STE 22 E Metropolitan borough of Stepney. ANNUAL REPORT For the Year 1925 BY D. L. THOMAS, M.R.C.S., L.R.C.P., D.P.H., BARRISTER-AT-LAW, Medical Officer of Health AND Administrative Tuberculosis Officer. 9 TOGETHER WITH THE REPORT OF THE PUBLIC ANALYST Vail, & Co., 170, Farringdon Road, London, E.C.I. PUBLIC HEALTH COMMITTEE. (November, 1924 to October, 1925.) Chairman: Councillor (Miss) M. Moses, J.P. Vice-Chairman: Councillor C. Edser. Alderman W. A. Pryde. Alderman (Mrs.) F. W. Reidy. Councillor A. Barber. Councillor J. C. Lawder. „ G. F. Brady. „ A. Magen. „ F. R. Ellis. „ W. G. Peacock. „ (Mrs.) F. Fardell. „ J. J. Reidy. „ (Miss) M. Hughes, J.P. „ (Miss) I. Samuel. „ D. Hume. „ F. Simms. „ J. Hurley, J.P. „ R. J. Woodham. „ A. W. Jones. MATERNITY AND CHILD WELFARE COMMITTEE. (November, 1924, to October, 1925.) The Members of the Public Health Committee, together with the following Members:— Mrs. F. Crawley. Mrs. A. Model. Mrs. E. C. Grenfell. Mrs. F. Newell. Mrs. M. H. Heasman. Miss B. M. Page. Chairman: Councillor (Mrs.) F. Fardell. Vice-Chairman: Councillor (Miss) I.Samuel. STAFF OF THE PUBLIC HEALTH DEPARTMENT. Medical Officer of Health and Administrative Tuberculosis Officer: D. L. Thomas, m.r.c.s., l.r.c.p., d.p.h., barrister-at-law. Assistant Medical Officer of Health: J. M. Browne, m.b., b.Ch., d.p.h. (Maternity and Child Welfare). Public Analyst: D. Henville, f.i.c. Food Inspector: H. Abson. Sanitary Inspectors: G. Bottomley. H. Mills. J. Twaits. A. C. Brown. G. O. Pavitt. W. T. Twynham. T. W. Dee. H. Quaintrell. R. Waterman. E W. Flint. W. Shepherd. J. White. H. O. Harris. R. Simpson. T. P. Wrack. J. W. Johnson. S. H. V. Trimming. c. F. Guy (Temporary) Health Visitors: E. Addis. M. Davis. D. Michell. D. Chabot. S. Foucar. I. Virtue. E. Clements. A. E. Gibbs. H. A. Whitty. A. M. Oordwell. E. Goodfellow. Clerical Staff: W. F. Lellow, Chief Clerk. G. Boulton (M. & C. W.) W. P. Howard. J. McMullon. R. Day. H. T. Kightley. D. Tapolski. S. Embleton. J. G. McCarthy. S. Vogler. Temporary Clerks engaged at the Maternity Centres and in the distribution of milk : it. Butler, L. Hannington, A. Healey, M. W. Hunt, K. Worsell. Senior Tuberculosis Officer: W. E. Goss, m.b., Ch.B. (Ed.) Tuberculosis Officer: A. Ferguson, m.b., b.s. (lond.), d.p.h. Tuberculosis Officer: T. S. Gibson, m.r.c.s., l.r.c.p. Nurses: E. P. Colledge. M. Prickman. H. M. Tayler. M. F. Weatherilt. Nurse Dispensers: M. Coulman. A. O. Jones. Dispenser: A. Wager. Clerk and Secretary to Care Committee: M. Grant. REPORT OF THE MEDICAL OFFICER OF HEALTH FOR THE METROPOLITAN BOROUGH OF STEPNEY FOR THE YEAR 1925. Public Health Department, 43, White Horse Street, May, 1926. To the Mayor, Aldeimen and Councillors of the Metropolitan Borough of Stepney. Ladies and Gentlemen, I have the honour to present to you my twenty-fifth Annual Report upon the Vital Statistics and Sanitary condition of the Borough for the year 1925. Before proceeding to a detailed description for the year, I beg to call your attention to the Memorandum issued by the Ministry of Health, which suggests that the present report shall contain a section dealing with the progress made during the past five years. (1) Population. -According to the Census taken in 1921, the population had declined nearly fifty thousand in twenty years. This was due to a large extent to the conversion of dwelling-houses into flats, business premises, and rooms in dwelling-houses into workshops. The greatest reduction has been in that part of the Borough bordering on the City. It is estimated, however, that the population has slightly increased since 1921, due to overcrowding, which undoubtedly exists to a greater extent than in 1921. (2) Births.—There has been a gradual decline in the birth-rate throughout the whole Borough, which is equally true of the whole country. In 1925, the birth-rate was the lowest on record, not only throughout the Borough as a whole, but in each part of it. In the Limehouse District (Limehouse, Ratcliff, Shadwell and Wapping) in 1921, and for thirty years previous to it, the birth-rate had not been below 32 per 1,000 of the population. Since 1921 it has been below 30 per 1,000, although it is much higher than in any other part of the Borough. 4 In St. George-in-the-East, twenty years ago the birth-rate was always above 40 per 1,000. During the last five years it has been below 25 per 1,000 with the exception of the year 1922— when it was 25.7. Previous to 1909, the birth-rate in Mile End Old Town was always above 30 per 1,000, but during the last five years it has been below 25 per 1,000. The greatest reduction has occurred in the Whitechapel District (Whitechapel, Mile End New Town, Spitalfields, etc.). Previous to 1897, it was always above 40 per 1,000. From 1897 to 1912 it fluctuated from 30 to 40 per 1,000 of the population. During the last five years it has been below 18 per 1,000. (3) Deaths.-Previous to the formation of the Borough Council in 1901, the death-rate had always been above 21 per 1,000 in the four districts included in the Borough. Since that time it has never been as high as 21 per 1,000 This improvement has been more marked in the Limehouse and St. George's Districts. Previous to 1901, the annual death-rate in these two districts was from 25 to 29 per 1,000. During the last five years, the death-rate has been less than 15 per 1,000, in these, as well as in the other districts. Taking the Borough as a whole, the death-rate has been below 14 pef 1,000 during the last five years. (4) Infantile Mortality.—Satisfactory as the reduction in the general death-rate must be considered to be, the lowered infantile mortality is still more satisfactory. In 1901 the infantile mortality for the whole Borough was 165 per 1,000 births. This was due to the high infantile mortality in the I.imehouse District—211 per 1,000 births—and .184 per 1,000 births in St. George's. Previous to that year, the infantile mortality in the Limehouse District had always been above.200 per 1,000 and was the highest in London, as well as one of the highest throughout the whole country. Since 1921, when it was 98 per 1,000, the infantile mortality in the Limehouse District has been below 80 per 1,000, a figure which refers to the whole Borough as well. The higher infantile mortality in 1921 was due to the very dry and hot weather we experienced during that summer as well as to the fact that there was an epidemic of Scarlet Fever and Diphtheria in our district, which caused the deaths of many infants under one year of age. (5) Infectious Diseases.—There has been no decline in the number of children suffering from Scarlet Fever and Diphtheria during the last five years, but there has been a great reduction in the mortality from these two diseases. 5 This is partly due to the fact that practically all the patients arc removed to Fever Hospitals, where they have a better chance of recovery than they would at their own homes, and partly to the change of type in these diseases. Measles and Whooping Cough are not notifiable diseases. The number of deaths is less than in former years. This may be due possibly to a change in type of the diseases, but more probably to the teaching received at the Infant Welfare Centres, where it is impressed on the mothers that these diseases are not of a trivial nature which can be ignored. In the first and second years of the Council's existence, the deaths from Lnteric Fever numbered 47 and 33 respectively. During the whole of the last five years the total number of deaths from this disease has been 9. In two of these five years there was not a single death. This improvement has been due to improved water supply, better supervision of food, and better sanitation generally. During the last five years, 183 cases of Ophthalmia Neonatorum have been notified but no blindness has resulted thereby, and in only six cases has vision been impaired. This is a disease which causes a purulent discharge from the eyes of newly-born children, and is notifiable if it occurs within 21 days of the date of birth. It is a disease which, if neglected, will cause total blindness, and has in the past been responsible for a good deal of blindness When a case is notified by a general practitioner (and the certificate is often brought by hand to the Public Health Office to save delay) the Health Visitor visits on the same day usually. If she finds that local applications to the eyes are necessary, oftener than the doctor is able to give, and the patient is treated at home, the East London Nursing Society is immediately communicated with by telephone, and a request is made to send a nurse. It is left to the discretion of the nurse to visit and apply treatment as often as she considers necessary, or as often as the doctor in attendance requires her to do so. The Borough Council pays for this nursing attendance per visit and not per ease, so that there is no reason why the baby's eyes should not receive prompt attention, and proper care. The fact that there has been no blindness due to this disease during the last five years and that vision has only been impaired in six babies, is very satisfactory. (6) Tuberculosis.—The deaths from Phthisis during the last five years were one-half the number that occurred annually when the Borough Council first came into existence, and the deaths from Tuberculosis—other than Phthisis—were less than one-quarter what they were at that time. The three Voluntary Dispensaries and the staff were taken over by the Borough Council 6 in April, 1921. The Dispensaries have since been utilised, more for preventive, rather than for curative, treatment. For this object, the members of the families of patients who have been exposed to infection have been examined by the Tuberculosis Officers at the earliest opportunity, and steps taken to effect a cure in those who show early symptoms of the disease. The examination of "contacts" has been more satisfactory during the last four years. It has been found possible to arrange for a much larger percentage to be examined. An arrangement has been in practice during the last four years with the L.C.C. School Medical Officers, which ensures that no "contact" of school age will remain unexamined. If the Dispensaries are unable to arrange an examination, the School Medical Officers are notified, and the examination is carried out at school. The result of the examination is communicated to the School Medical Officers, and reciprocal reports are exchanged as appears necessary. The desirability of routine "contact" examination has, on a number of occasions, been proved by the discovery of advanced and very infective cases, which have evidently disseminated infection to the other members of the family for years past. They have remained undiscovered and untreated until routine "contact" examination has revealed the source of infection. It is these "unknown" cases which are particularly likely to spread infection, owing to the fact, that they take no precautions against infecting others. It is more difficult to persuade adults, particularly men, to be examined than other "contacts," although the value of early diagnosis is becoming better known, and a larger percentage of adult "contacts" are being examined every year. A large proportion of the people suffering from Tuberculosis are still not notified, and we only discover them when their deaths are registered. There has been an improvement during the last five years. In 1921, 43 per cent. of the persons dying from Phthisis had not been notified during lifetime and, in addition, 5 per cent. were notified only at the time that the deaths were registered. In 1925, 20 per cent. only of the total deaths from Phthisis were not notified during lifetime, and 8 per cent. at death. The usefulness of the Dispensaries is severely handicapped, through the remissness on the part of medical men, in not notifying persons suffering from Phthisis, immediately they have made up their minds as to the diagnosis. It is true that some of the deaths occurred in Mental Hospitals, and no useful purpose would be gained by having them notified. These cases, however, form a very small proportion of the total, and most of them are notified during lifetime. The majority of the unnotified cases are those whose deaths occur at their own homes, and at the Poor Law Hospitals. 7 No age is altogether exempt from the disease, though it is generally considered to be rare at the two extremes of life. In our district, however, 31 per cent. of the total deaths were above 45 years of age, and 7 per cent. were above 65 years of age in 1925. During some years the figures have been higher. There has been more co-operation during the last two years between the Dispensaries and various other authorities. In addition to the arrangements with the School Medical Officers, the three Tuberculosis Officers have been appointed for consultative purposes—so far as tuberculosis is concerned—to the visiting staffs of the Hospitals under the care of the Stepney Guardians. This arrangement has proved most useful, as it introduces personal contact between the Hospital Medical Superintendents and the Tuberculosis Officers, without which proper co-operation is impossible. The co-operation between the general medical practitioners in the Borough and the Dispensaries is very satisfactory, and is better than it has ever been. A larger number of patients is being examined at each Dispensary at the request of private doctors, either for assistance in diagnosis or for advice and help, regarding suitable treatment. The assistance of the Tuberculosis Officers for consultation at the homes of patients, when required, is also more widely known, and appreciated, by the doctors. There is still an urgent need for the after-care of patients who have undergone a course of treatment. Many of these cases benefit considerably from Sanatorium treatment, but on discharge, they have to return to unsuitable occupations, and poor home conditions, with the result that the disease again becomes active. Nearly all the benefit obtained whilst under treatment is thereby lost. These cases would often profit if suitable work of a comparatively light nature, was provided for them and, no doubt, in some cases the disease would eventually become arrested entirely. Many are fit for such light work, but they are not fit to compete with healthy men and women in the open market. There is not yet any adequate organisation for dealing with the after-care problem, although there are two or three " colonies " in existence for the purpose. Another great problem remains, in the persons of the chronic and infective patients. Many of these cases are comparatively fit, but they are, none the less, a source of danger to others. Permanent institutional treatment for isolation purposes is, in most cases, out of the question, on account of the long period necessary. Assuming the necessary accommodation to be available, most patients would not remain in an institution, in some cases possibly, for years. 8 (7) Food Inspection.—The usual food inspection has been carried on at the wharves and in the shops and markets of the Borough. In addition to these, inspections at Bishopsgate Goods Station of foodstuffs arriving from the Continent by the Zeebrugge-Hanyich train ferry, which began in 1924, continued in 1925, and necessitated more inspections than in 1924. The food included meat and fruit from Belgium, poultry, eggs, fruit and vegetables from Italy. The total weight of meat imported through this channel in 1925, which consisted chiefly of calves and calves' offal, was 1,225 tons. The inspection of meat was carried out at first by two meat inspectors alternately, and that of fruit by a rota of district sanitary inspectors. In view of the increasing amount of foodstuffs arriving, the Council decided in July, 1925, that one Inspector should be detailed for this work, and that a temporary sanitary inspector should be appointed to take over his district when he was so engaged. This arrangement proved satisfactory. A great deal of diseased meat was discovered and condemned. The attention of the Belgian Authorities was directed to the importation of diseased meat into this country on six different occasions during 1925 and they were asked to arrange for the proper inspection of meat before it was exported. It is much easier to detect diseased meat at the time of slaughter than it is at Bishopsgate Station when carcases have to be examined without the offal and during the early hours of the morning. The Ministry of Health was also informed of this want of inspection with regard to meat from Belgium. At the end of 1925 these protests had no effect and the method of examination or rather the want of inspection, was still unsatisfactory. About a ton a day of unsound food of all kinds was dealt with during the year. This quantity is less than in previous years. On an average, a ton and a-half a day has been condemned as unsound during the last five years. It was not all destroyed, as the unsound tinned meat is used for extraction for commercial purposes, and unsound condensed milk is sold for pig and poultry feeding. (8) Housing.—The housing question is as acute as ever. Several hundreds of applications have been received for houses or flats Many families have been accommodated at Becontree, but the bulk of them still remain on the waiting list. It is unfortunate that many people convert a portion of their private dwelling houses into workshops. This generally begins by a conversion of the bedrooms on the top floor, and this displaces, possibly, a family which could utilise them for living. To our knowledge, there are workshops in 760 houses in the Borough in which this arrangement has taken place within 9 recent year-;. In 427 houses one room only is so used; in 285, two rooms are used; in 27, three rooms; in 18, four rooms; and in 3 houses, five rooms are used. In all, 1,185 rooms are used as workshops in private houses. Insanitary Areas and Clearing Schemes.—The acquirement and clearing of a site with subsequent re-housing is slow work. This will be appreciated by the following account of the present position with regard to insanitary areas that I have officially represented as unfit under the Housing Acts:— (a) Bell Lane Area.