STE 12 ANNUAL REPORT OF THE Medical Officer of Health and Public Analyst FOR THE Metropolitan Borough of Stepney. 1911. REPORT OF THE MEDICAL OFFICER OF HEALTH AND PUBLIC ANALYST. FOR THE YEAR 1911. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Gentlemen, I have much pleasure in submitting to you my eleventh Annual Report, which deals with the Vital and Sanitary Statistics of the Borough of Stepney for the year 1911. For a few years preceding 1910, the estimated population was higher than it actually was for several reasons. It was taken for granted and estimated accordingly, that the same changes took place between 1901 and 1911 that occurred between 1891 and 1901. Previous to the 1901 census, there had been a progressive increase in the population. Old houses were demolished and large model dwellings were erected on the old sites, and there was therefore a greater population. These buildings have ceased to be erected in the same proportion during recent years. There is not the same amount of overcrowding as in former years due to stricter administration of the Public Health Act. In this connection, two Inspectors have been specially appointed to administer the bye-laws affecting tenement houses or houses let in lodgings. Population. The resident population of the Borough of Stepney estimated to the middle of the year was 279,560; distributed as follows:— Limehouse District 53,696 St. George-in-the-East 47,050 Mile End Old Town 111,329 Whitechapel District 67,485 279,560 2 Overcrowding was prevalent in 1901, and it was most difficult to abate it on account of the dearth of empty houses. It was almost impossible to have a house without paying a premium which was called "key money." In 1904, the number of empty houses became abnormal, and the number was on the increase until 1908, as is seen by the following figures which the Borough Treasurer has supplied me with— In the quarter ended March 31st, 1904, the number was 1,073. In the quarter ended March 31st, 1906, the number was 1,670. In the quarter ended March 31st, 1907, the number was 2,865. In the quarter ended March 31st, 1908, the number was 2,944. In the quarter ended March 31st, 1909, the number was 2,729. In the quarter ended March 31st, 1910, the number was 2,529. In the quarter ended March 31st, 1911, the number was 2,408. It is therefore apparent that there is an improvement in this direction, and a large number of families who went into the suburbs to live a few years ago, have recently returned to live in the district. Births. The total number of births registered during the year was 8,464, or 703 less than in the preceding year. They consisted of 4,367 males and 4,097 females. 1,807 belonged to the Limehouse District, or at the rate of 33.6 per 1,000 of the population. 1,570 belonged to St. George-in-the-East, or at the rate of 33.3 per 1,000 of the population. 3,366 belonged to Mile End Old Town, or at the rate of 30.2 per 1,000 of the population. 1,721 belonged to the Whitechapel District, or at the rate of 25.5 per 1,000 of the population. The birth-rate throughout the whole Borough was 30.2 per 1,000 of the population, while that for the whole of London was 24.8 per 1,000. The number of births is lower than in the preceding year, and calculating the birth-rate by corrected figures obtained at the last census, the birth-rate in 1911 is the lowest on record, For the first time, the birth-rate of the Limehouse District is higher than that of St. George's. The birth-rate of the former has remained fairly constant during the last 11 years, while that of St. George's has varied from 44.1 per 1,000 in 1902, when it reached its maximum, to 33.3 in 1911. It has been gradually declining and was 25 per cent. less in 1911 than in 1901. 3 In former annual reports I commented on the abnormally high birth-rate in St. George's, and I expressed the opinion that in a few years the birth-rate would become normal. A few years ago, but more especially from 1901 to 1905, old residents moved into the suburbs, and their houses were taken by aliens who were chiefly of the child-bearing age. Old houses were demolished and large model dwellings were erected instead ; these dwellings were also occupied by a similar class of people. It is obvious that when the old residents left and their places were taken by young married people, the birth-rate, must for a few years, be above the average. The larger the number of persons of this age-period in a district, the greater will be the number of children born, and the higher will be the birth-rate. As time goes on, these families get beyond the child-bearing age, and the birth-rate, has a tendency year by year to decline and approximate more to the normal rate. These forecasts have come true. In the Limehouse district there has been less immigration and the birth-rate has not fluctuated to any appreciable extent in either direction. 523 births occurred in the Mothers' Lying-in Home, Commercial Road:— 89 belonged to Mile End Old Town. 132 belonged to the Limehouse District. 52 belonged to St. George-in-the-East. 26 belonged to the Whitechapel District. 224 belonged to outlying districts. 330 births occurred in the London Hospital:— 53 belonged to Mile End Old Town. 32 belonged to the Limehouse District. 34 belonged to St. George-in-the-East. 37 belonged to the Whitechapel District. 174 belonged to outlying districts. 52 births occurred in the St. George's Infirmary:— 47 belonged to St. George-in-the-East. 5 belonged to the Limehouse District. 49 births occurred in the Mile End Infirmary:— 48 belonged to Mile End Old Town. 1 belonged to the Whitechapel District. 66 births occurred in the Whitechapel Infirmary:— 50 belonged to the Whitechapel District. 1 belonged to the Limehouse District. 4 5 belonged to Mile End Old Town. 3 belonged to St. George-in-the-East. 1 belonged to outlying districts. 30 births belonging to this Borough occurred in Poplar, 28 having occurred in the Stepney Workhouse, 27 belonged to the Limehouse District and 1 to Mile End. 21 births belonging to the Borough of Stepney, occurred in the City of London Lying-in Hospital; 5 in Queen Charlotte's Hospital; 3 in the General Lying-in Hospital; 1 in the British Lying-in-Hospital; 3 in St. Bartholomew's Hospital; 2 in the Middlesex Hospital; 1 each in the Hackney Workhouse, Bethnal Green Workhouse, and Camberwell Workhouse. 3 births occurred in private houses in other boroughs. Illegitimate Births, 41 illegitimate births were registered in the Limehouse District, or at the rate of 22.6 per 1,000 births. 40 illegitimate births were registered in St. George-in-the-East, or at the rate of 25.4 per 1,000 births. 42 illegitimate births were registered in Mile End Old Town, or at the rate of 12.5 per 1,000 births. 63 illegitimate births were registered in the Whitechapel District, or at the rate of 36.6 per 1,000 births. Marriages. The marriages during the year numbered 2,520, or 16 more than in the previous year. The proportion of persons married was 18 per 1,000 of the population, while that for the whole of London was 17.8 per 1,000. 381 marriages occurred in the Limehouse District, or at the rate of 14.1 per 1,000 of the population. 307 marriages occurred in St. George-in-the-East, or at the rate of 13.0 per 1,000 of the population. 1,303 marriages occurred in Mile End Old Town, or at the rate of 23.4 per 1,000 of the population. 529 marriages occurred in the Whitechapel District, or at the rate of 15.6 per 1,000 of the population. 5 Deaths. The total number of deaths occurring in the Borough was 5,179 Deduct deaths occurring within the Borough among persons not belonging thereto 1,196 3,983 Add deaths of residents that occurred outside the Borough 871 4,854 The deaths consisted of 2,557 males and 2,297 females. The death rate throughout the Borough was 17.3 per 1,000 of the population, while that for the whole of London was 15 per 1,000. 1,192 of the deaths belonged to the Limehouse District, or at the rate of 22.1 per 1,000. 854 of the deaths belonged to the St. George's District, or at the rate of 18.1 per 1,000. 1,792 of the deaths belonged to the Mile End District, or at the rate of 16.0 per 1,000. 1,016 of the deaths belonged to the Whitechapel District, or at the rate of 15.0 per 1,000. The following table shows the death-rate throughout the whole Borough and in the various districts since 1890:— Limehouse. St. George's. Mile End. Whitechapel. The whole Borough 1890 26.8 35.0 20.0 24.0 25.2 1891 26.0 29.1 21.2 24.7 24.4 1892 25.5 27.8 23.0 25.2 24.9 1893 27.7 31.0 22.8 25.0 25.5 1894 24.2 26.5 21.1 20.3 22.3 1895 27.3 29.5 22.5 22.8 24.0 1896 23.7 24.4 19.9 20.1 21.7 1897 25.1 26.4 18.7 19.7 21.4 1898 23.7 24.8 23.4 19.7 22.7 1899 25.5 27.1 20.3 19.3 22.0 1900 25.9 24.4 19.3 18.1 21.0 1901 24.6 23.0 18.5 19.3 20.8 1902 23.6 22.1 19.0 19.2 20.5 1903 19.7 20.3 16.3 17.5 17.9 1904 23.2 21.4 18.2 17.4 19.5 1905 20.3 20.4 16.9 15.4 17.7 1906 21.0 19.1 10.5 16.0 17.6 1907 17.3 17.6 14.5 15.4 15.8 1908 20.1 17.2 15.7 14.9 16.6 1909 17.5 17.0 13.9 14.1 15.2 1910 15.6 14.9 12.8 12.3 13.5 1911 22.1 18.1 16.0 15.0 17.3 6 The death-rate is higher than in the preceding years in all the districts, due partly to the extreme heat, and partly to the epidemic of Measles which caused a large increase in the deaths of children under three years of age. The increase is not actually so high as it appears, as the population was over estimated during the last few years which caused the death rate to appear lower than it actually was. The figures given above are not corrected for difference of sex and age constitution of the population. Compared with 1910, the causes of death were :— Disease. 1910. 1911. Increase. Decrease. Small Pox — 8 8 — Scarlet Fever 12 9 — 3 Enteric Fever 16 5 — 11 Measles 93 291 198 — Diptheria and Croup 33 34 1 — Whooping Cough 110 44 — 66 Diarrhœa and Enteritis 205 506 301 — Rheumatic Fever 6 2 — 4 Phthisis 410 481 71 — Other Tubercular Diseases 137 166 29 — Bronchitis, Pneumonia, and other Respiratory Diseases 953 981 28 Heart Disease 335 334 — 1 Influenza 43 24 — 19 Puerperal Fever 15 9 — 6 Injuries 197 245 48 — Convulsive and Wasting Diseases 324 218 106 Premature Births 151 166 15 — Old Age 216 233 17 — Cancer 228 236 8 — Alcoholism 30 34 4 — All other causes 785 828 43 — 4,299 4,854 771 216 There were 652 inquests held on residents during the year. The causes of death were as follows :— Accidents 97 Accidents and Diseases of child-birth, including Puerperal Fever 4 Alcoholism 6 7 Aneurism of Aorta 7 Apoplexy 27 Appendicitis 1 Bright's Disease 13 Burns (adults) 7 Cancer 7 Cerebral Abscess and Chronic middle ear disease 1 Diabetes 3 Diarrhœa 7 Diphtheria 2 Diseases of the Lungs:— Bronchitis 23 Pneumonia 44 Phthisis 14 Other Respiratory Diseases 3 Diseases accelerated by self-neglect and want of proper nursing 9 Drowning 20 Epilepsy 2 Fracture and dislocation of cervical vertebræ—hanging 1 Gastric Ulcer 7 Heart Disease 77 Heart-failure following occlusion of corronary arteries causing necrosis of heart muscles 1 Influenza 1 Internal haemorrhage due to rupture of ectopic gestation 1 Justifiable Homicide 2 Murder 5 Perforation of stomach due to Gastritis 1 Ptomaine Poisoning 6 Rheumatism 1 Rupture of bloodvessel in stomach 1 Rupture of heart 1 Senility 8 Shock while undergoing a necessary operation under the influence of an anaesthetic 4 Strangulated Hernia 2 Suicide 35 Tuberculous Meningitis 4 Affecting Children (under five years of age):— Accidents 4 Accidents and Inattention at Birth 10 8 Accidental Suffocation caused by clothes in the cradle 1 Accidental Suffocation due to regurgitation of food into the Larynx 1 Acute Pemphigus 1 Asphyxia supervening on retropharyngeal abscess 1 Asphyxia caused by a perforated ulcer under the chin bursting into the throat 1 Atelectasis 1 Bronchitis 5 Burns and Scalds 11 Congenital deformity 3 Convulsions 48 Diarrhœa 22 Drowning 2 Exhaustion accelerated by septic suppuration in the region of the navel 1 Gastro-Enteritis 1 Heat exhaustion 1 Inanition 2 Laryngismus Stridulus 1 Marasmus 8 Meningitis 5 Murder 1 Overlying and suffocation in bed with the parents 26 Pneumonia 12 Premature births 16 Ptomaine poisoning 1 Respiratory obstruction and collapse of lung 1 Shock while undergoing a necessary operation under the influence of alcohol 2 Status Lymphaticus 1 Syncope 1 Tuberculosis 5 Tubercular Meningitis 1 There were 7 deaths due to accidents caused by Motor omnibuses, 2 by Motor cars, and 5 by Electric trams—a decrease of eight deaths from that in the preceding year. The deaths from "Justifiable Homicide" referred to the two criminals killed in Sidney Street. 13 deaths were due to the extreme heat during the summer months or were accelerated by the heat. 9 The following is a list of the Outlying Institutions and the number of residents who died in them during the year:— Babies Home, Shoreditch 1 Belmont Workhouse 3 Bethnal Green Infirmary 7 Brompton Hospital 3 Cancer Hospital 5 Camberwell Infirmary 1 Central London Sick Asylum 1 Children's Hospital, Great Ormond Street 19 Children's Hospital, Carshalton 12 Charing Cross Hospital 1 City of London Infirmary 3 City of London Chest Hospital 6 Convent Hospital, Carlisle Place 1 Easington Infirmary 1 Epping „ 1 Fairlight Sanatoriu m 1 Faversham Infirmary 1 Fever Hospitals:— Brook Fever Hospital 15 Eastern Fever Hospital 53 Grove Fever Hospital 1 North Eastern Fever Hospital 5 Park Fever Hospital 11 South Eastern Fever Hospital 30 Western Fever Hospital 1 Joyce Green Small Pox Hospital 8 South Wharf Metropolitan Asylum Board 1 Friedenheim Hospital 4 German Hospital 13 Guy's Hospital 5 Hackney Infirmary 2 H.M. Prison, Brixton 2 H.M. Prison, Holloway 1 H.M. Prison Pentonville 1 Home for Jewish Incurables 7 Homeopathic Hospital 1 Hospital of St. John and St. Elizabeth 1 King's College Hospital 2 Islington Workhouse 1 10 Lunatic Asylums:— Banstead 11 Belmont 1 Bethnal House 2 Cane Hill 3 Caterham 9 Claybury 40 Colney Hatch 50 Darenth 3 Dartford 7 East Sussex 1 Hanwell 5 Horton 4 Kent County 20 Leavesden 20 Long Grove 2 Peckham House 1 Tooting Bec 21 Metropolitan Hospital 3 Middlesex Hospital 3 Mildmay Mission Hospital 2 Montserat Nursing Home, Bournemouth 1 105, Nightingale Lane, Streatham 1 Nightingale Nursing Home, Torquay 1 Ockley Sanatorium 1 Ossulton House Convalescent Home, Hendon 1 Paddington Infirmary 1 Poplar Hospital 5 Poplar and Stepney Sick Asylum 204 Poplar Workhouse 1 Queen's Hospital 20 Queen Alexandra's Military Hospital 50 Quinton Polyclinic 1 Reigate Convalescent Home 1 Royal Boscombe Hospital, Bournemouth 1 Royal Chest Hospital 2 Royal Mineral Hospital, Bath 1 Royal Hospital, Portsmouth 1 St. Anne's Home, Heme Bay 1 St. Bartholomew's Hospital 22 St. Catherines Hospital, Ramsgate 2 St. George's Hospital 1 St. Joseph's Hospice 2 11 St. John's Hospital for diseases of the Skin, Uxbridge Road 1 St. Luke's House, Kensington 4 St. Marks Hospital 1 Seamen's Hospital 6 Shenfield Cottage Hospital 1 Sick Asylum, Blackwall 5 Soho Hospital for Women 1 Southwark Infirmary 3 Staines Infirmary 1 Stepney Workhouse 80 Stratford Workhouse 1 University College Hospital 1 West Ham Union Convalescent Home 1 West Ham Union Infirmary 1 871 The following number of deaths of residents occurred in Public Institutions in the Borough:— East London Hospital for Children 239 London Hospital 528 Mile End Infirmary 379 Mothers' Lying-in Home, Commercial Road 11 St. George's Infirmary 234 Whitechapel Infirmary 285 Whitechapel Workhouse, South Grove 50 1726 There were 1,196 deaths of non-residents in Public Institutions in the District. Notifiable Diseases. Excluding Measles, Phthisis and Chicken Pox, 1,544 notifications of Infectious Diseases were received, or 170 more than in the previous year, and 1,071 were removed to the various Hospitals and Infirmaries. 313 belonged to the Limehouse District, or at the rate of 5.82 per 1,000. 257 belonged to St. George-in-the-East, or at the rate of 5.46 per 1,000. 601 belonged to Mile End Old Town, or at the rate of 5.34 per 1,000. 373 belonged to the Whitechapel District, or at the rate of 5.52 per 1,000. There were in addition to the above 1,819 cases of Measles notified, 1,350 suffering from Phthisis and 219 from Chicken Pox. 12 Excluding Measles and Phthisis, the greatest number of notifiable diseases occurred during the fourth week in February and the first week in June, when in each of these weeks 51 cases were notified. In the former period, 26 cases of Small Pox and in the latter, 19 cases of Chicken Pox and 13 of Erysiplas were included. The number of notifications of Scarlet Fever was less than 10 a week during the first five months of the year. In the last week in June and the first week in July and August, 13 were notified, but this number dropped to 10 and under, for the remaining three weeks in July, and the second and third weeks in August. In the last week of August the number went up to 14, and it gradually increased until the fourth week in October when the number was 22, which was the maximum number in any one week throughout the year. The number of cases of Enteric Fever reached its maximum of 9 in the second week in October, which is about the usual time for this disease to be at its height. Diphtheria was at its height during the first and third weeks in March, the first week in August and the third week in November. The largest number of Notifiable Diseases occurred during the first week in February in the Limehouse District, the second week in April in St. George's, the fourth week in February in Mile End, and the second week in October in the Whitechapel District. Wrong Diagnosis. 72 cases of Infectious Disease were removed to the Hospitals of the Metropolitan Asylums Board, which were subsequently returned home in consequence of the patient being found not to be suffering from the disease stated on the certificate, or any other notifiable disease. 39 of the cases were notified from public institutions, chiefly the London Hospital, and 33 were notified by private practitioners. This number consisted of 36 cases of Scarlet Fever, 32 cases of Diphtheria, 1 of Typhoid Fever, 1 of Small Pox and 2 of Cholera. Bacteriological Examinations. 799 specimens were bacteriologically examined, 175 giving positive results. They included the examination of 256 rats for bacillus pestis which was found to be present in 4 rats. No. Positive. No. Negative. Consumption 109 265 Diphtheria 42 80 Enteric Fever 20 27 171 372 Chart showing the number of oases notified week by in the Borough, of Scarlet Fever, Typhoid Fever, and Diphtheria during 1911. Chart showing the total number of cases of In fectious Diseases notified week by week in Limehouse, St George's, Mile End and Whitechapel, during 1911. Chart showing the total number of cases of Infectious Diseases notified week by week in the Borough during 1911. The above Chart refers to the following Diseases:—Scarlet Fever, Enteric Fever Diphtheria, Membranous Croup, Erysipelas, Puerperal Fever, Cerebro-Spinal Fever, Small Pox, Opthalmia Neonatorum, Polio Myelitis and Chicken Pox, from the 22nd March to 21st June. 12/13 3 13 Small Pox. Copy of Report to the Public Health Committee, dated 2nd March, 1911. On February 21st I received information that three patients were suffering from Small Pox at the Mile End Infirmary, viz.:— Annie L., aged 12, vaccinated in infancy only. Elizabeth S., aged 31, vaccinated in infancy only. Mary Jane O., aged 50, vaccinated in infancy only. On making enquiries I find that A. L., of 3, Key Street, was taken ill on January 28th, and on the same day she attended the Receiving Room of the London Hosp'tal, where she was given a prescription. At this time she had no rash. She was again taken to the Receiving Room on February 4th and 5th. There is no doubt that on both these occasions she had a rash which resembled Chicken Pox. She was thought to be suffering from Chicken Pox, and was given a dose of medicine. The father of the patient seems to have been rather persistent on February 5th, and he wanted his daughter to have continuous treatment. He was told that she could not be treated at the Hospital, and he was advised to take his daughter home and call in the Parish doctor. On the same day the girl was removed in an ambulance on a Relieving Officer's Order to the Mile End Infirmary. She was taken to a general ward, where there were sixty women and children. She was seen by the Medical Superintendent and the Assistant Medical Officer. She must have been seriously ill, as she was soon placed on the dangerous list. Her relatives and friends were allowed to visit her daily, which they did. Unfortunately, her true condition was not diagnosed until late on Monday night, February 20th, when two other patients in the ward developed symptoms which resembled Small Pox. Dr. Brooks telephoned to Dr. Cameron, of the South-Eastern Fever Hospital, and the latter saw the three patients mentioned above, about midnight on February 20th. He was of opinion that they were all suffering from Small Pox, and they were removed in the course of the early morning of the 21st February to the Small Pox Hospital, near Dartford. During the course of the day, four other patients were removed to the Small Pox Hospital, two being from the infected ward, viz. Ellen Francis H., aged 3, not vaccinated (This patient is dead.) Elizabeth B., aged 23, vaccinated in infancy only. Mary Anne B., aged 30, vaccinated in infancy only. Sarah L., aged 11, vaccinated in infancy only. Mary Jane B. was a scrubber employed in the Infirmary one day a week. She worked in the infected ward (D 12). Sarah L., of 3, Key Street, is a sister of Anne L., and she was also seen by the Receiving Room Officer at the London Hospital on February 21st. 14 The L. family was removed to the Council's Shelter, where I examined them carefully on the morning of February 22nd. Leah L., aged 15, had a rash, and was removed to the Small Pox Hospital. She was vaccinated in infancy only. The case of Rebecca L., aged 8, was different. She had ihe remains of a slight rash which resembled Small Pox. It was fading, and it was very difficult to say whether it was due to that disease or not. I thought that it was due to Small Pox, and that it was probably about a fortnight old. I removed her to the Small Pox Hospital, where she is at the present time. She was vaccinated in infancy only. On making enquiries I discovered that she went to school on February 6th, but other children in the class told the teacher that they saw the "fever van" removing her sister Annie on the previous day. The "fever van" was the Guardians' ambulance. The teacher promptly sent her home, and told her to return to school on February 13th. On February 9th she was taken to the Receiving Room of the London Hospital, where she was seen by a different doctor to the one who saw Annie L. He diagnosed the disease to be Chicken Pox. She was given some medicine and sent home. On Monday, February 20th, Rebecca L. went to school. She was asked why she did not return on February 13th, as she was told, and she replied that she had measles and could not do so. She remained in school all day on Monday and until 4 p.m. on Tuesday, when she was sent for. It will be seen, therefore, that the class in the school in question became infected on February 20th and 21st. A strict watch is kept on all the scholars by the teachers, not only in this school, but in all the others as well. If a child becomes ill, or is absent from any cause, the teacher communicates with me at once, and I visit and keep the child under observation. On February 22nd, Feliz K., aged 1 month, and Theresa C., aged 21, were also removed from the infected ward at Mile End Infirmary. The former, who has died, was unvaccinated, and the latter, who is a nurse at the Infirmary, was vaccinated in infancy only. On February 23rd, eleven cases were removed from the same ward of the Infirmary, viz.:— Margaret N., aged 23, a nurse, vaccinated in infancy only. Mary T., aged 35, vaccinated in infancy only. Louisa S., aged 43, vaccinated in infancy only. (Dead). * Annie Louisa C., aged 4, vaccination doubtful. Beatrice G., aged 54, vaccinated in infancy only. Sarah Ann B., aged 49, vaccinated in infancy only. Mildred May B., aged 22, vaccinated in infancy only. Jessie T., aged 45, vaccinated in infancy only. * Dorothy T., aged 4, vaccination doubtful. Mary Ann C., aged 51, vaccinated in infancy only. Emily P., aged 46, vaccinated in infancy only. * (With regard to doubtful cases of vaccination I am asking the Medical Supertendent of the small pox hospital for definite information.) 15 Another member of the L. family was removed on February 23rd, viz. : Louis, L. aged 20. He was vaccinated in infancy only. On February 24th three cases were removed from the Infirmary, viz.:— John B., aged 1¾, not vaccinated. Charles P., aged 4, not vaccinated. (Dead.) Mildred J., aged 24, a nurse, not vaccinated. (Dead.) On February 25th six cases were removed, five being from the Infirmary, viz.:— Constance L., aged 2¼, not vaccinated. (Dead.) Rosina 0., aged 65, vaccinated in infancy. (Died at South Wharf, but it was found that she was not suffering from Small Pox.) Francis N., aged 42, vaccinated in infancy. Susannah M., aged 16, vaccinated in infancy. Florence F., aged 15, not vaccinated. and one case from outside the Infirmary, viz.:— Ada S., aged 30, of 24, Shandy Street, vaccinated in infancy only. The latter visited the infected ward in the Infirmary (D 12) on February 12th. The patient she visited was in the same ward, but not near Annie L. On February 26th two cases were removed to the Hospital, one from outside and one from the Infirmary. The latter, however, was returned on the same day, as it was found that she was not suffering from Small Pox. The genuine case was Mrs Eugenie D., aged 67 years, of 64, Jupps Road, who had previously been a patient in D 12 of the Infirmary and was discharged on February 13th. She was vaccinated in infancy. I had kept her under observation since February 22nd. On February 27th two cases were removed to the Hospital from the Infirmary:— Sarah R., aged 84, not vaccinated. (Dead.) A nurse, Marie K., aged 21, vaccinated in infancy only. On February 28th two cases were removed from the Infirmary, viz.:— Alice Maud C., aged 12 years, not vaccinated. Ellen S., aged 40 years, vaccinated in infancy. (Dead.) Condition with regard to Vaccination. Of the seven children under 8 years of age, two were vaccinated (doubtful cases calculated as being vaccinated) and five unvaccinated. Of the latter four are dead. The two former only had a mild attack of the disease. Of the fourteen cases between 8 and 30 years of age, three had never been vaccinated and eleven had been vaccinated in infancy. None re-vaccinated. One dead ; not vaccinated, even in infancy. 16 Of the thirteen cases between 30 and 60 years of age, all had been vaccinated in infancy, none had been re-vaccinated. Two have since died. Of three cases above 60 years of age, all had been vaccinated in infancy, none had been re-vaccinated, two have died. The total number of cases is thirty-seven, of whom eight have died. I at once communicated with the Medical Superintendent of the Infirmary and obtained a list of people who had come in contact with the patients, as well as others connected with the Infirmary who may have been exposed to the disease. I found that persons from sixty-eight houses in the Borough visited patients in D 12 ward during the time that the Small Pox patient was lying there. The inmates of these houses have been visited daily ; one case was discovered as the result of such visits on February 25th. There were visitors from forty-five houses resident outside the Borough. I have communicated these addresses to the various Medical Officers of Health of the districts as well as to the London County Council. There were about sixty patients in the ward. The home addresses of these patients are visited daily. Sixty-five patients who were discharged from the Infirmary since February 5th have been visited daily and examined. Mrs. Eugenie D. was one of them. There are also sixty-five officers working in the Infirmary who are not residents. These premises are also visited daily. There are thirty-five school children absent from the three schools which have become infected. I have also visited these, and kept them under observation. There is a history of a number of other persons who visited the Infirmary from the Workhouse ; I have no control over these. I have been in frequent communication with the Local Government Board on the matter, and I have seen Dr. Sweeting on several occasions. I have also received assistance from Sir Shirley Murphy and his two assistants, Drs. Hamer and Wanklyn, especially in tracing the contacts. In fact, practically all my inspectors, the thirteen Sanitary Inspectors of the London County Council (who worked under my direction), Drs. Hamer and Wanklyn and myself visited all the known contacts on Saturday last. The County Council Inspectors were especially engaged in tracing and examining the contacts living outside our Borough. The work of tracing contacts has been a very arduous one. A large number of the contacts had either given false addresses or had moved. It is essential that they 17 shall be kept under observation until Tuesday or Wednesday next, as is proved by the fact that two contacts have already developed Small Pox. Unfortunately the list of contacts is not a complete one. The names and addresses of the visitors to the wards on Sunday only are taken. These, even, are not complete nor are the addresses correct in many instances. The names of the visitors to patients on the dangerous list are not taken at all. As these have been allowed in Ward D 12 daily and for prolonged periods, it will be readily seen that I am not in possession of some of the addresses of the most important contacts. I have been able to discover some of them by making inquiries at the home addresses of the patients. The origin of the disease remained a mystery for a long time, but I believe I have discovered how it was communicated to Annie and Rebecca L. I obtained the names and addresses of all the acquaintances and friends of the L. family. By visiting and making enquiries I found that a friend visited them on or about January 21st. In order to follow and understand the story correctly I will start at the other end. On December 1st a patient was taken ill in the neighbourhood of Bell Lane. She had a rash, which the doctor in attendance considered to be Chicken Pox. He had some doubts of the case, and he called in another doctor in consultation to see the patient. They both agreed it was a case of Chicken Pox. Towards the second week the patient (Mrs. B.) had a miscarriage, and another doctor was called in, on December 6th. He continued to attend until December 12th, or thereabouts. This doctor recollects the rash, but it did not impress him at the time that it resembled that of Small Pox in any way. Mrs. B. had several young children, but they were all vaccinated. Mrs. B. was ill (probably from the effects of the miscarriage) until within a few days of Christmas. On December 20th a lodger (a boy of sixteen) was taken ill, the rash appearing about three days afterwards. He was away from work until January 16th. For three weeks he was hardly out of his room, and for a greater portion of the time he was in bed. On or about January 17th his sister was taken ill. She had a similar rash, but not of so severe a character. Both were attended by a doctor, who is of opinion that both had Chicken Pox. The girl (L. G.) returned to work on February 13th. It is quite possible that Annie L. contracted the disease from L. G. when she visited the premises in Bell Lane on January 21st, Annie L. should then be taken ill on February 1st or 2nd, the rash appearing on February 3rd or 4th. She was certainly ill on January 28th, and the rash had not then appeared. The facts, as stated above, do not point absolutely to the disease being communicated to Annie and Rebecca L. by the girl L. G., nor have I anything to prove that L. G and her brother had Small Pox. These facts are, however, very suggestive. B 18 From enquiries I have made and the interviews I have had, I cannot find that any friend or acquaintance of Mrs. B., L. G., or her brother, have had any illness with a rash since the beginning of December. If the illness was really Small Pox, then its infectivity must have been very feeble until it was transmitted to Annie L., who was very infectious. It is quite possible that the infectivity of the disease increased in force as it passed from one person to the other. L. G.'s brother was engaged in a foreign importer's office, but there is no record that he opened any parcel of foreign goods from the proceeding July until the date of his illness. Previous to, and since his illness, his evenings have been occupied in selling chocolate, &c., in various theatres, music halls and picture palaces. If he had Small Pox it is possible that he communicated the disease to persons in other districts, where the connection cannot be traced to this district. He and his sister have received a bath at our Disinfecting Station and their clothing disinfected. The bed-clothes have also been disinfected. There does not seem to be any direct connection between the cases of Small Pox which have occurred in Stepney and those which have occurred in other districts. Reginald H., of Westminster, did not work in the same premises as one of the L.'s, as stated in some quarters. He had only been working a week in this Borough before he contracted the disease. I should like to correct another error which has been made. It was stated officially at the last meeting of the Mile End Guardians that the epidemic of 1901 and 1902 started in Key Street. This is not so. No case of Small Pox occurred in Key Street in 1901 or 1902. Everything is done to stamp out the disease by this department that is humanly possible. I do not anticipate that we shall have very many cases, but it is too soon to prophesy until Monday or Tuedsay, when it will be possible to estimate the extent of the damage done through the contacts of D 12 ward of the Mile End Infirmary. Scarlet Fever. 423 cases of Scarlet Fever were notified during the year, or 75 less than in the previous year. 405 were removed to Fever Hospitals. 96 belonged to the Limehouse District, with no deaths. 52 belonged to St. George-in-the-East, with no deaths. 188 belonged to Mile End Old Town, with 6 deaths. 87 belonged to the Whitechapel District, with 3 deaths. The death rate for the whole Borough was .03 per 1,000 of the population, while that for the whole of London was .04 per 1,000. 19 Diphtheria and Membranous Croup. 472 cases were notified during the year, or 120 more than in the previous year and 445 were removed to Fever Hospitals. 105 belonged to the Limehouse District, with 7 deaths, or at the rate of .13 per 1,000 of the population. 102 belonged to St. George-in-the-East, with 14 deaths, or at the rate of •29 per 1,000 of the population. 159 belonged to Mile End Old Town, with 10 deaths, or at the rate of .09 per 1,000 of the population. 106 belonged to the Whitechapel District, with 3 deaths, or at the rate of .04 per 1,000 of the population. The death rate throughout the whole Borough was 12 per 1,000 of the population. The death rate for the whole of London was .14 per 1,000. Enteric Fever. 79 cases of Enteric Fever were notified during the year, or 32 less than in the previous year. 11 occurred in the Limehouse District, with no deaths. 16 occurred in St. George-in-the-East, with no deaths. 35 occurred in Mile End Old Town, with 2 deaths. 17 occurred in the Whitechapel District, with 3 deaths. The death rate throughout the whole Borough was .01 per 1,000 of the population. The death rate for the whole of London was .03 per 1,000. Erysipelas. 474 cases of Erysipelas were notified, or 97 more than in the previous year. 89 belonged to the Limehouse District, with 2 deaths. 79 belonged to St. George-in-the-East, with 1 death. 155 belonged to Mile End Old Town, with 9 deaths. 151 belonged to the Whitechapel District, with 1 death. Cerebro-Spinal Fever. 7 cases were notified during the year, 3 having occurred in the Limehouse District, 3 in Mile End Old Town and 1 in the Whitechapel District. 2 proved fatal, 1 death having occurred in Limehouse and the other in Mile End. B 2 20 Puerperal Fever. 29 cases of Puerperal Fever were notified, or 1 less than in the previous year. m 3 occurred in the Limehouse District, with 1 death. 5 occurred in St. George-in-the-East, with 2 deaths. 16 occurred in Mile End Old Town, with 4 deaths. 5 occurred in the Whitechapel District, with 2 deaths. Ophthalmia Neonatorum. 16 cases were notified during the year, 6 belonged to the Limehouse district, 2 to St. George's, 5 to Mile End Old Town, and 3 to the Whitechapel district. The following arrangements have been made with regard to cases of inflammation of the eye in newly born, notified by midwives to the Medical Officer of the London County Council:— (1) Visits are paid in the first instance by the London County Council Inspectors under the Midwives Act. (2) If hospital treatment is urgently necessary, the Inspectors take immediate steps to obtain it. (3) The name and address of each case are sent to this Department, special note being made of the fact if the patient has gone to hospital. (4) After the notification has been received, in the event of a medical man not being in attendance, I have found no difficulty in arranging for nurses to attend from the East London Nursing Society. Cholera. Report on Cases of Cholera notified in the Borough.—On August 16th, a notification certificate was received that I. S., aged 30, of Wilkes Street, was suffering from Cholera (European). The sanitary inspector visited the premises on the same date and found that the patient was at work. The inspector called on the doctor who had notified the case, and he accompanied the inspector to the patient's house. As the doctor insisted that the patient was suffering from cholera, he was removed to the fever hospital, and the premises were disinfected. The patient was a tailor, and was taken ill on August 15th with pains in the stomach, but there was an absence of sickness. No other illness occurred in this house. On the same date (August 16th) a certificate was received from the same doctor that B. S., aged 11 months, Old Montague Street, was also suffering from Cholera (European). The baby was removed to the fever hospital on the same day, and the premises were disinfected. No other illness occurred in this house. 21 Both these patients were discharged from the fever hospital on August 21st, the Medical Superintendent stating that they were not suffering from cholera. On August 17th, J. C., aged 45, of Hanbury Street, and on August 18th, R. L., aged 65, of Rothschild's Buildings, were certified to be suffering from Cholera. They were notified by the same doctor who had notified the other cases. They refused to go the fever hospital, and as the other cases were found not to be suffering from Cholera, I did not insist on their removal. R. L. was also seen by another doctor, who said she was suffering from gastric enteritis. J. C. was also seen by another doctor, who certified that he was not suffering from any infectious disease. There was no connection between any of the cases, and inquiries show that in none of the cases was there reason to suspect Asiatic cholera, although the doctor in attendance had experience of cholera in India. Zymotic Diseases. The total deaths from diseases of a Zymotic character numbered 898. It includes deaths from Measles, Scarlet Fever, Whooping Cough, Diphtheria, Croup, Enteric Fever, Puerperal Fever and Diarrhoea. The number is 491 more than in the previous year. 252 belonged to the Limehouse District, or at the rate of 4 69 per 1,000 of the population. 212 belonged to St. George-in-the-East, or at the rate of 4 50 per 1,000 of the population. 311 belonged to Mile End Old Town, or at the rate of 2.79 per 1,000 of the population. 