WES 87 St. Margaret and St. John, Westminster. With the Medical Officer of Health's compliments. SANITARY DEPARTMENT, The Town Hall, Caxton Street, Westminster, s.w. 25.2.96 ANNUAL REPORT upon the Public Health & Sanitary Condition of the UNITED PARISHES of St. Margaret & St. John, Westminster, FOR THE YEAR 1895, by JOHN NORTON, M.D., D.P.H.. Medical Officer of Health, MEMBER OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND; FELLOW OF THE INCORPORATED SOCIETY OF MEDICAL OFFICERS OF HEALTH; FELLOW OF THE BRITISH INSTITUTE OF PUBLIC HEALTH. London Wightman & Co., "The Westminster Press," 104 & 106, Regency Street, S.W. 1896 INDEX. page Bakehouses, cowhouses, &c. 29 Births and deaths 4-7 Black smoke, &c. 28 Combined drainage 29 Coroner's Court, Mortuary, and disinfection 23 Customs and Inland Revenue Act 29 Deaths, Distribution of extra parochial 5 Deaths, Tabulated statement of—St. Margaret 8-9 ,, ,, ,, St. John 10-11 Drainage and Water Supply 25-20 Factory an I Workshop Act—Outworkers 20 Hospital accommodation—Metropolitan Asylums Board 17 Houses let in lodgings 26-28 Housing of the Working Classes Act 20-21 Infectious disease charts 20-21 ,, diseases classified in streets 18-19 ,, ,, Remarks on 14-17 ,, ,, Tabular statement of 12-13 Inspectors—Reports of 32-34 Legal proceedings 30-31 Meteorology 3-4 Overcrowding of premises 23-24 Sale of Food and Drugs Act; Margarine Act; and unsound food 21-22 Underground rooms 30 Vaccinations 22 3 ANNUAL REPORT upon the PUBLIC HEALTH AND SANITARY CONDITION of the UNITED PARISHES of St. Margaret and St. John, Westminster, For the Year 1895, By JOHN NORTON, M.D., D.P.H., Medical Officer of Health, Member of the Royal College of Surgeons of England; Fellow of the Incorporated Society of Medical Officers of Health; Fellow of the British Institute of Public Health. To the Members of the United, Vestry. My Lords and Gentlemen, I have the honour to place before you my Annual Report on the health, sanitary condition, and vital statistics of the United Parishes, for the year 1895. METEOROLOGICAL SUMMARY. First Quarter. The mean reading of the barometer was 29.664 inches; the mean temperature of the air 35.2. The amount of rain measured during the quarter was 3.27 inches, and the amount of bright sunshine recorded was 146.2 hours. The weather was cold from the beginning of the year until the 13th January; it was then somewhat milder until the 31st, when a cold period of exceptional intensity set in and lasted until February 19th, and in a somewhat less severe form until March 9th. From March 10th to 18th the temperature exceeded the average, but on the last three days of the quarter it again fell below the average. Second Quarter. The mean reading of the barometer was 29.846 inches; the mean temperature of the air was 55.1; the rainfall was 1*91 inches, and the amount of bright sunshine recorded during the quarter was 457.8 hours. 4 April, generally speaking, was warm. In May the weather was generally fine, dry and sunny. During June the weather remained warm and bright, with the exception of the period from the 12th to the 20th, when the temperature fell below its average. Third Quarter. The mean reading of the barometer during this quarter was 29.812 inches; the mean temperature of the air was 62.3; the rainfall measured 6.46 inches, and the duration of bright sunshine recorded was 514.7 hours. With the exception of about ten days in the middle of July, the weather was dull and wet from the beginning of the quarter until August 14th. The remainder of the quarter was generally fine and bright, with a remarkably hot period during the last week of September. Fourth Quarter. During this quarter the mean reading of the barometer was 29.671 inches; the mean temperature of the air was 44.7; the rainfall measured 8.09 inches, and the duration of bright sunshine registered was 106.7 hours. The weather was dull and wet during the first ten days of the quarter, then generally bright and fine till the end of October, with a remarkably cold period in the last week of the month. In November and December the weather was generally dull, wet, and mild, the temperature exceeding the average on twenty-four days of the former, and on seventeen days of the latter month. Births and Deaths. The number of births registered during the 52 weeks ended December 28th, 1895, when all the corrections have been made, was 1,278, showing a birth-rate of 22.9 per 1,000 of the population. 322 births occurred in St. Margaret's parish, of which 160 were males and 162 females, giving a birth rate of 14 9 per 1,000; and 956 births in St. John's parish, of which 487 were males and 469 females, giving a birth rate of 27.8. The number of deaths of parishioners duly corrected amounted to 1,154, showing a recorded death rate of 20.7, and a corrected death rate of 23'4 per 1,000 of the population. Of these deaths 415 occurred in St. Margaret's parish, giving a recorded death rate of 19.3; and 739 deaths occurred in St. John's parish, giving a recorded death rate of 21.5. The death rates during the months of February and March were exceedingly high, being 35.5 and 34.8 respectively per 1,000 of the population. 5 The following comparative table shows the birth and death rates per 1,000 during the past five years for the united parishes, viz.:— Year. Birth Rate. Death Rate. Recorded. Corrected for age and sex distribution. 1891 26.8 19.7 22.2 1892 24.7 23.0 26.0 1893 24.4 23.1 26.1 1894 21.9 18.0 20.3 1895 22.9 20.7 23.4 In calculating the above birth and death rates I have used the figures of the population of the census of 1891, which has been done in former years, as I consider this more accurate than using the population calculated to the middle of 1895. The population of St. Peter's Close is also excluded in these returns. A notification from the office of the Registrar-General has been forwarded to the Superintendent-Registrars of the county of London, instructing them to take on the night of Sunday, March 29th, 1896, a census of their districts, in accordance with the provisions of the Metropolitan Equalisation of Rates Act. The following table gives the distribution of the deaths of parishioners dying in various extra parochial institutions, all of which are included in the mortality statistics:— Institution. No. of Deaths. Asylum — Banstead 1 „ Caterham 1 „ Central London Sick 1 „ Cleveland Street Sick 1 „ Colney Hatch 6 „ Darenth 1 „ Hanwell 4 „ Leavesden 6 „ Peckham House 1 Elsewhere 4 Friedenheim 1 Salvation Army Home, Hackney 1 Clapham Maternity Home 1 Hospital —St. Bartholomew's 1 „ St. Thomas's 20 „ St. Elizabeth's 1 „ St. George's 25 6 Institution. No. of Deaths. Hospital — St. Mary's 2 „ St. Camilla's 1 „ Children's 1 „ Evelina 1 „ Charing Cross 4 „ Guy's 2 „ Belgrave 8 „ General Lying-in 1 „ University College 2 „ French 1 „ Cancer 1 „ Brompton 9 „ Victoria 3 „ National 1 „ London Temperance 1 „ King's College 1 „ Western Fever 3 „ North Western Fever 3 „ South 8 Infirmary—St. George's 244 „ Lambeth 1 „ Wandsworth 1 Workhouse—St. George's 4 „ Hampstead 1 „ Marylebone 1 „ Strand Union 1 Total 382 In consequence of Westminster Hospital having being closed for re-drainage and repairs for three months, the extra parochial deaths are more numerous this year. Table I., giving the death rates from certain classes of disease in the district:— years. Whole District. St. Margaret's. St. John'*. 