STAPN 72 FIFTY-FIFTH ANNUAL REPORT of the Medical Officer of Health on the VITAL AND SANITARY CONDITION of thk Metropolitan Borough of St. Pancras. REPORT FOR THE YEAR 1910. by JOHN F. J. SYKES, M.D., D.Sc. " Preventive measures are always invidious, because when ■ most successful the necessity for them is least apparent." —Captain Cook;. B B 8 4 CONTENTS. page Map of St. Pancras, showing the Registration Sub-Districts 6 Public Health Committee 7 Staff 8 I.—Introduction— Census 10 Meteorology 10 II.—Vital Statistics— Public Institutions 13 Population 14 Marriages 14 Births 14 Deaths . 15 Ages at Death 16 Causes of Death 18 Comparative Mortality . 20 Annual Birth Rates and Death Rates during 1910 20 Influenza 22 Violent Deaths—Uncertified Deaths 23 Inquests—Mortuaries .. 23 The Prevention of Infantile Mortality 23 III.—Infectious Diseases— § 1. Discovery and Diagnosis—Bacteriological Tests 41 ,, 2. Notification and Diseases 42 „ 3. Isolation and Exclusion 65 „ 4. Disinfecting and Cleansing—Contact Shelter, Personal Cleansing House, Children's Baths, etc. 94 ,, 5. Vaccination 103 VI.—Sanitation— S 1. Inspections 106 ,, 2. Open Spaces and Atmosphere 112 „ 3. Dwellings 115 „ 4. Schools 125 ,, 5. Factories and Workshops 126 ,, 6. Water Supply and Water Service 134 „ 7. Drainage and Sewerage 135 ,, 8. Storage and Removal of Offensive Matter 137 „ 9. Nuisances, Notices, etc. 140 ,, 10. Summonses 141 V.-Food— § 1. Food Premises 142 ,, 2. Unwholesome Food 144 ,, 3. Adulterated Food 146 „ 4. Food Inspectors Reports . 151 4 CONTENTS—continued. Page VI.—Legislation— § 1. General Acts 156 ,, 2. Local Acts 164 ,, 3. Orders . . 167 „ 4. By-Laws 173 ,, 5. Regulations 173 ,, 6. Legal Decisions 174 VII.—Reports of Medicai. Officer of Health 175 VIII.—Appendix— A. — Statistical Tables— Table No. 1.— Showing the Population, Inhabited Houses, Marriages, Births, and Deaths for the past year and ten years preceding 177 Table No. 2.—Showing the Annual Birth and Deaths Rates, Death Rates of Children, and Proportion of Deaths in Public Institutions to 1000 Deaths for the past year and ten years preceding .178 Table No. 3a.—Showing Deaths Registered at all ages and from all causes during the past year 179 Table No. 3h.—Showing Summary of Diseases and Ages 183 Table No. 4.— Showing the number of Deaths at all Ages in the past year from certain Groups of Diseases, and Proportion to 1000 of Population and to 1000 Deaths from all Causes 184 Table No. 5a. — Showing the number of Deaths from the Principal Zymotic Diseases in the previous ten years and in the past year Table No. 5B.—Showing the number of Deaths from the Notifiable Infectious Diseases in the previous ten years and in the past year . . 186 Table No. 5c.—Showing the Morbidity per 1000 of Population and the Fatality per 1000 cases of the Notifiable Infectious Diseases during the previous ten years and the past year . . .187 Table No. 6a.—Showing the number of Population, Births and Deaths, and Ages at Deaths in the several SubDistricts of St. Pancras 188 Table No. 6b.—Showing the number of cases of each of the Notifiable Infectious Diseases certified, classified in ages 189 Table No. 7a.—Showing the number of cases of each of the Notifiable Infectious Diseases certified, classified in Sub-Districts . . 190 Table No. 7h.—Showing the number of cases of each of the Notifiable Infectious Diseases removed to hospital, classified in Sub-Districts . 191 5 CONTENTS — continued. page Table No. 7c.- Showing the number of Deaths from each of the Notifiable Infectious Diseases, classified in SubDistricts 19.2 Table No. 8.—Showing the number of Deaths from each of certain causes, classified in Sub-Districts 193 Table No. 9a.— Showing the number of Deaths from the principal Zymotic and certain other diseases in the SubDistricts for the year 194 Table No. 9b.—Showing the proportion of Deaths from the principal Zymotic and certain other Diseases to 1000 population 195 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 SubDistricts being redistributed proportionately to the population 196 Table No. 10b.—Showing the proportion of Deaths from certain Diseases and the proportion of Deaths at various ages, and the proportion of Births to 1000 of Population in the Sub-Districts for the year. Also the proportion of Deaths under one year, five years, and at all ages, to 1000 Births 197 Table No. 11a.- Inspections made during the year 198 Table No. 11b.—Re-inspections after Intimations made during the year 202 Table No. 12a.—Intimations as to Nuisances served during the year 206 Tables Nos. 12b, 12c, and 12d.—Intimations as to Breaches served during the year 207, 208 B. - Reference Lists — List I.—Houses of separate and self-contained Dwellings. . 209 ,, II. —Registered Common Lodging Houses 218 „ III. —Licensed Cowhouses 219 „ IV.—Licensed Slaughter-houses 220 „ V. — Market Places 221 „ VI.—Bakehouses 222 ,, VII.—Noxious Trades 229 ,, VIII.—Fried Fish Shops 230 „ IX.—Fish-smoking Places 232 ,. X.—Rag and Bone Stores 233 6 7 St. Pancras Borough Council. PUBLIC HEALTH DEPARTMENT PUBLIC HEALTH COMMITTEE, 1910. CHAIRMAN. Councillor Chahi.es Williams (Ward 5). DEPUTY-CHAIRMAN. Councillor George Blount (Ward 5; EX-OFFICIO. The Right Worshipful the Mayor, Councillor James Bryan, J.P. ALDERMEN. Guantlett, John Matthews, William Henry. Knight, William Stanley Paterson, Donald Robertson, Macbean, L.CC. M.W.B. COUNCILLORS. Ward. 2 Brown, Henry Joseph. 3 Bullock, Rev. Edward, M.A. 4 Carter, Henry James. 1 Coggan, Cornish Abthuk. 8 Collins, Thomas Andrew. 3 Cremin, Dr. William. 1 Grant, George Alexander. 8 Groom, Henry. 2 Hennessey, Daniel, J.P. 3 Idris, Mrs. Eveline Trevena Williams. 6 James Henry. 8 Paramore, Dr. Richard. 1 Russell, Rev. Thomas Henry, B.D. 7 Swift, Mansei.l James. 7 Tapping;, Dan. 4 Vosper, Dr. Percy, L.C.C. 5 Washington, Alfred Charles. 6 Woffendale, Rev. Zephaniah Banks. 8 St. Pancras Borough Council. PUBLIC HEALTH DEPARTMENT. STAFF, 1910. MEDICAL OFFICER OF HEALTH. John Frederick Joseph Sykes, M.D., D.Sc. PUBLIC ANALYST. John Kear Colwel.l, F.T.C. DISTRICT SANITARY INSPECTORS. Wards. Divisions and Sub-1 -Divions. N. =North, E.= East, W. = West, S.= South. Inspectors. 1 N. 1 (Highgate) G. Rackhaul N. 2 (St. John's Park) W. L. Brown N. 3 (Gospel Oak) 2 N. 4 (Grafton) B. H. Thompson N. 5 (Maitland Park) 3 E. 1 (Bartholomew) C. H. Johnston E. 2 (Camden Square) E. 3 (College) 6 E. 4 (Oakley Square) W. G. Auger Also Food Inspector for College and Oaklev Square Sub-Divisions) E. 5 (Ossulston) R. E. James 4 W. 1 (Castle) H. G. West W. 2 (Chalk Farm) W. 3 (Mornington) J. I. Lonnon 5 W. 4 (Regent's Park) W. 5 (Euston) G. W. Adkins 8 S. 1 (Argyle) E. G. Holmes S. 2 (Mecklenburgh) S. 3 (Burton) A. H. Walker 7 S. 4 (Endsleigh) . E. J. Dillon S. 5 (Whitfield) J. Landen SANITARY INSPECTOR OF WORKPLACES WHERE WOMEN ARE EMPLOYED AND FOR THE PREVENTION OF CONSUMPTION. Mary Elizabeth Bibby, B.A. SANITARY INSPECTOR AND HEALTH VISITOR FOR THE PREVENTION OF INFANT MORTALITY AND FOR THE CLEANSING OF CHILDREN. Celia Smith, 9 SANITARY INSPECTORS OF FOOD. Joseph Osborne (S. & W.). Harry Robert Child (N. & E.). Walter George Auger (E. 3 & 4) and District Inspector of E. 4. CARETAKER OF MORTUARIES, &c. Samuel Nicholas Davy. DISINFECTORS. Richard Carr Akers, Foreman and Engineman. Henry Catch, Disinfector and Fumigator. Joseph Roots, Assistant and Driver. Thomas Bartholomew, Stoker and General Assistant. ATTENDANT AT CONTACT SHELTER, PERSONAL CLEANSING HOUSE (WOMEN'S), AND CHILDREN'S BATHS. Mrs. Alice Oakfy [and Assistant]. RESIDENT CARETAKER AT GOLDINGTON BUILDINGS. Walter Brown. RESIDENT CARETAKER AT FLAXMAN TERRACE. John Evans. RESIDENT CARETAKER AT PROSPECT TERRACE. Alexander Hugh Reid. CLERICAL STAFF. Chief Clerk Alfred Powel Coke. First Clerk Harry Riches. Second Clerk George Stuart. Clerk Alfred George Capel. Clerk Henry John Treby. Clerk John Onesimus Ogden. Junior Clerk Percy William Pottier. Boy Clerk . William Cameron Christopher Wade. 10 Metropolitan Borough of St. Pancras. FIFTY-FIFTH ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH. Being the Report for the Year 1010. To the Right Worshipful the Mayor, Aldermen, and Councillors of the Metropolitan Borough of St. Pancras. Mr. Mayor, Aldermen, and Councillors,— I.—INTRODUCTION. I have the honour to present to you the Fifty-Fifth Annual Report upon the Vital and Sanitary Condition of the Metropolitan Borough of St. Pancras. Although the Registration District of St. Pancras has remained practically the same area since 1856, except for a few adjustments of boundary described in the Report for the year 1000, the changes in the areas of the Registration Sub-Districts since the last mentioned date have been great. Changes were made in 1000, at the census of 1901, and again in 1906, when the two southern Sub-Districts were amalgamated. So that now the four Registration Sub-Districts of St. Pancras, except for slight deviations of the outer boundary, coincide with the four Parliamentary Divisions. CENSUS. The time is fast approaching for taking another decennial census, and the Bill introduced into Parliament for this purpose has become law. METEOROLOGICAL RECORDS. Here follow the Meteorological Records for the year, as deduced from observations made at Greenwich and at Camden Square. 11 METEOROLOGICAL TABLE FOR LONDON, 1910. {Extracted from the Annual Summary of the Registrar-General.) Deduced from Observations at Greenwich, under the Superintendence of the Astronomer Royal. January. February. March. April. May. J une. July. August. September. October. November. December. Year 1910. Barometer. Mean Pressure at 323 F. at Station Level* (Bar. 159 ft. above M.S.L.) 29.681 29 500 29 991 29.672 29.713 29.720 29.709 29741 30 046 29. 841 29.476 29 .545 29.720 Air Temperature. Mean of Minimum A. 35.4 35.7 34.7 33.8 45.2 51.6 519 52.7 48.5 47.6 32.4 400 42.9 . Maximum B 441 47.9 51.3 55.4 63 3 710 670 70.8 64.6 59.8 45.4 48.3 574 Mean of A. and B 39.7 41.8 43.0 47.1 543 61.3 59.4 61.8 56.6 53.7 38.9 44.2 50.2 \ Difference from Average † +13 + 20 +0.5 —1.0 +0.5 + 10 .43 —1.1 —1.6 + 33 .45 +4.6 +01 Humidity 87 87 85 80 79 79 82 80 82 88 87 88 84 Earth Temperature at 3 ft. 2 in. depth 43.5 41.8 43 0 45.4 49.9 57.5 58.6 60.8 58.7 56.1 48.2 458 50.8 Bright Sunshine. Total Observed Hours 54 70 150 130 219 185 113 177 142 70 50 20 1380 Difference from Average † + 13 + 13 + 51 —17 +33 —12 —123 —34 —13 .25 +2 —13 —123 Per cent. of Possible 21 25 41 31 46 37 23 39 38 21 19 8 31 Rain and other forms of Precipitation. Number of Days 15 24 10 16 19 13 18 17 3 14 17 19 185 Total Fall Inches 1.72 2.69 1 10 2.62 2.24 208 3.52 2.43 0.74 1.81 3.57 3.54 28.06 Difference from Average † —0.16 +1.21 —0.42 + 1.05 —0.32 +004 +112 +009 —1.41 —0.97 +1.35 +1.71 +3.93 # The hours of observation are 9 a.m. and 9 p.m. f The averages used are obtained from observations extending over 65 years for Rain and Temperature and 10 years for Sunshine. »—» METEOROLOGICAL TABLE FOR SAINT PANCRAS, 1910. (Extracted from the Registrar-General'8 Quarterly Reports.) Deduced from Observations at Camden Square, n.w., under the Superintendence of H. Robert Mill, d.sc.,l.l .d. January. February. March. April. May. June. July. August. September. October. November. December. Barometer. Mean Pressure at 32J F. at Station Level* (Bar 159 ft. above M.S.L.) 29.720 29.537 30. 034 29.711 29.757 29.765 29 .750 29 786 30.087 29 890 29515 29.588 Air Temperature. Mean of Minimum A 34.6 36.3 35.4 39.8 46.3 53.2 53.1 54 2 49.6 48.3 32.3 400 Maximum B. 45.1 48.3 51.5 56.1 65.0 72.3 68.5 70.9 66.2 60.6 454 48.7 Mean of A. and B 39 9 42.3 43.5 48.0 55.7 62.8 60.8 62.6 57.3 54.5 38.9 444 Difference from Average † + 1.3 +23 +0.5 —0.5 + 1.4 + 1.9 —3.6 —0 7 —0.6 +4.1 —50 +4.9 Humidity 90 89 84 79 78 78 83 82 82 89 90 91 Earth Temperature at 4 ft. depth 13.3 41.2 42.2 44.0 48.5 55.1 56.9 53.2 57.3 55.0 49.4 455 Bright Sunshine. Total Observed Hours 50 59 120 115 196 159 102 140 125 57 47 13 Per c ent. of total possible 20 22 33 28 41 33 21 31 33 18 18 5 [ Differ ence from Average † Hours — — — — — — — — — — — Rain and other forms of Precipitation. Number of Days 14 21 9 18 19 13 17 21 5 13 16 20 Total Fall Inches 1.57 2.96 0.97 2.24 2.22 2.17 2.53 1.64 0.58 2.00 3'19 329 Difference from Average † —0.30 + 1 33 —069 + 0.56 +0.47 —012 —0'u4 —0.75 —1.59 —0.74 +083 + 1.24 * The hours of observation are 9 a.m and 9 p.m., local time. † The averages used are obtained from observations extending over 35 years for Rainfall and Temperature and 25 years for Sunshine, 13 II.-VITAL STATISTICS. PUBLIC INSTITUTIONS. Births —The number of births occurring in Public Institutions during the year 1910 was as follows :— Homes of Hope, South St. Pancras Sub-District .24 Workhouse, East St. Pancras Sub-District.123 147 Deaths.—The number of deaths occurring in Public Institutions during 1910 was as below :— Registration SubDistricts. Number of Inmates. St. Pancras Institutions. No. of Beds. Daily Average No. of Inmates Deaths.[/##] Parish ioners NonParish ioners. Total. St. Pancras West 102 St. Saviour's Hospital for Ladies of Limited Means 27 16 2 2 London Temperance Hospital .. 100 86 79 47 126 Central London Sick Asylum 264 247 1 151 156 University College Hospital 286 249 116 219 335 Home Hospitals 80 21 1 11 12 1 Medical and Surgical Home 8 7 1 4 5 1 Metropolitan Throat and Ear Hospital 13 7 ... ... ... South 71 7 London Skin Hospital 0 0 1 ... 1 Oxygen Home 0 0 ... ... ... Central London Ophthalmic Hospital 26 20 ... 1 1 Central Loudon Throat and Ear Hospital 26 20 l 9 10 Royal Free Hospital 165 146 47 154 201 r New Hospital for Women 60 55 3 20 23 Workhouse 1583 1443 61 7 68 East 1908- Infirmary (South) 400 410 299 20 319 North West London Hospital 0 0 1 ... 1 Infarmary (North) 542 600 383 10 393 North 616 Casual Wards 66 16 ... ... ... Totals in Institutions within the Borough 3596 3343 994 655 1649 ,, „ without the Borough 1 2361 562 ... 562 Totals 3596 5704 1556 655 2211 14 Institutions within the Borough.—It is estimated that about 500 of the daily average number of inmates in certain of the above-mentioned Institutions in the Borough are persons not resident in the Borough. Institutions without the Borough.—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 1909, are as follows :— St. Anne's Home, Streatham, a branch of St. Pancras Workhouse... 406 Lunatic Asylums 1095 Imbecile and Idiot Asylums 690 Fever and Small-pox Asylums 170 Total population 2861 In addition there are — Leavesden Schools, near Watford 550 The Children at these Tnsti Boarded out 44 tutions are part of the In Hospitals, R.C. Schools, Training Ships, population of the locality in which they are situated &c., about 200 . POPULATION. The figures of the 1001 census have been taken as a basis, and the 2,361 inmates of extra Borough Institutions have been added to the Sub-Districts in proportion to the population as the deaths amongst these inmates are included in the statistics in the year, and 500 non-residents in the hospitals in the Borough have been omitted as their deaths are also omitted. West 61,891 South 55 952 East 59,794 North 59,541 237,178 MARRIAGES. The number of marriages celebrated in St. Pancras during the year was 2,000, being 7 more than in the previous year and 102 less than the annual average of the previous ten years. BIRTHS. The number of births registered during the year was 5,385, being 147 more than in the preceding year, and 562 less than the annual average during the preceding decennium. 15 The 143 births in public institutions having been redistributed according to population, the number of births and the birth rate of each of the Sub Districts and of the District were as follows :— Sub-District. Number of Births. Birth Rate. West 1402 22.7 South 1034 18.5 East 1524 25.5 North 1425 23.9 St. Pancras 5385 22.7 London 114870 23.6 DEATHS. During the year 1910 the corrected total number of deaths from all causes at all ages was 3,267, being 254 less than during the preceding year and 685 below the annual average of the preceding ten years. Per 1000 of the population, the death rate was 13.8, compared with 14.8 in the previous year, and an annual average of 16.6 in the preceding decennium. The total number of deaths and the death rates in the Sub-Districts are set out below, 83 deaths from all causes not referable to any particular Sub-District being distributed according to population :— Sub-District. Number of Deaths. Death Rate. West 888 143 South 674 12.0 East 926 15.5 North 779 13.1 St. Pancras 3267 13.8 London 61756 12.7 * As compared to England and Wales for sex and age distribution, the factor of correction for St. Pancras is 1.0456, which makes the death rate so corrected 14.4 per 1000 of population 16 AGES AT DEATH. Under one year of age the number of deaths and the proportion per 1000 births and per cent. of total deaths were as follows :— Sub-Districts. Number of Deaths under 1 year. Per 1000 Births. Per cent. of Deaths at all Ages. West 152 108.4 17.1 South 112 108.4 16.6 East 195 128.0 21.1 North 121 84.9 15.5 St. Pancras 580 107.8 17.8 London 11809 101.6 19.1 Under fire years of age the number of deaths and the proportion per 1000 births and per cent, of total deaths were as follows : — Sub-Districts. Number of Deaths under 5 years. Per 1000 Births. Per cent. of Deaths at all Ages. West 254 181.2 28.6 South 173 167.3 25.7 East 314 206.0 33.9 North 198 139.0 25.4 St. Pancras 939 174.4 28.7 London - - - 17 St. Pancras.— Infant Deaths, 1910. Deaths from stated causes in Weeks and Months under One Year of Age. CAUSE OF DEATH. Under 1 week. 1—2 Weeks. 2—3 Weeks. 3—4 Weeks. Total under 1 Month. 1—2 Months. 2—3 Months. 3—4 Months. 4—5 Months. 5—6 Months. G—7 Months. 7—8 Months. 8—9 Months. 9—10 Months. 10—11 Months. 11—12 Months. Total Deaths under 1 Year. All Causes Certified Uncertified 108 ... 32 ... 27 ... 22 ... 189 ... 64 ... 49 ... 45 ... 26 ... 32 ... 20 ... 26 ... 39 ... 36 ... 26 ... 28 ... 580 ... Common Infectious Diseases. Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... 1 2 ... ... 1 1 1 7 9 8 12 42 Scarlet Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria: Croup ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 ... 2 Diarrhoeal Diseases. Whooping Cough ... ... ... 1 1 1 6 3 3 2 2 5 6 7 3 1 40 Diarrhoea (all forms) ... 2 3 1 6 5 3 5 2 6 5 ... 2 2 ... 2 38 Enteritis (not Tuberculous) ... 1 1 2 2 2 3 ... 1 1 2 1 ... ... ... 14 Gastritis. Gastro-intestinal Catarrh ... ... ... 1 1 1 1 1 ... 1 ... ... ... 1 1 1 8 Wasting Diseases. Premature Birth 68 14 5 1 91 8 1 ... ... ... ... ... ... ... ... ... 100 Congenital Defects 5 1 2 2 10 ... 2 1 ... ... ... ... ... ... ... ... 13 Injury at Birth 2 ... ... ...... 2 ... ... ... ... ... ... ... ... ... ... ... 2 Want of Breast-milk ... 1 ... 2 3 4 ... 1 ... 1 ... ... ... ... ... ... 9 Atrophy, Debility, Marasmus 7 8 7 4 26 18 13 12 5 4 3 ... 2 4 1 1 89 Tuberculous Diseases Tuberculous Meningitis ... ... ... ... ... ... ... ... ... 1 ... 2 1 ... 2 ... 6 Tuberculous Peritonitis : Tabes Mesenterica ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Tuberculous Diseases ... ... ... ... ... ... ... ... ... 2 2 ... 1 2 ... ... ... 7 Erysipelas ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... 1 Syphilis 3 1 1 5 1 ... 2 1 1 ... 1 ... ... 1 ... 12 Rickets ... ... ... ... ... ... ......... ... ... ... 1 1 ... 1 1 ... 4 Meningitis {not Tuberculous) ... ... ... ... ... ... ... 1 2 ... 2 1 1 1 ... ... 8 Convulsions 5 1 1 ... 7 4 ... 1 ... ... ... 2 ... ... ... 14 Bronchitis 1 ... 2 1 4 4 5 3 2 ... ... 3 3 ... 1 4 29 Laryngitis ... ... ... ... ... ... ... ... ... ... ... ......... ... ... ... ... ... ... ...Pneumonia ... 1 3 2 6 5 6 9 5 6 4 6 10 8 5 7 77 Suffocation (overlaying) 3 ... ... 3 5 4 1 3 1 ... ... ... ... ... ... 17 Other Causes 14 2 4 2 22 5 3 2 1 5 1 3 2 2 2 ... 48 108 32 27 22 189 64 49 45 26 32 20 26 39 36 26 28 580 Legitimate 5161 Population estimated to the middle of 1910 237,178 Births in the year Excluding non-residents in Hospitals 500 [Illegitimate 224 Including inmates of extra Borough Institutions 2,361 Deaths from all causes at all Ages 3,627 (Excluding non-residents and including residents dying outside the Borough.) 18 CAUSES OF DEATH. Notifiable Infectious Diseases. Principal Zymotic Diseases. Small-pox. Small-pox. Scarlatina or Scarlet Fever. Scarlet Fever. Diphtheria or Membranous Croup. Diphtheria. Typhus Fever. Typhus Fever. Tyhoid or Enteric Fever. Enteric Fever. Continued Fever. Continued Fever. Relapsing Fever. Puerperal Fever. Measles. Cholera. Whooping Cough. Erysipelas. Diarrhoea. Plague. Dysentery. Chicken-pox. At the end of the Report, in Table 7 c, will be found set out the number of deaths under 5 years of age and 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 " printipal 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. 9a and 9b and Tables Nos. 10a and 10b. and are compared as follows :— Phthisis.—This disease, the type of the tubercular group of diseases, was the cause of 297 deaths, compared to 374 deaths in 1909, 362 in 1908, and 376 in the year previous to that. The incidence of this disease in the Sub-Districts was as follows :— Sub-Districts. Number. Per 1000 Population. Per cent. of Total deaths. West 82 1.32 9.2 South 89 1.59 13.2 East 62 1.04 6.7 North 61 1.07 8.2 St. Pancras 297 1.25 9.1 London 5555 1.14 9.0 19 Bronchitis, Pneumonia, and Pleurisy.—These diseases, as typical of the respiratory group of diseases, caused 680 deaths, compared to 732 in 1909, 705 in 1908, and 712 in 1907; the incidence in the Sub-Districts being as follows:— Sub-Districts. Number. Per 1000 Population. Per cent. of Total Deaths. West 182 2..94 20.5 South 120 2.15 17.8 East 183 3.06 19.8 North 145 2.44 18.6 St. Pancras 630 2.66 19.3 London — — — 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 cent. of total deaths were as follows:— Sub-Districts. Number. Per 1000 Population. Per cent. of Total Deaths. West 20 0.32 2.2 South 9 0.16 1.3 East. . 20 0.33 2.1 North 14 0.24 1.8 St. Pancras 63 0.26 1.9 London — — — 20 The Principal zymotic Diseases.—The number of deaths from this group of diseases in the Sub-Districts and the proportion per 1000 of population and per cent, of total deaths were as follows : — Sub-Districts. Number. Per 1000 Population. ent. of Total Deaths. West 94 1.52 10.6 South 44 0.79 6.5 East 132 2.21 14.2 North 57 0.95 7.3 St. Pancras . 327 0.96 10.0 London 5559 1.14 9.0 COMPARATI VE MORTALITY. Throwing the Birth and Death Rates of the Sub-Districts in the foregoing tables into one table, we obtain this result:— Sub-Districts. Birth Rate Total Death Rate from all causes. Phthisis. Death Rates from Death Rates per 1000 Births. Bronchitis, Pneumonia. Pleurisy. Notifiable Infectious Diseases. Principal Zymotic Diseases. Under 1 Year. Under 5 Years. West 22.7 14.3 1.32 2.94 0.32 1 .52 108.4 181.2 South 18.5 12.0 1.59 2.15 0.10 0 79 108.4 167.3 East 25.5 15.5 1.04 3.06 0.33 2.21 128.0 206 0 North 23.9 13 .1 1.07 2 44 0.24 0.95 84.9 139.0 St. Pancras 22.7 13.8 1.25 2.66 0.26 0.96 107.8 174.4 ANNUAL BIRTH RATES AND DEATH RATES DURING 1910* Localities. Annual rates per 1000 living. Infant Mortality :— Annual Death Rate of Infants under one year per 1000 births. Births. Deaths from all causes. Deaths from seven chief epidemic diseases England and Wales 24.8 13.4 0.99 106 77 great towns 25. 0 14.3 1.23 115 136 smaller towns , 23.7 12.9 0.88 104 Rural England and Wales 25.0 12.8 0.74 96 (i.e., less the 213 towns) * These rates are subject to revision. 21 The Annual Death Rates for the Year 1910, according to the Registrar. General's Return, were in the six largest County Boroughs and Metropolitan Boroughs at the Census of 1901 as follows : — County Boroughs. Estimated Population, 1910. Death Rate per 1000. Infantile Mortality, per 1000 Births. Metropolitan Boroughs. Estimated Population, 1910. Death Ha te per 1000 Infantile Mortality per 1000 Births. Liverpool 767,606 17.7 140 Islington 858,356 13.4 94 Manchester 716,354 16.1 131 Lambeth 827,074 12.9 94 Birmingham 570,113 13.7 130 Stepney 314,379 14.3 112 Leeds 490,985 18.7 I8 2 Camberwell 286,058 12.5 94 Sheffield 478,768 13.4 127 Wandsworth 805,838 10.7 78 Bristol 382,550 11.5 90 St. Pancras 237,792 14 4 102 The Annual Death Rates for the Year 1910, according to the Registrar. General's Return, were in the six smallest County Boroughs and Metropolitan Boroughs at the Census of 1901 as follows : — County Boroughs. Estimated Population, 1910. Death | Kate per 1000. Infantile Mortality per 1000 Births. Metropolitan Boroughs. Estimated Population, 1910. Death Rate per10OO. inrantle Mortality per 1000 Births. Burton.on.Trent 54,977 11.3 79 London (City) 17,132 17.0 66 Great Yarmouth 53,715 14.4 10) Stoke Bury 59,409 14.7 126 Newington 54,838 11.5 64 Barrow.in Holborn 58,142 16.1 108 Furness 63,689 14.3 120 Chelsea 75,457 13.1 101 Bootle 70,548 14.7 128 Hampstead 95,729 9.7 60 Wigan 91,732 15.2 191 Finsbury 94,578 18.2 123 Loudon, Death Rate : 13.4. Highest—Finsbury, 18.2. Lowest—Hampstead, 9.7. The Annual Death Rates during the Year 1910, according to the Medical Officer of Health, were as follows :— Uncertified Deaths in St. Pancras 0 St. Pancras—Estimated Population, 237,178. Number of Births, 5,885. Corrected number of Deaths, 3,267. Birth Rate, 22.7. Death Rate, 13.8. Infantile Mortality Rate, 108. London—Estimated Population, 4,872,702. Number of Births, 114,870. Corrected number of Deaths, 61,750. Birth Rate, 23.6. Death Rate, 12.7. Infantile Mortality Rate, 102. The Number of Dangerous Infectious Diseases notified and the Notification Rate during the year were as follows : — St. Pancras—Estimated Population, 237,178. Cases notified 1215 Notification Rate per 1000 population 5. London—Estimated Population, 4,872,702. Cases notified 1,712 Notification Rate per 1000 population 4.5 22 INFLUENZA. Deaths from Influenza (including a few doubtful cases) during the years 1889 to 1910, inclusive, in St. Pancras. Year. 0—1. 1—5. 5—15. 15—25. 25—35. 35—45. 45—55. 55—66. 65—75. 75—85. 85 and upwards. Total Deaths under 5 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 1899 3 2 ... . 4 3 8 15 9 16 9 1 5 70 1900 1 3 2 2 12 13 22 29 28 19 6 4 137 1901 1 . . .... ... . . ... 2 5 3 3 2 8 1 1 25 1902 2 3 ... . 1 4 3 8 7 14 8 1 5 51 1903 1.. 1 ... . 1 4 1 5 2 2 5 1 1 22 1904 1 . ... ... . ... . 1 ... . 2 5 7 6 ... . 1 22 1905 1 1 . ... 1 ... . 3 2 2 2 1 1 2 14 1906 1 2 2 ... . 1 1 4 6 4 11 9 3 41 1907 . . .. 2 2 2 2 1 6 8 7 5 1 2 36 1908 . . .. 6 ... . ... . ... . 4 6 5 18 22 12 6 73 1909 . . .. 1 ... . ... . 2 2 6 11 16 14 7 1 59 1910 . . .. ... . ... . 2 ... . 4 3 ... . 6 4 1 ... . 20 23 VIOLENT DEATHS. Violence was the cause of 148 deaths during the year; in the three preceding years the numbers were 130, 163, and 146. UNCERTIFIED DEATHS. There were no uncertified deaths registered in St. Pancras in 1910; in 1909, 1908, 1907, and 1906, the numbers were 1, 1, 0, and 2. INQUESTS HELD. In the Coroner's Court—General cases 389 ,, „ Poor Law cases 28. Elsewhere in St. Pancras —x 417 PUBLIC MORTUARIES. Number of bodies deposited in the General Mortuary 407 „ „ „ Infectious 10 417 THE PREVENTION OF INFANT MORTALITY. Notification of Births. The Notification of Births Act, 1907, came into operation on 9th March, 1908. Primarily, the duty of notifying a birth to the Medical Officer of Health devolves upon the father of the child if he be resident in the house at the time of its occurrence ; secondarily, upon any person in attendance upon the mother at the time of, or within six hours after, the birth. The notice must be given by posting a prepaid letter or post card within 36 hours after the birth, or by delivery of a written notice of the birth at the office of the Medical Officer of Health within the same time. The local authority must supply, without charge, addressed and stamped post cards containing the form of notice to any medical practitioner or midwife residing or practising in their area who applies for the same. The notification is in addition to, and not in substitution of, the requirements of the Act relating to the registration of births, and it applies to any child born after the expiration of the 28th week of pregnancy, whether alive or dead. Liability to a penalty not exceeding twenty shillings is incurred by any person who fails to give notice of a birth unless there is reasonable ground to believe that notice has been duly given by some other person. 24 THE ST. PANCRAS PREVENTIVE SCHEME. The St. Pancras preventive scheme of infantile mortality is briefly as follows :— 1. Notification of Births.—From these are selected the most suitable cases to visit, commencing with the poorest houses in the poorest streets. 2. Advice Cards to Mothers.—A copy of the Advice Card is sent to the mother of every newly.born child as soon as the birth is notified. Supplies of these cards are also sent to medical practitioners, hospitals, dispensaries, and mid wives for distribution. 3. Medical Advice.—In cases where mothers are suffering from disease they are referred to doctors, hospitals, and dispensaries, and where mothers are in need of extra food and milk to continue breast.feeding they are referred to religious and charitable organisations, and especially to the St. Pancras School for Mothers. During the year, as previously, the work of the Woman Inspector in advising expectant mothers and in correcting defective and improper feeding has been supplemented by assistance received from a number of lady voluntary visitors. The St. Pancras Mothers' and Infants' Society, supported by voluntary contributions and voluntary workers, with its SCHOOL FOR MOTHERS at 37, Chalton Street, Somers Town, supplements the municipal work, and is doing a great good in the southern part of the Borough. On the 4th September, 1909, the Local Government Board issued an Order with respect to the qualification, duties, &c., of Health Visitors under the London County Council (General Powers) Act, 1908, which empowers the Borough Councils to appoint suitable women for the purpose of giving to persons advice as to the proper nurture, care and management of young children, and the promotion of cleanliness. The Act of 1908 enables the County Council to pay out of the County Fund any sum by way of contribution towards the salary of a Health Visitor appointed under the regulations, not exceeding in any case one.half the amount. During the year under review the Chief Medical Officer of the Local Government Board issued a complete report upon the subject of infant and child mortality. Amongst the remedies recommended are :—A more detailed investigation of all deaths occurring in infancy as a guide to administrative action ; inquiries into the circumstances attending still-births ; the adequate training of midwives ; the efficient administration of the Midwives Act; the adoption of the Notification of Births Act; and the making of arrangements for the giving of instruction on infant hygiene But the foremost means of securing a low infant mortality are:—Efficient domestic and municipal sanitation and housing, and intelligent and painstaking motherhood. There is much machinery which has already been devised to meet this last-mentioned end, including paid and voluntary women health visitors, schools for mothers, consultation centres for mothers, infant milk depots, and in some of the London Boroughs nursing and expectant mothers are able to avail themselves of the opportunities provided by philanthropic bodies of obtaining meals at trivial cost. Moreover, much assistance has been given in the same direction through such legislative enactments as the Notification of Births Act and the Midwives Act. 25 ACTION TAKEN DURING THE YEAR. During the year the action taken with regard to the prevention of the mortality of suckling infants is summarised as follows:— Births. W. S. E. N. Total. Total Births (excluding still births) registered (majority within 2 months) 1363 1024 1610 1388 5385 Births (includingstill-births*) notified within 36 hours 1158 961 1452 1160 4731 *Still-births ... 28 36 41 25 130 Of the total births registered the illegitimate numbered 34 56 102 32 224 Notification op Births. W. S. E. N. Total. (a) Notified by— -Eathers 341 179 416 489 1425 Mothers; 23 8 24 25 80 Other persons 360 348 454 224 1386 Professional Assistants 63 82 87 1 233 Midwives 255 198 152 321 926 Doctors 80 95 155 46 376 Workhouse ... ... 116 ... 116 Homes of Hope ... 23 ... 1 24 Not stated 36 28 48 53 165 1158 961 1452 1160 4731 (6) Attended by- —Doctors 326 357 403 266 1352 Midwives 328 153 326 671 1478 Professional Assistants 399 348 607 3 1357 Not stated 105 103 116 220 544 1 158 961 1452 1160 4.731 Advice Cards sent to cases notified within 36 hours (on day of receipt of notification) 4731 ,, „ „ registered (but not notified) on receipt of Registrars' Returns 922 Cautionary letters sent to cases registered but not notified 922 Visits.—Total number 2303 Inquiries made (at first visit) 1055 ,, (after 12th month) Additional visits 1009* *Of these—Infants " not known " at address given 3 0 at first visit „ "removed from „ 22} at 12th month visit. Extra Visits to Hospitals, Doctors, Midwives, Nurses, Creches, Workhouse, Infirmary, Relieving Officers, Distress Committee, School for Mothers, Charity Organization Society, etc, etc. 379 26  1908. 1909. 1910. 1911. Births. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Year 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Year 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Year 1st Qr. Total Births (excluding still-birtlis) registered (majority within 2 months) 1398 1378 1349 1421 5546 1351 1303 1360 1224 5238 1344 1415 1333 1293 5385 1311 Births (including still-births) notified within 36 hours 39 912 949 1060 2960 963 973 1009 1016 3961 1129 1286 1124 1192 4731 1160 Still-births ... 37 40 41 118 32 28 40 35 135 34 31 26 39 130 28 Of the total births registered the illegitimate numbered 44 51 61 59 215 54 63 55 44 216 43 55 52 74 224 57 Notification of Births. (a) Notified by—Fathers 17 341 352 380 1090 369 356 350 324 1399 351 419 360 302 1425 404 Mothers 2 18 9 12 41 11 13 8 12 44 10 25 22 23 80 30 Other Persons ... 204 285 325 814 277 302 336 346 1261 337 363 378 308 1386 317 Professional Assistants 1 105 34 43 183 64 49 48 20 181 11 14 24 184 233 13 Midwives 4 109 149 185 448 137 141 153 225 656 267 279 184 196 926 217 Doctors 9 102 92 78 281 62 75 83 62 282 86 100 79 111 376 102 Workhouse 6 32 27 34 98 33 31 23 21 108 27 39 24 26 116 18 Home of Hope ... 1 1 3 5 10 6 8 6 30 3 7 6 8 24 2 Not stated ... ... ... ... ... ... ... ... ... ... 37 47 47 34 165 57 39 912 949 1060 2960 963 973 1009 10 6 3961 1129 1286 1124 1192 4731 1160 (b) Attended by—Doctors 14 279 268 252 813 212 250 264 243 969 304 350 313 385 1352 498 Midwives 12 255 290 376 932 330 318 323 330 1301 378 397 345 356 1476 392 Professional Assistants 1 327 345 379 1054 352 317 328 351 1348 331 385 311 330 1357 270 Not stated 12 51 43 53 161 69 88 94 92 343 116 154 155 121 546 ... 39 912 949 1060 2960 963 973 1009 1016 3961 1129 1286 1124 1192 4731 1160 Advice Cards sent to cases notified within 36 hours (on day of receipt of notification) ... ... ... ... ... 963 973 1009 1016 3961 1129 1286 1098 1153 4666 1132 Advice Cards sent to cases registered (but not notified) on receipt of Registrars' Returns ... ... ... ... ... 398 370 341 268 1377 215 260 235 212 922 177 Cautionary letters sent to cases registered but not notified ... ... ... ... ... 273 370 341 268 1252 215 260 235 212 922 177 Visits—Total number 265 398 481 588 1732 460 414 597 736 2207 46 638 796 823 2703 533 Inquiries made (at first visit) 150 178 150 176 654 91 62 143 283 579 39 443 378 205 1065 134 „ (after 12th month) ... ... ... ... ... ... 104 107 90 301 ... ... ... ... ... ... Additional visits* 115 220 331 412 1078 369 248 347 363 1227 7 195 347 460 1009 399 *Of these—Infants "not known" at address given 3 10 1 9 23 2 ... ... ... 2 1 ... 2 ... 3 ... ,, "removed" from ,, at 1st visit ... ... ... ... ... ... ... 2 7 9 ... ... ... ... ... ... at 12th month visit 6 11 10 11 38 8 51 40 44 143 1 12 7 2 22 2 Extra visits to Hospitals, Doctors, Midwives, Nurses, Creches, Workhouse, Infirmary, Relieving Officers, Distress Committee, School for Mothers, Charity Organization Society, &c., &c. ... ... ... ... ... 89 93 84 72 338 78 72 71 158 379 97 27 RESULTS OF THE ACTION TAKEN. During the year 1910, of 5,385 live births registered, 4,601, or 85.4 percent., were notified within 36 hours—that te to say, nearly three-fourths of the livebirths were promptly notified, and, in addition, 130 still-births. The sending of cautionary letters in cases where there has been omission to notify is having the effect of bringing the notifications in earlier. The effect upon the infantile mortality has been as follows:— In 1904=151.6 deaths of infants per 1000 births. „ 1905=135.7 ,, ,, ,, „ 1906=131.1 ,, ,, ,, „ 1907=113.8 ,, ,, ,, „ 1908=115.0 ,, ,, ,, ,, 1909=108.8 ,, ,, ,, „ 1910=107.8 ,, ,, ,, THE POSITION OF ST. PANCRAS. The summers of 1907, 1908, 1909, and 1910 were cold summers, and the St. Pancras method of prevention was not put to the test of comparison with other boroughs and towns in the third quarter of the year. It was in this hot quarter of the year that St. Pancras did so well, by comparison, in lowering the mortality, as shown by the three years 1904, 1905, and 1906, especially in the last and hottest year of the three. When it is called to mind what a large proportion of infant mortality is caused by summer diarrhoea and other diseases due to improper feeding in the hot weather, it is apparent that the principal test of the value of a system of saving infant life by breast-feeding is the total mortality in the third, or summer quarter of the year. The prevalence of measles exerts its main effect in the second and fourth quarters, and cold in the presence of poverty, which connotes insufficient clothing and warming in the first or winter quarter of the year, and prematurity, more or less, all the year round. The Quarterly and Annual position of merit of St. Pancras, compared to London Boroughs and the 76 large towns, for the years 1904, 1905, 1906, 1907, 1908, 1909, and 1910 in regard to Infantile Mortality:— 29 London Boroughs. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr. Year. 1904 22nd 11th 25th 15th 19th 1905 24th 12th 18th 21st 19th 1906 25th 19th 13th 17th 13th 1907 6th 25th 20th 12th 9th 1908 27th 16th 12th 14th 13th 1909 20th 12th 18th 18th 12th 1910 11th 25th 18th 22nd 16th 28 76 Large Towns. 1st Qr. 2nd Qr. 3rd Qr. 4th Qr.  1904 40th 18th 44th 15th 31st 1905 42nd 21st 39th 49th 35th 1906 37th 36th 21st 24th 15th 1907 9th 51st 37 th 18th 18th 1908 44th 23rd 24th 16th 18th 1909 32nd 24th 32nd 37th 24th 1910 9th 43rd 14th 'list 25th The Actual Infant Mortality in St. Pancras Sub-Districts per 1000 Births during the years 1904, 1905, 1906, 1907, 1908, 1909, and 1910:— Years. West. South. East. North. St. Pancras. 1904 157.6 167.5 146.5 139.1 151.6 1905 130.0 164.9 138.9 115.6 135.7 1906 131.2 148.9 129.8 118.9 131.1 1907 106.8 144.0 130.4 84.2 113.8 1908 125.7 128.4 114.7 94.2 115.0 1909 124.6 126.7 98.9 90.5 108.8 1910 108.4 108.4 128.0 84.9 107.8 Infant Mortality in each of the Years 1904 to 1910. — Deaths under one year to 1000 births in the years— 1904 1905 1906 1907 1908 1909 1910 England and Wales 145 128 132 118 121 109 106 76 great towns, including London 160 140 145 127 129 118 115 London 145 130 131 116 113 108 103 142 smaller towns 154 132 138 122 124 111 104 England and Wales, less the 218 towns 125 113 116 106 110 98 95 29 INFANTILE MORTALITY AND VITALITY. In the prevention of mortality and disease, of ill-health and physical defects, we must commence with the child at the very earliest age possible. But we cannot reach the young infant directly, we must reach the infant through the mother, and therefore we must protest against the mother being omitted. Our medical service must be styled, not infant consultations, but medical consultations for mothers and infants—mothers first. Briefly the evolution of mothercraft in St. Pancras was as followsAt the beginning of this century distrust of artificial feeding of infants began to grow in St. Pancras, until in 1902-3 all leaflets on artificial feeding were destroyed and no more distributed, and in 1901 to 1906 the experiment of persistently preaching and teaching breast-feeding entirely, and converging efforts upon the mother was carried to the well-known successful issue in the extraordinary fall of the summer mortality of infants in St. Pancras, as compared with other boroughs and towns. In 1907 the St. Pancras School for Mothers was started to provide medical consultations for those mothers and infants unable to procure medical advice, dinners for mothers suckling their infants, and educational demonstrations in mothercraft at the School and in the home. In 1910 the School extended its work to children up to compulsory school age, with a view to preventing the defects so commonly found on the medical inspection of schools, and of working in association with day nurseries and nursery schools. We have got beyond the mere prevention of infant mortality, beyond the diminution of infant sickness, we are now steaming ahead to the greater improvement of infant health and physique, and for this purpose Schools of ^Mothercraft and Babe Training are necessary. A COMPREHENSIVE SCHOOL OF MOTHERCRAFT AND BABE TRAINING. (A) THE ST. PANCRAS SCHOOL FOR MOTHERS. (Associated with the St. Panems Dai/ Nursery and the St. Pancras Nursery School.) The St. Pancras School for Mothers has extended its activities so as to embrace the whole period from the expectancy of the mother to the compulsory school age of the child, and by association and co-operation with the Hay Nursery and the Nursery School has now become a comprehensive School of .Mothercraft and Babe Training. In St. Pancras the prevention of infantile mortality since 1904 has been successfully based on the discouragement of hand-feeding and the encouragement of breast-feeding of infants. The School for Mothers in 1907, in furtherance of this end, provided (1) periodical medical consultations (weighing and advice) for both nursing and non-nursing mothers and their infants, (2) daily dinners for nursing mothers, and (3) periodical instruction and demonstrations in the arts of Mothercraft at school and at home. 30 As experience was gained it became evident that poor mothers fully realised that it costs more—in money, time, and labour—to rear infants by hand than bv the hreast. Mothers even begged to be allowed to continue breast feeding beyond the usual 9 to 12 months on account of the expense of providing fresh cow's milk. Thus the school first dealt with sucklings and has been gradually extending its work to babes. The mothers cease to partake of the dinners with the cessation of suckling, but it was found necessary to extend the consultations and instructions through the second year of life of the infants. The medical consultations and weighings, which mothers and infants in their first and part of their second year attend fortnightly, are now extended to children Tip to five years of age, who attend monthly up to the end of the second year, and thereafter will attend quarterly for the purpose of supervising their growth and development, and for the prevention of those defects which are at present so commonly found in elementary school children, and which are now being remedied at such great cost. Instruction will also be given to mothers in training the functions, the habits, the senses, and the reasoning powers of their children accordingly as they advance in age, so as to prepare them for elementary school life. Furthermore, by affiliation and co-operation with the Day Nursery and the Nursery School, provision is now madei for those cases in which some of the children are cared for occasionally or trained regularly away from home during part of the day. The great difficulty with regard to the Day Nursery has been reduced to a minimum by means of restrictions upon the admission of infants under six months of age. A daily safeguard has also been adopted both by the Day Nursery and the Nursery Day School for the protection of the children from the spread of infectious diseases and the communicable disorders, by subjecting each child to careful scrutiny by the Matron or Mistress in charge before each admission to the Institution, and by sending any children not found in perfect health or condition to the Doctor, or by placing them in isolation until the Doctor comes, or until they can be sent to the Doctor. The Day Nursery and Nursery School have agreed to send their charges to the medical consultations and weighings at the School for Mothers, or to themselves conduct medical inspections periodically, according to age—under 1½ years, once a fortnight; 1½ to 2 years, once a month; and 2 to 5 or 6 years, once a quarter; and to keep records and interchange copies of case papers and entries. Thus the School for Mothers has become the link in the organisation of a comprehensive School of Mothercraft and Babe Training from the period of expectancy of the mother to the compulsory school age of the child. The objects of the St. Pancras School of Mothercraft and Babe Training may now be briefly defined as:— 1. The promotion of maternal health and the improvement of the capacity of mothers for the suckling, care, and training of their infants and young children. 31 2. The prevention of infantile mortality and sickness and the promotion of the health of sucklings. 3. The prevention of mortality and sickness from infectious diseases and communicable disorders, and the promotion of health amongst babes. 4. The prevention of the physical defects of young children before entering elementary schools, in order to avoid the necessity of having to remedy them at a later period of life. (B) THE ST. PANCRAS DAY NURSERY, 26, Cartwright Gardens, W.C. (Associated with the St. Pancras School for Mothers and the St. Pancras Nurtery School.) 1. Daily Scrutiny. In order to protect the Day Nursery from infectious diseases and communicable disorders, each child is carefully scrutinised by the Matron before each admission to the Institution, and any child not found in perfect health or condition is at once either sent to the Doctor or placed in the isolation room until the child can be sent to the Doctor. 2. Periodical Medical Inspection. In order that the health, growth, and development of the children may be properly supervised and advised upon, the children are sent to the medical consultations and weighings at the St. Pancras School for Mothers periodically according to age—under 1½ years of age, once a fortnight; 1½ to 2 years, once a month; and 2 to 5 years of age, once a quarter. 3. The Mothers. Mothers are invited periodically to the Day Nursery, in order to familiarise them with the methods, management, and training adopted, and are invited periodically to attend the classes at the School for Mothers, or are instructed at home periodically by ladies either from the Day Nursery or the School for Mothers. 4. The Homes. The homes of all children brought to the Day Nursery are visited by ladies either from the Day Nursery or the School for Mothers, in order to ascertain and record the hygienic and home surroundings provided for them; the results of the visits are recorded, and copies of the case papers or entries interchanged. 5. Infants under Six Months of Age. On account of the seriously excessive mortality, sickness, and lack of stamina of hand-fed as compared with breast-fed infants, and with a view to discourage premature weaning, which is the opprobrium of most Day Nurseries, infants under six months of ago are only admitted under special conditions:— (а) If an orphaned infant under six months of age, or previous to cutting its first tooth, has lost its mother, such an infant will be admitted to the Day Nursery until a permanent home can be found for it. (б) If an abnormal mother bring with her a medical certificate or reliable evidence to the effect that she has been sick or physically disabled c from suckling her infant through no fault of her own, or that she has 32 been advised by a medical practitioner, on account of her health or physical condition, to wean her infant, although under six months of age, such an infant will be admitted to the Day Nursery. (c) If a widowed or deserted mother be in a necessitous condition, then, in order that she may continue breast-feeding her infant for at least six months, she should be provided with home work or part-time work, under proper supervision to prevent "sweating," or work away from home only at such a place where she will be able to breast-feed her infant at proper intervals, or be otherwise tided over this nursing period by temporary assistance. Such home work, part-time work, factory work facdities, or home assistance, could be easily organised and supervised by a "Nursing Widows' Aid Association," as the number of necessitous mothers who have infants under six months of age and are also widowed or deserted cannot be large. (d) If the father lives with the mother and child and earns nothing, then attempts should be made to deal with the case in one of the following ways— (1) If the father be sick or disabled he should be assisted by "Sickness and Invalidity Insurance." (2) If the father be genuinely out of employment, he should be provided with work through the "Labour Exchange" or " Distress Committee." (N.P.—In either of these two circumstances of disablement or unemployment, suitable cases might be provided with temporary assistance by the St. Pancras Public Welfare Association through their visitors, or with temporary out-relief by the Guardians through the Women Relieving Officer.) (3) If the father be demoralised by wilful idleness, drink, vice, or crime, no assistance should be provided which can be shared by the father, but if he be placed under restraint in some labour colony or institution, the mother could be treated as widowed or deserted (see (c) above). (C) THE ST. PANCRAS NURSERY SCHOOL, 18, Crowndale Road, N.W. (For children aged three to six years.) (Associated with the St. Panaris School for Mothers and the St. Pancras Day Nursery.) 1. Daily Scrutiny. In order to protect the Nursery School from infectious diseases and communicable disorders, each child is carefully scrutinised bv the Mistress before each admission to the Institution, and any child not found in perfect health or condition is at once either sent to the Doctor or placed in the isolation room until the Doctor comes, or until the child can be sent to the Doctor. 2. Periodical Medical Inspection. In order that the health, growth, and development of the children may be properly supervised and advised upon, the children who are aged from three to six years are medically examined at the Day Nursery, or are sent to the medical examinations and weighings at the School for Mothers periodically once a quarter or once a term, and the results of the examination are recorded and copies of the case papers or entries interchanged. 33 3. The Mothers. Mothers are invited periodically to the Nursery Day School to attend demonstrations, in order to familiarise them with methods of management and training, and are invited periodically to attend the classes at the School for Mothers, or are instructed at home periodically by ladies either from the Nursery School or the School for Mothers. 4. The Homes The homes of all children brought to the Nursery School are visited either from the Nursery School or the School for Mothers, in order to ascertain and record the hygienic and home surroundings provided for them; the results of the visits are recorded, and copies of the case papers or entries interchanged. DOCTOR'S CASE PAPER FOR CHILDREN AGED 2 TO 5 YEARS.* Name Date of Entry or Transfer No. Address Date of Birth Fam. Hist.: No. No. Living Position in Family Causes of Deaths M. F. Teetotalers Pers. History: Measles Whooping Cough Rickets Bronchitis Other illnesses Age when walking began Pres. Cond.— General Height Weight Firm Anaemia Teeth, No. and Cond. Skin— Clean Cold Sweating Disease Scalp— Clean Disease Eyes— Con jnctivitis Squint Other diseases Digestion— Appetite Feeding Stomach Bowels Heart Lungs Mouth, Nose and Throat— Tongue and Mouth Throat Tonsils Adenoids Nasal discharge Glands Ears Nervous System— Mental Condition Speech Sleep, hours, &c. Open window Enuresis Deformities Clothing— Condition Clean Boots Remarks: Advice: *N.B.—The actual paper used is naturally much larger, and condition items are all in one long list to allow of periodical entries. 34 INFANT CONSULTATIONS AND SCHOOLS FOR MOTHERS. At un informal meeting, held on May 5th, 1911, at the National League for Physical Education and Improvement, 4, Tavistock Square, W.C., representatives of Infant Consultations and of Schools for Mothers suggested, with a view to harmonising the work of the two classcs of institutions, that it would be well to place on record the points of agreement which existed. The following were unanimously approved:— (1) That curative medical treatment, as apart from advice on the ordinary care, feeding, etc., of mothers and infants, does not come within the scope either of the Consultations or of the Schools. (2) That Infant Consultations should form the basis of every School for Mothers, and should be aimed at as the basis of all Infant Visiting and similar Associations. (3) That all Consultations should be conducted by properly qualified medical practitioners. (4) That no cases should be brought to the Consultations if they are being attended by their own medical attendant, except by desire of the latter. (5) That the indiscriminate distribution of printed matter giving instructions for artificial feeding is not to be recommended, and that this form of advice should be given in each individual case by the Medical Officer at the Consultation. (6) That all cases should be investigated, to ascertain their suitability, from the social and economic point of view, before admission to the services of either institution. It was suggested and unanimously approved, that it was desirable that the Societies of Infant Consultations and of Schools for Mothers, now in course of formation, should amalgamate to form one strong Central Association. This Association to consist, at first, of two sections, worked by a Committee, with representatives for the medical and for the lay aspects of the work respectively. The Association to have power to add to the numbers of its sections as its work developed. Every affiiliated Society to be invited to appoint at least two representatives, one of whom to be a medical practitioner; the Association's subscription to cover representation on both sections. The National League for Physical Education has published a long list of existing "Schools for Mothers and similar Institutions." BIRTHS IN THE WORKHOUSE AND INFIRMARY. In a circular of the Local Government Board, dated 16th June, 1910, addressed to Boards of Guardians and headed "Children under the Poor Law " on page 4, the second paragraph runs thus:— "The Board's attention has been drawn to the fact that infants frequently deteriorate in health after leaving the workhouse, and they would 35 urge that some simple form of instruction in the best methods of rearing infants might be provided for the mothers while they are inmates." According to the Annual Reports of the Registrar-General for the years 1906, 1907 and 1908, there were 799 illegitimate births in the Metropolitan Borough of St. Pancras. According to the Annual Reports of the Medical Officer of Health, St. Pancras, during the same three years, the number of births in the Workhouse and Infirmary was 406, and in the Home of Hope 102, making a total of 508, and in the Annual Report for 1908, page 28, the following statements were made under the head of "Poor Law Maternitv Cases":— The number of indoor maternity cases in the Workhouse for the past three years ending Lady-day was:— 1905-1906—169; 1906-1907—148; 1907-1908—129. The number of outdoor maternity cases during the three years ending Ladyday was:— 1905-6. 1906-7. 1907-8. Attended by Mid wives 23 25 19 Attended by District Medical Officers:— Ordinary Cases 7 16 8 Difficult Cases 3 1 8 33 42 35 The Report of the Medical Officer of the Workhouse as to the character of the indoor maternity cases is as follows:—"Most are single women who are admitted as destitute and pregnant. Concerning the married women, so far as I know all are genuinely destitute. A few are sent in requiring special treatment in the way of instrumental delivery, etc. Of the 442 cases, there were about 110 only legitimate as far as I can trace: particulars are given in all but about a dozen cases. This proportion would thus be 1 legitimate to 3 illegitimate births." Further inquiry elicited the fact that in twelve cases particulars were not given, probably also on account of illeg timacy, and furthermore in some of the remaining cases the statements as to marriage may be doubted. Therefore the proportion of births in the St. Pancras Workhouse is probably considerably more than three-fourths illegitimate, and all those occurring in the Home of Hope are illegitimate. From this it would appear that more than half the illegitimate births in the Borough take place in the Workhouse and the Home of Hope. During the last half of the year 1910 detailed inquiry was made into the births occuring in the Workhouse. It was found that between the 1st July and the 31st December, 1910, 60 births took place; that of these 48 were illegitimate and 12 legitimate, a ratio of 4 to 1, or 80 per cent. illegitimate. Of the twelve legitimate cases, 4 gave no address on going out, I lived in another Borough, and 7 were investigated with the following results:— 36 1. Baby 5¼ months, breast-fed and healthy. 2. Baby 4 months, partially weaned at 10 days, wholly at 3 weeks. 3. Baby breast-fed first month, mixed-fed to third month, entirely bottle after. 4. Baby 5½ months, breast-fed first month, mother returned to work, mixed- fed since. 5. Babv died of Enteritis in Workhouse three weeks old. 6. Family gone awav. Father a "seafaring man." 7. Emergency case. Twins. Family not destitute. With such unpromising material, the best method of procedure has been found to treat these mothers, in the first place, as if they were part of the ordinary population, by sending them Advice Cards in the usual manner immediately after the notification of birth, and on their discharge from the institutions visiting them and advising them or persuading them to attend the School for Mothers. The majority of these cases being illegitimate, the infants lire weaned from their mothers, and the mothers escape attention by removal. THE CHILDREN ACT, 1908. It is much to be regretted that the Metropolitan Borough Councils have no power under the Children Act, 1908, Part I., Infant Life Protection, Sections 1 to 11 inclusive, and Part II., Prevention of Cruelty to Children, Section 12. The last mentioned section would be much more valuable in the hands of the Borough Councils than in those of the County Council and Boards of Guardians, not for the purpose of prosecution so much as for the purpose of bringing sufficient pressure to bear upon the parents to make them stir themselves to procure necessaries for their children. Section 12 enacts that a parent who fails to provide medical aid, food, clothing, or lodging for a child under 16 years of age, or being unable to provide such medical aid, food, clothing or lodging, fails to procure the same under the Acts relating to the relief of the poor, is liable to a fine of £25, and, in addition, to imprisonment with or without hard labour for six months. This legislation intended to impress parental responsiblity upon the neglectful is unknown to those who most require its stimulus. There are many others besides the parents of illegitimate children who would be benefited and benefit their children if they could be galvanised into realising and shouldering their responsibilities. HOME OFFICE INQUIRY, 1908 & 1909. Results as regards the Feeding of Infants. In last year's Annual Report the results of the complete inquiry for the Hume Office into births and occupations in a selected area were fully set out. From those results the modes of feeding the infants have been extracted and arranged in the table appended hereto. It will be observed that of the infants born during the year 1908 in Somers Town, that is Ward VI. (SubDivisions 4 and 5 of East St. Pancras), no less than 61.4 per cent. were entirely breast-fed for over six months, that 68.9 per cent., or close upon 70 per cent., were entirely breast-fed for over 3 months, that only 6.5 per cent. were handfed from birth, and that only 12.3 per cent. were hand-fed before the second 37 month. When once breast-feeding is established it can generally be maintained if due attention be paid to the mother's health, so that there is hope that by advice, instruction, and assistance the infants of Somers Town may be breastfed for six months in 85 per cent. of cases, and probably ultimately 9 out of 10 infants will be breast-fed until the early signs of teething. In his Annual Report for the year 1909 the Medical Officer of Health of the London County Council shows, on page 22, that in 1909, as compared with 1905, the greatest decrease in infantile mortality was in the sixth and seventh month of age—that is, from over five to under seven months. On page 24 he further shows that during the five years the age incidence curve of diarrhceal diseases rose to a maximum in the fourth month and thereafter progressively declined. These indications point to the probable further decrease in mortality obtainable by the delay of weaning until teething. ST. PANCRAS, WARD VI.—SOMERS TOWN. (Consisting of Sub-Divisions Oakley and Ossulston.) Births occurring during 1908 in Ward 6 677 Of these "Removed" or "Not Known" at primary visit 69 ,, Removed at final visit at 12 months 184 ,, Dying during the first year 68 ,, Surviving the first year 356 Of the 356 Infants surviving the first year particulars were obtained of 350 ,, 68 „ dying during ,, ,, ,, 64 Total Infants 414 38 ANALYSIS OF MODE OF FEEDING THE TNFANTS. MOTHERS. Breast alone, in months. Breast partly, in months. Artificial entirely from birth. Feeding not ascertainable Total of all Feeding. 0—1 1—2 2—3 3—6 6 and over. 0—1 1—2 2—3 3—6 6 & over Of the 350 Surviving Mothers not industrially employed 8 15 8 17 196 .. .. .. 1 3 7 3 258 Mothers industrially employed at home 1 2 1 2 19 .. .. .. .. .. 3 .. 28 Total Mothers at home 9 17 9 19 215 .. .. .. 1 3 10 3 286 Mothers industrially employed away from home 2 10 2 7 37 .. .. .. .. .. 5 1 64 Total mothers of Surviving 11 27 11 26 252 .. .. .. 1 3 15 4 350 Of the 64 Dying Mothers not industrially employed 8 11 7 2 .. .. 1 .. .. .. 