123 belonged to the Whitechapel District, or at the rate of 1.82 per 1,000 of the population. Measles. The past year has been characterised by an unusual prevalence of Measles, not only in Stepney, but also in many other parts of the country, and especially in the Administrative County of London. The disease has shown a remarkable capacity to spread, and, judging from the heavy mortality, it appears to have been exceedingly virulent in type. The regular recurrence of Measles in epidemic form has naturally led administrators to consider the question of the control of the disease, but, so far, no measure has been uniformly successful. In no sanitary district, up to the present, can the disease be said to have been controlled. The occurrence of 22 so serious an epidemic last year in different parts of the country proved that, under present social conditions, no measures have yet been devised for the effectual control or prevention of Measles. The special difficulties in the way of controlling Measles have led some workers to regard the disease as beyond the scope of our present administrative methods and to question the efficacy, on a really extensive scale, of any method short of the application of a protective inoculation, which shall do for Measles what Vaccination has done for Smallpox. In 1911, 291 deaths were registered as due to Measles ; but before we deal with the special features of the recent epidemic, it may be of interest to trace briefly the history of the disease in the Borough since 1890. This survey, I hope, will convince the Council of one important fact : that, in spite of improvements, which are noticeable in other directions, there is still a deplorable sacrifice of life upon the altar of this disease. For purposes of comparison, Stepney is more fortunate than most centres of population. If the relative incidence of Measles on certain age-groups be considered, it will be found that the mortality from the disease falls heaviest on children under five years of age. Throughout the kingdom the birth-rate has been steadily and continuously diminishing during the last quarter of a century, and consequently, the proportion of children under five years of age to the entire population is now less than it formerly was. Where a falling birth-rate has been in progress, a comparison of the death-rate from Measles extending over a number of years would be fallacious. On the other hand, in Stepney, up to 1908, the birthrate remained fairly constant. The cause of this high birth-rate has been explained in this and previous reports. Owing to various causes, the age-constitution of the population of Stepney has changed, and the relative number of women between the ages of 15 and 45 has increased. This accounts for the apparent constancy of the birth-rate, but if the rate be expressed as the ratio of births to the number of married women of child-bearing age, the same phenomenon would be observed here as in the rest of the kingdom. The final results of the census have not been published, and it is impossible to give the number of persons living at each agegroup, but in view of the high birth-rate which has obtained in the Borough, the relative proportion of children under five years of age has probably not altered to any appreciable extent. The following chart shows the number of deaths from Measles per 100,000 inhabitants since 1890:— 23 The experience of Stepney has been somewhat similar to that of the whole of England and Wales. The means adopted for the prevention of Measles have not, up to the present, had the effect of steadily and continuously reducing the death-rate. During the third quarter of the last century, there was a decided improvement, but this was followed by a serious rise towards the end of the century. As Measles makes its appearance in epidemics, it would be fairer to dissect the figures in the charts, and take the mortality for certain definite periods. The following table gives the annual number of deaths per 100,000 inhabitants in quinquennial periods:— 1892-1896 82 1897-1901 65 1902-1906 56 1907-1911 73 For purposes of comparison, the figures have been expressed as the number of deaths per 100,000 inhabitants, but they may appear clearer and more distinct, if the actual number of deaths be given. In the twenty-two years, 4,398 deaths have been caused by Measles, or an annual average of nearly 200. In the same period, Scarlet Fever, Diphtheria and Typhoid Fever combined, have been the cause of 4,476 deaths, or an annual average of 203 deaths. In the twenty-two years, Smallpox has caused 325, but in Measles we have a disease which claimed as its tribute last year almost that number of lives. The number of deaths from Measles in the Borough since 1901 was as follows:— 1901 155 1902 158 1903 162 1904 176 1905 151 1906 171 1907 155 1908 264 1909 236 1910 93 1911 291 The harm done by Measles is not measured alone by the number of deaths from the disease. The disease leaves behind the seed of future trouble. Measles is often a cause of retarded growth and ill-health ; deafness and defects of the eyesight are attributable to it, and it often lights up latent tuberculosis. Measles is therefore not the trivial disease it is commonly assumed to be. The public are not aware of the serious drain upon life which an outbreak of Measles entails. It is the commonest of expressions, " oh, it is only Measles." Unfortunately, it is no uncommon practice for mothers to allow the other children to mix with the Measles patient, so that all can suffer together and reduce, as they think, the aggregate amount of 24 necessary nursing. No condemnation can be too strong for the practice of wilfully exposing other members of the family to this infection. There is no greater or more pernicious superstition than that which is so widely held, namely, that a child must have Measles. Probably no superstition is attended with more disastrous results, and the utter folly of such a belief cannot be too strongly emphasized. It is somewhat difficult to reconcile the popular attitude towards Measles with the undoubted havoc with which the disease visits districts. One explanation possibly lies in the fact that amongst children living under favourable conditions Measles may be a benign disease, and such children have a small percentage of fatal cases ; but children with lowered vitality from poor food and insufficient ventilation develop complications which make their percentage of deaths abnormally high. Another explanation may lie in the fact that it is not generally understood where and in what period of the illness the danger is greatest. The risk to life during convalescence and in the late stages of the illness is not appreciated. Parents allow themselves to be lulled into a false sense of security when the first few days of the " fever " have passed, and the child does not appear to have developed any alarming symptoms. Death does not very frequently occur during the eruptive stage of the disease except in very young infants, but it cannot be too widely known that Measles strongly favours the development of Broncho-pneumonia, which is most dangerous to life, and is, indeed, responsible for the terrible mortality associated with Measles. This attitude of the public affects the mortality from Measles in two ways. Sufficient precaution is not taken to prevent the spread of the disease, and sufficient care is not taken to avoid the later lung complications. The isolation of every case of Measles from the first onset to the end of the third week would undoubtedly enable an outbreak to be brought abruptly to a close, as no second crop of cases would occur. This ideal of prompt isolation will not for the present be accomplished, but, by the aid of the compulsory notification of the disease, the attention paid to invaded households, will, it is hoped, secure more precaution on the part of parents. It would also limit the cases very largely to children over school age, as in the majority of instances the disease is introduced into a house by a child attending school. After a certain period, the older the child, the less susceptible he is to the disease, and even if they contract the disease, children over five years of age rarely succumb. The age at which relatively the greatest number of children die of Measles is the second year of life ; while after the third year has passed, there is a rapid decrease in the proportion of children dying of the disease. Dr. Theodore Thompson in his report to the Local Government Board on the control of Measles states " that the incidence of attack is different from that of death. For while the main incidence of death is on the second year, the incidence of attack is chiefly on the third, fourth, and fifth years. From this different incidence Chart showing the Number of Cases of Measles notified week by week in the Borough, from the 12th May to 30th November, 1911. 25 of attack and of death it results that the fatality from measles is very much higher in the second year of life than in any of those succeeding years ; while, therefore, more children die of measles in the second year of life than at any other age, more children are attacked by this disease in each of the three years following : so that children in the second year of life, although less susceptible to attack, are much more likely to die if attacked than any other children." The above remarks hold true of the recent epidemic in Stepney. It would be unfair to quote from the cases which occurred before the introduction of compulsory notification. Dependent, as we were, up to May 12th upon school notification, it follows that the majority of cases amongst children under school age would not be reported except where children from the same house attended school. Measles was made a notifiable disease in May, and the order came into force on May 13th. Between May 13th and the end of November, 1,819 cases were notified, and the following table refers to these cases:— No. Notified. Deaths.* Under 1 year of age 207 24 Between 1 and 2 years of age 384 54 Between 2 and 3 years of age 290 6 Between 3 and 4 years of age 330 4 Between 4 and 5 years of age 281 1 Between 5 and 6 years of age 180 1 Between 6 and 7 years of age 69 None. Between 7 and 8 years of age 37 None. Over 8 years of age 41 None. * This includes the deaths of 28 children who were not notified, 10 being under 1 year of age, and 18 between 1 and 2 years of age Of the cases officially notified, the fatality was as follows:— Under 1 year of age 6.8 per cent. proved fatal. Between 1 and 2 years of age 9.3 ,, ,, Between 2 and 3 years of age 2.06 ,, ,, Above 3 years of age 63 „ ,, It is admitted that the difficulty experienced in the prevention of the spread of Measles in schools is also experienced in infected households. The disease is most infectious in its earliest stages, and before the rash appears. Circulars have always been distributed warning parents of the early infectiousness of measles, and, until parents take precautions during outbreaks of Measles, to isolate all children who may have running from the eyes and nose, it will be impossible to prevent the spread of the disease. After the adoption of compulsory notification, we were able to adopt special methods in those households which contained children of the most susceptible age. 26 Besides educating the public as to the means to be adopted in the prevention of the spread of Measles in the household, much remains to be done so as to secure proper nursing of, and attendance on, the patient. Where the patients are cared for in warm rooms well ventilated and protected from sudden changes of temperature, the progress of the illness may be regarded with equanimity in ordinary circumstances. To allow a child who is actually suffering from, or who is just getting over, the disease, to play in a cold room is a most dangerous proceeding, and cannot be too strongly deprecated. Unfortunately, in many instances, proper nursing facilities are impossible. Poverty reacts on the case-fatality of Measles in many ways. One authority asserts that a fire in the bedroom is one of the most necessary items in the treatment of the disease ; where poverty so great exists as to render this fire impossible, the children develop complications which make the percentage of deaths abnormally high. The liability to complications is also enhanced by the fact that the employment of the mother compels a large number of them to leave their homes during the day. On the subsidence of the symptoms associated with the eruptive stages, the child would often be left in the care of some person in the house other than the mother, or taken to a neighbour's house to be looked after. In either case, the same care would not be taken to avoid exposure as would be exercised by the mother. Formerly we were in ignorance of the conditions which obtained in the houses, and when a case was introduced into a family, usually all the susceptible children were attacked. So far we have dealt mostly with individual cases, and these have been considered solely from an administrative point of view. The difference of incidence of attack to that of death is of importance as bearing upon the epidemicity of the disease. If the assumption be correct and our figures bear out the assumption, the length of the inter-epidemic period is of importance. If the inter-epidemic period could be lengthened, not only some children would have reached an age when they would be less susceptible to an attack, but a larger number of children will, when the epidemic arrives, have reached ages at which the disease is little fatal. A large number of lives would thus be saved, which are now sacrificed to Measles. It must be admitted though, that the measures which have been adopted to meet epidemic prevalence of the disease, and the means by which it may be controlled so as to arrest or delay a threatened epidemic, have not yielded satisfactory results. It is generally agreed that Measles is spread on the largest scale by the attendance at public elementary infant schools of children in the catarrhal stage of the disease The occurrence of a similar spread in the boys and girls' departments of the same schools is prevented by the fact that most of the scholars in these departments are already protected by a previous attack. 27 From an administrative point of view, we are not concerned with the measures adopted inside the school for the prevention of an epidemic. The usual methods were adopted. Children suffering from the disease and all those coming from an infected household were excluded from attending the infants' department ; in the boys and girls' departments, children suffering from the disease and those coming from an infected household who had not previously suffered from an attack were excluded from school attendance. In passing, one might remark that the information as to a previous attack of Measles in children attending an adult school in this district is far from reliable. In a majority of instances, in practical working, when it is known by notification that Measles has entered the infants, department of a school, it is too late to take any effectual precautionary measures. School closure has probably more frequently taken place on account of epidemics of Measles than for any other disease ; but as the closure has been commonly deferred until a large proportion of the children are already absent, it has proved useless, for the purpose of preventing the spread of the disease. In view of this experience, a class closure of short duration after the occurrence of the first case of Measles in the class has been substituted ; but even temporary closure of the department or of a class only temporarily delays further extension of the disease. Of the 76 London County Council Elementary Day Schools and non-provided schools maintained by the County Council in the Borough of Stepney, Measles was so prevalent that in 43 of them the infants' department had to be closed, or the unprotected children were excluded from them for some time during the year. These measures had to be repeated on a second occasion in 11 of the schools, on three occasions in 7 schools, on four occasions in 1 school, and on five occasions in another school. List of schools where class closure was resorted to, or unprotected children were excluded owing to the presence of Measles for the dates mentioned during 1911:— School. Room. Period. Buxton Street Room A 30th Jan. to 3rd Feb. Deal Street Room F 30th Jan. to 10th Feb. Lower Chapman Street Room B 8th Feb. to 24th Feb. Brewhouse Lane Room L 8th Feb. to 24th Feb. Essex Street Room D 16th Feb. to 20th Feb. Northey Street (All under 5) 9th Feb. to 3rd Mar. Christian Street Room E 10th Feb. to 24th Feb. Farrance Street Infants 13th Feb. to 3rd Mar. Myrdle Street Room F 20th Feb. to 3rd Mar. 28 School. Room. Period. Good Shepherd Infants 23rd Feb. to 10th Mar. Trafalgar Square Rooms B & D 20th Feb. to 10th Mar. Chicksand Street Room A 20th Feb. to 3rd Mar. Thomas Street Room D 21st Feb. to 7th Mar. Thomas Street Room A 6th Mar. to 24th Mar. Good Shepherd Rooms A & B 6th Mar. to 24th Mar. St. Paul's Road Room F 6th Mar. to 24th Mar. Old Castle Street Room G 7th Mar. to 24th Mar. Buxton Street Infants 13th Mar. to 31st Mar. Jews School, Commercial Street School 3rd Mar. to 3rd April. Gill Street Room C 23rd Feb. to 10th Mar. Northey Street Rooms A1 & A2 22nd Feb. to 10th Mar. St. Joseph's (All under 5) 24th Feb. to 3rd Mar. Buckle Street (All under 5) 22nd Feb. to 10th Mar. Red Coat (All under 5) 23rd Feb. to 10th Mar. St. Anne's, Limehouse (All under 5) 23rd Feb. to 10th Mar. Essex Street Room E 23rd Feb. to 10th Mar. St. Paul's Road (All under 5) 27th Feb. to 10th Mar. Buxton Street Room D 27th Feb. to 17th Mar. St. John's, Halley Street (All under 5) 27th Feb. to 17th Mar. Commercial Street Jews Rooms 10, 12 27th Feb. to 17th Mar. St. Mark's (All under 5) 1st Mar. to 24th Mar. Vallance Road (All under 5) 15th Mar. to 31st Mar. Senrab Street (All under 5) 15th Mar. to 31st Mar. Blakesley Street (All under 5) 20th March to 4th April. Lower Chapman Street (All under 5) 20th Mar. to 31st Mar. Globe Road Rooms A & F 20th Mar. to 4th April. Gill Street (All under 5) 27th Mar. to Easter Holidays Single Street (All under 5) 27th Mar. Christian Street (All under 5) 30th Mar. „ Commercial Street (All under 5) 31st Mar. „ Christ Church (P. & N.) (All under 5) 3rd April ,, Heckford Street (All under 5) 3rd April, „ Trinity, Bridge Street (All under 5) 10 th April Holy Name R.C., Limehouse (All under 5) 10th April ,, Red Lion Street (All under 5) 3rd April ,, Thomas Street Room A 10th April ,, Trinity, Bridge Street Room E 1st May to 16th May. Dempsey Street Room G 1st May to 16th May. All Saints' Buxton Street Room D 5th May to 12th May. Christian Street Room F 8th May to 12th May. 29 School. Room. Period. Betts Street Room B 5th May to 12th May. Brewhouse Lane Room K 8th May to 26th May. Chicksand Street Rooms A & B 22nd May to 9th June. Thomas Street (All under 5) 11th May to 26th May. Old Montague Street (All under 5) 15th May to 26th May. Red Lion Street R.C. Room A 18th May to 26th May. Good Shepherd (All under 5) 17th May to 2nd June. Commercial Street Rooms E & F 17th May to 2nd June. Fairclough Street (All under 5) 17th May to 2nd June. Villareal (Girls 1 & 2) 19th May to 2nd June. South Grove Room B 19th May to 2nd June. Commercial Street Room D 29th May to 13th June. Buck's Row (All under 5) 29th May to June 16th. Farrance Street (All under 5) 1st June to 27th June. Brewhouse Lane Room L 9th June to 30th June. Old Castle Street Room G 12th June to 30th June. St. Paul's, Burdett Road (All under 5) 14th June to 30th June. Buxton Street Room A 14th June to 30th June. Red Coat (All under 5) 15th June to 30th June. Buckle Street (All under 5) 16th June to 7th July. St. Peter's, Mile End Room B 28th June to 7th July. Commercial Street (All under 5) 28th June to 7th July. Blakesley Street Room A 28th June to 7th July. Settles Street Rooms A & B 3rd July to 14th July. Gill Street Room C 10th July to 14th July. Settles Street Rooms A & B 15th July until the Summer holidays. Old Castle Street Room G 24th July ,, Lower Chapman Street Room F 24th July ,, Blakesley Street Room G 13th December to the Christmas holidays. The Commercial Street Jews School was closed from 3rd March to 3rd April, due to the number of children suffering from Measles which occurred in the school, and to the percentage in the number of children which had not previously contracted the disease. Previous to the date on which Measles was made a notifiable disease, the chief source of information of the existence of Measles was obtained from the school authorities, that certain children were absent from school, and that such children were supposed, to be suffering from Measles. As a rule, the teachers' information was based upon the report of the School Attendance Officer, or upon that given by children in the same house or neighbouring houses. When visits were made as a 30 result of this information by the Sanitary Inspectors, for the purpose of enforcing isolation and disinfection, the mothers of the children in question often denied the statement made to the teachers. The parents frequently stated that the children had suffered from a cold only, and at the time of the visits, they appeared to be quite well. In the early part of the year this information was rendered of less value from the fact that children had been absent from school for a considerable time before the information reached us. There was a great improvement in this direction after the beginning of March. During the school holidays, and while the infants' schools were closed, or the children excluded on account of the prevalence of Measles, we were without even this information. From January 1st to March 21st we received information with regard to Measles in 617 premises. The child was said to be absent actually suffering from Measles in 435 cases, and the child excluded on account of the existence of the infection in the house in the remaining 182. Of the former, the information was found to be correct in 310 instances, or 71 per cent. A medical man was in attendance in 218 cases, or about 50 per cent. In a number of instances an incorrect address had been given or the people had left. In 8 cases, the children in question had returned to school before we had received any information of their absence. Of the premises where the children were absent due to infection in the house, the information was acknowledged to be correct in 172 out of the 182 premises reported. A medical man was in attendance in 104 instances. In this period 111 deaths occurred from Measles ; 67 of these were in children under two years of age, 37 between 2 and 5 years of age, and 7 over 5 years of age. It will be thus seen that we received information of only a small percentage of the children suffering from Measles. From March 22nd to May 12th, we received 920 school notices referring to the absence of children from school. Of these, 694 referred to Measles, 477 referred to the absence of a school child suffering from the disease, and 217 referred to infection in the house ; in the latter case, a child living in the house, probably not of school age, was stated to be suffering from Measles. In this period detailed inquiries were made in all cases where we received information of the existence of Measles. Of the 477 instances where it was reported to us that children were suffering from Measles, in 83 instances information was also received from the Metropolitan Asylums Board Managers that they had removed patients to fever hospitals on the information of Poor Law Medical Officers. Of these, 44 were under 3 years of age. Of the remaining 394 premises visited, on information received from officers of the Education Department, in 86, the parentsi denied the existence of the disease. Doctors were in attendance in 212 homes. In 323 instances out of the 391 genuine cases, the patients were the first children 31 attacked, in 47 there had been one previous case in each, in 17 instances two previous cases had occurred in each house, and in 4 instances there had been three previous cases in each house. The addresses were incorrect or the families had removed in 14 instances, and one child had already returned to school. The Inspectors visited 217 premises during the same period in addition to the above, where it was stated that there was infection in the house, but the child suffering from Measles was not attending school. In 168 cases the information was found to be correct, and doctors were in attendance in 105. Ages of persons dying from Measles from March 22nd to May 12th, together with the number of notifications, &c., received from the schools and other sources:— Number of cases notified by the Schools, together with the number of deaths among children so notified. Deaths from Measles during the same period of which we had received no information previous to their deaths. Under 1 year 12, of whom 2 died 24 Between 1 and 2 years 18 „ 5 „ 34 ,, 2 „ 3 „ 18 „ 2 „ 7 ,, 3 „ 4 „ 31 „ 3 „ 5 ,, 4 „ 5 „ 84 „ 1 „ 3 ,, 5 „ 6 ,, 88 „ — „ 1 ,, 6 „ 7 „ 57 ,, 1 ,, — ,, 7 „ 8 „ 33 „ 1 „ — Over 8 years 50 „ 1 „ — Total 391 16 74 Although a great improvement probably took place in March, it will be seen from the table given that we had information of only a small percentage of the children suffering from Measles. Assuming that the fatality was similar in this period to what it was after the adoption of compulsory notification, there were between 2,000 and 2,500 children suffering from Measles concerning whom we had no information. This fact nullified, to a great extent, any results which would accrue from the action taken by the London County Council in 1903. In 1903 the London County Council made an order that all the sections of the Public Health Act, 1891, relating to notifiable diseases should apply to Measles, with the exception of that section which would make it obligatory on the nearest relative, or the doctor in attendance, to notify the patient so suffering to the Public Health Authorities. The Order was approved by the Local Government Board, and came into force on April 1st of that year. 32 A person was made liable to heavy penalties if he exposed infected clothing, or allowed a person suffering from Measles whilst under his charge to be in a public place. The prenvses must be disinfected when the patient had recovered from Measles, and was presumably free from infection. It was assumed by the County Council that information would be given to us by the school authorities, as well as by the parents themselves ; but it will be seen that the information was very incomplete, and, to some extent, unreliable. I have dwelt only upon some of the aspects in the history and administrative control of Measles in order to emphasize their bearing upon the action which the Council took during the year. The particular points which I have endeavoured to bring out are:— (1) The large number of deaths caused by the disease. (2) The difference in the incidence of attack to that of death. (3) The relation of the incidence of death to poverty. (4) Our ignorance as a Sanitary Department of the distribution of Measles during an epidemic. To meet these issues, the Health Committee during the earlier part of the year considered the question of the adoption of Measles as a compulsory notifiable disease. It is, of course, admitted that the more complete and accurate the information which an authority has of a disease, the greater are its opportunities of successfully dealing with that disease. On the other hand, the question had to be considered whether the information gained and the administrative action taken would be justified by the results attained. The compulsory notification of Measles has been tried in only a few places, and, I believe, only two towns have fully published the results of such notification. As early as 1881 the Corporation of Aberdeen obtained powers for the compulsory notification of Measles. Under the Aberdeen Local Act of 1881, notification by the medical attendant only was required. After the passing of the Infectious Disease Notification Act, 1889, the Town Council adopted it in 1891 in order to obtain the advantage of dual notification—that is, by the medical attendant and by the householder. After a report by the Medical Officer of Health the compulsory notification of Measles was stopped in February, 1903, as experience appeared to show that the benefit scarcely justified the large cost. The conclusion which Dr. Hay (the Medical Officer of Health for Aberdeen) comes to is " that it is obvious from the considerations as to the prevalence of 33 Measles, and as to the mortality from the disease, it is impossible to assert with confidence that notification has enabled us to exercise any distinct and effective control, and it can scarcely be urged that we have not made a sufficiently lengthy trial." The other town that tried compulsory notification was Burton-on-Trent, where Measles was scheduled as a notifiable disease from 1894 to June, 1900. The result there also was not deemed satisfactory. Dr. Millard, who formerly was Medical Officer of Health for Burton, attributes this want of success to the fact that many cases were un-reported, and also to the early stage at which Measles is infectious. A medical attendant is not always called in where measles makes its appearance in a family, while the householder rarely reports the presence of measles in a dwelling, whether a doctor has been called in to see the case or not. To this extent, therefore, compulsory notification fails to afford the Sanitary Authorities complete knowledge of all cases that occur in their district. Since these trials were made of the compulsory notification of Measles the conditions have materially changed. The establishment of health visiting and the better appreciation of health requirements which health visiting is calling forth, the medical inspection of schools and school children, the institutional treatment and isolation of selected patients—these and other measures have placed opportunities in the hands of local authorities which would enable them to utilise more satisfactorily the information obtained by the compulsory notification of Measles. Taking, first, the effect of notification upon the epidemicity of the disease, it is probable that the most hopeful line of action lays in the co-ordination and cooperation of school inspection and sanitary administration. In the schedule used for medical inspection one of the columns refers to the diseases from which the children have already suffered. This column should prove of immense value in the control of epidemics in schools. Under present conditions the information as to a previous attack of measles is far from reliable, and the value of the information would undoubtedly be enhanced by a system of compulsory notification of the disease. Not only in the schools, but also in the houses, additional precautions could be carried out for the protection of susceptible children. If by these means the inter-epidemic period can be lengthened, the benefits would be incalculable. Without an extended trial of a general notification of the disease throughout London it is impossible, of course, to express a definite opinion as to the effects of notification on the epidemicity of Measles ; but we are on safer ground when we deal with its effects upon the case fatality of the disease during the late epidemic. c 34 By the aid of notification we were enabled to ascertain the houses in which other susceptible children lived, and to advise as to the precautions which should be taken. We were also in possession of facts which enabled us to take advantage of the institutional isolation and treatment of selected cases. Our experience in some respects agrees with that of other towns where Measles was made a notifiable disease. A large number of cases remained unreported, and in fatal cases the first intimation we received was on the receipt of the death returns. These cases were probably at the onset of the disease unattended by a doctor, but it is a general experience that the percentage of cases medically attended is on the increase, and will in future become still higher. The tendency therefore will be, that a more complete notification will result on the adoption of compulsory notification in any district. As in other notifiable diseases, Measles was notifiable by the doctor in attendance as well as by the parents, but in no instance did we receive a notification by the parents. The adoption of compulsory notification of Measles caused a considerable amount of extra work on the staff of the Public Health Department, and for a short period some of the other work of the department had to remain in abeyance. All the premises from which cases of Measles were notified were visited and inquires made as to the conditions existing. Any exceptional circumstances were reported to me and where there were a considerable number of susceptible children in the house, or the facilities for nursing the patient were grossly inadequate, the patient was, if possible, removed to the fever hospital. Unfortunately the hospital accommodation was inadequate for the reception of more than a small proportion of the cases, and a large number of children were nursed in houses where the standard of isolation was very low, and the facilities for the nursing of the patient totally inadequate. Notice of each case was forthwith sent to the headmaster of the school attended by the patient, or by any other children in the house. When the sick child recovered and was free from infection, or when a death occurred, the premises were disinfected. I am not prepared to say what effect, if any, disinfection of the premises has had on the incidence of the disease. The disinfection of premises must, however, have an indirect effect by demonstrating to the inmates the fact that the sanitary authority considers Measles to be such a dangerous disease as to undertake the trouble and expense of disinfecting the premises. In addition to the fumigation of the premises, the contents of the rooms were disinfected and the rooms were efficiently cleansed by the owners. The ages at death will be found on Table III. of the Local Government Board. Chart showing the Total Number of Deaths from Measles occurring week by week in the Borough during 1911. 35 Of the 291 deaths in the Borough:— 84 occurred in the Limehouse District, or at the rate of 1.6 per 1,000 of the population. 72 occurred in St. George-in-the-East, or at the rate of 1.53 per 1,000 of the population. 113 occurred in Mile End Old Town, or at the rate of 1.15 per 1,000 of the population. 22 occurred in the Whitechapel District, or at the rate of .32 per 1,000 of the population. The death-rate throughout the whole of the Borough was at the annual rate of 1.04 per 1,000 of the population, while that for the whole of London was .57 per 1,000. The distribution of the cases notified between May 13th and the end of November was as follows:— Cases. Limehouse District 292 St. George-in-the-East 442 Mile End Old Town 523 Whitechapel District 562 To sum up, the first condition necessary in the administrative control of the spread of Measles, although not the only one, is the compulsory notification of Measles. The notification must be as complete as in Scarlet Fever and Diphtheria. In the second place there should be close co-operation with the Medical Inspectors of school children. When a child first attends school, his record with regard to infectious diseases should be entered on a schedule kept for that purpose. When a child attends school suffering from the preliminary catarrh of Measles, twelve days afterwards, the first crop of cases occurs among the children in this class. If the names of all the children who had previously suffered from Measles were known, all the unprotected children attending the class could be excluded from school for a certain period, and a further increase due to a second crop of cases could be prevented. Notification must be accompanied by removal of early cases to fever hospitals, particularly those children where there are no means of isolation at home, or where there are other susceptible children in the infected household. By prompt removal of the early cases, the beds at the disposal of the Metropolitan Asylums Board may be found to be sufficient if the epidemic is not of a virulent type. These measures should be supplemented by the more extended appointment of Health Visitors to visit infected households and see that the regulations for carrying out the remedies for preventing the spread of infection are observed, by efficiently disinfecting the premises, as well as by improved sanitary conditions generally. c 2 36 By these means we hope to lengthen the inter-epidemic period so that more children reach the age of 5 years without contracting Measles. At that age they are not so susceptible to attack, but even if contracted at that age or afterwards, the disease is only slightly fatal, as I have already mentioned. Whooping Cough. The number of deaths from Whooping Cough was 44, or 66 less than in the previous year. This corresponds to a death rate of .15 per 1,000 of the population, while that for the whole of London was .23 per 1,000. 16 belonged to the Limehouse District, or at the rate of .29 per 1,000 of the population. 3 belonged to St. George-in-the-East, or at the rate of .06 per 1,000 of the population. 16 belonged to Mile End Old Town, or at the rate of .14 per 1,000 of the population. 