1. Chief Zymotic Diseases 1894 2.1 1.5 2.4 1895 1.7 1.0 2.1 2. Phthisis 1894 2.3 2.3 2.4 1895 2.0 1.6 2.2 3. Pulmonary Diseases, including Bronchitis, Pneumonia and Pleurisy 1894 4.7 4.6 4.5 1895 5.6 5.3 5.7 7 Table II.— Comparative Table of deaths from the principal zymotic diseases and deaths of infants under one year of age:— Years. 1892. 1893. 1894. 1895. Deaths (Total) 1297 1290 1006 1154 Small Pox — — — — Measles 77 5 37 23 Scarlet Fever 18 25 8 9 Diphtheria 44 14 22 15 Whooping Cough 20 15 19 13 Typhus — — — — Enteric Fever 3 7 4 3 Simple and Ill-defined Fever — 1 — — Diarrhœa 22 43 11 27 Deaths of Infants under one year of age 233 255 180 246 Deaths under one year to every 1,000 Births registered 169 188 147 192 8 9 Table III.— DEATHS during the year 1895 in the Metropolitan Sanitary District of St. Margaret's, Westminster, classified according to Diseases, Ages, and Localities. Localities. ST. MARGARET. Mortality from all causes, at subjoined Ages. Mortality from subjoined causes, distinguishing Deaths of Children under Five Years of Age. At all Ages. Under 1. 1—5. 5—15. 15—25. 25—65. 55 & upwards. 1 2 3 4 5 6 7 1 8 9 10 11 12 13 14 15 16 17 is 19 | 20 21 22 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhœa and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Injuries. All other Diseases. Total Typhus. Enteric, or Typhoid. Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i) Westminster Hospital 141 15 25 8 7 78 8 Under 5 ... ... 13 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 11 ... 1 14 40 5 upwds. ... ... 2 ... ... 2 ... ... ... ... 1 ... ... ... ... ... 12 13 10 11 50 101 Convent 12 6 3 — 2 — 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... 3 1 ... ... ... ... ... ... 5 9 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 1 1 ... ... ... 3 Rest of Parish 207 31 12 6 9 83 66 Under 5 ... ... 2 1 ... ... ... ... ... ... ... 4 ... 2 ... ... ... 10 ... 3 21 43 5 upwds. ... ... ... 1 ... 1 ... ... ... ... ... 1 ... ... 1 1 11 43 28 1 76 164 Net Total 415 49 21 10 17 153 165 Under 5 ... 1 3 1 ... ... ... ... ... ... ... 4 3 4 ... ... ... 14 ... 5 35 70 5 upwds. ... 1 ... 1 ... 2 ... ... 1 ... ... 1 1 ... 1 1 35 101 46 10 144 345 The subjoined numbers have also to be taken into account in judging of the above records of Mortality. Parishioners dying outside parish 189 11 5 4 5 67 97 Under 5 ... 1 1 ... ... ... ... ... ... ... ... ... ... 1 ... ... ... 4 ... 1 8 16 5 upwds. ... 1 ... ... ... ... ... ... 1 ... ... ... ... ... ... ... 23 57 18 8 65 173 Strangers dying in parish 134 14 24 8 6 75 7 Under 5 ... ... 13 ... ... ... ... ... ... ... ... 1 ... ... ... ... ... 11 ... ... 13 38 5 upwds. ... ... 2 ... ... 1 ... ... ... ... 1 ... ... ... ... ... 12 13 10 10 47 96 No death occurred from Small Pox in this District during the year. 10 11 (A2) Table IV.— DEATHS during the year 1895 in the Metropolitan Sanitary District of St. John's, Westminster, classified according to Diseases, Ages, and Localities. Localities. ST. JOHN. Mortality from all causes, at subjoined Ages. Mortality FROM SUBJOINED CAU8ES, DISTINGUISHING DEATHS OF CHILDREN UNDER FIVE. At all ages. Under 1. 1—5. 5—15. 15—25. 25—65. 65 & upwards. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Measles. Whooping Cough. Diarrhœa and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia, and Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Typhus. Enteric (or Typhoid). Continued. Relapsing. Puerperal. (a) (b) (c) (d) (e) (f) (g) (h) (i) Grosvenor Hospital 3 ... ... ... ... 2 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 3 Station Hospital 10 ... ... ... ... 7 8 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... 1 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 1 ... 5 10 Rest of Parish 499 178 77 14 14 137 79 Under 5 ... ... 1 2 ... ... ... ... ... ... ... 18 9 20 ... ... 2 68 5 7 123 255 5 upwds ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... 1 ... 39 68 35 10 89 244 Net Total 739 197 97 29 34 261 121 Under 5 ... 2 8 2 ....... ... ... ... ... ... ... 18 9 23 ... ... 2 78 5 7 140 294 5 upwds ... 5 4 ... ... 1 ... ... 1 ... 1 ... ... ... 1 ... 75 121 50 18 168 445 The subjoined numbers have also to be taken into account in judging of the above records of Mortality. Parishioners dying outside parish. 230 19 20 15 13 121 42 Under 5 ... 2 7 ... ... ... ... ... ... ... ... ... ... 3 ... ... ... 10 ... ... 17 39 5 upwds ... 4 4 ... ... 1 ... ... ... ... ... ... ... ... ... ... 36 50 14 8 74 191 Strangers dying in parish. 3 ... ... ... ... 2 1 Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3 3 No death occurred from Small Pox in this District during the year. 12 13 ( B) TABLE (V.) OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, during the year 1895, in the Sanitary District of St. Margaret and St. John, Westminster, classified according to Diseases, Ages, and Localities. Localities. Population at All Ages Registered Births. Ages. New Cases of Sickness in each locality. Number of such cases removed from home to hospitals. Census 1891. Estimated to Middle of 1895. 1 2 3 4 5 6 7 8 9 10 11 Totals. 1 2 3 4 5 6 7 8 9 10 11 Totals. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Fevers. Cholera. Erysipelas. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Cholera. Erysipelas. Typhus. Enteric (or Typhoid). Continued. Relapsing. Puerperal. Typhus. Enteric (or Typhoid). Continued. Relapsing. Puerperal. <") (b) (c) (d) (e) ST. MARGARET. Westminster Hospital ... ... ... Under 5 ... 1 1 ... ... ... ... ... ... ... ... 2 ... 1 1 ... ... ... ... ... ... ... ... 2 5 upwards ... 1 ... ... ... 1 ... ... ... ... ... 2 ... ... ... ... ... 1 ... ... ... ... ... 1 Convent ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... 5 ... ... ... ... ... ... ... ... ... 5 ... 5 ... ... ... ... ... ... ... ... ... 5 Rest of Parish ... ... ... Under 5 ... 22 13 ... ... ... ... ... ... ... 1 36 ... 19 10 ... ... ... ... ... ... ... ... 29 5 upwards ... 52 15 1 ... 14 ... ... 2 ... 8 92 ... 46 10 ... ... 8 ... ... 1 ... ... 65 Total 21,433 20,504 322 Under 5 ... 23 14 ... ... ... ... ... ... ... 1 38 ... 20 11 ... ... ... ... ... ... ... ... 31 5 upwards ... 58 15 1 ... 15 ... ... 2 ... 8 99 ... 51 10 ... ... 9 ... ... 1 ... ... 71 ST. JOHN. Grosvenor Hospital ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 ... ... ... ... ... 