WES 4 ANNUAL EBPOET upon the Public Health & Sanitary Condition of the UNITED PARISHES of St. Margaret and St. 3obnt Westminster, FOR THE YEAR 1899, 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 ROYAL INSTITUTE OF PUBLIC HEALTH. WIGHTMAN & Co. Limited, The Old Westminster Press, Regency Street, S.W. 1900 INDEX. PAGE Acts and Orders, new 24-29 Bakehouses, cowhouses, milk shops, etc 35, 36 Births and deaths 5 Black smoke, etc. 31 Common lodging houses 33 Coroner's Court, Mortuary and disinfection 38 Customs and Inland Revenue Act 33 Deaths, Distribution of 6 Deaths, Tabulated statement of—St. Margaret 8 „ ,, „ St. John 10 Factories and Workshops 32 Food preservation 29 Houses let in lodgings 33 Housing of the Working Classes Act 33 Infectious disease charts 22-3 ,, diseases classified in streets 21-22 „ ,, Remarks on 17-20 „ ,, Tabular statement of 12 Inspectors—Reports of 42-44 Legal proceedings 40-41 Meteorology 3-4 Metropolitan Water Supply 32 Millbank Estate 34 New Buildings 34 Sale of Food and Drugs Act; Margarine Act; Unsound food 24, 34, 37 Scarlet Fever, re "return" cases of 17 Tubercular, &c., diseases. Comparative statement of deaths from 14-16 Tuberculosis and milk supply 20 Vaccinations 23 Water Supply, complaints as to 35 ,, to newly erected houses 36 ANNUAL REPORT upon the public health & sanitary condition of the UNITED PARISHES of iltargarft antr loljit, TiStjstmntstfr, For the Year 1899, By JOHN NORTON, M.D., D.P.H., Medical Officer of Health, Member of the Royal College, of Surgeons of England; Fellmc of the Incorporated Society of Medical Officers of Health; Fellow of the Royal 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 1899. METEOROLOGICAL SUMMARY. First Quarter. The mean reading of the barometer was 29.766 inches; the mean temperature of the air 41.8°. The amount of rain measured during the quarter was 5.07 inches, and the amount of bright sunshine recorded was 289.4 hours. The weather was mild from the beginning of the quarter until 23rd January, the temperature on eight days during this period ranging from 10.2° to 14.3° above the average. Colder weather prevailed from 24th January until 6th February, after 4 which a remarkably warm period set in, the temperature being 18-8° above the average on one day, and between 11-1° and 13*9° above the average on four other days. It was again cold from 24th February until 7th March, mild from 8th to 15th March, then cold until 25th March, particularly during the last five days of the period. On 26th March a sudden change occurred to mild weather, which continued until the end of the quarter. Second Quarter. The mean reading of the barometer was 29 796 inches; the mean temperature of the air was 52.8°; the rainfall was 5.41 inches, and the amount of bright sunshine recorded during the quarter was 549.6 hours. In April the weather was wet and dull, with very little sunshine; westerly winds were prevalent, and the fall of rain exceeded the average. In May it was generally cold and dull; on the 25th, 26th and 27th respectively, the temperature fell to 10.6°, 12.1° and 10.7° below the average. In June it was for the most part fine and bright with little rain; the temperature varied considerably, being 11.4° above the average on the 2nd, and 9-4° below the average on the 14th of the month. Thibd Quarter. The mean reading of the barometer during this quarter was 29.836 inches; the mean temperature of the air was 63.0°; the rainfall measured 4.32 inches; and the duration of bright sunshine recorded was 676.0 hours. The weather from the beginning of the quarter until 9th September was generally fine, bright, and warm; three remarkably hot periods occurred, extending from 6th to 22nd July, from 29th July to 27th August, and from 3rd to 8th September respectively. From 10th September until the end of the quarter, there was frequent rain, the amount at several stations being exceptionally heavy, but the temperature was above its average, except on 10th, 11th, 20th, 21st, and from 27th to 30th of the month. Fourth Quarter. During this quarter the mean reading of the barometer was 29'88 inches; the mean temperature of the air was 44.7°; the 5 rainfall measured 7.54 inches, and the duration of bright sunshine registered was 192.5 hours. The weather during the quarter was on the whole dull. The temperature was generally below its average until 23rd October, then above its average until 17th November, below from 18th to 21st November, and again above until 7th December; on 8th December a cold period set in, with several very low readings, and this lasted until nearly the end of the quarter. Bibths and Deaths. The number of births registered during the year 1899, was 1,114, showing a birth-rate of 20.0 per 1,000 of the population. 259 births occurred in St. Margaret's parish, of which 130 were males and 129 females, giving a birth-rate of 12.1 per 1,000; and 855 births in St. John's parish, of which 436 were males and 419 females, giving a birth-rate of 24.9. The number of deaths of parishioners duly corrected amounted to 1,174, showing a recorded death-rate of 21.1, and a corrected death-rate of 23.8 per 1,000 of the population. Of these deaths 367 occurred in St. Margaret's parish, and 807 in St. John's parish. The following comparative table shows the birth and death rates per 1,000 during the past seven years for the United Parishes, viz.:— Yeah. 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 1896 21.9 17.7 21.1 1897 22.2 18.0 20.3 1898 19.6 19.7 22.2 1899 200 21.1 23.8 6 Table I., giving the death-rates from certain classes of disease in the district:— Years. Whole District. St. Margaret's. St. John's. 1. Chief Zymotic diseases 1894 2.1 1.5 2.4 1895 1.7 1.0 2.1 1896 2.0 1.8 2.5 1897 2.1 0.9 2.9 1898 2.7 1.5 3.4 1899 1.4 0.7 1.8 2. Phthisis 1894 2.3 2.3 2.4 1895 2.0 1.6 2.2 1896 2.1 1.8 2.3 1897 2.5 2.1 2.7 1898 2.3 2.1 2.5 1899 3.1 1.8 3.8 3. Pulmonary diseases, including Bronchitis, Pneumonia and Pleurisy 1894 4.7 4.6 4.5 1895 5.6 5.3 5.7 1896 3.7 3.2 3.9 1897 2.9 2.8 3.0 1898 2.1 3.5 3.9 1899 4.5 4.6 4.2 The following table gives the distribution of the deaths of parishioners dying in various institutions and elsewhere, all of which are included in the mortality statistics:— Institutions. Deaths Institutions. DeathS Westminster Hospital 195 Asylum—Central London Sick 1 Station ,, 19 St. George's Infirmary 300 Asylum—Bethnal 1 Convent 1 H.M. Prison, Wormwood Scrubbs 1 St. George's Hospital 24 Charing Cross „ 4 Hospital for Women, Soho 1 Brompton ,, 6 Seymour - street Somers- St. Thomas's „ 9 town 1 South-Western Fever Hospital 1 Welbeck-street 1 Royal Free Hospital 1 Western Fever Hospital 9 Children's Hospital, Paddington 1 North-Western „ „ 1 Grove „ „ 2 All Saints' Home, St. Bartholomew's „ 1 garet-street 1 Chelsea Workhouse 2 General Lying-in Hospital 1 St. George's Workhouse 4 Wellington Barracks 1 Grosvenor Hospital 1 St. George's Home 1 Belgrave ,, 7 Guy's Hospital 1 Middlesex 1 British Lying-in Hospital 1 Friedenheim 1 University College Hospital 1 Hostel of God 3 Sydenham Hill 1 Asylum—Caterham 4 London Temperance Hospital 1 „ Colney Hatch 1 „ Hanwell 3 River Thames 3 „ Hoxton House 1 Elsewhere 5 ,, Cleveland-street 1 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. 1896. 1897. 1898. 1899. Deaths (Total) 1297 1290 1006 1154 987 1005 1093 1174 Small Pox — — — — — — — — Measles 77 5 37 23 17 23 48 17 Scarlet Fever 18 25 8 9 10 14 6 5 Diphtheria & Membranous Croup 44 14 22 15 22 20 20 11 Whooping Cough 20 15 19 13 28 13 37 5 Typhus — — — — -— — — — Enteric Fever a 7 4 3 10 5 10 9 Simple & ill-defined Fever — 1 — — — — — — Diarrhoea 22 43 11 27 28 40 26 30 Deaths of infants under one year of age 233 255 180 246 209 200 198 229 Deaths under one year to every 1,000 births registered 169 188 147 192 171 161 182 205 8 9 (A1) Table III—DEATHS during the year 1899 in the Metropolitan Sanitary District of St. Margaret, 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. At all Ages. Under 1 1—5. 5—15. 15-25. 25—65. 65 & upwards. Ages. 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. Typhus. Fevers Cholera. Erysipelas. Measles. Whooping Cough. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia and Pleurisy. Heart Disease. Injuries. All other Diseases. Total. Enteric (or Typhoid.) Continued. Relapsing. Puerperal. Westminster Hospital 195 20 27 11 15 111 11 Under 5 ... ... 2 ... ... 1 ... ... ... ... 1 1 1 1 ... ... 1 17 ... 3 19 47 5 upwds. ... ... 1 ... ... 6 ... ... ... ... ... ... ... ... ... ... 8 18 19 12 84 148 Convent 1 ... 1 ... ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 5 upwds. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rest of Parish 184 34 14 4 7 77 48 ... ... ... ... ... ... ... ... ... ... ... 1 1 6 ... ... ... 8 ... ... 32 48 5 upwds. ... ... ... ... ... 1 ... ... ... ... 1 ... ... 1 ... ... 12 26 29 6 60 136 Net Total 367 39 27 7 12 160 122 ... 1 1 ... ... ... ... ... ... ... ... 2 2 6 ... ... 1 10 ... ... 43 66 5 upwds. ... 1 ... ... ... 2 ... ... ... ... 1 ... ... 1 ... ... 39 66 44 7 140 301 The subjoined numbers have also to be taken into account in judging of the above records of Mortality. Parishioners dying outside parish 171 5 11 3 5 73 74 Under 5 ... 1 1 ... ... ... ... ... ... ... ... 1 1 ... ... ... 1 2 ... ... 9 16 5 upwds. ... 1 ... ... ... I 1 ... ... ... ... ... ... ... ... ... ... 26 39 15 1 72 155 Strangers dying in parish 184 20 26 11 15 101 11 Under 5 ... ... 2 ... ... 1 ... ... ... ... 1 1 1 1 ... ... 1 17 ... 3 18 46 5 upwds. ... ... 1 ... ... 6 ... ... ... ... ... ... ... ... ... ... 7 17 19 12 76 138 10 11 (A2) Table IV—DEATHS during the year 1899, in the Metropolitan Sanitary District of St. John, Westminster, classified according to Diseases, Ages, and Localities. Localities. st. john. Mortality from all causes, at subjoined Ages. Ages. Mortality from subjoined causes, distinguishing deaths of Children under Five. At all ages. Under 1. 1—5. o—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. Typhus. JPEVERS. Cholera. Erysipelas. Measles. Whooping Coueh. Diarrhoea and Dysentery. Rheumatic Fever. Ague. Phthisis. Bronchitis, Pneumonia: and Plfliiriav Heart Disease. Injuries. All other Diseases. Total. Enteric (or Typhoid). Continued. Relapsing. Puerperal. Grosvenor Hospital 1 ... ... ... ... 1 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 1 1 Station Hospital 19 ... ... ... 10 9 ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... 3 ... ... ... ... ... ... ... ... 1 ... 5 6 1 3 9 Kest of Parish 508 172 40 13 23 176 84 Under 5 ... ... ... 1 ... ... ... ... ... ... ... 13 3 21 ... ... 3 32 10 9 120 212 5 upwds ... ... ... 6 ... ... 1 ... ... ... ... ... 1 ... 1 ... ... 53 76 41 13 110 296 Net Total ... 807 190 58 22 47 351 139 Under 5 I 1 ... ... ... ... ... ... 1 13 3 22 ... ... 3 40 10 1 2 136 5 upwds 3 ... ... 7 ... ... ... ... 1 2 ... 1 1 ... 130 118 58 30 206 559 The subjoined numbers have also to be taken into account in judging of the above records of Mortality Parishioners dying outside parish 279 18 18 9 14 165 55 Under 5 ... 1 0 ... ... ... ... ... ... ... 1 ... ... ... ... ... ... 8 ... 3 16 36 5 upwds ... 2 3 ... ... ... 3 ... ... ... ... 1 1 ... ... ... ... 72 36 17 16 92 43 Strangers dying in parish. ... ... ... ... ... ... ... Under 5 ... ... ... ... ...! ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwds ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 12 13 (B) TABLE OF POPULATION, BIRTHS, AND OF NEW CASES OF INFECTIOUS SICKNESS, coming to the knowledge of the Medical Officer of Health, during the year 1899, in the Sanitary Districts 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. 1 2 3 4 5 6 7 8 9 10 11 1 2 3 4 5 6 7 8 9 10 11 Census 1891. Estimated to middle of 1899. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Fevers. Fevers. Cholera. Erysipelas. Totals. Smallpox. Scarlatina. Diphtheria. Membranous Croup. Typhus. Fevers. Puerperal. Cholera. Erysipelas. Totals. Typhus. Enteric (or Typhoid). Continued. Relapsing. Puerperal. Enteric (or Typhoid). Continued. Relapsing. (a) (b) (c) (d) (e) ST. MARGARET. Westminster Hospital ... ... ... Under 5 ... 1 ... ... ... ... ... ... ... ... ... 1 ... 1 ... ... ... ... ... ... ... ... ... 1 5 upwards ... 1 ... ... ... ... ... ... ... ... 1 2 ... 1 ... ... ... ... ... ... ... ... i 2 Convent ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rest of Parish ... ... ... Under 5 ... 14 3 ... ... 1 ... ... ... ... ... 18 ... 13 3 ... ... 1 ... ... ... ... ... 17 5 upwards 57 21 ... ... 22 ... ... ... ... 11 111 ... 48 19 ... ... 16 ... ... ... ... 2 85 Total 21,433 21,506 259 Under 5 ... 15 3 ... ... 1 ... ... ... ... ... 19 ... 14 3 ... ... 1 ... ... ... ... ... 18 5 upwards ... 58 21 ... ... 22 ... ... ... ... 12 113 ... 49 19 ... ... 16 ... ... ... ... 3 87 ST. JOHN. Grosvenor Hospital ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Station Hospital ... ... ... Under 5 ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 5 upwards ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Rest of Parish ... ... ... Under 5 ... 35 30 ... ... ... ... ... ... ... 6 71 ... 35 30 ... ... ... ... ... ... ... 1 66 5 upwards ... 93 45 ... ... 21 1 ... ... ... 35 195 ... 88 44 ... 18 1 ... ... ... 14 165 Totals 34 106 30,611 855 Under 5 ... 35 30 ... ... ... ... ... ... ... 6 71 ... 35 30 ... ... ... ... ... ... ... 1 66 5 upwards ... 93 45 ... ... 21 1 ... ... ... 35 195 ... 88 44 ... ... 18 1 ... ... ... 14 165 "Notification of Infectious Disease" has been compulsory in the District since i October 31st, 1889. The Isolation Hospitals are the Hospitals of the Metropolitan Asylums Board, and occasionally the London j 1* ever Hospital and the London Small-Pox Hospital. 14 Table V.—Comparative statement of deaths from Tubercular and other Zymotic diseases, with age incidence, death rates, &c. 1897. (Age.) Tubercular Diseases. Meningitis. Peritonitis. Bones. Totals. Small-pox, Scarlet Fever, Diphtheria and Enteric Fever (Notifiable). Measles and Whooping Cough (Non-Notiflable). Totals. Deaths from all causes. Lungs. General. Tabes Mesenterica. Under 5 l 6 8 16 l — 32 19 36 55 — 5 &under15 — 2 — 4 — l 7 12 — 12 — 15 to 45 138 1 — 1 2 2 144 8 — 8 Totals 139 9 8 21 3 3 183 39 36 75 1,005 Total Death Rates 3.2 per 1,000 of the population. 1.3 per 1,000 of the population. 18.0 per 1,000 of the population. 15 1898. (Age.) Tubercular Diseases. Meningitis. Peritonitis. Bones. Totals. Small-pox, Scarlet Fever, Diphtheria and Enteric Fever (Notifiable). Measles and Whooping Cough (Non-Notifiable). Totals. Deaths from all causes. Lungs. General. Tabes Mesenterica. Under 5 3 11 3 18 3 1 39 19 80 99 — 5 & under15 — 5 — 5 — 4 14 5 5 10 — 15 to 15 120 4 — 4 2 — 130 12 - 12 — Totals 123 20 3 27 5 5 183 36 85 121 1,093 Total Death Rates 3.2 per 1,000 of the population. 2.1 per 1,000 of the population. 19.7 per 1,000 of the population. 16 1899. (Age.) Tubercular Diseases. Meningitis. Peritonitis. Bones. Totals. Small-pox, Scarlet Fever, Diphtheria and Enteric Fever (Notifiable). Measles and Whooping Cough (Non-Notifiable). Totals. Deaths from all causes. Lungs. General. Tabes Mesenterica. Under 5 4 2 4 15 — — 25 10 20 30 — 5 & under 15 — — 1 2 — 2 5 2 2 4 — 15 to 45 132 4 — 4 3 3 146 13 — 13 - Totals 136 6 5 21 3 5 176 25 22 47 1,174 Total Death Rates 3.l per 1,000 of the population. 0.8 per 1,000 of the population. 21.1 per 1 000 of the population. 17 Note.—During 1899 eighteen deaths were registered as having occurred from "Marasmus," in every case the child being under two years of age. It will also be noted that during the last three years no deaths specially attributed to tubercular disease of the lungs have occurred in the age period from five to fifteen. Remarks on Infectious Diseases. Smallpox—(See Table II.) Not a single case was notified in the United Parishes during the year 1899. Scarlet Fever. Five deaths occurred from this disease during the year, compared with six in 1898, and 201 cases were notified. "Return " Cases of Scarlet Fever. Several return cases of Scarlet Fever have occurred during the past year. That is, after a child has been discharged from hospital as cured, upon its return home, other children in the house have become infected. Each return case was fully enquired into, and in no case could the medical officer of the hospital account for the occurrence, since the examination of the patients for all seats of recognisable infection before leaving the hospital had entirely negative results. The Medical Officer of Health for Wigan has had the following handbill printed and given to the parent or guardian when a child returns home; but I am afraid that in London, where space is so valuable, it would be rather difficult to carry out Clauses 1 and 5 precautions to be used. 1. To have a separate bed from other children, and, if possible, a bedroom in which other children of the family do not sleep, for two weeks after returning home. 2. The recovered person should not be allowed to foudle, nurse, or kiss other children of the family for a period of two weeks. B 18 3. Quiet exercise in the open air for a period of two weeks in the country, avoiding other children, is beneficial. 