—I made an official representation on December 2nd, 1919, that the houses in the area were unfit for human habitation and dangerous to the health of the inhabitants of the buildings therein. Further, that the most satisfactory method of dealing with the evils connected with such houses, and the sanitary defects in such area, was an improvement scheme for the re-arrangement and reconstruction of the streets and houses within such area. The area is situated in Spitafields to the west of Commerical Street, and to the east of Bell Lane, and is bounded on the north by Butler Street, and on the south by Wentworth Street, but includes six houses to the south side of Wentworth Street. It includes Bell Lane (east side), Bell Court, Tenter Street, Butler Street (south side), Freeman Street, Palmer Street, Tilley Street, Shepherd Street and Buildings, Emery Place, Eastman's Court, Katherine Terrace, Wentworth Street (31 to 73 and 52 to 62), Wentworth Courts, and Ann's Place. The area covers about 4 acres, and consisted of 293 houses with a population of about 1,351 people. 23 houses were unoccupied, 33 were used for business premises only, and the remaining 235 were occupied by members of the working classes. The houses were not all equally bad—some were much worse than others. Most of the houses in Bell Lane, Wentworth Court and Wentworth Street were probably built previous to 1800, and the remainder between 1800 and 1850. The Ministry of Health held a public inquiry at the St. George's Town Hall on October 29th, 1920. The inquiry lasted three days. In this area there were nearly thirty houses which were purchased by the Postmaster-General nearly 10 years previously, for the purpose of constructing a Telephone Exchange. Sixteen of the houses were unoccupied for many years, viz., ten in Butler Street, three in Tenter Street and three in Freeman Street. At the time they became vacant they were in a fair condition, but 10 after the lapse of many years they became dilapidated, and no doubt it would have cost a considerable sum of money to put them in a habitable condition. I he remaining houses in the area are becoming worse because the owners refuse to spend money on property which they believe will be demolished without compensation. Included in this area are Shepherd Street Buildings, consisting of 42 apartments with shops underneath. The buildings are badly built and ill-lighted. The washhouses on the second, third, fourth and fifth floors were condemned as dangerous structures by the District Surveyor about ten years ago, and are now in a dismantled condition. This resulted in eight of the flats or apartments being empty and inaccessible, due to the passage to them being demolished. The owner refused to reconstruct the demolished part of the buildings, and to put the property in habitable condition because of the "uncertainty of the result of the Ministry of Health's inquiry of 1920." He maintained that he did not feel justified in laying out any large sum of money. The south side of Butler Street, a part of Tenter Street, and the north side of Freeman Street have been demolished, and the building of flats has commenced on the cleared site. (b) Back Church Lane Area. The official representation was made on August 6th, 1919. This area is situated in St. George-in-the-East to the south of Commercial Road. It is bounded on the west by Back Church Lane, on the east by Berner Street, on the north by Boyd Street, and on the south by Ellen Street. It includes all the houses in Everard Street, Nos. 70 to 82 in Berner Street, 2 to 52, Boyd Street, the houses on the north side" of Ellen Street (Nos. 1 to 51). The area consisted of 112 houses with a population of 533. The number of persons suffering from Scarlet Fever, Diphtheria, Esysipelas, Small Pox and Spotted Fever was, in proportion, twice that for the whole of the Borough of Stepney in 191G and 1917, and eight times as much in 1918. In 1799 this area had a few houses adjoining Back Church Lane. The remaining houses were built in the early part of the 19th century. The narrowness, closeness and bad arrangement of the streets and houses, and the bad condition of the houses with sanitary defects connected therewith are dangerous to health, and the most satisfactory method of dealing with the evils connected with such houses is an improvement scheme for the re-arrangement and reconstruction of the houses and streets therein. 11 The local inquiry by the Minister of Health was held in October, 1920, but nothing has yet been done with regard to clearing the area and re-housing. (c) Prusom Street Area.- Official representation was made on June 7th, 1920, that this Area was an insanitary area, and that the most satisfactory method of dealing with the evils connected with the houses was by an improvement scheme for the re-arrangement and reconstruction of the streets and houses within such area. The area is bounded on the west by Red Lion Street and Dundee Street, on the east by Ship Street and Queen's Head Alley, on the north by Worcester Street, Watts Street and Prusom Street, and on the south by Greenbank, Hilliard's Court and High Street, Wapping. It consisted of 79 houses in Red Lion Street, 2 in Red Lion Court, 17 in Worcester Court and Worcester Street, 15 in Bostock Street, 9 in Chandler Street, 5 in Taylor's Rents, 16 in Meeting House Alley, 14 in Watts Street, 22 in Raymond Street, 18 in Lowder Street, 23 in Greenbank, 6 in Choppin's Court, 24 in Old Gravel Lane, 24 in Prusom Street, 10 in Clegg Street, 17 in Rygate Street, 3 in Hilliard's Court, 6 in Ship Street, 12 in Queen's Head Alley, 3 in High Street, Wapping, and 13 houses in Dundee Street. There is a great deal of empty space as well as empty dilapidated houses in this area. My suggestion to the London County Council was to prepare a comprehensive scheme for re-building and to start building on the part of the site which is now unoccupied. Having put up one block, the people in a part of the occupied area could be accommodated, and their houses demolished. When another block had been completed, this could be occupied, and so on, until the whole area had been cleared with as little disturbance as possible. The portion of the area between Red Lion Street and Dundee Street and to the south of Greenbank has been cleared, and the rebuilding of blocks of houses is now in progress. (d) Limehouse Fields Area.—On May 11th, 1925, I made an official representation under the Housing of the Working Classes Acts that certain houses, courts or alleys were unfit for human habitation, and that the narrowness, closeness and bad arrangement or the bad condition of the streets and houses within the area, or the want of light, air and ventilation, or other sanitary defects, etc., were dangerous or injurious to health, and that the most satisfactory method of dealing with the evils connected with such houses, courts or alleys was an improvement scheme for the re-arrangement and reconstruction of the streets and houses within such area. This area is in the north ward of the Parish of Limehouse, and is bounded on the east by the Regent's Canal, on the north by Manning Street, and on the south by Repton Street. 12 It includes 348 houses, consisting of 1,373 rooms used for dwelling purposes, containing 545 families with a population of 2,424—1,517 adults and 907 children of school age. The houses, generally speaking, are about one hundred years old. The area had only a very few houses on it in .1819, most of the ground being covered with ropeworks. In 1826 all the houses were built, with the exception of the houses in Manning Street, which were not built until 1843. Limehouse Fields has always had a high death-rate, including a very high infantile mortality. As far back as 1898 I made a special report to the late Limehouse District Board of Works, based on personal enquiries into all the deaths of infants under one year of age, where the infantile mortality in the districts known as Limehouse Fields was 220 per 1,000 births. As a result of this report it was decided to appoint a Flealth Visitor for this part of Limehouse, and the Sanitary Inspector was instructed to do everything in his power to bring the houses into a better sanitary condition, more especially to remedv the dampness, to insist on ventilation underneath the lower floors, etc. The infantile mortality has decreased, together with that throughout the whole Borough, but it is still much higher than in the whole Borough. Area. Whole Borough. 1921 186 per 1,000 births 89 per 1,000 births. 1922 84 „ 79 „ 1923 78 „ 62 „ 1924 161„ 74 „ The death-rate from Zymotic Diseases (Measles, Scarlet Fever, Whooping Cough, Diphtheria, Enteric Fever and Diarrhœa) was three times greater in the area than in the whole Borough in 1921, nearly twice as much in 1922 and nearly eight times as much in 1924. Infectious diseases of a notifiable character were at the rate of 15.2 per .1,000 of the population in the area in 1923 and 19 per 1,000 in 1924, whereas in the whole Borough the figures were 4'7 and 4'6, respectively. Deaths from Tuberculosis and from Respiratory Disease have been far more prevalent in the area than in the rest of the Borough. The roofs of most of the houses are made of pan tiles. When they become defective the roofs are very difficult to make weatherproof. The result is that sooner or later the ceilings fall down. There is a history of this kind in onehalf of the houses in the area during the last five years. Some of the houses are legally overcrowded, others are indecently occupied as well as being grossly overcrowded. 13 In some of the two-roomed cottages, the ground-floor room is occupied by one family as a living and sleeping room, and the room on the first floor is occupied by another family. In order, to reach the first floor room, the members of the family must pass through the ground-floor room, which, as I have stated, is used as a living and sleeping room. Forty-one of the houses are tworoomed cottages and 38 are three-roomed cottages. The Ministry of Health held an Inquiry at the Limehouse Town Hall, which commenced on August 10th. It was resumed on August 12th and adjourned until September 10th, and lasted five days, but the result of the Inquiry is not yet known. (e) Spitalfields Market.—In connection with the clearance of insanitary areas, I may mention the transformation that is taking place in connection with the enlargement of Spitalfields Market. It is already one of the most important centres in the country for the wholesale distribution of fruit and vegetables, and it will, probably, become the largest market in the kingdom lor vegetables. After nearly three centuries' existence as a private concern, the Market was purchased by the Corporation of the City of London, who propose to extend the premises to twice their present size. For the carrying out of the development and the enlargement of the street approaches to the Market, in order to minimise the traffic congestion which now occurs, demolition of much of the existing slum property has been rendered necessary. The occupiers had to be provided with alternative accommodation before the houses were demolished. This has been done by removing them to flats in High Street, Shadwell (Whitaker Buildings), and Dron Buildings, in Adelina Grove. More than one thousand people have been rehoused in these model flats. When completed, there will be wide new streets which will render the Market more accessible, instead of the sixteen narrow, badly congested, streets now leading to it. The area to the north of Brushfield Street has already been demolished, which includes one side of Steward Street, both sides of Gun Street, and one side of Crispin Street, as well as a part of Brushfield Street, from Crispin Street to Steward Street. No rebuilding has yet taken place. In conclusion, I have to thank the Maternity and Infant Welfare Committee, the Public Health Committee and Council for their kind support, as well as the members of my staff for the manner in which their duties have been performed. I am, Ladies and Gentlemen, Yours respectfully, D. L. THOMAS. 14 Population. The estimated population is 256,070, distributed as follows:— Limehouse, Ratcliff, Shadwell and Wapping 53,530 St. George-in-the-East 41,440 Mile End Old Town 105,900 Whitechapel, Spitalfields, Mile End New Town, etc. 55,200 Births. The total number of births during the year was 5,371—2,801 males and 2,570 females—or 86 less than in the previous year. The birth-rate was 20'9 per 1,000 of the population, while that for the whole of London was 18.0 per 1,000. 1,455 of the births belonged to the Limehouse district, or at the rate of 27.2 per 1,000 of the population. 873 of the births belonged to St. George-in-the-East, or at the rate of 21'0 per 1,000 of the population. 2,242 of the births belonged to Mile End Old Town, or at the rate of 21.1 per 1,000 of the population. 801 of the births belonged to the Whitechapel district, or at the rate of 14'4 per 1,000 of the population. The birth-rate continues to fall and it is the lowest on record, not only for the whole of the Borough, but for each district. Births in Public Institutions in the Borough. 1,098 births occurred in the Mothers' Lying-in Home, Commercial Road:— 236 belonged to Mile End Old Town. 270 belonged to the Limehouse District. 50 belonged to the Whitechapel Distict. 60 belonged to St. George-in-the-East. 482 belonged to outlying Districts. 412 births occurred in the London Hospital:- 64 belonged to Mile End Old Town. 47 belonged to St. George-in-the-East. 23 belonged to the Limehouse District. 44 belonged to the Whitechapel District. 234 belonged to outlying Districts. 200 births occurred in the St. George's Hospital (3, Raine Street):— 165 belonged to St. George-in-the-East. 35 belonged to the Limehouse District. 16 155 births occurred in the Mile End Hospital, Bancroft Road:— 138 belonged to Mile End Old Town. 15 belonged to the Limehouse District. 1 belonged to the Whitechapel District. 1 belonged to an outlying District. 96 births occurred in the St. Peter's Hospital, Vallance Road:— 73 belonged to the Whitechapel District. 8 belonged to Mile End Old Town. 2 belonged to St. George-in-the-East. 13 belonged to outlying Districts. 267 births occurred at 24, Underwood Street:— 81 belonged to Mile End Old Town. 90 belonged to the Whitechapel District. 37 belonged to St. George-in-the-East. 1 belonged to Limehouse. 58 belonged to outlying Districts. Births occurring outside the district, the parents being residents of the Borough. 161 births occurred at the City of London Lying-in Hospital, 102, City Road. Of these:— 6 belonged to Limehouse. 31 belonged to St. George's. 60 belonged to Mile End. 64 belonged to Whitechapel. 8 births occurred at the Queen Charlotte's Hospital: 4 belonged to Limehouse. 2 belonged to Whitechapel. 2 belonged to Mile End. 51 births occurred at the Mothers' Hospital, Clapton: 7 belonged to Limehouse. 3 belonged to St. George's. 29 belonged to Mile End. 12 belonged to Whitechapel. 27 births occurred at 2, Queensdown Road, Hackney:— 2 belonged to Limehouse. 4 belonged to St. George's. 10 belonged to Mile End. 11 belonged to Whitechapel. 16 10 births occurred at the Royal Free Hospital:— 7 belonged to Mile End. 2 belonged to Whitechapel. 1 belonged to Limehouse. 7 births occurred at the Middlesex Hospital:— 5 belonged to Whitechapel. 1 belonged to Mile End. 1 belonged to Limehouse. 3 births occurred at 2, Amhurst Road, Hackney:— 2 belonged to Whitechapel. 1 belonged to Mile End. 3 births occurred at 73a, Devons Road. All belonged to Limehouse. 1 birth occurred at 2a, Bow Road, which belonged to Limehouse. 5 births occurred at 18, Thavies' Inn, Holborn. All belonged to Limehouse. 1 birth occurred at St. Bartholomew's Hospital, which belonged to Limehouse. 24 births occurred at Queen Mary's Hospital, Stratford:— 17 belonged to Mile End. 4 belonged to Limehouse. 3 belonged to St. George's. 7 births occurred at Charing Cross Hospital:— 3 belonged to St. George's. 4 belonged to Mile End. 1 birth occurred at 65, Lauriston Road, Hackney, which belonged to Mile End. 5 births occurred at the Hospital for Women and Children, Harrow Road:— 1 belonged to St. George's. 2 belonged to Mile End. 2 belonged to Whitechapel. 13 births occurred at 4, Navarino Road, Stoke Newington:— 11 belonged to Mile End. 2 belonged to Whitechapel. 1 birth occurred at 94, Cazenove Road, Hackney, which belonged to Mile End. 2 births occurred at the All Saints' Maternity Hospital:— 1 belonged to Limehouse. 1 belonged to St. George's. 17 1 birth occurred in the Royal Infirmary, Bristol, which belonged to Limehouse. 1 birth occurred in the Westminster Hospital and 1 at the York Road Lying-in Hospital. Both belonged the Mile End. 1 birth occurred at the Mildmay Hospital, which belonged to Whitechapel. 68 births occurred in private houses outside the Borough:— 18 belonged to Limehouse. 9 belonged to St. George's. 20 belonged to Mile End. 21 belonged to Whitechapel. There were 137 stillbirths notified during the year, 60 sets of twins and 4 sets of triplets. Marriages. The total number of marriages was 2,059. The proportion of persons married was 16 per 1,000 of the population. 386 of the marriages were registered in the Limehouse District. 268 „ „ „ „ St. George-in the-East. 1,022 „ „ „ „ Mile End Old Town. 383 „ „ „ „ the Whitechapel District. 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 3,057—1,658 males and 1,399 females—or 55 less than in the previous year. 693 of the deaths belonged to the Limehouse District, or at the rate of 12.9 per 1,000 of the population. 474 of the deaths belonged to St. George-in-the-East, or at the rate of 11.4 per 1,000 of the population. 1,174 of the deaths belonged to Mile End Old Town, or at the rate of 11.0 per 1,000 of the population. 716 of the deaths belonged to the Whitechapel District, or at the rate of 12.9 per 1,000 of the population. The death-rate was 11.9 per 1,000 of the population, while that for the whole of London was 117 per 1,000. 