9 belonged to the Whitechapel District, or at the rate of '13 per 1,000 of the population. Summer Diarrhoea. Summer Diarrhoea is now believed by a large section of the medical community to be an infectious disease, capable of spreading from the sick to the healthy. Direct infection may be conveyed through the food, chiefly milk, as well as in other ways, such as rubbing the gums of the infant with the fingers, the use of comforters, placing the infants on dirty floors, &c. It is considered by some that the disease is due to a specific micro-organism, but the probability is that there are many different micro-organisms, all capable of exciting acute diarrhoea in infants. It cannot be proved at present, either on clinical or bacteriological grounds, that this or that variety of infantile diarrhoea is due to any particular micro-organism. Granted that Summer Diarrhoea is in the large majority of cases due to bacterial infection, we are still in the dark as to the sources of infection. A few years ago it was considered to be due to a micro-organism which resided in the superficial layers of the earth, which contained food suitable for it—that is, soil polluted with decomposing organic matter. The micro-organism was supposed to have the power of leaving the soil to be carried by the air, gain access to food, and be introduced into the human body. According to Dr. Ballard's report to the Local Government Board on the subject, from " food the micro-organism can manufacture a substance which is a virulent chemical poison, and this chemical 37 substance is in the human body the material cause of epidemic Summer Diarrhoea." The development and multiplication of the micro-organism depended on a high temperature, not in the air itself, but in the superficial layers of the soil. The rise in the diarrhoea death rate does not begin until the average weekly temperature of the thermometer (suspended in an iron tube 4 feet deep in the earth) has attained somewhere about 56° F. This takes place about a week later than in the air. Taking this into consideration, and that death occurs in a week to a fortnight usually after the onset of the disease, it will be observed that the relationship of the commencement of incidence of Summer Diarrhoea with the temperature recorded at a point 4 feet below the surface of the earth, is corroborated to a certain extent by the table given below, although it is not the opinion now that this is due to the growth of a micro-organism in the soil, as described by Ballard. There is no doubt that infection is largely spread through milk. Infants artificially fed are much more exposed to infection than breast-fed infants, and breast feeding renders children less s.usceptible to attack when exposed to infection, as well as less likely to die when they are infected. This may account for the fact that there are fewer number of deaths from Diarrhoea in the Whitechapel district than in other parts of the Borough. It is well known that Jewish mothers suckle the children more than others. In the Limehouse district, on the other hand, where a large proportion of married women work in neighbouring factories, and consequently are obliged to bring up their babies on artificial food, the mortality from Diarrhoea is correspondingly high. A good deal of attention has been paid within the last two or three years to the possibility of conveyance of infection by the common house-fly. Many observers maintain that flies are a great factor in causing Summer Diarrhoea, and in support of their argument state that : (1) house-flies are present in immense numbers in houses prior to primary attacks in those of infants, although not in all; (2) houseflies have been shown by means of bacteriological examination to convey infection. The matter was considered in detail by the London County Council in 1907, and reported on by Dr. Hamer in 1908. Dr. Hamer came to the conclusion that flies could not be the sole agents for the conveyance of Summer Diarrhoea from patient to patient, because flies were found in houses in the late autumn after the epidemic had ceased. It must be remembered, however, that, with the onset of cold weather, flies become much more sluggish in their movements and would therefore be less likely to spread infection rapidly. In years gone by, before the advent of the motor vehicle, the number of flies depended on increased mean temperature and diminished rainfall. With a record dry and warm summer the flies in this district at any rate have not been so numerous and have not been such a pest as in former years, although there has been a great 39 increase in the number of deaths from Diarrhœa. This decrease in the number of flies may be attributed to the fact that there are fewer horses employed on the streets than in former years, due to motor vehicles being employed instead. It is well known that horse dung forms the favourite breeding ground of the domestic fly, much more so than cow dung. I have no doubt that contaminated milk supply is the cause of Summer Diarrhoea, but in what particular manner it becomes contaminated I am not prepared to express an opinion. I do not think it has been conclusively proved that house-flies are the only source of the spread of the infection. A circular was received from the Local Government Board on the prevalence of Epidemic Diarrhoea amongst children, in which the Board suggested that:— (1) Advice should be given as to the feeding and management of children, and more generally as to preventing the exposure of their food from decomposing organic matter. (2) The diverting of inspectors from less urgent work and visiting of as many of the places where births have occurred during the last year to prevent the accumulation in, or in the vicinity of the houses of decomposing animal and vegetable matter. Efficient scavenging, of frequent and, if possible, daily removal of house and stable refuse. To see that all food is properly protected and that the houses are generally kept clean. (3) Ascertaining in which parts of their district Diarrhoea is especially prevalent and devoting close attention to street and court scavenging, and to the removal of stable and domestic refuse in these areas. The question of efficient scavenging belongs to the Borough Engineer's Department, and not to the Public Health Department. With respect to the remainder of the circular, it was decided by the Public Health Committee at its meeting on August 24th that the following circular should be printed in English and Yiddish. The addresses where births have occurred this year were to be visited by the Inspectors, the object of the visit being to ascertain the presence of accumulation of dirt, rubbish or manure in the immediate vicinity, and to leave one of the circulars with the parents of the child. 3,835 leaflets were sent by post to the addresses of all briths registered from August 1st to December 31st, 1910. 4,468 leaflets were left by the Inspectors at the addresses of births registered from January 1st to August 1st, 1911. In 725 instances the addresses were found to be incorrect, or the parents had removed. 39 Week ended Mean heading of Barometer. Mean Reading of Thermometer. Rainfall. Total Number of Deaths of Infants under 1 Year in London. Total Number of Deaths of Infants under 1 Year in Borough of Stepney. Deaths of Infants under 1 Year from Diarrhoea. Deaths from Diarrhoea in Borough between 1 and 2 Years, of age. July 1st 29.79 57.5° F. (4° below average) .50 of an in. 149 18 3 1 „ Sth 30.09 65.6° F. (3.5° above average) Nil. 144 15 4 Nil. ,, 15th 30.23 65.2° F. (2.3° above average) Nil. 159 15 4 Nil. „ 22nd 29.88 69.5° F. (6.2" above average) Nil. 150 31 9 3 „ 29th 29.82 71° F. (8.4° above average) .26 of an in. 173 28 14 6 Aug. 5th 29.84 68° F. (5.9° above average) .06 of an in. 304 49 31 8 „ 12th 29.91 72.5° F. (10.1° above average) Nil. 462 64 47 6 „ 19th 29.90 69.4° F. (7.2° above average) .58 of an in. 636 49 36 8 „ 26th 29.63 63.9° F. (2.9° above average) .29 of an in. 705 56 42 10 Sept. 2nd 29.92 65.3° F. (5.2° above average) .41 of an in. 712 49 36 7 „ 9 th 29 79 66.9° F. (7.7° above average) .01 of an in. 622 51 37 7 16th 29.91 60.3° F. (2.4° above average) .41 of an in. 555 33 20 6 „ 23rd 29.72 54.3" F. (1.9° below average) .48 of an in. 442 36 21 1 „ 30th 29.90 55° F. (being equal to the week's average) .44 of an in. 433 30 18 6 Oct. 7th 29'82 48.2° F. (4.9° below average) •27 of an in. 342 19 6 1 ,, 14 th 30.03 51.9° F. (.9° above average) .29 of an in. 304 25 7 2 „ 21st 29.hO 54.6° F. (5.2° above average) .37 of an in. 275 12 2 2 „ 28th 29.20 48 5° F. (.8° above average) 1.98 inches 191 5 1 Nil. Nov. 4th 29.83 48.4° F. (1.5° above average) .63 of an in. 185 10 2 1 „ 11th 29.51 44.5° F. (.6° below average) 1.16 inches 188 11 2 Nil. „ 18th 29.38 49° F. (5.9° above average) 1.7 inches 192 24 2 Nil. ,, 25th 29.39 39.3° F. (2.8 below average) .25 of an in. 209 15 2 Nil. With regard to the Mean Temperature, it is compared with the week's average in the 65 years ended 1905. 40 Copy of the leaflet which was left at all the premises where births occurred during the year. SUMMER DIARRHCEA. During the summer months more children die from Diarrhoea than any other disease. Very few deaths occur amongst breast-fed children, so, if possible, do not wean your children during the hot weather. Where the baby is hand-fed, the chief cause of Diarrhoea is dirt, and the dirt is usually present in the milk. The dirt may be in the milk through dust, flies, &c., and every care should be taken to prevent flies settling on milk. destroy alt. the flies in the house. During the hot weather boil the milk directly it comes into the house, and keep the milk in a clean jug in a basin of cold water and covered over with a clean cover. The best kind of bottle is the old-fashioned straight one with an india-rubber teat and without any tube at all. It is quite impossible to prevent corks and tubes from becoming foul and turning the milk sour. When the child has finished its meal, the Lottie must be rinsed and placed in clean water with a little soda in it until required again. Once a day it should be carefully cleansed with hot water in which a lit litile soda has been added. Be careful not to use the milk if it has turned sour. See that there is no accumulation of dirt, dust, &c., in the house or in the yard. Have the dust removed regularly. D. L. THOMAS, Medical Officer of Health, Public Health Offices, 43, White Horse Street, E. 41 Diseases of Respiratory Organs. There were 981 deaths due to diseases of the Respiratory Organs, which corresponds to a death rate of 3.50 per 1,000 of the population. 233 belonged to the Limehouse District, or at the rate of 4.33 per 1,000 of the population. 178 belonged to St. Geoige-in-the-East, or at the rate of 3.78 per 1,000 of the population. 336 belonged to Mile End Old Town, or al the rate of 3T0 per 1,000 of the population. 234 belonged to the Whitechapel District, or at the rate of 3.45 per 1,000 of the population. Phthisis. 481 deaths occurred during the year from Phthisis, or 71 more than in the previous year. This corresponds to a death rate of 1.72 per 1,000 of the population, while that for the whole of London was 1.35 per 1,000. 109 belonged to the Limehouse District, or at the rate of 2.03 per 1,000 of the population. 69 belonged to St. George-in-the-East, or at the rate of 1.46 per 1,000 of the population. 177 belonged to Mile End Old Town, or at the rate of 1.58 per 1,000 of the population. 126 belonged to the Whitechapel District, or at the rate of 1.86 per 1,000 of the population. Number of deaths from Consumption from 1901 to 1911:— Limehouse District. St. George's. Mile End. Whitechapel. Whole Borough 1901 125 186 107 208 626 1902 130 105 168 173 576 1903 123 122 189 193 627 1904 143 119 229 198 689 1905 98 117 171 187 573 1906 116 94 178 138 526 1907 98 90 141 153 482 1908 98 79 154 163 494 1909 93 102 146 180 521 1910 74 80 146 110 410 1911 109 69 177 126 481 42 Other Tuberculous Diseases. There were 166 deaths from Tuberculous Diseases other than Phthisis, or 29 more than in the previous year. This corresponds to a death rate of .59 per 1,000 of the population. 40 belonged to the Limehouse District, or at the rate of .74 per 1,000 of the population. 40 belonged to St. George-in-the-East, or at the rate of .84 per 1,000 of the population. 59 belonged to the Mile End Old Town, or at the rate of .52 per 1,000 of the population. 27 belonged to the Whitechapel District, or at the rate of .40 per 1,000 of the population. Deaths from Diseases of a Tubercular nature, other than Phthisis, from 1901 to 1911:— Limehouse District. St. George's. Mile End. Whitechapel. Whole Borough. 1901 60 73 54 52 239 1902 43 49 89 52 233 1903 52 37 61 45 195 1904 44 35 61 34 174 1905 42 29 53 35 159 1906 57 47 53 57 214 1907 51 50 59 42 202 1908 38 40 64 25 167 1909 37 41 40 26 144 1910 33 26 43 35 137 1911 40 40 59 27 166 Public Health Regulations, 1908, and Tuberculosis Regulations, 1911. 1,350 cases of Pulmonary Tuberculosis were notified under the above Regulations during the year, viz. :— Tuberculosis Regulations, 1908. Tuberculosis. Regulations, 1911. Voluntary. Limehouse District 77 148 14 St. George-in-the-East 79 160 11 Mile End Old Town 171 306 32 Whitechapel District 113 216 23 440 830 80 AGES OF PERSONS NOTIFIED. 14 were under 5 years of age. 153 were between 5 and 15 years of age. 223 were between 15 and 25 years of age. 676 were between 25 and 45 years of age. 253 were between 45 and 65 years of age. 31 were over 65 years of age. 43 About 40 to 45 per cent. of all deaths from Phthisis in 1911 occurred in the infirmaries attached to the four Poor Law Unions in the Borough. An additional 16 per cent. occured in lunatic asylums and other public institutions. Of the Tubercular diseases other then Phthisis, about 56 per cent. died in public institutions. The Public Health (Tuberculosis) Regulations, 1908. The Public Health (Tuberculosis in Hospitals) Regulations, 1911, and The Public Health (Tuberculosis) Regulations, 1911. The Public Health (Tuberculosis) Regulations, 1908. The Local Government Board issued an order, which came into force on January 1st, 1909, to provide for the notification of cases of pulmonary tuberculosis amongst the inmates of Poor Law Institutions and amongst persons under the care of District Medical Officers. The notification certificate, for which a fee of 1s. is paid, must be posted within 48 hours to the Medical Officer of Health of the District. The Public Health (Tuberculosis in Hospitals) Regulations, 1911. The Public Health (Tuberculosis in Hospitals) Regulations, 1911, came into operation on May 1st, and provided for the notification of cases of Pulmonary Tuber culosis occurring amongst the in-patients or out-patients at hospitals or other similar institutions, for the treatment of the sick, which are supported wholly or partially otherwise than by the contribution of the patients (or their relatives or guardians) and otherwise than from rates and taxes. Notification is to be sent within 48 hours by the doctor in attendance to the Medical Officer of Health, and a fee of 1s. is to be paid for each certificate. If the patient is not resident in the district, the Medical Officer of Health is to transmit the certificate without delay to the Medical Officer for the area in which the patient's residence appears to be situate, at the same time inform the Medical Officer of the hospital that he has done so. If the place of residence cannot be identified, the certificate is to be returned to the Medical Officer of the Hospital. A weekly statement of notifications is to be sent to the Medical Officer of the London County Council. Nothing in the Regulations shall have effect so as to apply any enactment which renders the patient liable to a penalty or subjects him to any restriction, prohibition or disability affecting him or his employment and on the ground of his suffering from Pulmonary Tuberculosis. 44 The Council are empowered to (1) take necessary measures for disinfecting infected premises and articles, and to secure the destruction of infectious discharges ; (2) supply all such reasonable assistance as will tend to diminish the risk of infection arising from the conditions affecting the use or occupation by the patient of a room as a sleeping apartment, and to supply for the use of the patient any appliance, utensil, or article (such as sputum boxes, or bottles, paper hand-kerchiefs, and disinfectants) which may be of assistance in preventing the spread of infection. The conditions under which the patient has been living are to be investigated, special attention being paid to the abatement of overcrowding, the provision of ample through ventilation, the removal of conditions causing dampness of the dwelling, the avoidance of dust, and to any other conditions tending to injure the health of the occupants of the dwelling. The Order allows the provision of appliances or apparatus such as temporary shelters with the necessary furniture and utensils for the use of the patient. By these means patients may sometimes be treated at their homes under suitable sanitary condnitions, or continue treatment at home after a short stay in a sanatorium Public Health (Tuberculosis) Regulations, 1911. These Regulations came into operation on January 1st. 1912. Every case of Pulmonary Tuberculosis is to be notified within 48 hours, and the Doctor is to be paid 2s. 6d. for each certificate. The School Medical Inspector receives no payment. On receiving a notification relating to a patient, whose place of residence is not within the area for which he is Medical Officer of Health, the Medical Officer of Health shall forthwith transmit the notification certificate to the Medical Officer of Health for the area in which the place of residence of the patient is situate, and at the same time inform the doctor notifying, of that fact. The Medical Officer of Health shall enter in a register the full particulars contained in every notification, name, address, age, date and name of notifying practitioner. It is also suggested that he shall keep a separate record of all particulars bearing on the probable factors concerned in producing the disease, on the existence of the disease in persons in contact with the patient, and on the action taken to obviate infection, to remove insanitary conditions and to aid the patient himself or any additional patients who may be discovered. He must send a weekly list of notifications to the Medical Officer of the London County Council, containing the age, address, sex, and date of notification. Upon receipt of a notification, the Medical Officer of Health, or an Officer acting under his instructions shall make such inquiries and take such steps as may appear to him to be necessary or desirable for preventing the spread of infection, and for removing conditions favourable to infection. 45 Special Powers of Councils.—The Council “may supply all such medical or other assistance, and all such facilities and articles as may reasonably be required for the detection of Pulmonary Tuberculosis, and for preventing the spread of infection, and for removing conditions favourable to infection, and for that purpose may appoint such officers, do such acts and make such arrangements as may be necessary.” The Council may provide and distribute in the form of placards, handbills or leaflets suitable summaries of information and instruction respjcting Pulmonary Tuberculosis, and the precaution to be taken against the spread of infection from the disease. Nothing in these Regulations shall have effect so as to apply any enactment which renders the patient, or a person in charge of the patient, or any other person liable to a penalty, or subject the patient to any restriction, prohibition, or disability affecting himself, or his employment, occupation or means of livelihood on the ground of his suffering from Pulmonary Tuberculosis. Treatment of Consumption. On May 15th, 1911, a Dispensary for the Prevention of Consumption was opened at 4, Arbour Square. In view of the large population of the Borough of Stepney, it was considered inadvisable to endeavour to cover the whole area from one Dispensary. The Stepney Dispensary therefore receives patients only from the eastern part of the Borough, bounded on the west by Jubilee Street and Sutton Street. Objects of the Dispensary.—The aim of a Tuberculosis Dispensary is to be a co-ordinating and central unit in a complete scheme for the prevention, treatment, and isolation of Tuberculosis. The scheme includes all the known means of prevention and treatment which we have at our disposal. It is the first line of attack, in that it approaches the disease in the homes of the poor. It is a selecting and distributing centre. Suitable cases are sent to Sanatoria. Advanced cases, when necessary, are drafted to the Infirmary or to Homes for the Dying ; other patients are treated at home, either in shelters in their gardens, or in their own rooms. Patients when considered suitable are treated with Tuberculin; many patients who show some slight symptoms and signs of the disease are carefully watched, and trained in the principles and application of aerotherapy, in order to prevent the onset of progressive active disease in the future. 46 The programme of a Tuberculosis Dispensary may be summarised as follows:— (1) The reception and examination of patients at the Dispensary, keeping a record of every case, with an account of the patient's illness, history, surroundings and present conditions, the record being added to on each subsequent visit. (2) The bacteriological examination of expectoration and other discharges. (3) The instruction of patients, how to treat themselves and how to prevent or minimise the risk of infection to others. (4) The dispensing of necessary medicines, sputum bottles, disinfectants and the like. (5) The visitation of patients at their own homes by (i.) a qualified medical man ; and (ii.) a specially trained nurse for the purpose of treatment and of investigation into the state of the dwelling, and general conditions of life and the risk of infection to others, as well as for the purpose of examination of " contacts." (6) The selection of more likely patients for hospital treatment, either of early cases for Sanatoria or of late cases for incurable homes, and the supervision when necessary of patients after discharge from hospital. (7) The guidance, generally, of tuberculosus patients and their friends, and for inquiries from all interested persons on every question concerning tuberculosis. In the 7½ months from the 15th May to the 31st December, during which the Stepney Dispensary has worked on the above lines, 671 patients have attended for examination. Of this number 243 were diagnosed as Pulmonary Tuberculosis and 146 as suspected Pulmonary Tuberculosis. That is to say, 36.2 per cent. of the patients who presented themselves were found to have Pulmonary Tuberculosis. Of this 671 cases, 469 were Christians and 202 were Jews. The percentage of Tuberculosis found being 36.8 per cent. in the former and 34.6 per cent. in the latter. No less than 276 of the patients were below fifteen years of age, and 26.8 per cent. of these were diagnosed as definite Pulmonary Tuberculosis. Thirteen patients were sent to Sanatoria either to the Council's beds, or through the Charity Organisation Society. Twenty patients suffering from late Tuberculosis were drafted to the Infirmary or to the Homes for Incurables. 47 A large number of patients have been examined at the request of General Practitioners, who desired a second opinion and possibly bacteriological examination of the sputum. The large number of children diagnosed as Pulmonary Tuberculosis suggests the need for some special provision for dealing with the disease at school age. It is hoped that the Dispensary will shortly have an addition to its usefulness in the form of an open-air school, where some 30 or 40 children will be treated. This, of course, is totally inadequate for the district, but it is a beginning in the right direction, and no doubt in the comparatively near future this important aspect of the work will receive more recognition than it does to-day. Perhaps one of the greatest needs in London at the present time is adequate provision for the isolation of advanced cases who may be dangerous to others, the only means we have of dealing with these cases is through the Infirmary, and to a very limited degree through the Homes for the Dying. One feels that at least a large part of the accommodation at the existing Chest Hospitals might be used to greater advantage if given over to the isolation of Tuberculosis in its later and more infected stages. As a result of the efforts which His Worship the Mayor—Alderman Potter— made in connection with the memorial to the late King Edward VII., a sum of nearly £1,000 was collected and will be used in furnishing and equipping three Tuberculosis Dispensaries in the Borough, situated respectively in Stepney Green, St. George's Street and Great Prescott Street. The premises in Arbour Square were only taken temporarily, and the Dispensary will be removed to more commodious premises in Stepney Green. Borough Council beds in Sanatoria.—On the recommendation of the Public Health Committee, the Council, as an experiment, retained 6 beds for male patients at Fairlight Sanatorium at £50 per annum per bed, and 4 beds for females at Maitland Sanatorium, Reading, at 28s. per week. The patients were selected, and only those in the early stages of the disease were chosen to be sent to the Sanatorium. It is too soon yet to state what permanent benefit was received, but the following patients stayed for the period mentioned in the report:— Mrs. W., Lower Chapman Street, was admitted to Maitland Sanatorium on July 17th, 1911, where she remained for 4 months. She gained 9 lbs. in weight, and on her discharge her temperature was normal. She could walk one to two miles and do housework without difficulty. The breath sounds were weak at the apices of both lungs, but no crepitations could be heard. Her general health was much improved. Six and half months after her discharge, it was found that her pulmonary 48 condition was about the same. There has been some return of the symptoms. She has been undergoing treatment with Tuberculin at the Tuberculosis Dispensary. Her temperature is normal. M. W., Raymond Street, was admitted to Maitland Sanatorium on July 17th, 1911, and remained there for 4 months. She gained nearly 7 lbs. in weight, and on her discharge her temperature was quite normal. She could walk two or three miles and do housework without difficulty. Fine crepitations could be heard at the apices of both lungs. Her " general health was excellent and the condition of lungs in statu quo." Six and half months after her discharge, it was found that there had been a return of symptoms. On examination, it was found that there was extension of the disease. She is not doing well. H. S., Anthony Street, was admitted to Fairlight Sanatorium on August 28th, 1911, and after remaining there for three months left contrary to the advice of the Medical Superintendent, although there was little or no activity of the disease at that time. The doctor thought it would have been wiser to wait for a few weeks longer in order that he might have been tested with the hardest grade of work. Six months afterwards, there has been no return of symptoms. The pulmonary condition shows no return of activity. He is doing well. E. B., Charles Street, was admitted to Fairlight Sanatorium on September 4th, 1911. At the end of 4 months, the Medical Superintendent reported that the patient was not very robust, but that there was not much, if any, active disease. His general physique is poor and he doubted his capacity of performing hard work, at any rate, unless his working conditions were very satisfactory. For the last month his temperature had not risen above 99 degrees in spite of the fact that he had been doing moderately hard work, e.g., digging broken ground, scrubbing and garden sweeping. He had gained 14 lbs. in weight. Two months after leaving the Sanatorium he had no return of symptons. The chest conditions are apparently healed. This case also shows a very good result. A. H. V., William's Buildings, Ann Street, was admitted to Fairlight Sanatorium on October 2nd, 1911, where he remained for 8 months, when he elected to emigrate to Canada, where a position was found for him on a dairy farm, and all arrangements were made by the Sanatorium Authorities. The Medical Superintendent considered this was the best chance for him. He had done very well at the Sanatorium, and for months he was doing the hardest forms of manual work without difficulty or rise of temperature. The Medical Superintendent was of opinion that the disease therefore was perfectly arrested. F. C. H., Oxford Street, was admitted to Maitland Sanatorium on October 12th, 1911, where she remained for 4 months. She gained 18½ lbs., and her temperature on discharge was normal. She could walk two to three miles and do light house- 49 work without difficulty. The percussion note was very flat at the apices of both lungs, and the expiration was prolonged. There was marked improvement in her general condition and no Tubercle Bacilli could be found in the sputum. After her return home, she was confined and her symptons returned. There has been no loss of weight since. She is attending at the Tuberculosis Dispensary, where she is receiving Tuberculin. J. H., Settles Street, was admitted to Fairlight Sanatorium on October lGth, 1911, where he remained for 5 months. He got on very well at the Sanatorium. On his discharge, there was no sign of active disease and no tubercle bacilli could be found in the sputum. For 5 weeks, he was doing grade IV work without discomfort, and his average daily temperature was 97 to 98.2 degrees. He gained 16 lbs. in weight, and the Medical Superintendent considered that the disease had been arrested. Three months after his discharge he had no return of activity or symptoms although he had lost 6 lbs. in weight. He is undergoing the Tuberculin treatment at the Dispensary. E. K., Watt's Buildings, was admitted to Fairlight Sanatorium on October 23rd, 1911. I informed the Public Health Committee that I did not consider the patient a suitable case for sanatorium treatment, and that the report of the Council's Medical Referee was unsatisfactory. It was, however, decided to send him to the Medical Referee of the Sanatorium who accepted him and he was sent to the Sanatorium. The Medical Superintendent of the latter institution wrote on November 14th that he did not think any good purpose would be served by keeping the patient there much longer. He had advanced Pulmonary Tuberculosis, and in addition, his general health was feeble. Since his admission he had made no real progress. His temperature had been constantly up to, and over 101 degrees, and was not affected by rest in bed to any extent. He was of opinion that he was not a suitable case for a sanatorium. E. K. died on November 30th. W. E., Johnson Street, was admitted to Fairlight Sanatorium on November 27th, 1911, where he remained for 10 weeks. The Medical Superintendent reported that considering the comparatively short time he was at the institution he had got on very well. He had extensive lung disease and early Tuberculous Laryngitis. There was, however, distinct diminution in the activity of the disease in both localities. He had gained 21 lbs. in weight, and for a considerable time he had no abnormal rise of temperature. He was able to do such work as light digging, carrying earth, &c., for four hours a day. Three months after his discharge he had lost 6 lbs. in weight. The pulmonary condition shows some activity. He has Tubercular Laryngitis, and is undergoing the Tuberculin treatment at the Dispensary. A. H., Gun Street, was admitted to Mail land Sanatorium on December 11th, 1911, where she remained for nearly 3 months, when she gained one stone in weight. Her temperature on discharge was quite normal, and she could walk well, and do D 50 hard work without difficulty. Her breathing was good and she was free from cough, She made excellent progress while at the Sanatorium. Three months afterwards, there had been no return of symptoms nor any sign of a return of activity. This case also shows very good results. The following cases were admitted to the Council's beds at the Sanatoria, and are still there at the time of writing these notes. E. B., Charles Street, admitted September 4th. H. S., Selby Street, admitted November 1st. L. G., Selby Street, admitted November 13th. Infantile Mortality. 1,261 infants died under one year of age, which corresponds to a death-rate of 149 per 1,000 births. This number is 220 more than in the previous year. The infantile mortality for the whole of London was 129 per 1,000 births. 343 belonged to the Limehouse District, or at the rate of 189 per 1,000 births. 268 belonged to St. George-in-the-East, or at the rate of 170 per 1,000 births. 466 belonged to Mile End Old Town, or at the rate of 138 per 1,000 births. 184 belonged to the Whitechapel District, or at the rate of 106 per 1,000 births. Deaths of Illegitimate Children. There were 67 deaths of illegitimate children under one year of age during the year, or at the rate of 360 per 1,000 illegitimate births. 16 belonged to the Limehouse District, or at the rate of 390 per 1,000 illegitimate births. 15 belonged to St. George-in-the-East, or at the rate of 375 per 1,000 illegitimate births. 16 belonged to Mile End Old Town, or at the rate of 380 per 1,000 illegitimate births. 20 belonged to the Whitechapel District, or at the rate of 317 per 1,000 illegitimate births. The increase on the infantile mortality this year over the preceding year is due to the extreme heat and the prevalence of Measles. 51 If the excess of deaths of infants under one from Measles, and the deaths o infants under one from Diarrhoea, which was due to the extreme heat, be deducted, the number of deaths under one year of age would be 985, or 56 less than in the preceding year, or at the rate of 116 per 1,000 births, which would only be slightly higher than in the previous year. There has been a marked decrease in the infantile mortality during the last 20 years or so in each district in the Borough, but nowhere so marked perhaps as in the Limehouse District, where it was above 200 per 1,000 births in the two quinquennial periods, 1895-1899, and 1900-1904. Average Infantile Mortality for 5-year periods, from 1890-1909 :— Limehouse. St. Georges. Mile End. Whitechapel. Whole Borough. 1890-1894 186 197 175 163 178 1895-1899 204 187 166 147 168 1900-1904 201 162 148 135 157 1905-1909 153 142 120 112 129 1910 137 120 100 110 113 1911 189 170 138 106 149 For a few years previous to 1911, the marked decrease in infantile mortality was probably due to such favourable conditions as cool and wet summers which we experienced. These conditions, however, cannot be held responsible for the gradual decline during the last 22 years. It must be due to improved sanitary conditions and an awakening to the fact that innumerable and unnecessary deaths were occurring from year to year. Great as the diminuation has been, and although it may be considered to be favourable when compared with other eastern Boroughs, it is still far too high. The tendency of recent legislation has been in the direction to protect infants and young children. The Insurance Act should assist in this direction by the maternity grant where it will be most needed and probably more utilised than in other districts. In the " Limehouse Fields " area, the infantile mortality is very high, and there are more women working in factories here than in any other part of the Borough of Stepney. The maternity grant will be of material assistance, as nothing is more fatal to young babies than the early resumption of work by mothers who have recently been confined. After receiving the grant, there will not be the same urgency for the early resumption of work. Report on the work of the Health Visitor. The Health Visitor devotes her energies especially to a part of the district where the infantile mortality has been for many years abnormally high. Last year she visited after the notifications of births were received, instead of after d 2 52 registration, unless a birth was registered which had not been notified. The first visit was made during the tenth or eleventh day when the doctor or midwife had ceased attendance. In the district in question a large percentage of young girls are employed in factories which are numerous in the immediate vicinity. They get married, when they are very young, and are quite ignorant of everything which can be of the least advantage to them as wives and mothers. It is the duty of the Health Visitor to visit these homes and supply them with information when it is most needed. I am pleased to say that the services of the Health Visitor are appreciated by these young mothers, who are willing and eager to learn the proper way to rear their off-spring. The number of births registered in this particular district was 580 The number of births not known at the address given 8 Number of removals before the Health Visitor's visit 2 Number of infants who died before the Health Visitor's visit 15 The net number of births periodically visited by the Health Visitor during the year was 555. The majority of the births was attended by midwives. When the Health Visitor made her first visit on the tenth day she found 490 infants breast fed, 15 artificially fed, and 50 mixed feeding. Infants born in the first six months of the year:— At the end of the second week, 9 were both breast and bottle fed. At the end of the first month, 23 were both breast and bottle fed, and 20 were brought up entirely on the bottle. At the end of the second month, 8 more were both breast and bottle fed, and 2 were brought up entirely on the bottle. At the end of the third month, 19 more were both breast and bottle fed, and 4 were brought up entirely on the bottle. At the end of the fourth month, 13 more were both breast and bottle fed, and 8 were brought up entirely on the bottle. At the end of the fifth month, 39 more were both breast and bottle fed, and 7 were brought up entirely on the bottle. At the end of the sixth month, 56 more were both breast and bottle fed and 6 were brought up entirely on the bottle. At the end of six months, of the 259 infants born in the first six months of the year:— 48 were breast fed entirely. 164 were breast and bottle fed. 47 were brought up entirely on the bottle. 53 96 died before they were a year old, which is equivalent to an infantile mortality of 165 per 1,000 births; if the 15 deaths of infants who died immediately after birth and before the first visit was made were excluded, the infantile motality for the area would be 139 per 1,000 births. Infantile mortality in the area where the Health Visitor works, together with that for the Limehouse district and for the Whole Borough:— Area. Limehouse District. Whole of the Borough. 1902 126 197 155 1903 161 165 141 1904 212 208 158 1905 145 163 142 1906 178 168 136 1907 142 131 119 1908 190 171 130 1909 114 133 118 1910 198 137 113 1911 165 189 129 Marasmus and convulsions were responsible for 25 deaths; Diarrhoea for 22, and Measles for 5 deaths. 165 mothers were employed in factories, &c., and 127 were engaged as outworkers. It will be observed that nearly 50 per cent. of the mothers are not engaged exclusively in domestic duties. Factories, &c., where the mothers were employed:— Jam, confectionery, &c 66 Rope and sack making 44 Tobacco factory 3 Tinplate machinists 10 Rag sorting 6 Bottle washing 4 Fish cleaning 10 Hawking flowers 6 Charing and office cleaning 10 Boot finishing 1 Gut scraping 1 Artificial flower making 2 Ironers in laundry 2 Total 165 54 12 of the above worked at their trades within a few days of their confinement, 29 more within a week, 47 from one to two weeks, 36 from two to four weeks, 31 from one to three months of their confinement. Mothers employed at their own homes:— Tailoring trade and other needlework 59 Washing and mangling 32 Umbrella making 2 Cardboard-box making 3 Brush making 1 Shop-keeping 30 Total 127 109 premises in various parts of the Borough were visited at the request of the Almoners of the London Hospital, and a report sent as to the home conditions. 57 premises were referred to the Sanitary Inspectors, and the conditions were reported to the National Society for the Prevention of Cruelty to Children in three instances. 40 newly-confined mothers were recommended for extra nourishment to the Stepney Invalid Kitchen, and granted in every case. 2,171 re-visits were made by the Health Visitor. The Health Visitor reported that the employment of the mothers sometimes led to the neglect of the infants, especially where the livelihood depended upon the woman's efforts. Work had to be finished and returned to the employer's premises before the next meal could be provided. 98 of the infants were first-born children ; the mothers were more anxious to learn, and appreciated the Health Visitor's visits and instruction, than the mothers who had several children. It was found that very little is known by the mothers of the nutritive value of different articles of food. Tea, bread soaked in tea, vegetables, etc., were frequently given to infants under one year of age. Breast feeding was generally carried out for the first three or four months, afterwards it was supplemented by some form of artificial food, boiled bread, oatmeal, cornflour being most favoured by the mothers. Machine-skimmed milk was largely used on account of its cheapness. On the whole, the Health Visitor considers that the conditions are improving, many of the mothers appreciate her efforts and carry out the instructions given to the best of their ability. On the other hand, some women refused to try to do better. 