4. No school, church, or public entertainment should be attended for a period of three weeks after discharge. 5. No general mixing with other children of the family or other playmates should be allowed till a full fortnight has elapsed after the discharge of the patient from the sanatorium. 6. The medical superintendent does not guarantee that the patient is free from infection when discharged as cured. Therefore the Corporation does not accept any responsibility in any fresh case or cases arising in the household after the return of the convalescent patient. 7. It is essential that great care be exercised in not allowing a convalescent patient after scarlet fever to mix freely with others till a fortnight has elapsed after the return home of the patient. 8. The use of a disinfectant soap such as carbolic soap, for washing the patient is desirable. Diphtheria Eleven deaths occurred from this disease during the year compared with 20 in 1898; and 99 cases were notified. Three cases occurring in a large establishment were the subject of enquiry during the month of March, but owing to strict precautions being taken there was no further spread of the disease. It is worthy of note that this year about 15 per cent, of the cases of both Scarlet Fever and Diphtheria occurred in Government Buildings, also that at the Guards' Industrial Home, Francis-street, four cases of Diphtheria occurred, otherwise there was no special incidence of either of the above-named diseases. The drains at the Industrial Home were found to leak, and were afterwards entirely reconstructed. A list of the streets with the number of cases of the principal infectious diseases occurring in such streets is given on pages 21 and 22. 19 Mumps.—During the early part of December an outbreak of mumps occurred in the Infants' Department of the Horseferry Road Board School. No less than 19 cases were reported to me. The department was closed, and the rooms were thoroughly disinfected. Influenza.—This disease was chiefly prevalent in the months of January, February, March, and December. Twenty-two deaths were registered from this disease during the year 1899. Diarrhoea.—This disease was responsible for 30 deaths, 28 of which occurred amongst young children under five years of age. As usual, most of the cases occurred during the months of June, July and August. Enteric or Typhoid Fever.—Nine deaths occurred during the year compared with 10 in 1898, and 44 cases were notified. Tiiree of the deaths occurred at the Guards' Hospitals, and the disease in these instances was no doubt imported into Westminster from Egypt. Measles.—Seventeen deaths occurred from this disease during the year. Measles was very prevalent amongst the children attending the St. James-the-Less school, Upper Garden-street, and the Holy Trinity school, Vauxhall-bridge-road. On enquiry being made at the above schools, it was found that 111 scholars were absent on account of Measles; 42 of the scholars were resident in St. George's Parish, and notice thereof was accordingly given to the medical officer of health of that district. The schools were fumigated and cleansed, and in several cases the houses of the patients were fumigated. Directions were given to the head teachers, and also to the parents of the patients, that no child was to return to school under 21 days following its recovery, and that the children attending school were to be strictly watched, and any suspicious case to be immediately excluded from the school. Whooping Couyh.—Five deaths occurred from this disease. B 2 20 Erysipelas. — Fifty-three cases were notified and three deaths occurred from this disease during the year. The Spread of Tuberculosis by Milk. The Public Health Committee considered a letter from the Hackney Vestry, forwarding for information particulars of the result of a bacteriological examination of 100 samples of milk for the presence of tubercle bacilli, suggesting that strong representations should be made on the subject to the heads of several of the Government departments, and that a circular, advising that all milk be boiled before use, be circulated amongst the inhabitants of the district. The Committee informed the Hackney Vestry that representations, similar to those suggested, had already been made by this Vestry, and they directed that a circular be prepared by the medical officer of health and circulated by post to every householder in the parish. The following circular was accordingly issued to every householder in the parish :— Suggestions as to the Use and Storage of Milk. Several dangerous infectious diseases, such for example as Typhoid Fever, Scarlet Fever, and Consumption, besides Diarrhoea and other disorders of the stomach and intestines, are frequently conveyed by milk, either of itself, or through the conditions of the utensils in which it is conveyed. These risks to health may be avoided by simply well boiling the milk immediately it is received into the house. Care should be taken to let the milk cool from the boiling in a covered non-metallic receptacle, which should be placed where pure air is freely admitted. On no account should milk be placed in damp ill-ventilated cupboards. With regard to the cleansing of milk utensils, I would advise that they be first rinsed out with cold water, and then that a small piece of soda be dissolved in boiling water and the utensils thoroughly scalded. Boiled milk should not be given to infants without being diluted with water varying in proportion to the age and strength of the infant, as may be advised by the family medical practitioner. 21 A list of the streets with the number of eases 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 — 1 Alexander-buildings 1 — — Ambroslen-avenue — 1 — Arthur-street 3 1 — Ashley-gardens 1 — 1 Buckingham-cottages 4 — — Carlisle-place 1 — — Carteret-street — 1 Castle-buildings 3 1 1 Catherine-street 7 1 — Cobourg-row 2 3 — College-mews — — 1 Dartmouth-street 1 — 1 Dean's-yard 1 1 Ennismore-gardens 1 — 1 Ennisinore-gardens-mews 2 — — Francis-street 5 — Great Chapel-street — — 1 Hill-street 1 — — Hyde Park-court 1 — — James-street 1 — — Kensington High-street — 1 — Kensington Palace-gardens 1 — — Lancelot-place - — 1 Lewish am-street — 2 3 Lowndes-terrace 2 — Montpelier-place 2 — — Montpelier-square 3 — — Palace-street — 1 — Parker-street 2 — — Peabody-buildings, James-street 7 — 1 Princes-gate 2 — — Princes-street — — 1 Queen Anne's-gate — — 1 Raphael-street 1 — — Rutland-gate 3 — 1 St. Ermin's-mansions — — 1 Soldier's-barracks 9 2 — Trevor-place 1 — 1 Trevor-square 1 — — Van don-street 3 — — Vaux hall-bridge-road 2 — 2 Victoria-street 2 1 Westminster Hospital 2 — 1 Whitehall 1 — — Willow-street 3 — York-street — 1 — 22 St. John's Parish. STREET OR PLACE. Scarlet Fever. Diphtheria. Typhoid Fever Artillery-row 1 - Barton-street 3 - — Bell-street 2 1 Bessborough-gradens - 1 Bessborough-place 2 1 2 Bessborough-street 1 1 chadwick-street 1 1 1 cobourg-row - 3 1 Carpenter-street 8 1 causton-street - - 1 Charl wood-street - - Dorset-place 1 2 Dorset-street 1 - Earl-street - 1 Frederick-street - - 1 Fyne-street 1 - Garden-street 1 4 Great Peter-street - 3 2 Great Smith-street 2 - Greycoat-place — — 1 Grosvenor-road 1 1 — Grub-street 1 1 — Hide-place 1 1 — Horseferry-road - 4 — Hugh-place 1 - Johnson-street 1 Laundry-street - 1 Lillington-street 8 6 1 Little College-street 2 - Marsham-street 2 - Millbank-street 3 1 Monck-street 5 3 New-street - 1 _ North-street 1 old Pye-street - 1 Page-street 3 2 Peabody-buildings 22 6 4 Ponsonby-place 2 - 1 Ponsonby-terrace 2 - Purbeck-place 2 - Regency-street 2 1 1 Rochester-row Roehampton-street 1 1 — - — - Romney-street 6 1 St. John-street 1 2 - St. Matthew-street 2 Smith-square 6 5 Strutton-ground - - 1 Tachbook-street 1 - Trinity-mews 1 _ Tufton-street 4 5 1 Upper Garden-street 7 1 Vauxhall-bridge-road 8 4 Victoria-street 1 1 Vincent-squre 1 - Warwick- street 1 - Wood-street 4 3 1 Chart Shewing Week by Week the Number of Cases of Scarlet Fever Diphtheria and Enteric Fever Notified by Medical Practitioners as having occurred in the Sanitary District of St. Margaret, Westminster, during the year 1899. Chart Shewing Week by Week the Number of Cases of Scarlet Fever Diphtheria and Enteric Fever Notified by Medical Practitioners as having occurred in the Sanitary District of St. John the Evangelist, Westminster, during the year 1899. 