7 6 42 Mothers industrially employed at home .. .. .. .. •• .. .. .. .. .. 1 .. 1 Total Mothers at home 8 11 7 2 .. .. 1 .. .. .. 8 6 43 Mothers industrially employed away from home 5 2 1 3 2 .. 2 2 .. .. 4 .. 21 Total Mothers of Dying 13 13 8 5 2 .. 3 2 .. .. 12 6 64 Of the 414 Total Infants Mothers not industrially employed 16 26 15 19 196 .. 1 .. 1 3 14 9 300 Mothers industrially employed at home 1 2 1 2 19 .. .. .. .. .. 4 .. 29 Total mothers at home 17 28 16 21 215 .. 1 .. 1 3 18 9 329 Mothers industrially employed away from home 7 12 3 10 39 .. 2 2 .. .. 9 1 85 Total of all Mothers 24 40 19 31 254 .. 3 2 1 3 27 10 414 5.8% 9.7% 4.6% 7.5% 61.4% .. .. .. .. .. 6.5% 2.4% .. 30 REPORT OF THE WOMEN INSPECTOR AND HEALTH VISITOR To the Medical Officer of Health. Sir, I submit a report of the work done for the Prevention of Infant Mortality in the Borough of St. Pancras during the year 1910. The work has been carried out on the same lines as in previous years. The year has been necessarily a somewhat broken one, as my predecessor left on March 9th, and I did not enter upon my duties until the 1st of August. I have spent these five months in making myself acquainted with all the poorer districts in the Borough, in order that visits may be paid and advice given where they are most needed, and in familiarising myself with the details of the St. Pancras scheme for the reduction of Infant Mortality. I have also endeavoured to come into touch, where possible, with the various charitable and philanthropic bodies whose help and co-operation are so necessary for the effective carrying out of the work. In every case I have found the various organisations most anxious to co-operate with the Public Health Department in helping necessitous and deserving cases. I have also worked in close co operation with the St. Pancras School for Mothers, not only referring cases to the Lady Superintendent, but where possible myself meeting the mothers there whom I had already visited, in order that they might realise the personal individual interest taken by us in their welfare. It is much to be wished that a similar school could be established in North St. Pancras as a centre of educational influence in that part of the Borough. The clerical work in connection with the Notification of Births Act has been done on the same lines as in previous years. Advice Cards are sent daily on receipt of each notification. Complete indices are kept of all registered births and deaths of infants under one year. A comparison of the births notified and registered is made each week, and cautionary letters sent to all parents who have failed to notify according to the provisions of the Act. I have had able assistance from time to time from fully qualified Women Voluntary Visitors, both with regard to the visiting and clerical work of the department. My report of work must necessarily be somewhat limited, owing to the short period I have worked in St. Pancras; but the table drawn up of the feeding of infants refers to the entire year, so is largely a record of information obtained by Voluntary Visitors before I began my duties in the Borough. The Midwives Act has been effective in ensuring skilled attendance for the mothers at their confinement, but the need for the education of the persons who act as nurses and attendants on the mother and baby requires to be emphasized. The London County Council has provided instruction for them in special classes during the winter months. I have endeavoured to come into contact with these women and urged them to refer cases to me which they consider suitable for subsequent special visiting. 40 A special inquiry was made into the cases notified during the last quarter of 1910, with a view to obtaining information as to the kind of skilled attendant who had been in charge of the confinement. In every case a doctor, midwife, or professional assistant had attended. I am, Sir, Your obedient Servant, Celia Smith, Sanitary Inspector. Mode of Feeding of Infants visited during the year 1910, representing the actual number of infants visited and the mode of feeding at the time of inquiry,—that is, at the particular month of age stated. Under 1 month. MONTHS. Total Infants. Under 1 week. 1—2 weeks. 2—3 weeks. 3—4 weeks. —2 —3 —4 —5 -6 —7 —8 —9 —10 —11 —12 Breast-feeding 6 21 151 253 343 29 6 1 — 1 1 1 — — 1 814 431 Mixed-feeding — 4 7 12 13 5 1 — — — — — — — — 42 23 Hand-feeding — 2 9 8 23 4 5 — — — — — — — — 51 19 Total in each period 473 379 38 12 1 — 1 1 1 — — 1 907 41 III.—INFECTIOUS DISEASES. §1—DISCOVERY AND DIAGNOSIS. It is well to know that unrecognised eases largely spread infectious diseases. Discovery.—Mild cases of indisposition or disease excite no particular attention, or are attributed to other than the real cause by parents, guardians, or friends, and are not submitted to medical examination. In the autumn there are generally several instances of parents and guardians failing to recognise as infectious cases of slight disturbances of health in children until other children become infected and develop typical symptoms. When cases of suspected infectious diseases occur there is sometimes considerable difficulty and delay in making an exact medical diagnosis in certain types of the diseases. Here bacteriological and additional clinical examinations are brought to bear upon doubtful types, and to check or confirm the diagnosis. Bacteriological Tents.—The number of specimens of secretion, blood and sputum submitted to bacteriological tests during the year in suspected cases of Diphtheria, Typhoid or Enteric Fever, and Tuberculosis, and the results of examination, were as follows:— Bacillus found. Doubtful. Bacillus not found. Total. Diphtheria (Secretion) 21 .. 70 91 Reaction obtained. Doubtful. Reaction not obtained. Total. Typhoid (Blood) 14 .. 15 29 Bacillus found. Doubtful. Bacillus not found. Total. Tuberculosis (Sputum) 16 .. 58 74 Infectious Diseases fall into several categories— (a) Permanent compulsorily certifiable diseases. (b) Permanent voluntarily certifiable diseases, e.g., consumption. (c) Temporary compulsorily certifiable diseases, e.g., chicken-pox when small-pox is present. (d) Non-certifiable diseases— (i.) Diseases notifiable by School Teachers, e.g., measles, whooping cough, mumps, tonsilitis. (ii.) Communicable Disorders notifiable bv School Teachers, e.g., ophthalmia (blight), ringworm, impetigo, scabies, pediculosis. (iii.) Suspicious Symptoms, e.g., sore throat, feverish cold, whooping, vomiting, diarrhoea, rash, &c. 42 §2.—NOTIFICATION AND DISEASES. 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 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 Small-pox .. 5 1 31 112 95 14 5 2 2 .. 7 238 314 28 3 .. .. .. .. .. .. Scarlet Fever 123 636 621 1279 2465 1255 1053 1067 913 970 858 650 971 1200 647 840 987 791 851 957 774 681 Diphtheria 58 437 298 432 732 491 522 458 506 473 548 580 898 781 489 332 278 271 337 292 312 259 Membranous Croup .. .. .. .. .. 11 16 9 6 13 11 5 6 9 6 7 4 4 8 4 3 3 Typhus Fever 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 34 137 217 119 163 188 .144 198 213 217 240 356 181 188 83 135 72 96 54 60 50 61 Fever, Simple and Continued 1 7 4 3 5 2 3 1 7 2 .. 1 .. 2 .. .. 1 .. 1 .. .. .. Relapsing Fever .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 1 9 8 27 24 11 17 19 14 17 13 9 13 12 5 9 10 10 4 8 15 14 Cholera .. 2 9 5 5 1 .. .. 3 4 1 .. .. .. .. .. .. .. .. .. .. 1 Erysipelas 70 373 370 426 678 470 408 366 393 324 305 227 243 253 222 251 228 231 188 156 160 186 Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. .. 181 1260 16 407 .. .. .. .. .. .. Cerebro-spinal Meningitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 5 6 10 Totals 288 1606 1528 2322 4184 2525 2178 2123 2057 2022 1976 1835 2731 4019 1496 1984 1580 1403 1448 1482 1320 1215 43 The number of cases of the Notifiable Infectious Diseases certified during the year 1910 and the Sub-Districts in which they occurred are shown in the following table:— Population West. 61891. South. 55952. East. 59794. North. 59541. Total. Diseases. Small-pox . . . . . . . . .. Scarlatina or Scarlet Fever 188 74 170 249 681 Diphtheria, MembranousCroup 93 43 59 67 262 Typhus Fever .. .. . . .. .. Typhoid or Enteric Fever 18 19 12 12 61 Continued Fever .. . . .. .. .. Relapsing Fever . . . . .. .. .. Puerperal Fever 5 1 4 4 14 Cholera 1 .. . . .. 1 Erysipelas 40 38 63 45 186 Plague .. .. .. .. .. Cerebro-spinal Meningitis 2 4 2 2 10 Totals 347 179 310 379 1215 The Case-fatttlity.—The following table gives the number of deaths from the Notifiable Infectious Diseases in the Sub-Districts of St. Pancras:— Population West. 61891. South. 55952 East. 59794. North. 59541. Total. Diseases. Small-pox .. .. .. .. .. Scarlatina or Scarlet Fever 3 .. 6 8 17 Diphtheria, MembranousCroup 9 3 6 2 20 Typhus Fever .. .. .. .. .. Typhoid or Enteric Fever 3 1 .. .. 4 Continued Fever .. .. .. .. .. Relapsing Fever . . .. .. . . .. Puerperal Fever 1 1 2 .. 4 Cholera 1 .. .. .. 1 Erysipelas . . 1 5 1 7 Plague .. .. . . .. .. Cerebro-spinal Meningitis 3 3 .. 3 9 Totals 20 9 19 14 62 44 From the preceding tables the Case-fatalitv of each of the diseases in 1910 appears as follows:— Cases. Attack rate per 1000 Population. Deaths. Fatality per cent. Small-pox — — — — Scarlatina 681 2.87 17 2.49 Diphtheria, Membranous Croup 262 1.10 20 7.63 Typhus Fever — — — — Typhoid or Enteric Fever 61 0.26 4 6.56 Continued Fever — — — — Relapsing Fever — — — — Puerperal Fever 14 0.06 4 28.57 Cholera 1 0.00 1 100.00 Erysipelas 186 0.78 7 3.76 Plague — — — — Cerebro-spinal Meningitis 10 0.04 9 90.00 Totals 1215 5.12 62 5.10 Seasonal Variation.—The annexed tables of the Number of Cases of Infections Diseases Notified, and of the number fatal, during each week in the past year show the seasonal variation in prevalence and virulence of those diseases. SAINT PANCRAS, LONDON. A. WEEKLY NUMBER OF INFECTIOUS CASES CERTIFIED TO THE MEDICAL OFFICER OF HEALTH DURING THE YEAR 1910. Quarters First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Totals. Quarters. Months January. February. March. April. May. June. July. August. September. October. November. December. Months. Week ending 8 15 22 29 5 12 19 26 5 12 19 26 Apr. 2 9 16 23 30 7 14 21 28 4 11 18 25 July 2 9 16 23 30 6 13 20 27 3 10 17 24 Oct. 1 8 15 22 29 5 12 19 26 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 33 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 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-pox. Scarlet Fever 14 14 15 14 20 20 21 15 18 17 9 15 16 10 20 13 20 11 14 17 4 17 12 11 11 9 16 16 18 15 11 9 8 10 11 12 9 12 10 20 13 15 11 14 10 10 14 8 12 5 8 7 681 Scarlet Fever. Diphtheria 4 2 6 7 7 4 5 3 3 5 2 3 1 7 8 4 4 6 4 4 4 5 7 3 2 5 3 3 10 8 8 5 2 5 5 5 8 7 5 10 3 2 7 6 8 6 5 8 6 3 4 2 259 Diphtheria. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 3 Membranous Croup Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus Fever. Enteric Fever .. .. .. .. 1 .. 1 .. 2 .. 2 .. .. .. 1 .. 1 1 1 .. 1 2 1 2 3 .. .. .. 1 2 .. 4 2 1 2 .. 4 1 .. 1 8 2 3 .. 2 1 .. 1 3 .. 1 3 61 Enteric Fever. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever. Puerperal Fever 1 .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. 2 .. .. .. 1 .. .. .. .. .. .. 2 2 .. 1 14 Puerperal Fever. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 Cholera. Erysipelas 8 1 5 2 3 2 3 6 4 3 1 4 5 3 4 4 2 1 2 4 3 7 5 4 4 2 5 1 1 3 5 4 1 4 2 4 1 2 6 3 2 8 4 4 4 6 3 3 4 4 3 7 186 Erysipelas. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Plague Cerebro-Spinal Meningitis .. .. 1 .. .. .. 1 .. .. .. 2 .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. 10 Cerebro-Spinal Meningitis Totals 27 17 27 23 32 26 31 24 28 25 16 22 22 20 33 23 28 19 21 25 12 31 25 20 .. 17 24 21 30 29 24 22 13 20 20 21 22 26 22 34 27 28 25 25 24 23 22 20 28 15 16 20 1215 Totals. SAINT PANCRAS, LONDON. B. WEEKLY NUMBER OF CERTIFIED DEATHS FROM INFECTIOUS DESEASES DURING THE YEAR 1910. Quarters First Quarter. Second Quarter. Third Quarter. Fourth Quarter. Totals. Quarters. Months January. February. March. April. May. June. July. August. September. October. November. December. Months. Week ending 8 15 22 29 5 12 19 26 5 12 19 26 Apr. 2 9 16 23 30 7 14 21 28 4 11 18 25 July 2 9 16 23 30 6 13 20 27 3 10 17 24 Oct. 1 8 15 22 29 5 12 19 26 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 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-pox. Scarlet Fever .. .. .. 1 1 1 .. 1 .. .. .. .. .., , 1 .. 1 .. .. 1 1 .. 1 .. .. .. .. 1 .. 1 .. .. .. .. .. ..' .. ... 1 .. .. 1 .. .. .. 1 1 1 .. .. .. .. 1 17 Scarlet Fever. Diphtheria .. .. .. 1 1 .. 1 1 .. .. .. .. .. 1 1 1 .. .. .. 1 .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. 1 1 1 1 .. .. .. .. .. 1 .. .. .. 3 .. .. 2 20 Diphtheria. Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Membranous Croup Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus rever. Enteric Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. 1 1 .. .. .. .. .. .. .. .. .. 4 Enteric rever. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever. Puerperal Fever 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. .. 1 .. .. 4 Puerperal Fever. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 1 Cholera. Erysipelas .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 .. .. .. .. .. .. .. 7 Erysipelas. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Plague. Cerebro-Spinal Meningitis .. .. .. 1 .. .. .. .. .. .. .. .. 2 .. .. .. .. .. 2 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 9 Cerebrospinal Meningitis Totals 1 .. .. 3 2 1 1 3 .. .. .. .. 2 2 1 2 .. 1 3 2 1 1 .. 3 .. .. 1 .. 2 .. .. .. .. 1 .. 1 1 4 3 2 2 3 1 .. 3 1 1 .. 3 1 .. 3 62 Totals. Phthisis 3 3 10 6 10 5 8 6 8 6 8 1 6 7 8 5 6 6 3 7 5 4 6 5 6 4 3 2 7 2 6 2 5 10 5 2 10 4 1 8 6 6 9 7 7 8 8 5 6 6 3 7 297 Phthisis. Measles .. .. .. .. 1 .. .. .. .. .. .. .. 2 .. 2 3 3 1 2 6 5 5 4 1 .. .. 2 3 4 5 5 4 6 6 5 5 5 2 2 1 1 1 3 2 3 4 8 14 6 5 4 2 143 Measles. Whooping Cough 1 1 .. 1 2 1 4 1 2 5 3 .. 4 8 3 5 5 4 1 9 1 1 1 7 3 .. .. 2 3 .. 3 1 1 .. 1 .. 1 .. 1 .. .. .. .. 2 .. .. .. 2 .. 1 .. 1 92 Whooping Cough. Diarrhœa and Dysentery 1 2 1 .. .. 1 .. 1 .. .. .. .. 1 1 1 1 .. .. .. 1 2 .. .. 1 .. .. .. .. .. 1 1 .. 1 1 1 4 1 2 3 4 4 4 2 .. .. 2 1 1 .. 1 3 .. 51 Diarrhœa and Dysentery. Influenza .. 1 .. 1 .. 2 2 4 ..1 .. .. 2 .. 1 .. 1 1 .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 .. .. 1 20 Influenza. 45 Number of Cases of In fectious Disease Notified in the several Boroughs of the Administrative County of Loudon during the Year 1910. Boroughs. Estimated Population in the middle of 1910. Small-pox. Scarlet Fever. Diphtheria (including Membranous Croup). Typhus Fever. Typhoid Fever. Continued Fever. llelapsing Fever. Puerperal Fever. Cholera. Erysipelas. Plague. (,'erebro-Spinal Meningitis. Anthrax. Glanders. Hydrophobia. West. Paddington 153,004 ... 261 120 ... 40 ... ... 9 ... 100 ... 7 1 ... ... Kensington 184,635 ... 263 155 ... 37 3 ... 10 ... 112 ... 2 ... ... ... Hammersmith 127,413 ... 341 165 ... 31 2 ... 9 ... 62 ... 2 ... ... ... Fulham 181,282 ... 354 257 ... 18 2 ... 20 ... 112 ... 7 ... ... ... Chelsea 75,457 ... 120 83 ... 16 ... ... 3 ... 20 ... ... ... ... ... City of Westminster 167,233 1 248 149 ... 48 ... ... 6 ... 61 ... 2 ... ... ... North. ... St. Marylebone 125,195 ... 208 127 1 22 ... ... 4 ... 117 ... 2 ... ... ... Hampstead 95,729 ... 144 51 ... 20 ... ... 2 ... 32 ... 2 2 ... ... St. Pancras 237,792 ... 681 263 ... 63 ... ... 13 1 191 ... 10 ... ... ... Islington 353,356 1 731 473 1 89 1 ... 20 ... 213 ... 16 ... ... ... Stoke Newington 54,838 ... 85 53 ... 10 ... ... 3 ... 31 ... 1 ... ... ... Hackney 239,979 ... 403 190 ... 64 ... ... 16 ... 254 ... 6 ... ... 1 Central. ... Holborn 53,142 ... 68 45 ... 25 ... ... ... ... 42 ... 1 ... ... ... Finsbury 94,578 ... 165 150 ... 30 ... ... 7 ... 170 ... 4 ... ... ... City of London 17,132 ... 21 20 ... 4 ... ... 1 ... 16 ... 1 ... ... ... E ast. ... Shoreditch 114,387 2 213 131 ... 48 ... ... 8 ... 130 .. 5 ... ... ... Bethnal Green 131,579 ... 236 182 ... 108 1 ... 13 ... 174 ... 7 1 ... ... Stepney 314,379 ... 554 404 ... 118 ... ... 29 ... 381 ... 7 ... ... ... Poplar 172,432 1 470 175 1 62 ... ... 15 ... 209 ... 3 1 ... ... South. Southwark 211,832 ... 419 284 ... 54 ... ... 16 ... 241 ... 3 1 ... ... Bermondsey 127 238 1 364 210 ... 38 ... ... 6 ... 130 ... 5 ... ... ... Lambeth 327,074 ... 908 327 ... 78 1 ... 19 ... 193 ... 5 ... ... ... Battersea 188,322 ... 488 227 ... 45 2 ... 16 ... 170 ... 5 ... ... ... W andsworth 305,838 ... 681 286 ... 54 ... ... 20 ... 182 ... 5 ... ... ... Camberwell 286,058 ... 511 272 ... 76 2 ... 7 ... 219 ... 2 ... ... ... Deptford 119,642 ... 301 130 ... 24 2 ... 2 ... 111 ... 1 ... ... ... Greenwich 112,935 ... 171 168 ... 20 ... ... 5 ... 89 ... 1 ... ... ... Lewisham 164,899 ... 573 224 ... 29 ... ... 5 ... 61 ... 2 ... ... ... Woolwich 135,422 1 526 172 ... 10 ... ... 8 ... 90 ... 1 ... ... ... Port of London ... ... 1 1 ... 3 ... ... ... ... 3 ... ... ... ... ... Administrative County of London 4,872,702 7 10509 5494 3 1284 16 ... 292 1 3982 ... 115 6 ... 1 SECONDARY NOTIFICATIONS. The secondary notification of infectious diseases lias grown to considerable proportions. A Daily List of Notifications is sent to:— 1. The Metropolitan Asylums Board. 2. The St. Pancrus Public Library. 3. The Day Schools attended by infected children. 4. The Day Schools attended by contacts. 5. The Sunday Schools attended by infected children, 6. The Sunday Schools attended by contacts. 7. Certain workplaces attended by contacts. 46 8. In small-pox cases to the Vaccination Officers. 9. In small-pox cases to the Public Vaccinator. 10. During June, July, and September (holidaj time) to the Children's Country Holiday Fund, when lists of over 1,000 children at one time are sometimes sent to be checked. In addition to these Notifications, Certificates of Disinfection have also to be provided in order that other persons in the family and the house may resume attendance at school, workplaces, &c. Notification of Erytipelas. Year. Population of St. Pan eras. Number of Cases Notified. Morbidity per 1000 Persons. Number of Deaths. Fatality per 1000 Cases. 1891 234,379 enumerated 370 1.6 12 32.4 1892 234,473 estimated 426 1.8 9 21.1 1893 234,567 ,, 678 2.9 36 53.1 1894 234,661 ,, 470 2.0 14 31.9 1895 234,755 „ 408 1.7 11 26.9 1896 234,849 ,, 366 1.6 13 35.5 1897 234,943 ,, 393 1.7 13 33.1 1898 235,037 ,, 324 1.4 10 30.9 Mean of 8 years 234,708 429 1.8 15 34.9 *1899 235,131 estimated 305 1.3 16 52.5 1900 235,224 estimated 227 1.0 8 35.2 1901 235.317 enumerated 243 1.0 10 41.2 1902 237,054 estimated 253 1.0 8 33.6 1903 237,032 ,, 222 0.9 11 49.6 1904 237,088 ,, 251 1.1 17 67.7 1905 237,150 ,, 228 1.0 17 74.6 1906 237,149 ,, 231 0.97 21 90.9 1907 237,173 ,, 188 0.79 11 58.5 1908 237,158 ,, 156 0.66 7 44.9 1909 237,247 ,, 160 0.67 10 62.5 1910 237,178 ,, 186 0.78 7 37.6 Mean of 11 years 236,797 234 0.89 13 54.2 *N.B.—This year is not included in either series because it was a transition year. This matter was considered by the Metropolitan Branch of the Incorporated Society of Medical Officers of Health in 1906, anil it was decided that it was undesirable to take any steps to remove erysipelas from the list of notifiable diseases. 47 SMALL-POX. Cases of Small-pox occurred in some of the London Boroughs and caused Public Health Authorities to review their means of fighting the disease in case of epidemic. The necessary preparations are— 1. Notification of Small-pox.—This is always in force. 2. Notification of Chicken-pox tchen Small-pox threatens to become prevalent. — On account of a rather severe outbreak of Small pox in the Borough of Stepney in February, the London County Council resolved, on March 14th, 1911, to make an Order requiring the notification of Chicken-pox to be compulsory for a period of three months, dating from the 22nd March, 1911. 3. Expert medical referees for the diagnosis of doubtful eases.—In the Circular covering the above-mentioned Order the London County Council stated that " it is assumed that in doubtful cases the certifying practitioner will confer with the Medical Officer of Health of the Borough, and, should a further opinion be required, the Council has arranged that the services of 1)r. Wanklyn, the Council's Assistant Medical Officer of Health, will be available." Dr. Wanklyn was Referee in the diagnosis of Small-pox for the Metropolitan Asylums Board during the epidemic of 1901-3. 4. Prompt removal of Small-pox patients to hospital.—The Small-pox Hospitals and Ambulance Service of the Metropolitan Asylums Board, in conjunction with the telephone service, are always available at a moment's notice. 5. Prompt inquiry into the case and discovery of contacts.—The names and addresses of contacts are immediately sent to the Medical Officers of Health of the Boroughs in which they respectively reside, and a copy of the form containing the results of inquiry is sent to the Medical Officer of Health of the London County Council, who circulates these forms to the Medical Officers of Health of the Metropolitan Boroughs. 6. Prompt disinfection of the infected dwelling and contents, and stripping and cleansing of the surfaces. 7. Immediate despatch of a copy of the notification certificate to the, Vaccination Officer, that he may be able to carry out his instructions promptly. 8. Treatment of Contacts.—(a) The delivery of notices to contacts warning them of the danger, and advising them to forthwith attend the Contact Shelter for the purpose of undergoing personal disinfection, and of receiving a certificate to the effect that they have been personally disinfected, and advising them to consult the Public Vaccinator. (A) Notification to the Public Vaccinator of contacts by sending him a copy of the form containing the results of inquiry. 48 CHICKEN-POX. As mentioned above, this disease was made notifiable for three months, on and from the 22nd March, 1911. The results of the notifications will appear in next year's report. CEREBRO-SPINAL FEVER. Cerebro-spinal Fever (Epidemic Cerebro-spinal Meningitis) was first made a notifiable disease in 1907, and the Order came into effect on the Pith March of that year, and the Order has been renewed from year to year since. The term cerebro-spinal fever includes posterior basal meningitis, but not meningitis due to tuberculosis, syphilis, middle-ear disease, or injury. The services of Dr. Wanklyn, Assistant Medical Officer of Health, Public Health Department, London County Council, 8, St. Martin's Place, W.C., are available for the investigation of cases in association with medical practitioners, should they so desire. PLAGUE. In November the Local Government Board issued a Memorandum and an Order in regard to the Prevention of Plague and the destruction of rats. The Order provides that in any district in which a representation is made to the Local Authority that rats in the district are infected or threatened with Plague, or that there is an unusual mortality among rats in the district, the Local Authority shall report the matter to the Local Government Board, and shall take measures for the destruction of all rats in their district, and, further, prevent the entrance of rats into buildings and other premises in the district. OPHTHALMIA NEONATORUM. The London County Council made an Order for the notification of Ophthalmia Neonatorum on the 8th November, 1910. This Order was approved by the Local Government Board, and the disease became notifiable from the 13th March, 1911. So far as the practice of certified midwives is concerned, there is already in existence a method of notification provided by one of the rules of the Central Midwives Board, which requires that every certified midwife shall advise the parents that medical assistance should be obtained in every case of inflammation of the eyes of the infant, however slight. This advice must be given in writing in a prescribed form, and a copy must be sent to the local supervising authority (in London, the County Council) within twentyfour hours. Notification will not only bring information to the Sanitary Authority of cases which at present are not notified to anyone, but it will also render more complete the provisions for securing continuous and efficient treatment of the child, who may be at present notified under the rule above mentioned. TYPHOID FEVER. A report, by Dr. Hamer, on certain localised prevalences of typhoid fever in London in 1910 was presented to the London County Council on 7th March, 1911. The report points out that in 1900 three localised prevalences of typhoid fever occurred, and one of these prevalences (in Southwark), involving some 120 cases of typhoid fever, was on a sufficiently large scale to allow statistical inferences to be drawn. Dr. Hamer was able to adduce evidence in favour of the view that the Southwark prevail nee was due to consumption of infected fish, and he raised the question whether the other two prevalences (in 49 Lambeth and in Kensal-town) might not have had a similar origin. In 1910 an area in Bethnal-green was especially affected; study was made of a number of other localised prevalences of typhoid fever in other parts of London and in Edmonton and Tottenham. Examination of the facts failed to show in each instance that any ordinarily accepted cause of typhoid fever had been operative, but it was found that all sufferers had partaken of fish (usually fried fish), and that in all the instances in which information on this head could be obtained, small plaice belonging to the category described by friedfish vendors as "late steamer fish," was in question. The report points out that much of the small plaice sold at Billingsgate comes from an area in which are situated certain "nursery grounds" not far from the mouth of the Elbe, and it is suggested as a possibility that estuary fish may be in question. CONSUMPTION (PULMONARY TUBERCULOSIS). Deaths from Consumption. The number of deaths in St. Pancras from the pulmonary form of Tuberculosis during each of the last eight years, at several ages, has been as follows Tuberculous Phthisis, Pulmonary Phthisis, and Phthisis. Year. Under 5. 5-15. 15—65. Over 65. Total. 1903 5 7 390 24 426 1904 10 15 397 18 440 1905 13 10 313 17 353 1906 13 12 359 17 401 1907 8 5 340 23 376 1908 14 5 329 14 362 1909 15 5 339 15 374 1910 4 4 266 23 297 During the past year the following have been the number of deaths from all forms of Tuberculosis at several ages of life:— Tubercular Diseases, 1910. AGES. Total. Under 5. 5—15. 15—65. 65 and upwards. TuberculousPhthisis(Pulm.Phthisis) 4 3 212 18 2.37 297 Phthisis 1 54 5 60 Tuberculous Meningitis 21 5 5 - 31 Tuberculous Peritonitis 2 1 4 1 8 Tabes Mesenterica 1 1 1 — 3 Lupus — — — — - Tubercle of other Organs 2 1 3 2 8 General Tuberculosis 10 2 12 2 26 Scrofula — — — — — 50 CONSUMPTION (PULMONARY TUBERCULOSIS). During the year the following action has been taken in regard to consumption : — Voluntary Notifications of Disease (Cases). Private & Public Cases (other than Poor Law). W. B. E. N. Total. Sputum examined 10 5 22 36 73 Medical certificates received 49 49 77 17 192 Cases notified by School Officers 5 9 4 - 18 Other cases not medically certified — 1 — — 1 Advice papers sent 51 50 79 17 197 Inquiry made 51 50 79 17 197 By request Segregation provided 1 1 2 1 5 Disinfection done 6 9 3 2 20 Sanitary Inspect on made - - - - Poor Law Notifications of Disease (Certificates, etc.. received, not Cases). W. S. E. N. Total. Sputum examined - - - - - Medical certificates received 124 148 26 217 715 Advice papers sent 114 140 209 217 680 Inquiry made 106 140 209 209 664 By request1 Segregation provided 85 110 183 183 561 Disinfection done 11 5 5 5 26 Sanitary Inspection made - - - - - Notifications of Disease under Poor Law Regulations (Certificates). W. S. E. N. Total. Notified by Medical Officer—Workhouse 201 - 201 ,, ,, South Infirmary — — 77 — 77 „ ,, North — — 290 290 ,, Ward 1 & 2 — — — 32 32 ,, ,, ,, 3 — — 1 — 1 ,, ,, ,, 4 2 — - 2 ,, ,, ,, 5 31 - - - 31 ,, ,, ,, 6 — - 28 - 28 ,, ,, ,, 7 — 14 — — 14 ,, ,, ,, 8 — 18 — — 18 ,, ,, Extra Parochial Institutions... — 10 5 6 21 Total ... 33 42 312 328 715 51 Poor Law Cases. Notices of Removal from Private Address. I Workhouse. South Infirmary. North Infirmary. Central London Sick Asylum. No Home. Without St. Pancras. Casual Wards. Total. Private Address to — 124 46 130 — - 9 — 309 Workhouse to — — 42 154 — 1 5 — 202 South Infirmary to 10 2 — 17 — 1 — — 30 North Infirmary to 78 9 — — — 9 5 — 101 Central London Sick - - - - - - - - - Asylum to 8 - - - - - - - 8 No home to — 62 - 4 - —- — — 70 Without St. Pancras to 19 4 - 1 128 — - — 152 Casual Wards to - - - - - - - - - Totals 115 201 92 306 128 11 19 — 872 N.B.—The same patient ruay have been removed to and fro several times, hence the above represents removals and not Patients. Number of cases of Consumption known to the Department as resident in the several places stated hereunder on the last day of the year 1910:— Poor Law Patients remaining in W. S. E. N . St. Pancras Workhouse - - - - - „ South Infirmary — - 28 — 28 „ North Infirmary — — - 188 188 Central London Sick Asylum — 18 - - 18 At Private Ad- dresses Under District Medical Officer — 4 8 3 15 Returned from Institutions from within St. Pancras 3 4 5 6 18 Returned from Institutions outside St. Pancras 2 1 — - 3 Total Poor Law Patients 5 27 41 197 270 Other Public Patients 46 30 55 24 155 Private Patients 2 1 1 2 7 Sum Total 53 59 97 223 432 52 NOTIFICATION OF PULMONARY TUBERCULOSIS. Voluntary Notifications.—The Scheme for the Voluntary Notification of Consumption was put into operation at the beginning of 1906, the fees paid being the same as for the Compulsiorily Notifiable Diseases. Poor Law Notifications.—By an Order dated the 18th December, 1908, the Local Government Board, in pursuance of Section 130 of the Public Health Act, 1875, as amended and extended by the Public Health (London) Act, 1891, and the Public Health Act, 1896, provided for the notification to medical -officers of health of sanitary authorities of cases of pulmonary tuberculosis {phthisis or consumption) occurring amongst the inmates of Poor Law Institutions, or amongst persons under the care of district (Poor Law) medical officers. This Order came into operation on the 1st January, 1909. Under the Public Health (Tuberculosis) Regulations or 1908, it is required that any person who is diagnosed as suffering from pulmonary tuberculosis and who is now in receipt of, or compelled for various reasons to seek, any form of Poor Law medical relief, has to be notified to the medical officer of health of the district within 48 hours. The notifications have to be made by medical officers of Poor Law Institutions, district medical officers, superintending officers of Poor Law Institutions, and, as to changes of address, by relieving officers. Nothing in the regulations authorises the medical officer of health, directly or indirectly, to put in force, with respect to any poor person in relation to whom a notification has been received, any enactment which renders the poor person, or a person in charge of the poor person, liable to a penalty or subjects him " to any restriction, prohibition, or disability affecting himself or his employment, occuption, means of livelihood, or residence, on the ground of his suffering from pulmonary tuberculosis." Another section of the article which contains this provision confers upon a local authority (subject, of course, to the foregoing proviso) power to take all such measures or to do all such things as are authorised in any case of infectious disease by any enactment relating to the public health having reference to the destruction and disinfection of infected articles or the cleansing or disinfecting of premises. Certain other powers, as affording assistance (in the form of appliance, apparatus, or utensil) to persons suffering from this disease, are also conferred. Each notification received is treated as confidential, and nothing is done to prejudice the patient's occuption or employment. Advice papers are sent in all cases notified, and inquiries are made by the Woman Inspector, and disinfection carried out when requested. Public Hospital and Dispensary Notifications.— The Regulations of 1908 have now been supplemented by the Public Health (Tuberculosis in Hospitals) Regulations, 1911. The former provided for the notification of pulmonary tuberculosis occurring amongst the inmates of Poor Law Institutions or amongst persons under the care of District Medical Officers. The latter provide for the notification of cases of pulmonary tuberculosis occurring amongst the in-patients or out-patients at hospitals, or other similar institutions for the treatment of the sick, which are supported wholly or partially otherwise than by the contributions of the patients (or of their relatives or guardians) and otherwise than from rates and taxes. 53 In forwarding the Regulations for 1911, the Local Government Board point out that the principle of compulsory notification which was embodied in the Regulations of 1908 has been justified by experience, and it is now generally recognised as affording valuable aid in securing effective administrative measures in relation to tuberculosis. A considerable number of Sanitary Authorities have advocated the immediate adoption of a scheme of notification of all cases of tuberculosis. But the Board feel that the object which they have in view can be most surely attained if the procedure is by stages and by a steady development of administrative machinery. The new Order, which is dated the 22nd March, 1911, takes effect from the 1st May, 1911. The most important provisions are as follows : — Notifications by Medial Officers of Hospitals and transmission of notifications by Medical Officers of Health. Article IV. of the Order imposes the duty of notification upon the Medical Officer who is in medical attendance upon the patient at the hospital. The notification must be sent within 48 hours after the first recognition of the disease. The notification is to be sent to the Medical Officer of Health for the area in which the hospital is situate. Article IV. (2) directs that a Medical Officer of Health who receives a notification relating to a patient, whose residence as described in the notification is not within the area for which he is Medical Officer of Health, shall without delay transmit the notification to the Medical Officer of Health for the area in which the patient's residence appears to be situate, at the same time informing the Medical Officer of the Hospital that he has done so. In other words, each Authority acts as a distributing centre for the hospitals in its area. Under Article IV. (3) the Medical Officer of Health for an area within the Administrative County of London is required to send to the Medical Officer of Health for the Administrative County of London a weekly statement of notifications received by him under this Order, and also under the Public Health (Tuberculosis) Regulations, 1908, of patients whose residence is situate within this area. Remuneration of Medical Officers. By Article VI. the remuneration of Medical Officers who are required to make notifications under the Order is fixed at one shilling, which is the fee payable to the Medical Officer of a public body or institution for a notification under the Public Health (London) Act, 1891. Provision for the Weltare of Patients. Some of the provisions of the Public Health Act, 1875, and of the Public Health (London) Act, 1891, relative to infectious disease are not usually appropriate in cases of pulmonary tuberculosis. It is, therefore, provided by Article VII. (1) that nothing in the Regulations shall have effect so as to apply or to authorise anyone to put in force with respect to a person in relation to whom a notification has been made any enactment which renders him or any other person liable to a penalty, or subjects him to any restriction, prohibition, or disability affecting him or his employment, occupation, means of livelihood, or residence on the ground of his suffering from pulmonary tuberculosis. 54 Special Powers of Council. The Order confers some special powers upon Councils for the purpose of the prevention of the spread of infection in cases of pulmonary tuberculosis. By Article VII. (2) of the Order the Council are empowered to take the necessary measures to secure the disinfection of infected premises and of infected articles, and to secure the destruction of infectious discharges. They are also empowered to supply all such reasonable assistance as will tend to diminish the risk of infection arising from the conditions affecting the use or occupation by the patient of a room as a sleeping apartment, and to supply for the use of the patient any appliance, utensil, or article (such, for instance, as sputum boxes or bottles, paper handkerchiefs, and disinfectants) which may be of assistance in preventing the spread of infection. An important object of notification is to afford the local authority an opportunity of investigating the conditions under which the patient has been living, and of ascertaining whether there are any other members of the household who should be encouraged to obtain medical advice. When investigating the conditions of living, special attention should be paid to the abatement of overcrowding, the provision of ample through ventilation, the removal of conditions causing dampness of the dwelling, the avoidance of dust, and to any other conditions tending to injure the health of the occupants of the dwelling. Councils are already empowered to provide hospitals for the treatment of pulmonary tuberculosis, and the Board are advised that this power extends to the provision of dispensaries or hospitals for the treatment of out-patients. It will be for each Council to consider whether its district has sufficient hospital provision for cases of tuberculosis. Many Councils have provided Hospitals for acute Infectious Diseases, and it has sometimes been found that these buildings, or some part of them, may (subject to proper safeguards) be economically used as sanatoria for patienls suffering from tuberculosis where they are not required for the purposes for which they were provided. The Order will allow of the provision of appliances or apparatus, such as temporary shelters, with the necessary furniture and utensils for the use of the patient; and by these means patients may sometimes be treated at their homes under suitable sanitary conditions, or continue treatment at home after a short stay in a sanatorium. By paragraph (v) of Article VII. (2) powers are given to the Council of appointing such officers and making such arrangements as may be requisite for giving advice and for carrying out the provisions of the present Regulations and of the Regulations of 1908. Under Article VII. (3) the Council, on the advice of their Medical Officer of Health, may provide and publish or distribute in the form of placards, handbills, or leaflets, suitable summaries of information and instruction respecting pulmonary tuberculosis and the precautions to be taken against the spread of infection. They are thus enabled to exercise an educative influence both upon phthisical patients and contacts, and upon public opinion generally. 55 INSTITUTIONS FOR CONSUMPTION. The General and Special Institutions dealing with Consumption were enumerated in last year's Annual Report, and the St. Pancras scheme described. During the year under review questions as to Institutions for Consumption have been raised on various occasions in various quarters. One of the most persistent questions has been that of providing accommodation for far-advanced and incurable cases which are such a danger to other members of poor families. The St. Pancras Guardians have provided at the North Infirmary four wards specially for Consumption, three of the wards containing 33, 33, and 20 beds respectively for men, and one of 16 beds for women ; a total of 102 beds. But it is interesting to consider generally the classes of institutions now provided for Consumption. Broadly speaking, the course of Pulmonary Tuberculosis is naturally continuous, but for convenience of classification it is generally divided into three or four stages, according to the period at which the disease is under treatment. The first stage embraces the doubtful and incipient cases; the second, the distinct and pronounced cases; the third, the established and advanced but partly or wholly arrested cases; and the fourth, the far-advanced, unarrested, uncured, and incurable. Several kinds of institutions exist for treatment away from home, exclusive of ordinary convalescent homes and health-restoring institutions, for those temporarily debilitated, with or without predisposition to pulmonary feebleness. The special residential institutions range themselves into three classes. Firstly, those admitting by preference early cases with incipient signs, or some with distinct, or perhaps pronounced, symptoms of the disease, embracing the two first classes mentioned above, and generally termed sanatoria; secondly, those admitting temporarily the more established or advanced cases, and either in the nature of, or expressly designated, hospitals; and, thirdly, institutions under various designations, such as poor law infirmaries, homes for the dying, and homes under the names of Saints or founders, admitting unarrested, uncured, and incurable cases. A good plea may be made for the use of the generic title " incuratoria" for institutions admitting far-advanced and chronic cases of Pulmonary Tuberculosis, unarrested, uncured, and incurable. Just as the term sanatorium is derived from sano, sanatum, to heal or cure, so the term incuratorium may be derived from incuratun, a, urn, uncured. We are all well aware of the fact that classification and the use of generic terms immensely facilitates the discussion and consideration of complex subjects, and one is struck constantly by the confusion of thought and expression in discussions upon the provision •of institutions for various classes of cases of consumption. 56 In November, 1907, the St. Pancras Guardians requested the Local Government Board to favourably consider a suggestion for the Metropolitan Asylums Board to be authorised as a temporary arrangement to admit into one of their hospitals patients suffering from phthisis. The Guardians stated that there were 134 at one of their Infirmaries, and that both Infirmaries were occupied beyond the certified limit. On the 8th January, 1908, the Local Government Board replied that it was inexpedient to sanction the proposal at the present time, even as a temporary measure, as the proposals involved many questions that would be dealt with by the Royal Commission on the Poor Laws which was then sitting. The Royal Commission on the Poor Laws reported, and the reports of that Commission did not touch the proposal made by the St. Pancras Guardians in November, 1907, and the same condition of overcrowding and accumulation of chronic consumptive cases at the Infirmary still continues. The Public Health Committee in reporting to the St. Pancras Borough Council on the 13th July, 1910, upon the result of the Conference of Representatives of the Metropolitan and City Boroughs, held at the Caxton Hall, Westminster, on Wednesday, the 25th May, 1910, whilst, on the one hand, in general agreement with the opinions expressed by the Conference, would not commit themselves to the particular methods of dealing with the matter, and considered that the methods of handling the subject should be carefully inquired into by the Central Authorities. On the other hand, the St. Pancras Public Health Committee expressed a strong view that the time had come when steps should be promptly taken to provide accommodation for those persons who are in such an advanced stage of consumption that they are not received for treatment at any of the existing Hospitals or Institutions except Poor Law Infirmaries, and especially having regard to the danger of their spreading the disease unless properly isolated. The Borough Council approved a resolution that a representation be made to the Metropolitan Asylums Board urging them to take immediate steps to provide a Central Home for chronic and incurable consumptive cases. The intention of the St. Pancras Board of Guardians, as well as the St. Pancras Borough Council, is to relieve the Poor Law Infirmaries of the Metropolis of the more chronic and incurable cases by admitting them to some central institution or institutions, and thus make room at the Local Infirmaries for the open-air treatment of more hopeful cases. The unlimited expenditure that appears to be possible if consumptives are allowed to be sent directly by medical practitioners into any Institutions established by the Metropolitan Asylums Board is, no doubt, what frightens, not only the Central Boards, but the public, and this with a very strong show of reason. But if the Metropolitan Asylums Board limited the admission of such cases to those which had first passed through the administration of the Poor Law Guardians, both the Central and Local Bodies could keep a firm grip on the limitation of expenditure. It is some device of this kind which is necessary for financial security. The Conference of Representatives of Metropolitan City and Borough Councils, held at Caxton Hall, Westminster, on the 25th May, 1910, mentioned above, passed the following resolutions :— 57 1.—That this Conference is of opinion that the provision of Sanatoria for the educational and curative treatment of cases of tuberculosis is advisable. 2.—(a) That, in the opinion of this Conference, it is desirable that a Sanatorium should be established for the accommodation of persons of the working classes of the metropolis suffering from tuberculosis, and that such Institution should be maintained by a charge upon the several Metropolitan Boroughs in accordance with their respective rateable values. (b) That, in the opinion of this Conference, the proposed Sanatorium should be under the direct control of the Metropolitan Asylums Board, and that such Authority be asked to seek the necessary Parliamentary powers for that purpose (if necessary). (c) That copies of the above resolutions be forwarded to the politan sylums Board and to the Local Government Board. 3.—That, pending the provision of a Sanatorium for the working classes, it is desirable that each Municipal Authority should secure beds in some existing Sanatorium, according to the provisions of Section 75 of the Public Health (London) Act, 1891. 4.—That, in the opinion of this Conference, the establishment of Tuberculosis Dispensaries in each of the Metropolitan Boroughs would be a desirable adj unct to the prevention and treatment of tuberculosis. Your Council were in general agreement with the resolutions passed by the Conference as set out above, but they considered that the methods of dealing with the matter should be made the subject of careful inquiry by the Central Authorities. Further, they were strongly of opinion that the time had come when steps should be promptly taken to provide accommodation for those persons who are in such an advanced stage of consumption that they are not received for treatment at any of the existing institutions, and especially having regard to the danger of their spreading the disease unless properly isolated; and it was resolved, on the 13th July, 1910, that a representation be made to the Metropolitan Asylums Board urging them to take immediate steps to provide a central home for chronic and incurable consumptive cases. A communication was subsequently received from the Asylums Board stating that they had considered the Council's letter urging the provision of Sanatoria for Consumptives, and pointing out in reply that the Managers have no power without the consent of the Local Government Board to make such provision. The subject has been frequently discussed, and several communications have been addressed to the Local Government Board on the matter, but hitherto the Managers have received from the Board no official indication of the view they take. With reference to Resolution No. 4 above as to the establishment of Tuberculosis Dispensaries, the Conference addressed a letter to the Local Government Board as to the legal right of the Borough Councils to establish such dispensaries other than for "poor persons" within the meaning of the Board's regulations. 58 The Board replied on the 15th December, 1910, that the provisions of Section 75 of the Public Health (London) Act, 1891, would empower a Sanitary Authority to provide an out-patient hospital or dispensary at which any inhabitant of the district suffering from tuberculosis could be received for medical treatment and advice. Provision of Dispensaries for Tuberculosis in London. Borough. Action taken. Battersea Movement started for establishing dispensary. Kensington Dispensary (voluntary). No contributions by Council. Lambeth Dispensary just established. Private funds. No contributions by Council. Stepney Movement started to establish dispensary which will be supported by voluntary contributions by members outside the Council. Paddington Dispensary established and supported by voluntary contributions. St. Marylebone Dispensary being established in Borough to be supported by voluntary contributions. St. Pancras Dispensary supported by voluntary contributions, commenced to examine contacts at the beginning: of 1969. Woolwich No dispensary in Borough. Council maintains seven beds at a Sanatorium. City of Westminster No dispensary in Borough. Westminster Health Society supported by voluntary contributions have four beds at a Sanatorium. Bermondsey No provision. Bethnal Green Camberwell ,, Chelsea ,, Deptford ,, Finsbury „ Fulham „ Greenwich ,, Hackney ,, Hampstead ,, Hammersmith „ Holborn „ Islington ,, Lewisham ,, Poplar ,, Shoreditch ,, Southwark ,, Stoke Newington ,, Wandsworth ,, The distribution of Consumption. An effort has been made to ascertain the distribution of Consumption through a series of years in St. Pancras by means of the death-rates from phthisis in the Registration Sub-Districts in relation to Census overcrowding 59 based upon the Census of 1901. The following tables A, B, and C show respectively—A, the death-rates from phthisis per 100,000 of population in the Registration Districts from 1896 to 1909, inclusive ; B, the death-rates per 100,000 from other respiratory diseases for the same areas and years ; and C, the percentage of statistical overcrowding at the Census of 1901—that is, more than two persons per room—in each of the Registration Sub-Districts. This last table, C, is a summary of the table of Census overcrowding in each of the Enumeration Areas published in the Annual Report of the Medical Officer of Health for 1903. A. St. Pancras.—Death Rates from Phthisis per 100,000 of population. Sub-Districts. 1896. 1897. 1898. 1899. 1900. 1901. ٭1902 North Kentish Town 163 167 175 140 139 167 153 North. East and West or Central Camden Town 188 302 154 154 191 106 165 Somers Town 198 213 207 271 186 273 222 Regent's Park 199 212 162 191 198 183 162 South Central St. Pancras 197 228 178 215 192 181 178 Central Tottenham Court 211 207 307 296 241 260 296 Gray's Inn Lane 261 220 243 253 290 190 240 South St. Pancras 237 214 274 274 267 221 261 South. All St. Pancras 193 200 199 198 196 187 192 †1903. 1904. 1905. 1906. 1907. 1908. 1909. Central North St. Pancras 151 144 137 143 151 138 136 North. East do. 158 174 159 184 129 161 157 West do. 193 209 149 160 171 132 152 Central do. 175 192 151 172 151 147 155 Central South do 220 216 150 191 184 182 188 South. All do. 179 186 119 169 159 153 153 * Mote.—In 1902 the division line between the Registration Sub-Districts of Gray's Inn Lane and Tottenham Court was moved westward from Burton Crescent (now Cartwright Gardens) to Upper Woburn Place. † Note.—In 1903 triangular pieces of the Camden Town and Somers Town Sub-Districts were added to the Regent's Park Sub-District to form the West St. Pancras Sub-District, and the remainder of Camden Town and Somers Town Sub-Districts were amalgamated to form the East St. Pancras Sub-District. 60 B. Sr. Paxckas.—Death Rates from Bronchitis, Pneumonia, and Pleurisy, pei 100,000 of population. Sub-Districts. 1896. 1897. 1893. 1899. 1900. 1901. *1902. North Kentish Town 251 293 262 349 239 256 314 North. East and West or Central Camden Town 370 416 201 422 283 247 281 Somers Town 440 418 448 506 387 422 479 Regent's Park 291 257 264 375 357 323 319 South 1 Central St. Pancras 362 346 321 433 344 324 348 Central. Tottenham Court 300 341 355 403 393 421 390 Gray's Inn Lane 377 444 327 444 443 361 385 South St. Pancras 341 395 340 425 420 389 387 South. All St. Pancras 311 337 301 396 348 322 348 †1903. 1904. 1905. 1906. 1907. 1908. 1909. Central North St. Pancras 233 242 247 260 253 284 264 North. East do. 287 343 318 317 355 340 328 West do. 248 306 272 294 307 310 318 Central do. 267 324 294 3.15 330 325 323 Central. South do. 290 338 313 255 284 252 325 South. All do. 264 397 287 282 300 297 309 * Note.—In 1902 the division line between the Registration Sub-Districts of Gray's Inn Lane and Tottenham Court was moved westward from Burton Crescent (now Cartwright Gardens) to Upper Woburn Place. + Note.—In 1903 triangular pieces of the Camden Town and Somers Town Sub-Districts were added to the Regent's Park Sub-District to form the West St. Pancras Sub-District, and the remainder of Camden Town and Somers Town Sub-Districts were amalgamated to form the East St. Pancras Sub-District. 61 c. CENSUS 1901 — OVERCRO WDING. Saint Pancras.—Table shewing the percentage of Statistical Overcrowding—that is, more than two persons per room—in each of the Registration Sub-Districts at the Census of 1901. Central. South. South. Central. Central. North. Sub-Districts. Regent's Park. Tottenham Court. Gray's Inn Lane. Somers Town. Camden Town. Kentish Town. Tenements of less than 5 rooms. Persons occupying same. Tenements of less than 5 rooms. Persons occupying same. Tenements of less than 5 rooms. Persons occupying same. Tenements of less than 5 rooms. Persons occupying same. Tenements of less than 5 rooms. Persons occupying same. Tenements of less than 5 rooms. Persons occupying same. Total 1003 33706 1672 15732 6560 21556 6564 21192 6369 23601 10206 36203 Overcrowded 1964 10965 1357 7088 1660 8903 2153 12076 1011 5733 1888 11629 Per cent overcrowded 1941 3253 29.04 45.05 25.30 41.30 32.80 49.91 15.85 24 29 18.49 28.19 Persons per cent, overcrowded in St. Pancras. North, 28.19; Central, 35.30; South, 42.88; All, 27 47. (Note.—A map graphically showing the distribution of overcrowding was published in the Annual Report of the Medical Officer of Health for 1904 ) WOMAN INSPECTOR'S REPORT UPON CONSUMPTION. To the Medical Officer of Health. Sir, I submit a report upon the work done during the year 1910 in connection with the notification of consumption. A table showing the sources of the notifications received is appended. The number of persons notified was 515. In the table the number appears to be slightly larger because in some cases the same person was notified by more than one medical practitioner. The scheme arranged for the joint work of the Public Welfare Association, the St. Pancras Dispensary, and the Municipality has worked well, and has only been hampered by want of time and money. There has been no practical difficulty in working the scheme. The visitors have been well received by the families concerned, and there is every encouragement to proceed further in co-operation with the many useful Institutions of the Borough. 62 In the early part of the year the Tuberculosis Exhibition of the National Association for the Prevention of Consumption visited the Borough with much success. The attendance was good and much interest was displayed. In addition to the ordinary attendance, parties of elder school children visited the Exhibition in charge of their teachers. Some of these children sent up to me later excellent written compositions on the subject of the Exhibition, which showed much intelligence and great interest in the teaching of the Exhibition. The help given by the St. Pancras Dispensary in examining contacts who are not in connection with any other medical institution or practitioner has been of great value. When visiting we are extremely careful always to refer any patient, contact, or suspect to the medical adviser to whom he would naturally apply without our intervention. We never detach patients from their own doctor. Consequently the only contacts of whom we are able to keep record at present are those who, being unable to pay for private advice and not being connected with any other Institution, are sent to the St. Pancras Dispensary. Of these we have reports on sixty-eight. Of these twenty-seven were either very probably or certainly affected, and forty-one others were suffering from asthma, bronchitis, rickets, adenoids, debility, or otherwise in need of medical care. We could have sent many more contacts for examination if it had been possible to arrange for an evening consultation at a time when working men and boys are able to attend. The St. Pancras Dispensary does this work without receiving any fee or any kind of financial advantage to the Institution, and we are much indebted for this help which is indispensable for the purposes of our scheme. There is still the difficulty that many persons in the early stages of the disease are unwilling to admit that they are or may be phthisical. If it were possible to arrange for the treatment of such cases in Institutions which did not proclaim themselves as homes for consumptives, but rather styled themselves convalescent homes, it might be possible to capture earlier cases. A11 evil result of incautious propaganda work is that an excessive terror of the disease may be fostered, with the result that patients fear to admit the possibility of their being affected lest they should suffer the social and industrial penalties of the infectious patient. We have attempted some early preventive work among young people by warning those about to begin industrial work as to the dangers and the desirable precautions in the case of the particular trade chosen. We have felt the need for further provision of open-air school accommodation for probable cases among children, and we should also be glad to see something of the nature of a Day Open-Air Convalescent Home for certain children. The admirable Day Nursery established by Miss Rendel is a valuable object lesson in fresh-air methods, but is not specially intended for delicate children. We have continued to urge the use of the provision made by the Guardians for the treatment of consumptives. It is to be regretted that it is not possible 63 to provide at Highgate space for outdoor exercise and employment to supplement the excellent and airy consumption wards. There is also need still for further provision for chronic and advanced cases. We have continued to work in close connection with the charitable and religious institutions of the Borough, and we have found this co-operation most useful. Friendly supervision and material help for our poor patients have been thus obtained. About a hundred and twenty cases were referred to the Public Welfare Association, either for visiting or with a view to material help, or for both reasons. If our work is to be thoroughly effectual, much supplementary help is needed, and it is to be hoped that public attention will be directed to the need for additional funds felt by the philanthropic bodies carrying on this portion of this work, without which the medical advice obtained cannot prove fully effective. We are most fortunate in being able always to rely upon the ready help of the philanthropic workers of the district. We are specially indebted to Miss Neville, Mr. Hood, and Mr. Edwards, the Hon. Secs, of the Public Welfare Association. A monthly meeting of visitors attached to consumptive families is held, and visitors consult the Department when necessary as to individual cases. It was proposed to organise a separate Tuberculosis Department or Dispensary on lines which have been successful elsewhere, but 110 great progress has been made yet. It should be noted that, although we have no actual tuberculosis dispensary, yet the principles upon which our work here is conducted are those which have made the success of the dispensary system. Much remains to be done in completing and amplifying our organisation for dealing with this disease, but it is satisfactory to have found that our scheme is, in its broad outlines, well suited to our purpose. I am, Sir, Your obedient Servant, M. E. Bibby, Sanitary Inspector. 64 Institutions and Ages of Persons notified. Poor Law Cases. Ages. At Private Addresses. At Rowton Houses and at Common Lodging Houses. Homeless Cases. Cases notified by the St.Paneras Dispensary Cases notified by Mount Vernon Hospital Outpatients. Cases notified by other Hospitals and Dispensaries. Cases from London County Council Schools. Cases notified by Private Practition ers. Total. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. - F. ALL Under5 4 3 — — - — - 1 — _ — — 1 — — — 5 4 9 5—10 4 4 — — - — 4 3 - — — - 7 1 — — 15 8 23 10—15 7 2 — — — — — 2 2 — — — 6 2 1 — 16 6 22 15—20 5 3 — — — — 2 4 1 3 1 — — — 1 - 10 10 20 20—30 15 12 11 — 1 — 5 11 2 1 4 4 — — 2 2 40 30 70 30—40 34 22 14 - 9 3 5 21 1 5 6 2 — — 4 1 73 54 127 40—50 23 18 26 — 13 6 5 25 3 1 — 1 — — 4 1 74 52 126 50—60 19 7 12 — 10 — 5 17 1 2 - — — — 3 1 50 27 77 Over 60 7 7 13 — 2 1 4 8 — - - — — — — 1 26 17 43 Not stated 5 3 - - - - - - - - - - - - - - 5 3 8 Totals 123 81 76 0 35 10 30 92 10 12 11 7 14 3 15 3 314 211 525 Adding together the above figures we obtain a total of 525 persons notified. From this total ten persons notified by two distinct Institutions must be deducted, givmg a total of 515 persons notified. At the time of inquiry the persons notified were resident as follows :— Poor Law Cases. Hospital and Dispensary Cases. Private Practitioners' Cases. School Cases. Total. At private address notified 60 149 14 14 237 Removed to Workhouse Infirmary 231 3 — — 234 Removed to Hospital 1 — — — 1 Dead at Public Institutions 19 - 19 Dead at private addresses 1 3 7 — 11 Not known or removed 5 7 — 1 13 Totals 317 162 21 15 515 SAINT PANCRAS, LONDON. C. WEEKLY NUMBER OF CASES OF "THE DANGEROUS INFECTIOUS DISEASES" REMOVED FOR ISOLATION DURING THE YEAR 1910. Quarters First Quarter. Second Quarter. Third Quarter. Fourth Quarter. ..Totals. Quarters. Months January. February. March. April. May. June. July. August. September. October. November. December. Months. Week ending 8 15 22 29 5 12 19 26 5 12 19 26 Apr. 2 9 16 23 30 7 14 21 28 4 11 18 25 July 2 9 16 28 30 6 13 20 27 3 10 17 24 Oct. 8 15 22 29 5 12 19 26 3 10 17 24 31 .. Week ending. Number of Week 1 9 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 ... ... ... ... ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Small-pox. Scarlet Fever 13 14 14 14 20 20 20 15 17 17 9 15 16 10 18 13 18 11 14 16 3 17 12 11 11 7 13 15 18 15 11 8 8 10 11 12 9 10 10 20 13 14 11 13 10 10 14 7 11 5 8 7 658 Scarlet Fever. Diphtheria 3 9, 6 6 7 4 5 3 3 5 2 3 1 6 8 4 4 6 4 3 4 5 6 3 2 5 3 3 10 8 8 5 2 5 5 5 8 7 4 10 3 2 6 6 8 6 5 7 6 3 4 2 251 Diphtheria. Membranous Croup ... ... ... ... ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 2 Membranous Croup Typhus Fever ... ... ... ... ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus Fever. Enteric Fever ... ... ... ... 1 .. 1 .. 1 .. 2 .. .. .. .. 1 .. 1 .. 1 1 1 2 2 .. .. .. 1 1 .. 4 1 1 2 .. 4 1 .. 1 8 2 2 .. 2 .. 1 3 .. 1 3 52 Enteric Fever. Continued Fever ... ... ... ... ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever. Relapsing Fever ... ... ... ... ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever. Puerperal Fever 1 ... ... ... 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. 1 .. .. .. .. .. 1 2 .. .. 8 Puerperal Fever. Cholera ... ... ... ... ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 Cholera. Erysipelas 4 ... ... ... ... 2 1 .. 2 1 1 .. 2 .. 1 .. 1 .. .. .. 1 .. 2 1 1 .. 2 .. .. 1 3 1 .. .. .. 1 .. 2 2 1 1 3 1 1 .. 1 2 .. 1 1 1 3 48 Erysipelas. Plague ... ... ... ... ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Plague. Cerebro-Sjpinal Meningitis ... ... 1 ... ... .. 1 .. .. .. 2 .. .. .. .. 1 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2 1 .. .. .. .. .. .. .. .. .. 1 .. .. 10 Cerebro-Spinal Meningitis Totals 21 16 21 20 29 26 28 18 23 23 16 18 19 16 27 18 25 17 19 19 9 23 21 17 16 13 18 18 29 25 22 18 11 16 18 18 21 24 17 32 26 22 20 20 20 17 21 15 23 12 14 15 1030 Totals. 65 GLANDERS. In Part VI. (Legislation) of the Annual Report for 1907 the London Order of the Board of Agriculture and Fisheries, dated 12th September, 1907, as to the Notification of Glanders in Horses was quoted, and also the Regulations of the London County Council thereunder. In Part III. (Infectious Diseases) of the same Annual Report paragraphs relating to human glanders were quoted, and it was explained that in future, by the Order, a Veterinary Inspector must report the existence of glanders to the Medical Officer of Health of the Borough as well as to the County Council. During the year 1910 the Veterinary Inspector reported 8 outbreaks of glanders in horses in various stables in the Borough. § 3.—ISOLATION AND EXCLUSION. The cases of Notifiable Infectious Diseases removed to hospital, and the Sub-Districts whence they were removed, are recorded in the following table:— Diseases. West. South. East. North. Total. Small-pox Scarlatina and Scarlet Fever 184 70 167 237 658 Diphtheria 90 41 57 65 253 Membranous Croup Typhus Fever .. .. .. .. .. Typhoid or Enteric Fever. 14 17 10 11 52 Continued Fever .. . . .. .. .. Relapsing Fever .. . . .. .. . . Puerperal Fever 2 1 3 2 8 Cholera 1 . . .. .. 1 Erysipelas 8 8 15 17 48 Plague .. .. .. .. Cerebro-spinal Meningitis 2 4 2 2 10 Totals 301 141 254 334 1030 The number of cases of Notifiable Infectious Diseases removed to hospital in each week of the year were as stated in the attached table. 66 HOSPITAL ACCOMMODATION FOR PUERPERAL FEVER. In the last Annual Report an account was given of the action taken by your Council in regard to hospital accommodation for Puerperal Fever. On the 16th July, 1910, the Managers of the Metropolitan Asylums Board adopted a recommendation of their General Purposes Committee "that the Local Government Board be informed that the Managers are prepared to make arrangements for the reception of certified cases of Puerperal Fever into their hospitals." There the matter stands. HOSPITAL ACCOMMODATION FOR OPHTHALMIA NEONATORUM. Your Council, in March, 1911, received a communication from the London County Council forwarding a copy of an Order made by them requiring the notification in the Administrative County of London, of cases of Ophthalmia Neonatorum, which had been approved by the Local Government Board. Your Council also, on the 12th April, 1911, considered as to hospital accommodation for this disease, and were informed that out of a total of 116,560 births in London in 1909 about 30,000 births were attended by midwives. From these 30,000 births there were about 165 cases of infants found to be suffering from inflammatory eyes, and of these about 16 cases, or one-tenth, were such as might have to be sent to the hospital for treatment. From these figures it was seen that there would probably be about 60 cases of Ophthalmia Neonatorum a year in London which would need hospital treatment. The Metropolitan Asylums Board having already agreed to provide accommodation in their hospitals for cases of Puerperal Fever, your Council were of opinion that it would be possible for them to also provide for the small number of cases of Ophthalmia Neonatorum at the same time, and recommended that the Metropolitan Asylums Board be asked to consider the advisability for providing a ward on the north and a ward on the south side of the Thames for urgent cases of Ophthalmia Neonatorum at the same time as providing similar separate accommodation for Puerperal Fever cases. M.A.B. HOSPITAL ACCOMMODATION FOR CONSUMPTION. The question of hospital accommodation has often been before the Managers of the Metropolitan Asylums Board, and by them has been referred to the Local Government Board. On the 16th July, 1910, the General Purposes Committee reported as follows :—" Sir Arthur Downes says, ' My general view would be, at present the Metropolitan Asvlums Board have no spare accommodation which could, without serious difficulties and objections, be turned over to this class of case, whether in the early or in the advanced stages,' and in this opinion we concur." HOSPITAL ACCOMMODATION FOR MEASLES. On the 16th July, 1910, the Metropolitan Asylums Board, on the recommendation of their General Purposes Committee, resolved, "That the Local Government Board be informed that the Managers are willing to arrange for the reception tentatively of measles, and other approved diseases, in their fever hospitals, provided the Board can empower them to admit selected cases from the poorer classes for which no accommodation is now available." The Local Government Board have approved of this course, and in April, 1911, the Metropolitan Asylums Board commenced to receive Poor Law Cases of Measles and Whooping Cough. 67 EXCLUSION OF CHILDREN FROM SCHOOL ON ACCOUNT OF COMMUNICABLE DISEASES AND DISORDERS. School Teachers Notifications of Exclusion (Patients, Contacts and Suspects), Year, 1909. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year 1909. A. Compulsorily Certifiable Diseases. Small-pox ... ... ... ... ... Scarlet Fever 156 218 231 231 836 Diphtheria & Membranous Croup 71 81 102 60 317 Enteric Fever 1 2 ... 1 4 Erysipelas ... 1 1 2 4 Cerebro-spinal Meningitis ... ... ... ... ... B. Voluntarily Certifiable Diseases Consumption ... ... ... ... ... C. Temporarily Certifiable Diseases. Chicken-pox 276 164 74 121 635 D. Non-certifiable Diseases. Measles 1086 405 66 48 1605 Whooping Cough 53 70 38 44 205 Mumps 67 111 30 15 223 Tonsilitis ... ... 2 1 3 E. Suspicious Symptoms. Sore Throat ... ... ... 1 1 Feverish Cold ... ... ... ... ... Whooping ... ... ... ... ... Vomiting ... ... ... ... ... Diarrhoea ... ... ... ... ... Rash, Eczema, etc. ... ... ... ... Etc. (principally Eczema) 9 18 14 5 46 F. Communicable Disorders. Ophthalmia 8 8 3 8 27 Ringworm 117 111 57 74 392 Impetigo 2 5 ... ... 7 Scabies 20 16 11 14 61 Pediculosis Corporis ... ... ... ... ... „ Capitis ... ... ... ... ... Total 1866 1246 629 625 4366 68 EXCLUSION OF CHILDREN FROM SCHOOL ON ACCOUNT OF COMMUNICABLE DISEASES AND DISORDERS. School Notifications of Exclusion (Patients, Contacts and Suspects), Year 1910. 1st Quarter. 2nd Quarter. 3rd Quarter. 4th Quarter. Year 1910. A. Compulsorily Certifiable Diseases Small-pox ... ... ... ... ... Scarlet Fever 281 243 160 279 963 Diphtheria & Membranous Croup 60 63 82 105 310 Enteric Fever 1 2 2 ... 5 Puerperal Fever ... ... ... ... ... Erysipelas 1 1 1 4 7 Cerebro-spinal Meningitis ... ... ... ... 2 B. Voluntarily Certifiable Diseases. Consumption ... ... ... ... ... C. Temporarily Certifiable Diseases Chicken-pox. 250 256 125 261 892 D. Non-certifiable Diseases. Measles 268 1215 282 584 2349 Whooping Cough 352 467 83 39 941 Mumps 94 111 27 36 208 Tonsilitis ... ... 1 3 4 E. Suspicious Symptoms. Sore Throat ... 1 ... 2 ... Feverish Cold ... ... ... ... ... Whooping ... ... ... ... ... Vomiting ... ... ... ... ... Diarrhoea ... ... ... ... ... Rash, Eczema, etc. 5 5 ... 1 ... Etc. 2 5 9 6 22 F. Communicable Disorders. Ophthalmia 18 24 12 21 75 Ringworm 63 108 45 55 271 Impetigo 8 ... 1 12 21 Scabies 11 16 . 12 14 53 Pediculosis Corporis ... ... ... ... ... ,, Capitis ... ... ... ... ... Total 1414 2517 842 1424 6197 69 CLOSURE OF CLASSES IN SCHOOLS ON ACCOUNT OF INFECTIOUS DISEASES. The Medical Officer (Education) of the London County Council usually gives such instruction for the closure of classes in provided schools as he deems necessary. With regard to unprovided schools, your Council, upon the advice of your Medical Officer of Health, under Article 51 of the Code of Regulations for Public Elementary Schools in England of the Board of Education,!gave notice to the Managers of St. Dominic's School, Southampton Road, N.W., to close the Babies' Class for infants under 5 years of age for a period of three weeks from 16th November, 1910. Measles and Elementary Schools. On the 21st December, 1910, your Council received and considered a Report of the Medical Officer of Health upon Measles in Elementary Schools, dated 23rd November, 1910, presented by the Public Health Committee, the most important part of which was as follows :— Measles - the Disrate. Description of the Disease. —Measles is an acute specific fever, highly infectious. After infection a period of latency occurs, during which there may be no symptoms. This period may vary from five to ten days, then follows a period of invasion, which shows itself by the development of the symptoms of a cold or catarrh, and usually from the third to the fifth day of the commencement of these symptoms the characteristic red blotchy rash appears. The two periods of (1) latency and of (2) invasion are usually reckoned together, and known as the incubation period, extending from the time of infection to the appearance of the rash, and this combined period is usually from ten to fourteen days in length. On or before the appearance of the rash the cold often becomes a bronchial catarrh. The rash lasts several days and gradually fades, to be followed usually by a fine branny shedding of the surface of the skin, which also lasts a variable number of days, the patient becoming convalescent about a fortnight after the appearance of the rash. The usual quarantine period for the sick is at least three weeks from the appearance of the rash, or at least four weeks from the appearance of the earliest symptoms, and healthy children are " suspect" for at least fourteen days from the last date of contact with a suffering patient. The disease is most infectious in its earlier stages, and is spread mostly by the secretions from the eyes, nose, mouth, and throat, the cough projecting particles of these secretions to a considerable distance from the patient. Thus the infection of measles may be conveyed— 1.—By direct contact, as in kissing, embracing, &c. 2.—Aerially, by the cough spray. !3. — By immediate indirect contact—e.g., pencil, slate, spoon, handkerchief, &c. 4. — By remote or deferred indirect contact—e.g., occasionally by certain articles of wearing apparel, such as a muffler or a veil, or the neck of a coat or bodice previously worn by a sufferer, and transferred to a younger child within a very short time afterwards 70 5.—Whether measles infection can be conveyed by carrier cases is not known—that is, by children convalescent from the disease, or who have been in contact, and who have not suffered from the disease— possibly not, but it is probable that very mild and unobserved cases spread the infection. Dr. E. W. Goodall (" Manual of Infectious Diseases," p. 148,) says that the contagion is not so persistent as that of some other infections diseases, but there is reason to believe that the infection may be harboured in fomites and conveyed by third persons. Second attacks are uncommon, they have been estimated to occur in from 2 to 5 per cent, of cases, but the mistaking of the rash of other complaints, such as German measles, erythema, &c., for that of measles may invalidate the statement by a parent that a child has already had measles. This error of statement is also a weak point in the system of admitting to infant departments of schools, children mid (?) to have already had measles. Few children escape the disease, but it is probable that it is less dangerous to life the later it is delayed towards the second teething' about the O «. seventh year. Mortality.—The death rate from measles of children under five years of age per 1000 living under five years of age exceeds the death rate of scarlet fever and diphtheria combined under that age. The Registrar-General's Annual Reports show that the annual mortality from measles in the two decennia (1881-90 and 1891-1900) after the decennium (1871-80), in which the Elementary Education Act came into force, was about the same as the annual mortality in the two decennia (1851-60 and 1861-70) preceding the advent of that Act in England and Wales as a whole, but that in London there was an increase during the two later decennia (18rtl-90 and 1891-1900). (See Table I appended hereto). The Annual Reports of the Medical Officer of Health of the Administrative County of London emphasise this increase during the two later decennia, when calculated upon the number of children living at ages 0-5 instead of upon the number of persons living at all ages. (See Annual Report of Medical Officer of Health of the London County Council for 1908, second table under Measles.; Whether thiswas due to greater fatality or greater prevalence it is not possible to ascertain in the absence of general notification of the disease. Diphtheria increased enormously in mortality during those two later decennia, but scarlet fever enormously decreased, due, no doubt, to the larger number of cases removed to hospital, and to the fewer carrier cases that scarlet fever appears to beget as compared with diphtheria. In the present decennium the Annual Reports of the Medical Officer of Health of the County of London show a pronounced fall in the mortality from measles, the reason for which will appear later on. Fatality. — It is only possible to ascertain the fatality of measles in places where the disease has been compulsorily notifiable. Sir Henry Littlejohn showed that during ten years compulsory notification of measles in Edinburgh, from 1880-89, the annual fatality varied from 5-9 per cent, of cases to 1"5 per cent., and averaged 3.1 per cent. At Aberdeen, where the disease was also notifiable, Dr. G. N. Wilson showed (Public Health, November, 1905) that from 1883 to 1902 it was epidemic every two or three years, that every third epidcmic was the worst, and that the annual average mortality per 1000 living was 0.43, and the fatality per 100 cases was 1.9. 71 Dr. Theodore Thompson found the fatality rate to be 6.1 per cent. of cases in his Inquiry. (See Table II. appended hereto.) Analysis shows that fatality varies according to periodic wave, epidemicity, season, and age. Influence of Season.—Years ago Buchan and Mitchell showed that in London, from 1845-74, there were two maximum mortality curves, the larger maximum extending through November, December, and three fourths of January, the smaller maximum extending through May, June, and half of July. The more recent diagrams in the Annual Report of the Medical Officer of Health of the Administrative County of London show, from 1891 to 1898 (both years included), that Dr. G. N. Wilson's experience in Aberdeen, from 1883 to 1902, is also ti.at of London, namely, that measles is most prevalent during the cold months of winter and spring. The London diagrams show a remarkable fall during the present decennium in the maximum curve of mortality calculated upon the basis of the mean of the years from 1891 to 1908, both inclusive, with a tendency towards irregularity in the double curves of maximum mortality during the year. Influence of Aye.—The best summary of (lie effect of age upon the morbidity, mortality, and fatality of measles is shown by Dr. Theodore Thompson's Table of an urban district, 1892-94. (See Table II. (a) appended hereto.) This table shows (1) that at 10 years of age and upwards the attack rate, the death rate, and the fatality rate are negligible quantities; (2) that from 5 to 10 years the attack rate is 62 per 1,000 living, the death rate 0.7 per 1,000 living, and the fatality rate 11 per 1,000 attacked; and (3) that under 5 years of age the attack rate is 137 per 1,000 living, the death rate 11'6 per 1,000 living, and fatality rate 85 per 1,000 attacked—that is to say, the fatality rate under 5 years of age is nearly eight-fold that of the subsequent 5 years of age, the death rate is about sixteen-fold, and the attack rate is over two-fold. The table further shows (a) that from 2 to 5 years of age is the period of maximum attack rate; (b) that the maximum death rate falls upon the second year of age, followed by the third year, and at some distance by the fourth, which approximates to that of the first year of life; and (c) that the incidence of fatality runs almost parallel with the ages of mortality, with this exception, that during the first year of life the fatality is double that during the fourth year, and approximates to the fatality of the third year. This gives the impression that delay in the age of attack by measles diminishes the risk of fatality analogous to the behaviour of scarlet fever. That there appears to be a diminishing risk of attack with increasing age is confirmed by the inquiries of the Medical Officer of Health of Willesden. lie has kindly supplied me with Table II. (b) in the Appendix, and this shows that the risk from 0-5 years of age is 70.7 per cent., as compared to 20.0 per cent. from 10-15 years, and of 52.4 per cent. in the five years between those two periods. Influence of School. -It is shown in Table I. that during the last two decennia the mortality from measles in London steadily increased. It is shown in Tables III. and IV. that during the present decennium the mortality from measles has steadily decreased in London. It is nlso shown in Table III., 72 through the kindness of Mr. Robert Blair, Education Officer of the London County Council, that during the seven years (1903 to 1909) the annual average number of children under 5 years of age on the roll of the Elementary Schools has steadily decreased, and the percentage of attendance has steadily increased. It is improbable that an increased parcentage of attendance of a smaller number of attendants should cause a diminishing mortality. In Table IV. it is further shown that of the children scheduled annually in London the percentage on the roll at ages 3 to 5 years has been steadily diminishing in direct ratio with the fall in the mortality from measles. It is probable that this diminution of the percentage of children aged 3 to 5 years attending school, a fall from 41.0 per cent. to 31.7 per cent., is the cause, or the main cause, of the fall in the death rate from measles. Children aged 5 to 14 years have during this period been attending school in about the same proportion, with a slight rise, namely, 97.2 per cent. to 97.5 per cent, of the number scheduled at ages 5 to 14 years. That it is very probable that the gradual diminution of the number of children under 5 years of age attending school is the cause of the diminished mortality is supported by the diminishing death rate from measles at ages 0-5, when calculated upon the number of children living at ages 0-5 by the Medical Officer of Health of the County of London, as shown in Table V. It is furthermore rendered most probable by that officer's chart of the monthly variations of deaths from the mean of measles and whooping cough from 1891 to 1908, wherein it will be seen that the mean mortality of both diseases commenced to fall about the end of the last decennium, and has continued to fall through this decennium. (See Annual Report of the Medical Officer of Health of the London County Council for the year 1908, facing page 25.) In a Report upon Attendance at Public Elementary Schools of children under 5 years of age, made by the Medical Officer of Health of Willesden in 1909, he savs:—"Fourteen per cent, of all the children under five attending the Infants' Departments of the Public Elementary Schools in Willesden caught the infection of measles at school, and were the first to introduce it into non-infected homes; 8.4 per cent. between five and six, 6.5 per cent. between six and seven, and 4.5 per cent. between seven and eight similarly contracted the disease. In the boys, girls, and mixed departments only 0.3 per cent. of the scholars between seven and ten similarly contracted the disease." The death rate per mille of measles increases in direct ratio with the centripetal aggregation of population. In the smaller towns it is about one-and-half times greater than in the villages, and in the larger towns it is again about one-and-half times greater than in the smaller towns. (See recent Annual Summaries and Reports of the Registrar-General.) In the face of such a fact, it is impossible to contend that infants drawn together to a school centre are not more likely to cause the more rapid sprtad of measles than if they played together in the various streets where they reside. It is also impossible to deny that the younger the children assembled together at school the more rapid the spread of measles, and the more fatal the result. Exclusion from School on account of Measles. There are various degrees and kinds of exclusion of children from school. 73 (a) All children may be excluded for a period (1) from a whole school; or (2) from a particular department of a school, boys', girls', mixed, or infants'; or (3) from a particular class of a department. These forms of exclusion are generally spoken of as "school closure," meaning total temporary exclusion. (ib) Partial temporary exclusion, or the exclusion of certain children from a class, may also be of different kinds, (li Children actually suffering from infectious disease; (2) children sleeping in the same bed or room as a child or adult suffering from infectious disease; (3) children sleeping or living with the same family, or in the same dwelling, as a person suffering from infectious diseas; (4) children living in the same house as a person suffering from infectious disease; (5) children living in the same building, but not in the same house or self-contained and air approached flat; (6) children who have not already had the. disease; (7) children who have not passed the more susceptible age for the disease. It is desirable, first of all, to show the opinions that have been reached with regard to school closure, or total temporary exclusion, and then to pass on to consider partial temporary exclusion. In a report by Dr. C. J. Thomas, Assistant Medical Officer (Education), London County Council, upon Measles in the Borough of Woolwich, published as an Appendix to the Annual Report of the Medical Officer (Education), London County Council, for the year ending -31st March, 1905, some general conclusions were drawn. "The general conclusions which the inquiry seems, as a whole, up to the present, to justify are: — "I. Meisles, at present, in London only spreads in classes under 5 years of age, except in certain better-class districts. Seventyfive per cent. of children above 5 in Infants' Departments are protected. "2. Measles tends to spread whenever a class accumulates unprotected members to the extent of between 30 per cent. and 40 per cent., and when spread has begun, it continues until the proportion is reduced to between 15 per cent, to 20 per cent. unprotected. "3. If children under 5 were excluded from school, closure for measles would not be necessary for some time in London, except in one or two special districts. If, however, this were successful in postponing attacks, the question would again become acute in a few years. "4. To deal efficiently with measles accurate knowledge is required; the measles history should be elicited for each child on admission to school. This should be done universally; if notification to School Authority was made compulsory oil every parent whose children attended school our hands would be greatly strengthened. Unless the amount of susceptible material is fairly accurately known for each school we shall only be working in the dark as heretofore, and nothing of any value can be expected to accrue from our methods. 74 "5. To effect any useful purpose school closure must take place before the 'first crop' falls. The old practice of waiting until the attendance fell to a certain limit was useless in arresting the spread of measles, and did absolutely no good. "6. The means of arresting spread of measles other than school closure are of enormous importance; to name two - sanitary buildings and training of teachers; these two factors probably have the greatest effect of all in determining the extent of spread of an outbreak. "7. Deaths often occur from ignorance on the part of parents. Circulars should be sent out wherever measles has appeared in a class (i.e., on the incidence of the first case) begging mothers to notice colds, and upon the slightest suspicion of such symptoms to keep the child at home for a day or two. In this way measles would probably be checked to a far greater extent than has been effected by any other means. Instances have come to our notice where heartbroken mothers have stated that, had they known, they would have treated colds seriously of which they took no note, and thereby their children's lives would have been saved. I suggest that circulars be thus used during next year in Woolwich. "8. Measles never spreads in the boys' and girls' departments. There is no need to exclude children from infected homes who attend the upper department. As a result of our inquiries this has actually been carried out at Brighton with satisfactory results. "9. There is too great a tendency to look at things from an 'attendance' standpoint. This is one of the greatest evils with which we have to contend. The withdrawal by the Board of Education of Article 101 was the greatest piece of official folly ever perpetrated. If a whole department is closed, the average attendance is not affected; but if, on the score of health, a single class is closed by order of Sanitary Authority, or by the Council's Medical Oificer, it is supposed that the attendances are missed, and the effect upon the average attendance and consequent grant is enormous. We thus have great difficulty in carrying out our measures, as much opposition is often encountered to the necessary closure of a single class, while the unnecessary closure of a whole department is gladly borne or even welcomed. "10. This is an economic question, which is not one of health at all; and, when attendance lias fallen to a certain percentage at which the loss of grant is so severely affected, the department should be automatically closed independently of the question of health. This percentage ought to be worked out." In a Paper upon "The Control of Measles, and the Results on Inquiry into the Benefits of Early School Closure," l.y l)r. Sidney Davies, .Medical Officer of Health, Woolwich, in association with Dr. C. J. Thomas, Assistant Medical Officer (Education), London County Council, read at the Second International 75 Congress on School Hygiene, London, 1907 (Trans. Vol. II., p. 638), some further conclusions were drawn. "The following conclusions have been jointly arrived at by the two w i iters:— "1 Probably every human individual is susceptible to measles until protected by a previous attack. "2. Exposure of unprotected individuals to infection is almost certainly followed by an attack. "3. It is impossible to prevent the frequent introduction of measles into schools. "4. Once introduced into a class, measles will spread with a rapidity proportional to the number of non-protected children attending if the class continues to assemble. "5. The first crop will occur in about twelve days after the first case, and in twelve days more the majority of unprotected children will have been attacked. "G. Closure, to be effectual, must occur within ten days of the first attendance of the initial case in an infectious state. ''7. With the means at present available early notification of the first case is not usually to be secured. "8. When closure is effectual in keeping measles out of a school for a time, the rate of spread when again introduced will increase proportionally, and it will only be possible to postpone an outbreak for a short time. "9. To the extent to which this can be done, and the age incidence raised, measles mortality will be lessened. " 10. School closure, as generally applied, is futile as a preventive measure. ''11. We consider that, with the present available means, early school closure cannot be applied with sufficient success to make it desirable, in view of the loss of school attendance and annoyance to parents and teachers caused. N.15. — It should be stated that Professor Dr. Eberstaller (Gratz) was rather more successful in the application of this measure. (See his paper, 'International Magazine of School Hygiene,' Vol. III., Part 1.) "12. Though preventive measures have largely failed to reduce the prevalence of measles, education of parents by leaflets, and instruction given by health visitors and others, has the effect of greatly reducing the mortality of this disease. "13. The great majority of children only have one attack of measles, and the infection is unlikely to be carried by a third person. "14. When two-thirds of a class are protected by a previous attack, measles is not likely to spread even if introduced, and measles contacts in the class who have had measles themselves need not be excluded from school. 76 "15. In view of the above conclusions, wliich have for the most part been arrived at independently by other observers, it is desirable that the medical officers and authorities of schools should revise tlieir regulations as to measles, with a view to avoiding unnecessary interference with education." In conjunction with the experience of the age distribution of measles, these general conclusions, in condemning the temporary closure of schools, departments, or classes, add support to the permanent exclusion from school of children under five years of age. If paragraph 3 of the general conclusions is intended to infer that it is desirable to allow children under 5 years of age to attend school in order that they may acquire the disease under that age, and so prolect the boys' and girls' departments, then, with the knowledge which we now possess—that measles is most fatal at the younger ages—allowing the younger children to attend school means adopting a policy of sacrificing the health and lives of a certain number of the younger children in order that as older children the survivors may put in a better school attendance. One of the writers of the last paper quoted evidently seeks to get at the root of the question, as in the Annual Report of Dr. Sydney Davies on the Borough of Woolwich for the year 1906 is found yet a further conclusion:— "Conclusion.—As the great majority of children excluded are under six years, the interference with school attendance has not been of a serious nature. It would probably diminish the mortality from measles, without prejudicing education, if children were not allowed to attend school at all until they were at least five years of age. There is no doubt that in a large proportion of cases the infection of measles is contracted at school and brought by children attending school to the younger members of the family not attending, among whom measles is so fatal. Now, obviously, if the age of school attendance were raised by one or two years, the number of families of young children, none of whom attended school, would be increased in proportion, and a large number of young children who are now exposed to the risk of infection would be comparatively safe. But it is clear that until some measures such as arc suggested above be taken very little result can be hoped from early school closure alter measles has appeared in diminishing the spread of measles and the mortality of the disease." At the same Congress Dr. Cuntz, of Wiesbaden, said:—"May I express, from a German point of view, our great and sad surprise that you in England have to deal with this question to such an extent. In Germany it is strictly forbidden by law to admit children under six years of age to public schools, and even up to six and a half years the child will be rejected for another year if its condition of health be not fully satisfactory. In Germany the poor widows and mothers of large families are so widely supported by public authorities that they do not need to do outdoor work ; they are thus enabled to devote their time to taking care of their children. I should hope that all nations may follow our principles:—"Keep the child in Us home and family an long as possible." In fact, in most civilised countries the age of compulsory school attendance is higher than in England. i 7 The latest ideas upon exclusion from school 011 account of measles are contained in a Memorandum of the Local Government Board and tlic Re<rulations of the London County Council as quoted below:— "'Ihe Memorandum on Closure of and Exclusion from School," issued jointly by the Medical Officers of the Local Government Board and of the Board of Education, September, 1909, runs as follows:— B.—Rui.es for the exclusion of individuals. (1) As regards children suffering from the disease. 48.—Children attacked by measles should be kept from school for four weeks. (2) As legards other children living in infected houses. 49. —In largo towns, and in the smaller districts in which the majority of children over seven years of age who are attending public elementary schools have had measles, the practice is frequently adopted, when measles breaks out in a household, of excluding from school attendance only those children of the same household who attend the iufants' schools and those older children of the same household who have not had measles. These particular children of the same household should be excluded from school until 21 days from the date of onset of the illness of the last patient with measles in the house. The Regulations for the exclusion of children from school adopted by the Education Department of the London County Council are as follows:— Measles. 1.—Children suffering from the disease:— Exclusion for at least one month. 2. — Children living in houses* where the disease exists:— Infants.—All infants to be excluded until M nday following 14 days from the occurrence of last case. Srniers.—If child has had the disease, not to be excluded. If child has not had the disease, exclude until Monday following 14 days from occurrence of first case. * Note.—a self-contained and air-approac-hed flat is regarded as a separate house, but a one-floor dwelling in an ordinary tenement house is not so regarded, all the dwellings in an ordinary tenement house occupied by two or more families are regarded as one house. In addition to the above Regulations the Medical Officer now orders the exclusion for a variable number of days (4 to 14) of all children under 5 years unprotected by a previous attack of measles. The value of this measure is dependent upon the statements of parents and the powers of the diagnosis of mothers, and a number of children who have not had the disease will be credited with having had it. It must be difficult for a mother to distinguish between measles, German measles, roseola, erv'hema, stomach rash, and other rashes, and difficult to resist the impulse to attribute the rash to measles when she wishes the child to go to school. So 78 that there is sure to be left in the school some unprotected. But even in attempting to exclude children with bad colds the teachers' efforts may fail —for instance, it is not unknown for the rash of measles to appear without any previously marked symptoms. Since the recent prevalence of measles in St. Pancras there has been remarkable activity in excluding for a varying number of days from Infants' Departments children under 5 years of age said not to be protected by a previous attack. This is intended to stop the extension of the disease amongst the children so excluded, but, as the Education Department has accepted the conclusions of the Woolwich experiments, they must expect the disease, if thus stopped, to be simply postponed, and the question for the departments to decide is how long this palliative measure postpones attack by the disease. If this form of exclusion postpones attack longer than the condemned form of closure something will have been gained, but it is not obvious why it should do so. It was reported from the Stanley School that all the children excluded for fifteen days as unprotected from the youngest class "took measles, and the whole class has now had them." In the School of St. John the Evangelist, Tottenham Court Road, the class for infants under 5 years had a roll of 51. The head teacher was requested to exclude all unprotected children for ten days—from Wednesday, 18th May, to Friday, 27th May, inclusive. On the 20th May there were 37, or 72.5 per cent., absent, of whom 29 were away on account of measles out of a class of 51. In spite of the exclusion of unprotected children under 5 years of age from the youngest class at Holmes Iioad School for a period of six days, the . following week 40 cases of measles were notified from the school, the next week 23, and the next week 7 cases, and six weeks after the first six-day period exclusion another period of 16 days exclusion was ordered. It seems extraordinary that the youngest infant classes in elementary schools should be carried on with absenteeism of 46.7, 68.3, 41.0, 45.3, 32.2, and 35.7 per cent. If the Woolwich conclusions are carefully read they will be found to indicate that temporary exclusion, whether total or partial, would fail in classes of children under 5 years of age, and permanent exclusion under this age is the only solution of the problem. Temporary partial exclusion disorganises the school work as much as temporary total exclusion from a class, as the class marks time until the return of the excluded ones, and the work that was done during their absence has to be done over again for the benefit of the returned absentees. The temporary partial exclusion of children under 5 years is nearly always too late, and when it is not too late it fails to effect its purpose, as the spreading of measles is resumed, sooner or later, after the excluded children return to school. There is no great value in dealing with special instances in individual schools over a short period to prove or disprove the facts. The supreme test is the effect of procedure upon the total number of notifications in the whole locality over a prolonged period. 79 At the second International Congress 011 School Hygiene, held in London in 1897, in his paper opening a discussion on "The Lower Limit of Age for School Attendance "Br. Arthur Newsholme, then Medical Officer of Health, Brighton, now Medical Officer of the Local Government Board, said in regard to the direct question of the lower age limit, '' none of these percentages, however, settle the point at issue One has, therefore, to fall back upon experience in administration, which always shows that attendance at school increases the risk of importation of infection into homes ; and upon the a priori high degree of probability that if children were not admitted to school until after five years of age the results would be that {a) fewer families would become infected; and (h) the children of those families still becoming infected would be infected; on the average at a higher age, with the result that fewer deaths would occur." This experience is confirmed by the statistics of diminishing mortality already quoted in regard to the diminishing number of children in London attending school at ages 3 to 5. Since then a noteworthy Report was issued in 1908 by the Consultation Committee of the Board of Education, which was lead up to by certain events. After the Education Act of 1902 came into force some authorities became more and more doubtful of the value of the attendance at school of children under five years of age. I11 1905 the Board of Education added to Article 53 of the Code a proviso that—"where the Local Education Authority have so determined in the case of any school maintained by them, children who are under five years of age may be refused admission to that school,"Discussion of the subject still continued, and in April, 1907, the Board of Education made a reference to their Consultative Committee "to consider and advise the Board of Education in regard to the desirability or otherwise, both on educational and other grounds, of discouraging the attendance at school of children under the age of (say) five years, on the assumption that, in the event of the change being found generally desirable, the moneys now payable bv the Board of Education in the shape of grants in respect of the attendance of such children should still be payable to the Local Education Authorities in greater relief of their expenditure in educating the children over five years of age." I11 August, 1907, the second International Congress on School Hygiene was held in London, and in Section VII. the conditions affecting attendance at school were discussed, those in regard to infectious diseases being prominent, and measles received a considerable share of attention. In July, 1908, the Consultative Committee of the Board of Education issued a large 8vo Report upon the "School Attendance of Cliildren below the Age of Five,"the volume consisting of four Parts and Appendices, and the Report proper of the Committee being contained in Part II. The Committee strongly recommended the appointment of a body of experts to make a thorough and conclusive inquiry into the question of the impurity of the air in public elementary schools, and the best methods of heating and ventilation. There was no recommendation for an inquiry into the question of infection and the methods of preventing morbidity and mortality from this cause, and the question of the cleansing of schools, the most practical form of disinfection, and one of the means for remedying the impurity of the air of schools, was not considered. 80 Although the Report proper dealt with children under five years of age and consisted of 44 pages, only two of these wore devoted to "the question of infection." It was stated "that there do not appear to exist at present any figures which show for the country generally the liability of children unprotected by previous attack to succumb to the attacks of different diseases at different ages, or the fatality rates among children so attacked." This is true of the "country generally," but there were available the figures of Dr. Theodore Thompson, C.M.G; of Dr. Arthur Newsholm, Medical Officer of Health, Brighton, now Medical Officer, Local Goverrment Hoard; of Dr. William Butler, Medical Officer of Health, Willesden, and of others, which distinctly revealed a prima faric case for inquiry in regard to measles, one of the two diseases (measles and whooping cough) of which the Report admitted that school attendance may tend to increase the spread amongst infants. It was assumed that even if it can be shown that children between three and five have caught infectious diseases at school, "this evil is more than compensated for by the great saving of infant life which can hardly fail to result from the prompt isolation and improved treatment of every child under five whose early symptoms of disease are detected at school." But measles is a disease which is not admitted to hospital isolation, and the detection and exclusion of children showing symptoms of the disease presupposes that they already have the disease, and that it will have already spread a certain amount of infection, so that the exclusion from the youngest and most susceptible class is nearly always too late. As to the saving of infant life, statistics show distinctly that measles is more fatal in the youngest class. It cannot possibly be suggested that, in order to obtain improved treatment for measles, it is desirable that children under five years of age should attend school so that they may acquire the disease under conditions which may cause it to be brought to the notice of the teacher, nurse, or doctor, when we know that this is the most fatal age period by reason of increased susceptibility and vulnerability, apart from treatment. There is the further assumption that "there is another means by which the risk of infection can be lessened amongst young infants, namely, by not insisting in their case upon their attending school as regularly as older infants.'' This assumption is not borne out by the experience of London, inasmuch as it has already been shown that the mortality from measles has not risen with the increased percentage of average attendance of children a ed three to five, but on the contrary, has fallen in direct ratio with the diminished percentage of children on the roll compared with the number scheduled; and it may reasonably be assumed that the mortality would fall still more if they were all permanently excluded. The Consultative Committee, at the end of' their Report, came to the conclusion not to recommend "any change at present in the lower age limit, either of voluntary or compulsory attendance, at school." The main reason for this conclusion, although not explicitly stated, appears to be that no proper or sufficient provision at present exists for reforming the mothering, homing, and training of those children under five years of age who have unsatisfactory parents and homes.— (Chap. 1 and 18 (1) ). They therefore recommended that those unfortunate infants should attend school (Chap. 12); 81 but did not indicate how this particularly unfortunate class of infants is to be compelled to attend school. They recommended that the baby class should still (Chap. 10) be attached to and organised on the lines of the Elementary School, but adapted to the age of those to be admitted and be called a Nursery School (Chaps. 3 and 4), open not solely to infants with unsatisfactory homes, but to all infants aged three to five years. The most valuable expression of opinion by the Committee is almost at the commencement of the Report. "There is in the natural relationship between mother and child, and in the other influences of good home life, a moral and educational power which it is of high national importance to preserve and to strengthen, and which educational policy should be careful not to impair." This beneficent ideal is pursued in a paragraph in Chapter 11, where, in discussing the lower limit of school age, the opinion is further expressed that "nothing should be done which might arrest the development of the idea that the best place for all children under five is a good home." But, the consideration of the means of attaining this ideal appears to have lain outside the Committee's province. The Report was full and thorough in its scholastic aspect, but those who regard scholastic education or scholastic association as inapplicable to infants under 5 years of age felt that their views received less consideration than the views of scholastic experts. It was satisfying, no doubt, to scholastic minds, but not so to hygienic, medical, and social minds. The Report spoke of the "large number of unsatisfactory homes," but no searching inquiry was held into the number of children admitted to school under 5 years of age whose homes were unsatisfactory, nor was anv suggestion made as to inquiries in future into the condition of such homes, with a view of ultimately finding a remedy or remedies. There was universal sympathy with the expression of opinion that no sufficient alternative was then available, and it behoves those who take into the perspective of the picture a proportion of hygienic, medical, and social views that they should seek to construct an alternative to the scholastic baby class. Conclusions. In coming to conclusions, it is necessary to have in mind a clear picture of the facts. Measles is a disease to which practically all children are susceptible. When they come into contact with the infection they develop the disease. The long incubation period, and the insiduous approach of the invasion period, render it impossible in practice to prevent the spread of measles in infant schools. The mortality of the disease amongst children over 8 years of age is not serious, but it is serious amongst children under 5 years of age. Admittance to school, that is, the convergence to a centre of a large number of children under 5 years of age, conduces to the spread of measles amongst those children in whom it is specially desirable to postpone exposure and attack. It is too late to take effectual precautionary measures after measles has entered an infants' department. If such measures are, on occasion, temporarily successful, the postponement is of short duration. The most effectual measure of precaution is the permanent exclusion of children under 5 years of age from the infants' departments of Elementary Schools. 82 Thus, I agree with the Medical Officer of the Education Department of the London County Council in his opinion that, in practical working, when it is definitely known by notification that measles has entered the infants' department of a school it is too late to take any effectual precautionary measures, and that temporary total exclusion (or closure) of the department, or of a class, will probably only temporarily delay further extension of the disease. But I am also of opinion that the half measures at present adopted of temporary partial exclusion are equally futile, and they lend a sense of false security to parents and managers, of which they justly complain. T am further of opinion that nothing short of the permanent exclusion from school of children under 5 years of age at least will help to reduce the mortality from measles, and if extended to 6 or even 7 years of ago—that is, the commencement of the second teething-—it would be still more effectual. I advocated this course many years ago, and find no reason for any alteration of my opinion. On the contrary, I have become more confirmed in this view. It will naturallv be asked, " What alternative do vou suggest ? " To this ^ . I would answer that the physique of the young child must be the first consideration, that the education of the mother is more important even than the education of the infant, and that the mother should be enlisted in the education of infancy instead of being divorced from it. Scholastic education is undesirable for infants under 5 years of age; it is training that is required, and this has been least cultivated. Education at, or attached to, an Elementary School will always be run on scholastic lines. This is not the kind or the method of education required. The desideratum for infants and very young children is not education, but training upon maternal and domestic lines—training of the functions, the habits, the senses, and the physical actions and mental ideas in due sequence through the first early years of life. All will agree with the opinion of the Consultative Committee of the Board of Education that "there is in the natural relationship between mother and child, and in the other influences of good home life, a moral and educational power which it is of high national importance to preserve and strengthen," and it is desirable not to drop but to pursue this ideal. Under modern conditions the father goes to his workplace and club, the children over school age leave home, the elder children go to school, the children under school age are left at the day nursery, and the mother goes out to work. To such, and they are not a few, there only remains a sleepingplace; there is no family life, there is no true HOME. This leads to the destruction of the idea of home and family life, and to the avoidance of procreation. But the generation to be born is the future nation, and we are hard up against a bed-rock physical fact, which is infinitely more important than questions of scholastic details. Efforts directed towards the prevention of physical deterioration and sickness and to the amelioration of the health, habits, and character of the individual must commence at the very earliest age, even at birth, and the most potent medium is the mother. The mothers must be enlisted in the army of recruits necessary for the early care and training of our future citizens, male and 83 female. They must be stimulated to realise their proucl position of preparing their children, and rendering tliem physically fit, ,for passing through the scholastic period, through which all children in a modern state must pass in order to enter the ranks of a civilised community. They should be advised, guided, and assisted by periodical medical consultations, by instruction in hygiene and the maternal and domestic arts, and by assistance in the training of their children, both in special institutions and at home. The solution of the difficulty lies in the formation of institutions for the teaching and practice of Mothercraft. Whether these are called schools, or consultations, or assemblies, or by any other name, matters not so long as they are free from scholastic influence and are run upon maternal lines. Such schools of Mothercraft should embrace the instruction of mothers as well as the training of children—one great essential of such schools should be medical consultations and advice not only for expectant, suckling, and nursing mothers, but also for their children from birth to compulsory school age—so that children might be weighed, measured, and medically examined periodically, but at longer intervals as age increases. Such periodical medical examinations at such institutions, coupled with timely advice and assistance, would prevent many of the defects now requiring to be cured, at great trouble and expense, and often discovered too late to be remedied. If the moneys and efforts now spent upon trying to educate scholastically children under five years of age, and the moneys contributed to the maintenance of milk depots, day nurseries, nursery schools, and similar philanthropic efforts, were all to converge into one channel of schools of Mothercraft, dealing comprehensively with mothers and infants up to compulsory school age, the effect of such a scheme could not fail to produce the most beneficial results. The last observation I would make is, that although a few Local Education Authorities exclude children under five years of age from school, I hope to live to see all such Authorities adopt this course. I also hope to live to see schools of Mothercraft at work everywhere, and the ailments of children, now discovered and cured at such great trouble and expense, prevented before they have arisen. 84 TABLE I. Registrar-General's Annual Reports. Annual Mortality per Million Persons Living. England and Wales. London. Period. Measles. Scarlet Fever. Diphtheria. Period. Measles. Scarlet Fever. Diphtheria. 1851-60 412 982 1851-60 530 1017 1861-70 443 971 187 1861-70 (389) 1133 179 576 1871-80 379 719 121 1871-80 (418) 510 600 122 1881-90 411 338 163 1881-90 (.365) 636 335 259 1891-1900 414 158 263 1891-1900 (474) 583 (482) 188 500 Note.—The figures in brackets in the measles column for London represent the annual mortality from measles per million children living at ages 0-5 in London, and have been extracted from the Annual Reports of the Medical Officer of Health for the Administrative County of London. 85 TABLE II. (a). Extract from a Report upon Measles in England and Wales, by Dr. Theodore Thompson. Supplement to Twenty-fourth Annual Report of the Medical Officer of the Local Government Board for 1894-5, p. 138. Table showing for a particular Urban District the number of persons known to have been attacked by measles at each of several age-periods, and also, in each instance, the number of deaths referred to this disease during a period of about two years, with the attack rate and death rate annually from this cause per 1000 living, and the fatality rate per 1000 persons attacked by measles during the period:— Age Groups. Estimated Mean Population, March, 1892, to March, 1894. Attacks by Measles, March, 189*2, to February, 1894. Deaths from Measles, March, 1892, to March, 1894. Measles Attack Kate Annually per 1000 living. Measles Death Rate Annually per 1000 living. Measles Fatality Rate per 1000 attacked. At all ages 35606 2031* 125 28 1.7 61 0-1 1155 166 16 72 6.9 96 1-2 974† 233 46 119 23.6 197 2-3 1028 354 36 172 17.5 102 3-4 1000 324 16 162 8.0 49 4-5 951 324 PL t) 170 2.6 15 Under 5 5108 1401 119 137 11.6 85 5-10 4530 560 6 62 0.7 11 10 and upwards. 25968 39 0 0-75 0.0 0 * As regards 31 of these persons there is no knowledge as to age. † Based upon the 1891 census figures. No doubt there has been confusion at the census between children under 1 year of age and children over 1 year of age. 86 TABLE II. (b). Measles—Willesden, 1909. showing the incidence ot measles upon children definitely exposed to infection, distributed according to age and history of previous attack. Age Period. Contacts Exposed. Total Number. Stated to have suffered previously. Stated not to have suffered previously. Contacts Exposed. 4. Contacts Attacked. 6. Per Cent. Contacts Exposed. 5. Contacts Attacked. 7. Per Cent. 0—6 months 73 — - — 73 6 8.22 6 months—1 year 41 - — — 41 39 95.2 Under 1 Year 114 - — — 114 45 39.5 1—4 .386 46 5 1.09 340 274 80.6 4—5 106 34 2 5.88 72 53 73.6 Under 5 years 606 80 7 8.75 526 372 70.72 5-6 87 39 1 2.56 48 30 62.5 6—7 101 66 1 1.51 35 24 68.6 7—8 140 105 — — 35 14 40.0 8—9 152 125 6 4.80 27 11 40.8 9—10 158 139 1 0.72 19 7 36.8 5—10 638 474 9 1.89 164 86 52.4 10—15 50.1 466 3 0.64 35 7 20.0 15 & upwards 1808 1735 — — 73 4 5.48 Totals . . 3553 2755 19 0.69 798 489 61.3 Notk.—This Table has been kindly supplied by the Medical Officer of Health of Willesden. 87 TABLE III. Attendance of Children under 5 years of age at Elementary Schools in London. Year ended. No. on Roll. | Average Attendance. Calculated Percentage. Measles mortality per million persons living. March, 1903 74975 55705 74.30 1902=507 , 1904 74224 57041 76.88 1903 = 445 „ 190) 72605 56822 78.30 1904=487 „ 1906 66427 52186 78.58 1905=366 , 1907 61722 49270 79.86 1906=405 ,, 1908 53428 46749 80.04 1907=380 ,, 1909 56057 45429 81.04 1908=313 Note.—In the above table the No. on the Roll and the Average Attendance have been kindly supplied by the Education Officer of the London County Council. From these the percentage of attendance has been calculated, and to these has been added the annual mortality per million extracted from the Registrar-General's Annual Report for 1908. TABLE IV. Number of Children scheduled at ages 3-5 years and 5-14 years, and percentage on roll respectively in London. Year ended Scheduled. Percentage on Roll. Measles. Mortality per million persons living. 3-5 years. 5-14 years. 3-5 years. 5-14 years. March, 1903 174,848 709,155 Year. 1902=507 „ 1904 17-i,191 709,289 41.0 97.2 1903=445 1905 174,359 709,793 41.1 97.3 1904=487 1906 176,416 706,824 35.8 97.4 1905=366 ., 1907 174,201 705,341 33.7 97.4 1906=405 „ 1908 172,555 700,589 33.2 97.6 1907 = 380 „ 1909 170,456 705,220 31.7 97.5 1908=313 Note.— The above table is composed of extracts from two tables contained in the Report of the Education Committee of the London County Council for 1908-9, pages vii. and xiii. The Annual Mortality figures are extracted from the Registrar-General's Report for 1908. 88 TABLE V. London.— Measles -Mortality among Children 0-5 calculated on the actual number of Children Hying at ages 0-5. Period. Death Kate per 1000 Children living at ages 0—5. Period. Death Rate per 1000 Children living at ages 0—5. 1851—60 3.89 1903 3.90 1861 -70 4.18 1.404 4.30 1871—80 1 3.65 1905 3.19 1881—90 4.74 1906 3.57 1891 — 1900 4.82 1907 3.29 1901 3.70 1908 2.71 1902 4.42 1909 .. Note.— This table is extracted from the Annual Report of the Medical Officer of Health of the County of London for the year 1908, page 24. POST-SCRIPTUM. Of the 327 Education Authorities of England and Wales 17-5 (more than half) partially or wholly exclude children under 5 years of age from elementary schools. Of these 173 Authorities 74 exclude children under 5 years because they decline to incur the expense for accommodation or staff, 62 exclude them from certain schools or intermittently, and of these 62 Authorities 41 permanently exclude all children under 4 years of age, and some exclude children until the term—quarter, half-year, or year—in which they will attain the age of 5 years. Thirty-two Authorities permanently exclude all children under 5 years of age from all elementary schools. (See 1908 Report of Consultative Committee of the Board of Education upon School Attendance of Children below the Age of Five, Appendix 5.) 