STPAN 50 BB 8 4 FORTY-THIRD ANNUAL REPORT of the Medical Officer of Health on the VITAL AND SANITARY CONDITION of the Borough of St. Pancras, London. REPORT FOR THE YEAR 1898, by JOHN F.J. SYKES, D.Sc. (Public Health), M.D., etc. Member of Council and Fellow of the Incorporated Society of Medical Officers of Health; Member of Council and Fellow of the Sanitary institute; Member of the Epidemiological Society; Foreign Member of the Société Francaise d' Hygiene; Member of the Deutscher Verein fur offenliche Gesundheitspflege, etc., etc. Medical Officer of Health for St. Pancras, and Lecturer on Public Health, Guy's Hospital. CONTENTS. PAGE Map of St. Pancras, showing the Registration Sub-Districts 6 Health Committee 7 Officers 8 I.—Introduction— Meteorology 9 II.—Vital Statistics— Public Institutions 10 Population 11 Marriages 11 Births 11 Deaths 12 Ages at Death 12 Causes of Death 13 Uncertified Deaths—Inquests 16,17 Coroner's Court—Mortuaries 17 Comparative Mortality of Sub-Districts 17 III.—Infectious Diseases— Notifications—Notification of Septic Diseases—Notifications from Hospitals—Diarrhoea Prevention 18-28 Isolation—Exclusion from School 29 Disinfection—Family Shelter 32 Vaccination—The Vaccination Act, 1898 32-36 IV.—Sanitation— Inspections—Entry—Rights of Entry—Exemptions 36-45 Open Spaces 45, 46 Dwellings—Number of rooms in dwellings—Conversion of Buildings—Unhealthy Dwelling-houses—Insanitary Areas—Conference on the Housing of the Working Classes 47-52 Schools 52 Workshops and Factories—Bakehouses—Laundries 52 Water Supply and Water Service 53 Drainage and Sewerage—New Buildings and DrainageDrainage Regulations—Combined Drainage—Draining and Paving of Stables—Sewer Ventilation 53-56 4 CONTENTS—continued. PAGE Refuse Removal—Removal of Manure 57 Nuisances—Smoke Nuisances—Cleansing of Persons 57-61 Summonses 62-65 V.—Food— Food Premises—Public Slaughterhouses 66-72 Unfit Food—Ice Creams—Bacteriological Examination of Milk 66-71 Adulterated Food 73 VI.—Legislation— Canals Protection (London) Act, 1898—Vaccination Act, 1898 75-77 VII.—Appendix— A.—Statistical Tables— Table No. 1.—Showing the Population, Inhabited Houses, Marriages, Births and Deaths, for the year 1893 and ten years preceding 78 Table No. 2.—Showing the Annual Birth and Death-rates, Death Rates of Children, and proportion of Deaths in Public Institutions to 1000 Deaths for the year 1898 and ten years preceding 79 Table No. 3a.—Showing Deaths registered at all ages and from all causes during the year 1898 80 Table No. 3b.—Showing Summary of Diseases and Ages 83 Table No. 4.—Showing the number of Deaths at all ages in 1898 from certain groups of Diseases, and proportion to 1000 of Population, and to 1000 Deaths from all causes 84 Table No. 5a.—Showing the number of Deaths from the Principal Zymotic Diseases in the previous ten years and in the past year 85 Table No. 5b.—Showing the number of Deaths from the Notifiable Infectious Diseases in the previous ten years and the past year 86 Table No. 6.—Showing the number of Population, Births and Deaths, and ages at Death, in the several SubDistricts of St. Pancras 87 5 CONTENTS.—continued. PAGE Table No. 7 a.—Showing the number of cases of each of the Notifiable Infectious Diseases certified, classified in Sub-Districts 88 Table No. 7b.—Showing the number of cases of each of the Notifiable Infectious Diseases removed to hospital, classified in Sub-Districts 89 Table No. 7c.—Showing the number of deaths from each of the Notifiable Infectious Diseases, classified in Sub-Districts 90 Table No. 8.—Showing the number of deaths from each of certain causes, classified in Sub-Districts 90 Table No. 9a.—Showing the number of deaths from the principal Zymotic and certain other Diseases in the Sub-Districts for the year 92 Table No. 9b.—Showing the proportion of deaths from the principal Zymotic and certain other Diseases to 1000 population 93 Table No. 10a.—Showing the number of deaths from certain Diseases, the number of Deaths at various ages, and the number of births in the Sub-Districts for the year. Births and deaths not referable to any certain SubDistrict being re-distributed proportionately to the population 94 Table No. 10b.—Showing the proportion of deaths from certain Diseases, and the proportion of deaths at various ages, to 1000 of total deaths in the SubDistricts for the year. Also the proportion of deaths under one year, five years, and at all ages, to 1000 births 95 Table No. 11.—Sanitary work accomplished during the year 96 B.—Reference Lists— List I.—Houses of separate and self-contained Dwellings 99 ,, II.—Registered Common Lodging Houses 103 ,, III.—Licensed Cowhouses 104 ,, IV.—Licensed Slaughter-houses 105 ,, V.—Bakehouses 106 ,, VI.—Marine Stores 113 ,, VII.—Market Places 115 St. Pancras, London. HEALTH DEPARTMENT. HEALTH COMMITTEE, 1898. CHAIRMAN: Close, Edward Mason (Ward 3). DEPUTY CHAIRMAN: Dean, John (Ward 8). EX-OFFICIO MEMBERS: Menzies, Hugh James, Chairman of the Vestry. J.P Cox-Sinclair, Edward, Churchwarden. Durant, Frederic, Churchwarden. Robinson, Nathan (Ward 3), Councillor L.C.C. Purchese, Frederick (Ward 6), Councillor L.C.C., Member Met. Asylums Board ELECTED MEMBERS: Ward 3 Austin, Albert. ,, 4 Blount, George. ,, 8 Chubb, John Burland. ,, 2 Dilley, John Thomas. ,, 1 Drake, William Henry. ,, 5 Easter, William Addington. ,, 7 Franks, Norman Walter. ,, 5 Harrison, George. ,, 3 Hawkin, Walter Thomas, Chairman Highways, &c., Committee. ,, 3 Hewett, John William. ,, 6 Horne, George. ,, 1 Long, Dr. Richard Patrick. ,, 5 MacCarthy, Dr. Eugene Florence. ,, 1 Miall-Smith, Hilda Caroline. ,, 8 Mills, Alfred. ,, 1 Orange, Frederick Charles. ,, 7 Pettit, Albert. ,, 6 Phillimore, Lucy. ,, 1 Prag, Joseph. ,, 2 Rogers, Joseph James, Chairman Burial Committee. ,, 7 Shaw, George Bernard. ,, 4 Smith, Dr. Walter, Chairman Lighting Committee. ,, 3 Thornley, Joseph, J.P., M.A.B., Chairman Special Busting Committee. ,, 7 Walters, Rev. Charles Ensor. ,, 4 Wills, John. St. Pancras, London. HEALTH DEPARTMENT. OFFICERS, 1898. MEDICAL OFFICER OF HEALTH: John FREDERICK Joseph Sykes, D.Sc., M.D. PUBLIC ANALYST: Thomas Stevenson, M.D., F.R.C.P. DISTRICT SANITARY INSPECTORS: North Division, Sub-Division 1, 2, „ „ „ 3, 4, 5, East Division, Sub-Division 1, 2, 3, „ „ „ 4, 5, West Division, Sub-Division 1, 2, „ „ „ 3, 4, 5 South Division, Sub-Division 1, 2, 3, „ „ „ 4, 5, George Rackham, Cert. San. Inst. Francis Hartnoll, Cert. San. Inst. Joseph Osborne. Walter George Auger, Cert. San. Inst. William George Kershaw, Cert, San. Inst. Peter Fulton. Charles Winton. Malcolm Grice, Cert. San. Inst. SANITARY INSPECTORS OF WORK-PLACES. Frederick Alfred Barth, Cert. San. Inst. Mabel Mary Vines, Cert. San. Inst. CARETAKER OF MORTUARIES, &c. Samuel Davy. DISINFECTORS: Samuel nicholas Davy, Cert. San. Inst. James Nunn, Assistant and Stoker. Thomas Gibson, Assistant and Driver. ATTENDANT AT FAMILY SHELTER: Mrs. Samuel Davy. CLERICAL STAFF: CHIEF CLERK: William Mallison. First Assistant Clerk Second Assistant Clerk Third Assistant Clerk Junior Clerk Junior Clerk BoY Clerk Harry Riches. George Benjamin Moon. George Stuart. Alfred George Capel. Herbert Edward Read. John Archibald Hall Weeden. Messenger—Downes St. Pancras, London. FORTY-THIRD ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH, BEING THE REPORT FOR THE YEAR 1898. TO THE VESTRY OF ST. PANCRAS. Mr. Chairman, Ladies, and Gentlemen, I—INTRODUCTION. I have the honour to present to you the Forty-third Annual Report upon the vital and sanitary condition of the Borough of St. Pancras. The map that appears as frontispiece shows the Registration Sub-Districts of St. Pancras, and the statistics of population, births, and deaths, relating to the Sub-Districts, refer to the areas shown upon this map. As in previous years, this Report commences with a summary of the principal Meteorological data of the past year, set out below. Meteorology of London, 1898. Periods. First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Year 1898. Barometer. Mean Inches 29.875 29.740 29.903 29.748 29.816 Departure from Average + .100 —.045 + .111 —.004 + .040 Temperature. Mean Degree 41.5 52.4 62.7 48.5 51.3 Departure from Average +1.8 —0.5 +2.5 +4.2 +2.0 Daily Range of Temperature, Mean Degree 10.5 16.8 21.2 10.3 14.7 Departure from Average —1.3 —3.2 + 1.5 —1.4 —1.4 Degree of Humidity. Mean (Saturation—100) 81 75 70 85 78 Departure from Average —3 —1 —7 —4 —4 Rainfall. Amount in inches 3.24 5.32 2.51 7.78 18.85 Departure from Average —1.71 —0.29 —4.77 +0.70 —6 07 10 II.—VITAL STATISTICS. PUBLIC INSTITUTIONS. Birth.—The number of births occurring in Public Institutions during the year 1898 was as follows :— Homes of Hope, Gray's Inn Lane Sub-District 43 Workhouse, Camden Town Sub-District 180 Total 223 Population and Deaths in Public Institutions. Registration Sub-Districts. Number of Inmates. Parochial Institutions. Daily Average No. of Inmates Deaths. Parishioners. NonParish ioners. Total. Regent's Park 28 St. Saviour's Cancer Hospital 13 4 4 St. Luke's House 15 3 30 33 Tottenham Court 359 University College Hospital 184 122 144 266 Home Hospitals 18 – 15 15 Central London Sick Asylum 157 — 178 178 Gray's Inn Lane 126 Royal Free Hospital 114 53 129 182 CentralThroat&EarHospital 12 – 6 6 Somers Town 103 Temperance Hospital 67 77 30 107 Hospital for Women 36 1 12 13 Camden Town 2122 Workhouse 2074 390 7 397 North West London Hospital 48 34 11 45 Kentish Town 479 Infirmary 479 351 7 358 Total in Parochial Institutions 3217 1031 573 1604 In Extra Parochial Institutions 2409 610 – 610 Totals 5626 1641 573 2214 Extra Parochial Institutions.—Of certain Public Institutions situated outside the boundaries of St. Pancras, the daily average numbers of inmates belonging to St. Pancras housed by them, corrected to the end of 1898, are as follows:— St. Anne's Home, Streatham, a branch of St. Pancras Workhouse 476 Lunatic Asylums 917 Imbecile and Idiot Asylums 716 Fever and Small-Pox Asylums 300 Total population 2409 In addition there are— The children at these Insti- Leavesden Schools, near Watford 598 tutions are part of the population of the locality in which they are situated. 11 POPULATION. The population of St. Pancras is regarded as stationary. The figures of the 1896 Census have been taken as a basis, and the 2409 inmates of Extra-parochial Institutions have been added to the Sub-Districts in proportion to the population. The deaths amongst these inmates are included in the Statistics of the Year:— Regent's Park Sub-District 38,192 Tottenham Court ,, 27,023 Gray's Inn Lane ,, 29,991 Somers Town „ 32,815 Camden Town „ 14,910 Kentish Town ,, 100,242 St. Pancras District 243,173 MARRIAGES. The number of marriages celebrated in St. Pancras during the year was 2,344, being 15 less than in the previous year, and 183 more than the annual average of the precious ten years. BIRTHS. The number of births registered during the year was 6,859, being 159 less than in the preceding year, and 217 less than the annual average during the preceding decennium. The 223 births in public institutions having been re-distributed according to population, the number of births and the birth-rate of each of the Sub-Districts, and of the District were as follow:— Sub-Districts. Number of Births. Birth-rate. Regent's Park 971 25.4 Tottenham Court 612 22.6 Gray's Inn Lane 852 28.5 Somers Town 979 29.8 Camden Town 439 29.4 Kentish Town 3006 30.0 St. Pancras 6859 28.2 London 132,432 29.5 12 DEATHS. During the year 1898, the corrected total number of deaths from all causes at all ages was 4658, being 122 more than during the preceding year, and 124 below the annual average of the preceding ten years. Per 1000 of the population the death-rate was 19.1, compared with 18.7 in the previous year, and an annual average of 20.1 in the preceding decennium. The total number of deaths and the death-rates in the Sub-Districts are set out below, 238 deaths from all causes not referable to any particular Sub-Districts being distributed according to population:— Sub-Districts. Number of Deaths. Death-rate. Regent's Park 646 16.9 Tottenham Court 567 21.0 Gray's Inn Lane 618 20.6 Somers Town 747 22.8 Camden Town 263 17.6 Kentish Town 1,817 18.1 St. Pancras 4,658 19.1 London 83,936 18.7 AGES AT DEATH. Under one year of age the number of deaths and the proportion per 1000 births and per 1000 total deaths were as follows:— Sub-Districts. Number of Deaths under 1 Year. Per 1000 Births. Per 1000 Deaths at all Ages. Regent's Park 173 178.2 267.9 Tottenham Court 139 227.2 245.2 Gray's Inn Lane 164 192.6 265.4 Somers Town 180 183.9 241.1 Camden Town 62 141.2 235.7 Kentish Town 451 150.1 248.2 St. Pancras 1,169 170.5 251.1 London 22,140 167.2 263.5 13 Under five years of age the number of deaths and the proportion per 1003 births and per 1000 total deaths were as follows:— Sub-Districts. Number of Deaths under 5 Years. Per 1000 Births. Per 1000 Deaths at all Ages. Regents' Park 229 235.9 354.5 Tottenham Court 208 340.0 366.9 Gray's Inn Lane 226 265.3 365.8 Somers Town 303 309.6 405.7 Camden Town 93 211.9 353.6 Kentish Town 702 233.6 386.4 St. Pancras 1,761 256.8 378.2 London 34,184 258.1 407.1 CAUSES OF DEATH. Notifiable Infectious Diseases. Small-pox Scarlatina or Scarlet Fever Diphtheria and Membranous Croup Typhus Fever Typhoid or Enteric Fever Continued Fever Relapsing Fever Puerperal Fever Cholera Erysipelas Principal Zymotic Diseases. Small-pox Scarlet Fever Diphtheria Typhus Fever Enteric Fever Continued Fever Measles Whooping Cough Diarrhoea Dysentery At the end of the Report, in Table 7c, will be found set out the number of deaths under 5 years of age, and at 5 years upwards from each of the Notifiable Infectious Diseases in the respective Registration Sub-Districts, and the entire District of St. Pancras. In Table 8 in a similar manner the deaths from the non-notifiable "principal zymotic diseases" will be found set out. From these two Tables the mortality of the respective diseases, and of each of the groups, have been obtained, as shown in Tables Nos. 9 A and B, and Tables Nos. 10 A and B, and as compared below. 14 The Notifiable Infectious Diseases.—The number of deaths from this group of diseases in the Sub-Districts, and the proportions per 1000 of population and per 1000 total deaths, were as follows:— Sub-Districts. Number. Per 1000 Population. Per 1000 Total Deaths. Regent's Park 23 0.60 35.6 Tottenham Court 17 0.63 29.9 Gray's Inn Lane 25 0.83 40.5 Somers Town 32 0.97 42.8 Camden Town 6 0.40 22.8 Kentish Town 107 1.07 58.9 St. Pancras 210 0.86 45.1 London 3433 0.76 40.9 The Principal Zymotic Diseases.—The number of deaths from this group of diseases in the Sub-Districts, and the proportions per 1000 of population and per 1000 of total deaths, were as follows:— Sub-Districts. Number. Per 1000 Population. Per 1000 Total Deaths. Regent's Park 75 1.95 116.1 Tottenham Court 62 2.29 109.3 Gray's Inn Lane 74 2.47 119.7 Somers Town 132 4.02 176.7 Camden Town 32 2.15 121.7 Kentish Town 272 2.71 149.7 St. Pancras 647 2.67 138.9 London 12565 2.78 149.7 15 Table 5a shows that measles caused 110 deaths, compared to 89, 1.30, and 217 in the three previous years that whooping cough resulted in 85 deaths, as against 122, 121, and 86; and that diarrhoea and dysentery gave rise to 261 deaths, the numbers in 1897, 1896, and 1895, having been 262, 217, and 218. Phthisis.—This disease, the type of the tubercular group of diseases, was the cause of 484 deaths, compared to 486 in 1897, 468 in 1896, and 4.31 in the year previous to that. The incidence of this disease in the Sub-Districts was as follows:— Sub-Districts. Number. Per 1000 Population. 000 Total Deaths. Regent's Park 62 1.62 96.0 Tottenham Court 83 3.07 146.4 Gray's Inn Lane 73 2.43 118.1 Somers Town 68 2.07 91.1 Camden Town 23 1.54 87.5 Kentish Town 175 1.75 96.4 St. Pancras 484 1.99 103.9 Loudon 7966 1.77 94.9 Bronchitis, Pneumonia, and Pleurisy.—These diseases, as typical of the respiratory group diseases, caused 733 deaths, compared to 820 deaths in 1897, 755 in 1896, and 841 in 1895; the incidence in the Sub-Districts being as follows:— Sub-Districts. Number. Per 1000 Population. Per 1000 Total Deaths. Regent's Park 101. 2.64 156.4 Tottenham Court 96 3.55 169.3 Gray's Inn Lane 98 3.27 158.6 Somers Town 145 4.48 194.2 Camden Town 30 2.01 114.1 Kentish Town 263 2.62 144.7 St. Pancras 733 3.01 157.4 London 13,500 3.00 160.8 16 Influenza.—The Table below gives the number of deaths from this disease, and the ages at death, since the epidemic period commenced. ST. PANCRAS. Deaths from Influenza (including a few doubtful cases) during the years 1889 to 1898, inclusive. Year. 0—1. 1—5. 5—15. 15-25. 25-35. 35—45. 45—55. 55—65. 65—75. 75—85. 85 and upwards. Total Deaths under Five Years. Total Deaths at all Ages. 1889 .. 2 1 .. .. .. .. .. .. .. .. 2 3 1890 4 2 2 2 5 12 7 3 5 4 4 6 50 1891 6 10 2 5 17 25 26 35 24 19 2 16 171 1892 4 10 1 5 8 13 25 29 34 23 1 14 153 1893 5 2 1 4 8 11 12 9 12 4 1 7 69 1894 3 .. 3 4 4 6 8 3 12 4 2 3 49 1895 4 6 3 6 5 11 15 24 26 12 3 10 115 1896 .. 2 .. 1 1 4 3 4 2 2 1 2 20 1897 .. 2 .. 2 3 3 6 6 5 1 1 2 29 1898 .. .. 1 4 1 4 9 17 21 23 2 82 VIOLENT DEATHS. Violence was the cause of '202 deaths during the year ; in the three preceding years the numbers were 184, 162 and 71. UNCERTIFIED DEATHS. There were no uncertified deaths registered in St. Pancras in 1898; in 1897, 1896 and 1895, the numbers were 2, 5 and 3. 17 INQUESTS HELD. In the Coroner's Court—General Cases 467 ,, ,, ,, Poor Law Cases 29 Elsewhere in St. Pancras 0 496 PUBLIC MORTUARIES. Number of bodies deposited in the General Mortuary 505 ,, ,, ,, Infectious ,, 20 525 COMPARATIVE MORTALITY OF THE SUB-DISTRICTS. In comparing the mortality of the six Sub-Districts per 1000 of population Somers Town appears, during the past year, as having the highest general deathrate, followed by Tottenham Court Road, but as the latter Sub-District has also the lowest birth-rate the mortality is relatively more heavy at the lower ages, and the same applies in a lesser degree to Gray's Inn Lane which follows, consequently the order of greatest fatility of infants per 1000 births is Tottenham Court Road, Gray's Inn Lane, and Somers Town. The Mortality from the principal Zymotic Diseases, and the principal Respiratory Diseases, is also highest in Somers Town, and from Phthisis in Tottenham Court Road, whilst Gray's Inn Lane will be found in the tables to follow always as second or third in comparison. Taking the general position of each Sub-District in order of demerit, they would rank— Somers Town, Tottenham Court Road, very closely followed by Gray's Inn Lane, which is followed at some distance by Kentish Town, the record of which is lowered by the high mortality from notifiable infectious diseases. 18 III.-INFECTIOUS DISEASES. NOTIFICATIONS. The annual numbers of cases of Notifiable Infectious Diseases certified since the commencement of notification, are shown in the following Table:— Diseases. 1889 2 mos. 1890 1891 1892 1893 1894 1895 1896 1897 1898 Small-pox – 5 1 31 112 95 14 5 2 2 Scarlet Fever 123 636 621 1279 2465 1255 1053 1067 913 970 Diphtheria 58 437 298 432 732 491 522 458 506 473 Membranous Croup – – – – – 11 16 9 6 13 Typhus Fever 1 1 — — — — — — — — Enteric Fever 34 137 217 119 163 188 144 198 213 217 Fever, Simple & Continued 1 7 4 3 5 2 3 1 7 2 Relapsing Fever — — — — — 1 1 — — — Puerperal Fever 1 9 8 27 24 11 17 19 14 17 Cholera — 2 9 5 5 1 — — 3 4 Erysipelas 70 373 370 426 678 470 408 366 393 324 Totals 288 1606 1528 2322 4184 2525 2178 2123 2057 2022 The number of cases of the Notifiable Infectious Diseases certified during the year 1898, and the Sub-Districts in which they occurred, are shown in the following Table:— Population. Regent's Park, pop. 38,192. Tottenham Court, pop. 27,023. Gray's Inn Lane, pop. 29,991. Somers Town, pop. 32,815. Camden Town, pop. 14,910. Kentish Town, pop. 100,242. Total. Diseases. Small-Pox – – – 2 – – 2 Scarlatina or Scarlet Fever 154 65 95 144 73 439 970 Diphtheria, Membranous Croup 45 39 78 70 27 227 486 Typhus Fever — — — — — — — Typhoid or Enteric Fever 33 20 24 27 10 103 217 Continued Fever – – – – – 2 2 Relapsing Fever – – – – – – – Puerperal Fever 1 2 3 4 1 6 17 Cholera — — — — — 4 4 Erysipelas 33 28 71 33 42 117 324 Totals 266 154 271 280 153 898 2022 The annexed Tables show the seasonal variation in the prevalence and virulence of the diseases from week to week during the past year:— SAINT PANCRAS, LONDON. WEEKLY NUMBER OF CERTIFIED DEATHS FROM "THE DANGEROUS INFECTIOUS DISEASES," 1898. Quarters First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Quarters Months January. February. March. April. May. June. July. August. September. October. November. December. Months. Weeks ending 8 15 22 29 5 12 19 26 5 12 19 26 Apl. 2 9 16 23 30 7 14 21 28 4 11 18 25 July 2 9 16 23 30 6 13 20 27 Sept. 3 10 17 24 Oct. 1 8 15 22 29 5 12 19 26 Dec. 3 10 17 24 31 Week ending. Number of Week 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 43 49 50 51 52 Number of Week Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-pox Scarlet Fever 1 .. .. .. .. 3 2 .. .. .. .. 2 2 1 1 .. .. .. .. .. .. 4 1 .. 1 2 3 1 .. 1 1 2 3 1 .. .. .. 2 .. .. 1 4 1 1 2 1 1 .. 3 .. 1 2 51 Scarlet Fever. Diphtheria 3 2 1 .. 2 2 3 .. 4 1 1 5 5 .. 1 1 4 1 1 2 2 .. .. .. .. 1 .. 2 .. 1 3 .. .. 1 .. 3 .. 1 1 .. 4 3 2 2 6 1 4 6 6 3 5 .. 95 Diphtheria. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 3 Membranous Croup Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus Fever. Enteric Fever 1 .. .. 2 1 1 1 1 1 .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. 2 .. .. .. 1 .. 1 .. 2 .. .. 2 .. .. 2 1 5 1 1 .. 2 4 3 1 3 1 .. .. 42 Enteric Fever. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever. Puerperal Fever .. .. .. .. .. .. 1 .. .. .. .. 1 1 .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 6 Puerperal Fever. Cholora .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 Cholera. Erysipelas .. .. .. .. 1 1 .. .. .. .. 1 .. 1 1 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 10 Erysipelas. *Totals 4 2 1 2 4 7 7 1 5 1 2 8 10 2 5 1 4 1 1 2 3 5 1 0 3 3 4 4 1 2 6 3 5 3 0 5 0 3 3 2 10 8 4 3 10 6 9 7 13 4 6 4 210 Totals. Measles 7 3 9 3 5 3 3 2 6 4 1 2 4 2 5 2 3 5 3 3 3 3 2 .. .. 1 .. 1 1 1 .. 1 1 .. .. 2 1 1 .. .. .. .. .. .. .. .. 2 5 2 5 .. 3 110 Measles. Whooping Cough 3 2 3 1 4 .. 1 .. .. .. 1 1 3 1 1 3 .. 3 2 5 5 .. 2 2 .. 2 .. 4 3 3 1 2 1 .. 1 2 3 2 3 .. 1 2 .. .. .. .. .. .. 3 1 .. 5 85 Who oping Cough. Diarrhœa and Dysentery .. 1 1 1 4 .. .. 1 .. .. 1 .. .. .. .. .. .. .. 1 .. .. 2 .. .. 2 1 5 4 8 6 10 21 24 25 20 13 29 19 15 9 7 5 3 3 4 .. 3 .. 2 3 3 2 261 (Diarrhœ and Dysentery. * The diseases in this table are the dangerous infectious diseases." If the last four be withdrawn, and the four added below be substituted, it becomes a table of the " principal zymotic diseases." SAINT PANCRAS, LONDON. WEEKLY NUMBER OF INFECTIOUS CASES CERTIFIED TO THE MEDICAL OFFICER OF HEALTH DURING THE YEAR 1898. Quarters First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Quarters Months .. January. February. March. April. May. June. July. August. September. October. November. December. Months. Weeks ending 8 15 22 29 5 12 19 26 5 12 19 26 Apl. 2 9 16 23 30 7 14 21 28 4 11 18 25 July 2 9 16 23 30 6 13 20 27 Sept. 3 10 17 24 Oct. 1 8 15 22 29 5 12 19 26 Dec. 3 10 17 24 31 .. Week ending. Number of Week 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 i 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 .. Number of Week Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Small-pox Scarlet Fever 9 13 12 16 9 15 12 13 6 16 13 15 13 18 15 13 13 15 16 9 11 14 9 12 14 11 18 27 23 25 16 12 22 21 18 27 25 14 24 29 36 21 26 34 37 47 28 27 14 24 21 21 970 Scarlet Fever. Diphtheria 11 8 8 14 6 8 12 9 8 7 12 12 7 11 8 7 7 6 6 6 6 9 8 8 5 11 5 7 8 8 8 5 6 6 8 7 9 4 9 7 9 12 13 12 15 17 13 17 20 9 9 10 473 Diphtheria. Membranous Croup .. .. .. 1 .. 3 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. .. 1 1 .. 2 .. .. .. 1 13 MembranousCroup Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus Fever. Enteric Fever 4 5 2 4 1 2 2 1 4 5 .. 2 3 .. 2 2 2 1 2 3 .. 1 .. 3 .. 2 3 2 1 5 6 1 4 4 3 7 4 3 5 6 8 7 12 10 13 6 9 10 15 5 10 5 217 Enteric Fever. Continued Fever .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 Continued Fever. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever. Puerperal Fever .. .. .. .. .. .. 1 1 .. .. .. 2 1 2 .. .. 1 .. .. 1 .. .. .. .. .. .. 1 2 .. .. .. .. .. 1 .. 1 .. .. .. 1 .. .. .. .. .. .. .. 2 .. .. .. .. 17 Puerperal Fever. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 1 .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4 Cholera. Erysipelas 4 7 7 5 3 7 5 2 1 4 6 9 6 4 4 6 3 7 1 8 10 5 4 6 6 5 9 2 6 5 4 4 4 3 5 9 9 4 4 15 12 14 9 7 11 10 10 7 13 7 4 7 324 Erysipelas. Totals 28 33 29 40 19 35 32 26 20 32 31 40 30 35 29 28 26 29 25 22 27 29 21 30 25 29 37 40 38 43 36 23 39 36 34 51 49 25 42 58 66 54 60 63 77 81 60 65 62 45 44 44 2022 Totals. 19 The Case-fatality.—The following Table gives the number of deaths from the Notifiable Infectious Diseases in the Sub-Districts of St. Pancras. Population. Regent's Park, pop. 38,192. Tottenham Court, pop. 27,023. Gray's Inn Lane, pop. 29,991. Somers Town, pop. 32,815. Camden Town, pop. 14,910. Kentish Town, pop. 100,242. Total. Diseases. Small-pox – – – – – – – Scarlatina, or Scarlet Fever 8 4 2 11 – 26 51 Diphtheria Membranous Croup 4 10 14 11 4 55 98 Typhus Fever — — — — — — – Typhoid or Enteric Fever 9 1 6 6 2 18 42 Continued Fever — — — — — — — Relapsing Fever — — — — — – — Puerperal Fever 2 — — 1 — 3 6 Cholera — — — — — 3 3 Erysipelas – 2 3 3 – 2 10 Totals 23 17 25 32 6 107 210 From the preceding Tables the Case-fatality of each of the diseases appears as follows:— Fatality Cases. Deaths. per cent. Small-pox 2 – — Scarlatina 970 51 5.3 Diphtheria 486 98 20.2 Membranous Croup Typhus Fever — — — Typhoid or Enteric Fever 217 42 19.4 Continued Fever 2 — — Relapsing Fever — — — Puerperal Fever 17 6 35.3 Cholera 4 3 75.0 Erysipelas 324 10 8.1 Total 2022 210 10.4 20 Diagnostic Tests.—The number of specimens of secretion and blood submitted during the year in doubtful cases of Diphtheria, and Typhoid or Enteric Fever, and the results of Examination were as follows:— Bacillus found. Doubtful. Bacillus not found. Total. Diphtheria (Secretion) 32 0 46 78 Reaction obtained. Doubtful. Reaction not obtained. Total. Typhoid (Blood) 24 3 24 51 NOTIFICATION OF THE SEPTIC DISEASES. The Septic class of diseases, popularly known as blood-poisoning, includes erysipelas, pyaemia and septicaemia, and puerperal fever. Whereas erysipelas attacks the surfaces, the skin and mucous membranes, and the tissues lying beneath, pyœmia and septicaemia affect the deeper parts and internal organs, the puerperal form commencing in the female pelvis. Pyœmia and Septicœmia.—The difference between pyœmia and septicaemia is one of degree, the former referring to a subacute or chronic condition of local septic foci, and the latter to an acute general distribution throughout the body. These diseases are not included amongst the dangerous infectious diseases notifiable to the Medical Officer of Health. Puerperal Fever.—The opinion of the Royal College of Physicians was sought by the London County Council, in the Autumn of the year, submitting the question: "Whether the diseases peritonitis and metritis, occurring in connection with parturition, as well as puerperal pyaemia, puerperal septicaemia, and puerperal saprœmia, all of which the Registrar-General includes under 'puerperal fever' were covered by that term for the purposes of notification." A Committee of the Royal College of Physicians, to whom the question was referred, gave the following reply "That this Committee is of opinion that, with a view to the limitation of dangerous infectious diseases, the London County Council would be acting rightly in adopting the view that the expression 'puerperal fever,' as contained in section 55 of the Public Health (London) Act, 1891, should be taken to include septicaemia, pyaemia, septic peritonitis, septic metritis, and other acute septic inflammations in the pelvis occurring as the direct result of child-birth." The Obstetrical Society of London gave a similar reply to a similar question submitted to them by the Metropolitan Branch of the Incorporated Society of Medical Officers of Health. 21 Puerperal fever is included amongst the notifiable infectious diseases. Upon the receipt of a medical certificate notifying a case, (1) enquiry is made at the house as to the circumstances and any possible source of infection; (2) sanitary inspection of the premises is made and the drains tested; (3) the question of the degree of isolation requisite is left to the medical attendant and nurse; and (4) upon recovery or removal disinfection of the bedding and clothing by steam is enforced. The disinfection and cleansing of the bedding and clothing is of extreme importance after puerperal fever, on account of the persistence of the infection and the facility with which it is communicable from bedding and clothing to those lying in. So also is the sanitary inspection and drain testing for the abatement of any nuisances, especially effluvia, as these are well known to be highly dangerous to the puerperal condition. Erysipelas.