STE 1 ANNUAL REPORT OF THE Medical Officer of Health and Public Analyst FOR THE Metropolitan Borough of Stepney. 1916. REPORT OF THE MEDICAL OFFICER OF HEALTH AND PUBLIC ANALYST FOR THE YEAR 1916. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Ladies and Gentlemen, I have much pleasure in submitting to you my sixteenth Annual Report, which deals with the Vital and Sanitary Statistics of the Borough of Stepney for the year 1916. The Report has been made shorter than usual; this is in accordance with a suggestion from the Local Government Board, and with the resolution of the Borough Council to effect an economy in labour and printing. Population. The estimated population for the calculation of the death-rate is 258,395, and for the birth-rate 281,138. The former is an estimate of the civilian population ; the latter of the total population based on the assumption that the ratio between the total and the civilian population is the same in the Borough, as in England and Wales as a whole. The war has made it impossible to adhere to the method of estimating the population hitherto in use. Men of military age have been largely drafted to military training centres, or sent abroad, and there has also been a great deal of migration of the female population. Births. The total number of births during the year was 7,121, or 385 less than in the previous year. 1,641 belonged to the Limehouse District, or at the rate of 30.4 per 1,000 of the population. 2 1,221 belonged to St. George-in-the-East, or at the rate of 25.9 per 1,000 of the population. 2,949 belonged to Mile End Old Town, or at the rate of 26.3 per 1,000 of the population. 1,310 belonged to the Whitechapel District, or at the rate of 19.2 per 1,000 of the population. The birth-rate throughout the whole Borough was 25.3 per 1,000 of the population. 658 births occurred in the Mothers' Lying-in Home, Commercial Road :— 125 belonged to Mile End Old Town. 149 belonged to the Limehouse District. 75 belonged to St. George-in-the-East. 36 belonged to the Whitechapel District. 273 belonged to outlying districts. 391 births occurred in the London Hospital: — 65 belonged to Mile End Old Town. 47 belonged to St. George-in-the-East. 17 belonged to the Limehouse District. 49 belonged to the Whitechapel District. 213 belonged to outlying districts. 22 births occurred in the St. George's Infirmary:— 20 belonged to St. George-in-the-East. 1 belonged to the Limehouse District. 1 belonged to an outlying district. 76 births occurred in the Whitechapel Infirmary:— 31 belonged to the Whitechapel District. 6 belonged to Mile End Old Town. 2 belonged to St. George-in-the-East. 1 belonged to the Limehouse District. 36 belonged to outlying districts. 215 births occurred at the Sick Room Helps Society, 24, Underwood Street:— 63 belonged to Mile End Old Town. 53 belonged to the Whitechapel District. 31 belonged to St. George-in-the-East. 68 belonged to outlying districts. 12 births belonging to this Borough occurred in the Poplar and Stepney Sick Asylum, 11 belonging to Limehouse and 1 to Mile End. 3 54 births belonging to the Borough of Stepney occurred in the City of London Lying-in Hospital; 8 in Queen Charlotte's Hospital; 5 in the General Lying-in Hospital; 4 in the Salvation Army Maternity Home, Hackney; 1 in the Clapham Maternity Charity; 2 in Paddington Workhouse; 7 in Poplar Workhouse; 1 in the New Hospital for Women; 1 in the Retreat, Mere, Wilts; and 2 in the street. Marriages. The marriages during the year numbered 2,831, or 297 more than in the previous year. The proportion of persons married was 20.1 per 1,000 of the population. 109 marriages occurred in the Limehouse District, or at the rate of 4 per 1,000 of the population. 248 marriages occurred in St. George-in-the-East, or at the rate of 10.4 per 1,000 of the population. 1,126 marriages occurred in Mile End Old Town, or at the rate of 20 per 1,000 of the population. 448 marriages occurred in the Whitechapel District, or at the rate of 13.2 per 1,000 of the population. Deaths. After deducting the deaths of non-residents who died in the Borough, and adding those of residents who died in outlying institutions, the total number was 3795—2,112 males and 1,683 females—or 732 less than in the preceding year. 895 of the deaths belonged to the Limehouse District, or at the rate of 17.9 per 1,000 of the population. 624 of the deaths belonged to St. George-in-the-East, or at the rate of 14.0 per 1,000 of the population. 1,361 of the deaths belonged to Mile End Old Town, or at the rate of 13.0 per 1,000 of the population. 915 of the deaths belonged to the Whitechapel District, or at the rate of 15.2 per 1,000 of the population. The death rate throughout the whole Borough was 14.6 per 1,000 of the population, while that for the whole of London was 14.3 per 1,000. A2 4 Homeless.—During the year there occurred in Lunatic Asylums the deaths of 117 persons, said to have been removed from addresses in this Borough to those Institutions, but no definite addresses could be given when the deaths were reported to the Registrars. 48 were above 65 years of age, 26 were said to have been removed from the Limehouse District; 18 from St. George's; 17 from Mile End; 56 from Whitechapel. Five unknown persons were found drowned. 10 unknown persons were killed in the streets; 2 in Limehouse; 3 in Mile End; 5 in Whitechapel. There were 16 deaths of unknown persons in Public Institutions in the Borough, viz.:—15 in the Whitechapel Infirmary and Workhouse, and 1 in the London Hospital. There were 14 deaths in the Poplar and Stepney Sick Asylum of persons stated to have been removed from the Limehouse District, and 9 from Mile End. Spies. One spy only was shot in the Tower of London. He was a commercial traveller, aged 37, from Lima, Peru. Notifiable Diseases. 