89 With a view of preventing the spread of infection in the schools the London County Council were urged by your Council, on 21st December, 1910:— (a) To give directions for the washing out of the infants' departments of their schools once a week instead of once in three weeks. (b) To give instructions for the prompt closing of classrooms at all schools directly measles break out, and for the disinfection and washing out thereof, before the children are re-admitted. (c) To cause the children to be carefully examined before they are allowed to re-enter the school alter exclusion on account of an outbreak of measles. Letters in reply were received from the London County Council stating that with regard to the question of the weekly cleansing of infants' departments, experiments were proceeding with a view to determining the effect of (1) more frequent (i.e., weekly) cleansing of classrooms in infants' departments, and (2) daily disinfection of classrooms, and that their Committee who were dealing with the matter would consider the representations of the Borough Council in connection with the report which would be presented to them thereon. As to the suggested closure of affected classrooms immediately upon an outbreak of measles, their Committee were satisfied that such stringent precautionswould seriously affect the education of the children without corresponding advantage in the diminution of the incidence of the disease, and that effective conti'ol was secured by the judicious exclusion of children who have not previously had the disease. On the question of the disinfection and the cleansing of rooms which have been closed, their Committee were advised that measles is spread almost entirely by contact with persons suffering from the disease, and that school furniture and other articles were negligible factors in the dissemination of the disease. Such disinfection and cleansing, therefore, appeared to them to be unnecessary for the purpose of preventing the spread of infection. With regard to the suggested re-examination of children before re-admission, after exclusion on account of measles, their Committee considered that the inspection of the children by the teachers, in accordance with the instructions issued for their guidance, was sufficient to secure that children were not readmitted to school in an infectious state, and that no useful purpose woidd be served by the examination of the children by the school doctor. They further stated that while it appeared that measles was a difficult disease to control, owing to lack of prompt notification by parents and to the concealment and ignoiance of the nature of the complaint, the practice of issuing notices to parents of children likely to be infected immediately the disease occurred in a school had had beneficial residts. In considering these views of the London County Council, your Council's attention was directed to the increase in the number of cases of measles amongst school children, and they were of opinion that the County Council should be urged to take strong measures to stamp out the outbreak of measles amongst children attending their schools. Further, that the Borough Council, 90 being responsible for the health of the Borough, should also take all possible means at their disposal to protect the children of the Borough from the spread of this disease. With a view to giving effect to the assistance to be rendered by this Authority, you instructed the Medical Officer of Health to communicate with the headmasters of schools in which measles occurred by sending intimations to them that it was necessary for the classrooms in question 10 be promptly and thoroughly cleansed and disinfected, and that if this were not done, and the headmaster would name a day when the cleansing could take place, the Borough Council would send men to carry out the work. Further, that should the rooms not be properly cleansed and disinfected, the Medical Officer of Health would order the closing of the rooms against the admission of the children if he considered such a course necessary. The effect of this was to secure the prompt cleansing of classrooms which otherwise would have been delayed. During the year 1910 the deaths from measles in St. Pancras numbered 143, including 135 under five years of age, and eight over five years, as compared with a total of 102 for the preceding year. In London the deaths numbered 1,980 and 2 324 respectively. The deaths were distributed in the Borough as follows:—West St. Pancras 39; South St. Pancras 21; East St. Pancras 60; and North St. Pancras 23. The death rate for the whole Borough was 0-60 per 1000 of the population. The death rate in the sub-divisions being:— West 0.63; South 0.37; East 1.00; and North 0.38. Measles accounted for more than twice as many deaths as all the notifiable infectious diseases put together, a total of 143, as compared with 62. The death rate in the Borough from all the notifiable diseases was 0*26 per 1000. With regard to the paragraph in the London County Council's letter, that "their Committee considered that the inspection of the children by the teachers, in accordance with the instructions issued for their guidance, was sufficient to secure that children were not re-admitted to school in an infectious state." In the Rules and Regulations as to the Infectious Diseases enclosed with their letter there is no specific instructions for the systematic inspection or examination of children admitted or re-admitted to school, but only an instruction to send home "children found to be ill in school, ailing in such a way as to interfere with their work." The Committee of the London County Council appears to be under a misapprehension as to their instructions to teachers. On the 10th May, 1910, your Council received the following circular letter from the Local Government Board on the subject of Measles in London:— Local Government Board, Whitehall, S.W., Sir, 10th April, 1911. Measles in London. I am directed by the Local Government Board to state that they have had under consideration the present outbreak of measles in London, and that, on the suggestion of the President, their Medical Otficer has 91 conferred with the Medical Officers of the London County Council and of the various Borough Councils as to the measures which may be taken for dealing with it. At the conference the view was generally expressed that Sanitary Authorities have been hampered in t heir efforts to check the spread of the disease by the absence of early information of cases, and the question was considered whether this difficulty would be removed if measles were made a notifiable disease. On this question widely divergent views as to the value of notification were shown to exist. A very large number of eases are not attended bv a doctor, and it was pointed out that in such cases the adoption of the Notification Act would be a dead-letter. It may also be observed that the notification of measles has been tried in a large number of towns and then abandoned. Without, therefore, expressing any view on the question whether the notification of measles would be justified, it is clear that such other means of obtaining information as are available should be fully utilised. The Board find that the School Attendance Department of the London Education Authority have supplied much valuable information as regards measles in the past, and, in view of the proceedings at the conference, it appeared to the Board that it might be practicable to arrange that this source of information should be made more readily available. On this question the Board have consulted the Board of Education, and it has now been arranged that so long as the present emergency lasts the School Attendance Officers will give speedy information to the Medical Officers of Health of all cases of illness coming under their notice. It is hoped that by this means eailv information of the majority of cases of measles will reach the Medical Officers of Health. The information thus obtained will necessarily require to be followed up. Probably many cases will be reported which are not measles, and arrangements should be made for obtaining a proper diagnosis, for securing that the cases are properly isolated, and for urging on the parents the need of obtaining medical aid where such aid is required. No doubt the Council's official who visits the home will be able to do much in the way of giving advice as to the care and nursing of the patients. Removal to Hospital. The Board have been in correspondence with the Metropolitan Asylums Board, and it is understood that that Board will agree to receive cases of measles on the recommendation of the Medical Officer of Health. The accommodation of the Metropolitan Asylums Board for this purpose is necessarily limited, and arrangements will be made by which preference will be given to those cases most needing hospital treatment. 92 The Board may also remind the Borough Council that they have power to provide temporary hospitals, and if at a subsequent date the amount of accommodation for measles which is available in the hospitals of the Metropolitan Asylums Board should come to be exhausted, thispower might have to be utilised. Stuff' required for dealing with outbreak. For dealing with this outbreak and properly following up the information which will be obtained it is essential that each Medical Officer of Health should be provided with an adequate staff, and the Board trust that the Council will at once appoint any additional temporary assistants i medical and other) that may be required. At the same time, I am to enclose a copy of a Memorandum which the Board's Medical Officer has prepared on the subject of measles. I am, Sir, Your obedient Servant, (Signed) H. C. Monro, To the Town Clerk, Secretary. St. Pancras. At the same meeting your Council considered a communication from the Stoke Newington Borough Council calling attention to the fact that at the present time those children who are above the Infant Class, and who have previously suffered from measles, are a'lowed to attend the elementary schools from infected homes, and stating that, in their opinion, this policy is opposed to public health interests, and that, with the object of asking the London County Council to reconsider their action in this matter, they had passed a resolution to the effect that "in the interests of public health the school regulations should provide that all children from houses infected with measles should be prohibited from school attendance." The Stoke Newington Council asked your Authority to support their action in the matter. The attention of your Council was called to the following statement on this subject in the Memorandum of the Medical Officer of the Local Government Board accompanying the letter set out above. Itefcrring to the general lines of action recommended in a previous Memorandum by the Medical Officer of the Local Government Board and of the Board of Education on "Closure of and Exclusion from School," the statement proceeds — "In that Memorandum the serious mortality from measles, as well as from "diphtheria and from whooping cough, among children under five "years of age is pointed out, and for this reason it is there recoin"mended that 'when cases of this disease occur in an infant school, '• ' there should be no hesitation in excluding children from attendance " ' who are below the age of compulsory school attendance.' 93 "Older children arc usually permitted to attend the boys' or gi'ls' "departments of schools from families in which there is at the time a "case of measles. There is no evidence that this practice leads to "spread of infection, whether this result be duetto the fact that the "infective material is seldom carried in clothes, or to the fact that "most of the children in these departments of schools are already " protected." In the joint Memorandum of the Medical Officers of the Local Government Board and of the Board of Education, under the heading "Measles—B. -Rules for the Exclusion of Individuals," the following paragraph also appears, viz:— " (2) As regards other children living in infected houses. "49—In large towns, and in the smaller districts in which the majority "of children over seven years of age who are attending public ''elementary schools have had measles, the practice is frequently "adopted, when measles break out in a household, of excluding "from school attendance only those children of the same household "who attend the infants' school, and those older children of the same "household who have not had measles. These particular children of "the same household should be excluded from school until 21 days from the date of onset of the illness of the last patient with measles '' in the house." It is important to note that the age of a child as notified from schools is the age which the child will attain, or has already attained, on the 31st March, the end of the school year. In other words, the actual age of a child officially notified as aged 5 may be just under 0 or just over 4 years, or a child officially notified as aged 6 may be just under 7 or just over 5 years, according to whether the birthday falls a day or more before or a day or more after the commencement of the official year. As the real age of a child may vary so much, it is desirable to apply the exclusion of children from infected houses to the whole of the infant department, in order to avoid error and confusion, apart from the question of the danger of infection to the whole of the department, by exclusion of an uncertain portion and the admission of another uncertain portion. Furthermore, up to 7 years of age the susceptibility to, and fatality from, measles does not diminish below the serious point. Your Council were not in accord with the view expressed by the Stoke Ncwington Council, that all children from houses infected with measles should be prohibited from school attendance, but having regard to the views here expressed, they were strongly of opinion that the exclusion should apply to the children attending the infants' departments, whether over the compulsory school age or not. Accordingly your Council 'resolved that the London County Council be urged that in the interests of public health, the school regulations should provide that all children attending infants' departments in elementary schools from houses infected with measles should be prohibited from school attendance, in accordance with Rule 49 of tnc Joint Memorandum of the Medical Officers of the Local Government Board and the Board of Education on the subject, dated September, 1909. 94 M— DISINFECTION AND CLEANSING. DISINFECTING STATION. I.— Disinfection—Rooms fumigated and sprayed and articles disinfected and destroyed during the year:— Disease. No. of Qases. No. of Houses. No of Rooms Contents Disinfected or Destroyed. No. of Rooms Sprayed and Fumigated. No. of Rooms Stripped and Cleansed by Council. Small-pox ... ... ... ... ... Scarlet Fever 644 621 659 686 ... Diphtheria 256 251 283 275 ... Membranous Croup 2 2 2 2 ... Enteric Fever 69 65 67 ... ... Erysipelas 105 105 105 1 ... Puerperal Fever 9 9 9 ... ... Typhus ... ... ... ... ... Continued Fever ... ... ... ... ... Relapsing Fever ... ... ... ... ... Cerebro-spinalMeningitis ... ... ... ... ... Consumption 95 95 82 68 ... Measles 16 16 16 12 ... Cancer 27 27 27 ... ... Other Diseases 23 23 23 7 ... Totals 1246 1214 1303 1051 ... Destroyed ARTICLES Disinfeottd 23 Beds 1298 19 Mattresses 1907 26 Palliasses 640 10 Bolsters 1186 21 Pillows 3064 10 Sheets 1899 8 Blankets 2576 9 Counterpanes 1576 49 Wearing apparel 5591 1 Rugs and Mats 352 I 16 Cushions 790 2 Carpets 279 4 Covers 564 10 Curtains 2091 26 Sundries 506 231 23359 Destroyed ARTICLES Disinfected Silk Satins Velvets ... ... ... 5 - Hats 172 7 Rounets 6 ... Gloves 16 14 Boots and Shops 605 7 Other Leather Goods 12 1 Furs 27 Skin Rugs & Mats 66 Braces and Garters 162 2 Other Elastic Goods 3 3 Toys 45 10 Books 24 3 Sundries 4 52 1082 95 CONTACT SHELTER. Number of families, and of persons in families, in contact with Infectious Disease sheltered, cleansed and disinfected. Date. Males. Females. Children under 10. Dwelling Place. District. Disease. Length of stay. 1910. Hours Jan. 5th 1 — — Crown Terrace North Scarlet Fever 2 to a „ 20th 2 — 1 Weedington Road „ ,, ,, Feb. 4th 1 — — Allcroft Road „ Puerperal Fever ,, „ 5th — 1 — Maiden Road East ,, „ 8th — 1 2 Barclay Street Scarlet Fever ,, March 1st — 1 — hhyl Street North ,, ,, ,, 8th — 1 — Dumpton Place West ,, ,, April 23rd 1 — — Castle Road „ ,, ,, May 2nd 1 — — Willes Road North Diphtheria ,, „ 9th 1 1 — Weedington Road „ Scarlet Fever ,, „ 10th June 15th 1 — — Carlton Road „ ,, ,, — 1 — „ „ ,, ,, July 16th 1 — — Francis Street South ,, ,, „ 29th — 2 — Hanover Street North Measles ,, Aug. 11th — 1 — Marsden Street „ Scarlet Fever ,, Sept. 6th 1 — — Endsleigh Gardens South ,, ,, Dec. 23rd — 1 — Murray Street East Puerperal Fever ,, „ 30th — 1 Islip Street „ „ ,, CLEANSING STATION. I.—Personal Cleansing.—The number of cleansings of the body and disinfesting of the clothing of persons applying at the Stations:— Slept previoufl night at Vermin. Adults. Children. Sum Total Males. Females 'Total. 10 to 15. 5—10 Under 5. Total. M. F. Private Phthirasis—Pediculi—Head ... ... ... ... 89 58 ... 147 147 Addresses „ —Body 181 42 178 589 583 739 5 1866 2039 Scabies—Acari 8 1 9 4 5 4 ... 13 22 Rowton Phthiriasis—Pediculi—Head ... ... ... ... ... ... ... ... ... Houses ,, —Body 188 ... 183 ... ... ... ... ... 483 Scabies—Acari 1 ... 1 ... ... ... ... ... 1 Common Fhthiriasis—Pediculi—Head ... ... ... ... ... ... ... ... ... Lodging „ —Body 1592 4 1596 ... ... ... ... ... 1596 Houses Scabies—Acari ... ... ... ... ... ... ... ... ... Salvation Phthiriasis—Pediculi—Head ... ... ... ... ... ... ... ... ... Army „ —Body 65 ... 65 ... ... ... ... ... 65 Shelter Scabies—Acari ... ... ... ... ... ... ... ... ... In the open Phthiriasis—Pediculi—Head ... . . . ... ... ... ... ... ... ... ,, —Body 482 29 511 ... ... ... ... ... 511 Scabies—Acnri 1 ... 1 ... ... ... ... ... 1 Phthiriasis- Pediculi—Head ... ... ... ... 89 58 ... 147 14.7 „ —Body 2753 75 2828 589 583 739 5 1866 4694 Scabies—Acari 10 1 11 4 5 4 ... 13 24 Doubtful ... ... ... 1 15 ... 16 16 Total 2763 76 2889 544 677 816 5 2042 4881 96 Bedfellows also cleansed and disinfested:— Vermin. AGES. Total. 15 and over. 10—15. 5—10. Under 5. Phthiriasis—Pediculi—Head ... ... 23 ... 23 „ —Body ... 67 251 4 322 Scabies—Acari ... ... ... 9 9 Total ... 67 274 13 354 II.—Cleausitig of Dwelling Places and Contents. (а) Number of rooms infested with vermin caused to be stripped and cleansed, 189. (b) Number of articles in an unwholesome condition removed from dwelling places to the Cleansing Station for purification or destruction, 81. AKTICLES. Purified. Destroyed. Total. AKTICLES. Purified. Destroyed. Total. beds 10 ... 10 Silks ... ... ... Mattresses 7 ... 7 Satins ... ... ... Palliasses 10 ... 10 Velvets ... ... ... Bolsters 9 ... 9 Hats l ... 1 Pillows 16 ... 16 Bonnets ... ... ... Sheets 8 ... 8 Gloves ... ... ... Blankets 5 ... 5 Boots and Shoes 2 ... 2 Counterpanes 9 ... 9 Other Leather Goods ... ... ... Wearing Apparel ... ... ... Furs ... ... ... Rugs and Mats ... ... ... Skin Rugs and Mats ... ... ... Cushions 3 ... 3 Braces and Garters ... ... ... Carpets ... ... ... Other Elastic Goods ... ... ... Covers 1 ... 1 Toys ... ... ... Curtains ... ... ... books ... ... ... Sundries ... ... ... Sundries ... ... ... Note.—Some rooms stripped and cleansed had no contents or none in a condition requiring removal, and some contents were removed from rooms that did not require to be stripped or cleansed. THE CLEANSING OF CHILDREN. The negotiations with the London County Council related in the Annual Report of last year are still continuing, and the following letter was received and was before your Council on the 18th January, 1911:— London County Council, Education Offices, Victoria Embankment, W.C., 22nd December, 1910. Sir, Cleansing of Children Infested with Vermin. With reference to the corrsepondence between the Council and the Metropolitan Borough Council of St. Pancras on the subject of the cleansing of children infested with vermin, I am to state that the Council is prepared, as an experiment for one year, and subject to the subjoined conditions, to enter into agreement with the Metropolitan Borough Council for the cleansing of children at the Cleansing Station established by them under the Cleansing of Persons Act, 1897:— 97 (1) The place of treatment of children shall be entirely distinct from any establishment used for the isolation of suspected cases of infectious disease contacts. (2) The exclusive use of the baths for the cleansing of children shall be allowed on certain days. (3) The Cleansing Station shall be in a convenient position, and the children must be efficiently supervised with female attendants for the treatment of girls. (4) A payment at the rate of 2s. per child shall be made to the Borough Council in respect of the cleansing of children infested with vermin ; the payment shall cover a period to the end of the calendar month subsequent to that in which the first cleansing takes place, and within the period specified it shall be irrespective of the number of baths required before a child can be regarded as cleansed. (5) This scheme shall be subject to the Metropolitan Borough Council's undertaking, where necessary, to deal with the homes of the children cleansed. The draft agreement is in course of preparation by the Council's Solicitor, and will be forwarded to you as soon as possible for your perusal. I am, &c., (Signed) R. Blair, The Town Clerk, Education Officer. St. Paneras. The Medical Officer of Health, prior to the receipt of this letter, called your Committee's attention to the report of the London County Council's Education Committee on the subject, and pointed out the importance of the attendance of the children at intervals of not longer than three days, as otherwise a child could not be effectively freed of vermin for the reason that if the cleansing were allowed to take place at intervals of, say, a week, other nits would be formed and developed, and this succession of events might continue indefinitely. The County Council's Committee appear to be aware of this, because they state in their report that " experience has shown that on an average three visits to a Cleansing Station are required before the child can be considered cleansed." Your Committee reported on this subject on the 1st June last, when the London County Counc il were informed that this Authority were in general agreement with their proposals, but desired that the scheme should provide that the payment of 2s. per child should not cover a period of time exceeding two weeks. Although the proposed agreement will extend the period of cleansing to a possible two months, your Committee do not consider it necessary to raise objection to the suggested conditions, provided the London County Council are 98 willing to add to condition (4) a proviso that the intervals of cleansing for each child should not be longer than three days. To effect this your Council resolved that the London County Council be informed that this Authority are willing to enter into an agreement in regard to the cleansing of school children in the terms set out in their Education Officer's letter of the 22nd December, 1910, provided that they will add to condition (4) the words " and that the intervals between the cleansings of the child shall not be longer than three days, except in case of illness or other reasonable cause of delay, Sunday being regarded as a dies nov. Communications were received from the London County Council stating, in reply, that their Committee who have the matter under consideration were unable to see their way to recommend their Council to vary the conditions of the proposed agreement, inasmuch as the interval of three days between the dates of cleansing is insufficient to enable a certificate to be given that the cleansing has been effected, and expressing the hope that the Borough Council would be able to accept the terms of the agreement as originally submitted. They further asked if the Borough Council would be prepared to allow the County Council's school nurses to be present at (he cleansing station whilst the process of the cleansing of the children is in operation, and stated that the nurses will regulate the supply of cases to be sent to the cleansing station, and in many cases compulsorily convey the children thereto, also that it will be necessary for the nurses to work in co-operation with the bath attendant, and that they will frequently need to be present when the cleansing is being carried out, but will not interfere in any way with the arrangements made by the Horough Council. Your Council, on 1st March, 1911, were still of opinion that the intervals of cleansing for each child should not be longer than three days, in order that the child may be effectively freed from vermin, as if this regular attendance is not insisted upon nits would be formed and developed, and this succession of events might continue indefinitely. With reference to the attendance of nurses at the cleansing station, your Council saw no reason to object to the proposal provided that the necessary frequency of the visits of the children is maintained. With a view to meeting the point raised by the County Council as to the issue of a certificate that the cleansing has been effected, your Council resolved, on 1st March, 1911, that (a) The London County Council be informed that arrangements can be made for the Borough Council's cleansing station attendant to issue certificates stating (1) the date a child first attends at the station for cleansing, (2) the date or dates that it is necessary for the child to again attend for cleansing, and (3) a final certificate upon the completion of the cleansing, stating that the child has been effectively cleansed. 99 [b) The London County Council be informed that this Authority have no objection to the proposed attendan e of the school nurses with the children at the personal cleansing station, provided that the necessary visits of the children at intervals of not longer than three • • days is maintained. The County Council's Committee, however, stated, in reply, that they could not see their way to advise the variation of the condition of the proposed agreement, inasmuch as they were of opinion that the interval of three days between the days of cleansing is insufficient to enable their nurses to issue a certificate that the cleansing has been effected. Your Council had considered this matter on the 1st March, 1911, and stated that thev still held that the interval of cleansing' fo • each child should not be longer that three days, in order that the child may be effectively freed from vermin, as if this regular attendance is not insisted upon nits will be formed and developed, and this succession of events might continue indefinitely. With a view to meeting the point raised as to the issue of a certificate that the cleansing has been effected, this Authority informed the County Council's Committee that arrangements could be made for the Borough Council's Cleansing Station Attendant to issue certificates stating (1) the day a child attends at the station for cleansing; (2) the day, or days, that it is necessary for the child to again attend for cleansing; and (3) the final certificate upon the completion of the cleansing, stating that the child has been effectively cleansed. A letter was then received from the Education Department of the County Council stating that the Council's Committee are still of opinion that the interval of three days between the dates of cleansing proposed by the Borough Council is insufficient to enable the nurses to certify whether or not the clean-ing has been effected, and regretting that they are, therefore, unable to vary the terms of the draft Agreement. The importance of the three days interval is vital, as unless it is insisted upon the cleansing of the children will be indefinitely prolonged, with the added risk of infecting other children ; and, further, the loss of the prospect of diminishing and stamping out the amount of vermin prevalent, and of reducing the expenditure upon the freeing of children from vermin, will follow. Your Council considered that the views of this Authority in the matter should be personally placed before the London County Council's Committee, and, therefore, resolved on 10th May, 1911, that the Committee of the London County Council dealing with the matter be asked to receive a Deputation consisting of the Chairman and Deputy-Chairman of this Committee (Councillors C. Williams and G. Blount) and the Medical Officer of Health, to lay before them this Authority's views on the subject. With regard to the Certificate given by the Attendant at the Childrens' Baths, which has been in use for some years past, the following is a copy, and it appears to cover all the points desired:— 100 (Obverse.) Metropolitan Borough of St. Pancras. PUBLIC HEALTH DEPARTMENT. CHILDRENS' BATHS. Entrance from St. Pancras Gardens, N.W. Please admit sex ___________ age _______ ______________________________ of the Department of School, to a hot bath, etc., at the Childrens' Baths, St. Pancras Gardens, Pancras Road, N.W., between the hours of 9.30 a.m. and 5.0 p.m. (Saturdays 1.0 p.m.). Date of issue of Bath Card Signature of Teacher or _______________________________________ other responsible person ______________________________________ Address of Child_____________________________________________ This Bath Card is to be retained by the Child, as it is available for more than one bath, according to the instruction of the Matron, and must be shown to Matron, Teacher, or other responsible person when ashed for. John F. J. Sykes, Medical Officer of Health. (Reverse.) THIS SIDE FOR USE OF ATTENDANT ONLY. Day, date and hour of attendance of child at Baths, and Matron's signature to be entered on this side of the Card. Also a note of whether another attendance is required or not, and the preferable day, date, and hour. Eleven spaces available here.) CHILDRENS' BATHS. 1st Quarter, 1911. Total attendances 926 No. of attendances per case (average) 4.6 Total cases (children) 201 Cases not cured and ceased attending during the Quarter 73 Cases cured 110 Cured cases commencing treatment before 1st January 14 ,, ,, ,, after ,, 96 Cases still attending and not yet cured (on 1st April, 1911) 18 101 NUMBER OF ATTENDANCES OF CURED CASES. Duration of Cure. No. of attendances of cases cured within the period stated in 1st column. Weeks. 1 2 3 4 5 6 7 8 9 10 11 12 or more Total. Under 1 .. 6 10 .. .. .. .... .. .. .. .. .. 16 1—2 .. 4 1 12 26 24 1 .. .. .. .. .. 68 2—3 .. .. .. 4 3 7 1 .. 1 2 .. .. 19 3—4 .. .. .. .. .. 1 1 .. .. .. 1 .. 3 4—5 .. .. .. .. .. .. .. .. .. .. .. .. .. 5—6 .. .. .. .. .. .. .. 1 .. .. 1 2 4 6—7 .. .. .. .. .. .. .. .. .. .. .. .. .. 7—8 .. .. .. .. .. .. .. .. .. .. .. .. .. Over 8 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 10 11 16 29 32 3 2 1 2 2 2 110 102 You considered that facilities should be offered to the County Council for the cleansing of persons infested with vermin, and on 16th March, 1910, your Council resolved that the Clerk to the London County Council be informed that this Authority are prepared to cleanse any persons sent from common lodging houses in the Borough, and, so far as is found to be possible, those who may be sent from neighbouring Boroughs, at a charge of 6d. per person per attendance. The London County Council then wrote stating that a scheme had been formulated by them by which it is proposed that the Metropolitan Borough Councils should undertake to cleanse inmates of common lodging houses in their own districts free of charge, and to cleanse inmates sent from common lodging houses in the neighbouring Boroughs for a charge of is. a head. Your Council understood that the scheme had been submitted to all the Metropolitan Borough Councils with a view to co-operation. At the present time this Authority cleanse inhabitants of St. Pancras at their station free of charge. If this suggestion of the London County Council is adopted, Is. a head will be received for persons who may be sent from other Boroughs, instead of 6d. per attendance per person sent from any common lodging houses in any Borough as previously proposed. Your Council, on the 1st June last, expressed the opinion that as "per head " might mean unlimited attendances, the number of attendances covered by the proposed charge should be limited, and on 27th July your Council resolved that this Council continue to cleanse at their Personal Cleansing Station, free of charge, any persons from common lodging houses in the Borough, and do agree with the London County Council to cleanse thereat any persons sent from common lodging houses in other Boroughs at a charge of 1s. per attendance. Your Council then received from the Solicitor to the London County Council a draft agreement which he prepared in connection with the matter, and which he stated he would be glad to hear had been approved by this Authority. This agreement contained numerous restrictions. In accordance with the Borough Council's decision, verminous inmates from common lodging; houses outside St. Paucras will be received and cleansed at the Personal Cleansing Station upon the written order of Officials of the London County Council at a charge of 1s. per attendance, and persons coming from common-lodging houses in the Borough will continue to be cleansed free, whether sent by the County Council Officers or not. Your Council did not see the necessity for the formal agreement, such as proposed by the Solicitor to the London County Council, and therefore resolved on the 12th April, 1911, that the Solicitor to the London County Council be informed that the Borough Council are quite prepared to carry out the cleansing of persons from common lodging houses, as decided by them on the 27th July, 1910, but see no necessity for entering into the agreement. 103 § 5.—VACCINATION.—The following arc the Returns kindly supplied by the Clerk to the Guardians:— Return respecting the Vaccination of Children whose Births were registered in the Parish of Saint Pancras, from 1st January to 31st December, 1909, inclusive. Registration Sub-Districts comprised in the Vaccinat on Officers' Districts. Number of "Births returned in Birih List Sheets" as Registered from let January to 31st December, 1909. Number of these births duly entered by the 31st January, 1910, in columns 1, 2, 4 and 5, of the "Vaccination Register" (Birth List Sheets), viz.: Number of these Births which on 31st January, 1910, remained unentered in the "Vaccination Register" on account (as shown by Report Book) of Number of these Births remaining on 31st January, 1910, neither duly entered in the "Vaccination Register" (columns 3, 4, 5, 6 and 7 of this return), nor temporarily accounted for in the "Report Book" (columns 8, 9, & 10 of this Return). Total number of Certificates of successful primary Vaccination at all ages, received during each of the calendar years 1909 and 1910 Column 1. Column 2. Column 4. Column 5. "Successful ly Vaccinated" "Insusceptible of Vaccination. "Had Smallpox." Number in respect of whom Certificates of Conscientious Objection have been received. "Dead Unvaccinated." Postponement by Medical Certificate. Removal to Districts.the Vaccination Officer of which has been duly apprised. Removal to Places unknown or which car not be reached; and cases not having been found. 1309. 1910. I 2 3 4 5 6 7 8 9 10 11 12 13 1. North St. Pancras 1372 847 2 ... 206 22 151 20 100 24 746 2. East St. Pancras 1534 860 1 ... 140 48 109 21 328 27 787 3. West St. Pancras 1366 840 3 ... 108 92 44 28 225 26 801 4. South St. Pancras 1013 550 ... ... 80 76 38 20 238 11 512 Total 5285 3097 6 ... 534 238 342 89 891 88 2846 North and East Districts (Mr. G. A. Pritchard) South and West Districts (Mr. A. E. Wolfe) 2906 1707 3 ... 346 70 260 41 428 51 1533 2379 1390 3 ... 188 168 82 48 463 37 1313 Total 5285 3097 6 ... 534 238 342 89 891 88 2846 104 SAINT PANCRAS. —RETURNS FOR THE SIX MONTHS, JULY TO DECEMBER, 1909. 1 2 3 4 5 6 7 8 9 10 11 Registration Sub Districts. Number of Births. Successfully Vaccinated. Insusceptible. Had Small-pox. Number of conscientious objections. Dead unvaccinated. Postponement by Medical Certificate. Removals to places known and Vaccination Officer apprised. Removals to places unknown and unvaccinated. Numbers not accounted for in previous columns. 1. North St. Pancras 671 363 l — 121 32 71 10 30 43 2. West St. Pancras 698 397 l — 52 55 65 8 95 25 3. East St. Pancras 769 370 — — 89 50 60 19 82 99 4. South St. Pancras 470 207 — — 39 36 36 21 62 19 Totals 2608 1387 2 — 301 173 232 58 269 186 105 SAINT PANCRAS. —RETURNS FOR THE SIX MONTHS, JANUARY TO JUNE, 1910. l 2 3 4 5 6 7 8 9 10 11 Registration Sub Districts. Number of Births. Successfully Vaccinated. Insusceptible. Had Small-pox. N umber of conscientious objections. Dead unvaccinated. Postponement by Medical Certificate. Removals to places known and Vaccination Officer apprised. Removals to places unknown and unvaccinated. Numbers not accounted for in previous columns. 1. North St. Pancras 701 450 — — 117 11 43 16 32 32 2. West St. Pancras 682 330 — — 76 28 62 11 154 21 3. East St. Pancras 854 458 — — 82 30 125 17 99 43 4. South St. Pancras 500 225 2 — 31 37 34 21 134 16 Totals 2737 1463 2 — 306 106 264 65 419 112 106 IV.—SANITATION. § 1.—INSPECTION. The following were the total number of inspections and re-inspections made by Sanitary Inspectors during the year 1910, as extracted from the detailed tables at the end of this Report:— Inspector. Area. Inspections. Re-inspections. Total. 1. Rackham N. 1 1469 1894 3363 2. Brown N. 2, 3 1402 2208 3610 3. Thompson N. 4, 5 1448 2302 3750 4. Johnston E. 1, 2, 3 1793 2191 3984 5. Auger E. 4 856 1471 2327 6. James E. 5 1681 2404 4085 7. West W. 1, 2 1478 2855 4333 8. Lonnon W. 3, 4 2047 1813 3860 9. Adkins W. 5 1378 2760 4138 10. Holmes S. 1, 2 1735 2197 3932 11. Walker S. 3 1224 3060 4284 12. Dillon S. 4 1425 2066 3491 13. Landen S. 5 1569 1382 2951 14. Auger E. 3, 4 1291 — 1291 15. Child Food and Food premises N. 1, 2, 3, 4. 5 E. 1, 2, 5 ) 3663 — 3663 16. Osborne W. & S. 3942 — 3942 17. Bibby Women — 1579 5 1584 18. Smith — 2404 — 2404 Totals — 32384 28608 60992 107 The following were the details of the inspections and re-iuspections made during the year 1910:— Duties and Premises. Inspections. lie-inspections after Intimation Notices. Total. Iufectious Diseases—Inquiry, removal, disinfection, &c. 1432 337 1769 „ „ Sanitary inspection after, &c. 1118 1242 2360 Complaints 2710 6322 9032 Drainage—Under notice. Plans, supervision, &c. 390 5437 5827 „ Voluntary, „ „ 610 5613 6223 ,, New Buildings. ,, „ 53 1866 1919 ( Weekly) Yards of Mews and Stables (170 on List) 5627 53 5680 House-to-house Inspections 430 222 652 Tenement Streets—Inquiries as to occupation of houses 225 3 228 ,, „ Mensuration for Registration 2 1 3 „ „ „ Inscription 17 3 20 Periodical Inspections— Dwelling Places. (Half-yearly) Registered tenement houses (2282 Registered) 2700 5899 8599 ,, Inscribed dwellings ( 339 Inscribed) 1:81 608 889 (Quarterly) Closed underground dwellings (471 on Register) 116 46 162 ,. Common lodging-houses ( 19 Registered) 2 ... 2 i(Weekly) Canal boat dwellings Wharves] ( 31 on Register) 61 ... 61 (Half-yearly) Day schools Woman] (40 „ ) 17 ... 17 Work Places [Women], Factories ,, ( 107 „ ) 16 1 17 „ Workshops ,, (404 „ ) 19 4 23 „ Work places „ „ Domestic workshops „ (71 „ ) 3 ... 3 „ Home work places „ ( 273 ) 13 ... 13 „ Laundries „ (74 „ ) 10 ... 10 „ Restaurant kitchens „ ( 158 ,, ) ... ... ... Work Places Men]. (Half-yearly) Factories [Man] ( 413 „ ) 69 18 87 „ Workshops ,, ( 1238 „ 541 197 738 ,, Work places „ ( 21 16 37 „ Bakehouses „ ( 133 „ ) 378 273 651 „ Restaurant kitchens,. ( 163 „ ) 188 132 320 (Weekly) Smoke Shafts „ ( 334 ,, ) 614 173 787 (Fortnightly) Cowsheds 7 Licensed ) 117 ... 117 Food Places, ,, Dairies 413 Regd. ) 1225 ... 1225 (Quarterly) Milkshops „ Ice Cream Premises ( 491 on List ) 340 ... 340 (Weekly) Slaughter-houses ( 17 Licensed ) 603 ... 603 „ Food Makers' Premises* ( 204 on List ) 824 29 853 (Alternate Daily) Marketing Places ( 39 „ ) 4991 2 4993 Unfit food—Seizure, condemnation, destruction, &c. 67 ... 67 Adulterated Food—Samples, transit, &c 756 ... 756 Special Places. (Quarterly) Effluvia Businesses [M] ( 14 on Register) 7 1 8 „ Fried Fish Shops (85 ,, ) 137 39 176 „ Rag and Bone Stores ( 34 „ ) 45 13 58 „ Offensive Trades [M] ( 2 Sanctioned) 20 ... 20 Railway Nuisances ... ... ... Legal Proc eedings—(1) Services of Notices 23 ... 23 ,, „ (2) Applications and Summonses 45 ... 45 ,, „ (3) Hearings and Adjournments 67 1 68 Other Duties not included in above 5454 57 5511 Total 32384 28608 60992 * Where Tripe, Sausages, Extract of Meat, &c., are prepared. 108 Intimations as to Nuisances so-red by Smitary Inspectors during 1910. Schedule of Nuisances. Totals. 1 Part of the house in a dirty condition 556 2 ,, ,, dump ,, 75 3 Roof defective 291 4 Guttering defective 62 5 Water fittings defective 192 6 Water-closet apartment with absence of external ventilation 66 7 ,, ,, so foul as to be a nuisance or dangerous to health 33 8 Water-closet basin foul 105 9 ,, ,, defective . 82 10 ,, ,, choked 152 11 Urinal in a foid condition 14 12 Privy in a foul condition 1 13 Soil pipe defective 53 14 ,, unventilated 39 15 ,, improperly ventilated 7 16 Absence of waste pipe to sink, lavatory, or bath 6 17 Waste pipe of sink, lavatory, or bath connected with drain 22 18 „ „ defective 66 19 „ „ foul 28 20 Inlet of drain improperly trapped 25 21 Drain defective 302 22 ,, stopped 142 23 ,, ventilating pipe defective 34 24 Rain-water pipe in direct communication with drain 54 25 ,, ,, defective 92 26 Unpaved condition of roadway 27 Undrained ,, ,, 28 Area or part unpaved 6 29 ,, undrained 2 30 Yard or space unpaved 10 35 ,, ,, undrained 9 32 Defective condition of washhouse paving 62 33 Dust-bin defective 323 34 ,, in an improper position 5 35 Accumulation of stagnant water which is a nuisance dangerous to health 27 36 Accumulation or deposit, which is a nuisance dangerous to health. . 216 37 Animals kept in such a manner as to be a nuisance dangerous to health 15 38 Part of the house so overcrowded as to be dangerous to health . . 69 39 Space below floor in basement or ground floor insufficiently ventilated 19 40 Issuing of black smoke in such a quantity as to be a nuisance 8 41 Discharging smoke in such a manner as to cause part of a building to be a nuisance dangerous to health 6 42 Tent, van, shed, or similar structure used as a human habitation which is in such a state as to be injurious or dangerous to the health of the inmates — 43 Other Nuisances 177 Total 3453 109 Intimations as to Breaches of Statutes and Statutory By-laics served by the Sanitary Inspectors during 1910. Breaches of Statutes and Statutory By-laws. Totals. 1 An occupied hou-e without a proper and sufficient supply of water 15 2 Water supply used for domestic purposes connected with cistern which is used for flushing the water-closet 3 3 Water-closet not supplied with a sufficient quantity of water for securing its effective action 177 4 Tank, cistern or other receptacle for storing of water used or likely to be used for man for drinking purposes—dirty condition of 50 5 Tank, cistern or other receptacle for storing water used or likely to be used by man for drinking purposes—absence of proper cover to 35 6 Tank, cistern or other receptacle for storing water used, or likely to he used, by man for drinking purposes placed in an improper position 5 7 Animals so kept as to be likely to pollute the water supply — 8 Offensive matters not deposited in manure receptacle 1 9 Manure not removed at proper intervals 6 10 Manure, absence of proper receptacle for 8 11 Manure receptacle not properly constructed 3 12 Sufficient drain to stables or cowshed — absence of a 1 13 Receptacle for house refuse—absence of a proper 314 14 Receptacle for house refuse - absence of a proper cover for 18 15 Yard or open space unpaved 3 16 ,, paving defective 151 17 Insufficient water closet accommodation to " lodging-house " 57 18 A furnace improperly constructed or negligently used 1 19 Effluvia arising from premises used for trade, business, or manufacture which is a nuisance dangerous to the inhabitants of the district 2 20 Qffensive matters suffered to run out of trade premises into an uncovered place — 21 Dairies and cowsheds -breach of By-laws as to — 22 Slaughterhouses—Breach of By-laws as to 1 23 Steam whistle—use of a, without authority — 24 Parts of houses infested with vermin requiring stripping, purifying and cleansing 189 25 Articles in an unwholesome condition requiring to be purified or destroyed 7 26 Other breaches 69 Total 1116 110 Intimations ax to Breaches of By-laws and Breaches of Statutes served by the Sanitary Inspectors during the year 1910. Registered Tenement Houses.—Breaches of By-laws. Totals. 1 Overcrowding 72 2 Inadequate water supply — 3 Contaminated water supply — 4 Foul closet, basin or trap 58 5 Want of means of ventilation — 6 Want of annual cleansing 123 7 Want of cleansing of tlie part or parts of premises used in common 542 8 ,, „ ,, in sole use 437 9 „ „ room or part of dwelling 113 10 Animals improperly kept 4 11 Other breaches 25 Total 1374 Factories, Workshops, and Workplaces.—Breaches of Statutes. s. 1 Want of cleanliness 100 2 Want of ventilation 5 3 Want of air space, overcrowding 3 4 Sanitary accommodation, absent or insufficient 6 5 ,, „ unsuitable or defective 9 6 ,, ,, not separate for sexes 7 7 Want of drainage of floors 3 8 Other nuisances 15 9 Illegal occupation of underground bakehouse — 10 Breach of special sanitary requirements for bakehouses 33 11 Failure as regards list of out-workers — 12 Giving out work to be done in premises which are unwholesome . . — 13 ,, ,, „ infected — 14 Allowing wearing apparel to be made in premises infected by scarlet fever or small-pox — 15 Other contraventions 1 Total 182 Ill Clerical Work. From 3rd January, 1910, to 31st December, 1910, inclusive. No. of Complaints received (communications) 2064 No. of Certificates of Dangerous Infectious Diseases received 1215 No. of Notices of Voluntary Drain-work received 283 No. of Letters, etc., despatched 3167 No. of Notices of Intention to Register 6 No. of Notices of Registration 2 No. of Sets of Advisory Notices as to Infectious Diseases forwarded 1215 No. of Statutory Notices requiring disinfection 1215 No. of Certificates of disinfection completed by Sanitary Authority 998 No. of Certificates of Infectious Disease sent to School Teachers 1636 No. of Intimation Notices issued 4241 No. of Statutory Notices of intention to proceed served 812 No. of Statutory Notices requiring stripping for vermin 57 No. of Statutory Notices requiring purification of articles 0 No. of Warning Notices of intention to summons sent 72 No. of Summonses Applied for 67 No. of Hearings and Adjournments 69 No. of Meetings of Council 17 No. of Meetings of Public Health Committee and Sub-Committees held 45 STAFF. In the Annual Report for 1907 an account was given of the changes which have taken place in the Inspectorial Staff from 1898 to 1907, and in subsequent Annual Reports the changes to date. On January 12th, 1910, Mr. Hugh Alexander Reid was appointed Caretaker of the Prospect Terrace Dwellings, then about to be opened. On the 22nd June, 1910, Miss Celia Smith was appointed Sanitary Inspector in the place of Miss Blanche Gardiner, resigned, and on the 30th November Miss Celia Smith was also appointed Health Visitor, in accordance with the Health Visitors (London) Order, 1909. The Public Health Committee had in view the desirability of being able to call upon the Officer to cover any part of the field of duties of a Woman Sanitary Inspector and also of those of a Health Visitor when necessary, and, at the same time, of placing her in such a position as to enable her to instruct and supervise the services of Voluntary Health Visitors with greater authority. The duties of a Women Sanitary Inspector embrace the inspection of day schools and factories as to sanitary accommodation ; of workplaces, workshops, domestic work places, home work places, laundries, and restaurant kitchens where women are employed. In recent years, in addition to the foregoing duties, Public Health Authorities are paying more and more attention to the 112 prevention of disease, and are coming to closer grips with infantile mortality and tuberculosis. To deal with the prevention of the disease, the officer should be fully acquainted with the prevention of insanitary environment and the methods necessary to remedy insanitary conditions. As a Sanitary Inspector fully acquainted with this, she is able to direct the attention of the District Inspectors carrying out the necessary remedies. As a Sanitary Inspector, she also has the power of entry, which as a Health Visitor she would not possess, and thus, during vacation and in emergency, she can take over the duties of her colleague, so that there is never any temporary neglect. The duties of the Health Visitor are partly statutory and partly permissive, and include those under the Notification of Births Act, the prevention of infantile mortality, the notifications from schools of verminous children, and the cleansing of the children, their bedfellows, clothing and bedding, and the notification from schools of the non-certificable diseases, e.g., measles. It is not, therefore, altogether easy to define where the statutory duties cease and the permissive duties commence, but, roughly speaking, they each respectively embrace about half the officer's time, so that her duties in the matter of time may be said to be equally divided between those of a Sanitary Inspector and a Health Visitor. § 2.—OPEN SPACES AND ATMOSPHERE. 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, 1901. Garden or Open Space. Area Maintaining Authority. A. R. P. North St. Pancras 59 Parliament Fields & Hampstead Heath 507 1 0 London County Council „ .. Waterlow Park 29 0 0 „ „ „ .. Highgate Cemetery 38 0 0 Cemetery Company „ .. Pond Square, etc., Ilighgate 0 3 28 St. Pancras Borough Council „ .. Lismore Circus 0 2 27 „ „ West St. Pancras 87 Primrose Hill and Regent's Park 400 0 0 H.M. Government „ 181 St. James's Gardens 2 2 31 St. Pancras Borough Council East St. Pancras 90 St.Martin's Gardens 1 3 0 „ „ „ .. College Gardens 0 0 17 „ „ „ , . St Pancras Gardens 5 1 0 „ „ South St. Pancras 183 Whitefield Gardens 0 2 0 Loudon County Council „ 178 St.George's Gardens 2 2 0 St. Pancras Borough Council „ .. St.Andrew'sGardens 1 1 0 „ „ 113 Mr. W. N. Blair, m.i.c.e., Borough Engineer, compiled the following table, from which it is seen that more than one-fourth of St. Pancras is public or semi-public open space and railways. PARISH OF ST. PANCRAS. Land in the Occupation of the Railway Companies, exclusive of railways in tunnels. Acres. Midland Railway Depots and Stations 117 Great Northern „ ,, 69 L & N.-W. „ „ 65 Open Railways (not included in the Depots and Stations) 47 296 Public Parks and Open Spaces, etc. Waterlow Park 29 Parliament Hill (within St. Pancras) 194 College Garden .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 „ 2.50 St. James's ,, 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 Whitefield 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 Cartwright Gardens (Burton Crescent) 1.45 Regent Square .70 Mccklenburgh Square 2.50 Fitzroy Square .75 St. George's Square .43 26 Total area of St. Pancras, 2,604 acres. Census, 1901. 688 114 The following information as been obtained by the Town Clerk, Mr. C. II. F. Barrett. The following Squares, &c., within the Borough are maintained by the inhabitants of such out of rates leviable as additional items of the General Rate by the Borough Council upon the precept served by a Committee elected by the inhabitants of each square, &c.:—Ampthill Square, Brunswick Square, Cartwright Gardens (Burton Crescent), Camden Gardens, Clarence Gardens, Fitzroy Square, Gordon Square, Harrington Square, Mecklenburgh Square, Mornington Crescent, Munster Square, Oakley Square, Regent's Square, Rochester Terrace, &c., and Tavistock Square. The following Public Gardens are maintained by the Borough Council out of the General Rate, namely:— St. Andrew's Gardens, Gray's Inn Road, by Wells Street. St. George's Gardens, Wakefield Street. St. James's Gardens, Hampstead Road. St. Martin's Gardens, Camden Street. St. Pancras Gardens, Pancras Road. Lismore Circus Gardens, Gospel Oak. Pond Square Garden, Highgate. College Garden, Great College Street. The undermentioned Open Spaces, the whole or part of which are situated in the Borough, are maintained by the London County Council, viz., Ilampstead Heath, Parliament Hill Fields, Waterlow Park, and Whitefield Gardens, Tottenham Court Road. Regent's Park and Primrose Hill Park, portions of which are in St. Pancras, are maintained by the Crown. The Borough Council have no control over the undermentioned Squares and Open Spaces situated in the Borough : - Fndsleigh Gardens, Euston Road. Owned by the estate of the late Thomas Cubitt. Euston Square, Euston Road. Owned by the London and North-Western Railway Company. Goldington Crescent Garden. The freeholders are the Duke of Bedford and the Brewers' Company, and the Garden is leased to the occupiers of the houses in the Crescent. Argyle Square Garden, King's Cross. Owned by the proprietors of the Battle Bridge Estate, whose agent is A. J. Dryland, Esq., No. 2, Guildhall Chambers, E.C. The Highgate Road Open Road Spaces are owned by Lord Dartmouth and others. Camden Square Garden is owned by the Marquis of Camden. The Crescent, Camden Road, is looked after by a Committee of the adjoining residents, the secretary of which is Mr. Corderoy, of No. 167, Camden Road. Leighton Crescent is controlled by a Committee of the adjoining residents, and the Secretary is Mr. Blunton, of No. 6, Leighton Crescent, N.W. 115 The Crescent, Euston Street, is owned by the London and North-Western Railway Company. The enclosed Gardens adjoining Regent's Park Terrace and Maitland Park Villas are owned by adjoining owners of land, and are maintained by them. ATMOSPHERE. Smoke. — In the Animal Report for 1902 the enactments dealing with smokewere set out in full. There are 334 smoke shafts on the Register ; 614 observations of these weretaken, and 173 re-inspections were made after notices served. These observations or inspections and re-inspections occupy a considerable amount of time, as theintervals between stoking are of considerable duration—at least twenty minutes, and often twice as long. The Inspectors are now instructed to limit their observation of a chimney tohalf an hour, and only to prolong it beyond this period so long as a nuisance is actually being committed. (See Minutes of Public Health Committee of 30th January, 1907.) Effluvia.—Of various businesses and places producing effluvia or offensive emanations there are 136 on the Registers, and of these 209 inspections and 53 re-inspections were made. (Sec also under the head of Nuisances § 9.) § 3.—DWELLINGS. (a) House-to- House Inquiries and Inspections.—(i) For the purpose of ascertaining the mode of sub-letting 430 inquiries and 222 re-visits were made as to the occupation of houses in tenemented streets, (ii) When the mode of sub-letting appears to be such as to necessitate periodical supervision of the sanitary condition of a house, a complete inquiry is made into the mode of occupation of each room of the house. (iii) When it has been decidcd to register a tenement house, each room is measured as to its dimensions and capacity and recorded in the Register. The forms in which the reports as to these matters are made were quoted in the Annual Report for 1904. (b) Tenement Houses.—During the year 2 inspections and 1 re inspection was made for the purpose of measuring tenement or lodging houses which it had been decided to register, and at the end of the year 2,282 houseswere upon the Register. Of these houses, 2,700 periodical half-yearly inspections were made, and 5,899 re-inspections after the service of notices ; also ot' the 339 dwellings entered in the Register of Inscribed Dwellings, 281 inspections were made, and 608 re-inspections after the service of notices. The following is a record relating to registered tenement houses:— On Register at end of 1909 2280 Registered during 1910 2 Total 2282 Ceased to be registered houses in 1910 0 On register at end of 1910 2282 116 THE SUPPLY OF WATER IN TENEMENT HOUSES. At the North London Police Court in April, 1911, the owner of some houses let in tenements to working men was summoned in consequence of alleged deficiency in the water supply. On behalf of the Islington Borough Council it was shown that, although two or three families resided in each house, the water supply was only obtainable in the scullery, and there were no taps upon the landings. The defendant claimed that the water supply came direct from the main and was adequate, and that when he provided taps on the landings they were liable to be meddled with by children, with consequent damage to the house. This would bring down the ceiling of the floor below, and the landlord would have to restore it at his own expense. The magist'ate made orders for the conditions complained of by the Borough (Council to be remedied. Taps may be so arranged that children are unable to interfere with them, and provision may be made for waste water to be carried off without inflicting damage, even if the taps are left running. The taps need n t necessarily be placed on the landings, they may be placed in some of the rooms. Inscribed Dwellings. For the purpose of periodical inspection a list of Inscribed Dwellings is kept. This List includes — 1. Cottages of one, two, three, or more rooms occupied by one family and which cannot be registered, e.g. Equity Buildings. 2. Dwellings over Stables which require periodical inspection but cannot be registered, e.g. Wakefield Mews. 3. houses in crtain areas represented under the Housing of the Working Classen Acts, some of which are registrable and some not, e.g., Chapel Grove and Eastnor Place areas. 4. Tenement Houses let in separate dwellings but in which the dwellings are not separately assessed, or, if separately assessed, in which the dwellings do not differ in arrangement or construction from those in an ordinary tenement house, but which houses, it may be contended, are not registrable as a whole. 5. Working Class Flats habitually overcrowded or kept in an insanitary condition. (e) Underground Duelhings.—At the end of the year there were on the Register 471 underground rooms which had been illegally occupied as dwellings, and had been ordered to be closed, and of which 116 inspections had been made and 46 re-inspections after notices served. Time is allowed to the occupants of these rooms to find rooms elsewhere, and during the time allowed the illegally occupied rooms are kept under observation and the number vacated or otherwise occupied ascertained and reported. The houses in which these dwellings are found are added to the register of registered tenement houses. (d) Common Lodging-houses.—There are 19 registered Common Lodginghouses in St. Pancras, and these are supervised by the London County Council, including the one Salvation Army Shelter in South St. Pancras. Rowton Houses are not so registered; of these there are in St. Pancras one at the southern end of King's Cross Road, in South St. Pancras, and another at the northern end of Arlington Road, in West St. Pancras. 117 (e) Canal Bout Dwellings.—During the year 61 visits of inspection were paid to the 151 wharves on the Regent's Canal. (f) Working Class Flats.—A list of the principal of these and the accommodation provided will be found in the Appendix to this Report. THE INLAND REVENUE ACT, 1903. Houses Tenements. during the Year 1910. No. comprised therein. No. for which Certificates were Notes. Granted. Refused. Deferred. 7 92 84 8 — The Housing and Town Planning Act, 1909, now provides also for the exemption of common lodging-houses for the working classes from inhabited house duty by Section 35. (g) HOUSING OF THE WORKING CLASSES ACTS. Of the various schemes made under these Acts only one now remains uncompleted, namely, the Chapel Grove and Eastnor Place scheme. Chapel Grove and Eastnor Place Scheme.— Weirs Passage.—Reference was made in last year's report to the unsuccessful proceedings before the Magistrate for the closing of the dwelling houses in Weirs Passage. In January, 1911, a communication was received from the Local Government Board enclosing a letter addressed to the Board by the Midland Railway Company with reference to these schemes. The Company proposed to pull down No. 5, Ossulston Street, No. 1, Wilstead Cottages, and the two-storey back addition at the rear of Nos. 6 and 8, Weirs Passage, so as to provide additional air space for the houses Nos. 2-10, Weirs Passage, and open up and bring considerably more light and air into this passage and to Wilstead Cottages. The sites of the back addition of Nos. 6 and 8, Weirs Passage, and of No. 1, Wilstead Cottages, would be thrown into the yard of the Weirs Passage houses, and the site of No. 5, Ossulston Street, would be left open, with some boundary posts, if the St. Pancras Council would be prepared to make an arrangement to keep it in order and repair until it came to be dealt with as part of the surrounding site, so that the Company would not lose their rights in it. The Board informed the Company that while they had no objection to offer to the proposed alterations, they could not regard them as so materially improving the conditions in regard to Weirs Passage as to justify deferring for an indefinite period further action for improving or clearing the areas comprised in the Chapel Grove and Eastnor Place Improvement Schemes. These proposals were also considered by your Public Health Committee, and from inquiries made they were satisfied that there was sufficient vacant 118 accommodation in the neighbourhood to provide for any persons who may be displaced by the proposed demolition of the property by the Midland Railway Company, but considered that any agreement come to in the matter should in nowise affect the rehousing obligations laid down by the Local Government Board's Order in regard to the Chapel Grove and Eastnor Place 1 mprovement Schemes. The Company were accordingly informed that the Council did not raise any objection to the above-mentioned proposals, provided that they did not prejudice the Council's position in the matter of rehousing or otherwise in regard to Weirs Passage or the rest of the areas, but nothing further has been done in the matter. The Housing and Town Planning Act, 1909.— In last year's report reference was made generally to this Act, which came into force on the 3rd December, 1909. The chief provisions affecting the Council were then summarised. It is now necessary to place on record one or two matters upon which special regulations have since been made by the Local Government Board under the powers conferred on the Board under the Act. Inspection of District. By Section 17 (1) of the Act it is enacted that it shall be the duty of every local authority within the meaning of Part II. of the Housing of the Working Classes Act, 1890, to cause to be made from time to time inspection of their district, with a view to ascertain whether any dwelling house therein is in a state so dangerous or injurious to health as to be unfit for human habitation, and that for that purpose it shall be the duty of the local authority, and of every officer of the local authority, to comply with such regulations, and to keep such records as may be prescribed by the Local Government Board. The Board have accordingly issued an Order, dated 2nd September, 1910, making Regulations with respect to the manner in which inspection of the District under this section shall be carried out, and with respect to the records to be kept of such inspection. The Regulations are as follows:— Article I.