50, do. st. Marylebone Infirmary St. Pancras Infirmary St. Peter's House, Kensington St. Thomas' Hospital Salvation Army Maternity Home, Hackney Seamen's Hospital, Greenwich Shoreditch Infirmary Sick Asylum, Cleveland Street Sick Asylum, Hendon Tailors' Benevolent Institution, Queen's Crescent, St. Pancras Throat Hospital, golden Square University College Hospital West London Hospital Western Hospital Westminster Hospital Whitechapel Workhouse Causes of and Ages at Death.– The Local Gernment Board Table IV.(page 73) gives the details as to the deaths of residents in the borough during 1909. In it will be found a considerable amount of information regarding the causes of death and the numbers which occurred in various age groups. 12 The question of age at death is one of some importance, and calls for somewhat fuller reference than is made to it in the table. The same remark applies to causes of death, and it is proposed to discuss both of these points somewhat more fully and to give some details especially with regard to the causes which have been chiefly responsible for the deaths. Deaths in Relation to Age. The following table contains an analysis of the 1,849 deaths according to age, and shows the numbers which occurred in certain groups. The fact that the extremes of life contributed the largest amounts is well brought out. Age Periods. Under 1 year. 1-5 5-15 15-25 25-65 65 and over. At all ages. No. of Deaths 259 117 41 70 746 616 1,849 So far as the deaths of persons over 65 are concerned, it may be said that to the 616 the various localities contributed as follows:— All Souls 146 St. Mary 166 Christ Church190 St. John 114 Of the total, 171 at death were aged 65-70; 279, 70-80; 139, 80-90; and 27, 90-100, and of these, two persons were aged 98 and one 99. The outstanding causes of death, apart from old age, were chronic bronchitis, 103; nephritis and Bright's disease, 27; cancer, 64; and epidemic influenza, 23. In 13 the cause was stated to be tuberculosis of the lungs. A comparison of the deaths that took place under 1 and those over 65 years of age is given below; the numbers occurring in each quarter of the year are also shown. JanuaryMarch. AprilJune. JulySeptember. OctoberDecember. Total. Infants under 1 year 77 60 48 74 259 Persons of 65 years and upwards 227 143 98 148 616 Infantile Mortality. The various points regarding the deaths of infants of under 1 year of age are considered under this heading. The total number of deaths occurring in this group during the year 1909 being 259, the infantile mortality rate, i.e., the number of deaths of children under 1 year of age per i,coo births occurring in the same year, is 102.3. The 13 rate for iqo8 was 104.3, and the average for the preceding ten years 141.7. The only year showing a lower rate is 1907, when it fell to 102.2 per 1,000, only one point below that for 1909. The number of infant deaths in 1907 was higher by 5 (264) than that in 1909. The rates for other Boroughs are shown in the table on page 9, and may be compared with that of St. Marylebone. The position occupied in 1908 was eleventh, with a rate of 104, the Boroughs with lower rates including Hampstead, Holborn, Westminster and Lewisham. For 1909, St. Marylebone is 9th in the list, 8 only having lower rates. Causes of Infantile Mortality and Ages at Death. The following Tables show the ages at which death occurred amongst the 259 infants who died in 1909, and the causes to which death was attributable. The figures relating to each of the registration sub-districts are also given. TABLE II. Sub-District. Months. 0 1 2 3 4 5 6 7 8 9 10 11 Total All Souls 23 12 6 3 5 2 0 1 1 1 2 1 59 St. Mary 30 2 6 1 — 3 - 1 1 — 3 2 49 Christ Church 37 15 9 5 9 4 10 8 5 8 8 5 123 St. John 8 3 1 1 1 2 - 1 5 2 1 3 28 Totals 98 32 22 10 15 11 12 11 12 11 14 11 259 TABLE III. Cause of Death. Diarrhoea. Prematurity. Marasmus, Atrophy and Debility Bronchitis. Pneumonia. Convulsions. Suffocation. Measles. Whooping Cough. Tuberculosis. Meningitis including Tuberculous. Miscellaneous. Totals. All Souls 10 20 4 1 5 3 3 — — 2 5 59 St. Mary 4 22 3 1 5 2 5 — — 1 1 5 49 Christ Church 18 36 9 9 11 1 5 7 6 3 3 15 123 St. John 3 8 4 6 1 — — 1 1 2 2 28 Totals 35 92 20 17 22 6 13 7 7 5 8 27 259 14 TABLE IV. Certified cause of Death. Months. 0-3 Months. 3-6 Months. 6-12. Totals. Diarrhoea 17 7 11 35 Prematurity 82 7 3 92 Marasmus, Atrophy and Debility 10 5 5 20 Bronchitis 5 4 8 17 Pneumonia 5 4 13 22 Convulsions 4 1 1 6 Suffocation 10 1 2 13 Measles — — 7 7 Whooping Cough 2 — 5 7 Tuberculosis 1 — 4 5 Meningitis (including Tuberculous) 1 2 5 8 Miscellaneous 15 5 7 27 Totals 152 36 71 259 In the last of the three tables the numbers dying from each of the causes mentioned in the second are arranged according to the age at which death occurred, the periods shown being those indicated at the head of the columns. Further statistical information regarding infantile mortality will be found in the Local Government Board Table V. at page 74. Several important points are brought out by these tables. In the first place it will be noted that most of the deaths are of children under three months of age, as many as 59 per cent, dying before completing the first quarter of the first year. Further, over one-third (96) of the total 259, died within the first month of life. The outstanding causes of death were Immaturity, Diarrhceal Diseases, and affections of the Respiratory Organs, to which causes over two-thirds of the total deaths were traceable. Under the heading of "Immaturity" are included Premature Birth, Wasting and Developmental Diseases; and the total number of deaths due to these alone was 113. Respiratory diseases include bronchitis and pneumonia which together caused 39 deaths. The number of infants who died from diarrhceal diseases was 35, while 15 died of infectious diseases (measles, whooping cough and diphtheria), and 13 of suffocation or overlying, 10 of these being less than three months old. Considered as percentages it is found that immaturity accounted for 43.6, respiratory diseases for 15, diarrhoea for 13.5 and infectious diseases for 5.7 per cent. Prevention of Infantile Mortality. These being the chief causes of death, any action taken with the object of reducing infantile mortality would of necessity have to be directed against them. The points to be considered are: what action can be taken and whether or not it 15 is likely to have any effect. At once it may be said that all these conditions are such as are capable of amelioration by means at the command of a Public Health Department. Most of these infants, as a matter of fact, died largely as a result of want of care on the part of the mothers. With care, many of the 113 babies who died of developmental diseases or because born prematurely, might have been saved ; with care, a considerable proportion of the 39 babies attacked by bronchitis or pneumonia, might have been protected from or tided over the attack ; and so with the 35 victims to diarrhoea, the 15 who died of infectious disease, and the 13 who were suffocated. For several years now, the Council, in addition to carrying out the general measures of sanitation which are referred to throughout this Report, have been carrying on work having as its object the prevention of mortality amongst children from the conditions named. A staff of three women inspectors were, during the year 1909, engaged day after day in visiting the houses, especially in the poorer districts, where babies had been born. Their duty at these visits is to advise the mother as to the care of the babies, and as to the care of their own health. They give details, printed and verbal, with regard to the feeding of the babies, and their clothing ; and when the babies are sick, advise as to the necessity of obtaining proper treatment. In this work a vast amount of assistance was obtained during the year, as heretofore, from the Health Visitors of the St. Marylebone Health Society. These visitors voluntarily give part of their time to visiting and re-visiting at regular intervals a large number of babies in the poorer districts. Their advice and counsel is of the utmost value, and their work and that of the female staff of the Health Department has done much good and will do much more in the future. The total number of babies visited by the women inspectors during the year was 2,730, and the number revisited 1,551, the number visited by the workers of the Health Society being 526. A part of the work done by the St. Marylebone Health Society, which must be regarded as exceedingly valuable, is that carried out at the Infant Consultations. These are held at two centres—one in Bell Street, Edgware Road, and the other at the Welbeck Dispensary in Welbeck Street. They are presided over, the former by Drs. Murrell and Murray, and the latter by Dr. Eric Pritchard. At them babies are weighed and mothers are advised as to 16 their care, and they are regarded with the greatest amount of favour by those who take advantage of them. The number seen at Bell Street was 186 and at Welbeck Street 148, the average weekly attendance being at the former 25 and at the latter 24. Home Office Enquiry.— In connection with the subject of Infantile Mortality, some reference may be made to an investigation carried out at the request of the Secretary of State, into the relation between maternal employment and deaths of infants under one year of age. The observations were carried out in connection with children born in the year 1908, and as each child was to be visited and reports made as to its feeding and progress during the first year of its life, the work was not completed till the end of 1909. In all, 260 infants were observed by the women inspectors. Of the cases, 58 were born in All Souls District, 53 in St. Mary's, 108 in Christ Church, and 41 in St. John's. Some of the facts elicited are of considerable interest, though it is doubtful if conclusions of any value can be drawn from the figures of this district alone. All the returns are to be analysed at the Home Office, and with the mass of information collected all over the country at his disposal, the Home Secretary doubtless will be able to draw valid conclusions and possibly determine as to what action it is necessary to take. As a matter of fact the proportion of employed mothers in the cases selected for investigation here is comparatively small—86 out of the 260, about 32 per cent. Of the 86, only 11 were employed in factories or workshops, one half of the remainder working at home, and the other at such occupations as office cleaning, etc. Of the 260 children born, 15 failed to live out the year, and two of these were children of women working at home, 1 of a woman employed in a workshop, 5 of mothers engaged in office cleaning, etc., and 7 of women only engaged in house work. In other words, 1 out of 11 born to factory workers : 5 out of 37 born to charwomen, etc., and 7 out of 174 to housewives, died within one year. The proportion of deaths amongst the babies whose mothers work away from home is, therefore, much higher than in the other cases. Some interesting facts regarding the occupations were brought to light. The chief reason for taking up work was to supplement a small income, and the average weekly earnings varied tremendously both before and after confinement. The lowest was 1s. to 2s. per week; the highest 12s. to 18s. Total family ncomes of 10s. per week were recorded in several cases. 17 The average time for giving up work before confinement seemed to be somewhere about three weeks, but of those who worked at home over 50 per cent, continued to do so till within one week of the birth. Most of those engaged away from home gave up their work three or six weeks before the confinement was expected to take place, The bulk of the homeworkers also started work within one month of the confinement, the other industrially employed mothers not returning till a much later date. As to the nursing of the babies, it was found that the total number nursed by persons other than the mothers was 12, four each of the women working at home, in workshops or elsewhere, finding it necessary to get assistance at home. The percentage of women working at home or occupied in charing who did not take entire charge of their infants was therefore very small. Only five of the babies were actually put out to nurse and in every case the mother was a charwoman. In connection with the feeding of the babies, it was found that only nine out of the total number were entirely artificially fed, all the mothers, even those industrially employed, apparently endeavouring to feed their babies either wholly or partially on breast milk. None of the women employed away from home fed their babies entirely on artificial food before the age of six months was reached. This seems to be one of the most important facts elicited in the whole investigation. Of the 15 babies who died, the age at death was, in one under 2 months ; 2 under 3 months; 4 under 6 and 8 under 12 months. The causes of death were: infectious disease, 2; wasting, 1, and other diseases 12. As already stated, no conclusions of any value can be drawn from these figures, and the final report of the Home Secretary is looked forward to with a considerable amount of interest. DEATHS IN RELATION TO DISEASE. In the list given in Table IV (Local Government Board Series, page 73), certain of the causes stand out over the others as chief, and it is necessary to make a few comments regarding these:— Diarrhceal Diseases. The total number of deaths during the year from these diseases was 45, the death rate being .35 per 1,000. The fact that 35 of the 259 infant deaths were due to this disease has already been noted. Diarrhoea 18 more especially the epidemic type, is well known to be more common and more fatal in early life. It is also well known to be an infectious disease and one which is preventible if proper precautions are taken to protect the food supply of the child and the child itself from infection. During warm dry summers, diarrhoea is always much more common than in wet, cold seasons, and more care must be exercised and greater precautions taken at such times. The summer of 1909 was not one favourable to the spread of the disease, less so than 1908, when the total deaths amounted to 55. A considerable amount of work in connection with the prevention of the disease is carried out by the women inspectors and the workers of the St Marylebone Health Society, who visit the homes in the poorer districts and advise as to the importance of cleanliness, feeding, etc., in preventing diarrhoea, and distribute and explain special leaflets regarding the disease. Infectious Diseases, Phthisis, etc., and Respiratory Diseases. The following table shows the comparative mortality during the fifty-two weeks ended the 1st January, 1910, from these diseases:— Total deaths Rate per 1,000 of the estimated population. 