WOO 67 Metropolitan Borough of Woolwich. Annual Report of the Medical Officer of Health for WOOLWICH. 1903. 2 Public Health Committee:— Jones, Eev. L. J. "Broomhill," Shrewsbury Lane, Plumstead (Mayor). Bull, W. J., 280, Plumstead Common Road, Plumstead (Chairman). Boubne, R. J., 196, Lakedale Road, Plumstead ( Vice-Chairman). Broughton, Alderman J., 1, Paget Terrace, Plumstead. Harper, Alderman J., 18, St. Margaret's Road, Plumstead. Adshead, J. E., 100a, High Street, Plumstead. Baglow, J., 67, Whitworth Eoad, Plumstead. Francis, W. J., 4 and 5, Green's End, Woolwich. Hall, A., 98, Vicarage Road, Plumstead. Jones, P., 89, Sladedale Road, Plumstead. Merritt, W. J., 50, Herbert Road, Plumstead. Pringle, P., 28, Wrottesley Road, Plumstead. Slater, G., 84, Eglinton Road, Plumstead. Medical Officer of Health:— SIDNEY DAVIES, M.A., M.D., Oxon., D.P.H., Camb., Fellow and Member of Council of Incorporated Society of Medical Officers of Health. Fellow Royal Institute of Public Health. 3 Chief Sanitary Inspector:— Albert G. Duck (Cert. San. Inst.) District Sanitary Inspectors:— Adam Mackie (Cert. San. Inst.), Burrage Ward. Food Inspector and Inspector of Cow-sheds and SlaughterHouses (Woolwich and Plumstead) and Eegistered Houses, Woolwich. William Woolley (Cert. King's College), St. George's Ward. John W. Eance (Cert. San. Inst.), Dockyard and St. Mary's Wards. William Little (Cert. San. Inst.), Herbert and St. Margaret's Wards. William Wood (Cert. San. Inst.), Parish of Eltbam. Alfred G. Potter (Cert. San. Inst.), Eiver Ward. William Tedham (Cert. San. Inst.), St. Nicholas Ward. Thomas W. Dee (Cert. San. Inspectors' Examination Board) Central and Glyndon Wards. Inspectors under Food and Drugs Act:— William Woolley, Parishes of Woolwich and Plumstead. William Wood, Parish of Eltham. Public Health Committee Clerk:— Charles Ellis. Assistant Clerk:— Amyas Britter. Junior Clerk:— F. H. Deans. 4 TABLE OF CONTENTS. Part I.—Statistics. page Population—New Houses 10 Births 12 Deaths—Corrections Applied 14 Life Capital Saved 16 Woolwich Death Rate compared with other Boroughs 17 Infant Mortality 17 Zymotic Death Rate 18 Inquests and Uncertified Deaths 19 Deaths in Public Institutions 20 Small-Pox and Vaccination 20 Measles—Closure of Infant Classes 22 Measures Adopted for Prevention 24 Scarlet Fever—Return Cases—Hospital Isolation 27 Diphtheria 32 Enteric Fever—Prevalence at Eltham 34 Diarrhœa 39 Erysipelas 40 Puerperal Fever 40 Influenza.41 Bronchitis and Pneumonia 41 Phthisis—Voluntary Notification—Incidence in Royal Arsenal 43 Preventive Measures—Spitting in Public Houses 48 Sanatorium Treatment 49 Cancer—Classification 51 Alcoholism—Death Rate in Public Houses 52 Meteorology 54 5 Part II.—Administration. page Water Supply 55 Food and Drugs' Act—Percentage Milk Adulteration 55 Pood Inspection 57 Dairies, Cow Sheds, and Milk Shops Order 58 Cow Sheds 58 Slaughter Houses 59 Nuisances—Complaints, Sewers, Drains, Public Urinals, House Inspections 59 Over-crowding, Dampness 61 Smoke Nuisance 62 Defective Light 63 Want of proper Water Closets 63 Flooding of Houses 64 Dust Removal—Collection, Cost of 65 Trade Refuse—Offensive and Inoffensive 65 Housing of the Working Classes—Houses Represented as unfit for Habitation 66 Vital Statistics of Special Areas 67 Houses Registered under the Bye-Laws for Registration— New Bye-laws 69 Underground Rooms 71 Factories and Workshops—Table of Inspections. Outworkers 71 Bakehouses 72 Disinfection—New Disinfecting Station 73 Health Shelter 77 Mortuaries 77 Cemeteries 77 Bye-Laws for Vans and Sheds 78 Customs and Inland Revenue Act 78 Public Ambulance 78 Covered Seats 79 Dentistry and the Care of Teeth 79 Sanitary Staff 80 6 LIST OF TABLES. page Table I.—Population. Births and Deaths for the whole Borough from 1890 to 1903, including Deaths of NonBesidents in the District, also Deaths in Public Institutions in the District, and Deaths of Besidents Begistered beyond the District 81 Number of Inhabited Houses, the Average Number per House and the Acreage 81 Ia—Institutions inside and outside the District receiving Sick and Infirm Persons from the District 82 ,, 1b—Deaths of Persons belonging to the Borough of Woolwich occurring in various institutions—1903 83 ,, II.—Population, Births Begistered, Deaths at all Ages and Deaths under One Year for each Ward during 1902 and 1903. 84 ,, III.—Cases of Infectious Disease Notified at all Ages, at various Age Groups, and Distributed according to Wards during 1903 85 „ IV.—Deaths at all Ages, at various Age Groups, from Various Causes in 1903 87-88 „ IVa.—Deaths from Various Causes arranged by Wards in 1903 Total deaths in Public Institutions in District in 1903 89-90 ,, V.—Case and Death Bate for various Diseases per 1,000 Persons on the Population estimated to the middle of the year for 1891 to 1903 91 ,, VI.—Ages, Schools, and other Particulars of the Cases of Scarlet Fever and Diphtheria during 1903 92 ,, VII.—Vital Statistics of the various London Boroughs for 1903 93-94 ,, VIII.—Meteorology and Begistered Deaths from all causes and from certain prevalent Diseases in each week of the year 95 7 LIST OF TABLES—continued. page Table Weekly Averages for Meteorology and Registered VIIIa. Deaths from all Causes and from certain prevalent Diseases. 97 ,, IX.—Summary of Statistics for the First Quarter of 1903 Corrected for Public Institutions 98 ,, X.—Summary of Statistics for the Second Quarter of 1903 Corrected for Public Institutions 99 „ XI.—Summary of Statistics for the Third Quarter of 1903 Corrected for Public Institutions 101 ,, XII.—Summary of Statistics for the Fourth Quarter of 1903 Corrected for Public Institutions 102 ,, XIII.—Birth and Death Rates for each Parish for the Year 1903 104 ,, XIV.—Deaths from Various Causes for the whole Borough in each week, Corrected for Public Institutions 105-6 ,, XIVa.—Total of persons belonging to the County of London, and registered in the 52 weeks ending 2nd Jauuary, 1904 107 „ XV.—Summary of the General Work of the Public Health Department for 1903, the Number of Nuisances Abated and the Notices Served in each Ward 108 ,, XVa.—Summary of Work of Chief Inspector & miscellaneous 110 ,, XVb.—Inspection of Factories, Workshops and Workplaces 111 ,, XVI.—List of Streets Inspected—House to House—and Number of Houses where Defects were found 114 ,, XVI1.—Prosecutions in 1903, under the Public Health (London) Act and By-laws 119 ,, XVIII—Summary of Articles analysed under the Sale of Food and Drugs' Act 120 ,, XVIIIa—Proceedings in 1903 under the Sale of Food and Drugs' Act 121 ,, XIX.—Food destroyed on Application of Owners and Seizures Condemned by a Magistrate 123 „ XX.—List of level Bake-Houses in the Borough, 1903 124 „ XXa.—List of certificated underground Bakehouses in the Borough, 1903 125 ,, XXI.—List of Slaughter-Houses in the Borough, 1903 126 „ XXII,—List of Cow-Houses in the Borough, 1903 127 PREFACE. METROPOLITAN BOROUGH OP WOOLWICH. To the Mayor, Aldermen and Councillors of the Metropolitan Borough of Woolwich, Me. Mayor and Gentlemen, In presenting you with my Third Annual Report, I have the pleasure of pointing to a most satisfactory improvement of the public health, the general death rate and the death rate from most of the infectious diseases being the lowest recorded. I desire to call your attention specially to the part of the report dealing with Measles and with Phthisis, two fatal diseases, which have received much attention, and with gratifying results. My observations with respect to 'life capital saved,' and isolation of Scarlet Eever, also, I think, deserve your attention. The provision by the Borough of municipal sanatorium treatment of phthisis creates a new departure in London. The work of the department fully detailed in this report, indicates the industry and devotion of the Sanitary Staff, of which I here desire to express my appreciation; I have specially to acknowledge the services of the Chief Inspector, who has rendered me much assistance in the preparation of this report, and is responsible for the description of the disinfecting apparatus and other matters. Hoping that I may count on receiving your continued confidence and support, I am, Gentlemen, Your obedient Servant, SIDNEY DAVIES. THIRD ANNUAL REPORT ON THE HEALTH OF THE METROPOLITAN BOROUGH OF WOOLWICH, Year ending 31st December, 1903. PART I. Statistics. 1. Population.—The usual mode of estimating the increase of population, i.e., by allowing an increase for the year proportional to that found to have obtained between the two preceding censuses, would certainly give wrong results if applied this year to Woolwich. The rapid increase in population during the Boer War has now ceased, owing to the reduced numbers employed in the Royal Arsenal, and probably since the middle of 1902, there has been no increase in the parishes of Woolwich and Plumstead. New houses have continued to go up, but many old ones are unoccupied. In Eltham, however, the case is different, and there has no doubt been a further considerable increase of population in this parish, though probably not in proportion to the number of new houses. B 10 2. I have estimated the population to the middle of 1903, to be 123,172, this number is arrived at as follows:—the populations of the parishes of Woolwich and Plumstead have been taken as calculated for 1902, without change, but the population of Eltham estimated for 1902 (10,002) has been increased by 667, this number being the product of half the number of houses certified for water between July, 1902, and June, 1903, (250) and the number of persons to a house in Eltham found at the Census—viz. 5.34. Thus population in Woolwich Parish, 1902 41,681 „ Plumstead „ 70,822 ,, Eltham, estimated 10,669 Estimated population of Borough 123,172 3. The following table shews the present number and increase since the census of houses in the Borough; houses rebuilt are not included among new houses. Houses in Borough at Census, 1901 18,086 New houses to June 30th, 1901 321 „ „ 1902 1,292 „ „ 1903 743 Total to middle of 1903 20,442 4. The population of each ward (except Eltham) has also been taken as calculated for 1902. This probably underestimates the population of St. Nicholas and St. Margaret's Wards, and slightly over estimates that of other wards, but not sufficiently to materially affect the succeeding statistics. The following table gives for each ward the population and number of inhabited houses at the census, the number of persons to a house, and the number of new houses certified for water certificates, June, 1902, to June, 1903. Wards. Dockyard. St. Mary's. River. St. George's. Burrage. Herbert. St. Margaret's. Central Glyndon. St. Nicholas. Eltham. Table II. gives the estimated population. North. South. Population 8,712 10,439 2,991 11,405 8,078 9,837 9,080 9,842 10,118 9,810 19,640 7,226 No. of Inhabited Houses 1,325 1,126 441 1,671 878 1,735 1,612 1,638 1,805 1,697 2,805 1,353 Persons to a House 6.57 9.27 6.78 6.83 9.20 5.67 5.63 6.00 5.61 5.78 7.00 5.34 New Houses— April to June, 1901 — — 4 — — — 12 61 7 8 85 80 June, 1901 to June, 1902 — — 71 — — — 79 265 7 8 455 407 June, 1902 to June, 1903 12 — 33 — — — 40 153 7 9 239 250 11 B 2 12 Births. 5. The number of births was 3691, and the birth rate 30.0, compared with 30.0 and 29.9 in the two previous years, and 30.9 the average rate of the ten years 1892—1901. The rate for the County of London was 28.4. 6. The following table shows the birth rate of the three parishes and eleven wards of the Borough, and how these compare with the neighbouring Boroughs :— Birth rate. 1901. 1902. 1903. Woolwich Parish 28.5 28.8 29.1 Wards. Dockyard 32.3 32.2 31.5 St. Mary's 19.9 21.2 21.3 River 28.7 N. 39.1 40.6 S. 25.6 24.2 St. George's 36.0 34.4 37.5 Plumstead Parish 31.5 31.5 31.4 Wards. Burrage 25.7 22.7 23.9 Herbert 26.1 26.4 27.0 St. Margaret's 31.6 37.2 33.7 Central 29.3 32.6 26.9 Glyndon 32.4 28.5 31.7 St. Nicholas 36.4 29.8 31.8 Eltham 22.3 23.8 24.1 Greenwich Borough 29.0 28.1 27.3 Lewisham Borough 25.8 25.7 26.2 West Ham 35.0 34.1 33.6 East Ham 36.4 36.4 34.4 13 Erith 30.9 37.3 38.9 London 29.0 28.5 28.4 England & Wales — 28.6 28.4 Woolwich Borough 30.0 29.9 30.0 7. The birth rate of Woolwich and Eltham parishes, and of St. Mary's, the North River, St. George's, Burrage, Herbert, Glyndon, and St. Nicholas Wards, were higher than in 1902, and the birth rate of Plumstead parish and of Dockyard, South River, St. Margaret's, and Central Wards, lower. 8. The highest birth rates were again in the North River Ward and St. Margaret's, and the lowest in St. Mary's, Burrage, Eltham, and the South River. 9. The following table gives the birth rate in each parish for the past eight years. 1896. 1897. 1898. 1899. 1900. 1901. 1902. 1903. Woolwich 30.5 31.5 30.2 30.3 28.2 28.5 28.8 29.1 Plumstead 32.7 32'3 30.2 30.2 29.8 31.5 31.5 31.4 Eltham 21.9 19.5 19.3 21.4 21.1 22.3 23.8 24.1 10. Illegitimate Births.—49 of the births registered ware illegitimate, 18 of these taking place in the Union Infirmary. 28 of the illegitimate births belonged to Woolwich parish, 20 to Plumstead and 1 to Eltham. The illegitimate births were equal to a rate of 13 per 1,000 total births, which compares with 40 per 1,000 in England and Wales in 1900. Marriages. 11. There were 937 marriages celebrated in the Borough; the proportion of persons married was 15.2 per 1,000 population. The rate in London was 17.8 in 1902. 14 Deaths. 12. Table I, gives the gross and nett deaths and death rates in 1903, and each of the past 11 years, and shews also how the nett deaths are arrived at. All death rates have been corrected for public institutions, and also for accidents in the street and on the river when these could be allocated to their proper district. Re correction which should be made for sex and age distribution, see Annual Report for 1902. Suffice it to say that the death rates of Woolwich and Eltham parishes would be distinctly higher if corrected for sex and age distribution, and this is even more the case with respect to St. Mary's and St. George's Wards. 13. The Death Rate—13.3—is the lowest that has yet been recorded, the lowest rate previously reached being 14.6 in 1901, and the average for the previous ten years, 16.6. 14. Table VII, taken from the "British Medical Journal," shews how Woolwich compares with the County and other Metropolitan Boroughs. Six Boroughs had a lower rate. The death rate in West Ham was 15.5 ,, East Ham „ 11.4 „ Erith „ 10.3 ,, England & Wales 15.4 ,, 72 large towns 16.3 ,, London 15.2 „ Woolwich 13.3 15 15. The following table gives the death rate in each parisl and each ward of the Borough for each of the past three years 1901 1902. 1903. Woolwich Parish 16.8 17.1 16.3 Wards. Dockyard 15.7 16.4 16.2 St. Mary's 11.6 14.0 14.1 River 20.1 N. 18.7 14.5 S. 18.7 17.9 St. George's 18.5 16.4 16.8 Plumstead Parish 13.2 14.3 12.3 Wards. Burrage 13.5 15.4 13.5 Herbert 11.3 13.1 9.7 St. Margaret's 11.7 13.5 14.0 Central 13.9 13.2 9.6 Glyndon 14.2 14.5 14.6 St. Nicholas 13.0 13.3 10.2 Eltham 13.6 8.5 8.2 16. Compared with 1902, there was a decreased death rate in all the Wards except St Mary's, St. George's, St. Margaret's and Glyndon. The Central, Herbert and Eltham Wards had the lowest death rate, and River-South the highest. The apparently low rate of St. Mary's compared with the other Woolwich Wards is misleading, and partly dependent on the favourable age constitution of the population. The recent removal of the worst area, however—Rush Grove—should produce a real improvement. 16 The progressive improvement in the death rate of the Eiver Ward in the three years 1901-1903, is striking and satisfactory. St. Margaret's Ward on the other hand shows a progressive increase of death rate. The marked decrease in the rates of St. Nicholas Ward and Eltham is doubtless partly a result of the development of the new estates in these wards, and their population with a provident class of persons. 17. The following table gives the death rates in each parish for the past seven years. The rate for each in 1903 was the lowest recorded; the diminution in the past three years is more marked for the parishes of Woolwich and Eltham than for Plumstead. 1896. 1897. 1898. 1899. 1900. 1901. 1902. 1903. Woolwich 20.4 17.3 20.1 21.0 21.8 16.8 17.1 16.3 Plumstead 15.6 13.6 16.2 14.0 15.8 13.2 14.3 12.3 Eltham 14.7 14.2 13.5 16.0 14.5 13.6 8.5 8.2 18. The death rate for males was 14.0, and that of females 12.5. 19. Life capital saved.—In my last Annual Report I estimated that life capital of the monetary value of about £30,000 had been saved during 1901 and 1902, by improved sanitary administration, principally in Woolwich and Eltham parishes (see p. 15). The experience of 1903 would allow of the addition of at least another £15,000 being added to this saving in life capital. The total saving of life capital attributable to the existing sanitary administration would be of course a very much larger sum. 17 20. Infant Mortality.—The infant mortality as measured by the proportion of deaths under one year per 1000 births was 106. This is the lowest rate recorded in the Borough; the lowest previously recorded was 109 in 1894. The following table gives the rate in each parish and each ward during the past three years, and for comparison the rate in London and certain neighbouring districts:— 1901. 1902. 1903. Woolwich Parish 137 119 132 Wards. Dockyard 141 98 102 St. Mary's 123 133 176 Eiver—North 158 192 114 Eiver—South 109 155 St. George's 118 127 129 Plumstead Parish 122 129 95 Wards. Burrage 94 123 72 Herbert 91 107 80 Glyndon 94 119 105 St. Margaret's 130 112 95 Central 120 135 94. St. Nicholas 143 152 97 Eltham 141 95 74 Greenwich — 138 127 West Ham 172 149 148 East Ham 156 119 113 Erith 141 103 93 London 148 139 130 England & Wales — — 132 Woolwich Borough 128 124 106 18 21. The following table shows the deaths per 1000 births during the past eight years in each of the three parishes : — 1896. 1897. 1898. 1899. 1900. 1901. 1902. 1903. Woolwich 175 160 175 167 171 137 119 132 Plumstead 133 116 156 124 129 122 129 95 Eltham 176 120 150 198 156 141 95 74 Woolwich parish had a lower rate in 1902, but in Plumstead and Eltham the 1903 rate was the lowest in the eight years. 22. River Ward North and all the Plumstead Wards had a lower rate than in 1902, the most marked diminution being in the River Ward North and St. Nicholas. 23. Table VII. shows how Woolwich compares with other Metropolitan Boroughs as respects infant mortality. Four Boroughs had a lower rate, viz.:—Hampstead, Lewisham, Holborn and St. Marylebone. 24. Deaths at various ages.—Table IV. shows the number of deaths at various groups of ages. The total deaths under five years of age were 551, giving a death rate (per 1000 living under five at the census) of 40.8, and per cent. of total deaths— 34. At ages between five and twenty, the number of deaths was very small; after the age of five, the actual greatest number of deaths occurred between 65 and 75. Thirty-five deaths occurred over 85. 25. Zymotic death rate.—The number of deaths from the principal zymotic diseases was 119, giving a rate of 0.96 per 1000 living, compared with 1.51 and 1.88 in the two previous years. The London zymotic death rate was 1.76. 19 The following table gives the rate in each parish for the past four years:— 1900. 1901. 1902. 1903. Woolwich 3.8 1.61 1.74 1.08 Plumstead 2.1 1.42 2.20 0.92 Eltham 0.33 1.51 0.19 0.84 26. Inquests.—There were 160 inquests compared with 145, 154 and 154 in the three preceding years. The following table gives particulars as to causes of death:— 1. Natural causes 70 70 2. Accidental causes:— Burns 11 Drowning 2 Falls 6 Fractures 4 Misadventure 27 Run over 5 Suffocation, being overlain in bed 10 65 3. Homicidal causes:— Suicide 18 Murder and Manslaughter 2 20 4. Found drowned 4 Exposure 1 — 5 Total 160 Of the above, 5 were certified by the Coroner to be accelerated by alcoholism. 20 12 of the deaths from misadventure were due to an explosion of lyddite in the Royal Arsenal. Of the remaining 53 deaths from accidental causes, 10 occurred on Sunday, and 11 on Saturday. 27. Certain accidental causes of death shew an increase: thus burns were 4 in 1901, 6 in 1902, and 11 in 1903; suffocations, by being overlain in bed, were 2 in 1901, 5 in 1902, and 10 in 1903. Homicides were 22 in 1901, 9 in 1902, and 20 in 1903. 28. Uncertified deaths.—There were only 6 deaths which were not certified either by a medical practitioner or by a Coroner after inquest. The rate per cent. of total deaths was 0.4, the lowest yet recorded. An inquest is now held on almost every person who dies without having medical attendance. It is most important that this should be the case, pending the introduction of a more scientific method of enquiry into the causes of such deaths. 