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and the sanitary condition of the remainder improved. The anticipated development
for commercial purposes has been delayed by the War. The new Kingsway and the
widening of part of Southampton Row led to the demolition of much insanitary
property. The houses of nearly all the Mews of the Borough have now been
demolished, either previously to 1909 or under the Housing Act of that year. Under
the same Act a number of small areas, and a large number of insanitary houses and
underground rooms have been dealt with. Since my appointment also a large majority
of the tenement houses have been provided with additional sanitary accommodation
and water supply, and the large fixed ashpits replaced by movable sanitary dustbins.
Very great improvement has been effected in the removal of house refuse, for in 1895,
there were 2,114 notices for the removal of refuse, mostly accumulations of several
weeks, in the Eastern part of the Borough, the then Holborn District Board of Works,
while in 1913, the year before the War, only seven genuine complaints of non-removal
were received from the whole of the Borough. In March, 1896, a new Contract for
the removal at least once a week was begun ; for many years there has been (except
partially during the War) in addition to a large increasing amount of daily
collection, at least a twice weekly collection.
The improvements in the general sanitary conditions have been followed by
improvements in the general health conditions and largely reduced death rates.
The death rate, which in 1895 was 24 4 per thousand, was gradually with slight
annual variations reduced to 14.4 in 1913, the year before the War, which unfortunately
led to generally adverse health conditions and gradually increased civilian death rates,
culminating in the epidemic of influenza of 1918 and a death rate of 22.3. Since
the War these rates have been again diminishing to 16.4 in 1919 and 15.2 in 1920.
The Phthisis death rates of the Borough have also been reduced from 3.24 per
1,000 in 1895 to 1.13 in 1920, with rises also during the War and falls since.
The Infantile death rate has been reduced from the high rate of 185 per 1,000
births in 1895 to 66 last year. This is a most satisfactory indication of the great
value of Maternity and Child Welfare Work, as the foundation of an A.l nation is the
maintenance of the health of expectant mothers and their infants.
In my Annual Report for 1919, I gave details respecting the great importance
of Self Help to health. I pointed out the marvellous complexity of the human body;
that it can in many ways be compared with a very complicated automatic machine;
that Medical men study Nature's methods so that they can assist recovery from disease
by acting as Nature's assistants. Therefore, when ill, at once call in a well trained
doctor, as Nature can be assisted most efficaciously at the beginning of the disease
before much damage has been caused. Much money is worse than wasted, because of
the harm that is so frequently done by the indiscriminate use of drugs and specious
quack medicines. Prevention is much better than cure, and everyone can act as
Nature's assistant, especially in the prevention of disease by Self-Help. Man is a
" bundle of habits " and I indicated the good habits necessary for the healthy