5,360 notifications were received, this number included 1,221 notifications of diseases of a tubercular nature. 2,160 were removed to various Hospitals and Infirmaries. Excluding Measles—which was not a notifiable disease in 1915—the number of notifications of infectious diseases was 1,034 less in 1916 than in the previous year. In addition to the above, 11 soldiers were notified to be suffering from infectious diseases, viz.:—7 from Diphtheria and 4- from Measles. Of the infectious Diseases:— 911 belonged to the Limehouse District, or at the rate of 18.2 per 1,000 of the population. 902 belonged to St. George-in-the-East, or at the rate of 20.3 per 1,000 of the population. 1,498 belonged to Mile End Old Town, or at the rate of 143 per 1,000 of the population. 828 belonged to Whitechapel District, or at the rate of 13.7 per 1,000 of the population. 5 Wrong Diagnosis. 127 cases of Infectious Disease were removed to the Hospitals of the Metropolitan Asylums Board, which were subsequently returned home in consequence of the patients being found not to be suffering from the diseases stated on the certificates, or any other notifiable disease. 62 of the cases were notified by private practitioners, 54 from the London Hospital, and 11 from other public institutions. This number referred to 51 cases of Scarlet Fever, 70 from Diphtheria, 5 of Enteric Fever, and 1 of Cerebro-spinal Meningitis. Scarlet Fever. 661 cases were notified during the year, or 797 less than in the previous year; 658 were removed to Fever Hospitals. 118 belonged to the Limehouse District, with 4 deaths; 135 belonged to St. George-in-the-East, with 2 deaths; 232 belonged to Mile End Old Town, with 7 deaths; 176 belonged to the Whitechapel District, with no deaths; The death rate for the whole Borough was .04 per 1,000 of the population, while that for the whole of London was .04 per 1,000. Diphtheria and Membranous Croup. 850 cases were notified during the year, or 180 less than in the previous year; 844 were removed to the Fever Hospitals. 164 belonged to the Limehouse District, with 11 deaths. 127 belonged to St. George-in-the-East, with 4 deaths. 285 belonged to Mile End Old Town, with 13 deaths. 274 belonged to the Whitechapel District, with 12 deaths. The death rate for the whole Borough was .15 per 1,000 of the population, while that for the whole of London was .14 per 1,000. Enteric Fever. 32 cases were notified during the year, exactly the same number as in the previous year. 12 occurred in the Limehouse District, with 3 deaths; 6 occurred in St. George-in-the-East, with no deaths; 6 10 occurred in Mile End Old Town, with 3 deaths; 4 occurred in the Whitechapel District, with I death. The death rate throughout the whole Borough was .02 per 1,000 of the population, while that for the whole of London was .03 per 1,000. Puerperal Fever. 10 cases of Puerperal Fever were notified, or 3 less than in the previous year. 5 belonged to the Limehouse District, with 3 deaths 1 belonged to St. George-in-the-East, which was not fatal; 3 belonged to Mile End Old Town, with no deaths; 1 belonged to the Whitechapel District, which proved fatal. Erysipelas. 244 cases were notified, or 45 less than in the previous year. 59 belonged to the Limehouse District, with no deaths; 32 belonged to St. George-in-the-East, with no deaths; 86 belonged to Mile End Old Town, with no deaths; 67 belonged to the Whitechapel District, with 2 deaths. Ophthalmia Neonatorum. 42 cases were notified, or 23 less than in the previous year. 23 occurred in the Limehouse District, 3 in St. George-in-the-East, 11 in Mile End Old Town, 5 in the Whitechapel District. Poliomyelitis. 12 cases were notified or 7 more than in the previous year. 4 belonged to Limehouse District, 3 to St. George's-in-the-East, and 5 to Mile End Old Town. Cerebro-Spinal Fever. 34 patients suffered from cerebro-spinal fever during the year, but 3 of them were not notified by the doctors in attendance, due to an oversight on their part. The first intimation of the cases was information in the death returns. 4 recovered, 25 died. 5 families moved and I am not able to obtain the later history of the patients. 11 of the deaths were those of babies under 1 year of age. 6 were children between 1 and 2 years of age, 4 were between 2 and 5 years of age, 1 was between 5 and 10 years of age, and 1 was between 10 and 15 years of age. 2 deaths were those of persons between 15 and 25 years of age. 7 Measles and German Measles. The Notification of Measles and German Measles Order, 1915, came into force on January 1st, 1916. This Order requires that parents or guardians must notify these diseases, unless they have been previously notified by medical practitioners. The medical practitioner is not required to notify the case, if another person suffering from the disease has been notified in the same household within the previous two months. The number of Measles notified was 2,255; 202 being under 1 year of age, and 1,463 between 1 and 5 years of age. 524 belonged to the Limehouse District, with 23 deaths, and a death-rate of 46 per 1,000. 588 belonged to St. George-in-the-East, with 20 deaths, and a death-rate of .45 per 1,000. 849 belonged to Mile End Old Town, with 16 deaths, and a death-rate of .15 per 1,000. 294 belonged to the Whitechapel District, with 4 deaths and a death-rate of .06 per 1,000. The death rate of the whole Borough was at the annual rate of .24 per 1,000 of the population, while that for the whole of London was .15 per 1,000. The number of deaths from Measles in the Borough since 1901 is as follows:— 1901 155 1902 158 1903 162 1904 176 1905 151 1906 171 1907 155 1908 264 1909 236 1910 93 1911 291 1912 172 1913 95 1914 174 1915 113 1916 63 8 Whooping Cough. The number of deaths from Whooping Cough was 69, or 19 more than in the previous year. This corresponds to a death rate of .26 per 1,000 of the population; the death-rate for London was .16 per 1,000. 