—Buchan and Mitchell many years ago pointed out the close correspondence in London between the seasonal mortality curve of erysipelas and that of puerperal fever. It is generally a more readily communicable disease even than puerperal fever, and overcrowding, want of ventilation, effluvia, dirt, and other insanitary conditions, are well known predisposing causes. The disease is due to the entrance into the system of septic micro-organisms. Usually vesicles or blebs, and bullœ or blisters are formed which dry up into crusts and fall. The skin also may desquamate and be shed in flakes or brainy powder. Sometimes suppuration and sloughing take place, and matter and tissues are discharged. The septic organisms are also found in abscesses and unhealthy wounds. These crusts, flakes, and discharges spread the disease directly, or else indirectly by infected bedding and clothing. The same preventive measures required in puerperal fever should therefore be applied to erysipelas, for the protection of life and health. In a letter to the Chelsea Vestry in 1892, the Local Government Board urged that it is an infectious disease, communicable to others, and of especial danger to lying-in women, vaccinated children, in surgical operations, and to wounds generally. Sporadic cases are always a source of danger, and in large institutions the disease occasionally assumes formidable epidemic proportions. Therefore very forcible reasons exist for the notification of the disease, and for taking preventative measures. Unfortunately the term erysipelas may be strained to embrace anything from the least inflammatory blush of the surface to the most intense inflammation and destruction of the deeper cellular tissue. If enquiry, sanitary inspection, and disinfection are applied to this disease, the probability is that the more trivial cases, giving rise to little or no risk of infection, will be reduced in number, and that notification will be more confined to those cases requiring disinfection and sanitary inspection of the premises, that is to say, those cases producing marked constitutional effects. With a view to ascertaining what course is taken by other authorities, a circular letter was sent to the Medical Officers of Health of the Metropolis, and from the replies the following has been compiled:— London Sanitary Authorities.—ERYSIPELAS. Course taken upon Notification. Marylebone—No action. Lambeth—Inquiry, isolation, disinfection, and sanitary inspection, like other Notifiable Infectious Diseases. 22 Hanover Square —Inquiry made, isolation best possible, disinfection if requested or desirable. Islington—Inquiry made as in other infectious diseases, isolation advised, infected room fumigated only. Shoreditch—No action, except upon special request of medical attendant. Paddington—Inquiry made, isolation not enforced, no disinfection done. Bethnai. Green—No inquiry, isolation, or disinfection done, but sanitary examination made. Newington—Inquiry made, and sanitary examination, isolation not prescribed, disinfection done only when requested. Camberwelt.—Inquiry made, no isolation insisted on, disinfect in exceptional cases. St. James, Westminster—Inquiry made, and sanitary inspection, no isolation enforced, only disinfect when requested. St. M. & St. J., Westminster—Inquiry made, isolation for serious cases, disinfection carried out. (Head teachers of Schools attended notified.) Clerkenwell—Inquiry made, no isolation, no disinfection. Chelsea—No action, except in special cases. Kensington—Inquiry made, and sanitary investigation, isolation left to medical attendant, disinfection in fatal and severe cases. Fulham—Inquiry made, isolation kept, disinfection done. Hammersmith—Inquiry made, isolation advised, disinfection done by authority. St. Luke—Inquiry made, and sanitary investigation, isolation not enforced, but patient excluded from food businesses, no disinfection. St. George-the-Martyr—Inquiry made, isolation required, disinfection in special cases. Bermondsey—Inquiry made, and sanitary inspection, no isolation or disinfection. St. George-in-the-East—Inquiry made, isolation under general instructions, no disinfection. St. Martin-in-the-Fields—No action, except to disinfection when asked. Mile End—No action. Woolwich—No action. Rotherhithe—Inquiry made, isolation recommended, occasionally enforced, disinfection always done after the disease. Hampstead—Inquiry made, no isolation, occasionally disinfect. Battersea—Inquiry, isolation, and disinfection, as in other notifiable infectious diseases. Hackney—Inquiry made, isolation required, and disinfection done. Stoke Newington—Inquiry made, and house inspected, isolation advised, but not enforced, disinfection done only upon application. Plumstead—Inquiry, isolation, and disinfection, but the two latter not strictly enforced as in scarlet fever. Whitechapel—All notified diseases treated alike as to routine, excepling the isolation of erysipelas. Greenwich & Deptford—Inquiry made, isolation required, and disinfection in fatal cases. Wandsworth—Inquiry and sanitary examination, but no further action. St. Giles—No action. Holborn—Inquiry made, no isolation, disinfection done if patient is removed to hospital, if not, instructions left to disinfect. Strand—Inquiry made, isolation only under special circumstances, disinfection sometimes if there has been discharges. 23 Lime house—Inquiry made, isolation required in serious cases, disinfection done after the disease. Poplar—Inquiry, isolation, and disinfection, as in other infectious diseases. St. Saviour—No action except when requested. Lee—Inquiry made, no isolation, no disinfection. Leyvisham—Inquiry made and premises inspected, isolation insisted upon, disinfectants supplied, and premises disinfected when requested. St. Olave—Inquiry made, no isolation, disinfection done if patient removed to hospital, in other cases, instructions left to disinfect. St. Pancras—No action, this inquiry being made with a view to taking action. NOTIFICATIONS FROM HOSPITALS. On the 27th May a circular letter was received from the Clerk to the Metropolitan Asylums Board enclosing, by direction of the Board, a copy of a report which the Board received from their Statistical Committee with regard to the notification of cases of infection arising amongst patients in hospitals. Metropolitan Asylums Board. Report of the Statistical Committee. 11th May, 1898. (1) On the 18th December last, the Board referred to us (with power to reply) two letters from the Vestry of the Parish of Hammersmith, with which were enclosed copies of certain correspondence between the Medical Officer of Health for Hammersmith and the Clerk to the Board, with regard to the notification of cases of infectious disease arising in a general hospital in that parish. Questions as to the correct course to pursue in cases of this kind, the Clerk to the Board informs us, have been frequently raised since notification of cases of infectious disease became compulsory in London. The subject is of considerable importance, and for that reason we have thought it desirable not to reply ourselves to the Hammersmith Vestry's letter, but to report formally to the Board, who, if they approve our views, may communicate them not only to the Vestry, but to all the Metropolitan Medical Officers of Health. By section 55 (1) (b) of the Public Health (London) Act, 1891, it is provided that "every medical practitioner attending on or called in to visit the patient shall forthwith, on becoming aware that the patient is suffering from an infectious disease to which this section applies, send to the Medical Officer of Health for the district a certificate, stating the full name and the age and sex of the patient, the full postal address of the house, and the infectious disease from which, in tha opinion of such medical practitioner, the patient is suffering, and stating also whether the case occurs in the private practice of such practitioner, or in his practice as a medical officer of any public body or institution, and where the certificate refers to the inmate of a hospital it shall specify the place from which and the date at which the inmate was brought to the hospital, and shall be sent to the Medical Officer of the district in which the said place is situate." 24 The words which we have printed in italics in the foregoing quotation are those which give rise to controversy; but it appears to us that the view of the Clerk to the Board is right, and that the words admit of no other interpretation than that, wherever a place is situated whence a patient is admitted to a hospital, the notification certificate must be sent to the medical officer of that place, and not to the medical officer of the district in which the hospital stands. In cases where a patient developes an infectious disease within a short time after admission to hospital, it may reasonably be assumed that the disease was contracted before admission, and obviously, in the interest of public health, the notification of the case should be made, as the Act directs, to the Medical Officer of Health of the district in which the patient had been previously resident. But the utility of such a notification is not so apparent in cases where the patient has been resident in the hospital for a considerable time. In either case undoubtedly it is desirable that the Medical Officer of Health of the district within which the hospital is situate should be made aware of any outbreak of infectious disease therein. But in our view this is met, as suggested by the Clerk to the Board in his letter to the Medical Officer of Hammersmith, by section 55 (1) (a) which provides that where an inmate of any house within the district of a sanitary authority is suffering from an infectious disease " the head of the family to which such inmate (in this section referred to as the patient), belongs, and in his default the nearest relatives of the patient present in the house or being in attendance on the patient, and in default of such relatives, every person in charge of or in attendance on the patient, and in default of any such person, the master of the house, shall, as soon as he becomes aware that the patient is suffering from an infectious disease to which this section applies, send notice thereof to the Medical Officer of Health of the district. The Managers will observe that the Act requires two things—a certificate from a medical practitioner, and notice from the head of the family or other persons, as mentioned in the sub-section last quoted. In the case of an inmate of a hospital who came to that hospital from a distance the ordinary notification certificate must, it seems to us, be sent to the medical officer of that district; but it seems to us that the local medical officer is entitled, not to a notification certificate, but to "notice" under sub-section (a) above quoted on the occurrence of any case of infectious disease; and although there is no provision for paying for this " notice," it seems to us that it would answer all the purposes which the Vestry of Hammersmith and, we understand, others have in view. We accordingly recommend— (a) That a copy of this report be forwarded to the Hammersmith Vestry in reply to their letters of the 3rd and 7th December last. (b) That a copy of the report be forwarded to each Metropolitan Medical Officer of Health for his information. (Signed) W. M. Acworth, Chairman. Norfolk House, Norfolk Street, Strand, W.C., 23rd May, 1898. Health Department, Vestry Hall, Pancras Road, N.W., June 4th, 1898. T. Duncombe Mann, Esq., Clerk to the Metropolitan Asylums Board, Norfolk House, Norfolk Street, Strand, W.C. Sir, Notification from Hospitals. I beg to acknowledge the receipt of your letter, dated the 26th ult., enclosing a report of the Statistical Committee of the Metropolitan Asylums Board, dated 11th May, 1898, in reference to Medical Certificates of notifiable Infectious Diseases referring to inmates of Hospitals, which are provided for by Section 55 (1) (b.) of the Public Health (London) Act, 1891, the last paragraph of which runs "and where the Certificate refers to the inmate of a hospital it shall specify the place from which and the date at which the inmate was brought to the hospital, and shall be sent to the Medical Officer of Health of the District in which the said place is situated." The Committee support your interpretation that the Certificate is to be sent to the Medical Officer of Health of the place from whence the patient is removed to the hospital, and not to the Medical Officer of Health of the District in which the hospital stands, and add that the obvious reason for this provision is that where a patient developes infectious disease within a short time after admission to hospital it may be assumed that the disease was contracted before admission, but that the utility of such notification is not apparent in the case of patients resident for a considerable time in the hospital. The Committee further add that it is desirable that the Medical Officer of Health of the District should be made aware of any outbreak of infectious disease in a hospital within it, and that this may be met by obtaining the lay notification under Section 55 (1) (a.) instead of the medical certificate. Allow me with all deference to ask, with regard to the last expression of opinion of the Committee, whether a hospital is included in the term "house," also whether the notice is intended to be a medical notice, or medically authenticated, although possibly regarded as a lay notice. I would point out that unless the notice is either a Medical Certificate or is 26 medically authenticated, the Medical Officer of Health who receives it can only regard it as ordinary information calling attention to the case, information which would require to be corroborated by a certificate from the medical practitioner in charge of or in attendance on the patient. Personally I have not experienced any difficulty in this matter, the following being the procedure which I adopt in this District. As soon as a Medical Certificate of dangerous infectious disease is received it is copied on to an inquiry 4form and delivered to the Sanitary Inspector of the SubDivision, who makes inquiry at the house, and fills up the form. The cases certified from hospitals outside this district are treated in the same manner, and if upon inquiry it is ascertained that the infectious disease has certainly or probably been contracted after the inmate has left the house from which he was removed to the hospital, the Medical Officer of Health of the District is infofrmed that the disease was probably contracted in the hospital and not in this District. Whether the Medical Officers of Health of other districts treat me in a similar manner I have no means of knowing, except in one or two special instances. I am, Sir, Your obedient servant, (Signed) John F. J. Sykes. Metropolitan Asylums Board, Norfolk House, Norfolk Street, Strand, 10th June, 1898. Dr. John F. J. Sykes, Medical Officer of Health, St. Pancras. Sir, In reply to your letter of the 4th inst., I have to state that, in my opinion, a hospital is undoubtedly included in the term "house" as used in Section .55 of the Public Health (London) Act, 1891. The "notice" required by Section 5.5 (1) (a) is not, in my opinion, required to be medically authenticated; it is merely information required, and it has the effect of bringing to the notice of the Medical Officer of Health any case which is, or is believed to be, an infectious disease ; but when such a notice comes from a hospital it seems to me you might generally assume it represents a medical and not merely a lay opinion. With regard to the last paragraph of your letter, I hope you will understand that the question of the notification of hospital cases was not raised by me, but by certain Medical Officers of Health who have experienced the difficulties which I am glad to hear you have been spared. I am, Sir, Your obedient Servant, T. Duncombe Mann, Clerk to the Board. 27 Diarrhœa Prevention.—On the 20th July, 1898, when Diarrhoea was prevalent, the Vestry approved of the following report, and notice for circulation. Diarrhoea is not a notifiable disease, and therefore the cases are only known after a fatal issue, as certified by the death returns. The course has been adopted of sending half-a-dozen copies of the notice to the person in charge of the deceased patient for distribution to other mothers and nurses in the house. Health Department, 13th July, 1898 To the Health Committee of the Vestry of St. Pancras. Mr. Chairman, Ladies, and Gentlemen, Diarrhoea. In accordance with the instructions of your Committee, I beg to submit the appended draft notice in reference to Diarrhoea, based upon the following facts. In London about 3,000 persons die on an average, in the course of a year, from Diarrhoea; in some years the number rises to over 4,000. in others it falls to under 1,800. Of every 100 of these persons about 72 are infants under 1 year of age, about 13 are children of 1 year, and about 3 are children of ages two, three, and four years, and the remainder are of persons of various ages scattered through life to seventy-five and upwards. Diarrhoea is therefore especially fatal to infants under one year, and over seven-tenths of these infantile deaths occur during the third quarter of the year, and especially when the temperature, measured by a thermometer buried four feet underground, rises above 56° Fahrenheit, this form of the disease being known as "Summer Diarrhoea." This form of Diarrhoea owes its origin to errors in food and feeding, and therefore the means of prevention is by observing proper rules of diet, as Diarrhoea once started in an infant in hot weather is difficult to arrest and rapidly runs to a fatal termination. I have, &c., John F. J. Sykes, Medical Officer of Health. NOTICE AS TO DIARRHŒA. For distribution to Mothers, and others having charge of Infants and Children. Saint Pancras, London.—Health Department. DIARRHŒA. Diarrhœa is rapidly fatal to infants and young children. The younger an infant, the more liable it is to be attacked by diarrhoea, and the more liable to die 28 when attacked, especially in summer time. As such a large number of children die from diarrhoea, parents are advised in all cases to immediately seek medical advice. The principal cause of diarrhoea is improper food and feeding. Until eight or nine months old an infant has neither the teeth to chew nor the juices to digest starchy foods, such as bread, potatoes, biscuits, rusks, oatmeal, arrowroot, wheat flour, and such foods cannot be made digestible by mixing them with milk and water, they should therefore not be given to young infants. Milk is the proper food for a young infant, and mother's milk the most natural, but, if absent, the best substitute is fresh cow's milk. Boil half-pint of cow's milk, remove the scum, add a teaspoonful of sugar, and dilute with half-pint of water, or a little more during the first three and a little less water during the last three months of the nine. As stale food is dangerous to an infant, small quantities should be frequently made as required, in the proportions mentioned. Use a feeder, the old-fashioned boat, or the long slipper-shaped bottle, with an opening at each end, one closed by a cork, the other by a teat. This form of feeder is the most easily cleansed, and an uncleansed feeder is dangerous to an infant. Cleanse the feeder before refilling by boiling it in water, thoroughly and completely cleansing the cork, and the teat, inside and out. It is convenient to have two feeders in use, the one not in use being placed after boiling in clean cold water, with the teat and the cork loose, until required. Feed every two hours during the first three months, every three hours during the second three, and every four hours during the third three. Feed also once or twice in the night for the first few months, then gradually discontinue night feeding. The quantity of milk and water should not exceed one pint a day during the first week, gradually increased to three pints at the ninth month. At the eighth or ninth month a commencement may be made with sops and porridges, at about the twelfth month pounded meat and soft foods may be given, and by the eighteenth month light solid foods. flaw hard fruits and vegetables should not be given to children under two years of age, and at no age should unripe or over-ripe fruit and vegetables be allowed to be eaten, particularly in summer time. July, 1898. John F. J. Sykes, Medical Officer of Health. SAINT PANCRAS, LONDON. WEEKLY NUMBER OF CASES OF THE DANGEROUS INFECTIOUS DISEASES REMOVED BY AMBULANCE DURING THE YEAR 1898. Quarters First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Total. Quarters Months January. February. March. April. May. June. July. August. September. October. November. December. Months. Weeks ending 8 15 22 29 5 12 19 26 5 12 19 26 Apl. 2 9 16 23 30 7 14 21 28 4 11 18 25 July 2 9 16 23 30 6 13 20 27 Sept. 3 10 17 24 Oct. 1 8 15 22 29 0 12 19 26 Dec. 3 10 17 24 31 . . Week ending. Number of Week 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 . . Number of Week Small-pox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Small-pox Scarlet Fever 9 13 9 14 8 13 9 13 5 11 11 11 10 11 13 11 8 14 16 6 11 12 8 12 12 11 17 21 18 18 12 13 21 19 15 25 22 10 22 22 30 17 22 29 23 38 26 22 11 19 17 17 814 Scarlet Fever. Diphtheria 10 7 5 11 2 6 8 8 5 7 10 7 4 9 6 6 6 6 5 6 5 8 8 5 4 8 4 4 4 4 4 6 6 7 6 9 3 7 4 8 9 11 8 14 14 11 13 18 7 6 8 372 Diphtheria. Membranous Croup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . 2 . . . . . . . . 3 MembranousCroup Typhus Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Typhus Fever. Enteric Fever 4 3 2 2 . . . . 2 1 . . 4 . . 1 3 . . 2 1 2 1 1 3 . . 1 . . 3 . . 1 3 1 1 5 5 1 2 2 1 3 3 1 2 2 5 5 10 4 10 4 7 6 12 2 8 3 145 Enteric Fever. Continued Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Continued Fever Relapsing Fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Relapsing Fever. Puerperal Fever . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . 1 . . . . . . 1 . . . . . . . . . . . . . . . . . . . . . . . . 5 Puerperal Fever. Cholera . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Cholera. Erysipelas . . 3 1 . . . . . . . . . . 1 . . . . 1 2 . . . . 1 1 1 1 . . 1 2 . . 1 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . 2 1 1 . . 1 1 1 . . . . . . . . 27 Erysipelas. Totals 23 26 17 27 10 19 19 22 11 22 21 24 19 20 21 19 17 22 23 16 17 23 16 21 17 20 24 27 24 27 23 17 31 27 23 35 34 14 31 32 43 33 44 42 52 58 45 44 41 28 31 28 1370 Totals. 29 ISOLATION. The cases of Notifiable Infectious Diseases removed to hospital, and the SubDistricts whence they were removed, are recorded in the following table: Diseases. Regent's Park. Tottenham Court. Gray's Inn lane. Somers Town. Camden Town. Kentish Town. Totals. Small-pox — — — 2 — — 2 Scarlatina and Scarlet Fever 135 51 76 130 63 359 814 Diphtheria 38 32 59 62 20 164 375 Membranous Croup Typhus Fever — — — — — — — Typhoid or Enteric Fever 18 12 17 20 9 69 145 Continued Fever — — — — — 1 1 Relapsing Fever — — — — — — — Puerperal Fever — 2 1 2 — — 5 Cholera — — — — — 1 1 Erysipelas 3 5 3 6 6 4 27 Totals 194 102 156 222 98 598 1370 The number of cases of Notifiable Infectious Diseases removed to hospital is each week of the year, were as stated in the attached table. INFECTIOUS DISEASES AND EXCLUSION FROM SCHOOLS. The code of regulations for day schools issued by the Lords of the Committee of the Privy Council on Education, and known briefly as the Day School Code of the Education Department, contains two important articles in reference to infectious diseases, which are numbered respectively 88 and 101* (starred). Article 88.—The managers must at once comply with any notice of the Sanitary Authority of the district in which the school is situated, or any two members thereof acting on the advice of the Medical Officer of Health, requiring them for a specified time, with a view to preventing the spread of disease, or any danger to health likely to arise from the condition of the school, either to close the school or to exclude any scholars from attendance, but after complying they may appeal to the Department if they consider the notice to be unreasonable. Article 101*—Where the Department are satisfied that by reason of a notice of the Sanitary Authority under Article 88, or in any provision of an Act of Parliament requiring the exclusion of certain children, or by reason of the exclusion under medical advice of children from infected houses, the average attendance has been seriously diminished, and that consequently a loss of annual grant would—but for this Article—be incurred, the Department have power to make a special grant, not exceeding the amount of such loss, in addition to the ordinary grant. 30 These Articles enable a Sanitary Authority to deal with a school endangered by infectious disease, eitlier in detail or as a whole, that is to say, either to exclude a particular scholar, or a particular group of scholars from a particular class, or a particular class or classes from a particular department, or else by closure to exclude the infants, girls, or boys department from the school buildings, or by total exclusion to close the entire school. The process of exclusion is set in motion either («) under the Public Health (London) Act, 1891, section 55, by the certificate of the medical practitioner attending the patient, and report of the inspector as to the schools attended by the children in the infected house, or (b) by the notification of the teacher under Article 148 (ii) of the Code of Regulations and Instructions for the guidance of managers, correspondents, and teachers, issued by the School Board for London, and generally known as the School Board Code. Article 148 (ii).—Any child showing symptoms of an infectious disease or any child coming from a house where an infectious disease exists, must be sent home at once, and the Superintendent of Visitors must be immediately informed of the case, in order that enquiries may at once be made with a view to proper steps being taken to prevent the children living in the same house or tenement from attending school. The Medical Officer of Health for the district must also at the same time be informed of the child's exclusion, and furnished with the name and address of the child and the reason for its exclusion on a form with which the teachers will be supplied by the head office. These infectious diseases include the dangerous infectious diseases, and also certain other infectious diseases. The dangerous infectious diseases are those set out by name in Sub-section 8 of Section 55 (the Notification Section) of the Public Health (London) Act, 1891, namely, smallpox, chickenpox, diphtheria, membranous croup, erysipelas, scarlatina or scarlet fever, and typhus, typhoid, enteric, continued, relapsing and puerperal fever. With reference to the septic diseases, erysipelas and puerperal fever, the School Board Code, while requiring the exclusion of children actually suffering from erysipelas, does not require the exclusion of health}' children attending school from houses in which erysipelas exists, nor from houses in which there is puerperal fever, and as children do not suffer from the last mentioned disease, for school purposes, it is practically disregarded altogether. The infectious diseases not set out in the Public Health (London) Act, 1891, Section 55, but notifiable to the Medical Officer of Health by Head-Teachers under the School Board Code, are chickenpox (exclusion 2 weeks), measles (exclusion 4 weeks), whooping cough (exclusion as long as the cough continues), mumps (exclusion 4 weeks), and ringworm (exclusion until cured). "Children coming from houses where chickenpox, measles, and whooping cough exist, but who are not themselves suffering from these diseases, must be excluded from school for fourteen days." To these infectious diseases might with advantage be added ophthalmia, which is well known to spread in schools, and sufferers from which should be excluded. As a precautionary measure also those suffering from certain dangerous 31 symptoms should be excluded, especially children suffering from sore-throat; and also, when measles and whooping cough are prevalent, children suffering from catarrhs, colds, and coughs should be excluded; and if not already detained by the malady, children suffering from diarrhoea in the heat of the summer should be sent home. With the guidance of the foregoing principles the exclusion of particular scholars, or of a particular group of scholars, is sufficiently indicated. It is not so easy to decide when it is justifiable to close an entire school, or a department of a school. It may be definitely said that a school divided into departments, carried on in separate and distinct premises, should, if possible, be closed by departments in preference to the closure of the whole school, but the difficulty is to decide when to close a department, that is to say, to answer the following questions: (1) What number of the classes must be infected to justify the closure of a department, and (2) what number of scholars must be excluded for inspection to justify the closure of a class ? In answer to the first question, the scholars of a department, although in different classes, may come into contact at many points on the school premises, and if every class in the department have on the roll a few scholars excluded or infected by a disease which is so prevalent as to necessitate the closure of one or more classes in the department, it is reasonable to assume that generally the best precautionary measure may be the closure of the department. But we are still thrown back upon the second question, the decision as to when it is justifiable to exclude all the scholars from a particular class or from particular classes occupying one class room. By the individual exclusion of scholars that may themselves be infected, or that may come from an infected house, a class or a classroom may be so depleted as to practically close itself; it is obvious that action should not be delayed till such a condition or any approximation to this state has established itself, or to await the exclusion of one-half of the children, or perhaps even of one-third. Of course, all questions of closure, that is, of entire exclusion, are largely dependent upon the prevalence of the disease in the neighbourhood. It would not be justifiable to close a class or a department when the disease is not prevalent in cpidemic form, but is accidentally or negligently spread by the presence of a scholar suffering from the disease in an unrecognised or modified form, since upon the discovery and exclusion of the sufferer, and those infected and suspected, the chances are that its course will be arrested. On account of the prevalence of measles in the neighbourhood and in the schools, it was found necessary in June to close the Infants' Department of the Home and Colonial Practising Schools in Gray's Inn Road, and also the Infants' Department of the National Schools in Camden Street. The prevalence of diphtheria amongst the scholars of the Board School, Haverstock Hill, also necessitated the closure of that school just before Christmas, for a period of a month. 