1 Station Hospital ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rest of Parish ... ... ... Under 5 ... 37 31 1 ... 1 ... ... ... ... 4 74 ... 25 29 ... ... 1 ... ... ... ... 2 57 5 upwards 6 65 44 ... ... 11 ... ... 1 ... 17 144 6 63 42 ... ... 9 ... ... ... ... 6 126 Total 34,106 33,550 956 Under 5 ... 37 31 1 ... 1 ... ... ... ... 4 74 ... 25 29 ... ... 1 ... ... ... ... 2 57 5 upwards 6 65 44 ... ... 12 ... ... 1 ... 17 145 6 63 42 ... ... 10 ... ... ... ... 6 127 "Notification of Infectious Disease" has been compulsory in the District since October 31st, 1889. The Isolation Hospitals are the Hospitals of the Metropolitan Asylums Board, and occasionally the London Fever Hospital and the London Small Pox Hospital. 14 Remarks on Infectious Diseases. Small-Pox.— No death was registered in either of the parishes during the year. Of the six cases notified (St. John's Parish), five occurred at Common Lodging-houses and one at a private house, the patient in the latter case having been employed in the neighbourhood of Whitechapel, where there was an outbreak of this disease. In this case four persons living in the same house as the man attacked were removed to the Vestry's Reception Rooms in Horseferry-road and the premises (13, Frederick-street) thoroughly fumigated. The patient stated that he suffered from a modified form of Smallpox seven years ago. With regard to the five cases occurring at the Common Lodging-houses in Great Peter-street and 6, Great Smithstreet, great difficulty was experienced in tracing where the patients had slept after they had noticed a rash on their bodies. In one case the man had slept at no less than five different places since he noticed a rash on his body. In another case the man when the rash was observed by the keeper of the lodging-house ran away, but was subsequently caught and removed to a Small-pox Hospital. In each of these cases the patients were removed to Isolation Hospitals and the rooms, bedding, &c., thoroughly disinfected. Notifications were sent to each Medical Officer of Health in whose district the patients had previously slept, and also to the Vaccination Officer. A special report of the cases was also sent to the Medical Officer of the Local Government Board. Scarlet Fever.—From this disease nine deaths were registered, two occurring in St. Margaret's Parish and seven in St. John's Parish; 81 cases were notified in St. Margaret's and 102 in St. John's, making a total of 183. In 1894 eight deaths were registered from this disease and 151 notifications were received. On two occasions during the year the relation of school attendance as a factor in the spread of infectious disease has received attention. In the first case, at St. Margaret's School, out of 20 cases of Scarlet Fever occurring in June and July, 13 were cases of children attending this school; the disease abated directly the holidays commenced. In the second case, namely, that of James-street Board School, especially in the Infant's department, it was observed that 11 out of 12 cases of Scarlet Fever notified between September 8th and October 4th were those of children attending this I 15 school. On October 4th I communicated with the Medical Officer of the School Board, with the result that this department (Infant's) was thoroughly fumigated and the floors and desks washed with a solution of Carbolic Acid. It was then noticed that cases which had been cropping up at intervals of a few days only then ceased, with one exception, namely, that of a child who had attended the school for the last time before the fumigation took place, viz., October 3rd. For the next three months only three cases of Scarlet Fever occurred in children attending this school. I think in this case it is clearly evident that the disinfection at least did good, and in the former case it is interesting to note how the separation of the children for the holidays caused the disease to decrease. An interesting case occurred in the district where a child who had been six weeks in a Metropolitan Asylums Board Hospital, suffering from Diphtheria, developed Scarlet Fever the following day, after being discharged from the hospital. Diphtheria.—Fifteen deaths wore registered from this disease, compared with 22 last year; three deaths occurred in St. Margaret's Parish and 12 in St. John's. 104 cases were notified, compared with 72 last year; of these, 29 were notified in St. Margaret's Parish and 75 in St. John's. On the occasion of a small outbreak of Diphtheria in November at Knightsbridge, out of ten cases, the first eight were either children actually attending Montpelier-street School in Kensington Parish, or in houses where children resided who went to that school. Dr. Dudfield very kindly informed me that steps had been taken by him to remedy any insanitary conditions observed at these schools. In all the cases notified special care has been taken to get a complete history of the case as to school attendance, &c., on the forms which were printed last year, and in each case all insanitary defects at the houses where the disease has occurred have been remedied. With regard to the use of the Antitoxin treatment in Diphtheria, the opinion of medical men seems to be still divided. One gentleman living in this district has very kindly supplied me with the history of a case of Diphtheria occurring in his family, where he states that the Antitoxin treatment undoubtedly cut short the progress of the disease. 16 In New York it is stated that the Antitoxin treatment of Diphtheria has been especially successful, and returns of deaths giveu for the first three quarters of 1895, where this method of treatment has been adopted, show a reduction in the death-rate of 43'94, as compared with the average death-rate for corresponding periods of the previous four years. Fevers.—Five deaths were registered, compared with four last year. Three of the deaths resulted from Enteric Fever and two from Puerperal Fever. Twenty-eight cases of Enteric Fever were notified, compared with 42 last year. Several patients were admitted this year, suffering from Enteric Fever, into Westminster Hospital, as I understand, at the request of the Metropolitan Asylums Board Authorities. It appears that notwithstanding the notification provisions of the Public Health (London) Act, 1891, no notification of the introduction of such cases into a district, under such circumstances, is necessary to the medical officer of health into whose district the cases are imported. The notification in these cases is sent to the medical officer of health of the district from whence the patient was brought to the hospital. (Section 55 b.) The Metropolitan Asylums Board state that no such provision is made in the Act, but, at the same time, wrote saying that it was desirable that such cases should be notified to the Sanitary Authority into whose district the cases' are imported, but they have no power to enforce this very proper proceeding. Measles —Twenty-three deaths were registered, compared with 37 last year; of these, 18 occurred in St. John's Parish and five in St. Margaret's. Whooping Cough. — Thirteen deaths resulted from this disease, compared with 19 last year; four deaths occurred in St. Margaret's Parish and nine in St. John's. Influenza.