23 The following vaccinations have taken place in the united parishes during the year 1899:— Primary Vaccinations. Re-Vaccinations by Public Vaccinator. Conscientious Objectors. Public Vaccinator. Private Practitioners. Total. 551 329 880 2 4 In the new vaccination return for the half-year ended June 30th, 1899, the total primary vaccinations throughout England were no fewer than 355,987 as compared with 278 588 in the corresponding half-year of 1898. This is equal to an increase of 27.78 per cent. Speaking at a recent dinner of the Association of Public Vaccinators, Mr. Chaplin said he was bound to admit that during the hot weather the lymph became inefficient when removed from cold storage and brought into the warmth. Abroad, the same difficulty had occurred, so that foreign vaccinators had suspended vaccination during the summer. With regard to the Vaccination Act of 1898, he stated that the passing of the Bill had had results which every one who favoured vaccination must regard as very satisfactory. He attributed the good working of the Act mainly to three things, viz.:— (1) Firstly, to the efficiency, tact and judgment with which the public vaccinators had performed their duties. (2) Secondly, to the fact that glycerinated calf-lymph from healthy calves was now only used, which made people less apprehensive. (3) Thirdly and chiefly, that it was the duty of the vaccination officer, when the guardians were opposed to vaccination, to act without their authority. He believed the Act of 1898 was proving a very distinct and a very considerable success; and that, happily, even the admission of the conscientious objector had been powerless to spoil it. 24 New Acts and Orders of 1899. With the exception of the London Government Act and the Sale of Food and Drugs Act, the actual legislation of the past year, so far as sanitary administration and local government are concerned, has not been of far-reaching importance. The following is a list of the Acts of the year 1899, which either wholly or in part relate to local government and sanitary administration:— Local Government Act. Metropolis Management Acts Amendment (Bye-laws) Act. Metropolis Water Act. Sale of Food and Drugs Act. Infectious Disease (Notification) Extension Act. Small Dwellings Acquisition Act. Baths and Wash-houses Act. Commons Act. Electric Lighting (Clauses) Act. Parish Councillors (Tenure of Office) Act. Tithe Rent-charge (Rates) Act. Telegraph Act. Expiring Laws Continuance Act. Sale of Food and Drugs Act, 1899. [62 & 63 Vict., Ch. 51.] The following summary will indicate briefly the main provisions of the new Act:— Section 1 provides that if there is imported into the United Kingdom any of the following articles, namely:— (a) Margarine or margarine-cheese, except in packages conspicuously marked "Margarine" or "Margarine cheese," as the case may require; or (b) adulterated or impoverished butter (other than garine) or adulterated or impoverished milk or cream, except in packages or cans conspicuously marked with a name or description indicating that the butter or milk or cream has been so treated; or 25 (c) condensed, separated, or skimmed milk, except in tins or other receptacles which bear a label whereon the words "Machine-skimmed Milk" or "Skimmed Milk," as the case may require, are printed in large and legible type ; or (d) any adulterated or impoverished article of food to which Her Majesty may by Order in Council direct that this section shall be applied, unless the same be imported in packages or receptacles conspicuously marked with a name or description indicating that the article has been so treated; the importer shall be liable, on summary conviction, for the first offence to a fine not exceeding twenty pounds, for the second offence to a fine not exceeding fifty pounds, and for any subsequent offence to a fine not exceeding one hundred pounds. Prosecutions under this Section are to be undertaken by the Commissioners of Customs, who are empowered to take such samples of consignments of imported articles of food as may be necessary for the enforcement of the foregoing provisions. When the Commissioners of Customs thus take a sample of a consignment they are to divide it into not less than three parts, and send one part to the principal chemist of the Government laboratories for analysis. For the purposes of this section, an article of food shall be deemed to be adulterated or impoverished if it has been mixed with any other substance, or if any part of it has been abstracted so as in either case to affect injuriously its quality, substance, or nature. But an article of food shall not be deemed to be adulterated by reason only of the addition of any preservative or colouring matter of such a nature and in such quantity as not to render the article injurious to health. Section 2 empowers the Local Government Board, in relation to any matter appearing to that Board to affect the general interest of the consumer, and the Board of Agriculture, in relation to any matter appearing to that Board to affect the general interests of agriculture in the United Kingdom, to direct an officer to procure for analysis samples of any article of food, and thereupon the officer shall have all the powers of procuring samples conferred by the Sale of Food and Drugs Acts, and those Acts shall apply as if the officer were an officer authorised to procure samples under the Sale of Food and Drugs Act, 1875. 26 Section 3 provides that it shall be the duty of every local authority entrusted with the execution of the laws relating to the sale of food and drugs to appoint a public analyst, and put in force from time to time, as occasion may arise, the powers with which they are invested, so as to provide proper securities for the sale of food and drugs in a pure and genuine condition, and in particular to direct their officers to take samples for analysis. If the Local Government Board or Board of Agriculture, after communication with a local authority, are of opinion that the local authority have failed to execute or enforce any of the provisions of the Sale of Food and Drugs Acts in relation to any article of food, and that their failure affects the general interest of the consumer or the general interests of agriculture in the United Kingdom, as the case may be, the Board concerned may, by order, empower an officer of the Board to execute and enforce those provisions or to procure the execution and enforcement thereof in relation to any article of food mentioned in the order. The expenses incurred by these Boards or their officers under this section are to be defrayed by or recovered from the defaulting local authorities. By Sub-section 5 of Section 3 it is also provided that any public analyst appointed under the Sale of Food and Drugs Acts, shall furnish such proof of competency as may from time to time be required by regulation framed by the Local Government Board. Section 4 empowers the Board of Agriculture to make regulations for determining what deficiency in any of the normal constituents of genuine milk, cream, butter or cheese, or what addition of extraneous matter or proportion of water, in any sample of milk (including condensed milk), cream, butter, or cheese, shall, for the purposes of the Sale of Food and Drugs Acts, raise a presumption, until the