26 belonged to the Limehouse District, or at the rate of .52 per 1,000 of the population. 10 belonged to St. George-in-the-East, or at the rate of .22 per 1,000 of the population. 26 belonged to Mile End Old Town, or at the rate of .24 per 1,000 of the population. 7 belonged to the Whitechapel District, or at the rate of .11 per 1,000 of the population. Summer Diarrhoea. The number of deaths from Diarrhoea (which includes Epidemic and Zymotic Enteritis, Dysentery and Dysenteric Diarrhoea) was 144, or 116 less than in the previous year. 50 belonged to the Limehouse District, or at the rate of 1.03 per 1,000 of the population. 24 belonged to St. George-in-the-East, or at the rate of .54 per 1,000 of the population. 50 belonged to Mile End Old Town, or at the rate of .47 per 1,000 of the population. 20 belonged to the Whitechapel District, or at the rate of .33 per 1,000 of the population. The death-rate for the whole Borough was .55 per 1,000. Zymotic Diseases. The total deaths from diseases of a Zymotic character numbered 340. It includes deaths from Measles, Scarlet Fever, Whooping Cough, Diphtheria, Enteric Fever, Puerperal Fever and Diarrhoea. This number is 186 less than in the previous year. 120 belonged to the Limehouse District, or at the rate of 2.40 per 1,000 of the population. 9 60 belonged to St. George-in-the-East, or at the rate of 135 per 1,000 of the population. 115 belonged to Mile End Old Town, or at the rate of 110 per 1,000 of the population. 45 belonged to the Whitechapel District, or at the rate of 74 per 1,000 of the population. Phthisis. 961 new cases were notified or 90 less than in the previous year:— Notifications. Rate per 1,000 of the Population. Deaths. Death Rate per 1,000. Limehouse 213 4.26 95 1.90 St. George's 148 3.34 69 1.55 Mile End Old Town 379 3.63 146 1.40 Whitechapel 221 3.68 165 2.74 Number of deaths from Consumption from 1901 to 1916:— Limehouse District. St. George's. Mile End. Whitechapel. Whole Borough. 1901 123 186 107 208 626 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 79 154 103 494 1909 93 102 146 180 521 1910 74 80 146 110 410 1911 109 69 177 126 481 1912 74 77 149 133 433 1913 98 55 137 140 430 1914 90 53 162 149 454 1915 118 74 176 131 499 1916 95 69 146 165 475 Others Forms of Tuberculosis. 260 new cases were notified or 24 less than in the previous year: 260 new cases were notified or 24 less than in the previous year: Notifications. Rate per 1,000 of the Population. Deaths. Death Rate per 1,000. Limehouse 64 1.28 21 .42 St. George's 57 1.29 21 .47 Mile End Old Town 97 .93 28 .26 Whitechapel 42 .69 19 .31 10 Deaths from Diseases of a Tubercular nature, other than Phthisis, from 1901 to 1916:— 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 1912 29 15 39 22 105 1913 33 32 39 21 125 1914 52 24 50 26 152 1915 30 24 43 21 118 1916 21 21 28 19 89 Diseases of the Respiratory Organs. There were 796 deaths due to diseases of the Respiratory Organs, which corresponds to a death rate of 3.08 per 1,000 of the population. This number is 260 less than in the previous year. 190 belonged to the Limehouse District, or at the rate of 3.81 per 1,000 of the population. 152 belonged to St. George-in-the-East, or at the rate of 3.43 per 1,000 of the population. 267 belonged to Mile End Old Town, or at the rate of 2.56 per 1,000 of the population. 187 belonged to the Whitechapel District, or at the rate of 3.11 per 1,000 of the population. Infantile Mortality. 656 infants died under one year of age or 205 less than in the previous year. 167 belonged to the Limehouse District, or at the rate of 101 per 1,000 births; 11 123 belonged to St. George-in-the-East, or at the rate of 100 per 1,000 births; 268 belonged to Mile End Old Town, or at the rate of 90 per 1,000 births. 98 belonged to the Whitechapel District, or at the rate of 74 per 1,000 births. The infantile mortality for the whole Borough was 92 per 1,000 births, while that for the whole of London was 89 per 1,000 births. Housing and Town Planning Act, 1909. Closing Orders were made in respect of:— (1) Nos. 1-21, Waterloo Court, Wicker Street, and no appeal against the Closing Orders were made. Five of the houses 16, 17, 18, 19, 20, were pulled down and the remaining houses were put in habitable repair. The Closing Orders were withdrawn or determined for the houses Nos. 1-15 and 21. (2) Nos. 1 and 2, French Place, Wapping.—These two houses were closed and as the repairs which were carried out were not sufficient to render them habitable, the Council decided to make demolition orders. (3) 29 and 30, Lomas Buildings.—Closing Orders followed by demolition orders were made for these two houses (4) Imperial Buildings, Wapping.—These buildings have for years caused a great deal of trouble due to their insanitary condition. They ultimately became so dangerous or injurious to health as to be unfit for human habitation, Closing Orders were made on all the 32 tenements. No attempt was made to put them into habitable repair and they were demolished. General Sanitary Work. 47,117 houses were inspected, 4,370 being the result of house to house inspections. 9,891 intimation notices were served for the abatement of various nuisances as well as 4,857 statutory notices. It was necessary to take police court proceedings against the owners or persons causing the nuisance in 28 cases. 48,138 revisits were made by the Inspectors to supervise the abatement of the nuisances complained of. 5,958 drains were tested with smoke or water, and 209 were re-tested; 1,623 drains were either constructed or re-constructed, cleansed or repaired, and 518 were trapped. 12 1,633 new soil pipes were fixed and ventilated; 806 new closet pans and traps were fixed; 1,727 closets were either cleansed or repaired or provided with additional light and ventilation; 1,460 water-closets were provided with proper flushing apparatus. 