stapan 77 Metropolitan Borough of St. panrras. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE YEAR 1915. T. SHADICK HIGGINS, M.D., B.Sc. Lond., D.P.H. Cantab. 3 CONTENTS. page Public Health Committee 6 Introduction 7 Part I.—General Statistics— Population 9 Marriages 9 Births 10 Illegitimacy 11 Notification of Births Act, 1907 11 Deaths 13 Mortality of Soldiers and Sailors 17 Infantile Mortality 17 Infectious Diseases 20 Part II.—Special Subjects— Maternity and Infant Welfare 24 Expectant Mothers 24 Work Done 24 Voluntary Institutions 25 Infantile Diarrhœa 27 Ophthalmia Neonatorum 27 Puerperal Fever 28 Tuberculosis 29 Work Done 35 Treatment of Tuberculosis 36 Scarlet Fever 37 Diphtheria 39 Typhoid Fever 41 Anterior Polio-Myelitis 42 Epidemic Cerebro-Spinal Meningitis 43 Other Notifiable Infectious Diseases 48 4 CONTENTS—continued. PAGE. Measles 49 Whooping Cough 50 Diarrhoea and Enteritis 51 Syphilis 51 Alcoholism 51 Cancer 52 Vaccination 52 Dwelling Houses 52 Inspection of Dwelling Houses 53 Water Supply 55 Underground Rooms 55 Houses Unfit for Habitation 55 Inland Revenue Act, 1903 57 Canal Boats Acts 57 Factories and Workshops: Bakehouses, Restaurant—kitchens, Laundries, Home-Work 58 Inspection of Food and Food Places 62 Sale of Food and Drugs Acts 62 Summonses 64 Lead Chromate in "Egg Powder" 65 Public Health (Milk and Cream) Regulations, 1912 65 Inspection of Food 67 Dairies, Cowsheds and Milksliops 67 Ice Cream Premises 68 Fried Fish and Fish Curing Premises 68 Other Food Premises 69 Slaughterhouses 69 Rag Flock Act, 1911 69 General Sanitary Work 69 Total Inspections 69 5 CONTENTS—continued. page Intimation Notices 69 Summonses 70 Smoke Prevention 70 Regulated Trades 70 Constructional Drain Work 70 Drainage Register 71 Water Service 71 Disinfecting and Cleansing Station 72 Disinfection 72 Cleansing Station 72 Public Mortuary and Coroner's Court 74 Bacteriological Examinations 75 Clerical Work 75 Staff 76 Appendix— Table No. 1.—Vital Statistics of the whole District for 1915 and previous years required by the Local Government Board 79 Table No. 2.—Showing registered Deaths classified for Causes Age and Sex 80 Table No. 3.—Summary of above 84 Table No. 4.—Meteorology 85 Table No. 5.—Showing Inspections made by the District Inspectors and Factory and Workshop Inspectors (Male) 86 Table No. 6.—Showing Re-Inspections Ditto 88 Table No. 7.—Showing Inspections and other work of the Food Inspectors 90 Table No. 8.—Showing Visits, etc., made by Women Inspectors 92 Table No. 9.—Showing Inspections and Re-Inspections made by individual Inspectors 93 Tables Nos. 10, 11, 12 and 13.—Showing details of Intimation Notices served 94 6 St. Pancras Borough Council. PUBLIC HEALTH COMMITTEE, 1915. CHAIRMAN. Councillor Dr. Kenneth Harrison Alloa Kellie (Ward 5). DEPUTY-CHAIRMAN. Councillor Henry Groom (Ward 8). EX-OFFICIO. The Right Worshipful the Mayor. (Alderman J. May, J.P.) ALDERMEN. Davies, David, J.P., L.C.C. Hickling, George, J.P. Tapping, Dan. Williams, Charles. COUNCILLORS. Ward 6 Bayly, Christopher Hodgson. 5 Blount, George. 3 Bolsom, Sidney. 2 Brown, Henry Joseph, J.P. 1 Carrington, Thomas. 1 Caunt, George Charles. 1 Coggan, Cornish Arthur. 3 Cooke, Joseph John. 2 Cosburn, George Frederick, J.P. 8 Davis, Abraham. 4 Escott, Arthur. 6 Knight, William Stanley Macbean. 4 Lloyd-Taylor, William, J.P. 3 Rolles, Harry. 5 Saunders, James. 8 Stoney, Rev. Ralph Sadleir, M.A. 7 Swift, Mansell James. 7 Wood, William Charles. 7 Public Health Department, Town Hall, Pancras Road, N.W. November, 1916. To the Mayor, Aldermen and Councillors or the Metropolitan Borough of St. Pancras. Gentlemen, I have the honour to present to you the Sixtieth Annual Report on the vital statistics and sanitary condition of the Sanitary District of St. Pancras, including particulars of the year's work of the department. This is the third annual report which it has been my duty to submit. The year 1915 was the first to be passed under war conditions throughout. It is to be regretted that it was marked by a serious fall in the birth-rate, which was twelve per cent. less than the average of the preceding four years. This was accompanied by an increase in the general death-rate (civilian) which was eight per cent. above that of the preceding four years and a similar increase of nine per cent. in the infantile death-rate. The fall in the birthrate is no doubt due to war conditions, and the increased number of deaths, not being explainable by the prevailing climatic or epidemic conditions is probably due to the same complex cause. As compared with 1914, the increase in deaths and the decrease in births represent for St. Pancras a falling off in the natural rate of increase of the population to the extent of 672 lives. In the face of these facts the present time is clearly not one for any unavoidable relaxation in the sanitary government of the borough. During 1915, there was a serious reduction in the staff of the public health department from the enlistment of its members. At the end of the year five sanitary inspectors were serving with the forces, apart from the vacancy caused by Mr. Osborne's death in 1914, which was still open. The Council's scheme for the Dispensary treatment of tuberculosis was brought into full operation during the year, and grants were paid to the Dispensary and Hospital concerned, though the formal agreements had not been concluded by the end of the year. In conclusion, I desire to express my hearty thanks to the members of the staff of my department, who have one and all done their best to cope with the increased strain due to reduction of staff; to your Public Health Committee, who have given me encouraging support; and to the members of vour Council for the personal consideration they have invariably shown me. I am, Gentlemen, Your obedient Servant, Medical Officer of Health. Metropolitan Borough of St. Pancras. REPORT of the MEDICAL OFFICER OF HEALTH For the Year 1915. Part I-GENERAL STATISTICS. For the purposes of this Report the year 1915 consists of the 52 weeks ended 1st January, 1916. POPULATION. The estimated total population of St. Pancras at the middle of 1915 including soldiers and sailors recruited from the borough is 218,387, which differs from the lower estimate arrived at by the Registrar-General's method. This figure, which is the census population of 1911 is adopted bccause the returns of the Rating Department as to occupied houses do not indicate a decrease in the population since the census year. The removal from the borough of many enlisted men of military age has, however, made it inadvisable to use this estimate in calculating death-rates of the civil population, and the civil population of the borough as given in the National Register is adopted for this purpose. This figure is supplied by the Registrar-General, and is 200,322. The Registration was carried out on loth August, 1915, which is only six weeks removed from the middle of the year, and the figure, unlike the census population, included habitual residents only, wherever they happened to be on that date. In the earlier part of the year there were of course fewer men enlisted than on 15th August, and in the later part more, and the figure 200,322 is taken as the mean civil population for the year. No figures from the National Register are to hand for the population of the different wards, and in calculating ward rates the census figures have been used. MARRIAGES. The number of marriages celebrated in St. Pancras during 1915 was 2951 (including marriages of soldiers and sailors). This is equal to a rate of 13.5 per 1,000 total population. 10 BIRTHS. The number of births registered in the borough during 1915 was 4,458. From information received from the Registrar-General, the excess of birthsto parishioners occurring outside the borough over births to non-parishioners occurring inside the borough was 296. The net number of births for St. Pancras registered during 1915 was, therefore 4,754, making an annual birth-rate of 21.8 per 1,000 total population, or 23.7 per 1,000 civil population. The following table shows the number of births thus corrected, and the birth-rate for each of the four Registration Sub-Districts and eight wards into which the Borough is divided, and also the corresponding rates in former years. In this table from 1911 onwards the transferred births referred to above are allocated to the Sub-Districts and Wards, in proportion to their respective populations, but some of the births which took place in St. Pancras Institutions are not re-distributed, but are allocated to the Districts in which the Institutions are situated. DISTRICTS. Estimated Population. West. South. East. Xorth. Whole Borough. Rate* for whole Borough calculated 011 the 1911 census population (218,387). County of London Birht Rate. Ward Total. Ward Total. Ward Total. Ward Total. 4 5 7 8 3 6 1 2 Number of Births Registered for the year 1915 .. 568 606 1174 270 558 828 847 580 1427 734 591 1325 4754 Birth Rate per 1000 population 218387 21.5 19.0 20.1 14.9 20.6 18.3 24.4 25.5 24.9 20.7 27.0 23.1 21.8 Birth Rate for the Year 1905 237149 25.3 20.9 26.2 25.2 24.5 27.1 „ „ 1906 237149 23.3 20.6 27.4 25.4 24.2 26.7 „ „ 1907 237173 23.9 17.3 25.7 25.2 23.1 25.8 „ „ 1908 237247 24.2 18.2 27.6 23.2 23.4 25.2 „ „ 1909 237247 22.4 17.9 24.7 23.0 22.1 24.0 24.2 „ „ 1910 237247 22.7 18.5 25.5 23.9 22.7 24.7 23.6 „ „ 1911* 237129 23.3 19.9 25.5 24.7 *23.4 25.4 24.8 „ „ 1912* 220353 22.1 23.4 27.7 24.0 *24.4 24.6 24.5 „ „ 1913 218387 23.3 22.5 28.2 24.8 *24.7 24.7 24.5 „ „ 1914 218387 24.2 22.0 26.5 22.5 *23.9 23.9 24.3 „ „ 1915 218387 20.1 18.3 24.9 23.1 *21.8 21.8 22.5 * For 1911 onwards the number of births and the rates are corrected for inward and outward transfers. 11 It will be seen that there was a serious reduction in the birth-rate as compared with former years, both in St. Pancras and in London as a whole. 289 births occurred in Public Institutions in the borough, equal to 6 5 per cent. of the total births which took place in the borough. Illegitimacy. Of the 4,458 births which were registered in the borough 192, or 4 3 per cent., were returned as illegitimate. Of the 4,751 births to parishioners within and without the borough 256, or 5 4 per cent., were registered as illegitimate. This is the figure which is to be taken as representing the proportion of illegitimate births in the St. Pancras population. The Notification of Births Act, 1907. Notifications were received during the year of 4,131 births, or 93.0 per cent. of the number of births registered. In the following table the total births notified and registered in the Borough are classified according to the Registration Sub-Districts and Wards in which the births took place:— W. S. E. N. Whole Borough 4 5 7 8 3 6 1 2 Total Births (excluding stillbirths) registered 532 568 245 521 800 549 686 562 4458 Births (includingstill-births) notified 476 519 329* 456 683 558* 601 509 4131 Still-births notified 15 23 80 15 16 15 10 13 137 * The excess of notified over registered births in Wards 6 and 7 is due to the non-redistribution of births in institutions in the notification figures. 12 In the tables below the notified births are also classified (in Registration SubDistricts and Wards) according to the person notifying the birth, and according to the person in attendance upon the mother in her confinement. Births. W. S. E. N. Total 4 5 7 8 3 6 1 2 Notified by—Fathers 104 79 11 45 215 39 305 169 967 Mothers 9 7 1 — 14 3 21 29 84 Others persons 61 86 86 143 66 35 79 65 621 Medical Students 109 259 15 70 211 365 13 33 1075 Midwives 178 57 46 104 136 26 147 196 890 Doctors 15 31 15 53 39 23 34 13 223 from Workhouse - — — — - 67 - - 67 Homes of Hope - — — 39 — — — — 39 University College Hospital - - 155 - - - - - 155 Not stated - - — 2 2 — 2 4 10 476 519 329 456 683 558 601 509 4131 4 5 7 8 3 6 1 2 Total Attended in their own homes by— Private Doctors 146 123 33 109 296 47 348 159 1261 Private Midwives 202 15 14 51 125 7 237 305 956 Doctors from New Hospital for Women 15 15 3 19 43 19 9 23 146 Medical Students from— University College Hospital 105 270 6 12 193 370 2 21 979 „ Middlesex Hospital — 52 69 3 — 3 — — 127 Royal Free Hospital — — 10 46 — 1 — — 57 „ St. Bartholomew's Hospital — — — 7 — — — — 7 Midwives from— University College Hospital — 24 36 125 — 1 — — 186 ,, Maternity Nursing Association, Myddleton Square ... - - 43 - - - - 43 „ Maternity Nursing Association, Oakley Square Branch 8 20 3 1 26 16 5 1 80 476 519 174 416 683 464 601 509 3842 Attended in Institutions— University College Hospital — — 155 — — — — — 155 Homes of Hope, Regent's Square — — — 39 — — — — 39 Lying-in Ward of Workhouse - - — - — 67 — — 67 Other Institutions — — — 1 — 27 — — 28 476 519 329 456 683 558 601 509 4131 Certain of the notified births set out in the above table as having taken place in St. Pancras institutions were of infants of mothers not resident in St. 13 Pancras. On the other hand a number of St. Pancras mothers were confined in institutions outside the Borough. On page 25 will be found a table showing the number of births to St. Pancras mothers, which took place in institutions within and without the borough. DEATHS. It is not possible to include in the figures relating to the mortality amongst St. Pancras residents the deaths of soldiers and sailors belonging to St. Pancras. Reports of a certain number of these have come to hand and are considered below, but the military authorities have not been able to furnish complete returns. Deaths of members of His Majesty's Forces belonging to St. Pancras are therefore excluded from the mortality statistics for 1915, and the deathrates are accordingly calculated upon the estimated civil population. The number of deaths of civilians that were registered during the year as having taken place in the borough was 3,523. Of these 672 were of persons whose residence was not in St. Pancras (nonparishioners), 637 dying in St. Pancras institutions, and 35 in other places in the borough. There were also reported by the Registrar-General 626 deaths of St. Pancras parishioners who died in institutions in other parts of the County of London, and 66 who died in other parts of England and Wales. This correction gives the net number of civil deaths for St. Pancras registered during the year as 3,543, making an annual death-rate of 17.7 per 1,000 civil population. (The death-rate, calculated upon the estimated total population, would be 16.2 per 1,000). The following table shows the number of deaths and death-rate for each of the four Registration Sub-Districts and eight Wards into which the Borough is divided, and also the corresponding rates in former years. In this table deaths in public institutions, whether within or without the borough, are classified in the respective Sub-Districts and Wards of their previous residence:— 14 DISTRICTS. Estimated Population. West. South. East. North. No Address. Whole Borough. Rates for whole Borough caculatcd on the 1911 Census population (211387). County of London Death Rate. Ward Total. Ward Total. Ward Total. Ward Total. 4 5 7 8 3 6 1 2 Number of Deaths Registered for the Year 1915 - 144 485 929 238 438 676 553 428 931 489 363 852 105 3543 Death-rate per 1000 population 218387 16.8 15.2 16.0 13.1 16.1 14.9 15.9 18.8 17.1 13.8 16.6 14.8 — 16.2 Death-rate for the Year „ „1905 237149 16.0 16.2 16.6 14.1 5.7 15.6 ,, ,, 1906 237140 15.8 16.1 16.9 14.5 — 15.8 15.8 „ „ 1907 237173 15.4 14.9 16.3 13.4 — 15.0 15.3 „ „ 1908 237247 14.7 14.9 16.5 13.8 — 15.0 14.6 „ „ 1909 237247 15.6 14.4 16.0 13.3 — 14.8 16.1 15.0 ,, „ 1910 237247 14.3 12.0 15.5 13.1 — 13.8 15.0 13.7 „ „ 1911 237129 14.8 15.4 15.1 14.0 — 14.1 15.4 15.0 „ „ 1912 220353 14.5 14.7 15.2 12.9 - 14.3 14.4 13.6 „ „ 1913 218387 14.9 15.0 15.3 14.8 — 15.0 15.0 14.2 „ „ 1914 218387 15.4 15.0 15.4 13.9 — 15.3 15.3 14.4 „ „ 1915 218387 16.0 14.9 17. 1 14.8 — 16.2 16.2 16.0 Thin increase in the death-rate is disquieting, and is found, on examination of the various causes of death, to be due to a general rise all round, and not to a special increase in any one cause. The Wards are set out in the table below in order according to their deathrates. Ward. Death-rate per 1000 population. Ward. Death-rate per 1000 population. 7 13.1 8 16.1 1 13.8 2 16.6 5 15.2 4 16.8 3 15.9 6 18.8 1,863 deaths occurred in Public Institutions in the Borough. Taking from these the number which were of non-parishioners (637), and adding the number of deaths of St. Pancras parishioners in Public Institutions outside the Borough (656—both from the Registrar-General's figures), the number of St. Pancras deaths which took place in Public Institutions is shown to be 1,882, or 53.1 per cent. of the total deaths. Thus, of the St. Pancras parishioners whose death took place during the year, more than one-half died in Public Institution. 15 Causes of Death. The deaths are fully classified for causes, sex and age periods in table 2 (pp. 80-83). The following table shows the deaths from infectious diseases and certain other causes classified according to Wards and Registration Sub-Districts:— DISEASES. West. South. East. North. No. Address Whole Brough. Ward Total Ward Total. Ward Total Ward Total. 4 5 7 8 3 6 1 2 Enteric Fever — 1 1 — 1 1 1 1 2 2 1 3 1 8 Small-Pox — — - — - - - - - - - - - - Chicken-Pox — — - — — — — 1 1 — — — - 1 Measles 4 16 20 4 10 14 8 6 14 9 6 15 - 63 Scarlet Fever 1 3 4 2 — 2 7 3 10 3 3 6 — 22 Whooping Cough 4 6 10 — 13 13 4 11 15 5 7 12 2 52 Diphtheria and Croup 2 5 7 2 2 4 6 1 7 2 4 6 — 24 Puerperal Fever - — - — — — 2 — 2 1 2 3 — 5 Influenza 7 6 13 1 3 4 4 2 6 8 3 11 1 35 Erysipelas 2 2 4 2 2 4 - — — 2 1 3 — 11 Tuberculosis, Pulmonary 64 55 119 29 50 79 55 41 96 44 40 84 20 398 „ Other Forms 21 14 35 7 9 16 10 15 25 12 12 24 2 102 Cancer, Malignant Disease 39 39 78 19 34 53 51 19 70 40 14 54 3 258 Rheumatic Fever 3 l 4 1 1 2 1 1 2 3 — 3 — 11 Heart Disease 67 44 111 35 41 76 68 38 106 68 41 109 20 422 Bronchitis, Pneumonia & Pleurisy 74 85 159 45 80 125 102 95 197 103 64 167 16 664 Diarrhoea and Enteritis 14 8 22 5 22 27 24 21 45 12 8 20 — 114 Injuries 17 26 43 6 16 22 27 23 50 15 18 33 2 150 16 Ages at Death. The next table shows the deaths for the year classified according to ages and localities:— AGES AND RATES. West. South. East. North. No Address. Whole Borough. Ward Total. Ward Total. Ward Total. Ward Total. 4 5 7 8 3 6 1 2 Under I year 54 76 130 33 58 91 80 81 161 55 58 113 2 497 I and under 5 38 42 80 11 25 36 41 67 108 34 51 85 2 311 5 and under 10 11 14 25 4 15 19 14 4 18 15 9 24 1 87 10 and under 15 10 12 22 1 1 2 5 8 13 7 7 14 1 52 15 and under 25 11 18 29 6 10 16 17 14 31 20 9 29 2 107 25 and under 35 25 30 55 19 23 42 27 19 46 23 17 40 4 187 35 and under 45 40 45 85 24 43 67 27 42 69 27 26 53 9 283 45 and under 55 61 58 119 40 72 112 67 44 111 47 35 82 15 439 55 and under 65 65 73 138 34 69 103 81 50 131 77 40 117 19 508 65 and under 75 79 55 134 27 67 94 90 48 138 88 57 145 22 533 75 and upwards 50 62 112 39 55 94 104 51 155 96 54 150 28 539 Total Deaths at all Ages 444 435 929 238 438 676 553 428 981 489 363 852 105 3543 The table below is constructed to show what percentage of total deaths is furnished by these age groups:— Ages. Percentage of deaths at all Ages. West. South. East. North. No Address. Whole Borough. Ward. Total. Ward. Total. Ward. Total. Ward. Total. 4 5 7 8 3 6 1 2 Under 1 year 12.2 15.6 14.0 13.9 13.2 13.5 14.5 18.9 16.4 11.2 16.0 13.3 1.9 14.0 1 and under 5 8.6 8.6 8.6 4.6 5.7 5.3 7.4 15.7 11.0 7.0 14.0 10.0 1.9 8.8 5 „ 10 2.5 2.9 2.7 1.7 3.4 2.8 2.5 0.9 1.8 3.1 2.5 2.8 0.9 2.5 10 „ 15 2.2 2.5 2.4 0.4 0.2 0.3 0.9 1.9 1.3 1.4 1.9 1.7 0.9 1.5 15 „ 25 2.5 3.7 3.1 2.5 2.3 2.4 3.1 3.3 3.2 4.1 2.5 3.4 1.9 3.0 25 „ 35 5.6 6.2 5.9 8.0 5.3 6.2 4.9 4.4 4.7 4.7 4.7 4.7 3.8 5.3 35 „ 45 9.0 9.5 9.2 10.1 9.8 9.9 4.9 9.8 7.0 5.5 7.2 6.2 8.6 8.0 45 „ 55 13.7 11.9 12.8 16.8 16.4 115.6 12.1 10.3 11.3 9.6 9.6 9.6 11.3 12.4 55 „ 65 14.6 15.0 14.8 14.3 15.8 15.2 14.6 11 .7 13.4 15.8 11.0 13.7 18.1 14.3 6 5 „ 75 17.8 11.3 14.4 11.3 15.3 13.9 16.3 11.2 14.1 18.0 15.7 17.0 21.0 15.0 75 and upwards 11.3 12.8 12.1 16.4 12.6 13.9 18.8 11.9 15.8 19.6 14.9 17.6 26.7 15.2 17 In the following table is shown the death-rate for the whole Borough for each of the age periods per 1000 population living at each period:— (Based on the figures of the 1911 Census.) Ages. Population. Death-rate. Under 1 year 4755 104.5 1 and under 5 16,995 18.3 5 „ 10 19,475 4.5 10 „ 15 18,073 2.9 15 „ 25 40,000 2.7 25 „ 35 40,584 4.6 35 „ 45 30,853 9.2 45 „ 55 22,493 19.5 55 „ 65 14,448 35.2 65 „ 75 7,830 68.0 75 and upwards 2,881 187.0 218,387 16.2 Mortality of Soldiers and Sailors. The number of deaths of Soldiers and Sailors that were registered during the year in the Borough was 32. Of these, 19 were resident without the Borough. Fourteen such deaths of St. Pancras residents were also reported by the Registrar-General as having taken place in other parts of the country. The total for St. Pancras was therefore 27. Of the 27 deaths, 5 were from wounds received in battle, 4 from other accidental causes, 18 from disease. These deaths, as previously stated on page 13, are not included with the deaths of the civil population occurring during 1915. Infantile Mortality. 497 deaths of St. Pancras infants under one year of age took place during the year. This is equal to a rate of infantile mortality of 105 per 1,000 births. The number of such deaths in 1914 was 481, and therefore the decrease in births has been accompanied by an increase in deaths of infants. 18 The table required by the Local Government Board, showing the causes of deaths amongst these infants is set out below:— 1915. Nett Deaths from stated causes at various Ages under 1 Year of Age. CAUSE OF DEATH. Under 1 week. 1 —2 weeks. 2—3 weeks. 3—4 weeks. Total under 4 weeks. 4 weeks & under 3 months. 3 months & under 6 months. 6 months & under months. 9 months & under 12 months. Total Deaths under 1 year. All causes Certified 106 31 23 15 175 94 88 64 76 497 Uncertified - - - — — - - — — - Small-pox — — — — — — — — — — Chicken-pox — — — — — — — — 1 1 Measles - - - - - - 1 4 12 17 Scarlet Fever — — — — — — — — — — Whooping-Cough — — — — — 3 6 7 8 24 Diphtheria and Croup — - — — — — — — — — Erysipelas — 1 - — 1 — 1 — — 2 Tuberculous Meningitis — — — — — — 2 3 3 8 Abdominal Tuberculosis - - - - - - - - 1 1 Other Tuberculous Diseases - - - - - — 2 3 1 6 Meningitis (not Tuberculous) - - - - - 1 1 4 2 8 Convulsions 1 — — — 1 1 2 1 — 5 Laryngitis - - - - - 1 - - - 1 Bronchitis 3 3 3 5 14 22 17 13 18 84 Pneumonia (all forms) 1 — — — 1 3 1 3 4 12 Diarrhœa — 1 1 — 2 2 6 2 3 15 Enteritis 1 - 4 1 6 17 20 13 8 64 Gastritis — - 1 — 1 2 — — - 3 Syphilis — 1 1 — 2 4 2 1 — 9 Rickets - - - - - - - - 1 1 Suffocation, overlying 2 — — — 2 2 3 — 1 8 Injury at birth 8 — — 2 10 — — — — 10 Atelectasis 5 1 — — 6 — — — — 6 Congenital Malformations 13 4 — — 17 3 3 1 1 25 Premature birth 60 8 7 5 80 9 2 1 — 92 Atrophy, Debility and Marasmus 5 5 4 2 16 16 9 1 5 47 Other causes 7 7 2 — 16 8 10 7 7 48 Totals 106 31 23 15 175 94 88 64 76 497 Nett Births in the year legitimate 4498 illegitimate 256 Nett Deaths in the year of legitimate infants 443 illegitimate infants 54 19 The next table shows the number of deaths of infants and the rates of infantile mortality for the several Wards and Registration Sub-Districts for the past 10 years:— Infantile Mortality West. South. East. North. No Address Whole Borough. County of London. Ward Total. Ward Total. Ward Total. Ward Total. 