contrary is proved, that the milk, cream, butter, or cheese, is not genuine or is injurious to health, and an analyst shall have regard to such regulations in certifying the result of an analysis under those Acts. Sections 5-8 relate especially to margarine. By Section 5 the provisions of the Margarine Act, 1887, as amended by this Act, are to extend to "margarine-cheese," provided that all "margarine-cheese'' sold or dealt in otherwise than by retail 27 shall either be enclosed in packages marked in accordance with the Margarine Act of 1887, as amended by this Act, or be itself conspicuously branded with the words " margarinecheese." Section 6 provides that where, under this Act, or the Margarine Act, 1887, it is required that any package containing margarine or margarine-cheese shall be branded or marked, the brand or mark shall be on the package itself, and not solely on the label, ticket, or other thing attached thereto. The letters required to be printed on the paper wrapper in which margarine or margarine-cheese is sold shall be capital block letters, not less than half an inch long, and distinctly legible, and no other printed matter shall appear on the wrapper. Section 7 requires every occupier of a manufactory of margarine or margarine-cheese, and every wholesale dealer in such substances, to keep a register showing the quantity and destination of each consignment of such substances sent out by him. Such register shall be open to inspection at all reasonable times by any officer of the Board of Agriculture, and if not properly kept, or if kept in a manner to deceive with fraudulent intent, the manufacturer or dealer shall be liable to a fine of £10, and for a second or subsequent offence to a fine of £50. Under Section 8 it shall be unlawful, under penalty, to manufacture, sell, expose for sale, or import any margarine, the fat of which contains more than ten per cent, of butter fat, and every person who manufactures, sells, or imports any margarine which contains more than that percentage, shall be guilty of an offence under the Margarine Act, 1887, and any defence which would be a defence under Section 7 of that Act shall be a defence under this section, and the provisions of the former section shall apply accordingly. Provided that nothing in this section shall apply to any margarine manufactured or imported in fulfilment of any contract made before the twentieth day of July one thousand eight hundred and ninety-nine. {Note.)—A well-known authority in discussing the proposal to make it illegal to sell margarine which contains more than 10 per cent, of butter fat, remarks :—" It must be borne in mind that, even without any admixture of genuine butter, margarine will rise above the proposed restricted maximum of quality, for in some districts of Scotland the rich milk which is used in the creameries to churn the margarine would, of itself, yield more than the statutory 10 per cent, of butter fat. 28 Section 9 requires every person who, himself or by his servant, in any highway or place of public resort sells milk or cream from a vehicle or from a can or other receptacle shall have conspicuously inscribed on the vehicle or receptacle his name and address, and in default shall be liable on summary conviction to a fine not exceeding two pounds. In the case of a sample taken of milk in course of deliveryor of margarine or margarine cheese forwarded by a public conveyance, the person taking the sample shall forward by registered parcel or otherwise a portion of the sample marked, and sealed, or fastened up, to the consignor if his name and address appear on the can or package containing the article sampled. Section 11 requires that every tin or other receptacle containing condensed separated or skimmed milk must bear a label clearly visible to the purchaser on which the words " Machineskimmed Milk, or " Skimmed Milk," as the case may require, are printed in large and legible type, and if any person sells or exposes or offers for sale condensed separated or skimmed milk in contravention of this section he shall be liable on summary conviction to a fine not exceeding ten pounds. Section 21 provides for the sending of articles of food or of drugs by the Court or Justices before whom proceedings are being taken, to the Commissioners of Inland Revenue for analysis ; and Section 22 contains certain provisions as to the certificates of analysis. The latter section provides, for example, that a copy of every certificate of the analyst must be sent to the prosecutor at least three clear days before the return day, and if it be not so sent the Court may adjourn the hearing on such terms as may seem proper. Sections 23 and 24 apply the Act to Scotland and Ireland. The Act came into force on 1st January, 1900. Metbopolis Watee Act. (62 and 63 Vic., Chap. 7.) This measure was framed by Mr. Chaplin with the object of preventing a recurrence of water famine in the East End of London, by carrying into effect an intercommunication of the mains of the several Metropolitan Water Companies. The Act provides, that the several companies shall submit to the Local Government Board schemes for the necessary works for supplying each other with water. The cost of the works is to be met by the several companies by the issue of debenture stock, under certain conditions. 29 Oysters Bill. Mr. Chaplin's Oysters Bill was abandoned towards the end of the session. It was a Bill entitled, " An Act for the Protection of Public Health against Dangers arising from the Consumption of Unwholesome Oysters." It consisted of the following clauses :— 1. Inspection of oyster layings, and prohibition of removal from insanitary layings. 2. Penalties and procedure. 3. Power of Local Government Board to act in default of local authority. 4. Inquiries and expenses. 5. Definition of oyster laying. 6. Importation of oysters. 7. Application to Scotland. 8. Application to Ireland. 9. Short title and commencement. The Bill was supported by Sir Richard Thorne Thorne, Dr. Bulstrode, and others. It was opposed by Mr. Rayden, Captain Austin, &c., the latter gentleman contending that the Bill would ruin the oyster trade, partly because it would be in the hands of medical officers of health, who knew nothing about oysters. Food Peeseevatives. During the past year the Local Government Board appointed a Departmental Committee, consisting of Sir Herbert Maxwell (chairman), Professor Thorpe, Dr. H. J. Bulstrode, and Dr. Tunnicliffe, to investigate and report upon the use of preservatives in connection with perishable articles of food. The Committee has not yet concluded its labours. With regard to the above question, an interesting historic record of the practice of employing preservatives and colouring matters in food, appeared in a recent issue of the Lancet. Various methods of preserving and colouring articles of food are traced back for nearly half a century, when in 1851 the Analytical Sanitary Commission of the Lancet started its remarkable crusade against the adulterations of food. The first methods resorted to were necessarily clumsy and often highly injurious, Thus, chromate of lead and red ochre were 30 frequently found in snuff, lead and mercurial salts in sweets, enormous quantities of copper in bottled fruits, sulphide of mercury in cayenne pepper, Venetian red in anchovies and sauces, &c. The use of modern preservatives appeared to follow closely upon the introduction of antiseptics in surgery in 1870. It was in 1887 that the Lancet pointed out that the practice of employing preservatives such as benzoate of soda, salicylic acid, and boric acid in articles of food was increasing to a very large extent. Some interesting experiments with adulterated milk were narrated by Dr. Annett, of University College, Liverpool, before the Departmental Committee on preservatives and colouring matters in food. Dr. Annett declared that tests he had made on kittens with milk containing formaldehyde in varying quantities showed that as the quantity was increased the retarding action on their growth increased. With regard to boracic acid, kittens treated with it in the proportion of 80 grains to a gallon of milk all died at the end of the third or fourth week, having