—Twenty-five deaths occurred from this disease, as against 14 last year; 15 occurred in St. Margaret's Parish and 10 in St. John's. Nearly all the cases occurred in the months of January, February and March. Diarrhœa.—Twenty-seven deaths were registered from this cause during the year; last year 11 deaths only were registered. Of the 27 deaths all were those of children under five years of age, and mostly under one year of age, and it is interesting to note that the majority of the cases, viz., 23 out of 27, occurred during the months of July, August and September. In England and Wales, during these months, no less than 18,118 deaths were attributed to Diarrhoea, and in only one September quarter, since that of the year 1884, has the Diarrhoea mortality in England and Wales reached this figure. 17 Cholera.— No death arose from this cause in the district, neither was any case notified. Sixty-one deaths were registered in London as occurring from this disease during the September quarter. Erysipelas.— One death only was registered as occurring from this disease, against two last year; 30 cases were notified, compared with 34 last year. It is interesting to note that a French Professor claims to have discovered a remedy for Erysipelas and Puerperal Fever and some other inflammatory diseases. The name of the new serum is Anti-Streptococique. The Metropolitan Asylums Board and Hospital Accommodation. On November 27th delegates were appointed by the Vestry to attend the Conference, convened by the Vestry of St. Marylebone for December 2nd, to discuss the question of the inability of the Metropolitan Asylums Board to provide sufficient accommodation for cases of the infectious sick. The chief resolutions adopted were:— 1. That the Gore Farm Hospital at Darenth should be opened for the reception of urgent cases of Scarlet Fever. 2. That the authorities making the rate, to raise the funds for the requirements of the Metropolitan Asylums Board, should be entitled to be directly and adequately represented upon that Board. 3. That the President of the Local Government Board be asked to receive a deputation in support of the foregoing resolutions. 4. That a copy of the foregoing resolutions be forwarded to the Local Government Board, the Metropolitan Asylums Board, and the several Vestries and District Boards of the Metropolis, who had appointed delegates to attend this Conference, and that each of those Vestries and District Boards be asked to appoint one representative to attend the proposed deputation to the President of the Local Government Board. On November 6th the Metropolitan Asylums Board wrote to the Vestry inviting suggestions as to any buildings which might be available as temporary hospitals, pending the erection of permanent buildings already in hand. The Vestry replied that they were unable to find that there was any building in the parish which would be available for the purpose. 18 A list of the streets, with the number of cases of the principal infectious diseases occurring in such streets, is given below:— St. Margaret's Parish. Street or Place. Scarlet Fever. Diphtheria. Typhoid Fever. Albert Hall-mansions ... ... 1 Alexander-buildings 1 ... ... Abingdon-street 4 ... ... Albert-gate 2 2 ... Ambrosden-avenue ... 1 ... Arthur-street ... 4 ... Artillery-row 3 ... ... Ashley-gardens 1 2 ... Brompton-road 1 ... ... Brewers Green-mews 1 ... ... Buckingham-chambers 3 ... 1 Catherine-street 3 1 ... Castle-buildings 1 ... ... Carlisle-place 5 ... ... Caxton-street 1 ... 1 Cobourg-row 3 3 1 Downing-street 2 ... ... Ennismore-gardens ... ... 1 Francis-street 2 ... ... Francis-place 2 ... ... Great Smith-street 1 ... ... Great George-street 1 ... ... Hyde Park-barracks 2 ... ... James-street 2 ... ... Knightsbridge-green ... 2 ... Kensington Palace-gardens 1 ... Lewisham-street 1 2 1 Montpelier-row 2 2 ... Princes-mews ... 1 ... Princes-gate ... 1 ... Peabody-buildings, James-street 6 1 ... Parker-street 6 ... ... Palace-street 2 1 ... Queen Anne's-gate 2 ... 1 Queen-street (Old) 1 ... ... Raphael-street 1 ... ... Rutland-gate ... 1 ... Stirling-street ... 1 ... Tothill-street 4 ... ... Tachbrook-street ... ... 1 Trevor-square 1 1 ... Victoria-street 5 2 1 Vauxhall-bridge-road 2 ... l Vandon-street ... ... l Willow-street 1 ... ... Willow-place 2 ... ... Westminster-hospital 2 1 1 York-street 3 ... 2 No case of Small-pox was notified in St. Margaret's Parish. 19 St. John's Parish. Street or Place. Scarlet Fever. Diphtheria. Typhoid Fever. Small-pox. Arneway-street 2 ... ... ... Bell-street 1 1 ... ... Bessborough-gardens 2 ... ... ... Bessborough-place 5 2 ... ... Bloomburg-street 8 ... ... ... Chadwick -street ... 2 ... ... Church-street 1 ... ... ... Cobourg-row 1 ... ... ... Carpenter-street 1 ... ... ... Churton-street 1 ... ... ... Causton-street ... 2 ... ... Carey-street ... 1 ... ... Chapter-street 1 ... ... ... Douglas-street 2 ... ... ... Douglas-place ... 3 ... ... Dorset-street 1 ... ... ... Esher-street 3 ... ... ... Frederick-street 2 ... ... ... Grosvenor-road ... 1 l ... Great Smith-street 1 ... ... 1 Great Peter-street 3 2 ... 4 Greycoat-place 1 ... ... ... Greycoat-street ... 1 ... ... Horseferry-road 3 ... 1 ... Harper's-place ... 3 ... ... Kensington-place 1 ... ... ... Little College-street ... 1 ... ... Lillington-street ... 1 1 ... Lower Garden-street ... 3 ... ... Marsham-street l 1 1 ... Medway-street ... ... 3 ... Moreton-street l ... ... ... North-street l ... ... ... New-street 1 ... ... ... Page-street ... 3 ... ... Peabody-buildings 14 8 1 ... Ponsonby-terrace 1 1 ... ... Ponsonby-place 1 2 ... ... Purbeck-place ... 1 ... ... Rochester-row 1 1 ... ... Rochester-street 1 ... ... ... Roehampton-street 1 ... ... ... Romney-street 4 2 ... ... Regency-street 6 2 1 ... Smith-square 3 1 1 ... Stanford-street ... 1 ... ... St. Matthew-street 1 ... ... ... St. Ann's-street ... 3 ... ... St. John's-street 1 ... ... ... Tufton-street 6 3 ... ... Tachbrook-street 4 3 ... ... Upper Garden-street 4 5 1 ... Vincent-street 3 5 ... ... Vincent-square 2 ... 2 ... Vauxhall Bridge-road 4 7 ... ... "Wood-street 2 2 ... ... 