4 5 7 8 3 6 1 2 Deaths of Infants under 1 year of age 54 76 130 33 58 91 80 81 161 55 58 113 2 497 - Infantile Mortality rate per 1000 births 95 125 111 122 104 110 94 140 113 75 98 85 — 105 — Infantile Mortality rate for year 1905 130 165 139 116 - 136 130 „ „ 1906 131 148 130 119 — 131 131 „ „ 1907 107 144 130 84 — 114 116 „ „ 1908 126 128 115 94 — 115 113 „ „ 1909 125 127 99 90 — 109 108 „ „ 1910 108 108 128 85 — 108 103 „ „ 1911 130 94 113 107 — 112 129 „ „ 1912 96 83 95 76 — 88 91 „ „ 1913 101 102 90 80 — 93 105 „ „ 1914 101 72 94 91 — 92 104 „ „ 1915 111 110 113 85 — 105 112 The work that is being done in regard to the prevention of infant mortality is described elsewhere in this report (pages 24-27). The infantile mortality occurring during the whole year per 1,000 births is classified in the following table according to the quarter of the year in which the deaths took place, and the corresponding figures are given for each of the past 10 years:— Infantile Mortality. 1st Quarter. 2nd Quarter 3rd Quarter. 4th Quarter, Whole Year. Infantile Mortality rate per 1000 births for year 1905 130 96 175 139 135.7 „ „ 1906 128 103 172 121 131.7 „ „ 1907 109 122 102 123 113.8 „ „ 1908 129 91 116 130 115.0 „ „ 1909 118 87 106 125 108.8 ,, „ 1910 94 103 95 143 107.8 „ „ 1911 100 82 178 126 121.3 (112.1)* „ „ 1912 105 82 87 102 94.3 ( 88.0)* „ „ 1913 97 72 105 121 99.1 ( 92.8)* „ „ 1914 105 66 102 111 95.9 ( 92.1)* „ „ 1915 119 94 94 132 109.9 (104.5)* * The figures in brackets are corrected for outward and inward transfers. This additional information was supplied by the Registrar-General for the first time for the year 1911. 20 INFECTIOUS DISEASES. The number of cases of the compulsorily notifiable infectious diseases that have been notified during 1915 is shown in the table below, where they are also classified according to ages. The figures have not been corrected for subsequent revisions of diagnosis. DISEASES. At all Ages. At Ages—Years. Under 1. I and under 5. 5 and under 10. 10 and under 15. 15 and under 25. 25 and under 65. 65 and upwards. 1. VarioJa or Small-pox — - - - - — - - 2. Scarlatina or Scarlet Fever 1009 16 297 425 165 74 32 - 3. Diphtheria and Membranous Croup 446 10 143 173 52 33 35 - 4. Typhus Fever — — — — — — — - 5. Enteric or Typhoid Fever 36 — 1 2 2 16 15 - 6. Fever, Simple or Continued — - - - - - - - 7. Relapsing Fever — — — — — — — - 8. Puerperal Fever 14 — — — - 8 6 - 9.Erysiperal 202 11 15 9 9 10 126 22 10. Cholera — — — — — — — - 11. Flague — — — — — — — - 12. Anthrax — — — — — — — - 13. Glanders — — — — — — — - 14. Hydrophobia — — — — — — — — 15. Cerebro-Spinal Meningitis 40 5 10 9 8 5 3 — l6. Polio-Myelitis 8 — 8 — — — - — 17, Ophthalmia Neonatorum 31 30 1 — — — — — *18. Chicken pox 247 27 75 124 13 5 3 — Total under Public Health (London) Act, 1891, Sec. 55 2033 99 550 742 249 151 220 22 Tuberculosis—Public Health (Tuberculosis) Regulations, 1912, Primary Notifications on Forms "A," "B," " C & D": Pulmonary 933 2 11 50 60 133 641 36 Do. other Forms 150 14 3° 37 22 18 22 7 *The notification of Chicken-pox was, by an order of the London County Council dated 10th March, 1915, made compulsory from March 17th to 10th June inclusive. ■ SAINT PANCRAS, LONDON. WEEKLY NUMBER OF CERTIFIED DEATHS FROM THE DANGEROUS INFECTIOUS DISEASES DURING THE YEAR 1915. 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 9 16 23 30 6 13 20 27 6 13 20 27 April 3 10 17 24 May. 1 8 15 22 29 5 12 19 26 July 3 10 17 24 31 1 14 21 28 4 11 18 25 Oct. 2 9 16 23 30 6 13 20 27 4 11 18 25 Jan. 1 .. 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 .. .. .. 2 .. 1 .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 1 .. .. .. .. .. 2 1 .. .. .. .. .. .. 2 3 2 1 1 .. 1 .. .. 22 Scarlet Fever. Diphtheria and Membranous Croup 3 1 .. 2 .. .. 1 1 2 • • 2 1 1 1 .. .. .. 1 .. .. .. 1 .. .. 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 1 .. 1 .. 1 .. .. .. 1 24 Diphtheria and Membranous Croup. Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus Fever. Enteric Fever. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. 1 .. .. 1 .. .. 2 .. .. .. .. .. .. 1 .. .. .. 1 .. .. .. 1 .. 8 Enteric Fever. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever. Puerperal Fever .. .. .. 1 .. .. .. .. .. .. .. .. 1 .. .. .. .. 2 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5 Puerperal Fever. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera. Erysipelas 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. 1 .. .. .. .. .. .. 1 .. 2 1 .. 1 .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. .. .. 11 Erysipelas. Pluge .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Plague. Cerebro-Spinal Meningitis .. .. .. 2 .. .. 1 1 1 2 .. .. 1 1 .. 1 .. .. .. .. 1 • • 2 1 .. .. 4 2 .. .. .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. .. 1 24 Cerebro-Spinal Meningitis Polio-Myelitis .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Polio-Myelitis. Ophthalmia Neonatorum .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Ophthalmia Neonatorum. Chicken-pox .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 Chicken-pox Totals 4 1 1 6 .. .. 2 2 4 2 2 2 5 2 2 1 .. 3 .. .. 1 2 3 2 2 1 5 2 1 2 1 1 3 1 • • 5 1 .. .. 1 1 .. 1 3 3 4 3 3 .. 1 1 2 95 Totals. Tuberculosis (Pulmonary) 14 9 9 12 10 10 8 13 10 16 5 7 7 8 11 5 7 5 5 8 9 3 5 5 7 6 8 6 6 4 5 12 5 8 8 6 5 6 3 11 12 4 8 6 5 7 8 7 7 10 5 12 398 Tuberculosis (Pulmonary) „ other forms .. 6 1 1 2 .. 3 3 1 5 4 1 1 1 1 .. 6 2 4 4 .. 3 3 2 4 5 1 2 4 2 3 1 1 1 3 2 1 2 3 3 .. 1 1 .. 1 .. 2 .. 2 1 1 1 102 ,, other forms Measles 1 .. 2 1 2 .. .. 5 3 .. 1 3 5 4 3 5 4 6 3 4 1 2 3 .. 2 .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. 63 Measles. Whooping Cough 2 2 2 .. 1 2 3 1 1 .. 3 1 1 3 .. .. 3 5 2 .. 2 .. 1 3 3 2 1 1 .. .. .. .. .. .. .. .. 2 1 .. .. .. .. .. .. .. .. 1 3 .. .. .. .. 52 Whooping Cough Diarrhoea and Enteritis 4 1 1 1 .. 1 ..' 1 .. 2 • • 3 2 1 .. 2 .. .. 1 2 .. 2 1 1 .. 1 2 1 1 2 1 2 3 3 4 4 4 8 9 12 11 5 2 4 2 1 .. 1 1 1 .. 3 114 Diarrhœa and Enteritis. SAINT PANCRAS, LONDON. WEEKLY NUMBER OF INFECTIOUS CASES CERTIFIED TO THE MEDICAL OFFICER OF HEALTH DURING THE YEAR 1915. 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 9 16 23 30 6 13 20 27 6 13 20 27 April 3 10 17 24 May. 1 8 15 22 29 5 12 19 26 July 3 10 17 24 31 7 14 21 28 4 11 18 25 Oct. 2 9 16 23 30 6 13 20 27 4 11 18 25 Jan. 1 .. 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 18 24 12 21 18 15 13 10 18 12 9 15 6 12 9 11 14 13 10 13 16 22 7 10 19 7 17 11 14 8 11 17 11 20 19 34 34 35 40 39 49 44 47 24 35 31 31 28 22 21 5 8 1009 Scarlet Fever. Diphtheria and Membranous Croup 14 12 11 8 10 6 9 5 10 4 10 9 3 5 11 12 4 11 12 3 12 2 3 4 8 11 14 3 7 9 4 6 2 6 4 8 10 10 10 12 24 13 13 7 10 4 12 8 11 15 9 6 446 Diphtheria and Membranous Croup. Typus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Typhus Fever. Enteric Fever 1 1 .. .. .. 2 .. 1 1 2 .. .. .. 1 .. 1 .. 3 1 .. .. .. 2 .. .. 2 1 .. 1 3 .. 1 2 .. • • .. 3 2 2 .. 1 .. 1 .. .. .. .. .. 1 .. .. .. 36 Enteric Fever. Continued Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Relapsing Fever. Puerperal Fever .. .. 1 1 .. .. 2 .. .. .. 1 .. .. .. .. .. .. 1 1 .. .. .. 1 1 .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 2 .. 1 .. .. .. 14 Puerperal Fever. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera. Erysipelas 8 3 2 5 4 5 1 5 3 3 2 3 3 2 4 3 1 1 2 7 3 7 3 4 3 5 7 3 4 3 2 5 5 5 5 4 5 4 5 4 6 6 5 5 2 6 6 1 3 4 2 3 202 Erysipelas. Pluge .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Plague. Cerebro-Spinal Meningitis .. .. .. 1 .. 1 1 3 4 2 1 2 1 1 3 .. .. 1 1 1 1 .. 3 1 .. 1 4 2 .. .. .. 1 .. .. .. 1 .. .. .. .. .. .. .. 1 1 .. .. .. .. 1 .. .. 40 Cerebro-Spinal Meningitis Ophthalmia Neonatorum .. .. 1 1 1 1 .. .. .. 1 3 .. 1 4 .. 1 • • .. 1 .. 2 .. 2 .. .. .. .. .. .. .. 2 .. .. 1 1 1 2 .. 1 .. .. 1 .. .. .. 1 .. .. .. 1 1 .. 31 Ophthalmia Neonatorum. Polio-Myeelitis .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 1 .. .. .. .. .. .. 1 .. .. .. 2 • • 2 .. .. .. .. 8 Polio-Myelitis. Chicken-pox .. .. .. .. .. .. .. .. .. .. 1 16 9 16 20 17 23 17 20 12 12 25 18 23 8 10 .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 247 Chicken-pox Totals 41 40 27 37 33 30 26 24 36 24 27 45 23 42 47 45 42 47 49 36 46 56 39 43 38 37 43 19 26 23 19 30 20 32 30 48 54 51 58 56 80 65 66 37 48 44 51 39 38 42 17 17 2033 Totals. 413 567 453 600 21 In the accompanying tables (inset) are shown the number of notifications of the notifiable infectious diseases received in each week of the year, and also the corresponding weekly numbers of deaths from these and certain other diseases. In the next table the number of notifications are set out for the past ten years. Diseases. 1905 19C6 1907 1908 1909 1910 1911 1912 1913 1914 1915 Small-pox — — — — — — — — — — — Scarlet Fever 987 791 851 957 774 681 445 598 568 1207 1009 Diphtheria 278 271 337 292 312 259 416 550 440 458 446 Membranous Croup 4 4 8 4 3 3 3 — — — — Typhus Fever - — — — — — — — — — — Enteric Fever 72 96 54 60 50 61 66 29 40 44 36 Fever, Simple and Continued 1 — 1 — — — — — 1 1 — Relapsing Fever - - - - - - - - - - - Puerperal Fever 10 10 4 8 15 14 16 20 11 18 14 Erysipelas 228 231 188 156 160 186 201 190 210 223 202 Cholera - - - - - 1 - - - - - Plague - - - - - - - - - - - Chicken-pox (part of year) .. .. .. .. .. .. 198 .. .. .. 247 Cerebro-Spinal Meningitis •• •• 5 5 6 10 7 3 5 2 40 Polio-Myelitis .. .. .. .. .. .. 2 3 9 3 8 Ophthalmia Neonatorum .. .. .. .. .. .. 26 18 23 34 31 Totals 1580 1403 1448 1482 1320 1215 1380 1411 1308 1990 2033 22 The notification of, and deaths from, the notifiable infectious diseases, are classified in the following tables, according to their Wards and Registration Sub-Districts:— INFECTIOUS DISEASES. Notifications. Deaths. West. Ward South. Ward EastWard North. Ward No Address. Whole Borough. West. Ward South. Ward East. Ward North. Ward No. Address. Whole Borough. 4 5 7 8 3 6 1 2 4 5 7 8 3 6 1 2 1. Variola or Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 2. Scarlatina or Scarlet Fever .. 100 130 44 61 169 250 132 123 .. 1009 1 3 2 1 6 3 3 3 .. 22 3. Diphtheria and Membranous Croup 51 78 33 50 62 44 65 63 .. 446 2 5 2 2 6 1 2 4 .. 24 4. Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 5. Entericor Typhoid Fever 7 4 9 1 4 3 6 2 .. 36 .. 1 .. 1 1 1 2 1 1 8 6. Fever, Simple and Continued .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 7. Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 8. Puerperal Fever 3 1 1 .. 3 1 3 2 .. 14 .. .. .. .. 2 • • 1 2 •• 5 9. Erysipelas 34 23 16 19 25 36 26 23 .. 202 2 3 2 2 .. .. 1 1 •• 11 10.Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 11.Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 12.Anthrax .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 13.Glanders .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 14.Hydrophobia .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. 15. Cerebro-Spinal Meningitis 4 4 2 6 8 6 3 7 .. 40 2 3 2 2 5 3 3 4 •• 24 16. Polio-Mvelitis 1 3 .. 1 1 1 .. 1 .. 8 .. .. .. .. .. .. .. .. .. .. 17. Ophthalmia Neonatorum 4 3 8 6 5 2 1 2 .. 31 .. .. .. .. .. .. .. .. .. .. 18. *Chicken-pox 13 14 5 21 57 49 50 38 .. 247 .. .. .. .. .. 1 .. .. .. 1 Total under Public Health (London) Act, 1891, Section 55 217 260 118 165 334 392 286 261 .. 2033 7 15 8 8 20 9 12 15 1 95 Tuberculosis primary notifications— Public Health (Tuberculosis) Regulations 1912, Articles 5 and 6, Forms "A" "B" "C" and "D"; ,, Pulmonary 125 117 82 116 102 106 121 80 84 933 64 55 29 48 55 41 45 38 23 398 „ other forms 8 20 5 20 14 43 19 12 9 1501 18 16 7 9 11 15 11 13 2 102 * The notification of Chicken-pox was, by an order of the London County Council dated 10th March, 1915, made compulsory from March 17th to June 10th inclusive. 23 Below is given the number of advices received from the London County Council Schools respecting the exclusion from school of children (patients, contacts, and suspects) on account of infectious conditions:— School Notification of Exclusion. Patients, contacts and suspects. Actual cases. Notifiable Infectious Diseases 2176 567 Measles 2669 1409 Whooping Cough 476 387 Chicken-pox 902 593 Mumps 239 223 Other Definite Diseases 197 149 Suspicious Symptoms 177 177 Ringworm 228 217 Impetigo, &c. 122 104 Scabies 30 29 Pediculosis 7 7 7223 3862 24 PART II.—SPECIAL SUBJECTS, MATERNITY AND INFANT WELFARE. The annual statistics in regard to births and deaths of infants are given on pages 10-13 and 17-19 of this report. The ordinary work of the department in regard to births reported under the Notification of Births Act has been continued, an advice card being sent to all the mothers , and home visiting being done by Miss Smith, Sanitary Inspector and Health Visitor. Owing to the smallness of our female visiting staff only a small proportion of mothers have received personal visits. Expectant Mothers.—A start was made in the department at the end of 1914 in the direction of work amongst expectant mothers. From that time the authorities of University College Hospital, Middlesex Hospital, the New Hospital for Women, and the Maternity Nursing Association have furnished the Medical Officer of Health with the names of those St. Pancras expectant mothers who have arranged with them for attendance at confinement. Miss Smith undertook the visiting of some of these women, and the names of the others were forwarded to the various voluntary maternity centres according to their place of residence for visiting by the staffs of the centres. In this way a considerable number of expectant mothers were brought under the influence of visitors for appropriate advice and assistance. They were also urged to attend periodically at one of the maternity centres, to be interviewed by the doctor in attendance and advised in accordance with their varying condition. Certain cases were referred to the Soldiers and Sailors Families Association and to the Invalid Kitchens Association. A card of advice for expectant mothers has also been drawn up by the Medical Officer of Health, and supplies of these cards are kept by University College Hospital, Middlesex Hospital, and the Maternity Nursing Association, one card being given to every St. Pancras expectant mother when she attends to arrange for confinement. The work done by the department during the year by the departmental staff in connection with maternity and infant welfare is indicated by the following figures:— Total births (excluding still-births) notified 3994 Still-births notified 137 Advice cards sent to cases notified (on receipt of notification) 3994 Advice cards sent to cases registered but not notified (on receipt of Registrars' returns) 400 Cautionary letters sent to cases registered but not notified 400 Visits—No. of births visited 980 Additional visits 1073 Total visits to mothers with infants 2053 No. of expectant mothers visited 235 Additional visits 46 Total visits to expectant mothers 281 Extra visits (to Maternity and Infant Welfare Centres, Hospitals, Mid wives, etc.) 460 25 "Voluntary Matermity and Infant Welfare Work. "Extern" Midwifery.—The number of St. Pancras mothers attended gratuitously at their confinements in their own homes during 1915, according to the birth notification returns, was as follows:— * New Hospital for Women (doctors) 146 University College Hospital (medical students) 979 Do. do. (midwives) 186 Middlesex Hospital (medical students) 127 Royal Free Hospital (medical students) 57 St. Bartholomew's Hospital (medical students) 7 * Maternity Nursing Association, Myddleton Square and Oakley Square (midwives) 123 1625 (or one-third of the total number of births). (* In some of these cases the women were charged reduced fees). Grants in aid of extern midwifery work were made by the Local Government Board for the financial year 1915-16 to University College Hospital (£380 10s. 0d.) and the Maternity Nursing Association (£116). "Intern" Midwifery.—The number of St. Pancras births which took place in lying-in and general hospitals and in the St. Pancras House—formerly the Workhouse—were as follows:— University College Hospital 99 Middlesex Hospital 127 Queen Charlotte's Lying-in Hospital 175 City of London „ „ 110 Other Hospitals 29 St. Pancras House 62 602 (or one-eighth of the total number of births). Infants' Clinic.—A special clinic for sick infants and children under school age has been held during the year at the St. Pancras Dispensary, 39, Oakley Square. Such infants are referred to the clinic from the various infant welfare centres and other sources. During 1915, 398 new cases, under 5 years of age, were treated at the dispensary, of which 65 were treated by the dispensary doctor in their own homes. The total number of attendances of these children was 1003, and the total number of home visits 184. A grant of £50 was made by the Local Government Board to the dispensary in respect of the clinic for the financial year 1915-16. The dispensary also attended 35 women for illness associated with pregnancy or the puerperum. Provision was made by the dispensary also, through the Maternity Nursing Association, for 24 ordinary midwifery cases (extern). 26 Maternity ami Infant Welfare Centret.—Two new voluntary centres were started in St. Pancras during 1915. One of these, the Camden Town Mothers' and Infants' Welfare Centre, Greenland Street, N.W., was opened in April. It is held in the St. Michael's Mission Buildings one afternoon per week, and the health visiting work in connection with it is done by the staff of the Public Health Department. The other new consultation, the Mothers' and Infants' Welfare Centre, 40, Argyle Square, was opened in May. It is held in a house of its own beautifully converted for the purpose, and during 1914 one consultation per week for infants and one for expectant mothers were held. In addition the Maternity Nursing Association, 73, Oakley Square, N.W., started in March a fortnightly consultation for expectant and nursing mothers who are to be or have been attended by the Association in their confinement. The Four Boroughs Maternity Scheme have supplied the Medical Officer for weekly pre-natal consultations at the Passmore Edwards Settlement School for Mothers and the Argyle Square Centre. The Highgate Road Maternity Centre, which was started in 1914 at 5, Grove Terrace, Highgate Road, N.W., was discontinued early in 1915, owing to the lack of funds, This is much to be regretted. The work done at the voluntary Maternity and Infant Welfare Centres during 1915 is shown in the following table:— Attendances. Visits. Expectant Mothers. Mothers with Infants. Expectant Mothers. Mothers. with Infants. New cases. Total attendances. New cases. Total attendances. St. Pancras School for Mothers 223 261 3029 1282 North St. Pancras School for Mothers:— Rhyl Street Centre 3 4 318 3411 13 2236 Winscombe Street Centre — - 45 585 184 Passmore Edwards Settlement School for Mothers 2 4 44 1039 17 282 * Camden Town Mothers' and Infants' Welfare Centre 18 43 91 315 22 267 †Argyle Square Mothers' and Infants' Welfare Centre 8 11 91 458 about 2800 Maternity Nursing Association, 73, Oakley Square 245 735 142 University College Hospital Royal Free Hospital 86 209 - - * 9 months only. † 8 With a few exceptions the visits stated in the above table were made by qualified visitors. 27 Government Grants.—The fo lowing grants were made for the financial year 1915-16:- Institution. Amount. Grant made by. £ s. d. St. Pancras School for Mothers 417 8 7 Board of Education. North St. Pancras School for Mothers 101 16 11 Local Government Board. Passmore Edwards Settlement School for Mothers 34 19 11 ,, „ Infantile Diarrhœa. 79 deaths of infants under one year of age from diarrhoea and enteritis were registered during 1915. The number of such deaths in each quarter of the year was as follows:— First quarter 7 Second „ 8 Third „ 35 Fourth „ 29 The number of deaths of children under 5 years of age from diarrhoea and enteritis was 107. OPHTHALMIA NEONATORUM. 31 cases of ophthalmia neonatorum were notified during 1915, 27 by medical practitioners, 2 bj midwives, and 2 by both. Of these, one case notified by a midwife proved lot to be a case of ophthalmia neonatorum, and one case was doubtful. The corrected number of notified cases was therefore 29, equal to an incidence rate of 6.1 per 1,000 births. Other numerical details will be found on pages 20-22. All the cases were visited by Miss Smith, who made full enquiries, and where necessary took steps, in some cases in consultation with the doctors in attendance, to ensure that the baby's eyes received proper attention. In this matter the services of the local District Nursing Associations have been of great assistance. In regard to severity, 3 of the cases were regarded by the visitor as grave, 16 as moderate, and 14 as slight. The cases are classified in the following table according: as the mothers were attended in their confinement, by doctors, midwives, or medical students (in their own homes), or were delivered in hospital. Attended at birth by Cases of Ophthalmia Neonatorum. Total n umber of births notifed. No. of cases per 1000 births notified. Doctors 7 1407 5 Midwives from U.C.H. 0 186 0 Private Midwives 7 956 7.3 Medical Students 4 1170 3.4 Delivered in Hospitals 10 .. .. „ Workhouse 1 .. .. 29 28 The 29 cases were treated as follows:— By private Doctor, nursing being done by members of family 2 „ „ „ „ Visiting Nurse 6 ,, Ophthalmic Hospitals (Central London and Royal London out-patient departments) 5 ,, Middlesex Hospital (out-patient department) 11 ,. New Hospital for Women (out-patient department) 2 „ Other Institutions 2 — 20 (Of these 9 were nursed by Visiting Nurse and 11 by their own family). Treated in St. Pancras Infirmary 1 29 The results of treatment were as follows:— Complete recovery 23 Sight slightly damaged, but improving 1 Partial blindness 1 Complete blindness 0 Cases lost sight of 3 Died a week after birth 1 29 PUERPERAL FEVER. 