become considerably emaciated. He inferred that the presence of preservatives in milk must be injurious to, he would not ray adults, but certainly to infants. Recently a firm was summoned for using boracic acid in cream, and medical evidence was summoned to prove that boracic acid was particularly injurious to young children, and that equally good preservative results were obtainable from cold storage or the sterilizing process. The magistrate held that the defendants had failed to satisfy him either that the use of boracic acid was uninjurious to health, or that it was necessary for producing and placing clotted cream on the market. He fined the defendants £10 10s. and £31 10s. costs. Dr. Liebreich, a professor in the University of Berlin, who has undertaken a series of experiments with regard to the effects of borax and boracic acid on the human system, says: " If harm could be done by borax and boric acid used in the preservation of food, the immense quantities which have already been swallowed would have aroused the attention of medical men, particularly as boracic preservation is openly practised, and has been unreluctantly accepted by the working classes." The following is a simple test for boracic acid:— Soak the material for a few minutes in methylated spirit and apply a light. If boracic acid is present the alcohol will burn with a characteristic green flame. Borax, 31 which is a compound of boracic acid with soda, can be detected in a similar manner, the addition of a few drops of strong sulphuric acid being made to free the boracic acid from the soda. At the Commission mentioned above, Mr. de Hailes, analyst to the Dairy Trade Protection Society, gave an account of the means by which milk was brought from distant places to London and insisted that preservatives must be used. As for cold storage he said that many farmers were without the means for adopting it. He was aware, he said, that some milkmen make a great point about not using preservatives, but they were careful to get their supplies from farms within a short distance of London. He would not like to say that it was impossible to supply milk to London for a greater distance than forty miles without preservatives, but he would say that the milk trade, as at present carried on, could not be carried on without preservatives. He saw great practical objection to vendors being required to make a declaration to each purchaser of the presence of preservatives, especially in view of the manner in which the Sale of Food and Drugs Acts were administered, although he should have no objection to a notice being exhibited in a shop saying that the milk sold there was preserved. He also saw objection to a declaration in each case when butter with a preservative was sold. Black Smoke and Noxious Fumes. During the year strict observation has been kept upon the chimneys of the various factories and workshops within the district, with a view to minimising these nuisances. When the wind blows in a certain direction we get all the ill effects of the smoke from Messrs. Doulton and Stiff's chimneys on the other side of the river, and complaint was made of the same during the year. During last Session a Member of Parliament asked the Home Secretary to require manufacturers in the neighbourhood of the Palace of Westminster to consume their own smoke, as the Committee rooms, the Terrace, and the dining-rooms of the House of Commons are often filled for hours with most unpleasant fumes. Amongst the offenders during the year were the Army & Navy Auxiliary Co-operative Stores, the Westminster Electric Supply Corporation, Hyde Park-couit, Royal Palace Hotel, Queen Anne's-mansions and Niagara, and the owner of a laundry in Church-street for causing noxious fumes to escape from the chimney shaft. Watch was kept on several other buildings and the owners cautioned as to the necessity of their discontinuing the nuisance. The Hon. Rollo Russell, in 32 delivering a lecture on "The Smoke Nuisance" during the early part of the year, stated that the "dense fogs with which we were familiar in the Metropolis and its immediate neighbourhood were due to coal smoke preventing the sun dissipating the vapour which arose in the morning. It was well known that cities burning wood or anthracite coal were comparatively free from all fogs. London would assume an entirely different aspect if the use of bituminous coal were prohibited. Fog not only caused misery, disease, and death, and was the cause of frightful waste and destruction, but it also spoilt the very pleasures of life. The lecturer next gave some notes of his observations, showing how the direction of the wind affected the transparency of the air in the country districts round London. He pointed out that "London thus had just half the sunshine of inland towns, and about a third of towns on the South coast. Fogs were conducive to the spread of infectious diseases, because during foggy weather windows had to be kept closed, thus preventing that proper ventilation of rooms which is so necessary in dispersing the germs of disease. Arriving at the consideration of remedies against fogs, the lecturer recommended improvement in our fireplaces and the more general adoption of gas firing. The air of London could be made almost transparent by the abolition of bituminous coal as a domestic fuel." Factories and Workshops. The workshops and factories in the district have been kept under supervision, and the limewhiting of walls and ceilings has been carried out. In some cases extra w.c.'s have been provided, bat the sanitary arrangements generally were found to be in a satisfactory condition. The London Water Supply. The final report of the Royal Commission appointed to inquire into the Metropolitan water supply was issued re cently. The Commissioners are unanimous in their conclusion that it is desirable that the undertakings of the water companies should be acquired and managed by public authority. They come to the conclusion, also, that it is not desirable that the London County Council should be the purchaser, but that the companies' undertakings should be transferred to a 33 manent water board consisting of not more than 30 members, appointed by the county councils of London, Middlesex, Surrey, Essex, Hertford and Kent, the West Ham Council, and the Thames and Lea Conservators. Common Lodging Houses. Nineteen of these exist in Westminster, having an authorised number of lodgers in the aggregate to the number of 1310. During the year the Divisional Court decided that a Salvation Army shelter is a common lodging house within the meaning of the Act, and as such is subject to the usual regulations. In the summons issued by the London County Council against Rowton Houses (Limited) for non-registration as a common lodging house of one of their places in Bond-street, Vauxhall, as required by the provisions of the Lodging Houses Acts, the Magistrate said that the " fact that registered common lodging houses had to be whitewashed or litnewashed showed the class of house to which that rule applied, and when he found that the walls of Rowton House were tiled, and the decorations better than that to be seen at a common lodging-house, that fact had a great bearing on the case. As a matter of fact, he found that it was not a common lodging-house, and he was glad to think that, from the public point of view, his decision would have no bad effect, because, as the house was now conducted, there was no necessity for supervision. He therefore dismissed the summons." Customs and Inland Revenue Act. Under this Act certificates were granted during the year to the owners of 54 tenements in Plogarth Buildings and to St Ann's Buildings. In the latter buildings, Nos. 1 to 18 were ordered to be cleansed. Housing op the Woeking Classes Act. Nos. 1 to 5, Harper's place, were closed during the year under the above Act as being unfit for human habitation. The houses have now been demolished. Houses Let in Lodgings. During the year these have all been duly inspected. The owner of Nos. 22, 44, and 46, Chadwick-street, was fined £9 C 34 and 6s. costs for failing to comply with notices requiring him to cleanse the walls and ceilings of the houses. In one other case it was found necessary to take proceedings for an infringement of the bye-laws. Unsound Food. During the year the following articles of food have been condemned and destroyed: — 2 trunks of plaice. 