1,724 yards, forecourts and areas were paved or repaired. Notices were served to provide 959 sanitary dust receptacles, and 18 manure receptacles; 623 offensive accumulations were removed from the rear of dwelling houses. 149 houses were ventilated under the lower floor. 30 underground rooms, which were illegally occupied, were discontinued from being used as such. 16 notices were served for the abatement of smoke nuisances. 303 visits were made to bakehouses. 3,386 notices were served to have houses cleansed; water supply was reinstated to 89 houses. 242 sink, bath or rain-water pipes, which were communicating directly with the drain, were disconnected. 5,967 miscellaneous repairs to roofs, floors, gutters, &c., were made as the result of notices served. 53 rooms were provided with additional light and ventilation, and the damp walls of 562 rooms were remedied. There are 761 houses registered as houses let in lodgings, and 1,172 visits were made under the bye-laws. Overcrowding.—12,417 inspections were made for the purpose of detecting overcrowding. 237 rooms were found to be overcrowded. The nuisance was abated in every instance without the necessity of taking Police Court proceedings. The number of registered milkshops at the end of 1916 was 477, and 1,838 visits were made to inspect the condition of the premises, milk receptacles, &c. Ice cream was manufactured at 144 premises and 305 visits were made to them 267 verminous persons were cleansed and their clothing disinfected, and 1,274 verminous premises were dealt with during the year. Acting in co-operation with the London Hospital the premises of 598 persons who were treated at that institution for Scabies were disinfected. 13 269 articles of clothing were destroyed at the request of their owners in addition to half-a-ton of damaged military clothing from the Tower of London at the request of the Military Authorities. 30,519 articles were disinfected at the Disinfecting Station during the year. The Mortuary. The number of bodies deposited in the Mortuary during the year was 496, 435 being removed by the Coroner for the purpose of holding inquests. 57 post mortem examinations were made; 50 bodies were deposited in the Jewish part of the Mortuary, but 19 only were officially "watched." The bodies of 9 persons who died from infectious diseases were placed in the Infectious Mortuary. 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. I.—At the Wharves. Tons. cwts. qrs. lbs. Fresh Meat 3 Crates of Rabbits — 1 2 22 Preserved Meats 82,009 Tins of Beef 57 12 3 21 4,757 „ Rabbits 4 5 3 12 866 „ Tongues 1 8 3 26 296 „ Mutton — 15 3 12 Fresh Fish 712 Boxes 49 18 0 0 Preserved Fish 26,933 Tins of Salmon 8 13 2 22 21,016 „ Crayfish 5 1 3 9 300 „ Herrings — 1 1 10 238 „ Lobsters — 1 0 25 Fresh Fruit and Vegetables 15,293 Crates of Bananas 359 2 1 0 43 Bags of Potatoes 2 3 0 0 15 Boxes of Oranges — 15 0 0 10 „ Tomatoes — 1 0 8 Carried forward 490 2 2 27 14 Unsound Food Destroyed during the Year—continued. I.—At the Wharves. Tons. cwts. qrs. lbs. Preserved Fruits and Vegetables 13,580 Brought forward 490 2 2 27 Tins of Assorted Fruits 16 2 3 16 2,030 „ Fruit Pulp 9 19 1 14 8,776 „ Pineapples 7 17 1 0 1,533 „ Tomatoes 7 14 3 24 706 „ Apricots — 13 2 20 174 „ Spinach — 3 3 15 Dried Fruits 483 Packages of Plums 9 7 0 0 Sundries 5,376 Tins of Assorted Canned Goods 4 16 0 0 384 „ Condensed Milk — 3 1 20 37 „ Soup — — 1 9 2 Bags of Cocoa — 1 3 26 55 Boxes of Cheese 4 9 1 4 359 „ Margarine 2 12 3 22 Total 554 5 3 1 II.—Diseased Meat and Offal destroyed, from Slaughter-houses and Offal Dealers :— Tons. cwts. qrs. lbs. 110 Sheeps' Carcases and Organs 1 19 1 7 34 Calves' „ „ 1 3 3 16 20 Forequarters of Mutton — 2 1 16 13 „ Veal — 4 1 16 29 Bullocks' Heads — 7 0 7 21 Bullocks' Tripes — 3 2 0 2 Briskets of Beef — — 1 0 1 Leg of Mutton — — — 10 9 Cows' Udders — — 3 26 415 Sets of Sheeps' Lungs — 8 1 7 177 „ Bullocks' „ — 15 1 0 18 „ Calves' „ — — 2 10 394 Sheep's Livers — 9 1 11 19 Bullocks' „ — 3 2 2 15 Calves' „ — — 1 27 Total 5 19 1 15 15 Factories and Workshops. The total number of workshops on the Register was 3,261; but this does not include factories, workplaces and out-workers' premises. 4,692 inspections to factories, workshops and workplaces revealed defects, which necessitated the service of 902 written notices. 50 of the notices, referred to factories, 843 to workshops including workshop laundries, and 9 to workplaces other than out-workers' premises. Cleanliness.— 457 notices were served to cleanse workshops. Ventilation.—The ventilation of 46 workshops was improved. Overcrowding.—Overcrowding was abated in 31 workshops. Sanitary Accommodation.—The sanitary accommodation was improved in 221 workshops by providing additional and suitable water-closets. Drainage of Floors.—The drainage of floors was found defective in two workshops. 65 other nuisances were remedied in workshops. Out-workers' Premises.—1,861 inspections were made to out-workers' premises during the year; 248 premises were found to be insanitary, and 75 cases of notifiable infectious disease occurred. A large percentage of addresses of out-workers was found to be incorrect, and on their being visited by the Sanitary Inspectors, it was found that the occupiers had either left the premises some considerable time previously, or had never lived there at all. 16 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—INSPECTIONS. Premises. Number of Inspections. Written Notices. Prosecutions. (1) (2) (3) (4) \ Factories (Including Factory Laundries) 747 50 .. Workshops (Including Workshop Laundries) 3,811 843 .. Workplaces (Other than Outworkers' premises) 134 9 .. Totals 4,692 902 .. 2.-DEFECTS FOUND. Particulars. Number of Defects Number of Prosecutions. Found. Remedied. Referred to H.M. Inspector. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts:— Want of cleanliness 457 457 .. .. Want of ventilation 46 46 .. .. Overcrowding 31 31 .. .. Want of drainage of floors 2 2 .. .. Other nuisances 65 65 .. .. Sanitary Accommodation insufficient 21 21 .. .. unsuitable or defective 184 184 .. .. not separate for sexes 16 16 .. .. Offences under the Factory and Workshop Acts:— Illegal occupation of underground bakehouse (S. 101) .. .. .. .. Breach of special sanitary requirements for bakehouses (SS. 97 to 100) 52 52 .. .. Other offences (Excluding offences relating to outwork which are included in Part 3 of this report.) 27 27 .. .. Totals 901 901 .. .. * Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act, 1901, as, remediable under the Public Health Acts. 17 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. Failing to keep or permit inspection of Lists. Failing to send Lists. Outworkers. Outworkers. Lists. Contractors Workmen. Lists. Contractors Workmen. Wearing Apparel— (1) Making, &c. 130 160 712 24 2 159 .. .. .. 240 240 .. 70 .. .. (2) Cleaning and Washing .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Household linen .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Lace, lace curtains and nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Curtains and furniture hangings .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Furniture and upholstery 1 .. 1 .. .. .. .. .. .. 1 1 .. .. .. .. Electro plate .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. File making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Brass and brass articles .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Fur pulling (Furriers) 1 .. 3 .. .. .. .. .. .. .. .. .. .. .. .. Cables and chains .. .. .. .. .. .. .. .. .. 1 1 .. 2 .. .. Anchors and grapnels .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cart gear .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Locks, latches and keys .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Umbrellas, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Artificial flowers .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Nets, other than wire nets .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Tents .. .. .. 1 .. 15 .. .. .. .. .. .. .. .. .. Sacks 1 .. 1 1 .. 3 .. .. .. .. .. .. 1 .. .. Racquet and tennis balls .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Paper, etc., boxes, paper bags 6 .. 20 1 .. 9 .. .. .. 6 6 .. 2 .. .. Brush making 2 .. 2 .. .. .. .. .. .. 2 2 .. .. .. .. Pea picking .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Feather sorting .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Carding, &c., of buttons, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Stuffed toys .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Basket making .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Chocolates and sweetmeats .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Cosaques, Christmas crackers, Christmas stockings, &c. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Textile weaving •• •• .. .. .. •• •• .. •• .. .. .. .. .. .. Total 141 160 739 27 2 186 .. .. •• 250 250 .. 75 .. .. B 18 4.—REGISTERED WORKSHOPS. Workshops on the Register (S. 131) at the end of the year 1915. Number. (1) (2) Bakehouses 156 Bool, Shoe and Slipper Making 159 Cabinet Making 97 Furriers 133 Hat and Cap Manufacturers 106 Miscellaneous 404 Laundries 17 Rag Sorting, etc. 89 Wearing Apparel (Tailors, Milliners, Dressmakers, etc., etc.) 2,100 Total 3,261 5.—OTHER MATTERS. Class. Number. (1) (2) Matters notified to H.M. Inspector of Factories: — Failure to affix Abstract of the Factory and Workshop Acts (S. 133, 1901) 14 Underground Bakehouses (S. 101):— Certificates granted during the year 1 In use at the end of the year 54 Table showing the number of milk premises, ice-cream premises, etc., together with the number of inspections made to them. PREMISES. NUMBER OF PLACES. Number of inspections, 1916. Number of prosecutions. 1916. No. on register at end of 1915. No. added in 1916. No. removed in 1916. No. on register at end of 1916. (1) (2) (3) (4) (5) (7) Cowsheds 28 ... ... 28 52 ... Milkshops 508 2 33 477 1838 2 Houses let in lodgings 759 2 ... 761 1172 ... Ice cream premises 205 4 65 144 305 ... 19 Slaughterhouses— Number of Inspections 11 Number of Notices Offensive Trades— Number of Inspections 26 Number of Notices 2 Smoke Nuisances— Number of observations 58 Number of nuisances and complaints 4 Number of Notices 16 Number of summonses — Housing and Town Planning Act—- Houses dealt with under Section 15 of Housing and Town Planning Act 57 Number of Closing Orders 57 Remedied after Closing Orders 16 Houses demolished 41 Underground Rooms— Number illegally occupied 30 Number closed or illegal occupation discontinued 30 Overcrowding— Number of rooms overcrowded 237 Number remedied 237 Prosecutions — Cleansing— Number of adults cleansed 267 Number of children cleansed — Number of rooms or premises cleansed 1,274 Water Supply to Tenement Houses— Premises supplied 5 Prosecutions — Inland Revenue Act (Applications for Certificates)— Number of houses 1 Number of tenements included therein 16 Applications granted 0 Refused — Deferred or withdrawn - B 2 20 Sale of Food— Number of premises used other than ice cream premises, milk shops, cowsheds 409 Number of Inspections 1,286 Disinfection Shelter— Persons accommodated 68 Mortuary— Bodies received 496 Number of infectious bodies 9 Ophthalmia Neonatorum Regulations— Number ol notifications received during the year from certified midwives 2 Food and Drugs. During the year 1,202 samples were submitted by the Inspectors for examination under the Sale of Food and Drugs Acts, consisting of:—850 Milks, 1 Separated Milk, 209 Butters, 2 Margarines, 8 Fresh Creams, 2 Preserved Creams, 1 Sterilised Cream, 2 Cheeses, 4 Lards, 7 Cocoas, 19 Coffees, 20 Mustards, 40 Peppers, 1 Ground Ginger, 5 Malt Vinegars, 6 Vinegars, 1 Arrowroot, 4 Pearl Barleys, 2 Oatmeals, 3 Baking Powders, 1 Custard. Powder, 3 Self-raising Flours, 4 Flours, 4 Camphorated Oils, 1 Castor Oil, 1 Crushed Linseed, 1 Linseed Oil. 147 Samples or 12.2 per cent. were found to be adulterated. These consisted of:- 99 Milks, 37 Butters, 4 Fresh Creams, 1 Mustard, 4 Malt Vinegars, 1 Vinegar, 1 Baking Powder. Proceedings were taken in 78 cases. Total fines secured on the prosecutions £348 6s. Total costs allowed, £62 6s. The average fine secured on the prosecutions was £4 9s. 3d. There were 6 prosecutions for infringements of the Margarine Acts resulting in £68 10s. fines, and £4 4s. costs. Sunday Samples. 