—(1) The local authority shall, as early as practicable after the date of this Order, take into consideration the provisions of Sub-section (1) of Section 17 of the Act of 1909, and shall determine the procedure to be adopted under these Regulations, to give effect to the requirements of that sub-section in regard to the inspection of their district from time to time. (2) The local authority shall, as part of their procedure, make provision for a thorough inspection to be carried out from time to time according to the varying needs or circumstances of the dwelling houses or localities in the district of tire local authority. (3) The local authority shall cause to be prepared from time to time by tire Medical Officer of Health, or by an Officer designated by them but acting under his direction and supervision, a list or lists of dwelling houses the early inspection of which is, in the opinion of the Medical Officer of Health, desirable. The list or lists may, if thought fit, relate to the dwelling houses within a defined area of the district witlrout specifying each house separately therein. Article II. - The inspection under and for the purposes of Sub-section (1) of Section 17 of the Act of 1909 shall be made by the Medical Officer of Health, or by an Officer designated by the local authority but acting under his direction and supervision, and the Officer making inspection of any dwelling house shall examine the state of the dwelling house in relation to the following matters, namely:— (1) The arrangements for preventing the contamination of the water supply. 119 (2) Closet accommodation. (3) Drainage. (4) The condition of the dwelling house as regards light, the free circulation of air, dampness, and cleanliness. (5) The paving, drainage, and sanitary condition of any yard or out-houses belonging to or occupied with the dwelling house. (6) The arrangements for the deposit of refuse and ashes. (7) The existence of any room which would in pursuance of Sub section (7) of Section 17 of the Act of 1909 be a dwelling house so dangerous or injurious to health as to be unfit for human habitation. (8) Any defects in other matters which may tend to render the dwelling house dangerous or injurious to the health of an inhabitant. Article III.—Records of the inspection of dwelling houses made under and for the purposes of Sub-section (1) of Section 17 of the Act of 1909 shall be prepared under the direction and supervision of the Medical Officer of Health, and shall be kept by the Officer of the local authority making the inspection or by some other Officer appointed or employed for the purpose by the local authority. The records may be kept in a book or books or on separate sheets or cards, and shall contain information, under appropriate headings, as to:— 1. The situation of the dwelling house, and its name or number. 2. The name of the Officer who made the inspection. 3. The date when the dwelling house was inspected. 4. The date of the last previous inspection and a reference to the record thereof. 5. The state of the dwelling house in regard to each of the matters referred to in Article II. of these Regulation:-:. 6. Any action taken by the Medical Officer of Health, or other Officer of the local authority, either independently or on the directions of the local authority. 7. The result of any action so taken. 8. Any further action which should be taken in respect of the dwelling house. Article IV.—The local authority shall, as far as may be necessary, take into consideration at each of their ordinary meetings the records kept in pursuance of Article III. of these Regulations, and shall give all such directions and take all such action within their powers as may be necessary or desirable in regard to any dwelling house to which the records relate, and a note of any directions so given and the result of any action taken shall be added to the records. Article V.—The Medical Officer of Health shall include in his Annual Report information and particulars, in tabular form, in regard to the number of dwelling houses inspected under and for the purposes of Section 17 of the Act of 1909 ; the number of dwelling houses which on inspection were considered to be in a state so dangerous or injurious to health as to be unfit for human habitation ; the number of representations made to the local authority, with a view to the making of closing orders ; the number of closing orders made ; the number of dwelling houses the defects in which were remedied without the making of closing orders; the number of dwelling houses which, after the making of closing orders, were put into a fit state for human habitation ; and the general character of the defects found to exist. He shall also include any other information and particulars which he may consider desirable in regard to the work of inspection under the said section. Article VI.—The Medical Officer of Health and any other Officer of the local authority shall observe and execute all lawful orders and directions of the local authority in regard to, or incidental to, the inspection of the district of the local authority under and for the purposes of Section 17 of the Act of 1909. and the execution of these Regulations. Appeals to Local Government Board from Closisng Orders and Demolition Orders made by Local Authorities. Closing Orders.—Under the Housing Act, 1890, closing orders were made by a Court of Summary Jurisdiction. Under Section 17 (2) of the new Act they will be made by the local authority. Sub-section (3) gives an owner aggrieved by a closing order a right of appeal to the Board within 14 days after the order is served upon him. 120 The new Act does not in any way prescribe the procedure to be adopted by the local authority before making a closing order. This matter is left to their di scretion. A closing order will not become operative so as to be put into actual force until either the time within which an appeal can be made has elapsed without an appeal being made, or, in case an appeal is made, the appeal is determined or abandoned, and no proceedings under the order are to be taken till it becomes operative (Section 39 (2)). The time within which, when a closing order has become operative, an occupvirg tenant with his family can be required to cease to inhabit the houses in respect of which the order has been made is increased by Section 17 (4) from 7 to 14 days after service of notice, and the tenant who makes default, instead of being subjected to a fine, as heretofore, will be liable to have a summary order to quit made against him. The local authority may make to any tenant a reasonable allowance on account of his expenses in removing. The amount of the allowance will be primarily determinable by the local authority with the owner's consent, though in default of such consent it will be fixed by a Court of Summary Jurisdiction. But an allowance for expenses of removal is not to be given if the house has been made unfit for habitation by the wilful act or default of the tenant or of some one for whom, as between himself and the owner or landlord, lie is responsible (Sub-section (-5) ). The local authority must, under Sub-section (6), determine a closing order made by them if they are satisfied that the dwelling-house has been rendered fit for human habitation, and the owner is given a right of appeal to the Board against a refusal on the part of the authority to do so. A Court of Summary Jurisdiction will no longer have power to enlarge the time for the execution of any works under a closing order (Section 21). Demolition Orders.—Section 18, which supersedes Section 33 of the 181)0 Act, deals with the demolition of dwelling-houses which have been closed by closing orders. Under Sub-section (1) proceedings with a view to an order for the demolition of a dwelling-house cannot be initiated until a closing order has been operative for three months, and when that period has elapsed the local authority must, before making a demolition order, give the owner an oppor tunity of being heard on the matter at a meeting of which he has had at least one month's notice. Sub-section (2) indicates the circumstances in which a demolition order must be made, and this must now be done if the local authority are of opinion that the dwelling-house has not been rendered fit for human habitation, and that the necessary steps are not being taken with all due diligence to render it so fit, or that the continuance of any building which is, or is part of, the house is a nuisance or is dangerous or injurious to the health of the public or of the inhabitants of the neighbouring dwelling houses. Where, however, the case is one in which the local authority consider that the dwelling-house can be made fit for human habitation, they can under Sub- o . . section (3) give the owner an opportunity to render it so fit, if he undertakes to execute the necessary work, by postponing the operation of the order for a period not exceeding six months. No enlargement of the time allowed for the execution of works or the demolition of a building can now be granted by a Court of Summary Jurisdiction (Section 21). Sub-section (4, gives to the owner of a building in regard to which a demolition order has been made a right of appeal to the Board. 121 Rules as to Appealx.—By Section 39 of the Act it is enacted that the procedure on any appeal, including costs, to the Local Government Board shall be such as the Board may by rules determine, and on any such appeal the Board may make such order in the matter as they think equitable, and any order so made shall be binding and conclusive on all parties, and, where the appeal is against any notice, order, or apportionment given or made by the local authority, the notice, order, or apportionment may be confirmed, varied, or quashed, as the Board think just. Provided that— (a) the Local Government Board may at any stage of the proceedings on appeal, and shall, if so directed by the High Court, state in the form of a special case for the opinion of the court any question of law arising in the course of the appeal ; and (ib) the rules shall provide that the Local Government Board shall not dismiss any appeal without having first held a public local inquiry. Any notice, order, or apportionment as respects which an appeal to the Local Government Board is given under this Part of this Act shall not become operative until either the time within which an appeal can be made under this Part of this Act has elapsed without an appeal being made, or, in case an appeal is made, the appeal is determined or abandoned, and no work shall be done or proceedings taken under any such notice, order, or apportionment until it becomes operative. The Local Government Board may, before considering any appeal which may be made to them under this Part of this Act, require the appellant to deposit such sum to cover the costs of the appeal as may be fixed by the rules made bv them with reference to appeals. In accordance with this section the Local Government Board have prepared a series of rules determining the procedure to be adopted on any appeal. The rules, which are dated 11th January, 1910, areas follows:— Role 1.—Every appeal to the Local Government Board shall be made to and be brought before the Local Government Board by means of a letter, or other representation in writing (hereinafter referred to as a " statement of appeal "), which shall be addressed and posted, or shall be otherwise given, sent, or delivered to the Local Government Board at their office, and of which a copy shall, at the same time, be addressed and posted, or shall be otherwise given, sent, or delivered to the Local Authority at their office. Rule 2.—Every statement of appeal shall be signed by or on behalf of every person (hereinafter referred to as an " appellant "), who makes, or who joins in making, the appeal, or, where an appellant is a corporation, or an association or body of persons unincorporate, shall be signed by an officer of or other person described as duly authorised by the corporation, association, or body, and shall bear a date corresponding to that of the day on which the requisite signature is affixed to the statement of appeal. Rule 8.-—Every statement of appeal shall set forth in detail the grounds of the appeal, all material facts in relation to the description or position of every appellant as a party to the appeal, and to his interest in any dwelling-house or premises to which the appeal has reference, or to his interest in or to such other concern or association as he may have with any subject-matter of the appeal, and also all material facts in relation to any such proceeding by a Local Authority, or by an officer of or person authorised by a Local Authority, as affects the grounds of appeal, the appellant, the interest of the appellant in any dwelling-house or premises to which the appeal has 122 reference, or the interest of the appellant in or such other concern or association as he may have with the subject-matter of the appeal. Rule 4.—Every statement of appeal shall be accompanied by every such document as an appellant has in his possession or at his disposal, and is able to furnish, and as consists of, or comprises, or gives particulars of, any notice, order, demand, or apportionment relating to the grounds or subject-matter of the appeal, or otherwise relating to any material facts set forth in the appeal; and shall show by appropriate particulars in the statement of appeal, or by an appropriate entry on any such document accompanying the statement of appeal, the date of service upon an appellant of the notice, order, demand, or apportionment. Rule 5.—Where an appeal appears to the Local Government Board to require for its due consideration that information, other than such information as is set forth in the statement of appeal, or is supplied by means of any document accompanying the statement of appeal, or by means of any statement by or correspondence with an appellant or the Local Authority respecting the appeal, shall be furnished to the Local Government Board, the requisite information shall, on the written request of the Local Government Board, be furnished by an appellant or by the Local Authority, as the case may be, in such manner, in such form, and within such time as the Local Government Board in writing specify. Rule 6.—Where the Local Government Board on an appeal are satisfied that there is reasonable cause for dispensing, either conditionally or unconditionally, with compliance with any requirement of the foregoing Rules, or for varying any such requirement, the Local Government Board may, by a notification in writing to an appellant or to the Local Authority, as the case may be, give the necessary dispensation to the appellant or to the Local Authority, as the case may be, or may make and give effect to the necessary variation and to any incidents or consequences of that variation ; and, in the case of any such dispensation when given subject to any condition, or in the case of any such variation, an appellant or the Local Authority, as the case may be, shall comply in all respects with the condition or variation, and with any requirement of the notification by the Local Government Board, as if the condition, variation, or requirement formed part of the foregoing Rules. Rule 7.—Where the Local Government Board, before considering an appeal, require an appellant to deposit a sum to cover the costs of the appeal, the sum shall be — (а) In every case in which the Office of the Local Authority is at a distance not exceeding fifty miles from the Office of the Local Government Board— Seven Pounds; and (b) In every other case— Ten Pounds. For the purposes of this Rule, the distance shall be measured by a straight line drawn on the third edition of the map of the Ordnance survey on the scale of 3 '-5 ,5 or one mile to one inch, from the nearest point in one Office to the nearest point in the other Office. Rule 8.—Except so far as this Rule otherwise provides, and so far as regards any costs incurred by the Local Government Board in relation to a public local inquiry held in pursuance of these Rules, all costs of and incidental to an appeal shall, when incurred by an appellant or by the Local Authority, be borne by the appellant or by the Local Authority as the case may be: Provided that the Local Government Board may, by any Order made under Sub-section (1) of Section 39 of the Housing, Town Planning, &c., Act, 1909, direct by whom any such costs, when incurred by an appellant or by the Local Authority, shall be borne ; and that nothing in this Rule shall have effect in contravention or in derogation of any such direction. Rule 9.—The Local Government Board shall not dismiss an appeal without having first held a public local inquiry. Where the Local Government Board are required to hold a public local inquiry, and written notice of the time and place at which the inquiry will be held has been given 123 by the Local Government Board to every appellant and to the Local Authority, a printed copy of the notice shall be posted by the Local Authority at every place specified in writing by the Local Government Board as necessary or suitable for the purpose. Conference on Town Planning.—Under the auspices of the Royal Institute of British Architects an important Conference on Town Planning was held in London in October, 1910, at which the Council was represented by the Chairman and Deputy-Chairman of the Public Health Committee Housing Regulations ancl Back-to-Back Dwellings. The regulations governing the inspection of districts under the Housing and Town Planning Act of 1909, issued by the Local Government Board, contain several requirements which are of importance. The regulations aim at extending the practice of systematic sanitary inspection of dwellings. All Councils arc now required to arrange for the necessary inspections of dwellings to be made by or under the direction of tbe Medical Officer of Health, who is to submit lists of dwelling houses and areas in the district, early inspection of which is, in his view, desirable. The inspection is to be of a comprehensive character, and, in addition to the determination of a series of questions specified in the regulations, is to include examination for any defects which "may tend to render the dwelling house dangerous or injurious to the health of an inhabitant." The Housing and Town Planning Act contains a clause, which gave rise to considerable controversy in Parliament, forbidding the future erection of "back-to-back" houses as dwellings for the working classes, and limiting the erection of tenement houses in which the tenements are placed back-to-back to buildings which the Medical Officer of Health certifies to have sufficient available ventilation. Since the well-known report by the late Dr. F. W. Barry and Mr. Gordon Smith, in 1887, on "back- to-back" houses, the drawbacks of this type of dwelling, in a sanitary sense, have been generally recognised. Bows facing north get little or no sunshine into any part of the house, while those facing south, having all the rooms exposed to the sun, may become intolerably hot; the rooms are conspicuously stuffy, while much inconvenience and nuisance result from the absence of a backyard and the position of closets and ashbins. The probability that a higher death rate exists in houses built "back-to-back," when compared with "through " houses in the same neighbourhood, was indicated for the town of Salford by Dr. J. W. Tathan for the years 1879-83, and by similar statistical comparisons which have since been made in a few localities, notably in Shipley, by Mr. Herbert Jones, in Bradford by Dr. W. A. Evans, and in Manchester by Dr. J. Niven. An extensive inquiry into the subject has now been made for the Local Government Board by Dr. L. W. Darra Mair, whose report, with an introduction by the Board's Medical Officer, has lately been issued as a Parliamentary Paper (Cd. 5314). In order to avoid, as far as practicable, the many sources of error which are liable to arise in the comparison of populations for this purpose, Dr. Darra Mair extended his investigations over 13 industrial towns in the West Riding of Yorkshire in which "back-to-back" houses are common, and limited the comparison to houses in good structural condition situated in relatively healthy areas. With the aid of the Medical Officers of Health concerned, the vital 124 statistics of these houses were obtained for a ten-year period, and by means of special inquiries in each district material was obtained for the correction of death rates for the age and sex distribution of the populations. The inhabitants of the "through" and "back-to-back" houses compared in the report were of the same class, with similar occupations and wages, though the rent of the "through" houses, averaging 5s. (id. a week, was naturally higher than the rent of the "back-to-back " houses, which averaged 4s. 6d. a week. The corrected average annual death rate from all causes was found to be greater in the "back-to-back" houses than in the " through " houses to the extent of 15 per cent. When only those "back-to-back" houses built in continuous rows were taken for comparison the excess was still greater, amounting to over 20 per cent. " Back-to-back " houses in blocks of four, each house having means of side ventilation, showed an average annual death rate similar to that in " through" houses. The outstanding causes of deaths which produced the excess of mortality in the " back-to-back " houses were pneumonia, bronchitis, and other pulmonary diseases (exclusive of phthisis), and diseases of defective development and malnutrition in young children. An excess of mortality in "back-to-back" houses from infectious fevers and from phthisis could also be traced, but these increments were less conspicuous than in the case of deaths from the causes above mentioned. The chief sufferers from residence in " back-to-back" houses are infants and young children and old persons. In part, this probably results from the greater liability of both young and old to death from pulmonary diseases other than phthisis. The higher mortality in infants was also in a large degree due to an excess of deaths certified as due to atrophy, debility, marasmus, convulsions, and teething. From the first three of these causes the mortality in the " back-to back" houses stood to that in " through " houses in the proportion of 169 to 100 ; from the last two the ratio was 164 to 100. These conditions are associated, on the whole, more closely than any other group of certified causes of death with the effects of impaired nutrition, imperfect growth, and abnormal development of the young child, and it is scarcely tobe doubted that in the earliest period of life the nature of the home, especially, perhaps, its facilities for obtaining fresh air and sunlight, exert a powerful influence on their production. The value of these statistical observations is increased by the fact that the broad conclusions which are indicated by a studv of the figures in the aggregate are also supported by the figures for the individual towns in which the investigations were made, in practically all of which an excess of mortality was found to have occurred in the dwellings of the "back-to-back " group. The construction of many blocks of flats and tenements may usefully be considered in the light of this report. UNDERGROUND ROOMS. Underground Dwellings.—These are controlled under the Public Health (London) Act, 1891, Sections 96, 97 and 98. Underground Sleeping Room*.—These are now controllable under Regulations to be made by the Council under the Housing and Town Planning Act, 1909, Section 17 (7). 125 The provisions of Sub-section (7) are as follows :— A room habitually used as a sleeping place, the surface of the floor of which is more than three feet below the surface of the part of the street adjoining or nearest to the room, is, for the purposes of Section 17, to be deemed to be a dwelling house so dangerous or injurious to health as to be unfit for human habitation, if the room either — (a) is not on the average at least seven feet in height from floor to ceiling; or (b) does not comply with such regulations as the Council, with the consent of the Board, may prescribe for securing the proper ventilation and lighting of such rooms, and the protection of the rooms against dampness, effluvia, or exhalation. The Board are empowered, if the local authority, after being required to do so by the Board, fail to make such regulations as above mentioned, or such regulations as the Board approve, themselves to make regulations, and the regulations so made are to have effect as if they had been made by the local authority with the Board's consent. It is, however, provided that a closing order made in respect of a room to which the sub-section applies is not to prevent the room being used for purposes other than those of a sleeping place ; and that if the occupier of the room after notice of an order has been served upon him fails to comply with the order, an order to comply with it may, on summary conviction, be made against him. Underground Lining Rooim.—These are mainly used for the purpose of preparing, cooking, and partaking of food—that is, they are practically underground domestic kitchens. Underground Working Rooms.—These are used either as workshops or as offices, and efforts are being made to control some of the worst types. Underground bakehouses have been under the control of the Factory and Workshop Acts for many years. § 4.—SCHOOLS. At the 40 grant-receiving schools, 17 inspections and 0 re-inspections were made during the year by the Woman Inspector. The Board of Education having decided to relieve Local Authorities from the obligation to provide school places for children under the age of five years, the age at which compulsory school attendance begins, many authorities are ceasing to admit school children from three to five years of age. Infectious Diseases as concerning schools is dealt with in Part III.. § 3, Isolation and Exclusion. 126 § 5— FACTORIES AND WORKSHOPS. Factories.—The Men Inspectors had 413 and the Women Inspectors 107 factories upon the Registers for periodical inspection as to water service, sanitary conveniences, drainage, and nuisances. During the year 69 and 16 inspections of factories respectively were made, and 18 and 1 re-inspections after notices served. Workshop*.—The Men Inspectors had 1,238 (apart from bakehouses) and the Woman Inspectors 404 workshops (apart from laundries) on the Registers for periodical inspection. During the year 562 and 19 inspections respectively of these premises were made, and 213 and 4 re-inspections after notices. Worl;places.—These include restaurant kitchens, cab and omnibus yards, laundries and domestic workshops and home workplaces. Domestic Workshops and Home Workplaces.—The Woman Inspector has. 71 of these on the Register, of which 3 inspections were made. These places vary in number from year to year, and according to the season of the year. Laundries.—On the Register are 74 laundries, at which the Woman Inspector made 10 inspections. Restaurant Kitchens.— Of these the Men Inspectors had 163 and the Woman Inspector 158 on the Registers. At the former 378 inspections and 132 re-inspections were made, and at the latter 0 inspection and 0 re-inspection. Bakehouses.—At the commencement of the year there were 133 workshopbakehouses. Of these, and of the three factory bakehouses and the three bakehouses in hotels, 378 inspections and 273 re-inspections were made. Off'eimce Trades and Effluvia Businesses. — These are dealt with under the section relating to Nuisances. Tabular Statement.—The following is a tabular statement of the work of the Men Inspectors in the form desired by the Factory Department of the Home Office:— METROPOLITAN BOROUGH OF ST. PANCRAS, 1910. Factories, Workshop?, Laundrifs, Woukfi.aces, and Homework. 1.—Inspection. Excluding inspections made by the Woman Sanitary Inspector, for which see appendix to her report. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 87 6 Nil. Workshops (including Workshop Laundries) 775 52 Workplaces (Restaurant Kitchens) 320 75 Total 1182 133 .. 127 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied. Referred to h.m. Inspector. Nuisances under the Public Health Acts :— Nil. Want of cleanliness 97 97 Want of ventilation 2 2 Overcrowding o 0 Want of drainage of floors 3 3 Other nuisances 15 15 Sanitary accommodation Insufficient 4 4 Unsuitable or defective 8 8 Not separate for sexes 4 4 Offences under the Fact ory and Workshop Act:— Illegal occupation of underground bakehouses (S. 101) Breach of Special san itary requirements for bakehouses (SS. 97 to 100) 33 33 Other offences 1 1 Total 167 167 3.—Home Work. This is dealt with by the Woman Inspector (see her Report). 4.—Registered Workshops. For list of Workshop-Bakehouses se$ Appendix at end of Annual Report. 5.—Other Matters. Class. Number. Matters notified to H.M. Inspectors of Factories :— Failure to affix Abstract of the Factory and Workshop Act (S. 133) .. Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (S. 5) Notified by H.M. Inspector 7 Reports (of action taken) sent to H.M. Inspector 7 Other .. Underground Bakehouses (S. 101):— Certificates granted during the year In use at the end of the Year .. 133 128 Underground Bakehouses.—The following report of the Medical Officer of Health, dated 6th July, 1910, was under the consideration of your Council on the 13th of that month : — Some years ago the Borough Council laid down certain requirements to which underground bakehouses in general, and certain of such bakehouses in particular, should conform. It having come under my observation that some of such bakehouses were ceasing to regard the requirements ordered by the Borough Council, I instructed the Inspectors to report to me all undegrouud bakehouses having open stall-board ventilation. The Reports are tabulated, and I beg to present a tabular list of underground bakehouses infringing the Council's requirements, and to recommend— (1) That a communication be sent to the occupier of each underground bakehouse with open stall-board or pavement ventilation, calling upon him to forthwith comply with the requirement of the Borough Council that there should be "no direct stall-board or pavement ventilation " to the bakehouse. (2) That it be an instruction to each District Inspector to make himself familiar with the requirements of the Borough Council in each case to which a certificate was granted to each of the underground bakehouses in his district, and if these requirements are departed from to call the attention of the occupier to the fact by an intimation of breach of statute, and in case of non-compliance, report to the Committee in the usual manner for statutory notices. I beg to append hereto a copy of the General Minimum Requirements. The Special Requirements are contained in the papers and plans referring to each particular underground bakehouse. General Minimum Requirements. (1) Cubic Capacity.—At least 1,000 cubic feet. (2) Square Feet.—At least 150 square f et of floor space. (3) Height. — At least 7 feet from floor to ceiling or roof. (4) Level of Ceiling or Roof.—Not more than 1 foot below the level of the street. (5) Open Space or Area.—On one of the sides of the bakehouse or an open roof. (6) Floor.—Of hard, even, smooth, impervious material, and in good condition. (7) Walls.— Of hard, even, smooth, impervious material, and in good condition. (8) Ceiling.—Impervious to dust and dirt, and in good condition. Any opening in the ceiling for the purpose of passing up bread, &c., to be closed by a tight fitting trap door and protected by a cabin hood and door, or similar form of protection. (9) Admission of Fresh Air.—One or more windows or skylights opening directly into the external air of at least 12 square feet in area, and so made as 10 be entirely opened with facility. Removal of the partition 129 between a front and back basement room, so as to open up the bakehouse to the remaining window or windows and to any open area or other open space. (10) Exclusion of Foul Air.—Any coal or other cellar shut off and ventilated into the open air independently of the bakehouse. (11).Exclusion of external Dust and Dirt.— Every opening so situated and so devised as to be protected from dust and dirt blown or falling from the street. No direct pavement, stall-board, or dwarf area ventilation into the bakehouse, and any window, fanlight, or door in a front area to be protected, either by hooded or winged sashes or by a horizontal covering or by a lean-to glass roof, so placed as not to obstruct the entrance of light and air, but to intercept any fallen or blown dust and dirt from the street, and any door to be automatically self-closing. (12) Extraction of Fumes, Effluvia, Sfc.—By outlet ventilators into any disused Hues, a valve or door into the oven flue, and an extraction or upcast shaft in the bulkhead or space over the oven, terminating at least 8 feet above the street level if situated in front of the premises. (13) General.—Compliance with the statutory requirements applicable to all bakehouses. Notk.—Special requirements were also made in regard to each particular underground bakehouse before a certificate was issued by the Borough Council, and these requirements are stated in the plans on record. This report your Council approved and adopted, and the Public Health Committee gave instructions : — (1) That a communication be sent to the occupier of each underground bakehouse with open stall-board or pavement ventilation, calling upon him to forthwith comply with the requirement of the Borough Council that there should be " no direct stall-board or pavement ventilation " to the bakehouse. (2) That it be an instruction to each District Inspector to make himself familiar with the requirements of the Borough Council in each case to which a certificate was granted to each of the underground bakehouses in his district, and if these requirements are departed from to call the attention of the occupier to the fact by an intimation of breach of statute, and in case of non-compliance report to the Committee in the usual manner for statutory notices. 130 Report of the Woman Inspector of Workshops, &c. To the Medical Officer of Health. Sir, I submit the following Report upon work done by me during the vear 1910:— COMPLAINTS. Factories. Workshops. Domestic Workshops. Laundries. Restaurant Kitchens. Schools. Total. Complaints dealt with during the year 5 11 1 1 l l 20 Complaints made by H.M. Inspector 3 10 .. 1 .. .. 14 Complaints made by other persons 2 l l .. l l 6 PREMISES AND INSPECTIONS, Including complaints and periodical inspections, the complaints being distributed according to the premises:— Premises. N umber on Register, 31st Dec., 1910. Approximate Number Employed. Inspections. Re-inspections after Intimation Notice. Intimation Notices. Statutory Notices. Prosecutions. Dav Schools 42 .. 18 .. .. .. Nil. Factorv Laundries 18 204 3 . . . . Other Factories 89 2575 18 l l .. Workshop Laundries 74 317 11 l l .. Other Workshops 404 2930 30 9 9 1 Domestic Workshops 71 152 13 . . . . .. Home Workplaces 273 273 4 . . . . ... Restaurant Kitchens 158 337 1 .. , . .. Other Duties .. .. 1475 .. .. .. Totals .. 6788 1573 11 11 l The work of the year 1910 was extremely difficult. The number of Consumption Notifications was large, and there was much to be done with regard to the general organisation of the subject, more particularly in promoting the necessary co-operation of various useful agencies. Investigations into outbreaks of measles among school children and visits in connection with the cleansing of children occupied much time. 131 In addition to this, from early in March until August there was 110 special officer for the work relating to the Prevention of Infantile Mortality. In consequence the work arising out of the Notification of Births Act required my close and constant supervision for a great part of the year. I wasfortunate in securing the help of several excellent Voluntary Visitors, who did very useful work, but who could not fill the place of a responsible officer or be left to work without continual guidance. Only the more urgent matters connected with industrial premises could receive attention, and little routine inspection in that direction was possible. A separate report upon the subject of Consumption is submitted to you. A table relating to industrial work is appended. I am, Sir, Your obedient Servant, M. E. Bimtv, Sanitary Inspector of Workshops (Women). 132 Woman Inspector's Work ONLY. FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES, AND HOMEWORK. 1.—Inspection. Including Inspections made by Sanitary Inspectors or Inspectors of Nuisances. Premises. Number of Inspections. Written Notices. Prosecutions. Factories (including Factory Laundries) 22 1 Nil. Workshops (including Workshop Laundries) 41 10 Workplaces (other than Outworkers' premises included in Part 3 of this Report) 1 — Total 64 11 — 2.—Defects Found. Particulars. Number of Defects. Number of Prosecutions. Found. Remedied, Referred to H,M. Inspector. Nuisances under the Public Health Acts: — Nil. Want of cleanliness 3 3 Want of ventilation 3 3 Overcrowding 2 2 Want of drainage of floors .. .. Other nuisances .. .. Sanitary accommodation Insufficient 2 2 Unsuitable or defective 2 2 Not separate for sexes 2 2 Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) .. .. Breach of special sanitary requirements for bakehouses (SS. 97 to 100) .. .. Other offences (excluding offences relating to outwork which are included in Part 3 of this Report) .. .. Total 14 14 133 3.—Home Work. Nature of Work. OUTWORKERS' LISTS, SECTION 107. Lists received from Employers. Addresses of Outworkers. Inspections of Outworkers premises. Twice in the year Once in the year. Lists. Outworkers. Lists. Outworkers Received from other Councils. Forwarded to other Councils. Contractors. Workmen. Contractors. Workmen. "Wearing Apparel— (1) Making, &c. . . 32 18 113 8 16 19 848 110 22 (2) Cleaning and washing .. .. .. .. .. .. 5 .. 1 Lace, lace curtains and nets. . .. .. .. .. .. .. .. .. .. Artificial flowers . . .. .. .. .. .. .. .. .. .. Nets, other than wire nets . . .. .. .. .. .. .. .. .. .. Tents .. .. .. .. .. .. .. .. .. Sacks . . .. .. .. .. .. .. .. .. .. Furniture and upholstery .. .. .. 1 21 11 5 27 .. Fur pulling .. .. .. .. .. .. .. .. .. Feather sorting .. .. .. .. .. .. .. .. .. Umbrellas, &c. .. .. .. .. .. .. .. .. .. Carding, &c., of buttons, &c. .. .. .. .. .. .. .. .. .. Paper bags and boxes .. .. .. 1 .. 20 13 1 .. Basket making .. .. .. .. .. .. .. .. .. Brush making 2 .. 7 .. .. .. 6 5 .. Racquet and tennis balls .. .. .. .. .. .. .. .. .. Stuffed toys .. .. .. .. .. .. .. .. .. File making .. .. .. .. .. .. .. .. .. Electro-plate .. .. .. .. .. .. .. .. .. Cables and chains .. .. .. .. .. .. .. .. .. Anchors and grapnels .. .. .. .. .. .. .. .. .. Cart gear .. .. .. .. .. .. .. .. .. Locks, latches, and keys .. .. .. .. .. .. .. .. .. Pea picking .. .. .. .. .. .. .. .. .. Total 34 18 120 10 37 50 877 143 23 134 4.—Registered Workshops. Workshops on the Register at the end of the year. Number. Ordinary Workshops 404 Workshop Laundries 74 Domestic Workshops 71 Total 549 5.—Others Matters. Class. Number. Mutters notified to H.M. Inspector of Factories— Failure to affix Abstract of the Factory and Workshop Act (S. 133) Action taken in matters referred by H.M. Inspector as remediable under the Public Health Acts, but not under the Factory and Workshop Act (S. 5). Notified by H.M. Inspector 14 Reports (of action taken) sent to H.M. Inspector 14 Other § 6— WATER SUPPLY AND WATER SERVICE. Metropolitan Water Board. Number of Notices as to houses from which water has been cut off:— 1.—Demolition 56 2.—Empty 45 3.—Leakage 14 4.—Non-payment of Rates 25 5.—No statement 1 6.—By request 14 155 Water Supply to Tenement Houses.—Under Part IV., § 3 (b), of the Annual Reports for 1907 and 1908 reference was made to Section 78 of the London County Council (General Powers) Act, 1907, empowering the Sanitary Authority to require water to be supplied on the storey or one of the storeys in which the rooms or lodgings in the separate occupation of each family are situate in a tenement house. In the same part and section of this Annual Report reference is made to the same subject. 135 Flush Tanl;s for W.C's.—Your Council considered a communication from the Borough of Wandsworth forwarding a copy of the following resolution, and expressing the hope that your Council will concur in the views expressed, and will inform the Water Board accordingly :— "That the Water Board be informed that this Council is of opinion that, "in the interests of public health, the substitution of two-gallon for "three-gallon waste preventers and the removal of valve closets "should not be insisted upon, and is further of opinion that the " alteration would not conduce to the economic use of water." Your Council understood that the alterations referred to were not being; insisted upon by the Metropolitan Water Board, except in cases where they had evidence that a waste of water is taking place. Your Council were in agreement with the views of the resolution received from the Wandsworth Council, and therefore resolved that a similar communication be addressed to the Metropolitan Water Board, and that the Wandsworth Borough Council be informed of the action taken. § 7.—DRAINAGE AND SEWERAGE. Drainage Register.—The following is an analysis of the Drainage Register during 1910 : — Total number of Applications and Plans .. .. 804 Number of Applications without Plans . . 317 Number of Plans.. 487 ,, Plans—Old Buildings under Notice . . 222 Plans—Old Buildings, Voluntary.. 233 487 Plans—New Buildings and additions.. 32 136 Drain Tests.—The following table represents the results of Tests applied to Drains during 1910 :— 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 143 141 1 ... 19 ... 304 2. No result 737 198 5 ... 52 ... 992 3. Total 880 339 6 ... 71 ... 1296 By Exposure by the Department. 1. Defects found ... ... ... ... ... ... ... 2. No result ... ... ... ... ... ... ... 13. Total ... ... ... ... ... ... ... Smoke. 1. Defects localised ... 2 ... ... 1 ... 3 2. No result ... 1 ... ... 1 ... 2 3. Total ... 3 ... ... 2 ... 5 By Water. 1. Not found water- tight ... ... ... ... 128 21 149 2. Found water-tight ... ... ... ... 1187 206 1393 3. Total ... ... ... ... 1315 227 1542 Sum Total | 143 143 1 ... 148 21 456 Sum Total 737 199 5 ... 1240 206 2387 880 342 6 ... 1388 227 2843 Lavatory Accommodation for Women.—The question of the lavatory accommodation for ladies at railway stations has been taken up by a conference of representatives of the Royal Sanitary Institute, the National Health Society, the Women's Imperial Health Association, and the Women's Sanitary Inspectors' Association. On November 21st the following resolutions were carried:— 1. That in the opinion of this meeting sufficient sanitary accommodation for women's use should be provided free of charge by sanitary authorities, railway companies, and in places of public entertainment and resort. 2. That in the opinion of this meeting it is essential, in the interests of public health and decency, that there should be an attendant in charge of the sanitary convenience provided for women's use in public places. 3. That in the opinion of this meeting all sanitary conveniences provided for the use of women should be subject to periodical inspection by women sanitary inspectors appointed by the local sanitary authorities. 137 4. That this meeting desires to call the attention of the railway companies, and managers of theatres and other places of public resort, to the unsatisfactory character of much of the sanitary accommodation provided for women, and to the necessity for having only sanitary conveniences of good modern type and construction. With regard to Resolution No. 1, it is pointed out that, although the system now so largely adopted by the railway companies of providing lavatory carriages on long-distance trains has proved an enormous benefit to both men and women travellers, still there is considerable evidence that the accommodation for women at railway stations all over the country is often insufficient and insanitary, whilst the necessity for payment, which is still universal for women at railway stations, operates harshly on the travelling public of the more necessitous classes. Appropriate communications on the subject of the aforesaid resolutions have been addressed by the Council of the Royal Sanitary Institute to the Local Government Board, the Board of Trade, the London County Council, and the principal railway companies. § 8.—STORAGE AND REMOVAL OF OFFENSIVE MATTERS. CLEANSING AND SCAVENGING. Trade Refuse.—A communication was considered by your Highways, Sewers, and Public Works Committee from the London County Council stating that they have received a suggestion from the Islington Borough Council that the Public Health (London) Act, 1891, should be so amended as to include in the definition of " trade refuse " refuse produced by restaurants, hotels, laundries, and similar trading institutions. Before coming to any definite decision on the matter, the County Council desired to obtain the observations of the Local Authorities on the suggestion, and the Borough Council was therefore asked to give their views on the proposal of the Islington Borough Council, as well as on the epiestion of the possibility of instituting in the Borough a system of daily removal. The County Council would at the same time be pleased to receive particulars of the methods now in operation within the Borough for the removal of refuse from restaurants. A letter was also received from the Islington Borough Council forwarding copy of the following letter they addressed to the London County Council upon the question, and asking the Borough Council to support the action taken: — Metropolitan Borough of Islington. Town Hall, Upper Street, N., 10th January, 1910. Sir, Public Health (London) Act, 1891. Removal of Refuse. My Council have recently had under consideration applications bv Messrs. Lyons & Co., the Lauiulerer's Association, Ltd., and other similar trading 138 undertakings, for the daily removal of refuse created at their various establishments in this Borough. It is to be borne in mind that in cases some time since before the High Court the refuse created at Messrs. Lyons & Co.'s restaurants was decided to be "house refuse," but notwithstanding these decisions it has been the practice of Messrs. Lyons & Co. to pay for the removal of their refuse at an agreed rate when they required it to be removed more frequently than the " once-a-week " removal, which is the practice of this Council as regards house refuse. .Recently, however, Messrs. Lyons & Co. disputed this liability, and in a summons taken out by this Council before Mr. Bros, at the Clerkenwell Police Court, the magistrate, notwithstanding the County Council's by-law was cited as this Council's justification in the matter, dismissed the summons with two guineas costs against the Council, and expressed the opinion that the refuse in question should be removed daily. This decision in connection with the various applications which, as before mentioned, have been received from other quarters is likely to lead to a very large increase in the cost of the removal of refuse in this Borough, and it is the opinion of my Council that the Public Health (London) Act, 1891, should be so amended as to include in its definition of trade refuse such refuse as that produced by restaurants, hotels, laundries, and other similar trading institutions in the carrying on of their business, notwithstanding that the refuse produced at such establishments is similar in character to that produced in private houses. I am therefore directed to express the hope that the London County Council will see their way by means of a General Powers Bill or otherwise, to obtain such an amendment of the Public Health (London) Act, 1891, as may be necessary to secure the object in view. I am, &c., (Signed) Wm. F. Dewey, Town Clerk. The Clerk of the London County Council. The Engineer and Surveyor was requestod by your Highways, &c., Committee to submit a report on the subject, and has done so as follows: — 11th March. 1910. To the Chairman and Members of the Highways, Sewers, and Public Works Committee. Gentlemen, Removal of Refuse. It is provided by the Public Health (London) Act, 1891, as the duty of cverj' Sanitary Authority to secure the due removal, at proper periods, of "house refuse " from premises, and bv by-law the Council has determined that removal once per week shall be effected. It is also provided that " trade refuse " shall be removed at the cost of the owner or occupier of any premises. The Definition Clause of the same Act describes "house refuse" as meaning "ashes, cinders, breeze, rubbish, night soil, and filth," but does not include " trade refuse." 139 The expression "trade refuse" means "the refuse of any trade, manufacture, or business, or of any building materials." Several eases have been taken to the Court?, which either modify the definitions above given or make more clear their meaning. St. Martin's Vestry r. Gordon decided that clinkers produced in the furnaces of boilers in an hotal used to generate steam for supplying power for the electric lighting of the hotel, for heating the public rooms and passages, for cooking, and for working the lift, and pumping water to the top of the hotel are not " refuse of any trade, manufacture, or business " within the meaning of Section 128 of the Metropolis Local Management Act, 1855, and, therefore, the Vestry within whose district the hotel is situated are not entitled to be paid for the removal of them. This decision has been sustained in a case under the Public Health (London) Act, lb91, in regard to the same premises, namely, the Hotel Metropole. Gay v. Cadby decided that ashes from coals burnt in the furnace of a steam engine used for the purpose of sawing timber and carrying on the business of pianoforte manufacturer were refuse of a trade, business, or manufacture. The Corporation of the City of London t. Lyons decided that refuse which included coffee grounds, egg shells, broken crockery, and general sweepings came within the description of " house refuse," but the Lord Chief Justice said that the case was one of considerable difficulty and importance, and he hoped it would be taken to a higher Court. The other Judges agreed. The London and Provincial Laundry Company r. Willesden Local Board decided that clinkers produced in the furnaces of boilers belonging to a steam laundry used to generate steam for the purpose principally of heating the water used in the business, but also for the purpose of warming the laundry, nre not " house refuse." The condition applying generally throughout the Borough as to the frequency of removal is that imposed bv the by-law, namely, a weekly collection, but in the various streets named by the Commissioner of Police as within the " special limits," which comprise the main roads, such as Tottenham Court Road, Euston Road, Gray's Inn Road, Judd Street, Hampstead Road, and Drummond Street, daily collection is made if householders choose to avail themselves of it by putting their refuse out on the kerb before 10 a.m., but it is not all who do so, many being content with removal two or three times a week. Daily collection is made from the hospitals, large hotels, restaurants, and coffee-houses; and from the railway stations and principal localities for boarding houses, and from most of the large blocks of Hats the dust is removed two or three times a week. No attempt is made to draw a hard-and-fast line between " house refuse " and "trade refuse." If it were, most of the shopkeepers in the Borough would bo in difficulties, and so long as the quantities are not excessive from any premises, the refuse is removed without cost to the tenant, but endeavour is made to exclude all builders' refuse and incombustible material, such as boiler clinker, and the refuse of materials in factories of all classes. Some of the larger firms regularly bring their combustible refuse to the Destructor, and pay for it at the rate of 5s. per ton. I have, &c., Wm. N. Blair, Engineer and Surveyor. 140 Your Council resolved on 4th May, 1910, that the London County Council be informed that this Authority are in favour of legislation being promoted in order to properly define what is trade refuse, and that a copy of the Report of the Engineer and Surveyor be sent to thein for their information. § 9— NUISANCES, &c. Urgent's Canal Water.—Specimens of water taken from the Regent's ('anal within the Borough were sent for analysis to the Public Analyst. The general tone of his reports was that the water was sewage-polluted, but that the contamination was not such as to cause a nuisance. Offensive Trades.—The two licensed noxious trade premises in St. Pancras have been regularly inspected, and the tallow-melting works in Tudor Place have been kept under continual observation. Effluvia Businesses.—In addition to the above businesses producing offensive effluvia, the businesses of a vendor of fried fish, a fish-curer, and a rag and bone dealer have been brought under under control by Section 10, Part II., Sanitary Provisions, of the London County Council (General Powers) Act, 1908. By this section the County Council may make by-laws for regulating the conduct of these businesses, and with respect to the premises, utensils, and appliances used in connection with these businesses, and it is the duty of the Borough Councils to enforce these by-laws. The framing of these by-laws is under consideration. Tal/oir-metting Premises, Tudor Place.—For a long time past complaints have been received through the London County Council and by this Authority of the nuisance caused by the effluvia emanating from the tallow-melting works in Tudor Place. Your Council have long refrained from recommending that proceedings should be taken in regard thereto, inasmuch as they have been informed that negotiations were proceeding between the proprietor of the works and the London County Council in regard to plans which had been submitted, with a view of bringing the premises into compliance with the by-laws. A petition was, however, received from eleven inhabitants of Tottenham Court Road, certifying that the business carried on at the premises in question causes effluvia which is a nuisance and dangerous to the health of the neighbouring inhabitants. Inquiries from the London County Council elicited the information that they informed the proprietor of the business on the 9th March, 1010, that his Architect, had not fulfilled his engagement to submit proper plans and sections with the necessary specifications, giving full details as to the method proposed to be adopted in order to biing the premises intocompliance with the by-laws, and the Architect was also written to on the 14tli March, 1910. Notwithstanding this the Clerk of the London County Council wrote on the 4th April, 1910, to state that the promised plans, &c., had not been received. Your Council were of opinion that the nuisance complained of should no longer be allowed to continue, and that the provisions of Section 21 of the Public Health (London) Act, 1891, which lays down the duty of the Sanitary Authority in such matters, should be put in operation, and they resolved on the Bith April, 1910, the Council's Solicitors be instructed to make a complaint in the matter to a Metropolitan Police Magistrate. »S'moke.—During the year the usual observations of smoke shafts were made bv the inspectors and re-inspections made after notices served. 141 The Inspectors limit their observations of a chimney to half an hour, and only prolong the observation beyond this period so long as a nuisance is actually being committed. The London County Council (General Powers) Act, 1910, contains some new powers for dealing with the smoke nuisance in London. By this Act the Sanitary Authority may request the Count}' Council to enforce the provisions of Sections 23 and 24 of the Public Health (London) Acr, 1891, with regard to smoke consumption. The County Council also have the power of enforcing these provisions in their application to any premises belonging to or used by a Sanitary Authority. Furthermore, the County Council may spend money up to £500 per annum upon experiments and investigations with respect to smoke consumption, and the abatement of nuisance arising from smoke. § 10.—SUMMONSES. Under the Public Health (London) Act, 1891 (except in respect of food). Situation of Property. Offence. Result of Proceedings. 63, Fortess Road Failing to provide a dustbin. Fined 5s.; Costs 2s. 73, ,, ,, ,, ,, ,, ,, 5s.; ,, 2s. 34, Johnson Street Failing to pave yard or open space. „ £1; „ 2s. 34 ,, ,, Failing to cleanse certain parts of. „ £i; „ 2s. 32, Little Clarendon Street ,, ,, ,, „ £1; „ 2s. 36, ,, ,, ,, ,, ,, „ £1 ; „ 2s. 37, „ ,, ,, ,, ,, „ £1; „ 2s. 38, ,, ,, ,, ,, ,, „ £1; „ 2s. 44, ,, ,, ,, ,, ,, „ £1; „ 2s. 44, ,, ,, Failing to provide a dustbin. „ £1; „ 2s. 44, ,, ,, Washhouse paving defective. „ £1; „ 2s. 50, ,, ,, Failing to cleanse certain parts of. „ £1; „ 2s. 51, ,, ,, Defective water fittings at. „ £1; „ 2s. 52, ,, ,, Failing to cleanse certain parts of. „ £1; „ 2s. 41, Stibbington Street ,, ,, ,, „ £1; „ 2s. 5, Heathcote Street Absence of a proper and sufficient supply of water. Closing Order made. 5, ,, ,, Failing to comply with the provisions of a Closing Order. Fined 5s.; Costs 2s. 26, Balmore Street Failing to provide and maintain sufficient w.c. accommodation at. „ £5; „ 2s. 14> V.-FOOD § 1.—FOOD PREMISES. The dairies, cowsheds, and milkshops, the slaughter-houses, the places where foods are prepared, and the marketing places have been regularly visited and inspected. The markets and marketing streets have also been regularly inspected on Saturday nights and Sunday mornings during the summer months. .Bakehouses, restaurants, kitchens, and similar workplaces w here food is prepared, being also controlled by the Factory and Workshop Acts, have been dealt with under Part IV. Covering and Protection of Food. — In the Lancet of the 22nd October, 1910, under the heading "An Example from Rome," the following interesting paragraph appeared: — The Syndic, Signor Ernesto Nathan, has issued an "ordinanza" to safeguard the public from a danger of long standing—the consumption of bread and pastry which has been exposed in shop windows, or even at shop doors, to the contamination of flies in the one case and of promiscuous dust in the other. These articles of food must henceforth be exhibited to the buying citizen under glass. Another risk which the " ordinanza " provides against is that of the handling of these articles to test their consistency or freshness— a real risk if one considers the neglect of personal ablution on the part of a public with whom the nail-brush is by no means invariably an appurtenance of the toilet. Henceforth the purchaser will be prevented from fingering the bread and pastry exposed for sale, these articles having now to be exhibited under glass furnished with " cartelli indicatori" (card labels). If, in violation of the "ordinanza," they have been handled by the customer, they are to be impounded and "esclusi dalla vendita" (removed from sale). Bakers are forbidden to take back or to offer for sale such articles, even after being "grattugiati" (grated), v\hich have been exposed and handled in restaurants or carried back from private houses by the distributors. In restaurants or at railway buffets bread will be put on the table in the necessary quantity, and no more; it will be wrapped in paper; and, if already handled or left behind by preceding guests, it cannot again be offered for consumption. Contravention under any of these heads of the "ordinanza" incurs a severe penalty. The Syndic is already assailed, censoriously, for these opportune measures; but the better-inspired and better-mannered public are on his side, hoping as they do that the worse than untidy practices at which they are aimed will gradually disappear, like that of spitting in public vehicles or on the floors of restaurants —a practice which died hard till its danger to public health was seen to be not less real than its offence to decency. 143 SUMMONSES.—MILK PREMISES. Under the Dairies, Cowshkds and Milkshops Order, 1885; Amending Order, 1886. Situation. Offence. Result of Proceedings. Nil. SUMMONSES—ICE CREA.M PREMISES. Under the London County Council (General Powers) Act, 1902. Situation. Offence. Result of Proceedings. 180, Albany Street Manufacturing ice-creams in a living room and selling them where they were exposed to contamination Warrant granted for arrest. 212, Gray's Inn Road Do. do. Fined 10s. and costs 2s. SUMMONSES.—FOOD PREMISES. Under the London County Council (General Powers) Act, 1908, Sec. 8. Situation. Offence. Result of Proceedings. Nil. 1-44 § 2 -UNWHOLESOME FOOD. FOOD DESTROYED. The following food, unfit for human consumption, was destroyed during the year: — Date. Division and Sub-Division. Description of Article. Action taken. 1910. Removal Jan. 4 East — Bartholomew 1 bullock's liver requested Feb. 15 „ „ „ „ „ Mar. 10 South —Argyle 20 lobsters „ „ 21 North—Gospel Oak 4 boxes of tomatoes „ „ 22 West—Mornington lib. mushrooms „ „ 23 North— High gate 1 pair of pig's lungs „ „ 30 West—Mornington 3 boxes of roe „ „ „ East—Oakley Scpiare ,, ,, „ April 1 ,, Ossulston 90 lbs. of fish „ „ 5 North—Maitland Park 40 lbs. of apples Seized and condemned „ 10 „ Grafton 51 tins of sardines Removal requested May 4 East—Bartholomew 2 bullocks' livers „ ,, 17 West—Euston 1 barrel salted pigs' heads „ „ „ East—College 1 pair of ox lungs „ „ 30 „ „ 1 ox liver „ June 15 „ „ 1 pair of ox lungs „ „ 20 „ „ ,, ,, „ „ 28 „ Bartholomew 1 bullock's liver „ July 5 South—Argyle 14 lbs. of cherries „ „ 7 West—Regent's Park 10 lbs. of strawberries „ „ 8 South—Mecklenburgh 7 lbs. of cherries „' Aug. 6 East—Bartholomew One trunk of whiting „ „ 9 N or th —St. John's Park 1 bullock's liver „ „ 17 East—Oakley Square 1 bag of mussels „ „ 24 ,, Bartholomew 1 bullock's liver 2 pairs of sheeps' lungs 1 „ „ 29 West—Mornington 1 bushel of whelks „ „ „ ,, Chalk Farm 1 box of Scotch fillets „ „ 31 East—Bartholomew 1 pair of sheep's lungs „ Sept. 6 ,, Ossulston A quantity of plums „ ,, 15 West—Regent's Park 1 cwt of mussels „ Oct. 1 East—Oakley Square 3 boxes of kippers „ ,, 5 North—Highgate 1 trunk of cod fish „ „ 13 West—Chalk Farm 1 trunk of haddocks „ „ 19 South—Whitfield 1½ cwt. of cod fish „ „ 25 East — Bartholomew 2 fore-quarters of beef „ „ 27 „ Oakley Square 1 ½ cwt. of skate. „ Nov. 14 „ „ „ 2 boxes of grapes „ Dec. 19 „ Bartholomew.. 