18 Notifiable Diseases. 1,956 notifications of infectious diseases were received, or 168 more than in the previous year. 1,625 were removed for treatment to fever hospitals and infirmaries:— 395 belonged to the Limehouse District, or at the rate of 7'37 per 1,000 of the population. 383 belonged to St. George-in-the-East, or at the rate of 9.24 per 1,000 of the population. 698 belonged to Mile End Old Town, or at the rate of 6.59 per 1,000 of the population. 480 belonged to the Whitechapel District, or at the rate of 8.69 per 1,000 of the population. Wrong Diagnosis. 125 cases of infectious disease were removed to the Metropolitan Asylums Board Hospitals, which were subsequently returned home because the patients were found not to be suffering from the disease stated on the certificates, or from any other notifiable disease. 83 of the cases were notified by private practitioners, 25 from the London Hospital, and 17 from other Public Institutions. This number referred to 36 cases of Scarlet Fever, 85 of Diphtheria, 3 of Enteric Fever, and 1 of Cerebro-Spinal Menineitis. Bacteriological Examinations. 839 bacteriological examinations were made on behalf of the Public Health Department during the year. The specimens and the results were as follows:— Positive. Negative. Total. Swabs (for Diphtheria bacilli) 74 735 809 Blood (for Typhoid bacilli) 2 23 25 Cerebro-spinal fluid 1 3 4 Miscellaneous 1 — 1 Small Pox. No case of Small Pox was notified during the year. This is the third year in succession in which no notifications have been received, although one patient actually suffering from Small Pox landed from a ship which had arrived at a wharf, for the purpose of consulting a doctor as to his illness. He was a ship's fireman and had a rash which the doctor thought resembled that of Small Pox. 19 I saw the patient in the doctor's waiting-room, and I had him removed immediately to the Small Pox Hospital. The ship had just arrived from Newcastle-on-Tyne, and as it was lying in the river, I communicated with the Medical Officer of Health to the Port of London, who examined the rest of the crew. He discovered another fireman who had been taken ill three weeks previously and who was then recovering from a milk attack of Small Pox. He had undoubtedly given the disease to the ship's fireman who landed in our district. Their domicile was the ship, and both cases were included in the Port of London's returns. Scarlet Fever. 555 cases were notified during the year, or 18 more than in the previous year. 545 patients were removed to fever hospitals:— 108 belonged to the Limehouse District, with 5 deaths. 109 belonged to St. George-in-the-East, with no deaths. 182 belonged to Mile End Old Town, with 3 deaths. 156 belonged to the Whitechapel District, with no deaths. The death-rate for the whole Borough was .03 per 1,000; that for the whole of London was .02 per 1,000 of the population. Diphtheria and Membranous Croup. 5G8 cases were notified during the year, or 124 more than in the previous year. 564 were removed to fever hospitals:— 128 belonged to the Limehouse District, with 7 deaths. 117 belonged to St. George-in-the-East, with 6 deaths. 207 belonged to Mile End Old Town, with 9 deaths. 116 belonged to the Whitechapel District, with 2 deaths. The death-rate for the whole Borough was .09 per 1,000, while that for the whole of London was .11 per 1,000 of the population. Enteric Fever. 24 cases were notified, or 3 less than in the previous year. All were removed to hospitals:— 1 belonged to the Limehouse District, with no death. 9 belonged to St. George-in-the-East, with no deaths. 10 belonged to Mile End Old Town, with no deaths. 4 belonged to the Whitechapel District, with no deaths. There were no deaths in the whole of the Borough. The death-rate for the whole of London was 01 per 1,000 of the population. 20 Puerperal Fever. 15 cases were notified during the year, or one more than in the previous year. All were removed to hospitals:— 3 belonged to the Limehouse District, with one death. 5 belonged to St. George-in-the-East, with 3 deaths. 4 belonged to Mile End Old Town, with one death. 3 belonged to the Whitechapel District, with one death. Erysipelas. 133 cases were notified, or 26 more than in the previous year. 39 were removed to hospitals and infirmaries:— 23 belonged to the Limehouse District, with two deaths. 20 belonged to St. George-in-the-East, with one death. 56 belonged to Mile End Old Town, with no deaths. 34 belonged to the Whitechapel District, with three deaths. Pneumonia, Malaria, Dysentery and Trench Fever Regulations. 220 cases of Pneumonia were notified under these Regulations. The cases occurred in the Districts as follows:— Limehouse. St. George's. Mile End. Whitechapel. Pneumonia 63 16 111 29 Malaria — — 1 — Dysentery — — — — Ophthalmia Neonatorum. 34 cases were notified, or 12 more than in the previous year. 6 belonged to the Limehouse District, 6 to St. George-in-the-East, 14 to Mile End Old Town, and 8 to the Whitechapel District. Total number of cases notified 34* „ „ visited 29 „ „ treated at home 25 ,, „ treated in hospital 9 Total No. of cases in which vision was impaired 2 „ „ „ „ unimpaired 32 Total number of cases of total blindness nil Total number of deaths nil, but one died from acute Bronchitis. *5 not traced after being discharged from Hospital as cured. 21 Polio-Myelitis and Polio-Encephalitis. 1 case was notified during the year, or 2 less than in the previous year. It occurred in the St. George's District. Encephalitis Lethargica, 20 cases were notified, or 18 less than in the previous year. 4 belonged to the Limehouse District, 2 to St. George-in-the-East, 7 to Mile End Old Town, and 7 to the Whitechapel District. 11 proved fatal, 5 were reported to have entirely recovered, and 2 were still receiving medical attention at the end of the year. Cerebro spinal Fever or "Spotted" Fever. 1 case was notified, or 5 less than in the previous year. It occurred in the. Whitechapel District. The patient recovered. Measles, The number of deaths from Measles was 28, or 29 less than in the previous year. 10 belonged to the Limehouse District, or at the rate of .18 per 1,000 of the population. 10 belonged to St. George-in-the-East, or at the rate of .24 per 1,000 of the population. 4 belonged to Mile End Old Town, or at the rate of .03 per 1,000 of the population. 4 belonged to the Whitechapel District, or at the rate of .07 per 1,000 of the population. The death-rate for the whole Borough was .10 per 1,000. The death-rate for the whole of London was .08 per 1,000 of the population. Measles is not a notifiable disease so that many cases occur which are not recorded. The London County Council notifies us of all cases occurring in school children. Where the Health Visitor knows that there are younger children in the family she visits the home and urges the parent to keep the infected child isolated as far as possible. Where this cannot be done, owing to the overcrowding in the home or if the child cannot be moved at home, it is then removed to the M.A.B. Hospital. Arrangements have been made with the East London Nursing Society for the nursing of cases of Measles in their own homes. By securing good nursing at an early stage of the disease many of the complications of measles are avoided, particularly Broncho-pnuemonia and Conjunctivitis. 510 cases of Measles were seen by the Health Visitors during the year. 22 Whooping Cough. The number of deaths from Whooping Cough was 68, or 29 more than in the previous year. 22 belonged to the Limehouse District, or at the rate of .41 per 1,000 of the population. 8 belonged to St. Geroge-in-the-East, or at the rate of .19 per 1,000 of the population. 24 belonged to Mile End Old Town, or at the rate of .13 per 1,000 of the population. 14 belonged to the Whitechapel District, or at the rate of .25 per 1,000 of the population. The death-rate for the whole Borough was .26 per 1,000, and that for the whole of London was 19 per 1,000 of the population. Whooping Cough occurs in epidemic form, but sporadic cases appear from time to time. It is directly contagious from person to person, and dwellingrooms, houses, schoolrooms, etc., may be infected by a sick child, but it is less contagious in this way than other infectious diseases. It is most contagious in the early period and girls are more subject to the disease than boys. Children between one and six years of age are most liable to be attacked, but sucklings are not altogether exempt. Adults and old people are sometimes attacked. As a rule one attack protects and second attacks are very rare. The complications of Whooping Cough, more especially Broncho-Pneumonia, make Whooping Cough a very fatal affection, ranking among the first of the acute affections as a cause of death in children under five years of age. Children with the disease should not be sent to school or exposed in public in any way, but unfortunately the latter is the most difficult thing to accomplish in the poorer districts, such as ours. It is not sufficient to keep the patient indoors and in a warm room during the early stages, but for six weeks at least. The period after the severity of the attack has passed and convalescence has begun is the time when the fatal Broncho-Pneumonias are apt to develop. There is more neglect, superstition, and ignorance in connection with Whooping Cough than with any other disease. We often see children being exposed in cold weather in the vicinity of gas works, as well as being frightened out of their lives by being held in open railway carriages while passing through tunnels. The belief that inhaling the sulphur fumes and other "stinks" is beneficial to the child suffering from Whooping Cough is very difficult to eradicate. The difficulty in isolating the children is appreciated from the fact that among the deaths registered from Whooping Cough, one of the children lived 23 in two rooms with the parents and seven other children. In another, the family, including six children, lived in two rooms. In the case of two families who occupied two rooms, there were five children in each family; another two families occupying the same number of rooms had four children, respectively. Four families living under similar conditions had three children each. Four of the families lived in one room. During 1925, 66 deaths of children under five years of age were due to Whooping Cough and its complications. This corresponds to 10 per cent. of the total deaths under five years of age. The number of deaths from Whooping Cough in the first quarter was 45, or 26.5 per cent. of the total deaths of children under five years of age. 34 were under a year-and-a-half old; 26 of these were under a year, and 10 of the latter were under six months. The younger the child, the greater is the likelihood of the attack proving fatal. Whooping Cough has been more prevalent and Broncho-Pneumonia has intervened more frequently, due to the more treacherous weather we experienced during the first quarter of the year, which was the most fatal. 37 of these deaths, or 83 per cent., died in Public Institutions, and only eight died at their homes. Whooping Cough is not a notifiable disease, but the Metropolitan Asylums Board admit patients suffering from Whooping Cough into their Fever Hospitals whenever the Medical Officer of Health certifies that there are urgent reasons why the patients should be removed, or on the request of Medical Superintendents of the Poor Law Institutions. In the first quarter of the year, 18 children were admitted to Fever Hospitals, of which number 4 died. The disease was, naturally, more fatal among delicate children. Of the 45 children who died in the first quarter of 1925, 8 had been delicate from birth, another puny child had been prematurely born, and two were twins. Both parents of one child were consumptive, and were constantly away from home for special treatment. In another family the child's father was consumptive, and the family, consisting of the parents and three children, lived in two rooms. Epidemic Diarrhœa, The number of deaths was 114, or 41 more than in the previous year. 18 belonged to the Limehouse District, or at the rate of .33 per 1,000 30 „ St.-George-in-the-East „ „ .72 „ 49 „ Mile End Old Town „ „ .46 „ L7 „ the Whitechapel District „ „ .30 „+ 24 96 of the deaths, or nearly 84 per cent., were those of infants under 1 year of age. The deaths from this disease is not limited to the hot weather, as is generally believed, and is not therefore due entirely to climatic conditions. Less than one-half of the infants under one year of age who were certified as having died from Infective Enteritis or Diarrhoea died in July, August and September. The following table shows the number of deaths of infants under one year of age from Diarrhœa and the period of the year, etc., for the years 1913-1925:— Year. 1st qtr. 2nd qtr. 3rd qtr. Oct. & Nov. Dec. Total under 1. Percentage of deaths occurring from July 1st to end of November. per cent. Deaths from Diarrhœa over 1 and under 2 years of age. 1913 31 21 131 58 8 249 75 38 1914 16 15 131 60 8 230 83 39 1915 9 13 121 45 4 192 86 43 1916 14 6 53 28 1 102 80 25 1917 5 20 52 24 7 108 70 31 1918 9 9 17 23 7 65 61 7 1919 12 8 60 9 — 89 77 15 1920 4 13 41 16 3 77 74 5 1921 16 10 96 18 3 143 80 27 1922 6 11 13 16 5 51 56 6 1923 13 8 26 12 6 65 58 9 1924 8 14 16 17 5 60 55 10 1925 8 7 41 31 9 96 33 16 Diseases of the Respiratory Organs, 718 deaths were due to diseases of the Respiratory Organs, or 59 less than in the previous year. 182 belonged to the Limehouse District, or at the rate of 3.40 per 1,000. 98 „ St. George-in-the-East ,, „ 2.36 „ 247 „ Mile End Old Town „ „ 2.33 „ 191 „ the Whitechapel District „ „ 3.46 ,, The death-rate for the whole Borough was 2.80 per 1,000 of the population. 25 Influenza. 30 deaths were due to Influenza, or 37 less than in the previous year. 5 belonged to the Limehouse District, or at the rate of .09 per 1,000. 8 „ St. George-in-the-East „ „ .19 „ 6 „ Mile End Old Town „ „ .05 „ 11 „ the Whitechapel District „ „ .19 „ The death-rate for the whole Borough was at the rate of .11 per 1,000, and that for London as a whole was .23 per 1,000 of the population. Cancer. 298 deaths were due to Cancer, or 3 less than in the previous year. 6'2 belonged to the Limehouse District, or at the rate of 1.16 per 1,000. 43 „ St. George-in-the-East „ „ 1.03 „ 133 „ Mile End Old Town „ „ 1.25 „ 60 ,, the Whitechapel District ,, „ 1.08 „ The death-rate for the whole Borough was at the annual rate of 1.16 per 1,000 of the population. Zymotic Diseases. The total deaths from diseases of a Zymotic character was 242, or 40 more than in the previous year. They include all deaths from Measles, Scarlet Fever, Whooping Cough, Diphtheria, Enteric Fever and Diarrhœa. 62 belonged to the Limehouse District, or at the rate of 1T5 per 1,000. 54 „ St. George-in-the-East „ „ 1.30 „ 89 „ Mile End Old Town „ „ .84 „ 37 „ the Whitechapel District „ „ .67 „ The death-rate for the whole Borough was '94 per 1,000 of the population. Phthisis. 505 new cases were notified, or 44 more than in the previous year. Notification of New Cases. Number of Deaths from Phthisis. Death Rate per 1,000. Limehouse District 100 58 1.08 St. George-in-the-East 96 45 1.08 Mile End Old Town 179 106 1.00 Whitechapel District 130 82 1.48 Whole Borough 505 291 1.13 26 Number of deaths from Consumption from 1916 to 1925:— Limehouse District. St. George's. Mile End. Whitechapel. Whole Borough. 1916 95 69 146 165 475 1917 108 82 162 154 506 1918 102 92 184 164 542 1919 81 51 123 112 367 1920 60 48 94 81 283 1921 64 49 87 99 299 1922 53 54 109 98 314 1923 62 49 95 59 265 1924 57 44 102 69 272 1925 58 45 106 82 291 Of the 291 deaths certified to be due to Phthisis, 59 had not been notified during lifetime. 26 were notified at death. 10 „ „ within 1 week of death. 24 „ „ between 1 week and 1 month of death. 60 ,, ,, ,, 1 month and 6 months of death. 20 „ „ „ 6 months and 1 year of death. 92 „ „ before 1 year of death. Other Forms of Tuberculosis, 100 new cases were notified, of 29 less than in the previous year:— Notifications. Deaths. Death-rate per 1,000. Limehouse District 22 13 .24 St. George-in-the-East 18 15 .36 Mile End Old Town 39 13 .12 Whitechapei District 21 12 .21 Whole Borough 100 53 .20 Deaths from diseases of a Tubercular nature, other than Phthisis, from 1916 to 1925. Limehouse District. St. George's. Mile End. Whitechapel. Whole Borough. 1916 21 21 28 19 89 1917 23 26 39 25 113 1918 20 22 32 12 86 1919 16 6 12 16 50 1920 11 7 18 14 50 1921 9 13 14 11 47 1922 11 10 12 9 42 1923 15 11 18 7 51 1924 19 9 16 7 51 1925 13 15 13 12 53 27 Of the 53 deaths certified to be due to Tuberculosis other than Phthisis, 32 had not been notified during lifetime. 11 were notified at death. 2 „ „ between 1 week and 1 month of death. 2 „ „ „ 1 month and 3 months of death. 2 „ „ „ 3 months and 6 months of death. 3 „ „ „ 6 months and 12 months of death. 1 was „ before 1 year of death. Tuberculosis Dispensaries. During the past years, it has been noticeable that the number of advanced cases examined for the first time at the Dispensaries becomes less and less, and this year a new advanced case has been very rare. This, I think, shows that few patients with definite tuberculosis continue without treatment. With respect to the scheme mentioned in last year's report regarding the boarding-out by the London County Council of children from infected homes, it is a matter for regret that the necessary accommodation has not been available. Since the last report, the London County Council modified its scheme and decided to take children for so long as appeared advisable, rather than for the three months originally 'suggested. In a district such as this to efficiently carry on such a scheme would require a very large accommodation. A great proportion of the patients examined at the Dispensaries are sent by private doctors, who avail themselves, more and more, of the help which the Dispensaries offer. WAR PENSION CASES. New cases. Cases in attendance during the year. Stepney Dispensary 4 77 Whitechapel Dispensary 6 37 St. George-in-the-East Dispensary 6 66 16 180 28 FORM R.