55 It will be observed that in 1911 the infantile mortality was much less in this area than in the previous year, whereas it was very much higher in the Limehouse district as a whole. I have arranged that in future the Health Visitor has to visit the homes of all the babies born in the Parishes of Limehouse and Shadwell, as well as in the Hamlet of Ratcliffe. The other part of the Borough, where infantile mortality is highest, is St. George-in-the-East, and I am of opinion that another Health Visitor in this district would be of great benefit in reducing the large number of deaths of infants under one year of age. I understand that a branch of the Mother's Home and Babies' Welcome is about to be established in this part of the Borough, and the appointment of a Health Visitor would strengthen and supplement the efforts of this voluntary agency. Situate at 587, Commercial Road, close to the area where the Health Visitor has been devoting most of her energies, is the Stepney School for Mothers. The Health Visitor and the School for Mothers have the same object, namely, to teach mothers the art of rearing healthy babies, and so to lessen the high mortality among infants, and improve the health of those who survive. The activities of the School, centre round the Infant Consultations which are held every Tuesday afternoon throughout the year. Two medical men are in regular attendance at these consultations, each mother has a personal interview with the Doctor, and each infant is weighed. During 1911, 1,292 attendances were made at the Infant Consultations, 244 new babies being brought during the year. In special cases when ordered by the Medical Officer, dinners are given to expectant and nursing mothers. During the year, 60 mothers partook of 2,739 dinners, being an average of 45 dinners to each mother. In almost every case, these dinners are given free after careful enquiry into the circumstances of the family On Wednesday, Thursday, and Friday afternoons, classes of instruction in Infant care and Home Nursing, in Cooking and in Sewing are held at the school, large numbers of mothers attend these lectures, and take much interest in the practical demonstrations which are given. Many instances are known of mothers who are putting into practice in their own homes the knowledge gained at the School for Mothers. During the summer months special instruction is given, both orally and by leaflets, on summer diarrhoea and how to prevent it. It is three years since the school was opened, and it is slowly creating a strong public opinion on such subjects as cleanliness, comforters, thrush, &c. 56 Among the other voluntary agencies which are established in the district for the purpose of diminishing infantile mortality are creches. There are numerous factories in the Borough of Stepney, where married women are employed. This industrial occupation compels the mothers to leave their homes for a considerable part of the day. They are compelled to leave the baby in charge of a very young child, in a " baby-minder's " house, or a creche. As far as sanitary conditions are concerned, there is no doubt that a creche is superior to the other two. There are five creches in the Borough of Stepney. (1) Dr. Barnardo's Creche.—The number that can be accommodated is limited to fifty, the average number being forty per day. The distance whence the babies are brought is limited to the radius of one mile from the creche. The children are looked after and fed for twopence a day, and in the case of widows, for one penny per day. (2) Nursery for Jeioisli Infants, New Road.—Fifty infants can be accommodated at this creche, but the average number is thirty-five per day. The amount paid for each child is twopence per day, and no child is admitted if its home is more than 1½ miles from the creche. (3) St. Paul's Creche, Wellclose Square.—The average number of infants accommodated is twenty-four to thirty-four, although there is room for forty. The mothers pay threepence per day for each child. Most of the mothers reside in St. Georges or Whitechapel, but no child is refused. (4) George Yard, Creche.—The average number of infants is eighteen, although twenty can be accommodated. The mothers pay threepence a day, and the infants are brought from any distance. (5) 154, St. George Street.—This is a creche in connection with a soup kitchen at this address. Babies from the immediate vicinity only are admitted. No fixed charge is made, but the mothers pay what they can afford. Old Age. 233 deaths were attributable to Old Age. This corresponds to a death-rate of .83 per 1,000. 70 belonged to the Limehouse District, or at the rate of 1.30 per 1,000. 25 belonged to the St. George-in-the-East, or at the rate of .53 per 1,000. 102 belonged to Mile End Old Town, or at the rate of .91 per 1,000. 36 belonged to the Whitechapel District, or at the rate of .53 per 1,000. 57 Table showing the ages of persons who died over 65 years of age and the localities:— Limehouse. St. Georges. Mile End. Whitechapel. Total Between 65 and 70 years of age 45 37 105 65 252 „ 70 „ 75 „ 56 40 97 63 256 „ 75 „ 80 „ 48 14 73 35 170 „ 80 ,, 85 „ 29 12 56 24 121 „ 85 „ 90 „ 11 4 24 14 53 Over 90 years of age 1 1 13 4 19 190 108 368 205 871 The deaths of persons over 65 years of age occurred as follows:— At their own homes. In Lunatic Asylums. In other Institutions. Total. Limehouse District 85 13 92 190 St. Georges 40 4 64 108 Mile End 199 21 148 368 Whitechapel District 87 16 102 205 401 54 406 871 Alcoholism. The number of deaths due to Alcoholism and Cirrhosis of the Liver was 34, or 4 more than in the previous year. 8 belonged to the Limehouse District, or at the rate of .14 per 1,000. 8 belonged to St. George-in-the-East, or at the rate of .17 per 1,000. 10 belonged to Mile End Old Town, or at the rate of .08 per 1,000. 8 belonged to the Whitechapel District, or at the rate of .11 per 1,000. The death-rate throughout the whole Borough was .12 per 1,000 of the population. Cancer. The deaths due to Cancer were 236, or 8 more than in the previous year. This corresponds to a death-rate of .88 per 1,000 of the population. 64 belonged to the Limehouse District, or at the rate of 1.19 per 1,000. 25 belonged to St. George-in-the-East, or at the rate of .53 per 1,000. 81 belonged to Mile End Old Town, or at the rate of .72 per 1,000. 66 belonged to the Whitechapel District, or at the rate of .96 per 1,000. 58 It will be observed by the following table that the deaths from Cancer do not diminish in number but seem to be gradually increasing, although the population has been decreasing since 1901. With the exception of 1904 and 1906 the number was greater last year than in any year for the last 11 years:— The number of deaths from Cancer in 1901 was 211. ,, ,, 1902 „ 201. ,, ,, 1903 ,, 223. ,, ,, 1904 „ 240. ,, ,, 1905 „ 228. ,, ,, 1906 „ 263. ,, ,, 1907 „ 213. ,, ,, 1908 „ 223. ,, ,, 1909 „ 202. ,, ,, 1910 „ 228. ,, ,, 1911 „ 236. Glanders. Under the London (Notification of Glanders) Order, 1907, the Veterinary Inspector of the London County Council reported, in accordance with the provision of that Act, the existence of Glanders in only one stable in the Borough, in which one horse was affected. This is a great improvement on the previous year, when 16 horses contracted the disease, and 85 in 1909. Anthrax. One man suffered from Anthrax. He was employed at Morocco Wharf, carrying foreign skins from the ship to the wharf. A cow in one of the cowsheds in the Borough suffered from the disease. On January 23rd, I received a notification that a cow was taken from a licensed cowhouse in the Borough to the Islington Cattle Market to be slaughtered. After the cow was slaughtered, it was discovered that she had Anthrax. The whole of the shed was disinfected and the milk stopped. The temperatures of the other cows were taken and they were found to be normal. A bacteriological examination was made by the Board of Agriculture and the diagnosis was confirmed. The carcase was destroyed. Anthrax is specially virulent in sheep and cattle. An animal may suddenly drop down, with symptoms of collapse, and death may occur in a few minutes. In less acute cases, the animal is apparently out of sorts, and does not feed ; its pulse 59 and respiration are quickened; rigors occur, succeeded by high temperature. There is progressive weakness, with cyanosis, death occuring in from 12 to 48 hours. In the more prolonged cases, widespread oedema and extensive enlargement of lymphatic glands are marked features. In the glands, especially about the neck, actual necrosis with ulceration may occur, constituting the so-called Anthrax Carbuncles. On post-mortem examination, the most noticeable feature is the enlargement of the spleen, which may be two or three times its natural size. It is of a dark red colour, and on section the pulp is very soft and friable. Anthrax is due to a pathogenic organism called Bacillus Anthracis. The bacilli form spores (or eggs) which are enclosed in a thick membrane and are more tenacious of life than the bacilli. They are able to stand heat, cold, and comparatively strong disinfectants. Not only so, but under circumstances which would rapidly prove fatal to the bacilli, the spores remain viable for years. The bacilli are killed by two minutes exposure to a 1 per cent. solution of carbolic acid in water, but the spores will remain alive for more than a week in a similar solution. Anthrax is almost invariably transmitted to the healthy animal through the medium of food or water containing the spores of the disease. The cow in question had been in the shed for two months. It is therefore evident that the disease was contracted through the food supply. The most likely cause was the oil cakes which were used to feed the cows. These cakes—Bombay cakes—are about 18 inches long and 6 to 7 inches wide. They are imported from India in bales without any covering, or being put in sacks. It is quite possible that skins or hides were placed on top of them in the hold of the ship, and that spores from an infected hide became attached to one or more of the cakes. Plague. The occurrence of Plague in human beings in East Anglia in 1910 together with the existence of this disease among rats, hares, and other rodent animals in that locality, has naturally drawn the attention of the public to the danger from this disease, which has not been epidemic in this country for over 200 years, but small outbreaks have occurred during the last 12 years in Glasgow, Liverpool, Cardiff, and Leith. Plague bacilli have, however, been discovered in dead rats in the docks by the Port Sanitary Authority during the summer months for the last 3 or 4 years. It has been definitely proved that the disease particularly affects rodent animals such as rats, and that it is communicated from the animal to man by means of fleas. When the animal dies, or is dying, it becomes cold, and the blood does no longer circulate and afford nutriment to the fleas. They consequently leave their host, and attach themselves to another rodent or even to man. When a flea requires 60 nourishment, it pierces the skin with its prickcr, at the same time injecting an irritating acrid fluid which causes the well-known irritation associated with the bite of these insects. If the flea had previously been feeding on the blood of an animal the subject of plague, the stomach would contain numerous plague bacilli in a living condition. These bacilli may be rubbed into the wound made by the pricker, or the contents of the stomach are regurgitated through the mouth of the flea, and the bacilli are then injected into the host with the saliva. On December 17, 1910, I sent a circular to the managers of all the wharves in the Borough to this effect: "Dear Sir,—In view of the possibility of a spread of plague by the means of rats, I should be greatly obliged to you if you would communicate with me immediately you observe a number of dead rats on your premises." On June 9th, 1911, I received a telephonic communication from the manager of one of the wharves that there were a number of dead rats on the wharf. It seems that five had died, and one was in a moribund condition, and was killed. Three of these were sent to the bacteriologist of the Local Government Board. One was in a state of advanced decomposition and could not be bacteriologically examined. The other two showed that they had died from pneumonic plague. I received this information on Monday, June 12th, and on the same day, accompanied by Dr. Reece. of the Local Government Board, I visited and inspected the premises, and gave instructions as to precautions to be taken in handling rats. On Tuesday, June 13th, six dead rats were found on the same premises; one was too decomposed to be examined. Five were sent by hand to the bacteriologist of the Local Government Board, but two of them were too decomposed to be examined bacteriologically. The remaining three had died from Plague, two from the pneumonic variety and one from bubonic Plague. The wharf is situated on a kind of island, bounded on the west by Wapping Basin, on the east by Shadwell Basin, on the north by the London Docks, and on the south by the Thames. I caused the following circular to be given personally to the manager of each wharf on the river frontage throughout the Borough: "Dear Sir,—With reference to my letter to you in December last, with regard to rats, I beg to call your attention to the fact that the seasonal prevalence of rat Plague has commenced, and I should be glad if you notice any dead rats on your premises to communicate with me at once. I would strongly urge on you the necessity of at once starting a campaign to kill all the rats on your premises by trapping them." At the same time I instructed the Inspectors who took these circulars to the wharfingers to ask in each instance if there were any rats on the premises, or if they had recently seen any dead rats there. On the same day I instructed three other Inspectors to make a house to house inspection in the infected area and to inquire, first, whether there were any rats on the premises, and secondly, whether there were any dead rats. Although a large number of rats were found in a number of the premises, no dead rats had been seen in any of them. On the first floor of the wharf in question, there was a large quantity of peanuts, the bags of which had teen torn by rats, and some pea-nuts evidently eaten by them. They endeavoured to catch all the rats at the wharf until June 13th, without much success. On June 13th and 14th they set about 60 traps, but only caught two on each night. Arrangements were made with rat-catchers to catch rats on all the premises where they were to be found along the riverside from the Poplar boundary to the City boundary, as well as on all the premises situated in the island mentioned above. Instructions were given to the Sanitary Inspectors, Dustmen, Sewer-men, &c., to bring to the Public Health offices all dead rats found in other parts of the Borough. The latter and all the rats caught (256 in number) were bacteriologically examined by the Local Government Board bacteriologist, but with the exception of the five previously mentioned, no Plague bacilli were discovered. After sufficient rats had been caught for the purpose of examination to ascertain the extent of the disease, a campaign was started to exterminate them. Ratcatching by professional rat-catchers was not a success, and a virus from the Ratin Bacteriological Laboratory was used, which proved satisfactory in every way. (52 RETURN OF RATS CAUGHT ALIVE AND BACTERIOLOGICALLY EXAMINED. Address. Date of setting traps. No. of traps set. No. of rats caught. Date when rats were caught, or traps examined. Dundee Wharf 1911. 8th July 16 None 1911. 10th July. Limekiln Wharf 8th July 2 None 10th July. 150, Narrow Street (P. & 0. Branch Office, Sail Loft). 8th July 7 None 10th July. 148, Narrow Street (J. & R. Wilson, Ship Stores). 8th July 4 None 10th July. 146, Narrow Street (Hay Wharf) Unable to get into Wharf. — — 144, Narrow Street Empty. St. Dunstan's Wharf 8th July 1 None 10th July. Dunbar Wharf, 134, 136, 136½, 138, 140, and (stables across Street) 141, Narrow Street. 8th July 30 3 rats caught in 136½, 2 in cellar, and 1 on milk floor (raised ground floor) 10th July. Ditto, ditto 10th July 9 3 in cellar, 1 on milk floor 11th July. Brewery Wharf (G. J. Anderson) 11th July 1 None 12th July Lower Brewery (Wharf C; White) 11th July 2 None 12th July. 63 Return of Rats Caught, &c.—continued. Address. Date of setting traps. No. of traps set. No. of rats caught. Date when rats were caught, or traps examined. Anchor Wharf (Hy. Crane) 1911. 11th July 3 None 1911. 12th July. 116, Narrow Street Empty. Essex Wharf (E. J. Hay) 11th July 10 None 12th July. Ditto, ditto 12th July 6 None 13th July. 108, Narrow Street No traps set. Duke Shore Wharf No traps set. 100, Narrow Street (Sander Bros.) 10th July 15 1 in cellar 11th July. Ditto, ditto 11th July 8 None 12th July. Ditto, ditto 12th July 10 2 in cellar 13th July. 98, 96, Narrow Street (Houses) No traps set. No signs of rats. 92, 94, Narrow Street (Sparks) 10th July 2 None 11th July. 90, Narrow Street (G. & W. Lamb) 10th July 2 None 11th July. 88, Narrow Street (Fielder) 10th July 2 None 11th July. 86, Narrow Street (Barnet) No traps set. No signs of rats. 64 Return of Rats Caught, &c.—continued. Address. Date of setting traps. No. of traps set. No. of rats caught. Date when rats were caught, or traps examined. 84, Narrow Street (Etheridge) 1911. 10th July 2 None 1911. 11th July. 78 to 82, Narrow Street (Mason) 10th July 4 None 11th July. 76, Narrow Street (Wm. Higgins) 11th July 2 None 12th July. 74, Narrow Street (Harbour Master's Office). No traps set. No signs of rats. 70, 72, Narrow Street (Grape Wharf) 11th July 8 None 12th July. Ditto, ditto 12 th July 3 3 on ground floor 13th July. 68, Narrow Street (R. Waters) 11th July 3 1 in cellar 12th July. Blyth's Wharf No traps set. Jubilee Wharf 11th July 6 None 12th July. 54, Narrow Street (Coffee House) 11th July 2 None 12th July. Dover Wharf 11th July 12 7 in lower cellar, 2 in cellar, 3 on dustbin in yard. 12th July. Hough's Wharf 12th July 24 1 in cellar, 1 on ground floor 13th July. 65 Return of Rats Caught, &c.—continued. Address. Date of setting traps. No. of traps set. No. of rats caught. Date when rats were caught, or traps examined. Hough's Wharf 1911. 13th July 12 None 1911. 14th July. 48, Narrow Street (Beerhouse) 12th July 2 None 13th July. Victoria Wharf 13th July 6 1 mouse 14th July. Chinnock's Wharf 13th July 7 3 on ground floor 14th July. 42, Narrow Street Empty. Old Sun Wharf (Stable) 14th July 2 None 15th July. Old Sun Wharf ((1st floor) 14th July 4 None 15th July. Old Sun Wharf (2nd floor) 15th July 2 None 17th July. Old Sun Wharf (B warehouse, N. side) 14th July 6 None 15th July. Oporto Wharf (Ground floor) 14th July 4 None 15th July. Oporto Wharf 15th July 6 None 17th July. Vanes' Wharf (Ground floor) 13th July 4 None 14th July. Vanes' Wharf (D 2 and D 3) 14th July 4 None 15th July. New Sun Sufferance (B1 and C1) 13th July 10 None 14th July. e 66 Return of Rats Caught, &c.—continued. Address. Date of setting traps. No. of traps set. No. of rats caught. Date when rats were caught, or traps examined. New Sun Sufferance (B 2 and C 2) 1911. 14th July 7 1 on 1st floor 1911. 15th July. New Sun Sufferance (B 3 and C 3) 14th July 4 None 15th July. New Sun Sufferance (F warehouse on North side). 13th July 7 1 small rat 14th July. Ditto, ditto 14th July 2 None 15th July. New Sun Sufferance (J warehouse on North side. Ground floor). 14th July 6 1 on ground floor 15th July. Ditto (1st floor) 14th July 3 None 15th July. Eagle Wharf (A cellar) 13th July 3 None 14th July. Eagle Wharf 14th July 6 None 15th July. Eagle Wharf (A cellar) 15th July 6 2 rats 17th July. Eagle Wharf (A ground floor) 15th July 2 None 17th July. Eagle Wharf (E warehouse, North side) 15th July 3 None 17th July. Narrow Street (Crown Mill Wharf) 15th July 10 None 17th July. Narrow Street (London Wharf) 15th July 6 None 17th July. 67 Return of Rats Caught, &c.—continued. Address. Date of setting traps. No. of traps set. No. of rats caught. Date when rats were caught, or traps examined. Narrow Street (Globe Flour Mills) 1911. Empty. 1911. Narrow Street (Ratcliffe Cross Flour Mills) 15th July 8 None 17th July. 20, 22, Narrow Street (Anglo-American Oil co.). No traps set. No signs of rats. 18, Narrow Street (Phoenix Lower Wharf) Empty. 16, Narrow Street Empty. Narrow Street (Phoenix Wharf) Empty. 12, Narrow Street Vacant Land. Broad Street (Ratcliffe Cross Wharf) 15 July 14 None 17th July Ratcliffe Cross Wharf (Stables and Yard) 17th July 12 1 rat caught in yard 18th July. Marine Brewery Holt 17th July 12 None 18th July. Hubbucks Wharf 17th July 14 None 18th July. Free Trade Wharf No traps set. Using Raten f or several weeks. 12, Broad Street (Moore & Co., Bottle warehouse). 18th July 31 1 caught in front warehouse, 1 on first floor back warehouse, 1 in bottle washing room, 6 in basement. 19th July. B 2 68 Return of Rats Caught, &c.—continued. Address. Date of setting traps. No. of traps set. No. of rats caught. Date when rats were caught, or traps examined. 8, Broad Street (Finnis, Fisher & Co.) 1911. 18th July 5 None 1911. 19th July. 6, Broad Street Empty. Charrington, Sells, Dale & Co. 18th July 9 None 19th July. "Ship" Beer House, Lower Shadwell 18th July 2 None 19th July. Shadwell Fishmarket Empty. The Linde British Refrigeration Co., Ltd. Empty. Tunnel Wharf, S. Bew, Lighterman No traps set. No signs of rats. Pier Head (Parson's Destructor) 18th July 6 None 19th July. 56, Wapping Wall and Garton's Crystal Glucose. 20th July 4 None 21st July. ,, ,, ,, 21st July 1 None 22nd July. Prospect of Whitby (Public House) 20th July 2 None 21st July. Nash and Miller, Barge Builder 20th July 4 1 on ground floor 21st July. Thorpe Wharf 20th July 10 1 on ground floor, 4 on first floor, 1 on fifth floor. 21st July. 69 Return of Rats Caught, &c.—continued. Address. Date of setting traps. No. of traps set. No. of rats caught. Date when rats were caught, or traps examined. Queen's Wharf 1911. Empty. 1911. Metropolitan Wharf 20th July 10 None 21st July. Metropolitan Wharf 21st July 2 1 in office 22nd July. Metropolitan Wharf (C warehouse, North side). 20th July 6 None 21st July. Jubilee Wharf (J. and J. Coleman) 20th July 4 None 21st July. Lusk's Wharf 20th July 4 None 21st July. River Plate Wharf Empty. New Crane Wharf 20th July 18 None 21st July. Anchor and Hope (Public House) 20th July 2 None 21st July. St. Helen's Wharf 21st July 8 None 22nd July. Albion and Brewers Wharf 21st July 27 None 22nd July. Hastes Warhf 21st July 8 None 22nd July. Watsons Wharf 21st July 20 None 22nd July. Tidman's Wharf 22nd July 12 None 24th July. —I o Return of Rats Caught, &c.—continued. Address. Date of setting traps. No. of traps set. No. of rats caught. Date when rats were caught, or traps examined. Sewards' Wharf 1911. 22nd July 14 None 1911. 24th July. Globe Wharf 22nd July 36 1 in cellar, 7 on ground floor 24th July. Old Globe Wharf 22nd July 15 1 on ground floor 24th July. Colonian Wharf 24th July 53 None 25th July. Granite Wharf 24th July 15 None 25th July. Hermitage Wharf 25th July 36 3 on quay, 1 on ground floor, 1 on third floor. 26th July. Carron Wharf 25th July 20 None 26th July. Carron Wharf 26th July 58 1 on quay 27th July. Upper Gun Wharf (partly empty) 26th July 10 None 27th July. Carron Wharf 27th July 16 None 28th July. Gas Works 16th to 19th June 2 rats 16th to 19th June. Middleton's Wharf 9th to 14th June 10 rats 9th to 14th June. Jacob's Wharf 7th to 10th July 12 2 rats 7th to 10th July. 71 Return of Rats Caught, &c.—continued. Address. Date of setting traps. No. of traps set. No. of rats caught. Date when rats were caught, or traps examined. Jacob's Wharf 1911. 10th and 11th July 4 4 rats 1911. 10th and 11th July. Lower Gun Wharf 15th to 17th July 16 1 rat 15th to 17th July. Middle Gun Wharf 14th and 15th July 17 1 rat 14th and 15th July. King Henry Wharf 10th and 11th July 16 4 rats 10th and 11th July. King Henry Wharf 11th and 12th July 16 2 rats 11th and 12th July. King Henry Wharf (K warehouse) 12th and 13th July 8 None 12th and 13th July. King Henry Wharf (H warehouse) 12th and 13th July 8 4 rats 12th and 13th July. ,, ,, ,, 13th and 14th July 8 2 rats 13th and 14th July. Gibb's Soap Works' 13th and 14 th July 8 None 13th and 14th July. F warehouse 17th and 18th July 9 1 rat 17th and 18th July. G warehouse 17th and 18th July 9 None 17th and 18th July. Old Aberdeen Wharf 18th to 20th July 9 1 rat 18th and 19th July. Eagle Wharf 18th to 20th July 18 2 rats 19th and 20th July. Baltic Wharf 18th to 20th July 9 None 18th to 20th July. 72 Return of Rats Caught, &c.—continued. Address. Date of setting traps. No. of traps set. No. of rats caught. Date when rats were caught, or traps examined. Eagle Sufferance Wharf 1911. 20th and 21st July 17 None 1911. 20th and 21st July. Morocco Wharf 20th and 21st July 15 None 20th and 21st July. Gun Wharf 21st and 22nd July 17 None 21st and 22nd July. St. John's Wharf 21st and 22nd July 17 None 21st and 22nd July. Orient Wharf 22nd to 24th July 17 2 rats 22nd to 24th July. Oliver's Wharf 22nd to 28th July 16 1 rat 26th to 28th July. 85, High Street, Wapping (Eating House) 26th to 29th July 2 None 26th to 29th July. 92, High Street, Wapping ("Waterman's Arms" Public House). 26th to 28th July 4 None 26th to 28th July. 87, High Street, Wapping (Public House) 26th to 28th July 3 None 26th to 28th July. 103, High Street, Wapping (Public House) 26th to 28th July 2 None 26th to 28th July. 73 Deaths of the Homeless and of Inmates of Common Lodging Houses. During the year, there occurred in lunatic asylums the deaths of 67 persons stated to have been removed into such institutions from this district, but for whom no definite addresses could be given when the deaths were reported to the Registrars. Fifteen of these were stated to have been removed from the Limehouse District, 8 from St. George-in-the-East, 16 from Mile End Old Town, and 28 from the Whitechapel District. There were 206 deaths in public institutions of persons admitted from Common Lodging-houses in the Borough, and nearly 30 per cent. of them died from Consumption. The bodies of 4 unknown persons were found drowned on the foreshore of Shadwell and Wapping and were included in the Limehouse District returns, together with those of 4 unknown persons who died in Poplar and Stepney Sick Asylum, and 5 in the Stepney Workhouse. Eleven children with unknown addresses died at the Carshalton Infirmary; 4 were stated to have been removed from Limehouse, 4 from St. Georges, 1 from Mile End and 2 from Whitechapel. In the St. George's returns are included the deaths of 3 persons with unknown addresses who died in St. George's Infirmary. In the Mile End returns are included 7 deaths of persons who died under similar conditions in the Mile End Infirmary, and one unknown person who died in the street. In the Whitechapel returns, there are included 67 deaths of persons with unknown addresses, 62 having occurred in the Whitechapel Infirmary and Workhouse, 2 in the London Hospital, and 3 in the street. Inhabited House Duty. During the year 4 applications were received for certificates under the Inland Revenue Act, 1903 for the purpose of securing exemption from inhabited house duty. Certificates were granted for 30 tenements, and refused for 7 tenements. 74 Verminous Persons. 2,111 verminous persons were cleansed during the year, and their clothing disinfected. Of these, 2,015 were adults—2,001 males and 14 females—96 children were cleansed, all of school ages—71 being boys and 25 girls. Mortuary and Coroner's Court. The number of bodies deposited in the Mortuary during the year was 581. Of these, 509 were removed by the Coroner, 56 by the Police, 1 by the Relieving Officer, 8 at the request of friends, and 7 on my instructions. 2 of the bodies were persons who had died of Infectious Diseases, and were placed in the the infectious part of the Mortuary. 100 bodies were placed in the Jewish Mortuary. Of these, 46 were "watched" in accordance with the Jewish custom. 565 Inquests were held in the Coroner's Court, and 95 Post-mortem examinations were made. Articles Destroyed on Account of their Condition and at the Request of the Owners. Mattresses 43 Pillows 6 Beds 24 Quilts 2 Palliasses 15 Sheets 2 Bolsters 4 Sundries 38 Cushions 5 Sacks of Waste Paper 48 Coats 6 75 ARTICLES DISINFECTED DURING 1911. ARTICLES DISINFECTED. January. February. March. April. May. June. July. August. September. October. November. December. TOTALS. Beds 139 135 155 89 118 146 152 139 113 174 152 133 1,645 Mattresses 74 114 97 73 82 79 71 88 106 198 134 106 1,222 Palliasses 67 91 78 76 77 99 89 83 79 117 84 101 1,041 Bolsters 86 93 85 73 69 93 102 73 101 138 91 105 1,109 Pillows 267 231 339 267 246 288 266 273 242 328 379 305 3,431 Sheets 173 216 204 148 133 126 135 124 113 259 318 207 2,156 Quilts 150 166 141 88 93 121 171 84 79 188 165 101 1,547 Blankets 180 223 213 135 148 1,482 259 431 117 245 248 106 3,787 Vests 35 52 44 38 30 32 39 41 38 51 37 35 472 Trousers 41 51 49 53 29 42 61 48 39 62 45 49 569 Cushions 53 83 90 32 63 84 73 55 78 145 118 70 944 Coats 34 63 152 37 30 33 45 26 39 244 53 35 791 Sundries 824 3,029 1,223 894 1,986 1,421 497 412 398 1,016 1,042 974 13,716 TOTALS 2,123 4,547 2,870 2,003 3,104 4,046 1,960 1,877 1,542 3,165 2,866 2,327 32,430 Articles of Clothing in a Verminous Condition 18,997 Total for Year 51,427 76 Housing, Town Planning, &c., Act, 1909. A large number of the least satisfactory dwelling houses were inspected during the years 1910 and 1911, and were reported upon to the Public Health Committee. Closing Orders were made in respect of dwelling houses in several courts, but the owner of two houses in Regents Place made an application to the High Court for an injunction restraining the Council from proceeding further with the closing orders on the technical ground that the form of the Orders was not in accordance with the form prescribed by the Local Government Board. The application was heard in the Chancery Division on the 21st June, 1911, when the Judge decided that the words following the seal and signature in the Local Government Board's form were intended to be a part of the form, and these words having been omitted from the Council's Orders (for the reason that they were looked upon as being merely inserted for the the purpose of assisting the person who filled up the form), the Judge held that the Closing Orders were void. This ambiguity in the Board's instructions as to the form of Order to be adopted, led to similar errors being made by several local authorities throughout the country. In view of the foregoing, the Council did not proceed to make demolition orders in respect of any of the dwelling houses with regard to which they had purported to make closing orders, but notwithstanding this, the owners of some of the houses did not reopen them or make any attempt to improve their condition, but kept them uninhabited until fresh Closing Orders were made. Closing Orders have been made for houses in the following Courts, and nothing has yet been done to improve their condition:— (1) Miller's Court. (2) Adelaide Court. (3) Crown Court. (4) Tenter Court. Miller's Court.—This Court, which contains 7 houses, is situated as in a well with high buildings all round it, and the entrance is through a narrow covered entrance. On account of the position of the houses in the Court there is stagnation of air, and the conditions are injurious to health. They are two-roomed houses without through light and ventilation. They have, therefore, all the bad qualities of back-to-back houses. There are no damp-proof courses. As the brickwork is old, the rain water soaks through the bricks and the dampness creeps up from the earth. In some cases the dampness is hidden by boards. The windows of No. 7 are directly opposite and within 3½ feet of the doors of the water-closets which are common to all the houses. 77 Adelaide Court.—There are 4 houses in this Court, which is approached by a long covered entrance from Heneage Street. The houses have been empty for nearly two years. The houses are very dilapidated, the brickwork is old, and there are no damp-proof courses. The walls are very wet. There is no through ventilation of the rooms or of the ground underneath the lower floor. There are no separate w.c.'s or water supply. There are two w.c.'s at the end of the Court for the use of the 4 houses. They are badly lighted and ventilated. One is choked, with no water supply, and in the other, the flush pipe is defective. Crown Court.—This is a Court approached from Little Pearl Street by a long covered entrance. Nos. 1 and 2 have yards, the others have no back yards. The former can be improved without a Closing Order. There is no water supply to any of the houses, but water is supplied by a tap which is close to the w.c. The floors are dilapidated. No. 3.—The walls of the ground floor are damp. The ceiling is dilapidated. No. 4.—The walls are damp. Nos. 5 and 6.—The walls are boarded up all round. No. 7.—The back wall is damp. There are two w.c.'s to five houses containing 16 families. The w.c.'s are situated in the yard. The roofs of the w.c.'s are defective and the seats are very wet and dirty. All the rooms are let furnished. Tenter Court.—This Court is a turning on the west side of Tenter Street. The Court is closed by a door which is generally nailed up. There are 3 houses in the Court which have been empty since November, 1909. The ground floor rooms have a match-boarding over the walls. In the portion of the wall that is not boarded, the dampness of the wall can be observed. There is no separate w.c. or water supply to any of the houses. There is no through ventilation, and there is no opening or a window in the back wall. There are no back yards. The houses have a high wall in front separated only by the Court, which is less than 3 feet wide. There had been, at one time one w.c. which was for the use of the 3 houses, but it was condemned by the District Surveyor. Nos. 2, 9, and 16, Shepherd Street Buildings were also closed. On account of their structural condition, the rooms are without sufficient light and ventilation, and are for that reason unfit for human habitation. The Act cannot be proceeded with further with regard to these tenements, as it is impossible to proceed with a Demolition Order without at the same time pulling down the whole of Shepherd Street Buildings. 78 Nos. 43 to 62, Ely Terrace.—Closing Orders were made with respect to these 24 houses in March, 1910. The floors were taken up, a space excavated underneath and ventilated, and new floor boards were supplied. Staircases were repaired or new ones provided. In fact, the whole of the inside and outside portion of the premises was thoroughly done up, and the drains and water-closets were reconstructed. The Closing Orders were rescinded in June, 1911. Bennett's Place.—Closing Orders were made for the 5 houses in this Court, but they were rescinded in October, 1911. These two-roomed houses were without through light and ventilation. They had no back yards, no separate water closet accommodation, and there was no water supply provided to any of the houses. There was one water closet just within the entrance of the Court which was common to the 5 houses. The walls were damp and there were no damp-proof courses. The floors were on the bare earth. After the houses were closed, 4 water closets were constructed. The earth underneath the ground floor of each house was excavated and the space ventilated by air-bricks. Damp-proof courses were provided and a separate water supply was provided to each tenement. There is now through ventilation in each tenement. The houses have been thoroughly repaired and re-decorated. Cornwall Place.—The 5 houses had been unoccupied for some time. The walls were damp and there were no damp-proof courses. Closing Orders were made in January and rescinded in March. All the houses were thoroughly repaired. Cornwall Square.—The 4 houses in this Square had been for years a source of continuous trouble due to their dilapidated condition. Sufficient work was done to barely satisfy the requirements of our various notices. Closing Orders were made in January and rescinded in July, after the premises had been put in a thorough state of repair. Regulations made by the Borough Council in 1911 as to Underground Rooms habitually used as sleeping places. Whereas by Section 17 of the Housing, Town Planning, &c., Act, 1909, it is enacted as follows:— Sub-Section 7. A room habitually used as a sleeping place, the surface of the floor of which is more than three feet below the surface of the part of the street adjoining or nearest to the room, shall for the purposes of this section be 79 deemed to be a dwelling house so dangerous or injurious to health as to be unfit for human habitation, if the room either— (a) is not on an average at least seven feet in height from floor to ceiling; or (b) does not comply with such regulations as the local authority, with the consent of the Local Government Board, may prescribe for securing the proper ventilation and lighting of such rooms, and the protection thereof against dampness, effluvia, or exhalation: Provided that if the local authority, after being required to do so by the Local Government Board, fail to make such regulations, or such regulations as the Board approve, the Board may themselves make them, and the regulations so made shall have effect as if they had been made by the local authority with the consent of the Board. Provided that a Closing Order made in respect of a room to which this subsection applies shall not prevent the room being used for purposes other than those of a sleeping place; and that, if the occupier of the room after notice of an order has been served upon him fails to comply with the order, an order to comply therewith may, on summary conviction, be made against him. Now, therefore, we, the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney, being the local authority for the said Metropolitan Borough, hereby prescribe the following regulations with which a room habitually used as a sleeping place, the surface of the floor of which is more than three feet below the surface of the part of the street adjoining or nearest to the room, shall comply, namely:— (a) Such room shall in every part thereof have at least three feet of its height above the surface of the street or ground adjoining or nearest to the room. Provided that if the width of the area hereinafter mentioned is not less than the height of the room from the floor to the said surface, or is not less than six feet, the height of the room above such surface may be less than three feet, but not in any case less than one foot. (b) Every wall of such room shall be constructed with a proper dampproof course, and, if in contact with the soil, shall be effectually protected against dampness from that soil by means of a vertical dampproof course or otherwise. (c) There shall be outside of, and adjoining such room, and extending along the entire frontage thereof, and open upwards from six inches below the level of the floor thereof, an area properly paved and effectually drained, and at least four feet wide in every part. Provided that the width of such area may be not less in any part than three feet, if the mean width of the area be not less than four feet. Provided also 80 that in the area there may be placed steps necessary for access to the room, and over and across such area there may be steps necessary for access to any buildings above the room, if the steps are so placed in such case as not to be over or across any external window of the room. (d) The space (if any) beneath the floor of such room shall be provided with adequate means of ventilation. (e) Every drain passing under any such room shall be properly constructed of a gas-tight pipe. (f) Such room shall be ffectually protected against the rising of any effluvia or exhalation by means of a layer of good cement concrete at least six inches thick, laid upon the soil of the site of the entire room, or in some other equally effective manner. (g) Every such room which is without a fireplace, and a flue properly constructed and properly connected with such fireplace, shall be provided with special and adequate means of ventilation by a sufficient aperture or air shaft, which shall provide an unobstructed sectional area of 100 square inches at the least. (h) Such room shall have one or more windows opening directly into the external air, with a total area clear of the sash frames equal to at least one-tenth of the floor area of the room, and so constructed that onehalf at least of every such window can be opened, and that the opening may in every case extend to the top of the window. Canal Boats Acts 1877 and 1884. Pursuant to the Third Section of the Canal Boats Act, 1884, I have to report, with regard to the execution of such Acts and of the Regulations made thereunder, and as to the steps taken during the year, to give effect to the provisions of the said Acts and Regulations, viz.:— (1) Canal boats coming within the district are inspected by a Sanitary Inspector, who receives a sum of £10 per annum for the performance of this duty. His inspection is irrespective of the examination of boats made by the Examining Officer prior to their registration. (2) The number of Boats inspected in 1911 was 83, and the condition of the Boats and their occupants, as regards the matters dealt with in the Acts and Regulations, was very good. (3) Infringements of Acts and Regulations were discovered as follows:— (a) Registration—One. (b) Notification of change of Master—Nil. (c) Certificates—One. 81 (d) Marking—Nil. (e) Overcrowding—Nil. (f) Separation of sexes—Nil. (g) Cleanliness—Nil. (h) Ventilation—Nil. (i) Painting—Two. (j) Provision of Water Cask—One. (k) Removal of Bilge Water—Nil. (I) Notification of Infectious Disease—Nil. (m) Admittance of Inspector—Nil. (4) No legal proceedings were taken. (5) In the case of infringement, notice was sent to the owner of the Boat requiring him to remedy the cause of complaint, and to forward to this Borough, within a specified period, a certificate signed by some duly appointed Inspector of Canal Boats that the same had been duly done. Such certificate was afterwards received. (6) No case of Infectious Disease occurred. (7) No Boats were detained for Cleansing and Disinfection. (8) The total number of Boats on the Register on the 31st December, 1911:— (a) Number of Boats believed to be in use or available was 13 (b) Number of Boats that cannot be traced Nil. (9) No Boats were Registered in 1911. Human Bones at 16, Walburgh Street. Human remains were disturbed on the above premises when men were excavating the earth to construct an underground stable. The bones were not found in any one particular spot. Some were found in the basement and others just outside the building where the ground was dug to make an entrance to the stable. There were no signs of coffins, that is, no wood or coffin plates were seen, and no whole skeletons were found. On the contrary, two or more skulls were found with a small number of bones and in other places, a large number of bones were found with one skull only. Twenty-two skulls were disturbed and more than double that number of thigh bones. It seems to me that the burial ground had been previously disturbed many years ago, and the bones thus disturbed were re-buried anyhow in another part of the ground. This part of the ground has now been again dug up. As far as I have been f 82 able to gather information on the subject, it appears that the ground was used as a burial ground until 150 years ago. It was attached to a Roman Catholic chapel or church. In connection with the burial ground a portion of it was set aside for the burial of Lascars. Between 60 and 70 years ago, this portion of the ground was partly built over, and in constructing the foundation of the building human bones were disturbed. This fact came to the knowledge of the Lascars who were at the time staying in the locality, and they caused a great deal of rioting. The present building was then constructed as a cooperage in 1860, some bones were again disturbed and the Irish people on this occasion caused a disturbance, not without reason probably, as I am informed that boys picked up the bones and sold them to rag and bone shops. Immediately it came to my knowledge that the bones were again disturbed, I communicated with the Home Office, and they were removed in proper receptacles and re-buried under proper supervision. Dairies, Cowsheds, and Milkshops Orders. At the end of the year there were in the Borough 1,125 registered premises where milk is sold, which included 33 cowsheds. 