150 Samples were taken on 25 Sundays:—141 Milks, 9 Butters, 11 Milks and 2 Butters or 8.7 per cent. were adulterated, and 8 prosecutions resulted. 21 Unofficial Samples. 514 Samples purchased informally by the Inspectors were examined, consisting of:—47 Milks, 386 Butters, 1 Cocoa, 1 Coffee, 1 Pepper, 1 Sugar, 35 Baking Powders, 17 Egg Powders, 19 Self-raising Flours, 4 Saffrons, 2 Sweets Of these, 159 Samples, or 30-9 per cent, were adulterated, 28 Milks, 127 Butters, 4 Saffrons. 30 Samples were examined for the General Public, consisting of:—10 Milks, 14 Butters, 1 Gelatine, 1 Isinglass, 1 Phosphate of Lime, 1 Baking Powder, 1 Cream of Tartar 1 Food Colour. Of these, 7 Samples, or 23.3 per cent. were adulterated, 7 Butters. Preservatives. All Samples of Milk, Butter and Cream were tested for preservatives. No preservatives were found in the Milks. 7 Butters contained small quantities of Boron preservative. 4 Samples of Cream contained Boron preservative. 2 Samples of Preserved Cream contained Boron preservative, but not in excess of the amount declared on the label. 5 Samples of Milk were artificially coloured. In addition to the samples already enumerated, 17 miscellaneous samples were examined for the Public Health Department. STATISTICS OF ADULTERATION FOR THE YEAR. District. Number Examined. Number Adulterated. Number of Prosecutions. Percentage of Adulterations. Percentage of Prosecutions. Whitechapel 335 36 19 10.7 5.7 St. George's 256 30 19 11.7 7.4 Limehouse 211 23 10 10.9 4.7 Mile End 400 58 30 14.5 7.5 Total 1,202 147 78 12.2 6.5 22 RESULT OF INSPECTORS' WORK UNDER THE SALE OF FOOD AND DRUGS ACTS, MARGARINE ACTS, &c., DURING THE YEAR. INSPECTOR. Samples taken. Number Adulterated. Number of Prosecutions. Fines Secured. Costs Allowed. Cases of refusing to sell, obstruction, &c., and offences under the Margarine Acts. No of Cases. Fines. Costs. £ s. d. £ s. d. £ s. d. £ s. d. J. W. Johnson 72 5 3 5 0 0 2 2 0 ... ... ... H. Quaintrell 67 11 5 10 0 0 4 4 0 1 1 0 0 1 1 0 R. H. Waterman 72 7 2 3 0 0 1 1 0 ... ... ... J. Twaits 100 15 7 12 0 0 4 4 0 ... ... ... G. O. Pavitt 100 11 5 3 0 0 2 2 0 ... ... ... E. T. Crook 100 22 14 172 0 0 13 11 0 1 0 10 0 ... R. Simpson 100 10 4 2 10 0 2 2 0 ... ... ... A. W. Stiles 77 17 12 21 10 0 8 8 0 ... ... ... J. White 72 6 4 1 0 0 3 5 0 ... ... ... E. W. Flint 77 4 3 9 0 0 3 3 0 ... ... ... T. W. Dee 17 2 ... ... ... ... ... ... G. Bottomley 13 1 ... ... ... ... ... ... T. P. Wrack 90 4 2 6 10 0 2 1 0 ... ... ... H. Mills 88 14 7 44 17 0 5 7 0 1 3 0 0 1 1 0 A. Cook 85 8 6 7 19 0 6 12 0 ... ... ... W. Shepherd 72 10 4 50 0 0 4 4 0 3 64 0 0 2 2 0 Total 1,202 147 78 348 6 0 62 6 0 6 68 10 0 4 4 0 23 Three of the Sanitary Inspectors and six of the Clerks are serving in His Majesty's Forces, their place being occupied pro tem. by female clerks. The laboratory assistant and four of the disinfectors also joined the Forces. One of the disinfecting men has been killed and two of the clerks have been severely wounded. I have again to express my indebtedness to the Sanitary Inspectors and Clerical Staff—including the temporary 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, Ladies 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. 1. July, 1917. 24 TABLES OF STATISTICS OF THE BOROUGH DURING 1916 AND PREVIOUS YEARS. Area of Borough in acres (land and inland water) 1,765.6 Total population of all ages 279,804 At Census of 1911. No. of inhabited houses 36,217 Average number of persons per house 7.7 Total families or separate occupiers 56,949 25 TABLE 1.—Vital Statistics of Whole District during 1916 and Previous Years. Metropolitan Borough of Stepney. Year. Population estimated to Middle of each Year. Births. Total Deaths Registered in the District. Transferable Deaths. Nett Deaths belonging to the District. Uncorrected Number. Nett. of Nonresidents registered in the District. of Residents not registered in the District. Under 1 Year of Age. At all Ages. Number. * Rate. Number. * Rate per 1,000 Nett Births. Number. * Rate. N umber. Rate. 1 2 3 4 5 6 7 8 9 10 11 12 13 1911 279560 8798 8464 30.2 5179 18.5 1196 871 1261 148 4854 17.3 1912 277315 8990 8579 30.9 4566 16.4 1044 722 986 110 4244 15.3 1913 275300 8419 8165 29.6 4467 16.2 1081 775 917 112 4161 15.1 1914 273265 8396 7983 29.2 4844 17.7 1093 799 1000 125 4550 16.6 1915 265731 7919 7506 28.2 5065 19.0 1319 781 861 114 4527 17.0 1916 281138 for the births and 258395 in the deaths. 7615 7121 25.3 3893 15.0 1110 1012 656 92 3795 14.2 *In Column 6 arc included the whole of the deaths registered during the calendar year as having actually occurred within the district, but excluding the deaths of Soldiers and Sailors that have occurred in hospitals and institutions in the district. In Column 12 is entered the number in Column 5, corrected by subtraction of the number in Column 8 and by addition of the number in Column 9. Deaths in Column 10 are similarly corrected by subtraction of the deaths under 1, included in the number given in Column 8, and by addition of the deaths under 1 included in the number given in Column 9. 26 TABLE II.