—Table referring to persons residing in the area which is served by the St. GEORGE'S DISPENSARY. Number of Under observation at the Dispensary on Jan. 1st pending diagnosis. Examined for the first time during the year. Total. Found to be Under observation at the Dispensary on Dec.31st pending diagnosis. Ceased attendance before completion of diagnosis. Suffering from Tuberculosis. Not suffering from Tuberculosis. Pulmonary NonPulmonary. (a) All persons (including "Contacts.") Adults. M. 8 122 130 44 3 73 6 4 F. 7 176 183 35 2 122 16 8 Children under 15. M. 12 170 182 3 7 163 7 2 F. 9 175 184 5 7 154 11 7 Total 36 643 679 87 19 512 40 21 (b) "Contacts" (included in 00). Adults. M. 2 51 53 8 1 40 2 2 F. 2 97 99 10 0 78 7 4 Children under 15. M. 6 121 127 0 0 124 2 1 F. 5 126 131 1 1 121 6 2 (c) Insured persons (included in (a) ) M. 4 89 93 37 2 47 5 2 F. 2 54 56 11 1 33 8 3 1. Number of patients under treatment or supervision (excluding persons under observation or domiciliary treatment) on the 31st December* 242 2. Total number of attendances of patients at the Dispensary during the year Insured 841 Uninsured 1854 3. Number of persons placed during the year under observation at the Dispensary for the purpose of diagnosis 133 4. Number of cases in which the period of observation at the Dispensary exceeded two months 52 5. Number of insured patients under domiciliary treatment on December 31st † 141 6. Number of reports received from Insurance Practitioners in respect of insured patients under domiciliary treatment during the year 3 7. Number of persons referred to affiliated hospital for consultation 15 8. Number of consultations with medical practitioners at the homes of patients Insured 10 Uninsured 9 9. Number of other visits paid by Tuberculosis Officers to the homes of patients 72 10. Number of visits paid by Nurses or Health Visitors to the homes of patients for dispensary purposes 1535 11. Number of specimens of sputum examined in connection with the work of the Dispensary 436 *Insured persons under domiciliary treatment by Insurance practitioners should be excluded, even though they may attend the dispensary at intervals for examination or consultation. Such cases should be included under Head 5. †All insured persons in the dispensary area who are actually receiving domiciliary treatment from Insurance practitioners should be included, irrespective of the date upon which they were placed under domiciliary treatment and of an attendance at the dispensary 29 FORM R.—Table referring to persons residing in the area which is served by the STEPNEY GREEN DISPENSARY. Number of Under observation at the Dispensary on Jan. 1st pending diagnosis. Examined for the first time during the year. Total. Found to be Under observation at the Dispensary on Dec. 31st pending diagnosis. Ceased attendance before completion of diagnosis. Suffering from Tuberculosis. Not suffering from Tuberculosis. Pulmonary NonPulmonary. (a) All persons (including "Contacts,") Adults M. 10 182 192 50 2 123 13 4 F. 9 227 236 52 3 167 10 4 Children under 15. M. 13 154 167 15 4 136 9 3 F. 7 169 176 14 2 146 10 4 Total 39 732 771 131 11 572 42 15 (b) "Contacts" (included in (a) ). Adults. M. 6 1C9 115 16 2 93 3 1 F. 4 133 137 14 3 115 3 2 1 Children under 15. M. 8 110 118 5 2 103 6 2 F. 3 131 134 6 2 119 4 3 (c) Insured persons (included in (a) ). M. 3 114 117 33 1 76 5 2 F. 2 67 69 22 0 43 2 2 1. Number of patients under treatment or supervision (excluding persons under observation or domiciliary treatment) on the 31st December* 257 2. Total number of attendances of patients at the Dispensary during the year Insured 821 Uninsured 2007 3. Number of persons placed during the year under observation at the Dispensary for the purpose of diagnosis 81 4. Number of cases in which the period of observation at the Dispensary exceeded two months 31 5. Number of insured patients under domiciliary treatment on December 31st† 129 6. Number of reports received from Insurance Practitioners in respect of insured patients under domiciliary treatment during the year 9 7. Number of persons referred to affiliated hospital for consultation 13 8.'Number of consultations with medical practitioners at the homes of patients Insured 9 Uninsured 2 9. Number of other visits paid by Tuberculosis Officers to the homes of patients 134 10. Number of visits paid by Nurses or Health Visitors to the homes of patients for dispensary purposes 2643 11. Number of specimens of sputum examined in connection with the work of the Dispensary 462 *Insured persons under domiciliary treatment by Insurance practitioners should be excluded, even though they may attend the dispensary at intervals for examination or consultation. Such cases should be included under Head 5. i All insured persons in the dispensary area who are actually receiving domiciliary treatment from Insurance practitioners should be included, irrespective of the date upon which they were placed under domiciliary treatment and of any attendance at the dispenary. 30 FORM R.—Table referring to persons residing in the area which is served by the WHITECHAPEL DISPENSARY. Number of Under observation at the Dispensary on Jan.1st pending diagnosis. Examined for the first time during the year. Total. Found to be Under observation at the Dispensary on Dec. 31st pending diagnosis. Ceased attendance before completion of diagnosis. Suffering from Tuberculosis. Not suffering from Tuberculosis. Pulmonary NonPulmonary (a) All persons (including "Contacts.") Adults. M 4 279 283 99 3 181 0 0 F. 2 331 333 45 1 281 4 2 Cmldren under 15 M. 12 184 196 6 8 170 6 6 F. 5 206 211 5 6 193 4 3 Total 23 1000 1023 155 18 825 14 11 (b) "Contacts'' (included in (a) ) Adults. M. 2 139 141 17 0 124 0 0 F. 2 224 226 8 1 213 3 1 Children under 15. M 7 139 146 5 1 135 1 4 F. 2 159 161 0 4 154 1 2 (c) Insured persons (included in (a) ). M. 4 154 158 61 3 94 0 0 F. 1 77 78 16 0 57 4 I 1. Number of patients under treatment or supervision (excluding persons under observation or domiciliary treatment) on the 31st December* 298 2. Total number of attendances of patients at the Dispensary during the year Insured 1225 Uninsured 2557 3. Number of persons placed during the year under observation at the Dispensary for the purpose of diagnosis 105 4. Number of cases in which the period of observation at the Dispensary exceeded two months 3G 5. Number of insured patients under domiciliary treatment on December 31st† 157 6. Number of reports received from Insurance Practitioners in respect of insured patients under domiciliary treatment during the year 2 7. Number of persons referred to affiliated hospital for consultation 32 8. Number of consultations with medical practitioners at the homes of patients Insured 1 Uninsured 1 9. Number of other visits paid by Tuberculosis Officers to the homes of patients 170 10. Number of visits paid by Nurses or Health Visitors to the homes of patients for dispensary purposes 2226 11. Number of specimens of sputum examined in connection with the work of the Dispensary 798 *Insured persons under domiciliary treatment by Insurance practitioners should be excluded, even though they may attend the dispensary at intervals for examination or consultation. Such cases should be included under Head 5. †All insured persons in the dispensary area who are actually receiving domiciliary treatment from Insurance practitioners should be included, irrespective of the date upon which they were placed under domiciliary treatment and of any attendance at the dispensary. 31 PUBLIC HEALTH (TUBERCULOSIS) REGULATIONS, 1912. Summary of Notifications during the period from the 4th January, 1925, to 2nd January, 1926, in the Metropolitan Borough of Stepney. Age periods. Notifications on Form A Notifications on Form B.† Number of Notifications on Form C. Number of Primary Notifications. TOTAL Notifications on Form A. Number of Primary Notifications. TOTAL Notifications on Form B. Poor Law Institutions. Sanatoria. 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards. Total Primary Notifications. Under 5 5 to 10 10 to 15 Total Primary Notifications. Pulmonary Males — 4 10 8 22 44 57 54 65 32 13 309 381 — 2 1 3 3 98 226 ,, Females — 6 14 4 36 26 41 33 20 8 4 192 218 — — 1 1 1 63 109 Non-Pulmonary Males 2 18 11 10 5 — 6 2 1 2 1 58 63 — 3 1 4 6 19 27 ,, ,, Females 1 7 8 5 3 4 4 1 — — — 33 35 — 2 3 5 6 3 21 Col. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) (20) (21) In filling up the form the following notes should be carefully observed— Patients notified as suffering from both pulmonary and non-pulmonary disease should be included among the "pulmonary" returns only. All notifications on Form D should be disregarded in preparing this return. *Primary notifications relate to patients who have not previously been notified in this or former years, either on Form A or o Form B, in the area to which the return relates. Any additional notification of a case which has been previously notified in the area is to be regarded as duplicate. (Note—No primary notifications should be made on Form C). †A School Medical Inspector, or the Medical Officer of Health of a county, county borough, or other district, if acting as a School Medical Inspector, is required to notify on Form B all cases of tuberculosis discovered in the course of Inspection of children attending public elementary schools whether or not these have previously been notified. Cols. 2-13. Only those cases which have been notified for the first time during the year on Form A in the area concerned, and which have never previously been notified in the area, either on Form A or on Form B, should be included in these columns. Col. 14. The object of this column is to show the extent to which duplicate notification occurs on Form A, and all notifications on Form A, whether duplicate or not, should be included in this columm. Cols. 15-18. Only those cases which have been notified for the first time during the year on Form B in the area concerned, and which have never previously been notified in the area, either on Form A or on Form B, should be included in these columns. Col. 19. All notifications which have been made during the year on Form B in the area concerned, whether the cases have previously been notified in the area or not, either on Form A or on Form B, should be included it this column. Col. 21. If, in the case of any institution belonging to the Council, formal notifications on Form C have not been made, the totals of the weekly admissions during the year of patients proper for notification on Form C should be shewn (according to classification in column 1) in brackets in column 21. T. 115. 32 SUPPLEMENTAL RETURN. New cases of Tuberculosis coming to the knowledge of the Medical Officer of Health or Chief (Administrative) Tuberculosis Officer during the period from the 4th January, 1925, to the 2nd January, 1926, otherwise than by notification on Form A or Form B under the Public Health (Tuberculosis) Regulations, 1912.* Age periods 0 to 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 and upwards Total Cases. Pulmonary Males — 1 1 — 1 2 6 4 5 13 4 37 „ Females 2 3 — — 2 2 3 4 2 3 1 22 Non-Pulmonary Males — 6 1 — — 1 1 2 — — — 11 „ „ Females 1 4 2 — 2 1 1 — 1 — — 15 *Note—New cases first coming to knowledge otherwise than by formal notification may in some instances afterwards be formally notified on Form A or Form B. Such cases should be included in the appropriate columns of the Summary Notifications and not in the Supplemental Return, unless the formal notification in any of such cases was improperly made, e.g., after death of the person, in which event the case should appear in the Supplemental Return. No Case should be included both in the Summary of Notifications and in the Supplemental Return. 33 Finsen Light Treatment and the Supply of Artificial Pneumo-Thovax Refills, Eleven applications were received during the year from the London Hospital respecting 5 patients undergoing Finsen Light Treatment. Payment was guaranteed by the Council for 132 attendances. Twenty-nine Refills were supplied by the Brompton and Victoria Park Hospitals with respect to 5 patients receiving Artificial Pneumo-Thorax Treatment. Payments were made by the Council for such Refills. Infantile Mortality. 397 infants died under one year of age, or 10 less than in the previous year. 109 belonged to the Limehouse District, or at the rate of 74 per 1,000 births. 75 belonged to St. George-in-the-East, or at the rate of 85 per 1,000 births. 157 belonged to Mile End Old Town, or at the rate of 70 per 1,000 births. 56 belonged to the Whitechapel District, or at the rate of 70 per 1,000 births. The infantile mortality for the whole Borough was 73 per 1,000 births, while that for the whole of London was 67 per 1,000. List of Maternity and Child Welfare Centres and Tuberculosis Dispensaries:— 1. Municipal Centres:— When open Limehouse Town Hall, Mondays: 2—5 p.m. Commercial Road. Thursdays: 10.30 a.m. (women). Thursdays: 2—5 p.m. (Sewing Class). 52, Red Lion Street, Mondays: 10—12 noon (Centre & Wapping. Sales). Wednesdays: 2.30—5 p.m. Fridays: 10—12 noon (Centre& Sales). St. George's Town Hall, Tuesdays: 2—5 p.m. Cable Street. Fridays: 10—11.30 a.m. (Centre & Sales). Working Lads' Institute, Thursdays: 2—5 p.m. 279, Whitechapel Road. St. Philips' Institute, Wednesdays: 1.30—5 p.m. Newark Street. 31 2. Voluntary Centres:— When open Mission Hall, Carr Street. Friday afternoons. Stepney Infant Welfare Centre Monday afternoons. and Babies' Nursing Home, Thursdays, 10 to 12 noon (Dental). 587, Commercial Road. Thursday afternoons. The Memorial Hall, Wednesday atternoons. High Street, Shadwell. Jewish Centre, Monday afternoons. 38, Betts Street. Wednesday afternoons. Congregational Buildings, Wednesday afternoons. Burdett Road. Thursday afternoons. Dame Colet House, Monday afternoons 3, St. Helen's Terrace. The Cottage, Tuesday afternoons. 10, Duckett Street. Wednesday afternoons (Gentiles & Jews.) Jewish Maternity Home, Mondays, 10 a.m. to 1 p.m. (Dental). 24, Underwood Street. Monday afternoons (Sewing Class). Tuesday afternoons. Wednesday afternoons (Sewing Class). Thursday afternoons. 49, Church Street, Minories. Monday afternoons. Friday afternoons. Jewish Centre, Wednesday afternoons. Camperdown House, Half Moon Passage. Jewish Centre, East Stepney, Monday afternoons. 198, Mile End Road. Thursdays, 9.30—12 noon. 3. Tuberculosis Dispensaries: — Mondays, 9.30 a.m.—5.30 p.m. 35, Stepney Green. Tuesdays, 9.30 a.m.—8 p.m. 18, Gt. Prescot Street. Wednesdays, 9.30 a.m.-l p.m. Thursdays, 9.30 a.m.—5.30 p.m. 208, High Street, Shadwell. Fridays, 9.30 a.m.—5.30 p.m. Saturdays, 9.30 a.m.—12 noon. 35 VISITS BY THE HEALTH VISITORS:— E. Addis D. Chabot E. Clements A.M. Cordwell M. Davis S. Foucar ! A. E. Gibbs j E. Goodfellow j D. Michell I. Virtue H. A. Whitty Total Primary 754 590 393 710 453 310 367 188 410 350 267 4,792 Revisits:— To infants under 1 year 680 651 937 499 944 634 474 520 452 719 853 7,363 To children between 1-5 years 887 2,030 1,631 1,438 3,010 2,192 1,888 1,088 609 1,766 1,486 18,025 Ante-natal:— Primary 185 5 131 56 — 15 13 33 217 1 153 809 Subsequent 16 1 37 38 — — — 2 308 1 62 465 Miscellaneous 324 488 238 1,075 237 787 432 1,310 495 41 546 5,973 Total 2,846 3,765 3,367 3,816 4,644 3,938 3,174 3,141 2,491 2,878 3,367 37,427 CENTRES ATTENDED:— Municipal 52 88 57 48 1 19 66 177 67 117 116 808 Voluntary — 4 — 3 93 145 66 — — 2 — 313 Total 52 92 57 51 94 164 132 177 67 119 116 1,121 36 Feeding of Infants;— Breast fed 4,454 Artificially fed 155 Mixed feeding 183 4,792 No. dead before first visit of Health Visitor 1ll Municipal Centres. Limehouse. St. George's. Spitalfields. Wapping. Whitechapel. No. of sessions held 45 47 . 46 177 53 No. of attendances of infants 1,532 1,879 602 1,608 1,706 No. of attendances of children 1-5 years of age 1,098 723 355 850 1,245 No. of doctor's consultations 45 47 29 52 52 No. of doctor's morning consultations 40 — — — — No of first Attendances 128 — — — — Subsequent attendances 80 — — — — Sewing Classes:— No. of classes held 36 — — — — No. of attendances '238 — — — — Supply of Milk to Expectant and Nursing Mothers and to Children. The approximate quantity of milk, etc., distributed during the year together with the cost, was as follows:— No. of Applications Granted. No. of Persons Quantity Cost. £ s. d. Cows Milk— Free 6,045 8,344 29,219 3/4gals. 3,181 5 11 Half-price 162 254 892½ 48 6 0 Dried Milk— Free 874 972 6,734 lbs 499 11 0 Half-price 44 58 376 „ 13 15 6 Virol— Free 166 205 3,312 ozs. 13 15 4 Half-price 1 1 16 „ — — 8 37 Health Week. Health Week in Stepney this year took place on Monday, October 5th, to Friday, October 9th. The general scheme was that every aspect of the health and hygiene of the Borough should be considered. The welfare centres, both voluntary and municipal, were open to visitors every day during the week, as were also the baby nurseries. The lectures throughout the week were very well attended. The halls were crowded every night, mainly by young men and women, the people whom we wish to interest in Health Week. Public Health (Meat) Regulations, 1924. These Regulations came into operation on April 1st, 1925. In order that they should be brought into effective operation with as little friction as possible, I arranged a conference with the butchers, stallholders and costermongers dealing in meat, ham, or bacon at the St. George's Town Hall. The Town Clerk was also present and we explained fully the requirements of the Regulations. Some diversity of opinion was expressed as to the measures which would be regarded as an adequate compliance with certain parts of the Regulations. The Council, on the recommendation of the Public Health Committee, adopted the following:— 1. Stalls. (a) All trimmings, refuse and rubbish to be placed in properly covered metal receptacles. (b) Stalls to front on to the footway, the sides and backs of the stalls to be constructed of glass, wood or suitable metal, which must be kept in a cleanly condition; and (c) A clean white gauze or muslin curtain or curtains, suspended from a rail along the top of the front, should cover the front of the stall. 