32 DISINFECTION. The following is a record of the disinfection carried out during the year:— Number of rooms fumigated 1349 Number of rooms stripped and cleansed 1239 Destroyed. Articles. Disinfected. 50 Beds 2044 15 Mattresses 1133 31 Palliasses 1352 5 Bolsters 1803 5 Pillows 4098 3 Sheets 18 -... Blankets 4154 1 Counterpanes 1049 556 Wearing Apparel 16,662 9 Rugs and Mats 758 34 Cushions 552 23 Carpets 759 2 Covers 450 2 Curtains 430 153 Sundries 490 889 35,751 Family Shelter.—The following Table gives for the year the dates of admission, the number of families, of males, females, and children, the place from whence they came, and the disease after which disinfection was required, and for which the Shelter was sought: — Date. 1898. Males. Females. Children under 10. Duelling Place. District. Disease. Length of Stay. Jan. 3rd 1 — 2 Howland Street S. Scarlet Fever 1 „ 5th 1 2 3 Pancras Square E. ,, ,, 1 „ 15th 2 1 2 ,, ,, E. ,, ,, 1 Feb. 18th — 1 1 Dalby Street N. Diphtheria 1 Apr. 13 th — 2 3 Osnaburgh Street W. Scarlet Fever 1 „ 28th — 1 2 ,, ,, ,, ,, ,, 1 July 25 th — 2 2 Whitfield Street S. Diphtheria I Sept. 24th — 2 6 Loxham Street ,, ,, ,, 1 VACCINATION. The usual Tables, kindly supplied by the Vaccination Officers—Messrs. Richards and Webb—are set out in the two following pages:— 33 RETURNS FOR THE SIX MONTHS, JULY TO DECEMBER, 1897. Registration Sub-Districts Number of Births. "Successfully" Vaccinated. "Insusceptible." Had Smallpox. Dead, Unvaccinated. Postponement by Medical Certificate. Removed. 1. Kentish Town 1422 1039 7 — 120 109 147 2. Regent's Park 508 373 1 — 37 58 39 3. Camden Town 316 212 — — 31 11 62 4. Somers Town 506 342 — — 40 66 58 5. Tottenham Court 322 228 1 — 27 38 28 6. Gray's Inn Lane 455 311 3 — 33 48 60 Totals 3529 2505 12 — 288 330 394 34 RETURNS FOR THE SIX MONTHS, JANUARY TO JUNE, 1898. Registration SubDistricts. Number of Births. "Successfully" Vaccinated. "Insusceptible." Had Smallpox. Dead, Unvaccinated. Conscientious Objectors. Postponement by Medical Certificate. Removed. Un- vaccinated 1. Kentish Town 1473 863 5 — 87 7 134 128 249 2. Regent's Park 471 234 — — 49 9 84 91 3. Camden Town 318 180 4 — 27 4 11 68 24 4. Somers Town 505 238 1 — 45 16 3 125 77 5. Tottenham Court 303 152 — — 30 12 3 60 46 6. Gray's Inn Lane 421 181 1 — 38 18 4 112 67 Totals 3491 1848 11 — 276 66 159 577 554 35 The Vaccination Act, 1898.—The principal sections of this Act arc set out in Part VI., under the head of Legislation. The points are briefly, that the period for infant vaccination is extended from three to six months, that Public Stations are abolished, and Public Vaccinators are to visit and vaccinate children in their own homes, that the infants of certificated conscientious objectors are exempted, that the penalties and punishments are mitigated, and that the Local Government Board may make Pules and Regulations as to Public Vaccinators. They have accordingly ordered that Public Vaccinators shall use only glycerinated calf lymph or such other lymph as the Local Government Board may issue. The most pressing question, however, and one not touched either by the new Act, or by the new General Order, is that of the standard of vaccination. Standard of Vaccination.—In the Amended Regulations of the Local Government Board General Order, dated 18th October, 1895, Third Schedule, Instructions to Vaccinators under Contract (that is, Public Vaccinators), the standard of vaccination is set out in Instructions 7 and 8. "(7) In all ordinary cases of primary vaccination the Public Vaccinator must aim. at producing four separate good-sized vesicles, not less than half an inch from one another. The total area of vesiculation resulting from the vaccination should not be less than half a square inch." "(8) * * * * In cases of successful primary vaccination the Public Vaccinator must record the number of separate scarified areas, punctures, or groups of punctures made, and the number of separate normal vaccine vesicles or groups of vesicles which have been produced. In case of re-vaccination he must register as "successful" only those cases in which either vesicles, normal or modified, or papules surrounded by areolce have resulted." Unfortunately these Instructions do not apply to oilier than Public Vaccinators, and Private Vaccinators have only to certify that a child has been ''successfully vaccinated." A District Medical Officer has elicited from the Local Government Board the meaning of the words "successfully vaccinated," in a letter dated from Whitehall, 12th November, 1898, and published in the British Medical Journal 19th November, 1898, to the following effect:—"The Board are of opinion that the performance of vaccination in such a way as to only produce one or two vaccine vesicles is much to be deprecated, and that such vaccination affords less protection against smallpox than when done in accordance with the instructions issued to Public Vaccinators. It appears to the Board, however, that for the purposes of their regulations a person who has on him the distinct mark of one vaccine vesicle must be deemed to have been successfully vaccinated." It is, therefore, clear that the minimum results of distinct vaccination, affording little or no protection, rank as successful vaccination as the maximum results, affording the maximum protection of immunity. A certificate of successful vaccination is justified by the appearance of the smallest vesicle, and tender-hearted mothers who can afford it secure this result, and yet satisfy their consciences by avoiding the Public Vaccinator and making the practice of the Private practitioner depend upon the present production of the least discomfort to the child. 36 The remedy for this is that the description of successful vaccination as set out in Clause 7 of the Instructions to Vaccinators under the Third Schedule of the General Order of October 18th, 1898, made under the Vaccination Acts, be inserted in, and form part of, the Medical Certificate of successful vaccination, Form E, Fifth Schedule of the General Order; and also that the Medical Certificate of successful vaccination be amended by the addition, after the words "has been successfully vaccinated by me," of the words "that is to say, the results have been (here insert number of) separate good sized vesicles or groups of vesicles, and a total area of vesiculation of not less than . . . (here insert area)," or words to the like effect. The parent or guardian should be required to notify the fact of vaccination, and the medical expert should be required to certify the kind and result of such vaccination, that is, the precedent of the Infectious Diseases (Notification) Act 1889, should be followed, and one standard of "efficient vaccination" should apply to rich and poor alike. Strangely enough the strongly anti-vaccination Board of Guardians of King. Norton Union take the same view, but with a different object. They say that vaccination is embittered by class distinctions, and that "the first step to the removal of this bitterness of feeling must be the placing of all classes on a footing of strictly equal treatment in regard to vaccination."This of course referring to the fact that the minimum amount of vaccination is not rejected as insufficient by the Local Government Board, that persons who can afford to pay can bring such pressure to bear as to whittle the amount down to the very minimum, whereas those who cannot afford to pay must be subjected to the regulation amount, both being regarded by the Local Government Board as successful vaccination. In other words, there are two standards, a private and a public standard, and both are justified by the Board. Morally, socially, medically, the position is at present a false one, and for the public benefit the sooner it is altered the better. IV.—SANITATION. Inspections.—The following were the number of inspections and re-inspections made by the Sanitary Inspectors during the year: — Parliamentary Sub-Divisions. Inspections. . Re-inspections after Notice. Totals. Inspector Osborne E. 1, 2, 8 - 2437 1859 4296 ,, Fulton W. 3, 4, 5 - 3292 2447 5739 ,, Winton S. 1, O 8 . 2910 1321 4231 „ Hartnoll N. 3, 4, 5 - 1244 249 3735 ,, Newlyn N. 3, 4, 5 - 183 184 867 „ Grice S. 4, 5 - 2036 2140 4176 ,, Auger E. 4, 5 - 1562 2335 8897 ,, Kershaw W. 1, 2 - 1513 2606 4119 ,, Rackham N. 1, 2 - 1330 2691 4021 ,, Barth - 1254 1884 3138 ,, Vines - 1959 306 2265 Totals - - - 19,720 20,264 89,984 Mr. Bush, who resigned at the end of 1897, was succeeded by Mr. Rackham in January, 1898; and Mr. Hartnoll, who resigned in November, 1898, was succeeded by Mr. Newlyn in the same month. 37 ENTRY. A very important decision was given in the Queen's Bench Divisional Court, on January 18th, 1899, before Lord Justices Lawrance and Channell, in the case of Mabel Mary Vines (St. Pancras Yestry) v. the North London Collegiate and Camden School for Girls, which makes clear what before was very obscure, namely, the power of entry of a sanitary officer under the Public Health (London) Act, 1891. On the 17th February, 1897, the Vestry of St. Pancras approved of the desirability of the Woman Sanitary Inspector inspecting Infants' and Girls' Schools (especially those conducted privately) from time to time. The View Sub-Committee of the Health Committee had found sanitary defects in the large majority of the public elementary schools visited by them, and in January there was a considerable amount of infectious disease about, and Miss Yines, the Woman Sanitary Inspector, in accordance with the Vestry's approval and the duty of the Authority under Section 1 of the Public Health (London) Act, 1891, applied for admission into the North London School, for the purpose of ascertaining whether any nuisance existed, or whether there was any infraction of the bye-laws. This admission was refused. An application was made under the Act (Sec. 115, Sub-s. 3) to a Stipendiary Magistrate (Mr. Plowden), to issue a warrant for entry, the Act stating that "if a Justice is satisfied, by information on oath, that there is reasonable ground for such entry, and that there has been a failure or refusal to admit to such premises, and that reasonable notice of the intention to apply to a Justice for a warrant has been given, the Justice may, by warrant under his hand, authorise the Sanitary Authority, or their Officers, or other person, as the case may require, to enter the premises." The Inspector, before the Magistrate, did not state that a nuisance was suspected, but demanded the warrant as a right, replying:—on the wording of Section 1, which provides that it shall be the duty of every Sanitary Authority to cause to be made from time to time inspection of their district, with a view to ascertain what nuisances exist calling for abatement: on Section 2 the " nuisance clause " ; on Section 40 giving power to Sanitary Authorities to enter and examine drains and sanitary fittings; and on Section 10 stating the right of the Sanitary Authority to enter premises to examine nuisances. The Magistrate refused the application on the ground that in point of law there was no evidence before him of reasonable ground for such entry within the meaning of Section 115, Sub-section 3 ; he, however, stated a case, the result of which is that the magisterial decision has been upheld and the appeal dismissed with costs. The following are the material portions of the Judgment:— Mr. Justice Lawrance: "I think the Magistrate arrived at a perfectly proper conclusion in this case. The application was made under Sections 10 and 40—either one or the other of them, or both—to enter into this particular house; under one' section for the purpose of examining as to the existence of a nuisance requiring to be dealt with summarily, and under Section 40, which says that 'the Sanitary Authority may examine any of the following works, that is to say, any water-closet, earth-closet, privy, ashpit, cesspool,' and so forth. Now, the application was made by the Appellant in this case, who 08 was the Sanitary Inspector for the Parish of St. Pancras; and she gave notice to the lady who was the head of the school, that she desired to inspect, and was refused admission to the school for the purpose of inspecting. Then it became necessary for her to have recourse to Section 115, and to go before a Magistrate; and going before a Magistrate, it was her duty to satisfy him, by Information on oath, that there was reasonable ground for such entry ; that is to say, the entry which she desired to make. The object was, I suppose, to see whether there was, under Section 10, a nuisance liable to be dealt with summarily under the Act, or to see whether all the taps and drains, and so forth were in good order under Section 40, whichever it was she was bound to supply to the Justice, or to show to him, that there was reasonable ground for her application for such entry, and that was to be on Information on oath. I have read the Information. It is quite true that I thought it stopped at the end of the first page, because I thought that the notice was a notice which had been given afterwards, and was merely a copy of the notice ; but on looking through it, and going to the end of the first notice, I find there is another notice given. It seems to me that there is absolutely no ground whatever, whether reasonable or not, stated by her, upon which she could ask the Magistrate for leave to enter. No ground is stated by her. She says again "I wanted to enter, and I then and there applied" (this is to Mrs. Sophie Bryant, the Head Mistress of the School) "for permission to enter the school premises for the purpose of examining as to the existence of any nuisance therein." Now that throws us back to the question: Is that a reasonable ground? The reasonable ground must be a ground with some reason for it. "Why do you want to go in ?" the Magistrate has a right to ask; and the answer to that is, as far as it is given on this Information. "I have no more right than that which was given to me by the Statute, and it is enough for me to swear that I wish to go in, because the Statute gives me power to go in." That in my judgment is not a reasonable ground, or such a reasonable ground as was contemplated by section 115, sub-section 3, namely, a reasonable ground which she is to give to the Magistrate to satisfy him before he makes the Order which is asked for. Under these circumstances, I think the Magistrate was perfectly justified in his conclusion, which was the only proper conclusion ho could come to, that there was no evidence upon which he could act. No evidence of any reasonable ground was afforded to him, and therefore he did the only thing which in my judgment he ought to have done, namely, refused the right to enter. Mr. Justice Channell: I am of the same opinion. I think the case entirely turns on the construction of section 115, sub-section 3 of this Act of Parliament; and for the purposes of my Judgment, I assume that a right of entry did in fact exist, both under section 10 and under section 40, I assume that it existed. Therefore a right is given, and the entry is in fact refused by the people at the school. Then we come to see what provision is made by the Legislature as to enforcing that right which they have given, and the provision is that "where a Sanitary Authority have, by virtue of any enactment, a right to enter"—it only applies where there is the right in fact—" and entry is refused, then the following provisions shall apply, if a 39 Justice is satisfied by Information on oath that there is reasonable ground for such entry." Now it is not, if he is satisfied that the right exists, because it starts with the assumption that the right exists, but then it says that he must be satisfied that there is reasonable ground for the entry; that is to say, he must be satisfied that there is reasonable ground for exercising that right which ex hypothesi exists, because otherwise the section would not apply at all —he must be satisfied that there is reasonable ground for exercising that right in respect of the premises in question. It follows from that that the mere statement that the right does exist cannot be of itself a ground for saying "I want to exercise it in this particular case." You must say something; and this lady, for some reason, did not say anything at all. She says "Very well, in every case where the right exists, without giving any reason for saying why I want to go into these particular premises, the Magistrate is bound to give me the right to enter into these particular premises." I venture to think the Legislature has said clearly: No. They have interposed a stipulation that the Magistrate is to be satisfied that there is a reasonable ground for exercising the right in the particular case. Something must be said. In this particular case they said nothing; and consequently, as Mr. Macmorran has said, if that is so, you can go to a Magistrate, and go into every house within the district. Possibly if she had said there were special circumstances existing with reference to the school, such as the various things which have been suggested, that might have been enough; but she has not said anything at all except that the right does in fact exist. It is quite clear that the existence of the right cannot be a reasonable ground for exercising the right, when it follows a section which begins by assuming that the right does exist. It seems to me, therefore, quite clear that the Magistrate was right in the decision in this case, and that the appeal must be dismissed. Rights of Entry. The powers of entry of sanitary authorities or their officers may be classed as;— (a) Entry on premises in general— (1) For general purposes. (2) For special purposes. (b) Entry on particular premises for various purposes— (1) Dwelling premises. (2) Premises other than dwelling premises. (c) Entry on certain premises for a special purpose. Premises in general will include ordinary dwelling-houses and also particular premises. Particular premises will include certain dwelling premises, as tenement dwelling-houses, or houses let in lodgings to members of more than one family, common lodging-houses, canal boats used as dwellings, and movable dwellings, such as tents, caravans, and sheds; also certain premises not used as dwellings—as schools, factories, workshops, laundries, and bakehouses; and also slaughter-houses, cowsheds, dairies, and milk-shops, and offensive trade premises. 40 A. (1.)—Entry on premises in general for general purposes.—This power is contained in Section 10 of the Public Health (London) Act, 1891, by which the sanitary authority have the right to enter from time to time any premises for the purpose of examining as to the existence thereon of any nuisance liable to be dealt with summarily, and by Section 115 (3) the power of entry may be put in force, (a) if there is reasonable ground for such entry, or (b) if there is reasonable cause to believe that there is some contravention of the Act, or of a bye-law under the Act. The general power of entry, therefore, resolves itself into deciding what is reasonable ground or oause. "Reasonable ground" for entry upon premises would appear in the meaning of the Act to include :— (1) A written complaint, whether signed or anonymous. (2) A verbal complaint, which should be transferred into writing as soon as received by a clerk, inspector or other officer, and, together with the name and address of the complainant, the date and officer's signature, should be deposited with and filed by the sanitary authority in the same manner as a written complaint. (3) Without written or verbal complaint some reasonable cause to believe that there is some nuisance or some contravention of the Act, or of a bye-law under the Act. This should be formulated by the officer requiring entry, and be recorded as a written complaint—as required by Section 105 (3)—which should be treated in a similar manner to the two fore-mentioned for the protection of the officer, and as evidence in case entry be refused. It would therefore appear that, assuming the above very necessary precautions have been taken, the power of entry upon premises in general is acquired by a written complaint and for the special purposes provided in the two sections which follow. A. (2.)—Entry upon premizes in general for special purposes.—These powers are contained in the following sections of the Public Health (London) Act, 1891. By Section 40 the sanitary authority may examine any water supply or drainage upon any premises at all reasonable times, after twenty-four hours' notice, or without notice in case of emergency, or with the consent of the occupier. By Section 60 (3) the sanitary authority may enter by day (6 a.m. to 9 p.m.) on any premises to ascertain whether the master has complied with a notice to cleanse and disinfect, and, if not, to carry out the cleansing and disinfection. It may be asked how can house to house inspection be carried on under these conditions, and the answer is by the goodwill and consent of the occupiers, for it is by this method of inspection that houses let in tenement dwellings and requiring to be registered are discovered, and if entry to such a house be refused it can be registered and a compulsory power of entry be thus acquired. 41 B.—Entry upon Particular Premises.—These, as already stated, may t>9 conveniently divided into (a) particular dwelling premises, and (b) premises other than dwelling premises. (1.) Entry upon Particular Dwelling Premises.—These premises include registered tenement houses, registered common lodging-houses, registered canal boats, and movable dwellings. Registered Tenement Houses.—Entry is provided for by the Public Health (London) Act, 1891, Section 94, empowering sanitary authorities to mako bye-laws as to houses let in lodgings or occupied by members of more than one family, and sub-sections (1) (b) and (c) for the registration and inspection of such houses, and a bye-law made under the latter sub-section empowering entry at all reasonable times to inspect houses so registered. Common Lodging-houses.—In London these premises, instead of being provided for in the Public Health (London) Act, 1891, are controlled by the Common Lodging-Houses Act, 1851, Section 12, by which it is provided that the keeper of a common lodging-house, or the person in charge, shall at all times give free access to any Officer of the Local Authority, the Local Authority at that time being the Metropolitan Police, now being the London County Council. Outside London these premises are supervised by Urban Distriot Authorities. Canal Boats used as Dwellings.—It is provided by the Canal Boats Act, 1897, Section 5, that a person duly authorised by a sanitary authority, may enter a canal boat by day (six a.m. to nine p.m.) if he has reasonable cause to suppose that there is a contravention of the Act, or that there is on board a person suffering from an infectious disorder. Movable Dwellings.—The Public Health (London) Act, 1891, provides by Section 95 (3) that a person duly authorised by a sanitary authority may enter by day (six a.m. to 9 p.m.) a tent, van, shed, or similar structure used for human habitation, if he has reasonable cause to suppose that it is in such a state as to be a nuisance, or is overcrowded, or is in contravention of any bye-laws made as to such structures, or harbours any person suffering from a dangerous infeotious disease. (2) Entry upon premises other than dwelling premises.—These premises include schools, workshops, with which are laundries and bakehouses, factories, slaughterhouses, cowsheds, dairies, food premises generally, and offensive trades premises. Schools.—The powers of entry upon school premises appear to be upon complaint, or to examine water-supply or drainage, or to disinfect. The powers of sanitary authorities as to schools are altogether inadequate to meet the case, and should be more extensive than the powers upon any other class of premises, even than those relating to factories and workshops. Broadly speaking, schools may be divided into (1) Board Schools, (2) other schools under the Education Department, and (3) schools not under the Education Department. 42 Without hesitation, it may be said that there is no more important work in the future welfare of the nation than the supervision of the sanitary construction and hygienic arrangements of those schools in which such matters are either neglected or performed only in a perfunctory manner. Workshops.—By the Factory and Workshops Act, 1891, Section 3 (2) " For the purpose of these duties with respect to workshops (not being workshops to which the Public Health (London) Act, 1891, applies), a sanitary authority and their officers, shall, without prejudice to their other powers, have all such powers of entry, inspection, taking legal proceedings or otherwise, as an inspector under the principal Act." The powers of an inspector of factories and workshops under the principal Act, viz, the Factory and Workshops Act, 1878, are contained in Section 68, and are as follows:— Factory and Workshop Act, 1878, Sec. 68. An inspector under this Act shall, for the purpose of the execution of this Act, have power to do all or any of the following things, namely: — (1) To enter, inspect, and examine at all reasonable times by day and night a factory and a workshop and every part thereof when he has reasonable cause to believe that any person is employed therein, and to enter by day any place which he has reasonable cause to believe to be a factory or workshop; and (2) To take with him in either case a constable into a factory (or workshop) in which he has reasonable cause to apprehend any serious obstruction in the execution of his duty; and (3) To require the production of the registers, certificates, notices, and documents kept in pursuance of this Act, and to inspect, examine, and copy the same; and (4) To make such examination and inquiry as may be necessary to ascertain whether the enactments for the time being in force relating to the public health and the enactments of this Act are complied with, so far as respects the factory or workshop and the persons employed therein ; and (5) To enter any school in which he has reasonable cause to believe that children employed in a factory or workshop are for the time being educated; and (6) To examine either alone or in the presence of any other person, as he thinks fit, with rcspect to matters under this Act, every person whom he finds in a factory or workshop, or such a school as aforesaid, or whom he has reasonable cause to believe to be or to have been within the preceding two months employed in a factory or workshop, and to require such person to be so examined and to sign a declaration of the truth of the matters respecting which he is so examined; and (7) To exercise such other powers as may be necessary for carrying this Act into effect. 