— Cases of Infectious Disease notified during the Year 1916. Metropolitan Borough of Stepney. Notifiable Disease. At all Ages. Number of Cases notified. Total Cases notified in each Locality. Total cases removed to Hospital. At Ages—Years. 1. 2. 3. 4. Under 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. Small-pox .. .. .. .. .. .. .. .. .. .. .. .. .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria (including Membranous Croup) 850 25 340 409 41 32 3 .. 164 127 285 274 844 Erysipelas 244 15 20 36 25 61 63 24 59 32 86 67 36 Scarlet Fever 661 10 206 343 91 10 1 .. 118 135 232 176 658 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 32 .. .. 12 6 10 4 .. 8 4 10 10 24 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever 1 .. .. .. .. .. 1 .. .. .. 1 .. .. Puerperal Fever 10 .. .. .. 1 9 .. .. 5 1 3 1 9 Cerebro-spinal Meningitis 32 13 13 3 3 .. .. .. 6 9 16 1 29 Poliomyelitis 12 2 9 1 .. .. .. .. 4 3 5 .. 8 Ophthalmia Neonatorum 42 42 .. .. .. .. .. .. 23 3 11 5 .. Pulmonary Tuberculosis 961 2 23 184 155 399 175 23 213 148 379 221 419 Other forms of Tuberculosis 260 7 52 149 22 24 6 .. 64 57 97 42 83 M uasles and German Measles 2255 202 1463 551 27 11 1 .. 524 588 849 294 50 Totals 5360 318 2126 1688 371 556 254 47 1188 1107 1974 1091 2160 27 TABLE III.— Causes of, and Ages at Death during the year 1916 Metropolitan Borough of Stepney. Causes or Death. Nett Deaths at the subjoined ages of "Residents" whether occurring within or without the District. Total Deaths whether of "Residents" or "nonResidents" in Institutions in the District. All ages. Under 1 year. 1 and under 2 years. 2 and under 5 years. 5 and under 15 years. 15 and under 25 years. 25 and under 45 years. 45 ana under 65 years. 65 and upwards. All causes Certified 3,795 656 235 171 146 150 512 968 957 2,325 Uncertified .. .. .. .. .. .. .. .. .. .. Enteric Fever 7 .. .. .. 2 1 2 1 1 5 Small-pox .. .. .. .. .. .. .. .. .. .. Measles 63 10 35 16 2 .. .. .. .. 17 Scarlet Fever 13 2 2 5 4 .. .. .. .. .. Whooping Cough.. 69 34 19 15 1 .. .. .. .. 25 Diphtheria and Croup 40 3 11 19 6 .. 1 .. .. 18 Influenza 27 .. .. .. 1 .. 2 8 16 4 Erysipelas 2 1 .. .. .. 1 .. .. .. 5 Phthisis (pulmonary tuberculosis) 475 1 .. 5 11 59 190 168 41 223 Tuberculous Meningitis 52 9 12 12 15 1 3 .. .. 89 Other Tuberculous Diseases 37 10 8 3 9 3 2 1 1 66 Cancer, malignant disease 232 .. .. .. .. 4 33 121 74 182 Rheumatic Fever 5 .. .. .. 2 2 1 .. .. 2 Meningitis 25 11 6 4 2 2 .. .. .. 21 Organic Heart Disease 403 .. 1 2 14 21 59 156 150 134 Bronchitis 349 38 11 5 1 4 9 102 179 110 Pneumonia (all forms) 421 94 69 42 10 16 45 95 50 220 Other diseases of respiratory organs 26 2 2 1 3 .. 10 7 1 21 Diarrhoea and Enteritis 144 102 25 10 1 .. 1 3 2 129 Appendicitis and Typhlitis 14 .. .. 1 8 1 2 2 .. 46 Cirrhosis of Liver 20 .. .. .. .. .. 3 13 4 8 Alcoholism 2 .. .. .. .. .. 2 .. .. 1 Nephritis and Bright's Disease 124 .. .. 2 2 3 33 57 27 61 Puerperal Fever 4 .. .. .. .. 1 3 .. .. 17 Other accidents and diseases of Pregnancy and Parturition 25 17 .. .. .. .. 8 .. .. 16 Congenital Debility and Malformation, including Premature Birth 263 263 .. .. .. .. .. .. .. 165 Violent Deaths, excluding Suicide 172 19 8 12 26 7 22 41 37 120 Suicide 11 .. .. .. .. 1 5 4 1 4 Other Defined Diseases 639 24 16 13 20 19 68 177 362 610 Diseases ill-defined or unknown 71 16 10 4 6 4 8 12 11 6 Totals 3,795 656 235 171 1 16 150 512 968 957 2,325 Sub-entries included in above figures Cerebro-spinal meningitis 25 11 6 4 2 2 .. .. .. 21 Poliomyelitis 1 .. 1 .. .. .. .. .. .. 3 28 TABLE IV.— Infant Mortality. 1916. LIME HOUSE 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 28 5 6 4 43 31 44 26 23 167 Uncertified .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. 1 1 2 Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. 1 1 2 4 3 2 12 Diphtheria and Croup .. .. .. .. .. .. .. .. 1 1 Erysipelas .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis .. .. .. .. .. .. .. .. .. Abdominal Tuberculosis .. .. .. .. .. .. .. 1 .. 2 Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. .. .. .. .. .. .. 1 1 2 Convulsions 1 .. .. .. .. 2 3 1 1 9 Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis .. .. .. .. .. 4 1 2 2 9 Pneumonia (all forms) .. .. 1 .. 1 4 8 4 8 25 Diarrhœa .. 1 .. 1 2 9 13 9 3 36 Enteritis .. .. 1 .. 1 .. .. .. .. 1 Gastritis .. .. .. .. .. .. .. .. .. .. Syphilis .. 1 .. .. 1 .. .. .. .. 1 Rickets .. .. .. .. .. .. .. .. .. .. Suffocation, overlying 1 .. .. .. 1 1 1 .. .. 3 Injury at Birth 6 .. .. .. 6 .. .. .. .. 6 Atelectasis 1 .. .. .. 1 .. .. .. .. 1 Congenital Malformations 1 .. .. .. 2 1 .. .. 1 4 Premature Birth 17 2 1 .. 20 .. .. .. .. 20 Atrophy, Debility and Marasmus .. 1 1 .. 2 6 11 3 2 24 Other causes 1 .. 2 .. 3 1 2 1 .. 7 Cerebro Spinal Meningitis .. .. .. .. .. .. 1 .. 1 2 Totals 28 5 6 4 43 31 44 26 23 167 29 TABLE IV.— Infant Mortality. 1916. 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 19 7 8 5 39 26 18 20 20 123 Uncertified .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. 3 7 Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. .. .. 1 1 1 2 5 Diphtheria and Croup .. .. .. .. .. .. .. .. 2 2 Erysipelas .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis .. .. .. .. .. .. 1 .. 1 2 Abdominal Tuberculosis .. .. .. .. .. 1 .. .. .. 1 Other Tuberculous Diseases .. .. .. .. .. .. .. .. .. .. Meningitis (not Tuberculous) .. .. .. .. .. .. .. .. .. 1 Convulsions .. .. .. .. 3 1 .. 1 .. 5 Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis .. 1 .. .. 1 4 1 2 1 9 Pneumonia (all forms) 1 .. .. .. 1 4 3 6 8 22 Diarrhœa .. .. 2 .. 2 3 5 5 1 16 Enteritis .. .. .. .. .. 1 .. .. .. 1 Gastritis .. .. .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. .. .. .. 1 Rickets .. .. .. .. .. .. .. .. .. 1 Suffocation, overlying 1 .. 1 1 3 .. .. .. .. 3 Injury at Birth .. .. .. .. .. .. .. .. .. .. Atelectasis 3 .. .. .. 