2. Shops, Stores, etc. (a) The walls and ceilings of shops and stores to be limewashed once in every six months; (b) All persons handling meat to wear clean, washable overalls or smocks; (c) No fowls to be plucked in such shops or stores; (d) No meat to be exposed for sale in front of any shop window, on any bench or board; 38 (e) Meat exposed for sale to be covered by white gauze or muslin, except during the busy hours of the day, or, as an alternative, an electric expulsion fan to be placed opposite the doorway causing a draught of air to blow outwards towards the street; (f) All meat not exposed for sale to be kept either in a refrigerator or behind or under glass screens or muslin curtains. 3. Trans-port and Handling. (1) Every person who conveys or causes to be conveyed any meat in a vehicle:— (a) Shall cause to be kept clean the inside and covering of the vehicle, the receptacles in which the meat is placed, and such parts of any slings or other implements or apparatus used for loading or unloading, as come into contact with the meat or its covering. (b) If the vehicle is open at the top, back or sides, or if any other commodity is being conveyed therein shall cause the meat to be adequately protected by means of a clean cloth or other suitable material. (c) Shall not permit any live animal to be conveyed in the same vehicle at the same time as meat. (2) A person engaged in the handling or transport of Meat:— (a) Shall not permit any part of the meat to come into contact with the ground. (b) Shall take such other precautions as are reasonably necessary to prevent exposure of the meat to contamination. (3) Every person who handles meat in a market in which meat is sold to retailers shall wear a clean and washable head covering and overall. The above Regulations do not apply to any meat which is packed in hampers or other strongly constructed and impervious cases, or is adequately wrapped in jute or some other stout fabric. Unsound Food. The following is a list and quantity of the foodstuffs destroyed during the year under the Public Health (Imported Food) Regulations, 1925:— 1. At the Wharves— Fresh Meat. tons. cwts. qrs. lbs. 6 sides of bacon — 2 3 25 6 pigs carcases — 4 9 4 bullock's livers — — 2 24 39 Preserved Meats. 79,393 tins of beef 95 19 1 24 2 tins of brisket — — — 2 12 tins of ox cheeks — — 1 '20 3,600 tins of assorted meats — 4 0 2 10,640 tins of mutton 28 10 2 18 1,523 tins of sausages — 13 2 11 7 tins of ox tails — — — 7 1,429 tins of tongues ' 2 19 0 12 Fresh Fruit and Vegetables. 61 packages of apricots — 6 2 4 1,044 crates of bananas 28 9 0 0 1 package of beans — — — 12 2 packages of bilberries — — — 14 43 packages of cherries — 4 2 10 4 packages of currants — — 1 20 1 package of lemons — — 1 12 5 packages of oranges — 2 3 14 15 packages of pears — 1 3 20 119 packages of potatoes 4 16 2 8 537 packages of plums 2 17 2 3 729 packages of tomatoes 7 19 3 0 Preserved Fruit and Vegetables. 2,400 tins ot cherries 2 3 1 20 90 bags of peaches 3 17 0 0 40,320 tins of pineapples 36 3 0 24 16 tins of plums — — 1 4 572 boxes of prunes 2 11 1 20 2.721 tins of fruit pulp 12 4 0 6 2,500 tins of Brussels sprouts — 11 0 18 1,481 tins of tomatoes 1 1 0 0 Preserved Fish. 8 barrels of anchovies — 15 0 0 5,454 tins of crab 1 4 1 11 36,900 tins of fish paste 6 9 2 0 117,717 tins of salmon 71 0 0 5 2,876 tins of herring roes 1 5 2 20 40 Sundries. 11,518 tins of assorted canned goods 10 3 2 0 14 bags of chicory — 14 1 26 31 bags of chocolate — 13 0 0 94 bags of cocoa 5 13 2 13 1,440 tins of steak and kidney puddings — 12 3 12 3 boxes of raisins — — 1 4 330 19 2 6 2. At Bishopgate Street Station, ex, Harwich-Zeebrugge train ferry- tons. cwts. qrs. lbs. 2 trucks of peas 4 18 1 19 2 trucks of cauliflowers 9 16 3 10 140 calves plucks — 10 0 4 34 calves livers — — 5 24 11 calves lungs — — 1 24 4 bullocks kidneys — — — 12 2 calves heads — — 1 12 1 ox liver — — — 15 15 7 3 8 During the month of December 2,416 casks of tallow, weighing 966 tons 8 cwts., were detained as Conditionally Admissable Meat, such casks not being officially stamped. Of these, 208 casks, weighing 83 tons 4 cwts., were released either for export or for soap manufacture. Unsound Food seized by, or surrendered to the District Sanitary Inspectors:— Fish. Tons. Cwts. Qrs. Lbs. Bream — — 2 12 Fish — — 2 23 Fish (tinned) 28 0 2 0 Haddock — 2 2 17 Herrings (pickled) 1 1 1 4 Kippers — — — 14 Mussels — 1 1 9 Plaice — 2 0 0 Salmon (tinned) — — 2 12 Skate — — 2 0 41 Fruit. Apricots — 4 0 2 Apples — 5 0 0 Bananas — 3 0 0 Fruits (dried) — — — 16 Fruits (tinned) 1 9 3 0 Grapes — 1 1 4 Greengages — 12 0 0 Lemons — 2 0 5 Oranges (Seville) — 11 2 0 Oranges 14 5 0 0 Pears 17 1 2 15 Plums 1 0 1 8 Red currants — 3 0 0 Strawberry pulp — 4 2 0 Meat. Beef — 7 0 0 Beef (tinned) — 10 3 26 Fowls — — 1 7 Hams — 1 1 10 Meat cubes — 14 2 5 Meat paste — 6 2 12 Pigs' heads — 3 0 8 Rabbits — 1 0 7 Sausages — 14 1 14 Vegetables. Beetroots 2 1 0 0 Peas — 1 1 14 Tomatoes (tinned) — — — 6 Tomatoes — 6 2 20 Miscellaneous. Baking powder — 14 2 0 Barley — 1 1 10 Biscuits — . 7 1 4 Cafe au lait — 1 1 27 Canned goods (assorted) 6 8 1 0 Cocoa and milk — 1 0 0 Cornflour — — — 27 Custard powder — 8 2 0 42 Miscellaneous—continued. Egg substitute — 3 0 16 Flour — 1 2 12 Grapier — — l 0 Lemonade crystals — — 8 8 Milk (condensed) 8 3 1 « Motza meal — — 2 0 Patent foods — 1 3 5 Soup powder 2 2 2 15 Starch powder 2 12 2 19 Tomato sauce — — — 8 92 11 1 7 The Mortuary. The number of bodies deposited in the Mortuary during the year was 203 Of these, 178 were removed by the Coroner's Order, 23 by the Police, 1 at the request of the deceased's friends, and 1 on my instructions. 38 bodies were placed in the Jewish part of the Mortuary, but only 23 were officially " watched." 199 inquests were held in the Coroner's Court, and 133 post-mortem examinations were made. 20 persons were accommodated at the Council's Shelter—i.e., 4 men, 4 women, and 12 children. Verminous Persons. 420 persons were cleansed during the year and had their clothing disinfected—399 males and 21 females. Increase of Rent and Mortgage Interest (Restrictions) Acts. 24 applications for certificates and reports were received during the year. Of these, 13 were granted, 10 were refused, and 1 was withdrawn. Sale of Food and Drugs Act, 1899, and the Butter and Margarine Act, 1907. 2 applications for registration as Butter Factories were received during the year. Certificates were granted in both cases. 43 Milk (Special Designations) Order 1923. - 13 applications for licences under the above Order were received during he year. All the licences were granted and the description and number f licences issued are as follows: — Dealer's Licences: — "Grade A (Tuberculin tested)" Milk 2* "Grade A" Milk 2 "Certified" Milk 2 Dealer's Supplementary Licences:— "Grade A (Tuberculin tested)"Milk 2 "Grade A" Milk 1 "Certified" Milk 2 "Pastuerised" Milk 2 *1 is in respect to a bottling establishment. Rats and Mice Destruction Act, 1919. Complaints received 568 Number of drains tested 568 Number of drains found to be defective 77 Number of Notices served 77 Number referred to the Borough Engineer 491 Disinfecting: Station. 1,633 rooms were fumigated and the bedding, etc., were removed and disinfected by steam. Of these, 1.403 rooms were fumigated because of infectious disease, 175 as a result of Pulmonary Tuberculosis, and 55 because they were verminous. In addition to these, Scabies occurred in 130 families and the bedding was taken away and disinfected by steam. 208,581 articles were disinfected. Of these, 153,735 were second-hand articles of clothing for export abroad, 48,976 were from premises where infectious disease occurred, and 5,870 because they were in a verminous condition. 1,967 articles of bedding were destroyed with the owners' consent. Canal Boats Acts 1877 & 1884. Pursuant to the Third Section of the Canal Boats Acts, 1884, the Metropolitan Borough of Stepney, being the Registration Authority under the above Acts, has to report as follows with regard to the Execution of such Acts and of the Regulations and thereunder, and as to the steps taken by them as sucli authority 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 44 formance 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 1925 was 46, 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 Nil. (b) Notification of change of Master Nil. (c) Certificates Nil. (d) Marking Nil. (e) Overcrowding Nil. (f) Separation of Sexes Nil. (g) Cleanliness Nil. (h) Ventilation Nil. (i) Painting Nil. (j) Provision of Water Cask Nil. (k) Removal of bilge water Nil. (l) Notification of Infectious Disease Nil. (m) Admittance of Inspector Nil. (4) No legal proceedings were taken. (5) No infringements were found. (6) No cases of Infectious Disease occurred. (7) No boats were detained for cleansing and disinfection. (8) The total number on the register on the 31st December, 1925:— (a) Number of boats believed to be in use or available was 4 Boats propelled by Motor Nil. (b) Number of boats that cannot be traced Nil (9) No Boats were registered during the year. General Sanitary Work. 36,612 inspections were made to houses. 45,845 re-visits were made by the Inspectors to supervise the abatement of the nuisances found in 15,263 houses. 7,760 statutory notices were served 70 summonses were taken under the Public Health (London) Act, 1891. 45 4,630 drains were tested with smoke, and 114 were re-tested; 1,504 drains were either constructed or re-constructed, cleansed or repaired; 876 were trapped. 127 new soil pipes were fixed and ventilated ; 709 new closet pans and traps were fixed; 3,113 closets were either cleansed or repaired, or provided with additional light and ventilation; 1,227 water closets were provided with a proper flushing apparatus. 42 cisterns were cleansed and covered. 42 cases of overcrowding were abated. Water supply to houses was reinstated in 133 instances. 1,536 yards were cleansed, paved or repaired; 21 areas and stables were paved and drained; and 483 washhouses and forecourts were paved. There were 37 nuisances under the Public Health (London) Act, 1891, with respect to the keeping of animals, and these were abated. 10 nuisances with respect to open fires in yards were remedied. Notices were served to provide 1,543 sanitary dust receptacles, and 11 manure receptacles were provided or re-constructed. 475 offensive accumulations were removed. 69 houses were ventilated under the lower floor., 4 underground rooms, which were illegally occupied, were discontinued from being used as such. 20 urinals were fixed. 37 notices were served for the abatement of smoke nuisances. 330 visits were made to bakehouses, and 249 cleansings were carried out. 7,928 notices were served to have houses or parts thereof cleansed. 154 sink, bath, lavatory, or rain-water pipes, which were communicating directly with the drain, were disconnected. 16,907 miscellaneous repairs to roofs, floors, gutters, etc., were carried out as the result of notices served. 32 rooms were provided with additional light and ventilation, and the damp walls of 1,128 rooms were remedied. 1,090 verminous premises were cleansed. 46 Number on Number of Number of Premises. register at Inspections- prosecutions. end of 1925. Cowshed 23 61 — Milkshops 437 1,401 — Houses let in lodgings 2,645 3,887 2 Ice Cream premises 285 498 — Slaughterhouses 1 1 — Offensive Trades 7 41 — Total Fines and Costs. Fines. Costs. £ S. d. £ S. d. Public Health (London Act) 1891 44 15 0 129 19 0 Food and Drugs Acts 60 0 0 18 18 0 Butter and Margarine Acts 1 12 0 4 4 0 London County Council (General Powers) Act, 1908 1 7 6 2 4 0 London County Council By-laws 11 10 0 6 6 0 By-laws Houses Let in Lodgings 5 0 0 2 2 0 Housing Acts 1 10 0 2 2 0 £125 14 6 £165 15 0 List of Ante-Natal Clinics and Creches in Stepney. Ante-Natal Clinics:— Limehouse Town Hall Thursday mornings 10.30 to 1 p.m. (Municipal), Commercial Road London Hospital, Wednesday mornings 8.30 Whitechapel Road. East End Mothers' Lying-in Wednesday mornings 9 to 1 p.m. Home, 396, Commercial Friday mornings 9 to 1 p.m. Road. Monday afternoons 2 to 6 p.m. Jewish Maternity Home, Wednesday mornings 11.30 24, Underwood Street. Ailing Mothers' Clinic:— 587, Commercial Road. Second Tuesday in each month at 10.30 a.m, Creches:— Jewish Day Nursery, 23, New Road. Port of London Day Nursery, 5, Pier Head, Wapping. Marie Hilton Creche, Stepney Causeway. St. Paul's Day Nursery, Wellclose Square. 47 SANITARY INSPECTORS' REPORT-1925. H. ROTTOMLEY. T. W. DEE. E. W. FLINT. H. O. HARRIS. J. W. JOHNSON. H. MILLS. G. O. PAVITT. H. QUAINTRELL W. SHEPHERD. R. SIMPSON. S. H. V. TRIMMING. J. TWAITS. R, H. WATERMAN. J. WHITE. T. P. WRACK. A. C. BROWN. W. T. TWYNHAM. C. F. GUY (Temporary) TOTALS. Number of Inspections House to house 490 267 431 118 193 184 727 296 658 800 277 838 735 388 435 72 78 234 7221 Miscellaneous 1785 942 1135 1938 1185 1277 535 1417 1320 932 1416 882 1536 1824 1736 1258 1139 370 22622 Complaints 236 116 272 809 70 308 711 166 102 222 430 513 75 100 757 268 75 21 5251 Infectious diseases 46 49 123 133 96 92 137 146 63 89 124 132 100 85 82 2 ... 19 1518 Re-visits—Number of 2602 1845 1852 2896 2482 2300 1424 1550 2257 4077 2367 3006 2317 2680 2651 2870 2894 775 45845 Intimations served 1189 524 745 985 636 855 1305 526 619 1148 842 1118 875 862 848 973 994 269 15263 Statutory notices served 182 348 656 665 195 402 872 146 121 607 527 955 246 465 514 384 320 155 7760 Summonses taken out under the Public Health (London) Act, 1891 4 3 12 3 2 4 5 3 ... 2 10 4 15 1 1 ... 1 ... 70 Food and Drugs Acts, etc.—No. of samples taken 91 60 86 92 62 101 90 87 106 112 94 97 90 90 120 ... ... ... 1378 „ „ No. of summonses taken ... 3 2 1 ... ... 3 ... 1 3 1 1 1 1 ... ... ... ... 17 Animals kept so as to constitute a nuisance, removed 2 ... 4 2 2 3 ... 6 3 2 1 ... 3 3 ... 3 3 ... 37 Areas and stables paved and drained ... ... 1 1 ... 8 ... 3 ... 2 ... 2 1 3 ... ... ... 21 Bakehouses—No. of inspections to 70 6 26 30 22 30 22 22 12 22 20 28 14 10 20 ... ... 6 360 „ No. cleansed 26 4 22 30 22 30 22 22 10 22 20 23 14 10 20 ... ... 4 306 CisternsDcleansed and covered 6 ... 5 4 ... 8 1 2 4 ... 1 3 2 4 ... 2 ... ... 42 Damp walls remedied 46 40 33 126 76 49 89 31 16 26 133 98 72 38 22 137 87 9 1128 Drains—Cleansed or repaired 81 19 31 115 132 54 138 90 2l 123 47 72 74 57 74 75 47 9 1259 Constructed or reconstructed 16 4 10 32 12 9 29 10 4 16 11 29 28 9 23 ... ... 3 245 Soil pipes fixed and ventilated 12 12 4 7 20 7 1 8 2 5 2 10 18 3 13 ... ... 8 127 Trapped 10 31 51 16 17 64 29 3 10 8 ... 35 14 32 41 ... ... 15 376 Dust receptacles provided 76 44 81 146 104 70 144 58 40 173 36 162 55 48 24 80 172 85 1543 Houses or parts of houses cleansed 404 244 506 476 372 342 738 240 434 671 341 778 588 388 448 361 532 165 7928 „ ventilated beneath the lower floor 3 1 4 2 2 3 10 4 ... 2 ... 26 7 4 ... ... 1 ... 69 Light and ventilation provided to rooms 2 ... 1 13 ... ... ... 1 3 1 1 6 3 1 ... ... ... ... 32 Manure receptacles provided or reconstructed ... 1 2 1 ... ... ... 2 ... 2 ... 1 ... 2 ... ... ... ... 11 Offensive accumulations removed 10 9 6 30 6 94 8 15 28 10 24 31 18 17 123 33 12 1 475 Open fires in yards abolished 6 ... ... ... ... ... 1 1 1 ... ... ... 1 ... ... ... ... ... 10 Overcrowding in dwellings abated 6 3 5 8 3 2 2 1 ... 3 ... 1 ... 5 2 3 1 2 42 Sheds occupied as dwellings discontinued ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Sink, bath, lavatory pipes and rainwater pipes disconnected ... 6 2 5 2 6 ... 1 ... 9 ... 39 41 13 30 ... ... ... 154 Smoke nuisances abated ... 3 3 ... ... ... 1 1 1 4 1 1 2 16 4 ... ... ... 37 Underground rooms—Illegal occupation discontinued 1 ... ... ... ... 2 ... ... ... ... ... ... ... ... ... ... ... 1 4 Urinals fixed 8 1 1 ... ... 1 ... ... 2 2 ... 1 1 ... 3 ... ... ... 20 Verminous rooms cleansed 36 16 106 76 44 73 31 41 42 30 139 116 30 52 78 96 61 23 1090 Wash-houses, forecourts, &c., paved 6 2 4 10 69 8 10 3 164 12 2 49 21 24 3 11 85 ... 483 Waterclosets—Cleansed or repaired 271 110 81 257 157 282 105 82 3 192 216 199 142 64 173 242 359 76 3011 „ Light and ventilation provided ... 6 8 2 4 9 8 ... 10 ... 2 6 46 3 2 2 ... 4 102 „ Pans and traps fixed 25 52 16 42 41 50 59 30 28 63 13 53 103 32 57 26 11 8 709 „ Water supply or flushing apparatus provided ... 58 27 138 86 78 32 16 30 107 54 68 159 45 82 92 140 15 1227 Water supply to houses reinstated 9 2 2 4 1 4 4 13 3 3 ... 1 67 9 3 5 3 ... 133 Yards cleansed, paved, or paving repaired 80 39 121 93 83 64 132 73 40 164 42 146 77 90 23 86 162 21 1536 Miscellaneous repairs to roofs, gutters, floors, sashes, fireplaces, coppers, etc. 670 282 894 816 1422 773 1281 561 497 1159 667 1549 956 734 732 1855 1849 210 16907 48 Housing Conditions—Statistics, 1925, Ministry of Health Table. 1.—General. (1) Estimated population 256,070 (2) General death-rate 11.9 per 1,000 (3) Death-rate from tuberculosis 1.34 per 1,000 (4) Infantile mortality 73 per 1,000 (5) Number of dwelling-houses of all classes 31,708 (6) Number of working-class dwelling-houses 31,708 (7) Number of new working-class houses erected — 2.—Unfit Dwelling Houses. I.—Inspection. (1) Total number of dwelling-houses inspected for housing defects (under Public Health or Housing Acts) 24,748 (2) Number of dwelling-houses which were inspected and recorded under the Housing (Inspection of District) Regulations 7,221 (3) Number of dwelling-houses found to be in a state dangerous or injurious to health as to be unfit for human habitation— (4) Number of dwelling-houses (exclusive of those referred to under the preceding sub-heading) found not to be in all respects reasonably fit for human habitation 2 II.—Remedy of Dejects without service of formal notices. Number of defective dwelling-houses rendered fit in consequence of informed action by the Local Authority or their Officers 113 III.