20 Factory and Workshop Acts—Outworkers, &c. In the special report submitted to the Vestry in November last I made a compend of the principal sections of interest to sanitary authorities in the New Factory and Workshop Act, coming into operation on January 1st, 1896. The only case of infectious disease occurring amongst outworkers in this district was one of Small-pox, particulars of , which are given below. All necessary precautions were, however, taken with good success. On 3rd September notice was received from the Medical Officer of Health for Battersea, that a person named Sarah H., aged 18, of 33, Kingsley-street, Battersea, was removed to hospital suffering from Small-pox, and that prior to Friday, the 30th August last, she had been employed in dress-making at a factory in Westminster. Upon inquiry at the factory I ascertained that this was correct, and also that a Mrs. B., of 61 or 68, Albert-mansions, Wilcox-road, Wandsworth, was employed in the same room as the former patient who had had three of her children removed from her address, on 31st August, suffering from Small-pox, and that she had been at work in the factory up to the evening of the same day. The manager of the factory stated that as soon as it came to his knowledge he caused the work-rooms to be scrubbed out with disinfectant and took every precaution. He was not, • however, aware of the case of the woman first-mentioned. No further cases occurred. Housing of the Working Classes Act, 1890. The following houses were closed during the year under the above Act, being unfit for human habitation, viz.:— St. Margaret's Parish. 17, Snow's-rents. Nos. 1, 3, 4 & 5, St. Ermin's-hill. No. 1, St. Ermin's-hill has now been put into proper repair, and the Vestry have given permission to the owners to apply to the magistrate for the rescinding of the Closing Order, so that the house may again be occupied. One house, No. 5, Lancelot-place, was closed under the Public Health (London) Act, 1891, and afterwards re-opened , having been put into proper repair. The voluntary closing and demolition of property in Willow-street, referred to in last year's report, is still being proceeded with, but to a much smaller extent. I 21 St. John's Parish. Notices were served under the above Act with regard to the following Houses, viz.:— Houses. Result. 5 and 6, Laundry-yard Demolished. 21, 23 and 25, Cobourg-row Demolished. 1, 2, 3 and 4, Bull's Head court Demolished. 9 and 9|, Marsham-street Proceedings pending. The houses Nos. 44, Tufton-street and 6, Gulston-cottages, which were closed by order of a magistrate, during 1894, having been repaired to the satisfaction of the Vestry, were re-opened, and are again occupied. Nos. 1, 3 and 23, Chadwick-street were closed by order of the magistrate until such time as they were rendered fit for habitation. The restoration of these houses has been put in hand, and the repairs for Nos. 1 and 3, will be completed in about one month. Immediately upon the completion of these two, No. 23 will be proceeded with. Sale of Food and Drugs and Margarine Acts. During the year 100 samples of food, including two under the Margarine Act, have been purchased for the purpose of analysis; and in addition five samples have been submitted by ratepayers under the standing order. Tabulated lists are given below:- Article. No. of Samples. Genuine. Adulterated. Fines. Costs. £ s. d. £ s. d. Arrowroot 6 6 — - - Butter 24 18 6 29 10 0 8 7 6 Bread 1 1 — — — Cocoa— Loose 6 - 6 5 10 0 5 8 6 Packet 3 — 3 No action taken. Protected by label. Coffee 3 3 — — — Cake 3 3 — — — Flour 3 3 - - - Gin 3 2 1 0 10 0 1 3 0 Milk 36 30 6 9 0 0 3 4 6 Mustard 3 2 1 0 10 0 0 12 6 Pepper 6 6 — — — Whisky 3 3 — — — Totals 100 77 23 £45 0 0 £18 16 0 22 Margarine Act. Article. No. of Sample. Genuine. Adulterated. Fines. Costs. £ s. d. £ s. d. Butter 2 — 2 4 0 0 1 5 0 Samples Submitted by Ratepayers. Article. No. of Samples. Genuine. Adulterated. Remarks. Butter 2 2 - Found genuine and certificate sent to person submitting. Milk 1 1 — — Vinegar 1 — — Not analysed. Hair-wash 1 - - Not analysed. Unsound Food. About 2 cwt. of mutton was examined and found to be unfit for food, and was consequently destroyed. Five hundred and twenty-eight head of poultry, one barrel of crabs, and one bushel of whelks were also found unfit for food and were destroyed. Table VI.— Vaccinations during the Year 1895. Primary Vaccinations. Re-Vaccination by Public Vaccinator. Public Vaccination. Private Practitioners. Total. 628 426 1054 6 In the 23rd Annual Report of the Medical Officer of the Local Government Board for 1893-1894, some interesting comments are made on the Vaccination officers returns for 1891, where it is shown that an increasing number of infants escape vaccination every year:— No less than 13.4 per cent. of the children born in that year remain unaccounted for as regards vaccination. In the Metropolis the percentage was 16.4. Both in the Metropolis and in the rest of England the great increase in default under the Vaccination Laws set in during 1889, the year that the Royal Commission was appointed. Since that date, Dr. 23 Thorne states that "an increasing number of Boards of Guardians have, more or less, completely abstained from enforcing compliance with the law as to vaccination, pending the issue of the report of the Commission "which has yet to be issued. Coroner's Court and Mortuary. Number of articles disinfected from Guards'Hospital Quarters 8,35 Number of articles disinfected from United Parishes 11,805 Number of rooms disinfected 370 Number of families removed to the Vestry's Reception Rooms, Horseferry-road, during the disinfection of their dwellings 139 Number of bodies removed to Mortuary 156 Number of Inquests held at the Coroner's Court 119 A special report was made to the Vestry by Dr. Dupre and myself in December with regard to the best disinfectants to be used for various purposes in the United Parishes. It will be remembered that owing to communications from the Lieutenant-Colonel and the Surgeon of the 2nd Life Guards, dated February 15th, 1895, asking the Vestry to offer facilities for disinfection of articles of clothing, bedding, &c., from the barracks and army hospitals within the Parish, the Vestry undertook to disinfect all infected articles from the barracks and hospitals in question free of charge. The Mortuary Sub-Committee have also given permission to the staff of the Grosvenor hospital to use the mortuary for making post-mortem examinations free of expense until the hospital mortuary is built, provided they conform to the rules and regulations laid down by that Sub-Committee. Alleged Overcrowding in Peabody-buildings James- street. Owing to the above statement, the Sanitary Committee ordered a thorough inspection of the above buildings to be made, and a report was sent to them on February 13th, 1895. It was found that in no single instance was there any overcrowding, even in the bedrooms, and in the majority of the tenements there was excellent space accommodation. The total number of occupants was found to be 551, which counted as 465 adults. There are 359 living rooms and one board room, and it was ascertained that there were less than 1.3 persons (as adults) per room. 24 The following table gives a good idea of the number of rooms in the different blocks and the number of