29. Deaths in Public Institutions.—Table I. shews the actual number of deaths occurring in public institutions in the Borough, viz., 272. Only 245 of these however were residents in the Borough. 171 deaths of residents in the Borough occurred in public institutions outside the Borough. Table lb shews how the institutional deaths were distributed among the various hospitals, asylums, &c. Of 171 deaths from phthisis, 53 occurred in the poor law infirmary, and 16 in asylums, chest hospitals, &c. Small-pox and Vaccination. 30. Six cases of small-pox only were notified, and there were no deaths. Tbe cases occurred in the months of April, 21 May and June. Three cases were inmates of the Workhouse, and must have been infected by a visitor having undetected small-pox. All the inmates of the Workhouse and Infirmary who had been in contact with these patients were revaccinated, and no further cases occurred inside these institutions. A scrubber at the Infirmary, however, was not vaccinated and she contracted the disease a fortnight later. A fifth case was infected at a remand house in Camberwell. The sixth case was a salesman in Hare Street; the source of his infection was not traced. All the cases were removed to Hospital. Besides those in the Workhouse and Infirmary, 11 contacts were re-vaccinated and two refused re-vaccination. The case rate per 1000 population was 0 05. There were no deaths. 31. The following return kindly furnished by the Vaccinating Officer gives particulars as to vaccination of children born in Woolwich and Plumstead parishes in 1902. Compared with 1901 there has been an increase in vaccinations of 79, and conscientious objections fell from 127 to 78. Births 3435 Vaccinated 2826 Insusceptible 18 Had Small-pox 1 Conscientious objections 78 Dead unvaccinated 262 22 Medical postponements 11 Removed — Vaccination Officer apprised 7 Removed, unknown, and not found 232 Measles. 32. There were 25 deaths from Measles, giving a death rate of 0.20, compared with 0.18 and 0.33 in the two preceding years. The death rate in London was 0 44; only three Boroughs (Metropolitan) had a lower rate, viz.: Hampstead, Chelsea and Kensington. Twenty-three of the patients were under 5 years of age, one from 5 to 10, and one from 15 to 20. 10 were males and 15 females; 8 were in Woolwich parish, 14 in Plumstead, and 3 in Eltham, giving death rates of 0.19, 0 20 and 0.28 respectively. All the deaths, and nearly all the cases occurred in the first six months of the year, and 10 of the deaths occurred in the last three weeks of May and the first week of June. 33. 661 Notifications of Measles were received from school teachers and others, compared with 323 and 646 in the two preceding years. The mortality was thus 3.8 per cent. of notifications. There were doubtless many cases occurring in families whence no children attended school, so that the real case mortality was less than 3 8, but probably exceeded 3 0. Evidently Measles is at the present time a more fatal disease than Scarlet Fever. 23 34. The following table gives the death rate per 1,000 population from Measles in each parish for the past 13 years, compared with London:— Woolwich. Plumstead. Eltham. London. Year. No. Rate. No. Rate. No. Rate. Rate. 1891 26 0.63 33 0.62 0.43 1892 16 0.39 19 0.35 0.79 1893 14 0.34 47 0.84 0.38 1894 39 0.95 20 0.35 0.76 1895 6 0.14 24 0.41 0.60 1896 72 1.75 68 1.14 0.82 1897 1 0.02 3 0.05 0.43 1898 53 1.27 59 0.94 0.69 1899 13 0.32 3 0.04 0.48 1900 29 0.69 46 0.68 0.43 Average, 10 years 0.65 0.54 0.58 1901 11 026 9 0.13 1 0.14 0.43 1902 10 0.24 31 0.43 0 — 0.51 1903 8 0.19 14 0.20 3 0.28 0.40 The reduction in the deaths from Measles in Woolwich and Plum8tead during the past three years is most striking and satisfactory, being equivalent to an annual saving of 38 lives, compared with the measles mortality in the previous ten years; it is, I believe, due as much to diminished fatality as to lessened spread of infection, and no doubt the efforts made to enlighten parents by leaflets and the educational effect of the application to measles of certain sections of the Public Health (London) Act, have been productive of much good. Exposure of a case of Measles is now penal equally with that of Smallpox. This is a reform I have advocated for ten years. 24 35. The numbers notified as attending each school were:— Eltham National, 79; Pope Street, 60; Grangehill Road, 57; Slade, 50; Burrage Grove, 47; St. Michael's, Wood Street, Plum Lane and Plumstead Road, 35 to 33; Earl Street, High Street, Ancona Road and Union Street, 27 to 20; and smaller numbers at 16 other schools. 36. The following is a copy of a report presented on 1st July, 1903. Measles.—Result of closure of classes in the six months, January to June, 1903. "In accordance with the arrangement come to with the Medical Officer of the School Board, 22 classes or classrooms of Elementary schools have been closed during the six months ending June 30th, for the prevention of Measles in the parish of Eltham, and in St. Margaret's, Glyndon, Central and St. Nicholas Wards of Plumstead. With two exceptions (Eltham Boys and Girls National Schools) all the classes closed have been in the infant department. The period of closure has varied from 6 days to 3 weeks. 1 Class (or room) was closed for 6 days 3 Classes (or rooms) were closed for 7 days 1 9 „ 8 10 „ 1 14 „ 1 16 „ 1 17 „ 2 19 „ 4 21 ,, The average period of closure was thus 13 days, including Saturdays and Sundays. 25 37. "The object of school closure is to prevent the attendance of children in the preliminary stage of Measles, i.e., when they have Catarrh and are highly infectious, but owing to the rash not having appeared, Measles is not suspected. When one case of Measles has been present in a class, it is to be expected that in from 10 to 14 days there will be, if the class is not closed, three or four or more children in the class sickening for Measles, and if these are allowed to remain (and only exceptionally are they detected) they will probably each infect three or four more cases, and cases will then go on occurring until most of the susceptible children in the class or room have been attacked. If on the other hand the class is closed, the disease can only spread in the house and from house to house, or perhaps to a slight extent by children playing together out of doors, but there is no doubt that its spread in this way is very slow and limited. 38. "To justify school closure there are two questions to answer:— (1) Did further cases occur after the closure and during the period of closure ? (2) Was the class free from Measles when the children returned to school ? "A satisfactory answer to these questions depends on punctual notifications from school teachers and, unfortunately, it is certain in some cases that these are not obtained. A satisfactory answer to question (2) depends also on whether the teachers are careful to exclude children coming from infected houses, a duty I fear sometimes neglected. 39. "It appears that of the 22 classes closed no subsequent cases were notified during the period of closure in 8, but in 3 of these I feel little doubt that cases occurred and either the c 26 teacher did not learn of them or neglected to notify. In the five remaining classes, in one a Saturday and Sunday intervened between the last attendance and the rash, and in others there may have been a mistaken diagnosis. At any rate in from two-thirds to three-fourths of the classes closed the closure was justified by the occurrence of further cases after the expected incubation. The second question can be answered still more satisfactorily, for in all, but one class the closure had the effect of preventing the occurrence of Measles in the class after return to school. In the one exception there was probably default of the parents or neglect of the teacher in allowing children to attend school from infected houses before the incubation had expired. 40. "571 cases of Measles were notified from schools in the whole Borough, 235 being in Woolwich Parish and the Herbert and Burrage Wards, where closure was not enforced, 157 in the rest of Plumstead (St. Margaret's, Glyndon, Central, and St. Nicholas), and 179 in Eltham. "Closure must therefore be said to have failed in staying the spread of the disease in Eltham; its spread appears to have been largely independent of the schools. Unfortunately it gained headway in a private school, from which no notifications were received and had spread widely before I knew of its existence. "In Plumstead, however, I consider that but for closure there would have been very much more Measles. 41. "It must not be overlooked that in schools where closure was not enforced, the teachers were specially warned when Measles appeared in the neighbourhood, and advised as to looking out for and excluding suspected cases. I am aware 27 that some teachers by their vigilance, kept their schools almost free from Measles. I would specially mention Burrage Grove, Union Street and St. Mary's, as schools where the infant teachers seem to have been particularly vigilant and successful in keeping off the infection. In addition to this Dr. Thomas, Assistant M.O. of the London School Board, visited schools where cases occurred and examined the children, excluding any suspected to be infectious." 42. Under an order of the London County Council, Measles has been a dangerous infectious disease under the Public Health (London) Act since April 1st, 1903. This course was recommended by me seven years ago. Measles is however exempt from the provisions relating to notification, hospital isolation, milk supply prohibition, and prohibition of retention of dead body in sleeping room. 20,000 handbills were printed, calling attention to this order, and distributed in the primary schools. Scaelet Fever. 43. There were 389 cases of Scarlet Fever notified, equivalent to a case rate of 3.16 per 1,000 population; this rate exceeds that of the two preceding years, but otherwise is lower than in any years since 1891. The following table shews the occurrence rates from Scarlet Fever for the Borough and each parish during the past three years, compared with London:— 1901. 1902. 1903. Borough 2.64 2.14 3.16 Woolwich Parish 2.55 2.49 3.05 Plumstead ,, 2.63 1.88 3.19 Eltham „ 3.42 2.45 3.40 London County 4.1 4.0 2.75 c 2 28 44. Table III gives the age distribution, the number of cases in each ward, and the number of these removed to hospital. The heaviest incidence was on St. Margaret's Ward, and specially affected the Slade School. Several mild cases were, on examination by Dr. Thomas and myself, found to be attending this school in an infectious state. Other unnotified and unisolated cases I discovered in this district by visiting the houses, one of whom was notified as Measles. The cases were mostly exceedingly mild, as shewn by the exceptionally low case mortality (1.0 per cent.) and were also of feeble infectivity, or there would certainly have been a much wider spread epidemic. One boy after an absence of a week from school for 'cold,' was found a few days after his return to be peeling and sent home by the teacher. The illness must have commenced fully two weeks before, and he had during that time been closely associated with five brothers and sisters, none of whom were known to have had Scarlet Fever before; yet only one of these was infected and he not for 10 days after the first exposure. 45. There were only four deaths, giving a death rate of 0 03 per 1,000 population, the lowest rate that has occurred to my knowledge. The lowest rate previously recorded was 0.04 in 1891, and again in 1901. The London death rate was 0.08. The following table gives the Scarlet Fever case mortality (deaths per 100 cases), compared with London in the past three years:— ] 1901. 1902. 1903 The Borough 1.6 3.0 1.0 London County 3.2 2.80 2.9 29 46. Hospital Removal.—Of the 389 cases, 337, or 86 per cent., were removed to the Fever Hospitals of the Asylums Board, compared with 85 and 86 per cent. in the two preceding years. 11 cases or 3 2 per cent. of admissions were reported not to be Scarlet Fever after observation at the hospital. The average stay in the hospital was eight weeks and four days. 47. Return Cases.—In 10 cases the source of infection was traced to a patient recently returned from the Fever Hospital, the 10 cases having been infected by four such patients; one of them infected two at his home, three schoolfellows, and two relations (not included among the 12) in an adjoining parish, where he was sent after his mother was told to isolate him. Each of the three returned cases had either on his return home or within two or three days a nasal discharge. One of the infecting cases was 12 weeks in hospital, one 10, one 9, and one 7. The interval between return home and infection of the secondary case varied from 3 to 15 days. One case began with Scarlet Fever on the day of his return after Diphtheria. 48. Home isolation.—Six cases were certified to be properly isolated at home under the arrangement with the Principal Medical Officer of the Royal Arsenal commenced in 1900. 49. The value of Hospital isolation.—The question of the success of Hospital isolation in Scarlet Fever has been raised in recent years by more than one Medical Officer of Health. From the point of view of treatment and benefit to the individual there is no doubt that removal of a sick patient from a poor home where cubic space, cleanliness, suitable diet, and 30 proper nursing are all absent or deficient, to one of the admirably equipped Hospitals of the Asylums Board, is of very great advantage. In many houses too, it is difficult or impossible to secure isolation, and removal to Hospital obviates the spread of infection in the home. But when we come to answer the question 'does Hospital isolation diminish the prevalence of Scarlet Fever ?' an affirmative answer cannot be readily given, though I think that it was formerly anticipated that this would be the natural and speedy result of suitable provision of Hospital accommodation, and of isolation becoming general. Over 60 per cent. of the notified cases of Scarlet Fever in Plumstead have enjoyed the advantage of Hospital isolation every year for 10 years past, and the proportion has steadily increased, until during the past three years over 85 per cent. of the cases in the Borough have been isolated. Yet although the last four years show a marked diminution of cases compared with the preceding eight years, they are still more than in 1891, when only 20 per cent. were isolated in Hospital, and there is no sign of the disappearance of the disease. The death rate on the other hand has shown a marked and persistent decline, and this may I think be reasonably attributed to the existence and use of the Hospitals in the more serious cases, and in those coming from the poorer homes. At a rough estimate I should say that about half the Woolwich cases are benefited by removal to Hospital, but that the other half might be satisfactorily isolated at home with benefit to themselves and without risk to others. Each patient costs about £17 (i.e., 42/6 a week) for maintenance in hospital (p.p. 37 and 207 Asylums Board Annual Report, 1902), so that if my surmise is correct that hospital isolation is useless for one half the patients, a sum of £2,856 31 was spent last year out of the rates which produced no public benefit, and only saved a much smaller amount to the pockets of persons who did not require such pecuniary assistance. 50. The reason why Hospital isolation has failed to abolish Scarlet Fever is that this disease is now kept up mainly by mild undetected cases, and by 'return cases.' The greater part of the cases which go to Hospital would be isolated if left at home ; the very mild cases cannot be isolated because they are not detected, and the Hospital isolation is itself responsible for frequently sending home patients supposed to be cured and free from infection, while experience soon shows that they are capable of giving the disease to other persons. Under the present state of medical knowledge it is impossible to detect such cases and prevent return cases, and it seems hopeless to expect Scarlet Fever to be eliminated. Thus it becomes a serious question whether so large a sum should be expended in general isolation, when equally good results would probably be obtained by home treatment of a large proportion of those now sent to Hospital. 51. Duration of Isolation and return cases.—As stated above, the duration of Hospital isolation during 1903 was 60 days. The length of stay in Hospital has been reduced of late years, but is still in my opinion unnecessarily long. Most authorities are now of opinion that the later stages of desquamation are non-infectious, and that the infection resides in the discharges of the nose and mouth. Prolonged Hospital isolation, besides being an unnecessary expense, seems to increase the liability to return cases, at any rate it does not diminish it. The following resolutions were unanimously 32 passed at a meeting of the Metropolitan Branch of the Society of Medical Officers of Health:— (1) That there is now strong and increasing evidence that at least the later desquamation of Scarlet Fever is not infectious. (2) That bacteriological researches indicate that the tonsillar and buccal mucus not only in the early but also in the later stages is the principal source of infection. (3) That notification of the discharge of a fever patient from Hospital should be sent to the Medical Officer of the District concerned, and in the event of such patient having nasal, aural or other complication, the details should be sent at the same time for the private information of such Medical Officer. Diphtheria. 52. The 186 cases of diphtheria notified, compare with 216 and 233 in the two preceding years. The case rate was 1.51, the lowest recorded since 1892. There were 13 deaths compared with 23 in the preceding year. The death rate was 0.11, the lowest recorded since 1891. (See Table V.) The London death rate was 0.16. 53. Fifty-three cases were in Woolwich parish, 118 in Plumstead, and 15 in Bltham. The following table shews the case rate in each parish in the past three years compared with London. 1901. 1902. 1903. The Borough 1.84 1.87 1.51 Woolwich Parish 1.56 1.67 1.27 Plumstead ,, 1.9 2.09 1.67 Eltham ,, 2.33 1.08 1.40 London 2.7 2.3 1.64 33 54. 153 of the cases were between 1 and 15 years of age. Since the birth rate is higher in Plumstead than in Woolwich parish, and the infantile death rate much lower, it follows that the proportion of children to the whole population is much greater in Plumstead than Woolwich, and this difference largely accounts for the higher incidence rate of Diphtheria, Scarlet Fever, and Measles in Plumstead. 55. 157 cases or 85 per cent. were removed to Hospital. The case mortality was 7 0 per cent., compared with 8.8 and 9 9 in the two preceding years, and 9.8 in London All but one of the deaths (12) occurred in the Fever Hospital. 56. The largest number of cases proportionally to population occurred in St. Margaret's and Central Wards, and the smallest number in Herbert Ward. 57. School Attendance.—The largest number of cases, viz., 18, attended Conway Road School. 58. Bacteriological diagnosis.—Swabs from the throat or nose of 66 persons suspected to have diphtheria were examined bacteriologically by the Lister Institute of Preventive Medicine. The result was positive in 15 cases, negative in 45, the pseudo bacillus was found in 5, and one was stated to contain a few suspicious bacilli. In 1901, 26 swabs were examined and 7 positive results obtained; in 1902, 97 swabs and 27 positive results. 59. Mistaken Diagnosis.—19 cases or 12 per cent. of admissions were found not to be Diphtheria after removal to Hospital. 34 60. Return Gases of Diphtheria are now quite exceptional, as it is I believe the rule at the Brook Hospital not to discharge cases till they are found free from the bacilli. Last year however, there were six cases in one family in which infection followed the return home of a child with a nasal discharge, which was found to contain diphtheria bacilli. This child though sent to Hospital for Diphtheria, was found not to have that disease, but to have Measles on admission, and was separately treated in an isolation Ward. The nasal discharge apparently acted as a carrier of the diphtheria bacilli, which gained access in spite of the precautions taken. Another case developed Diphtheria a few days after the return of a brother from Hospital on recovery from Scarlet Fever. In his case however, a bacteriological examination failed to detect the Diphtheria bacilli. 