1. Zymotic Diseases 113 0-89 2. Phthisis and other Tubercular 200 1-58 3. Respiratory Diseases 324 2-57 Zymotic Diseases. The diseases included in this group are:—Smallpox, measles, scarlet fever, whooping cough, diphtheria and membranous croup, typhus, enteric and continued fevers, diarrhoea and enteritis. The number of deaths due to each of these will be found in Table IV. Phthisis and other Tubercular Diseases. Under this heading are included deaths from pulmonary phthisis (consumption), tubercular meningitis, general tuberculosis, tabes mesenterica and other forms of tuberculosis. The deaths due to the first named numbered 170, 19 affections of the brain coverings (meninges), peritoneum, etc., accounting for the remaining 30. The total deaths due to tubercular diseases in 1908 was 203, and in 1907, 229. The following table gives the rates for these and other years. TABLE V. DEATHS FROM PHTHISIS AND OTHER TUBERCULAR DISEASES. Year. No. of Cases, Population. Rate per 1000 of Population. 1909 200 126,027 1-58 1908 203 126,867 1-70 1907 229 127,718 1-79 1906 244 127,960 1-90 1905 248 129,453 1-92 Respiratory Diseases. The conditions referred to as respiratory diseases include bronchitis, pneumonia, pleurisy and certain other diseases of the respiratory organs, the figures for the first-named being 209, and for the second 105; total 314, death rate 24 per 1,000. The figure for 1908, in which year the weather conditions were less severe than in 1909, was 298, and the death rate 2.5. Cancer and Malignant Disease. During 1909, cancer or malignant disease was certified as the cause of death in 156 cases. The death rate was 12 per 1,000. The number of females who died from the disease exceeded the number of males by 24, and the bulk of the deaths in both sexes occurred, as shown in the accompanying table, at ages over 50. Ages. Under 10 10 and under 20 20 and under 30 30 and under 40 40 and under 60 50 and under 60 60 and under 70 70 and upwards Males — 3 6 21 24 12 F emales 1 — 1 4 6 27 25 26 Totals 1 — 1 7 12 48 49 38 20 The parts affected by the disease are set out below, but it may be mentioned that in the 66 men attacked, the organs of digestion were affected in 29 (44 per cent.), and of the 99 women, in 31 (34 percent.). The breast or womb was the seat of the disease in 27 of the 90 women (30 per cent.). Cancer and Malignant Disease of various parts of the body. Males. Females. Total. Face, Tongue, Jaw 6 3 9 Throat, Neck, Gullet 10 1 11 Stomach 12 10 22 Intestines 17 21 38 Liver 4 11 15 Breast — 10 10 Uterus and Generative Organs — 17 17 Various 17 17 34 66 90 156 Alcoholism. For statistical purposes, alcoholism and cirrhosis of the liver (which in the majority of cases is due to alcohol in excess) are considered together. In 1909, the number of deaths due to these causes was 30, as compared with 35 in 1908. In all probability many other deaths stated to be due to other causes were contributed to by excessive consumption of alcohol, e.g., conditions affecting the kidneys. The number of deaths due to nephritis (inflammation of the kidney) and Bright's disease of the kidneys, was 69. Accident and Suicide. During the year, deaths to the number of 64 occurred as the result of accident or negligence, while 15 cases of suicide were recorded. The number of deaths of infants caused by suffocation or overlying was 13. RECORDS OF DISEASES. Under this heading it is proposed to consider all diseases compulsorily or voluntarily notifiable in the Borough. In the case of the diseases known as small-pox, cholera, diphtheria or membranous croup, erysipelas, scarlet fever, and typhus, relapsing, continued and puerperal fevers, notification to the Medical Officer of Health is called for by Section 55 of the Public Health (London) Act, 1891. Cerebro-spinal fever is notifiable under an order of the London County Council, and phthisis (consumption) under a form of voluntary notification in 21 force in the Borough, and also compulsorily, in the case of persons coming under the Poor Law Medical Officers, under the Public Health (Tuberculosis) Regulations, 1908. Other infectious diseases, e.g., measles, whooping cough and diarrhoea are not notifiable. Notifications.—The total number of notifications for 1909 was 1,066, as compared with 873 in 1908 and 695 in 1907. The increase for the year is due chiefly to an increase in the number of notifications received in the case of phthisis (334 cases) brought about as a result of the working of the Public Health (Tuberculosis) Regulations. Full particulars with regard to the notifiable diseases is given in the Local Government Board Table III., which will be found at page 72. The notification rate (proportion to population of notified cases of infectious disease) was 6*9 per 1,000. The following table shows the amounts paid in fees for notifications since 1901, and the cost per thousand of population:— Year. Amounts paid to Medical Practitioners. Cost per 1,000 of Population. 1901 98 5 6 0 14 10 1902 152 5 0 1 3 0 1903 85 11 6 0 13 0 1904 99 1 0 0 15 2 1905 61 5 6 0 9 6 1906 74 14 0 0 11 8 1907 74 0 0 0 11 7 1908 70 6 6 0 11 1 1909 73 5 6 0 11 7 Of the cases reported, a very large number were removed to hospital for treatment, viz.:— Diphtheria 103 or 94.5 per cent, of the cases notified Erysipelas 43 or 32.0 „ „ „ Scarlet fever 443 or 95.5 „ „ „y Enteric fever 16 or 72.7 „ „ „ Cerebro spinal fever 6 or 100.0 „ „ „ Phthisis 144 or 43.1 „ „ „ The total amount expended on notification fees during the year was £73. 5s. 6d., the cost per thousand of the population being 11s. 7d. 22 Discharge Notices. The number of certificates received from the Metropolitan Asylums Board regarding the return of patients sent to hospital with infectious diseases was 306 and referred to 511 cases. Visits were paid to these cases by the District Inspectors, and advice given as to the date of the return of children to school, and the advisability of obtaining treatment for and isolation of any suffering from any sequel of a disease. Diphtheria and Membranous Croup. The number of cases notified during the year was 109, of which 9 proved fatal (8.2 per cent.) The number of cases per 10,000 of the population was 8.6. Swabs from 73 doubtful cases were examined bacteriologically, with a positive result in 16 instances and a negative in 57. The districts which suffered most from the disease were All Souls with 29 and Christ Church with 45 cases. St. Mary with 21, exceeded St. John (14) by 7. • As will be seen from Table III (page 72), the majority of the cases occurred in the age groups 1—5 and 5—15, practically all the deaths taking place in these groups also. In investigating the notified cases, the following nuisances were found and dealt with by the Inspectors:— Dirty premises, etc. 33 Defective drainage 16 Scarlet Fever. The total number of cases of this disease notified in 1909 was 458, as compared with 409 in 1908. Deaths due to scarlet fever numbered 8 (17 per cent.). The incidence of the disease was chiefly in children in the age groups, 1—5 and 5—15, and the quarter ending 2nd October gave the bulk of the cases. The district most affected was Christ Church (181), a slight epidemic in the early autumn in the neighbourhood of Circus Street, Marylebone Road, and traceable to one or two mild undetected cases, accounting for the increase in the third quarter of the year. All the deaths from the disease were of children between one and 15 years of age. The weekly rise and fall in the number of cases is shown in the chart inset at the beginning of this report. As regards the source of infection, in 264 of the 458 cases, no definite clue could be obtained. In the remaining 194, infection was supposed to have been acquired from another member of the family in 92 instances; from a previous case 23 in the same house (tenement) in seven instances; at school in 25; and from another case in the neighbourhood in 55 instances. In 15 cases the source was unclassifiable. Visits and inquiries at the homes of the notified cases resulted in the discovery of nuisances and defects in sanitation to the number of 227. In 58 of these the condition discovered was defective drainage, while in 169 the nuisance was want of cleanliness. Notices calling for remedies were served in each instance. Enteric Fever. During 1909, 22 cases were notified, and there were no deaths. Half of the number of cases notified were in the All Souls' District; St. Mary's and Christ Church having 4 each, and St. John's 3. The number of cases (34) in 1908—which, being drier and warmer, was distinctly a "typhoid fever year"—exceeded that for 1909 by 12. During the year, 8 specimens of blood from doubtful cases were examined, and in each case the result was negative. In four of the 22 cases notified, suspicion fell upon iood as the source of infection, viz.: Ice cream, 1;oysters, 1;fish, 1;and fruit, 1. Defects in sanitation to the number of 9 were found in the infected houses by the District Inspectors. Of these, 7 were ordinary nuisances— dirty houses, etc.—and the remaining 2 were defects in drainage. Notices were served and the defects remedied. The curve showing the number of cases occurring each week will be found at the beginning of the report. Cerebrospinal Fever. This disease continues to be notifiable throughout the Metropolitan area, and during the past year 6 cases were notified as occurring in the Borough. In each case the patient was removed and treated in hospital. Erysipelas. This disease, though included in the list of those notifiable, is not isolated by the Metropolitan Asylums Board. A certain number of cases are treated in the Workhouse Infirmary and General Hospitals, whence most of the notifications come. The total number notified in 1909 was 134, and of this number 2 died. 24 Puerperal Fever. Three cases of this disease were notified in 1909. One of the cases notified died, and 3 other deaths, attributable to this cause, were certified as having occurred outside the Borough. Measles. This disease being non-notifiable a correct record of the number of cases cannot be kept. The cases occurring in the Elementary Schools in the Borough are reported by the teachers at the schools, and notices in each case are sent to the parents, advising them of the precautions which should be observed. In several school outbreaks during the year the class rooms affected have been closed and other measures have been adopted, such as the exclusion of unprotected children from attendance at school, to avert the spread of the disease. London (Notification of Glanders) Order, 1907. During the year two notices were received from the Veterinary Inspector of the Public Control Department of the London County Council, of outbreaks of glanders in the Borough. The first dated the 14th January, 1909, was in respect of the premises No. 2, Townshend Road, and the second dated the 27th May, in respect of premises in Wyndham Mews. In both cases the necessary steps in connection with the outbreak and the cleansing and disinfection of the infected premises were carried out by the County Council officers. The living rooms, in the case of No.2, Townshend Road, were found on inspection to be fairly clean, but the drains being in a defective condition were reconstructed. At Wyndham Mews the drainage and general sanitary conditions were found on inspection to be defective and the premises unfit for habitation, and they were voluntarily closed by the agent to the Portman Estate. There were no cases of human glanders notified during the year. Phthisis. Information with regard to this disease was derived partly as a result of notification under the voluntary form of notification in force in the Borough; partly from notification under the Public Health 'Tuberculosis) Regulations, and partly from the death returns. 25 Notifications.—The total number of cases notified was 334. Of these 98 were sent in voluntarily, the remainder under the Regulations by Poor Law Medical Officers. The number received from medical men in practice was 78 (23.3 per cent.) and from general hospitals 20 (5.9 per cent.). The number notified in 1908 was 176, only about half the total for the present year. The increase is, of course, due to the fact that at the beginning of 1909 the regulations already referred to came into force and made notification of all cases seen by Poor Law Medical Officers compulsory. A considerable amount of additional work has been thrown on various members of the staff as a result of the new regulations, but this has gone on very smoothly and very few difficulties of any consequence have been encountered. Phthisis Deaths.—Deaths to the number of 170 were certified as being due to pulmonary phthisis, equal to a death rate of 1.35 per 1,000 of the estimated population. The death rate for 1908 was 1.21. Of the 170, 72 had been notified during the year as suffering from the disease. The following table, which gives the figures for the years 1900-1909, shows also the distribution of the deaths throughout the Borough. Christ Church district, it will be noted, again heads the list with 66 out of 170. The inhabitants of this district include, it is well known, many whose circumstances and habits are such that they readily fall victims to the disease, inasmuch as they are poor, frequently out of employment, and when employed follow occupations which are hard and exposed. Moreover, as a result of their poverty, they are compelled to live under unhealthy conditions, improperly fed, in overcrowded rooms, which they themselves in many cases, neglect to keep clean and properly ventilated. TABLE VI. DEATHS FROM PHTHISIS. Population. Year. All Ages. All Souls. Sub-Districts. St. Mary. Christ Church. S. John. 126,027 1909 170 43 41 66 20 126,867 1908 154 35 33 61 25 127,718 1907 179 42 46 64 27 127,960 1906 197 36 64 73 24 129,453 1905 195 37 56 69 33 131,000 1904 214 43 57 82 32 131,700 1903 241 71 56 78 36 132,650 1902 225 59 59 71 36 133,301 1901 223 71 60 56 36 135,350 1900 276 80 64 68 63 Of the deaths, 83 took place in Poor Law Institutions, 12 in general and other hospitals and 75 at home. The age and sex distribution of the deaths is given below. More males than females, it will be noted, died of phthisis. This is well known to be the 26 case, as is also the fact, here shown, that most deaths occur about the middle period of life. Ages. Under 10 10 and under 20 20 and under 30 30 and under 40 40 and under 50 50 and under 60 GO and under 70 70 and upwards Totals. Males 3 3 7 25 27 20 11 3 99 Females 3 2 17 15 10 12 8 4 71 Totals 6 5 24 40 37 32 19 7 170 The following tables contain an analysis of the deaths in relation to occupation. In the case of the males the fact that the highest mortality from phthisis occurs amongst those employed in work entailing exposure is well brought out. MALES. Work with exposure. Sedentary work. No occupation. Workmen. Foremen, Masters, etc. Workmen. Foremen, Masters, etc. Professional work. Total. 7 59 1 19 8 5 99 FEMALES. No occupation or house work. Work with exposure. Sedentary work. Professional work. Total. 