The mileage of public streets to be paved, lighted, cleansed, and watered, had multiplied two, three, and four times since 1855; the number of houses in many districts had more than doubled; the drainage work had increased proportionally; the scavenging and removing of refuse also. Nominal duties had become real ones, and new duties had been added--the disinfection of infected houses and infected clothes, the inspection of food, the working of the Food and Drugs Act--these, with numerous smaller matters, meant a very considerable amount of work, expense, and responsibility. But all these were what one of the Vestries in their Report described as "well-worn grooves of familiar routine." In addition thereto, and now more than ever of primary importance, was the great duty of inspection--inspection of houses, and of rooms in houses, and of workshops, and often the consequent proceedings for the abatement of nuisances, or the punishment of offenders. "House-to-house inspection," wrote the Medical Officer of Health for Islington in 1893, "is the only efficient remedy for extensive sanitary evils. It is the life and soul of sanitary work." House-to-house inspection of their districts was the most necessary of all sanitary work--as it was the means by which most sanitary defects and malpractices were detected--but it was the first to be sacrificed under the increased pressure of work, and the last for which adequate provision was made. "A house-to-house inspection has been attempted more than once," wrote the Medical Officer of Health for Islington in 1893, "but it has never yet been brought to a complete and satisfactory finish." In fact the main breakdown of the Vestry administration in London was their antipathy to inspection, and their refusal to appoint a sufficient number of inspectors. "The subject of overcrowding alone," wrote one Medical Officer of Health, "if properly attended to, would pretty well occupy the whole of the time of the present staff." The complaints of the Medical Officers of Health were frequent and insistent on the inadequacy of the inspectorate. Thus the Medical Officer of Health for Fulham wrote:-- "The Vestry must clearly understand that the present staff of Sanitary Inspectors is quite inadequate to properly perform the duties devolving upon the Sanitary Authority. There is only one Sanitary Inspector to every 35,000 inhabitants. Should the Vestry persist in their refusal to employ an adequate staff, the inference will be unavoidable that they are unwilling that the Acts--for the faithful administration of which, in the interests of the public health, they as Sanitary Authority are responsible--should be properly carried out." Interesting light is often to be found in the reports sometimes of the Vestries, and oftener of the Medical Officers of Health, upon various aspects of the great housing problem.