61. The value of Hospital Isolation in Diphtheria is decidedly greater and more general than in Scarlet Fever. The injection of antitoxin and the performance of tracheotomy in laryngeal cases, are operations which can usually be much more safely performed in a well equipped Hospital than in the patient's home. Further, the practice of examining all cases bacteriologically before the discharge obviates the occurrence of return cases, as pointed out above, so that Hospital isolation can only exceptionally be held responsible for any spread of infection. Enteric Fever. 62. There were 37 cases of Enteric Fever, (excluding 5 found not to be Enteric after observation in Hospital), giving a case rate of 0.34, compared with 0.59, 0.58, and 0.40 in the three preceding years. This is the lowest rate recorded. The London case rate was 0.51. 35 63. There were 6 deaths giving a rate of 0 05, compared with 0 11 and 010 in the two preceding years. This is the lowest death rate recorded. The London death rate was 0 08. 64. The following were the cases occurring in each parish during the past four years. ] 1900. 1901. 1902. 1903 Woolwich 23 21 17 10 Plumstead 39 32 24 22 Eltham 4 15 9 10 65. Two cases were attributed to eating oysters, one to periwinkles, one to crayfish and crabs bought and cooked at Hull, four to watercress, five to unknown causes outside the Borough, viz., at Felixstowe, Shoeburyness, Portsmouth, Brighton, and Newport, respectively; one fell in the Victoria Dock 10 days before the onset, and one was employed on a river steamer; in seven cases the infection was contracted from a previous case in the home, viz., one in one home, and six in another, the first case in each instance not having been diagnosed till the others had been infected. In five cases occurring in Eltham, the infection was attributed to a milk supply coming from a farm in Mottingham, outside the Borough. 66. On the 22nd April, I made the following report on Enteric Fever in Eltham:— Enteric Fever at Eltham.—The Borough of Woolwich has been remarkably free from Enteric Fever during the present year, only six cases having occurred up to this date. Three of these have, however, been in Eltham, one at each of the following houses :— F., 32, " Eathavon," West Park, began 26/2/03. M., 5, " Wensley House," Court Road, began 12/3/03. F., 18, Park Villas, Court Road, began 6/4/03. 36 Full particulars as to the occurrence of Enteric Fever at Eltham in 1901 and 1902 are given in the Annual Reports for these years, where it is shewn that Court Road and West Park have been specially affected. These two roads are practically continuous, and the lower part of Court Road and the whole of West Park are nearer to the shops in the village of Mottingham than to those in Eltham. I am informed that four cases of Enteric Fever have occurred in the small village of Mottingham this year, and that seven cases occurred last year, or a total of 11 cases in the last 15 months. Nine of these cases had their milk from a Mottingham dairyman. During the same time 8 cases have occurred in Court Road and West Park, 6 of which had their milk from the same dairyman, who supplies 38 out of 86 houses in these two roads. The case at Wensley House began 15 days after arrival from Newport, Monmouth, so that it is at least equally probable that the infection was contracted at Newport or in transit, as in Eltham. One of the cases occurring last year in 2, West Park, had milk from another dealer in Mottingham, where a case of Enteric Fever had recently occurred. These two cases (Wensley House and 2, West Park) are the only ones of the eight cases in Court Road and West Park, occurring in 1902 and 1903, not supplied by the dairyman above referred to. Except the milk supply, nothing else has been found in common between the Enteric cases which is likely to cause Enteric. The houses are large villa residences, the occupiers of the upper middle class, the water supply by the Kent Company and continuous; where storage cisterns exist they are regularly cleansed. No wells are known to exist at any of the houses. At the three houses affected this year, the drains had been recently relaid, and are disconnected from the sewer. 37 At the affected houses in Court Road, the drains are of recent date. All the houses in West Park have been recently inspected house to house, the drains tested with smoke, and wherever found defective relaid. All houses where Enteric Fever has occurred, and many others in Court Road, have been similarly dealt with, and the drainage in both roads is probably decidedly superior to that of most houses in town or country. As regards the complaint of Mr. Payne of neglect to inspect his drains, there has been no neglect at all, but the drains were relaid in October, 1902, and a proper disconnection and manhole supplied; they have since been twice tested (October, 1902, and 29th March, 1903), and found satisfactory. There are two sewers draining Court Road and one draining West Park; these are all ventilated with shafts and work satisfactorily. It is, however, under consideration to put an automatic flushing tank at the head of the West Park sewer. I have ascertained that the main West Kent sewer runs under Mottingham and the south-west end of West Park; this is, however, at a depth of 50 to 60 feet, so it is not likely that it can have any injurious effect on these localities. Shell fish, ice creams, and other foods which occasionally cause Enteric Fever have been excluded. On the whole, it appears that the recent occurrence of Enteric Fever in Court Road and West Park is connected with its occurrence in Mottingham. The Eltham cases occurred in January, March and December, 1902, and February, March and April, 1903. The Mottingham cases in February, April and November, 1902, and March, 1903. What the connection is, is not at present obvious. Although I have shown some reason to suspect a particular milk supply, I am not aware of any condition that would cause a milk supply to be 38 ated during so long a period of time. Further, the farm and dairy premises have been inspected by Dr. Tew, Medical Officer of Health of West Kent combined sanitary districts, and the conditions found to be satisfactory. Also, the cows have all been examined by Mr. Shaw, Veterinary Surgeon, and found healthy. No case of Enteric has been known to have occurred among any of the dairy employees. There does not appear sufficient reason for interfering with the milk business in question, but it would certainly be a wise precaution for the inhabitants of the district to boil all milk before use. 67. The conclusion at which I arrived as to the source of the prevalence in West Park and Court Road has since been confirmed by Professor Simpson of King's College Hospital, who investigated the prevalence on behalf of a Committee of the residents. The automatic flushing tank referred to above has been provided. Although, like myself, he failed to discover any actual source of infection, Dr. Simpson considers that the polluted condition of a small watercourse running through a field in which the cows of the suspected farm are turned out, offers sufficient explanation of the infectiousness of the milk. This watercourse received surface drainage from a farm and a piggery in the Borough and various other pollutions from outside. At one of these farms owing to the waterlogged conditions of the soil it had been found impracticable to empty the cesspool as often as it filled up, and consequently it overflowed into the watercourse. This has been remedied by the Borough Council making a special sewer to this farm, which is now being properly drained. The piggery has also been abolished. A letter has been sent to the occupier of every house in Court Road and West Park warning them to boil all milk before use. 39 68. Bacteriological Diagnosis.—Blood serum from 23 cases of suspected Enteric Fever was submitted to the Lister Institute for the application of the Widal reaction, compared with 27 and 30 cases in the two previous years. A positive result was obtained in 9 cases, and a negative in 14. 69. Twenty-seven cases were removed to the Fever Hospital and 5 or 18 per cent. were found to be a mistaken diagnosis, compared with 12 and 14 per cent. in the two previous years. 70. Diarrhœl Diseases.—The deaths from Diarrhcea, Dysentery and Epidemic or Zymotic Enteritis, numbered 44, or 0.36 per 1,000 population, compared with 0 82 and 0.48 in the two preceding years. The rate for London County was 063. There were in addition 15 deaths from Enteritis and GastroEnteritis, making a total of 59 deaths, probably due to the same disease under different names. 71. Of the above 59 deaths, 41 were under one year of age. The following table shews the death rate from these diseases per 1,000 births in each Ward and Parish in the past three years:— Diarrhœal Diseases per 1,000 Births. 1901. 1902. 1903. Woolwich Parish 37 19 22 River Ward, North 62 37 35 ,, South 23 28 Dockyard 32 17 18 St. Mary's 19 18 31 St. George's 20 7 6 40  1901. 1902. 1903 Plumstead Paeish 31 23 13 St. Nicholas 43 29 21 Central 20 12 7 Glyndon 34 31 9 St. Margaret's 22 25 12 Herbert 21 11 11 Burrage 23 22 Nil Eltham 39 9 11 72. The River Ward, North, again had the highest diarrhoea death rate; Dockyard, St. George's, the Plumstead Wards, and Eltham shew an improved rate, St. Mary's and River Ward an increased rate, compared with 1901. 73. Table XIV. shews that 19 out of 44 deaths from diarrhoea occurred in September, and 8 in October. The temperature, 3 ft. below the ground reached the highest point—61.64—in the third week in July. 74. Leaflets on the feeding of infants are now distributed largely by clergymen at baptisms, and in other ways as opportunity is found. No general arrangements have yet been made by which a copy can be sent to each mother after the birth of a child. 75. Erysipelas.—There were 58 cases of Erysipelas compared with 72 and 98 in the two preceding years. The case rate from this cause, 0.47, is the lowest on record. There were no deaths. 76. Puerperal Fever.—There were only 2 cases of Puerperal Fever notified, compared with 8 and 11 in the two preceding years. The case rate was 002, and the death rate (one death) 0.00, both beiDg the lowest on record. 41 One case, which proved fatal, was attended in the confinement by a midwife, and one by a medical man. 77. Influenza, Bronchitis and Pneumonia. — Influenza caused 27 deaths compared with 62, 22 and 60 in the three preceding years. Bronchitis and Pneumonia caused 258 deaths, compared with 407, 245 and 299 in the three preceding years. Table VIII. shows that the highest number of deaths from Bronchitis and Pneumonia was reached in the first week of February and the third week of April. The latter succeeded a week having a mean temperature of 39.'5, making it with one exception the coldest week of the first half of the year. Tuberculosis. 78. There were 237 deaths from tuberculous disease, giving a death rate of 1.92, compared with 2.29 and 1.86 in the two preceding years. The following table gives the number of deaths from each of the various forms of tuberculosis in the past three years, and for comparison the deaths from simple meningitis:— 1901 1902 1903 Tubercular meningitis 17 20 28 Simple meningitis 26 19 24 Tuberculosis-intestines & peritoneum 37 29 14 Tuberculosis—other forms 24 Phthisis 215 183 171 It thus appears that while phthisis has much diminished in the past three years other forms of tuberculosis, especially tubercular meningitis have somewhat increased. This is an unexpected result, and may perhaps be only apparent; the diagnosis between simple and tubercular meningitis being very D 42 difficult and uncertain, it may be that there has been a transference from simple to tubercular meningitis, i.e., that cases which a few years ago were called meningitis are now called tubercular meningitis. 79. The deaths from phthisis were 171, giving a death rate of 1.39 compared with 1.79,1.80 and 1.47 in the three preceding years. There was thus a reduction in the four years of 23 per cent. in phthisis mortality. 80. The following table gives the death rate from Phthisis per 1000 population, in each ward during the past three years:— 1901. 1902. 1903. No. Rate No. Rate. No. Rate. Woolwich Parish 105 2.52 83 1.99 81 1.94 River, North 46 3.17 4 115 4 1.16 ,, South 25 2.15 26 2.27 Dockyard 17 1.95 18 2.03 13 1.49 St. Mary's 23 2.20 19 1.79 22 2.10 St. George's 19 2.35 17 2.06 16 1.98 Plumstead 104 1.49 94 1.30 84 1.18 St. Nicholas 33 1.63 25 1.08 29 1.26 Central 15 1.46 13 1.24 8 0.78 Glyndon 18 1.83 14 1.39 11 1.11 St. Margaret's 14 1.37 17 1.41 12 1.01 Herbert 12 1.30 9 0.91 7 0.72 Burrage 12 1.22 16 1.59 17 1.72 Eltham 6 0.77 6 0.59 6 0.56 The Borough 215 1.80 183 1.47 171 1.39 London .. 1.66 .. 1.60 •• 1.55 43 81. As in previous years River Ward South had the highest death rate, and after it St. Mary's and St. George's. Eltham again had the lowest rate, followed by Herbert and Central Wards. The difference between the North and South River Ward as regards the Phthisis death rate is very noteworthy. 82. The following table shows the death rate from Phthisis in recent years in Woolwich and Plumstead parishes. 1895 1896 1897 1898 1899 1900 1901 1902 1903 Woolwich — 2.1 1.9 2.0 2.4 2.4 2.52 1.99 1.94 Plumstead 1.64 1.3 1.5 1.27 1.45 1.50 1.51 1.30 1.18 The rate for each parish in 1903 was the lowest recorded. 83. Sex and age. 114 of the deaths from phthisis were males, and 57 females, i.e., the males were just twice as numerous as the females. Other forms of tuberculosis were nearly equally divided among the two sexes. 10 only of the 171 deaths from phthisis were in persons under 20 years of age, and 9 only of the 66 deaths from other forms of tuberculosis were in persons over 20 years of age. Thus Tuberculosis is equally prevalent among males and females under 20, but much more prevalent among males over 20. The largest number of deaths from phthisis proportionally to numbers living was at the age period 55 to 65, the mortality increasing regularly from the age period 20-25 upwards. 84. Notifications. Voluntary notification commenced in 1901. 167 cases were notified in 1903, compared with 189 in 1902. The largest number of notifications proportional to population came from River, Burrage and St. Margaret's Wards. 65 were notified by the Poor Law Medical Officers, and 31 by the Medical Officers of the Royal Arsenal. d 2 44 85. Of 147 cases notified between January 1st and September 30th, 43 died before the end of the year, 21 dying within one month of notification, and 17 more within 6 months. In 23 notified cases the previous duration of the disease was under six months, in 30 between six months and a year, in 23 between one and two years, and in 72 over two years. So far then voluntary notifications cannot be said to have been very successful in getting early information of the occurrence of these cases ; but it must be remembered that the majority of them belong to a class who are very slow in seeking medical assistance. 86. The source of infection in 125 notified cases was probably as follows:— Relatives, 39—viz. (father 8, mother 11, brother 11, husband 3, sister 5, son 1.) Friends 3 Lodgers 3 Neighbours 2 Landlord 1 Hospital 1 Army 1 Workshop 35 Public house 39 If a probable source of infection could not be found in home or friends, and the patient was employed in a workshop, the infection was put down to this source unless there was distinct evidence of intemperance. Cases of intemperance, and others occupied out of doors, in such occupation as dock labourers, carters, etc., and known to frequent public houses were classed under this heading. 87. Of 99 adults (viz. 75 notified and 24 deaths) as to whom information was obtained, (excluding persons under 20 years of age) 7 were said to be teetotallers, 59 temperate or moderate drinkers, and 33 intemperate. Teetotaller often means not an 45 habitual drinker, and temperate, not a drunkard, but even as the figures stand, it is a striking fact that 33 per cent. or one third of consumptives should be intemperate according to their own or their friends admission. 88. Of the houses of notified consumptives, 16 were to some extent dirty, 4 had damp walls, and 2 dark rooms. 89. Age distribution.—The following table gives the age of notified cases:— 0-1 1-5 5-15 15-25 25-45 45-65 over 65 0 5 9 34 76 41 0 In proportion to numbers living, the largest number of notifications was between the ages 45—65. 90. Sex—The males notified were 112, and the females 55. 91. Occupation.—Of the 112 notified males, 57 or more than one-half were Arsenal employees, of whom 23 were labourers. The departments and workshops affected are as follows:— Royal Laboratory (27) including— Wheelwright's shop 1 Main Factory 1 Electric Branch 1 Rifle Shell Foundry 2 No. 2 Cartridge Factory 2 No. 2 Danger Buildings 2 Primer Branch l Fuse Branch 4 No. 9 Magazine 1 Detonating Factory 1 Cordite Factory 1 46 Royal Carriage Department (13), including— Tinman's Shop 1 Erecting Shops 2 Slide Shop 1 Forge 1 Saw Mills 1 Coopers' Shop 1 Royal Gun Factory (5), including— Engine Repair Shop 1 Torpedo Factory 1 Naval Ordnance Department 1 Army Ordnance Department 2 Central Office 1 Seventeen outside the Arsenal were labourers (6 being Dock labourers); 3 were soldiers, 2 coal porters, 2 carmen, 2 bandsmen, E.A., 2 clerks, 2 potmen, 2 schoolboys; the remainder included a mountebank, a cat's meat man, a stoker, a laundryman, a stableman, a salesman, a contractor's foreman, an errand boy, a hairdresser, a pensioner, a tailor, a cashier, and a racquet ball maker. The 53 females included 3 servants, 2 dressmakers, 2 machinists, a housemaid, a barmaid and a cook. 92. The incidence in the Royal Arsenal per 1,000 employees was 4.1 in the Eoyal laboratory, 4.6 in the Carriage Department, 2.1 in the Gun factory, and 1.3 in the Army and Naval Ordnance Departments. In the laboratory the incidence was more especially on those employed in the danger buildings, being there 8.1 per 1,000 employees. 47 By the kindness of the Superintendents of the Royal Laboratory and Carriage Departments, and of the Principal Medical Officer, I was enabled to inspect the different workshops of these departments. Many of these are so lofty and the cubic space so ample, that the conditions of labour approach those of open air work. In most the ventilation is good, much improvement having taken place in recent years, and the usual practice is to sprinkle and sweep the floors every morning. Notices are posted in every shop forbidding expectoration, and though the rule is not yet rigidly enforced, breaches of it seem to be exceptional. The workshops in the danger buildings however, though kept exceptionally clean, are an exception to the rule of good ventilation. It is considered necessary to keep these rooms at a high temperature, and to prevent the access of outside dust, and consequently windows are as a rule kept closed. This may explain the special incidence of Phthisis on the men working in these buildings. 93. The figures given above do not indicate special incidence on any one or more workshops, and I do not consider these as frequent sources of infection, although no doubt some personal infection takes place there. It is probable that the want of ventilation and the high temperature in some shops acts indirectly by weakening the constitutional resistance and thus making the men more susceptible to infection met with in other places. Samples of sweepings from the floors of six different workshops were examined at the Lister Institute by innoculation experiments for the presence of tubercle bacilli; the bacilli were not found in any of the samples. 48 94. The Public House as a source of infection.—I have already pointed out that 33 per cent. of the notified cases were intemperate, and 90 per cent. habitual drinkers (and as such frequenters of public houses.) The fact that men are affected more than women, that men are affected more after the age of 35, and that the incidence is specially on such occupations (dock labourers, musicians, carmen and cabmen, barmen, and others employed at publichouses) as give opportunity to frequent public-houses is further proof of the close connection between the tavern and consumption. Seeing that drink bars are frequented largely by men in all stages of consumption, and that spitting on the floor is a general practice in these places, it is to be expected that they should be a fruitful source of infection, and as shown above, my enquiries go to show that they are the most frequent source of the disease. To put this supposition to the test, samples from the bar sweepings of six public houses were examined by innoculation experiments, and the tubercle bacillus was found in two of them. During the past two years, six deaths from phthisis have occurred among persons engaged in the drink traffic, giving a mortality of 3.8 per 1000 persons so employed, or nearly thrice the mortality of the Borough. 