24 stone 4 lb. of lamb. 2 J stone of pork. 1 ton of butter. 1 box of skate. 1 box of soles. 1 box of mackerel. 1J cwt. of cod and haddock. 2 dozen crabs. 40 lobsters. 1| cwt. of hams. 25 boxes of tomatoes. New Buildings. The re-building of the houses in Hide-place, Vinoent-streeit, and Regency-street (in all twelve houses) will serve to accommodate about 300 persons. Millbank Estate. I.—Hogarth-buildings have been completed and provide accommodation for 306 persons. II.—The following buildings are now in course of erection: — Leighton 120 „ Millais 120 „ Turner 430 „ Ruskin 430 „ Romney 290 „ Rossetti 290 „ Total 1,680 „ 35 III.—The construction of the following buildings will shortly be started:— Reynolds 400 persons. Gainsborough 396 „ Lawrence 296 „ Maclise 296 „ Landseer 230 „ Mulready 230 „ Morland 300 „ Wilkie 300 „ Total 2,448 „ Total of I., II., and III. 4,434 „ Bakehouses and Milkshops. These have been periodically inspected and the necessary limewhiting and cleansing carried out. In two or three cases accumulations of dirt, etc. were found under the troughs. These, however, were immediately removed on the nuisances being pointed out. At the same time the cisterns for water supply were duly examined. Water Supply. During September a complaint was received from a medical practitioner alleging the water supply to No. 3, James-streetmansions to be contaminated with lead. I consequently had samples of the water taken and submitted to the analyst, who reported as follows, viz.: "That the water may contain lead, but only in an exceptionally small degree, viz., below -jgrain per gallon, and far below the smallest quantity which has ever been supposed to be injurious." In consequence of a complaint by one of the inmates of Alberthall-mansions, alleging the water supply to be contaminated, a sample of the water was submitted to the analyst for examination and report. The analyst reported subsequently that " the sample of water is of the highest quality, and has all the characteristics of a pure unpolluted water from the chalk below the London clay." The owners of Nos. 6, 7 and 8, Harper's-place, and 20, Vauxhallbridge-road, were summoned under the Public Health (London) Act for permitting the nuisance of allowing the premises (which were inhabited) to be without a proper water supply. 36 In one small house there were no less than four families, and two families in each of the others. There had been no water supply for ten days. The representative of the owners consented to closing orders and stated that he had been taking County Court proceedings with a view to the ejectment of the tenants, who would not vacate the premises and disregarded all notices to quit. The magistrate subsequently made the closing orders, and allowed costs for the Vestry. Water Supply to Newly-erected Houses. Section 48, Public Health (London) Act, 1891. One hundred and seventy-five certificates were granted as to water supply to newly-erected houses. Cow-houses and Slaughter-houses. The Vestry offered no objection to the renewal of licenses for the following cow-houses and slaughter-houses, the several premises being in good condition: — cow-housks. St. Margaret. St. John. 7, Arthur-street. 13, Marsham-street. 28, Winchester-terrace. Slaughter-houses. St. Margaret, St. John, 29, Great Chapel-street. 14, Regency-street. Stables and Mews. These have been duly inspected during the year, and many new works carried out, such as paving and drainage. Nuisance from stable manure.—The Public Health Committee considered a letter from the London County Council in August last, with reference to nuisance arising from peat moss litter and other stable refuse during the process of removal from stable yards, and offering suggestions with a view to obviating such 37 nuisance. The Committee were of opinion that if the Bye-laws made by the Vestry under the Public Health Act, 1891, relating to the removal of manure or other offensive matter, were properly administered, there need be no further provision on the subject. In two cases legal proceedings were taken for the non-removal of manure, and in each case the owners were fined. Sale of Food and Dkugs Acts. During the year 123 samples of food, Ac., have been purchased for the purpose of analysis; 108 were certified as being genuine and 15 as being adulterated. The following is a table of the samples taken together with the fines and costs imposed in the cases where summary action was taken:— Articles Purchased. No. of Samples. Genuine. Adulterated. Result of summary proceedings. Fines. Costs. £ s. d. £ s. d. Arrowi-oot 9 9 — — — Butter 39 34 5 9 0 0 3 4 6 Cocoa 6 2 4 No action. Coffee 12 10 2 2 0 0 1 12 6 Condensed milk 3 3 — — — Golden syrup 3 2 1 0 5 0 0 12 6 Milk 33 30 3 4 0 0 1 5 0 Mustard 3 3 — Olive oil 3 3 — — — Sulphate of quiuiue 3 3 — — — Tea 3 3 — —. — Vinegar 3 3 — — — Whiskey 3 3 — — — Total 123 108 15 15 5 0 6 14 6 Amongst the above samples taken was one of butter, which was found to be adulterated with 90 per cent, of margarine, two of cocoa adulterated with oxide of iron, and three of milk adulterated with various quantities of water. Several interesting cases of adulteration were decided by the Metropolitan Magistrates during the year, one of which was "Is salad oil a food or a drug?" In one case the prosecution failed owing to the contention upon which the prosecution was based, that it was a drug only. As pointed out by the British Medical Journal, olive oil is a food as well as a drug. Another contention was, What is golden syrup ? A recent article in 38 the Lancet points out that the syrups of commerce are glucose adulterated with so-called cane syrups—that is with the drippings and refuse of sugar refineries. Other cases of adulteration were coating coffee berries with sugar and thus increasing the weight of the coffee from 5 per cent, to 10 per cent. Sometimes the coffee berry is imitated by treating maize in a certain way. Another case was that of adulterating cheese with margarine. Another, coffee adulterated with chicory, sand, &c. Attention has also been drawn during the year by the Bast Kent Chamber of Agriculture, to the use of a substance known as milk extract. This substance enables dairymen to make 500 gallons out of 400 gallons of milk—the mixture of milk, hot water and the extract being sold to the public as natural milk. The Board of Agriculture has reported that it cannot legally stop the sale of such a mixture. Coroner's Court and Mortuary. Summary of work -performed during the year 1899. Number of articles disinfected from the Guards' Hospitals 1,545 Number of articles disinfected from the United Parishes 17,200 Number of rooms disinfected 430 Number of families removed to the Vestry's Reception rooms 21 Number of bodies removed to the mortuary 272 Number of inquests held at the Coroner's Court 230 Number of bodies to await burial 42 W. C. Webber resigned his position as Mortuary-keeper on February 7th, and H. Cooke was elected to fill the vacancy. Mottuary; time for making post-mortem examinations.—In consequence of the receipt of a letter from a local medical practitioner complaining of the refusal on the part of the mortuarykeeper to allow a post-mortem examination to be made at the Vestry's mortuary after ten p.m., the Committee directed that, 39 unless in case of emergency, the room to medical men be open for the purpose of post-mortem examinations from six a.m. to nine p.m. Removal by the Police of bodies "found drowned" to the mortuary.