43 The occupier of every factory and workshop, his agents and servants, shall furnish the means required by an inspector as necessary for an entry, inspection, examination, inquiry, or the exercise of his powers under this Act in relation to such factory and workshop. Every person who wilfully delays an inspector in the exercise of any power under this section, or who fails to comply with a requisition of an inspector in pursuance of this section, or to produce any certificate or document which he is required by or in pursuance of this Act to produce, or who conceals or prevents a child, young person, or woman from appearing before or being examined by an inspector, or attempts so to conceal or prevent a child, young person, or woman, shall be deemed to obstruct an inspector in the execution of his duties under this Act, provided always, that no one shall be required under this section to answer any question or to give any evidence tending to criminate himself. Where an inspector is obstructed in the execution of his duties under this Act, the person obstructing him shall be liable to a fine not exceeding five pounds ; and where an inspector is so obstructed in a factory or workshop, the occupier of that factory or workshop shall be liable to a fine not exceeding five, or where the offence is committed at night, twenty pounds, and where an inspector is so obstructed in a factory or workshop within the meaning of section sixteen of the Act, the occupier shall be liable to a fine not exceeding one, or where the offence is committed at night, five pounds. Factory and Workshop Act, 1895, Sec. 51. An inspector, if so authorised in writing under the hand of the Secretary of State, may, although he is not a counsel or solicitor, or law agent, prosecute, conduct, or defend, before a Court of summary jurisdiction or justice, any information, complaint, or other proceeding arising under the Factory Acts, or in the discharge of his duty as such inspector. It will be observed that London is expressly excluded from Section 3 (2) of the Factory and Workshop Act, 1891, and that London Sanitary Authorities and their officers have not the powers of entry, inspection, etc., that sanitary authorities and their officers in the Provinces possess in reference to workshops, no similar section to the above having been inserted into the Public Health (London) Act, 1891. So that in London the powers of entry are restricted to those of premises in general, namely, upon complaint, or to examine water supply and drainage, or to disinfect. Therefore, what is wanted is an addition to the Public Health (London) Act, 1891, of a section on the lines of Section 3 (2) of the Factory and Workshops Act, 1891, so as to give to London Sanitary Authorities and their officers proper powers oE entry into workshops, including laundries and bakehouses. Laundries.—These are not separately mentioned in the Public Health (London) Act, 1891. Bakehouses.—Entry to these premises is obtained under Section 26 (2) of the Public Health (London) Act, 1891, which applies the provisions of that Act with respect to the admission of a sanitary authority and its officers into any 44 premises for any purpose in relation to nuisances to the purposes of Section 26 (I), and these are the carrying out of Sections 34, 35 and 81 of the Factory and Workshops Act, 1878, and Sections 15 and 16 of the Factory and Workshops Amendment Act, 1883 (which relate to cleanliness, ventilation, and other sanitary conditions). Factories.—The power of entry is under the conditions for premises in general, namely, upon complaint, or to examine water supply and drainage, or to disinfect. Slaughter-houses.—By the Public Health (London) Act, 1891, Sec. 20 (7), the sanitary authority have a right to enter any slaughter-house or knacker's yard at any hour by day (6 a.m. to 9 p.m.), or when the business is in progress or usually carried on, for the purpose of examining whether there is any contravention therein of this Act, or of any bye-law made thereunder. Dairies, Cowsheds and Milkshops.—The general powers of entry before mentioned are applicable to these premises, and also under the Public Health (London) Act, 1891, Sec. 71 (1), if a dairy is spreading dangerous infectious disease the medical officer of health, armed with the order of a Justice, may inspect the dairy. Under Section 28 of the Public Health (London) Act, 1891, the Local Government Board may make a general order for the inspection of cattle in dairies and other purposes, and for authorizing the London County Council to make byelaws for this and other purposes. The Local Government Board made the general order under the Contagious Diseases (Animals) Act, 1886 (19 and 50 Vict., Ch. 32, Sec. 9), and the London County Council made the bye-laws, of which that relating to entry runs "every Inspector appointed under this Act is hereby authorised to inspect all cattle upon the premises of all persons registered under the Act." So that officers of the council only are entitled to entry for the purpose of inspecting cattle in London, outside London the smallest sanitary authority may exercise the power. C.—Entry on Certain Premises for a Special Purpose. Food.—By the Public Health (London) Act, 1891, Sec. 47 (I), any medical officer of health or sanitary inspector may at all reasonable times enter any premises to inspect and examine any animal or article intended for the food of man. (Reasonable times may be interpreted by "6 a m. to 9 p.m." and "when the business is in progress or usually carried on.") Smoke and effluvia.—By the Public Health (London) Act, 1891, Sec. 23, the provisions of this Act in relation to nuisances also apply to the admission of the sanitary authority into any premises for the purpose of enforcing the abatement of smoke or noxious or offensive effluvia in buildings used for the purpose of trade or manufacture. Offensive trades.—Under the Public Health (London) Act, 1891, Sec. 19 (4), the London County Council may make bye-laws for regulating the conduct of offensive trades, in addition to the structure of the premises, and provide for entry under the bye-laws. This is another matter that London Sanitary Authorities might be trusted to control as well as an Urban District Council, or a County Borough. 45 EXEMPTIONS. Government Buildings are exempt, from the control of Sanitary Authorities. The Crown Estate Acts, 5th Geo. IV., cap. 100 (Regent's Park Act), 11 & 12 Vict., cap. 112 (Commissioners of Sewers Act), and 14 & 15 Vict., cap. 95 (II.M. Commissioners of Works Acts) exempt the houses on the Crown Estate round Regent's Park. Various public and private Acts exempt the Railway Companies, either generally or particularly. OPEN SPACES. Public Open Spaces.—The parks, gardens, and other open spaces secured against building operations in and adjoining St. Pancras, together with their situation, approximate area, and the authority under which they are maintained, are enumerated, in the following table:— Sub-Districts. Density of Persons per acre, Census 1891. Garden or Opon Space. Area. Maintaining Authority. A. R. p. Kentish Town 59 Parliament Fields & Hampstead Heath 507 1 0 London County Council ,, Waterlow Park 29 0 0 ,, ,, ,, High gate Cemetery 38 0 0 Cemetery Company ,, Pond Square, &c., Highgate 0 3 28 St. Pancras Vestry ,, Lismore Circus 0 2 26 ,, ,, ,, College Garden .. 0 0 17 ,, ,, Regent's Park 87 { Primrose Hill and 400 0 0 H.M. Government Regent's Park St. Martin's Gardens Camden Town 90 1 3 0 St. Pancras Vestry ,, • • St. Pancras Gardens 5 1 0 ,, ,, Somers Town 181 St. James Gardens 2 2 31 ,, ,, Tottenham Court 183 Whitfield Gardens 0 2 0 London County Council Gray's Inn Lane 178 St. George's Gardens 2 2 0 St. Pancras Vestry ,, St. Andrew's Gardens 1 1 0 ,, ,, Mr. Wm. Nisbet Blair, M.I.C.E., the Engineer, has compiled the table quoted below, from which it will be seen that of 2672 acres, the total area of St. Pancras, 688 acres are unbuilt upon, and that more than one fourth of St. Pancras is public or semi-public open space and railways. 46 PARISH OF ST. PANCRAS. Land in the occupation of the Railway Companies (exclusive of railways in tunnel). Acres. Midland Railway Depots and Stations 117 Gt. Northern „ „ „ 69 L & N. W. 63 Open Railways (not included in the Depots and Stations 47 296 Public Parks and Public Open Spaces. Waterlow Park 29 Parliament Hill (within St. Pancras) 194 College Gardens .20 Lismore Circus .66 Primrose Hill (within St. Pancras) 15 Regent's Park (within St. Pancras) 75 St. Andrew's Gardens 1.25 St. George's „ St. Jame's „ 2.50 2.66 St. Martin's „ 1.75 St. Pancras „ (exclusive of Infirmary and Coroner's Court) 5.25 Highgate Cemetery (new) 20.25 ,, ,, (old) 17.50 Pond Square .80 Whitfield Gardens .50 366 Gardens and Squares. Rochester Square 1.08 Camden Square 2.07 Goldington Crescent .50 Mornington Crescent 2.84 Oakley Square 1.75 Harrington Square 1 Ampthill Square 1 Argyle Square .80 Clarence Gardens .70 Munster Square .46 Euston Square 2.20 Endsleigh Gardens 2.40 Gordon Square 2.30 Tavistock Square 2.30 Burton Crescent 1.45 Regent Square .70 Mecklenburgh Square 2.50 Fitzroy Square .75 26 688 Total area of Parish 2672 acres. 47 DWELLINGS. House-to-house Inspections.—The number of streets, or parts of streets, inspected from house to house during the year, was 11; consisting of 84 houses, all occupied, containing 623 rooms, 619 occupied, and 4 unoccupied; let to 273 families, consisting of 681 adults, and 391 children under 10 years of age. Upon these houses 50 notices were served. Houses occupied in separate dwellings.—These consist of houses (1) so constructed, or (2) adapted as to be occupied in dwellings that may be (A) selfcontained, or (B) not self-contained. (A.) Houses occupied in separate and self-contained dwellings.—A list of houses let in separate and self-contained dwellings is appended to this Report. Selfcontained implies a structural severance of one dwelling from another in addition to the structural severance of one room from another. Self-contained dwellings may be (a) completely self-contained, or (b) partly self-contained, the latter embracing these where the w.c., or the w.c. and washhouse, is not situated within the structurally severed dwelling, but altheugh situated elsewhere in the house is reserved for the exclusive use of the dwelling and not used in common by two or more families. (B.) Houses occupied in separate but not self-contained dwellings.—These embrace (1) new houses constructed (a) so that the w.c.'s, washhouses, balconies, &c., any one or more of these are used in common, forming a partly common dwelling house, and in some cases (b) so that every room opens separately and directly on to a staircase or corridor, as in an ordinary type of old house, forming a wholly common dwelling house, and (2) old houses originally constructed for occupation by one family, and made down to let out in separate dwellings to more than one family, and formed into a wholly common dwelling house. Underground dwellings.—During the year, in ten cases underground rooms let separately from the rest of the house were discontinued as dwellings. Registered houses.—The number of houses let in separate dwellings or lodgings to members of more than one family was 135 at the end of th6 year. Registered Common Lodging Houses.—The number of these houses in St. Pancras is 26, as set out in the List in the Appendix, and they are supervised and controlled by the London County Council. Canal Boats.—Thirty-six canal boats used as dwellings, and moored in this District, were inspected during the year and found satisfactory. Stable Dwellings.—The attention of the Health Committee has been called to the fact that when Mews are in private hands, and the roadway and footway (if any) are maintained by the Owner, it is possible in redraining stables, with dwellings over, and water-closets and gullies under the dwelling, to place a disconnecting chamber outside the building, and also the disconnecting gully, a methed of construction much to be desired. But when the roadway and footway (if any) of the Mews are taken over by the Vestry and maintained, it is then forbidden to put the gulleys, disconnecting chambers, dust receptacles, &c., outside 48 the buildings; and as these buildings have no other open space, and most frequently have dwellings over, it follows that the whole of the sanitary arrangements are inside the house, a very undesirable conditiou. The position of houses in a Mews differs fundamentally from that of houses in an ordinary street, as they possess no open space in the rear, the open space having been originally provided in front for the use of the occupants. Where the Mews becomes public, manure receptacles, dust receptacles, drain manholes, gullies, or other sanitary conveniences are not allowed to be placed in the open space in front. The reason for this unsatisfactory proceeding on behalf of the Sanitary Autherity appears to be because a Mews, when it comes to be included in the term "street" is treated like a "street" of a totally different kind. The remedy for this appears to be either to cause the owners to provide open spaces in recesses for their sanitary conveniences in lieu of the open space appropriated by the Autherity, or else for the Autherity to allow the owners to retain certain privileges over the open space on conditions set out in an undertaking. The attention of the Highways, Sewers, and Public Works Committee was directed to the unsatisfactory procedure of placing manure receptacles, dust receptacles, drain manholes, gullies, and other sanitary conveniences inside houses in Public Mews contrary to the metheds adopted in Private Mews, and they have been urged to assist in the modification of this procedure, in the direction of improved sanitary requirements, protecting the Vestry by the necessary undertaking. Number of Rooms in Dive/lings.—As indicating the kind of new dwelling accommodation being provided in London, the last Report of the Improved Industrial Dwellings Company, Limited, furnishes useful information. That Company has provided — '28 Tenements of 6 Rooms. 320 „ 5 „ 1,680 „ 4 „ 2,947 „ 3 „ 379 „ 2 „ 28 ,, 1 Room 132 Shops. 46 Workshops. 5,560 Each tenement is structurally severed, and contains separate domestic conveniences, such as kitchen or scullery, water-supply, closet, coal-place, etc. Conversion of Buildings.—The London County Council has made the following important Rules as to the Conversion of Buildings under the London Building Act, 1894, section 211. Unless in any case the Council otherwise allow, no person shall— 1—Convert into or use as a dwelling-house any building or part of a building not originally constructed for human habitation; 49 2—Convert into one dwelling-house two or more dwelling-houses constructed originally as separate dwelling-houses; 3—Convert into or use as two or more dwelling-houses any building constructed originally as one dwelling-house; 4—Convert a building which, when originally erected was legally exempt from the operation of any building enactments or bye-laws in force within London into a building which, had it been originally erected in its converted form, would have been within the operation of these enactments or bye-laws; 5—Reconvert into or use as a dwelling-house any building which has been discontinued as or appropriated for any purpose other than a dwellinghouse; 6—Convert into or use as a dwelling-room or part of a dwelling-room any room or part of a room used as a shop; or 7—Convert a dwelling-house or any part of a dwelling-house into a shop; in such manner that the building or part of a building so converted as aforesaid when converted will not be in conformity with the provisions of this Act relating to the class of buildings to which the building when so converted will belong. 12—Every person who, witheut the consent of the Council, converts or uses a building contrary to any of the provisions of the section of this Act, of which the marginal note is "Rules as to conversion of buildings," shall be liable to a penalty not exceeding ten pounds, and to a daily penalty not exceeding the like amount for every day on which the building remains so converted or is used contrary to the provisions of the said section. UNHEALTHY DWELLING-HOUSES. Under the Housing of the Working Classes Act, 1890, Part II., the following houses were represented as unfit for human habitation:— Date of representation of Medical Officer of Health. Premises. Date and Resolution of the Vestry. Result. 19th January, 189S 32, Tovey Place 19th January, 1898 Notice to be given to render the premises fit for human habitation Premises rendered fit „ „ „ 34 „ „ INSANITARY AREAS. Churchway Area.—The attention of your Vestry was, on the 6th July, 1898, directed to the fact that in the Improvement Scheme made by the London County 50 Council for the Churchway Area, for which the Home Office made a Provisional Order, and has now become an Act of Parliament, the Council is displacing 1086 persons and re-housing 580 persons, or only little more than one half of the population. A communication was addressed to the Council asking them to provide accommodation for an additional number of persons to the 580 provided for by the Act, either under Part III. of the Housing of the Working Classes Act, 1890, or in some other manner. In reply, the Council stated that the Housing of the Working Classes Committee were advised that it would not be practicable to make any appreciable difference in the number now proposed to be accommodated on the area to be cleared, and asked the Vestry to indicate what site or sites in the Borough are, in their opinion, suitable for the erection of dwellings thereon. A communication was also received from the Valuer to the Council, enclosing a plan and proposing a modification of this Scheme, the amendment being that instead of continuing a narrow strip of small dwellings on each side of Wellesley Street, to abolish Wellesley Street, and on the site of the roadway to erect a block of dwellings, leaving ample space on the north and south sides of the buildings, which will also open up the backs of the houses on the south sides of Lancing Street and the north side of Grafton Place. With a view to assisting the London County Council in carrying out the improvement, your Vestry in March last, rescinded their former resolution, and agreed to the Scheme being modified by the abolition of Wellesley Street, and the erection of a block of dwellings thereon as proposed by the Council. Brantome Place and Prospect Terrace Areas. —With reference to the communication mentioned in the last Annual Report as received from the Local Government Board, dated 18th October, 1897, stating "that the Board must require the Vestry to submit proposals for the re-housing of a much greater number of persons than the number for which their present Schemes would provide," details from Mr. Keith Young as to the amount of additional cubic space that could be provided upon these Areas, were supplied, and your Vestry resolved that the requirements of the Local Government Board made in their letter of the 25th June, 1897, be accepted, and that dwelling accommodation be constructed on the Brantome Place and Prospect Terrace Areas, so as to provide 500 cubic feet of dwelling space for each person rehoused on the sites, and further, that additional lands be acquired for re-housing the remainder of the persons not re-housed on the aforesaid sites. A further communication from the Local Government Board with reference to the improvement of these Areas was received asking to be furnished with copies of an amended Scheme and Plans showing (1) the additional lands proposed to be acquired for the purpose of re-housing displaced persons who will not be accommodated on the sites which are to be cleared; (2) the number of persons who will thus be re-housed; (3) plans showing how it is proposed that the areas shall be laid out; and (4) a revised estimate of the cost of the Schemes. Sites for this purpose were viewed by the Health Committee and submitted to your Vestry on the 21st December, as follows:—Early Mews, Equity Buildings, Harrison Street, Wakefield Mews, Greenland Place, Elm Road, Great College Street Stone yard, Camden Street, Rochester Place, Leighton Road, Cromer Street, Georgiana Street Stone yard, Purchese Street. The last three were found unobtainable or unsuitable. 51 East of Chalton Street Area.—On the 11th May, 1898, your Vestry rescinded so much of the Scheme as dealt with Chapel Yard, Chapel Grove, Wilstead Cottages, and Wiers Passage prepared under Part II. of the Housing of the "Working Classes Act, 1890, approved and adopted by the Vestry on the 15th of January, 1896, and approved and adopted the amended Scheme dated the 3rd January, 1898, dealing with this area under Part II. of the said Act, and resolved that a copy of the Scheme dealing with Eastnor Place and of the amended Scheme be forwarded to the Freeholder, which was done. Your Vestry on the 7th September, 1898, resolved that the Seal be affixed to the "Chapel Grove" and "Eastnor Place" Improvement Schemes, and directed that all necessary steps be forthwith taken for carrying these Schemes into effect, and on the 16th November last it was reported that Notices of the Schemes had been served on every Owner or reputed Owner, Lessee or reputed Lessee, and Occupiers of any part of the areas comprised in the Schemes, so far as these persons could reasonably be ascertained; and subsequently, on the 21st December, 1898, it was resolved that the Seal of the Vestry be affixed to the Petitions to be presented to the Local Government Board for the holding of a Local Inquiry, for carrying into effect these Schemes, and for the issuing of Orders sanctioning the same. A communication has been received from the Solicitor to London County Council, enclosing copy of a Joint Report of the Council's Officers of 23rd November, 1.898, relating to the Chapel Grove and Eastnor Place Improvement Schemes, suggesting various amendments whereby the number re-housed will be reduced from 448 to 440 out of a displacement of 690, and the amount of open space increased, Eastnor Place not being built upon. Conference on the Housing of the Working Classes. The Conference held on 15th July, 1898, at the Bermondsey Town Hall on the subject of Overcrowding and Housing of the Working Classes, forwarded to your Vestry the following resolutions:— (a) That the London County Council be asked to exercise their power under Part III. of the Housing of the Working Classes Act to provide accommodation within the County of London, where required. (b) That the London County Council be approached with a view to the insertion of a clause in their General Powers Bill for 1899, to enable Metropolitan Vestries and District Boards to erect Municipal Dwellings under Part III. of the Housing of the Working Classes Act, 1890. (c) That the London County Council should contribute towards the cost of building dwellings for the Working Classes by Local Autherities in London, such contributions to be determined in case of dispute by the Local Government Board. (d) That Local Autherities should be allowed to permanently retain and manage any dwellings for the Working Classes erected by them, and that the provision of Section 12 (5) of the Housing of the Working Classes Act, 1890, requiring them to sell or dispose of such dwellings within ten years from the completion thereof, unless the Local Government Board otherwise determine, should be repealed. 52 (e) That in view of the heavy cost of land in London, and the fact that the value of such land is more likely to increase than decrease, that Local Autherities should not be compelled to repay the cost of such land out of the income from the dwellings, and that the period for borrowing for buildings should be extended to 100 years. A communication was addressed to the London County Council, informing them that your Vestry concurred in the resolutions (b) and (a) above referred to, passed by the Conference of Local Autherities on 15th July, 1898, but that the housing of the working classes was under the consideration of the Council on the 29th November, 1898, when the following Resolutions were adopted:— (а) " That housing accommodation should be provided for a number of " persons, equal to that of working classes displaced by any Scheme "under the Housing of the Working Classes Act, 1890, or under " the provision of any Improvement Act, but not necessarily in the " immediate neighbourhood of the displacement, due consideration " being given to the needs of these living on any particular area, " and that a Register be kept of all persons displaced, such persons, "if possible, to have the refusal of tenancy." (б) " That all clearances under the Housing of the Working Classes Act, " 1890, which involve re-housing, be done at the sole cost of the " Council." SCHOOLS. A list of the Schools in St. Pancras recognised by the Education Department and the School Board for London, together with their accommodation, was given in the Annual Report for 1897. An account of the case of the North London Collegiate School for Girls, an of the powers of entry of the Sanitary Autherity has been given above under the head of Entry. WORKSHOPS AND FACTORIES. The following table shows the work of the Sanitary Inspectors of Workshops and Factories during the year 1898:— Number on Register. Inspections. Re-inspections after Order or Notice. Total. Private Day Schools (Woman Inspector) 21 on Register 91 75 166 Factories (Men) 0 on Register 263* 638† 901 „ (Women) 94 on Register 156 22 178 Workshops (Men)— 457 on Register 255 520 775 „ (Women) 480 on Register 1266 110 1376 Bakehouses (Men) 198 on Register 486 527 1013 Laundries (Women) 116 on Register 474 234 708 Smoke (Man Inspr.) 83 Complaints Obser vations 132 * Three inspections made by District Inspectors. † Two re-inspections made by District Inspectors. Note.—The man Inspector has in addition performed the duties of District Inspector during vacation and vacancies. 53 Water Supply and Water Service. The condition of the Waters supplied by the West Middlesex Water Works and the New River Companies during the year, as stated in the returns of the Registrar-General, has been already reported in the Monthly Reports presented to your Vestry. DRAINAGE AND SEWERAGE. Drainage.—The following table represents the results of tests applied to drains during the year 1898. After Infectious Disease. Upon Complaint. Upon systematic Inspection Old Buildings. New Buildings at completion of work. Total. At commence ment of work. At completion of work. By Grenade. 1. Defects found 104 351 32 8 3 ... 498 2. No result 160 246 20 1 36 ... 463 3. Total 264 597 52 9 39 ... 961 By Exposure. 1. Defeats fcund ... ... ... 2 ... ... 2 2. No result 1 ... ... 1 ... ... 2 3. Total 1 ... ... 3 ... ... 4 By Smoke. 1. Defects localised ... 4 ... 1 1 ... 6 2. No result 1 4 ... 1 2 ... 8 3 Total 1 8 ... 2 3 ... 14 By Water. 1. Not found water-tight 1 1 9 94 ... 105 2. Found water-tight... ... 1 1533 12 1546 3. Total 1 i 10 1627 12 1651 Sum Total 104 356 33 20 93 ... 611 Sum Total 162 250 20 4 1571 12 2019 266 606 53 24 1669 12 2630 Plans for the making of drains in new and existing houses, including additions and amendments to the number of 825, were approved during the year. New Buildings and Notice of Drainage.— A communication was received from the Vestry of Clerkenwell stating that their attention has been frequently drawn to the fact that new buildings are erected to plans approved by the District Surveyor, or the County Council, and after the building is up, application is made to the Vestry to modify the Bye-laws relating to water-clo3ets, soil-pipes, &c., 54 because it is difficult, if not impossible, to comply with them. These details, being within the province of the Vestrv, do not seem to receive the consideration of the Council; but the Vestry are not furnished with plans, and cannot therefore see that the requirements of the Bye-laws are being provided for. It might be advantageous for the London County Council to give instructions to the various District Surveyors, to draw the attention of builders to the necessity for making application to the Local Autherity before commencing to build, submitting details as to proposed drains and sanitary conveniences, copies of the Bye-laws of the Council being at the same time handed to the builder. At present, when the plans have passed the District Surveyor, many are under the impression that the sanitary arrangements have received the sanction of the London County Council. The Vestry of Clerkenwell decided to make the above suggestions to the Council, and having asked your Vestry to co-operate with them in the matter, a communication was forwarded to the London County Council supporting their action. Drainage Regulations.