2 pairs of bullocks' lungs 1 bullock's liver „ 145 Deterioration of Milk in Transit.—At the last meeting of the Gloucester Chamber of Agriculture the County and City Analyst, Mr. George Embrey, related the results of investigations into the problem of preventing the deterioration of milk in transit from the farm to the wholesale depot in London. Mr. Embrey had consignments of milk from Gloucester to London kept under close observation, and yet the milk, which contained 4'3 per cent, at the farm, showed only 3.5 per cent, when it reached the depot. In the unloading of the milk at London it was discovered that there were considerable leakages as the result of the tilting and rough handling of the churns. The shaking on the railway aids the rising of the cream to the surface, so that the milk that is lost is the richest, and this is suggested as the explanation of the extent of the deterioration. Mr. Embrey has been giving attention to the perfecting of a churn which will make leakages impossible, and hopes by means of indiarubber rings to solve the problem. The loss of 0'8 per cent, on the railway journey is serious both for producers and distributers in that the average milk is unable to bear so great a reduction and comply with the Government standard of 3 per cent, butter fat.—The Times, February 11, 1911. SUMMONSES.—UNFIT FOOD. Under the Public Health (London) Act, 1891, in respect of Food. Situation. Offence. Result of Proceedings. Queen's Crescent. Depositing at a stall for the purposes of sale 40 lbs. of apples unfit for food. Fined 11s. 6d. 146 § 3. ADULTERATED FOOD. Analysis.—Samples taken under the Sale of Food and Drugs Acts Articles of food of which samples have been taken. Total number of samples. Genuine. Adulterated. Milk 379 340 39 Butter 147 141 6 Lard 43 38 5 Pepper 22 22 — Mustard 20 19 1 Golden Syrup 5 5 — Vinegar 2 2 — Preserved Peas 1 1 — Coffee 20 19 1 Jam - 5 5 — Smoked Fish 1 — 1 Arrowroot 9 2 — Cheese 4 4 — Camphorated Oil 3 3 — Glycerine 3 3 — Demerara Sugar 3 2 1 Margarine 25 25 — Cream 18 6 12 Cod Liver Oil 19 19 — Olive Oil 18 18 — Cocoa 1 1 — Spinach 1 — 1 Whisky 9 2 — Gin 3 3 — Rum 1 1 — Brandy 9 2 — 750 683 67 Milh,- Sampling Analysis.—An analysis of the Inspectors' Sampling Books and of the Quarterly Returns of the Public Analyst (omitting samples sent direct to him and not through the Public Health Department) show the following circumstances and results as regards milk: — 147 Stage of Sale. Place. Reason. Number of Milk samples examined. Result of Analysis. Prosecutions Genuine. Adulterated. On sale to In street Periodical—Week-day 16 16 — — public „ Sunday 74 67 7 4 By request — — — — „ In shop Periodical—Week-day 160 141 19 10 „ Sunday 31 29 2 1 Consecutive* — — — — By request — — — — On delivery At shop Periodical — — — — Consecutive* 1 1 — — By request — — — . — „ At Railway Depot or Station Periodical 72 71 1 1 Consecutive* — — — — By request 25 15 10 8 Totals 379 340 39 24 * Warranties.—It is the practice of the Food Inspectors when sampling to inquire whether a warranty in any form is held by the vendor, and if there be a warranty and the sample prove to be adulterated, to take a sample of the milk of the guarantor upon delivery at the vendor's premises. The control sample is not a sample of the suspected milk, but it affords evidence in some degree of the kind of milk supplied by the guarantor. The Board of Agriculture point out that the repeal of the Warranty Clauses demanded by those who desire to strengthen the law as to fraudulent adulteration as well as those who desire to protect the farmer. It is alleged that certain dealers and milk-sellers are adulterating milk and selling the milk which they know to be adulterated, relying on those clauses to afford an almost certain way of escape in case they are prosecuted. The following table shows the number of samples analysed during the last seven years, and the number and percentage of adulterated samples:— Year. Number of samples analysed. Number of samples adulterated. Percentage of adulteration. 1904 750 130 17.3 1905 750 96 12.8 1906 750 145 19.3 1907 750 126 16.8 1908 750 117 15.6 1909 750 95 12.7 1910 750 67 8.9 148 Margarine.—In September, fifteen samples of margarine were purchased and submitted to the Public Analyst for the purpose of ascertaining their detail composition, and the following is the Report of the Public Analyst:— Chemical Laboratory, Town Hall, Rosebery Avenue, E.C. 3rd October, 1910. To the Public Health Committee of the Metropolitan Borough of Sr. Pancras. Mr. Chairman, Madam, and Gentlemen,— In accordance with your instructions 1 have analysed the fifteen samples of butter substitutes submitted to me during the early part of September by your Inspectors, Messrs. Osborne, Child, and Auger. The results obtained are set forth in the following table:— Sample marked. Analysis of Sample, per cent. Examination of Fat. Approximate Composition of Fat. Water. Fat. Curd. Mineral matter. Specific gravity at 100°C. water 15.5. Refractometric figure at 35°C. Valenta figure. Reichert Value. Iodine number. Cotton Seed Oil, per cent. Cocoanut Oil, per cent Animal fat, per cent. X 14.42 80.80 1.24 3.54 .8676 56 83 0.99 81.19 40* — 60 XI 14.18 81.59 1.39 2.84 .8656 48 59 3.85 67.05 50 40 10 la 13.56 82.54 1.96 1.94 .8703 44.5 54 4.73 38.24 20 60 20 2a 9.11 88.61 1.05 1.23 .8734 44 42 6.38 25.49 — 50 50 3a 12.06 85.35 0.88 1.71 .8691 43 30 6.38 25.31 — 70 30 4a 11.90 86.04 1.08 0.98 .867 5 43.5 32 5.72 28.78 — 65 35 5a 13.97 82.76 1.08 2.19 .8655 46 53 4.73 38.46 — 50 50 6a 12.41 84.54 1.35 1.70 .8732 48 65 4.18 49.73 20 40 40 7a 13.63 82.39 0.99 2.99 .8653 51 59 3.63 53.74 20 20 60 8a 13.37 83.55 1.36 1.72 .8687 42.5 35 5.94 31.00 — 60 40 9a 13.86 83.18 1.23 1.73 .8690 44 41 6.16 33.01 10† 60 30 10a 12.70 83.62 1.95 1.73 .8693 40 25 6.49 20.19 — 80 20 Z1 9.38 87.87 1.40 1.35 .8660 43.5 43 5.83 32.40 — 55 45 Z2 14.75 81.42 2.64 i 1.19 .8669 45.5 45 5.72 36.21 — 45 55 Z3 14.42 81.88 2.21 1.49 .8665 45.5 45 5.17 34.90 — 45 55 * Cotton Seed and Sesame Oil. † Sesame Oil. 149 There is little need to comment upon these results except to emphasise the fact that all the samples contained large quantities of vegetable oils mixed with more or less fat of animal origin, coloured to represent butter. Mineral oil was not found to be present in any case. It may be of interest to point out that where, as was formerly the custom in many laboratories, refractometric index and velenta number only were relied upon for roughly distinguishing between margarine and butter, many of these samples would have been passed as genuine butter. There can be little doubt that at the time margarine was defined as anything made in imitation of or resembling butter, it was generally understood that it was composed of animal fats mixed with milk, but with the increasing importation of edible vegetable oils and improved processes of manufacture, not to mention the possibility of the use of mineral oil, it seems desirable that margarine should be more strictly defined. Every purchaser ought to know what he is buying—at present the term margarine permits too much latitude. I am, Mr. Chairman, Madam, and Gentlemen, Your obedient Servant, (Signed) J. Keak Colwkll. In order than an opinion may be formed in regard to margarine or other butter substitutes, and before a definition thereof can be framed, it is necessary to know what oils fats, and waxes are considered edible, and their relative values as articles of food. It is possible that some of these may be found to be more nutritive even than butter. On the other hand, however, some may be found to be less nutritive, and possible some to have no nutritious value whatever, and others to be even injurious if consumed as articles of food. W ith a view to obtaining this basic information, your Council resolved on the 30th November, 1910, that the foregoing Report of the Public Analyst upon the composition of margarines submitted to him be forwarded to the Local Government Board, with a suggestion that reliable research into the relative nutritive, digestive, and palatable values of animal, vegetable, and mineral oils, fats, and waxes would form a valuable guide to Local Authorities in determining ... . their action in respect of butter substitutes offered for sale to the public. Sule of Margarine Bill. — On November 23rd, 1910, I reported as follows :— In the Sale of Margarine Bill it is proposed to alter the definition of margarine in Section 13 of the Butter and Margarine Act, 1907. In that section it is provided that " the expression ' margarine' shall mean any " article of food, whether mixed with butter or not, which resembles butter, " and is not milk-blended butter." In the new Bill, Clause 5, it is proposed to substitute the words " the expression ' margarine ' shall mean any sub" stance prepared from beef or mutton fat, or from any vegetable oil which in " any way resembles butter, or is capable of being used for the same general " purposes for which butter is used, and which is not butter." The object of this new definition is in conjunction with the prohibition of the addition of colouring matter to margarine " to prevent margarine resembling butter." 150 Some butters are as white as margarine in colour, and from a health point of view there is on more reason for forbidding the addition of colouring matter to margarine than there is to forbid its addition to butters to which it is frequently added, so long as it is a harmless vegetable colouring matter used in small quantities. But the most objectionable feature of this Bill is the proposed definition of margarine. The experience of your Public Health Committee is that margarine, which was originally made from beef and mutton fats, and generally recommended by the medical profession as a wholesome food equal to butter in nutritive and digestive values, is steadily deteriorating by the increasing proportion of vegetable fats of which it is being composed, and that if the proportion of animal fats can with impunity sink as low as 10 per cent, there is nothing to prevent margarine being sold which will contain on animal fat at all. This undesirable result should be averted. It has been regarded as essential that those who intend to purchase and eat butter should be protected from the fraudulent substitution of other fats. Those who intend to purchase and eat animal fats other than butter have a right to equal protection from the substitution of cheap vegetable fats of less nutritive and digestive values. If the medical profession and the public find that margarine is not only no longer what they believed it to be, namely, that margarine is the prepared fat of the ox, just as butter is the prepared fat of the milk of the cow, but is not even composed of animal fats, it will do infinite damage to the use of a wholesome article of food. If manufacturers and distributers wish to make and sell vegetable fats for those who desire them, there is nothing to prevent them, and no objection, provided that they are not denominated " margarine," so as to mislead the public into imagining that they are composed of animal fats. I beg therefore to recommend— (1) That the Sale of Margarine Bill be strongly opposed at the proper time. (2) That immediate representations be made to the Board of ture and to the Local Government Board urging the desirability of amending the definition of margarine in Section 13 of the Putter and Margarine Act, 1907, by the addition of the words " solely of animal fats or animal oils " after the word " food," so as to read— " the expression ' margarine ' shall mean any article of food con" sisting solely of animal fats or animal oils, whether mixed with " butter or not, which resembles butter, and is not milk-blended " butter." This will not preclude the sale of vegetable fats and oils either under their proper names, or, if mixtures, as vegetable lmtter or butter substitutes. I have, etc., John F. J. Sykes, Medical Officer of Health. 151 Post- Scriptum . Without definitions the Food and Drugs Acts are of little value. Even if it be proved that a valuable constituent has been partly abstracted and a less valuable substance partly substituted, in the absence of definition the case would be dismissed. Before standards of foods were fixed in America it was the common and growing practice to substitute the cheapest fats and oils more and more for nutritious fats and oils used as foods. Now all foods and drugs are defined as to composition in America. J. F. J. S. Summouse's.—Under the Sale of Food and Drugs Acts—Adulteration. No. of Sample. Article. Result of Analysis. Result of Proceedings. Penalty. Costs. £ s. d. £ s. d. C 8 Milk Added Water 22 per cent. 0 5 0 0 12 6 C 12 „ „ 12 ,, 0 5 0 0 is 6 4 Butter Foreign Fats, i.e., Fats other than Butter Fat, 83 per cent. 0 10 0 0 12 6 C 26 Milk Added Water 7.6 per cent. — 0 12 6 C 39 Butter Foreign Fats, i.e., Fats other than Butter Fat, 58 percent. 1 0 0 0 12 6 34 Milk Added Water 7.2 per cent. I 0 0 0 12 6 14 „ Deficient in Milk Fat 13.3 per cent 0 1 0 0 12 6 45 ,, Added Water 8 per cent. 0 10 0 0 12 6 C 64 „ „ 8.4 „ \ C 66 „ „ 15.3 ,, c 70 „ „ 8.7 „ 10 0 0 5 0 0 C 71 „ „ 7.8 „ C 72 „ „ 68 ,, C 73 „ ,, 6 ,, / C 69 „ „ 71 „ 2 0 0 0 12 6 65 „ Deficient in Milk Fat 6.6 per cent. 0 12 6 87 „ Added Water 7 per cent Summons withdrawn. 75 Coffee Chicory 20 per cent. — 0 12 6 107 Milk Deficient in Milk Fat 6.7 per cent. — 0 12 6 C 112 „ „ „ 11.3 „ — 0 12 6 116 „ „ „ 116 „ 0 2 0 0 12 6 A 23 Butter Foreign Fats, i.e., Fats other than Butter Fat, 84 per cent. 7 0 0 0 12 6 A 25 „ Water 8.4 per cent, in excess of standard 0 10 0 0 12 6 A 26 Lard 100 per cent. Fat Foreign to Genuine Lard 3 0 0 0 12 6 C 143 „ ,, ,, ,, 1 10 0 0 12 6 C 145 „ 50 ,, ,, ,, and 6.7 per cent. of water 1 10 0 0 12 6 164 Butter Foreign Fats, i.e., Fats other than Butter Fat, 25 percent. 2 10 0 0 12 6 169 Milk Deficient in Milk Fat 16 6 per cent. 1 0 0 1 12 6 C 152 Lard Foreign Fats 100 per cent. 0 10 0 0 12 6 C 176 Milk Deficient in Milk Fat 7 per cent 3 0 0 0 12 6 C 216 „ „ „ 6 „ 2 0 0 3 8 0 C 270 „ „ „ 27.3 „ 9 0 0 0 12 6 C 271 „ „ „ 92.6 „ Crystallised Copper Sulphate 5.81 grs. per lb. 2 0 0 0 12 6 291 Spinach 2 0 0 0 12 6 C 316 Milk Added Water 19 6 per cent. 5 0 0 1 3 6 £ 52 3 0 26 11 6 § 4—FOOD INSPECTORS' REPORTS. Food Inspectors.—The history of food inspection in St. Pancras may be briefly stated in order that it may be made clear. Upon their original appointment, Inspectors Osborne (October, 1885), Auger (January, 1897), and hackham (January, 1898) were not appointed Inspectors under the Food and Drugs Acts, but at this period, and previous thereto, all the Sanitary Inspectors took samples. Owing to some doubt arising as to whether Sanitary Inspectors, not being styled Inspectors of Nuisances, required special authorisation, in 152 November, 1898, the late Vestry commenced to elect newly-appointed Sanitary Inspectors, also Inspectors under the Sale of Food and Drugs Acts, and Inspectors Newlyn (November, 1898), West (May, 1898), Landen (May, 1898), and Warwick (October, 1899) were so appointed. In November, 1899, the late Vestry appointed two special Food Inspectors, namely, Inspectors Auger and Warwick, and the Sanitary Inspectors ceascd to take samples. After this date certain newly-appointed Sanitary Inspectors were appointed under the old resolution in error, the words " Inspector under the Sale of Food and Drugs Act" not having been struck out, although it had been decided that they were unnecessary, but these Inspectors never took any samples under the Food and Drugs Acts. They were Inspectors Lonnon (November, 1899), Brown (November, 1899), Child (March 1900), and Johnston (April, 1900). The words " Inspector under the Sale of Food and Drugs Act " were subsequent to this year struck out of the resolution of appointment as unnecessary, and the following Inspectors were appointed Sanitary Inspectors without the additional words, namely, Inspectors Dillon (January, 1901), Storer (January, 1901), Walker (April, 1901), James (permanent, November, 1902), Holmes (permanent, November, 1902), Adkins (April, 1904), and Thompson (October, 1909). In the meantime, to go back a little, upon the resignation of Inspector Warwick, in April, 1900, Inspector Osborne was appointed a Food Inspector in his place, and on 30th October, 1901, Inspector Child was appointed a Food Inspector in the place of Inspector Auger, who during the small-pox epidemic and some time after, acted as Special Inspector. In March, 19u6, Inspector Auger was reinstated as Food Inspector and District Inspector in part of his former District. The following are the Reports of the Inspectors of Food and Food Premises:— To the Medical Officer of Health. Sir, I herewith submit my Annual Report for the year ended 31st December, 1910. Markets.—The market streets, costermongers' barrows, stalls, fish shops, and curing premises have been inspected daily, 2,083 inspections being made. The following articles of food have been destroyed, the same being unsound or diseased, and unfit for human food : — Lobsters, 20. Mushrooms, 1 peck. Cherries, 14 lbs. Strawberries, 10 lbs. Cherries, 7 lbs. Mussels, 1 cwt. Kippers. 3 boxes. Haddocks, 1 cwt. Codfish, ^ cwt. Scotch Fillets, 1 box. Mussels, 1 cwt. Whelks, 1 bushel. Food Makers.—I have made 418 inspections where food is prepared, such as sausage polonies, pies, etc., and have found all the ingredients used sound, wholesome, and fit for food, and the premises generally in a clean and sanitary condition. 153 Ice Cream Makers.—118 inspections have been made by me, and I have found it necessary to report to the Committee two cases for prosecution for infringement of the regulations. One was fined at the Clerkenwell Police Court; the other returned to his native land, and has not been since seen by me. Slaughter-holmes.—I have made 273 inspections of the slaughter-houses in my district, and have not found any diseased or unsound animals ; the premises have been kept clean, and the London County Council By-laws properly observed by the holders of licences. Cowsheds.—There are three licensed cowsheds in my district, registered for 70 cows. 47 inspections have been made, the animals kept clean, and the London County Council By-laws observed. Milkshops and Dairies.—I have made 514 inspections of the above-named places during the year, and there have not been any prosecutions for infringement of the By-laws. It is very difficult to get the keepers of small general shops to use any precautions to protect the milk from contamination, and I find it is useless calling their attention to the danger ; they seem to ireat the matter as of no importance, and as official " busybodyism " if you do speak about it. As I said in my last Annual Report, quite 65 per cent, of the shops should not be allowed to keep or sell milk—the people who keep the shops are as unfit as the place is. Fond and Drugs Act.—I have submitted 325 articles of food to the Public Analyst. (For results see his Report.) Legal Proceeding*.—I have attended at the Police Court 24 times in connection with my duties as prosecuting Food Inspector. (For results see Appendix.) I am, Sir, yours obediently, J. Osborne, Food Inspector. To the Medical Officer of Health. Sir, CANAL BOATS ACTS, 1877 & 1874. I herewith submit my Annual Report under the above Acts. During the year ended December, 1910, I have inspected 61 dwelling-boats under the above Acts. In one case I found a family of seven persons, two adults and five children, occupying one small cabin, which was in a very dirtv condition and quite unfit for human occupation. There was not any registration form on board, but the cabin was very much overcrowded and the smell very offensive. The boat was in a leaky condition and in a bad state of repair. A notice was served on the owner, who at once dismantled the boat and made her into a refuse barge having no cabin. I have not found any cases of infectious disease or other illness, the occupiers being generally strong, robust, and healthy, the children especially so, most of them having rather dirty faces and hands. I am, Sir, yours obediently, J. Osborne, Canal Boat Inspector. 154 To the Medical Officer of Heath. Sir, I beg to submit my report for the year 1910. I made 788 visits to the market streets and took 100 samples under the Sale of Food and Drugs Acts. 52 visits were made to the premises where food was exposed for sale or in course of preparation for sale. 177 visits were made to the cowsheds, dairies and milkshops. I made 108 inspections of the licensed slaughter-houses, where I saw the following animals killed and dressed 101 Bullocks 108 Sheep 1 Lamb and examined the following carcases of : — 53 Beef 67 Mutton 4 Lamb I had the following food destroyed : — 6 boxes of Roe 2½ cwt. of Salted Pigs Head 3 pairs of Ox Lungs (tuberculosis) 1 Ox Liver (flukey) 1½ cwt. of Skate 2 boxes of Grapes I am, yours obediently, W. G. Auger, Inspector of Food and Food Places and- District Inspect) r. To the Medical Officer of Health. Sir, I beg to report on my work in the Northern and Eastern Divisions of the Borough for the year ended December 31, 1910, as Inspector of Food and Food Places. Markets.— I made 1,826 inspections of the various market places, including butchers, pork butchers, fishmongers, and greengrocers' shops and stalls. The following articles were removed and destroyed, being unfit for the food of man. 1 trunk of Whiting 1 trunk of Cod Fish 90 lbs. of Plaice, Skate, and Cod 51 tins of Sardines 7½ sieves of Plums 40 lbs. of Apples 4 boxes of Tomatoes 155 Food Makers.—I made 321 visits to the premises where sausages, tripe, &c., are made, and found the premises generally satisfactory, utensils clean and the food sound. Licensed Slaughter-houses. —There are 5 slaughter-houses in my district. I made 222 inspections, during which I saw 416 sheep, 89 bullocks, 108 pigs, and 30 lambs killed and dressed, and such organs as on examination were found to be diseased I had removed by the written request of the owners under Sub-section 8 of Section 47 of the Public Health (London) Act, 1891. The by-laws relating to slaughter-houses have been generally observed. There is one thing I feel I must call attention to, that is, the " blowing " of lambs at the time of dressing being done by slaughter-men with their mouths, an old-fashioned method, but, to say the least, a very dirty and dangerous one. The following table shows the number of animals and organs found to be diseased, nature of disease, &c.: — No. Description of Carcase. Disease. Where Affected. How disposed of. 2 Bullocks Tuberculosis Livers Destroyed by burning at the Dust Destructor 2 „ „ Lungs „ „ 1 „ „ Fore-quarters Liver, Lungs, and Head „ „ 5 „ Abscess Livers „ „ 1 „ Flukes „ Destroyed on premises. In addition to the above a number of sheep's and pigs' livers and lungs were affected with parasitical diseases and destroyed. Licensed Cowsheds. —I paid 49 visits to the cowsheds and found them satisfactory. There are 3 cowsheds in my district, licensed to keep in all 63 cows, but the cows actually kept have never approached that number. Milkshops. - I made 551 inspections of milkshops, and with few exceptions found the milk vessels clean. During these visits I found 21 persons selling milk without being registered in accordance with the Dairies, Cowsheds and Milkshops Orders. I cautioned them, and they afterwards applied for registration. Sale of Food and Drugs Acts.—I obtained 325 samples of articles of food and drugs and submitted them to the Public Analyst for analysis under these Acts, 28 of which were adulterated. Of the samples of milk, 42 were taken promiscuously at the St. Pancras (M.R.), Kentish Town (M.R.), and King's Cross (G.N.R.) Stations, and only one sample found to be adulterated. 156 Proceedings were taken in this case and a fine inflicted. I procured 10 samples of butter substitutes for analysis to be made, with a view to knowing what ingredients were used in its manufacture. For results of analysis, please refer to your special report on Margarine. Ice Cream Makers.—I made 185 inspections of the ice cream makers premises and barrows, and had to complain of dirty utensils, dirty premises and other breaches of the by-laws. In some cases the vendors were cautioned by order of the Public Health Committee. During the year I attended before the magistrates at the different police courts 49 times in the discharge of my duties. Harry R. Child, Inspector of Food and Food Places. VI-LEGISLATION. In last year's Annual Report, under Part IV.—Sanitation, § 1—Inspection, and paragraph '' Staff," a list of General and Special Acts, Orders, By-laws and Regulations, passed since 1888, affecting Public Health, was given. § 1.- GENERAL ACTS. The Children Act, 1908 [8 Edw. VII., Ch. 67.] Part I.—Infant Link Protection. Section 1.—Notices to be given by persons receiving infants for reward. 2.—Appointment and powers of Inspector, &c. 3.—Persons prohibited from receiving children for reward. 4.—Local Authority to fix number of infants which may be retained. 5.—Removal of infant improperly kept. 6.—Notice to Coroner. 7.—Avoidance of policies of life insurance of infants kept for reward. 8.—Provisions as to notices. 9. —Prosecution of offences and application of fines. 10. - Local Authorities and expenses. 11.—Exemptions. 1. - (1) Where a person undertakes for reward the nursing and maintenance of one or more infants under the age of seven years apart from their parents or having no parents, he shall, within forty-eight hours from the reception of such infant, give notice in writing thereof to the local authority : Provided that this section shall not apply, as respects any infant, where the period for which it is received is forty-eight hours or less. (2) Where a person undertakes for reward the nursing and maintenance of an infant already in his care without reward, the entering into the undertaking shall, for the purposes of this part of this Act, be treated as a reception of the infant. 157 (3) The notice shall state the name, sex, and date and place of birth of the infant, the name of the person receiving the infant, and the dwelling within which the infant is being kept, and the name and address of the person from whom the infant has been received. (4) If a person who has undertaken the nursing and maintenance of any such infant changes his residence, he shall within forty-eight hours thereof give to the local authority notice in writing of the change, and, where the residence to which he moves is situate in the district of another local authority, he shall give to that local authority the like notice as respects each infant in his care as he is by this section required to give on the first reception of the infant. (5) If any such infant dies or is removed from the care of the persen who has undertaken its nursing and maintenance, that person shall, within fortyeight hours thereof, give to the local authority notice in writing of the death or removal, and in the latter case also of the name and address of the person to whose care the infant has been transferred (6) Where at the commencement of this Act any infant is under the care of any person who has, before the commencement of this Act, undertaken its nursing and maintenance under such circumstances that if its nursing and maintenance had been undertaken after the commencement of this Act he would have been required to give notice to the local authority under this section, he shall, within one month after the commencement of this Act, give to the local authority the like notice as if the nursing and maintenance of the infant had been undertaken after the commencement of this Act: Provided that nothing in this sub-section— (a) Shall apply to any person who on the reception of an infant gave such notice as was required by the Infant Life Protection Act, 1897; or (A) Shall exempt any person who ought to have given notice under that Act from any liability which he may have incurred thereunder. Subject as aforesaid, this part of this Act shall apply to an infant whose nursing and maintenance has been undertaken for reward before the passing of this Act in like manner as it applies to an infant whose nursing and maintenance has been so undertaken after the commencement of this Act, and as if any notice given under the Infant Life Protection Act, 1897, had been a notice given under this Part of this Act. (7) If any person required to give a notice under this section fails to give the notice within the time specified for giving the notice, he shall be guilty of an offence under this Part of this Act, and, if the infant in respect of which notice ought to have been given was an infant the consideration for whose nursing and maintenance consisted in whole or in part of a lump sum, the person failing to give the notice shall, in addition to any other penalty under this Part of this Act, be liable to forfeit that sum or such less sum as the Court having cognizance of the case may deem just, and 158 the sura forfeited shall be applied for the benefit of the infant in such manner as the Court may direct, and where any such sum is ordered to be forfeited the order may be enforced as if it were an order of the Court made on complaint. 2 —(1) It shall be the duty of every local authority to provide for the execution of this Part of this Act within their district, and for that purpose they shall from time to time make inquiry whether there are any persons residing therein who undertake the nursing and maintenance of infants in respect of whom notice is required to be given under the foregoing section. (2) If in the district of any local authority any persons are found who undertake the nursing and maintenance of such infants as aforesaid, the local authority shall appoint one or more persons of either sex to be infant protection visitors, whose duty it shall be from time to time to visit any infants referred to in any notice given under this Part of this Act, and the premises in which they are kept, in order to satisfy themselves as to the proper nursing and maintenance of the infants, or to give any necessary advice or directions as to their nursing and maintenance: Provided that the local authority may, either in addition to or in lieu of appointing infant protection visitors, authorise in writing one or more suitable persons of either sex to exercise the powers of infant protection visitors under this Part of this Act, subject to such terms and conditions as may be stated in the authorisation, and, where any infants have been placed out to nurse in the district of the authority by any philanthropic society, may, if satisfied that the interests of the infants arc properly safeguarded, so authorise the society to exercise those powers as respects those infants, subject, however, to the obligations to furnish periodical reports to the local authority. (3) A local authority may combine with any other local authority for the purpose of executing the provisions of this Part of this Act, and for defraying the expenses thereof (41) A local authority may exempt from being visited, either unconditionally or subject to such conditions as they think fit, any particular premises within their district which appear to thein to be so conducted that it is unnecessary that they should be visited. (5) If any person undertaking the nursing and maintenance of any such infants refuses to allow any such visitor or other person to visit or examine the infants or the premises in which they are kept, he shall be guilty of an offence under this Part of this Act. (6) If any such visitor or other person is refused admittance to any premises in contravention of this Part of this Act, or has reason to believe that any infants under the age of seven years are being kept in any house or premises in contravention of this Part of this Act, he may apply to a justice, who, oil being satisfied, on information in writing on oath, that there is reasonable ground for believing that an offence under this Part of this Act has been committed, may grant a warrant authorising the visitor or other person to enter the premises for the purpose of ascertaining whether any offence under this Part of this Act has been committed, and, if the occupier of the premises or any other person obstructs or causes or procures to be obstructed any visitor or 159 other person acting in pursuance of such a warrant, he shall be guilty of an offence under this Part of this Act. 3.—An infant, in respect of which notice is required to be given under this Part of this Act, shall not, without the written sanction of the local authority he kept— (a) by any person from whose care any infant has been removed under this Part of this Act or the Infant Life Protection Act, 1897 ; or (b) in any premises from which any infant has been removed under this Part of this Act by reason of the premises being dangerous or insanitary, or has been removed under the Infant Life Protection Act, 1897, by reason of the premises being so unfit as to endanger its health ; or (c) by any person who has been convicted of any offence under Part II. of this Act or under the Prevention of Cruelty to Children Act, 1904 ; and any person keeping or causing to be kept an infant contrary to this section shall be guilty of an offence under this Part of this Act. 4.—The local authority may fix the number of infants under the age of seven years which may be kept in any dwelling in respect of which a notice has been received under this Part of this Act, and any person keeping any infant in excess of the number so fixed shall be guilty of an offence under this Part of this Act. 5.—(1) If any infant in respect of which notice is required to be given under this Part of this Act is kept— (a) in any premises which are overcrowded, dangerous, or insanitary; or (ft) by any person who, by reason of negligence, ignorance, inebriety, immorality, criminal conduct, or other similar cause, is unfit to have care of it; or (c) by any person or in any premises in contravention of any of the provisions of this Part of this Act, any visitor or other person appointed or authorised to execute the provisions of this Part of this Act may apply either to a justice or to the local authority for an order directing him to remove the infant to a place of safety until it can be restored to its relatives or be otherwise lawfully disposed of. (2) Any person refusing to comply with such an order upon its being produced and read over to him, or obstructing or causing or procuring to be obstructed the visitor or such other person in the execution thereof, shall be guilty of an offence under this Part of this Act, and— (a) if the order was made by a justice, the order may be enforced by the visitor or by any constable ; and (b) if the order was made by the local authority the visitor or other person may apply to any justice for an order directing the removal of the infant, which order may be enforced by the visitor or by any constable. 6. — (1) In the case of the death of any infant respecting which notice is required to be given under this Part of this Act, the person who had the care of the infant shall, within twenty-four hours of the death, give notice in writing thereof to the coroner of the district within which the body of the infant ties, an I the coroner shall hold an inquest thereon, unless a certificate under the hand of a duly qualified medical practitioner is produced to him, certifying 160 that he has personally attended the infant during its last illness, and specifying the cause of death, and the coroner is satisfied that there is no ground for holding an inquest. (2) If any person required to give a notice under this section fails to give the notice within the time specified for giving the notice, he shall be guilty of an offence under this Part of this Act. 7.—A person by whom an infant in respect of which notice is required to be given under this Part of this Act is kept shall be deemed to have an interest in the life of the child for the purposes of the Life Assurance Act, 1774, and, if any such person directly or indirectly insures or attempts to insure the life of such an infant, he shall be guilty of an offence under this Part of this Act, and, if a company, within the meaning of the Life Assurance Companies Acts, 1870 to 1872, or any other company, society, or person, knowingly issues, or procures or attempts to procure to be issued, to or for the benefit of such a person as aforesaid or to any person on his behalf, a policy on the life of such an infant, the company, society, or person shall be guilty of an offence under this Part of this Act. 8.—(1) If any person required to give a notice under this Part of this Act knowingly or wilfully makes, or causes or procures any other person to make, any false or misleading statement in any such notice, he shall be guilty of an offence under this Part of this Act. (2) Every notice by this Part of this Act required to be given may be sent by post in a registered letter addressed to the clcrk of the local authority or to such other person as the local authority may appoint, or in the case of a notice to a coroner, to the coroner, or may be delivered at the office of the local authority, or, in the case of a notice to a coroner, at his office or residence. 9.—(1) Every person guilty of an offence under this part of this Act shall on summary conviction be liable to imprisonment for a term not exceeding six months or to a fine not exceeding twenty-five pounds, and the Court may order any infant in respect of which the offence was committed to be removed to a place of safety. (2) Any fines under this Part of this Act shall, notwithstanding any provision in any other Act, be paid to the local authority, and be applied to the purposes to which the fund or rate out of which the expenses of the local authority are to be defrayed is applicable. 10.—(1) The local authority for the purposes of this Part of this Act shall— (r/) as respects the County of London, exclusive of the City, be the County Council ; (b) as respects the City of London, be the Common Council ; (r) elsewhere be the Guardians of the Poor Law Union. (2) All expenses incurred by or on behalf of the local authority in and about the execution of this Part of this Act shall be defrayed - (a) in the case of the County of London, out of the county fund as general county expenses ; (b) in the case of the Citv of London, out of the general rate ; (c) in the case of a Board of Guardians, out of the common fund. 11.—(1) The provisions of this Part of this Act shall not extend to any relative or legal guardian of an infant who undertakes the nursing and 161 maintenance of the infant, or to any person who undertakes the nursing or maintenance of an infant under the provisions of any Act for the relief of the poor or of any order made under any such Act; or to hospitals, convalescent homes, or institutions established for the protection and care of infants, and. conducted in good faith for religious or charitable purposes, or boarding schools at which efficient elementary education is provided. (2) For the purposes of this section the expression " relatives" means grandparents, brothers, sisters, uncles, and aunts, by consanguinity or affinity, and in the case of illegitimate infants the persons who would be so related if the infant ware legitimate. THE CHILDREN ACT, 1908. Cruelty to Children atul Young Persons. 12.—Punishment for Cruelty to Children and Young Persons. (1) If any person over the age of sixteen years who has the custody, charge, or care of any child or young person wilfully assaults, ill-treats, neglects, abandons, or exposes such child or young person, or causes or procures such child or young person to be assaulted, ill-treated, neglected, abandoned, or exposed in a manner likely to cause such child or young person unnecessary suffering or injury to his health (including injury to or loss of sight, or hearing, or limb, or organ of the body, and any mental derangement), that person shall be guilty of a misdemeanour, and shall be liable— (a) a conviction on indictment to a fine not exceeding £100, or alternatively, or in default of payment of such fine, or in addition thereto, to imprisonment, with or without hard labour, for any term not exceeding two years ; and (A) on summary conviction to a fine not exceeding £25, or alternatively, or in default of payment of such tine, or in addition thereto, to imprisonment, with or without hard labour, for any term not exceeding six months; and for the purposes of this section a parent or other person legally liable to maintain a child or young person shall be deemed to have neglected, him in a manner likely to cause injury to his health if he fails to provide adequate food, clothing, medical aid, or lodging for the child or young person, or if, being unable otherwise to provide such food, clothing, medical aid, or lodging, he fails to procure the same to be provided under the Arts relating to the relief of the poor. (Authorities who may enforce this are the Guardians and the L.C.C., see Sec. 31, p. 51; and N.S.P.C.C., see Sec. 38, p 52.) (2) A person may be convicted of an offence under this section, either on indictment or by a court of summary jurisdiction, notwithstanding that actual suffering or injury to health, or the likelihood of such suffering or injury to health, to the child or young person was obviated by the action of another person. (3) A person may be convicted of an offence under this section either on indictment or by a court of summary jurisdiction, notwithstanding the death of the child or young person in respect of whom the offence is committed. (4) Upon the trial of any person over the age of sixteen indicted for manslaughter of a child or young person of whom he had the custody, charge, or care, it shall be lawful for the jury, if they are satisfied that the accused is 162 guilty of an offence under this section in respect of such child or young person, to find the accused guilty of such offence. (5) If it is proved that a person convicted under this section was directly or indirectly interested in any sum of money accruable or payable in the event of the death of the child or young person, and had knowledge that such sum of money was accruing or becoming payable, then — (a) in the case of a conviction on indictment, the Court may in its discretion either increase the amount of the'fine under this section so that the fine does not exceed £200 ; or in lieu of awarding any other penalty under this section, sentence the person to panal servitude for any term not exceeding five years ; and (b) In case of a summary conviction, the Court in determining the sentence to be awarded shall take into consideration the fact that the person was so interested and had such knowledge. (6) A person shall be deemed to be directly or indirectly interested in a sum of money under this section if he has any share in or any benefit from the payment of that money, though he is not a person to whom it is legally payable. (7) A copy of a policy of insurance, certified by an officer or agent of the insurance company granting the policy to be a true copy, shall in any proceedings under this section be prima fade evidence that the child or young person therein stated to be insured has been, in fact, so insured, and that the person in whose favour the policy has been granted is the person to whom the money thereby insured is legally payable. (8) An offence under this section is in this Part of this Act referred to as an offence of cruelty. ***** 24. -Warrant to Search for or Remove a Child or Young Person. (1) If it appears to a justice on information on oath laid by any person who, in the opinion of the justice, is acting in the interests of a child or young person, that there is reasonable cause to suspect— (a) that the child or young person has been or is being assaulted, ill-treated, or neglected, in any place within the jurisdiction of the justice, in a manner likely to cause the child or young person unnecessary suffering or to be injurious to his health; or (b) that an offence under this Part of this Act, or any offence tioned in the first schedule to this Act, has been or is being committed in respect of the child or young person, the justice may issue a warrant authorising any constable named therein to search for such child or young person, and, if it is found that he has been or is being assaulted, ill-treated, or neglected in manner aforesaid, or that any such offence as aforesaid has been or is being committed in respect of the child or young person, to take him to and detain him in a place of safety until he can be brought before a Court of Summary Jurisdiction, or authorising any constable to remove the child or young person with or without search to a place of safety, and detain him there until he can be brought before a Court of Summary Jurisdiction ; and the Court before whom the child or young person is brought may commit him to the care of a relative or other fit person in like manner as if the person in whose care he was had been committed for trial for an offence under this Part of this Act. 163 (2) A justice issuing a warrant under this section may by the same warrant cause any person accused of any offence in respect of the child or young person to be apprehended and brought before a Court of Summary Jurisdiction, and proceedings to be taken against such person according to law. (3) Any constable authorised by warrant under this section to search for any child or young person, or to remove any child or young person with or without search, may enter (if need be by force) any house, building, or other place specified in the warrant, and may remove the child or young person therefrom. (4) Every warrant issued under this section shall be addressed to and executed by a constable, who shall be accompanied by the person laying the information, if such person so desire, unless the justice by whom the warrant is issued otherwise directs, and may also, if the justice by whom the warrant is issued so directs, be accompanied by a duly qualified medical practitioner. (5) It-shall not be necessary in any information or warrant under this section to name the child or young person. * » • • * 34. - Institution of Proceedings by Guardians, &c. (1) A board of guardians may institute any proceedings under this Part of this Act for any offence in relation to a child or young person, and may, out of their common fund, pay the reasonable costs and expenses of any proceedings so instituted by them. (2) The like powers of instituting proceedings may, in London, be also exercised by a local authority for the purposes of Part I. of this Act, and the expense of such proceedings shall be defrayed as expenses of the authority under Part I. (Note -The Local authorties under Part I., Sec. 10, are for the Metropolis the London County Council and the City of London Common Council.) 38.—Interpretations of Part II. (1) In this Part of this Act, unless the context otherwise requires— The expression "fit person," in relation to the care of any child or young person, includes any society or body corporate established for the reception or protection of poor children or the prevention of cruelty to children. (2) For the purposes of this Part of this Act— Any person who is the parent or legal guardian of a child or young person, or who is legally liable to maintain a child or young person, shall be presumed to have the custody of the child or young person, and as between father and mother, the father shall not be deemed to have ceased have the custody of the child or young person by reason only that he has deserted, or otherwise does not reside with, the mother and child or young person. Any person to whose charge a child or young person is committed by any person who has the custody of the child or young person shall be presumed to have the charge of the child or young person ; and Any other person having actual possession or control of a child or young person shall be presumed to have the care of the child or young person. . 164 (3) This Part of this Act shall apply in the case of a child or young person who has before the commencement of this Act been committed to the care of a relative or other fit person by an Order made under the Prevention of Cruelty to Children Act, 1904, as if the Order had been made under this Part of this Act. MEDICAL ATTENDANCE AND MEDICAL AID. The Local Government Board has laid it down that the test of the Guardians' duty in the matter is the destitution of the patient; and this will not necessarily depend upon his being in actual receipt of poor relief, but may consist in his being unable to obtain at his own cost the requisite medical attendance, nursing mid accommodation {i.e., inability to pay for necessary treatment or operation). (Letter to Holbeach Union, " Poor Law Officer* Journal," Vol. XIV., p. 297. Poor Law Annual 1907-8, p. 308.) $ 2.—LOCAL ACTS. Extract from LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1902. Part IX. —Common Lodging Houses. Council may give notice requiring application for licence to keep a Common Lodging-House. 46. — The Council may within six months after the passing of this Act give notice to every keeper of a common lodging-house in the county who shall then be registered under the Common Lodging-Houses Acts, 1851 and 1853 (hereinafter referred to as " registered common lodging-house keepers "), requiring him to make application in writing to the Council within one month after the receipt of such notice, or within such further period as the Council may prescribe, for a licence to keep a common lodging-house in the county, and to receive lodgers therein, and such application shall specify the premises in respect of which application is made for such licence and the number of lodgers proposed to be received therein. Such notice shall be given by leaving the same for each registered common lodging-house keeper at his lodging-house, and may be in the form set out in the schedule to this Act, or to the like effect. Council to inquire as to suitability of Applicant and of Premises 47.—The Council shall, as soon as practicable after any such application shall have been made to them, make, or cause to be made, all necessary and proper inspections and inquiries, both as to whether the person so applying is a fit and proper person to have the control and management of a common lodging-house, and as to whether the premises in respect of which the applicat ion is made for a licence are structurally and otherwise suitable for use and occupation as a common lodging-house, having regard to the number, health, safety, and convenience of persons occupying or intended to occupy the same. Granting of Licence. 48.—If, in the opinion of the Council, the person applying for a licence is a fit and proper person to have control and management of a common lodginghouse, and the premises in respect of which the application is made are suitable for a common lodging-house, the Council may grant to such person a licence 165 to use the premises specified in his application for the purpose of a common lodging-house, and to receive lodgers therein, and such licence shall specify the maximum number of persons who may at any one time occupy such premises. Period of Licence, and as to Renewal and Cancellation. 49.—Such licence shall be valid for the period of one year from the date thereof, but after the expiration of the said period the same shall be of no force or effect. The person named in any such licence (hereinafter referred to as " a licensed lodging-house keeper ") may at or before the expiration of the said period make application to the Council to renew his licence in respect of the same premises, and if the Council shall think fit they may renew such licence accordingly for a further period of one year from the expiriation of any licence, and so from time to time. Appeal against Refusal to License. 50.—(1) The Council shall not refuse to grant or renew a licence under this part of this Act, except upon the ground (a) that the person applying to be licensed is not a fit and proper person to be licensed as a common lodging-house keeper, or \b) that the premises are not suitable or suitably equipped for the purposes of a common lodging-house (2) If the Council refuse to grant a licence under this Part of this Act, they shall, if required by the applicant, deliver to him a statement in writing of the ground or grounds upon which such licence is refused. (3) If the licence or renewal of licence be refused, any person aggrieved by such refusal may appeal to a metropolitan police magistrate, provided that such appeal is made within fourteen days from the date of such refusal and not less than twenty-four hours' notice of such appeal be sent to the Council. (4) If a licence or renewal of licence be refused upon the grounds that the premises are not suitable or suitably equipped for the purposes of a common lodging-house, the magistrate shall have power to appoint a person being a properly qualified surveyor or architect to examine and report to him upon the condition of such premises and their suitability for the purposes of a common lodging-house. (5) The costs of any such appeal, including the expenses of any such examination and report as aforesaid, shall be paid in such manner and by such parties to the appeal as the magistrate may direct. Unlicensed Person not to keep a Common Lodging-House. 51.— From and after the expiration of the period of notice to be given by the Council as aforeaaid, no person, unless he shall have applied for and obtained a licence under this Part of this Act shall keep a common lodging-house in the county or receive lodgers therein. Future Applications for Licences. 52.—Any person who shall hereafter be desirous of becoming a licensed lodging-house keeper in the county shall be at liberty to make application to the Council in the same manner as if he had at the date of the passing of this Act been a registered common lodging-house keeper and the provisions of this Part of this Act shall apply accordingly. 166 By-laws relating to Common Lodging-Houses. 53.—(1) From and after the passing of this Act, Section 9 of the Common Lodging Houses Act, 1851, shall cease to be operative or have effect in the county. (2) The Council may make by-laws — (a) For fixing and from time to time varying the number of lodgers who may be received into a common lodging-house and for the separation of the sexes therein ; and (b) For promoting cleanliness and ventilation in such houses ; and (c) For the giving of notices and the taking of precautions in the case of any infectious disease ; and (d) Generally for the well ordering of such houses. (3) Any by-laws made by the Council under the provisions of this section shall be made subject and according to the provisions referred to in Section 114 of the Public Health (London) Act, 1891. As to keeping Lodging-Houses open after Deaith of Registered Keeper. 54.—Notwithstanding anything in the Common Lodging Houses Act, 1853, contained to the contrary, notice shall be given to the Council of the death of any registered lodging-house keeper in the county forthwith after the same shall have occurred, and the right by Section 3 of the last-mentioned Act conferred upon the widow or any member of the family of a registered lodginghouse keeper to keep such common lodging-house open and of receiving lodgers therein for four weeks after such death without registration shall not be exerciseable unless such notice shall have been duly given. Penalties or Fines to be paid to Council. 55.—Whenever, in consequence of proceedings taken by the Council against any person in respect of any offence in connection with a common lodginghouse in the county, a pecuniary penalty or tine is inflicted, the amount of such penalty or fine shall, notwithstanding anything in the Metropolitan Police Act, 1839, or in any other Act or Acts contained to the contrary, be payable and paid to the Council. Saving and application of Provisions of General Acts. 56.—Notwithstanding anything in this Act contained the provisions of the Common Lodging-Houses Acts, 1851 and 1853, shall, except so far as the same are varied by or inconsistent with the provisions of this part of this Act, continue to be of full force and effect, and the provisions of the said Acts with respect to a registered common lodging-house keeper shall, except so far as the same are varied bv or inconsistent with the provision of this part of this Act, apply to a licensed common lodging-house keeper. Offences. 57. — Section 14 of the Common Lodging-Houses Act, 1851, and Section 11 of the Common Lodging-Houses Act, 1853, shall extend to offences against any of the provisions of this part of this Act, or any by-laws made thereunder, so as to render the offenders liable to penalties or imprisonment as in the said sections respectively mentioned. HOUSING ANI) TOWN PLANNING ACT, 1909. 35.—Exemption of Lodging-Houses for the Working Classes from Inhabited House Duty. (1) 'lhe assessment to inhabited house duty of any house occupied 167 for the sole purpose of letting lodgings to persons of the working classes, at a charge of not exceeding sixpence per night for each person, shall be discharged by the Commissioners acting in the execution of such Acts relating to the inhabited house duties, upon the production of a certificate to the effect that the house is solely constructed and used to afford suitable accommodation for the lodgers, and that due provision is made for their sanitary requirements. (2) The provisions of Sub-section (2) of Section 26 of the Customs and Inland Revenue Act, 1890 (53 and 54 Vict., c. 8), in relation to the certificate mentioned therein, shall, so far as applicable, apply to the certificate to be produced under this section. The Customs and Inland Revenue Act, 1890 (53 Vict., ch. 8), Section (26) 2, provides that the assessment to inhabited house duty of any house originally built or adapted by additions or alterations and used for the sole purpose of providing separate dwellings for persons at rents not exceeding for each dwelling the rate of seven shillings and sixpence per week (now an annual value of forty pounds), and occupied only by persons paying such rents, shall be discharged by the said Commissioners, provided that a certificate of the medical officer of health for the district in which the house is situate shall be produced to them to the effect that the house is so constructed as to afford suitable accommodation for each of the families or persons inhabiting it, and that due provision is made for their sanitary requirements. The medical officer of health of a district, oil in quest, by the person who would be liable to pay the house duty on any house in the district if the duty were not discharged as aforesaid, shall examine the house for the purpose of ascertaining whether such a certificate can be properly given, and if the house be constructed so as to afford such accommodation and due provision be made as aforesaid, shall certify the same accordingly. (See also Annual Report of the Medical Officer of Health for 1904, Part IV.—Sanitation, § 3—Dwellings, pages 64 to 66, Revenue Act, 1903.) § 3.—ORDERS. HOUSING (INSPECTION OF DISTRICT) REGULATIONS, 1910. The Order of the Local Government Board, dated 2nd September, 1910, making1 Regulations as to the inspection of a district ander the Housing and Town Planning Act, 1909, is quoted as regards its principal provisions in Part IV. Sanitation, under § 3 Dwellings earlier in this Report. RULES AS TO PROCEDURE ON APPEAL, 1910. The Order of the Local Government Board, dated 11th January, 1910r making rules determining the procedure to be adopted in any appeal is alsoquoted as to its principal provisions in the part and section of this Report mentioned above. THE DIPHTHERIA ANTITOXIN (LONDON) ORDER, 1910. To the Sanitary Authority for the execution of Public Health (London) Act, 1891 :— To the Medical Officers of Health of the Authorities aforesaid;— And to all others whom it may concern. Whereas under Section 77 of the Public Health (London) Act, 1891, any Sanitary Authority for the execution of that Act may, with the sanction of 168 the Local Government Hoard, themselves provide, or contract with any person to provide, a temporary supply of medicine and medical assistance for the poorer inhabitants of their District; And whereas it is expedient that, subject as hereinafter stated, the sanction of the Local Government Board should be given under the above-cited enactment to the provision by any such Sanitary Authority of a temporary supply of the medicine known and hereinafter referred to as " diphtheria anti-toxin," and of medical assistance in connection with the temporary supply of diphtheria anti-toxin ; And whereas, in pursuance of the enactments in that behalf, the Local Government Board, by the Sanitary Officers (London) Order, 1891, prescribed, in relation to Medical Officers of Health appointed by the Sanitary Authorities for the execution of the said Act, regulations with respect to the duties and salaries of the said -Medical Officers of Health ; And whereas, with respect to the said Medical Officers of Health, it is expedient that further provision should be made with regard to the following matters ; that is to say— (a) the duties of the said Medical Officers of Health in connection with the use of diphtheria anti-toxin in cases of disease, as well for the prevention of disease as for the prevention of the extension ; and [b] the compensation of the said Medical Officers of Health for the discharge of the said duties : Now therefore, We, the Local Government Board, in the exercise of Our powers in that behalf, do hereby Order as follows:— Article 1.—We sanction the provision by every Sanitary Authority as aforesaid, or their contracting with any person for the provision, in pursuance of Section 77 of the Public Health (London) Act, 1891, of a temporary supply of diphtheria anti-toxin, and of medical assistance in connection with the temporary supply of diphtheria anti-toxin, for the poorer inhabitants of their district, .subject to the following condition, that is to say — The arrangements with respect to the keeping, distribution, and use of the diphtheria anti-toxin shall be made in accordance with the advice of the Medical Officer of Health. Article II.—The duties assigned to the Medical Officer of Health by the Sanitary Officers (London) Order, 1891, or other the regulations for the time being issued by us and superseding the regulations prescribed by that Order, shall be deemed to extend to and to include all action by the Medical Officer of Health in the execution of this Order. Article III.