52 8 11 — 71 Preventive Measures against Phthisis.—The work of the department in connection with the prevention of the disease, in addition to ordinary measures for improving sanitation in the Borough, is largely educative. Further, however, wherever possible, isolation of the sick is recommended and often obtained, and disinfection of infected rooms and articles is carried out. The education of the sick and of contacts is attempted by the women inspectors, and in this work they are greatly assisted by the phthisis visitors of the St. Marylebone Health Society. In all cases, as soon as possible after receipt of the notification, a visit is paid by one of the Inspectors (women), who obtains information as to the onset 27 of the disease, etc., and enquires into the sanitary condition of the house. Advice (printed and verbal) as to the best method of disposing of infected expectoration, etc., is given, and disinfection of the rooms, clothing and other articles belonging to the patient is arranged for. If isolation seems urgently called for, and the patient is poor, assistance in obtaining this is frequently given. After the first visit, a note of the name and address of the patient is sent to the St. Marylebone Health Society whose visitors re-visit from time to time, and see that proper precautions are taken. Towards the end of the year the Health Society arranged for a visit of the Anti-Tuberculosis Exhibition to the district, and for several days in December some of the rooms in the elementary school in Bell Street, Edgware Road, were given over to a demonstration of various points in connection with the disease. Large numbers of the inhabitants of the Lisson Grove district visited the exhibition and took advantage of the instruction given. During 1909, also, the idea of an Anti-Tuberculosis Dispensary for St. Marylebone was mooted, and a provisional committee has been formed with the object of carrying the idea into force. The work of such a dispensary, which includes examination of patients, visitation of their houses, and, most important of all, examination of members of the patient's family who have been in contact with him, would certainly have a marked tendency to reduce the number of cases of phthisis, and also of deaths from the disease. It is to be hoped that the attempt at establishment will be successful and that the dispensary will be at work before long. A system somewhat resembling that mentioned above has been in operation in connection with the Brompton Hospital, and certificates are from time to time received from this institution regarding St. Marylebone patients under treatment. The Hospital Authorities express themselves as prepared to examine the contacts in the families of such patients, and during the year this arrangement was taken advantage of in one case. In connection with disinfection in the case of phthisis it may be mentioned that wherever possible, houses are disinfected after death or removal of patients. During the year disinfection was carried out on account of consumption in 46 instances. Bacteriological examinations of 77 specimens of expectoration from doubtful cases of phthisis were made during 1909. Of these, 26 were found to contain the bacillus of tuberculosis, and in 51 the result was negative. (The figures relating to forms of tuberculosis other than that of pulmonary phthisis will be found on page 18.) 28 DISINFECTION. The following tables contain particulars regarding the work of disinfection carried out after the infectious diseases during 1909. The second table refers to articles, the third gives the actual number of disinfections in each month, and the conditions rendering disintection necessary. For the disinfection of infected articles one steam disinfector was used, viz., Goddard Massey & Warners' machine. Formic aldehyde gas, produced by an Alformant lamp burning 30 tabloids per 1,000 cubic feet, and sulphur dioxide gas in cylinders were used for the disinfection of premises. The number of separate rooms disinfected during the year was 809. In 720 cases one room was dealt with, in 67 two rooms, in 8 three rooms, in 2 four rooms, in 1 five rooms, in 2 six rooms, in 2 seven rooms, in 1 eight rooms, and in 1 nine rooms. Four wards of a hospital and one motor garage were also disinfected. 1908. 1909. Number of rooms disinfected 764 809 Number of articles disinfected 11,784 11,524 The number and nature of articles disinfected during 1909 are shown below. Articles. 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Total. Beds 65 75 160 73 373 Mattresses 100 102 134 74 410 Bolsters 130 140 194 123 587 Pillows 300 283 484 258 1,325 Sheets 90 85 403 229 807 Blankets 370 401 389 285 1,445 Sundries 1,401 1,254 2,341 1,581 6,577 Totals 2,456 2,340 4,105 2,623 11,524 The number of journeys made by the disinfecting vans during the year January to December, 1909, was:— January 39 February 32 March 31 April 50 May 32 June 34 July 55 August 54 September 48 October 40 November 34 December 29 478 The vans were used 549 times in 1908. 29 REASONS FOR DISINFECTION. Cerebro-spinal Meningitis. Scarlet Fever. Diphtheria. Enteric Fever. Puerperal Fever. Measles. Phthisis. Vermin. Cancer. Erysipelas. Influenza. Chickenpox. Death, etc. Totals. January ... 21 8 4 ... 2 1 ... 2 2 ... 2 ... 42 February ... 8 5 2 ... 9 5 1 1 ... ... ... 4 35 March ... 18 13 6 ... 2 2 2 ... ... 2 1 3 49 April ... 29 11 ... ... 3 3 ... ... ... 1 ... 6 56 May ... 34 6 1 1 3 4 3 ... 2 ... ... ... 54 June ... 47 8 1 ... ... 1 ... 1 ... ... ... ... 58 July ... 85 10 ... ... 1 10 ... ... 1 ... ... 2 109 August ... 52 10 1 ... ... 5 ... 1 1 ... 4 74 September ... 56 6 1 ... ... 2 2 ... ... ... ... 67 October ... 39 10 4 ... ... 4 ... ... ... 1 ... 2 60 November ... 30 8 1 ... ... 6 ... 1 ... ... ... ... 46 December 1 18 7 ... ... ... 3 ... ... ... ... ... ... 29 4 437 102 21 1 20 46 8 6 6 4 3 21 679 BACTERIOLOGICAL EXAMINATIONS. These examinations are carried out by Dr. Eastes at the Laboratory of Pathology and Public Health, 38, New Cavendish Street, in doubtful cases of Typhoid Fever, Diphtheria and Phthisis, and the following table gives particulars as to the number of cases examined and the results obtained:— Positive. Negative. Total. Typhoid Fever — 8 8 Diphtheria 16 57 73 Phthisis 26 51 77 Totals 42 116 158 Part II. DEPARTMENTAL. 33 DEPARTMENTAL. During the year the work of the department was carried on on the lines laid down in the scheme of re-organisation of 1908, and this, despite the fact that one Medical Officer of Health (Dr. Young), who had been responsible largely for preparing the scheme, left, and another (Dr. Porter) took his place. The staff of the Public Health Department during the greater part of 1909, included, in addition to the Medical Officer of Health, a deputy Medical Officer (Dr. J.R. Prior), 2 Drainage Inspectors, 1 Outdoor Superintendent, 1 Meat and Food Inspector, 4 District Inspectors, 3 Women Sanitary Inspectors (including one temporary), 1 Dust Inspector, 1 Chief and 2 Assistant Clerks, and an Office Youth. In addition to this staff, there are under the control of the Committee the Keeper of the Public Mortuary, the Matron and staff of the Shelter Baths, 2 disinfectors, the men and women attendants at the conveniences, and the men employed in flushing the overground conveniences. It is proposed to deal in this part of the report with the work of each of the above-named inspectors or groups of inspectors, but it may be said at once that practically without exception all the members of the staff—clerks, inspectors, etc.—have worked well during the year, and have in every way sought to make the working of the department under the new scheme as successful as possible. PROTECTION OF THE FX)OD SUPPLY. To all intents and purposes this portion of the report is concerned with the work of a new branch of the department. Prior to 1909 the meat and food supplies have been supervised, and sampling under the Sale of Food and Drugs Acts carried out, by each district inspector in his own area. At the beginning of the year, however, an inspector responsible for this work exclusively was appointed, and to him was entrusted the duty of examining foods in shops, etc.; inspecting premises in which food was sold, stored or prepared, e.g., milkshops and stores, kitchens of restaurants, bakehouses, ice cream shops, slaughterhouses, cowhouses, etc. He was also expected to take in hand the sampling of food and drugs throughout the Borough under the appropriate Acts. Food Inspection.—The work of inspecting and examining food, meat, etc., stored or exposed for sale was carried on regularly throughout the year, the food inspector and certain of the inspectors specially qualified as meat inspectors taking it in turn to carry out Saturday night and Sunday morning inspections. Taking advantage of the provision which allows purveyors of meat, etc., to submit articles to inspectors for examination and to voluntarily surrender food found by them to be unsound, several butchers and other food retailers in the Borough handed over considerable quantities of food for destruction. To such, 34 a small charge for removing and destroying the articles was made, and a certificate that this had been done given. Unfortunately, owing to the fact that the food inspector (Emerton) was no longer in the employ of the Council when the annual returns came to be made up, it is found impossible to give any definite statement as to the total quantity of food dealt with in this way. Apart from unsound food so treated it was found necessary in several cases to seize certain articles which were unsound or unwholesome or unfit for human food, and have them dealt with as prescribed by Section 47 of the Public Health (London) Act, 1891. The following is a list of these articles and shows the name of the inspector who carried out the seizure, the article seized and the result of the prosecution. In all these cases it may be said that the articles seized were submitted to the Medical Officer of Health and examined by him, and the person from whom they were seized was given every opportunity of having them examined by anyone he cared to name, either before or after the order for destruction had been obtained from the justice or magistrate : — PUBLIC HEALTH (LONDON) ACT, 1891, Section 47. Unsound Food. Inspector. Offence Result. Emerton Exposing for sale 220 tins of condensed milk which were unsound and unfit for human food at Nos. 10&12, Earl Street Fined £40 and £10/10-costs Emerton Exposing for sale four jars of pickles which were unsound and unfit for human food, at No. 40, Queen Street Fined £1 and 2/-costs Emerton Exposing for sale one jar of pickles which were unsound and unfit for human food, at No. 106, Seymour Place Fined 10/-and 12/6 costs Emerton Depositing and selling an article of food, to wit, about 80 1b. of cherries, which were unsound and unfit for human food, on a fined 10/-and 2/-costs for depositing and £1 and 2/- costs for selling Emerton Exposing an article of food, to wit, about 30 1b. of beef, which was unsound and unfit for human food, at No. 7, Salisbury Street Fined £5 and £2/6/- costs Emerton Exposing articles of food, to wit, about 28 1b. of pears and peaches which were unsound and unfit for human food, at No. 21, Hatton Street Fined 2/6 and 4/- costs for exposing and 2/6 and 4/- costs for de¬positing Smith Exposing for sale a quantity of crabs which were unsound and unfit for human food, at No. 57, Great Titchfield Street Fined £10 and £1/3/- costs 35 Smith Exposing for sale on a stall in Bell Street a quantity of fruit which was unsound and unfit for human food Fined £i and £1/3/- costs for exposing and 2/- costs for depositing Smith Depositing, for the purpose of the preparation for sale, certain pieces of meat which were unsound and unfit for human food, at No. 6, Crawford Terrace Fined £3 and £2/2/-costs Smith Exposing for sale certain unsound fruit, to wit, pears, grapes and melons, which were unfit for human food, at No. 14, Union Street, Middlesex Hospital Fined £2 and £2/2/-costs Smith Exposing and depositing for sale, at No. 57, Bell Street, two pigs and two sets of organs which were diseased with tuberculosis and were unfit for human food Fined £5 and £3/3/-costs Three of the above seizures, it will be noted, refer to meat, and one of these was of pig carcases and organs diseased with tuberculosis. The seizure in this instance was made at Christmas time. The animals were proved to be country fed and slaughtered, and a note of the circumstances of the case was sent to the Medical Officer of Health of the district whence the carcases had come. As the fact that pork has been fed and slaughtered in the country is commonly taken as a guarantee of its excellence, it is worth while entering a word of caution regarding it, viz.: that very frequently no examination whatever has been made of the carcase from which it is derived before it leaves the country, and it is just possible that no examination is made in town at the retail shop, which may be one of hundreds, and therefore liable to escape inspection. There is no doubt of the existence of a certain laxity in connection with examinations at country slaughterhouses, and as attention is continually being called to it, the signs are hopeful that the future may see some improvement in this respect. Slaughterhouses. The following list gives the number and situation of premises used as slaughterhouses in the Borough, and the conditions under which the licences are granted. Premises. Conditions. 75, Abbey Road Nil. 6A, Bolsover Street, rear of Nil. 178, Edgware Road Nil. 4, Henry Street, St. John's Wood Small cattle only. 50, Henry Street, St. John's Wood Small cattle only. 134, High Street, St. John's Wood On the clear and distinct understanding that the room over the slaughterhouse is not used as a living room. 31, Little Church Street Small cattle only. 32A, Union Street, Middlesex Nil. Hospital 36 Notices of intention to apply to the London County Council for the renewal of these licenses were duly received by the Sanitary Authority, and no opposition having been raised the licenses were granted for the year ending the 31st October, 1910, by the Public Health Committee of the London County Council at their meeting at the Clerkenwell Sessions House on the 25th October, 1909. The premises have been under constant supervision, and no action has been necessary in connection with them during the year. MILK SUPPLY. Cowhouses.