49 premises were removed from the register, due to their unsuitability, and 29 were refused registration for a similar reason. 76 premises were registered conditionally, but they were mostly transfers. Each shop was considered on its merits and certain conditions were imposed before it was registered. The conditions for every new registration generally included that— (1) The shop, milk receptacles and utensils must be kept scrupulously clean. The milk must also be kept in a cleanly condition. (2) The milk must be covered by a proper ventilated cover; paper, muslin, or a plain board is not allowed.. (3) Boxes of minerals, or other boxes, sacks, bags, &c., must not be allowed to remain on the floor, but raised on shelves at least a foot from the floor. This allows the floor to be swept, otherwise it would only be swept when the sacks or boxes became empty and dirt would accumulate under and behind them. (4) The shop floor must be swept and scrubbed frequently. (5) The shelves must be kept free from dust. (6) No paraffin, coal, coke, vegetables or Dutch herrings are to be sold. Police Court Proceedings under the Dairies, Cowsheds and Milkshops Orders. On February 23rd. Mr. Abraham Statinsky, of 75, Nelson Street, was summoned for not having his milk utensils in a clean condition. He was fined 20s., with 23s. costs. 83 On March 14th. Mrs. Jacobs, of 78, Bedford Street, was summoned for selling milk without being registered. She was fined 40s., with 23s. costs. On March 20th. Mr. Horace John Rich, of 42, Cornwall Street, was summoned for selling milk without being registered. He was fined 10s., with 12s. 6d. costs. On June 16th. the appeal of Mrs. Freedman, of 131, Jubilee Street, against the decision of the Stepney Borough Council for removing her name from the Register of Milkshops. The complainant did not appear and the appeal was dismissed. On June 16th. Mr. Tartarsky, of 2, Mulberry Street, appealed against the decision of the Stepney Borough Council for removing his name from the Register of Milkshops. The complainant did not appear and the appeal was dismissed, with £2 2s. costs against him. On June 16th. Mr. Nathan Darevinski, of 118, Jubilee Street, also made an appeal against the decision of the Council. The complainant appeared but did not wish to go on with the appeal. The appeal was dismissed with £2 2s. costs. On June 16th. Mr. Nathan Darevinski, of 118, Jubilee Street, was summoned for selling milk after his name had been removed from the Register. He was fined 7s., with 23s. costs. On June 26th Mr. Rich, of 42, Cornwall Street, was summoned for selling milk without being registered. He was fined £2, with 23s. costs. On July 11th. May Davidson, of 36, Duval Street, was summoned for selling milk without being registered. She was fined 2s. On July 12th. Mr. Morris Steinberg, of 48, Finch Street, was summoned for selling milk without being registered. He was fined 10s., with 2s. costs. On July 14th. Mr. David Thomas, of 285, Oxford Street, was summoned for using dirty milk utensils. He was fined 10s., with 12s. 6d. costs. On November 6th. Mr. Marks Frankfort, of 100, Nelson Street, was summoned for selling milk without being registered. He was fined £2, with 23s. costs. On November 7th. Mr. Joseph Shinebaum, of 13, Mount Street, was summoned for keeping his milk utensils in a dirty condition. He was fined 21s., with 23s. costs. On November 10th. Mr. James Read, of 7, Salmon Street, was summoned for selling milk without being registered. He was fined 20s., with 23s. costs. On November 21st. Mr. Henry Weintrob, of 23a. Newark Street, was summoned for selling milk without being registered. He was fined 20s., with £2 4s. 0d. costs. f 2 84 On December 5th. Mr. Simon Kossof, of 30, Langdale Street, was summoned for selling milk without being on the Register. He was fined 20s., with 23s. costs. On December 7th. Mrs. Freedman, of 131, Jubilee Street, appealed to the Magistrate against the decision of the Council for removing her name from the Milkshop Register. The case was dismissed, with £2 2s. costs against the appellant. Unsound Food Destroyed During the Year. The following foodstuffs were destroyed during the year under the Unsound Food Series and the Public Health (Foreign Meat) Regulations 1908:— At the Wharves. Tons. Cwts Qrs Lbs. Fresh Meat 7 Pigs Carcases — 4 0 7 1 Sheeps Liver — — — 2 3 Sets of Sheeps Lungs — — — 3 Preserved Meats 80 Casks of Australian Salt Beef 10 14 1 4 38,022 Tins of Beef 103 11 2 16 1,610 „ „ Rabbits 1 8 2 26 949 „ „ Tongues 1 4 0 16 73 „ „ Rabbits — 4 1 2 5 „ „ Ox Cheeks — — — 10 Fresh Fruits and Vegetables 2,401 Crates of Bananas 59 11 2 0 553 Packages of Pears 10 16 1 20 305 „ „ Apples 5 4 2 18 38 „ „ Oranges 1 18 3 0 21 „ „ Onions 1 0 2 0 8 „ „ Melons — 7 3 0 5 „ „ Tomatoes — — 3 0 2 „ „ Potatoes — 2 0 0 Dried Fruits 40 Packages of Currants 1 0 0 0 Preserved Fruits and Vegetables 16,798 Tins of Pineapples 14 13 2 0 10,694 „ ,, Assorted Fruits 11 12 3 23 3,900 „ „ Tomatoes 6 9 1 1 1,061 „ „ Fruit Pulp 5 7 0 2 1,821 „ „ Apricots 2 4 2 1 189 „ „ Pears — 4 0 15 1,149 „ „ Spinach 1 5 0 0 132 „ „ Mushrooms — 1 0 20 55 „ „ Peaches — — 3 26 26 „ „ Celery — — 2 3 85  Tons. Cwt Qrs. Lbs. Preserved Fish 10,395 „ „ Crayfish 3 14 3 2 4,326 „ „ Salmon 2 0 1 24 510 „ „ Sardines — 4 1 0 303 „ „ Lobsters — 2 3 15 251 „ „ Crabs — 2 0 27 53 ,, „ Anchovies — 1 0 18 Sundries 71 „ „ Condensed Milk — 7 2 0 14 „ „ Ox Tail Soup... — — — 19 Full Total 246 2 0 12 Diseased Meat and Offal destroyed, from the Slaughter-houses and Offalshops, under-the supervision of Mr. H. Abson, the Food Inspector:— Tons. Cwts Qrs Lbs. 5 Pigs Carcases — 3 1 23 4 Sheeps Carcases — 2 0 22 2 Calves Carcases and all Organs — 2 1 20 2 Bodies of Cow Beef and all Organs — 7 2 16 190 Sets of Bullocks Lungs — 15 2 27 60 „ „ Sheeps Lungs — — 2 20 1ll Sheeps Livers — 1 3 9 40 Bullocks Livers — 4 1 24 19 „ Heads — 5 0 14 18 „ Tripes — 2 2 20 37 „ Spleens — — 3 27 4 Cows Udders — — 1 22 1 Calfs Liver — — — 3 1 Set of Calfs Lungs — — — 1 1 Sheeps Head — — — 3 1 Loin of Beef — — — 26 1 Flank of Beef — — — 12 Total 2 8 0 9 86 Unsound Food seized or surrendered to the District Sanitary Inspectors:— Tons. Cwts. Qrs. Lbs. Apples, 31 Packages 1 2 0 0 Bananas, 4 Packages — 2 0 0 Cherries, 9 Packages — 2 0 24 Crabs, 15 Packages — — — 13 Eggs, 850 and 1 quart liquid — 1 0 10 Fish, 12 Packages — 10 2 13 Fruit, Mixed — 2 0 0 Grapes, 1 Package and 10 lbs — 3 0 10 Kippers, 16 Packages — 1 1 2 Lemons, 1 Package — 1 0 0 Livers, Bullocks, 4 — — — 22 Lobsters, 192 tins — 1 2 24 Melons, 80 Packages 4 0 0 0 Milk (condensed), 18 Packages — 9 0 0 Olives — 17 1 0 Onions, 5 Packages — 3 0 0 Oranges, 1 Package — — 2 0 Pears, 138 Packages 1 18 0 24 Plums, 1 Package — — — 24 Potatoes, 15 Packages — 14 0 12 Rabbits, 60 Packages — — 3 20 Salmon (smoked) — 8 2 25 Sausages (smoked) — 1 2 0 Sloes, 338 Packages 4 6 0 0 Strawberries, 2 Packages — — — 24 Tomatoes, 571 Packages 3 5 1 4 Total 18 12 0 27 Parasitic condition of Australian Beef (Salt), lying on a Wharf in the Borough. In the early part of 1910, the attention of the Local Government Board was drawn to the presence of certain nodular masses in frozen quarters of meat arriving in this Country from Australia. These nodules were found to contain a parasitic worm which has been described as occurring in Australian cattle under the name of Spiroptera reticulata At first, it was thought to be merely a surface affection of the flank and brisket of the forequarter, which could readily be removed by slicing away these superficial portions of the meat in which nodules were observed. Later, it was found that the nodules were also deeply situated in those parts, especially in the intermuscular fat. 87 The absence of superficial nodules was no indication that the meat was free from parasites in its deeper parts, and a careful and systematic plan of inspection was found to be necessary. As the parasites were found to be present in a large proportion of the carcase, it was decided to cut off from every forequarter while still frozen those parts to which the parasitic nodules were known to be chiefly confined, viz., the flanks and briskets. The remainder of the forequarter was then released ; the flanks and briskets were detained by the Sanitary Authority in cold store until the importer gave notice that he wished to dispose of them, either for industrial or for food purposes. If it was desired to use the detained parts purely for industrial purposes, examination of the meat would not not, of course, be called for, and it would only remain to take the necessary steps to insure that no part of this meat could be used for human consumption. If, however, the importer wished to utilise the detained flanks and briskets for food purposes, he would be required to have these parts thawed out and cut up in slices under supervision, and to have destroyed any meat which appeared unfit for human food. Few of the importers it seems availed themselves of the option of having the detained flanks and briskets examined with a view to disposing of them for food purposes. In the great majority of cases they have found it more convenient to surrender the parts in question for destruction. The situation which has arisen has naturally entailed considerable loss to the importers, who, however, have practically, without exception, realised the gravity of the matter, and have shown their willingness to comply with the requirements of the sanitary authorities. According to reports made to the Local Government Board by Dr. MacFadden and Dr. Leipir, a copy of which I received on January 13th, 1911, and from which I have extracted the above information, the Local Government Board have been informed " that steps are now being taken in Australia to provide for removal of portions of quarters affected by parasitic nodules before exportation. Provided this is done with sufficient system and under adequate supervision (including, of course, measures to prevent affected portions being utilised in other ways in the preparation of meat foods sent to this country), the procedure should have advantages from the point of British administration." Previous to receiving the above-mentioned reports, my attention was called by Mr. Abson—the Wharf Inspector—on January 2nd, 1911, to the presence of 80 casks (tierces) of salt beef on a wharf in this Borough. Each cask weighed about 3 cwt. These casks were landed on or about December 30th. The contents of the casks were examined, and found to be briskets and flanks. On a superficial examination we found that 14 per cent, of the pieces of meat were infected with the parasites. 88 I called the attention of the owners to the condition of the meat on January 3rd, and suggested that it should be destroyed or a careful examination made by boning and slicing the meat, afterwards destroying the unsound portion. I received a reply on January 5th asking that a further examination of the meat should be made. After some conversation on the telephone, I made a further examination on January 9th, and wrote to the owners that I had found the parasites present on the second examination, and I again requested that the meat should be dealt with as suggested in my letter of January 3rd. On January 14th I received a letter stating that my request will be an exceedingly expensive operation, and that the owners " are considering the question of re-shipping the whole of the parcel back to Australia. If it can be arranged, we presume there can be no objection to this course as far as your department is concerned." A similar request for re-shipment was received by me on January 19th. I replied on the same date that I would not permit them to re-ship the meat to Australia. I further iniormed them that if they could not accept either of the two suggestions made in my former letters, the only other alternative would be to have the matter dealt with by a Stipendiary Magistrate, as laid down in the Unsound Food Regulations. I afterwards saw a representative of the owners, who desired me to place the facts before the Public Health Committee, and to read the following:— " Referring to the conversation the writer had with you last week respecting the above parcel, when he asked you if the position could be reconsidered and we be allowed to re-ship it back to Australia on condition that we would give an undertaking that the meat would not find its way back to this country in any form whatever We gladly give this undertaking, and we can assure you that the authorities in Queensland are taking every precaution to prevent any brisket and flank meat being exported. " Our reason for asking permission to re-ship the goods is because we think we can make special arrangements with the Shipping Company in the matter of freight; and we have facilities for turning the product into manure, which do not exist at this end. Thereby we hope to some extent to minimise the loss, which will necessarily be heavy." The freight to Australia is probably more than the difference in the price received for it in Australia for manure, purposes and that received for it if sold for similar purposes in this country. The owners could appeal to the Magistrate, who, if satisfied that the meat will not be used for human food, could make an order for it to be re-shipped to Australia. 89 The portions affected by parasitic nodules had been removed from the rest of the carcases, and were exported to this country separate and distinct from the sound portions. The Public Health Committee, having considered all the facts, refused to grant permission to have the diseased meat returned to Australia, as there was not conclusive evidence that these briskets would not be converted into tinned meat and then re-exported into England, when the disease could not be detected by the naked eye. They were therefore destroyed. Police Court Proceedings for Selling Unsound Food. On February 8th, 1911. Mr. Wm. S. Brady, 118, Salmon Lane, was summoned for selling and exposing for sale 60 rabbits which were unfit for human food. He was fined £25 and £2 4s. costs or six weeks imprisonment. On March 30th. Mr. Adam Mahringer, of 337, Commercial Road, was summoned for having 50 eggs and 1 quart of liquid eggs which were unsound and unwholesome on his premises in the course of preparation for sale as the food of man. He was fined £2 and £3 3s. costs. On May 8th. Mr. Harris Zikrow, of 32, Wolesley Street, was summoned for exposing for sale a quantity of pears which were unsound and unfit for human food. He was fined £5 and £1 3s. costs. On September 8th. Mr. Morris Domb, of 83, Hessell Street, was summoned for having on his premises for the purpose of preparation for sale 377 eggs which were unsound and unfit for human food. He was fined £5 5s. and £3 3s. costs. On Friday, October 27th. Acting on my instructions, Mr. Abson went to a butcher's shop in Whitechapel High Street about 6.30 a.m. He saw two packages and one hamper containing meat. One package contained two pigs and the other one pig. The hamper contained seven pigs. He examined the first three pigs, and he found that the glands in the throat of one of them were very enlarged and tuberculous. The lumbar and inguinal glands were also affected with the same disease. The pig was seized, and after I had examined it, it was taken to the Thames Police Court, where it was condemned by the Magistrate. The owner, who resided in Braintree, Essex, was communicated with, and he identified the pig as belonging to him. On examining the seven pigs contained in the hamper, the glands on both sides of the throat of one pig and the glands on one side of the throat of another pig had been removed. These glands had been removed before sending the pigs to London, 90 and the suggestion was that it had been done for the purpose of removing evidence of disease. Four carcases were alright, but in the remaining one the throat and lumbar glands were extensively affected with tuberculosis. This pig was also seized and condemned by the Magistrate at the Thames Police Court. The pigs had been slaughtered in a village in Essex. Mr. Frederick Thomson, of Bocking, was fined £15 15s. and £5 5s. costs for depositing one of these diseased pigs for sale, and Mr. James John Nash, of Braintree, was fined £42 and £10 10s. costs for depositing the other diseased pig for sale. Mr. Nash had been previously fined £20 and £5 5s. costs for a similar offence in February, 1910. On Saturday, October 28th, the proprietor of the same butcher's shop in Whitechapel High Street telephoned to the Public Health Office and asked that someone should call at his place as he had put aside carcases of pigs which he thought were diseased and unfit for human food. The throat glands of two pigs were extensively affected with Tuberculosis, and the pigs were condemned by the Magistrate at the Thames Police Court on the same afternoon. The pigs belonged to Mr. James Parish, Coggeshall Hall, near Colchester, and had been sent by him to be slaughtered by Mr. Frank Garrard, of Kelvedon. The pigs were slaughtered by Mr. Gerrard at his own premises on October 26th and sent to London on the afternoon of October 27th. Mr. Parish was fined £10 10s. and £5 5s. costs for depositing the diseased pigs for sale, and Mr. Frank Gerrard was fined £20 and £5 5s. costs for aiding and abetting. In each instance the defendants stated in the witness-box that although they had heard of tuberculosis, neither of them would be able to recognise meat affected with that disease. They had no idea what a tuberculous gland would look like. It must be admitted that these admissions give rise to feelings of disquiet and even of alarm. If these admissions are honest, and I have no reason to doubt them, there is disclosed a somewhat serious state of affairs. The public naturally assume that these men are sufficiently acquainted with any evidence which may be present of such a common disease as tuberculosis in cattle, and have been led to rely upon the supposed knowledge of these men for protection against the consumption of diseased meat. Under present conditions it is obviously impossible to have every carcase examined by officers of sanitary authorities, and considerable responsibility rests on butchers and other purveyors of food. In London the question is not a difficult one except from a monetary point of view. The establishment of public abattoirs with clearing houses would ensure the 91 adequate examination of every carcase, but the question af present is more urgent in country districts than in London. Inspection of shops and other places where food is sold or prepared for sale is fairly satisfactory, but in country districts food inspection is very inadequate, and in some, even non-existent. The establishment of public abattoirs in rural districts is impracticable, if not impossible, and the solution of the problem is probably in the direction of licensing suitable and experienced men as slaughterers. A licensed slaughterman could always be under the control of a constituted authority, and as the license would presuppose a certain amount of knowledge of the more commonly diseased conditions in cattle, there would be no excuse for ignorance. I am well aware of the objections that suitable men could not be obtained in country districts. The same objection was raised when the licensing of midwives was proposed, but by the help of grants from County Councils and other authorities there has been no dearth of midwives in country districts, and no one now denies the benefits which have accrued from the passing of the Midwives Act. Possibly at the commencement there would be a difficulty in obtaining suitable men as licensed slaughterers, but the demand usually creates a supply. General Sanitary Work. In the Sanitary Inspectors' Report table will be found the amount of work carried out by each Inspector during the year, together with its nature. 42,883 houses were inspected, 5,6'21 being the result of house to house inspection. 14,719 intimation notices were served for the abatement of various nuisances, for which it was necessary to serve 6,089 statutory notices before the defects vere remedied. 70,893 re-visits were made to supervise the abatement of the nuisances complained of. 1,210 visits were made to the houses of consumptive people who had been notified to be suffering from that disease. Police Court proceedings were taken in 72 instances where the statutory notices were disregarded. This number does not, of course, include proceedings under the Food and Drugs Acts. 8,876 drains were tested with smoke, and 2,533 were either constructed or re-constructed, cleansed or repaired, and 956 were trapped. 292 new soil pipes were fixed and ventilated ; 1,830 new closet pans and traps were fixed, and 2,240 closets were either cleansed and repaired or provided 92 with additional light and ventilation, as well as 2,074 water closets provided with proper flushing apparatus. 3,503 yards, forecourts and areas were paved or repaired. Notices were served to provide 1,569 sanitary dust receptacles ; 37 manure receptacles were provided; 644 offensive accumulations were removed from the rear of dwelling houses. 605 houses were ventilated underneath the lower floor. 62 underground rooms, which were illegally occupied, were discontinued from being used as such. 70 notices were served for the abatement of smoke nuisances. 364 bakehouses were visited and 293 cleansing notices served. 4,155 notices were served to have houses cleansed, and water supply was reinstated to 161 houses. 440 sink, bath or rainwater pipes, which were communicating directly with the drains, were disconnected. 5,875 miscellaneous repairs to roofs, floors, gutters, &c., were made as the result of notices served. 748 damp walls were remedied, and 115 rooms were provided with additional light and ventilation. The nuisance due to the keeping of too many animals in back yards was abated in 119 houses. Overcrowding. 17,442 Inspections were specially made for the purpose of detecting overcrowding, and 548 living rooms were found to be overcrowded. 631 intimation notices were served for the abatement of the nuisance and 174 statutory notices. It was only necessary to take Police Court proceedings in one instance. Police Court Proceedings under the London County Council (General Powers) Act, 1908. On March 30th. Mr. Adam Mahringer, of 337, Commercial Road, was summoned for keeping butter and other materials intended for the food of man in a store attached to a bakehouse where due cleanliness was not observed. He was fined 20s., with 42s. costs. SANITARY INSPECTORS' REPORT. TWAITS. JOHNSON. WRACK. COOK. PAVITT. CROOK. MILLS. SHEPHERD. WHITE. FLINT. SIMPSON. QUAINTRELL. STILES. DEE. WATERMAN. HARRIS. BOTTOMLEY. TOTALS. Number of Inspections— House to house 339 217 316 355 149 206 350 476 436 637 455 582 281 553 269 .. .. 5621 Miscellaneous 2015 2044 1500 1315 1803 1422 2135 1918 1804 1115 1800 1837 1882 1436 2027 1578 1922 29553 Complaints 73 161 231 270 169 249 223 140 115 108 45 143 245 82 110 149 8 2521 Infectious diseases 318 275 241 261 250 786 338 139 162 168 218 178 198 189 257 .. .. 3978 Visits to Cases of Consumption 65 71 75 96 107 126 99 64 73 76 83 99 47 62 67 .. .. 1210 Intimations served 740 1071 682 763 850 711 1243 968 696 702 966 571 1346 733 862 840 975 14719 Statutory notices served 542 656 123 450 548 496 885 120 441 549 736 98 629 116 146 78 76 6689 Houses re-visited 4813 5360 3704 3768 5706 3920 4231 3551 3791 3267 5102 2570 4655 3290 4368 3676 5121 70893 Summonses taken out under the Public Health (London) Act, 1891 3 1 .. 1 8 3 27 .. 3 2 3 4 6 1 1 5 4 72 Samples taken under the Food & Drugs Acts 100 72 111 97 100 101 92 73 72 72 110 72 72 42 72 .. .. 1257 Summonses „ ,, ,, ,, 12 .. 5 7 15 14 2 7 5 .. 3 3 .. .. 3 .. .. 83 Houses or parts of houses cleansed 178 363 203 312 104 135 319 242 272 193 269 132 221 316 236 277 384 4155 Water supply to houses re-instated 13 26 7 8 10 5 5 4 5 7 11 20 23 2 11 1 3 161 Drains constructed and reconstructed 250 32 17 12 200 50 81 20 37 10 99 30 52 62 117 .. 20 1089 ,, cleansed and repaired 49 144 89 71 153 140 64 47 62 47 109 82 127 48 84 49 79 1444 ,, trapped 268 47 53 41 16 15 316 16 33 12 16 12 38 3 70 .. .. 956 New soil pipes fixed and ventilated 7 40 9 18 19 42 44 6 3 3 12 30 9 50 .. .. 292 New closet pans and traps fixed 262 63 59 162 224 140 204 77 79 10 156 48 71 86 157 12 20 1830 Closets provided with a water supply and flushing apparatus 83 147 68 214 44 115 285 113 69 19 183 57 172 145 248 93 19 2074 Closets provided with light and ventilation 9 32 •• 11 24 14 34 3 4 3 2 3 14 4 6 .. 163 ,, cleansed and repaired 29 166 169 154 12 104 165 190 73 89 166 36 79 238 144 165 98 2077 Yards cleansed, repaved, or paving repaired 365 221 44 128 263 204 182 201 143 7 7 218 99 90 381 284 60 113 3073 Wash-houses, forecourts, areas, &c., paved 79 42 17 17 31 10 55 20 16 9 17 29 33 39 5 11 430 Sanitary dust receptacles provided 144 176 58 32 132 55 78 75 32 41 181 143 76 81 118 57 90 1569 Sink, bath, and lavatory pipes and rain-water pipes disconnected 65 76 35 16 16 12 49 8 9 4 14 7 4 29 96 .. .. 440 Houses ventilated under lower floor 259 12 8 38 9 10 9 23 7 8 4 3 44 137 33 .. 1 605 Miscellaneous repairs, viz.: roofs, floors, gutters, &c. 138 652 221 254 216 290 369 373 362 301 455 329 789 157 421 264 284 5875 Overcrowding in dwelling rooms abated 9 6 8 32 18 6 81 18 35 14 20 14 70 28 36 68 80 543 Illegal occupation of underground rooms discontinued 2 6 2 2 2 12 2 , , 3 1 .. 1 8 2 .. 9 52 Manure receptacles provided or reconstructed . . 9 4 3 1 3 2 2 1 .. 2 3 1 2 4 .. .. 37 Offensive accumulations removed 9 19 115 62 6 7 89 67 9 17 18 52 29 31 66 22 26 644 Bakehouses inspected 30 30 26 22 22 34 28 30 10 22 24 28 32 8 18 .. .. 364 ,, cleansed 30 15 26 11 22 12 28 13 10 22 24 28 32 8 12 .. .. 293 Smoke nuisances abated 2 7 9 .. .. 1 4 3 10 8 2 4 6 12 2 .. .. 70 Animals kept so as to constitute a nuisance, removed 2 2 2 15 .. 7 19 6 .. 4 11 .. 12 5 14 13 7 119 Damp walls remedied 21 87 10 35 45 10 54 23 29 31 17 11 89 161 89 8 27 748 Cisterns removed or cleansed and covered 18 .. 10 2 7 9 10 10 .. 3 3 1 11 10 29 2 6 131 Urinals fixed 6 .. .. .. .. .. 1 .. .. 1 2 .. .. .. 4 .. .. 14 Open fires in yards abolished .. .. .. 3 2 4 11 3 .. 6 .. .. 3 .. .. .. .. 32 Canal Boats inspected .. 83 .. .. .. .. .. .. .. .. .. .. .. .. .. 83 Areas and stables paved and drained 16 2 .. 7 .. 1 13 .. .. 3 .. 7 .. 2 6 .. .. 57 Occupation of shed as dwelling discontinued .. .. .. .. .. 1 .. .. .. .. .. 1 .. .. .. .. 2 Light and ventilation provided to rooms .. 5 .. 5 .. 6 27 .. .. 10 .. .. 11 17 15 14 5 115 93 On May 17th. Mr. Morris Harris, a Restaurant Keeper, of 169, Commercial Road, was summoned for not observing due cleanliness in his store room where meat was prepared for sale as human food. He was fined 17s., with 23s. costs. On May 17th. Mr. Lewis Rosenberg, a Restaurant Keeper, of 62, Mile End Road, was summoned for not observing due cleanliness in his store room where meat was prepared for sale as human food. He was fined 10s., with 23s. costs. On July 21st. Mr. Davis Rosenblatt, of 56, Gold Street, was summoned for having his fish shop in a dirty condition. He was fined 20s. with 23s. costs. On July 24th. Mr. Harry Hoffeneister, of 198, Mile End Road, was summoned for having his factory premises where human food was prepared in a dirty condition. He was severely cautioned by the Magistrate and ordered to pay 23s. costs. On July 31st. Mr. Israel Solomon, of 18, Heneage Street, was summoned for preparing food for man in dirty and unsuitable premises. He was fined 20s., with 23s. costs. On September 29th. Mr. Abraham Feldman, of 362, Mile End Road, was summoned for keeping the shop occupied by him (butcher's) in a dirty condition. He was fined 20s. and £2 2s. costs. On October 27th. Mr. Joseph Goide of 72, Commercial Street, was summoned for allowing the flooring of his bakehouse to be in a filthy condition. He was fined 20s., with 23s. costs. Police Court Proceedings under the Public Health (London) Act, 1891. On January 30th. Miss R. Joseph, of 5, King Edward Road, South Hackney, was summoned for failing to abate a nuisance at 510a, Mile End Road. An order was made to carry out the work within 10 days, with 27s. costs. On January 30th. Miss R. Joseph, of 5, King Edward Road, South Hachney, was summoned for failing to pave a yard at the above premises (510a, Mile End Road), the summons was adjourned for 14 days, and withdrawn on the completion of the work. On February 13th. The owner of the Paragon Music Hall, was summoned for not complying with the Council's order to remedy the defective condition of the drains, etc. A Solicitor attended the Court and gave an undertaking to close the premises until the defective drains were remedied. The case was adjourned sine die. 94 On March 14th. The owner of Newman's Buildings, Short Street, was summoned for not complying with the Council's notice to re-instate the rain water pipes and eaves gutters. An order was made to do the work in 7 days, with 40s. costs. On April 18th. Mr. A. Cohen, of 127, Whitechapel Road, was summoned for the [defective drainage of 8, Finch Street. An order was made to abate the nuisance in 7 days with £6 6s. costs. On April 18th. Mr. A. Cohen, of 127, Whitechapel Road, was summoned for the defective drainage of 6, Finch Street. An order was made to abate the nuisance in 7 days with 2s. costs. On April 18th. Mr. A. Cohen, of 127, Whitechapel Road, was summoned for the defective drainage of 10, Finch Street. An order was made to abate the nui-ance in 14 days with 2s. costs. On April 18th. Mr. A. Cohen, of 127, Whitechapel Road, was summoned for the defective drainage of 12, Finch Street. An order was made to abate the nuisance in 14 days, with 2s. costs. On April 18th. Mr. A. Cohen, of 127, Whitechapel Road, was summoned for the defective drainage, of 7, Frostic Place. An order was made to abate the nuisance in 14 days, with 2s. costs. On April 18th. Mr. A. Cohen, of 127, Whitechapel Road, was summoned for the defective drainage of 8, Frostic Place, An order was made to abate the nuisance in 14 days, with 2s. costs. On April 19th. Miss R. Joseph, of 5, King Edward Road, was summoned for failing to abate a nuisance at 35, Longfellow Road. An order was made to abate the nuisance in 5 days, with 12s. 6d. costs. On April 19th. Miss R. Joseph, of 5, King Edward Road, Hackney, was summoned for failing to pave a yard at 35, Longfellow Road. She was find 20s., with 23s. costs or 10 days' imprisonment in default of distress. On April 19th. Miss R. Joseph, of 5, King Edward Road, Hackney, was summoned for failing to provide an ashpit at 35, Longfellow Road. She was 20s,, with 23s. costs or 10 days' imprisonment in default of distress. On April 19th. Miss R. Joseph, of 5. King Edward Road, Hackney, was summoned for failing to pave a yard at 36, Longfellow Road. She was fined 20s., with 23s. costs or 10 days' imprisonment in default of distress, On April 26th. The Owner of 23 and 24, Frostic Mansions, Old Montague Street, Mrs. R. Specterman, of 320, Commercial Road, was summoned for failing 95 to abate a nuisance arising from the defective condition of the roof. An order was made to abate the nuisance in 24 hours, with £2 2s. costs. On May 15th. The Owner of 16, Gt. Alie Street, was summoned for a nuisance caused by a stopped drain. The " Owner" was fined 40s., with 27s. costs, and an order was made to abate the nuisance in 7 days. On 9th June. The owner of 173, St. George Street was summoned for failing to abate a nuisance arising from the defective condition of the roof at the above premises. An order was made to abate the nuisance in 7 days, with £2 8s. costs. On June 9th. Mr. F. H. Seddon, the owner of 105, Coutts Road, was summoned for failing to abate a nuisance arising from a defective drain. An order was made to abate the nuisance in 21 days with £2 4s. costs. On June 21st. Mr. Jacob Koproff, of 51, Brick Lane, was summoned for failing to abate a nuisance arising from the foul and offensive condition of fish boxes and barrows. An order was made to abate the nuisance in 7 days, with 10s. costs. A recurring order was also made. On June 28th. Mr. Barnett Rudkinsky, of 30, Finch Street, was summoned for disobeying a Prohibition Order made on the Gth October, 1910, for abating the nuisance arising from the foul p.nd offensive condition of fish barrows. He was fined £2, with 2s. costs. On July 17th. Messrs. Hall & Newman, of 107, Bishopsgate, E.C., the owner of 157, Cannon Street Road, were summoned for failing to comply with the Council's notice with respect to the W.C. being without a sufficient water supply. They were fined, 40s., with 23s. costs. On July 17th. Messrs. Hall & Newman, of 107, Bishopsgate, E.C., were summoned for failing to pave a yard at 173, Cannon Street Road. They were fined 20s,, with 23s. costs. On July 17th. Messrs. Hall & Newman, of 107, Bishopsgate, E.C., were summoned for not keeping the W.C. in a proper slate of repair at 177, Cannon Street Road. They were fined 20s., with 23s. costs. On July 18th. The owner of 59, Wilkes Street, was summoned for failing to abate the nuisance due to the walls of the basement rooms being damp and the flooring being on the bare earth. An order was made to abate the nuisance in 21 days, with 23s. costs On July 18th. The owner of 75, Hanbury Street, was summoned for failing to abate a nuisance due to the eaves gutters and rain water pipe of the back addition being defective, and the roof of the house being in a defective condition. An order was made to abate the nuisance in 7 days. 96 On July 18th. The owner of 77, Hanbury Street, was summoned for failing to abate various nuisances arising from the defective drainage, the stables not being properly paved and drained, and not removing an accumulation of manure from the above premises. An order was made to abate the nuisance in 28 days. On July 24th. Mr. W. Carter, 84, Mile En 1 Road, was summoned for failing to abate a nuisance arising: from the defective roof of 32, Wicker Street. The work having been done at the hearing of the summons, he was ordered to pay 44s. costs. On July 24th. Mr. W. Carter, of 84, Mile End Road, was summoned for failing to maintain the yard at 32, Wicker Street in good order and condition. The work having been done at the hearing of the summons, he was ordered to pay 23s. costs. On July 31st. Messrs. Hall & Newman were summoned for the defective condition of the W.C. of 26, Heneage Street. They were fined 20s., with 23s. costs On August 31st. The owner of 547, Commercial Road, was summoned for not complying with the Council's notice to abate a nuisance and to provide a dust receptacle. The notice having been complied with before the hearing of the summons, he was fined 7s., with 46s. costs. On September 15th. The owner of 13, Old Church Road was summoned for not complying with the Council's notice to abate a nuisance The work being in hand at the hearing of the summons, an order was made to abate the nuisance in 7 days with 27s. costs. On September 15th. The owner of 23, Old Church Road was summoned for not complying with the Council's notice to abate a nuisance. The work being in hand at the hearing of the summons, an order was made to abate the nuisance in 7 days, with 27s. costs. On September 8th. Mr. Specterman, of 320, Commercial Road, was summoned for failing to abate a nuisance at 14, Kinder Street, arising from the defective condition of the roof of house. He was fined 7s. and 23s. costs. On September 15th the owner of 31, Old Church Road, was summoned for not complying with the Council's notices to abate various nuisances. The work being completed at the hearing of the summons, he was fined 20s., with 23s. costs. On September 27th. Messrs. Hall & Newman, 107, Bishopsgate, E.C, were summoned for failing to remedy the defective drainage of 31, Old Montague Street. The Magistrate made an order to abate the nuisance within seven days, with 27s. costs. On September 27th. Messrs. Hall & Newman, of 107, Bishopsgate, E.C., were summoned for failing to remedy the defective drainage of 33, Old Montague Street. An order was made to abate the nuisance in 14 days, with 27s. costs. 