95. Infection of Children.—Enquiry was made into 34 deaths of children from general tuberculosis and tubercular meningitis, and 18 were found to have been infected by relatives or friends suffering from phthisis, but only one of whom had been notified; 7 were infected by the father, and 5 by the mother ; 7 more of the 34 were probably infected by parents or friends in an early and unrecognised stage of consumption. These facts show both the importance of early recognition and notification of phthisis, and the fact that only a very small proportion of cases are yet notified as early as is desirable. 49 96. Bacteriological diagnosis.—Sputum from 144 cases of suspected phthisis was examined by the Lister Institute, and the tubercle bacillus was found in 44 cases. In 1902, 36 samples were examined and 12 positive results obtained. 97. Disinfection was performed in 108 houses, 80 being after death, and 28 after removal to Infirmary or Hospital, or during occupation. In the three preceding years, 18, 86, and 89 premises respectively were disinfected. In addition to disinfection, special wet cleansing was recommended in all cases, and whenever the rooms affected were found dirty, and in some other cases the walls were stripped and cleansed. 98. Sanatorium treatment. At the instance of your Council, a conference was held between delegates of the Councils of the three Boroughs of Greenwich, Lewisham, and Woolwich, as to the advisibility of establishing a joint Sanatorium for the treatment of phthisis. The conference decided that this was not advisable, but as an alternative recommended that the Asylums Board should provide for Sanatorium treatment of consumption. 99. Your Council therefore decided as an experiment to maintain two beds at the Peppard Common Sanatorium. This is a small sanatorium of 12 beds in Oxfordshire, six miles from Reading; it is admirably situated in an open and elevated situation, 375 ft. above sea level; the soil is gravel over chalk. The two beds are both intended for men, who form the majority of the cases, as well as being the wage earners ; since however, the existing accommodation did not permit of men being received till after Xmas, two women were admitted in 50 the first instance. One remained three months, and returned very much improved in every way ; the other remained two, and though her chest symptoms improved and she gained considerably in weight, abdominal tuberculosis developed and she had to be transferred to the Workhouse Infirmary. Two men are now undergoing treatment, and are both doing well. 100. The object of a Sanitary Authority in maintaining Sanatorium treatment is three-fold:—Firstly, the restoration to health and to work of the sick; Secondly, their temporary removal from homes where they may be a source of infection to others; Thirdly, their education in the principles of open air treatment, and in the mode of life required to prevent their being a source of infection to those with whom they come into contact. This last object is, perhaps, the most important of all, and it is to be expected that those who have spent a couple of months at the sanatorium will continue to live and sleep with open windows, and to avoid spitting so as to endanger the health of others. With this end in view it is desirable that the stay at the sanatorium should be short to allow of the education of as many as possible, but it must not be expected that patients can be cured by two or even three months' residence. 101. The prevention of promiscuous spitting. The L.C.C. have made a bye-law prohibiting spitting in public conveyances, places of public amusement, and public waiting-rooms. This bye-law applies to railway carriages, trams, theatres, &c., but 51 unfortunately does not apply where most needed, viz.: public houses. Notices requesting persous not to spit on the floor are posted in the bars of nearly all the licensed houses in the Borough. A letter was also sent to every landlord or manager of a licensed house, calling his attention to the excessive death rate from phthisis among public-house servants, due no doubt chiefly to their dangerous occupation of sweeping the bar floors. The necessity for wet cleansing was insisted on. Spitting flasks. These are supplied in the Health Department at cost price, viz : 6d. each. 23 were applied for during the year. Cancer. 102. There were 93 deaths from Cancer (malignant disease), giving a rate of 0 75 per 1000, compared with 0 70 and 0 83 in the two preceding years. There were 32 deaths in Woolwich parish, 57 in Plumstead, and 4 in Eltham. Thirty-nine of those who died were males, and 54 females; 13 were under 45 years of age, and 80 over 45. The highest number of deaths proportionally to persons living was at the age periods over 75, and the absolutely highest number between 55 and 65. The highest mortality was in Burrage Ward. 103. Two of the deaths from malignant disease were classed as Sarcoma, one affecting the lungs, and the other the bladder. 52 The following table shews the sex and the region affected of the remaining cases:— Seat of primary disease Male Female Head and face 1 Mouth and tongue 3 2 Pharynx, larynx and neck 2 1 Æsophagus 3 Stomach and pylorus 6 8 Intestines (excluding rectum) 2 1 Rectum 6 2 Liver 9 6 Pancreas 1 Lungs and chest 1 1 Male urinary organs 3 Female ,, ,, 1 Female genital organs 19 „ breast 8 Pelvis and groin 1 1 Total 39 52 104. It appears that cancer in men affects principally the digestive organs, and in women the genital organs. Alcoholism. 105. There were 18 deaths from alcoholism, and 24 due to cirrhosis of the liver, making a total of 42 deaths from intemperance, compared with 52 and 40 in the two preceding years. In addition to the above, 313 deaths were due to disease of the brain, nervous system, heart, blood vessels and kidneys, of which a large proportion were certainly caused directly or indirectly by alcohol. 53 106. The following table shews the death rate from alcoholism, and cirrhosis of the liver, in the past three years, in various divisions of the Borough compared with London. 1901. 1902. 1903. Public Houses per cent. of total houses. The Borough 0.44 0.32 0.34 1.0 Woolwich Parish 0.74 0.61 0.41 2.0 River Ward 1.10 0.86 0.53 2.8 „ South — 0.94 0.70 2.9 Plumstead Parish 0.27 0.19 0.35 0.5 St. Nicholas Ward 0.49 0.17 0.26 0.2 Eltham 0.25 Nil Nil 0.6 London County — 0.31 — — The above table shews that to a large extent the mortality from alcoholism is proportional to the number of public houses. In my last annual report, the death rate of the population living in 24 public houses in the River Ward was shown to be 29.3 (twice that of the Borough) and the Phthisis death rate 5.3 (about thrice that of the Borough). See p. 43, A.R. 1903. Syphilis. 107. Fourteen deaths were certified to be from Syphilis, 8 being under one year of age. Five of the deaths occurred in the Infirmary, and 4 in outlying hospitals, thus two thirds of these deaths occurred in public charitable institutions. It is not to be understood that this represents the real facts of the case, but it means that private medical practitioners are unwilling to state on a death certificate a cause which would perhaps be an impeachment of the character of the person to whom it was given, or if not of his own, perhaps of his friend's character. No doubt the real number of deaths from Syphilis, 54 infantile and adult, would be nearer 40 than 14. In investigating the death of an infant attributed to ' debility,' I obtained distinct information that the child had suffered from hereditary Syphilis, and this was no doubt only an instance of many. Meteorology. 108. The weather of 1903 was generally favourable to health. In the first or winter quarter 12 weeks had a temperature above the average of the previous fifty years, and one only had a temperature below the average. In the second quarter, 5 weeks had a temperature above the average, and 8 below. In the third or summer quarter, the temperature was below the average in 9 weeks, and in the fourth quarter, it was above in 10. The temperature three feet below the ground varied between 40°90 in the third week of January, and 61°64 in the third week of July. The lowest temperature of the air was 23°6 in the second week of January and the highest 87°5 in the second week in July. The year was characterised by an abnormally high rainfall, which reached to 35.33 inches, compared with 20.16 and 20.13 in the two preceding years. The third quarter had the highest rainfall, viz : 12.32 inches. The heavy rainfall and low temperature of the summer both contributed to the low mortality of the year, reducing especially the number of deaths from diarrhoea. 55 Part II.—Administration. Water Supply. 1. The Kent Water Company on the south of the river, and the East London Company on the north, maintained an effective and satisfactory supply of water during the year. The supply was constant over the greater part of the district. No complaints were received as to water being turned off. With one or two exceptions, all houses are supplied by the above companies. 70 Defective and foul cisterns were found and remedied or cleansed. In 61 houses the supply was deficient or temporarily cut off, and notices served to provide a sufficient supply. The question as to what constitutes a proper and sufficient water supply must be considered on its merits for each house, but the general practice of the department is to aim at getting for every house a separate tap with sink inside the house. 629 New houses were certified to have a proper and sufficient water supply, compared with 920 in the preceding year. Food and Drugs Act. 2. 539 Samples were submitted to the Public Analyst, and 31, or 5.7 per cent. were found adulterated, compared with 5.5 and 4.1 per cent. in the two preceding years. 56 Proceedings were taken in 25 cases, and a total of £43 10s. in penalties, and £14 7s. 6d. for costs obtained. 392 of the samples were milk, and 24 of these, or 6.1 per cent. were adulterated, compared with 4.8 in 1902. 102 Samples were sold as butter, and 6 found to be adulterated with margarine. The other articles analysed are shown in Table X., only one of them was adulterated, a sample of coffee. Of the adulterated milk samples, 15 had added water, and 9 abstracted fat. 3. Up to the middle of 1903, only those samples of milk were reported as adulterated in which at least 10 per cent. of adulteration was found, samples adulterated below this amount being returned as suspicious. Since the summer of last year, all adulterations have been reported, and this change of practice probably accounts for the small increase of adulterated samples and at the same time for the fact that proceedings were not taken in every case of adulteration. 4. The percentage of adulterated milk found in the Borough is small compared with other districts. In London County the percentage in 1902 was 15 6, and in England and Wales, 10 0, (see Report on Milk supply of Finsbury, Dr. Newman, 1903), as compared with 6.1 in the Borough. It appears that about 50 per cent. more samples are taken in Woolwich than in the County; this fact accounts for a part of the difference, but only a small part. It would be wholly satisfactory if it could be considered that the discovered adulteration was a reliable measure of the actual adulteration, but I fear this is not the case. 57 5. Two milk prosecutions were withdrawn on proof of the vendor holding a warranty from the farmer. Convictions were obtained in all other cases. Two samples were sent to Somerset House; in one, the Borough Analyst's analysis was confirmed; in the other, the Government Analyst found 2½ per cent. less added water. The lowest amount of adulteration for which a conviction was obtained was 5 per cent., the highest, 26 per cent. The fines inflicted varied from 5s. to £5, and 12/6 costs were allowed in each case. Twelve of the samples of milk were sold as separated milk, the cans aud the trollies being so labelled. One of these was found rich in fat for separated milk, and the vendor was shortly after caught selling by an assistant adulterated milk. Food Inspection. 6. Inspector Mackie continued to act as special food and meat inspector ; he was, however, assisted during the latter part of the year by Inspector Dee. Inspectors Eance, Tedham and Dee having passed the Food Inspectors' Examination of the Sanitary Institute in December, were appointed from the 1st January, 1904, to succeed Inspector Mackie as special food inspectors, acting in rotation. 7. Thirteen seizures of unsound food were made, and 10 lots were surrendered spontaneously by the owners. 15 lots were butcher's meat, 2 rabbits, 6 fish, 2 fruit. The 13 lots seized were condemned by a magistrate, two owners were cautioned, and eight prosecuted ; one was sentenced to three months' imprisonment, one was fined £20, one £15, and three £10. In 1901, there were 8 seizures, and 9 surrenders, and in 1902, 7 seizures and 13 surrenders. E 58 Dairies, Cowsheds, and Milk Shops. 8. There were on January 1st, 1903, 123 milk shops on the register; 31 were added during the year, and 0 removed, leaving 154 registered at the close of the year. These were all inspected once during the year, and 8 notices served for defects found, which were all remedied without proceedings. Letters have been sent to all occupiers of milk shops calling their attention to the regulations, and requiring them as a means of conforming with the latter, to keep all vessels containing milk covered either with a permanent cover or with a clean piece of wet muslin. This requirement is now complied with in most cases. 9. There was no change in the number of registered cowsheds, 18 being still the number under inspection. These were all inspected thrice during the year. Notices were served with respect to 7 cowsheds, requiring nuisances to be remedied previous to the licensing sessions, and objections were made to the licenses of four of these, with the result that the conditions complained of were all remedied. One of these was Chapel Farm, where the yards were in a very dirty state; but this was partially due to a waterlogged and overflowing cesspool; a sewer has now been laid to the farm, so that the cesspool can be abolished. Much improvement was obtained, also at Coldharbour Farm, Lyme Farm, and Pellipar Eoad Cowshed. Cowkeepers have been warned that in order to comply with the regulations, the cows' udders and teats, and the milkers' hands, must be cleansed before milking. 59 Slaughterhouses. 10. There was no change in the number of registered slaughterhouses. The 11 on the register were all inspected four times. Notices were served with respect to 3 slaughterhouses, and the work required done. Nuisances. 11. Complaints.—The nature of the complaints received by the Health Department are multifarious, and there are few that do not receive some attention. But when a mother writes complaining that the large quantity of ice cream sold to her little boy made him sick, it is obvious that she expects too much from preventive hygiene, and this is an instance of many complaints received. 493 Complaints of sanitary defects were received, and 70 of non-removal of dust, compared with 623 and 160, and 45S and 114, respectively, in 1901 and 1902. (See Table XV. (a) and (b), giving particulars of the work of the Department). 21 Complaints of non-removal of dust came from Woolwich, 38 from Plumstead, and 11 from Eltham. 12. Sewers have been relaid in the following streets in North Woolwich :—Winifred, Mary Ann, and Auberon ; and in Martyr's Passage, Shooter's Hill, and Red Lion Lane. 13. Drains.—264 Drains or soil pipes were tested by the smoke test, and the same number of relaid drains were tested with water. 28 Defective combined drains, draining 152 houses, were investigated and reported on, compared with 29 in 1902. These were all referred to the Borough Engineer. E 2 60 14. 722 Private drains found choked or defective, were examined, cleared and relaid where necessary at the expense of the owners. 369 were in Woolwich parish, 215 in Plumstead, and 77 in Eltham. In 1901, 786 drains were repaired and in 1902, 693. 813 water closets were repaired and 719 defective cisterns remedied, compared with 1864 of both in 1901, and 1444 in 1902. 179 foul pans were cleansed, compared with 120 and 54 in the two preceding years. 11 Additional closets were provided to factories, workshops, &c., 8 being in the Eiver Ward. 15. Public Urinals.—The public lavatories and urinals maintained by the Borough Council were kept scrupulously clean ; those attached to public houses were systematically inspected, and many notices served to cleanse and remedy structural deficiencies. But in the absence of specific by-laws there is difficulty in securing that such places are kept clean. 16. House. Inspection.—6223 Houses were inspected, house to house, and 7791 for infectious disease, complaints, etc., as compared with 4526 and 10956 respectively in the preceding year. The decrease of inspections for infectious disease and consequent increase of house to house inspection is partly the result of the satisfactory cessation of small-pox, but the total number of inspections under both heads greatly exceeds that made in 1901, viz.: 4797 house to house, and 7123 infectious disease and complaints, and shews a satisfactory increase of work done by the Inspectors ; there has been no increase of the staff, but the provision of bicycles has no doubt enabled more work to be done. 61 Table XVI. gives an analysis of the house to house inspection. The highest proportion of defects was found in St. Mary's and Dockyard Wards; in all the Wards except Central, Burrage, and Eltham, more than half the houses inspected had some defects. In Sun Street, Martyr's Passage, Sarah Place, Morris Place, and Down Place—every house had defects. In Sand Street, Morris Street, Clara Place, Speranza Street, and Bassant Road, more than three-fourths of the houses had defects. At 2,711 houses, interiors were cleansed or repaired, as compared with 3,082 and 2,318 in the two preceding years. 580 damp walls were remedied, compared with 608 and 369 in the years 1901-2. Through ventilation was provided in 142 houses, compared with 250 and 185 in the two foregoing years. 708 Dust bins were supplied, compared with 269 and 1008 in the two preceding years. I made, personally, a house to house inspection of 57 houses in Rodney Street, Collingwood Street, Nelson Street, Meeting House Lane, and High Street, Woolwich, in addition to 685 miscellaneous inspections. 17. Overcroiuding.—126 Cases of overcrowding were found and dealt with, compared with 145 and 137 in the two preceding years. The largest number was found in St. Margaret's and Herbert Wards, not probably because more overcrowding exists in these wards, but because the Inspector was more particular in applying the standard. Per cent of houses inspected there was less than one case of overcrowding found. In my own 57 house to house inspections, I found 8 cases of overcrowding, or 14 per cent. I chose the poorest streets 62 where overcrowding is most likely to exist. In reinspecting 51 houses which had been recommended for registration in the two preceding years, but not registered (either because the conditions improved, or were not considered bad enough), I found 12 cases of overcrowding, or 23 per cent. The actual percentage of overcrowding in the Borough is no doubt intermediate between my own and the Inspectors' figures, say 5 per cent. of houses. Overcrowding here means less than 300 cubic feet for sleeping per adult, and 400 cubic feet for living and sleeping; two children under 10 being counted as one adult. 18. Smoke Nuisance.—133 Observations of smoking chimneys were made, compared with 105 in 1902. Much smoke nuisance occurred from the chimneys of the Royal Dockyard. Observations showed that one shaft emitted black smoke for 46 minutes, and lighter smoke for 96 minutes out of 2½ hours; another chimney emitted black smoke for 59 minutes, and lighter smoke for 40 minutes out of 2 hours. A copy of the observations was sent to the Chief Superintendent, with the result that considerable improvement took place. Complaint being made that certain South-Eastern Railway engines emitted unnecessary smoke en route, an inspector was stationed where he could observe and take the numbers of offending engines; particulars as to 10 offenders were sent to the Traffic Manager, and here also improvement resulted. Observations were made, and nuisance observed at the Town Hall New Buildings; notice was served, and the nuisance abated. 