—The Sanitary Officers (London) Order, 1891, or other the regulations for the time being issued by us and superseding the regulations prescribed by that Order, shall apply and have effect as if the regulations thereby prescribed included a provision authorising the Sanitary Authority, or requiring them at our direction, to pay from time to time to the Medical Officer of Health, in addition to the salary or other compensation payable under 169 the said regulations, a reasonable compensation for all action by the Medical Officer of Health in the execution of this Order. Article IV.—This Order may be cited as "The Diphtheria Anti-toxin (London) Order, 1910." Given under the Seal of Office of the Local Government, Board, this Fifteenth day of August, in the year One thousand nine hundred and ten. John Burns. President. THE PUBLIC HEALTH (TUBERCULOSIS IN HOSPITALS) REGULATIONS, 1911. To the Mayor, Alderman, and Commons of the City of London in Common Council assembled ; — To the Councils of the several Metropolitan Boroughs; — To the Councils of the several Municipal Boroughs and other Urban Districts in England and Wales; — To the Councils of the several Rural Districts in England and Wales; — To the Trustees, Committees of Management, other Governing Bodies, Secretaries and Medical Officers of all Hospitals as herein defined; — And to all others whom it may concern. Whereas We, the Local Government Board, are empowered by Section 130 of the Public Health Act, 1875, as amended by the Public Health Act, 1896, from time to time to make, alter, and revoke Regulations with a view to the treatment of persons affected with any endemic or infectious disease and for preventing the spread of the disease; and to provide for the enforcement and execution of the Regulations; And whereas Tuberculosis is an endemic disease and that form of the disease which is known as Pulmonary Tuberculosis is an infectious disease; And whereas by the Public Health (Tuberculosis) Regulations, 1908, We made certain Regulations for preventing the spread of Tuberculosis, including Pulmonary Tuberculosis; And whereas it appears to Us to be expedient that such further Regulations as are hereinafter set forth should be made in relation to Pulmonary Tuberculosis; Now therefore, We, by this Our Order and in the exercise of the powers conferred upon Us by the Public Health Act, 1875, the Public Health (London) Act, 1891, and the Public Health Act, 1896, and of every other power enabling Us in that behalf, do make the following Regulations, that is to say:— 170 Definitions. Article I.— In these Regulations, unless the contrary intention appears:— (a) Words importing the masculine gender include females; (b) Words in the singular include the plural, and words in the plural include the singular; (c) Expressions referring to writing include references to printing, and to other modes of representing or reproducing words in a visible form, and references to printing include references to other mechanical modes of so representing or reproducing words ; (d) The expression "Hospital" means any hospital, dispensary, or similar institution for the treatment of the sick, which is partially or wholly supported otherwise than by the contributions of the persons treated thereat or of their relatives or guardians and otherwise than from rates and taxes; (e) The expression "Medical Officer" means any medical practitioner who is in medical attendance on a patient at a hospital; (f) The expression "Council" means, as the case may be, the Mayor, Aldermen, and Commons of the City of London in Common Council assembled, the Council of a Metropolitan Borough, the Council of a Municipal Borough or other Urban District, or the Council of a Rural District: and (g) The expression "Area" means the area subject to the jurisdiction of the Council for the purposes of the Public Health (London) Act, 1891, or of the Public Health Act, 1875, as the case may be. Commencement of Regulation*. Article II.— These Regulations shall come into operation on the First day of May, One thousand nine hundred and eleven and, subject to the provisions of Article VIII., shall then and thereafter apply and have effect throughout England and Wales, and shall be enforced and executed by every Council and their officers. Supply of Forms of Notification. Article III. — For the purposes of these Regulations — (i) Every Council shall provide and maintain a sufficient supply of printed copies of the form set forth in the Schedule to these Regulations; (ii) Every Council shall as soon as practicable after these Regulations come into operation, and afterwards from time to time when application is made to them, supply printed copies of the form set forth in the Schedule to these Regulations to the Trustees, Committee of Management or other Governing Body of every Hospital within the area of the Council for use by the Medical Officers of the Hospital. Notifications by Medical Officers. Article IV.— (1) A Medical Officer of any Hospital, within the period of forty-eight hours after his first recognition of Pulmonary Tuberculosis in a person upon whom he is in medical attendance at the Hospital, shall complete, 171 sign and transmit a notification of the case in the form shown in the Schedule to this Order to the Medical Officer of Health for the area within which the Hospital is situate. (2) A Medical Officer of Health who receives a notification relating to a patient whose residence as described in the notification is not within the area for which he is Medical Officer of Health shall fortwith transmit the notification to the Medical Officer of Health for the area in which the patient's residence is situate, and shall at the same. Unit inform the Medical Officer of the Hospital that he hat done so and shall give to him the name and address of the Medical Officer of Health to whom the notification has been sent. Any expenses incurred by a Medical Officer of Health in carrying out the duties imposed upon him by this sub-division shall be defrayed by the Council of the area for which he is Medical Officer of Health. (3) The Medical Officer of Health for every area within the Administrative County of London shall, after the end of each week, send to the Medical Officer of Health for the Administrative County of London a statement of every notification received by him during the week in pursuance of these Regulations and relating to a patient whose residence as described in the notification is situate within the area for which he is Medical Officer of Health, and of every notification received by him during the week in pursuance of the Public Health (Tuberculosis) Regulations, 1908. Such statement shall contain the name of the Hospital, if any, the home address, age, and sex of the patient and the date of the notification. Article V.— A notification to be transmitted to a Medical Officer of Health in pursuance of these Regulations may be transmitted by being delivered to that Officer or by being delivered at his office or residence, or may be sent by prepaid letter-post addressed to him at his office or at his residence. Remuneration of Medical Officers. Article VI.— The Council shall pay to the Medical Officer of the Hospital the sum of one shilling in respect of each notification sent by him in pursuance of these Regulations and relating to a person whose residence as described in the notification is situate within the area of the Council, and the said sum shall in every case be deemed to cover all expenses, including the cost of transmission. Exception and Application of Enactments and Special Powers of Councils. Article VII.— (1) Nothing in these Regulations shall have effect so as to apply, or so as to authorise or require a Medical Officer of Health or a Council, or any other person or authority, directly or indirectly, to put in force with respect to any patient in relation to whom a notification in pursuance of these Regulations has been transmitted to a Medical Officer of Health, any enactment which renders the patient, or a person in charge of the patient, or any other person, liable to a penalty, or subjects the patient to any restriction, prohibition, or disability affecting himself, or his employment, occupation or means of livelihood, on the ground of his suffering from Pulmonary Tuberculosis. 172 (2) Subject as aforesaid, a Council on the advice of their Medical Officer of Health, in the case of a patient in relation to whom a notification in pursuance of these Regulations has been transmitted to the Medical of Health, may— (i) take the necessary measures to secure the disinfection of infected articles and the cleansing or disinfecting of premises which have been used by the patient; (ii) take the necessary measures for the safe disposal or destruction of infectious discharges of the patient; (iii) supply all such reasonable assistance, facilities, and articles as will tend to diminish the risk of infection arising from the conditions affecting the use or occupation of any room, when used or occupied by the patient as a sleeping apartment; (iv) furnish, for the use of the patient, on loan, or otherwise, any appliance, apparatus, or utensil which may be of assistance iu preventing the spread of infection; and (v) appoint such officers, do such acts and make such arrangements as may be requisite for giving advice and for carrying out the provisions of these Regulations, and of the Public Health (Tuberculosis) Regulations, 1908: Provided that nothing in this sub-division shall be deemed to authorise a Council to take any of the measures herein mentioned at any Hospital. (3) A Council, on the advice of their Medical Officer of Health, may provide and publish or distribute in the form of placards, handbills, or leaflets, suitable summaries of information and instruction respecting Pulmonary Tuberculosis, and the precautions to be taken against the spread of infection from that disease. Modifications consequent upon Local Acts. Article VIII.— Nothing in these Regulations shall have effect in derogation of any power conferred, or of any obligation imposed with respect to Pulmonary Tuberculosis by a Local Act. Subject as aforesaid and subject to the condition set forth in sub-division (1) of Article VII., these Regulations shall apply and have effect in relation to every area in which a Local Act containing provisions with respect to Pulmonary Tuberculosis is in force : Provided that, on the application of the Council for the area, We may, by Order, direct that, after the date fixed by the Order, these Regulations shall apply to the area with such exceptions or modifications as are specified in the Order. Short Title. Article IX.— These Regulations may be cited as "the Public Health (Tuberculosis in Hospitals) Regulations, 1911." 173 SCHEDULE. Form of Notification. Public Health (Tuberculosis in Hospitals) Regulations, 1911. To the Medical Officer of Health for the------------------------------------ of ; I hereby give you Notice that, in my opinion, who is now an in-patient out-patient at the Hospital and in relation to whom particulars are appended, is suffering from Pulmonary Tuberculosis. Residence* prior to attendance at or admission to the above-named Hospital.----------------------------------------------------------------------------- Age__ Sex Dated this day of . 19 . Signed Medical Officer in attendance on the above-named Patient. * Care should be taken to ascertain accurately the patient's place of residence. The name of the town or village and of the county in which it is situated should be stated, as well as the name or number of the house and the name of the street. Given under the Seal of Office of the Local Government Board, this Twentysecond day of March, in the year One thousand nine hundred and eleven. ©John Burns, President. 174 § 6.—LEGAL DECISIONS. MILK. —Sale of—Registration of Purveyor—Registration in one District — Sale of Milk from Barrow in another District— Contagious Diseases (Animals) Act, 1878 (41 & 42 Vict., c. 74), s. 6. (1)— Dairies, Cowsheds, and Milkshops Orders, 1885 and 1886. Case stated on a summons taken out by the appellant against the respondent for that he, on the 4th October, 1909, at F—Street, in the district of the Borough Council of Marylebone, did unlawfully carry on the trade of a purveyor of milk without being registered in the district of the local authority as required by Section 6 (1) of the Dairies, Cowsheds, and Milkshops Order of 1885, as amended by the Dairies, Cowsheds, and Milkshops Amending Order 1886. The Dairies, Cowsheds, and Milkshops Order made under Section 34 of the Contagious Diseases (Animals) Act, 1878, provided by Section 6 (1) as follows:— "It shall not be lawful for any person to carry on in the district of any local authority the trade of a cowkeeper, dairyman, or purveyor of milk unless he is registered as such therein, in accordance with this article." But no special form of registration is provided. By Section 9 of the Contagious Diseases (Animals) Act, 1886 (49 & 50 Vict., c. 32), the powers vested in the Privy Council by the former Act of making orders were transferred to the Local Government Board so far as regards England, and that Board, on the 1st November, 1886, made an Order known as the Dairies, Cowsheds, and Milkshops Amended Order of 1886, Art. 3 whereof provides that if any person is guilty of an offence against the order of 1885 he shall be liable to a penalty of £5. And by Art. 4 it is provided that the expression "local authority" means (inter alia) "in the metropolis (except the City of London and the liberties thereof) the Metropolitan Board of Works." By the Local Government Act, 1888, the powers of the Metropolitan Board of Works became vested in the London County Council, and the London Government Act, 1899, enacted by Section 6 (4) as follows:— " It shall be the duty each Borough Council to enforce within their Borongh the By-laws and regulations for the time being in force with respect to dairies and milk." It was admitted by the prosecution that the defendant was duly registered as a purvey or of milk in the Borough of St. Pancras. On the 4th October, 1909, the defendant sold a pennyworth of milk from a churn carried on a hand cart or barrow in F Street. F Street is in the Metropolitan Borough of St. Marylebone, and not within the Metropolitan Borough of St. Pancras. The sale of milk from such itinerant vehicles is one of the usual methods of distributing milk to customers by purveyors of milk in the metropolis, and such distribution is regulated by Section 9 of the Food and Drugs Act, 1899 (62 & 63 Vict., c. 51), which requires the seller to have his name and address conspicuously inscribed on the vehicle or receptacle from which the milk is sold, which was properly done in this instance. It was contended that the defendant was shown to have carried on the trade of a purveyor of milk in the district of the borough of Marylebone contrary to the provisions of Section 6 (1) of the Dairies, Cowsheds, and Milkshops Order, 1885, by reason of the above-mentioned sale. The magistrate was of opinion that the defendant was not shown to have carried on the trade of a purveyor of milk in the district of the Borough of Marylebone by reason of the sale in F Street from the itinerant handcart, but that the place from which the cart and milk was dispatched and where 175 the defendant kept his carts and vans, viz., 3, Churchway, St. Pancras. was the place where he carried on his business within the meaning of the Orders; and, there being no penalty imposed on a person merely for "selling" milk in the district of any local authority without being registered, the defendant was not prevented by the orders from selling in the manner proved beyond the limits of the local authority in which he was so registered, provided he did not carry on a separate business outside such limits, which would in each case be a question of fact and degree. Held (dismissing the appeal) that under the circumstances the magistrate was right. [Emerton (app.) v. Hall (resp.), K.B.Div. : Lord Alverstone, C.J., Channell and Coleride, J. J. May 24th, 1910.] VII.—REPORTS OF MEDICAL OFFICER OF HEALTH. REPORTS OF MEDICAL OFFICER OF HEALTH, In addition to Annual, Quarterly, and Weekly Reports. Date of Report. Date of Committee and page of the Minutes. SUBJECT. 1910. Jan. 26th April 5th 1910. Vol. 19. Feb. 16th, p. 206 April 5th, p. 235 Upon the inspection of Licensed Premises. Upon the duties and work of Miss Gardiner, Woman Sanitary Inspector, resigned. July 6th July 6th, p. 295 Upon the Sanitary Conveniences in the basement of the Town Hall. „ „ „ p. 296 Upon the Stall-board ventilation of Underground Bakehouses. Nov. 23rd Nov. 23rd, p. 372 Upon Measles in Elementary Schools. „ „ „ p. 381 Upon the Sale of Margarine Bill. Dec. 14th Dec. 14th, p. 389 Upon the cleansing of Verminous Children. Conference of Metropolitan Cities and Boroughs on matters relating to Public Health, convened by the London County Council, at Spring Gardens, S.W., Thursday, 6th April, 1911. Houses Let in Lodgings. That the efficient administration of Section 95 of the Public Health (London) Act, 1891, relating to the registration and regulation of houses let in lodgings is a matter of extreme importance to the public health of London. Pulmonary Tuberculosis. (a) That the principle of compulsory notification should be extended to all cases of pulmonary tuberculosis. 176 (b) That the establishment of tuberculosis dispensaries throughout London is urgently required. Measles. (a) (1) That a better organisation is desirable in London for the control of measles in schools. (2) That during a serious outbreak of measles children under five years of age should be excluded from school attendance. (3) That compulsory notification of measles is desirable. (4) That the cleansing of infants' departments and of the furniture, lower walls, and floors thereof shall take place once a week. (5) That accommodation should be provided in the Metropolitan Asylums Board Hospitals for urgent non-pauper cases of measles. (b) That in the interests of public health the school regulations should provide that all children from houses infected with measles should be prohibited from school attendance. Water Supply to Tenement Houses. That houses of three or more storeys occupied by more than one family of the working class should have at least one water supply and a sink placed on a landing convenient for the occupants of the second and third storeys. Places where Food is Prepared and Exposed for Sale. (a) That it is desirable that regulations should be made to limit the pollution resulting from exposure in an improper manner in public places or adjacent to the public way of food and food receptacles. (b) That it is desirable that all places where food is prepared for sale should be regulated by by-laws made by the London County Council and administered by the Sanitary Authorities, and should be subject to annual licensing by the Sanitary Authority. Notification of Births Act, 1907. That in view of the adoption of the Notification of Births Act, 1907, throughout London, and the provisions of the recent Orders of the Local Government Board with regard to the compulsory notification of consumption, the appointment of one or more women health visitors or women sanitary inspectors in each metropolitan borough is eminently desirable. Chapels of Rest. That it is desirable that chapels of rest, apart from mortuaries for bodiesawaiting inquest, should be established by Sanitary Authorities. That all private mortuaries should be registered and regulated. I have the honour to be Your obedient Servant, JOHN F. J. SYKES, Medical Officer of Health. 177 VIII.—APPENDIX. (A) STATISTICAL TABLES. Table. 1. ST. PANCRAS SANITARY DISTRICT. Table showing the Population, Inhabited Houses, Marriages, Births, and Deaths for the year 1910 and 10 years preceding. Gross Numbers. The Year. Estimated Population. No. of Inhabited Houses. Marr ages. Registered Births. Corrected No. of Deaths. Deaths of Parishioners in Public Institutions. Total All Ages. Under One Year. Under Five Years. 1910 237,178 .. 2000 5385 3267 580 939 1556 1909 237,247 . . 1993 5238 3521 570 868 1625 1908 237,158 . . 1973 5546 3555 638 955 1682 1907 237,173 . . 2130 5484 3552 624 1015 1541 1906 237,149 . . 2103 5744 3747 753 1162 1648 1905 237,150 . . 2117 5801 3728 787 1183 1575 1904 237,088 . . 2093 6116 4129 927 1399 1577 1903 237,032 . . 2095 6339 3829 847 1346 1460 1902 237,054 . . 2197 6452 4482 950 1519 1741 1901 237,115 23,715 2133 6304 4320 975 1447 1603 1900 . . . . 2188 6448 4655 1037 1579 1594 Average of 10 years, 1900 to 1909 . . 2102 5947 3952 811 1247 1605 Notes. 1. Population at Census 1891, 235,317. 2. Average number of persons in each house in 1901, 9.9. 3. Area of District in acres, 2694. 178 Table 2. ST. 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 1910 and 10 years preceding. In the Year. Birth Rate per 1000 of Population. Corrected Death Rate 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 Institutions per 1000 of Total Deaths. 1910 22.7 13.8 107.8 177.5 287.4 476.3 1909 22.1 14.8 108.8 161.9 246.7 461.7 1908 23.4 15.0 115.0 179.4 268.6 473.3 1907 23.1 15.0 113.8 175.7 285.7 431.0 1906 24.2 15.8 1311 201.0 310.2 440.0 1905 24.5 15.7 135.7 2111 317.4 422.5 1904 25.8 17.4 151.6 2245 338.9 382.0 1903 26.7 16.2 133.6 221.5 351.6 381.4 1902 27.2 18.9 147.2 212.0 339.0 388.5 1901 26.5 18.1 154.7 225.7 335.0 387.3 1900 26.5 19.1 160.9 222.8 339.2 342.5 Average of 10 years 1900 to 1909. 25.0 16.6 135.2 203.6 313.2 411.0 179 Table 3a. deaths registered from all causes for the year 1910. note.— The Deaths of Non-Residents occurring in Public Institutions situated in the Borough are excluded, and the Deaths of Residents occurring in Public Institutions situated beyond the limits of the Borough are included. Cause of Deaths. AGES 0 to 1 1 to 5 5 to 10 10 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. Total under 5 years. a.— general diseases. 1.—Miasmatic Diseases. Smallpox Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... Not Vaccinated ... ... ... ... ... ... ... ... ... ... ... ... ... ... Doubtful ... ... ... ... ... ... ... ... ... ... ... ... ... ... Cow-pox. Effects of Vaccination ... ... ... ... ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... ... ... ... ... Measles (Morbilli) 42 93 8 ... ... ... ... ... ... ... ... ... 143 135 Epidemic Rose Rash, German Measles ... ... ... ... ... ... ... ... ... ... ... ... ... ... Scarlet Fever ... 6 7 3 ... 1 ... ... ... ... ... ... 17 6 Typhus ,, ... ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... ... Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Influenza ... ... ... ... 2 ... 4 3 ... 6 4 ... 20 ... Whooping Cough 40 50 2 ... ... ... ... ... ... ... ... ... 92 90 Mumps ... ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria, Membranous Croup 2 14 4 1 ... ... ... ... ... ... ... ... 21 16 Cerebro-Spinal Fever 5 2 1 1 ... ... ... ... ... ... ... ... 9 7 Simple Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever ... ... ... ... ... 2 2 ... ... ... ... ... 4 ... 2.—Diarrhœal Diseases. Asiatic Cholera ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... Epidemic Diarrhœa, Epid. (or Zym.) Enteritis 10 2 ... ... ... ... ... ... ... ... ... ... 12 12 Diarrhoea, Choleraic Diarrhœa 28 6 ... ... ... ... ... ... 2 ... 1 ... 37 34 Dysentery ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... 3.—Malarial Diseases. Malarial Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4.—Zoogenous Diseases. Hydrophobia ... ... ... ... ... ... ... ... ... ... ... ... ... ... Glanders, Farcy ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anthrax, Splenic Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tetanus ... ... 1 ... ... ... ... ... ... ... ... ... 1 ... 5.—Venereal Diseases. Syphilis 12 ... ... ... ... 2 ... ... ... ... ... ... 14 12 Gonorrhoea, Stricture of Urethra ... ... ... ... ... ... ... ... 3 1 ... ... 4 ... 6.—Septic Diseases. Puerperal Septicæma, Sapræmia ... ... ... ... 1 3 ... ... ... ... ... ... 4 ... Puerperal Pyaemia ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Phlegmasia Dolens ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever ... ... ... ... ... ... ... ... ... ... ... ... ... ... Infective Endocarditis ... ... ... ... ... ... 1 1 ... ... ... ... 2 ... Erysipelas 1 1 ... ... ... ... 1 ... 1 1 1 1 7 2 Septicaemia (not Puerperal) 1 1 ... ... ... ... 2 1 ... 1 ... ... 6 2 Pyaemia (not Puerperal) ... ... ... 1 ... ... ... 1 ... ... ... ... 2 ... Phlegmon, Carbuncle (not Anthrax) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Phagedæna. ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Septic Diseases ... 2 ... ... ... 1 ... 1 ... ... ... ... 4 2 7.—Tubercular Diseases. Tuberculous Phthisis (Pulm. Phthisis) 2 2 1 2 34 46 51 45 36 17 1 ... 237 4 Phthisis ... ... ... 1 5 17 9 12 11 5 ... ... 60 ... Tuberculous Meningitis 6 15 4 1 3 1 ... 1 ... ... ... ... 31 21 Tuberculous Peritonitis ... 2 ... 1 3 ... ... ... 1 1 ... ... 8 2 Tabes Mesenterica ... 1 1 ... 1 ... ... ... ... ... ... ... 3 1 Lupus ... ... ... ... ... ... ... ... ... ... ... ... ... ... Tubercle of other Organs 1 1 ... 1 ... ... 1 1 1 2 ... ... 8 2 General Tuberculosis 4 6 1 1 6 2 ... 3 1 2 ... ... 26 10 S???rofula ... ... ... ... ... ... ... ... ... ... ... ... ... ... 180 Table 3a—con. Deaths Registered from all Causes for the Year 1910—continued. Cause of Deaths. Ages. 0 to 1 1 to 5 5 to jo 10 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 Total under 5 years. a . — General diseases—Con. 8.—Parasitic Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... 9.—Dietic Diseases. Starvation ... ... ... ... ... ... 1 ... ... ... ... ... 1 ... Scurvy 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 Alcoholism, Delirium Tremens ... ... ... ... ... 1 3 6 2 1 ... ... 13 ... Opium, Morphia Habit ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ptomaine Poisoning ... ... ... ... ... ... ... ... ... ... ... ... ... ... Industrial Poisoning by Lead ... ... ... ... ... ... ... ... ... ... ... ... ... ... by Phosphorus ... ... ... ... ... ... ... ... ... ... ... ... ... ... by Arsenic & other Metals ... ... ... ... ... ... ... ... ... ... ... ... ... ... 10.— Constitutional Diseases. Rheumatic Fever, Acute Rheumatism ... 1 ... 1 2 1 2 1 ... ... ... ... 8 1 Rheumatism of Heart ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... Chronic Kheumatism ... ... ... ... ... ... ... ... 1 1 2 ... 4 ... Kheumatic Arthritis, Rheumatic Gout ... ... ... ... ... ... ... ... 1 1 2 ... 4 ... Gout ... ... ... ... ... ... ... ... 1 1 ... ... 2 ... Carcinoma ... ... ... ... 1 7 16 37 43 52 21 4 181 ... Sar???cma ... 1 ... ... 2 1 1 3 4 1 ... ... 13 1 Malignant Disease, Cancer 1 ... ... ... 1 3 1 20 21 20 5 ... 72 1 Rickets 4 5 ... ... ... ... ... ... ... ... ... ... 9 9 Purpura 1 ... ... ... 1 ... ... ... ... ... ... ... 2 1 Hæmophilia, Hæmorrhagic Diathesis ... ... ... ... ... ... ... ... ... ... ... ... ... ... Anæmia, Leucocythæmia ... 1 ... ... ... ... 1 2 1 ... ... ... 5 1 Diabetes Mellitus ... ... ... ... 1 4 ... 1 5 2 4 ... 17 ... 11—Developmental Diseases. Premature Birth 100 ... ... ... ... ... ... ... ... ... ... ... 100 100 Congenital Defects 13 1 ... ... ... ... ... ... ... ... ... ... 14 14 Injury at Birth 2 ... ... ... ... ... ... ... ... ... ... ... 2 2 Atelectasis 9 ... ... ... ... ... ... ... ... ... ... ... 9 9 Want of Breast Milk 9 ... ... ... ... ... ... ... ... ... ... ... 9 9 Teething 2 2 ... ... ... ... ... ... ... ... ... ... 4 4 B.— Local Diseases. 1.—Diseases of the Nervous System. Meningitis, Inflammation of Brain 8 11 3 1 1 ... 1 ... 2 ... ... ... 27 19 Softening of Brain ... ... ... ... ... ... ... ... 1 2 ... ... 3 ... General Paralysis of Insane ... ... ... ... ... 5 10 9 1 ... ... ... 25 ... Insanity (not Paerperal) ... ... ... ... 2 ... 5 6 6 4 3 ... 26 ... Chorea ... ... ... ... ... ... ... 1 ... ... ... ... 1 ... Epilepsy ... ... ... ... 2 ... 4 ... 2 ... ... ... 8 ... Convulsions 14 1 ... ... ... ... ... ... ... ... ... ... 15 15 Laryngismus Stridulus ... ... ... ... ... ... ... ... ... ... ... ... ... ... Locomotor Ataxy ... ... ... ... ... ... ... ... 2 ... ... ... 2 ... Paraplegia and Disease of Cord ... ... ... ... 2 2 2 2 2 ... ... ... 10 ... Neuritis, Periph., Poly-Neuritis ... ... ... ... ... 1 ... 1 ... 1 ... ... 3 ... Brain Tumour (not specific) ... ... 2 ... 1 1 1 1 3 ... ... ... 9 ... Nervous System, other Diseases 2 ... ... 1 ... ... ... 3 3 ... ... ... 9 2 2.—Diseases of Organs of Special Sense. Otitis, Mastoid Disease ... 1 ... ... 1 ... ... ... ... ... ... ... 2 1 Epistaxis, Nose Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia, Eye Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3a.—Diseases of Heart. Valve Dis., Endocarditis (not Infective) ... ... 2 2 10 6 7 13 15 13 8 ... 76 ... Pericarditis ... ... 1 ... ... ... 1 ... 1 ... ... ... 3 ... Hypertrophy of Heart ... ... ... ... ... ... 1 ... ... 1 ... ... 2 ... Angina Pectoris ... ... ... ... 1 ... ... ... 1 1 1 ... 4 ... Dilatation of Heart ... ... 1 ... 1 1 5 2 13 7 7 ... 37 ... Fatty Degeneration of Heart ... ... ... ... ... ... ... 5 5 7 10 4 31 ... Syncope, Heart Disease (not specified) 2 ... 1 3 1 6 15 20 27 30 12 1 118 2 181 Table 3a—con. Deaths Registered from all Causes for the Year 1910—continued. Cause of Deaths. ages. 0 to 1 1 to 5 5 to 10 10 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. Total under 5 years. B.— Local Diseases—con. 3b.— Diseases of Blood-vessels. Cerebral Hæmorrhage, Embolism, Thrombosis 3 ... ... ... 1 1 6 10 22 24 19 3 89 ..3 Apoplexy, Hemiplegia ... ... ... ... ... 1 2 7 10 10 12 ... 42 ... Aneurism ... ... ... ... ... ... 3 4 1 1 ... 1 10 ... Senile Gangrene ... ... ... ... ... ... ... ... ... ... ... ... ... ... Embolism,Thrombosis (not Cerebral) ... ... ... ... ... ... 3 ... ... 1 1 ... 5 ... Phlebitis ... ... ... ... ... ... ... ... 1 1 ... ... 2 ... Varicose Veins ... ... ... ... ... ... ... ... ... ... ... ... ... ... Blood-vessels, other Diseases ... ... ... ... ... ... 3 3 3 8 2 ... 19 ... 4.— Diseases of Respiratory System. Laryngitis ... 1 ... ... ... ... ... ... ... ... ... ... 1 1 Mem. Laryngitis (not Diphtheritic) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Croup (not Spasmod. or Membr.) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Larynx, other Diseases (not specified) ... ... ... ... ... ... ... ... ... 1 ... 1 ... Bronchitis 29 11 ... 1 1 8 8 24 46 73 54 13 268 40 Lobar, Croupous-Pneumonia 2 5 ... 1 3 3 9 5 10 7 7 ... 52 7 Broncho,Catarrhal, Lobular, Pneumonia 64 60 5 ... 4 1 5 4 8 7 5 1 164 124 Pneumonia 11 18 4 2 5 7 15 13 19 22 8 2 126 29 Emphysema, Asthma ... ... ... 1 ... ... ... ... ... 1 1 ... 3 ... Pleurisy 3 ... ... ... ... 3 2 1 1 5 4 1 20 3 Fibroid Disease of Lung ... 1 ... ... ... ... ... ... ... 1 ... ... 2 1 Respiratory Diseases, other ... ... ... ... 1 1 2 ... ... 1 ... ... 5 ... 5.—Diseases of Digestive System. Tonsillitis, Quinsy ... 1 ... ... ... ... ... ... ... ... ... ... 1 1 Mouth, Pharynx, Disease (not specific ... ... ... ... ... ... ... ... ... ... ... ... ... ... Gastric Ulcer ... ... ... ... 2 4 7 1 4 1 ... ... 19 ... Gastric Catarrh 1 ... ... ... ... ... ... 1 ... ... ... ... 2 1 Stomach, other Diseases (not Malignant 2 2 ... ... ... ... 2 1 ... 3 1 ... 11 4 Enteritis (not Epidemic) 13 8 ... ... ... ... ... 1 1 ... ... ... 23 21 Gastro-Enteritis 8 3 ... ... ... ... 1 ... ... ... 1 ... 13 11 Appendicitis, Perityphlitis ... 1 ... ... 2 2 1 2 1 3 ... ... 14 1 Hernia ... ... ... ... 1 ... 3 4 2 1 2 1 14 ... Intestinal Obstruction 3 ... ... ... ... 1 1 1 4 4 ... ... 14 3 Other Diseases of Intestines 3 ... 1 ... ... ... ... 1 ... ... ... ... 5 3 Peritonitis (not Puerperal) ... ... ... 2 ... 2 2 1 2 1 ... ... 10 ... Cirrhosis of Liver ... ... ... ... 1 1 4 14 11 5 ... ... 36 ... Liver and Gall Bladder other Diseases ... ... ... ... ... ... 4 5 4 3 ... ... 16 ... Digestive System, other Diseases ... ... ... ... ... 2 2 2 3 2 ... ... 11 ... 6.—Diseases of Lymphatic System and Ductless Glands. Spleen Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... Lymphatic System, other Diseases ... 1 ... 1 2 ... 1 ... 1 ... 1 ... 7 1 Thyroid Body Disease ... ... ... ... ... ... ... ... ... ... ... ... ... ... Supra Renal Capsules Disease ... ... ... ... ... ... 1 1 ... ... ... ... 2 ... 7.—Diseases of Urinary System. Nephritis, Acute 1 ... ... 1 2 4 4 8 3 11 6 ... 40 1 Chronic Bright's Disease, Albuminuria ... ... ... 2 ... 1 7 13 10 21 2 1 57 ... Calculus (not Biliary) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Bladder and Prostate Disease ... ... ... ... ... 1 ... 2 4 8 4 1 20 ... Urinary System, other Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... 8a. — Diseases of Organs of Generation. Ovarian Tumour (not Malignant) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Ovary ... ... ... ... ... ... ... ... ... 1 ... ... 1 ... Uterine Tumour (not Malignant) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other Diseases of Uterus and Vagina ... ... ... ... 1 ... 1 ... ... ... ... ... 2 ... Disorders of Menstruation ... ... ... ... ... ... ... ... ... ... ... ... ... ... Genr. and Mam. Orgs., other Diseases ... ... ... ... ... ... ... ... ... ... ... ... ... ... 182 Table 3a-con. Deaths Registered from all Causes for the Year 1910—continual. Cause of Deaths. AGES. 0 to 1 1 to 5 5 to 10 10 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. Total under 5 years. B.— Local Diseases—con. 8b.—Diseases of Parturition. Abortion, Miscarriage ... ... ... ... ... 4 1 ... ... ... ... ... 5 ... Puerperal Mania ... ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Convulsions ... ... ... ... ... ... ... ... ... ... ... ... ... ... Placenta Previa, Flooding ... ... ... ... ... 1 1 ... ... ... ... ... 2 ... Other Accidents of Pregnancy and Childbirth ... ... ... ... 1 4 4 ... ... ... ... ... 9 ... 9.—Diseases of Bones and Joints. Caries, Necrosis ... ... 1 ... 1 ... ... ... ... ... ... ... 2 ... Arthritis, Periostitis ... ... ... ... 1 ... ... ... ... 2 ... ... 3 ... Other Diseases of Locomotor System ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... 10.— Diseases of Integumentary System. Ulcer, Bedsore ... ... ... ... ... ... ... ... ... ... ... ... ... ... Eczema 1 ... ... ... ... ... ... ... ... ... ... ... 1 1 Pemphigus ... ... ... ... ... ... ... ... ... ... ... ... ... ... Skin Diseases, other 1 ... ... ... ... ... ... ... 1 ... ... ... 2 1 C.— Violence 1.—Accident or Negligence. In Mines and Quarries ... ... ... ... ... ... ... ... ... ... ... ... ... ... Vehicles and Horses .. ... 5 ... 2 1 1 ... 1 1 ... ... 11 ... Ships, Boats and Docks (not Drowning) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Railways ... ... ... ... ... ... ... ... 2 ... ... ... 4 ... Building Operations ... ... ... ... ... ... ... ... ... ... ... ... ... ... Machinery ... ... ... ... ... ... ... ... ... ... ... ... ... ... Weapons and Implements ... ... ... ... ... ... ... ... ... ... ... ... ... ... Burns and Scalds 1 10 1 ... ... ... ... 2 ... ... 2 ... 16 11 Poisons, Poisonous Vapours ... ... ... ... ... ... ... 1 2 1 ... ... 4 ... Drowning ... 1 1 ... ... ... 2 1 1 1 ... ... 7 1 Suffocation 20 1 ... ... ... 1 ... 1 ... ... ... ... 23 21 Falls ... 3 1 ... ... 2 3 2 7 11 5 2 36 3 Weather Agencies ... ... ... ... ... ... ... ... ... ... ... ... ... . Otherwise or not stated 2 1 1 ... 1 ... 1 1 1 ... ... ... 8 3 2.—Homicide ... ... ... ... 1 ... ... ... ... ... ... ... 1 ... 3. — Suicide ... ... ... ... 1 10 8 10 4 5 ... ... 38 ... 4.—Execution ... ... ... ... ... ... ... ... ... ... ... ... ... ... D.— Ill-defined and not Specified Causes. Debility, Atrophy, Inanition 89 3 ... ... ... ... ... ... ... ... ... ... 92 92 Old Age ... ... ... ... ... ... ... ... 5 34 110 52 201 ... Dropsy Ascites, Anasarca ... ... ... ... ... ... ... ... ... ... 1 ... 1 ... Tumour ... ... ... ... ... ... 2 3 ... ... ... ... 5 ... Abscess ... ... ... 1 2 ... ... 1 ... ... 1 ... 5 ... Hæmorrhage ... ... ... ... 1 ... ... ... ... 2 1 ... 4 ... Sudden Death (cause not ascertained) ... ... ... ... ... ... ... ... ... ... ... ... ... ... Other ill-defined causes 1 ... ... ... ... ... ... 1 ... 1 ... ... 3 1 Causes not specified ... ... ... ... ... ... ... ... ... ... ... ... ... ... 183 Table 3b. Summary of Diseases. I. —Specific Febrile, or Zymotic Diseases:— VI.— Local Diseases—con. 1. Miasmatic Diseases 806 2. Diarrhœal ,, 51 Brought forward 2654 8. Malarial „ — 6. Diseases of Lymphatic System 9 4. Zoogenous ,, 1 7. ,, ,, Urinary System 117 5. Venereal ,, 18 8. ,, ,, Reproductive System— 6. Septic ,, 25 (a) Organs of Generation 3 7. Tubercular ,, 373 (4) Parturition 16 II.— Parasitic Diseases — 9. ,, ,, Bones and Joints 6 III—Dietic Diseases 15 10. „ ,, Integumentary System 3 IV.— Constitutional Diseases 318 V.— Developmental Diseases 188 VII.— Violence :— VI.— Local Diseases:— 1. Accident or Negligence 109 1. Diseases of Nervous System 138 2. Homicide 1 2. ,, Organs of Special Sense 2 3. Suicide 88 3. „ Circulatory System 488 4, Execution — 4. ,, Respiratory System 642 VIII Ill-df.fined and not Specified Causes 311 5. ,, Digestive System 189 Total 8267 Carried forward 2654 Summary of Ages. 0 to 1 1 to 5 5 to 10 10 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. Total under 5 years. I, Specific Febrile, or Zymotic Diseases 141 177 23 6 3 9 10 9 6 9 6 2 401 318 Tubercular Diseases 13 27 7 7 52 66 61 62 50 27 1 ... 373 40 II. Parasitic Diseases ... ... • • • ... ... ... ... ... ... ... ... ... ... ... III. Dietic Diseases 1 ... ... ... ... 1 4 6 2 1 ... ... 15 1 IV. Constitutional Diseases 6 8 ... 2 8 16 21 64 77 78 34 4 318 14 V. Developmental Diseases 135 3 ... ... ... ... ... ... ... ... ... ... 138 138 VI. Local Diseases 171 125 23 19 51 74 157 192 256 294 172 29 1563 296 VII. Deaths from Violence 23 16 9 ... 5 16 15 18 18 19 7 2 148 39 VIII. Deaths from Ill-defined and not Specified Causes 90 3 ... 1 3 ... 2 5 5 37 113 52 311 98 Totals 580 359 62 35 122 182 270 356 414 465 333 89 3267 989 184 Table 4. ST. PANCRAS SANITARY DISTRICT. Showing the number of Deaths at all ages in 1910 from certain groups of Diseases, and proportion to 1,000 of Population and to 1,000 Deaths from all causes. Divisions. Deaths. Deaths per 1000 of Population at all ages. Deaths per 1000 of Total Deaths at all ages. 1. Principal Zymotic Diseases 327 1.38 100.0 2. Respiratory Diseases 642 2.70 196.6 3. Tubercular Diseases 373 1.57 114.2 Notes. 1. Includes Small.pox, Measles, Scarlet Fever, Diphtheria, Whooping Cough, Typhus, Enteric (or Typhoid) and Simple and 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 other Tubercular Diseases. 185 Table 5a. ST. PANCRAS SANITARY DISTRICT. Showing the Number of Deaths from the principal Zymotic Diseases in the 10 years 1900 to 1909 and in the year 1910. Disease. 1900 1901 1902 1903 1904 1905 . 1906 1907 . 1908 1909 Number of Deaths, Annual Average of 10 years 1900.09. Number of Deaths in 1910. Proportion of Deaths to 1,000 total Deaths in 10 years 1900.09. Proportion of Deaths to 1,000 total Deaths in 1910. Small.pox . 41 82 .. . .. .. . .. 12.3 3.1 .. Measles 123 65 111 189 125 77 96 91 46 102 102.5 143 25.9 43.78 Searlet Fever 10 33 48 23 27 27 32 26 20 17 26.3 17 6.7 5.20 Diphtheria and Mem. branous Croup 71 109 106 39 40 26 22 28 23 28 49.2 20 12.4 6 12 Whooping Cough 104 84 109 86 79 80 68 76 67 27 78.0 92 19.7 28.16 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 63 31 44 13 17 8 13 4 10 6 20.9 4 5.3 1.22 Simple Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa and Dysentery 244 196 83 80 173 141 163 55 87 46 126.8 51 32.1 15.61 Totals 615 559 583 430 461 359 394 280 253 226 416.0 327 105.3 100.1 186 Table 5b. ST. PANCRAS SANITARY DISTRICT. Showing the Number of Deaths from the Notifiable Infectious Diseases in the 10 years 19o0 to 1909, and in the year 1910. Disease 1900 1901 1902 1903 1904 1905 1906 1907 1903 1909 Number of Deaths, Annual Average of 10 year 1900.09 Number of Deaths in 1910. Proper. tion of Deaths to 10.0 total Deaths in 10 years 19U0.09 Proportion of Deaths to 1000 total Deaths in 1910. Small pox . 41 82 ... .. .. .. .. .. .. 12.3 .. 3.1 .. Scarlet Fever 10 33 48 23 27 27 32 26 20 17 26.3 17 6.7 5.20 Diphtheria 69 105 103 39 37 25 21 27 22 28 47.6 20 12.0 6.12 Membranous Croup 2 4 3 .. 3 1 1 1 1 .. 1.6 .. 0.4 .. Typhus Fever .. .. . .. .. .. .. .. .. .. . . .. .. Enteric Fever 63 31 44 13 17 8 13 4 10 6 20.9 4 5.3 1.22 Fever,Simple & Continued . .. .. .. . .. . .. .. .. .. .. .. .. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever . 3 5 5 1 5 5 7 1 2 7 4.1 4 1.0 1.22 Cholera . .. .. .. .. .. .. .. .. .. .. 1 .. 0.30 Erysipelas 8 10 8 11 17 17 21 11 7 10 12.0 7 3.0 2.14 Plague .. .. .. .. .. .. .. . .. .. .. .. .. .. Cbicken.pox .. .. 2 .. .. .. . .. .. .. 0.2 . 0.05 .. Cerebro.spinal Meningitis .. .. .. .. .. .. .. 2 1 4 0.7 9 0.17 2.75 Totals 155 229 295 87 106 83 95 72 63 72 125.7 62 31.8 18.97 187 Table 5c. SAINT PANCRAS. Morbidity—Cases per 1000 population. Fatality—Deaths per 1000 cases. Year. Population. Small.pox. Scarlet Fever. Diphtheria and Membranous Croup. Typhus Fever. Enteric, and Simple or Continued Fever. Relapsing Fever. Puerperal Fever. Cholera. Erysipelas. Morbidity. Fatality. Morbidity. Fatality. Morbidity. Fatality. Morbidity. Fatality. Morbidity. Fatality, Morbidity. Fatality. Morbidity. Fatality. Morbidity. Fatality. Morbidity. Fatality. 1891 234379 enumerated — — 2.6 51.5 1.3 268.5 — — 0.9 126.7 — — 0.03 875.1 0.04 555.7 1.6 32.4 1892 234473 estimated 0.1 64.5 5.5 52.4 1.8 263.9 — — 0.5 213.1 — — 0.1 444.4 0.02 — 1.8 21.1 1893 234567 ,, 0.5 80.3 10.5 41.0 3.1 271.9 — — 0.7 142.9 — — 0.1 500.0 0.02 400.1 2.9 53.1 1894 234661 ,, 0.4 84.2 5.3 35.1 2.1 247.1 — — 0.8 210.5 — — 0.05 636.3 — — 2.0 31.9 1895 234755 ,, 0.06 71.4 4.5 48.2 2.3 243.5 — — 0.6 190.5 — — 007 706.0 — 1.7 26.9 1896 234849 ,, 0.02 — 4.5 34.7 2.0 2120 — 0.8 145.7 — — 0.08 263.1 — — 1.6 35.5 1897 234943 ,, 0.01 — 4.0 26.3 2.2 218.8 — — 0.9 172.7 0.06 4.28.6 0.01 666.6 1.7 33.1 1898 235037 ,, 0.01 — 4.1 52.6 2.1 201.6 — — 0.9 191.8 0.07 352.9 0.02 750.0 1.4 30.9 1899 235131 ,, — — 3.6 29.1 2.4 198.6 — — 1.0 179.2 — 0.05 769.2 1.3 52.5 1900 235224 „ 0.03 — 2.8 15.4 2.5 121.4 — — 1.5 176.5 — — 0.03 333.3 10 35'2 1901 235317 enumerated 1.0 172.3 4.1 34.0 3.8 120.6 — — 0.8 171.3 — 0.05 384.6 — — 10 41.2 1902 237054 estimated 1.8 261.2 5.1 40.0 3.3 134.2 — — 0.8 213.6 . — 0.05 416 7 — — 10 33.6 1903 237032 ,, 0.1 — 2.7 35.5 2.1 78.8 — — 0.4 156.7 •— 002 200.0 — — 0.9 49.6 1904 237088 ,, 0.01 — 3.5 32.2 1.4 118.0 — — 0.6 125.9 — — 0.04 555.7 — — 11 67.7 1905 237150 ,, — — 4.7 27.4 1.2 92.2 — — 0.3 111.l — — 0.04 500.0 — — 10 74.6 1906 237149 ,, — — 3.3 40.5 1.2 80.0 — — 0.4 135.4 — — 1.0 700.0 — — 1.0 90.9 1907 237173 ,, — — 3.6 30.6 1.4 81.2 — — 0.2 74.0 — — 0.04 250.0 — — 0.8 58.6 1908 237158 „ — — 4.0 20.9 1.2 77.7 — — 0.2 166.7 — — 0.03 2500 — — 0.6 44.9 1909 237247 ,, — — 3.3 22.0 1.3 88.9 — — 0.2 120.0 — — 006 467.0 — — 0.7 62.5 1910 237178 ,, — — 3.0 24.9 1.1 76.3 — — 0.3 65.6 — 0.06 285.7 0.00 37.6 0.8 37.6 188 Table 6a.—Sr. Pancras Registration Sub-Districts and District. Table of Population, Births, and Deaths from all Causes, classified according 10 ages and localities, occurring during the year 1910. Public Institution Non-Kesidents in Public Institutions within the District are excluded. Residents in Public Institutions without the District are included. Residents in Public Institutions, whether within or without the District, are classified in the respective Sub-Districts of their previous residence. West St. Pancras. South St. Pancras. East St. Pancras. North St. Pancras. No Address. Totals St. Pancras. Population at all Ages. Census, 1881 64534 57976 61397 52351 .. 236258 ,, ,, under 5 .. .. .. .. .. .. „ ,, 5 and under 10 .. .. .. .. .. .. Census, 1891 59235 62666 60704 53776 .. 234379 ,, ,, under 5 .. .. .. .. .. .. ,, ,, S an<l under 10 .. .. .. .. .. .. Census, 1901 60562 55707 60320 58728 .. 235317 „ „ under 5 .. .. .. .. .. .. ,, ,, 5 and under 10 .. .. .. .. .. .. Supplemented and Re-distributed as to Public Institutions 61937 56000 59711 59599 .. 237247 Under 5 .. .. .. .. .. .. 5 and under 10 .. .. .. .. .. .. Registered Births 1363 1024 1610 1388 .. 5385 Birth-rate See Table 10b. Deaths from all Causes at Suhjoisfd Ages Under 1 year (infants) 152 112 195 121 .. 580 I and under 101 61 119 77 1 359 5 and under 10 12 3 24 23 .. 62 10 and under (5 13 5 11 6 .. 35 15 and under 25 36 26 29 29 2 122 25 and under 65 310 287 ! 303 282 40 1222 65 aid upwards 240 162 224 221 40 887 Totals— Under 5 253 173 314 198 1 939 5 and under 15 25 8 35 29 .. 47 15 and upwards 586 475 556 532 82 2231 Total Deaths at all Ages 864 656 905 759 83 3267 Death-rate per :o^o population Infantile Mortality. Rate per 1000 Births See Table 10b. 189 Table 6b.—St. Pancras Registration District. Cases ok Infectious Disease Certified Notifications, classified according to diseases and ages, occurring during the year 1910. PUBLIC INSTITUTIONS. Non-Residenis in Public Institutions within the District are excluded. 1 Residents in Public Institutions without the District are included. At all Ages. At Ages—Years. Under 1. 1and under 5. 5 and under 10. 10 and ' under 15. 15 and under 25. 25 and under 65. 65 and upwards.[/### Notifiable Infectious Diseases. i. Variola or Small-pox . . . . . . . . . . . . . . . . 2. Scarlatina or Scarlet Fever 681 7 199 273 121 43 33 •• 3. Diphtheria 259 8 108 66 31 27 19 •• 4. Membranous Croup 3 •• 3 •• •• •• •• •• 5. Typhus Fever •• •• •• •• •• •• •• •• 6. Enteric or Typhoid Fever 61 •• 2 7 5 15 32 •• 7. Fever ,Simple or Continued •• •• •• •• •• •• •• •• 8. Relapsing Fever •• •• •• •• •• •• •• •• 9. Puerperal Fever 14 •• •• •• •• 4 10 •• 10. Cholera 1 •• •• •• •• •• 1 •• 11. Erysipelas 186 5 6 4 3 23 129 16 12. Plague[o] •• •• •• •• •• •• •• •• 13. Anthrax [o] •• •• •• •• •• •• •• •• 14. Glanders [o] •• •• •• •• •• •• •• •• 15. Hydrophobia [o] •• •• •• •• •• •• •• •• 16. Cereoro-Spinal Meningitis 10 4 2 1 2 1 •• •• Totals Notifiable Infectious Diseasfs. 1215 24 320 351 162 118 224 16 Phthisis •• •• •• •• •• •• •• •• 190 Table 7a.—St. Pancras Registration Sub-Districts and District. Cases of Infectious Disease Certified Notifications, classified according to diseases, ages, and localities, occurring during the year 1910. Non-Residents in Public Institutions are excluded. Residents in Public Institutions without the District are included. AGES. west. South. East. North. No Address. Totals. Totals. All Ages. Notifiable Infectious Diseases. I. Variola or Small-pox Under 5 .. .. .. .. .. .. .. 5 & under 15 .. .. .. .. .. .. 15 & upwards .. .. .. .. .. .. 2. Scarlatina or Scarlet Fever Under 5 62 22 46 76 .. 206 681 5 & under 15 104 37 09 144 .. 294 15& upwards 22 15 15 29 .. 81 3. Diphtheria Under 5 59 20 33 24 .. 116 259 5 & under 15 39 10 13 29 .. 97 15 & upwards 14 7 11 14 .. 46 4. Membranous Croup Under 5 1 .. 2 .. .. 3 3 5 & under 15 .. .. .. .. .. .. 15 & upwards .. .. .. .. .. .. 5. Typhus Fever Under 5 .. .. .. .. .. .. .. 5 & under 15 .. .. .. .. .. .. 15 & upwards .. .. .. .. .. .. 6. Entericor Typhoid Fever Under 5 .. 1 1 .. .. 2 61 5 & under 15 4 4 3 1 .. 12 15 & upwards 14 14 8 11 .. 47 7. Fever, Simple or Continued Under 5 .. .. .. .. .. 5 & under 15 .. .. .. .. .. .. 5 & under 15 .. .. .. .. .. .. 8. Relapsing Fever Under 5 .. .. .. .. .. .. .. 5 & under 15 .. .. .. .. .. .. 15 & upwards .. .. .. .. .. .. 9. Puerperal Fever Under 5 .. .. .. .. .. .. 14 5 & under 15 .. .. .. .. .. .. 15 & upwards 5 1 4 4 .. 14 10. Cholera Under 5 .. .. .. .. .. .. 1 5 & under 15 .. .. .. .. .. .. 15 & upwards 1 .. .. .. 1 11. Erysipelas Under 5 1 2 2 6 .. 11 186 5 & under 15 3 .. 1 3 .. 7 15 & upwards 35 36 66 36 1 1 8 12. Plague [o] 13. Anthrax[o] 14. Glanders[o] 15. Hydrophobra[o] Under 5 .. .. .. .. .. .. .. 5 & under 15 .. .. .. .. .. .. 15 & upwaids .. .. .. .. .. .. 16. Cerebro-spinal Meningitis Under 5 1 3 2 .. .. 6 10 5 & under 15 1 .. .. 2 .. 3 15 & unders .. 1 .. .. .. 1 Total Notifiable Infectious Diseases Under 5 104 48 86 105 .. 344 1215 5 & under 15 .. 57 126 9 .. 513 15 & upwards 91 74 98 9 1 358 All Ages 3,6 79 310 379 1 121 Phthisis Under 5 .. .. .. .. .. .. .. 5 & under 15 .. .. .. .. .. .. 15 & upwards .. .. .. .. .. .. 191 Table 7b.—Sr. Pancras Registration Sub-Districts and District. Cases of Infectious Disease Ambulance Removals, classfied according to diseases, ages, and localities, occurring during the year 1910. Non-Residents in Public Institutions arc excluded. Residents in Public Institutions without the District are included. AGES. West. south. East. North. No Address Totals. Totals All. Ages. Notifiable Infectious Diseases. 1. Variola or Small-pox Under 5 .. .. .. .. .. .. .. 5 and under 15 .. .. .. .. .. .. 15 and upwards .. .. .. .. .. .. 2. Scarlatina or Scarlet Fever Under 5 62 22 45 75 .. 0 658 5 and under 15 100 37 108 133 .. 378 15 and upwards 22 11 11 9 .. 76 3. Diphtheria Under 5 38 18 33 23 .. 112 251 5 and under 15 39 16 12 29 .. 96 15 and upwards 12 7 11 13 .. 43 4. Membranous Croup Under 5 1 .. 1 .. .. 2 2 5 and under 15 .. .. .. .. .. .. 15 and upwards .. .. .. .. .. .. 5. TyphusFever Under 5 .. .. .. .. .. .. .. 5 and under 15 .. .. .. .. .. .. 15 and upwards .. .. .. .. .. 6. Enteric or Typhoid Fever Under 5 .. 1 1 .. .. 2 52 5 and under 15 3 4 3 1 .. 11 15 and upwards 11 12 6 10 .. 39 7. Fever, Simple or Continued Under 5 .. .. .. .. .. .. 5 and under 15 .. .. .. .. .. .. 15 and upwards .. .. .. .. .. .. 8. Relapsing Fever Under 5 .. .. .. .. .. .. .. 5 and under 15 .. .. .. .. .. .. 15 and upwards .. .. .. .. .. .. 9. Puerperal Fever Under 5 .. .. .. .. .. .. 8 5 and under 15 .. .. .. .. .. 15 and upwards 2 1 3 2 .. 8 10. Cholera Under 5 .. .. .. .. .. 1 5 and under 15 .. .. .. .. .. 15 and upwards 1 .. .. .. .. 1 n Erysipelas Under 5 .. 1 .. 3 .. 4 48 5 and under 15 .. .. 1 .. 1 15 and upwards 8 7 15 13 4 12. Plague [o] 13. Anthrax[o] 14. Glanders[o] 15. Hydrophobra[o] Under 5 .. .. .. .. .. 5 and under 15 .. .. .. .. .. .. 5 and upwards .. .. .. .. .. .. 16. Cerebro-Spinal Meningitis Under 5 1 3 2 .. 6 10 5 and under 15 1 .. .. 2 .. 3 5 and upwards .. 1 .. .. .. 1 Total Notifiable Infectious Diseases Under 5 102 45 82 101 33 5 and under 15 143 57 12 16 49 1030 15 and upwards 56 29 4 67 .. 11 All Ages 301 141 234 334 .. 103 Phthisis Under 5 .. .. .. .. .. .. 5 and under 15 .. .. .. .. .. 15 and upwards .. .. .. .. 192 Table 7c.—Sr. Pancras Registration Sub-Districts and District. Cases of Infectious Disease Certified Deaths, classified according to diseases, ages, and localities, occurring during the year 1910. Non-Residents in Public Institutions are excluded, Residents in Public Institutions without the District are included. AGES. west. South. East. North. No Address Totals. Totals All Ages. Notifiable Infectious Diseases. i. Variola or Small-pox Under 5 .. .. .. .. .. 5 and under 15 .. .. .. .. .. 15 and upwards .. .. .. .. .. 2. Scarlatina or Scarlet Fever Unders i .. 2 3 .. 6 17 5 and under 15 2 .. 4 4 .. 10 15 and upwards .. .. .. 1 .. 1 3. Diphtheria Under 5 8 3 4 .. .. 15 20 5 and under 15 1 .. 2 2 .. 5 15 and up words .. .. .. .. .. .. 4. Membranous Croup Under 5 .. .. .. .. .. .. .. 5 and under 15 .. .. .. .. .. .. 15 and upwards .. .. .. .. .. .. 5. Typhus Fever Unders .. .. .. .. •• .. .. 5 and under 1 5 .. .. .. .. .. .. 15 and upwards .. .. .. .. .. .. 6. Enteric or Typhoid Fever Under 5 .. .. .. .. .. .. 4 5 and under 15 .. .. .. .. .. .. 15 and upwards 3 1 .. .. .. 4 7, Fever,Simple or Continued Under 5 .. .. .. .. .. .. 5 and under 15 .. .. .. .. .. .. 15 and upwards .. .. .. .. .. .. Relapsing Fever Under 5 .. .. .. .. .. .. .. 5 and under 15 .. .. .. .. .. .. 15 and upwards .. .. .. .. .. .. 9. Puerperal Fever Under 5 .. .. .. .. .. .. 4 1 5 and under 15 .. .. .. .. .. 15 and upwards 1 1 2 .. .. 4 10. Cholera Under 5 .. .. .. .. .. .. 1 5 and under 15 .. .. .. .. .. .. . 15 and upwards 1 .. .. .. .. 1 11. Erysipelas Urder 5 .. .. 1 1 .. 2 7 5 and under 15 .. .. .. .. .. .. 15 and upwards .. 1 4 .. .. 5 12. Plague*[o] Under 5 .. .. .. .. .. .. .. 13. Anthrax [o] 5 and under 15 .. .. .. .. .. .. 14. Glinders[o] 15 and upwards .. .. .. .. .. .. 15. Hydinponia [o] 16. Cerebro-Spinal Meningitis Under 5 3 3 .. 1 .. 7 9 5 and under 15 .. .. .... 2 .. 2 15 and upwards .. .. .. .. .. Total Notifiable Infectious Diseases Under 5 12 6 7 5 .. 30 62 5 and under 15 3 .. 6 8 .. 15 5 and upward 5 3 6 1 .. 15 All ages 20 9 19 14 .. 62 Under 5 .. .. .. .. .. 5 and under 15 .. .. .. .. 15 and upwards .. .. .. .. 193 Table 8. St. Pancras Registration Sub-Districts and District. Table of Deaths from Certain Causes classified according to diseases, ages, and localities, occurring during the year 1910. Non-Residents in Public Institutions are excluded, Residents in Public Institutions without the District are included. AGES. West. south. East. North. No Address. Totals. Totals All Ages. Diseases. Notifiable Infectious Diseases Under 5 12 6 7 5 •• 30 62 5 and under 15 3 •• 6 8 .. 7 15 and upwards 5 3 6 1 •• 15 Measles Under 5 38 21 55 21 •• 135 143 5 and under 15 1 •• 5 2 •• 8 15 and upwards •• •• •• •• •• •• Whoopirg Cough Under 5 30 5 40 15 •• 90 92 5 and under 15 1 •• 1 •• •• 2 15 and upwards •• •• •• •• •• •• Diarrhoea and Dysentery Under 5 8 12 17 9 •• 46 51 5 and under 15 •• •• •• •• •• •• 15 and upwards 1 2 2 •• •• 5 Rheumatic Fever Under 5 1 •• •• •• •• 1 18 5 and under 15 1 •• •• •• •• 1 15 and upwards 3 2 1 •• •• 6 Influenza Under 5 •• •• •• •• •• •• 20 5 and under 15 .. •• •• •• •• •• 15 and upwards 9 3 5 3 •• 20 Phthisis Under 5 2 •• 1 1 •• 4 297 5 and under 15 1 2 1 •• •• 4 15 and upwards 76 85 57 60 11 289 Bronchitis, Pneumonia & Pleurisy Under 5 55 37 70 41 •• 203 630 5 and under 15 3 5 5 •• 13 15 and upwards 121 81 100 97 9 414 Heart Disease Under 5 •• 1 1 •• •• 2 271 5 and under 15 2 •• 4 4 •• 10 15 and upwards 68 49 73 61 8 250 Injuries Under 5 4 13 15 7 •• 39 148 5 and under 15 2 2 4 1 •• 9 15 and upwards 29 25 28 16 2 100 All o her Diseases Under 5 103 78 108 99 1 39 1545 5 and under 15 11 4 9 9 •• 15 and upwards 274 225 278 91 52 1123 Tolal Deaths Under 5 253 73 34 108 1 939 5267 5 and under 15 25 8 5 29 . . 97 15 and upwards 585 475 556 562 82 1131 All ages 86 66 905 759 83 326 194 Table 9a. ST. PANCRAS SUB-DISTRICTS. Table showing the Number of Deaths from the principal Zymotic and certain other Diseases in the Sub-Districts for the year 1910. Deaths not referable to any certain Sub-District being redistributed proportionately to the population. Sub-Districts. Population, 1910. Variola, Small-pox. Scarlatina, Scarlet Fever. Diphtheria and Membranous Croup. Typhus Fever. Enteric or Typhoid Fever. Fever, Simple and Continued. Measles. Whooping Cough. Diarrhœa and Dysentery. Total Zymotic Diseases. Rheumatic Fever. Influenza. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Injuries. All other Diseases. Total Deaths from all causes at all Ages. West 61891 •• 3 9 •• 3 •• 39 31 9 94 5 9 82 182 72 36 314 888 South 55952 •• •• 3 •• 1 •• 21 5 14 44 2 3 89 120 52 40 280 674 East 59794 •• 6 6 •• •• •• 60 41 19 132 1 5 62 183 80 48 283 926 North 59541 •• 8 2 •• •• 23 15 9 57 ••.. 3 64 145 67 24 362 779 St. Pancras 237178 •• 17 20 •• 4 •• 143 92 51 327 8 20 297 630 271 148 1239 3267 London 4872702 •• 214 134 196 1980 1363 1368 •• •• •• 5555 •• •• 2397 •• 61756 195 Tabi.e 9b 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 1910. Sub-Districts. Population, 1910. Variola, Small-pox. Scarlatina, Scarlet Fever. Diphtheria and Membranous Croup. Typhus Fever. Enteric or Typhoid Fever. Fever, Simple and Continued. Measles. Whooping Cough. Diarrhoea and Dysentery. Total Zymotic Diseases. Rheumatic Fever. Influenza. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. 1 Injuries. All other Diseases. Total Deaths from all causes at all ages. West 61891 .. 0.04 0.14 .. 0.04 .. 0.6 0.50 0.14 1.52 0.08 0.14 1 .32 2.94 1.16 0.58 o*07 14.3 South 55952 .. .. 0.05 .. o.o1 .. 0.37 0.08 0.25 0.78 o.o3 0.05 1.59 2.14 0.9.3 0.71 5 01 120 East 59794 .. 0.1 0.10 .. .. .. 1.00 0.68 0.31 2.21 o.o1 0.08 1.04 3.06 1.34 ■80 4.74 15.5 North 59541 .. 0.13 0.03 .. .. .. 0.38 0.25 0.15 0.95 .. 0.05 1.67 2.43 1.12 0.40 6.08 13.1 St. Pancras 237178 .. 0.07 0.08 .. 0.02 .. 0.60 0.3S 0.21 1.38 0.03 0.08 1.25 2.66 1.14 0.62 5.23 13.8 London 4872702 .. 0.04 0.09 .. 0.04 .. 0.41 0 28 0.28 .. .. .. 1.14 .. .. 0.49 .. 12.7 196 Table 10a. ST. PA NCR AS SUB-DISTRICTS. Table showing the Number of Deaths from the Notifiable Infectious Diseases, the number of Deaths at various Ages, and the num er of Births in the Sub-Districts for the year 1910; Births and Deaths not referable to any certain Sub-District being redistributed proportionately to the population. SubDistricts. Population, 1910. 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. Plague. Cerebro-spinal Meningitis. Total Notifiable Infectious Diseases. Total Deaths under 1 Year of Aye. Total Deaths under 5 Years of Age. Total Deaths under 10 Years of Age. Deat s at 10 and under 65 Years of Aye Deaths at 65 Years of Age and upwards Total Deaths at all Ages and from all causes. Registered Births. Per 1"00 Births. Deaths under 1 year. West 61891 .. 3 9 .. .. 3 .. .. 1 1 .. .. 3 20 152 254 266 371 251 888 1402 108.4 South 55952 .. .. 3 .. .. 1 .. .. 1 .. 1 .. 3 9 112 17 176 327 171 674 1034 108.4 East 59794 .. 6 6 .. .. .. .. .. 2 .. 5 .. .. 19 195 314 338 354 234 926 1524 128.0 North 59541 .. 8 2 .. .. .. .. .. .. .. 1 .. 3 14 121 198 221 327 231 779 1125 84.9 St. Pancras 237178 .. 17 20 .. .. 4 .. .. 4 1 7 .. 9 62 580 939 1001 1379 887 3267 5385 107.8 London l872762 .. 214 431 .. 196 .. .. .. 1 .. .. .. .. 11809 .. .. .. 61756 114870 101.7 197 ST. PANGEAS SUB-DISTRICTS. Table 10b.. 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 1910. Sub-Districts. Population, 1910. 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. Plague. Cerebro-spinal Meningitis. 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 Births. West 61891 .. 0.04 0.14 .. .. 0.04 .. .. 0.02 0.02 .. .. 0.04 0.32 2.46 4.10 4.30 6.00 4.06 14.3 22.7 South 55952 .. .. 0.05 .. .. 0.02 .. .. 0.02 .. 0.02 .. 0.05 0.16 2.00 3.09 3.15 5.85 3.06 12.0 18.5 East 59794 .. 0.10 0.10 .. .. .. .. .. 0.03 .. 0.08 .. .. 0.32 3.26 5.25 5.65 5.92 3.92 15.5 25.5 North 59541 .. 0.13 0.03 .. .. .. .. .. .. .. 0.02 .. 0.05 0.23 2.03 3.33 3.71 5.49 3.88 13.1 23.9 St. Pancras 237178 .. 0.07 0.08 .. .. 0.02 .. .. 0.02 o.oo 0.03 .. 0.04 0.26 2.45 3.90 4.22 5.82 37.4 13.8 22.7 London 4872702 0.04 0.09 .. 0.04 .. .. .. .. .. .. .. .. 2.4 .. .. .. .. 12.7 23.6 Tabi.e 11a. Inspections durtng DUTIES AND PREMISES. n. i. Highgate. n. 2. St. John's 1 ark. N. 3. Gospel () k. N. 4. Grafton. N. 5. Maitland Park E. 1. Baitholomew. Infectious DinEases—Inquiry, removal, disinfection, etc. 50 83 72 82 98 81 „ ,, Sanitaiy inspection after, etc. 51 48 54 5 82 79 Complaints 40 95 84 83 91 102 Drainage—Under notice. Plans, supervision, etc. 12 28 26 17 20 16 ,, Voluntary do. do. 29 16 17 23 11 44 ,, New Buildings do. do. 3 3 .. 1 .. 4 (Weekly) Yards of Mews and Stables (170 on List) 294 225 17 181 245 211 House-to-Housf. Inspections 529 . .. 1 .. .. te.nement Streets—Inquiries as to occupation of houses 16 .. .. .. .. .. „ ,, Mensuration for legistration .. .. .. 1 .. .. ,, ,, ,, ,, Inscription .. .. .. .. .. .. Period'cai Inspections— ' (Half-yearly) Registered tenement houses (2282 Registered) 537 43 158 64 78 3 Dwelling lares. „ Inscribed Dwelling houses (339 Inscribed) .. .. .. .. .. .. (Quarterly) Closed underground dwellings (4 71 on Register) .. .. .. .. .. .. ,, Commonlodgingnouses[L.C.C.] (19 Registered) .. .. .. .. .. .. (Weekly) Canal boat dwellings [Wharves] (31 on Register) .. .. .. .. .. .. Work Placcs [W] (Half-yearly) Day Schools [W] (40 ,, ) .. .. .. .. .. .. ,, Factories [W] (107 ,, ) .. .. .. .. .. .. ,, Workshops [W] (404 ,, ) .. .. .. .. .. .. ,, Workplaces [W] .. .. .. .. .. .. ,, Domestic Workshops [W] (71 ,, ) .. .. .. .. .. .. ,, Home Work Places [W] (273 ,, ) .. .. .. .. .. .. „ Laundries [W] (74 ,, ) .. .. .. .. .. .. ,, Restaurant Kitchens [W] (158 ,, ) .. .. 1 .. .. .. 198 199 the Yrar 1910. E. 2. Camden Square. E. 3. College. E. 4. Oakley quare. E. 5. Ossulstoii. W.. 1. Castle. w. 2. Chalk Farm. vv . 3. Morni gton. w. 4. Regent's ark. w . 5. Euston. S. 1. Argvle. S. 2. Mecklen burgh. S. 3. Burton. S. 4. Endsleigh. 5' Whitfield. ??? Work Place. Women. Totals. E. 3 & 4. N. & E. I, 2. & 5. W. & S. M. E. B. C. S. & visitors 39 94 16 75 145 31 76 90 88 69 50 9 36 34 .. .. .. .. .. 1432 38 81 36 51 130 24 71 94 83 32 29 18 32 20 .. .. .. .. .. 1118 59 191 188 261 132 153 198 191 '139 145 151 100 29 150 1 1 .. 6 .. 2710 18 18 10 17 32 11 27 35 27 .. 1 3 8 14 .. .. .. .. .. 390 27 38 I 2 35 49 58 36 41 52 17 15 41 15 31 .. .. .. .. .. 610 .. 5 2 1 2 6 1 2 3 1 3 16 .. .. .. .. .. .. .. 53 152 29 76 66 139 232 24 478 54 101 462 21 76 422 .. .. .. .. .. 5627 •• .. 14 65 5 4 .. .. 6 •• 3 .. 3 .. .. .. .. .. .. 430 .. .. .. 11 .. .. .. .. 17 112 22 .. 17 .. .. .. .. .. .. 225 .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. 8 9 .. .. .. .. .. .. .. .. .. .. .. 17 .. 16 357 no 37 9 22 8 177 98 84 365 218 316 .. .. .. .. .. 2700 .. .. .. 170 .. .. .. .. 1 26 6 66 .. 12 .. .. .. .. .. 281 .. .. .. 29 •• 2 •• •• 1 19 6 .. .. 59 .. .. .. .. .. 116 .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 6l .. .. 61 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 17 .. 17 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 16 .. 16 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 19 .. 19 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 3 .. 3 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 13 .. 13 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 10 .. 10 200 Inspections during DUTIES AND PREMISES. N. 1. Highgate. No. 2. St. "John's Park. No. 3. Gospel ak. no. 4. Graf'on. no. 5. Maitland Park. E. 1. olomew. Work Places [M]. (Half-yearly) Factories [M] (413 011 Register) .. .. 3 10 .. .. „ Workshops [M] (128 „) 1 1 .. 4 .. 2 ,, Work Places [M] 6 .. .. 3 2 7 ,, Bakehouses [M] (133 ,, ) 15 23 28 16 20 .. ,, Restaurant Kitchens [M] (163 ,, .. .. .. 3 1 .. (Weekly) Smoke Shafts [M] (334 on Register) .. 5 17 61 1 .. Food PI ices. (Fortnightly) Cowsheds (7 Licensed) .. .. .. .. .. .. ,, Dairies (413 Registered) .. .. .. .. .. .. (Quarterly) Milkshops .. .. .. .. .. .. ,, Ice Cream Premises (491 on List ) .. .. .. .. .. .. (Weekly) Slaughterhouses (17 Licensed ) .. .. .. .. .. .. Food Makers' Premises* (204 on List ) .. .. .. .. 1 .. (Alternate Daily) Marketing Places (39 „ ) .. .. .. 3 1 .. Unfit Food—Seizure, condemnation, destruction, etc. .. .. .. .. .. .. Adulterated Food—jamples, transit, etc. .. .. .. •• •• .. Special Places. (Quarterly) Effluvia Businesses [M] (14 on Register) .. .. .. .. 