persons living in them:— Blocks. Rooms. Adults. Children. Total as Adults. No. of persons (as Adults') per room. East 83 81 49 105½ 1.2 West 67 64 25 76½ 1.1 North 89 96 27 109½ 1.2 South-West 49 57 26 70 1.4 South-East 71 81 45 103½ 1.4 Total 359 379 172 465 1.3 nearly. During the year 1894 only ten cases of Infectious Disease occurred, viz.: two Scarlet Fever, seven Diphtheria, and one Enteric Fever. In the 13th Annual Report of the Peabody Trust it was found that in the Peabody-buildings generally the birth rate was 36.3 per 1,000; the death rate 15.7 per 1,000, and the infant mortality was 102.1 to each 1,000 births, showing that the birth rate is exceedingly high and the death rate exceedingly low. Great improvements have been made in the ventilation, &c., of D Block Peabody-buildings, Old Pye-street, during the year. overcrowding at the salvation Army shelters. So much has been said during the past year of the necessity of bringing these shelters under the same rules and regulations as the Common Lodging-houses, that the Vestry passed a resolution to that effect in October last, and at the same time agreed that there could be no question but that it would be a wise and judicious thing to do. At the beginning of November, having received an anonymous letter with regard to the overcrowding of the Salvation Army Shelter in Horseferry-road, I visited the shelter and found that there was considerable overcrowding every night and very bad ventilation. In No. 1 room there were 83 beds, and the walls were damp; in No. 2 room, 75 beds; in No. 3 room, 94 beds; in No. 4 room, part of which is partitioned off as a kitchen, there were 17 beds ready to be used in case of emergency. There are 5 water tanks under the roof of No. 3 room, all uncovered and thus receiving the breath emanations of the 94 persons sleeping nightly in this room. The closets, 7 25 in number, are on the trough principle, connected with a large automatic flush tank, which discharges 250 gallons of water at a time. Generally, the floors, bedding, &c., were clean, and appeared to be well kept. Suggestions were made at head quarters, with a view to improving the state of affairs and reducing the number of beds, and I can testify to the good spirit in which they were received and the improvements carried out. They are as follows:— 1. Forty-two beds have been done away with. 2. Top panes have been taken out of the windows for ventilating purposes. 3. Average cubic space now for each person is 220 cubic feet. 4. A new sanitary dustbin has been provided. 5. Water cisterns have been covered. 6. Yard has been re-paved and the walls fresh colored. Drainage and Watek Supply. The following important drainage schemes have been carried out this year under the superintendence of the Vestry. St. Margaret's Parish. 1. HydePark-court—Re-drained at acost exceeding£3,000. 2. Westminster Hospital—Old brick drains existed here. A modern system of drainage has now been carried out. 3. St. Margaret's Schools. 4. James-street Schools. 5. Institute of Civil Engineers. St. John's Parish. 1. Church House, Great Smith-street. 2. Artillery-mansions. 3. Greycoat-mansions. 4. "Lord High Admiral" public-house, Vauxhall-bridge- road, 5. Carriage Factory, 11, Church-street. 6. Ninteen cottages in Garden-street. 7. Stables (Slater & Co.), Millbank-street. Owing to the serious flooding of basements in Rochesterrow, Dorset-street, and Tufton-street, during August and September, a temporary remedy had to be found to try and abate this serious nuisance and prevent its recurrence, if possible. This has been done by fixing screw-down manholecovers and raising the inlets to the drains, and by other works. 20 Relief-sewers alone are the only positive remedy for this state of affairs, but, at least, the works now done will keep the sewage out of the houses and confine it to the back yards when it rises. In several cases the sewage soaked through the floors, and a regular deposit was found underneath same, so that it became a nuisance and dangerous to the health of the occupants of the houses. Water Supply to Newly Erected Houses, &c. In St. Margaret's parish over ninety new water closets and their connections to soil pipes were examined, and thirty-six certificates of proper water supply to houses were given in pursuance of section 48 of Public Health London Act, 1891, and the bye-laws of the London County Council. In St. John's Parish notices were received that the water supply had been discontinued to thirty-three unoccupied houses and premises, and to fifteen occupied houses and premises. The notices received in respect of the fifteen occupied houses and premises were mostly occasioned by the bursting of pipes following the severe frost last winter. Certificates were granted to seventy-nine separately occupied dwellings that the same were provided with a proper water supply. The water of one artesian well was examined by Dr. Dupre and at that time found to be of good quality. During March the Sanitary Committee had under their notice the question as to the amendment of the present regulations made under the Metropolis Water Act, 1871, limiting the discharge of a waste preventing apparatus of a water closet to two gallons of water at each flush, so that the discharge shall not be less than two or more than three and a-half gallons. The Committee decided that the supply secured by the present regulations is sufficient, and they recommended that the Vestry take no action in the matter. Constant Water Supply.—It is proposed by the London County Council to serve a notice on the Chelsea Waterworks Company to give a constant supply of water on and after March 1st, 1896, to a district bounded by a line starting in Victoriastreet—the Sanctuary and Bridge-street to the bank of the Thames, thence along the bank of the Thames to Page-street, along Page-street, Vincent-square, Rochester-row, and Struttonground, to the point in Victoria-street aforesaid. Houses Let in Lodgings. I am glad to be able to report considerable progress this year in the number of houses registered and inspected by Inspector Kirk and Mr. Foster, 27 The Vestry has retained the services of Mr. Foster until June 30th, 1896, when I hope that by that time all the houses let in lodgings in the United Parishes will have been registered. The amount of work which the Bye-laws enforce is very considerable, and the following form of procedure has to be adopted in every case Before a tenement is registered it is necessary— a. To serve a return form upon the landlord of the premises requiring him to furnish a true statement to the Yestry, respecting the number of rooms in the house let as lodgings, the names, numbers, ages, and sexes, of the persons occupying the same, with the amount of rent payable by each lodger. b. The dimensions of each room let as a lodging, must be taken, and the general sanitary condition of the house