—The Vestries and District Boards of the Metropolis have made regulations as to drainage under Section 83 of the Metropolis Local Management Act, 1855. It has not been disputed that such regulations apply in their entirety under Section 76 to the drain of any new house or building or of any rebuilt house or building or of any premises not before possessing a drain draining directly or indirectly into any sewer. Whether or not these regulations apply to any new drain, whatever the expression "new drain" may mean, it is impossible to discuss with profit here, as it would run to too great length. That, however, "these regulations cannot have reference to old drains" was argued by Mr. Macmorran, Q.C., and Mr. Courthepe-Munroe, and so decided by the Court of Appeal at Clerkenwell Sessions on May 14th, 1898, in the case of Arlidge v. Kershaw (St. Pancras Vestry). The same Court further decided that "these regulations cannot have any reference to repair," and they only have reference to the "making of a drain." Therefore notice must be served under the Public Health (London) Act, 1891, Section 4. This means that in serving notice to abate a nuisance [Section 4 (1)] arising from a defective drain, and to prevent its recurrence [Section 4 (2)] the sanitary autherity may specify any works to be executed, but as nearly all owners require to know the works to be executed, and many owners are anxious to do any necessary work if only the autherity would inform them what is necessary, and as magistrates almost invariably adjourn cases for the purpose of causing owners to be so informed, it obviously follows that the sanitary autherity must specify any works to be executed, and in the absence of any bye-laws must describe the manner in which the works must be executed for the abatement, and to prevent the recurrence of drain nuisances. Therefore, the present methed of procedure for abating drain nuisances is a very cumbersome and complex process, entailing the service of a very long notice, or of a number of separate shorter notices, and it is not apparent how this is to be remedied, except by bye-laws applicable to any portion of a drain made or re-made. Combined Drainage.—The amended Metropolitan Sewers and Drains Bill drafted by the Conterence of Sanitary Autherities to amend the definition of combined drains, approved by your Vestry and sent to the London County Council to introduce and promote as a County Bill in Parliament, as set out in last year's 55 Report is now before the Houses of Parliament. This Bill and the accompanying Report and recommendations were the result of long and serious consideration at many meetings of the Conference and of the Committee of the Conference, all which were attended by your Medical Officer of Health. Draining and Paving of Stableh.—Until quite recent years there was no theught of using anything but straw as bedding for horses. For transport and commercial purposes horses are now worked continuously, and no provision is made for them to lie down during their working years. This change in treatment of horses in large cities has led also to a change in nomenclature, the word bedding has almost disappeared, and in its place we find the word litter. As stable litter the following substances are used—straw, peat, wood-shavings, sawdust, sand, mould. Since the diminution in the use of straw, and the use of other materials, the idea of the requisite qualities required of stable litter appears to have changed also. Formerly, straw was regarded as an ideal litter, because it formed a soft elastic bed of hollow tubes which drained away the liquids wtheut interruption and witheut staining a recumbent animal. Now litter appears to be most esteemed for its absorbent property, since horses no longer require to lie down. The effect of the use of absorbent friable materials as litter is that they gain access to the gullies or horsepots, usually placed either in the centre, or at the tail end of the stalls in stables, and very soon block them and the drains leading from them. The result has been that some of the large companies carrying goods and passengers by road have abolished gullies and horse-pots inside their stables. This has led some to express the opinion that stables do not require paving and draining. If by this, is meant laying underground drains, then so much of the proposition may be conceded, but, nevertheless, stables require to be paved and drained. It cannot be admitted that an absorbent litter is capable of so completely absorbing liquid matters as to altogether prevent pollution of the soil beneath, at any rate, in a place permanently occupied as a stable, whatever latitude may be allowed for temporary usage, as at agricultural shows. That being so, the earth should not be allowed to remain the floor of a stable, but should be covered with hard, durable, impervious material. Neither can it be granted that all liquids can and will be completely absorbed by the absorbent litter, nor that stables can altogether dispense with periodical cleansing and flushing. That being so, and it being granted that drain openings are undesirable inside a stable, more especially if there is a dwelling over, it follows that the impervious surface of a stable must be so evenly levelled and so sloped as to completely drain away any liquid matter that may fall upon the surface to an opening situated outside the stable, and this is the methed now adopted by all the large railway companies, carriers, and commercial firms. Sewer Ventilation.—Mr. W. N. Blair. M.I.C.E., your Engineer, has kindly supplied me with a copy of the Report by Sir Alexander Binnie, Chief Engineer of the London County Council, as to the results of a Conference of the Surveyors of the various Vestries and District Boards of the Metropolis upon 56 the ventilation of sewers. The expression of opinion by so many experts being valuable it is desirable to place it upon permanent record. London County Council. Ventilation of Sewers. Report by Engineer as to the result of a conference of engineers and surveyors of the several vestries and district boards of the metropolis. To the Main Drainage Committee. In accordance with the instructions of the Committee, I issued two circular letters to the engineers and surveyors of the various vestries and district boards in the county, inviting them to a conference on the subject of the ventilation of sewers, with a view to some uniform system being adopted, if possible, for dealing with complaints of offensive emanations from gratings connected with both local and main sewers. In response to the invitation a meeting was held at the County Hall on Friday, 25th February, at which upwards of 40 of the gentlemen invited were present. A list of these who signed the attendance book, together with the names of the districts represented by them, is appended hereto. The discussion on the subject of the ventilation of sewers occupied a period of over two hours, and resulted in the following resolutions being passed, namely— 1. That the closing of sewer ventilators in response to complaints increases the general evil, the diminution of which is to be attained by the multiplication of the ventilators at regular frequent intervals. 2. That in connection with any interceptor hereafter fixed on a main house drain it is advisable to carry up a ventilating pipe from the sewer side of the interceptor, up the front, side, or back of the house, to the satisfaction of the local sanitary autherity, and that the outlet drain from the interceptor shall not be flat-trapped in sewer, unless required by the local sanitary autherity. 3. That pipe ventilators up buildings, or otherwise where possible, should always be adopted, in addition to surface ventilation. It will be observed that the general result of the conference has confirmed the action of the Committee and the Council in recent years, and that the remedy for 6ewer emanations is to be looked for from the maintenance of more frequent ventilating openings, both at the street level and by means of pipes carried up houses and other buildings. I would suggest that, as the meeting was a very representative one, this report be printed, and that copies be sent to each member of the Council and to the engineers and surveyors of the district boards and vestries in the metropolis. Alex. R. Binnie. -Spring Gardens, S.W., 24th March, 1898. 57 REFUSE REMOVAL. At the end of the year it was proposed to transfer the control of the collection of house refuse from the north and south divisions of the Borough to the Special Dusting and Refuse Destructor Committee, and the Health Committee acquiesced in the transfer at the expiration of the contracts in March, 1899. REMOVAL OF MANURE. A communication was received from the London County Council stating that, in investigating complaints of nuisance alleged to arise from stable manure at various premises in London, the attention of the Council has been directed to the use of peat litter which appears to be increasingly creating nuisance, and asking to be informed whether the Vestry find that nuisance from peat litter is so great as to render it desirable that the Council should include such litter within the provisions of its Bye-laws under Section 16 of the Public Health (London) Act, 1891, prescribing the hours of removal of offensive matter throughout London, and the construction of the carriage conveying such matter. Also a communication from the Secretaries to the London Horse Owners Committee, pointing out the advantages of peat moss over straw as litter, and that if peat moss manure is placed within the range of Section 16, and the manure has to be removed from stables between the hours of 4 and 10 in the early morning, it will have the effect of seriously damaging the business of all horse owners in London, for reasons stated by them. Also a report from the Medical Officer of Health, from which it appears the nuisance from stable manure, dung and litter, occurs in these stables, where not only peat litter is used, but also wood shavings, sawdust, &c., and, therefore, any suggested bye-law should apply to dung aud litter other than straw. That the nuisance is mainly caused when the dung and litter are disturbed and turned over for the purpose of transference from the fixed receptacle for dung to the movable receptacle or carriage used for removing the dung and litter away from the stable premises. The main object should be to avoid this disturbance during the transference from one receptacle to the other of fermenting duag and litter, and all receptacles for dung mixed with stable litter other than straw should be so constructed and used that the whole of the contents, in and together with the receptacle, could be removed witheut disturbance. The London County Council has been informed that your Vestry is in favour of the Council including peat litter within the provisions of its Bye-laws under Section 16 of the Public Health (Landon) Act, 1891, prescribing the hours of removal of offensive matter throughout London, and the construction of the carriage conveying such matter. NUISANCES. Smoke Nuisances.—During the year, 83 complaints of smoke nuisances were received, 132 observations were made, 13 notices to abate were served, in 9 cases they were complied with, 4 cases remaining under observation, and there were no prosecutions. 58 Vermin and the Cleansing of Persons. The Cleansing of Persons Act, 1897 (60 & 61 Vict., Ch. 31), is headed "An Act to permit Local Autherities to provide Cleansing and Disinfection for Persons infested with Vermin." It is to be regretted that the word" disinfection "should be misused in an Act of Parliament in conjunction with the word "infested." Disinfection means the destruction of infection and not of vermin, the proper term for which would be infestation, and by analogy its destruction would be disinfestation. This explanation by the way, in order to avoid any misunderstanding and to make it quite clear that true infection and disease are not dealt with under this Act. The Act provides, in the two first and principal sections, as follows:— "1.—On and after the passing of this Act, any Local Autherity shall have the power, when in their discretion they shall see fit, to permit any person who shall apply to the said Autherity on the ground that he is infested with vermin, to have the use, free of charge, of the apparatus (if any) which the Autherity possess for cleansing the person and his clothing from vermin. The use of such apparatus shall not be considered to be parochial relief or charitable allowance to the person using the same, or to the parent of such person, and no such person or parent shall by reason thereof be deprived of any right or privilege, or be subject to any disqualification or disability. " Local Autherities may expend any reasonable sum on buildings, appliances, and attendants that may be required for the carrying out of this Act, and any expenses for these purposes may be defrayed out of any rate or fund applicable by the Autherity for general sanitary purposes or for the relief of the poor. "2.—In this Act, 'Local Autherity' means, in England, the Council of any county borough, the district council of any district, any board of guardians, and, in the County of London, any sanitary autherity as defined in the Public Health (London) Act, 1891." Vermin is a term applicable to all sorts of small noxious animals and iusects, but the vermin in the Act is intended to refer to the little animal forms that may frequent the human body and clothing, and live there more or less parasitically, and include, bugs, fleas, various kinds of lice, and the itch mite and pimple mite, which for clearness and brevity's sake may be called human parasitic vermin. The Board of Guardians provide that every inmate upon admission shall have the body and clothing cleansed, cloth and woollen clothing, etc., being steamed or baked, linen or cotton clothing, etc., either steamed or boiled and washed, and the person bathed, hair cut and shaved if necessary, also that every casual shall be treated in a similar manner, excepting hair cut and shaving. It must be quite clear that the only proper, therough, and satisfactory manner of dealing with verminous persons is that adopted by the Board of Guardians for their inmates, and any provisions made by a Sanitary Autherity must be equally therough to be of any permanent value. 59 It would be very undesirable to bring verminous persons to a disinfecting station, and into contact with bedding, clothing, &c., infected with dangerous infectious diseases, and with persons sheltering from rooms so infected. On the other hand, it would be undesirable to bring verminous persons and clothing to baths and washhouses amongst cleanly persons and clothing, altheugh it might be possible to establish a station of this kind in connection with baths and washhouses; yet, on the whole, the weight of evidence will probably most strongly incline to a separate establishment, especially when the requirements of such a station are fully considered. The experience of Marylebone is interesting. The Act as drafted will probably be of no great utility; this was the first opinion formed. As a tentative measure, the Vestry provided a special bath in a separate building near the shelter, in case any request were made. A great surprise was in store. The very first day it was opened for use, namely, 2nd March, 1898, there were four applicants, and, as to results since, I cannot do better than quote Mr. A. Wynter Blyth, the Medical Officer of Health:— "From 2nd March to 31st March, a period (exclusive of Sundays) of twenty-five days, 148 persons, or an average about six per day, have attended at the premises, bathed, and simultaneously have had their clothes disinfected by superheated steam. With the exception of one woman, all the applicants have been males; 134 have given as an address the Salvation Army Shelter; eight the Shaftesbury Institute; and six various common lodging-houses in the Parish. By far the majority have evidently for some time suffered great discomfort, the skin being in a state of eruption from parasites, the hair matted with filth, and the clothes indescribably foul. A few of the applicants were so offensive as to constitute a nuisance. What chance such men would have of getting even a casual employment, before purification, may be gathered from the fact that a brief interview in the open air would excite a feeling of nausea and repulsion. The operation of the Act thus affords an opportunity for a certain class of the extremely poor to obtain decent regular employment. Beside such personal advantages, the diminution of the possibility of cleanly people becoming accidently infected with loathsome skin disease from mixing in crowds, or making use of public seats in the parks and open spaces, is a distinct public gain. The solitary bath was admittedly an experiment. This being successful, it follows that adequate arrangements must be made. The Vestry have, therefore, on the recommendation of the Sanitary Committee, passed resolutions to provide necessary staff, to provide a second bath for males, and a second bath for females, and also an auxiliary disinfecting steam chamber in the same building as the baths, so that there shall be no loss of time in the operations, and no interference with ordinary routine disinfection. "Duriug the month of April, 293 males have cleansed themselves and had their clothes disinfected at the bath provided by the Vestry; this brings the total number, since March the 2nd, up to 441. "During the month of May, 276 men and two women took advantage of the facilities afforded for personal cleansing, and had their clothes disinfected. It is 60 satisfactory to note that the Local Autherity of St. Olave is about to follow the example of this Parish, and will establish one or more baths under the above Act. "Owing to various circumstances, the Cornish boiler, the new baths, and the auxiliary disinfecting apparatus, have not yet been fixed up near the shelter. "During June, 337 males availed themselves of the purifying and disinfecting facilities at present existing. The total number of bathers, from March 2nd to 30th June, is 1055. "The number of persons who have taken advantage, in July, of the cleansing and disinfecting facilities which the Vestry have provided, is 376; this brings the total number since the opening of the premises up to 1,430." A certain proportion of these undergoing bathing and cleansing at the place erected in Marylebone return, no doubt, to again undergo the process, and perhaps more often than a second time. Repeated bathing and cleansing and more vigorous measures, especially the treatment of the hair and beard, are necessary to obtain riddance of some of the human vermin which occasionally prove most intractable. Provision also is to be made for women, probably in the proportion of about one-half of the accommodation provided for men. Regular daily cleansing of all seats in the public parks, gardens, and other public places should be carried out effectually, and it is a question whether vermin infesting the dwelling should not be regarded as a nuisance to be abated. ST. PANCRAS, LONDON. Sanitary Autherities of London, and the action taken by them under the Cleansing of Persons Act, 1897. Marylebone.—Provision made as set out in previous Report. St. Pancras.—The Guardians of the Poor take action. Lambeth.—Nothing as yet. St. George's, Hanover Square. — Have done nothing, and had no application. Islington.—No reply. Shoreditch.—Very few applications have been received, but the Disinfecting Apparatus is available free of charge for clothing. Paddington.—Has made no special arrangements. No application has been received. Bethnal Green.—Has done nothing. Nkwington.—Has no accommodation at present, but a room and bath room are being provided, next the disinfecting apparatus, that may be available for this purpose. Camberwell.—Has done nothing. St. James, Westminster.—Have taken no action and have had no applications. 61 St. Margaret and St. John, Westminster. — Have received no applications, but the Officers are empowered to act if any are made. Clerkenwell.—Vestry has directed that any cases that might apply should be referred to the Guardians, who have agreed to deal with them. Chelsea.—Has not at present taken any action. Kensington.—Has made arrangements with the Guardians to carry out the Act at half-a-crown per case. Fulham.—Consideration adjourned till next year. Hammersmith.—Has not yet done anything in reference to the Act, but has treated clothes infested with vermin in several cases. St. Luke.—Has taken no steps. The Guardians propose to deal with the subject. St. George-the-Martyr, Southwark.—Nothing done. Bermondsey.—No reply. St. George-in-the-East. — Have done nothing. The present contract only covers disinfection. St. Martin-in-the-Fields. — No application received, but would act if necessary. Mile End.—Do not propose taking any steps. Woolwich.—Nothing has been done. Rotherhithe.—Has taken no action. Hampstead.—Have not had occasion to put the Act in force. Battersea.—Has had no occasion to do anything. Hackney.—Nothing has been done. Stoke Newington.—Has decided to take no action beyond autherising the Medical Officer of Health to deal with any case that may arise. Plumpstead.—Has done nothing. Greenwich and Deptford.—Nothing done. Wandsworth.—Has had no occasion to proceed. St. Giles.—Provision made by arrangement with the Guardians. Three, or four applications have been received. Holborn.—Has for the present declined to take any action. Strand.—Has received no application. Will use Shelter-bath and disinfecting apparatus in case of necessity until demand arises. Limehouse.—No action has been taken. Poplar.—No reply. St. Saviour, Southwark.—Has done nothing. Lee.—No reply. Lewisham.—No reply. St. Olave, Southwark.—Declines to provide accommodation for this purpose at the Shelter. Whitechapel.—The Guardians have become the Local Autherity for carrying out the Act. November, 1898. Your Vestry resolved that the Board of Guardians be asked to carry out the provisions of the Act in cases where application is made to the Sanitary Autherity in a similar manner to the methed adopted when application is made to them. 62 SUMMONSES Under the Public Health (London) Act, 1891, and Metropolis Local Management Acts. Situation of Property. Offence. Result of Proceedings. 80, Seymour Street Defective drain Abatement order within 14 days, and £1 7s. costs. '28, Clarendon Square Failing to provide sufficient w.c. accommodation contrary to bye-laws of London County Council. Fined £4, and 2s. costs. 15, Hethersett Street Defective drain Abatement order within 14 days, and 6s. costs. 83, Leighton Road Failing to provide an interceptor syphon trap with fresh air inlet, or ventilating pipe to drain. Fined 1s., and £2 10s. costs. *233, Arlington Road Failing to relay drain in concrete as required by the Vestry respecting house drains. Fined 10s. and £2 2s. costs. „ „ Failing to provide an Interceptor syphon trap to the drain. Fined £1, and 2s. costs. „ „ Failing to provide ventilation to the drain. Fined £1, and 2s. costs. 12, Castle Place Damp condition of walls, and an accumulation of water under the floor of the basement. Abatement order within 7 days, and £1 3s. costs. 43, Wellington Street Failing to provide sufficient w.c. accommodation contrary to bye - laws of London County Council. Summons adjourned sine die. Fresh summons granted against Defendant's son, it being proved he was the owner. „ „ Failing to provide sufficient w.c. accommodation contrary to bye - laws of London County Council. Summons withdrawn. Number of occupants reduced. 12, Wellesley Road Non-existence of a portable metal dust receptacle. Nuisance abated. Summons withdrawn. 3s. costs. 14, „ „ Failing to provide sufficient w.c. accommodation contrary to bye - laws of London County Council. Summons withdrawn. Number of occupants reduced. £1 3s. costs. * County of London Sessions. Before Mr. Loveland-Loveland, 14th May, 1893, three appeals against convictions allowed, with costs. 63 Situation of Property. Offence. Result of Proceedings. 31, Wellesley Street Defective drain Abatement order within 10 days, and £1 7s. costs. 17, Dickenson Street Failing to provide sufficient w.c. accommodation. Fined £3 10s., and 2s. costs. 11, Lady Somerset Road Failing to provide soil pipe contrary to bye-laws of London County Council. Summons not served. Defendant abroad. 75, Regent's Park Road Unlawfully and wilfully stopping up and interfering with the drain. Fined £5, and £1 7s. costs. 73, „ Unlawfully and wilfully obstructing in the execution of a Warrant of Entry on 21st April, 1898. Fined £1, and 2s. costs. 36, Wellesley Road Do., on 23rd April, 1898. Defective yard paving and an accumulation of rubbish in the yard. Fined £1, and 2s. costs. Summons not served. Defendant's address not known. 14, Clarendon Grove Failing to provide a suitable manure receptacle at stables. Receptacle provided since summons was issued. Summons withdrawn. 2s. costs. 190, Kentish Town Road Diseased bullocks' lungs deposited for the purpose of preparation of sale, and intended for the food of man. Fined £10, and £2 2s. costs. 13, Litcham Street Failing to provide sufficient w.c. accommodation. Occupants since reduced. Summons withdrawn, and £1 4s. costs. 62, Carlton Road Defective condition of yard paving. Abatement order within 14 days, and £1 costs. 9, Warren Street Defective drain Abatement order within 28 days, and £1 7s. costs. Fortess Mews, Fortess Grove Defective drain and defective state of yard paving and stable floors. Abatement order within 21 days, and £1 3s. costs. 44, Seymour Street Fixing a new trap and soil pan to w.c. witheut notice to the autherity. Fined £1, and 4s. costs. Chalton Street Exposing for sale 3/4 cwt. oranges unfit for the food of man. Fined 10s., and 2s. costs. „ „ Exposing for sale 4 lbs. of apples unfit for the food of man. Fined 10s., and 2s. costs. 32, Maiden Road Failing to provide sufficient w.c. accommodation. Fined £1, and 2s. costs. 64 Situation of Property. Offance. Result of Proceedings. Regent's Park Road Exposing for sale 1 cwt. of oranges unfit for the food of man. Fined 5s., and 2s. costs. 49, Fitzroy Road Fixing a valve w.c. witheut first giving notice to the sanitary autherity. Fined £2, and 2s. costs. 24, Ferdinand Street Failing to provide a w.c. basin contrary to the byelaws of the London County Council. Summons dismissed. Magistrate held that byelaw 3 of the bye-laws of the London County Council did not apply. „ „ Failing to provide a soil pipe outside the premises contrary to the bye-laws of the London County Council. Fined £1, and 2s. costs. 1, Preston Street Defective drain, yard paving, and dust receptacle, and want ot ventilation under the floors. Abatement order within 14 days. „ „ Failing to provide sufficient w.c. accommodation. Fined £1, and £1 3s. costs- 66, Ferdinand Street Exposing for sale 3 boxes of tomatoes unfit for the food of man. Fined 10s., and 4s. costs. 145, High Street, Camden Town Exposing for sale 4 lbs. of pears and oranges unfit for the food of man. Fined 10s., and 4s. costs. 66, King Street Failing to provide sufficient w.c. accommodation. Fined £4, and £1 3s. costs. Jeffreys Place Failing to provide sufficient w.c. accommodation at premises used as a workshop. Sum vmons withdrawn. Sufficient w.c. accommodation since provided. 1, Carlow Street Defective drain, dirty condition of premises, and absence of a proper receptacle for house refuse. Abatement order within 14 days, and 6s. costs. „ „ Failing to provide sufficient w.c. accommodation. Fined 10s., and 2s. costs. In default, 7 days. 5, Little Albany Street Failing to provide sufficient w.c. accommodation at workshop. Fined £1, and 2s. costs. 127, Highgate Road Failing to provide sufficient and suitable w.c. accommodation and an efficient supply of water for domestic purposes for the persons employed. Fined £5, and £1 8s. costs. 65 Situation of Property, Offence. Result of Proceedings. 129, Highgate Road Failing to provide sufficient and suitable w.c. accommodation for the persons employed. Fined £2 10s., and 2s. costs. Premises adjoining 129, Highgate Road Failing to provide sufficient and suitable w.c. accommodation and a proper supply of water for domestic purposes for the persons employed, also overcrowding. Fined £2 10s., and 2s. costs. 14, Clarendon Grove Stable and yard unpaved and undrained, and drain from sink untrapped. Summons dismissed, Magistrate holding that there was no nuisance injurious to health. 15, „ „ Defective drain, and yard and stable paving defective. „ „ Fortees Mews, Fortess Grove Failing to comply with a Nuisance Order made in respect to these premises on 9th September, 1898. Fined £5, and 2s. costs. 24, Lancing Street Damp condition of basement walls. Abatement order within 14 days, and 6s. costs. 34, Ferdinand Street Foul pan trap, offensive accumulation of matter in the yard and shed, dirty yard, fowls improperly kept, defective paving of yard and washhouse, non-ventilation of floor space in the basement, and general dirty condition of premises. Abatement order within 14 days, and £1 1s. costs. 138, Highgate Road Defective drain Fined £2, and £2 2s. costs. „ „ Failing to provide a manure receptacle contrary to the bye-laws of the Vestry. Fined 3s., and 2s. costs. 1, Carlow Street Failing to comply with Nuisance Order requiring abatement of nuisance from defective drain and dirty condition of premises, and absence of dust receptacle. Fined £5, and £1 1s. costs. In default, 1 month. 66 V.-FOOD. FOOD PREMISES. The licensed slaughter-houses, cow-sheds, and dairies have been inspected from time to time. The markets and market streets were kept under observation, and were also visited on Saturday nights and Sunday mornings during the summer months. UNFIT FOOD. The following food, unfit for human consumption, was seized during the year:— Date. Division & Sub-Division. Description of Article. 