24 observations were made on bakehouses, 48 on private factories in North and South Woolwich, and 30 on chimneys of the Royal Arsenal, and no serious nuisance found. As regards 63 the Royal Arsenal, although the smoke emitted would have justified proceedings against a private firm, it was so slight compared with previous years, and with the smoke of the Dockyard chimneys, that no action was taken. 19. Defective Light.—The importance of light in dwellingrooms in preventing disease was pointed out in my last annual report. In 108 houses new windows were supplied, or existing windows enlarged, or other works carried out for improving the light of inhabited rooms and passages. At one recently built block of tenement houses called Scotch Flats, certain of the rooms were found to be very dark, the light being obstructed by a balcony and gangway forming the approach to the block. The light was improved by making a window in the wall between the dark rooms and the adjoining rooms. I pointed out that this block complied with the requirements of the Building Act, and that this fact shewed that the Act required amendment so as to make it impossible for similarly dark houses to be erected in future. This defect in the Building Act was communicated to the L.C.C. Out of the 57 house to house inspections which I made, 23 houses were found to have dark rooms and passages. Although a dark passage is a less serious nuisance than a dark dwellingroom, it most certainly is a nuisance and injurious to health, especially in houses occupied by two or more families, for it will not be kept clean, and may thus convey infection. 20. Want of proper and sufficient Water Closets.—Every house must have a proper and sufficient water closet, and houses occupied by more than one family must have one water closet for every twelve persons. Beyond this numerical 64 limitation there is no legal guide as far as I am aware as to what makes a water closet proper and sufficient. I represented that four houses in Hill Street were without proper and sufficient water closets, in that the closets were situated 80 to 87 feet distance from the houses at the end of gardens without a paved or gravelled footpath leading to the same. On the Health Committee's order, notices were served requiring the erection of closets contiguous to the houses. These houses were also without a proper and sufficient water supply to each house, there being one tap in the garden to each two houses. The result of the notices was that the houses were closed. 21. Flooding of Houses.—Owing to the exceptional rains of last year, numerous complaints were received of flooding of houses in low lying parts. Such flooding may be due to incapacity of branch drains and sewers, or to incapacity of the main outfall sewer, and in most cases the latter appeared to be the principal cause. Charlton Vale, 11-20, Trinity Street, 1-11, 15-21 and 43-53, Reidhaven Road, Heverham Eoad, and the north side, west end of Marmadon Road, were affected. Several of the affected houses in Charlton Vale were closed partly on this account (See Housing of Working Classes, paragraph 24.) Here, and in Trinity Street, the stagnant water remaining after flooding was pumped away by the Council's employees as a palliative measure urgently needed; disinfectants were also supplied to several houses. To partially abate the flooding at 1-11 Reidhaven Road, which has frequently occurred, the manhole of the sewer was raised in Beadle's Yard. For the rest no action was taken, but representations were made to the L.C.C. as to the urgent need for a relief sewer. 65 Dust Bemoval. 22. Only 70 complaints of non-removal of dust were received, 21 being from Woolwich parish, 38 from Plumstead and 11 from Eltham. The Plumstead collection thus appears to have been more efficiently performed last year than for many years past. The Woolwich destructor received and destroyed 9291 loads of house refuse, the cost of collection being about £1,600. The Plumstead destructor commenced work on the 26th May, and from that date to the end of the year, 6801 loads were destroyed. The cost of this collection was £2,909 15s. 4d. compared with £3,100 paid for 1902. The reduction in price is due to the contractors reducing their contract charge by £500 a year from the time the destructor commenced work, but an additional charge is made each year for new houses. The amount paid for the Eltham dust removal was £588 3s. 8d., compared with £480 in the previous year, the difference being the pro rata amount for new houses. The chimney of the Woolwich destructor continues to emit grey fumes; that of Plumstead gives off very little smoke. During the heavy rains of last year much difficulty was experienced in consuming the Plumstead dust, and this was attributed to the dust getting wet from omission to keep the pails covered. In consequence, bills were printed and distributed, reminding occupiers that under the L.C.C. Byelaws there was a penalty of £5 for not keeping dustbins covered. This appeared to have the desired effect. removal of Trade refuse. 23. The system of collection of Trade refuse has been changed during the past year, the collection of the inoffensive 66 refuse being undertaken, since June, by the Borough Engineer. The collection of the offensive refuse is still under the control of the Public Health Department. During the year there have been 8486 receptacles of offensive refuse removed, for which the sum of £106 1s. 6d. has been paid. From January to June there were 441 loads and 481 bushels of inoffensive refuse removed, for which the sum of £37 1s. 8d. was paid. There are now 63 tradesmen on the books from whom offensive trade refuse is collected. Housing of the Working Classes. 24. The following six houses were represented as unfit for habitation under Section 32. Housing Working Classes Act:— 39, Church Street; 1, 2, 4, 5 and 15, Charlton Vale. The preliminary notice was served in each case, but no further proceedings taken, as the work required was done at 39, Church Street, viz.: providing a proper and sufficient water closet and water supply, and the houses in Charlton Vale were closed by the owners voluntarily. These houses were all dilapidated, waterlogged in wet weather, and frequently flooded, owing to failure of the sewer to carry off storm water when the outfall is charged full. 25. The following vital statistics for three special areas were reported to you. They shew death rates much in excess of that for the Borough; the death rates for these areas are, however, less than the rates for the Princes Road area (23.9), Globe Lane and New Street (29.5), Salutation Alley (42.2), and the houses represented as unfit for habitation in 1901 (36.1). These areas have received and continue to receive special attention, and all necessary measures are taken to secure that nuisances are remedied. 67 26. Death rates of Dicey, Delvin, and James Streets (Woolwich Common). Census Population, 967.—Years 1901, 1902, 1903 to middle of year. Year. Total. Under 1 Year. 1 to 5 Years. Diphtheria. Enteric Fever. Diarrhoea. Phthisis. Other Tuberculous Diseases. Alcoholism. 1901 22 5 5 .. .. .. 2 1 2 1902 20 7 2 •• •• •• 2 1 •• 1903 5 1 1 •• •• •• 1 2 1 47 13 8 •• •• •• 5 4 3 Death rate, 19.4; Phthisis death rate, 2.1; Alcoholism death rate, 1.2; Tuberculosis death rate, 3.7; Deaths under 1 year per cent. of total deaths, 27.7. Death rates of Pore House, Albert House, Stanley House, and Sydney House. Census Population, 192.—Years 1900, 1901 and 1902. Year. Total. Under 1 Year. 1 to 5 Years. Diphtheria. Enteric Fever. Diarrhœa. Phthisis. Other Tuberculous Diseases. Alcoholism. 1900 4 1 .. .. .. .. 1 .. .. 1901 3 .. .. •• •• •• .. .. • • 1902 5 1 .. .. .. .. .. .. •• 12 2 .. .. •• •• 1 •• •• Death rate, 20.8; Phthisis death rate, 1.7; Alcoholism death rate, 3.4; Deaths under one year per cent. of total deaths, 16.0. 68 27. Vital Statistics for 1901 and 1902, of the Reidhaven Road area, i.e., the following streets:—Eeidhaven Eoad, Gavin Street, Heverham Road, Abery Street, Gunning Street, Whitehart Lane, Garibaldi Street, Kentmere Road, Barth Road, Hartville Road, Mabyn Road, Bateson Street, Marmadon Road, and Glenside Road. Population—Census 1901 3865 Average Births—estimated 139 Average deaths 66 Birth rate—average of years 1898, 1899, and 1900 36.0 Death rate 17.1 Deaths under 1 year—Average 24 Deaths per 1000 births 173 Deaths from 1 to 5 years—Average 7 Diphtheria deaths ,, 0.5 Diphtheria notifications ,, 12 Enteric Fever deaths ,, 0 Enteric Fever notifications „ 4 Diarrhoea deaths „ 7 Phthisis deaths „ 7 Phthisis death rate 1.81 Other tuberculous diseases, deaths—Average 4 Alcoholism—deaths ,, 2 Death rate from alcoholism 0.52 The above statistics indicate that there has been a continued improvement in the sanitary condition of this area. The death rate shows a very decided diminution, and one which is much greater than the coincident diminution in the death rate of Plumstead parish. The deaths from 1—5 years, and from infectious diseases which chiefly occur at this age, also showed a marked reduction. The same is true to a smaller extent of diarrhoea and phthisis. The infantile death rate shows only a very slight diminution. 69 28. Owing to the War Office determining to build married quarters for soldiers, 34 houses in Artillery Place, and the whole of Rush Grove, Ann Street, Mason Street, and Catherine Square, comprising altogether about 85 houses have been demolished. As these houses comprised some very insanitary property, their removal is salutary, but it is to be regretted that no accommodation was provided for the displaced tenants. 29. The Council's 25 new houses at North Woolwich were completed, and are now all occupied with one exception. Houses registered under the Bye-laws. 30. 132 Houses were on the register at the commencement of the year, (compared with 88 and 103 in the two preceding years). 42 were recommended for registration, of which 28 (22 in Woolwich, and 6 in Plumstead) were placed on the register; 7 were removed, and 20 were demolished, leaving 133 registered at the close of the year (100 in Woolwich and 33 in Plumstead). The 20 demolished houses were in the Artillery Place area referred to above. 31. These houses were all inspected either quarterly or half yearly. 132 notices were served to remedy sanitary defects. Only one prosecution was undertaken, for refusal to fill up the form for a registered house, and this was dismissed on the technical ground that the owner was not the landlord under the bye-laws. 17 cases of overcrowding were found and remedied. 32. With a view of testing the necessity for registering and specially regulating houses of a certain class, I made an inspection of 51 houses which had been recommended for 70 registration during the previous three years, but which had not been registered because they were reduced to occupation by one family, or overcrowding or dirty conditions were remedied, or the conditions were not thought bad enough to justify registration. I found that 43 of these houses were still occupied by two or more families, 28 of these were in a dirty condition, and overcrowding existed in 12. Such a result shews conclusively that this class of houses requires to be dealt with in a special way. 14 of the worst of these houses were ordered by the Committee to be placed on the register. I inspected also a large number of the houses on the register and found their condition markedly superior to those referred to above. 33. On the 16th March of the current year, your Council approved of revised By-laws, which contained neither rent limit, nor other exception, being applicable alike to all houses occupied by more than one family without registration being a necessary preliminary. It remains to see if the Local Government Board will approve the By-laws in this form. Owing to recent legal decisions other alterations have been made by which the owner is made responsible for annual cleansing and for providing means of light and ventilation, and ensuring that he shall not be responsible until notice has been served upon him. With these exceptions the person responsible for carrying out the By-laws will be either the lodger or the landlord, the landlord being the person who sublets to the lodgers, and who is therefore in many cases a resident of the house let in lodgings. Owners who let to one tenant only are not, and will not be under the new By-laws, responsible for overcrowding. 71 Common Lodging Houses. 34. Owing to the London County Council now having power to require an annual renewal of the license, and to refuse the same, great improvements have been made in the Common Lodging Houses. All these houses are, I believe, now provided with lavatories and footbaths. Underground Rooms. 35. Two underground rooms separately occupied were dealt with, one being closed, and the other made to conform with the Public Health (London) Act. One was in Samuel Street, and the other in Rope Yard Rails. Several underground rooms not separately occupied and not used for sleeping were remedied as regards light and in other ways. Factories and Workshops. 36. There were at the end of 1903, 239 workshops on the register to which 977 visits were paid. 109 Sanitary defects were found (including 13 cases of overcrowding), and 38 notices were served. The nuisance was remedied on notice in all cases. A full summary of the inspection of factories, workshops, and workplaces is given in Table XV. (c). The workshops were inspected by Mr. Wood in Woolwich and Eltham parishes, and Mr. Little in Plumstead. Women are employed in 116 of the 239 workshops. Outworkers. 37. Full particulars as to the inspections of outworkers are given in Table XV. (c). Only 39 nuisances were found in 424 inspections. 72 Bakehouses. 38. One bakehouse has been added to the register and 10 underground bakehouses have been removed, leaving 62 on the register at the close of the year, of which 24 are underground, and have been certified as suitable in all respects under the Factory and Workshop Act. Very great improvements have been secured in these underground bakehouses, so that for the most part they are now superior in structure and cleanliness to the level bakehouses, and little behind as regards light. 39. The minimum requirements demanded by the Council before granting a certificate were set out in my last year's report, so that I need not now repeat them; I need only say that, if not in themselves very exacting, they were strictly adhered to. The increased height (7 ft. 6 in.) secured in many bakehouses, the cementing of walls, the tiling of floors, and the provision of larger window space or of prismatic lights have produced a remarkable transformation, and one which has been in most cases no less pleasing to the bakers than to the sanitary authority. Unless perhaps in one case, I am not aware that any distinct hardship has been involved by the closing of bakehouses which did not satisfy the Council's requirements. 40. As regards the above ground bakehouses I reported after my last half yearly inspection that in ten there were dirty conditions or other nuisances, and the remainder were satisfactory. 11 notices were served. In two cases I recommended prosecution on the ground that these bakehouses had been repeatedly found dirty, and that though a notice had the effect of causing the bakehouse to be cleansed the nuisance quickly recurred and the place was not kept clean. The Health 73 mittee were advised, however, that it would be difficult to obtain a conviction in such a case. It would appear, therefore, that the existing law is inadequate to ensure that bakehouses are kept clean, and that special bye-laws are required. Ice-Cream Shops, Restaurants and Kitchens. 41. Sixty four places where ice-creams are sold or prepared for sale are on the register, 17 having been added, and 2 removed during the year. These were all inspected thrice, and four notices served. 54 Inspections were also made of restaurants, kitchens and other places where food is prepared. 17 notices were served and very considerable improvements as regards cleanliness and lighting of some of these places secured. Disinfection. 42. Disinfection of rooms, bedding, &c., was performed after all notified cases of infectious disease, and after death from Phthisis, or removal of the patient, gratis. In cases of Measles, if an application is made, disinfection is performed free of charge. In other infectious diseases, verminous rooms, &c., disinfection is performed by request, and a charge made sufficent to cover the expense incurred. 43. Altogether rooms were disinfected at 744 houses compared with 687 and 945 in the two preceding years. In most cases the disinfection was by Formalin tablets, 25 being used per 1000 cubic feet. 44. The Manlove and Alliot disinfecting apparatus originally fixed at the dust destructor station at Woolwich, has been removed to the Electric Light Works, White Hart Road, where two archways have been fitted up for the disinfectors under the approach to the tipping platform of the Dust Destructor. f 74 The Disinfecting Station is divided down the centre, forming two distinct apartments, one for the reception of the infected articles, and the other for the disinfected articles; each apartment is 24 ft. by 23 ft., and 11 ft. in height, and lined internally with white glazed bricks. There are large doors through which the vans can be taken and infected articles transferred direct into the disinfecting apparatus. Shelves have been provided in each apartment for the storage of articles. There are four box or covered vans in use, two for taking the infected articles to the station, and two for returning them when disinfected; these vans, when not in use, are stored in the apartment to which they belong. Alongside is a Goddard & Massey apparatus, which was purchased in 1899 by the late Plumstead Vestry. There is room in the building for a third apparatus to be fixed if necessary. Both the apparatus in use have been fitted up by the Council's workmen, and are the most complete and efficient of their kind, and are so arranged as to obtain the most satisfactory results in the shortest possible time. 45. In addition to the special apparatus of the makers, an apparatus has been fitted consisting of a Westinghouse vacuum pump which is attached to both machines, by which 20 inches to 25 inches of vacuum can be obtained. This is of considerable value in removing the moisture caused by the steaming process. 46. I reported last year that the steam pressure used had been reduced from 25 lbs. to 5 lbs. giving a temperature of 227°; this was in consequence of occasionally having 75 plaints of damage being done to articles of clothing, bedding, &c., but since the reduction no complaint has been received and I have no evidence that the disinfection is less efficient. 47. It has been impossible hitherto to disinfect by wet steam any goods consisting wholly or partly of leather, furs, books, &c., without serious damage being done. An apparatus adapted by Chief Inspector Duck from one used by Dr. Hopwood at the London Fever Hospital, has been connected with the vacuum apparatus for disinfecting such articles with Formaldehyde. It is a specially constructed brass cylinder into which is placed cotton wool saturated with a 25 per cent. solution of Formalin and is so arranged that when a vacuum is obtained in the disinfector by opening a tap connected with the cylinder, air is admitted which has to pass through the saturated cotton wool, this becoming highly charged with Formalin. By this system the most delicate articles and books can be thoroughly disinfected without the least possible damage deing done. 48. The steam necessary for working the apparatus is obtained from the boilers of the Dust Destructor, which are worked at a pressure of 200 lbs.; this is reduced by a reducing valve to 60 lbs. for use in the disinfecting station. The Disinfectors have been covered with a silicate cotton and steel lagging, thus reducing radiation and condensation to a minimum. The station is fitted with Electric light. 49. The disinfecting apparatus has been used 1135 times during the year. Disinfection was performed in 514 cases of infectious disease, in connection with which there were 60,451 articles. In 16 of these cases there were more articles than could be disinfected in the apparatus at one time, so that the apparatus was twice used in those cases, making a total of 530 disinfections. 