noted. c. The cubical contents of each room have to be calculated and entered in the register. d. A registration notice must be prepared and served, on which is specified the number of persons who may lawfully occupy by night only and by day and night each room let as a lodging. In addition, a copy of the Bye-laws is served on the landlord of each registered house, which often has to be called for to prevent unnecessary delay. The number of houses which have been registered during the year 1895, with the number of registration notices, return forms and copies of bye-laws which have been served, is:— No. of houses registered 575 Comprising tenements 1,621 Return forms served 575 Registration notices served 729 Copies of bye-laws served 729 The total amount of work which has been done since the bye-laws were enforced is:— St. Margaret's. St. John's. Total Nos. No. of houses registered 127 852 979 No. of rooms registered 508 2,827 3,335 No. of registration notices served 127 852 979 No. of return forms served 127 852 979 No. of copies of bye-laws served 127 852 979 28 The houses in the following streets have been registered under the bye-laws:— St. Margaret's Parish. Parker-street Lewisham-street Vandon-street Horse Shoe-alley Willow-strreet St. Ermin's-hill Willow-place King's Head-court St. John's Parish. Chadwick-street Great Peter-street Romney-street Tufton-street St. Ann's-lane St. Matthew-street Regency street Ponsonby-terrace Ponsonby-place Medway-street Horseferry-road Blue Anchor-court William's-place Carpenter-street Johnson-street Grosvenor-street Monck-street Champion's-alley Wood-street Wood's-place Hide-place Vincent-street Garden-street Little College-street Winchester-terrace Tripp's-buildings Little Tufton-street Laundry-yard Noxious Fumes and Black Smoke. Public Health (London) Act, 1891, Sections 23 and 24. Several complaints have been received of the emanation of noxious fumes from the chimney shaft of Niagara-hall. In April last an "intimation" was served on the secretary of the Company to abate the nuisance, and whilst the place was closed in the summer the chimney shaft was raised much higher, the condenser enclosed, and the boiler-power increased, with the result that, since the re-opening of the hall in November, only slight noxious smells have been occasioned in the neighbourhood, and when complaints have been made, Inspector Dee has not been able to trace them to the works in question. Several cases of the excessive issue of black smoke have occurred in the United Parishes. In only one case in St. Margaret's parish was it necessary to take proceedings, viz., against the proprietors of Queen Anne's-mansions, with the result that they were fined five guineas and five pounds costs. In St. John's parish 16 complaints were made during the year. In most instances the owners of the premises have effected improvements which have prevented a recurrence of the nuisance. Statutory notices were served in two cases only. 29 Bakehouses, Cowsheds, Slaughter-houses, Mews and Stables. In both parishes the above-named premises have been systematically examined. Attention has been given to bakehouses with regard to overcrowding. Licenses were granted by the London County Council to four cowhouses and five slaughter-houses in the United Parishes. In St. John's parish an inspection of various stables disclosed the fact that 21 dung-pits were not in accordance with the bye- laws. In only two cases was it found necessary to proceed against the owners. In one case a fine of £5 and 12s. 6d. costs was imposed, and in the other case a fine of 10s. and 12s. costs. Customs and Inland Revenue Act. Sections 4 of the Acts of 1890 and 1891. Application was made for exemption from inhabited house duty by the owners of Buckingham-chambers, but all the requirements not being entirely carried out, the certificate was not granted. The necessary works being carried out, certificates were granted to the owners of Nos. 2, 16 and 30, Lower Gardenstreet, and 59, Tufton-street. Combined Drainage. It is satisfactory to note that the London County Council, after numerous applications from local authorities on this subject, have decided to apply to Parliament for an amendment of the words "sewer" and "drain" in the Metropolis Local Management Act, by extending the meaning of the word " drain " so as to include any drain the plan of which has not been approved as a sewer under Section 69 of the Act of 1853, and Sections 45 and 48 of the Act, 1862. During the past year the Vestry have had under consideration two cases of alleged combined drainage. In one case the owner of two houses, the drainage of which drained into a single drain which was found to leak badly under the water test, asserted that the defective drain was a sewer and not a drain and therefore repairable by the Vestry. Police court proceedings were eventually taken, and after several adjournments by the magistrate and conclusive evidence on the part of the Vestry, the magistrate decided that it was a drain and not a sewer. The defective condition of the drain being contested by the owner, an authority other than the officer of the Vestry was appointed by the magistrate to examine and 30 report upon the condition of the drain. Upon the report being duly presented it was found that the drain was defective, but the magistrate dismissed the summons. In the second case, the owner of certain premises at which drainage alterations had been made under the Inspector, claimed damages from the Vestry, he asserting that because a rain water pipe from a roof adjoining drained into the drain of his house, that the latter became a sewer, and therefore, repairable by the Vestry. The Vestry repudiated all liability. Undergeound Rooms. Eleven cases of illegal occupation of underground rooms occurred in St. Margaret's Parish. The question of the occupation of several underground rooms (nine) at James-street Mansions has occupied the attention of the Sanitary Committee on more than one occasion. The rooms mentioned do not conform with Sec. 96, Public Health (London) Act, 1891, and the Vestry has refused to allow such rooms to be occupied as dwelling houses until certain works have been carried out. In St. John's Parish 15 cases of illegal occupation of underground rooms were investigated during the year. In only one case (Medway-street) was it found necessary to take proceedings. The offender was fined £12 and 37s. 6d. costs. Legal Peoceedings. The following summonses have been taken out during the year 1895, by order of the Vestry:— St. Margaret's Parish. Inspector Dee. Seventeen summonses have been taken out during the year, seven were decided in favour of the Vestry, with a total in fines and costs recovered of £14 7s. 6d. One case was dismissed, upon a decision that the person summoned was not technically the owner. The other nine cases were adjourned sine die, but will be brought before the magistrate again, almost immediately. They refer to the underground rooms at Jamesstreet-mansions. St. John's Parish. Inspector McNair. 