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iv
The success of the Council's efforts is shown by the fact that only about 800 cases occurred in common
lodging-houses out of 9,296 cases notified during the year ended 31st August, 1902, by which date the
epidemic was practically at ail end. Full details of the outbreak as affecting common lodging-houses
are given in a report prepared bv Dr. Hamer and presented to us by the medical officer. (Appendix I.)
We have repeatedly had before us the question of the risk of the spread of diphtheria and
scarlet fever owing to the aggregation of children in schools. We conferred on this subject with
members of the School Board for London some years ago, and we now note that it appears from the
recently published annual report of the medical officer of the Board that this matter is receiving the
careful attention of the Board, and we gather that in the future due regard is likely to be paid to the
need of adopting preventive measures adequate to the occasion in cases of necessity.
The deaths from measles in the Administrative County of London during 1902 numbered 2,360,
as compared with 1,952 in 1901. The large mortality which this disease causes amongst the children
of the poor has led us to advise the Council to apply to measles certain sections of the Public Health
(London) Act, 1891, which in effect, while not making this malady notifiable, placa it on a level in
other respects with the chief infectious diseases. We hope that the Council's order, which has only
recently come into force, will enable sanitary authorities to grapple more successfully with the disease,
and bring home to parents and guardians of children, especially among the poorer classes, the dangers
which result from the neglect of proper precautions.
The agency of milk in the spread of infectious disease was evidenced in the case of a serious
outbreak of scarlet fever in the early part of May, 1901, in the north and east of London, due to
infected milk from a farm in Staffordshire. In connection with this outbreak our attention was directed
to the fact that there was no power under the existing law to exclude an infective milk supply from
London as a whole, and that the machinery which could be put in force with regard to the 29 sanitary
districts into which London is divided involved serious delay. The Council, on our recommendation,
decided to apply in its General Powers Bill of 1902 for further powers on this subject, and also in
relation to tuberculous milk. We regret to say that these powers were not granted by Parliament,
although similar powers have been given to the local authorities of a number of districts outside
London. The pronouncement of Dr. Koch, to the effect that there is little probability of tuberculosis
being communicated from animals to man, was, of course, quoted against the Council's proposals,
and we are therefore interested to observe that recent experiments made by other observers have not
tended to support Dr. Koch's theory. In the exercise of the powers already possessed by the Council,
13 examinations of all the cows in London cowsheds have been made and the milk of numerous
cows found to have tubercular disease of the udder has been eliminated from the London milk supply.
The number of cases of enteric fever in London attributed to the eating of oysters or other
shellfish which had been exposed to contamination by sewage led to a number of representations being
made to the Council as to the necessity for further legislation on tha subject. The Council, on our
recommendation, has urged the Local Government Board to seek such an amendment of the law as
would prohibit, under heavy penalties, the laying down of edible forms of shellfish in sewage-polluted
creeks or other dangerous localities and the sale of such shellfish for human consumption, and so that
unpolluted layings and beds may be protected from pollution.
The need of adequate enforcement throughout London of by-laws regulating houses let in
lodgings has been continuously before us. The census returns show a decrease in 1901 as compared
with 1891 in the extent to which tenemented houses are overcrowded, aud there is a growing appreciation
of the advantages to be gained by making use of the by-laws now in question. We have continued
to urge the importance of this matter upon sanitary authorities, and a further return, showing the
work done in the various metropolitan boroughs has, by our direction, been prepared by the medical
officer and published, and is now under our consideration. (Appendix III.)
While unsuccessful in its endeavour to secure legislation as regards milk the Council obtained in
its General Powers Act of last year the power to annually license common lodging-houses, together with
powers enabling the sanitary authorities to deal with ice cream. The licensing of common lodginghouses,
involving as it does the question of the suitability of each house in relation to the number,
health, safety and convenience of the occupants, has added very considerably to our labours.
In connection with the question of establishing a municipal lodging-house for women, we had
further inquiry made as to the accommodation of women and children in common lodging-houses.
The result is shown in a special report by the medical officer. (Appendix IV.)
We have devoted much consideration to the question of the adequacy of the sanitary staffs
employed in the various districts of London. A return prepared by the medical officer (Appendix VI.)
shows the number of inspectors employed in the several districts in comparison with the population.
In some cases we have thought it desirable to ascertain the needs of the district by a special inquiry
into its administration. The result of such an inquiry in Hammersmith by Dr. Young, in the early
part of 1902, is shown in his report. (Appendix V.)
We have called the attention of the London sanitary authorities to the importance of systematically
inspecting the kitchens of hotels, restaurants, and other places where food is sold or prepared
for sale, and have urged these bodies to exercise their powers for the removal of any insanitary conditions
which may be found as the result of such inspections.
G. J. Cooper,
Chair wan.
County Hall,
Spring-gardens, S.W.
17th December, 1903.