—In consequence of an order issued by the police authorities, prohibiting the police from what had hitherto been their practice of removing drowned bodies from the river to the public mortuary, serious delay was experienced in this parish, while elsewhere the operation of the new order had caused delay and exposure which had been described as a grave public scandal. The Public Health Committee was aware that the withdrawal of the police from such service was founded on a strict interpretation of the law ; but they submitted that the demands of public decency in such cases should be paramount, and that the duty should be discharged in the most expeditious and decorous manner possible, by the authority upon whom the investigation for purposes of identification, and possibly of prosecution, would devolve. The Committee therefore recommended that a communication be addressed to the Commissioner of Police urging that the order in question may not be further acted upon and that the former practice may be reverted to. I understand that this has now been virtually agreed to by the Commissioner. Disinfection. During the year Formic Aldehyde vapour has been tried for disinfection, and with success., but the vapour is most irritating to the eyes. It may be generated in special spirit "Alformant" lamps, which are constructed so as to volatilize tablets of "paraform." A more trustworthy method is by using the "Autoclave," a somewhat complicated apparatus, by which the gas is generated outside the room, and introduced by means of a tube passed through the keyhole. The action of Formalin is rapid; it does not attack metallic surfaces, except iron; and is harmless to leather and to nearly all colours. In a strength of 1 per cent, vapour it is a germicide to most organisms. At the same time it must be regarded as almost entirely a surface disinfectant. A new covering was ordered by the Committee for the disinfector, and the same was supplied at a cost of £9 19s. 40 LEGAL PROCEEDINGS. Inspector Dee. Teh summonses for infringements of the Public Health (London) Act, 1891, and one summons under the Food and Drugs Act, were taken out during the year, in all of which the Vestry were successful in obtaining fines or costs; the amount so recovered being a total sum of £46 4s. LEGAL PROCEEDINGS. Inspector Macnair. Premises. Offence. Fine. Cost. £ s. d. £ s. d. 54, Chapter-street Obstructing thoroughfare 0 5 0 0 2 0 79, Vauxhall-bridge-road Do. do. Moreton-3treet 0 10 0 0 2 0 52, Vincent-street Failing to remove manure 1 0 0 0 2 0 7, Regency-streot Selling margarine as butter 1 0 0 0 12 6 Do. do. Do. do. without label — 0 2 0 Bloomburg-street Obstructing thoroughfare 1 0 0 0 12 6 24, Dorset-street Selling adulterated milk 1 0 0 0 12 6 85, LiHinc;ton-street Do. do. butter 2 0 0 0 12 6 79, Vauxhall-bridge-road Obstructing highway at Moretonstreet 1 0 0 0 2 0 Chapter-street Obstructing highway at Chapterstreet 0 5 0 0 2 0 Carey-place Obstructing highway at Careyplace 1 0 0 0 2 0 Causton-street Defective w.c., works completed on hearing of summons, Order made to abate nuisance — 0 2 0 35, Dorset-street Overcrowding — 0 2 0 76, Tufton-street Selling adulterated butter 1 0 0 0 12 8 28, Ponsonby-place Do. do. 2 0 0 0 12 6 20, Moreton-street Soil-pipe fixed contrary to byelaws Qf the L.C.C. 2 0 0 0 10 6 27, Churton-street Selling adulterated milk 3 0 0 0 12 G 34, Vincent-street Do. do. butter 3 0 0 0 12 G Chapter-street Obstructing highway at Chapterstreet 2 0 0 0 2 0 25, Lillingtou-street House let in lodgings—inadequate w.c. accommodation, works done on hearing of summons — 0 2 0 1 to 5, Harper's-place Houses unfit for i closing orders made — 2 2 0 human habitation 95, Rochester-row Obstructing highway 0 1 0 0 2 0 6,7 & 8, Harper's-place and Houses unfit fori closing orders made — 1 10 0 20, Vauxhall-bridge-road human habitation 20, Vauxhall-bridge-road Failing to comply with closing order — 0 2 0 52, Vincent-street Failing to lemovc manure 1 0 0 0 2 0 £23 1 0 £10 10 6 WES 4 11 LEGAL PROCEEDINGS. Inspector Kirk. The following summonses have been taken out by order of the Public Health Committee, the tabulated statement herewith showing the result of the proceedings. Act of Parliament under which proceedings were taken. Situation of Premises. Offence. Result. Fine. | Costs. Public Health (Loudon) Act, 1891 Billiard Table Works, Great Peter-street Smoke nuisance Vestry's action upheld £5 10/- Do. do. Electric Light Works, Millbank-street ... Do. £10 2/- Do. do. Laundry, 3, Church-street Noxious & offensive fumes from business Summons withdrawn upon completion of works ... 7/6 Do. do. 48, Tufton street Defective roof Do. ... 7/6 Do. do. 2, Romney-street Overcrowding Magistrate's abatement Or-1 er made ... 6/- Public Health Act (Byelaws for), Houses let in lodgings 24, 44, 46, Romney-st. Dirty condition of premises throughout Vestry's action upheld £9 6/- Public Health (London)Act, 1891 37, Tufton-street Overcrowding Magistrate's Order made Nil. Nil. L.C.C. Byelaws 52, Millbank-st. Constructing w.c. without notice to clerk to sanitary authority Vestry's action upheld 5/- 2/- Public Health (London)Act, 1891 Electric Light Works, Millbank-street Black sinoke nuisance Do. £20 £1 1 /- Public Health (London) Act, 1891 (L.C.C. Bye-laws) 2, Cowley-street Failing to give notice in writing to fclcrk of intention to fix new w.c. and soil pipe Do. £1 2/- Sale of Food & Drugs Act 79, Tufton-street Selling coffee adulterated with 60 per cent, chicory Do. £1 12/6 Do. do. 50, Great Peterstreet Selling coffee adulterated with 50 per cent, chicory Do. £1 £1 Total £47 5s. £4 16/6 d 42 Inspector Dee's report for Year ended 30th December, 1899. Wards Nos. 1 and 2, St. Margaret, Westminster. January, 1900. Inspections made 973 Defects found 965 Notices served 708 Works complete! 685 Notices outstanding, Dec. 31st, 1898 32 Notices uncompleted, Dec. 30th, 1899. 55 Re-inspections made 1,564 Water-closets 261 Drains 153 Water apparatus 130 Dust receptacles 26 Premises in uncleanly condition 64 Overcrowding 4 Premises improperly ventilated 3 Yard paving 7 Limewashing 9 Stables, cow-sheds, slaughter-houses, and bake-houses 23 Houses in which infectious disease has occurred 115 Accumulation of manure, refuse, etc. 49 Receptacles for manure. 1 Black smoke (including short emissions) 53 Registration of houses let in lodgings 1 Miscellaneous 86 Total defects found 965 Inspector MacNair's report for the year ending 31st Dec., 1899. Wards Nos. 1 and 3, St. John. Inspections made 1,047 Defects found 1,341 Notices served 664 Works completed 674 Notices outstanding., 1898 89 Notices outstanding, 1899 54 43 Nuisances from the following have been abated, viz.:— Water-closets 124 Drains 158 Water apparatus 143 Dust receptacles 84 Premises in uncleanly condition 213 Overcrowding ... 8 Underground rooms illegally occupied — Premises improperly ventilated 6 Yard paving 48 Lime-whiting 203 Stables, cow-sheds, slaughter-houses and bake-houses 23 Houses in which infectious disease occurred 89 Animals improperly kept 5 Accumulation of manure, refuse, etc. 24 Receptacle for manure 18 Black smoke 4 Registration of houses let in lodgings 1 Miscellaneous 190 1,341 Inspector Kirk's report for the year ending Dec. 31st, 1899, for Wards No. 3, St. Margaret, and No. 2., St. John the Evangelist, Westminster. Notices brought forward from 1898 46 Inspections made 1,006 Re-inspections made 781 Defects found 1,213 Notices served 665 Works completed 651 Notices not complied with, 31st Dec., 1898 41 Nuisances from the following have been abated: — Animals kept so as to be a nuisance 3 Accumulations of manure, etc. 40 Black smoke 45 Cisterns (dirty) 22 Cisterns (defective covers) 15 Dust receptacles (dilapidated and not in accordance with Bye-laws) 15 Dust (accumulations) 31 Drains (new, defective relaid, repaired, unstopped, and ventilated) 74 44 Effluvium nuisance from works 6 Houses in which infectious disease has occurred 170 Lime-whiting of yards, bake-houses, stables., cow-shei, and slaughter-house 76 Lavatory waste pipes discharging into soil pipe 4 Overcrowding ... 19 Premises improperly ventilated 6 Premises in an uncleanly condition 389 Paving to yards defective 30 Roofs defective 21 Soil pipes (defective) repaired and new fixed 20 Sink waste pipes in direct communication with drain 4 Underground rooms illegally occupied 3 Unsound food destroyed (parcels) 4 Ventilation to premises provided 6 Water supply apparatus defective 15 Water-closets stopped 41 Water-closets defective (repaired) 23 Water-closets (new) fixed 58 Miscellaneous 73 Total 1,213 I remain. My Lords and Gentlemen, Your obedient Servant, JOHN NORTON, M.D., D.P.H., Medical Officer of Herilth. Town Hall, Westminster, January, 1900.