3 .. ,, Fried Fish Shops (85 ,, ) .. .. 11 13 23 .. ,, Rag and Bone Stores (34 ,,) .. •• 12 13 3 .. „ Offensive Trades [M] (2 sanctioned) .. .. .. .. .. .. Railway Nuisances .. .. .. .. .. .. Legal Proceedings : (1) Services of Notices .. 1 .. 1 .. .. ,, (2) Applications and Summonses 1 1 •• .. 3 .. >( ,, (3) Hearings and Adjournments 3 1 •• .. 1 .. Other Duties not included in above 43 65 88 72 76 49 Totale 144 645 753 717 7(0 608 * Where Tripe, Sausages, Extract cf Meat, etc., are prepared. 201 the Year 1910—con. £. 2. Cam len Square. E. 3. College. E. 4. Oakley Square. E. 5. Ossulston. W. 1. Castle. W. 2. Chalk Farm. W. 3. Morning'ton. W. 4. .<eeent's Park. W. 5. Euston. S. 1. Argyle. S. 2. Merklenburgh. S. 3. Burton. S. 4. Fndsleigh. S. 5. Whitfield. Food Places Work places. Women. Totals. E. 3 & 4. W. & E. 1, 2, & 5. w. & s w. E. B. C. S. &visitors .. .. 1 .. 5 3 .. 1 5 .. .. .. .. 41 .. .. .. .. .. 69 1 8 3 6 1 .. 2 4 31 6 25 35 43 368 .. .. .. .. .. 541 .. .. 1 .. .. .. .. .. .. .. .. .. 1 1 .. .. .. .. .. 21 7 23 15 29 27 16 22 23 22 17 2 6 20 21 .. .. .. .. .. 378 .. .. 1 .. 1 .. 5 3 21 9 19 .. 20 105 .. .. .. .. .. 188 .. 3 .. 186 1 .. 32 10 225 .. 13 4 56 .. .. .. .. .. .. 614 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 21 49 47 .. .. 117 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 160 551 514 .. .. 1225 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 37 185 118 .. .. 340 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 108 222 273 .. .. 603 1 4 4 4 7 5 1 4 1 .. .. .. .. .. 52 321 418 .. .. 824 1 .. .. 66 5 4 14 .. 6 .. 64 9 51 47 788 1826 2083 .. .. 4991 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 9 32 26 .. .. 67 .. .. .. .. .. .. .. .. .. .. .. .. .. .. 100 331 325 .. .. 756 .. .. 1 .. 1 .. .. .. .. .. .. .. 2 .. .. .. .. .. .. 7 2 .. .. 9 10 6 .. .. 9 8 6 1 11 6 14 .. .. .. .. 137 1 .. 2 2 3 3 .. .. 3 .. .. 2 1 .. .. .. .. .. .. 45 .. .. .. .. .. .. .. .. .. .. .. .. 9 11 .. .. .. .. .. 20 .. .. 7 3 3 .. .. .. 6 .. 1 .. .. .. .. .. .. .. .. 23 .. •• 1 .. .. .. .. .. .. .. 5 .. 1 .. 1 23 9 .. .. 45 .. 3 4 .. .. .. .. .. .. 1 4 1 4 .. 4 26 15 .. .. 67 13 59 28 90 84 98 112 100 92 53 43 133 61 67 .. 91 53 1475 210 5454 359 844 829 1686 819 668 952 1095 1369 715 1035 1183 1295 1715 1295 3663 3912 157 2404 32384 202 Table 11 b. Re-Inspections after Intimations during DUTIKS AND PREMISES. N. 1. Highgate. N. 2. St. John's Park. N. J. Gospel Oak. M. 4. Hrafton. 5. Maitland Park.] E. 1. Bartholomew. Infectious Diseases—Inquiry, removal, disinfection, ctc. 9 6 16 47 55 1 ,, ,, Sanitary inspection after, etc. .. 41 72 120 127 20 Complaints 340 218 272 221 310 115 Drainage—Under notice, flans, Supervision, etc. 269 406 376 316 263 86 „ Voluntary do. do. 271 204 142 92 147 278 ,, New Buildings do. do. 113 175 5 9 .. 60 (Weekly) Yards of Mews and Stables (170 on List) 1 2 .. 1 11 .. House-to-House Inspections 171 .. .. .. 35 .. Tenement Streets—Inquiries as to occupation of houses .. .. .. .. .. .. ,, ,, Mensuration for registration .. .. .. 1 .. .. ,, ,, ,, ,, Inscription .. .. .. .. .. .. Periodical Inspections— .. .. .. .. .. .. Dwelling Places Hall-yearly) Registered tenement houses (2282 Registered) 565 37 283 506 216 .. ,, Inscribed dwelling houses (339 Inscribed) .. .. .. .. .. .. (Quarterly) Closed underground 471 on Register dwellings .. .. .. .. .. .. ,, Common lodging houses [L.C.C.] (19 Registered) .. .. .. .. .. .. (weekly) Canal boat dwellings [Wharves] (51on Register) .. .. .. .. .. .. Work Places [W]. Half-yearly) Day Schools [W] (40 „ ) .. .. .. .. .. .. ,, Factories [W] (107 ,, ) .. .. .. .. .. .. ,, workshops [W] (404,, ) .. .. .. .. .. .. „ Workplaces [W] .. .. .. .. .. .. ,, Domestic Workshops [W] (71 ,, ) .. .. .. .. .. .. Home Work Places [W] (273 ,, ) .. .. .. .. .. .. ,, Laundries [W] (74 ,, ) .. .. .. .. .. .. „ Restaurant Kitchens [W] (158 ,, ) .. .. .. .. .. .. •203 the Year 1910. E. 2. Camden Square. K.3. College. E. 4. Oakley Square E.5. Ossulstor.. W. 1. Castle. W. 2. Chalk Farm. W. 3. Mo/nington. W. 4. Regent's Park. W. 5. Euston. S. 1. Argvle S. 2. Me. klenburgh. S. 3. Burton, S. 4. E. d sleigh. S. 5. Whitfield. food places. Work Places. W omen. Totals. E. 3 & 4. N. & E. 2. 5. W. & S. M.E. B. C . S. & Visitors .. .. 15 22 15 2 19 28 46 7 2 17 16 14 .. .. .. .. .. 337 9 21 35 92 99 12 101 195 106 1 3 43 27 18 .. .. .. .. .. 1242 77 232 266 693 448 362 192 291 648 375 384 327 289 262 .. .. .. .. .. 6322 180 278 65 137 84 242 201 251 372 94 187 133 368 129 .. .. .. .. .. 5437 203 231 82 232 61 87 2 22 245 411 95 44 743 525 298 .. .. .. .. .. 5613 2 113 5 148 53 97 4 15 453 37 34 305 195 43 .. .. .. .. .. 1866 .. .. .. .. .. 1 1 .. .. .. .. .. 36 .. .. .. .. .. .. 53 .. .. 10 .. .. .. .. .. 6 .. .. .. .. .. .. .. .. .. .. 222 .. .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. 3 .. .. .. .. .. .. .. 3 7 .. 738 624 60 35 12 15 519 188 220 1034 512 528 .. .. .. .. •• 5899 .. .. .. 415 .. .. .. .. .. 83 1 102 .. 5 .. .. .. .. .. 608 .. .. .. .. .. .. .. .. 1 .. .. 37 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 4 .. 4 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 204 Re-Insptctions after Intimations during DUTIES AND PREMISES. N. 1. Highgate. N. 2. St. John's Park. N. 3. Gospel Oak. N. 4. Grafton. . 5- Maitl-md Park. E. 1. Bartholomew. Work Places [M] (Half-yearly) Factories [M] (413 on Register) .. 1 4 6 .. .. ,, Workshops [M] (1238 ,,) .. .. .. 10 .. 1 ,, Workplaces [M] .. .. .. 5 3 .. ,, Bakehouses [M] (133 ,, ) .. 14 7 14 15 2 ,, Restaurant Kitchens [M] (163 ,, ) ( .. .. .. 3 4 .. ( Weekly) Smoke Shafts [M] (334 on Register) .. .. 2 1 .. .. Food Places. (Fortnightly) Cowsheds (7 Licensed) .. .. .. .. .. .. ,, Dairies (413 Registered ) .. .. .. .. .. .. (Quarterly) Milkshops ) .. .. .. .. .. .. ,, Ice Cream Premises (491 on List) .. .. .. .. .. .. (Weekly) Slaughter-houses (17 Licensed) .. .. .. .. .. .. ,, Food Makers' Premises* (204 on List) .. .. .. .. .. 1 (Alternate Daily) Marketing Places (39 on "List) .. .. .. .. .. .. Unfit Food: seizure, condemnation, destruction, etc. .. .. .. .. .. .. Adulterated Food: samples, transit, etc. .. .. .. .. .. .. Special Places. (Quarterly) Effluvia Businesses [M] (14 on Register) .. .. .. .. .. .. ,, Fried Fish Shops (85 ,, ) .. 1 8 6 13 2 „ Rag and Bone Stores (34 ,, ) .. .. 4 6 2 .. ,, Offensive Trades [M] (2 sanctioned ) .. .. .. .. .. .. Railway Nuisances .. .. .. .. .. .. Legal Proceedings : (1) Services of Noticcs .. .. .. .. .. .. ,, ,, (2) Applications and Summonses .. .. .. .. .. .. ,, ,, (3) Hearings and Adjournments .. .. .. .. .. 1 .. Other Duties not included in above .. .. .. .. .. .. Totai.s 1739 1105 1191 1124 1203 66 * Where Tripe, Sausages, Extract of Meat, &c., are prepared. the Year 1910—con. E. 2 Camden Square. E. 3. College. E.. 4. Oalclev Square. E. 5. Ossulston. W. 1. Cattle. W. 2. Chalk Farm. W. 3. Morninyton W. 4. Regent's Park. W. 5. F.uston. S. 1. Argvle. S. 2. Mecklenburgh. s. 3. Burton. S. 4. Endsleigh. S. 5. Whit Held. hood Places. Work Places. Women. TOTALS. E. 3 & 4. N. & E. I 1. 2.5. \V. & S. M.E. B. G. S. & Visilois. .. .. .. .. .. .. .. .. 5 .. .. 1 .. .. .. .. .. .. .. 18 .. .. .. 4 7 .. 2 2 77 .. 3 35 3 53 .. .. .. .. .. 197 .. .. .. .. .. .. .. .. 4 .. .. 3 .. 1 .. .. .. .. .. 1 6 1 1 13 40 6 4 6 .. 27 15 27 26 .. 55 .. .. .. .. .. 273 .. .. .. 2 .. .. .. .. 38 .. .. 2 .. 83 .. .. .. .. .. 132 .. .. .. .. .. .. 1 1 5 .. .. 163 .. .. .. .. .. .. .. 173 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 1 5 •• 10 7 .. .. 4 .. .. .. .. .. .. .. .. .. .. 29 .. .. .. .. .. .. .. .. .. .. .. 2 .. .. .. .. .. .. .. 2 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. 5 .. .. 3 .. .. .. .. .. .. .. 39 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. 13 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. •• .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. 53 .. .. .. .. .. 57 480 877 1434 240 1644 1250 761 1043 2732 997 1205 2982 19.1 1550 .. .. .. 5 .. 28608 205 206 Table 12a.—Intimations as to Nuisances served by the Sanitary Inspectors during the Year, 1910. A Schedule of Nuisances. Districts and Inspectors. Ward 1, N. G. R. Ward 2 (part W. L. B. Ward 2 (part of). B. H. T. Ward 3 (part of) . C. H. j. Ward 4. H. G. W. Ward 5. N. j. i. l. W ard 5. s. G. W. A. Ward 6 (part of . R. E. j. Ward 7, N. e. j. 1). Ward 7. s. j. l. Ward 8, N. A. H. W. Ward 8, s. e. G. h. Food places. Work Places. Women. Totals. W.G.A. Part of Wards 3 & 6. N. & E. H. H. C. w. & S. J. 0. m. e. B c. s. & Visitors. 1 Part of the house in a dirty condition ... 130 33 48 43 32 59 35 50 27 10 22 50 17 — — — — 556 2 ,, ,, damp ,, ... 13 8 7 6 10 6 1 2 3 4 8 7 — — 75 3 Roof defective ... 26 34 56 9 26 14 12 29 9 15 35 18 8 — — 291 4 Guttering defective ... 7 6 14 5 14 3 — 2 2 3 — 3 3 — — — — 62 5 Water fittings defective ... 34 8 52 3 29 4 10 10 1 8 7 — 26 — — — — 192 6 Water-closet apartment with absence of external ventilation ... 1 2 5 16 5 6 7 1 13 5 2 — 3 — — — — 66 7 ,, ,, so foul as to be a nuisance or dangerous to health ... — — 2 — — 4 8 1 2 11 1 — 1 — — — — 33 8 Water-closet basin foul ... 3 1 15 5 22 7 8 7 2 14 2 10 9 — — — — 105 9 ,, ,, defective ... 8 10 11 6 16 4 1 2 2 7 10 2 3 — — — — 82 10 ,, ,, choked ... 11 13 15 2 10 10 22 ii 6 5 9 15 23 — — — — 152 11 Urinal in a foul condition ... — 1 — 2 — — 10 1 — — — '— — 14 12 Privy in a foul condition ... — — — — — — — — 1 — — — — — — — 1 13 Soil pipe defective ... 7 3 — 6 5 1 6 1 9 5 6 4 — — — — 53 14 ,, unventilated ... 7 7 1 7 5 1 4 — 1 — 4 1 1 — 39 15 ,, improperly ventilated ... 2 2 1 — — 1 — — — — 1 — — — — — 7 16 Absence of waste pipe to sink, lavatory or bath ... — 1 — — 1 1 1 — — — — 2 6 17 Waste pipe of sink, lavatory, or bath connected with drain ... 2 1 — 5 3 1 2 — — 6 — 2 — — — — — 22 18 ,, ,, ,, ,, defective ... 15 10 5 11 5 1 10 — 1 1 1 5 1 — — — — 66 19 ,, ,, ,, ,, foul ... 4 3 — 7 4 2 4 1 — — 3 — — — — — — 28 20 Inlet of drain in.properly trapped ... 2 1 1 8 4 3 1 — 4 — — — 1 — — — — 25 21 Drain defective ... 17 27 34 45 62 10 31 13 13 7 7 24 12 — — — 302 21 ,, stopped ... 12 7 9 13 24 18 13 17 10 2 3 8 6 — — — — 142 23 ,, ventilating pipe defective ... 4 1 5 — 10 8 4 1 — — — 1 — — — — — 34 24 Fain-water pipe in direct communication with drain ... 5 5 5 6 11 2 5 1 2 5 2 5 — — — — — 54 25 ,, ,, defective ... 8 9 22 2 12 3 11 1 4 2 2 10 6 — — — 92 26 Unpaved condition of roadway ... — — — — — — — — — — — — — — — — — — 27 Undrained ,, ,, ... — — — — — — — — — — — — — — — — — 28 Art a or part unpaved ... — — — — — — 6 — — — — — — — — — — 6 29 „ undrained ... — — — — — 1 — — — — — 1 — — — — — 2 30 Yard or space unpaved ... 2 1 — 2 — 1 3 — — — 1 — — — — — — 10 31 ,, ,, undrained ... 1 1 — 4 1 1 — — — — 1 — — — — — — 9 32 Defective condition of washhouse paving ... 7 7 5 — 5 10 14 6 1 — — 4 3 — j — — — 62 33 Dust-biu defective. ... 34 33 40 1 45 7 24 67 8 8 8 33 15 — 1 — — 323 34 ,, in an i.nproper position ... — — — — 1 — — — 1 2 — — 1 — — — 5 35 Accumulation of stagnant water which is a nuisance dangerous to health ... — 2 — 3 2 4 1 5 — 2 — 6 2 — — — 27 30 Accumulation or deposit which is a nuisance dangerous to health ... 6 5 8 10 21 18 46 13 1 26 9 16 29 — — — — 216 37 Animals kept in such a manner as to be a nuisance dansr?i ous to health ... — — 3 — 4 — 3 1 2 — 1 1 — — — — — 15 3888 Part of the house so overcrowded as to be dangero to health ... 3 5 6 3 8 1 27 7 — 5 1 2 1 — 69 39 Space below floor in basement or ground floor insufficiently ventilated ... 3 5 7 2 — — 1 — — — — 1 — _ — 19 40 Issuing of black smoke in such a quantity <s to be a nuisance ... — 1 — — 1 — — — 4 1 1 — — — — — — 8 41 Discharging smcke in such a mariner as to cause part of a building to be a nuiance dangerous to h- alth ... 3 1 1 1 — — — — — — — _ 6 42 Tent, van, shed, or similar structure used as a human habitation which is in such a state as to be injurious or dangerous to the health of the inmates ... — — — — 43 Other nuisances ... 34 4 3 19 27 8 36 15 8 3 11 7 2 — — — 177 Totals ... 408 259 332 249 430 219 258 265 142 171 158 239 173 — — — — 3453 207 Table 12b.—Intimations as to breaches of Statutes and Statutory By-laws served by the Sanitary Inspectors during the Year 1910. B Breaches of Statutes and Statutory By-laws. Districts and Inspector-. Ward , N. G. R. Ward 2 (part of). W L. R. Ward 2 (part of). B. H.T. Ward 3 (part ot). C. H. J. ward 4. H. G. W. Ward 5, N. J. I. L. Ward 5, S. G. W. A. Ward 6 (part of). R.E. J. Ward 7, N. E. J. D. Ward 7, S. J. L. Ward 8, N. A. H. W. Ward 8, S. E. G. H. Food Places. Work Places. Women. Totals. W. G. A. Part of Wards 3 & 6 N. & E. H. R. C W. & S. J. O. M. E. B. C. S. & Visitors. 1 An occupied house without a proper and sufficient supply of water 1 - 3 - 4 - 2 - 2 - - 3 - - - - - 15 2 Water supply used for domestic purposes connected with cistern which is used for flushing the water-closet - - 1 - 2 - - - - - - - - - - - - 3 3 Water-closet not supplied with a sufficient quantity of water for securing its effective action 25 30 1 20 2 16 16 9 13 7 9 7 22 - - - - 177 4 Tank, cistern, or other receptacle for storing of water used or likely to be used by man for drinking purposes—dirty condition of 2 5 10 5 6 3 12 1 - 1 1 3 1 - - - - 50 5 Tank, cistern, or other receptacle for storing water used or likely to be used by man for drinking purposes—absence of a proper cover to 3 1 6 2 4 1 13 1 - 2 - 1 1- - - - - 35 6 Tarnk, cistern, or other rece tacle for storing water used or likely to be used by man for drinking purposes placed in an improper osition 1 - 3 - - - - - - - - 1 - - - - - 5 7 Animals so kept as to be likely to pollute the water supply - - - - - - - - - - - - - - - - - - 8 Offensive matters not deposited in manure receptacle 1 - - - — - - - - - - - - - - - - 1 9 Manure not removed at proper intervals 1 - 3 - 2 - - - - - - — — — — — 6 10 Manure—absence of proper receptacle for 3 - 1 - 1 — - — — — — 2 1 — - - - 8 11 Manure receptacle not properly constructed - 1 2 - - - - - — - - - - - - — — 3 12 Sufficient drain to stables or cowshed—absence of a — — — — — — — — — — — 1 — — — — l 13 Receptacle for house refuse—absence of a proper 20 24 10 87 22 7 11 24 3 14 13 36 43 — — — 314 14 Receptacle for house refuse—absence of a proper cover for — 1 3 — 6 1 2 - — 4 — 1 - - - - - 18 15 Yard or open space unpaved 2 — — 1 — — — - — — — — — — — — 3 16 ,, paving defective 12 18 10 17 8 1 24 37 1 5 2 14 2 - - - - 151 17 Insufficient. water-closet accommodation to "lodging house" 3 10 10 3 7 7 1 2 1 3 2 4 4 — — — — 57 18 A furnace improperly constructed or negligently used 1 - - - - — - - - — — - - - - 1 19 Effluvia arising from premises used for trade, business, or manufacture which is a nuisance dangerous to the inhabitants of the district - - - - 1 - - - - 1 - - - - - - - 2 20 Offensive matters suffered to run out of trade premises into an uncovered place - - - - - - - - - - - - - - - - - - 21 Dairies and cowsheds—br ach of By-laws as to — - - — — — - - - - - - - - - - - - 22 Slaughterhouses—breach of By-laws as to - - - - - - - - - - - - 1 - - - - 1 23 Steam whistle-use of a, without authority - - - - - - - - - - - - - - - - - - 24 Parts of houses infested with vermin requiring stripping, purifying, and cleansing 8 — 14 6 30 5 17 32 5 6 21 1 44 — — — 189 25 Articles in an unwholesome condition requiring to be purified or destroyed 1 — — — — 2 — — - — — 4 — — — 7 26 Other breaches 3 5 2 4 4 11 8 2 18 1 4 4 3 — — — 69 Totals 87 95 79 145 99 54 106 108 43 44 52 78 126 - - - - 1116 208 Table 12c.—Intimations as to Breaches of By-laics and Breaches of Statutes served by the Sanitary Inspectors during ike Year 1910. c Registered Tenement Houses—Breaches of By-Laws. Districts and Inspectors. Ward 1, N. G. R. Ward 2 (part of). W. L. B. Ward 2 (part of). B. H. T. Ward 3 (part of). C. H. J. Ward 4. H. G. W. Ward 5, N. J. I. L. Ward 5, S, G. W. A. Ward 6 (part of). R. E. J. Ward 7. N. E. J. D. Ward 7, S. J. L. Ward 8, N. A. H. W. Ward 8, S. F. G. H. Food places. Work Places* Wom^n. Totals. . W. G. A. Part of Wards 3 & 6. N. & E. H. R. C. W. A. S. J. O. M. E B C. S. & Visitors. l Overcrowding ... _ 19 — — — 20 14 11 - 2 4 2 - _ - - 72 2 Inadequate water supply ... - — - - - - - - - - - - - - - - - 8 Contaminated water supply ... - - - - - - - - - - - - - - - - - - 4 Foul closet, basin or trap ... - 11 1 1 1 1 2 6 15 3 6 11 — — 58 5 Want of means of ventilation ... - - - - - - - - - - - - - - - - - - 6 Want of annual cleansing ... — — 3 — 1 — 1 — 118 — — - — — 123 7 Want of cleansing of the part or parts of premises used in common ... 33 40 1 7 11 36 51 79 33 93 54 84 — — 542 8 ,, „ „ in sole use ... 43 65 1 14 7 34 33 9 8 84 53 86 — — 437 y Want of cleansing of the room or part of the dwelling ... - — 1 — — 2 1 72 36 1 — — —- — — 113 10 Animals improperly kept ... — - - — — — 1 2 — — — — 1 — — — — 4 11 Other breaches ... - - — 1 — 12 2 1 — — 6 — — — — 25 Totals ... - 76 135 7 23 20 126 106 181 210 183 123 184 — - — — 1374 D Factories, Workshops and Work Places—Breaches of Statutes. Districts and Inspectors. Ward 1, N. G. R. Ward 2 (part of). W. L. B. Ward 2 ( part of. R. H. T. Ward 3 (part of). C. H. J. Ward 4. H. G. W. Ward 5, N. J. I. L. Ward 5, S. G. W. A. Ward 6 (part of). R. E. J. Ward 7, N. E. J. D. Ward 7, S. J. L. Ward 8, A. H. W. Word 8, S. E. G. H. Food places. Work Places. Women Totals. W. G. A. Part of Wards 3 & 6. N. & E. H. R. C. w. & s. J. O. M. E. B. C. S. & Visitors. 1 Want of cleanliness ... - 7 5 1 1 3 15 1 11 47 4 2 - - - 3 - 100 2 Want of ventilation ... 1 - - - - - - - - - - - - - - 3 — 5 3 Want of air space, overcrowding ... - - - - - - - - - - - - - - - 3 — 3 4 Sanitary accommodation, absent or insufficient ... 1 — 1 — — 1 — 1 - — — — — — 2 — 6 5 ,, ,, unsuitable or defective ... 1 — — — 2 5 — — — — '— — — 1 — 9 6 ,, ,, not separate for sexes ... 1 — — 1 1 1 - - - - - - - - - 3 — 7 7 Want of drainage of floors ... 1 1 - - - - - - - 1 - - - - - - 3 8 Other nuisances ... 1 1 — — — 6 — — 6 1 — — — — — — 15 9 Illegal occupation of underground backhouse ... - - - - - - - - - - - - - - - - - - 10 Branch of special sanitary requirement for bakehouses ... - - 13 3 5 3 - - - - - - 9 - - - - 33 11 Failure as regards list of outworkers ... - - - - - - - - - - - - - - - - - - 12 Giving out work to be done in premises which are unwholesome ... - - - - - - - - - - - - - - - - - - 13 ,, ,, ,, infected ... - - - - - - - - - - - - - - - - - - 14 Allowing wearing apparel to be made in premises infected by scarlet fever or small-pox ... - - - - - - - - - - - - - - - - - - 15 Other contraventions ... - - - - - - 1 - - - - - - - - - - 1 Totals ,, 3 10 21 5 7 10 27 3 11 53 6 2 9 - — 15 — 182 209 (B) REFERENCE LISTS. ST. PANCRAS, LONDON, 1910. List I. Buildings constructed in separate and more or less severed dwellings of less than five rooms, let at weekly rentals, and self-contained or associated as to appurtenances. l 2 3 4 5 6 7 8 9 10 11 12 Division and Sub-Division. Name and Situation, and Number of Houses. Name and Address of Owner. When Opened Total Number of Rooms. Dwellings of Total Number of Dwellings. Street Door or Gate, when shut, and by whom. Common Stair. Inter-Communication of Rooms in Dwellings. Is this Independent of the Common Stair? How many Dwellings use each appurtenance. Weekly Rental. Minimum and Maximum. Remarks. 1 Room. 2 Rooms. 3 Rooms. 4 Rooms. 5 or more. Outside or Inside. Open or Enclosed W.C. Scullery. Washhouse. N. 1 Somerset House, 31, Dartmouth Park Hill (1 house) Mrs. Osmond, 10, Falkland Road, Kentish Town 1876 31 .. .. .. 7 .. 8 Street door. Not locked Inside Enclosed Independent 1 1 1 7/- to 8/6 4 rooms. Scullery used for washing. N. 1 Churchill House, 11, Churchill Road (1 house) Mr. Atchley, 5, Wyndham Crescent 1881 32 .. .. .. 8 .. 8 Street door. Not locked at night Ditto Ditto Ditto 1 In kitchen 8/6 to 9/- 4 rooms. Sink and copper in kitchen. W.C. opens into kitchen. No resident caretaker. E. 1 Artizans' Dwellings, Great College Street and Rochester Place (8 houses) The Leasehold Investment Company, 37, Norfolk Street. Strand; R. Stone, Esq., Managing Director 1885 306 .. 99 36 .. .. 135 Street door. Closed at night by Superintendent Ditto Ditto Ditto 1 1 1 6/8 to 11/- Superintendent resides in one of the houses. Sculleries not included as rooms. E. 1 Clarence Buildings, Great College Street and Kentish Town Road (18 houses) Mr. Toye, at the Buildings 1886 501 .. 109 81 10 .. 200 Ditto Ditto Open at rear Ditto 1 1 1 7/6 to 13/- Ditto. E. 3 King House and Queen House, King Street (2 houses) Mr. Longland, Holly Lodge. Bounds Green Road, Wood 1892 48 • • .. 16 .. .. 16 Street door. Always on the latch Ditto Enclosed Ditto 1 1 1 9/6 to 11/6 No resident caretaker. Sculleries not included as rooms. E. 3 York House, King Street (1 house) Ditto 1895 32 .. .. .. 8 .. 8 Ditto Ditto Ditto Ditto 1 1 1 13/- Ditto. E. 3 Goldington Buildings (5 blocks) St. Pancras Boro' Council 1904 166 2 2 48 4 .. 56 Gate On latch by caretaker Ditto Open Ditto 1 1 1 5/to 15/- - 210 List I.—con. Buildings constructed in separate and severed dwellings.— confirmed. 1 2 3 4 5 6 7 8 9 10 11 12 Division and Sub-division. Name and Situation, and Number of House. Name and Address of Owner. When Opened. Total Number of Rooms. Dwellings of Total Number of Dwellings. Street Door or Gate, when shut, and by whom. Common Stair. Inter-Communication of Rooms in Dwellings. I8 this Independent of the Common Stair ? How many Dwellings use each appurtenance. Weekly Rental, Mininum and Maximum. Remarks. 1 Room 2 Rooms. 3 Rooms. 4 Rooms. 5 or more. Outside or Inside. Open or Enclos'd W.C. Scullery. Washhouse. E. 4 Pancras Square, Pancras Road (5 staircases. Balconies) Metropolitan Association of Industrial Dwellings; Ed. H. Merston, Esq., Sec.,Pancras square, N.W. 1847 285 .. 18 83 .. .. 101 Gate closed at night by Superintendent Outside .. Independent 1 1 All 5/6 to 9/6 Centre blocks have 1 w.c. to each tenement. At wings of block 1 w.c. to every two tenements. Superintendent resides in one of the buildings. E. 5 Ossulston Houses, Ossulston Street (4 houses) Hampden House, Ltd. 1884 210 .. .. 70 .. .. 70 Gates to staircases closed at night by tendent Inside Open Ditto 1 1 1 8/6 to 9/- Sculleries not included as rooms. Caretaker of Hampden House performs duties as to lighting, &c. E 5 Stanley Buildings, Pancras Road (5 staircases) Improved Industrial Dwellings Co., 37, Finsbury Square, E.C; Jas. Moore, Esq., Sec. 1865 244 .. 50 48 .. .. 98 Gates to stairs. Always open Outside .. Ditto 1 1 1 6/to 8/- Superintendent resides in one of the buildings. Sculleries not included as rooms. E. 5 Polygon Buildings. Clarendon Square (12 houses) Midland Railway Co. 1894 576 96 96 96 .. .. 288 Gates to courtyards always open. Doors to buildings closed at night by caretakers Inside Enclosed. Ditto 2 1 on each floor six dwellings All (on roof) 2/6 to 7/6 Two caretakers reside in one or other of buildings, one for each pair of blocks. Company's servants given preference. E. 5 166, Ossulston Street (1 staircase and balconies) Mrs. Wark, The Old Hall. Highgate 1880 24 .. 12 .. .. .. 12 No street door or gate Outside .. Not severed. Every two dwellings within one outer door and closed lobby 4 Tap and sink in kitchen All (on roof) 6/6 to 7/- Dwellings of two rooms, with one entrance from closed lobby common to 2 dwellings with 1 outer door opening on to outside stone staircase. No resident caretaker. 211 List I.—con. Buildings constructed in separate and severed dwellings—continued. 1 2 3 4 5 6 7 8 9 10 11 12 Division and Sub Division. Name and Situation, and Number of Houses. Name and Adress of Owner. When Opened. Total Number of Room. Dwellings of Total Number of Dwellings. Street Door or Gate, when shut, and by whom. Common Stair. Inter-Communication of Rooms in 1 'wellings. Is this Independent of the Common Stair? How many Dwellings use each appurtenance Weekly Rental, Minimum and Maximum. Remarks. 1 Rooms. 2 Rooms. 3 Rooms. 4 Rooms. 5 Rooms. Outside or Inside Open or Enclos'd w.c. Scullery. Washhouse. E. 5 Phœnix Buildings, Phœnix Street Hampden House, Ltd. 1901 28 .. 5 6 .. .. 11 Street door closed at night by tenants Inside Enclosed Independent 2 1 All 7/6 to 10/6 Caretaker from Hampden House performs duties as to lighting, &c. No dust shoots Galvanised tins in yard. E. 5 Wellesley Buildings, Seymour Street London County Council (Housing Department) 1901 180 .. 60 20 .. .. 80 Gates open all night. Outer door closed at 11 p.m. by caretaker Ditto Ditto Ditto 1 1 1 7/- to 10/6 Resident Caretaker at No. 23. No dust shoots. Galvanized tins in courtyard. E. 5 Seymour Buildings Ditto 1902 128 2 48 10 .. .. 60 No door, railings outside Ditto Ditto Ditto 1 1 1 4/6 to 9/- Caretaker resides at 23, Wellesley Buildings. No dust shoots. Galvanised tins in courtyard. E. 5 Somerset Buildings Ditto 1902 109 .. 16 19 5 .. 40 Ditto Ditto Ditto Ditto 1 1 1 7/6 to 11/- Ditto. E. 5 Culross Buildings, Battle Bridge Road (5 houses) Great Northern Railway Co. 1892 128 .. 16 .. 24 .. 40 No street door Outside .. Ditto 1 1 1 4/6 to 8/6 All Railway Company's men. Superintendent resides in one of the buildings. W. l 58, Crogsland Road Mr. Peacey, 114, Park Street, N.W. About 1878 8 .. 4 .. .. .. 4 Street door Inside Open at rear Ditto 1 1 1 5/to 6/- Two dwellings have each a scullery and washhouse and two have tap and sink in kitchen, and these two have w.c. opening into unventilated lobby of bedroom and kitchen. No caretaker. 212 List I. — con. Buildings constructed in separate and several dwellings —continued. 1 2 3 4 5 6 7 8 9 10 11 12 Remarks. Division and Sub-Division. Name and Situation, and Number of Houses. Name and Address of Owner. When Opened. Total Number of Rooms. Dwellings of Total Number of Dwellings. Street Door or Gate, when shut, and by whom. Common Stair. Inter-Communication of Rooms in Dwellings. Is this Independent of the Common Stair? How many Dwellings use each appurtenance Weekly Rental, Minimum and Maximum. 1 Room 2 Rooms. 3 Rooms. 4 Romms. 5 or moor Outside or Inside. Open or Enclos'd W.C. Scullery. Washhouse. W.3 Mornington Buildings, Mornington Road London and NorthWestern Railway Co. 1901 232 ... ... 8 52 ... 60 Street door. Closed by tenants Inside Enclosed Independent 1 1 1 9/9 to 11/9 — W.3 Stalbridge House, 231 and 233, Hampstead Road Ditto 1908 50 ... 10 10 ... ... 20 Ditto Ditto Ditto Ditto 1 1 1 9/6 to 13/- - W.5 Hampstead House, William Street (1 house) Mr. H. Hooke, 93. Hampstead Road 1897 35 ... ... 5 5 ... 10 Street door. Shut at night by caretaker Ditto Ditto Ditto 1 1 1 12/to 16/- Caretaker on premises. S.l Derby Buildings, Britannia Street and Wicklow Street (4 staircases) Improved Industrial Dwellings Co., 33, Finsbury Square 1867 494 ... ... 70 71 ... 141 No street doors Outside Independent 1 1 1 5/9 to 9/- Notice up as to trespassers. Superintenden lives at No. 28. S.l Stanley House, St. Chad's Place (1 house) Mr. L. H. Ball, 1, Lower Charles Street, Clerkenwell 1889 32 ... 13 2 ... ... 15 Street door. Lock constantly broken by tenants Inside Enclosed Ditto 3 Tap and sink in kitchen All (one on each floor) 5/- to 7/- Scullery consists of a tap and sink in kitchen and living room. Caretaker resides in No. 2. S. 1 Garfield House, 5, Leeke Street (1 house) Messrs. Foster, 79. to 82, Fore Street 1887 16 ... 2 ... 3 ... 5 Street door. Closed by tenants Inside Enclosed Not severed. Every room opens on to landings of staircase All All All 3/6 to 6/6 A combined scullery and washhouse with a sink and copper on first floor. Three w.c.'s for general use on the second floor. No resident caretaker. S. 1 Whidborne Buildings, Whidborne Street (4 staircases) East End Dwellings Co., 24, Old Square, Lincoln's Inn; Superintendent, Midhope Buildings, Midhope Street. St Pancras 1892-3 254 55 56 29 ... ... 140 Street gate of courtyard always open Outside ... Independent 2 to 4 4 to 8 All 2/9 to 9/- Sculleriesconsist of sinks and taps on balconies. Wash houses in a separate building. 213 List I.—con. Buildings constructed in separate and severed dwellings—continued. 1 2 3 4 5 6 7 8 9 10 11 12 Division and Sub-Division. Name and Situation, and Number of Houses. Name and Address of Owner. When Opened. Total Number of Room Dwellings of Total Number of Dwellings. Street Door or Gate, when shut, and by whom. Common Stair. Inter-Communication of Rooms in Dwellings Is this Independent of the Common Stair? How many Dwelling's use each appurtenance. Weekly Rental Minimum and Maximum. Remarks. 1 Room. 2 Rooms, 3 Rooms. 4 Rooms. 5 Rooms. Outside or Inside. Open or Enclos'd W.C. Scullery. Washhouse. S. 1 Ferris House, Whidborne Street (1 house) East End Dwellings Co.; T. Wilkinson, Esq., Sec., 24, Old Sq., Lincoln's Inn 1892 8 ... 1 2 ... ... 8 Street door closed at night by tenants Inside Enclosed Not severed Every room opens on to landings of staircase 1 1 1 2/6 to 8/3 W.C., scullery, and washhouse, and each of 3 habitable rooms open separately on to landing of each floor. S. 1 Midhope Buildings, Midhope Street (4 staircases) Ditto 1892 235 25 105 ... ... ... 130 Street gate of courtyard always open Outside ... Independent 2 to 4 4 to 8 All 2/to 6/6/ and 12/- Sculleries consist of taps and sinks on balconies. Washhouse in a separate building. Superintendent of estate resides in these buildings. S. 1 Charlwood House, Midhope Street (1 staircase) Ditto 1893 82 ... 8 6 12 ... 26 Street gate of staircase lock'd at night by Assist. Superintendent Ditto Enclosed Ditto 1 1 1 7/6 to 8/6 Notice up as to trespassers. Sculleries not included as rooms. S, 1 Kellett House, Tankerton Street (1 staircase) Ditto 1893 68 ... ... 12 8 ... 20 Ditto Ditto Ditto Ditto 1 1 1 10/6 to 12/- Notice up as to trespassers. Sculleries not included as rooms. S. 1 Tankerton House, Tankerton Street (1 staircase) Ditto 1891 60 ... ... 20 ... ... 20 Ditto Ditto Ditto Ditto 1 1 1 7/to 8/- Notice up as to trespassers. S. 1 Loxham house, Loxham Street (1 staircase) Ditto 1891 30 ... ... 10 ... ... 10 Ditto Ditto Ditto Ditto 1 1 1 9/6 to 10/6 Notice up as to trespassers. 214 List I.—con. Buildings constructed in separate and severed dwellings—continued. 1 2 3 4 5 6 7 8 9 10 11 12 Division and Sub-Division. Name and Situation, and Number of Houses. Name and Address of Owner. When Opened. Total Number of Rooms. Dwellings of Total Number of Dwellings. Street Door or Gate, when shut, and by whom. Common Stair. Inter-Communication of Rooms in Dwellings. Is this Independent of the Common Stair? How many Dwellings use each appurtenance Weekly Rental, Minimum and Maximum. Remarks. 1 Room 2 Rooms. 3 Rooms. 4 Rooms. 5 or more. Outside or Inside. Open or Enclos'd W.C. Scullery. Washhouse. S. 1 Lucas House, Lucas Place (1 staircase) East End Dwellings Co., T. Wilkinson, Esq., Sec., 24, Old Sq., Lincoln's Inn 1892 24 .. 12 .. .. .. 12 Street gate closed by tenants Outside Enclosed Independent Each dwelling has an open forelobby 1 4 1 8/to 8/6 Each dwelling has an open space enclosed by a fence and gate in front of the outer door. S. 1 Cromer House, Cromer Street (1 staircase) Ditto 1892 64 .. 8 6 .. 5 sets of 6 rooms 19 Street gate closed by Assistant Superintendent Ditto Enclosed Independent 1 1 1 7/6 to 11/6 Dwellings constructed back to back. S. 1 5. 7, 9, and 11, Wicklow Street (4 houses) Miss Gee, 6, Longridge Road, Earl's Court, S.W. 1893 60 3 25 1 1 .. 30 Street doors always open or ajar Inside Enclosed door at rear opening on to balcony Ditto 2 1 Tap and hopper bead on each balcony 2 in basement 4/to 8/- Tower at rear, one half w.c. and one half balcony, with tap and gully. Back yard of each house used as a drying ground. Caretaker resides at No. 7. S. 2 Barham House, Handel Street Dairy Supply Co., 28 & 32, Museum Street, W.C. 1902 30 .. 6 6 .. .. 12 Street door closed at night Inside Enclosed Ditto 1 1 .. 7/- to 12/- Common washhouse on roof. S. 3 32, 34, and 36, Bidborough Street (Tonbridge House) Mr. Conway, 26, Blandford Road. Bedford Park, Chiswick 1900 33 .. .. 7 3 .. 10 Street door closed by tenants Ditto Enclosed Ditto 1 2 All 11/6 to 17/6 Caretaker resides on premises. 215 List I.—con. Buildings constructed in separate and severed dwellings—continued. 1 2 3 4 5 6 7 8 9 10 11 12 Division and Sub-Division. Name and Situation, and Number of Houses. Name and Address of Owner. When Opened. Total Number of Room. Dwellings of Total Number of Dwellings. Street Door or Gate, whan shut, and by whom. Common Stair. Inter-Communication of Rooms in wellings. Is this Independent of the Common Stair? How many Dwellings use each appurtenance. Weekly Rental, Minimum and maximum. Remarks. 1 Room. 2 Rooms. 3 Rooms. 4 Rooms. 5 or more. Outside or Inside. Open or Enclos'd W .C. Scullery. Washhouse. S. 3 Marchmont House, Marchmont Street Mr. T. Willis, 31, Leinster Terrace, W. 1891 12 .. .. .. 3 .. 3 Street door key for each tenant Ditto Ditto Ditto 1 1 .. 21/- - S. 3 Kenil worth House, Kenton Street Mr. A. Croker. 1, Kenilworth House 1903 35 .. .. 5 5 .. 10 Street door, key for each tenant Inside Enclosed Independent 1 1 .. 10/to 15/6 Washhouse and bathrooms in common. S. 3 Ivanhoe House, Kenton Street Ditto 1903 35 .. •• 5 5 .. 10 Ditto Ditto Ditto Ditto 1 1 .. Do. Ditto. S. 3 Waverley House, Nos. 1 to 10 Ditto 1906 40 .. .. .. 10 .. 10 Ditto Ditto Ditto Ditto 1 1 .. 17/6 to 23/- Scullery and washhouse combined. Rent from £46 to £60. paid some cases monthly and quarterly and weekly. S. 3 Waverley House, Nos. 11 to 20 Ditto 1906 40 .. .. .. 10 .. 10 Ditto Ditto Ditto Ditto 1 1 .. Do S. 3 Robsart House, Nos. 1 to 10 Ditto 1907 40 .. .. .. 10 .. 10 Ditto Ditto Ditto Ditto 1 1 .. Do. S. 3 Robsart House, Nos. 11 to 20 Ditto 1907 40 .. .. .. 10 .. 10 Ditto Ditto Ditto Ditto 1 1 .. Do. S. 3 Aberdeen House, Nos. 1 to 10 Ditto 1909 40 .. .. .. 10 .. 10 Ditto Ditto Ditto Ditto 1 1 .. .. S. 3 Aberdeen House, Nos. l1 to 20 Ditto 1909 40 .. .. .. 10 .. 10 Ditto Ditto Ditto Ditto 1 1 .. .. S. 3 Tonbridge House, Ton bridge Street East End Dwellings Co., Ltd., T. Wilkinson, Esq., Sec., 24, Old Square, Lincoln's Inn 1904 245 .. .. 73 5 1 79 No gate Ditto Open Ditto 1 1 .. 11/to 13/6 There is one washhouse on each landing. 216 List I . — con. Buildings constructed in separate and severed dwellings— continued. 1 2 3 4 5 6 7 8 9 10 11 12 Division and Sub-Division. Name and Situation, and Number of Houses. Name and Address of Owner. When Opened. total Number of Rooms. Dwellings of Total Number of Dwellings. Street Door or Gate, when shut, and by whom. Common Stair. Inter-Communication of Rooms in Dwellings. Is this Independent of the Common Stair? How many Dwellings use each appurtenance. Weekly Rental, Minimum and Maximum. Remarks. 1 Room 2 Rooms. 3 Rooms. 4 Rooms. 5 or more. Outside or Inside. Open or Enclos'd W.C. Scullery. Washhouse. S. 3 Thanet Houses. Nos. 1 to 24 London Housing Society, Ltd., 49. Euston Road 1910 48 3 18 3 .. .. 24 Street door key for each tenant Inside Enclosed Independent 1 1 .. 5/6 to 12/6 - S. 3 Thanet Houses, Nos. 25 to 42 Ditto 1910 48 .. 6 12 .. .. 18 ditto Ditto Ditto Ditto 1 1 .. 5 to 12/6 — S.3 Sandwich Houses, Nos. 1 to 18 Ditto 1910 48 .. 6 12 .. .. 18 ditto Ditto Ditto Ditto 1 1 .. 6/6 to 11/9 - S. 3 Somerset Terrace, Duke's Road (1 staircase) Francis House, Esq., 3, Abchurch Yard, E.C. 1889 67 .. 12 9 4 .. 25 Street doors closed at night Outside .. Independent 1 1 All (on roof) 10/- to 21/- Washhouse locked; ery tenant has key on application to care- taker. Staircases, glazed tiles. No dust shoots; dust pails kept under sinks and ral portable bins in yard. Caretaker dent in one of the buildings. S. 3 Endsleigh Terrace, Duke's Road (2 staircases Ditto 1889 60 .. .. 20 .. .. 20 Ditto Inside En- closed Ditto 1 1 Do. 10/- to 13/- S. 3 Flaxman Terrace, Cartwright Gardens St. Pancras Borough Council 1908 216 .. 36 48 .. .. 84 Street door closed by tenants Ditto Ditto Ditto 1 1 1 6/to 12/6 — S. 3 Hastings Houses, Hastings Street East End Dwellings Co., 24, Old Square, Lincoln's Inn 1909 172 2 36 26 5 .. 69 .. Ditto Ditto Ditto 1 1 1 5/to 11/9 - 217 List I.—con. Buildings constructed in separate and severed dwellings—continued. 1 2 3 4 5 6 7 8 9 10 11 12 Division and Sub-Division. Name and Situation, and Number of Houses. Name and Address of Owner. When Opened. Total Number of Rooms. Dwellings of Total Number of Dwellings. Street Door or Gate, when shut, and by whom. Common Stair. Inter-Communication of Rooms in Dwellings, Is this Independent of the Common Stair? How many Dwellings use each appurtenance. Weekly Rental, Minimum and Maximum. Remarks. 1 Room. 2 Rooms. 3 Rooms. 4 Rooms. 5 or more. Outside or Inside. Open or Enclos'd W.C. Scullery. Washhouse. S.5 Percy Buildings, Whitfield Street (1 house) 11. Perkins, Esq., 2, Cambridge Place, Regent's Park 1883 22 1 11 .. .. .. 12 Street door generally closed at night by one of the tenants Ditto Ditto Ditto 4 .. All (on roof ) 7/to 9/- W.C.; a tap and sink in room. No resident caretaker. S. 5 10, Tottenham Street Mr. Nodes, 12, Tottenham Street 1892 23 .. 1 7 .. .. 8 Street door closed by caretaker Ditto Ditto Ditto 3 .. All 6/to 12/6 Caretaker resident in one of the dwellings. Tap and sink on each landing. S. 5 12, Tottenham Street Ditto 1892 24 2 2 6 .. .. 10 Ditto Ditto Ditto Ditto 3 3 All 5/ to 14/ Ditto. 218 List II. ST. PANCRAS, LONDON. REGISTERED COMMON LODGING HOUSES. Situation. Authorised Number of Lodgers. Accommodation. Notes. Males. Females. Married couples (persons). North Division. (4, Grafton) 15, Litcham Street 36 36 .. .. 10, ,, ,, 23 23 .. .. East Division. (2, Camden Square) 60, King's Road 38 .. 38 .. West Division. (1, Castle) 104, Harmood Street 35 35 .. .. South Division. (1, Argyle) 30, Argyle Square (entrance North Place) .. 80 .. .. Salvation Army Home. 322, Gray's Inn Road 66 66 .. .. (4, Endsleigh) 1 to 8, Whitfield Place 280 280 .. .. (5, Whitfield) Bennett Chambers, 9, Charlotte Place 77 .. 77 .. Unlicensed. 27, 28-29, Percy Street 210 210 .. .. 219 LICENSED COWHOUSES. Registered No. Situation of Licensed Premises. Name of Licensee. Registered amount of breathing space in cubic feet. No. of Cows Licensed for. North Division. 2993 12, South Grove Charles Edward Davies and Alfred Joseph Marriot 16,065 25 7204 8, Bassett Street Jane Watkin 14,469 24 3024 Fitzroy Farm Thomas Ward 8,795 14 East Division. 1582 51, Bayham Street John Morgan and John Evans 20,160 28 West Division. 2671 96, Little Albany Street John Josh. Newman Nichols 24,491 38 549 50, William Street David James 12,267 19 Douth Division. 13129 28, Hastings Street John Edwards 8,839 13 220 List IV. ST. PANCRAS. LONDON. LICENSED SLAUGHTER-HOUSES. Registered No. Situation. Name of Licensee. Remarks. North Division. 223 61, High Street, Highgate George Attkins Pigs only 231 317, Kentish Town Road George Fredk. Kimber 224 89, Leighton Road Lidstone, Ltd. East Division. 252 12, Crowndale Road George Samuel Barrett Small Cattle only 304B 114, Great College Street Salvanus Webber 304A 206 & 208, Kentish Town Road Charles Matthew Knight 249 166, Great College Street Sylvanus Webber West Division. 242 10, Chalk Farm Road Walter Whitlam 267 11, Hampstead Road Tompkins Bros., Ltd. 266 157, High Street (adjoining) Lidstone, Ltd. 240 67, Kentish Town Road Henry Hooke & Sons Small Cattle only 273 65, Osnaburgh Street Percv William Bragg 262 75, Park Street Lidstone, Ltd Large Cattle to be received before 8 a m. 239 3, Prince of Wales Crescent Henry Eaton Goldfinch Small Cattle only 240 10, William Street Fredk. James Hooke 260 10, Delancey Street (yard in) Robert Joyce South Division. 296 10, Charlotte Mews Walker Bros. 303 147, King's Cross Road Thomas Griffiths Small Cattle only 221 List V. 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 Wellington Street North Division. Maiden Road Queen's Crescent Kentish Town Road (part of) Fortess Road Highgate Road South Division. Little Goodge Street Charlotte Street Tottenham Court Road King's Cross Road Gray's Inn Road Cromer Street Judd Street Leigh Street Compton Street Marchmont Street Cleveland Street 222 List VI. SATNT PANCRAS, LONDON. BAKEHOUSES, end of 1910. No. on Diagram. Consecutive No Situations. Divisions, and Sub-Divisions. Name of Occupier. Distance of floor above or below ground level. Distance of ceiling above or below ground level. Underground Baking Rooms—U. Baked B—Bread. C—Confectionery b—Biscuits. As to Certificate and date when granted or refused, and other notes. NORTH DIVISION. 1.—Highgate. 14 1 134, Fortess Road Karl Bass Level 8ft. 2in. above . . B. C. 9 2 49, Leverton Street E. G. Moir & Son Level 8ft. 6in. ,, . . P. C. 16 3 60, Chetwvnd Road R. M. Boswell Level 8ft. . . B. C. 92 4 121, Dartmouth Park Hill John Leister 7ft. 6in. below Level U. B. Certificate granted 21st Sept., 1904. 58 5 151, E.W.Russell 6ft. 6in. „ Level U. B. Do. 5th April, 1905. 83 6 9, Retcar Street 7ft. 3in. ,, 6ft. below .. U. B. Do. 23rd Nov., 1904 13 7 4, South Grove Horseley & Son One level 8ft. 3in. above . . B. C. (closed). 164 7a ,, ,, ,, One 8ft. 6in. below 10 in. below U. B. C. Do. 1st June, 1904. 88 8 37, York Rise John A. Skinner 7ft. 6in. below 1ft. l in. above U. B. Do. 23rd Nov., 1904. 2.—St. John's Park. 126 9 99, Brecknock Road A. Sconce 8ft. below Level U. B. C. Do. do. 145 10 68, Falkland Road I. J. L Sparke 8ft 6in. below .. U. B. C. Do. 27th July, 1904. 125 11 47, Fortess Road Carl Werner 8ft. 6in. below Level U. B. C. Do. 5th April, 1905. 36 12 7, Willow Walk F Lister One 6ft. 2ft. 3in. above U. B. C. Certificate refused 13th July, 1904. 50 12 a 11, Fortess Road „ One 2ft. 5ft. 3in. „ . . 3.—Gospel Oak. 94 13 101, Allcroft Road Anton Bleser 7ft. 6in. below Level U. B. C. Certificate granted 13th July, 1904. 22 14 108, Carlton Street Feter Schneider Level 7ft. 6in. above . . B. 21 15 55, Haverstock Road Leopold Orth Level 7ft. 6in. ,, . . B. 23 16 63, Highgate Road J. Davidson Level 7ft. 6in. „ . . B. C. 51 17 141 Francis Paterson 6ft. below 1ft. 6in. ,, U. B. C. Do. 23rd Nov., 1904. 27 18 2, Lanible Street Level 7ft. 2in. ,, . . B. Not in use. 6 19 10, Lismore Circus Level 9ft. 6in. ,, . . B. C. 8 20 66, Mansfield Road Joachim Peter Level 9ft. ,, . . B. C. 162 21 163, Queen's Crescent Richard Filby & Son 8ft. 6in. below 6in. below .. U. B. C. Certificate granted 2nd Nov., 1904 55 22 167, A. Dahms 6ft. 6 in. ,, 1ft. 6in. above U. B. C. Do. do. 110 23 37, Wellesley Road 7ft. 6 in. ,, 6in. below .. U. B. Do. 23rd Nov., 1904. (Not used for baking.) •223 List VI—con. BAKEHOUSES - continued. No. on Diagram. Consecutive No. Situations. Divisions, and Sub-Divisions. Name of Occupier. Distance of floor above or below ground level. Distance of ceiling above or below ground level. Underground Baking Rooms—U. Baked B—Bread. C—Confectionery b—Biscuits. As to Certificate and date when granted or refused, and other notes. North Division—con. 1 4.—Grafton. 17 24 160, Weedington Road F. Hook Level 8ft. above . . B. C. 20 25 10, Dalby Street H. Brooker Level 7ft. 6in. above . . B. C. 35 26 46, Grafton Road A. Portwood 2ft. below .. 5ft. 6in. „ . . B. 93 27 265, Kentish Town Road Rose Konig 7ft. 6in. below Level ,, U. B. C. Certificate granted 13th July, 1904. 10 28 321, James B. Storey Level 8ft. Oin. above . . B. C. 15 29 385, A. Zwanziger Level 8ft. 2in. „ . . B. C. Do. 2nd Nov., 1904. 49 30 13, Warden Road Ernest Boger 5ft. 6in. below 1ft. 4in. ,, U. B. 48 31 70, Weedington Road Harriet Crawley 6ft. Oin. 2ft. 2in. ,, U. B. Do. 27th July, 1904. 5.—Maitland Park. 39 32 29, Maiden Road Christopher Vogel 2ft. 9in. below 4ft. 9in. above . . B. 175 33 53, ,, Lutz Bros. 8ft. 6in. ,, 1ft. Sin. below U. B. C. Certificate granted 27th July, 1904. 112 34 110. ,, N. Liell 7ft. 6in. „ 9in. „ U. B. C. Do. 2nd Nov., 1904. 155 35 143. ,, F. Franz 8ft. 6in. ,, Level U. B. Do. 13th July, 1904. 38 36 160, Prince of Wales Road Ahrendt Bros. 2ft. 6in. ,, 5ft. above . . B. C. 146 37 72, Queen's Crescent K. Menten 8ft. ,, 6in. below U. B. C. Do. 12th Oct., 1904. 66 38 69, Weedington Road John Sondenheimer 7ft. ,, Level U. B. Do. do. WEST DIVISION. 1.—Castle. 53 39 54, Castle Road M. Aurbun 6ft. 5in. below Level U. B. Certificate granted 5th April, 1905. 172 40 19, Chalk Farm Road Chadney & Macdonald 9ft. Level U. B. C. Do. 14th Dec., 1904. 118 41 48, J. K. Jung 7ft. 9in. ,, 3in. below .. U. B. C. Do. 22nd Feb., 1905. 25 42 76, . . . . . . . . Level 7ft. 6in. above . . B. C. Now a printers. 19 43 87, . . . . . . . . Level 7ft. lOin. „ . . B. Empty. 26 44 36. Harmood Street W. Riddle Level 7ft. 6in. . . B. C. 73 45 108, Letitia Strceton 7ft. below .. Level U. B. Certificate refused 1st Feb., 1905. Bakehouse now closed. 152 46 51, Hawley Road C. Veit 8ft. 3in. below Sin. below .. U. B. Certificate granted 22nd June, 1904. 105 47 81, Kentish Town Road.. C. Thorp 7ft. Bin. ,, Level U. B. C. Do. 21st Sept., 1904. 11 48 ! 143, . . . . . . . . . . . . . . . . Demolished. 133 49 151, H. Reiff 8ft. below Level U. B. C. Certificate granted 15th Mar., 1905. 106 50 22, Leybourne Road P. Schmidt 7ft. 6in. below Level U. B. Do. 11th Jan., 1905 86 51 63, Prince of Wales Crescent W. Bishop 7ft. 5in. „ Level U. B. Do. 27th July, 1904 . . ,, 7, ,, ,, Letitia Streeton Level 9ft. 9 in. above 224 List VI.—con. BAKEHOUSES—continued. No. on Diagram. Consecutive No. Situations, Divisions, and Rub-Divisions. Name of Occupier. Distance of floor above or below ground level. Distance of ceiling above or below ground level. Underground Baking Rooms—U. Baked B-Bread. C—Confectionery b—Biscuits. As to Certificate and date when granted or refused, and other notes. 1 West Division.—con. 2.—Chalk Farm. 62 52 211, High Street .. .. .. .. 7ft. below 3ft. 6in. above U. B. Certificate granted 27th July, 1904. (Now demolished). 54 53 237 E. Petzold 6ft. 6in. below 2ft. U. B. C. Do. 5th April. 1905. 53 54 253 A. Doig 4ft. below 3ft. 9in. „ U. B. C. Do. 27th July, 1904. 29 55 20, Park Street G. H. Rees Level 7ft. B. C. 182 56 31, Princess Road G. H. Itter 10ft. below 1ft 3in. below U. B, C. Do. 2nd Nov., 1904. 72 57 109, Regent's Park Road R. Paine 7ft. „ Level U. B. C. Do. 13th July, 1904. (Not used for baking.) 132 58 164, ,, ,, Edwin George Moore 8ft. „ Level U. B. C. Do. 21st Sept., 1904. (Not used for baking.) 148 59 40, St. George's Road Philip Beischer 8ft ,, 1ft. below U. B. C. Do. 2nd Nov., 1904. 181 60 79, Gloucester Road Carl Schlager 9ft. 8in. below 8in. ,, U. B. Do. 13th July, 1904. 3.—Momiington. 46 61 28, Arl ington Road M. Natus 4ft. 9in. below 4ft. 3in. above U. B. Certificate granted 21st Sept., 1904. 59 62 171, P. Lunken 6ft. 6in. ,, Level U. B. C. Do. 11th Jan., 1905. 3 63 128-142, Albert Street W. & G. Buszard Level 10ft. above.. . . C. 32 64 24, Cumberland Market 1ft. below .. 6ft. 9in. above . . . . Not in use, now a general shop. 121 65 40, Delancey Street J. Lines 7ft.lOin. below Level U. B. C. Certificate granted 21st Sept., 1904. 163 66 43, High Street Mrs. A. Coral 8ft. 7in. „ 6in. below U. B. C. Do. 14th Dec., 1904. 7 67 125, J. J. Smith .. Level (both) 7ft.l0in. above . . B. C, 18 67a ,, ,, ,, 9ft. . . B. C. 44 68 183, 4ft. 6in. below 4ft. 6in. „ U. B. C. Not in use, now a tailor's shop. 77 69 182, Stanhope Street J. Foltvniewicz 7ft. 3in. „ 1ft. U. B. Certificate granted 11th Jan., 1905. 4.—Regent's Park. 173 70 80, Albany Street 9ft. below Level . . Not in use, now a bookseller's. 174 71 115, James Crabb 9ft. „ Level U. B.C. Certificate granted 12th Oct., 1904. 56 72 186, J. Drury & Co. 6ft. 9in. below 9in. above U. B. Do. 2nd Nov., 1904. 74 73 4, Cumberland Street F. Finnimore 7ft. below .. Level U. B. C. Do. 22nd June, 1904. 151 74 9, Munster Square John Werner 8ft. 3in. below 6in. above U. B. Do. 12th Oct., 1904. 134 75 45, Osnaburgh Street W. Gas 8ft. Level U. B. Do. 2nd Nov., 1904. 169 76 84, J. Mulford 8ft. 9in. ,, 1ft. above U. B. Do. do. 136 77 52, Robert Street Philip Herrman 8ft Level U. B. Do. 12th Oct., 1904. 154 78 77, Robert Todd 8ft. 6in. ,, 6in. above U. B. C. Do. 23rd Nov., 1904. 225 List VI.—con. BAKEHOUSES—continued. No. on Diagram Consecutive No. Situations, Divisions, and Sub-Divisions. Name of Occupier. Distance of floor above or below ground level. Distance of ceiling above or below ground level. Underground Baking Rooms—U. Baked B—Bread. C—Confectionery b—Biscuits. As to Certificate and date when granted or refused, and other notes. West Division—eon. 5.—Euston. 80 79 191, Drummond Street John Herrning 7ft. 3in. below 6in. above U. B. Certificate granted 2nd Nov., 1904. 57 80 33, Edward Street F. G. Warren 8ft. 6in. „ ,, U. B. Do. 21st Sept., 1904. 107 81 79, Euston Street J. Young 7ft. 6in. ,, ,, U. B. Do. 27th July, 1904. 108 82 30, Exmouth Street F. A. Thielemann 7ft. 6in. ,, ,, U. B. Do. 2nd Nov., 1904. 38 83 37, Hampstead Road S. E. Pierce 8ft. ,, ,, U. B. C. b. Do. 5th April, 1905. 122 84 87, W. Steel 7ft, 10 in. ,, ,, U. B. C. Do. 14th Dec., 1904. 47 85 133, Adam Hahn 5ft. 5in. „ 1ft. 8in. above U. B. C. Do. 27tli July, 1904. 135 86 10, Melton Street H. Lagna 8ft. ,, Level U. B. Do. 13th July, 1904. 179 87 39, Robert Street 9ft. ,, 3ft. below U. Not in use, now a private house. 52 88 6, Seaton Street S. Skelton 6ft. ,, 1ft. above U. B. Certificate granted 21st Sept., 1904. 147 89 219, Seymour Street E. H. Junker 8ft. ,, Level U. B. Do. 2nd Nov., 1904. 166 90 72, Stanhope Street K. Naumann 8ft. 6in. ,, 2ft. below U. B. Do. 15th March, 1905. EAST DIVISION. 1.—Bartholomew. 89 91 277, Great College Street C. Henkes 7ft. 6in. ,, 6in. above U. B. C. Do. 2nd Nov., 1904 37 92 82, Oseney Crescent H. Govey 2ft. 6in. „ 5ft. 6in. ,, . . B. 67 93 81, Peck water Street A. Portwood (and 46, Grafton Road) 7ft. „ Level U. . . Certificate refused 1st Feb., 1905. Not in use, bread and confectionery only sold. 95 94 88, Torriano Avenue A. Snelling 7ft. 6in. ,, Level U. B. Certificate granted 22nd June, 1904. 63 95 102, A. Norton 7ft. „ 1ft. 3in. above U. B. C. Do. 24th May, 1905. 2.—Camden Square. 161 96 106, Camden Road . . . . . . . . 8ft. 6in. ,, 3in. below U. B. C. Do. 23rd Nov., 1904. (Not in use.) 128 97 1, Camden Park Road W. C. Schneider 8ft. ,, Level U. B. Do, 2nd Nov., 1904. 97 98 20, Cantelowes Road Charles Cardiiell 7ft. 6in. ,, ,, U. B. Do. do. 68 99 164, Great College Street Mrs. Giesel 7ft. ,, ,, U. B. C. Do. 12th Oct., 1904. 57 100 121, King's Road E. C. Chapman 6ft. Gin. ,, 6in. above U. B. C. Do. 14th Dec., 1904. 127 101 1, Murray Street . . . . . . . . 8ft. ,, Level . . Not in use, now a laundry. 153 102 179, York Road Mrs. A. E. Carpenter 8ft. 6in. ,, 1ft, above U. B. C. Certificate granted 1st June, 1904. 226 East Division—ton. 3.—College. 28 103 10, Crowndale Road M. Backhaus Level 7ft. above . . B. 30 104 84, Great College Street K.J. Thorne Level 9ft. . . B. C. 96 105 155, ,, H. Weigand 7ft. 6 in. below Level U. B. C. Certificate granted 1st June, 1904. 41 106 12, Hamilton Street F. Klage 4ft. ,, 6ft. above U. B. Do. 14th Dec., 1904. 65 107 4, King Street P. Werner 7ft. ,, 3in. ,, U. B. C. Do. do. 124 108 31, ,, J. Weber 7ft. 10 in. ,, 6in. below U. B. Do. 2nd Nov., 1904. 111 109 42, ,, J. W. Roake 7ft. 6in. ,, 6in. ,, U. B. Certificate refused 1st Feb., 1904. — 109a 42, ,, J. W. Roake Level 9ft. 4in. above . . New level baking room constructed. 40 110 16, Pratt Street J. Roos 4ft. 6in. below 3ft. 6in. ,, U. B. Certificate granted 13th July, 1904. 24 111 34, ,, A. Ragg Level 7ft. 6in. ,, . . B. 4.—Oakley Square. 93 112 66, Clarendon Street F. C. Hall 7ft. 6in. below Level U. B. Do. 2nd Nov., 1904. 129 113 17, Crowndale Road — 8ft. Level U. Bakehouse closed. 99 114 38, Eversholt Street Edwin George Moore 7ft. 6in. ,, Level U. B. C. Certificate granted 21st Sept., 1904. 100 115 20, Stibbington Street J. Honing 7ft. 6in. ,, Level U. B. Do. 23rd Nov., 1904. 82 116 45, J. Lohr 7ft 3in. ,, 3in. below U. B. Do. 2nd Nov., 1904. 101 117 116, Camillo Ferraro 7ft. 6in. ,, Level U. B. Do. 12th Oct., 1904. 5.—Ossulston, 130 118 10, Chalton Street Mrs. M. Zeigler 8ft. Level U. B. C. Do. 14th Dec., 1904. 102 119 27, ,, R. & C. Green 7ft. 6in. ,, Level U. C. Do. 1st June, 1905. 71 120 38, ,, J. K. Jung 7ft. Level U. B. Do. 22nd June, 1904. 103 121 88, ,, C. Feucht 7ft. 6in. ,, Level U. B. Do. 14th Dec., 1904. 104 122 3, Chapel Street James Davies 7ft. 6in. ,, Level U. Eels & Meat-pies An Eating House. 64 123 13, ,, — 7ft. 6in. above .. U. . . Now a Florist's. 69 124 2, Charrington Street — 7ft. Level U. B. Bakehouse disused, now a builder's. 70 126 57½, M. Jones 7ft. Level U. B. Certificate granted 21st Sept., 1904. (Now a Chandler's Shop.) 4 125 1, Chenies Place H. Jacobs Level 11ft, above . . B. C. 5 127 35, Church way — Level 10ft. 3in. ,, . . Dinners Dining Rooms. 79 128 8, Drummond Street Jacob H. Lievertz 7ft. 3in. below Level U. B. Certificate granted 12th Oct., 1904. 156 129 37, Ossulston Street — 8ft. 6in. ,, Level U. B. Certificate refused 15th Mar., 1905. Now a private house. 131 130 164, T. Higgins 8ft. below Level U. B. Certificate granted 23rd Nov., 1904. 34 131 18, Phoenix Street — 2ft. „ 5ft. 6in. above . . B. Empty. 171 132 38, Seymour Street A. Bartelmeh 9ft ,, Level U. B. C. Certificate granted 22nd Feb., 1905. 227 List VI.—con. BAKEHOUSES—continued. No. on Diagram. Consecutive No. Situations, Divisions, and Sub-Divisions. Name of Occupier. Distance of floor above for below ground level. Distance of ceiling above or below ground level. Underground Baking Rooms—U. Baked B—Bread. D—Confectionery b—Biscuits. As to Certificate and date when granted or refused, and other notes. SOUTH DIVISION. 1.—Argyle. 2 133 36, Acton Street 10 ft. above 19ft. above Not in use. Now a private house. 178 134 84. Cromer Street Aichroth & Co. 8ft. below Level U. B. Certificate granted 24th May, 1905. 119 135 296, Gray's Inn Road 7ft. 9in. ,, 3in. below U. Certificate refused 1st Feb. 1905. Baking room not in use, shop still open. 33 136 312, J. Measures 2ft. 7ft. above U. B. C. 176 137 125, King's Cross Road Lot Vickers 9ft. 4in. „ U. B. Certificate granted 1st Feb., 1905. 31 138 151, „ T. W. Davey 1ft. 7ft. „ U. B. Do. 1st June, 1904. 75 139 163, „ W. H Maundrell 7ft. Level U. B. C. 140 140 39, Manchester Street L. J. Sage 8ft. ,, U. B. C. Do. 27th July, 1904. 2.—Mecklenburgh. 142 141 38, Coram Street John Dunsbier 8ft. ,, ,, U. B. C. Do. 23rd Nov. 1904. 143 142 4. Gough Street A.Pitt 8ft. ,, 3in. below U. B. Do. 2nd Nov. 1904. 147 143 83, Grav's Inn Road Mrs. E. Davidson 8ft. ,, 6in. ,, U. B. C. Do. 15th Mar., 1906. 113 144 238, „ „ Herbert Tilbury, jr 7ft. 6in. ,, 1ft. below B. C. Disused. Level bakehouse constructed. 109 145 274 ,, Georce Covell 7ft. 6in, ,, Level U. B. C. Certificate granted 13th July, 1904. 42 146 63, Kenton Street ,, 4ft. ,, 4ft. 4in. above U. B. Certificate refused 5th April, 1905. (Demolished, now flats). 167 147 27, King's Cross Road Henry Snowley 8ft. 8in. ,, 4in. below .. U. B. Certificate granted 23rd Nov., 1904. 76 148 14, Mount Pleasant Miss H. Engelmann.. 7ft. ,, 4in. ,, U. B. Do. 15th Mar., 1905. 87 149 35, Sidmouth Street W. Inglis 7ft 6in. ,, 1ft. 6in. above U. B. Do. 5th April, 1905. 3.—Burton. 91 150 42, Compton Street W. Wagner & Sons 7ft. 6in. ,, 2in. U. B. Certificate refused 5th April, 1905. 158 151 54, ,, H. Loss 8ft. 6in. ,, Level U. B. Reconstructed 1906. Now above ground. 180 152 1, Cromer Street John Measures 9ft. 4in. ,, 1ft. 2in. below U. B. C. Certificate granted 1st Feb., 1905. 144 153 4, Hastings Street George Fabel 8ft. 4in. „ U. B. Certificate refused 5th April, 1905. 61 154 76, Judd Street C. Werner 6ft. 10in. ,, 10in. above.. U. B. C. Do. do. 168 155 135, — 8ft. 9in. „ 6in. below U. . . Do. do. 170 155 j 135, — 8ft. 9in. ,, 1ft. 9in. ,, U. . . Now an undertaker's. 120 156 29, Leigh Street — 7ft. 9in. „ 11in. „ U. . . Certificate refused 5th April, 1905. (Demolished.) 177 157 92, Marchmont Street — 9ft. ,, 6in. ,, U. B. C. Certificate refused 5th April, 1905 (Demolished.) 139 158 8, Woburn Buildings — 8ft. „ Level U. B. C. Now a chandler's shop. 228 List VI.— con. BAKEHOUSES—continued. No. on Diagram. Consecutive No. Situations, Divisions, and Sub-Divisions. Name of Occupier. Distance of floor above or below ground level. Distance of ceiling above or below ground level. Underground Baking Rooms—U. Baked B—Bread C—Confectionery b—Biscuits. As to Certificate and date when granted or refused, and other notes. South Division—con. 4.—Endsleigh. 141 159 134, Cleveland Street George Zoller 8ft. below Level U. B. C. Certificate granted 23rd Nov., 1904 175 160 26, Fitzroy Street J. Zeller 9ft. Level U. B. Do. 11th Jan., 1905 149 161 47, J. Drury 8ft. 2in. „ Level U. B. C. Do. 22nd Feb., 1905 1-59 162 24, Gower Place — 8ft. 6in. „ Level U. B. C. Do. 14th Dec., 1904 Baking room and oven in Gowei Street disused. 71 163 49, — 7ft. 3in. ,, 9in. above . . . . Not in use. Now a tea-house. 1 164 Grafton Street James Shoolbred & Co. Top Floor .. . . B. C. 114 165 66, H. Scheel 7ft. 8in. below Level U. B. C. Certificate granted 2nd Nov., 1904 150 166 94, Huntley Street — 8ft. 2in. „ 1ft. below U. Certificate refused 5th April, 1905 (Demolished). 160 167 117, Tottenham Court Rd. F. Legg 8ft. 6m. „ 2in. „ U. C. Do. 15th Mar,, 1905 85 168 15c, Warren Street W. Wermann 7ft. 4in. „ Level U. B. Certificate granted 23rd Nov., 1904 5.—Whitfield. 117 169 33. Charlotte Street A. Vandenhaute 7ft. 9in. „ Level U. B. C. Do. 13th July, 1904 81 170 16, Goodge Street N. Graff 7ft. 3in. ,, Level U. B. C. Do. 22nd June, 1904 123 171 46, Albert Pettit 7ft 10in. „ 4in. below .. U. B. Do. 2nd Nov., 1904 12 172 10 & 11, Little Howland St. Fietta Bros. Level 8ft. 6in. above . . C. 84 173 17, Tottenham Court Rd. Veglio & Co. 7ft. 3in below 9in. U. C. Do. 11th Jan., 1905. 115 174 33, Charles Schneider 7ft. 8in. „ 10in. ,, U. B. C. Do. 23rd Nov., 1904. 45 175 75, A. K. Williams 4ft. 6in. ,, 4ft. 3in. ,, U. B. C. Do. 27th July, 1904. 90 176 50, Tottenham Street — 7ft. 6in. „ 6in. ,, U. Not in use. Now a general shop. 116 177 89, Whitfield Street J. Bauer 7ft. 9in. ,, 3in. ,, U. B. Certificate granted 21st Sept., 1904. 60 178 21, Windmill Street Charles Schneider 6ft. 8in. ,, Level U. B. Do. 11th Jan., 1905. Bakehouses which are also Non-Textile Factories using machinery. 128-142, Albert Street W. & G. Buszard Level 10ft. above 179 21, Camden Road The Aerated Bread Company, Limited Level Various heights above 180 72, Crowndale Road G. H. Kemp 2ft. below 10ft. above . . . . Not in use. 181 142, Kentish Town Road A.A.Hodges Level 10ft. – 61, Weedington Road W. Pearson Level 12ft. Bakehouses at Hotels. 182 Euston Hotel (L. & N.W.R.) L. & N. W. Railway 12ft. below 3ft. below . . . . Certificate granted 5th April, 1905. 183 Midland Grand (M.R.) Midland Railway 10ft. 12ft. above . . . . Do. 11th Jan.. 1905. 184 Great Northern (G.N.R.) Gt. Northern Railway 7ft. 9in. ,, 2ft. 6in. ,, . . . . Certificate refused 1st Feb., 1905. Bakehouse not now used. 229 List VII. ST. PANCRAS, LONDON. NOXIOUS TRADES. Registered No. Situation of Premises. Name of Occupier. Trade. 11 160, Kentish Town Road Hales, Thomas Charles Tripe Boiler. 6a Tudor Place Brand, Lewis Tallow Melter. 230 List VIII. ST. PANCRAS, LONDON. FRIED FISH SHOPS. NORTH. 1.—Highgate. 149, Dartmouth Park Hill. 2.—St. John's Park. 3, Dartmouth Park Hill. 13, Fortess Road. 3, Fortess Road. 126, Fortess Road. 3.—Gospel Oak. 36, Hanover Street. 16, Rochford Street. 119, Highgate Road. 37, Lismore Road. 13, Lismore Circus. 54, Wellesley Road. 4.—Grapton. 12, Dalby Street. 86, Grafton Road. 57, Grafton Road. 164, Weedington Road. 1, Raglan Place. 5.—Maitland Park. 119, Maiden Road. 63, Weedington Road. 47, Rhyl Street. 33, Maiden Road. 116, Maiden Road. 51, Weedington Road. 6, Maiden Road. EAST. 1. — Bartholomew. 31, Brecknock Road. 69, Torriano Avenue. 188, Kentish Town Road. 59, Torriano Avenue. 144, Kentish Town Road. 214, Kentish Town Road. 2.—Camden Square. 195, Great College Street. 23, York Road. 23, Little Randolph Street. 5, Murray Street. 3.—College. 86, Great College Street. 29, King Street. *28, High Street. 85, King Street. 4.—Oaklf.y Square. 32, Johnson Street. 34, Stibbington Street. 31, Sidney Street. 5.—Ossulston. 1)8, Chalton Street. 22, Phoenix Street. 36, Drummond Street. 62, Churchway. 112, Seymour Street. 73, Chalton Street. 19, Lancing Street. 84, Chalton Street. 231 List VIII. — con. FRIED FISH SHOPS- con. WEST. 1.—Castle. 1, Castle Road 43, Ferdinand. Street. 81, Chalk Farm Road. 18, Grange Road. 13, Ferdinand Street. 133, Kentish Town Road. 11, Kentish Town Road. 18, Grange Road. 2.—Chalk Farm. 46, St. George's Road. 210, High Street. 4, Wellington Street. 59, Regent's Park Road. 3.—Mormnuton. 25, High Street. 159, High Street. 4. — Regent's Park. 2, Cumberland Street. 94, Osnaburgh Street. 62, Osnaburgh Street. 5.— Eustox. 107, Drummond Street. 99, Euston Street. 144, Drummond Street. 14, Stanhope Street. SOUTH. 1.—Argyle. 135, King's Cross Road. 97, King's Cross Road. 195, King's Cross Road. 2. — Meckienburgh. 208, Gray's Inn Road. 3.—Burton. 97, Cromer Street. 219, Gray's Inn Road. 7, Cromer Street. 4. —Endsleigh. 138, Cleveland Street. 131,'Whitfield Street. 94a, Cleveland Street. 333, Euston Road. 319, Euston Road. 5. — W hitfield). 18, Tottenham Street. 27, Little Goodge Street. 8, Tottenham Court Road. 28, Tottenham Court Road. 232 List IX. ST PANCRAS, LONDON. FISHSMOKING PLACES NORTH DIVISION. 2.—St. John's Pakk. 3, Dartmouth Park Hill. 126, Fortes- Road. 4.—Grafton. 164, Weedington Road. 5.—Maitland Park. 66, Queen's Crescent. 56, Warden Road. EAST DIVISION. 1. — baktholomew. 31, Brecknock Road. 4.—Oakley Square 10, Sidney Street, 5.— Ossulston. 70, Churchway. WEST DIVISION. 2.-Chalk Farm. 27, Chalk Farm Read. 2 and 4, Kelly Street. 141, High Street. 13, High Street. 3.— Mornington. 103, High Street. 5. —Euston. 111, Hampstead Road. SOUTH DIVISION. 3.—Burton. 84, Marchmont Street. 233 List X. ST. PANCRAS, LONDON RAG AND BONE STORES. SITUATION. NAME OF OCCUPIER. NORTH DIVISION. 109, Dartmouth Park Hill Arthur Patey 14, Lamble Street Harriet Hayward 56, Litcham Street Annie Marshall 7, Litcham Street William Miller 13, Rochford Street John Baker 74, Weedington Road Oliver Churley 85, MarsdenStreet Edward James Knightley 15, Hanover Street Robert King 56, Wellesley Road Jane C. Baker 1, Dalby Street Alice Payne 60, Wilkin Street Oliver Churley WEST DIVISION. 176, Arlington Road Charlotte Graham 9, Cobourg Street James Tombliug 11, Grange Road Jolin Senior 1, Kingstown Street Edwin Messeder 41, Little Albany Street Philip Wolstenholme 3. Powlett Place Alfred Smith 37, Redhill Street George Sack 19, Seaton Street Benjamin Harris 8, Underbill Street James Webster 29, Ferdinand Street Ralph Robins 98, Euston Street Joseph Atkinson 72, William Street Albert Philip SEagell 2, Wellington Street George Cox 35, Hartland Road Frederick W. Richardson EAST DIVISION. 1, Drummond Crescent James Cann 17, Drummond Street William Andrews 54, Little Clarendon Street Benjamin Thorogood 31, Slibbington Street Benjamin Thorogood 2, Little Randolph Street Arthur Churley 81, Peckwater Street Thomas James Gregory 25, King Street Joseph Jacobs SOUTH DIVISION. 30, Leigh Street Joseph Atkinson 19, Warren Street Elizabeth Cox 24, Warren Street Joseph Atkinson 48, Cromer Street Joseph Atkinson