14 patients were notified as suffering from puerperal fever during the year, equal to an incidence rate of 2.9 per 1,000 births. Five deaths from this disease were registered during the year, giving a case mortality of 35.7 per cent. 13 cases followed the birth of live-born infants, and one case an abortion. 7 of the patients were primiparæ (i.e., women who had not previously borne children), and 7 multiparæ;. In 6 cases " instruments " were used at the confinement. Inquiries were made in each case as to the existence in the home of scarlet fever, erysipelas, or other infectious disease, or of septic conditions, with negative results, except that in one case the patient had a septic wound resulting from a scald on the ankle three weeks before confinement. Symptoms developed on 1st day after delivery in 1 case. „ „ „ 2nd „ „ „ „ 2 cases. „ „ „ 3rd ,, ,, ,, ,, 2 ,, „ „ „ 4th ,, ,, ,, ,, 2 ,, „ „ ,, 5th ,, ,, ,, ,, 1 case. „ „ „ 6th „ ,, ,, ,, 1 „ „ „ 7th ,, ,, ,, ,, 1 ,, „ „ 11th ,, ,, ,, ,, 1 ,, „ „ 3 weeks ,, ,, ,, 1 ,, In two cases this information was not available. 29 In the following table the cases are classified according to the manner in which the patients were attended in their confinements : — Confinement attended by No. of casei of Puerperal Fever. Total number of births notified. No. of cases per 1000 births. Doctors 7 1407 5 Midwives from U.C.II. 0 186 0 Private Midwives 3 956 3.1 Medical Students 1 1170 0.8 In Hospital 2 — — No Attendance 1 - - The cases were treated as follows :— At home 6 In M.A.B. hospitals 2 In other hospitals 6 TUBERCULOSIS. Under the Public Health (Tuberculosis) Regulations, 1912, medical practitioners are required to notify every case of all forms of tuberculosis unless there are reasonable grounds for believing that the case has already been previously notified. Such notifications are made on " Form A," except in the case of the notification of school children by school medical inspectors, which is made on "Form B." "Form C" is used for the notification of admission to Poor Law Institutions and Sanatoria of previously notified cases, and these notifications should be sent to this authority whenever a St. Pancras case is admitted to any such institution. " Form D" is used for the notification of discharge from Poor Law Institutions and Sanatoria of previously notified cases, and these notifications should be sent to this authority whenever a case is discharged to a St. Pancras address. The total number of notifications of cases of tuberculosis received during 1915 (Forms A, B, C and D), including duplicate notification was 1,982 (1817 pulmonary: 165 non-pulmonary). 917 notifications (781 pulmonary, 136 non-pulmonary) were received during the year on forms A and B. Of these 117 (111 pulmonary, 6 nonpulmonary) had been notified to this authority before; so that the number of primary notifications received on forms A and B was 800 (670 pulmonary, 130 non-pulmonary). 1065 notifications (1036 pulmonary, 29 non-pulmonary) were received on forms C and D. Of these 283 (263 pulmonary, 20 non-pulmonary) were in respect of cases which had not been notified previously to this authority. The total number of primary notifications received during the year was, therefore, 1,083 (933 pulmonary, 150 non-pulmonary). In the previous year (1914) the number of primary notifications received was 1,014 (893 pulmonary, 121 non-pulmonary). In the following table the notifications received are set out in the form suggested by the Local Government Board. 30 Public Health (Tuberculosis) Regulations, 1912. Summary of Notifications during the period from 3rd January, 1915, to the 1 st January, 1916 (inclusive). Age Periods. Number of Notifications on Form a, Number of Notifications on Form 13. Number of Notifications on Form C. Number of Notifications on Form D. Primary Notifications. Total Notifications (i'.e.,including cases previously notified by other Doctors), Primary Notifications. Total Notifications including cases previously notified by other Doctors). Poor Law Institutions. Sanatoria. Poor Law Institutions. Sanatoria. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Total. Undr 5 5 to 10 10 to 15 Total. Pulmonary—Males 2 3 16 14 13 31 65 93 74 35 16 362 419 — 5 6 11 14 364 141 166 130 ,, Females — 5 15 18 24 35 59 71 32 17 8 284 332 — 3 10 13 16 82 70 28 55 Non-pulmonaiy—Males 10 11 9 3 2 3 4 3 1 1 4 51 54 6 4 10 10 6 9 1 3 ,, Females 4 14 10 10 8 4 4 4 - — 2 60 62 1 5 3 9 10 3 6 1 — Totals 16 33 50 45 47 73 132 171 107 53 30 757 867 1 19 23 43 50 455 226 196 188 Age Periods. Number of Primary Notifications on Form C. included in above. Number of Primary Notifications on Form D. included in above. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Total. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Total. Pulmonary—Males — 3 3 5 2 14 37 42 33 22 9 170 — - 2 — 1 2 5 5 4 — 1 20 ,, Females — — 5 6 5 6 19 12 5 5 2 65 — - 1 1 — - 2 2 — 2 — 8 Non-pulmonary—Males — 3 5 — 1 — 1 1 — 1 — 12 — - — — — — — — — — — — ,, Females — 1 2 2 — — 1 — 1 — 1 8 - - - - - - - - - - - - Totals - 7 15 13 8 20 58 55 39 28 12 235 — - 3 1 1 2 7 7 4 2 1 28 31 The 1,083 primary notifications are analysed for age and sex in the next table:— Primary Notifications during 1915. Ages. Pulmonary Tuberculosis. Other Tuberculosis. Total all forms. Males. Females. Total. Males. Females. Total. 0—1 2 — 2 10 4 14 16 1—5 6 5 11 14 16 30 41 5—10 26 24 50 20 17 37 87 10-15 25 35 60 7 15 22 82 15—25 63 70 133 6 12 18 151 25—35 107 80 187 5 5 10 197 35-45 140 85 225 4 4 8 233 45— 54 111 37 148 1 1 2 150 55—65 57 24 81 2 — 2 83 65 and upwards 26 10 36 4 3 7 43 Totals 563 370 933 73 77 150 1083 The rates for 1915 of (primary) notification of tuberculosis based on the 1911 census population of the Borough (males 106,728, females 111,659), and the rates based on the civil population (see p. 9) were therefore:— Of males per 1000 male population. Of females per 1000 female population. Total persons per 1000 population. Total persons per 1000 civil population. Pulmonary tuberculosis 5.27 3.31 4.27 4.66 Other forms of tuberculosis .68 .69 .69 .75 All forms of tuberculosis 5.95 4.00 4.96 5.41 The deaths from tuberculosis during the year numbered 500, of which 398 were from phthisis, and 102 from other forms of tuberculosis. 32 These are analysed for age and sex in the following table :— Deaths from Toberculosis during the Year 1915. Ages. Phthisis. Other Tuberculosis. Total. Males. Females. Total. Males. Females. Total. 0-1 l — l 9 5 14 15 1—2 — — — 9 5 14 14 2—5 l — l 8 12 20 21 5—10 2 4 6 13 3 16 22 10—15 2 8 10 3 8 11 21 15—25 14 23 37 5 6 11 48 25-35 52 29 81 2 5 7 88 35—45 67 30 97 1 2 3 100 45—55 69 27 96 3 1 4 100 55—65 34 13 47 — 1 1 48 65—75 11 8 19 — 1 1 20 75—85 3 — 3 — — — 3 85 & upwards - - - - - - - Totals at all Ages. 256 142 398 53 49 102 500 The death rates for 1915 from tuberculosis based on the 1911 census population of the borough, and the rates based on the civil population, were therefore:— Of males per 1000 male population. Of females per 1000 female population. Total persons per 1000 population: Total persons per 1000 civil population. Phthisis 2.40 1.27 1.82 1.99 Other forms of tuberculosis .50 .44 .47 .51 All forms of tuberculosis 2.90 1.71 2.29 2.50 33 The deaths from tuberculosis in 1915 are classified in the following table according to the part of the body affected and according to age and sex. 0-1 1-5 5—15 15—25 25—35 35—45 45—55 55—65 65—75 75—85 85 up. Total Males. 0—1 1-5 5—15 15—25 25—35 35-45 45—55 55-65 65-75 75—85 85 up. Total Females. Total Persons. Pulmonary Tuberculosis 1 1 4 13 43 58 60 33 10 3 - 226 - - 11 19 23 26 24 11 7 - - 121 347 Phthisis (not defined as tuberculous) - — - 1 9 9 9 1 1 - - 30 - - 1 4 6 4 3 2 1 — - 21 51 Total Pulmonary Tuberculosis 1 1 4 14 52 67 69 34 11 3 - 256 - - 12 23 29 30 27 13 8 - - 142 398 Acute Phthisis - - - - 1 1 - - - - - 2 - — — 1 2 — - — - - - 3 5 Acute Miliary Tuberculosis 3 - — 1 — — 1 - — - - 5 1 2 3 1 2 1 - - - - - 10 15 Tuberculous Meningitis 5 15 9 1 - - 1 — - — - 31 3 11 5 2 - 1 - - - - - 22 53 Tabes Mesenterica - - - - - - - - - - - - - - - - - - - - - - - - - Other Peritoneal and Intestinal Tubercle 1 - 1 1 - — 1 — — - - 4 — 2 1 1 - — - - - _ - 4 8 Tuberculosis of Spinal Column — - 1 1 - - - - - - - 2 — — — - 1 — - - - - - 1 3 Tuberculosis of Joints - - 2 - - - - - - - - 2 - - - - - - 1 - 1 - - 2 4 Lupus - - - - - - - - - - - - - - - - - - - - - - - - - Scrofula - - - - - - - - - - - - - - - - - - - - - - - - - Tuberculosis of other Organs ... — 1 1 - 1 — - - - - - 3 - - - - - — - 1 - - - 1 4 Disseminated Tuberculosis — 3 - 1 - - - - - - - 4 1 2 2 1 - - - - - - - 6 10 Total Non-Pulmonary Tuberculosis 9 19 14 5 2 1 3 - - - - 53 5 17 11 6 5 2 1 1 1 - - 49 102 Total all forms of Tuberculosis 10 20 18 19 54 68 72 34 11 3 - 309 5 17 23 29 34 32 28 14 9 — - 191 500 34 In the next table the new cases notified daring 1915 are classified according to the part of the body affected and according to age and sex. Location of Disease. Ages. Total. 0—5 5-15 15 and upwards. Males. Females. Males. Females. Males. Females. Pulmonary Tuberculosis 8 5 51 59 504 306 933 Bones and Joints - 2 8 13 10 9 42 Meninges 16 12 5 4 1 1 39 Glands 3 — 10 11 3 7 34 Abdominal 2 5 1 2 4 2 16 Genito-Urinarv — — - - 4 2 6 General — 1 1 - - 1 3 Other Organs 3 — 1 2 2 2 10 Toial Non-pulmonary Tuberculosis 24 20 26 32 24 24 150 Total all forms of Tuberculosis 32 25 77 91 528 330 1083 In the following table the deaths from and primary notifications of tuberculosis, together with the corresponding rates, are classified in Wards. tration Sub-District. Primary Notifications. Notification Rates. Deaths. Death-rates. Ward. Pulmonary. Other Forms. All Forms. Pulmonary. Other F rnw. All Forms. Tulmonaiy. Other Forms. All Forms. Pulmonary. Other Forms. All Forms. West 4 125 8 133 474 .30 5.04 64 18 82 2.42 .63 3.10 5 117 20 137 3.67 .63 4.30 55 l6 71 1.73 .49 2.22 South 7 82 5 87 4.52 .28 4.80 29 7 36 1.60 .39 1.99 8 116 20 136 4.28 .74 5.02 48 9 57 1.77 .33 2.10 East 3 102 14 116 2.94 .40 3.34 55 11 66 1.58 .32 1.90 6 106 43 149 4.67 1.89 6.36 41 15 56 1.80 .06 2.46 North 1 121 19 140 3.40 .53 3.93 45 11 56 1.27 .31 1.58 2 80 12 92 3.60 .55 4.21 38 13 51 1.74 .59 2.33 No Address - 84 9 93 — - — 23 2 25 — — — Whole Borough - 933 150 1083 4.27 .9 4.96 398 102 500 1.82 1.47 2.29 35 In the following table are shown the death-rates from tuberculosis for the past 10 years:— Year. Estimated Population. Tuberculosis Death-Rate. Corresitondiny rates for all Fonnt" based on 1911 census Population. County of London Phthisis Death Rate. Phthisis. Other Forms. All Forms. 1906 237149 1.69 .52 2.21 1.50 1907 237173 1.59 .43 2.02 1.46 1908 237247 1.53 .41 1.94 1.39 1909 237247 1.58 .33 1.91 2.07 1.46 1910 237247 1.25 .32 1.57 1.71 1.25 1911 237129 1.39 .35 1.74 1.89 1.35 1912 220353 1.48 .32 1.82 1.84 1.35 1913 218387 1.46 .30 1.79 1.79 1.30 1914 218387 1.67 .30 1.97 1.97 1.39 1915 218397 1.82 .47 2.29 2.29 1.50 The weekly distribution of deaths from tuberculosis will be found in the table inset at page 21. Work Done. As in former years the work in connection with tuberculosis has been done by the female staff under the direction of the Medical Officer of Health. Miss Bibby has devoted part of her time to it, and Miss Giles most of her time. The work which has been done has consisted mainly in the visiting of notified cases. At these visits a case paper is filled up for each case, and advice is given as to the means that can be adopted by the patients to assist their recovery, and by the families of the patients to avoid contracting the disease. Where there are contacts whose health is not all that can be desired, or where the patient appears not to be under adequate medical attention the contacts or patients are advised to seek medical advice. In many such cases use has been made of the two approved dispensaries. Care has been taken not to trespass upon the preserves of private practitioners, and no complaints have been received on this score. Practically all cases notified during the year have been visited, and a good deal of systematic re-visiting has been done. Disinfection of bedding and bedrooms has been carried out on the advice of the tuberculosis visitors, and on application after the death or removal of patients, and in other cases. Where insanitary conditions have been found they have been reported by the tuberculosis visitors to the District Sanitary Inspectors, and dealt with in due course. Much good work has been done by the tuberculosis visitors in putting necessitous patients and families into touch with various charitable and other 36 agencies. They have also been in frequent attendance at the approved dispensaries to see cases who have been treated there. The actual work done by the Lady Inspector and Visitor is shown below : — No. of visits to homes of notified cases— (а) First visits 977 (b) Subsequent visits 433 No. of cases in which disinfection was carried out 99 Attendances of inspector or visitor at the dispensaries 85 Other visits made for various purposes 135 Treatment of Tuberculosis. Tuberculosis Dispensaries.—The Council's scheme for the dispensary treatment of tuberculosis is as follows:— The part of the borough lying north of Euston Road (viz.: Ward 1-6, comprising a population of 173,132) is served by the approved tuberculosis dispensary at the St. Pancras Dispensary, 39, Oakley Square, N.W., together with a branch of this dispensary at 132, Maiden Road, N.W. (this branch was opened in December, 1915, and has been since approved by the Local Government Board). A full-time tuberculosis officer and visiting nurse are attached to these dispensaries. Annual payment is to be made by the Council to the St. Pancras Dispensary for these services of £564 in respect of noninsured persons, and £250 in respect of insured persons. The part of the borough lying south of Euston Road (viz. : Wards 7 and 8, comprising a population of 45,255) is served by the approved tuberculosis dispensary at University College Hospital, Gower Street, W.C., which also serves all the borough of Holborn. A full-time tuberculosis officer and a visiting nurse are attached to the dispensary. Annual payment is to be made by the Council to the hospital for these services to St. Pancras persons of £200 in respect of roninsured persons, and £100 in respect of insured persons. Of the grants in respect of non-insured persons, one half is to be repaid to the Council by the Local Government Board and one quarter by the London County Council, while the whole of the grants in respect of insured persons are to be repaid by the London Insurance Committee. The scheme was approved during 1915 by the Local Government Board, the London County Council, and the London Insurance Committee, and draft agreements were made between the Council on the one hand and the London Insurance Committee, the St. Pancras Dispensary and University College Hospital on the other. These agreements, however, had not been executed by the end of the year. 37 The work done at the dispensaries during 1915 is shewn in the following table based on figures supplied from the dispensaries:— St. Pancras Dispensary. University College Hospital. Insured. Ifoninsured. Total. Insured. Noninsured. Total. No. of new cases 56 257 313 35 91 126 ,, ,, new contacts — 141 141 0 51 51 Total number of attendances:— Cases 372 1498 1870 224 298 522 Contacts. . 0 75 75 No. of examinations for determining form of treatment about 30 about 50 about 80 Residental Institutions.—Institutional treatment (sanatorium and hospital) is provided by the London Insurance Committee for insured persons, and bv the London County Council for non-insured persons. In addition, many tuberculous poor are dealt with by the Guardians in the Infirmaries, and charitable societies send away a certain number of cases. Bacteriological Examinations.—321 specimens of sputum from St. Pancras patients have been examined for medical practitioners by the Lister Institute of Preventive Medicine at the expense of the Borough. 78 of these were reported as containing tubercle bacilli, and 243 as negative. SCARLET FEVER. 1,009 St. Pancras (civil) patients were notified during 1915 as suffering from scarlet fever. This figure includes St. Pancras cases wrongly notified to medical officers of health of other authorities and transmitted to St. Pancras, and excludes 28 cases notified to this authority but belonging to other districts. Of the 1,009 cases notified, 109 were afterwards found not to be suffering from scarlet fever, 99 by the Medical Superintendents of the Metropolitan Asylums Board Hospitals, and 10 by other Medical Practitioners. This gives the net number of cases of scarlet fever notified during the year as 900, equal to an incidence rate of 4.1 per 1,000 population, and 4.5 per 1,000 civil population (see p.9). The number of deaths from scarlet fever certified during the year was 22, equal to a death-rate of 0.10 per 1,000 population, or 0.11 per 1000 civil population, and a case mortality of 2.44 per cent. of cases notified. Interim grants on the scale of the scheme were made by the Council to the two dispensaries in respect of non-insured persons as from 1st April, 1915, and proportional repayment duly received from the Board and the Countv Council. No corresponding payment was made for insured persons, but since the end of the year this has been done as from 1st October, 1915. 38 Other statistical facts in regard to the disease will be found at pp. 20-22. In the following table are set out the number of cases of scarlet fever notified, the number of deaths, and the corresponding rates during the past 10 years:—  Number of Notifications. Notification rate per 1( 00 Population. Number of Deaths. Death-Rate per 1000 Population. Percentage of Cases Removed. Case-Mortality per Cent. 1905 987 4.16 27 0.11 95 2.74 1906 791 3.34 32 0.13 94 4.05 1907 851 3.59 26 0.11 91 3.06 1908 957 4.04 20 0.08 93 2.09 1909 774 3.26 17 0.07 97 2.20 1910 681 2.87 17 0.07 96 2.49 1911 445 1.88 10 0.04 95 2.24 1912 598 2.71 5 0.02 97 0.08 1913 568 (536) 2.55 (2.41) 6 0.03 94 1.06 (1.12) 1914 1207 (1180) 5 53 (5.40) 19 0.09 91 1.57(1.61) 1915 1009 (900) 4.62 (4.12) 22 0.10 96 2.18 (2.44) The figures in brackets are corrected for errors of diagnosis. The other figures are not corrected. The notification rate of scarlet fever per 1,000 population for the County of London was 3.94. Five Metropolitan Boroughs had notification rates greater than St. Pancras and 22 (exclusive of the City) less. The death-rate from scarlet fever per 1,000 population for the County of London was 0.07. Of the notified cases of scarlet fever, 971 (or 96 per cent.) were removed to hospital, as follows:— To Metropolitan Asylums Board hospitals 960 To other hospitals 11 971 Return Cases of Scarlet Fever. The definition of "return-case" of scarlet fever adopted is as follows:— A return-case of scarlet fever is one beginning within 28 days of the return from hospital to the same house of a previous case of scarlet fever. Upon this definition there were 27 return-cases of scarlet fever during 1915. These were made up as follows:— Houses with one return-case only 14 „ „ a series of 2 return cases 2 „ „ „ „ 3 „ „ 3 39 There were, therefore, 19 return outbreaks of scarlet fever, which means that 19 houses were affected. In 17 of these the return-case or cases were in the same family as the infecting (?) case, and in 2 in a different family in the same house. The cases are classified below according to the number of days that elapsed between the return of the infecting (?) case and the onset of illness of the return-case : — 2 days 1 11 days 2 18 days . . 1 4 „ 1 12 „ 1 20 1 5 ,, 3 13 ,, 1 22 ,, 1 6 „ 2 14 „ 1 24 „ 1 7 „ 1 15 „ 1 25 „ 1 Six of the infecting (?) cases had rhinitis subsequently to their return from hospital (of which 1 also had desquamation), one otorrhœa, and one boils subsequently to their return. (All the infecting (?) cases were not examined, and therefore there may have been others with discharges or other infectious conditions.) In addition to the above cases there were 5 cases of scarlet fever occurring more than 4 weeks and less than 8 weeks after the return of a former case to the same house. Three of these were in the same houses as 3 of the 27 return cases considered above, and the other 4 were in separate houses. One case of scarlet fever occurred 24 days after the return home from hospital of a case of diphtheria in the same family. There was no evidence of any spread of scarlet fever through infected milk supplies during the year. Outbreaks of Scarlet Fever in intitutions. At the Orphan Working School, Maitland Park, in continuation of the outbreak of 1914 there were 5 cases of scarlet fever (and 6 of diphtheria) in the first five months of 1915. Since then the school has been free from these diseases. There are no other outbreaks in institutions to record. DIPHTHERIA. 446 St. Pancras (civil) patients were notified during 1915 as suffering from diphtheria or membranous croup. This figure includes St. Pancras cases wrongly notified to medical officers of health of other authorities and transmitted to St. Pancras, and excludes 24 cases notified to this authority, but belonging to other districts. Of the 446 cases notified 65 were afterwards found not to be suffering from diphtheria, 63 by the Medical Superintendents of the Metropolitan Asylums Board hospitals, and 2 by other medical practitioners. This gives the net number of cases of diphtheria notified during the year as 381, equal to an incidence rate of 1.7 per 1.000 population, and 1.9 per 1000 civil population (see page 9.) The number of deaths from diphtheria certified during the year was 24, 40 equal to a death-rate of 0.11 per 1,000 population, and 0.12 per 1000 civil population, and case mortality of 6.30 per cent. of cases notified. In the following table are set out the number of cases of diphtheria notified, the number of deaths, and the corresponding rates during the past ten years:— Year. Number of Notifications. Notification Rate per 1000 Population. Number of Deaths. Death Rate per 1000 population. Percentage of Cases Removed. Case-Mortality per cent. 1905 282 1.19 26 0.11 91 9.22 1906 275 1.16 22 0.09 88 8.00 1907 345 1.46 28 0.12 92 8.12 1908 296 1.25 23 0.09 91 7.77 1909 315 1.33 28 0.12 93 8.89 1910 262 1.10 20 0.08 97 7.63 1911 419 1.77 37 0.15 94 8.83 1912 550 2.50 26 0.11 98 4.73 191.3 440 (391) 1.98 (1.76) 19 0.08 97 4.31 (486) 1914 458 (426) 2.10 (1.95) 30 014 87 6.55 (7.04) 1915 446 (311) 2.04 (1.75) 24 0.11 95 5.38 (6.30) The figures in brackets are corrected for errors of diagnosis. The other figures art not corrected. The notification rate of diphtheria per 1,000 population for the County of London was 2.11. Five Metropolitan Boroughs (exclusive of the City) had notification rates greater than St. Pancras, and 21 less. The death-rate from diphtheria per 1,000 population for the County of London was 0.16. Other statistical facts in regard to diphtheria will be found on pages 20-22. Of the notified cases of diphtheria 425 (or 95 per cent.) were removed to hospital, as follows:— To Metropolitan Asylums Board hospitals 402 To other hospitals 23 425 Return Cases.