76 In addition to this, a request was received from the Royal Arsenal Authorities to disinfect 22,456 blankets that had been returned from South Africa. This required the use of the disinfectors 600 times. A charge of £169 8s., was made, and paid to the Borough Council by the War Office. £1 17s. 6d. was paid by private persons for disinfection in non-notifiable diseases. The disinfectors were therefore used on 1135 occasions, and a total of 82,907 articles disinfected. £ s. d. 50. Total cost of Manlove & Alliot apparatus formerly used at Woolwich 485 3 0 Cost of apparatus, including boiler, bought by the Plumstead Vestry 304 0 0 Extras 2 11 2 Pitting up of the two apparatus by the Council's workmen 123 6 8½ Cost of Westinghouse Vacuum Pump „ Lagging round Disinfector 27 0 0 and Steam Pipes 28 0 0 „ two Vans used by Plumstead Vestry 93 10 0 „ two Vans used by Woolwich Local Board 108 0 0 Apportionment of cost of site 14 7 2 Do. do. buildings 477 0 1 Do. do. Roads, approaches, &c. 87 6 7 Apportionment of cost of Drainage 7 14 4 Do. do. Water supply 1 3 3 77 Three men are employed for disinfecting, at wages respectively of 32/-, 30/- and 30/-. Health Shelter. 51. The health shelter was not once used during the year. As disinfection by formalin can be completed in the course of a few hours, it is seldom, if ever, that the shelter is reeded for its original purpose. It was found useful during the small-pox epidemic for isolation purposes, but only one of the two sets of rooms has ever been used. The Health Committee considered the desirability of letting one floor of the shelter, but decided that it was inexpedient. The Mortuaries. 52. The Sun Street Mortuary was used for 183 bodies compared with 156 and 164 in the two preceding years. 177 were deposited for inquest, 6 for custody; 75 post mortem examinations were made, all but two by resident medical practitioners. Particulars of the causes of death are given at the commencement of this report. The Eltham Mortuary was used for 4 bodies, 2 being for inquest and 2 for custody. No post mortems were performed here. The Health Committee have decided not to allow this mortuary to be used in future for post mortems, but to reserve its use for custody only as originally intended. Cemeteries. 53. The two Borough Cemeteries were properly maintained and gave rise to no complaints of nuisance. 663 bodies were buried in the Woolwich Cemetery, and 694 in the Plumstead, compared with 691 and 788 respectively in 1901, and 695 and 78 817 in 1902. 115 bodies were buried in the Plumstead Churchyard, compared with 146, 164, 144, and 125 in the four preceding years. Bye-Laws foe Tents, Vans, and Sheds. 54. Tents and vans were kept under observation, and 12 special inspections made. Where necessary the bye-laws as to water and closet accommodation were enforced. Customs and Inland revenue Act. 55. Application was made under this Act for a certificate for a house comprising 16 dwellings. This is the house already referred to, in which I found several dwellings insufficiently lighted; in addition to this defect none of the dwellings comprised a bedroom containing 900 cubic feet, i.e., there is no bedroom large enough for a father and mother and two infants to sleep. The certificate was consequently refused. Public Ambulance. 56. In my last report I described how an ambulance for accidents and non-infectious illness had been provided by public subscription, vested in trustees (the Rector of Woolwich, Messrs. Kelham, Lewis, and Dr. S. Davies) and put in the care of Mr. Chick, Cab proprietor, to horse and let at the statutory cab fares. The ambulance was used 90 times during 1903. The following were the journeys made:— Guy's Hospital 22 London Hospital 8 Cottage Hospitals 13 Charing Cross „ 8 King's Hospital 16 Infirmary 3 St. Thomas' „ 12 Other Hospitals 5 Private houses, 2. 79 Covered Seats on Plumstead Common. 57. I have on several occasions shown how greatly the provision of covered seats would enhance the utility of Plumstead Common as a resort for the delicate and invalids. The London County Council was again asked by the Borough Council to provide such seats, but replied by stating that while unwilling to incur the expense itself, it had no objection to the Borough Council providing them. Unfortunately, the Borough has no authority to spend money in this way, and consequently, invalids must still travel to the seaside or other health resorts in order to enjoy advantages which might easily be placed at their own doors. Dentistry and the care of the Teeth. 58. One of the principal causes and accompaniments of physical degeneration is early decay of the teeth. Whatever is the cause of this decay, there is no doubt that it is easily preventable if the teeth are properly cared for and systematic resort had to the dentist. It is with pleasure that I have to record that the Woolwich Guardians have recognised this, and have appointed a dentist to examine and treat the teeth of the children in the Goldie Leigh Homes, his duties being to preserve the children's teeth, and so enable them to benefit by the food they eat to a much greater extent than is possible to children whose teeth are neglected. Sanitary Staff. 59. There was no change in the Sanitary Staff during the year. A list of the staff is given at the commencement of the report. 80 Bicycles were granted to Inspectors Rance and Potter, making a total of five bicycles now supplied to the Department, viz.: to the Chief Inspector and four District Inspectors. Much time is thus economised and the amount of work done is increased. Three of the Inspectors, Messrs. Eance, Tedham and Dee, passed the examination of the Sanitary Institute in Pood and Meat Inspection, and were awarded the Institute's certificate. 81 TABLE I.— Borough of Woolwich. Vital Statistics of Whole District during 1903 and previous years. Year Population estimated to middle of each Year. Births. Total Deaths Registered in the District. Total Deaths in Public Institutions in the District. Deaths of Nonresidents registered in Public Institutions in the District. Deaths of Residents registered in Public Institutions beyond the District. Nett Deaths at all Ages belonging to the District. Number Rate* Under 1 Year. At all ages. Number Rate per 1000 Births registd. Number Rate* Number Rate* 1 2 3 4 5 6 7 8 9 10 11 12 13 1891 99312 3345 33.6 476 142 .. .. .. .. .. 1870 18.8 1892 100751 3294 32.6 425 129 .. .. .. .. .. 1730 17.1 1893 102222 3361 32.8 478 142 .. .. .. .. .. 1899 18.5 1894 103727 3304 31.8 362 109 .. .. .. .. .. 1566 15.1 1895 105265 3321 31.5 476 143 .. .. .. .. .. 1757 16.7 1896 106840 3363 31.5 508 151 .. .. .. .. .. 1878 17.5 1897 108611 3406 31.3 455 133 .. .. .. .. .. 1642 15.1 1898 110273 3269 29.6 472 144 .. .. .. .. .. 1935 17.5 1899 113148 3367 29.8 534 158 .. .. .. .. .. 1889 16.6 1900 115498 3303 28.6 469 142 .. .. .. .. .. 2057 17.8 1901 117740 3535 30.0 455 128 1600 13.6 433 42 164 1722 14.6 1902 122505 3730 29.9 462 124 1678 13 7 278 43 208 1843 14.7 Averages for 10 years 1893—1902 110583 3396 30.6 467 137 .. .. .. .. .. 1818 16.4 1903 123172 3691 300 390 106 1511 12.3 272 41 175 1637 13.3 * Rates in Columns 4, 8, and 13, calculated per 1,000 of estimated population. Note.— The deaths to be included in Column 7 of this Table are the whole of those registered during the year as having actually occurred within the district or division. The deaths to be included in Column 12 are the number in Column 7, corrected by the subtraction of the number in Column 10 and the addition of the number in Column 11. By the term " Non-residents" is meant persons brought into the district on account of sickness or infirmity, and dying in public institutions there ; and by the term " Residents " is meant persons who have been taken out of the district on account of sickness or infirmity, and have died in public institutions elsewhere. The " Public Institutions " to be taken into account for the purposes of these Tables are those into which persons are habitually received on account of sickness or infirmity, such as hospitals, workhouses, and lunatic asylums. Area of District in Acres Total Population at all ages 117,178 (exclusive of area 8239.7 Number of Inhabited Houses 18,086 At Census of 1901. covered by water) Average number of persons per house 6.47 g 82 TABLE 1A. I. II. Institutions within the District receiving Sick and Infirm Persons from outside the District. Institutions outside the District receiving Sick and Infirm Persons from the District. Woolwich Union Infirmary Lewisham Infirmary Royal Arsenal Hospital Greenwich do. Auxiliary Hospital Herbert Hospital Woolwich and Plumstead Cottage Hospital Seamen's do. Brook do. Eltham Cottage Hospital Park do. Guy's do. King's College do. Charing Cross do. Middlesex do. St. Bartholomew's do. St. Thomas's do. Friedenheim do. Children's do. City of London do. Brompton do. German do. National do. University do. Bethnal Green Chest Hospital L.C. Asylum, Dartford Banstead Asylum Cane Hill do. Caterham do. Colney Hatch do. Clabury do. Horton do. Leavesden do. 83 TABLE 1B. Deaths of Persons belonging to the Borough of Woolwich occurring in various Institutions—1903. Names of Institutions, &c. Number of Deaths Grand Totals M. F. Totals Woolwich Union Infirmary 124 99 223 Greenwich do. 1 — 1 Lewisham do. 5 4 9 Total Poor Law Infirmaries .. .. — 233 Herbert Hospital 21 — 21 Female do. 1 5 6 Royal Arsenal Hospital 15 — 15 Total in Government Hospitals .. .. — 42 Cottage Hospital, Woolwich 5 1 6 Do. Eltham 4 3 7 Total in Cottage Hospitals .. .. — 13 Fever Hospitals 12 10 22 22 Seamen's Hospital 3 — 3 Guy's Hospital 11 6 17 King's College Hospital 7 3 10 London do. 5 1 G St. Bartholomew's do. 1 0 1 Charing Cross do. 3 2 5 Middlesex do. — 1 1 St. Thomas's do. 1 1 2 National do. 1 — 1 University do. — 1 1 German do. i — 1 Total in General Hospitals .. .. — 48 Children's Hospitals 2 2 4 4 City of London Chest Hospital 2 — 2 Brompton do. do. 1 1 2 Bethnal Green do. do. 1 — 1 Total in Chest Hospitals .. .. — 5 Lunatic Asylums 24 21 45 45 Eight other Institutions 2 7 9 9 Totals 253 168 421 421 g 2 84 TABLE II. Vital Statistics of Separate Localities, 1901-2-3. Increase of Population since 1901 Census, estimated by number of new houses occupied and number of persons to a house in the Parish. Wards. 1901. 1902. 1903. Population estimated to middle of Year. Births Registered. Deaths at all ages. Deaths under 1 Year. Population estimated to middle of Year. Births Registered. Deaths at all ages. Deaths under 1 Year. Population estimated to middle of Year. Births Registered. Deaths at all ages. Deaths under 1 Year. Doekyard 8712 282 137 40 8712 286 146 28 8712 275 141 28 St. Mary's 10439 203 122 25 10439 226 149 30 10439 222 147 39 N. River S 14504 416 292 66 N. 3450 135 66 26 3450 140 50 16 S. 11444 293 219 32 11444 277 205 43 St. George's 8078 298 151 35 8078 284 135 36 8078 303 136 39 Burrage 9837 253 133 24 9837 228 154 28 9837 235 133 17 Herbert 9195 240 104 22 9679 261 129 28 9679 261 94 21 St. Margaret's 10193 325 120 42 11826 448 163 50 11826 399 166 38 Central 10220 299 142 36 10263 341 138 46 10263 276 99 26 Glyndon 9829 319 140 30 9882 287 146 34 9882 313 144 33 St. Nicholas 20239 737 265 106 22985 698 312 106 22985 731 235 71 Eltham 7787 177 108 26 10002 243 85 23 10669 258 87 19 85 TABLE III. Cases of Infectious Disease Notified during the Year 1903. Notifiable Diseases. Cases Notified in Whole District. Total cases notified in each locality. No. of Cases removed to Hospital. No. of Cases of Mistaken Diagnosis (included in (preceding figures), At all Ages. At Ages—Years. River Dockyard St. Mary's St. George's Burrage St. Margaret's Herbert Glyndon Central St. Nicholas Eltham Under 1 1 to 5 5 to 15 15 to 25 25 to 65 65 and upwards Small Pox 6 .. .. 1 .. 3 2 .. .. .. .. 1 .. .. .. .. 5 .. 6 .. Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diphtheria 186 3 53 90 28 12 .. 20 13 13 7 12 28 1 19 27 31 15 157 18 Membranous Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas 58 2 3 2 7 40 4 6 7 3 3 6 6 2 7 7 8 3 .. .. Scarlet Fever 389 .. 115 212 42 20 .. 43 21 25 38 25 95 28 13 26 39 36 337 11 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 42 .. 1 10 21 9 1 1 5 2 2 5 3 2 1 1 10 10 27 5 Relapsing Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Continued Fever 3 .. .. 2 .. 1 .. .. .. .. .. 1 .. .. .. .. .. 2 .. .. Puerperal Fever 2 .. .. .. 1 1 .. .. .. .. .. 1 .. .. .. .. 1 .. .. .. Plague .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Phthisis 165 .. .. .. .. .. .. 27 8 14 15 18 21 5 9 13 31 4 .. .. Totals 251 5 172 317 99 86 7 97 54 57 65 69 153 38 49 74 125 70 527 34 87-88 TABLE IV.— Causes cf, and Ages at Death during the Year 1903. Disease. Deaths in or belonging to whole District at subjoined ages. All Ages Males Females Under 1 1 to 5 5 to 10 10 to 15 15 to 20 20 to 25 25 to 35 35 to 45 45 to 55 55 to 65 65 to 75 75 to 85 Over 85 Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles 25 10 15 3 20 1 .. 1 .. .. .. .. .. .. .. .. Scarlet Fever 4 4 .. .. 1 2 .. 1 .. .. .. .. .. .. .. .. Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza 27 12 15 2 2 .. .. .. 1 4 2 1 5 6 3 1 Whooping Cough 27 8 19 14 13 .. .. .. .. .. .. .. .. .. .. .. Diphtheria and Membranous Croup 13 6 7 1 6 4 2 .. .. .. .. .. .. .. .. .. Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever 6 5 1 .. .. .. .. 1 1 2 1 .. .. .. 1 .. Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa and Dysentery 17 8 9 8 3 .. .. .. .. 2 .. 2 .. .. 1 1 Epidemic or Zymotic Enteritis 27 16 11 22 5 .. .. .. .. .. .. .. .. .. .. .. Enteritis 15 7 8 11 .. .. .. .. .. 1 1 1 .. .. 1 .. Other Continued Fevers .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever 1 .. 1 .. .. .. .. .. .. .. 1 .. .. .. .. .. Syphilis 14 5 9 8 1 .. .. .. 1 .. 1 2 1 .. .. .. Rheumatism 9 6 3 .. .. .. 2 .. 1 2 1 1 .. 1 1 .. Gout 1 1 .. .. .. .. .. .. .. .. .. .. .. 1 .. .. Other Septic Diseases 8 7 1 .. .. .. .. 1 1 2 2 2 .. .. .. .. Intermittent Fever and Malarial Cachexia 2 2 .. .. .. .. .. .. .. 2 .. .. .. .. .. .. Tuberculosis of Meninges 28 11 17 7 13 5 2 1 .. .. .. .. .. .. .. .. Tuberculosis of Lungs (Phthisis) 171 114 57 .. 4 1 2 3 23 33 39 34 .. 7 1 .. Tuberculosis of Intestines and Peritoneum 14 9 5 6 4 .. 2 .. 1 1 .. .. .. .. .. .. Other forms of Tuberculosis 24 14 10 6 4 3 2 1 .. 2 4 1 .. .. 1 .. Alcoholism 18 7 11 .. .. .. .. .. .. 3 8 2 2 2 1 .. Cancer 93 39 64 .. .. .. 1 .. 1 2 9 19 27 23 10 .. Meningitis 24 12 12 10 11 2 .. 1 .. .. .. .. .. .. .. .. Premature Birth 61 33 28 61 .. .. .. .. .. .. .. .. .. .. .. .. Developmental Diseases 114 68 46 105 7 1 1 .. .. .. .. .. .. .. .. .. Old Age 72 32 40 .. .. .. .. .. .. .. .. .. .. 19 30 23 Inflammation and Softening of Brain 6 4 2 .. .. .. .. .. 1 .. .. .. 3 2 .. .. Other Diseases of Brain and Nervous System 57 30 27 19 5 .. 3 .. 2 2 4 9 4 8 1 .. Organic Diseases of the Heart Cerebral Hœmorrhage, Embolism and 110 57 53 .. 2 .. 4 5 3 7 15 14 22 26 12 .. Thrombosis 62 31 31 .. .. .. .. .. .. .. 3 8 12 25 12 2 Apoplexy and Hemiplegia 20 10 10 .. .. .. .. .. .. .. .. 2 3 10 5 .. Other diseases of Blood Vessels and Heart 20 15 5 .. .. .. .. .. .. 1 3 2 4 7 3 .. Acute Bronchitis 74 42 32 38 6 1 .. .. .. .. 2 2 13 6 5 1 Chronic Bronchitis 66 25 41 .. 1 .. .. .. .. .. .. 3 12 27 20 .. Lobar (Croupous) Pneumonia 8 5 3 1 1 1 .. .. .. 1 .. 1 2 1 Lobular (Broncho) ,, 57 34 23 26 17 1 2 1 .. 1 1 3 .. 3 2 .. Pneumonia 53 29 24 7 11 1 .. .. 1 8 8 5 4 4 4 .. Other diseases of Respiratory System 11 6 5 .. 7 .. .. .. .. 1 1 .. 1 .. 1 .. Diseases of Stomach 16 8 8 10 1 .. .. .. 1 2 1 .. .. 1 .. .. Obstruction of Intestines 10 8 2 6 .. .. .. .. .. .. 1 .. 2 .. 1 .. Cirrhosis of Liver 24 15 9 .. .. .. .. .. 1 .. 5 5 8 5 .. .. Other diseases of Digestive System 15 7 8 1 .. 1 .. .. 2 3 1 2 .. 4 .. .. Nephritis and Bright's Disease 38 22 16 .. .. .. .. .. .. 3 2 7 13 7 5 1 Tumours and other Affections of Female Genital Organs 2 .. 2 .. .. .. .. .. .. .. .. 1 .. 1 .. .. Accidents and Diseases of Parturition 7 .. 7 .. .. .. .. .. 3 2 2 .. .. .. .. .. Deaths by Accidents or Negligence 66 50 16 15 5 4 3 l 3 12 10 2 5 3 2 1 Deaths by Suicide or Homicide 20 18 2 1 .. .. .. .. 2 2 6 6 1 1 .. l Deaths from ill-defined causes 25 15 10 7 1 .. .. 2 .. 1 4 1 6 1 2 .. All other Diseases 55 31 24 4 3 2 .. 1 1 8 3 4 13 11 5 .. Totals 1637 898 739 399 155 30 26 20 50 110 141 142 187 212 130 35 89-90 TABLE IVA. Disease. Causes of Deaths in Wards. Deaths in Public Institutions in the District. Deaths in Outlying Institutions. River Dockyard St. Mary's St. George's St. Nicholas Central Glyndon St. Margaret's Herbert Burrage Eltham North South Small Pox .. .. .. .. .. .. .. .. .. .. .. .. .. .. Measles .. 3 2 2 1 1 .. 2 10 1 .. 3 .. 1 Scarlet Fever .. 1 1 .. 1 .. .. .. 1 .. .. .. .. 4 Typhus Fever .. .. .. .. .. .. .. .. .. .. .. .. .. .. Epidemic Influenza .. 2 1 3 2 4 2 3 4 1 1 .. .. Whooping Cough .. 3 2 3 1 6 5 4 2 .. .. 1 .. 1 Diphtheria and Membranous Croup .. 1 .. 1 1 3 2 .. 1 .. .. 2 .. 12 Croup .. .. .. .. .. .. .. .. .. .. .. .. .. .. Enteric Fever .. .. .. .. .. 3 1 .. .. .. .. 2 2 2 Asiatic Cholera .. .. .. .. .. .. .. .. .. .. .. .. .. .. Diarrhœa and Dysentery .. 4 1 2 1 2 .. 2 3 2 .. .. 2 3 Epidemic or Zymotic Enteritis 5 1 2 5 .. 10 .. 1 1 1 .. 1 .. .. Enteritis .. 3 2 .. 1 4 2 .. 1 .. .. 2 1 .. Other Continued Fevers .. .. .. .. .. .. .. .. .. .. .. .. .. .. Erysipelas .. .. .. .. .. .. .. .. .. .. .. .. .. Puerperal Fever .. .. .. .. .. 1 .. .. .. .. .. .. .. .. Syphilis .. 6 .. .. .. 2 1 1 2 .. .. 2 5 4 Rheumatism .. 1 1 .. 2 2 .. 2 .. .. 1 .. 2 1 Gout .. .. .. .. .. .. 1 .. .. .. .. .. .. .. Other Septic Diseases .. .. 1 1 1 2 1 .. 1 .. .. 1 .. 7 Intermittent Fever and Malaria Cachexia .. .. .. .. .. .. .. .. .. 1 .. 1 .. .. Tuberculosis of Meninges .. 3 4 4 3 2 1 1 4 2 2 2 5 1 Tuberculosis of Lungs ( Phthisis) 4 26 13 22 16 29 8 11 12 7 17 6 53 16 Tuberculosis of Intestines and Peritoneum 3 3 1 .. 2 .. 2 1 1 .. 1 .. 3 Other forms of Tuberculosis .. 3 2 1 1 6 3 1 4 1 2 .. 2 2 Alcoholism .. 4 2 1 2 2 1 2 1 .. 3 .. 6 3 Cancer 3 9 8 3 9 13 8 8 10 7 11 4 16 7 Meningitis .. 3 2 2 5 6 .. 2 2 1 1 .. .. 1 Premature Birth 6 2 2 4 12 15 4 .. 5 3 6 2 3 .. Developmental Diseases 1 10 4 11 11 18 12 11 12 11 8 5 5 3 Old Age .. 14 6 5 2 8 6 9 5 4 11 2 27 2 Inflammation and Softening of Brain .. .. 1 2 .. 2 .. .. .. 1 .. .. 4 .. Other Diseases of Brain and Nervous System 1 7 8 2 6 6 3 8 6 2 5 3 5 16 Organic Diseases of the Heart 5 14 5 9 5 11 5 11 12 13 13 7 20 7 Cerebral Hœmorrhage, Embolism and Thrombosis 1 4 6 6 6 8 .. 10 11 2 3 5 11 1 Apoplexy and Hemiplegia .. 1 3 2 1 1 3 1 1 4 2 1 2 1 Other diseases of Blood Vessels and Heart 1 7 .. 2 2 1 .. 1 2 1 1 2 3 4 Acute Bronchitis 5 6 11 8 6 8 5 8 6 1 7 3 1 .. Chronic Bronchitis .. 10 8 7 1 13 4 8 2 3 5 5 17 3 Lobar (Croupous) Pneumonia .. 1 2 .. .. 2 .. 1 2 .. .. .. .. .. Lobular (Broncho) ,, 1 4 4 5 6 10 5 5 9 2 4 2 2 1 Pneumonia 2 7 7 2 9 4 .. 8 3 3 3 5 6 7 Other diseases of Respiratory System .. 1 1 .. 2 3 1 1 1 1 .. .. .. 3 Diseases of Stomach 1 1 3 2 2 1 .. .. 2 1 1 2 .. .. Obstruction of Intestines .. 1 1 1 1 1 .. 1 1 .. 1 1 .. 5 Cirrhosis of Liver .. 4 2 .. 2 4 1 2 1 4 4 .. 4 4 Other diseases of Digestive System 1 2 .. 3 1 1 2 .. 3 1 .. 1 1 7 Nephritis and Bright's Disease 4 10 3 4 1 3 .. 3 3 .. 4 3 10 8 Tumours and other Affections of Female Genital Organs .. .. .. 1 .. .. .. 1 .. .. .. .. 1 1 Accidents and Diseases of Parturition .. .. 1 .. .. 1 2 .. 1 1 .. 1 3 .. Deaths by Accidents or Negilgence 2 14 8 8 7 5 5 5 5 1 2 4 13 8 Deaths by Suicide or Homicide 1 4 3 4 2 .. .. 1 3 1 1 .. 3 2 Deaths from ill-defined causes 1 2 .. 1 .. 3 2 3 6 3 4 .. .. 7 All other Diseases •• 3 7 8 2 8 3 4 4 5 7 4 10 13 Totals 50 205 141 147 136 235 99 144 166 94 133 87 245 171 91 TABLE V. Rates per 1,000 Persons on the Population, estimated to the Middle of the Year. Year Small Pox. Cholera. Erysipelas. Diphtheria and Membranous: Croup. Scarlet Fever. Typhus Fever. Enteric and Continued Fevers. Relapsing Fever. Puerperal Fever. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. Cases. Deaths. 1891 0.01 • • • • 0.58 0.05 0.51 0.08 1.52 0.04 0.01 • • 0.37 0.06 • • • • 0.15 0.03 1892 0.04 • • • • 1.00 0.07 1.3 0.41 9.4 0.33 • • • • 0.41 0.13 • • • • 0.09 0-02 1893 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 1894 0.35 0.03 • • • • 0.96 0 .04 1.7 0.56 7.8 0 .42 • • • • 0.47 0 .11 • • • • 0.04 0.03 1895 0.19 0.01 • • • • 0.93 0.02 2.0 0.47 5.5 0.20 • • • • 2.5 0.38 • • • • 0.08 0.03 1896 0.03 • • • • • • 1.03 0.04 2.8 0.87 5.0 0.24 • • • • 0.62 0.07 • • • • 0.03 0.01 1897 0.01 • • 0.03 • • 0.83 0.04 2.6 0.58 6.0 0 .12 • • • • 0.45 0 .05 • • • • 0.04 0.02 1898 • • • • 0.02 • • 0.86 0.02 2.2 0.31 5.7 0.16 • • • • 0.52 0.11 • • • • 0 .09 0.08 1899 • • • • • • • • 0.83 0.06 3.0 0.36 7.8 0.09 • • • • 0.52 0.09 • • • • 0.09 0.07 1900 0.01 • • • • • • 0.91 0.05 3.1 0.27 3.9 0.09 • • • • 0.59 0.10 • • • • 0.06 0.01 1901 0.18 • • • • • • 0.61 • • 1.8 0.16 2.6 0.04 • • • • 0 .58 0.11 • • • • 0.06 0.02 1902 1.82 0.30 • • • • 0.78 0 .01 1.87 0.18 2.14 0.06 • • • • 0.40 0.10 • • • • 0 .09 0.05 1903 0.05 • • • • • • 0 .47 • • 1.51 0.11 3.16 0.03 • • • • 0.34 0.05 • • • • 0.02 • • Note.