—Action under Statutory Powers. (a) Proceedings under Section 3 of the Housing Act, 1925. (1) Number of dwelling-houses in respect of which notices were served requiring repairs 2 (2) Number of dwelling-houses which were rendered fit: — (a) By owners 1 (b) By Local Authority in default of owners 4 (3) Number of dwelling-houses in respect of which Closing Orders became operative in pursuance of declaration by owners of intention to close 4 (b) Proceedings under Public Health Acts. (1) Number of dwelling-houses in respect of which notices were served requiring defects to be remedied 13,106 49 (2) Number of dwelling-houses in which defects were remedied:— (a) By owners 13,106 (b) By Local Authority in default of owners (c) Proceedings under Section 17 and 18 of the Housing, Town Planning, &c., Act, 1909. (1) Number of representations made with a view to the making of Closing Orders — (2) Number of dwelling-houses in respect of which Closing Orders were made — (3) Number of dwelling-houses in respect of which Closing Orders were determined, the dwelling-houses having been rendered fit — (4) Number of dwelling-houses in respect of which Demolition Orders were made — (5) Number of dwelling-houses demolished in pursuance of Demolition Orders — Unhealthy Areas. Areas represented to the Local Authorities with a view to Improvement Schemes under (a), Part I., or (b), Part II., of the Act of 1890:— (1) Name of area Limehouse Fields (2) Acreage 9.32 acres (3) Number of working-class houses in area 348 (4) Number of working-class persons to be displaced 1,517 adults, 907 children 4.—Number of houses not complying with the building bye-laws erected with consent of Local Authority under Section 25 of the Housing, Town Planning, &c., Act, 1919 5.—Staff engaged on Housing work with, briefly, the duties of each Officer — (No special Inspectors engaged, but 17 district nspectors proceed rom time to time under the Housing Acts.) Slaughtering of Poultry. These bye-laws made by the London County Council to control the slaughterers of poultry are now operative and 31 slaughterhouses have already been registered after the necessary reconstruction has been carried out. Second-hand Clothing. Second-hand garments purchased for export to South Africa have to be disinfected before they are admitted to that country. 153,735 articles were disinfected during the year for this purpose. 50 Exhumation of bodies. In the course of excavation for enlarging business premises in the Whitechapel Road, the remains of 200 persons were dealt with in accordance with licences issued by the Home Secretary. The work of removal was carried out under my supervision and they were reburied in the Cemetery at Manor Park. House to House Inspection List of streets in which all the houses have been inspected as a result of house-to-house inspection during the year 1925. (a) limehouse. Mr. Johnson. Amoy Place. Rich Street. Chivers Court. Rugg Street. Claydens Buildings. Tenbury Place. Cottages, The. Trinidad Street. Gill Place. Waterloo Street. Notgrove Court. Whitehall Place. Notgrove Street. Willow Row. Padstow Place. Mr. Quaintrell. Ben Jonson Road. Lufton Place. Blount Street. Manning Street. Carr Place. Maroon Street. Eagle Place. Neats Cottages. Ebenezer Place. Oxford Street. Hope Place. Pattison Street. Mr. Waterman. Brook Street. Market Buildings. Caroline Street. Mercer Street. Bewley Buildings. Monza Street. Dellow Street. Peabody Buildings (South Block). Devonport Street. Ratcliff Cross Street. Dorset Street. Sage Street. Giles Place. Schoolhouse Lane. Horndon Place. Schoolhouse Lane Buildings. James Place. Solander Street. Lowood Buildings. Twine Court. Manor Court. Warton Place. (b) Mile End. Mr. Harris. Baker Street. Johns Place. Bakers Court. Perth Street. 51 Mr. Pavitt. Cambridge Mansions. Oley Place. Cephas Street. Orson Place. Claremont place. Paragon Mansions. Diggon Street. Pelican Passage. Eagle Place. Pole Street. Edward Street. Portman Place. Faith Street. Railway Place. Garden Street. Redmans Road. Hadleigh Street. Silver Street. Hannibal Road. Smiths Place. Jamaica Street. Terrace Place. Key Street. Tillotson Street. Latimer Street. XX Place. Maria Terrace. Mr. Simpson. Alderney Place. Harford Street. Bale Street. Jewell Street. Bohn Street. Knott Street. Bridge Street. Little Bridge Street. Bude Place. Lomas Buildings. Dongola Street. Louvain Street. Duckett Street. Mays Buildings. Elizabeth Cottages. Monsey Street. Emmott Street. Monteagle Street. Ernest Street. Ocean Street. Essian Street. Single Place. Ferriers Court. Victoria Buildings. Globe Buildings. Wades Place. Grebe Court. Mr. Twaits. Alma Road. Maplin Street. Baggally Street. Salisbury Street. Canal Road. Silas Street. Copperfield Road. South Grove Buildings. Coutts Road. Treby Street. Ewing Street. Venour Road. Forrester Street. Wilson Street. Maidman Street. Woodison Street. 52 (c) St. George's. Mr. Bottomley. Crellin Street. Norfolk Buildings. Eileen Mansions. Philip Buildings. Hessel Street Buildings. Pinchin Street. Hogarth Houses. Prince of Orange Court. Langdale Street. Sander Street. Matilda Street. Tasburg Buildings. Mr. Dee and Mr. Guy. Artichoke Hill. Pennington Place. Breezers Hill. Pennington Street. Chigwell Hill. Raine Street. Cuttle Place. Raines Mansions. Johns Court. Royal Jubilee Buildings. Juniper Court. St. George Street. Lavender Place. Seven Star Alley. Malay Street. Star & Garter Yard. Mary Place. Watts Street. New Tower Buildings. Watts Street Buildings. Pearl Street. Whitethorn Court. Penang Street. Whitethorn Place. Mr. Flint. Agra Place. Pell Street. Anthony Street. Phoenix Court. Betts Street. Princes Square. Chapman Place. Ratcliff Street. Denmark Street. Sly Street. Goodhart Place. Walburgh Place. Graces Alley. Walburgh Street Kinder Street. Waterloo Court. Library Place. Well Street. Ludens Place. Wellclose Square. Neptune Street. Winterton Buildings. Pell Place Wrights Row. Mr. White. Buross Street. Sheridan Street. Coburg Buildings. Spencer Street. Cross Court. Star Place. Hungerford Street Tarling Street. Lucas Street. White's Gardens, 53 (d) Whitechapel. Mr. Mills. Casson Street. Perrys Avenue. Cholsey Buildings. Princelet Street. Finch Street. Mr. Shepherd. Alexander Buildings. Fleur-de-lis Street Artillery Lane. Newcastle Place. Artillery Passage. Newcastle Street. Blossom Place. Old Castle Street. Brunswick Buildings. Peabody Buildings. Castle Court. Rosetta Place. Duval Street. Whites Row. Eastmans Court. Mr. Trimming. Albert Cottages. Spring Gardens. Blackwall Buildings. Underwood Street. Brady Street. Vallance Road. Hanbury Street. Mr. Wrack. Albert Buildings. Katherine Buildings. Alfred Buildings. Little Tongue Yard. Brownsons Court. Newnham Street. Bull Stake Court. Victoria Buildings. POLICE COURT PROCEEDINGS. I. UNDER THE PUBLIC HEALTH (LONDON) ACT, 1891. On 8th January, C. C. & T. Moore were summoned for failing to provide separate W.C. accommodation for the workpeople employed at 17, Wellclose Square. They were fined £10, with £3 3s. costs. They were previously convicted in respect of the same offence on 22nd October, 1924. On 13th January, J. Hodges was summoned for failing to remedy the dirty and dilapidated walls and ceilings and defective roof, etc., at 23, Halley Street. An Order was made to do the work within 14 days, with £2 8s. costs. On 19th January, the Owner was summoned for failing to remedy a defective drain at 51, Watney Street. An Order was made to do the work within 7 days, with £2 8s. costs. 54 On 20th January, L. Segalov was summoned for failing to remedy the defective roof, etc., at 6, Lytton House. The work having been completed at the time of the hearing of the summons, she was ordered to pay £2 4s. costs. On 20th January, Athawes, Son & Co. were summoned for failing to remedy the defective roof and dirty walls and ceilings at 35, Thirza Street. They were fined £1, with £2 4s. costs. On 20th January, Athawes, Son & Co. were summoned for failing to remedy the defective roof at 37, Thirza Street. They were fined £1, with £2 4s. costs. On 20th January, C. M. Leigh was summoned for failing to provide a proper sanitary dust receptacle at 13, Tewkesbury Buildings. He was fined £2, with £2 2s. costs. On 20th January, C. M. Leigh was summoned for failing to provide a proper sanitary dust receptacle at 3, Tewkesbury Buildings. He was fined £2. On 22nd January, A. Benabo was summoned for failing to remedy the defective roof and gutters at 61, Emmott Street. He was fined £5, with £2 2s. costs. On 29th January, C. J. Edmunds was summoned for failing to remedy the dirty walls and ceilings at 25, St. Thomas' Road. He was fined £2, with £2 8s. costs, and an Order was made to do the work within 7 days. On 29th January, C. J. Edmunds was summoned for failing to remedy the dirty and dilapidated walls and ceilings at 27, St. Thomas' Road. He was fined £2, with £2 8s. costs, and an Order was made to do the work within 7 days. On 30th January, K. Fowles was summoned for failing to remedy the defective soil pipe and washing copper at 71, Plumbers Row. An Order was made to do the work within 14 days with £2 8s. costs. On 2nd February, R. Wallaker was summoned for failing to cleanse and repair the dirty and dilapidated walls and ceilings, etc., at G, Rich Street. An Order was made to do the work within 21 days, with £2 8s. costs. 55 On 2nd February, Franks & Simons were summoned for failing to cleanse and repair rooms and staircase at 10, Hope Place. An order was made to do the work in 7 days, with £2 8s. costs. On 5th February, Z. Wohl was summoned for failing to cleanse the dirty walls and ceilings and to remedy the defective yard paving at 93, Sidney Street. The work having been done at the time of the hearing of the summons, he was fined 10s., with £2 2s. costs. On 20th February, B. Durell was summoned for failing to abate a nuisance arising from the defective roof, etc., at 55, Chicksand Street. He was ordered to do the work in 14 days, with £2 6s. costs. On 25th February, B. Durell was summoned for failing to abate a nuisance arising from the defective roof, etc., at 57, Chicksand Street. He was ordered to do the work in 14 days, with £2 6s. costs. On 3rd March, J. Hodges was summoned for failing to repair the defective roof and rain-water pipe at 92, Stepney Green. An Order was made to do the work within 7 days, with £2 8s. costs. On 10th March, A. Barsht was summoned for failing to remedy the defective roof gutter at 72, St. George Street. The work having been completed at the time of the hearing, the Magistrate adjourned the summons, sine die, on payment of £2 2s. costs. On 16th March, Franks & Simons were summoned for failing to remedy the defective paving, flooring, stairtreads, etc., at 19, Mayfields Buildings. They were ordered to pay £2 8s. costs. On 17th March, A. Dietsch was summoned for failing to remedy the defective yard paving and broken manhole cover at 91, Grove Street. An Order was made to do the work within 7 days, with £2 8s. costs. On 8th April, C. Benabo & Sons were summoned for failing to remedy the defective roof and drain, etc., at 35, Halley Street. An Order was made to do the work within 14 days, with £2 8s. costs. On 1st May, D. Galinski was summoned for failing to repair the defective roof at 133, Jubilee Street. The work having been completed at the time of the hearing of the sum mons, he was ordered to pay £2 4s. costs. 56 On 22nd May, S. Jacobs was summoned for failing to provide a proper water supply and to remedy the defective roof, and dirty and dilapidated walls and ceilings at 1, Turners Road. An Order was made to do the work within 21 days, with £2 8s. costs. On 12th June, W. Rutkowski was summoned for failing to remedy the defective roof and damp walls, etc., at 6, Denmark Street. The work having been completed at the time of the hearing of the summons, he was ordered to pay £2 4s. costs. On 12th June, Franks & Simons were summoned for failing to remedy the defective roof, etc., at 17, Mayfields Buildings. An Order was made to do the work within 14 days, with £2 8s. costs. On 12th June, Franks & Simons were summoned for failing to remedy the defective roof, flooring, yard paving, and damp walls, etc., at 18, Mayfields Buildings. An Order was made to do the work within 14 days, with £1 7s. costs. On 12th June, Franks & Simons were summoned for failing to remedy the dirty walls and ceiling, etc., at 11, Mayfields Buildings. An Order was made to do the work within 14 days, with £2 8s. costs. On 16th June, S. Bernstein was summoned for failing to provide a proper sanitary dust receptacle at 7, Marmaduke Place. The receptacle having been provided at the time of hearing, the summons was withdrawn on payment of £2 4s. costs. On 19th June, J Davey & Son were summoned for failing to remedy the defective roof, etc., at 7, Swedenborg Street. They were fined 2s., with £2 2s. costs. On 25th June, S. Jacobs was summoned for failing to comply with the Order of the Court to repair and cleanse 1, Turners Road. He was fined £2, with £2 2s. costs. On 3rd July, B. Gales was summoned for failing to remedy the defective roof and dirty walls and ceilings at 13, St. George Street. The work having been completed at the time of the hearing of the summons, she was fined 2s., with £2 4s. costs. On 20th July, C. Wilks was summoned for failing to remedy the defective drain at 65, Devonshire Street. An Order was made to do the work within 21 days, with £2 8s. costs. 57 On 23rd July, J. P. G. Kyffin was summoned for failing to provide a proper sanitary dustbin at 12, Lee Street. He was fined £2 2s., with £3 3s. costs. On 23rd July, J. P. G. Kyffin was summoned for failing to provide a proper sanitary dustbin at 22, Lee Street. He was fined £2 2s., with £3 3s. costs. On 80th July, D. Clapman was summoned for failing to remedy the defec tive roof, yard paving, rain-water pipes, etc., at 39, Princes Square. An Order was made to do the work within 14 days, with £2 8s. costs. On 5th August, A. Miller & Son were summoned for failing to remedy the defective roof and dirty walls and ceilings at 5, Fournier Street. An Order was made to do the work within 14 days, with £2 8s. costs. On 27th August, H. Lever, was summoned for failing to remedy the dirty and dilapidated condition of 9, Clinton Road. An Order was made to do the work within 7 days, with £2 8s. costs. On 1st September, L. Lyons was summoned for failing to remedy the defective roof and stove, and dirty walls and ceilings at 13, Ship Alley. He was ordered to pay £1 3s. costs. On 1st September, A. Borges was summoned for failing to remedy the defective roof and eaves gutters at 198, St. George Street. He was fined 1s., with £2 4s. costs. On 21st September, C. M. Leigh was summoned for failing to remedy the defective roof, sashes, and drain, etc., at 19, Prince's Square. He was ordered to pay £2 4s. costs. On 9th October, B. Gales was summoned for failing to remedy the defective yard paving and dirty walls and ceilings at 1, Anthony Street. She was fined £1, with £2 2s. costs. On 28th October, B. Gabriel was summoned for failing to remedy the defective roof at 84, Pelham Street. An Order was made to do the work in 14 days, with £2 6s. costs. On 29th October, J. Silverstone was summoned for failing to remedy the defective roof and damp wall at 24, Newbold Street. He was fined £2 2s., with £1 1s. costs. 58 On 29th October, J. Silverstone was summoned for failing to provide a proper sanitary dustbin at 24, Newbold Street. He was fined £2 2s., with £1 1s. costs. On 3rd November, R. Benabo was summoned for failing to remedy the defective roof and damp wall at 35, Casson Street. An Order was made to do the work within 14 days, with £2 6s. costs. On 10th November, H. Cohen was summoned for failing to remedy the defective roof and soil pipe at 82, Hanbury Street. The work having been completed before the hearing of the summons, he was fined 2s., with £2 2s. costs. On 10th November,. H. Cohen was summoned for failing to cleanse the dirty walls and ceilings at 86, Hanbury Street. An Order was made to do the work within 7 days, with £2 6s. costs. On 1st December, L. Woolmark was summoned for failing to remedy the damp walls at 4, Wellington Buildings. He was fined 10s., with £2 2s. costs. On 1st December, H. Cohen was summoned for failing to remedy the damp, dilapidated and dirty walls and ceilings at 133, Hanbury Street. An Order was made to do the work within 14 days, with £2 6s. costs. On 1st December, M. Segalov was summoned for failing to remedy the defective rain-water pipe and eaves gutters, and damp and dilapidated wall at Augustine House, Pelham Street. The work having been completed before the hearing, the summons was withdrawn on payment of £2 4s. costs. On 2nd December, H. Bresloff was summoned for failing to repair the defective pavement at 11, Twine Court. An Order was made to do the work within 7 days, with £2 8s. costs. On 2nd December, H. Bresloff was summoned for failing to remedy the choked drain and the dirty and dilapidated condition of 14, Twine Court. An Order was made to do the work within 7 days, with £2 8s. costs. On 2nd December, H. Bresloff was summoned for failing to remedy the dirty and dilapidated condition of 16, Twine Court. An Order was made to do the work within 7 days, with £1 7s. costs. 59 On 2nd December, H. Bresloff was summoned for failing to remedy the defective roof and dirty condition of 19, Twine Court. An Order was made to do the work within 7 days, with £1 7s. costs. On 4th December, H. E. Schmidt was summoned for failing to remedy the dirty and dilapidated walls and ceilings of 52, Great Hermitage Street. He was fined 10s., with £2 2s. costs. On 4th December, M. Stiegman was summoned for failing to remedy the defective roof at 64, Greenfield Street. He was fined 10s., with £2 2s. costs. On 23rd December, R. Benabo was summoned for failing to remedy the defective drain at 9, Farrance Street. The Magistrate made an Order for the work to be done within 14 days, with a penalty of £5, and £2 2s. costs. On 29th December, The Reliance, Ltd., were summoned for failing to provide a proper sanitary dust receptacle at 46, Copley Street. They were ordered to pay £2 2s. costs. On 29th December, The Reliance, Ltd., were summoned for failing to remedy the dirty walls and ceilings and defective roof at 24, King John Street They were fined £1, with £2 2s. costs. II. UNDER THE LONDON COUNTY COUNCIL BYE-LAWS. On 9th July, F. E. Walker, Ltd., were summoned for conveying offensive matter through the Borough in improper receptacles on 18 June. (Fish offal in open barges through the Limehouse Cut Canal.) They were ordered to pay £1 1s. costs. On 9th July, The Belvedere Fish Guano Co., Ltd., were summoned for aiding and abetting in the previous case. They were fined £3, with £2 2s. costs. On 27th August, Wickens, Pease & Co., Ltd., were summoned for causing to be conveyed through the Borough, offensive matter in improper receptacles on 30th July. They were fined £5, with £2 2s. costs. A second summons against Wickens, Pease & Co., Ltd., for aiding and abetting the carman in the case was dismissed. 