—In six houses cases of diphtheria occurred within 28 days of the return from hospital to the same house of a former case of diphtheria. The interval between date of return of first case and date of onset of illness of second case were 1, 5, 12, 14 and 22 days respectively (no record in one case). In one case the (?) infecting case had rhinitis, but" in the other 5 cases there was no history of anything wrong with the (?) infecting case. In two houses also cases of diphtheria occurred within 28 days of the return from hospital to the same house of a case of scarlet fever. In one of these 41 houses (where there were three return cases of diphtheria), the scarlatinal case was found to have rhinitis. No evidence of the spread of the disease by milk was found. Six cases of diphtheria occurred at the Foundling Hospital in the first half of the year. There are no other important outbreaks in institutions to record. Bacteriological Examinations.—256 swabs from St. Pancras patients were examined during the year by the Lister Institute of Preventive Medicine for the presence of diphtheria baccilus at the expense of the Borough. Of these 68 gave positive results and 188 negative results. TYPHOID FEVER. 36 cases were notified as suffering from typhoid fever during 1915, Of these 36 cases, 12 were afterwards reported not to be suffering from the disease (by Medical Superintendents of Metropolitan Asylums Board hospitals). Of the remaining 24 cases, 8 were soldiers admitted to hospitals in the borough from abroad already suffering from typhoid fever (2) or paratyphoid fever (6). The true cases of typhoid fever belonging to the civil population notified during the year were therefore 16 in number, equal to an incidence rate of 0'08 per 1,000 civil population. Eight deaths (civil) were certified in 1915 as due to typhoid fever, equal to a death-rate 0 04 per 1,000 civil population. Three of these were of St. Pancras patients in outlying lunatic asylums. Of the 16 notified cases, 5 died, the case mortality being therefore 31 per cent. In the following table are set out the number of cases of tvpboid fever notified, the number of deaths certified, and the corresponding rates during the past 10 years:— Year. Number of Notifications. Notification Rate per 1,000 Civil Population. No. of Deaths. Death Rate per 1,000 Civil Population. Case-mortality per cent. 1905 72 0.30 8 0.03 11.11 1906 96 0.40 13 0.05 13.54 1907 54 0.22 4 0.02 7.40 1908 60 0.25 10 0.04 16.67 1909 50 0.21 6 0.03 12.00 1910 61 0.26 4 0.02 6.56 1911 66 0.27 7 0.04 10.60 1912 29 0.13 2 0.01 6.89 1913 41 (26) 0.18 (0.12) 6 0.03 14.6 (23.0) 1914 44 (27) 0.20 (1.12) 4 0.02 90 (14.8) 1915 28 (16) 0.14 (0.08) 8 0.04 28.6 (31.2) The figures in brackets are corrected for errors of diagnosis. The other figures are not corrected. 42 Other statistical facts in regard to the disease will he found on pp. 20-22. The 36 persons notified were treated as follows:— Cases notified. Not Typhoid. Diagnosis not contradicted. In hospitals of the M.A.B. 19 12 7 In other public hospitals 13 0 13 In their own homes 4 0 4 36 12 24 The following are the results of inquiries into possible sources of infection in the 16 civil cases:— Arrived in St. Pancras already ill 2 History of having eaten shell-fish a few days before the onset of illness (oysters, 2; periwinkles, 1: cockles, 1; crab and lobster, 1) 5 No source traced 1 In no instance was there more than one case in a house, and no evidence was found of the spread of the disease by means of "carriers," or through the agency of milk. Bacteriological Examinations.—20 specimens of blood of St. Pancras patients were examined by the Lister Institute of Preventive Medicine for the Widal reaction of typhoid fever at the expense of the Borough. Of these 7 gave positive results, and 13 negative results. ANTERIOR POLIO-MYELITIS. • 8 cases of Anterior Polio-Myelitis were notified during 1915. The following table, constructed to show the seasonal prevalence of the disease, indicates the quarter of the year in which notified cases have occurred since the disease was made notifiable :— ST. PANCRAS. COUNTY OF LONDON. 1st quarter. 2nd quarter. 3rd quarter. 4th quarter. Total. 1st quarter. 2nd quarter. 3rd quarter. 4th quarter. Total. 1911 .. .. .. 2 .. .. .. .. 41 .. 1912 0 0 3 0 3 19 22 69 24 134 1913 0 2 3 4 9 9 22 60 55 146 (June) 1914 0 1 1 1 3 6 7 56 24 93 (June) 1915 0 2 1 5 8 11 11 36 31 89 43 Particulars about the individual cases are given in the following table:— Date of Notification. 1915. Age and Sex. Date of Onset. 1915. Subdivision of Boro'. Removal to Hospital. 1915. Muscles affected. Result. Notified by. 9th April M. 2 20th Mar. W.2 in Ward 4 No. Right arm (Lost sight of.) R.M.O. at University College Hospital. 15th May F. 3 28th April S.2 in Ward 4 University College Hospital, 17th May Left anterior tibial muscles. Paralysis persists. Ditto 2nd Sept. F. 3 23rd Aug. W.4 in Ward 5 University College Hospital, 31st Aug. Both lower limbs. Paralysis persists. Ditto 22nd Oct. M. 1½ Aug, N.5 in Ward 2 No. Right leg. Paralysis persists. R.M.O. at Hampstead General Hospital. 18th Not. F. 3½ 10th Nov. W.2 in Ward 4 No. All the muscles below the neck. Legs (more) and arms (less) still paralysed: still improving. Consulting Physician. 19th Nov. M.1½ 11th Nov. E.3 in Ward 3 No. Left leg. Paralysis persists R.M.O. at University College Hospital. Sth Nov. F. 3 2nd Nov. E.5 in Ward 6 London Temperance Hospital, 8th Nov. Left arm and hand; left side of face; loss of speech. Left arm and left leg still affected. R.M.O. at London Temperance Hospital. 30th Nov. F. 3 5th Nov. W.4 in Ward 5 London Temperance Hospital, 11th Nov. Both arms and legs; intercostals. Paralysis persists in arms and legs. Ditto Careful inquiries were made in each case and no source of infection or relation between the cases was discovered. EPIDEMIC CEREBRO-SPINAL MENINGITIS. St. Pancras shared in the outbreak of cerebro-spinal fever which made its appearance in London and other parts of the country in 1915. 37 cases were duly notified, 3 of which afterwards proved not to be suffering from this disease. In addition 4 other cases were reported after death. Of the 38 true cases, one was in the person of a soldier, the number of civilian cases notified being 37, giving an incidence rate of 0.18 per 1000 civil population. 25 deaths from this disease were registered as belonging to St. Pancras. Of these, one was in the person of a sailor (R.N.), the number of civilian deaths being 24, equal to a death-rate of 0.12 per 1000 civil population. 44 Of these deaths 4 (including the naval case) were of persons who contracted and succumbed to the disease outside of St. Pancras. Of the notified St. Pancras cases 21 died, the case mortality being therefore 55.3 per cent. The above figures include three cases notified as post-basic meningitis, two of which died. Only one of these—a fatal case—could be clearly differentiated from cerebro-spinal meningitis. An analysis of the 1915 cases of the disease was published by the writer in Public Health (1915, page 193), and the remainder of this section is an abridgement of this (including the first case, which took its onset in 1914). The cases are classified below according to the manner in which the diagnosis was confirmed:— (1) 18 cases. Meningococci isolated in culture from the cerebro-spinal fluid during life (15), or from the cerebro-spinal fluid or meningitic exudate post-mortem only (3). (2) 10 cases. Meningococci identified by cytological examination only of the cerebro-spinal fluid during life (6), or of the cerebro-spinal fluid or meningitic exudate post-mortem only (4). (3) 3 cases. Diagnosis confirmed by post-mortem examination without any bacteriological tests. (4) 6 cases. Diagnosis made on clinical grounds only. Thus at least 28 of the 37 cases were considered to be bacteriologically confirmed; and of the remaining 9 cases, 3 presented the appearances of the disease post-mortem. The London County Council offered free facilities for bacteriological diagnosis of this disease, through the Borough Medical Officer of Health, and this was taken advantage of in a number of cases. In the following table are set out the number of St. Pancras deaths certified as due to cerebro-spinal fever and posterior basic meningitis since 1901, which was the first year when deaths from the disease were separately recorded, together with the number of cases that have been notified since 1912, when the disease became notifiable:— Certified Deaths from Cerebro-spinal Fever. Certified Deaths from Posterior Basic Meningitis. Notified Cases of Cerebro-spinal Fever. 1901-1906 0 1907 0 5 (part year) 1908 l 5 1909 4 6 1910 9 10 1911 4 7 1912 0 l 3* 1913 0 0 3 1914 1 l 3 1915 23 2 39 * From 1913 onwards the notifications were corrected for errors of diagnosis, etc.; this was not so for former years. 45 It is striking that the sudden increase in 1915 followed upon three years when cerebro-spinal fever was at a low ebb in London. Apart from the case mentioned above as having begun in December, 1914, the first St. Pancras case began on the 20th January, the second on the 12th February, and from that date onwards the cases were frequent. From the 12th February to the end of April, 21 cases sickened with the disease. In the early part of July the number of new cases fell off, and there were subsequently only two cases taking their onset in August, two in October, and one in December. The number of cases beginning in the four quarters of the year were respectively 14, 12, 8, and 3. The highest mortality was in July, in which month six patients died. There was an almost entire absence of any indication of a spread of infection from patient to patient. Amongst the 39 cases (involving 37 houses), in only two instances was there more than one case in the same family or house ; and in one other instance a case of the disease occurred in each of two adjacent houses. The details of these cases are given on the next page. Otherwise there was no apparent connection between any of the cases. The distribution of the cases through the borough was fairly even, and although some districts were affected somewhat more than others, this was not markedly so. There was certainly no evident tendency for the cases to group themselves round particular foci. Only three streets besides those mentioned above had more than one case. These had two each, but no connection could be traced between the cases. In regard to schools, the 15 school children affected belonged to 11 schools, all of which had only one case each except two schools which had two cases each and one school which had three cases. In these instances, however, there was no evidence of direct infection, and the cases were well separated as to time. There was, then, no indication of spread by means of schools. Nor were any other agents (e.g., milk supply, etc.) discovered to be spreading the disease. As to the social condition of the patients, it was found that although the disease was not confined to the very poor, all the cases were in working-class families. No conclusive evidence was obtained as to whether in general the meningococcal infection was derived from soldiers or sailors. Two of the cases were in the persons of soldiers who had recently returned from camps. Further, in about half the total number of cases the patient had recently been in contact with a soldier, either in the same family or the same house, home on leave from military duty. There was no reliable history obtainable as to whether there had been any cases amongst these men's units, though this was said to be so in two instances. In a few other cases, the patients were known to have been in contact with soldiers not living in the same house. This however, is a thing which can now be said about almost everybody, and this fact makes it unwise to assume without further evidence that the infection was indeed derived directly from the soldier-contacts. In only two instances were possibly military "carriers" examined for the presence of the mening- 46 ococcus in the throat, and in these cases the result was negative. It is evident that no conclusions on this head can be drawn from these data. Not much light, indeed, is thrown by our experience in St. Pancras upon the question of carriers. Only 22 contacts were swabbed (in contact with 8 cases), of whom 3 exhibited the meningococcus (in contact with 3 cases), and the rest were negative. Some interesting facts, however, in regard to infection from the Military, appear when the cases are analysed from the point of view of the virulence of the infection as indicated (1) by the occurrence of further cases in the same family, and (2) the fatality of the illness. In regard to (1), it was observed that tbe only cases which were followed by secondary cases in the same family—or, indeed, in the same house—were the two cases in the persons of soldiers. Both of these secondary cases were fatal (for details see below). Further, in regard to (2), the facts were as follows. Of the 13 civilian cases (including the two secondary cases) where there was a history of recent contact with a soldier home on leave in the same house 13 cases, or 68 per cent., were fatal: whereas of the 16 cases where no such history was obtained, 7 cases, or only 44 per cent., were fatal. The two soldier cases, however, both recovered. In regard also to the possibility of certain cases of sore-throat or catarrh being mild and non-meningeal instances of meningococcal infection, our results are mainly negative. In one case, related in detail below, a contact with an influenza-like illness which appeared as a possible source of infection, proved to be " carrying " the germ, but in most instances the persons living in the same family or house as the patients did not seem to be more affected with catarrhal conditions than an average family. It may be of some interest to give the details in regard to the cases which were followed by secondary cases :— (a) J.C. (aged 15), a soldier discharged from the Army on the 9th February, fell ill at home on the 17th February, became unconscious the same day, and was removed to hospital on the 23rd February with cerebro-spinal meningitis. A few days later, his mother (Mrs. C., aged 40), developed a sore throat with influenzal symptoms, and on the 3rd March, E. C. (aged 5), sister of the first case and daughter of Mrs. C., suddenly fell ill, and was removed to hospital the same day with the disease. On swabbing Mrs. C's throat, meningococci were found. The first case (J.C.) recovered, but the little girl died. (b) C.H.D. (aged 18), a soldier home on leave from France, became ill on the 1st March, and was removed to hospital next day with cerebrospinal meningitis. On 29th March his sister, M.L.D, (aged 4) was taken ill, removed to hospital, and died next day of a fulminating attack. On the 1st April the first case, C.H.D., returned home, and he and seven other persons in the house were swabbed. All were negative except C.H.D., from whose throat the meningococcus was obtained. Several persons in the house, however, had had catarrhal colds. While C.H.D. had been in hospital most of the members of his family visited him, but the second case, M.L.D., had not done so. (e) E.E.E. (F., 13½) had headache and malaise on the 21st May. She became better, but fell suddenly ill on the 31st May, and died at 47 home next day; post mortem cerebro-spinal fever was discovered. W.K.R. (M., 9 months), next door, became ill on the 1st June, and was removed to hospital on the 3rd June, where the diagnosis of cerebro-spinal fever was confirmed. He recovered. There was no definite history of actual contact between the cases, and an indefinite history of " colds " at W.K.R.'s house was elicited. Age and Sex Distribution.—The 37 cases and the 20 resulting deaths had the following Distribution :— Age Distribution. Age—Years, Cases. Deaths. 0—1 6 5 1—2 4 2 2—3 0 0 3—4 0 0 4—5 3 2 Total under 5 13 9 5—10 8 6 10—15 7 3 15—20 5 l 20—30 2 l 30—40 1 0 40—50 1 0 The Sex Distribution was as follows :— Sex Distribution. Sex. Cases Deaths. Case Mortality Rate. Male 18 9 50% Female 19 11 58% Amongst the 21 cases under 10 years of age, the case mortality was 71 per cent., while amongst the 16 cases over 10 years of age the case mortality was only 31 per cent. The mortality varied, not only according to the age of the patients, but also according to the season of the year. Amongst the 21 cases (11 under 10 years of age and 10 over 10 years of age) which took their onset before May, the case mortality was 38 per cent., while amongst the 16 cases (10 under 10 years of age and 6 over 10 years of age) which began during or after May, the case mortality was 75 per cent. This difference can clearly only be accounted for to a small extent by the different age distribution of the patients 48 before and after May. It would appear that winter and spring weather tend to produce a high incidence rate in the disease but summer weather a high case mortality. Duration of Ulrntss in Fatal Cases.—Most of the fatal cases were of very short duration, but a few drifted on to more than two weeks. The actual figures were :— Total Cases. 1 day's duration 5 Cases. 2 days' „ 4 „ 5 ,, ,, 2 ,, 7 ,, ,, 1 Case. 8 ,, ,, 1 ,, 15 ,, „ 1 ,, 3 weeks' „ 2 Cases. 6 „ 2 „ 7 ,, „ 1 Case. 21 „ „ 1 „ The fulminating character of some cases is indicated by the fact that inquests were held in four instances. There was some indication from the histories obtained from the patients' friends that a certain number of .cases have a slight illness, such as malaise and catarrhal symptoms, appear to recover, and then develop meningitis suddeuly one or two weeks later. Petechial Rash.—In 8 cases (3 of which recovered) there was a history of hsemorrhagic rash. It may be that a few others also had petechiae without my having been able to obtain such a history ; but there appears to be no doubt that the majority of the cases did not have the feature which has given rise to the name " spotted fever." In four cases there was a definite history of an early transient rash of a measles-like nature, and I am inclined to think from vague histories in other cases that this feature appeared in more than that number of cases. After-effects.—A striking characteristic of the St. Pancrae cases is the absence of after-effects. Enquiries have been made into the after-history of the 17 survivors, and in the 15 cases where patients or their friends were interviewed, the recovery was said to be quite complete, while in the two remaining cases I have no reason for thinking it was otherwise. This is surprising in view of the purulent condition of the cerebro-spinal fluid noted in some of the cases during their illness. OTHER NOTIFIABLE INFECTIOUS DISEASES. No case of small-pox was notified in St. Pancras during 1915. Eleven cases were reported in the County of London (exclusive of the Port), in Fulham, Greenwich, Kensington, and Stepney. 49 Chicken-pox was made notifiable in London from March 17th to June 10th by an order of the London County Council. During this time 247 cases were notified in St. Pancras. No case of Typhus was notified in the Borough, though four cases (Stepney) was reported in the County. No case of Anthrax or Glanders occurring in man was notified in St. Pancras, though 8 cases of the former and one of the latter were reported in different parts of the County of London. Cholera, Plague, and human Hydrophobia were completely absent both in the Borough and in the County. 57 persons were reported during the year as having been in contact with cases of sinall-pox (mostly on shipboard), and 30 as having been in contact abroad with other dangerous infectious diseases. These were all kept under observation, with negative results. Two outbreaks of glanders in horses, and one of anthrax in sheep were reported as occurring in the borough during 1915 by the Veterinary Inspector of the London County Council. In each case the site was visited, and no human cases occurred. MEASLES. In the following table are set out the deaths and death-rate from measles for the past ten years for the whole Borough and for the four registration sub-districts:— Year. Deaths. Kate per 1,000 population. West. South. Eaat. North. Whole Borough. West. South. East. North. Whole Borough. 1905 14 15 23 25 77 0.22 0.26 0.38 0.41 0.82 1906 28 26 30 12 96 0.45 0.46 o.50 0.20 0.40 1907 37 5 33 16 91 0.60 0.08 0.55 0.27 0.40 1908 9 13 5 19 46 0.14 0.23 0.08 0.31 0.19 1909 30 9 30 33 102 0.48 0.16 0.50 0.55 0.43 1910 39 21 60 23 143 0.65 0.87 1.00 0.38 0.60 1911 26 28 19 40 113 0.42 0.60 0.32 0.68 0.47 1912 25 11 33 25 94 0.41 0.24 0.58 0.43 0.42 1913 8 5 6 17 36 0.13 0.10 0.10 0.29 0.16 1914 10 10 21 12 58 0.17 0.22 0.36 0.19 0.24 1915 20 14 14 15 63 0.34 0.31 0.24 0.26 0.29 Of the 63 deaths, 17 were in children under one year of age, and 55 in children under five years of age. 50 The distribution of the deaths in wards is shown in the next table. Deaths from Measles, 1915. Year. West. South. East. North. No Address. Whole Borough. Ward. Total. Ward. Total. Ward. Total. Ward. Total. 4 5 7 8 3 6 1 2 1914 7 3 10 1 9 10 8 13 21 4 8 12 .. 53 1916 4 16 30 4 10 14 8 6 14 9 6 15 •• 63 WHOOPING COUGH. In the following table will be found the deaths and death rate from whooping cough for the past ten years for the whole Borough and for the four registration sub-districts :— " Year. Deaths. Rate per 1,000 population. West. South. East. North. No address Whole Borough West. South. East. North. Whole Borough 1905 15 17 31 17 .. 80 0.24 0.39 0.51 0.28 0.33 1906 18 15 22 13 .. 68 0.29 0.27 0.37 0.21 0.28 1907 17 19 22 18 .. 76 0.27 0.34 0.37 0.30 0.32 1908 22 12 16 17 .. 67 0.35 0.21 0.26 0.28 0.28 1909 2 6 9 10 .. 27 0.03 0.10 0.15 0.16 0.14 1910 13 5 41 15 .. 92 0.50 0.08 0.68 0.25 0.38 1911 81 7 12 16 .. 48 0.22 0.12 0.20 0.26 0.20 1912 6 14 22 5 .. 47 0.10 0.30 0.38 0.09 0.21 1913 8 3 8 17 .. 86 0.13 0.06 0.13 0.29 0.16 1914 11 1 16 21 .. 