97 On September 27th. Messrs. Hall & Newman, of 107, Bishopsgate, E.C., were summoned for failing to remedy the defective drainage, defective rain water pipe eaves gutter at the rear and on the back addition roof of 35, Old Montague Street. The Magistrate made an order to abate the nuisance in seven days with 27s. costs. On September 29th. Mr. Abraham Feldman, of 362, Mile End Road, was summoned for non-compliance with a notice served to abate a nuisance caused by the improper keeping of animals. The Magistrate made an order to abate the nuisance within seven days, with 27s. costs. On October 5th. Mr. Jacob Koproff, of 51, Brick Lane, Spitalfields, was summoned for non-compliance of abatement order made on June 21st, 1911, for the foul and offensive condition of fish barrows. He was fined £2 and 23s. costs. On October 5th. Mr. Phillip Rueben, of 21, Elder Street, Norton Folgate, was summoned for non-compliance with an abatement order made 14th July, 1910, for the foul and offensive condition of fish barrows at 15, Old Montague Street, Whitechapel. He was fined £2 and 23s. costs. On October 26th. Messrs. Hall & Newman, of 107, Bishopsgate, were summoned for failing to abate a nuisance due to the defective condition of the roof, at 22, Finch Street. An order was made to do the necessary work in 14 days, with 23s. 3osts. On October 31st. The owner of 11, Ronald Street, was summoned for failing to remedy a nuisance arising from the defective condition ot the drain. An order was made to do the work in 21 days with 27s. costs. On October 31st. The owner of 5, Pier Head, Wapping, was summoned for non-compliance with the Council's notice to abate a nuisance due to a defective soil pipe. The case was adjourned to enable the Port of London Authority to do the work, they agreeing to pay the costs (£2 5s.) On November 9th. Mrs. R. Specterman, of 320, Commercial Road, was summoned for failing to abate a nuisance arising from the defective yard paving, as well as from the defective condition of the roof of the workshop at 15, Old Montague Street. The Magistrate made an order to abate the nuisance in 10 days, with 23s. costs. On November 9th. Mrs. R. Specterman, of 320, Commercial Road, was summoned for failing to remedy the defective condition of the roof of 21, Old Montague Street. The Magistrate made an order to abate the nuisance in 10 days, with 23s. costs. On December 29th. Messrs. Hall & Newman, of 107. Bishopsgate, were summoned for failing to remedy the defective condition of the roof of 15, Frostic Mansions. The work having been done at the hearing of the summons, they were fined 1s. with 21s. costs. G 98 On December 29th. Messrs. Hall & Newman, ef 107, Bishopsgate, were summoned for failing to remedy a nuisance arising from the defective connection of the flush pipe to the W.C. pan at 9, Old Montague Street. The work having been completed on the day of the hearing of the summons, the defendants were fined 1s. with 21s. costs. On December 29th. Messrs. Hall & Newman, of 107, Bishopsgate, were summoned for failing to comply with notices to abate nuisances due to the walls and ceilings of the back basement room, the passage and staircase being dirty and dilapidated, and the connection of the flush pipe to the W.C. pan being defective at 29, Old Montague Street. The work having been done at the hearing of the summons, the defendants were fined 1s., with 21s. costs. On December 29th. Mrs. R. Specterman, of 320, Commercial Road, was summoned for disobeying the Magistrates' order, made on November 9th, with regard to 15, Old Montague Street. The work having been done, the defendant was fined 1s., with 21s. costs. On December 29th. Mrs. R. Specterman, the owner of 21, Old Montague Street, was summoned for disobeying the Magistrate's order, made on November 9th. The work having been done, the defendant was fined Is., with 21s. costs. Police Court Proceedings under the Metropolis Local Management Act, 1855. On May 11th. Mr. F. Harmer, of 128, 130, Long Lane, Borough, was summoned for constructing at 38, Mile End Road, a new drain and building (a water closet) contrary to the London County Council's bye-laws, also without giving notice to the Sanitary Authority. He was fined £3, with 42s. costs. On July 7th. Mr. Robert Stone, of 37, Cadogan Terrace, was summoned for constructing a new drain at 108, Commercial Road, without previously having obtained the consent of the Council. He was fined 20s., with 23s. costs. On July 17th. Messrs. Hind & Son were summoned for failing to comply with the Council's notice to maintain the drain in good order and condition at 85, Grove Street. They were fined 40s., with 23s. costs. On July 18th. Mr. A. Cohen was summoned for failing to comply with the Council's notice to maintain the drain in good order and condition at 28, Fairclough Street. He was fined 40s., with 23s. costs. Police Court proceedings under the London County Council Bye-laws made under Sec. 16 of the Public Health (London) Act, 1891. On October 11th. Mr. Harry Slater, of 109, Rosher Road, Stratford, was summoned for removing offensive matter through the streets during prohibited hours. He was fined 10s. and 12s. costs. 99 On Octobcr 11th. Mr. Richard Waddington, of Marsh Gate Lane, Stratford, was summoned for removing offensive matter in improper utensils. He was fined 10s. and 12s. costs. On October 24th. Mr. James Woodward, of 75, Hungerford Road, Islington, was summoned for causing offensive matter to be conveyed during prohibited hours and in improper receptacles through Commercial Road. He was fined 10s., with 23s. costs. On October 24th. Mr. William Kerridge, of 75, Bride Street, Islington, was summoned for conveying offensive matter in improper receptacles through the streets. He was fined 5s., with 15s. costs. On November 10th. Mr. Thomas Webb, of 170, Abbey Road, Barking, was summoned for removing fish offal from 125, Bridge Street, during prohibited hours. He was fined 40s., with 23s. costs. December 1st. Mr. Richard Taylor, of 33, Robinson Road, N.E., was summoned for carrying offensive matter in improper receptacles through the streets. He was fined £4 and 23s. costs. Police-Court Proceedings under the London County Council (General Powers) Act, 1904. On July 17th. Messrs. Hall & Newman, 107, Bishopsgate, E.C., were summoned for failing to cleanse a verminous room at 155, Cannon Street Road. They were fined 10s., with 44s. costs. On July 31st. Messrs. Hall & Newman were summoned for failing to cleanse a verminous room at 28, Heneage Street. They were fined 40s., with 23s. costs. On July 31st. Messrs. Hall & Newman were summoned for failing to cleanse a verminous room at 32, Heneage Street. They were fined 40s., with 23s. costs. Police Court Proceedings for the abatement of Overcrowding. On July 31st. Mr. Isaac Franks, 15, New Court, Fashion Street, was summoned for failing to abate a nuisance arising from overcrowding. An order was made to abate the nuisance within seven days. Public Analyst's Annual Report. During the year 1911, 1,257 Samples were examined under the Sale of Food and Drugs Acts, consisting of:—931 Milks, 5 Separated Milks, 5 Skimmed Milks, 178 Butters, 5 Milk-blended Butters, 7 Margarines, 1 Cheese, 2 Lards, 4 Cocoas 22 Coffees, 24 Mustards, 38 Peppers, 1 Oatmeal, 8 Rices, 2 Sagos, 3 Baking G 2 100 Powders, 3 Jams, 1 Golden Syrup, 1 Wine, 3 Bees Waxes, 11 Blaud's Pills, 2 crushed linseed. 139 Samples, or 11.1 per cent, were found to be adulterated. These consisted of:—107 Milks, 1 Separated Milk, 1 Skimmed Milk, 15 Butters, 3 Cocoas, 3 Coffees, 1 Pepper, 1 Bees Wax, 7 Blaud's Pills. Proceedings were taken in 73 cases. The total fines secured on the prosecutions was £315 4s. 0d., and £68 8s. 6d. was allowed in costs. The average fine secured on the piosecutions was £4 6s. 4¼d. Compared with the last io years, the adulteration, &c., was as follows:— YEAR. Samples Examined. Number Adulterated. Number of Prosecutions. Percentage of Adulteration. percentage of Prosecutions. Amount secured in Fines. Average Fines. £ s. d £ s. d 1902 1187 260 118 21.9 99 220 15 0 1 17 4 1903 1171 214 88 18.3 7.5 175 18 0 1 19 11½ 1904 1191 190 58 15.9 4.9 131 11 0 2 5 4¼ 1905 1176 187 76 15.9 6.5 137 11 i | 1 16 2¼ 1906 1147 241 122 21.0 10.6 252 3 o 2 1 4 1907 1208 219 77 18.1 6.4 129 9 0 1 13 6 1908 1210 190 84 15.7 7.0 301 4 0 3 11 8½ 1909 1203 140 75 11.6 6.2 342 7 0 4 11 3½ 1910 1222 155 75 12.7 6.1 298 16 0 3 19 8 1911 1257 139 73 11.1 5.8 315 4 0 4 6 4¼ Average for the 10 years 1197 193 85 16.2 7.1 230 9 10 2 16 3¼ Sunday Samples. 96 Samples were taken on 17 Sundays, 95 Milks and 1 Butters; 13 Milks and the Butter were adulterated, and 8 prosecutions resulted. The adulteration of Sunday samples was at the rate of 14.6 per cent. Unofficial Samples. 232 Samples which were purchased formally by the Inspectors were examined. These consisted of 61 Milks, 147 Butters, 1 Margarine, 3 Coffees, 1 Bread, 1 Ground Almonds, 16 Blaud's Pills, 1 Camphorated Oil, 1 Bees Wax. Of these, 93 samples, or 40T per cent., were found to be adulterated consisting of :—36 Milks, 49 Butters, 5 Blaud's Pills, 1 Bees Wax, 2 Coffees. 101 63 Samples were submitted for analysis by the General Public, consisting of:— 50 Milks, 6 Butters, 1 Cheese, 1 Milk Powder, 4 Flours, 1 Ground Almonds. Of these, 17 Samples or 27.3 per cent., were found to be adulterated, consisting of 16 Milks, 1 Butter. Pearl-Coated Pills. 27 samples of Blaud's Pills were obtained for examination, 11 being purchased officially and the remainder informally. The majority of these pills were of the variety known as " Pearl-Coated." " Pearl-Coating " for pills appears to have been first used about 25 years ago and rapidly gained favour with some makers, probably owing to the portability and improved appearance of the finished article. The coating consists of Magnesium Silicate, commonly called Talc or Steatite. The amount in each pill varied, but in some cases it was as much as 40 per cent, of the pill, the actual amount by weight being 3 grains. In 8 cases talc had been incorporated with the pill mass and 4 were slightly deficient in Carbonate of Iron. The facts were reported to the Public Health Committee, and after due consideration it was decided not to take proceedings in the Police Court against the vendors. Experiments were conducted in the laboratory to ascertain how these pills would be acted upon by the gastric juice. Artificial digestion experiments showed that the coating was broken up into irregular and insoluble masses. Under the microscope the fine portion was transparent and angular, and had the appearance of finely powdered glass. The ingestion of such inert siliceous matter by persons with delicate digestive organs, must be attended with some amount of danger. The popularity of Blaud's pills is largely due to the fact that the " iron " which they contain is present in an absorbable and non-astringent form. It may thus be taken by persons whose stomachs would be too sensitive to retain and utilise some of the other preparations of iron. Indeed it may be said that in many instances digestive disturbances are present, either secondary to the Anaemia or as a primary cause of the anaemic condition. The ingestion of a not inconsiderable quantity of insoluble non-digestible and non-absorbable substance like magnesium silicate, must aggravate a condition of the stomach and bowels, and nullify any beneficial effects of the " iron." It may even cause serious injury by its mechanical action. In 1909, the Local Government Board in a pamphlet called attention to the growing habit of polishing cereals, such as rice, with talc, and the danger to health which might result from the use of rice so treated, and The Lancet, June 18th, 1910, contains the report of a case of Pancreatic Calculus in a man attributed to the consumption of rice polished with talc. 102 STATISTICS OF ADULTERATIONS FOR THE YEAR 1911. Nature of Sample. Number Examined. Number Adulterated. Number of Prosecutions. Percentage of Adulterations. Percentage of Prosecutions. Milk 931 107 57 11.5 6.1 Milk (separated) 5 1 ... 20.0 ... Milk (skimmed) 5 1 ... 20.0 ... Butter 178 15 13 8.4 7.3 Butter (milk blended) 5 ... ... ... ... Margarine 7 ... ... ... ... Cheese 1 ... ... ... ... Lard 2 ... ... ... ... Cocoa 4 3 ... 75.0 ... Coffee 22 3 3 13.7 13.7 Mustard 24 ... ... ... ... Pepper 38 1 ... 2.7 ... Oatmeal 1 ... ... ... ... Rice 8 ... ... ... ... Sago 2 ... ... ... ... Baking Powder 3 • • • ... ... ... Jam 3 ... ... ... ... Golden Syrup 1 ... ... ... ... Wine 1 ... ... ... ... Bees Wax 3 1 ... 33.3 ... Blaud's Pills 11 7 ... 63.6 ... Crushed Linseed 2 ... ... ... ... Total 1,257 139 73 11.1 5.8 District. Whitechapel 372 34 20 9.1 5.4 St. George's 258 22 10 8.5 3.8 Limehouse 216 22 5 10.2 2.3 Mile End 411 61 38 14.8 9.2 Total 1,257 139 73 11.1 5 8 103 SAMPLES TAKEN BY INSPECTORS DURING THE YEAR 1911. Nature of Sample. Inspector— J- Johnson. H. Quaintrell. R. H. Waterman. J. Twaits. G. O. Pavitt. E. T. Crook. R. Simpson. A. W. Stiles. J. White. 1 E. W. Flint. T. W. Dee. T. P. Wrack. H. Mills. A. Cook. W. Shepherd. TOTAL. Milk 38 37 47 80 79 88 100 63 51 36 32 97 63 80 55 941 Butter ... 19 10 6 14 11 6 6 6 14 23 2 14 28 13 11 183 Margarine ... ... 2 2 ... 1 1 ... ... ... ... 1 ... ... ... ... 7 Cheese ... ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 1 Lard ... ... ... 1 ... ... ... ... ... ... ... 1 ... ... ... ... 2 Cocoa ... 2 ... ... ... 1 ... ... ... ... ... ... ... ... 1 ... 4 Coffee ... 4 2 5 3 2 3 ... ... ... ... ... ... 1 1 1 22 Mustard ... 5 7 3 ... 1 ... 9 ... ... ... 2 ... ... ... 2 24 Pepper ... 5 8 5 1 1 3 1 6 4 ... ... 2 2 38 Oatmeal ... ... ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 1 Rice ... ... ... ... ... ... ... ... ... ... 8 ... ... ... ... ... 8 Sago ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... ... 2 Baking Powder ... ... ... ... ... ... ... ... ... ... 3 ... ... ... ... ... 3 Jam ... ... ... ... ... 3 ... ... ... ... ... ... ... ... ... ... 3 Golden-Syrup ... ... ... ... ... 1 ... ... ... ... ... ... ... ... ... ... 1 Wine ... ... ... ... ... ... ... 1 ... ... ... ... ... ... ... ... 1 Drugs ... 4 6 1 ... ... ... ... 3 1 ... ... ... ... ... 1 16 Total ... 72 72 72 100 100 101 110 72 73 71 42 111 92 97 72 1257 104 In addition to the samples already enumerated, 57 other samples of various descriptions were examined in the Laboratory during the year, consisting of:— For the Public Health Department— 1 Sample of Milk. 1 Sample of Sterilised Milk. 5 Samples of Water. 3 Samples of Bread. 1 Sample of Jam. 1 Sample of Cheese. 3 Samples of Ginger Beer. 3 Samples of Desiccated Cocoa-nut. 1 Sample of Milk Powder. 1 Sample of Liquid Eggs. 1 Sample of Carbolic Fluid. 1 Sample of Carbolic Powder. For the Electrical Department— 3 Samples of Lubricating Oil. 9 Samples of Boiler Covering Composition. 1 Sample of Flue Corrosion. 8 Samples of Arc Carbons. 2 Samples of Carbon Dust. For the Works Department— 11 Samples of Carbolic Fluid. 1 Sample of Carbolic Powder. 105 RESULT OF INSPECTORS' WORK UNDER THE SALE OF FOOD AND DRUGS ACTS DURING THE YEAR 1911. INSPECTOR. Samples taken. Number Adulterated. Number of Prosecutions. Fines Secured. Costs Allowed. J. W. Johnson 72 7 0 £ 0 s. 0 d. 0 £ 0 s. 0 d. 0 H. Quaintrell 72 6 3 3 0 0 2 6 0 R. H. Waterman 72 9 2 2 12 0 2 6 0 J. Tvvaits 100 16 10 38 0 0 9 4 0 G. O. Pavitt 100 18 12 44 7 0 11 4 0 E. T. Crook 101 21 14 148 0 0 16 4 6 R. Simpson 110 6 2 6 0 0 4 6 0 A. W. Stiles 72 9 9 1 0 0 1 3 0 J. White 73 4 3 15 0 0 3 17 0 E. W. Flint 71 3 2 1 5 0 1 3 0 T. W. Dee 42 6 3 1 10 0 3 9 0 T. P. Wrack 111 10 5 23 10 0 5 15 0 H. Mills 92 4 2 4 0 0 1 15 6 A. Cook 97 13 6 10 0 0 4 12 0 W. Shepherd 72 7 7 17 0 0 1 3 0 Total 1,257 139 73 315 4 0 68 8 6 106 ARTICLES ADULTERATED. Number. Article. Adulteration. Result. 2.B. Blaud's Pills 8 per cent. foreign mineral matter No action. 3.B. Blaud's Pills 12 „ „ „ No action. LA. Blaud's 11 „ „ „ No action. l.H. Blaud's Pills 5 ,, deficient in carbonate of iron No action. 2.H. Blaud's Pills 11 ,, foreign mineral matter No action. 3.H. Blaud's Pills 5 ,, deficient in carbonate of iron No action. l.J. Blaud's Pills 10 ,, foreign mineral matter No action. 3.D. Milk 4 „ added water Caution. 4.D. Butter 80 ,, foreign fat £10 fine, 23s. costs. 5.D. Butter 10 „ „ £2 fine, 23s. costs. 2E. Milk 8 ,, deficient in fat £1 fine, 23s. costs. 4.E. Butter 20 ,, foreign fat Caution. l.N. Milk 6 „ deficient in fat 23s. costs. 7.E. Milk 23 „ added water £5 fine. 6.D. Milk 24 „ „ £5 fine. 8.E. Milk 34 „ „ £20 fine and £3 3s. 9.E. Milk 13 „ „ costs. 5.G. Milk 4 „ „ Caution. 6.G. Milk 3 „ „ Caution. 7.G. Milk 2 „ „ Caution. 4.S. Milk 7 „ „ £4 fine. 7.S. Milk 19 „ „ £2 fine. 3.F. Milk 13 „ „ £10 fine, 23s. costs. 6.F. Butter Margarine £10 fine, 23s. costs. 10.E. Milk 10 per cent, added water 30s. fine. 9.G. Milk 3 ,, deficient in fat Caution. I4.D. Milk 17 ,, added water 30s. fine, 23s. costs. 15.L. Milk 5 „ deficient in fat Caution. 16.L. Milk 2 „ added water Caution. 17.L. Milk 9 „ „ 30s. fine, 23s. costs. 22.L. Milk 14 „ „ £15 fine, 23s. costs. 24.L. Milk 3 „ „ Caution. 7.F. Milk 23 ,, ,, £50 fine, £3 3s. costs. 8.F. Milk 11 „ „ £1 fine, 12s. 6d. costs. 14.E. Milk 3 „ deficient in fat Caution. 30. L. Milk 3 „ added water Caution. 31.L. Milk 24 „ „ £2 fine, 23s. costs. 18.N. Butter 13 ,, excess of water £3 fine. 19.N. Milk 3 ,, deficient in fat Caution. 3.C. Milk 3 „ „ „ Caution. 36.L. Milk 4 „ added water Caution. 37.L. Milk 7 „ „ £1 fine, 23s. costs. ll.F. Milk 4 „ „ Caution. 14.F. Milk 17 „ „ £10 fine, 42s. costs. 107 Articles Adulterated—continued. Number. Article. Adulteration. Result. 15.E. Milk 15 per cent. added water £1 fine, 23s. costs. 17.E. Butter 80 „ foreign fat £2 fine, 23s. costs. l.T. Milk 14 „ deficient in fat £1 fine, 23s. costs. 8.S. Milk 8 „ „ „ £2 fine. 9.S. j Milk 10 ,, added water £2 fine. 10.S. Milk 9 „ „ „ £2 fine. 13.S. Milk 7 „ „ „ Dismissed on informality. 4. J. Milk 5 „ deficient in fat Caution. 9.J. Milk 11 „ added water £3 fine, 23s. costs. 16.F. Milk 11 „ „ „ £3 fine. 16.G. Milk 10 „ „ „ £6 fine, 44s. costs. 23.D. Milk C „ deficient in fat Caution. 25.D. Milk 5 „ „ „ Caution. 13.H. Milk 5 „ „ „ Caution. 14.H. Milk 2 „ added water Caution. 17.H. Milk 6 ,, deficient in fat Caution. 21.H. Milk 9 ,, added water £1 fine, 23s. costs. Skimmed 19.H. Milk 9 „ „ „ No action. 9.K. Milk Separated 11 „ deficient in water 25s. fine, 23s. costs. 34. M. Milk 19 ,, added water No action. 28. N. Milk 5 „ „ „ Caution. 30. N. Milk 5 „ deficient in fat Caution. 40.G. Milk 11 „ „ „ £2 2s. costs. 37.D. Coffee 30 „ chicory £1 fine, 23s. costs. 42.M. Milk 8 „ added water £2 fine, 12s. 6d. costs. 17.C. Milk 3 ,, „ Caution. 18.C. Milk 3 „ Caution. 20. C. Milk 3 ,, ,, Caution. 58. L. Milk 11 ,, deficient in fat £4 fine, 23s. costs. 22. J. Milk 10 £2 fine, 10s. 6d. costs. 36.N. Milk 12 ,, added water No action. 38.N. Milk 10 „ „ £2 fine. 39.N. Milk 5 „ deficient in fat Caution. 12.B. Milk 14 „ „ „ Dismissed. Warranty. 13.T. Milk 5 „ „ „ Caution. 18.T. Milk 4 „ added water Caution. 18.A. Milk 5 „ deficient in fat Caution. 28.A. Cocoa 3 ,, added alkali ... Caution. 29.A. Cocoa 2 „ Caution. 39.F. Milk 5 „ added water £4 fine, 23s. costs. 45.E. Milk 6 „ deficient in fat 17s. fine, 23s. costs. 50.M. Milk 10 „ £2 fine, 23s. costs. 54.E. Milk 8 „ „ £1 fine, 23s. costs. 26.H. Milk 8 „ „ Dismissed. 33.B. Butter 30 ,, foreign fat £2 fine, 23s. costs. 34.A. Milk 3 „ deficient in fat Caution. 54.F. Milk 19 ,, added water £4 fine, 23s. costs. 108 Articles Adulterated—continued. Number. Article. Adulteration. Result 59.F. Milk 5 per cent, added water Caution. 40.K. Milk 5 „ „ Caution. 41. K. Milk 6 „ deficient in fat and Dismissed on warranty. 5 ,, added water 41.J. Milk 31 ,, added water £10 fine, £2 4s. costs. 54.D. Butter 80 ,, foreign fat £5 fine, and 23s. 55.D. Butter Margarine costs. 58.M. Milk 5 ,, deficient in fat Caution. 56.D. Milk 3 „ added water Caution. 59.D Milk 10 „ „ Caution. 56.E. Milk 14 „ „ £2 fine, 23s. costs. 57.E. Milk 3 „ „ Caution. 63.E Milk Contained formalin Caution. 63.F. Milk 4 per cent, deficient in fat Caution. 73.G. Milk 8 „ added water Dismissed on warranty. 68.F. Milk 4 ,, deficient in fat Caution. 71F. Milk o ,, ,, Caution. 73.F. Milk 5 „ added water Caution. 75.F. Milk 8 „ „ £2 fine, 23s. costs. 53.N. Milk 12 „ „ £1 fine and 23s. 54.N. Milk 12 „ „ costs. 40.B. Beeswax 75 „ resin No action. 76.F. Butter Margarine £50 fine, 23s. costs. 79.F. Milk 12 per cent, added water Dismissed on warranty. 45.C. Milk 4 „ „ Caution. 46.C. Milk 7 „ „ £2 fine, 23s. costs. 69.N. Milk 6 „ deficient in fat £2 fine, 23s. costs. 85.E. Cocoa 2 „ added alkali No action. 54.S. Butter Margarine £5 fine, 23s. costs. 85.F. Milk 6 per cent, deficient in fat Caution. 76.N. Milk 13 „ added water £2 fine and 23s. 77.N. Milk 13 „ „ costs. 28.T. Milk 8 „ „ 23s. costs. 30.T. Milk 7 „ „ Caution. 92.D. Milk 8 ,, deficient in fat £1 fine, 23s. costs. 81.F. Milk 8 ,, added water £1 fine, 23s. costs. 90.F. Milk 17 „ „ £2 fine, 23s. costs. 91.F. Milk 13 ,, deficient in fat £1 fine, 23s. costs. 64.C. Pepper 2 ,, foreign starch No action. 66.C. Coffee 15 ,, chicory 12s. fine, 23s. costs. 69.C. Milk 6 ,, deficient in fat Caution. 59.B. Coffee 35 „ chicory £1 fine, 23s. costs. 70.D. Butter Margarine £5 fine, 23s. costs. 95.E. Butter Margarine £10 fine, 23s. costs. 39.T. Milk 9 per cent, added water 10s. fine, 23s. costs. 65.A. Milk 3 ,, deficient in fat Caution. 66.A. Milk 3 „ „ Caution. 98.D. Butter 57 ,, foreign fat £7 10s. fine and 23s. costs. 109 Proceedings for Refusing to Sell under the Food and Drugs Acts. On March 28th. Mr. Lazarus Finklestone, 90, Sidney Street, was summoned fur refusing to serve a sample of milk for analysis. He was fined 40s., with costs. On June 6th. Louis Marcus, 21, Leslie Street, was summoned for refusing to serve a sample of milk for analysis. He was fined 40s., with 23s. costs. On September 15th. Mr. William Jarratt, 23, Bale Street, was summoned for refusing to serve a sample of milk for analysis. He was fined £5, with 33s. costs. On October 19th. Mrs. Polley Cohen, 95, Redman's Road, was summoned for refusing to serve a sample of milk for analysis. She was fined 20s., with 23s. costs. On October 24th. Mr. John Morgan, 185, Commercial Road, was summoned for refusing to serve a sample of milk for analysis. He was fined £10, with 43s. costs. On November 6th. Mr. John Morgan, 185, Commercial Road, was summoned for refusing to serve a sample of milk for analysis. He was fined £10, with 23s. costs. On November 6th. Mr. William Werner, 66, Tilly Street, Poplar, was summoned for refusing to serve a sample of milk for analysis. He was fined £3, with 23s. costs. On November 7th. Mr. Thomas Christmas Thomas, 13, Beaumont Street, was summoned for refusing to serve a sample of milk for analysis. He was fined £10, with 23s. costs. On December 15th. Mr. Louis Marcus, 21, Leslie Street, was summoned for refusing to serve a sample of milk for analysis. He was fined £10, with 23s. costs. 110 Proceedings under the Margarine Act, 1887 On March 10th. Mrs. Alice Mackenzie, 44, Rhodeswell Road, was summoned for serving a sample of margarine in an unstamped wrapper. She was fined 30s., with 23s. costs. On August 8th. Mr. Averbuck Simon, '27, Hardinge Street, was summoned for exposing for sale margarine in an unlabelled box. He was fined 1s., with 23s. costs. On October 12th. Mr. Jacob Segal, 598, Mile End Road, was summoned for serving a sample of margarine in an unstamped wrapper. He was fined 40s., with 23s. costs. On December 29th. Mr. John Davies, 52, Gold Street, was summoned for serving a sample of margarine in an unstamped wrapper. He was fined 20s., with 23s. costs. On January 19th. Mr. William Thomas Smith, 220, Bow Common Lane, was summoned for serving a sample of margarine in an unstamped wrapper. He was fined £7 10s., with 23s. costs. On January 30th. Mr. John Davies, of 1, Upper Chapman Street, was summoned for exposing for sale margarine which was not labelled. He was fined 40s., with 23s. costs. Total Fines and Costs. Fines. Costs. Under the Public Health (London) Act for £ s. d. £ s. d. various nuisances 27 4 0 64 13 6 For selling unsound food 125 10 0 35 18 0 By-laws for Houses let in Lodgings General Powers Acts 10 17 0 15 12 0 Metropolis Management Act 8 0 0 5 11 0 Food and Drugs Acts ... 315 4 0 68 8 6 Refusing to serve samples for Analysis 53 0 0 10 14 0 Margarine Act, 1887 14 1 0 6 18 0 Dairies, Cowsheds and Milkshops Orders 13 0 0 19 1 0 Total 566 16 0 226 16 0 Ill Table showing the number of milk premises, slaughter houses, ice-cream premises, &c., together with the number of inspections made to them. PREMISES NUMBER OF PLACES— Number of inspections, 1911. Number of notices, 1911. Number of prosecutions, 1911. On register at end of 1910. Added in 1911. Re- moved in 1911. On register at end of 1911. (1) (2) (3) (^) (6) (6) (7) Milk premises 1102 .39 49 1092 2375 406 9 Cowsheds 34 ... 1 33 61 1 ... Slaughter-houses 6 ... ... 6 16 2 ... Other offensive trade premises 7 ... ... 7 28 3 ... Ice cream premises 160 35 10 185 354 46 ... Registered houses let in lodgings 2881 36 6 2911 4842 (a) 354 (a) (b) 2167 ((b) 9 (a) For overcrowding. (b) For other conditions. Total number of Intimations served for all purposes 14,719 Overcrowding— Number of Inspections 17,442 Number of dwelling houses overcrowded 548 Number of Notices served Intimations 631 Statutory Notices. 174 Number remedied 547 Number of Prosecutions 1 Underground rooms— Illegal occupation dealt with during the year 62 Number of rooms closed 18 Insanitary Houses— Number closed under the Public Health (London) Act, 1891 — Number closed under the Housing and Town Planning Act 9 L.C.C. (General Powers) Act, 1903. Part VIII. Number of prosecutions for breach of by-laws as to conveyance of dead horses through the street 112 L.C.C. (General Powers) Act, 1904— Number of verminous rooms cleansed (Sec. 20) 1,953 Number of filthy articles purified (Sec. 19) 56 Number of sanitary conveniences altered (Sec. 22) 4 Number of sanitary conveniences removed (Sec. 22) — Number of fixed ashpits removed (Sec. 23) 13 L.C.C. (General Powers) Act, 1907. Number of tenement houses dealt with as regards water supply (Sec. 78) 40 Shelters provided under Sec. 60 (4) of the Public Health (London) Act, 1891— Number of persons accommodated during the year 59 Places where Food is prepared for sale— Number on Register 400 Number of Inspections 869 Number of Notices served 170 House to House Inspections— Number of Inspections 5,621 Number of defects 3,149 Number of Notices served Intimations 3,010 Statutory Notices 957 Revenue Acts— Number of houses for which applications were received during the year 4 Number of tenements comprised therein 37 Number of tenements for which certificates were (a) granted 30 (b) refused 7 (c) deferred — Number, of prosecutions under By-laws under the Public Health (London) Act, 1891— (a). For prevention of nuisance arising from snow, ice, salt, filth, etc — (b). For prevention of nuisance arising from offensive matter running out of any manufactory, etc — (c). For the prevention of keeping of animals in such a manner as to be injurious to health — (d). As to paving of yards, etc., of dwelling houses 2 (e). In connection with the removal of offensive matter, etc 6 (/). As to cesspools and privies, removal and disposal of refuse, etc. — (,g). For securing the cleanliness of tanks, cisterns, etc — (h). With respect to water closets, earth closets, etc — (/'). With respect to sufficiency of water supply to water closets — (;'). With respect to drainage, etc. (Metropolis Management Act, Sec. 202) 4 (A). With respect to deposit of plans as to drainage, etc. (Metropolis Management Acts Amendments (By-laws) Act, 1899) Mortuaries— Total number of bodies removed 581 Total number of infectious bodies removed 2 113 Factories and Workshops. The total number of workshops on the Register was 3,338 ; but this does not include factories, workplaces and out-worker's premises. 5,453 inspections revealed defects, which necessitated the service of 1,213 written notices. Of the notices 20 referred to factories, 1,125 referred to workshops including workshop laundries, 68 to workplaces other than out-worker's premises. Cleanliness.—627 notices were served to properly cleanse workshops. Ventilation.—The ventilation of 79 workshops was improved. Overcrowding.—Overcrowding was abated in 48 workshops. Sanitary Accommodation.—The sanitary accommodation was improved in 168 workshops by providing additional and suitable water-closets. Drainage of Floors.—The drainage of the floor was found defective in five workshops. 316 other nuisances were remedied in workshops. Outworkers' Premises.—4,443 inspections were made to out-workers' premises during the year ; 698 premises were found to be insanitary, and notifiable diseases occurred in 47. The number of inspections appears small compared to the number of addresses of out-workers received from other Councils. These premises are mostly registered workshops, and are included as such in our returns, although in a way they may be deemed out-workers' premises, as work is carried on there for business houses in other districts. These premises are included in the column of addresses of out-workers' premises received from other Councils ; but the record of visits made to them is included in the number of visits made to registered workshops. Again, a large percentage of these addresses is incorrect, and on being visited by the Inspectors it is found that they have either left the premises some considerable time previously or have never lived there at all. The actual number of out-worker's premises varied from time to time, but at the end of the year it was 3,327. 3 114 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—INSPECTIONS. Premises. (1) Number of Inspections. (2) Written Notices. (3) Prosecutions. (4) Factories (Including Factory Laundries') 114 20 1 Workshops (Including Workshop Laundries) 5,108 1,125 1 Workplaces (Other than Outworkers' premises) 231 68 .. Total 5,453 1,213 2 2.-DEFECTS FOUND. Particulars. (1) Number of Defects Number of Prosecutions. (5) Found. Remedied. (3) Referred to H.M. Inspector. (4) Nuisances under the Public Health Acts :—* Want of cleanliness 627 627 .. .. Want of ventilation 79 79 •• .. Overcrowding 48 48 .. .. Want of drainage of floors 5 5 .. .. Other nuisances 316 316 .. 2 Sanitary Accommodation insufficient 24 24 .. .. unsuitable or defective 115 115 .. .. not separate for sexes 29 29 .. .. Offences under the Factory and Workshop Act:— Illegal occupation of underground bakehouse (S. 101) 1 1 .. .. Breach of special sanitary requirements for bakehouses (SS. 97 to 100) 44 44 .. .. Other offences (Excluding offences relating to outwork which are included in Part 3 of this report.) .. .. .. .. Total 1,288 1,288 .. 2 * Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act as remediable under the Public Health Acts. H 2 3.—HOME WORK. NATURE OF WORK. Outworkers' Lists. Section 107. Outwork in Unwholesome Premises, Section 108. Outwork in Infected Premises, Sections 109,110. Lists Received from Employers. Notices served on Occupiers as to keeping or sending lists. Prosecutions. Instances. Notices Served. Prosecutions. Instances. Orders Made, (S. 110). Prosecutions (Sections 109, 110). Twice in the Year. Once in the Year. railing to keep or permit inspection of Lists. Failing to send Lists. Lists. Outworkers. Workmen. Lists. Outworkers. Workmen. Wearing Apparel— .. (1) Making, &c 302 4375 15 89 .. .. .. 667 667 .. 46 .. .. (2) Cleaning and Washing .. .. .. .. .. .. .. .. .. .. .. .. .. Household linen .. .. .. .. .. .. .. .. .. .. .. .. .. Lace, Lace Curtains and Nets .. .. .. .. .. .. .. 1 1 .. .. .. .. Curtains and furniture hangings .. .. .. .. .. .. .. .. .. .. .. .. .. Furniture and Upholstery .. 2 .. .. .. .. .. 2 2 .. .. .. .. Electro Plate .. .. .. .. .. .. .. .. .. .. .. .. .. File Making .. .. .. .. .. .. .. .. .. .. .. .. .. Brass and brass articles .. .. .. .. .. .. .. .. .. .. .. .. .. Fur Pulling (Furriers) .. 6 .. .. .. .. .. 7 7 .. .. .. .. Cables and Chains .. .. .. .. .. .. .. .. .. .. .. .. .. Anchors and Grapnels .. .. .. .. .. .. .. .. .. .. .. .. .. Cart Gear .. .. .. .. .. .. .. .. .. .. .. .. .. Locks, Latches and Keys.. .. .. .. .. .. .. .. .. .. .. .. .. .. Umbrellas, &c .. 10 .. .. .. .. .. 6 6 .. .. .. .. Artificial Flowers .. .. .. .. .. .. .. .. .. .. .. .. .. Nets, other than Wire Nets .. .. .. .. .. .. .. .. .. .. .. .. .. Tents .. .. .. .. .. .. .. .. .. .. .. .. .. Sacks 4 6 .. .. .. .. .. .. 1 .. .. .. .. Racquet and Tennis Balls .. .. .. .. .. .. .. .. .. .. .. .. .. Paper Bags and Boxes 8 123 .. .. .. .. .. 13 13 .. 1 .. .. Brush Making 2 9 .. .. .. .. .. I 1 .. .. .. .. Pea Picking .. .. .. .. .. .. .. .. .. .. .. .. .. Feather Sorting .. .. .. .. .. .. .. .. .. .. .. .. .. Carding, &c., of buttons, &c .. .. .. .. .. .. .. .. .. .. .. .. .. Stuffed Toys .. .. .. .. .. .. .. .. .. .. .. .. .. Basket Making .. .. .. .. .. .. .. .. .. .. .. .. .. Total 322 4531 18 97 .. .. .. 698 698 .. 47 .. .. Column 6. The numbers in this column contain a large number of addresses which, on being inspected by the Sanitary Inspectors, were found to be already registered by us as Workshops, and are therefore not included in the actual number of outworkers resident in the Borough. The same addresses were included on the Lists of several employers, some being sent in on a dozen Lists. 115 116 4.—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year. (1) Number. (2) Bakehouses 175 Boot, Shoe and Slipper Making 210 Cabinet Making 116 Furriers 147 Hat and Cap Manufacturers 81 Miscellaneous 396 Laundries 27 Rag Sorting, etc. 78 Wearing Apparel (Tailors, Milliners, Dressmakers, etc., etc.) 2,108 Total 3,338 5.—OTHER MATTERS. Class. (1) N umber. (a) Matters notified to H.M. Inspector of Factories : — Failure to affix Abstract of the Factory and Workshop Act (S. 133) 67 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 168 Reports (of action taken) sent to H.M. Inspector. 132 Other 36 Underground Bakehouses (S. 101): — Certificates granted during the year .. In use at the end of the year 59 117 BAKEHOUSES. 49, Anthony Street 36, Christian Street 104, Anthony Street 135, Christian Street 22, Batty Street 137, Christian Street 20, Bedford Street 122, Clark Street 51, Bedford Street 62, Cleveland Street 38, Bell Lane 59, Commercial Road 60, Bell Lane 81, Commercial Road 43, Ben Jonson Road 136, Commercial Road 81, Ben Jonson Road 192, Commercial Road 70, Berner Street 265, Commercial Road 150, Bow Common Lane 336 & 338, Commercial Road 224, Bow Common Lane 337, Commercial Road 26, Brick Lane 411, Commercial Road 48, Brick Lane 508, Commercial Road 70, Brick Lane 631, Commercial Road 122, Brick Lane 821, Commercial Road 21, Brady Street 72, Commercial Street 3, Bridge Street 18, Copley Street 92, Bridge Street 9, Coke Street 91, Brook Street 81, Coutts Road 58, Burdett Road 13, Devonport Street 91, Burdett Road 3, Dock Street 54, Buxton Street 12, Duckett Street 20, Cable Street 73, Duckett Street 36, Cable Street 137, Eastfield Street 86, Cable Street 31, Fieldgate Street 111, Cable Street 48, Fieldgate Street 186, Cable Street 38, Globe Road 278, Cable Street 142, Globe Road 293, Cable Street 32, Great Hermitage Street 415, Cable Street 48, Great Garden Street 367, Cable Street 65, Greenfield Street 43, Cadiz Street 13, Grove Street 108, Cannon Street Road 4, Hanbury Street 49, Charles Street 102, Hanbury Street 127, Charles Street 156, Hanbury Street 167, Charles Street 68, Harford Street 9a, Chicksand Street 19, Hawkins Street 14, Chicksand Street 34, Heath Street 32, Church Lane 7, Hessel Street 118 BAKEHOUSES—continued. 71, Hessel Street 99, Redman's Road 54, High Street, Whitechapel 90, Red Lion Street 56, High Street, Whitechapel 3, Repton Street 3, High Street, Shoreditch 31, Repton Street 28, Hunt Street 35, Rhodeswell Road 2, Jubilee Street 56, Rhodeswell Road 115, Jubilee Street 132, Rhodeswell Road 135, Jubilee Street 71, Salmon Lane 201, Jubilee Street 131, Salmon Lane 5, King David Lane 181, Salmon Lane 32, King Edward Street 209, Salmon Lane 1, Lamb Street 53, Settles Street 38, Leman Street 40, Sheridan Street 117, Leman Street 1, Short Street 7, Limehouse Causeway 89, Sidney Street 40, Limehouse Causeway 16, Spelman Street 84, Locksley Street 4, Stepney Green 67, Lower Chapman Street 43, Stainsby Road 76a, Maplin Street 64, St. Ann's Road 68, Middlesex Street 31, St. George Street 11, Mile End Road 31, St. Paul's Road 132, Mile End Road 117, St. Paul's Road 205, Mile End Road 6, St. Peter's Road 397, Mile End Road 10, St. Mark Street 622, Mile End Road 36, Three Colt Street 4, Morris Street 51, Three Colt Street 34, New Road 77, Three Colt Street 107, Old Gravel Lane 93, Three Colt Street 6, Old Castle Street 45, Thomas Street, Limehouse 67, Old Montague Street 22, Umberston Street 87, Old Montague Street 57 & 59, Umberston Street 75, Oxford Street 76, Umberston Street 249, Oxford Street 23, Vallance Road 256, Oxford Street 38, Vallance Road 275, Oxford Street 79, Vallance Road 35, Pelham Street 17, Waley Street 42, Philpot Street 49, Watney Street 41, Portland Street 1, Wentworth Street 1, Providence Street 41, Wentworth Street 77, Plumber's Row 75, Wentworth Street 119 BAKEHOUSES—continued. 91, Wentworth Street 146, White Horse Street 7, West Street 147, White Horse Street 96, West Street 185, Whitechapel Road 42, White Horse Street 84, White Horse Lane 105, White Horse Street 87, Wilkes Street LIST OF COWHOUSES. Number of Cows kept in October. Number of Cows licensed to be kept. 63, Brook Street 19 19 21a, Black Lion Yard 46 46 Batson Street 1 50 408, Commercial Road 7 8 77, Commercial Road 26 26 136, Charles Street 13 14 155, 156 & 157, Railway Arches, Drewton Street 39 41 18, Fairclough Street 54 56 1, Hannibal Road 25 25 37, Hanbury Street 18 18 66, Harford Street — 10 12, Hilton Street 8 8 42, Jubilee Street 44 44 15, Maroon Street 12 12 5, Meeting House Alley 11 12 28, Mile End Place 8 8 25, Norfolk Street 48 56 36, Old Church Road 145 148 37, Old Montague Street 12 16 64, Pelham Street 16 16 56, Princes Square 32 32 5, Russell Street 6 7 Ship Street 10 12 1, Sidney Street 20 21 150, Sidney Street 23 20 Saw Yard 8 8 33, St. Ann's Road 19 19 15, Tilley Street 13 14 Tredegar Dairy, Upper Montague Street 79 75 120 LIST OF COWHOUSES—continued. Number of Cows kept in October. Number of Cows licensed to be kept. 11, Umberston Street 14 14 1, Upper Chapman Street 11 19 37, White Horse Street 23 29 (34, White Horse Lane 13 14 There were more cows at Tredegar Dairy and 150, Sidney Street than the owners were allowed to keep. LIST OF SLAUGHTERHOUSES. 2, High Street, Whitechapel 3, High Street, Whitechapel 199, Mile End Road 26, Three Colt Street 160, White Horse Street 49, High Street, Wapping I have again to express my indebtedness to the Sanitary Inspectors and Clerical Staff for the manner in which they have assisted me in carrying out the duties of my office. I have the honour to be, Mr. Mayor and Gentlemen, Your obedient Servant, D. L. THOMAS. Medical Officer of Health and Public Analyst. Public Health Offices, 43, White Horse Street, Commercial Road, E. May, 1912. 121 VITAL STATISTICS OF THE WHOLE BOROUGH DURING 1911 AND PREVIOUS YEARS. Required by Local Government Board. Area of Borough in acres (exclusive of area covered by water) 1,902.766 Total population of all ages 280,024 No. of inhabited houses 36,217 Average number of persons per house 7.7 At Census of 1911. TABLE I.—Vital Statistics of Whole District during 1911 and Previous Years. Metropolitan Borough of Stepney. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths.J 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 per 1,000 Nett Births. Number. Rate. * dumber. Rate.* 1 2 3 4 5 6 7 8 9 10 11 12 13 1906 288710 10926 10668 36.9 5871 20.3 1202 766 1454 136 5435 18.8 1907 286850 10475 10226 35.6 5121 17.8 990 765 1217 119 4896 1.0 1908 285020 10404 10124 35.5 5456 19.1 1062 782 1320 130 5176 18.1 1909 283190 9819 9502 33.4 5225 18.4 1142 676 1130 118 4759 16.8 1910 281360 9512 9164 32.5 4792 17.0 1128 635 1041 113 4299 15.2 1911 279560 8798 8464 30.2 5179 18.5 1196 871 1261 148 4854 17.3 * Rates in Columns 5, 7, and 13 calculated per 1,000 of estimated population. Note.—The deaths to be included in Column 6 of this table are the whole of those registered during the year as having actually occurred within the district or division. The deaths included in Column 12 are the number in Column 6, corrected by the subtraction of the number in Column 8 and the addition of the number in Column 9. By the term " Non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there ; and by the term " Residents " is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The " Public institutions" to be taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses, and lunatic asylums. TABLE II.—Cases of Infectious Disease notified during the Year 1911. Metropolitan Borough of Stepney. Notifiable Disease. At all Ages. Cases notified in Whole District. Total Cases notified in Locality. each No. of Cases removed to Hospital from each locality. At Ages—Years. 