—The number of cowhouses in the Borough is small—five—most of the milk coming into the district from outside. The situation of the premises is as follows:— Premises. No. of Cows. 58, Acacia Road (Sheds Nos 1, 2 and 3) 44 56, Bell Street 15 *42A, Clipstone Street 10 26, John Street 14 3, Malthouse Mews 22 Total 105 *This license is granted on the undertaking of the licensee not to keep more than 10 cows on the premises. Application for renewal of these licenses is made annually, and the Borough Council having raised no objection the renewals were granted by the licensing authority, the London County Council. As a matter of fact, though, as the above table shows, the sheds are licensed for 105 cows, at the time of the annual inspection only 41 were actually stabled, as follows:— Premises. No. of Cows. 58, Acacia Road 7 56, Bell Street 7 42A, Clipstone Street 10 26, John Street 3 3, Malthouse Mews 14 Total 41 The premises were regularly and frequently visited during the year. In no case was it found necessary to issue notices with regard either to cleansing or nuisances. Milks/tops, etc.—The number of premises upon which milk is sold is 264. During the year 31 applications were received for registration, of which three 37 were refused, as provided by the London County Council (General Powers) Act, 1908, on the ground that the premises were unsuitable. Taking advantage of the powers granted by the same section, two names were removed from the register, and in addition thereto nine names were removed, the persons having voluntarily discontinued selling milk. During the year an important question was raised in connection with the sale of milk in the streets of the Borough by purveyors whose names did not appear in the register of milk sellers, purveyors, etc., kept by the Council. A case was brought before the magistrate (Mr. Denman) at Great Marlborough Street Police Court, and it having been proved to his satisfaction that the defendant, though unregistered in St. Marylebone, was registered in another Borough, he dismissed the case, but consented to state a case for the Council, who decided to appeal. The appeal, at the time of writing, is pending, and further reference will be made to the matter in a later report. In addition to this case, six others were prosecuted for offences against the Dairies, Cowsheds and Milkshops Orders. By order of the Public Health Committee, three, the circumstances in which were similar to those described above, were withdrawn, fines and costs being imposed in the remaining three. The following statement gives full particulars regarding each of the cases : Offence. Result. Selling milk in Hereford Street and Lisson Grove from dirty utensils, viz., one churn and one hand can, and for failing to register his name as a purveyor of milk. Fined £2 and £\ 10/- costs for dirty utensils, and fined 10/- for failing to register, Selling milk from dirty utensils from footway in Earl Street, and for failing to register as a purveyor of milk. Fined 10/- and 12/6 costs for dirty utensils, and 10/- and 2/- costs for failing to register. Purveying milk in Carburton Street without being registered. Purveying milk in Cleveland Street without being registered. Purveying milk in Foley Street without being registered. Note.—In the three, preceding cases the Vendors were registered in St. Pancras and Islington, and purveyed milk in St. Marylebone. The Public Health Committee directed the Solicitor not to proceed in these cases having regard to the fact that Mr.Derman in a case brought by Hampstead Borough Council decided against that Authority in respect of a defendant registered in the County of Middlesex purveying milk in Hampstead. Purveying milk from the premises No. Defendants fined £2 and 2/2, Westmoreland Street, without being costs. registered. 38 Purveying milk in the Borough without being registered. Defendant was convicted for adulteration, but the summons in respect of his failure to register as a purveyor in St. Marylebone was dismissed. Notice of appeal was given and the case for hearing in the High Courts is pending. Examination of Milk.—Apart from a small number taken for bacteriological examination, all samples for analysis are taken under the Sale of Food and Drugs Acts, but as this portion of the report deals with milk, it is considered convenient to refer to the subject of milk examination here. The sampling during the year was carried out by the Meat and Food Inspector, who took a number fixed by the Medical Officer of Health each week and submitted them to the Public Analyst. Most of the samples were taken during the day, but several were also obtained in the evening or early morning and on Saturday night and Sunday morning. A certain number of samples were also taken at railway stations once a month. The total number of milks examined was 403. Of these, 23 (5 7 per cent.) were found to be adulterated. In the case of samples reported on as genuine by the Public Analyst, a note was sent to the vendor informing him that 110 further action would be taken in connection with the sample. So far as the adulterated samples are concerned, proceedings in all cases were instituted, unless the adulteration was trivial or other circumstances existed which rendered such a course inadvisable. The actual number of cases prosecuted was 15, and the number of convictions 14. In the latter, fines and costs to the amount of £30. 2s. 6d. were recoveredIn one case, the defendant absconded before the summons was served. In the case of the railway station samples, it is customary to send one-third of the sample to the consignor and to communicate with him when the analysis is completed. Of the 38 such samples taken during the year, none were found to be adulterated. The following table gives the quarterly returns as to milk sampling during 1909:— Quarter of the Year. No. of Samples Taken. No. of Samples Adulterated. Percentage Adulterated. No. of Prosecutions Instituted. Fines and Costs. 1st 63 6 7.9 2 £ s. d. 2 5 0 2nd 54 7 12.9 5 9 2 6 3rd 147 5 3.4 6 16 2 6 4th 139 6 4.3 2 2 12 6 Total for year 403 23 5.7 14 30 2 6 39 Ice Cream Premises. There are 80 such registered in the Borough in accordance with the London County Council (General Powers) Act of 1902. They have been regularly inspected, and in three instances proceedings were instituted in respect of offences against the Act. As the following statement shews, all these were successful:— Offence. Result. Selling ice cream in Great Titchfield Street, on two occasions, from a barrow not marked with the name and address of the manufacturer Fined 10/- and 2/- costs for each offence Selling ice cream in Carlisle Street from a barrow not marked with the name and address of the manufacturer Fined 5/- and 2/- costs Manufacturing and storing ice cream in an improper place at No. 119, Princess Street Fined £2 and 2/-costs Butter, Margarine, etc. The number of persons registered as dealers in and manufacturers of margarine under the Margarine Act, 1887, Sec. 9, and the Sale of Food and Drugs Act, 1889, Sec. 7 (4), is seven, and of wholesale dealers in butter and milk blended butter, under the Butter and Margarine Act, 1907, three. Two names were added during the year, and the various premises have been regularly inspected. The matter of sampling of butter, margarine, etc., is dealt with under the heading "Sale of Food and Drugs Acts." Restaurants, Food Stalls, etc. Premises on which food is prepared for sale exist in the Borough to the number of 163 (restaurant and dining room kitchens 55, hotel kitchens 18, coffee shops, pastrycooks and tea-rooms 90). Each of these was visited at least once during the year by the special Meat and Food Inspector. A number of notices were served chiefly for breaches of Section 8 of the London County Council (General Powers) Act, 1908, which deals with the question of sanitation in such places. The food stalls in the market streets—Bell Street, Great Titchfield Street, etc.—have been regularly inspected, and during the year a proper system of inspection on Saturday nights and Sunday mornings was inaugurated. Offensive Trades. Only two premises in which trades classed as offensive are carried on are situated in St. Marylebone. In both instances tripe-boiling is the industry followed, and in neither, though frequently visited, was any cause for complaint found. 40 Bakehouses. No bakehouse has been removed from the register during the year, and none have been added. The number at present on the register is 78, 70 of which are below the ground level. These have been subject to regular inspection during the year. During the latter half of 1909, the system of drawing the attention of the occupiers of such premises to the fact that under the Public Health (London) Act, 1891, and the Factory and Workshop Act, 1901, in all bakehouses, where limewashed, the limewashing shall be renewed at least every six months, was introduced. This regulation applies to the inside walls of the rooms of the bakehouse and all the ceilings or tops of such rooms and to the passages and staircase of the bakehouse. If the walls, etc., are painted and varnished, the paint or varnish (three coats) must be renewed once in seven years, and be washed with hot water and soap once at least in every six months. A bakehouse in which there is any contravention of this rule is to be deemed not to be kept in conformity with the Factory and Workshop Act, and liability to a penalty is incurred by the person so offending. This regulation, so far as the records show, had been rather neglected in the past, but after the service of the notice the requirements of the Act were complied with without in one instance having to put into operation the legal remedy for non-compliance. In future reminders will be sent out twice a year, and all bakehouses kept under close observation. Sale of Food and Drugs Acts. The system in vogue in connection with food sampling is for the Medical Officer of Health to hand the Meat and Food Inspector a list each Saturday of the number of samples to be taken of various articles during the ensuing week. In some cases he is instructed to sample at certain shops and to visit at certain hours and on certain days. A considerable number of the samples taken during 1909 were purchased by an "agent." The total number of samples submitted to the Public Analyst was 756, and of these 4l(5.4 per cent.) were found to be adulterated. Proceedings were instituted in 31 cases, and fines and costs to the amount of £93. 4s. 6d. were recovered. As shown below, only in one case was it necessary to take proceedings for obstruction to the carrying out of the Acts. The penalty enforced will probably act as a deterrent to other persons tempted to obstruct. Offence. Result. Obstructing an officer in the course of his duty at No. 20, Blenheim Terrace. Fined £3 and £1 3s. costs. 41 The following table and report from the Public Analyst gives full information with regard to the samples submitted to and examined by him:— Articles submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under the direction of a Local Authority, under Section 13 of Act, and, if so, the name of such Authority. Result of Analysis; showing whether the sample was Genuine or Adulterated, and if Adulterated, what were the nature and extent of the Adulteration. The sum paid in respect of the Analysis. vations. FIRST QUARTER ENDING 31st MARCH, 1909. 57 milks Food Inspector Genuine. 16 contained an aniline colouring matter. £500 per ann.for 700 samples. Over that number 7/6 per sample. 1 do. Private purchaser Genuine. 1 do. Do. Adulterated 10.8 per cent. water and 13.4 per cent. deficient in fat. 3 do. Food Inspector Adulterated. No. 2058 10.8 per cent. added water. No. 2058. Proceedings were not taken on the advice of Solicitor. Do. No. 2076 7.64 do No. 2076. Fined 10/- and 12/6 costs. Do. No. 2075 9.41 do. No. 2075. Do. 1 skimmed milk Do. Adulterated, 4.3 per cent. added water, No. 2167. No. 2167. Proceedings were not taken on the advice of Solictor. 21 butters. Do. Genuine. 15 contained boric acid from traces up to 35 grains per lb. 1 do. Do. Adulterated with 90 per cent. of fat other than butter fat. No. 2037. Fined £5 and 12/6 costs, and for selling margarine in an unstamped wrapper, £1 and 2/- costs. 1 do. Do. Test sample adulterated (margarine). 1 bread and butter Do. The butter probably not genuine. Too small a quantity of butter to certify with certainty. 5 creams Do. Genuine. 2 contained boric acid 0.67 and 0.22 per cent. respectively. 2 cheeses Do. Genuine. 7 margarines Do. Do. 3 whiskies Do. Do. 1 do. Do. Adulterated. Alcoholic strength 20 degrees under proof, No. 2203 Proceedings were not taken on the advice of Solicitor. 3 brandies Do. Genuine. 4 gins Do. Do. 3 sherries Do. Do. 3 beers Do. Genuine (one a test sample). 1 coffee Do. Genuine. 1 do. Do. Adulterated with chicory ; only 40 per cent. coffee, No. 2053. Solicitor advised no prosecution since label on tin specified coffee & chicory mixture. 5 cocoas Do. Genuine. 2 peppers Do. Do. 1 mustard Do. Do. 1 do Do. Adulterated, 20 per cent. wheat starch, No. 2175. Proceedings not taken on the advice of Solicitor. 1 malt vinegar Do. Adulterated being a wine vinegar, No. 2152. Do. 1 do. Do. Genuine. 1 jam Do. Do. 2 marmalades Do. Do. 1 sugar Do. Do. 1 sweets Do. Do. 2 condensed milks Do. Do. 42 Articles submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under the direction of a Local Authority, under Section 13 of Act, and, if so, the name of such Authority. Result of Analysis; showing whether the sample was Genuine or Adulterated, and if Adulterated what were the nature and extent of the Adulteration. The sum paid in respect of the Analysis. vations. 2 canned apricots Food Inspector Genuine, but contained a trace of tin equal to 0.4 and 0.1 grains of tin per lb. 1 potted shrimps Do. Genuine, free from preservatives. 1 salmon & shrimps Do. Genuine. 1 chicken and ham Do. Do. 1 turkey and tongue Do. Do. 2 beef drippings Do. Do. 1 beef sausages Do. Do. 2 pork sausages Do. Test samples, 1 genuine, 1 with 17 grains per lb. of boric acid. 3 "Stauber" delicacies Do. Genuine. 1 quinine wine Do. Do. 1 quinine wine and sherry Do. Do. 2 ipecacuanha wine Do. Do. 2 ginger wines Do. Do. 2 elderberry wines Do. Do. 2 ammoniated tinctures of quinine Do. Do. 4 sweet spirits of nitre Do. Do. 4 camphorated oils Do. Do. 5 olive oils Do. Do. 2 chlorate of potash lozenges Do. Do. 1 pepsin Do. Do. 2 gall and opium ointments Do. Do. 2 flours Do. Do. SECOND QUARTER ENDING 30th JUNE, 1908. 16 milk Food Inspector Genuine. 7 do. Do. Adulterated. No. 2188 7.53 per cent. added water No. 2188. Defendant absconded, summons not served. Do. No. 2247 12 per cent. deficient in fat. No. 2247. Fined £1 and 12/6 costs. Do. No. 2261 10 do. No. 2261. Do. Do. No. 2262 4 do. No. 2262. Vendor was cautioned. Do. No. 2269 9.4 do. No. 2269. Fined £2 and 12/6 costs. Do. No. 2273 10 do. No. 2273. Fined £1 and 12/6 costs. Do. No. 2280 8 do. No. 2280. Do. 1 milk Private Purchaser Genuine (undivided) 23 butter Food Inspector Genuine. 18 of the butter samples contained borax from a trace up to 33.90 grains per lb. expressed as boric acid. 1 bread and butter Do. Do. 2 do. Do. Adulterated. No. 2277. Contained 80 per cent. of fat other than butter fat No. 2277. Fined £2 and 12/6 costs. Do. No. 2278 do. No. 2278. Case dismissed with costs against Council. 