49 0.19 0.02 0.27 0.36 0.22 1915 10 13 15 12 2 52 0.17 0.29 0.26 0.21 0.24 Of the 52 deaths, 24 were of children under one year of age and 49 of children under five years of age. 1 he ward distribution of the deaths is shown in the next table:— Deaths from Whooping Cough, 1915. Year West. South. Kast. North. No Address. Whole Borough. Ward. Total. Ward. Total. Ward. Total. Ward. Total. 4 5 7 8 8 6 1 2 1914 3 8 11 .. 1 1 3 13 16 10 11 21 .. 49 1915 4 6 10 •• 13 13 4 11 15 5 7 12 2 52 51 DIARRHŒA AND ENTERITIS. 114 deaths from diarrhoea and enteritis were registered during 1915, equal to a death-rate of 0.52 per 1,000 population. Of these 107 were in children under five years of age and 79 in babies under one. Reference is made on page 27 to infantile diarrhoea. SYPHILIS. Far more deaths are due to this disease than appear under its name, partly owing to a reluctance to place the name upon a death-certificate which is handed to the friends of the diseased, and partly owing to the fact that many diseases with other names are due to antecedent syphilis. In the following table are given the age and sex distribution of deaths certified during 1915 as due to (a) declared syphilis, (b) locomotor ataxy and general paralysis of the insane, which are believed by most experts to be late manifestations of the disease, and (c) aortic aneurysm, which many authorities now consider to be at any rate frequently caused by it:— 0-1 1-5 I5-15 15-25 25-35 35—45 45—55 55—65 65—75 75—85 85 up. Total Males. 0-1 1-5 5-15 15-25 25-35 35-45 45—55 55-65 65—75 | 75—85 | 85 np. Total Females. Total Persons. Syphilis 4 3 - - - 1 - 2 - - - 10 5 - - - - 2 - - - - - 7 17 Gummatous disease - - - - - - - - - - - - - - - - - - - - - - - - - Total declared Syphilis 4 3 — — - 1 - 2 - - - 10 5 - - - - 2 - - - - - 7 17 Locomotor ataxy - - - - - 1 2 1 1 - - 5 - - - - - 1 - - 1 - - 2 7 General paralysis of the insane - - - - 3 5 5 3 1 — — 17 — — — 1 — 1 — — — — — 2 19 Aortic aneurysm - - - - - 2 4 1 1 — 1 9 - — — — — 1 1 — 2 — — 4 13 As in previous years the deaths of adult males are in excess of those of females. There is reason to believe that many abortions and miscarriages are caused by this disease and also that it is responsible for a certain mortality (occulted) amongst infants and young children. ALCOHOLISM. As in the case of the last disease, the number of deaths due to excessive use of alcohol is in no way represented by the number certified as such. During 1915 seven deaths were returned as due to alcoholism, and three others to alcoholic cirrhosis of the liver. There were 39 deaths from cirrhosis of the liver not returned as alcoholic. 52 CANCER. 258 deaths were registered during 1915 as due to cancer, under the various names of cancer, carcinoma, epithelioma, scirrhus, rodent ulcer, sarcoma, &c. This is equal to a death-rate of 1.18 per 1,000 population, and 1.28 per 1,000 civil population (see p. 9). The sex distribution of the deaths and death-rates is shown in the following table: — Sex. No. of Deaths. Death-rates per 1,000 males or females living (based on lyil Census). Males 120 112 Females 138 1-23 Both Sexes . . 258 1-18 VACCINATION. In consequence of the War, the returns in respect of children whose births were registered in the Parish of St. Pancras from the 1st January to 31st December, 1914, are not available. DWELLING HOUSES. As has been pointed out in previous reports, the housing of the working classes in St. Pancras is most unsatisfactory. A typical case is a house consisting of a basement and ground floor with two or more floors above, each floor (consisting of two rooms) being let out to one family. It cannot be denied that a family which includes boys and girls needs four rooms as an irreducible minimum ; one bedroom for the parents, one for the boys, one for the girls, and one living room. In addition to this, private scullery and water-closet accommodation is necessary, and also the provision of a yard or balcony in immediate proximity to the living rooms. The contrast between these very moderate requirements and the accommodation which so many St. Pancras working-class people have to put up with is striking—although, indeed, these people are in the main " respectable," and pay rents which ought to secure adequate dwellings. To indicate this it is sufficient to mention that very many families live in two rooms without separate kitchen, scullery, food-storage, water-closet, and yard accommodation for the separate tenements, and without proper separation between the different tenements in the sub-let houses. ^3 Inspection ok Dwelling-Houses. At the present time inspection of dwelling-houses is carried out under the following circumstances :— 1.—Whenever a case of notifiable infectious disease (except Consumption) is reported, the house where the case occurred is subjected to a sanitary inspection and the drains tested. During the year 1,090 such inspections were made, followed by 1,271 re-inspections. 2.—Whenever a complaint is received as to the condition of any house a sanitary inspection of the house is carried out. The drains of many houses are tested by this procedure. During the year 1896 inspections were made in consequence of complaints, and 4,613 consequent re-inspections. 3.—All registered tenement houses, and certain other dwellings which require frequent inspection (known as " inscribed dwellings") are visited periodically (six monthly, where possible), and inspected. There were at the end of 1915, 2,364 houses on the tenement house register (i.e., the register of "house let in lodgings, or occupied by members of more than one family "). These are sub-let houses which are of such a nature as to make frequent inspection desirable. They are nearly all let unfurnished. The number of " inscribed dwellings " at the end of the year was 207. 562 routine inspections and 288 consequent re-inspections of these houses were made during 1915 in addition to those made under the Housing, Town Planning, etc., Act, 1909 (see below). Weekly inspections were also made of the yards of mews and stables. 3839 inspections of these and 39 consequent re-inspections were made in the year. 4.—During 1915 the routine inspection of houses prescribed by Sec. 17 (1) of t ie Housing, Town Planning, etc., Act, 1909, has been continued, though to a reduced extent by reason of the disturbance in the work caused by present conditions. This sub-section provides that "it shall be the duty of every local authority to cause to be made from time to time inspection of their district with a view to ascertaining whether any dwelling-house therein is in a state so dangerous or injurious to health as to be unfit for human habitation." It also enacts that in this connection regulations made by the Local Government Board must be complied with. In accordance with the regulations a list of streets was prepared by the late Medical Officer of Health, the houses in which, in his opinion, ought to be inspected at once. This consisted of those streets, the majority of the houses in which were already subject to periodical inspection as registered tenement houses or " inscribed dwellings." The number of houses included in these streets was 3824. The inspections under the regulations were begun on 1st January, 1913, and in every instance a case paper has been filled ut) and filed. A number of streets which uro not included in the above-mot' ">n( d lit have also b en inspected. During 1913 and 1914, 3127 houses were inspected for the first 54 time under the Act, and 815 of the houses received a second routine inspection during those years. In 1915 there have been made 408 further first inspections, and 951 houses have had a subsequent routine inspection. Since 1st January, 1913, therefore, 3535 of the 25,000 houses in the Borough have been inspected under the Act, and 1766 of these have received subsequent routine inspections. It is not to be forgotten that most of these inspections involved re-inspections after the service of intimation notices. The details of this work (first inspections only) are set out in the following table :— First Routine Inspections under Sec. 17 (1) of the Housing, Town Planning, etc., Act, 1909, made during 1915. Division and SubDivision. Street or Place. No. of Houses inspected under Sec. 17 No. of intimations served. North Highgate Dartmouth Park Hill (108) 57 33 ,, ,, South Grove (60) 9 6 ,, St. John's Park Falkland Place (23) 15 15 ,, ,, Torriano Mows (19) 15 6 Gospel Oak Oakfield Crescent (21) 6 5 ,, ,, Wellesley Road 60) 9 9 Grafton Tovey Place (26) 2 2 ,, ,, Weedington Road (84) 62 44 Maitland Park Weedington Road (69) 44 33 ,, ,, Wellesley Road (7) 4 3 East Bartholomew Nil ... ... ,, Camden Square Little Randolph Street (26) 21 20 ,, College Nil ... ... ,, Oakley Square Nil ... ... ,, Ossulston Nil ... ... West Castle Ferdinand Street (56) 18 14 ,, ,, Victoria Road (90) 1 1 Chalk Farm Erskine Road (4) 4 2 ,, ,, James Street (58) 16 11 ,, ,, Wellington Street (40) 33 27 ,, Mornington Nil ,, Regent's Park Nil ... ... ,, Euston Euston Road (46) 2 ... ,, ,, George Street (76) 1 1 ,, ,, Melton Street (28) 7 4 ,, ,, Netley Street (27) 14 12 ,, ,, Seaton Street (31) 10 6 ,, ,, William Street (19) 1 ... South Argyle Nil ... ... ,, Mecklenburgh Nil ... ... ,, Burton Nil ... ... ,, Endsleigh Nil ... ... „ Whitfield Howland Street (54) 54 5 ,, ,, Kirknian Place (3) 3 2 Totals (1034) 408 261 55 The number of houses inspecte* under Sec. 17 by individual Inspectors is shown in the next table :— Inspector. Number of Houses Inspected. Total. 1st routine inspection. Subsequent routine inspection. Mr. Rackham 66 42 108 ,, Brown 45 — 45 „ Thompson — — — „ †Dillon 21 — 21 „ †James — — — ,, †Lonnon — — — ,, †Adkins 35 35 70 ,, Holmes — 97 97 ,, Walker — 446 446 ,, Landen 57 254 311 ,. Akers 72 — 72 ,, †Pottier 112 77 189 Total 408 951 1359 * On Active Service all 1915. †On Active Service part of 1915. As was previously stated most of the above recorded inspections involved subsequent visits for supervising work in progress and other purposes. Water Supply. Section 78 of the London County Council (General Powers) Act, 1907, provides that every house let to the working classes and occupied by members, of more than one family must have a water supply on every floor let to a separate family or families. In this borough the section has only been used to secure that every family shall have a water-tap on its own or the next floor. In the house comprising basement, ground, first and second floors with water on the ground floor level only,. we have been satisfied with an additional tap on the landing between the first and second floors. During 1915 notices were served for additional water supply in regard to 3-38 houses, but no such notices were served subsequently to 8th September, 1915. Underoround Rooms. During the year letters were sent in respect of 49 underground rooms (in 44 houses) which did not comply with the requirements of the Housing, Town Planning, etc., Act, 1909, and the Regulations made thereunder. 33 closing orders in respect of underground rooms (in 30 houses) were made. In addition, 3 intimation notices were served during the year under the Public Health (London) Act, 1891, in regard to underground rooms illegally occupied as dwellings. As indicated by these figures, there was a great reduction in this work as compared with 1913 and 1914. Houses unfit for Human Habitation. During 1915, in addition to underground rooms, 16 houses were represented 56 by the Medical Officer of Health as unfit for human habitation. 29 closing orders were made. Closing orders were determined in respect of 23 houses which had been rendered fit for human habitation. . In the following table are given the particulars in reference to all the houses which have been represented as unfit by the Medical Officer of Health during 1913-1915:— Address. Date of M.O.H.'s representation. Date of Closing Orders. Date of determination of Closing Orders, houses having been made fit for human habitation. Date of Demolition Orders. Condition at end of 1915. Little Clarendon Street Nos. 29-43 (inclusive) 1913 1913 — 1914 demolished. Nos. 44-54 (inclusive) ,, ,, 1914 — re-occupied. Equity Buildings— Nos. 1-4(inclusive) ,, ,, 1914 — re-occupied. Nos. 5-10 inclusive) ,, - 1915 — re-occupied. Nos. 11-20(inclusive) ,, ,, — — empty. Nos. 21-37(inclusive) ,, ,, 1915 — re-occupied. Nos. 2a and 3a ,, ,, — 1914 empty. Warren Street, No.37 ,, ,, — — empty. Little Clarendon Street, No.16 ,, ,, - - empty. Johnson Street, No.23 ,, ,, — — empty (repaired). Aldenham Street— Nos. 94, 98 and 104 ,, ,, — — empty. Ashdown Street, No.45 1914 - — — repaired and re-occupied. Cromer Street, No.61 ,, ,, — — ,, Stibbington Street, No.79 ,, - - - partly empty. Crawley Mews— Nos. 3 and 5 ,, - — — re-occupied. Nos. 6 and 7 ,, 3rd Mar., 1915 — — empty. Wakefield Mews— Nos.1,2,3,4,5,6, 7,7a,8a,9,10,11 and 12 ,, - - - demolished. Nos.14,15,16,17 and 18 ,, - - - empty. St. George's Mews— Nos. 3,4,5 and 6 ,, 3rd Mar., 1915 — — in course of repairs. Nos. 1,2,10,11,13, 14,15 and 16 ,, ,, - - empty. Redhill Street, No.38 ,, — — — repaired and re-occupied. Newbury Mews— Nos. 2,3,4,5,6,8, 9,10,11,12,13,14, 15,16,17 23rd June, 1915 6th Oct., 1915 — — negotiations continuing. Hampstead Road— No.143 3rd Feb., 1915 — — — empty. 57 In accordance with the Housing (Inspection of District), Regulations, 1910, the following table is submitted for the year 1915 :— The number of dwelling-houses inspected under and for the purposes of Section 17— Totals. First routine inspections 408 Subsequent „ 951 1359 The nnmber 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— As regards the whole house 16 ,, underground rooms (49 rooms) 44 60 The number of representations made with a view to the making of closing orders— As regards the whole house 16 „ underground rooms (33 rooms) 30 46 The number of closing orders made— As regards the whole house 29 ,, underground rooms (33 rooms) 30 59 The number of dwelling-houses, the defects in which were remedied without the making of closing orders 1343 The number of dwelling-houses which, after the making of closing order were put into a fit state for human habitation 23* Inhabited House Duty. Inland Rtvenue Act, 1903. Applications for certificates under Section 11 of the above Act (dealing with the abatement of Inhabited House Duty in the case of certain tenement dwellings) were received by the Medical Officer of Health during 1915 in respect of 3 blocks of dwellings. The certificates required, are to the effect " that the house is so constructed as to afford suitable accommodation for each of the families or persona inhabiting it, and that due provision is made for their sanitary requirements." Certificates were granted and refused as follows : — Granted: Application made before 1915 2 Applications made during 1915 3 Total granted 5 Refused nil. Held over to 1916 nil. Canal Boats Acts. The inspection of canal boats h is been done by Inspector Auger. During the year he inspected 55 boats, registered to carry. 119 adults and 59 children, and actually carrying 92 adults and 62 children. Contraventions were found on 5 boats, 4 in rcspect of certificates and one in respect of overcrowding. * The Closing orders in respect of these houses were ma'Je in 1913. 58 FACTORY AND WORKSHOP ACTS. The following five tables are those asked for by the Home Secretary:— 1.—Inspections made by Male and Female Sanitary Inspectors. Premises. (1) Number of Inspections. (2) Written Notices. (3) Prosecution!. (4) Factories (including factory laundries) 588 113 - Workshops (including workshop laundries) 1885 297 — Workplaces (other than Outworkers' premises included in Part 3 of this Report) 533 87 — Total 3006 497 — 2.—Defects Found. Particulars. (1) Number of Defects. Number of Prosecutions. (5) Found. (2) Remedied. (3) Referred to H.M. Inspectors. (4) Nuisances under the Public Health Arts*:— Nil. Want of cleanliness 84 84 Want of ventilation 1 1 Overcrowding 1 1 Want of drainage of floors 4 4 Other nuisances 109 106 Sanitary accommodation Insufficient 18 16 U nsuitable cr d efective 203 190 Not separate for sexes 10 10 Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouses (s. 101) - - Breach of special sanitary requirements for bakehouses (ss. 97 to 100) 7 3 73 Other offences (Excluding offences relating to outwork which are included in Part 3 of this Report) 10 10 Total 513 495 — — * Including those specified in sections 2, 3, 7 & 8 of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. Outworkers' Lists, Section 107. Outwork in unwholesome premises, Sec. 108. Outwork in infected premises, Sections 109, 110. 3.—Home Work. nature of work. Lists received from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions, Instances. Notices served. Prosecutions. Instances. Orders male (S. 110). Prosecutions (Sections 109, 110). Sending Twice in the year. Sending Once in the year. Failing to keep or permit inspection of lists. Failing to send lists. Lists. Outworkers. Lists. Outworkers. Contractors. Workmen. Contactors. Workmen. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Wearing Apparel— (1)making, etc 20 46 79 - - - - - - - - - 2 - - (2)cleaning and washing — - - - - - - - - - - - 1 - - Household linen — _ - - - - - - - - - - - - - Lace, lace curtains and nets - - - - - - - - - - - - - - - Curtains and furniture hangings - - - - - - - - - - - - - - - Furniture and upholstery - - - - - - - - - - - - - - - Electro-plate - - - - - - - - - - - - - - - File making - - - - - - - - - - - - - - - Brass and brass articles - - - - - - - - - - - - - - - Fur pulling - - - - - - - - - - - - - - - Cables and chains - - - - - - - - - - - - - - - - Anchors and grapnels - — — - - - - - - - - - - - - Cart gear - — - - - - - - - - - - - - - Locks, latches and keys - - - - - - - - - - - - - - - Umbrellas, etc. - - - - - - - - - - - - - - - Artificial flowers - - - - - - - - - - - - - - - Nets, other than wire nets - - - - - - - - - - - - - - Tents - - - - - - - - - - - - - - - Sacks - - - - - - - - - - - - - - - Racquet and tennis balls - - - - - - - - - - - - - - - - Paper bags and boxes - - - - - - - - - - - - - - - Brush making 1 1 - - - - - - - - - - - - - Pea picking - - - - - - - - - - - - - - - Feather sorting - — - - - - - - - - - - - - - Carding, etc., of buttons, etc. - - - - - - - - - - - - - - - Stuffed toys - - - - - - - - - - - - - - - Basket making - — — — — — — — — — — - — Total 21 47 79 — — — - - - - - - 3 — — 59 60 Mr.H.G. West, Sanitary Inspector, was appointed temporarily as factory and workshop inspector in 1914. On 24th June, 1915, this appointment was made permanent. During 1915 Inspector West continued his first routine inspections of all factories, workshops and workplaces in the borough, in the course of which he is preparing new card-index registers of these places. 4.—Registered Workshops. Workshops on the Register (Sec. 131) at the end of the year. Numbers. (1) (2) Bakehouses 159 Restaurant kitchens 222 Laundries 113 Domestic workshops — Other workshops where women are employed 526 Other workshops 1159 Total number of workshops on Register 2179 5.—Other Matters. Class Number (l) (2) Matters notified to II. 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 13 Reports (of action taken) sent to H.M. Inspector 13 Other -- Underground bakehouses (s. 101):— Certificates granted during the year - In use at the end of the year 80 61 The number of factories, workshops and workplaces added to and removed from the register during 1915 was as follows:— Added to register. Removed from register. Bakehouses— Workshop 0 10 Factory 0 0 Laundries— Workshop 6 46 Factory 2 0 Restaurants kitchens 102 56 Other workshops and workplaces 395 610 Other factories 161 75 The number of inspections that were made during 1915 were as follows: — Factory and Workshop Inspector. Woman Sanitary Inspector. District Inspector. Total. Inspections. Re-inspections. Inspections. Re-inspectiona. Inspections. Re-inspections. Inspections. Re-inspections. Bakehouses 253 156 - - - - 253 156 Restaurant kitchens 274 122 - - - - 274 122 Laundries 37 13 - - - - 37 13 Domestic workshops — - 5 - - - 5 - Other workshops 919 546 5 - - 3 924 549 Other workplaces 61 42 49 - - - 110 42 Other factories 328 221 2 - - 2 330 223 Total 1872 1100 61 - - 5 1933 1105 Bakehouses.—At the end of the year there were 180 bakehouses on the register (i.e., in use), including 21 factory bakehouses. 116 of these were underground bakehouses. Restaurant Kitchens.—At the end of 1915, 222 restaurant kitchens were on the register. 62 INSPECTION OF FOOD AND FOOD-PLACES. Sale of Food and Drugs Acts. 756 samples have been taken under these Acts, and 684 of these proved to be genuine and 72 adulterated. The details are given in the following table : — Article! of food of which samples have been taken. Total number samples. Genuine. Adulterated. Milk 378 332 46 Cream and Preserved Cream 21 17 4 Butter 197 178 19 Lard 28 28 - Pepper 4 4 - Mustard 10 10 — Rice 1 1 — Coffee 27 26 1 Jam 5 5 — Flower of Sulphur 1 1 — Arrowroot 1 1 — Cheese 5 5 — Olive Oil 13 13 — Yeast 1 1 — Epsom Salts 2 2 — Zinc Ointment 2 2 — Citric Acid 7 7 — Oatmeal 1 1 — Tartaric Acid 7 7 — Cocoa 24 24 — Sausages 1 — 1 Egg Powder 10 9 1 Custard Powder 10 10 — Total 756 684 72 Of the 756 samples 8 were informal samples, viz., 6 of butter and 2 of milk. Two of these (butter) were found to be adulterated. Other informal samples have also been taken and not submitted for analysis. 63 The milk samples are further classified in the following table :— Stage of Sale. Place. Reason. Number of Milk samples examined. Result of Analysis. Prosecutions. Genuine. Adulterated. On sale to public In street Periodical—Week-day 22 15 7 3 ,, Sunday 54 52 6 1 In shop By request - — — — Periodical—Week-day 177 161 16 9 „ Sunday 47 41 6 2 By request 1 1 — — On delivery At Railway Depot or Station Periodical 62 54 8 6 By request 11 8 3 2 Totals 378 332 46 23 The record of the samples taken and the results of analysis are shown in the following table for the past ten years: — Year. Number of samples analysed. Number of samples adulterated. Percentage of adulteration. 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 1911 750 86 11.4 1912 750 76 10.1 1913 750 76 10.1 1914 755 57 7.5 1915 756 72 9.5 Prosecutions were undertaken in respect of 34 of the 72 samples which were reported during the year as being adulterated. Two prosecutions were also undertaken for other contraventions of the Food and Drugs Acts. These are set out in the following table:— 64 Summonses—Under the Sale of Food and Druara Acts. No. of Sample. Article. / Result of Analysis. Date of Hearing of Summont. Result of Proceedings. Penalty. Costs. 