1- 2. 3. 4. 1. 2. 3. 4. Total cases removed to Hospital. U nder 1. 1 to 5. 5 to 15. 15 to 25. 25 to 45. 45 to 65. 65 and upwards. Limehouse. St. George's. Mile End. White chapel. Limehouse. St. George's. Mile End. Whitechapel. Small-pox 39 1 6 5 11 7 7 2 .. •• 37 2 •• •• 37 2 39 Cholera • • •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Diphtheria (including Membranous croup) 472 29 264 129 29 17 4 •• 105 102 159 106 99 97 148 101 445 Erysipelas 474 17 31 45 63 158 131 29 89 79 155 151 8 11 22 40 81 Scarlet fever 423 11 173 216 15 8 •• •• 96 52 188 87 90 51 182 82 405 Typhus fever •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Enteric fever 79 •• 2 27 14 28 7 1 11 16 35 17 11 14 34 17 76 Relapsing fever •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Continued fever •• •• •• •• • • •• •• •• •• •• •• •• •• •• •• •• •• Puerperal fever 29 •• •• •• 7 22 •• •• 3 5 16 5 2 4 11 3 20 Plague •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• •• Cerebro-spinal fever 7 3 4 •• •• •• •• •• 3 •• 3 1 2 •• 1 1 4 Phthisis. Regulations— Under Tuberculosis, 1908 440 1 6 25 36 220 125 27 77 79 171 113 69 64 147 102 382 1911 830 •• 6 57 183 453 127 4 148 160 306 216 15 19 30 18 82 Voluntary 80 •• 1 71 4 3 1 «• 14 11 32 23 •• 1 4 3 8 Ophthalmia Neonatorum 16 16 •• •• •• •• •• • • 6 2 5 3 •• •• •• •• •• Polio-Myelitis 5 3 1 1 •• •• •• •• •• 1 3 1 •• •• 1 •• 1 Anthrax •• •• •• •• •• •• •• .. .. •• •• •• •• •• •• .. •• Chicken Pox 219 30 103 84 1 1 •• •• 36 33 94 56 •• 2 3 2 7 Measles 1819 207 1285 312 11 4 •• •• 292 442 523 562 30 58 32 53 173 Totals 4932 318 1882 972 374 921 402 63 880 982 1727 1343 326 321 652 424 1723 TABLE III.—Causes of, and Ages at Death during the year 1911. Causes of Death. Nett Deaths at the subjoined ages of " Residents" whether occurring within or without the district. Total Deaths whether of " Residents " or " nonresidents " in Institution in the District. All ages. Under 1 year. t and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 yeirs. 45 and under 65 years. 65 and upwards. All causes Certified 4854 1261 462 286 156 171 627 1020 871 Uncertified Enteric fever 5 •• •• •• 1 •• 3 • • 1 11 Small pox 8 1 •• 3 •• •• 3 •• 1 •• Measles 291 70 140 69 12 •• •• •• •• 70 Scarlet fever 9 1 2 4 2 •• •• •• •• .. Whooping-cough 44 17 15 10 2 •• •• •• •• 17 Diphtheria and croup 34 6 11 14 3 •• •• •• •• 28 Influenza 24 •• •• •• •• 2 2 11 •• 5 Erysipelas 13 3 •• •• •• 2 3 5 •• 7 Cerebro-spinal fever 2 1 1 •• •• •• •• •• •• 15 Dysentery 2 •• •• •• •• 1 •• •• 1 •• Anterior polio myelitis •• •• •• •• •• •• •• •• 2 Phthisis (pulmonary tuberculosis) 481 2 4 7 10 54 237 140 27 207 Tuberculous meningitis 80 15 11 32 21 1 •• •• •• 87 Other tuberculous diseases 86 16 24 17 12 7 3 4 •• 78 Rheumatic fever 2 •• •• •• •• 1 1 .. 2 Cancer, malignant disease 236 •• •• 1 1 4 28 127 75 209 Bronchitis 399 51 19 4 1 3 28 143 150 137 Broncho-pneumonia 282 118 75 32 6 1 8 23 19 221 Pneumonia (all other forms) 264 26 30 23 6 15 48 86 30 109 Other diseases of respiratory organs 36 8 3 2 1 4 5 9 4 35 365 Diarrhoea and enteritis. 506 382 79 16 1 •• 3 12 13 Appendicitis and typhlitis 19 •• •• 1 10 1 3 3 1 67 Alcoholism 8 •• •• •• •• •• 5 2 1 4 Cirrhosis of liver 26 •• •• •• 1 •• 7 14 •• 15 Nephritis and bright's disease 157 5 1 •• 2 5 25 82 34 101 Puerperal fever 9 •• •• •• •• 2 7 •• •• 21 Other accidents and diseases of pregnancy and parturition 31 16 •• •• •• 3 12 •• •• 17 Congenital debility and malformation, including premature birth 384 384 •• •• •• •• •• •• •• 151 Violent deaths, excluding suicide 208 31 13 15 15 6 39 49 40 160 Suicides 37 •• •• •• •• 4 15 13 5 11 Old age 233 •• .. •• •• •• •• 12 221 75 Heart diseases 334 5 •• 1 23 25 54 118 108 154 Other defined diseases 578 103 16 30 26 29 86 166 122 525 Diseases ill-defined or unknown 26 •• 18 2 •• 1 3 •• 2 6 4854 1261 462 286 156 171 627 1020 871 2912 TABLE IV.—Infant Mortality. 1911. BOROUGH OF STEPNEY. Nett Deaths from stated Causes at various Ages under One Year of Age. Cause of Death. Under 1 Week 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under One Year. All Causes. Certified 194 44 42 34 314 232 261 225 229 1261 Uncertified •• •• •• •• •• •• •• •• •• •• Small-pox •• •• •• •• •• 1 •• •• •• 1 Chicken-pox •• •• •• •• •• •• •• •• 1 1 Measles •• •• •• •• •• •• 4 28 38 70 Scarlet Fever •• •• •• •• •• •• •• •• 1 1 Diphtheria and Croup •• •• •• •• •• 1 2 1 2 6 Wliooping Cough •• •• •• •• •• 1 4 5 7 17 Diarrhoea •• •• 5 •• 12 60 102 87 54 315 Enteritis •• •• 2 • • 2 12 21 12 20 67 Tuberculous Meningitis •• •• •• •• •• 1 5 6 3 15 Abdominal Tuberculosis (b) •• •• •• •• •• •• 2 1 •• 3 Other Tuberculous Diseases •• •• •• •• •• 1 6 3 5 15 Congenital Malformations (c) 12 6 3 1 22 7 2 5 1 37 Premature Birth 122 21 7 6 156 10 •• •• •• 166 Atrophy, Debility and Marasmus 13 4 11 8 36 54 40 17 9 156 Atelectasis 14 1 2 •• 17 3 1 •• 2 23 Injury at Birth 15 1 •• •• 16 •• •• •• •• 16 Erysipelas •• •• •• •• •• 1 •• 2 •• 3 Syphilis 2 2 •• 1 5 7 1 •• 2 15 Rickets •• •• •• •• •• •• •• 1 2 3 Meningitis (not Tuberculous) •• •• •• •• •• 1 3 6 7 17 Convulsions 8 2 3 5 18 16 17 4 4 59 Gastritis •• •• •• •• •• •• •• •• •• •• Laryngitis •• •• •• •• •• •• •• •• •• •• Bronchitis •• •• 1 1 2 20 13 10 6 51 Pneumonia (all forms) 1 2 3 3 9 19 26 32 58 144 Suffocation, overlaying 4 1 2 •• 7 11 7 2 •• 27 Other causes 3 4 3 2 12 6 5 3 7 33 194 44 42 34 314 232 261 225 229 1261 Nett Births legitimate, 8,278 Nett Deaths in legitimate infants, 4,787 in the year illegitimate, 186 the year of illegitimate infants, 67 TABLE IV.—Infant Mortality. 1911. LIMEHOUSE DIVISION. Nett Deaths from stated Causes at various Ages under One Year of Age. Cause or Death. Under 1 week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under One Year. All Causes. Certified 44 13 9 12 78 63 77 60 65 343 Uncertified •• •• •• •• •• •• •• •• Small-pox •• •• •• •• •• •• •• •• •• •• Chicken-pox •• •• •• •• •• •• •• •• 1 1 Measles •• •• •• •• •• •• 1 9 10 20 Scarlet Fever •• •• •• •• •• •• •• •• •• •• Diphtheria and Croup •• •• •• •• •• •• •• •• •• •• Whooping Cough •• •• •• •• •• •• •• 1 3 4 Diarrhoea •• •• 1 3 4 11 31 21 16 83 Enteritis •• •• 1 •• 1 5 12 4 10 32 Tuberculous Meningitis •• •• •• •• •• •• •• 1 •• 1 Abdominal Tuberculosis (b) •• •• •• •• •• •• •• 1 •• 1 Other Tuberculous Diseases •• •• •• •• •• •• •• 1 3 4 Congenital Malformations (c) 4 2 1 •• 7 1 •• 1 1 10 Premature Birth 29 9 4 3 45 4 •• •• •• 49 Atrophy, Debility and Marasmus 3 1 1 2 7 16 14 1 3 41 Atelectasis •• •• •• •• •• 2 •• •• •• 2 Injury at Birth 5 •• •• •• 5 •• •• •• •• 5 Erysipelas •• •• •• •• •• •• •• 1 •• 1 Syphilis •• •• •• •• •• 2 •• •• •• 2 Rickets •• •• •• •• •• •• •• 1 •• 1 Meningitis (not Tuberculous) •• •• •• •• •• •• 1 3 1 5 Convulsions 3 1 1 •• 5 5 4 2 •• 16 Gastritis •• •• •• •• •• •• •• •• •• •• Laryngitis •• •• •• •• •• •• •• •• •• •• Bronchitis •• •• •• 1 1 8 4 4 1 18 Pneumonia (all forms) •• •• •• 1 1 4 8 7 14 34 Suffocation, overlying •• •• •• •• •• 3 2 •• •• 5 Other causes •• •• •• 2 2 2 •• 2 2 8 44 13 9 12 78 63 77 60 65 343 Nett Births ( legitimate, 1,766 in the year ) illegitimate, 41 Nett Deaths in ( legitimate infants, 1,176 the year of I illegitimate infants, 16 TABLE IV.—Infant Mortality. 1911. ST. GEORGES DIVISION. Nett Deaths from stated Causes at various Ages under One Year of Age. Cause of Death. Under 1 week. 1-2 Weeks. '2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under One Year. All Causes. Certified 24 6 7 3 40 64 56 51 67 268 Uncertified •• •• •• •• •• •• •• •• •• •• Small-pox •• •• •• •• •• •• •• •• •• •• Chicken-pox •• •• •• •• •• •• •• •• •• Measles •• •• •• •• •• •• 1 7 12 20 Scarlet Fever •• •• •• •• •• •• •• •• •• •• Diphtheria and Croup •• •• •• •• •• 1 1 •• 1 3 Whooping Cough •• •• •• •• •• •• •• •• •• •• Diarrhoea •• •• •• •• 1 14 20 20 17 72 Enteritis •• •• •• •• •• 1 5 5 4 15 Tuberculous Meningitis •• •• •• •• •• •• 3 2 1 6 Abdominal Tuberculosis (b) •• •• •• •• •• •• 1 •• •• 1 Other Tuberculous Diseases •• •• •• •• •• •• 3 1 1 5 Congenital Malformations (c) 2 •• •• 1 3 1 1 1 •• 6 Premature Birth 14 3 •• l 18 3 •• •• •• 21 Atrophy, Debility and Marasmus 3 •• 3 •• 6 15 10 5 2 38 Atelectasis 2 1 1 •• 4 1 •• •• 2 7 Injury at Birth •• •• •• •• •• •• •• •• •• •• Erysipelas •• •• •• •• •• •• •• •• •• •• Syphilis 2 •• •• 1 3 2 •• •• 1 6 Rickets •• •• •• •• •• •• •• •• 1 1 Meningitis (not Tuberculous) •• •• •• •• •• •• 1 • • 1 2 Convulsions •• •• •• •• •• 7 5 .. 1 14 Gastritis •• •• •• •• •• •• •• •• •• •• Laryngitis •• •• •• •• •• •• •• •• •• •• Bronchitis •• •• •• •• •• 5 1 2 2 10 Pneumonia (all forms) •• 1 •• •• 1 1 2 8 18 30 Suffocation, overlying •• •• 1 •• 1 3 2 •• •• 6 Other causes 1 1 •• •• 2 •• •• •• 3 5 24 6 7 3 40 54 56 51 67 268 Nett Births legitimate, 1,530 in the year illegitimate, 40 Nett Deaths in legitimate infants, 839 the year of illegitimate infants, 15 TABLE IV.—Infant Mortality. 1911. MILE END DIVISION. Nett Deaths from stated Causes at various Ages under One Year of Age. Cause op Death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under One Year. All Causes. Certified 89 21 16 12 138 81 96 84 67 466 Uncertified .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. 1 .. .. .. 1 Chicken-pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. 2 9 12 23 Scarlet Fever .. .. .. .. .. .. .. .. 1 1 Diphtheria and Croup .. .. .. .. .. .. 1 1 1 3 Whooping Cough .. .. .. .. .. 1 3 1 2 7 Diarrhoea .. .. 1 .. 3 23 35 34 14 109 Enteritis .. .. 1 .. 1 4 2 2 5 14 Tuberculous Meningitis .. .. .. .. .. 1 2 3 1 7 Abdominal Tuberculosis (b) .. .. .. .. .. .. 1 .. .. 1 Other Tuberculous Diseases .. .. .. .. .. 1 3 1 1 6 Congenital Malformations (c) 3 2 2 .. 7 3 .. 2 .. 12 Premature Birth 56 9 2 2 69 2 .. .. .. 71 Atrophy, Debility and Marasmus 6 3 5 2 16 16 13 8 2 55 Atelectasis 9 .. .. .. 9 .. 1 .. .. 10 Inj ury at Birth 7 .. .. .. 7 .. .. .. .. 7 Erysipelas .. .. .. .. .. 1 .. 1 .. 2 Syphilis .. .. .. .. 2 2 1 .. .. 5 .Rickets .. .. .. .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. .. .. .. .. 1 1 1 4 7 Convulsions .. .. .. .. 8 3 6 2 3 22 Gastritis .. .. .. .. .. .. .. .. .. .. Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis .. .. 1 .. 1 6 6 3 3 19 Pneumonia (all forms) 1 .. 2 .. 5 10 11 13 17 56 Suffocation, overlaying 2 1 .. .. 3 4 3 2 .. 12 Other causes 2 3 2 .. 7 2 5 1 1 16 89 21 16 12 138 81 96 84 67 466 Nett Births in { legitimate, 3,318 Nett Deaths in { legitimate infants, 1,776 the year {illegitimate, 42 the year of { illegitimate infants, 16 TABLE IV.—Infant Mortality. 1911. WHITECHAPEL DIVISION. Nett Deaths from stated Causes at various Ages under One Year of Age. Cause of Death. Under 1 Week. 1-2 Weeks. 2-3 Weeks. 3-4 Weeks. Total under 1 Month. 1-3 Months. 3-6 Months. 6-9 Months. 0-12 Months. Total Deaths under One Year. All Causes. Certified 37 4 10 i 58 34 32 30 30 184 Uncertified •• •• •• •• •• •• •• •• •• •• Small-pox •• •• •• •• •• •• •• •• •• •• Chicken-pox •• •• •• •• •• •• •• •• •• •• Measles •• •• •• •• •• •• •• 3 4 7 Scarlet Fever •• •• •• •• •• •• •• .. •• .. Diphtheria and Croup •• •• •• •• •• •• •• .. .. .. Whooping Cough •• •• •• •• •• •• 1 •• 2 6 Diarrhoea •• •• •• •• •• 12 16 12 7 51 Enteritis •• •• •• •• •• •• 2 •• 1 6 Tuberculous Meningitis •• •• •• •• •• .. •• •• 1 1 Abdominal Tuberculosis (b) •• •• •• •• •• .. •• •• •• •• Other Tuberculous Diseases •• •• •• •• •• •• •• •• .. •• Congenital Malformations (c) •• •• •• •• 5 2 1 •• .. 9 Premature Birth 23 •• •• •• 24 1 •• •• •• 25 Atrophy, Debility and Marasmus 1 •• •• •• 7 7 3 •• •• 22 Atelectasis 3 •• •• •• 4 •• •• •• •• 4 Injury at Birth 3 •• •• •• 4 •• • • •• •• 4 Erysipelas •• •• •• •• •• •• •• •• •• . Syphilis •• •• •• •• •• •• •• •• 1 2 Eickets •• •• •• •• •• •• •• •• 1 1 Meningitis (not Tuberculous) •• •• •• •• •• •• •• •• 1 3 Convulsions •• •• •• •• 4 •• 2 •• •• 7 Gastritis •• •• •• •• •• •• •• •• •• •• Laryngitis •• •• •• •• •• •• •• •• •• •• Bronchitis •• •• •• •• •• 1 2 1 •• 4 Pneumonia (all forms) •• •• •• •• 2 4 5 4 9 24 Suffocation, overlaying 2 •• 1 •• 3 1 •• •• •• 4 Other causes •• •• l •• 1 2 •• •• 1 4 37 4 10 1 58 34 32 30 30 184 Nett Births in ( legitimate, 1,658 Nett Deaths in I legitimate infants, 996 the year ( illegitimate, 63 the year of i illegitimate infants, 20 129 LIST OF STREETS in the Borough of Stepney, their situation and the number of Infectious Diseases that occurred in them during the year. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever. Diphtheria. .Membranous Croup. Erysipelas. Total. A Abbott’s Cottages Limehouse .. .. .. .. .. .. .. Abel's Buildings Whitechapel .. .. .. .. .. .. .. Aeland Street Limehouse .. .. .. 2 .. .. 2 Adelaide Place Spitalfields .. .. .. .. .. .. .. Adelina Grove Mile End .. 1 .. 2 .. .. 3 Agatha Street St. Gforge’s .. .. .. .. .. .. .. Agnes Street Limehouse .. .. .. .. .. .. .. Agra Place St. George’s .. .. .. .. .. .. .. Albany Street Ratcliff and Mile End .. .. .. .. .. .. .. Albert Buildings, Cartwright Street Aldgate .. 1 .. .. .. .. 1 Albert Cottage, Albert Street Mile End .. .. .. .. .. .. .. Albei t Square Ratcliff .. .. .. .. .. .. .. Albert Street Buildings Shadwell .. .. .. .. .. .. .. Albion Cottages Shadwell .. .. .. .. .. .. .. Albion Street Mile End .. 2 .. 1 .. .. 3 Albion Terrace I limehouse .. .. .. .. .. .. .. Alderney Place Mile End .. .. .. .. .. .. .. Alderney Road Mile End .. .. .. 1 .. .. 1 Albert Street Mile End New Town .. .. .. .. .. .. .. Albion Court, Redman's Road Mile End .. .. .. .. .. .. .. Albert Workshop Great Pearl Street, Spitalfields .. .. .. .. .. .. .. Arbour Square Mile End .. 1 .. 2 .. 1 4 Alexander Buildings, Commercial Street Spitalfields .. .. .. .. .. 1 1 Alfred Buildings, Cartwright Street Aldgate .. .. .. .. .. .. .. Alie Place Whitechape .. .. .. .. .. .. .. Alma Road Mile End .. 1 .. 1 .. .. 2 Amber Place St. George’s .. .. .. .. .. .. .. Amoy Place Limehouse .. .. .. .. .. .. .. Anchor Street Limehouse .. .. .. .. .. .. .. Angel Alley Whitechapel .. .. .. .. .. .. .. Ann Street Ratcliff .. .. 1 2 .. 3 6 Ann Street Mile End .. .. .. .. .. 1 1 Ann’s Place, Wentworth Street Spitalfields .. .. .. .. .. .. .. Antcliff Street Mile End .. .. .. .. .. .. .. Anthony Street St. George’s .. .. .. 1 .. .. 1 Argyle Road Mile End .. .. .. .. .. .. .. Arno Place Limehouse .. .. .. .. .. .. .. Antill Road Mile End .. 1 .. 1 .. 1 3 Artillery Lane Spitalfields and Old .. .. .. .. .. .. .. Artillery Passage Artillery Ground Ditto .. .. .. .. .. .. .. 130 Returens of Insfectious Diseases.-continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. Artichoke Hill St. George’s .. .. .. .. .. .. .. Ashcroft Road Mile End .. .. .. .. .. .. .. Assembly Mews Mile End .. .. .. .. .. .. .. Assembly Passage Mile End .. .. .. .. .. .. .. Assam Street Wliitechapel .. .. .. .. .. .. .. Aston Street Limehouse .. .. .. 1 .. 2 3 Ashford House, Puma Court Spitalfields .. .. .. .. .. .. .. Augustine House Mile End New Town .. .. .. .. .. .. .. Apsley Street Mile End .. .. 1 .. .. .. 1 Antill Terrace Mile End .. .. .. .. .. .. .. Arbery Road Mile End .. .. .. .. .. .. .. B Back Church Lane Whitechapel and St. George’s .. .. .. 1 .. 1 2 Baggally Street Mile End .. 1 .. .. .. 1 2 Baker Court Mile End .. .. .. .. .. .. .. Baker Street Mile End .. 4 .. 3 .. .. 7 Bale Street Mile End .. .. 1 .. .. .. 1 Balls Buildings Ratcliff .. .. .. 1 .. .. 1 Bancroft Road Mile End 31 2 .. 3 .. 6 42 Barnes Street Ratcliff .. .. .. .. .. .. .. Barnett Street St. George’s .. .. .. .. .. .. .. Batson Street Limehouse .. .. .. .. .. .. .. Batty Gardens St. George’s .. .. .. .. .. .. .. Batty Street St. George’s .. .. .. 1 .. 3 4 Baythorne Street Mile End .. .. .. .. .. .. .. Beachcroft Buildings, Brook Street Ratcliff .. .. .. .. .. .. .. Beagle Street Whitechapel .. .. .. .. .. .. .. Beard's Place Limehouse .. .. .. .. .. .. .. Beaumont Square Mile End .. 1 .. .. .. 1 2 Beaumont Street Mile End .. .. .. .. .. .. .. Beccles Street Limehouse .. .. .. .. .. 1 1 Becksbourne Buildings Ratcliff .. 1 .. .. .. .. 1 Bedford Street Mile End .. .. .. 1 .. 4 5 Belgrave Street Ratcliff .. 1 .. 1 .. .. 2 Bell Court Spitalfields .. .. .. .. .. .. Bell Lane Spitalfields .. 1 .. .. .. 1 2 Bennett’s Place Spitalfields .. .. .. .. .. .. .. Ben Jonson Road Limehouse and Mile End .. .. .. 1 .. 1 2 Bere Street Eatcliff .. .. .. .. .. .. .. Bermuda Street Mile End .. 1 .. .. .. .. 1 Berner Street St. George’s .. .. .. .. .. .. .. 131 Returns of Infectious Diseases.— continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total Berney Buildings St. George’s •• •• •• •• •• •• •• Bett Street St. George’s •• •• •• 1 •• •• 1 Bewley Buildings Shadwell •• •• •• 2 •• •• 2 Birchfield Street Limehouse •• •• •• •• •• •• •• Bird Street St. George’s •• •• •• •• •• •• •• Black Bull Court Ratcliff •• •• •• •• •• •• •• Bellevue Place, Cleveland Street Mile End •• •• •• •• •• •• •• Black Eagle Street Spitalfields •• •• •• •• •• •• •• Black Lion Yard Whitechapel •• •• •• •• •• •• •• Blackwall Buildings, Thomas Street Whitechapel •• 5 1 1 •• •• 7 Blakesley Street St. George’s •• 1 •• •• •• 1 2 Bloomfield Road Mile End •• 2 ] 1 4 Blossom Court Norton Folgate •• •• •• •• •• •• •• Blossom Street Norton Folgate •• •• •• •• •• 1 1 Blount Street Limehouse •• •• •• •• •• 1 1 Boarded Entry St. George’s •• •• •• •• •• •• •• Boar's Head Yard Whitechapel •• •• •• •• •• •• •• Bohn Street Mile End •• 1 2 •• •• •• 3 Booth Street Spitalfields and Mile End New Town •• 2 •• 1 •• 2 5 Booth Street Buildings Spitalfields •• •• •• 1 •• 1 2 Bostock Street St. George’s •• 1 •• •• •• •• 1 Boundary Court Spitalfields and Mile End New Town •• •• •• •• •• •• •• Bow Common Lane Mile End and Limehouse •• 4 •• 3 •• •• 7 Bower Street Ratcliff •• •• •• •• •• •• •• Bowyer's Building St. George’s •• •• •• •• •• •• •• Boyd Street St. George’s •• •• •• •• •• •• •• Bradwell Street Mile End •• •• •• •• •• 1 1 Brady Street Whitechapel •• •• •• •• •• •• •• Brady Street Buildings Whitechapel •• 7 1 •• •• 1 9 Brady Street Mansions Whitechapel •• 4 •• •• •• 3 7 Breezer's Hill St. George’s •• •• •• •• •• •• •• Brenton Street Limehouse •• 2 •• •• •• •• 2 Brewer's Court Shadwell •• •• •• •• •• 1 1 Brewhouse Court Wapping •• •• •• •• •• •• •• Brewhouse Lane Wapping •• •• •• •• •• •• •• Brick Lane Spitalfields and Whitechapel •• 2 1 1 •• 7 11 Bridge Street Mile End •• 1 1 2 •• 1 5 Bridge Terrace Limehouse •• •• •• •• •• •• •• Brighilingsea Buildings Ratcliff •• •• •• •• •• •• •• Britton's Court St. George’s •• •• •• •• •• •• •• Brilliant Street Mile End •• •• •• •• •• •• •• I 2 132 Returns of Infectious Diseases.- continued. Streets. Districts. SmaU Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. Broad Street Ratcliff •• •• •• •• •• •• •• Bromhead Road Mile End •• •• •• •• •• •• •• Bromhead Street Mile End •• •• •• •• •• •• •• Bromley Street Ratcliff •• 2 1 2 •• 1 6 Brook Street Ratcliff . , 3 . . 3 •• 2 8 Browning's Court St. George's •• •• •• •• •• •• •• Brownson's Court, Grea Alie Street "YVbitechapel •• •• •• •• •• 1 1 Brunswick Buildings, Goulston Street Whitechapel 1 •• •• 1 •• 4 6 Brunswick Place Ratcliff •• 2 •• •• •• •• 2 Brunswick Street St. George's •• •• •• •• •• •• •• Brunton's Cottages Ratcliff •• •• •• •• •• •• •• Brunton's Place Ratcliff •• •• •• •• •• •• •• Brushfield Street Spitalfields and Old Artillery Ground •• •• •• •• •• •• •• Buckeridge Street Mile End •• •• •• •• •• 1 1 Buckle Street Whitechapel •• •• •• •• •• •• •• Buckle Street Buildings Whitechapel •• 1 •• •• •• •• 1 Bull Court Whitechapel •• •• •• •• •• •• •• Bull Stake Court Whitechapel •• •• •• •• •• •• •• Bulwer House, Pelham Street Whitechapel •• •• •• •• •• •• •• Burdett Road Limehouse and Mile End •• 2 •• 9 •• 6 17 Burgess Street Limehouse •• 2 •• •• •• •• 2 Buross Street St. George's •• •• •• 2 •• 1 3 Burr Street Whitechapel •• •• •• 1 . . .. 1 Burslem Street St. George's •• •• •• •• •• •• Burton's Entry Ratcliff •• •• •• •• •• •• •• Bushel Street St. George's •• •• •• •• •• •• •• Butcher Row Ratcliff •• •• •• •• •• •• •• Butler Street Spitalfields •• •• •• •• •• •• •• Buttress Gardens Mile End New Town •• •• •• •• •• •• •• Buttress Street Mile End New Town •• 1 •• .. •• •• 1 Buxton Street Mile End New Town •• 2 •• 2 •• 1 5 c •• •• •• •• •• •• •• Cable Street Shadwell and St. George's •• 5 1 8 •• 7 21 Cadiz Street Mile End •• 2 •• 2 •• 1 5 Calverley Street Mile End •• •• •• •• •• •• •• Cambridge Read Mile End •• 1 1 •• •• •• 2 Cambridge Mansions Mile End •• •• •• •• •• •• •• 133 Returns of Infectious Diseases.— continued. Streets. Districts. Small Pox. 1 Scarlet Fever. Typhoid Fever Diphtheria. M embranous Croup. Erysipelas. Total. Cameron Place Mile End .. .. .. .. .. .. .. Canal Road Mile End .. 3 .. 1 .. 2 6 Cannon Place Mile End and Whitechapel .. .. .. .. .. .. • • Carlton Road Mile End .. 1 1 .. .. 1 .. Carlton Square Mile End .. .. .. 1 .. .. 1 Carter Street Mile End .. 1 .. .. .. 1 2 Carter Street Spitalfields .. .. .. .. .. .. .. Caroline Place Limehouso .. .. .. .. .. .. .. Caroline Street Rate] iff .. .. .. 1 .. .. 1 Carrick's Buildings Limehouse .. .. .. .. .. .. .. Carr Street Limehouse .. .. .. .. .. .. .. Cartwright Street Whitechapel .. .. .. .. .. .. .. Casson Street Whitechapel .. .. .. 1 .. 2 3 Castle Court Whitechapel • • .. .. .. .. .. .. Catherine Terrace Whitechapel .. .. .. .. .. .. .. Causeway Court Ratcliff .. .. .. .. .. .. .. Cayley Street Limehouse .. .. .. .. .. 1 1 Cecil Street Mile End .. 1 .. .. .. .. 1 Cephas Street Mile End .. 2 1 3 .. .. 6 Caroline Place, Globe Road Mile End .. .. .. .. .. .. .. Cannon Street Road St. George's .. 3 .. 4 .. 1 8 Challis Court St. George's .. .. .. .. .. 1 1 Chamber Court Whitechapel .. .. .. .. .. .. .. Chamber Square Wapping .. .. .. .. .. .. .. Chamber Street Whitechapel .. .. .. .. .. .. .. Chancery Place Shadwell .. .. .. .. .. .. .. Chancery Buildings Shadwell .. .. .. .. .. .. .. Chandler Street St. George's .. .. .. .. .. .. .. Chapel Place Norton Folgate .. .. .. .. .. • • .. Chapel Place Mile End .. .. .. .. .. .. .. Chapel Street Spitalfields .. .. .. .. .. .. Chapman Place St. George's .. .. .. .. .. .. .. Charles Place Shadwell .. .. .. .. .. .. .. Charlotte Court, Hunt Street Mile End New Town .. .. .. .. .. .. .. Charles Street Mile End .. .. .. 1 .. .. 1 Chaseley Street Ratcliff .. .. .. .. .. .. 3 Chicksand Street Mile End New Town .. .. .. .. .. 2 3 Chicksand Place Mile End New Town .. .. .. .. .. .. Chigwell Hill St. George's .. .. .. .. .. 1 1 Chiver's Court Limehouse .. .. .. .. .. .. .. Christian Street St. George's .. 1 .. 3 .. 0 9 Choppin's Court St. George's .. .. .. .. .. .. .. Christopher Court Whitechapel .. 1 .. .. .. .. 1 Church Court Wapping .. .. .. .. .. .. .. Church Lane Whitechapel .. .. .. 1 .. .. 1 134 Returns of Infectious Disease s.—continued. Streets. Districts. Small Pox. Scarlet Fever. iTyphoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. Church. Passage Spitalfields .. .. .. .. .. 2 2 Church Row Limehouse .. 1 .. 1 .. 2 4 Church Street Holy Trinity .. .. .. .. .. .. .. Church Street Wapping .. .. .. .. .. .. .. Chusan Place Limehouse .. .. .. .. .. .. Claremont Place Mile End .. .. .. .. .. 1 1 Clark Street Mile End .. .. .. 2 .. 3 .. Clayden's Buildings Limehouse .. .. .. .. .. .. .. Clegg Street St. George's .. .. .. 1 .. .. 1 Clemence Street Limehouse .. .. .. 1 .. 1 .. Cleveland Grove Mile End .. .. .. .. .. .. .. Cholsey Buildings, Booth Street Spitalfields .. .. .. .. .. .. .. Church Street Mile End New Town .. .. .. .. .. .. .. Clinton House, Pelham Street Mile End New Town .. .. .. .. .. .. .. Cleveland Street Mile End .. .. .. .. .. .. 1 Cleveland Buildings Mile End .. • • .. .. .. .. .. Clinton Road Mile End .. .. .. .. .. .. .. Clive Street Mile End .. .. .. .. .. 1 1 Clifford House, Wellclose Square St. George's .. .. .. .. .. .. .. Cobbs Street Whitechapel .. .. .. .. .. .. .. Coborn Road Mile End .. .. .. .. .. .. .. Coburg Court Spitalfields .. .. .. .. .. .. .. Coburg Buildings St. George's .. .. .. .. .. .. 1 Coburg Place Mile End .. .. .. .. .. .. .. Cohen's Court Mile End .. .. .. .. .. .. .. Coke Street Mile End .. .. .. .. .. .. 1 Colchester Street Whitechapel .. .. .. .. .. .. 1 Coleman Street Shadwell .. .. .. .. .. .. .. College Buildings, Wentworth Street Whitechapel .. .. .. .. .. .. .. College Street Mile End .. .. .. .. .. .. .. Collhurst Villas, Devonshire Street Mile End .. .. .. .. .. .. .. Collingwood Street Ratcliff .. .. .. .. .. .. .. Colmar Street Mile End .. .. Cologne Street Mile End .. .. .. .. .. .. .. Commercial Mansions Mile End .. .. .. .. .. .. .. Commercial Road Whitechapel, St George's, Mile End. Limehouse .. 10 .. 5 .. 3 18 Commercial Street Whitechapel and Spitalfields .. .. .. 2 .. 1 3 Commodore Street Mile End .. 2 .. .. .. .. 2 Conder Street Limehouse .. 1 1 .. .. 1 3 Copenhagen Place Limehouse .. 2 .. 1 .. 1 4 135 Returns of Infectious Diseases.—continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever. Diphtheria. Membranous Croup. Erysipelas. Total. Copley Street Mile End .. 2 .. 3 .. .. 5 Copos Buildings Limehouse .. .. .. .. .. .. .. Copperfield Road Mile End .. 5 .. .. .. .. 5 Corbett's Court Whitechapel .. .. .. 1 .. .. 1 Cordelia Street Mile End .. 1 .. .. .. 1 Cornwall Place Mile End .. .. .. .. .. .. .. Cornwall Road Mile End .. .. .. .. .. Cornwall Square Mile End .. .. .. .. .. .. .. Cornwall Street St. George's .. .. .. 2 .. .. 2 Cosh's Buildings, Dunstan's Place, Brook Street Ratcliff .. .. .. .. .. .. .. Cosh's Buildings, School House Lane Ratcliff .. .. .. .. .. .. .. Cottage Court Mile End * * .. .. .. .. 1 1 Cottage Grove Mile End .. .. .. .. .. .. 1 Cotton Street Whitechapel .. .. .. 2 .. .. 2 Court Street Whitechapel .. .. .. .. .. .. .. Coutts Road Mile End .. .. .. 5 .. 2 8 Cowley Street St. George's .. .. .. .. .. 1 1 Cox Square Spitalfields .. .. .. .. .. .. .. Cranford Cottage Ratcliff .. .. .. 1 .. .. 1 Crelliu Street St. George's .. .. .. 1 .. .. 1 Cressy Houses Mile End .. .. 1 2 .. 1 4 Cressy Place Mile End .. .. .. .. .. .. .. Crispin Street Spitalfields .. .. .. .. .. 1 1 Cross Street Whitechapel .. .. .. .. .. .. .. Cross Street St. George's .. .. .. .. .. .. .. Cross Street Ratcliff .. .. .. .. .. .. .. Crown Court Spitalfields .. .. .. .. .. .. .. Crown Street Spitalfields .. .. .. .. .. .. Cross Court, Dean Street St. George's .. .. .. .. .. l 1 Cleveland Urove Mile End .. 2 .. .. .. .. 2 D Dalgleish Place Limehouse .. .. .. .. .. .. .. Dalgleish Street Limehouse .. .. 1 2 .. l 4 Dakin Street Limehouse .. .. .. .. .. .. .. Darby Street Whitechapel .. .. .. .. .. .. .. Davis Avenue, Hunt Street Mile End New Town .. 1 .. 2 .. .. 3 Davis Mansions, New Goulston Street Whitechapel .. 2 .. 1 .. l 4 Davis Terrace, Hunt Street Mile End New Town .. .. .. .. .. .. .. Davis Houses, Philip Street St. George's .. .. .. .. .. .. .. 136 Returns of Infectious Diseases.—continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. Davis Buildings, Myrdle Street Mile End .. .. .. .. .. .. .. Deal Street Whitechapel .. .. .. .. .. .. Dean Street St. George's .. .. .. 1 .. .. 1 Dellow Street Shadwell .. 1 .. .. .. .. 1 Dellow Street Buildings Shadwell .. 2 .. .. .. .. .. Dempsey Street Mile End .. 4 .. .. .. .. .. Denmark Street St. George's .. .. .. •• .. 1 1 Devonport Street Ratcliff .. .. .. 3 .. .. 3 Devonshire Place Limehouse .. .. .. .. .. .. .. Devonshire Street Mile End .. 1 .. 2 .. 1 4 Diggon Street Mile End .. .. .. .. .. 1 1 Dixon Street Limehouse .. .. .. .. .. 1 .. Dock Street Whitechapel and Wapping .. .. .. .. .. .. .. Dod Street Limehouse .. 1 .. .. .. 2 3 Dora Street Limehouse .. 2 .. .. .. .. 2 Dongola Street Mile End .. .. .. .. .. 1 .. Doris House St. George's .. .. .. .. 1 .. 1 Dorset Street Ratcliff .. .. .. .. .. .. .. Doveton Street Mile End .. .. 1 .. .. .. .. Drew's Buildings, Juniper Street Shadwell .. 1 1 .. .. .. Drew's Buildings, High Street Shadwell .. .. .. .. .. .. Drew's Building, Elbow Lane Shadwell .. .. .. .. .. .. .. Drewton Street Ratcliff .. .. .. .. .. .. 2 Driver's Buildings Mile End .. .. .. .. .. .. .. Drum Yard Whitechapel .. .. .. .. .. .. .. Duckett Street Mile End .. .. .. .. .. 2 4 Dudley Terrace Mile End .. .. .. .. .. .. .. Duke Shore Alley Limehouse .. .. .. .. .. .. .. Duke Street Old Artillery Ground .. .. .. .. .. 2 2 Duncan Street Whitechapel .. .. .. .. .. .. .. Dundee Street Wapping .. .. .. .. .. 1 .. Dunk Street Mile End New Town .. .. .. .. .. 6 .. Dunstan's House Mile End .. .. .. .. .. .. .. Dupont Street Limehouse .. .. .. .. .. 1 .. Durer Place St. George's .. .. .. .. .. .. .. Dunstan's Place Ratcliff .. .. .. .. .. 2 4 Durham Row Ratcliff .. .. •• .. .. .. .. Durward Street Whitechapel .. .. .. .. .. 1 1 Duval Street Spitalfields .. .. .. 1 .. 7 8 137 Returns of Infectious Diseases.— continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria Membranous Croup. Erysipelas. Total. E East Arbour Street Mile End . . . . . . . . . . . . . . Eagle Buildings Limehouse . . . . . . . . . . . . . . Eagle Place Mile End New Town . . . . . . . . . . . . . . Eagle Place Mile End . . . . . . . . . . . . . . Eele Street, King Edward Street Mile End New Town . . . . . . . . . . . . . . Easington Buildings Whitechapel . . . . . . 1 . . . . 1 Eastbury Terrace Mile End . . . . . . . . . . . . . . Eastfield Street Limehouse . . 1 1 4 . . 3 9 East India Dock Road Limehouse . . . . . . 1 . . 1 2 Eastman's Court Spitalfields . . . . . . . . . . . . 1 East Mount Street Whitechapel . . . . . . . . . . . . . . East Pier Wapping . . . . . . . . . . . . . . East Smithfield Wapping . . . . . . . . . . . . . . Eaton Place Mile End . . . . . . . . . . . . . . Ebenezer Place Limehouse . . . . . . . . . . . . . . Edinburgh Road Mile End . . . . . . 1 . . . . 1 Edward's Road Mile End . . 1 . . . . . . . . 1 Edward Street Mile End . . . . . . . . . . . . . . Edward Mann Buildings . . . . . . 3 . . 1 4 Elbow Lane Shadwell . . . . . . . . . . . . . . Elbow Lane Buildings Shad well . . . . . . 1 . . 1 2 Elder Court Norton Folgate . . . . . . . . . . . . . . Elder Street Norton Folgate . . . . . . . . 1 1 2 Elizabeth Cottages St. George's . . . . . . . . . . . . . . Elizabeth Place Limehouse . . . . . . . . . . . . . . Elizabeth Place Whitechapel . . . . . . . . . . 1 1 Ellen Court St. George's . . . . . . . . . . . . Ellen Place St. George's . . . . . . 1 . . 2 3 Ellen Street St. George's . . 2 . . . . . . 2 4 Elm Row Shadwell . . . . . . . . . . . . . . Elsa Street Limehouse . . 5 2 . . . . 1 8 Elsie House St. George . . . . . . . . . . . . . . Eltham Place Mile End . . . . . . . . . . . . . . Ely Place Whitechapel . . . . . . . . . . . . .. Ely Terrace Mile End . . . . . . . . . . 2 '2 Emanuel's Almshouses Wapping . . . . . . . . . . . . . . Emery Place, Butler Street Spitalfields . . . . . . . . . . . . . . Emmot Street Mile End . . . . . . . . . . 6 5 Endive Street Limehouse . . 1 . . 1 . . 1 3 Entick Street Mile End . . . . . . . . . . . . . . Eric Street Mile End . . . . 2 . . . . 2 Ernest Street Mile End • • . . . . . . . . . . . . Essex Street Mile End . . 1 . . . . . . . . . . 138 Returns of Infectious Diseases.— continued. Streets. Districts Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. Essian .Street Mile End .. 2 1 .. .. .. 2 Everard Street St. George's .. .. .. .. .. 1 1 Ewing Street Mile End 1 1 .. .. . . •• 2 Exmouth Street Mile End .. .. 1 .. .. .. 3 F .. .. .. .. .. .. .. Fair Street Mile End .. 1 .. .. .. .. 1 Fairclough Street St. George's .. .. .. .. .. 2 2 Faith Street Mile End .. .. .. .. .. .. .. Farmer's Row Limehouse .. .. .. .. .. .. .. Farrance Street Limehouse .. 2 .. .. .. 2 Fashion Court Spitalfields . . .. .. .. .. .. 1 1 Fashion Street Spitalfields .. .. .. .. .. 1 1 Felix Houses St. George's .. .. .. .. .. .. .. Fenton Street St. George's.. .. .. .. 1 .. 1 2 Ferrier's Court Mile End .. .. .. .. .. .. .. Ficklin Buildings.. St. George's.. .. .. .. .. .. .. 1 Fieldgate Street Whitechapel 4 4 Fieldgate Mansions Mile End .. 1 .. 3 .. 1 .. Finch Street Whitechapel and Mile End New Town .. .. .. .. .. 1 1 Five Bell Alley Limehouse .. .. .. .. .. .. .. Flamborough Street Limehouse .. 4 .. 1 .. .. .. Fleur-de-lis Buildings Norton Folgate .. .. .. .. .. .. .. Fleur-de-lis Street Norton Folgate .. .. .. .. .. .. .. Floreston Street Mile End .. .. .. .. .. .. .. Flower and Dean Street Spitalfields .. .. 1 1 .. 4 .. Ford Square Mile End .. .. .. .. .. .. .. Fordham Street Mile End .. .. .. 1 .. .. 1 Forrester Street Mile End .. .. 1 .. .. .. 1 Fort Street Old Artillery Ground .. .. .. .. .. .. .. Fournier Street Spitalfields .. .. .. .. .. 1 1 Frederick Place Mile End .. 6 .. .. .. .. 6 Freeman Street Spitalfields .. .. .. 1 . . .. 1 Freeman's Cottages Mile End .. .. .. .. .. .. .. French Court St George's .. .. .. .. .. 1 .. Friar's Hill St. George's .. .. .. .. .. .. .. Frimley Street Mile End .. .. .. 1 .. .. 1 Frostic Mansions Whitechapel .. .. .. .. .. .. .. Frostic Place Whitechapel . . 1 .. .. .. .. 1 Frying Pan Alley Spitalfields . . . . . . . . . . . . . . Fulbourne Street Whitechapel . . 3 . . . . . . . . . . Fulcher's Buildings Mile End . . . . . . . . . . . . . . 139 Returns of Infectious Diseases.—continued. Streets. Districts, Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. G . . . . . . . . . . . . . . Garden Street, Smith Place Mile End . . .. . . . . . . . . . . Gainsborough Road Mile End . . . . . . . . . . . . . . Gait Street Limehouse . . . . . . . . . . . . . . Garden Cottages Limehouse . . . . . . . . . . . . . . Garden Place Mile End New Town . . . . . . . . . . . . . . Gardorn Street Mile End . . . . . . . . . . . . . . Garden Street Mile End . . . . . . . . . . . . 1 Garth Street Shadwell . . . . . . . . . . . . . . Gates Head Place Mile End . . . . . . . . . . . . . . George Court Whitechapel . . . . . . . . . . . . . . George Place Ratcliff . . . . . . . . . . . . . . George Place Mile End . . . . . . . . . . . . 1 George Street Ratcliff . . . . . . . . . . . . 1 George Street, Tower Hill Aid gate . . . . . . . . . . . . . . George Yard Whitechapel . . . . . . . . . . . . . . Georgina Place Mile End . . . . . . . . . . . . . . Gertrude House St. George's.. . . . . . . . . . . . . . . Giles Place Ratcliff . . . . . . . . . . . . . . Gill Street Limehouse . . . . . . . . . . . . 2 Gill Place Limehouse . . . . . . . . . . . . . . Glamis Road Shadwell . . . . . . . . . . . . 7 Grace's Alley- Whitechapel . . . . . . . . . . . . . . Glasshouse Buildings Whitechapel . . . . . . . . . . . . . . Glasshouse Fields Ratcliff . . . . . . . . . . . . 1 Glasshouse Street.. Whitechapel . . . . . . . . . . . . . . Globe Alley Limehouse . . . . . . . . . . . . . . Globe Buildings Mile End . . . . . . . . . . . . . . Globe Place St. George's . . . . . . . . . . . . . . Globe Road Mile End . . . . . . . . . . 4 . . Globe Street St. George's . . . . . . . . . . . . . . Gloucester Court Limehouse . . . . . . . . . . . . . . Gloucester Buildings St. George's . . . . . . . . . . . . . . Gloucester Court Mile End . . . . . . . . . . . . . . Godfrey House, Thrawl Street Spitalfields . . 1 . . 1 . . . . 2 Gold Street Mile End . . 1 . . . . . . 1 2 Goodhart Place St. George's . . . . . . . . . . . . . . Goodman's Stile Whitechapel . . . . . . . . . . . . . . Goodman's Yard Whitechapel . . . . . . . . . . . . . . Gould's Hill Shadwell . . . . . . . . . . . . . . Goulston Street Whitechapel . . . . . . . . . . . . . . Govey's Place Mile End . . . . . . . . . . 1 1 Gowor's Walk Whitechapel . . . . . . . . . . 1 1 Grafton Street Mile End . . 1 . . 3 . . 1 5 Gray Street Mile End . . 1 . . 3 . . . . 4 140 Returns of Infectious Diseases.— continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever. | Diphtheria. Membranous Croup. . Erysipelas. Total. Green Bank Wapping and St. George's .. 1 .. .. .. .. 1 Green Dragon Yard Whitechapel .. .. .. 1 .. .. 1 Green Street Ratcliff .. .. .. .. .. .. .. Greenfield Street Mile End .. 1 .. 2 .. 1 4 Green's Place Whitechapel and Mile End New Town .. .. .. .. .. .. .. Greenwood Street Mile End .. 1 .. .. .. .. 1 Grebe Court Mile End .. .. .. .. .. .. .. Grenade Street Limehouse .. .. .. 1 .. 1 2 Grey Eagle Street Spitalfields .. .. .. .. .. 1 1 Grigg's Court Whitechapel .. .. .. .. .. .. .. Grocer's Court Wapping .. .. .. .. .. .. .. Grove Cottages Mile End .. .. .. .. .. .. .. Grove Court Ratcliff .. .. .. .. .. .. .. Grove Place St. George's .. .. .. .. .. .. .. Grove Road Mile End .. 2 .. .. .. 2 4 Green Street Whitechapel .. .. .. .. .. .. .. Great Tower Hill Aldgate .. .. .. .. .. .. .. Grosvenor Street Mile End .. .. .. 1 .. .. 1 Grove Street St. George's •• 2 .. .. •• 2 4 Great Alie Street Whitechapel .. .. .. 1 .. .. 1 Great Eastern Buildings, Quaker Street Spitalfields .. .. .. .. .. 1 1 Great Garden Street Whitechapel .. .. .. 5 .. .. 0 Great Hermitage Street St. George's .. .. .. 1 .. .. 1 Great Pearl Street Spitalfields .. .. .. .. .. .. .. Great Prescot Street Whitechapel.. .. .. .. 1 .. 1 2 Gun Square Limehouse .. .. .. .. .. .. .. Gun Street Old Artillery Ground .. .. .. 2 .. 1 3 Great Eastern Buildings, Fieldgate Street Whitechapel .. .. .. .. .. .. .. H Half Moon Passage Whitechapel .. 1 .. .. .. .. 1 Half Wilk Court Spitalfields .. .. .. .. .. .. .. Hall Street M ile End .. .. .. .. .. .. .. Halley Street Limehouse .. .. .. 2 .. 1 3 natnpsliire Court Mile End .. .. .. .. .. .. .. U anbury Fields Spitalfields .. .. .. .. .. .. .. Hanbury Street Spitalfields and Mile End New Town .. 3 .. 6 .. 6 15 Hannibal Mews Mile End .. .. •• .. .. .. .. Hannibal Road Mile End .. .. .. 4 .. .. 4 Hanover Court Whitechapel .. .. .. .. .. .. .. Harding Street Ratcliff .. 2 .. 1 .. .. 3 Hardy's Place Mile End .. .. .. .. .. .. .. Hare Street Mile End .. .. 1 .. .. .. 141 Returns of Infectious Diseases.- continued. Streets. Districts.. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total Harford Street Mile End .. 4 1 2 .. 1 8 Harlow Place Mile End .. .. .. 1 .. .. 1 Harriet Place Spitalfields .. .. .. .. .. .. .. Harrison's Court Spitalfields .. .. .. .. .. .. .. Harris Terrace St. George's .. .. .. .. .. .. .. Harold Alley Wapping .. .. .. .. .. .. .. Havering- Street Ratcliff .. 1 .. 1 .. .. 2 Hawkins Street Mile End .. 2 .. 2 .. 3 7 Haydon Street Holy Trinity .. .. .. .. .. .. .. Haydon Scpiare Holy Trinity .. .. .. .. .. .. .. Harod's Place Whitechapel .. .. .. 1 .. .. 1 Harod's Alley Whitechapel .. .. .. .. .. .. .. Harriet Court Whitechapel .. .. .. .. .. .. .. Hayfield Passage Mile End .. .. .. 1 .. .. 1 Hayfield Place Mile End .. .. .. .. .. .. .. Hayfield Yard Mile End .. .. .. .. .. .. .. Heath Street Mile End .. 1 .. 1 .. 1 3 Heckford Street Limehouse .. .. .. 1 .. .. 1 Helena House, Loleswortl Street Spitalfields .. 2 .. .. .. 1 3 Helena Terrace, Chieksan Street Spitalfields and Whitechapel .. .. .. .. .. .. .. Hellings Street St. George's .. .. .. .. .. .. .. Heneage Street Whitechapel and Mile End New Town .. 1 1 1 .. 2 5 Hessel Street St. George's .. .. 1 1 .. 1 3 Hewitt's Court Mile End .. .. .. .. .. .. .. High Street Shadwell .. .. 5 4 .. 5 11 High Street Wapping .. .. .. .. .. .. .. High Street Ratcliff .. .. .. .. .. .. .. Hilliard's Court St. George's .. 1 .. 1 .. .. 2 Hilton Street Ratcliff .. .. .. .. .. 1 1 Hobson's Cottages, Pelhau Street Mile End New Town .. .. .. .. .. .. .. Hobson's Place Mile End New Town .. .. .. .. .. .. .. Holford Street Mile End .. .. .. .. .. .. .. Holkar Place Limehouse .. .. .. .. .. .. .. Holloway Street Mile End .. .. .. .. .. .. .. Hooper Street Whitechapel .. .. .. .. .. .. .. Hope Court Limehouse .. .. .. .. .. .. .. Hope Place Limehouse .. .. .. .. .. 1 1 Hope Street Whitechapel .. .. .. .. .. .. .. Horseferry B ranch Road. Ratcliff .. .. .. .. .. .. .. Horsley Buildings Mile End .. .. .. .. .. .. .. Howard's Buildings Mile End New Town .. .. .. .. .. .. .. Huddart Street Mile End .. 2 .. .. .. .. 2 Hungerford Street St. George's .. .. .. 2 .. .. 2 Hunt Court Mile End New Town .. .. .. .. .. .. .. 142 Returns of Infectious Diseases.-continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. Hunt's Mews Shadwell •• •• •• •• •• •• •• Hunton Place Whitechapel •• •• •• 1 1 •• 1 Hunt Street Mile End New Town •• •• •• •• •• •• 1 Hogarth Houses, Batty St. St. George's •• •• •• •• •• •• •• Hogarth Houses, Christian Street St. George's •• •• •• 1 •• . . 