—Data for 1903 could not be obtained. 92 TABLE VI. Scarlet Fever and Diphtheria. Number of Patients attending each School. School. On Roll. Scarlet Fever. Diphtheria and Membranous Croup. Wood Street 1131 4 1 Maryon Park 727 4 2 Mulgrave Place 949 14 1 Union Street 600 4 .. Elizabeth Street 746 9 6 Eglinton Road 1200 10 1 Fox Hill 177 2 • • Bloomfield Road 1728 13 5 Burrage Grove 989 3 6 Vicarage Road 1012 4 6 Plum Lane 417 10 • • Earl Street 1009 7 8 Ancona Road 1277 12 8 Plumstead Road 938 4 7 The Slade 1016 22 .. High Street 1311 10 5 Conway Road 1390 10 18 Purrett Road 1309 7 2 Timbercroft Road 395 5 2 Wickham Lane 431 .. .. Bostal Lane .. 7 4 Church Man or way • • • • 1 Greening Street 432 1 1 Grangehill Road 382 11 2 Pope Street 614 3 2 Deansfield Road • • 2 .. Earlshall Road .. .. 1 St. Mary 778 5 5 St. Peter 650 17 2 St. Michael 688 3 2 St. Thomas 452 3 .. Christ Church 105 1 • • All Saints' 468 2 .. Central 607 16 .. St. Patrick 217 1 1 Roper Street 414 1 .. All other Schools .. 12 4 Total 25,559 239 103 93-94 TABLE VII. Analysis of the Vital Statistics of the Metropolitan Boroughs, and of the City of London, after Distribution of Deaths in Public Institutions during 1903. Boroughs. Estimated Population middle of 1903. Births. Deaths. Annual Rate per 1000 living. Deaths from Principal Infectious Diseases. Small-Pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Simple and Ill-defined Fever. Diarrhoea. Phthisis. Deaths of Children under 1 year of age to 1,000 Births. Births. Deaths. Principal Infectious Diseases. County of London 4,613,812 130,906 69,737 28.5 15.2 1.76 8,088 13 2,046 361 740 1,627 3 368 5 2,925 7,124 130 Paddington 146,032 3,303 1,928 22.7 13.2 1.31 191 .. 40 10 15 54 .. 7 .. 65 155 119 Kensington 178,409 3,567 2,468 20.0 13.9 1.56 278 .. 34 14 24 90 .. 9 .. 107 223 145 Hammersmith 115,803 2,989 1,634 25.9 14.1 1.60 185 .. 27 8 17 30 .. 9 .. 93 170 141 Fulham 147,780 4,789 2,046 32.5 13.9 2.22 327 .. 62 8 24 46 .. 15 .. 172 204 127 Chelsea 74,169 1,516 1,131 20.5 15.3 1.14 84 .. 14 2 4 29 .. 4 .. 31 116 142 City of Westminster 179,052 3,018 2,432 16.9 13.6 1.00 179 .. 49 9 15 34 .. 14 .. 55 301 123 St. Marylebone 131,234 3,984 2,148 30.5 16.4 1.60 210 .. 37 17 26 56 .. 13 .. 59 240 96 Hampstead 85,197 1,456 848 17.1 10.0 0.58 49 .. 8 4 10 16 .. 2 .. 9 63 88 St. Pancras 235,716 6,339 3,806 27.0 16.2 1.91 448 .. 193 23 37 91 .. 14 .. 90 428 133 Islington 339,137 8,983 4,837 26.6 14.3 1.45 489 .. 125 24 42 153 .. 23 .. 121 472 126 Stoke Newington . 52,069 1,091 655 21.0 12.6 1.46 76 .. 24 .. 7 19 .. 5 .. 21 64 119 Hackney 224,082 6,182 3,099 27.7 13.9 1.78 397 .. 113 21 48 67 .. 36 .. 112 283 119 Holborn 57,845 1,631 1,072 28.3 18.6 1.44 83 .. 18 5 8 18 .. 5 .. 29 181 95 Finsbury 99,717 3,693 2,015 37.1 20.3 2.32 231 .. 69 11 11 54 .. 10 .. 76 227 135 City of London 24,539 338 358 13.8 14.6 0.86 21 .. 3 1 2 4 .. 3 .. 8 39 136 Shoreditch 117,513 3,905 2,273 33.3 19.4 2.90 340 .. 102 7 22 44 .. 13 .. 152 272 171 Bethnal Green 130,028 4,627 2,363 35.7 18.2 2.24 290 .. 85 12 27 42 .. 12 .. 112 272 141 Stepney- 302,153 11,329 5,430 37.6 18.0 2.36 712 4 173 21 58 108 .. 27 .. 321 633 138 Poplar 169,550 5,832 3,078 34.5 18.2 2.99 505 2 161 19 60 80 .. 17 .. 166 294 154 Southwark 207,369 6,717 3,742 32.5 18.1 1.99 412 .. 83 18 23 68 .. 23 .. 197 496 148 Bermondsey 129,801 4,201 2,387 32.5 18.4 2.05 265 .. 51 25 18 41 .. 12 .. 115 225 158 Lambeth 307,711 9,080 4,659 29.6 15.2 1.73 530 4 130 23 29 126 .. 23 .. 194 430 125 Battersea 173,422 4,961 2,464 28.7 14.2 1.98 343 .. 108 7 29 81 .. 17 .. 101 223 134 Wandsworth 249,678 6,722 3,083 27.0 12.4 1.61 401 .. 107 17 44 89 .. 18 .. 126 237 109 Camberwell 265,562 7,311 3,627 27.6 13.7 1.36 359 .. 81 13 34 72 .. 17 .. 142 323 123 Deptford 112,537 3,379 1,674 30.1 14.9 2.19 246 .. 62 18 45 45 .. 4 .. 72 152 134 Greenwich 99,824 2,716 1,326 27.3 13.3 1.74 173 .. 28 9 27 37 .. 1 .. 71 111 127 Lewisham 136,405 3,563 1,516 26.2 11.1 0 .96 131 .. 34 11 21 6 .. 10 .. 49 114 92 Woolwich 123,172 3,691 1,637 30.0 13.3 1.10 134 .. 25 4 13 27 .. 6 .. 59 171 106 95 Table VIII. Meteorology and Registered Deaths from all causes, and from certain prevalent Diseases in each week of the year 1903. Week. Date of ending. Temperature of Air. Temperature 3 feet below ground. Mean Humidity, Complete Saturation = 100. No. of days Rainfall. Rainfall in Inches. Deaths corrected for Public Institutions. Highest during Week. Lowest during Week. Mean Temperature. All Causes. Diarrhœa. Six other Zymotic Diseases. Bronchitis and Pneumonia. Tubercle. Jan. 10 53.9 35.0 46.5 + 44.66 85 5 0.95 42 0 2 7 2 ,, 17 37.0 23.6 30.1 — 43.45 64 1 0.21 31 0 1 6 2 ,, 24 48.9 33.3 40.4 + 40.90 92 6 0.36 35 0 3 6 4 ,, 31 52.6 39.3 46.7 + 42.77 81 4 0.37 26 0 1 6 6 Feb. 7 52.1 30.7 42.5 + 43.11 83 2 0.22 32 1 1 9 9 ,, 14 56.0 36.4 47.7 + 44.42 84 0 o.oo 31 0 1 2 4 ,, 21 58.3 26.2 44.4 + 44.17 77 1 0.01 36 0 4 2 6 ,, 28 53.5 35.2 45.0 + 44.71 77 7 1.13 37 2 3 2 8 Mar. 7 54.9 34.0 42.7 + 44.22 83 5 0.86 35 0 2 4 7 ,, 14 57.8 29.5 42.9 + 43.58 77 2 0.17 23 0 3 6 5 ,, 21 57.2 32.8 46.6+ 44.03 71 3 0.17 30 1 3 4 6 ,, 28 68.0 38.6 51.0 + 45.93 72 6 0.60 34 0 2 7 10 April 4 56.6 35.4 46.2 + 46.52 78 5 0.81 37 0 0 3 5 1st Qr 68.0 23.6 12 W + 1 W— 44.03 78 47 5.86 429 4 26 64 74 April 11 56.8 33.3 46.4 + 46.31 72 1 0.03 40 0 3 8 6 ,, 18 49.5 30.2 39.5 — 45.93 62 2 0.05 36 0 1 5 6 ,, 25 58.4 28.4 42.1 — 45.87 66 0 o.oo 30 0 0 9 3 May 2 60.9 34.7 49.4 + 45.97 81 6 1.42 26 0 3 4 0 ,, 9 65.3 38.2 50.4 — 48.27 82 7 0.79 41 0 1 7 2 ,, 16 60.9 31.3 48.8 — 49.08 76 3 0.31 35 0 3 4 7 ,, 23 77.9 35.4 54.6 + 49.95 67 2 0.34 32 0 4 4 1 ,, 30 77.5 38.1 58.4 + 52.74 72 1 0.33 23 0 4 4 3 June 6 82.6 42.0 57.0 — 55.47 71 1 0.13 36 0 3 6 9 ,, 13 65.1 37.1 52.8 — 55.81 84 4 2.34 17 0 0 0 2 ,, 20 67.0 41.3 49.9 — 54.37 85 6 3.73 27 0 1 2 4 ,, 27 83.3 38.7 59.6 — 54.63 71 0 o.oo 25 1 1 3 3 July 4 84.8 50.6 65.2 + 59.03 59 0 o.oo 44 0 l 4 3 2nd Qr 84.8 28.4 5 W + 8 W — 51.03 73 33 9.47 412 1 25 60 49 96 Table VIII— continued. Week. Date of ending. Temperature of Air. Temperature 3 feet below ground. Mean Humidity, Complete Saturation. = 100. No. of days Rainfall. Rainfall in Inches. Deaths corrected for Public Institutions. Highest during Week. Lowest during Week. Mean Temperature. All Causes. Diarrhoea. Six other Zymotic Diseases. Bronchitis and Pneumonia. Tubercle. July 11 87.5 42.2 63.6 + 60.58 65 0 0.00 22 1 0 1 4 „ 18 77.1 46.0 60.7 — 61.64 74 3 0.57 32 0 2 1 7 „ 25 74.9 47.2 60.5 — 61.39 80 5 3.18 27 0 1 3 5 Aug. 1 71.5 49'0 58.6 — 61.07 84 5 1.52 33 2 2 4 4 ,, 8 77.5 44.2 61.2 — 60.70 70 3 0.35 27 1 1 3 2 „ 15 73.5 45.3 59.5 — 60.87 79 4 2.11 31 0 2 3 5 „ 22 73.4 47.6 58.3 — 60.49 74 5 1.11 20 1 0 3 2 „ 29 71.0 44.3 58.1 — 59.83 78 4 1.23 25 2 0 2 5 Sept. 5 82.0 48.9 62.9 + 60.69 78 4 0.86 35 5 1 3 3 „ 12 67.9 40.3 53.7 — 60.53 78 5 0.55 26 2 0 3 7 ,, 19 64.3 38.4 51.7 — 57.98 75 1 0.01 37 7 0 2 7 „ 26 70.5 50.5 59.3 + 57.87 89 4 0.22 29 5 0 9, 5 Oct. 3 70.7 50.2 59.3 + 58.72 85 3 0.61 28 3 1 1 6 3rd Qr 87.5 38.4 4W + 9 W — 60.18 77 46 12.32 372 29 10 31 62 Oct. 10 64.8 39.2 54.9 + 58.33 85 6 1.05 32 3 1 6 5 „ 17 62.6 42.3 52.0 + 56.44 81 6 1.39 32 3 1 6 5 ,, 24 56.6 36.5 49.3 + 54.80 86 4 0.60 39 9. 0 4 5 „ 31 58.7 38.2 50.8 + 53.65 84 7 1.39 29 0 0 8 0 Nov. 7 56.2 35.2 47.1 + 52.66 87 3 0.23 42 0 1 11 5 „ 14 57'0 35.3 48.4 + 51.37 88 4 0.26 25 n 1 7 4 „ 21 54.6 26.4 41.1 — 49.90 84 2 0.07 42 1 1 12 4 „ 28 53.1 34.2 45.3 + 48.46 82 5 1.18 36 0 1 6 7 Dec. 5 45.8 25.2 35.2 — 46.59 83 4 0.28 32 2 1 6 2 „ 12 52.8 28.5 41.5 + 44.68 86 6 1.12 83 0 8 11 2 „ 19 49.9 36.2 42.0 + 44.73 88 2 0.02 28 1 2 7 6 „ 26 48.9 34.1 40.2 + 44.66 89 0 o.oo 18 0 0 5 1 Jan. 2 43.5 23.8 32.6 — 43.28 78 3 0.09 44 1 2 12 7 4th Qr 64.8 23.8 10 W + 3 W . 49.96 84 52 7.68 432 13 14 101 53 Whole Yr 87.5 23.6 31 W + 21 W — 51.30 73 178 35.33 1645 47 75 256 238 97 Table VIIIA. Weekly Averages. Temperature of the air. Temperature 3 feet below ground. Mean Humidity Complete Saturation = 100. No. of days Rainfall. Rainfall in inches. Deaths corrected for Public Institutions. Average of weekly maxima. Average of weekly minima. Average of weekly means. All Causes. Diarrhœa. Six other Zymotic Diseases. Bronchitis and Pneumonia. Tubercle. 1st Quarter 54.4 33. 0 44.0 44.03 78 3 0.45 33 .30 2 5 6 2nd Quarter 68.4 36.9 51.0 51.03 73 2 0.73 32 .07 2 5 4 3rd Quarter 73.9 45.7 59.0 60.18 77 3 0.74 28 2.2 0.7 2 5 4th Quarter 54.2 33.4 44.6 49.96 84 4 0.59 33 1.0 1.0 8 4 98 TABLE IX. Summary of Statistics for the First Quarter, 1903 (13 weeks), ending 4th April, corrected for Public Institutions. A.—Birth and Death Statistics for the Borough of Woolwich. Rates calculated per 1,000 population Births. Deaths under one year of Age. Deaths at all Ages—Gross. Deaths in Public Institutions. Deaths of Non-Residents in District. Deaths of Residents Registered beyond District. Deaths at all Ages corrected for Public Institutions. Population estimated to middle of year. Number. Rate. Number. Rate per 1,000 Births Registered. Number. Rate. Number. Rate. 124,888 877 28.1 98 112 389 — 78 9 49 429 13.7 B—Birth and Death Rates for each Parish. Woolwich. Plumstead. Eltham Population estimated to middle of year. Birth Rate. Death Rate at all Ages. Deaths under 1 Year per 1,000 Births. Population estimated to middle of year. Birth Rate. Death Rate at all Ages. Deaths under 1 Year per 1,000 Births. Population estimated to middle of year. Birth Rate. Death Rate at all Ages. Deaths under 1 Year per 1,000 Births.. A B C D A B C D A B C D 41,741 25.7 18.0 123 72,815 30.6 121 95 11,075 18.4 7.6 39 99 C—Notifications of Infectious Diseases. Woolwich. Pldmstead. Eltham. Total. Small Pox — — — — Scarlet Fever 26 22 6 54 Diphtheria 17 24 4 45 Enteric Fever 1 1 2 4 Erysipelas 4 10 1 15 Puerperal Fever — — — Phthisis 21 21 1 43 Measles (Reported by School Teachers) 119 116 12 247 TABLE X. Summary of Statistics for Second Quarter (13 weeks) ending 4th July, 1903, corrected for Public Institutions. A.—Birth and Death Statistics for the Borough of Woolwich. Rates calculated per 1,000 population. Births. Deaths under one year of age. Deaths at all Ages—Gross. Deaths in Public Institutions. Deaths of Non- Residents in District. Deaths of Residents Registered beyond District. Deaths at all Ages corrected for Public Institutions. Population estimated to middle of year. Number. Rate. Number. Rate per 1,000 Births Registered. Number. Rate. Number. Rate. 122,505 987 32.2 84 86 378 65 13 47 412 13.4 100 B.—Birth and Death Rates for each Parish. Woolwich. Plumstead. Eltham. Population estimated to middle of year. Birth Rate. Death Rate at all Ages. Deaths under 1 year per 1,000 Births. Population estimated to middle of year. Birth Rate. Death Rate at all Ages. Deaths under 1 year per 1,000 Births. Population estimated to middle of year. Birth Rate. Death Rate at all Ages. Deaths under 1 year per 1,000 Births. A B C D A B C D A B C D 41,681 30.0 16.1 90 70,822 33.8 12.8 87 10,002 26.9 6.6 45 C.—Notifications of Infectious Disease. Woolwich. Pldmsteap. Eltham. Total. Small Pox — 6 — 6 Scarlet Fever 64 57 6 127 Diphtheria 10 34 8 52 Enteric Fever 1 4 3 8 Erysipelas 6 8 — 14 Puerperal Fever — — — Phthisis 23 24 — 47 Measles 32 166 189 387 (Notified by School Teachers) 101 Table XI. Summary of Statistics for Third Quarter (13 weeks) ended 3rd October, 1903, corrected for Public Institutions. A.—Birth and Death Statistics for the Borough of Woolwich. Rates calculated per 1,000 population. Population estimated to middle of year. Births. Deaths under one year of age. Deaths at all Ages—Gross. Deaths in Public Institutions. Deaths of NonResidents in District. Deaths of Residents Registered beyond District. Deaths at all ages corrected for Public Institutions. Number. Rate. Number. Rate per 1000 Births Registered. Number. Rate. Number. Rate. 122505 947 30.9 84 90 339 — 71 10 43 372 12.1 B.—Birth and Death Rates for each Parish. Woolwich. Plomstead. Eltham. Population estimated to middle of year. Birth Rate. Death Rate at all ages. Deaths under 1 Year, per 1,000 Births. Population estimated to middle of year. Birth Rate. Death Rate at all ages. Deaths under 1 Year, per 1,000 Births. Population estimated to middle of year. Birth Rate. Death Rate at all ages. Deaths under 1 Year, per 1,000 Births. A B C D A B C D A B C D 41681 29.4 16.3 127 70822 32.3 10.2 68 10002 27.2 8.8 88 102 C.—Notifications of Infectious Disease. Woolwich. Plumstead. Eltham. Total. Scarlet Fever 26 55 5 86 Diphtheria 9 28 4 41 Enteric Fever 6 5 3 14 Continued Fever — 1 2 3 Erysipelas 7 13 — 20 Puerperal Fever — 2 — 2 Phthisis 14 22 2 38 Measles (Notified by School Teachers) 1 22 — 23 TABLE XII. Summary of Statistics for the Fourth Quarter (13 weeks) ending 2nd January, 1904, corrected for Public Institutions. A.—Birth and Death Statistics for the Borough of Woolwich. Rates calculated per 1,000 population. Population estimated to middle of year. Births. Deaths under one year of age. Deaths at all Ages—Gross. Deaths in Public Institutions. Deaths of Non-Residents in District. Deaths of Residents Registered beyond District. Deaths at all Ages corrected for Public Institutions. Number. Rate. Number. Rate per 1000 Births Registered Number. Number. Rate. 123,172 880 28.7 134 152 405 58 9 36 432 14.0 h B.—Birth and Death Bates for each Parish. Woolwich. Plumstead. Eltham. Population estimated to middle of year. Birth Rate. Death Rate at all Ages. Deaths under 1 Year per 1,000 Births. Population estimated to middle of year. Birth Rate. Death Rate at all Ages. Deaths under 1 Year per 1,000 Births. Population estimated to middle of year. Birth Rate. Death Rate at all Ages. Deaths under 1 Year per 1,000 Births. A B C D A B C D A B C D 41,681 30 2 16.5 187 70,822 27.9 13.2 135 10,669 280 11.2 112 C.—Notifications of Infectious Disease. Woolwich. Plumstead. Eltham. Total. Small Pox — — — — Scarlet Fever 20 76 19 115 Diphtheria 16 31 — 47 Enteric Fever 3 11 2 16 Erysipelas 3 6 1 10 Puerperal Fever — — — — Phthisis 7 31 2 40 Measles (Notified by School Teachers) 4 7 — 11 103 104 Table XIII. Birth and Death Rates for each Parish for the Year 1903. Woolwich. Plumstead. Eltham. Population estimated to middle of year. Birth Rate. Death Rate at all ages. Deaths under 1 year, per 1,000 Births. Population estimated to middle of (year. Birth Rate. Death Rate at all ages. Deaths under 1 year, per 1,000 Births. Population estimated to middle of year. Birth Rate. Death Rate at all ages. Deaths under 1 year, per 1,000 Births. A B C D A B C D A B C D 41681 29.0 16.7 132 70822 31.3 12.2 95 10668 24.1 8.2 74 105-106 TABLE XIV. Deaths from Various Causes for the whole Borough in each week, corrected for Public Institutions, nett. Week ending. Small-Pox. Measles. Scarlet Fever. Epidemic Influenza. Whooping Cough. Diphtheria and Membranous Croup. Enteric Fever. Diarrhoea and Dysentry. Erysipelas. Puerperal Fever Rheumatism. Tubercle. 1 Alcoholism. Cancer. Bronchitis. Pneumonia. Accidents. Homicide and Suicide. January 10 .. .. .. 4 2 .. .. .. .. .. .. 2 3 .. 4 3 3 .. ,, 17 .. 1 .. 3 .. .. .. .. .. .. .. 2 1 1 4 2 1 .. ,, 24 .. .. .. 1 1 1 .. .. .. .. .. 4 .. 1 5 1 1 .. ,, 31 .. 1 .. .. .. .. .. .. .. .. .. 6 .. 1 4 2 2 1 February 7 .. 1 .. 1 .. .. .. 1 .. .. .. 9 1 .. 5 4 .. .. ,, 14 .. .. .. 1 .. .. .. .. .. 4 .. 1 .. 2 4 1 ,, 21 .. 1 .. 1 1 2 .. .. .. .. .. 6 1 .. .. 2 1 .. ,, 28 .. 1 .. 2 .. .. 2 .. .. .. 8 1 1 2 .. 2 1 March 7 .. 1 .. 2 1 .. .. .. .. .. .. 7 .. 1 3 1 1 .. ,, 14 .. 1 .. .. 2 .. .. .. .. .. .. 5 1 1 3 3 .. .. ,, 21 .. 2 .. .. 1 .. .. 1 .. .. .. 6 1 .. 1 3 .. .. ,, 28 .. 2 .. .. .. .. .. .. .. .. .. 10 .. .. 2 5 3 1 April 4 .. .. .. 2 .. .. .. .. .. .. .. 5 1 2 1 2 .. .. 1st Quarter .. 11 1 14 10 4 .. 4 .. .. .. 74 10 9 34 30 18 4 April 11 .. .. .. .. 2 .. 1 .. .. .. .. 6 1 2 4 4 2 .. ,, 18 .. 1 .. 2 .. .. .. .. .. .. .. 6 2 1 2 3 .. 2 ,, 25 .. .. .. 2 .. .. .. .. .. .. .. 3 .. .. 6 3 1 .. May 2 .. 1 .. 1 2 .. .. .. .. .. .. .. 1 2 3 1 1 .. ,, 9 .. 1 .. .. .. .. .. .. .. .. 1 2 3 5 3 4 1 .. ,, 16 .. 3 .. .. 1 .. .. .. .. .. 1 7 .. 2 2 2 1 1 ,, 23 .. 1 1 1 2 .. .. .. .. .. 1 1 .. 2 2 2 2 .. ,, 30 .. 3 1 .. .. .. .. .. .. .. .. 3 .. 4 2 2 2 .. June 6 .. 3 .. .. .. .. .. .. .. .. 1 9 1 2 3 3 .. .. ,, 13 .. .. .. .. .. .. .. .. .. .. .. 2 .. 2 .. .. 1 .. ,, 20 .. .. .. .. 1 .. .. .. .. .. .. 4 1 3 .. 2 1 .. ,, 27 .. 1 .. 1 .. .. .. 1 .. .. .. 3 2 5 3 .. 1 .. July 4 .. .. .. .. .. 1 .. .. .. .. .. 3 1 2 3 1 19 1 2nd Quarter .. 14 2 7 8 1 1 1 .. .. 4 49 12 32 33 27 32 4 July 11 .. .. .. .. .. .. .. 1 .. .. 1 4 2 2 1 .. 3 .. ,, 18 .. .. .. .. 1 .. 1 .. .. 1 .. 7 1 1 1 .. .. .. ,, 25 .. .. .. .. .. 1 .. .. .. .. .. 5 1 1 1 2 1 2 August 1 .. .. .. .. 1 .. .. 2 .. .. .. 4 .. 1 2 2 4 .. ,, 8 .. .. .. .. .. 1 .. 1 .. .. 2 .. 3 2 1 1 1 ,, 15 .. .. .. .. 1 1 .. .. .. .. .. 5 .. 4 2 1 2 1 ,, 22 .. .. .. .. .. .. .. 1 .. .. .. 2 .. 1 1 2 .. 2 ,, 29 .. .. .. .. .. .. .. 2 .. .. .. 5 1 1 1 1 .. 1 September 5 .. .. .. .. .. .. 1 5 .. .. .. 3 .. 3 1 2 .. .. ,, 12 .. .. .. .. .. .. .. 2 .. .. .. 7 2 2 .. 3 .. .. ,, 19 .. .. .. .. .. .. .. 7 .. .. .. 5 1 2 2 .. 1 .. ,, 26 .. .. .. .. .. .... .. 5 .. .. .. 3 1 5 2 .. .. .. October 3 .. .. .. .. 1 .. .. 3 .. .. 1 6 .. 2 .. 1 2 .. 3rd Quarter .. .. 1 1 4 3 2 29 .. 1 2 58 9 28 16 15 14 7 October 10 .. .. .. .. 1 .. .. 3 .. .. .. 5 1 3 2 4 .. 1 ,, 17 .. .. .. .. .. .. 1 3 .. .. .. 5 .. 2 2 4 2 .. ,, 24 .. .. .. .. .. .. .. 2 .. .. .. 5 .. 3 2 2 1 .. „ 31 .. .. .. .. .. .. .. .. .. .. .. .. .. 1 5 3 .. .. November 7 .. .. .. .. 1 .. .. .. .. .. 2 5 3 2 7 4 .. .. „ 14 .. .. .. 1 1 .. .. .. .. .. .. 4 1 1 2 5 1 .. „ 21 .. .. .. .. .. .. 1 1 .. .. .. 4 .. 1 6 6 2 3 „ 28 .. .. .. .. 1 .. .. .. .. .. .. 7 .. 1 5 1 .. .. December 5 .. .. .. .. .. .. 1 2 .. .. .. 2 1 1 1 5 .. .. „ 12 .. .. .. .. 1 2 .. .. .. .. .. 2 2 3 6 5 .. .. „ 19 .. .. .. .. 1 1 .. 1 .. .. .. 6 1 2 3 4 .. .. „ 26 .. .. .. .. .. .. .. .. .. .. .. 1 2 3 2 2 .. January 2 .. .. .. 2 .. 2 .. 1 .. .. .. 7 1 1 12 .. 1 .. 4th Quarter .. .. .. 3 6 5 3 13 .. .. 2 53 10 23 56 45 9 4 Total for Year .. 25 4 25 28 13 6 47 .. 1 8 234 41 92 139 117 73 19 107 TABLE XIVA. Total Deaths of Persons belonging to the County of London, and Registered in the 52 weeks ending January 2nd, 1904, All Causes. Small-pox. Measles. Scarlet Fever. Diphtheria. Whooping Cough. Typhus. Enteric Fever. Pyrexia (origin uncertain). Diarrhoea. Phthisis. Deaths of Infants under 1 year of age. Deaths under 1 year to 1,000 Births Registered. 1st Quarter 19,328 5 666 99 238 759 1 82 2 258 1909 4241 127 2nd Quarter 16,311 2 758 82 171 443 2 44 1 268 1694 3384 102 3rd Quarter 15,581 3 247 91 144 217 • • 79 2 1717 1631 4552 139 4th Quarter 18,514 3 375 89 187 208 • • 163 • • 682 1890 4801 152 Whole year 69,734 13 2046 361 740 1627 3 368 5 2925 7124 16978 130 Death Rates 15.1 0.00 0.44 0.07 0.16 0.35 0.00 0.08 0.00 0.63 1.54 • • 130 h 2 108 TABLE XV. A Summary of Nuisances Abated, Notices Served and General Work of the Public Health Department for the 12 months ended 31st December, 1903. Sanitary Inspectors' Districts. St. Mary's and Dockyard. River. St. George's. Central and Glyndon. St. Margaret's and Herbert. St. Nicholas. Burrage and Registered Houses. Eltham. Total. PREMISES INSPECTED. No. of Houses inspected, house to house 748 551 857 884 762 1048 975 398 6223 „ Re-inspections after service of notice 2020 2104 1460 1960 1985 1870 1044 1560 14003 „ Houses and Premises specially inspected, including infectious diseases and complaints 795 1039 457 1105 1210 1267 1097 821 7791 ,, Houses where drains have been tested by smoke test 40 25 21 42 30 30 42 34 264 ,, Houses where drains have been tested by water 86 61 10 26 29 7 4 41 264 ,, New Houses inspected for Certificates 4 80 40 12 136 188 — 169 629 NUISANCES ABATED—DRAINS. Waste Pipes from baths, lavatories and wash-house sinks repaired or disconnected 129 60 20 46 45 36 13 19 368 Choked and defective drains 186 146 37 85 117 47 27 77 722 Defective Traps.. 