1915. £ s. d. £ s. d. A.4 Milk Added water, 16.2 per cent. 28th March 3 0 0 0 12 6 A.12 ,, ,, 49 26th „ 1 0 0 0 12 6 C.26 ,, Deficient in milk fat, 13 per cent. 26th „ Warranty defence successfully pleaded. A.17 ,, ,, 20 9th April Warranty defence successfully pleaded. C.69 ,, ,, 6.3 5th May 3 0 0 0 10 6 C.79 ,, ,, 5.8 7th ,, 6 0 0 0 10 6 C.81 ,, ,, 5.4 7th ,, 4 0 0 0 10 6 A.81 Butter Foreign fat, oth«r than the fat of butter, 80 per cent 7th „ 4 0 0 0 10 6 A.91 ,, ,, ,, ,, 78 1st June 3 0 0 — A.90 ,, ,, ,, ,, 79 „ 1st ,, 2 0 0 — A.114 ,, ,, ,, ,, 40 ,, 11th ,, 2 0 0 0 10 6 C.102 ,, ,, ,, ,, 20 ,, 11th „ 2 0 0 0 10 6 C.61 Milk Deficient in milk fat, 68.6 per cent. 18th ,, 5 0 0 0 10 6 C.116 ,, ,, 5 ,, 11th „ Summons withdrawn. Magistrate considered milk was delivered as given by cow C.155 ,, Added water, 9.7 per cent. 16th July 1 2 0 0 10 6 A.144 ,, Deficient in milk fat, 23.3 per cent. 22nd „ Summons dismissed. Magistrate holding that there had been no abstraction of fat, proceedings justified owing to poverty of milk C.161 ,, ,, 3 „ 27th „ Summons dismissed. Magistrate holding that the milk was in same condition on delivery as given by cow C.162 ,, Added water, 97 per cent.; also deficient in milk fat, 15 per cent. 27th ,, ,, ,, A.178 ,, Deficient in milk fat, 66 per cent. 20th August — 2 2 0 C.174 ,, 15.6 20th „ - 1 13 6 C.175 ,, 9.3 20th „ A.179 ,, 13.3 20 th 5 0 0 — C.219 ,, 25 20th „ Warranty defence successfully pleaded C.233 Butter Foreign fat, other than the fat of butter, 84 per cent 15th October 4 0 0 — C.286 Milk deficient in milk fat, 30 per cent. 26th Nov — 2 0 0 A.247 Butter Foreign fat, other than the fat of butter, 83 per cent. 10th Dec — 0 12 6 C.301 Milk Deficient in milk fat 20.6 per cent. 17th „ Warranty defence successfully pleaded C.292 Butter Foreign fat; other than the fat of butter, 86 per cent. 17th „ 0 5 0 0 10 6 C.325 Milk Added water, 22.2 per cent. 31st 3 0 0 0 10 6 C.320 ,, Deficient in milk fat 7.3 per cent. 31st 1916. Warranty defence successfully pleaded C.349 Butter Foreign fat. other than the fat of butter, 85 per cent. 11th Jan 3 0 0 — A.360 Milk Deficient in milk fat 10 per cent. 21st „ Warranty defence successfully pleaded C.353 ,, Added water, 6.5 per cent. 4th Feb Summons withdrawn ,, ,, ,, ,, ,, 4th ,, 1915. 1 10 0 0 10 6 ,, Refusing to sell at 114, Seymour Street milk required for analysis 7th May 5 0 0 — ,, Obstructing the carrying out at 114, Seymour Street of the Sale of Food and Drugs Act 7th „ 5 0 0 - 65 Lead Chromate in "Egg Powder." An interesting sample of egg-powder was taken in June, 1915, which proved on analysis to be coloured with chromate of lead. The matter was brought to our knowledge through the Local Government Board, lead chromate having been found in a sample of egg powder which was purchased in a London suburb and was found to have been made in St. Pancras. The powder was made by a cornchandler who sold it in four shops of his own in and about Loudon, but did not supply other shopkeepers. He readily admitted that the pigment employed was "chrome yellow (medium)," which he obtained from an oil and colour shop, and that the formula in use was 2 oz. of chrome yellow to 14 lb. of "egg powder." He further said that he had no idea that chrome yellow contained lead and that he, and his father before him, had made "egg powder" in this way for many years. He had never heard of any ill effects from its use, although it was used in his own household. The Public Analyst returned the powder as containing 0.56 per cent. (39.2 grains per lb.) of lead chromate (Pb Cr O4) which is equivalent to 0.358 per cent. (25.06 grains per lb.) of lead and 0'088 per cent. (6.l6 grains per lb.) of chromium. The pigment was not evenly distributed, however, and in one portion he found as much as 1.40 per cent. (98"0 grains per lb.) of Pb Cr O4, equal to 0.895 per cent. (62.65 grains per lb.) of lead and 0.228 per cent. (15.96 grains per lb.) of chromium. "Egg powder" is ordinary baking-powder to which a yellow pigment has been added in order to give cakes, etc., a colour similar to that produced by eggs. Food made with this particular "egg powder" would contain enough lead chromate to give it a perceptible yellow tint. The instructions given with the powder were "a full tea-spoonful to 1 lb. of flour." It is interesting to note that no case of lead poisoning from the use of this "egg powder " had come to our notice. A number of samples of various makes of "egg powder" and "custard powder" were taken in consequence of this discovery, but they were found to be free from poisonous metals. The Public Health (Milk and Cream) Regulations, 1912. The following is the Report of the Administration in connection with the above regulations asked for by the Local Government Board. 66 PUBLIC HEALTH (MILK AND CREAM) REGULATIONS, 1912. Report for Year ended 31st December, 1915. 1. Milk, and Cream not sold as Preserved Cream. (a) Number of samples examined for the presence of a preservative. (b) Number in which a preservative was reported to be present. Milk 378 - Cream 8 4 Nature of preservative in each case in column (b) and action taken under Regulations in regard to it:— Cream. 0.14 per cent, boron trioxide, equal to 0.248 per cent, of crystallised boric acid. „ 0.133 per cent, boron trioxide, equal to 0.235 per cent, of crystallised boric acid. ,, 0.105 per cent, boron trioxide, equal to 0.186 per cent, of crystallised boric acid. „ 0.11 per cent, of boron trioxide, equal to 0.195 per cent, of crystallised boric acid. In all these cases an explanation was asked of and furnished (by letter) by the vendors and a warning letter addressed to the vendors by order of the Public Health Committee. No legal proceedings were instituted. 2. Cream sold as Preserved, Cream. (а)Instances in which samples have been submitted for analysis to ascertain if the statement on the label as to preservatives were correct:— (i)Correct statements made 13 (ii)Statements incorrect — 13 (b)Determinations made of milk fat in cream sold as preserved cream:— (i)Above 35 per cent 13 (ii)Below 35 per cent — 13 (c)(i)Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream in Article V.(1) (as to declaration of preserved cream in advertisements, price lists, or trade lists) have not been observed. Nil. (ii)Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream under the proviso in Article V. (2)(as to the placing of notices in a conspicuous position or making statements on bills of fare, or giving similar information by some other adequate means 67 in public refreshment rooms, restaurants, shops, or other public premises where preserved cream is sold for comsumption on the premises) have not been observed. Nil. (d) Particulars of each case in which the Regulations have not been complied with, and action taken. Nil. 3.Thickening substances. There was no evidence of the addition to cream or preserved cream of any thickening substances. Inspection of Food [Public Health (London) Act, 1891, Sec. 47]. The Food-Inspectors, have kept under regular inspection food exposed or deposited for sale in slaughterhouses, shops (especially butchers', cooked meat and fishmongers' shops), stalls, and market places. The district inspectors have assisted during the summer (from June to September, inclusive) with the inspection of market streets. During these months four district inspectors and one food inspector were on duty for this purpose on every Saturday night, and two district inspectors and one food inspector every Sunday morning. They were selected for this duty by rotation. Four seizures of unsound food have been made during 1915, the details oi these are given in the next table. Date. Division and Sab Division. Description of Article. Prosecutions and Result. 1915. Sept. 19 West—Euston 32 lbs. plums Nil „ 20 ,, Regent's Park 2 pork pies ,, „ 21 South—Endsleigh 3 chickens Fined £l0 Dec. 11 East—Ossulston 1 loin of pork Nil On 41 occasions during the year unsound food has been surrendered by the owners to the food inspectora and destroyed as trade refuse. Dairies, Cowsheds, and Milkshops. Cowsheds.—There were at the end of 1915 five licensed cowsheds in tbe borough, as in the previous year. These are registered for 110 cows. They have been kept under inspection by the food inspectors, 58 inspections having been made during the year. Milkshops and Dnirict.—32 applications for registration under the Dairies, Cowsheds, and Milkshops Orders were considered during 1915, and of these the Council decided to register in 30 cases, and to refuse to register on account of unsuitability in 2 cases. 68 The figures in regard to registration of milkshops are set out below :— No. of purveyors of milk at retail milkshops on register at end of 1914 241 Deduct No. of purveyors removed from register during 1915 24 Add No. of purveyors added to register by resolution of Council during 1915 30 No. of purveyors of milk at retail milkshops on register at end of 1915 247 At the end of 1915 there were on the register in addition to these 247 retail milkshops and 5 cowsheds (of which 4 are attached to retail milkshops included in the 247), 2 persons in respect of premises where only a wholesale milk trade is done, and 6 itinerant vendors without milkshops, one of whom was added to the register during 1915. Legal Proceedings.—In the following cases prosecutions were undertaken under the Dairies, Cowsheds, and Milkshops Order of 1885 and 1886 in respect of the sale of milk by unregistered persons. In all these cases the Durvevors had been removed from the register or refused registration in virtue of the power conferred on the Council by Sec. 5. of the London County Council (General Powers) Act, 1908 : — Unregistered Premises. Date of Hearing of Summons. Result of Proceedings. Penalty. Costs. Unlawfully carrying on the business of a purveyor of milk at 52, Tottenham Street, without being registered with ' O o the Local Authority. . 1915. Apr. 20 £10 0 - Do. at 39, Sidmouth Street Apr. 24 £5 0 0 — Do. at 20, Rochford Street Mav 28 £1 0 0 — Do. at 86, Cromer Street July 15 2s. £100 Ice-Cream Premises. 386 visits were paid to these premises by the food inspectors during 1915. No legal proceedings were taken in respect of the manufacture or sale of ice cream. Fried Fish and Fish Curing Premises. At the end of 1915 there were 65 fried fish vendors' premises in the borough, at four of which fish curing was also carried on. There were 16 fish curers' premises, including these four. 228 visits were made by the food inspectors to these premises during the year. A large number of these premises are not in compliance with the by-laws as regards the structure of their premises and apparatus, but as practically all of them have been in use for some years they are exempt from the operations of the by-laws in this respect. 69 Other Food Premises. The number of inspections made of butchers' and fishmongers' shops, premises where prepared meats (such as sausages, pies, tripe, cooked meat, &c.) are made, marketing places, &c., will be found in table 7 on page 90. Bakehouses and restaurant kitchens are referred to under the heading of Workshops (see pages 60-61.) Slaughter-Houses. There were 12 licensed slanghter-houses in the borough at the end of 1915. 208 visits to slaughter-houses were made by the food inspectors during the year. The Rag Flock Act, 1911. No samples were taken under this Act during 1915. GENERAL SANITARY WORK. In this section reference is made to sanitary work carried out during the year by the staff. Some of this is mentioned in the foregoing parts of the report. Total Inspections. Altogether 49,503 inspections were made during 1915 by the staff of Inspectors. These consisted of 25,809 inspections and 23,694 re-inspections (generally after the service of intimation notices). Of these inspections 34,377 were made by the District Inspectors 3103 by the Factories and Workshops Inspector, 6,233 by the Inspectors of Food and Food-places, and 5,790 by the Women Inspectors. The inspections actually made by each individual Inspector are shown in table 9 on page 93. The work of the District Inspectors, Factories and Workshops Inspector, Women Inspectors, and Food Inspectors is set out in detail in tables 5 to 9 on pages 86 to 93. Intimation Notices. 2,362 intimation notices (comprising 4,339 items) have been served by the Sanitary Inspectors during 1915. These were made up as follows — In respect of Nuisances 2,563 In respect of Breaches of the Tenement House By-laws 466 In respect of Breaches of Statutes in Factories, Workshops and Work-places 259 In respect of other Breaches of Statutes and By-laws 1,051 4,339 70 These intimation notices are classified in tables 10, 11, 12 & 13 on pages 94-96. Summonses. The following prosecutions were undertaken in respect of general Sanitary work: — Situation of Property. Offence. Date of Hearing of Summons. Result of Proceedings. 47,Drummond Crescent Failing to provide a sufficient water supply, and to remedy dampness in basement rooms Jan. 29th Summons dismissed with £5 5s. costs. 48, ,, Failing to remedy dampness in basement rooms ,, Do. 27,Exmouth Street Failing to provide a sufficient water supply April 9th Fined £2. 24,Bridgewater Street Do. June 2nd Fined £1 10s. 28, ,, Do. ,, Fined £1 10s. 36,Ferdinand Place Failing to repair dustbin and roof, and to cleanse part of house June 25th Abatement order made. 36, ,, Failing to pave yard or open space ,, Fined 5s. 3,Balmore Street Failing to cleanse part of house June 24th Fined £1. 15, ,, Do. ,, Fined 10s. 15, ,, Failing to pave yard or open space ,, Fined 10s, Smoke-Prevention. During the year 297 observations of smoke shafts were made and 6 reinspections after the service of notices. There were no prosecutions. Regulated Trades. Offentite Trades.—There are two licensed premises for such trades in St. Pancras, viz., a tripe-dresser's in Kentish Town Road, and a tallow-melter's in Tudor Place. Constructional Drain Work. The construction of, and repairs to, house drains are supervised by the sanitary inspectors. During the year the following work has been done under this heading:— First Consequent inspections. re-inspections. Drainage work done under notice 488 4133 Voluntary drainage work 835 3078 Drains of new buildings 133 695 1456 7906 71 The tests which have been applied to drains during 1915 are shown in the following table:— 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 84 25 1 — 12 — 122 2. No result 629 43 2 — 57 — 731 3.Total 713 68 3 - 69 - 853 By Smoke. 1.Defects localised — 1 — . — — — 1 2.No result — — — — — — — 3.Total — 1 — — — - 1 By Water. 1.Not found water-tight — — — — 18 — 18 2.Found water-tight — — — — 501 34 535 3.Total — — — - 519 34 553 Total 84 26 1 — 30 — 141 629 43 2 — 558 34 1266 713 69 3 — 583 34 1407 Drainage Register.—The following is an analysis of the Drainage Register during 1915:— Plans deposited—Old Buildings under Notice .. 116 „ „ —Old Buildings, Voluntary 163 ,, ,, —New Buildings and Additions 43 322 Applications without Plans 172 Total number of Applications and Plans 494 Water Service. Ther following notices have been received from the Metropolitan Water Board as to houses from which water has been cut off:— 1.—Demolition. 1 2.— Empty 17 3.—Leakage 4 4. — Non-payment of Rates 8 5.—No statement (Withdrawals) 3 6.—By request 1 34 72 DISINFECTING AND CLEANSING STATION. Disinfection. The work done during the year by the disinfecting staff is shown in the following table:— Disease. No. of Cases. No. of Houses. No of Rooms Contents Disinfected or Destroyed. No. of Booms Sprayed and Fumigated. Scarlet Fever 1168 1119 1224 1210 Diphtheria 436 426 466 456 Enteric Fever 31 31 81 — Erysipelas 127 127 128 — Puerperal Fever 12 12 12 — Cerebro-Spinal Meningitis 27 27 84 29 Consumption 105 105 99 97 Measles 31 31 35 20 Cancer 23 23 23 10 Other Diseases 72 72 79 22 Totals 2032 1973 2131 1844 Below is shown the number of articles destroyed or disinfected daring the year on account of infectious disease (see also p. 74):— Destroyed. Disinfected. Beds, mattresses and palliasses 71 1872 Bolsters and pillows 37 4237 Sheets, blankets and counterpanes 20 6981 Bugs, mats, cushions, carpets, covers, and curtains 44 1801 Wearing apparel 90 3401 Books 27 100 Sundries 97 534 Total 386 18926 The following table shows the number of persons cleansed and disinfected after having: been in contact with infectious disease : — Males. Females. Children under 10. Scarlet Fever 4 — — Diphtheria 1 — - Puerperal Fever — 5 — Erysipelas — — — Chicken Pox 1 — — Other diseases 1 3 — Cleansing Station. 73 The amount of work done here during the year is indicated in the table below. The figures represent the number of attendances. At each attendance the person receives a bath, and his or her clothes are stoved. Slept previous night at Reason for Cleansing, Adults. Children. Sum Total Males. Females. Total. St. Pancras Outside St. Pancras. 10 to 15. 6—10 0-5 Total. 10 to 15. 5—10 0—5 Total. M. F M. F. Private Addresses Pediculosis—Head - 20 20 9 204 163 8 884 2 41 48 - 86 490 —Body 63 9 72 35 4 19 - 58 23 2 2 —- 50 180 —Both -- 8 8 242 318 423 - 983 241 203 246 - 698 1684 Rowton Houses —Head - - - - - - - - - - - — —- —- —Body 56 - 56 - - - - - — — — - 56 —Both 2 - 2 - - - - - - - - - - 2 Common Lodging Houses —Head - - - - - - - - - - - - - - —Body 186 3 139 - - - - - - - - - - 139 —Both 8 4 7 - - - - - - - - - - 7 Salvation Army Shelter —Head - - - - - - - - - - - - - - —Body 4 — 4 - - - - - - - - - - 4 —Both - - - - - - - - - - - - - - In the open — Head — 1 1 - - - - - - - - - - 1 —Body 70 4 74 - - - - - - - - - - 74 —Both 2 1 3 - - - - - - - - - - 3 Total Pediculosis ,, —Head — 21 21 9 204 163 8 384 2 41 43 — 86 491 „ —Body 329 16 345 35 4 19 — 58 23 2 25 — 51 458 „ —Both 7 13 20 242 318 423 — 983 244 203 246 — 693 1696 Doubtful — — — 4 — 2 — 6 — — 2 — 2 8 Soabies 25 10 35 47 29 61 1 138 38 31 48 1 118 291 Totals 361 60 421 337 555 668 9 1569 307 277 364 1 949 2939 69 of the verminous adults cleansed were soldiers, including 21 from Penton Street Barracks, Finsbury. In addition to the foregoing work, the following cleansings were carried out in respect of bedfellows of these :— Vermin. St. Pancras Children. Outside St. Pancras Children. Sum Total. 15 and over. 10—15. 5-10. Under 5. Total. 15 and over. 10—15. 5—10. Under 5. Total. Pediculosis-Head - 12 31 6 49 - 2 5 - 7 56 ,, -Body — 1 3 — 4 — 1 4 — 5 9 ,, —Both — 37 159 1 197 — 28 54 — 82 279 Doubtful — — — — — — — — — — — Scabies — 6 56 8 70 — 6 51 — 57 127 Totals — 56 249 15 320 — 37 114 151 | 471 74 The school children included in the first of the foregoing two tables have been brought to the cleansing station from the Public Elementary Schools, by officials of the London County Council as the Education Authority under the powers conferred upon them by their General Powers Act, 1904, Sec. 36, and the Children's Act, 1908, Sec. 122. A sum of two shillings for one month's course of cleansings for every child is paid by the County Council to the Borough Council, according to an agreement between the two Authorities. During the year the children for whom a month's treatment was paid for by the London County Council numbered 1,927. The health-visitor, Miss Smith, has devoted part of her time to visiting the homes of these verminous children, and helping the families to rid themselves of these verminous conditions. For this purpose the bedding and bed fellows in the household have been cleansed in many instances. The visits paid for this purpose have numbered 103, but the female staff is quite inadequate to deal with this problem effectively. In March 1915, an arrangement was made with the Finsbury Borough Council whereby verminous persons resident in Finsbury may be cleansed at the St. Pancras cleansing station at a charge of one shilling per attendance to be paid by the Finsbury Council. During 1915, 21 verminous persons (all soldiers) from Finsbury were cleansed under this arrangement. 37 verminous persons from common lodging bouses outside the borough were also paid for by the London County Council at the rate of one shilling per attendance. The following articles have been destroyed or disinfected during the year on account of verminousness :— Destroyed. Disinfected. Beds, mattresses and palliasses 10 53 Bolsters and pillows 4 101 Sheets, blankets, and counterpanes 9 2580 Rugs, mats, cushions, carpets, covers, and curtains 2 302 Wearing apparel 46 1054 Elastic goods — — Skin rugs — — Sundries 80 112 Total 151 4202 These figures include 2593 blankets, 527 rugs, 32 bolsters, 4 mattresses and 886 articles of wearing apparel which were disinfected for the military authorities, or for voluntary bodies (such as the Y.M.C.A.) who provide accomodation for soldiers. PUBLIC MORTUARIES AND CORONERS' COURT. Number of bodies deposited in the General Mortuary during 1915 492 „ ,, Infectious „ „ 8 Total 500 75 Inquests held during 1915— In the Coroner's Court—General Cases 421 „ „ Poor Law 69 Elsewhere in St. Pancras — Total 490 BACTERIOLOGICAL EXAMINATIONS. The following work has been done by the Lister Institute of Preventitive Medicine, Chelsea Gardens, S.W at the expense of the Borough in respect of St. Pancras persons : — Total. Positive. Negative. Examinations of swabs for B.diphtheria 256 68 188 „ sputum for B.tuberculosis 321 78 243 „ blood for Widal reaction (typhoid) 20 7 13 CLERICAL WORK. The following figures give an indication of the clerical work done during 1915. Much other clerical work (such as the vital statistics, and the keeping of notification and other accounts) is also done by the clerical staff. No. of complaints received (communications) 1486 ,, notifications of dangerous infectious disease received 2033 „ ,, reported in daily returns to Metropolitan Asylums Board 2033 ,, ,, „ „ School Teachers 2157 ,, „ „ ,, St. Pancras Library 2033 ,, advisory notices sent to householders in respect of above notifications 2033 „ statutory notices served requiring disinfection 2033 ,, certificates of disinfection forwarded 1460 ,, cases of tuberculosis notified (received: Forms A,B,C, & D) 1982 „ „ „ reported in weekly returns to London County Council 1982 ,, advice-cards sent to notified cases of tuberculosis 1083 ,, notices of voluntary drainage work received 163 „ drainage plans received 322 birth notifications received 4131 ,, reported in weekly returns to London County Council 4131 76 No. of advice-cards re infants' nurture sent to mothers 3994 ,, general letters received (other than complaints and notices of drainage work) 2009 „ letters, etc., despatched 4880 „ intimation notices served 2362 „ statutory ,, „ 1173 „ summonses applied for 50 „ hearings and adjournments 37 „ meetings of Council 16 „ „ Public Health Committee and Sub-Committees 24 THE STAFF. The staff of the department has been much depleted on account of the enlistment of a number of its members, as shown in the following list:— Name. Office. Date of Joining the Colours. J.I.Lonnon Sanitary Inspector 2nd Nov. E.J.Dillon „ 21st Sept. R.E.James „ 30th Nov. G.W.Adkins „ 26th Nov. B.H.Thompson ,, 4th Aug., 1914 P.W.Pottier Junior Clerk and Tem- 7th Nov. porary Sanitary Inspector H.F.Mullis Clerk 5th Nov. G.N.Cove „ 5th Nov. J. Molloy Junior Clerk 26th Oct., 1914 The staff of male sanitary inspectors is further diminished by the fact that the vacancy caused by the death in 1914 of Mr. J. Osborne has not been filled. Whereas before the war there were 15 male inspectors in the department, there are now 9. Of these, one acts as food inspector, one partly as food inspector and partly as district inspector, one as factory and workshop inspector, and 6 as district inspectors. The normal number of district inspectors is 12. Mr. C.Batter and Mr. W.C.Harvey continued to act during 1915 as temporary clerks. On 10th February, 1915, Mr. W.G. Auger, formerly part-time food inspector and part-time district inspector, was appointed whole time food inspector for the West and South Divisions of the Borough, and inspector under the Canal Boats Acts. He had been acting in the latter capacities since December, 1914. 