60 On 27th August, F. W. Oates was summoned for conveying offensive matter through the Borough during prohibited hours on 30th July. He was fined 10s. On 9th October, A. Allard was summoned for conveying offensive matter through the Borough in an improperly constructed vehicle on 26th September. He was fined £3, with £1 Is. costs. III. UNDER THE LONDON COUNTY COUNCIL (GENERAL POWERS) ACT, 1908. On 21st February, S. Fishman, of 101, Cephas Street, a seller of poultry, was summoned for failing to observe due cleanliness. He was lined 7/6d. On 30th March, H. Samuels was summoned for failing to observe due cleanliness in the bakehouse at 22, Umberston Street. He was fined £1, with £2 4s. costs, or 5 days in default. IV. UNDER THE HOUSING AND TOWN PLANNING ACT, 1919 (SECTION 29). On 16th May, H. Goldblum was summoned for not having the name and address of the owner of the house and the name and address of the Medical Officer of Health on the rent book of the tenant of 26, Knott Street. He was fined £1 10s., with £2 2s. costs. V. UNDER BYE-LAWS FOR HOUSES-LET-IN-LODGINGS. On 18th June, D. Galinski was summoned for failing to cleanse the floors of the passage and staircase at 16, Great Alie Street. He was fined £5, with £2 2s. costs. Factories and Workshops. The total number of workshops on the Register was 2,908; but this does not include factories, workplaces and out-workers' premises. 3,721 inspections to factories, workshops and workplaces revealed defects, which necessitated the service of 1,190 written notices. 52 of the notices referred to factories, 1,101 to workshops including workshop laundries, and 37 to workplaces other than out-workers' premises. Cleanliness.—498 notices were served to cleanse workshops. Ventilation.—The ventilation of 66 workshops was improved. Overcrowding.—Overcrowding was abated in 15 workshops. Sanitary Accommodation.—The sanitary accommodation was improved in 217 workshops by providing additional and suitable water-closets. 376 other nuisances were remedied in workshops. 61 FACTORIES, WORKSHOPS, LAUNDRIES, WORKPLACES AND HOMEWORK. 1.—INSPECTIONS. Premises. Number. (1) Inspections. (9) Written Notices. (3) Prosecutions. (4) Factories 565 52 ... (Including Factory Laundries) Workshops 3,025 1,101 2 (Including Workshop Laundries) Workplaces (Other than Outworkers' premises) 131 37 ... Total 3,721 1,190 2 2.—DEFECTS FOUND. Particulars. Number of Defects. Found. Remedied. Referred to H.M. Inspector. Number of Prosecutions. (1) (2) (3) (4) (5) Nuisances under the Public Health Acts:—* Want of cleanliness 498 498 ... ... Want of ventilation 66 66 .... ... Overcrowding 15 15 ... ... Want of drainage of floors 2 2 ... ... Other nuisances 376 376 ... 1 Sanitary Accommodation insufficient 29 29 ... ... unsuitable or defective 170 170 ... ... not separate for sexes* 18 18 ... 1 Offences under the Factory and shop Acts:— Illegal occupation of underground bakehouse (s. 101) ... ... ... ... Breach of sj ecial sanitary requirements for bakehouses (ss. 97 to 100) 12 12 ... ... Other offences 6 6 ... ... (Excluding offences relating to outwork which are included in Part 3 of this report.) Total 1,192 1,192 ... 2 *Including those specified in Sections 2, 3, 7 and 8, of the Factory and Workshop Act, 1901, as remediable under the Public Health Acts. 62 3.—OUTWORKERS. The net number of outworkers in the Borough engaged in various trades is as follows:— Making of wearing apparel 2,541 Cleaning of wearing apparel 1 Paper boxes, etc. 29 Furriers 34 Xmas crackers 4 Brushes 4 Furniture 2 Artifical flowers 1 Bags, sacks, etc. 2 Umbrellas 13 Total 2,631 The number of inspections made to outworkers' premises was 1,113, and the number of premises where sanitary defects were found to exist was 201. The number of premises where cases of infectious disease had been notified was 139. There are 119 firms in the Borough employing outworkers. Of these, 110 sent in their lists twice in the year, and 9 once. These related to 788 outworkers, 364 were transferred to other Boroughs as they were not resident in this Borough, and 424 were residents. In addition, 274 lists relating to a net number of 2,207 outworkers were received from other Boroughs during the year. 63 4.—REGISTERED WORKSHOPS. Workshops on the Register (s. 131) at the end of the year 1925. (1) Number. (2) Bakehouses 153 Boot, Shoe and Slipper Making 112 Cabinet Making 130 Furriers 140 Hat and Cap Manufacturers 62 Miscellaneous 461 Laundries 6 Rag Sorting, etc. 51 Wearing Apparel (Tailors, Milliners, Dressmakers, etc., etc.) 1,790 Total 2,908 5.—OTHER MATTERS. Class. (1) Number. (2) Matters notified to H.M. Inspector of Factories:— Failure to affix Abstract of the Factory and Workshop Acts (s. 133, 1901) 2 Action taken in matters referred by H.M. Inspectoras remediable under the Public Health Acts, but not under the Factory and Workshop Acts (s. 5. 1901) Notified by H.M. Inspector 579 Reports (of action taken) sent to H.M. Inspector 579 Other — Underground Bakehouses (s. 101):— Certificates granted during the year In use at the end of the year 51 64 Causes of, and Ages at Death during the Year, 1925. Metropolitan Borough of Stepney. Causes of Death. 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. 4-5 and under 65 years. 65 and upwards. All Ages. Enteric Fever ... ... ... ... ... ... ... ... ... Small Pox ... ... ... ... ... ... ... ... ... Measles 3 11 12 2 ... ... ... ... 28 Scarlet Fever ... 2 1 3 2 ... ... ... 8 Whooping Cough 29 26 11 2 68 Diphtheria and all deaths from Croup (except "spasmodic" "false" "stridulous" and "catarrhal") ... 7 9 8 ... ... ... ... 24 Influenza ... ... ... 1 1 4 11 13 30 Erysipelas ... ... ... 2 ... ... 3 1 6 Cerebro-Spinal Fever ... ... ... ... ... ... ... ... ... Typhus Fever ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... Dysentery ... ... ... ... ... ... ... ... ... Glanders ... ... ... ... ... ... ... ... ... Anthrax ... ... ... ... ... ... ... ... ... Lead Poisoning ... ... ... ... ... ... ... ... ... Phthisis (Pulmonary Tuberculosis) 1 ... 2 6 64 105 91 22 291 Tuberculous Meningitis (Acute Hydrocephalus) 5 1 6 3 3 2 ... ... 20 Other Tuberculous Diseases 2 7 4 3 5 7 4 1 33 Rheumatic Fever ... ... ... 2 1 ... ... ... 3 Cancer, malignant disease (Sarcoma, Rodent Ulcer, etc.) ... ... ... ... 3 30 142 123 298 Bronchitis 10 9 4 1 3 17 139 175 358 Broncho-Pneumonia 61 36 14 4 2 10 38 42 207 Pneumonia (all other forms) 12 6 2 6 5 23 56 27 137 Other diseases of Respiratory Organs ... 1 ... 2 ... 3 6 4 16 Diarrhoea and Enteritis (all deaths from Diarrhoea, except those secondary to some well defined disease) 96 15 2 1 ... ... ... ... 114 Appendicitis and Typhlitis ... ... ... 8 4 5 3 2 22 Alcoholism, Delirium Tremens, acute and chronic alcoholism (but not those from organic disease due to alcoholism) ... ... ... ... ... ... 1 ... 1 Cirrhosis of Liver ... ... ... ... 1 1 6 5 13 Nephritis and Bright's Disease ... 1 2 1 12 43 25 84 Puerperal Fever (Pyaemia, Septicaemia, Sapraemia, Pelvic Peritonitis,Peri- and EndoMetritis occurring in the Puerperium) ... ... ... ... 3 2 1 ... 6 Other accidents and diseases of Pregnancy and Parturition 12 ... ... ... 2 9 ... ... 23 Congenital Debility and Malformation, including Premature Birth, Atrophy, Marasmus, want of Breast Milk, but not from Atelectasis 130 ... ... ... ... ... ... ... 130 Violent Deaths, excluding Suicide 8 1 7 19 3 14 17 24 93 Suicides ... ... ... ... 3 4 10 2 19 Heart Disease 1 1 1 6 18 40 115 119 301 Old Age ... ... ... ... ... ... 2 141 143 Other Defined Diseases 24 6 10 13 21 61 193 236 564 Diseases ill-defined or unknown 3 1 ... ... ... ... 1 1 6 Encephalitis Lethargica ... ... ... 2 5 2 2 ... 11 Total 397 131 85 96 150 351 884 963 3,057 65 Infant Mortality, 1925. Deaths from stated Causes at Various Ages under One Year of Age for the whole Borough. 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 ... ... ... ... ... ... ... ... ... ... Uncertified ... ... ... ... ... ... ... ... ... ... Small-pox ... ... ... ... ... ... ... ... ... ... Chicken-pox ... ... ... ... ... ... ... ... ... ... Measles ... ... ... ... ... ... 1 1 1 3 Scarlet Fever ... ... ... ... ... ... ... ... ... ... Diphtheria and Croup ... ... ... ... ... ... ... ... ... ... Whooping Cough ... ... ... ... ... 2 4 13 10 29 Diarrhoea ... 1 2 3 6 16 43 18 13 96 Enteritis ... ... ... ... ... ... ... ... ... ... Tuberculous Meningitis ... ... ... ... ... ... 1 3 1 5 Abdominal Tuberculosis ... ... ... ... ... ... 1 ... ... 1 Other Tuberculous Diseases ... ... ... ... ... ... ... 1 1 2 Congenital Malformations 9 1 ... 1 11 3 2 1 ... 17 Premature Birth 49 7 7 2 65 ... ... ... ... 65 Atrophy, Debility & Marasmus 8 2 1 3 14 10 7 3 ... 34 Atelectasis 6 ... ... ... 6 ... ... ... ... 6 Injury at Birth 11 1 ... ... 12 ... ... ... ... 12 Erysipelas ... ... ... ... ... ... ... ... ... ... Syphilis ... 1 ... ... 1 2 ... 1 ... 4 Rickets ... ... ... ... ... ... ... ... ... ... Meningitis (not tuberculous) ... ... ... ... ... 3 2 2 1 8 Convulsions 4 ... ... ... 4 1 ... 1 ... 6 Gastritis ... ... ... ... ... ... ... ... ... ... Laryngitis ... ... ... ... ... ... ... ... ... ... Bronchitis ... ... ... ... ... 5 3 1 1 10 Pneumomia (all forms) 1 ... 1 2 4 16 22 13 17 72 Suffocation, overlying ... ... ... 1 1 3 ... ... ... 4 Other causes 6 4 1 1 12 3 3 3 3 24 Total 94 17 12 12 136 64 89 61 47 397 66 Cases of Infectious Disease notified during the Year, 1925. Metropolitan Borough of Stepney. Notifiable Disease. Number of Cases notified. Total Cases notified in each Locality. Total cases removed to Hospital At all Ages At Ages—Years. 1 Limehouse 2 St, George's 3 Mile End 4 Whitechapel Under 1 1 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 and upwards Small-pox ... ... ... ... ... ... ... ... ... ... ... ... ... Cholera ... ... ... ... ... ... ... ... ... ... ... ... ... Plague ... ... ... ... ... ... ... ... ... ... ... ... ... Diphtheria (including Membranous Croup) 568 15 230 237 57 25 4 ... 128 117 207 116 564 Erysipelas 133 1 13 12 16 34 45 12 23 20 56 34 39 Scarlet Fever 555 6 244 260 35 10 ... ... 108 109 182 156 545 Typhus Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Enteric Fever 24 ... 3 6 5 5 5 ... 1 9 10 4 24 Relapsing Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Continued Fever ... ... ... ... ... ... ... ... ... ... ... ... ... Puerperal Fever 15 ... ... ... 4 10 1 ... 3 5 4 3 15 Cerebro-spinal Meningitis 1 1 ... ... .. ... ... ... ... ... ... 1 1 Polio-Myelitis 1 ... 1 ... ... ... ... ... ... 1 ... ... 1 Polio-Encephalitis ... ... ... ... ... ... ... ... ... ... ... ... ... Ophthalmia Neonatorum 34 34 ... ... ... ... ... ... 6 6 14 8 12 Pulmonary Tuberculosis 505 10 40 128 185 125 17 100 96 179 130 349 Other forms of Tuberculosis 100 3 25 43 12 13 3 1 22 18 39 21 64 Encephalitis I.ethargica 20 ... 1 2 7 5 5 ... 4 2 7 7 11 Totals 1956 60 527 600 264 287 188 30 395 383 698 480 1625 67 BOROUGH ANALYST'S REPORT. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Stepney. Ladies and Gentlemen, I have the honour to submit to you my second Annual Report, dealing with the work carried out in the Borough Laboratory during the year 1925. During the year, 1,414 samples were submitted to me for analysis. Of these, 1,378 were purchased by Inspectors under the Food and Drugs Acts; 31 samples were analysed for the Public Health Department; 4 for the Borough Engineer's Department; and 1 for a private purchaser. The 1,378 samples taken under the Food and Drugs Acts comprised 886 formal samples and 492 informal samples. Table A shows the nature of the samples taken under the Food and Drugs Acts, and gives the numbers and percentages found to be adulterated. Table A. Number of Samples. Number Genuine Number Adulterated. Percentage Adulterated. Milk 825 801 24 2 9 Butter 141 140 1 0.7 Margarine 137 136 1 0.7 Spirits 25 20 5 20-0 Cream & Preserved Cream 24 24 — — Dispensed Medicines 23 19 4 17.4 (National Health Insurance Act) Coffee 17 17 - - Pepper 13 13 — — Vinegar 12 10 2 16.7 Sponge Cakes 12 12 — — Glycerine 9 9 — — Ground Ginger 9 9 — — Sweet Spirit of Nitre 8 6 2 25.0 Camphorated Oil 8 8 — — Condensed Milk 6 6 — — Cheese 6 6 — — Flour 6 6 — — Cocoa 6 6 — — ' Honey 5 4 1 20.0 Sal Volatile 4 2 2 50.0 Milk of Sulphur 4 4 — — Sausage 4 4 — — Sulphur Ointment 4 4 — — 68 Table A.—Continued. Number of Samples Number Genuine. Number Adulterated Percentage Adulterated. Ammoniated Tincture of Quinine 3 3 - - Epsom Salts 3 3 — - Purified Borax 3 3 — - Citric Acid 3 3 — - Tartaric Acid 3 3 — - Dried Milk 3 3 — - Corn Flour 3 3 — - Boric Acid 3 3 — - Castor Oil 3 3 — - Glauber's Salt 3 3 — - Boric Ointment 3 3 — - Arrowroot 3 3 — - Rice 3 3 — - Zinc Ointment 3 3 — - Cod Liver Oil 3 3 — - Tincture of Iodine 3 3 — - Cream of Tartar 3 3 — - Milk Sugar 3 3 — - Tea 3 3 — - Sugar 3 3 — - Grey Powder 3 1 2 66.7 Ice Cream 3 3 — — Tinned Fish 2 2 — — Pish Paste 1 1 — — Camphor and Oil 1 1 — — 1,378 1,334 44 32 The number of samples found to be adulterated was 44 or 3.2 per cent. Table B shows the number of samples analysed and the number found to be adulterated during the past ten years. Table B. Year. Number of Samples. Number Adulterated, Percentage Adulterated. 1916 1,202 147 12.2 1917 1,123 120 10.6 1918 1,124 123 10.9 1919 1,175 70 6.0 1920 1,190 55 4.6 1921 1,402 86 6.1 1922 1,417 78 5.5 1923 1,398 27 1.9 1924 1,456 45 3.1 1925 1,378 44 3.2 69 Table C shows the distribution of the 1,378 samples, taken under the Food and Drugs Acts, amongst the four districts of Stepney. Table C. District. Number of Samples. Number Adulterated Percentage Adulterated. Offences under Butter and Margarine Acts. Mile End 450 10 2.2 3 Whitechapel 379 14 3.7 6 St. George's 279 10 36 1 Limehouse 264 10 38 4 1,378 44 3.2 14 Table D shows the number of samples taken by each Inspector, and gives particulars of offences and prosecutions. Table D. Inspector. Samples Taken. Number of Samples. Number of Prosecutions. Adulterated. Unlabel led. Food & Drugs Acts. Butter & Margarine Acts. Bottomley 91 8 — — — Cook 94 1 — 1 — Dee 60 3 — 3 — Flint 86 4 — 2 - Harris 92 3 — 1 — Johnson 62 — — — - Mills 101 3 2 — — Pavitt 90 3 3 2 1 Quaintrell 87 — — — — Shepherd 106 4 3 — 1 Simpson 112 3 3 2 1 Twaits 97 4 1 1 — Waterman 90 3 - 1 - White 90 2 2 — 1 Wrack 120 3 — — — Total 1,378 44 14 13 4 Legal Proceedings. Legal proceedings were taken in 17 cases. Details of the individual prosecutions are given later under the various headings. 70 Table E summarises the results and compares them with the results of proceedings taken during the years 1923 and 1924. Table E. Year. Number of Summonses. Total Fines. Total Costs. Average Fine. Average Total Penalty. £ s. d. £ s. d. £ s. d. £ s. d. 1995 13 Food and Drugs Acts 60 0 0 18 18 0 4 12 4 6 1 5 4 Butter and Margarine Acts 1 12 0 4 4 0 - 8 0 1 9 0 17 Total 61 12 0 23 2 0 3 12 6 4 19 8 1924 19 Food and Drugs Acts 54 0 0 34 13 0 2 16 10 4 13 4 8 Butter and Margarine Acts 7 5 0 8 8 0 - 18 2 1 19 2 27 Total 61 5 0 43 1 0 2 5 4 3 17 3 1923 9 Food and Drugs Acts 20 0 0 13 13 0 2 4 5 3 14 9 19 Butter and Margarine Acts 33 0 0 13 5 6 1 14 8 2 8 8 28 Total 53 0 0 26 18 6 1 17 10 2 17 1 Milk. 825 samples of milk were analysed, of which 24, or 2.9 per cent., were adulterated. Table F shows the number of samples of milk examined and the percentage of adulteration during the last ten years. Table F. 1916. 1917. 1918. 919. 1920 1921. 1922. 1923. 1924. 1925. Number of samples 850 739 737 665 858 824 838 837 895 825 Percentage of adulteration 11.6 12.4 16.0 8.6 5.7 4.5 3.1 1.5 3.0 2.9 71 The average composition of all the samples of milk analysed, for each month of the year, is shown in table G. Table G. Month. Numbered examined. Fat per cent. Solids-not fat per cent. Total Solids per cent. January 71 3.68 8.64 12.32 February 68 3.63 8.69 12.32 March 94 3.57 8.69 12.26 April 57 3.53 8.66 12.19 May 78 3.48 8.68 12.16 June 80 3.37 8.79 12.16 July 92 3.59 8.67 12.26 August - — — — September 69 3.72 8.81 12.53 October 78 3.77 8.76 12.53 November 76 3.90 8.78 12.68 December 62 3.83 8.76 12.59 Whole Year 825 3.64 8.72 12.36 Legal Minimum — 3.00 8.50 11.50 The figures representing the percentage of fat obtained throughout the year are satisfactory. There is a gradual decrease from 3.08 per cent, of fat in January to the lowest figure, 3.37 per cent., recorded in June; a steady increase follows until the highest figure is reached in November, when the percentage of fat begins to fall slightly in the final month. There is very little variation in the percentages of solids-not-fat, the highest figure occurring in September, and the lowest—8.64 per cent.—in January. This latter figure follows the low average—8.54 percent.