1898. Jan. 6 East —Oakley Square ½ bushel apples and 16 oranges. Feb. 19 South—Burton 10 oranges. ,, 26 „ —Mecklenburgh 38 apples and 17 oranges. April 13 East —Ossulston 27 dried kippers. „ 22 ,, —Oakley Square 30 boxes tomatoes. „ 29 „ —Barthelomew Pair of beast's lungs. „ „ „ —Ossulston 2 cwt. oranges. May 7 „ —Oakley Square 25 lbs. tomatoes. June 2 „ —Ossulston Pair bullock's lungs & 2 bullocks' melts. „ 6 West—Regent's Park 7 lbs. cherries. July 1 East —Barthelomew Small quantity of saveloys. Aug. 2 „ —Ossulston 1/3 sieve of cherries. „ „ „ — „ Quantity of cherries. „ 3 West—Chalk Farm 10 lbs. cherries. „ 12 East —Ossulston 1/4 bushel peals. „ 24 „ — „ 4 lbs. apples. „ 26 „ — „ 7 lbs. peaches. „ 28 „ — „ 3/4 cwt. oranges. „ 29 West—Chalk Farm 1 cwt. oranges. Sept. 3 „ —Euston Basket of tomatoes. „ „ „ —Mornington 4 lbs pears and 8 oranges. „ 6 East —Ossulston Quantity of apples. „ „ West—Castle 3 boxes tomatoes (14 lbs.). „ 7 East —Ossulston 3 sieves plums. „ 10 North—St. John's Park ½ bushel pears. „ 12 West—Chalk Farm Basketful of pears. „ 17 „ —Castle 20 oranges. Oct. 25 East —College 112 lbs. of mackerel. Dec. 10 „ —Ossulston 6 boxes Teneriffe tomatoes. „ 17 „ — „ 1 ton of turkeys. if 30 „ — „ 620 herrings. 67 Ice-creams.—In June a communication was received from the Coroner for Central London, stating that an Inquest was held on the 10th of June, concerning the death of a boy who died from septicoemia, following an irritant poison introduced into the system by eating ice-cream purchased from a street vendor, and the Jury appended the following rider to their verdict:—"And the Jurors, having heard in evidence that another child in the same family was also affected in the same way, would call the attention of the Sanitary Autherities to the case." Your Vestry approved of eight samples of ice-creams being taken from street vendors and being subjected to analysis for the purpose of ascertaining whether they contained any injurious substance, mineral, vegetable, or animal. Accordingly in July eight samples were taken, four of which were examined chemically and found genuine, and four examined bacteriologically, with the following results:— The first contained upwards of 500,000 organisms per cubic centimetre. The bacteria isolated were the B coli communis (the cream contained 200 or 300 per c. c.), Streptococcus pyogenes, Staphylococcus, pyogenes aureus, Staphylococcus pyogenes albus, B. liquidus, B. liquefaciens fluorescens, B. ubiquitous. No Oidium lactis could be found, nor could any Diphtheria bacilli be discovered. The second contained upwards of 450,000 organisms per c. c. The bacteria isolated were the B. coli communis (there were 150 to 200 per c. c.), Staphylococcus albus, Streptococcus, B. liquefaciens fluorescens. No Oidium lactis or Diphtheria bacilli could be found. The third contained upwards of 120,000 organisms per cubic centimetre. Of the bacteria present the most numerous were bacilli belonging to the Mesentericus vulgatus. The B. liquefaciens and liquefaciens fluorescens were also present. Neither Typhoid bacilli, B. coli communis, Klebs Loffler bacilli, nor Streptococci could be found. Staphylococcus pyogenes aureus was not found, but the Staphylococcus albus was isolated. The fourth contained about 160,000 organisms per c. c. The bacteria isolated were B. liquefaciens fluorescens, B. liquefaciens, B. ubiquitous, B. mesentericus vulgatus, and Staphylococcus albus No Oidia, Klebs Loffler bacilli, B. typhi abdominalis, nor B, coli communis could be discovered. It was evident that the condition of the milk used was an important factor in the composition of ice-creams, and accordingly I reported upon the subject from the point of view of the bacteriological examination of food, and especially of milk. The Bacteriological Examination of Food and especially of Milk. Health Department, Vestry Hall, Pancras Road, N.W. 9th November, 1898. Report of the Medical Officer of Health upon the Bacteriological Examination of Food. To the Health Committee of the Vestry of St. Pancras. Mr. Chairman, Ladies and Gentlemen, In July last your Committee gave instructions for the Bacteriological 68 examination of samples of Ice Cream, the results of which were anything but satisfactory, and were duly reported to the Vestry at its Meeting on the 7th September last. At the Meeting of your Committee on Tuesday, the 27th September last, I explained that the condition of the Ice Creams was mainly dependent upon the condition of the milk from which they were made, and I informed your Committee that it was my intention to report to you upon the question of the Bacteriological Analysis of Food, when I had obtained sufficient matter and information upon which to carefully base the methed of procedure in taking such a step. The only prosecutions that have hitherto taken place in this direction have been under the Food and Drugs Acts. In one case recently at Southwark, a conviction was obtained by proving that the Ice Cream was a mixture of milk and other ingredients, and that the milk was sour at the time of sale, as proved by the discovery of the germ causing souring of the milk (oidium lactis) present in the Ice Cream, and therefore that the Ice Cream was a mixture injurious to health. Altheugh Ice Cream can thus be dealt with under the Food and Drugs Acts, milk alone could not be so treated, since it is not necessarily a mixture, and therefore it is necessary to find some other methed of dealing with unsound milk, or other food, that is not so visibly unsound as to render it liable to seizure and yet may be dangerous to health. This methed of dealing with unsound food is found possible under the Public Health (London) Act, 1891, in Section 47 (3) of which it is provided that " Where it is shown that any article liable to be seized under this Section, and found in the possession of any person, was purchased by him from another person for the food of man, and hen so purchased was in such a condition as to be liable to be seized and condemned under this Section, the person who so sold the same shall be liable to the fine and imprisonment above mentioned, unless he proves that at the time he sold the said article he did not know, and had no reason to believe that it was in such a condition." So that when food has been purchased for the food of man, and it can be proved that it was unfit at the time of purchase, the vendor may be prosescuted, altheugh the food has not been previously seized aud condemned. The procedure of a London Autherity under this Section would appear to be (1) to find in the possession of any person any article of food purchased by hiin from another person for the food of man (whether for consumption or for re-sale) that is diseased, or unsound, or unwholesome, or unfit for the food of man; and (2) to prove that it was in such a condition when purchased by the person in whose possession it was found. It would therefore appear within the power of any London Autherity to cause samples of food intended for the food of man to be subjected to bacteriological examination, and if found diseased, unsound, unwholesome, or unfit, to prosecute the vendor. I therefore recommend the purchase of samples of food, and the submission of such samples to bacteriological examination, with a view to taking action under this sub-section if found necessary. The kind of food that lays itself open to be most effectually dealt with is obviously milk. During the last 50 years there has been a great reduction in all 66 forms of Tuberculosis or Consumption, especially that form attacking the lungs, and excepting that form attacking the bowel. This last form, which occurs in children at the milk-drinking age, has shewn a considerable increase of late years, and there is little doubt that tuberculous milk is the cause of it. Professor Delepine examined a number of milks entering Liverpool and Manchester for the purpose of confirming the truth of this mode of infection from the cow. He produced no tuberculosis from unmixed milks from cows shewing no evidence of tuberculosis, but produced tuberculosis from 27.24 per cent. of unmixed milk from cows shewing distinct advanced tuberculosis; 5.55 per cent. from mixed milks from town dairies, the condition of the cows being unknown; and 17.6 per cent. of milks from country farms, the condition of the cows being unknown to him. He also ascertained that in a small herd of cows tested recently by him with tuberculin, over 43 per cent. were tuberculous or consumptive, and this accords with records of foreign abattoirs and municipal slaughterhouses. Now, if the germs of tuberculosis or consumption can be found in milk, and it can be successfully brought home through the person distributing the milk to the farmer producing it, that he is spreading a dangerous infectious disease, a very powerful effect will be produced towards inducing farmers to test their cows with tuberculin, and weed out the infected animals from their herds. A methed of extending the use of tuberculin for the purpose of preventing the spread of tuberculosis which appears to have been overlooked by the recent Royal Commission. Milk may be unfit for food from the presence of various injurious germs. 1.—Pathegenic germs may be added to milk by means of impure water used to dilute it, or used to wash the utensils. The germs of typhoid fever {bacillus typhi abdomtnalis) may gain access in this manner. 2.—Pathegenic germs may be added to milk by the attendants. The germs of diphtheria (bacillus diptherice) have been found in milk, possibly derived from the throats of these handling it, and attendants with sores on their hands or elsewhere may add the germs found in such sores (streptococci and staphylococci). 3.—The common germ of the animal intestines (bacillus coli communis) may be derived in an exceptional case from the dirty habits of an attendant, but the most usual source is the dirty skin and udder of the cow, after she has lain in her own dung, and it has dried upon her surface, and is brushed off in the process of milking. These organisms multiply in the milk, turn it sour, aud produce poisonous toxins that are injurious to milk-drinking children. 4.—Purulent organisms may gain access to milk from sores on the surface of the cow's udder, and may be found in the milk. 5.—There may be a tuberculous or other abscess on the udder of the cow. If tuberculous, the tubercle bacilli may be found in the milk; if non-tuberculous, then streptococci and staphylococci [strep, pyogenes, strep bovis, staph, pyogenes aurei) may be found. In either case such milk would be considered injurious. 6.—Milk may become unfit for consumption by the growth of non-pathegenic organisms turning it sour (oidium lactis, etc.), or causing other changes. 70 The method of taking samples of milk for the purpose of bacteriological examination should be—at the time of purchase—to receive the samples intended for examination in sterile vessels, and either to pack them in ice, or to convey them as soon as possible to the laboratory. There is no reason why the samples to be tested bacteriologically for organisms, should not be the same samples as these purchased to be tested chemically for adulteration. Last year, of a total of 234 samples taken, 112 were samples of milk, and of these 29 were taken at railway stations in transit, leaving 83 or about 35 per cent. purchased by the Autherity. A bacteriological examination may include:— 1.—A quantitive examination of the number of organisms of various kinds present, this possibly giving a measure of the care with which the milk has been handled. 2.—A search for tubercle bacilli. 3.—A search for diphtheria streptococci. 4.—A search for pus organisms (staphylococci pyogenes aureus). A search for typhoid organisms would almost surely be negative, as these organisms have not yet been isolated from milks except in artificial experiments. A search for colon bacilli would always result in finding them, as these bacilli are common in the intestine of the cow as well as of man, altheugh an enumeration of these particular bacilli might be some measure of the degree of cleanliness in which the cows were maintained. If, in addition to the presence, enumerations of the several organisms mentioned, were required separate, more extended bacteriological examinations would have to be made for each organism. In the case of tubercle bacilli this might be desirable. There is another point to which the attention of your Committee may be directed. A previous report from me dated 31st May, 1897, considered by your Committee on the 16th June, 1897, and approved by the Vestry on the 23rd June, 1897, recommended that a communication be addressed to the Local* Government Board to further such legislation as may be necessary to enable Sanitary Autherities to prohibit and prevent the preparation, storage, and sale of food in places which they may consider unfit for the purpose. A bacteriological examination may form some guide as to this question in reference to milk, and, as experience dictates, possibly to other forms of food later on. In the meanwhile, I beg to recommend that samples of milk purchased for chemical analysis be taken with due precaution, and be submitted to bacteriological analysis for tubercle bacillus. I have, &c., John F. J. Sykes. On the 18th of January of the present year your Vestry approved of the purchase of samples of milk for bacteriological examination for the purpose of ascertaining the presence of tubercle bacilli, provided "that the number of 71 samples to be examined bacteriologically do not exceed fifty, at a fee per sample not exceeding ten shillings and sixpence, and that when the number of samples has been exhausted the result be reported to the Vestry." The samples are now being taken. * The Report referred to was the following:— Health Department, St. Pancras, 31 sit May, 1897. To the Health Committee. Mr. Chairman, Madam, and Gentlemen— Preparation, Storage, and Sale of Human Food in Unfit Places. By letter, dated 22nd April, 1897, the Clerk of the Strand Board of Works has forwarded a Resolution passed by his Board to your Vestry with regard to the preparation, storage, and sale of food, which letter has been forwarded to your Health Committee. The Resolution is to the effect that, " the Committee, having had under consideration the fact that food is often prepared for sale and sold in places (such as fried fish shops, ice cream shops, and dripping in rag and bone shops), some of which are sanitarily unfit for the purpose, recommend that the Local Government Board be requested to issue such regulations as will place these places under more efficient control, and that a copy of this Resolution be sent to the other Metropolitan Sanitary Autherities." In addition to the above-mentioned articles of food may be mentioned milk, butter, bread, cheese, bacon, lard, oil, stored and sold in places where paraffin, blacking, turpentine, and various other disagreeable and sometimes injurious substances are kept. Sometimes also food is prepared or stored in crowded dwelling rooms or in proximity to sanitary conveniences. This applies particularly to articles of confectionery. It will be universally conceded that such an extremely perishable food as milk is highly susceptible to the absorption of noxious odours, effluvia and dangerous organisms, and should not be stored or sold in conjunction with other substances than dairy products and human food. Under these conditions, altheugh the Resolution of the Strand District Board is not in a desirable form for your Committee to recommend and the Vestry to adopt, I would beg to suggest that if the principle be approved by your Committee, the latter part of the Resolution be worded as follows:—" That the Local Government Board be requested to further such legislation as may be necessary to enable Sanitary Autherities to prohibit and prevent che preparation, storage, or sale of food in places which they may consider unfit for the purpose." I have, &c., John F. J. Sykes. A communication was addressed by your Vestry to the Local Government Board to that effect. 72 Public Slaughterhouses.—On the 30th November, 1898, Mr. Coggan, as Chairman of the London Butchers' Trade Society, and Chairman of the Meat Section of the London Chamber of Commerce, addressed the Vestry at the head of a deputation in favour of the retention of private slaughterhouses in the Metropolis, the London County Council having expressed the opinion that it is desirable as a first step towards ensuring a proper inspection of meat that private slaughterhouses should cease to exist in London. There are about 400 or 450 slaughterhouses, and about 8000 or 9000 butchers in the Metropolis. The London County Council have nothing to say against the manner in which the private establishments are kept to-day. The only reason the Council has for bringing forward the question of public slaughterhouses at this time is for the better inspection of meat. The Deputation do not object to the inspection of meat. Meat killed in private slaughterhouses, which is only about five per cent. of the meat consumed in the Metropolis, needs inspection less than any other, because only the finest beasts go to these places. Nine-tenths of the animals killed in private slaughterhouses have to pass the Inspector at the Islington Market, and all the other beasts have to pass the Inspectors in other markets. Diseased animals come to London dead; they never find their way into private slaughterhouses. The public slaughterhouses would probably cost the London County Council about a million of money, and the cost of maintenance would be great. The meat of animals killed in the public slaughterhouses, or sent from a private place to a public inspection chamber, would be very likely to seriously deteriorate in quality in transit, and would have a different appearance altogether to home killed meat. If the private places are done away with, the butchers might just as well buy the meat dead. A special class of Inspectors might be appointed to inspect the animals killed in the private slaughterhouses. He referred to the recent report of the Royal Commission on Tuberculosis, in which it is stated that during the last twenty years whilst the consumption of meat has been very great, tuberculosis amongst these persons who consume meat has decreased twenty-five per cent. In Continental cities and America, where public slaughterhouses have been established, he understands that the price of meat is dearer than in the Metropolis, and at Brighton, Belfast, and other places where abattoirs have been established, they are carried on at a loss. He asked the Vestry not to support the Council in the abolition of properly conducted private slaughterhouses. The Deputation then retired. Your Vestry resolved "that the London County Council, the London Chamber of Commerce, and the London Butchers" Trade Society, be informed that this Vestry is in favour of the establishment of public slaughterhouses, but do not desire to suppress properly conducted private slaughter houses." In my Annual Report for the year 1895 (page 61 and following) the two sides of this question were reviewed, and it is appropriate at this moment that attention should be directed to the facts there set out for the purpose of reference. 73 ADULTERATED FOOD. Analysis.—Samples taken under the Sale of Food and Drugs Acts. Articles of Food of which samples have been taken. Divisions. Total. Remarks. South. East. West. North. Milk— Number taken 23 43 41 31 138 Adulterated 7 13 18 7 45 Genuine 16 30 23 24 93 Butler— Number taken 8 10 8 10 36 Adulterated 2 1 2 3 8 Genuine 6 9 6 7 28 Pepper—Number taken 3 • • 1 • • 4 Adulterated • • • • • • • • • • Genuine 3 • • 1 • • 4 Tinned Apricots— Number taken • • 1 • • • • 1 Tin 0.31 grs. per lb. Zinc0.16 ,, „ Coffee— Number taken 6 6 6 6 24 Adulterated 1 2 • • • • 3 Genuine 5 4 6 6 21 Ice Cream— Number taken • • 4 2 2 8 Adulterated • • • • * * • • * Four samples of Ice Cream were submitted to Bacteriological Examination. Genuine • • 4 • • • • 4 Water— (Ice Cream Washings). Number taken • • 4 • • • • 4 Adulterated • • • • • • • • • • Genuine • • 4 • • • • 4 Scotch Whisky— Number taken • • 5 • • • • 5 Adulterated • • 2 • • • • 2 Genuine • • 3 • • • • 3 Demerara Sugar— Number taken 3 • • • • • • 3 Adulterated 1 • • • • • • 1 Genuine 2 • • • • • • 2 Gin— Number taken • • 5 • • • • 5 Adulterated • • 1 • • • • 1 Genuine • • 4 • • . . 4 Mustard— Number taken • • • • • • 5 5 Adulterated • • • • • • • • • • Genuine • • • • • • 5 5 Brandy— Number taken • • • • 5 • • 5 Adulterated • • • • • • • • • • Genuine • • • • 5 • • 5 Rum— Number taken 5 • • . . • • 5 Adulterated 1 • • • • • • 1 Genuine 4 • • . . • • 4 The number of samples to be taken during the year under the Sale of food and Drugs Acts has been increased by resolution of your Vestry from 250 to 500. 74 SUMMONSES—Under the Sale of Food and Drugs Acts. No. Nature of Article as Purchased. Result of Analysis. Result of Proceedings. Penalty. Costs. £ s. d. £ s. d. 873 Butter Foreign fats, i.e., fats other than butter fat, 44 per cent. 0 10 6 0 2 0 874 Milk Added water, 16 per cent. 0 10 6 0 2 0 770 Butter Foreign fats, i.e., fats other than butter fat, 78 per cent. 2 10 0 0 12 6 771 Milk Added water, 15 per cent. 2 10 0 0 12 6 772 ,, ,,9 ,, 0 10 0 0 12 6 194 ,, ,, 9,, 0 5 0 0 12 6 471 ,, ,,13,, 2 0 0 0 12 6 476 Butter Foreign fats, i.e., fats other than butter fat, 55 per cent. 2 0 0 0 12 6 85 Milk Deficient in butter fat, 17 per cent. 0 5 0 0 12 6 364 Butter Foreign fats, i.e., fats other than butter fat, 70 per cent. 2 0 0 1 3 0 201 ,, Foreign fats, i.e., fats other than butter fat, 80 per cent. 2 10 0 0 12 6 52 Milk Deficient in butter fat at least 20 per cent. 1 0 0 0 12 6 369 ,, Added water, 7 per cent. 0 10 0 0 12 6 94 Coffee Chicory, 20 per cent. 2 0 0 0 12 6 780 Milk 10 per cent. of added water 1 10 0 0 12 0 782 ,, 13 ,, ,, 2 0 0 0 12 6 485 ,, 13 ,, ,, 0 10 0 0 2 0 213 ,, 9 ,, ,, 1 0 0 0 12 6 104 ,, 22 ,, ,, 1 0 0 0 12 6 379 ,, 8 ,, ,, 1 0 0 0 12 6 61 ,, 11 ,, ,, 2 0 0 1 3 0 62 Butter Foreign fats, i.e., fats other than butter fat, 72 per cent. 3 0 0 0 2 0 64 ,, Foreign fats, i.e., fats other than butter fat, 72 per cent. 2 0 0 1 3 0 *636 Milk Added water, 20 per cent. 5 0 0 0 12 0 638 99 ,,10,, 0 12 6 640 Butter Foreign fats, i e., fats other than butter fat, 75 per cent. 1 0 0 0 12 6 784 Milk Added water, 7 per cent. 0 10 0 0 12 6 645 99 ,,9 ,, 3 0 0 0 2 0 107 Scotch Whisky Water over and above that contained in 25 degrees u.p. Whisky, 3½ per cent. 0 10 0 0 2 12 0 387 Milk Added water, 7 per cent. 5 0 0 0 6 215 ,, ,,9 ,, 0 10 0 0 12 6 891 ,, ,,15 ,, 0 10 0 0 12 6 * This sample was procured at the railway terminus in the course of delivery to the consignee. 75 VI.—LEGISLATION. During the year, the following Public Acts of health interest to the Metropolis were added to the Statutes : — 61 & 62 Vict., chap. 16.—An Act to provide for the protection of dangerous places on Canals in the County of London. (Canals Protection (London) Act, 1893.) 61 & 62 Vict., chap. 49.—An Act to amend the law with respect to Vaccination. {Vaccination Act, 1898.) Canals Protection (London) Act, 1898.—The principal sections in this Act are 1, 2, 3, and 8, and they explain the scope of the measure. 1.—If in the opinion of any local authority any part of a canal within the jurisdiction of that local authority, or the bank or towing.path thereof is so insufficiently protected at any place where it abuts upon any public highway existing at the time of the passing of this Act as to involve danger to human life, such local authority may by notice in writing require the canal company to erect and maintain such fences, gates, turnstiles, or rails on any part of the bank or towing.path, or on adjacent property of the canal company, as may in the opinion of the local authority be required to obviate such danger. Provided that no fences, gates, turnstiles, or rails shall be required to be erected which would be between the waterway of the canal and the towing.path thereof, or which would otherwise interfere with the free passage of traffic along the canal or towing.path. 2.—If the canal company refuse to comply with any notice under this Act, or fail from one month from receipt of any such notice to comply therewith, it shall be lawful for a court of summary jurisdiction by order on complaint by the local authority to determine, after due inquiry, whether any such danger exists, and whether the works required by any such notice are necessary, and such as the canal company may reasonably be required to carry out, and whether the whole or any such works shall be carried out, and to limit, a time within which any works shall be executed, and to determine whether the costs of any such works and the future maiutenance thereof shall be borne by the local authority or the canal company or in what proportions between them. 3.—If any such order be not complied with by the canal company within the time so limited, the local authority may execute the works necessary tor compliance with such order, and may recover the costs thereof from the canal company, so far as payable by them. * * * * 8.—In this Act— "Canal company" means any company or person, in possession of a canal or any part thereof. " Local authority " means and includes the London County Council, a Vestry or District Board of Works under the Metropolis Management Acts, the Mayor, Commonalty, and citizens of the City of London, or the Woolwich Local Board of Health, as the case may be. 76 Vaccination Act, 1898.—This Act is of such great importance that it is desirable to quote it fully. The first eight sections practically contain the measure and run as follows :— 1.— (1.) The period within which the parent, or other person having the custody of a child shall cause the child to be vaccinated shall be six months from the birth of the child, instead of the period of three months mentioned in section sixteen of the Vaccination Act of 1867, and so much of that section as requires the child to be taken to a public vaccinator to be vaccinated shall be repealed. (2.) The public vaccinator of the district shall, if the parent or other person having the custody of a child so requires, visit the home of the child for the purpose of vaccinating the child. (3.) If a child is not vaccinated within four months after its birth, the public vaccinator of the district, after at least twenty.four hours notice to the parent, shall visit the home of the child, and shall offer to vaccinate the child with glycerinated calf lymph, or such other lymph as may be issued by the Local Government Board. (4.) The public vaccinator shall not vaccinate a child, if, in his opinion, the condition of the house in which it resides is such, or there is or has been such a recent prevalence of infectious disease in the district, that it cannot safely be vaccinated, and in that case shall give a certificate under section eighteen of the Vaccination Act of 1867, of postponement of vaccination, and shall forthwith give notice of any such certificate to the Medical Officer of Health for the district. (5.) Notwithstanding any regulation of any lying.in hospital or infirmary, or other similar institution, the parent of any child born in any institution shall not be compelled under such regulation or otherwise to cause or permit the child to be vaccinated at any time earlier than the. expiration of six months from its birth. 2.— (1.) No parent or other person shall be liable to any penalty under section twenty.nine or section thirty.one of the Vaccination Act of 1867, if within four months from the birth of the child he satisfies two justices, or a stipendiary or metropolitan police magistrate, in petty sessions, that he conscientiously believes that vaccination would be prejudicial to the health of the child, and within seven days thereafter delivers to the Vaccination Officer for the district a certificate by such justices or magistrate of such conscientious objection. (2.) This section shall come into operation on the passing of this Act, but in its application to a child born before the passing of this Act there shall be substituted for the period of four months from the birth of the child the period of four months from the passing of this Act. 3.—An order under section thirty.one of the Vaccination Act of 1867, directing that a child be vaccinated, shall not be made on any person who has previously been convicted of non.compliance with a similar order relating to the same child. 77 4.—No proceedings under section thirty.one of the Vaccination Act of 1867 shall be taken against any parent or person who has been convicted under section twenty.nine of the said Act on account of the same child, until it has reached the age of four years. 5.—Persons committed to prison on account of non.compliance with any order or non.payment of fines or costs under the Vaccination Acts shall be treated in the same way as first.class misdemeanants. 6.—The Local Government Board may make rules and regulations with respect to the duties and remuneration of public vaccinators, whether under contracts made before or after the passing of this Act. 7.