43 Articles submitted for Analysis State whether the sample was submitted to the Analyst by an Officer acting under the direction of a Local Authority, under Section 13 of Act, and, if so, the name of such Authority. Result of Analysis; showing whether the sample was Genuine or Adulterated, and if Adulterated what were the nature and extent of the Adulteration. The sum paid in respect of the Analysis. Observations. 8 margarines Food Inspector Genuine. 1 margarine Do. Adulterated. No. 2217 contained 16 per cent. of butter fat. The third sample was. sent to Somerset House, and the Analyst certified that the sample did not contain 10 per cent. of butter fat. Case dismissed, costs against Council £2/2/-, less cost of analysis 10/8. 2 cheese Do. Genuine. 1 lard Do. Do. 1 brandy Do. Do. 2 whiskies Do. Do. 2 beer Do. Do. 3 coffees Do. Do. 2 mustard Do. Do. 3 condensed milk Do. Do. 1 beef dripping Do. Do. 1 ground ginger Do. Do. 1 cod liver oil Do. Do. 1 shrimps Do. Do. THIRD QUARTER ENDING 30TH SEPTEMBER, 1909. 141 milks Food Inspector Genuine. Twenty-one of the samples of milk were artificially coloured. 1 do. Private purchaser Do. 5 do. Food Inspector Adulterated. No. 2329, 6 per cent. added water. No. 2329. Fined £1 and 12/6 costs. Do. No. 2330. 13 per cent. deficient in fat and 9.7 added water No. 2330. Do on each of the two summonses. Do. No. 3337. 11.53 per cent. added water No. 2337. Fined £1 and 12/6 costs. Do. No. 2342. 11.71 do. No. 2342. Fined £5 and 12/6 costs. Do. No. 2503. 11.18 do. No. 2503, Do. 45 butters Do. Genuine. 2 do Do. Adulterated. No. 2390. 18.5 per cent. of water No. 2390. Fined £10 and £0 3/- costs. Do. No. 2400. 83 per cent, fat other than butter fat No. 2400. Fined £7 and £1 5/- costs on first summons and 2/- costs for selling margarine in an unstamped wrapper. 19 margarines Do. Genuine. In four of these cases the margarine was sold in an unstamped wrapper, with results as follows : No. 2386. Fined £3 and 12/6 costs. No. 2388. Fined £2 and 12/6 costs. No. 2405. Fined £3 and 12/6 costs. • No. 2410. Do. 44 Articles submitted for Analysis. State whether the sample was submitted to the Analyst by an Officer acting under the direction of a Local Authority under Section 13 of Act, and, if so, the name of such Authority. Result of Analysis; showing whether the sample was Genuine or Adulterated, and if Adulterated what were the nature and extent of the Adulteration. The sum paid in respect of the Analysis. Observations 1 margarine Food Inspector Adulterated. No. 2424 contained 17 per cent. of butter fat No. 2424. Fined £5 and 12/6 costs on each of two summonses, the sample being sold in an unstamped wrapper. Two other margarines were doubtful but as sample only weighed 1.5 oz. it was insufficient for analysis to be repeated 2 cheeses Do. Genuine. 3 lards Do. Do. 2 whiskies Do. Do. 1 brandy Do. Do. 1 gin Do. Do. 1 rum Do. Do. FOURTH QUARTER ENDING 31ST DECEMBER, 1909. 132 milks Food Inspector Genuine. 10 of these were artificially coloured, 2 were test samples. 6 do. Do. Adulterated. No. 2509 2.8 per cent. added water. No. 2509. Fined £1 and 10/- costs. Do. No. 2538 4.0 do. No. 2538. Fined 10/- and 12/6 costs. Do. No. 2569 10 per cent. of fat abstracted. No. 2569. See footnote. Do. No. 2621 5.4 per cent. added water. No. 2621. Do. Do. No. 2626 12.3 do. No. 2626. Do. Do. No. 2726 3.53 do. No. 2726. Vendor cautioned 1 skimmed milk Do. Genuine. 32 margarines Do. Genuine, 6 of these of these were sold unlabelled. No. 2501. Owing to summons not having been applied for in the time specified in Act, proceedings were not taken. No. 2514. Fined 10/-.and 12/6 costs. No. 2528. Fined £1and 12/6 costs. No. 2619. See footnote. No. 2699. Fined 5/- and 12/6 costs. No. 2746. Fined 10/-and 12/6 costs. 54 butters Do. Genuine. 1 do. Do. Adulterated. A test sample, 80 per cent. of foreign fat. 3 do. Do. Adulterated. No. 2561 90 per cent. of foreign fats. No. 2561. See footnote. Do. No. 2642 80 do. No. 2642. Do. Do. No. 2735 80 do. No. 2735. Fined 10/- and 12/G costs on each of 2 summonses. 45 Articles submitted for Analysis State whether the sample was submitted to the Analyst by an Officer acting under the direction of a Local Authority under Section 13 of Act, and. if so, the name of such Authority. Result of Analysis; showing whether the sample was Genuine or Adulterated, and if Adulterated what were the nature and extent of the Adulteration. The sum paid in respect of the Analysis. Observations 3 cheeses Food Inspector Genuine. 1 coffee 4 Do. Do. A test sample. 2 Gregory powders Do. Do. 1 do. Do. Adulterated. No. 2650 contained 56 per cent. instead of HO per cent. of magnesia. No. 2650. See footnote. 1 compound liquorice powder Do. Genuine. 4 creams . Do. Do. Note.—Proceedings were not taken in these cases in consequence of the Inspector having been removed from his office in acccordance with Article 10 of the Sanitary Officers (London) Order, 1891. SUMMARY. Total number of Number Samples Analysed. Adulterated. 1st Quarter 182 12 2nd „ 109 10 3rd „ 224 8 4th „ 241 11 Totals 756 41 REPORT OF THE PUBLIC ANALYST ON WORK DONE UNDER THE SALE OF FOOD AND DRUGS ACTS. The total samples submitted during the year was 756; of these 41 or 5.4 per cent. were certified as adulterated. Milk.-—As usual the greater number of the samples sent were those of milk. 403 samples of milk were dealt with; of these 23 or 5.7 per cent. were adulterated; this bald statement is below the truth, for the common practice of adding separated milk to new milk and thus indirectly lowering its quality to the low official standard of 3 per cent. fat and 8.5 per cent. other milk solids, is widely prevalent. If therefore the samples which just attain the official limit be added to those which were certified adulterated, it then may be said that 14.5 per cent. of the milk samples were either poor, watered, or deprived of fat. In the 25 samples certified as adulterated the highest amount of water added was 12.5 per cent.; the highest amount of fat abstracted 13.4 per cent.; 45 samples of milk were artificially coloured, an objectionable practice and absolutely unnecessary. It is gratifying to be able to state that in very few 46 cases had any preservative been used; the practice formerly prevailing ot adding boric acid to milk has become unpopular among dairymen. In two cases small quantities of formalin were discovered. Butter.—Including test samples, and also samples of "bread and butter," 155 samples were analysed; of these, II, or 7 per cent., were certified as adulterated. One only had an excess of water; the other 10 were either margarines or mixtures of margarine and butter. Boric acid is still used largely as a preservative of butter. 107, or 69 per cent. of the samples examined, contained boric acid up to 38 grains per lb. Cream.—At the present time a considerable amount of attention is being paid to cream. It is believed that certain brands are thickened with lime, sweetened with saccharin, and preserved with salicylic, benzoic acids or other preservative. Nine creams were analysed during the year; in two, boric acid up to 067 per cent. was found, but they were all otherwise genuine. Drugs.—Experience has shown that at the present day the drugs sold retail, although variable in quality, are seldom wilfully adulterated. The 30 samples of drugs submitted were genuine, save a sample of Gregory's powder; the powder should have contained 60 per cent. magnesia, and it only contained 56 per cent., an evidence of carelessness rather than fraud, for of the components of Gregory's powder, magnesia is the cheapest. Canned Goods.—It will be seen by the table that quite a considerable number of articles preserved in tins were examined. Some canned apricots contained tin up to 0.4 grain per lb. All fruits are more or less acid, and it is impracticable to treat tin in such a manner as to prevent small quantities of the metal being dissolved. Hence no fruit whatever should be preserved in tinned vessels. On the other hand, glass or earthenware receptacles are so much heavier than tin that the cost of carriage is materially increased. We may hope for some new material to be invented, insoluble in acids, which may replace tin. As things are, it is advisable not to buy preserved fruits in anything but glass or porcelain. The other samples require no comment. A. WYNTER BLYTH, Public Analyst. 3, Upper Gloucester Place, N.W., March 2nd, 1910. 47 ANALYSES UNDER THE SALE OF FOOD AND DRUGS ACTS DURING 1909. Article. Genuine. Adulterated. Milk 379 22 Milk, skimmed 1 1 Butter 143 8 Bread and Butter 1 3 Cream 9 — Cheese 9 — Margarine 66 2 Whisky 7 1 Brandy 5 — Gin 5 — Rum 1 — Sherry 3 — Beer 5 — Coffee 5 1 Cocoa 5 — Pepper 2 — Mustard 3 1 Ground Ginger 1 — Malt Vinegar 1 1 Jam 1 — Marmalade 2 — Sugar 1 — Sweets 1 .— Lard 4 — Condensed Milk 5 — Canned Apricots 2 — Canned Shrimps 2 — Canned Salmon and Shrimps 1 — Canned Chicken 1 .— Canned Turkey and Tongue 1 — Beef Dripping 3 — Beef Sausages 1 — Pork Sausages 2 — Sauces 3 — Ginger Wine 2 — Elderberry Wine 2 — Quinine Wine 2 — Elderberry Wine 2 — Ammoniated Tincture of Quinine 2 — Ipecacuanha Wine 2 — Sweet Spirits of Nitre 4 — Camphorated Oil 4 — Olive Oil 5 — Chlorate of Potash Lozenges 2 — Pepsin 1 — Gall and Opium Ointment 2 — Cod Liver Oil 1 — Gregory's Powder 2 1 Compound Liquorice Powder 1 — Flour 2 — Total 715 41 48 BACTERIOLOGICAL EXAMINATION OF FOOD. During the year 26 samples of milk, eight samples of condensed milk, one sample of skimmed milk, one sample of separated milk, one red salmon, two ox tongues, one salmon steak, and one sample of liquid eggs were taken for microscopical and bacteriological examination. Of these samples 24, of which 15 were milks, were adversely reported upon by the bacteriologist (Dr. Eastes), and communications were at once sent to the party who seemed to be responsible for the unsatisfactory condition of the article. In the case of contaminated milks, the Medical Officer of Health of the district from which the milk came, if the source seemed to be on the farm, was written to, and in every instance enquiries were made by this Officer and steps taken to prevent contamination and to ensure the sending of as pure a milk as possible into the Borough. This practice of taking samples for bacteriological examination, inaugurated by the Public Health Committee in iqo8, is being continued, and is likely to result in a considerable amount of good being done. WATER SUPPLY. Water Supply to Dive I ling Houses.—Under the provisions of Section 48 of the Public Health (London) Act, 1891, certificates have been granted to 23 premises which have been rebuilt. Under Section 78 of the London County Council (General Powers) Act, 1907, which calls for the provision of a supply of water to upper storeys of tenement houses, 164 Intimation Notices were served. In 115 of these cases the notice was complied with, without the necessity for serving a Statutory Notice. Of the 49 owners upon whom the latter notice was served, only three were prosecuted for failure to comply with the requirements. The particulars of these prosecutions will be found on page 60. Water supply cut off.—During the year in 118 cases, the water supply to premises was cut off by the Metropolitan Water Board, notice being given to this Department as required by Section 49 (1) of the Public Health (London) Act, 1891, in each case. The reasons for discontinuing the supply were:— Premises empty 88 Premises demolished 11 Defective pipes 8 Non-payment of rates 9 Waste of water 1 Supply not required 1 Total 118 49 In connection especially with those cases in which the premises deprived of water were tenement houses, valuable assistance was obtained from Alderman J. Lea-Smith, the Council's representative on the Metropolitan Water Board, who takes a great amount of interest in this part of the work and endeavours to ensure that no undue hardship shall result to the occupants of the tenements, on account of the discontinuance of the supply. HOUSING. During the year proceedings, as shown below, were taken under the Housing of the Working Classes Act in two cases only. In these, applications were made for a closing order which was not obtained in either, the summons in one instance being withdrawn on the owner of the premises undertaking to make them habitable to the satisfaction of the Medical Officer of Health. In the remaining case the magistrate refused to grant an order as the owner had carried out certain works between the time the summons was served and the case heard- Offence. Result. The premises, No. 10, Watson's Mews, unfit for human habitation. Summons withdrawn. Owner undertook that the premises should not be occupied for three months. He conferred with the Medical Ofificerof Health as to the necessary works required to make them habitable, and executed them accordingly. The premises, being the cottage at the rear of No. 32, Burne Street, unfit for human habitation. Magistrate refused to grant a closing order as certain works were executed between the time the summons was served and the date of the hearing of the case. Summons dismissed. The Housing, Town Planning, etc., Act, 1909, most of which comes into force on 1st January, 1910, makes considerable alterations in connection with the matter of closing orders, leaving the making of these to the Local Authority. The considerable improvements made in 1909, in connection with housing, have been made mainly as a result of notices served under the Public Health Act or the by-laws, but partly as a result of pressure brought to bear upon owners of property, who in most instances readily agreed to meet either the Medical Officer of Health or the Inspector to discuss matters. In several cases such meetings resulted either in considerable alterations being made, or if remedies seemed impossible, in voluntary closure of the premises. Several exceedingly insanitary dwellings in mews and over stables were closed in this way. In no case were proceedings taken for closure under the Public Health Act. 50 Houses Let in Lodgings. The work of re-registering the premises on the old register, under the by-baws of 1907, has been proceeded with steadily during the year. The number of tenement houses on the original register was 758, and at the end of 1909, 250 had been re-examined and re-registered, and certificates issued to the owners and occupiers. No new houses have been added as yet to the register, and until the re-registration is complete there seems little likelihood of anything being done in this direction, or in that of systematically inspecting places on the register. The number of inspections made in connection With re-registration was 692. In 437 cases notices were served, proceedings following in four of these. Common Lodging Houses. The particulars with regard to houses of this class are contained in the following table. Visits of inspection have been made from time to time throughout the year. Address. Registered Owner. Registered number of occupants. 