— obtained in December, 1924. The average quality of the milk supply is maintained, the figures for the year closely resembling those obtained in previous years. Table H. shows the extent of the adulteration and the action taken in each case. 72 Table H. Number. Deficient in Fat. per cent. Added water per cent. Action; Result of Proceedings. G 20 40.0 - Vendor fined £5 with £1 1s. costs. T 19 7.0 - Vendor fined £2 with £1 costs. K 4 — 5.2 Summons dismissed. Warranty proved. N 5 — 4.0 Summons dismissed. Warranty proved. D 13 — 3.9 Vendor cautioned. D 26 — 4.1 Vendor cautioned. T 20 — 5.2 Vendor paid £1 Is. costs. E 5 100 6.7 Vendor fined £20, with £5 5s. costs. E 6 18.3 6.5 Vendor fined £20, with £3 3s. costs. C 24 — 19.4 Vendor fined £4. M 36 — 3.5 Vendor cautioned. G 41 9.0 - Summons dismissed on production of Warranty. T 36 12.0 - Vendor fined £3, with £2 2s. costs. D 50 6.7 16.1 Summons dismissed on production of Warranty. K 48 26.7 - Vendor fined £1, with £2 2s. costs. S 54 6.0 - Vendor cautioned. E 34 20.0 - Vendor cautioned. C 61 — 3.5 Vendor cautioned. G 80 6.7 — Vendor cautioned. The samples K 4 and N 5 were obtained from the same vendor and legal proceedings were taken. At the first hearing of the case the Magistrate wished to dismiss both summonses as he considered that if there were any adulteration it was so minute as not to count. At the suggestion of the Council's Solicitor the case was adjourned for the Analyst's Certificate to be explained. A second hearing was adjourned owing to the indisposition of the Magistrate, and at the third hearing the defendant's solicitor requested that both samples should be sent to Somerset House for analysis, the case again being adjourned. At the fourth hearing it was shown that the Somerset House analyses confirmed the adulteration of the samples. The defendant then produced a Warranty and the Magistrate dismissed the summonses as the Warranty was proved. This was the sixth occasion upon which summonses against the defendant for selling adulterated milk had been dismissed on production of the Warranty. 73 D 50, a highly adulterated sample, was also dismissed on production of the Warranty. Since these cases were heard the Milk and Dairies Consolidation Act, 1915, previously postponed, has come into force, and the provisions of the Sale of Food and Drugs Acts with regard to the Warranty defence are amended by Section 9 of this Act in conjunction with the Third Schedule, in which it is stated that In order to be entitled to plead a warranty as a defence in any proceedings the retailer must, within sixty hours after the sample of milk was taken, request the local authorities to obtain a sample of milk from a corresponding milking, as soon as practicable from the wholesaler," and that " The local authority may take proceedings against the wholesaler instead of, or in addition to, the retailer." A number of applications for samples to be taken have been made to the Medical Officer of Health since the Act came into force, but up to the present time the samples connected with these requests have all been genuine. With regard to sample C 24, the defendant stated, when the sample was purchased, that the milk was sour and was to be used for cheese-making. The milk was, however, perfectly fresh, and this fact was pointed out on the certificate of analysis. The defendant's solicitor, at the hearing of the case, admitted the offence and stated that, owing to the supply of milk running short, a further quantity had been purchased elsewhere and this had proved to be adulterated. Sample E 34 showed a deficiency of 20 per cent. of fat. The vendor stated that there was a continuous sale of milk to consumers while the cows were being milked, and that the sample represented the milk of one cow only and not the mixed milk of the herd. At his request, samples of evening and morning milk were taken from this cow, together with samples of morning milk from the remainder of the herd. The results of these analyses are given in the following table:— Number, Fat per cent. Solidsnot Fat per cent. Yield in Quarts. Deficiency of Fat per cent. Afternoon Milk H 49 5.20 8.45 7 - Morning Milk H 59 1.60 8.65 13 46.7 Morning Milk H 50 4.20 8.50 5 — „ „ H 51 2.45 8.55 10 18.3 „ „ H 52 2.75 8.95 9 8.3 „ „ H 53 1.50 8.70 8 50.0 „ „ H 54 3.90 8.40 6 — „ „ H 55 3.20 8.50 6 — „ „ H 56 3.25 8.50 7 — „ „ H 57 3.35 8.55 6 — „ „ H 58 2.60 8.90 11 13.3 74 Percentage of fat in the mixed milk of the morning samples, allowing for the different yields = 2.68 per cent. The chief cause of low percentages of milk fat in the morning milk of a herd of cows during the summer months is to be found in the unequal periods of milking. The percentage of milk fat in morning and evening milks should not differ by more than 0.2 per cent. to 0.4 per cent. when the intervals of milking are approximately equal. In the case of samples H 49 and H 59, the afternoon sample was taken at 4.30 p.m. and the morning sample at 8.0 a.m., representing intervals of 8½ hours and 15½ hours. It is possible that the other samples which showed a low fat percentage would have shown a higher figure at the evening milking. On the other hand, the cows from which these samples were obtained may be giving at all times poor quality milk. In this connection it is interesting to note that this cowshed was one of a number which exist in the Borough. In these sheds the cows remain for a period of about ten months. A good quantity of milk low in quality is first obtained, then the quality gradually improves and the quantity drops until, finally, after a period of about ten months, the cow, which has fattened during this period is disposed of. Butter. 141 samples were examined, of which 1 or 0.7 per cent. was returned as adulterated. H 32 (Informal). Contained 15 per cent. Margarine. A subsequent formal sample was genuine. The amount of boron preservative found to be present in 13 samples was estimated. No sample contained more than 0.5 per cent. expressed as boric acid. The results are shown in Table J, together with the corresponding figures for 1923 and 1924. Table J. Amount of Boric Acid per cent. Percentage of samples, 1925. Percentage of samples, 1924. Percentage of samples, 1923. nil. 90.8 82.9 89.4 o.1 7.8 12.8 7.8 0.2 1.4 2.9 1.4 0.3 1.4 1.4 75 Margarine. 137 samples were examined, of which 1 or 0.7 per cent. was found to be adulterated. C 39 (Informal). Contained 2.4 per cent. excess water. A subsequent formal sample was genuine. The examination for preservatives resulted as under:— 39 or 28.5 per cent. of the samples were free from boric acid. 61 or 44.5 per cent. of the samples contained 0.1 per cent. boric acid. 33 or 24.1 per cent. of the samples contained 0.2 per cent. boric acid. 4 or 2.9 per cent. of the samples contained 0.3 per cent. boric acid. In 14 cases the vendors had not complied with the requirements of the Butter and Margarine Acts with regard to labelling : 10.2 per cent, of the samples were unsatisfactory in this respect. The 14 samples consisted of 4 informal and 10 formal samples. Proceedings were taken in 4 cases and in 6 cases the vendors were cautioned. The results of the proceedings are shown in Table K. Table K. Number. Offence. Result of proceedings. S 103 Unstamped wrapper Vendor fined 7s. G 112 Unstamped wrapper Vendor fined £l, with £2 2s. costs. E 16 Improperly labelled Vendor paid £2 2s. costs. J 25 Unstamped wrapper Vendor fined 5s. Cream and Preserved Cream. 24 samples were submitted for analysis, of which 22 were sold as Preserved Cream and 2 as Cream. Preserved Cream.—22 samples were satisfactory, containing more than the legal minimum of 35 per cent. of fat, of these 21 were correctly labelled with a label stating the nature and amount of preservative present, and in one case the carton was not labelled with the prescribed declaratory label. In four cases the carton was inscribed with the words "Thick Rich Cream," in addition to the declaratory label, the word "Preserved" being omitted. In no case did the amount of boric acid exceed the legal maximum of 0.4 per cent. Cream.—The two samples sold as cream were free from preservative- Further particulars are given in the following tabular statement required by the Ministry of Health. 76 Public Health (Milk and Cream) Regulations, 1912 and 1917. 1. Milk and Cream not sold as preserved cream: — (a) No. of samples (b) No. in which examined for preservative was preservative. reported to be present. Milk 825 Nil. Cream 2 Nil. 2. Cream sold as preserved cream: — (a) Correct statements 21 Statements incorrect — No label on carton 1 Total 22 In no case did the amount of boric acid exceed the legal maximum of 0.4 per cent. (b) Determinations of milk fat in cream sold as preserved cream : — Above 35 per cent. 22 Below 35 per cent. — (c) Instances where (apart from analysis) the requirements as to labelling or declaration of preserved cream had not been observed: — In one case the carton was not labelled with the statutory label. B 55 (Informal). No declaratory label. A further sample taken from the same vendor was correctly labelled. In four cases, three taken informally and one formally, the cartons were labelled with the statutory label, but were otherwise incorrectly described. B 61. Described as "Thick Rich Cream." Subsequent sample to B 56. Vendor cautioned. Spirits. Of 25 samples examined, 5 were found to be below the required strength. All these samples were taken formally and the vendors of the adulterated samples were cautioned. L 18 Whisky. 9.7 per cent. excess water. L 20 Whisky. 8.5 per cent. excess water. L 24 Whisky. 16.2 per cent. excess water. F 64 Whisky. 13.5 per cent. excess water. H 27 Gin. 7.7 per cent. excess water. 77 Flour. 6 samples were examined. One sample contained traces of potassium persulphate a so-called " improver."' Honey. Of 5 samples examined 1 was found to be adulterated. This sample was contained in a small wooden pill-box. Further samples taken on two occasions from the same vendor were contained in cartons and consisted of genuine honey. S.98 (Informal). Contained 38 per cent. cane sugar syrup. Vinegar. 12 samples were analysed. Of these, 2 were deficient in acetic acid. M 24 (Informal). 6.5 per cent. deficient in acetic acid. M 36 (Same vendor as M 24). 5.0 per cent. deficient in acetic acid. Vendor cautioned. Dried Milk. 3 samples examined were genuine. In one case the container was not labelled. Vendors of dried milk and powders containing not less than 70 per cent. of dried milk must comply with the Public Health (Dried Milk) Regulations, 1923, which came into operation in May, 1924. These Regulations require that dried milk containers must bear a label stating the grade of dried milk with particulars of any added substances, and stating the number of pints of the corresponding grade of standard milk equivalent to the total contents of the tin. Each grade of dried milk must satisfy stated requirements as to composition. Drugs. Of 83 drugs examined, 6 or 7.2 per cent. were adulterated. S 1 Grey Powder (Informal). 38.1 per cent. deficient in mercury. S 2 Grey Powder (Informal). 85.3 per cent. deficient in mercury. Each of these samples represented one dose for a child, the age being the same in each case. 78 In the first case (S 1) a dose of 5.2 grains, containing 1.1 grains of mercury was supplied, and in the second case (S 2) a dose of 3.7 grains, containing 0.2 grain of mercury, was obtained, the quantity of mercury being 5½ times greater in one case than in the other, while the powders were deficient in their proportion of mercury to the extent given above. Prescriptions specifying Grey Powder were presented in obtaining further formal samples, when the vendor of S 1 supplied Grey Powder of the correct B.P. strength, while from the vendor of S 2 none was obtainable. K 63 Sweet Spirit of Nitre (Informal). 3.0 per cent. deficient in alcohol and 32.9 per cent. deficient in ethyl nitrite. K 67 Sweet Spirit of Nitre (Informal). 2.4 per cent. deficient in alcohol and 30.9 per cent. deficient in ethyl nitrite. Repeat formal samples taken from the same vendors were found to be of the required strength. F 126 Sal Volatile (Informal). Contained 1.5 per cent. of chloroform and was 8.2 per cent. deficient in alcohol. Specific gravity 0.924 at 60° F. F 152 Sal Volatile (Same vendor). Contained 2.5 per cent. of chloroform and was 10.1 per cent. deficient in alcohol. Specific gravity 0.930 at 60° F. Vendor fined £5 with £5 5s. costs. It was stated that the presence of the chloroform could not be accounted for. A possible explanation is that, before the informal sample had been taken, the stock had been made up by the addition of a Sal Volatile mixture, in the manufacture of which Spirit of Chloroform (alcohol containing 5 per cent. chloroform) had been used instead of alcohol. When the formal sample was taken there was not sufficient in the bottle, but the required quantity was supplied, more of this mixture presumably being added. A medicinal dose of this Sal Volatile would contain a medicinal dose of chloroform. Dispensed Medicines (National Health Insurance Act). 23 samples were analysed, of these 4 were found to be unsatisfactory. J 26 Potassium Bromide Mixture (Informal). 34.8 per cent. deficient in potassium bromide. 79 J 30 Potassium Bromide Mixture (Informal). 31.3 per cent. excess in potassium bromide. H 8G Sodium Salicylate Mixture (Informal). 20.0 per cent. excess sodium salicylate. D 17 Sodium Salicylate Mixture (Informal). In this case 8 ounces of medicine were supplied in place of 12 ounces required by the prescription, the sample being also slightly below the required strength. The total deficiency of ingredients supplied amounted to 39.1 per cent. deficiency of potassium bicarbonate and 36.2 per cent. deficiency of sodium salicylate. Repeat formal samples taken in each of these cases were found to be accurately dispensed. The examination of dispensed medicines was begun in 1922. The following table gives the percentage of unsatisfactory samples for each year:— Table L. 1922. 1923. 1924. 1925. Number of Samples 35 14 13 23 Number unsatisfactory 15 nil 1 4 Per cent. unsatisfactory 42.9 - 7.7 17.4 Miscellaneous Samples. Private Purchaser.—1 sample of Salt was examined. Borough Engineer.—1 sample of Asphalt, 1 sample of Carbolic Powder, and 2 samples of Salt (for snow melting purposes) were examined for the Borough Engineer. Public Health Department.—31 samples were examined for the Public Health Department, consisting of: — Tinned Fish 5, Tomato Sauce 4, Apples 4, Formalin 3, Tinned Meat 2, Disinfecting Fluid 2, Cocoa 2, Tea 1, Insects 1, Glauber’s Salt 1, Medicine 1, Ointment 1, Water 1, Infants' Food 1, Mould 1, and Sweets 1, 80 The five samples of tinned fish were unsatisfactory. The interior of the tins showed considerable corrosion and all contained excessive quantities of tin, namely, 5.3, 2.5, 4.2, 4.0 and 4.2 grains of tin to the pound, respectively. The presence of tin in quantities approaching 2 grains of tin to the pound indicates that the sample is potentially deleterious to health. Sweets received from the Metropolitan Police, and of which one mauve sweet was stated to have caused painful burning in a woman's throat, consisted of cachous of various colours. These were found to be free from any poisonous ingredients or impurities. The mauve cachous were rather strongly flavoured with ginger, but were quite harmless. Four samples of Jonathan apples were examined for arsenic. Arsenic was found on the skin but not in the flesh of a number of the apples examined. As the amount of arsenic on each apple showed considerable variation, the total arsenic in the whole apple was estimated. In no case did the proportion of arsenic per pound for any apple exceed one hundredth grain of arsenic per pound. None of the remaining miscellaneous samples calls for comment. I wish here to acknowledge the valuable help given me in the Laboratory by Miss J. Brown. I have the honour to be, Ladies and Gentlemen, Your obedient Servant, DOUGLAS HENVILLE. Borough Analyst. Chemical Laboratory, 43, White Horse Street, E.l. April, 1926. 81 INDEX. A PAGE. Analyst's Report 67 to 80 B Back Church Lane area 10 Bacteriological Examinations 18 Bell Lane Area 9 Births 2, 14 to 17 C Canal Boats Acts 43, 44 Cancer 25 Cerebro-Spinal Fever 21 Clinics 36,46 Cowhouses 46 Creches 46 D Deaths 4, 17, 64 DiphtheriaandMembranousCroup 19 Disinfecting Station 43 E Encephalitis Lethargica 21 Enteric Fever 19 Epidemic Diarrhoea 23,24 Erysipelas 20 Exhumation of bodies 50 P Factory and Workshops Acts 60 to 63 Fines and costs (total) 46 Finsen Light Treatment 33 Food and Drugs Act 1899, Registrations under 42 Food and Drugs Acts, samples taken, proceedings, etc. 67 to80 Food Inspection 8, 38 to 42 82 PAGE G General Sanitary Work 44 to 47 H Health Visitors, visits, etc. 35 Health Week 37 Houses let in Lodgings 46 House to House Inspection 50 to 53 Housing 8 to 13 I Ice Cream Premises 46 Increase of Rent and Mortgage Interest (Restrictions) Acts 42 Infant Welfare Centres, 33 to 36 Infantile Mortality 4, 33, 65 Infants, Feeding of 36 Infectious Diseases 4, 5, 18 to 21, 66 Influenza 25 Inquests and post-mortem examinations 42 Insanitary Areas 9 to 13,49 L Limehouse Fields Area 11 to 13, 49 M Marriages 17 Maternity and Child Welfare Committee 1 Measles 21 Membranous Croup 19 Milk and Cream Regulations 76 Milk Distribution Scheme 36 Milk (Special Designations) Order 43 Milkshops 46 Mortuary and Coroner's Court 42 Municipal Centres, list of 33 Municipal Centres, work at 36 N Notifiable Diseases 18 to 21 83 O PAGE Offensive Trades 46 Ophthalmia Neonatorum 20 Outworkers 62 P Phthisis, number of notifications and deaths 25, 26 Pneumonia, etc. Regulations 20 Pneumo-thorax treatment 33 Police Court Proceedings 53 to 60 Poliomyelitis 21 Population 1, 14 Prusom Street area 11 Public Health Committee 1 Public Health (Meat) Regulations, 1924 37, 38 Puerperal Fever 20 R Rats and Mice Destruction Act 43 Respiratory Diseases 24 S Sanitary Inspectors' Report 47 Scarlet Fever 19 Second-hand Clothing, disinfection of 49 Sewing Classes 36 Slaughterhouses 46 Slaughtering of Poultry 49 Small-pox 18 Spitalfields Market 13 Spotted Fever 21 Staff 2 Statistics Housing Conditions—Ministry of Health Table 48, 49 Cases of Infectious Diseases notified 66 Causes of, and ages at death 64 Infantile Mortality 65 Form R.— Work carried out at the Tuberculosis Dispensaries - 28 to 30 Tuberculosis—Summary of notifications 31, 32 84 T PAGE Tuberculosis 5, 6, 7 Tuberculosis Dispensaries, list of 34 „ Dispensaries, Report on 27 to 29 „ Summary of notifications 31, 32 „ Form R 28 to 30 „ Other Forms, number of notifications and deaths 26, 27 „ War Pensions Cases 27 U Unhealthy areas 9 to 13, 49 Unsound Food 8, 38 to 42 V Verminous persons 42 Voluntary Centres 34 W Whooping Cough 22,23 Workshops 60 to 63 Wrong Diagnosis of Infectious Disease 18 Z Zeebrugge—Harwich Ferry Service 8,40 Zymotic Diseases 25