—The Local Government Board may by order, if in their opinion it is expedient by reason of serious risk of outbreak of small.pox or of other exceptional circumstances, require the Guardians of any Poor Law Union to provide vaccination stations for the vaccination of children with glycerinated calf lymph or such other lymph as may be issued by the Local Government Board, and modify as respects the area to which the order applies, and during the period for which it is in force, the provisions of this Act requiring the public vaccinator to visit the home of the child, otherwise than on request of the parent. 8.—The clerk of any sanitary authority which shall maintain a hospital for the treatment of small.pox patients, shall keep a list of the names, addresses, ages, and condition as to vaccination of all small.pox patients treated in the hospital, such entries to be made on admission, and shall at all reasonable times allow searches to be made therein, and upon demand give a copy under his hand or under that of his deputy, of every entry of the same on payment of a fee of sixpence for each search, and threepence for each copy. I have the honour to be, Your obedient Servant, JOHN F. J. SYKES, Medical Officer of Health. Table 1. 78 ST. PANCRAS SANITARY DISTRICT. Table showing the Population, Inhabited Houses, Marriages, Births and Deaths for the year 1898 and 10 years preceding. Gross Numbers. The Year. Estimated Population. No. of Inhabited Houses. Marriages. Registered Births. Corrected No. of Deaths. Deaths of Parishioners in Public Institutions. Total All Ages. Under One Year Under Five Years. 1898 243,173 26,768 2344 6859 4658 1169 1761 1641 1897 243,008 2359 7018 4536 1185 1739 1490 1896 242,902 2226 7042 4460 1185 1729 1376 1895 236,432 2243 7099 4794 1236 1952 1420 1894 236,432 2065 6935 4283 1012 1569 1395 1893 236,432 2215 6937 5163 1221 1993 1528 1892 236,432 2140 6892 5157 1189 2011 1371 1891 236,432 24,611 2120 7188 5198 1121 1792 1520 1890 236,432 2098 6999 5151 1163 1879 1567 1889 236,451 2011 7298 4454 1059 1612 1125 1888 236,470 2139 7349 4628 1109 1874 1219 Average of 10 years 1888 to 1897. 2161 7076 4782 1148 1815 1401 Notes. 1. Population at Census 1896, 240,764. 2. Average number of persons in each house in 1896, 8.6. 3. Area of District in acres, 2,672. 79 Table 2. SI'. PANCRAS SANITARY DISTRICT. Table showing the Annual Birth and Death Rates, Death Rates of Children and Proportion of Deaths in Public Institutions in a Thousand Deaths for the year 1898 and 10 Years preceding. In the Year. Birth Rate per 1000 of Population. Corrected Death Bate per 1000 of the Population. Deaths of Children under 1 year, per 1000 of Registered Births. Deaths of Children under 1 year, per 1000 of Total Deaths. Deaths of Children under 5 years, per 1000 of Total Deaths. Deaths of Parishioners in Public Insti. tions, per 1000 of Total Deaths. 1898 28.2 191 178.2 267.9 351.5 352.3 1897 28.9 18.7 168.9 261.4 383.5 328.5 1896 29.0 18.3 168.3 265.1 387.9 308.5 1895 30.0 20.3 174.1 257.8 . 407.2 296.2 1894 29.3 18.1 146.0 236.3 366.4 304.7 1893 29 .2 21.8 176.0 236.5 386.0 296.0 1892 29.1 21.8 172.5 230.6 389.9 265.9 1891 30.4 22.0 156.0 215.7 344.8 290.5 1890 29.6 21.8 166.2 225.8 3620 304.2 1889 30.9 18.8 145.5 237.7 361.9 352.6 1888 31.1 19.6 150.9 239.6 404.7 263.4 Average of 10 years, 1888 to 1807. 29.7 20.1 162.4 250.7 379.4 301.1 80 Table 3a. Deaths Registered from all Causes during the Year 1898. Note.—The Deaths of Non.Residents occurring in Public Institutions situated in the District are exoluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the District are included. AGES 0 to 1 l to 5 5 to 15 15 to 25 25 to 35 35 to 45 to 55 55 to 65 65 to 75 75 to 85 85 A upwards ' Total Under 5 years. 1.—Specific Febrile or Zymotic Diseases. 1.—Miasmatic Diseases. Smallpox . Vaccinated ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• Unvaccinated ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• No Statement ••• ••• ••• ... ••• ••• ••• ••• ••• ••• ••• ••• ••• Measles 26 82 l 1 ••• ••• ••• ••• ••• ••• ••• 110 108 Scarlet Fever 1 31 19 ••• ••• ••• ••• ••• ••• ••• ••• 51 32 Typhus ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• Whooping Cough 39 45 1 ••• ••• ••• ••• ••• ••• ••• ••• 85 84 Diphtheria 6 59 30 2 l ••• ••• ••• ••• ••• ••• 98 65 Simple Continued & Ill.defined Fever ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• Enteric or Typhoid Fever ••• l 2 18 13 4 3 1 ••• ••• ••• 42 1 Other Miasmatic Diseases (Influenza) ••• 1 1 4 1 4 9 17 21 23 2 83 1 2.—Diarrhoeal Diseases. simple Cholera 2 ••• ••• ••• ••• ••• ••• 1 ••• ••• ••• 3 2 Diarrhoea, Dysentery 187 42 ••• ••• l 5 3 8 8 6 1 261 229 3.—Malarial Diseases. Remittent Fever ••• ••• ••• ••• ••• ••• ••• ••• ••• ... ••• ••• ... Ague ••• ••• ••• ••• ••• ••• ••• ••• ••• ... ••• ••• ••• 4.—Zoogenous Diseases. Cowpox and Effects of Vaccination ••• ••• ... ... ••• ••• ••• ••• ••• ••• ••• ••• ••• Other Diseases (e.g., Hydrophobia, Glanders, Splenic Fever) ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ... 5.— Venereal Diseases. Syphilis 21 ••• ••• ••• 1 1 ••• 1 ••• ••• ••• 24 21 Gonorrhoea, Stricture of Urethra ... ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• 6.—Septic Diseases. ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• ••• Erysipelas 3 1 ••• 1 1 1 ••• 1 1 ••• 1 10 4 Pyaemia, Septicaemia 1 ••• ••• 1 1 2 1 ••• ••• ••• ••• 6 1 Puerperal Fever ••• ••• ••• 2 4 ••• ... ••• ••• ••• ••• 6 ••• 11.—Parasitic Diseases, 1 I Thrush, and other Vegetable Parasitic Diseases 1 ... ••• ••• ••• ••• ••• ••• ••• ••• ... 1 1 Worms, Hydatids, and other Animal Parasitic Diseases ••• ... ••• ••• ••• ••• ••• ... ••• ••• ••• ••• ••• III.—Dietic Diseases. Want of Breast Milk, Starvation 1 ••• ... ••• ••• ... ••• ••• ••• ••• ••• 1 1 Scurvy ••• ••• ••• ••• ••• ••• ... ••• ••• ••• ••• ••• ... Chronic Alcoholism ... ... ••• 1 1 7 5 2 l ••• ••• 17 1 Delirium Tremers ••• ••• ••• ••• 3 2 2 1 ••• ••• ••• 8 ••• IV.—Constitutional Diseases. 1 Rheumatic Fever, Rheumatism of the Heart ••• 1 5 2 3 3 3 ••• ••• ••• ••• 17 1 Rheumatism ••• ••• ••• ••• 1 4 2 3 ••• 2 ••• 12 ••• Gout ••• ••• ••• ••• ••• ••• 2 2 1 1 1 7 ••• Rickets l 5 ••• ••• ••• ••• ••• ••• ••• ••• ••• 6 6 Cancer, Malignant Disease ••• ••• ••• 3 10 21 60 59 49 23 1 226 ••• Tabes Mesenterica 16 12 ••• ••• ••• ••• ••• ••• ••• ••• ••• 28 28 Tubercular Meningitis,Hydrocephalus 30 42 8 1 ••• 1 ••• ••• ••• ... ••• 82 72 Phthisis 4 10 10 62 101 116 108 60 10 3 ••• 484 14 Other forms of Tuberculosis, Scrofula 11 17 10 2 7 5 3 1 1 ••• ••• 57 28 Purpura, Hemorrhagic Diathesis ••• ••• 1 ••• ••• ••• ••• ••• ••• ••• ••• 1 ••• Anaemia, Chlorosis, Leucocythasmia ••• 1 ••• 1 1 1 1 4 1 ••• ••• 10 1 Glycosuria, Diabetes Mellitus ••• ••• ••• 2 3 2 2 2 2 1 ••• 14 ... Other Constitutional Diseases ••• ••• ••• ••• ••• 1 ••• ••• ••• ••• ••• 1 ••• * Chicken.pox. 81 Table 3a.—con. Deaths registered from all causes during the year 1898—continued. AGES. 0 to 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 .0 ana upward* Total. under 5 years. V.—Developmental Diseases. Premature Birth 164 ... ... ... ... ... ... ... ... ... ... 164 164 Atelectasis 10 ... ... ... ... ... ... ... ... ... ... 10 10 Congenital Malformations 5 ... ... ... ... ... ... ... ... ... ... 5 5 Old Ape 1 ... ... ... ... ... ... 5 45 23 41 214 ... vi.—Local diseases. 1.—Nervous System. Inflammation of Brain or Membranes. 34 34 7 7 1 ... ... 1 1 ... ... 85 68 Apoplexy, Softening of Brain, Hemiplegia, Brain Paralysis 1 1 2 1 6 16 38 46 59 26 8 199 2 Insanity, Genl. Paralysis of the Insane ... ... ... ... 9 11 13 10 13 12 3 71 ... Epilepsy ... ... 1 3 4 9 5 3 1 1 ... 27 ... Convulsions 62 7 1 1 ... ... ... ... ... ... ... 71 69 Laryngismus Stridulus (Spasm of Glottis) 4 2 ... ... ... ... ... ... ... ... ... 6 6 Disease of Spinal Cord, Paraplegia, Paralysis Agitans ... ... ... 1 2 6 9 6 9 4 1 38 ... Other Diseases of Nervous System ... 1 1 ... ... ... 1 ... ... ... ... 3 1 2.—Organs of Special Sense, (e.g., of Ear, Eye, Nose) ... ... ... 1 ... ... ... ... ... ... ... 1 ... 3.— Circulatory System. Pericarditis ... ... ... ... ... 2 4 1 1 ... ... 8 ... Acute Endocarditis ... ... 3 2 4 1 2 ... ... ... 1 12 ... Valvular Diseases of Heart ... ... 6 12 9 19 17 24 19 14 1 121 ••• Other Diseases of Heart 4 1 2 10 7 14 4 35 33 15 2 160 5 Aneurism ... ... ... 1 2 4 4 1 1 ... ... 13 ... Embolism, Thrombosis 1 ... ... ... ... ... ... 3 2 4 ... 10 1 Other Diseasesof Blood Vessels ... ... ... ... ... ... ... 4 1 ... ... 5 ... 4.—Respiratory System. Laryngitis ... 4 3 1 ... 1 ... ... 1 ... ... 10 4 Croup ... 1 1 ... ... ... ... ... ... ... ... 2 1 Emphysema, Asthma ... ... ... 3 ... 1 3 5 2 ... ... 14 ••• Bronchitis 131 112 2 3 8 22 46 76 95 52 9 556 243 Pneumonia 22 26 10 6 14 23 19 18 18 3 ... 159 48 Pleurisy ... ... 1 1 2 1 6 4 2 1 ... 18 ... Other Diseases of Respiratory System 4 1 ... 1 j 4 3 2 2 2 1 22 5 5.—bigeslive Systemi Dentition 25 9 ... ... ... ... ... ... ... ... ... 34 34 Sore Throat, Quinsey ... ... ... ... ... ... ... ... ... ... ... ... ... Diseases of Stomach 8 1 1 1 1 2 1 2 2 2 ... 21 9 Enteritis 116 22 1 ... ... ... ... 3 1 2 ... 145 138 Obstructive Disoasesof Intestine 4 2 3 1 2 2 8 2 5 2 ... 31 6 Peritonitis ... 1 8 11 6 4 5 2 3 ... ... 40 1 Ascites ... ... ... ... ... ... ... 1 ... ... ... 1 ... CirrhosiB of Liver ... ... ... ... 4 13 21 14 7 2 1 62 2 Jaundice and other Diseases of Liver 2 ... 2 ... ... 2 1 ... ... 1 ... 10 2 Other Diseasesof Digestive System. 8 ... ... ... ... 1 1 7 1 2 1 21 8 6.—Lymphatic System (e.g.,of Lymphatics and of Spleen) ... 1 ... ... ... ... ... ... ... ... ... 1 1 7.—Gland.like Organs of Uncertain Use {e.g., Bronchocele, Addison's Disease ... ... ... ... ... ... ... ... ... ... ... ... ... 8.—Urinary System. ... ... ... ... ... ... ... ... ... ... ... ... ... Nephritis ... ... 4 3 3 6 12 10 9 3 ... 50 ... Bright's Disease, Albuminuria ... ... ... ... 4 11 13 18 8 5 ... 59 ... Disease of Bladder or of Prostate ... ... ... ... 1 1 1 2 5 5 ... 15 ... Other Diseases of the Urinary Systern ... ... ... ... ... 1 3 ... ... 2 ... 6 ... 82 Table 3a . con. Deaths Registered from all Causes during the Year 1898— continued. AGES. 0 to 1 1 to 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and up.. wards Total under 5 year 9.—Reproductive System. A—Of Organs of Generation. Male Organs ... ... ... ... ... ... ... ... ... ... ... ... ... Female Organs ... ... ... ... ... ... ... ... ... ... ... ... ... B—Of Parturition. Abortion, Miscarriage ... ... ... ... 3 1 ... ... ... ... ... 4 ... Puerperal Convulsions ... ... ... ... 1 ... ... ... ... ... ... 1 ... Placenta prævia, Flooding ... ... ... ... 1 1 ... ... ... ... ... 2 ... Other Accidents of Child Birth ... ... ... 2 3 ... ... ... ... ... ... 5 ... 10.—Bones and Joints. Caries, Necrosis ... 1 ... 3 ... ... ... 1 ... 1 ... 6 1 Arthritis, Ostitis, Feriostitis ... ... ... ... ... ... ... 2 3 3 ... 8 ... Other Diseases of Bones and Joints ... ... ... ... ... ... ... ... 1 1 ... 2 ... 11.—Integumentary System. Carbuncle, Phlegmon ... ... ... ... 1 ... ... 1 ... ... 1 2 ... Other Diseases of Integumentary System 1 ... ... ... 1 ... ... ... ... 1 ... ... 3 1 VII.—Deaths from Violence. 1.—Accident or Negligence. Fractures and Contusions 2 3 8 5 9 12 11 12 12 7 3 84 5 Gunshot Wounds ... ... ... ... ... ... ...... ... ... ... ... ... ... Cut, Stab ... ... ... ... ... ... ... ... ... ... ... ... ... Burn, Scald ... ... 1 1 1 2 1 1 2 ... l 16 6 Poison ... ... 1 ... ... ... 2 ... ... ... ... 3 ... Drowning ... ... 2 2 1 1 3 1 ... ... ... 10 ... Suffocation 42 2 1 ... 1 ... 1 1 1 ... ... 49 44 Otherwise. 1 ... ... ... ... ... ... ... ... ... ... 1 1 2.—Homicide. Manslaughter ... ... ... ... ... ... ... ... ... ... ... ... ... Hurder 3 ... ... 1 ... ... ... ... ... ... ... 4 3 3 .—Suicide. Gunshot Wounds ... ... ... ... ... ... ... ... ... ... ... ... ... Cut, Stab ... ... ... ... 1 2 2 3 1 ... ... 9 ... Poison ... ... ... 1 2 3 3 4 ... ... ... 13 ... Drowning ... ... ... ... 1 3 ... 3 1 ... ... 8 ... Hanging ... ... ... ... 1 2 ... ... ... ... ... 3 ... Otherwise ... ... ... ... 1 ... ... ... 1 ... ... 2 ... 4.—Execution. Hanging ... ... ... ... ... ... ... ... ... ... ... ... ... VIII.—Deaths from Ill.defined and not Specified Causes. Dropsy ... ... ... ... ... ... ... ... ... ... ... ... ... Debility, Atrophy, Inanition 163 5 ... ... ... ... ... ... 1 1 ... 170 168 Mortification ... ... ... ... ... ... ... ... ... ... ... ... ... Tumour ... ... ... ...... ... ... ... ... ... ... ... ... ... Abscess l ... ... ... ... ... ... 1 ... ... ... 2 l Useeorrhage ... ... ... ... ... ... ... ... ... ... ... ... ... Sudden Death (cause not ascertained) ... ... ... ... ... ... ... ... ... ... ... ... ... Causes not Specified or Ill.defined ... ... ... ... ... 1 ... ... ... ... ... ... ... 83 Table 3 b. SUMMARY OF DISEASES. I.. —Specific Febrile, or Zymotic Diseases :— VI.—Local Diseases, con.—■ 1. Miasmatic Diseases 469 Brought forward 4120 2. Diarrhæal ,, 264 6. Diseases of Lymphatic System 1 3. Malarial „ 0 7. ,, ,, Gland.like Organs of Uncertain Use 0 4. Zoogenous ,, 0 8. ,, ,, Urinary System 130 5. Venereal ,, 24 9. ,, ,, Beproductive System— 6. Septic ,, 22 (a) Organs of Generation 0 11. —Parasitic Diseases 1 (b) Parturition 12 III —Dietic Diseases 26 ,, ,,Bones and joints 16 IV.. —Constitutional Diseases 945 ,, ,, Integumentary System a V. —Developmental Disease 393 VII.—Violence :— VI.. —Local Diseases :— 1. Accident or Negligence 163 1. Diseases of Nervous System 500 2. Homicide 4 2. Diseases of Organs of Special Sense 1 3. Suioide 35 3. Diseases of Circulatory System 329 4. Fixefiiitinn 0 4. Diseases of Bespiratory System 781 VIII.—Ill.defined and not Specified Causes 172 5. Diseases of Digestive System 365 Total 4658 Carried forward 4120 Summary of Ages. AGES. 0 to 1 lto 5 5 to 15 15 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and upwards Totals. Under 5 Years. I. Specific Febrile, or Zymotic Diseases 286 262 57 29 20 17 16 29 30 29 4 779 548 II. Parasitic Diseases 1 ... ... ... ... ... ... ... ... ... ... 1 1 III. Dietic Diseases 1 ... ... 1 4 9 7 3 1 . . . ... 26 1 IV. Constitutional Diseases 62 88 34 73 126 154 181 131 64 30 2 945 150 V. Developmental Diseases 179 227 ... ... ... ... 5 45 123 41 393 179 VI. Local Diseases 427 59 75 101 179 268 306 311 165 22 2140 654 VII. Deaths from Violence 49 10 13 10 18 25 23 25 18 7 4 202 59 VIII. Deaths from Ill.defined and not Specified Causes 164 5 ... ... ... ... ... 1 1 1 ... 172 169 Totals 1169 592 163 188 269 384 495 500 470 355 73 4658 1761 84 Table 4. ST. PANCRAS SANITARY DISTRICT. Showing the numbers of Deaths at all ages in 1898, from certain groups of Diseases, and proportion to 1,000 of Population, and to 1,000 Deaths from all causes. Divisions. Deaths. Deaths per 1,000 of Population at all ages. Deaths per 1,000 of Total Deaths at all ages. 1. Principal Zymotic Diseases 647 2.67 138.9 2. Respiratory Diseases 781 3.21 167.7 3. Tubercular Diseases 657 2.70 141.1 Notes. 1. Includes Small.pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Typhus, Enteric (or Typhoid), and Simple, Continued Fevers, and Diarrhoea and Dysentery. 2. Includes Laryngitis, Croup, Asthma, Emphysema, Bronchitis, Pneumonia, Pleurisy, and other Diseases of the Respiratory System. 3. Includes Phthisis, Scrofula, Tuberculosis, Rickets, Tabes, and Hydro. cepbalus. 85 ST. PANCRAS SANITARY DISTRICT. Table 5a. Shewing the Number of Deaths from the principal Zymotic Diseases in the 10 years 1888 to 1897, and in the year 1898. Disease. 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 Number of Deaths, Annual Average of 10 years 1888.97. Number of Deaths in 1898. Proportion of Deaths to 1,000 total Deaths in 10 years 1888.97. Proportion of Deaths to 1,000 total Deaths in 1898. Small.pox 1 .. .. .. 2 9 8 1 .. .. 2'1 .. 0.4 .. Measles 206 86 131 69 229 149 86 217 130 89 139.2 110 29.1 23.6 Scarlet Fever 52 28 27 32 67 101 44 51 37 24 46.3 51 9.7 10.9 Diphtheria and Mem. branous Croup 72 62 141 80 114 199 124 131 99 112 113.4 98 23.7 21.0 Whooping Cough 142 108 140 155 147 103 111 86 121 122 123.5 85 25.8 18.3 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 57 29 32 27 26 24 40 28 29 38 33.0 42 6.9 9.0 Simple Continued Fever 1 2 1 1 .. .. .. .. . . .. 0.5 .. 0.1 .. Diarrhoea and Dysentery 114 183 174 158 139 188 105 218 217 262 175.8 261 36.8 56.1 Totals 645 498 646 522 724 773 518 732 633 647 633.8 647 132.5 [ 138.9 86 ST. PANCRAS SANITARY DISTRICT. Table 5b. Shewing the Number of Deaths from the Notifiable Infections Diseases in the 10 years 1888 to 1897, and in the year 1898. Diseases, 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 Number of DeatbB, Annua] Average of 10 years 1818.97. Number of Deaths in 1898. Proportion of Deaths to 10C0 total Deaths is 10 years 1868.97. Proportion of Deaths to 1000 total Deaths in 1898. Small.pox 1 • • • • • • 2 9 8 1 • • • • 2.1 • • 0.4 • • — Scarlet Fever 52 28 27 32 67 101 44 51 37 24 46.3 51 9.7 10.9 —Diphtheria 72 62 141 80 114 187 117 125 94 109 113.4 95 23.7 20.4 —Membranous Croup 12 7 6 5 3 3 0.6 Typhus Fever • • • • • • • • • • • • • • • • • • •• • • . • • • • —Enteric Fever 57 29 32 27 26 24 40 28 29 38 33.0 42 6.9 9.0 Fever, Simple &Continued 1 2 1 1 .. . • • • • • • • • 0.5 • • 0.1 • • Relapsing Fever • • •• • • • • • • • • • • • • • • • • • • • • • • • • Puerperal Fever 13 6 14 7 12 12 7 12 5 6 9.4 6 2.0 1.3 Cholera 4 1 2 5 • • 2 • • • • • • 2 1.6 3 0.3 0 6 Erysipelas 21 11 22 12 9 36 15 11 13 13 16.3 10 3.4 2.2 Totals 221 139 239 164 230 333 238 234 183 195 222.6 210 46.5 45.0 87 Table 6. St. Pancras District and Sub.Districts. Table of Population, Births, and Deaths from all Causes, classified according to ages and localities, occurring during the 52 Weeks ended Saturday December 31st, 1898. [public institutions. Non.Parishioners in Public In. stitutions within the District are excluded. Parishioners in Public Institutions without the District are included. Parishioners in Public Institutions, whether within or without the District, are classified in the respective Sub.Districts of their previous residence. Regent's Park. Tottenham Court. Gray's Inn Lane. Somers Town. Camden Town. Kentish Town. No Address. Totals St. Pancras. Population. Census, 1881, at all ages 39115 27729 30247 34369 17311 87487 .. 236258 „ „ under 5 4600 2905 3448 4513 2122 11803 .. 29391 ,, ,, 5 and upwards 34515 24824 26799 29856 15189 75684 .. 206867 Census, 1891, at all ages 36590 26321 27455 32829 15419 95765 .. 234379 ,, ,, under 5 3922 2431 2909 4251 1802 11893 .. 27208 ,, „ 5 and upwards . 32668 23890 2450 28578 13617 83872 .. 207171 Census, 1896, at all ages 37341 26757 29426 32161 16669 98410 .. 240764 Re.distributed, Public Institutions in. eluded 38192 27023 29991 32815 14910 100242 .. 243173 Births. Number Registered See Table 10 B Birth.rate Deaths. From all causes at subjoined Ages : Under 1 year 172 138 163 179 62 448 7 1169 1 and under 5 54 68 60 121 31 246 12 592 5 and under 10 16 14 16 18 5 46 1 116 10 and under 15 8 4 5 8 1 20 1 47 15 and under 25 20 20 29 27 10 75 7 188 25 and under 65 229 215 226 248 91 548 91 1648 65 and upwards 110 82 89 114 50 334 119 898 Total under 5 226 206 223 300 93 694 19 1761 „ 5 and upwards 383 335 365 415 157 1023 219 2897 „ Deaths at all Ages 609 541 588 715 250 171 7 238 465S Death.rate See Table 10 B 83 Infectious Diseases.—Table 7A.—Notifications. St. Pancras District and Sub.Districts. Table of cases of Infectious Sickness Certified Notifications, classified according to diseases, ages, and localities, occurring during the 52 Weeks ended Saturday, December 31 st, 1898. 'PUBLIC INSTITUTIONS. Non.Parishioners in Public Institu tions within the District are excluded. Parishioners in Public Institutions without the District are included. Parishioners in Public Institutions, whether within or without the District, are classified in the respective Districts of their previous residence. AGES. Regent's Park. Tottenham Court. Gray's Inn Lank. Somers Town. Camden Town. Kentish Town No Address. Totals St. Pancras. Totals St. Pancras, All Ages. Notifiable Infectious Diseases. 1. Variola, Smallpox Under 5 •• •• •• •• •• •• •• •• 2 5 upwards •• •• •• 2 •• •• •• 2 2 Scarlatina, Scarlet Fever Under 5 38 20 28 50 22 116 •• 274 97 5 upwards 116 45 67 94 51 323 •• 696 3. Diphtheriaj Under 5 17 13 21 21 9 87 •• 168 473 5 upwards 27 26 54 48 18 132 •• 305 4. Merr.branous Croup Under 5 1 •• 2 1 •• 4 •• 8 132 5 upwards •• •• 1 •• •• 4 •• 5 5. Typhus Fever Under 5 1 •• •• •• •• •• •• •• •• 5 upwards 32 20 23 26 8 100 •• 209 6. Enteric or Typhoid Fever Under 5 1 •• 1 1 2 3 •• 8 217 5 upwards 32 20 23 26 8 100 •• 209 7. Fever, Simple and Continued Under 5 •• •• •• •• •• •• •• •• 2 5 upwards •• •• •• •• •• 2 •• 2 8. Relapsing FeverJ Under 5 •• •• •• •• •• •• •• •• •• 5 upwards •• •• •• •• •• •• •• •• 9. Puerperal Fever Under 5 •• •• •• •• •• •• •• •• 17 5 upwards 1 2 3 4 1 6 •• 17 10. Cholera Under 5 •• •• •• •• •• 3 •• 3 4 5 upwards •• •• •• •• •• 1 •• 1 11. Erysipelas Under 5 2 •• 4 2 3 3 •• 14 324 5 upwards 31 28 67 31 39 114 •• 310 Totals Under 5 59 33 56 75 36 216 •• 475 2022 5 upwards 207 121 215 205 117 682 •• 1547 All ages 266 154 271 280 153 898 •• 2022 89 Infectious Diseases.—Table 7 B.—Ambulance Removals. St. Pancras District and Sub.Districts. Table of cases of Infectious Sickness Ambulance Removals, classified according to diseases, ages, and localities, occurring during the 52 Weeks ended Saturday, December 31st, 1898. PUBLIC INSTITUTIONS. Non.Parishioners in Public Institutions within the District are excluded. Parishioners in Public Institutions i without the District are included. Parishioners in Public Institutions, whether within or without the District, are classified in the respective Sub.Districts of their previous residence. AGES. Regent's Park. Tottenham Court. Gray's Inn Lane. Somers Town. Camden Town. Kentish Town. No Address. Totals St. Pancras. Totals St. Pancras. All Ages. Notifiable Infectious Diseases. 1. Variola, Smallpox Under 5 • • •• •• •• •• •• •• •• 2 5 upwards •• •• •• 2 •• •• •• 2 2. Scarlatina, Scarlet Fever Under 5 34 18 22 49 21 95 •• 239 814 5 upwards 101 33 54 81 42 264 •• 575 3. Diphtheria Under 5 16 9 17 16 8 70 •• 136 372 5 upwards 22 23 42 45 12 92 •• 236 4. Membranous Croup Under 5 •• •• •• 1 • • 1 •• 2 3 5 upwards •• •• • • •• • • 1 •• 1 5. Typhus Fever Under 5 •• •• •• •• •• •• •• •• • • 5 upwards •• •• • • •• •• •• •• .. 6. Enteric or Typhoid Fever Under 5 •• •• 1 •• 1 1 •• 3 145 5 upwards 18 12 16 20 8 68 •• 142 7. Fever, Simple and Continued Under 5 •• •• •• •• •• •• •• •• 1 5 upwards •• •• • • •• •• 1 •• 1 8. Relapsing Fever Under 5 •• •• •• •• •• •• •• •• •• . 5 upwards •• •• •• •• •• •• •• •• 9. Puerperal Fever Under 5 •• •• •• •• •• •• •• •• 5 5 upwards •• 2 1 •• •• •• •• 5 10. Cholera Under 5 •• •• •• •• •• •• •• •• 1 . 5 upwards •• •• •• •• •• 1 •• 1 11. Erysipelas Under 5 •• •• •• 1 •• •• •• 1 27 5 upwards 3 5 3 s 6 4 •• 26 Totals Under 5 50 27 40 67 30 167 • • 381 1370 5 upwards 144 75 116 155 68 431 • • 989 All Ages 194 102 156 222 98 598 •• 1370 90 Infectious Diseases.—Table 7 C.—Deaths. St. Pancras District and Sub.Districts. Table of cases of Infectious Sickness Certified Deaths, classified according to diseases, ages, and localities, occurring during the 52 Weeks ended Saturday, December 31st, 1898. PUBLIC INSTITUTIONS. Non.Parishioners in Public Institutions within the District are excluded. Parishioners in Public Institutions without the District are included. Parishioners in Public Institutions, whether within or without the District, areclassified intherespec. tive Districts of their previous residence. AGES. Regent's Park. Tottenham Court. Gray's Inn Lane. Somers Town. Camden Town. Kentish Town. No Address. Totals St. Pancras. Totals St. Pancras, All Ages. Notifiable Infectious Diseases. I. Variola, Smallpox Under 5 •• •• •• •• •• •• •• •• •• 5 upwards •• •• •• •• •• •• •• •• a. Scarlatina, Scarlet Fever Under 5 5 2 •• 6 •• 19 •• 32 51 5 upwards 3 2 2 5 •• 7 •• 19 3. Diphtheria Under 5 2 7 8 7 4 35 •• 63 95 5 upwards 1 3 6 4 •• 18 •• 32 4. Membranous Croup Under 5 1 •• •• •• •• 1 •• 2 3 5 upwards •• •• •• •• •• 1 •• 1 5. Typhus Fever Under 5 •• •• •• •• •• •• •• •• •• 5 upwards •• •• •• •• •• •• •• •• 6. Enteric or Typhoid Fever Under 5 •• •• •• •• •• 1 •• 1 42 5 upwards 9 1 6 6 2 17 •• 41 7. Fever, Simple and Continued Under 5 •• •• •• •• •• •• •• •• •• 5 upwards • • •• •• •• •• •• •• •• 8. Relapsing Fever Under 5 • • •• •• •• •• •• •• •• •• 5 upwards • • •• •• •• •• •• •• •• 9. Puerperal Fever Under 5 5 upwards •• •• •• •• •• 3 •• 6 6 10, Cholera Under 5 •• •• •• •• •• 2 •• 2 3 5 upwards •• •• •• •• •• 1 •• 1 11. Erysipelas Under 5 •• •• 2 1 •• 1 •• 4 10 5 upwards •• 2 1 2 •• 1 •• 6 Totals Under 5 8 9 10 14 4 59 •• 104 210 5 upwards 15 8 15 18 2 48 •• 106 All ages 23 17 25 32 6 107 •• 210 91 Table 8. St. Pancras District and Sub.Districts. Table o f Deaths from certain Causes, classified according to diseases, ages, and localities, occurring during the 52 Weeks ended Saturday, December 31st, 1898. PUBLIC INSTITUTIONS. Non.Parishioners in Public Institutions within the District are excluded. Parishioners in Public Institutions without the District are included. Parishioners in Public Institutions, whether within or without the District, are classified in the respective Sub.Districts of their previous residence. AGES. Regents' Park. Tottenham Court. Gray's Inn Lane. Somers Town. Camden Town. Kentish Town. No Address. Totals St. Pancras. Totals St. Pancras, All Ages. Diseases. 1. Notifiable Infectious Diseases Under 5 8 9 10 14 4 59 • • 104 210 5 upwards 15 8 15 18 2 48 •• 106 2. Measles Under 5 11 12 17 21 4 39 4 108 110 5 upwards •• 1 •• •• •• 1 •• 2 3. Whooping Cough Under 5 9 9 6 18 5 34 3 84 85 5 upwards •• •• •• •• 1 •• •• 1 4. Diarrhoea and Dysentery Under 5 31 18 21 56 15 88 •• 229 261 5 upwards 1 5 6 7 1 5 7 31 5. Rheumatic Fever Under 5 •• •• •• •• •• 1 • • 1 17 5 upwards 3 2 1 2 3 5 • • 16 6. [Ague 0] Influenza Under 5 •• •• •• •• •• •• •• •• 82 5 upwards l6 6 3 6 2 17 32 82 7. Phthisis| Under 5 2 2 1 1 1 7 •• •4 484 5 upwards 56 78 68 63 21 157 27 470 8 . Bronchitis, Pneumonia & Pleurisy Under 5 33 36 35 63 11 113 •• 291 733 5 upwards 65 57 60 79 18 141 22 442 9. Heart Disease Under 5 •• 2 •• •• •• 3 •• 5 | 281 5 upwards 39 29 33 24 17 109 15 276 10. Injuries Under 5 6 9 10 16 1 17 •• 59 202 5 upwards 12 15 22 26 7 56 5 143 11. All other Diseases Under 5 126 109 123 111 52 333 12 866 2193 5 upwards 176 134 157 180 85 484 111 1327 Totals Under 5 226 206 223 300 93 694 19 1761 4658 5 upwards 383 335 365 415 157 1023 219 2897 All ages 509 541 588 715 250 1717 238 4658 92 Table 9 A. ST. PANCRAS SUB.DISTRICTS. TABLE shewing the Number of Deaths from the principal Zymotic and certain year 1898. Deaths not referable to any certain Sub.District being re.distributed proportionately to the population. Sub.Districts. Population. Variola, Small.pox. Scarlatina, Scarlet Fever Diphtheria and Membranous Croup. Typhus Fever. Enteric or Typhoid Fever. Fever, Wimple and Continued. Measles. Whooping Cough. Diarrhoea & Dysentery. Total Zymotic Diseases. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Injuries. All other Diseases. Total Deaths from all Causes at all ages. Regent's Park 38,192 • • 8 4 • • 9 • • 12 9 33 75 3 • • 62 101 41 19 345 646 Tottenham Court 27,023 • • 4 10 • • 1 • • 13 10 21 62 2 • • 83 96 33 24 267 567 Gray's Inn Lane 29,991 • • 2 14 • • 6 • • 17 7 28 74 1 • • 73 98 35 33 304 618 Somers Town 32, 815 • • 11 11 • • 6 • • 22 18 64 132 2 • • 68 145 36 43 321 747 Camden Town 14,910 • • • • 4 • • 2 • • 4 6 16 32 3 • • 23 30 18 8 149 263 Kentish Town 100,242 • • 26 55 • • 18 • • 42 35 96 272 6 • • l75 263 118 75 908 1817 St. Pancras 243,173 • • 51 98 • • 42 • • 110 85 261 647 17 • • 484 733 281 202 2294 4658 London 4,504,766 1 583 1772 4 585 9 3075 2160 4376 12,565 367 • • 7966 13,500 • • 3514 • • 83,936 93 Table 9 B. ST. PANCRAS SUB.DISTRICTS. TABLE showing the proportion of Deaths from the principal Zymotic and certain other Diseases to 1000 Population in the Sub.Districts for the Year 1898. Sub.Districts. Population, 1998. Variola, Small.pox. Scarlatina, Scarlet Fever. Diphtheria and Membranous Croup. Typhus Fever. Enteric or Typhoid Fever Fever, Simple and Continued. Measles. Whooping Cough. Diarrhoea & Dysentery. Total Zymotic Diseases. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Injuries. All other Diseases. Total Deaths from all Causes at all Ages. Rgent's Park 38,192 — 0.21 0.11 — 0.23 — 0.31 0.23 0.86 1.95 0.08 — 1.62 2.64 1.07 0.50 9.04 16.9 Tottenham Court 27,023 — 0.15 0.37 — 0.04 — 0.48 0.37 0.89 2.29 0.07 — 3.07 3.55 1.22 0.89 9.88 21.0 Gray's Inn Lane 29,991 — 0.07 0.47 — 0.20 — 0.57 0.23 0.93 2.47 0.03 — 2.43 3.27 1.17 1.10 10.13 20.6 Somers Town 32,815 — 0.33 0.33 — 0.18 — 0.67 0.55 1.95 4.02 0.06 — 2.07 4.48 1.10 1.31 9.79 22.8 Camden Town 14,910 — — 0.27 — 0.13 — 0.27 0.40 1.07 2.15 0.20 — 1.54 2.01 1.21 0.54 9.99 17.6 Kentish Town 100,242 — 0.26 0.55 — 0.18 — 0.42 0.35 0.96 2.71 0.06 — 1.75 2.62 1.18 0.75 9.06 18.1 St. Pancras 243,173 — 0.21 0.40 — 0.17 — 0.45 0.35 1.07 2.67 0.07 — 1.99 3.01 1.16 0.83 9.44 19.1 London 4,504,766 — 0.13 0.39 0.0009 0.13 0.0019 0.68 0.48 0.97 2.78 0.08 — 1.77 3.00 — 0.78 — 18.7 94 Table 10 A. ST. PANCRAS SUB.DISTRICTS, TABLE shewing the Number of Deaths from the Notifiable Infectious Diseases, the number of Deaths at various Ages, and the number of Births in the Sub.Districts for the year 1898. Births and Deaths not referable to any certain Sub.District being re.distributed proportionately to the population. Sub.Districts. Population, 1898. Variola, Small.pox. Scarlatina, Scarlet Fever. Diphtheria. Membranous Croup. Typhus Fever. Enteric or Typhoid Fever. Fever, Simple and Continued. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. Total Notifiable Infectious Diseases. Total Deaths under 1 Year of Age. Total Deaths under 5 Years of Age. Total Deaths under 10 Years of Age. Deaths at 10 and under ! 65 Years pf Age. Deaths at 65 Years of Age and upwards. Total Deaths at all Ages and from all Causes. Registered Births. Per 1000 Births Deaths under 1 Year. Regent's Park. . 38,192 — 8 3 1 — 9 — — 2 — — 23 173 229 245 272 129 646 971 178.2 Tottenham Court 27,023 — 4 10 — — 1 — — — — 2 17 139 208 222 250 95 567 612 227.2 Gray's Inn Lane 29,991 — 2 14 — — 6 — — — — 3 25 164 226 242 272 104 618 852 192.6 Somers Town 32,815 — 11 11 — — 6 — — 1 — 3 32 180 303 321 296 130 747 979 183.9 Camden Town 14,910 — — 4 — — 2 — — — — — 6 62 93 98 108 57 263 439 141.2 Kentish Town 100,242 — 26 53 2 — 18 — — 3 3 2 107 451 702 749 685 383 1817 3006 150.1 St. Pancras 243,173 — 51 95 3 — 42 — — 6 3 10 210 1169 1761 1877 1883 898 4658 6859 170.5 London 4,504,766 1 583 1772 4 585 9 — 184 130 165 343322140 34184 — — — — 132432 167.2 95 Table 10 B. ST. PANCRAS SUB-DISTRICTS. TABLE showing the proportion, of Deaths from the Notifiable Infectious Diseases, and the proportion of Deaths at various Ages, and the proportion of Births to 1000 Population in the Sub-Districts for the Year 1898. Sub-Districts. Population, 1898. Variola, Small-pox. Scarlatina, Scarlet Fever. Diphtheria. Membranous Croup. Typhus Fever. Enteric or Typhoid Fever. Fever, Simple and Contined. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. Total Notifiable Infectious Diseases. Total Deaths under 1 Year of Age. Total Deaths under 5 Years of Age. Total Deaths under 10 Years of Age. Deaths at 10 and under 65 years of Age. Deaths at 65 years of Age and Upwards. Total Deaths at all Ages and from all Causes. Registered Rirths. Regent's Park 38,192 — 0.21 0.08 0.03 — 0.23 — — 0.05 — — 0.60 4.5 6.0 6.4 7.1 3.4 16.9 25.4 Tottenham Court 27,023 — 0.15 0.37 — — 1.04 — — — — 0.07 0.63 5.1 7.7 8.2 9.3 3.5 21.0 22.6 Gray's Inn Lane 29,991 — 0.07 0.47 — — 0.20 — — — — 0.10 0.83 5.5 7.5 8.1 9.1 3.4 20.6 28.5 Somers Town 32,815 — 0.33 0.33 — — 0.18 — — 0.03 — 0.09 0.97 5.5 9.2 9.8 9.0 4.0 22.8 29.8 Camden Town 14,910 — 0.27 — — 0.3 — — — — — 0.40 4.2 6.2 6.6 7.2 3.8 17.6 29.4 Kentish Town 100,242 — 0.26 0.53 0.02 — 0.18 — — 0.03 0.03 0.02 1.07 4.5 7.0 7.5 6.8 3.8 18.1 30.0 St. Pancras 243,173 — 0.21 0.39 0.01 — 0.17 — — 0.02 0.01 0.04 0.86 4.8 7.2 7.7 7.7 3.7 19.1 28.2 London 4,504,766 — 0.13 0.39 0.0009 0.13 0.0019 — 0.04 0.03 0.04 0.76 4.9 7.6 — — — — 29.5 Table 11 A. 96 Sanitary Work Accomplished (A, Clerical). From 2nd January to 81st December, 1898, inclusive. No. of Complaints received 2380 No. of Dust Complaints received: 2761 No. of Certificates of Dangerous Infectious Diseases received 2216 No. of Notices of Voluntary Drain.work received 404 No. of Letters, etc., despatched 3600 No. of Sets of Advisory Notices as to Infectious Diseases forwarded 1708 No. of Cautionary Notices for Sanitary Amendments issued 1984 No. of Statutory Notices of intention to proceed served 497 No. of Warning Notices of intention to summons sent 102 No. of Summonses 85 No. of Meetings of Health Committee and Sub.Committees held 75 Sanitary Work Accomplished (B, Inspectorial) From 2nd January to 31st December, 1898, inclusive. Inspections. Re.inspections after Notice. Total. Dwelling Houses or parts 8232 17665 25897 Underground Dwellings 4 10 14 Tenement Lodging Houses (152 registered) 33 228 261 Common Lodging Houses (31 registered) — — — Canal Boat Dwellings 62 — 62 Day Schools 91 75 166 Factories (94 on register) 419 660 1079 Workshops (937 on register) 1521 630 2151 Bakehouses (198 on register) 486 527 1013 Laundries (116 on register) 474 234 708 Dairies and Milkshops 2 — 2 Cowsheds (20 licensed) 96 — 96 Slaughterhouses (26 licensed) 174 1 175 Markets (38 on list) 5978 5 5983 Mews and Stable Yards (170 on list) 2148 229 2877 Totals 19720 20264 89984 97 Table 11.—Con. Sanitary Work Accomplished (B, Inspectorial.)—Continued. Houses, Premises, &c., cleansed, white.washed, and repaired 625 Rooms and contents Disinfected after Infectious Disease 1239 Water Supply, for domestic purposes provided 7 ,, ,, cisterns cleansed, repaired, and covered 58 ,, ,, overflow pipes connected with drains, &c., abolished ... ,, ,, new Cisterns provided 2 „ „ draw-off taps provided on supply pipes 23 ,, „ re.instated after being cut off 41 Water.closets repaired, cleansed 875 ,, ,, basins supplied with water 181 ,, ,, ventilated 62 ,, ,, new provided 136 House Drains tested—(See page 58) 2630 ,, „ repaired 240 trapped 444 ,, ,, ventilated 622 „ ,, disconnected from sewer 435 ,, ,, re-constructed 218 „ ,, new provided 546 „ ,, cesspools abolished 6 Yard Paving repaired 151 ,, ,, new provided 87 Dust.bins repaired, covered 30 ,, ,, new provided 205 Manure.bins provided 20 Eemoval of overcrowding 52 ,, ,, refuse, dung, stagnant water 109 ,, ,, animals improperly kept 14 Underground Rooms discontinued as dwellings 10 Smoke Nuisances suppressed 5 Steam whistles and steam trumpets discontinued 3 98 Table 11—Con. House.to.house Inspections were made in the following Streets and Places :— Name of Street. No. of Houses. No. of Rooms. No. of Dwellings and Families. No. of Persons. No. of Notices Served. Remarks. Occupied. Un- occupied. Occupied. Unoccupied. Adults. Children. Bennett Street 6 — 48 — 30 52 35 4 Not completed. Cleveland Street 6 — 45 — 20 43 25 8 99 9* Crawley Mews 2 — 3 — 1 3 5 2 99 99 Euston Street 6 — 44 — 21 41 5 — 99 99 Hampden Street 20 — 198 — 83 264 164 21 99 99 Preston Street 4 — 23 1 20 35 3 5 4 99 99 St. George's Road 8 — 72 — 22 65 23 7 >9 99 Windmill Street 21 — 148 — 60 141 58 4 99 99 Winscombe Street 1 — 6 — 2 4 11 1 99 99 Wybert Street 6 — 19 2 7 16 21 2 99 99 York Passage 4 — 13 1 7 16 11 2 Completed. 99 List I. SAINT PANCRAS, LONDON. Houses constructed in separate and self-contained Dwellings. Division and Sub-Division. Name and Situation of House. Name and Address of Owner. Opened. Total Number of Rooms. Dwellings of Total Number of Dwellings. Minimum and Maximum Weekly Rentals. 1 Room. 2 Rooms. 3 Rooms. 4 Rooms. 5 or more Rooms. N. 1 Chuhchill House, 11, Churchill Road (1 house) Mr. Atchley, 5, Wyndham Crescent • • 32 • • • • • • 8 • • 8 8s. 6d. to 9s. N.l Somerset House, 31, Dartmouth Park Hill (1 house) Mrs. Crocker, No. 3, Somerset House • • 31 • • • • l 7 • • 8 7s. to 8s. 6d. E. 1 Artizans' Dwellings, Great College Street and Rochester Place (8 houses) The Leasehold Investment Co., Ltd., 37, Norfolk Street, Strand; Richard Stone,Esq., Man. Director 1885 306 • • 99 36 • • • • 135 6s. 8d. to 1 Is. 8d. E. 1 Clarence Buildings, Great College Street and Kentish Town Road (18 houses) Mr. Toye, at the Buildings 1886 501 • • 109 81 10 • • 200 7s. 6d. to 10s. 6d. E. 4 Pancras Square, Pancras Road (2 staircases) Metropolitan Association of Industrial Dwellings, 8, Finsbury Circus, E.C.; Chas. Gatcliff, Esq., Sec. 1847 285 • • 18 83 • • • • 101 5s. 6d. to 9s. 3d. E. 5 Ossulston Houses, Ossulston Street (6 houses) Hampden House, Limited 1884 210 • • • • 70 • • 70 8s. to 9s. 100 Houses constructed in separate and self-eontained Dwellings—(Continued.) Division and Sub-Division. Name and Situation of House. Name and Address of Owner. Opened. Total Number of Rooms. Dwellings of Total Number of Dwellings, Minimum and Maximum Weekly Rentals. 1 Room. 2 Rooms. 3 Rooms. 4 Rooms. 5 or more i Rooms. E. 5 Stanley Buildings, Pancras Road, at King's Cross (5 staircases) Improved Industrial Dwellings Co., 37, Finsbury Square, E.C.; Jas. Moore, Esq., Sec. 1865 354 • • • • 50 51 101 6s. to 8's. E. 5 Polygon Buildings, Clarendon Square (12 houses) Midland Railway Co. 1894 576 96 96 96 • • • • 288 2s. 6d. to 7e. 6d. E. 5 166, Ossulston Street (1 staircase) Mrs. Wark, The Old Hall, Highgate, N. 1880 24 • • 12 • • • • • • 12 6s. 6d. to 7s. WA 58, Crogsland Road (1 staircase) Mr. G. J. Smith, 89, Chalk Farm Road. About 20 years 10 • • 2 2 • • • • 4 4s. 6d. to 6s. W. 5 Hampstead House, William Street (1 house) Henry Hooke, Esq., 93, Hampstead Road, N.W. 1897 35 • • • • 5 5 • • 10 12s. to 15s. 8.1. Derby Buildings, Britannia Street and Wicklow Street (4 staircases) Improved Industrial Dwellings Co., 33, Finsbury Square 1867 494 • • • • 70 71 • • 141 5s. 9d. to 8s. 8.1. Stanley Houses, St. Chad's Place (1 house) Mr. L. H. Ball, 221, Goswell Road 1889 32 • • 13 2 • • • • 15 5s. 6d. to 7s. 8.1. Garfield House, Leeke Street (1 house) Messrs. Foster, 79 to 82, Fore Street, E.C. 1887 16 • • 2 1 1 1 5 3s. 6d. to 6s, 6d. 101 Houses constructed in separate and self-contained Dwellings—(Continued.) Division and Sub-Division. Name and Situation of House. Name and Address of Owner. Opened. Total Number of Rooms. Dwellings of Total Number of Dwellings- Minimum and Maximum Weekly Rentals. 1 Room. 2 Rooms. 3 Rooms. 4 Rooms. 5 or more Rooms. S.I. Whidbourne Buildings, Whidbourne Street (4 staircases) East End Dwellings Co.; Thos. Wilkinson, Sec., 24, Old Square, Lincoln's Inn, W.C. 1892 260 55 59 29 143 2s. 9d. Ferris House, Whidbourne Street (I house) " " " • • 12 10 1 • • • • • • 11 2s. 6d. to 15s. Midhope Buildings, Midhope Street (4 staircases) " " " • • 231 25 104 • • 2 • • 131 2s. to 6s. 6s. and 12s. Charlwood House, Midhope Street (1 staircase) " " " 1893 104 • • • • 8 10 8 26 7s. 6d. to 13e. 6d S.l. Kellet Houses, Tankerton Street (1 staircase) " " " • • 88 • • • • • • 12 8 20 10s. 6d. to 12s. Tankerton Houses, Tankerton Street (1 staircase) " " " 1891 60 • • • • 20 • • • • 20 7s. to 8s. Loxham Houses, Loxham Street (I staircase) " " " • • 40 • • • • • • 10 • • 10 9s. 6d. to 10s. 6d Lucas House, Lucas Place (1 staircase) " " " • • 36 • • • • 12 • • • • 12 8s. to 8s. 6d. 102 Houses constructed in separate and self-contained Dwellings—(Continued.) Division and Sub-Division. Name and Situation of House, Name and Address of Owner. Opened. Total Number of Rooms. Dwellings of Total Number of Dwellings. Minimum and Maximum Weekly Rentals. 1 Room. 2 Booms. 3 Rooms. 4 Rooms. 5 or more Rooms. Cromer House, Cromer Street (l staircase) East End Dwellings Co.; Thos. Wilkinson, Sec., 24, Old Square, Lincoln's Inn, W.C. 1892 78 • • • • 8 6 5 sets of 6 rooms 19 7s. 6d. to 11s. 6d 5, 7, 9 & 11, Wicklow Street (4 houses) Messrs. Nokes & Nokes, 67, Caledonian Road • • 60 4 28 • • • • • • 32 4s. to 7s. 6d. S. 3. Somerset Terrace, Duke's Road (2 staircases) Francis House, Esq., 3, Abchurch Yard, E.C. 1889 67 • • 12 9 4 • • 25 9s. to 10s. Endsleigh Terrace, Duke's Road (2 staircases) " " " • • 60 • • • • 20 • • • • 20 9s. to 18s. 89 & 91, Cromer Street (2 houses) Messrs. Nokes & Nokes, 67, Caledonian Road, N. • • 72 4 34 • • • • • • 38 3s. 6d. to Ss. 6d. S.5. Rothwell Buildings, Whitfield Street (7 staircases) W. H. Sheriff, Esq., 80, Carlton Road 1881 140 • • 70 • • • • • • 70 5s. to 68. 6d. Percy Buildings, Whitfield Street (1 house) R. Perkins, Esq., 2, CamPlace, Regent's Park 1883 24 • • 12 • • • • • • 12 5s- to 8s. 6d. 103 List II. ST. PANCRAS, LONDON. Registered Common Lodging-Houses. Situation. Authorised Number of Lodgers. Accommodation. Notes. Males. Females. Married couples (persons). North Division. 15, Litcham Street 16, " j 59 59 — — West Division. 20, Chalk Farm Road 13 13 — — 10 additional beds not required to be registered by L.C.C. East Division. 8, Kentish Town Road .. 15 15 — — 6, Clarendon Grove 6 '6 ___ 60, King's Road 38 38 — _ 69, Euston Square .. 62 62 — 174, Euston Road 40 40 — — South Division. 6, Charlotte Place 15 _ 15 _ 7, „ „ 15 — 15 3, Crescent Place 26 — 26 63, Euston Road .. 31 31 — — 310, Gray's Inn Road 50 — 15 30 322 „ „ 66 66 — — 1, Mabledon Place 31 31 — — 18, „ „ 49 49 — — 55, Tonbridge Street 29 29 — ___ 1 & 2, Whitfield Place 86\ 86 — — 3, „ „ 24 24 — 4, „ „ 34 34 — ____. 5, „ „ 28 [ 28 — — 6, „ „ 27 27 — — 7, „ „ 28/ 28 __ — 8, „ „ 6 6 — — 29, Percy Street 67 67 — — 104 List III. ST. PANCRAS, LONDON. LICENSED COW-HOUSES. Consecutive No. Situation. Name of Licensee. Registered amount of breathing space in cubic feet. No. of Cows Licensed for. North Division. 1 12, South Grove, Highgate Charles Davies 27808 34 2 8, Bassett St., Winchester Yard Thomas Davies 19880 22 3 Fitzroy Farm, Shed A Thomas Ward 22176 50 „ B 9384 „ c 9163 ,, , -D 4040 4 27, Gospel Oak Grove, Shed A P.Conrad & F. Williamson 20925 22 27, „ „ „ B 4563 5 5 279,Kentish TownRd., Y icarage Yard William Morgan Capner 11822 14 6 15, Modbury Street Evan Benjamin 12285 15 West Division. 7 4a, Little Albany Street, Shed A ,, B Edwin Jennings 9152 11 3120 4 8 96, Little Albany Street ... John Joseph Newman Nichols 36406 45 9 23, Longford Street, Shed A to Edwin Jennings 16992 12 33, ) ,, „ B 2200 2 10 50, William Street David James 14880 12 East Division. 11 58, Aldenham Street John Thomas Thorpe 6075 7 12 51, Bayham Street Mary Jones 26544 30 13 11, Hampden Street Richard Davies 19097 20 14 37, Prebend Street, Shed A | Charles Morgan 7309 9 " " B 2636 3 South Division. 15 28, Hastings Street 9048 11 105 List IV. ST. PANCRAS, LONDON. LICENSED SLAUGHTER HOUSES. Consecutive No. Situation. Name of Licensee. Remarks. North Division. 1 61,High Street,Highgate Elizabeth Attkins 2 317, Kentish Town Road James Hook 3 89, Leighton Road Lidstone, Limited 4 37, Maiden Road - Robert Arthur Elvidge West Division. 5 1, Grange Road. Walter Whitlam 6 11, Hampstead Road Edward Tomkins 7 157, High Street Lidstone, Limited 8 67, Kentish Town Road Philip Stone Small cattle only. 9 65, Osnaburgh Street George Runnicles 10 58, Park Street Lidstone, Limited 11 75, „ „ „ „ Large cattle only to be received before 8 a.m. 12 3, Prince of Wales Crescent Thomas Hersant Small cattle only. 13 10, William Street Henry Hooke 14 7½, Delancey Street Robert Joyce East Division. 15 12, Crown dale Road George Samuel Barrett Small cattle only. 16 114, Great College Street John Stone 17 3, Wolsey Mews Catherine Knight 18 166, Great College Street John Penney South Division. 19 10, Charlotte Mews Harry Lugg 20 10,10J, and 11, Hastings Stephen Colebrooke 21 Street 1, Hertford Place Charles Palmer 22 147, King's Cross Road Thomas Griffiths Small cattle only. 106 LIST V. ST. PANCRAS, LONDON. BAKEHOUSES, end of 1898. No. on Diagram. Consecutive No. Situations, Divisions, and SubDivisions. Name of Occupier. Distance of floor above or below ground level. Distance of ceiling above or below ground level. North Division. 1.—High gate. 16 1 134, Fortess Road P. Gotfries & Sons Level 8ft. 2in. above 10 2 49, Leverton Street G. E. Moir Level 8ft. 6in. „ 17 3 60, Chetwynd Road J. Wilson Level 8ft. 100 4 121, Dartmouth Park Hill John Leister 7ft. 6in. below Level. 58 5 151, ,, ,, James Hudson 6ft. 6in. „ „ 88 6 9, Retcar Street Frank Malan 7ft. 3in. „ 6in. below. 179 7 4, South Grove Horslev & Son Level and one 10 in. „ 14 7a ,, ,, ,, ,, 8ft. 6in below ground 8ft. 3in. above. 95 8 37, York Rise John A. Skinner 7ft. 6in. below 1ft. 2in. „ 2.—St. Johns Park 157 9 93, Leighton Road Not in use 8ft. below 6in. below. 135 10 99, Brecknock Road Mr. Sconce 8ft. „ Level. 158 11 68, Falkland Road Frost Bros. Sft. „ 6in. below. 136 12 47, Fortess Road E. Parker 8 ft. 6in. below Level. 48 13 7, Willow Walk, or 11, H. Elliott One 6ft. and 2ft. 3in. above. 36 13a tess Road one 2ft. below 5ft. 3in. „ 3.—Gospel Oak. 36a 13b 21, Rochford Street Not in use 2ft. 2in. below 6ft. 9in. above. 101 14 101, Allcroft Road Anton Blesser 7ft. 6in. below Level. 4 15 45, Ashdown Street Not in use Level 10ft. above. 26 16 108, Carlton Street Peter Schneider Level 7ft. 6in. „ 20 17 55, Haverstock Road Leopold Orth Level 7ft. 6in. „ 21 18 63, Highgate Road.. W. H. J. Mortimer Level 7ft. 6in. „ 49 19 141 „ „ Francis Paterson 6ft below 1ft. 6in. „ 28 20 2, Lamble Street William Griggs Level 7ft. 2in. „ 5 21 10, Lismore Circus H. Stubenhagen Level 9ft. 6in. „ 56 22 3, Mansfield Road Not in use 6ft. 6in. below 6in. „ 6 23 66, ,, ,, Joachim Peters Level 9ft. ,, 177 24 163, Queen's Crescent Richard Filby & Son 8ft. 6in. below Gin. below 54 25 167, „ Leopold Gerhard 6ft. 6in. below 1ft. 6in. above. 18 26 160, Weedington Road A. White Level 8 ft. „ 119 27 37, Wellesley Road Nicholas Hahn 7ft. 6in. below 6in. below. 107 List V.—con .BAKEHOUSES—continued. *. No. on Diagram. Consecutive No. Situations, Divisions, and SubDivisions. Name of Occupier. Distance of floor above or below ground level. Distance of ceiling above or below ground level. North Division. 4.—Grafton. 22 28 10, Dalby Street Mr. Brooker Level 7fc. 6in. above 34 29 46, Grafton Road Thomas Brown.. 2 ft. below .. 5ft. 6in. „ 102 30 265, Kentish Town Road W. J. Walkley.. 7ft. 6in. „ .. Level 11 31 321, ,, ,, James Storey .. Level 8ft. 6in. ,, 15 32 385, ,, , Unoccupied .. r. Level 8ft. 2i&. ,t 47 33 13, Warden Road Charles Steele .. 5ft. 6in. below lft. 4in. „ 46 34 70, Weedington Road Charles E. Pinn 5ft. 6in. „ 2ft. 2in. ,, 5.—Maitland Park. 39 35 29, Maiden Road Christopher Vogel 2ft. 9in. below 4ft. 9in. above 180 36 53, ,, ,, 8ft. 6in. „ lft. 3in. below 121 37 110, ,, ,, Jacob Piroth 7ft. 6in. ,, 9in. 169 38 143 ,, ,, John Granger 8ft. 6in. „ Level 38 40 160, Prince of Wales Road Philip Serf 2ft. 6in. ,, 5ft. 159 41 72, Queen's Crescent Mr. Menten 8ft. 6in. 69 42 69, Weedington Road John Sondenheimer 7ft. Level 96 43 16, Queen's Crescent Not in use 7ft. 6in. ,, 6in. above West Division. 1.— Castle. 52 44 54, Castle Road William Staudt 6ft. 5in. below Level 187 45 19, Chalk Farm Road Chappell & Sons 9ft. Level 128 46 48 ,, ,, Henry Ulmer 7ft. 9in. „ 3in. below 24 47 76, ,, ,, James Robins Level 7ft. 6in. above 25 48 36, Harmood Street J. Hahn Level 7ft. 6in. ,, 70 49 108, ,, ,, Louisa Streeton 7ft. below Level 164 50 51, Hawley Road H. Schaefer 8ft. 3in. ,, 3 in. below 103 51 81, Kentish Town Road Harry Bartlet 7ft. 6in. ,, Level 17a 51a 87, Chalk Farm Road Mr. Tucker Level .. 7ft. lOin. above List V.—con. BAKEHOUSES—continued. No. on Diagram. Consecutive No. Situations, Divisions, and SubDivisions. Name of Occupier. Distance of floor above or below ground level. Distance of ceiling above or below ground level. West Division—con. 12 52 143, Kentish Town Road Jumes Henderson Level 8ft. 6in. above 137 53 111 „ „ H. Reiff 8ft. below Level 104 54 22, Leybourne Road John Huchelheim 7ft. 6in. below yy 93 55 63, Prince of Wales Crescent W. Bishop 7ft. 5in. „ yy 2.—Chalk Farm. 64 56 211, High Street William Weston 7ft. below aft. 6in. above 53 57 237, „ F. H. Buchele 6ft. 6in. below 2ft. ,, 42 58 253, „ Frederick King 4ft. below aft. 9in. „ 29 59 20, Park Street Adolf Franz Level 7ft. „ 200 60 31, Princess Road G. H. Itter 10ft. below 1ft. 3in. „ 71 61 109, Regent's Park Road 7ft. „ Level 138 62 164, „ „ „ Edwin George Moore 8ft. „ „ 161 63 40, St. George's Road Philip Fuchs 8ft. „ lft. below 199 64 79, Gloucester Road Carl Schlager 9ft. 8in. below Sin. „ 3.—Mornington. 65 28, Arlington Road W. C. Siegrist 4ft. 9in. below 4ft. 3in. above 59 66 171, „ Christopher Luken 6ft. 6in. ,, Level 31 67 24, Cumberland Market Charles Case 1ft. 6ft. 9in. ,, 131 68 40, Delancey Street 7ft. lOin. „ Level 178 69 43, High Street James Dougall 8ft. 6in. „ 6in. below 60 70 85, „ Unoccupied 6ft. 6in. „ Level 19 71 125, „ George Leideg Level (both) 7ft. lOin. above 8 72 9ft. 43 73 183, „ C. Williams 4ft. 6in. below 4ft. 6in. „ 72 74 47, Mornington Crescent Unoccupied 7ft. „ Level 81 75 182, Stanhope Street William Hall 7ft. 3in. „ lft. 4.—Regent's Park. 188 76 80, Albany Street Humphreys & Groom 9ft. below Level 189 77 115, „ James Crabb 9ft. ,, yy 55 78 186, „ George Cash 6ft. 6in. below 9ft. above 108 109 List V.—con. BAKEHOUSES—continued. No. on Diagram. Consecutive; No. Situations, Divisions, and SubDivisions. Name of Occupier. Distance of floor above or below ground level. Distance of ceiling above or below ground level. West Division—con. 73 79 4, Cumberland Street Mr. H. J. Heady 7ft. below Level 166 80 9, Munster Square John Werner 8ft. 3in. below 6in. above 139 81 45, Osnaburgh Street Mr. W. Gass 8ft. Level 182 82 67, „ 8ft. 8in. „ „ 184 83 84, „ George D. Meldrum 8ft. 9in. „ lft. above 140 84 52, Robert Street Philip Herman 8ft. „ Level 168 85 77, „ Robert Todd 8ft. 6in. „ 6in. above 141 86 82, William Street 8ft. Level 5.—Euston. 142 87 48, Drummond Street William Ryall 8ft. below Level 83 88 191, „ John Herrning 7it. 3in. below „ 170 89 33, Edward Street F. G. Warren 8ft. 6in. „ „ 105 90 79, Euston Street Mr. H. Wickert 7ft. 6in. „ „ 106 91 30, Exmoutb Street F. A. Thielmann 7ft. 6in. „ „ 143 92 37, Hampstead Road S. E. Pierce 8ft. „ 132 93 87, The National Bread and 7ft. 10 in. „ „ Tea Co., Ltd. 45 94 133, ,, Mr. R. T. Banks 5ft. 5in. „ lft. 8in. above 144 95 10, Melton Street Joseph Sturmer 8ft. Level 196 96 39, Robert Street 9ft. 3ft. below 51 97 6, Seaton Street John Maycock . 6ft. „ lft. above 145 98 219, Seymour Street 8ft. „ Level 84 99 13, Stanhope Street Unoccupied 7ft. 3in, „ „ 181 100 79, ,, Charles Pettit 8ft. 6in. „ 2ft. below East Division. 1.—Bartholomew. 4a 100a 142, Kentish Town Road Mr. Hodges Level 10ft. above 107 101 184, Great College Street Not in use 7ft. 6in. below Level 97 102 277, 7ft. 6in. „ 6in. above 37 103 82, Oseney Crescent J. R. Cox 2ft. 6in. ,, 5ft. 6in. above 74 104 81, Peckwater Street 7ft. Level 65 105 102, Torriano Avenue F. Larsen 7ft. lft. 3in. above 108 106 88, „ A. Snelling 7ft. 6in. „ Level 2.—Camden Square. 176 107 106, Camden Road John Wilson 8ft. 6in. „ 3in. below 146 108 1, Camden Park Road James Wayland 8ft. Level 110 List. .—con. BAKEHOUSES—continued. No, on Diagram. Consecutive No. Situations, Divisions, and SubDivisions. Name of Occupier. Distance of floor above or below ground level. Distance of ceiling above or below ground level. East Division—con. 167 109 179, York Road James Findlay 8ft. 6in. below lft. above 109 110 20, Cantlowes Road Charles Cardnell 7ft. 6in. „ Level 75 111 164, Great College Street Edward Geisel 7ft. „ 57 112 121, King's Road L. Weigand 6ft. 6in. „ 6in. above 147 113 8ft. Level 3.— College. __ 114 30 115 10, Crowndale Road. Miss E. Davey Level 7ft. above 32 116 72 ,, „ 2ft. below 10ft. „ 9 117 84, Great College Street A. Scott Level 9ft. ,, 110 118 155 „ H. Weigand 7ft. 6in. below Level 41 119 12, Hamilton Street John Wicke 4ft. 6ft. above 68 120 4, King Street W. Stone 7ft. „ 3in. „ 134 121 31, ,, „ J. Webber 7t. 10 in. below 6in. below 120 122 42, ,, ,, J. Hodder 7ft. 6in. ,, 6in. „ 40 123 16, Pratt Street F. Akast 4ft. 6in. „ 3ft. 6in. above 27 124 34, ,, ,, Lorinz Iffland Level 7 ft. 6in. „ 4.—Oakley Square. 50 125 38, Clarendon Street Matthew Ockenden 6ft. below lft. 6in. above 111 126 66, ,, ,, W. Jung 7ft. 6in. „ Level 148 127 17, Crowndale Road James Pells 8ft. „ 112 128 38, Eversholt Street Edwin George Moore 7ft, 6in. „ „ 113 129 20, Stibbington Street Jesse Dench 7ft. 6in. „ „ 87 130 45, ,, ,, John Jacobi 7ft. 3in. „ 3in. below 114 131 116, „ Camillo Ferrars 7ft. 6in. ,, Level 5.—Ossulston. 149 132 10, Chalton Street William Green 8ft. Level 115 133 27, „ ,, Henry T. Green 7ft. 6in. „ „ 76 134 38, „ ,, W. Jung 7ft. „ 116 135 88, „ „ C. Feucht 7ft. 6in. ,, „ 117 136 3, Chapel Street James Davies 7ft. 6in. „ „ 67 137 13, „ „ James Buhler 7ft. 6in. above 77 138 2, Charrington Street W. Goldner 7 ft. Level 78 139 57½ ,, „ Arthur J. Mills 7ft „ 2 140 1, Chenies Place Jonas K. Jung Level lift. above 3 141 35, Churchway Edwin Davey „ 10ft. 3in. „ 1ll List V.—con. BAKEHOUSES—continued. No. on Diagram. Consecutive No. Situations, Divisions, and SubDivisions. Name of Occupier. Distance of floor above or below ground floor. Distance of ceiling above or below ground level. East Division—con. 171 142 35, Drummond Crescent C. Duhamel 8ft. 6in. below Level 85 143 18, Drummond Street Jacob Hubert Lievertz 7ft. Sin. „ „ 172 144 37, Ossulston Street Not in use 8ft. 6in. „ „ 150 145 164, „ Mr. Brown 8ft. „ 35 146 8, Phoenix Street Charles Holland 2ft. 5ft. 6in. above 190 147 38, Seymour Street Andrew Tait 9ft. Level 151 148 88, ,, William Fetter.. 8ft. „ South Division. 1.—Argyle. 1a 148a 1, Tonbridge Street Unoccupied Level lift. 6in.above 195 149 84, Cromer Street George Weiss 9ft. below 2ft. below 80 150 282, Gray's Inn Road Lewis Alfred Thompson 7ft. 2in. below Level 129 151 296, „ John Bearman 7ft. 9in. „ 3in. below 192 152 125, King's Cross Road Lot Vickers 9ft. 4in. „ 194 153 151, ,, ,, L. Loss 9ft. lft. „ 79 154 163, „ „ E. Edwards 7ft. Level 152 155 39, Manchester Street Lewis John Sage 8ft. „ 2.—Meckltnburgh. 33 156 312, Gray's Inn Road Unoccupied 2ft. 7ft. above 155 157 4, Gough Street B. Charles Smith 8ft. 3in. below 160 158 83, Gray's Inn Road Mr. Jones 8ft. 6in. „ 122 159 238, „ „ Herbert Tilbury 7ft. 6in. ,, lft. „ 118 160 274, ,, ,, George Covell 7ft. 6in. „ Level 183 161 27, King's Cross Road Mr. Auger 8ft. 8in. „ „ 94 162 35, Sidmouth Street Peter Natus 7ft. 6in. „ lft. 6in. above 3.—Burton. 99 163 42, Compton Street William Wagner 7ft, 6in. „ 2in. above 173 164 58, „ H. Loss 8ft. 6in. ,, Level 66 165 11, Crescent Place Unoccupied 7ft. lft. above 198 166 1, Cromer Street John Measures 9ft. 4in. „ lft. 2in. below 156 167 4, Hastings Street George Fables 8ft. 4in. 63 168 76, Judd Street C. Berger 6ft. l0in. „ l0 in. above 91 169 121. „ „ William Ingles 7ft. 4in. „ 4in. „ 90 169a „ „ „ „ 7ft. 4in. „ l0 in. „ 185 170 135, „ J. W. Haybali & Co. 8ft. 9in. „ 6in. below 186 170a „ „ „ „ 8ft. 9in. „ lft. 9in. „ 124 171 22, Leigh Street Unoccupied 7ft. 8in. „ Level List V.—con. BAKEHOUSES—continued. No. on Diagram. Consecutive No. Situations, Divisions, and SubDivisions. Name of Occupier, Distance of floor above or below ground level. Distance of ceiling above or below ground level. South Division—con. 130 172 29, Leigh Street 7ft. 9in. below 11 in. below 153 173 8, Woburn Buildings Frank Dilly 8ft. Level 197 174 77, Marchmont Street Mary Balfour 9ft. 3in. „ 3in. below 193 175 92, „ „ Charles Ragg 9ft. 6in. „ 4.—Endsleigh. 154 176 134, Cleveland Street George Kriegbaum 8ft. Level 191 177 26, Fitzroy Street J. Zeller 9ft. 99 162 178 47, „ „ Mr. C. H. Carrey 8ft. 2in. „ 99 174 179 24, Gower Place Mr. Blaker 8ft. 6in. „ 99 82 180 49, „ „ Mr. Rawle 7ft. 3in. „ 9in. above 123 181 66, Grafton Street Moor & West.. ,, 7ft. 8in. „ Level 163 182 94, Huntley Street.. John Musson 8ft. 2in. „ lft. below 175 183 117, Tottenham Court Road F. Legg 8ft. 6in. „ 2ins. „ 61 184 126, Alfred Smith 6ft. 6in. „ Level 92 185 15c, Warren Street,. W. Wermann.. 7ft. 4in. „ „ 5.— Whitfield. 165 186 1a, Charlotte Street Italian Bread Company 8ft. 3in. „ 3in. abov& 127 187 33, ,, ,, E. Duchemin .. 7ft. 9in. ,, Level 86 188 16, Goodge Street Mr. Graff .. 7ft. 3in. „ 99 133 189 46, ,, ,, Albert Pettit .. 7ft. lOin. „ 4in. below 89 190 17, Tottenham Court Road Veglio & Co. 7ft. 3in. ,, 9in. „ 125 191 33, „ „ Charles Schneider 7ft. 8in. „ lOin. „ 44 192 75, A. H. Williams 4ft. 6in. „ 4ft. 3in. above 98 193 50, Tottenham Street Mr. Giraud 7ft. 6in. „ 6in. „ 126 194 89, Whitfield Street Robert Wilgreo Davies 7ft. 9in. „ 3in. „ 62 195 21, Windmill Street Charles Schneider 6ft. 8in. „ Level 13 196 10 & 11,Little Howland Street Messrs. Fretta Bros. .. Level 8ft. 6in. above 112 113 List VI. ST. PANCRAS, LONDON. MARINE STORES. Situation. Name of Occupier. North Division. 109, Dartmouth Park Hill 14, Hanover Street 14, Lamble Street 56, Litcham Street 34, Rhyl Street 13, Rochford Street 52, Southampton Road 74, Weedington Road 81, Marsden Street 85, Marsden Street 4, Leverton Place - Emily King George Gould Harriet Hayward Charles Marshall Rose Hoolee John Baker James Arch Charles Wiggins Harry Lee Edward Knightly Benjamin Travil West Division. 176, Arlington Road 196, „ „ 6, Buck Street 9, Coburg Street 11, Grange Road 3, Kingstown Street 43, Little Albany Street 77 „ „ 3, Powlett Place 37, Redhill Street 15, Sea ton Street 8, Underhill Street - Caroline Hayward James Pearce Harriet Beacham James Tombling John Senor Edwin Messeder Edward Durling Isabella Felton William Smith George Sack Benjamin Harris James Webster East Division. 1, Drummond Crescent 17, Drummond Street 3, Hampshire Street 54, Little Clarendon Street 117, Ossulston Street 67, Ossulston Street 31, Stibbington Street 2, Little Randolph Street - William Wright William Andrews John Armes Benjamin Thorogood Sarah Wynne Henry Mather Benjamin Thorogood George Churley 114 List VI. —con. MARINE STORES—continued. Situation. Name of Occupier. 2, Harrison Street 30, Leigh Street 1, Pitt Street 19, Tonbridge Street 19, Warren Street 24 116, Whitfield Street South Division. Alfred Hilditch William Smith James Sack John Lewis Henry Sadler Robert Whitmarsh William Wall 115 List VII. ST. PANCRAS, LONDON. THE PRINCIPAL MARKET STREETS. East Division. Chapel Street Chalton Street Churchway Midland Railway, Ossulston Street Kentish Town Road (part of) High Street (part of) Seymour Street Murray Street York Road Brecknock Road Camden Road Great College Street King Street Pratt Street West Division. Eden Street Seaton Street Hampstead Road Drummond Street High Street (part of) William Street Osnaburgh Street North Division. Maiden Road Queen's Crescent Kentish Town Road (part of) Fortess Road South Division. Goodge Street Charlotte Place Tottenham Court Road King's Cross Road Gray's Inn Road Cromer Street Judd Street Leigh Street Marchmont Street Compton Street Cleveland Street