54, Bell Street Alfred Crew 55 men 2, Burne Street and Lisson Street William Booth 594 men 46, Carlisle Street Thomas Hennesy 21 men 37, Little Church Street 6, Charlotte Place Charles Weatherhogg 7 women 123A, Church Street Colin Fitz-William Campbell 60 men 29, Circus Street William H. G. Richardson 136 men 3, Gee's Court Margaretta E. Howell 39 men 4, Gee's Court Margaretta E. Howell 27 men The Shaftesbury Institute, Harrow Street and Union Street, Lisson Grove Meredith Brown 102 women 47, Hereford Street Alfred Wilson 19 men 45, Lisson Street Alfred Wilson 45 men 3, Little Grove Street James Grant 100 men 12, Molyneux Street Frederick Charles Walters 17 men 13, Molyneux Street Frederick Charles Walters 129 men 7, Venables Street James Howell 56 men 25, Venables Street James Howell 18 men 1,316 men 109 women Total 1,425 51 House to House Inspection. The amount of routine inspection of houses in any one district done during the year was very small. The total, 264, resulted in the discovery of 639 defects, and the issue of 286 notices (Intimations, 264; Statutory Notices, 22). Prosecution followed in one case only. Overcrowding. The number of dwelling rooms found to be overcrowded during 1909 was 240. This is, of course, only a comparatively small fraction of the number of cases investigated regarding which complaint had been received with regard to overcrowding. Many complaints were, as usual, anonymous, and many were unfounded. Notices were served in each of the 240 undoubted cases and reduction of the overcrowding followed without the necessity for a prosecution arising. Underground Rooms. The number of illegal occupations of such premises dealt with was 163. In all of these cases notices were served, and, with the exception of one, in which the owner was prosecuted, led to closure of the rooms complained of or to their being let only in conjunction with rooms on other floors. The Housing, Town Planning, etc., Act, 1909, deals with the habitual occupation of rooms underground as sleeping rooms, and contains a section which comes into force in July, 1910, which has for its object the prevention of this. Customs and Inland Revenue Acts. Six certificates were granted during the year for exemption or reduction of inhabited house duty, in accordance with the provisions of the Customs and Inlaid Revenue Acts, in respect of the premises mentioned below, the number of tenements covered in the certificates being 55. One certificate covering two tenements was refused, the owner failing to carry out certain amendments to the sanitar) fittings, and the premises being, so far as their sanitary accommodation and condition was concerned, unsuitable. In one other case, comprising four tenements, the granting of the certificate was deferred pending the relaying of the drains which were found to be in a very defective condition. The sanitary fittings were also defective and required renewing thoughout. This case is referred to in the list of the proceedings for the abatement of nuisances on page 58. 52 The number of certificates granted and the situation of the premises are shown in the following list:— Premises. No. of Tenements. 30, Mitcham Street 22 Molyneux House, Molyneux Street 5 Northwick House, St. John's Wood 1 34 & 35, Horace Street 3 88 & 90, Great Titchfield Street 12 92 & 94, Great Titchfield Street 12 55 FACTORIES AND WORKSHOPS. This portion of the annual report is made in compliance with the requirements of Section 132 of the Factory and Workshop Act, 1901, which imposes on the Medical Officer of Health the duty of reporting each year on the administration of the Act in workshops and workplaces. A copy of the annual report, or of this portion, is to be sent to the Secretary of State for the Home Department, along with the tables, immediately following. Following the re-organisation of the work of the department, the inspector in charge of each district is made responsible for the workshops and workplaces in his own district ; those in which women are employed being left to the women inspectors. As the majority of the workshops and workplaces are largely in the two districts bounded on the north by Marylebone Road, on the south by Oxford Street, on the west by Edgware Road, and on the east, broadly speaking by Tottenham Court Road, most of the work is done by two inspectors. Of these two districts, that lying on the east of the area described is by far the heavier in every respect, and the amount of time which the inspector in charge of this district can give to workshops and workplaces is small. As a matter of fact, no routine inspections and reinspections have been made for some time, either by the men or women inspectors. All that is done is to attend to complaints and to measure up for the purposes of registration such places as are notified as ''unregistered" by the Home Office Inspectors, or by the persons who have taken or are about to take the premises. The following tables contain information with regard to the number of visits paid, and to other matters. Of the 2,277 visits, 688 were paid by the women, and 1,589 by the men inspectors; 73 were made after receipt of a complaint. 53 Report on the administration of the Factory and Workshop Act, 1901, in connection with Factories, Workshops, Workplaces and Heme work. I.—INSPECTION. Premises. (1) Number of Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories (Including Factory Laundries.) 13 3 — Workshops (Including Workshop Laundries.) 2,005 131 — Workplaces (Other than Outworkers' premises included in Part 3 of this Report.) 259 22 — Total 2 277 156 — 2.—DEFECTS FOUND. Particulars. (1) Number of Defects. Number of Prosecutions. (5) Found. (2) Remedied. (3) Referred to H.M. Inspector. (4) Nuisances under the Public Health Acts:— Want of cleanliness 141 141 — — Want of ventilation 11 11 — — Overcrowding 2 2 — — Want of drainage of floors — — — — Other nuisances 71 71 — — Sanitary accommodation insufficient 13 13 —- — unsuitable or defective 17 15 — — not separate for sexes 11 11 — — Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (s. 101) — — — — Breach of special sanitary requirements tor bakehouses (ss. 97 to 100). — — — — Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report.) — — — — Total 266 264 — —- 54 3.—HOME WORK. NATURE OF WORK. OUTWORKERS' LISTS, SECTION 107. Inspections of Outworkers' premises. OUTWORK IN UNWHOLESOME PREMISES, SECTION 108. OUTWORK IN INFECTED PREMISES, SECTIONS 109, 110. Lists received from Employers. Addresses of Outworkers. Notices served on Occupiers as to keeping or sending lists.‡ Prosecutions. Instances. Notices served. Prosecutions. Instances. Orders made (S. 110). Prosecutions (Sections 109, 110). Lists. Sending twice in the year. Lists. Sending once in the year. Received from other Councils. Forwarded to other Councils. Failing to keep or permit inspection of lists. Failing to send lists. Outworkers. Outworkers. Con. t'ct'rs. Workmen. Cont'ct'rs. Workmen. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) Wearing Apparel— (1) Making, etc. 132 ... 1894 4 ... 14 1294 1406 62 ... ... 275 ... ... ... ... ... ... (2) Cleaning and washing ... 14 ... ... ... ... ... 8 ... ... ... ... ... ... ... ... ... ... Furniture and Upholstery ... ... ... ... ... ... 8 ... ... ... ... 1 ... ... ... ... ... ... Fur pulling ... ... ... 1 ... 2 ... ... ... ... ... ... ... ... ... ... ... ... Umbrellas, etc. 2 ... 16 ... ... ... ... 6 ... ... ... ... ... ... ... ... ... ... Basket making ... ... ... ... ... ... ... ... ... ... ... 2 ... ... ... ... ... ... Total 134 14 1910 5 ... 16 1302 1420 62 ... ... 278 ... ... ... ... ... ... ‡These figures refer to written reminders only, and not to Statutory Notices. 55 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year. (1) N umber. (2) Workshops (Dressmaking, Tailoring, Millinery, Laundry, Wood Carving, &c.) 3,098 Coffee Shops and Restaurants 237 Bakehouses 78 Total number of workshops on Register 3,413 5.—OTHER MATTERS. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Act (s. 133) 8 Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (s. 5.) Notified bv H.M. Inspector 41 Reports (of action taken) sent to k H.M. Inspector 22 Other — Underground Bakehouses (s. 101):— Certificates granted during the year — In use at the end of the year 78 NUISANCES. Work of the Sanitary Inspectors. The continued increase in the work of the Public Health Department is well illustrated by the figures relating to the receipt of complaints, the number of nuisances discovered by the Inspectors and the service of statutory notices. During 1909 there were 1,899 complaints received, as compared with 1,768 in 1908, an increase of 131. In respect of nuisances, 514 statutory notices were served, being an increase of 234 over the previous year, when 280 were sent out. Of the notices, 49 were served on owners to provide a proper and sufficient supply of water to the upper storeys of tenement houses under the London County Council (General Powers) Act of 1907. In 1,385 cases the nuisances were abated by the persons responsible on 56 the service of a preliminary (intimation) notice of the existence of the defect. The table immediately following gives the total inspections made by each district inspector, and the number of nuisances of various kinds detected and remedied. In 32 cases only was it found necessary to resort to legal proceedings to enforce compliance with statutory notices, and the table on page 57 gives the details of the cases so dealt with, the Act or By-laws under which proceedings were taken, and the results. A fine was levied on the defendants, it will be noted, in 7 cases, the others, 25 in number, being dealt with in a summary manner, the magistrate making an order for the work to be completed in a specified time and granting costs to the Council. In only one instance was the magistrate's order not promptly complied with, the defendant being penalised. Insp. Smith Insp.Andrews. Insp.Hodges. Insp. Wilson. Total. Inspections from Journal 4,089 4,111 3,487 4,042 15,729 Houses damp, dirty or dilapidated remedied 218 218 104 136 676 Doors, windows, floors, ceilings, sash cords, etc., repaired 22 32 16 6 76 Overcrowding cases abated 44 16 12 88 260 Illegal occupation of underground rooms 11 46 19 69 145 Water closet defects remedied 275 210 105 136 726 Water closets erected 2 1 5 29 37 Urinal defects remedied 11 7 2 3 23 Soilpipe and ventilating shaft defects remedied 187 106 47 39 379 Soilpipes and ventilating shafts erected 30 11 18 14 73 Yard defects remedied 197 131 40 55 423 Waste pipe defects remedied 94 78 24 52 248 Water cistern defects remedied 68 22 8 14 112 Rubbish, manure, etc., accumulations removed 25 38 23 28 114 Dung or dust receptacles repaired or renewed 150 124 42 68 384 Drains relaid or amended 127 70 55 34 286 Drains cleared 95 50 25 19 198 Rainwater pipes repaired or renewed 56 30 33 15 134 Water supply to houses reinstated 56 34 16 44 150 Roofs and gutters repaired 15 15 5 10 45 Area defects remedied 34 45 20 48 147 Washhouse defects remedied 147 57 22 29 255 Bakehouses cleansed or repaired 2 4 2 6 14 Animal nuisances abated 5 5 1 5 Basement defects remedied 15 31 2 3 51 Stables cleansed or repaired 10 3 1 3 17 Water supply laid on to upper storeys of house 58 33 14 11 116 Miscellaneous nuisances abated 31 13 8 19 71 Smoke nuisances abated 50 42 9 13 114 Verminous rooms cleansed 13 6 1 4 24 Workshops damp, dirty or dilapidated remedied 17 3 5 20 45 57 LEGAL PROCEEDINGS IN CONNECTION WITH NUISANCES. During the year 24 summones were issued under Sections of the Public Health Act, relating to nuisances, water supply, etc., 1 under the by-laws of the London Council, 2 under the London County Council (General Powers) Act, 1904, and 3 under Section 78 of the London County Council (General Powers) Act, 1907. Three cases under the clauses relating to Ice Cream in the London County Council (General Powers) Act, 1902, are noted on page 39. Public Health (London) Act, 1891. Offence. Failure to provide a proper receptacle for the storage of house refuse at No. 22, Boston Place. Failure to provide a proper supply of water to the w.c., repair the w.c. pan, and provide a proper receptacle for the storage of house refuse at No. 20, Boston Place. Failure to provide a proper supply of water to the premises, cleanse the walls of the yard, repair the defective paving and renew the rainwater pipe at No. 18A Boston Place. Failure to provide a proper receptacle for the storage of house refuse at No. 12 Gresse Street. Failure to unstop and cleanse the w.c., and cleanse the washhouse and basement passage at No. 14, Harrow Street. Failure to comply with a statutory notice to re-drain the premises No. 344, Edgware Road. Failure to cleanse the premises and provide water to the upper storeys of the house No. 21, Bolsover Street. Failure to cleanse the premises No. 11, Little North Street. Result. Summons withdrawn, receptacle having been provided. Costs 5/-. Summons withdrawn, work having been completed, and receptacle provided. Costs 5/- Summons withdrawn, work having been completed. Costs 1 5s. Summons withdrawn, new receptacle having been provided. Costs 12/6. Magistrates order for work to be executed within 7 days. Work was completed and summons withdrawn. Costs 3/-. Work completed before hearing of summons which was withdrawn. Magistrate ordered cleansing work to be executed forthwith and water to he provided within 14 days. Works executed. Summons withdrawn. Costs £1 5s. Summons withdrawn. Works having been completed. 