77 On 9th June, 1915, the appointment of Mr. H.G. "West as Factory and Workshop Inspector (for males), which had been made temporarily in June, 1914, was made permanent. On 21st July, 1915, Miss Mary Giles was appointed half-time health visitor and half-time sanitary inspector. Miss Giles had been acting temporarily in this capacity for over two years. On the same date the Council resolved to appoint two other women as health visitors and sanitary inspectors, but these appointments were postponed by the Council until after the end of the year. APPENDIX. Table No. 1. VITAL STATISTICS OF WHOLE DISTRICT OF ST. PANCRAS DURING 1915 AND PREVIOUS YEARS. Year. Population estimated to Middle of each Year. Births-. Total Deaths Registered in the District. Transferable Deaths Nett Deaths belonging to the District. Uncorrected Number. Nett. of Nonresidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. Rate. Number. Rate. Number. Rate per 1,000 Nett Births. Number. Rate. 1910 237178 5385 - 22.7 3415 14.4 710 562 580 107 3267 13.8 1911 237129 5135 5555 23.4 3418 14.4 673 611 623 112 3356 14.1 1912 220353 5008 5367 24.4 3147 14.3 595 605 472 88 3157 14.3 1913 218387 5167 5517 24.7 3409 15.6 728 662 512 93 3343 15.0 1914 218387 4945 5225 23.9 3386 15.5 721 677 481 92 3342 15.3 1915 218317 4458 4751 21.8 3523 16.1 672 692 497 105 3543 16.2 Area of district in acres (land and inland water), 269.4 ; total population at all ages, 218,387; number of inhabited houses, 22,246; average number of persons per house, 9.82; at Census, 1911 (cf. Census, Vol. V.). 79 80 Table No. 2. Deaths Registered from all Causes for the Year 1915. 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 Death. AGES. 0 to 1 1 to 2 2 to 5 Total under 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. M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. f. m. f. M. f. m. f. M. f m. f. m. f m f. persons 1.—General Diseases. 1.Enteric Fever - — — — — - — - — — — — — 1 — 2 — 3 1 1 - — - - — - - 4 4 8 2.T yphus - - — — — - — - — — — — — — — — — — - — — - — - — - - - - - 3.Relapsing Fever - — — — — — — - — — — — — — — — — - - — — - - — — - - - - - 4.Malaria - - — — — — — - — - — — — — — — — - - — — — — - — — - - - — 5.Small Pox— (a)Vaccinated - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (b)Not Vaccinated - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (c)Doubtful - - - - - -_- - - - - - - - - - - - - - - - - - - - - - - - 6.Measles 10 7 10 13 9 6 29 26 4 4 - - - - - - - - - - - - - - - - - - 33 30 63 7.Scarlet Fever - - 1 1 7 3 8 4 5 3 - 1 - 1 - - - - - - - - - - - - - - 13 9 22 8.Whooping Cough 9 15 5 10 4 6 18 31 2 1 - - - - - - - - - - - - - - - - - - 20 32 52 9.(a)Diphtheria - — — 2 6 5 6 7 3 6 - 1 1 - - - - - - - - - - - - - - - 10 14 24 (6)Group - — - — — — - — — - — — - — - — - - - - - - - - - - - - - - — 10.Influenza - - - - - - - - 1 - - 1 - - - 2 1 - 2 1 4 5 3 7 5 2 1 - 17 18 35 11.Miliary Fever - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 12.Asiatic Cholera - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 13. Cholera Nostras 14. Dysentery — — — — — _ 2 _ - 1 1 - — 1 1 i 1 — 3 4 7 15. Plague - - - — - - - - - - - - - - - - - - — — 16. Yellow Fever - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 17. Leprosy - - - - - - - — - - - - - - - - - - - - - - - - - - - - - — 18. Erysipelas 1 1 - - - - 1 1 — — — — — — — 3 1 1 1 — — 1 2 - - - 8 3 11 19. (a) Mumps — — - - — — — — — — — - - — - - - - - - — — - - — - - — — — (b) German Measles — — - - - - - - — — — — - — - - - - - - - — — - - - - - — — — (c) Varicella — 1 - - — — — 1 — — — - — - - - - - - - — — - - - - - — 1 1 (d) Other Epidemic Diseases — — - - — — — — — — - — — — - - - - - - - - - - - - - - — — — 20. (a) Pyaemia 1 1 — - — — 1 1 — — - — — - - - 1 - - - - - - — - - — - 2 1 3 (b) Septicaemia 1 — - - — 1 1 1 — — — — — — — 3 - - - - 2 — 1 - - 4 4 8 (c) Vaccinia - - - - - - - - - - - - - - - - - - - - - - - - - - - - 21. Glanders — — - - — — — — — — - — - — - - - - - - - - - - - - — — — — 22. Anthrax (Splenic Fever) — — - - — — — — — — - — - - - - - - - - - - - - - - - - — — — 23. Rabies — — - - — — — — — — - — — - - - - - - - — - - — - - - - - — — 24. Tetanus — — - - - - - - - - - — - - - - - - - - - - - - - - - — — — 25. Mycoses — — - - - — — — - — - — - - " - — - - - - - - - - - - - - - - 26" Pellagra — — — — — — — — — - - - —- -— 27. Beri-Ber - - - - - - - - - - - - - - - - - - —- - - - - - - - - : 28. (a) Pulmonary Tuberculosis 1 - - - 1 - 2 - 2 4 2 7 13 19 43 23 58 26 60 24 33 11 10 7 3 - - - 226 121 347 (6) Phthisis (not defined as tuberculous) - - - - - - - - - - - 1 1 4 9 6 9 4 9 3 1 2 1 1 - - - - 30 21 51 29. (a) Acute Phthisis -_ - - - -— - - -— -— -— -— -— - 1 1 2 1 -- - - -— - - - - - - - 2 3 5 (b) Acute Miliary Tuberculosis 3 1 - - - 2 3 3 - 1 - 2 1 1 - 2 - 1 1 - - - - - - - - - 5 10 15 30. Tuberculous Meningitis 5 3 8 5 7 6. 20 14 8 2 1 3 1 2 - - - 1 1 - - - - - - - - - 31 22 53 31. (a) Tabes Mesenterica —- - - - —- - - —- —- —- - —- —- - - - - - - - - - - - - - - _- —:- —- —- (b) Other peritoneal & intestinal tubercle 1 - - - -— 2 1 2 1 -— - 1 1 1 - - - - 1 - - - - - - - - - 4 4 8 - - - - - - - —- 1 - - - 1 - - 1 - - - - - - - - - - - - 2 1 3 33. Tuberculosis of Joints —- - - - -— - - -— - -— 2 -— - - - - - - - 1 -— - - 1 -' - - - 2 2 4 34. (a) Lupus —- - - - —- —- - —- - —- - —- —- - - - - - - - - - - - - - - —:- —- —- (b) Scrofula —- - - - -— -— -— -— - -— - - - - -— - - - - - - - - - - - - - -— -— (c) Tuberculosis of other Organs - - 1 - - - 1 - 1 - - - - - 1 - - - - - - 1 - - —- - - - 3 1 4 35 Disseminated Tuberculosis —- 1 - - 1 2 1 3 2 —- - 2 1 1 —- - - - - - - - - - - - - - 4 6 10 36. Rickets, Softening of Bones -— 1 - 1 - -— 3 2 —- —- - -— -— - —- - -— - - - - - - - - - - - 3 2 5 37. Syphilis 4 5 3 - —- —- 7 5 —- —- - —- —- - —- -- 1 2 —- —- 2 - —- - —1- - - 10 7 17 38. Other Venereal Diseases — - - - -— -— — — - — - — — - —- - - -— - - - - - — - - - - - - - 39. Cancer of tho Buccal Cavity —- - - - -— -— -— -— - —- - —- —- - -— -— - -— 6 - 5 2 2 - 1 - -— - 14 2 16 40. ,, Stomach, Liver, &c. —- - - - —- — — —- - —- - —- —- —- —- 1 1 2 12 4 13 10 13 8 7 3 - 1 46 29 75 41. „ Peritoneum, Intestines, and Rectum - - - - - - - - - - - - - - 4 - 2 - 2 3 9 6 10 11 1 8 - 1 28 29 57 42. „ Female Genital Organs - - - - - - - - - - - - - - - 1 - 4 - 16 - 12 - 5 - 2 - - - 40 40 43. ,, Breast - - - '- - - - - - - - - - - 1 -- 2 -—- 7 - 2 - 3 - 3 - - - 18 18 - - - - - - - - - - - - - - - - 1 - 1 - - - - - - 1 - - 2 1 3 1 - - - 1 - 2 - - - - - - - 2 1 2 1 3 5 6 4 9 6 5 1 - 1 30 19 49 - - - - - - - - - - - - - - - - 2 - - 1 - - 1 1 - - - - 3 2 5 47. kheumatic Fever - - - - 1 - 1 - 1 - - - 1 - - 2 - - 3 l -— 1 - 1 - - - - 6 5 11 48. (a) Chronic Rheumatism - —- - - - - - - - - - - - - - - - - - - 1 - - - l' - - - 2 2 (b) Osteo-Arthritis - - - - - - - - - - - - - - - - - - - - 1 - 1 2 1 - - - 3 2 5 (c) Gout —- -— - - - — — -— -— - — -— -— - - - - - - - - 1 - 1 - - -- 2 - 2 49. sc arvy —- —- - - —- - - —- —- — - —- -—- - - - —- - - —- —- - - - —- - - - —'- —- —- 81 Deaths Registered from ai.l Causes for the Year, 1915—continued. Cause of Death. ages. 0 to 1 1 to 2 2 to 5 Total under 5 * to 10 10 to 15 15 to «i5 25 to 55 35 to 45 45 to 55 55 to <»5 65 to 75 75 t > 85 85 and upwards Totals. 1. General Diseases—con. m. f. m. f m. f. m. f. m. f. m. f. m. f. m. f. m. f m ;f. m. f m f ai f • im f > f . persons 50. Diabetes — - - - — - — — — — — — - — — — 1 2 1 1 2 6 1 2 - 2 - - 5 13 18 51. Exopthalmic Goitre — - - - — - — - - — — — — — — - — - - - - - - - - - - - - - — 52. Addison's Disease — - - - — - — - - — — — 1 — — — - - - 1 - - - - - - - - 1 1 2 53. Leucocythasmia Lympbadenoma — — - - — — — - - 1 — — - — — - - - 1 — - - - - - - - - 1 1 2 54. Anaemia, Chlorosis — 1 - - — — — 1 - — — — - — — 1 - 2 - 1 1 - - - 1 - - 2 5 7 55. (a) Diabetes insipidus — — - - — — — — - — — — - — - - - - - - - - - - - - - - - - — (b) Purpura — — - - — - - — - — — — - — — - - 1 - - - - - 1 - 1 (c) Haemophilia — — - - — — - — - — — — — — — — - - - - - - - - 1 - - — - - — (d) Other General Diseases — — - — 1 — 1 — - — — - — 1 — - 1 - 1 — - - - - - - - — 3 1 4 56. Alcoholism (acute or chronic) — — - — — - - — — — — — - — 1 — - 1 2 2 1 - - - - - - — 4 3 7 57. (a) Occupational Lead Poisoning — — - — — — - — — — — - - — — — - - - — 1 - - - - - - - 1 - 1 (b) Non-occupational Lead Poisoning — - - - — — - — — — — - - - — — 1 - - — - - - - - - - - 1 - 1 58. Other Chronic Occupational Poisonings — - - — — - — — — — — - - — — - - - - — - - — - - - - - - - — 59. Other Chronic Poisonings — - - — - — — - - - — - - — - - - - - — - - - - - - - - - - — 2. Diseases of the Nervous System and of the Organs of Special Sense. 60. Encephalitis — - — — — 1 - 1 — — — — - — - — - — — — - - - — — - - — — l 1 61. (a) Cerebro-Spinal Fever 3 1 1 1 1 1 5 3 2 4 2 2 1 — 1 — - 1 - — - - - - — - - - 11 10 21 (b) Posterior Basil Meningitis 1 - — 1 — — 1 1 — — — — 1 — - — - — — - — - - - — - 2 3 (c) Meningitis, other forms 1 2 3 1 2 — 6 3 — 1 — 1 1 1 1 - — 1 1 — - - — — - - 8 8 16 62. Locomotor Ataxy — - - — — — - — — — — — - — - — 1 1 2 — 1 - 1 1 — - — — 5 2 7 63. Other Diseases of the Spinal Cord 1 1 — — — — 1 1 — — — — 1 — 1 — 1 — 1 — 1 1 2 3 — 1 - 1 8 7 15 64. Cerebral Haemorrhage, Apoplexy 2 1 — — — - 2 1 — — — — - - 2 — 3 4 8 12 14 5 20 13 4 15 - 1 53 51 104 65. Softening of Brain — — — — — — — — — — — — — — — — — 1 — 1 2 2 1 — - - 1 4 4 8 66. Paralysis without specified cause — — — — — — — — — — — — — 1 1 — 2 1 — 1 2 3 5 1 5 - 3 7 18 25 67. General Paralysis of the lnsare — — - — - - — — — — — 1 3 - 5 1 5 — 3 — 1 — - - - — 17 2 19 68. Other forms of Mental Alienation — — — - — - - — — — — — — 1 - 1 1 2 1 3 — — 1 - - — 7 3 10 69. Epilepsy — — - - — - - — — 1 — — 1 — 1 1 1 2 — 1 3 1 1 1 - — - — 7 7 14 70. Convulsions (Non-puerperal; 5 years and over) - - - - — - - — — — - — - - - - 1 - - - - - - - - — 1 1 71. Infantile Convulsions (under 5 years) 4 1 1 1 — — 5 2 — — — — - — — — - — - — — — — — — — - - 5 2 7 72. Chorea — — - - — — — — — — — — - 1 — — — — - — — — — — — — - - — 1 1 73. Hysteria, Neuralgia, Neuritis — — - - — — - — — — — — - — — — — 1 1 1 — 1 - — - — - - 2 3 5 74. Other Diseases of the Nervous System — — — - — 1 — 1 — 2 — — 1 — — — 1 1 3 4 — — 1 — - — - - 6 8 14 75. Diseases of the Eyes and Annexa — — — - — — — — — — — — — — — — — - — — — - — - — - — 1 — 1 76. (a) Mastoid Disease 1 — 1 — — 2 - 2 — — — — — — — — - — — — — - - — - — 4 — 4 (b) Other Diseases of the Ears 1 - 1 - - 1 2 1 1 - - - - - - - 1 - 1 - - - - - - - - - 5 1 6 3. Diseases of the Circulatory System. 77. Pericarditis — — — - — 1 — 1 — — — — 1 1 1 — — — 1 1 — - 1 1 — — — - - 4 8 78. Acute Myocarditis and Endocarditis 1 1 — - — 1 1 2 — 2 1 — 1 1 2 - - 2 4 — 1 — - — — — — - 10 7 17 79. (a) Valvular Disease — — — - 1 — 1 — — 1 2 2 2 1 6 3 7 8 15 18 22 15 25 7 8 2 4 57 92 149 (b) Fatty Degeneration of the Heart — — —i - 1 — 1 — — — — — - — 1 - 2 1 2 4 3 7 6 10 4 5 2 - 21 27 48 (c) Other Organic Disease of the Heart — — 1 - 1 — 2 — 1 2 2 1 1 1 1 5 12 7 9 12 21 32 28 23 24 28 6 7 107 118 225 80. Angina Pectoris — — — - — — — — — — — — — — — — — — — — — — — 1 1 — - 1 1 2 81. (a) Aneurysm — — — - — — — — — — — — — — — — 2 1 4 1 1 — 1 2 — — 1 - 9 4 13 (b) Arterial Sclerosis — — — - — - - — — — — — — — — — — 1 ] 1 2 4 2 3 2 1 10 7 17 (c) Other Diseases of Arteries — — — - — - - — — — — — - — — — — — — - 1 1 — — — — — - 1 1 2 82. (a) Cerebral Embolism and Thrombosis — — - - - - - - — — — — - — — — — 1 1 2 2 5 7 7 4 5 — ] 14 21 35 (b) Other Embolism and Thrombosis — — - - — — — — — — — — - — — — — — — — 1 — — 1 ] 1 — - 2 2 4 83. Diseases of the Veins (Varices, Haemorrhoids, Phlebitis, etc.) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 84. (a) Status Lymphaticus 3 - — - — — 3 1 — — — — - - — — — — — - - — — - - — - 3 1 4 (6) Other Diseases of the Lymphatic System - 1 - - - — — 1 - — - - - - - - - - - - - - - - - - - - - 1 1 85. Haemorrhage; other Diseases of the Circulatory System - — — - - - - - — — — — - - - - 1 - — — - - - - - - - - - - 1 4. Diseases of the Respiratory System. 86. Diseases of the Nasal Fossa) - - -| - - - — — - — - — - - - - - - - - - - - - - - - - - - 87. Diseases of the Larynx 1 - - - 1 1 2 1 - — - — - — - - - - - 1 - - - - - - - - 2 2 4 88. Diseases of the Thyroid Body — — — - — - — — — — — — — — — 1 - - 1 - - - 1 - - - - 1 2 3 89. & 90. Bronchitis 15 12 4 1 5 3 24 16 1 — - — 1 - 2 2 7 9 14 7 38 20 36 32 36 49 9 19 168 154 322 91. Broncho-Pneumonia 29 28 13 15 9 10 51 53 1 — 1 — 3 - - 1 1 1 1 3 3 1 8 2 5 7 1 1 75 69 144 92. (a) Lobar Pneumonia 2 1 2 2 2 — 6 3 — — 1 — 3 2 4 3 7 - 1 3 10 6 7 4 4 7 - - 43 28 71 (b) Pneumonia (typo not stated) 4 5 5 7 4 5 13 17 — 1 — - - 3 3 2 6 1 11 5 14 11 4 12 3 7 1 2 55 61 116 93. Pleurisy 1 1 - - — - 1 1 — — — - - - 2 - - 1 1 1 - 1 2 1 - - - - 6 5 11 82 Deaths Registered from all Causes for the Year, 1915—continued. Cause of Death, AGES. 0 to 1 1 tc 2 2 to 5 Total under 5 5 to 10 10 to 15 15 to 26 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 85 and npw ai df- Totals. 4. Diseases of the Respiratory System—con. M. F. M. F. M. F. M. F. M. F. M. F. M, F. M. F. M. F. M. F. M. F. M. F. iM : F. M. F. H. F. PERSONS 94. Pulmonary Congestion.Pulmonary Apoplexy - - — — — — - — — — — — — — — — — — — 2 - 1 3 1 — — - 4 5 9 95. Gangrene of the Lung - - - - - - - - - - - - - - - - 1 - - - - - - - - - - - 1 — 1 96. Asthma - - — — — - - — — — — — — — — — — — — 1 - - - 1 - — — — — 2 2 97. Pulmonary Emphysema - - — — — - - - - - - - - - - - 2 1 — — 1 — i 1 1 1 — — 5 3 8 98. (a) Fibroid Disease of the Lung — — — — — - - - - - - - - - - - - - - - - - 1 1 - — — — 1 1 2 (b) Other D.iseases of the Respiratory System ... — - — - — - - - — — — - — — — — — — - — - - 1 - — — — - 1 - 1 5. Diseases of the Digestive System. 99. (a) Diseases of the Teeth and Gums — — — — - - - - - - - - - - - - - - - — — — 1 - - - - - 1 1 (b) Other Diseases of the Mouth and Annexa - - — - - - - - - - - - - — — - - —- - - - - - - - - - - 100. Diseases of Pharynx, Tonsillitis 2 — — — — 1 2 1 — 1 1 1 — — — — — — — 2 — — — — — — — — 3 5 8 101. Diseases of CEsophagus — — — — - - — — — — — — — — — — — — — — — — — — — — — — — — 102. Perforating Ulcer of Stomach — — — — — - - — — — — — 1 — 1 — 1 — 2 4 — 1 1 1 — 1 — — 6 7 13 103. (a) Inflammation of Stomach 2 1 — — 1 2 2 - - - - - - - - - - - - 1 1 - - - - - - 3 3 6 (b) Other Diseases of Stomach — — — — — - - — -— — — — — — — — — — — 1 — — 1 — — — — — 1 1 2 104 & 105. (a) Infective Enteritis 7 6 1 — — — 8 6 — — — — — — — — — — — — — — ~ — — — — - 3 6 14 (b) Diarrhoea (not returned as infective) 7 8 2 4 - 1 9 13 - - - - - - - — — - - — — - - - 1 - - 9 14 23 (c) Enteritis (not returned as infective) 7 16 3 8 2 2 12 26 - - - - - - - - - - 1 1 - 1 - - 1 1 - - 14 29 43 (d) Gastro-Enteritis (not returned as infective) 17 11 1 2 2 - 20 13 - - - - - - - - - - - - 1 - - - - - - - 21 13 34 (e) Dyspepsia (under 2 years of age — — — - - - - — — - — — — - — — — — — — — — — - - - - - — - - (/) Colic — — — — — - - — — — — — — - — — — — — — — — — — — - - - — (g) Ulceration of Intestines — — — — — - - — — — — — — 1 — — — — — — 1 — — — — 1 — — 1 2 3 (h) Duodenal Ulcer — — — — — - - — — — — — — — 1 — 3 - 2 — — — — — — — — - 6 - 6 106. Ankylostomiasis — — — — — — — — — — — — — — — — — — — — — — — — — — — — — - — 107. Other Intestinal Parasites - - — — — — - - — — — — — — — — — — — — - — — — — — — - — — 108. Appendicitis — — — — — - - — — — 1 — 2 1 — 1 2 1 — 1 — 1 — — — — — - 5 5 10 109. {a) Hernia 1 — 1 — — — 2 — — — — — — — — — — 1 — - 3 1 — 1 — 1 — - 5: 4 9 (b) Intestinal Obstruction 5 2 — — — 1 5 3 — — 1 — — — — — — — — 2 1 2 — 3 — 2 — 2 7 14 21 110. Other Diseases of the Intestines — — 1 — 1 - 2 — — — — — 1 — — — — — — 1 1 — 1 1 — — — — 5 2 7 111. Acute Yellow Atrophy of Liver - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1 - 1 112. Hydatid of Liver — — — — — - - — — — — — — — — — — — — — — — — — — — — — — - - 113. (a) Cirrhosis of the Liver (not returned alcoholic) - - - - - - - - - - - - - - - - - 2 7 8 6 6 4 3 2 1 - - 19 20 39 (5) Cirrhosis of the Liver (returned as alcoholic) - - - - - - - - - - - - - - - - 1 - - - 2 - - - - - - - 3 3 (c) Diseases formerly classed to " Other Diseases of Liver and Gall Bladder" - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 114. Biliary Calculi — — — — — - - — — — — - - - - - - 1 1 2 — 1 — 2 — - - - 1 6 7 115. Other Diseases of the Liver — — — — — 1 — 1 — — — — — - — — — — — 2 — — 1 2 — — — — 1 5 6 116. Diseases of the Spleen — — — — — - - — — — — — — — — — — — — — — — — — — — — — - - - 117. Peritonitis (cause unstated) — — — 1 — 1 — 2 1 — — — — — — — — 1 — — — - — 1 — — — - 1 4 5 118. Other Diseases of the Digestive System — — — — — - - — — — — — — — — — 1 — — — — — — 1 — — — — 1 1 2 6. Non-Venereal Diseases of the Genito-Urinary System and Annexa- 119. Acute Nephritis 1 - — - — - 1 - - 1 - - - - - - - - - - - - - 1 - - - - 1 2 3 120. Bright's Disease — - — — — - - - - - - - 5 - 6 2 7 3 15 9 25 10 21 12 11 3 - - 90 89 129 121. Chyluria — - — — — - - - - - - - - - - - — - - - - - - - - - - - - - - 122. Other Diseases of the Kidney and Annexa - - - - - - - - - - - - - - - - - - 1 - - - - - - - - - 1 - 1 123. Calculi of the Urinary Passages - — 1 - — 1 - - - - 1 - - - - - - - 1 - - - - - - 1 2 3 124. Diseases of the Bladder — — — — - - - - - - - - - - - - 1 - 1 - 5 - 2 2 - - 9 2 11 125. Diseases of the Urethra, Urinary Abscess. &c. - - - - - - - - - - - - - - - 1 - 1 - 1 - - - - - - - 3 - 3 126. Diseases of the Prostate - - — — - - — — — — — - - - — - - - — 1 - 5 - 5 - - - 11 11 127. Non-Venereal Diseases of Male Genital Organs - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 128. Uterine Hemorrhage {Non-puerperal) - - - - - - - - - - - - - - - - - - - - - - - - 1 - - - - 1 129. Uterine Tumour (Non-Cancerous) - - - - - - - - - - - - - - - 1 - - - 1 - - - - - - - - - 3 3 130. Other Diseases of the Uterus - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 131. Ovarian cyst, Tumour (Non-Cancerous) - - - - - - - - - - - - - - - - - - - 1 - - - - - - - - - 1 1 132. Other Diseases of the Female Genital Organs - - - - - - - - - - - - - 1 - 3 - 1 - - - - - - - - - - - 5 5 5 133. Non-puerperal Diseases of the Breas (No"-caricroup) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 83 Deaths Registered from all Causes for the Year, 1915—continued. Cause of Death. ages. 0 to 1 1 to 2 2 to 5 Total under 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. 7. The Puerperal State. M. ..F. M. f. M. f. M. f. M. f. m. f. m. f. m. f. m, f. m. F. M. f. m. F. m. f. m. f. m. f. persons: i 134. Accidents of Pregnancy - - - - - - —- - - - - —,- - - - —- —- —- - - - - - —- - —- - - —- —- 135. Puerperal Hemorrhage - - - —- - - - - - - - —-- —- - - 1 - 2 - - - - - - -— —- - - 3 3 136. Other Accidents of Childbirth - - - -— - - - - - - - - - - - - - - - - - - - - - -— -— - - —- -— 137. Puerperal Fever - - - —- - - - - - - - - - 4. - 1 - - - - - - -: - - - - - - 5 5 138. "Albuminuria and Convulsione —- - - -— - - - - - - - - - 2 - 1 -— - - - - - - -— - - - 3 3 139. " Phlegmasia Alba Dolens, Embolism and sudden death - - - - - - - - - - - - - - - - —- —- - - - - - - - - - - - - 140. ,, Insanity - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -— — 141. ,, Diseases of the Breast - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - —- 8. Diseases of the Skin and of the Cellular Tissue 142. (a) senile Gangrene - - - - - - - - - - - - - - - - - - - - 1 - 2 - - 1 1 1 4 2 6 (b) Gangrene (other types) - - - —- —- - - - - - - - - - - - - - - 1 - - - 1 —- - - - - 2 2 143. Carbuncle, Boil —- - - - - - - - - - - - - - 1 - - - - - - - - - - - - - 1 - 1 144. Phlegmon, Acute Abscess 1 —- 1 —- —- -— 2 —- - - - - - - - - 1 —- 1 - - —- 1 - - - - - 5 - 5 145. Diseases of tae integumentary System 6 —- — —- — -- 6 —- - - - - - - - - - - - - - - - - - - - - 6 - 6 9. Diseases of the Bones and of the Organs of Locomotion. 14(5. Diseases of the Bones - - 1 - - - 1 - - - - - - - - - - - - - - - - - - - - - 1 - 1 147. Diseases of the Joints - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — 149. Other diseases of Locomotor System - 1 - - - - - 1 - - - - - - - - - - - - - - - - - - - - - 1 1 10. Malformations. 150. Congenital Malformations 8 17 1 - - - 9 17 —- - - 1 - - - - - - - - - - - - - - - —- 9 18 27 11. Diseases of Early Infancy. 151. (a) Premature Birth 54 38 - - - - 54 38 - - - - - - - - - - - - - - - - - - - - 54 38 92 (b) Inf.mtile Debility, Icterus, and Sclerema 31 16 1 3 - - 32 19 - - - - - - - - - - - - - .- - - - - - - 32 19 51 152. Oth^r Disease * peculiar to early Infancy 10 5 - - - - 10 5 - - - - - - - - - - - - - - - - - - - - 10 5 15 153. Lack of Caro - 1 1 - - - 1 1 - - - - - - - - - - - — - —- - - - - - - 1 * 1 2 12.old age 154. (a) Senile Dementia - - - - - - - - - - - - - - - - - - - - - - - 2 2 3 - 2 2 7 9 (b) Senile Decay - - - - - - - - - - - - - - - - - - - - 3 - 7 12 31 66 13 13 54 35 139 13. Affections Produced by External Causes. 