3, New-street, defective and combined drain. The magistrate, Mr. Shiel, caused the drain to be examined by Mr. Large, district surveyor for St. George, Hanoversquare, who certified same to leak to the extent of 7 gallons in 10 minutes. The magistrate, however, dismissed the case against the Vestry. 31 50, Tufton-street, defective w.c. and dirty premises. Fine of sixpence imposed and twenty-five shillings costs. 5 and 6, Laundry-yard, insanitary dwellings. Closing order made and 14s. 6d. cost. 15 and 17, Medway-street, three illegally occupied underground rooms. Fine of £12 and 37s. 6d. costs. 105, Regency-street, improper dung receptacle. Fine of £5 and 12s. 6d. costs imposed. 7, Bessborough-mews, improper dung receptacle. Fine of 10s. and 12s. 6d. costs. 1, 2, 3 and 4, Bull's Head-court, insanitary dwellings. "Closing Order" made and £3 cost. 21, Strutton-ground, goods projecting an footway. No fine imposed in this ease, defendant promising not to offend again; £1 1s. costs. St. Margaret's and St. John's, Parishes. Inspector Kirk. Twenty-six summonses were taken out by order of the Sanitary Committee during the year—twenty-one of which were under the Sale of Food and Drugs Acts, two under the Margarine Act, and three under the Housing of the Working Classes Act, with the result, that £15 as fines, and £18 16s. costs were recovered under the Sale of Food and Drugs Act, £4 as fines and £1 5s. costs under the Margarine Act, and £2 8s. costs under the Housing of the Working Classes Act, making a total of £49 as fines, and £22 9s. costs recovered. Sale of Food and Drugs Act. In only one instance was there any difficulty in serving a defendant with a summons; he having given a false name, and at the time of the issue of the summons had sold his business. He was, however, recognized in Marsham-street, and was followed to a shop in that street, which he was about to open. He was then watched and followed up Great Peter-street, where the Warrant Officer served him with the summons. The defendant, however, denied that he was the man in fault. On the first hearing of the case he failed to appear, and the hearing was adjourned for a week. In the meantime he had disappeared from Marsham-street and had left a manager in the shop who represented himself to be the proprietor. A letter from the solicitor, addressed to the defendant was given to this man, informing him that if he did not appear on the second hearing a warrant would be issued for his arrest. At the second hearing, however, he appeared and accepted the service of the summons, and was fined £10, and bad to pay £5 5s. costs. 32 Inspector Dee's Report of the Sanitary Work completed in the Parish of St. Margaret for the Year 1895. Inspections made 1,273 Defects found 1,431 Notices served 763 Works completed 775 Notices outstanding, 1894 61 Notices uncomplied, 1895 49 Details of defects found under headings as in Report Book:— W.C. supplied from drinking water cistern 13 W.C. without water supply 45 W.C. dirty, defective or not ventilated 255 New cisterns 7 Cisterns without covers and foul 6 Waste-pipe from sink into drains 4:8 Water apparatus defective 68 Dust bins defective, or new one required 28 Rooms dirty 102 Passages or staircase dirty 18 Rooms overcrowded 32 Houses or rooms requiring disinfection 133 Underground rooms illegally occupied 11 Drains stopped 65 Defective brick or pipe drains 123 Defective traps to drains 240 Yard paving defective 12 Walls of yards or wash-houses to be lime-whited 7 Stables or cowsheds dirty or defective in respect of drainage 2 Accumulation of refuse 45 Bakehouses dirty 1 Miscellaneous 170 1431 Inspector McNair's Report of the Sanitary Work completed in St. John's Parish for the year 1895. Number of premises inspected 1,308 „ intimations, notices, &c., served 844 ,, houses, &c.,in which works are completed 864 ,, defects found 1,828 ,, notices, &c., outstanding, 1894 84 ,, notices, &c., uncomplied, 1895 76 33 Written intimations, notices, &c., served in relation to the above-mentioned matters:— W.C.'s flushed from drinking water cisterns 51 W.C.'s without water supply (defective apparatus) 93 W.C.'s dirty, defective, or not ventilated 171 New cisterns required 148 Cisterns without proper covers 66 Cisterns in foul state 25 Cistern overflow pipes into drains 7 Waste-pipes from sinks into drains 99 Water fittings defective Ill Dust bins defective, or new required 109 Rooms dirty 106 Passages and staircases dirty 84 Rooms overcrowded 31 Houses and rooms disinfected 219 Underground rooms illegally occupied 15 Drains choked 49 Defective brick or pipe drains 122 Do. traps to drains 172 Yard paving defective 35 Walls of yards or wash-houses lime-whited 28 Accumulations of refuse removed 32 Bakehouse requiring to be lime-whited 10 Miscellaneous 45 Total 1,828 Number of houses inspected on the occurrence of infectious disease therein 219 Number of same found defective 87 Inspector Kirk's Refort for the Year 1895. (See also details, on pages 26 and 27, of work done by Mr. Foster and himself in respect of Houses Let in Lodgings.) Notices under the bye-laws have been served to remedy the following Sanitary defects:— Water-closets without a supply of water 19 Water apparatus defective 2 Dilapidated receptacles for dust 3 Dirty condition of walls and ceilings of rooms 832 Dirty condition of walls and ceilings of staircases and passages 148 Overcrowded condition of rooms 10 Drains stopped 5 Defective drains 5 Defective traps to drains 17 34 Yard paving defective 3 Dirty condition of walls of yard 125 Accumulation of refuse 11 Damp condition of rooms 2 Defective roofs 2 1,184 Public Health (London) Act, 1891. Secs. 1, 3 and 4. In addition, ninety-nine Inspections have been made under section 1, and sixty four Intimations and Notices, where necessary, have been served under sections 3 and 4, requiring the abatement of the following nuisances:— Rain-water pipes communicating directly with drain 14 Water-closets without water supply 7 W.C.'s defective and unventilated 3 Cisterns without covers 1 Cisterns in a dirty condition 2 Waste-pipe from sinks communicating directly with drain 1 Water apparatus defective 2 Dust-bins defective or new ones required 10 Rooms dirty 50 Passages and staircases dirty 8 Rooms over-crowded 2 Drains stopped 3 Defective drains 25 Defective traps to drain 98 Yard-paving defective 1 Dirty walls of yard 2 Accumulation of refuse 1 Defective dung pit 1 Soil-pipes and drains not ventilated 28 Defective roofs 6 Old lead, D traps, and pan closets defective 2 Dilapidated flooring 1 268 I have the honour to be, My Lords and Gentlemen, Your obedient Servant, JOHN NORTON, Town Hall, Medical Officer of Health Caxton Street, Westminster. January 21st, 1896.