1 I Imperial Buildings St. George's •• •• •• 1 •• 1 2 Irene House, Flower and Dean Street Spitalfields •• •• •• •• •• •• •• Irish Court Whitechapel •• •• •• •• •• •• •• Island How Limehouse •• •• •• •• •• •• •• J Jamaica Passage Limehouse •• •• •• •• •• •• •• Jamaica Street Mile End •• •• •• 1 •• 1 2 James' Place Ratcliff •• •• •• •• •• •• •• James' Street Mile End •• •• •• 1 •• 1 2 Jane Court St. George's •• •• •• •• •• •• •• Jane Street St. George's •• •• •• 1 •• •• 1 Jewell Street Mile End •• 2 •• •• •• •• 2 John's Court, Casson Street Whitechapel and Mile End New Town •• •• •• •• •• •• •• John's Court St. George's •• •• •• •• •• •• •• John's Gardens Limehouse •• •• •• •• •• •• •• John's Hill St. George's •• •• •• •• •• •• •• John's Place Mile End •• 2 •• •• •• •• 2 John's Place, Old Montague Street Whitechapel •• •• •• •• •• •• •• Johnson's Buildings Wapping •• •• •• •• •• •• •• Johnson's Court Whitechapel •• •• •• •• •• •• •• Johnson Street St. George's •• 4 1 •• •• •• 5 Joseph Street Mile End •• 1 •• 1 •• •• 2 Joseph Street St. George's •• •• •• 1 •• •• 1 Josephine House, Thrawl Street Spitalfields •• •• •• •• •• 1 1 Jubilee Buildings Wapping •• •• •• 4 •• 1 5 Jubilee Street Mile End •• 5 •• 6 •• 4 15 Juniper Street Shadwell •• •• •• 2 •• 1 3 Juniper Court St. George's •• •• •• •• •• •• Jupp's Road Mile End •• 1 •• •• •• 5 6 143 Returns of Infectious Diseases.—continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. K Katherine Buildings, Cartwright Street Aldgate .. 2 .. 1 .. 1 4 Key Street.. Mile End 4 .. .. .. .. .. 4 Kent and Essex Yard Whitechapel .. .. .. .. .. .. .. Kinder Street St. George's .. .. .. .. .. .. .. Kiag David Lane Shadwell .. .. .. .. .. .. .. King Street Aldgate .. .. .. .. .. .. King John Street Mile End .. 1 .. .. .. .. 1 King Street Mile End .. 1 .. .. .. .. 1 King Edward Street Mile End New Town .. 1 .. 1 .. .. 2 King's Arms Court Whitechapel .. .. .. .. .. .. .. Kirk's Place Limehouse .. .. .. .. .. 1 1 Knott Street Mile End .. .. 8 .. .. .. 8 Keate House, Lolesworth Street Whiteohapel .. .. .. 1 .. .. 1 L .. .. .. .. .. .. .. Lady Mica's Almshouses Ratcliff •• .. .. .. .. .. .. Lake Street Limehouse .. 1 1 .. .. 2 4 Lamb Court Spitalfields .. .. .. .. .. .. .. Lambeth Street Whitechapel .. .. .. .. .. .. .. Lamb Street Spitalfields .. .. .. .. .. .. .. Lancaster Place Whitechapel .. .. .. .. .. .. .. Lance Street Limehouse .. .. .. .. .. .. .. Langdale Street St. George's .. .. .. 1 .. 1 2 Lang dale Place St. George's .. .. .. .. .. .. .. Lang-dale Mansions St. George's .. 2 .. 4 .. 3 9 Lansdown Cottages Whitechapel .. .. .. .. .. .. .. Latimer Street Mile End .. .. • • 1 .. 1 2 Lavender Place St. George's .. .. .. .. .. .. .. Law-ton Road Mile End .. .. .. .. .. .. .. Leading Street Shadwell .. .. .. .. .. .. .. Leatherdale Street Mile End .. .. .. .. .. 2 2 Lee Street Limehouse .. 1 .. .. .. .. 1 Leman Street Whitechapel .. .. .. 1 .. .. 1 Leopold Street Mile End .. .. .. .. .. 1 1 Leslie Street Mile End .. .. .. .. .. .. .. Lewin's Buildings Mile End .. .. .. .. .. .. .. Lillian House St. George's .. .. .. .. .. .. .. Limehouse Causeway Limehouse .. .. .. .. .. .. .. Lincoln Street Mile End .. .. .. 1 .. .. 1 Lindley Street Mile End .. • • .. .. .. 1 1 Lichfield Road Mile End .. 1 .. 1 .. .. 2 Little Alie Street Whitechapel .. 1 .. .. • • .. 1 Little Ann Street St. George's .. .. .. .. .. .. .. 144 Returns of Infectious Diseases.— continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. Little Bridge Street Mile End .. .. .. .. .. .. .. Little Halifax Street Whiteehapel .. .. .. .. .. .. .. Little Hermitage Street St. George's .. .. .. .. .. .. .. Little Holloway Street Mile End .. .. .. .. .. .. .. Little John Street Ratcliff .. .. .. .. .. .. .. Little John Street Whiteehapel .. .. .. .. .. .. .. Little Montague Street Spitalfields .. .. .. .. .. .. .. Little Pearl Street Spitalfields .. .. .. 1 .. 1 2 Little Prescot Street Whiteehapel .. .. .. .. .. .. .. Little Thames Street Aid g ate .. .. .. .. .. .. .. Little Tongue Yard Whiteehapel .. .. .. .. .. .. .. Little Tower Hill Aldgate .. .. .. .. .. .. .. Little Turner Street St. George's .. .. .. .. .. .. .. Loate's Buildings Aid gate .. .. .. .. .. .. .. Lockhart Street Mile End .. .. .. 1 .. .. 1 Lockside Limehouse .. 1 .. .. .. .. 1 Locksley Street Limehouse .. 1 .. 2 .. 2 5 Lolesworth, Buildings, Thrawl Street Spitalfields .. 2 .. 3 .. .. 5 Lolesworth Street Spitalfields .. .. .. .. .. .. .. Lomas Buildings Mile End .. .. .. .. .. .. .. Lombard Street Mile End New Town .. 1 .. .. .. .. 1 London Street Ratcliff .. .. .. .. .. .. Longfellow Road Mile End .. .. .. .. .. .. .. Longnor Road Mile End .. .. .. .. .. .. .. Lotus Court Spitalfields .. .. .. .. .. .. .. Louisa Street Mile End .. .. .. .. .. .. .. Louisa Gardens Mile End .. .. .. .. .. 1 1 Louvaine Street Mile End .. .. .. .. .. .. .. Love Lane Shadwell .. .. .. 1 .. .. 1 Love Court Shadwell .. .. .. .. .. .. .. Love Lane Square Shadwell .. .. .. .. .. .. .. Lowder Street St. George's .. .. .. .. .. .. .. Lowell Street Limehouse .. .. 1 .. .. .. 1 Lower Chapman Street St. George's .. 2 .. 1 .. .. 3 Lower East Smithtield Aldgate .. .. .. .. .. .. .. Lower Fenton Street St. George's .. .. .. .. 1 .. 1 Lower Shadwell Shadwell .. .. .. .. .. .. .. Lowood Buildings Shadwell .. .. .. .. .. .. .. Lucas Street St. George's .. .. .. 3 .. 1 4 Ludens Place St. George's .. .. .. .. .. .. .. Lufton Place Limehouse .. .. .. .. .. .. .. Luntley Place Whiteehapel .. .. .. .. .. .. .. LyalRoad Mile End .. .. .. .. .. .. .. Lydia Street Mile End .. .. .. .. .. 2 2 Lytton House, Pelham Street Mile End New Town .. .. .. .. .. .. .. Lydbrook Street Limehouse .. .. .. .. .. .. .. 145 Returns of Infectious Diseases.—continued. Streets. Districts Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. M Magdalen Passage Whitechapel .. .. .. .. .. .. .. Maidman Street Mile End .. .. .. 1 .. .. 1 Malay Street St. George's .. 1 .. .. .. .. 1 Manning Street Limehouse .. .. .. .. .. .. .. Manor Court Ratcliff .. .. .. .. .. .. .. Mansell Street Whitechapel .. 1 .. .. .. .. 1 Maplin Street Mile End .. 1 .. .. .. 3 1 Mansell Passago Whitechapel .. .. .. .. .. .. .. Maria Terrace Mile End .. .. .. .. .. .. .. Maritime Street Mile End .. .. .. .. .. .. .. Market Street Ratcliff .. .. .. .. .. .. .. Market Hill Shadwell .. .. .. .. .. .. .. Market Buildings Shadwell .. .. .. .. .. .. .. Marmaduke Place St. George's .. .. .. .. .. .. .. Maroon Street Limehouse .. .. .. 2 .. .. 4 Martha Street St. George's .. 1 .. 1 .. .. 2 Mary Ann Street St. George's .. 1 .. 1 .. .. 4 Mary Street St. George's .. .. .. .. .. .. .. Mary Place St. George's .. .. .. .. .. .. .. Mason's Court Mile End New Town .. .. .. .. .. .. Master's Street Mile End .. .. .. .. .. .. 1 Matlock Street Limehouse .. .. .. .. .. .. 1 Matilda Place St. George's .. .. .. .. .. .. .. Matilda Street St. George's .. .. .. .. .. .. .. May's Cottages Limehouse .. .. .. .. .. .. .. May's Buildings Mile End .. .. .. .. .. .. .. Mayfield Buildings St. George's .. .. .. .. .. .. .. Medland Street Ratcliff .. .. .. .. .. .. .. Medway Road Mile End .. .. .. .. .. .. .. Meeting House Alley St. George's .. .. .. .. .. .. .. Meeting House Building St. George's .. .. .. .. .. .. .. Mercer Street Shadwell .. .. .. .. .. .. .. Meredith Buildings St. George's .. .. .. .. .. .. .. Metropolitan Buildings Mile End New Town .. .. .. .. .. .. .. Middle Shadwell Shadwell .. .. .. .. .. .. .. Middlesex Street Whitechapel .. .. .. .. .. .. Mile End Buildings Mile End .. .. .. .. .. .. .. Mile End Place Mile End .. .. .. .. .. .. .. Mile End Road Mile End .. .. .. .. .. .. .. Milk Yard Shadwell .. .. .. .. .. .. .. M iller's Court Spitalfields .. .. .. .. .. .. .. Miller's Cottages Mile End .. .. .. .. .. .. .. Mill Place Limehouse .. .. .. .. .. .. .. Mill Yard Whitechapel .. .. .. .. .. .. 1 Minories (part of) Holy Trinity .. .. .. .. .. .. .. Mitre, The Limehouse .. .. .. .. .. .. .. K 146 Returns of Infectious Diseases.— continued. Streets. Districts, Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. Monmouth Street Shadwell .. .. .. .. .. .. .. Montague House, Old Montague Street TVhitechapel .. .. .. .. .. .. .. Montague Place Whitechapel .. .. .. .. .. .. .. Monteagle Street Mile End .. .. .. .. .. .. .. Montefiore House St. George's .. .. .. .. .. .. .. Monza Street Shadwell .. 1 .. 1 .. .. 2 Moody Street Mile End .. 1 .. 2 .. 2 5 Morgan Street Mile End .. 2 .. .. .. .. 2 Morgan Terrace Mile End .. .. .. .. .. .. .. Morrison's Buildings, Sout 1 Whitechapel .. .. .. .. .. 1 1 Morris Street St. George's .. .. .. .. .. .. .. Moss Buildings, St. Mary Street Whitechapel .. .. .. .. .. .. .. Mossford Street Mile End .. .. .. .. .. 1 1 Mount Stroet Whitechapel .. .. .. .. .. .. .. Mountford Street Whitechapel .. .. .. .. .. .. .. Monsey Street Mile End .. .. .. .. .. 1 1 Murdock Cottages Mile End .. .. .. .. .. .. .. Mulberry Street Mile End .. .. .. 2 .. .. 2 Mundy's Place Whitechapel .. .. .. .. .. .. .. Myrdle Street Mile End .. .. .. 1 .. 1 2 Morrison's Buildings, North , Mile End .. .. 1 1 .. .. 2 Morgan Houses St. George's .. .. .. .. .. .. .. N Nag's Head Yard Whitechapel .. .. .. .. .. .. .. Narrow Street Limehouse and Ratcliff .. .. .. .. .. .. .. Nathaniel Buildings Spitalfields .. 2 .. 2 .. .. 4 Nelson's Court, Fashion Streot Spitalfields .. .. .. .. .. .. .. Nelson Street Mile End .. 1 1 .. .. .. 2 Neptune Street Wapping Nesbitt's Rents L'mehouse .. .. .. .. .. .. .. New Alley Limehouse .. .. .. 1 .. 1 2 New Alley Square Limehouse .. .. .. .. .. .. .. Newark Street Mile End .. 2 .. 2 .. 1 5 Newbold Street Mile End .. .. .. .. .. 1 .. New Buildings, Tenter Street Whitechapel .. .. .. .. .. 1 .. Newton s Rents Shadwell .. .. .. .. .. .. .. Newcastle Street Whitechapel .. .. .. .. .. 2 2 Newcastle Place Whitechapel .. .. .. .. .. .. 1 New Court, Duval Street Spitalfields .. .. .. .. .. .. .. Nelson's Court, Winthrop Street Whitechapel .. .. .. .. .. .. .. 147 Returns of Infectious Diseases.— continued. Streets. Districts. Small Pox. | Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. . New Church Street Mile End New Town .. .. .. .. .. .. .. Neat's Cottages Mile End .. .. .. .. .. .. .. Norfolk Buildings St. George's .. .. .. .. .. .. .. New Court, Fashion Street Spitalfields .. .. .. .. .. .. .. New Goulston Street Whitechapel .. .. .. .. .. .. .. New Gravel Lane Shadwell .. .. 1 .. .. .. 1 Newman's Buildings, Cox Square Spitalfields .. .. .. .. .. .. .. New Martin Street Whitechapel .. .. .. .. .. .. .. New Square Spitalfields .. .. .. .. .. .. .. Newnham Street Whitechapel .. .. .. 1 .. .. 1 New Tower Buildings Wapping .. .. .. 2 .. .. 2 New Road Whitechapel and Mile End .. 1 .. 1 .. .. 2 Newman's Buildings, Pelham Street Spitalfields .. .. .. .. .. .. .. Nicholas Street Mile End .. 1 .. .. .. 1 2 Nightingale Lnne Limehouse .. .. .. .. .. .. .. Nightingale Lane Aldgate .. 1 .. .. .. .. 1 Norfolk Street Mile End .. 1 .. .. .. .. 1 Northey Street Limehouse .. 1 1 2 .. .. 4 Norton Folgate Norton Folgate .. .. .. .. .. .. .. North-East Passage St. George's .. .. .. .. .. .. .. Norway Place Limehouse .. .. .. .. .. .. .. Norway Yard Limehouse .. .. .. .. .. 1 Norwich Court Whitechapel .. .. .. .. .. .. .. Notgrove Street Limehouse .. .. .. .. .. .. .. Nottingham Place Mile End .. .. .. 2 .. 1 3 Norman's Buildings St. George's .. .. .. .. .. .. .. North Place Mile End New Town .. 1 .. .. .. .. 1 North Street Spitalfields .. .. .. .. .. .. .. North Street Mile End .. .. .. .. .. .. .. o Oak Lane Limehouse .. .. .. .. .. .. .. Oak Place Mile End .. .. .. .. .. .. .. Ocean Street Mile End .. 1 2 .. .. 2 5 Old Castle Street Whitechapel .. .. .. .. .. .. .. Old Church Road Mile End .. .. .. 3 .. 2 5 Old Gravel Lane St. George's .. 1 1 S 7 Old Montague Street Whitechapel .. 2 1 1 .. 2 6 Old Tower Buildings Wapping .. .. .. .. .. .. .. Oley Place Mile End .. .. .. 1 .. .. 1 Orange Court St George's .. .. .. .. .. .. .. Orange Mews Mile End New Town .. .. .. .. .. .. .. Orchard Gardens Mile End .. .. .. .. .. .. .. K 2 148 Returns of Infectious Diseases.—continued. Streets. Districts, Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. embranous Croup. Erysipelas. Total. Orchard, The Ratcliffe • • • • • • • • • • • • • • Orson Place Mile End • • • • • • • • • • Osborn Court Whitechapel • • • • • • • • • • • • • • Osborn House Whitechapel • • • • • • • • • • 1 1 Osborn Place Whitechapel • • • • • • • • • • • • • • Osborn Street Whitechapel • • • • • • 2 • • • • 2 Oxford Street Mile End and Whitechapel • • 5 • • 1 .. 3 9 P Painter's Rents Ratcliff • • • • • • • • • • • • • • Palmer Street Spitalfields • • • • • • • • • • • • • • Paragon Mansions Mile End • • 1 • • 1 • • • • 2 Parfett Street Mile End • • • • • • • • • • • • • • Park Road Mile End • • • • • • • • • • • • • • Park Street Limehouse • • • • • • • • • • • • • • Parkhurst Buildings, Samuel Street Limehouse • • • • • • • • • • • • • • Parliament Court Old Artillery Ground • • • • • • • • • • • • • • Parnham Street Limehouse • • • • • • • • • • • • • • Pattison Street Mile End • • 1 • • 1 • • • • 2 Paternoster Row Spitalfields 1 1 Pauline Terrace, Old Montague Street Whitechapel • • • • • • • • • • • • • • Pavilion Yard Whitechapel • • • • • • • • • • • • • • Peabody Buildings Shadwell • • • • 1 1 • • • • 2 Peabody Buildings Whitechapel • • • • • • 1 • • 2 8 Peabody Buildings Spitalfields • • • • • • • • • • • • • • Pearl Street St. George's • • • • • • 1 • • • • 1 Pearl Place Mile End • • • • • • • • • • • • • • Peck's Yard, Haubury Street Spitalfields • • • • • • • • • • • • .• • Peel's Alley Shadwell • • • • • • • • • • • • • • Pelham House Mile End New Town and Spitalfields • • • • • • • • • • • • • • Pelham Street Spitalfields . . 1 • • 2 • • 3 6 Pelham Street Buildings Spitalfields • • • • • • • • • • • • • • Pelham House, Spital Square Spitalfields • • • • • • • • • • • • • • Pelican Passage Mile End • • 1 • • • • • • • • 1 Pelling Street Limehouse • • 1 • • 2 • • • • 3 Pell Place St George's • • • • • • • • • • • • • • Pell Street St. George's • • • • • • • • • • 2 2 Pennington Street St. George's • • • • 1 • • • • • • 1 149 Returns of Infectious Diseases.—continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. Padstow Place Limehouse .. .. .. .. .. .. Pennington Street Building s St. George's .. .. .. .. .. .. .. Pennington Place St. George's .. .. .. .. .. .. .. Periwinkle Street Ratcliff .. 1 .. 1 .. .. 2 Perry's Avenue, Booth Street Spitalfields .. .. .. 2 .. .. 2 Perth Street Mile End .. .. .. 1 .. 1 2 Phillip Street St. George's .. 1 .. 2 .. .. 3 Phillip Buildings St. George's .. .. .. .. .. .. .. Philpot Street Mile End .. 1 .. .. .. .. 1 Philpot Place Mile End .. .. .. .. .. .. .. Phoebe Street Limehouse .. .. .. .. .. .. .. Phoenix Court St. George's .. .. .. .. .. .. Pier Head St. George's .. .. .. .. .. .. .. Pigott Street Limehouse .. 1 .. .. .. 1 2 Pinchin Street St. George's .. .. .. .. .. .. .. Pitsea Place Limehouse .. .. .. .. .. .. .. Pinchin Street Buildings.. St. George's .. .. .. .. .. .. .. Pixley Street Limehouse .. .. .. .. .. .. .. Planet Street St. George's .. 2 .. 2 .. 1 5 Pleasant Row Ratcliff .. .. .. .. .. .. .. Plough Alley St. George's .. .. .. .. .. .. .. Plough Square Whitechapel .. .. .. .. .. .. .. Plough Street Buildings Whitechapel .. .. .. .. .. .. Plough Street Whitechapel .. .. .. 1 .. .. 1 Plumber's Row Whitechapel and Mile End .. 1 .. 4 .. 1 6 Pole Street Mile End .. .. .. .. .. .. .. Poonah Street St. George's .. .. .. .. .. .. .. Poole's Square Spitalfields .. .. .. .. .. .. .. Pope's Hill Shadwell .. .. .. .. .. .. .. Pope's Head Court Spitalfields .. .. .. .. .. .. .. Portland Street Ratcliff and Mile End .. .. .. .. .. .. 2 Potter's Buildings Limehouse .. .. .. .. .. 1 1 Priestley's Buildings St. George's .. .. .. .. .. .. .. Princes Place Whitechapel .. .. .. .. .. .. .. Princes Place Limehouse .. .. .. .. .. .. .. Princes Square St. George's .. .. .. 1 .. .. 9 Princelet Street Spitalfields .. .. .. 1 .. .. 1 Princes Street Mile End .. .. .. .. .. .. 1 Princes Street St. George's .. .. .. 1 .. .. 1 Prince of Orange Court St. George's .. .. .. .. .. .. .. Prospect Place St. George's .. .. .. .. .. .. .. Prospect Place Limehouse .. .. .. 1 .. .. 2 Prosperous Place Limehouse .. .. .. .. .. .. .. I'rovidence Street St. George's .. .. .. 1 .. .. 1 Prusom Street St. George's .. 1 .. .. .. .. 1 Prusom Street Buildings St. George's .. .. .. .. .. .. .. Puma Court Spitalfields .. .. .. 1 .. .. 1 150 Returns of Infectious Diseases.—contimied. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. Q Quaker Street .. .. .. .. .. .. 2 Queen Ann Street Whitechapel .. .. .. .. .. 2 2 Queen's Head Alley Wapping .. .. .. .. .. .. .. Queen's Place St. George's .. .. .. .. .. .. .. Queen Street Aldgate .. .. .. .. .. .. .. Queen Street Mile End New Town .. .. .. .. .. .. .. Queen's Cottages Mile End .. .. .. .. .. .. .. Queen's Head Place St. George's .. .. .. .. .. .. .. R Raby Street Ratcliff .. .. .. .. .. .. .. Railway Place Limehouse .. 1 .. .. .. .. 1 Railway Place Mile End .. .. .. .. .. .. .. Ramar Place Mile End New Town .. .. .. .. .. .. .. Raine's Mansions St. George's .. 1 .. .. .. .. 1 Raine's Street St. George's .. .. .. .. .. 1 1 Ratcliff Square Ratcliff .. .. .. .. .. .. .. Rat cliff Street St. George's .. .. .. .. .. .. .. Raven Row Whitechapel and Mile End .. .. .. 1 .. .. 1 Raymond Street St. George's .. .. .. .. .. .. .. Rectory Buildings Shadwell .. .. .. .. .. .. .. Rectory Square Mile End .. 1 .. .. .. 1 2 Red Lion Court Wapping .. .. .. .. .. .. .. Red Lion Street St. George's and Wapping .. .. .. 1 .. 2 3 Regent's Cottages Limehouse .. .. .. .. .. .. .. Reginald Houses, Fieldgate Street Whitechapel .. .. .. .. .. .. .. Red Mead Lane St. George's .. .. .. .. .. .. .. Red Lion and Spread Eagle Yard Whitechapel .. .. .. .. .. .. .. Redman's Gardens Mile End .. .. .. .. .. .. .. Redman's Road Mile End .. 2 .. .. .. 1 .. Reform Place Limehouse .. .. .. .. .. .. .. Regent's Court Limehouse .. .. .. .. .. .. .. Regent's Place Limehouse .. .. .. 1 .. .. 1 Regent's Place, Blossom Street Norton Folgate .. .. .. .. .. .. .. Regent's Place Mile End .. .. .. .. .. .. .. Regal Place .. .. .. 1 .. .. 1 Repton Street Limehouse .. .. .. 1 .. 3 4 Rhodeswell Road Limehouse and Mile End .. .. .. 3 .. 1 9 Rich Street Limehouse .. .. .. 1 .. 2 3 151 Returns of Infectious Diseases.—continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. 51 embranous Croup. Erysipelas. Total. Richard Court St. George's .. .. .. .. .. .. .. Richard Street St. George's .. .. .. 3 .. .. .. Richardson Street Mile End .. .. .. .. .. .. .. Robert Street Limehouse .. .. .. .. .. .. .. Robeson Street Mile End .. .. .. .. .. .. .. Roger's Court St. George's .. .. .. .. .. .. .. Romford Street Mile End .. .. .. .. .. .. .. Ronald Street Ratcliff .. .. 1 1 .. .. .. Ropner Place Limehouse .. .. .. .. .. .. .. Ropemakers' Fields Limehouse .. .. .. .. .. .. 1 Ropery Street Mile End .. .. .. .. .. .. .. Rose Place Mile End .. .. .. .. .. .. .. Rose Lane Ratcliff .. .. .. .. .. .. .. Rose Lane Limehouse .. .. .. .. .. .. .. Rosetta Place Spitalfields .. .. .. .. .. .. .. Rosemary Court Spitalfields .. .. .. .. .. .. .. Rosina Cottages Rothschild's Buildings, Whitechapel .. .. .. .. .. .. .. Thrawl Street Whitechapel .. 1 1 .. .. 1 .. Rowsell Street Mile Eud .. 2 .. .. .. 1 .. Royal Mint Royal Mint Square Aldgate .. .. .. .. .. .. .. Buildings Aldgate .. 1 .. .. .. 1 2 Royal Mint Street Whitechapel and Aldgate .. .. .. .. .. 2 2 Rugg Street Limehouse .. .. .. .. .. .. Rupert Street Whitechapel .. .. .. 1 .. .. 1 Russell Street Mile End .. .. .. 3 .. .. 3 Russell Court Ruth House, Flower and St. George's .. .. .. .. .. .. .. Dean Street Spitalfields .. .. .. .. .. 1 1 Rutland House St. George's .. .. .. .. .. .. .. Rutland Street Mile End .. 4 .. 1 .. .. 5 Rycroft Court St. George's .. .. .. .. .. .. .. Rygate Street St. George's .. .. .. 1 .. .. 1 Royal Jubilee Buildings. . St. George's .. .. .. .. .. .. .. s Sage Street Shadwell .. .. .. 1 .. .. 1 Salisbury Str eet Mile End .. .. .. .. .. .. .. Salmen Street Mile End .. .. .. .. .. .. .. Salmon Court Limehouse .. .. .. .. .. .. .. Salmon Lane Limehouse .. 2 .. 3 .. 1 6 Salter Street Limehouse .. .. .. .. .. .. .. Salter Street St. George's .. .. .. .. .. 2 2 Sampson's Gardens St. George's .. .. .. 1 .. .. 1 Samuel Court Mile End New Town .. .. .. .. .. .. .. 152 Returns of Infectious Diseases.—continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. Samuel Street Limehouse .. 2 .. .. .. 1 3 Sander Street St. George's .. .. .. .. .. .. .. Sander Street Buildings St. George's .. .. .. .. .. .. .. Sandy's Row Spitalfields .. 1 .. .. .. .. 1 Sarah Street Shadwell .. .. .. .. .. .. .. Sawyer's Yard Whitechapel .. .. .. .. .. .. .. Scarborough Street Whitechapel .. .. .. .. .. 1 1 Sceptre Street Mile End .. 2 .. 1 .. 3 6 Sclioolhouse Lane Ratcliff .. .. .. 1 .. .. 1 Selby Street Mile End New Town .. .. .. 1 .. .. 1 Selsey Street Limehouse .. 1 .. 1 .. 1 3 Selwyn Road Mile End .. .. .. .. .. .. .. Senrab Street Mile End .. .. .. 2 .. 2 4 Settle Street Mile End .. 1 .. 1 .. 1 3 Seven Star Alley St. George's .. .. .. .. .. .. .. Seven Star Yard Spitalfields .. .. .. .. .. .. .. Severne Street St. George's .. .. .. .. .. .. .. Shadwell Fish Market Shadwell .. .. .. .. .. .. .. Shadwell Green Shadwell .. .. .. .. .. .. .. Shandy Street Mile End 1 3 1 .. .. 4 9 Sharpe's Buildings Aldgate .. .. .. .. .. .. .. Sheba Street Spitalfields .. .. .. 1 .. .. 1 Shepherd Street Spitalfields .. .. .. 1 .. 3 4 Shepherd Street Buildings Spitalfields .. .. .. .. .. .. .. Shepherd's Place Spitalfields .. .. .. .. .. .. .. Sheppy Yard Holy Trinity .. .. .. .. .. .. .. Sheridan Street St. George's .. 2 .. 4 .. 1 7 Ship Street St. George's .. .. .. .. .. .. .. Ship Alley St. George's .. .. .. 2 .. 1 3 Shoreditch High Street Whitechapel .. .. .. .. .. .. .. Short Street Spitalfields .. .. .. .. .. 1 1 Shorter Street St. George's and Wapping .. .. .. .. .. .. .. Shorter's Rents, Lamb Street Spitalfields .. .. .. .. .. .. .. Shoulder of Mutton Alley Limehouse .. .. .. .. .. .. .. Silas Street Mile End .. .. .. .. .. 1 1 Single Gardens Mile End .. .. .. .. .. .. .. Single Place Mile End .. .. .. .. .. .. .. Single Street Mile End .. 1 .. .. .. .. 1 Sidney Street Mile End .. 4 1 2 .. l 8 Sidney Square Mile End .. .. .. .. .. .. .. Silver Street Limehouse .. .. .. 1 .. .. 1 Silver Street Mile End .. .. .. .. .. .. .. Silver Street St. George's .. .. .. 1 .. .. 1 Sion House Mile End .. .. .. .. .. .. .. Sion Square Mile End .. .. .. .. .. .. .. Size Yard Whitechapel .. .. .. .. .. .. .. 153 Returns of Infectious Diseases.—continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. 1 Erysipelas. Total. Skidmoro Street Mile End .. 2 .. 2 1 3 8 Sly Street St. George's .. .. .. .. .. .. .. Smith Place Mile End .. .. .. .. .. .. .. Smith Street Mile End .. .. .. .. .. .. .. Solander Street Shadwell .. 1 .. .. .. 1 2 South Grove Mile End .. 3 .. 4 .. .. 7 South Grove Buildings Mile End .. .. .. .. .. .. .. South Street Limehouse .. 1 .. .. .. .. 1 Spring Gardens, King Edward Street Mile End New Town .. .. .. .. .. 3 3 Spring Gardens Limehouse .. .. .. .. .. 1 1 Speck's Fields Mile End New Town .. .. .. .. .. .. .. Spectacle Alley Whitechapel .. .. .. .. .. .. .. Spelman Court Whitechapel .. .. .. .. .. .. .. Spencer House, Lolesworth Street Whitechapel .. .. .. .. .. .. .. Spencer Street St. George's .. .. .. 2 .. .. 2 Spencer Street Limehouse .. .. 1 .. .. .. 1 Spelman Street Whitechapel, fields, and Mile End New Town .. .. .. 1 .. 1 2 Spenlow Street Limehouse .. .. .. .. .. .. .. Spital Court Mile End New Town .. .. .. .. .. .. .. Spital Square Norton Folgate .. .. .. .. .. .. .. Spital Street Mile End New Town .. .. .. 1 .. 2 3 Spitalfields Market North South East No Houses West .. .. .. .. .. .. .. Splidt Street St. George's .. 2 .. .. .. .. 2 Spring Garden Place Mile End and Ratcliff .. 1 1 .. .. .. 2 St. Ann's Road Mile End .. 2 1 .. .. 3 6 St. Ann's Row Limehouse .. .. .. .. .. .. .. St. Anne's Street Limehouse .. .. .. 1 .. .. 1 St. Dunstan's Road Mile End .. .. .. .. .. 2 2 St. George's Buildings St. George's .. .. .. .. .. .. .. St. George's House, George Yard Whitechapel .. .. .. 3 .. .. 3 St. George's Street St. George's and Wapping .. 4 .. 7 .. 7 18 St. George's Terrace St. George's .. .. 1 .. .. .. 1 St. Mark Street Whitechapel .. .. .. .. .. .. .. St. Mary Street Whitechapel .. .. .. .. .. .. .. St. Paul's Road Mile End and Limehouse .. .. 1 1 .. 2 4 St. Peter's Road Mile End .. .. .. 1 .. 1 2 St. Thomas' Road Mile End .. 2 1 .. .. .. 3 St. Thomas's Yard Mile End .. .. .. .. .. .. .. 154 Returns of Infectious Diseases.—continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. M embraDous Croup. Erysipelas. Total. Stainsby Road Limehouse .. 1 .. .. .. 2 3 Stanfield Road Mile End .. .. .. .. .. .. .. Star and Garter Yard St. George's .. .. .. .. .. .. .. Star Place St. George's .. .. .. .. .. .. .. Starch Yard St. George's .. .. .. .. .. .. .. Shadwell Place St. George's .. .. .. .. .. 1 1 Stayner's Road Mile End .. .. .. .. .. 1 1 Steel's Lane Mile End .. .. .. 1 .. .. 1 Stephen's Cottages, Couder Street Limehouse .. .. .. .. .. .. .. Stepney Causeway Ratcliff .. .. .. 3 .. 1 3 Stepney Green Mile End .. 1 1 .. .. .. 2 Stepney High Street Mile End .. .. .. .. .. .. .. Stepney Industrial Dwelling's Mile End .. 2 .. 2 .. 4 8 Stepney Square .. .. .. .. .. .. .. Steward Street Old Artillery Ground .. .. .. .. .. .. .. Stocks Place Limehouse .. .. .. .. .. .. .. Storer's Buildings Mile End .. .. .. .. .. .. .. Strafford House, Wentworth Street Spitalfields .. .. .. .. .. .. .. Strahan Road Mile End .. .. .. .. .. .. .. Streatfield Street Limehouse .. 2 .. 1 .. .. 3 Stutfield Street St. George's .. .. .. .. .. .. .. Sugar Loaf Court Whitechapel .. .. .. .. .. 1 1 Sun Tavern Place Wapping .. .. .. .. .. .. .. Sutton Street St. George's .. .. .. .. .. .. .. Swallows Gardens Whitechapel .. .. .. .. .. .. .. Swan Street .. .. .. .. .. .. .. Swan Yard High St., Whitechapel .. .. .. .. .. .. .. Synagogue Place Mile End .. .. .. .. .. .. .. T Tait Street St. George's .. 1 .. .. .. 2 3 Tarling Street St. George's .. 1 .. 4 .. .. 5 Tasburg Buldings St. George's .. .. .. .. .. .. Taylor's Plaice Limehouse .. 3 .. .. .. .. 3 Taylor's Rents St. George's .. .. .. .. .. .. .. Tenbury Place Limehouse .. .. .. .. .. .. .. Terrace Place Mile End .. .. .. .. .. .. .. Tench Street St. George's .. .. .. 1 2 3 Tenter Buildings, St. Mark's Street Whitechapel .. .. .. .. .. .. .. Tenter Court Spitalfields .. .. .. .. .. .. .. Tenter Street Spitalfields .. 1 .. .. .. .. 1 Tenter Street North Whitechapel .. .. .. .. .. .. .. Tenter Street South Whitechapel .. .. .. .. .. 1 1 Tenter Street East Whitechapel .. 1 .. 1 .. .. 2 155 Returns of Infectious Diseases.—continued. Streets. District*. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. IMembranous Croup. Erysipelas. Total. Tenter Street West Whitechapel .. .. .. .. .. .. .. Tewkesbury Buildings Whitechapel .. .. .. .. .. .. .. Thirza Street Ratcliff .. .. .. 1 .. .. 1 Thomas Street Limehouse .. 2 .. 1 .. .. 3 Thomas Place St. George's .. .. .. .. .. .. .. Thrawl Street Whitechapel .. .. .. .. .. 2 2 Three Compass Court Ratcliff .. .. .. .. .. .. .. Three Colt Court Limehouse .. .. .. .. .. .. .. Three Colt Street Limehouse .. .. .. .. .. .. 1 The Cottages Limehouse .. .. .. .. .. .. .. Tile Yard Limehouse .. .. .. .. .. .. .. Tilley Street Spitalfields .. .. .. .. .. 1 1 Tillman Street St George's .. .. .. .. .. .. .. Tillotson Street Mile End .. .. .. .. .. .. .. Toilet Street Mile End .. 1 .. .. .. .. 1 Tomlin Terrace Limehouse .. .. .. .. .. 1 1 Tower Bridge (North Arch) Whitechapel .. .. .. .. .. .. .. Tower Hill Whitechapel .. .. .. .. .. .. .. Tower of London .. 1 .. 2 .. .. 3 Tower Buildings, Brewhouse Lane Wapping .. .. .. .. .. .. .. Tower Buildings, High Street Wapping .. .. .. .. .. .. .. Trafalgar Square Mile End .. 1 .. .. .. .. 1 Tredegar Square Mile End .. 4 .. .. .. 2 6 Trinity Almshouses Mile End .. .. .. .. .. .. .. Trinty Square Aldgate .. .. .. .. .. .. .. Troon Street Ratcliff .. .. .. .. .. .. .. Turner's Buildings St. George's .. .. .. .. .. .. .. Turner's Place Limehouse .. .. .. .. .. .. .. Turner's Road Limehouse and Mile End .. 2 .. .. .. 1 3 Turner's Street Mile End .. .. .. 1 .. 2 3 Twine Court Shadwell .. 1 .. .. .. .. 1 u Umberstone Street St. George's .. .. .. .. .. 1 1 Underwood Street Mile End New Town .. .. .. 1 .. 1 2 Union Buildings Mile End .. .. .. .. .. .. .. Union Court, Wheeler Street Spitalfields .. 1 .. .. .. .. 1 Union Passage St. George' .. .. .. .. .. .. Union Place Limehouse .. .. .. .. .. .. .. Union Row Mile End .. .. .. .. .. .. .. Union Street Mile End .. .. .. 2 .. .. 2 156 Returns of Infectious Diseases.—continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Membranous Croup. Erysipelas. Total. Union Street St. George's .. .. .. .. .. 1 1 Union Terrace Limehouse .. .. .. .. .. .. .. Upper Chapman Street St. George's .. .. .. .. .. .. .. Upper Fenton Street St. George's .. .. .. .. .. .. .. Upper Montague Street Mile End .. .. .. .. .. .. .. Upper East Smithfield Aldgate and Wapping .. .. .. 1 .. .. 1 V Vallance Road Whitechapel and Mile End New Town .. 1 3 2 .. 7 13 Varden Street Mile End .. 1 .. .. .. 1 2 Yenour Road .. .. .. .. .. .. .. Victoria Buildings, Cartwright Street .. .. .. .. .. .. .. Victoria Cottages, Albert Street Mile End New Town .. 1 .. .. .. .. 1 Victualling Office Square Whitechapel .. .. .. .. .. .. .. Victoria Buildings, Emmott Street Mile End .. 1 .. .. .. .. 1 Vine Court Whitechapel .. .. .. .. .. .. .. Vine Yard Spitalfields .. .. .. .. .. .. .. Vintners' Almhouses Mile End .. .. .. .. .. .. .. Virginia Court St. George's .. .. .. .. .. .. .. w Wade's Place Mile End .. .. .. .. .. .. .. Wainwright Place St. George's .. .. .. .. .. .. .. Walburgh Street St. George's .. .. .. .. .. .. .. Walburgh Court St. George's .. .. .. .. .. .. 3 Walden Street Mile End .. 1 .. 2 .. .. Walker Street Limehouse .. .. .. .. .. 2 2 Wallwood Street Limehouse .. .. .. .. .. 1 1 Walter Street Ratcliff .. 5 .. 1 .. .. 6 Wapping Wall Wapping .. .. .. .. .. 1 1 Warwick Place Limehouse .. .. .. .. .. .. .. Waterloo Place St. George's .. .. .. .. .. .. .. Waterloo Street Limehouse .. .. .. .. .. .. .. Watney Street St. George's .. 1 .. .. .. .. 1 Watts Street St. George's .. .. .. .. .. 1 1 Watts Street Buildings St. George's .. .. .. .. .. .. .. Weaver Street Whitechapel .. .. .. .. .. .. .. Webb's Place Whitechapel .. .. .. 1 .. .. 1 Wells Street Whitechapel .. .. .. .. .. .. .. 157 Returns of Infectious Diseases.—continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever Diphtheria. Jlembranoua Croup. Erysipelas. Total. Wellclose Square St. George's, Whitechapel and Wapping .. .. .. .. .. .. .. Wellesley Street Mile End .. .. .. .. .. .. .. Wellington Buildings St. George's .. .. .. .. .. 1 1 Wentworth Street Spitalfields and Whitechapel .. .. 1 .. .. 3 4 Went worth Court East Spitalfields .. .. .. .. .. .. .. Wentworth Court West Spitalfields .. .. .. .. .. .. .. Wentworth Buildings Whitechapel .. .. .. 1 .. 4 5 West Gardens Shadwell .. .. .. 1 .. 1 2 West Gtirdens Buildings Shadwell .. .. .. .. .. .. .. West Pier Wapping .. .. .. .. .. .. .. West Arbour Street Mile End .. .. .. 2 .. 1 3 West Street Mile End .. 1 .. 2 .. 3 6 West India Dock Road Limehouse .. .. .. .. .. .. .. West's Folly St. George's .. .. .. .. .. .. .. Western Passage St. George's .. .. .. .. .. .. .. Whaley Street Mile End .. .. .. .. .. 1 1 Wharton Place Limehouse .. .. .. .. .. 1 1 Wheeler Street Spitalfields .. .. .. 1 .. .. 1 Whitechapel High Street Whitechapel .. .. .. 1 .. .. 1 Whitechapel Road Whitechapel and Mile End .. 4 .. 8 .. 9 26 White's Gardens St. George's .. .. .. .. .. .. .. White's Rents Limehouse .. .. .. .. .. .. .. White's Row Spitalfields .. 1 .. 1 .. 3 6 White Hart Court Mile End .. .. .. 1 .. .. 1 White Horse Lane Mile End .. 3 1 .. .. 2 6 White Horse Street Ratcliff .. .. .. 1 .. .. 1 White Lion Street Spitalfields and Norton Folgate .. 2 .. 1 .. .. 3 Whitehall Court Limehouse .. .. .. .. .. .. .. Whitehall Place Limehouse .. .. .. .. .. .. .. Whitehead Street Mile End .. 4 1 .. .. 1 6 k Whitethorne Court St. George's .. .. .. .. .. .. .. Whitethorne Place St. George's .. .. .. .. .. .. .. Whitman Road Mile End .. .. .. 1 .. .. 1 Williams' Buildings Mile End .. .. .. .. .. 1 1 Williams' Place Limehouse .. .. .. .. .. .. .. William Street St. George's .. .. .. .. .. .. .. Willow Row Limehouse .. .. .. .. .. .. .. Willow Street Mile End .. 1 .. .. .. 1 2 Wilk Court Spitalfields .. .. .. .. .. .. .. Wilkes Street Spitalfields .. 2 .. 2 .. .. 4 Wilson's Place Limehouse .. .. .. .. .. .. .. Wilson Street Mile End .. 2 .. 2 .. .. 4 Winifred House, Thraw Street Spitalfields .. .. .. .. .. .. .. 153 Returns of Infectious Diseases.— continued. Streets. Districts. Small Pox. Scarlet Fever. Typhoid Fever. Diphtheria. Membranous Croup. Erysipelas. Total. Winterton Buildings St. George's .. .. .. .. .. .. .. .. Winterton Street St. George's .. .. .. .. 1 .. 1 2 Winter's Buildings Mile End .. .. .. .. .. .. .. .. Winthrop Street Whitechapel .. .. .. .. 1 1 1 3 Wicker Street St. George's .. .. .. 1 2 .. 1 4 Wolsey Street Mile Eud .. .. 1 .. .. .. .. 1 Woodison Street Mile End .. .. .. .. .. .. .. .. Woodside Mansions St. George's .. .. .. .. .. .. 1 1 Wood's Buildings Whitechapel .. .. .. .. .. .. .. .. Worcester Street St. Geoigs's .. .. .. .. .. .. 1 l Worcester Court St. George's, .. .. .. .. .. .. .. .. Wright's Buildings, Salmon Lane Limehouse .. .. .. .. .. .. .. .. Wright's Bow St. George's .. .. .. .. .. .. .. .. X XX Place Mile End .. .. 1 .. .. .. .. l Y Yalford Street Mile End .. .. .. .. 1 .. 1 2 Yeomans' Yard Whitecliapel .. .. .. .. .. .. .. .. Yoakley's Buildings Whitechapel .. .. .. .. .. .. .. .. York Buildings Limehouse .. .. .. .. .. .. .. .. York Buildings St. George's .. .. .. .. .. .. .. .. York Place Limehouse .. .. .. .. .. .. .. .. York Road Ratcliff .. .. .. .. .. .. .. .. York Square Ratcliff .. .. .. .. .. .. .. .. Yule Court St. George's .. .. .. .. 1 .. 1 2 159 Returns of Infectious Diseases.- continued. Streets. Districts. Puerperal Fever. Bancroft Road Mile End 1 Bloomfield Street Mile End 1 Bower Street Limehouse 1 Brick Lane Whitechapel 1 Burdett Road Limehouse 1 Copley Street Mile End 1 Crispin Street Whitechapel 1 Dalgleisli Street Limehouse 1 1 luiidee Street 3t. George's 1 Emmott Street Mile End 1 Fair Street Mile Eud 1 Frederick Place Mile End 1 Grafton Street Mile End 1 Harford Street Mile Eud 1 Martha Street St. George's 1 Morris Street St. George's 1 Mossford Street Mile End 1 Nathanit-1 Buildings Whitechapel 1 Nelson Street Miie End 1 Oxford Street Mile End 1 Pier Head, Wapping St. George's 1 Pole Street Mile End 1 St. Ann's Road Mile End 1 St. George Street St. George's 1 Shandy Street Mile End 1 Turner Street Mile End 1 Yallance Road Whitechapel 1 Wentworth Street Whitechapel 1 Yalford Street Mile End I Cerebrospinal Fever Cable Street Limehouse 1 Crecsy Houses, Stepney Green Mile End I Edward Mann Buildings Limehouse 1 Endive Street Limehouse 1 Fashion Street Whitechapel 1 Ford Square Mile End 1 Wades Place Mile End 1 PolioMyelitis. Essex Street Mile End 1 Planet Street St. George's 1 Plumber's Row Whitechapel 1 Toilet Street Mile End 1 West Street Mile End 1 160 Returns of Infectious Diseases.—continued. Streets. Districts. Ophthalmia Neonatorum. Aston Street Limehouse 1 Beaumont Square Mile End 1 Copenhagen Place Limehouse 1 Duckett Street Mile Eud 1 Elsa Street Limehouse 1 Globe Road Mile End I Hawkins Street Mile End 1 Jane Street St. George's 1 Little Alie Street Whitechapel 1 Lydbrook Street Limehouse 2 Oxford Street Mile End 1 Sheridan Street St. George's 1 Vallance Road Whitechapel 2 West India Dock Road Limehouse 1 161 INDEX. A PAGE Alcoholism 57 Articles of Bedding, &c., disinfected 75 Articles of Bedding, &c., destroyed 74 Analyst's Report 99 Proceedings (number of cases) 100 Articles adulterated 106 to 108 Samples purchased by Inspectors 103 Statistics of adulterations, 1911 102 Articles adulterated in various Districts 102 Inspectors' work under the Food and Drugs Acts 105 Sunday samples 100 Unofficial samples 100 Pearl-coated Pills 101 Proceedings for Obstruction, &c. 109 Anthrax 58 & 59 Australian Beef, Parasitic condition of 86 to 89 B Births 2, 3 & 4 Bacteriological Examinations 12 Bakehouses, in the Borough, List of 117 to 119 C Canal Boats, Inspection of 80 & 81 Cancer 57 & 58 Charts (Infectious Disease) between 12 & 13 Cerebi o-Spinal Fever 19 Cholera 20 & 21 Consumption, Treatment of 45 to 50 Cowhouses in the Borough, List of 119 & 120 162 D PAGE Deaths 5 Total number of deaths in the Borough 5 Total number of non-residents 5 Total number of residents outside the Borough 5 Death-rate in various districts in the Borough 5 Causes of death compared with 1910 6 Deaths of residents in outlying institutions 9, 10 & 11 Deaths of residents in public institutions in the Borough 11 Deaths (Homeless) 73 Dairies and Milkshops in the Borough 82 Diarrhoea 36 Diphtheria and Membranous Croup 19 E Enteric Fever 19 Erysipelas 19 F Factory and Workshops Acts 113 Administration of (tables for Home Office) 114, 115 & 116 Fines and Costs (total) 110 G General Sanitary Work 91 & 92 Glanders 58 H Health Visitor, Report on the work of 51 to 56 Housing and Town Planning Act, 1909 76, 77 & 78 Human Bones from No. 16, Walburgh Street, Removal of 81 & 82 163 I PAGE Infantile Mortality 50 & 51 Infectious Diseases and the Streets in which they occurred during 1911 129 to 160 Inhabited House Duty 73 Inquests, number and cause of death 6, 7 & 8 Illegitimate Children (Deaths of) 50 & 51 M Marriages 4 Measles 21 to 36 Chart showing the number of Deaths per 100,000inhahitants between 22 & 23 „ „ Cases notified „ 24 & 25 ,, total number of Deaths each week „ 34 &35 Mortuary and Coroner's Court 74 N Notifiable Diseases 11 & 12 O Old Age 56 & 57 Ophthalmia Neonatorum 20 Other Tuberculous Diseases. 42 Deaths from Diseases of a Tubercular Nature in various Districts in the Borough, 1901-1911 42 Outworkers 115 Overcrowding 92 P Population 1&2 Proceedings:— List of, under the Public Health (London) Act, 1891 93 to 98 Under the Food and Drugs Acts 106 to 108 Under the Dairies, Cowsheds and Milkshops Orders 82, 83 & 84 164 PAGE Under the Dairies, Cowsheds and Milkshops Orders, and London County Council (General Powers) Act, 1908 92 & 93 For the abatement of Overcrowding 99 Under the London County Council (General Powers) Act, 1904, Sections 20 and 22 99 Under the Metropolis Local Management Act, 1855 98 Under the Margarine Act, 1887 110 Under Bye-laws (Section 16) Public Health (London) Act, 1891 98 & 99 Phthisis:— Total number of Deaths in the Borough 41 Deaths in various Districts in the Borough, 1901-1911 41 Plague 59 to 72 Puerperal Fever 20 R Respiratory Diseases 41 S Sanitary Inspectors' Report between 92 & 93 Scarlet Fever 18 Slaughter Houses in the Borough, List of 120 Small Pox 13 to 18 Statistics:— Table 1. Of whole district during 1911 and previous years between 121 & 129 „ 2. Cases of Infectious Diseases notified during the year 1911 121 & 129 3. Causes of, and ages at death, during the year 1911 121 & 129 ,, 4. Infantile Mortality during the year 1911 „ 121 & 129 Streets, List of, and the number of Infectious Diseases occurring during 1911 129 to 160 Sanatorium treatment of Consumption 47 to 50 Summer Diarrhoea 36 to 40 165 PAGE T Tables as suggested bv the Medical Officer of Health for the London County Council 111 & 112 Tables of Milk Premises, Cowsheds, Slaughter-houses, other Offensive Trades, Ice Cream Premises, and Registered Houses Let in Lodgings 111 Number of Intimations served for all purposes 111 Overcrowding 111 Underground rooms 111 Insanitary houses 111 House to House Inspection 112 Number of Places where Food is prepared for Sale 112 Tuberculosis Regulations (Public Health), 1908, Tuberculosis Regulations, 1911, and (Tuberculosis in Hospitals) Regulations, 1911 42 to 45 Treatment of Consumption 45 to 50 U Underground Rooms :— Regulations made by the Borough Council 78, 70 & 80 Unsound Food:— Destroyed 84, 85 & 86 Proceedings 89,90 & 91 Y Verminous Persons (Cleansing of) 74 Vital Statistics of the whole Borough during 1911, and previous years 121 & 129 W Whooping Cough 36 Wrong Diagnosis 12 Z Zymotic Diseases 21