155 to 163. Suicides - - - - - - - - - - - - 1 - 4 - 2 4 2 5 7 1 4 - - - - - 20 10 30 164. Poisoning by Food - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 165. other acute poisonings - - - - - - - - - - - - - - - - - - 1 1 - 1 - - - - - - 1 2 3 166. conflagration - 3 167. buras (conflagcation excepted) - - 2 1 5 3 7 4 - 1 - - - - 1 - - 1 - 1 1 - - - - 1 1 - 10 3 - 168. Absorption of Oeleterious GaseB (Conflagration excepted) 8 4 - 2 - - 8 f6 - 1 - - - - - - - - - - 1 - - 1 1 1 - - 10 9 18 169. Accidental Drowning - - - - - - - - - - - - - - - - - - - 1 1 - 1 - - -■* - - 2 1 3 i70tol76. Injuries 2 - - - 1 1 3 1 3 2 6 1 3 1 3 1 1 3 5 4 7 6 4 6 2 4 1 1 38 30 68 177. Starvation - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 178. Excessive Cold - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - —- 179. Effects of Lleat - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 180. Lightning - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 181. Electricity (Lightning excepced) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - | 182 to 184 Homicide 1 1 - - - - 1 1 - - - - - - - - - 1 - - - - - - - - - - 1 2 3 | 185 Fractures (cause not specified) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - | 186. (a) Other Violence - - - - - - - - - - - 1 - - - - - - - 1 - - - - - - - - - 2 2 (b) " " though hospital airahips - - - - - 1 - 1 - - - - - - 1 - - - 1 - 1 - - - - - - - 3 1 4 14. IU,-defined Causes. 187. Liropsy - - - - - - - - - - - - 1 - - - - - - - - - - - - - - - 1 - 1 188. (a) Syncope (aged 1 year and under 70) - - - - - - - - - - - - - - - - - 1 - - - - - - - - - - - 1 1 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 189. (a) Heart Failure (aged 1 year and under 70) - - 1 1 - - 1 1 1 - - - - - - - - - - - - - 1 - - - - - 3 1 4 (b) Atrophv, Debility, Marasmus (aged 1 year and under 70) - - - - - - - - - - - - - - - - - 1 - - - - - - - - - - - 1 1 (c) Teething - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (d) Pvrexia - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (e) Other ill-defined Deaths - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - (f) Cause not specified - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Table No. 3. Summary of Ages. 0 to 1 1 to 2 2 to 5 Total under 5 years 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. General Diseases 74 63 71 208 54 24 54 108 134 187 144 113 52 4 1082 Diseases of the Nervous System and of the Organs of Special Sense 20 11 7 38 13 5 8 14 29 46 39 58 26 6 282 Diseases of the Circulatory System 7 1 5 13 6 8 8 17 39 66 118 133 94 24 5 26 Diseases of the Respiratory System 99 49 40 188 8 2 12 19 38 50 107 119 121 35 604 Diseases of the Digestive System 92 24 13 129 2 4 6 3 14 37 31 24 11 2 263 Non-Venereal Diseases of the Genito-Urinary System and Annexa 1 1 - 2 1 - 7 12 ] 2 29 89 44 25 - 171 The Puerpsral State —-- -—- -—- -—- -—- -—- 6 3 2 —-- -—- -—- -— - 11 Diseases of the Skin and of the Cellular Tissue 7 1 - 8 —- —- —- 1 1 2 1 4 1 2 20 Diseases of the Bones and of the Organs of Locomotion 1 1 - 2 - - - - - - - - - - 2 Malformations 25 1 - 26 —- 1 - - - - - - - —-- 27 Diseases of Early Infancy 155 5 —- 160 - - - - - - - - - - 160 Old Age —- -—- -—- -—- —-- —-- -—- -—- —•- -—- 3 21 96 28 148 Affections produced byExternal Causes 16 5 11 32 7 8 5 10 12 22 26 16 9 3 150 —- 2 — 2 1 —• 1 -— 2 -— -— 1 —- -— 7 Totals 497 161 147 803 87 52 107 187 283 439 508 533 435 104 8543 Table No. 4. METEOROLOGICAL TABLE FOR SAINT PANCRAS, 1915. (Extracted from the Monthly Returns of the Meterological Office.) Deduced from Observations at Camden Square, n.w., under the Superintendence of II. 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 123 ft. above M.S.L.) 29.512 29.512 29.89 29.916 29.917 29.926 29.782 29.896 29.893 29.917 20-810 29-518 Air Temperature. Mean of Maximum A •14.2 46.7 49.0 57.6 67.4 72.9 71.5 72-2 09.3 67.5 45.4 48-8 Minimum B 35.6 34.7 36.0 39.1 45-5 510 53-4 54.6 49.9 44-1 33-8 38-9 Mean of A. and B 33.9 40.7 42.5 48.4 56.5 62 .0 62.5 63.4 59.6 50.8 39-6 43.9 Difference from Average † +1-3 +0.7 -0-5 —0-1 +2-2 +1.1 —1-9 +0.1 +1.1 +0.7 —4-3 + 4-4 Humidity—Morning 88% 87% 83% 70% 70% 72% 72% 74% 77% 88% 68% 89% Earth Temperature at 4 ft. depth 43.8 42.5 42.6 44.0 49.2 55.0 57-6 58-1 57-4 54-0 48-3 44.4 Bright Sunshine. Total Observed (Daily mean) Hours 0-97 1-96 2.58 5 .03 6.48 5-87 5-26 4.77 5.37 1.58 2.00 0-61 Per cent, of total possible 12 2o 22 37 42 42 33 33 43 15 23 8 . Difference from Average Hours — — -- — - - - - - — — —- .Rain and other forms of Precipitation. Number of Days 19 18 12 9 8 8 15 15 5 12 9 22 Total Fall Inches 4.1 3.4 0.9 1.1 3.7 0-7 4.1 2.3 1.9 2.1 2.3 5.6 Difference from Average +2.28 —1.81 — -0.55 + 1.97 -1.58 + 1.54 -0.12 —0-32 —0-71 -0-08 + 3-88 +*The hours of observation are 9 a.m. and 9 p.m., local time. t The averages used are obtained from observations extending over 35 years for Rainfall and Temperature and 25 years for Sunshine, Tahi.f. No. 5. Inspections made by District Inspectors and DUTIES AND PREMISES. N. 1. Ilighgate. N, 2. St. John's Park. N. 3. Gospel Oak. NO.4- Gr?fton. NO. 5. Maitland Pork. Infectious Diseases—Inquiry, removal, disinfection, etc 83 92 90 159 189 Subsequent sanitary inspection, etc. 3.7 57 75 73 89 Complaints . 94 34 90 52 107 Drainage—Under notice. Plans, supervision, etc. 4 22 24 154 24 Voluntary 14 16 16 64 42 5 — — 1 — Yards of Mews and Stables 267 171 201 107 213 House-to-House Inspections— Housing, Town Planning, etc., Act, 1909: 17 (1). First Inspections .. 66 30 15 64 48 Subsequent routine Inspections ,. 42 — — 43 34 Inspections of registered tenement houses other than above - - - - - other house-to-house Inspections - - - - - Visits to closed underground rooms - - - - Smoke Shafts observed — 1 11 — — Factories — — — — — Workshops — — — — — WORKPLACES — — — — — BAKEHOUSES Restaurant Kitchens — — — — — Laundries — — — — — REGULATED TRADES. Offensive Trades - - - - - Rag and Bone dealers - - - - - Other effluvia businesses — — — — — Inspections of Market Streets — 5 7 1 9 Other Duties 7 5 — 1 18 Totals 619 433 529 719 773 87 Factory and Workshop Inspector (Male) during the Year 1915. E.1. Bartholomew. E. 2. Camden Square. E. 3. College. E. 4. Oakley Square. E. 5 Ossulston. W. 1. Castle. W. 2. Chalk Farm. W. 3. Mornington. W. 4. Regent's Park. w. 5. Euston. S. 1. Argyle. S. 2. Mecklenburgh. S. 3. Burton. S. 4. Endsleigh. 5. Whitfield. Factories and Workshops. Whole Borough. Totals. 91 95 136 '93 212 201 63 93 129 106 90 63 65 83 71 3 2308 19 37 35 65 78 112 43 60 62 91 47 20 20 29 4' — 1090 58 99 99 75 134 101 82 170 146 86 121 104 79 57 ICO 8 1896 35 39 53 18 18 3 3 22 25 15 2 — 3 9 11 4 488 35 5 22 13 28 133 163 46 42 36 41 50 13 12 39 5 835 1 2 — — 2 83 19 — 2 — 2 8 2 1 5 — 133 — 9 3 17 290 108 203 207 271 269 116 280 301 370 436 — 3839 — 21 — — — 19 53 — — 35 — — — — 57 — 408 35 36 61 209 237 254 — 951 — — — — 15 — — — 4 — — — 10 — — 29 31 31 — — — — 18 10 20 — — 85 27 5 112 89 136 — 502 — — — — 2 14 12 3 — 148 '9 — 40 47 — — 297 - - - - - - - - - - - - - - - 328 328 - - - - - - - - - - - - - - - 919 919 - - - - - - - - - - - - - - - 61 61 - - - - - - - - - - - - - - - 253 253 - - - - - - - - - - - - - - - 274 274 - - - - - - - - - - - - - - - 37 37 - - - - - - - - - - - - - - - - - - — — — — 4 6 — — — — — — — — — 10 - - - - - - - - - - - - - - - - - 18 3 4 9 16 6 2 3 4 11 — 32 9 — 23 12 174 — — — 8 8 11 30 10 2 5 33 3° 16 13 9 15 221 257 311 352 398 806 820 699 614 683 926 534 653 900 957 1182 1919 15084 88 Table No. 6. Re-Inspections after Intimations made by the District Inspectors and DUTIES AND PREMISES.; N. 1. High gate. N.2 St. John's Park. N 3. Gospel Oak. N. 4. Grafton. N. 5. Maitland Park. Infectious Diseases—Inquiry, removal, disinfection, etc. 13 16 5 2 7 Subsequent sanitary inspection, etc. 1 76 190 71 96 Complaints 563 204 348 123 166 Drainage—Under notice. Elans, Supervision, etc 132 331 441 13 40 Voluntary 39 167 92 56 16 260 36 1 20 1 Yards of Mews and Stables 1 1 — — — House-to-House Inspections— Housing, Town-Planning, etc., Act, 1909 : 17 (1). First Inspections 330 200 228 361 233 Subsequent routine Inspections 449 — — 149 126 Inspections of registered tenement houses other than above — — — — — Other house-to-house inspections . — — — — — Visits to closed underground rooms — — — — — Smoke Shafts observed — — 1 — — Factories — — — — — Workshops — — — — — Workplaces — — — — — Bakehouses — — — — — Restaurant Kitchens — — — — — Laundries — — — — — Regulated Trades. Offensive Trades — — — — — Rag and Bone dealers - - - - - Other effluvia businesses — — — — — Inspections of Market Streets — — — — — Other Duties — — — — — Totals 1888 1031 1306 795 685 89 Factory and Workshop Inspector (Male) during the Year 1915. E.1. Bartholomew. E. 2. Camden Square, E. 3. College. E. 4. Oakley Square. E. 5. Ossulston. W. 1. Castle. W. 2. Chalk Farm. W. 3. Momington. W. 4. Regent's Park. W. 5. Euston. S. 1. Argyle. S. 2. Mecklenburgh. S. 3. Burton. S.4. Endsleigh. S. 5. Whitfield. Factories and Workshops, Whole Borough Totals. 8 21 20 26 20 — — 1 2 48 1 1 15 23 57 2S6 II 10 13 ll6 14 '37 76 83 175 101 5 5 7 40 37 7 1271 84 124 121 l60 217 166 144 136 308 376 394 332 231 136 253 27 4615 331 500 729 18 62 298 225 101 145 283 73 43 98 72 186 22 4133 58 54 103 46 122 10 8 78 113 555 315 519 183 100 342 2 3078 13 9 40 1 9 — — — 1 34 26 73 67 12 92 — 695 — 4 - - 1 - — — 2 30 - - - - - - 39 4 28 20 232 897 117 252 — 2 429 114. 4 — 85 '9 26 3481 — 45 — — — — — — 38 202 190 26 1222 5C4 449 — 3400 — — — - 60 l6 — — .— 25 —. — - 3 1 — 105 — — — — — - — - - - - - - - - - - — — — 1 89 — — — 7 18 2 — — 33 33 — 183 — — — - — 1 — - - - - - - - - - 6 - - - - - - - - - - - - - - - 221 223 - - - - - - - - - - - - - - 546 549 - - - - - - - - - - - - - - - 42 42 - - - - - - - - - - - - - - 156 156 — — - - - - - - - - - - - - - 122 122 - - - - - - - - - - - - - - - 13 13 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - — - - - - - - - - - - - - - - - - 1 509 795 1046 600 1491 745 605 400 793 2110 1120 993 1823 1008 1469 1184 22396 90 Inspections and Re-Inspections and other uerk of the Food Inspectors during 1915. DUTIES AND PREMISES. Visits and Inspections. Re-Inspections after Intimation Notices. Inspector Auger. Inspector Child. Totals, Inspector Auger. Inspector Child. Totals. Milkshops 142 368 510 - - - Dairies 160 16 176 - - - Cowsheds 10 48 58 - - - Other Premises of Milk Purveyors 1 8 9 - - - Margarine Factories - - - - - - Butter Factories - - - - - - Ice Cream Premises 185 201 386 - Slaughter Houses 32 176 208 - - - Premises where Prepared Meats are made (sausages, pies, tripe, cooked meat, &c.) 7 166 173 - - - Butchers' Shops 20 314 334 - - - Fishmongers' Shops 62 197 259 - - - Fried Fish Shops 77 151 228 - - - Marketing Places 1559 1322 2881 - - - Other Premises where Food or Drugs are sold 2 - 2 - - - Other Visits 32 133 165 — — — Total 2289 3100 5389 — — — SAMPLES, &c„ TAKEN. Formal Samples Informal Samples No, of Milk samples 198 178 376 — 2 2 ,, Cream samples 11 10 21 - - - ,, Butter and Margarine samples - 92 191 1 5 6 ,, Other samples (specified below)— Lard 10 18 28 - - - Cheese 3 2 5 - - - Coffee 12 15 27 - - - Rice 1 - 1 — - Yeast 1 - 1 - - - Epsom Salts 2 - 2 - - - Tartaric Acid 2 5 7 - - - Arrowroot 1 - 1 - - - Mustard 3 7 10 — - - Oatmeal 1 - 1 - - - Flower of Sulphur - 1 1 - - - Olive Oil 6 - 13 - - - Pepper - 4 4 — - - Jam 2 3 5 — - - Cocoa 14 10 24 - - - Zinc Ointment 2 - 2 - - - Citric Acid 2 5 7 - - - Sausages 1 - 1 - - - Custard Powder 6 4 10 - - - Egg Powder 6 3 9 — — — Total 383 364 747 1 7 8 Samples taken under the Rag Flock Act — — — — — — 91 Table No. 7.—con. Visits and Inspections. Re-Inspections after Intimation Notices. DUTIES AND PREMISES. Inspector Auger. Inspector Child. Totals. Inspector Auger. Inspector Child. Totals. UNSOUND FOOD. Surrendered Seized No. of surrenders and seizures :— Meat — — — — 1 1 Fish 6 5 11 — — — Shellfish — 1 1 — — — Other Foods (specified below):— Apples 1 — 1 — — — Strawberries — 2 2 — — — Tomatoes 1 — 1 — — — Pork pies — — — — 1 1 Offal — 1 1 — — — Pig's Head — 3 3 — — — Celery — 1 1 — — — Eggs 3 1 4 — — — Pears 1 — 1 — — — Plums 1 3 4 — — 1 Ptarmigan 1 — 1 — — — Spleen — 1 1 — — — Broccoli,Parsley and Cabbages — 4 4 — — — Poultry — 1 1 — 1 1 Potatoes — 2 2 — — — Tomatoes (Tinned) — 1 1 — — — Total 14 26 40 — 4 4 Inspections of Registered Canal Boats 55 — 55 — — — 92 Table no 8 Visits, etc., made by Women Inspectors during 1915. DUTIES, First Visits. Re-Visits. Miss Bibby. Miss Smith. Miss Giles. Voluntary Visitors. Whole Borough. Miss Bibby. Miss Smith. Miss Giles. Voluntary Visitors. Whole Borough. Births visited — 519 165 366 1050 — 509 14 141 664 Other visits re births where admission not obtained — 433 49 86 568 — — 22 29 51 Visits re verminous persons — 77 3 2 82 — 9 5 14 Other ,, where admission not obtained — 7 — — 7 — — — — Visits re Ophthalmia Neonatorum . 1 25 2 — 28 — 70 6 — 76 Visits re Puerperal Fever 1 12 1 — 14 — 8 — — 8 Visits re other cases of illness, &c. 41 52 4 4 101 — 9 — — 9 Visits re Tuberculosis notifications 21 — 805 33 856 64 — 307 12 383 Other ,, „ where admission not obtained 17 — 184 20 221 — — 50 — 50 For other purposes ,, ,, ,, ,, — 5 35 3 43 — — 13 — 13 Visits to Hospitals and other voluntary institutions 392 328 221 22 963 — — — 22 22 Factories 2 — — — 2 — — — — — Domestic Workshops 5 — — — 5 — — — — — Home Workplaces 46 — — — 46 — — — — — Laundries — — — — — — — — — — Restaurant Kitchens — — — — — — — — — — Other Workshops 5 — — — 5 — — — — — Other Workplaces 3 — — — 3 — — — — — Other Visits, Inspections and Committees. 375 97 25 1 498 3 1 — 4 8 Total 909 1555 1494 534 4492 67 606 412 213 1295 93 Table No. 9. Total Number of Inspections and Re-inspections made by individual Inspections during the year 1915. Inspector. Inspections. Re-inspections. Total. 1. Mr. Rackham 807 2058 2865 2. „ Brown 1231 2523 3754 3 ,, *Thompson — — — ,, Pottier (Temporary Inspector) 1466 1231 2697 4. „†Dillon 510 2057 2567 „ Auger 86 408 494 5. „ †James 818 1673 2491 6. „ Akers 1677 1366 3043 7. „ †Lonnon 1159 1163 2322 8. ,, †Adkins 877 1973 2850 9. „ Holmes 1306 2189 3495 10. „ Walker 1273 2256 3529 11. „ Landen 1955 2315 4270 12. „ West (Factories & Workshops) 1910 1184 3103 13. „ Auger Food and Food premises 2732 — 2732 14. „ Child 3501 — 3501 15. Miss Bibby 909 67 976 16. „ Smith 1555 606 2161 17. „ Giles 1494 412 1906 18. Voluntary Visitors 534 213 747 Totals 25809 23694 49503 * Away on Active Service during whole of 1915. † ,, „ part of 1915. Table No. 10. Intimations as to Nuisances served by the Sanitary Inspectors during 1915. A Schedule of Nuisances. Inspectors. Mr. Rackham. Mr. Brown, Mr- Pottier. Mr. Dillon. Mr. James. Mr. Akers. Mr. Lonnon. Mr. Adkins. Mr. Holmes. Mr. Walker. Mr. Landen. Mr. West. Mr. Auger. Mr. Child. Mies Bibby. Miss Smith. Totals. l Part of the house in a dirty condition 19 90 56 49 12 57 23 35 32 19 27 2 3 - - - 424 2 ,, ,, damp 21 22 20 14 1 9 5 3 11 10 8 — — — — 124 3 Roof defective 31 75 76 23 11 104 9 25 19 39 44 11 4 — — 471 4 Guttering defective 7 11 6 5 — 12 6 2 1 4 4 — — — — 57 5 Water fittings defective 5 6 23 1 — 5 1 5 1 3 3 38 3 — — 94 6 Water-closet apartment with absence of external ventilation 1 7 1 2 — — 6 1 1 1 5 14 — — — 39 7 , , ,, so foul as to be a nuisance or dangerous to health — — — — — — — 3 — 1 4 4 — — — 12 8 Watcr-clo3et basin foul 2 2 5 3 3 — 2 2 3 2 24 49 — — — 97 9 „ ,, defective 5 7 3 5 3 10 2 — 1 8 10 14 — - — — 68 10 ,, ,, choked 3 6 13 3 7 14 3 10 14 6 14 16 5 - — — 114 11 Urinal in a foul condition — — — — 1 — — — — — 1 9 — — — 11 12 Privy in a foul condition - - - - - - - - - - - - - - - - - 13 Soil pipe defective 7 2 — — — — — 1 — — 9 — — — — 19 14 ,, unventilated 1 5 - - 1 - - - - - - 2 - - - - 9 15 ,, improperly ventilated 5 4 - - - - 1 - - - 1 - - - - - 11 16 Absence of waste pipe to sink, lavatory or bath 1 - - - 1 - - - - - - - 1 - - - 3 17 Waste pipe of sink, lavatory, or bath connected with drain 1 — — — — 2 — — 2 — 2 3 — — — 10 18 ,, ,, ,, ,, defective 6 4 3 1 1 6 3 5 1 3 4 2 — — — 39 19 ,, ,, „ ,, foul 3 5 3 — — 1 1 1 — 5 2 — — — — 21 20 Inlet of drain improperly trapped 4 — — — — 2 1 — 1 — — 1 — — — 9 21 Drain defective 12 25 15 15 9 25 8 10 7 7 16 6 1 — — 156 22 ,, stopped 12 8 5 4 8 16 8 1 6 2 2 3 3 — — — 78 23 ,, ventilating pipe defective 10 2 — 1 — 5 3 — 3 — — 1 1 — — 26 24 Rain-water pipe in direct communication with drain 3 2 1 3 2 — 3 — 1 — — — — - — — 15 25 ,, ,, defective 10 20 5 2 8 8 1 4 4 3 5 2 1 — — 68 26 Unpaved condition of roadway — — — — — — — — — — — — — — — — 27 Undrainod ,, ,, — 1 - - - - - - - - - - - - - - 2 28 Area or part unpaved - - - - - - - - - - - - - - - - - 29 ,, undrained — - - - - - - - - 1 - - - - - - 1 30 Yard or space unpaved — 1 — 3 — 1 — — 1 1 1 — - - — — 8 31 ,, ,, undrained - - - - - 1 - - - - 1 - - - - - 2 32 Defective condition of washhouse paving 2 4 4 — — 8 16 6 3 2 1 1 1 — — 47 33 Dust-bin defective 4 26 24 3 3 12 12 14 7 11 13 8 1 - — — 138 31 ,, in an improper position — — — — — 1 — — — — — — — — — 1 35 Accumulation of stagnant water which is a nuisance dangerous to health — 1 1 — — 1 3 — 1 6 8 — - - - — 21 36 Accumulation or deposit which is a nuisance dangerous to health 6 5 5 3 5 10 6 20 8 16 20 2 2 — — 108 37 Animals kept in such a manner as to be a nuisance dangerous to health 2 2 1 — — 3 - 1 1 1 2 — - — — 13 38 Part of the house so overcrowded as to be dangerous to health 4 4 5 — — 3 - 13 6 — 3 — - — — 38 39 Space below floor in basement or ground floor insufficiently ventilated 1 2 2 — — — 1 — 1 — — — — — — 7 40 Issuing of black smoke in such a quantity as to be a nuisance — - - - - 1 - - - - - - - - - - 1 41 Discharging smoke in such a manner as to cause part of a building to be a nuisance dangerous to health - - - - - - - - - - - - - - - - 2 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 22 12 9 29 5 37 6 12 10 4 7 16 — — — 199 Totals 210 361 286 169 76 351 130 174 146 155 242 384 26 — — — 2563 94 Table No. 11. Intimations as to Breaches of Statutes and Statutory By-laws served by the Sanitary Inspectors during 1915. B Breaches of Statutes and Statutory By-laws. Inspectors. Mr. Rackham. Mr. Brown. Mr. Pottier. Mr. Dillon. Mr. James. Mr. Akers. Mr. Lonnon. Mr. Adkins. Mr. Holmes. Mr. Walker. Mr. Landen. Mr. West. Mr. Auger. Mr. Child. Miss Bibby. Miss Smith. Totals. lA An occupied house without a proper and sufficient supply of water(1907 Act, Sec.78) 3 22 142 11 5 86 3 41 - 3 16 — 6 — — — 338 1B ,, ,, (other than above) — 3 1 8 2 3 7 3 2 — 2 — — — — — 31 2 Water supply used for domestic purposes connected with cistern, which is used for flushing the water-closet — — — — — — — — — — — — — — — — — 3 Water-closet not supplied with a sufficient quantity of water for securing its effective action 8 27 7 6 6 24 11 10 4 4 8 3 2 — — — 120 4 Tank, cistern, or other receptacle for storing of water used or likely to bo used by man for drinking purposes—dirty condition of 5 5 — — 1 — 5 2 — 1 5 — — — — — 24 5 Tank, cistern, or other receptacle for storing water used or likely to bo used by man for drinking purposes—absence of a proper cover to 6 6 2 - 1 2 1 2 — — 7 1 — — — — 28 6 Tank, cistern, or other receptacle for storing water used or likely to be used by man for drinking purposes placed in an improper position — — — — — — — — — — 1 — — — — — 1 7 Animals so kept as to be likely to pollute the water supply — — — — — — — — — — — — — — — — — 8 Offensive matters not deposited in manure receptacle — — — — — — 1 — 2 — — — — — 3 9 Manure not removed at proper intervals — — 2 — 2 10 8 3 10 — 4 — — — — — 39 10 Manure — absence of proper receptacle for — 1 — — — — 1 — 1 — 3 — — — — — 6 11 Manure receptacle not properly constructed — 1 — — — — — — — — — — — — — — 1 12 Sufficient drain to stables or cowshed—absence of a — — — — — 1 — — — — — — — — — — 1 13 Receptacle for house refuse—absence of a proper 27 7 8 4 3 19 4 5 3 7 18 6 1 — — — 112 14 Receptacle for house refuse—absence of a proper cover for — 1 — 2 1 — 1 — — — 3 — — — — — 8 15 Yard or open space unpaved 19 1 — — — — — — — — — — — — — — 20 16 ,, paving defective 5 16 13 8 4 16 10 16 4 2 1 5 1 — — — 101 17 Tnsulicient water-closet accommodation to "lodging house " 1 2 2 — 3 5 — 1 1 1 6 2 — — — — 24 18 A furnace improperly constructed or negligently used — — — — — — — — — — — — — — — — 19 Etlluvia 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—breach of By-laws as to — 1 — — — — — — — — — — — — — — 1 22 Slaughterhouses—breach of By-laws as to — — — — — — — — — — — — — 2 — — 2 23 Steam whistle—use of a, without authority — — — — — — — — — — — — — — — — — 24 Parts of houses infested with vermin requiring stripping,purifying, and cleansing 7 2 22 3 11 17 4 5 5 15 20 — 3 — — — 114 2 5 Articles in an unwholesome condition requiring to be purified or destroyed — — — — 1 — — — — — — — — — — — 1 26 Underground room illegally occupied as a dwelling — — — — 1 — — — — — 2 — — — — — 3 27 Other breaches 7 3 12 10 — 10 12 2 3 4 3 3 — 2 — — 71 Totals 88 98 211 52 41 193 67 90 34 37 102 20 13 5 — — 1051 95 Table No. 12. Intimations as to Breaches of By-laws and Breaches of Statutes served by the Sanitary Inspecter during 1915. c Registered Tenement Houses—Breaches of By-Laws, Inspectors. Mr. Rackham. Mr. Brown. Mr. Pottier. Mr. Dillon. Mr. James. Mr. Akers. Mr. Lonnon. Mr. Adkins. Mr. Holmes. Mr. Walker. Mr. Landen. Mr. West. Mr. Auger. Mr. Child. Miss Bibby. Miss Smith. Totals. 1 Overcrowding 2 - 1 - - 3 — 5 4 2 - - - - - - 17 2 Inadequate water supply - - - - - 2 - - - - - - - - - - 2 3 Contaminated water supply - - - - - - - - - - - - - - - - - 4 Foul closet, basin or trap — — 3 — — — — — — 3 6 — — - — — 12 5 Want of means of ventilation — — — — — — — — — — — — — — — — — 6 Want of annual cleansing — — — — — — — — — — 52 — — — — — 52 7 Want of cleansing of the part or parts of premises used in common 7 — 57 — 3 4 — 10 10 60 45 — 1 — — 197 8 ,, ,, „ in sole use 10 — 36 — 4 7 — 5 6 56 21 — 2 — — — 147 9 Want of cleansing of the room or part of the dwelling 1 — — — — 2 — 2 1 1 31 — — — — — 38 10 Animals improperly kept — — — — — — — — — — — — — — — — — 11 Other breaches — — — — — — — — — 1 — — — — — — 1 Totals 20 — 97 — 7 18 — 22 21 123 155 — 3 — — — 466 Table No. 13. D Factories, Workshops and Work Places—Breaches of Statutes. Inspectors. Mr. Rackham. Mr. Brown. Mr. Pottier. Mr. Dillon. Mr. James. Mr. Akers. Mr. Lonnon. Mr. Adkins. Mr. Holmes. Mr. Walker. Mr. Landen. Mr. West. Mr. Auger. Mr. Child. Miss Bibby. Miss Smith. Totals. l Want of cleanliness — — — — — — — — — — — — 157 — — — — 157 2 Want of ventilation — — — — — — — — — — 1 — — — — 1 3 Want of air space, overcrowding — — — — — — — — — — — 1 — — — — 1 4 Sanitary accommodation, absent or insufficient — — — — — — — — — — 18 — — — — 18 5 ,, ,, unsuitable or defective — — — — — — — — — 1 — — — — 1 6 ,, ,, not separate for sexes — — — — — — — — — 10 — — — — 10 7 Want of drainage of floors — — — — — — — — — — — 4 — — — — 4 8 Other nuisances — — — — — — — — — — 67 — — — — 57 9 Illegal occupation of underground bakehouse — — — — — — — — — — — — — — — — 10 Breach of special sanitary requirements for bakehouses — — — — — — — — — — — — — — — — — 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 — — — — — — — — — — — — — — — — 10 Totals — — — — — — — — — — — — — — — — 259 96