58 Offence. Failure to renew w.c. pan, and cleanse the drinking water cistern at No. 33, Little North Street. Failure to cleanse the premises No. 9, Weston Place. Failure to trap the sink and lavatory waste pipe at No. 344, Edgware Road. Failure to renew the defective drains at No. 46, Church Street. Failure to trap the bath and lavatory waste pipes and renew the defective drain at No. 72, Abbey Road. Failure to abate the nuisance of the emission of black smoke from the bakehouse chimney at No. 31, Blandford Street. Failure to renew the defective drain at Nos. 424 & 426, Edgware Road. Failure to cease letting an underground room at No. 12, Gresse Street, which was illegally separately occupied. Failure to provide proper drainage and w.c. accommodation at the premises No. 1, Beaumont Street. Failure to remedy a defective drain at premises at the rear of No. 8, Church Street. Result. Summons withdrawn. Works having been completed. Summons withdrawn. Works having been completed. Magistrate ordered work to be executed within 7 days with 16/6 costs. Work was not executed whereupon a penalty of £1 was imposed with a further 2/- costs. Summons withdrawn. Work having been completed. Costs £1 3s Fined £1 and 12/6 costs. Magistrate granted a prohibition order and fined defendant £3 and £1 -3/- costs. Order made to execute works within 14 days. 12/6 costs. In view of the question of disputed ownership of the premises, and an allegation that the drainage of the premises was in combination and also in view of the fact that a serious nuisance existed on the premises, the Council decided to execute the works and proceed to recover the cost from the owner. Proceedings in this matter are pending. Fined 10/- and £1 3s. costs. Summons withdrawn, the owner having died. Work was subsequently completed. Magistrate ordered work to be completed within 14 days. Costs 12 /6 59 Offence. Failure to cleanse the walls and ceilings of the passages and staircase at No. 23, Gosfield Street. Failure to relay a defective drain at No. 17, Hallam Street. Failure to relay a defective drain at No. 19, Hallam Street. Failure to relay a defective drain at No. 99, Hallam Street. Failure to relay a defective drain at No. 10, Ordnance Road Failure to abate the nuisance from the emission of black smoke from the bakehouse chimney at No. 55, Church Street. Result. Work was complete before the issue of the summons. Magistrate ordered work to be executed within 21 days. Costs £1-3/-. Magistrate ordered work to be executed within 28 days. Costs £1-3/-. Magistrate ordered work to be executed within one month. Costs 6/-. Magistrate ordered work to be executed within 14 days. Costs £2-2/-. Fined 1/- and 2/- costs. London County Council By-Laws as to removal of House Refuse. Offence. Removing offensive and noxious matter and liquid from shops in High Street, St. John's Wood, in an unsuitable vehicle and improper receptacles. Result. Fined 10/- and 4/- costs. London County Council (General Powers) Act 1904. Section 20 (1). Offence. Failure to cleanse the verminous rooms at No. 5, Circus Street. Failure to cleanse the verminous rooms at No. 8, Weston Place. Result. Fined £5 and £1 3s. costs in respect of verminous rooms and £2 2s. and 2s. costs in respect of the dirty condition of the said rooms. Summons withdrawn, work having been completed. 6o London County Council (General Powers) Act 1907. Section 78. Offence. Failing to comply with a Statutory Notice requiring water to be provided to the upper storeys of the premises, No. 21, Bolsover Street. Do. No. 8, Venables Street. Do. No. 23, Gosfield Street. Result. Magistrates ordered this work, together with other work under Public Health (London) Act, 1891, to be executed, and granted £1 5s. costs. Fined £1 and 12/6 costs. Magistrate ordered work to be executed within 14 days and granted 4/- costs. DRAIN PLANS AND DRAINAGE. Work of the Drainage Inspectors. Two Inspectors, one in charge of the district north of Marylebone Road, the other of that south of this road, have been responsible for drainage work to new as well as existing premises during the year. To these Inspectors the supervision of the remedying of nuisances due to defective drainage is transferred by the District Inspectors, if anything more than slight alterations are to be carried out. The total number of inspections made was 6,850, as against 4,371 for the previous year. The number of plans dealt with by the Public Health Committee is shewn in the accompanying statement. South District. (Inspector Gorniot.) No. of plans of drainage of New Buildings received 69 No. of plans of drainage of Old Buildings received 188 No. of Inspections 2542 North District. (Inspector J. C. Wilson.) No. of plans of drainage of New Buildings received 16 No. of plans of drainage of Old Buildings received 248 No. of Inspections 4308 Plans deposited during 1909 (whole Borough) 521 Plans deposited during 1908 Do. 480 Note.—In some cases the plan shews the drainage of more than one premises. 61 Intimation Notices with regard to drains to the number of 286 have been served. In 195 instances the necessary works were only carried out after a Statutory Notice was sent, and summonses to enforce compliance were issued in 9 cases. Proceedings were instituted in one case for infraction of the By-laws, as follows:— Offence. Improperly constructing a sink and bath waste pipe on the 3rd floor at No. 54, Bryanston Street without giving notice. Result. Summons withdrawn, plans having been deposited, and the work amended so as to comply with the By-laws. Combined Drainage. Orders under seal as to combined drainage were granted by the Council to the number of 23. In 6 cases no record of a combination of the drains of two or more premises being in the possession of the Council, so much of the work as devolved upon the Council was carried out by the Borough Surveyor at their expense. The whole of the necessary drainage work was carried out by the Council in one instance, in order that a serious nuisance might not be allowed to exist, pending the settlement of a dispute as to whether or not the drain found to be defective was combined. This question will be decided at the time action is taken by the Council for the recovery of the cost of the works done. BLACK SMOKE NUISANCES. The plan of giving each of the four district inspectors, the outdoor superintendent, and the dust inspector, at the beginning of each week, a list of premises other than dwelling houses, the chimneys of which were to be observed during the week, was continued. In all 1,207 observations were made, and 29 nuisances were discovered. Following the discovery of the nuisance a letter calling attention to its existence was sent to the occupier, and the inspector's report and any reply received from the occupier, were considered by the Public Health Committee. Statutory Notices were served with respect to 18 of the cases, and prosecutions instituted in 2. As shown in the list of prosecutions on page 57, one of the defendants was fined £3 and £1. 3s. costs, a prohibition order also being granted; the other defendant was fined 1/-and 2/-costs, the magistrate refusing to make an order. 62 REMOVAL OF HOUSE REFUSE. The removal of house refuse still continues to be done by contract. The contract for the North District is held by Messrs. William Mead and Co., Ltd., for two years, commencing 1st April, 1909, and that for the South District, which expires on the 31st March, 1910, by the same firm. The cost of this work under the existing contracts for the North District amounts to £3,276 per annum, and for the South District to £7,395 per annum. The following tabular statement gives the number of complaints, letters, and refusals received in respect of the removal of house refuse, together with the fines levied and recovered by the Council for contraventions of the terms of the Contracts during the last six years. NORTH DISTRICT. Year. Complaints. Letters. Refusals. Fines. 1904 49 52 28 — 1905 53 66 227 W. Mead & Co., Ltd., £20 and £26. 5s. 1906 49 61 51 W. Mead & Co., Ltd., £15, and E. H. Jackson & Co., Ltd., £5 1907 46 54 83 E. h. Jackson & Co., Ltd., £50 1908 26 63 114 — 1909 18 68 135 — SOUTH DISTRICT. Year. Complaints. Letters. Refusals. Fines. 1904 194 184 63 T. Hobbs, £20 1905 72 170 366 — 1906 69 157 556 T. Hobbs, £15, £1. 1s., and £50 1907 1O6 173 471 — 1908 63 159 228 W. Mead & Co., Ltd., £1 and £2 1909 58 191 316 W. Mead & Co., Ltd., £2, £1 and £1 In the North District contract which commenced on the 1st April, 1909 the system of daily kerb collection was extended to the following streets, viz: Chapel Street; Circus Road, from Wellington Road to St. Ann's Terrace on the north side, and from Wellington Road to High Street on the south side; St. John's Wood Terrace from St. Ann's Terrace to Aquila Street on the north side only; High Street, St. John's Wood; and Lisson Grove from Marylebone Road to Church Street. In the South District Contract, which has recently been under consideration in view of the expiration on the 31st March, 1910, it has also been decided to 63 extend the system of kerb collection by including in the Schedule of streets where this method of collection shall be in force, the premises in the following thoroughfares, viz.: Castle Street, East; Duke Street, Manchester Square; James Street, Oxford Street; Newman Street; Orchard Street; and York Place. The work of the Contractors in removing the refuse has been under the constant supervision of the Public Health Committee, who have received at each meeting reports from the Dust Sub-Committee, which under the Chairmanship of Alderman J. Lea-Smith met fortnightly throughout the year to consider the reports of the Dust Inspectors regarding their work and the complaints, letters and refusals received. The policy of the abolition of dust shoots in favour of the more sanitary and convenient moveable metal receptacles has been continued and new metal receptacles to the number of 113 have been provided. During the year the two Inspectors supervising the dust collection paid 4,769 visits, and succeeded in obtaining the abolition of old brick receptacles in 38 cases. In 10 instances Statutory Notices were served regarding defaults in connection with dust removal, and in two of these prosecutions were necessary. VERMINOUS PERSONS BATHS. During 1909 these Baths were used by 11,114 adults (males, 8,563; females, 2,551). The children bathed numbered 4,684, 2,725 being boys and 1.959 girls. The addresses given by the male adults included Salvation Army Shelter 7,306, and Lodging Houses 800. In 334 instances no address was given, and in 123 the applicants stated they had come from the Church Army. The Shaftesbury Institute was given as an address by 200 females, the remainder (2,350) stating that they had slept in the streets on the night previous to making application. The children resorting to the baths from the schools in the Borough have received a considerable amount of attention during the year, and numerous visits have been paid to their homes by the women inspectors. Several communications were received from the London County Council (Education Department) with regard to the possibility of the Council arranging definitely to bath verminous children sent from the schools at a fixed charge per head. The Public Health Committee gave the matter very serious consideration, and eventually decided to inform the London County Council that 90 children could be treated per day at a charge of 6d. per bath or 2s. for a series not exceeding three baths. The final acceptance of this offer has not yet been received. 64 The following tables show the number of persons—adults and children— bathed each month during 1909, and the numbers of persons treated each year since 1898. The Matron of the Shelter and Baths and the various attendants have carried out their duties in a satisfactory manner. CLEANSING OF PERSONS ACT, 1897. Table shewing the number of Adults and School Children using the Baths provided under the above-mentioned Act during the year 1909:— 1909. ADULTS. CHILDREN. Males. Females. Total. Males. Females. Total. January 898 236 1,134 233 164 397 February 689 161 850 355 250 605 March 715 139 854 418 172 590 April 640 184 824 232 171 403 May 517 201 718 170 175 345 June 735 271 1,006 198 248 446 July 701 277 978 164 143 307 August 931 294 1,225 81 60 141 September 760 244 1,004 198 159 357 October 675 205 880 218 128 346 November 621 183 804 274 165 439 December 681 156 837 184 124 308 Totals 8,563 2,551 11,114 2,725 1,959 4,684 Table showing the number of persons using the Baths during the years:— Year. ADULTS. CHILDREN. Males. Females. Total. Males. Females. Total. 1898 3,301 5 3,306 — — — 1899 4,340 — 4,340 — — — 1900 3,431 31 3,462 — — — 1901 4,140 142 4,282 — — — 1902 4,326 202 4,528 — — — 1903 5,515 655 6,170 — — — 1904 7,089 1,376 8,465 — — — 1905 7,981 1,431 9,412 107* 353 460 1906 6,891 1,974 8,865 1,873 3,311 5,184 1907 6,785 1,807 8,592 2,367 3,404 5,771 1908 8,741 2,563 11,304 2,198 3,040 5,244 1909 8,563 2,551 11,114 2,725 1,959 4,684 Totals 71,103 12,737 83,840 9,270 12,073 21,343 *The Children's Baths were opened in June, 1905. 65 THE SHELTER. The number of times the shelter was used and the reasons for such use are shown in the accompanying statement. The longest period of occupation was 34 hours, and the shortest 2 hours. No. of hours Occupied. Reason of Occupation. No. of Persons. April 1st 2 Private 2 adults April 13th and 14th 16 Diphtheria 2 adults 1 child April 23rd and 24th 18 Diphtheria 5 adults 3 children April 28th, 29th and 30th 30 Skin Disease 2 adults 3 children June 2nd and 3rd 14 Diphtheria 1 adult 4 children July 4th and 5th 26 Scarlet Fever 2 adults August 10th and 11th 34 Scarlet Fever 2 adults 4 children August 17th and 18th 26 Scarlet Fever 1 adult 2 children October 1st and 2nd 26 Scarlet Fever 1 adult 1 child November 16th 10 Scarlet Fever 3 Children PUBLIC MORTUARY. The following table gives all the necessary details regarding the use of the Mortuary during the year. The Outdoor Superintendent has paid a large number of visits to the premises as has also the Medical Officer of Health. Report of Mortuary Keeper. FOR THE YEAR 1909. Number of bodies deposited from 1st January to 31st December, 1909. Males. Females. Males. Females. Brought forward. 103 90 January 26 22 July 19 10 February 16 18 August 11 5 March 19 22 September 20 11 April 15 9 October 18 9 May 14 13 November 18 18 June 13 6 December 25 17 103 90 214 160 Grand total 374 Number of bodies received from 1st January to 31st December, 1908,—414. Number of Inquests held from 1st January to 31st December, 1909. Brought forward 72 January 14 July 14 February 15 August 7 March 16 September 17 April 9 October 13 May 12 November 14 June 6 December 14 72 151 Number of Inquests held from 1st January to 31st December, 1908—178. Number of Infectious Cases received from 1st January to 31st December, 1909—4. Total number of bodies received from 1st January, 1889, to 31st December, 1909—9,372, 66 PUBLIC SANITARY CONVENIENCES. These have been regularly inspected during the year by the Outdoor Superintendent and the women inspectors, who have submitted reports periodically to the Public Health Committee. The Conveniences Sub-Committee having visited the underground conveniences at Oxford Circus, Foley Street, Portland Road, and Marylebone Road, gave instructions for the repainting of these at a cost of £63. 5s. The takings were regularly reported to the Public Health Committee during the year. The question of providing a new convenience underground in Marylebone Lane, in place of the existing overground urinal received a great amount of consideration, but owing to difficulties in connection with the vaults belonging to the owners of various properties adjoining, it was found impossible to go on with the scheme. The Public Health Committee, however, determined to close the urinal temporarily, and to substitute for it and the overground structure in Barrett Street, an underground convenience in the latter position. It is hoped that 1910 will see the Marylebone Lane and Barrett Street urinals removed, and an underground convenience constructed in their stead. SANITARY INSPECTION. Summary. The following is an amended list of the special premises in the Borough requiring constant supervision:— Milk premises 264 Cowhouses 5 Slaughterhouses 8 Offensive trades 2 Ice cream premises 80 Bakehouses 78 Restaurant and dining-room kitchens 55 Hotel kitchens 18 Coffee shops, Pastrycooks and Tea Rooms 90 Houses let in lodgings— On old register 75^ Number re-registered 250 250 Workshops, work places and factories 2,277 Total 3,127 67 A statement, with special reference to the list set out above is contained in the following tables:— Number of places Number of inspections, 1909. Number of notices, 1909. Number of prosecutions, 1909. On register at end of 1908. Added in 1909. Removed in 1909. On register at end of 1909. Milk premises 247 28 I I 264 — — — Cowsheds 5 — — 5 — — — Slaughterhouses 8 — — 8 — — — Offensive trade premises 2 — — 2 — — — Ice cream premises 80 — — 80 — — — Houses let in lodgings* 758 — — 758 692 437 4 *These premises are being re-registered, and to the end of 1909. 