3 1 .. .. .. 4 Congenital Malformations 1 1 .. .. 2 .. 1 1 .. 4 Premature Birth 9 3 3 2 17 .. .. .. .. 17 Atrophy, Debility and Marasmus 1 .. 1 .. 2 6 4 1 .. 13 Other causes 1 2 1 .. 4 .. .. .. 1 5 Cerebri) Spinal Meningitis .. .. .. .. .. 2 .. 1 1 4 Totals 19 7 8 5 39 26 18 20 20 123 30 TABLE IV. —Infant Mortality. 1916. MILE END 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 57 20 10 6 93 61 46 34 31 268 Uncertified .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. 1 1 Scarlet Fever .. .. .. .. .. .. .. 1 1 2 Whooping Cough .. .. .. .. .. .. 4 2 4 12 Diphtheria and Croup .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis .. .. .. .. .. .. .. 3 1 4 Abdominal Tuberculosis .. .. .. .. .. .. 1 1 .. 3 Other Tuberculous Diseases .. .. .. .. .. .. .. .. 2 2 Meningitis (not Tuberculous) .. .. .. .. .. .. 3 .. 2 5 Convulsions 1 1 2 1 5 4 3 1 2 15 Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis .. .. .. .. .. 7 1 1 2 11 Pneumonia (all forms) .. .. 1 .. 1 8 7 9 9 34 Diarrhœa 1 1 1 .. 3 10 9 10 3 35 Enteritis .. .. .. .. .. 1 .. .. .. 1 Gastritis .. .. .. .. .. .. .. .. .. .. Syphilis 1 .. .. .. 1 .. .. .. .. 1 Rickets .. .. .. .. .. .. .. 1 1 2 Suffocation, overlying 2 .. .. .. 2 .. 1 .. .. 8 Injury at Birth 7 .. .. .. 7 .. .. .. .. 7 Atelectasis 4 1 .. .. 5 1 .. .. .. 6 Congenital Malformations 1 1 1 .. 3 .. 1 1 .. 5 Premature Birth 34 9 2 1 46 .. .. .. .. 46 Atrophy, Debility and Marasmus 5 5 3 2 15 17 9 1 4 46 Other causes 1 2 .. 2 5 5 6 l 1 18 Cerebro Spinal Meningitis .. .. .. .. .. .. 1 2 1 4 Totals 57 20 10 6 93 61 46 34 34 268 31 TABLE IV.— Infant Mortality. 1916. 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 I Month. 1-3 Months. 3-6 Months. 6-9 Months. 9-12 Months. Total Deaths under One Year. All Causes. Certified 21 10 2 6 39 22 16 10 11 98 Uncertified .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. .. .. .. .. .. .. .. Scarlet Fever .. .. .. .. .. .. .. .. .. .. Whooping Cough .. .. .. 1 1 .. 1 2 1 5 Diphtheria and Croup .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis .. .. .. .. .. .. 1 .. 2 3 Abdominal Tuberculosis .. .. .. .. .. .. 1 .. .. 1 Other Tuberculous Diseases .. .. .. .. .. 1 .. .. 1 2 Meningitis (not Tuberculous) ..1 .. .. .. 1 .. .. .. .. 1 Convulsions 1 1 .. 1 3 1 1 2 .. 7 Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis .. .. .. .. .. 3 4 .. 2 9 Pneumonia (all forms) .. .. .. .. .. 2 3 3 3 11 Diarrhœa .. .. .. .. 1 7 1 1 .. 10 Enteritis .. .. .. .. .. 1 .. 1 .. 2 Gastritis .. .. .. .. .. .. .. .. .. .. Syphilis .. .. .. .. .. .. .. .. .. .. Rickets .. .. .. .. .. .. .. .. .. .. Suffocation, overlying .. .. .. .. .. .. .. .. .. .. Injury at Birth 4 .. .. .. 4 .. .. .. .. 4 Atelectasis 1 1 .. .. 2 .. .. .. .. 2 Congenital Malformations .. .. .. .. .. 1 .. .. .. 1 Premature Birth 14 7 1 1 23 .. .. .. .. 23 Atrophy, Debility and Marasmus .. 1 1 1 3 4 4 .. 1 12 Other causes .. .. ... 1 1 2 .. .. 1 4 Cerebro Spinal Meningitis .. .. .. .. .. .. .. 1 .. 1 Totals 21 10 2 6 39 22 16 10 11 98 32 TABLE IV. —Infant Mortality. 1916. 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 125 42 26 21 214 140 124 90 88 656 Uncertified .. .. .. .. .. .. .. .. .. .. Small-pox .. .. .. .. .. .. .. .. .. .. Chicken-pox .. .. .. .. .. .. .. .. .. .. Measles .. .. .. 1 1 1 1 2 5 10 Scarlet Fever .. .. .. .. .. .. .. 1 1 2 Whooping Cough .. .. .. 2 2 5 10 8 9 34 Diphtheria and Croup .. .. .. .. .. .. .. .. 3 3 Erysipelas .. .. .. .. .. .. .. .. .. .. Tuberculous Meningitis .. .. .. .. .. 1 1 3 4 9 Abdominal Tuberculosis (b) .. .. .. .. .. 3 2 2 .. 7 Other Tuberculous Diseases .. .. .. .. .. .. 1 .. 3 4 Meningitis (not Tuberculous ) 1 .. .. .. .. .. 3 2 3 9 Convulsions 5 2 2 4 13 8 7 5 3 36 Laryngitis .. .. .. .. .. .. .. .. .. .. Bronchitis .. 1 .. .. 1 18 7 5 7 38 Pneumonia (all forms) 1 .. 2 .. 3 18 21 22 28 92 Diarrhœa 1 2 3 2 8 29 28 25 7 97 Enteritis .. .. 1 .. 1 3 .. 1 .. 5 Gastritis .. .. .. .. .. .. .. .. .. .. Syphilis 1 1 .. .. 2 1 .. .. .. 3 Rickets .. .. .. .. .. .. 1 1 1 3 Suffocation, overling 4 .. 1 1 6 6 2 .. .. 14 Injury at Birth 17 .. .. .. 17 .. .. .. .. 17 Atelectasis 9 2 .. .. 11 2 .. .. .. 13 Congenital Malformations 3 2 1 1 7 2 2 2 1 14 Premature Birth 74 21 7 4 106 .. .. .. .. 106 Atrophy,, Debility and Marasmus 6 7 6 3 22 33 28 5 7 95 Other causes 3 4 3 3 13 8 8 2 3 34 Cerebro Spinal Meningitis .. .. .. .. .. 2 2 4 3 11 Totals 125 42 26 21 214 140 124 90 88 656 33 INDEX. A page Analyst's Report 20, 21 & 22 B Births 1, 2 & 3 C Cerebro-Spinal Fever 6 Cowhouses 18 Cleansing 19 D Deaths 3 & 4 Diarrhœa 8 Diphtheria and Membraneous Croup 5 Disinfection of Articles 13 Disinfection Shelter 20 E Enteric Fever 5 & 6 Erysipelas 6 F Factory and Workshops Acts 15 to 18 Food and Drugs 20, 21 & 22 G General Sanitary Work 11, 12 & 13 German Measles 7 H Houses let in Lodgings 18 Housing and Town Planning Act, 1909 11 & 19 34 I PAGE Illegitimate Children, Deaths of — Infantile Mortality 10 & 11 Inhabited House Duty 19 Inquests, number and cause of death 6, 7 & 8 Ice Cream Premises 18 M Marriages 3 Measles 7 Milkshops 18 Mortuary and Coroner's Court 13 & 20 N Notifiable Diseases 4 O Ophthalmia Neonatorum 6 & 20 Overcrowding 12 & 19 Offensive Trades 19 P Phthisis, number of notifications and deaths 9 & 10 Poliomyelitis 6 Population 1 Puerperal Fever 6 R Respiratory Diseases 10 S Scarlet Fever 15 Slaughter-Houses 19 Spies 4 Statistics :— Table 1. Of whole district during 1916 and previous years 25 „ 2. Cases of Infectious Diseases notified during the year 1916 26 ,, 3. Causes of, and ages at death, during the year 1916 27 „ 4. Infantile Mortality during the year 1916 28 to 32 Summer Diarrhœa 8 Smoke Nuisances 19 Sale of Food 20 35 T PAGE Tuberculosis 9 & 10 Typhus Fever 12, 13 & 14 U Underground Rooms 19 Unsound Food destroyed 13 & 14 W Whooping Cough 8 Wrong Diagnosis 5 Water Supply 19 Z Zymotic Diseases 8 & 9