52 55 28 68 11 14 12 15 255 Defective and unventilated soil pipes 52 15 2 4 8 7 12 24 124 W.C.'s W.C.'s repaired, new traps or pans provided, fittings repaired 162 185 117 85 55 53 87 69 813 Water supply apparatus repaired 91 100 31 89 112 186 68 42 719 Foul pans cleansed 6 33 21 21 44 22 22 10 179 Additional w.c.'s provided to Factories and Workshops, &c. — 8 — 2 — — 1 — 11 109 TABLE XV. A—continued. Sanitary Inspectors' Districts. St. Mary's and Dockyard. River. St. George's. Central and Glyndon. St. Margaret's and Herbert. St. Nicholas. Burrage and Registered Houses. Eltham. Total. PREMISES. Underground Rooms not in accordance with Act 1 1 — — — — — — 2 Interiors cleansed and defective roofs repaired 249 366 430 336 343 374 387 226 2711 Damp walls remedied 88 53 51 106 111 78 47 46 580 Paving in yards and wash-houses repaired 112 108 72 195 103 41 67 29 727 Through ventilation provided 17 19 8 30 8 29 8 23 142 Wash-houses without sinks and outlets for waste water 26 5 — 2 1 — 27 — 61 Defective guttering and rain water pipes 57 116 65 120 65 111 59 8 601 Dustbins supplied 36 100 116 142 96 90 57 71 708 Dung pits provided 5 5 1 1 1 1 2 10 26 Cases of overcrowding remedied 6 11 18 9 49 16 7 10 126 Deficient light—windows supplied or enlarged or other works 43 18 4 14 15 2 8 4 108 Dampness in premises from defective water pipes 5 6 3 29 6 45 6 3 103 ANIMALS. Animals kept in such a state as to be a nuisance — 2 — 6 2 1 4 — 15 Accumulations of manure removed.. 5 26 2 8 15 3 12 5 76 WATER. Defective and foul cisterns used for dietary purposes 3 4 10 2 8 36 7 — 70 Defective and foul rainwater tanks remedied 2 3 1 11 5 1 14 — 37 Insufficient supply and water cut off by Water Company 10 11 1 6 12 10 11 — 61 Smoke observations — 5 119 2 — 5 — 2 133 Tents, wans, &c., inspected — — — — — 12 — — 12 N.B.—The Inspectors of St. George's and Eltham Wards also worked in River and Dockyard Wards. 110 Table XV. B SUMMARY OP WORK OF CHIEF INSPECTOR. Premises Inspected 1130 New Buildings Inspected 136 Ditches Cleansed 11 Defective Combined Drains Investigated and Reported on 28 Number of Houses referred to in such Combined Drains 152 Cowhouses and Slaughterhouses Inspections 35 Complaints Investigated 167 Attendances at Police Court 32 MISCELLANEOUS, INCLUDING WORK OF CHIEF INSPECTOR, DISTRICT INSPECTORS, and CLERKS. Number of Cases of Inattention to Notices reported to Town Clerk for Proceedings 101 Summonses at Police Court, after Inattention to Town Clerk's letter 17 Bakehouses Inspected and Cleansed twice during the year 64 Number of Houses Disinfected after Infectious Disease 744 Letters received 3940 „ written 3141 Notifications received 844 Certificates issued after Disinfection 1626 ,, of Infectious Disease forwarded to Schools 850 Complaints of Sanitary Defects 493 ,, of Non-removal of Dust, viz. Woolwich 21 Plumstead 38 Eltham 11 Smoke Nuisances—Observations 25 Written Intimation Notices 3631 Statutory Notices 513 PARTICULARS OF OUT-WORKERS' LISTS. Lists Received. No. of Lists from Local Employers. No. of Outworkers on Local Lists. No. of Lists from Outside Employers. No. of Outworkers on Outside Employers' Lists. Total No. of Lists received. Total No. of Outworkers. February 48 234 7 29 43 263 August 41 205 11 31 52 236 Ill TABLE XV. C. Inspection of Factories, Workshops and Workplaces. Class of Works. Number op Places ‡ Number of Inspections, 1903. Number of Notices 1903. Number of Prosecutions, 1903. On Register at end of 1902. Added in 1903. Removed in 1903. On Register at end of 1903. Premises. Rooms. Factories— Factory Laundries — 1 — 1 2 1 — — Factory Bakehouses 4 — — 4 — 4 — — Other Factories — — — — — 19 — — Workshops*— Workshop Laundries 9 10 19 45 41 7 — Workshop Bakehouses 71 1 9 62 62 142 11 — Other Workshops 129 33 4 158 180 311 31 — Workplaces— Outworkers' Premises — 212 — — — 424 39 — Places where food is prepared for Sale† — — — — — 54 17 — Total .. 213 257 13 244 289 996 105 Nil. * In a separate Table the more important classes of workshop industry should be distinguished, each in a separate line. ‡ A Register is required by Section 131 in the case of Workshops only. † Under this head should be included Hotel Kitchens, Eating Houses of all sorts, Tripe Shops, Pried Fish Shops. 112 TABLE XV. C—continued. Matters Dealt With. Particulars. Number of Defects. Notices Issued. Prosecutions. Found. Notified by Home Office. Remedied. Notified to Home Office. Nuisances under the Public Health (London) Act, 1891— Want of Cleanliness 30 — 30 — 38 — Want of Ventilation 35 — 35 — — Want of Air Space—Overcrowding 13 — 13 — — Sanitary Accommodation (Sec. 38)— Insufficient 2 — 2 — — Unsuitable 1 1 1 — — Not separate for Sexes 1 — 1 — — Want of Drainage of Floors — — — — — Other Nuisances 27 — 27 3 — Total 109 1 109 3 38 Nil. 113 TABLE XV. C—continued. Cases reported to H.M. Inspector— Abstract not affixed 2 Number of Underground Bakehouses in use at end of 1903 24 Certificates Granted (Section 101) 24 Number of Workshop Rooms Measured 21 List of Outworkers (Section 107). Class of Homework. Number of Lists Received. Number of Addresses of Outworkers. Up to February 1st. Up to August 1st. Forwarded to Other Authorities Received from Other Authorities No. of Lists. No. of Outworkers. No. of Lists. No. of Outworkers. Wearing Apparel* 51 273 51 212 51 60 Total 51 273 51 212 51 60 * The more important branches of Homework Wearing Apparel should be distinguished, each in a separate line ; i.e., Dressmaking, Tailoring. 114 TABLE XVI. Details of House to House Inspection. Name of Street. Number of Houses Inspected. Number where Defects were Found. ST. MARY'S AND DOCK YARD WARDS. Sun Street 12 12 Warwick Street 64 49 George Street 28 18 Church Street 85 56 Anchor Alley 3 3 Martyr's Passage 7 7 Paradise Place 23 16 Limbrey's Buildings 7 1 Railway Cottages 7 5 Harrington's Buildings 5 5 Simm's Buildings 8 7 Eustace Place 12 10 Willow Cottages 3 3 Sarah Place 6 6 Mary Place 9 8 Elgin Terrace 9 8 Samuel Street 134 85 Coleman Street 42 26 King Street 75 58 Rectory Place 21 14 Mulgrave Place 15 7 Hill Street 46 24 Wood street 52 33 Woodville Street 8 3 Godfrey Hill 10 3 Henry Street 57 39 Harden's Manorway 12 5 Charlton Vale 55 41 Siemen's Road 27 13 Trinity Street 33 25 Bowater Road 10 9 Sand Street 68 55 Morris Place 6 6 Morris Street 33 26 Harden Street 29 20 Acorn Street 26 14 Oak Street 20 10 Glenalvon Street 9 5 Total 1076 735 115 TABLE XVI.—continued. Name of Street. Number of Houses Inspected. Number where Defects were Found. RIVER WARD. Walpole Place 29 7 Havelock Place 3 2 Anglesea Road 44 22 Sandy Hill 17 15 New Road 40 28 Brookhill Road 31 21 Anglesea Avenue 9 7 Wilmount Street 39 27 Taylor Street 19 12 Helen Street 11 7 Elizabeth Place, High Street 5 4 Powis Street 40 31 Parson's Hill 10 7 Charles Street, Woolwich 60 40 King Street 21 14 St. Mary's Street 9 6 Salutation Alley 6 6 Brewer Street 78 42 Brewer Place 12 5 Red Lion Street 22 15 Monk Street 17 11 Rodney Street 6 6 Collingwood Street 9 9 Meeting House Lane 8 7 Clara Place 14 13 Nelson Street 6 6 Pore & Albert Houses, High St. 7 7 Barge House Terrace 7 5 Auberon Street and Terrace 57 20 Rhea Street 25 9 Winifred Street 48 21 Kate's Place 14 10 Ann's Place 4 3 Dock Street 12 7 Davey's Square 4 1 Mary Ann Street 9 4 Albert Road 142 70 Elizabeth Street 23 5 Total 917 542 116 TABLE XVI.— continued. Name of Street. Number of Houses Inspected. Number where Defects were Found. ST. GEORGE'S WARD. Manor Street 37 27 Sandy Hill 13 8 Hanover Terrace 12 3 Millward Street 53 34 Eglinton Road 15 8 Engineer Road 53 17 Nightingale Vale 50 26 Jackson Street 57 34 Dicey Street 42 35 James Street 49 34 Ordnance Road 11 3 Ritter Street 39 18 Ordnance Terrace 6 1 Fenwick Street 61 44 Keemore Street 34 20 Total .. 512 312 BURRAGE WARD. Armstrong Street 25 3 Armstrong Place 31 15 Arthur Street 41 10 The Avenue, Sandy Hill Road 22 7 Bignell Road 15 1 Burrage Grove 40 13 Charles Street 18 8 Chester Place 13 2 Conduit Road 28 5 Crescent Road 36 14 East Street 26 17 Eton Road 28 3 Eton Street 10 3 Bloomfield Road 101 27 Mount Pleasant 23 6 Helen Street 11 6 Parry Place 32 11 Plumstead Road 61 16 St. James' Place 65 6 Sandy Hill Road 135 26 Cambridge Place 8 3 117 TABLE XVI. — continued. Name of Street. Number of Houses Inspected. Number where Defects were Pound. BURRAGE WARD—contd. Whitworth Place 25 10 Spray Street 38 14 Scott's Passage 5 1 Hanover Road 12 2 Total 849 229 ST. MARGARET'S AND HERBERT WARDS. The Slade 51 34 Winn's Cottages 7 3 Garland Street 45 38 Upper Garland Street 9 7 Pendrell Street 39 30 Llanover Road 05 37 Whitworth Road 79 48 Paget Road 17 10 Hudson Road 86 31 Coupland Terrace 39 22 Vicarage Road 27 20 Raglan Road 37 30 Palmerston Road 78 52 Burwash Road 51 24 Durham Road 55 26 Bramblebury Road 72 40 Manthorpe Road 5 4 Total 762 456 CENTRAL AND GLYNDON WARDS. Orchard Road 80 37 Inverary Place 8 6 Walmer Road 64 39 Roydene Road 103 42 Goldsmid Street 10 4 Sladedale Road 77 40 Parkdale Road 121 66 Down Street 14 13 Down Place 7 7 Thomas Street, Plumstead 21 17 118 TABLE XVI.—continued. Name of Street. Number of Houses Inspected. Number where Defects were Found. CENTRAL AND GLYNDON WARDS—contd, Robert Street 30 26 Charlotte Street 39 28 Charlotte Place 6 3 Richmond Place 44 28 Vicarage Road 63 46 Inverness Place 28 18 Pattison Road 94 65 Hudson Road 31 17 Raglan Road 28 16 Railway Place 16 5 Total 884 523 ST. NICHOLAS WARD. Bastian Road 21 7 Scotch Flats 32 4 Bostall Hill 23 6 Purrett Road 88 31 Saunders Road 42 19 Hull Place 11 6 Bostall Lane 6 4 Abbey Wood Road 55 28 High Street Plumstead 170 79 Speranza Street 48 42 Brookdene Road 37 31 Tewson Road 115 92 Rippolson Road 36 28 Bassant Road 34 27 Swingate Lane 14 5 Lakedale Road 40 25 Benares Road 140 41 Riverdale Road 116 57 Total 1028 532 ELTHAM Lannoy Road 19 9 Blanmerle Road 17 15 Southwood Road 19 2 Osborne Terrace 15 5 Total 70 31 119 Table XVII. Prosecutions under Public Health and Housing of the Working Classes Acts. Date of Hearing. Offence. Situation. Result. 1903. Jan. 23 Unsound food 6, High Street, Plumstead Fined 40/- and 42/- costs Feb. 13 Premises unfit for habitation 2, Lewis Place Work completed. Costs £2 14/- do. 3, ,, Mar. 11 Unsound food 59, Church Street Fined £20 and £2 2/- costs „ 11 Nuisance 42, Dicey Street Fined £5 and £1 3/- costs „ 27 Smoke Nuisance King's Norton Metal Works, Abbey Wood Fined £5 and £1 3/- costs do. do. Fined £5 and £1 3/- costs do. do. Fined £1 and £1 3/- costs April 3 Nuisance 137, High Street 24/- costs ,, 3 do. 138 ,, 3/- costs June 23 Defective receptacle for manure 79, New Road Fined 40/- and 23/- costs ,, 23 Manure deposited in roadway 79 ,, Costs 2/- ,, 23 Nuisance from keeping of swine Abbey Wood Costs 23/- ,, 23 Defective w.c. 25, Church Street Costs 2/- ,, 23 Unsound ox tongue 50b, Beresford Street Three months hard labour ,, 23 Throwing rubbish into roadway 106, Brookhill Road Fined 10/- and 23/- costs July 21 Unsound bananas On stall in Plumstead Road Fined £10 and 4/- costs ,, 21 Unsound meat 47, Hare Street Fined £15 and 23/- costs ,, 28 Unsound fish On barrow in the street Fined £1 and 2/- costs Sept. 7 Sanitary defects 45, Llanover Road Costs 23/- ,, 7 do. 43 ,, Costs 2/- ,, 30 Failing to maintain w.c. in working order 5, Sand Street Fined 40/- and 23/- costs Oct. 11 Defective yard paving 12, Whitworth Road Costs 23/- ,, 14 Sanitary defects 8 ,, Fined 5/- and 23/- costs ,, 14 do. 14 ,, Fined 20/- and 23/- costs Nov. 4 do. 35, Samuel Street Costs 2/- and Prohibition Order made ,, 4 do. 33 ,, Fined 20/- and 23/- costs ,, 4 Unsound meat 47, Hare Street Fined £10 and 44/- costs ,, 4 Neglecting to repair w.c. apparatus 88, Vicarage Road Fined 1/- and 23/- costs Dec. 3 Nuisances 92, Raglan Road Fined 40/- and 23/- costs ,, 3 Failing to maintain w.c. in proper condition 14, Whitworth Road Fined £5 and 23/- costs ,, 23 Refusing to fill in form of Registered house 33, Engineer Road Case dismissed with £2 2/costs against Council ,, 23 Nuisances 64, King Street Fined 20/- and 23/- costs 120 TABLE XVIII. Summary of Articles Analysed under the Sale of Pood and Drugs Act, during the year ending 31st December, 1903. Article. Number analysed. Number adulterated. Milk 392 24 Butter 107 6 Margarine 1 0 Dripping 1 0 Cheese 3 0 Separated Milk 12 0 Vinegar 2 0 Tea 8 0 Coffee 1 1 Cocoa 1 0 Bovril 1 0 Condensed Milk 1 0 Sugar 2 0 Rum 1 0 Whisky 1 0 Gin 1 0 Bread 2 0 Flour 2 0 Total 539 31 121 Table XVIIIa. Proceedings under the Food and Drugs Act for the Year 1903. Article. Nature of Adulteration. Name and Address of Vendor. Remarks and Result of Proceedings (if any). Butter 11/12 margarine J. Saunders, 6, Sand Street Fined £3 and 12/6 costs Butter 9/10 margarine A. Bamforth, 52, Raglan Road Fined 20/- and 12/6 costs Coffee 20 per cent, chicory G. Collins, 32b, Plumstead Road Withdrawn, declaration made on wrapper as to mixture Milk 10 per cent, fat abstracted J. Ferdinand, 102, Raglan Road Fined 10/- and 12/6 costs Milk 26 per cent, fat abstracted H. Perrett, 2, The Parade, Eltham Fined £5 and 12/6 costs Butter Nearly all margarine .. R. G. Dalton, 55, Eglinton Road Fined 20/- and 12/6 costs Milk 10 per cent, fat abstracted M. Fowler, Fairy Farm, Eltham Fined 10/- and 12/6 costs Milk 10 per cent, added water A. Handsley, 2, Stannary Street Withdrawn—warranty proved Milk 5 per cent, added water A. Smith, 30, High Street, Eltham Fined 10/- and 12/6 costs. (Sent to Somerset House, whose certificate stated sample contained 2½ per cent, added water) Milk 20 per cent, added water Chas. Dix, 78, Reidhaven Road Fined 40/- and 12/6 costs Milk 5 per cent, added water Thomas Ralph, 12, The Broadway, Eltham Fined 5/- and 12/6 costs Milk 11 per cent, added water H. Furber, Southend Hall, Eltham Fined 40/- and 12/6 costs Milk 16 per cent, fat abstracted W. Coppin, 7, Waverley Cottages Fined 20/- and 12/6 costs Milk 7 per cent, added water E. Skeggs, 54, High Street 12/6 costs Milk 6 per cent, fat abstracted M. Williamson, 46, Church Street Fined 5/- and 12/6 costs Milk 16 per cent, added water F. Plummer, 27, Harden Street Fined 10/- and 12/6 costs 122 Table XVIIIa—continued. Article. Nature of Adulteration. Name and Address of Vendor. Remarks and Result of Proceedings (if any). Butter 60 per cent, foreign fat P. Adams, 11, Armstrong Street Pined 40/- and 12/6 costs Milk 5 per cent, added water A. Smith, 30, High Street, Eltham Pined 10/- and 12/6 costs. (Sent to Somerset House, whose certificate stated sample contained 5 per cent, added water) Milk 3 per cent, added water W. Graham, Marlesford Withdrawn—warranty proved Milk 4 per cent, added water . No proceedings. Further samples taken Milk 5 per cent, added water — McWilliam, Oliver Street 12/6 costs Butter 32 per cent, foreign fat J. Berry, 82, Samuel Street Fined £6 and 12/6 costs Butter 99 per cent, margarine E. J. Tucker, 82, Brookhill Road Fined £5 and 12/6 costs Milk 9 per cent, added water E. Hiscock, 315, High Street Fined £6 and 12/6 costs Milk 5 per cent, fat abstracted M. A. Surman, 68, Beresford Street Fined 10/- and 12/6 costs Milk 2 per cent, added water . No proceedings taken. Further samples taken Milk 3 per cent, added water . No proceedings taken. Further samples taken Milk 9'8 per cent, added water S. A. Graves, 19, Glyndon Road Fined 40/- and 12/6 costs Milk 10 per cent, fat abstracted M. Hilton, 69, Henry Street Fined 40/- and 12/6 costs Milk 10 per cent, fat abstracted E. J. Hellyer, 27, Church Street Fined 40/- and 12/6 costs Milk 7-8 per cent, fat abstracted E. Hiscock, 315, High Street Case not heard, hearing adjourned in consequence of vendor suffering from Scarlet Fever 123 Table XIX. Food Seized, or Surrendered by Owners, as unfit for consumption. Articles. Quantity or Weight. Date of Seizure or Surrender. Remarks. Beef 15 lbs. 2nd Jan Condemned by Magistrate. Owner fined 40/- and 42/- costs Mutton 4 shoulders 12th Jan. Condemned by Magistrate. Owner cautioned Babbits 3 12th Jan. Kidneys (Pigs) 16 lbs 10th Jan Surrendered Beef . 3rd Feb Condemned by Magistrate. Owner fined £20 and £2 2/-costs Kidneys (pigs) 16 lbs. 31st Jan Surrendered Plaice 1 box 7th Feb Surrendered Oranges 1 box 16th Feb Surrendered Bullock Whole carcase (black quarter) 9th Feb Surrendered Beef 20 lbs. 18th Feb Condemned by Magistrate Pork 10 lbs. 18th Feb Tongue (ox) 1 20th May Condemned by Magistrate. Owner sentenced to 3 months Pish 1 trunk 25th May Surrendered Mutton 20 lbs. 20th June Condemned by Magistrate. Owner fined £15 and 23/- costs Bananas 161 4th July Condemned by Magistrate. Owner fined £10 and 4/- costs Haddocks 73 14th July Condemned by Magistrate. Owner fined 20/and 2/- costs Babbits 90 26th Sept Surrendered Plaice 1 trunk 5th Oct Surrendered Cod 1 trunk 5th Oct Surrendered Plaice 1 trunk 6th Oct Surrendered Babbits 5 8th Oct , Condemned by Magistrate. Owner fined £10 and £2 4/- costs Beef 45 lbs. Mutton 15 lbs. Tongue (ox) 1 Bacon 40 lbs. 23rd Oct Condemned by Magistrate. Owner cautioned Mutton 2| lbs. 23rd Dec Condemned by Magistrate. Owner fined £10 and £3 3/- costs 124 Table XX. List of Level Bakehouses, Name. Address. Mrs. S. Fuller 48, Princes Road, Plumstead Chadwell Bros 60, Plumstead Common Road C. Pullen 105, Plumstead Common Road J. R. Allway 126, High Street, Plumstead J. E. Porter 1, Riverdale Road do. E. Goodsell 307, High Street do. A. E. Paine 14, Gunning Street do. A. Jewiss 68, Glyndon Road do. F. Grant 102, Ann Street do. A. Chapman 2, High Street do. J. Fletcher 92, Plumstead Road do. — Letchford 109 do. do. J. Tait 136 do. do. J.Clark 152 do. do. G. Mackintosh 64, Villas Road do. R. Moaks 54, Parkdale Road do. W.C.Hill 82, Bannockburn Road,do. J. Stratton 2, Stratton Terrace, Bostall Lane, Plumstead S.Harrison 122, Benares Road, Plumstead W. J effery 123, Burrage Road do. P. H. Mack Ill, High Street, Woolwich T. Newman 94, Wellington Street do. H. Moore 100, High Street do. a. Bradshaw 3, Green's End do. G. Porter 29, Charles Street do. F. W. Jackson 184, Elizabeth Street, North Woolwich C. Haas 122, Albert Road do. Mrs. Dennis 90, Brookhill Road, Woolwich H. Myers 33, Samuel Street do. — Bonner 36, Chapel Street do. F. Holcombe 45, Warwick Street do. G. West 10, King Street do. C. H. Wyatt 94, High Street, Eltham E. Scriven 114 do. do. F. Cook 142 do. do. C. Worboys 5, The Parade, New Eltham E. Shillito 13 do. do. E. Hobbs 6, Well Hall Parade, Eltham 125 Table XXa. List of Certified Underground Bakehouses. Name. Address. S. Betchley 33, Eglinton Road, Plumstead Merritt & Co 50, Herbert Road do. H. Gilder 14, Westdale Road do. H. Percival 223, High Street do. J. Werner 1, Park Road do. S. Collin 58, Pattison Road do. E.Phillips 53, Ann Street do. — Plummer 46, Raglan Road do. 0. Degen 14, Conway Road do. P. Farrier 30, Burrage Road do. W. T. Akers 16, Armstrong Place do. Dalton & Sons 13, Eton Road do. W. Arnold 57, Plumstead Road do. R. G. Davis 2, Crescent Road do. a. E. Sims 24, St. James' Place do. J. Colver 165, Sandy Hill Road do. E. Fairbrother 16, Woolwich Common B. Flood 31, Beresford Street, Woolwich L. Wilkenning 72, Henry Street do. F. Ginger 8, Hill Street do. W. C. Clothier 51, Albion Road do. F. Harper 23, George Street do. J. Franklin 21, Albion Road do. A. Hills 32, Church Street do. The Underground Bakehouses at the following 10 premises have been closed during the year:— 82, Broolihill Road 38, Artillery Place 57, Burrage Road 24, Chapel Street 140, High Street, Woolwich 1, Lower Pellipar Road 15, New Road 48, Church Street 57, New Road 18, Prospect Place The Bakehouses at the following premises have been opened during the year:— 100a, High Street, Woolwich 82, Bannockburn Road 2, Stratton Terrace 122, Benares Road 126 Table XXI. List of Slaughterhouses. No. Name of Owner. Situation. 1 Eliza Biggs 168, High Street, Eltham 2 Jos. Leech 78, Frederick Place, Plumstead 3 H. T. J. Reed & J. W. Funnell 25, Parry Place, Plumstead 4 t. Mead 6, High Street, Plumstead 5 Hedley Vicars 41, Church Street, Woolwich 6 Walter Monk 14, Church Street, Woolwich 7 Frederick Bucknell Love Lane (rear of Wellington Street), Woolwich 8 James & George Mitchell 25, Hare Street, Woolwich 9 Hedley Vicars 30, Hare Street, Woolwich 10 H. T. J. Reed & J. W. Funnell 38, Plumstead Common Road, Plumstead 11 Henry Fretter 33, Herbert Road, Plumstead 127 Table XXII. List of Cowhouses. No. Name and Address of Owner. Situation. 1 Wm. J. Miller Keightley House Farm, Southwood Road, Eltham 2 Richard Higgs Coldharbour Farm, Chislehurst 3 John & Alfred Low, Avery Hill Farm, Eltham Park Farm, Eltham 4 W. F. Corp Lyme Farm, Eltham 5 E. Fisher & Sons, Crescent Farm, Sidcup Belmont Park Farm, Eltham 6 John Grace Pippinhall Farm, Eltham 7 William Ridewood Chapel Farm, Eltham 8 George Keen Clay Farm, New Eltham 9 Maurice Bay ley Middle Park Farm, Eltham 10 Harry Furber Victoria Road Farm, Southend, Eltham 11 William Killick 52, St. James' Place, Plumstead 12 W. F. Corp, Lyme Farm, Eltham 13, Princes Road, Plumstead 13 Henry Woolbey 50, Francis Street, Plumstead 14 Reuben Mehew 16, Lakedale Road, Plumstead 15 W. Ridewood, Chapel Farm, Eltham 3, Kipon Road, Plumstead 16 F. G. Cook 13, Raglan Road, Plumstead 17 Chas. Lambeth 1, Griffin Road, Plumstead 18 John Chas. Terrington, 117, Shooters' Hill Road, Blackheath Rear of 14, 15, 16, Pellipar Road, Woolwich