250 premises on the old register had been completed and duly registered and certilicates issued to the owners and occupiers. MORTUARY. Removed by Inspectors. Number of bodies received 374 — Number of Infectious bodies received 4 4 Disinfection. Number of rooms disinfected 809 Number of Articles disinfected 11,524 Cleansing of Persons Act, 1897. Adults. Children. Males. Females. Males. Females. Total. Number of persons cleansed 8,563 2,550 2,725 1,959 15,797 Bakehouses. Number on register at end of 1909 78 Number above ground 8 Number underground 70 Number of inspections 167 Number of prosecutions Nil Places where Food is prepared for Sale. Number on Register at end of 1909 163 Number of Inspections Number of Notices House to House Inspections. Number of Defects discovered 639 Number of Notices issued Intimations, 264 Statutory Notice 22 286 Number of Prosecutions 1 68 House Refuse. Number of Inspections 4769 Number of Old Brick Receptacles abolished 38 Number of New Metal Reccptacles provided 113 Number of Complaints of Non-removal received 76 Number of Letters received re Removal 259 Number of Refusals of Occupiers to have House Refuse removed 451 Number of Statutory Notices served 10 Number of Prosecutions 2 Water Supply. London County Council (General Powers) Act, 1907. Section No. 78. Number of Premises where water supply has been provided to Upper Storeys 164 Number of Statutory Notices served 49 Number of Prosecutions 3 Overcrowding. Number of Dwelling Rooms overcrowded 240 Number remedied 240 Number of Prosecutions Nil Underground Rooms. Illegal occupation dealt with 163 Number of rooms closed or let with rooms on other floors 163 Number of prosecutions 1 Insanitary Houses. Number closed under Public Health (London) Act, 1891 Nil Number closed under Part II of the Housing of the Working Classes Act Nil Verminous Rooms. London County Council (General Powers) Act, 1904, Section 20 (1). Number of premises cleansed 24 Number of prosecutions 2 Shelter provided under Section 60 (4) of the Public Health (London) Act, 1891. Number of persons accommodated during the year: — 18 adults. 21 children. Revenue Acts. Number of houses for which applications were received 8 Number of tenements comprised therein 61 Number of tenements for which certificates were granted 55 „ „ ,, refuse 2 ,, „ ,, deferred 4 69 STATISTICS. COMPARATIVE STATEMENT. 1909. 4 wks. 30th Jan 4 wks. 27th Feb 5 wks. 3rd Apr 4 wks. 1st May 4 wks. 29th May 5 wks. 3rd July 4 wks. 4 wks. 31st July 28th Aug 5 wks. 4 wks 2nd Oct, 30th Oct 4 wks, 27th Nov 5 wks. 1st Jan. 1910. 13 wks. 3rd Apr 13 wks. 3rd July 13 wks. 2nd Oct. 13 wks. 1st Jan 1910. 52 wks. 1st Jan 1910 Births Corrected 182 217 247 211 183 231 199 157 228 215 214 250 646 621 584 679 2530 Deaths 161 204 286 145 130 142 101 85 137 93 145 220 651 417 323 458 1849 Birth Rate per 1000 of pop. 18.7 22.3 20.3 21.7 18.8 18.2 20.51 16.18 18.81 22.2 22.06 20.62 20.47 19.36 18.51 21.52 19.98 Death ,, ,, 17.6 22.3 25.1 15.9 14.2 12.4 11.08 9.33 12.02 10.3 15.92 19.31 21.93 14.05 10.88 15.43 15.53 Zymotic Diseases number 9 10 22 6 13 8 4 12 6 5 7 11 41 27 22 23 113 Death Rate per 1000 of pop. .98 1.09 1.93 .65 1.42 .70 .43 1.31 .52 .55 .76 .96 1.38 .90 .74 .77 .94 Phthisis and O. T. D. 22 18 23 17 10 19 11 8 16 16 19 21 63 46 35 56 200 Death Rate per 1000 of pop. 2.4 1.9 2.01 1.86 1.09 1.66 1.20 .87 1.40 1.75 2.08 1.84 2.12 1.55 1.17 1.88 1.68 Respiratory Diseases 32 55 72 23 20 9 6 6 10 11 27 53 159 52 22 91 324 Death Rate per 1000 ot pop. 3.5 6.03 6.32 2.52 2.19 .79 .65 .65 .87 1.20 2.96 4.65 5.35 1.75 .74 3.06 2.72 Infantile Mortality 17 25 35 16 22 22 15 14 19 18 29 27 77 60 48 74 259 Death Rate per 1000 Reg. Births 93 115 141 76 123 99 75 89 83 84 135 108 119 98 82 109 102 Infectious Disease. Diphtheria 5 10 13 10 7 9 12 10 8 9 8 8 28 26 30 25 109 Erysipelas 24 11 11 4 6 20 3 12 7 12 11 13 46 30 22 36 134 Scarlet Fever 21 18 25 20 31 61 69 52 71 37 29 24 64 112 192 90 458 Enteric Fever 3 3 4 — — 3 — 2 — 3 — 1 10 3 2 4 22 Puerperal Fever 1 — — 1 1 — — — 3 — — — 1 2 3 — 3 Cerebro Spinal Fever 1 — 2 2 — — 1 — — — — 1 2 2 1 1 6 Phthisis 21 36 54 34 8 36 20 24 34 13 20 34 111 78 78 67 334 Totals 75 78 109 75 53 129 105 100 123 74 68 81 262 253 328 223 1066 Inquests 12 17 21 12 12 15 17 11 19 11 14 22 50 39 47 47 183 70 TABLE I. VITAL STATISTICS OF THE BOROUGH OF ST. MABYLEBONE DURING 1909 AND PREVIOUS TEARS. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District. No. Rate. Under 1 year of Age. At All Ages. No. Rate per 1,000 Births No. Rate. No. Rate 1 2 3 4 5 6 7 8 9 10 11 12 13 1899 135,160 3,106 22.9 530 191.5 2,079 15.3 1,001 339 836 2,576 19.0 1900 134,600 3,125 23.2 589 183.0 2,098 15.6 944 285 887 2,700 20.1 1901 133,301 3,042 22.8 449 147.6 1,742 13.0 941 328 797 2,211 16.6 1902 132,010 2,960 22.4 434 146.6 1,961 14.9 1,118 395 892 2,458 18.6 1903 130,900 2,818 21.5 402 142.6 1,683 12.9 1,070 356 853 2,180 16.6 1904 129,970 2,791 21.5 393 139.9 1,716 13.2 1,062 369 825 2,172 16.7 1905 128,960 2,618 20.3 358 138.5 1,625 12.5 895 400 801 2,026 15.7 1906 127,960 2,648 20.7 322 121.6 1,506 11.8 1,240 334 759 1,931 15.1 1907 127,718 2,583 20.2 264 102.2 1,574 12.3 1,229 433 790 1,931 15.1 1908 126,867 2,559 20.2 267 104.3 1,703 14.3 794 652 794 1,845 15.4 Averages for years 1899 to 1908 130,794 2,825 21.5 400 141.7 1,768 13.5 1,029 389 823 2,203 16.8 1909 126,027 2,534 20.0 259 102.3 1,758 14.7* 824 678 769 1,849 15.4* Total population at all ages 133,301, at Census of 1901. Area of District in acres, 1,427.8 acres. Number of inhabited houses, 13,536 „ Average number of persons per house, 10.6 ,, *The death rates in columns 8 and 13 have been corrected by multiplying the figures by the Registrar-General's factor 1.0652. 71 TABLE II. Vital Statistics of Separate Localities in 1909 and the ten Previous Years. Names of Localities. The Whole Borough. All Souls. St. Mary. Christ Church. St. John. Year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages Deaths under 1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under1 year. Population estimated to middle of each year. Births registered. Deaths at all Ages. Deaths under1 year. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. a. b. c. d. 1899 136,900 3,006 2,576 530 35,485 545 506 102 38,239 873 906 145 31,561 766 608 148 31,615 822 556 136 1900 135,350 3,125 2,700 569 35,082 642 575 114 37,805 868 762 127 31,201 790 659 154 31,262 825 704 174 1901 133,301 3,042 2,211 449 35,388 583 514 92 37,963 854 607 90 39,527 1178 704 202 20,423 427 386 65 1902 132,650 2,960 2,458 434 35,219 570 503 74 37,763 777 721 113 39,342 1182 775 182 20,326 431 459 66 1903 131,700 2,818 2,180 402 34,966 607 479 73 37,493 802 591 114 39,061 1003 746 172 20,180 406 364 43 1904 131,000 2,791 2,172 393 34,781 598 512 79 37,293 740 560 106 38,853 1058 753 168 20,013 395 347 40 1905 129,453 2,618 2,026 358 34,370 527 438 81 36,853 696 530 81 38,394 1043 723 154 19,836 352 335 42 1906* 127,900 2,648 1,931 322 33,974 520 408 64 36,428 627 556 72 37,951 1088 652 141 19,607 413 315 45 1907 127,718 2,583 1,931 264 33,908 537 415 47 36,358 629 510 51 37,881 1029 083 131 19,571 388 323 35 1908 12fi,867 2,559 1,845 267 33,683 460 419 55 36,177 588 506 77 37,628 1107 675 105 19,439 404 245 26 Averages of Years 1 1899 to 1908 131,290 2,815 2,203 398 34,686 559 475 78 37,231 746 625 97 37,140 1,024 698 156 22,233 486 105 67 1909 126,027 2,534 1,849 259 33,460 674 424 59 35,878 502 461 49 37,379 1041 681 122 19,310 317 283 23 *The Rectory and St. Mary's Registration Sub-Districts were amalgamated this year. 72 TABLE III. Cases of Infectious Disease Notified during the Year ending 1st January, 1910. Notifiable Disease. Cases notified in whole District. Total cases notified in each locality. Number of cases removed to Hospital from each locality. Cases isolated at home At all ages. At ages—years. All Souls St. Mary W. Christ Church St. Joan Totals. All Souls St. Mary W. Christ Church St. John Totals Under 1 1 to 5 5 to 15 15 to 25 25 to 65 65 and upwards Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria, including Membranous Croup 109 2 36 50 12 9 ... 29 21 45 14 109 27 21 45 10 103 6 Erysipelas 134 2 7 8 6 96 15 21 41 67 5 134 8 21 13 1 43 91 Scarlet Fever 458 4 127 281 27 19 ... 75 143 181 59 458 74 141 176 52 443 15 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever Relapsing Fever 22 ... ... 7 3 12 ... 11 4 4 3 22 7 3 4 2 16 6 Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 3 ... ... ... ... 3 ... ... ... 3 ... 3 ... ... ... ... ... 3 Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cerebro-Spinal Fever 6 2 3 1 ... ... ... 1 ... 5 ... 6 1 ... ... ... 6 ... Phthisis 334 3 4 24 27 252 24 38 133 152 11 334 11 79 51 3 144 190 Totals 1066 13 177 371 75 391 39 175 342 457 92 1066 128 265 294 68 755 311 The Workhouse is situated in the Sub-district of St. Mary. 73 TABLE IV.—Showing deaths from certain specified diseases during the year ending 1st January, 1910. Registered Births and Deaths. Corrected Births and Deaths. Births. Deaths. Births. Deaths. M. F. M. F. M. F. M. F. 2077. 1964. 837. 921. 1312. 1222. 907 942. 4041 1758. 2534. 1849. No CAUSES OF DEATH. All Ages. Deaths in whole district at subjoined ages. Deaths in localities at all ages. Deaths in Public Institutions. Under 1. 1 to 5. 5 to 15. 15 to 25. 25 to 65. 65 and upwards. All Souls. St. Mary. Christ Church. St. John. 1 Small-pox — — — — — — — — — — — — 2 Measles 33 7 22 3 1 — — 3 5 22 3 5 3 Scarlet Fever 8 — 4 4 — — — 1 o 5 — — 4 Whooping-Cough. 24 7 17 — — — — — 4 14 6 — 5 Diphtheria, Membranous Croup 9 1 5 3 — — — — 2 4 3 1 6 Enteric and Continued Fever — — — — — — — — — — — 3 7 Typhus Fever — — — — — — — — — — — — 8 Diarrhoea, Dysentry 36 32 2 — I 1 — 9 3 21 1 3 13 9 Epidemic or Zymotic Enteritis 3 2 — — — 1 — 1 — 2 — — 10 Enteritis 5 1 1 — — 2 1 1 4 — — 2 11 Asiatic Cholera — — — — — — — — — — — — 12 Erysipelas 2 — — — — 2 — 1 1 — — — 13 Puerperal Fever 4 — — — — 4 — 1 — 3 — 3 11 Other Septic Diseases 13 3 1 — 1 4 4 2 4 6 1 11 15 Epidemic Influenza 43 1 3 1 3 12 23 5 16 13 9 2 16 Intermittent Fever and Malarial Cachexia — — — — — — — — — — — — 17 Tuberculosis of Lungs 170 — 3 5 18 131 13 43 41 66 20 36 18 Tuberculosis of Meninges 9 4 5 — — — — 2 2 3 2 5 19 Other forms of Tuberculosis 21 5 5 2 — 9 — 5 6 6 4 13 20 Alcoholism and Cirrhosis of Liver 30 — — — — 26 4 10 8 8 4 11 21 Cancer 156 — 1 — — 91 64 40 29 61 26 209 22 Premature Birth 47 47 — — — — — 9 8 25 5 39 23 Developmental Diseases 76 66 7 2 — 1 — 18 17 28 13 26 24 Old Age 142 — — — — — 142 37 38 42 25 12 25 Meningitis 11 4 3 1 2 1 2 4 4 1 9 26 Inflammation and Softening of the Brain 4 — — — — 2 2 2 — 1 1 — 27 Organic Diseases of the Heart 70 — — 1 11 43 15 21 20 17 12 31 28 Croup (Spasmodic) 1 — 1 — — — — — — 1 — — 29 Acute Bronchitis 49 16 3 2 — 14 14 2 7 26 14 6 30 Chronic Bronchitis 170 1 — — 1 65 103 36 46 60 28 35 31 Lobar (Croupous) Pneumonia 33 3 5 1 2 18 4 5 11 16 1 13 32 Lobular (Broncho-) Pneumonia 72 19 16 — 2 20 15 13 17 28 14 21 33 Diseases of the Stomach 16 — — 1 1 11 3 5 3 4 4 15 34 Obstructions of the Intestines 16 — — — 1 12 8 4 1 9 2 18 35 Nephritis and Bright's Disease 69 — — — 1 41 27 18 21 24 6 25 36 Tumours and other affections of Female Genital Organs 5 — — — 1 4 — 2 1 — 16 37 Accidents and Diseases of Parturition 7 — 1 — — 6 3 — 3 1 8 38 Deaths by Accident or Negligence 64 13 5 6 4 21 15 15 15 26 8 24 39 Deaths by Suicide 15 — — — — 13 2 3 5 3 4 2 40 Deaths from ill-defined causes — — — — — — — — — — — 1 41 All other causes 416 27 7 9 20 191 162 105 120 128 63 209 Totals 1849 259 117 41 70 746 616 424 461 681 283 824 74 TABLE V.—Infantile Mortality during the Tear 1909. Deaths from stated Causes in Weeks and Months under One Tear of Age. CAUSE OF DEATH. Under 1 Week. 1 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-2 Months. 2-3 Months. 3-4 Months. 4-5 Months. 5-6 Months. | 6-7 Months. 7-8 Months. 8-9 Months. 9-10 Months 10-11 Months. 11-12 Months. Total Deaths under 1 Year. All Souls. St. Mary. Christ Church. St. John. Totals. i. Common Infectious Diseases. 'Smallpox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. 1 .. 1 Measles .. .. .. .. .. .. .. .. .. .. .. 1 .. 3 3 .. 7 .. .. 7 .. 7 Scarlet Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria: (including Membranous Croup) .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. 1 .. 1 Whooping Cough .. .. .. .. .. .. 2 .. .. .. 2 2 1 .. .. .. 7 .. .. 6 1 7 ii. Diarrhœal Diseases. Diarrhœa, all forms .. 1 .. .. 1 4 .. 1 4 .. 1 2 1 2 .. 1 17 4 .. 11 2 17 Enteritis, Muco-enteritis Gastro-enteritis .. .. 3 2 5 .. 2 1 1 .. 1 .. 1 .. .. .. 11 3 3 4 1 11 Gastritis, Gastrointestinal Catarrh 1 1 .. 1 3 2 .. .. .. .. .. .. 1 .. 1 .. 7 3 1 3 .. 7 iii. Wasting Diseases. Premature Birth 35 4 3 1 43 1 1 .. .. .. .. .. 1 .. .. 1 47 11 11 22 3 47 Congenital Defects 16 2 3 2 23 7 7 4 1 2 .. .. 1 .. .. .. 45 15 12 13 5 45 Injury at Birth .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Want of Breast-milk Starvation .. 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 Atrophy, Debility, Marasmus 4 2 1 .. 7 2 1 1 2 2 1 .. 1 1 2 .. 20 4 3 9 4 20 iv. Tuberculous Diseases. 'Tuberculous Meningitis .. .. .. .. .. .. .. 1 .. 1 .. 1 .. .. .. 1 4 1 .. 2 1 4 Tuberculous Peritonitis: Tabes Mesenterica .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Other Tuberculous Diseasesj .. .. .. .. .. 1 .. .. .. .. .. .. 2 .. 1 1 5 .. 1 3 1 5 v. Other Causes. Erypsipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Rickets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. 1 .. .. 1 .. .. .. .. .. .. 1 .. 1 1 .. 4 1 1 1 1 4 Convulsions 1 .. 1 1 3 .. 1 1 .. .. 1 .. .. .. .. .. 6 3 2 1 .. 6 Bronchitis .. .. .. .. .. 3 2 .. .. 4 2 1 2 2 .. 1 17 1 1 9 6 17 Laryngitis .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. 1 .. 1 Pneumonia 1 .. .. .. 1 2 2 .. 3 1 3 .. .. 1 5 4 22 5 5 11 1 22 Suffocation, overlying 2 .. .. .. 2 5 3 .. .. 1 .. 1 1 .. .. .. 13 3 5 5 .. 13 Other Causes 5 1 .. 2 8 5 1 1 4 .. .. 1 .. 1 .. 2 23 5 4 13 1 23 65 13 11 9 98 32 22 10 15 11 12 11 12 11 14 11 259 59 49 123 28 259 Population. Estimated to middle of 1909—126,027. Births in the year, legitimate, 2,414; illegitimate, 120. Deaths in the year of legitimate infants, 226; illegitimate infants, 33. Deaths from all causes at all ages, 1,849.